3676 Greensboro Dr
Use BLUE or BLACK Ink
~-----------------I
I for Office Use I
u ~City of Eajan j Permit
I Permit Fee: O' OV 1
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site dress: 7b e,-, r-e2 n ~UY G' P c
Tenant: r
oV, 4&_ Suite
D6f I
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: (Ajenl-4
ov
Construction Cost: 4 Multi-Family Building: (Yes / No )
1/17) L"
CONTRACTOR Name: I l-e S I - 4 License
Address: 76 City: 5-` ,
State: Zip: Phone:
Contact: 31~e Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
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 ans.
Vex
J
Applicant's Printed Name Applicant's ' nature
r Page 1 of 3
CITY OF EAGAN
? --' ? 3830,"Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454•8100
BUILDING PERMIT Receipt# ??,,.L.c:t??+.. •
To be used for lir .#WLj(;A?. Est. Value 470, C?W Date OC10BER 13 ,19 r??•
SiteAddress 36% GREF:NSiY:Sk;? qR
Lot '• Block ? Sec/Sub. Gg•?ENSW_r'? 21ND
Parcel No.
OFFICE USE ONLY
On Site Sewage Occupancy $"9 U"1 ?
MwCC system x Zoning
On Site Well (Actual) Const
City Water x (Allowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
¢ rvan
; Add
0 City
a
.,Zo
ou
V?
. ?
Name SAM
City
Name
Address
City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State ot
Minnesota 5tatutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: __??'°• ?'r? S'?? ?????'T???Xn?
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
APPROVAL FEES
•` `14.0Q :
Engr./Assess. Permit ')5'00 ?
Planner
Council Surcharge
Plan Review 227.
? ?
Bldg. Off. SAG City
z?•00 ?
Variance SAC, MWCC
S?•? ?
WaterConn.
WaterMeter 67•00
Road Unit 32300
204•00
Treatment P1
Parks
?
,
TOTAL
.
?, .5 12
.00
Permit No. Permit Holder Date Tslsphone it
1510hbing ?'' L y?J , ?. ?P-? ??/S
Electric -TiJ 4 00->?'14' 6 e.?. ??15 e ys.v?.
Softener
Inspection Data Insp. Comments
Footings I ;
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul. 1 5
Fireplace
Final Htg.
Final Plbg.
Bidg. Final ??p U
Cert Occ.
Temp. LP
Deck Ftg.
DeCk Final
We11
Pr. Disp.
CONTRACT PRICE
Site Address
Lot ` Block
? Name
? Addre:
c City _
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KMOB RQAD, EAGAN, MN 55122
PHONE: 454-8100
PERMIT #
RECEIPT #
DATE:
BLDG. TYPE
' Sec/Sub Res.
1 F,- Mult
,
Comm.
o?,,,..,, ? ? ? : ^ - r - ? , cy , Other
WORK DESCRIPTtON
New
Add-on
Repair
?
Name FEES
RES
HVAC 0
100 M BTU
-$24
00
.
- .
c Address ADDITIONAL 50 M BTU - 6.00
"
? (RES
HVAC INCLUDES A/C ON NEW
h O C?tY Phone
?--
`-? .
E CONSTRUCTION)
1 PER PERMIT)
GAS OUTLETS
MINIMUM
- 1
50
EA
-
( . .
? TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU ^%`°-?• =G APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU ? TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond.
-^?
M BTU $?
?
MINIMUM COMMERCIAL FEE
- 20.00
STATE SURCHARGE PER PERMIT - .50
? Vent CFM R (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # $ BEYOND $1,000)
Other
FEE ?r? • ?'
;? ??, ?'7 i ? ?, ' ;?;?n l ? ?
' . , l - ?. .. ` -?
S/C: • ?
SIGNATURE OF PERMITTEE . Y
TOTAL•
FOR: CITY OF EAGAN
PERMIT #
. TYPE ; WORK DESCRIPTION
New
Name
? Name
3 Addre
0 Ciry =
PLUMBING PERMIT RECEIPT # _
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: "
PHONE: 454-8100
Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
EAGAN
Mult. Add-on
Comm. Repair .
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO FIXTURES TOTAL .
Water Closet - $3.00 $
Bath Tubs - S100 ?
Lavatory - $3.00 -
Shower - $3.00
/ Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
' Floor Drains - $1.50 ZWater Heater - $1 50
Whirlpool - 53.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
---,_Private Disp. - $10.00
_=?__Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL:
01-3210 Bidg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
61-3446 SAC/Adm.
01-2155 Surcharge
75?3860 Road Unit
2U-2275 SAC
20-3865 Water Conn.
24-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
TOTAL
CITY OF EAGAN
3830 Pitot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ..,
PHONE: 454•8100 - a
BUILDING PERMIT Receipt# =..?•, ? :?':'?'?:'=' ',f ?''
To be used for SF DRG,' '_AK Est. Value $70*0W Date ,"", %'BLR 13 ,19 A `'
Site Address 3676 Gm+`FyA03K1 pt
Lot 3 Block S Sec/Sub. u-$N81l4R0 211D
Parcel No
z Name .f08 liI=R C0NSTRlfb'TIt?:i
; Address 11133 C'?D4R AVE 3
o City `'1?':-LPhone 434-10U1
a IVkme SA?
o
ou Address
? Cit)l; Phone
a
W Name _
= Address
t7
W CitY-
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable 5tate of
Minnesota Statutes and Citpot Eagan Ordinances.
5ignature of Permittee
A euilding Permit is issued to:_-?i?="AWXZ'' CONL-)`i'i?UCT'ION
op the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
BuildingOfficial __.__
OFFIC E USE ONLY '
OnSlteSewage Occupancy F'r'3 %"I'
MWCC Syatem X Zoning
i
k-1
On Site Weil (Actual) Const V-F?
City Water x (Allowable) V'01
PRV Required # of Stories
Booster Pump Length SQ ,
Depth 37'
,
S.F. Total
Footprint S.F. ,
APPROYALS FEES
?
4i4'00
Engr./Assess. Permit
" 5'W
Planner Surcharge ?
Council Plan Review 21 7• 1`O ?
Bidg. Otf. SAC, City 1cll?•00 ?
Variance SAC.MWCC 5 51D•?
Water Conn. co50 •
water Meter 67.
? ?
Road Unit 325•? ?
Treatment P1 204•00 .j
Parks ?
TOTAL
?
2' S 12. 00
CITY OF EAGAJV
3830 Pitoi Knob Roa§
P.O. Box 21199
I Eagan, MN 55121
Conn. Chg:
Permit No: 'Q Date
Meter No: Size:
Reader No:
?
ClTY OF EAGAN Permit No: I 116
?07i(?
3830 Pilot Knob Road B/P No: '
P.O. Box 21199
Eagan, MN 55121
Owner. ? -1llex
Site Address: ' _ ' • c- rreen
L3 B S
MWCC: r r 0. ??0"
City Chg: 100. 0Qpd
Acct. Dep: ZS.OQpd
Permit Fee: 00°-'"
Surcharge: ? .-
No. of Units:
Date:
Date:
Date:
IZ
I agree to comply wFth the City of Eagan
Ordinances.
Bq
SEWER SERVICE PERMIT
=CITIIO): EAGAN PermitNo: t0 024 3830 PilQt Knob Road, Meter No: r S- date: `?- Z Z"'- ?
P.O. Box 21199 Size: aCx
Eagan, MN 55121 Reader No: lo?
Dale: 107 - f- j?e_
baro I
Conn. Chg:
Acct. Dep:
Permit Fee:
5urcharge: s
fr. Plant -?
uleter
wisc.: ' • t?
Zoning: 4
No. of Unils:
1 agree to comply with 1he Clty ol Eagan
Ordinances.
By ''
WATER SERVICE PERMIT
C31TY OF EAGAN- Permit No: 11166
..- .-.+
5830 Pilot Knob Road _ B/P N o: =:$&,- - Date: 1 ?-2I-88
P.O. Box 21180 Date:
Eagan, MN 55121
Owner._ ine wrf y 7
:. Site qddress: 3576 Green
. Plumber: plymouth Plvmbin?
M WCC:
City Chg: 100.00
Acct Dep: 15. 00 d
Zoning•
No. of Units:
. Permit Fee: _ 1 C. OOnd I agree to comply wifh t?re City a Eagan
? Surcharge: 5 Ordlnartces.
C nnisc.: --
gy i:
SE1NER SERYICE PER ?
MIT
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
/?V / ? 3830 PILOT KNOB RD - 55122 170,00
651-681-4675
IewConsWCfionReaulremenls RemadeVRaoairReauirements l al?rC{ y?J ? 1
3 registerad sile surveys showing sq, ft, of IoC sq. fl. of house; and all roofed areas • 2 copies o( plan ?
(20% maximum lol coverage allowed) . 1 set of Energy Calculations for heated additlons
2 copies of plan showing beam & window sizes; poured found design, efc.) • 1 site survey for extenor addifions d decks
1 sef of Energy Calculafions . Indicate'rf home served by septic syslem for additians
3 copies of Tree PreservaUon Plan'rf lot platted after 717/93
Rim Joist DetaY Options seledion sheet (hidgs wilh 3 or less units)
)ATE
JOB SITE ADDRESS -3&76 G/'-f?S?
F MULTI-FAMILY BUILDING, HOW MANY UNITS?
'ROPERTY OWNER C??kvc Con L.2(
'YPE OF WORK
4PPLICANT r??-2v' t C_.
%DDRESS 7W-2
'AGER #
1 2 3
(/v? d 4?^ ZIPCODE
CELL PHONE # I51-271 Y74-10 FAX #?L/--73o- 0 2-Oy
NEW 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
Plumbtng Conhactor: _
Plumbing Systcm Includes:
Mechanical Conhactor:
Mechanical System Includes:
Sewer/Water Contractor.
FIREPLACE(S) _0
PHONE #
Phone #
kII above information must be submitted prior to processing of application.
Tee: $90.00
Fee: $70.00
hereby acknowledge that I have read this application, state that the information is correct, cAii"-9RFQ48:=
iII applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applicanf
;ertificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Watcr Soflener
_ Water Heaier
No. of'Batlis
. \
Phone
Lawn Spruikler
_ No. of R.I. Baths
Phone #
_ Air Condilioning
Heat Recovery 5ystem
VALUATION
D/'/v--__
Updated 1101
OFFICE USE ONLY
- I ,
] 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
] 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
] 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
7 04 02-plex ? 10 08-plex X 18 Deck ? 23 Porch (screened)
7 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
] 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
X 31 New
] 32 Addition
] 33 Alteration
] 34 Replacement
? 30 Accessory Bldg
? 31 6ct. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg only) - Give PCA handout to applicant
? Z
0--
/aluation q60
- Occupancy
:ensus Code Zoning
iAC Units o ti Stories
dbr. of Units Sq. Ft.
dbr. of Bldgs Length
ype of Const V? Width
-V/ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
_ Drain Tile
Roof Ice & Water Final
_ Frannng- -
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
2 3
REQUIRED INSPECTIONS
FinaVC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By l J[-dYIC/J? , Building Inspector
3ase Fee
iurcharge
?lan Review
dC/ES SAC
;ity SAC
Nater Supply & Storage
i&W Permit & Surcharge
'reatment Plant
1umbing Permit
Aechanical Permit
.icense Search
;opies
)ther
fotal
, REQUEST FOR ELECTRICAL INSPECTION
?p^ _^ ? See insVUdions for completing ihis brm on eack o1 yellow mpy.
'? - "X" Befow Work Covered by This Request
ee-ooooi-w
6 3 34
ew Add Rep. TypeofBuilding AppliancesWired EquipmentWired
me Range Temporary Service
plex
Z Water Heater ElecMc Heating
Apt. 8uilding Oryer Other (Specify)
Comm./Industrial Furnace
Farm ' Air Conditioner -
Other (spacily) Contraclor's Femarks:
Compute Inspection Fee Below:
# Other Fee # 5erviceEntrancesize Fee # Circuits/Feeders Fee
Swimming Pool ? 0 to 200 Amps ? 0 to 100 Amps 3 g
Trans(ormers Above 200 _ Amps Above 700 _ Amps
Signs Inspectorg Use Ony: TOTAL
Irrigation Booms f?s sd
Special Inspection
AlarmlCommunication " f?-
?
Other Fee J
4
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. F?nal
OFFICE USE ONLV '• ?-??,.±? J? ?.
vC..e.?.
This repuest vdtl 18 months fiom
.:
Pequest Dalc Fire No . Raugh-in Inspection I Required7 ? Ready Now Ilill5vi
??or
?Ves ?No hen Ready
IP(licensed contractor ? owner hereby request inspection of above alectrical work at:
Jab Atldress (Street, B. or Rou1e NoJ
? Cily
E
3C9 7(e (;+-eenb 60.0
?? u-e ay an
Nama or No. Raige No. Counry
777 r Da1C.4q
Occupant(PHINr)
ozoe /W. //? Crn?? Phonej+o.
Y3l -?OO/
Power $upplier1
?
G Atltlress
4
(e
try
n., FQnMr/1
Eleclrical Contrnaaor (Comp/e/ny Name)
r`e?ec?ii,c ContractoB License No.
Mailing Atltlress (ConVat[or or Owner ^Makirg Instellation)
/YOSS C?-r.n? `11..! ?
`
?,F,.?2c ?vrnsv???•p ?'S3?7'
Au[ho?ixetl 5' na (Contredor/O ?allation) Ptwne Number
??
MINNESOTA STATE BONHD OF ELE6pg1CIiY THIS INSPECTION REQUEST WILL NOT
Gngge-Midway 61Ag. - Room frfl3?' BE ACCEPTEO BV THE STATE BOAFD
1821 Unlveniry Ave., St. Peul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phom (612) 862-0800 ENCLOSED.
' CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 557 27 N? 15707
PH ON E: 454-8100
BUILDING PERMIT Receipt# Ducuu
To be used for SF DWG/GAR Est. Value $70, 000 Date OCTOBER 13 ,19 88
Site Address 3676 GREENSBORO DR
Lot 3 Block 5 Sec/Sub. GREENSBORO 2ND
Parcel No.
a Name JOE MILLER CONSTRUCTION
; Address 18133 CEDAR AVE S
° City FARMINGTON phone 431-2001
a Name_
?a Address
? City_
•¢
W W Name_
Fw
i ? Address
aw City_
I hereby acknowletl9e ihat I have reatl ihis application antl slate that ihe
infotmation is correcl and agree to comply with all applicable State of
Minnesota Statu[es and Cit Ea Ordi nces.
Si9natureofPermittee _1??? -'-
A Building Permit is issued to _JQE .MII,I,ER_C_QNSTRILCTIQN
on Ihe ezpress contli[ion that all work shall be done in accordance with all
applicable State Of Mi?nn-eso?ta?•?StatUles and City of Eagan OrdinanCes.
Building Official_,/I 1 ???
?l? a-(
OFFICE USE ONLY
On Site Sewage _ Occupancy R-3 M-1
MWCC Syslem X Zoning R-1
On Site Well _ (ACtuap Const V-N
Cirywater X (Allowable) V-N
PRV Required _ n of Stories
BoosterPump _ Length 50'
Depth 371
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Pefmit 454.00
Planner Surcharge 3$.00
Council PlanReview 227-00
BIdg.Olf. SAC, City 100.00
Variance SAC, MWCC $50.00
Water Conn. 550_00
Water Meter 67.00
ROadUnit 395_00
Treatment P1 204.00
Parks
TOTAL 2,512.00
2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 <L4 -Y3?C)?
Telephone # 651-675-5675 FAX # 651-675-5694 yVIA" O?
NevrConsWCtionReauirements RemodeVReoairReouirements
3 registered site suneys showing sq. it of lot, sq. R of house; and &H roofed areas 2 copies of plan
(20% maximum lol coverage albwed) 1 set of Energy Calculations for heated addNOns
2 copies of plan sMwmg beam & window slzes; poured found design, etc. 1 site survey for additions & deda ?aeye?i? u ?
i set of Eneigy Calculations Addffion - intlkate if on-sfte septic system
3 copies of T2e Preservation Pian H bt platted aRer 711193
Rim Joist DetaJ Options selection sheet (bidgs wifh 3 w less units
?
Date Z+ / C)q- , ???, bo1?o bR . Construction Cos[ ?? f? ?? ?
Site Address . 3c- -7-, - ??.? UnitlSte #
Description of Work DTI pti '
Slo//nc}
Multi-Family Bldg _ YK-IV Fireplace(s) _ 0
?i ?1 _ 2
Property Owner 0, ?v cs--,,1 Telephone # ( )
Contractor
Address City lF--kit? Ir?U-E-,L-
State iM.`j Zip S502A Telephone #(6 S() 94?, 3-3 5-1 cl-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - M?esota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
• ResidenUal Ventilatlon Category 1 Worksheet • New Energy Code Worksheet
(J submission lype) Submitted Submitted
• Energy Envelope Calcula6ons Submitted
Have you previously constructed a building in Eagan with a similar plan?
tee applies.
Licensed Plumber
Mechanical Contractor
Sewer/water Contractor
o ? ? ? T m
JUL 2 6 2004
B
Telephone #( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
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 plicant's Signature
_ Y _ N If so, 25% plan review
Telephone #(
Telephone #(
OFFICE USE ONLY
Sub Types ' '
? 01 Foundation ? 07 05-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg
E3 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. 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 O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
?,` 32 Addition ? 36 Move Building ? 42 Demolish Foundafion ? 45 Fire Repair
,
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 2 Occupancy MCES System
Census Code L4 Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ? Width
_ Footings (new bldg)
_ Footings (deck)
? Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
? Fireplace Y R.I. -X Air Test v Final
? Insulation ??
REQUIRED INSPECTIONS
Final/C.O.
? FinaVNo C.O.
_ Plumbing
_ HVAC
Other
_ Pool Ftgs _ Air/Gas Tesu Final
_ Siding _ Stucco _ Stone _ Brick
W indows
_ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
I q 4
MA,fw iZ / o
xr?-
Xs'/= l// 3y`a
/ y ;4-v
Li a-? . C) ("
Pennit Numbar
ItEScktck Compliance CertiCuate cnedcea syioare
2000 IECC
RESeheatSoRwam Vecsim 3.5 ReleaSO 1
Dsta filmeme, C:Uhmgam F1ks\CbacYlR2Scheck1CQNKE[.icY
TITLE: CANKEL
CCfY: Darom
STATE: Manewia
F[DD: 7491
CONSTRUGTION T"1'PE: Single Famlty
DATE: 08l02/04
DATE OF PI.AN$: 07-22-04
COMPLIANC6: Passes
Meximum UA = 328
Yotir TTome UA = 326
0.6% Better Tfien Cade (UA)
Gross Glaaiog
Area or Cavity Cait. or poor
Perimeter R-Valua R-Value U-Feaor UA
Ceiling L• Plst Ceiliog or Scissor Ttuss 1174 44.0 0.0 32
Wntl 1: Wood F7mmq ] 6" o.c. ] 107 19.0 0.0 53
Wmdow 1: VmylFreme:DoublePano 185 0.440 Bl
Door I: Crlacs 40 0.142 6
wall 2: Wood Framq 16" o.c. 615 19.0 0.0 31
Wiadow 2: V'vryl Fimu:bauble Pane 104 0.440 46
Wa113: Masomy Bbck wtth Irttegrel Tnailaeon:w/ Additine[ Interia lnsuterion
430 11.0 0.0 38
Floar i: AIl-Wood 1'oisUTms:Ova Unconditioned Space 1174 0.033 39
COMPLIANC£ STATEMENT: 7'he propoyed builcling desigo descsibed hae is ooreistent with the building plans, specificetions,
md aher celcakations submitced wiH, ilre perntit applicadon. Tix proposed building haa bcen designad to mcet tho 20001ECC
requiremenca in TL}'sS checkVasion 3.3 Retease 1(fornurly MfiCchecio and to comply with ehe maadetary requiremems listed in the
REScheatlnspecrim Cb=U-W'
suaaermes??"
I d 86tr0 dN 3111A3Htll O8f1 WdEMl 400Z 'Z 9ntl
Tablel: AfisoAvuilwodatlm 7Aklbnaufor ChaehnogHotWaFVPtpft
Luuletion Thiclmess in fnches bY Pi Ge Siaes
Heated Waw Non-(,'hca latipz Rwam C'vxvladntc Maims md Ruoouu
Tempenadwe( F) Up to 1" Ua to 1.25" LS" w 2.0" Over 2'•
»atso os 1.0 ,s 2.0
140-160 0.5 0.5 LO 1.5
100-130 0.5 0.5 0.5 1.0
rnelez, hfininrumb?salaaonrArcbruajorAVacPlpu.
Fiuid Temp. Insulatiaa'TMkk^^Qa in loches bv Pive Sizes
P',IARZ Syscem I'vnes Rmnge(F) z-Runows t^ aod i.eu i.zs° w 2" 2.5^ ro a"
Eleatiag Systems
I.owPressaelCempaanue 201•250 1.0 1.5 1.3 7.0
I.ow Temperamrc 120-200 0.5 1.0 1.0 1.5
Steam Condraeate (for feed water) Any 1.0 1.0 1.3 2.0
Cooliog Syetema
ChiOed Water, Refirigeran; 40.55 0.5 0.5 0.75 1.0
and Brmr Helow 40 1.0 1.0 1.5 13
IVO7ES TO FIELD (BuildinB Depammem ilse OnIY)
r *a asroloN 3?11n3Hai 390 waro:ai Vaoa t Rnr
titi-Ibk'
rRI'LAND CO. SITE PLAN FOR:
SURVtYING
SERVICES JOSEPH MILLER CONST
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55126
LEGAL DESCRIPTION; LOT 3,BLOCK 51 GREENSBORO 2ND
ACCORDING 0 T RECORDED PLAT
THEREOF COUNTY, MINNESOTA
896„IB
g `? esew»
Fz0 v '??c' `3°`
D,\30 AO
? soa,oN?
G 60
\?,? ,?v. oc+ ?R4 1,5
?om
? r ---
`f, 0\\?? -/ w 903.95.,,,,?
907re1 GARAGE
a ?
3 ? I N ? -
904.63?
qp HOUSE
L'0 T
a_l ? RS?T_ ? ' 'y6 . . .II 4
I
905.29 9(a. 5
/ LO
.45
? I .
a_`j I 2b W
L I
EAr- ^^i
??? ?
? ;
?o
BY Vrc-rs %?i - 6 OD \ r
BW?,...._ .,..????.,..., uLPT.
? Scole:I"e30'. .. . 'I , ZC3//?? .,.-? ...:,_
F'
916.84 x\
LE(iEND / \SpL/T ENTRY
o DENOTES IRO MN ONUMENT IN?RT ELEVATION AT SERVICE EXTENSION=
* DENOTES WOOD HUB SET PROPOSED GARAGE FLOOR ELEVATION = 905.5
PROPOSED FIRST FLOOR ELEVRTION = o. o
DENOTES EXISTINfi SPOT PROPOSEDBASEMENT FLOOR - d
ELE VATION ELE VATI OM
OENOTES PROPOSED SPOT
LEVON
DENOTES DRAINAGE ID RECTION NOTE . VERIFY ALL FLOOR HEIGMTS WITH
FINAL HOUSE PLANS .
l hersbp eertlfy thaf tAis survsyg pian or
raport wos prepared by me or under my
direct supervision ond fhat I am a duly
Repistered Land Surveyor undor the
Laws oi ths Stote of Minnesota.
Bradley J. Swens , Mn. ReQ. No. 18233
Date : ?O-fe -AR
tt8-1b24
TRI'LAND CO. gITE PLAN FOR:
SS?YINS
ER ICE JOSEPH MILLER CONST
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55126
LEGAL DESCRIPTION; LOT 3,BLOCK 5, GREENSBORO 2ND
ACCORDING 0 T RECORDED PLAT
KoVk
COUNTY,MINNESOTA
THEREOF
896,18
? `? 896s77
?W ?? ??
D`??'? '
/ ? ,.
,+ ??$QSe05
Lo e
c I 5
Epg01 i ?
? ? \a
907.e1 ? / ? ZA \
?904.63
'L 9PZO3
er?bZ` 6 HP?'?g6
' ?..
C"
??,?9 o LOT
9 ? 3
?ti ti
a
L
?
? Scale:l??=30?.
LEOEND
o DENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE OIRECTION
l henb?r certify that tAis survsy,plan or
rsport was prapared by me or under my
direct suparvislan and that I am a duly
Replstersd Land Surveyor undK the
Laws of tAe State ot Minnesoto.
/
I
? I
1/ 2'
1 I.
? I
?
?
:.?..'.. ..
I ? I
o ?---
1 I GARAGE
N ?
? MWSE
\2? ? L_Ci i
4
??..L _._..,..
... . . . .... ... . ??:;_-?:?,
/ \ SpL IT ENTRY
WVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION J?
PROPOSED FIRST FLOOR ELEVATION = d•o
PROPOSED BASEMENT FLOOR - a
ELEVATIOM
NOTE: VERIFY ALL FLOOR MEIGHTS WITH
FINAL HOUSE PLANS ?
a
Bradlsy J. Srvens , Mn. Rep. No. 19235
Date ? 10-fe -w
s-u RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
681-681-4675
NewConsVuctlon HeautremaMs
• 3 registereA sile surveys showing sq. fl. of lot, sq. it. ot twuse; arM ?Ii roofed areas
(200% ma)dmum bt coverege albwed)
• 2 copies of plan sMwlng beam & winAOw sizes; poured fourM tlesign, etc.)
• lsetofEnergyCakulatbns
• 3 copies of Tree Preservation Plan tl bt platletl atter 711/93
• Rim,bist Detail Optbns seleclion shaet (bidgs wib) 3 or less unh)
DATE
SIiE ADDRESS 3 (o 76 V xe? Sir)yav
TYPE OF
APPLICANT
MULTI-FAMILY BLDG Y N
w-s FIREPLACE(S) _ 0_ 1_ 2
.iL, 4??vxa,?e s-
STREET ADDRESS /t 99 ?f Gl'IY &2-"P v CITY A?"? ?1e STATE A' ZIP 5??3 7
1 ' FAX #q_?p `gp?? 'qoll
TELEPHONE CELL PHONE # Ia ? 70-N/2
PROPERN OWNER iELEPHONE #
------------------------------- ------------------------------ --------------------- ------------
COMPLETE THIS SECTION FOR ••NEW- RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 D
(4 aubmisslon typa) . Residential VentilaHOn Category 1 Worksheet Submitted •
• Eneigy Envelope Calculations SubmiHed
Plumbing Conhactor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Wafer Conhacfor.
_ Air Conditioning
_ Heat Recovery System
I hereby acknowledge ihat I have read fhis application, state that the
with all appllcable State of Minnesota Statutes and City of Eagan Ord
Signafure of
OFFICE USE ONLY
AUG 13 2002
Fee: $90.00
Fee: $70.00
and agree to comply
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Water Softener
_ Water Heater
_ No. of Baths
Phone #
Lawn Sprinkler
No. of R.I. Baths
g &. 7S'
pemotleVReoelr HeauhemeMs
• 2 coples of plan
• lsetofEneryyCalculationsforheatedaddttions
• 1 sNe survey for erterior addhions & decks
. Intlicate If home served by septic system for additions
VAWATION
Phone #
Phone #
Updated 4/02
(91
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
657-681-4675
New Conetructkn RaauiremeMa
• 3 regWereG siie surveys showing sq. fl. of bt, sq, tt. ol house; antl II roofetl areas
(20% maximum bt coverage albweC)
. 2 copies of plan shaxing beam 8 window sizes; poured found design, etc.)
• 1 set ot Energy CaMulatlons
• 3 copies of Tree Presenation Plan tt bt platled atter 711/93
• Rim,bislDBtailOptlonsselectbnsheet(Oldgsw0h3orlessunils)
DATE
SITEADDRESS 3(-a 7? 62e"S Qc-XQD
NPE OF WORK ILe- F--0O
J??UO,a' O
? MULTI-FAMILY BLDG _ Y _ h
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT Z2 z-S
STREETADDRE S CITY ??,'??°STATE ?ZIPS??3?
TELEPHONE #? S CELL PHONE # ol?I,9-7 FAX #(V??
PROPERNOWNER i!? U"""`'_e ?
TELEPHONE #
-------------- ------------------ --------------------------------------- ----° °----
COMPLETE THIS SECTION FOR ••NEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINN =
(4 submission type) . Residential Ventilation Category 1 Worksheet SubmitteC • New h
FFUL Z ?
• EnargyEnvelopeCalcula6onsSubmitted O 2 2oo2
Plumbing Conhactor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Conhactor.
Mechanical system includes:
Sewer/Water Conhactor.
Phone #
Phone #
Fee: $70.00
I hereby acknowledge that I have read this application, state That the Information is correct, and agree to comply
wiih all applicable State of Minnesota Siatutes and City of Eagan 0rdinanc9s._r-_-7>
Slgnafure of Applicanf
OFFICE USE ONLY
_ Air Conditioning
_ Heat Recovery System
/ C>)_ ? . .2 J
namwuunnuun nemunnwnmu
• 2 copies of plan
• lsetofEnergyCalculatbnsforheatedadd'Abns
• 1 stte surveytor exterior a00ftbns 8 decla
• Indicate M home served by septic system for add'Aions
VALUATION
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
*A
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MFICC system
On site well
City water
PRV required _
Booster Pump _
ZNCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MOST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS 4l OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - C$ECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CObAERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, aCT 0 7 1988
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
oel To Be Used For:?{) l Valuation: 7' Date: -7??
Site Address -A/n 9cnBUZII?A • OFFICE USE ONLY
Lot `3 v Block S lOn site sewage Occupancy
Parcel/Sub
Owner
Address
City/Zip Code
Phone
Contractor .tiMPit,
Address
City/Zip Code .J ??i • ??'7j' c? /
Phone _ y,3
Arch./Engr.
Address
City/Zip Code
APPROVALS
Zoning
Actual Const
Allowable
II of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
r •
R 3 M-i
R-1
V-N
V-N
S?
37`
Engr/Assess Permit NSy,00
Planner Sureharge
F?
3510
Council Plan Review 22 ov
Bldg. Off. 1 IO/jZ SAC, City 0,00
Variance SAC, MWCC 1650,470
Water Conn $40, 00
Water Meter 6?, OJ
Road Unit Z$,oo
Treatment Pl ZoylDa
Parks
Copies
TOTAL
Phone li
VAti;lA'T ?
?
6A?A6,E
ZZ.xZ.I:: 4/62 X I'-F= (.N68
?MEI?T`
a? x v
s
__.-----
9T8 x 13= 12?i?{
?4DUSie
38xZ4= `?IZ
) N 1z-= 12
?? ., r•-? ;? ,
` ?.
.. ?._
zx ? : ly
5 X 1 g ? v??1o . .,
loz? xN9_?d3r7 z
. ?,
G5 554
88-162 ,
TRI'LAND CO. SITE PLAN FOR:
SURVEYING
SERVICES J OSEPH M ILLER CONST
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55126
LEGAL DESCRIPTION; LOT 3,BLOCK 5, GREENSBORO 2ND
ACCORDING 0 T . RECORDED PLAT
THEREOF COUNTY, MINNESOTA
996„15
-1342 e96w77
904,O? D ,? 123! . .
G \?? 64,4. ?o"V(V?
?
U13 i -' - -
CARAGE
907.e1 / 2,, I N
\ ? ---
904.63,, ID W ?
2ry ???0 '/ 2\ 5, HOUSE
<<' H•''?'? ? ppE /l.2' 1? \2? i '?
s P I L-C t
? 57so 904,11 4
?'??} f
90 5.29 gm' g
`'4`9 0? LOT
3 ?
: ;r I tih a? w
G I ?
1+?
I m\
?s OD \
? sooie: 1"=30'
LE(iEND
o DENOTES IRON MONUMENT
? DENOTES WOOD HUB SET
DENOTES EXISTIN(i SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINi4GE DIRECTION
l Mnbp certify fhat tMs survsy,plae or
report was prepored by rrK or undsr my
dirsct supervision qnd that 1 om a duly
Repistersd Land 5urveror under the
Laws of tha Stote ot Minnesoto.
.?
,I e-I dG---
/ \)Pur EN;eY
INVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAQE FLOOR ELEVATION -
PROPOSED FIRST FLOOR ELEVATION = o.o
PROPOSED BASEMEMT FLOOR = ? •
ELEVATION
NOTE ' VERIFY ALL FLOOR HEICaHTS WITH
FINAL HOUSE PLANS ?
Brodley J. Swens , Mn. Rap. No.1b235
Dote ' 10-!e -W
One or Two Famil;;
All Ot}ter
Ci`PY OF BUILDINQ llEPARTI•lEIJT N??I
kXTER"[OR ENVII,OPE AVERAGE IIU II C0I4PUTATION
(To be submitted with huilding permit application)
Dwelling Owner
Site Addresa
Cantractor lJO?;a{'? ?JW? 110N?;T-
LINEAL FEET OF h
EXPOSED VIALL
OPAQl1E WALL COt7STRUCTION: "U'f Value x Area
Date Phone
ft, ttbove grade = JRO(1J, ?jZ--
ToTAL EXPOSED VVpLL AREA SQ, FT,
Detail liUn i b zJ x SC2.-FT. TiJ,r72i ?DI ?? /??)?A)
reference "U"
x
a x
SC7,.
SQ
FT. !U?ktn= D (U)(A)
FT
I
-
"
?? . .
(4
.,4= (U)(A)
attaclied U
u
u X SR• FT, _ ?U)(A)
sheeta p
n x 3R. FT. _ (U) (A)
Un x SQ. FT. _ (U)(A)
WINDONSs "U" Vulue x Area
Halce & Type
Ii „ ll
nUlr _ ??
-x
SQ.
/????}(],
FT.?=
S?L i! ??)(A)
U x SQ. _
FT. - (U)(A)
u n npu x SQ. FT. _ (U)(A)
? _x SQ. FT. - (U) (A)
DOORSc "U" Value x Area
Italce & Type
u „
u u
TOTAL (U) (A) VpLUE$
/ C/ _
DIVIDED By TOTAL }7pLL pREp
AVERA(3E "Ulk , ?'j5-?Q? less for ,1&2 family divelli ge
?
ROOF/CEILINCis ?-J,-
TOTAL AREA: _ ?np m
--?
FT. I ? ?CO (U) (A)
FT. o'= r- ,?" (U)(A)
FT. _ (U)(A)
FT. _ (U)(A)
r'T. ? (U) (A)
Detail reference liUll 2-1f ?7 ?lY
f ro m -----------X SQ. FT. (4 0= Gi0 r (U)(A)
attached sheeta. IIUII--?------x SQ. FT. -?(U) (A)
Describe openinga uUv?--?----_x SQ. FT, _ M(A)
in roof. ,?U?? x 3Q, FT. _ (U)(A)
TOTAL (U) (A) VALUES DIVIDDD y = ` x ST7?L?-j ?(Q? ?,ft 7-OrI(ACV (?t )
A
TOTAL ROOF/CEILINQ AREA
-O -2 l(oo I
AVERA(3E ° ventilated roofa.
x SQ.
J G' ??Uu= ??F''7 --x SQ.
npn --x Sa
li„ll -- .
- x SQ,
TOTALS OCD, 7,6Q,
AVERADE l'U't
t .
,-
I? N
v ? I I w
`_A f?4'-CdhUl? ?
'?;qo,o
v?l? s
2? Z4X?v ? z2i 5?( 2 -?}-z? , o
Z'?CnX?xo = l?iS?Z = Zl?o
Z" 04X4-;cp - I7(5XZ = OE5lo
2`ZaX7)? - I?XI=
? o ?3
::;.--
3°-Sr1- , t?Z-, W/SLl -.
Z? Gi L- CF- , = -z?,o
?6 pl?T1a p? ?? 4z ? n
,
.
_
oCa- SZ
ONc, 9z,?
'r Rw`
tupu5l
llstermLning itUil valuee at Rooft Wall-
Rim# and qono. $loalt
.
ROOF/tlEILItIO
1.) Interlor Air r'ilm
2.) 51811 ayp. Bd.
3.) Ineuletioa
4.1 .
5.) Exterior Air Film
(9TILL)
!1 YALU,
0.61
.56
44, cv
.61
liull .O21 iOTAL (R)e ? 7g
. , ?.
WIILL
6.) Interior Air Film
7,) P aYP. Bd.
8.) Ineulation
9• ) bufL'/'-RITF
l0.) Itnsonite siding
11.) Exterior Air Film
R VALU
0,68
. 1i5
19•00
z.67?
.17
t94-:? TOTAL (n)n 23.01
?-
?
12.) Interior Air Y'i1m
130 Ineulation
14.) 211 Fir Riro Joiet •
15.) 9-v1LT- R'1TG
160) lfaeonite 8ldiug
17.) Exterior Air Pilm
li YALU
0.68
19•00
1.88
2. 6?
.17
"p" o I/Ko .pe]-D TaTAL (A)n Z??I?
----
FOUti
18.)
19.)
20,)
zl.)
22.)
23.)
7ATI01
Interior Air Film
?-I/ 51R?Pr?P
1211 Ooporete Bloolt
Exterior Air Film
11u11 p ??na -07b
?
.?-
A YALU
0.68 .
c??
H.
1.28
•.17
ToTn1, (n)o 13.1?.
APFLr?ATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
......................................
.
w N:7f'6: PAYAIIE7f OF FEE AT TiME OF y
; nrrLicAazoN ooFS Nor coN- :
i SfP1f11E APPRG57AL OF PII2NIIT_ .'k
r
s I[15PFX•PION OF SEwII.'R ANID/OR F7PIlIIt +
?.
a: INSTNdATION5 WII.L NOT HE SCID[II.m
x i!NPIL PF]tMIT HAS BEQJ AppROVfI1. ?
ff?itfft?tff+x?ti?k?itt?+f+xi+ff:??+?f
itV OF (zC9qC9i9
(PLEASE PRINT
1) PROPII2TY ADDRESS: ???o??o ?K-cr?5 ?iv?? ? b",
r,Fr:nr DESCRIPTION:.
Lo? Q
t B ock Sub ivision or,Tax Parcel ID
IF EXISTING STRL'CT[JRE, DATE OF ORIGINAL BUILDING PERMZT ISSC?ANCE:
Nbnt ear
PRESENT ZONING/PROPOSID USE: ,
Q.CODMERCIAL/RETAIL/OFFICE SINGI,E FAMiLY
Q INDT-ISTRIAL E] R-2 DUPLEX (3teo Units)
a INSTITUTIONAL/GOVERAP9ENT Q R-3 TOWN30L?SE (Three + Units) ( Units)
Q R-4' APARTMENT/CODIDOMINICM ( Units)
2) NAME: A?
AoDxESS: _lfl/33 Ge?44d- 4ucd
CITY, STATE, ZIP:
PHONE:
3) ' ? NAME= For City Use
Plisnbers License:
ADDRESS: Active
?
Expired
CITY, STATE, ZIP: Not recorded
PHONE: 4/7A/ MASTER LICENSE # i'?'1o`?fJ ?oS ?_
4)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
Sta?'Initiar
5) 16M
EaeQNNFCTION TO CITY SEWER [:gQb1SNECTION TO CITY WATEE2 O(YPfM
6)
***************************Ye9ti********rt*****;F/e*?k*************dr?r****?.'***YC'k***:h*eF********************k
ZYIE GOID COPY OF 'IIIE PII2NIIT WLLL BE SET7P DIl2FX,`IS,Y TO PUBI.IC WORKS M FACLLITATE METER PICK-OP. *
* PLEASE ALLAW 2FA WURI(ING DAYS FDR PROCFSSING. SOAIDONE FROM TfM CITY WILL ODN1`ACP YOL IF Tfm2E *
?
* P,RE ANY PROBI,ENLS. *
'?*?**??******?*+??**#*******+***********?****?***+*****?*******??***********?*******+************+*i
FOR CITY USE ONLY PERMIT # ISSLED
r,I 2 ?
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLDDE SL'RCHARGE)
$ L? ?'L10 $ WATER METER/COPPERHORN/OLTSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ / C`•o-? ACCOUNT DEPOSIT - SEWER
$ $ ACCOONT DEPOSIT - WATER
$ $ WAC
$ Ip S(? U O $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFZT/TRUNK WATER
S $ TER ANT SLR
RE
T
E
P
HARGE
WA A
T
M
NT
L
C
$ $ OTHER:
$ `V71'eO $ TOTAL
ss?2 / 1) . f s e-IVV
RECEIPTT- RECEIPT
DOES LTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q ROADWAY" MLST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SOBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
?--*
s?
??,.? ,•.
.
?oty of
3830 PILOi KNOB ROAD. P.O, BOX 21199
EAGAN, MINNESOiA 55121
PHONE. (612) 454-8100
Date: ?o /.3 I$8
Requested By:
D c
,?Y-7ii
i _> ct 33?i?S -37
VIC ELLISON
Special Assessment Search M?r
nHawseGAN
0.4ViD K. GUSTAfSON
PAMEIA McCRFA
1HEODORE WACHTER
C.il MemDen
nHonnns HeoGEs
Re Ciry Atlminutrolw
EUGENE VAN OVERBEKE
0ry Cleik
L3
On the attached form is the City's response to your search
request on the identified property. The information includes the
original amount of the assessments and the payoff amounts of the
assessments on the parcel. In addition, pending assessments are
included for improvement projects that have been ordered to be
installed by the City Council as they may aPfect this parcel.
The levied and pending assessments may or may not reflect the
complete aseassment obligation based upon the parcel's current
use or zoning. Certain parcels have not been assessed at the
appropriate rate per their zoning/use. The City's policy is to
review the assessment obligation of parcels at platting, replat-
ting, rezoning, waiver of platting, and prior to the issuance of
conditional and special use permits and certain building permits
and in other uni•que situations. A condition of approval requires
the parcel to assume its additional assessment obligations that
have not previously been levied for existing public improvements.
The City's Engineering Division can provide further clarification
of this policy, if you desire.
WAIVER/DISCLAIMER:
Neither the City of Eagan nor its employees guarantees the
accuracy or completeness of the information provided which was
required by the oerson or persons indicated. Nor does the City
or its employees assume any liability for the correctness
thereof. Tn consideration of receiving and using information on
the attached form and for all other consideration of any nature
whatsoever, any claim against the City or its employees rising
therefrom is hereby expressly denied. Pending assessments cannot
be paid until levied. Levied assessments can be paid to the CITY
OF EAGAN.
Very truly yours, ?
? ?- c
SPECIAL ASSESSMENTS
Attachment
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA139120
Date Issued:10/11/2016
Permit Category:ePermit
Site Address: 3676 Greensboro Dr
Lot:3 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David L Conkel
3676 Greensboro Dr
Eagan MN 55123
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163259
Date Issued:08/25/2020
Permit Category:ePermit
Site Address: 3676 Greensboro Dr
Lot:3 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-030
Use:
Description:
Sub Type:Reroof & Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic.
Valuation: 15,000.00
Fee Summary:BL - Base Fee $15K $265.50 0801.4085
Surcharge - Based on Valuation $15K $7.50 9001.2195
$273.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David L Conkel
3676 Greensboro Dr
Eagan MN 55123
Highmark Exteriors
8720 Eagle Creek Pkwy
Savage MN 55378
(952) 882-8904
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA178718
Date Issued:08/30/2022
Permit Category:ePermit
Site Address: 3676 Greensboro Dr
Lot:3 Block: 5 Addition: Greensboro 2nd
PID:10-30901-05-030
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David L & Linda M Conkel
3676 Greensboro Dr
Saint Paul MN 55123--223
(651) 285-3796
Clearwater Plumbing & Heating
19260 Mushtown Rd
Prior Lake MN 55372
(952) 440-3779
Applicant/Permitee: Signature Issued By: Signature