735 Lasso LaneCASH RECEIPT
. Y;
CITY OF EAGAN .
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19 er- y
REC PROM `_?C.C- ?Y \/.?•1-ia.«/ i _"? ??1+?-?
AMOUNT $
, ? /G v
& DOLLARS
1 oa
? CASH [SCHECK
FOR 1r?!.?ji%????'I N/?? .?',C???/vu?*-?.e?
i
FUNO CODE AMOUNT
i G Z- ' ?
Thank You
ev
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Receipt PLUMBING PERMIT Pe?it No.
CITY OF EAGAN
L? Fee
Fill in numbered spaces S/C
Type or Printlegib/y
Tot. 5. ?> D
7. Date 2. Mstallation Cost /3?0.CC'
3. Job Address 7-U LeiSSC G:.. ? Lot L' Blk. L Trac"t
4. Owner Q '/- t,.,?
5. Contractor I/ ,C7 a.?. ? s l??h Phone l?sS // %rJ
6. Address ?7kG' G?.
7. City State ^'/N. Zip
8. Building Type: Residential pr Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. DCSCribe xi 4c?-' '?-•_
17,
No,
_ Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
_ Bath tubs Septic Tank
Lavatory Softner
_ Shower Well
Kitchen Sink
_ Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
72. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rougb Pioal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
? • CASH RECEIPT
..?" ..
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55127
DATE l `_ .. 19 REC61VgD ` -
ft9di.
AMOUNT ,$
&
CASH CHEC /
. ?. ,? A ir_? _ ?3a3?1.? ?
'> .:,.? <-
"-
.?" f„ __ J ? ? ? :S - ?'
FUND CODE AIAOUNT
Thap"ou
White-Payers Copy
Vellow-Posting COpy
Pink-File Copy
w
.
7
CITY OF EAGAN Remarks
Addition Saddlehorn Lot 3 pik 1
owner 14, 735 Lasso Lane
-4{! 7 /l1.?)}l-l?-.., • /
MN 551
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1$S5OO C00878 7-9-84
STREET RESTOR. 570 1981 1210,00 60.50 20 968.00 C008786 7-9-84
GRADING
SANSEW TRUNK SO$ 1981 280.00 14.00 20 224.00 C008786 7-9-84
+6EWERLATERAL b 1981 3359.51 167.98 20 2687.63 C008786 7-9-84
WATERMAIN
VlATER LATERAL 1981
WATER AREA 1981 280,00 14.00 20 224.00 C008786 7-9-84
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. Rp' 44215 6-20-84
PER. 20.50 2]5] 4-26-76
sa,c $400.00 12085
- -
PARK
CITY OF EA
3840 Pilot K
, GAN
not Road
WATER SERVICE PERMIT
P. O. Box 21 199 PERMIT NO
:
Eagan, MN 55121 .
DATE °,+
Zoning:
No. of Units:
Owner:
Ad
dross:
SiM Address: 131 S?tddlehorn
mber.
tor No.:
5
ze: ? 'i
? 1./
, ? --------------
- Connection Charye:
00
d
F>
Aceount Deposlt: ??. 00 pd
Reade No.: Permit Fee: i'.00 t?d
1 a0?w M eom y?r w!1? Nw Ciry of la9e. Surcharge: . 5 0 n? i
Ordinonow. Misc. Chorges: oc r:e?er'
Totol:
B
Y
X DaM Paid:
Dot
fInsp.:
0
Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55731 D^TE: "
Zoning: No. of Units:
Owner: ._en.n e _;euLiann
Address:
Site Address: ? aeso ane '. Fi W- Saddle'lorn
Plumber: ` • RBIS a
11-S-474
..1n nn ..a
1 pras fo eemPlq wilh !Ir Cifq ef legaa
O?dinancea.
By
Dote of Insp.:
Connection Charpe:
Account Deposit: 15 . C?Q vd
Pem,it Fss: 1 ?. O O
Surcharps: .50 pd
Misc. Chorqes:
Totat:
DoM Paid:
CITY OF EAGAN
3$30 Pilot Knob Road WATER SERVICE PERMIT
P. O. Box 21199 PERMIT NO
:
Eagan, MN 551
21 .
,
2oning: 1 DATE:
Denn e ? evma NO? ? Un?cs:
nn
Owner;
Nddress:
Site llddress: aso :ne aC e.;or?z
Plumber: • ?fll9 sr
AAeMr No.: Connection Charge: . ??
Siu: Account De
posit:
Reoder No.: Permit Fee:
a
I e0rs? to eanp wh1? !w Cit
of E •? n'
r
?Yo Surcharge: .
OrJimenuL Mlu. Cho 77 - .- nr
rpes: r
Totol:
B
Y Data Paid:
?at f I
e o nsp..
?- -
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
? ?F75-? 3830 PILOT KNOB RD - 55122
651-681-4675
New Constructlon Reauirements
• 3 registered sile surveys showing sq. ft. of lol, sq. ft. of house; and all roofed areas
(20°k maximum lot croverage allowed)
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE (v ?
JOB SITE A
-o r
?
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY
41Ga?• /9
CaIl-ed b'19'01
RemodeYRemir Reauirements
. 2 copies o( plan
• 1 set of Energy Calculatlons for heated additions
• 1 site survey for euterior additions & decks
• Indicate if home served by septic system for additions
VALUATION
TYPE OF WORK&2! TIaV FIREPLACE(S) _ 0_ 1_ 2
APPLICANT e8a &a?5M COFL[.Y? PHONE# 411'4,2?7/72&
ADDRESS 4G je ZIPCODE
PAGER # CELL PHONE # FAX # C+S?` l+Q ? /l ?
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residen6al Ventilation Category 1 Worksheet Submitted
- Enerav Envelooe Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumb(ng Contractor: _
Plumbing System Includes:
Mechanical Contractor: _
Mechanical System Inciudes:
Sewer/Water Contractor:
- Air Conditioning
_ Heat Recovery System
Phone #
Phone #
, . D.
Fee:
$70.00
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 Statutes and City of Eagan Or ances.
Iignature of Appflcant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/Ot
_ Water Softener _
_ Water Heater _
No. of Baths
Phone #:
Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 FoundaGon
13 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
01,31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 OS-piex O 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
O 10 OS-plex ? 18 Deck
? 11 10-plex O 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.) .
bP 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? , 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demalish (Interior) [3 44 Siding
? 36 Move Bidg. ? 42 Demolish (Foundation) O 45 Fire Repair
r
'? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
`DemoliNon (Entire Bldg only) = Give PCA handout to applicant
Valuation ?
D?O
Occupancy
C-3
Census Code ? Zoning
SAC Units Stories
-?
Nbr. 'of Units ? l Sq. Ft. •.. `? ??..
Nbr`-of 81dgs. ? Length , • ? a.- .
Type of Const - Width
_ Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace R.I. Air Test Final
? InsulaHon
MC/ES System
City Wa'ter '
Booster Pump
PF2V
'Fire Sprinklered _ Other
_ Pool Ftgs Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By ?ZG) , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
? Finavc.o.
FinaUNo C.O.
_ Plumbing
HVAC
?O
c-
?? ? x ,
.12
j, o cPkk
CITY of EAGAN
B ILDING PERMIT
owae: ?t.f:,?ne..... .?? . . ...... . ... . .................
. . .... .....................
Address (preaen!) ...<.??...... .- -
Suilder .................. 110?............................ ..............................
r.aa:ess .............................................................................................. -
DESCRIPTION
r, i+
N2 3906
3795 Pilot Knob Road
Eagan, Mianeaofa 55122
454-8100
n8:. ?......Ap!?A ..../..?,.7..C..
Storiea To Se Used For on! Depth Hsight Eel. Cos! Permi! Fsa Aamarlu
l ? ?
V I
d,7_ ( 7?00 " I'll ' LOCATION ?
il, Road or other Deacription o! Location Lo! ek Addflion or Tsac!
i
7? I
?
This permi3 does not aulhori:e 1he use of streets, roads, alleys or sidewalks nor doen it give !he ownet or his ageat
ihe right to create anp situation which is a nuuaace or whieh presenls a haaard !0 3he health, safely, convanience and
general weltara !o anpone ia the community.
THIS PERMIT MUST,R£'1?qEPT ON T REMISE WHILE THE WORK IS IN PROGRESS.
This is io cezlifp, fha?].?L.... .. . . ._.. ....--•--•--..has permissioa !o erect a.... . . .............................. _upoa
ihe above described mise subjeci So Yhe provisions of all applicable ardVlAncea for ih Eagaa. L
.
........F.`!!........._. ..-?---°-._...----..._ ................... Per ..... .-. •° ---- -. ........ . .. ...... ........................ ...... .............
YoT Buildinq Impeetos
czmY oF EaGAnT
3795 Pi1ot Ynob Road
Eagan, Minnesota 55122
FERNLTT NO, : 219
The City of Eagan hereby grants to PON KSSLING
oi IGI3 _.._ y
SEPTIC TANK &
a DRAINFIELD Permit for: (Cwr_er) H. Y.irchner
_
a,t 735 Lasso Lane , pursuant to aprlication dated 12/6/4
Fee Paid: $10.00 dai;ed this 6th day of Dec. ,19 74 .
. JO
Building Inspector
Macrsa.ical Per.mits:
Bid Total:
- ? CITY of EAGAN
BUILDING PERMIT
?
----. u,...""` :.................:..'....: ?`.................-----..........
o Wn.:
Addzess (aresen3) ...... ...1t"`???"? ? ,
.. ........................................
Builder .................. -'........................................................
Addrese .............•••••••••••••••.....°-.................__......_.........•-••...........
DESCAIPTION
?
. ?.
: N2 3453
3795 Filot Knob Road
Eagan. Minnesota 55122
454-8300
Dela .?/?`r- •• ?
.....................
.......
5tories To Ba Used For Fron! Deplh Heigh! Eel. Cos! Pe:mi! Fee Remaslcs
I ,(?:,..? diy?,i? • I c?Li ?y 1 i,2! /ac?
? G 9•0-o I
/!. o-v ?v /?,,??z ?'_?•---c-
?;? / ,r.?-•?<,F-..?1-?--?$?
LOCATION 'S'O, zz'
Slree2. Road or other Deacripiion of LoeaYion I Lo! B1ock I Addition or Trac!
73 .S` ?^-?' o?--.t.c.? 3 / ?.??.2?•Q?.w.,- Cd? 1??
This permit does not auihorise the use of sLreeis, roads, alleps or sidewalks nor does it give the ownes or hia agent
the righ! !o create aap siYUalion which is a nuisance or whioh presenls a hesasd !o the heallh, aafetp, convenience aad
general welfare fo anyone in the communitp.
THIS PERMIT MUST BE KEPa' ON TFIE P EMISE WHILE THE WORK IS IN PROG
This is !o cerlilp. !ha! .7C`••=:?'...?..4"-=.-`-.=? ................. .°---°------.has permisaion !o erect a••--• •._.... .. .... .
the above described premise subject Yo the provisions of all applicable Ordinances for the Cit of Eagan
........... ...••••••• •?.:!-?--------•••••••••
'?-.. -•••••........ ••••-••......._...•••.... Per .....••.----- -----•-°----.??•-_. !?::?....•-••••....._......
Mayor -A Suilding Inspecios
as
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: e^,
The City of Eagan hereby grants to w i o, s,a q & ue"+.... Tng
of iAnn Kenti g8it 55122
aprxnumrwr_ Permit for: (Owner) H q: ?. .?.. * "ien
at ?3S yasso ya&ue ? pursu2nt to application dated o i, o i-,? .
Fee Paid: $1000 dated this ?_ day of sep.? , 19
.50 s/c
Building Inspector
Mechanical Permits:
Bid Total:
.
.Sadd?t'hvi'r?
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 764
The City of Eagan hereby grants to
Complete Air Heating & Cooling INC.
of 5611- 152nd St., Hngo, NIN 55038
a HEATING Permit for: (Owner) Harvey iCirchner
7,z??A
at 735 745, 7 Lasso ? pur$u2nt to application dated 11/20/75
Fee Paid: $60.00 dated this 26
1.50 a c
day of Nov. 9. 1 9 75 .
Buildirig Inspector
Mecha.n.ical Permits:
Bid Totals
?
Receipt _ ( PIUMBING-PERMIT Pgit No. IWW
CITY OF EAGAN
Fee
? fill in numbered spaces S/C
Type or Print legi6ly Tot. ?
1. Date bl'-.2U-?5! 2. Installation Cost DU
3. Job Address 7U la.SSO LeA t Lot0-3_Blk. 0 / Tra i?
4. Owner !/; i1/e w m ? ti
5. Contractor J?czd?s f'?/? Phone ySS- 1199
6. Address G7V0 Ee.?cm;
7. City Z.6,/y. State Miv, Zip SS"07S
8. Building Type: Residential ;V Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair 0
10. Describe Cryce,,e fror r.(/??/ -'4' c4 tt/a'?/«,
11.
No. Fixtures
Water Closet No. Fixtures
Cess
ool /D rainf ield
_ Bath tubs p
Septic Tank
Lavatory Softner
_ Shower Well
_ Kitchen Sink
_ Urinai/Bidet
Laundry Tray Other
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the a6ove information is true and correct, and I agree to
oomply with all roinances and codes governing ihis type of work.
Signed: for
R ough F inal /?
Inspections: Date Insp. DateG'L9-V/?sp. tLJ49_
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
7sq55
. i?? . 0-t)
2006 RESIDENTIAL BUILDING rExMiT ArrLlcaTroN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construetion Requiremenls
3 registered site surveys showing sq. ft. o( lot, sq. ft. o( house; and all roofed areas
(20% maximum bt wverage allowed)
1 Soils Report if proposed building is to be placed on disturbed soil
2 copies oi plan showing beam & window sizes; poured found design, efc.
1 set of Energy Galculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Defail Options selec6on sheet (buildings with 3 or less units)
Minnegasco mechanipl ven6lation form
RemodeURepair Requirements Office Use Onlv
2 copies of plan showing footings, beams, joisfs Cert of Survey Recd' Y _N
1 set of Energy Calculations tor heated additions Soils Report Y _ N
t site survey for additions & decks Tree PresPlan Recd. _ Y _ N.
Addition - indicate if on-site septic system Tree Pres Required _ Y _ N
On-site Septic System ! _ Y _ N
J ?I al
Date Construction Cost
Site Address Unit/5te #
Description of Work 1.0?ry-'
Multi-Famity Sldg XY _ N Fireplace(s) _ 0 2 ,
&Io hone #(??[)`?
Tete
Property Owner p
Contractor
?
Address ? L City
State Zip
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan.'
E Tele hone #
P ( 1 -
Licensed Plumber 2
Mechanical Contractor NOV 2 1 2006 Telephone #(
Sewer/Water Contractor l?Y> Telephone # (
I hereby apply for a Residentiai Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approv of plans.
?
Applicant' Printed Name App 'cant's i ature
DO NOT WRITE BELOW THIS LINE
Sub Tvaes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Firepiace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/perola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ?P 25 Misceilaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
VZ 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 ReplBCement •Demolition (Entire Bldg) - Give PCA handout to applicant'
D¢SCflptlDll: Watec DaFnage _ Yes.
Valuation ?G???• -
Plan Revievir 100% or 25%
Census Code `43 c(
SAC Units
# of Units
# of Bldgs
Type of Const ? .
Occupancy MCES System
Zoning ? City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
_ Sheetrock
FinaUC.O.
?o FinaUNo C.O.
HVAC
Other
_ Pool Ftgs Au/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
RetaininQ Wall
Approved By:Building Inspector
Base Fee
5urcharge
Plan Review
MC/ES SAC
Cify SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT # 11
RECEIPT DATE:
USIDEPTIAL PLUbI$IN6 PMiT APPLICATION
crrY o? FAem
3830 Pu.or xxos Rn
FSR&lEN, b!N 551 £E
651-6$7-4675
Please complete for. ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS:
0
_11"'
OWNER NAME: :
TELEPHONE #:
(AREA CODE)
INSTALLER NAME: l c) T0.? PCUALdJ`14:L? TELEPHONE #: YS ? T CfRI-/ " 7 y7 Z
D
STREETADDRESS: 1qo23 ?-y?tirvSv/I'P N/w'/ (AREA CODE)
CITY: 6utNS11111
Place a check mark next to the oermit work tvne
STATE: IA V v ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to exfstinq dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: 6Aa1,A Q a?'? ? o o w.
Septic System, new/refurbished - $ 225.00
. includes County & Consulting Inspector fees
. requires MPC license
State Surcharge $ .50
Total $ ?d•??
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby adcnowledge that i have read this application, state lhat the information is cortect, and agree to comply with all applicable City of Eagan ordinances. It
is the applicanl's responsibility to notlTy the property owner that the Cily of Eagan assumes no liabilily for any damages?used by the City during iis normal
operational and maintenance acGvitles to the facilities constructed under this permit within Citylproperty/right-o(- u?yle ment.
N?r \ at
SIGNATURE OF PERMITTEE
Updaled 1101
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
C1TY OF EAGAN
?/ /? 3830 PILOT KNOB RD - 55122 4j Q
?V ? 651-681-4675 1
New Conshuction Reaufremenh Remodet/Renair Recuiremenh
? 3 registered sfle surveys showing sq. ff. of loi, aq. H. oi house 2 coples of plan
and cll raefed areas (20%'o maximum lot coveraae nilawed) 1 sei ol energy ealculafions for heated additions
? 2 copies of plans (show beam d. window sizes; poured fnd. design; etc.) 1 stte survey for exterior addHions & decks
? 1 set of energy calcutafions
? 3 copies of hee preservation plan N tof plalled after 7/1/93
DATE: h I? I?7 q CONSTRUCTION COST:
DESCRIPTION OF WORK: i.ha? I4.)`- f?
STREET ADDRESS "7 3 S- j4 .c So
LOT: T?3 BLOCK: ? SUBD./P.1.D. #:
Name: 0'" r-- linbpe- t- Phone#: ??I'oSZ 3 T Zg c'
PROPERTY last First
OWNER
Street Address: 3? L? s's ??..?
City State: .-1 Zip: 2--3
Company: Phone #:
(area code)
CONTRACTOR
ARCHITECT/
ENGINEER
Street Address: License # Exp.
City
Telephone #: area code (
Street
City
Sewer 8 water licensed plumber (reauired for new construetlon onlv):
State: Zip:
Name: _
State:
PenaHy applies when address change and lot change is requested once permff is issued.
Zip:
I hereby acknowledge that i have read this applicatfon, state that the Information is correct, and agree to comply wlth ail applicabl
State of Minnesota Statutes and City ot Eagan Ordinances.
Signature of Appllcant: zilm6Z4 6Q4?
Certificates of Survey Received _ Yes
Tree Preservation Plan Received Yes
OFFICE USE ONLY ?a C? r' ';?'_'• ,
No ?
- 1;? I
_ No _ Not Required
Registration #:
I
?i??•y •I
2/84
CITY OF EAGAN
t
APPLICATIJV FOR PER'"IIT
? - SE.dER AND/OR WATLR CONNECTIO:T
(PLEASE P9INT)
1) PF.OPE.T'I'" ACDRESS: 7.35 ?ass0 La& e- EQyo-ti
t.Fr;L DESG4T_PT_TCN:
(Lot/Blocic/Subaivisicn or Tac Parcei I.D. :;t?„?r)
(' "1T•
D3= G-F CRT_?l dA;.
.L.LU1.. l.. i h..._. .
"
? FP?S'-:._ ,^,?,??::C?CS? LS?. ? R-i Sj-?-':G'?. PA-',,,?,-y
? R-2 DIIPT-=. ('Iti:O L,IITS )
? R-3 TG,11.TE:CtiSE (Tf?.? + L':IITS) ( i.TiT2^_S)
? :t-4 PPAR?".TM"`:P/CviZG==.i ( L:VIi ;i
? CCiA1%E?1CI.-.L/R'-TAIL1/OF'F'T_CE
p rmL'S i RIAI,
? NSTI'I'ujTiGti.\L/G cv.T:\1=
2) hpnj,TG= (PLchSc ?RI9i)
AGDRESS:
CITY, S=, ZIP: -
PI:O:Z:
T.i['
3} numnER. T1?':L ?+
lY. ? (PLE?PR1Ni)
(/e fJl'Gla.i^S q. FOR CiTY USE O4LY
ADDRESS:
:
617 ko PLUHBERS IICEtiSE:
Active
CITY, STATE, ZIP: I/IlH,,.t- Wjs
` 0 Expired
PNOti`E= ,hN') i t'
`aSs -/ l 9 J PLUHBER LICENSE N [?] Not oi Record
arr :nitia
4) UL'C:u:AiJ'P/GT.'7:.TM'_ lrLLx.?c rninI)
NA.'1E: ,?eu a? s //e w ma ?t
ADDRESS: ? 73S ? asso `av e-
CITY, STATE, ZIP: ?'QqaH
? _
PHO:+E:
5) INDIGA'Ir Trl!-lIC:3 PEF"•tIT IS BEI?:G F2A2UESTrT :
? CC T',"VEC.':IGN 'IO CITY SE?•JER
El CC:T.JIDCI'ICN `It7 CIT'i ivATER
Q UI"rER (PLEASE DESCRIBE)
6) L.D= C::L:
? PI.=_`SE I?OLD r1PP??a,I;D PER:•1IT FOR PICN-UP BY O.*IE OF r'1Ba,IE
? 7TFASL tiVJL APPRO% M. PERAIT 'IO 1, 2, n 4 A&T.7E
(Circle one)
7) SIG!.'-%ZL.:?E: DATE :
/ ?
?! !! OI:aF?01 #?A il ?r ?! l??fl? f? 1t !7 r?? ?.?_a ?i Of ? ?:i?:i? tf? a? ?R YR E?:?! ?i? ! ! ! ?c S ??7??r s
F 0 R C I T Y U S E O N L Y
PERMIT °- ISSUED
F7_ 7
F°ES: $
Y
$
S
$
$
S
$
S
s
$
S
$
$ •
Dz'q%iT'^ (_„^u_•^_
WATER PER24IT (INCLUDE SURCHARGE)
WATER METER/COPPERHORN/OUTSIDE REAuER
waTER maP ( i:vci,oDL coRPcRATIev sTcP)
SE:'IEP T^,p
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIm _ WAmrR
WAC
Sac
T?2UNIC ?1AT°R ASSESS.IE:IT
TRli`1K SE:dER ASSESS2•?EVT
LATE°AL BENEFIT/TRUVK SE:%=
LATERAL BENEFIT/TRUNi: S+IATER
OTHiR
$ TOTAL
, $ A:tiIOUNT PAID/RECEIPT #
DOES UTILITY CONNECTIr]N REQUIRE EXCAVATION IN PUBLIC RIGiiT OF SvAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERIDIG DIVISION. LIST AS A CONDI-
TION.
SUDJECT TO TFIE FOLLOTHIDIG CONDITIONS:
APPROVED BY:
TIT?,E :
DATE:
044p_"wAW .?W OR 'WwE?OR W*?00 wt= sN
MASTER CARD
LOCATION
OWNER
S7RUCTURE AND
LAND USED AS
Permit
No.
Issued
-- Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL -
---?-rr??-
----6??=--
-?-a- i
.
ELECTRICAL ?
HEATING 7? 4
GAS INSTALLING
SANITARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Weli
FOOTWG 74 SEPTIC
FOUNDATION T
Z • ? _ ?T
' ?
CESSPOOI
FRAMWG 5-?23 TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD ? -
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
MASTER CARD
LOCATION pp,Q? ? 7,3d'
OWNER
STRUCTURE AND ?
LAND USED AS ?????,?G aOX Z'S?
Permit
No.
Issued Issued To
Contractor Owner
BUILDING 39?? 00,'
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS 1NSTALLING
SANITARY SEWER
OTHER ?
07HER i
?
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING -? .R SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE fIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLA710N
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violstions Noted
on Back
COMMENTS: 4e
735- A4Ss'o c,).s
??& ?W
L,Pt ;? 5o 11.61 .
I cma?
caTr oF EticAN .
E.CtERiOR $IIYELQFE, AYERAGE a Ul COl4Pl}T"A?IQti
Y b
OkINERi cc d?O
?, -°?--•.
?...
9T.TE ADDRESS'
.._. , .
CqNTRAC?OA : ?AATE: C, - z ` C?? PHONE: ?
Determine s+orking square faotage of eacb:
1. Tatel exposed wasl area ... i L-7 2. aq, ft. a v11 = l?,,,2g• C'?--
2. Tata1 raaf/ceiling area ... tP 44 sq. ft. x e025
Tota2 eaposed srall area above rioar = 11 U2- ,
a. ?ctai wall window area .....................8....?. ?..,R
C. Toial door a r e a ................................... --
Q. Total sliding g2ass aI'e8
d. Total !"ireplace wa11 brea ......................... C?
e. TOtBl wall framing area (average 10%) .............
f. Total net Wali area sbove flaor ...................
g. Total rim joist area ..................?...o,a•••,•
Tntal ezposed foundation area s S Lo
h . Total faurid2tion windoN area . . ....... .. . • . . .... * ... .C=.?
i. SaLal net floundation area above grsde,,....ao...... 5 CIS
Detertaine 'U' value of each srall segment:
Z?.t,o _ 2°? - t co
a•?.....? i _ x' U' 2
?"
b. d x' J' c = c+
- -.,_.? _.-
Y IU I 3 . tO - -
d . C? x ' U'
e . x ' U' ..?: ,.?.$ ,,...-.-. ?
f' . .'L? x ' u' = 3
g; . x ' L"
ti 4r ,... z ' U' ?.?..., = Q
!.. x ' l"
3. ......... ,,........a ................................ ?ota2 =
If item 03 is the same as or less than item 41, you hsve met the inLent 4f SHG
60Gb(c)2.
iotal ezpased raoflceilieg area s
J. Total akylight area ..........................o.... a
k. 1'ota: rooflceiling framing area (average i03) .....???~ ?
3. ToLal net insulated roof/cefling area.............. ?,Zma-
DVER
.
x
x ' ul
. ?
w
lU' ? ozz ? -?
?...?.?' L? --
.............................. Total
? . ........................
If tatal of t4 is Che same as or less than J2, you have met the intent af S9C
60Qb(c)t.
A2ternate Buiiding 5nvelope Desfgn
'fo utllf2e the total envelope syatem method, tihe va3,ues established by trie sufn
af Items 03 and 04 shall not be greater than the sum of Items 31 and #2.
t. + 2. =
-
g, + y. -
?
?
;
2
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