4604 Manor DrINSPECTI4N RECORD
CITY OF EAGAN PERMiT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
1 f t' F, ,4,: . . '. W?,4t
SITE ADDRESS: ,, ?? ???? ? APPLICANT:
,,,,: ? ??1?iP1[iFt ?? ???:? ?, .; s,??r•? a??i
, rI1ZMi)k lAkf ftit:?1 1,F4r.-04,'4
PERMIT SUBTYPE: TYPE OF WORK:
, - i?i ?; ; i ?? ???, ? o c??. .. t?t ????tr 1>?iE;???t
001 '1PfH i b I I I; I ld?y!
?
KF MARVtir 1?' k 12' ' llfCY r(si',; ':i: t'1) FOI? 1=11 I'lIRE ('(If:f'll . P ',;l rt ll (tll? CI.f.AR '4•AN
( RW';5E5 {1ft c/1 f FIf tiFrAl i ' t l l 1 NG ( ] . E. . MpMfI t I t + 1 M f 11 1 ' A F 1 " L ! t ' ! . I 1 r F l t C N I P R k T ltiil
;
?
?
Permk No. Pertnlt Holder Date Telephone IF
ELECTRIC
PLUMBING
HVAC
Inspection Dab Insp. CommsnM
FOOTiNGS
FOUND .
FRAMING
ROOFlNG
ROUGH
PLUMBIN(3
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FiREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLD(i FINAL
BSMT R.I.
BSAAT FlNAL
DECK FfG "7 Z
DECK FlNAL
t
? CASH RECEIRT, _ 0
?` 1
CITY OF114f AN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
r
UATE ?-% 19?
nECerveo i
F&W
AMOUNT $
a ooWRs
,m
o casH o-cHecK
FM
r
'i!{Ir?CN L?? '.;? • (1??%t4
BY
?
(,` 13 a51 "me--P.,'m C°°" ?
V.Uw*-f'Qftng Copr
Ar*--FIM c4m
Thank You
I
SEWER & WATER PERMIT
I? CITY OF EAGAN
3830 Pilot Knob Rd.
i Eagan, MN 55i22-1897
DATE ' • JUP'F. 5, 1 941
4604 MAIiOR DYl V E
SITE ADDRESS f
LOT __?_PLOCK 3 SEClSUB MAW)F. LAKG
? APPLICANT: KE'iLAND ti0r+E`;
ADDRESS: 14450 BURN3VI LLE °K`.J'(
? CITY, STATE BURNSVILLE ZIP 55337
PHONE:
? PLUMBER: p•L•-MECtiAN1CA1,
` ADDRESS: 4253 W 140TEi 51
I CITY, STATE SAVAGE Zlp 55378
PHONE: 994"'2778
OWNER: _
ADDRESS:_
CITY, STATE
PHONE: -
OFFICE USE ONLY
METER # PERMIT DATE 615/91
CHIP # PERMIT # -' • ?? -?
METER SIZE B.P. RECEIPT # ?13P?51
ISSUE DATE B.P. RECEIPT DATE 6/71r 1
ZIP
PERMIT REQUESTED
SEWER ? WATER - TAPS
- COMM/IND Y,_ RESIDENTIAL
? NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit VfJILL NOT be given for Deduct Meters.
'
` I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
_ PRV _ BOOSTER PUMP
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSIMG. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE JUNE 5, 1991
OFFICE USE ONLY
METER # PERMIT DATE 6/5/91
CHIP # ?? ? ??
METER SIZE PERMIT # 120 -5C. -
B.P. RECEIPT # C 13351
ISSUE DATE ??d B.P. RECEIPT DATE
- PRV _ BOOSTER PUMP
SITE ADDRESS r 46% r1AhOit DR1VE
LOT 5 BLQCK ? SEC/SUB MANOB LAKE •
? APPLICANT: KEL LAIN3D HOMES
ADDRESS: 14450 BURN5VILLE PKWY
CITY, STATE BU??NSVIi,LE ZIP 55337
PHONE:
PLUMBER: p • ? • ?%'O'HANI::AL
ADDRESS: 4253 6J 140TH ST
CITY, STATE SAVAGE Zip 55378
PHONE: &94-277$
PERMIT REGIUESTED
X SEWER x WATER - TAPS
- COMMiIND
X RESIDENTIAL
X NEW
EXISTING
Lawn Sprinkler Meters are to be Instalted
Ahead o€ `19omestic Meters on Water Line_
Credi!YOLLNOT be givan f4r Deduct Meters.
?-
?
I AGREE TO COMPI,Y WITH TY OF
OWNER: EAGAN ORDINANGES
ADDRESS: ? (\_ _ ll n l?
CITY, STATE ZIP % "%`"'
PHONE: SIGNATURE WHEN MET SUED
PLEpSE ALLOW TWO WOHICING bAYS FOR PAOCESSING. CALL 4545220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
1
, . CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDINC PERMIT PHOME:454-8100
Receipt #
To be used foy Sg OW13f 13AR Est. Value $73,000 Date aU?3E S 199t
Site Address qouq TWURM aRjvIS I
Lot " g Block 3 Sec/Sub. ?? OFFICE USE ONLY
PBCCEI N0.
Occupancy ?
?3
? ?1 FEES
?? ?
= r??? ?$
Name Zoning
lActual) Const ? Bld
Permit = 518.00
?
1 ?K?s? g.
3 AddfeSS (Allowable) ? 36.30
?
0 City 111V1U''6
Phone # ot Stories
- Surcharge
Pl
R
i g3?.? i
$AM Length ?a an
ev
ew
?
i?
?
o Name Depth Ci
SAC •
?
ty
,
?¢ Address S.F. Total - ?w?
~
CIIy PhOnB
S.F. Fpptprints
_ SAC, MCWCC +
6?.00 :
r
a On Site Sewage _ Water Conn
9
u Name on sice werr 3•00 .
? Z
? Water Meter i
?, Address w1wCCSystem 003
30
?
_
¢
3m
Acct. Depasit .
<
W City PhOne CityWater _ 30.00 i
PRV Required _ S/W Permit ?
I hereby acknowfege that I have read this application and state that the
r
i
f
i Booster Pump - S/W Surcharge ?so r
n
o
mat
on is correct and agree to comply with all applicable State ol
Minn 2?6
00
esOta Statutes and City of+Edn Ordinancqs.,/ Treatment PI *
Signature of Permitee 1
ApPROVALS
Road Unit 37040
A Building Permit is issued to: Ptanner - Park Ded.
on the express condition that all work shall be done in accordance with all
Councii
? ?
applicable State of Minnesota Statutes and Ciiy ot Eagan Ordinances. Bldg. Off. Copies
Building Official ? ` ?' ` Variance - TOTAL ?3? 1?3?? ?
. Permit No. Permit Holder bate Telephone #
wnrEa a?O O C° 5?
SEWF-R '
PLUMBING
2W.
H.V.A.C. &jf 91
ELECTRIC ??O JCQ??f . Oh 9/'/ /v ?
inspectian Date Insp. Comments
Footings I ?/?
Foundation '? . 3 . ? ?s
Framing ???
Roofi?g
Rough Plbg. .Z ?. p?
Rough Htg. 7/?y aL
Isul. Z? / ?S ??7? i ?., - !'L??/ !!-5
Fireplace
Final Htg.
Orstat Test ?
Final Pibg- -L ( Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final ?_ . ?
Dedc Ftg.
Dedc Final
weu
Pr. Disp.
- ?.
4k
? (gtr#i#tr?te of (Orrupauxy
Citp of Cagan
BeParhttrttz of %'t(dittg itwprrtian
Tlitr Certificate issuad pursaant to the requirements ojSection 306 of the Unijorm Building
Code Qertilyin811uu at the dre of i.uuance this uruclure was in cornpliance with the warious
ordinaiuxs of rlre (Yly rqulatirtg building cvnstrrxtion or rrse For the jollowing:
u,e C76ai6neon $rL aC.4GAR EIOg„ yinit No, 19174
OOMP.Ky Tya R1,41I Z,.it Duit R 1 'rype caau )N
owoerofBwleog K,'YLi1M HMM Addnu 1445) RlQN7F. PftaP- gIVII7F.
Bwldioa Abdeaa _.LI " ??M. ND1E [.oaiitt j„5 ? R'? ? MAN^R T?i?
u.tc QJ1+fQ1
POST IN A CONSPIWOIJS PU1CE
Address: 4604 MANOR DRIVE Lot 5 B1k 3 Sec/Sub yqpg 7,mT
These items were/were not complete at the time of the final inspection.
9/4/91 Yes No ?
Final grade (6" from siding) ?
`Permanent steps - garage ?
Permanent steps - main entry
Pexmanent driveway f
Permanent gas
Sod/seeded grass ?
Trail/curb damage
Porch
Basement finish
Deck
Please verify wSth the builder the removal o£ roof test caps from the plvmbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. ?
White - City copy Yellow - Resident copy Pink - Contractor copy
BUILDING PERMIT
To be used for SF DWG/GAR
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
Est Value $73,000
Receipt #
.iUNE 5
N°_ 19179
C./3?S_
91
is-
Sle Address 4604 MANOR DRIVE
Lot •5 Block 3 Sec/Sub. MANOR LAKE
Parcel No. occupancy
Zoning
W Name KEYLAND HOMES (p??uap Const
? Address 14450 BURNSVILLE PKWY (Allowable)
° City B' VILLE phone 894-2636 ,r oi stones
Length
? Name SAME Depih
Q
?
~
U
AddfeSS
S.F.TOtal
? City Phone S.F. FootpriMs
F On Stle Sewage
Fw Name on saewen
6-0 AddfBSS MWCCSystem
aW City Phone city water
PqV Required
I hereby acknowlege that I have read this apphcalion and state that ihe Booster Pump
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of n Ordinanc .
'
Siqnalure oi Pertnitee
APPfi04ALS
A Buildmg Permit i5 issued ro: KEYLAN? HOT Plenner
on the expiess crondrtion ihat all work shall be done m accordance with all CuuncA
applicable State ol MinnesoA Statutes and City Eagan Ordmances. BIdg.Ott
Buddmg OHicial
z' Variance
OfFICE USE ONLY
R-3,M-1
R-1
FEES
t 918.00
oiuy. reFFFIlL
Surcharge
Plan Review
-(8i SAC, Ciry
xx
XX
SAC,MCWCC
W ater Conn
Water Meter
Acct. oeposil
S/W Permit
SNJ Surcharge
Treatment PI
Road Unit
Park Ded
CopiBs
TOTAL
36.50
337.00
100.00
650.00
660.00
95.00
30.00
30.00
.$0
276.00
370.00
a3.103.00
;ESee QUESoFORoE?ECTRoCAo INSPECTION
1 211 qn "X" Below Work Covered by This Request
EB-000'0/1-0/8
e-?Ada
j ep" " TypeofBuiltling
Home AppAancesWued
Range EqwpmentWued
orary Service
Ouplez Water Heatar HeaUng
Electric
Apt Building Dryer +
r (Specify)
Comm /Indusinal Furnace
Farm Air Conditioner
Ofier lsyeoiryl
Compute Inspecnon Fee Below GaNrectors Remarks
# Other Fee # ServiceEniranceSze I F e # CrtcwtslFeeders Fee
Swimming Pooi 0 to 206 Amps to 100 Amps
Trensformers Above200_Amps 0 Amps
Sigf1S Inspecmr's Llse Only O TOTAL `
J
Ungatwn Booms ?
Special Inspecuon
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTH
I, the Electncal Inspector, here6y Rouyn-io oece
p ?
cerhfy ihat the above inspection has
been made
f
OFFICE USE ONLY
Th5 Rqupsl vaid 18 mOnlM1S 1rOm .
140ozVir
Requesl Date Fr Rough-in Inspection
ReQmred'+
-
?I Reatly Now ?Offf NoUfy Inspector
R
Wh
O
9
/ ?s
M. en
ea
y
IZ,-ricensed contractor ] owner hereby request mspec4on of above electrical work at:
Job AaOrStr¢etO or Rwfe N. I?? ? Gty
Seclion N. Township Name or No Fange No Cou y ?
Occopa? ? Phone No.
Power 5 ier AtlOress
E eclnc ' nt:aclor (Gompany Na e? / ConVacror? c se No
?
Mei?tlaress onlractoror Owner Making Inslallation)
n
r
C
?
I
ll L
PM1
N
b
omract
One
um
m?i
?
nsia
e
o , ?
MINNESOTA STATE BOAqp OF ELECTRIQTY ? THIS INSPECTION REOUEST WILL NOT
Gnggg-Mitlwey Bltlg. - Room 5473 BE AGGEPTED BV THE-STATE BOARD
1821 Universtly Ave, St. Vaul. MN 55104 UNLESS PROPER WSPECTION FEE IS
VM1One (612) 643-p800 ENCLOSED
2004 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
A(0 3'?? 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruction Reauirements Remodel/Fteoair Reauirements
3 regislered sile surveys showing sq. fi of lot, sq. R of house, and all roofed areas Z upies of plan
(20% maximum lol coverage allowed) 1 set of Errergy Calculations for heafed addi6ons
2 copies of plan showing beam 8 window sizes; poured found design, etc 1 stle survry for additions & decks
1 set of Enxgy Cakulations Addifion - indicate if on-sife septic system
3 copies of Tree Preservation Plan if lot plafled aNer 711193
Rim Joisl Detail OpGons selec(ron sheet (bldgs wilh 3 w less uniGs
a'-?0 ") 6
--94 yv\.r.&
tit?xe Fke 6?tv
c?rt or s?cyr tze?a. .: .
7"tee:PresP.lan RecdfreePres.Requireil::
Q0-sil'e?Septie3?'stem: :
Y.?:'?...N
_Y:_N.
Y.i.: ry
___Y,;:.T N
Date 1,3 7 Construction Cost ?I 'S 6o
SiteAddress LY (r/oOv ??J /?" ?4YL0t- ON(_rt UniUSte #
C? 4 !'t .
Description of Work
6lJ4 Gj ' a ?
Multi-Family Bldg _ Y_VN Ftireplace(s) _ 0_ 1_ 2
Property Owner - .Z r0"? Telephone#(&'M) (0gC0-I °a
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 7 Worksheet . New Energy Code Worksheet
(Jsubmissiontype) Suhmitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagdn with a similar plan?
fee applies.
Licensed Piumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 257o plan review
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the informa gyn is cdrrt?e a?ntl acaurate;
that the work will be in conformance with the ordinances and codes of the City o agan an t e tate of MN
Statutes; I understand this is not a permit, but only an application for a pernut, and work is not to start without a
permit; that the work )Arill be in accordance with the approved plan in the case of>York which requires a review and
approval of plans.
\ oScP? ?. /J
ApplicanYs Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Muiti
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Mutti Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
work T,,Pes SC2F? Pr?n.Gtf ?r?? ?Un.e,la?
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Adddion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
?c 33 Alteration ? 37 Demolish 8uilding• ? 43 Reroof ? 46 WindowslDoors
/0 34 Replacement 'Demolition (Entire Bldg) - Give PCA handaut to applican[
Valuation oco Occupancy MCES System
Census Code 72 Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
_ Foorings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drein Tile
Roof Ice & Water Final
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
1( Framing _ Siding _ Stucco _ Stone _ Brick
Fireplace _ R.I. _ AirTest _ Final _ Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Pertnit 8 Suroharge
Treatment Plant
License Search
Copies
Other
Total
SL?L,?'- cJ
?
( qy 0 -1, q //0
? " INSYECTIUN RECUKll
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILDING
026067
07/21/95
SITEADDRESS:P'I'N.: 10-47275-050-03 APPLICANT:
Lq7: 5 BLOCK: 3
4604 MANOR DR NORDSTROM
MANOR LAKE (612) 686-0424
PERMIT SUBTYPE: TYPE OF WORK:
DECK
DESCRIPTION
JOE
NEW
F7GS - FUTURE PORCH
REMARKS: 12' x 12' OECK FTGS SIZED FOR FUTURE PQRCH. FTG5 SIZED FOR CLEAR 3pAN
7RUSSES OR CATHEDRAL CEILING (Z.E. HAND FRAMED RAFTERS WITH CENTER RIDGE
F BEAM) _ _ -?
,?ITY OF EAGAN
/" 3@30 Pilot Knob Road
? Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
??4'?W'?7
BUILDING
026067
07J21/95
SITE ADDRESS:
P.I.N.: 10-47275-050-03
4604 MANOR pR
LO7: 5 BIOCK: 3
MANOR LAKE
DESCRIPTION:
FTGS - FU7URE PORCH
Buiiding?l,permit Type DECK
Building Work Type NEW
.,
,
;.
?.
, r..
? ?.
4!
REMARKS:
12' X 12' DECK FTGS SIZED FOR FU7URE PORCH. FTG5 SIZED FOR CLEAR SPAN
TRU5SE5 OR CATHEDRAL CEILING (I.E. HAND FRAMED RAFTERS WTTH CEN7ER RIDGE
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant
NORDSTROM JOE
4604 MANOR DR
EAGAN MN
(612)686-0424
I hereby acknowledge that I heve read this application and state that the
infiormation is Gorrect and agree Lo eomply with all applicable State ot Mn.
3tatutes and City of Eagan Ordinances. J
APPLICAN /P MITEE S ATURE ISSUE : SIGNATURE
CITY OF EAGAN
. 3830 PILOT KNOB RD - 55722
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Conshur2ion Reaulrements RemodeLReneir ReaWrements
? 3 repisterod eke wrveys ? 2 copies af plan
? 2 copiss ot plena pndutle beam 3 window sizea; poured fid. design; etcJ ? 2 sfta surveys (exterior addRions & dedcs)
? 7 enerpy wlculations ? 1 enerpy ealculations for heated addkions
? 3 copies of Uee prosenation plen if bt plaCed after 711/93
mquired: _ Yes _ No
CONSTRUCTION COST:
;--? ?
DESCRIPTION OF WORK:
STREETADDRESS: 76(oq
LOT Af BLOCK J SUBDJP.I.D. #:
1lJ ?s-? ?ti?
PROPERTY Name:? Phone#: - 61
OWNER ?• .a•, oy z?
Street Address_?`? M 4?0 ^
City: E 4 state: M n. zip: Ss? ?3
coN7w?c7oR Company: C A- PA t:- Phone #:
Street Address: License #•
City: State:
ARCHITECTI Company: S tq- V'L E
ENGINEER
Name:
Zip•
Phone #-
Registration #•
Street Address?
City; State: Zip:
Sewer & water licensed plumber:
dfange are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the info aUon is co and agree to comply with all
appBcable State of Minnesota Statutes and City of Eagan Ordinances. ? ?
Signature of Applicant:
rtmt??f?MUfr5
OFFICE USE ONLY
Certificates of Survey Received
_ Yes _ No
iiii 141995
Tree Preservation Plan Received - Yes - No
OFFICE USE ONLY
BUILDING PERMtT TYPE
0 01 Foundation o 06 Duplex o 11
0 02 SF Dwelling o 07 4-plex o 12
0 03 SF Addition o 08 8-plex o 13
0 04 SF Porch o 09 12-plex ? 14
0 05 SF Misc. a 10 _-plex ,M-' 15
WORK TYPE
0 16 Basement Finish
0 17 Swim Pool
0 20 Public Facility
0 21 Miscellaneous
/llort : /Zy rZ 6 l.eK- 00i"yt
Sgtk Fo? Furkac Pe22M
.?31 New o 33 Afterations o 36 Move
a 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const (Adual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
Zoning Sq, g.
# of Stories gq, ft.
Length sq. ft.
DePth Footprint sq. ft.
APPROVALS
Pianning
Pertnit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Pertnit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Total:
i
CZD ed 0 - SI&r4 4)
FTt, s. t, z te FOa CctAR. SP?-v
rRUsris 0.4:- G'4rra,40ve- c¢,?,.?y
61. P flf aeFm,%re R»?+arc.Qr w ccwrra
R?44c gf?.k?
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. 5'3 Y
5AC Code
Census Btdg i
Census Unit O
Buiiding Engineering Variance
Valuation: $
Apt./Lodging
MuRi Repair/Rem.
Garage/Accessory
Fireplace
Deck
% SAC
SAC Units
hh=1'?'-i??-'"?1 Plull le;R ?L lu?Ji=11'?Ii?U ie I?IILL ll?l?. 1?fcl. b?u??1=+ ti?k3-uz4.}
s,v^-1d
4604 MANOFi CIRIVE 0tL
sURVEYOR'S GERTIFICA7'E
NOr6I NO al'ltFiC 301L9 IMVESTIGASION HAS BEEN COMPI.ETED
ON 7H19 LOT 8Y THE SW1yEY0R, THE $U17ABIlIIY OF
!ql! TO $UPPCAPT THE 9rfCIFIC HWSE PRppOSEO IS
kOT TNE RElPGNrgIMLJTY Of THE SURVEYOR.
kl A NOR
09
5 ?
AROPO ?
? ?i 4pIVHWAY
M ' I (9,71 0 ? M
20.0 ` 23A0?
o
O I N GAR. o
0 I ? ' C9.S1?O) ? I
M b
30.0 ? NMj N
POS a
. ?-.a .». N/Pj USEEU i YI ? I
0
? ,- 96.00 IV 89024' $7' E _
C9t7 4) i', s s`?`? C91B,3)
q
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tJ
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O I
in
N I
ry3ao `, sC
`w
K- t 7
0461 Pc,_"
?
? ?'G 34i0-IT=?,, ?
EYLAND HOMES
?? .
cc)
{" -
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O
?r yµt I Q
peg ;o-?EU? C ' k?
`. I ? T 5 N
O?.iMfiAGE .,^.::7iLIT't
EA3EMEMT PER PLAT
- 1
•00 M 89° 24 47 E7
r I ' ?" ? ^ =r
DR I bEe
N
?
NOTE: BU1LpItdG DIMEMSlONS SH01Yt7 ARE
? 1 FGK HOItf2 ?*4 ? 4FRTlCAL iAC-
??.__.? _..
/
SINGLE Y
FA'tiILY DWE INGS
1991 BUILDING PERMIT APPLICATION
CITY OF EAGAN
MULTIPLE DWELLINGS
go
?
-5
'1?1
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTER.ED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUI.ATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS -
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUIL?ING PERMIT IS ISSUED,
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: (A `?valuation:? Date: ?
? ` '? ` 7?
Site Address G?.??y'-? Mqpaotz "Doelv? OFFICE USE ONLY
Lot 65 Block
Occupancy R-3 M-l
?n I rZoning ?_ 1
Parcel/Sub ?v,?0'2 l ow-w Actual Const V-N
Allowable Y-N
Owner # of stories
Length 50
Address Depth ?
S.F. Total
City/Zip Code Footprint S.F.
Phone
Contractor
Address LAA.?
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone # ?
COMMERCIAL
FEES
Bldg. Permit 518,00
Surcharge ]aSO
Plan Review 3317,o'D
SAC, City /DD,Ck?
SAC, MWCC ??OD
O
Water Conn. 460,0
Water Meter 45' 0o
Acct. Deposit 3040
S/w Permit 30.0a
S/W Surcharge 1.50
Treatment P1. 2I6-00
Road Unit 370 ,0'D
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change -?r--
TOTAL
i
C(SignatO(?` dContractor) agrees that all work shall be ?ione in accordance with
ure?of ?-
On site sewage`
On site well _
MWCC System _
City water ,
PRV ,
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off
Variance
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
"rOV'+ MHIYUK UmIVE -44I0-II-B
SUR1iE1fOR'S CERTIFICATE KEYLAND HOMES
NOTE: NO 3PEICFIC 30163 INVESTGA710N HAS BEEN COMPLETED
ON TNIS lAT BY THE SURyEYOR. 7FE $UITABILITY OF
SqL$ TO $UPfOqT THE !PlCIFIC HOUSE PROPOQHO IS
NOT THE Rf9PONSIBN.ITY OF THE SURVEYOR. OAK
MANOR_
R
C9z7. q)
1-
l?
_ J
W
?
In
M
0
O
fn
0
O
6
N
96.00
DRIVE
0
?
N 89°24'47'E
0
F - - - P
I ?
I
I o
I N
i • C931.o? N
--- so.o -
? ?? ?
HOUSE
I (431.0?
L OT 5
4
? y
I
23AOt?
F-
lf? DRAINAGE 9 U71L17Y
S EASEAIENT PER PLAT °--- `-
g
- -- -- --" ?" --- ?
?
`. 96 .00 N 89024 47 E-
NOTE: BUILDINfi DIIipI51
ONM
A
R
E
0N
S
SH
.r
? ?
p
?
Trm
ATIapN?TIN TIII! OIY ?
o
c
t?L.
. .
AIICHITECTUN. PLAM !OR NlLLDING
9 FqJNOATtON DIYLlqfONl.
+ DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCAIE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - y)j,3 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 9t8•5- FEET
(000.0) DENOTES PROPOSED ELEVATION PfiOPOSED TOP OF BLOCK - 4 3 h 7 FEET
WE HEREBY CERTIFY TO KEY LAND HOMES THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
LAT 5, BLOCK 31 MANOR LAKE ADDITION, ACCORDING TO THE
RECORDED PLAT THEREOF, DAKOTA COUNTY,MINNESOfA.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYEp BY ME OR UNDER MY DIRECT SUPERVISION THIS 13TN DAY OF MAY , 1991•
WiOPOSEO GRADES SHOWN 14ERE TAKBi
FNOM THE fiMqNO 6 EROgpN W N7RpL
PLAM OF MANOl1 LAl1E 2ND AD4, PREpARED
BY ULTEIG ENG.,INC.,LAST DATED8-29-99
R. HILL, INC.
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19826
? o ? ?? o ? ? D James R
Hill
inc
o ? .
,
.
o r o ?? n ° W m ? PLANNERS / ENGINEERS / SURVEYORS
" ? Oz m v?i ? i
' 2500 W. CN. RD. 42 o BURNSVfLLE, MN. 56337 a 612-880-6044
C9ze.3)
n°W
?-
. In
M
e
O
(A «
EXTERIOR ENVELOPE AVERAGC "U"COMPIITII:FION
--- - z-Y (O
,
.,,
r '
1 7
nnTr:
OWNE R: ------ _
_
----
T ) la ?V?=' PNONE:
SITE ADDRESS:
PLAN 3y 10
CONT RACTOR :
Determine working square footage of each
??5 `I3 sq. ft. x.11 = 2dZ., 73
1. Tota] exposed wall area.:...
1Z
??1 sq. ft. x.026 =
32
2. Total -
roof/ceiling area.....
Total exposed wall area above floor= lLe k $
I
a. Total wall window area ............... ...........................
...... .
.
b. Total door area ...................... ..................... 3 Z?
c. Total sliding glass door area ........ ........................... .
d. Total fireplace wall area ............
ea (average 10%)
i ...........................
........................... . '?1 ?
. L.
e. Total ng ar
wall fram
.. .
. ,? I
f. Total rim joist area ................. .
.................
... . I?iS??Z
g. net wall area a6ove floor ......... ........................ - -
h. wall area above floor ......... ........................... .
............... .
i. wall area a6ove floor ......... ............
j. frame wall area at foundation...
Total exposed foundation area= "7
k. Total foundation window area ....................... -'
1. Total net foundation area above grade .............. 7
Determine "u"
(e.g, window, value
door, of each wall
each separate segment
wail section)
a.
I 3? ? i y
X
„U„
.`f 7
= 4't. Lf 5
b. X liuii r?Z = (Z, I(o
C. X „u„
d. -? X iluit
e.
f,
g.
? 4 I , (s
i S I
I6-IS(oIZ
X
X
X
"ut,
11 U..
'lull
n. x liui, _
x „u„
;. .
X "U"
j.
k. - X iluit
1. ? LA X Ru„
3 . .................................Total
= 11 ?
If item 03 is the !
as, or less than i'
01, you have met t!
intent of SBC 6006
, Total exposed rooP/cei.linq area = IZ-? 1
• ? ? , , • ..--
n. 'ibtal skyli.sht zrea ............................
a. Total roo`/cei'_in, framing arca (:ivcrage
o. iotal net i^sulated roof/cciling area.....::..... ' 11 .3
Determine "U" value L-or each roof/ceiling segrnent
n X "U"
M. r.. 1L4?-I a,lUll ioZy_-- 3?C?
(?`?b3 X
, ........................... Zbtai = ( 2 5'?? S
:' ?o=e1 c= -- is the sama as, or less S:han #2, you have met the. intent o: -
Sb? 50::5 ic) 1 • •
AlteYn=te Building Enve'..ope Design _
^o l±ze t'r.e totzl envelope'systeJn method, the values estzblished by the s:ua of :te•ns r3 z.d :4 sha11 not be greater than the sum of itens ,°.1 and n2. .
,. Zoz.?l3 + a. 3Z?41 y = z_ 3
3. ? + 4. 1f.? , 3 ? ? . . . .
4. TOTAL EXPOSEO RQOF/CEILIMG CALCULA710N5:
Tofal expnsed
roof/ceiling area........ sq ft
j) Total skyliah[ area....... ?f sq ft x"U" °
k) Total roof/ceilinq framing
area (Averaqe 16510 ,..... iz(/_59 ft x"U"
1) Total net insulated
roof/ceilinq area.......? sq ft x"U" ?d ?i5
4 TOTAL j) thru 1)
tf total oc °I+ is the same as, or less than N2, you have met the intent of
2MfC?Z 1.16005 A ar.d 0.
. ALTERNATE BUILDIPlG ENVELOPE DESIGN
To uti lize the :otal erivelope system mr_thod, the values established by the sum
of iCens =3 and 6`4 shall oot be ci reater than the sum of items 9 1 and '-`2.
+ 2. Ge'
+ 4. ? ? Id = 7,l?,ct4
PLArr # iZ- 34 to-1T
* LrxEAL rEer EXPosED wnLL
si.,ocx? ?t ?- + z (? + ?t ? + z?o = i ?k g
101EE : Zc? ,-zvf 3a = 8Z
w.o..
FULL i: `(S +z7,s+i3 + i,s-+3s-+zco = ?sl
fULS, 2:
FIREPIACE:
RIM:
* SQUARE FEEP EXPOSID WALL ARFA
BLACK: Ili % x .5 = -7?
KPIEE: r6 y x 5= O
W.O.: x 8 =
FULL1: ?SI x 8 = 12OC6
Ft7LL2: x 8 =
FZREPLACE: x =
RIM: x 1= I S I
TOTAL i8`t3
* SQUARE FEEf EXPOSID CEILING l Z C,'j
W %I%i I u 06%YS
1 I I- Z`( 3? G?c.. = i z= 3 c„
t -Z33? c S.S`i
? -z3k7 ? Z,sl
1-t?13S z-
\- Z8K$ ?a?- ,?$.l.t ZG ?40
? - zw4o??- =13
? DOORS
$ 3 Fs
z
? ?
PAT20 DOORS
? BASIIMEN'T UNTTS
/J?r Use ?? aF?opc4ue t,ul l area for
- fYar+rE C[Y?SEruGf'?Un
t4A LL.
EIG. *1
ScLj_ ISehLssC
R- VAI,UE
corrsTxucrzoN=- FRAMIxr - -
1. INTERIOR AIR FILM 0.68
2. 2 BD .45
3. 5 1 2 SOFf 4X)OD 6.87
4. -14' R.?v:iv'StlEati-l,r.u? , ?.+su?l 5•4
5. SID' G ,8r-
6. EXTERIOR R FILM 0.17
AfET
1-
1.
-
IN'PIItIOR AIR FILM AL R= ) .1 q
v= .6-7
0.68
R. ' i 2 Gl'PBD .45
3.
4. L.
?° ?r1Ai? sNEd+'IF1?NC
??wsw..l 5
S.
ING T
61
6. R A R LM 0.17
TgrAL
U
. o q
1. INTERSOR AIR FIIM 0.68
2. 6 INSUL. 19.00
3. x R JO
4.
5.
31DING
.62
6. MTER-IOR AIR rILM 0.17
a'1.-rca
U= • °`}
JFd?ATSlA
WJtLl.
?G A3
L ?
,_. L,• `7
'?, b ,r ?u„ •
BiACK
1. INTERIOR AIR FILM 0.68
2.
3. 0 . 0
4. PROTECTIVE BARRIER
5.
6. A
TOTAL R= .13
U= .14
SLAB ON GRADE
F3-r" s44
? . . ? ?
- l) . , ?'• ? - }
I ? .? a * c
.-
?{? ? ?? Da "„? ?Il?+=
/?f •, P e ? • • ? - ? l'
?
LLL S? ? _° /i1 =
?
NOTE: INDICATE T'YPE, "R" VALi7E. DEP'IH AND
PLACIIMffNT OF INSUiATION.
pR4PE HnLL
ROOF-CEILING
d
J-J ?J
VENTEp I A H£AT FDOia
u UP
FIG. #5
FiEAT FIAW UP
ll
FT6. #6
' R-VALiJE
2.
3. ?ia-,? ? uaT ntil - $4?• °?
4.
Tt7j.Ai 3 fx
U - , oZ5
?
tL
2.
3.
4. rxrsrunQ Az ?.,-i--?
'
U = Z-11.
1.
2.
3.
4.
5. ..
1. TOTAL.
U =
?
2.
3.
4.
5.
1. _
U =
2.
3.
4. '
U =
NOTE: USE ADDTTIONAL SMF.TS IP YDIT SPACE IS
NEIDID FOR DErAIIS AAID CAI.CIJiATI0N5 •
FIG. #7
NWN-Vt1v1LV ? f
t?'aT FLOw L1
? lJP
ROOF-CEILING
? . ? , . .
VFNf /% U ` : ?v?+v?
?-Q??--
Z\ HY-AT F'PpIt1
L?• ? ?
?u
FTG, #S
CONSTRUCTTON ' R-VPiaJE
1. INTERIOR AIR FIIM 0.61
2.
3.
4. ,I,OT
U = .02
FRAME
INTERIOR AIR FI"i14 0.61
2. 57B'r, . . '
3. X -
4. - ?J,.
U = 0.024
CONSTRUCTION
1. INSIDE PSR £ILM 0.61
2.
3.
4.
5. •' 1OTAL
U =
FRAt'fE
1 INSIDE AIR FILM • 0.61
? H?kT F-iAW tJP
VEN'I'ED
FIG. # E
?) r4
,.
,.
f , ? ,,. _?=f=3
14 a "Q2
NON-VE.N'I-M
i-I£AT FLOW
lJP
15
%
?
s /
? .
2.
3-
4.
5. ?T TOT?+L
U =
INSIDE AIR FIIM 0.61
2. ?
3.
4. .
s. To:aL
u =
NOTE: USE ADDITIONAL SHEETS IF YORE SPP.C- IS
NEEDED FOR DETAILS AND CALCULATT-aNS.
?'_G. =7
CITY OF EAGAN FOR CITY USE ONLY ,
3830 PIIAT RNOB ROAD ?
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT #_
DATE: Co /
PLEASE COMPLETE IIPPER PORTZON ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WFIEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ -------------------------------------------------------
WORK DESCRIPTION FEES
NEW CONST _
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS: D7./ 0? 1_rin.o-'1 L14
•
?
LOT: oJ BIACK I
SUBD.
INSTALLER: _fy4)t7l-o ( .CtA ?.c? •
ADDRESS : /'6 g 80 (?XtX.c_c?-.-.?? C.,C.c+.v . xY •?
CITY:?.?Lse? l7l217i ZIP: , 5537?-?
PHONE #:
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUSTOTAL: $_!EZ2_-06
STATE SURCHARGE: .50
TOTAL: $1222.50
.
GNATURE OF PERMITTEE
P04II4ERCIAL/TNAIIS'TKIAtt PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARR
NOT REQUIRED FOR EACH DWELLZNG UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADnnggS;
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ZIP:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIi Fifi.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
$
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
- • 3830 PILOT RNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
9m&oglwn
NSAgq1xw
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE : 7 - .?. y ?M I
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNER NAME: 6r.a Ls%'-\A
SITE ADDRESS:
LoT: S Br.oCK 3 SUBD.'?r`?.r??
INSTALLER: OC-- ?C?cJ1\Cc.?
ADbRESS:?7J?S?S ? 0C •
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00 ?-
? WATER CIASET 3.00
1 BATH TUB 3.00
?o LAVATORY 3.00 [tx _ ?
i KITCHEN SINK 3.00
i LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
I WATER HEATER 3.00
? FIAOR DRAIN 3.00
GAS PIPING DUT.
? (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50 ,S`d
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL $ '?D-SO
ST. SURCHARGE .50
TOTAL: $ ?? , LO
?t)?IItERCSAL;j?ND1#3T&IALz PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MiTLTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQIIIRED FOR EACH
DWELLING UNST.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
ZIP:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
$
( S IGNATIJRE )
CITY:f ?? e- ZIP: ?J3??
CITY OF EAGAN
CASHIER: SS TERMINAL NO: 794
DATE: 04/06/00 TIME: 11:08:22
ID:
NAME: DAVID SCHWEICH CONSTRUCTION
3210 9001 4604 MANOR DR 125.2'.
3430 9001 4604 MANOR DR 0.2E
2155 9001 4604 MANOR DR 3.0(
Total Receipt Amount: 128.50
CR125650
USER ID: JAN
***********+***?**?*?++***+++++?,f+f++++
2000 BUILDINC PERMIT APPLICATtON (RESiDENT1AL)
•-" cInr oF encari
3830 PILOT KNOB RD - 55122
V J 651-681-4875
f
New Conatn;
> 3 reglateretl Yte wrveys alwwtny aq. H, p1 bt, sq. M. ol house
and gu raoled areas 470% maxlmum lot coveraae allowedl
> 2 coples d plans (show pgem & wlntlow sizes; poured fM1. tlealgn; s1cJ
: 1 set of enarpy calculatlona
> 3 coplea ol hee preservaHan plan H lof ptattsd aRer 7/1 /93
Cc3-A_X .A.n9
RemoAet/Reoadt Reaulremenh
?C)
3-aFs-v6
2 capie8 W plan
1 set of energy cadCUlaHons for heafed addlHaia
1 site wrvey for axierbr adtliHOns 8 decW
?
DATE: 3- 27 CONSTRUCf10N COST: 11,000. ao
DESGRIPTION OF WORK: G=??? At>b? O^-) ?2- 2 x I fp
STREET ADDRESS: 4(,OC-1
LOT: 5 BLOCK: ? SUBD./P.I.D. t: Y Y l0. i!\d r L
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
EN6INEER
Nama: J'-'?:Q- S'r? M
Laat Flrat
'-t6o"Md??2 4J2cv ?
Sheet Address:
Phone#:C6,?5" 1? c,?'?? -- 1CJS
?
city state: t-" ? nP: S? ` z 3
Company: T)?-ri rJ S c{-a- wE1 ?'- H Phone #: &a
(area code)
Sheet Address: / L)a- ucense # 3L07 Exp.
aty s?ate: zip:
Company: Name:
Teiephone #: ( )
Sfreef Addresa: Regishullon N:
Ciry
Sta4e:
Sewer/water licensed plumber (if instaliina sewerhvaterl: Phone #:
Zip:
I hereby acknowledga ttwt I have read Ihis applicatbn, staTe IhaF Iha informaFbn ia conect, and agree to eomply wHh aA appticable StatE
of M,Mnneaofa Statutea and Cify of Eagan Ordinancea
Signalura of Appttcant
;•OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
_ No
- No - Not Required
PKR L 7 27i
_ ?
OFFICE USE ONLY
BU{LDING PERMIT 3UBTYPES
? 01 Foundation O 07 05-plex ?,13 16-plez ? 21 Porch (3-sea.)
? 02 SF Dwelling O 08 06-plex ?C 17 Garage p 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex O 18 Deck O 23 Porch (screened)
? 04 02-plex O 70 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex O 11 10-plex Pibg Yor_ N ? 25 Miscelianeous
? 06 04-plex O 72 12-plex ? 20 Pool 0 30 Accessory Bldg.
WORK TYPE
-??31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bidg)" ? 44 Siding
? 33 Aiteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code af # of Stories ? sq. ft.
No. of Units d Length ?z sq. ft.
No. of Buildings 1 Width i 6 Footprint sq. ft.
Const. (Actual) ??? Basement sq. ft. Census Code
(Aliowable) ? Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. Ciry Water
Zoning " sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS p
Pfanning Suilding 0.?G Engineering Variance
i
v. ,
? 31 ?_xt, Aft - Multi
? 33 E'xt. Aft - S F
? 36 MuRi
LI38
Permit Fee ) a-? - a?
Surcharge a -O v
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 H
Copies
Total:
valuation: $ Sf 7 0 o
SAC Units
% SAC
4604 MANOR DRIVE
, ,dR'S CERTIFICATE
4C 501L$ INVES7GATION HAS BEEN COMP'LETED
lAT BY THE SUNVEYOq. TFE SUITAOILITY OF
SUPf4RT THE lPOCIfIC HOUSE PROPOlEO IS ?.
RE9f'ONSIBILITY OF TME SURVEYWt.
r MANOR_ DR IVE
2
C9z?•?l) i ;
W
M
q
tn
M
0
O
cn
HOUSE
?-
LJ
_ J
°o,
?
N
,. 96.00 N 89°24'4TOE -
o Q
,r- - - -- rROro ?'
NOWA
I (93?.0) . . I
? I
I ! ' ?931•0?
? tssi.o) ; I?W
I `?-- C93o-s) .1
? LOT 5
?, f'4 {• ,. ?t A
DRAINAGE 9 U7ILITY
?lASEAAENT PER PLAT_J?\ ` ?5
( 938 0 ',
, 96.00 N 89024' 4T"E ?
0
fo
3410 -II-B
KEYLANO HOMES
C9z8,3)
W
'IA
In
M
e
O
N (ci
?-
N
I
-C f310-L--
NOTE: BUILDING pMENS10N4 SMOWH ARE
r fOR p1?? l e?1 TICAL 49.
.?.? l? I L_ ?J I L. ATION ETIN?TIN< WLY•
ARCMIiECTWI PLAI{R Id1 IttILDNG
B /dNDATION DIMIpq10Nl.
+--- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSEA GARAGE FLOOR - Y)l.3 FEET
X000.0 DENOTES EXISTINCa ELEVATION PROPOSED LOWEST FLOOR - 9t8,S FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 97 1.7 FEET
WE HEREBY CERTIFY TO KEY LAND HOMES THAT THIS IS A TRUE ANO CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
LAT 5, BLOCK 3, MANOR LAKE ADDITION, ACCOitDiNG TO THE
RECORDED PLAT THEREOF. DAKOTA COUNTY,MlNNESOTA.
iT DOES NOT PURPOR7 TO SHOW IMPROVEMENTS OR ENCROACHMEPJTS, c'XCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 13TH DAY OF MAY , 1991.
SIGNE . JA R. HILL, INC.
W10POSE0 GRppf9 9HOWN WfiqH TAI(DI
FROM 1N[ pNqNO 6 [lIOWN GOHTIIO?. •?'
rI.AN (1P MAN(M1 1 Ala INP ANII W1RMW
MY 14 IRht FM?,iw. ,i etr ?r N oa w f,,Ik??1N 1?Nth+N,
MtNNOm N 1? 141Nuh N1??11?F1ti Wo
James R. Hill, inc
I
'A
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
#?O Q I ?1 CITY OF EACAN
U-? n 3830 PILOT KNOB RD - 55122
? I? I 3 U?p?7 651-881-4875
w
> 3 registared fife wrveys ahowing sq. N. d bt, sq. ft. of house
ane gl( rooled areas (jIQ%_rrwximum lol covemae albwed)
a 2 coples ol plam (ahow beam 8 wlndow sizes; poured tnd. deal9n; etc.)
> 1 sel of energy calculaflona
> 3 coples ot free presenalbn plan If lof platled aRer 7/1/93
DATE:
DESCRIPTION OF WORK: S
STREET ADDRESS:
LOT: 5
Ramodel/Reoair Reaulremenh
$ q9-)?5
GplW ???aJoo
?
2 copies W Plan
t set of energy cdcWaMans for heated atltllMons
1 site wrveY for exfedor adtliHOns R tlecka
CONSTRUCTION COST:
'V>4=1 Q-?
4r b b " P-'t A-r,j ? ? b V--
2 SUBD./P.I.D.
BLOCK: -2
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: Jo? ?o??s-?ZOM Phoneu: (D`D I-
Lqd Firat
Sheet Address: /J(°O~ D Q_
CNy
State:
M K-?
03z)
Lp: 5?512S
Company. Phone f:
i tic. (area code)
Sheef Address: 2\-T 1? ?iCa k-- f--- llcense If 3?f'-7 ExA• O L
aty t
State: Zip:
Company: iD 5(? fIQ C- - Name:
Telephone C ( )
Sheet Address: Regishaflon #:
CHy
State:
Sewer/water licensed plumber (if installina sewarlwaterl: Phone #:
Zlp:
I hereby acknowledge that I have read this applicalbn, slate Ma11he InfortnaMon is cortect, and agree to compy wilh an oPPncable SfatF
of Minnesota SMtufes and CNy ot Eagan Ordinanees. `r--?-
?
Signafure of Applieanh
OFFICE USE ONLY
Certificates of Survey Received J Yes _ No
Tree Preservation Plan Received - Yes - No ? Not Required ;1b
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
? 02 SF Dwelling O 08 08-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 OS-plex
? 05 03-plex ? 11 10-piex
0 06 04-plex ? 12 12-plex
WORK TYPE
,%K 31 New
0 32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ? 21
? 17 Garage ? 22
? 18 Deck _-'5<23
? 19 Lower Level ? 24
Plbg _Y or_ N ? ZS
? 20 Paol ? 30
Porch (3-sea.)
Porch/Addn. (4-sea.)
Porch (screened)
Storm Damage
Miscellaneous
Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolitlon permit
GENERAL INFORMATION
SAC Code Q ?
No. of Units o
No. of Buildings I
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building ?G
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MClES System
City Water
Booster Pump
PRV
Fire Sprinklered
Engineering Variance
? 31 Ext. Alt - Mufti
? 33 Eut. Ak - SF
0 36 MuRi
4 3'/
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:
Valuation: $ %OrIU
SAC Units
% SAC
I•IrI'i'-lS-'`1 Plull I.L 11-11 .llN Illl.l. III?
IC'_L. hl?tn.L_ ?Jl9--u?-61
1a461 F'L'I?
!J5 rG 341G
EYLA(VD HQMES
__MANOR_ DRIVEe
? o
?
-- 96,00 N 89024' 47` E
017•q> % I o - -
g yl-- --- • - -.. -- PaoPO ? s $
W DAIV6WAY O W
? ' } ? - - f - - - / 20.0 ? 23A0
?? N)
. ? o ' • O931.o? N GAR.
p
(A I 30.0
Mo ?? f p
I N PROPOSEU v ? I
HOVSE l
?-
23.60 ?. .O ? F
4
1 ??_?
O ? DLGK (9 / ?S?
- •-' O I ?`'_ ? O
?`r?z ) Q
?DR`k ?
6.?. t„?
N , 8??`? C N
3N. (o? ? I
? ^ft[I.INtlGE C UT;LIY'i
? y3P0 ?? S? EA9EMC•NT PER r AT?? ? 5 1
'? ?
?.98.0?) N 89°24 47 E -
N
NOTE: BUlLDING pMENS10N5 SHOMTI qRE
rl Fl)R NOf1ti(WTAt g VF7trrnf i nr_
- ---_"' •?rass
N07L, HO lPFLFIC ]Oli.9 IHVESTGATIOH HAS BEEN COMPI.ETED
ON TMi9 lOT BY THE 31ptyEYpR, r}E gU17ABIL17Y OF
lOILJ 70 3UPFORT THE !!!CI#IC HWSE pqqpOSEO IS
MOT TIIE qC3P0?rgIMLITY Of TNE SUqVEYOR.
? L 2006 RESIDENTIAL BUILDING rExnar .arrLrcaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
New Conshvcfion Reouiremems
3 registered site surveys showirg sq.1L of IoL sq. R of houss; and all roofed arezs
(20% ma)jmum bt coverage allrnied)
2 copies of pian showing beam & window s'rzes; poured found design, etc
1 setof EneTgy Calculations
3 copies of Tree P2serva5on Plan'rf lol piatted aRer 711193
Rirn Joist DetaO Options selec6on sheet (bummgs wilh 3 or less units)
Minnegasco medhaniral ventilation fortn
RemodeUReoair Reauiremenfs
2 copies of plan showing foofings, beams, joisfs
t set of Enerqy Calwiafions iw heated additiore
7 sAe survey fa additions 8 decks
Addifion - indicate JonsRe sepUc sysfem
'P-y) Po
Dffice'?Jse?On '
7ree:P?es£IailReca=F???:-_-Y_ _
T?°e,?Pe !J
s,k?9ui?ed
Qn stte SepLc.$Yst@in Y.' k.l-n
ConstruMion Cost o2 S o U
Date ?p
? /??
///
Site Address 7 eo GV n UniUSte #
-?CVKOU-C_ ACxSD+ti".Y' ?-cX- bfn
I)escription of R'ork
Mu1N-Family Bldg _ Y xN Fi eplace(s)
kjor`I`1
_ 0 --X1 _ 2
Property Owner a Telephone IF ((v5 oO ?
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA OPILY IF CONSTRUCTING A BiE1N BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . ResidenUal Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J su6mission Type) Submitled Submilted
. Energy Ernelope CaIwlaUons Submitted
In the last 12 months, has the CiTy of Eagan issued o permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # {
Telephone # (
Telephone # (
L hereby apply for a Residential Building Pemut and aclrnowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, but only an applicarion for a permit, and work is not to start without a
permit; that the work will be in accordance with the approv lan in the case f work which requires a review and
approval of plans.
L. /(lj o-j s-??v? .,?
ApplicanYs Printed Name Ap icant's Si hue
Fnr Offi.a Use
Permit
n
City of E
a~d
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ! - )0` 0 Q Site Address:'-/ 6 O t Mawr 1" r fJl t'l f t1 , -5
Tenant: Suite
RESIDENT / OWNER Name: - - [ Ud Y Phone:
Address /City /Zip. c) q M,i
Applicant is: Owner Contractor
TYPE OF WORK Description of work: I J rot)
Construction Cost: l0, 0o C i U Multi-Family Building: (Yes / No )
CONTRACTOR Name:C('_~, Y1 a o k7 VGL\ ~ 1 71 A (Jo yt h License
Address: 11 1 - a s E p, r
City:CCo yt o )l 1 U LL S State:fs1/A(s Zip: S~~a
Phone LS 0 - a&.3 L) 9c( Contact Person: U
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category I 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 they 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 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. D
x tl C n S A- % x C U~- y
App iccant's Printed Name Applicant's Signature
Page 1 of 3
U°- jr------------
I
For Office Use
CityofE*1 Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122
Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 staff:
2009 MECHAN CAL PERMIT APPLICAT N
Date: Site Address: arm Y- I/
Tenant: T6
Suite
RESIDENT / OWNER Name: be, Phone: L5! 66& /009
Address / City / Zip:
CONTRACTOR Name: o.2 zz"nd'yv .~r,N Lic es # I~L-Z r, f~ zj
Address: 140 y UG/~/YIiLLi :tJ Sr
City: S ci 5 State:,~~Zip:5 5
Phone: 5a ti 3`7- q' 77 Contact Person:
TYPE OF WORK New Replace ent Additional Alter tion Demolition
Description of work: '0 ro
NOTE: Both roof mount d and g nd mounted mechanical equipment is required to
be screened by City Code. PleWse contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace - New Construction Interior Improvement
Air Conditioner - Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install / _ Remove)
" When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or•alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
- If Permit Fee is less than $1,000, surcharge is $.50. _ $ Permit Fee
- If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
er acknowledge that this i formation is complete and accurate; that the work will be in co formance with the ordinande and codes of the City of Eagan; that
I unders nd this snot a per ut only an application for a permit, and work is not to start it o a permit; that the work ' I be in accordance with the approved
plan in case of work whi r uires r iew and approval of plans.
X LdNam x
Applic Ap lican s Signature
FOR O ICE USE
Reviewed By: Date:
Required Inspections:-Under Ground Rough In -Air Test _Gas Service Test -In-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125600
Date Issued:07/28/2014
Permit Category:ePermit
Site Address: 4604 Manor Dr
Lot:5 Block: 3 Addition: Manor Lake
PID:10-47275-03-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Amy Jilk
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Joseph L Nordstrom
4604 Manor Dr
Eagan MN 55123
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126188
Date Issued:08/15/2014
Permit Category:ePermit
Site Address: 4604 Manor Dr
Lot:5 Block: 3 Addition: Manor Lake
PID:10-47275-03-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Joseph L Nordstrom
4604 Manor Dr
Eagan MN 55123
(651) 686-1008
Scherer Brothers Lumber Company
9401 73rd Ave. N
Suite 400
Brooklyn Park MN 55428
(952) 277-1600
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA135534
Date Issued:03/22/2016
Permit Category:ePermit
Site Address: 4604 Manor Dr
Lot:5 Block: 3 Addition: Manor Lake
PID:10-47275-03-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Joseph L Nordstrom
4604 Manor Dr
Eagan MN 55123
(651) 686-1008
Scherer Brothers Lumber Company
9401 73rd Ave. N
Suite 400
Brooklyn Park MN 55428
(952) 277-1600
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA158774
Date Issued:10/31/2019
Permit Category:ePermit
Site Address: 4604 Manor Dr
Lot:5 Block: 3 Addition: Manor Lake
PID:10-47275-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Joseph L Nordstrom
4604 Manor Dr
Eagan MN 55123
(651) 686-1008
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA168712
Date Issued:04/30/2021
Permit Category:ePermit
Site Address: 4604 Manor Dr
Lot:5 Block: 3 Addition: Manor Lake
PID:10-47275-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Joseph L & Carrie A Nordstrom
4604 Manor Dr
Saint Paul MN 55123--216
(651) 686-1008
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature