800 Golden Meadow RdCITY OF EAGAN e?
?- . 3830 Pil?ot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121 1`? ??
`
' BU,lLQING PERMIT PHONE: 454-8100 ReCeipt p "
To be used for SF u'G/GAR Fsr vaiijP $ 67 ,000 n„o JULY 2 ,a 86
Site Address 800 GOLDEN MEADOW ROAD E C7 R3
O
rect ccupancy
Lot 3 Block 1 SecISub. xIN6 ADDITION Remodel ? Zoning kPL)
Parcel No. Repair ? 7ype of Const. Vn
Addition ? No. Stories
¢
Name B. H. GRACE CORP Move ? Length 51
Z
l
2004 VIENNA LN Demolish ? Depth 34
;
° Address
EA
GAN
456-9030 Int.impr. ? S Ft
Q
city phone Install 0
SA:'?SE ?Apro,ri
= o Name
? ? Address Assessment _
~ City Phone Water & Sew.
Police
Fire
Eng.
Planner
Council
I hereby acknowledge that I have read this aQplication and state that the gldg. Off. 7 Z 8 5
information is correct and agree to comply with all apploable Slete of
Signature of Perrrftgfu? 11 I
A Building Permit is issued ta: B. H.
all work shall be done in accordance with
Var.
Fees
Permit ' 00
Surcharge 33.50
Plan Review lb-/ .000
0
SAC 500.00
Water Conn.
Water Meter? 00
Road Unit?00
Tr. PI. '
Parks
Copies t 119;00
Total
on the express condltion that
City of Eagan Ordinances.
Permk No. Pe?mlt Holda Date Tdsphone M
PluenbiAq c-
H.V.A.C. S IO S /?? ? g ? 6
o.ctdc
SORMN
Inapeetion Oate Insp. Commenls
Fooa,w. i g W
FooNnysll
FoundsNon
Framiny ?
Rooflny
Rouyh Plby.
Rouyh Hty.
Inmul. ?
Finplaee
FinM Hty.
Final Plby.
&dy. Final ? -- ? i
- v
Colt.OCC.
?
Doek Ftq.
Doek Frmg.
i
Wall Doscdbe Loutlon:
Pr. Disp. Lt77 w Gfed 5f 7-$7 Lr• 7.
PERMIT # -7 w SCI
, - ? PLUMBINA PEftMIT RECEIPT #
' CITY OF EAGAN
3830 ?T KNOB ROAD, EAGAN, MN 55121 DATE:
' CONTRACT PRICE: PHONE 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot - Block ? Sec/Sub
1-
Res. New
? Name ? '? ''' - • '? Mult Add-on
a?
?o Address ''? ? ' Comm. Repair
c City - %??, ? ?•'?L ? . Phone Other
Name 7 NQ.. FIXTURES TQ AL
_..?-_Water Closet - $3.00
3 Address Bath Tubs - $3.00
. __.?.,_Lavatory - $3.00
? _ O Cit1' Phane ? ' 17
, Shower - $3,00
FEES -w-Kitchen Sink - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE ? Urinal/Bidet -$3.00
MINIMUM - RESIDENTIAL FEE _ $1p,pp -?-?undry Tray - $3.OU
' Floor Drains - $1.50
MINIMUM - COMM/IND FEE -20•00 ' Water Heater -$1.50
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50
i BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
' •' ? Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE `
STATE S/C: '
FOR: CITY OF EAGAN ? GRAND TOTAL: -' ?
?.
CONTRACT PRICE:
Site Addross
Lot ? Block
y Name 474
.
.S Address ?
c City
V PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE _
•""' o"? ' gLDG. TYPE WORK DESCRIPTION
Sec/Sub
Res. ? New
Mult Add-on
Comm. Repair
Phone
Name
?
c Address
0 City t ay? o v Phone c
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUets #
Other
/ cZ? M BTU
M BTU
M BTU
M BTU
CFM
/
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FEE .1 u
S/C: ?O
TOTAL:
FOR: CITY OF EAGAN
CITY OF EAGAN WATER SERVICE PERMit
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.: '
Esgan, MN 55121 DATE: •
Zoniny: _ No. of Units: 1
Ownwr:
Si?Address:
Plumbsr: ' - '
Meter No.: S7 a lS aI 3 IAI on Chorge:
Stze: DOXIMMit:
Readar No.: 05N95c?-S?efore di?gittj LS
I M?w h ao?u* ?riN? Hw ?•E ? _ '; !- ? p d :
REQUiaE
oto;?'? . - . ?
BY Dote Paid: I
Dote of Insp.: Insp.:
CITY OF EAGAN WATBt SERVICE PERNIR
3830 Pilot Knob Road
PERMIT NO.:
P. O. Box 21199
Eagan, MN 55721 DATE:
Zoninp: _ No. of Units:
Owrnr.
Addresx
Sih /lddrcst:
Plumber: --
Meter No.: Connectian Chorps:
Stze: Account DePosit:
Reodsr No.: Permit Fee:
1 Nm te eow* wilh IM Cihr oi Eowa Surcho?9e:
Ordi"neir. Misc. Charges:
By
Dote of Insp.:
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199
Eagdn, MN 55121
Zonirq:
Owrnr. ? - - Addrcss:
Slh Addi
Plumber.
Total: ?
Dote Poid:
Irop.:
SEVVER SERVlCE PERMIT
PERMIT NO.:
D/RTE:
z
No. of Units:
I ym M?ewI ll wmb tM G1p OF M"¦ Conrwdion Ciwege:
pnswamoL Accoiwnt Depodt:
Permit Foe: -
Surcharpe:
gy Misc. Cl+arpes:
Dote of irap.: Total:
Insp,: Doft Poid:
i
E-
CITY OF EAGAN C
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12225
BUILDING ' PHONE: 454-8100 / ?/3 ?'/
PERMIT ? aeceiptu ? 7` ?
iobeusedfor SF DWG/GAR Est.value $67,000 Date JULY 2 19 86
SiteAddress 800 GOLDEN MEADOW ROAD Erect E9 Occupancy R3
Lot
KING ADDITION Remodel ? Zoning PD
3 Block 1 Sec/Sub.
Parcel No Repair ? Type of Const. VIl
. Addition ? No.Stories
GRACE CORP Move ? Lengm 51
B
H
W
z Name .
.
2004 VIENNA LN Demolish ? Depth ?d
a Address Int. Impr. ? Sq. FI
City EA GAN phane 456-9030 Install ?
o a Name SAME Approvals Fees
0? Address A55esSflt2nt Permit $ 334.00
? city phone Water&Sew. Surcharge 33.50
?Q Police PlanReview 167.00
F W Name Fire SAC 575.00
I
? u
Address
S??.OQ
Eng. Water Conn.
aw ciry phone Planner waterMeter 63.50
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply?? all applle Sjate of
Minnesota Statutes aod CrfJ o}iEaoan Ordi
Signature of
A euilding Permit is issued to: GRAC/? CORP
all work shall be done in accordance with all appli able Stat 1
Building Official
Council
Bldg. Off. 7/2 /86
Var.
RoadUnit 290 •00
Tr. pi. 156.00
Parks
Copie 2 119 . 00
T...ei
on the express condition thet
Ciry of Eagan Ordinances.
?
7q3li
Zoos RESIDENTIAL PLUMBING PeRnnIrAQPticaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Piease complete for modifications to existing residentiai dweilings.
/s's?
Date___?_??r?
Site Street Address g'o02 Unit #
Telephone #
Property Owner
lephone# (?J,??-'i???i 7+?
Te
l
J
Contractor
/
2 ? City ?Z S(//LGP_ State12'Id/, ZiP
?
0
Addres
Other
t
C
t
_
or _
rac
on
The Applicant is: _ Owner
Rerurbished Submii 2 sets of plans and MPC license
New
Septic System Includes County fee
_
_ $ 100.00
Per as-buiit $ 10.00
Alterations to existing dwelling 50.00
includes instalfation of a water softener and/or water ?
Thi
f
ee
s
Add plumbing fixtures.
heater at the same time. !f you are installinga9nlv a water sofrener and/or water
heafer, do not complete this section; mpuC'?o the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Tumaround (add $130.00 if a 5!8" meter is required)
Other: i
? Water Softener _ Water Heater $ 15.00
_ new X replacement
Lawn Irrigation _RPZ _PVB _new _repair :rebuild $ 30.00
$ '50
State Surcharge
$
Total
?nrl ?rrivaha' thaf thE
I hereby appiy for a Residential Plumbing Yerm¢ ana acKnowieaye inaL uIc III I UI 11. .,?..,,,..•....•... -.---.-_-, ...-- --
work will be in conformance wiih the ordinances and codes of the City of Eagan and the plumhing codes; that 1
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordanc,.Q with the approved plan in the event a p!an is required to be reviewed andAp oved.
App ca Ys Pnnted Name ? AppO(carfYs Signature
1986 BOILDIAG PEAMIT APPLICATIOH - CITY OF EAGAN
HOYE: ALL CONTRACTORS MOST BS LICE95ED iiITH TBE CIT7f OF EAG9N
SINGLE FAMIILY DiiEI.LINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OE ENERGY CALCULATIONS
lIOLTIPLE DTiitEI.LINGS - BESIDSNTIAL REl1TAL IIdITS FOE SALS UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SDRVSY - CHECH i1ITH BLDG. DEPT.,
1 SET OF SNERGY CALCULATIONS
COMAMRCIAL
INCLUDE 2 SETS OF ARCHITECTUAAL
7 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
& STRUCTURAL PLANS, /
SET OF
6?77b4
To Be Used For: `j F p Valuation: ?0 Date: Z-)' 4
S$ba
Site Address
Lot 3.- Block ?
-
Pareel/Sub kt?? A?(d?
Owner [?. tlt Gr?4ce
Address Z oo y UtcN,,,,a
City/Zip Code ? ?c?n .51? 17 z-
-J
Phone 4 3v
Contractor S A(Y) l.:
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
OFFICE OSB ONLY
Erect ?S Occupancy
Remodel Zoning ?
_
Repair Type of Const
Addition # of Stories
Move Length
Demolish Depth ?
-
Int.Impr. _ Sq Ft
Install
arpaoveis Fess
Assessments Permit 3,5Y
Water/Sewer Surcharge -,? 3 - 5'b
Police Plan Review /ai
Fire SAC 5 7 S
Engr Water Conn
Planner Water Meter 6; ?'• J C7
Couneil ,. . ?` Road Unit 296)
Bldg Off(' Treatment Pl ?
APC Parks
Yarianee Copies
TOTAI ?
o 0
9
, 1
,
Phone 4 -1 1
?
HOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOFIEOiiNEB MDST DESIGHAiE AHICH ADDRBSS
IS DESIRfiD. NO CHANGES fiILL HE 9LLOiiED ONCS BOILDING YEBNIIY IS ISSOSD.
rH edlund Engineering Services 9201E061W°°m'a'°"f`"~°l `
buomuplon, Mwrwlo ?0420 .
LYOO Srlvoyari Clrll Enqinpn Lontl Plcnnen PAOne: 1Wd•0269
SAUVROld"s eatiliwe
r ? ?jGc?iK._FHG? -
J08 N0, ? r°? 2?
SIIfiVEY fCA: B . H . (?race
pESCptUp AS: Int 3, Block 1, EING ADDITI(lN 1o EAGAN, City of Eagan, Bakota County,
D4innesota and reserving easements of record.
0
93? ?
i?
? Sx4f? s ?sr ?
./ \
?
?. i
M? x? S
?
'
9 e
--f ?
? 9_
,e.
/ ? \ SyF F
/ ^ .
?v
(,3
GJ'?
o r C?
S„
h
N'?9o
??9,
sN i
?
?
.(
?
?
?
/
q
? q.
? ?.
?
?
\
?
?
?
Q 9JS3? / ?
S
, ?o
.
v - •o•?
/ Sx
? /cP
/ ,.?G S
rl ?
? -'
TOP OF FOUNDATIGN = 936.0
GARAGE FLOOR = 935.6
BASEMENT FLOOR = 928•6
SEWER SLRVICE ELEV. =`?Z?A ?
PROPOSED ELEVATIONS : O
EXISTING ELFVATIONS :
DRAINAGE DIRECTIONS :
DENOTES LOT CORNERS : 0
DENOTES OFFSET STAKE: 0
CERTIFICATE OF SURVEY
I Mreby urlify IAoo on (,/Z(O 18(, I wrveyed tM property Oeatti0e4 odovo and Ihat
1M aoov plat is o correct represenlohon ol so10 wrvty..
Colvln N.INdlund, Wnn. Re4 No. 5942
MMRIQt FNVQAPE AVERAM "U" MWJU?TiM (1 ?
. aWNEe: 70/yl VL B."
sr1E nnREss: L-oi- 3,
?MCMR: ?%TJ • ??'/?"t ?" nm: PME:
DErEMME 4AtiMG SQIARE FOOTALE OF FAL7H:
1. 102AL. F1M6F.D WAI,i. AREA........ a6-73 aq ft x '41"
2. TOPAL PDOF/(EIIMC AWA....... . sq ft x"U' .026 • %''.- •
?
3. 1LYPAL EXPO6FT1 WALL ARFA GK.C[QATICFS:
Total exposed wall
area above Eloor. . . . . .. . . aq ft
t
a) Total wall windaw azea:
. . glazed aq ft x 'U' . `!?•? • 5?, ? /
. . . .
d
l ft x "U" •
m
g
..... aq
b) Total door area.......... 3?•d6 aq ft x"U" a,V3
c) ,FrrQwrt?
Totel sUding gleas door axea:
glazed..... aq ft x"U' ? -
,_
glazed.... sq ft x "D"
d) Total Hreplace wmll arna sq ft x'9P' ?
. _
e) Total wall freanLng area
(Average 1(17.) . . . . . . . . . 0?I673o
aq
ft x "p"
0 9b
?
9"- , /d
---
-
--
?
•
f) ')Total net wal.l area ebove
floor (inau7.ated)....... 9 /6¢.86 ?
aq
ft x"Il"_
16
g)^ Tocal rim joiat srea..... M, sO- aq rrt :?'U'? , o(13
Tbtal foundatian
area (8poaed) . . . . . . . . 53 sq ft
h) Total fomdatia?
wLndow area............
- aq
ft x ,
i) Total net fouidatian
a:ea above" grade . . . . . . . 33 aq R x "U"
'1C1PAI. a) thru i) •
If item $3 is the amw as, or less ttm item A, ynu hsve aoet the inta?t of
2 WAR 1.16008 Aand 0.
Fsg?e 1
;r.
's .
LVi1fY fYMM WOF/MWR/ VMD/1L14V i - '
TOCBl ampOBBd
:+oof/oeiling asea......... 105?- eq ft
--,---
3 ) lbtai atryli.ght atea........ - aq tt x 'v'
-- ? ?-
k) 7bta1 rcof/aeiling fraidn8
• ' asea Uweiage = . . . . . ' S . } eqftx 'tl"
-« /?
1) Total net insulated
svof/beiliag ma... .... 9yG. 8D oq ft x"U' y o a a- .ao43
4. M1'Ai. j) thtu 1) ?
f
Alteawte Huilding ?
velope Desi?
If total of #4 ia t3?e sae as. ar less t3et #2. Ynu l?av?e met the intsc?t o
2 MCAR 1.16008 A. a?d 0.
To utilize.the total a?velape ayetem mettiod, the valuea eatablished by the aa
of' iteme 13 asd /4 shall not be gimater ttm the sua of itemr #1 atd #2.
1. +2. ' .
3. +4,
CERTIFICATION
I he:eby certify that I tiave calcail.ated the '11' , factora ?d "R" values
herein eid that the huilding hec+e deecrihad maetr or ewceads the State of
Mitstaeota Pn"a Cawuvation Act.
(siwaturs) C? _r.???'r%7
,
(Date)
?
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*XYPF': PAYMENP OF FFE AT TIME OF
APPLICATION DOES NC7P CONSTIITJIE
APPROVAL OF PERNIIT.
INSPDGTION OF SEWE2 ArID/OR FTATFR ;
rnSmar.ramrpA7S WILd, Ndf BE S(HK>- ?
UI? OIdFII, PIItMIT HAS BEESI ?
APPRWID. ;
,
:
- - - - - - - - - - - -
P e se Print)
1) PROPERTY ADDRESS: y
LEGAI. DESCRIPTION;
. Lot Block Su ivl6Aon or Tax Parce ID )
7F EXISTING S2RL'CI[.'RE, DATE OF ORZGINAL BUILDING pERN1iT ISSL'ANCE:
i
PRESENP ZONING/PROPOSID USE: (Mon Year)
C] COMME[tCIAL/RE,TAIL/OFFI(E
F7 IDIDCSTRIAL
n INSTI2L'TIONAL/GpVERDAENT
2) ?
NAb1E:
ADDF2FSS :
CITY, STATE, ZIP:
PHONE:
Zr-R- SINGLE FAMILY
Q R-2 DLPLEX (Tko L?nits)
? R-3 MWDII-IOUSE (Three + Units) ( C?nits)
Q R-4 APARZr1ENT/COAIDOMINIDM ( Units)
3> •°?: ?• _ Nr?Me: TOM HESSIAM P1.UM81NG, INC. For City Use ..
Plumbers License:
ADDRESS: Aoa a vA. i Active
- LLF.]C,S+2a A FScpired
i CITY, STATE, ZIP: R ryot recorded
PHoNE: MASTER LICENSE# .? ? ?2,0 Y St? t?al
4) •?• • ? i?•
ADDRFSS:
CZTY, STATE, ZIP:
PHONE:
..
r. • 04• 1 : o • ? • DID -
NNECTION 1O CITY SEAIII2 NM?7C,TION ZU CITY FIATER ? OTHm ' .
6) ? r•? r ? PLEASE HOI,D APPROVFD PERMIT FC)R PICK-OP BY ONE OF ABOVE `--- _
PLFASE MAIL APPROVID PERMIT 7U 1. 2.4. ABOVE
(Circ e one) '
7) r r u• • ^ ? -V
FOR CITY USE ONLY -- ' -PERMIT # ISSOED
'00?, 1
Pd w/Bldg. Permit
$
S
$
$
$
$
S_ SaO• Crc?
$
J 7S/?
$
$
$
$
$ O b
$
$
RECEIpT
FEES:
$ /d - S'v
$ /G-S?
$
S
SEWER PERMIT (INCLUDE SL'RCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHORN/Of:TSIDE READER
WATER TAP (INCLODE CORPORATION STOP)
$ SEWER TAP
$ RzD ACCOUNT DEPOSIT - SEYdER
$ ACCOL'NT DEPOSIT - WATER
$ WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BEN IT/TRL?NK WATER
.+?iif,c V. ??.? t7Q??2?? ?'?
$ 37,?:"l ,3WS75ER3°tAiATMENT PLANT SCRCHARGE
;Sr?? :'lt.A Y3.41AV a:u44..
$ OTHER:
$ J /
?v
, TOTAL
RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE : _ ? // //? IG
CZTY OF EAGAN
3830 PILOT SNOB ROAD
`'Ee.GAtV, TIDi 55122 i. qj_ y(ooa
PHONE: (612)-454=04Bfl
DWELLINGS fi
NTIAI:':: PLEASE COMPLETE IIPPER PORTION ONLY FDR SINGLE FAHILY
TOWNHOMES/CONDOS WHEN PERMZTS ARE REQUIRED FOR EACH UNIT.
---------------ti --- ----------- __------_____________________--
WORK DESCRIPTION ! FEES
? "J
NEW CONST
ADD ON
REPAIR _ I?OWNER NAME: hf?U.f'AzJZ ?SdiLJc-!G
SITE ADDRESS;
IAT: 3 BIACK ? SUBD.
TIISTALLER: Rnn'c Marhaniral. Tn?
ADDRESS: 1919 F._ Rhaknnaa Avamia
C.IZ'I': Shakn no- Mn ZIP: 9S379
PHONE #: 017/1414 S -RSRS
&i&il?*JUD M90422w?,J
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
v'o
SUBTOTAL: 15 $ ?
STATE SURCHARGE: .50
TOTAL:
g Sr? 5t?
'7/L" i-?
SIGNATU PERMITTEE
FOR CITY OSE ONLY
PERHIT iF
RECEIPT
DATE:
PLEASE COMPLETE THIS PORTION FDR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
ZIP:
PHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PF.OCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
$
$
( S IGNAT[TRE)
CI.AI1f VOUCl1f.R - RErUND ftLR11F.ST
CI?Y OF EACA17
CLAI!ihNT RON'S MECHANICAL INC.
ADDRESS 1812 E. SHAKOPEE AVENUE
SHAKOPEE, MN 55379
l.ncat ion
Acceip[ No./Date
Reason fcr Refund
Tcre o[ Refund
9 130 ?q z
800 GOLDEN MEADOw RoAn
1'L3 B1, KING ADDITIOALSO EAGADL
107771-9/21/92
OVERPAYMENT F MEr r
E]ectrical Fermit
Flumbing Termit
}techariical T'ermit
Surchnrqe -
Water Connectlon Permit
Sewer Connection Permit
Account Deposit
Util3ty Aecoun[ Over-!'oyment
ncner:
01-3211 S
01-3212 S
01-3213 S 3.00
01-2155 $
20-37t3 S
20-3747 S
,
20-2252 S
20-2250 S
S
$
TO'IAL S 3.00
7 declarr under the rpnnltiec oF law tliat tliis account, claim or demand is Just and .
that no part oE i ha!+ been naicl.
? 9/30/92
ature bate
?jy.7 y 2004 RESIDENTIAL BUILDING PERMIT APPLICATION `'i' ?a1• ?`f'
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
New Conshuction Reauirements RemodeVReoair Reauirements tNfiC'e Use On
3 regletered site surveys showing sq. il of lot sq. ft of house; and all roofed areas 2 copWs of plan CeW, 8 anfey`-?E `i?-?"?'
(20%maximum btcoverage allowed) 1 setof Ener9y Calcula6ons for heated additions Trewm 0 I2nRecd ;Y ,_ N;
2 capies of pWn showing beam & window sizes; poured found design, etc. 1 srte survey for additions & dedcs Tree Pres Reqmred _X _ N
7 set of Energy Cakulations Addi6on - indicate il on-sife sepfk system O,A?d?Se,ptie S?!.ste?l Y„=N.
3 copies of T2e Preservation Plan'rf lot platted afier 7/7193
Rim Joist Detal Options selectlon sheet (bldgs vnfh 3 or less units
Date 03 1 04
SiteAddress gpp 1 04
r,)lr3a.+ Ma=Arw unfj Construction Cost $$ ,000.00
UniUSte ti
Description of Work convert screen porch to four season
Multi-Family Bldg _ Y X N Fireplace(s) X 0 _ 1 _ 2
Property Owner pa ul gnd Tean ; k Telephone #( 651 Yi87-9A92
Contractor pou4 Carlson Inc
Address 7185 - 132nd Street West
State Minnesota City arm7va11ay
Zip 1?74 Telephone #( 952) 4,'41 _aARR
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateaorv 1 _
. Residential Ventilatlon Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculatlons Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee appiies.
Licensed Plumber
, ., AZ _
MechanicalContractor 'Iivi?
Sewer/Water Contractor
? ? ?? ??• Telephone #(
Telephone # (
Telephone #(
N If so, 25% plan review
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 City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an applicarion for a permit, and work is not to start without a
pemut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Ibuglas V. Carlson ' ?LA sw
ApplicanYs Printed Name ' Applicanignature
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
OFFICE USE ONLY
Sub Types
? 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 Ext. Ait- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage A 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
A 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
O 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EnUre Bldg) - Give PCA handout to appliwnt
Valuation Occupancy IG. MCES System
Census Code
?
T Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const v W idth
REQUIRED INSPECTIONS
Footings (new bldg) Final/C.O.
Footings (deck) ?C FinaVNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests Final
Framing _ Siding _ SNCCO _ Stone _ Bri ck
Fueplace R.I. Au Test Final Windows
T/ Insulation Retauvng Wall
Approved By: / 2 , Building Inspector
Base Fee S 411Zli;?
9 ?. To
Surchar e
Plan Review
MC/ES SAC
C,tySAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
This rnquesl void Y-
18 rrpnths (rom
C 20163 L3,8l
J? - ?s 67 y
XV
Ranu t ac
ry
?
? ??I Fire No. Nough-in InsPection
Aa,?qufi ?tl? ??,/
?ReaGy Now ? will No?ify InsPec-
tot Wh
R
d
O ?Ves ?NO en
ea
y
VLicenseA ElecVical ConVactor 1 hereby requasl inspection of ebove
? Owner electricel wotk instellad at:
Street Address, eox or R vte No.
f10o G
/ Citv
F
o
.e
,07
a ?
ecuon o. Townshi0 Name or No. anee No. Cwnty
Occu nntlPqlNT) -
,?' tri4 G ea e -e 60057` a. Phone No. .
Power SupDier Atldr ss
/-
-"
r
? i'm '
Elecvical Con[r tor ICOmDa yName Contrar,tor's Liconse No.
CJ
(
?
?
o
PC)
0 8
?(:aP F
Mailine .°.ddrass IConuactor or Owner Meking Inslar I ionl?
uthorized Si t (Co actod ner Maki Installation) Phone Number
MINNESO STATE BDARD OF ECTpICITY THIS INSPECTION flEQUEST WILL NOT
GrieHS• idwey Bldp. - Room N-791 BE ACCEPTEO BY THE STATE BOAND
1821 UniversitY Ave., St. Peul, MN 55104 UNLE55 PNOPER INSPECTION FEE I$
Pn..... (8121 197.2111 ENCLOSED. '
REQUEST FOR ELECTRICAL INSPECTION
w
Sea insiructions lor completinp this form on beck o1. Vellow copy. ? /???
-C ?016 3 '"X'" 8elow Work Covered by This Request p y
AAd flep• TYpe ol BuilAing Apolinncea Wired EpuiVnient Wired ?
L_1 I I Home Range Temporarv Service
Bulk
p Fee ServiceEntlenceSize H Fee fexdars/5ubteeders p Fex Circuits
U to 200 qm s 0 to 30 qm s 9 ?4 1 0 to 30 Am s
Above 200 qmps 37 to 700 qmps 31 to 100 qm
SwinxningPool Above 100_Am s Above 100_AmP`+
Transiormers rrigation Booms Partial-'Other F
Signs Special InsUection
emsrks TOTAL F K
if'^• ' _ i
1, the ElectTFeeY?
Inspectoq herehy
certilV that tpa above
inSpection he5 bBBn
Thle repueat valtl
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140895
Date Issued:01/30/2017
Permit Category:ePermit
Site Address: 800 Golden Meadow Rd
Lot:3 Block: 1 Addition: King Addition To Eagan
PID:10-41950-01-030
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Ross Rosemark
800 Golden Meadow Rd
Eagan MN 55123--196
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature
r For Office Use/60/‘.0
0
ti1*
Permit#:
E AGA N
Permit Fee:
6,0 - bb
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspectionsacityofeagan.com
2020 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: '- (1 ZD Site Address: t1 V1/1P,at 4A0 cSi
Tenant: j, Suite#:
Name: 46 S A DSC' 11.� Phone: t� 17—
Resident/Owner _
Address/City/Zip: C607,) ( u \ 11\4460 460 ) �'(te n A`" \, S i 2?
7 7
Name: PS hf) eNt(rf'l,,_ License#:
ContractorAddress: City:
State: Zip: Phone:
Contact: Email:
Type O WOfk ' —New —Replacement —Repair —Rebuild X Modify Space —Work in R.O.W.
Description of work:
Tankless Water Heater Lawn Irrigation( RPZ/—PVB)
Standard Water Heater
Description Add Plumbing Fixtures( Main/ is Lower Level)
Pti Water Softener
Description: ?0, \
Septic System
New Abandonment Connection to City Water from Well
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 New fixtures, adding or removing piping (includes State Surcharge)
$60.00 Septic System Abandonment
$100.00 New Residential (fee collected with Building Permit)
$115.00 New Septic System (includes County fee and State Surcharge)
$60.00 Connecting to City Water from Well*+$290 for Meter and $200 for Radio Read =$550
`Sewer&Water Permit also required for connection charges
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.qopherstateonecall.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.citvofeanan.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 no o 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 pla
N3 DcernWit x /
Applicant's Printed Name Applic nt's Signature
Page 1 of 2
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172726
Date Issued:10/13/2021
Permit Category:ePermit
Site Address: 800 Golden Meadow Rd
Lot:3 Block: 1 Addition: King Addition To Eagan
PID:10-41950-01-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Ross Rosemark
800 Golden Meadows Rd
Saint Paul MN 55123--196
(612) 875-1373
Built Strong Exteriors Llc
2215 Quebec Ave S
Lakeland MN 55043
(651) 702-1300
Applicant/Permitee: Signature Issued By: Signature