3437 Highlander Dr
Jun. 8. 2011 2:45PM SELA ROOFING No.6530 P. 17
Use BLUE or SLACK ink
~
' j Permit A V j
t~ of Ea an I l
Permit Fee: e I
3830 Pilot Knob Road
r I Date Received: l
Eagan MN 55122 ~ u `a~3lp f
Phone: (651) 676-5675
Fax: (651) 675-5694 l stafI
1 1
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
02te: . Site Address: 6~7 ~ J4 rT 1 U : y ~
Name: ' Phone: 16:91- 60 Ola~yJ
_71n haxl_~q
OWNER Address t City x4 q-~400
~
Applicant is_ Owner Contractor
TYPE OF WORK Description of wark:
L&L U,
Construction Cost: - Multi-Family Building: (Yes / No ___J
Company Contact: lfiblv_uyze
CONTRACTOR Address: _ 166 { t_gts-,L U1 Q V City:- Louycs
Stater Zip: 5541 Phone;
License* OZD Lead Certificate 9 td~ 1 77A 50
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 supportihwdocumehts. M.at you submit are, considered to be public information.. Porl'iolts of
the information may be classified as non-public if you provide specific reasoi7s that would permit the .City to
conclude that the 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
that the work wlll be in
Eagan; that I understand this is not a permit, but only an application for a permit, and work is n=La-4~1
accordance with the approved plan in 4the/cae of work which requires a review and approval x a VAIQV ICf ~~L_,5 x 1/1 Applicant's Printed Name want's
Signature
Page 1 of 3
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122
DATE
RECEIVED
19
AMOUNT $ I
& DOLLARS
+oo
? CASH ? CHECK
?. /3k!l surrc -? ;Idts 4 1,-
-
FUND COGE pMpUNT J
r r ?
v
B Y
NUMERICAL FILE COPY
CITY OF EAGAN Remarks •
Addition SiiRRRY 14FIr,H19 6th Lot 6 Blk 4 Parcel 10 73005 060 04
owner - ? street 3437 Highlander Drive State Eagan, MIIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 S ll Cl T OI'1 1 8 narc 6l
* SEWER LATERAL
WATERMA I N
* WATER LATERAL 1975
WATER AREA
STORM SEW M[ 975
STORM 5EW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
t
WATER CONN. 2,50.UO - -
9UILDING PER. -T4-693 9299 3-IU-16
sAC 500.00 9299
- -
PARK
CITY OF EAGAN Remarks
AdditionSL18BEY HF.IGHTS 6th Lot ? eik 4 Parcel 10 73005 030 04
Owner St?eec 3439 Highlander Drive state Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 assessed der origina ar G'1
* SEWERLATERAL 1975 1845.02 369.00 5 738.01 A004083 5-19-77
WATERMAIN
* WATERLATERAL 1975
WATERAREA 1973 assessed der OTl 1l11 ar el
* STORM SEW =et 1975
STORM SEW LAT
CUFB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 250.00 3-1U-78
BUILDING PER. #4694
s,ac 500.00 9299 3-10-78
PARK
CITY OF EAGAN
Remarks
Owner I. ?+'-'•??? ? Street
Blk _t{ Parcel 10 73005 Oln 04
ve ?„*p Eagan, NW 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN SEW TRUNK 1970
I,* SEWER LATERAL
WATERMAIN
* WATER LATERAL
WATER AREA 973 ssessed der Orl 1I18 ar 1
* STORM SEW 975
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 250.00 9299 3-10-78
BUILDING PER. 4695
sAC 500.00 9299 3-10-75
PARK
CITY OF EAGAN Remarks
Addition Si1RRRY HF.TGHTS f ith Lot Z Blk 4 Parcel 10 73005 020 04
owne?= - screet 3443 Hi ghlander Drive state Eagan, NBV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN 5EW TRUNK
* SEWERLATERAL 1975 845O2 369 00 5 738.01 004083 5-19-77
r
WATERMAI N
* WATERLATERAL 1975
WATER AREA 1973 a sessed d r OI'1 111 1 3 BZ
* STORMSEW = 975
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. Z$O. 00 9299 -10-78
BUILDING PER. #4696
sac 500.00 9299 -10-78
PARK
CITY OF EAGAN Remarks
Addit;on SORREY HEIGHTS' 6th Lot 5 Bik -4 Parcel 10 73MS AA#?g"
Owner ' Street State ?? C-)q
(GARAGE)
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER. #4693 9299" 3-10-78
SAC
PARK
CITY OF EAGAN Remarks
Addition SURREY HEIGHTS 6th Lot 4 Rik 4 Parcel 10 73005 040 04
Owner _ Street tate
rr_nnerF? ? V; 7
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIOEWALK
STREET LIGHT
WATER CONN.
SUILDING PER. #4694 9299
SAC
PARK
CITY OF EAGAN Remarks
Addition SURREY HEIGHTS 6th
Owner Street
Ik 'S Parcel In 71005 02.0 03
bAxAUL 3 Y:? `? n P?
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
? BUILDING PER, 4696 9299 - -
CITY OF EAGAN
3795 Pilot Knob Roed
, Eagan, Minnesofa 55122
Phons: 454-8100
qLAfiIN! . _ pERMIT
Dote:
September 13, 1979
Site Address: 3441 Highlander I3L'iVe
Lot 3 Block ?F Sub/Sec. _ 'H Hth
No. y 284
39
Receipt No.:
Single
Residential
Multi Res., Comm./Ind.l unit tnhie
Name new
New/Alter. /Repair
.
; Address Cost ot Instailation
O
' ^oRiI1gt?Jr1 '? •o r?!?,
City Phorre: Permit Fee
. *3?_.ider s Son 2:rce
N me Surchorge ?
Q.
° Address'?C r. Til 1tl'?r A-ve.
0
V . `;C ? r'!}
City ` Phone: Totol '
This Permit is issued on the express condition that oil work shall be done in occordance with oll applicable State of
Minnesnto Statutes and City ot Eogan Ordinances.
Official
CITY OF EAGAN
3745 Pilot Kaob Road
+ • " ? Eagaw, Minnesota 55122
Phoire: 454-8100
PLUMBI:?u _ pERMIT
Date: "1j 14j78
Site Address:
Lot
3441 Highlander Dr.
a4ock ? Sub/Sec.
SH 6
Uoia ;,?.edaJ.i:.on Corp
Name
? (Db(7 :?00,,t^ , ;tc: Lff Flaza
3 Address -
a C,ry , -)1 S. Phorre: o%:'
Nome ya'o j eCt rl:l;abing
.
, t
!'cJ i:UcitjQlCit "1V°. .r.
? f1ddfE55
C
O
V aao
GitY Phone:
This Permit is issued on the express condition that all work shall be
Minnesota 5tatutes nnd City of Eogon Ordinances.
No. 11L:-
Receipt No.: 1085;
Sin91e I
Residential
Mulii Res., Comm./lnd. 1
nrv;
New/Alter. /Repair
Cost of Instollotion
Permit Fee
Surcharge ?
Tota I
done in occordance with all nppliceble State of
Building Officiai
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4695
, PHONE: 454-8100
BUILDING PERMIT .'r 3 3, 0'.:; . Receipt # 9299
Tounhouse M3T• 10 1078
Site Address J"l nll
t
Lot Block Sec/Sub.
po„cel # 10 73005 011
oe Nome "ol2 ?leuaaaivn wrp
z Address 650 Southgate Off_Plaze
0? Name _
0
?U Address
Name
Address
I hereby acknowledge that I have read this application ond state that
the informotion is correct and ngree to comply wirh ail opplicabie
State of Minnesoto Statutes and City of Eogan Ordinances.
Signoture of Permittee
A Building Permit is issued to:
nll work sholl be done in acco
Building Officlal
Erect ?x Occupancy ?
Alter ? Zoning
Repcir ? Fire Zone 3 -,
Enlarge ? Type of Const. V ?•
Move ? # Stories
Demolish p Front ft.
Grode ? Depth ft.
Approvals Fees
Assessment
Woter & Sew.
Pol ice
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit • , ,;"
Surchorge ' ? • -'?'
Plan check
SAC
Water Conn.
Water Meter
Total -' 4, 50
Lva, w?
on the express condition thot
e State of Minnesota Statutes and City of Eagan Ordinances.
pe?nM # OeM Iwwd hrwMfN
Plumbin9 y 7-iY-7Y - '^ •
Mechanical 4_ y' ff
INSPECTIONS DATE INSP• RouqMln find
Footings Dote Irup. Data Irup.
Foundation Plumbing ,
Frome/ins. Mechonicol ! -2
Final ir.
i i
Remarks:
CITY OF EAGAN
? • 8795 Pilot Ksab Road
Eugan, Minwesola 95122
P6one: 454-8100
-A`y'T A(; _ PERMIT
`'F
Date: SLpt
Site Address: 3443
13, 1978
lander Drive
Lot Block "- Sub/5ec. _ ` '?
Name P.
.
3 Address
O
City - nipcm{ggton Phone:
Name ?. 94-.Acilgr- s: G.nt3 TTiC
.
?
? AddreSS ? 'n ?. ?l?t?• ,- - ??,
0
V
City ,-' S, T.3Phone:
This Perm' is issued on the express condition that all work shall be
Minn Stoiutes ond City of Eagan Ordirwnces.
No. 12.85
11639
Receipt No.:
Single I
Residentlol
Multi Res., Comm.flnd.' L;^1t--
{Vew/Alter./Repair ile?
Cosf of Installation
Permit Fee 20.00
Surchorge • S?-,?? z,?'?
Totol ?
done in acoordence with oll cpplicable State of
Building Officiai
CITY OF EAGAN
a•- '. 8795 Pilof Knob Roed
Eoyas, Minnesota 55122
Phona: 454-8100
Dote:
PLUMF3IIJv pERMIT
7/14/78
,-.. ::ighlander :jl-ive
Site /lddress:
Lot _ 4
IName
= Block Sub/Sec. -
..._?' .::edAl; .. t-arp.
? Address
Ciry _
650 5outhgate Off Plaza
pl s.
?H6th
Phone: '.3J-7262
No. ia63
Receipt No.:
Single
Residential
Multi Res., Comm./Ind.
nevr
New/Alter. /Repair
Cost of Instullotion
Permit Fee
Nome _ "Oj@Ct PZl1mbitiQ .?
? 5urthorge
Address 743 Hu:;tboldt nve. .. .
? '?
e
0
u City y.• :,. `? phone: Totol ~•; p.•.
This Permit is issued on the express condition thet oll work shall be done in accordonce with all applicoble State of
Minnesota Stotutes ond City of Eogon Ordinonces.
i Building Official
?
CITY OF EAGAN -
3795 Pilof Knob Road Eagan, MN 55122 N2 4696
.
' PHONE: 4548100
BUILDING PERMIT ReceiPt # 9299
T- L- -J L-- l (,4JtZrOUSC c_. v-i.... 1'1,.F.. "l$r• 10! 10 70
Site Address )"-> i ,
Lot ` Block 4 Sec/5ub.
Parcei # io 73005 Q?'O
g Name vvau n?eaaaxivn wrp
i Address 650 Southgate Off Plaza
3
o
o Name LLit GusL&?soi= aam2
?? Address
f rr... oL___
Name _
Address
I hereby acknowledge thot I hove read this application and state that
the information is correct ond ogree to comply with all applicoble
State of Minnesota Statutes and City of Eagan Ordinonces.
Erect ? X Occupancy j
Alter ? Zoning R4
Repair
? ?
Fire Zone -
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
Aoaro vols Fees
Assessment
Water & Sew.
Police
Fire
Eng.
Plunner
Council
Bldg. Off.
APC
Permit i = = +' _
?
Surcharge -i
Plan check
SAC Q
r
Water Conn.
Water Meter _
Totol ') 54. 50
Signature of Permittee I
;": • " ?
A Building Permit is issued to: on the express condition that
oll work shall be done in accordonce with all appliwble Stote of Minnesoto Statutes and City of Eagon Ordinances.
Building Official ,
PennM # pofe larad POsitN"
Plumbing //th 3 7?+ ??,? • r.? •
Mechanicol
INSPECTIONS DATE INSP.
Rouph-I n
Find
Footings - 3? 7f Date Inap. Dote Insp.
Foundation Plumbing ? . 7
00
Frome/ins. Mechanical -
- ?
Final
Remorks: r- M" 7 / rs e4, (
. , ; CITY OF EAGAN
3795 Pilot Kwob Road
fa9as, µinweseto 55124
Pbone: 454-8100
PERMIT
Dute:
September 13, 1978
Site Address:
3439 Highlandex Drive
Lot ? Block `' Sub/Sec. _ SS' Gth
No.
1283
Receipf No.:
5ingle I
Residential
Multl Res., Comm./Ind.
Name I H. Gustzisor, new
New/Alter./Repair. 3 Address Cost of Instollation
O
City lcamington Phone: Permit Fee
Name j?• fiinder & 5on In^. •??
., Surchorge
? Address '20 E. Butler Ave.
e
0
?
City Pest St. T'au ] "r ? ]_8 Phone: Total 'n..r^
This Permit is issued on the express condition thot all work shall be done in accordance with all applicable State of
Minnesoto Statutes and City of Ecgan Ordinances.
-1/ Buildin9 Official
CITY OF EAGAN
3795 Pilot Kwob Road
Ea9en, Minnesota 55122
Phone: 4544100
- .. , - PERMIT
- ;o
Dote: ?
Site Address:
Lot
3439 Hgihlander Dr.
4
Block 5ub/5ec.
SH *ft
:a? ld r;edallfon Corp
Name
?
Address rjbC Southgare Off Plaza
?
; ?? .,. :3?--•?f 2
City Phone: s'roject Flumbiriq
Name
?
? Address
e
? .>
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Stotutes ond City of Eagan Ordinonces.
No.
Receipt No.:
Single I X
Residential
Multi Res., Comm./ir?d. I
,..,..
New//11ter. / Repair
Cost of Instnllution _
Gf,.(iC
Permit Fee
5urchorpe • v .
Tota I
done in accordance with all opplicuble State of
Building Official
? CITY OF EAGAN
. 3795 Pilot Knob Rood Eogan, MN 55122 N2 4694
PfiONE; 4548100
BUILDING PERMIT ReceiPr #
Ta be used for "'??n`?n??Se Est. Volue Date ?g .
5ite Address 3439 fiighZander. U'x.
Erect ? x
Occuponcy
Surrey Hghts ?'th
4
Lot B[ock 5ec/Sub. Aiter ? Zoning
Parce! # ' 0 73005 030 04 Repair ? Fire Zone
Eniorge ? Type of Const.
W Name Cold ?F4edallion C02'?; Move ? #k Stories
3 Address 650 SOtt thgatP i.,f f '' ?=? == Demolish ? Front ft.
? Cih,
- Phone Grade Depth ft.
°c Nome _
0
?Q Address
?
Assessment _
Water & Sew.
Pol ice
uix
Name
FW Fire
uu Address Eng. -
aW Citv Phone Planner _
Cauncil _
I hereby acknowledge that I have read this opplicotion and state that gldg. Off.
the informotion is correct and agree to cornply wifh all opplicoble APC -
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: Gol ;(edaIlion
oll work shall be done in eccordance with all appficable Stute of Minnes
Building Official - -
Fees
Surcharge
Plan check
SAC °
Woter Conn.
Woter Meter
Totai
on the express condition thot
Statutes and City of Eagan Ordinances.
vemk # care ln„ea rwnMro.
Plumbing
_Mechanical ?-
!NS?ECT10N5 DATE INSP. RauQh-!n Finol
Footings s j-?,f Date Insp. Dcte Irup.
Foundotion Plumbing ?
Frome/ins. Mectwnicol
Finol -a-?-? I
Remarics: / J? _.1? -, $ ?,??„ ???CC? •
I Control No. 1246
INSPECTION RECURD
; CITY OF EAGAN PERMIT TYPE: AUZ L 0 J NG
? 3830 Pilot Knob Road Permit Number: *r> > 11
j Eagan, Minnesota 55123 Date lssued: 14 I2g/ 9 2
I (612) 681-4675
SITE ADDRESS: 1.011 6 BLacK j4 APPLICANT:
34'17 NI4HtAMDER OR A b 3 MASbMRY
I SURpFY HE I6NT!3 fsi'H (612) 489-2066
-i
PERMIT SUBTYPE: TYPE OF WORK:
S r (N 1 yr. REPaIR .
Qt'il.RIPYxOp AAltAA!' dIACK wALI
Peimn tro. Ferms Holaw oats Ta.phone s
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectton Date Inap. Commerrts
Footi^gs I '/o/q
Foundatfon
Framing
Rooflng I
R"gh Pfb9•
Rough Htg. I
lsul,
Fireplaee I
Final Fftg-
Orset Test
Fnel Plbg. Pibg. InspeCtor - Notlly F+Iumber
Conet. Meter
Eng?JPlan
a?dg. Fmal
Deck Ftg. Ao?
beok Finel
WeU
Pr. Dlep.
INSPE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
,.1
',11Rf;F Y il? ! tiFl'1 `.. f• I FI
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
n 111 u ?i 4PPUCANT:
( t, i • ', -6? 1 iiWts
s 1MLU[1 ?'; {N.310 (l(1T :3) {441 SI()t 1) :i443 Ciiil' ?)
V 1 f ', ((+ I 1 t' f F 0 t i pl V> 1 R MI 1 #.' H n c• I ( 1 (17 : t, Fa L. R 1, `: 1.1 F7 ft I
13uit 1) 1 NCi
a;e4r0
A.; /'I t iy;.9
' PERMIT SUBTYPE: TYPE OF WORK: ;t PA[k ?
? •I: 1 i i 11I? (:M -- 'S11)ENfi
Permit No. Permk Holder Dste 7elephone #
SAAI
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inapectlon Date Insp. Commanta
Footings I
Foundation
Framing
Roofing
Fough Plbg.
Rough Htg.
Isul.
Fireplece
Final Htg.
Orsat Test
Fnel Plbg. Plbg. Inspector - Noti(y Plumber
COrtst. Meter
Engr./Plan
Bidg. Final
(
Dedc Ftg.
Oeck Final
Well
Pr. Disp.
CITY OF EAGAN
. 3795 Pilot Knob Road
- Eogen, Minnesota 55122
Phona: 454-8100
PLUMBING
PERMIT No. 116G
7 i 14/'78, 10857
Dote: '
Receipt No.:
I
Single
Site Address: Residential
?
?
Lot
Block
Sub/Sec. Multf Res., Comm./Ind.
_. ? _. . LG'...1..:.. ..C: '-
Ncme New/Alter
air
/ Re
.
p
Address Uf1? 'r'laZz
Cost of Instullation
?
'
'1v•
?
City
`
Phone: Permit Fee
:' i?? GL. r fl ? iW1:1?3
Name : J.:
Surcharge
.
i
'
P 43 l
umboldt Ave.„
Address y'
e
0
. `_f .
.. : .. ..r _
V ?? J ?.
..
?
C+ty ? Phone: Total
This Permit is issued on the express condition that oll work shall be done in accordonce with all applicable State of
Minnesota Statutes and City of Eagon Ordinances.
Building Officiol
?
CITY OF EAGAN
3795 Pilot Knob Road
? Ea9an, Minnasote 55122
? Phone: 454.e100
H'•TTING - PERMIT
No. ' 282
pate: September 13, 1-' . Recelpt No.:
Single
Site Addre . ?`'= 37 Ri^. i:lullcter ? . Residentiul
Lot `
Block _ 5ub/Sec.
SH 6th
Name
? Address
City ''::Lnqton Phone:
Na,,,e . t-lir,der & Son Inc.
.
?
? Address ':r Av-.
a
S
City ' Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes ond City of Eagan Ordinonces.
Multi Res., Comm./Ind. ? .. .. I?;,•?
New/Alter./ Repaf r
Cost of instollation
Permit Fee 20.00
^50
c ...?,,,...
,. ,
Total `
done in accordonce with all applicoble 5tute of
Building Official
BUILDING PERMIT
,-w;fluse
Site Address
Lot
Parcel # -
W Name
3 Addre:
0
dt
, o Name _u
I
R4
3
V
- ft.
h.
?
Fecs
pu ?dr? Assessment Permit ' ? • ' ` •' _
ug Ci Ph Water &$ew. Surcharge lb. 50
one
F
cl? Police Plan check
FZ Name Fire SAC • '?
xE5 Address Eng. Water Conn. - '?
aW Ci Phone Planner WaterMeter
Council
I hereby acknowledge that I have read this application ond state that Bldg. Off.
the informotion is corred and agree to comply with all applicable APC Total _•?` °
State of Minnesota Stotutes ond City of Eagan Ordinonces.
Signoture of Permittee
"edal_1.ioZ (.orp
A Building Permit is issued to: on the express condition that
ctrr oF EAGAN
3795 Pilot Knob Road Eagan, MN 55122
PHONE: 454-8100
Receipt #
y _.' _. •
Block ' Sec/Sub.
N4 4-693
?
Erect ? Occuponcy -
.S 6t" Alter ? Zoning
,d-,4 Repair ? Fire Zone -
? E
l e
t
T
f C
n
arge . p yp
.
o
ons
Move ? $k Stories -
Demolish ? Front
Grade ? Depth
oll work sholl be done in accordonce with all applicoble State of Minnesota Stotutes and City of Eogon Ordinances
Buifding Officinl
r.mi+ # oere ima.e r.anr«
Plumbing
Mechonical /.3 _ 7 y .
INSPECTIONS OATE INSP. Rou9h-In Final
Footings .3 - j-TS Date Insp. Dcta Inw.
Foundation Plumbing .,? -?-
Frume/ins. Mechoniccl
Final
Remarks:
? . , . . . . GAS. WORK ORDER
1082 Payne Ave. STANDARD
St651/772-2449101 6HIEATING09
& AIR CONDITIONING
410 W. Lake St.
Minneapolis, MN 55408
6121824-2656
A Blue Dor Service (-o. EQUIPMENT INFORMATION
LAST FIRST TYPE I
ADDRESS ` MAKE " r ?I
CITY ?MAA) ZIP MODEL ??rq-vO 6 0(0
HM PH L/? ??7 qr? WK PH SERIAL p -
TECH DATE ' - a -? / INPUT ? '?-?
ORSAT TEST RECORD
,
;''
C02 ' % METERED INPUT ' vCfh CHIMNEY TYPE
02 % UMIT SETTING ,Qv ° FLUE SI2E Yin.?
CO 11dot % PILOT oUTAGE sec CONNECTOR SIZE in.
NET STACK TEMP G O 0 TOTAL CHIMNEY INPUT btuh
}c` ;
? D.
i, INC. 5001 W. 78TH STREET. BLOOMINGTOV. MINNESOTA 55437
NUMBER? VENDOR NAME SUB•COMPANY NAME CHECKOATE CHECKNO.
MEMO INFORMATION INVOICE IDENTIFICATION INVOICE DATE INVOICE AMOUNT TERMS DISCOUNT AMOVNT PAID
Building Pe
Block 4 and its for
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lock 1
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Surrey Sixth Addition j• `•
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CITY OF EAGAN SEWER SERVICE PERMIT
3795 Filot Knob Rood PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning: No. of Units:
Owrter:
Address: V
Site Address:
Plumber:
I a9ree to comply with the City of Eagan
Ordinances.
BY -
Date of Insp.:
No.;
to eomPlr with the City of Eogon
Connection Chorge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges:
Total: _
Dote Poid
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
- No, of Units: _
Connection Charge: -
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Chorges:
Torol:
Dote Paid: -
CITY OF EAGAN WATER SERVIC E P
3795 Pilot Kno6 Road ERMI
Tl
Eagan, MN 55122 PERMIT NO.: _
Zoning: _ ?ATE:
Owr.er:
No. of Units: '
Address: -
Site Address:
Piumber: -
Meter No.:
Size:
Cannection Chorge:
Reader No.: Account Deposit:
1
ogree to eom
Ph with Fhe CiEy of Eogan Permit
Fee:
----
ardinances. Surchorge:
Misc. Chorges:
BY Torol;
Date of Ins
p.:
?e POid'
Insn_r
CiTY OF EA6AN WATER SERVICE PERMIT
3745 Pilot Knob Rood PERMI7 NO.:
Fagan, MN 55122 DATE:
Zoning: No. of Units:
Qwner:
Address:
5ite Address:
Plumber:
Meter No.: _
Ci7o•
Reader No.:
1 agree to wmply with fhe Cityr of Eagan
Ordinances.
R.,
Dote of Insp,
Connettion Chorge:
ACCOUIIS DCpOSIT:
Permit Fee:
Surcharge:
Misc. Charges:
Totol:
Dote Poid: -
I nSp.:
CIT`: OF EAGAN SEYVER SERVICE PERMIT
3745 Pilot Knob Rood PERMIT NO.:
Eogan, MN 55122 DATE:
Zoning: No. of Units:
Owner
. ?
Address: --
Site Address:
Pl
ber: -
um
I egree to oomply with the City of Eagan Connection Charge:
Ordinaeces. Account Deposit:
Permit Fee:
Surcharge:
gy Misc. Charges:
Dote of Insp.: Totol:
Insp.: . Date Paid:
WATER SERVICE PERMIT
CITY OF EAGiAN I
3795 Pilat Knob Road PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning: _ No. of Units:
Owner:
Address:
Site Address: -
Plumber: --
Meter No.: - Connection Charge:
Size: _ Account Deposit:
Reoder No.: Permit Fee: -
1 agree M Comply with fhe City of Eagan Surcharge:
Ordin4nces. Misc. Chorges:
Total:
By Date Paid:
Date of I nsp.: - I nsp.:
Y OF EAGAN
9 Pilot Knob Road PERMIT NO.:
?n, MN 55142 DATE:
n9' No, of Units:
3r:
ess:
Address ?
- ,'_.*r_
Plumber.
--?._ ?
1 neree to comply with the City of Eagan Connection Churge:
Ordinances. Account De
posit: _
Permit Fee:
B Surcharge:
y Misc. Cl?arges: _
Dote of Insp.: Totaf:
Insp.: Date Paid:
CIT` QF EAGAN
3795 Pilot Knob Rood PERMIT NO.;
Eagce, MN 55122 DATE:
Zoning: No. of Units: -
Qwner.
Address: --
5(te Address _
Plumber:
I agree to eomply with
Ordinanoes.
By
DaYe of lnsp.:
Insp.: __
Connection Charge; Account Deposit:
Permit Fee:
Surchorge:
Misc. Gwrges:
Total:
Date Poid: -
100.9
u,Dv--i?cv(J
s request void 18 months from
P 87Q08
Date of this Request_ 6-16-1978
I, asAX Licensed Electrical Contractor ? Owner, do hereby request inspection of the ahove electri-
cal wiring installed at: ?-??
Street Address or Route No. 3441 Hi?;hlander Drive City Eagaaa
Section Township
Range County Dakota
Whilh is occupied by D H Guetaf son
(Name of Occupant)
Is a roughin inspec[ion required on [his job? No ? Yes EIK Ready Now ? Will Call Oc
Power Supplier Dakota CtY. Address Farmington
Electrical Contractor O.B. Thomneon Electric Co. Contractor's L9cense NoA33735
(Company Name)
Mailing Address 12201 E2tka Alvcii. Mtk,41, 5V43
Authorized Signature Phone No. 933•2521
' (Electrlcal Contractor or Owner Making Thiz Installatlon)
This inspection request will nai 6e accepted 6y the
C{ (? State Baard unless proper inspection fee is enclased.
Mmnesota 5tate tsoard ot tiectncrty
1954 University Ave., St. Paul, Minn. 55104-Phone 645•7703
' FiErQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQliEST
P 87809
Tylte of BuJBing New Add. Aep. Check Appliances W'ved For Check Fquipment Wired Foi
Humt, 7E El ? Range ? Temporary Wiring ?
Duplex.
Apt. Bldg. ?
? ?
? ?
? Water eater ?
Dryex Lighting Fintures
Electric Heating ?
?
Cpmmercial Bldg. ? ? ? Fumac ?
?
? Silo Unloader ?
lndustrial Bldg. ? ? ? A'v Co
n `??? Bulk Mtlk Tank ?
Patm ? ? ? List List
Other ? El El Iltheis) ? Disp.D19h.
ere ? Others?
Here )
CdAPUTE INSPECTION FEE BELOW
Service Entrance Size: it Fee Fceders&Subfeeders: # Fee Cirwits: # Fee
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres
Ol to 200 Ampsl 31 to 100 Am eres 31 to 100 Am eres
Abeve 200 Amps. Above 100 Amps. Above 100 Amps.
Transfotmecs RemoteControlCiic. Partialorothetfee •
Signs Special lnspection Minimum fee
Remarks E11T1Ch TOTAL F WQ. 40 40. 50
I, the Electrical Inspector, hereby certif?j?jt the a ov inspection has been a? Z
(YLough-in) Date
(Final) Date,
This request void 18 months from
v..?.7--i?ty?o
s request void 18 months from
.
/ 0.5'W,=3
Date of this Request 6-16-1978 P 8780 7
I, as JaLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
: ,
Street Address or Route No. 344 3 Highlander Dj?ive Cit,,Eagart
Section Township
Range County Dakota
Wtiich is occupied by D.H. Guata£eon
(Name oi Occupant)
Is a roughin inspection required on this job? No ? Yes:M Ready Now ? Will Call 19:
PSwer Supplier Dakota Ct.Y. Address Faraington
Electrical Contractor O.B. Thomosoxi Electric Co. Contractor's License No 33735
(COmpany Name)
Mailing Address
Authorized
vd.. Mtka
(Electvltal Contr2cl8r or
Phone No. 933-2521
(??j /?? r;a u 5?? p o?y???- ???? This inspectian request will not be accepted 6y the
?? ?1 Stete Board unless proper inspection fee is endosed.
Minnesota State 8oartl ot tlec[ncity
University Ave., St. Paui, Minn. 55104-Phone 645-7703
`? ; REQUEST FOR ELECTRiCAL INSPECTION P 87806
CH€CK ELOW WQRK COVERED BY TH1S REQUEST
Type ot BuAding New Add. Rep. Check Appliances Wired For Check Equipment Wired For
yome 7a ? ? Range ? Temporary W"ving ?
Duplex ? ? ? Water Hea:er ? Lighting Fixtures fa]C
Apt. Bldg. ? ? ? Dryei Elecuic Heating 0
Commercial Bldg. ? ? ? Fuma
IW% Silo UNoadec ?
Industrial Bldg. ? ? ? Av Co ition A 8ulk Milk Tank ?
Farm List List
Othei ? ? ? p Heie S p
Heiers?
COMPUTE INSPECTION FEE BELOW
Seevice Entiance Size: # Fee Feeders&Subfeede[s: # Fee C'vcuits: # Fee
0 to 100 Am s. 0[0 30 Am xes 0 to 30 Am eres
101 to 200 Ampsl II 31 to 100 Amperes 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Above 300 Amps.
Transfocmers Remote Control Circ. Partialoio[herfee .50
S" ns Speciallns ection Minimum fee
Remarks E1?iC7 TOTALF ?d.d?/ 0.50
1, the Electrical Inspector, herc ftif v spection has been ma
(Rough-in) ? Date
(Finai) Ct7??;o? Date IY - aJ'
This request void 18 months from
Minnesota State Board of Electricity
1954 !Jniversity Ave., St. Paul, Minn. 55104-Phone 645-7703
? . ReQUEST FOR ELECTRICAL INSPECTION
CHEC°-BELOW WOJtIC COVERED BY THIS REQUEST
? OS"?13
P 87807
Type f Building New Add. Rep. Check Appliances W'ved For Check Fquipment Wired Fo[
Hume ? ? ? Rxnge ? Temporary Wiring ?
Du,plez ? ? ? Water Heater ? Lighting Fixtuces Ym1C
Apt. Bldg. ? ? ? Dry Electric Hea[ing ?
Commetcial Bldg. ? ? ? Fur
??
P
? Silo Unloader ?
.ndustria] Hldg. ? ? ? A'v
,
dit" Bulk Milk Tank ?
Farm ? ? ? List List )
Other ? ? ? p
Heheis? 18P. 13 • Heherst
)
COMPUTE INSPECTION FEE BELOW
Service Entcance Size: # Fce FeedersBcSubfeeders: # Fee Circuits: # Fee
0 to 100 Am s. 0 to 30 Am ies 0 to 30 Am tes
(Ol to 200 Amps. i OjJ 31 to 100 Amperes 31 to 100 Am eres
`Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers 1 1 RemoteControlCirc. Partialorotherfee
Signs Speciaf Ins ection Minimum !ee $
Remarks Ih11T1C?1 TOTALP (r6,6 0.5Q
I, the Electncal Inspector, hereby ce at t ve /nspection has been m
(Rough-in) Date
(Final) Date
This request void 18 months from
?'hi4? 9L?e? voiN618 months from
Y P
? 87806
Date of this Request 6-16-1978
I, as EcLicensed Elec[rical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: ?? 13 6 G y.?
? 6/ ?" ?
Street Address or Route No. 3439 HiFhl'ti"y? ari er Drive Cit)k'a.gan
Section Township
Range County Da.kota
1Yhich is occupied by D.H. Gustafsoxi
(Name of Occupant)
Is a roughin inspection required on [his job? No ? Yes42 Ready Now ? Will Call $
Power Supplier Da.kota Cty. Address _ Farmington
Electrical Contractor O.B. Thompsar: Plectric Co. Contractor'sLicenseNdl35
(COmpany Name)
MailingAddress 12201 14?tka Bled., I4Ttka 5..5h43
Authorized Signature
sThN B0ARD COPY
Phone No. 933-252I
This inspectian request will not 6e accepted by the
State Board unless praper inspectiontee is enclased.
4V.?U-- geu rD
This request void 18 montNs from
y .
/ o.s-1,43
P 87805
_
Date of this Request 6-ill
I, asiff Licensed Electrical Contractor Owner, do hereby request inspection of the above electri-
eal wiring installed at: , J&??? y C? t?r,.:. ??
O< ?
Street Address or Route No. 3437 Iiit?'hlander Driae City E2ean
Section Township
Range County Dakota
Which is occupied by D.H. Gustafson
(Name of OctuOant)
Is a roughin inspection required on this job? No ? Yes OK Ready Now ? Will Call Ox
Power Supplier Dakota Cty. Address Parmington
Electrical Contractor O.B. Thompaon Electric Co. Contractor's License No. A33a3;
(COmpany Name)
Mailing Address 12201 1'itka Ba,ad bitlca 55U3
Authorized Signature 5Z;) Z,-`x? Phone No. 933-2521
(Electrical Contrectar or Owner Making This Installatlon)
This inspectian request will not he accepted by Uhe
tl 0 State Board unless proper insp¢ction fee is enclosed.
Minnesota State eoartl ot tiectricity
-Phone 645•7703
qw-hrQniversUEST'FOR ity Ave., St. Paul, Minn. 55104
N
ELECTRICAL INSPECTION
CNF.CK RF.i f1W W(SiFK CnVF.RED BY THIS REOUEST
P 87805
Type of Building New Add. Rep. Check Appliances Wired Foi Check Fquipment Wired For
Home 7tb5C ? ? Ran ? Temporary W'ving ?
Duplex
Apt. dldg. ? ?
? ? ?
? Wat H ec/// ///??''''? ??1??1 ??
Dry / / \ `
?
? Lighting Fixtures .?
Electric Heating ?
Commercial Bldg.
Industrial Bldg.
Farrti ? ?
??
? ? ?
?
? Fu ? ce ?
"
? `
Air Condit? n r 1'S
Lis[ 71i a r? hi ch vwv Silo Unloader ?
BWk Milk Tank ?
Lis[ 1
Othei
? ?
?
Heiels? p
}
Hehersf
CnMPi ITF. fNSPF.CTiON FF.F. BGLOW
Secvice Entcance Size: u Fee Feeders&.Subfeeders: # Fee C'¢cuits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eies
101 to 200 Ampsl 5 0UG 31 to 100 Am eres 31 to 100 Am exes
Abeve 200 Amps. Above ]00 Amps. Above 100 Amps.
Transfoimers RemoteControlCi[c. Partialor o[herfee
Signs Special [ns eclion Minimum fee
Remarks Ellrich TOTALF ELf6,0?/ 0.50
I, the Electrical Inspector, hereby c tha e bofe ection has been
(Rough•in) Date
(Final) Date -a3 -?
This request void 18 months fro '
This requeti void 18 months from b_41- /-2,
R 5 2 7 0
Date of this Request
I, as O Licensed Electrical Contractor wner, do hereby request inspection of the above electri-
cal wiring installed at: „
Street Address or Route
Section
1Vhich is occupied
Is a roughin inspection required on this job? No ? Yes Cd Ready Now ? Will
Power SuppK?.-s?.???? J -? --?? Address
Electrical Contractnr ° Contractor's License No.
. (COmpany Ngne)
Mailing Address
Elec rical Co t?cto r Qw e? Making This In5ta11ation?f ??aC -
Authorized Signature ?." Phone No!&O.R c?7-23
( ectrl 1 nt ctor or Owner Making Install lon)
C(OpU This ins ection re uest wil not be acce ted 6 the
?t?G;l ll? Q? ?, a J-? r, ?
A State Board unless proper inspection fee is enclosed.
, -' . Minnesota State Board of Electricity
19541Jniversity Ave., St. Paul, Minn. 55104-Phone 645-7703
, REQUEST FOR ELECTRICAL INSPECTION
CHECK I3ELOW WORK COVERED BY THIS REQUEST
/ '--7 oZ /eZ
R 5270
Type of BuOding New Add. Rep. Check Apptiances Wiced For Check Fquipment W'ved For
Home ? ? Renge ? Tempoiary W'ving 0
Duplex ? ? ? Watec Heater El Lighting Fintuces ?
Apl. Bldg. ? ? ? Dryer ? Elec[ric Heating ?
Commercial Bldg. ? ? ? Fumace ? Silo Unloadex ?
Industrial Bldg. ? ? ? Ait Conditionei ? Bulk Milk Tank ?
Farm Lis[ L
ist
Other
?
?
? p
Heh p
Heeis
re?
)
COMPUTE INSPECTION FEE BEL
Service Entrsnce Size: # Fce Fceders $ ee Cixcuits: # Fce
0 ro 100 Am s. 0 to 30 Am res 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers RemoteControlCirc. Partial or other fee
CJ
Signs Speciatins ection Minimum fee $5.00
Remazks f TOTAL FEE
1, the Electrical Inspector,? cer?p?J?Z inspection has been ma
(Rough-in) V `?' Date ? ?f
(Finat) " vate -1-
This request void 18 months m
crrr oF eacaN
? , . . 3795 %lot Knob Road Eagan, MN 55142 No 4696
PNONE: 4548700
$43 000 9299
BUILDING PERMIT APPLICATION Receipt # -
Townhouse Mar. 10,
1q78
To be used for Est. Value Date _
Sire Address 3443 HiRhlander Di. Erect ?X Occupancy I
Lot Z elock 4 Sec/Sub.Surrey Hghts 6th qlter ? Zoning R4
.
Parcel # ? Repair ? Pire Zone _.3
Enlarge ? Type of Const. V
rc Name Gold Medallion Colp µpve ? # Staries
z Address 650 Southgate Off Plaza pe,od;sh ? Front - ft.
Ci MPls Phone R35-7262 Gmde ? Depth ft.
p Nome T, R
G'
af
69•• c^••,? PV
o< -
.
,
Address Assessment_
r Water & Sew.
Ci Phone
?
Police
-
0 idw Name
Fi
FW re
?? Address Eng.
<Ci Phone Planner _
Council -
I hereby acknowledge that I have read this opplicotion ond state that gldg. Off. _
the informotion is correct and agree to comply with all applicable
Sfote of Minnesoto Statutes ond City of Eagan Ordinantes. APC
Signature of Pertnittee rovale Feas
A
Pem,it 1[3.uu
Surchar9e 21.50
Plan check
SAC 500.00
Woter Conn. 2 50, 00
Water Meter 60.00
? 7orul 954.50
A Buildinq Permit is issued to: Gold Medallion Corp on the expreu condition that
all work shall be done in accor ce ith oll ppli oble State of Minnesota Statutes and City of Eogon Ordinonces.
Building Officiol
BUILDING PERMIT APPLICATION
._ ,_ ,__ Townhouse ,
$33,000.
Receipt #
Mar. LO
1978
Site Address 3441 Ni hbander Dr. 6
Lor 1 Block 4 Sec/Sub. Surre Nght th
parcel # 10 73005 OLO 04 --Lln
? Name Gold Medallion Corp
; Addre 650 Southgate Off Plaza
o s,pTTs --8J.') - T2b Z
y
Ncme U CI IiUSL9I50II JBItIH
p
Z
O?u Address
Name
I hereby acknowledge thot I have read this opplication ond state thot
tha informotion is mrrect and agree to comply with all applicable
Smte of Minnewta Statutes and City of Eagan Ordinonces.
Signature of Permittee
A Building Pertnit is issued to: GOld
all work shcll be done in actordo 94 with t
Building Official
cin oF Fr,raN
3795 Pilof Knob Rood Eagon, MN 35722
PHONE: 4546100
Erect E]X Occuponcy ?
Alter ? Zoning R4
3
Repair ? Fire Zone
Enlarge ? Type of Const. V
Move ? # Stories
Demolish E] Front fr.
Grade ? Depth ft.
Approvah Fees
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit 70.VV
Surcharge 16.50
Plon check
SAC 500. 00_
Woter Conn. 25().$o
Woter Meter 60. 00
Toral 924.50
110n COTp _ on the express wndition that
iA State of Minnesoto Statutes and Ciry of Eagan Ordinances.
N? 4695
9299
CITY OF EAGAN
' 3795 Pila Kno6 Roed Eagen, MN 55722
.. . . PHONE: 4548100
BUILDING PERMIT APPLICATION $43,000. Receipt #
Townhouse ?_? „_, _ „_,_ Mar. 10
Site nddress 3439 Highlander Dr.
Lor 3 Block 4 Sec/Sub. Surrey Hg
Parcel ;p 10 73005 030 0?
c Name Gold Medallion Corp
z 650 Southgate Off Plaza
? Addre p 5 ^ 83-J-/ZbZ
Name _
Zp
u
?Q Address
s
Name
I hereby ackrrowledge that I have read this opplication and state that
the information is wrrect and ogree to comply with oll applicoble
State of Minnesota Statutes and City of Eogon Ordinances.
Signature of Permittee
A Building Permit is issued to: Gold Med8111on CO
all work shnll be done in acco2t w???t?fi ali vppli 461e S+?e, oG?
Building Official -r
?
NR 4694
9299
.,, 78
Erect ? X Occuponcy I
Alter ? Zoning R4
Repair ? Fire Zone 3
Enlorge ? TYPe of Const. V
Move ? #"$tories
Demolish ? Front ft.
Grade ? Depth fr.
Aoorovnls Fees
Assessment -
Water & Sew.
Police -
Fire Eng.
Planner ?
Council -
Bldg. Off.
APC
Permit 1[3.Vu
21.50
Surchorge
Plan theck
SAC 500.00
Woter Conn• 250.00
Water Meter 60.00
Torol 954.50
on the express mndition that
Statutes and City o4 Eagan Ordinances.
ciTr oF eaG,sN
? - .. 3795 Pilot Knob Road Eogan, MN $5122 N4 _ 4693
? PHONF: 454-8100
BUILDING PERMIT APPLICATION 4
000
3 Receipt # 9299
3
.
,
Te be used fer TownhoUSe Est
Value Date Mar . 10
. _,
Site Address 3437 HiChlander Dr. Erect pX Occuponcy i
Lot 6 Block4 Sec/Sub. SUrTey HghtS 6th qlter ? Zoning R4
1
0 73005 Repair ? Fire Zone 3
.
060 04
Parcel #
Enlorge ? Type of Const. V
rc Name Gold Medallion CoLp Move ? # Stories
3 Addrea 650 Southgate Off Plaza pe,,,olish ? Fronr - ft.
? 835-7262
MPls Grade ? Depth _ ft.
Ci
Phone
D H Gustafson Same Avwo.nb Feea
Z
G
u°a
f
Name
I hereby acknowledge thot I have read this application and state that
the infortnotion is correct and ogree to comply with all applicable
Stace of Minnesota Statutes and City of Eagan Ordinonces.
$ignature of Permittee _
A Building Permit is issued to:
oll work shall be done in accd
Assessment -
Water & Sew.
Police -
Fire
Eng.
Planner _
Council -
Bldg. Off. _
APC
Permit yt1. VU
surchorge 16.50
Plan check
S,qC 500.00
Water Conn. 250,00
Water MeMr 60.00
roral 924.50
Gold Medallion Corp on the express mrdition rhor
with all-a))pliwble State of Minnesoto Stotutes and City of Eagan Ordinonces.
Building Officiol
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?.
2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
' L:.
Please complete for: single family dwellings & townhomes/condos when pertniu are requ'ved for each unit
Date __4_._ / i?t) jc=
Site Address 3yA"1 ?????1 a..fl(ftev -Dr ' Unit k
Property Owner 1 , ? CSG?. ??QO+?? Telephone # (u7=)i
Cantractor Dan Wohlers Southside Htg. & A/C
6950 W. 146' St., #106
StreetAddress Apple Valley, MN 55124 - City
State _ (952) 431-7099 Telephone # ( )
Bond #: T2,?- -?- 35 4 "-7 QI FS -7 Ezpires:
The Applicant is _ Owner x Contractor _ Other
Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to existing dwelling unit $ 50.00
? fumace _Additional ?Replacement _ New
air exchanger
air conditioner
heat pump
otlier
r-? - -
State Surcharge
?
$ .50
APR 1 6 200?
T
l
ota
I hereby appty for a Residential Mechanical Permit and acknowledge that the information is comple[e and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a
pertnit, 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.
Cbad ?.?-`_c_>hte.rS ( ?a??
ApplicanPs Frinted Name Applicant's Signature
? 2004 RESIDENTIAL BUILDING PERNIIT APPLICATION
- City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-1 `--j o U ()
New Construclan Reauiremenis RemodeVReroir Reouiremenis OFficet7seDniV
3 registered sile surveys shaxing sq. H. of lot, sq. ft, of house; and all roofed areas 2 copies of plan Cer4 oFSurvey:ReGd Y N
(20°6 mazimum lot coverage allowed) 1 set of Energy Calalations for heated addifions TCeAPr6Pl? Recd _ N.
2 capia of plan shaxing beam & window sizes; poured found design, etc. . 1 site survey for addilions & decks res A11es Required
1 set of Energy Cakulations Add'dron - indicafe 'rf on-sife septic system 9ASit83gpYiC?sl6R1
3 copies of Tree Preservation Plan if loi platted afler 7/1/93
Rim Joist Detail Options selection sheei (bldgs with 3 or less units
Date ia l;L jW l ['_Y
Site Address 3 vv t ConstructionCost ?1'6g e,
UnitlSte #
Description of Work Fro l ,E f r?[ f
Multi-FamilyBldg r Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner Gus ra C? Telephone #( 9r.? ) 9.11 - s's 7s
Contractor wz.,{e 13 jjui
Address 13
State Y1?' 35-ye
Y y Ae A/• City I'/y.... f?
>
Zip ffTelephone#(G)2) aio- 6rSv
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catezorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber 4'?7vp?, 1t ? Telephone # (
?`"? ? 9 a 2GOA
MechanicalConhactor `I,' U? Telephone#(
Sewer/Water Conhactor Telephone # (
I hereby apply for a Residential Building Permit and acknowledge 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 permit, but only an application for a permit, and work is not to start without a
pemut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
/pr/I SIC rfvM
Applicant's Printed Name
?J ?
(ivt ff
Applicant's Signature
OFFICE USE ONLY
Sub Types '
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ait - SF
? 04 02-plex 0 10 DS-plex ;13? 18 Deck ? 23 Porch (screen/gazebo) ? 38 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Levei ? 24 Stortn Damage
? 06 04-plex ? 12 12-pleac Plbg_Yor_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demalish Interior ? 44 Siding
? 32 Add'Rion ? 36 Move Building 0 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 WindowslDoors
)zr- 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 0,_-9"0 Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const +Lkq Width
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Dcain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ RI. _ Air Test _ Final
_ Insulation
Approved By:
REQUIRED INSPEC'I'IONS
FinallC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
Ciry SAC
Utility Connection Charge
S&W Pertnit 8, Surcharge
Treatment Plant
License Search
Copies
Other
ToWI
ol7/?C
1"Al-15i fi,m-
?l ?t-e-0
Vol
?????
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits aze required for each unit
&3o.s-b
Date /d 3
Site Address Unit #
ProperTy Owner Telephone # (? )
Contractor
Street Address 410 WEST LAKE STREET City
State ?12-R9n-2(RB? ZiP Telephone # ( )
The Applieant is _ Owner A Conuactor _ Other
Add-on, modi5cation or alteration to existing dwelling unit $ 30.00
furnace replacement
air exchanger
? air conditioner
other
State Surcharge $ •<
`?
? $ Jd '?
Tota ?
I hereby apply for a Residential Mechanical Permit and acowledge that the information is wmp:
be in conformance with the ord' s and codes of the City of Eagan and with the Mechanic
pe ' but only an applica ' or a p mut, and work is ?ot to start o ermit that e v
ap o ed plan in the Faye o ork whic requires a review ?nd approv of p
? .
)
ApplicanYs Printed Name App?eYs ignatur,
acwrate; that the work will
iat I understand tlus is not a
1bg in accordance with the
A
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
The Applicant is _ Owner _ Contractor _ Other
Work Type
Newconstruction UndergroundTank _Install _Remove
interior Improvement Call for inspection du ring installation/removal of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (incWdes S1ate Surcharge)
ConhactVaiue $ x 1`/0 = $ YermitFee
• If permit fee is $1,000 or less, add $.50 => $ State Surcharge
If pemut fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Pemut and aclmowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes oF the Ciry of Eagan and with the Mechanical Codes; that I understand this is
not a pertnit, but only an appiication for a pemut, 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.
ApplicanPs Printed Name ApplicanPs Signature
Approved By: , Inspector Date:
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
ana; i-i[oria ot? rrn?rt?o sT??iira?
PERMIT SUBTYPE:
il1I5('f Ll_i1Pl i:'J!J
TYPE OF WORK:
1) i:SCRIf'T70N
?
E;tiri.o.rN r,
c; ? 4s ? ; ?,+
REPAIR
itF - STf)TPIG
L
f'iF14A fih;S : LI`llUf)I4 :54 (?.0?::?1 ?q'?}l (LC)l" 1j Fi'i?l :;; (L.67
1-EP3 ci7Li(_CTE o OiV f'Ef2h111 It?C? 467 (LOT „ aLl< J, ?URRtY HT1- q TH}
PERMIT <5 i?t -l
>( CITY'OF EAGAN Z?l?
3830 Pilot Knob Road PERMIT TYPE: u u T. ? o z n! r
Eagan, Minnesota 55123 Permit Number: 70
(612) 681-4675 Date Issued: t? 3 1_1 .L / 4 3
SITE ADDRESS:
LOT: b C;LOCS.= /I
:;I1(?I>.FY il? I l6HT`.; Cilii
P.I-aN.: ;?d-73t99ti-4? 6P?-G)4
DESCRIPTION:
RE-FIDCi?F
? ni?il?iag ?rr;nil. I;^;??: P71.;???=llr^I?Lt1lJ3
' f?>i;.!diriq Work fype ItE:PAlr2.
UF3C Clceupancy k -%
REMARKS:
r.Ni_unr5 3 4 : ;s ( 1 n, ra'? t ( inr ) =nIIs rt c?
_1 z;
FF F?; rn<<[rrrn nu p=?m n tr>,qr?1 rtnr "iIc i ;U P r<r- v Far"a orH?
FEE SUMMARY:
CONTRACTOR: rapu 1 11 c,:? n; i; r 1-1 .r,OWNER:
NETRCI SIDI:NG 15h/1.fl4BPI 00e1/1:461 ^n!1HRcY IiTS 70 WN fiOUSF ASSOC
7I? ;+1[ u ;+?R q c}VE Pi. iIJ Gii? 11"!01=17 DR
PlYPi0U7h MIV ?I'!; Lfi?3ldh( 'I?P!
[ hsr?6y oulF•dija i_hL 7 h'i 4e ro.;cJ l`.hi; a p plfcatio n nd
ir,forinei'.i.oo is. r.ox -? c,: ?nc aorec Co comnly wr'_hi „11 3 p pl.i.c.1Vil.?> ';r,st w ni ?In
;T.atu'?o, o.nd Cit:y of Eaq,an Urd.innnr:=_?.
L
q
-
APPLICANT/PERMITEE SIGNATURE ISSUED.Py: SIGNATURE I
REACTIVATE _
PERMIT IF '
"filth
CITY OF EAGAN
1993 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: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 93 Valuation of work SCE fEAMiT foK 3409
Site Address: 343-7 NIGNLANOEElz De. 6NGUJ4-L"'S 3431, 3?F41.3443
STREET SUITE M
Tenant Name: (commercial only)
T & BIACK 4 SIIBD. Sup-eEY 4EIlsNTS P.I.D. N 10 ?300S ?o d4
I
3 I 2 Co ?
Descri tion of work: Res ?O
The applicant is: ? Owner ?1 Contractor ? Other (Descrfbe)
Name S0r« 0 N r-,c gsSoc Phone
Property LAST FIRST
Owner
qddress
SiREET STE M
City State Zip
Company'cti2AYO S,s-3 i.r? Z NC Phone s57-109
Contractor Address Na yy a 3- g s'e No License #:' i?6 / Exp. j 3/ 93
City &Md?4 State ZiP ,JrSrf'/7
Company Phone
Archttect/
Engineer Name Registration #
Address
City 5tate Zip
Sewer & water licensed plumber . Processing time for
sewer 8 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:
OFFICE USE ONLY
BUILDING PERMIT TYPE ?
El 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
O 02 Sf Dwg. ? 07 4-Plex )< 12 Multi. Misc.
? 03 SF Addition ? OS S-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 fireplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations El 35 Tenant Finish
O 32 Addition A34 Repair O 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
11 Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Yariance
? Footing
? Final
? E314ment F?'nish
Ct 17 3wim"Pool
0 IS Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Cade
SAC Code
Assessments
0 Framing ? Insulation
0 Draintile ? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
tity SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
vatuetim: $
F'? ccxcE-creo 6?
Fbf- -3+o'? Ni?r-r??o?z
PERm r #
De.
SAC %
SAC Units
_
yq?3
DpTEPdarch 8, 1978
BUILDING PERMIT APPLICATION
Znclude 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
1b be used for
site Addresc
.-.Z`cr
= valuation 313000
3437
f1- a ,4 /d A A A
3439, 3441, 3443, 3445, 3447, 3449,3451 Highlander
lq ^l
Lot Block See ub,
T-
Prelim'inary Platted as Surrey He
owner Gold Medallion CorA.
address 650 Southgate Off. Plaza
I1pls., Minn.
Dr.
Parcel Number / D 7A4O5 D 6 D
ights Sixth Addition
Te2ephone 835-7262
,
i
Inc.Telephone 835-7I/62
Contractor D.H. Gustafson & Assoc.,
Address 650 Southaate Office PLaza
Mols., Minn.
Arch./Enq. Robert G. Maanev, A.I.A
address 11408 Oak Ridae Lane
Minnetonka, Minn.
Telephone 544-9219
OFFICG USE
Erect X
Alter
Repaiz
LYilarge
Nbve
Demolish
Grade
OFFZCE USE
Taate of Approval & Initial
Asaessment 121. ? /?78' ^
Water/Sewer Police
Fire
Eng.
Planner
Gbuncil
Aldg. Off.
A.P.C.
Occupancy
Zoning
Fire Zone
Type of Const. _
# of Stories
Front
Depth
FEES
Permit -
Surcharge
Plan Check
snc lH I='
'52 n . ao
t?ater Conn.
67ater Meter .?KG+• G O
bn . G>O
U
TOTAT,
?/1.0 v
pnTEPdarch 8, 1978
BUILDING PERMIT APPLICATION
76?
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
'
To be used for e
Valuation
Site Address: 3437 3439, 3441, 3443, 3445, 3447, 3449,3451 Highlander
ot Block Sec. S, Parcel Number ?? 005 030
p
li
i
y
l
d
re
m
nar
P
atte
as Surrey Height s Sixth Addition
Oamer Gold Medallion CorQ. Te2ephone 835-7262
Address 650 Southaate Off. Plaza
Mols., Minn.
Contractor D.H. Gustafson & Assoc.. Inc.Telephone 835-7262
Address 650 Southaate Office PLaza
Mpls., Minn.
Arch./Eng. Robert G. Macrnev, A.I.A. Telephone 544-9219
Address 11408 Oak Ridqe Lane
Minnetonka, Minn.
OFFICP USE
Erect X
Alter
Repair
L•lilarge -
Nbve
Demolish
Grade
OFFICE USE
Date of Approval & Initial
Assessment
Water/Sewer
Police
Fire
Eng.
Planner
Council
Rldg. Off.
A.P.C.
Occupancy ?
Dr.
0?/
7.oning A"
Fire Zone
Type of Const.
#1 of Stories
Front
Depth
FEES
a?
PeYmit
Surcharge
Plan Check
SAC Si70 . n/>
Water C.onn. F,ti-QTj
Sdater Meter
TOTAL
,?qt'95-
BUILDING PERMIT APPLICATION
npTEMarch 8, 1978
Include 2 sets of plans, 1 site plan w/elevations and 1 set of enezgy calculations.
'L?. <. O'c;
1b be used for Valuation 3 •jCd C%
Site 3Wdress; 3437, 3439, 3441 3443, 3445, 3447, 3449,3451 Aighlander Dr.
Lot Block Sec. Sub. / Parcel Number p/ D O?
% .3
Preliminary Platted as Surrey Heights Sixth Addition
owner Gold Medallion Corp. Telephone 835-7262
Address 650 Southcxate Off. Plaza
Pdpls., Minn.
Contxactor D.H. Gustafson & Assoc.,
Addreas 650 Southcrate Office PLaza
Mols., Minn.
InC.Telephone 835-7262
Arch./Enq. Robert G. Maqnev, A.I.A.
Aadress 11408 Oak Ridae Lane
Minnetonka, Minn.
Erect x
Alter
Repair
Enlarqe
Move
nemolish
Crdde
Telephone 544-9219
Occupancy
OFFZCH USE
Zoning
Fire 7one
Type of Const.
H of Stories
Front
Depth
0£FICE USE
1?ate of Approval 6 Initial
Assessment
Plater/Sewer?
Police
Fire
E7ig. _
Planner
Council
Bldg. Off.
A.P.C.
FF..ES
c? ?rt
Pezmit
--- ---- -_ -. ?
Surcharge 16 `
Plan Check
SAC 5122 Da
Water Conn. 4S0 . c'YO
S°Jater Meter / n. na
SU
TOTAL ? _ •
??o ?0
npmgP4arch S, 1978
BUILDING PERMIT APPTIC2ITION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To he used Por ? Valuation
site T.ddress; 3437, 3439, 3441, 3443 3445, 3447, 3449,3451 Highlander Dr.
p y ?.?j?"6
Lot Block Sec. ub. Parcel Number 71P05
?Preliminary Platted as Surrey Heights Sixth Addition
owner Gold Medallion Corp. Telephone 835-7262
address 650 Southaate Off. Plaza
HIpls., Minn.
Contractor D.H. Gustafson & Assoc..
Address 650 Southqate Office PLaza
Mpls.. Minn.
Inc.Telephone 835-7262
Arch./Eng. Robert G. Maanev, A.I.A.
Address 11408 Oak Ridqe Lane
Minnetonka, Minn.
Telephone 544-9219
OFFICE CTSE
Erect X
Alter
Repair
L•ttilarge -
Nbve nemolish
Grade
Occupancy ?
Zoning
Fire 7•one
Type of Const.
N of Stories
Front
Depth
OFFZCE USE
Date of A r val & Initial
-?,
Assessment
water/Sewer
Police
Fire
Png.
Planner
Council
Rldg. Off.
A.P,C.
FEES
Permit
Surcharge
Plan Check
SAC S"no . n?)
Water Conn. 4r6
t-later Meter
.-".
TOTAL
! ? J
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 6 BLOCK: 4 3437 HTGHLANDER DR B& J MASONRY
SURREY HET.GHTS 6TH (612) 489-2056
F-
Control No. 1246
BU7:1_t]ING
001717
10129J92
-7
?
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) I2EPAIR
. [7FSCRIPTION GARAGE BLOCK WALI.
PERMIT
CITY OF EAGAN
3830'Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Control No. 1246
PERMIT TYPE:
Permit Number:
Date Issued:
f3UILDING
Cnd1717
10/29/92
SITE ADDRESS:
3A37 IITGHI.RNCIER pR
LOTe 6 BLOCKa 4
SURF2EY HEI6HTS G'1-4i
DESCRIPTION:
-" GAftAGE t3LOCK WALL
.. ? B u i..1 cli'.xa,q P e r m i t 7 y p e S F°tM7-,'C"? t0
, Bui.letirlrj:'?Work Type REPAIR
U8C f7ccuparre..,y hl-1
,
7
:
F
? 1t1 '4 y ? y?_'I 't ? 1 ? t{ r 1 E vi
' J ? ?a x ..£
,. .. ? - . ..?.? L ...._[?
°.?.... 1.....„.
REMARKS:
Gt '?
FEE SUMMARY:
VALUAT;I:ON $1,690
Base Fee $37.0 0 CUPY 5@
:;urcharge ..„.._.,_._?....._____. $1Totai Fee $38.50
Subtotal $35.00
CONTRACTOR: - Ataplicant - OWNER:
B&.] MASOMRY 14$92056 EiRILEY ENTERPRISES
434 HAl'L"H AVE WABASHlh
ST PHUL MN 55117 57 PRUL MN
(612) 489-2056
I hersby ackndwledge that i Have read Chis applicrata.4n and st,ate tVrat GFi2
ittformation is correcC antl agree to eornply wath aJ,l appiicable State bt Mrr.
L s and C' y bf Eagan Ordinances. J
?v?nl m?rl
APPLICANT/P TEESIGNATURE ISSU D IGNATRE
?
PERMIT N
REACTIYA3E
CITY OF EAGAN
1892 BUILDING PERMIT
681-4675
APPLICATION
?
?f
SINGLE 8 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 whi
h
t
c
re ues
is made or lot chan e is re uested once ermit is issued.
D n CrIV
Date (0 / 2" Yaluation of work Cr
Site Address: S Li 3 r] `Cr4
STREET SUITE N
Tenant Name: (commercial only)
LOT ? SLOCR SUBD. ??}- I
?Tt£.? r??l/??? lr ?? P.I.D. 0
Descri tion of work:--T'_ ?a?. t..l?.?? d- ?ce?? c.?` ??e- 2??0d
The applicant is: ? Owner ractor O Other (Oeseribe)
Name ?/ Phone
?aY-S `i?--
Property ,
LA:T FIRST
Owner pddress 4?0-
S7REET STE N
City State Zip
Company Phone
CO?tf8Ct0r Address ? f 3Lt '?P License # Exp.
City State ZiP
Company Phone
Architect/
Engit1BBr Name Registration N
Address
City State Zip
Sewer 6 water licensed plumber Processing time for
sewer & water permits is two days once area has been approve .
I hereby acknowledge that I have read this application and state that the information is
correct and agree Lo comply ith all appiicable 5t te of Minnesota 5tatutes and City of
Eagan Ordinances.
Signature of Applicant: . U ` ?""--
?
BUILDING PERMIT TYPE
D 01 Foundation
? 02 SF Dwg.
? 03 SF Addltion
O 04 SF Porch
? 05 SF Misc,
WORK TYPE
OFFICE USE ONLY
? 06 Duplex
El 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
i
Ir 44
? 11 Apt./Lodgintf
? 12 Multi. Misc.
?13 Garage/Accessory
? 14 Fireplace
? 15 Deck
? 31 New ? 33 Alterations
? 32 Addition A 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
? 35 Tenant Finish
? 36 Mave
Basement sq. ft.
lst F1. sq. ft.
? 2nd F1. sq. ft.
5q. Ft. total
Footprint 5q. ft.
On-site well
On-site sewage
? lb`Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS RC1PA?oL C.Ayq AGE t3toC-14, t,vAC,?_,
? Site ?footing ? Framing ? Insulation
? Nallbaard Final ? Draintile ? Fireplace
Permit Fee 410
Surcharge
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Nater Meter
Acct. Deposit
5/W Permit
S/W 5urcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total: ?g,9?g0
v.tuecfon: S I 6!Q O
SAC %
SAC Units
a
STATE RESIDENTIAL CONTRACI'OR/REMODELER
LICENSING INFORMATION
PERMIT #
1. I have made application for license to the Department of Commerce.
Date of Application
_ Residential Building ContraMor
_ Remodeler
" Signature Date
2. I am exempt because I am a Qpg specialty remodeler.
lT
Signature Date
3. <
I am exempt because my annual gross receipts aze less than $15,000.
Signature Date
4. I am exempt because contracts oa individual projects in aggregate do not
exceed $2,500.
.
Signature Date
Questions regazding the licensing law should be directed to the Department of
Commerce, 133 East Seventh Street, St. Paul, Minnesota 55101, (612) 296-6319
Licensing Information, (612) 296-2594 (Enforcement).
CITY USE ONLY
? I PERMIT #:
RECEIPT DATE:
C? ?
US1DEN71AL 14IECRi4NICAL PEitMIT APPIICATION
crnt oF gnsAx
3830 Paor xxos en
raeax auQ ssi EE
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ? ('9
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
?-
TELEPHONE #:
(AREA CODE)
TELEPHONE#:
(AREA CODE)
STATE:
Place a check mark next to the oermit work tvoe
ZIP:
New residential dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on, modification or alteration to existinq dwelling unit $ 50.00
• furnace replacement
• air exchanger ?
• air conditioner
• other
Nature of work: fleSI) (0 C.Q/ (Q?
State Surchar e $ .50
Total
Reminder: Call for inspections.
i
MAR 1 5 2001
Updared 1/Ol
CITY USE ONLY
PERMIT #: RECEIPT DATE:
APPROVED BY: , INSPECTOR
COMbIEftCLAL MECIIANICAI. PEfiMIT APPLICATION
CtfY oF EA6m
3$30 PILOT KNOB RD
£RHAN. MN 551EE
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
i)ATE:
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLI):
PHONE #: -
(AREA CODE)
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE: ZIP:
WORK TPPE: New conshvction
_ Intenor Improvement
_ Processed Piping
Specify Nature
_ Install U.G. Tank
_ Remove U.G. Tank
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing Iinspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimnm fee
Contract price: $ x 1°/a = $
State surcharge
TOTAL
$
(Base Fee)
calculate at $.50 for each $1,000 Base Fee
SIGNATURE OF PERMITTEE
Updated 1/Ol