3619 Falcon Way:'?.?AG`:y lAM FOR BAM:7I' &UL.; 1/2^_ /t ? CITY OF EAGAN
?'3830?PilotRKnob Road, P.O. Box 21-199, Eagan, MN 55121
P-il 2 1iG?'t9
BUILDING PERMIT PHONE: 454-8100
Rece ipt# ? -
;?
To be ussd br j.)'„c,/G:.it Est.Value $57, 000 Date
.uulKCH 19 86
, 19
Site Address .1619 rALLk-; : rJILY Erect ? X Occupancy ?-?
Lot 1 Block A Sec/Sub
j•E XxNG1P0N PL SIDmodel ? 2oning
.
Parcel No Repair ? Type of Const
. ? Additian ? No. Stories
W Name CRkiIJ Move ? Length
=
a 1 f 12 I'.0 P tC ? iJ ? C:RU:i S ttOAD Demolish
Address I
I ?
? Depth
Ft
S
City ` ' 't„ Phone 54`? - 7 mpr.
nt.
333 Install
? q.
.
o NBme SAME Approvab
=
0
?
Address
Assessment
~ City Phone Water 8 Sew.
? Q Police
F Name Fi
= re
? Z5 Address Eng.
¢ W
<
City Phone
Planner
Permit ? 3U4.00 I
Surcharge 28.50
Plan Review 152.00
sAC 575.00
Water Conn. 5U0 . OU
Water Meter 63.50
%IvuIwn Road Unit 290 - 00
I hereby acknowledge that I have read this application and state that the gldg. Off, 3 18 6rr, Pl. 156.00
information is correct and agree to comply with all applicable State ot
Minnesota Statutes and City of Eagan Ordinances. APC Parks
Var. Date 4/17/ #Copies
Signature of Permittee "-
Total $2,069.00
A Building Permit is? issued to: nkRIN THUMPSn[J HOi?1?:5 on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building
PermN Mo. PKmit Holder Daie tNephotM N
Plumbin9 :5 /aZ
H.Y . '. , & 8? ? ?,(: ?GC?J "'A (I
E? 370 3 8
?'
? ?
S7
IMpectlon Dale IMp. Commwts
Footin9s 1
Footinqs II
Foundatbn
Fwmfnp ? (dA I
Rootfnq
Rouyh Mbp. _ -?
Rough Hty. G
Ingul.
Flnplace
•
Final Htp.
Flnal Plby.
Bldg. Final
c.d. occ.
Detk Fty. /S y •? ? N• .r. ??? ? c' ?
Deck Frmy.
We11 d f
Pr. Wsp. ? .
?s„? ?. ? ? ? y?' S ? ] ?%. ?. g ?.? ?5 X - ?I -i ? ?o
, ys.
PERMIT # - G).- ''
' MECHANICAL PERMIT RECEIPT # ? S
/
G
/
J
0
3830 PILOT K OB OAD, EACAN, MN 55121 DATE:
7
"
4
" a
CONTRACT PRICE: PHONE 454-8100
Site Address
Lot Bl
k Lr^'
/S
S
b BLDG. TYPE WORK QESCRIPTION '
'
ac ec
u /
? I
Res.
New
? Name I
Mult Add-on
Address ` ?
? Comm. Repair
c City MP& Phone s '!? &' )
I
pther
i
Name FEES
c Addr ?L;?' JLL 1l.I,J RES. HVAC 0-100 M BTU -$24.00
p City ???? ?- Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
v ? GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1%OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU $ STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Gas Piping Outlets # I-
Other
FEE
v SIGIJATURE OF
ERMITTEE
S/C: _
Y-
?
U
TOTAL: o
,
FOR: CITY OF EAGAN
? PLUMBING PERMIT
qTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Address .
Lot Block `- ;
- Name
Address r? t •. C I '
c City Phone
- Name - ?
3 Address , I c z, '-
p Ciiy Phone • '-'
FEES
COMM/IND FEE - 146 OF CONTRACT FEE
MINIMJM - 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)
OF
FOR: CITY OF EAGAN
FEE
STATE S/C:
GRAND TOTAL:
PERMIT # _
RECEIPT # _
DATE:
TYPE WORK DESCRIPTION
Res. New -
Mult Add-on
Comm. Repalr
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
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
PERMIT # k -S
? rvame r
m Address
c City x..?
? Name _
3 Address
O City -
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN S5122 DATE: ?
Phone
Phone ' ? -
FEES
, COMM/IND FEE - 1°1o OF CONTRACT FEE
I APT. BLDGS - COMM RATE APPLIES
; TOWNHOUSE & CONDO - RES. RATE APPLIES
j MINIMUM - RESIDENTIAL FEE - $12.00
' MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR: CITY OF EAGAN
BLDG. TYpE WORK DESCRIPTION
Res. - ' New
Mult Add-on
Comm. Repair
pther
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki?chen Sink - $100
Urinal/Bidet - 5100
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
- Private Disp. - $10.00
Rough Openings - $1.50
FEE:
, STATE S/C:
-i CITY OF EP.GAN `,?} ?S WATER SERVICE PERMIT
? 3830 Pilat Knob Rosd ??W pERµIT NO.: ,
! P. O. k3ux 21199 DATE:
I Eagan, MN 55121 ,
? No. of Units:
E.
f O?ivner. _ _ •,, - _..
/1ddress:
Site NddrlSS:
Wuxnber:
Nlater No.: ? 70
OII
Reader No.: ?r .? " • • ? ? t4fti -
1 prM to ee?Vlf w? !Iw Ckq q?4???1?F.5W?eh rge? -
tiz-
Ord1NSeM.
L y
Dote Pcld:
ay gtd( Dare of . ?rpp.:
86
SEVyER SER1/eCE PERMIT
PERMIT NO.:
ee a.wiVy? w*b w. Gh? ef lN°w
5urchor0e: -
Misc. C+orgm
By
Totai: -
pote of IrNp.:
DoM Pdd: -
I nsp.:
CITY OF EAGAN Remarks
Addition Lexington PlarP Sput-b Lot ? Blk ? Parcel 10 45e60 010 02
Owner
Street State
Eagan,
Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 41 1 -
SEWER LATERAL 326 .20
1.45.87
WATERMAIN 1985
65.91
13-16
9
WATER LATERAL 0 1 1996 873 .43 1'71+ . 68
WATER AR EA 4$. 74
22 9 9
STORM SEW TRK 426 .54 -
8 5. 3 0
STORMSEW LAT 101 b 1986 803 . 34 - 160.?. 6 6 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PAR K
CITY OF EAGAN
Np
1160
3830 Pilot Knob Road, P.O. Box 21-1 99, Eagan, MN 55121
-
PHONE: 454-5100
6
1
BUILDING PERNi1T 7
Receipt x o
86
SF DWG/GAR
MARCH 19
$57,000
7obeusedmr
Est.value 19
Date
SiteAddress 3619 FALCON WAY Erect C? Occupancy R3
1 2 LEXINGTON PL SORemodel ? Zoning R7
Lot Block Sec/Sub.
Parcel No pepair ? Typeo(COnst IT
.
Addition ? No. Stories
ORRIN THOMPSON HOMES Move ? Length 3a
W Name
HOPKINS CROSSROAD
3 Demolish ? oepth_49
Address
°
MTKA
3 Int. Impr. ? Sq. FI
ciry
phone Install ?
o Name SAME Apprmala Fees
$a nddress Assessment Permit $ 304.00
Ciry Phone Water & Sew. Surcharge 28.50
w Police Plan Review 152. 00
b
FW Name Fire SAC 575.00
LE
Address
u ?
Eng.
5U0. ?0
Water Conn.
a W Ciry Phone Planner Water Meter 63. 50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Ott. 3/18/$ Tr.PI. 156.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ci of Eagan Ordina ces. APC Parks
Var. Date 4/17/8 Copi
es
Signamre ot Permittee ??'%
2'069 . 00
Total
ORRIN THOMPSON HOMES
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applic?kSJq Stalq of Mlhnesbo Statutes and City of Eagan Ordinances
Byilding Official Ex? k"?'??Z?
This requast void 044/377
i
7c?G& /
9 ,mn,ns 1wm
C 4 4 3 8 6
Renues[ Date ' ir¢ No./ Rn'hAh-in Inspar.tion ? T
;HE
R
[Qo9Gill N
I
R
A
N
tif
-
du rec ea
y
nw
o
y
nsDec
o
qA ?No mr When Reody
[^] ?licensed Elec[rical Conhactor I hereby requast insoaction of ebova
l1dV?+'n¢r eleciricel work installed at:
Sireet Atltlress, eox or Roure No.
3(Q15 FAL-r-orJ Wx City
,4A!
ecuon o. Townsbip Name or No. Hanee No. Cawrty
O •'
Oc?upanPRINTI
( v Phune Ne.
Pawer Suppli?er ]/? ?`
? fT GLEC--1?)(- Aadress
.
Elechical ContraclarlCOmOany Namel ConGactor's License No.
Mailinp AtlJress iContractor or Owner Making Installation)
A a tur 1 MraclodOwner Making Ins[allation) Phone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION ftEUVEST WlLl NOT
Griggs-Midwey Bldg. - Foom N•791 BE ACCEPTED BV THE STATE BOARD
1821 University Ave., St. Paul, MN 65104 UNLESS PROPEfl INSPECTION FEE IS
Phona (612) 291-2711 ENClO$ED.
114G/$7 REQUEST POR ELECTRICAL INSPECTION olft .e-fe-oooo?-oa
It See instretlions lor completin9 this form on back ot Vellow copy.
C-443 g 6 "X" Below Work Covered by 7his Request
Now, Adtl Peo. Type of Builtline APCluancee Wirod Equipment Wired
Home Range Temporary Service
Duplex Water Heater Liyhting Fixtures
Apt. BuilAing Dryer Electric He2Un
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm mr, ae,:1 v eine, Ism?o,ivl
l 9? I?CCI(y O[11¢i oth.,
Compute lnspection fee Below
'p Fae ServiceEntrance$ize M Fee Feede,s/Subleedars i+ Fee Circuita
0 to 200 Am 5 0 to 30 qm 5 0 in 30 Am
Above 200 qmps 31 to 100 Amps 31 to 100 qm s
Swimming Pool Above 100-Amps Above 100_Am .'
Transrormers rngation 13ooms Partial-"Other Fee
Signs Special Inspectfon
'q
$
TOTAL
E
Aemark
tllfa l i?Atrr??.1T
'
v 6E
?
/??
1, the Electricel
Inspector, hereby
certify thet tha above
inspection has been
mede.
Tlile reQUae1 void
This request voitl 7 ` /3?-??
18 months from -7 ?
C - 3709 Z-/, i3a
G?V,7F'
? ?7 Q?
ire rvo. nouPn-in msper.UOn
Re?ypu'i'red? []Ready Nuw15JV,11 NoIity, Inspec-
`0 (Q . ?Qµ95 ? Na tor When NBOdy
Wice-sed ElecVical ConVactor I herehy m0uest inspection ol above
? Owner alecttical work inslalled et
Sveet Adtlress, Box or Noute No. City
?
eMion o. Townshi0 Name or No. anee No. Co n
Occupant(PNINT) Phone No.
5V 7Y33
Power SuoDI,er Atltlress - ' YKZ 2 ,
PRVO-s-Ai.(I '
EI nca
l
C
onvactor (COmpany Namel Conlractor's lica e No.
.,
(
?
?fYLI 7 /
M
ailinB AdJres ICoMra or or Own r MekinB
Ins
tailation)
/
?
?
[Q . 1/""_?"?' /GV'
Aut
IConhacto
kine InstallatioN Phone Number
=
?
o?y
M}flnE50TA STATE BOARO OF ICITY THIS INSPECTION NEQUEST WIIL NOT
BE ACCEPTED BV THE STqTE 90APD
Griggs-Midway Bldg. - Roo - 81 UNLESS PflOPEN INSPECTIDN FEE IS
1821 Univaraity Ave., St. Peul. MN 55704
Phane (612) 297-2111 ENCLOSEO.
() L REQUEST FOR ELECTRICAL INSPECTION ee-oiwoi.oa
Ii, See inetructiens fof tomoletin9 this form on beck of vellow copy. ? O?/? C?
3709 X" Below Wak Covered by lhis Reques! Y 4
AAd eD. SvDe of Builtling AoPliancea WiroE Equipment Wired
Home Range Temporary Service _
Duplex Water Heater Ligh[in, Fixuues
Apt. Building Dryer Electric HeaUn
Commercial Bldy. Fumace Silo Unloader.
Industrial Blda. Air Conditioner Bulk Milk Tnnk
p Fee ServieeEntrenea5ize fl Fae Feadees/Subieeders N Fne Cireuits
0 to200Ams
1 ,pp Oto30Ams 0 tn30Ams
Above 200 Ampy .d 0 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100_Amps Above 100_Amps
Transiormers Irrigation Boorris Partial-?Other Fee
I Signs ISpecial Inspection ?S , TOTA E
Hemaras /T7 ? / . ?' "?D
..__^ ... ? v. vy/Y????L? y --^ ?? I. "e Electrical
? Inspac?or, hereby
A certify thel the above
Final DaeR inypection hes been
.5?/? made.
mie repuasl wiE 78 montlre Irom /N.?
,o' /J-&/
* ?U]7?
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
OFEAGAN
3830 PIL10T IaIOB RD - 55122
851-881-4675
w Conshucnon ReaWremeMa Cj '?
> 3 reglsfared alfe aurveya ahowing sq. fL of lot, sq. fl. of house
and g({ rooted areas t20X maximum bf coveraae alloweN
> 2 coplea of plana (show beqm & wlndow sIzes; poured hxf, deslgn; e1cJ
> 1 set of eneryy cdculatians
? 3 coplas of hee prefervaMOn plpn if lof platted after 7/1 /93
DATE: S Is )00
DE5CRIP'fION OF WORK:
SiREET ADDRESS:
LOT: I BLOCIG a SUBD./P.I.D. f: l-
PROPERiY
owNee
Remodel/Reoair Reauiremenls
2 coptes of plan
1 set M energy cdculaHans (or heated addiHons
T aHe wrvey tor extedor addlNOns R decks CONSiRUCTION COST:
qT000 IQ ?
Name: ??•1 ? ? ( ? , ? ? Vl Phone #t: 'G1?I "rS"
last Flrst
stfeet
C, ck C'i, C'---
. CI}y State: v' v(\ _ v Zlp: S?
Company: P c I Cr? ??- Phone t:
(area code)
corirencroR Sheet Address:1 k S g-? )R, wp ?"s
License # an LMDl9ExP•
City Q?.f 9J?TC111.Q ? Stafe: Mlv` Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: ( )
Sheet
City
State:
Sewer/water licensed plumber (N instellina sewerlwaterl: Phone #:
Zlp:
I hereby acknowledge Ihaf I hpve read Ihis appikation, slate Mat ihe Infortnalan is cortect, and agree fo comply wilh a0 opplicable StatE
of Minnesota Statutes and C1fy of Eagan Ortlinancea
Slgnalure of ApplicanY.
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Pian Received _ Yes
No . ?liAY - $
No - Not Required
Regisiration #:
?
; ?.
?_ . .
1986 BIIILDING PBRAIIT APPLICATI0N - CITY OF EAG6A
NOTE: ALI. CONTRACTORS MQST BE LICENSED WITH THE CITY OF EAG9H
COMMERCI9L SINGLE FAMIILY DfiTEl.LINGS
INCLIIDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 9ET OF
ENERGY CALCULATIONS?
$2V000 LANDSCAPE BOND
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: ^
?
_?17_?.?;1CE Valuation: S? OJO Date: 3-7-63(0
Site Address 3t0l 9 F/R.e.d?J C.t) OE'F3CL II3E ONLY
Lot ? Bloek Z '?Lfiy Zo 4 Erect 7- Occupancy - lZ•3
Remodel Zoning e l
Parcel/Sub L?1(f 44'1r.1 l(i('j,g?- SJn.r714 Repair ` Type of Const :9:
Addition U of Stories
Owner Move Length ?
Demolish' Depth ¢^?
Address _ Int.Impr. ? Sq Ft
City/Zip Code
Phone
Install
APPROYALS FEBS
Contractor ?Z 1711?1 1 I'tVM ?jNi tt0??? Assessments Permit 3r24
Water/Sewer Surcharge 28 ?
Address (? ? Z?IL.tf.ls dA735? Police Plan Review l SZ ,
Fire SAC 5"IS
City/Zip Code MN? ? JA K S`ie 343 Engr Water Conn Soo.
Phone 7133 Planner
C Water Meter -Z3 ?-°
ouncil Road Unit ZG o
Bldg Off 31986Wreatment Pl 1510,
Arch./Engr. APC Parks
Address Variance .??-e4 Copies
qpTA
,,
City/Zip Code
Phone #
NOTE: ADDRSSSES FOR CORHER IAT3 - CONTRACTOR/HOMSOWAER MD3T DESIGNATS AHICH
ADDRESS IS DSSIRED. NO CHANGES TiiILL BE ALLOAED ONCE BQILDING PERMIT
IS ISSOED.
. _ //?PL17
?,i,nnc? cnviivccniivu ?vrirHlVx • Zi}l7 WHYLH'1'A tSVULLYAItU • ?'illvlVGHYVLIJ? CYV • YtIUNL:
CGRTTFICkT£ OF SURVEY F'OR:
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'
• Iron monument found
° Wood sCake set
,yoo.a Existing spot eleyation
oo. Proposed spot elevation
Drainage direction
? ,Dr'aina9e ? U/i/i?y EaseMen
S 89°21'54'E 110.00
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BLU E JAY WAY
Lot 1, Block 2,
LEXINGTON PLACE SOUTH,
Dakota County, Minnesota
I hereby cer[ify [haz this is a true and correct representation of a survey of the
boundaries o£ the land above described and of [he location of all buildin9s, if any,
[hereon, and all visible eneroachmen[s, if any, from or on said land. I fucthec
cer[ify [hat [his survey uas prepared by me oT under my direct supervision and tha[ I
am a duly Reqisteced Land Surveyor under the lavs of the StaGe of Minnesota. 1(?/--sr ? ? n o IMl Reg. No. ?j '??y Date
`.I 1•) REV. 3-14-86 .. ROTATEb HOUSE- REStA
Proposed House x As-Built House._ Drawn hv P--N Prniart nn.85io4
Y
Q
3
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lt11?774[\IQI??iq:Y??l?'Y.'1?I7171:?,\?I?]
.JP7Idh^J??:UY7f?1Y:?7QMY11?n1?Mi6:]?Z0
?.!_VY71i?J?1:7u?YY.'?
. 'Ro • ' • W ei a f • •• ' 2? ' 1 1 • • 71'
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A
?TY OF EAGAN
. . ..
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' .... . t:'..".. . "..-..' MM i., .. . . . ' ' ^ - ,
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---
- • APPLICATION FOR PERMIT SEWER ANIIJ/OR WATER CANDIDCTION
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Ik7GAL DESC'R7mT _,,
O13: '
;-. (Lot ock 5 vision or Tax Parcel I.D. Number)
-
IF EXISTING SZRPCZLRE..DATE OF OtIGINAL
BUILDII? PERNIIT ISSIJANCE:
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PRESEN'f ZONiNG/PROPOSF:D USE: R-1 SIN= FAMILY
R-2 DOPLEX ('Ikn Llnits)
R-3 TOWtOMISE (Three + C?nits).( Units)
r 3, : x R-4 APART'1vMT/CAPIDOFffNI[.T7 ( thv.ts}
FR
. x CpNAIERCIAi./RE'PAIL/OFEICE
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: . . :?.-.: . .. •. . ?INSTI1'
.TIONAL/GOVERNMENT
'
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NANIE:
: P,DDRESS: •
_ CITY, STATE, ZIP:
PHONE: -?7??_?J?•?i
3) • i: ?' .,- -- For City Use
NAME' Plumbers License:
ADDRESS:
_
L= Active
CITY, STATE, ZIP: C Ecpired
O Not Recorde
PHONE: MASTER LICENSE #
St?t{-dl
4) ? ? ?• ?
NAME:
ADDRFSS: .
-CITY,..STATE. 2IP: -
PHONE: '- ..
5) - " • ?• • ? ?? - ..
? CAiVNECTION TO CITY SEWR NNECTION 'i0 CITY WATER
7
? OTFEt (Please Describe)
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W
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PE?2A1IT a ISSUED
? rn . .
, Frrs $
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M1ar .:'? fi e '
f t 4?
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C I T Y •.US E .rONL
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2007 RESIDENTIAL PLUMBING PeRMir aPPUCaTioN
CITY OF EA6AN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please com lete for modifications to existin residential dweilin s
Date 5 ! o(. S 1 0 1
Site Street Address UnR #
Properly Owner l>" Telephone #(?
Contractor Telephone# ((pra
S?LQH':'L?Oa
Address afL S.'&w17nn laki lllyr) CNv , C'S'?L^1Cl.In State IMN Zip
The Applicant is: _ Owner 8 OccupaM L7censed PlumbFng Contractor
Septle System _ New _ Refurbished Submit 2 sets of plans and MPC license Inciudes Coimly fee
$ 100.00
Per asbuitt $ 10.00
Fire Repalr (repiace bumed out Nxtures, etc.) $ 90.00
This fee applies when extensive umbi re irs are made to a buitdin .
Altera8ons to exlsting dwelling $ 50.00
_ Add plumbing fixtures to main levei lower level. This fee indudes
instaliation of a water softener and/or water heater at the same time. If you are
insfaBtng onfv a watar sofCener and/or water heater, do not complete this section;
move to the next secdon and place a checkmark next to the appliance(s) you are
installing.
_Sep6c System Abandonment
_Water Tumaround (add $136.00 'rf a 5!8' meter is required)
aner:
_ Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irtigation _RPZ PVB _new _repair _rebuild $ 30.00
State Sureherge $ 50
Total $ 3Q,GD
I hereby apply for a Residential Plumbing Permit and acknowledae that the infortnation is comoiet e and accurate: that the
work wilf be in confortnance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but oniy an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the eveM a plan is required e revi d and approved.
G Sc? Z-e,ls c.j CvA.
ApplicanYs Printed Name licaa s Signature
n JUN 0 5 2007 ??D
' r
s E
~-For Office Use I
City ~
1 i Permit I Permit Fee: 1
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:__
Phone: (651) 675-5675 I "
Fax: (651) 675-5694 i Stair:_
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: _5-Lq-0q___`_ Site Address: W_!-
Tenant: Suite
RESIDENT / OWNER Name: p=~-- Phone: to 456
Address / City / Zip: _\S!-~!y}-~~ - -
CONTRACTOR Name: Ct Y11~~G~7_~~ 6'_ _ License
Address:
City: a Gc) _ - - - -Stater -Zip: _t)
Phone: Contact Person: _ ® _
TYPE OF WORK --New _Replace tent Repair Rebuild Modify Space Work in R.O.W.
Description of work: r Luaw
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation -Add Plumbing Fixtures
RPZ / _ PVB) Main - Lower Level)
_ Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
'Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES
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.
App ants Printed Name Applicants S14
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -Rough-In Air Test _--_Gas Test - Final
Use BLUE or BLACK Ink
r
For Office Use I
Permit#: G"
City of Eakan I ~s-mss
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: G/ Unit M
Name: Z/VPhone: 6h"/ i-~ 0 3 Z,
RESIDENT I f
OWNER Address / City / Zip:
Applicant is: OwnersContractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No )
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License m Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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.
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.gopherstateonecall.org
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code m c ete iii 180
days of permit issuance.
Applicant's Printed Name Applican ' ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126940
Date Issued:09/16/2014
Permit Category:ePermit
Site Address: 3619 Falcon Way
Lot:1 Block: 2 Addition: Lexington Place South
PID:10-45060-02-010
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 -
Benjamin Athneil
3619 Falcon Way
Eagan MN 55123
(651) 456-0322
Homesure Inc
2924 Anthony Lane, Suite 115
St. Anthony MN 55418
(612) 353-5781
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164940
Date Issued:10/12/2020
Permit Category:ePermit
Site Address: 3619 Falcon Way
Lot:1 Block: 2 Addition: Lexington Place South
PID:10-45060-02-010
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 -
Benjamin & Sandra Athneil
3619 Falcon Way
Saint Paul MN 55123--222
Ashco Exteriors Inc
11164 Zealand Ave N
Champlin MN 55316
(763) 225-8333
Applicant/Permitee: Signature Issued By: Signature