4683 Kingsbury Dr
DRAIN PRO PLUMBING Fax:952-985-5282 Aug 19 2010 09:28am P002/004
Use BLUE or BLACK Ink
1------~---- ^ s
MILY of Wan ~ Pemnit
1 Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 1 date Received: 1
1 I
Phone: (651) 675~5675
Fax: (651) 675-5594 staff:
•-+---------------J
j INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: V J?) ' Site Address: "63P 4 0 Uf Y. :55 (2-7--
Tenant:►Ct tw+ i ~IGLt~ ~a Gl suite
RESIDENT / OWNER Name- wX L-" ✓i valq C Phan e: 6'5[ *,5+ L3 i 3.~..r'
T~
Address I City i zip: 4 ~ k 5 ~'r y~'". jFAq &Lq. ~ ,
Name: t GLi"'P 10 -P [vw•~v f ~t dice se # Q Oro 13 RM
Address: Seta zjCity, 4Lte-rr vi j le:
CONTRACTOR n,~
State: ! "i Zip:L..' Phone: ~-t
Contact: Deto O{ t5 ~ Email:' 1Uyw~1 X Cl 11"$.4, C-0 ~%4
PLUMBING (Within the building envelope) SEWER & W TER (Outside the building envelope)
TYPE OF WORK X Sump Pump Repair Repair
_ Other. Other.
DESCRIPTION Description of work: tV-u 6 UfF~U~^'+' Ur..t Y Qs~+Ct 2r ~~w,
Q Uel(~ it ~ r vt G>v~~i f~ ~
FEES
$55.001 Each (includes $5.00 State Surcharge) (Rev. 6-3010) TOTAL FEE $ ~J O
Termit fees will NOT be reimbursed by the City of Eagan. If you plan to submit IC~I repair costs for
reimbursement, two quotes from qualified contractors must accompany this appMication. A list of contractors
can be found by visiting wmnr.cityofeagan_com„/inflow, or City Hall at 3830 Pilot ilob Rd.
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. he on call.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.Leview and approval of plans.
x 2llq6 v" La-r--5o A
App +cant's Printed Nance Ap nt'e Sig atu
. ~ v::v%y" -d..'^ F ;w; y, ry' •tt?:. ;..T... ey,.-~: i _ '.T;. ,;.,:t~:y~~..
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TION R
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
I (612) 681-4675
? SITEADDRESS:
PERMIT SUBTYPE:
„ 'rii I I
f' [ W di I
PERMIT TYPE: ' ; " t I I' I n`'
Permit Number: c? 11 N /'{0
Date Issued: 014 /A,; E 96
APPLICANT:
t:t
i „ 1 ' t `• , Fi 69 . "?
TYPE OF WORK:
RF"!'A1R
)
UF`.?1?IF'l lilN tSIUCMti
?..a
Permit No. Permit Holder Dete Tefephone k
ELECTRIC
PLUMBING
HVAC
Inapection Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PL6G
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
BSMT R.I. i
I
BSMT FINAL
DECK FTG
DECK FINAL
?
_-_ __-____ N-RIECURv
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
?
PERMIT SUBTYPE: TYPE OF WORK:
tti0 „Nc;
w'3: /c,3
AN/0:i/9N
f i4oMA'.
R( PAIF
kFRijti!
INSPECTION .. . ..
I rsNKSs'f? EROtIf L7UV 10 ;Tt)Rp DAMAfi1
Permit Holder Data Telephone #
PLUMBING
HVAC
Inspection Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
AW7 `
ROUGH
PWM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUI
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG -
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITV
7E5T
IIYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition RF.A('nN HTT.i AnnTTTON Lot 18 Blk 3 Parcel 10 13500 180 03
Owner Street 4683 Kingsb? DriVe state F.agan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. b4e 1982 1806.93 200.77 9 1806,93 C007559 10-1-81
STAEET RESTOR.
GRADING j 1982 526.46 58.50 9 5. C007559 10-1-81
SAN SEW TRUNK 3 1976 135.97 9.06 15
SEWERLATERAL f{j 1982 3116.46 346.27 9 3 C007559 10-1- 1
WATERMAIN
* WATEfl LATERAL 19$2 9
WATER AREA 1982 198.01 22.00 9 198.01 C007559 10-1-81
* Stubs 1982 9
STORMSEW TRK 1982 359.82 39.98 9 359.82 C007559 10-1-81
* STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
xOAD UNIT 250.00 34844 3-18-83
WATER CONN. 450.00 "
BUILDING PER. 7847
SAC n n
PARK
CASH RECEIPT
CITY OF EAGAN ?
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 ?
DATE 19
RFCEIVED
FROM
AMOUNT $ I
& DOLLARS
iee
? CASH ? CHECK
/
FOF
FUND CODE qMOUNT
Thank You
6Y
White-PaYgrs CoPY
Vellow-Poating Copy
Pink-File Copy
f ?
I? Receipt MECHANICAL PERMIT Permit No. .-=
? CITY OF EAGAN Fee
Fill in numbered spaces S/C I
TYpe or Print /egiA/y Tot. ?
1. Date 2. Installation Cost ?
3. Job Address kot' •? ?-' Blk. r' Tract r 1
4. Owner
5. Contractor ' Phone
6. Address
7. City State Zip
8. Building Type: Residential 0 Commercial ? Institutional ?
8. Work Description: New ? Add ? Alter ? Repair ?
10, Describe ? Fuel Type
11,
No. Eauioment 8TU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
;
Mfg, g
_ Boilers
Mfg. _ Mech. Exhaust
Unit Heater •
Mfg. Other
Air Cond.
Mtg.
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.
Signed : " ' for
Rough mal
Inspections: Date- Insp. . Date -/a- i Insp..6.0f_
This is your permit when numbered and approved.
Approved CITY OP EAGAN 454-8700
'y(
Receipt MECHANICAL PERMIT P ermit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print /egibly Tot
.
1. Date ? U 2, Installation Cost
? ,
3. Job Address ?'? ?? ? `> = %r'-? "Lot Blk. Tract ?
4. Owner Z ?r /i , c .S
? C
5. Contractor ? % •r ? d t 5 ? `/ /U! phone
6. Address
7. CitY ?
jTf)ii- ('/? State // f ?V/
2ip -'
8. Building Type: Residential L?Y Commercial ? Institutional ?
9. Work Oescription: New ? Add ? Alter LW Repair ?
10, Describe
11.
I Type
No, Equioment STU - M. Ea.
Forced Air No. Equipment CFM
Mfg. Air Handling:
_ Boilers
Mfg, _ Mech. Exhaust
Unit Heater
Mfg. Othe
_,X
Air Cond. r
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinar}ces and cqdes governing this type of work.
i
Signed : ? j . , _/ for
Rough Fin 1 ,
Inspections: Date Insp.__ Date7 Insp._
This is your permit when numbered and approved. "gle '
Approved CITY OF EAGAN 454-8100
Receipt S.
PWMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print /egibly
Tot.
1. Date 2. Installation Cost
ti-
3. Job Address Eot' Vsi, Blk. ? Tract '
(
.
4. Owner
5. ContraMOr
if
762 EX-,elsior ,'
6. Address ?6 `,1[nnSSu18 v5.
?43
a38- i 8B(1
7. City State Zip
8. Building Type: Residential 0 Commercial ? Institutionai ?
9. Work Description: New Eg Add ? Alter ? Repair 0
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cess
ool /D rai nf ield
Bath tubs p
Se
tic Tank
_ Lavatory ? p
Softner
_ Shower ? Well
_ Kitchen Sink
Urinal/Bidet Other
_ Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
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.
Signed :
for ,
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
MECHANICAL PERMIT
CITY OF EAGAN
Permit No.
Fee
? Fill in numbered spaces S/C Type or Print fegibly Tot. -
1. Date I-7r)f 93 2. Installation Cost
3. Job Address J/yiN?BuRy Loc Blk. l" Tract
4. Owner
5. Contracto ?r'1'i?CN S fT/ ??' Phone
,--
6. Address
7. City4?v,fAf /PfI? X (?C- State Zi
P
8. Building Type: Residential I? Commercial ? Institutional ?
9. Work Description: New'lf Add ? Alter ? Repair ?
10. Describe Fuel Type /?? S
11.
No.
iv Eouipment BTU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
_ Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
.'--" Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply wit h all ordinances and codes governing this type of work.
Signed: iin ,1;;-'-e for
Rough Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
?
-? -, .
Receipt PLUMBING PERMIT Permit No.
CITY OP EAGAN
Fee _- : i
;
Fill in numbered spaces S/C
Type or Print /egibly Tot.
?
1. Date 2. Installation Cost
3. Job Address ?r, Lot I}__??lk. Tract
4. Owner
.
i%
5. Contractor._,?T?'?i - ; Phone.??? ? t?=t
?
6. Address
7. City <.?- R r> U/// _? State / `l/ ,' . Zip
8. Building Type: Hesidential p
9. Work Description: New tff
Commercial ? Institutional ?
Add O Alter ? Repair O
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
/ Bathtubs SepticTank
'_?w Lavatory Softner
% Shower Well
? Kitchen Sink
Urinal/Bidet
Other
_L Laundry Tray
Floor Drains I ,
.
Drinking Ftn.
Slop Sink
Gas Piping Outleu
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes gov,erning this type of work.
Signed : 17 Y for
Rouph F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Parmit No. Parmit Holdsr Misc. Permit No. Holder
Plumbinp 33?;to 43
H.V.A.C. 3 5`y O YYJ/le o- ? - 2I'k3
Wall
Weter
Disp.
S?wer
eleMric WOw 75o EaA £,c-. 3 -Z$'-
w6733z`( 1? I ( 5-5-`63
Inapection Date Insp. Other
Footings "J
Foundation
Frsminp 4243 I V?i
RouYh Piba `j'"ZS-i7 u7 rt kla
Rough HVAC
????at?o? a s
Final Plbg. /?+ j!3 aJ(r
Final HVAC
Final
Watar posaibe Loeation:
Wsl I
Sewe?
Pr. D'up.
BUILDING PERMIT
Site Add.ess 46$3 hinesbury Drive
Lot -13_ Block ISee/Sub. p a on }t i 7 1
Porcel # 1 ') 1 3570 190 03
c Name rlzintrac F, T.incla Kica
Z Address 7500 VincpnY AvP_ Sn_
a Name Feature Builders
?
?u Add.ess _ 15513 Logarto Lane
7 I G Z S-_Rl1.4'3
Nome
1 hereby acknowledge that I hove reod tfiis application ond stote thnt
? the iniormotion is correct and agree to comply with all applicable
Stote of Minnesota Stotutes and City of Eogan Ordinances.
? " . .-
Signnture of Permittee ?:::k7 ? r+4.,-9? . ?.? ?
Featutc Builders
A Building Permit Is issued fo:
oll work shall be done in accordonce with all qopijcable Stot5 of Myv
Buildiry Officiol
CITY OF EAGAN
9795 Pile! Knob Road Eagan, MN 55122
PHONE: 454-8100
Receipt #
Na 7847
Ered Occuponcy K-- i
Alter ? Zoning R'1
Repair ? Fire Zone NA
Enlarge ? Type of Const. ?
Move ? # Stories
Demolish ? Length 4()
Grade ? Depth4R-Sq. Ft.-
Assessment
Woter 8 Sew.
Police
Fire
Enp.
Plonner
Council
Bidg. Off.
APC
Permit Vi I •()()
Surchorge 31 On
Plan check 165 50
SAC S')5 aP
Water Conn.4 5 0. G(d._
Water tAefer 6(j . 00_
Rood Unit 2510_0f)
TMoI S731-50
on the expreu conditfon thnr
Statutes and City of Eayan Ordirwnces.
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CITY OF EAGAN SEWER SERVICE PERMIT
3793 Piloe Kneb Road PERMIT NO.:
Fa;an, MN 55122 DATE:
Zoning:
No, of Unitr.
Owner:
Address:
Site Address: • -
Plumber:
1 aprea ro eompy with the Ciry of FAyen
Ordinaneet,
By
Dote of Insp.:
Insp.:
Connedion Chorpe: .
Account Deposit:
Pertnit Fee:
Surcharge:
- Misc. Charges:
- Total:
- Data Pold:
CITY Oi EAGAN WATER SERVICE PERMIT
3795 Pilat Knob Read PERMIT NO.:
Eay.,n, MN 55122 DATE:
ZO^'^9: No. of Units:
Owner: ,
Address: 1 ?
Site Addreu:
Vlumber: -
AAeter No.: "%? r-' 7Connection Charge:
Size: f. / ' Account Deposit:
Reoder No.: - - ' ` . -
? Permit Fee: I a9ree to cobply wifh fhe City of Eagan Surchcrge:
Ordi^ance+. Misa Chorges:
Total:
BY Dote Paid:
Date of Insp.: Insp.;
This requesl void' I ?/ ,r??
18 months from ?1 b J
A C' 69.76 5 ?- I ? A n ?
&..fir? 1"h I/ n
? I tz l?-?i
1v. V V
Request Date
`
t-n
Fire No. Rouph•in InsDection
Aequired?
y Nuw ? Will Notify, Inspec-
to
Wh
fi
% ?ves ?No r
en
eady
>KL icensed Electrical Conlractor I hereby repuest inspection oi ebove
? Owner electrical work instelled et:
Street Address, Box or Rout No.
. Gty
Ot?7'1
e ion o. Township Name r o. Range No. Cowlry
Occupan[(P )?
. ? Phon¢ No. -
SupDlier Address
Eleciricel Contractor (Co any ie) Co tractor's License No.
?
Mailinp Address (Contractor or Owner Makin stailation)
Authorize Signature (Contr r/Owner Making Installation) Ph n mber ?/
?..+1 ? . LC'7
MINNESOTA STATE BmO.fID OF EIECTRICITY THIS INSPECTION qEQUEST WILL NOT
Griggs-Midwey Bldg. - Noom N-191 0E ACCEPTED BY THE STATE BOARD
l1NLESS PROPEH INSPECTION FEE IS
1821 University Ave., St. Paul, MN 55104
Phone (612) 297-2111 ENCLOSED.
LAL{(I-7rI REQUEST FOR ELECTRICAL INSPECTION k1ft EB-°o°°' °a
' See instructions tor completiuglthis fwm on 6ack of yellow coOV• .
A
New Adtl 'ReD- - Type ot Buiiding Appliances Wired Equipmeaf Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tdnk
Farm Othei Specify .iherlspecifvl
t er Specify Other 069765 "'X" Below Work Covered by This Request
Other
Compute lnspectlon Fee Below
q Fee Service Entrance5ize k Fea Faeders/Subfeeders N Fee Circuits
Oto200Am s 0 to30Am s 0 to30Am s
Above 200 qmp5, 31 to 100 Amps 31 to 100 Amps
Swinvning Pool Above 100_Am s Above 100_Am
Transformerg Irrigation Booms ?.?-. Partiel,'Other Fee
Signs Speciallnspection $
OTA L?
E
Remarks ,
f n_oV
Roueh-in Date
1, the Electrical
Inspector, here6y
ce?tif
that the »b
v
Final ?
??l e
? y
o
e
inspection has 6een
%3.. mda.
This request vold 18 montBe from ?/ ?• "`?? ""?/' "?f{ ^
?
! CITY OF EAGAN Include 2 sets of plans,
1 site plan w/elevations &
/6cLV-gUIL,pING pERM2T APPLICATION 1 set of energy calcul ations.
, ?- / d'? Date ??i .??83
9-0 7.b Be Used Fbr Valuation
Site Address 1,/6 S,3 Lwu??run.?i OFFICE USE ONLY :
IAt ? Block SeC./Sub. Lz,c9 Erect pccupancy
Parcel #: /D ( 3S(7C) 19-0 C) ? Alter Zoni.ng
? p? Repair Fire 2one (
Owner: di-fi? c•n7?" ? v? ?.d?? &c,C?
Address 73?-aD - U.4,o2?
City/Zip Code: Z % • Q
Phone #:
Contractor:
Address: % s S/ o s?-
City/Zip Code:
Phore # :
ArCh./F.hg. -
Address:
City/Zip Code:
Phone #:
Enlarge Type of Const. ?,-
Nkove # Stories ?
Dernolish Fmnt 6?d it.
Grade Depth y? ft.
APPROVALS FrEES
Pssessments Permit 33j -"OL
[aater/Sewer Surcharge 33
Police Plan Check 3?
Fire SAC S?S
gg. Water Conn.
Planner Wat,er Meter /a(S
Council Road Unit
Bldg. Off.
APC
?8,???
? ?? ?
? 6 Q ?'
? ?? o-
?s ;??
L(T? c?? 4<<`
C R ECTION NOTICE
DATE:•?
Address "/ ?
Site Name
Owner/Agent Telephone
Owner/Agent Address / - :??s
?
Ordinance Nos. and Corrections - Correct By
..
?
For reinspection
Eagan Dept. of Inspection
3795 Pilot Knob Rd.
Eagan, Minnesota 55122
454-8100
Inspector:
REQUEST FOR ELECTRICAL INSPECTION ee•ooooi-oa
' ' See inetructions for completing this form on back of yellow copY. m
.
?
'"X?' BeTo?49"or?C`overed by This Request :55 (01(0
AAd Rap. 7ype of Buildine Applinncns Wired Equipment Wiied
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electric Heatm
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm
r ther lSuucityl
t er Spacify t OthLr
Compute lnspection Fee Below
p Fea Sefvice EntrenCeSizB p Fee fenders/Subteeders b Fee Circuits
U to 200 Am s 0 to 30 Am s 5.- 0 to 30 Am s
Above 200 Am )s; 31 to 100 Arnps HOO 31 ta 100 Am s
Swimming Pool Above 100_Am s Above 700_Amps
Transfonners Irrigation Boorcis Partial,"Other Fee
Signs Speciallnspection $ J? TOTA
F
Rernarks E
`?? ?
.I .i
'U v
Boueh-in DaLe
d- I, the lectrical .
%,• Inspector, hereby
certiT
that the ab
v
I
Final hDate
k y
o
e
inspection has been
"- -yrp?- mede.
This reauest void 18 monttu irom
This request void S- S
18 months from
W 073324
Ll8' t 63 j 6 ?A_c.ovv 4 i ( t 3 S (a (o b
qq f SC)
Request Date Fire No. Roughe?.lnspection ?Ready Now Will Notify, Inspeo-
?-?8 .G13 Yes ?No [or When R?adV
1
Licensed Electrical Contractor I hereby request inspection o1 a6ove
Owner electrical work inslalled at:
Streei Address, Box or Route No. Cicy
_r
Y ?
ecvon o. Township No or Nn. Range No. Com
raD
O
upant
P
cc
RINT)
( Phone No,
+
..
.
?
?
/ G?.c.,itifl A+a-/
Pow
r Sup
e
Vlier Address
?
/
y
J./G:?/r??C?/
Electrical Contracmr (Comuany Name) Contractor's Licunse No.
EAGI,E ELECTRIC C0. 0¢1603-4
Mailing Address (Contractor or Owner Makinp Instailationl
S
Authorized Signatur (Contracmr/ ner Making I ist lation) Phune Numher
.,(? 6 36-8899
MINNESOTA STqTE BOARD OF ELECTflICITV THIS INSPECTION REQUEST WILI NOT
Griggs-Midway Bidg. - Room N-197 8E ACCEPTEO BY THE STATE BOARD
1821 University Ave., St. Peul, MN 55104 UNLESS PROPER INSPECTION FEE IS
pti,,,,,, lai ?1 Iq7 91 11 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION w EB-00001-04
r:
• ' See instructions tor completirg this form on 6ack of yellow copy.
.z.??-06 6 25 0 riLcq 3`7
""X" Below Work Covered by This Request .
Nes, Hdd Rep. Type o1Building Appliences Wired Equipment WireA
Home Range Temporary Service
Duplex Water Heater Lightiii,y Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bidg. Air Conditioner Bulk Milk Tank
Farm Other pecify OMherlSUCrifyl
Ihr.r (SpeCity Othnr Other
(.0II7OC/t2 IqSD@Ctl0I1 FeB BBIOW
# ee ServiceEntrenCeSi2e q Fee feederS/Subfeeders N Fee Circuits
U to 200 qm s 0 to 30 Am s 0 to 30 Am s
Above 200 Amps 31 to 100 qmps 31 to 100 A s
Swimminy Pool Above 100_Amps Ahove 100_AmPy
Transformers Irrigation Boorns Partial•`Other Fee
Signs Special Inspection
$6Z)
T
Remarks LFEEars
Rough-in Date ? ectriCnl
Inspector, hereby
'Final ? ? vAtE certify that the a6ove
? f y G inspection has 6een
'? w 1 made.
This rmuaat vniA 19 monihs Iram - ?- 6--
This renuest void 3-zg L'tL93 / 9kQtB^ -3qq g -7
18 months from
W 066'250 4(,)1 10,00
Request Da
?/??
? z"s? Fire No. Rough-in Inspec[ian
R qu red?
?Ready Nuw Will Notify InsDec-
to
Wh
R
d
o Yes ?No en
r
ea
y
Licensed ElecVical Contractor 1 hereby request inspection of above
Owner electrical work installed at:
Street AdAress, Box or Route No. City
l_Il V ? ?
ecLOn o. Township Name or o. ffR..91 o. County
Occuo.mt(PRINT) Phone No.
Po upplf1er' ?
1 W? Address
ELarical Con[ractor (C p y Na Contracmr's License No.
141 lov3-
Mailin0 dress (Contr cta or or Owner Making Instailatiqnl
Authorized Signature ( on r tor/Owner Makin I stallation) Phone Num r
MINNESOTA STATE BOAND OF ELECTRICITV THIS INSPECTION NEQUEST WILL NO7
Griggs-Midwey Bldg. - Room N-791 BE ACCEP7ED BY THE STqTE BOAHD
1821 University Ave., St. Paul. MN UNLE55 PROPER INSPECTION FEE IS
(11rr#ifirtttr uf COrrupttnry
Citp of (Eagan
lIr,pttrtmrnf nf Builbing Jnaprrfinn
Tbit Cartificatc isturd purJUant to the requiremrrrtr of Seuion 306 of the Uniform Building
Codc catifying that at t!x timr of iuuante this ttsuuurr wdr in complianct wrth thc variour
ordinunus of the City ?rgulating breilding connrrraion or rue. For the fallowing:
u.clunrx.tion SE DWG/GAR lMaa.e<w;,No. 7847
O-jeancrryce R3 TYrocowu?fioo V FiRum NA - aoinag nUt„ct Rl
Ow= a?MdinDzintras & Linda Ki!?7500 Vincent Ave. So., Ri
B.adine.M. 4683 KinQSburv Dr.,,._,:...Lot 18.Block 3_Beacon Hi]
By
. FEATURE BUILDEffS
IWT IM ? CANI?ICUW? KAC[
June 17, 1983
'' CITY OF EAGAN Np 7847
-• 9795 Pllot Knob Rood Eogon, MN 55122 •
BUILDING PERMIT PHONE: 454-8100 ?L ,1? /•
Receipt
To be u.ed fe. SF DWG/GAR Esr. Volue $66,000 pO1e March 18 19 83
Sire Address 4683 Kingsbury Drive
Lot 18 Block 3 Sec/Sub. Beacon Hill
parcel ,# 10 13500 180 03
W I Name Dzintras & Linda Kics
z
Address 7500 Vincent Ave. So.
c;h, _%%HNN Rich. a,,,,,e 55423
o Name Feature Builders
o? Address- 15513 Logarto Lane
uP Burnsville ,k,,.,e 435-8443
Nome _
Address
I hereby acknowledge that 1 have read this opplicotion ond state that
the inlormotion Is correct and ogree to wmply with oll opplicable
State of Minnesota $tatytes-?d City of Eagan 09 inances.
i ? . ?
Signoture of Permittee
Erect M Occuponcy 1`-?
Aiter 0 Zoning
Repair p Fire Zone
Enlarge Q Type of Const.
Move ? # Stories
Demolish ? Length 50
Grade ? Depth 48 Sq. Ft._
Approvals Faes
Assessment _
Water & Sew.
Police
Fire
Eng.
Plonner _
Council
Bldg. Off. _
APC
Permit »1.Uv
Surchar9e 33.00
Plan check 165.50
SAC 525.00
Water Conn.4 5f1 _ fln
Water Meter 6n - nn
Road Unit 250.00
roral $1814.50
A Buildin Permit Is issued to:
9 on the express Conditlon tMf
'-4,sh` be done in accordance with all 2ppl' ??ateXof ' nesota Statutes and City of Eogan Ordirwnces.
cl
Minnesota State Board of Electricity
1954'University Ave., 5t. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUEST
/4 0?.?
S 17 ?; ?i !
Type of Building New Add. Rep. Ch¢ck Appliances W'ved For Check Equipment Wued For
Home ? ? El Range ? Temporazy Wiring
Duplex El ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commetcial Bldg. ? 11 ? Furnace ? Silo Unluader ?
Industrial Bldg. ? ? ? Aic Conditioner ? Bulk Milk Tank ?
garm E] List List )
Other ` ] ? Heie s?
f Qehers}
tt 1
COMPUTE INSPECTION FEE BELOW
Secvice Entrance Size: # Fee FeedersBcSubfeeders: # Fee Circuits: # Fee
0 to 100 Am s. 30 er 0 to 30 Am eres
101 [0 200 Amps. 10 e` s';', 31 to 100 Am res
Above 200 Amps. ve Above 100 Amps.
Transfo:mers emo on Partial oi othei fee
Signs Special lnspection Minimum fee
Remazks
y?}
??{ W . ?' ??4'-?p?, i,{?
TOTAL EE ?d
?
,
I, the Electrical Cnspector, hereby certify that the above
(Final)
This request void 18
has been m?a 'e:
Date ?v
Date ? °2J-'?? f
. st void 18 months from LG.2??v ? G 6?
:
Da o is Request S. 17939
I, Licensed Electrical Contractor O Owner, do hereby request inspection of the above electri-
cal wirin installed at:
Street Address or Route No. City m6w?
Section Townstup Range County ' pi'?%??
Which is occupied by
!s a roughin inspection required on this job? Nv? Yes ? Ready Now ? Will C&<
Power Suppiier Y? Address
Electrical Contractor E?'? ?- Contractor's License Not767f
(COmpany Name)
Mailing Address ? ? ??? (L-I'(47,?- (`?" &f2?,('' ?U6t.[c- ----
Authorized Signature
C
1 nstal lat lon)
Phone No.
(tteciflcal contractor or Own1
??E ° 0 ano OpT
This inspection request will not 6e accepted 6y tfie
Stete Board unless proper inapection fee is enclosed.
IIIIIf III I IIIIII?II) REQUEST FOR ELECTRICAL INSPECTION?7'??
I Minnesota State Board of Electricity
1821 University Ave., Rm. -128, St. Paul, MN 55104
* 0 3 0 R17 4* Phone (812).U2-0800 ///?'j'
Home Duplex Apt. Bldg. Othe : New Addn
Commercial Industrial Farm Remod Re air
Air Cond. Htg. Equip. Water Hir. Load Mgmt. Other:
Dryer Ran e Elec. Heat Tem . Service Ce Y2 LaC2ment
"X" above fhe work covered by this request. Enter remarks in fhis space and on the back of fhe white copy only.
Calculate inspection Fee - This Inspection Requesf will not be accepted withouf the conect fee:
Olher Fee # Service Erdmnce Sae Fee # Circuifs/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps
Transformer/GeneraTor INSPECTOR'S USE ONLY w TOTAL
Sign/Outline Ltg. Xfmr. 0
?v ?
20. 50
Alartn/Remote Control
Swimming Pool
I hereb cetli ihat I ins xied Ihe eledriml inshllafion descnbed herein on Ihe dakt statad
Irrigation Boom
Rough-In ,
Dale -
Speciallnspedion - '
Investigative Fee Finol j ? Dat
d' 3d
THIS INSTALLATION MAY BE ORDERED DISCONNECTEDCfF OT COMPLETED WITHIN 18 MONTHS.
? J O-17 9? ?FFICE U E ONLY This request void 18 months from volidation daM pnnted in }his box.
?LZID ?
PLEASE PRINT OR TYPE
RequeH Date Rough-in inspection required2 ? Yes E] No Inspedion Other Than Rough-In: ff Ready Now 0 Will Call
10 2 7/ 95 (You must call the inspedor whe n ready) Dole Rendy:
I, El licensed confracior ? owner hereby request inspecFion of the above electrical work at:
Job Add/ess ($treel, Boz, or Roufe No.) City Zip Code
4683 Kingsbury Drive Eagan
$ecfion No.
Tovmship Name or Na.
Ranga No.
Fire No.
Couny
I I Dakota
O¢upant Phone No.
Thomas Chantara 686-9271
Power Supplier Address
Dakota Electric Inc. 4300 - 220th St. Farmington, MN
Elecfi<vl Confraclor (Comparry Name) Conhactar license No. Master Li<. No. (Plant Elect. Only)
CA01834
Mailing Address (Conhactor or Owner Pedorming InstalloHOn)
1537 92nd lane N.E. Bl aine, YIN 55449
Authorized $i notuq (C imcior or Ownar Pedorming InslollolionL Phone No.
L
4 ??-?
ar 786-8484
_
2
0 - - n
EB-OOOOlA-10 6/95 STATE BOARD COPY- SEE INSTRUCTIONS ON BACKOF VELLOW COPV
PERMIT
----? CITY,OF EAGAN
s830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT_TYPE:
Permit Number:
Date Issued:
4683 KTNGSBUFtY DR
LOT: 18 BLOCKs 3
BEACQN HILL
P.I.N.: 10--13500-180-03
DESCRIPTION:
N?fc
J?
?r!.. . ... ?aSn` 1Zr5-' a-i?Y is?& ? '+y[ 3P£e 'o@ ua ?
suzLpzNG
032763
08/03/98
REMARKS:
REROOF DUE TO S70RM'DflMAGE.
FEE SUMMARY:
CONTRACTOR:
APPLICANT/PERMITEE SIGNATURE
aERnoF
Permit 7ype STORM DAMAGE
Rprk Type REPAIR
434 ALT. RESTDENTIRL.
OWNER: - APplicant -
CHAMTARA TMOMAS
4683 KINGSBUftY pR
EA6AN MN 55122
(651)686-9271
BY.
, 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
u 3 C? oF ??
3830 PII.OT KNOB RD - 55122 3_ 9?S
? 681-4675
Mew Construction Requirements
? 3 registered site surveys
? 2 copies of plans (inGude beam 6 window s¢es; poured fid. design; etc.)
? 1 energy calwlations
? 3 copies of tree p servatlon plan 'rf iot piatted after 711l93
required: Yes _ No
DATE: 2
DESCRI N OF WORK:
STREET ADDRESS:
Name: C`'(`/9 n-?4 P_ .9- I N c> M r9 S. Phone #:
i.ast First
LOT: ? D BLOCK: ?- SUBD./P.I.D. Q)-?a-C_U> V`
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Street Address: <? 6 k- 3 K( v?i- ?,h cl J2 i{ ? 1^
Ciry ? rq lr-,?/ State: Zip: 12 z
Company: Phone #:
Street Address:
City State:
Company:
Narqe:
RemodeVRepair Requirements
? 2 eopies of plan
? 2 site surveys (exlerior adddions & decks)
? 1 energy wlculations tor heated additions
CONSTRUCTION COST; I 1, U 00
License #
Phone #:
Zip:
Registration #:
Street Address:
City
Sewer & water licensed plumber (new construction oniy):
and lot change is requested once permit is issued.
Siate:
Zip:
Penaliy applies when address chang
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with atl applicabl
State of MinnesoW Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes - No
.
OFFICE USE ONLY `
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling O 07 4-plex
? 03 SF Addition ? OS 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _ piex
WORK TYPE
? 31 New O 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi RepairlRem. ?
? 13 GaragelAccessory 0
? 14 Fireplace O
? 15 Deck
? 36 Move
D 37 Dec?olition
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 5prinklered
_ 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 MCM1S SAG
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units ..
v: - ..
C:11 Y t:ll li"AG,b1N
(.;f1`aH:CE:R: S 11:::RM:!:RAI._ N0° 24
L"r1TG:^ 09/03/96 ?':1:P`i4F.:' W5:3.^.23
Ir? -,
NAP1F r, (1NI;E.
::32111 9001 4683 tCl:Ni=ST.:sl..lh'Y 187.25
205 9001 4683 Pt7:Nr#3Bt.iftY 6w00
7!a'!: a:L I;rrceip+ l-tmount r L`?.a;3„i 5
CRO637c3=3
I.JSIe.:Fi :!:L! s NAi'.C`l
?X:.Y??X'R)R?x??iC?#?%d?%?X?'d?k???'F?Km>F?L)K?'Ci A<il?l<Pti?f%>i h.ri'?YFY?7,C rv?
CITY bF EAGAN
3830 Pilot Kno6 Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
?
BUILDING
028730
09/03/96
SITE ADDRESS:
4683 KINGSBURY OR
LOT: 18 BLOCK: 3
BEACON HILL
P.I.N.: 10-13500-180-03
DESCRIPTION:
(STDING)
idirf,44,,Permit Type
ldxn9.WA?r.k T,YRe
k vx
atiP
SF (MISC.)
REPAIR
434 ALT. RESIDENTIAI
14Q E'?`? 5? x s??, `•.r'i
hir
`W 1 ???? E f ?a §°''i
a.r?'
? i xem > i i .. ??,'? ? €?+
W _ iav?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Tatal Fee
VALUATION
$187.25
$6.00
$193.25
$12,000
CONTRACTOR: - Applicant - , ST. LIC.OWNER:
AMERICAN REMODELING 15530025 0002406 CHANTARA THOMAS
3700 ANNAPOLIS LANE 4683 KTNGSBURY DR
PLYMOUTH MN 55447 EAGAN MN 55122
(612) 553-0025 (612)585-9271
?eret?y `acky?riwlectge ?tY?a??'? hau?<`rea_tith.i=suapp?.t i?brr ?anc! state ?hat ?he ,
7,7
? informa?i?on i,s c°s?x;rect;.?andn=aagra?'to:eomplry?wit?s al?.. aPpl??,"cableSta'te o,? M'n StatuCes?.anct City ,of iici gara,tlyda.iJances
r;.
eAPPLICANT/PERMITEESIGNATURE ISSUD +:51 GNATURF
r?
i ? ,n f1
CITY OF EAGAN 16130 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Reguirements
RemodeUReoair Requirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? 1 energy calculations ? 1 energy calculations for heated addRions
? 1 tree preservation pian if lot platted after 711193
required: _ Yes _ No
DATE: &, CONSTRUCTION COST: f4
.?
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT ? BLOCK
? SUBD./P.I.D. #:
rZ? ?
PROPERTY Name. QS Phone #:
OWNER FIRST
Street Address- ?? '40A ?+ b j-
City: State: 1'?17 ?Z.- Zip: '
CONTRACTOR Company: Phone #:
Street Address: 3
? ?
4????r,e?al?_s
?
License #: ???voc
? S
?y/7'I
Clty: /u- :S`
y 7
ARCHITECT/ Company: Phone #:
ENGINEER
Name: Registration #•
c±reet Address•
City: State: Zip:
Sewer 8 water iicensed plumber:
change are requested once permit is issued.
Penalty spplias when address change and lot
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.
.
Signature of Applicant: 24Z;4.4->
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preserva6on Plan Received Yes No
BUILDING PERMIT TYPE
OFFICE USE ONLY
0_.
? 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling o 07 4-plex ? 12 Multi (Misc.) ? 17 Swim Pool
0 03 SF Addition a 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. ? 10 Multi (additional) ? 15 Deck
WORK 'F'YPE
? 31 New ? 33 Alterations ? 36 Muve
? 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
?ODqAVA1C
Planning Building Engineering Variance
Permit Fee Valuation: $ ?
Surcharge
Ptan Review
License
MCNVS SAC
n•.. n
vity vor+.
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
n ' h 1
CITY USE ONLY
L BL ? RECEIPT #:
SUBD. 4?J?tic? ??Xx? DATE: & ? ?7S
11A5 939'1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 681-4675
Please complete for: ? single family dweilings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
Hcid-on air condiiioning Hdd-on airexciianger, i.e. Vanee sysiem, eic.
Date: lv J ? 3J %?
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU -24766--
Additional 50 M BTU --6-60"-
0- Gas Outlets (minimum of 1 required @$3.00 each) ?.r "?-
? State Surcharge .50
TOTAL ? 0r?90 ?
SITE ADDRESS: `f? ?'3 ?aGSBU,e y f ?2/ ?
OWNER NAM
PHONE #: /?l ' `i?71
INSTALLER
STREET ADDRESS: lololl azo , tl.e/Gk y,4?D 4?
CITY: sakD??e STATE: /;V,4-/ ZIP:
PHONE #:
/
w,:'?, ,
rdkr_
v F:
cinr use oNLY
L BL
SUBD.
RECEIPT #:
DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: all commercial/industrial buii ngs.
?.' 1T?.
WORK TYPE:
NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee QI 1% of
? Processed piping - $25.00
? State surcharge of $.50 per $1,
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TELEPHONE #:
TENANT NAME: (IMPROVEMtNT.S oNLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE #:
? ulti-family buildings when eparate permits are g2t required
for ach dwelling unit.
\ !`nkJrrf'
fact pn , whichever is greater.
of gg r f due on all permits.
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
I I CER1"I FICATE 0F SURVEY
?eob 41-14"W
-
?
r 13s.s7
.---_ ?
5 ? -- -`
I I
1 N?
- PROPOSEO 9I
o ? I LOCATION
? I .
I LOT I$ z s'
? PROPOSEo
N Li B LOCK 3 W
U*) I HOUSE
in
M I
0 I 36
Iz ?
I
zs' ?
``n- T??ITY EASEMENT
9 ? DRAINAGE
22
G4R.
2 2'
33.05' ???
9 `
? ? h E
?.
?o
? a
?
? N
M
_o I ?
N _ I
I O
Ml
N ?
C
V? I ?
?
32.93
?D ? 136.86
N66°?030E
ee >
Q?
0
?
?
co
v
?
Y
Elevs3tions shoren aro oxlsting greidoa and are aseumo8 datum.
I laes°oby costify that this fe a oorreot repreaentation of m survey ofs
Lot 18, Block 3, HEACON HILL, D?lrota County. Minneaota, accordiag to tkee
plat theroof on filn and of reoord.
csn8 th&b I sw o duly regi3torad lex?l surrreyar uader tho larre of the 3tate oP b?ina9aota.
Gene L. Jaombeon, . Reg= Nod 7734
Datod this 14th do.y of Ys:rcah., 2983
DR. BY JC SCALE - I= 30? a DENOTES IRON MON. BEARINGS ARE ASSUMED OATUM.
Prop2rod for:
Fe:sturo Buildsrs
15513 LAP,art o I.fzne
Burnsvillo, P1inn. 55339
JAC08SON SURVEYO?RS
LAKEVILLE, MINN. :55044
PHONE 469 -43 '3
,
n .? ? .. ?
F?. EXTERIOR ENYfI'OPE AVERA6E •U" COMPUTATION
? ?/
-'OYINER 1?2ir?TAi3 d- ?..iMJA Ki ?-5 ..
SITE AOORE55 q(0Y3?A_'1t164Lb Q,ebKt T?ctA? m?
CQNTRACTOR f:EN7 u 2AE *-01I S DArE /- /o-D PHONE 4zf'- e4 L?
Deter-mine working square foota9e Ot each.
1. Total exposed vrall area .,....sq. ft. z .tI a Za S
2, Total rooF/ce;linoj arc,? ....., 1f ?5.33 sq, ft. z____,OS' •??
Total expoied E:all area above floor ¦I IF2Z
a. Totat wa's1 window area ........................... r20 .G6
b, Total door area ................................ Z z.^,i
c. Total siiding ylass door area ................... 4 o•p z
fireplace e (avera 10?....•...,...•
4 r`' 9e
e. Tatei wall frami t?p.7 Q
)...,........
f, Total net wall area above floor ................. t'3 5-2.03
g. Total rim ,joist ct•ea ............................ 19, 2 a
Total e%:posed foundatlon aiaa = 9 4-47
h, totai found-,ticn, vindow area ..................... Z.GZ
i. Toal net foundation area above gre.«A ..........., z-s
Detcrmine "U" value of each ::ull segment.
a• ?0??____ % Nun
b. X "un --?--_, _ • Q .°l/
c. e o.az x "u^ -? • 2Z.oi
d r-- X
nV• , -
.
e. 19 0.?79 z "u' •fz • Z.L",
f. «M.0 ? z °u• -0.7 . 1?4ha
g q q. Zo x pu• -od . S•qJ.
n._ -Lc z z pus •. r . ?.d a
i. g2.0S x ^v" • 47 • ??gu-
3 . . . . . . . . . . . . .?`3 ?7 . . . . .. . . . .. . .Total
if item 13 is the sam2 as, or less than ltem I1, you have pet the fntent
of SBC 6006(c)2.
. ? -
r
, 'otal exposea roof/ceiling area = ?I2 S•S?
j. Total skyliqht area .... ....... .......•..... ..
?
k. Tota) roof/ceiling framing area (average 10%)...
1, Total net in5u1ate4 roof/ceiling drea........... t I ZS' 12_
Determine "U" value for each roof/ceilinp segment.
i K "u" s
. ' ---
k. x "U" ` -
1 1L2r? ca 7( °U" ? • 5?6-?7
4 . . . . . . . . . . . . . l l.Zs.• S?. . . . . . . . . . . . Tota l
If total of !d Ss the same as, or less than t2, you have met the intent of
SBC 6006(c)1.
Alternate Building Envelope Design
7o utillze the total envelope system method, tne valnes established by the
sum of ltems 13 and d4 sha11 not be greater than the sum of items #1 ana 02.
1.!}Z4 2.-T6. 7 • 40-(oZ
3. + 4. ? 12?
1804 Melody lans
Bumsville, Minnwota
8903083
WEPJA CO. PLAN SERVICE
EO ANDER30N
ARCNIt'[CTVML 0931GNIN0 AND PLANNING
Oftica:? . - ' Offite:
U29'CUP4460d
gg44636
Bumsvilk, Minnesou
Se c-4 33
,
SEVERSON,SHELDON,
DOUGHERTY & MOLENDA, P.A.
SUIT'E 600
7300 WEST 147TH STREET
APPLE VALLEY, MINNESOTA 5 5 124-7 5 80
(952) 432-3136
TELEFAX NUMBER (952) 432-3780
E-MAIL bauerr@seversonsheldon.com
TO: John Gorder, Assistant City Engineer
FROM: Robert B. Bauer, City Attorney 6y--"
DATE: April 19, 2004
RE: Thomas K. Chantara and Phet Chantaza
Drainage and Utility Easement - Easement No. 1007
Project 823
Our File No. 206-19158
Enclosed for the City's records, please fmd the original Drainage and Utility Easement dated
August, 20, 2001 arid recorded with the Dakota County Recorder as Document No. 2149770 on
December 9, 2003.
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DRAINAGE AND UTILITY EASEMENT
2149770 z ?
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DATE RECEIVfQ T Z
17AItOTA COUNTY a J
°@'REASll R-A IT4R o ti
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THIS EASEMENT, made this ? t H day, of 40, o " 2001, between
THOMAS K& PHET CHANT ff%f6?M to as " andowner"), and the CITY OF
EAGAN, a municipal corporation, organized under the laws of the State of Minnesota,
(hereinafter referred to as the "Ciry").
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a permanent drainage and
utility easement, over, across and under the following described premises, situated within Dakota
County, Minnesota, to-wit:
A permanent drainage and utility easement over, under, and across RECENED -MAJL
Lot 18, Block 3, Beacon Hill Addition described as follows:
Beginning at the southwesterly corner, thence NO0°33'S2"W NOV 05 2003
a distance of 40.00 feet, thence S64°49' 15"E a distance of oaKOra couHrv'
82.25 feet more or less to the southerly property line, thence TREASWER-AUDrrOR
S86°10'30"W a distance of 75.00 feet more or less to the
point of beginning.
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The grant of the foregoing permanent easement for drainage and urility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains;
and the further right to remove trees, brush, undergrowth and other obstructions. After
completion of such construction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found prior to the commencement of such actions, save
only for the necessary removal of trees, brush, undergrowth and other obstructions.
And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the Ciry.
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IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed
as of the day and year First above written.
STATE OF MINNESOTA)
)ss.
COUNTY OF ' 'Uit/
------: (?
-
THOMAS K CHANTARA
PHET CHANTARA
The foregoing instnunent was acknowledged before me this day of
2001, by THOMAS K and PHET CHANTARA, husband and wife.
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APPROVED AS TO FORM
City Attorney's Office
Dated:
APPROVED AS TO CONTENT:
F t----?q?
Public Works Departme
Dated: 8 - 3 0 -o (
NoAjFy Pubhc ?
JOEL ALAN RAUSCH
NOTARY PUBLIC - WINNESOTA
My Commission Ev3rea Jan. 31, 2005
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, SHELDON, DOUGHERTY &
MOLENDA, P.A.
7300 West 147th Street, Suite 600
Apple Valley MN 55124
(952) 432-3136
Easement #1007
Project #823
2
RESIDENTIAL
- ' BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-6814675
New Construction Reauirements RemodellRepair Reauirements
• 3 registered sile surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage aliowed) • 1 set of Energy Calculations for heated additions
• 2 copies oi plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exlenor additions 8 decks
• 1 set of Energy Calculations . Indirate i( home served by septic system for additions
• 3 copies of Tree Preservalion Plan if lol platted after 7l1193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE VALUATI N (EXC[UDING LAND)
JOB 51TE ADDRESS_ 1" RJWU-e-)
IF MULTI-FAMILY BUIL ING, HO V'XY U_NITS?
PROPERTY OWNER
TYPE OP WORK
APPLICANT
ADDRESS ,}uN'-
PAGER # CELL PHONE #
FIREPtACE(S) _0 1 2 3 /+
PHONE # ?P ?I ?b 7 ?
?ZIP CODE h SD 1 5?
FAX# 100'M' IP5-0
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Ca!culations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor. _
Plumbing System Includes
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
All above information must be submitted prior to processing of application.
Phone #
Phone #
Fee: $90.00
rw: $70.00
p T i't
I hereby acknowledge that I have read this application, state that the information is correct, omp y wi
all applicable State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Water Softcner
Water Heater
_ No. of Baths
_ Phone #:
Lawn Sprinkler
No. of R.I. Baths
_ Air Condidoning
Heat Recovery Systern
Updated 1/01
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 5iding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement "Demolition (Entire Bldg oniy) - Give PCfi handout to applicant
Valuation Occupancy MClES System
CensusCode -Zoning CitylNat2r
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of 81dgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) Plumbing
Foundation HVAC
1Jrain 1 ile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation Windows (new/replacement)
Approved By , Building Inspector
-----------------------------------
Base Fee ------ ----------?J -- -----------------
( . ? ------------------------------------------------------ ---------------------------------
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppiy & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total q q
6DA
PAID
For Ofoe _Use
L
JUL 2 3 M9 I
1 I Permit
City of Ea
V
Permit Fee:
3830 Pilot Knob Road
I
Eagan MN 55122 Date Received:
~
Phone: (651) 675-5675
Fax: (651) 675-5694 i Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
r
Date: -74, 3-/ Site Address: , u
---r
Tenant: 1 /7 'S; of LJG °t y Suite
RESIDENT/OWNER Name: 4v►'1 11N Phone:
U/ el
Address / City / Zip: 5 ! 1 ~t y4,ey A
Applicant is: Owner -K Contractor
TYPE OF WORK Description of work: 7,-evi c-
Construction Cost: d C2~-w Multi-Family Building: (Yes /-No
CONTRACTOR Name: TWIN CITY HOME REMODELING, INC. License
HIOCRINAWWW
Address: Sp ft t *o PAr #IM W32
City: (M W-~ State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 - Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 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 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.
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 t start without a permit; that the work will be in
accord ce with the approved plan in the case of work which requires a review and approval plans.
Applicant's Printed Name Applicant's Signature
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