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967 Kettle Creek Rd Use BLUE or BLACK Ink For Office Use I j Permit `1 -7a City o Eap I 55,00 3830 Pilot Knob Road Permit Fee: II ~1 Eagan MN 55122 j Date Received: t2 10 l Phone: (651) 675-5675 I O-VI Fax: (651) 675-5694 Staff: 0 2010 MECHANICAL PERMIT APPLICATION Date: 1Z_ I D Site Address: (0 -7 / f , ~i C Tenant: Suite RESIDENT / OWNER Name: On e/_;e? Phone: Address / City / Zip: CONTRACTOR Name: 0. `f'f ~e i icense#: 8 Address: Q ? l~ f r City: 81~i y State: W 1~- Zip: Phone: l 9D-6J4 Contact: Email: TYPE OF WORK New X Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and giro u6 mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install / J Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ 6 Wt."-) TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) = $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ,TGC Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test -In-floor Heat -Final Exterior HVAC Screening Inspection CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT 7o be used for S! WA/QU Est. Value $Gt oom 1447 "s Receipt # 1 ? 7& ? Date D`cxmm 7 19,7 Site Address ?? ?U so" Lot s Block 1 Sec/Sub. MING= SMAU Parcel No. 7U AM. c Name 'roLL= CYTY Caft_ = Address b» 1 1?g iT. ? City 'A.Y. Phone 431-1211 a .o Name - u? ?Q Address' ?m City Phone "' ¢ u W Name WW ? =o Address . g W City Phone I here6y acknowledge that I have read this application and state that the information is correct and agree to comply wi[h all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signatufft ot Permittee _ A Building Permit is issuetl to: COLUM CITY_ CM_ on the express condition that all work shall be done in accordancewith all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building ORicial - OFFICE USE ONLY On Site Sewage Occupancy MWCC System = Zoning On Site Well (Actual) Const City Water x (Allowable) PRV Required # of Stories Booster Pump APPROVALS Engr./Assess. _ Planner _ Council _ BIdg.Off. _ Variance _ Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review sAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P7 AM(COPr) TOTAL ? ? rf YD 40 ? ? 367.a . 30.54 143.111 1oo.a_ s:s.a sts.a `7•(K? ws.oL'. 180•OU • 2 2dj.S: . .. BLDG. PERMIT I30. , . ,:_ _ f, ?? ,?- ; ?_E,? __%?. ?•??? 01 3210 Bldg. Permit 01-3422 Plan Check ? --- ?--' `J 01-3445 5urch./Adm. 01-3446 SAC/Adm. ? .J 01-2155 Surcharge 17-3860 Road Unit CD - r 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 kater Meter ? ?- 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 5ewer Permit 79-3866 5ewer Conn. 11-3855 Park Ded. TOTAL ? CASH RECEIPT CITY OF EAGAN 3830 PILOT:(PTOB ROAD EAGAN, MINNESOTA 55122 i DATE RECCIVED FROM AMOUNT $ ?' I . ` . 8 DOLLARS ?oo []CASH CHECK FOR\ BY ? 96 Z k; White-Payart Copy Yellow-Postiny CoPY Pink-File Copy Thank You INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: '+ f I i' I nf; 3830 Pilot Knob Road `' ri `''•? Permit Number: Ea an, Minnesota 55122-1897 9 Date Issued: (612) 681-4675 SITE ADDRESS: APPLiCANT: PERMIT SUBTYPE: TYPE OF WORK: Permit No. Permit Holder Date Telephone 8 ELECTRIC PLUMBING HVAC Inapection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TE5T FINAL PLBG fINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG ( t ?C? DECK FINA1. .: .. tgrr#ifiratr rf Orrupttnry Citp of Cagan luPpttx'hIlPltf D# g1ttlbttm jitwPlttDtt This Ceraficate issued pursuant to the requirements ojSection 306 ojthe Uniform BuiJding Cade certifying that ar !he time of issuance this structure was in compliance with the various ordinonces of the City regula[ing building corutruction or use. For the followrng: uw awneauoo SF ixlG%GAR elae. rtrnfit No. -! Oocupaacy lype 1: ; 7qoing Di+lria Type Cortu. owoerofBiulding fTft-?"Tre?_. pddreu E.?.,?'yt' 'SSI a,. BuildingAddrtas l.oality 13. J1, p,te: .'ANZJARY 27, 1988 suamng arK.;.i POST IN A CONSPICUOUS PLACE ?- --' CITY OF EAGAN . , 3830 Pilot Knob Road, P.O. Box 21 •199, Eegan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# ?" ??:': •'`i? ? To be used tor+ Est. Value ?1'? Date ??? ? t 987 i Site Lot } BIoCk i Sec/Sub. LinI??m SQUMR ITIN • Parcel No. : Name COLL= C_TY CMT W O z Addres? o City ' ' Phone 431- ,o Name ?i Addre a OFFICE USE ONLY u On Site Sewage Occupancy x st- MWCC System Zoning On Site Well (Actuaq Const w City Water x (Allowa6le) rit PRV Required # ot Stories Booster Pump Length ? Depth S.F. Total Footprint S.F. p- City rnone pppROVALS FEES ; 36r0? ? 6 yVj W Name En r./Assess. 9 Permit ?? ?0 ? = =n Address Planner Surcharge (aJ?? Q W City Phone Council Plan Review 100 00 Bldg. OH. SAC, City • I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 325•00 s13 ?? information is correct and agree to comply with all applicable State of n Ordinan Minnesota Sta[ut nd Cit f E Water Conn. ---- 6T -Oo es a y o aqa ces. Water Meter . Signature of Permittee Road Unit O'00 COLL= CITY Cnew x YV0'00 A Building PermR is issued to:. Treatment Pt on the express condition that all work shall be done in accordance with all ?Lar?? ?? applicable State of Minnesota Statutes and City of Eagan Ordinances. 2 Building Official TOTAL ? ?2?? •? -"- Permit No. Permit Holder Date Talephone it Piumbing _ ? , , ?, ? :/,:%j'• k.V.A.C. : Electric c-v (p ? Sottener Inspoction Date Inap. Comments FOOtlfl(JS I "??/ ? r Footings II Foundation Framing , ?. v, Roofing Rough Plbg. Rough Ntg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final c?s r/« cl ? y 4 f J,j ! C6ff. OCC. ?l e[ R.rt Lr ?. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. PERMIT # PLUMBING PERMIT CITY OF EAGAN RECEIPT q 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE Site Addre?s Lot = % Block JSec/Sub ? Name ?; E,, r Address ,:%7. c City ' Phone Name _ Address Phone_ FEES COMM/IND FEE - 19b 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 OF FOR: CITY OF EAGAN BLDG. TYPEj WORK DESCRIPTION.. Res. ? New --?? Mult Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLaWING: NO PIXTURES TOTAL ? Water Closet - $100 $ ? ?Bath Tubs - $3.00 Z Lavatory - $3.00 -Shower - $3.00 y Kitchen Sink - $3.00 -Urinal/Bidet - $3.00 Z Laundry Tray - $100 Z Floor Drains - $1.50 / Water Healer - 51.50 _Whirlpool - $3.00 Gas Piping Outlets - $1.50 ' (MINIMUM - 1 PER PERMIT) -Softener - $5.00 -Well - $10.00 - Private Disp. - $10.00 ?Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL: CONTI Site Ac Lot - PERMIT # MECFIANICAL PERMIT RECEIPT # ? CfTY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55722 DATE PHONE: 454-8100 m Name k- ! Address c City 1 Name rL_ oi ' TYPE OF WORK Forced Air Boiler Unk Heater Air Cond. Vent Gas Piping Outlecs # Other ? TYP BLDG Sub . E WORK DESCRIPTION ? , , Res. New Mult Add-on ,? - Comm. Repair Other M BTU $ M BTU $ M BTU $ M BTU $ CFM R R ' FEE: S/C: , TOTAL• FEES ? RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - &00 ; (RES. HVAC INCLUDES A/C ON NEW ' CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIr) - 1.50 EA. ? COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES i TOWNHOUSE 8 CONDOS - RES. RATE APPLIES ? MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ? REMODELS - 12.00 MINIMUM COMMERCIAL FEE ? - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) i I SIGNATURE OF PERMITTEE w FOR: CITY OF EAGAN d CITY OF EAGAN 3830 Pibt Knob Road P.O. Box 211.99. Eagan,'MA 55121 f Owr E Site € Plun f Permit No: Date: B/PNo: "' Date: MWCC: " 2oning? CityChg: ' No. of Units: Acct Dep: Permit Fee: I agree to comply wNh the City oi Eagen Surcharge: • 5`?T'•? Ordinances. By SEWER SERVICE PERMIT CITY OF EAGAN Permit No: 3830 Pilot Knob Road Meter No: P.O.Box21190 ' ReaderNo: Eagan, NiN 55127 Site Conet. eek Re Date: Size: Date: ton Sa 7th Conn. Chg: _ 525.00pd .,? Zoning: Acct Dep:_ Permit Fee: 15 •uoDa 10. OOnd No. of Units: 1 Surcharge: Tr. Plant . 5dpd 180. QOpd I agree tc comply with the Clty of Eagan _ Meter r Ordinances. Misc : 7 00€4 . BY WATER SERVICE PERMIT CITY OF EAGAN Permit No: f Date: 3830EilofXnob Road Meter No: ffg 3? / Size: P.O. Box 21199 Reader No: Q3 T?Ll/ Date: Z s'L ? Eagan, MN 55121 Owner. C;itv Geu SiteAddress: 967 hettle Cree': Eoa?' 311 '.(2::'.',: t= j'-? Plumber ?r" ???1 4 Conn. Chg: 525. OOpdf,,.,, g:,?i ,,,, ,.3{rbQROb, Acct Dep: 15. 00" ?IQf•l Permit Fee: - - rcharge: .5?Vnl j1??F)l8*e . Plant i00. JJD Ordina er 67 nn...a yly ?l I ith the CR of Eagan ; WATER SERVICE PERMIT I CITY OF EAGAN N°_ 14 4 71 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE:454-8100 ? ?j???9 BUILDING PERMIT Receipt# / To be used for SF DWG/GAR Est. Value $61, 000 Date DECEMBER 7 19 87 Site Address 967 KETTLE CREEK ROAD OFFICE USE ONLY R3 LEXINGTON SQUARE Lot 5 Block 1 Sec/Sub on Site Sewage Occupancy . 7TH ADD. MWCC System X Zoning Parcel No. Vn On Site Well _ (Actual) Const COLLEGE CITY CONST x Name Cirywater X (Allowable) Vn Address 6970 151TH 5T. PRV Required # of Stories 3 ? City A.V. Phone 431-1211 BoosterPump _ Length 40 Depth 44 , p Name SAME S.F. Total ?Q Address FootprintS.F. ? City Phone APPROVALS FEES ? W Name En9r./assess. Permit $ 367.0( Planner Surcharge 30.5( =Z Addf@SS Council Plan Review 183. 5( Q W City phone Bidg. Off. SAC, City 100.0( I hereby acknowledge ihat I have read this application and state that the Variance SAC, MWCC 525.0( information is correct and agree to comply with all applica6le State of Water Conn. 525 OC Minnesota Statutes and Cit vof? gan Ordinan es. 67 0( ? Signature of Permittee Water Meter Road Unit . 305.0( A Building Permit is issued to: COL GE CITY CONST Treatment P1 180.0C on the express condition that all work shall be done in accordance with all ??1c(copy) . 5C applicable State of Minnes ot a S j ? tut es and City Eagan Ordinances. / ? ? ( J ? , TOTAL $2 .283 5? • Building Official__S?'6t?la ?- J .o4uesl void ? PO /'J 0 18 months trom D 0 7 6 `? 27 J. .' !aI , M . Renuest Dale ' Fire o. Hough-fri.l spection flequiredl ` ?Ready Now ?WIII Notify, Inspec- m Wh R /S r ? ?Ves No r r.n eadY Licensed EIecVical Contractor 1 hereby requastinsoection o/ above ?j Owner alectrical work installed at: $treet Address, Box oRute N 7 ? f ` 9 11 Cit?. cc c a?> , ? L ?/ ecLOn o. Township Name or No. Range No. Cnw / 9 o TA OccuOant (PR T),., ? Cy r ' PYwne No. Power piie A ? 1 CX Addr?e ? 0 A a eG Electri I Contractor np any Nam9l?• !/v/jJ7 L°/L GG ? C tractor's)L(ic?ense No. ?? d O Mailing Address ( Mraclor r Owner Making Instal Au[horize i nawre on r tor Opner Making Installation) Phon Number N ?Y MINNESOTp STAfTE 80AflD Of ELECTRICITV THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N•191 BE ACCEPTED eY THE STATE BOAHD 1821 Universitv Ave.. S1. Paul, MN 56104 UNLESS PROPEH INSPECTION FEE IS Phone(612)642-0800 ENC?OSE?. REQUEST FOR ELECTRICAL INSPECTION ? es-oooot-os ? , ,..? See ine4ructions for completing ihis torm on 6ack Ot yellow copy. 76927 "X" Below Work Covered by This Request New AAd Rep. Type of Building APPlinncea WifeA EquipmBnt Wir¢d Home Range Temporary Service Duplrx Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldy. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othror oeci v OtherlSnecify) 1 .r SVeci(y Other Othcr Cmmnute lnsnectinn Fae Ralnw M Fee Servic En rance Size H Fae FeadersI5ubteeders k Fee Circuits 0 Amps 0 to 30 Am s •? 0 to 30 Am s A ove 200 qmpy 31 to 100 Amps s,cYi 31 to 100 Amps Swimmin Pool Above 100_Amps Above 100_Am s Transiormers Irrigation Booms .t Partial.'Other F Signs Special Inspection ? J? TOTAL E / flertw?rks `? ? l0 ?- Rough-in C)ate?` ?^? 1, the Elecirical Inspector, hareby certify thaf the a6ove Final } inspection has been d . me e. This request voiA 18 months from RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN ? 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConsWction Reauirements • 3 registered site surveys showing sq, ft, of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 capies of plan showing beam & window sizes; poured found design, etc.) • t set of Energy Calculations . 3 copies of 7ree Preservation Plan ii lot ptatted aRer 711(93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE SITE ADDRESS TYPE OF WOR APPLICANT ! ?- fi? IULTI-FAMILY BLDG Y vN FIREPLACE(S) _ 0 _ 1 _ 2 STREET ADDRESS `k,? j TELEPHONE # ?ISZ-7y?,-t?cgo CELL PHONE # ? -7 G7? RemodellReoair Reauirements • 2 copies of dan • 1 set of Energy Calculations for heated addi6ons • 1 site survey for extenor additions & decks . Indicale if home served by septic system for additions VALUAiION ? i ??r 0 (f) CITY ?Z°G iK STATEH k ZIP S' 3S?y FAx # 9C7-" Zy6 PROPERTYOWNER ..-? vGtk ?d k ` TELEPHONE# ?U-('I°33Z -'17%? ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY L MINNESOTA RULES 7672 (d submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Enveiope Calculations Submitted Plumbing Contractor. ___------------- _ Phone # _ Plumbing system includes: Water Softener _ Lawn Sprinkler Fcc: $90.00 WaCer Heater No. of R.I. Baths No, of Baths ? Mechanical Contractor. Phone # Nlechanical system includes: Air Conditioning rec: $70.00 Hea[ Rccovcry System Sewer/Water Contractor: Phone # °^ fP- ^ EI ?' =; .n l5 -------------------------------------------------------------°---------------------------------- j?"'? I hereby acknowledge that I have read this application, state that the information is correct,agree?o comply with all applicable State of Minnesota Statutes and City of Eagan Ordi ?? Signature of Applicant -- - -- - -------- - ---- - ---------------- - -- - --------- - -------- - -------- - ---------- - -- - --------------- - --------- - -- - ----- - ----- - ----- - -------- - - - -- OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 OS-plex ? 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool 0 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bidg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. p 42 Demolish (Foundation) C] 45 Fire Repair ? 33 Aiteration ? 37 Demolish (Bidg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bidg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Canst W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) Plumbing _ Foundation HVAC _ Drain Tile Other Koof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MCIES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Piumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector ?-CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMITTYPE: BUILDING Permit Number: 0 2 8 3 2 9 Date Issued: 9 7/ 2 2/ 9 6 967 KE7TLE CREEK,RD LOT: 5 BLOCK: 11 LEXZNG7tlN SQUARE 7TM P.I.N.s 10-45081-950-01 DESCRIPTION: DECK NEW 434 AL.T. RESIDEMTIAL e ?c *?P Yi, i ?,l ,? iix 'i aszi3 kL .A'?:,3 Q?L°I•'?" tR ? ?. st+tt? g?; c?sr actm1k ??r?ry?? ?:?"a!x•. ? .?ro? REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee CONTRACTOR: $45.00 $.50 $45.5@ APPLICANT/PERMITEE SIGNATURE OWNER: - APPlicant - GRAY KENNETH 967 KETTLE CREEK RD EAGRN MN (612)456-9056 ISSUED BY: SIGNATURE CITY OF EAGAN `3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESiDENTIAL) 681-4675 BemodellRenair Reauirements ? 3 registered site surveys ? 2 eopies ot plan ? 2 copies of piens (indude beam d window sizes; pou2d fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks) ? 1 energy calculatfons ? i energy calculations tor heated edditions ? 3 copiea of Uee presenstion plan N bt platled after 7/1193 required: _ Yes _ No DATE: ?) u 194 1q% CONSTRUCTION COST: ???0p tr m I -D DESCRIPTION OF WORK: STREET ADDRESS: lE.cf-1-1 e L. rer,;!? LOT S BLOCK ' SUBD./P.I.D. #: • v PROPERTY OWNER CONTRACTOR ARCHITECTI ENGINEER Name: 6y4 J2_ P h o n e y?T - ? e) 5? N., .M.. Street Address- '76 ??e City: State: A) Zip: s Q. eyi C_ Company: ' Phone #., - - Street Address: License #: City: State: Company: ?' Name: l?? 1 Zip. Phone #- Registration #* Street Address• City: State: Zip: Sewer & water licensed plumber: . Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that f have read this application and state that the information is coRect and agree to comply with all appllcabie State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OFFICE USE ONLY ???ENED Certificates of Survey Received _ Yes _ No • .? ?? ; __u_ _?_ ????, Tree Preservation Plan Received _ Yes _ No . -? _ _ _ _ - :l?c? OFFICE USE ONLY ._, BUILDING PERMIT TYPE ? Oi Foundation ? 06 Duplex 0 02 SF Dwelling a 07 4-plex 0 03 SF Addition o 08 8-plex 0 04 SF Porch a 09 12-plex n 05 SF Misc. a 10 _; plex WORK TYPE W'3?New n 32 Addition o 33 Alterations ? 34 Repair GENERAL INFORMATION Censt (Actuan (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS 0 11 Apt./Lodging a 0 12 Multi Repair/Rem. ? 0 13 Garage/Accessory o a 14 Fireplace o GP%15 Deck a 36 Move 0 37 Demotition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous v+J Basement sq. ft. ,\/1 Main level sq. ft. 72-3 sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee Surcharge Plan Review License MGWS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pt. Road Unit Park Ded. Trails Ded. Other Copies Total: MCM/S System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Valuation: $ 4/ A1 n! I D % SAC SAC Units ?TRI-LAND C0. suRvEYiNG SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 SITE PLAN FOR: COLLEGE CITY LEGAL DESCRIPTION: LOT 5,BLOCK I , LEXINTON SQUARE 71h. ACCORDING TO THE RECORDED PLAT SCALE= I"= 30' THEREOF DA KOTA COUNTY, MINNESOTA ? \?o 93 "'7 V"c 4nt ,.4. C) ?l° h? % I .? - r_ I: 2 : 11 ? ?Q /49s? / ? us`. /3 N LN 'r + ? 9- ? a? •?-? .? LEGEND o DENOTES IRON MONUMENT o DENOTES WOOD HUB SET DENOTES EXISTING SPOT ELE VATION DENOTES PROPOSED SPOT ELE VATI ON ? DENOTES DRAINAGE DIRECTION I hersby certify that this survey,plan or report wus prepcred by me or under my direct supervision and that i am a duly Reqistered Land Survfror undsr the Laws of the State of Minnesota. / / LOT 5 8. s V> 0 ? `v9 Fs. Ro0F \ 4 "O l3' S a A qz? RAX a ?fF0, c qe 893,c7 0 Sk , \\9yr7 ? / / G4" 4e 893x ,?+?•, y?o ''4 c 414 ?1 s e 5, 2 \? INVERT ELEVATION AT SERVICE EXTENSION= PROPOSED GARAGE FLOOR ELEVATION = 8=9S20 PROPOSEO FIRST FLOOR ELEVATION = 9?t5 s.?o PROPOSED BASEMENT FLOOR = ELEVATION NOTE'• VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS Brndlei?JSwenson, Mn. Rey. No. 15235 Date : ??i 2111Pn CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS : LEGAL DESCRIPTION: L ? ? I e n *ATE: PA)nIF'Nfi` OF k'EE AT TIM6 pF APPLIcAazoN noFS Nar aoNgrzTUTE APPROVAL OF PERrIIT. INSPECTION OF SE.WER AND/M MTFR IINSTA7.ra,mrpNS WML NOT gE SCEgD- UIED UNTIL PERMIT FIAS BEFN APPROVID. _ tLOL/rslocK/SUbdivisidt? or Tax arcel ID ) IF EXISTING SI'RC'C'MME, DATE OF ORIGINAL BuILDING PERMIT ISSL'ANCE: ; PRESENP 2ANING/pROPOSID LSE: ftn Year . .. q corNERcuL/RErAs,/oFFzcE [I INIDL?STRIAL n INSTI2L'TIONAL/GpV?N'p 2) ? NAN1E: ADDRESS: CI'PY, STATE, ZIP: PHONE: 3) • i: ?- NAME: ADDRE.SS; CIT3t, STATE, 2IP: PHONE: E R-1 SINGLE FAMILY ? R-2 DUPLEX (Ztao Units) R-3 MWNHOLSE (Three + Units) ( Lnits) R-4 APARTTENp/COI+IDOMINIDM ( Units) ? MASTER LICENSE# 33 ?j 4) .• • i?- ? NANIE: X-1?LL+cLS i-acense: Active EScpired Not recorded Staff 7nitial / _ ADDRFS.S: CITY. STATE, ZIP: . PHONE: -5) IPICONNECTION 10 CITY SEWER ?CONNECTION TO CITY WATER ? pTfIEIt '. ? 6) slief. •?' PLEASE HOID APPROVED PERMIT FOR PTQi-LTP BY ONE OF AHOVE --- -- --- q PLF?SE APPROVED PERMIT TO 1, 2t 3, 4, ABOVE . ' 7) (Circle one) ' t fOR CITY USE ONLY PERMIT # ISSUED I ?;lj ?;_V Pd w/Bldg. Permit FEES: $ $ 0 . .?? $ $ 16 • j? $ 7, QO $ $ $ $ $ SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SIIRCHARGE) WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP (INCLt'DE CORPORATION STOP) SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ $ WAC $ G? ?-.?• U?? $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRL7NK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER T - TREATMEPI PLANT SURCHARGE $ $ OTHER: $ / .3 TOTAL 47 c4o, RECEIPT RECEIPT DOES LTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F__j' YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q NO ROADWAY" MUST BE ISSLED By THE ENGINEERING DIVISIO N. LIST AS A CONDITION. SLi BJECT TO THE FOLLOWI[VG CONDITIONS: APPROVED BY: /--??rL /) TITLE: DATE: 14 /a q? A 7 - I VV 1987 BIIILDING PERMIT PLI ATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS - INCL[1DE(DE.TS OF PLANS4a?CBRTIFICATES OE SQEtVEY, 1? ST OF ENERGY CALCQLATIOAS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTORlHOMEOWNER MIIST DESIGNATE WHICH ADDRESS I IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSQED. MQLTIPLE DWELLINGS - RESIDEAITIAL RENTAL DNITS FOR SALE ORITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECg WITH BLDG. DEPT., 1 SET OF SNERGY CALCULATIONS CO.MRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL:PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND Sir,ylb Fauily, it To Be Used For: du-fnCAttQ., N2w-HoAv- Valuation: ?'?^ Date: Site Address q?7 KR.'?'(Q. CY&k A.& - W/ Lot .? Block ? On Site Sewag t,,-' ??.?, MWCC System Parcel/Sub 'c.l? On Site Well City tilater Owner Address ?z-? ?.lA?.X ? • City/Zip Code EQ a.lti Jr `J 12-3 Phone ?5 1, - 9 54o APPROVALS Contractor C a I i.2 L 044 e o nG+ruC-h i5?^ Address ta9`y6 151 Sf ,??'• City/ZiP Code Aaa4 L", rneu 55124 Phone 431Jo?ll Areh. /Engr. SCt'YkQ, G. S O(A kQh Address City/Zip Code RW'D A?? 1987 e Oceupancy P- 3 ve Zoning R -I Type of Const (Actual) v-N (A1lowable) Y-H # of Stories Length qo, Depth S.F. Total Footprint S.F. FEFS Assessments Permit 36 7,00 Water/Sewer Surcharge 30,50 Police Plan Review 183.50 Fire SAC, City LDp,pp Engr SAC 9 MWCC '15s,5, ov Planner Water Conn 5zS.00 Council Water Meter 67,00 Bldg Off ' l2 13 Road Unit a, 00 APC Treatment Pl I_$p,Da Varianee Parks Copies ,SD - TOT9L E-62YA .5 Phone 4k GARAGE Zo X2? _ ?lt?t7 X/2 = ?g01? , ?- ?OL(Se 7- `! X t-l O = 5Ay t xio = 56a x Sg = S SGBo , . lx?o = loxyy s 4 yc? d v y Z? i ,. ?,;,r • uu;. tiu+ 1 f,i 5,.; U r UU ? r?.?.> • UU-;- r;'j•?lii, 1 r;t) • Uil : , . T RI - LAN D C 0. SURVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 89s%, LEGAL DESCRIPTION: LOT 5,BLOCK I , LEXINTON SQUARE 7th. ACCORDING TO THE RECORDED PLAT SCALE= I"= 30' THEREOF DAKOTA COUNTY,MINNESOTA N i?/? \4?s 0 qs *'1 v^ c 4.,. ,. ?. ° /\0 .00 1 0•: tso 60 / / . / ? ?Q ; F? ? Nk? L. / \ Fn V' 0 ? v°+ . °s O 'p"0 ? a? .n. SITE PLAN FOR: COLLEGE CITY ^ ? ? sg ?o s / LOT 5 ? s,sos? o,? . ? A ? 6 q Q'o'Jt 0O Fo. a? o l?. c 5 /?•? ? k 893x7 \ \ ` 89yx7 ? ? ?` ?ara ? F. \26b0a, O V GY`?? 6 vq ? . 4nr 893X s ! y 2 \? LEGEND o DENOTES IRON MONUMENT * DENOTES WOOD HUB SET DENOTES EXISTING SPOT ELE VATI ON DENOTES PROPOSED SPOT ELEVATION ? DENOTES DRAINAGE DIRECTION I hereby certify ihat this survey, plan or report was preporod by me or under my direct supervision and that I om a duly Re9istered Lcnd Surveyor under the Laws of the State of Minnesoto. Bradle,?/Swenson, Mn. Req. No. 15235 Date : !/? I f- -r L,, , r INVERT ELEVaTION aT SERViCE ExTENSiON= PROPOSED GARAGE FLOOR ELEVATION = B PROPOSED FIRST FLOOR ELEVATION = 45,,.7b PROPOSED BASEMENT FLOOR = ELEVATION NOTE : VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS , oWNEa I LzTrniaa. ENVELopE ntEancE "w" coiirutnrIori cownIDZA stTE nouaESS % ?aq a.,4- j {!lI I, . 551 ZZ_ , COfI1MCTUlI COLLEGE CITY C0lISTRUCTION bA1E b 7 DIIUf1E 612-431-1211 . •' • . , . . Oetermine working square footage of each. 1. total exposed wall area'...... 17ZP-) sq. ft. x_. / /90,vr- .2. Total roof/ceiling area ...... `jbO sq. ft. x=?0??? -Total exposed wall area abave flovr =_?`7 2 E• a. Total wall wihdow area ........................... i b. Total door area ................................. . ?: -. . c. lotal sllding glass door area ................... ::? • d. Total fireplace wall area ........................ • e. Total Wall framing area (average 10%)........... P. Total net wall area above floor ................. ?:'fl.•?;?:?'? g. 7vta1 rim foist area ............................ B 6 tl Tvtal-eicposed foundation area ? 85.7o76I .,. . h. 1ota1 foundation window'area.:.........:......... .. ? 1. Toal net foundation are"a abovq;grade ........:... 8,4.3 ?(o ` .. I petermine "U'value of each wall segment. . , _ a. I4-I,b?,9' . X „ull . A-9,017 , , . b; 16G7 x „u,e , Ize = 42._.-3 . C• O ,x itU„ • • J • {J Q ,111 V 11I! A w a ? ' . e. I 7z . So z Jou,e . 09 z ? ( 5,697 . f. (291. 4-88 X loun o4-3 = 55 S?Z g. 13 5.37(o X "ult. ?Od-) ? 3•`? . , ' h . • V v Mu11 ? ` . ? ? I. S s.37 b x„U„ .079 3 ............... " Total ...................... ° ? I?5.3?. If item 13 1s the same as, or less than.item 11? you have met the tntent of SE3C 6006(c)2. . . . / 5 , ,. ? , . .•. • , . . ? . . ... . Total..exposed roof/ceiling area ? 9 G4 ' ?. Total skylight area...........?...:............. . k. Tntal rooflceiling iraminq area (average lOX).,. 9(e; p 1.. Tota1 net,insulated roof/ceiling area..::.......?? p . • p0termine,`U" value for each roof/ceiling segment. , ? ? ? p • x uUu - e . -. , .. . k. 96 x '#lu„' ,174- ? I6.?104- . •, , 8bd-.,00 X l,Ull'. vZZ . ' ? Iq.oo3 C a 0 0 10 0 4• 6 6 9 a 6 0 0 0 a a 6 a 0 6 a 0 a 0 6 0 a 61 Otal ? -.'? J.??L • , ' . lf total of 14 is the sarpe as, or less than (2, you have met the intent oF , SIlC,60U6(c)1. ' Alternate Building Envelope besign To uttllze tlie total envelope system method, the values establislied by tlle ' sum of items 03 and 14 sha1.1 nnt be greater than the sum oF ltems .'1 and 01, ?._ 19 CiP.2g+ zrS, Pq 3._ 4. . . , . . . . . . •.?• ? ?.?.?.?....?. ?a??? ? . . ? ' . . . , r? ? . • u...???.??.r?.?.??. . . ? . . • •. ..... ?.??..?......? ... ' ' ? ? . , , J ? ' ....?..??..?'._?.? .. . ? ? , . . . ?' ??._...??..? _?'?' ? • . . , • ' ? • . , . . i . , , . . . ? . ? . ?. • ? • ? • .. .? ? ' ? ' ? ? , . ,.1 V N • u AN D? V AL E. AN.41.. Y S l:s 01:?? ? S ccT? ? a/5 R ? M Jo I S -r 1? rt F. A : "R" - vA L uE •(Ol _I nltF-F- l02 ,,1P- /P1L M 4-0 1 NSU LAT)ON CP•!q ) Z. a(c 2-S Z SHEATiu4 ?v ?.T-_,(Z?iG .,?o 7 LaP siar?a 4 - ?Z,i _ l, 98 ),h" SoFi'wvo? . 17_f ,crfR. 10 R A r+? 2?Tor n c-' R.-?• VAr-u.c TbTA? F?ri.c,? 1 OUKI D AT ION WALL- AREA CADovc qRAoX.D ,. 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FOOfAqG ¦ SLIDINq (4-LA55 Q70g AI2&A: 'rYpc. aP DaoR: $/g /NSuC-?G G..• SL lOlal%Q 4L459 L?OORS 140,VL O!R'/ 7i,ST4R FoR"R=VAL•Kry TNCYAItiQ'?.1 L-'M*SO A80?R AeJO M?1y ?1O H.3.St tiN?.p A VIS I G?PIGiA?'[) ?/AL.KL o1L 'R."• •ZBJ .?r. Alo FILr'l$ Ny? . ?J'?1a = 1/ _1=331= Fveri 4 cr ' DooR. Artca : 7YPe p` DooR ; 7'N e¢-uAf• =T"rz,u pO0[Z UNI'TS HAY(- 6f-fN TLSr[O .?.10 fouyA To HqVt A0l VAULtIL ois T. B I _! ?Nq Ala ao1,.Mi, , Z ? FODTA?.c R. ?+ I}?? ? ?/Rd? ,5PEc/qLs ; . TYPE ' , waM c-? ,?nu,+.q? ' pqr?•. s?NEc? - 3 ? 5 cJ'1-u:D / FRAM iN4 vA L ue _?Lrvre*oR aIR Fi." .4_5 t z G Vr.su M wAc"001+10 ?, 9-15-5 sor r rvooc Z.06 ?b I?AP siciuc, 2 ` VAFWL 6ARArt•¢. rreRIa? ?IX. f,"M t?. 83 o rA L' R...#; /Axac. `'?, =1/a..? . 1 / "0.9?.5 • .O To rAL PoorAG c i ?NSU.C.ATE-o ARlA B&TWiLaM 57I640S ,.R.._ vALwL • . bl iure.aiorr ^IR rluM i 11 ' . 45 Z- 4Y psum y?/A??.peqQ.o 19,0 IusuLwr Ia•r [R,19 ) Z.o?o 4?/ SNtA TM IHfi $VILTR.1"Cs , b7 IA. s1 0 104 G LRP •ir1.1[.19M /1iR Iryt,M Z 2. D T A L PUw j. YA LuAL- ??.,a.,?,,, , ?, Z Z.q b. TOTA L lbOfA 4L h ?? IWG".1t, Unrc; 5'4uLo_. G ? 5 .. •R•. vA Lu & ,bl .INTE91oR ^IR FILM ,375 3?z. soRrwaoo 5/B GYPSU.M WALc.boA4D -_ " vA,PaR 17 I NTLrR loa. AlR P14M S, -135?T07 A L " Rwi VnLu-E - ro7AL FmrA49 zIJSt1LA7t? AREA i5rj-tW"N tHE X01ST-5 "R" • 1/ALtA.C .?IWrERiOR AlR RII.M 00 ??I N3?1.LATION •?,6 4YPSUM wAu.adaao VAaaR DA01L4M¢. ?? 1 N rE R 102 AiR f?4 M 453roTA4 "R.?,?' vaLu.L 14,, : Ixz = i/ ?-S,3lo = o?z l4DTA6 worAc-e. 0" A, 1 •/n/1b Rtr pArrr siyANd____-_--- -- -- ._. 566 PERMIT City of Eagan Permit Type: Building Permit Number: EA104832 Date Issued: 06/12/2012 of 1(]D Permit Category: ePermit ~It~ E Site Address: 967 Kettle Creek Rd Lot: 5 Block: 1 Addition: Lexington Square 7th PID: 10-45081-01-050 Use: Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing Comments: inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $4K $103.25 0801.4085 Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195 Total: $105.25 Contractor: Owner: - Applicant - Home Depot At Home Services Tin Nguyen 656 Mendelssohn Ave. N 3389 Rolling Hills Dr Golden Valley MN 55427 Eagan MN 55121 (763) 542-8826 1 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. Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink _ _ - - _ _ _ - - _ _ - - _ i 'Ilk f1f] I For Office Use I Cit 01 EaRtIR I Permit y I Permit Fee. V I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: U 2-. l3 Site Address: P-4 -Unit 7 2 2-m Name: ( Ivey-((r/~= Phone: 9 f 2~ Resident! Owner Address / City / Zip: 3 r('y~~~ r`N ext,,1~ / Applicant is: Owner _IK_ Contractor Type of Work Description of work: {pro " S'1 l~ U C) Construction Cost: [3~w Multi-Family Building: (Yes f / No Company: y Pcults (-ut ~i n - d k,-7 672k Contact: °lfk-A~ P yr Contractor Address: City: p: s ri q + 4(2- 6 State: Zi / Phone: License ro Lead Certificate 3 If the project is exempt from lead certification, pleas explain why: (see Page 3 for additional information) s s i COMPLETE THIS AREA ONLI 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: L Sewer & Water Contractor: Phone: I 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 th t they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. o herstateonecall.ora 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 Minnesota State Building Code must be completed within 180 days of permit issuance. x `HT x Applicant's Printed Name Applican Signature Page 1 of 3