3420 Ivy Ct--- --?
4
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
ON RECORD
PERMIT TYPE:
Permit Number:
Date issued:
?1 11 1
N? I3k1
SITE ADDRESS: H L ,?c F
? ??? ? ???????i :`,til?', i????`• tH ?'iV11
PERMIT SUBTYPIi:
(F,.i.1 "'.It ol qr. .142 .4
TYPE OF WORK:
M u
t I lit ?)
INSPECTION
i-,. i ; t,, I .• .
,. , ;I .•
1?1',If! 1? 1 I??i't f 1 k?tt
I f f? I : 1,•': ? i
iiK F4V.14.7 RYAti i'I fic;'
F
7
Permit No. Permft Holder Oate Telephone S
S!W
PLUMBING T
HVAC
ELECTRIC
ELECTRIC
Inapection Dete Insp. Comments
Footings I
rzl
Foundation i
Freming
7
I
Roofing ?
Rough Plbg. /1
Rough Htg. 9y
Isul. Z
.?
Fireplace ??
-2 - /2
Final Htg.
Orsat Test
Fnal Plbg. Plbg. in&pector- Notify Plumber
Const. Meter
EngrJPtan '
gidg. Final
Deck Ftg.
Deck Final
Weli ?
Pr. Disp.
1 ? vz,-?% ? --
CITI( OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
?'JCORD
PERMIT TYPE:
Permit Number:
Date Issued:
f111 I ?(? { N Ei
A7 /N! /?:f
SITE ADDRESS: 101
i:ir u????f,t f?rdi.?•, w???: ? i?
i PERMIT SUBTYPE:
TYPE OF WORK:
Nf W
! I HF : 1
INSPECTION .• • .•
I?r
I 1 !r,s,
APPLICANT:
? , , ???.,?•,;a ? • :? . ?
14h (6 1 F') 4 AI' A14
I kP MA/2KSr ', & W 114 Hlt W N1. -kYAtV i'1 EiEi
Permit No. Permit Holder Date Telephone #
SNV
PLUMBING
HVAC ?
ELECTRIC
ELECTRIC
Inapection DsW Insp. CommsMs
Footings I
Foundation
Framing
Roofing
Rough Pibg. !y°? /' 20-'-7 L' ! G G4 ?
Rough Htg. ?}/
?o [.4- o _
lsul.
Frepiace c? 3 G% ? C F-
Final Htg. Z 3_93 0,0
'
orsat rest W,/S I
Fnal Plbg. `Z 3Gl ?
!J ? Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
wen
Pr. Disp.
?, ? 4 ? ,
- *4 ?
? :1 rw?
1- /- /
Address 3420 Tvx rrxntr Zip 5512 3
I.ot I Blk I Sub
nffi woCDrarms rORni uro
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: (a Yes No Inspector:
Final grade (6" from siding)
Permanent steps (gazage) I,/
Permanent steps (main entry)
Permanent driveway ?
Permanent gas ?
Sai/Seeded grass ?
TraiUcurb damage ? .
Porch ?
Basement finis6 ?
Deck
Please verify with the builder the removal of roof test caps fmm the plumbing syscem and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681•4645 before working in right-of-way or installing underground spcinkler system. ?
Wtiite - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
d ?g 9q.
a _3?
Reque t Date ' • Flre No
?^
-
3 Rough-in Inspection
Raqwre +
Ready Now ill Notiy InspeIXOr eRrO
P
tl
+
H'h
. O
?/ es ? No an
ea
y
zucensed contractor D owner hereby request inspection of above electrical work at.
Job AOaress /(Str/ee-t Box or FOUte N
3 - /J ?. Pty
?
7? U
1 l//
Secnon No Township Name or No Renge No Co
C.?
OccuOantIPFINTI ? -/ Phone No
Pawer Su her ? . C
9% r Y Atltlress
CX?YG,C.?I,a Z/?.C?CiI
Elecincal ConVactor?COmpany Nam ConVattor5 Li se NO
Do ? 5z
Md,liAtl4r855(C. nrtacro' o, Owner Making Insieilauo )
/
( (?
awhonzed Efb,ature iCOnvaaonQxner Maxmq installation) ? P?o Nu r
'
o-
MINNESOTA STATE BOAPD OF ELECTRIQTY ? THIS INSPEGTION REOUEST WILL NOT
Grigge-MlEwey BIGg. - Poom 5493 • BE ACCEPTED BY THE STATE BOARO
182I Unlvn¢Iry Ave., St. Feul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612) 642-0800 ENCLOSED
s(?/??/Q 2 REQUEST FOR ELECTRICAL INSPECTION
u 0? 7 d? ? See insvuclions for complalmg this form on back ol yetiow copy
'7 n A!1 4 "1C" F2a1nw Wnrk Cnvarwd hv Thi.c Roniw.cl
?y &oL?/
e ,2SC Aop. Type of Building ApphancesWired EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Other (Speafy)
Comm /Industrial Fumace
Farm Au Condrtwnet
Other (syecfy) ConVaqors Rem3Bs
Compute Inspection Fee Below.
# Other Fee # ServiceEntranceSae Fee # Circurts/Feeders Fee
Swimmmq Pool 0 to 200 Amps - 0 to 100 Amps -
Trensformers Above 200 _ Amps Above 100 _ Amps
Slgns Inspecror5 Use Onty TOTAL
Irngation Booms Q .00 0
Speaal Inspection
AlarmrCommunication THIS INSTALLATION MAY BE ORDERED OISCONNECTED IF NOT
Other Fee ? COMPIETED WITNIN 18 MONT .
I, the Electrical Inspector, hereby
Certify that the above inspeChon hes
been made. Rouqn-in " /
F?nei • oai ,7..
C
D e
OPFICE IISE ONLY
This request vottl 18 monfis from
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: LoT:
3420 IVY CT
7HE WQODLANOS NORTH 2N0
PERMIT SUBTYPE:
DUPLEX
1 BLOCK: 1 APPLICANT:
SIEKMANN CONST
(612) 447-2424
TYPE OF WORK:
DESCRIp7I0N
BUILDIN6
021380
07(07/93
NEW
(1 0F 2)
INSPECTION
FOOTING .. .
FRAMINC, ..
INSULATION FIMAL
FIftEpLACE
REMARKS: S& W PLBR - GENZ-RYAN PlBC,
+
PERMIT
? CFTY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: s u z Lo z N G
Eagan, Minnesota 55123 Permit Number: 021380
(612) 681-4675 Date Issued: 0 7 J 0 7/ 9 3
SITE ADDRESS:
DESCRIPTION:
100
32
?? ,j
4.`-`JL,FC ?lJ?jjr?? ? t
3420 IVY CT
LOT: 1 BLOCKs 1
THE WOODLANDS NORTH 2ND
, ?- (i eF z)
BUildi•ngl.Permit Type DUPLEX
Building Wo?rk Type NEW
(-'UBC Occupancy\ R-3 M-1
/
Construction T?ype V-N
Zoning PD
/
Building Length j
? Building Width
1
'.-
?
?
i (i
1
REMARKS:
S& W PLBR - GENZ-RYAN PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
3AC
SAC 8
SAC Units
Subtotal
VALUATZON
$650.00
$422.50
$51.50
$750.00
100
$1,874.00
$103,000
MISCELLANEOUS $1.744.50
Total Fee $3,618.50
CONTRACTOR: - Appl3cant - sT. Lsc. OWNER:
SIEKMANN CONST 14472424 0001436 COUNTRYHOME BLDRS INC
6648 RUS7IC RD SE 6648 RUSTIC RD SE
PRIOR LAKE MN 55372 PRIOR LAKE MN 55372
(612) 447-2424 (612)447-2424
I hereby acknowledge that I have read th3s application and state that the
information is correct and egree to comply with all applicable State ofi Mn.
5tatuCes and City of Eagan Ordinances.
L
-
?APPLICANT/PERMITEESIGNAT RE ISSUEDB:SIf NATUFLE k
REACTIYATE
PERMII"i
CITY OF EAGAN
1893 BUILDING PERMIT
681-4675
$
APPLI 1
_ JUN > > 1993
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy oIF y
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 Yaluation of work ? '-
5ite Address: 3
STREET SUITE t
Tenant Name: (commercial only)
IAT
I
BIAC& ?
lb%6g
?/
P(?
P.I.D. N
Descri tion of work: ?
The applicant is: ? Owner Contractor ? Other coe.or;be>
Name Phone
Property ??ST FIRST
Owner
Address
57REET STE M
City State Zip
Compan,y Phane
C011tf8Ct0r Address License Exp. 7S
City 5tate cpz2/ Zip ?-r3'7Z
Company Phone
Architect/
Engineer Name Registration N
Address
City State Zip
44
Sewer & water licensed plumber . Processing time for
sewer 8 water permits is two days onc are s been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to c with all applic ble State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant.
v
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. 0 15 Deck
WORK TYPE
,X
IBaVwn!k- F i n i s h
? 11 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
O 21 Miscellaneous
? 31 New ? 33 Alterations O 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INF ORMATION
Canst. (Actual) \i N Basement sq. ft. MWCC System Yr3
(Allowable) _v- N lst F1. sq. ft. City Water ?
UBC Occupancy a_3 rn 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
!? of Stories Footprint Sq. ft. Fire Sprinkl er
_
_
Length D u On-site well Census Code 73
E
Depth On-site sewage SAC Code 61
APPROVALS -=
/
Planning Building Assessments
Engineering Yariance
REGIUIRED INSPECTIONS
? Site
? Wallboard
? Footing
O Final
? Framing
? Draintile
0 Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % goo
SAC Units (
Yetuat;a,: s D 3 0-0 '
OAGs: VnLcuE qS;odo
paya.CH ? 32D GA45TsjLL
`p il J-bu
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Ploneor Enflnearin•
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P. BSt
e, MN 85120
Aafas 951-049g
426 Hfghwey 10 NorNdes!
Blafie, UN 85434
Certificate of Survey For: Woodland Gountry H, peg
House Aadress; _ Ivy?pur F?,,,,., ..d=m s 1B`20.
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NO7E: CONTRACTOR MUST yqZIFy qLL pIMENSiONS ANtf ORJVeW,qY DESIGZNA??
x 006,0 Denatee ExletMy Vevotion
R?A Denot#e Prepoaod EIevQtlon ..
-? Dgno4?r brolnqge' & Utillty E11164men! ---+Denotee p
oFok 783-133S
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rotnaye Ffaw orrectron P.$.4posED HQUSE , vanoy
onuMent '
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- Denotsa Offset Hub geortnye shown orc oaaum Qaredcgm , $fab Etevotlon:9
LbT?, ?LOCK 1 THE W?dD?eNn? NOIRTH
OAK07A ppU?? ? ~~v
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I herehY e?nlfr IAot thli lyrWY. nlun w mpqt ?qpuq bY mA un
arder tht bNa of O?e 8uu ol M1nnuoU. AMW ehi? 4?v o1 C. r nee .vp lon md W4um duN Rwk?ww Wd $vMVa
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LOT BORVEY CHECRLIBT FOR RESZDE;:=.AL
Registered Land Surveyor signature and company
Building Permit Applicant
Legal description
Address
North arrow and bar scale
House type (rambler, walkout, split w/o, sp11t
lookout, etc.)
Directional drainage azrows with slope/gradient $.
Proposed/existinq sewer and water services
Street name
Driveway
ELEVATIONB
entry,
Exiatina
? 0' p • Sewer service
D 0 • Lot corners
0 CV ? • Top of curb at the driveway
0['J? 0 • Elevations of any existing adjacent homes
prooosed
?7 ? ? • Garage floor
01? 0 ? • First floor
D la" 0 • Lowest exposed elevation (walkout/window)
D--?? ? • Property corners
wQ' ? • Front and rear of home at the foundation
PONDINa AREAS (if aoDlicable)
0 30? 0 • Easement line
O [3' 0 • NWL
0 t? ? • xwL
? 0 Pond # designation
? 0 0 • Emergency overflow Elevation
DIMENBION9
0'' 0 0 -
@' 0 0 •
0, 0 ? •
e---0 ? •
? D' ? •
Lot lines
Right-of-way and street width (to back of curb)
Proposed home dimensfons including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent foottngs)
Show all easements of record and any City utilities within
those easements
Setbacks of proposed structure and setback of adjacent
existing homes
Ret
Reviewed:
October 1992
Date of 8urvey:
DOCUMENT BTANDARDB
S .
EXTERIOR ENVELOPE AVERAGE "U" COMP.UTATION
WOODLAND
INC.
CONTRACTOR: COUNTRYHOME BUILDERS, INC. DA7E:
DETERMINE WORKING SQUARE FOOTAGE OF EACH:
1. TOTAL EXPOSED WALL AREA .............. 1,804.00 sq ft x"U" 0.110 =• 198.44
2. TOTAL ROOF/CEILING AREA :................ 1,435.00 sq ft x"U" 0.026 = 37.31
3. TOTAL EXPOSED WALL AREA CALCULATIONS:
Total exposed wall area above floor......... 1,804.00 sq ft
a) Total window area:
Double glazed ........... ............. 134.00 sq ft x"U" 0.430 ? 57.62
g I azed ........... .............
sq ft x "U"
b) Total door area :.................................... 38.00 sq ft x"U" 0.070 = 2.66
c) Total sliding door area:
Double glazed ........... ............. 80.00 sq ft x"U" 0.430 = 34.40
g I a z ed ....... ... . ... ... .... ...
di Total fireplace wall area :.......................
e) Total wall framing area
(AVERAGE 10%).........
sq ft x "U"
- 0.00
- 0.00
sq ft x"U" 0.370 = 0.00
180.40 sq ft x"U" 0.095 =
f) Total net wall area
above floor (insulated)....... ., .................. 1,279.60 sq ft x"U" 0.043 = 55.02
g) Total rim joist area :............................... 92.00 sq ft x"U" 0.034 =
Total foundation area (exposed) ..............NA
sq ft
3.13
h) Total foundation window area .. ............. NA sq ft x"U" 0.430 = 0.00
i) Total net foundation area above grade..... 0.00 sq ft x"U" 0.045 = 0.00
3. Total a) thru i) 169.97
If item #3 is the same as, or less than item ll1 you have met the intent of 2 MCAR 1.16008 A and O.
Page -1-
S
4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS:
Total exposed roof/ceiling area . ............. 1,435.00 sq ft
j) Total skylight area ................... ............. 0.00 sq ft x"U" = 0.00
Total roof/ceiling framing area
k) (Average 70% ............. 143.50 sq ft x"U" 0.039 = 5.60
d) Total net insulated
roof/ceiling area .................................... 1,291.50 sq ft x"U" 0.024 31.00
4. Total a) thru i) 36.59
If item #4 is the same as, or less than iiem Jl2 you have met the intent of 2 MCAR 1.16008 A and O.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total evelope system method, the values established by the sum of Items #3 and Item #4
shall not be greater than the sum of Items #1 and tt2.
1. 198.44 + 2 37.37 = 235.75
3. 169.97 + 4 36.59 = 206.56
CERTIFICATION
I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here
in described meets or exceeds the state of Minnesota Energy Conservation Act.
(SignaWre)
(Date)
Page -2-
l'
STATE OF MN DEPT. OF COMMERCE
?^ nte' ...
• ? . 4?
133 East Seventh St
St. Paul, MN
55101 ?'
(612) 246-6314 11, ?m
"'9•..'... <:: ..
BUILDING CONTRACTOR
ue • . 03117193 Expires: 03/31/95
JAMES SIEKMANN
S7ATE OF MINNESOTA
DEPAHTMEN7 OF COMMERCE
133 East Seventh St
St. Paul, MIV 55101
(612) 296-6314
DUILDING CONTRACTOR
ID#0008508
RE.riIDENTIAL CONTRACTOR
CORPORATION
Iss' d
COUNTRYHOME DLDRS INC
7625 METRO BLVD
STE 145
' cMOOSqEDINA MN 55439-0000
? ID#0008508
RESIDENTIAL CONTRACTOR
CORPORATION
i I
I Issued: 03/17/93-03/31/95
I JAMES SIEKMAIVN
COUNTRYHOME DLDRS INC
i 7625 METRO BLVD
? STE 145 ; EDINA MN 55439-0000
SO# IDOd W869'40 E6-I0-LO
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FlOUBA AdtlYe99: u?Planear Enslnearin• 7831683
CertlficaFe of 5urvey for: Woodland C?untr, Homes
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?14•Frix e81-9486
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IVY COURT
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ldonument I ED HOUS ci Fvenn?
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Denofes Offsat
Hub Qa?age
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LbT?,,?, BLOGK e cisumed
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NOTE: CON7RACTOR MUsT VER{Fy p,Lt DIMENSI6NS ANtI ORIVEtyqy DEStcH
n ooo.o Denotee Exim4ing ttevotion
N?P Danotse Prepoood Elevotian ' ..
-? Den64•r brotnag4 ?e Uttllty tds&man! -'-?-Denot p
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Ploneor Enflneerins 763168E p,01
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1419 tAtPrprlaa Drlve
Mendola Hslyhle. Mn ss+ao
* eng neer np < <. e ,cc+e ?-?.
$26 H19hwoy 10 NortMelt
Blohe, uN 55434
(e12) 753-18e0.Fax 783-1ee3
Cartificate of Survey Fcr: WQOdl4C1 C0untry Ho-,nes
1 HouBe Aqtlte6s: Ivy!QQur} aaan &
N 00'21'17" E
72.23
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IVY COURT
I hercbr eaitlr 1Aes %hlg surnY. itan pr rypyq ?parp 6Y mS ? und?, r1nY Irat an and duN Replq??ai
ardar the Um ot tAo 8?+u of MlnnotaU. Drkd LNidw o? 'Y . A.D. tC U+d fv.?wYw
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NOiE: CONTRAC70R MUST YERIFY ALL DIMENSIONS Atl ORIVEVtqY OESIGN
r 60.0 Denatee Eximttng EIevction
? DDenotat dRO{?t brain g? & ?U?I?
ygas6msn! • ?
?Denotea prolnoqe Flpw qirection S O S Ti
---a- Denolas Idonument ' Qa?aym $Icb ?levotlesn:?_4p
?--?- Denotes Offaet Hub 8eortnye ehown cre eaeumed LOT?,?, BLOCK 1 THE W?7aDLA.?S NOR'
OAKOG ppUNpY, WNWSpTA
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T0'd
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMiTS ARE.REQUIRED FOR EACH UNIT.
NO. FIXT'URES EACH TOTAL
? yFifl:.i R 3.03 .?
.?_ WATER CLOSET
.00
3
12
_ BATH TUB
3.00 ?
? LAVATORY 3.00
? KITCHEN SINK 3.00 3
LAUNDRY TRAY 3.00 9
HOT TUB/SPA 3.00
HEATER
FLOOR DRAIN 3.00 y?
? GAS PIPING OUTLET - -wi-um - i 3.00
ROUGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVATE DISP. • uak.ay. tic I5.00
U.G. SPRINKI..ER • 6ome uuac mnst. 3.00
ALTERATIONS -io ausring 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL:
SI'?'E
OWNER NAME: wooni,Arm COUrrrxnioMEs
INSTALI.ER: GENZ-RYAN PLUMBING & HEATING C0.
14745 South Robert Trail
CITy; Rosemount STATE: MN ZIP CODE: 55068
PHONE #: (612 ) 423-1144
PLUMBING PERMIT (RESIDENITAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLWGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTfS ARE REQUII2ED FOR EACH UNTT.
- - - -------- - -------------------------- - - ------- -
,k NEW CONSTRUCfION
ADD-ON A/C
A17D-ON FURNACE
DATE -7
FEES
HVAC: 0-100 M BTU $ 24•00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 C$3.00 EACH) -?. Qv
ADD-ON/REMODEL (ExISTING CoxsTtUCrtoN) $ 15.00
STATE SURCHARGE .50
TOTAL 27,
SITE
s
OWNER NAME: Si &,1/_.v.w? ev..s k TELEPHONE #: 147' Z424
INST.
ADDRESS::zG11 fwl?? 61-1
CTI'1': STATE: L/V ZIP CODE: S"i_5_7 Q
TELEPHONE #: ?1D ?3J ?
S 1 URE OF P RMITTEE
1993 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
Oct 02 13 03:48p Meschke 7637548901 p.1
Use BLUE or BLACK Ink
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City of Eap I g,~-,~
I Permit Fee:
I 2
3830 Pilot Knob Road
Eagan MN 55122 Date Received: 1 101_~.h3...___ 11
Phone: (651) 675.5675 1 1
Fax: (651) 675-5694 I Staff: I
1 I
2013 RESIDENTIAL BUILDING :PERMIT APPLICATION i~ l3
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, & LI ~6Tr 1'26,83
~
Date: Site Address: ?i~l?~✓;' G1~. Unit
` JJ J`A•ILA I `L..
Phone: 63--Z3 1,(o7z f
Name: F.1)Q?pI AN~ •.~D~)~~'izy /M~ `~J hll~ s` ~
Resident/ 54-q
Sig a!
Owner Address / City / Zip: 3 y ,7-0, e r, a A rv~ ~J s.~ rZC
Applicant is: Owner X_ Contractor
Doscription of work: I ``Gt~AI ROOF-
Type of Work
Construction Cost: .J~r Multi-Family Building: (Yesx _ / No
Company: Mrs C P CON -'5rn t1 C: r DvV DX_ Contact: yrVZ ; f...alkf
Address:
Contractor Nth City: /n1fi~0i/~c~i
$tate: Zip: Phonc: 7~ 7S y^ Z-7 77
License Lead Certificate
If the project is exempt from lead certification, please explain why; (sec 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, (late and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Ceti Gopher State One Call at (651) 454-0002 for protection against undt3rground utility damage. Call 48 hours
boforo you intend In dig Ib receive locates of underground utilities. www.ooor or_~_it~~~ni+fall_~xg
I hereby acknowlodgo that this information is complete and accurate: that tnF 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 :applirrilion for a permit, and work is not to start without a permit: that tho work will bo in
accordance with the approved plan in the ease of work which requires a review and approval of pl:9ro;,
Exterior work authorized by a building permit issued in accordance with the Minnesota Stato Building Code must be a ted within 180
days of pormit issuance. ~r
r
Applicant's Printed Name Applicant Signature
Page 1 of 3
Oct 02 13 03:48p Meschke 7637548901 p.4
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I Permit Fee: �
3830 Pilot Knob Road � I
Eagan MN 55122 BY: i Date Received: � ��/ �
Phone: (651)675-5675 � �
Fax: (651)675-5694 . � Staff___—___— �_---J
2014� RESIDENTIAL P UMBING PERMIT APPLICATION
4
Date: '' Site Address: /�
Tenant: Suite#:
`t���a,�s v�"ay,y��.,;�"��ra���+,��� � . � f�
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ra� s � aern# �'�`s�a` d ��� �NB�'1C: P ng; � � �
Resi en�/Own�e;r�
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���r�� :�� wr�� . . Address+City/Zip: ����
G��:��� =�f����''� �,� Milbert ompany lnc dba Iign Water
�,r��� ,= Name: ��cense#: WC643176
a
' ��������������'�� Aaaress: 180150t Street East c;tY: Inver Grove Hgts.
����Contractor �
'f+����� ��'��"`�'k ' state: :M N z 55077 651-451-2241
sdj�,!i�"�� a,� `,,r � � t,i; p: Phone:
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;'�`�����' �s�s`' ����, Contact: W I�(I a 171'��R.M I��J e ft EmaiL• �
�A-
. a t?�,�k��^ ��9'. ,�x � � �. . . .
�`�'��������}•��� °`" _Nlew eplacement _Repair Rebuild Modify Space Work in R.O.W.
� ,�Type of Wor„ — — —
����€� }'
�.��� °_ � �� . �� Description of�work: �
���'°���'`'_ � ���� RESIDENTIAL � � � �
F.����� � �
������� a t � � � .
� �� � Water Heater
'`�`�z��� �� ���.��
`����'��`� ` �� x��r,� Lawn Irrigation(�RPZ/_PVB) �Water Softener
���z w
, ��Pe�i�it�f
i'�� , ��� � �p ° • Add Plumbin Fixtures Main/ Lower Level
�, � �.��4>��a����;��'`�' Septic System 9 � — )
� �,�'������� �K° . .
�� � �"�`��� �� 7 � New Water Turnaround
�s�e"�'a��°^r �' "� . - �
.x �"�.��'�',.�s .�s,� �.� �� �
� �i�'��4 .>a at, 2cT s � AbBild�11111@�lt
RESIDEN?IAL fEES: "
�60.Of�V'vaier i-ieai�r,.'v'vafer Softener, or Vliater Heater anc� 5o�tener(includes��.00 State Surcharge) �
$60.00 Cawn Jrrigation;(includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Tumaround*(includes$5.00 State Surcharge)
'Water Turnaround(add$200.00 if a 5/8"meter is required)
$115 00 Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) Qd
TOTAL FEES S —
CALL BEFORE YOU DIG. Call Gophe�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.aoaherstateonecall.or4
I hereby acknowtedge fhat this informa:ion is complete and accurate;that the work will be in conformance with the ordinances and codes of the Clty of
Eagar�; that I understand this is not a permit but ony an application for a permit, and work is not to start without a permit;that the work wlll be In
accordance with.the approved plan in the case of work which requires a review and approval oi plans.
x � X
Applic nt' ' inted Name Applic nature '
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� .�.k�� . :. �2�� . te��``' � ..__�� ��..� . : � . ., . _... . � .,� ���.�'���
Use BLUE or BLACK ink
�-----_--_--------�
I For Office Use �
. �
I
� Petmit#:� � I
Cl�y of �a�a�a � PErmit Fee: V , i �
3830 Pilot Knob Road � �--1 _ �� I
Eagan MN 55122 � Date Raceived:l D �
Phone:(651)675�5676 �;� {�`; ��' =�� I � �
Fax:(651)675-5694 � 5taff: �
I�,�;�� " �-------�----�--- �
, a. � a� ��9.9 _�
2015 RESIDENTIAL BUILDING PERMIT APPLICA,TIQN
Wwt,LArU b C'c,v.��/:Y /�c+�rl Z5
Dat�: -�'� � ��' �/� Slte Address: 3 4/x v ��y �`r' Unit#:
Name: �/�' � �- 7r /�A�ur4W� /"1 Lti'7" Phone:
R�sldent/
OWnel' Address/City/Zip: ��5� �E C�rr�Q A�� ,c� Q�V� Caa t.��N 1/�w 1.��r /Y/� S"S 4.2'7
Applicant is: Owner X Contractor
Type of Work
�escription of work: 7'��2 a�� b �1 b-2�f' �.�e c u D�S ���2Qor►�
C�nstruction Cost: 8,3']o.� Multi-Family Building:(Yes /No�)
Company: � � l c',�rt:,2�o R n'!���.3��. C'�r2 n Contact: �r►� � ��'E�J�l t 5
Contractor Address: L/c�s w ���'� S�%• city: l�'��l.S�
State: �''1ti Zip; SS����� Phone: L��,�-�`'''Lz�� Email: X�►�" �� ,�E/x,K .. �c,v�
License#: �� ��{��� > Lead C�rtificate#:
If the project is exempt from lead certification, please explain why:
`d.:�L.'T '1"lo�"7' /7�' J 9 � ni ia•1� Ui�'�^u 2��/.��er Pi�,h:"i�.9 J c,.�.+ ///Q L�.y
COMPLETE THIS AREA ONLY (F CONSTRUCTING A N�W BUILDING
In the last 12 months,has thv City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master pian:
Licensed Plumber: Phone:
Mechanical Contraetor: Phone:
Sewer 8 Water ConVactor: Phon�;
Fire Suppression Contractor. Phone:
NOTE:Plans and supportin9.•docaments that yau subrr►lt are considere�d tQ'be p'ubllc,Irilo�rr►atian. Portions oi�
fhe lnl'ormation mey,be class�ed as non publ�c M'you prov/de specific reasons th.ae worr/d pernil�t the City�.to
� conclude fhat the� are�E�ade ae�e�ets. � � '
CALL BEFORE YOU DIG. Gell Gopher Stata One Call at(651)46d-0002 for prolectfon against underground utility damage. Call 48 hours
befora you intend to dig to receive locates of underground utllltle�, www.qooherstateonecall.ora
i nereby actcnowieage mat tnis informatlon is complete and accurate;that the work wili ba In ConfomlanCe wlth the ordin8ncas and esdAs of 4he Cily OF
Eagan; thet I �nderstand thls is not a permit, but only an application far a permit, and wo�k Is not to staR withouC a permit; tnal the+kork will he in
accordance with the approved plsn in the case o�work which raqulres a roview and approval of plans.
Exteriar work authorized by a bullding p�rmlt issued in aeeo�danee with tNe Mlnnesota State Bu' ' g Coda mU6t 6e eompletod withi�160
days of parmlt isauance.
x �A✓� :� '��..�2,?i S x
Applicant's Printed Name Applicant's Signaturfr
Page 1 of 3
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