835 Lone Oak RdCITY OF EAGAN Remarks
Addition Section 2 Lot 4 Bik 78 Parcel 10 00200 040 78
Owner ?LL +:f i?L? C eJ 11 Street 835 LOriE 08,2{ Rd. State E3gn11.MN 55121
& W??, ? 301-1 - E
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ?le 168 100.00 3.33 0 P37.d
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA y 1977 160.00 10.66 1
STORM SEW TRK 1985 899.0 59.93 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
HUILDING PER.
SAC
PAR K
BUILDING PERMIT
. . ,. . . . . . ..:r. .. . .. .
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
io ce usea ror wH[MM Est. Value #00000
Site Address 833 I.UlQE OAK 8D
Lot 6 Biock 78 Sec/Sub. SZC4`IOIt 2
Parcel No.
W Name Cd1RY KAJER
3: Address a's LM ouc RD
0 City KAGAH Phone 43i-5081
o Name SU'88aL COitt
$Q Address 185$ C0!!0 /1V8
? City SY PAUL Phone 645-0331
?
W w Name _
Address
z
iW C11V-
I hereby acknowlege 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.
Signalure of Permitee ? A Building Permit is issued ro: SUSSEL CO&E'
on Ihe express condition that all work shall be done in accordance with all
applicable Slale of Minnesola Statutes and City ol Eagan Ordinances.
Building Official
.-? 1?•?2?
i 4 ?111
Receipt #
Occupancy
Zoning
(ACtuap const
(Allowahle)
M o1 stories
Lergth
Depih
S.F. Total
S.F. Footprints
On Site Sewage
On Sile Well
MWCC System
City Water
PRV Required
Booster Pump
APPROVALS
Planner
Council
Bldg Off.
Variance
OFFIC E USE ONLY
FEES
- Bldg. Permit 81 •oo
- Surcharge 1-?
221 Plan Review
140' SAC, City
- SAC,MCWCC
Water Conn
M
W
- ater
eter
_ Acct. Deposit
S/W Permit
- S/W Surcharge
Treatmenl PI
Road Unit
- Park Ded.
TOTAI 84•00
I I PmnM No• I Permil Flolder I Date I Telephone # I
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspeetion Uate Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough PI6g.
Rough Hig.
Isul.
Fireplace
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspector - Notity Plumber
ConsL Meter
EngrlPlan
Bldg. Final
Deck Ftg.
Dedc Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
I (612) 681-4675
I SITE ADDRESS:
... : ? } 11 .
! PERMIT SUBTYPE:
I TYPE OF WORK:
fiff'! ! F) I NF;
0?i99,1iii
i.uf/N3 197
pl i14f ['
tiFl!!'ir 110V1
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
4 y? Ot C ? APPLICANT:
? . . . .. ,.? : r .
: ;. i .: ?1? t . ?.•.
I k ItdN!
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBCa
FINAL HTG
ORSAT
TEST
BLDG FINAL o ,,s
BSMT R.I. /SS v to
BSMT FINAL 10r 349 Ie1 S'
DECK FTCa
DECK FINAI
16IF?4J` REQUEST FOR ELECTRICAL INSPECTION
0 4 7 9 9 0poo See Inslructlons for completing this form on back ol yellow copy.
"X" Below Work,Covered by This Request
dl?pm% . es-ooooi-os
?;054 / 81
Ne Add Rep. Type oi Building Appliances Wired Equipment Wired
X Home Range Temporary Service
Du lex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm.lindustrial Furnace Other (Specify)
Farm Air Conditioner
Other (specity) Connactor s Femarks:
Compute Inspection Fee Below: Service change
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 Am s Above 100 -Amps
SI nS Inspector's Use Oniy: TOTAL 65.
Irrigatlon Booms vv ?
?sr .
S ecial Ins ection $65 .
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in '. ,
c oace
certify been madethe ahove inspection has Final ? Data
OFFICE USE ONLY L L
'fTis request voltl 18 months from
004 7990 v_ooaoo-o40-7? Job #
Siequest Date
1/13/95 Flre No. Rouqh-In Inspectlon,Requlred
(You musl call inspector when ready)
? Yes $? No Inspectlon Olher Than Rough-In
?qeady Now ? Will Noiify Inspector
Date Rea
IJNM licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (Slreet, Box or Route No.)
835 Lone oak Road City
Eagan
Sectlon No. Township Neme or No. Ranqe No. County
Dakota
Occupant(PRINT) Phone No.
Power Supplier Atldress
Dakota Electric Farmin ton
Elecldcel Gontracror (Company Name) Contractor's Llcense No.
Hilite Electric Inc. 040445
Mailing Address (CoMracior or Owner Making Installation)
195 Midneginta 55122
Authorized Signat e( nlractorlOwner ag I on) Phone NumGer
452-8886
MINNE66Tk'STAYE IrOARD OF ELECTRICii 7HIS INSPECTION REOUE5T WILL NOT
Grlggs-Mldwey Bldg. - Room 5-128 BE ACCEPTED BY THE STATE BOARD
1821 Universlty Ava., St, Paul, MN 56104 UNLESS PROPER INSPECTION FEE IS
Phone 18121 662-0800 Fd?•"' ENCLOSED.
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex °-- - - . . .... - ??.r - -- --- ?- ?---°-
- ----
? p---- ? ?/
Address (Presenf) -----_k-'1...5.......----°-------° -?"c`?pG----/?!•
Builder --..'.`.-e?2'c?c?.--°°•---`-`-------------- - d.'o ,
---------- ----- ------ -- - -..
Address _. - - - -- -
--- ---
DESCRIPTION
N° 913
Eagan Township
Town Hall
Date -/?-/ ........ 4--- -
---- ----°---- °----°--------------
SYOriesl To Be Used For Froni Deplh Heighf Esi. Cos3 Permit Fee Remarks
a y
?
- ?
`?iss0
'S'=
/o 1 ,O?-??
LOCATION
Street, Road or olhe: Descripiion of Location Loi I Block AddiYion or Traci
?
This pexmif doas noi aufhoriae the use of sireets, roads, alleys or sidewalks nor does if give the owner or his ageni
the right !o create any siiuafion which is a nuisance oz which presen3s a hazazd fo the healih, safely, connenience and
general welfare to anyone in the commuai3y.
THIS PERMIT MUST BE Kp;/. T O?N?T?HE REMISE WHILE THE WORK I5 IN PROGRESS.
This is to certify, that.----?,t?-?`'-`----°-----°--....has permission to ereci a---°°--- -.---------°- --------- upon
the above desciihed premise subject !o the provisions of the Building Ordinance for Ea °n Town ip adopted April 11,
1955. ?f
.......... --------- 1."= -'_".°.................... -- - - Per ........... .........--°-- --?L ?.°-- ?.{- --`:-".`:"?R.-f
Chairman of T?wn Bord B„ G?? Building InspeeYor
4 111?citV oF eagan
,,) _ eg 6??d 0 - ? Vi
August 11, 1997
MR WILLIAM OTTING
OTTING HOUSE MOVERS
11640 275h' ST E
LAKEVILLE MN 55044
hmx Movt
RE: HOUSE MOVE PERMITS
821, 835, AND 845 LONE OAK ROAD
EAGAN MN
Dear Mr. Otting:
THOMAS EGAN
Mayor
PATRICIA AWADA
BEA BLOMQUIST
SANDRA A. MASIN
THEODORE WACHTER
Council Members
THOMAS HEDGES
Gry aamlNSrrator
E J, VAN OVERBEKE
Cify Clerk
On August 5, 1997, you submitted applications to move three houses located on Lone Oak Road in the
Eagan Business Commons subdivision. At that time, you were advised that before house move permits
could be issued, we must be in receipt of a plumbing permit for each address issued to a licensed pfumber
for abandonment of the septic systems.
On August 8, 1997, I was informed that these houses have been moved. I, therefore, contacted the
Department of Transportation, the department responsible for licensing of building movers. I was
informed that a condition of a mover's license is to comply with local permits and ordinances. I contacted
Becky Schantz of Max Steininger Construction to inform them of the situation, as well. The City of
Eagan's regulations to move a building have not changed since the last moving permit was issued to you
for a house on Elrene and Yankee Doodle Roads. That permit was also delayed while you compiled
documentation verifying the abandonment of the well and septic system.
I felt that by giving you the policy and ordinance and explaining it to you in person, we could avoid the
situation that now exists. To resolve this problem, I am anticipating your timely response. Please contact
me at once at 681-4699. Thank you.
Sincerely,
b?AA
Dafe Schoeppner
SeniorInspector
DS/js
cc: Doug Reid, Chief Building Officia(
7im Lindway, Dept of Transportation, 1 110 Center Pointe Curve, Mendota Heights, MN 55118
Greg Steininger, Max Steininger Ina, 3070 Lexington Ave S., Eagan, MN 55121
MUNICIPAL CENTER
3830 PILOT KN06 ROAD
EAGAN. MINNESOiA 551 22-1 897
PHONE. (612) 681 -4600
FAX: (612) 681-4612
TDD:(612)454-853ti
THE LONE OAK TREE
THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITV
Equal OpporTunity/AfflrmaTive Action Employer
MAINTENANCE FACILITY
3501 COACHMAN POINT
EAGAN, MINNESOTA 55122
PfiONE: (612) 681-4300
FAX.(612)681-4360
fDD:(612)454-8535
?A- 4, ti l(t , Jj z
Community Development Department
Planning Division
City of Eagan
3830 Pilot Knob Road
Eagan, MN 55122
(612) 681-4685 Fax: 681-4694
TO: JON HOHENSTEIN, ASSISTANT TO THE CITY ADMINISTRATOR
FROM: DALE SCHOEPPNER, SEIVIOR BUILDING INSPECTOR
DATE: MARCH 31,1997
RE: HIGHWAY 55 CORRIDOR REDEVELOPMENT DISTRICT
As per our discussion on this morningA35, 845 and 85:ftone Oak-Road have been redesignated
as substandazd structures according to the guidelines estabiished in State Statute 469.174,
Subdivision 10.
This redesignation is due to an increase in the cost of materials and labor. An electrical service
of 100 amps was added to upgrade to current standards. This was not in the original estimate.
The house at 825 Lone Oak Road does not meet the criteria to be classified substandard even
with the changes described above. An on-site visit with access to the interior may reveal
conditions unapparent on the original inspection.
ff you need any additional information, please contact me.
Senior Buiiding Inspector
DS/mg
cc: Doug Reid, Chief Building Official
Y
?
. . .?,? ???;?
?
?
Fwm Apparad
OM9 No. 29004088
HEALTH AUTHORITY APPROVAL - INDIVIDUAL
a ?WATER-SUPPLY AND SEWAGE-DISPOSAL SYSTEM VA CASE NO. "
0 ir- ? 3
va oF lce
IMPORTANT-TTis form sEould be tompleud and Cded an requhed by ezisting law 38 U.S.C. 1904 and 1910.
PART I-TO BE COMPLETED BY VA
MORTGAGEE NAME ANDAUDRE95 (/qcludeZ/PCode)
-
. , .
•/;' ;, . MOR GAGOR OR SPONSOR
G Y KAJER
,
- - -
; CENTRUST MORTGAGE CORPORATION
!, 1380 CORPORATE CENTER CURVE, SUITE 210
EAGAN, MN 55121
. PRO TY AODRE55
835 LONE OAK ROAD
EAGAN, MN 55121
/0 06?200 d ?D 7c?'
. ' . - SUBDIVISIONlLOTNO. '
TOTAL NUMBEN ' IS THERE A BASE-
MENT7 IS THIS A NEW
INSTALLATION2 CAN THE ATTIC OR OTHEH AREA BE MAOE INTO
ADDITIONALBEDROOMS7(!f"Ya
"bowmany7/
LIVINGUNIT6 BEDROOMS BATNS _ . ,
. . ._. .. ..... . .
C] VES ?NO . ..
[]VES ?NO .... .. . _ ... . ._ .. . _ . . . ,,
?YESV,..'ONO . .
WATER SU LV BV: SVSTEM DESIGNED FOR
? PUBLICSYSTEM ? COMMUNITYSVSTEM INOIVIDUAL . .. . Na.OFBEDROOMS GAHBAGEDISPOSAL
InMAGE DISPOSA BY: ,
?PUBLICS E CpMMUNITYSYSTEM ?INDIVIDUAL
?VES ?NO
PAAT II-TO BE COMPLETED 8V HEALTH DEPARTMENT OR COMPIIANCE INSPECTOR
INSPECTOH'S SKFTCH (TO RBPORT A&BUlLT DEVlATfONS FROMAPPRDY6D PLAN)
i`
.
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- - - - - - - - - - - - -
- - - - - - - - - - - - -
[t h ttie oploi of the Q SWte Q County Q'Local Department of HealU that Uds indWidual watm-supply system Eitrffis aot sadsfaMory as s domestic waur supply "
for the subject property.
It is the op'vdo o State ? County ? Local Department of Health that this individuat uwagediaposal syslem with proper maintenance Q ean be expected to functlon
sadsfactonly ia ? likely to create unaanitary conditions ? cannot be expected to function satisfactonly.
D TE
-! O - F/ 51 ATURE
„ . TITLE .
. ` . . ,
NOTE: The health suthority should complete the appropriate opinion statement above and affix date, signature and title in the spaces Qrovided.
NOTE: Use of the rcveree of thb folm ia at the opdon of the health authority.
PART 111-70 BE COMPLETED BY VA
I have reviewed the foregoing and the pertinent Compliance Inspection Report and recommend that the indiviAUal watersupply system be
considered (3acceptable ? not acceptable and that the sewagedisposal system be considered 0 acceptable ? not acceptable.
DATE '
. . ?.??.. .. , ? :. SIGNATUREOFCHIEFAPPRAISALSECTIONOROESIGNEE -
... .,. . , .
MAV 19A5 Z6'6395
E7(ISTING STOGKSOF VA FORM 26$395,
APR 1982, WILL BE USED.
YE.
?.?i \ ? ,y ..,._: ? .:? M1 ? f . . . . ,... . ..... . . . . .. . . ? . . . .
?
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
• Eagan, Minnesota 55122-1897 Permit Number. 0 8 0 9 2 0
(612) 681-4675 Date Issued: 10 / 0 3/ 9 7
SITE ADDRESS:
835 LONE ORK RD
LOT: 4 BLOCK: 78
SEGTION 2
DESCRIPTION:
NOUSE MOVE
ermit Type
A,r
,? TYPe
MTSCELLANEOUS
MOVE
? e
?
,
REMARKS:
FEE SUMMARY:
8ass Fee
Surcherge
7ota1 Fee
$75.@0
$.50
$75.5@
CONTRACTOR: - q p p 1 i c a n t-
OTTING HOUSE MOVERS 14613265
11640 275TH ST E
LAKEVILLE MN 55044
(612) 461-3265
APPLICANT/PERMITEE SIGNATURE
OWNER:
R J RYAN CO
6511 CEDAR AVE 5
APPLE.VALLEY MM 55044
?'_'??1??
IS E BY: SIGNATURE
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
New Construction Reauirements RemodeVReoair Reauirements
? 3 registered sRe surveys ? 2 copies of plan
• 2 copies of plans (inciude beam & window s¢es; poured fid. design; etc.) ? 2 ske surveys (exterior additions 8 dedcs)
? 1 energy calculations ? 1 energy calculations tor heated additions
? 3 copies of Vee preservation plan if lot platted after 7/1/93
required: _ Yes _ No •
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS:
?
LOT BLOCK
PROPERTY
OWNER
CONTRACTOR
ARCHRECT/
ENGINEER
Company: _
Name:
Street Address:
City:
State:
Registration #:
Zip:
Sewer & water licer.aed plumber (new construction only): . Penalty applies when address change
and lot change are iequested once permit is issued.
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.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
CONSTRUCTION COST:
??bU.CI ??Ov
;2 t SUBD./P.I.D. #:
Z
Name: Coh c,L Phone #:
? nRbi
Street Address:
City: ?V?? State: ?r/V zip: S"'S"?j?3
Company: ?2Lh9 Phone #:
Street Address: ?_ License #: / 3%yO/ o
City: State: /G Zip; S ro yy
Signature of Applicant:
_ Yes _ No
_ Yes _ No
Phone #:
_ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duptex ? 11 Apt./Lodging ?
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ?
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ?
? 04 SF Porch ? 09 12-plex o 14 Fireplace ?
? 05 SF Misc. ? 10 _ plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations 6? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
,
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
_ Basement sq. ft. MC/WS System
_ Main level sq. ft. City Water
_ sq. ft. Fire Sprinklered
_ sq. ft. PRV
_ sq. ft. Booster Pump
_ sq. ft. Census Code. ?
_ Footprint sq. ft. SAC Code ?
Census Bldg
Census Unit
Building ? Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
? ,.
OWNER'S PERMIT APPLICATION (FOR BUILDING MOVE)
0' Date of Application: e? 27
0 Address & legal descriptionT)Qf building being moved:
0 Address & legal description of proposed destination:
-2,7? ?Z? ,7,-
0 Building owner's name:
address:
phone #: c
0 Landowner's name: _ /? < ? ??? •' - ?-
00,
address: C? ?l ` q-?" ? •
phone #: 3
If landowner is different from building owner, provide approval, from
landowner to operate on the property.
0 Indicate if structure is conneeted to:
City sewer City water Septie Well
Electric service Gas service Other (list)
0 Indicate party responsible for utilities disconnect:
Owner Mover ? Other
OFFICE USE ONLY
Aeal estate taxes/assessments on building
Real estate taxes/assessments on land
Utility disconnect:
Eleetric
Gas
Sewer/water
Landowner approval
2
MOVER'S PERMIT APPLICATION (FOR BIIILDING MOVE)
, 0 Date of Application:
0 Address &_legal desgription of building?being mA
el
0 Address & legal description of proposed destination:
2? ? Z Z3 "-1- S? - le ,
0 Qieck situation that applies:
(/ Building preseatly lxated in Eagan - to be moved out of Eagan
Building presentlq located in Eagan - to be relocated in Eagan
(Requires Counei2 approval)
Building located outside of Eagan - to be relocated in Eagan
(Requires Council approval)
Building located outside of Eagan - to be moved through Eagan to
another City.
?
0 Mover's Name:
Address: _ JCC-?{ 0 9-.,
Phone ? ?-?j r - Z
Mn. Mover's License # t ?
(submit a copy of license)
0 Highlight origin, route, & destination on current City map. If County
or State roads are used, provide copy of those permits.
0 Proposed date & time of move (notify Eagan Police Department). 80TE2
Eagan Police Frill aot aecompany move until time eoordiaation has beea made
vith neighboring municipality.
0 Size & weight of structure: ?q ?< '7"a/
OFFICE IISE ONLY
Mover's permit fee
Permit #
Guarantee to repair
3
?
RUG-. 4-97 _ 110N 8007 RJ RYAN COtISTRUCTION IRC FA}{ N0. 6328880390 p• Q3
vrifJJ:l?t0 m3w WEJ. co PdM 02
"'E?4 M aow1Y?OGAhOM M/1d801A0[PART1fEiT Qf MEAL1}I MrfNlOM VMIfl Mnf1 UM1r.0 '. .. . ..... ''
1M?.1 AI?BORMIG SEAL?Kti AECdRE) 1
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aNwNRaL SpaiYR Gww Y0.41
Nv won0? . rwwrn .?9.f ^s!r " oww..a0e*a?a?+,eoan -- :,.'__
Eqdn 27 23 E,??f„?y 7-31-91
;?amuns?rae?..:wtr.?aww pku' ,p _ ----
835 l,one oax Rd. •an •-o?oa.,K..s.wnp... 2S7_,,.
uw NOqaGM? M wa9 e?eyy
W??+: • ont..fn'X', ?T.x,_?i?Y??b /100iBke ?.r. ?.. a . ?.?.
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6511 Cedar Ave S
"p1s., 14N 55423
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LSSI.IED TO:
V41ILL1AM QTTING
Fhe above nauud license holder has complied wiih the Iictnse requirements and is heroby issued tRis Minnesou Buildmg Morer LKenee which wi{I
eacpire on tl+e dare shown ixbw.
EXPiRATION DA7'E: JUNE 30, 1998
The iicense holder agrees m comply with all applicabie Srm and Federal Regulations, Faiture to comply may result in revocation of th6 lianse.
7'he L{ccnse Nolder may not perForrn Duildieg rparimg operations m Minnesaa ureless the vehicles have betn registercd snd display a valid
wleaafication qb card iswed by rhe Minnesota Deparpncni of Transpcxtation.
FOit VERIF[CATfON CALL (612) 405fi060
WR-Z.IAM OTTQVG AHA: OTTING HOU55 MOYERS
11640 E. 27517H STREET
LAKEVO.i.E MN 55044 EFFECTIVE DATE, 0611ll97
. 1941 BIIILDIG"IZLSATIUN
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS C0MMERCIAL
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 UNZTS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRE55 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 BEEN COMPLETED.
PERMIT MUST SHOW A LIGENSED PLUMBER.
To Be Used For: 6uYaluation: 3A-40-; `611 Date:
''?l't`' ? -
Site Address
Lot ? Block 1?
Parce2/Sub jiltp ?
owne r Cr ?, n .. , fC 4 '1 ?e, f`
Address `?.3 •? L m 17 -e, U' a, j( 9,1
City/Zip Code /^. R, ? qc,y :S`' l.Z f
?
Phone y5'' ?/ S^ a ?f
Contractor ,.,stc,s s e-J
Address 19,(?,2 L p{y? 6, )1 Ve
City/Zip Code S51 ['I Q
Phone _ LY.rO.3.j-
Arch./Engr.
Address
'7- 15'^ I
OFFICE USE ONLY
FEES
Occupancy Bldg. Permit _
Zoning Surcharge _
Actual Const Plan Review
_
Allowable SAC, City _
# of stories SAC, MWCC
_
Length ? Water Conn.
_
Depth Water Meter
S.F. Total Acct. Deposit _
_ Footprint S.F. S/w Permit _
S/W Surcharge _
On site sewage_ Treatment P1. _
On site well Road Unit
MWCC System _ Park Ded. _
City water _ Trail Ded. _
PRV _ Copies _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
SUBTOTAL _
Penalty _
Lot Change _
TOTAL ?
City/Zip Code
Phone #
Sewer/Water Licensed Contr.
? 1n y??
?-c? 1?s-i.Q agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.