988 Kettle Creek Rd
Use BLUE or BLACK Ink
r
For Office Use/ / 7
~ q`-7 City of E(] (]j~ I Permit#:
I~ - 1
I Permit Fee: Cc) 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: to ``~a \-v /,C> Site Address: 77&. C - ~~rC X6ic.-
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address/ City/ Zip:
Applicant is: Owner ~ Contractor
TYPE OF WORK Description of work: f`{.%TCo-t>r
Construction Cost: 0 Multi-Family Building: (Yes / No >c )
CONTRACTOR Name: d# IS License
Address: ,3l J~ PC City: Wit= ~o~ L-C
,5C ?
State: t"j Zip: Phone: -
Contact: Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gol)herstateonecall.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.
x OY 1J 1114,16-1-UV x
Applicant's Printed Name Applicant's Signature
Page 1 of 2
IBLDG. PERMIT NO.
L/:,?-- 11 ,, j
' 01-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
01-344¢ SAC/Adm.
01-2155 Surcharge
75-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
h Y
U
?
/o o ID0-
TOTAL c
CASH RECEIPT
? CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
`
DATE ...-? . ? .? L... (?' .
/ . /
? T'-f47
7
?
,
7 ! C•
i
Thank You
BY . 4,
White-Payers Copy
Yello?PosGng Copy ?
Pink-File CoPY .
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 ?` 7•? ? ?jucl Date
SiteAddress yii? KnITLE: Clci:EK RD
Lot 7 Block •' Sec/Sub. LEX1KGTCh 771
Parcel No.
a Name fL'STf1:•: i10P4E5, ZNC
W
=
Address i' BO?; lt)yk)
? City Bi'8:10VIl.I.E Phone 454__9383
, o Name 5Af!f;
? ? Address
? Cify Phone
? W
W Name
?y
_z.
Address
,
U
e Z W
City Phone
t hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State bf
Minnesota Statutes and City ot 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 Official
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System X Zoning
On Site Well (Actuaq Const
City Water (Allowable)
PRV Required # of Stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Feview
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P7
Parks
TOTAL
?9 3fil 4
J tl e
'19 Z'?
k-3/id-4
Pv x-?
V-ti
V--m
551
409
243.'v_
100, i'r' `
550.:
550.c;
61.("
(4.11.
?ACTI1l4LTED FOR DECK 9/20/88 CITY OF EAGAN
" NWE'tiBD 3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
,UL OBERHAUS 452-6756 PH ONE: 454-8100
BUILDING PERMIT Receipt#
To be ua" for Est. Value Date ,19
Site Address
Lot Block Sec/Sub. '-
Parcel No.
a Name "
z Address - '
o `
Ciry Phone
o Name_
? ` Address
? City_
Address
City
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
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 Otficial
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System ^ ZoNng I
On Site Well (ACtual) Const
City Water _ (Allowable)
PRV Required _ ik of Stoiies
Booster Pump _ Length
Depth .
S.F. Total
Footprint S.F.
I APPROVALS
Engr./ASSess
Planner
Council
Bldg. Off.
Variance
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
,' .
.?.-, 3 .
55C
' Permit No. Parmit Holdsr Date Tslephons #
, Plumbing •
H.V.AC. C??? c u? ?/8 0
Electric
WAAdn.'t_c.Gt.?
Softener
Insprction oate Insp. Comments
Footings I
Footings II
Foundation
Framing P D g)yo ,-e;-2 yT?,
Roofing
Rough Plbg.
Rough Htg. .y ?
Isul. AO--
Fireplace
Final Htg. 2
Final Plbg. 7fj
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg.
DeckFinal Fl./,C. /?S 9 fiet'l
Well
Pr. Disp.
?
+t ?_ _.-?+?•"?
(Irr#ifiratr of (Orrupanry
titp of eagan
EP}i8TbliPltf of lIrilbiltJ lI16}1PtftIItt
This Cenifecate issued pursuant to !he requiremenu ojSection 306 of the Uniform Buikling
Code cenifying that at the time of issuance thir strucrure was in compliance wllh the various
ordinances oJlhe City regulating building construclion or use. For rhe following.•
Ux Clcvifintioe SF 9X`AR Bldg. Rrmit No. 15304
OmupanY TYPe R3"M11 Zomng Disaict :v?IC` ? Tra ?? ?
o»ne.oreudding WLRO QiSICM NO1ES aaaP.O. HOB 1(Y+9, BURNSVIIIF
euftnB naa.ess rTiFMK R(]AD Local.h' L,, B2, IF.XI.NGICRd SJ[JARE 7TH.
Wte:
Bwlding Otririil
POST IN A CONSPICUOUS PIACE
n.???e J ' '.
' . .,.. . .
' . . .. .
'
f • • ' . ` • - PEHMIT #
MECHANICAL PERMIT RECEIPT ii
CITY OF EAGAN
3830 PIL OT KNOB pOAD, EAGAN, MN 55122 DATE:
I, CONTRACT PRICE PH NE: 454-8100
I Site Address
Lot Block r
Sec/Sub
X BLDG. TYPQ- WORK DESCRIPTION
Res. New ?` ,?
°
' Name i' Muft Add-on
-
m
Addres8 "
"" !, • , Comm. Repair
c City g: n? ,4 .,,w_? Phone i- Other ;
FEES
Name RES. HVAC 0-100 M BTU -$24.00 '
3 Address ADDITIONAL 50 M BTU _ 6.00
O ? Phone (RES. HVAC INCLUDES A/C ON NEW ;
-' • CONSTRUCTION) +
GAS OUTLETS
MINIMUM
PER PERM
T
j
(
- 1
I
) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1a/o OF CONTRACT FEE
Forced Air ? M BTU APT. BLDGS. - COMM. RATE APPLIES ?
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES '
Unit Heater
M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 ?
Vent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES I
Gas Piping Outlets # BEYOND $1,000)
Other
FEE: -
.
S/C: SIGNATURE OF PERMITTEE (,
TOTAL•
FOR: CITY OF EAGAN
, PERMIT #
PLUMBING PERMIT "
CITY OF EAGAN RECEIPT # '
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PRICE: PHONE: 454-8100 `
Site Address F -=?
Lot Qlock Sec/Sub _
m Name
?o Address
c City ?.-
Phone
.
Name i4 . ?.
;
o Address
c.ry Phone 'i ?- '
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 PERMITTEE
CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. ^5: New ?
M u It. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
?Water Closet - S3 00 $
J_Bath Tubs - $3.00
?Lavatory - $3.00
-Shower - $3.00
J-Ki!chen Sink - $3.00
-Urinal/Bidet - $3.00
I Laundry Tray - $3.00 -
_i Floor Drains - $1.50
-1-Water Heater - $1 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: c;
STATE S/C:
GRAND TOTAL• " ?
q
t
CITY OF EAGAN Permit No: Date:
3830 Pilet Knob Road Meter No: Size:
P.O. Box 21199 Reader No: ? s Date: 4'1
Eagan, MN 55121
Owner. 'tetr?? i:<<stoui }i,}a:ey
Site Address: r?88 Kettle Creek Road L7 B2 Leaineton Sa Ith
Conn. Chg: ;Sii _ COnd Zoning:
Acct. Dep: 0x0n0 No. of Unils
Permit Fee: -- 1 tl _ tl(lnd
?
Surcharge: _ 5!1ra 1 agree to comply with the City ol Eagan
Tr. Plant_ 9;;4 Q flnd
. Ordinances.
Meter.
Misc.: gy 'vV
WATER SERVICE PERMIT
,CITY OF EAGAN Permit No: sDate: ' 3-88
3830 Pilot Knob Road g/p Np; ':53(4 Date: 7 -,-A° ' P.O. Box 21199
Eagan, MN 55721 ?
? Owner. .^t3s'a;-: Homes
? SiteAddress: Fe?:"te i:IP-et: FOdrT L% 77 i,@7jmnrcn i
Plumber: 0I-Ber,,7 ;,ce?:'ler °_v.c
?
MWCC: ?'O.OO"n:i Zoning• =1
City Chg: 110, nonG No. of Units:
Acct. Dep: 1 S. Oa;pt! Permit Fee: 10• W)Pj I agree to comply wRh the CHy oi Eagan
Surcharge: Ordinances.
Misc.: By
SEWER SERVICE PERMIT
? i
CiTY OF EAGAN Permit No:
Date: 7 7
?
3830 Pilot Knob Road Meter No: Size:
P.O. Box 27199 qeader No: Date:
Eagan, MN 55121
Owner. t_e:ro Cast^- ?•?•-?;:
Site Address: 988 Kett? oad L7 82 LuiaAton 3q 7t5
Plumber 01• Setgf;:
Conn. Chg: 55 0.0nd Zoning: R
Acct Dep: 1 5.2Oew1 No. o( Units: 1
Permit Fee: 1 0_00td
Surcharge: - SvFd I agree to comply with the City ot Eagan
Tr.Plant -
Meter
s )4_hnPd Ordinances.
-
.
Misc: T;A!
By
WATER SERVICE PERMIT
CITY OF EAGAN NO- 1 5 3 0 4
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55 121
PHONE:454-8100 Q?3 ?
B UILDING PERMIT Receipt# u
To be used for SF DWG/GAR Est. Value $78,000 Date JULY 6 /1 g 88
Site Address " 988 KETTLE CREEK RD OFFICE USE ONLY
Lot 7 Block 2 Sec/Sub. LEXINGTON SQ 7TH On Site Sewage occupancy R-3 /M-1
MWCC System X Zoning PD R-1
ParCel No. On Site well (ACtual) Const V-N
m Name METRO CUSTOM HOMES INC City water X (Allowable) V-N
z Address P 0 BOX 1049 PRV Required # of Stories
3
0
Ciry BliRNSVILLE Phone 454-9383
Booster Pump _
Length
55'
Depth 401
, p Name SAME S.F. Total
? Q Address Footprint S.F.
? City Phone APPROVALS FEES
?
W w
ame
Engr./Assess.
Permit
486.00
? z
Address Planner Surcharge 39.00
_?
¢= City Phone Council PlanReview •
aW 100
00
BIdg.Off. _
I hereby acknowledge that I have read t' ?ilication and stat e Variance _ jjjr information is correct and agree t iFh-31T`ap ' tat I
Minnesota Statutes and City of rdin
Signature of Permittee
A Building Per A issued to: OMES ? INC
on the expres condition that a workshall be done in accordance with all
applicable State of Minnesota S'Ita,?tutes and City o( Eagan Ordinances.
Building Official?.t?1,_I ?L
SAC, CIty
SAG MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
550.00
_ 550.00
67.00
125_nn
?n[L nn
2.564.00
This request void ?1//Od
18 monihs frOm ? ? O
E 2 8 4 3 9
Req _pa?e
r, ^
?
? Fire o. ouPh-inns tion
equired?
[]ReaAy Now [j WiII Nolifv. Inspec-
r
'
(J O ?Ves No tar When ReadV
censed Electrical Co??traceor I hereby request inspection of abova
? Owner eiectrical work instelled at:
?,r??j
$RFA,et %1 ,Qbdlgss, Box Route No,
L %
VJ? ' II
J V ?
CitV ?
- /?-
?
G
L
ecuon o. Towa hip Name or No. Ranee No. Counry
OccuGant 1F'RINT Phun No.
-?I383
Power Su '? ?
. Address
Electrical ConVactor (Company Name)
xFNnRrr.x FL? ??
??
/1y Contractor's License No.
v a
.
..
Mailing Address IContractot orwnerAl inp InstailaUOn)
14540 PENNOCK LANE
Auth i i_ t r O ?i.71A?taA(otion)
- . . i 1 GsfS? Phone Number
MINNESOTq STATE BOAHD OF ELECTRICITY THIS INSPECTION REQUEST WILL NO7
Griggs-Midwey Bldg. - floam N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 Universitv Ave.. St. Pnul, MN 55104
uh.,.,o IF191 f.49-lIROl1 ENCLOSED.
?- '7//(/8'$' REQUEST FOR ELECTRICAL INSPECT.ION ?- ee-00001/-06
1, See instructions tor completing this form on batk of yellow copy.
E2,843 9 "X" 8elow Wofk Covered by This Requesi
New HAd Flep. Type o1 Builain8 Appiiances Wired Equiument Wired
Home Range emporary Service
Duplex Water Heater Lightin,y Fixtures
Apt Building Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloader
industrial Bldg. Air Conditioner Bulk Milk Tenk
Farm Otner Saecify Otner ISne,:NVI
t er Speci(y Other Other
Comntjte lnspection Fee 8elow
p Fee Service EntrenceSize fl Fee FeederS/Subfeeders p Fee Circuits
U to 200 Am s 0 to 30 Am s 0 to 30 Am s
Above 200 qmp5 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_AmPS
Transtormerg Irrigation Booms Partial.`Other Fee
Signs Speciai Inspection
?
$
A
FE
flertw rks ?
6
? G
Rough-in Dttte ? e Eiectnca
Insp aby
ertify thnt the above
Final ?!? I,
??/ inspection hes 6een
.
mea.
rnb rmuont vnid 1N mnnthu Irom
' REQUEST FOR ELECTRICAL INSPECTION . EB-00001-06
lqtav ? See instructions tor completi?p this form on back of yetlow copy.
,. 3.s' 9sa-
E 2`83 U.,U "X" Below Work Covered by lhis Request
Nev4 d Nep• TYpe Ot Builtling Appliancea Wired Equipmeni Wired
LO, Home Range Tem y Service
Dupiex Water H ter ightin,y Fixtures
Apt. Building Dr Electric Heatin
Commercial Bldy. urnace Silo Unloader
Industrial Bldg. Air Conditioner Buik Milk Tank
Farm Othei per,i y Otht:r ISnecityl
I .r Specily Oiher Othiir
ompute lnspection Fee 8elow
M FeB ServiceEntrqncBSize fl Fee FgadBrs/Subteaders d Fe Circuit5
0 1o200 Am s 0 to30Am s 1/1 -IVLV 0 to30Am s
Above 200 qm py 31 to 100 qmps 31 to 100 Am s
Swinttning Pool Above 100_Am s Above 100_Am s
' Transformers Irrigation Booms artial-"Ot e
Signs Special inspection
S
TOT
Rertuirks n '/o
v
Rough-in Di ,the al
1 Nq/ / ,,o;-, Inspector, hereby
c ffy that the abova
Final r D7 ^ nspection has been
mede.
rhis reauesivoldl8montMfrom " 44
This request void gs" Js-
P-
18 months from ?
E 2.8366 L 7
8a A? . 5
.? I
"°
Ne t Dat
r
v ? ? Fire N, Rouph-in I
Reqwre ecLOn
OReady Now
Will ?, ns
pec-
rWh
es ? No en 4
A.ensed Electrical Contractor I hereby request inspection of above
Owner electncal work installed at:
S e dressJIV or Houte No.
E/
V City
ec ion o. owns ip ame or o. Range No. County
O ent (PflINT)
• i 1.
' " •'?J Phun /N
? ^ ?
Power u plier
? Address /
Electrical Contractor (Company Name)
KEIVDRTT?
?'rmvrn Co rar.to 's License No.
G'
,
Ma?l?n14 AddresstTrac o o king Instailation)
C4? on P??OCK LAI?TE
J
fLu
Au Mna r 3nt?uiBPo @vP1? I?,fkinq }qs,?a llation)
l?ti 1' tv11tl :7;7 1 G`f Phone er
MINNESOTA STATE BOAHD OF ELECTRICITY THIS INSPECTION HEQUEST WILL NO7
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STqTE BOpRD
UNLESS PROPER INSPECTION FEE IS
1821 Universilv Ave.. St. Paul. MN 55104
Phone(612) 642-0800 ENCLOSED.
' ' 1988 BUILDING PERMIT APPLICATIQN - CITY OF EAGAN ? %b
SINGLE FAMILY DWELLINGS ( 05 5 O 4
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
, IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
y
MULTIPLE DWELLINGS RENTAL [JNITS FOR SALE UNITS 4k OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIEICATE OF SURVEY - CHECK WITA BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CONIlMERC2AL •
INCLUDE 2 SETS OF ARCHITECTURAL & STAUCTURAL PLANS?
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: ?/fet ,Valuation: Date:
Site Address ?D ?kEJJ/ (-r2POno - OFFICE USE ONLY
Lot 2- Block On site sewage_ Oecupancy
Pareel/Sub
owner (-4,4lc'7-
Address (/ , 0, Qcx??L rz ?
City/Zip Code
Phone Vj y- J3?3 ';?
Contraetor S'Tiyi, p
Address
City/2ip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
MWCC system i/' Zoning
On site well Actual Const
City water v Allowable
PRV required _ Jk of stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
'f2-'3 M-1
P.L) R -- I
V_14
V-N
5?-
APPROVALS FEES
Engr/Assess Permit qg(o, bD
Planner Sureharge '39.00
Couneil Plan Review 243,00
Bldg. Off. . ?? ?(o SAC, City 100,00
Varianee SAC, MWCC 55D•00
Water Conn SO, bb
Water Meter 6r), 40
Road Unit pp
Treatment Pl O , OD
Parks
Copies
TOTAL
` VALUAMON
G ARAGE
ay x-4-L
?---
y9Z x )y - Gs$s
zs?yo= ?ouo
L ?C r?7 z i o Z
i Li32G
0=F ,
3)c/Z _ 3?-
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e w ? .
... ?
_ .,
4, - - -
-
ROBE
ENGiNE?i?1NG ?
COMPt?M'?, INC.
?„?.? 1000 E1lST 1461if STREE7?
METRo Cu3Tam
\ #/642,D1
CIIH5i1tTiHd EHdiHEfAS
PIAHHEAS und LAHD ?UHVE'i0!!S ?C+at? 115
PA? ?e
BURNS???LL£ ? WtHNES?Tx S=".i37 P? ?32°3ooa
C?r?z?'i cra?e .? Sz?tr?e t?
Z,a?cl ..Ur,..?cri.o?zorL • LOT 7, BLoCK 2, ?EXiN6ToN SQc//riPE 7T?/ AI?D/T/o,V,
- pAKOTA CoU?v7Y, MiNNESOTA
30? F2oNT , B!J/LD/NG
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C???? D6t/oTES ?X/ST?NG El.EVATIQN
?863.5 ) DEnIDTES PROR7? EGEI/.4T/oN
^ ? `/ ? 2 • ,, ?
?i.s? ??' ? O re.?
?se,,s) h ? ? ? 3??' ? DD , p0 ? ?.?- /ND/CATES D/RECT/ON OF
s ?? ?-, _ ?/ / `?, ? ?5 ?? BUr?FACE oR?i?/?16E ?
\? , o
?>a sa?\ ` ? ? a 1.? ? ?.? B3 = F/iV? N w 1 ?? ,E FLG?D?e
RS_ o c?? / ??i E??? ? ? ?'`-G ',y-?-?`r? '?' +,?-?, ?
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D?PA/NA6E A^/o -- --? : ?
?2_.? UT/L:/TY EflSEM?iVT ? ?----?7_"T"'? 'a .
. , Cai.? • : . ?$G?11 ENCINEERII?d?
I her:by cartify that t?ia ia. a t:?le and c?rrsct rspresentatic? o!'? 4r? ??'
laad as eho+m'and deacribe3 hrr'eon.• Aa.prnpared by tne on th3s ? day of
?vNE ,' I9 88 , . • . .
: -:<::_ _ .
, . ? :' ? t??u?l Hirm ?. Re? ? 110. /_?ad_„5
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1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN P-'_f? -' ',-! " i`J..1"),
SINGLE FAMILY DWELLINGS I ?3D
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUAVEY,
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/
IS DESIRED. NO CHANGES WILL BE ALLOWEDWC
MULTIPLE DWELLINGS RENTAL QNITS
OF ENERGY CALCULATIONS
NER MUST DESIGNATE WHICH ADDAESS
DING PERMIT IS ISSUED.
SALE QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICAT F SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CONII?IERCIAL
--??
INCLUDE 2 SETS ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF CIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
SEP 15 1988
To Be Used For: Valuation: vO Date: 15 *LL26P?r gR
Site Address 9185 Lot ? Block 2-_
Parcel/Sub ?xinlCr?nr} ?k?e'. '?,yly,
Owner
Address a8% " j?e ?o ?
City/Zip Code E4GW 551 L?3
OFFICE USE ONLY
On site sewage_
MWCC system
On site well
City water
PAV required _
Booster Pump _
Phone L457--(o'IS(p
?
Contractor
Address
City/Zip Code
Phone
Arch./Engr. Address
City/Zip Code
Phone; tF
c
APPROVALS
# OF UNITS
Oecupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Engr/Assess Permit
Planner Surcharge
Couneil
Bldg. Off. 61ltV19 Plan Review
SAC, City
Variance SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
?
' METRo Cu87ofil
§Af)rtc " e 1,6a2,or
E4VGiNECR[NG • ,OHi11lTlH4 Eti(31NEfAS .
PLAHNEA3 and lAHO ?UAVEYOQS ?ov1? 115
Pq? , e
COMPANY, t:NC.
?5000 EAS7 (iSlh STAEE7, BURNSVtLLE. ItIHNESOiA 5=37 PH 432-300Q
Cel"'Z ZZ CLZ?e [
?: cl -?"-s ? r? P? ? o?• LOT 7, BLOCK 2, LEX/N6Tait/ S4f,14949 7771 A0,01710ti'
• CAKOTA CDUw7Y, M/NNESOTA
30' C,eo,vr. a01Lo11v6
SETBAC.4?' L.iivE -
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? ? ? ? ? ??'6, •.n
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9iD
6,64a : /" = 3a '
CICZ3) DEN07ES i5XiST?^/G ELEVATioN
oo ? 0' 1r
aati,?
? ?
?/ .
i?883.5 ) DENOTES PROfVS'ED ELEI//aT/aN
?-'- /Np/CAjE$ D1REC7-1,ON 'OF
SU?FACE OR41NA6E
?a s
Rs.^ o ? ? //
??'- \ \` /S/ ^y\
?
Ag3,83 _
y
-OK41NA6E ANO .y
'
UTiG/7Y EASEM?'NT D u
:D , .,.+5,.4kQ6E FZV&
?prtf ' ? ?"? ?• ,? `? ??`
?7 t .. ?.
4, y
EXGIil'd 't;i;CIiq
LLs<II'dr-;
I herlby cartify that thia ia a t:?le and currant rspraaentxtiott of,ja tract cf`? =
lind as eho+m' and deacribed hrAa prepared by ine on this 30daY of
?vNE ,' 19 88, • •
_. _. ,.. ?
Hifln. 9tag& No.
3 p70T£: PAY94W OF FEE AT TIME OF M1 ^?
• arPrsca27oN DOEs Nar cau-
. ;
* STINl'E APPRGiIAI. OF PER6fIT. ,
t
? INSPE7_`FION OF SE.T?7Fit ADID/OEi 4iAi'lER .*k.
; iNsrAtLwioNS wus. Nar sE scExlrm ?
* [!NrIL PF7aAIT HAS BN:HS] APPROVID. *
fxn?f?xrxtx*??*xx??xit?x???,ef4*?+*?3+*
APFLICATION FQR PERMIT
SEWER AND/OR WATER CONNECTIQN
oF eagan
_ (PLEASE PRINT
1) PROPERTY ADDRESS : `J,fA ??,E r r- 1- 4 Cwz,612 RG
LE X . ? o . 7 rrr
TFGAT, DESCRIPTION:
or
2)
IF EXISTING STRLiCTURE, DATE OF ORIGINAL BiJILDING PF.RNLZT ISSLANCE:
Nont Year
„ PRESENT ZONING/PROPOSID USE:
Q CONAIEF2CIAL/f2ETAIL/OFFICE
Q INDLSTRIAL
Q INSTITUTIONAL/GOVERNMENT
NF1ME: U e_c-r'9c2
ADDRESS :? b S.? ,CS a1 1m r..J +=,.i ?-2 •
CITY, STATE, ZIP: ?f..?. /,?[ r). .S..f-/2
R-1 SINGLE FAMILY
? R-2 DC1PLEX (3'Hro Lnits)
? R-3 TOWNHOUSE (Three + Units)
Q R-4 APARTMENT/CONDOMINIUM
PHONE: It31 - e7,7J
3) ° i-*' NAME: 0 L- - dniC-_/L.G
rDDxESS :( y o 0 13 /? S?- C r,..
CITY. STATE, ZIP: A. L? .. jy.'). WF.
PHONE : MASTEE2 LICENSE #
( Lnits)
( ... . Units)
Lse
uumners License:
I Active
Expired
Not recorded
Staf Initia
4)
NAME: InErQO (ytD%LS' .
ADDxEsS: (? o goX 16qq
CITY. STATE. ZIP: 8 L), p w,s u rz C?
PHONE: J? ?q - g3 g 3
5) au??3i ae
59-CONNECTION TO CITY SEWEEt ? CONNECTION TO CITY WATER a O'I'HII2
6) ? ' I " 7 A cP e
***************************************************************************************************?
*
* TFIE GOLD COPY OF THE PERMIT WILL BE SELVP DIREC77,Y TO PUSLIC WORKS 'IO FACLLITATE ME'I'ER PICK-IIP. ;i
* PLEFI.SE ALLOW TWO WORKING DAYS FC)R PROCFSSI[QG. SONIDONE FROM THL CITY WILL CONPACT YOI7 IF TIIME *
* ARE ANY PROSLEMS. +
?**********et aE?r?FYr*******:k***?t9e**?rlrie?e?r?r*?tt*?Fie*?k ?k***k*?riririr*9rakvk**?F?F**?Y*?F************?t*****?t?k*kie******9e*'y
_ F'4R -CITY USE ONLY
PERMIT # ISSOED ? ? 7 V-?-
Pd w/Bldg. Permit FEES:
$ $ ! n5? SEWER PERMIT (INCLUDE SURCHARGE )
$ $ WATER PERMIT ( INCLLiDE St'RCHARGE )
$ Co r7?? $ WATER METER/COPPERHORN/Ot'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ p-f-) ACCOIINT DEPOSIT - WATER
$ a? 5^D - ?z? $ wac
$_ ?,? ?D • O d $ sAc
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BEI3EFIT/TRUNK SEWER
$ $ LATERAL BENLFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ $ TOTAL
C/ 37s-
RECEIPT RE EIPT#
DOES UTILITY CONNECTIO[V REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
El YES IF YES, THEN A"PERMIT FOR WORK F4ITHIN PUBLIC
Q
ROADWAY" MLST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
Use BLUE or BLACK Ink
/ i
' For Office Use I
City of Eagan I Permit
Permit Fee.
3830 Pilot Knob Road 11
/
Eagan MN 55122 t F L-El ` -E-i 1
,3 , I Date Received: 1
Phone: (651) 675-5675 1
Fax: (651) 675-5694 JUG. U 9 2012 I Staff: 1
I I
T 2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 67 '4® Site Address: le C&C # A
Unit
Name: In AAZ . ~ 17 67 kY . ~ M~
h Phone: o--53 -,r
RESIDENT /
OWNER Address / City / Zip: 9~6 X 45 % rL E C9 6-k A QWd &S'"/ -&.3 54 411-7r ~~AX ;3L 3 -7,p
Applicant is: 4 Owner Contractor
TYPE OF WORK Description of work: ~!C ' /A
®~a
Construction Cost: _ Multi-Family Building: (Yes _/No
)
,
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt fro lead ertification, please explain why: (see Page 3 for additional information)
S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
_ conclude that 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. wANv,_g~hE.rstateor ecall.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.
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~ M " I M~ i x 11lt4
Applicant's Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES q 0 1~ (,2
Foundation - Fireplace _ Porch (3-Season) _ Storm Damage
_ Single Family - Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of - Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition - Move Building Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION ~7~,
Valuation U Occupancy MCES System
Plan Review Code Edition SAC Units
(25%- 100% Y) Zoning City Water
Census Code ~~~TTT''' Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction V 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
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests _Final
Framing Siding' -Stucco Lath Stone Lath Brick
- -
Fireplace: -Rough In _Air Test -Final Windows
Insulation Retaining Wall: - Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector -
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge 7dq
Treatment Plant
y
Copies
TOTAL
Page 2 of 3
• /METRO L`U3T~rrJ L/C/~ES
# 16D2IJl
ROBE
COtiM71HO ENGINEUtS ,
ENGINEr.-RING pLANKEAS and LAND iUHVEVGISS F !IS
P~ r e
n IN
comptiv y I NC. Paz-so
1000 EAST 1461h STREET, BURNSVILLE, MINHE!GTA S_337 FH 00
C.E3"'z~ D- t')_3 LET 7, 91-aek 2, LEXInl674 S4r~Ri~E 77t/ A~diT/0rV,
pAKoTA cOV~In; M/~ivES~TA
4
30" FRQ~IT . BG//LD/NG 2
9E7",8RCK LINE
~88l,q•~
lip
A. ~d).~ CAB-i;~'? p~h1DT~.fi EX1Sr/NG ELE!/ATIO14
iZ Eys 3 E ?
8 $ uPPrIc 0883.5) OEA1079 PRa 'L41 gL46 /ATIDA!
rg_
C8 8~.s) ~iL 0 0 D4 i 11V,9IC4TE5 DIREe7_141V -OF
I ~ ~ / o sU~F~9CE Or~A/rtlA6E
s
X41A/,46E 4AIP I3 -
Z ff T/CI ?Y Ei9sENJ~NT L'____~
~NCINEERINW
I heriby certify that this is. a. t:,.le and correct representation CLA tea of
land as sehc+►n' and de-seribesl hrr's0 As. prepared by me on this day