811 Golden Meadow Rd?? .
CASH RECEIPT
.?.
CITY OF Ei4GAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
. ' ?
DATE ", tg
?
AMOUNT $ fl--• / , / ' (?
12
& DOLLARS
ioo
p CASH CHECK
FOR;
4.1 l"
FUND PBJECTJ AMOUNT
d 0 j A Ctv , V Ci L'
O 3 ? G (Z)
D ?3 'G, U
Thank You . sv
Whi1e-Payers CoPY
Yellow--Pos6ng CaPY
Pink-File Copy
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-5100
BUILDING PERMIT Receipt iTo be used for Est. Value a'4 6,Date JL'NE 2
Site Address 811 GGLLi'!y MEAllOW RD
Lot i Block 1 5ec/Sub. hYNG 2ND
Parcel No
a Name ?=CK CONSTItiiCTION CU
= Address 6483 BONNER CT
° City 1NV r:R GR(?VE Phone 1`! ;- 1244
,o Name 5?
? ? Fy?idress
°C
?- City Phone
?- ¢
W yj Name _
"W
r
Address
vZ
? W City-
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all appiicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
AISuilding Permit is issued to: TI094 CV
on the express condition that all work shall be done in accordance with all
ap9lfcable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System k 2oning
On Site WeU (Actual) Const
City Water k (Allowable)
PRV Required x 7k of Stories
Booster Pump Length
Depth
S.F, Total
Footprint S.F.
?108
,19 ?o
iR-3 H-1
V-4i
Y-d
51'
43'
APPROVALS FEES
Engr./Assess. Permit 558•00
Planner Surcharge 48.00
Council Plan Review 279•00
Bidg. Oft. SAC, City 100• 00
Variance SAC, M WCC 550,
?Q
Water Conn. S 50.
Water Meter 67,
Road Unit 32 S. t30
Treatment P1 204•0(j
pm%Copies 1.00
2'00
2
TOTAL ?
PERMIT NO.
01-32?0' v Bfdg.'P"eYmT
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 3urcharge
,
75-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
TOTAL
r j• ,. .. , . .
?
CASH RECEIPT
kIJ
CITY OF-EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE---
19
?o
FWU
AMOUNT
& DOLLARS
10°
I
? CASH 4,7 CHECK i
I
e-•
Thank You BY
A W,k&-Peyars Cop„
Yellow-Pasti^9 GoPY
Pink-File CopY
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAO, EAGAN, MN 55122
PHONE: 454-8100
Site Address ?
lot ? Pock i Sec/Sub _
-? t -
? Name
co Address
c Ciry Phone ' -
Name
3 Address
O City Phone
FEES
COMM/IND FEE - 1a/o OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
WORK DESCRIPTION
New
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
O. FIXTURES
N TOTAL
.
- Water Closet - $3.00 $ U
Bath Tubs - $3.00 -
Lavatory - $3.00 _J
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $100
Floor Drains - $1.50
Water Heater - Si 50 _ -?
Whiripool - $3.00 '
" Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
.j Rough Openings - $1.50 ?
' ' '
? MECHANICAL PERMIT
/ ` ' '
• RECEIPT #
CITY OF EACAN
4
3830 PIL OT KNBB ROAD, EAGAN, MN 55122 DATE:
Q
CONTRACT PRICE: PHQNE: 454-8100
Site Address j BLDG. TYPE WORK 0 CRIPTION
Lot81ock ? Sec/Sub
? ?? Fies. New ?
Name Mult Add-on ?
Address . j Comm. Repair ?
? ciry &:' / 4Q - hone 7 - ocher -
?
.
7 '
FEES
? Name RES. HVAC 0-100 M BTU -$24,00
3 Address ADDITIONAL 50 M BTU - 6.00
0 City ph9ne 7 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION) - - -
G
AS OUTLETS (MINIMUM - t PER PERMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air gTU APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM
$ STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF
PERMIT PRICE GO
Gas Piping Outlets # 12
$ 3.0C
BEYO D$1,pp0)
r
Other ? .-
FEE ?, ? ?, ? ?•. 4 ? ??, ?,.?? ?
S/C: SIGNATURE OF PERMITTEE
TOTAL:
FOR: CITY OF EAGAN
CITY dF EAGAN + r a t: ?
3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121
^-
PH O N E: 454-8100
SUILDING PERMIT Receipt #
To be used far Est. Value '' iz •??'' Date 119
8t1
Lot ' Block ' Sec/Sub.
ac IVame : 0
W
z
Address
9 City Phone )?-J` '''4
, o Name
oa Address
? City Phone
?Q
uW
W Name
W
f
= E.
Address
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.
Signature ot Permittee
A Buiiding Permit is issued to: '
on the express condition that all work shall be done in accordance with all
appiicable State Df Minnesota StBtutes and City of Eagan Ordinances.
Building Official_
OFFlCE USE ONLY
On Site Sewage Oocupancy
MWCC System Zoning
Qn Site Well (Actual) Const
City Water (Allowable)
PRV Required # of Stories
BDOSter Pump Length
Depth ?
S.F. Total
• Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge ?
Council Plan Review ?
Bldg. Off. SAC, City _
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
Permit Na. Permlt No4der Date Telepfione #
Pfum6ing
H.r?ac. '?.c, c,e., ? ??'i,?`,
Electric
r?k:3, ?
u-?.- r?
Cd'-?,?) ?v
Softener
inspectfon Date Insp. Comm@nts
Footings I 4-"'
Footings II
Foundation
Framing
Roofing
Rough Plbg. S=?
Rough Htg.
Isul. ?asf ...
Fireplace
,
Final Htg. 30 8? , l 66 . e?G
Final Pibg. ?6? A?c/M??vuM
Bldg. Final
Cert Occ.
Temp.LP
DeCk Ftg.
Deck Final t4e 0,,
Well ?
Pr. Disp. ?
Eagan, MN 55121
CITY AF EAGAN
3830'Pllol Knob Road
P.O. Box 21199
Permit No: 97t?,? Date: '- 19 Meter No: 41117 '/ 6 8 Size: ? Oc?
Reader No: 4Y 3 g Date: ?6
Conn. Chg: 550. 0Opd Zonin9: r?
Acct Dep: 15. 00pd No. of Units: Z
Permit Fee: 10. QOpd
Surcharge: • S0pd 1 agree to compl
with th
Cit
o1 E
Tr. Plant
2 `'I • ,')OPd y
e
y
agao
Ordinances
Meter. 67 _ nnpd
V
Mi
?
° RF
11
r
'Rk 7
;
.
SC.:-
. .Qj
7
' 8Y
7
WATER SERVICE PERMIT
?
i
L..yo,,, mn
Owner
Conn. Chg: 550.OOpd Zoning: 1171
Acct Dep:_ I5-OOTK; No. of Units:
Permit Fee: 1?. (}r??r
Surcharge: 1 agree to comply with the City of Eagan
Tr. Plant 2` Ordinances.
Meter.
Misc.: `' , - By
WATEA SERVECE PERMIT
CITY OF EAGAN
3830 Pilat Knob Road
P.O. 6ox 21199
Eagan, MN 55121
Permit No: I ??2 S
B/P No:
Coast.
Site Address:
Date:
Date: 5-2-88
,
Plumber: Weierke TreLChin, [n b _ -
MWCC:
Ci Ch
A ct. Dep:
?
Permit Fee:
Surcharge:
No. of Units:
I agree to comply with the City of Eagan
Ordinances.
By
CITY OF EAGAN N2 1510 8
3830 Pilot Knob Road, P.O. 8ox 21 •199, Eagan, MN 55121
, PNQNE:454-8100 P??j (!/
0 ?) d
BUILDING PERMIT Receipt#
To be used for SF DWG Est. Value $96 , 000 Date .IliNE 2
Site Address 811 GOLDEN MEADOW RD
Lot 1 Block 1 Sec/Sub. KING 2ND
Parcel No,
s Name MOGCK CONSTRUCTION CO I
W Address 6483 BONNER CT
0 z
City INVER GROVE phone 753-3244
¢ Name 5AME
.o
? a Address
0? Ciry Phone
t¢
w W Name
i? Address
g w City Phone
?l1_, OFFICE USE ONLY
I hereby acknowletlge that I have read ihis aDPlication and state tha[ the
information is correct and agree to comply with all applicable Sta[e of
MinnesotaStatutesandCityofEa nOr mances.
Signature of Permittee ?-/L-
A euiming Permit is issued to: 1'10 CK CONS RUCT?f ION CO
on ihe express cond ition that all work shal I be done in accordance with all
applicable State of Minnesota Statutescay?nd Ciry of Eagan Ordinances.
Building Otficial-AAk4-&JA .1 l
On Site Sawage - Occupancy R-3 M-1
MWCCSystem X Zoning
On Site Well _ (Actual) Const V-N
Ciry Water x (Allowa6le) V-N
PRV Required X # of Stories
Booster Pump _ Length 511
oePm 43'
S.F. Total
Footprint S.F,
APPROVALS FEES
Engr./ASSess Permit 558.00
Planner Sumharge 4$.0?
Council alan aeview 279.00
eldg.OH. SAC,City 100.0?
Variance SAC,MWCC _5,50_.9O
WaterConn. 5.$0 ?99
WaterMeter
D
67_0
RoadUnit 325-,00
Treatment P1 204.00
ParxsCopies 1.00
TOTAL Zeb$Z.DO
RESIDENTIAL
BUILDING PERMIT APPLICATION
'5040 ? CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
New ConsUuction Reauirements
• 3 registe2d site surveys showing sq. ft ot lot, sq. ft. M house; and all roofed areas
(20 % maCimum lat coverage allowed)
• 2 copies of plan slwwing beam 8 window sizcs; poured found design, etc.)
• 7 set of Energy Calculations
• 3 copies of Tree Preservation plan if IW plaped after 711193
• Rim Jolst Detail Options seledian sheet (bldgs with 3 or less units)
DATE
1yz'S.
4S- - D V
RemodeUReoair Reouirementa
. 2 copies of Plan
. 1 set of Energy Calculalions for heated addNOns
• isitesurveyforexterioradditbns&decks
• Indicate'rfhomeservedhysepticsystemforaddNons
VALUATION 1&0 •
SITE ADDRESS O I I 0 I Ci ?C, 'IV I Pa (V a (-,) K6 MULTI-FAMILY BLDG _ Y X' N
TYPE OF
APPLICANT
STREET ADDRESS I " (,l'Pi)Q l Q. rl d"d i
TELEPHONE # 65-1- (p33-b39_'StELL PHONE #
cirr
FIREPLACE(S) _ 0 _ 1 _ 2
ji?LhVATE,knZIPall,)-
FAX # 65-1- (033-&q '7 /
PROPERTY OWNER K?+-P l)e erI G I` S o r1 TELEPHONE# 6?9l 9393
I ----------------------------------------°---------------------------------------
COMPLETE THIS SECTION FOR KNEW" RESIDENiIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RiJLES 7670 CATEGORY 1 MINNESOTA RiJLES 7672
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Piumhing Contractor:
Plumbing system includcs:
Mechanical Contractor.
Mechanical system includes:
Sewer/Water Contractor:
Water Softener _
Water Heater _
No. of Baths
Phone #
Lawn Sprinkler Fce $90.00
No. of R.I. BaYhs
_ Phone # ?P
n MAY 1 7 ZD?Z i
Phone MI
--------°-°---------------°----------------°-------°----° °-------------------° °-?-?-.?--.- ----°------------
I hereby acknowledge that I have read this application, state that the information is rrect, and agree to comply
with all appiicable State of Minnesota Statutes and City of Eagan inances
Slgnature of Applicant
--------------------- --'---------- --°----- - --------------- _ -°-'°---------------------- °'----------------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
Air Conditioning
Heat Recovery System
198& BpILDING PERMIT 9PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLING3
'?.
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVE?i', 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CON'fRACTORI$OMEOWNER MUST DESIGNATE WHICH ADDREpSS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENT9L UNITS FOR SALE UNIT3 0 OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB WITH HLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CDMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
Rffo MAY 17 ?q$g
To Be Used For: S1N(.LE?qMIL? Valuation: /b, Date:
DwEt 1I
i y?.?
(??n
Sit
Add
6
2
?o L3 I
NLY
/
e
o
ress
.
1 OFFIC E USE O
Lot ? Block On site sewage_ Oceupancy
r MWCC system Zoning
Parcel/Sub .,? aU On site well Actual Const V-N
City water ? Allowable V- N
Owner PAV required # of stories
Hooster Pump _ Length - 5 d'
Address Depth y2'•9"
S.F. Total
City/21p Code Footprint S.F.
Phone ' APPROVALS FEES
Contraetor Engr/Assess Fermit 5SL9•00
Q?^u•-PAt??J Planner Surcharge
Address (.L.,,JrJd2 c6j2T- Couneil Plan Review ZQ9 ,pJ
Bldg. Off. SAC, City laO,oo
City/Zip Code Varianee SAC, MWCC 650,00
Water Conn bU
Phox?3Z4N Water Meter 6r1'OD
----- ? Road Unit
,DO
-12
Arch./Engr. Treatment P1 G 14,oo
Parks .
6ddress Copies. ?
TOTAL ? i
City/Zip Code
--- - ?
--
---
Phone B
.??
CTAR A(,,e
2 `FkZo s y80 x14= (,, 720
t?sm i
??-I,33)e 22=
NousE
vq L-uA`r' i o N
.? , ? ? . ., ..
l 53'1?/
I
S4q
3 z`I
31 .r
114?3X?3 ?
ay = ?3-2-
/ K 14 = ! ??
tx q ? ?
zZ?t z(, e 5'7Z
S y?Jz: Go
Zx/o- 20
r---
?5?? 73K`43
9 ?rt------
1
LIA
?
c??, bZ
' -- ---
; ?- - - --- - -- ;
?
I i ? I
? l I ? qe3•?y. ? '--~_ ? ? ?, ?n?
IrE ?
.j I I? j ?}?c3•?2 ? i ld.Rnv?
' v? , ; ' ' - `j?z•L'S
' f t i . j 1!
I
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.
. ,
----? - ;
?
i o HACKMORE URIVE
°
--
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? _ _ --
499 53 --- --- --
?
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W
u? I
?
01
a I7 O
?
Q ? I 3
°
a
I ;zo.co
-- - - -- - -?
?
zaoo Naeose'i5"`
o i
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- -
-t ?-ao.oo - o
o
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a
i ?
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m ?i
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i
. i25 I
./3 I Z
I ? l07 ??
N
?I2 3 PJl ? P N
f_
10 mI
?
11 Z
4
6 r? . 'oo (D
.
o i
?
pQ
W o
? $ o - it• v?•.
R ? ??s
C)4
?
X
2o
S ..
2j ,,
C.LTY OF FAGAN
E:t;FRICR E:tVELQPE AYERIGE 'U' COHPuTATION
OwMER: f?jpR[?fn)e-K<c) ti1
,
SITc anoaess: /ej0b,s z r3
CONTRACTOR: ?'?1?J?IJSi72 G47Q1J(4t) DATE:_ ? to PH04E: yssCc?37
Cetermine xorking syuare fco'l:ge of each:
1. To.*.a1 e:t;,userf .rai1 az-ea ... a sG. ft. x.tI =. P`S?•J-1
2. Total roo£!ceiiir.3 area ... If) l? sq. £t. x,025 = ??.2C_
Total exposed wall area above tloor =
a. Total wall :+indow ar^a ............ ................. 1`1 lir
b.
TOC:]i
tiOp!' 3PP_3 ................................... p
?7 Q
c. 10ta1 sliding ,1ass ar?a .......................... -
d. Total iireplace wall a-ea ......................... /D
e. :'otal wall ?!".lR:'^g 3C?d (8V2Cdg° ............. --423U.2-
f. TOt3= :12t 4211- 3C?3 ubOVi? *'_^OC ...................
TriCdi !'1[!1 jo1:iL ,3rP.:7 ............. .....s...........
iotal 2xposed tocndation area :_ 191
h. Tot?1 fnundacior: .rind;>w area ........ ............ 9-75
i. Tnral n.r.t loun,g.:ti::n ar^a atove ,'ade .............. :91 .$
^etermine `u' :alue of eacn wall 3-;ment:
.? • _._l.9. ?L___-_ y ' ? ? , . ?? i ? - ?I i ? ?
b.
?.
{
(. ,
17.9 y `
. _.12???--- • ? u ? ?'? ?
9
- _ 01
..
__.1
`-
k
5?
:
'
:. ................................. ............. ...... :o:?-
., i.- . ,?„ ., .... ? ? .. >>
L) ?
j. . .-.:t .,:i'.i;, - a• . ................................ ?--
.. . , ' '. .. . . _ . , . , .. . .. _ , . . . ' ! . . . . . . _____?_'.5?+.?._._
i..,o ....- ,...?.i _ ,...,f .............?
OVER
Ceter:nine 'U' value for each rnof/ceiling segmant:
j. x 'i;' -
k. z:5-/ x ' U' , DZ ? _ . ??• Z?i
L. x u, 022-
4 . ...... ...... .................................... ...... To?al
If total of i14 is the saina as a- less than #2, you have .,:et. tite itrtent of SBC
5005(c)1.
Alternate ?uilding Envelope Desi;n
io utilize inz total znvelva_ sysrem ^iethod, Y,ne va;;es astab'_ish-'d by t`.:° sum
oi Ite!1s #3 and ;!4 shall r.o* be ;reater than the sum o: itams i11 and ?!2.
1. + 2•
3. + 4.
,
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*Orw,: PA7WKS OF FF.E AT TIME OF
ArrrIcr.TTOrr DM rOr o010TzTUTE
APPROVAL OF PfI2PIIT.
iNsPncriota oF sEWst AM/ox wr=
TISTATS.ATTONS WII.L Id0T BE .9CEIID-
ULFD ONTIL PII2NIIT AAS BFaI
APPROVID.
P ease Print
1) PROPERTY ADDRESS: 811 '?'olda n i'eadow ;d. •••
LEGAL DESCRIPTION: IE?lock I 7_tngs 2nd Add.
Lot Block Subdivision or Tax Parce ID
. r
IF EXISTING STRL'CiLM, DATE OF ORIGINAL HIJILDING PERMIT ISSL'ANCE: '
?
-
PRFSEDII' ZQNING/PROPOSID OSE: Nbn ear
Q COPNERCIAL/RE1'AIL/OFFICE 01? R-1 SINGLE FAMILY .
Q 'STRIAL F-I R-2 DL?PLEX (Trv Units)
0 INSTIZS]TIONAL/GOVERNMENp ? R-3 TOWNHOLSE (Three + Units) ( Units)
. Q R-4 APARTMEN'P/CODIDOMIDIILTI ( Units )
2)
NAME:-
ADDRESS: l
CITY. STATE, ZIP:
PHONE:
3? • ?: ?• Far City Use ..
N71f?: '7aieri?e _ plbar3 Plumbers License:
ADDRESS: ? ? Active
+iCl nl iff Rr9_ FSCpired
; CITY. STATE. ZIP: Eagan, i:n. 55123 rrot recorded
PHONE:_!GJy 7ti7FMASTER LI(:EDISE# (1C)3FipT?.'?
- - St?Initial
4) ?• • i?• ,
NAM: Sa?ve as ?-r,plicant
ADDRFSS:
CITY, STATE, ZIP:
PHONE:
'S) " a' ' ?' : a • ?? - ??
mNrWrioN TO ciTSr sEWER ?.: mrsEcrioN zo czxY wAxEa Q rn.M
6) '? • ?? i? PLEASE KOLD APPROVID PEE2NIIT FY)R PICK-C?P BY ONE OF ABOVE
? PLEASE MAIL APPROVID PERMIT T0 1, 2, 3, 4, .A80VE
(Circle one)
7) rl l_ °
_ FOR :CITY USE ONLY -
PERMIT # ISSUED ,
Pd w/Bldg. Permit FEES:
$ $ /d • S? SEWER PERMIT (INCLUDE SDRCHARGE)
$ $ ?O • S? WATER PERMIT (INCLDDE SURCHARGE)
$ ?i 7?C?C? S WATER METER/COPPERHORN/OOTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ f?1 CJ77 ACCOUNT DEPOSIT - SEWER
$ $ ??? `O C7 ACCOONT DEPOSIT - WATER
$ 5??o "Ci e) $ WAC
$ $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ r`-e? 't ? d O $ WATER TREATMENT PLANT SORCHARGE
$ $ OTHER:
$ $ CJ D TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PLBLIC RIGHT OF WAY?
F I YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE ISSLED BY THE ENGINEERING
DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
'k`{ U '?? 1-i ` 651•681•4875 ? I I o 0
New ConshucHon Reauiremanh
* 5 reglstered dte wrveys ahowinp fq. tt. pt bf, eq. fl. ol house
and gfi rooted areas (20% mmclmum lot coveraae allowetn
> 2 coplea of pWna (show beam & window aizes; poured Ind. design: eta)
a 1 set ol energy calculallorn
n 3 coplea of hae presenaHOn plan It bt platted after 7/1 /93
DATE: D / / ///U
. ? _-. .
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: --?- BLOCK: SUBD./P.I.D. S:
Name: ??f ?iS D ?l , ???°_t.?K ?• Phone
I.oat First T
C-
PROPERTY
OWNER
COMRACTOR
ARCHf1ECT1
EN6INEER
Sheet
Clty
Remodel/Raoair Reauiremenh
2 copfes Ot Plan
i set ol energy cdculaHOns for heated addflons
1 Nte survey lor axfedor adtliHOna & decks
CONSTRUCTION COST:
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• •--•- State: ZiP:
Company. Phone M: _
(area code)
She6t Address: LlCense # Exp.
City
Sfate:
Compuny: 5 7o I'T Name:
Telephone t: ( )
Sheet Address: Regishation #:
Ci1y
Sfate:
Sewedwater licensed plumber iif installina sewer/waterl: A?,74 . Phone
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Zip:
Zlp:
1 hereby acknowledge thot 1 have read this appikaHon, date that the WortnaHon is cortect, and agree to compty wilh all appqcable Sfate
of Minnesota Stadutes and Ciryr of Eagan Ordinonces. ?
Signafure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No '
Tree Preservation Plan Raceived _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDiNG PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex O 21 Porch (3-sea.)
? 02 SF Dweliing ? OS 06-plex ? Garage ? 22 Poroh/Addn. (4sea.)
p 03 01 of _ plex ? 09 07-piex Deck ? 23 Poroh (screened)
? 04 02-plex ? 10 OB-plex O 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 11 70-plex Plbg _V or_ N O 25 M(scellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WOtK TYPE
,8r 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demoiish (Interior) ? 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAG Code m t
No. of Units d
No. of Buildings ?
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Permit Fee j 60.50
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Oed.
Other
Copies _2 5
Total:
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Engineering Variance
Valuation: $ 1,2 et,
? 31 Ext Alt - MuM
? 33 Ext. Att - SF
? 36 Mutti
5AC Units
% SAC '
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P.R.V. REQUIRED
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MINNESOTA STATE BOARO OF THIS INSPECTION XEQUEST WILL NOT
BE ACCEPTEO
Griggs-Midway Bidg. - Noom N•191 eY THE STpTE BOAND
MN 55104 UNLESS PPOPEP INSPECTION FEE IS
1821 lJnivarsitv Ave.. 5t. Paul, ENC LOSEO.
Phona (612) 642-0800
CfL,camsetl ElecviCal Conlrsctor 1 hereby request inspection of ebove
? Owner electrical work installed at:
i u 6 REQUEST FOR ELECTRICAL INSPECTION .. Es-ooooi-os
, Sae instructiens for comple4ng this lorm on bxck oi vellow copy.
1..' 4 2 83 5 "X" Be/ow Work Covered by lhis Request
elew?Adtl? Nep.l TyDe o1 Bulltlinq ' AOPliontea WIreE ? Equiumem Wi1e4
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I I I I DuDlex I I Water Heater mV Lioh[inu Fiztures I
al Bldo. I I Air
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?.p7? U to 200 qm s 0 to 30 qm s 0 to 30 Am s
Above 200 qinps? 37 to 100 qmps 31 to 100 Am s
Swimming Pool Akwve 100_Amps Ahove 100_Amls
Trensrormers Irrigation Boorcis $a Partial,? e
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA127864
Date Issued:10/17/2014
Permit Category:ePermit
Site Address: 811 Golden Meadow Rd
Lot:1 Block: 1 Addition: King 2 nd Addition To Eagan
PID:10-41951-01-010
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fixtures:2 toilets, 2 lav sinks, 1 shower, 1 tub
Denise Weibel
13963 45th Place Ne
Fee Summary:PL - Permit Fee (miscellaneous)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ferdinand M Diaz
811 Golden Meadow Rd
Eagan MN 55123
Paladin Plumbing Llc
13963 45th Place NE
St. Michael MN 55376
(612) 770-2282
Applicant/Permitee: Signature Issued By: Signature
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA138410
Date Issued:08/25/2016
Permit Category:ePermit
Site Address: 811 Golden Meadow Rd
Lot:1 Block: 1 Addition: King 2 nd Addition To Eagan
PID:10-41951-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ferdinand M Diaz
811 Golden Meadow Rd
Eagan MN 55123
(651) 690-1318
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA147342
Date Issued:12/29/2017
Permit Category:ePermit
Site Address: 811 Golden Meadow Rd
Lot:1 Block: 1 Addition: King 2 nd Addition To Eagan
PID:10-41951-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ferdinand M Diaz
811 Golden Meadow Rd
Eagan MN 55123
Dakota Water Treatment
17484 Goodland Path
Lakeville MN 55044
(952) 953-4643
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150025
Date Issued:06/18/2018
Permit Category:ePermit
Site Address: 811 Golden Meadow Rd
Lot:1 Block: 1 Addition: King 2 nd Addition To Eagan
PID:10-41951-01-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Ferdinand M Diaz
811 Golden Meadow Rd
Eagan MN 55123
(608) 234-3763
Clear Point Construction Inc
9040 Quaday Ave NE, Suite 206
Otsego MN 55330
(612) 327-5040
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165608
Date Issued:11/10/2020
Permit Category:ePermit
Site Address: 811 Golden Meadow Rd
Lot:1 Block: 1 Addition: King 2 nd Addition To Eagan
PID:10-41951-01-010
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
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 -
Ferdinand M Diaz
811 Golden Meadow Rd
Eagan MN 55123--196
(651) 690-1318
Minnesota Roofing Company
1071 Cty. Hwy. 10, Suite 230
Fridley MN 55432
(612) 888-7663
Applicant/Permitee: Signature Issued By: Signature