3453 Highlander Dr
Jun, 8. 2011 2:48PM SELA ROOFING No.6530 P. 29
Use BLUE or BLACK Ink
j Permit
9 O/I
City of Eap I
Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55922 Date Received:
Phone: (659) 675-5676 I Staff. I
Fax_ (651) 675-5694 UILA I I
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Data: G• / Site Address:3~ a - L3C55, 3A51 Um~~
Name: 1 b ne: un c
RESIDENTI
Orx 1A
WNER Address I City/ Zip: (GrU tr L
Applicant is: _ Owner Contractor
TYPE OF WORK Description ofwork: 4rc_
Construction Cost: ~a 0-Waow Multi -Family Building, (4y I No__)
Company: C 60 AJ G Contact: "L" VWV LU
CONTRACTOR Address: `cdo/D LLS 4 3LV~ city: ~ 1 s7L(.1 ' PILL
State: Zip: 4 Phone:
License ~0,(~ 5 Lead Certificate#: 1t4~'O1 r~11c:? t'~ !
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: Pli. is and suppordn#46cuments diet you.submit air consiorered to.be public information: Pordbris of
the.infcrrmation maybe. classified as horn public if 'you provide specific reasons that would pennit the.City,to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-OD02 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities, www.aoaherstateonecali.orcg
I hereby acknowledge that this information is complete and acaurate; 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 v krich requires a review and approv plans.
14 dX
Applicant's Printed Name Applicant's signature
Page 7 of 3
CITY OF EAGAN Remarks GARAGE
Addition SURREY HGTS. 4th Lot 1 Rlk 10 Parcel 10 73003 010 10
Owner E4 ,? lu '' street 3453 Highlander Drive state Eagan, NA1 55122
Improvement Date Amount
STREET SURF.
STREET FiESTOR.
GRADING
SAN SEW TRUNK
SEWER LATEFiAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
Date
CITY OF EAGAN Remarks GARAGE
Addition SURREY HEIGHTS 4th Lot 2 Bik 9 Parcel 10 73003 020 09
OwnerCPJ'f'i 1 L' I`I ' • '0
Screet 34-55 Hi gh l ander Dri ve State E, agan. 14IIV 55122
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.
SAC
PARK
CITY OF EAGAN Remarks
Addition SURREY HEIGHTS 4TH ADDITION Lot_
awner l'f;,i . - _ Street GARAGE
? Rlk a Parcel 10 73003 QO?I,p /D
State
Improvement Date Amount v 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.
CITY OF EAGAN Remarks
Addition- SIfRRFY HF.TGNTS 4th Lot I Blk Q Parcel 10 73003 010 09
'
Owner' Street 345 Highlander Drive 5tate Eagan, hW 55122
' ?
I Improvement I Date I Amount I Annual I Years I Payment I Receipt I 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.
SAC
PARK
CITY OF EAGAN
Addition ' SURREY HEIGHTS 4th Loc 6 Rik 9 Parcel 10 73003 060 09
oWner street_ 3453 Highlander Drive 5tate Eagan, NW 55122
Improvement Date Amount Annual Years Payment Aeceipt Date
STREET SURF.
STREET RESTOR.
? GRAOING
SAN SEW TRUNK
* SEWERLATERAL 1975 1845.02 369.00 5 738.02 A004083 5-19-77
WATERMAIN
* WATER LATERAL 1975
WATER AREA 1
* STORM SEW TdW ' 1975
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN, j(Q.QQ 2$9 6-23-76
BUILDING PER. #3990 6-23-76
sac 450.00 3289 6-23-76
PARK 40.00 $OHI 1-14-77
i
CITY OF EAGAN Remarks
Addition ' SURREY HEIGHTS 4th Lot 3 Blk 9 Parcel 10 73003 010 0g
owner DU%I ; ' f` ,?_. street 345 Highlander Drive state Eagan, MN 55122
?
-);,I,?l f mti v:l,n_i vk
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWERLATERAL 1975 1845.02 369.00 S 738.02
WATERMAIN
WATERLATERAL 1975
WATE
R AREA
1
SE'5S@ Uri
r origina
arce
t
STORM SEW IIi? 441-
STORM SEW LAT
CURB & GUTTER
51DEWALK
STREET LIGHT
WATER CONN. 160.00 3290 6-23-76
BUILDING PER. ${3991 3290 6-23-76
sAC 450.00 3290 6-23-76
PARK
1-14-77
f CITY OF EAG AN Remarks
Addition ' SURREY HEIGHTS 4th Lot 5 RIk 9 Parcel 10 73003 050 09
I oWner' 'or t' Street 3457 Highlander Drive 5tate Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWERLATERAL 1975 1845.02 369.00 5 738.02 8 - 9-77
WATERMAIN
* WATER LATERAL 1975
WATER AREA 1 ']
* STORM SEW =? 1975
STORM SEW LAT
CURB & GUTTER
SIQEWALK
STREET LIGHT
WATER CONN. I60.00 3291 6-23-76
BUtLOING PER. #3992 3291 6-23-76
sAC 50.00 3291 6-23-76 '
PARK 40.00 508 1-14-77
w
CITY OF EAGAN Remarks
Addition ' SURRFY HEIGHTS 4th Lot 4 e1k
oWner'.' ,,,, street 3459 Highlander Drive
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL
197
184 02
369.00
5
38.
b-ig-77
WATERMAIN
* WATER LATERAL 1975
WATERAREA 1973 SSS@SSe er origina par 8
? STORMSEW= 1975
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN, I60.00 3292 6-23-76
BUILDING PER. #3993 3292 - -
sac 450.00 3292 6-23-76
PARK _ 7
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTIO
SITE ADDRESS: , „ r ;
1, , 1 ,1;1 ,1101` R orr
111;IA •+ tEl. 1 i:11 I- p i i{
RECORD
PERMIT TYPE•
Permit Number: . ?' •' N `? ?•' ?
Date Issued:
APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
I.- t'PAfft
R[- stnrwA
-1
?
.r.
RFMAFtY`,: 1N1 Uiit"•=? 7345E, (1.1lI t) <r!'?1 (t I1( 1;) :i4S9 4101 $} •
1=1 f1. rM IFr1t(i oN v FitM1! 4 20 a+, I flCit 3. HIK t, ti11ftREY HTS 4"fN)
Permit Na. PermR Holder Date Telephone 7k
S/VN
PIUMBING
HVAC
ELECTRIC
ELECTRIC
Mopectfon DaLs Insp. Comments
Footinga I
Foundation
Framirg
Rooflng
Rough Plbg.
Rou9h Htg.
Isul.
Flreplece
Flnal Htg.
Orsat Test
Final Plbg. Pibg. Inspector - Notiiy Plumber
Const. Meter
EngrJPlan
Bldg. Firtal
Deck Ftg.
Deck Final
Well
Pr. Disp.
Receipt a MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee
Fill in numbered spaces 5/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address ' Lot Blk. ' Tract '
?---
4. Owner F?
5. Contractor Phone %
6. Address
7. City State Zip -
8. Building Type: Residential ? Commercial O Institutional ?
9. Work Description: New ? Add ? Alter Repair ?
10. Describe - Fuel Type
1 11.
No,
? Equipment 9TU - M. Ea.
Forced Air No. E_quipment CFM
Ai
H
l
Mfg. r
and
ing:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Othe
Air Cond. r
Mtg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
YIgA6Y OF FrKO11M
3T95 PiIM Kneb Rood
Eogan, MN $5122
Zodn6: RII
Gustafson - G
Owner:?---
?
nddress: - 3453 H?ghla
Site Address:
Consolidatec
SEWER SERVICE PERMIT
PERMIT N9?7? /,76
DATE: 1
No. of Units:
Dr.
Plumber: - 100.00 pd
' 350.00 pd
??,se b camplY w,Kh the ylpege 04 Eagan Connection Chazge : -
Aceount Deposit: 0.00 pd
Ord`nancm Pernvt Fee: . . 0 pd
Surchazge:
Misc. Charges:
sy:
Total:
Date of Insp.: Date Paid:
Insp.:
YILLAOpiOF EAC11N
i
1790Pilot Kneb Rood
Eagon, MN 55132
GoNng: _._RII _
S)wner: UKURJ
Addmss: -LL9.
site Addmss: 395;
WATER SERVICE PERMIT
PERMITNO.:?026 (2025)
DATE: 7/27/76
No. oC Units: ?
RAGnld Medallion
Plumber: OD21SOllddted P1Urtlb1n9 lA. 4itT'__
,nteter No.: Connection Charge: 320.00 Ad
Size: Account Deposit:
-
-
Render No.: 00 p?
.
Petmit Fee: 10
-
I oqrw fo eemyly ?+ifh fhe Village ef Eeyan .50?
Surc harge:
O.dinanus. Misc. ChargaA-
Total:
Itv Date Paid:
Uate of Insp.: Insp.:
v aoe qF eacae WATER SERVICE PERMIT
3795 PiKnoL Raad PERMlT IVO.: 2024
Eaga??MN 55122 DATE: 27/76
Zoning: ?i No. oF Units: 2
,Owner:
Address.
Site Addresi
Plumbex
Meter No.:
Size:
Reader No
I egros fo eomply witb fhs Villoga of Eoyan
Ordinancas.
By
Date of Insp.:
Connection Charge: - 320.00 pci
Account Deposit:
Permit Fee; 10.00 pd
Surchazge: .50 pd
Misc. Chazges•%7G
Total:
Date Paid:
Insp.: -
VILl4QE OF fJ10AN
"379J l ilet Kneb Road
Eagon. MN $3123
SEWER SERVICLURMIT
PERMIT NO.:"?? A
DATE: 7/27/76 '
2oning: Nq. of Units: -141 Owner: Gustafson - Gold Me allion
Address: ? f -oc,v - Si[e Address: 3455 Highla er
Plumber: Consolidated . p
350.00 pd
I ay.ss ro comvlr with fh* Villaga of Eagan Connectlon Chazge:
Oedinancas. Account Deposit:
Permit Fee: 14 00 Pd
Suichazge: 50 Ad
By:
Date of Insp.:
Inap.: _
Misa Chazges:
Totat:
Date Paid: -
? '
p
323549 #t?
a ' $/--
Request pale
^
? Fire No. Rough-in I eclion
Requiretl?
VReatly Now G wili Notity mspector
When Featl
?
u
V = Ves : No y
I)( licensed contractor ? owner hereby request inspection of above eledrical work at
Job Aatlress ISlreel. Box or Route No.I Ciry
Secbon No, TownSM1ip Name or No. Ranqe No. Counly
0 9 i?roT,?.
Ocapam (PRINT)
vl, so ,J Phone Na.
Powe:SupPher Atldres
s
'
,/
?l0 ?} / * ? /.4 L?hl /
/
/-- ?" /'?. 1
I(.Y ??N
ElecUi onvacror?COmpany Namej (Yhtractors Gcen58 No.
DHogb4l-
Mailing Aatlress iGOnvacmr or Owner Making InstauaLOn)
.Sll-/?/1i ? L?
2 '7 ?
,
t ,l
Awnon nanra ?Con r nOwner aNing Ins?allation? ?
Phone Nvmber
` 68,9 -e, 47
MINNESOTAjOATE BOARp OF ELECTRICITY THIS INSPECTION REOIJEST W4l NOT
Griggs-Mitlwey Bltlg. - Foom 5413 .. BE AGCEPTED 8Y THE STATE BOARp
1821 Univeniry Ave.. SL Paul. MN 55106 IINLESS PPOPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL WSPECTION
? ? See msmrnons for oompleting mis brtn on baUc ol yeiloa wpy.
?4 °X" Befow Work Covered by This Request
?f '? EB-000 t08
ew Ady Rep.(^ 7ypeoBuilding AppliancesWired EquipmentWired
? ? _me ?Fange Temporary Service
I
_ IDUplez
--ApL Building Water Heater
Dryer Electric Heating
Other (Specity)
-,CommJ? Indusirial Fumace
- IFarm Y Air Contlitioner
?
OtheY lspecityl GonVactor5 FemeBS:
?- -?-- N e q-T' ?y wt? D?P lOo.z/C
f Compute lnspechbn Fee Belaw:
P, Other - Fee # ServiceEniranceSize Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
SignS -
Irrigation Booms ? Inspector5 Use Onty: ? TAL
Special Inspection
Alarm/Communication ' THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT
Other Fee I S(s COMPLETED WITHIN 78 MONTHS.
1. the Electrical Inspector, hereby
if
h Ro.9n-m oate
y t
cert
at the above inspection has
been made. oate
??uZ-?
OFFICE USE ONLY •
This requesc wki 18 montbs Imm
' y CITY of EAGAN
BUILDING PERMIT
Owae: ..??. --.??.-c1:.?E?P..r........?
??..... .
Addreaa (Dreseni) •---..v....? .l .......... Z41.lJ..D.......ZA .....?-
Sullder ...................... ' . .. .. .. ........ .
Addrees ............... . ? ........................................ ?..?^j?
0'.I•
N2 3993
3795 Pi1o3 Knob Road
Eagan, Minnesota 55122
454-B100
ne:. ?u:.?s(....?`? •,?1. .7..?.
1.e1'W 13k9 513st's_-7?
6iories To Be Uaed For I Fron! Daplh Haigh! Eet. Coa! Perm[! Fsa Remarks
?
? 6 / LOCATION
or
A?
This pexmit does aot ulhorise the use of siteets, roada, alleps os sidewalks nor does !t give/llte odvaes os Lis agent
the righ!!o ereale eny siSUalion which is a autsance or which presenis ahazard !o ffie heal2h, safaly, eoavenlanee aad
ganeral welfare !o anpone ia the eommunify.
THIS PERMIT MUST?8Eic /T yON T REMISE WHILE THE WORK IS IN PAOG /j .
This is !o earlitp, ?)..ps.?.G.LIi,t.oyJ...9.`.. ??R...l?.haspermission !o erae! a... ..... .....?.`?.-..?C`tpon
the above escribed pr y,v,. u1?7eci !0 24?e provisions of all applicsbl inan s for ! of Eagan. ?
. ^ .............. Per /?-??7.? f l.-----.......-----....._.................--
""" '....... . ..v ...............Suilding Impactos
?
,
CITY of EAGAN
Owaes
Addrees (Pzesanl) ..._? ..l.. . YY ?I ?.....
Builder ......"-........ ... .. ...... ........ ... . ..........................
Address ....... .
? ... ..
DE3CRIPTi?N
. ,.
N2 _ 3992
3795 Pilot RnoL Aoad
Eagam Minnesoia 55122
454-8100
Deta .(,/. .... J.lf...l.7...C..Lz...
r Rle 4 ?lla?:c ?{?-'
6tories To Ba Used For Fron! Deplh Heigh! Eaf. Coe! Pszmit Fea Remsslu
LOCATION //? ? -
Slreel. Aoad or other Deserlplioa of L?alion I Lo! Bloek ? Addilioa or 7'raet
o3Y?
9a^
This permi2 does nof mi'{horize !6e use of sireels, roads, alleps or sidewalks nar does it give(!he owner or hte sgen!
!he =ighi !o creale anp siluation whiah is a auisa¢ce or which praset?fs a hasard !o !he heellh, safetp, tonvenisnn aad
general welfare !o anpone in lhe.communiiy.
THIS PERMIT MUST E T ON TH EMISE WHILE THE WORK IS IN PR??S. q ? ?/ ///}}}
This is 2o cerLtp' !ha ..... ..?.--./•lct?f!!? :has permissioa !o eraet a.?e.?.Lr:. .?N?i• •??•l.'?.!F..:....._upea
Yhe above described W.- ubj ci fo ih provisions of all applicable 7?1!2 he City or"-_"'_'_'•"... ........ Per •
... """_'••"""........ . ............_----
..-----. .................. ...o: --... . . Suildtag Iaepeefor
,/ BUILDING ERMIT
?p..?,.?..?a???....d....G..?-?.:........ .? . 10 i d , ?
?
? CITY of EAGAN
BUILDING PERMIT
owo.c .I11.71i...r4 t-?.v.?...1.`.....W???t'??,,..,.,,?.:r?_ .
Addsess (DsetanS) ...4r2?0.6••.'-'fN......?Q .........
Butlder ....... ......?...../_?°??-,x..(?....... .. ....... ... ---................. ....
Aaa:a.. ..... . .......5...?J...-9;3. ?
DESCRIPTION
s iw
N2 3991
3795 Piloi Knob Road
Eagan, Minnesofa 55122
654-810D
Dals
?c 4"` L at?? t? 4,- ? uats y?
62oriea To Be Ucad Fo y Fron! Daplh Heighf Est. Cwt ezmi! Fea Remuks -?--
,??,.vDO??'-/? - ??040°? /?'' ? ?A? • ? u?.?f
Slrael. Road or olher Deseripiion af Locaiion I Lo! "I Slock I Addliioa or Trae!
This pesmit does not pUhorize the use of sireels, zoads. alleya or eidawalke aor doae it givq/ihe owaer or his ageaf
the righ!!o cseale any silualion whieh is a nuisenoe ox which presents a hazard fo the healffi, eefefp, conveaienee and
ganeral welfare !o anyone in the eommunily.
THIS PEAMIT MUS E T ON TH P EMIS?E ?W"HILE THE WOAK IS IN PROG S
This is !o ee:liip. lh?l... ..-G.(J Cfrr.n..Y?{?.va[.-hes permiasion !o ereet a ... . . .... . ...1/?............_upea
the above described pr se subj ci !o ih6 provuions of all applicable ' ees for 3 of Eagan.
. ........... ?i:•............... ---.................... per ... ? . ....... ...... .__ .. ......
........... ? ?y? ?
a or BulldinQ Inspcelor
?
CITY of EAGAN
BUILDING PERMIT
oWn.: 41:21.//,...
Addsea (Preaenl) .._?..?..l1.!?..`.......... ltY......f.?.0..?.'?........??.
BuSlder ...... ........................... a?-M's:.P..............y...J........................ ....
Addrece ......-?/O.A.f3!!.1.?.A.r?f....?R.:?t.........?..!l.(J.....?..... t?s?1,3 7
!
DESCRIPTION
s i•
N4 3990
3795 Pilo! Knob Aoad
Eagan, Mimesofa 55122
454-8100
ae:. .%v ?...<........ ?.3,..1..?J..?.
tor i•Ox la 5 i/qts I/v'
Btosieo . To Be Ueed Fo: FronS DeP!h Hef9h! Eel. Cos! Pesmi! Fsa Aemuln
af av /D?'a
L
,
{ ?70D0 /?' ° L
?
i niJa c o i
LOCATION
j 1573
or
This permit does not duthoriae !he use of slraels, zoada, alleys or sidewalka nor doee it giva /'6e ownsr or Lls egen!
!he righi !o ereale anp ailualion which is a nuisanae or whieh presenls a hasazd !o !he 6ealih, aefefy, oonvenienea and
general welfare !o anpone in the eommunity: ^
THIS PERMIT MUST SE KEPT ON THE, PREMISE WFIILE THE WORK IS IN PROG?jESS
This is 2o certify. !,t:tn!?:4.?Lf.4.<!C.-'---hes permiaaion !o e:ec! a.Gt??j' .. .... ........ ... ....snpon
!he above desaribed premise su?i !o fhe provisions of all applicable ces fos fhE Ci! of Eagan.
.__"' .. /?...Z£/............ ."""--' -?--............---'_.._--_...._.... Per ....... ... ' "'__' _'-'...""""-........'-"_'...........
uildlnq Iwpxtos
` par
35k 9
Surr¢j/ ?yYs V'
•
CI1^Y CF IIACAN
3793 Pi?.o ' Knob Road
Eagan, Mir.nesota 55122
PE:iMIT NO.: 848
T:ie City of Eagan hereby grants to A. i;inder ,4 Son Inc, _
of 120 *.'. £utler, W. St. Pay].
a FT?:+'^7"(? Permit for: (Owner) c:ustafson & Associates
at 3453-SS 57-50 ?rylanner , pursuant to application dated r/17/76
Fee Paid: SE0.00 dated this 22 day of Junc 9 7(. •
2.00 s/c
Building Inspector
DYechanical Permits:
Bid Total:
' 3
?
c1TY eF E.acarr
7? ? P;.lot Kiio3 Road
Eagan, Mir.nesota 55122
PE:iMIT NO,: 688
The City of Eagan hereby grants to Project Plumbina Oo.
of 9743 Humboldt Ave. So.. Mple. 55431
g PLUMRING
Permit tor: (Owner) D. 8..6ustafaon & Aesociatea
at "S-3-05 57-619-Hylander Dr-? pursuant to application dat,d _ 6/10/76
Fca Paid: $80.00 dated this 14 day of ?JIM y 19 76 •
2.00 s/c
Building Znspactor
'.,iech.emieal Permits:
csic'. ?':: tal: 3
)?? ` r p I RESIDENTIAL BUILDING
?Y Pertnit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5674
New ConsWction Reouirements RemodelRieoair Reauiremenis
3 registared site surveys showing sq. ft. of lot, sq. ft. of Iwuse; and all roofed areas 2 copias of plan
(20% mazimum bt coverage alfaved) 1 setof Energy Catculations for heated addifions
2 mpies of plan showing 6eam & windovr sizes; poured found design, etc. 7 site suney for additions & decks
1 set of Energy Calalalions Addifron - indirate if on-site septic system
3 copies of Tree Preservatlon Pyn if bt platted afler 7l1/93
Rim Joist Dehail Op6ons selection sheet (blajs wAh 3 or less uni4s
P ) o10
OtFice Use Onlv
_ CeR af Survey Recd
Tree Pras Plan Reod
Tree Pres Not Reqd
_ On-site Seplic System
W" ? A (? ti
Date k", / aQ /(31 Construction Cost 1 x
Site Address UniUSte #
?- ?
Descriptian of Work ] `41uc rJ'W?? ?'?ePs
RP
1 T
Property Owner? vmP_ M?,e'? Telephone;# ( 4StlJ %aa- S S7S_
Contractor _ American Building Contractors, Inc.
Address _ 12247 Nicollet Ave South City.
State Bumsville, MN 55337 Telephone #( )
(952) 707-6459
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Resldenllal Ventilation Category 1 Worksheet • Naw Energy Code Worksheet
(q submissiontype) Submittad Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and aclnowledge 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
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
G? L Luo,
Appiicant's Pt ted Name AppIic t's Signature
OFFICE USE ONLY • - •
,
Su b Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex OF 18 Deck ? 23 Porch (screen/gazebo) O 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level 13 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
91 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
VeluaYlOn -2 /`OJ=
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const 1? ?1
Occupancy R -3
Zoning
Stories
Sq. Ft.
Length
W idth
Footings (new bldg)
V,) Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & R'ater Final
?C Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
Fina7/C.O.
? FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
TreaVnent Plant
License Search
Copies
Other
Total
wi?HLANDER o?
? ?N 55122-1309
???HLANDER DR
W MN %122-1309
r?
67
DR
_:i,,+te
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
3AP,3 HIGFII ?`?I!]ER CJR i+9?1F70 :?T[) [PaG
„c'r . 1(1?1 ?lt. (61?1 4hi ?Rid?
PERMIT SUBTYPE:
M 7:SCELLANC0 1)
S
TYPE OF WORK:
CEP!C:F.7?) -I TCiN?
F,' urif ne
49"N,?!bG
rn? jll!°13
a??nrH
hiF-;7 ilJPd[z
f??=1?1(`xIl?llli.??"`? 4 5?.`o {IOT :s'j 3„17 ("I(7i S) ) 31`?^. (L.[i?I 13,
l
F6ES COL1 LCTE11 ON PE.`i/IL1SI_'0 9h1. ( LUl' , i-'? L\ :I., IJ?'iP.EY I-ITt; 4 TH)
I ?
L ?
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675 PERMIT
PERMIT TYPE:
Permit Number:
Date Issued_ C3-r?-?
r, u i i. ? r?; n
0 ? m a r, 6
o l19.'.•
SITE ADDRESS:
.;45 ? ':r(?HLMNOF F: Dt2
?_Of: n FLt1Cl:.: _
r,URRCY hFf1GII7S 1 -1 N -
p . ?f . ?W . : 7 Vl - 7 "J @ 0 " _ G? ; 4+ - t9 9
DESCRIPTION:
, 1,1, F-51:() 1.1,1 g
iI i 'cifnq Pcti, i?i. 1}?::• i?IlSCEILAPI`_tlUS
tiui .1Ciiiit)`!,Jnr1-, RE11
fli6+
UBC Occup'!riae .,
'
. . . .. ._i REMARKS:
I:N l.fiOCS 3!IES:) (t.OT J) <<Q'i? (?f.) T P:) s??) ^-, (Iq"! '!)
F -EFS C p! ! f-CTFfI 0N P' P?Ri+1l"f L4i0 41;1 i`I il'' - NI # I. ^.i! F;krV I-i?l?'; TH1
FEE SUMMARY:
CONTRACTOR: - njj;,1,n,;r>. - sr. i r
rie'rR 0 ?1P iN c., zIn >7 1 ?;aa '0 (A 0 18 o
147f}11 kq I;VC h!
I'^'L`fNIOUTI-I NIN 5541 7
(672) C?7.75%i:
?WNER:
SURRFY H T S TOWNI-IOUSE 61SSOC
ill'Gill !'PJI7i i? U?:
i-F!(1 AII F1P1
Z Fiereby ?scl:r7owladoe t:hi,at Thc,vs; eead tI'iis applac.,k3on ?and ,,i..ot¢ Lhat tiiF
infc) I°:n.i:ion i? z:orrr=c, i. ,_:d aqr:C. t.o com,ily, ',,it'i ,li _pu1 ??,?,1•d.
S+,-r,L'ui;:e5 e,nd t;9 ty ot Fagan 0r't1'lnancz,s.
L
Z' ?',^^--
APPLANTlPERMITEE SIGNATURE
flNiq ? nf ?
ISSUEO Y:'SIGNA UR
J
REACTIVATE _
PERY,IT # '
?O
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 picke(i 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 9 3 Yaluatio of work 5? `?mrr FoR 3¢0?
Site Address: .3?}53 f-?-iGr+i.a??a? D? .tj c.Wo e3 34 55, 3?{57, 3459?
STREET / SUITE M
Tenant Name: (commercial only)
i
T (O BLOCR 2 FD.? ffEfC?H-T5 P.Z.D. 1F lo ?3?3 ?0
4- 4
Descri tion of work: R-es %
The applicant is: ? Owner 0 Contractor ? Other (Deseribe)
Name Surre I?c? S'?0%A)4a SSo Phone
Property LAST flRST
Owner
pddress
STREET - STE X
City State Zip
Company YYVe ? r e S, o iw S ?- N c Phone
Contractor Address I ya'-A/ a3 gve N6 License # yF6, Exp.33i ?
City PL4!°?'+ov4 State 1072 /^JN Zip 'S`S J
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
.?-
Signature of Applicant: J-
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
O 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
0 10 Multi. Add'1.
WORK TYPE
? 31 New
? 32 Addition
? 33 Alterations
?•34 Repair
d* 0 0 "
. `'+? ±r
? 11 Apt./Lodging ? iG 1'E'lfaAjineat'Finish
)1?12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory O 18 Comm./Ind.
? 14 Fireplace . 0 19 Comn./Ind. Misc.
? 15 Deck ? 20 Public facility
? 21 Miscellaneous
? 35 Tenant Finish
? 36 Move
? 37 Demolish
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
? Final
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
0 Framing ? Insulation
? Draintile ? Fireplace
Permit Fee veiuac;on: g
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Fp(Z 3409 Nc.A-nrOC7p2 D2.
414
Water Meter
Acct. Depasit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
cirr use oNLr p / S
L ? BL /? 7 RECEIPT#: pn / 7-i /
SUBD. RECEIPT DATE: ?? J^
1998 PI,iMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3630 PILOT IINOB RD
EAGP.N, A47 55122
(612) 681-4675
Please complete for: D single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EpCH # TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
a 3.00 x
ater Heater 3.00 x ? = Za u?7
Ffoor Drain 3.00 x =
Gas Piping Outlet * minimum - 1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under cunstruction 5.00 X =
Water Softener ' for existing dwelling 20.00 x =
U.G.Spflflkl2f `tordwellingunderconst. 3.00 =
U.G. Sprinkler • for existing dwelling 20.00
=
Alfef2ti0n5 ' to ezisting residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems " nbandonment 20.00 =
STATE SURCHARGE 50
TOTAL Z-O-Sd
- - ---------------------------------------•--•--....--?-•----- - -•---•--------- ------°---------------------- --------------------
I hereby acknowledge that I have read this application, state that the iMOrmation is correct, and agree to comply wkh all applicable City of Eagan ordinances.
tt is the applicenYs responsi6ility to notiTy the property owner that the City of Eagan assumes no lia6ility for any damages caused by the City during its
normal operatlonel and maintenance_activities to the facilitiss.construdetl under this pertnit within City propertyfright-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
C1TY:
ROTT,JEROME
3459 HIGHLANDER DRIVE
EAGAN, MN 55122
(612) 683-9727
MN
TELEPHONE #:
STATE:
ZIP:
OF PERMITTEE
JSIFORMS BLOGlPLBG PERMIT (RESIDENTIAL) 1998
MASTER CARD
Y
Permii
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLWG
SANITARY SEWER
OTHER I
O7HER I
Items Approved
(Initial)
Date Remarks
Disfance From Well
FOOTING SEPTIC '
FOUNDATION ? CESSPOOL
FRAMING TIIE FlELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALIATION i
SE7TIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL f?If fj,?
_-F••
SANITARY SEWER
Violations Noted
on 8ack
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF 085ERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
NON-COMPLIANCE. BWIDER WILL COMPIY
WITHOUT DELqY.
DATE OF INSPECTION
NON-COMPCIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLlOWS:
? REII35PECTION REQUIRED DATE OF REINSPECTION
REINSVECTION REVEALED
CERTIFICATION -1 certify that I have carefully inspected the abwe in which I have na interest present or prospective, and that I have reported herein
all significant conditions oLserved to be at variance with Ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABtY COMPLETED
6UILDING I
DATE
Permii I
No.
Issued Issued To
Owner
Coniractor
BUILDING I
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER I
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM8ING 7-/Q_7L
?LI?
WELL
SANITARY SEWER
-114 A
Violations Noted
on Back
COMMENTS:
MASTER CARD
_ 6-9
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPIY.
? GOMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
DESCRIBED AS FOLlOWS:
r-I REINSPECTION REOUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FICATION - I cenify that I have carefully inspected the abOVe in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property insyected.
? ALL IMPROVEMENTS ACCEPTAJLY COMPLETED
DATE
low s.
Cities Digital Quality Control
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Eti "T Gi?PrTr,ImTr?t• CHH:CK
LotJ??...1B1r?it.Y' `- Ari:?.?'_ti::l1
_ /
!
Parcel an3 seetion nu*,;ber
Streoc_y/l.i???
Ovn er. ZIL'?
Develc,_r_=:r6"?Z
Zone-Oruinance #52
?c•Lot Size
??
-Y13t.'t2d
v?
nN?ilc;.rg Size
Occupar.cy
Type of ccnstriiction
SetSacks: S';,rs=t sides
' sides
Pe.rlir.ga Tota7. area
Pari:i, ; area setbacl-s:
Str;::,t side
LaZdscape arp:cval
eas?
?-- ----
Adcse^s ? T E:.L^«._.Y.
° Total area ----- _?_,
p
? Unp].atted
X ^1ot,al asea
x Rsar
r._
Tul;al spaces
Z ?a ?Olv?#--c? ? ?-'?-----
r ?,?,?
:tear ? 1? ?sb'aeO_. --
Bon3 requ,.rud?)
r
- V -_-_.?_--
? a ? ,"t=
0 $450.00 ?=--
+a Rc?
?=ed-µ , ?r=, ik'iaeseased
loc'rf a?seseed Conn???.f.on?efi"?l?._. l?t+ ???? = G?. <5? L•,°fC
If unassee::ed: Cor?ectio?l cha.g?? ??rv ? ??
Lot di--:.s ion:
Aacliticmal assessments neede3 ` No ; r,eened`?
Laterals:
Assessed r-' Not assessed
?ry'ai7er of hearina: .
N:e:.e3 Not r,seded
Assessme..t clk?f ? Watar & Sevae: DeptRuil3ing ?ept
Police Dept Fire Dept (Carun u Ind only)
gk7` Sur?ey l?yt' 4t"
? .
LotJ .. .jB1r'-icy-
.eaa;:;seat?3on ?m
;;
e,
Dev,3lo_r_?r
Zcne-Orc'::;nzr.ce #52
?? ?v?,o?c Si.ze
I
?, ;,?4.? attea
(?lca.rg Size
OCCl2^yaT1C,}T
TypB Of CCRS'tT71C t7.OR
PvILD17 i,7 G
?
ti;?PLrrA'r ,-(Y7 riTr"k'
,
Dt1TLs? ?
Nuinber,
Addresa
ZP A4d2'888.JF . . . TFt
1 ^tota.7. area
?
Unp7.atted ?
R Total srea
?
SetSacks: S';,rzqt sides
siaes
P=^•T`1''^ge T0t2J. 3T'cF7.
h'v2S L? ,) e
----- - ?-? j? ?J
Total spaces
?Q ?-------
Parr;ir? area setbacl:s:
Strc:,t side Rear
Landseapa agp: cJal , Bond requ:re:dn
Speaial Assess:sents:
S1.C charge $4r0.00 :? ? (,? t .,•
---
Water areaa
Assessed Utiassesserl
Tf asses:,ed: Conm-?'*Uon aiia^aa L?'`EG
If nnassc--s?d: Cor•ner;tioaZ cha?ga
Lot di;;.siono
kfidit:ional assessments neede3 ?
_??_---=--
No; needed
I
xot aesaeasea
Not aeeded ?
Police Dept
Water &'`3awer Dept"-, Huilditlg Dept
''101"-F3xe Dept (Corun E: Ind only)
MASTER CARD
y
Permit
No.
Issued Issued To
Confracfor I Owner
BUILDING
PLUMBING
/,a
w-
CESSPOOL - SEPTIC TANK
WEIL
ELECTRICAL
HEATING
GAS WSTALLING
A
SANITARY SEWER i
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
`OOTING SEPTIC
FOUNDATION CESSPOOL
fRAMING TILE FIELD FT.
FINAL
EI_ECTRICAL
HEATING DEPTH
OF WEIL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING ?
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
IAND USED ASV 5?AD
,4?
COMPLIANCE INSPECTION REPOATS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION -
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON{OMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL. -
ITEMIZFD AND DESCRIBED AS FOLlOWS:
? REINSPECTION REQUIRED
DATE OF REINSPECTION
CE RTI FICATION - I certify that I have carefully inspected the a6ove in which I have no interest present or prospective, and that I have reported herein
all significant conditions o6served to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require.
menu for off-site improvements retating to the property inspected. '
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOft DATE
.Ojm?. s.
lm?'S Sk', Sorre'/l?? y?
-/-4 J 9,ee - _?t-"V}l
DATL:7
L'UI ' , ?T l>Y: ? IC,?.;.IMI? CHFGK
?-
LotAa1_tion r,?;iNi'etl F13? ? .`
Parcel znd seetion nunber
StraoL
Okmer ???1? ?j
Devalc_r_er?
Zone-Ord:inance #52
Ad3rees 0 Ts1r
? .?yot S:tze R Tota1 area
?) -,,? ?
?, ???atted ? Unp].atted
D clir.g Size X Tota1 asea
Occupar..cy
Type of ecnstruction
Setbaeks: StrF=t sides
sides
Paxl:ir_gc Tota1 area
oai
Rear C° --- ?
r159-
o b
?__,?_ _
Tatal spac:es *
?
Par's:i, s area setbackse z `a g g
Stree, side ?ear ? ?s ---
???_ .
Landscape apprcval Bond requisc,d
Special Assess:sents: ?
SY'C charge Q$lt;0.00 =? ? y{ G? ?vT._.
-?-?--- ---/???? z
Water area: '
Assessed V--? Ut:assessad
?'J!a D
Sf a:ses4ed: Conn•xt?.cu-? cna;•ge (e/? &?
If unassessed: Cornec:tiaz cha:ge_
Lot di;d.sl.onc
Aciditional assessments neede3
Laterals:
Asse:,sed
Waiver of heasing:
Needed
Assess*_nc-nt clk? / Watar & Secaer Dept33uilding Dept
Police Dept
Fire Dept (Corm ?. Ind only)
Not r.eeded
? z ?
Not a,:,sessed ?_.
Not n.sedad ?
1?
MASTER CARD
STRUCTURE AND ^ L ? /
LAND USED AS S?? ? .'f!
W9''E* Y
Permif I I
No.
Issued Issued To
Coniractor Owner
BUILDING 3?93
PLUMBING
Auf?
(oI _
CESSPOOL - SEPTIC TANK .
WELL
ELECTRICAL
HEATING
GAS INSTALLING h_.?i
S? _?!S -
SANITARY SEWER I
OTHER
OTHER j I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING
FOUNDATION SEPTIC
CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEAiING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
i
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION R,EPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
O&SERVED.
1:1 ACCEPTABIE SU85TITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILI BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REInSPECTION REQUIRED DATE OF REINSPEGTION
REINSPECTION REVEAIED
CE RTI FICATION -1 certify that 1 hwe carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions otserved to ba at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
? sa
8 I{`9' Surr e)/ 14g7s /{?°_"
-?-? ? . -
CTHFCk
An-.-,, 'Ii:;,i r?;/? r"e?/
?/ - •3? ?
Parcel znd''S"e-tion n.zr,;ber
Stre.•c -? v'C'
r -
,ry /Lit,
Orn?t?-.,.- a ? Aduress --
; . ?4 a Adaresa,?
lvY,ot Size " S Tota7, aroa .
?
atted Unp?.atted ?
? lc:irg Size X Total srea
OCC:llpal?CV -q-- j-,
Typa of ecnstrixcticn
SetSacks: Strest sides
siaes
P.sl_ir.gc Toba7. area_
Pari:ir ; zsea setbacl.s:
Strc-st side
Landscape z,pprcval
Speo3al Ass°s,..:ents:
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Rear
Tol;al
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, Bon3 ren,u_;sc:d n
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S;:C charge
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Water area:
a
Q .v4r0.00
? ?, ? ? •?< -
Assessed Ur.as5ess2d
,t.- --.---? Tf aesesee3: ConnyetJ.on cna ?,r,a L• `f0
If unasseSsad: Ccr:iection cha::ga
Lot di-.71s-iono
kciditional assessments neede3 _ Not rieeced
Laterals:
Assessad v' Not ar,sessed
Try'aiver of hearin,:
P?
Building Dept
ire Dept (Cam & Ind asi]y) ?
,
.a•.M. ,ii _
Not nseded
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan M¢ 55122 -?
^ u 3? Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date -7 / / / 03
SiteAddress ?y ? ?????,? ?• Unit#
ProperTy Owner k o r"-- Telephone # ?I 2 D
Contractor Bumsviile Heating & A1C, Inc.
12 81 Rhode Island Ave. So.
Street Address Savage, MN 55378-1122 City
State Zip Telephone #
The Applicant is _ Owner ? Contractor _ Other
Add-on, modi6cation or alteration to existing dwelling unit $ 30.00
furnace replace ment
air exchanger
? air conditioner
other
State Surcharge $ .50
zoral i
$30 .50
I hereby apply for a Residential Mechanical Perxnit and acknowledge ihat 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 undeistand this is not a
pernut, but only an application for a perroit, 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 wluch requires a review and approval oF plan,p,
Llna ?
Applicant's Printed Name Applicant's Signature
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Piiot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: commercial/industrial buildings
mul[i-family buitdings when separate permits are not required for exch dwelling uni[
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
SMeet Address City
State Zip Telephone # ( )
The Applicant is _ Owner _ Contractor _ Other
Work Type
New construction Underground Tank _Install _Remove
Interior Improvement Call for inspection during installationlremoval of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minunum Pee (includes State Surcharge)
Contract Value $ x .01% _ $ Permit Fee
• If pemilt fee is $1,000 or less, add $.50 ? $ State Surcharge
If peanit fee is over $1,000, add $.50 per
$1,000 Pemvt Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Pernut and aclmowledge 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 with the Mechanical Codes; that I understand this is ,
not a permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with
the approved plau in the case of work which requires a review and approval ofpIans.
Applicant's Printed Name .
ApplicanYs Signature
Approved By: , Inspector Date:
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION _2A?
City Of Eagan
3830 Pilot Knob Road, Eagau MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date/9/ ?5
Site Address J? ,? ??Yll W+ 1? ,??1 Unit #
Property Owner Telephone #( )
Contrsctor
Street Address City a L}
State Zip Telephone # (?P5 ? ) , ??? J ` ??? ?
Bond #: -J J ?q'1 N b Expires: (.0)G " ?o
4
ontractor
The Applicant is _ Owner _ Other
Add-on or alteration to existing dwelliog unit $ 30.00
furnace _Additional _Replacement
' air exchanger , ?
i
?
diti
N
R
l
t
rcon
a
oner _
ew !
ep
acemen
other
State Surcharge $ 50
l
T
t $ 30 5D
o
a
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work wil]
be in conformance with the ordinances and codes of the City oFEagan and with the Mechanical Codes; 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 plan . ,
?15 ?INN?
OU' PiJ3?t?P Applicant's Printed Name ApplicanYs 5ignature 2 2 2005
30-So
+rvh?
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Boad, Eagan MN 55122
Telephone # 651-675-5675
Please complete foc commercial/industrial buildings
. multi-family buildings when separate pertnits are no[ required for each dwelling unit
Date I /Jq / 05
Site Street Address Unit #
Tenanf Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner ? Con[rac[or _ O[her
Work Type
New Construction _ Underground Tank _ Install _Remove *'see below
fnterior Improvement _ Install Piping _ Processed _Gas
Nature ofWOrk:
*`When insfalling/removing underground fank, call for inspection by Fire Marshal and Plumbing lnspector
Permit Fees: $70.50 Underground tank installation/remova!
$50.50 Mtreimum (includes Sfa[e Suroharge)
or
Contract Value $ x 1% _ $ Permit Fee
• If ep rmit fee is $1,000 or less, add $.50 ? $ State Surcharge
If ep rmit fee is over $1,000, add $.50 for
every $1,000 pe rmit fee $ Total Fee
I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; that I understand this is
not a permit, bu[ 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.
Applicant's Printed Name
ApplicanYs Signature
Approved By: , Inspector Date:
Clty of EapR
- =?x------------
JUL 1 7 2008 ? ? Permit#:
I Permit Fee:
Date Received:
? Staff:?
. L ________________'
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 7_*-06 Site Address:
Tenant:
Sufte #:
RESIDENTIOWNER Name: C Phone:
Address / City / Zip:
CONTRACTOR Name: License #: 5?? ° + ?
€
Champion
Address:
City: 3?70 Dodd Rd: #100 State: Zip:
V m
, Phone: Contact Person:
TYPE OF WORK _ New V/Repla ment _ Repair _ Reb ild Modify Space _ Work in R.O.W.
Ular
e
Descri tionofwork:
PERMITTYPE RE,SIDENTIAL
? Water Heater _ Water Softener .
_ Lawn Irrigation Add Plum6ing Fixtures - --
, ? RPZ /_ PVB} ? Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (indudes $.50 State Surcharge)
;
$30.50 Lawn Irrigation (includes $.50 State Surcharge) . - - . ;
r
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
'Water Turnaround (add $136.00 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, etcJ (includes $.50 State Surcharge) ?
TOTAL FEES $?
x y,,. n s+ w -? ?t,a'i,k ,y .'.
FOR OFFICE ?i??''???`±? ?? z ?
Requirecl inspecfions =_Unclei 6rounds??-?'?.??? ?Ir? ?rs,Test?'?"`?C?-ra?s??es???`??? Fimal? y?? ?? ?? '?
?
1 hereby acknowledge tha[ this information is complete and accurate; ihat the work will be in conformznce wkh the ordinances and codes of the City of
Eagan; that I understand Ihis is not a permil, but only an application tor a permit, and work is not to start without a permik Ihat the work will be in
accord`ance with ihe approved plan in the case of work whlch requires a review and approval of plans.
x ?
XS d? Q< GjLup f
ApplicanYs Printed Name ApplicanY ignature,,?-
i-----------------,
? For Office Us I
? Permit N: ?
? ??, 752I ?
I?
I ?
? Permil Fee:
? I
? Date Receiveq: I
I ?
? Staff. ?
I _________________.
2008 MECHANICAL PERMIT APPLICATION
Date: Iao-e?, SiteAddress:'3tt'Q /)?-
Tenant:
Suite #:
RESIDENT/OWNER Name: ?P1??4??'? /1J41,12? Phone6lai^?G?J' 0?j7
Address / Ciry / Zip:
CONTRACTOR Name:Av J? f tl n1j cn? ?r ? License #:
' ?
'
Address: ?(OC?Cis ? G??i ?j /y?c
City: Lc- (Ce?i rrC State: Zip: JJay?'l
Phone:qD -S'ay XJ-l ContactPerson:
TYPE OF WORK - New V Replacement _ Additional _ Alteration _ Demolition
Description of work:
NOTE: Both`roof mounted and ground mounted mechanical equipment is required to
be screerred by C7ry Code. Please contact the Mechanical Mspecior or one of the
Planners tor ln?ormalion on ermitted screenin methods.
NESlDENTIAL COMMEHClAL
PERMIT TYPE ? Fumace _ New Construction _ Interior Improvement
Air Condilioner _ Install Piping _ Processed
_ Air Exchanger _ Gas _ Exterior HVAC Unit
' HVAC units musl he screened
_ Heat Pump Under 1 A6ove ground Tank L Install I_ Remove)
Other " When installing/removin9 tank(s), call tor inspection by Flre
Marshal and Plumbin Ins ecror
RESlDENTIAL FEES:
$50.50 Minimum Add-on vr alteration to an existing unit (includes $.50 State Surcharge)
$90.50 FII'B f0p8if (replace 6urned out appliances, duciwork, etc.) (inCludes $.50 StBte Sul'Charge)
$ TOTALFEE
COMMERClAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 7%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permil Fee is less [han $1,000, surcharge is $.50.
II Permit Fee is >$1,000, surcharge increases by $.501or each =$ State SurCharge
$1,000 Permit Fee (i.e, a$7,007$2,000 Permit Fee requires a$1.00 surcharge).
$ TOTAL FEE
I hereby acknowledge that ihis iniormation is complete and aCCUraie; that ihe work will be in conlormanca with [he ordinances and codes o( the City of Eagan; that
i undersland ihis is rwt a permit, but only an application tor a permit, and work is not to slart without a permR; that the work will he in accordance with ihe approved
plan' e case oi r which requires a r iew and ppmval of plans.
z °'1 ?a„/?!5 x d-? ??11
ApplicanYs Pnnted Name ApplicaM's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough In _Air Test Gas Service Test In-floor Heat Final