956 Greensboro LaneCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 956 Greensboro Lane
Lot: 1 Block: 5 Addition: Greensboro 2nd
PID:10- 30901 - 010 -05
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276 -1680
Applicant/Bermitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Lois K Bullock
956 Greensboro Lane
Eagan MN 55123- -224
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
Building
EA089250
05/19/2009
ePermit
Es
REQUEST FOR ELECTRICAL INSPECTlON . -oooot-os
• , See instructions lor completirq this form on back ot Yellow copy. /7
?) y
E7 "X" Be(vw N'aA Cavered by Thrs•Heqaest
New AAd Rep. Tyve nf Bwltling Appliances Yrired Equipment Wired
Home Range ' Temporary Service
puplex WaterHeater Lighuny Fixtures
Apt. Building Dryer Electrii; Heatin
Commercial Bldy. Furnace Silo UnloadF:r
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Oinrr oeci y ine, i5ue,:,}yi
ttxar uecify ther 0Ih4r
;. ompute lnspeciron Fee Below
M Fee ServiceEntrenceSize N Fee Feeders/Subleede?s +? Fee Circuits
U to 200 Am S 0 to 30 Am s a tn 30 Am s
Above 200 qmE?S 31 to 100 Amps 31 to 100 A s
5wim'ini'ng Pool Above t00?Am s Above 100_Am)s
Transformers Irrigation Booms Partial• Other Fee
Signs Special Inspection S TQTAL FEE
Remarks ?
?
"°?"-"' ----- I,the Electrical
Inspector, he?ebV
certily that the above
Final Dale inspection hes been
mede.
Thls requeat vo4d
This request vaid ?/ C( .?{/'"? ? ?'"?? ,; ?._?? . . . ?'??S? / ;
18 month5 frOm ?3I9
E 268971,/ PA
avyutl?l V04 rl?d I?Y. liVU{???-111 1?19VG(:11U1`
? q y c` I HNqu??? ?k? eady Nuw [] Will Noiifv InsPec-
Q tor When Ready
ucynseo c?eccn?a ?Rrcwr ? I hareb p?bst ins tion O} ebovB
Oy?ner ?ectri 1 vl?rk inst led at: •
Str et Addrass, telo. ?.? C?t
uon o. wnshlp Na or NoN Range o. ? County
?
Qccup HINTI , Phone No.
..1? i
lC.iC r
Pow upplier Address ,
o iL ? rm ? f? 7?
EI¢ctrical Contracmr ICompany ;e)
l
` ? Contractor's License No.
`? ?
e
nC.
7 1 S-
Ma'rlinp Ad res3 (Contraclor or Owner Making Irtstailafion)
,-
4
)(.Y ? W 1
W ! 3 ? / / ! o.
Authori ed S+gnaWre (Con ctor/Owne aking Installation) one Number
,_ v -636
MINNESOTA STATE BOARD Of ELECTRICITY THIS INSF£CTION REQUEST WILL NOT
Griggs-Midway BIAg. - Room N-191 BE ACCEPTED BY THE STqTE BOARD
UNLESS PpOPER INSPEGTION FEE iS
1827 Univerailv Ave.. Sl. Paul. MN 55104
@?,16--LW:AIO.. ------------- - ?,.x.ENC,-
REQUEST FOR ELECTRfCAL INSPECTION EB-000?01-0 s
See instructions for completinp this form on back ot yellow copy.
: E 5 'x,Bel9?v Work Covered by 7hrs Requesf
?-
Add ReD• TvPe o1 Building pPGances Wired Equipment Wired
Hume Rang Temporary 5ervic;e
Duplex } Wate, eater U,yhtin,y Fixtures
Apt. Building D ye Electrie Meatin
Commercial Bldy. ace
4
Silu Unloader
Industrial Bld . ir Ccindrtioner Bulk Milk Tank
(SP'r.ifvl
HP
p Fee Servic Entranc t+ e eeders/SuGfeeders 11 Fee Circuits
U to 290 Am 0 to 30 An, ps ?? tr? 30 nm s
Above, 200 ? 1 to 100 Amps 31 to 100 Am s
Swim i ol Above 100_Amps Above 100_Am s
Trans rmers Irrig2tion Booms Partial Other Fee
' 1 _k_\ 15pecial Inspection ' S
AL FEE
. " "' I, lhe Eiectrical
''S• , Inspector, hereby
certity that the above
Final Uate insvection has baen
made.
tlds requeal voitl 16 monttm trom
This reQuest void -7 -
78 months from d A
E 2 ? 15 5 / / ?.N
Hequest Uate FireNo. R4eoquoh-,tnI nsuec iion
ird?
?Heady Now?Will NnUfy Inspec-
?Q ? ? ? ? ??` 4
Yos ' ? N. tnr WhNn R?adY
Ucensed Electrical Contracmr ?'
I.here6y request inspection of ebove
Owner 4 lectri9al work installed at:
Street Address, Box or Route Citv
ection T w ns h i p e or N, a g . Count?
Oc• ,upnt ( ?
l J ?
r Phono No.
? `_ ? ? (
(?•Ci % -
tl Suva?i ? Address u
,QYr1f fl c, Ta%
E$ctr o ntr tor mpa Namel Contractor's License No.
Maili '
_ IContracior or Owner Making Instailationl
mA
,.J 6 / /
Authori ed Si gnature Contractor/ wner ing Installationl P one Number
:? v -? ?
TNIS INSVECTION REQUEST WILL NOT
MINNESOTA STATE 80ARD OF ELECTRIGItY BE ACCEPTED BY THE STATE BOARD
Gripys-MidweV Bldg. - Room N-191
UNLESS PROPER INSPECTION FEE IS
1827 Univeraitv Ave.. St. Peul. MN 56104
Phone (612) 842-0800 ENCLOSED.
CITY OF EAGAN
3838 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-6100
BUILDING PERMIT
To be used for : !'•Est. Value
151$5
r
Receipt
Date JC'NE 14 ,19 86_
Site Address Gkl1Fh.`,; ItOFtU L1L'
Lot ? Block S Sec/Sub. GRI:BNS13lii10 2.j '
Parcel No.
m Name ??ATUxE, PUJLlit ;<,.
?z Address 15 A 3 LOGAhTO L1s
° City Phone 435w-8443
, & Name
o < Address
? City Ph
V W Name
= Z
? Address
Q W City ' Ph
L
I hereby acknowledge that I have read this application and state that the
information iA correct and agree to comply with all applicable State o(
Minnesota Statutes and City of Eagan Ordinances.
s }
Signa;re of Permittee
A Building Permit is issued to:
on the bxpress condition that all work shall be done in accordance with all
applicable State o( Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
On Site Sewage Occupancy R"3 M"1 1
MWCC System ?Zoning x'1
on site wsu (actuBi) consc V-4% ?
City Water A (Allowable) v "IN
PRV Required * of 5tories
Booster Pump Length 541
Depth 36 '
S,F. Total
Footprint S.F.
APPROVALS FEES
Engr.{Assess. Permit 622•00
Planner Surcharge 57.50
Councii Plan Review 331.00
Bldg. Off. SAC, City 100.00
Variance SAC, MWCC 550•00
Water Conn. 550.00
WaterMeter 67•00
Road Unit 325.00
Treatment P1 204-b(2
Parks
TOTAI 2,786.50
CASH RECEPT
CITY 4F EAGAN
3830 P1LOT KNOB ROAD
EAGAN, MINNESOTA 55122
t ? ..
DATE
RECEIVEO ^
FqOM I? .;1. "_0 I ' '!-
AMOUNT $
,k
& DOLLARS
loo
? CASH Q?CK
:j
FORi?}?
BY •
;-.
Whito--Payers CopY
8 (? ¢ Yelbw-Postin9 Copy
707
... Pink--File Copy
Thank You
? PWMBING PERMIT
CITY OF EAGAN
--? 3830 PILOT KNOB ROAD, EAGAN, MN 55122
ONTRACT PRICE PHONE: 454-8100
Name
?
? Addre
c City !
? Name
3 Addre
0 C'ty
=
Phone
FEES
COMM/IND FEE -1gU OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & 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
SIGNATURE OF PERMITTEE
FOR: CITY OF
PERMIT # Y
RECEIPT ft ??^ •°' '--`2"
DATE: ?BLDG. TYPE WORK D?SCRIPTION
Res. 1-' New i-
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
N FIXTURES TOTAL
Water Closet - $3.00
?Bath Tubs - $3.00 Lavatory - $3.00
?Shower - $3.00 % -
Z_Kitchen Sink - $3.00
Urinal/Bidet - $3.00
?Laundry Tray - $3.00 ,- '--'
?Floor Drains - $1.50
? Water Heater - $1.50 ! • ` ?
Whiripool - $3.00
_Z Gas Piping Outtets - $1.50
/ (MINIMUM - 1 PER PERMIT) ,
Softener - $5.00 ?-
Well - $10A0
Private Disp. - $10.00
_...2_Rough Openings - $1.50
FEE:
c.
STATE S/C: GRAND TOTAL• - `-'
PERMIT #
• ' MECHANICJIL PERMIT '
RECEIPT #
I
• CITY OF EAGAN
•
, ,
? (? -
•
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address ` ^ ' BLDG. TYPE WORK DESCRIPTION
LotZ
.;j_ Bloc
k ec/Sub '
_
ti
` Res. Vi
New '
Mult Add-on
? Name ' k,
m - • y q • Comm. Repair
? Addre?s
S ' Other
c City I
&&? 13S kU
0f 1LQ ne •
FEES
Name "r f RES
HVAC 0-100 M BTU -$24A0
? .
c Address ADDITIONAL 50 M BTU - 6.00
O Ciry Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GA5 OUTLETS (MINIMUM
1 PER PEk
+lll'T) - 1
50 EA
.
-
i
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air ? M BTU ? APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU $ " MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent. CFM
, (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # O BEYOND $1,000)
Other
FEE
S/C: SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
` PH ON E: 454-8100
BUILDING PERMIT Receipt4k
? To be used for Est. Value ? ? ? • ' Date ' "a?> > ,19
Site Address
Lot Block Sec/Sub. "' ?' ? •'?` ' ` ? ?? ?
Parcel No.
ac Name
W
z Address
° City Phone [, 3
,o Neme
e=iU 6rlrlroc¢
yVj W Name _
?W
Address
0
mWZ City Phone
a
I hereby acknowledge that I have read this application and state that the
information is coRect and agree to comply with all applicable State of
, Minnesota Statutes and City of Eagan Ordinances.
- Signature of Permittee
• A Building Permit is issued to: _-
on the express condition that al I work shal I be done in accordance with all
?applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFIC E USE ONLY
On Site Sewage Occupancy
MWCC System ' Zoning ?- ?
On 51te Well (Actual) Const
City Water { (Allowable) -
PRV Required # of Stories
Booater Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
EngrJAssess. Permit
Planner Surcharge )7 • 5U
3+ 1. .?
Council Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC 5NJ ' `u
Water Conn. `
S?• "a
Water Meter ?' ? •' ' ?
Road Unlt ? ?: . . , +o
TreatmentPl -???•?'l_
Parks
? ??
TOTAL
Permit No. Permit Holder Date Talophone
Plumbing i2
H.v.ac. p 8'
EleCtric
Softener
Inspection Dste Insp. Comments
Faotings I
Footings II
Foundation
Framing !?/ S
Roofing
Rough Pibg.
Rough Htg. ?
IsuL
Fireplace b
Final Htg.
Final Plbg.
Bldg. Final
Cert.Oca
Temp. LP r
Deck Ftg.
Deck Final
Well
Pr. Disp.
}
CITY OF EAGAN
3830 Pi1ot Knab Road
P.O. Box 21199
Eagan, MN 55121
Address:
CC:
Chg: !,!rF. ? - ----
?'•()T)r.
Dep: AS.t?r,ra
nit Fee: ! ? • r`?-,;.`
? ,.
h8rO2: _ • . r'r<'
Permit No: 10591
BlPNo: - ;.s
No. of Units:
Date: 7 ? 8
Date: c n
I agree to compiy with the City of
Ordinances.
CITY OF EAGAN Permit Na: 974; Date: 7' 7
3830f f1ot Knob Road Meter No:
P.O:. 3.bx 21199 Size:
Eagan, MN 551Y Reader No: Date:
. .
Owner. 8a4.1ider?
Site Address: _ C,
Plumber D ?e a/Dr?sh?r £?c?
Conn. Chg:
ACCC DBFI:-
Permit Fee: ' :"? nr?,- •?
Surcharga:
Tr. Plant
Meter. ?
Zoning: _
No. of Units:
I agree to comply with the Clty of Eagan
Ordinances.
? WATER SERVICE PERMIT
CITY OF EAGAN Permit No: 9 74 5 Date: ^
3830 Pllot Knob Road Meter Na -AIQ 7 4i<0 / 7 SL
Size:
P.O. Box 21199
Reader No: d_.S"/Z3 E7 S"$' pate:
Eagan, MN 55121
Owner. Feature :BuildeXs
SiteAddress: 956 ^' ee7,1 Lat-j- T7 T'S ^ti',:4'6IlCYG T-
- -
Plumber. ; i •-R¢?; /?r??rpr ? -r?
Conn. Chg: +": n rl nnd Zonin
g?
Acct Dep:
No. of Units:
Permit Fee:
Surcharge: - SaIT ? I agree to comply with the Cf Ea
Tc Plant
Meter. gan
Ordinapppggges.
Misc.: ??
WATER SERVICE PtRMtT f-4~fyw
F??I/ee REQUEST FOR ELECTRICAL INSPECTION . ea-ooooi-os
? Sae insUUChuns for complelmg this lorm on bxck ot Vellow capy
L " 1??JC?Cp '?
E 49755 "X" 8elow Work Covered by lhis Request
AAd Rep. TVOe o1 Bwldine Appliancne W rted Equiyment WveA
Home Ranye Temporary Service
Duplex Water Heaier LiyhLny Fixtures
Apt. BwlAing Dryei Eler,tnc Heatin
Commercial Bldg Fumace Silo Unloader
Industnal Bldg. Air CondiLOner Bulk Milk Tank
Farm otnNr aer.i v Lnor Isnnr.irvl
? v? ucc.ify f er Qihi;i
Comoufe Insoection Fee Below
p Fee ServiceEntreneeS¢e H Pee Fexders/Subfeeders N Fee Cu wts
Z pp U to 200 Am s 0 to 30 Am s 'Z IJV 0 tn 30 Nt+ s
Above 200 Amps, 31 to 100 Ainps 31 to 100 A s
Swimming Pool Above 100_Am 5 anove 10o_Ami)s
Transtormers Irngation Booms .Jt7 Pdrtial/Other Fee
SignS Special Inspectwn 5, I,,,,Sd
TOTA F6
Remarks yls .
fY
RouBh-m pp 55,the Electncal
,i4 InsPector, hereby
?
Flnal 2C?spechon hes been
mede.
Thla reQUeat voltl 18 monthn irom
This request vaid G j?//?
16 rtqnihs lrom ?? ? ?
E 4 9 7 5 5/. r. ?35 ,?? ?-oy '
Repuest Oate
Q?
/ Fre No. pouph-m InsDecuon 1
He Wred? 1-
eatly Nuw Q Will Nubty InsoeC-
lor Wh
n fl
A
.? Yes ?No e
ea
y
0 Licensed Electncal Contractur 1 hereby raquastinsPaction of above
? Owner electncal work irtslallad ab
SVeet AAtlress. Box or Rau1e No.
?'SCv ?i-cc ns loer& 0" , ?n Ciry
?c"' :" czn
ecbon o TownshiD Name or No. Range No. County
Occupant(PRINT) p Phone No.
Power upplier
k-A4k a-69 , c AAdress
,'i>??,? T?
Elect al Conlractor ICOmUanv Namel
?/?e n C?i, J4 ?, Conlractor's L¢ense No.
d?/?9?5 -3
MaJ?Jress IConVacmr or Owner Making Instailationl '
Aut nzed Sie7 ature ICOnhacmr/Owner Maka g Installatiunl
1??LL-!'.._.l?L'"?{X,(/...-_ . Phone Nu4m?/e.
? L Ll r? / /
'fO ? (O
MINNESOTA STpTE BOARD OF ELECTqICITY THIS INSPECTION FEDUEST WILI NOT
Griggs-Midway Bld9. - Room N-197 BE ACCEPTED BY THE STATE BOAND
UNLESS PPOPEH INSPECTION FEE IS
1921 Unrversitv Ave.. St Peul. MN 55104
on....e .wivi wnv.nwnn ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION dft ee-oooooi-os
( ? Sea instmclions lor comOleiin0 this frnm on beck of vallow copy
~ y?? J ?
E' 2 6$ 9 7 "'X" 8e/ow Woik Covered by lhis Request
Plain ,4da Pep. Type of Builtling Aoplioncna WireA Ea.iu.+enl WireA
Home Ranye Temporary Seroice
Duple,x Water Heater Liyhhny Fixtures
Apt. Bwldmg Dryer Etectnc Heatin
Commercial Bldy. Fumace Silo Unloader
InAusirial Bldg. Av Condrtioncr Bulk Milk Tank
Farm omrr sp', v nin,!, Isucc?iv)
t e Sua'aty the, Othm
Compute Inspecbon Fee Below
p Fee ServweENrencaSize tt Fee Faeders/5uhfexders ? Fon Gircwts
0 to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 Amps 31 to 700 Amps 31 to 100 A
Swmvning Pool Above 100-Amps Above 100_Am `.
Transiormers Irrigation &ooms Partial, Other Fee
Signs Special Inspection
$ '
TOTA
F
Rerrr? rks
L
EE
I, the Elactiicel I
InsOaclor, hera6V
cerldV that tM1e xbave
Final inspaction hes been
/ maAe.
Tnie repuesl vola te
?
This reQuest void
18mo ?3/?"
n?hs fmm ??'
E 2 6 8 9 7/. P,41 ?,V
nen??es? ua? ' i rve rvo. noupo-m ms0e,? oq r
?Y Required? Ready Nuw Q W??I Nolity Insoec-
? o / tor When fleady
\
MI-icynsed Elecin a" ctor ? I hnreb deb st inso ction of ebove
eL
Strdet AdAress, te No. / C?t
?p
ecvon o. T wnship Na or No. RanBe No.
I Count?
OccuOa HINT) / Phone No.
Puwup
Pher ' ?
kd?6 Plec. Address
.
?cr?m ?m ? hcfp7z
ElecVical ConVactor ICOmD?ny ame)
'?
"
J Cnntrnctot"s License No.
A.? ?
? c ?
?^ nC.
r c_
Mailma Ad ress (COMractor or Owner M
,)& 7s akinB I nstailanonl
l3
Authoryed SignaWre ICOn ctodOwne aking InstallaLOnl one Number
U
THIS INSPEGTION XEQUEST WILL NOT
MINNESOTA STATE BOAflD OF ELECTNICITV
Grie9s•Midwey Bldg. - Noom N•191 BE ACCEPTED 6Y THE STATE BOAHD
UNLESS PNOPEN INSPECTION FEE IS
1821 Universitv Ave.. SL Ppul. MN 55104 ENCLOSED.
Phnnw (F121 942.0A00
This 110ue.s[ wjd p18 months fmm ? `5/0 ? d
E 27155?i.
Renuest Uate Fve No. qepu'vedlnsper.tion ?Neady Nuw W?II NnufY Inspec-
?
`? ?(Y 1'es ?No ?or When Reatly
Licensed Electncel ConVactor here qy request onspection of above
?Owner electrcal work mstelled at
Stueet Address. Bon /or`Rovte No. Crty
eclion o. Township Name or No. ? tfl n . Coun ??
?
Occup t INT/? p /f Phone No.
C?l 1 v l?L? Ci( ?% ?
Po Supplier
(
k Address ?
m
nG7-
?N
?
r?
?- c
c
c2
E\ctncal Conu3etor omp ' Neme) C,nittaclor"z L?cense No.
YS = 3
0q (
c
Mailing-dddn6ss IContracmr or Owner Making I nstallalionl
G?1L l ?--SQ[.'4C
Auffion ed Signature?(COnttactor Owner a ing Installationl one Number
e -?c3
MINNESOTA STATE BOAPD OF ELEC?RICITV THIS INSPECTION NEQUEST WILL NOT
Gripgs-Midway Bldg. - floom N-191 gE ACCEPTED BV TME STATE BOAPD
UNLESS PROPER INSPECTION FEE IS
1827 Univers?tv Ave.. SL Pqul, MN 55704
ENCLOSED.
7?5?88? REQUEST FOp ELECTRICAL INSPECTION 10 e(?laC-ooaooi-os
? Sea insLVCbons for comolaUng this form oa baek of Yellow cooV O ?l d??
E^271 55 "X- Below Wofk Coveted by This Reques!
FAtl NeD. TypB oi 8uiltlm9 'Alippinuncas Witetl Eqwpmenl WireA
Home Rang Temporary Service
Duplez ? Wat eater liyhuny hxtures
Apt. Building D,{y Electne Heabn
Commereial Bldy. u ace Silo Unluader
Industnal Bldg. ir Cdrxlrtioner Bulk Milk Tunk
Farm ?n«. nao v oinc, lsnnl.Avl
[ PI UCCIIV 1 l Of OIhl`!
Comoute In ec n Fee Bel.o4? I \V
p Fee Servic?Entrenc ? h "Fa ewtlers/SahFeeders N Faa Circwts
U to 200 0[0 30 Am s 0 to 30 Am
Abov 200 pmj ? 1 to 100 Ainps ' 31 to 100 Am s
Swin ol ? \ Abave 100_Amps Above 100_Amps
Tran rmers Irrigation Booms Partial.'Other Fee
Si ? \ Speciallnspectwn $ TOTAL PE
emn.kk ? ? E
°°d••-"• ?? I. the Elecniwl I
Insoecbr, heioby
ceriifV thot the above
rFinal 3.1e insueetion haa baen
I metle.
TMs recuost roie 18
BLDG.
07-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
75-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
203868 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
CITY OF EAGAN N? 1518 6
3830 Pilot Kn&o Road, P.O. Box 21-199, Eagan, MN 55121
? ?011111 PHONE:454•8100
BUILDING PERMIT `
Receiptx ?J1b I
Tobeusedfor SF DWG/GAR EstValue $115,000 Date JUNE 14 ,19-aB--
Site Address 956 GREENSSORO LN OFFICE USE ONLY
Lot 1 Block 5 Sec/Sub. GREENSBORO 2ND On5ite5ewage _ Occupancy R-3 M-1
MWCC System 7( Zoning R-1
Parcel No. V
N
On Site Well _ (Actuaq Const -
a Name FEATURE BUILDERS City water -X_ (qllowable) V-N
? Address 15513 LOGARTO LN PRV Requrted _ # of Stories
o Ciey B[iI2NSVILLE Phone 435-8443 BoosterPump _ Length 54'
Depth 361
?
.o Name SAME S.F. Totei
?a AddreSS FootprintS.F.
? City Phone APPROVALS FEES
°w
w Name Engr.lAssess Permit 622•00
?=
i?
AddfCSS Planner SurCharge 57.50
a W
City Phone Council PlanReview 311.00
Bldg Off. SAC
Ciry 100.00
I1:er6by acknowtedge that I have read this application and state thaf the Variance ,
SAC, M WCC 550.0
0
mformation is correct and agree to wmply with all applicable State oF Water Conn. 550.00
Minnesota Statutes and C Eagen Ordinances.
Water Meter
67.00
Signature of Permittee Road Unit
n
199D
A Bwldmg Permit is issued to:_F ATliRE RiiTT i1Eg4 Treatment P1 704. M
on the ezpress contlihon that al I work shal I be done in accordance wrth al I
apphcable State of
Mm
ne
so
ta Sta
[ut s end
City of Eagan Ordinances. Parks
?
?
?
p
!
p
? TO7AL 2,786.50
Bwldmg Ofticial_I 1 14A.?J__I1.LALl,
? y.
RESIDENTIAL
, . BUILDING PERMIT APPLICATION
CITY OF EAGAN
? 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction NeaulremaMs
. 3 registered sile surveys shaving sq. M. of bt, sq. ri. of trouse; and II roofed areas
(20% maximum bt coverage allaxed)
• 2 coples of plan ahowing 6eam & win0ax sizes; poured found design, atc.)
. 1 set of Energy Cakulatbns
• 3 coples W Tree Preservatbn Plan'rf Wt platled after 711/93
• Rim,bist Detail Op1Wns seleclbn sheet (bldgs wAh 3 a less unds)
DATE 7I3bIdZ
pematleVHeoeir Beoulrements
. 2 copie8 of plan
. 1 set of Energy Calculatpns for heatetl addilbns
. 7 stle survey tor ezterior add'Abns & decks
. Indirate tt home served by septic system lor a00nions
VALUATION
SITE ADDRESS ?ld ? G/?a.? iboro L,e?n 2 MULTI-FAMILY BLDG , Y ?
NPE OF WORK 4 5ea;&OA i oo++V4., "c;? - FIREPLACE(S) 60 _ 1_ 2
APPLICANT
STREET ADDRESS CIN)Ej6?j4. ____STATEA11 ZIP ?
TELEPHONE#6-5-1 '`/63`3"`(CELLPHONE# 612-?$a`'?36__- FAX#
PROPERTY OWNER ? ??Ck TEIEPHONE #
COMPLETE THIS SECTION FOR -NEWn RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(4 submission type) • ReaitlenGal Ventilation Category 1 Worksheet Submitted • aP arg o e
• Energy Envelope Calculations Submitted A PR 3 0 2002
G
Piumbing Contractor: Phone # BY
Pluxnbing system includes: _ Water Softener _ Lawn Sprinkler Fee:
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contracfor: _
Mechanical system includes:
Sewer/Water Conhactor:
Phone #
Phone #
Fee: $70.00
I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply
with all applicable State of Minnesota StatuTes and CiTy of Eagan O aaR es. ?
SignalureofAppifco t
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
_ Air Conditioning
_ Heat Recovery System
OFFICE USE ONLY
? 01 Foundaiion
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? OB 04plex
? 07 OSplex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex 0 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (&sea.)
X 22 Porch/Addn. (4sea.)
? 23 Porch (screenetl)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Oemolish (interior) Q 44 Siding
x 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndatbn) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (eldg)' ? 43 Reroof O 46 WindowslDoor3
? 34 Replacement "Demolition (Entire Bldg only) - Gine PCA handout to appllcant
Valuaflon 1/ciga Occupancy 9-3 MC/ES System
Census Code L!_'3N Zoning /0 p_ City Water
SAC Units ? Stories ? Booster Pump
N6r. of Units ? Sq. Ft. J PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth 13
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
? Footings (deck) ? FinaUNo C.O.
_ Footings (addition) Plumbing
_ Foundation ? HVAC
_ Drain Tile Other
Roof _f Ice & Water ? Final _ Pool _ Ftgs _ Air/Gas Tests Fina]
?
? Framing _ Siding Stucco _ Stone
F'veplace _ R.I. _ Air Test _ Final Windows (new/replacement)
Insulation _ Retaining Wall
Approved By
Base Fee
surcnarge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
-?-[.L_ ICY
Building Inspector
?o?35) =
MAY- 8-U% WED 11:07 AM UBC I.AKEVII.I,E MI?
`; ' 'MAY. 8.2002 9=43F1M UBC i'Po2IBRUL7 '
MNcheck CoMPI,IANCE AF,pOAT
:nNCh6Ck tSOftware Versiorl 3.0
COUNTY: Dakota
5TATE; M111T1880td
20NE: 2
CONSTRUCTION TXPE: 9ingle Family
DATE: 5-8-2002
DATE OF pLnNS: 05/07/02
TITLE: FOUR SEASON PORCH
PROJECT INFQP.MTjON:
956 GRF,EN'90R I.ANF;
CO[fQANY INFORMIS'!,'ION:
SHRBFFER CONTRACTING 9ERVICES
COMPLIANCE: PASSES
R6qulTAlf UA = 460
Yaur Fiomo = 917
9.9% 6etter Than Coda
___°_w.-"----------------"------
CETLTNGS
CEILINGB: Rei9ed Trues
CEzLiNG3: Raised Truss
WALLS; Wpod Frame, 164 O.C.
WAtLS: wood Frame. 16^ C.C.
BSMT; Conc. 7,7• htl7.0' bq/7_7'
GLAZTNG: Windows ox Doorg, Abave
GLA2TNG: Windows os Daara, Above
DOORS
DOOR3
PLOORS• 0
FAX N0. 9524694721 P. 2
N0.213 P.2i2
Pesmit M i
I f
I I
I Checked bv/Date E
Area or CavStV Cont. Glazinc/Dopr
Perimater
------------ R-Value
--------- R-Value
-- t7-t7aluo UA
B32
38.0 ------
1.5 ---------- '- --•-
1:1
255 38.0 1.5 6
195 38.0 1.5 5
2930 19.0 2,6 i3g
329 19.0 2.0 16
insul 1155 11.0 1.0 g,y
Grade 290 0.350 10L
Grade 90 0.350 32
ge 0.350 1'
Ie 0.350 6
F'I.OORS: qver Outaide Air 33 25.0 1.0
195 25,0 1.9 j
- - ---------------------------------------------------------
COMpLiANCE 5TaTEMENT:- Thevproposed buildina deRiqn deaeribed here ia ~ V
consistenc with the buildinQ plans, sAecificata.ons, and other caiculations
submieted with the pezmit pplicatzon. The n oposed btiildinv has been
designed to maet tha r remeqX.s- oP th '¢sotd Enerqy Code.
Suilder/pesigner ' _ 74 nate---
bb-utsi
' TRI-LAND C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
SITE PLAN FOR:
FEATURE BUILDERS
LEGAL DESCRIPTION: LorI,BLOCK5 , GREENS60R0 2Np
ACCORDI T 6FfXECORDED PLAT
THEREOF COUNTY,MINNESOTA
TBC
909,92 ?
TBC
910.72
x
<<,
..,
i?
•,,
/
rec •
906k52 ?
o24?pg`
G?
?6 x9OZ52
907.52a` ' t
34' 0 .
ryry °???, / / , ,? N f9
? +n N
/
/ 909.12 ?
? 1
/
`.y°6
.?p?? 1 / YU
913.52
913?5/2\ 'ar N CO ,
' Ot? 913.
q?. yF. ? ?, U U(?
915 72 ?
6.5 + 49P622
907.12
1
/ O
!
/
LEGEND
o DENOTES IRON MONUMENT
a DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINACaE DIRECTION
a ?oh2 ?i
90932xC? CC) •
(EST.)
{ V
SCALE:•1'• a 30'
INVEFt t ELEVfaTiON AT SERVIGc EkTcNSivN-r
PROPOSED GARAGE FLOOR ELEVATION =
PROPOSED FIRST FLOOR ELEVATION =
PROPOSED BASEMENT FLOQR
ELEVATION
NOTE ? VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
I hersby certify fhaf this survey, pian or
report was prepored by me or under my
direct supervision ond that 1 om a duly
Reqistered Land Survtyor under fhe
Laws ot the STate of Minnesoto.
Bradley J.,Swanson, Mn. Rep. No. I5235
Date
88-081
TRI-LANa C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
SITE PLAN FOR:
FEATURE BUILDERS
LEGAL DESCRIPTION: LOTI,BLOCK-5-, GREENSBORO 2Np
ACCORDI T ECORDED PLAT
' THEREOF COUNTY,MINNESOTA
TBC •
906t52 ?
0
TBC
909.9
?
2
rec
910.72
z
.
•?,
iJ
?
o
ry ?? 10, D` ?'• ? ? 1 ? 0 W ?
? eos.i2?/ N 11? ?
/
? y0 ?
? ???e1 /
/?? ?
913.52
ryry , ?
5 913+52` ..A
?O i
' 0C?.? ? 913.62 o
?
6.5 ? (o \ 915a72
\ 4y?4 a X?AB.22
?QQ???? / \ . 907.12
\Y / %
/
/
? O
0
/
/
LEGEN4
o DENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINA6E DIRECTION
? s? ?D`
%
, a /otc
w tiiJ n,•
Y^ ?V
90R32x Lo
(EST.)
N
SCALE :. I`= = 30'
I hereby csrtify fhaT ihis survey,plan or
report was preparsd by me or under my
direct supervision and that I am a duly
Reqistered Land Survsyor under the
Laws of the State of Minnesota.
INVtR i ELEVi:1TiON AT StR'JIGc cxTctiSiviJ=
PROPOSED GARAGE FLOOR ELEVATION = /
PROPOSED FIRST FLOOR ELEVATION
PROPOSED BASEMENT FLOOR =-ELEVATION
NOTE'• VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bradley J..-S`wenson, Mn. Req. No. 13235
/
Date - !'? ? ?
PERMIT# ' -i" 1 ? a (, RECEIPTDATE:
8008 RESIDEN77AL PLUM$1NG PEiMiT APPLICAT10N
crrYoF eAeAx
3830 Paoz Kivos Rn
KA6AF, btN 55122
651-6$1-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITEADDRESS: lJ(o Gk'?ScaxsJ I,-0wz'T-
OWNER NAME: : ?`(5?35 ??cJll?-w-- 7ELEPHONE #:
(AREA CODE)
INSTALLER NAME: TELEPHONE #:
(AREA CODE)
STREET ADDRESS: G]? ?k ?'?OQJwu.?,??J
CITY: STATE: VL^ti ZIP: S',5-29 2,5')
_ SEPTIC SYSTEM, newlrefurblshed (requires two sets of plans and MPC license) $ 100,00
includes $40.00 Gounty fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
ZAdding fixtures to lower lavels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5(8" meter if needed -$118)
Other:
_ RPZ: new installation/repairlrebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ water softener _ water heater $ 15.00
State Surcharge $ .50
TOtal S 5?0• sd
I herebyacknowledge that I have read this applicatlon, state that the information is cortect, and agree to complywith all applicable Cityof Eagan ordinances. It
is the ap0licanPs responsibility to notiy the property owner that the Cfty of Eagan assumes no liabili or an amages caused by ttie Ciry during i[s normal
operalional and maintenance activities lo the facih6es construded under Ihis perrnit wi in Ci pe gl -w ent.
i
?URE OF PERMITTEE 1f02
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
851-881-4875
New Construction Reauirements
• 3 regislered sile survays showing sq. ft of lol, sq. ft. othouse; and all raofed areas
(20Na miucimum bt coverage albwed)
• 2 copies of plan showing 6eam & window s¢es; poured found design, etc.)
. 1 set of Energy Calculatlons
• 3 copias of Tree Preservation Plan if lot platted atter 711193
. Rim Joist Oetad Oplions selectlon sheet (bldgs with 3 or less uniGc)
DATE 1?fLSIUL
't ?? o_G6
RemodaVReoairReauirements
. 2 copres of plan l
. 1 set of Energy Calculatlons for heated addilions
• i site survey forexterior addi6ons & decks
. Indicate if home served by seplic system for additions
VALUATION
51TEADDRESS CIS?tsS Crck.??.?S1?1 ?4?? MULTI-FAMILYBLDG _Y ?TN
TYPE OF WORK gftatto,?z'1Y A,?Srj FIREPLACE(S) 7x 0_ 1_ 2
APPLICANT
STREET ADDRESS 1r 2,Z6 i?-Y<Sr45;1qJ '"ITY ^C,44? STATEw?"ZIP 5-57c)7A'
TELEPHONE # GT(-!t3-35y4 CELL PHtSNE #
PROPERTY OWNER
TELEPHONE #
------------------------------------------------°---------------- ------
COMPIETE THIS SECTION FOR "NEW°" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNL;SOTA RULFS 7670 CATEGORY I MINNLSI?i??$
?
(J submission type) • Residential Vantilation Category 1 Worksheet Submitted • New En ?de?/orkshe
. EnergyEnvelopeCalculations5ubmitted ? APR 2 5
Plumbing Conhactor: _`_
Plumbing system includes:
Mechanical Contractor:
Mcchanical syslem includes:
Sewer/Water Contractor:
Air Conditioning
_ Heat Recovery 5ystem
Phone #
Phone #
?
Fee: $90.00
Fcc: $70.00
--------- °------------- °-------- ° ---- ° ---- ° ---- ° °----------- ° ----------------- °-°---- ° ------------° --------° °
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinancp .
Signature of Applicant
_ Water Softener
_ Water Heater
No. of Batlis
r _? _ FAX #
PIlO1lC # .
Lawn Sprinkler
No. of R.I.13aths
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 af _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? DS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex 1<19 Lower vel
? 12 12-plex Plb Y or N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 EM. AIt - Multi
0 33 EM. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
?/ 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bl dg anly) - Give PCA handout to applicant
Valuation 62' 0 0 Occupancy R-.3 MC/ES System
Census Code -1g Zoning Q- n City Water
SAC Units U Stories Booster Pump
Nbr. ot Units U Sq. Ft. PRV
Nbr. of Bldgs I Length Fire Sprinklered
Type of Const ? Width
REQUIRED IN SPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) ? FinallNo C.O.
Footings (addition) ? Plumbing
_ Foundation ? HVAC
Drain Tile Other
/ Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
'b Framing Siding Stucco Stone
Fireplace _ R[. _ Air Test _ _
Final _ Windows (new/replacement)
y Insulation _ Retaining Wall
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Tota I
Approved By 'S ( N? z"? ?d Building Inspector
V 1 v'+? vr. I
patl W. t}Stn. A4wt .._. :•.
pNYJNy.san es+z+ EX7ERIOR .EMYE? c kYERAGE "U" COMPUTATION ? --A'•:'?•..-?,'??',.: •`.::'::
,•„ -, ..
,. " ,
OSiNER FEATuQe-- 13vit- DE25 SITE ADDRESS _ f l.•A u aC 7• 1787 P'l
CONTRACTOR 5ArAe, DATE ? PHOk:
Determine xorking square footage of each.
i. Total exposed wa11 area ...... 7-439 sq. ft. x, 11
2. Total roof/celling area ...... 108!? sq. ft."x _d,?b
Total exposed wa11 area above floor = I 006
a. Total wa11 Nindow area ......... :........:........ 1q3 ,
b. Total door area ................................. 38
c. Total sliding glass door area .................... . 40
d: Total flreplace rra71 area......................... 1(? •
e. Total wal7 framing area (average lOx)...:........ 160.8 „
f. Total net wa71 area above floor ................. 1391 ? •
g. Total rim joist area ............................ Zs?
Total exposed foundation area ? 9 9 h. Total foundation window area..................... l, .
i. Toal nei foundation area abpve grade ............ 93
D'etermine "U" vatue of each wall segment.
a•143 X "U" . SS = "Jg.? +
b. T,g g stult.
C._ 4p X"U" rS5 = ZZ
d. I V X"U". .20 ? 3. 2
e._ 18o.S' X"U" , 696 a 11 ,35
f. 1391 X"U" . 04.S - lo2S9
g. 23? X "U" , a11 a .s
h._ ts X"U° . SS . 3.3
i. 93 X"U" . aba- - 7. ?=
3. ......:..... .........:...........Tatal
If item 03 1s the same as, or tess than item fl, you have meC the intent
of 5BC 6006(c)2.
?ti
. ? .y? : ;? . ?r..a? ?jcei llng area n - 1 ?Uq ?
,.ir?? :r : =.:
? • .,.. . ;. ?. ' aA? r?;. .
, ,
; ;Mrf 7oLa1 9ro( cei'11rtqg aPea m?;.?, ? ?f?4, `?;-?' ,r "- , ". . • .
, . : ,
_ ' • :. •:J. Tota1 st?ylighf area ...................
......
; ... k: Yota1 roof/ceiling framing area .:.......,..
? 1. Tota7 net insulated roof/ceiling area......, ve?q, 4 . .
•, - •
-- ..,..s : ., w _. . • . _. . .
• Determine "U" yalue for each roof/ceiling segment.
....?e..•..~` . •s.. .?F..i• . ..X oUM • tD s .,.;` .. .
• k._ ? 108, LI ? x N'u• _ . ,o zy' • , ` . .
V ?• 9?9.4 X"U'• , d•22 ?, z, 3
4 ....... ............................ Tota1
.. . •• . • . • . . . .
If total of #4 •1s ihe same as, or'less than.02. you'have aret the intent, of •
SBC G006(c)V. . • . • . . •
To utilized the total envelope system method, the values.establiahed by the
sum of items i3 and 14 shall not be greater than the sum af 1tems !1 and /2. ;
#••2. ?' ? ? ? . . .? . .
'•? . • .
3• ' + .4. •
?'rffi?? • 'Thero. 8ssivtaaoa "Rn
• • ' . ?
'Srterior diT .. , ? ' • '
Siding?][starisl .
Sheathing '.. 37
•
InsultCtion . . . 12 . . .
SLeetrook • , t_ .
InSarior Ait , . ,
8t7Ada
8iiL . . r . . .
Cono. 81ka. ? .
. .. ... '_ ' • '. s
• ? . -.. . . .
? , . . .
, ; . ? .
? .. . .. . . .. ? .
. ' . . , . . . . . .. . .. ,
. . + . w.
r.?'_..wr_ "'_" _" ' "' wM..•...?'ti??..--.?w.?w..Mn?..?+.?..
19M H`cLDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS 15 1 s ?
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER M[JST DESIGNATE WHICH ADDRESS
IS DESIRED, NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS 0 OF UNIT3
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECA WITH HLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For:-h0w° k{-ar?Valuation: Date: 6 l7 f 88
Site Address 75'6 )J'1?e,I,,,,,.,
Lot 1 Block 5-
Parcel/Sub
Owner ?y??,?.dn.?a, g.t?l,?..¢•?
Address / ,SS/,3
?
City/Zip Code ??Qr 5?3?7
Phone ?' 3 5- $ (Ff 3
Contractor ?/•? 9111?,
Address '" o.a, C1-v-?
City/Zip Code
Phone
9rch./Engr. _
Address
City/Zip Code
Phone #
!
On site sewage_
MWCC system
On aite well
City water ?!'
PRV required _
Booster Pump _
Occupancy
Zoning 1?^?
Aetual Const V-N
Allowable
Ik of stories
Length -?-
Depth ?
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit Oo
Planner Surcharge sel, sa
Council Plan Review 311, o0
Bldg. Off. ?tolo SAC, City IfaD.Oa
Variance SAC, MWCC p, op
Water Conn ?iQD
Water Meter 6?. oO
Road Unit 2 Do
Treatment Pl , a0
Parks
Copies
TOTAL
,So
? V,4Ll.lATlo*?
. .:
GA-9ACC
?zxz2.. =
`r3sm T
I `!X/9 = -2- 5z
3 z%K2s- ?6ao
y ey x 14 = 6? `I (?
/ vSZX 1!) = 13?? 60,
15 j PL-er=A?
?+brwT = 1
?'`?
/ ut a 'Y, Ltq =- 5 z'?l Z-0
Z N-a ??0+2
32x?? = ?3s y- Wk= ?--
Ilw??l?
.?
APFLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIQN
, ...............
.
t N7fE: PAYtgITf OF Pffi AT TIME OF ..
.
F
? APPLICATiOP7 D06 P](7f CdN- y
? 91'IISJTE APPRGIN. OP PIItMIT- a
i
4 TIdSPflC12ON OI'' $EVQt AND/OR VAMER +
}
i INSl'ALLATIIXiS WiLL NOT SE SCIDUfED :
[TI1ZL PIIt[•ffT FiAS 8P.E33i APPRCNID. :
fif:??3+::f:i+tteKrtR?vn<xxxfrrt+rrrat?s+
OF CC1gCAf1
(PLEASE PRINT
1) PROPII2TY ADDRE55: 2 E?„?sQo.e o`W .
T.MTAT DESCRIPTION: ^ L/ & L S 6f??.?.isBa.2 0 or
IF EXISTING STRLiCT[JRE, DATE OF ORIGINAI, BiJILDING PERMIT ISSUANCE:
Mont Year
PRESENT 7ANING/PROPOSID USE:
II COfM7E[tCIAL/RETAIL/OFFICE
Q INDUSTRIAL
Q INSTI7UTIONAL/GOVERDMENT
2) ? NArE: llRFS
ADDRESS: /0
? R-1 SINGLE FAMILY
El R-2 DUPLEX ('iSvo L?nits)
? R-3 TOWNIIOC?SE (Three +, Onits) ( Units)
Q R-4 APARTMENT/CODIDOMINIUM ( . Units)
e-
CITY, STATE, ZIP: A?PLC U?t ?E ?,///.? ' SS'/2 `/
PxorE: (i3? - 877s1
3) • ? NPME:
ADDRESS:
CITY, STATE, ZIP:
Oc. -6?6
?`?? U/.?1 S r ST . CT •
.4
PHONE: 415 2`70?'7 MASTER LICENSE # 3(. I//PI-I _
4 ) °.?' " e ?•
NAME: E? 9rcc R-E QL 02 S
ADDRFSS:
CITY, STATE, ZIP: 0 T7 t LT ?, /YJ,? •
PHONE:
I? Active
Expired
Not recorded
St Initia
5) is ?. y•?• i . o
m CONNECTIO[V TO CITY SE4VER Fl WNNECTION TO CITY WATER a OTfiII2
6)
*?**?********?*+.***:r****.**+********?*****,r,?***x?******,r+*++******?+******?**,e********:?****,r*******
*
* TfE GOrD COPY OF THE PERNIIT WILL BE SENP DIRDCIT,Y TO PUBLIC WORKS 7U FP.CII,ITATE MEPER PICK-OP. *
* PLEASE ALLOW ZSaO WORKING DAYS EOR PROCESSING. SOMEONE FROM TM CITY WIIS, CONTACT YOL IF Tf1II2E *
* ARE ANY PRO$LEMS. +
FOR CITY USE ONLY
PERMIT # ISSUED
7
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLUDE SURCHARGE )
$ ? 7` $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ $ /?, Ur) ACCOUNT DEPOSIT - WATER
$ ? S D • D?? $ WAC
$ (a 5 D U-o $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
$ $ LATERA L BENEFIT/TRUNK SEWER
$ $ LATERA L BENEFIT/TRLNK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ / D $ TOTAL
- ???7a7 ?.375
RECEIPT RECEIPT
DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MLST BE ISSL'ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWILVG CONDITIONS:
APPROVED BY:
TITLE:
DATE: ? 7 ?Wi'
CLAIpf VOUCHER - REFUND REQUEST
CITY OF EAGAN
CLAIMANT ASPF.N F.T,F.f,TRTC
ADDRESS_ 7675 WEST HIGHWAY 13
_ SAVAGE. MN 55378
Location 956 GREENSBORO LANE
T1 RS CRFFNSRORO 2N?
Receipt No./bate 85337/-7-5-88
Reason for Refund PER E T F ASPEN ELECTRIC
Type of Refund Electrical Permit 01-3211 $1'.00
Plumbing Permit 01-3212 $
Mechanical Permit 01-3213 $
Surcharge 01-2155 $
Water Connection Permit 20-3713 $
Sewer CannecCion Permit 20-3743 ? $
Account Deposit 20-2252 $
Utility_Account Over-Payment 20-2250 $
Other: $
S
TOTAL $ 12.00
I declare under the penalties of law that this account, claim or demand is just and
thaG'no-part of,;it has been paid.
/i
' Signature _?PTEMBER 8, 1988
Date
<
CLAIM VOUCHER - REF[JND REQUEST
CITY OF EAGAN
CLAIMANT A .N . .F. TRIC
ADDRESS 7675 WEST HIGHWAY 13
-_SAVAGE. MN 55378
Location 956 GREENSBORO DRIVE
? I,I. B5, GREENSBORO 2ND
Receipt No./Date 85587/7-13-88
Reason for Refund DUPLICATE PERMIT
Type of Refund Electrical Permit 01-3211 $ 12.00
Plumbing Permit 01-3212 $
Mechanical Permit 01-3213 $
Surcharge 01-2155 $
Water Connection Permit 20-3713 $
Sewer Connection Permit 20-3743
Account Deposit 20-2252 $
Utility Account Over-Rayment 20-2250 $
Other: $
$
TOTAL $ 12.00
I declare under the penalties of law that this account, claim or demand is just and
that no part of it has been paid.
Signature ?,LY l 988
Date
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115919
Date Issued:10/01/2013
Permit Category:ePermit
Site Address: 956 Greensboro Lane
Lot:1 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
William Krech
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 -
Lois K Bullock
956 Greensboro Lane
Eagan MN 55123--224
(612) 669-5042
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
,
' Use BLUE or BLACK Irrk
� Far t3ffice Use.^'� __ _ '
,
' . 1���a I ` �.
� ��ft#: �
� � i ��� �� j
��� �� ' � ��� � Peemit�ee: � �
383f1 Pi}cst Knob Road y �
Eagan MN�5122 � Da#e Receiu�d`
Photte:(6�"t)675-5675 � �
Fax:(651)675-5694 1` Staff: !
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Da#e- �"' � � S�te Addrtss: � .�.�II`�,�.��`� 11riit#; ��.�
� t�ame: - �..�� <��.:� �.�.� ���� 2� A ��a., ��,�� Phc�ne.� �� �- _��'• �
; � � a � �
�� F�B�IC�E?Tt#1 � ,
� �3wt�E:C � Address 1 City 1�p: � r' . �• , ` �
�
` ApP[fcant is: Owner C�nntractor
�
� _.,�.���.�.�ta�.x�<�,��.��.�� ��:,,�,���.�e���'� �. ,�..�� � r�- R �-�� k
..�F � C?escriptiQn ofi work: �� �' �# '�' ``` � '-`�� � �
< 'Cj/pe Uf U1IQrk � #
� ��� �
� Canstructicsn Cost: ���....�� � �,..R� .� �u1ti-�ami{y BuiEtling: (Yes /Nc���� �
Campany��� � ��� ��R.�'�� ���._� Gontact � ��'`�� 1���� �.,,,� ��
4 �
' � �-� � �r" �` � �a"'�8 �a .� � .. 2� �.
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'� � � `� � `' f:i �.,�t � � ��f� �
�°Cs1C1?�t'c"�6#Ot' �
t� .,� ��
Y State: r'� ��° Zip: ���µ� �, � '� Phone: ����`� �����°� ��� 1,�,.� �
LiCEnSe#����� ����.�� ���r�� LeBd Gert#�Ca�t?#,�, °���`1��������>'.:�,���:� � �.�.�,.��
. .�KK�M�..��. .>,_. -��.��,�9�.��»._ ..�.,�:�.,���..�,�.,��.x�.�.a�.� . � �
� !f the project is exempt from lead ct�rtifiC�tion, ple�se explain why; (see Page 3 for addit'sdna!infus�mation} �
�
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�v.y=�.�.�. �..,�::���,�-ve���,..�,-�.�.�.,�.�-:W�,.���x�.����.�sr.��.-�..�..,��w�..:..:�n��..A.,�:�.,T.;.�_,m..�,��:�.�..�,m,,;,�.:� �.,:.�.�._�-���.�,.��:.,
C�MP�.ETE THI� AREA QNL1� t� Ct�NSTRUCTING A NEEW BUfLD6NG
_ a
% �
� in th�(as#12 months,i�as the City trf Eagan issued a perrttit€ar a similar pian based vn a rnaster plan? �
�
i
,` .Yes �i�Fa !f yes, date and atldress�afi master p1an: ;
z: Licensed Plumber: Phone: �
�
; (VP��haC11G�1 COft�C'1C�gg: P�Is��tE: �
�
Se�nrer&Water C�r�tractor Fhone: ��
J�#�1'��:�dans at�d stipp+9�ttg�cfCt�m�rtf5 fh��y�C1�El�it7r►f�t�C��fd+2l�d�t�bE��Jblt��l��t��dlJ,�ft�ifl. Pc�rtic����#` �
the iraf,ar,�afican m��be cta�sifr`�as nt�n:puJ�lic if y�c�prt�vide sp�if��r�asrtns tfi�t�ro�1�pe.C�`rrrif the C�r tct �
s._,�<_,��.�..,� .u...� r� _ .���..,�.�,...���... ��„�,.cor�ciud�fhat tftegr are trade se+ct��#s. � ���.,���w. a ���...���.�,.,��..����
CAi.L BEFC)RE YGU CJiG. Cal(Gopher State One Cal1 at(6S1}454-tl462 for protection against undergro�nd utiiity damage. Call 48 haurs
before yo�c intend to dig to receive tocafes of underqround ut�iities_ www aaqherstateanecali orn
1 hereby aeknowtedge that this informatic+n is eompiete and accurate;that#he work witi be in conformanee wifh the ardinances and codes of fMe Gity of
Eagan; thaE 1 understand ihis is nat a permit, but only an application for a pertnit, and wo�Ic is not#o sfart without a permit;that the uto[k wi{I be in
accordance with the appraued plan in the case of work wYtich r�equifes a revi�w and approVal of pians.
Exterior woric authttrized by a buiiding permit issued in accordance wi#h the 11Sinnesota State Bu[Eding Gvde m�st he campieted with;n�8U
day��f pertntt issuaMce.
�g . � �. � X���� d�` t �� �'�, ����'��'�/'��`�
�_
. »� ^ _. 1 �R�fd/�a�`�'aa dP ax'... .' 7ro�
I X ���� ������� ���� � �
Agpllcar�t's Printed iVame ApPllcant`s Signatuce
Rage�o#3
� � �
� <� t�f� NAT WRfTE BELE)W'T�IIS l.1NE � ������
SUB TYPES
` �oundation �ere}�6�ce Pc�reh(3-ueason} S#t�rm Datrtage
�o �ingle Famiiy ! �arage � Porch{4Seasor�� , Exterit�rAi#eratior�:{Single Farnily)
� i�ttufti _ T3e�k Porch{S�reeNGazebafPergula) � Exttrior Atteration#l4�ui#i}
` Q1 of_Pi+�x Y L+�wer Levet � Pt�oi Miscell�n�ous
! Accessory Bu�tding -..� �
1NORK TYPES
IVew lnteriar im�rovem�nt SidEng �smoi'rsh Bu�iding*
` Addition � Muve�uiiding � Reroof ____ I3emc+lish irtte�ior
� Atteratic�n � �ire Repair � Windows Derv�alish�our�datban
Reptace Repair �gress W�ndc�w Water Damage
_ Retaining 1NaiE *t}eamotitian of antire�tuiid'►ng—give PCA h�ndout to appliaant
DESC#iiPT1fJN
� _
Vatc��#iQ� S t3ccu r�
I� 7/ � .0� pa cy �2 C I NICES Systet�t.
F�tan Review G�d�Editian �r1 Z.��', �:AC UrtitS
I�'� ���°ln�'���°l� �17f1111� �l7 �il�j/�(a"�telf
' Census Cade �tories Booster Pump �
' #of Units Square �eet PFtV
#tsf�uildings Lenc�th Fire 5prinklers
?'ype csf Cs�r�struction �1� Widfh
REQlltRED iNSP�CTIf)[�!S
Foofangs{�€ew Buif,ding) Mefier Size;
Fou#ings{DecK} �inat f C.t3.Requir�d
Footin�s(Addif�on3 � Finat t�le�+�.�?.Required
�oundat�on HYAC G�s Service Test Gas Lir�e,Air Test
� L�rain Tite t?th�r.�
Raof:�lc�&UVater �Finai Pocsf:�Ft�otings AirtGas Tests ___�inal
Framing Siding:�Stucco Lath �Stone Lath �Brick
Fireptase;�Rc�ugh tn _Air Tes# ____�inat Winc#ows
Insulat►on Reta�ning Wa6t>�Foatings_Backfitl Fina1
She�#hing Radon Cc�n#rc�i ^
Shee#rc�ck �rosic?Fa COtt#rt�1
Reviewed B : / c� rM ,(1f1 i K l�- , g p I'
y B�i�din lns ectpe ',
RESIflENTfAL FEES 'i
Base Fee '�
Sur�harg�
Plar� Ft�vi�w
MCES SAG
Cifi�(SA�
tlfility Ctsnnectic�n Charge
S&W Permit 8�Surcharge
Treatment Plant
f;opies
TC?TA�
Page 2 of 3
Use BLUE or BLACK Ink
For Office Use
::::e:
Cl y of Ea � a D3,9
3830 Pilot Knob Road / ` ,.
Eagan MN 55122 Date Received: `v
Phone: (651)675-5675 �o ff
Staff: o
Fax: (651)675-5694film
t:0 i
2012 RESIDENTIAL BUILDING PERMITAPPLICATION ii-g3" I (a
Date: i' t 15 I lig Site Address: G(�` €e l 5 i r., V).5190YO 1-41
W t Unit#: deli
�x Name: L I'� L u c f Lot,i S Phone:
RESIDENT/ / /^ �
OWNER i Address/City/Zip: 'i td CI b''. ...(/1 S l00 Y0 L. V1
k Applicant is: Owner Contractor
Description of work: ( fA )/l tlJt l� 1.�� i ', / ,rK't
TYPE OF WORp
K
<t! ,,-.''sConstruction Cost: ��p_Q___ Multi-Family Building:(Yes /No x )
Company: 0 Al ems, I I II C- Contact:
�` Address: 9 51 +r1 t h j') h(2( ,.. City: v1 mom j�',�j
CONTRAGTO:kc, St')
j / "
State: MN Zip: car')tit,}(.1? Phone: �'i I )`-)7 --1 VI 1
License BC318360 Lead Certificate NAT-26342- .
if the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
V?(, C (C
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that°the 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
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesot. ate Building Code must be completed within 180
days of permit issuance. ,
x
ttiwn ( {� (2ta I' �.:�
Applicant's Printed Name V i/ Applicant's Signature
Page 1 of 3
• DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) y Storm Damage
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Single Family)
Multi — Deck — Porch(Screen/Gazebo/Pergola) Exterior Alteration(Multi)
_ 01 of_Plex — Lower Level _ Pool _ Miscellaneous
_ Accessory Building
WORK TYPES
_ New ?o Interior Improvement _ Siding — Demolish Building*
Addition ____ Move Building Reroof _ Demolish Interior
___ Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 1i 962'c) . te Occupancy 5TZ C- 1 MCES System
Plan Review Code Edition d7i7 20 f.s SAC Units
(25% 100%)' ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction V 8 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
—
Footings (Deck) Final f C.O.Required
Footings(Addition) Final/No C.O.Required
Foundation X HVAC—Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof:_Ice&Water __Final Pool:_Footings Air/Gas Tests _Final
icl Framing Siding:_Stucco Lath Stone Lath _Brick
Fireplace: Rough In Air Test _Final Windows
?" Insulation Retaining Wall:_Footings_Backfill_Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: [ ' 114;k474-- , Building Inspector
RESIDENTIAL FEES 2-1 )C11 ----. 15/ 5, • (-
Base Fee
Surcharge A' 2 c' er S9 ' fr..
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
yy$'y �+y}y y�y5' .Jk2:R An'I" _'db''AA5kM .. Yt ....., i 1,nH 'i":'."§.34.. x�;,.,K..S.`.s4Y. ,S v:.',i4:{SP�'i:.?'K"m-.£3 r.,�,i,,� "£:C,Vis•+
Copies 7 g a D -e-
TOTAL TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139975
Date Issued:11/16/2016
Permit Category:ePermit
Site Address: 956 Greensboro Lane
Lot:1 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Lois K Bullock
956 Greensboro Lane
Eagan MN 55123--224
(612) 669-5042
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
Foralice Use
401/'' Ci Permit#: /C 1D Zz7
�� O�nLn n 4�U� Permit Fee: 9 O
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675 Staff:
Fax:(651)675-5694
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: /2/2l/ ' Site Address: ci56 tee.z-bDro L °vim.
Tenant: Suite#:
RESIDENT I OWNER Name: L a i5 /J 041.0)as Phone: Cb—,2 - 9/3-5-9'25
Address/City/Zip: Sam cts cc.ba•,A
CONTRACTOR Name:S7to ,3ci.i ci. PL.(.4)iv License#:?�6 206.79
• Address: I,e, LK ,J/11-?6> City: ( ceC`
State: im l.) Zip: S"3' ' l I Phone: '763- Ni)/-4.9 ,
Contact: Email:
TYPE OF WORK _New _Replacement r_Repairf_Rebuild �X Modify Space _Work in R.O.W.
Dinal.g on of work: `-otkw r�iT cirYio.nJ)�)ICL(X S�1 k IJ 434 kichj iaz•C Fe 4-(43<g-6r-
PERMIT
(U 'r—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:
$50.50 Minimum Water Heater,Water Softener,or Water Heater Softener(includes$.50 State Surcharge)
$30.50 Lawn Irrigation(includes$.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes$.50 State Surcharge)
"Water Turnaround(add$166.00 if a 5/8"meter is required)
$100.50 Septic System New($10.00 per as built)(includes County fee and$.50 State Surcharge)
$90.50 Fire Repair(replace burned out appliances,ductwork,etc.)(includes$.50 State Surcharge) •
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.gooherstateonecall.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 /94 X(70 r/9 x /.
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: ___Under Ground ___Rough-In _Air Test _•Gas Test _Fina)
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154402
Date Issued:03/19/2019
Permit Category:ePermit
Site Address: 956 Greensboro Lane
Lot:1 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-010
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.
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 -
Lois K Nicholas
956 Greensboro Lane
Eagan MN 55123
Signature Home Services
15631 Darling Path
Rosemount MN 55068
(651) 731-1147
Applicant/Permitee: Signature Issued By: Signature