4492 Lakeshore TerIN
C . CITY OF EAGAN
3830 Pilot Knob Road
, Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: E r`" ?' ' f
! i•+ 1:?F ?:.Mtl)kF' i 1 f?
I At £ 3N
PERMIT SUBTYPE:
;; .•.
TYPE OF WORK:
1,; ,s 1; I t t a isli
M F IJ
<<r R If I.0 t 1 rxE ?
INS
C
ON
PE
Ti DA • .•
r l? ,?I1 11 i l i?l? I I! i i'k r:? I
CCORD
PERMIT TYPE:
Permrt Number:
Date Issued:
K!1 i I it 1 M(3
G!.'ri q:if,
ou lo f I'Q(-,
"" ."' ,. ? APPLICANT:
:s.,; : ,;-o; ri !l?i•t , I f+?t
t f, I' 1 it?tq •?;iklJ
i R E M l# R M?.) r'i 6 !d P (. B ft - 44F IM J f L P 1 , 60
t.
Parmit No. Permit Holder Date Telephone 1!
ELECTRIC $ joc? .t
PLUMBING o y?? -
HVAC Sag q4p Po?5 G47
Inspection a Insp. Comments
FOOTI NGS
i/
SGv, L
FOUND ? IQG
/ ?
FAAMING M8
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARb
6
FIREPLACE f?y
FIREPLACE
AIR TEST
FINAL PLBG f2v
FINAL HTG
ORSAT
TEST
BIDG FINAL
BSMT R.I.
BSMT F)NAL
OECK FfG
pECK FINAL
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: .+t; t r>> mi3 ,
3830 Pilot Knob Road Permit Number:
C Eagan, Minnesota 55122-1897 Date Issued:
, (612) 681-4675
' SITE ADDRESS: APPLICANT:
'PERMIT SUBTYPE:
RtNtC;H t N
TYPE OF WORK:
f'ltdAi
PermR No. Permk Holder Date Telephone #
ELECTRIC
PLUMBfNG
HVAC
Inspection Date Insp. Cotnments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR 7EST •? ??
FINAL PLBG
FINAL HTG
ORSAT
TEST
6LDG FINAL
BSMT R.I.
eSMT FINAL
DECK FfG
DECK FINAL
I
?
INS]
CITY QF EAGAN
? 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
, .1 :1 •..' 1 Af l..11,)I i. P_
? C I. E `: t 7 AP 1 ?47 HOR`^ GI .
PERMIT SUBT1fPE:
. i-1i:.
t
TYPE OF WORK:
#'1i ?; 4;k ff''f 1 0 hi
c; I I r i a i: rs
W?3 nHh.
o n 1(h7/ij
N F t-i
f 7Eftn t??i i t 1 NFI
INSPECTION rA • .A
t t•1'.141 S 3 ?t1! { I }+; , 1
y?llt"#i I PJ 4'3 1:;,
?1-4 hI
1 1 s MI A It if S; S: & W P Ifi R-- t.l t 13 7 iL P? R!
?
N
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
r1.t.?? 8 44 -- 9 k Hr
Permit No. Permit Holder Date Telephone N
EIECTRIC 341AJ? ? cw
PLUMBtNG
HvAC
Inspection insp. Comments
FOOTItJGS ?._/3?4
FOUND
t
FRAMING
ROOFiNG
ROUGH
P UMBING
r/
j ? ? .:7? ? • ? ?n
PLBG
AIR TEST ? `--
ROUGH
HEATING
0- 9
GAS SVC
TEST
INSUL
t
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT F1NAL
I
DECK FTG
DECK FINAL
Wei.?trficate nf Cccupanc4
61MV of Cfagan
Tc.offtwcut of lorili* 3u4#ecti0a _ • -?
Tltis Certicateissued pursuant to the reqnerements of the Uniforrn Buildireg Code
certifying that at rhe tinee of issuancc tieis structure was in compliance with the variaus
ordinances of tfu City reguluting building construction or use. For the following:
usc c-ussir,n,;a,_ SF DwG awg. eem;t r,o. 28485
0-V-1yT"C R-3 U-1 y*WoE Diswic R-3 Tyrm conu. VN
OmwofB,,;id;,,g HOFFMAN AOMES Ad&rms 2214 E 117TH ST., BUENSVILLS, MAl
8??Ming Addmn 4494 LARESHORE TER [Acw;ry Ll, B3, :;L1FF LAKE SHORES
/ Dow ?
suum" offic;ld '
POST IN A 0ONSPFCl10US PLACE
.* . • *
u " 4r 1 4 i 0 P' t ?. '?)
?f_? 1- ; •(?' .
Werdticate of cccupaitc?
W" of Cfagan
zevartmear of 13xitb* 3*60ectiori
Tiiis Cenificate issued pursuant to the requirements of the Uniform Building Code
certefying thaa at the tinu of issuanct this srrWCtare was in compliance with rhe various
osdinances of the City regulating building construclion or use. For the following:
?clusif"Mfim SF DWG Bwg_ Pe,,,,;, Na. 28486
O-Uw-yT?W R-3 U-1 yoWng phmw pD Type Const. VN
ow,aota„aa;eg HOFFlfAN RO!!ES 1NC nadnm 2214 E 117TR ST.. BURNSVILLE, MN
ei,; - 4492 LAKESHORE TERR L,.wky L2, B3, CL FF I.AKE SHORES
EWe-
nding ?POST IN A CONSPICUOUS PLACE
1y'I? III iREQUEST FOR ELECTRICAL INSPECTION
In ?III IIJ? II I I(I I II ? II II) ? I II I II Minnesota State Board of Electricity
11 III 1821 University Ave., Rm. S-1 8, St Paul, MN 55704.
? g?(p ? ??•
* 0 3 3 6 4 4 2 9* Phone (612) 642-0e00
Home Duplex Apt. Bidg. Other: ew Addn
ommercial Industrial Farm Remod Re air
Air Cond. Hfg Equip. Wafer Hfr. Lood Mgmf. iher:
D er Range Elec Heat Tem . Service
"X" above Mre work covered by this requesG En}er remarks in this space and on the back of the while mpy only.
2&S'-30 2-50 ISC7J-
Colculate Inspechon Fee - This Inspeciion Reques/ will not be ocrepted withoui ihe correci (ee:
Olher Fee ? $ervice EMmnce Sae Fee S CircuiTs/Feeders Fee
Mobile Home Purk Sfall 0 to 200 Amps 0 to 100 Amps
S}reei Lig./Traffic Sig. Above 200 Am Amps
Enso
TransformedGenerator ,
INSPECTOR'SUS v Ly'1?
? TOTAL
Sign/Ou}line Ltg. Xfmr. L?
„r•^'
Alortn/Remote Confrol
$wimming Pool I hercb c. i ai I ins eckd the eleanml insmllat herein on the dates s t
Irrigation Boom Rovgh.ln
Special Ins
edion ?f
p
Inveshgafive Fee Final
THIS INSTALLATION MAY BE OROERED DISCONNECTED OT COMPLETED WITHIN 18 MONTHS.
3 J?° 4 4 2? Q?C USE OIJLV This re est vo I8 m nPos fmm vaLda?ion dota pnnled in M?s 6ox Q
5/
?
?
PL'EASE PRINT OR TYPE 7-7
Rpuest Dob Rovgh-in InspMion reqm ? N. Inspemmm O?her Than Roagh-In ? Ready Now Coll
? ? (You mux? m11 the mspecbr whe rcaz te Aead
I, Ef-49ensed contmdor ? owner hereby request inspedion of fhe above el rical wo QO
Job Address (Sireef, 8oe, RoWe No ) Gp ? C
.
Sedion Na Tawnship Nome or No, Ranga N. Fra N. Caunp
Occ?pont Phone No
Powsr Supplier Address
'
Eletln (Conhaclar iCompany Name)
at.? Conrcador ' nse N.
C°.A Moakr 4c No. jPlam Elect Only)
Moiling Pddmaa (Conhodor or/Oymer PeAormi
zed SignaNm (Conhocror or O+.ner PeAorming Immllafian) Phone No.
Ee-00001 10 6195 STATEBOAflO V-SEEINSTPUCTIONSONBRCKOFYELLOWCOPV
?IIIII ?I I II II II IIIII III I) REQUESI FOR ELECTRICAL INSPECTION il Minnesota Slate 8oard of Electricity
1821 Universiry Ave., Rm. S-1j?8, SAPa? , MN 55104 ??
0 3 3 6 4 4 3 7? Phone (612) 642-0800 o?K9 0?0
Nome Duplex Apf. Bldg. Other: New Addn
ommercial Industriai Parm Remod Re air
Av Cond. Htg. Equip. Wafer Hfr. Lood Mgmt. Other:
D er Ran e Elec Hedt Tem . Service
'R" above ihe worV: covered by ihis requesf Enfer remarks in this space and on the back of fhe white copy only.
s?r-
Calculate Inspectian Fee - This Inspection Requesf will noi be occepted without fhe mrrecf fee-
OHier Fee # Service EMrance Size Fee # Circuils/Feeders Fee
Mo6ile Home Pork $fall 0 l0 200 Amps 0 to 700 Amps
Sfree} L}g./TraHic Sig. Above 200 Amps Above 700 Amps
Tronsformer/Generator INSPECTOH'SUSEONLY TOTA
$ign/OWline Lig. Xfmr. O?? 7.
Alarm/RemofeCon}roI :+;?o?-? Mybt
Swimming Pool
I hereb mrh thaf the e tlnml inabll described herem on ihe dote:ela
Irrigahon Boom Rough-In
S
eciallnspedion
p
Inves}igahve Fee hr.1
THIS INSTALLATION MAY BE ORDERED fd108Q$ED OT F?.Wt 5.
33 6 - 4 4 3 IT
1
PLEASE PRINT OR TVPE OFFI USE ON Y This request veid 18 m:Nhz from .aLdotmn dak pnnted m lfus bo ?
??-g?9
? dv
3
Requnl ak p.q?gh-m mspecrvon reqwred Yes ? N.
?Yo? mus? coll Ihe inspMOr when ody) Inspecnon Other Thon Rouqh-In 0 keady Naw dl Ca?l
Dok Reody.
I, 'censed coniractor ? owner hereby requesf inspection o( fhe above electncal work ut:
)ob 04'ess (Street, Bav, or R No. Ciq
L
' Zip Code
b r
Sernan No. Towns i ame or No Raige N. Fire No Co np
Ocwpanl Phone No.
Power 5 Address
Eled' I onhacror (Campany Nome)
` Con nor Lice ? No. Mmkr lic No. (Plam Elect Only)
1 I?Pddress (Conhamr or er PeAarming Inaklianon)
P?Ah cd SigmNrc (Conhatl1`or or?Owna Pe/?homurg Insmllonon?
JQw V o`?-?/l Phone No
EB-010OOlA-10 95 STpTEBOARDC?Y-SEEINSTAUCTIONSONBACKOFYELLOWCOPV
?i/b 2D06 RESIDENTIAL BITIIIDIlVG PERMIT APPLICATION
? ? City Of Eagaa
3830 Pilot Knob Road, Eagan MN 55122
TeIephone # 651-675-5675 FAX # 651-675-5694 '
New Construction Reaumrtents RemetleUReoeir Reomrm+en6 Office llse Onlv
3 ra3istered sde surveys shovring sq. ft af IoL sq. R of hause; and all roofetl areas 2 wpies af plan shawmg iacbngs, baems, jasts Cert of Survey RecC Y N
(20% maximum lot coverage aiovretl) t set of Energy Calalatlana fa haated atltlitlons Tree Pras Plan Recd Y N
2 copes of plan shovnng 6eam 6 wmOav srzes; poured found desgn, etc 1 site survey for addibans & tledcs Tree Pres Raquved Y N
7 set of Enugy Caldtlatlons Addilion - m*cate rf onsde sep6c system On•site Sep6c System _ Y N
3 copies of Tree P'eservehan Plan if bt Platted aftg 7l1M
Pom Jast Detaii Opbons sekNOn sheet (biddngs wdh 3 ar fess mifs)
Minnegazco mechenical venulatioa form
Date /0 l 0?(l 00? Constzuction Cost N?7 DO SiteAddress UnibSte
ss?a
Descnption of Work
Mniti-Family Bldg _Y? _ N Fireplace(s) _ 0_ 1_ 2
Property Owner
Covtractor
Address
Sta[e \
City
Zip Te(epnone
? -
CaMPLE7E T3-11S Ai2EA ONLY iF ZaNSTRL3C77MG A NE'1V BL3ILDING
Energy Code Category 'r Minnesota Rules 7670 Cate2orv 1 _ Minnesota Rules 7672
(J subrrnssion type) • Resitlential Ventilatron Category 1 Worksheet • New Energy Code Worksheet
Suhmitted Suhmilted
• Enargy Ernelape Calculatlons Suhmiitatl
In ihe last 12 monThs, has the Cify of Eagan issued a pertnit 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
Telephone #(
Telephone #( J
Telephone # (
I hereby apply for a Residential Building Permit and aclrnowledge 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 th case of work which requires a review and
approval ofplans.
G
91 Applican 's Printed Name Applicant' Sign?ture
RESIDENTIAL
BUILDINC PERMIT APPLICATION
cirr oF encaiu
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Constructlon Reouiremenb RemodellReoair Reauirements
• 3 registered site surveys showing sq. fi. of lot, sq. ft of houu; and all rppfetl areas • 2 copies of plan
(20%maxunum lot cove2ge allowed) . 1 set of Energy Calculations far heated adtliGons
. 2 copies of plan showug beam & wiMow s¢es, poured found desgn, etc.) . 1 site survey for extenor addBions & decks
• 1 set of Ertergy Calculatans . Indicate rf home served by se0tic system for additians
. 3 copies of 7ree Preservatbn Plan il lot platted after 7/1193
. Rim Jotst Detail Options selection sheet (bldgs wifh 3 or less unAS)
DATE ??w 'I e?102
SITE ADDRESS
TYPE OF
APPLICANT
v- ut/1 cc Gase'l%a; e .
STREETADDRE55 ?KS (,?ra1. NLf/Y4 13 CITY I"O.Sd / STATE/'UZIP
TELEPHONE 051-NO-056 CELL PHONE # fAX #
COMPLETE THIS SECTION FOR wNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'1'A RUI.FS 767U CA'1'EGORY l _ MI ftJ6?
(J submission type) • Residential VentllaGon Category 1 Worksheet Submitted 2 5IV8get
• Energy Envelope Calculations Su6mitted
Plumbing Conhaetor: _ Phone #
Plumbing system includes: _ Water So$ener _ Lawn Sprinkler
Water Heater ? No. of R.I. Baths
No. of Baths
Mechanical Contractor. Ae PL 1-(7( O67?r Gi Ar Phone #
Mcchanical syslem includcs: _ Air Conditioning
Hcat Recovery System
Sewer/Water Contractor:
VALUATION ? 9 nOn .
MULTI-FAMILY BLDG _Y N
(Q fIREPLACE(S) _ 0 i!1 _ 2
Phone #
SS.3317
Fee: $90.00
95? -?U-O7s 8
P'ee: $70.00
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 Statutes and City of Eagan Ordin ces. n
Signature of Applicanf ?,/ ` ?/^ l??T_
------- _------- _.___----- -_. .... ..__..... °.......... __..____------------------- __-------- __--------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement •Demolition (Entire Bldg only) - Giva PCA handout to applicant
Valuation Occupancy MCIES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footmgs (deck) FinaUNo C.O.
_ Footings (addition) _ Plutnbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final Windows (new/replacement)
_ Insularion _
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8, Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total
' .. LOT SURVEY CHECKLIST FOR RESIDEiJTIAL
UILDING PERMIT A PLICATION
PftOPERTY LEGAL: +"?
?
: ?7L
DATE OF SURVEY"
' LATEST REVISION:
DOCUMENT STANDARDS
< z ?
?? ? • Registered Land Surveyor signature and campany
M-?-o ? • Building Permit Applicant
2?'? O • Legal description
a • Address
?? ? • North arrow and scale
9-'13 ? • House type (rambler, walkout, split w/o, spl'd entry, lookout, etc.)
C-i--'o ? • Directional drainage arrows with siope/gredient %
G-IC3 ? • Proposed/e)dsting sewer and water services 8 invert elevation
2-'13 ? • Street name
2-'13 ? • Driveway
ELEVATIONS
Ebstina
ey"cl ? • Sewer service (or Proposed)
Er'ci ? 0 Property comers
e--,o ? • Top of curb at tfie driveway
P--13 ? • Elevadons of any exasting adjacent homes
Praoosed
CY'D ? • Garage floor
cr'o ? • Frst floor
Zr? ? ? • Lowest exposed elevation (walkaut/window)
P-- ? ? • Property comers
tY ? ? • Front and rear of home atihe foundation
PONDING AREA fif aoolicable)
? H' ? • Easement line
? d ? • NwL
? d ? • HWL
? CT" ? • Pond # designation
? 9- ? 9 Emergency Overflow Elevation
DIMENSIONS
Ia- ? ? • Lot lineslBearings & dimensions
?Y ? ? • Right-of-way and street width (to back of curb)
jY ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
cr- ? ? • Show all easements of record and any Ciry utiidies within those easements
r3' ? ? • Setbacks of proposed structure and sideyard setback of adjacent ebsGng structures
? 6?- ? • Retaining wall requiremenA if any
Reviewed: -? -
TA ?
January 1996
CRAIG19G8r8LDGPRMT.FM
? ,.
. ?N?
HOFPMAN HOMES, INC.
2214 East 117th Street
Telephone Burnsvil(e, MN 55337
(612) 894-9807
Fax CONTRACTOR 1t 9284
(612) 894-9878
1-(3„ IR ?
Mc 7oe Voels
City of Eagan
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) I e7- , Block _3, Cliff Lake Shores, as were used on
Lot(s) I t, ", Block y , Cliff Lake Shores. None of the structural building
components, HVAC, plumbing or electrical will change from engineered drawings dated
IPil L?yCJ
PCHfjem
pcwceglo-
YatncK (;. HOYttriatl
President
?i
???????.
CITY OF [:'AGAN
.i i1=1iMSNAI_ NOr. 95
PATEv 08/07t96 ?IME.: t4:58:34
rri ;
NAMN=:: I-IOf=FMAN HOMES INr
2256 9001 4494 L.A}.f SFIORE 4y49c?.38
2256 9001 4492 I..AKFSHOfiE 4,432.38
To+,a1 FecAiGr Amoun+,: 0y984.76
rR[7C,i:t714
l.U^f:.:F; TDa NRNCY
Y??k?k?F?K ?k:?F?kMA? %c%c %? ?k ? a? # # kCYF*YF ?kc?k?NC?k??K?K ?X ? ?K?kX? %??k ?
? PERMIT 0-AL0 67-17 l4/
-CITY OF EAGAN
3830 Pilot Knol3 Road' PERMIT TYPE: B u z Lo zNe `
Eagan, Minnesota 55122-1897 Perm it Number: 0 2 8 4 8 5
(612) 681-4675 Date Issued: 6 g/ 0 7/ 9 6
SITE ADDRESS:
4494 LAKESHORE TER
LOT: 1 BLpCK: 3
CIIFF LAKE SHORES
P.I.N.s 10-17785-010-03
DESCRIPTION:
Anz'. (ZEftO LOT LINE)
Au9lkd1pvj,?Perm3t Type SF DWG
Soidl`.L1,€14104.?tk Type NEW '
C} ?? t7}`b a I1 C;W? R- 3 U-1
-? e V-N
A(l
,
jdir?gr
3$
w3dth
° dI??q
4
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ss
1
?rrg?e??,br??&.:?
il
102 1 - FAM. ATTACH
er I ,?,P`
?esie P„ ?rca ;i?s td?°t?€5'
4P
!i .iF? w?'(?'
"ai'Sla¢°er
+??.
F 71
REMARKS:
5& W PLBR - WENZEL PlB6
, FEE SUMMARY:
Base Fee
Plan Review
5urcharge
SRC
5AC ?
SAC Units
Subtotal
VALUATION
$1,@67.25
$533.63
$68.00
$900.00
100
1
$2,568.88
$136,000
MTSCELLANEOUS $1,923.50
Total Fee $4,492.38
CONTRACTOR: - Applicant -- 5T. Lzc.OWNER:
HOFFMAN HOMES ZNC 18949807 0009284 HOFFMAN HOMES SNC
2214 E 117TM 5T 2214 E 117TH ST
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 894-9807 (612)894-9807
t _ I Eter-eby av ft140
C?_'t:
. " :x,•r i Y . ' ' _
ha?qr resd` -th10 'a;p?13.c a??.On aYJd s?at? thd?,ath? : tr
?9??e trr a?mP??r t;a,p.plie4br`stat4s 8? Mr?
arr???
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t _ . ?.
?
--?I EDBY IG TUF"
?y z q Jg
CITY OF EAGAN 44 4
3830 PILOT KNOB RD - 55122 , 4 J D
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
!1466 681-4675
? 3 registered site surveys ? 2 copies of plan
? 2 copies o( plans (indude beam 8 wind(yw sizes; poured fnd. design; ete.) O 2 site surveys (exterior additions 8 decks)
? t energy calculallons ? 1 energy calculations for heated additions
? 3 copies of tree preaervation ptan if tot plaNed atler 717193
required: _ Yes l No DATE: 7- 130 15 v CONSTRUCTION COST:
DESCRIPTION OF WORK: 'R ES?DE?-C;A?. 1o..?,aNov?E
STREET ADDRESS: a 49 i -ferzs-AC.E
LOT l BLOCK 3 SUBD./P.I.D.#: lO' t'}$`''014-03`
I 1uvG?x L07- -Z 3-? 'LVkA(- +.iKKsr swd&s
PROPERTY Name: i4oFFma.a ?-1CIrces ??-•
OWNER " """
Street Address• u"k e-
City: State: ?n?
CoNTRACTOR Company: >ANe '
5treet Address:
City: State: _
ARCHITECT/ Company: M 4.,)-1Ctn?4n
ENGINEER
Name: Lyt-c
Phone #: g`?`t-`S$°-A
Zip; 5533-'t
Phone #:
License #: 4Zgj
Zip:
Phone #: 93`t- 7t`?p
Registration
Street Address• go W- SKoie-r 5.., re -*zt o
Cilty:
C r?pJ NA-.66.J
State: Mli Zip:553n-
Sewer 8 water licensed plumber: '^)EL..+2.F-,. Kc..ca? A.??GACIi Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this appiication and state that the inform ion,i's ' orrect and agree to comply with all
appiicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applicant:
OFFICE USE ONLY
Certificates af Survey Received
Tree PreservaGon Pian Received
?
_ zy.. No
_ Yes _ No
RECEWED
3 9 5996
? --
BUILDING PERMIT TYPE
OFFICE USE ONLY
ao ? ^ A • t '?
?'• ? an
- .• ? ? t•
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0?'102 SF Dwelling o 07 4-plex ? 12 Muiti Repair/Rem. ? 17 Swim Pool
0
? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
a 05 SF Misc. 0 10 _-plex a 1
c"
WORK'7YPEw
• ?
7
' 31' New `-
0""
-a- 33-ARe s
?
6- ove
,
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) -14 Basement sq. ft. C? Cn MCIWS System ?
(Allowahle) Vr-N Main level sq. ft. ?'1-2 City Water
UBC Occupancy TZ- u / sq. ft. Fire Sprinkiered
Zoning /1-L)_ sq. ft. PRV
# of Stories 6r?r- sq. ft. Booster Pump
Length Z?6 sq. ft. Census Code. 10z
Depth _
la(? Footprint sq. ft. SAC Code
Census Bldg
Census Unit /
APPROVALS
Planning
Building
Engineering
Variance
Permit Fee Valuation:
Surcharge
Plan Review .. .
License
MCNVS 5AC
` City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
' SNV 5urcharge /
Treatment PI. ? `?
Road Unit
Park Ded.
Traiis Ded.
Other
Copies
Total:
g 0,00
v
L 01(. , . l,
b?1
Lv
6 0 C/
S?
qvC !'
% SAC
• SAC Unfts
lu:l? E129344305 ' --
I•1INNETONI<A UESIGN FAC,E ?; • EX7ER.IQR EfIVELOPE AVERAGC "t!" COM. . F'lITA.'f.10N
-- _ _ . ........ ....... .
.
.
NER;?___•_W- _?.._... __? nnrr: `i-13??5 I
$I7E ADDRESS: PHONE:
CON7RACTOR:_tto1r-mAN ?1or??s PIAN
Determine working square footage of each
1. Total exposed wall area...., sq. ft, x.11 = ZD?X,OZ?
2. Total roof/ceiling area..... 102.(,p sq, ft. x .026 =
Total exposed wall area above,f}oor=!??,'?
a.
b.? " Total
Total wall window area ....................
door
e
????????? " '" ?? 3
`
C. Total ar
a..
sliding glass door area., '.... . .....................
..... ?7,1
d. Total fireplace wall area
.........................••••
e.
f Total
T ...............
wal] framin area . .. .... . . . . . " """ " " '
?a?er.age 10") .......... ...........
. otal .....
rim ,?oisfi area,,
,
9- net .
walt area a6ove floor, ..•••..........?............••••-'
h. ? .........................
wall ..... . .....
area d6ove flcor
?• .
. ... . . " '. " " "
wa11 area a6ove floor
.
j. ..
.
frame wdll area at foundatian ...................................
Total exposed founddtion area= '?620C::?
k, Tota1 foundaCion window area,
l.
Total ,,,,,,,,,,,,,,,,,
net foundation area above grade .............._?
Oetermine "u" value of each wall segment
(e.g, window, door, each separate wall section)
x „U"
? b. 1-1 X „ u„ (jo 9q
C_ X „u„
• d. X Oull
e._ \31?Co1 x llu,t ,p? '= 12
3g •
_,
f. I?O?, lS x.,u„?,?` = CPI
Us ?
'
?
s. X „u„ ?F`?
?
h. X 4jUll _ ?
I
;. ? X „U,1 - ?
i
, • A V Ilull ^ ' S
k, X„U„ If item #3 is the sa;
u as, ar less than ite%
-1.? X U
???(p = s
? #1, you have met the!
i
t
_
, n
ent of SBC 6006
. ....... ..... ..................... Total
--------
___ -
3
?.
i;
10:13 6129344305
MINNETONKA DESIGIJ
PAGE 08
tOTAL EXPDSlO RAQP
??? ? ? 1na w.cuw?riars i .
?' . Total,exposed roof/ul l Int
.t araa. ...... , 2 •
J) Totai Sky)I ?9 ?t
yht area....... •
k) 7otat roo(/caf 1 ing /raniqy . SQ ?t x?• ?
?---?
- ares (Avaraaa lA7t)...... ? Z Y4 ?'t x•?U,rJZ?- .
Tota1 nat lnsuTated • ~ 3 ?
• ' -'--------
; roof/ceillnq area....... ??(p?S '
y ? s4 ft x?,0??»
If tot?l oF st 707AL J) thru 1) 23??(p .
Z%CAA 1.16048 A the same as, or 1e5: than h, you ard 0. have MCC th
, e intanC of
•' • .
, ACTERNA7'E BUILOIHG ENVELOPE pESlCN
To utTllxa th? tot?l envnlcpa syxt? ?thod, •the values esca6)•12hed bY thq sum
°f lta^s ?3 and 14 :ha • .
1) net•6a 9raater thdn iha suro'cf tte.s eP)
2- ' .
3. M
?.
. . • .
? ' • .
. ,
.
I
I
j
li
F_- . .
10:13 6129344305 t•IINNETONKp DESIGN
* LINEAL FEET EXPpSED YAGL
BLOCK : 1cp? ? ?
KNEE:
WALKOUT: 3? %
FULL 1: 10 ??s
FUGL 2:
FIREPLACE:
RIM: `(D?, Irj
SQDABE FEET EXpOSEO iTALL ABEA,
BLOCK x .5
KNEE: X S ?
WALKOUTt x 8 a 30`?
FULL 1: ?(0'?, ? a x 8=
FUL(. 2: 8 ?
x
FIREPLACE:
X a
?-l I,c
h • I( o
'
YM. v - x 1. +• ?CD7 ?S
A
SQUARE FEET ERPOSED CEILING IC9Z(pt
WINDOWS: 12--7i3t- DOORS: 3717?
2(?4Cp ?Ht' 11 Sq ,5?
2L1?3{,Q } ???-'Z PATIO DQORS:
?o ? I I II 2? q2
305 0 ? M? g? SASEMENT UNITS:
2Lv40 1 l 1? ??3
?0 SID?LIG?tI? 1? ?"? SKYLIGHTS:
IZy.3
FAGE 09
. . ? ?N?
HOFPMAN HOMES, INC.
2274 Enst 117th Street
Telephone (3urnsvi(!e, MN 55337
(612) 894-9807
Fax CONTILICTOR # 9289
(612) 894-9878
i-j3o (q?
Mr. Joe Voels
City ofEagan
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) I e 7- , Btock 3, Cliff Lake Shores, as were used on
Lot(s) 1 ,
4" Block 'L, Cliff Lake Shores. None of the structural building
components, HVAC, plumbing or electrical will change from engineered drawings dated
io(,? (55r
PCH/jem
pchfeaglv
Yatnck U. Hottman
President
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
euxLozNS- l
028486
08/07/96
SITE ADDRESS:
P.I.N.: 10-17785-020-03
DESCRIPTION:
h"
38
a, 66
X
102 1 - FAM. ATTACH
ffir ? `sa
T?^.3? IV.s
REMARKS:
S& W PLBR - WENZEL PLBG
FEE SUMMARY:
8ase Fee
Plan Review
Surcharge
SAC
SAC $
SAC Units
Subtotal
4492 LAKESHORE TER
LOT: 2 BLOCK: 3
CLIFF LAKE 5HORES
(ZERO LOT LINE)
ermit Type SF DWG
?k Type NEW
R-3 U-1
Q V-N
PD
VALURTION
$1,667.25
$533.63
$68.00
$900.00
100
$2,568.88
4,P
??a'=??s? ?M•?, ,g.?` a?`?;0 ei?Mi?u A?"siud.'§ ?a?$?$? a`_„?
"W1
Z c,??x utn -1 iL?
?
$136,000
MISCEI.LANEOUS $1,923.50
Total Fee $4,492.3$
CONTRACTOR: - Appiicant - sT. LIC.OWNER:
HOFFMAN WOMES INC 15949807 0009284 HOFFMAN HOMES INC
2214 E 117TH ST 2214 E 117TH ST
BURNSVILLE MN 55337 BURNSVILI.E MN 55337
(612) 894-9807 (612)894-9807
L. ili G 1 Y••l' 6+ A ? T ?FI µ . - , k' 1..F '
i he?r;?h?+ ?;???t]?auz'???cCge tF?? I hai7e th?s ?a?p?aa'Vian arnd?-stWtA, ?'t?h aGh-o -
< xYi`?or-ri?a^G3ts?a,?'?e ?si€npiy ia??.t?1r..?1? ap?i?:catkls `.??a?.a,
S't8tUt$R+'
i
a v,. ? r s u, 3
P LICAN MITEESIGNATURE ? ISUEDB?SIG,ATURL?-[?
- CITY OF EAGAN
? 1996 BUILDING PERM T APPLBICATION (RESIDENTIAL) 4?1 4qj
•? ?
681-4675
)116
n
? 3 registered aite surveys , ? 2 copies of plan
? 2 copies of plans (include beam 8 window sizes; poured tnd. design: etc.) ? 2 site surveys (exterior additions S decks)
? 7 energy calculatlona 4 1 energy calculations tor healed additions
? 3 coples ot Uee preservation plan if lot platled aNer 7l1/93
required: _ Yes __L No l
OA7E: ?I-60 I4e
CONSTRUCTION COST:
DESCRfPTION OF WORK:
STREET ADDRESS:
{ZESt DE?.1-r? A ?. `1 ?.,.r?t{o?E
?t?t9'?' LAtieSNae? T?n.n,ac.?
LOT -I-- BLOCK 3 SUBD./P.I.D. #: 1O '?-*-t$5 -°3
c??FF LPK? S?a?S
b1-r,LC!?' Gr,r - /? /3 •3
?
PROPERTY Nam@: +?OrPrtA.?J N?K6S ?*'?• Phone #: $?`?'9$0?
OWNER ""'
Street Address, ZZ`'k 6' ? k }7??i 'i;-t ZtE,- City: 'a-h State: mP-? Zip: 5533?
CoN7w?croR Company: SAne ' Phone #:
Street Address: License #: 4Zg?
State:
ARCHITECT/ Company: M; uA-riewaich t7es%(V?
ENGINEER
Name: Ly4c
Zip:
Phone #:
Registration
StreetAddress• gO ti^'- 2$."+ sES""e-r S..t re -*? Ztp
City:
C H,d.) NA-6EJ
Sewer 8 water licensed plumber:
change are requested once permit is issued.
State: mli Zip: 953k1"
Penaity applies when address change and lot
I hereby acknowledge that I have read this application and state that th ' m on,is' correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
%
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes No
Tree Preservation Plan Received _ Yes _ No
OFFICE USE ONLY n,, ',sq ° , ' • . ,
.-•...
BUILDING PERMIT TYPE `
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
jw4-02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 5F Addition o OS 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 21 Miscellaneous
0 05 SF Msc.io 10 _-plex ? 15
WORK TYPE ???-O ? Gc7 T? G/?C
,?'31 New ? 33 Atterations ? 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) _9? A/ Basement sq. ft. /, (o/!o MC/WS System ?
(Allowable) :V-,4 Maii-i level sq. ft. ? 74/7 City Water
UBC Occupancy -i21/a.l sq. ft. Fire Sprinklered
Zoning F_ 6 sq. ft.. PRV
# of Stories / ArtsmY. sq. ft. Booster Pump
Length 38 sq. ft. Census Code. D Z
Depth 66 Footprint sq. ft. SAC Code d/
Census Bldg /
Census Unit /
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ , 3 000
Surcharge
Plan Review 2
License -
MCNVS SAC
- ? City SAC
Water Conn.
Water Meter
ACCt. Deposit
SIW Permit
S1V1f 5urcharge' ' C Treatment PI.
,V.,, Road Unit
? Parli Ded.
Trails Ded.
Other
. ,. ' Copies __ ?/?j/
U'
ToWI:
°k SAC
SAC Units
??**uy
C:C'1'Y C?F FF:UAt:
;:Atzf-I:I:ERs JS T'E'fiilrNAl_ N'?c 5:39
IiArs:,, 9.0/43/97 '1'?M 1.1•c59•:?'r,
v;
f4:? a
?'.4?iE:i HC11=(-MRN I-i0M1=Ei '_'NIC
,3?if3 e700''. 4494 I...AM;1=tiHCiiF .itl.Il;l
2255 3701 4494 LA`:F_fiSHni'i: Ci.f:afl
3430 '?CJCI:L 4494 I..AS;1=SliranW 5,(10
TO:q=. RF.',Cpj,p1; Ell?OUFit,., ;J;:i.','.TQ
rf:QB176'?
±.1'.irE:Tt `.[''u 1Flr!
,v,t%kx*X?* %K*.;:'i;m*1 ** "'?X* *•l,<.* >ka, 1 %k* >'/.M* >k>>f M?k;t:W 4 *ik
PERMIT
CITY-OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: suILozwG
Eagan, Minnesota 55122-1897 PermitNumber: 1)30914
(612) 681-4675 Date Issued: 10 / 0 3/ 9 7
SITE ADDRESS:
4494 LAKE5WORE TER
LOT: 1 BLOCK: 3
CLIFF LAKE SHORES
p.I.N.: 10-17785-010-03
DESCRIPTION:
?IYTp
nym
,rd;.-, ? x,. qva
??ermit Type FZREPLACE
9?77rt ?Type NEW
=>r`w,ri?i;;?°;'?ix`ii;e?,?:1?, 434 ALT. RESIDENTSAL
VVI'o
• ` t. h" ? I?F?+v _'&t¢?
'I_iSI'*d+:l:o-'j??f9 " :"a?'x"?'3I".J? •
? ? ? E4S:<???'g??g
?
N7?q1, e„ ??, q=-?rv?
:i.' x ,
?.?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search Fee
Total Fee
,
$5e.ee
$.50
$5.00
$55.5@
CONTRACTOR: - ppplicant - ST. LIC OWNER:
HQFFMAN HOMES INC 18949807 0009284 OAVSO50N IONE
2214 E 117TH S7 4494 LAKESHORE TER
BURNSVILLE MN 55337 EAGAN MN
(612) 894-9807 (612)686-8329
T' h?v##r)
SCstieatgsp a"nd:e CI,t ?oz,n. R ?Q.l m?
?
ISSUED : SI NA UFIE
CITY OF EAGAN
1997 FIREPLAC 681ERMIT APPLICATION
?' CQt,eicl I ?
DATE: /U PERMIT FEE: $50.50
DESCRIPTION OF WORK: ? CONSTRUCT NEW FIREPLACE ALTERATIONS TO EXISTING
_ INSTALL GAS INSERT ONLY
INSTALL GAS LINE ONLY
OTIiER:
STREET ADDRESS: / `7 U? dGOi'
LOT ( BLOCK 3 SUBD./P.I.D. #:
APPLICANT: (circle one only) OWNER CONTRACTOR
¢?-?
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 Minnesots Statutes and City of Eagan Ordinances.
?2 Ve^ g325
PROPERTY Name: ?L-Q /L?_ Phone #:
OWNER
Signature:
??
Street Address:
-
City: (? ?w State: Zip: 2a
FIREPLACE Company: 0 P-'?Q- ?l ?vWS phone #: 7
INSTALLER
Signature: -kLLZ?
Sveet Address: zZ I`t ? f I7?` Sf - License # : 9ZgV
City: 2? ?u•-•c4?? Z? State: Ml? ZIP; .?rJ 33 2
GAS LWE
2
/4
Company:
-,?2i
- phone #:
IN5TALLER
Name: n-?-
Signature:
Street Address:
City: Q-(?,a? State: ?N Zip:
s• , '_
OFFICE USE ONLY
BUILDINIG PERMIT TYPE
0 14 Fireplace
WORK TYPE
? 31 New a 33 Alterations
0 32 Addition o 34 Repair
GENERAL INFORMATION
Census Code. 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
?Z&rsra 2-
4ECEIPT :f ? 770 ,?'-
IPT DATE
I]A Ty' /I ` Z C.. -q(,.
.ro K??kl,
,ros
au trEx
e
/
PLe.ASz BE ADVIScD '°HAT T?ME IS A FEE SHORTA GE ON THE ABOVE
ea
a'T.e.CTRIGL I2STALLA1.70N T_N TF+W' AMOtJNT OF
SHCRTAGe^, MLST BE ?AID SiHI7H2N 14 ID1Y5.
RHMAR16
cuits= /C.,?
100 amo. circuirs= ?
0 c0 100 amo service=
? 101 t0 200 amo, se-vice= ?C)
4EN?L^I A COPY OF iHIS FO!L*1 WIIH REMZTT.INCE.
PERMII:I
ORIG. RECZIPT;1
RECEZP? DATE CS/-? ?? K
Cities Digital
? Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
1? -r
?
. ?
. ? ?1/
r.CASHRECEIPT
d
CITY OF EAGAN ?
. , . . . 360 PILOT KNOB ROAD ?
EAGAN, MINNESOTA 55122
! oerE ?.•^7? y_1 ',4` P.? % l? 1e 1 i-.
A?UN?7 : ( 51 0 0
a oouAr+s
? CASH XCHECK 1m
V
?
?
' ? ? ?)??M. ? ? ?a•"- "!??
FUND O&IECT AMOUNT
(t;Z-0
C 23596
Thank You :, .
.? ?? -
??
-
WNW-?ym Ov,
Yeuow-4Naun9 CAVY
P'uk-FIe Copy ,
.
63
? j?4 ?1NOS}ir'-----
i
serial # 513 5' 92 30 4p
Chip# d?y? B tyZ
PertnR #
?nddress: l?'(o:k MerlUf (.?v?ti:':':[??
1 AGREE TO COYPLY WRH,CIiY OF EAGAN,i
' L CITY USE ONLY
Z BL ?
SUBD. ?
RECEIPT#: ?-L"
DATE:
7996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: ? single family dwellings
I/ ? townhomes and condos when permits are required for each unit
New construction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: <W1'gY1 `?1?i
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00?
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) si ;?'z
? 5tate Surcharge .50
TOTAL 194
?
0414
SITE AD[
OWNER
INSTALLI
STREET
CITY: No, STATE: IIIAI, ZIP: 67(j?y
PHONE #: (
bT(iNAT
cinr use oNLv
L BL RECEIPT #:
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: ?$25.00 minimum fee 2C 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of permit fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:_
cinr:
PHONE #:
TELEPHONE #:
STATE: ZIP:
SIGNATURE:
SIGNATURE OF PERMITfEE
CITY INSPECTOR
? ? ?
?ak5'
,
L BL CITY USE ONLY
SUBD.
1161
RECEIPT #:
DATE: ?/a? 0r°
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.
Date: ?'a t-y4
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00 ?
Additional 50 M BTU 6.00
Gas Outlets (minimum of 1 required @$3.00 each) ?0±?r/
,
? State Surcharge .50
TOTAL ??
SITE ADDRESS:_
OWNER NAME:
INSTALLER NAM
STREET ADDRE:
CITY:
PHONE #
V? gh STATE: A) ZIP: SW 7
CITY USE ONLY ?
L
SUBD.
BL
RECEIPT #:
DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for: ? all commercial/industrial buildings.
? mutti-family buildings when separate permits are not required
for each dwelling unit.
DATE: CONTRACT PRICE: .?..?
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee g[ 1% of contract price, whichever is greater.
* Processed piping - $25.00
? State surcharge of $.50 per $1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (iMPROVenneNrs oNLv)
INSTALLER:
ADDRESS:_
CITY:
PHONE #:
TELEPHONE #:
STATE: ZIP:
SIGNATURE:
SIGNATURE OF PERMITTEE
CITY INSPECTOR
CITY USE ONLY ?
° L 2- BL ?-- RECEIPT #•1n5yD
SUBD. DATE: 1OI J7IRCa
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACF! NSL TOTAL
Shower 3.00 x 2 = .?
Water Closet 3.00 x
Bath Tub 3.00 x =
Lavatory 3.00 x 3 = 9.?
Kitchen Sink 3.00 :< _L = '31
C?
Laundry Tray 3.00 :5°?
Hot Tub/Spa 3.00 :c 3 • &V
Water Heater 3.00 :< 3 • &V
Floor Drain 3.00 x "3. CV
Gas Piping Outlet * minimum - t 3.00 :c ? _?
Rough Openings 1.50 x .3_ = 4.5a
Water 5oftener 5.00 x - _-
PrivBte Disposal " Dakota Cty. iicense 85.00 =
(new and refur6ished systems)
U.G. Sprinkler * home under const. 3.00 =
Aiferations ' to extsttnq 20.00 =
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL ?2. OD
SfTE ADDRESS: -14 C? ? Z??4le-e
OWNER
INSTALLER
STREET
CI1Y: ??}?.?/a•tJ
STATE:
PHONE #: ( 41Z ) 452 - I.?C S
ZIP: 5-5-12-2--
OFFICE USE ONIY
L 8L RECEIPT #:
SUBD. DATE:
1996 PLUM8ING PERMIT (CAMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? all commerciallindustrial buildings.
. multl-family buildings when separate permits are DQt required for each dwelling
unit.
DATE:
WORK TYPE: _ NEW CONSTRUCTION
DESCRIPTION OF WORK:
CONTRACT PRICE:
ADD ON _ REPAIR
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLU5HOMETERS TO BE INSTALLED7 , YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES ^ NO.
1F SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINYiLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of ii fee due on ali permits.
CONTRACT PRICE x 1%
STATE SURCNARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CIN: STATE:
PHONE #: SIGNATURF:
OFFICE USE ONLY
APPLICANT
ZIP:
,.
METER SIZE: DATE: INSPECTOR:
,. CITY USE ONLY
' L ? BL ? RECEIPT #: ?D
SUBD. ? DATE: 1,91319
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 661-4675
Piease complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES F•AC.H NQ.. TOTAL
Shower 3.00 x ?'3 = 9. ?
Water Closet 3.00 x 3_ = 9.?
Bath Tub 3.00 x =
Lavatory 3.00 x
Kitchen Sink 3.00 ;c = 3.cfo
Laundry Tray 3.00 3xv
Hot Tub/Spa 3.00 :c 3,c)6
Water Heater 3.00 :( 1 = -3•cz)
Floor Drain 3.00 :< 3•C0
Gas Piping Outlet ' minimum -1. 3.00 :c ?L = 9,00
Rough Openings 1.50 :< ?_ = 1• ?
Water Softener 5.00 :c =
Private Disposal ' Dakota Cty. Ifeense 65.00 =
(new and refurbished systems)
U.G. Sprinkler ' home under const. 3.00 =
Alterations ' to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL 5t, OD
SITE
OWNER
! LAKE?dr?? `?
INSTALLER NAME: k)IWZ E(_.. NE"44NlCA L..
STREET
CITY: L,96AAV STATE: ZIp; SS/? 2
PHONE #: ( 612) 452
Zal'
/o- 7- 4G
L 8L
SUBD.
OFFICE USE ONLY
RECEIPT #: ' • i
DATE:
PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for w all co mercialfindushial buildings.
. muRi-fa ily buildings when separate pertnits are B12 required for each dweiling
unit.
DATE:
WORK TYPE: NEW CONSTR CTI(
DESCRIPTION OF WORK:
IS WATER METER REQUIRED7 YES
WATER FLOW: GPM. ARE
FAILURE TO PROVIDE THIS INFORMATI(
NO. IF 50, PLEASE PROVIDE THE FOLLOWING:
?USHOMETER:i TO BE INSTALLED? _ YES NO.
I WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A I
iF SO, YOU iYii1$Y APPLY FOR A SEPARATE
FEE: 825.00 minimum fee or 1% ai contract price,
$1,000 of pgLO]It fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER: _
ADDRESS: _
CfTY:
PHONE #:
is greater. State surcharge of $.50 per
#
SIGNATURF:
OFFICE USE ONLY
METER SIZE: ' DATE:
CONTRACT PRICE:
ADD ON REPAIR
2E U.G. SPRINKLER SYSTEM? _ YES _ NO.
SPRiNi:LER PERMIT.
STATE: ZIP:
APPLICANT
_ INSPECTOR:
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
?-----------------
i
? Pertnit #:
I (11;
i Pertnit Fee: --60D? +
? Date Received: ?? 1 17U' 0 G? I
I
_ {?.1// ?
I. Staff: ,?1 ?
------------------I
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: (o z6 ' 08
SiteAddress: +µ11+ (,-Rke-5)AOI`e 1 errace, Ea
Tenant LdYr0.iVte QV SkAak
Suite #:
RESIDENTlOWNER Name: L-O'cYQfvieOSr">kaL Pnone: (0 5 f 4-5Z 13 ( 6
adaress/ ciri /zip: Ter race ,Laqa? 55 12,Z
CONTRACTOR Name:License#:_D6b(o
Address: Z-6 Q ++ ,47t . '
cicy: Lalce Jr ( l2 state: M ?.1 zip: 5?`F q
Pnone: R`??'Z- `t ??(Rcf ContactPerson: J??nH
TYPE OF WpRK _ New 4Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Descri tion of work:
PERMIT TYPE RES/DENTIAL
? Water Heater _ Water Softener
Lawn Irriga6on Add Plumbing Fixtures
L- RPZ !_ PVB) C_ Main _ Lower Level)
_ Septic System Water Tumaround
-
New
Abandonment
RESfDENTfAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (inctudes $.50 State Surcharge)
S30.50 lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
'
Water Turnaround (add $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire R@pair (replace burned out appliances, ductwork, etc.) (indudes $.50 Shate Surcharge)
TOTAL FEES $ SO - J ?
I herebv acknovAedoe that tn,? -..,.ae?., .,.,. ..........._. .._..?_ ...". __ .? _ ._ _ . --;u .. ..
--...r.-'-' .... ............... ?m, u?c mn? mn w ui unuannantx wrtn Ine OfolnanCeS ana COCPS ot Ule City of
Eagan; that I understand Nis is not a pertnit, but only an apptication for a pertnit, and vrork is not to start without a pertnit; fhat the work will be in
acoortlance with the approved plan in the wse of woAc which requires a review and X I of plans. ?
x ?&oYCz-ln ?'(Sof.t
ApplicanYs Printed Name / e r,.„+•.
FOROFF.ICEUSE. 5?.; .r°
` ?R X
v'
A
Re
uired Ins
q Unci ? t
??
r ^??.
m
`a&
City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
^-----------------
? Far?Qffic?'Use /? ?
j Permlt #: ? l O I
i Permll Fee:
I
? Date Received:
I
i i
I Statf: ?
I ------------------'
2008 RESIDENTIAL BUILDING PERMIT APPLICATfON
Date: "v-? () SiteAddress: u-1-`? ????q - ""'°"" SVIpirr' TR"ykce-
Tenant:
Suite #:
RESIDENT/OWNER Name:CLl4 14l?Z sYtUC3 (uU.)N`'10YVLQ.S Phone:
Address/Ciry/Zip:??Q CA1O? W(e' CC t 04•? 551 aa -0-415
Applicant is: _ Owner _:?L Contractor
TYPE OF WORK ??y-? _(?
Description of work: l QC1V' rXk` 1-?13Ut" ? W I Y1GL0Q?? ? 6j '
Construction Cast: ?2400D•OJ Multi-Famity Building: (Yes X_ / No ?
CONTRACTOR Name:?"Y1CY1 b&A?Ca_LtYQC ? T-I& License ri: ?? (obM
Address: crjq`Ao 3(.Lt;IUCI.k W• A LQD
State: ? Zip: ? aJ
hAd'mi t 1Q
Cit
,
y:
Phone:06 a'l En ' ?!9l Contact Person: Yllaa4' &f/LtCAY
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
Minnesota Rules 7670 Categorv 1
_
_
Energy COdC • Resitlential Ventilanon Category 1 Worksheet • New Energy Code Worksheet
Ca[BgOfy Submitled Submitted
(4 su6mission type) • Energy Envelope Calculations Submitted
In the last 12 months, has ihe 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 Contraclor: Phone:
g docume'itPs fhai you submlf.;arerconsialeredtto ?e publrc !n7`'oPmaf{o" 'PofTionsof-.
NOTE: Plans and supporti
`
Crty to -;
re
fhe informatiort may @e cle'ssified as non public if{you?rovrde specif?o reasons thaf would permrF ihe
ro,, a " - .cb'nclude;stfia"?dhe' aare'tratle?`?'orels , ..?„.:.??,.,?_r.3?x..a.ei?:l5 .?? ?•,.., . ,
I hereby acknowledge that this information is complete and accurate; that the work will be in conforrnance with the ordinances and codes of the City ot
Eagan; ihat I untlerstand 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 ol plans.
x Ucivic, Scn.14Per X
ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation
? Single Family
? 01 of _ plex
? 02-Plex
? 03-Plex
? Oa-Plex
WORK TYPES
? New
? Addition
? Alteration
? Replacement
DESCRIPTION:
0 05-plex O 16-plex ? Accessory Building
? 06-plex ? Fireplace O Porch (3-season)
? 07-plex ? Garage p Porch(4season)
? 08-plex ? Deck ? Porch (screen/gazebo/pergola)
? 10-plex ? Lower Level O Storm Damage
CI 12-plex O Miscellaneous
? Interior Improvement
? Move Building
? Fire Repair
Valuation Occupancy
Plan Review Code Edition
(25°/,_ 100% 2oning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Const. Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addition) ? Foundation
Drein Tile
^ Roof: Ice & Water Final
Framing
Fireplace:_R.I. _Air Test _Final
Insulation
Reviewed By:
? Pool
? Ext. Alt. - Multi
? Ext. Alt. - SF
? Multi Misc.
? Siding ? Demolish Building*
? Reroof ? Demolish Interior
? Windows ? Demolish Foundation
? Egress Window ? Water Damage
' DemolNion (entire 6uildmg) - give PCA hantlout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final/C.O.
FinaUNo C.O. '
HVAC
Other:
Paol: _Footings _Air/Gas Tests Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
_ Retaining Wall
Building Inspector
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2 of 3
- -. ?
CER TIFICA TE OF SUR VEY
(sis.s
918.4
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/ I
(
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ti
OO ^
JO)\
923.7
-? - -
- ? --?
a ? 3 - ---_ _-
ry
P2?
?LqK
9 E4492
SHpRE
?ZSO 8 4 So
? ? ry ?
4P.00 (szS?oJ
?. _
L ?
1
8¢ 0O
? 4?00 T-?
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F 3BOo
Wd t 916?
o°
ry
( (920.7)
sis.s
i
,
r
!
F?
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LpT 1
44g4 .
TERRq ?? _
4,500 ? '
o „
¢ ?O
39
J
L;__ -- -- T--y??
C[-... - ±lYtlll?nl l.
Top of lrons @ Offsets
?^ AO 10.00' Offsef 919.32
? OB 10.00' Offsef 918.40
LEGAL DESCR/P770N:
Lot 7 and Lot 2, Block 3, CLlFF
LAKE SHORES according to the plat
thereof, Dokota County, Minnesota
roP or erack = 925.48
Lowest Floor = 917.33
Garage Floor = 925.10
GRAPHIC SCALE
zo o ,o zo 00
(IN F'EET )
1 inch = 20 ft.
930.0 Denofes Sanitary Sewer Service lnvert
865.0 denotes existing e/ev.
(865.0) denotes proposed elev.
denotes surface drainage
• Dertotes iron monument found
O Denates iron monument set
Searings based an assumed datum.
! hereby certify that this survey wos prepared
by me or under my direct supervision and that
1 am a duly Regisfered Land Surveyor under fhe
to.
laws? Z17717
L?,???
?.5. Dote
Craig
Registration No. 23021
?9?S10
?
J w
r - - ? r OD N
rn ?
ai 1
?
i ! (sp. -- / - ? ! ,
Tc)
?
I ? !
/ I
I
i
Lq_?-
KESy0RE-
r
r
r
?
r
O 10.00' Offsef 916.19
? O 10.00' Offsef 923.02
(924.2)
912.5
r
RRq ,? ?-
Cc I
923.1 ?
?REQUESTED BY.-
? HOFFMAN HOMES INC.
? ? . WeBtwood Professionol Services, !nc
? 14180 Wesf Trunk Hwy. 5
Eden Proirie, MN 55344
? ? uRe ? (612) 937-5750
& ??rreR ! Revised: ?/Z4/ss Ez [aound t7ev.
?
? ?
-? ? -zz
Drown by MS Dote: 7122196 Job No: 95198
Lots 1& 2, 8lock 3
83L00-02.DWG
Use BLUE or BLACK Ink
r----------------�
I For Office Use / �
� �3 � � ;
' � Permit#: � �
Clt� of �a��� � ��� ;
� 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
Date: �� 1��l S� Site Address: ����' ��'�,idtwL ���''��f�' ���1°"'� �� �����nit#:
� �� Namex�.��.�,��IIYY �, GGt�,L j ln.ov!,s..,�.���.� Phone: ... ���
F��SIC�4t�#� J, � �
Address/Cit /Zi ���2� ��'� ��� 1`�'dU� � � r�l CSI 2 L
� C�W�1�:t' Y P�
Applicant is: Owner Contractor
Description of work: W�✓�� ��
Ty�e�f 1NQrl�
Construction Cost: � �•`T' Multi-Family Building: (Yes /No�
� � � /`' /� �. �� ,�
� ` Company:�it/►t.�� f�-{2fi�� (�''"i�G7a 1� �hc. Contact: ��f �Y�'� �� �s�-�- �
� Address: JS�'b �'�,�J �Jtiv� l�� � Suifc �sl Cit : ! '�I1� 1l
C�n�raC't�1r � Y
� State:�Zip: SSy�� Phone: '7�3-5,�� �Gn'�� Email: ��� � �arn�.I�r�iruY�����y1.
License#: �G '�o� 7q.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?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
N�T�:1���r��,�t�d�u�Aor�ang al�cument�that yo��ubm��are ct��sic�iered�a be�rub�tc ir���rn��tiaa. Po�o��c►f
the infvrmat�t�n r���r be classf�ed�rs�n=pub#�c if yc��pro�ride��e�i�1c reas�ns th�#�ir�ot�ld�er��t�he Ci�y!to
c�rrr�l�de,tlaat the are tratls�ecrets:
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.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 t Building Code must be completed within 180
days of permit issuance.
�
X �u1S �r�����..�- X
Applicant's Printed Name Appli s Sign ture
Page 1 of 3
Use BLUE or BLACK Ink
- r----------------�
I For Office Use �
� �3 3`� � ►
C��� O� n���� � Permit#: �
� I �� I
� Permit Fee:
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 � Staff: I
I �
2015 RESID�NTIAL BUILDING PERMIT APPLICATION
N��. -�lq� � �, s�.s�z z
Date: � 2 �-S > � Site Address: ��-���.r��y� /-��a �'�" ���r Unit#:
�w� F .�:.Name: r. _�w,°.^1�l`�., ...,��i�,�... S��l'. ._,��.�,.,.d� w . ....���...�d_aPhone: ._�..�,...__��...,�.w,�...,�.�_w�
" � �
� R�sidsr�#/ � y�'�2,m ���� � ./� .r � C�' ssjZz
(,)��{;1'' Address/City/Zip: �' � ,lwo<- `��d'�, ct- G�^ /J
�
�
Applicant is: Owner Contractor
��,.. ..�,��...�..��,.� - .�...�.,..e��o.u..�._.�..� ...�.�m..�x�,.,e�.�.,�.�,�..�_.��.���.�.�.��..�..�,....w...,...
� Description of work: J f��i'�
7'yp+e a�F 1�lar� /,�
� � Construction Cost: /�� �' �� Multi-Family Building: (Yes /No� �
3 � + � ���� j"
�Y� � Company:�� cS ���4e� �U�%fr���-y��nr. Contact: ���5 vo9 kA.,�, ,�.�.,.�,,�.,.�,�,.�
a �
� � 35� �/,� �u�� �� �.� s��� ��;f � �
� Address: �`5S s� City: �' �j/7�a� • �
Co�a�ractor
� �..�y�% Phone:�G3�.�.Sb-�� Email: L.cf'i.fc� �eJL.� �� � �
:� State:�Zip: . �l3 �.u� �u ���,
� �
License# ��U o �7 /3 Lead Certificate#:
�,::.�...��,�...��..�.�,�, �.�m..,� ...��,.��,K���a�„�.�.�VT.�.,n,�,�, �,.�,,.�. v,��......,w,�..�...._..w.m�...�,��.,,���w..�..�..,,..�.....�.a.�._n�.�.w.�.�.._
� If the project is exempt from lead certification, please explain why:
� _ �,.,.��..�..,�,���..,o.�,.��,�.,��_ ��.....,_.�s,_ _.�,u...���.o�e�.�.,���,,.��..._ �..�.........��. - -
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? �
,
9
�
Yes No If yes, date and address of master plan: �
� Licensed Plumber: Phone: �
% Mechanical Contractor: Phone: �
Sewer&Water Contractor: Phone: �
Fire Suppression Contractor: Phone:
lV�T�:#����$and�r�p�ar���docu�»+en�tfi�a��ou��s��are co�»��ed to be p��r�i�fic x�r�o�tf�. Po�ar�s c�#' ;:k
t�e iu��'�rnra#i��►r���r�e cfa�si�ed a�n�n pe�b�e�`y��pro�v�s�pec��rea�nr�s tha#t�a�r�p�t���:G3�+�a
� c�r��l�r/�#�a�'t�s �re t�°a�le,�c�°e#�. �
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. CaII 48 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 St e uilding Code must be completed within 180
days of permit issuance.
x L��'��.5 �1��(,c�:�.�,� X .�---�
ApplicanYs Printed Name App c s Si ature
Page 1 of 3
I
I
For Office Use
e
e e a `eEAGAN.
Us
ISi)e: � J®t
` -' >"LIVED r� 1�
Date Received: �P-A-16
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 JUN 2 0 2018 •
buildinginspections(�cityofeagan.pom Staff:
L 1 J
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:44: Site Address:'AJ--ek,
if - /l ' 1 y
Tenant •
.
t .�
-
Wr
•0Rr:f.d@ r � Name: ,(� �'' - one: ,
nr io
7a•
3
•
r � �� Address/city/zl 'illi____,. ..........` , '
g .1� .r..t 9 1 t- f /GJ! ri� �'(
1i k F R {�Y
1y Name: MILBERT COMPANY dba CULLIGAN WATER License#: WC6 F'1376
lO AO%."1414:.-0.4V1
F }i.ice $1 .4)i
Vb' Address: 1801 50TH STREET EAST City: INVER GROVE HEIGHTS
ace.‘ s i t :4,1 State: MN Zi 55077
' at p Phone. 651-451-2241
Xii�ts y ;,. ,.+? Contact: BILL MILBERT
Email: gloria.abast�cuiligan4water.com
tr °t �`f °� ' -New Replacement —Repair Rebuild Modify Space Work in R.O.W.
� Y0ee , :oi, p
Led, tt1` -4., �:4:,,s''to riV:, , �t*-' t{4x .
> r r p x ____ ,x; Description of work:
�'� ,1ru {' RESIDENTIAL
TAlt
.1 1Z,VV Y '�,', Water Heater
,fr 30 1 H z'," `c-' _Lawn Irrigation( RPZ/ PVB) X Water Softener
� ertn it,Ty'0'0
, 'tltt !�t _Add Plumbing t�flr{ rr . �1 11 _Septic System Fixtures( Maln./ Lower Level)
?i � t " �f Y New_ !Water Turnaround
5.;;p is 04. It }
,!.ii; �. ,f.� r Abandonment
RESIDENTIAL FEES: -�....._.----------
$60.00 Water Heater,Water Softener, or Water Heater and Softener(Includes State-Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60,00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter Is required)
$115.00 Septic System New(Includes County fee and State Surcharge) 'TOTAL FEES$ 60.00
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454.0002 for protection against underground utility damage.Cal48 hous before you
Intend to dig to receive locates of underground utilities, www.gopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www,citvofeagan,com/subscribe.
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 ot to start without a permit; that the •rk will be in
accrdance w''t the approved an In th case of wor which requires a review and approval o pia . <
rbOS-\ (\ I
Applicant's Printed Name x -
Applicant's Signature
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA151152
Date Issued:08/10/2018
Permit Category:ePermit
Site Address: 4492 Lakeshore Ter
Lot:2 Block: 03 Addition: Cliff Lake Shores
PID:10-17785-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Jeffrey M Halbur
4492 Lakeshore Ter
Eagan MN 55122
(507) 340-3793
Boys Mechanical Inc
490 Villaume Ave, Suite 300
South St. Paul MN 55075
(651) 340-5956
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151161
Date Issued:08/10/2018
Permit Category:ePermit
Site Address: 4492 Lakeshore Ter
Lot:2 Block: 03 Addition: Cliff Lake Shores
PID:10-17785-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Jeffrey M Halbur
4492 Lakeshore Ter
Eagan MN 55122
Champion Window Company Of Mpls
5100 HWY 169 N, #B
New Hope MN 55428
(763) 574-2054
Applicant/Permitee: Signature Issued By: Signature