The URL can be used to link to this page

4476 Lakeshore Ter. . INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road ? Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: 117RF!-?; • (. C. 1 , i 1194 43fiOl . ? PERMIT SUBTYPE: TYPE OF WORK: ;rRn lnI i rNF:? INSPECTION D. . .• . ,?,,,i?, ?•?i E F` M A F ? K % i f"l U F' ! k' Y . L l I 1' I4 4416 l A k F _ S FI rY R f " I E R ( L C)1 10) ?, b? W Pi tlR -•- 1lFNM. P1ARS, Psrmit No. Permit Hoider Date Telephane # ELECTRIC ?717 &v PLUMBWG HVAC Inspection 'plio Insp. Comments FOOTINGS FOUND N FRAMING ROOFING ROUGH PLUMBING 717 PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINALHTG ORSAT TEST BLDG FINAL t BSMT R.I. BSMT FINAL DECK FfG OECK FINAL ` T INS: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: ? ;;? ? ,ia??,-? ? r ,. i I ? ?If:! •??(1tf?.?`i , I PERMIT SUBTYPE: ON RECORD PERMIT TYPE: Permit Number: Date Issued: Kli t t 11 1010 4).'9H49-4 f u /tultIA ' v " APPLICANT: TYPE OF WORK: N 1- !,J ( lt: Rt) 1 07 1 t Nt": ) • .A • DA I IA FY kaT TH 447H l.pKl'S#1OOF YElt (!t)T 9) ., W P1 p it -1 {..it:hl!C' i I.) I.E3C; I %- Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC lnspectlon 11-140 Insp. Comments FOOTINGS '7 FJ FOUND FRAMING 5? ?, ROOFING PL?UMBING --,2C -? I? c77 PLBG AIR TEST n . I ROUGH HEATING GAS SVC TEST A' INSUL 5?2'L97 ? ! GYP BOARD FIREPLACE ? FIREPLACE AIR TEST FINAL PLBG FINAL HTG G I ORSAT TEST BLDG FINAL gt, BSMT R.I. BSMT FINAL DECK FfG DECK FINAL ?„ ;.. ? Wertificate of Ccc"anc? ??4 of Cfagan Tepartaeat of $K[bhxg 3a60rction Tlus Certificate tssued parsuant to the requirements af the Uniform Building Code i certifying that a1 the time of issuance this structure was in co?npliance wrth the various oradiiwnces of the City regulating building constnrction or use. For the foflowing: SF DWG 29002 Use Qusifrcatioa: Bldg. Pertnit No. 0-vpancr'i'rae R-3 U-1 zoNOs niw? pD Tra caMt. VN ownrr orau.u;ng HOFFMAN HOMES Addmss 2214 E 117TH ST., BURNSVILLE, MN Ekia;og Addmz 4478 LAKESHORE TER Locality L9, B3, {:L1FF LAKE SHORES ? ? o„e. BuiMin6 OfTicial ' P0.ST IN A CONSPICUOUS PLACE ?, ., • '? C?;e?tiJicate nf Cccu41anc? (Fi#4 of Wagan Zcpartwexr of YSKiUatg 3t##ection This Certr;frcaie issued purstrant to the requirements of the Uniform Building Code certifying lhat a1 the tirne of issuance this stnrclure was in compliance with the various ordinances of tlee City regulating building constnrctiaR or use. For the following: ?se cusafic,,;m. SF DWG / GAR slag. Peffn;, No. 29003 0-w-Y TYve R-3 U-1 z..,? D4.i,, PD Type c«,u. Vn o,,,m of e„ue;ng HOFFMAN HOMES 1N? naa? 2214 E 117TH ST., BURNSVILLE, MN Building Address 4476 LAKESHORE TER L10. B3, ^.L1FF LAKE SflORES B?? °?? -7 POST IN A CONSPiCl30US PIACE { ? . a RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? 76, b U 651-681-4675 NewConstructlonReauirementa RemodeUReoairReauirements i4A • 3 registered site surveys showirg sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (ZO%maximum blwve2ge aliowed) • 1 set of Energy Calculations for healed additians • 2 capies of plan showirig beam & windaw saes; poured found design, etc.) • 1 site survey for axterior additions & decks • 1 set of Energy Calculations • Indicate d hame served by septic system for addiUons • 3 copies ot Tree Preservation Plen if lol platted after 717183 • Rim Joist DetaB Options selection sheet (61dgs wBh 3 a less unds) DATE A rl . (X v ?h JOB SITE ADDRESS' ? ? ? /, nk 2 IF MULTI•FAMILY BUILDIN?G, HOW MANY UNITS? PROPERTY OWNER / /?Cd YJ ZN t ?P-P_!',(/l TYPE OF WORK T s ?CAll Cc- ? as rfI i,^ erfU APPUCANT JE1 ?N2sjd P Ly Y'vlErl ?'I ADDRESS .3?7,5= (') UJ. W/u ri 13 PAGER # CELL P'HONE # FAX # NEIV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) _ MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 Plumbing Contractor. _ Plumbing System Includes: - New Energy Code Worksheet Submitted Phone Water Softener _ Lawn Sprinkler _ Water Heater _ No. of R.I. Baths No. of Baths Fee: $90.00 Mechanical Conhactor. i Y`e.Cj de&(7 y' X AY` Phone # 95P -0 '7Q^( Mechanical System Includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Contractor: Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Stotutes and City of Eagan Ord' nces. Sfgnature of Applfcant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 VALUATION M02C) (S)_0_1_2 yu FIREPLACE PHONE# 9'-607 10Id!/, ZIP CODE /Q •? ?o '?. JVG. oFFlCe use oxLr mi: ,equest vnid 18 months tram .oliaanon a? qY.red n this .. ? 0?4 IIIII II I?IIIIIII IIII I IIIII II I I??????r.63, ???-? ? ? * 0 4 0 5 3 3 0 2* PLEASE PRINT OR TYPE ?D Request [Dme Roagh-in inspanio? requiredz Yes ? N. Inspecoon Olher Thon RaugMn? Ready Now ill Call lYou must call Ihe inspxror whe reo ) Doh Reody i, i sed contractor ? owner hereby request inspection of the a6ove elechical work at: Job Address (Streat, Box, m R No ) ? ?. Gy F- Secton 7ownship Name or No Range No. fire No. Coeny ? Occu nt Phore N. ' Power Suppl r ? Address / Eiean I hacror ICompony Nam`) Conhocmr i se No Mosler Lic N. (%onl Elect 0n1y1,,, e ? IMilmg AJdrm t(eonn r or Pe?Forming In:wilarionl xtor or Owner Performing Insiollmion) AW StgnaWro ICo^n hone N. c V 1 ? EBOODOIAi 1 9/96 sinis annw174*v. SFF VusiwHCnfieLS ON eACK O?YELLOW COPY 1o?w/q? 405-330 ? ? - REQUEST FOR ELECTRICAL INSPECTION Mionesota State Board of Eleciricity ' 1821 Universiry Ave., Rm S-128, SL Paul, MN 55104 Phone (612) 642-0800 ? ome Duplex Apt. Bld Ofher. - Addn Commercial Indushial Form Remod Re ir Air Cond. H. Equip. Wafer H od Mgmt. Other Dryer Range Elx. Heaf Tem . Service "X" above fhe work covered by Miis request. En rem ks in this space and w fhe back oi the while mpy only. Ca/culofe Inspecfion Fee - 7his Inspecfion Request will not be accepfed wiihouf the correcl fea: Other Fee # Service Entrance Size Fee # Circuits/Feedea fee Mobile Home Paric Stall 0 to 200 Amps 0 to 100 Amps Sheef Ltg./Tmffic Sig. Above 200 Am s 00_Amps Tmnsformer/GenemtOr INSPECTOP'S USE O TOTAL Sign/Outline Lfg. Xfmr. ? Alarm/Remote Conhol $wimming Pool ??CJ I hereb cent thm i e elecniml in:mllmion deuri6ed hxein on ihe dares wkd Irrigafion Boom xouyMn oare Special Inspection Investigalive Fee ?/' Fiiwl Da -4b ?'S?o THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 78 MONTHS. !/? 2006 RESIDENTIAL BUII.DING PERMIT APPLICATION ?l- City Of Eagan ?f 3830 Pilot Knob Road, Eagan NiN 55122 Telephone 9 651-675-5675 FAX # 651-675-5694 ' New Cons W cfion Reouiremen5 7 registered site surveys showing sq. R of lot sq, ft of house; and afl roofed areas (20°k mammum lot cwerage allowed) 2 copies of plan showing beam & unndaw srzes; poured `ounC design, etc. t set of Energy Calaiahons 3 copies of Trce Preservaaon Poan if lot platted aRer 711193 Rim Jast Delail0phons selectlon shaet (buAdings wtlh 3 orIess units) Minnegazco mechsmcal ventilauon forxn Date /0 / SiteAddress Descripfion of Work RemodeVReoair Reawrements 2 copies of plen shawmg footlngs, beams, jaists t set ot Eneryy Calalafions for heated aGditlons i ste survey for additions & decks AddiNon -mdCate if on-srfe septlc system Constrvction Cost ;6 Telephone #( Multi-Family B1dg ? Y J_ 1Y ti/ Flreplace(s) _ D _ 1 _ 2 ?I Property Owuer I " elephane # (9? ? C t t ( /t L G 'V? 6 ? 0 ' on rac or J ?. ? J 44 Address ? ./ City State ' Zig Teiephoae Af(??(? ') ZSc:???? Q ' I GaMPLETE T}i!S A]?E.A ONLY 1F CaNSTStLJC?7NG A 3VE3M BL314.DiNG - Minnesota Rules 7670 Cateeorv 1 Niinnesota Rules 7672 Energy Code Category . Residential VenUlaBon Category '1 Worksheet . New Energy Code Worksheet (J suhmission type) Submdted Submitted • Energy Ernelape Calculatlons SubmitteC In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of masTer plan: licensed Plumber Mechanicai Contractor Sewer/water Contractor / 3?as Ofice Use Onlv CertofSurveyRecd Y N Tree Pres Plan Recw Y N Tree Pm Raquired V N Orostle Sep6c System _ Y_ N Telephone #( J Telephone #( I hereby apply for a Residential Building Permit and aclmowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry 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 starc without a permit; that the work will 6e in accordance with the approved plan in th case of work which requires a review and approval of plan 9" s I . -?51 vOhs Applicanf's Printed Name Applicant'p Sig7ture ? y LOT SURVEY CHECKLIST FOR RESIDENTIAL . UILDING PERMIT APPLICATION ? PROPERTY LEGAL: 0 ? ? DATE OF SURV : ? U ? o '? LATEST REVISION: DOCUMENT STANDARDS a z ?? ? • Registered Land Surveyor signature and company a-,? ? • Building Permit Applicant W" ? ? • Legaldescriptlon g-, ? O • Address ?? ? • North arrow and scale ?? ? • House iype (rambler, walkout, split w/o, split entry, lookout, etc.) Q?' ? ? • Directional drainage arrows with slopelgradient % Er" ? ? • Proposed/epsting sewer and water services & invert elevation C9??1 ? • Street name 13 • Driveway ELEVATIONS Exdstlna 2-,? ? • Sewer service (or Proposed) B"? ? • Property cornets 13 • Top of curb at the driveway ? ? • Elevations of any ebsting adjaceM homes Pro _ _ M" ? ? • Garege floor e"? ? • First floor ff-11 ? / ' ? • Lowest exposed elevatlon (walkouUwirrclow) e o ? • Properiy comers Ek""El ? • Front and rear of home at the foundation PONDING AREA fif aoolicable) ? ? • Easement line ? ? • NWL ? 9-'O • HWL ? GI'-'o • Pond # designation ? ?o • Emergency Overflow Elevation DIMENSIONS " ? ? ? • lot IinesBeadngs & dimensions e' ? ? • Right-of-way and street width (to hack of curb) 0 • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (.e. all structures requiring permaneM footings) ? • Show all easements of record and any City utilitles within those easemenis ?? 0- - O U? • • Setbacks of proposed structure and sideyard setback of adjacerrt existing structures Retaining wall requiremenis, if any Reviewed: J Aame T / ate J January 1996 CRAIC19B51BLDGPRMf.FM PERIVIIT ?P-oq19 ? CITY OF EAGAN 3830 Pilot Knob Road PERMiTTYPE: auzLorruG Eagan, Minnesota 55122-1897 Permit Number: 029003 (612) 681-4675 Date Issued: 10 / 10 /9 6 SITE ADDRESS: 4476 LNKESHORE TER IOTa 10 6LOCK: 3 CLIFF LAKE SHORES P.I.N.: 10-17785-100-03 DESCRIPTION: mt e ,tit ;? ?,;, w ? 'm'" °??? I ?. p? ?P a`i:,^ - ?? _ '?.. REMARKS: DUPLEX WITH 4478 LAKESHORE TER (LOT 9) S& W PLBR - WENZEL PLBG gs?"" (ZERO LOT LINE) 4 din°t? Permit 7ype SF DWG ?. Type NEW R-3 U-1 «j CdtSS?CF.tGt?.Ot7 T?e V-N Z?s n`i f1 q P D 1:ctin9 L;ent??CC? 38 . uir g '1k2d?fr `?? 66 ? : +Sr?z:s.;;??= PWild?tlt't 1 ? C?`? 102 1- FAM. ATTACH FEE SUMMARY: VNLUATION $136,0@9 Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal $1,067.25 $533,63 $68.00 $900.00 100 1 $2,563.88 MTSCELLANEOUS $1,923.50 Total Fee $4,492.38 CONTRACTOR: - Applicant - sT. LIC pN?NER: HOFFMAN NOMES INC 18949807 0009284 HOFFMAN HOMES TNC 2214 E 117TH ST 2214 E 117TH ST BURNSVILLE MM 55337 BURNSVILLE MN 56337 (612) 854-9807 ?(612)894-9807 - - - - - "" - - - % I h:e'r'e6y ac ??raw?.?t?e wE?3?$ ?!?€a?':'?he infdr'mat3 tft_?1.11 a,b?s 5t8.t EteS' S?. 411?'y 'Or?EfT?['?anrx-e? »,. . . , .. .._.. ,_.. . _._....._..... ... ._........:.. I ... ...., , ." .., .... .. ?. ' ? . .....,. _..z ... . ? APPLICANTIPERMITEESIGNATURE ?SSLJED BY? IGRATRE ? ?? ,a CITY OF EAGAN 4[ ? 3830 PILOT KNOB RD - 55122 / 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 remen ? 9 regislered sile survays ? 2 copies of plan . ? 2 copies of plans (include beam 8 window sizes; poured (nd. design; elc.) ? 2 site surveys (exterior additions 8 decks) ? 1 energy calculallona ? t energy calculahons (or healed addilions ? 3 co0iea ot tree presarvellon plan H lol plaqed after 7!11l93 required: _ Yea 4- No C?GI- Y?aP_C.l?lJla??? DATE: i 01" lq 4 CONSTRUCTION COST: DESCRIPTION OF WORK: EsaT?A?. tk. sAE STREET ADDRESS: "feA-"cC-- LOT I p BLOCK 3 SUBD./P.I.D. #: tO - t--k-t$ 5 - t 00 03 '?kvcrg ?/ Gor • 9 C-L,FF +-i"`Vsr -CA+Wws PROPERTY OWNER Name: floyRr-taa Wor4,es ,'z-?• u.. ?q?. Street Address: City: SANC Phone #: i3.iLYSJ. i.?.(a CON7RACTOR Company: Street Address: City: License #: qZg State: Zip: ARCHITECTI Company: ENGINEER Name: L'1Lr-- Phone #: ck3`t' -"V' Registration #: Street Address- g" U-'- S'O'&-r re Z( o CItY: C N,d.) NAS6E.J Sewer 8 water licensed plumber: `-3E'-'2f-'- change are requested once permit is issued. State: µ?j Zip:S531" Penalty applies when address change and lot I hereby acknowledge that 1 have read this application and state that the informatio is g rect and agree to comply with all applicable State of Minnesota Statutes and City oi Eagan Ordinances. ' Signature of Applicant: OFFICE USE ONLY Certiflcates of Survey Received _ Yes Tree Preservation Plan Received ^ Yes Phone #: No _ No State: 'MY*-? Zip: 5533't 0 C T 0 3 1996 ? OFFICE USE ONLY BUILDING PERMIT TYPE ,• 0 01 Foundation ? 06 Dupiex ? 11 Apt./Lodging ? 16 Basement Finish eK- 02 5F Dwelling ? 07 4-piex ? 12 Multi Repair/Rem. ? 17 Swim Pool , ? 03 SF Addition ? 08 S-plex o 13 GaragelAccessory o 20 Public Facility ? 04 5F Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous ? 05 SF Misc. ? 1 = plex ? 15 Deck WORKTY E -??/Lo - LpT " C<?? ?'31 New ? 33 Alterations ? 36 Move a 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const (Actual) Al_ Basement sq. ft. MC/WS System c>,,-' (Ailowable) ?•K Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklere d Zoning P? sq, ft. PRV # of Stories I 4Bsr R sq. ft. Booster Pump Length 78 sq. ft. Census Code. a a- Depth (o? Footprint sq. ft. 5AC Code r+i Census Bldg ? Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Other Copies ToWI: I Valuation: $ T00 /r 0-1 ? G ? GS. /? [??' G ?? I % SAC SAC Units :e:d3;:+..:.::?:>?: ?:?i ?:1:k<wkm ?:;°1cY?.;n ? w?:t;??=?.W.>e?¢:F'>,?.?:hY.M•1';';i?k r„rTY i.li" I'_f-:CAN CAi:»-;'f.',=f,;= ., TI'r:Ri77:NIi11.. N0.;a 74 VAt:: !.O!I.n/96 'r','iI'_a i1;2029 ? ' 1 iltl F"i'Sr?'? : [?C 056 900:1 g.S:S`f=, IAliE.?.'>Hfil:i:h bn/t:dF„3R ^c"rrr., `Jitt7l 4478 ':.AiiFci4apr't[: 4749208 Cota:I. R,_. .rn; "oC A;n;'.u.ihi.a W8I, f ...,. Lt='OF'::: r'i_?S! I.lii't'R T.fi % Mi"rl ry JYi I"rwJ:?1'?+.:rYG$/d$(Y,a%?c%?=9F'4Vkh:d?F1?.7(->,°.:;;$i4U? ?d%Y.h;?'q;t.d;?>!? ? ?. ? CITY OF'EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT avqzG PERMITTYPE: BuxLozNc Permit Number: 029002 Date Issued: 10 / 10 / 9 6 SITE ADDRESS: 4478 LAKESHORE TER LQTs 9 BLOCK: 3 CLTFF LAKE SNORE5 p.I.N.: 10-17785-090-03 DESCRIPTION: (ZEftO LO7 LINE) Permit Type SF DWG r?k T Y p e N E W R -3 ll -1 ? C¢gtStYUC'Ci'Z7Ct ?`?f?e V-N ?W 2orifi!t8 ` PfJ =. L"eng.th.: rP ?3U&I.din9 38 ,,.. 66 ??ra.E's sou k"o--d' s?E?`?,' ? . G 102 1- F A M. A T T A C H _ , £?V C? ` ? t ?.? ? ? ?'?snf REMARKS: DUPLEX WITH 4476 LAKE5HORE TER (LO7 10) S& W PIBR -- WENZEL PLBG FEE SUMMARY: r Base Fee Plan Review 5urcharge SAC SAC % sac units Su6total VALUATTON $1,067.25 $533.63 $68.00 $900.00 ieo 1 $2,568.88 $136,000 MISCELLANEOUS 1 923.5g 7vtaJ, Fee $4,492.38 CONTRACTOR: - Applicent - sr. Lzc OWNER: HQFFMAN HOMES INC 18949807 0009284 HOFFMAN HOMES INC 2214 E 117TH 5T 2214 E 117TH S7 BURNSVTLLE MN 55337 BURNSVILLE MN 55337 (612) 894-9807 (612)894-9807 I her?eby a, clk informatip?i,.i?, C? Stdt?iy?es r0ad ?thi-s" ?`Pp?14' ?n;etat,e thAt,the y! of ;w?.? , , , . ? a ? . F . . .... ..... . . .. "$P°?'E. ?n 4. 4 ' .a _ ?.. . ... _._- _ bi'd --?16 E e : ICi- 1?ATU'REf 01A - CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? J regislered sile surveys ? 2 copies of plans (include beam & window sizes; poured 1nd. design; ete.) ? 1 energy wlculationa ? 3 copies of Iree preservation plen if lot platted afler 717193 required: _ Yee -%- No RemodeVReoaii Reauirements O 2 copies of plan ? 2 site surveys (exterior additions & decks) ? i energy calculations for heated additions , DATE: t Qt ZI `I l,. CONSTRUCTION COST: 13?e,ooo DESCRIPTION OF WORK: -geS i DE?4T? A ?. i o,..?.?NoyA6 STREETADDRESS: ???% L-Av-&`?k?g? LOT 4 BLOCK 3 SUBD.lP.LD. #: ?O '???g 5' 0 4fl - 0 3 uOGLk' Gor-/o c.?iPR ?.?+x? 50,a.b5, PROPERTY Name: {--Io?Rr-c?.?f N?x.?s .z?• Phone #: OWNER Street Address: Ciry: State: M2*3 Zip: 5533-1- CONTRACTOR Company: SA?Ac Phone #: Street Address: License #: 4 Zg i City: State: Zip: nRCHITECT/ Company: M? u?1ct,>t4.n DES'%c.^j Phone #: 93`t' Iy`kA ENGINEER Name: L'1?-?= Registration #: Street Address- $`? L"'- ?$ ??a SK?r SA , re z.t o City: C Ha~' NAS6EJ State: K.i Zip: 553t'1" Sewer & water licensed plumber: WE'`' 2.F-" Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the inform ion \is rrect and agree to comply with all applicabie State of Minnesota Statutes and City of Eagan Ordinances. i Signature of Applicant: ? OFFICE USE ONLY CertiFicates of Survey Received Tree Preservation Plan Received " Yes No _ Yes No OCT 0 3 1996 ? OFFICE USE ONLY BUILDING PERMIT TYPE . 0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 ?02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? ? 03 5F Addition o OS 8-plex ? 13 Garage/Accessory ? 0 04 SF Porch ? 09 12-plex o 14 Fireplace 11 ? 05 SF MISC. ? 10 -? ? ' -"- DeCk WORK TYP f./2-0 iAl ? ?31 New o 33 Alterations ? 36 Move a 32 Addition ? 34 Repair ? 37 Demofition GENERAL INFORMATION ConsL (Actuap j .. (Ailowable) N UBC Occupancy /? • Zoning P-h # of Stories Length 38 Depth .?_ APPROVALS ,?. Planning . 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. l, GI L MC/WS System gzpL Main level sq. ff. I. 7y7 City Water o.r- sq. ft. Fire Sprinklered sq. ft. PRV Sq. h. Booster Pump sq. ft. Census Code. Footprint sq. it. SAC Code Census Bldg Census Unit ? Building Engineering Variance Permit Fee:, Surcharge Plan Review License MCNVS SAC City 5AC Water Conn. - Water Meter Acct. Deposit SIW Permit, S/W Surcharge Treatment PI. Road Unit a Park Ded. Traiis Ded. Other ? Copies Total: 96 SAC SAC Units 6 b 7.a 533. ?? L.f? b"o 9w. valuation: $ /36' di7O G G? ?? ? . . s , ?. i ' ??______ - •? C - _ - , ' L /E - ' ?J\\ ? `70' PZ: i i 911 - LAKESHORE T J ERRA . ... __,?;•.'s1p`? til (' A';i ?+ (? 1 1 ?F UTILITO` i10NfL. 7HIS F(?R -- -- '? PURPOSES 0NLY AhiD A?a IT SHQ?1lD tlGl';r, ?' TFd? C3i TE. . -= =--- ,, . 6129344305 P1I14NETONI<A DESZGh! ----" EKTERI-OR- ENyELOPE AVERAGE "U" COMF'UTn7rQN PAGE 07 ^-----------._._....___...........__.. . , ..... ----------_?..._. ____ nnrr : 9 -13-RS PHONE: conrRacroR:qoE-r-nAN - Ptaiv # Determine working square footage of each 1. Total exposed wa11 area..... ?8j I , ` s q. f t, x.11 = ZsJ`? ?QZ 2. 7otal roof/cetling area 1(Q2.1 p 5I7E ADDRESS: .... sq, ft. x .026 = 42,7? Total exposed wall area above,floor=?(„ a." Total wdll window area „ b.* Total door area.. .................................... c. Total sliding glass door area „ ...... ........... '........ ...... d. Total fireplace wall area .... ............................. .....•- e. Total wall framing area -.. ................. (average IO%)..... f. Tota1 rim Joist area.. " •. •••••••••-••.. 9- net wal] area above floor .............. .....'.'...... ` h. wdll re .................. ......... ? ? -'-- a a a6ove floor ................... ............ ?_wa11 area above floor.. ???•••••- • J• ?frame wdll drea 9t foundation ..... .......... ................. ---- ................................... Totd1 exposed foundation area= k. Totat foundation window area ........... i l. Totat net foundation area above grade,,,. ,.,,,,,,,,,; ? Determine "u" vdiue of each wa11 segment (e•9. window, door, each separate wa11 section) a._ 127, 3 X„ull = CDZ,3?? '' ? b• X „u,l I(01 c. „U„ , ? d. x 3 e. 13'I? 1 X f. 3?01, ?S X 9. x n i .7, k, 1, , ----,_ „u„ ,.u„ -----=. X ,lUl, '----?_ X -?-----? ---- X u'l X "U" ----W-?--..Y = r c. -------?--------- b Z,-- ??-'---.--- X,lu„ ,)l o ? s---? ................................. Total = 7?AZ.?'15 If item 13 qs the sa ( as, or less than ite(; 11 . you have met the !; tntent oP S9C 6006 (;; . 1995 10:13 6129344305 t+IINNETONI<A DESIaN PAGE 08 a. taTAL IxPOSto RacrlcEILINa utCuLartais: • Tot+) sxposed ' roaf/eeitfnrt araa........ (p'L !q fG J) Totai skyllyht araa...... ' sq ft x "U'• " k) Toul roof/cntling fr+pinq '\ arna (Avarao 1(1> ) ? 2 y '• ft „„ 0?? • 3c , ,..... q e 1) • Totol nat fnsulated • ? roof/cet l Tnq area....... sq . ft x "U" `?7- ? 2? ? • h 4• • TOTAI. j) th ru 1) 33? ??p 1f total of sli is the sama as, or tcss than fl2, yau havn met the intent of • 2:lGAR 1 .16008 w xnd 0. ' ' ` . ,, ' . ACTEfWATE BUILDlHG ENYELOPE AE5lCS .' 7o utTtlxn the total envalope systaa i+ethod. •the values extsbl•lshed by thQ sum " of (tems E3 and 14 shall nat be g raater thbn tha suaa'of Itms pt snd !2. . i• t 2. ' 3 • . . } ll . ' . - . , . , . * . 10:13 6129344305 t•IINNETONKA DESIGN PRGE 09 * LINEAL FEET EXPpSEa WAGL K : KNEE: WAl.KOUT; 3? FULL 1: 1c.9"7s,S FUGL 2; FIREpLpCE: R IM :`(.p1 i IS. ? SQDABE FEET EXppSED pALL ABEA BLOCK : I V, KNEE: waLKOUTr 3? x S Q FULL 1; p 7C p ° 3? x 8 FULL Z: FIREFLACE: x $ - - RTH: x Q A x ?• I Co? , f? SQUARE FEET ERPOSED CEILING IC9Z? WINDOWS: jZ-7 3k , y, DOORS : 37,'"1j'1` ,?,?"?? ?lY1?J' ? ?/ ls-? 'S1 2C°3(,p 1 &,k2 PaTIo nooRS: IDdk z(3 S<Z? I I II v ?? ?OSo ? ? a44 tl It BASEHE:iT Ut3iTS: . ??;1a SKYI.Z6HT5: ~ i23.3 ? .+ . ?N? HOFFMAN HOMES, INC. 2214 Enst 117th Street Telephone (3urnsvilfe, MN 55337 (612) 894-9807 pax CONTRACTOR # 9284 (612) 899-9878 I-0 /y/9 cC Mr. 7oe Voels City of Eagan Plan Review Department Dear Mc Voels, This letter is to inform you that Hoffman Homes, Inc. will be using the exact same plans for the layout for Lot(s) 1(i t? , Block 3 , Cliff Lake Shores, as were used on Lot(s) I /}-, Block ;?- , Cliff Lake Shores. None of the structural building components, HVAC, plumbing or electrical will change from engineered drawings dated ?o/?rf45 Sincerely, rPatrick C. Hoffman President PCHfjem pch/eagltr - -- -- --- --- -- CITY USE ONLY ?,/ y ?j L L BL ? RECEIPT#: /.? 9 SUBD. ? RECEIPT DATE: S1-07 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681.4675 Please complete for: . single family dweilings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTLIRES EACH TOTAL Shower 3.00 x lNater Closet 3.00 x 2 = 6. eD Bath Tub 3.00 x = Lavatory 3.00 x Kitchen Sink 3.00 x 1 = 3: Do Laundry Tray 3.00 x / _ ,oo Hot Tub/Spa 3.00 x l. = 3, ao Water Heater 3.00 x I = 3, ao Floor Drain 3.00 x J = 3:ob Gas Piping Outlet ' minimum - 1 3.00 x 19 Rough Openings 1.50 x 3 = 4,s-b Water Softener "for dweilings under conaWction 5.00 x = Water Softener ' for existing C+valifng 20.00 x U.G. Sprinkler `fordwelling underconst. 3.00 = U.G. Sprinkler ' for existing dwelling 20.00 = Alterations ' to existing residence 20.00 = WaterTum Around 20.00 = Private Disposel System " Dak IXy lic. 75.00 = (new and refurbished systems) Private Disposal Systems `Abandonment 20.00 = STATE SURCHARGE .50 TOTAL 5b' co I hereby acknowladga that I heve read this application, stata that the iMormation is mr2ct, and agree to comply'witA all epplicable City at Eagan oMinances. B fs the applipnt's responsibility to nMify the property owner that the City of Eagan assumes na-liabfliry tor any damagea caused by Me Ciry during Its namiel aperetional and maintenance ad'nfties to the Tadlities construded underthis pertnRwilhin City propertylrightof-way/easement. SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET ADDRESS: ? 757 J crn: _ E,4& 44 SELEPHONE #: 4 SL- ISFc S STATE: 114AJ ZIp: " S/22 SIGNATURE OF PERMITTEE V" •? GITY USE ONLY ?I L _9 BL RECEIPT#: X35 81 SUBD.f t RECEIPT DATE: 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681.4675 Please complete for: . single family dwellings • townhomes and condos when permits.are required for each unit . backFlow preventer for underground sprinkler system FIXTURES EACH MQ 70TAL Shower 3.00 x Z = C40 4llater Closet 3.00 x 2__ _ _oa Bath Tub 3.00 x = Lavatory 3.00 x Kitchen Sink 3.00 x Laundry Tray 3.00 x ! _ ?.bo Hot Tub/Spa 3.00 x Water Heater 3.00 x Floor Drain 3.00 x Gas Piping Outlet ` minimum -1 • 3.00 x ? = bb Rough Openings 1.50 x s = 4;'S8 Water Softener ' for dwellings under construction 5.00 x = Water Softener ' for existing dwelling 20.00 x = U.G.Sprinkler "fordweliingunderconst. 3.00 = U.G.Sprinkler 'forexistingdwelling 20.00 = Alterations ' to exis[ing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' oak Cty iic. 75.00 = (new and refurbished systems) Private Disposal Systems ' nnandonment 20.00 = STATE SURCHARGE .50 TOTAL ,5?7. 00 I herehy adcnowladge that I have reed this application, stete that the inMrtnatlon is corted, and agree tocompty with all epplicableCity of Eagan ordmances. It is the apphpM's-responsibility to notify the property owner that the Cily of Eagan assumesno liability for any damages qused 6y Ne CRy during iGa nbrmal operational and maiMenance ecdvSies to the facilities constructed under Mis pertnit within City property/rigM-of-way/easemeM. SITE ADDRESS: OWNER NAME: INSTALLER NAME: S'ff2EET ADDRESS: I / D -7 cirr: FAGAn-) .L1ANlCh(- TELEPHONE#: _7SZ-I`S?aS G,JNsE 120 5TATE: /''N ZIp; SS/2Z SIGNATURE OF PERMITTEE ' L BL ? CITY USE ONLY RECEIPT #: SUBD. DATE: 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit _ New construction Add-on furnace - Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc. ate: ll- lGi''%ll ? Minimum Fee: Add-on/Remodel (existing residence only) ? HVAC: 0-100 M BTU Additional 50 M BTU ? Gas Outlets (minimum of 1 require? @$3.00 each) ? State Surcharge TOTAL SITE ADDRESS: J;a-1 l° OWNER INSTALLER NAME: STREET FEES $ 20.00 24.00 ? 6.00 3. 9? .50 a 7 ? PHONE #: .R!21: _!d, CITY: YY Iy/n STATE: N? ZIP: 6??q'g PHONE #: ( ) ?AATDA ' n CITY USE ONLY L 7 BL .? RECEIPT #: WP SUBD. DATE: ?? ?`s G 1996 MECHANICAL PERMIT (RESIDENTIAL) C(TY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit 9/ New construction Add-on furnace _ Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc. Date: I I ` I 1! 'C14 ? Minimum Fee: Add-on/Remodel (existing residence only) ? HVAC: 0-100 M BTU Additionai 50 M BTU ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge TOTAL SITE ADDRESS: ` OWNER NAME.-b INSTALLER NAME:_ STREET ADDRESS:_ CITY: r 1 I1?? Jx PHONE #: ( / FEES $ 20.00 24.00 6.00 :3 iw .50 ?7.? PHONE #: Ry47 MA' ------------------ ? j Permit #: .f ` ?,6v j ? Permit Fee: ? I ' ? Date Feceived: ? j I ? I Staff: I ) I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date:*" S Q) SiteAddress: tate, 5km Twa(ce Tenant: SuiTe #: RESIDENTIOWNER I ?l??A?ll?'lOYVLQS Phone' NameGll`Ck L4?t .SYW ? ? ? n ( Atldress/CitylZip:,?"V`CV Cllr-Y LAILL cc•?pkj?11i ?G).)? Applicant is: _ Owner _:?L Contrector TYPE OF WORK Description oF work: 1 QG.V' ZXk' YMUt'? ?A1 l YY.Ld? l? 3) - Construction Cost: ? ? ?aa • ? Multi-Family Building: (Yes X_ / No CONTRACTOR Namehqi'1a41 bdiky y0Y-, License #: ?? ?5005 Address: m(Po Z(.LO<( uC1,k W.,*Cw Ciry: hlA!(j)CIA ? (.2 State: _ M ?j_ Zip: ?JJ PhoneA.5 a ,cn ' 16CLS11 ContactPerson: Ua.nk, cSCI&Lc¢.1'ZY COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Ene1'yy COdB . Residential Ventilation Category 7 Worksheet • New Energy Code WorksAeet CaYBgOry Submittetl Su6mitted SUbmission type) • Energy Envelope Calculations Submitted In the last 12 months, tias 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: NOTE: P/ans,and:xupporfJng-dncusrienls thaf"??"y sq??t,?r??ras?6e ?u?tfa l?i or?a?rb"?` x?; r?iorrs dt ;` i ` ?' i f t? ? v6ou? perr? it e r y t4 -: the informatibn?may be class?ired as?iiort prtbr? rf yor?>?,trawrtfie s?S?+?+??=heato#slt/ „ co?cldd?:t?iat?he I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of [he City of Eagan; that I understand this is not a permit, but only an applicaLOn for a permit, and work is not to start without a pertnit; that the work will be in accortlance with the approved plan m tbe case of work which requires a review and approval ot plans. xaci.vIc, ScWA-'ey- X 6?1 S-? ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 CER TIFICA TE I I I I ? - ? , _ - - - (913.80) p (9Z? ? S? ? 913 15 q oi X 0 ' " `?-- _ - 37.52 N88 40 56 w 78.1 ^i ? + --- y? ?9S 40.00 { 0 ' 200 -- W LOT 9 92 2 1 I I W 2.00 o Q e - - of 700 I ? pp m W I Approximafe - d- ? Retoining Wall Locotion B O O ' I S88°40 S6' E 7a. o0 ? T O izi ? N Y o 7.oo 4 Q V' ? - - J zo o I 2.00 ---? ' ? a sq L OT 10 I 9 ' 9?'94 --- 4000 2 + - - - 37 55 78. 0( L i oo) t o° ? 913.93 O I I - ? I I I ? O v + OF SURVEY I ? (927.70) I ? 921.47 . ? 971-0---1- - ---1oT8 ' 6.04% ? N I ? ? ? g N m 10.00 A I I ?.o ----? _? O I ? ? I ? O v 0) w m I O O ry I 91p? 10.009 ? ? ? 23. oo ' ^ U I ? ° Z A ---- - 3 N --- -- ?? - \ 909.6 I ?? y I \ ' ? I ? L- _ Top of /rons @ Offsets O 70.00' Offset 914.39 OB 10.00' Offset 912.96 O 10.00' Offset 913.82 DO 10.00' Offset 920.89 r-? ?, 4) ? L ? V L!... D --? Dxl?. (921 .20) ? I I f?" - 920.04 ? J w -I ---- I o ? A1?4 i ? RE I? IG I I 2 ? I p --- --? . i ---?!-Y-- PY _ _ I I Q I?nr? ?' ..? . ? . _ I I J I LEGAL DESCR/P710N: Lots 9& 10, Block 3, CL/FF LAKE SHORES, according to the plot thereof, Dokota County, Minnesota Top of Block = 922.8 Lowest Floor = 914.7 Garage Floor = 922.4 GRAPHIC SCALE ZQ 0 ,0 20 90 ( IN FEET ) 1 inch = 20 ft. 865.0 Denofes Sanitory Sewer Service /nvert 865.0 denotes existing elev. (865.0) denotes proposed e/ev. denotes surface drainoge • Denotes iron monument found o Denates iron monument set Beorings based on assumed da[um. l hereby cerfify that this survey was prepared by me or under my drrect supervision and that l am a t/uly Register d Lond Surveyor under the lows?o,?itheJStafe f n soto. / L'"Mortrn J. Wefier,l R.L.S. Oote Registrotion No. 12043 RcQUES7ED BY.- HOFFMAN HOMES /NC. w Wesfwood Professional Services, Inc 74180 West rrunk Hwy. 5 Eden Prairie, MN 55344 (srz) 937-5150 Revrsed: 9130196 Add Elevations Drown by MS Dote: 9125196 Job No: 95198 Lots3&10, Block3 B3L09-70.DWG PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA130970 Date Issued:05/26/2015 Permit Category:ePermit Site Address: 4476 Lakeshore Ter Lot:10 Block: 03 Addition: Cliff Lake Shores PID:10-17785-03-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mary K Borrell 4476 Lakeshore Ter Eagan MN 55122--247 Haley Comfort Systems 122 3rd St W Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA132718 Date Issued:09/01/2015 Permit Category:ePermit Site Address: 4476 Lakeshore Ter Lot:10 Block: 03 Addition: Cliff Lake Shores PID:10-17785-03-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mary K Borrell 4476 Lakeshore Ter Eagan MN 55122--247 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA132941 Date Issued:09/14/2015 Permit Category:ePermit Site Address: 4476 Lakeshore Ter Lot:10 Block: 03 Addition: Cliff Lake Shores PID:10-17785-03-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mary K Borrell 4476 Lakeshore Ter Eagan MN 55122--247 (651) 686-7204 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r-----------------� I For Office Use � ' � Permit#: � �� j C��J �� "�"� I Perrnit Fee: �J � � 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION . Date: �L �� S Site Address: ��C ��`��'°'�� Unit#: � �mName: . V�l f'Y��,.., u_u�L.�_nw,�p.�..�Gi/� �.�.�.�.,,.,w�,.m�,�,r�.......��.. Phone:v,,,,.�, �_...�.�.�,��.,� G S � ��c��r ; � _ � Address/Cit /Zi ��`�"�"� ` � L��er Y p� � � Applicant is: Owner Contractor ��.�,�.�..��,....a�� .��,��.�� .�.��d.�.��..��.�_��.�.� -.�....�.�.�� Description of work: � Ty�p+� C��f 1��rk Construction Cost: Multi-Family Building: (Yes /No� �.w.K � ,�,_.. � �..�.,�.�.....�.�..�,y�.�...�.,..�, ..w,.�...�� Company: JLt/lt� (�V[�U'� L.�1�.G�o J� �hc. Contact: /�`l,f 7-`� ��. ��--- � � � � � f r/a�'_ `y/1.0 C�?t1�#PaC�O� .� Address: JSab U'G�;J bu�� /J � Sul � �1/ City: �i � State:�Zip: �Sy�t� Phone: '7�3-5.��-vn''�� Email: �� av�;J;��in,c��Yl t /� � License#: /-�C �� .3 Lead Certificate#: �...,�.,�a�,._.n�....w,,.,..� ,..��„_,�._ _�_�..,�a��,�..�.,�,�..��.�.,_w.�..�.,,�..�„A ,,....,��.._�,.,�.�.�,�.�,�.�.,.,�,�.,�...a.,�....��..�...,..�_ ,,�,. ¢ 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? � � Yes No If yes,date and address of master plan: � Licensed Plumber: Phone: � Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: � 1�1�TE:P��s a�►d s�r�c��g c�o�u�era#s t��yo�r�w�.��e ca�ts�d��ed�o#e p�bl�ira�r�'�. Pr�n�o�' ' �r�ln�or�a��ay�e cla�si�ed a�nan p��btac i��ro��l�e�ec�reaso�i�aa��vo��1 psr�t�:.C3�y t�o � cor�cl��le�i�t t�e a�e��le s�c��f�. � CALL BEFORE YOU DIG. Call Gopher State One Cafl at{651 j 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.4opherstateonecall.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 Code must be completed within 180 days of permit issuance. ,/ "�-�--•.---_._ x �(.t�f rYr.(c��o`�� x Applicant's Printed Name Appli s Sign ture Page 1 of 3 Use BLUE or BLACK Ink - � r-----------------, I For Office Use � . � �� C��T7 0� n�� Permit#: � i � 11 � ��P,�� i � 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 PERMIT APPLICATION S'.fi z Z ��l7(�`�1�17� � � .I, � N Unit#: Date: � � �S �f� Site Address: � �� °d� ��a � � �� Name: t✓1/!"�.0 ��%��, �f'��'.�..,�.�.� e,., ,�..�_»w..o� Phone: ,�....�.�...�..W„�,...�,�.._d..�.�.�� 1�IT�� AddresslCity/Zip: ��7�'` w�7� ��j.�-ooL �-ci�s��cc� � C�--, �;J .�.s/2� , Applicant is: Owner Contractor ��.�� Description of work: J��r i� T�e afi i�Jv�i� ,J � Construction Cost: /ryl �' �� Multi-Family Building: (Yes /No� � �� Company: .,......,�.n�.�x v�-( ��'h%r�r�oy-�...�m..�.�Contact: ��5 ��°� ka.,�, .�,�.�..� �fx r J ,LL)7r. � �� ? r� � � �'��,t //or�� . � � Address: J5� VjG�S�,�� G� � �u 3S/ City: ��'/z%�7.�7h � COi!'��1'�C'�i01' ; � (�i1��,�(�3..I G� � � State:�Zip: �Sy�� Phone:��3�'.SS6-Q��13 Email: �'�1"c� �uG��r,rr�� ' � License# ��v � �7 /� Lead Certificate#: ....�.�,.��,�,......�_.,�,.�.,�..�.w.,s�...�,_..�..,,,�,.._��,��,.,,�...�_,.�,.,rt,.,�.,�,�,...��-�.�.�,��..�.�,.�...,.�..�.,�.,s�,_�.��._...�..�..,�.�_,..�,�..�� M�,.�....w,� �� 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? a � 3 Yes No If yes, date and address of master plan: � � Licensed Plumber: Phone: � � Mechanical Contractor: Phone: � � Sewer&Water Contractor: Phone: � � Fire Suppression Contractor: Phone: �l��T�:F��s arr�d sct��a�i�g d�acu��erats tfiat,�ou�w#�#�re co�s�F€.�'�d t�be p�r�i�r��. l�r�s c�' t�e kr�'�r�ra�o�rr�ay be cl�assi�ed as�t�n p�b�c ��ro�le;speci�c rea�►�s�lha�t�Fa�fr�p�rr��t f�r�G�+�a � cor��de t�� are t�^ade s�c�. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 e uilding Code must be completed within 180 days of permit issuance. x L.��S �Y�jG�,� X �— ApplicanYs Printed Name App c s Si ature Page 1 of 3