3608 Falcon Way
' - CITY 4F EAGAN 0' 70`4
MN
3830 Pil
K
O
E .
nob Road, P.
. Box 2
ot 1-199,
agan, 55121
PHONE:681-4675
' j
BUILDING PERMIT Receipt #
To be used for BASEMENT FiNISH Est. Value Date MAR 3 , 1992
Site Address 36oa lw1.CON WAY
Lot 3 Biock s Sec/Sub.LEXINCTON PLACE O?F 3CE USE ONLY FEES
Parcel No. Occ "Pa"`y ? 35
00
i
Z Bldg. PermR .
on
ng
s J0?'[N Si?00!lQUI ST
? (nctual) Const - s?rcharge •?0
9608 lA1.CON iJAY (Allowable) •
W ?d?S - Plan Revfew
? E?. N ?
C?Y ZP M of Slories
th
Len -
?? 5.00
?
p g -
phone Depin - snc, city
? D/IVID SC?iNEICH CONS?
N? S.F. rotal - sac, nnCwcc
17160 IIAMIT
'['(3N DR S.F. Footprints
? .
AddfPSS Sit
Se
a
e
O Water Conn
Cfty 1.AKEVII.L£ MH ZP 55044 w
g
n
e
On Site Well _
Water Meter
? T-a808
Phone 44 MWCC Syslem =
necc
DePosic
8 u
0W3??r cirywater _
.
?? # PRV Required _ SNV Permit
I hereby acknowlege that I have re d Ihis application and state that the Booster Pump - SrW Surcharge
information is correct and agree f?comply with all apoNicable Slate of
Minnesota Statutes and City of Eag OrdinMces. t ?
/ Treatment PI
iA/1-
Signature of Permitee ? APPROVALS Road Unit
A Building Permit is issued to: DAVID VCMrEICi! COHST Pianner - Park Ded. ;
on the express condition that ali work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. g?j, pff. _ ?P1eS ?
Building Official - e Variance - TOTAL 41 • Q? ?
?
Permk No. Permit Holder DNe Telephone #
S/W
PLUMBING
FMAC
El_ECTRIC
EL.ECT'RIC
Inspeetion Date Insp. Commenffi
Foolings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. !L
lgul. 3-?.sz s
Freplace
Final Htg.
Orsat Test
Final Plbg• Plbg. Inspedor - Notily Plumber
Const. Meter
Engr?Plan
Bldg. Final
Oedc Ftg.
Dedc Final
Pr. Disp.
CITY OF EAGAN 11705
3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?-
PHONE• 454-8100
BUILDtNG PERMIT . Receipt #
SF DWG/GAR
$57,000
Site Address 3608 FAi,CON WAY Erect K?
ls' Occupancy
Lot 3 elock 5 Sec/Sub. LE?f ING`1'UN r'L SOiemodei ? Zoning R1
Parcel No. Repair ? Type of Consk V
Addition ? No. Stories
Name ui?.;Z j iv T:i0MPSON HOME$ Move ? Length
z 1712 iiUYK21?1$ CROSSROAD Demolish ? Depth 3y
o Address Int Impr. ? Sq. Ft
ICity- I'`TKi9 Phone 544-7333 fnstall O -
= o Name
? ¢ Address
r,?---
Phone
1 hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicabte State oi
Minnesota Statutes and City of Eagan Ordinances.
?-...
Signature ot Permittee
O.fZRIN THOMPSON NOME
A Building Permit is issued to:
all work shall be done in accordance with all appliofible State oi Minnesc
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Bldg.
Permit -'"'' • vv
Surcharge 28•50
Plan Review 1-52- 0 0
SAC 575.00
Water Conn. 50U . OU
Water Meter 63.50
Road Unit 2904
Tr. PI. 156,00
Var. Date I Copies
Total ? . 0 0
on the express conditlon that
City of Eagan Ordinances.
-2 a 31 l ? - 6 la 12 L
Ps?mft Na Permit HAdw Date TN*pharo M
Plumbiny
. L 3
•
H.V.A.C.
Eleetric A-d
SoMsner
ImpecHon Dats Insp. Commenh
Footinys I
FooUnqsil
Foundatbn
Framiny • ? ??
RooNnq
Rouyh Plbq. ?
fiouph Hly.
Ingul.
Fireplaee
Flnai Hty.
Flnal Plbp.
Bldy. Flnal D. .S..t c d p^ "?6
Cerl. Oec.
Deck Fty.
Deek Frmy.
Well '
Pr. Dlsp.
PERMIT # CITY OF EAGAN
? r. ? MECHANICAL PERMIT
RECEIPT ? 454-81 00
? z MINIMUM RE8IDENTIAL FEE - $10.00 +5.50
DATE MINIMUM COMMERCIAL FEE - $20. $•50
1. Bldg. Type: Res Comm Inst 2. New Add _
3. Total Bid Price 4. Job Address
Lot ? Block 5- l?s 5.
6. Contractor
(Mame) lStreeq
7. Contractor Phone #
FEE &2 V" `-;D
S/C .o
TOTAC;Z' 5 b
Alter
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDEN AL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIF ATIONS/ALTERATIONS -$10.00 minimum fee
" HEATING VENTILATING HOT WATER STEAM AIR COND.
eIR PIPING PROCESSED PIPING AIR NANO. EQUIP. RtFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND. R - BIQ PRICE PLUS $.50 STATE S? HARGE j0 ?ACH $7,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. ate Final Insp.
PLUMBING PERMIT RECEIPT #
' CITY OF EAGAN
u 3?30 PILOT KNOB ROAD, EAGAN, IIAN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
SiteAddress BLDG.TYPE WORK DESCRIPTIQM
L
ot --= Block Sec/Su b V
/
?
Gl?i-
y Name Mult Add-on
?a Address Comm. Repair
c
J/ ?l
City ?'-? Phone 1 ' ? jL Other
.
i? ?-'i; ? - ..>>. .. ?
Name
>fc, ? ? Nq. FIXTURES T07AL
.
? Address
O Ciiy Phone ?- ?J LLavatory - $3.00
T
FEES Kitchen Sink - $3.00
Urinal/8idet - $3.00
COMM/IND FEE - 1°a OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $1D.00 ?
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES ? Gas Piping Outlets - $1.50
BEYOND $1,000.00)
" Softener - $5.00
1 /
; Well $1 0
00 .
FOR: CITY OF EAGAN
PERMIT#
Res. ? New
Water Closet - $3.00 ?
-?Bath Tubs - $3.00
Shower - $3.00
Laundry Tray - $3.00
Floor Drains - $7.50
T_Water Heater - $1.50
?
Whirlpool - $3.00
-
_,_Private Disp. - $10.00
? Rough Openings - $1.50
FEE
STATE S/C: - Z
GRAND TOTAL• ?' ?' ?
Control No. 0379
INSPECTION REC4RD I
CITY OF EAGAN PERMIT TYPE: btlik. Q 1mfl '
3830 Pilot Knob Road Permit Number: 0004f'6 -Eagan, Minnesota 55123 Date Issued:
(612) 681-4675 SITE ADDRESS: L O T t 3 "LOCK ;b APPLICANT:
3606 rALcaN wnv sc:HwErcH CawSr. anvxu ?
LExraGTO+a E-t_ncE s (?;t2) 447-e908
i
PERMIT SUBTYPE: TYPE OF WORK: ?
I+t i t NCW i
INSPECTION .. . .A
rnoi, lNa FtNAL
I
1
? ?•?Y`*L?+4y_? -. • ? ' • f ?.."? ? 31I ? .; ? ITM+ :. 1S I I I I ?? . .. . ? ? I
,_..._. .-. .. ? . . .-. . .
. . . - . ? ? . ? .. . .. . ? ? - -. . -. .
i ? ,_,.. . . .. . . . - ? : ... . , ; . ?
M
- - - - - - - - - - - - - - - - - - - - - - - - - - - -
Peemk No. Permlt Holder Date Telephone #k
S/VH
PWMSING
HVAC
ELECTRIC
ELECTRIC
InsQsctlon Date Insp. Comments
Fooiings I
Foundation
Framing
Rooting
Rough Plbg.
Rough Htg.
Isul.
F(replace
Fnal Htg.
Orsat Test
Final Plhg. Plbg. Inspector - Notify Plumber
Const. Metcr
Engc/Pisn
Bldg. Flnal
Deck Ftg.
Declc Final
WeII
Pr. Disp_
'OFEAGAN ?
Pilot Knob Road wATER SERVICF PERMIT ?
,,,,
Bux 11199 PERMIT NO.:
i, MN 55121 DATE: -
o: No, of Units: 1
;`omes
llddrcss: 3+'?Je `'alcon W8y I3 B5
No..
te ee.oy wi16 !M
Tocoi: _
Dote Paid:
5
Date of Insp.: InSP6:
?y (o
CITY OF EAGAN $MR MVlCE PERMR
3830 Pilot Knab Rwd
P. O. Rox 21199 PERMIT NO.:
Eagan, MN 55121 pATE;
ZO^i^0: - No. of Units:
Owrnrnr.
Addrcss:
Sits Address: ' 08 FSl eor. , '-
Plumber: `'eT2z-Rpan
3--28-36 61: ' :;. ? .
I "M ho Mf woh !M CIly af so"w CorrNetlon Chorpt:
Aotounf DEpOqt: _
PermR Fee:
Surctw?p:
By Misc. Chorqes: -
DcM of Insp.: Total:
Iresp.: Dah Prold:
CITY OF EAGAN WpTpt SERVICE PERMIT
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Eagan, MN 'a5121 ? DATE:
Zonir*: _ No. of
Owner;
Addross: -
Sih Addrcm . ?
Plumber: ::'r,?;•-sn - %i tE
AAeter No.:
Slze:
Reoder No.:
1 qm to ason/1? M11h Ne Ci1p of
OnAweaoM.
Deposit:
IRiCflu.t???•
Pertnit Fee:
rz?
SurcFwrOa:
Misc. -?r
Total:
By po" Patd:
Date of Inap.: Irnp.:
CITY OF EAGAN SEWER SERVlCE PERMIT
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Eagsn, M11! 55121 DATE:
Zoninp: No. of Units:
OwrNr.
Addrcss: -
Site Address:
Plurribar. - - ,?
I qrM te poopfy wIM !w Ci1p oi iqp¦ Connoetion Choepe: .
araimmas. /lcoount Depodt:
Permit Fee:
Surdwrpe:
By Misc. Cho?wsc
Dote of Irnp.:
Inap.: Totoi:
Dah Poid:
CITY OF EAGAN Remarks
Addition Ltxington Place South Lot 3
Owner Street 3608 Falcon
10 45060 030 OS
an, MN
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
x??i. aZ
SAN SEW TRUNK 041 24764
-
SEWER LATERAL 101. 1986 1 631.. 0 0 3 Z t-. Z 0 ? ? -
Services 101 1986 729.39 145.87 5
WATERMAIN
WATER LATERAL 1012, 19 8 6 8 7 3. 43 .174.68 5
WATERAREA 10111- 1986 243.73 ' 48.74 5
WAT LAT BEN 10 13 1986 111.98 22.39 5
STORMSEWTRK 101rI 1986 426.54 85.30 5
STORMSEW LAT 101 t 1986 803.34 160 . 66 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER. '
SAC
PARK
N ' CITY OF EAGAN No20176
3830 Pilot.Knob Road, P.O. Box 21-199. Eagan, MN 55121
PHONE: 681 -4675
?
17& (2
BUILDING PERMIT Receipt # - L
To be used for BASEMENT FINISH Est. Value Dale MAR 3 1991-
Site Address 3608 FALCON WAY
Lot 3 Black 5 SeGSub. LEXINGTON PLACE oFFICE uSE oNLr
FEES
PBrcel NO. R-3
Occupancy
i
Z 35.00
Bldg. Permit
ng _
on
N2file JOHN BLOOMQUIST (nctuapConst - Surcharge .50
w p,ddrp,ss 3608 FALCON WAY (Allowable) - Plan Review
Cj(?r EAGAN MN Zp en9 h?aries = ?? 5.00
0
Phone Deplh - SAQ City
¢ Nyme DAVID SCHWEICH CONST S.F.7otal - Snc, rnCwCC
?
qddresS 17160 HAMILTON DR S.F. Footprints
Sit
O
S
water Conn
ewage _
n
e
Cky LAKEVILLE MN jjp 55044 OnSitewell Waterr?neier
? Phone 4?+7-$$OS =
MWCC System qmt
Oeposit
cg 0003607
V
l1S6 # caywater - .
ce PRV Required _ SM Permit
I hereby acknowlege ihat I have re d this application and state that ihe Baoster PumO - SPN Surcharge
information is correct antl a ee U omply with all ap icable State of
Minnesota Slatules and City rdin ces ?
ag 7realmanl PI
Signature ol Permitee APPR04AL5 Road Unil
A Building Permit is issued to: DAVID SCHWEICH CONST Planner - park0ed.
on the express condition thai all work shall be done in accordance with all Ca+mil -- .50
applicable State of Minnesota Statutes and City
of Eagan Ordinances. Bldg. OII. _ Copies
?/
Building Oflicial 1kl/1 ,?11?: j ??,U Variance - TOTAL 41.00
BUILDING PERMIT
Receipt# Wi n
11705
7obeusedfor SF DWG/GAR Est.Value $57,000 pat, MARCH 27 1g86
3608 FALCON WAY R3
SiteAddress Erect LS Occupancy
Lat 3 eloc
k 5 Sec/Sub. LEXINGTON
PL SORemodel
? R1
Zoning
Parcel No. Repair ? Type of Const. V
Addition ? No.Stories
ORRIN THOMPSON HOMES Move ? Length 38
W Name 1712 HOPKINS CROSSROAD Demolish ? Depth 39
3
° Address
MTKA 544-7333 Intlmpr. ? Sq.Ft.
Ciry Phone Insiall ?
o SAME
i Name
? ¢ Address
? Ciry Phone
Wo W Name
Address
z
i w City Phone
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 Ordina?ncies.
Signature of Perminee ?w
O? y-/?
ORRIN THO"rIPSON HOME:
A Building Permit is issued to:
all work shall be done in accordance with aU-epp " ble State of imestl
CITY OF EAGAN
13830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721 Np
-
PHONE: 454-8100 , , i
Assessment Permit 304.00
Water & Sew. Surcharg?30
Police Plan Review 152. 00
Fire SAC 575.00
Eng. WaterConn. 500.00
Planner water Meter 63. SO
Council Road Unit 290. Q0
BIdg.Off. 3/27/8 Tr. PI. 156. 00
APC Parks
Var. Date Copie
rotal 2.069.00
on the express conditlon that
§tafdtes and Ciry of Eagan Ordinances.
Building
(trx#ifirtt#r of (Orrupttnry
Citp of (tagart
Ep{tFlTfritPI1T IIf BLtIIDtItQ 3ItS}iPtfilttt
Thi.r Certijcate i.rsued pursuanr to the requiremenu of Section 306 oJthe Uniform Build(ng
Code cerrrjying that at the fime ojissuance this structure was in comp(iance with the various
ardin¢nces oJthe City regu(aNng building construc[ron or use. Foi the jollowing:
usscinvdia,nm SF DWC:/(:AR BWg.FtnWiNa 11705
o=wm rype R 3 zon;,,g Dw,;a R 1 rya c.nna V
o.aeWWiqXORRIN THOMPSON Add? 1712 HOPKINS CROSSROA
eww;h An• 366/8 ?• FALCON WAY Local;ty L 3 B 5 LEXINGTON PL.
1;[/ 0.k: d??? 24r1986
Budding OBioalg,?'
POST IN A CONSPICUOUS PLACE
5
1 3
p 4 3 4
111
Request Dat Fire No.
Q? " RougM1-in Inspection
RequireC?
C, Ready Now I?Jill Notity Inspector
??W?en Reatly?
? es C No
Alicensed contraaor ] owner hereby request inspection of above electrical work ai:
Job Atltlress (Sheet BoH or Rawe No.)
? d? ot ?Cr.? ?'i/ Ciry
LC.? /j.v'
Sedion No. Townsnip Name or Na. Range No. Counry /
,
?ylr A- f? .
Ocwpant •
6?oc.?
.sf
? Phone No.
u
h
o
Power Sunvher .
D4 ko& E/o_v .-« qedress
f
Elecmcal Coniractm (COmpany Namel I
C
E/ Contracu r5 License No.
SS ??
?
E
T???G a Z
Mailing qetlres/s ??GOn? aor orOw?ne? aNln installaiion)
4'/E7?
N
?
0?" /C
?
Ov
d .
GI a.?.
Auaonzetl SiS^anre ICO) I vOwner yaking Insl " n? Phon umber
6e -- ao yz---
MINNESOTA STATE B RD OF ELECTRICITY 1HI5 INSPEGTiON fiE0UE5T WILL NOT
Griggs-MiEwey Bltlg. - Room S473 BE ACCEPTEO BY THE STPTE 80ABD
1821 University Ave.. SL Paul. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone (612) 642-0B00 ENGIOSED.
REQUEST FOR ELECTRICAL INSPECTION
J? See mscructons for complating this lorm on baok ol yellow oopy.
"X" Below Work Covered by This Request
; 4t'A
N?•-?
.a..
ew Atltl kep. Typeof8uilding ? AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleclric Heating
Apt. Building Dryer Other (Specily)
Comm./Intlustrial Fumace
Farm Air Conditioner
Olher (sypcify) Conlractors RemaBS' ' // a
,5??+-/ re
yv. ? /
Compufe Inspection Fee Below: ?s?7?/
s O?her Fee # ServiceEniran eSize Fee '# Gircuits/F eders Pee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transtormers Above 200 _ Amps Above 100 _ Amps
Siqns Inspectars Use Only: TOTAL
Irrigation Booms p • b30 tp
Special Inspection
niarm/COmmunication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Ro°gn-'° oaie? , Z
certify that the above inspection has
been made. F;oai , oaie? , Y
OFFICE USE ONLY
This recuesl voitl 18 monPS Irom
This requesl void U (,//1 ` `
18 mpn[hs from
-C ' 3718 L3, B 5, eX??rcTOA/??.So ,??,ly =
Reque t Uate
`? ? • Fire No. qo??he?? lnspection
Ies ?NO ?Ready Nuw?Will NotitY Insoec-
? mr When PeaAY
[41-icensed Electrical Convacmr I hereby raquest iasoection of ebove
? Owner electrical work installad et
Street Atldress. Box or Route No. Ci[
O
eciwn o. TOwnshi0 Nam¢ or N. RanOe No. C rt
OccuVeM IPRINT) Phone No.
--73.?;? ._ .
o r Sup liar .
?? ?
EI nical Conuacto? ICompany Neme) Cnmractor's License No
Mailinp Addr ss ICoM ctor al Owner Making Ins[ailation
l i??'V•
Authori ed Signature ICOnvactor Owner MakfnB Installation) Phane Number
2 - zrN
NESOTA STATE BOAflD OF TRICITV THIS INSPECTION 0.EQUEST WILL NOT
BE ACGEPTED BY THE STATE BOARO
rig g s -Midway Bldg. - Roo •191
1821 Universitv Ave., St. aul, MN 55704 UNLESS PqOPER INSPECTION FEE IS
on- 16121 29].2111 ENCLOSED.
VsjI /?1d REQUEST FOR ELECTRICAL INSPECTION , ee•ooooi-a
`
It See insimctions br comoletirq tbis torm on beck oI Yellow copy.
f- R71A "X" Below Work Covered by This Request F."HAdI peD.I TYOe of Boileing I ApDliancea Wiretl I EquiUment Wired I
ee
M Fee Service EntrenceSize tt Fae Feaders/3ubieeders N Fxp Circuits
40-406 0 to 200 qm s . 0 to 30 Am s 0 tn 30 Am
Above 200 Am 1 51 to 100 qmps 31 to 100 Am s
Swimming Pool Above 100_Am s Abave 100_Am s
Transiorme?s Irngation Boorris Pdrtial."Oth
Special Inspection iO7AL
..__e. ... / U • the Elec ilLc
sPecbq hereb?
cartily thet the bove
Final te c inspaction hes Ceen
? ?/ ? 'matle.
mb rpuaat witl 18 moniha from
\ /
? CITY'OF tAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT PERMIT TYPE:
Permit Number:
Date Issued:
9UILDINO
00@456
05/04/92
SITE ADDRESS:
3608 FALCON WAY
LOT: 3 BLOCK: 5
LEXINGTON PLACE 5
DESCRIPTION:
Building Permit 7ype
? OECK
Building lJork Type
NEW
?
Ll
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Subtotal
$25.00
$.50
$25.50
COPIE3 $1.00
Total Fee ;26.50
CONTRACTOR: - Applicant - S7. LIC. OWNER:
3CHWEICH CONST, DAVID 14478808 0009607 BLOOMQUIST JOHN
17160 HAqILTON DR 3608 FALCOPI WAY
LAKEVILLE MN 55044 EAGAN MN
(612) 447-8808 (612)681-0153
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 Pln.
Statutes and City ofi Eagan Ordinances.
?
Li -os?
APPL CANT/PE ITEE SIGNATURE
I
'nuo Rri-,r f Nt1
ISSUEDBY: SI NAT RE
Control No. 0379
INSPECTION RECORD Control No. 0379
CITY OF EAGAN PERMITTYPE: auiLoiNG
3830 Pilot Knob Road Permit Number: 000456
Eagan, Minnesota 55123 Date Issued: 05 /04 /92
(612) 681-4675
SITEADDRESS: LoT: 3
3608 FALCON WAY
LEXINOTON PLACE S
PERMIT SUBTYPE:
DECK
IFOOTIN(i
F
L
t,r L?.n.
eLoCK: s APPLICANT:
SCHWEICH CONST, DAVID
(612) 447-8808
TYPE OF WORK:
NEW
, , .. I w4 : : , 0 u 1.
t i ' , i•i n? :.
In? ri
i.
.,i? i ? ?? i ?•i ?
FINAL
?
?
PE?'cMI7 #" qf4
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested,"but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date !z / ) 9 / 92- Valuation of work 44 5c-9-
Site Address: ??3 ? ofI /Qc,,,., a,,..L?
STREET STE i'
Tenant Name:?lof/•?/ RLoo yh C?oist'
oT _? eLaK
Descri tion of work:
The applicant is: ? Owner ? Cantractor ? Other (oescribe)
Name A Loar3q r:,>i rl' -fo id/W Phone
Property «5T FIRST
Owner
Address ;?G o? ? 'ec
STREET STE /
City r?/> A+? State ?,?-.? Zip
Company Phone 441r7- PF-&8
Contractor 4-
Address _ l1,t66 MAA,147,arV y?A License M 00D36C17 Exp. 3) 9?
City b9/C-A 1/??L E7 State Al/ Zip Lr3'0 '/y
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area as been approve .
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: f???/
vrrwc uac vnLT
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish
? 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch
? 04 Multi-fam. T.H. =OS Deck 13 12 Comn./Ind.
woRK rYPe
0'31 New
? 32 Addition
? 33 Alterations
? 34 Repair
? 35 Tenant Finish
0 36 Move
GENERAL INFORMATION
Const. (Actual)
(A1Towable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
E3 37 Demolish
? 99 Undefined
Basement sq. ft.
lst F1. sq. ft.
2nd fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Site ,1?"Footing
? Wallboard Pr Final
? Framing
? Draintile
_73-2
0 Insulation
? Fireplace
Permi t Fee 2 s v.tu.cion: s
Surcharge s?
Plan Review
License
MWCC SAC
City SAL
Yater Conn.
Mater Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Co pies
Ot her ?
Total : 2d, I
, t..
l?
46PG611c Fac.
? 14 Agricultural
? :5 Miscellaneous
MWCC System
City Water
PRV Required
Booster Pump
Fire 5prinkler
Census Code
SAC Code
Assessments
SAC 9G
SAC Units
?Wvarr GIVUl[VL'CI<1N(a cAxWnNY 0 2815 Y7AYZATA
C6RTIFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation .
BENCHMARK: Top nut of hydcant at '
southwest corner of Hummingbird
Lane and Falcon Way.
Elevation = 904.54 ft. (NGUD-1929)
fRONT GARAGE SLAB:
Proposed El. = 905.05 ft.
• MINNEAPOLIS, FA1 • PHONG: 379-4740
Scale: 1" = 30'
• Iron monument found
° Wood stake set
, yon.o F,xisting elevation
?
?---draina?e 6 UJi'/.ity Easemenf
a ;o . !
'
"
°
21
5 89
S4
E 126.54
Q 0
3 ? 2o.e3 Q ?
?
30.i r
OD 18.5
. I
`D ?
µf 6.O7: a N 0
z
-.D ?
M m
7
83 n O ?
3
10 8 .
m
? LO
T
3
O ? .i
W
.e h ^ IS
? ?
U
J m l!)
b O.o ? 3
O
? 2 I .
O
d
U
' z I
N ? ss.s
I
o
I
U- 1 1 ??? 11
I ? ' _ ?'^; •
/ N
0
a N 96 21'54" W 127.17
I
N
O
a
? ?EGilis d'w/ aE .
cANTa 1 vP00
a? ? F TNA? i s
Lot 3, Block 5,
LEXINGTON PLACE SOUTH,
Dakota County, Minnesota
I hereby certify Uiat Gliis is a true and correct representation of a survey of [he
boundaries of the land above described and of the location o£ all buildin95, if any,
[hereon, and all visible encroachments, i£ any, from or on said land. I fureher
cer[ity [hat thls sucvey vns prepareA by me or under my direcG supervisLon and ChaC I
am a duly Registered Land Surveyor under the lavs of the State o£ MinnesoCa. .
\?,i ?{ /?'y f?Y aI MIIJ Reg. No. /?7y,CJDa[e
_r `?U
Proposed House x As-Built House _, Drawn by 5^i 'Proiect no_851on
7986 HOII.DING PEHlQT ApPLICATIOH - CITY OF EAG9N
NOTE: ALL CONTRACTORS MQST BE LICENSED 1iITH THE CITY OF EAGAN
201
COMRERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
To Be Used For: L5(RS?,v????
SINGLE F9MILY DfiSl.LINGS
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
Valuation: Date: ?j- ici -?
Site Address F0.L-Qn "? OFFICE BSE ONLY
Lot ? Hlock ?j
Parcel/Sub G??
Owner
Address
City/Zip Code
Phone
Erect X Oceupaney _ R
Remodel Zoning ?
Repair _ Type of Const $?
Addition # of Stories
Move Length
Demolish Depth 39
Int.Impr. Sq Ft
Install
APPROVALS FSES
Contractor QKy, n "o-
Assessments _
Permit
15p. c
I..,
Add
W Water/Sewer _ Sureharge p
ress J
1 I2
-npk; poliee Plan Review po
Fire SAC -?t,, po
City/Zip Code ?: Yl? ?( L/? + VIA „-3q3 Engr Water Conn r-pp. pp
Planner Water Meter
Phone Couneil Road Unit 2?10. G?
Bldg Off
L2X
Treatment Pl
P<4.,, p0
Areh./Engr. APC Parks
Varianee Copies
Address TOTAL ? co
City/Zip Code
Phone #
NOTE: ADDAESSES FOR COBHSR IATS - CONTBACTOE/HOMEOiiNLE M[JST DSSIGNATE i1HICH
ADDRESS IS DSSIRED. N0 CH9NGES {iILL BE ALLOHEp ONCE BIIILDING PERMIT
IS ISSIIED.
C[.ARK ENGIIdGERING COI4pANY o 2815 WAYZATA F300LEVARD • MINNEAPOGIS, hQ1 • PHONE: 374-4740
CERTIFICA2E OF SURVEY FOR: ,
ORR1N THOMPSON HOMES
A Division of U.S. Home Corporation Scale: 1" = 30'
BENCHMARK: Top nut of hydrant at ' a Iron monument found
southwest corner of Hurtvningbird ° Wood stake set ?
Lane and Falcon Way. „ 500.0 Existing elevation
Elevation = 904.54 ft. (NGVD-1929) •
FRONT GARAGE SLAB:
Proposed El. = 905.05 ft. '
?---draina?¢ d U/i/.ity Easeme?t
? P .
'
? 589°21
S4"E 126.54
?r 4
-?
?
3 0 :o.s3 Q ,
o
30.1 ?
lyJ 6.0 °/. a N 0 .
-Z
7.83 k O LOT 3
O 10 a?
m
Q
3
O
.
w
? 15 )
u
V
? I ?
e.o
I ,
m
?
.
J = O
Q ? Z I ?N 35.5 I
? O .
4.
?
ioJ N
m
89°21' 54"W 127.17
R v
0
A
Lot 3, Block 5,
LEXING717N PLACE SOUTH,
Dakota County, Minnesota
I hereby ccr[iCy tha[ Ulis is a true and correct represenW[ion of a survey of the
boundaries of Lhc ]and above described and of Cfie lotation oE all buildings, if any,
[hereon
and ail
i
i
,
v
s
ble encroachments, if any, from or on said land. I Eucther
cereify tha[ thls survey vas prepared by me o7 undeC my direet supervision and tha[ I
an a duly Rcgis[eced [.and Sucveyor unclerthe lavs of Che StaCe of Minnesota.
S;" io hW Reg. No.r/Cj,7,7,QDa[e !/ • ????
Proposed House X As-Suilt House _ Drawn by Ev 'proiect no_ 8510a
lolic
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-0675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
cff- tions, 1 copy of energy calcs.
n
Penalty appli hen typing of p t is requested, but not picked up by last working day
of month in r e i adel lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Locatio • i,??? rv
STREET STE #
Tenant Name:_ IT-orlN /K'Loo P7 ? rJ IST?
LOT 3
I BLOCK f
SUBD.
?-n,rl
P.I.D. #
Descri tion of work: 5+»{- '; s?l
The appl i cant i s: ? Owner f;? Contractor ? Other coesor;ne>
Name & oa r;q dVt 5r G-a,M/? Phone 6cF'?)- 6/.S3
Property LAST FIRST
OWner
Address 36 z$ R eX1,Car? tAI-IV Y
STREET STE #
City r6_>1 il/ State /?""? Zip
Company 1?4VIO /'owsT Phone y?-??'4'?
Contractor Address _ 1714,K0 /?,4.'yll7-0-1 ,t7/? License #. tc>et?34o 7 l1K
City State Z;p
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ??
BUILDING PERMIT TYPE
? 01 Foundation
? 02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
'9.90 New
? 91 Addition
? 92 Alterations
OFFICE USE ONLY
? 06 Garage/Accessory ? 11 Res. Add./Porch
? 07 Fireplace 0 12 Comm./Ind. New
? eck ? 13 Comm./Ind. Add
09 Basement Finish 0 14 Comm./Ind. Rem
? 10 Swim Pool ? 15 Public Fac.
9 93 Remodel ? 96 Move
? 94 Repair ? 97 Demolish
? 95 Tenant Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy
Zoning
Const. (Actual)
(Allowable)
# of Stories
Length
Depth
APPROVALS
Basement sq. ft. s.s'R-Ae
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Planning Building DS 'i-3-92
Engineering Variance
REQU1RED INSPECTIONS
? Site ? Footing 15 Framing
? Wallboard ? Final ? Draintile
? Insulation
? Fireplace
vatuas;m: ?-----
Permit Fee 35,00 Surcharge
Plan Review
License ?
MWCC SAC
City SAC
Water Conn.
Water Meter
Road Unit
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies ?
Other
Total:
r r ,
? 16 Agricultural
? 17 Building Move
O 18 Demolition
? 20 Miscellaneous
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Cade
Assessments
SAC %
3AC Units
._ i'i Y i1 I" l= !-`c l:;i A N
F,PPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRESS: ?
LEGAL DESCRIPTION:
tLOt/ttlocK/SUbdivision or Tax Parce
r
3-Z.8-Xh •_
IF EXZSTING STRL'CLiTRE, DATE OF ORIGINAL BL'ILDING PERMIT ISSL'ANCE: " -
(Nbn YearJ
PRESENr ZONING/PROPOSFD'L?SE: C] C'011MEE2CIAL/RETAII,/OFFICE
Q, IDIDf.'STRZAL
n INSTI1i1PI0NAL/GOVEUZg,'NT
IK R-1 SINGLE FAMILY :
? R-2 DCPLEX (Zt,o Cfiits)
? R-3 'IO[tiT][-tODSE (Three + Units) ( Dnits)
? R-4 APART:IENP/CO:IDOMINIUM Units)
'?J1'.,. .. ..• . _ :. .\ i.. ?_.. . .
tiI'PLS(117'IGN IYJT'.S UJP CYi.'.?.;,'I'iiPtE :
r
APPROVAL OF PgihffT. *
*
INSPF]C.TZON OF SES+]ER AND/OR YFiTET2
INSTAT.T.ATTONS WIIS, NU'P BE SQ1ED- *
UL,ID UNITL PII2t+IIT HAS BEEJ
APPF20VFD. • ' ,*?
w
w
r
*:*+***:**?**?***?**t*****f?*t:*t*
2) ?
NAt,1E
ADDRESS
? czTY, srATE, ZZP:./Ni???7Z.1.tJ/?CA?
PHONE: !`7'si/fI-
3) ?
NAME:
ADDRESS:
CITY, SI'ATE, ZIP:
PHONE:
l.
LicENsE# 1 t3f?9?t
Active
bcpired
Not recorded
Staff initiat
4) oeo • • i?+• _ -
NAME: , .
ADDRFSS: ' .
CZTY, SPA'PE, ZZP:
PHONE: .
5) IM, a• ?• ?cr .?. -ii -?y-yua? -
? CONNEC.'TION 'IO CITY SEWER ? CpNNECrION 'Ib CITY WATER ? OTfEIt
6) PI,EA,gE HOLD APPROVID PEE2MIT FOR PICK-UP BY ONE OF ABJVE
PLEASE MAIL APPROVED PERMIT 70 1, 2,(g 4, AMVE
(Circle one) '
7)
,?'?:3"?"_7 e57'?'?=`??:i??'auiul?t?n__r_a°hf!'-53a'?'ao.???e,;..,?,. T?. r ?.??.? ..i ?u?.??'•? -o .
Ml:71I:.AO::Jli7,'II
FUII CITY USE ONLY . •-,
PERMIT # ISSL'ED
??7 = 31, 6 6
Pd w/Bldg. Permit
<
S
$
$
s
$
$ ? "O D U-v
$
?7Sv (3
$
$
$
$
S
FEES:
$ ro- s-a
$
$ ,.
$
$
S
$
S
S
$
$
$ '
$
$
S
SEWER PERMIT (INCLODE SURCHARGE)
WATER PERMIT (INCLL'DE SURCHARGE)
WATER METER/COPPERHORN/OC'I`SIDE READER
WATER TAP (INCLL'DE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOC'NT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRCNK SEWER ASSESSMENT
LATERAL BENEFIT/TRL'NK SEWER
LATERAL BENEFIT/TRCNK WATER
WATER TREATMENT PLANT SCRCHARGE
OTHER:
SZ $ d / • Q ? TOTAL
2-
RECEIPT RECEIPT
DOES UTILITY CONNECTZON REQLIRE EXCAVATION IN PUBLZC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSL'ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUI3JECT TO THE FOLLOWIDIG CpNDITIONS:
APPROVED BY:
TITLE:
Di1TE: ?13 /f g,
.?? s • w •?? • r. ?. r.••na? • ? ?i a? • ? :
6) t, u ? ? ? , .. . ;;.,
_
'; _ .., .. _?. -
- : •a ?.,a
=
_
? .
.
? PLEASE HOLD APPROVID PF?2bffT FOR PIQC-BY OI? OF ABOVE
PLEASE I?IL APPROVID PERPffT TO 1. 2. 3. 4, ABOVE
W.
6` ne)
(Circl o
71„:: r ,• . `
? , R?
. ' ",? ? ` ?i ' L
rr
'Ar 4 ?M3' . q 1 ? - 4 C
.e
OR C
_ _?... . _Tr..?--r..Pb:.:VY.':t-??T'?°_.:::'- ?
, ... ._. _ . w.w 4ff_ :'4 r _. ,. ?,... -??.. . . +. . . :'. ? __ .. ....
J;:.=y o i}/. ?;y?t- _u i 1??1 c ? :... ? .i? Y.?.J ?
?? T1u.x Es??x asstssrE?,?r ..
{?'^
f +5 .; LAT?RAL?B?TEFI,T/TRUNK SET•:z."
$ .' . `
'?'
T
I;ATERr1L.$EiV£?
I
tTRU`K WATE:
? - _ .., ?. -•1 _
i?57
d`O r
6 •
.:,.. WATER TREATMLNT PLANT S URCHARGE
?- $ lOTIIElt:* ? -•^? , y^°
: b r Y'
?
_
.• ? 1
"
j 1?
L
v`
^" '. t
? 1
" - } "
T
?
< ,(
4
. ",
7.+?
N( r
?
_
q.
t
{ -
[
-
• --uii+i+i ivwurc.t.i'lutv_xttluixt_EXCAVATION.IN PUBLiC.RIGHT 1
- _ . . ' - "^? : ._aa?..•?. . J j.'. 6M ?'S;: `i`T{
„> ?? ? YES + , l IF YES ri THEN A' ".$ERP2ZT - f?OF?i WORK WITHIP
j - _- ^? ?*;?cPUBLIC°ROADWAY"--MUST ?E ?SSUED BY THE
-' Q NO ENGINEERING DIVZSION LIST AS A CQND7
??T TION :+' ? ""
?-
. ?
3JECT. T¢ THE FOLL?WING CoN?iTIONS - ,.-.-_. _... - -
? , . -
-
f .
- , . _Y.
. . -i. . ... . .
APP ROVED SY. ?
TIT LE.
DAT°
R
+,? . .
I l Y t} .1
? ? ...TS !
.: . __?
i
??
? ? { p r
5.. S
- c. .
\ / L 3 S
1 h
?
??v ?
CITY OF EAGAN
3830 PILOT RNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE:
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
N0.
NEW CONST
ADD ON
REPAIR
OWNER NAME: ?\c'
SITE ADDRESS: ?--CkAC'- v__.j `? C:_`?
IAT: ?? BIACK ? SUBD.
INSTALLER:
?
ADDRESS:
CITY: ZIP:
PHONE #:
SIGNATURE OF
?--G-?
COMPLETE THE FOLLOWING:
FIXTURES EA.
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CIASET 3.00
BATH TUB 3.00
IAVATORY 3.00
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
HOT TUS/SYA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUh1 - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE
lU1HL
TOTAL
3 -
?-
?
S IS• ?
.50
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS AND
MULTI-rAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME:
SITE ADDRESS:
LOT: BIACK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
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:
$
(SIGNATURE)
CITY OF EAGAN
??,?? ? 3? I ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
New Construction Reauiraments RemodellReoair Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. tt. ol house; and all roofed areas . 2 copies of plan
(20%maximum lot coverage allowed) . 1 se[ of Energy Calculations for heated additions "? ? s
• 2 copies of plan showing beam 8 wintlow sizes; poured found desgn, etc.) . 1 site survey tor exterior additions & decks
• 1 set of Energy Calculations . Indicate if home served by sepGc system foradditions
. 3 wpies ot Tree Preservation Plan if lot platted aker 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE 7- Z- b Z- I ??
VALUATION j?.
?.
SITE ADDRESS,j° ???co ???? MULTI-FAMILY BLDG _ Y ?
TYPE OF WORK •/ ? FIREPLACE(S) _ 0(0_ 2
c.> ? J-(ti .F
APPLICANT
STREETADDRESS IZZy-7 /jii'co/%,,A?ci 5 CITY rirns '/ STATE /,ZIPS5--337
TELEPHONE #95-Z_ ;h-7.. 69s9 CELL PHONE # FAX #
PROPERTY OWNER Jaa..l 41 TELEPNONE # loS/- Z7(o -//ZL
""---------------------------------------°"_"----""_".'---?--"'__"'----'_"""'-----
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINN1:50'l':A RULI:S 7670 Cxl'I:GOI2Y 1 NIIVN
(J su6mission type) • Residential Ventilation Category 1 Worksheel Submitted • New
• Energy Envelope Calculations Submitted
Plumbing Contractor: ____
Plwubing syslem includcs:
Mechanical Contractor:
Vlcchanic.d svstcm inclu(Ics:
Sewer/Water Contractor:
_ Wa[cr Sottcncr
Watcr Hcatcr
-- \'o.ol'Baths --
Air Conditioning
I-Icat Rccovcry Systcm
Phone #
Phone #
.)tlI 1 5 2002
Fcc: $70.00
---------------------------°-°----°----------------°°------------...-------°-------------°-----------°------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota StaTutes and City of Eagan Ordinances.r?
Signafure of Applicant
---------------------------------------------------------- ---------- '----------------- __------ ----- ------------------------------------------------------ ------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
_ Phonc #
I.awii Sprinkler
No. of R.I. Baths
jOa?ie_S
j
A-F4_e_c
gflWConatructbn HeaulremeMs
• 3 regislered site surveys slwwetg sq. tt. of lot, sq. N. of house; and 4II roofed areas
(20% meximum bt ooverege allowed)
• 2 copies of plan showkig beam & wlndow sizes; poured lound design, etc.)
• lsetofEnergyCetuletions
• 3 copies of 7ree Preservatbn Plen If bt platted after 7/7J93
• Rim Joist Dateil Oplions seleclbn sheet (bMgs wNh 3 or less unns)
DATE 7 2 -o Z
SITE ADDRESS Zag
TYPE OF WORKZe
wi
APPUCANT.J? ?
STREET ADDRESS / Z z " /bi ?,
TELEPHONE #9S? 7o?/,9s9CELL PHONE #
'"//e STATE/Ar`k' ZIPS
FAx # 95z.?i(Z???
PROPERN OWNER ??: Q-k DcQ TELEPHONE #GS /r 2-7&- //Z/
COMPLETE THIS SECTION FOR uNEWff RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 r
(4 submission lype) . ResideMial VeMlletion Category 1 Worksheet Submitted •
• Energy Envelopa Calr.ulations Submined
Plumbing Conhacfor:
Plumbing system includes:
Mechanlcal Conhactor:
Mechanical system includes:
Sewer/Water Contracror.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55722
651-681-4675
_ Water Softener _
_ Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Phone #
.IUI 1 5 2002
Fee: $70.00
I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signnlure of Applicanf
OFFICE USE ONLY
15 7. Z,$
RemoEeUReoelr ReaufremeiHs
• 2 copies of plen
• 1 set of Energy Cakulations lor heated additbns
. 1 sife sunrey Por exladar atltlttans & decks
• Indicata H home served by septic system for atlAifbns
VALUATION
MULTI-PAMILY BLDG _ Y ??
fIREPLACE(S) _ 0 2
?4(i.Q I
O
Certificates of Survey Received _ Tree Preservation Pian Received _ Not Required _
uPaetaa aroa
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163377
Date Issued:08/28/2020
Permit Category:ePermit
Site Address: 3608 Falcon Way
Lot:3 Block: 5 Addition: Lexington Place South
PID:10-45060-05-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Dawn L Hoffner
3608 Falcon Way
Eagan MN 55123
(701) 371-9758
Estate Claim Services Llc
6701 Penn Ave S, Suite 201B
Richfield MN 55423
(651) 309-1114
Applicant/Permitee: Signature Issued By: Signature