3873 Gold PtCITY OF EAGAN Remarks
Addition COUNTRYSIDE VILLA Lot Rtik Parcel 10-18350-11$-01
Owner 5treet 3873 GOLD POINT state r.AGAN MN 55122
. Cnndn 14 C;AraaP 1Q
Improvement Date Amount Annual Years Payment Receipt Date
? STREETSURF. ? 1976 Paid unde original p rcel
STREET ftESTOR.
GRADING
SAN SEW TRUNK y 1968
* SEWER LATERAL c( 1982 v
* WATERMAIN I982
WATER LATERAL
WATER AREA ?J 9?7 '? "
* STORM SENf TflIC I9gZ tt 11
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LfGHT
ROAD UNIT 240.00 #30279 6-1-82
WATER CONN. 420. OO
BUILDING PER. 7303
SAC
PAR K
3795
BUILDING PERMIT
CITY OF EAGAN
Kwob Rosr Eoyon, MN 55122
PHONE: 454-8100
Receivt #
Date 19
Slte Addrcu - Erect 0 Occupency
Lot Blotkj
' $sc/Sub.
,..' ` Alter 0 Zoniny
?
¢
Parcel l(? J?D A U ? Repair ? Firo Zone
E
nlorpe p Type oF Const.
W Nome ' Mpve
?
# Stories
? Addross Demoliah p Length
r;.., w,,...e Grode n Death Sa. Ft.
o Nome
?
?u Address
r- r:... e?---
Nome - L
/lddress
I hereby ocknowledge that I have reod this opplicotion nnd state thaf
the informotion is correct and agree to comply with oll applicable
Stota of Minnesoto Stotutes and City of Eaflan Ordinances.
Sipnnture of Pem+ittee
/1 13uildin9 Permit Is issued ta:
all work shell be done in occordunce with all opplicoble Stote of Mir
Buildinq Officiol
Asseument _
Water & Sew.
Police
Firo
Enp.
Plonner
Council
Bldy. Off. -
APC
Permit
Feoa
Plan check
SAC
Woter Conn.
Woter Meter
Rood Unit
Taol
I
on the express condition thnt
aotu Statutes ond City of Eoqon Ordinances.
ovt5E •?o ?? a?E 'u 2T'7 V Vn.el O?? ?
Psrmit No. Permit Holder Misc. Permit No. Holder
?ga 3 ` W
c
EHM.A.C. ?7 ? wt l-?
erecc.ic
Inwadion Dsie Insp. Other
Footingt 5 -zs- WA-
`tm9 *.Fb y-ao - ts p
Foundation
Framiny
? A.
Rouqh Pibp. ,
Rou{?h HVA
Inwlation
Final Plbp.
Finsl HVAC .` ? a
Final -aD''k
Waftr . Desuibs Location:
VYell -
S?vwr
Pr. Dbp.
Reoeipt MECHANICAL PERMIT
CITY OF EAGAN
Permit No.
Fee
Fil/ in numbered spaces S/C
Type or Prini /egib/y Tot.
1. Date 2. Installation Cost •
3. Job Address Lot f Blk. Tract •
4. Owner
5. Contractor
Phone
6. Address 7. City State Zip ;r
8. Building Type: Residential El Commercial ? Institutional ?
9. Work Description: New 0 Add ? Alter O Repair ?
10. Describe Fuel Type
11.
No. E.qujpment BTU - M. Ea.
Forced Air No. EquiPment CFM
:
Air Handlin
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond. ,
Mfg.
' 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 F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved _ CITY OF EAGAN 464-8100
•-, - Receipt PLUMBING PERMIT
CITY OF EAGAN
Permit No. ' ? -
Fee
Fill in numbeied spaces S/C
Type or Print /egibly Tot.
1. Date 2. Installation Cost -?-
3. JobAddress3?%?? ?Lot ? Blk. / Tract
4. Owner
L ? •/N
5. Contractor V /,Phone
r
6. Address
7. City State Zip
8. Building Type: Residential 13 Commercial ? Institutional ?
9. Work Description: New Q Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
1 Bath tubs Septic Tank
? Lavatory
Softner
Shower well
Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
! Ftoor Drains
Drinking Ftn.
, Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and 1 agree to
comply with aN ordinanaes and codes governing this type of work.
Signed: for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved C{TY OF EAGAN 454$100
?: , 1 ? ? • ' I
iF EAGAN WATER SERVICE PERMtT
iiot Knob Roed PERMIT NO.:
MN 55122 DATE:
- ' No. of Units: "
Meter No.: Connection Charge:
$ize: Acwunt Deposit:
Reoder No.: Permit Fee: '
1 egree to oomply wlth the GtY of Fagan Surcharge:
Ordinenees. Misc. Charges:
Total:
By Dote Paid:
Date of Insp.: Insp
:
.
CITY OF EAGAN SEVIfER SERVICE PERMIT
3795 Pilot Knob Rosd PERMIT NO.:
Eagon, MN 55122 DATE:
Zon%np: No. of Units:
Owner: ? ?• _ _
Address:
Site Address: -'L rO- • *' - - -- ----- -
Plumber: - -
'
r.,? ?.,:•, -
1 o9eee to wmply wlth the Ciry of Eagan Connectton Charge: C ;'? ??•;
Ordinaneeu Account Deposit;
Permit Fee:
Surcharge:
BY Misc. Charges:
Date of Insp.: Total:
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
l? LA --? `? 3830 PILOT KNOB RD - 55122
651-681-4675 -C) (
New Constructian Reauirements RemodellReoair Reauirements
• 3 registered site surveys showmg sq. fl. of IoL sq. ft of house; and all roofed areas • 2 copies of plan
(20% mazimum lot coverage allowed) • 1 set of Energy Calculatiore for heated additions
• 2 copies of plan showing beam & window sizes; poured foufM design, etc ) . 1 site survey for extenor additions 8 decks
• 1 set of Energy Calala6ons
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (hldgs with 3 or less umts)
08
DATE '3- 20 ` O? VALUATION (EXCLUDING LAND)
JOB SITE ADDRESS 3'V 7 3 6ro ?p? Po
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER e001411Lry 5 rG1G 1/i IIIi tei?h NcIne'
TYPE OF WORK T=r aa QC r`co 4 FIREPLACE(S) _0 _1 _2 _3
APPLICANT SCI4 ROC 'Cik,a PHONE# Q'Col-YA'3'"lay6
ADDRESS OWVd 15XC15I <,trY T?tycA ZIPCODE SS4116
PAGER # CELL PHONE #
FAX #
NEOV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbin., System Includes:
Mechanical Contractor:
Y[cclsmical Srslcm [ncludes:
Sewer/W ater Contractor:
Air Conditioning
Hca[ Rccovery Systein
All above information must be submitted prior to processing of application.
Phone #
Phone #
Fcc: 590.00
Pee: $70.00
I hereby acknowledge that I have read ihis application, state that the information is correct
M0.r6, ac)
agree to comply
all opplicable State of Minnesota Statutes and City o( Eagan Ordinances.
nv
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Water Softener
Waler Heater
No. ot Batlis
Phone #:
Luwm Sprinkler
No. of R.I. Batlis
Updated 1/01
CITY OF EAGAN ' N p 7 3 03
. 3795 Pilot Knob Roed Eegan, MN SSI!! -
/ PHONli 454•8100
DING PERM
I IT ?f?i? ReceiDf #
BU
L
SF
d f
T
M Value $20 v 000 pOfe
DWG/GAR Est June 1 1982
ma
or
e .
Site Address 3R71 C.nIA Point Ered ?`cupancy R-3
1 Countryside Villa ?e?
1 Zo,,;,,q PD
Block
Lot ?
Sec/Sub.
r ? fim Zone NA
Parcel
Enlorpe ? Type of Const. V
a lName Countrvside Builders, Inc.
w
z Addres 1500 E. 79th St.
-_ Alnrnninahan e1___ 854-6721
p Nama Owner
U Addreu
Nome Deb34n Partnershin
Addreu iS c Fi fth ct
1 hereby acknowledga 1Mt I have read this applicofion and state thaf
fhe inlormalion is correct and agree to comply with all avvlicable
Stofe of Minnesota Statutec and City of Eagan Ordinunces.
$iynoture of pertnittee
A Buflding Permit Is issued to: r^u^*ysid
oll work sholl be done in occordance with ull npplicable
Move ? #' $tories
Demolish ? Length
6rode ? Depth-NA-Sq. Ft.-
Aoeroralt Fees
Assessment _
Wafer & Sew.
Police -
Fire
Enp.
Plunner _
Council -
Bldg. Off. _
APC _
Pefmit 14V.7v
SurcFwrge 10.00
Plan check 70.25
SAC 525.00
Wafer Conn. 420.00
Woter Meter 60.00
Road Unit 740 _ 00
Total $1465_75
on expreu cordition thnt
i o?naan Ordirwnces.
Buildirq Offfcial
- cirY-oF EaGaN 7214
9793 Pilet Kno6 Rmd ? Eagen, MN 55141 -
.?" --PFfONE: 451-8100
BUILDING PERMIT "? e?e1p? ?`7t3
re ee usea fe. .5F ??? Ed.voiue ,000 Ma 3 19 82 ,
siro n?admu"' 387 -Gold int ide V lla Ere occ ?cy ? ?3
Lot Blxk Sec b. A r ][$ '"j
ir FNe Zone ?
Porcel Enlarge O/TYPe of . V
oc Nome ?m i? , ?T3 '?1'SC. Mav/ ? ?? Stories
? qddren 1500 E. 7 th St. ----?Demolish-p' Length NA
ci gl vnon 4-4721- _Gfdea ? Depth NA sq. Fc.-
Approvols Fees
p Name r ?
o?
Mdress Assessment _
Warer & Sew.
? Cit PMone
li
P
o
ce -
ww Name Fl
F re
~
x? 15 S F`i St ..
Address eno.
<W Ci ?1s• phom 338-8889 Planner -
Council _
t hereby ackrrowledge tFwt I hove reod this opplicotion and stote that Bidg. Off. -
the intormation is corrett ond ogree to comply with nll opplicable APC
Sfate of Minnewta Stofutes and City of Eogon Ordirwnces. _
Signature of Permittea
??t?? ?ld? g
A Building Permif is issued to:
'
StaM f i
all work sholl be done in accordonce with oll opplico ? ewta $tawtes
Buildinp Officiol -
Pertnit 1`W•?
SurcFwrge 10•00
Plan check 70•25
sac 525.00
Water Conn. 420,0
WarerMeter 60_00
Road Unit 240...Q.Q-
TMOI ?1465-7
_ on tha expresf condition thm
Ciry of Eoqan Ordinonces.
v)
k,6 L-L) , 13{P
.?
CITY OF EAGAN
BUILDING PERNfIT APPLICATION
Include 2 sets of plans,
1 site plan w/elevations & '
1 set of enexgy ca].cul.ations.
To Be Used For s . Valuatian ?2p,d-o-? Date
Site Address: ?? i OFFICE USE ONLY
Lot ? Block L Sec./5ub. Oo?+??r S?' i
(
?Erect Occupancy
Parcel #: Alter _ A Zoning
Repair Fire Zone ?
Ormer: Enlarge _ Type of Const.
? Nbve # Stories
Address: ?cTO b f. 7 9'
? ? . Deirolish ft.
Front
/I
City/Zip Code:
- _
Grade ?-f
t.
Depth
Phone #= a VCSl- -,/ APPROUALS FEES
Contractor:
Address:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police _
Fire
Eng.
Planner
Pexmit
Surcharge
Plan Check?'7a? ?
SAC
Water Conn. h'P v v''
Water Meter (y?
Arch./En9• : B1dgciOff. Road Unit _
Address: APC
City/Zip Code:
Phone #: 3 3 F'- ?' $ g9' TOTAL
g?-?-
-1'(N91 --I S
COUNTRYSIDE VILLA
PERMIT
DATE &
USE
2l82 8-PLEX
3I82 8-PLbX
3/82 DUP
6/82 SF
LOT BL
18350
ADDRESS
100 Ol %-1983/ GOLD TRAIL
101 o1 1981/
102 01 / 1979/
103 01 1977/--
104 01 ? 1983B/ (-
105 01 1981B/
106 01 \
1979B/
107 01 1977B
108 01 3867/ GOLD POINT -??
109 01 3865/
110 01 ; 3863/
?
111 Ol I 386ll
112 01 3867B/
113 01 3865B/ '
114 01 3863B/
115 01 3861B ,
116 Ol (3871f, GOLD POINT
117 01 "?,3 869
3
118 01 GOLD POINT _
387
25
.Residential Conhact
/ Minneapolis St. Paul
612-823-8046 651-644-5362
Fax 612-823-1078
ItOOPINGhND
ItDlnuri.iNG
4100 Excelsiar Boulevard
St. Louis Park, MN 55416
* State of Minnesota
License ID #0001050
* Bonded
* Insured
'ROPDSALSUBMITTE4 O ? 11 PHO DATF 9/15/00
Countrysid Villa s k! /, / 7i51 - ?
, I -,?
STREET 4 JOBNPME - ' ' - I
3863 Gold Point ? ns o?? ?(y'?, _-
CITY,STATEandZIPCODE , JOBLUCAiION ?
nrIN /1 <l/f ' /( vl Li ( ? /'1 ', S 1
? - - ?7,?
W8 PYOpOSe hereby to furnish material and labor-complete in accordance with specihcations below, tor [he sum of:
Payment
lo 6e made
When
Balance Due & Payable Upon Completion
? -?`? 1- i e ao -??
I Innn Ftarl Q
All material is guaranteetl lo be as speafied All WORK ro be Eshm9ted Start Date
completed in a workmanlike manner according !o standard WeatherPermitting
practices. Specihed work and quoted price subject to change
upon tliscovery of hidden dafects All agreemenls contingent quthorized
upon stnkes, ar,cidenis or tlelays beyond our control Owner ro
nature
Si M
carry fire, tomado and other necessary insuranca Our workers
g
_ --
are tully covered by Workmen's Compensation Insurance
Products and malenals may be subsLtuted tor equivalent Pdote Thls proposal may be
products due to availabtlity wilhdrawn by us i1 not accepted wtlhin
Owner
We hereby submit specifications and estimates for
ruo3ECT:
in Full Upon C=letion $ _
Paqe No of
Pages
1. Protect siding, bushes, and building with plywood or tarp as much as possible
2. Tear off all shingles from building.
3. Pull and remwe all old vents, valley's, ilashim and plumbing stack. Not to included fumace flue pipes.
4. Sweep roof clean and pull old nails.
5. Any miscellaneous wood repair needed on sheathing will be done at $45.00 per hour, per worker, plus
materia(, over and above original bid.
6. If roof needs a redeck, due to code icsues, 5ela will redeck roof for $50.00 per sheet of plywood, labor and
material, over and above original bid.
7. Install ice and water slrield 6 ft. up from edge of roof.
8_ Install ice and water shield all the way up the valley's.
9. Cover remauung roof area with fiberglass reinforced underlayment and felt.
10. Install drip edge where necessary.
11. Install gutter apmn where necessary.
12. Appty new self sealing starter course on entire buildutg.
13. Optional: Install either GAF, Certainteed, or Owens Corning shingles on entire building. Owner to select
mattufacturer. Style of shingle is 3-Tab. 25 year warranty.
14. Install new 24" preformed galvanized metal valley's on entire building where needed. Vailey's will be 24"
wide.
15. Nail and install shingJes, as per manufacturer apecifications. 4 nails per shingle.
16. Nail and install matching ridge shingJe using a minirnum of 2 nails, as per manufacturers specificationa.
17. In9tall all new energy vents to meet code. Color of vents to be chosen by owner.
18. Install all new plumbing stacks.
19. Insiall all new metal kitchen vents.
dollars ($ Li v - -I q '? ? )
ll). Listall au ncw uauuuum uampci i,cuis.
21; Install new step flashing and counter flashing on entire roof system.
22. Any chimney needing a special sadtd?le', will be done at $275.00 per chimney, over and above original bid
price. 6 N?`? I ? itiE ?UI?`
23. Any custom pans will be done at $300. 00, oer and above original bid price. E) P k-l IF (-;;
24. Any additional work will need to be pre-apprrn%ed by management before work commences.
Noles
All jobs are scheduled on a weather permitlinq basis
Contracl includes all permits and applicabie taxes
Conlractor to deamup 8 remove all debns from eniire yartl
CoNractor to magneoze yard & driveway
Conlractor nol responsi6le for damage lo trees, bushes & shruhs during normal reroohng opmralion
ta n
Conlractor not responsible for dust xnA do6ris in anms during rocimg. Selx rar,nmmonds
homeowners cover Ihev belongmgs
Comractor nol responsible br driveway damage
Coniractor nol responsi6le lor mterior damage due b condensation, ice damming or ice hackup
Contrecbr to pmvide mechanic's Ilen warver upon recert of lull paymPnt of 26ove work
Sela Io provide VYear ManulacWrer's Warranty to oriqinal owner
Sela to provide 10 Vear La6or Warranty to anginal nwner
Sela Rno!ing miJ Remodalmm Inc is a lully insured hrorivrd antl hnnACd owanizai,on
pmviAinq thc highest qiwlity workmanghip end mdleoals for wer 17 yrrirv
See Reverse Side For Important Notice.
Acceptance of Contract-.he above prices, specllicellon9 antl
conJibons are sabsfaclory and are hereby rccepl¢C Vou are 9ulM1Orized to Ao Ihe work
ns speahed Paymanl will ba mnde as oulline0 above
?ate nl Accnpterwo _ L -
A lale lee ol 5% wfll ha imposetl on any balance nol paid within Irve (5) Eays ol wh¢n
tlue Owner shall pay all Coniractor's collecLOn cosls, mclutling aVOrney's fee's, d Owner
nninulls on oermenl.
slannture('11W, kA\l
[V(ryl???? 1?pc?7 %\?
S?aneNre_.
i??
Li st of Owner/Occupants fo r CVCHA
/ February 5, 2001
11-977A Gold Trail Marion & Joseph K alata (H) 405-6980
/19776 Gold Trail Linda Crandall (H) 688-2401
/1979A Gold Trail M. Mary Whetston (H) 454-2107
J9796 Gold Trail Jennifer Smith (H) 994-8224
0 1981A Gold Trail Daisy Pitkin (H) 406-9763
/19816 Gold Trail Dehra Matei (H) 406-9209
/1983A Gold Trail Patricia Rosentha l (H) 686-7567
? 983B Gold Trail Charles Koch (H) 688-8122
/3861A Gold Point Sue Nesheim (H) 994-9668
J38616 Gold Point Kevin Steenhoek (H) 994-1330
3863A Gold Point Jayne Steuland (H) 688-8256
38636 Gold Point Barb Renn (H)_
' ?SSOC"97r.PS?
3865A Gold Point Qale & Jane Kuhl (H) 454-4454
'J39656 Goid Point Jennifer Nord (H) 681-1306
J3867A Gold Point Fred & Lorene Davis (H) 405-6615
)3867B Gold Point Therese Blanchard (H) 686-0777
` 3869 Gold Point Shane Martin )E°`- (H) 905-0424
/3871 Gotd Point Jackie Stafford (occupant)
Juel & Marsyl Casperson (own er)
11101 France Ave South
Bloomington, MN 55431
(H) 612 888-3612
3873 Gold Point Leann Binde.
?? t`', ?' ??°?'uZ
?/? a6ed `Wd95:Z 10-L-Jey4 :5408468Z56 !1N30(113 1SNId :A0 }Uag
?-.---.- ---i
i ?aU<?NfceL? ?
? Permit# 2? 7?4 3 C? 1
? PermitFee. :5V
I 2? ?
? Date Received: ? ??? ?
? Staff?
L -- ---------?
2008 MECHANICAL PERMIT APPLICATION
Date: SiteAddress: Cnol,? ?n1 Y,\
Tenant:
Suite #:
Name:\JctVhleq -ROhn?eSS Phone(-013- 3(-%, q9C1k,
RESIDENT/OWNER
Address / City / Zip.
Li
#
N
kC
-S
=
CONTRACTOR cense
:
ame:
0y.s ;
tv
Lp..c _
Address: r? 4 ;( G?. WA? ?w? ? iF.J
?T
City: ?n 1--1 ?kur State:y?`1hV Zip: C1y1
eL Snr
l(
&J
P
? K
' 4'?7
S"
..
'
-
hone
J Contact Person:
-
v
TYPE OF WORK _ New placement Additional _ Alteration _ Demolition
Description of work: F-4' n{ 6.c? }j a co
?=NOTE: Both, roof, mounted and g[ou,'nd mburife8 mechanica! equipmenf is required'fo rr
be scree»ed'by City Code' Please contact-Yfie Me'chanica! Inspector?q? oae of fhe
-Plannersfncmforittatiori"on ermittedscreen'm methods.?
RESIDENTIAL COMMERClAL
PERMIT TYPE 1_? Interior Improvement
New Construction
Flmace _
_
Air Conditioner _ Install Piping _ Processed
Air Exchanger _ Gas _ Eutenor HVAC Unit
Heat Pump _ Under / Above ground Tank (_ Install /_ Remove)
_ " When installinglremoving tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESlDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 FII'e fep8lf (replace burned out appliances, ductwork, etc.) (inCludOS $.50 State SUfChaTge)
$ TOTALFEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $ 50.
- If Permit Fee is >$1,000, surcharge increases by $.50 for each =$ State Surcharge
$1,000 PermR Fee (i e. a$1,001-$2,000 Permit Fee requires a$1.00 surcharge)
$ TOTALFEE
I hereby acknowledge that this infortna4on is complete and acwrate; lhat the work will be in conformance wdh the ordinances and codes of the City of Eagan; that
I undersWnd this is not a pertnit, but only an application for a permit, and work is not to start without a pertnit, that the work will be in accordance with the approved
plan in the case of work which requires a review and approval of plans. /
X 1 w,ckll UCS 1Y?n\. NY? ,A
ApplicanYs Printed Name Applicant's Signatu
FOR
, .... ? ' .:" ? j l :'° i ReAeWed By D2te
Reqwred In'pecbons.' ? Under Ground???') ?is Rpugh In AU 7est Gas ServiceTest In fioor Heat ? i_Pmal
1 Exterior HVAC:Screenin9 InsPechon ?'
This request void °! z-O t' I I $i 6 6?! ee u. Rj,?`C-F-I,, 31(o Z_Z
18 monihsr-m
Date o this FequBSt d-? .l 1 F,?No. T39048
I, as Licensed Electncal Contract r? Owner, do hereby request inspection of the above electri-
cal wmng installed at:
F_A
Street Address or Route No. 7 Cl?? ?rp???o?„ City
Section Township Range County
Which is occupied by ?_ d, 1 ????Z c- ?,
Is a roughin inspection required on this job? No ?
PowerSupplier o1,1210 tl
Electrical Contractor
. (COmpany Name)
Mailing Address _ x L? V , ?!.,
Au[horized
o,
Yes ? Ready Now ? Will Call ?
ress `?-Ttr?".s,??a.?
. C Contractor s Lic?
.?_ Ma, -z, 1 -1
No.
(tlettrl Oentractor or owner Making 7nis Installaflon)
'U?L".1?? ? ? D QOo p? This inspectian request will not 6e accepted 6y the
Stste Board unless proper inspection fee is enclosed.
' minnesoia awXe ooara ar nec[ricicy
Griggs Midway Bldg. - Room N191
1827 University Ave.. St. Paul, Minn. 55109 - Phone 297-2111
hTEQUEST FOR ELECTRICAL INSPECTION
CHtiCK BELOW WOAK COVERED BY THIS REQUEST
EB-00001-02
3L (Q Z2
T 39048
Type ot Bui.kiing ew Add. Rep. Check Appliances Wired For Check Fquipment Wired Foc
Home ? ? ? Range ? Temporacy Wiring ?
Duplex ? ? ? Water Heater ? Lighting Futures ?
Apt. Hldg. ? ? ? Dryer ? Eiecttic Hea[ing ?
Commercial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bidg. ? ? 11 A'v Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Othec
?
?
? p
Hehe?s? p
Heheers?
COMPUTE INSPECTION FEE BELOW
Sewice Entrance Size: # Fee Feede Subfeedets: e Fee Crtcuits: # Fee
0 ta 100 Am s. Q o30Ain eres 0 to 30 Am eres I
101 ro 200 Amps. 11 4b 100 4lmpexes OO 31 to 100 Am eres
Above 200 Amps ? ?,' ve 190? Amps. Above 100 Am s.
Transformers einbteControlCiic. Partial or other fee
Signs Special Ins ec[ion Minimum fee $5.
Remarks `l 7'OTAL FEE •,J?
I, the Electrical lnspector, hereby cerY [ th 6 irispec ' n has been mad
(Rough-in) Date = Y
(Final) _ ?? Da[e
This request void
18 months from
Use BLUE or BLACK Ink
Date:
City of Ea�ali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
��3 Site Address: l -b (Obi a I bjr+1 Eurn 1v ' 'unit #:
T 9 jS,dt Irll��! ,p
Name: tC,p�lVtiW28S f �"�eSI6R.►n�i'
Address / City / Zip: R 115 Go )c I' 0) rif-
Applicant is: Owner Contractor
Description of work: L�. \
Construction Cost:' cs� / '°D Multi -Family Building: (Yes / No X, )
J
Phone: % J �' ��� ��► a l
,an r11 5-5 as
Company: 1 x'1.1 K'e
r d a F act e41.- G a ra.y-
`E3Y�6G o tact: l' I Y'X
nveck
Address: p . Q I -goy
State:
Zip: s Sq Lf L) Phone:
License #: P r Q 0 3
City: KaS S 6 n
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x Hi 1/4- 142,
Applicant's Printed Name
x
nt A ppli 's
Signature
Page 1 of 3
CEIVED
JUL 15 2020
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinginspections aAcityofeagan.com
For Office Use ,,
Permit #: 1024 f to
Permit Fee: Q9I dQ • i r
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / - 2-0 Site Address: 31-13 C.c. td P. % . 4 4 6... es., MN , S'Si 3.1. Unit #: 3 s7 3
1
Resident!:
Owner
Name: Ps,,etvi.e ZZ o "Ndir,S Phone: 4. i 2 - 7c. t. • 4'tZ2
Ronk'
Address / City / Zip: 31113 Codt4Tree-A, B.�pe.e1 , tJ, SS12'_
Applicant is: Owner AContractor J
Type of Work
t sipag,4,. Iui ,,,d.M,,,o.eS k 2. Deem t., e.a1-1.0A. a er 4
•/ Description of work: Q.tw v s5:
r+. it 1 t tte k1 Mti fi .a.e- 44%x) v t no 1 S?$ i,
p
Construction Cost I�00®� Multi -Family Building: (Yes / No )( )
Contractor
Company: 1347 ezt+er7oe-S Contact: Tw61.4. 2,e4-2toSF.
Address: 5INS X'fa si'4+.S4 4 ` Sty ¥ Sra a 74^a l City: 11 as pi er.. PI atq
State: i%N Zip: SS3S9 Phone: -7k3+- Zito - Email:J Oil^ �Q be reex}er:ors.Cate
3s7 2. J
License #: BC-32447.1`l Lead Certificate #:
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of the information may be
classified as nonpublic if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the Clty's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
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.00pherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plan
X 313L pr
oPC-
Applicant's Printed Name