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4473 Lakeshore Ter, - ?• ?_ ? INSPECTION RECORD CITY 6F EAGAN PERMIT TYPE: f 3830 Pilot Knob Road Permit Number: " Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ' ?. i i36.1' •,II??t:{ ? t t; ?I?? f? rt:,?l #It?14i •, t ??!? + 1 F t i Akf= ':.lltihtj 5 PERMIT SUBTYPE: .,. TYPE OF WORK: KAI ,I ? ? i? ?;: ? ? i t ?. ? r? £., 1: Ft 0 !. o a i t INSPECTION D. . D. 1 l I M .I11 r1 11 'li,! KFM NF4 litlf' t F k W l; l tl 44 73 I. A K F1 F. F?R ( 1 fl i S h 14 t' f E# la - Wf M! f 1 i' 1 13 ('i ' . .' "' Permit No. Permit Holder Date Telephane # ELECTRIC PLUMBfNG kw.. HVAG , ?/7? Inspectian D Insp. Camments FOOTINGS FOUND 7196 FRAMiNG ROOFING 42 ROUGH PLUMBING G PLBG AIR TEST ? ROUGH HEA7ING GAS SVC TEST INSUL l GYP 80ARD - FIFIEPLACE FIREPLACE AIFi TEST FINAL PLBG ?? o pf <V FINAL HTG ORSA7 TEST , BLDG FINAI v BSMT R.I. • BSMT FINAL DECK FTG DFCK FINAL .' 1J .. l -? - ? - ' CfY"Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 ON REC4RD PERMIT TYPE: Permit Number: Date lssued: ttEi I I.Ii 1 M[ A: r:i?t4 fiqJ; ci/.:1r SITE ADDRESS: J. N . ' 10 t 1 785 -01.-A-0'? E n'I Y ? At i- ".Nltf?F ` • '' _ PERMIT SUBTYPE: , APPLICANT: f t. k.' ) r?yqT? TYPE OF WORK: t3 F'.; 4 P iP '1 IU N Hf'!I {.FR(1 t(?t 1 1 P1E 1 INSPECTION .A . D. ti;..,?ti t?11 I:?{ , i; t?'? •.r 1 ?I W. 1 7 C1fSl kFMA(? F(?Ilf'IE'Y 11lll1111 4411, l.AFFiHfikF'. 1"E.IrR (1(11 t.) . . 14 tl 1Ii I;1: l•Ir Nl l'.1 P! fir, , t Permit No. Permit Holder Date Telephone # ELECTRIC ''J',?I$` ' ?/ 9G ? PI.UMBING HVAC Inspection e Insp. Comments FOOTINGS 57 /? f FOUND v FRAMING l +? ROOFING ROUGH PLUMBING ` ? pl PLBG AIR TEST ROUGH HEATING GA5 SVC TEST ,p INSUL ,' ? • ?? ? UJ GYP BOARD FIREPLACE FIREPLAGE AIR TEST FINAL PLBG ? ? F1NAL H7G OEST T T ? ? rI BLDG FINAL BSMT A.I. BSMT FINAL OECK FTG DECK FINaL I L Werdlicate vf cccuvaUc4 ?t?rta?eut o? ?$x?Ii?g ???ecrion This CeNificate issued parsuant to the requirements of the Uniform Building Code certifying that ar tke time of essuance this strucmrr was in compliance with the various ordinances of tlte City regulating building construction or use. For the following: use cbs"xadon: SF DWG/GAR Bldg. Pemit No. 27394 OC-P-r iYM R-3 U-1 Zoming nisaia PD ryM const. V-N Ovmm of B,,;ld;,g HUFFMAN HOMES 1NC Ad&r.% 2214 E 117TH ST., BURNSVILLE, MN s?? Adcbm 4473 . LAKESHORE TERR Loewity L6, B2, CLIFF LAKE SHORES Doe: OH'r?al ? POST IN A CONSPICUOUS PLACE ? - ,?, ? .. ' . %ertcfCCate vf cccupanc# (Fitio of ftgan ?c?art?c?t o f erii* 3xbvtctisK This Cenificate issued pursaant to the reqairenunts of the Uniform Building Code certefying that at tlrt time of rssrrencc thrs stntcture was in complranee with the varinus ordenances of the Ciry regwlatrng building canstruction or use. For the following: u? Cbmsificabo,: SP DWG/GAR gldg. Fftnik No. 27393 O-UP-Cr TM R-3 U-1 yoming oio;« PD TYW cow. V`N Owwr of 8uiwm HOFFMAN HOMES Addmn 2214 E 117TH ST., BU&PISVILLE, !Ql Bwmbw Add,= 4475 }..AKESHORE TER L,,d4 LS, B2, CL1FF LAKE SHORES ? i <i prc. - Buddi6 Offacial POST IN A CONSPICUOUS PLACE . ? t , ?. II REOUEST FOR ELECTRICAL INSPECTION I II I II I I i?I I II Minnesota State 6oard of Electricily ? *1 2 7 6 1 Ei 4 9 * anooe (si2)Serya2 osao ?'?e ul, MN 55109 /> . ome Duplex Apt. Bldg. Other: ew Addn ortCnercial dushial Farm Remod Re air AirCond. t mp H Woter Hic Ld gmt. Other. e an e Elec. Heat Tem $ervice "X" above fhe work covered by this request Enter remarks in this space and on the 6ock oi fhe whife copy only Calculate Inspecfion Fee - This Inspection Request wJl not be acrepted withoui the mrrecf fee: Ollter Fce .it $ervim Enharroe $ae Fee S Circuils/Feeders Fee Mobile Hame Park Slall 0 to 200 Amps 0 to 100 Amps Sireet Ltg./Troffic Sig. Above 200 Amps Above 100 Amps TiansfortnedGenerator INSPECTON'SUSEONLY TOTAL Sign/Outline Lig. Xfmr. , 7 ?/J ? Alarm/Remote Confrol $Wimming Poo? I hereb cerfi 1hof I im eckd ihe elecrcical in Ila n d cribed herein on ihe dWes sfoled Irrigation Boom Ro„gh-in ?k r, Special Inspedion Inves}igotive Fee Final ?e THIS INSTALLATION MAY BE ORDERED DISCONN TED IF NOT COMP ED WITHIN 18 MONTHS. 2767184 ? OFflG ONLY Thiz requesl wid 78 momhs from volidaiion daro pnnred i?s ho' 5 ?9?v ? ? ? PLEASE PRINT OR TYPE S Li Reqoaf Dare Rough-in inspeceon reqmred Yas No Inspadmn Oiher Than Raugh.ln: 0 Ready Now ill Cnll - 4 (1'ou must mll the inspecbr wh rwdyl Da1e Reody. I, licensed conhador ? owner hereby requesf inspection of ihe a6ove eledrical work af: lob Addreu (Sheel, 8ox, or We N. ? ? Gry Lp Coda x ? ? S«iion No. Township ame or No Ranga N. F?re No CoT Occupanl Phqp ?AQT?-V\M,A Po..er Svpplier Mdrea, Q EIMn I Conhocror (Compony N e) , Conrcocror Lc n No ?j Masbr Lc Na. (Plonl Eled Only) l 0 Mailing Pddms (Canwctor O»+ar Perfom?mg Inamlian . q67 ??igna?kqctor or O+mar erfortning Insbllanan) Phone No. ? / ? ?--' r rv« - EB-OOOOAI 6/95 STATEBOAIgCOPY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY 11111 I ? I II 11II REQUEST FOR ELECTRICAL INSPECTION JS/? Minnesota State Board ot Elec[riciry 8 1* Pn2w,e ?siz?s z-oaoo Ss-i???? aul, MN 59104 11 * U 2 7 6 U181 I'lome Duplex Apf. Bldg. Other: New Addn Commercial Industrial Farm lilRemod i Re air Air Cond. Htg. Eqmp. Water Htr. Load Mgmt. Other. D er Ran e Elec. Hea} Tem .$ervice "X" above fhe work mvered 6y thu request. Enter remarks m this spoce and on the back of 1he whife copy only. Caltulate Inspecfion Fee - This Inspedion Requesf wdl not 6e o«epfed wiffiouf fhe coaecf fee: Olher Fee # $ervice Enhonce Size Fee # Circui6/Feeders Fee Mobile Home Park Stall 0 fo 200 Amps 0 to 700 Amps Sireet Lig./Tmf$c Sig. Above 200 Amps A6ove 100 Amps Transformer/Generator INSPECTOP'SUSEONLY TOTAL C? $ign/Outline Lfg. Ximr. , W Alarm/Remote Conirol ?? Swimming Pool i ha.,b oem thot i?r: i de?m r o? Be.criba min on the dare::mted Irriga}ion Boom koogh-In Da Speciol Inspedion Investigatrve Fee Finol 0 1 ? THIS INSTALLATION MAY BE ORDERED DISCO D I WIIHIN 18 MONT S. 2 1 6-18 3?l > ' OFFI E?E NLY This requesrvoid 78 months fmm .alldmion dab pnnre ??? PLEASE PRINT OR TYPE Request Dole Rough-in inspechon requ Ves ? No Inspecnon Olher Thon Rough-In, [] Ready Naw JI Co0 _$' (Yau must mll the mspecbrwhe rmdy) Dale Rmdy I, licensed controdor ? owner hereby requesf inspedion o( the above eledrical work af: Job ?ress (Slrcet, Bo., or Routa No ) =J Crry Zip Cada Senion No. Township Name ar No% Range No. Fim No. Coenp Occupant Phone N. PowxrSuppli / ^? bN+"• nndre:: ? Eleddml oMmnw (Compony Nome Comra r Lice?e No Marnr 4< No. (Plant Eletl. Only) e ?o q Mailing Adnss (Comraeor er Pedorming Insmllana L16 L7 d Aufho Siypd gnawre (Conhoclor or Owner PeAorming insmllv_ M1on' alau- rx;?.. ?ra Phone No _ ? E9OOOD1 -10 6/95 STATEBO?COPY•SEEINSTRUCTIONSONBACKOFYELLOV/COPY Addl(0ss 4475 LAKESHORE TER Zip 5512? I?t 5 Blk 2 Sub U1FF LAKE SHORES THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: '7 10(o Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) vll? Permanent steps (main entry) ? Permanent driveway V Permanent gas v Sod/Seeded grass ? TraiUcurb damage V/ Porch Basement finish ? Deck VI/ Please verify with the builder the removal of roof [est caps from the plumbing system and the shuboff of water supply to the outside lawn faucet before freeze potential exists. Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy 0 Ad{lteso 4473 LAKESHORE TERRACE L.ot b Blk Sub CLIFF LAKE SHORES Zip 5512_ THESE ITEMS WERE / WERE NOT COMPLLTE AT THE TIME OF THE FINAL INSPEGTION. Date: 015 <j(Q Yes No Inspector: Final grade (6" ftom siding) Permanent steps (gazage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass TraiUcurb damage ? Porch ? Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to the outside lawn faucet before freeze potential exis4s. ContaM engineering division at 6814645 before working in rightof-way or installing underground sprinkler syscem. White - City Copy Yellow - Resident Copy Pink - Contracwr Copy & ? n 2006 RESIDENTIAL BUILDING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan NIlV 55122 Telephone 9 651-675-5675 FAX 4 651-675-5694 ' New Construction Reawrements 3 regis[ered srte surveys showmg sq. R of lot, sq. R. of house; and all roofed areas (20%maximum lot wverage allowed) 2 copies of plan shmvmg beam 8window sizes; poured found desyn, etc i set of Eneny Calculahans 3 wpies of Tree Preservation Pian if lot plalted aRer 771/93 Rim Jorst Oetail Ophons sHechon sheet (6mldingsmih 3 ar less umts) Minnegasco mechanical ventilatton foim Date lV / 04? / 0CJ Site Address Description of Work { Y / _ N Multi-Family Bldg -?/ Property Owner Covtractor Address 5tate ` RemadeVReoair Reawrements 2 copies of plan showing footings, beams, joists 1 set of Energy CalcLla6ons for heated additlons 1 site surrey for addiGonS & deck5 Adtlitiai - indicate iFon-site septlc sysfem Construction Cost ? 55 Fireplace(s) _ 0 _ 1 _ 2 8& 8/,)-. 2y9. ?2'6- Office Use Onlv Cert afSurveyRecd _Y _N iree Pres Plan Recd _ Y_ N Tree Ptes Required _ Y_ N On-site Sep6c System _ Y_ N #(9?! L3 ? y?li?J City •.:r / l U?/(?C l?/Ls?olC? ? n Telepnoner(??(??? ? j J Ct3MPLETE TH1S AREA ONLY 1F CONSTRUCT7NG A NE'N Bl31LDING - Minnesota Rutes 7670 Cateeorv I Minnesota Rufes 7672 Enefgy Code Category . Residential Verrtilation Category 1 Worksheet • New Energy Code Worksheet (d su6missian rype) 5ubmitted Submittetl • Energy Emrelope Calculadans Submitted In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a masTer pian? _ Y _ N If yes, date and address of master plan: Licensed Ptumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, 6ut only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in th case of work which requires a eeview and approval ofplans. pt? ? Applican'sPrintedName Applicant' Sign'pture Telephone # ( ,_ ,?, • LOT SURVEY CHECKLIST FOR RESlDENTIAL ' BUILDING PERMIT APPLICATION ? PROPERTY LEGAL: ? ? DATE OF SURVEY. > LATEST REVISION: ? t; DOCUMENTSTANDARDS 6 ?? ? • Registered Land Surveyor signature and company 00? ? O • Building Pertnft Applicant Q-? 0 0 • Legaldescriptlon 0-?Cl ? • Address Ze-?C] ? • North arrowand scale C;-?'o ? • House type (rambler, walkaut, split w/o, splR entry, lookout, etc.) a-'cl 0 • Directlonal drainage arrows wifh siope/gradient % Er'O ? • Proposed/exdsting sewer and water services & irnert elevation Er- ? ? • Street name Z-?o ? • Driveway ELEVATIONS Fxistlna Tr'? ? • Sewer service (or Proposed) a' ? ? • Praperty comers 2-?0 13 • Top of curb at the driveway Q? ? D • E3evatians of arry existlng adjacent homes Prooosed B'O ? • Garage floor Q? ? ? • Frst floor 1;i- ? ? • Lowest exposed elevation (walkout/window) [!r ? ? • Property comers C?-- ? ? • Front and rear of home at the foundation PONDING AREA fif aoolicable) ? IT-'o • Easement line ? m'o • NWL ? Ef'13 • HWL ? ff-,? • Pond # designation ? ? ? • Emergency Overflow Elevation DIMENSIONS ? 0 ? • Ii B i nes Lot earings & dimens ons ? 0 O • Right-of-way and street width (to back of curb) .ff, ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (.e. all structures requiring permanent footings) ?? ? • Show all easemenis of record and any City utiifies within those easemenls z'cl ? • Setbacks of praposed structure and sideyard setback of adjaceM exissting structures ? ? • Retaining wall requirements, i ,ayy o Reviewed: Janwry 1996 CRAM3190C9LOGPRMT.FM I CITY OF EAGAN 3830 Pilot Knob Road (612) 681-4675 PERMIT Eagan, Minnesota 55122-1897 PERMIT TYPE: Permit Number: Date Issued: d"557'45 BUILDING 027394 04/29/96 SITE ADDRESS: P.I.N.: 10-17785-060-02 DESCRIPTION: 4473 LAKESHpRE TER LpT: 6 BLOCKs 2 CLIFF LAKE SHORES (ZERO LOT LTNE) ermit Type SF DWG c?k 7ype NEW ?_ ? jt?s R-3 U-1 yY.u ?, e V - N PD .,$ 9 B 66 >' urz 102 1 - FAM. ATTACH ??a ?p @effa!?? ,-e"9 a ai r,?,i ?;' "u <iaH? ? gi ? ere ? s s w+ r? '?tPCU ? T"enw k ? REMARKS: DUPLEX WT7N 4475 LAKESHQRE TERR (LtlT 5) S& W PLBR - WENZEL PLBG FEE SUMMARY: VALUA7IpN Base Fee Plan Review 5urcharge SNC SAC % SAC Units Subtotal $1,067.25 $533.63 $68.00 $900.00 100 $2.568.88 $136,000 MISCELLANEOU5 $1.923.50 ' Total Fee $4,492.38 CONTRACTOR: - ppplicant - sT. GxC.OWNER: HOFFMAN HOMES SNC 18949867 0009284 HOFFMAN HOMES INC 2214 E 117TH ST 2214 E 117TH ST 6URNSVILLE MN 55337 BURNSVII.LE MN 55337 (612) 894-9807 (612)894-9807 Z"bei°v by ?'o c k'n in'fcrrrttaCisSnt,3 ed?e th?i: ? re4dth??;'_appl3rea?toii a.nd ?ta.G? ?h??,`?he ;== ka i?e•re.?Se`?t^?a?d camph.a1 I aRfdM . ? k ? p ? . + q -- r...._.., a. . . , ? _ ...,:.i_....,x . _ 3 .. . ? . i " _ _ _. : ... ............ .. : SI A RE I U Y? SI RE CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL) n? ( i1394 687-4675 C(?.??CP?it? it? New ConsUUdion Reauirements Remodel/Reoair Reauirements ? 3 regislered sNa surveys ? 2 copies of plan ? 2 copies of plana (induda beam 8 window sizes; poured ind. design; etc ) ? 2 sile surveys (exterior additions 8 decks) ? 1 energy calculatione ? 7 energy oalculations for heated addilions ? 3 eopies of tree preservation plan it lot platlad aRer 7l1/93 required: _ Yes A No DATE: 7-?; CONSTRUCTION COST: L° ? ° -0a lk---C`' t t_ DESCRIPTION OF WORK: STREET ADDRESS: `4`I l-3 LA1C? SM?Y?E 'rE¢_¢.{,GE LOT (- BIOCK y SUBD./P.I.D. #: lo - l41$ 5- 6clf,LL5e w/ Lor - S Lfus' S",?s PROPERTY owNeR CONTRACTOR ARCHITECT! ENGINEER Name: +IoFiTMaa kosties 'z-*K• Phone #: $lk -`l$°l U81 fiN6l Street Address: City: e)?'-?'y? State: w,-+ ZiP; 5533} Company: SAAc Street Address: City: State: Company: M: uuc??ar.n l?es?v,.? Phane #: License #: 4 Zg ,+ Zip: Phone #: g3`t' -"'kp Name: LIL-I:- T4?•N Registration #: Street Address 5.,4 ra '#'zt p CItY: C NpJ NA`?aE.J State: M.s Zip: 5535} Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowiedge that I have read this application and state that applicabie State of Minnesota Statutes and Ciry of Eagan Ordinances. OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Signature of Applicant: _ Yes No _ Yes _ No the,iafe a fon i c rrect and agree to comply with all ? APR 2 3 s9s6 BUILDING PERMIT TYPE OFFICE USE ONLY ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 6p?? 02 SF Dwelling ? 07 4-plex ? 12 Muiti Repair/Rem. ? ? 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 0 04 5F Porch ? 09 12-plex ? 14 Fireplace 0 ? 05 SF Misa ? 15 -.Deck WORK TYP(___???? -? o r' ? G r e?C C ? ? 31 New ? 33 A tef ?ations ? 36 Move 0 32 Addition o 34 Ftepair ? 37 Demolition GENERAL INFORMATION Const. (Actual) ;L-1-V Basement sq ft. (Allowable) 4r_- /y Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories / LQs?r 59 ft Length ? sq. ft. Depth Footprint sq . ft. APPROVALS Planning Building r ? ;? "' w ..? • u> ., 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous / (6 MC/WS System /, 7417 City Water ? Fire Sprinklered PRV Booster Pump Census Code. o Z SAC Code a i Census Bldg Census Unit ? Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License _ 2 MCNVS SAC ?G City SAC Water Conn. l b' Water Meter ?j Acct. Deposit 5/W Permit S/W Surcharge Treatment PL Road Unit 9/?G Park Ded. ? Trails Ded. Other Copies Total: % SAC SAC Units ,. ?i °?,t ? ? • . ? J . ?- . GMH_a .? , ? ? ? ? ? ? ? • . ? . VAL -END SERVICE ta' 8GATE ? /vt ? rROM 9LDG. (TYP.) i ?r d ? ? ? / / ? ?• , H YD ? MN-12 ? '? ;'? ' •? " 8'-6 " D.I.P. i?rc-920.30/ aa?.a /3"x 8" TEE i GROUND EL=9 ?. ?FF=920.30?/ ., i ? ? .30; 9o..e FF=91 7 . , - F7--?92?4.90r' 911 O i' 10 _°- ?,FF=922.20/ 2-A ,? BENC ` .FF=92220;' 9oe+ ^ ? ? Fr=91 ?.9 17 (so7.o ? ? ? . , t , , A? a• ? `1 ". ? f 3 " Y ? ? ' i r , Z i ? ?.. FURi-0 ;?:.:J ;.?,'„''D - MH-71 G IT ??o?'._;1 ?? ???,=',."-, ao7•`? ? ? _?... SlTE ? ?. . ??--?; ?r • LAKESHORE TERRACE ????-? t lDi'1,?4 iWt 9i1 ? -Ui1.8 j ? i i , .. I j 1111'--8" DI WATEk MAI ? I 7.5' MIN. C_ VER j i - PAY D ?P fl-I j M H 17 - ... r ? ??. bu ? Rt =9?3 57 ? 5 2 . 49 oI I i . ? _. I f I i j . _ I ? F elu . " ? - - - _ . . - UTILI- - --- 'Y LOCr-C) I -- '^3 -- ? - I ? , .. T ti EV OF ??J. THIS ??{?. ? r D.-eT,? i.? r, ?;? ? 1 y ,?t % ? , .? kf?a ?? FURPQuu ?„I :e . ? o ? IT ' MN-11 -5 - `- S7A. 26-f00 RE = 914.7 IE N. = 902 60 ? ? I ? - IE E. - 902, 50 ? ? c • ? , . . . ?N? HOFFMAN HOMES, INC. 2214 East 117th Street Telephone Burnsvrlle, MN 55337 (612) 894-9807 pax CONTRACTOR # 9284 (612) 894-9878 Mr. Joe Voels City of Esgan Plan Review Department Dear Mr. Voels, This letter is to inform you that Hoffman Homes, Inc. will be using the exact same plans for the layout for Lot(s) sA 4, Block Cliff Lake Shores, as were used on Lot(s) '*", Block z_ Cliff Lake Shores. None of the structura] building component/s, ?HVAC, plumbing or electrical wilf change from engineered drawings dated lPll ?'IQ> Sincerely, ? ? Patrick C. Hoffman President PCH/jem pch/eagla , CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: OZo657a5 BUILDING 027393 04/29/96 SITE ADDRESS: P.I.N.: 10-17785-050-62 4475 LAKESHORE TER LOTs 5 6LOCKs 2 CLIFF LAKE 5HORES DESCRIPTION: (ZERO LO7 LINE) ermit Type SF pWG "k Type NEW ,? R-3 U-1 tsXf='-T'y?`??e V-N PD 38 8ra?,;ld?A?f9 d?h? 66 A102 1 - FAM. ATTACH ?n 'AT _0 k ° }5r`M";? ?t 0'?4'S' „$?i3? ?+'?m"+s(Z r ?:?I •!?'?' .?xi?? ria?x zm??;?' ?E ????'m??? ?ti ??? ?'??sd"a m ??E €%= REMARKS: DUPLEX WTTH 4473 LAKESHORE 7ERR (LQT 6) S& W PLBR - WENZEL PLBG FEE SUMMARY: VALUA7TON Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal $1,067.25 $533.63 $68.00 $900.00 190 1 $2.568.88 $136,000 MTSCELLANEOUS $1.923.50 Total Fee T $4,492.38 CONTRACTOR: _ ppplicant - sT. I.IC.OWNER: HOFFMAN HOMES INC 18949807 0009284 HOFFMAN HOMES INC 2214 E 117TH ST 2214 E 117TM 5T BURNSVILLE MN 55397 BURNSVTLLE MN 55337 (612) 894-9807 (612)894-9807 x I her?Gy a?I?naw????e a?sPb?.ca??t?n ?tud gts?ed ?l?d?,?th? . o?.?? ?i? t?ppiicab ?_._.. . ..., e?n3 ahv _f .n .?........_ ......a a_. ..,....... L...e.. _ v . .... .,...a..i..... a w . '? ? APPLICANT/PEflMITEE SI NATURE ISSUED 8: SIGNAy E _. '- ?• CITY OF EAGAN Z 3q 3830 PILOT KNOB RD - 55122 r 14ms 1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL) 681-4675 New Construdion Ranuirements RemodeVReoair ReaviremeMs ? 3 registered site surveys ? 2 copies ot plan ? 2 copies ot plans (Include beam 6 window sizes; Doured fnd. design; etc.) ? 2 site surveys (exlerior additions 8 decks) ? 7 energy calculatlons ? 1 energy calculations for heated addifions ? 3 copies of tree preservalion plan i( lol platted afler 711199 requhed: _ Yes X No )'- DATE: CONSTRUCTION COST: j LZ,Q?? . ? DESCRIPTION OF WORK: STREETADDRESS: 5* LA«ES+ha? `7bR.2r+.cE LOT 5 BLOCK SUBD./P.I.D. #: DL?GEX WZ ?T-?o G?-1FF LAKfs SN?LExS PROPERTY OWNER CONTRACTOR Name: 44orgmn.a koKqs ?'Z*?• - Phone #: .r rixsr Street Address: City: State: ml's Zip: 5533't Company: SArAe Street Address: City: Phone #: License #: q2-91 Zip: State: ARCHITECTf Company: N; .,,4e-io,aY.h 17e5?G?! ENGINEER Phone #: 93`t- -Vl`ip Name: L`IL-L- -I`t-jj^,3 Registration #* Street Address: $O ?'?'• ?'? j?+ S??T 5..? rE -1,1zt o Clty: C H,dJ t-tA56E..1 Sewer & water licensed plumber: change are requested once permit is issued. State: N,J Zip:S531-1" Penalry applies when address change and lot I hereby acknowtedge that I have read this application and state that the informati n is,e rrect and agree to comply with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. ? Signature of Applicant: m'---? OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ,p( 02 SF Dwelling 0 03 SF Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE ? ,d- 31 New ? 32 Addition 0 06 Duplex ? 11 Apt./Lodging 0 ? 07 4-plex ? 12 Multi Repair/Rem. o ? OS 8-plex ? 13 Garage/Accessory ? a 69 12-plex o 14 Fireplace 0 ? 10 -plex o 15 _ Deck ???_- G?r ???•?? ? 33 Alterations ? 36 Move ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actuai) (Allowable) UBC Occupancy Zoning # of 5tories Length Depth APPROVALS Pianning ,17-1y Basement sq ft. N Main level sq ft. / sq. ft. ?- ? sq. ft. 3,?7 sq ft. 3Y sq. ft. Footprint sq. ft Building Permit Fee Surcharge Plan Review License MCNVS SAC ciry sAc Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment PI. Road Unit Park Oed. Trails Ded. Other Copies ToWi: % 5AC SAC Units ..? ... rv? .. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System ? 7'Z City Water Fire Sprinkiered PRV Booster Pump Census Code. ?D Z SAC Code Census Bldg i Census Unit _ Engineering Variance .ao- valuation: $ i a0o ? (6111 ,2 0 ?G 5' 61293443?75 hiII?iPJETDNKp UESIGIJ PAGE 07 EKTERIOR E?3VELOPE AVERAGC "ll" COMPUTA7ION /R: .. __? nnrr: SI7E ADDRESS: PHONE: CON7RACTOR: ?oFI'n1A ? UY\?S PIAN # Determine working square faotage of each 1. Tatal exposed wall area..... M 1 I ` sq. ft, x.11 -?? 'Qz- 2. Tota1 roof/ceiling area...... ?(? z?Y sq, ft. x .026 = 4'2,71 Total exposed wall area above.floor=\ ?l2- a.' Total wall window area ........................................... 6.' Total door area...... . .................... . . ..................... C. Total slidinq glass door area .................................... ??fl d, Total fireptace wall area ........................................ e. Totdl wdll framing area (average lOp) ............................ _ _, f. Total rim joist area............................................. ? g. net wall area above floor ..................................... h. wa11 area a6ove floor ..................................... i. 7 ? wa11 area a6ove floor ..................................... j. frame wall area ALt foundation ................................... Total eXposed founddtion area= 'F;2?-Ts < k. Total foundation window area ' .......... ? 1. Total net foundation area ahove grade .............. Oetermtne "u" value of each wall segment (e.g. window, door, each separate wall section) a. 127,3 x b. X c. x d. „u„ COZ. ,. u„ .`45 = 1(Dg°I ..U„ 4D x Oull e. ? 5`I\Qt\ X --U".n f. 15 x ,.U„ ,p x plul. t h. X "U" > i. X uUll - x „u„ _ k, X "U" ,dl(P = s ?? If item i3 is the sa as, or less than ite #1, you have met the Sntent of SBC 6006 ( 3 . .................................Total = =z.qS 995 10:13 6129344305 h1INNETONI<A DESIuN PAGE 08 ??. rorAL 4xrasea Racx/ce i LMa cALcuuria,s: • ' Totsioxpossd , roaf/e.Jllnq area........ (p2 iq /t J) Total fkyllyht aras....... ' sq ft x"U" ? k) Totat roof/celling PrwFng ' area (AvaraOn )AkI...... ` 2? sq tt x•"U??Z? • . 3? 1): Total nee lnsutated • ?? : roof/cellinq sq ft x"U" ??Z .. 2?1,2(,() .• ?'. . 7ora?. J?nru t) 33,iC.p 1f total oF A 1s the same as, er lnss than you hava ertet the tntent of • Z:fCAit 1.16008 A erd 0. • •, , ? • . . . : . .• . • , ALTERMIITE BUIiDEHC 6HVELOpE AESlGk . • To utilixa tha totsl envatope systaa rethod, -the valuhs esta6]•ished 6y thp sum 3 of lxems I?3 and #4 shatl nat 6n graater than tha suoo'cf ttas 11 sed !z, . .: " :. . ?' - + 2. . ' • 4. ?. r .. . _' ... a- . . . • . . ' . . ` 10:13 6129344305 BLOCK: lQs,r:> KNEE: WALKOUT: 3?-3 FuLG i : \ (p-7,`S FUL(, 2; FIREpLACE: RIM: ?(,p1, iS BLOCK: ; KNEE: WALKOUTt F'ULL 1; FULL 2: FIREPLACE: RzM: MINNETONKA DESIGN * LINEAL PEET EXPpSED WAGL * SQQARE FSET F.7CPOSED WAC.L AgEA x x 5 a x8a3?. x 8 x 8 - x Q SQUARE FEET ERPOS ED CEILItVG wixflows: 12-I 2(pKv ?-H-r' fl ?q ,s? 2Cv3Co I ??kz Zosc? I 11} ? q2? 305o I 1???? 2?.v40 l 1 1 ? ?g ? IZ?,3 DOORS : PATIO AODRS: 1?atz BASEMENT UNITS: SKYLIGHTS: PAGE 09 Telephone (612) 894-9807 Fax (612) 894-9878 Mr. Joe Voels City of Eagan Plan Review Department Dear W. Voe(s, HOFFMAN HOMES, INC. 2214 East 117th Street 6urnsville, MN 55337 CONTRACTOR # 9284 This letter is to inform you that Hoffman Homes, Inc. will be using the exact same plans for the layout for Lot(s) 5ek 4, Block ')' , Cliff Lake 5hores, as were used on Lot(s) 14 ", Block y, Cliff Lake Shores. None of the structural building components, HVAC, plumbing or electrical will change from engineered drawings dated LPtI L/9e- Sincerety, Patrick C. Hoffman ? President PCH/jem peNeagltr CITY USE ONLY a6a, L CP BL ? RECEIPT #: s O SUBD. DATE• ? ?711fel 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? singie famiy dwellings ? ? townhomes and condos when permfts are required for each unit New construction Add-on fumace A`Id_hn air ?n-djt,[nniRg Add-en air exchangsr, i.s. !/anee system: stc. Date: f4 0 ? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTtJ 24.00 Additional 50 M BTU 6.00 Gas Outlets (minimum of 1 required @$3.00 each) 1. ? State Surcharge .50 TOTAL ?` SITE ADDR OWNER NA INSTALLER STREET AC CITY: ?//'//,?5? STATE:?i PHONE #: PHONE #: 24-1§41 ZI P: Syo _ CITY USE ONLY L _ BL _ RECEIPT #: SUBD. DATE: -k. 1996 MECHANICAL.PERMIT(COMMERCIAL) • rCITY OF- EAGAN 3830 PILOfi FCNOB RD % EAGAN, MN`55122 ?;- (612)'681-4675 `,'i Please complete for.?? all'commerciaUndustrial;ibuildings. ?? multi-family buildings winen separat? permits are ?t required ? for ?each dwelling unit. ?1' '? ; y rJA?F: i CnNT,R'ACT PR!rt- G i WORK;PE:7 _ N.E/1N CONSTRUCTION /INTERIOR IMPROVEMENT . „ , DESCRIPTION OK'WORK: FEES: ?$25.00 min ? um fee 4t 1% of conhact price, whichever is greater. ? Processed pi 'ng - $25.00 ? SSate-surcharg of $.50 per $1,000 of pgn3jt tee due on all permits. CONTRACT PRICE x 1°l0 PROCESSED PIPING STATE SURC'HARGE ; TOTAL SITE ADDRESS: ?7 ?7 ' ? ? '??% '" .°,ryA ' OWNER NAME:,; _,? ?? %//,?''?TEL•'??P O #: TENANT"Ei IMPRON?MENT$,ONL Ii: ? 7..: b ' ' iN8TALLER: ' ?,fi? ADDRESS: CITY: ZIP?Q / ? PHONE #: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR yL r BL ?- CITY USE ONLY RECEIPT #: °???;?l SUBD. (? ?- w7te? DATE: 4 ?-71f? 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: • single family dwellings z ? townhomes and condos when permits are required for each unit New construction Add-on fumace Add-on aEr conditioning Add-3n airaxchanger, a.e.Vanse p,steT, etc. Date: 6vq'I4 FFFR ? Minimum Fee: Add-oNRemodei (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 4.0 Additional 50 M BTU 6.00 .w- ? Gas Outlets (minimum of 1 required @ $3.00 each) 1 ? State Surcharge .50 TOTAL ? SITE OWNER INSTALLER PHONE #: 0?14 STREET ADDRESS: f(Poel ?- ri r r.?rcz? i I yc. CITY: )//A S STATEAV,_ ZIP: o PHONE #: ? L SUBD. 7996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3$30 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? singie family dwellings RECEIPT #: DATE: ?O?fP 9 ? townhomes and condos when permits are required for each unit EIXTURES FACH N.O. TOTAL Shower 3.00 x 2 = 6.VV Water Goset 3.00 x Bath Tub 3.00 x _L = 3,erv Lavatory 3.00 x •t.CV Kitchen Sink 3.00 ;c Laundry Tray 3.00 :< Hot Tub/Spa 3.00 ;c Water Heater 3.00 :c 3. &0 Floor Drain 3.00 x '3. vo Gas Piping Outlet * minimum - t 3.00 :c Rough Openings 1.50 :< _ Water Softener 5.00 r Private D'ISpoSal ' Dakota Cty. lieense 65.00 = (new and refurbished systems) U.G. Spflnkler " home under const. 3.00 = Alterations ' to exdsvng 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL 69• S-C' SITE ADDRESS: 447?5- Lq/CEsNeyer- Er?? OWNER INSTALLER NAME: k/GW'z-&z° Nc-r-NAu?cA<, STREET ADDRESS:- 1959 5N4WN45Z?- Rv CITY: Ene --4AJ STATE: I??? ZIP: 5?17 2 7- PHONE #: ( 6IZ) 45-24SbS tSFPETZ10fiTTE CITY USE ONLY BL ? LIt BL ? CITY USE ONLY RECEIPT SUBD. DATE: 7?°2 9 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 551::2 (612) 681-4675 Please complete for: ? single famity dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH N-Q. TOTAL 5hower 100 x s = 91 ? Water Closet 3.00 x _s Ba4h Tuu 3.00 ic = lavatory 3.00 x Kftchen Sink 100 ;c 3,0V laundry Tray 3.00 :c 3,CV Hot Tub/Spa 3.00 :c 15, ? Water Heater 3.00 ;c _L = 3vev Floor Drain 3.00 :< 3.&v Gas Piping Outlet ` minimum -1 3.00 :c _? = 9•? Rough Openings 1.50 ;c = Water Softener 5.00 x f = S•? Private Disposal ' Dakota Cty. ticense 85.00 = (new and refurbished systems) U.G. Sprinkler * home under const. 3.00 = Alterations ` to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL 3q, 5D SITE ADDRESS: OWNER NAME: INSTALLER NAME: ?- STREET ADDRESS: Pe-D CITY: ?A&A/tJ STATE: MAJ ZIP: PHONE #: ( 612 ) F)IA, A / 76,Z27 2005 RESIDENTTAL BUII.DING PERNIIT APPLICATION City Of Eagan 3830 Pilat Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodellReoair ReouiremenYs Otfice Use Onlv 3 registe2d sile surveys showing sq. fl. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Survey Reotl _ Y_ N (20% maximum lat coverege allowed) 1 set of Energy Calculations for heated additians Tree Pres Pian Recd - _ Y_ N, 2 copies of plan sfwwing beam 8 windax sizes; paured found desgn, etc. 7 si[e survey for addffions & decks Tree Pres Required%:, ? _ Y_ N lselofEnergyCalculations Ad0iUon-indiceteifon-sifesepNcsystem OnsiteSeptiaSystein' _Y _N 3 copies of Tree Preservation Plan d lot plafled afler 717193 Rim Jolst Defail Opfions selecfion sheet (buildings with 3 or less unifs) DateAl-/?/? SiteAddress Coostruction Cost I-1 S' Sy\pre _V"L? 0d ? Unit/Ste # Description of Work ? p? CA - 6?vt f, \ b Multi-Family Bldg ? Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owoer ?" 5I Telephooe #(C(% 76_7' 6 l Sj Contractor 6.npr'(5,,,? ?U A,.nL„ LPAVfclG?-W S 1, 8C Address \`? c-,AT ' State ?.?.\ , J o\\P? ??_? Zip City Telephone #(?( a) 707 -(9?. COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submittad • Energy Envelope Galculations Suhmitted Have you previously constructed a buiiding in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #[ Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. C1Q?,\ C vfrkh Applicant's Printed Name & Lur\ Applic t's Signature I,a3? 4 City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ------------------ ? I j Permittt:__ ??J ? ? Permit Fee: ? Date Received: j I ? I Staff: I I -----------------? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ,c?, O Site Address: 4,475 ? ? 414-11S " ""'a'" 5?JM «V4C6 Tenant: Suite #: RESIDENTIOWNER Name:CISQ LCa-(,l SYUx'QC yv?A.?V1!'1pYVLQ.s Phone: Address / City / Zip: ?? CAl Fk L4l42, r.l-. ? r?lSUt Applicant is: _ Owner _?L Contractor TYPE OF WORK Description of work: ?QaY 1X?c' Y"F.?131yt' ? w I YIGId? ? c51?( (1G? 5 Construction Cost: `P -7 o,,cf' OD ? Multi-Family Building: (Yes K_ / No ? CONTRACTOR Nameh1r(VA'l_ CItiY'1 ejgAfA _TV1C? License#: ?? (PbOC5 Address: oLq(Po \3(.L0<«Ci.k W- -`Y (oD Ciry:y5l?IA( Lo- State:?}N Zip: 90-?>3 Phone:"(?a -1 un , bq! l Contact Person: ItJl04' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheel Category Submitted Submitled Submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _NO It yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: top5e:pub6c m°?n.`rmafton .YPortionso`f -, are) eonsideied' NOTE: Pfaris and supPoPting ?7o 'cuinenl`s'thaf:you sutimit ? , , tbe infor'mation may>b,e class1fr'ed as non public7ftyausprovide.specrfrc ieasons that wou/d p`ermitiBe City fo ,... r r:.?m-.?...x::.._. . 41 I hereby acknowledge that ihis information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permil, and work is not to start without a perrnit; that the work will be in accordance with the approved plan in Ihe case of work which requires a review and approval oi plans. X'?G.UIG Sc,{?t?lc e{"Q t? x ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 . . . ? . CER TIFICA TE ------??-----?-- I ,o. _a _ I ? ? Too of lrons 9 Offsets ? AO 10.00' Building Offset 916.48 -' I OB 10.00' Building Offset 915.25 OC 10.00' Building Offset 91325 I ? I O 10.00' Building Offset 919.26 ? Q ? ( w I ExISTiNG CURB --------._.???---_- ----?AND GU77ER ? I ? ? (920.1) S88040 1 = 979 55 I ? ? w 9t8.14 I 2 < ? ? J 6 908.7 g?g ? ?3.00 ?700 ----- - - - - - - - - - E- 4.58% 0 o I 5 (979.44TC) I 919.12 O o- lo_oo 1.00 I ? 1 qW I I (918.48 TC) N ? g G ? V 918.27 - I 7.689 1 ? 7200 I 7pp J Z 9? ----- ?? 6, s. e I ? N ? I 907.3 ? N ----- ----.3o'e a==- I ?/ 918.17 ? (918-3) 918.23 ? ? - - I ? ?'----- ? OF SURVEY I ? , 1 i r r ? ? ? i , , .W ? ?r i EAGAi'd ? No rE: (916.1) ?? l) PORCH AND DECK ARE OPrIONAL $ 916.54 ? 2) D/MENSlONS DO NOT REFLECT BR/CK FACING a X (920.0) -4 O\ / 1 7R nn g! ?` Lii ? ? U < V ? ? LLJ ? NBS°40'S6"W 78.00 LL) 0 ? LLI Q J 1 78.00 g z (918.3) Y 2 00 o ? 0 $ CL a ? O O n ?} rn vo.oo O8 ? `O rn O C? 09 J 97S0 0 q I ? i I-? 1.00 8i 3 a O '?o io• (916.0) i`Oo 914.66 i y ^ I DEP'i'. REOUESTED BY. Top of 8lock = 920.68 Lowesf Floor = 912.53 Goroge F/oor = 920.30 GRAPHIC SCALE Zo w ( IN FEET ) I inch = 20 ft. 930.0 Denotes Sanrfary Sewer Service 1nver2 865.0 denotes existing e/ev. (865.0) denotes propased e/ev. - denofes surface droinage • Dertates iron monumenf found o Denotes iron monument set Bearings based on ossumed dotum. ! hereby certily that this survey wos prepared by me or under my direct supervision and thof l am a7de'/y RVistered Lon# orveyor under fhe tows of.the ?tote of Mi t I : Aforfin J. Weber. .L w Date l-l Registrotion HOFFMAN DEVEL OPMENT LEGAL DESCR/PAON: Lot 5 and Lot 6, Block 2, CLIFF .? LAKf SHORES, according to the plat ? - - thereof, Dokota County, Minnesota R E 2A;7E_ -?Z? ? ? AA . Westwood Professiona! Services, !nc 14180 West 7runk Hwy. 5 Eden Prairie, MN 55344 (612) 937-5150 Drawrt by MS I Dote: 4112196 I Job No: 95198 Lots 5-6, Block 2 Use BLUE or BLACK Ink r----^---^-------� I For Office Use � • I � �� C�� 0� jl� �� j Permit#: � � � � � Permit Fee: � �� 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL BUILDING P RMIT APPLICATION � � 1Z J��S'� �l��l 3 �eJl��, vv✓e,�, �� M� �,/ �,y Date: Site Address: Unit#: �� mName:...n,�jl Y`�.� �,_^_N,��,..�,,,�,j�`�i/�__��._�,� _�a��.,ti�. ��..,_.�.,,Phone�...��d,...�.�_..��.,��..�.� I G � Resiti�:�tf � ��.�v�.� � � �}�y.�$r � Address/City/Zip: � , " � . � Applicant is: Owner Contractor �_ �.�.�....�..��,�..�,�„��,�._�,,.,.,�a„�.�.�...��.�.�.w.�..�.��.��..�-��..�.��.x_�,.�_..�,��...,M..�.....�..�.�.u�,.��-- -.�.,.�...� T�1`pe af 11�n1"1c � Description of work: W�Vz� Z' � Construction Cost: � �� Multi-Family Buiiding: (Yes /No_� �� Company:�'Gt/►t� �{�lb� (��G�1 �d�c. Contact: /-�"�� t r�� -�" � � � � f u�,_ � � � � � COtl�t'aCtO�' � Address: �S�'b �'G�J btM�� /J � SuJ � �s/ City: ! � ` � State:�Zip: �5��'� Phone: 71�3-S.S��.vr�� 1 � 4 ��e�'c�vl.� Email: �av� .I r9�n.c� � License# �c �0� 7�.3 Lead Certificate# �..�,_,e,.M�,�..=m�a..�,.��....�m�,,,.�.. �,�...K._»��.,..�.,�,�..�.�..HM,,,�....,�.�,.�..N.�.�.��,� �m�,�.�.��...:,��..�..u,..r�.,,��.��.��.�.� If the project is exempt from lead certification, please explain why: , ...�...,��.��a.��w_ ...��,.�� ,��n,.��,�m.m..��,..�,.�,.,�,w�,�.. �,�.�.M..�.�.�. .�....,�..�. ,d.,...�...� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING � r In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? � � � � Yes No If yes, date and address of master plan: � �� Licensed Plumber: Phone: � Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: � ufN�DT�':��ns a�d su�ort��g�docu��:r��ts t�a#,�a��#�r��f�r�car�s�ct�red t�b�p��c�rr�arr��an. Por�+�r�s o#�; � ' t�re in�`orr�a#��n�ay be'c��ass��"�d as nr�n p�rbl�c�f y�t�pro�i�►�e spec�i�t�easor�t�a�`�o��f perr��t t�:`Gi�ta � �� c�r�c%le��iat t�e �re tra�le�ec�et�. �.. �.�� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota S t Building Gode must be completed within 180 days of permit issuance. �. X Lu�s f y°ic�'�-�-=�-." X b ApplicanYs Printed Name Appli s Sign ture Page 1 of 3 Use BLUE or BLACK Ink - r------------------, I For Office Use � ' �i 1 � L i Permit#: � �� I �� O� Y�� I Permit Fee: �� 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I i � 2015 RESIDENTIAL BUILDING PERMIT APPLICATION -� S;fi z Z Date: � � �-s �� Site Addr��sl y�� e.r�°�c ��a �'�'` C��"�N Unit#: � � �.�-Name:��,ra4 /'�!"�..n .._u,�,�,�i�x�.,.�., �f'�%�I'_,,,,W w�r,�,�_w ,,,,��,.�_w Phone: .�...w.,,,�,..,�.�..�..,�,w��..�a (.�(� L � �tes��d�tt � ��73- �Y7S' L � f �' rr' a ssrz� �: C1YA►t��!' Address/City/Zip: � < .lwo c, ��d'K cz C� Applicant is: Owner Contractor µ�� ,�...,�,w.,�.�,..�,�.:..�._ a.�.,�,�.,-,�...�„��,., _ _-�.�.�,,.,�-�..�..,�.�..,�,.,�.�.,M.u. .�,a��„�_.�.,.��a.�a.��...�.�_.�....�.....�..�... � Description of work: J��i'� �' Tppe 4#�l�lOrfC � ,J � ; Construction Cost: /�l �` v� Multi-Family Building: (Yes /No� � ��,..��..�,� ��.�;:�..�..�,.��..�.�_.n.�.�, ..,.�.,�..,�.,..�.�,.��...�...,..w.,.,,...�,.w.,, _.�...�.,,,.,� -�,.,�. �„�.� � � Com an C� ES ��v�-f �l�'i�:l"�-��f nc. Contact: ��s ��`��t4a,�, � P Y� �� s Cor�tract�r � Aaa�ess: 35� i/,�5s�u� G� h� .S�f` �sr c�ty: �'��,�u� • � � /� ,- �(, � � 1 � � State:�Zip: �-Sy�% Phone:��3��.s6-��13 Email: L-��'�-1C�Caa�/�I��t,l�.e�+.ItaGT��j,� : � � � License#: ��v d G�7 �!3 Lead Certificate#: _,�...�._ �..�. ` If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? � 5 � Yes No If yes,date and address of master plan: } � Licensed Plumber: Phone: � � Mechanical Contractor: Phone: � Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NiDT�'.Plaua�ar��sup�o�v��ndocu�+�n�s t�aa�you s��re co.��a'�d i�b�p�rb�r'��. Fo�+r�s of tf�e en�ort�ta�rot��be cl�ss��ed as�r��t p��e i�',�o��ro�u�d�e�pec�re��s��iat ta�or�t p�r,��i� G#�to �.�.,.,� � G�Dl3��8�'��1�9� e��'�S'�!�dS�C�'B�'S. �., ,�. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota S e uilding Code must be completed within 180 days of permit issuance. x (��/��.� / /�+`�(,(s�,,��/ X �� ApplicanYs Printed Name App c s Si ature Page 1 of 3