4767 London Lane• w __. .,
CITY OF EAGAN
3830 Pilot Knob Roed, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt# b'lo7 3 S'
To be used for Est. Value ? 30,`?` 'Date,19
Site Address ' 7 ' "? ;• ?' ' Z
Lot Block ? Sec/Sub.f`T_,ANY 20714
Parcel No.
¢ Name TliLL?F';r`..it :;,; LL:`PRS INC.
z Address 1?617 AVT•'.
° Ciry ? ? , F . ?Phone ?'32-11('f
,a Name '
>? .
City
Address
City _
I hereby acknowledge that I hafevssd this application and state that the
information is correct and agree to comply with all applicable State ol
Minnesota Statutes and City of Eagan Ordinances.
Signature ot Permittee
.... . . . ...
A Building Permit is issued to:_
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Officia
OFFI CE USE ONLY
On Stte Sewege _ Occupancy '?'`{
MWCC System _ Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required K # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, City '
Variance SAC, MWCC
Water Conn.
Water Meter `
Road Unit
Treatment P1
Parks
TOTAL
Permit No. Permit Holder Dats Telephona u
Plumbing . ? ? ? G;;???
H.4.I1C. C??C, y.yv - ?v ? ??'
Electric .,/?l?j9 C''
? ? ? s ?f
Softener
Inspectlon Date Insp. Comment6
Footings I
?
Footings II
Foundation
Framing
Roofing
Rough Plbg. ,
Rough Htg.
isui.
Fireplace
Final Htg.
,zn ?
Final Plbg.
Bldg. Final ?z j,' S
Cert. Occ. /z +? S
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
- Use BLUE or BLACK Ink
�-----------------,
� For Office Use I
��4 Vt 11� �lt j Permit#: � /Q i
I �
3830 Pilot Knob Road � Permit Fee: �� �Q �
Eagan MN 55422 I �
�'j-"�'�-i ° "`� � Date Received: (D ' �� - �� �
� Phone:(651)675-5675 . .,�..., _,� ;� ,� � �
Fax:(651)675-5694 � --� I
Staff �
.;�ir+� � F f�ii�t I------------"---'� .
2015 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
Date: �� O/�Site Address: �7�7 �-(/I1l�(1Y1 �/��
Tenant: Suite#:
l�Ls[deCitfQWtler'', Name: Phone:
! Address/City/Zip: Z.4 �t l? �y l,Z.
`' Name: !� 7` � L GL1� �'`'/�t� L cen" se�
C:�t1tflC�t>C ..:�
Address: ZZ'Z � City: ���GL.�r„1� .��`GCX
State:_�r J/�J Zip: .3�v7� Phone: �D�J� "�S7—ff 7��
�-- �' Contact: EmaiL• �
New Replacement Additional Alteration Demolition
Type,pf Wprk ' Description of work:
� ,
" NOTE Rocrf mountei�aind ground mounfect mechani�al equipmenf[s requ�red t�be screened b���ty
;; ': Co�#e.:.Pleas�conta�fi the Nf�"chanicat 1"nspectar;for ihfarmatt�srt o�p��tr�tt�d sc,reenin�.methcscf�
;.
RESIDENT/AL COMMERC/AL
Furnace New Construction _Interior Improvement
�����-���� �Air Conditioner �Install Piping _Processed
, ,-.
' ' ' _Air Exchan er
': .,.;_. 9 Gas Exterior HVAC Unit
Heat Pump Under/Above ground Tank �Install/_Remove)
' V Other ��G�� --
RES/DENT/AL FEES
$60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) /I
$100.00 Residential New(includes$5.00 State Surcharge) _$ i!/���0 TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal =$ Permit Fee
*If contract value is LESS than$10,010, Surcharge=$5.00 =$ Surcharge"
"If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005
***If the project valuation is over$1 miliion, please call for Surcharge =$ TOTAL FEE
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 wiil be in accordance
with the approved plan in the case of work which requires a review and approval of plans. �__.
X �r��C. �i i10��'" X ��� �''t �----�''�...�
Applicant's Printed Name Applicant's Signature
� , ,: �
FQE�:OFFIC�:tJS� , `.,: s
;
RQ�'�urr�d�lns ections " ' ; Fteviewed By � �� C�a#e
q �
�E
���Undercji�iund . '� �f��,ugh t�.,:=` � Air'Fest . '��, ; Gas Ser�fie�:T�st._� " kn�fl�aar#f�a� ;'�� Fana1;��, � �
C��l���reert����
(Etr#ifirttfr of (Orrupttnry
Citp of (eagan
EPp1'tptPilt of fli[tbit[J Jtt9WPtttDri
Thrs Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code cenifying that ar the dme ojissuance this structure was in compliance with the various
ordinances of the City reguladng buikGhg construction or use. For the following.•
lke C7actifinUOn :-.'' t14UBMg. hrmit No.
1.. ? 9
Occ,uPa-Y TYX : ?Tj'• ? 2oning Distrid 'IyPe Const.
Owner af Bwlding .! i.?.F? BU??•?;r.. :?• pdd. r 'r i; ? . . . . ._ ..... . .
31.. Ii,! J'1Mt
Buitding qddreg ' - I.onlity
Dale:
Building Olficial
POST IN A CONSPICUOUS PLACE
. ,. ._ , ._„
? ? .c . _ .
. ?
PERMIT #
MECHANICAL PERMIT
CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
I CONTRACT PRICE: PHONE: 454-8100
Site Address <17 -- -7 .N >? „i
' Lot i l c Block ? Sec/Sub
FE I z , A .> +m
m Name `' - -
m Address j-!'7-1!-4_?n.
?
c City ??-.- Phone _-Jz
Name
c Address 2- 47 Fia - - -
p City Y ,
- - Phone
TYPE OF WORK ,
Forced Air lo- M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other R
FEE:
S/C:
TOTAL• ? • ?
BLDG.TYPE
Res. ?
Mult.
Comm.
Other
WORK DESCRIPTION
New ?
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
OF
- $24.00
- 6.00
- 1.50 EA. j
- 12.00
- 20.00
- .50
FOR: CITY OF EAGAN I
, ., . . ,. , 1
. . :?'
?
Site Address `
Lot Block
Name _
Address
City _
? Name
c Address
p City Phone
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 - COMMJIND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR CITY
PLUM&NG PERMIT
- CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
:E: PHONE: 454-8100
PERMIT # .
RECEIPT ft .
DATE: ?`'
BLDG. TYPE WORK OESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWINCi:
NO. FIXTURES TOTAL
-Water Closet - $3.00 $
_Bath Tubs - $3.00
-`?Lavatory - $3.00
-Shower - $3.00
' Kitchen Sink - $3.00
_Urinal/Bidet - $3.00
Tra
_Laundr
- $3
00
y
.
y
yFloor Drains - $1.50
-Water Heater - $1.50
Whirlpool - $3.00
iGas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
?SoHener - $5.00
-Well - $10.00
_Private Disp. - $10.00
=Rough Openings - $1.50 ,
FEE:
STATE S/C:
GRAND TOTAL•
CITY OF EAGAN •
,
454-8100
DEPT. OF BUILDING INSPECTIONS •
Correction Notice
Located at L26 2 Zoh ah Lh.
I have this day inspected fhis structure and
these premises and have found the following
violations of city codes governing same:
l lilP4/ OM '1/ J C/„ Izrv?> b(
0K -,
?_ri ?'? i ?f ciP ?u r 6F ri..av•
When corrections have been made, please
call 454-8100 for inspection.
r
Date
Inapector City of Eagan
DO NOT REMOVE THIS TAG
_ z
CITY•OF EAGAN Permit No: Date:
3830 Pilot Knob Road B/P No: =-? Date:
F.O. Box 21199
Eagan, MN 55721
.'. A?.l?. ..r. . .
Owner.
Site Address: ° T ' * r - } 0
Plumber: "
MWCC:
CityChg: ;•)?.;1Jn?'
Acct. Dep:
Permit Fee: ?
Surcharge:
Misc.: ^. ' ^(:. `T '
Zoning. i
No. oi Units:
I agree to comply with tlhe CHy of Eagan
Ordinances.
By
SEWER SERVICE PERMIT
Date:
CITY UF EAGAN Permit No:
3830 PNoI Knob Road Meter No: Size:
P.O. Box 21199 •. Reader No: Date:
Eagan, MN 5512;
' "i.,f'iCtl xidLa.
Owner.
Site Address: ' -' ?ne L16 IIl B?ittsn
Conn. Chg: SSt) . G0•,3 _
Acct Dep: 15' 00P0
Permit Fea 10' 00P`!
SU(Chef(Je: •'r??'r`
2 04
??l'`-1
Tr. Ptant •
Meter 67 QQpt1
.
Misc.: 7? 217 91'Q*frupn
Zoning: -
No. of Units:
I agree to comply with the City of Eagan
Ordinances.
By
CITY OF EAGAN Permit No: Data ,,. ,.
3836 Pilpt Knob'Road Meter No: yU L Q.1- 9a- Size:
P.O. Box 21199 Reader No: Date: fi
Eagan, MN 55121
Owner.
SiteAddress: 4757 IAIIdpR Lane L16 °1 k;riCc,zac y.iit?:
Plumber. Star Plunbing
Conn.Chg: 550.00-o.. Zoning:
Acct Dep: 15.00pd No. of Units:
Permit Fee: l:? . 0?
1 agree to comply with the Clty oi Eagan
Surcharge: •`?` ad
Tr. Plant 20,+x0T'd Ordinances.
Meter. h7_nnPa ,;'/ /,. • ? / /'`
Misc.: ??,? ^r;?nT a..r, By
L__.... -
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 •
BUILDING PERMIT PHONE:454•8100 Receipt # ?& -7 -1 S?
To be used for '' : / ^ ' Est. Value I 1' - 0<`(- Date ??GUG"? ` ,79
Site Address 4767 ;-:A i,A;dF, OFFICE USE ONLY
Lot •' Block ` Sec/Sub12'11Th"771011 On Site Sewage _ Occupancy R-3 /M 1
t
MWCC System _ Zoning k-1
Parcel No. On Site Well _ (Actuaq Const
c Narqe TOL',+:FSC):i Htt; L') r.;o1?
City Water
(Allowable)
= Adc?ieSS 17617 PA1 R! :' ;ti AV '. PRV Required # ot Storfes
? City'RPPGE 'JALLEYphone ?+31-11J0 BoosterPump _ Length ??
Depth 3?
o Name S.F. Total
,
? a Address Footpr(nt S.F.
P City Phone AppROVALS FEES
?y W
Name Engr./Assess. Permit Z 692.00
Address Planner Surcharge hR_O(Y
4
?= Council Plan Review 3
6•00
a W City Phone 81dg. Off. SAC, City 100.00
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC ???-` •?4
info,[mation is correct and agree to compiy with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter hT .QO
Signature of Permittee Road Unit 323.00
A Building Permit is issued to: ?`'1??? •? ''? U)_t2.S If!!?. Treatment P1 204.0
'on the express condition that al I work shall be done i n accordance with all
applicable State of Minnesota Sfatutes and City of Eagan Ordinances. Parks
BuildirfgOtficial TOTAL '?2 n'"2•'?''
' CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, fv11NNESOTA 55122
DATE 19
f1ECEIVED ? -
1 . i ? .
AMOUNT $
? CASH
? CHECK
'; P , / 'Zln .:D / /
Thank You
BY ?
' ? .
? . White-Payers Copy
Yelbw-POSting Copy
Pink-File Capy
& DOLLARS
iw
BLDG. PERMIT NO
1-7 6-1 L-c
Ot-3210
01-3422
01-3445
01-3446
01-2155
75-3860
20-2275
20-3865
20-3868
20-3716
20-2252
20-3713
20-3743
79-3866
28-3855
I ?-5 Ji C4? Z
Bldg. Permit
Plan Check
Surch./Adm.
SAC/Adm.
Surcharge
Road Unit
SAC
Water Conn.
Water Trmt.
Water Meter
Acct. Dep.
Water Permit
Sewer Permit
Sewer Conn.
Park Ded.
c? n a ?)
l .3 C?
co (? Coy
?13 a -?? 00
550 ?
t::?O 'q O(
loo Ioo
TOTAL ? "?7 C)
CITY OF EAGAN
•? l' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Na- 15462
PHON E: 454-8100 ?
BUILDING PERMIT Receipt # 15 (P'1 3O
To be used tor SF DWG/GAR Est. Value $136, 000 Date AUGUST 18 ,18 88
SiteAddress 4767 LONDON LANE
Lot 16 Block 1 Sec/SubBRITTANY lOTH
Parcel No.
m Name TOLLEFSON BUILDERS INC.
z Address 12617 FAIRGREEN AVE.
0
City APPLE VALI.EYphone 431-1100
U¢IName S? I
o ? Address
? City Phone
a
W Name_
= Address
c?
W City_
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all appf a61e State of
Minnesota Statutes and City Eagan Ordinance
Signature of Permittee
a, suilding Permit is issued to: TO??$FS ?iIILRERSTN^,_._
on the express condition that all work shall one in accordance with all
applicable State of Minne Statutes an ity of Eagan Ordinances.
Building Official ? L?'?
OFFICE USE ONLY
On Site Sewage Occupancy R-3/M-1
MWCC System X Zoning R-1 _
On Site Well _ (Actuaq Const VN
Ciry Water X (Allowable) VN
PRV Required X # oi Stories
Booster Pump Length 66
Depth 32
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit *_692-00
Planner Surcharge __4$.-00
Council Plan Review _34f QO
BIdg.Off. SAC,City OO.QO
Variance SAC,MWCC 550.00
WaterConn. _550,?0
WaterMeter 67-00
Road Unit 325_.D0
Treatment P1 _244.90
Parks
TOTAL _ 990 ,OO
REQUEST FOR ELECTRICAL INSPECTlON . ee-ooaoi-os
? See instructions for completiog th15 form on baek o1 vellow copy. d?2 17
? 9767 "X" Below Wark Covered by This Request
ev? AAd flep. Type ol Building ADPliances Wued Equipmeril Wired
Home Range - Temporary Service
Duplex Water Heater Ligh[in,y Fixtures
Apt. Building Dryer Electric Heaun
Commercial Bldy. Fumace Silo Unloader
Industrial Bldg. Afr Conditioner 8ulk Milk Tank
F2rm Other oeci v therlSVr_r:ifvl
t er Speci y thCr Olher
ompute lnspection Fee Below
p Fee Sefvice Entrence5ize p Fee Fexders/Suhleeders # Fee Circuits
0 to 200 qm )s 0 to 30 qm s 0 tn 30 Am s
Above 200 qmps 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100-Am s Above 100_Amps
Transformers Irrigation 8ooms PartiaL'Other Fee
Signs Special Inspection $ TOTA
Nerryrks
? EE
?JI
Rough-in D. te 1 ihe EI al
In pector, here6y
rtily thnt the above
Final te ingpeccion has been
• ? ?i? made.
This rmuest voitl 18 monlhs trom
This request void
18 months from
E 4-9767 r
Request Uate
? Fire No. R u h-in InsUer.tion
Ne ired?
?Heady Now?
Will Nntify. Inspeo
-/ - ?? Yes ?No ,.r When ReadV
Licensed Elecirical Coniractor 1 hereby reQUest inspection ot above
Owner electrical work installed et:
Street Ad ress, Box or Route No.
`?76:?'7 Lan l.eJp City
ecuon o. Township Name or No. Range No. Coun / ?
r ^
Occupant (PNINT)
?
u
6-3 Phone No.
. -,sc-/n
i
_
PoWer pplier Address ?
Ele Con[ractor (Comp ny Nam 1
?
X Contr tor"s License No.
q
3
.?:e° h ?.
er? P' o
/ q?rs
Mailing ABdress (Contractor or Owner Making In ts allation)
7 s(-0
Auth -zed Signaw e(Con[ractor Ow`e Making Installation)
2
? ? P one Number
3 C
? --?
?
?
& ,
MINNESOTA STpTE BOARD OF ELECTRICITY TNIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Hoom N•191 BE ACCEPTED BY THE STqTE BOARD
1821 Universitv Ave.. St. Paul. MN 55104 UNLESS PNOPER INSPECTION FEE IS
Phnno f5721 6420800 ENCLOSED.
This request void C7//
18 months from
E 49 83 2 L
?-17 v O
Request Date
?
q
??
y fire No. H -ein Insper.tion
H, i rd? r-y
?Re fy. I
ady Nuw p?? Will Notinspec-
l? lor Wh
R
A
`
( Ves ?No en
ea
y
?Licensed Electrical Contractor I hereby request inspection of above
Owner eiectrical work installed at:
Street Address, Box or Route No.
LI76-7 L/,U0,i:oGr-x? City
?P
ecUOn o. Township Name or No. Rangc No. Cow
Occupant(P/RINT) Phone No.
Power /Slier
? Address '
?
Elecirical Contractor (Company Name) Contra, or's Lfr,ense No.
C???'?
Mailinp A Jress (Conttactor or Owner Making Instai ationl
AuthorY SiBnature (CoFtraclo 10 ner M nB Installation) Phone Number
36 f?
MINNE50?A STATE BOARD OF ELECTflICITY THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwey Bldg. - floom N-791 gE ACCEPTED BY THE STATE BOARD
1827 Universitv Ava.. St. Paul, MN 55104 UNLESS PHOPEP INSPECTION FEE IS
on....a taim aa?_nnnn ENCIOSED.
0j /1 REQUEST FOR ELECTRICAL INSPECTION . eB-0000,1-06
r- 0 See instructions for comoleting this form on beck of yellow copy. O O?
E 4s?mz "X" 8elow Work Covered by This Request T
Netiw AAd flep. Type of Building ApplianCes Wired Equipment Wired
Nome Range Temporary Service
Duptex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bidk Milk Tank
Farm Oihe, peci v .ther ISm=ciryl
t .r Specify ther 01her
ompute lnspecrion Fee Below
p Fee ServjCe EntrBncO Size R Fea Faeders/SubfeeAers # Fee Circuits
U to 200 Am s O to 30 Am s 3 dU O to 30 Am s
Above 200 qmpy 31 io 100 Amps ,51crp 31 to 100 Am s
Swimming Poot Above 100_Amps Above 100_/>mP5
Transiormers Irrigation Booms Sd Partial,'Other F
Signs Special Inspection
---o
TOTAL FE
Remarks
/
Rh-in Date 1. the Electrcel
InspeCtor, heteby
tify thxt the 6ove
ae? "• inspection has been
? - made.
TAie mnuwwf vniA 1R monlhe ffom -
So g &?? /
RESiDENTtAt
BUILDING PERMIT APPLICATION 1
CITY OF EAGAN ?
3830 PILOT KNOB RD, EAGAN MN 55122 /
651-681-4675
New Conetruction Regulrementa RemodeVRepair Reaulrements
• 3 registered ske surveys Showing sq. it. of lot, sq. fl. of house; and all rooted areas • 2 copies ot plan
(20% maximum bt aoverage albwed) . 1 set of Energy Calculations for heatetl additbns
• 2 copies ol plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior addttions & decks
• 1 set of Energy Calculations . Indicate ii home senred by septic system lor additions
• 3 copies ot Tree Preservetion Plan 'rf lot platted afler 7/1/93
• Rim Joisl Detail Optbns seleCtion Shest (bldgs with 3 or less units)
?
?
DATE 13S ` a9 VALUATION
SITE ADDRESS °44G 4 (-Z
? MULTI-FAMILY BLDG ?Y _N
TYPE OF WORK_ ??Q•-OF ? g'? G41",07 FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT _ 10 ?k N
STREET ADDRESS *1503ti-5 CAt?RtbQC -?TT-?'?f CITY ?• "kxs PaaSTATE rar-) ZIP S-S`?'I -?
TELEPHONE # rSG CELL PHONE # l(o 6-K -Cse t CO ?F FAX # qas -
PROPERTY OWNER dC1v .ss TELEPHONE #
----------------------------------------------- ------------ ----------- -------------------------
COMPLETE THIS SECTION FOR "NEW°" RESIDEIdTIAI BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RULES 7670 CATEGORY i MINNE50TA RiJI.ES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submiried
• Energy Envelope Calculations Submitted
Plumbing Conhacfor: ?___
Plumbing system includes:
Mechankal Contractor:
Mechanical system inciudes
Sewer/Wpter Contractor:
- Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
------------------------------- ------ --------- ----------------- --------------- ----------------- -------------- ------- ------
I hereby acknowledge that I have reatl this application, state that the information is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature o( ApplicaM
OFFICE USE ONLY
Water Softener
? Water Heater
No. of Baths
Phone #
? Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
1988 BUILDING PERMIT APPLICATION - CYTY OF EAGAN, •,
?
SINGLE FAMILY DWELLINGS • ? ?? ?
l
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OE SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTftACTOR/HOMEOWNER MUST'DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
NNLTIPLE DWELLINGS RENTAL QIJITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS, OF PLANS,: CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,-
1 SET OF ENERGY CALCOLATIONS
CONMERCIAL
INCLIIDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
e)
To Be Used'For: Valuation: Date:
Site Address 417 OFFICE USE ONLY
Lot _L(e_ Block / On site sewage_ Oecupaney
MWCC_ system r/ Zoning R_
Parcel/Sub On site well Actual Const j/,{/
City water ? Allowable ,f/
Owner _.0" PRV required ? 4k of stories
Booster Pump _ Length_
Address Depth ? 2
S.F. Total
City/Zip Code Footprint S.F.
Phone
Contractor
Address
a,?Z j
Phone 4d APPROVALS FEES
City/Zip Cod
Phone
Areh./Engr. =
Address
City/Zip Code. ?
Engr./Aasess Permit ?v?Z
Planner Surcharge ?
Council Plan Review 3 v4 _
Bldg. Off. SAC, City 0 O
?
Varianee SAC, MWCC S 0
Water Conn , 0_
Water Meter l? 7
Road IInit 3 Z S
Treatment PZ Z 4 y
Parks
Copies '
TOTAL `?' O 1, • o U
, .
?-
?-----
Z?X 410
- ?OYD
8
y
z !.
k
l `/. k z
2,? !
z?
?
/? Yd
?---
I ? z ?l ,?- y9 = ?? r>7`
?-
z? _ tayo
---
......... .. ._
1/2y k 13= !y ?/ z
/. 72 f /
zXl3 .- zG
`4- S",?- ?y- ?lba
. .?
I 35 ?G/,2
. i
RoaE ?NGINEEfl1NG
COMpnNY, IMCa
? 1000 EAST 1461h STREET,
?a?al ..Dt?J cr??oc? Z c rtoT %6, B[oCK % BR/TTANY /oTff AODiT<oN,
DAK07".9 COUrVTy, M/NNESaTA
C25?s) DEN07?"5 EX/,97"/N6 E(.EV,qTl4N
corisumna (110111EEn1`$?K- $z
pLp11N(l15 nnd IAHp ?URVEYDQS
P,0E 73
BUf1N5VILLE, MIfINE.OTJ1 65:,37 PII 432'3000
(94-7. 7) DE/JOTES PROPaSEp EGE 097-10il/
,-d--- /iVD/CAT,oS D/RECT/n/V oF SORFACE 0?49/N?'E
9¢$'00 _ F1N1911ED 6ARA6E FGOOR ELE•9T101t/
SCAIE ; ??? = 30? C9?,,ti)
DRA1414GE 4A10
7o-u,5F.s6v 25r0fzP6es
? * /679.Oi
EAGAN
R E V I E W E D
aY .,.10 ?A
DATE 9,; -
?
UT/UTV 699?5?JE/VT
5 65 95 35 / A \
?4????NJ 4J?lJ
\ P.M.
?? ? ?? ? ?? ? `r,yC_?\
, .6
• l ?., \ l? ?yi ?i, ? Y?
0
?t ? •''6.o w
yw
.Pr= \
?
b _
z
I hereby certify thet t}lie ie e, t:ue and correct reprza.ntitinn af a tract o[
land af aho+m' and deecribed hernon.• Ae preparad hy me on thii daY af
19?8. •
/PEV?SE? 8-/? -68 FUPl?b N? ?K $v//1?25 PFd?rJE,?T
All
.AGAN
CE' P'IZ--jI'Z C LZze c'
--
EPT
,Vp6p
VI NX
SETBQCK LiNE
\ b -i )
O
C ?
? y3•0? Z?
0
5v "OOF
V
CITY OF BIIILDZNG DEPARTKENT
E7CTERIOR EIiVII.OPE AVERAGE "U " COMPUTATIQN
(Ta be submttted wi.th building permit appl3cation)
Oae or Two Family Dwelling Owner
All Other Site Address LeT Mpck ?
T SV rrrAw? ID14
Contractor 'ot,l.SJ;?p/f.? fvu. w- ?iuC,? , Date Phoae
LINEAL FEET OF
EXPOSED VdALL L6g "Gc'oR,, Cl?aa?7It Pt. above grade = ? $•9?0
TOTAL E3G°OSED WALL ARF,A SQ,. FT.
0?AQUE WELL CONSTRU:TIOt;: "U'f Value x Area
Detail t'-KAm E "U" -d43 x SQ,
rePerence itUt' - a48 x Sq.
from fut 04d x sQ,
attacned ' "Ux SQ,
sheets liUlt x Sq,
njj n x SQ.
6YINDObYS: "U" Value x Area
FT. 1 5z. . $. (II)(A)
FT. 93,So= 9.19 (U) (A)
FT. Zo .f = ?.3(o(U)(A)
FT. _ (U)(Q)
FT. - (U) (A)
FT. - (U)(A)
A1ake & Type livyvL• dyOyLJ' ,rUll •?Q?
n nUn x SQ. FT. foS.lO = 79• 4U
Z (A)
()
n _
nUn x 3Q. FT. (U)(A)
x sq. FT. . (U) (A)
n n nU?i _
% sq. FT. (U)(A)
DOORS: "U" Value x Rrea
Make & Tyne 6TCV. 1 G,vt>, nIIn •Iq- x sq.
n Y4TlI7 ri
Un-- , 48 x SQ.
n n --fljjtf x SQ,
n n , nUn 7C SQ
.
TOTALS 231$.9(,0 SQ.
AVERAGE ItUl'
TOTAL M(A) VALUES 200• IS
' . D?SCo
DIVIDED BY TOTAL 4dkLL AREA Z315•9(a
dVF,RAGE "Ull<!?7 1 r less for 1&2 family dwellinge
ROOF/CEILINa:
TO TAL AREA : 1176 ZtT
Detail reference flUff .0Z,1 x
froat nUn S
attached sheeta, i_aUn x
Describe openings x
in roof. IIIIII x
TOTAL (U) (A) VALUES DIVIDED BY 24-o 109
?
TOTAL R00^/GEILING i,REA II ]&
AVA:FAGE 'lU? . 25 r ventilated roofs.
FT. 540•00 =-7-5+ (U) (A)
FT. Z,D = 20.1ln (U) (A)
FT. _ (U) (A)
FT. - (U)(A)
YT. 200•16P (U) (A)
sq. Fr. ll 7& = zg.69 MW
SQ. FT, s a (U) (A)
S@. FT. a (U)(A)
SQ. FT. = (U)(A)
SQ. (Q) (A)
`iTALe7 117(O _ ?4-ff ?g?(,u(A?
ozr ,
?
'a
(?,?
q.5o x (9z+4t ?,?St28) =
5-83 X CZStZB t zS-rzg) -
CoAl& ,
.(o7x(,4zt42tZsrz$? -
ll A)OXK 54ET /1
1330. oa
g8?, gCP
2318.`l(v -,? -
93.So?-
y, ? ?
. s3 +s? ?--
bowS _
zox3lrq= s.o
z4xz4 = 'I.o
Za X (v0 = $. 3
?4x48 = S, o
lonRS _
3 ° s?.• v?Z sc;
(o = ?,a.-tr c
x 3 = Is. vo
x f = ?{• o0
X 7 = a?"S. !O
X !1 = S8• o0
1&5? ?0 4-
U'wtk, Z 31 g,4 !a
1.?y5 do,Ae. 93.gr,
?r ?iH7 Z,o9.l?v
N W AW'? l bS.! b D(D
1J '
?.s g $oa
75z.
00
l4xzs = 39z
. . , `•
--WALI, SECTIOB--
Determining "II" values at Roof, Wall, Rim, and Conc. Block
ROOF/CEILING
1.) Interior Air r•ilm
2.) 5/8 11 Gyp. Ba.
3.) Insulation
4.l
5.) Exterior Air Film
(STILL)
(R) VALUE
0.61
.56
4S,oo
.bt
nIIu s t/R= .OZ' i'OTAL (R)- T(p,7g
?•
WALL
6.) Interior Air Film
7.1 i" GYP. Bd.
8.) Insulation
gu?cr-- Jz?TE
9. ) yz."
10.) I4ASOnite Siding
17.) Exterior Air Film
(R VALUE
o. 68
.45
r91'oa
• Z,o?}
. 67
.1'j
njjn _ 1/g= .67¢3 TOTAL (R)= z3.o j
RIM
12.) Interior Air rilm
13.) Insulation
14.) 2'l Fir Rim Joist
15.) /!zlp XvlvT- 9)75
]6.) Masonite Siding
i?•) Exterior A:Lr Film
R VALUE
0.68
141,00
1.88
Z?
.67
.t7
nIIn = t/R= .041? TOTAL (13)=
FOUNDATION
18.) Interior Air Film
19.)
zo. )
21=) 12" Coacrete Block
22,) ? mrD l?srx,
23.) terior Air Film
R VALU
0.6$
1.28
8.00
.17
?-
nUti = 1/R= TOTAL (R)= IQ,J?j
?
.
APFLIfCATION F4R PERMIT
SEWER AND/OR WATER CONNECTION
?. x .................F.,?.?...,. ..
,*?NITE: PA7tM12dr OF FEE AT TIME OF M1•' -?
?
? APPLICATIOPI DDFS N(YI' CON- t
? STI7[TCC APPRUOL OF PII2NIIT.
#
; inisPBMaa oF sEMM AND/oR wAxEa e
?.
; iN.srtsrLATZONS wnL N(Yr sa scmtLID;
* L?NTIL PQiMIT HAS $Fa] AppR0VED. .*k
-citV **+s.,r??x??w?? ?+r:*a++tt+r?:?+t,t,r,rx?,rw*
OF eacjan
(PLEASE PRINT
1) PROPERTY ADDRESS:
LF7GAL DESCE2IPTION;
IF EXISTING STRC?CT[)RE, DATE OF ORIGILVAL BUILDING PERMIT ISSC?ANCE:
Mont Year
PRESENT ZONING/PROPOSID USE:
r7 COM[11EEtCIAL/RETAIL/OFFICE
? INDDSTRIAL
? . I NSTITUTIONAL/GOVERDIMENT
2) ? NANE:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
I=yrR-1 SINGLE FAMILY
r_-_-] R-2 DLPLEX ('iu-o Units )
? R-3 TOWNHOtiSE (Three + T-Inits) ( Lnits)
Q R-4 APARTMENT/CONDOMINILM ( Lnits)
3)
: ?NAME: Q t-
ADDRESS: t
CITY, STATE, ZIP:
PHONE:
y r t Y L _ L? L-7...iLA k.,,
MASTII2 LICENSE # Vh 3
4)
Plimibers License:
Ij Active
Expired
Not recordec
St Ia n7-' Titia?
5)
EETCONDIECTION TO CITY SEWER FUq-60'NNECTION TO CITY WATF.E2 a OTfER
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
6)
^E-U
********************* *** *******,?,??.****************?**,r******************************************?
* THE GOLD COPY OF THE PERMIT WILL BE SEPlr DIREX.TLY TO PUBLIC WORKS TO FACILITATE MEIER PICK-LiP. ?
* PLEZLSE ALLOW TUC WORKING DAYS E'OR PROCESSING. SONIEONE FRoIN TIm CITY WILL CONPAr-T YOL IF TBQ2E
* 11RE 11NY PROBLEM1S. ?
?4***+***********************************,r******?r***************************************************;
FOR CITY USE ONLY
PERMIT # ISSL'ED
"
Pd w/Bldg. Permit
$
c
$
$
$
$
$ -? .S? • CJZ?
$ G% .S?r . C/ZJ
$
$
$
$
$
$
s
RECEIPT
FEES:
$ f D
$
$
c
$ SEWER TAP
$ /rSU--o ACCOUNT DEPOSIT - SEWER
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRCNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENLFIT/TRONK WATER
$ WATER TREATMENT PLANT SURCHARGE
$
$
RECEIPT
sa
SEWER PERMIT (;INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
OTHER:
TOTAL
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PL?BLIC
Q RQADWAY" MUST BE ISSCiED By THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ?p ??
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Use BLUE or BLACK Ink
� �----------------- ��d
. I For Office Use ��
I �/ �2,
Cl� Ol �� �ll j Permit#: /�Q�7 b �.�4
Y � � ,
� Permit Fee: ���' �� �
3830 Pilot Knob Road I ��r 3� r� �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �`� �
Fax: (651)675-5694 I Staff:
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
��� �2 � � �� ��s� �isa --����l
�� Name: J�� f� L� Phone:�_
� ReSi
� � ��v� ���'�N /4�1✓_� 1�4��.. �"�/�.2
Qyy����� Address/City/Zip:
����::
�� ��
,� t� vrr ��������� � Applicant is: �Owner �Contractor
� _���.��:
����� � ,. �
��� �������`��� � � � ` Gf.'�Iv,� t��13 �'�
,�. ��#� ��. Description of work: l3
�� ��� ...� �� - ��t
���� .:� ��� Construction Cost: � � '� Multi-Family Building:(Yes /No )
�� � ' ^� �
�� ���� Company: Contact l
r p /�v,,� ---'1
��0�11�C . F' Address: , ,G <- (./� City: � �.. �
�
� � " ���'� � State:�Zi �� � Email: /C� �.G✓ ���[�7 �_G�'=•�
, �����, p: � Phone: .
�� £ ; �� �;.r License#: �C��� Lead Certificate#: '�—�
If the project is exempt from lead certification, please explain why: \
�
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:
Fire Suppression Contractor: Phone:
� � �. .
NOTE ns ar�� �P,c� ���men� �# . ��� m� a►�e�c�����f ,�be�`ru� � #�ortiQx��
#����``��matrari§�»ay# � �etl as nz�M ublic�� y icav�d�sp#�t �f �i#� it the� a y
���
������ � # . ����� � t.�r►��e thai` � ,��r�,�'�' ���� �m � ,,� � "#4
,
�« . u. t.�� ,, : # .
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 ithout a permit; that the work will be in
accordance with the appro ed 'n th se of work which requires a review and approval of plans.
,
Exterior work aut a bu'di permit issued in accordance with the Minnesota State� uild' ode m s completed within 180
days of p rm' ' sua
x �„/ X `
ppli 's Pr nted Name A pli nt's igna
��� ����� Page 1 of 3
�
`7 �,l`y- � ��/2�G/'J ��f , DO NOT WRITE BELOW THIS LINE ! �C���(� .,
SUB TYPES �
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of_Plex �( Lower Level _ Pool _ Accessory Building
��a
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
Addition Move Building Reroof Demolish Interior
� Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retalning Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION �'y
Valuation � � tl Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_100%�) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/No C.O. Required
Foundation � HVAC Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings Air/Gas Tests _Final
� Framing Drain Tile
Fireplace: _Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: � (/ , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review �
MCES SAC
City SAC :'�r
Utility Connection Charge
SB�W Permit&Surcharge - � � � � � ��
Treatment Plant � � � `` ,�
�
Copies �
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
= r----------�-------�
1 For Oftice Use �
�
' � Permit#: � �o�-��,�I
Clt of �� �� ; . �
� � Permtt Fee:__�f����J�
3830 Pilot Knob Raad � t
Eagan MN 55122 i �te Received: I
Phone: (651)675-5675 � �aff_ i
Fax: (651}675-5694 �---------------- �
2015 RESfDENTiAL PLUMBING PERMtT APP�ICATIaN
Date:_� ���I� Site Address: �'�� ��d�'�-� ���-
Tenant: Suite#:
_ ;. ;.: , ,, ,. , .
; Residentl0wner , Name: �V.�12�� ,��,f�;/� �.-��c,�t Phone: �����,�'� �t'��
Address 1 City/Zip: 5r��7 ��y�-, G>.•�.L
.. .._: .. .
<:..,. „_ ,.,: ._�, _ ,:_
,_,: _ .,:, ,:,,: ,.:,: .
�, � _:_.
Name:� �l��.,d,�j'n� ��ti,y��y_ri'�1� �sn, License#: /�.�"c`–' ��'l��y
Contractor Address:�����' o� �'�/� �w Ci#y: �i�� ��"��
State:./`�� Zip: -��'`.,33 � Phone: �5�� SJ.�-'B' –��a�
' Contact: �/�k� Email:_ C. � ��"�/�+i6?�;r+}' � �`.fe. Ge�✓L,
Ty�Of WOYk —New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of vr►oNc:
, - , ._ _ , ,.
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigafion(_RPZ/_PVB)
Permit Type
Septic System X Add Plumbing Fix#ures(�Main/ �Lower Level)
N�H, Water Turnaround
Abandonment
.. .:. ..:..... . >,, ,_::.::,.. .. ,... _ .:,:: :.. : .,:. > : , ;..
�___ . �_.... _ __..,_.�_, __,__...... . <
RESIDENTIQL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
` a60.00 Lawn Irrigation(inciudes State Surcharge)
; $&0.00 Add Plumbing Fi�ures, Septic Svstem Abandonment,Water Tumaround*(includes sta#e Surchargej
*Water Turnaround(add$210.00 if a 5/8"meter is required}
$115.00 Septic SYstem New(includes Coun#y fee and State Surcharge}
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protec#ion against unde�ground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.popherstateonecatl.orq
I hereby acknowtedge that ttgs ir�formation is complete and accurate;that the work witl be in conformar�e with the ordirrances and codes of the City of
Eagan;that I understarx!this is r�t a permit, but or�y an application for a permit, and work is noh to start without a permit; that the work wili be in
�rdance with the approved plan in the case of work wtuch req�tes a review and approval of ptans.
X �.� �---��,�j
Applicant's Printed Name Applicarrt's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Raugh-In Air Test Gas Test Finaf
Meter Related Items: Meter Size Radio Read Manameter Staff:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA160731
Date Issued:04/08/2020
Permit Category:ePermit
Site Address: 4767 London Lane
Lot:16 Block: 1 Addition: Brittany 10th
PID:10-15009-01-160
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
Russell Loucks
4767 London Lane
Eagan MN 55122
Binder Heating & Air Conditioning
222 Hardman Ave N
South St Paul MN 55075
(651) 457-8781
Applicant/Permitee: Signature Issued By: Signature