961 Greensboro Lane.. T _...?, . ?.-
BLDG. PERMIT N0. `! 4• V :7 ?
.
- ;
01;-3210 Bldg. Permit
01-3422 plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm. J
01-2155 Surcharge
17-3860 Road Unit
20-2275 5AC 71
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Cann.
11-3855 Park Ded.
TOTAL
1
? CASH RECEIPT ?
• ? CITY OF EAGAN
' 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
.?
narE
R[Ci1viC . ' .
RROM
AMOUNT $
v
? DOLLARi
?oo
? CASH CHECK
? ?.
? . • i
. i
FUND GOOfi qMOUNT
Thank You
BY
White-PaYert CoPY
• Yellow-Posting Copy
Pink-File CoPY
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
? (612) 681-4675
SITE ADDRESS:
AW i awF
I PERMIT SUBTYPE:
tl I i't r, r
:CORn_?
PERMIT TYPE:
Permit Number:
;?? /n?i
'
Date Issued: t / I
APPLICANT:
, . • ?i! ?
TYPE OF WORK:
,. , , ,,.;'
<<,,,' - I
I I:.,•1(,1.1 1 1 - I I I: IaaI
Pormft No. Permk Holdar Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST ? ?,tNCic .
FINAL PLBG v`e • r?
FINAIHTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?i
, . . . CITY OF EAGAN
. `3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100
BUILDING PERMIT Receipt ? To be used for Est Value Dete !' i?_, ut : ? 19
Site Address t1'?i 4 S Fso_wu .,Pv
Lot Block Sec/Sub. 1N;D
Parcei No.
s Name
3 Address
0 C:itv ,
, o Name '
? ? Address
I- City Phone
I hereby acknowledge that I have read this application and state
that the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
On Site Sewage T
MWCC System _
On Site Well ?
City Water _
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Planner
Councll
BId9. Off.
APC
Variance
Occupancy
Zoning
Type of Const
(Actual)
(Allowable)
# of Storiea
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
,u
t3
, p
I
A Building Permit is issued to: ' on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statute!k and City of Eagen Ordinances
Building Official
Permit No. Permft Holder Date Telephone #
Pl.mbing
H.V.AC. U'??
Electric
Softener `
Inspaction Date Inap. Comments
Footings 1 Z
Footings II
Foundation
Framing
i
Roofing
Rough Pi
Rough H F r
Isul. ?
Fireplace
Final Htg. 23
Final Plbg.
Bldg. Final aAf
Cert.Occ.
Temp. LP
Deck Ftg.
DBck Frmg.
Well
Pr. Disp.
PERMIT #
r RECEIPT # I, MN 55122 DATE:
?
3
p ,.....
Addr?ss
Ciry _ ? - -
Phone
.` ,
TYPE OF WORK
? tr y? ?/? ?
?
?
Forced Air I `
?
?uM BTU $?
? ?. Boiler M BTU $?.
Unit Heater M BTU ?.
, Air Cond. M BTU $`
j Vent CFM $`
i Gas Piping Outlets #
r ?
$_
( Other
? FEE:
S/C:
(L.
BLDG. TYPE WORK DESCRIPTION
Res. ?-- New
M ult Add-on
Comm. Repair
Other
'
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION
)
GAS OUTLETS (MINIMUM - 1 PER PERiIAIT)
- 1.50 EA,
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPL.IES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
GOES
\\ .
?:?fA \r1 P?.?u_rw
TOTAL• _. ? - •`>-II
FOR: CITY OF EAGAN
• ' PERMIT # 'L?!2 ?:7
. ' PLUM9ING PERMiT RECEIPT # 2?Z
CITY OF EAGAN
3830 PILOT KNOB ROAO, EAGAN, MN 55122 OATE:
CONTRACT PRICE PHONE: 454-8100
Site Address 'zz/
Lot / (,? Block Sec/Sub
? Name ?
a?
m Address
c Ci Phone
? Name
c Address
-
p City- Phone& 3,o?. &x? /
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PEIIMITTEE
BLDG. TYPE WORK DESCRIPTjt>N
Aes. New
? MuIL Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO FIXTU R ES TOT
Water Closet - $3.00
Bath Tubs - $100
Lavatory - $3.00
- Shower - $3.00
_LKitchen Sink - $3.00
Urinal/Bidet - $3.00
::71-aundry Tray - $3.00
Floor Drains - $1.50 ::iWater Heater - $1.50
Whiripool - $3.00
-/-Gas Piping Outlets - $1.50
? S
(MINIMUM - 1 PEH PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00 ?
?Rough Openings - $1.50
FEE:
STATE S/C: ! -SD
FOR: CITY OF EAGAN GRAND TOTAL:
RW
- CITY OF EAGAN ? j0
18109
3830 Pilpt Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUII.DING PERMIT Receipt # -
$l'?
?? JULY 6 ?
To be used for
Est. Value Date , 19
Site Address 461 GitEEli8IIOR0 LN
Lot 10 Block 4 Sec/Sub. C1tEBH$1l0Rlf ND OFFICE USE ONLY
P3fC81 N0. Occupancy - FEES
QASIII SEiEIK zoning 25.00
W Name (Actuaq Const - Bldg. Permit
o
Address
(AlloWable)
- S
h • ?
City EAGM Phone
? ot stories urc
arge
-W
Plan Review
DOl?i81lIL4$ COi?$TRUCTI0?1 lef1' -III?
F Name Depth - SAC, cry
t
gQ Address S.F. Total -
?
t
i
F
F
t SAC, rncwcc
City Phone pr
n
.
oo
s
S. -
Water Conn
?
On Site Sewage
_
W Name On Site Well - Water Meter
?
_= Address Mwcc system _
¢=
`W
City Phone
City Water Acct. Deposit
_
S/N Pe
mit
PRV Required r
_
I hereby acknowlege that I have read this application and state that the Bwste* PumP - S/W Surcharge
information is correct and agree to comply with all applicable ? of
Minnesota Statutes and Cit
of Ea
an
rd
ance
y
g
Q
?
,;. ? Treatment PI
Signature of Permitee APPROVALS
Road Unit
DONNMLLE CMST Planner
A Building Permit is issued to: - Park Oed.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. e1dg. Off. _ Copies ?
•
'
Buiiding Official ' ' ' - Variance - TOTAL
Permit No. Permit Hoider Dale Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
EIECTRIC
Inapeelion Date Insp. Comments
FooUngsl 7 ?
Foundation
Framing
Foofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Fnal Htg.
Finat Plbg.
Const. Meter Plbg. Inspedor - Notify Plumber
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final l f y 69
Well
Pr. Disp.
CITY OF EAQAN Permit Na
3830 Pot Knob Road B/P No:
P.O. Boic 21199
EaApfi, MN 55121
Site
MWCC: .
City Chg:
Fee:
Miller Const.
SEWER SERVICE PERMIT
Date:
Date: , ? h r
ens:?? -?? ? 1
->
1.
ly wRh the City of
CITY OF EAGAN Permit No: ° Date:
3830 PNat-Knob Road Meter No: Size:
P.O. Box 21199 Reader No: Date: C- - 2'7
Eagt,.a, MN 55121
Owner joe m T T
1,1Q ,,, ,•_ ..i? -„
Site Address: "n I re -
Plumber 1 vmnur F °_?1 ?_ -??6- . a E
Conn. Chg: ,?,n 1 ¦ ¦ r..? 1r„5.
Acct. Dep:_ 1 5_ n(1RA--- d:--:aR..?IvMdO*W?@c
Permit Fee: ' •
5urcharge: S?? I a r o qr?y the City of Eayan
Tr, Plant Qa."° w
Meter.
WATER SERVICE PERMIT
?
OF EAGAN Permit No: ijj' `' Date:
Pilot Knob Road B/P No: Date:
Box2atJ9 ,? .
m, MN 55Y11
r ,... JOe! ".Il;c?2' 1,oII8C..
Address: 761 Grcensboro Lane I
nber: P Yvwut . P umbing
:,C
Chg: 1 i
. Dep:
nit Fee:
_i.
CITY OF EAGAN
3830 Pilot Knob Road
P.O. Bqx 21199
Eagan, MN 55121
1 ? Zoning.
• No. of Units:
agan '
?
?
SEWER SERVICE PERMIT
9109 Date: " 3U-o7
PermR No:
Meter No: Siz?
Reader No:
1 agree to comply wfth the City oi E
Ordinances.
ey
Date:
?
Owner. Joe . .,r Q4 nrse..a},.,r., TT
Site Address: °? ' ?'re _
Plumber. PlyMourthn p '
Conn. Chg: 525 00ad
Acct Dep:
Permit Fee: IO ?} l?nd
Surcharge:
Tr. Plant tS? 00-3)d
Meter.
Zoning: -
No. ot Units:
I agree to comply wfth the City of Eagan
Ordinances.
WATER SERVICE PERMIT ?
REQUEST FOR ELECTRICAL INSPECTION e/e-ooaoi-os
? See instructions lor completinq this form on back oi yellow copy. jr?, ??
D 4:1 96'1 x" 8elow Work Covered by Ihis Request
FAJ Nap. Type ot 8uiltlmg AOOliances Wned Equiumem Wved
Home Ranye Temporary Scrvice
Duplex Water Heater LiGh[iny Fixtures
Apt. Bmldmg Dryei Electrle Heavn
Commercial Bldg. Fumace Silu Unloader
Industrial Bldg. Air Condieoner Bulk Milk Tank
Farm Ome? oec? v oinu,
l Fl.! VCC1Iy OShf!f Olhp!
Compute Mspection Fee Below N Fee ServiceEnhenceSixe fl Fee Fenders/5ubteeders N Fae Circu?s
D O 0 to 200 qm s 0 to 30 Am s d ?
' 0 tn 30 An! s
Above 200 Amps 31 to 100 Amps 31 to 100 qm -
Swimming Pool Above 100_Amps Above 100_Am
Transiormers Irrigation Booms ? Pertial."Other Fee
Signs Special InspecLOn
flemarks 7pTAL F
5- 7?
v-
Pough-in Date ?
I, the Electricwl
h'Inspector, heraby
certity that ihe abova
Final P Dnle ' apeetion hes been
!.-? ? 3?p aa.
TiareQueatvoitll8monttmimm 6/,
This reQuest voiE
?8 months fmm
D 4186.1
L( Fl-
g?1-1n insuecuon
/ Rep rted, [:]fleatly Nuw Wdl Notifv Inspec-
O? es ?No o' When qeady
?Lfcnnsed Electncal ConVactor 1 hareby requestina0ac[wn oteEove
?Owner elactrical work installed at:
Sheet Atldress, Boz or Poute No. Citv
a.?.
cbo?? o. Township Name or No. flange No. Cowny
Occupant (PpINT) Phune Nn.
cT0 s oro 7?'hv?7? ^ Lf3 (_ .200
Pa?+er Supplier Atldress
Mj' t?0 K
ElacVical ConVactor (COmpany Name) Canirar.tor's Licenso No.
a
Mailinq AdJress (Contractor or Owner Mak mg Instailation)
? SC70 ._ G?J_ L D? 2 / y, ,,, 3 3 7
Aut nzed SlpnaNre IContractor/Owner Mak?nq Instaliatmnl Phone Number
Z a- JGl/
SIINNESOTA/CTATE BDARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Gness•Midway 61tlg. - floom N491 BE ACCEPTED BY THE STqiE BOAND
1821 Umveositv Ave.. St. Paul, MN 56104 UNLESS PROPER INSPECTION PEE IS
Phon¢16121642-0600 ENCLOSEO.
CITY OF EAGAN N2 1415 8
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 '
BUILDING PERMIT 1 PHONE: 454-8100 Aeceipt #,-I I 3 --Z) C)
"
7obeusedfor SF DWG/GAR EstValue $71,000 Date SEPTEMBER 14 19 87
SiteAddress 961 GREENSBORO LN
Lot 10 Block 4 Sec/Sub. GREENSBORO 2ND
Parcel No.
W Name JOE MILLER CONST
z Address 18133 CEDAR AVE
o pity FARMINGTON phone 431-2001
o Name SAME
? a Address
0? City Phone
wwW Name
F
x?
Address
g w City Phone
I hereby acknowledge thet I have read This application and state
thattheinformationiscorrecAndagreetocomply ithallapplicable
Stete ot Minnesota Stafut$s ab?d City of Ea rdi?a s.
Signature of Permittee
A Building Permit is issued to: OE MILLER CONST
all work shall be done in accorda e with all applicable at I
Building Official
OFFICE USE ONIY
onSitaSewage Occuvancy R3
MWCCSystem Zoning RI
On Site Well Type of Const yn
City Water _ (ACWaQ ?
(Allowable)
# of Stories .
Length ??
Depth J10
S.F. Total
Footprint S.F.
APPROVALS FEES
4. 402.00
Assessmenis _ Permit
WaterySewer _ Surcharge ---- 357-50
Police Plan Review 201.00
-
-
Fire _ SAC, City TODE
00
Engr. _ SAC, MWCC 525.00
Planner WaterConn. 525.00
Council _ WaterMeter 67_00
BIdg.Off _ Road Unit 1f15 _!10
APC _ Treatment P1 li?oa?on n0
Variance _ Parka
Coples
TOTAL $2,34n_50
on the express candition that
innesota,S{atutes and City of Eagan Ordinances.
?
r y.
CITY OF EAGAN NO - 18109
3830 PiloYKnob F?oad, P.O. Bax 21-199, Eagan, MN 55121
PHONE: 454-8100 C ? ?
-q
BUILDING PERMIT Receipt x O
To be used for DECK Est. Value $1,000 Date JULY 6 , i990
Site AddresS 967 GIZF.ENSRORO T.N OFFICE USE ONLY
LOf _1.0 BIOCk 4- SBGSUb.GRF.F.NSRORO 2ND
P8fC01 N0. Occupancy - FEES
i
Zon
ng -
a Name QASIN SHEIK (ACWaI)Const - BIdg.Permit 25.00
w
o
AddfesS 961 GREENSBORO LN
(Anowable)
-
Surcr?arga
.50
City EAGAN Phone 681-9320 x ol Stones -
161 Plan Reviaw
LengM
a Name BONNEVILLE CONSTRUCTION pePm 1o' snc,ciry
a
0 Address 7201 PONTIAC CIR S.F.7otal - MCwCC
SAC
,
? City CHANHASSEN phone 470-0057 S.F. Footprmts - ,
i
S Waler Conn
awage
On S
te _
0W Name On Ste weil - Water Meier
x3 AddfBSS MWCCSyslem -
02 Acct. Deposit
aw City Phone aywatef -
PRV R
i
d SPN Permil
re
equ -
I hereby acknowlege ihat 1 have read this applicaLOn and state Ihat the Booster Pump - SNJ Surcharge
informanon is correct antl agree to comply with all applicable St e ot
ty of Eagan Ordinances. ?
Minnesota Slawtes and Ci Trealmenl PI
,
SignaNre ot Permitee ?J IIPPROVALS Road Unit
A eunding Permit is issued to: BONNEVILLE CONST Pianner ? park Ded.
on the ezpress condition that all work shall be done in accordance with all Council
nd City of Eagan Ordmances.
apphcable State of Mmnesota StaW
tes a Bldg. Olf. _ CuPies
?
I
Building OXiCial MAn ./ 1\ 01,(A, 1 J? , A Variance - TOTAL 25.50
???q'_?_-
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauirements RemodeUReoair Reauiremenls Oifice Use Onlv
3 registered sAe surveys showing sq ft. of bt, sq. fl. at house; and all rookd areas 2 copies of plan CeA of Survey Recd _ Y_ N
(20% maximum lot coverage allowed) 1 set of Energy CalculaUons for healed add'Aions Tree Pres Plan Recd _ Y_ N.
2 copies of plan shawing beam & window sizes; poured found design, etc. 7 si[e survey foradd0ions & decks Tree Pres Required _ Y_ N
lsetofEneyyCalculations Add'Rion-indicateilonsifesep6'csysfem OnsReSepticSystem _Y _N
3 copies of Tree Preservation Plan'rf lot platted aRer 711193
Rim Joist Oetail Options selection sheet (buildings wAh 3 or less units)
Date a ` /?/ 10S Construction Cast a o I 'LD! /
Site Address ?l(/ ? / .Q
l7('Q.'C-r?D QA1?Q... Unit/Ste #
Description of Work IkiIJ 1 sC,9_ 1 ,r\L?CLl?
?
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0_ 1 _ 2
Property Owner E'( Telephoneti((psI) 79ZI'y??s
Renewal By Andersen
Contractor 1920 County Rd. "C" West
Address Roseville, MN 55113 c'h'
state 651-264-4777 ae # ( )
License 920130983
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
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitled
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and aceurate;
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
oermit; that the work will be in accordance with the approved plan in the case of work whigh reguires a review and
approval of plans.
, ,Sd"
Appticant's Printed Name
??i??P 1?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
? 3830 PILOT KNOB RD, N MN 55122
NewConstruction Raauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. o( house; and all roofed areas
(20% mauimum lat coverage allowed)
. 2 copies of plan showing heam & window s¢es; poured found design, elc.)
• 1 set of Eriergy Calculatians
• 3 copies of Tree Preservation Plan if lol platted after 7/1193
• Rim Joist DeWU Optbris selection sheet (bld9s with 3 or less uniGs)
DATE I gO (O 16 ?
I a-?. as'
RemodeVReoair Reauirements
• 2 copies of plan
. 1 set of Energy CalculaUOris (ar heated additbris
• 1 site survey (or exterior additlons & decks
• Indicate'rfhomeservedbysepticsystem(oraddiAOns
VALUATION 251 D 6.3%
N
SITE ADDRESS 941 C?R tK-/VSj&!P Q(.J) A1 E_: MULTI-FAMILY BLDG _ Y X
TYPE OF WORK ?29-Rn1 f- FIREPLACE(S) _ 0_ 1_ 2
APPLICANT &RGSrlp RoOfaA)&-
STREETADDRESS 3`'l°I(D ID2iU& CITYjkAZr1Tft STATE d?!1/?ZIP 553V
TELEPHONE # 'Is- CELL PHONE #Cjs2`95t- L{Z-yZ- FAX # °(s Z- 1'I I I- 3-Z ZZ
PROPERTYOWNERC?P? 1 rN?u ?? TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
(x 51- (n ?8-073(Q
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RUI.ES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelopa Catculatlons Submitted
Plumbing Contractor: ___
PlumUing systcm includes:
Water SofLener
Water Heater
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. oC R.I. Baths
Fce: $90.00
Mechanical Contractor: Phone # - --;-,
Mechanical system includes: Air Condiuoning Fee: ?$70.00
_ Heat Recovery Syslem
Sewer/Water Contractor: Phone #
?3v-= _-?
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 Ordinances.
u-?
Signature of Appllcant
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4/02
PERMIT
C1TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
031672
03J30J98
SITE ADDRESS:
961 GREENSBORd LANE
LOT: 10 BLOCK: 4
GREENSBORO 2ND
P.I.N.: 10-36901-100-04
DESCRIPTION:
; Cens?US Code?
A'
1. ?
?
r.
}. `.:.
? Y? .,.?r. ...'•"2
(Gas)
B?Sikdinc?_Permit Type
"6uilding WQrk Type
FIREPLACE
NEW
434 ALT. RESIDENTIAL
?.,t
4f ?? Lf kv U
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: -
FIRESIDE CORNER SNC
2700 N FAIRVIEW
OOSEVILLE MN
(612) 633-2561
Applicant - S7. LIC
16332561 2009091
AVE
55113-0847
owNeR:
STONE CHSP
961 GREENSBORO LN
EAGAN MN 55123
(612)688-0756
I hereby acknowledge thax I have "read this' appficaC`fori an4 sta"te ,that4 'tlie ?
Ynfarmation is'corr-ect and ergree to'`esrmply';wL`tM .642r°aFrPlY6able'Stat6 of«Mrr:
,. ?
Stat,utes aod Ci.ty o'f Eagan..Or.di.nances.,
APPLICANT/PERMITEE SIGNATURE
?ot,ct l11tr1
issue s . i rN-
CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122 4-??Zo
? 1997 FIREPLACE PERMIT APPLICATION
681-4675
Q
DATE: ? Cl l(` p?a \L0' PERMIT FEE: 50.5
DESCRIPTION OF WORK: ? CONSTRUCT NEW FIREPLACE _ ALTERATIONS TO EXISTING
_ INSTALL GAS INSERT ONLY
? INSTALL GAS LINE ONLY
OTHER:
STREET ADDRESS: I
LOT BLOCK ?
SUBD./P.I.D. #: ADPAj16'(D' ,241
APPLICANT: (circle one only) OWNER (- CONTRACTOR
Name: J?jJq {J ? 1 l? Phone #: 2-5
Signature:
Street Address: r)"rP ev?r??J?? ^R? P
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.
PROPERTY
OWNER
FIREPLACE
INSTALLER
GAS LINE
WSTALLER
City:
Company: V-?i
Signature: _
5treet Address:
State: a)
City: l!>Wvt? d i l( e, v State: )!I&,
Company: _
Name:
Signature:
Street Address:
CiTy:
Zip: ?? r/oC 3
one #:
License #: Jo:LZ1L?V! ,
Zip: ?
Phone #:
State:
Zip:
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1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLAnS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS SEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: JE(X< Valuation: 1000 ? Date:
Site Address
Loc 16 slock 'A
Parcel/Sub 6RLc-vSh„ega ZVA A7lprj
Oc,mer SAF/e
Address 9Ga l Cif'EQ/S A/wO L41
City/Zip Code LA64A) /'IJV
Phone ? ?? '?320
Contractor ?Jt{^4=?Lj zc- C,OQ6S -'
Address 7,20 / /'G?,4JY/!}[_ C/e
City/Zip Code e-?'AOUliGSS?.°v
Phone / 70- od..? 7
Arch./Engr. D/./R/- U/L.LC
Address Z75-
City/Zip y/Zip Code l ?
7 -S -90
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length Z ?
Depth !o'
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off. J!117/&.
Variance
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit'
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
133-07
Phone #
TRf°LAND C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
030 ' ti"" W 9o7Rb
S 3151? h ?w
LEGAL DESCRIPTION: LoT LD ,eLocK 4, 6fCFNS6b.0D 2-V ADLW.
ACCORDING TO THE RECORDED PLAT
THEREOF 10'Q.1107p COUNTY,MINNESOTA
ry
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n V
0
VhI?
.`I
tOT
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SITE PLAN FOR:
JOE MILLER GONST,
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6It
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SL_?
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isaa
N yS• 51' /y"E
G REENSI30 RO
LEGEND
o pENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
I hMsb?eertify fhot tAls surver,plan or
raport wos prepored by me or under my
direct supervision and that 1 am a duly
Repisterad Land Survtror under fAs
Lowt oi the State of Minnesota.
Bradley J ensai, Mn. Rep. No. 15235
oare : q W187
W
t
a ..
a?
O"p
•
a
?
L ANE
N
sCAL-E: ?'?-3d
- - --?
INVERT ELEVATION A? SERVICE EXTENSIOfV=
PROPOSED GARAGE FLOOR ELEVATION a 9/(o c3
PROPOSED FIRST FLOOR ELEVATION = IL6x8
PROPOSEDBASEMENT FLOOR °
ELEVATION
NOTE * VERIFY AlL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
?
, -
/(//5800
'% r
?TION - CITY OF EAG9H
SINGLE FAMILY DWELLINGS
INCLODE 2 SETS OF PL6NS, 3 CERTIFIC9TES OF SUItVEY, 1 SET OF ENERGY CALCULATIOPS
NOTE: ADDRESSES FOR CORNfiR LOTS - COHTRACTOR/HOMEOWNER MDST DESIGAAYE AHICH ADDRESS
IS DFSIRED. NO CHANGES WILL BE ALLOiiED ONCE BIIILDING PERMIT IS ISSDED.
MOLTIPLE DTdELLINGS - RFSIDENTIAL RENTAL DAITS FOR SALE i1@lI4S
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVfiY - CHECK WITH BLDG. DEPT.0
1 SET OF ENERGY CALCULATIONS
COMR7ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: `(Lpw fllofr? Valuation: 4gr&6L&_ Date:
Site Address Li LO I_Z-*100/YLLLII= LA• r) ao OFF:
r I ? ? ? -
Lot 10 Block L} On Site Sewage_
?p MWCC System ?
Parcel/Sub „vJ14pJh,(???,? QLf On Site Well
City idater /
Owner
Address
City/Zip Code
Phone
Contracto '
Address M&3 Lao-k 11f..Q .
City/Zip Code "4aApvjjfyld'}7fl(1
Phone ' C'?'00 (
Arch./Engr.
Address
City/Zip Code
Phone #
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off 9 14-
APC
Variance
Occupancy R_3
Zoning R-1
Type of Const
(Actual) V-N
(Allowable) V-N
ll of Stories
Length i{ 14
Depth 1140
S.F. Total
Footprint S.F.
FEES
Permit
Surcharge
Plan Review
SAC, City
snc, rnacc
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
y02.00
35.?0
2o1•Oo
100100
,-?3 VD
C)
?
?3?C2z= Sob X!L ? 609 2
lsr- t [??nt r
I?XqyZ= I?I
z2X 30= ?Gv
&k 3= 32
XS- !?o
713Z X s? ? 4?w56
ZkD ?.
/nXlb'= ISo
Zn X lb? 3?
5-0? X L(U - Z2uoo
? o,5 z.
?
,
One or Two Family
All Other Site Addresa qbl C7?ee,4L? tu .
Contractor Date Phone
?
LINEAL FEET OF
EXPOSED WALL ft. above grade = Z2? (D
TOTAL EXPOSED 6YpLL AREA 'SQ. FT.
OPAQUE WALL COftSTRUCTION: "U" Value x Area
Detail ?? ?AL? itUt, ? x SQ. FT. ? Z. (U)(p)
reference IIU" x SQ. FT. (U)(A)
from ) nUn x SQ. FT. SU) (A)
attached x SQ. FT. _ (ll)(Q)
sheets liult x SQ. FT. - (U) (A)
foUl' x SQ, FT. - (U) (A)
VJII'dD06YS: "U" Value x Area
t•fake & Type L IIUII x SQ. FT.
n 479 = 93,05 (U)(A)
n uU° x SQ. FT. - (U)(A)
?? uUu x SQ. FT. - - (U)(A)
"U" x SQ. FT. - (U)(A)
DOORS: 'lUll Value x Area
Maice & Type ZS uUn ? x SQ. FT. 53 = 7. 7i (U)(A)
u n upu
?? nUu i X SQ. FT.?= 1053 (U)(A)
X SQ. E'T. _ (U)(A)
u u upli
x SQ. FT. _
_ (U)(A)
ToTnr.s sq,. r-T. 22Ko, 3 ?(v) (a)
AVERRAAPGF, u
TOTAL ( U) ( A) VALUES „a1
?(lI`
DIVIDED BY TOTAL {7pI,L AREA
AVERA(3E f'Ull , 115 or lesa for 1&2 family dwellinge
ROOF/CEILIN(3•
TOTAL AREA: • f Y4?
Detail reference flUff x SQ. FT. - (U)(A)
from "mr- flUn . b x SQ. FT.?. (U)(A)
attached sheeta. ? °Ull x SQ. FT. _ (p)(p)
Describe openings °Uot x SQ. FT, _ (U)(A)
in roof. IIUII x S@. ET. - (U)(A)
TOTAL (U) (p) VALUES DIVIDED BY ? 60G Pr 116a( Fif
CV4A>
TOTAL ROOF/CEILIN(i AREA ? ?OZJ
CITY OF BUILDIYdG DEPARTI-1SNT
EXTERIOR ENVII.OPE AVERA4E 110ii COI•iPUTATION J
(To be submitted ivlth building permit applicatio
Dwelling Owner
AVERAGE "Ull ,025 for ventilated roofs.
? 14 10A. F=--? ?;w l-r -
:
rn.-•-,'Determining 44U" Valuea°at RooT; Wallp?°Riiu-,"eiia"'Co'nc-. Bloc&""'"?"""` -"?'''A"'
ROOF/CEILINQ
1.) Interior Air P'ilm
2.) 5/8 10 ayP. sa.
3.J Inauletion
4.1 .
5•) Exterior Air Film
(BTILL)
R V1lLUE
0.61
.56
*f, 00
.61
n0u ? 1/R= 'POTAL (R)= ?S17g
WALL R VALUE
6.) Interior Air Film 0.68
7.) }" (3YP. Bd. .45
8.) Ineulation 19,00
'9.) .Pocr-P,rr Z.o
.
10.) Masonite Siding ?
.6
11.) Exterior Air Film .17
nun a 1/go.. .p? j TOTAL (R)=;5.0,
RIM R VALUE
12.) Interior Air Film 0,68
13.) Insulation ?7,00
14.) 211 Fir Rim JoisE 1.88
15. ) .P;vIL"r- f I T05- Z od.
16.) Mssonite Siding .67
17.) Exterior Air Film .17
upn = 1/R= TOTAL (R)=
.rL T'1
?
FOUt7DATI0N R VALUE
180 Interior Air Film o.68
19.)
20.)
ic-li sr?t?r??
1/00
21.) 12" Concrete Block 1.28
zz.)
23.) Exterior Air Film .17
npn = 1/R= a, 07(o TOTAL (R)
TRI-LAND C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
S 31s30 1 y. W 907fb _
LEGAL DESCRIPTION: LOT L ,BLOCK # , 6dL'ENSB17A7 9'v AmQw-
• ACCORDING TO THE RECORDED PLAT
THEREOF DAKCTA COUNTY, MINNESOTA
LOT /0
7
w
?
H
0
0
e
h
0
?
SITE PLAN FOR:
JOE MILLER CONST.
s
a_
o
v,E
a ? 1
,T u, N?\
s1- -
I I
aM o
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- --- -?'
?J
N
J
N
\\ ? _
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\h
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qo7`O
FIt^
I
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ssoo
N 1I3'• 5Y' /y"E
.
a
ri
CAIo*;
N
f?LE : i'^ 3d
GREENSBORO LANE !
LEGEND
o DENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
INVERT ELEVqTION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION=,cl/(oK3 ,
PROPOSEO FIRST FLOOR ELEVATION = 4/(ot8 I
PROPOSED BASEMENT FLOOR =
ELEVATION
NOTE ' VERIFY ALL FLOOR HEI6HTS WITH
FINAL HOUSE PLANS
I Iweby esrtify that tAis survey,plan or
rsport was praparad by me or under my
direM supervision and that 1 am a duly
Repisfered Land Survfyor under fAe
Laws oi the State of Minnesota.
Bradlsy J enson, Mn. Rep. No. 1523b
ocre : q 8 I 87
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
PIOT?': PAYMUTi' OF FEE AT TIME OF
arri.icaTTON noES Mr oONa-rrTUTE
APPROVAL OF PER6IIT.
INsrncrioN oF sZM r,rm/OR vmM
I[CTATSATTON$ WIIL Ndj' BE $CHED-
[nM ocarn. PERMIx [As BEM
aePxovFn.
x-__w...__________________..______
P ease Print
?1) PROPERTY ADDRESS : J?? l ? u,as LUrd L4.?/e. "
LEGAL DESCRIPTTON: ?p '71 ."
(LOt/1110CK/SUbQ1V1SlOil or Tax Parcel ID #) .
IF EXISTING STRC'CILRE, DATE OF ORIGZNAL BLILDING PERMIT ISSCANCE: ". -
(Mon ear ..
PRFSIIJP 7ANZN3./PROPOSID LSE:
[:] COMAEitCIAL/RETATI,/OFFICE
Q INIDCSTRIAL
0 INSTI'IL'TIONAL/GOVII21ZMENT
[9--l2-1 SINGLE FAMILY
Q R-2 DLPLEX (Two Onits)
? R-3 1OWNHOL'SE (Three + Units)
p R-4 APARZMEN'P/COAIDOMINIUM
ilnits )
( Units)
Q?
2)
N11ME:
AooxFSS:
CITY. STATE. ZIP: riav m J-? c i-•? ?/'+'1 ?
PxorE: Y31-Ioor ?
g) For City C?se .
NAME= Plumbers License:
Active
AoDxFSS X")
F?cpired
CITY. STATE, ZIP: j?? .i?'/6? Not recorded
PHONE: SS MASTER LIMSE# ?065
St?a f-Initlal
4) •• 's.? t?..iu?: - - ----
NAME: SK+µr e 43
P.DDRESS:
CITY. STATE, ZIP:
PHONE:
5) ?? «• •a• :a •n? ??
[9?'CON6IIEX.TZON ZO CITY SEWM grltON?EX,'PION 7O CITY WATER Q OTmR
6) ?? • • i- DgZASE HOLD APPROVID PIIiMIT FOR PICK-UP BY ONE OF AHC3VE
[3 PLEASE MAZL APPROVID PERMIT TO 1, 2, 3, 4, AHOVE
(Circle one)
7)
.Cr.S?i.'slL?••'^9 /?C/ difYt?? ? 1? iY`)? _ ?_? J YY:?,-?/ i, ??i4 f??J
. fOR -CITY USE ONLY
PERMIT # ISSUED
J/ C
Pd w/Bldg. Permit FEES: .
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ 4O- S? WATER PERMIT (INCLUDE SORCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ IS^ ? ?> ACCOUNT DEPOSIT - SEWER
$ ACCOONT DEPOSIT - WATER
$ ..?`_ Z J L?D $ WAC
$ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
$ S LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
7UYJ $ .?/•G ?: TOTAL
-7 7 3 3
RECEIPT REChIPT ? -
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
F-1 YES IF YES, THEN A" PERMIT FOR WORK SVITHIN PUBLIC
Q
NO ROADWAY" MLST SE
DIVISION
IS ISSUED BY THE ENGINEERING
. L
T AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: ,??_??.? ??-zr-•?c?
TITLE:
DATE: IJ57,7
? /
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139464
Date Issued:10/25/2016
Permit Category:ePermit
Site Address: 961 Greensboro Lane
Lot:10 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale E Erickson
961 Greensboro Lane
Eagan MN 55123
Roof Time, Inc.
6190 White Drive
Prior Lake MN 55372
(952) 447-7663
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA157772
Date Issued:09/06/2019
Permit Category:ePermit
Site Address: 961 Greensboro Lane
Lot:10 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-100
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale E Erickson
961 Greensboro Lane
Eagan MN 55123
Golden Valley Heating & Air
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163552
Date Issued:09/04/2020
Permit Category:ePermit
Site Address: 961 Greensboro Lane
Lot:10 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 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 -
Dale E Erickson
961 Greensboro Lane
Eagan MN 55123
Signature Home Services
7373 West 147th St
Apple Valley MN 55124
(651) 731-1147
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165118
Date Issued:10/19/2020
Permit Category:ePermit
Site Address: 961 Greensboro Lane
Lot:10 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-100
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale E & Heather A Erickson
961 Greensboro Dr
Eagan MN 55123
Signature Home Services
7373 West 147th St
Apple Valley MN 55124
(651) 731-1147
Applicant/Permitee: Signature Issued By: Signature