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4646 Kingsbury DrCASH RECEIPT C1TY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 REGEIVEO FRpM AMOUNT $ I & DOLLARS loo F-I CASH 0 CHECK FOR Fl1ND COOE NtAOIINT Thank You :?)/ L BY White-Payers CopV Yellow-Posting Copy Pink-File Copy CITY OF EAGAN Remarks Addition BEACON HI LL ADDITION Loc 7 eik 4 Parcel 10 13500 070 04 Owner l Lvlf' )r• ? YvuJ? "?? ? y',Fi lck Street 4646 Kingsbury DTive State Eagan. MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. g0 1982 1806.93 200.77 9 1806.93 C007579 10-1-81 STREET RESTOR. GRADING 1982 526.46 58.50 9 526.46 C007579 10-1-81 SAN SEW TRUNK 3 I* SEWERLATERAL 1982 3116.46 346.27 9 C007579 10-1- 1 WATERMAIN WATER LATERAL ZJHZ 9 WATER AREA 1982 198.01 22.00 9 198.01 C007579 10-1-81 * Stubs 1982 9 STORMSEW TRK 46 v 1982 359.82 - 39.98 9 359.82 C007579 10-1-81 * STORM SEW LAT 1982 J CURB & GUTTER SIDEWALK STREET LIGHT Roa Unit 185.00 24930 6-3-81 WATER CONN. 335.00 24930 6-3-81 BUILDING PER. 6702 so,c 525.00 24930 6-3-81 PARK I 1 - ? CiTY OF EAGAN ?- ?- 3795 PIlot Kneb Raad Eayan, MN 55124 , . PHONE: 454-8100 d ~J ? BUILDING PERMIT ReceiPt # , _ Te M upd fer nrnr c nnan-. Esf. Volue ijSQQ Dme T311Y 17 19--&3_ I Siro AddreuT4666 If,inBat•Lr-Y nrivP Eroct Q occuPancy A-3 Lot 7 Block 4 Sec/5b. ReBCOn Alter ? Zoniny u_1 ? Pefcel # 10 13500 070 04 Repolr ? Fire Zone ue Enlarpe ? Type of Const. V ' W Nome .7xmes A_ Sca petta? T=, ?Ve ? # Stories ; Addreu 4646 K3n'gebury Dri-ve Demolish p Length2.2 U cityl,aaan 2 Phone 452-6648 Gmde ? Depth.l4 Sq. Ft.- ? . ?hp Name ''Jk`nt?T Apyrorals Fees ?U Address f r-:... Name _ Address I hereby ocknowledge that I hove read this application and state ihnT the information is correct and ogree to tomply with all opplicable State of Minnesoto Statutes and City of Eaaon Ordinonces. Siqnature of Pennittee ' ;' I? A Building Permit Is issued M:.' I oll work shall be done in accordorxe with all Buildinq Officiol i, Assessment - Water & Sew. Police Fire Eng. Plcnner _ Council _ Bidg. Ofi, _ APC Permit ? 5 _ M su.charfle i _ on Plon check SAC Water Conn. Woter Meter Rood Unit Torol $26.00 on the exprcss condition thai Statutes ond City of Eogan Ordinances. Parmit No. Parmit Holder Misc. Permit No. Holder Plumbing H.V.A.C. Well Water Disp. Sewer ' EMMrie Impeetlon Date Insp. Other Footlnys a4l Foundation Framing Rouyh P16q. Rough HVA Inwlation Final Plbg Final HVAC Final IRV Water Wwibs Loeation: Vllell y ? Sevwr ' Pr. Disp. / . 0 Tprufiratr of (Orrixpttnrlj Citp of (Eagan Uppttrttttrnt n# Building Jnoprrtiutc Thir Ccrtificata rrsued purruant to the requiremrau of Section 306 of the Uni farm Buildiwg Code rcrtif ying tbat at the time o f isruarae thir rtructure wa.c in compliunce with the variou.r ordinaruec o f the City rcgulating building construction or use. For the f oltowing: um clamsmsm Single Family Dirg/Garage gldg.PemtitNo, 6702 Occupancy Type R3 Type Coortnution Vn Fire Zon NA Zoning D'utrict "+ Owmrof&tllding Centex Homes Addrcss 8601 Darnel Rd.., Eden Pr BiedWg,,dd= 4646 Kingabury Driv&,,;tY Lot 7,Block 1„Beacon Ril er: BwldinqOfticial July 30, 1981 ,_ ,? Date: roer iw w cwis??c?o?s ?uce , LITX0IN 1.5.P. r = ? CITY OF EAGAN , ' • ' 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt .# N2 6702 Te be utsd for ';/GF.R Est. Value Date Site Address Erect p Occupancy Lot Block $ec/Sub. 4-_' r,--^- --i - • Alter ? Zoning Pcrcel -10 070 04 Repair ? Fire Zone _ Enlarge ? Type of Const. W Name ':r?pt,ey„ TjomP.s Move ? # Stories Z 3 Addreu ,r Demolish ? Front ft. O Ci _l Phone ' 6rade ? Depth ft. p Name f ?? Address f rls., o6,...e Name _ Address Feas Water & Sew. Po4ice Fire Eng. Planner _ Council - Permit Surcharge Plan check SAC Water Conn. • ? 3 ? • -??) Water MeYer Road Unit I hereby acknowledge thot I have read this applicotion and stote that gldg. Off. the information is rnrrect and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signoture of Permittee A Building Permit is issued ta on the express condition thot oll work sholl be dona in accordance with all applicable State of Minnesota Statutes and City of Eagon Ordinances. Building Official PxmM # Dafe Iwu?d PaeMtw Plumbing o??33 -( -7 - $' f /1z- ' 0. Mechonical ,255? -(7'- $ E l' f i F Ec. _TY'7' 7-2-$ f_(? E e?• INSPECTIONS DATE INSP. Rouph-In Final Footings Date Insp. Date Insp. Foundotion ame/ins plumbing Mechanical f2 Eq/ vq!?' Finol 7- ,36-fi/ Remarks: Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered speces S/C Type or Prini /egibly Tot. _ i. Date 2. Installation Cost ' 3. Job Address Lot Blk. Tract 4. Owner '?? • 5. Contractor Phone - " ., -- 6. Address e 7. City .. r...-,T State Zip 8. Building Type: Residential,)O Commercial O Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures ? Water Closet ! No. Fixtures Cesspool/Drainfield _ Bath tuhs Septic Tank _ Lavatory Softner ? Shower Wel l - Kitchen Sink . ? Urinal/Bidet Laundry Tray Other ' Floor Drains Drinking Ftn. SlopSink Gas Piping Ouilets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final . tnspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt 1. Date MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print /egibly Tot. 2. Installation Cost 3. Job Address ',6 Kizt'sb•.::" I:d't': Blk. Tract 4. Owner , 5. Contractor Phone " 6. Address - • • 7. City ? • State -?• Zip :. 8. Building Type: Residential El Commercial ? Institutional ? 9. Work Description: New E3 Add ? Alter ? Repair ? I 10. Describe- gas forced -iT ¢uelType 'l .t I 11. No. Equjpment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli : Mfg. r ng an _ Boilers Mfg, _ Mech. Exhaust Unit Heater _ Mfg. Other i Air Cond. Mfg, i Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. , $igned: for Rough Final ? Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 . ?_ CITY OF EAGAN SEWER SERVICE PERMIT 9795 Wlat Kneb Road PERMIT NO.::. Eogan, MN 55122 DATE: ? ZO^i^o: - No. of Units: Owner. ?<ntez Hotles Address: Site Addreu: Plumber. . . ., l . . 1ayree fo wmpy wiFh Nro CiFy of Eagan Connection Churpe: Ordinaneq. AccourM Deposit: Permit Fee: - ' Surcharpe: BY Misc. Charges: Dote of Irap.: Totol: Insp.: Dats Pold: ciTr oF eaCaN WATER SERVICE PERMIT 3745 Pilot Knob Road PERMIT NO.: Eogan, MN 55722 DATE: Zoning: No. of Units: Owner; Address: _ Site Address: Plumber: Meter No.: - Connection Chorge: Size: Account Deposit: Reader No.: ? Permit Fee: I agree M eomply with t6e City of Eagan Surcharge: Ordinaneos. Misc. Charges: • Total: BY Date Paid: Dote of Insp.: Insp : . & 70.;:2, . gY146V CITY OF EAGAN Ic:clude 2 sets of plans. 1 site plan w/elevations & gUILDING pgRMIT APPLICATION 1 set of energy calculations• D ?DO ate Tb Be Used For -??id Valuation ) - OFFICE USE OI?Y site Address: ? ?c - 3 , ` Occupancy I,?t ? Block ? Sec./Sub.f Erect Alter --? Zoning - Parcel #: AO /?517G 47D 211 geepair Fire Zone !/ E??e q?ype of Const Owner: l_??i1 teX t?dmP ° Nbve # Stories_ ft DP1rolish Front . Adclress: Grade Depth ft City/Zip Oode: E'EES/ Phone # : yY/ - 411,71 Contractor. ? /1;? •? Address: ? City/Zip Code: Phone #: Arch. /Eng. Address: City/Zip Code: s, APP11)UAIS y0 , Permit Assessments Water/Seaer Surcharge Plan Check /D 71 Polioe ? SAC Fire Water Conn. ?g Planner • Water Meter Council Ftoad Unit Bldg. Off. ? APC _ 'IC]TAI, / 17 /41- ? ov Phone #• CITy pF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. Zb Be Used For -i' Valuatio ??.5(`fl7 Date Site Address .? S' OFFICE USE ONLY Lot ? Blockq sec./sub Faeo /1 l1? Frect f/ Occupancy 3 Parcel #: ?? 1 --5 ?'jc-xo fzo c) Alter Zoning & Owner: Address: City/Zip Cocle: Ll Phone # : 4s?? - Repair rq ? 'T/L _ Enlarge ? Move Desnolish ?--?' Grade _ Fire Zone Type of Const. # Stories Front o2 ft. Depth 11 ft. APPROVALS FEES Assesstnents Perntii.t ?$ ?aater/Sewer Surcharge ) Police Plan Check Fire SAC Eng. Water Conn. Planner Water Meter Council Road Unit Bldg. Off.. APC Contractor: S Q? Address: City/Zip Code: Phone #: Arch./Ehg.: ACIdr255 : City/Zip Code: Phone #: TOTAL Z-leg r ? >Q CITY OF EAGAN - 8795 Pllot Knob Rmd Eagan, MN 55122 ?7 1?I ? 823$ PHONE: 454-9100 ? BUILDING FERMIT ReceiPt # ?G6 y To bs uaed for nF.CK S, Pl1RC'U Est. Volue ,$1590 Oate .Tu lv 12 _ 1 q_u Site Addreu 4646 Kin gsbiiry Drive " Erect [I Occuponcy R-3 Lot 7 Block 4 Sec/Sub. Beacon Hill Alter p Zoning R-1, Parcel # 10 13500 070 04 Repoir ? Fire Zone HIA Enlor9e ? Type of Const. V aWC Name James A. Scarnetta, Jr. Move ? .# Srories ; Address - 4646 Kin QSburv Drive ' Demolish p,. Length zZ C; EaQ an 55122 452-5645 Phone Grode 0 Depth 14 Sq. Ft.- o Neme Owner App.o.al: Fee. ? ?? Address f r:.., Name _ Address I hereby acknowledge that I hove read ihis oppliwtion and state that ihe information is Correct and agree to tomply with oll appliCpble State of Minnesom Statutes qad Citv of Eaadd Ordirronces. ,. Signature of Pertnittee '4 A Building Permit is issued t• ? all work shoil be done in occnrdorxe with oll c Assessment Water 8 Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit 25 _ 00 Surchorge i . nn Plan check SAC Woter Conn. Water Meter Road Unit Totol $26.00 on the express condition thal Statutes ond City of Eogan Ordinances. Bullding Official nnrn1eaoia owiv ooaru 01 cIocuici[y Griggs Midway Bldg. - Room N191 K 58'F1 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ' - RT;QUEST FOR ELECTRICAL INSPECTION CHECK BEi.OW WOKK COVF.REn RY THIS KF.nllF.ST EB-00001-02 ?51eo? T 42764 Type of Building Ne Add. Rep. Check Appliances Wir For Check Equipment Wired Foi . Home liEil ? ? Range Temporary Wiring plex ? ? Water Heater Lighting Fixtwes ? . Bldg. ? ? ? Dryer ? Electric Heating ? mmercial Bldg. ? ? ? Fumace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner Bulk Milk Tank ? Fazm ? ? ? List List Other ? ? ? Others? Here f Others? Here S COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eies 101 to 200 Amps. 31 to 100 Am eres 31 to 100 Am eres Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers ?Remote Control Circ. Paztial or other fee 54L- Signs ?` ? j` ? j? J JS pecial [nspection Minimum fee $5.00 . Remarks TOTAL FEE 2CM I, the Electncal Inspector, here?y/?tify?f?wpection has beerr ry?de. l-d (Rough-in) ? Date ?J' (Final) Date ?- This request void ° t 18 months from This equest void 1"7 t3c{ 18 rconths froro 25 L?O (.0 . i Date f this Request ? ? ldsl Fire No. ° 48764 I, aLicensed Electrical Contractor OOwner, do hereby request inspection of the above electri- cal wiring installed at: et Address or Route No. ection Township _ Which is occupied by 106 Range County ?,.....,...,. ?„_..,......, Is a roughin inspection required on this job? No ? Y9 Ready Now ? Will CaVC Power Supplier. ? Address W"0 'VGTbd Electrical Contractor kw CL-&TR? Contractor's License No 31 567u (COmpany Name) Mailing Address 1E, cw "_ Authorized Signature (eiectricai contractor or owner M?? ? (M ED Off or owner maKing rnis ins[auavon) s.' Phone No. is S S? This inspection request will not he accepted 6y the State Board unless proper inspection fee is enclosed: CITY OF EAGAN 3795 Pilof Knob Road Eagan, MN 55124 PHONE: 454-87 00 BUILDING PERMIT APPLICATION N° 6702 Receipt .#' ^" `?.???.? To be wed for $F 09/(i`M Est. Value 100,000 Date .TtIY1E 3 , 19 a Site Address 4646 IL1=8btu'3t DI`iVe Erect [$ Occupancy R3 Lot 7_ Block A._ Sec/Sub. BeBCOri H i11$ Alter ? Zoning Rl Parcel #-_lfl 13500 070 04 Repair ? Fire Zone _ Enlarge ? Type of Const. Vn s Name Centes AOID@S Move ? .#' Stories 2 3 Addres 8601 Darnel Rd. 55379 Demolish ? Front 48 ' tt. ° Cit eden Prairie Phone 941-6671 Grade ? Depth ft. o Ivome Owner Approvals Feea ? ?? Address Ci ~ u?.?, Owner Name ?W I - Address I hereby ocknowledge that I have read this application and stote that the information is correct and ree to comply with al applicable State of Minnesota Statutes y?City 0?4c9-Qfdiry r} es. ,A/ Signature of Permittee AssessmentAg_-5r_2] Water & Sew. 1Permit 215-29 Surcharge 50•00 Police Plan check 107•75 Fire SAC 525.00 Eng. Planner Woter Conn. 335. ? WaterMeter 60•00 Council Road Unit 185.00 Bldg. Off. nPC Tor,i 1478.25 A Building Permit is issued to: V g? on the express condition that oll work shall be done in accordance with pplic I ate of Minnesotn Statutes ond City of Eagan Ordinonces. Building Officiol 1999 BUIlDING PERMIT APPLlCATION (RE51DENTIAL) 6?Up 0 ^D - CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ?O 651-681-4675 ? ?- New Conshuction Reauirements Remodel/Repair Reaviremenfs A 3 regisiered sfle surveys showing sq. tt. of lot, sq. Ff. of house and all roofed areas (20%maximum lot coverafle allowed) > 2 copies of plans (show beom 8 window sizes; poured fnd. design; etc.) ? 1 set of energy calculaHons ? 3 copies of tree,preservpTlon plan if lot platted affer 7/1/93 DATE: q /30 DESCRIPTION OF WORK: STREET ADDRESS: LOT: L/n 2 copies of plan 1 set of energy calculations tor heated addNions 1 sNe survey for exterior additions L decks CONSTRUCTION COST: 7 C? 4(? , o O BLOCK: 'T SUBD./P.I.D. #: --r- Name:_ ?p?P7_r?(' K DF? '?i? Phone#: I 1?" E'7 ?? 5 PROPERTY I.asi OWNER Street ?n CitY ??J /? V State• / Yi?T_ Zip: ? ? Company: ^ 2? A C? Phone ?r? e(> ? J?- (area code)L? CONTRACTOR Street Address: A 53 3_/7v02 ?/? • license # Exp. ? ^7CitY t D? c State: Zip: ARCHITECT/ r- I n ?#----- ENGINEER Company:_? 1 O Name: Pr ?l 1 E P6??5Aq? Telephone #: area code ( ) Street Address: Registration #: ^ City State: Zip: Sewer & water Iicensed plumber (reauired for new construciion ontv): Penatty applles when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, ond agree to comply wBh all applicable State of Mlnnesota Statutes and City of Eagan Ordinances. 5ignature of Applicant: „aykyl I; OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No , , '?-'--- - _ - . Not Required OFFICE USE ONLY BUILDING PERMIT TYPE O 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 03 1 of _ piex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Parch (screened) ? 04 2-piex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pooi ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr s? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof '' Give PCA handout to applicant for demolition permit - GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq.ft. Footprint sq. ft. Census Code SAC Code No. af Units No. of Bldgs MClES System City Water Booster Pump PRV Fire Sprinklered APPROVALS Planning Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S!W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units Building Engineering Variance Valuation: $ % SAC ? CertiPiaate for: Centex Homee Midrvest Inc. 8601 Darnell Road Eden Prairie, Mn. 55344 DELMAR H. SCHWANZ I.ANOSURVEYOR ? Rsgistarad Under Laws of Yha Stats of Minnesota \ 2978 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE BtZ 129-7769 \V 3?o SURVEYOR'S CERTIFICATE ? ' ??•2 SCALE: 1 inch - 30 feet' N ? Denotes set wood hub ?n, / ?^ \ 42 4' ?1,? Denotes proposed finiah grade \9 ? 31- ? E ,,N ?r? `?a?,°'?' ? y??? ?V 30 3 '888\.s \ 7 / ?.5 Top of block ? Drainage & utility/ Basement floor eaeement ;?\?u Garage floor 962. Z Z2 rv M' Benchmark: Top of hydrant between Lots 13 & 14, Block 1, E1ev. 957,26 Pt. 9;,p I hereby certiPy that this is a true and correct repretsentation of I,ot 7, Block 4, BE/ICON HILL, according to the recorded plat thereoP, Dakcrta County, Niinnesota. Dated: January 28, 1980 Revised to show proposed house May 19, 1981 I .? ? MINNESOTA REGISTRATION N0.882B ?l - CertiPicate for: Centex Homes Midwest Inc. • 8601 Darnell Road . " Ecien Prairie, Mn. 55344 DELMAR H. SCHWANZ I.ANDSURVEVOR ? Reqistarsd Under Laws of Tha State ot Minnesota ` 2978 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 \V 'Y ip. 3° C '$a SURVEVOR'S CERTIFICATE PHONE 812 428-1789 3CALE: 1 inch a 30 feet D Denotes set wood hub ? Z Denotes proposed Finiah grade a ? ? Top of block Baeement floor Garage floor 962.2 ¢=3x sj ? ¢ E- ? h ? ? /y 7 ?5 ? Arainage & utility/ S 6?, easement ? 2Z? ? N. \M? N Benchmark: Top of hydrant between ? Lots 13 & 14, Block 1, Elev. 957,26 Pt. I ? ?v ? ? I hereby certify that thia ie a true and correct repredentation of Lot 7, Block 4, BEACON HILL, according to the recorded plat thereof, Dakcrta County, Minneeota. Dated: Janua,ry 28, 1980 Revised to show proposed house Ma.y 19, 1981 ? •`? ? , p o , `ti`'?'''s?`,?'?''? MINNESOTA REGISTRATION N0.8626 ,? i l.? ?j(y?-d1.1? . ?________________- ? FOES7?Qe?US? ? ? Permit #: I ? I ? Permit Fee: ? I ? I ? Date Received: I I I Staff: ? I I ------------------ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I IO M_ Site Address: ury AJr: ?t- 1 ..? r Tenant: 1 r u d-\,/ S+ +q nL-M0 Suite RESIDENTlOWNER Name: du S'TrqnLmU Phone: q-Sa - ?Q 3 --7S95- Address / City / Zip: %o Ss- I Applicant is: _ Owner -,/-Contractor TYPE OF WORK Description of work: _ I?f - r0 L 1' Construction Cost: Multi-Family Building: (Yes _ I No ? CONTRACTOR Name: C?rPCt" ?x`{ffi0(t License#: ?(D ? I?ISII Address: C ? ?, a ? ? City: FQ rwi I N/?.?, Siate: !'N Zip: 5? V r? N Phone: ? I;? '? l b' O b ga F Contact Person: J.J COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet CetegOry Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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"andsupporting docuinents that you submrt'are consider,etl to be publrc information Portions of - h i f b ` t e n ormation may e classifieal as non=pu6lic?f you provrde,speclfic ieason$ thaf would permit the Grty fo" ,conclutle [hat the y, ere iratle secrets. -• ? ? 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 qccordance with the approved plan in the case of work which requires a review and approval of plans. X JJ oe14- " X / 4"4& ApplicanYs Printed Name Appii Signature Page 1 of 3 Use BLU� or BLACK Ink �--------------- —, � For Otfice Use � �, ' ' l� ��0`7 � C�ty of �a�a� � Permitt�: � ('� v� � � j Perrnif Fee: �v• I 3630 Pilot Knob Road I � � Eagan MN 55122 i Date Received: � r� � � r-, Phone: (651) 673-5675 � Staff: � � Fax: (651)675-b 694 I________ ______ � ��J O Z 20�4 RESiDENTIAL PLUMBIIVG PERMIT APPLICATICJN Date: Site Address; 7� 7(� �!�!f��C�' I.J �ti/T . Tenant; Suite i�: ResidenUOwner Name: Pnone: Address I City 1 Zip: !1� -I � ` c�LJ �• Cl Ct n /�!�/ ��Z� Name: �� -Y L�m�i�� '� �r'�1� License#: ��3�� Cont�actor Address: �L/�l N� ��" �.i ' City: [,l.t� (..�1 �4 State: r l(I v Zip: P�one: f�� ' ��I�� ZG�� ` ContacL � �� Email; �� 1�Vt�'1 • �(i� Typ@ Of WOrk .—New _Replacemenl �Repair _Rebui�d _Modify Space _Work in R.O.W. DescriptPon of worK: ��n.`i��Oc?i1� �+Nt.UG� � (�[; r,wC, '�`�^'� 5�n RESIDENTIAL Water Heater Lawn Irrigation�RPZ/_PVB) �aterSoftener Permit Type �Add Plurnbing Fixtures(�Main/_Lower Level) Sepl+c System New Waler Tumaround Abandonrnent RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Wafer Heater and Softener(includes$5.00 5tate Surcharge) $fiO.OQ Lawn Irrigatiorl (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonmenf, Water Turnaround"(includes$5.00 State Surcharge) "Water Turnaround(add$200.00 if a 5t8"meter is requir�d) $115.00 SepEic System New($10.00 per as built) (includes County fee and$5.Q0 State Surcharge) � �,r�7 TOTAL FEES$ • CALL BEFORE YOU D1G. Call GopherState One Call at (fi51)454�0002 for prutecllon against underground uU[ity damage. Call 48 hours before you intend fo dig to receive locates of underground ufilities. www.aoaherstaEeonecali.orq I hereby acknowledge thal fhis in(ormafion is complele and aacurate;that lhe vrork will be in aonfortnance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, buf only an application for a perrnif, and work is reot to start wiihout a permit; fhaf the work will be in accordance with fhe approved plan in the case ofwork which requires a revievl and approval of � � 4 x � � x 0 o; App icant's Printed Name Applicant's Signature � o FOR OFFICE USE Reviewed By: Date: � � Required Inspections: Under Ground Rough-fn Air Test Gas Test Finai � Meter Related Items: Meter Size Radio Read Staff: � Q PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA132675 Date Issued:08/28/2015 Permit Category:ePermit Site Address: 4646 Kingsbury Dr Lot:7 Block: 4 Addition: Beacon Hill PID:10-13500-04-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Trudy A Scarpetta Strandemo 4646 Kingsbury Dr Eagan MN 55122--271 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature