3615 Falcon Way
Use BLUE or BLACK Ink
I-----------------,
I I
Permit
City of Ea~fl
Permit Fee:
3830 Pilot Knob Road i
Eagan MN 55122 AUG 2 0(C'D i Date Received:
Phone: (651) 675-5675 I i
Fax: (651) 675-5694 Staff-
2010 p 2010 MECHANICAL PERMIT APPLICATION
Date: Site Address: A(AS IFCot
Tenant: A Suite
RESIDENT / OWNER Name: W►WA Phone:
Address/ City /Zip:
Name:
CONTRACTOR .1
Address: <rls City:. AJ~
State: Zip: Phone:
4-
Contact:
TYPE OF WORK New replacement Additional -Alteration Demolition
Description of work:
o r mo a nicae9 u(p Y` a uifed`' c. a ed Gi
e ease c ~ p « a
hki hanical (nspectorkforJ.nformatron;,on peirr~ittec~ g6ie hingrmetho s ,
it ec
RESIDENTIAL COMMERCIAL
PERMIT TYPE _jZFumace _ 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 $ x1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
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.aopherstateonecail.oro
I hereby acknowledge that this information Is complete and accurate; that the work will be In conformance with the ordinances and odes 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 o work which requires a re a and approval of plans
X x
Applicant's Printed Name Appli t ignature
.:':'vs . a-<.:..•.s 7<. 'j>~: , tix iR ,%iFf s° ?r. ~ ~e,k ..n ~~l~ ~ ."^.+s~ 5.,
F S eviewe B . te.f
e u: a spe s Qugj rAIrT`st;,, aS~Service }
<*k ~Iw Y• ~ . }~~FactenorHVAC Screening'rlrispection_ _:r....:, ~ . +,..:"Y t
' CITY OF EAGAN t?s 0
w^*?-- + 3830 pilat Knob Road, P.O. Box 21-199, Eagan, MN 55121 12877
•
B ,? PHONE: 454-8100
UILDING PERMIT \. Receipt #
Tobeusedtor SF DwGfGAR FQf ?a?„P $6$,0(}0 n2+o NOVF"161BER 17 10 86
Site Address 3 615 FALCON WAY Erect ? Occupancy Rj
Lot 2 Block 2 Sec/Sub. LExINGTO Remodel
? Zoning K1
Parcel No. Repair ? Type of Const. V
Addition ? No. Stories
W Name ORRIN TYiO["fPSO{Q HOMES Move ? Length 42
z 1712 F30PKIf1S CROSSROAD
Address Demolish
i ?
? Depth dti
a
City MTKA Phone 544-7333 mpr.
lnt.
Instau
? Sq. Ft
o Name SAME Approvafs Feea
OU a Address Assessment Permit $ 337.00
r cicy Pnone Water & Sew. Surcharge 34.00
P
li 168.50r-
PlanR
i
?s
F W Name o
ce
Fire ev
ew
?
SAC 575.00
?z Address Eng,
?
WaterConn. 500.40
e W city Phone Planner Water Meter 63 . 50 ?
Cauncil _
?
Road Unit 290,00
A Buildin
all work ;
Building
all
State of
Var.
1/17/8 Tr. PI. 155.Ofl Parks
Copie ?
Total ' .
on the express condition that
City of Eagan Ordinances.
I I PermR No. I ParmR Molder I Dats I TNephone N I
Fty.
Dlap.
.?)q:-.F: YIr
PERMIT # ?-
?' ' ? • MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN 1986
I>ece:nber 'U
, 3830 PILOT KNOB ROAD, EAG/1N, MN 55121 ,
DATE:
CON TRACT PRICE: PHONE: 454-8100
f• 5 Fal
Site Address con t•,a
BLDG. TYPE
WORK DESCRIPTION
Lot Block 2 Sec/Sub
L.exin to n Place ?4outh N
v
m Name Genz- a n P&H Res.
M
lt ew
Add
?
Address 14?45 8o
uth Robert Tra:i.l u
Comm: -on
Re
air
c CityRosemount. M23 phone 423-1144 Other p
IName urrin znoatPs?
-
c Address1712 Hopkins
p CityMinneton.ka, i,:1V
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Oudets #
Other
7S M BTU
M BTU
M BTU
M BTU
CFM
FEE
S/C:
TOTAL•
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
AdDIT10NAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.?
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
- -1 0 "
SIGNATURE OF PERMITTEE
CITY OF EAGAN
PERMIT #
.
' • • • , PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
. 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE PHONE 454-8100
Sibe Address
Lot Block
m Name uenz-xyan
? Address 7.4745 Sout
c Clty :ose:naun{-.
? Name US Hoates/ orrir
c Address 1712 Nopic; og c r
0 City Mznne±-•-,rf ;_, '', Phone
FEES
COMM/IND FEE - 146 OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARCaE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE Ca0E5
BEYOND $1,000.00)
OF PERMITTEE
BLDG. TYPE WORK DESCRIPTION
Res. New
M ult Add-on
Comm. Repair
Other
Nq. FIXTURES -TOTAL
?Water Closet - $3.00 s ..:.?
Bath Tubs - $3.00 ?
-?/--Lavatory - $3.00
Shower - $3.00
_LKitchen Sink - $3.00
Urinal/Bidet - $3.00
=Laundry Tray - $3.00 7- ? 7
-,./_Floor Drains - $1.50
-_/-_Water Heater - $1.50
Whirlpool - $3.00
/_Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50 =
FEE 00
STATE S/C: ?
CRAND TOTAL•
FOR: CITY OF EAGAN
1 ? - ?
Ter#iftrafP uf (IDrrupanry
titp of eagan
DrprbtttW uf luilbing ImVpriinn
Thrs CertiJ"icate issued putsuant to the requiremenu of Seclion 306 of the Uniform Building
Code cerlifying that at rhe iime of issuance this structure was tn contplrnnce wuh the various
ordinances of the City regulating 6uilding construction or use. For ihe following:
cl?irk.ow, 5:
ux L, eldg. Rn,w No.
OcruPsne9 TYPe R3 ZoninE DLwict R ` TYPe Co"SL
Bailding.4ddrear Laylity i•.? B2• ?_ii_V lI: LY.
pare;
BuilQing OH'Mid
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pllof Knab Road 8319
P.O. BOx 21199 PERMIT NO.:
Esgan, MN 55121 -- - J
DATE:
2oning: P`1 No. oi Units:
Owner. Thompson Homes
Addess: 3615 Faicon Way LZ B'L Lexington
No.:
No.: u (a I tt 71(o
to comply with th•
' Date Paid:
e oi Insp.: Insp.:
TY OF EAGAN SEWER SEItVlCE PERMIT
30 Pilot Knob Road
0. Box 21199 PERMIT NO.: -
gan, MM 55121 DATE: - i%
^i^0:
mer. No. of Units: '
dress:
Mdros: ':1 ; ot.,^tor, al --
_-__ _ .4 i?
rk6er.
rM h p?Plp whi fw Cihr of 6"a Cainsctian Chorot: ' .- -
Moom /lcaount Depoalt: " ^:,iu.'
Permit FM:
Surcharpc _
Misc. Charpes:
' ? InsP-: Totoi:
. Dote P+oid:
i P
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?f.
?19
DATE'
RECEIVED . FROM '
AMOUNT & coLLwws
,oo
Thank You ?
BY
. •) L' `' ' White-PaYen CoPY
I Yellow-Postin8 CoPY -
1 Pink-File CoPY
i ?
cX 7
BLDG. PE
_?- ' RMIT ??• ?
a i?'
? S?= S
01-3210 Bldg• Permi*_
01-3422 Plan Check
01-3445 Surch. /AdM •
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275
2p-3865
20-3868
20-3716
20-?252
ZO-3713
20-3743
79-3866
11-3855
SAC
Water Conn.
Water Trmt-
Water Meter
Acct. peP•
Water Permit
Sewer Permit
Sewer Conn.
Park Ded.
TOTAL
[] CASH ? CHECIC
?OR
CiTY OF EA GAN Remarks
Addition Lexington Pl ara 501-jth Lot 2 Blk Parcel
Owner Street 3615 Falcon W ay 5tate Eagan, MN
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK "
SEWER LATERAL 0 19 3. 326..
ervic s 01S 1986 729.39 145. 7 5
WATERMAIN &` - i
WATER LATERAL 10 1 1986 $ 7 3.43 114.68 5
WATER AREA 10 1t}- 9 243. 7 48.74 5
WAT LAT BEN 101--l 1986 111.98 ,,
22
3 5 ?
STORM SEW TR K 101q 1986 4 2 6. 5 4 ,
_
85.3 5 I
STORMSEW LAT lOlb 1986 803.34 . 160.66 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
8UILDING PER.
SAC
PARK
CITY OF EAGAN t?I
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 'v ? ??877
PHONE: 454-8100 ? -I /
BUILDING PERMIT. Receiptu Y
To be used lor SF DWG/GAR Est Value $ 68 ,000 pete NOVEMSER 17 19 86
SiteAddress 3615 FALCON WAY Erect IN Occupancy R3
Lot 2 slock Z SeciSub. LEXINGTON PL SO Remodel ? zoning Rl
Repair ? Type of Con
Parcel No st. 3]
.
Addition ? No. Stories
a Name ORRIN THOMPSON HOMES nnove ? Length 42
? 1712 HOPKINS CROSSROAD Demolish ? Depth
Address
? S
F? 46
o
Int. Impr.
q. ..
Ciry MTK1 Pnone 544-7333 Install ?
Approvals
o Fees
Name SANN1E
?¢ Address Ass25Srt18nt P2rmit $ 337.00
Clty Phone Water85ew. Surcharge 34.00
?Q Police PlanReview 168.50
FW Name Fire SAC 575.00
Z
Address
?u Eng.
5 0 0. ? ?
%WaterConn.
<W ciry pnone Planner WaterMeter 63.50
Council Road Unit 290.00
Iherebyacknowledgethatihavere
plicationandstatethatthe gld
ll/17/86
Off 156.00
rr
ai
g.
.
information is correct and e to with all appli
cable State ot .
.
Minnesota Slatutes and Eaances. APC
y
Parks
Signature of Permittee Var. Date Copie Total 2,124 . 00
A Building Permit is issued to: OR N THOMPSON HOMES on the express condition that
all work shall be done in accordance with all appli le State of Mi n
ota ytat-u
tes and Ciry of Eagan
-es Ordinances.
?
.
?
Buildinq Official ?-_L?; -
rnig reauast voia/ G/??, Co `?'e,L? C>
18 montha irom
C 6 7 0 4 97? .? r.o
Request ete ?? -
?? Fire,Klo. 7Rauph-in InspecUOn
Reputretl?
?Reatly Nuw/?Wi11 Noti}y InSPec-
?es ? No ?or When peady
Okicensed Eleclrical Contratlor I herebv requeet inapection oi above
? Owner electricel wark inatallad et:
SVeet Address, Bo or Poute No.
?eeyJ
& /s C
i
L'??
ectmn o. ownehio Neme or No. nnge o. Coun/
O uPant IPRINTI
/N /??'v w° P.?r7 /.'23J
Power SuvOlier Atldress ?
a cal Convactor (Compeny N@mel
l n
1"?.?c.7lo.,r??.?u.?-? Conttactor's Lica e No
.
Mailin0 Atldr s IC ntracy r or Owner M ing Instailatio
Aut rized Sip tw?(Contrect r Own MakinO Installation) Phone Number MINNESOTA STATE BOARD Of TqICITY TMIS INSPECTION PEQUEST WILL NOT
Grippa-Mitlway BId9• " Moo •181 BE ACCEPTED BY THE STATE BOqRD
1821 Univereifv Avs.. St. ul, MN 86704 UNLESS PROVER INSPECTION FEE IS
Phone(612)642-0800 ENCLOSED.
V REQUEST FOH ELECTHICAL INSPECTION Ee-o/o/ooi-os
0 See inatruetiona lor eompletllW this lorm on beck of vallow cooy.
C 57?0Qq "X" Below Work Covered by 7his Request
add 9eo• Tvue ot euiiainy Applinncee Whatl Equiymenl WireO 1
M Fee SarviceEntrencsSlze p Fee Feeders/Subfeaders N Fee Circuits
Uto200Ams Oto30Ams Oto30Am
A6ove 2_qmps I 31 to 100 Amps 31 to 100 Arnm
Swinvnin POOI Above 100_Am s Above 100_Am s
Transrormers rnpation Booms Partial.'Other Fee
1, the Elecbicel
Inapoctor, heraby
eertity ehet the »bove
InaDSetion has been
nqueat
/) 1486 BDILDING PERHIT APPLICdTIOA - CITY OF EAGAN
,ypTE; 9LL CONTRACTORS MIIST EE LICENSED SiIT$ THE CITY OF EAG3N
SINGLE FAMILY DHELLINGS
INCLU?E 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, 1 SET OF r.NERGY CALCULATIONS
,*SpLTIPLE DWELLINGS - RESIDENTIAL RENT9L. IIttITS FOR SALE IINITS
IvCLUDE 2 SETS OF ?LANS, CERTSFICATE OF SUR4EY - CHEC3 SiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
C0M4SERCTAi.
INCLUDE 2 SETS OF ARCHITECTURAL & STR'UCTURAL PLt1NS, ? J?
1 SET OF SPECIFICATIONS 9ND 1 SET OF
ENERGY C.ILCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: e.?_Z 11741-1 +(? Valuation: tog, DaC) Data: I (- 4'66?
Site Address 3 L)5 FA-t-LCJ" W?
Lot Z Block Z
Parcel/Sub LL-t4
[.n?1 YI/tZ
4
? ?7Li77?
Owner
Address
City/Zip Code
Phone
Cont:aetor OF_J %Fa 1 123}&P.Sv1J
Address )712 } ttIG14.$ c4aSa-e/h7
City/Zip Code M+11)?- 00 -1:5M3
Phone `_?333
Arch./Engr.
Address
City/Zip Code
Phane +?
OFFICE DSE ONLY
nrect ? Oecupancy R 3
Remodel Zaning RI
Repair _ Type oi Const $Z
Addition ;k of Stories
Move ? Length ?Z
?emolish Depth 440
Int.Impr. _ Sq Ft
Install
APPROVALS ??
Assessments Permit
Surchar
e 337oz)
.00
vlater/Sewer g
Police Plan Review .S U
Fire SAC 1575.00
Engr Water Conn SDO•C>o
Planner Water Meter 143,
Council Road Unit O.OJ
Bldg Off Treatment P 1 IS?.oo
9PC Parks
Variance Copies
20T9I. IZ o0
NpTE: ADDRESSES rOR CORNER LOTS - CGNTRACTOR/HOHEOWNER 4lIIST DESIGNATE HHICH ADDRESS
IS DESIRED. NO CE9NGr^S WILL BE AI.LOWED ONCE BDILDING PERMIT IS ISSDED.
?.A"Irruvx •
• 1'I1LYlVG(it'VLilJ/ l'lY • C[MVL: J/y-y/y?J
ORRIN THOMPSON HOMES
A Division of U.S. Hane Corporation SCale: 1" = 30 '
o Iron monument set
• Iron monument found
? 5pike or wood stake set ?
PROPOSED ELEVATION: .sno.o Existing spot elevation
Proposed spot elevation
FRONT GARAGE SLAB: ?- Drainage direction
E1. = 904.63 ft.
1reiiiale and Ufi Edsr.weaf
S 89° 21' S4" E. 110.00
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17.0
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4.50
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89° ZI' 54' W IIO.oo
Lot 2, Block 2,
LEXINGTON PLACE SOUTH
Dakota County, Minnesota
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I heceby certity tha[ thia is a tcue and correct representa[ion of a survey of [he
boundaries of the land above described and of [he location of all buildings, if any,
[hereon, aM all vieible encroachmenCS, if any, fran or on said land. I further
certity thaG thia aucvey vas prepared by me or under my direct supervision and [ha[ I
am a duly Registered Land Surveyor under [he lawn of the State of Minneaota. tRi Reg. No.7g Da[e
Proposed House.li As-8uilt House_ Drawn bV KAE pKOiect no. 8680_
RING COMPANY • 2815 WAYZATA BOULEVARD • MINNEAPOLIS, M • PHONE: 374-4740
CE(2TIFICATE OF SURVEY FOR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Corporation
BENCHMARK; Top nut of hydrant at
Blue Jay Way and Falcon Way
Elevation = 904.02 ft. (NGVD-1929)
FRONT GARAGE SLAB:
Proposed el. = 904.45 ft.
Scale: 1" = 30'
• Tron monument found
° Wood stake set
,900.0 Existing spot elepation
oo, proposed spot elevation
- Drainage direction
? /dr'ainaye f U/i//fy Easemen
5 896 2I'54:'E 110.00
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33 m
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110•Q0
BLU E JAY WAY
S v u-nt- o.=
t-JS 2 6?? 2
3 fi i5 FKSe? a
Lot 1, alock 2,
LEXINGTON PLACE SOUTH,
Dakota County, Minnesota
? I hereby cectiEy tha[ [his is a true and correct representation of a survey of the
, 6oundaries of the land above described and of the location of all buildings, if any,
_thereon, and all visible encroachments, if any, from oc on said land. I£urther
certify [hat [his survey rras prepared 6y me or undec my direct supervision and that i
am a duly RegisteQred Land Sucveyor under the lavs of the State o£ Minnesota. •
hIN Reg. No. ;5 Z;'. Date ? - ??'p ?
1.) REV. 3•14-$6 ,.. ROTqTEO HOVSE- RESTAKEO
Proposed House x As-Bui1C House_ Drawn by /'E^v 'Project no.85104
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31019 fNtn..nv=
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EDK;INEERING C70MPANY • 9RI9 WAY7.ATA RO[7i,EVARD • MINNEAPOLISi hIIV • PHONE:
CERTIFICATE OF SURVEY E'OR:
ORRIN, THOMPSON HOMES
A Division of U.S. Home Cocporation
Scale: 1" = 30'
• Iron roonument found
o Spike or wood stake set
.900.40 Ex3sting spot elevation,
oo.a Proposed spot elevation
? Drainage direction
_NUMMINGIDRD I-AlAE
'R //tiy"I'v E?semen
5 89° 21'54"E llD•oo
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0
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4fni3
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YA 'j, l. 50.2
= o ;
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a
Lot 3, Block 2,
LEXINGTON PLACE SOUTH
Dakota County, Minnesota
lo'
. I heceby cecGi£y [hat this is a true and correct representation of a survey of the
. boundaries of [he land above described and of the location of ali buildin9s, if any,
? [hereon, and all visihle encroachments, if any, from or on said land. I Eurther
cer[ify [hat [hie survey vas prepared by me or under my direct supervision and ChaC I
am a duly Registered Land Surveyor under the lavs o£ the State of Minnesota. Reg. No./,'577Z;q DaGe v--/ -96
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Proposed HouseA.- As-Built House_ Dravn hv KAE Drniort .,,,_ $51a3 3&1
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UIT`1"' O(° LAG/aN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY.ADDRESS:
LEGAL DESCRIPTION:
? NJ'i' :. YF1Yiilii:: (.` OI' E:P TIPii Oe
* APPI,IGATIOti DO3iS ISOP COiv,"TI7VI'i,
? APPROVAL OF PII2MIT.
INSPDCTSON OF SESM AND/Oi MaER
TT1R'1'AT.TATTON$ FTIITa NOI` $E $QHID-
ULED UN1M PERMIT AAS BF,W,
APPROVFD.
IF E}ffSTING SIRC'CiURE, DATE OF ORIGINAL BL'ILDING PERMIT ISSCAN(E: .
PRESENr ZANING/PROPpSID LSE: (Mn ear
E) =7"1ERCIAL/RETAIL/OFFICE
? ZNIDIISTRIAL,
? INST12[Pi`IONAL/GOVII2I.Z=
i?
K R-1 SINGLE FAMILY "
r-I R-2 DIIPLEX (7Wp C?nits)
? R-3 ZOWNEiOIISE (Three + Units) ( Onits)
R-4 APAR7rI6NNT/CObIDOMINILRK ( Units )
2) ?
rmrE:?f?f?/N 7??}0//t11l?Sd? }}?r?7Ed
ADDxESS17ja #00KzX25 .Poss o.v-v
CZTY. STATE, ZZP'&.INXJ9]nitJIKMIf)
PHONE: .'YVy-
3) u c y•
NAME:
ADDRFSS:
CITY. SrATE. ZIP:
PHONE:
MAS'I'ER LICCE[vVSE#
Q) osa •:.?
-- N71ME:
_ ADDRFSS:
CITY, STATE, ZIP:
PHONE:
Pltunbers License:
Active
EcPired
Not recorded
staff Initial
•$) ? :? a• - ,•? a• • ?• -
CONNEC.TION 7.C1 CITY SEWgt Eg CpNNECpION TO CITY WATER Q O'i'EER •.
6) 7'? •?o?- E] PI,EASE HOI.D ApPROVID PERMIT .FOR PICK-LTP BY ONE OF ABdVE
? PLFASE MAIt, ApPROVID PERMIT '10 1, 2. (D 4. AHOVE
? (Circle one)
FORCITY USE ONLY
PERMIT # ISSL'ED
?3/ `i -?
Pd w/Bldg. Permit
?
$
S ? 3 s2?
$
$
?
$
S ?F5 O C) C)
$
$
$
$
$ -b D
$
$ Sz)
RECEIPT
FEES:
$
$
S
c
$ - SEWER TAP
S ACCOUNT DEPOSIT - SEWER
$ e' ACCOONT DEPOSIT - WATER
$ WAC
S SAC
$ TRONK WATER ASSESSMENT
$ TRLNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRLNK SEWER
$
$
$
?f? S y
RECEIPT
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLLDE SIIRCHARGE)
WATER METER/COPPERHORN/ODTSIDE READER
WATER TAP (INCLL'DE CORPORATION STOP)
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
DOEB OTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC
Q RQADWAY" MLST BE ISSDED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CpNDITIONS:
APPROVED BY:
TITLE:
DATE:
S 37 S ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITV DF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Canstruction RaauiremeiAs RemodelfRaoair ReauiremeMs
• 3 2gistered sile surveys showing sq. ft. of lot sq. R. of house; and all roofed areas • 2 cnpies of plan
(20%max'unum lat covera9e allowed) • t set ot Energy Calculations tar fceated add@wns
. 2 cropies of plan showing beam & window sizes; poured fountl desgn, etc.) • 1 site survey for exterior additions & decks
• 1 set of Eneyy Calculations • Indicate it home served 6y sepdc system for additions
• 3 copies of Tree Preservatbn Plan if lat platled aher 711193
• Ran Jaut Detail Options selection sheet (bldgs wifh 3 a less uniLs)
DATE VALUATION
SITEADDRESS ?3G?/S t'.9LCO?U l.J?¢y MULTI-FAMILYBLDG Y N
TYPE OP WORK }k - F00 ? FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS &6'66'6DEX) ?rFIE '6f ?D. S?il? I3 d
TELEPHONE # 73;?-?7"/-1S033CELl PHONE #
• Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
PROPERTYOWNER??/.4ifJ TELEPHONE# 667- n83-0(o66?
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RliLES 7670 CATEGORY 1 MIYNESOTA RULFS 7672
(J submission type)
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhactor.
Mectivnical system includes:
Air Conclitioning
Heat Recovcry System
Phone #
Sewer/Water Contractor. Phone #
I hereby acknowledge that I have read ihis appiication, state that the information is conect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagon Ordinances.
Signature of Appllcanf
.....___._........ __------ ---------- ------ -_------------- __......... ......... -------------------- __----- W- -
OFFTCE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
_ Water Softener _
_ Water Heater _
No. of Baths
nP ?-M
FAX # C/so?'g y1/' /?8 q
• New Energy Code Worksheet Submitted
Phone #
Lawn Sprinkler
No. of R.I. Saths
RESIDENTIAL
BUILDING PERMIT APPLICATION ?1 •
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construdion Reaulramenh
• 3 registered s8e surveys shwring sq. R. of lot, sq, ft. of house; a(M all iooted areas
(20% mazimum lot coverege allowed)
• 2 copies of plan showing beam & wiMOw sizes; poured found desgn, etc.)
• isetofEneigyCalculafions
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
. Rim Joist Defail Optbris selec6on sheet (bidgs vnth 3 or less units)
DATE /O " I ? - 0 Z
SITE ADDRESS 3(0 1,5 `¢?COA) bJ
TYPE OF WORK 7?e "SrdP.
APPLICANT
STREET ADDRESS la5HS ,:E.D£.[JdACG Blvb •
TELEPHONE # 'F??-57'f7S?03rCELL PHONE #
RemodaNReaair Reauirements
. 2 copies of pian
. 1 set of Enefgy Calculalions for heated additians
• 1 site survey for extenor additions 8 decks
• Indicale if home served hy septic system for additions
?D(oS.
VALUATION
MULTI-FAMILY BLDG _ Y _ N
_ FIREPLACE(S) _ 0 _ 1 _ 2
h11V ZIP v`-S`3Y &
FAX # 97 4/-1S8 Y
PROPERTYOWNERSU.SdilJ 8 CJ/ TELEPHONE#&3'1'Zn83-0 4, 55'
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01'A RUI,ES 7670 CATF.GORY I MIVNESOT.A RULES 7672
(J submission type) • ResidenUal Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheel Submitted
• Energy Envelope Calculations Submifted
Piumbing Contractor: _
Plumbing system includes:
Water Softener
Water Heater
No. of Baths
Pl1one # _
Lawn Sprinkler
No. of R.I. Baths
Fee: $90.00
Mechanical Controctor. Phone #
Mechanical system includes: Air Conditioning Fee: $70.00
Heat Recovery Sys[em r---- --
i? F_?
Sewer/Wafer Contractor. Phone #
i i
-----------------------------------°----------------------------°----------------------- ---------------------------.._J
I hereby acknowledge that I have read this application, state that the information is correctyand agree to comPlY j
with all applicable Stote of Minnesota Statutes and City of Eagan Ordinonces. `- ---
Signature of Applicant ---?_----
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140240
Date Issued:12/05/2016
Permit Category:ePermit
Site Address: 3615 Falcon Way
Lot:2 Block: 2 Addition: Lexington Place South
PID:10-45060-02-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Derek B Wiley
3615 Falcon Way
Eagan MN 55123--222
(651) 330-0980
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169941
Date Issued:06/15/2021
Permit Category:ePermit
Site Address: 3615 Falcon Way
Lot:2 Block: 2 Addition: Lexington Place South
PID:10-45060-02-020
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Derek B & Marilyn J Wiley
3615 Falcon Way
Eagan MN 55123--222
Options Exteriors
460 Hoover St NE, Suite 2
Minneapolis MN 55413
(651) 705-6376
Applicant/Permitee: Signature Issued By: Signature