853 Great Oaks Tr
Use BLUE or BLACK Ink
ForOffice Use I
Permit 1
I 1
1151L of Ealicin
Permit Fee: ~~~s 1
3830 Pilot Knob Road I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I staff: j
Fax: (651) 675-5694 L___-- _
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION ~
Date: 1 I Site Address: O ~~C4-S IVY
Tenant: SuiteM
RESIDENT / OWNER Name: Phone: ~ 09- 01~b n
Address/ City /Zip: rn'ibs MrN~S5t23
CONTRACTOR Name: ~UL nsel# VY~ Y
Address:-~ City. State: n; Zip: loa- Phone:
Contact: ua~~(i, LU
TYPE OF WORK _ New 1~__ Replacement _ Repair _ Rebuild _ Modify Space e Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation C_ RPZ PVB) Add Plumbing Fixtures Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
`Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $VL~
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.gopherstateonecall.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
acc rdtance with the approved p lap the case of ok whic quires a review and app oval of plans.
x x
App ant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
? ? -
INSPECTION RECORD
. CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
I Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS• 1 `?• `? •'`? '
• 1411 APPLICANT:
iri . i'? ! i:.tF? '? ? ? 1 .' ? ,,?; . +:) . ? • ,
PERMIT SUBTYPE:
? t
TYPE OF WORK:
PJ i I.J
QC) TFNI;';
1' tNh t
V?
Pem?it No. Permk Holder Date Telophone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL ??D/
INSPECTION RECQRD
' C'i`i`li' OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55123 • Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
?
? ? _ ? ? • ? • ??•+ ? . _ I _i?
PERMIT SUBTYPE:
?
L? .
TYPE OF WORK:
• t •?; . ,:-, i
, .
• .: a?'r 4
INSPE
TI
N
C
O D { A
¢ (I
?•?iftli I
1 v r MllFrr s
i Fe LJ 1' 1 t t I: I, I ha 11 11
- - __ - - - - -_ _ __ -- 7-1
PermFt No. PermH Holder Dete Telephone N
S/W
PLUMBING 9?-412
HVAC ' a?T ,9 ??f-CfS
ELECTRIC
ELECTRIC
Inspeetlon Daie Insp. Comments
Footings I
Foundation 3fa??ys
Framing ?
Roofing
Rough Plbg.
?u
Rvugh Htg.
isui. ' a 95
Fireplace
/l CG p t /?? /s
Final Htg.
Orsat Test Y
Finai Pibg. /,,(I
/ f? Ptbg. IaSpeCtoi - SdotiSy Plumber
Const. Meter
Engr./Pian
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
c..-L I
REQUEST FOR ELECTRICAL INSPECTION
? ? See insUclions Iw compleling Ihis lorm on Eack ol yellow copy
d. 3 5_6 2 7 "X" Be/ow Work Covered by 7his Request
,g °"`N,. ee-00001-0e
6 g
??•? ?+
ew Add Pep. 7ypeofBuilding AppliancesWired EquipmeniWired
Home fiange Temporary Service
Duplex Water Heater Electric Heatin9
Apl Builtling Dryer Othec(Specify)
Comm./Industrial Fwnace
Farm Air Condltioner
Otner (syecify) Contraorork Remarks.
Compute Inspection Fee Below:
# Other Fee # ServicaEntranceSize Fee # Circuils/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 100 Amps
Transformers A6ove 200 _ Amps Above 100 _ Amps
Signs Inspecmr4 Use Only TOTAL
Irrigation Booms U
Special Inspection
AiarmlCommunication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITNIN 18 MONTHS.
I, the Electrical Inspector, hereby °ugh-in oere
certity that the above inspection has
been matle. pit1e1 oa?
OFFICE USE ONLY
ThiS request voi0 18 months trom
L
? l-,
?
Af J ?. ?°?
.5
! Y3 :
, C?-
Fepuast Date ire No. Rough--in Inspection
Required?
? Ready Now XWill Notity Inspeclor
Wh
R
?
tl
? Yes No en
ee
y
I? licensed contractor El owner hereby request inspection of above electrical work at:
Job AdOresS (Straet Box or Rowe No.)
?
?
? Ciry
.?- ?
Section No.
I
Town4hip Neme or No.
qanga No.
County /' /
??f.?i ? ! ?
OccuOant PRINT)
P
h
ne No.
o
'
'7
?
/?? J
(?
/ i /
Pawer SupOi?e AtlOress
ElacVical omractor ICOmpany Name) ConhactaS License No.
Maeing ntltlress iCOnttanor or Owner Making ingtallaiion)
j
Autn rize ?gnature (Convacbr Owner Me¢?n mstanetion)
?..,.? ?- _ Pn a Number
?24C `2 ?o
-_--
MINNESOTA STAT 80 RD OF EIECTqICITY THIS INSPECTION REOUEST WILL NOT
GrlgpeMiEway BI . Poom 5-»7 BE ACCEPTED BY TME STATE BOAFD
1821 Univarelty Av ., SI. Peul, MN 55104 UNLES$ PROPEF MSPECTION FEE IS
Phone (812) 642-0800 ENClOSED.
P-I3,j ^ j3J REQUEST FOR ELECTRICAL INSPECTION ?B 00001 09
, See'mstmc[ions tor comple6ng Ihis form on back oi yellow oopy-
'X" Be/ow Work Cavered by This Request ?
Ne Add Rep. Type ot Building Appliances Wired Equipment Wired-
X Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building ?ryer d Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (speaily) Con(roc[or's Remerks:
Compute lnspection Fee 8elow:
# Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Poal 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps e 100 _Hmps
Si OS inspecmr's usa Ony: 1 TOTAL
Irrigation eooms (J
/J' $93. 50
Special Inspection
?
Alarm/Communication D DISCONNECTED IF NOT
THIS INSTALLATION MA V
R ERE
Other Fee COMPLETED WITHIN 78 MONTHS.
I, the Electrical Inspector, hereby R°°9n-m j; o7 YJ
?
certity that the above inspection has
been made. Final Oate?
OFFICE IlSE ONLV
This request voitl 18 months from
Zf yr/OS
Req est Da FireNa. Roug -In InspecGOn Requiretl
il i
t
h
tl
Y Inspectian Otner Th n Rouqh-In
ecior
? Will Nolity Ins
R
tl
N
4/ 03 / 9 5 O???$ t ce
r?5pec
or w
en rea
y)
(
' p
?
ea
y
.
}?Yes ? No DateReatl
I jE7licensed contracror ?owner hereby request inspection of above electrical work at
Job Atltlress (SVBet, Box or Roule No.) Ciry
853 Great Oaks Trail Eagan
Seclion No.
TownsM1ip Name or No.
Range No.
County
I Dakota
Occupant(PRINT) Pnone No.
Kurt Manle
Power Suppller Atltlress
Dakota Electric 4300 220th St. W., Farmington
Electrical Contractor (Company Neme) Conrcaclor's License No.
Joos Electric Co. CA 00961
Meiling Addrese (Comrector or Owner Mak'mg Inatallation) .
3980 Beau D' Rue Drive E:a an MN 55122
Authotlxetl SignaNre (Conlredor/Owner Making I Phone Number
688-6180
MINNESOTA STATE 90ARD OF ELECTRIC THIS INSPECTION REOUEST `NILL NOT
GrIgge-Mitlwey Bldg. - Faam 5428 I I I I I I II II BE ACCEPTED BY THE $TATE 80ARD
1821 Oniverslry Ave., St. Peul, MN 55104 I I II I I I UNLE55 PROPER INSPECTION FEE IS
Phone(fi12) 84b0800 ENCLOSEO.
Address 853 CRFnT nnus an Zip 5512 55123
L.bf 12<c Bik I Sub
cREAr oaKs
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: /0 /? 95 Yes No Inspedor:
Final grade (6" from siding) y
Permanent steps (garage)
Permanent steps (main entry)
Permanentdriveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verifV wi[h the builder [he removal of roof [est caps from the plumbing system and the shut-off of water sapply to
the outside Iawn faucet before freeze potendal exists.
Contac[ engineering division at 681-4645 before workingin rightof-way or installing underground sprinkler system, ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
? ba
2006 RESIDENTIAL BUILDING rERMIT arrLicaTiox
City Of Eagan ?
? 3830 Pilot Knob Road, Ea gan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuction Reauiremenb
3 registered site surveys showing sq. N. of lot, sq. ft. ot house; and all roofed areas
(20°h mauimum lot coverage albwed)
1 Soils RepoR "rf proposed building is to be placed on disluibed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
7 set of Energy Calculations
3 copies of Tree P2servation Plan H bt platted aNer 7/1/93
Rim Joist Detail OpUons selec6on sheet (buildings with 3 or less unAs)
Minnegasco mechaniplventilationform
RemodeVReoair Requirements
2 copies oi plan showing footings, beams, joisfs
1 set of Eneigy Calculations for heated additions
t sAe survey for addPoons & decks
Adddion - indicate il on-sde sep6c system
Office Use OnN
CeAoiSurveyRecd _Y_N
SoiS Report.. ' Y - N
TreePresPlanRecd -. _Y-_N.
Treepmp ired . . _Y _N
On* e
JAN 1 7 2007
D
5 i
Date 4 /?/ ??) ?
ConstrucUon Cost / -1o
a,- J
Site Address 01) 1?) (AA! K i,., UnitlSte #
?
? Mjr)
Description of Work ?(JAJ 6
Multi-Family Bldg _ Y? N Fireplace(s) _ 0 ? 1 _ 2
Property Owner T06 Telephone # kj? ) W?9AP
Contractor tieaM & Home TeOMplp
- ?, ?pp.
-
Address Ebe FiraeWe
uO? 20519080
City
State
- ?• ? ?11S
-wt,WO-0Sb1 Zip Telephone # ( )
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
(4 submissiontype) 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 plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone #( )
Mechanical Contractor Telephone #( )
Sewer/Water Contractor Telephone #( )
I hereby apply for a Residential 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 pl in the cas of work which requires a review and
approval of plans.
v?? ;
Applicant's Printed Name Appli ant's Sign r
2004R+1,S^DlE1V-`I7AL,STftDINGPERMLT'APRLICA.TI"ON "-c1 ?
City Of Eagaxc --
3830 P-Uo E Knob 1Zoad, Eagan 112N 55122 -.---
---
--
Ftevr Consfnicfion Reauiminentq . .. .
3 rcgisfered sitesur2ys showkQsq, ft of bf, sq. R, of house; and aif roofed areas
(20% mazimum fof coverage allmved)
2 copies_ofplan'shot»ng 6eam g vrindowsizes; poured (qma desbn, eta
lsetofEneigyCalculations 3 copies ofTree Preservafon Pfan'rflof p(affed a,4er7/1193 --
RimJoistDeW Optionsselectionsfieet (bfdgswitli3orlessunil5
SSifa Address
Desrsiption of Wozk
MnIti-Famtly Bldg
Properfy Owner
Confractor
Address
RemddellReoairReauireinen(s - 2 copies of plan '
1 setof Epeigy Ca[cufafions for heated addifions
isifes[uveyfof additions&decls '
Add'dion_ kMlceEeifon-srfesepficsys(em
Constr¢ction CosE -
IIniflSfe #
_ y _ N
FirepIace(s)
n
State
Zip
coMPLETE 'FHIS AREA
.,
_ 0 2
TeIephone # (
City'lpC-wllB'
_ Teiephone # ((OE?,j ) Z 6?l - u -I -I 1
Enetgy Code CafegOry
?- ??0? Rutes 7570 Cafe, oiv 1
(dsubmission type) . • fdentlal Ventifation Category.iWorksfieet
. ? Subiniffed . ?,_ ;C:
• Ene Envelo ' ?`'`'
r9Y pe Cafwfations:SubmfEted
A NEW
_ Wnnesota Riiles.'7672 `
, • New Erjergy Code Worksheet
Slibtnilted lave you previously consfructed p buifding in Eagqn with a similar plan?
:e app(ies. Y_ N ff so, 25% plan review
::ensed Plumber
echanical Confirpctor
wer/Wafer Contracfor
Telephone #(
Telephone # (
Tefephone #(
ereby apply, £or a Resideniial Building parmit and aclmowledge that the infonnaiion iS complete arid aecutate;
E tIie work will be in con#'omaance with the ordiaances and codes of the Cify of Eagan and the Sfafe of MN
hrtes; I imderstand this is not a permit, but only an application for a permit, and work is not to stazt without a
nit; that the work will ba in accordauce wit7i the approved plan in #lie case ofwork wfiich reqirires a review and
-ova1 ofpl s.
? Ct.+f n S6N
7Jicant`s Priuted Name . Ap- , ?Z' xi/?_ ?e ?
Phcant's Signafure ???
"?.?e,s.?-,?, iuv zc.au rna (od O!t 443D HC1VLrITAL til°BNUtSKr`12fl1' ..
re al
,?,. 3urre 7, 20t}] . . - ' .
- ?ty of Eagaa 3836 PiIaf Knoj?goad -
Eft8ml. MI+I 55•122
_ . ;?.
. To Whom k May Cotcem: Eidcr Jenqs to ??? ?p? b??g ?ts farR$?sewal {?y Aadezsem_ ptease allow
Provide this sPrvi
date bcyond 616I01: ce for us in Hagsn, 'TTtia anthotizatibn is vatid for any
to the City- uutii a?? bY Andcrsen managr ?Y revokes it tn wcicing
oulr bu ???o?be accepted.oxp?flously, aa to not delay in thn processing of
cantacded at 763-Sfl2-470G.z?r. Ptcaac caIl mc If tfictc anc nnp qneattons..I can Ixi
' .. _ Your tmmpdiabe aitcation ta thfs mattcr ia a?mcfered. .° '. .
Sinoeialy>
Ymoud R &-Pm
tistallarion 2vlauager
Renowal by Andascn Corporatzott
C'.e.: Karn Fide,r Snne_a ,
12 .
MY M, ?
iQl U V
Received Time Jufl. 1. 1:01P}d
, ., . _
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMITTYPE:
BuzLoiNs
Permit Number: 0 2 8 9 0 9
Date Issued: 0 9/ 2 6/ 9 6
853 GREAT OAKS TR
LOT: 24 BIOCK: 1
GREAT OAKS
P.I.N.: 10-30950-240-01
DESCRIPTION:
? Bd1ldin61Permit Type
Building Wa?rk 7ype
`Census Code ?
?
?
--?
?
?
?
` L
pECK
NEW
434 ALT. RESIDENTIAL
4I:j?..
1 7. ? ?4 l}? ? ?(? ?? ? t t j t .i l? ,-?•? }
REMARKS:
FEE SUMMARY:
Base Fee $45.00
Surcharge $.50
Total Fee $45.50
CONTRACTOR: OWNER: - Applicant -
MANLEY KURTIS
853 GREAT OAKS TR
EAGAN MN 55123
(612)683-9433
I
I hereby acknowled9a that I have read this application and.staCe that Che
informatfon is correct and agree to comply with all applicable State ot Mn.
Statutes and City of Eagan Drdinanees. '
APPLICANTiPERMITEE SIGNATUR?1_1" ISSUED BYiSIGN}ATURE'-?
CITY OF EAGAN
3830 PILOT KN08 RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
10909 681 -4675
Remodel/Reoair Reauirements
t) 4ff ,-1), o
? 3 registered s8e surveys ? 2 eopiea of plan
? 2 copiea of plans (Include beam 8 window sizes; poured tnd. design; etc.) ? 2 ske aurveys (exterior addklons 8 decks)
? t energy calculatiorre ? 1 energy ealeulations ta heated additions
? 3 copies of tree presenaNon plen N bt platled efter 7/1/93
requlred: _ Vas _ No
DATE: -7 1 1 ` I9? CONSTRUCTION COST: ?'??•?
DESCRIPTION OF WORK: P-C° L- x? '?fl ??ST?%ac. 1? E-u-"'c-
STREET ADDRESS: 4 $53
LOT BLOCK SUBD./P.I.D. #
PROPERTY Name: S Phone -qL433
OWNER '^'* `°"
Street Address- $:33
City: E.sc3ft-*4 State: mN Z;p: 55 ia?
CONTRACTOR Company: owNc,t?, ' Phone #,<rejA?)GS3-9,.I33
? /R.
Street Address: License #•
City: State: MN • Zip' t5:5 Ia3
ARCHITECT! Company: [?` =L?--n Phone #•?'R1y??"°? a`A
ENGINEER
Name: 9-ic-v- rv1f.-e_P...?c.ic,. Registration #-
Street Address- 3y3=> wPasN lNc,-FlRN C>X..
City: E4.c'P.?4 State: cYVa Zip:,ZZ I
Sewer 8 water licensed plumber: V-4 /P.- . Penalty applies when address change and lot
change are requested once pertnit is issued.
I hereby acknowledge that i have read this application and state that the infortnation is corcect and agree to comply with ali
applicable State oi Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
Certificates ot Survey Received
Tree Preservation Plan Received
Signature of Applicant:
_ Yes No
_ Yes _ No
Soi 2 ? 129B
TPrt tf trtttP ior f
prepared for: KU,R7` MANI,EY
I ?
81211.94
?Ltr u PLJ
8
S?
, LOT 24, BLOCK 1,
GREAT OAKS `
occording to the recorded plat thereof. i ?.
DAKOTA COUNTY, MINNESOTA
i i
i i
i
? r
?' - 1 30'
? .
N6'
? ? ,%
oS 25
,, 4 lqti
(J, NN ?o?J
?? BENCHMARK.
a? m 24° 66L
.fmt 27, 2" 1,
902.28
i
> ? ? gRl.2 ? ?pT 2
i
BbOC
? 1?"8q2!IDr cn
V C.?,
o. .. ? 3.' r
/ ?Qf9• ? ?
?o' 1 ?qpg,' oo ? ?r
C ???, ° N t 6R E,2
Z ?{;'1I, V A A ` 3J^ ?` ?O ?_C)j 2 2
O ?I?:gq'I,VI ? \ O
1 za
o ? ? ° 22p0 ? \
.P 11? ala2 x 5A
1 32.00 ?0
l ? At 6q$_o
p 1? Y?'? OT 2? ?? EqSEMENi PER PLNOTE.?
?tlLlTy VERIFY ELEVATIONS &
pRAINAGE g9o5o156,? ?i 158 DIMCONSTRUCTION TO
N 11 _? ? .OO
e Denotss iron mcnumer.t ??..?4)
983.5 x Deno,tes existing elev.
?PS?Pr J1'Plt $C .?SSDPtFltPB, JILC. (987.0) Denotes proposed elev.
n Denotes Off-Set hub
---- LAND SURVEYDRS ---- (?'= Top of block elev.
= Top af fin, goroge floor
8500 210TH STREET WEST LAKEVILLE, MINNESOTA 55044 - Top of basement floor elev.
PHONE :(612) 469-1699 FAX: (612) 469-1899 609
3'?ndicates direction of surface droinage
?
I IC4E6Y CERIfY 1M1i M$ SIqVEY NAS PflfPAfSD BV tlf (R IfMR N1' pPECI 91FERVSQY. 6 Cd11Kt1 i0 tfE BESI CF W NWWIEUGE .WO fftff. MAS EROIiEU N ACC(WO.WQ MiX IK QHRH1
FECWYEIOEO iIiJCEW11E5 fCq 1M Pfl1CilCE UG LMO SAVEYNG NLNLED BY TE ?IA SOIElT 6 VflOfC451MAL SU1'/EYqS. N9 TIU! 1.W A pAT LY£NSEO UIO 4AYFYOR IMFR
!K LAW$ Cf lfE SI1IE K W11ESDiA 1M5 LENI?K w5 ilE LKAId K Kt 0.lClYS /.iiAfHp 10 5A0 fAW? YO i1E LCCA1Nk1 Ci I4L ?L?LF FNCA0IL'?4flli5. f 41?. f(pY qi P1 eA^
LA'l1. NJ LMBl1iY 6 ASSIIKO E%qPi IO 'K 4 f fOp ?qI LN$ $WVEY NA5 WEP/JFD. 16 1EN5. YO A59L14 Na SID LNBUfY 6 ASAUED d1Y fqi 11E ACiYK CO$! Cf iN5 9PKY.
Ffeld BoOk 17189 o?*m TMsl/lLn? o?(??l -iw?,
J1655 Minnesoto Regrstrofion No. 19790
Job N0. Don R. Westergren
INSPECTION RECORI,
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 025 y..
Eagan, Minnesota 55123 Date Issued: 0 2 J 17 / 9 5
(612) 681-4675
SITE ADDRESS: L a r : 24 B L 0 C K s 1 APPLICANT:
853,,; GREAT OAKS TR MANLEY KURTZS
GREAT OFlKS (612) 683-9433
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION
FOOTINGS .. .
FOUNDATTON .A
FRAMING ROOFING
INSULATION FIREPLACE
OUGH IN PLBG ROUGH IN H7G
FINAL PLBG FINAL
REMflRKSs S& W PLBR - D C MECH
?._ . .. ._. . _..... `: . ? . _r_ .? ._.. _,.. __ _ ?
PERMIT
??CITY OF EAGAN J- "v S-s
3830 Pilot Knob Road PERMIT TYPE: e u zLo z N G
Eagan, Minnesota 55123 Permit Number: 025132
(612) 681-4675 Date Issued: 0 2/ 17 ( 9 5
SITE ADDRESS:
853 GREAT OAKS TR
LOT: 24 BLOCK: 1
GREAT OAKS
P.I.N.: 10-30950-240-01
DESCRIPTION:
BUildingiPermit Type SF DWG
puzldinq W3.rk Type NEW
,"UBC Occupancy? R-3 M-1
\
? Construction Typ.e V-N
2oning '--? R-1
? Building Length Q 78
Building Width 46
? Building staries - 3
`-?Sg'uare Feet 3,116
" a
'V:J ???,LZ ?';SllC?
?'?? Y.,`!ti.,,r G.
REMARKS:
5& W PLBR - D C MECH
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC ?
SAC Units
Subtotal
$2,708.18
$220,000
MTSCELLANEOUS $1,$92.50
Total Fee $4,600.68
CONTRACTOR:
OWNER: - Applicant -
MANLEY KURTSS
4145 DEERWOOp TR
EAGAN MN 55122
(612)683-9433
L
i hereby acknowledge that I have read this epplication and state that the
information is correct and agree to cnmply with all applicable State ofi Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
VALUATIpN
$1,059.50
$688.68
$110.00
$850.00
100
1
4),??? ?leal.1
I UED : SI A7U E
I
CITY OF EAGAN 4 I? ?
3830 PILOT KNOB RD - 55122
7995 BUILDING PERMIT APPLICATION (RESIDENTIAL) ??
681-4675
New Conslruction Reauirements RemodeVReoair Reouirements
? 3 regiatered ske surveys ? 2 copies of plan
? 2 copies of plans (include beam 8 window sizes; poured fnd. design; etc.) ? 2 sile surveys (ezterior addkions & dedcs)
? 1 energy celculations ? 1 energy calculations for heated addRions
? 1 tree preservation plan if lot plalted e8er 711l93
required: _ Yes _ No
DATE: ? I? I ?15 CONSTRUCTION COST: C10c)°O
DESCRIPTION OF WORP
STREET ADDRESS:
LOT QL- BLOCK I SUBD.lP.I.D. #: o" " c
83- ``f 33
PROPERTY Name: 1?1 p.???l S Phone #: 61
OWNER ""* """
Street Address- L-1 1 y 5
City: State: Zip: --5751 Q a
CONTRACTOR Company: Phone #: <- V3 -9'4 3 3
5treet Address: y 1 L-l 5?.?e..-a?? License #: ?lrl
c;ry: ?? ?, rn.? SS i aa
ARCHITECTJ Company: (-C?) Phone #- i-4 2 D - -70y °?
ENGINEER
Name: c-? rnE-y-eAc-? Registration #,
Street Address
City: E-P.Gr,?3 State: rf\,j . Zip: S5 1 a 3
Sewer & water Iicensed plumber. ?e C-14 r-,? )C-p- . Penalry applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the informatlon is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ? - --? L:?9
OFFICE USE ONLY
Certfficates of Survey Received
v Yes
No
? Np
Tree Preservation Plan Received _ Yes
REcEVED
FE 1 0 6 1995
---------------
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwelling ? 07 4-piex ? 12 Multi (Misc.)
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory
? 04 SF Porch o 09 12-piex ? 14 Fireplace
? 05 SF Misc. ? 10 Muiti (additional) ? 15 Deck
WORK TYPE
? 31 New ? 33 Afterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Footprint sq. ft
Planning Building
Y
0 16 Basement Finish
? 17 Swim Pool
? 20 Public Facility
0 21 Miscellaneous
MC/WS System ?
/, yw City Water °C
/,7as Fire Sprinklered
PRV
Booster Pump
Census Code. _/Q/
/!D 5AC Code
e Census Bldg /
Ex 3 Z Census Unit /
y sco
Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
e-g- Al Basement sq. ft.
?-n Main level sq. ft.
Y?-???-1 /r1OPl2 sq. ft.
e - z sq. ft.
sq. ft.
7(3 sq. ft.
r
Valuation: $ Z Z O, oa'° ^
Lc?c?-
z,? 3m ° 7y
7•/y
iz.s? qy = S?
?/ K T y " l Z-'_
Sy =
[30, laxe
I`/ x SL = y`?`?'
/b ,r fn fv ? /, aSCo
Y x 3a - ?zg \
6 tcl,
I, 7u? ? Sy r ----
, y 070
/ _?-
__---- ?
Z3, QoY
?---- -
C?iz S . ? S?aP
.------
_
3Y?x ?o - / ?yo
Zz.sx `1 ' 90
d xzz = /32
,33F1z = ly
/ 3?? x l(v =
L
' 62/16/1995 11:18 6124691899 WESTERGRE7d & ASSOC A PAGE 02
8/11/91
Trrtif irtttp of *uruPig
prepared for: t5trX4
URT MANLEY T?-
K
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i o?
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? .&b,e?,v.Pt;.?,. : 853 (nR?r C)a?r?s 'T¢A?? ??t?? '.t' ?ba
LOT 24, HLOCK 1
GREAT OAKS
according {o the recorded
OAKOTA CDUNTY, MNN
7Ep,GAN
SCALE : 1 " = 30'
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? 1,91? PI.A A j 4] ¢A{M NOTE.•
?A 16$.OD DIMENS10NS PRIOR TD
CONSTRUCTION
C?•?? S a? - JypL
??
notes iron monument(4w1c{)
D
•
983.5 • e
DCnotes Cxi3ting elev.
?rstrr?Jren aG AgS1TrttitPB, Jnr. (sev.o) Denotes proposed elev.
t h
b
ff
S
6 -
e
u
Denotes O
---- LAND SURVEYORS ---- ?l - rop of block elev.
= Top of fin. gorage floor
8500 270TH S7REET WEST LANEVILLE, MPAJESOTA 55044 = Top of basement floar elev.
PHONE :(612) 469-7899 FAX: (612) 469-7699 ?
/ ndicates direction of surfnr.e drainage
I IEROV QIRiY iW.T MS AAJEI ?AS PRVMEU H! ?E pl YM.f11 M/ OPff.l 9MliILOLL 9 CYQECI i0 M B[fi1 Of ur NIqM.f4R NY Bfl?l. NK EYFd1EO N.1CMMNAE'MM ilE CW6hi
qFpWl(II?FO WtlCE?SFS fOR iME M?t[ 6 LAID 91R'IE??f ?'I[L M M MK39in 6Ml?v O MpC1YbY1 APK?W. ?m ?W'1' I?V ? OLLV LF'?o lIW APH?O? 11ao
?
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TO fA0 l??D
.
1K 4K Or i1[ 51111C Ui YMECOIA TW CG? TI[ lOC Tb! Of ?U s.LbILS 1iI?C?
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IBl1
? V?4
tala eoot
ovl? .
-.
G1(? M6(AL?
MrnneSOtv Regrstrofron No. 79790
oD N0. ?1 BrJJ pon 2 Weete?gren
R=95%
6124691899 I 02-16-95 10:19AM P002 #23
LOT BIIRVEY CHECRLIBT FOR ItEBIDENTIAL
? BDILDING PERMIT 71PPLICATION
? PROPERTY LEGALS aZ
?
K Dat• of 8urvey:
? ?
? _. ..
DOCIIMENT BTANDARBS
Er'e'0
? 0 - iteqistered Lnnd Surveyor siqnature and company
210'
0 0 • Building Permit Applicant
0 • Legal description
? 0 • Address
0 • North arrow and bar scale
H' D 0 • House type (rambler
eplit w/o, split entry,
walkout
,
,
lookout, ete.)
V 0 • Directional drainage arrows with elope/qradient t.
R 0 • . Proposed/existinq aewer and water services
L 0 • Street aame
e?b 0 • Drivaway
ELEVATZOl18
6? 0
D
• Zxistina
Sewez service
0-' 0 0 • Lot corners
V 0 • Top of curb at the driveway
0 • Elevations of any existing adjacent homes
BroDOged
0'?0 0 • Garaqe floor
fK 0 0 • First floor
0? 0 D • Lowest exposed elevation (walkout/window)
v 0 • Property corners
0 • Front and rear oP home at the foundation
PONDING ]1REA8 (if anolieable)
0 e D • Easement line
0 ? 0 • NWL
D D • HwL
0 ???0 • Pond # 8esignation
D g' O • Emerqency Overflow Elevation
U 0 0 • Lot lines
0 • Riqht-of-way and street width (to back oP curb)
P0 • Propoeed home dimensions including any proposed decks,
overhangs gzeater than 2', porches, etc. (i.e. all
structures requiring permanent footings)
'1' D 0 • Show all easements of record and any City utilities within
those easements
13 0 • Setbacks of proposed structure and setback of afljacent
/ existing homes
a D ? • Retaining OVrequi?ments, if any
Revievea: ?i Z/ /G/' f?`--
October 1992
16°x6" REDUCFR 82.
HYDRANT (899-?)
897.76 PERMANENT ILIN &
78.0' pRAINAGE EAS MENT
_ L
Woter Onl _
892.0
16+45 _ \
16+SU(San.Unl )? ? g86.3 ?
884.9
?- '
\
_17±54 `'7 ?) ' ?
14 Gl?Y QF EAGFePd DOE
ILI , ? ?50 ? - _ ?
E
?t7r? 1 5" ?? T E
- , ,???t1F3PP Y OF U x 16
PEDUCER
FLEVF?TIONS. x6
; .. pO - C.??? .,_ V. & BOX ?3??•. ? ?o.i ?
. ?, ?.,0N pUR ?
A?? ??i ? ,?,,- ,"•.v,' .4;.- 16" B.
•:.'-:3?d? Uc.,ING IT SH , g" G.V. & BOX r r ? ?
1 /32 BENU
- - \ ' -
??„?ATIOiV ON THE Sl E. c.C
57 3' , 3"
L +65
" 878.6 ? 52.g
?'?r ?. ? ?? -.? I , ??• ?
? 7:i 0' <"\g? ? / \ \ \ ?`,?
.
54.6' 50.8'
105
?
MH 15
16
I ?
O ? 1
II ?S, ?? BM 53.3' ? -.
HYORANT 105 \.
581.15 ? \ 61.3'
I ? 65.8
19"5 1 8±1 6
. 879.5
C,
60.5`'-. .O.
? C.O., 6" -1 8 13EflD
?• ?? i 19±33 '? . 19 ,00-
'' 879.0 ? 39.5, 878.8
? 884.20_____ Ro
EAT aNv?nRA175'W INT. 0 F_^ G
. C" i,_!Vli JLI?v.IV?J ?.. i:•:? . .?.v- - . . r - -
L°
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_. _. ,
, ..
.;. W:,T-?'t ? RV! ., S IG .,_
`" ^ V ^ " ?:: ? ^
THE ClTY 0F EAGAN DOES P,f'?' CUARAF! iEE
Q ? THE t;GGi1RACY OF UTILfI'Y !.OCATION3 ? L
?•- - ? r ?i ? , ,
?0? Or rYDRAf?.- A, 7. 7= F? E%a-•r? a;? r. ? E :;: T 10 ???. 7 Ni ,3 '?,? i,', I., ? F Q R
3= ? r'_ -UL-D='-SAr 0 vR?A? OAKS 7 RAi? (PE-A,-;il0i. PUR?0Z?.:.3 C":LY AND .L
Cl"IivG IT SNQUL'U VLr,i; Y TFEc
Ift!t=0RMiA710N ON THESITE.
Ivli-!-12. ? 870
-._.._...__..._.._--F?
.._..._. _.._ _ --.__.
M---
Mr-'3 t92;
1L_i?05 C
885.33 Lr) Z j 80'-'i E" .. D i::) : ?.
• M?_, 5 T D?SIGh '` b o i
7+28, ' 8'R7. 14.0 ?
87899 I '
{?
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? 6 R I 6'n
I 7,2120'-E DIP CL. 52 ° I a) c r ? ?'? ? a
un?
I y
0 j ? Ln
__..__._. 1 _.. . _....___ _ ___ . -._.._._ .. ..-- _ ._. .._ _......__._.
236'
? -2-35' B,, ?,V?? pVC. ',OR'-s° ?VC, 125'-8" P?-C,
SDR 35 SDR 35 @ 0:40% S3R 26 C? ?SDR 26 ??2 0
0.36 , 0.34 0.48
--- ----------_-- - ___-.------1- ___----. ____-_. __
cD ?n ' BELOW Sv4NITARY SEWCR LI)
+ f : ? INSTALL WAT`ER MAiN ?I • ? °?? o : ??? °`,,' '
?ELO1N S`W^R, SERVICES' coi ? cal ?, Ti'? o?
,
MINNESOTA STATE ENERGY GODE CALCULATIONS
BASED ON CHAPTER 5 OF T}IE
MODEL ENERGY CODE _ 1983 EDITION
Adoption EffectLve,
Owner??? ? ?6jy Phone
Site Address
Contractor Phone
Building Classification: Type A1 (Single Family & Duplex)?
Type A2 (Residential, 3 stories or less) (Orer 3 stories) (Other)
BOTE: Complete pages 3 and 4 flrst.
GENE[;p,I INFORt7ATI0N
C9
1. Building Perimeter ???`?' ?? ft.
l?
2. Wall height (ground to eave) ft.
3. 1. X 2. (above) gross wall area sq.ft.
4. Huilding dimensions (L) ` X(W) ?sq.ft.roof & flcor area
5. Sq. foot area of rim joist - Floor jo size (2 X
.J ?! )
1-? X -(Perimeter) _ sq.ft.
lZ .
6. Doors - Area
Thickn 2j in U. factor .
Type of Construction Perimeter ft.
t9anufacturer
7. Total door's perimeter ft.
8. Windows: Manufag turer /i`'?-"?PT State approved
U factor
TYPE SIZE AREA (:.q.Ft.) NUMBER OF TOTAL EACH UNITS SQ FEET
t°
9. Total sq.ft. Glass j%5-'
10. Fireplace area: Width X tieight = R = sq.ft.
11. Exposed foundation: tieight X Perimeter-LL?X (5, _ sq.ft.
COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MASOR
REt90DELING AtlD BUILDINGS HEING MOVED W}iERE ENERGY, OTHER TtiAN THE MINIMAL
CODE ALLOWANCE, IS USED.
-1-
12. Framing area = 10$.of gross wall area.
13. Gross wall area 4?75- sq.ft.
Window area A -L 75 . sq.ft. U windows =?
Rim joist area A J sq.ft. U rim joist=_ ?
Door area A T sq.ft. U door area=
other doors area A'W sq.ft. U other doore=-,
Exposed fndn A_LQ__sq.ft. O foundation= 10
Framing area A It_5 sq.ft. U framing area=
G '
i
Net wall area'AZL?622L5sq.ft. U Wall=
( 13S) TOTAL . . . . . . . . .
ct 4-q67 ?0
UxA = ? 7.?j
UxA = ?
UxA =
UXA
UxA
UxA = ?
UxA = 1 J
UxA = 3/ J
14. Gross.wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code
(13. above)
x 0.23 (A-2 other residential)
x .23. (Other buildings)
x .28 (Over 3 etorLes)
B1'Uf{ must be larger than or same
x U Code_ , i l _ oF. as 13B above
15. Ceiling framing area (Af) equale l0$ of ceiling area
15A. Gross ceiling area =(L) ?- x(W) f sq.ft.
158. Joist area (Af) = l0t ceiling area sq.ft:-
15C. Net ceiling area (AC) (15A - 15B) sq.ft.. -
U ceiling x Ac _ < J C.??I ( x i Z =141
U framing x A f X
15D. TOTI..L U x A .................. ........
16. Ceiling aren (15n) x 0.026 (A-1 single family & duplex)
= allowable UxA/C;ode
x 0.033 (A-2 other Lesidentiel)
x 0.06 (other)
J_??ln
A(15A)G.r !vx U
Code 7 BTUH
°F. must be larger than or same
as 15D above
NOTE: Use U anii A vnlues obtained fYOm paqes 1, 3 attd 4.
QERTIEI-QA'LI4N.: I heroby certify that I have calculated the "U" factors and
"R" values hereLn and that tha building here described meeta or exceeds the
State of t4lnnesota Energy Coneorvction Act.
Date
sianature
-2-
Y04?hwn
5s °x <?S?D WA LL
19 0 '7?
?: Zvqlo ?_
(,?ll)lJnwy _
3ZZq -13k3 ?39_ --
4,r) ?A --
Z41 co
?tf-1l/ 72 ; `
:-? _- I-
r 2
I r/ 6:5?Pa-r rn
??STL U;t w? ? `./L ? 5/
??)
,/ CITY USE ONLY
L O?`? BL L RECEIPT #: 13M
SUBD. hl/tZaJ Ak DATE: y4"?
1995 MECHANICAL PERMIT (RESIDENTIAL)
CIN 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
l/?New construction Add-on furnace
Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date: - ?5
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $20:00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
SITE
TOTAL
?3,4 D
ADr)RFSS• ° 5? J
OWNER
INSTALLER
PHONE #:
STREET ADDRESS:
CITY: V STATE:ZIP: 5
•
PHONE #: ( ) 3 7, q53.2-
PERMITTF-E
CITY USE ONLY
SUBU??.AX ?
2
-?
?
a
/
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outiet ' minimum - 1
Rough Openings
Water Softener
Private Disposal ' Dakota cty. license
U.G. Sprinkler * home under const.
Alterations ` to existing
Water Turn Around
EACH
NO.
TOTAL
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
3.00 x
1.50 x
5.00 x
20.00
3.00
20.00
20.00
STATE SURCHARGE
4crai
.50
3. sZ>
SITE
OWN
INSTi
STREET ADDRESS:
CITY: S/i.UL? STATE: A-1 /J ZIP: S S 3??
PHONE #:
RECEIPT 7
DATE: s -2 `9 S
.?rlt
Z
/A v'v
cn'
/-le
3• ffv
?
.i•
;?'
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
856
GREAT OAKS
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
LOT: 20 BLOCK:
GREAT OAKS TR
PERMIT SUBTYPE:
SF DWG
APPLICANT:
1
BREAM BLORS INC
(612) 298-1044
TYPE OF WORK:
NEW
BUILDING
023725
05/26/94
INSPECTION
FOOTIN6S .A .
FOUNDATION .•
FRAMTNG ROOFZNG
INSULA7ION FIREPLACE
ROUGH IM PLBG ROUGH IN HTG
FINAL PLBG FINAL
REMARKS: 5& W PLBR - MURR PLBG
F
L
?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
023725
@5/26/94
SITE ADDRESS:
856 GREAT OAKS TR
LOT: 20 BLOCK: 1
GREAT OAKS
P.I.N.: 10-30950-200-01
DESCRIPTION:
Building'-Permit Type SF DWG
Building Wo,rk Type NEW
UBC pccupancy?-" R-3 M-1
Construction Type V-N
?Zoning -- PD
Buildin9 Length ? 72
? Building Width ? 54
?- Building stories 2
„ i i--
?
-;Y?' L?? ?
REMARKS:
5& W PLBR - MURR PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
3AC Units
Lic. Search Fee
5ubtotal
$2,531.40
$199,000
MISCELLANEOUS $1,828.59
Total Fee $4,359.90
CONTRACTOR:
BREAM BLDRS INC
961 GRAND
ST PAUL
(612) 298-1044
- APP.tioant - sr. Lic. OWNER:
12981044 0081775 BREAM BLORS SNC
AVE 961 GRAND AVE
MN 55105 ST PAUL MN 55105
(612)298-1044
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan Ordinances.
?
r < ,
APYPL`I' NT/PERMITEE SIGNATURE
PERMIT
VALUATION
$986.00
$640.90
$99.50
$800.00
100
i
$5.00
application and state that the
with all applicable State of Mn.
J
.Oiln 9 o A I nl,?
ISSUED BY SI NATURR
-?-
- CITY OF EAGAN (?:EC ?????
' 1994 BUILDING PERMIT APPLICATION
? q 26nwtf ` ' 681-4675 9 1994
r I r ??
-
3INGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 5 / 2 /q4_ Valuation of work ?zSo,ooO
Site Address: ?S(p
STREET SUITE #
Tenant Name: (commercial only)
LOT 20 BIACK ? SUBD.AKaT T P - I.D. #
Descri tion of work: (JEW
The applicant is: ? Owner ,?fContractor ? Other (Describe)
Name G4(Ax1'E.i'7A A&MES Phone
Property LAST FIRST
Own@1'
qddress
STREET STE M
City State Zip
Company MSEW (ziUluric-ne-& I F-JG, Phone
Contractor Address?tol License #62701S Exp.3 3? qS
City ti •(?uL State Q`/CN , ZipSSloLS
Company J?l)CC.,O6r-S Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber M06-l2 ?lld,ht?iit?U . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply w' all applicable State of Minnesota Statutes and City of
Eagan Ordinances. C,
Signature of Applicant: ,Vl-
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
B 02 SF Dwg. ? 01 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessary
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
M 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair O 36 Move
GENERAL INFORMATION
w?a ,q
? M
- .; '?•
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 31 Demolish
Const. (Actual)
(Allowable) V/y
"?!`
' Basement sq. ft.
l
t fl
f 1%52 MWCC System ?
?
' s
. sq.
t. /vs? City Water
UBC Occupancy ?:? 2nd F1. sq. ft. ,
15" PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories z Footprint Sq. ft. Fire Sprinkler
Length '2- On-site well Census Code o
Depth 5? On-site sewage SAC Code
Census Bldg ?
APPROVALS Census Unit
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
?.5ite
? Wallboard
? Footing
Final
vat?me;on:
f3swta-Isi- ?
2?'+
8"Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
,-M Framing
? Draintile
coo
3 z.z
126
yi.Di
5-8, 3S
z8
Zy
zy
l
l?-s7 3?X?9=
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3y
z ?N z : %v
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9524/94 id: d9
avia
CERTIFICATE OF SURVEY
For BREAM CUSTOM HOMBS
?
PROPER'iYOESCRIPTION: Lot 20, Block 19 CiFtEAT OAKS, Dakata
_Countv, Mlnnesota. . T
We ?erebY certifY tmt thi$ iS a Uue and correct survey oT the abOwe describeq pr?p ?ty-8 ?@at R was
perFormed by me or under my direct supervision ana that I am s duly LlCenBe S?urb? t't?lnqer lhe
laws of the State of Minnesote. This survey does not purport to show all impr??f'eitihdr6t ,?ePaments
or encroachments, lo the property exoept as shown thsreon.
--?- r z5.?
e?_?._._?------
Signed ihis day oi fof , 19 fdl
a E
? . By:
? _ Oary R. H *is, Minnesota LS. No. 10943
Notes:
1. Buiiding dimenslons shown are for
horizontal & vertical location of structure only.
See architaciural plans far building 8
foundation dtmensions.
2. Ne specific aoils investigatian has been
campleted on this lot by Jemes R. Hill, lnc.
The suftabiliry at soils to support the specific
house proposed is noi the responsibility of
James R. Hill, Inc or the surveyor,
3. Proposetl grades shovm were taken from
the grading 8/or development plan prepared by
Ottw
0 Danotas set Iron monumeM
• Denotes tound iron monumenl
X 927.68 Denotes e"ng elevaUon
(930.?) Denotes proposed elevaBon
--+ Denotes ptupased drainage
Bench Merk: l,[,C. c er- L.,a.T
t- I ? zZ.:Nc- o(-4. J
Proposed darage Floor = !28 z.. g
Proposed House Top Blodc= ee z.?
Proposed (ieraga ToQ elack= 48 z. t,.
Propoeed Lowest Pbo? a -), 4. U
Beerings are on assumed datum
Scale: 1 "=3 0 '
Page 1 of 2
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° m b? PL4NNERS / ENGINEERS / SURVEYORS
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2800 W. CTY. Rp, 42 0 BURNSVILLE, MN. 55337 0 812-880-8044
R=96% '1 1 612 890 6244 05-24-96 02:48pM P004 #12
05/24i94 14:50
SURVEYQH'S CERTIFICATE
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PLANNERS / ENGINEERS / SURVEYORS ?
2500 W. CTY. RD. 42 • BURN$VII.LE, MN. 56337 a 812-880-6044
i
05-24-94 02:46PM P005 #12 .
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LOT SIIRVEY CHECRLIST FOR RESIDENTIAL
BUILDING
PROPERTY LEGAL•
Date of survey: 91 el
i
pOCIIMENT STANDARDS Alft-- S/t- / ( / y
Registered Land Surveyor signature and company
Building Permit Applicant
Legal description
Address
North arrow and taa-s-scale
House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
Directional drainage arrows with slope/gradient ?.
Proposed/existing sewer and water services
Street name
Driveway
ELEVATIONS
Existina
K7? ? ? • Sewer service
1? ? ? • Lot corners
fT? ? • Top of curb at the driveway
p?? ? • Elevations of any existing adjacent homes
Proposed
H?-? ? • Garage floor
P--?? ? • First floor
pl- ? ? • Lowest exposed elevation (walkout/window)
8? ? • Property corners
? • Front and rear of home at the foundation
PONDING AREAS (if applicable
er' ? ? • Easement line
B? ? ? • NWL
? ? ? • HWL
p? ? ? • Pond # designation
? p'?'p • Emergency Overflow Elevation
Z"?? ? • Lot lines
Pr-?? • Right-of-way and street width (to back of curb)
B? 0 0 • Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
Ql ?? • Show all easements of record and any City utilities within
those easements
$' p? • Setbacks of proposed structure and setback of adjacent
existing homes
?D--,[3 • Retaining ents, if any
Reviewed: ?requi
?/ 2L/ Jy
October 1992
.2 )
GR
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OAKS
?
22
/'CB /
19
.?
?8
POND JP-14.1 ?
ZC NwL=aso
HWL=864
8TM=856.7
STATiC V=1. ACFT
V=2.0 CFf
Q=.6 CFS
a ria 1., I?' n:'
°?,? ?:?CJRACY OF UTILf7Y Lt7CAT10fUg
?`1'?`?IaR ELEVATIONS. THIS DATr? fg FOR
PcRSOUSTI0R1 PURPOSES OIVLY ,qND
IJSING IT SHOULD VERIFY THE
f NFORMATION ON THE SITE.
3
z7-
sS- ?1 U
,
PERMANENT,DRAINAGE-
AND UTILITY EASEMENT
PFRMANF\IT flRefnier_?7_
27
PERMANENT DRAINAGE-
AND UTILITY EASEMENT
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EXTERIOR ENVELOPE AVERAGE "U"'COMPUTATION
ewNER_ J I M f?FELt.FY 641 P- ?ETT A.
SITE ADDRESS 04%- ?S Tr'b,l (?
CONTRACTOR0!;t?4 .tA ILjUII,.??tlj DATE CJII9I1W' PHONE 2-1a'1044-
Determine working square footaqe of each.
1. Total exposed wall area ...... 5112, 5 sq. ft. X ?11 -_ 51 I? ??5
2. Total roof/ceiling area ..... 1$7.0, p sa. ft. X , V0
A. Total wall window area........................... . 14-5. i3
B. Total door azea ................................. FP"71 lo'15L.
C. Total sliding qlass door area ...................
D. Total fireplace wall area ....................... ?Z.
E. Total wall framing area (averaqe 10$)........... Iq,2 5.
F. 1bta1 Rim joist area .....:.............•........
G. 1bta1 Net wall area above floor.................
Z?
Total exposed foundation area.- Zq2???ra
H. 'fotal foundation window area .................... - O-
I. Total net foundation area above qrade........... 2R2A75
Detezmine "U" value o£ each wall segment.
a. 143. fo3 x ..U-
b. ,10151. x ^n°
C. (A .O X "U"
a. L. I15 x ?u"
y 1l ? 2 x "u"
e . .?
f. l.Z'1, 5 x ..,,.,
9• X "U"
h. X l.u.,
, 33 = 44S, 3a1
q
,13 'I , 4a'1b
?33 = 2a,7q
, °I25 a 5, ???
, ro = S .qz5
1 042. ° L1/ •? ??
.046
.
= l2 q.l326
_v-
i. Zq1.375 X..u" . Iz a 9,715, a
s ...................................Total
If item N3 is the same as, or less than item #1, you have met the intent of
SBC 6006(c)2.
V
i'
A
Total exposed roof/ceiling area O
j. Total skylight area ................................ - O-
%ca Tbtal roof/ceilinq framing area (averaqe 109)...... ?ft? Z,p
1. Total net insulated roof/ceiling area .............. Ite3 t ,p
Detezmine "U" value for each roof/ceiling segment.
j• ? d '
'
X °Q" -Q-
k. I 82 , o T-
x ^o• , 021 s 3.822
1n --?-
. , l.?_?In7p.0 X"0" ? DI $ a 2,q,4
4 .....:.........................:.....Total Q 33,3 0(?
Zf total of k4 is the same as, or less than #2, you have met the intent of
SBC 6006(c)1.
. . ,
_ >. . _
Alter'nate Suildinq Envelope Design
Tb utilize the total envelope system method,• the values established by.the
sum of items #3 and p4 shall not be qreater than Lhe sum of items C. and #2.
1. + 2. ? .
3
+
a
L •
? D
1994 PLUMBING PERMTT (RESIDENTIAL)
CITY OF EAGAN
3830 PII,OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
NO. FIXT[JRES EACH TOTAL
SHOWER 3.00
? WATER CLOSET 3.00 7
BATH TUB 3.00
LAVATORY 3.00
KITCHEN SINK 3.00 ?
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00 ?
FLOOR DRAIN 3.00
GAS PIPING OUTLET • minimum - 1 3.00
ROUGH OPENINGS 1.50 -?-
WATER SOFTENER 5.00
PRIVATE DISP. • Dak.Cry. lic. 20.00
U.G. SPRINKLER • home uneer mnst. 3.00
ALT'ERATIONS • to nristing 20.00
WATER TURN AROUND 20.00
STATE SURCHARGE
TOTAL: sd ?
SITE
OWNER
INST.
--.Jre-Q +vi &l 44 rf
v-r
ADDRESS: !/ T 0 Cj1 Y`,Sr{eps:'c n// At,
CITY: W'(. STATE: 1`117`1. ZIP CODE: -?L
PHONE #: (0a) qSS^ _wc-
?..?
NATURE RMITTEE
PLEA3E COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUII2ED FOR EACH UNTT.
_ '/NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DAT'E ? I1 ( 1 q L-i
FEES
atLk
HVAC: 0-100 M BTU $ 24.00 " I'L°'CO'o
ADDTfIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExISTING CoNSTRUCI'[oN) $ 20.00
STAT'E SURCHARGE .50
TOTAL ,3p .Sp
SIT'E
?S
OWNER NAME: ?cL?-r1 auikl,a? TELEPHONE #:
°V_
CITYJ,0 •?1•`?ct.+--1-P STATE: ZIP CODE: SSD 7 5
TELEPHONE #: L/J -7-- rp 7 f/
Ld?,u?.
SIGNATURE OF PERMITTEE
1994 MECHA1vICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
RESIbEi'vYIAL
BUILDING PERMIT APPLICATION
r-? GTY OF EAGAN
4__?--- 3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Constructian Reouirements
• 3 registered site surveys showing sq. (1. of lot, sq. ft. of house; and all roofed areas
(20°h maximum lot coverage allowed)
• 2 copies of plan showing 6eam & window sizes; poured found design, etc.)
• 1 set of Energy Calculalions
• 3 copies of Tree Preservation Plan if bt platted after 711193
• Rim Joist Detail Options seleclbn sheet (bldgs with 3 or less units)
DATE 31''4Q.C.-O o`Z
,?- -
SITE ADDRESS `t?S3 Glo+ Qo.ICS -Va%1 MULTI-FAMILY BLDG _Y _N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
- ifoo .
APPLICANT
STREET ADDRESS
TELEPHONE #
RENEWAL BY ANDERSEN
1920 COUNTY ROAD "C" WEST
ROSEVILLE. MN 55113
LICENCE #20130983
STATE _ ZIP
_ FAX #
PROPERTY OWNER °r0`n. TELEPHONE #
COMPLETE fOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUL,ES 7670 CA'1'EGORY 1 MPINESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted . New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
PlumUing system includes:
Mechanical Contractor:
Mechanical systcm includes:
Sewer/Water Conhactor:
ree: $90
D ?(i-?Vi
JAN 0 9
L ree: $70
Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with alI applicable State of Minnesota Statutes and City of Eaga??inanc .
Signature of Applicant L.?l?l?1
-°----°--------------°----------•-----------------°---°----__...-------°------------------------------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Waler Softener
Waeer Heater
No. of Balhs
1 a? - a?
RemodeVReoair ReauiremeMs
• 2 coples of plan
• 1 set ot Energy Calculations for heatei additions
• isitesurveyforexterioraddNonsBdecks
• IndicateifhomeservedhysepticsystemforaddNons
VALUATION S,Stanl'?
Phone #
I,awn Sprinkler
No. of R.I. 13aff
_ Air Conditioning
HeaC Rccovery System
*"
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use %
Permit #: `/ / / ! /
Permit Fee: /30,1'n
Date Received: 4-/
Staff: C
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 2- 6Av t1 Site Address: ' 3 6_ ' t Oct IZ S
Ati cl A eckeck
Tenant:
Suite #:
RESIDENT / OWNER
Name:
Address / City / Zip:
Ts -3 6_44 hs
Phone:
Applicant is: Owner
Contractor
TYPE OF WORK
Description of work: g-f-rwo,;e-
Construction Cost:
itflew re6, l at, e
Multi -Family Building: (Yes / No( )
CONTRACTOR
Name: /��l-Ttr'rc-r - i t-i�
Address: o 1 f^/ct-fL rr
City: 1
Phone: 6 t l_ c SS' I c) Contact Person:
License #: .o 3 3 . t
s
State: /l'l Al Zip: ') s 7y 3 7
114
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code
Category
(I submission type)
Minnesota Rules 7670 Category 1
• Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the informationmay be classified as non-public if you provide specific reasons that would permit the Ci
conclude that they are trade secrets.
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.
xb i1 od
Applicant's Printed Name
MJ 2 6 2009
plicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New / Interior Improvement
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season) _
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
fra-n%11-fs 4 -
Addition Move Building
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Construction
0 62 0
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: _Ice & Water _Final Pool: _Footings _Air/Gas Tests
Framing Siding: _Stucco Lath _Stone Lath
Fireplace: _Rough In Air Test Final Windows
Insulation Retaining Wall
Meter Size: Radon Control
Erosion Control
Reviewed By: 1 u " , Building Inspector
Final
Brick
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
ruz.
01,6 -le
Page 2 of 3
Oily of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: £'
Permit Fee: 4 7• -3
Date Received: / —
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - I C(— 16 Site Address: 6 5-3 C--vi,P 44 0 A. i<y fi+Z ,
Tenant: Suite #:
RESIDENT / OWNER
Name: lbw. c1- IV A vv e_ R 4 -14--
5-- 3
1A-53 k 6 4--145
Address / City / Zip:
Applicant is:
Phone: t!, I- iv S1 -c1 L e
TAA` 1
Owner 2Contractor
TYPE OF WORK
Description of work: G ,Q.
Construction Cost: i 04e-4:7 Multi -Family Building: (Yes / No )
CONTRACTOR
Name: g 0 U 5 t o e;+- License #: 0 tic) a 3't/
Address: / 7 - kt4 & Z.Uth y City: v�
State: hi\ -e ,, Zip: �i 7 t 3 Phone: / 5-1 — �% �� 6 7 8 ', , I
Contact: ) V `' 1 I Email: YV 1 2 1 (�'e k,411 Cd Cf3v-NCu15�• ►"Y4
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:
Ph one:
Sewer & Water Contractor:
ITE Plans and supporting documents chat you submit are considered to be public information Portions a;
information may be classified as non-public;if youprovide specific reasons that woulu permit the City to.
conclude that they'are trade secrets.
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.gopherstateonecall.orq
Ihereby 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.
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
.4 Single Family
Multi
01 of Plex
Accessory Building
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
_ Storm Damage
Exterior Alteration (Single Family)
_ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
Pool Miscellaneous
WORK TYPES
_ New _ Interior Improvement
_ Addition _ Move Building
Alteration_ Fire Repair
_ Replace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% x )
Census Code
#of Units
# of Buildings
Type of Construction
?it?
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
)( Framing
Fireplace: _Rough In
Insulation
Meter Size:
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
_ Demolish Building*
Demolish Interior
Windows Demolish Foundation
Egress Window _ Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: Footings _Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath Brick
Air Test _Final y Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Erosion Control
, Building Inspector
Reviewed By: ( L
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
1 tom
(2 (9 9
Page 2 of 2
City ofEagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit#:
Permit Fee: 6`9
6-0
Date Received a
Staff: e-
2010
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ,� <15- / 0 Site Address: 6 3 Cj if .42. Q._7- n A,e 5 7i/eu
Tenant: *Ct,1.1 —' 4 7/¢
J
Suite #:
RESIDENT / OWNER
Name: Phone:
Address / City / Zip:
CONTRACTOR
Name: /frv�? jj.-e,- --eX SpA,
License #: 5---V:4----7:::Address:
"14..,,,44„,
6� f4-51- a <7,,,- G7 7- City: 1t/4.sa_ t, s /---0-r1
.t:(..,
State/JQ � Zip:,ig Phone: cf a 4( 2 ? q
Contact: l4l 2 D1 2 /q/ Email:
TYPE OF WORK
New Replacement _ Repair Rebuild Modify Space Work in R.O.W.
_ _ _
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
( RPZ / _ PVB) ( Main Lower Level)
_
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge),
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.000herstateonecall.orq
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 ofplans.
x j7M YO,
Applicant's Printed Narhe
FOR OFFICE USE
Required Inspections;
App) ant's Signature
Reviewed 1
Rough -I
C!ty of Eaaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
9r50
Permit Fee: 1555 co
Date Received:
Staff:
1-/-as-1/
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date SQ IL ')' a 11 Site Address:
Tenant:
g G2C,� OA ks TRAIL, C 1 N1 K IJ c,c-O 3
Suite #:
RESIDENT / OWNER
Name: I) PM S 4- N A O Cy A l ATA Phone: 6 c ( -6O (' 68'.
Address / City / Zip: Ts -3 afar OAVS -re. EAGA r.f MN S.:S t
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
Sump Pump Repair Repair
Other: X Other: CAPS 0 N 6X1-6410 access
Pa(NV-S
DESCRIPTION
Description of work: PIA CC 'k SCAL c A PS ON 096N Pvc PIPE
N F0 Nrc YA P -f
FEES
$55.00 / Each (includes
$5.00 State Surcharge) TOTAL FEE $ *
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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
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.
x 4\40Yraged C
x TkOtS C , A P "rP
Applicant's Printed Name
Applicant's Signature
Required Inspections
Under Ground
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA109710
Date Issued:03/29/2013
Permit Category:ePermit
Site Address: 853 Great Oaks Tr
Lot:24 Block: 1 Addition: Great Oaks
PID:10-30950-01-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Craig Angell
12253 Nicollet Ave. S.
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Thomas C Arata
853 Great Oaks Tr
Eagan MN 55123
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature