3683 Greensboro DrBLDG. PERMIT N0.
v4k_4?r-,?
01-3210
01-3422
01-3445
0I-3446
01-2155
17-3860
20-2275
2Q-3865
20-3868
20-3716
Bldg. Permi
Plan CYreck
Surchs/Adm.
SAC/Adm.
Surcharge
Road Unit
SAC
Water Conn.
Water Trmt.
Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
INSPEC
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
! SITE ADDRESS:
I . ?r i ?1•.t?t??.,?i ?,;.
i PERMIT SUBTYPE:
N RECORD
PERMIT TYPE:
Permit Number:
Date issued:
APPLICANT:
'I s P I 1
, .. t • 4 s,11, 1,.[111
TYPE OF WORK:
r<<r t ? fi I
414
I INSPECTION .• . .•
I
Permit No. Permit Holder Date Telephone N
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Dete Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
lsul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Pibg. Inspector- Natify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg. C
Deck Final
Well
Pr. Disp.
? . . PERMIT # ?
PLUMBING PERMIT RECEIPT # ?
. • CITY OF EAGAN ?.
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
Site A`;?ess
Lot 1 81ock
? Nan
? Add
c City
Name
1 l -
FEES
COMM/IND FEE -1% OF CONTRACT FEE
APT. BLDGS - COMM FATE 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
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO- FIXTURES TOT-PL
Water Gloset - $3A0 $
1r
Bath Tubs - $3.00 ?
Lavatory - $3.00
Shower - $3.00 -?
?-Kitchen Sink - $3.00 --S
Urinal/Bidet - $3.00
-7-Laundry Tray - $3.00
Floor Drains - $1.50 ?_Water Heater - $1.50 -Whirlpool - $3.00
TGas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=-Raugh Openings - $1.50 { `5 SIGNATURE OF
FOR CITY OF EAGAN
FEE
STATE S/C:
GRAND TOTAL•
.? L? ?
PERMIT #
; MECHANICAL PERMIT RECEIPT #
,
.
CITY OF EAGAN
--,
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: P ONE: 454-8100
Site Address '` f BLDG. TYPE WORK DESCRIPTI ON
Lot Bloc k-. Sec/Sub 'l ^' R? c_- New
Name ? Mult Add-on
Comm. ReP air
'' Other
c Ci
ty Phoire
FEES
Name RES
HVAC 0-100 M BTU -$24
00
. .
c Address < C:' ADDITIONAL 50 M BTU - 6.00
p City Phone " 7 RES. HVAC INCLUDES A/C ON NEW
C
ONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1
50 EA
.
.
?. TYPE OF WORK , •
y COMM/IND FEE - 1°.6 OF CONTRACT FEE
Forced Air M BTU ' ?
'- APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler
I M BTU MINIMUM RESiDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
I
!Air Cond. M BTU $ MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT - 20.00
-
50
?
Vent
i
i CFM (ADD $.50 S/C IF PERMIT PRICE GOES
BEY
ND $1 .
r Gas P
p
ng OWlets # ,000)
O
Other
? ?
FEE
S/C: SIGNATURE OF PERMITTEE ?
TOTAL:
? FOR: CITY OF EAGAN
CITY OF EAGAN
, 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
PHONE: 454-8100 , f ?
BUILDING PERMIT
14017
Receipt #
To be used for Est. Value Date ' 119 1
Site Address '
Lot Block SeGSub. '
Parcel No,
a Name
? Address
Ciry Phone
, o Name
? ? Addresa
? City Phone
Phone
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System _ Zoning •i
On Site Well _ Type of Const
Ciry Water _ (Actual)
(Allowable) ?
# of Stories
n
th
L
g
e
Depth `
S.F. Total
Footprint SF. -
APPROVALS FEES
.
Assessments _ Permit . ?j
__T ?
Water/Sewer _ Surcharfle
'
Police Plan Review
Fire
Engr. _ SAC, Ciry
_ SAC, MWCC
Planner _ Water Conn. '
Council _ Water Meter ?
I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unil
that the information is correct and agree to comply with all applicable APC _ Treatment P1
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee T07aL
A 8uilding Permlt is issued to: on the express condition that
all work shall be done in accordance with all appUcable State of Minnesota Statutes and City of Eagan Ordinancea
Building OHiclal
, Pa.mit No. Permit Holder Dsto Tslephona ?t
Plumbing ? "-'.?/ ?7 ? G?,??? ?
H.V.A.C.
Electric
Softener
Inspection Date Insp. Comments
Footings I ? Z
Footings II
Foundation
Framing
Roofing
Fiough Plbg. ? . _ . ?
Rough Htg.
Isul. •
Fireplace
Final Htg.
Final Plbg. ?
Cert. ?--
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
- - .. .._- _•,r"=-•- _. :e--?.: . . .. _ . __.. ,- .. - .
CITY OF EAGAN SE1NE
3830 Pqot?Cnob Road ,. . R SERVICE PERMIT
P.O. Box 24199 PERMIT NQ.:
Eagan,UN 55121
DArE:
Zoning:.: ' No. of Units: ?- ?
Owner. J4e Millez C.onst. ;
... ?
to comply wflfi the'qtpoi Eapan
ices. ?
BS+
Date of Insp.:
insp.:
Connection Charge: 5? 5 _ 00„ri
Account Deposit: 1 5 (1l1:Pd
Surcharge: ,
Misc. Charges:
'•r-
CITY OF EAGAN Permit No: 2JOW 9046 e.
3830 Pilot ICnob Road Qate:
P.O. Box 2,1199 ?er No:" Size:
Eagan, A.'" 55121 Reader No: Date:
Ownec 'I Toe t317 7 0,.
- ---s ooro orive ^- r
' Plumber, ?Z uttt °lumbjn L
Cann. Chg: 5' S . f30pc? ;
Acct Dep: 15. Oo?ri Zoning: r;l 4
? Permit Fee: 10. Qp No. of Units; 2
, Surcharge: _ . 50pc! ' *.
j Tr pl$nt 180, 00pd ---.- 1 agree to comply wlth the City of Eagan `
? Meter. Ord1nances. -
Misc.: `
sy
? WATER SERVICE PERMIT
CtTY OF EAGAN Permlt No: 2mm Date:
44-9 3830 Nilot Knob Road Meter Na 3 f % Size: 49" Kad
P.O. Soz 21199 Reader No: ? Date: q- JC"7
Eagan, MN 55121 '7-
Owner. Jae :=iller (:onst.
Site Address: 36?3 Greensboro PT'iVE: - '' ' r'rr?n^ ,•,,?-?, r7
Conn. Ghg: --- 2[?. Uupd WT Afl??? ,
Acct Dep: 15, O0p PfOr diaaina {W4,jg?Mq"jt,M ?
Permit Fee: I0.0Op(F1 FPUnnr[ rLECTPiC • GAS Etc.
Surcharge: •?? I a res to comply with the City of Eagan
Tr. Plant l,%?).00 F?rn 1?
Meter: 7 ?? `
... i?%, ? ..
WATER SERVICE PERMiT
3830 Pilot Knob Road
P.O.. Box 21199
Eaijan, MN 55121
2oning: RI
Owner. Joe P
Address:
Site Address: 3 683
Plumber. Plvinc
R_S_5:
i ag.ee to cmpry wnn me cny
orainances. Before
By
Date of Insp.:
SEWER S,ERVICE PERMIT
' PERMIT NO:: 1
DATE: 9-15-87
No. of Units: 1
r Const.
- Data
ioo.oop_,?
?ha?ge: r r Qop?;
CITY OF EAGAN N° 1 4 O 1 7
3830 Pilot Kpob Road, P.O. Box 21-199, Eagan, MN 55121 -
?/p p
BUILDING PERMIT I PHONE: 454-8100 ao,.= i.,* ? 77 a
To be used tor SF DWG/GAR
AUGUST 5
19 87
Site Address 3683 GREENSSORO DR
Lot 8 Block 3 Sec/Sub. GREENSBORO 2ND
Parcel No.
a Name JOE MILLER CONST
; Address 18133 CEDAR AVE SO
o Gity FARMINGTON phone 431-2001
Est.Value $119,000 Date
d Name SAME
Address
,
i- City Phone
¢
z
u
z
w
Name _
Address
City _
I hereby acknowled9e that I have read this application and state
thattheinformationisconectandagreetocomglywith$Ilapplicable
State W Minnesota Statu)es, and Giry of 56110n Ord'piancea
Signature of
A Builtling Permit is issued to:
all work shall be done in accoi
Building Official
with all
JOE
OFFICE USE ONLY
R3
OnSiteSewage _ Occupancy
MWCCSystam ? Zoning R1
On Site Well Type of Const v
City Water ? (Actual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
$ 560.50
qsgessments Permit --
Water/Sewer _ Surcharge ?9. 50
--
-
Police PlanReview 78U
. 2 5
-
-
-
Fire _ SAC,City i?
.
DO
Engr, SAC, MWCC 525.00
Planner WflterGOnn. 525.00
Gouncil _ WaterMeter 67.00
BIdg.Off. _ Road Unit _?L00
APC _ Treatment P1 1 RO _ 00
Variance _ Parks
? Copies
TOTAL $2•602•25
CONST on the express condition that
nnesoja tutes'arW City of Eagan Ordinances.
?
? `7?I1 / d' I
S l(?j?
a 0904
REQUEST FOR ELECTRICAL INSPECTION
a!?'"`N, ee-00001-07
1? See instmctions tor completing inis form on back of yellow ropg `? 31
Below Work Covered by This Request
ew Add Rg1 TypeotBuilding AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex water Heater Electric Heating
Apt. Building Dryer Other (Specity)
Comm./Industrial Furnace
Farm Air Canditioner
Other (speoifyJ Conlrador5 Pemarks'
Compute Inspection Fee 8elow:
# Othei Fee # ServiceEnirance5ize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 100 Amps
Transformers Above 200 _ Amps ? Above 100 _ Amps • O
SIgf15 Inspectors Use Only: TOTAL ?
Irrigation Booms ,,.Z?.@v
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 16 MONTHS.
1, the Electrical Inspector, hereby Rocqn-m oace
certify that the above inspection has
been made. Finai ?
?L?
D.I.
•-?
OFFICE USE ONLY
This requesl voitl 18 monlhs Im.
C5 6 1?? zy?l?n
-
3 7 0 9 0 4 i-Yi 6= a a="? ?a? 3tt
Raquesl Date
7??/ ? 4a
/ Fire No. RI Inspection
Requiretl9
? Yes L4?
? Reatly Now ' i I Notify Inspector
When Reatly?
I censed contractor ? owner hereby request inspection of above electrical work at:
Jo0 AOOress (Sireet. Box or Rou No.l
31,Y3 ?- Ciry
Seclion No. Township Name or No. Range No. County
OcrP?TL Pho?V-y-A-7-7
Power upplier Atltlress
-.?API &14?n
Elect I Con[racmr (Company Name) ? GonVatlm§ License No
Malling AtlOress (GOnlraclor or Owner Ma41ng InStall io
Avinor¢e Sig ture ttactoriDwner Ma' n stall3von)
? Phone Num?ar ??
MINNESOTA STATE BOARD OF ELECTPICITY THIS INSPECTION REOUEST WILL NOT
Grl9gs-MiGway Bltlg. - Noom 5-173 8E AGCEPTED 8Y THE STATE 00ARD
1821 Universlty Ave., SL Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone(614)fi42-0B00 ENCLOSED.
>f
rnis reaueveia161??'.'?
18 months i m
ro
D 4189U.?7 /?
,7a 6v
Nuw
I Notify Insoec-
When ReatlV
ucenseaflectncal Contractor 1 herebv repuest inspaction ol ebove
Owner electncel work instelled at
Street Atldress, Box or Fome No. City
3? 3
1 T??.
ecuon hip Name o? No.
r qTnge No. Couuty
Occupant IPqINT? Phone No.
Power SupO??er Atltlress
I AVII"Z.us
Elecbical Contractor (Company Namel Convar,lor's License No.
????u F/???-?,? o Ul?i o
Madma AdJress (COmracror or Owner Makine Inslailation)
oZSdo (,v, Go. TZd tl?. Bu<u •v;/i¢ rrr,? ,S's33 7
Aut rized SaWre (ConVactor?Owne? MakinB Installalim) Phune Number
NNESOT/(/$TATE BOARD OF ELECTRICITY 7MI5 INSPECTION REQUEST WILL NOT
?i99s-MifTway Bltle. - floom N-791 BE ACCEPTED BY THE STATE BOAPD
1821 Universilr Ave.. St. Faul. MN 56700 UNLESS PROPEfl INSPECTION FEE IS
Phone1672?642-08D0 ENClOSED.
REQUEST FOR ELECTRICAL INSPECTlON ea-ooaoi-os
A .' / See instructions lor comolaHrg Ihis form on back oi yellow cooV.
D 41890 "X" Below Work Coveied by This Request
Hdtl Rep. TypB OI BUilding AppllOnCBa WIfBG EqUlymenl Wired
Home Range Temporary Service
Duplex Water Heater LiGhtinp Rxtmes
Apt. Buildmg Dryer Electrie Heatin
Commercial Bidy. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tnnk
Farm 01her paci v .?hcrl5ur.c,(y)
om?, n,n.,
Compute lnspection fee Below
M Fee ServlceEntrenceSize M Fee Fentle,s/SUbfeetlers b Fe¢ Circoits
i.di U to 200 qm s 0 to 30 qm s It, 01.417 0 to 30 Am s
Ahove 200 qmps 31 to 100 Amps 31 to 100 Am s
Swinming Pool Above 100-Amps Above 100_Amps
Transiormers Irngation Booms Partial,Othe e.
Signs Special hnspection Q
Aemarks SO
y TOTAL F E_/1 ?0
????
Xough-in , Dal' "
the Elec
nsPecbr, hereby
certiiy that the abova
Final f Oate
111SpBCtiD11 b85 bBBl1
1a^/Jaa.
Thle reuueat rolE 18 monihs irom
Clty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6755675
Fax:(651)675-5694
-- - - - - - - ,
? Permit#: ?/ ? ?W ? I
I Permit Fee: 7
I ?
? Date Received: ?
i i
? Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant: aJL ?) _ ? ACw.c . Suite #:
RESIDENT/OWNER Name: Phone:?v`>??
Address / City / Zip: ? 6 U 3 ?a-t a p?(Ll"s+. w??
Applicant is: _ Owner ? Contractor
7YPE OF WORK Description of work: Lia.w/ ?
Construction Cost: ?&?b Multi-Family Building: (Yes No ?
CONTRACTOR Name: ? . ? vr1S.eL?L License #:
Address:
City: ( .?.??w,,.. ?? State: PVI?/ ip=
Phone: 1 14T V Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
CaYCQOry Suhmitted Submitted
14 5ubmission type) . Energy Emeiope Calcula5ons Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plum6er: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor: Phone:
NOTE: Pia»s antl supporting documents'that you submif are considered to be'public information. Portions of'
; the information may 6e classified as non-public if yow provide specriic reasons fhat would permif ihe City fo
conclud'e'thatthe??aretradesecrets, qa ?
I hereby acknowledge that this information is wmplete and accurate; that the work will be in wnformance 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 is not to start without a permit; that the work will be in
accordanL9,y\?ith the ap ?Qvjed plan in the/ ?caseg((?work which requires a review and apprwal oi p s.
X X
ApplicanYs Printed Name Applicanfs Signature
Page 1 of 3
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
New ConsUuction ReouiremeMs RemodeUReoair Reouirements INfice Use Onlv
3 registered site surveys showing sq. il. of lot, sq. R. of house; and all roofed areas 2 copies of plan CeR of Survey Recd
(20Ya maximum bl coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addNons & decks Tree Pres Not Reqd
lsetofEnergyCalculations Addifion - indicateilon-sitasepficsystem _On-siteSepticSystem
3 copies of Tree PresarvaUon Plan if lot platted afler 711193
Rim Joist Detail Options selection sheet (bldgs wAh 3 or less units
Date co/ / 3 A
6
N Construction Cost
Site Address
g UnitlSte #
Ir
Description oF Work I
Multi-Faroily Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner Telephone#(e51 ) 7'JrY'+7O g
?
Contractor
Address City
State Zip fliq Telephone # ( (0?"j ()
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateea
(J submisslon type) ' Residential Ventilation Categc
Submitted
• Energy Envelope Calculations
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
BUILDING
`\'1\,
??? M' esota Rules 7672
? .% ew Energy Code Worksheet
??Submitted
elephone #(
Telephone #(
Telephone # f
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 ofplans. •
J ov ?R2 cFin An s o
Applicant's Printed Name Applicant' Si ature
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: BuzLorNG
3830 Pilot Knob Road Permit Number: 0 2 2 2 0 4
Eagan, Minnesota 55123 Date Issued: 10 / 12 / 9 3
(612) 681-4675
SITE ADDRESS: Lo T: s B L 0 C K: 3 APPLICANT:
3683 GREENSBORO DR WILKIE WILLIAM
GREENSBORO 2N0 (612) 348-5409
PE pM?T SUBTYPE:
TYPE OF WORK: NEw
- - -- - - - - - - - -- -- . -?
?
PERMITT ck
k. CITY OF EAGAN
3830 Pilot Knob Road PERMITTYPE: sur?osNs
Eagan, Minnesota 55123 Permit Number: 022204
(612) 681-4675 Date Issued: 10 / 12 / 9 3
SITE ADDRESS:
3683 GREENSBORQ pR
LOT: 8 B1.OCK: 3
GREEN38QRtl 2ND
P.I.N.: 10-30981-080-03
DESCRIPTION:
B 3,1 I Permit Type pECK
Uild2pq rk Type NEW
aG C1c?tta{#odw R-3
?
?1 ? +.?'
1? ? L,
?Eh y oP a
REMARKS:
FEE SUMMARY:
Base Fee $25.90
Surcharge $,50
Total Fee $25.50
CONTRACTOR:
W9 L-K"-' - HPpWILLIAM
3683 GREENSBpRO OR
EAGAN MN 55123
(612)348-5409
?
?. I hgra6y atknou.tv,44a tkrAt i. ?hvvs
':lj044`??tl4+3 is, ttttf*4ot 404.aqt-00; to CV#'ng?ki
$tatUtes, arrd City 9f 'EftgarR Or diir?'?YY???.: V
??APPIICANTPE? SIGNATURE
? Q?A rl I 1P A ?PA. I 1 I I.?
ISS D BY SI ATURE'?.
REACTIVATE ?U Q E 7CEIVED CITY OF EAGAN
P?ERMTT'# 993 BUILDING PERMtT APPLICATION
681-4675 $16•60
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of ener9y
calcs.
COMMERCIAL 2 sets of architectural & structurdl plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Yaluation of work
Site Address:
STREET AIITE M
Tenant Name: (commercial only) '
IAT ? BIACK 3 SIIBD. Cs2tacti54o¢o Sdc.o..b A?.i Y.I.D. *
Descri tion of work: 7q_04_
The applicant is: ET?Owner ? Contractor O Other coesortne>
Name W=L_kSe Ws?OVAM Phone 451A•q'ja$
Property LAsT FIRST Y1' 346_54oq
OWneC . 348- $} bb
'
C
l
'
2,
ceo
srcecn?s
Address
a?3
STREET STE M
City _ t;k c,Ar.? State Zip SS123
Company 0wn1Ea-- Phone
Co ntractor Address License d Exp.
City State Zip
Company Owsa?:.'^n- Phone
Architect/
Engineer Name Registration N
Address
City State ZiD
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 w' h all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
?
5ignature of Applicant:
OFFICE USE ONLY
BUtLDING PERMIT TYPE
?
? 01 Foundation ? 06 Duplex
.? 02 SF Dwg. ? 07 4-P1ex
? 03 SF Addition ? 08 84lex
? 04 SF Porch ? 09 12-Plex
? 05 SF Misc. ? 10 Multi, Add'1
WORK TYPE
)(31 New - ? 33 Alterations
O 32 Addition ? 34 Repair
GENERAL INFQRMATION
? 11 Apt./Lodging
? 12 Multi: Misc.
? 13 Garage/Accessory
O 14 Fireplace
Je15 Deck
i ? 36 Move y s .
? 35 Tenant Finish
16 BasemeKJ+d sh
ti 17 Swim Pool
0 18 Comm./Ind.
0 19 Comn./Ind. Misc.
? 20 Public Facility
? 21 Misce'llaneous
? 37 Oemolish
Const. (Actual) -• Basement sq. ft.
(Allowable) - lst F1. sq. ft.
UBC Occupancy 2nd F1. sq. ft.
Zoning Sq. Ft,... total
(f af Stories Footprint Sq. ft.
Length On-site well
Depth On-site sewage
APPROVALS
Planning. _ , Building
Engineerim g ,.. Variance
REQUIRED INSPECTIONS
[I Site ooting
0 Wallboard Final
' MWLC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code ?
SAG Code
t
?
Assessments
? Framing 0 Insulation
? Draintile ? Fireplace
Permit Fee
5urcharge
Plan Review
License
MWCC SAC
City 4AC
Water Con».
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Un9ts
25' e ao
• s?
?
r
CITY OF EAGAN
APPUCATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*14TR: PAYSKF.nTP QF FFL+ AT TM OF
APPLTCAMCN DM NOr CONMTM
r,PPRovaz, oF PERrsr.
nusPncr1U4 oF sEWx AND/Ct t,A'mt
INSTALIATxoNS waa. rOr BE scRED--
c7lEn [7N'FII. PERMT AP,S BEEN
APPROVID.
-xxxxxxxxxxxxx?-xx-xx--xx----x- wxxx-
P ease Print)
? 1) PROPERTY ADDRESS: 3483 (?,?,?5 ?OFO ?F '"
LE6AL DESCRIPTION: $ 3 "
ti,oL/15locx/.7uDa1v1S10I1 Or Tax PdYCel ID #) .
t .
IF EXI3TING STRLY.'1[JRE, DATE OF ORIGINAL HCIILDING PERMIT ISSUANCE: '
.
PRFSENI' ZONZNG/PROPOSID L'SE: (Mon t+ar
[] COI44ERCIAL/REPAIL/OFFICE
Q IfIDL?STRIAL
n INSTMLITIONAL/GpVF]2APg,'NT
B-?R-1 SINGLE FAMILY '
Q R-2` DOPLEX (Rtwo Onits)
? R-3 7UWNIIiOT-ISE (Three + Units) ( Lnits)
? R-4 APARTMEDPP/COAID()MIIVILIM ( Units )
2) NAME:
?DREss: lR/33
CITY, STATE, ZIP:
PHO
3) • c a?• NAME:
ADDRESS:
CITY, STATE,
PHONE: MASTER LI(ENSE# l?7?7m1a5?
Active
EScpired
Not recorded
al
.
4) •• •cN7,00iu5:
rAME: Sa?.? As C?7) . ,
•
ADDRESS:
CZTY, STATE, ZIP: ?
PHONE:
'S) ?? r• ?• : a • ?.
D--'CbNNKPZON 10 CITY SEWIIt M--CpNAII?X..TION 'IO CITY WATER ? OTf-IER `.
6) ?? •' ?? a-AEAiE HOLD APPROVID PEf2NffT F'UR PICK-UP BY ONE OF ABOVE --- -- --
Q PLEASE MAIL APPROVID PERMIT Z+D 1, 2, 3, 4, ABO\7E
' (Circle one) •
7)
?' ' S ' ?-?*??cts?y? .
:-FOR :CITY USE ONLY PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURC;HARGE)
$ $ ?D S? WATER PERMIT (INCLLDE SURCHARGE)
$ ? 7'U-z $ WATER METER/COPPERAORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ J s•(1 o ACCOUNT DEPOSIT - SEWER
$ $ /'S •?l'? ACCOUNT DEPOSZT - WATER
$ `?j Z,S' cr?7 $ wAc
$ $ SAC
$ $ TRDNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ Ybd t? $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ? •C?c? ,S TOTAL
. ?/??? _
772 3? .
RECEIPT RECE]:PT
DOES LTILITY CONNEC TION REQLIRE EXCA VATION IN PDBLIC RIGHT OF WAY?
;
F__j YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST SE
DIVISION
LIST ISSLED BY THE ENGINEERING
AS A CONDITION
. .
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: .C?J?..
TITLE:
DATE: __????/p /1,
1987 BQZLDING PERMIT 9PPLICATION - CITY OF E9GAN
SINGLE FAMILY DWELLINGS
INCLUDS 2 SETS OF PLANS, 3 CERTIFICATES OF SQEtOEY, 1 SET OF ENERGY CALCQLATIONS
NOTE: 9DDRESSES FOR CORNER LOTS - CONTRACTOR/HOME05iNER MDST DESIGAAiE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BDILDING PERMIT IS ISSQED.
MOLTIPLE DWELLINGS - RFSIDENTIAL REHTAL [JP7ITS FOR SALE DNISS
INCLUDE 2 SETS OF PLANS, CERTIFICATS OF SURVBY - CfIEC[{ iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCI9L
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
I ' S
y,?,,(`/?/,, rC?c"?,
To Be Used For: ? Q?(? y?'-U Valuation: ry-fteff)
Site Address 3LLa.JVl QQAokI/ li , OFFI'
Lot -?? Block ?
Parcel/SubAlu.Qmaba-j_0 p)nd
Owner
Address
City/Zip Code
Phone
Contractor (9{?, ( (/L(_yI,('J?
Address 0AGae,(?( ,
City/Zip Code S-?
Phone ry?:?_ ? ::?610/
Arch./Engr.
Address
City/Zip Code
Date: / "3/^22
On Site Sewage`
MWCC System ?
On Site Well
City Water
APPROYALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Oecupancy 12.?
Zoning (Z I
Type of Const
(Aetual)
(Allowable) '
ri of Stories
Length 5Z
Depth 4 4
S.F. Sota2
Footprint S.F.
PECsS
Permit n(?o. '-
Surcharge '.:?9
Plan Review '2_p,0. z:
SAC, City ( OD
SAC, MWCC SZ5
Water Conn 5_2- _
Water Meter
Road Unit ? S
Treatment Pl I60
Parks
Copies
TOTAL
SJ
Phone #
8 - S Z?a '
,
? ???? ? C??o x(Z = 7 I 20
? z
f??&?? ('?7)
87 - r G4
TRI-LAND C0.
SURVEYING
SERVICES
SITE PLAN FOR:.
JOE MII.LER coNST.
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
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LEGAL DESCRIPTION; LOT-8-,BLOCK-3-,GREEN980RoSEGONOADO.
ACCORDING TO THE RECORDED PLAT
THEREOF DAK07^ COUNTY,MINNESOTA
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LEGENO
o OENOTES IRON MONUMENT
? DENOTES WOOD HUB SET
gow7 DENOTES EXISTING SPOT
ELEVATION
906.2, DENOTES PROPOSED SPOT
ELEVATION
.?- DENOTES DRAINAGE DIRECTION
y?` `P `ph a\
h?
LCOI 9
I hersby certify tAat this survay,plan or
report was prepored by me or under my
dirsct supervision and that I am o duly
Repiafered Land Surveyor undsr ths
Laws of the Stcte of Minne:ofa.
N
SGqtE : f " = SU'
INVERT ElFV,4TI0N AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION =
PROPOSED FIRST FLOOR ELEVATION =
PROPOSED BASEMENT FLOOR =
ELEVATION
NOTE * VERIFY ALL FLOOR HEiGHTS WITH
FINAL HOUSE PLANS
13.nJd, a
8radleyeF. I2 SMenson, Mn. Req. No. IS235
Dote : `? ! V/87
`„ r r;uvrt; nvE1211(iE "p ll COIdPU'PATION -? ?
, ;To be, eubmitted ivitli buiiding permit applicution)
Ot%o or Trvo Family ywe111n6
A].1 other Owner
. Bite Addresa
Coutractor
?1JsT Date Phone
LIIlf;/1I, FFCT OF
EXPOSED YlALL Gj J ? p ?(
PLK ?7IfE?T f t. above grade ?. Z lO?• ?p ?'-("'
• TOTAL EXPOSED W/lLL AREA S@, FT.
OPAQUE W/U,L COt1S'i'RUCTION t ?? it ? Value x Ar.ea
Detail 6ri1? nu 11
p??_ x Stj,
reference -=C2° ^? ?1 ul? . x 9R.
trom p . pgo x Sq,
atteclled IlUlt slieots IlUll X SQ.
VII IJ ip WS t
'. npII X s@.
x tgQ,
uu n
Malce & Type
It It
11 it
nooits i
fluit
yalue x /lroa '
Ilalce & Type ? Fi L ??f SiJL
If ??Ull . ?
" X SQ.
u It npu
n npu E SQ.
" x 5q,
u?u
? x SQ,
TOTALB ?.l_03-(6 - S@.
TOT/IL (U)(A) VAI,UE9 AYEIiAdE °Uto
Z18.7q
DIVIDEU BY TOT1l1, 1'lA[,L AI?EA ,_
R3.?3
AVEltAaL IIU? ,??5 r leoe for
1&2 fnnlilq dwellinge
RoOF/CEILINa
FT. ZZ?? 0. O (0)(p)
FT. I O¢• c?= ? ? ?)? h)
-r?(U) (A)
FT.
£T.
(U)(A).
FT.
_ (U)(d)
FT. 0 = 7,S'8? (u)(n)
s
- (U)(n)
FT.
FT. _ (u)(n)
_ (u)(n)
FT. 5(v.oo = ,g (U)(A)
FT. FT. Z.U?=_11-71_(U)(A)
FT. (U) (A)
- (U) (A)
f'T. 2:15. 77 (U) (A)
1
TOTAI, AREAS •
•
Detail reference
from IIU„ -
•?Z
(
nttqcli
d itu x sQ. FT.11z
v = Z3, (u)(n)
e
slteete,
Deticribe openingo
SQ. FT.
8Q. FT.?^
. (U)(n)
in root.
??pn
x
8Q. FT. _
(U)(n)
?)!?)
= (
ToTAL (U)(A) VALUE9 DIVIllLD
"I'O'1'
1L BY
Z?.lv? ? Sq. FT .
--'
7or?L5 Il?
?U)(A)
Sq,? Z_ 3•(0?- (???
/
I200F/CEILIIIO /lI2EA
11 Z? OZ j
nvEllnaC it 025 -
Vnlue x Aroa
U?? x sq.
n?n x gR.
x y@.
x s@.
?or ventilnted roofe.
t! ??j-r- -AE?T /1
10-3; X 0SZ-t-5L.+Zfo } Z(o? = 2557.4-5
Soa x S..g? - 44-%s
??P°?D corl e •
-?? X ?SZ+SZ+ZCo+-z.(v? = fp4;rZ ?
.S-?Z--
x(sZ+SZtZ??z(C) _
.83X S ?
\4r4pok.,s
z7,c ? 4 = 2. ?v
1(ox3Co = ?.o
Zox3? = 5,0
z?x48 = l? •7
Z4x48 = S.o
.?'= s-rc-• w?z s.c. •
zg
lv - t'xtr v
X 3=
X Z =
X Z =
X .3 =
X 9 =
X g =
Z?o- s z
4-?S
ZCv¢. Co7 -?
7.50
S. o0
1a.oo
00,10
7z,no
CD7, z a
19ts'• io --?
= 3s.oo
_ zl,oo
?8.na?
L?ss Co?1 e .
u paoR?s
LL-L
2qo3. ??
lo4.sZ
z?4. c?7
? (v5z.zq
ISs.169
98•0o Z ? ?
zr)•?7
?r
78?
14X z? = 308
IX14 = ?4
r•sx tco
;I :- Determining '!U" valuea at Roof, Wull# Rim, And Conc. Block
ROOF/CEILINQ
1.) Interior Air E'ilm
2.) 5/81, ayp. sa.
3.) Insulat3oa
4.1
5.) Exterior Air Film
(STILL)
R VILI,UE
` 0.61
.56
?:00
.61
uU" = 1/R_ OZI 'i'OT!!L (R)=41 f;Q 75
?
WALL
6.) Interior Air Film
7.) P GYP. Bd.
8.) Insulation
9.1
10.) Masonite Siding
11.) Exterior Air Film
(R VALUE
0.68
.45
I`I+00
z674-
.17
uUn = 1/R= TOTAL (R)= Z3.p)
RIM
12.) Interior Air Film
13.) Insulation
14.) 2" Fir Rim Joiat
15. ) ?vlC -T- et7eF
16.) Masonite Siding
17.) Exterior Air Film
R VALUE
0.68
19. o0
1.88
Z• ?-
.17
IIR= . P1p TOTAL (R)= Z`f-.?
?1
FOU27DATION R VALUE
18.) Interior Air Film 0,68
19.)
20.) P13EE44-A4: Il.oo
21.) 12" Concrete Block 1,28
22.)
23.) Exterior Air Film .77
ripn TOTAL (R)= ??7. f?
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
c? 3830 PILOT KNOB RD - 55122 s V)?
1 651-681-4675
a
RemodeliRaoair Reaulrert?enh a a wyiarored aro wNers anowmy w. n a im, w. e. w nou»
and gg roofetl areas (2Q°J6 mmdmum lof covemae dlowedf
> 2 caples a Wns (show beam a window fizax Pa+red fnd aasipn; etc.)
D 1 tef of anerpy calcWaMOns
> J coples of hee Presenotlon Dlrni R bt plaMecl a8er 7/1/93
DnTE: a.ooa
DESCRIPfION OF WORK: &A-Q?YZP n? ('
STREET ADDRESS: &n?
O
x eoplea a plan t sel W energy cdcWaHons lor heCfttl adcNBOns
1 site wrvey tor extador additfau & decks
CONSTRUCTION COST: ? o ". C) d d
LOT: ? BLOCK: -3 SUBD./P.I.D. #:
k-)j m
PROPERiY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: 01t4.t,40 Phoae l: (OJ 1 - ! S ? "' ? S Db
Las1 PiM
S1reet Address: 3 G d? 1.:7 Q?Ef? S iJC1 Rn 1?/? •
CIfY C-A Qa k--) State: M Zlp:
?Ij
Compony: S cy? ? ? I?E' C ?%c -iv d ` • Phone #:
Sheet
City
Company:_
Telephone #: (
51reet Address:
citY
State:
Lpt
Sewer/water ticensed plumber (if imtallhw sawerMraterl: Phene #. (_,
I hereby acknowledpe ihpt I have read thic appiicalion, atate thaf Ihe fnfortnotbn careci agree to comPM wNh a8 app8cable Sfate
of Minnesota Sialufss ond CNy of Eapan Ordinances.
Siynalure of AppNcant
OFFICE USE ONLY
Certificates M Survey Recelved _ Yes _ No '
Tree Preservation Plan Received _ Yes _ No _ Not Required
b? 3S Ex3-31 aoo 0
" I k/ ' Zip:
Name:
)
ReglshaHon Y:
6s l qs?- -,n3s
(area code)
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation O 07 OS-plex O 13 16-plex O 21 Porch (3-sea.)
? 02 SF Dwelling ? OS 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of ^ piex O 09 07-plex O 18 Deck O 23 Porch (screened)
? 04 02-plex ? 10 08-plex 19 Lower Level O 24 Storm Damage
? 05 03plex p 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous
? 06 04-plex p 12 12-plax ? 20 Pool p 30 Accessory Bidg.
p 31 Ext Alt - Muki
? 33 Ext. Alt - SF
p 36 Mutti
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition p 37 Demolish (Bldg)• a 44 Siding
X 33 Alteration O 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair p 42 Demolish (Foundation) O 46 Windows/Doors
• Give PCA handout 1o applicant for demolition permit
GENERAL INFORMAi1
QN
,
SAC Code # of Stories sq. ft.
No. of Units
- Length s9• ft•
No. of Buildings
?
Const. (Actual) Width
Basement sq. ft. Footprint sq. ft.
Census Code ?
(Allowable) Main levet sq. ft. MC/ES System
UBC Occupancy sq. ft. Gity Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS ??,???
?
Planning Bui lding
??Y u?/
-7 Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCIES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Vaiuation: $?
SAC Units
% SAC
Sueo.? eL ? I CI7Y USE ONLY
o 2
RECEIPT#; I./7CjYQ
RECEIPTDA7E:
PERMIT# GL
2000 PLUM$1Nfi PEfibliT (liESID£NT1AL)
crrYoF Ewsnri
S$SO PILOT KNOB fiD
£AfiAN, MN 55122
651-881-4675
Please complete for: ? single family dwellings
D townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIYTI IRFC
EACH
TOTAL
Alterations tog? isting dwelli m imum fee
Oescribe: ?L7t,,y? ?
$ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas i in outlet ` minlmum - 1 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $ I
Laund tra 3.00 x = $ ?
Lavato 3.00 x = $ = I
Se tic S stem newrrerumi5ned • r0qulres MPC Iic. 7$.00 x = $
Se fiC S stem abandonment 30.00 x = $I
RPZ new insWlla6oNrepair/rebuild - 30.00 X _ $ ?
Rou h o enin 1.50 x = $ I
Shower 3.00 x = $
Under round s rinkler if dwellin is under conswction 3.00 x = $
Under rounds rinkter ifezistlngdwellin
W ater closet 30.00
3.00 x
x = $
$
Water heater 3.00 x = $
Water softener If dwelling under constructian 5.00 x = $ i
W ater softener if existin dwelling 30.00 X = $
Water turnaround 30.00 x ---- _ $
State Surchar e .50 --' ---'' ""' $ •So
Total --> --? ----> ----> $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
----------- ••------ - - ------ • ----- • -------------- - - - - ---•--------•--------------------••------
•
-
-corcect, antl agree to comply with all applicable Ciry of Eagan ordinances.
- that•
?I-have•read-
- Nis-appliption- , ste(e ihat ?he informaUOn-is-
'I hereby-acknowledge-
It is the applicant's responsibility to noGfy the propeAy owner Ihat the City of Eagan aswmes no liability for any damages caused by ihe Ciry during it5 rwrmal
operational and maintenance activilies to the facilities conSWCted under this Dermit wittiin City propertylrighl-of-way/easement.
SITE ADDRESS:
OWNERNAME:: TELEPHONE#:
, . . (AREACODE)
INSTALLER NAME: LM TELEPHONE #: .65?7.3 S7?C)
(AREA COOE) .
STREET ADDRESS: 7?Q0(9 S74
CITY: L)D?"? STAT : ZIP
I ATURE OF PERMITTEE
L BL C1TY USE ONLY RECEIPT#: / y??,7/a',?l
SUBD. 106AQMJA4?W CX ?v RECEIPTDATE: 71-W9'
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 687-4675
Please complete for: . single family dwellings
? townhomes and condos when permits are required for each unR
New construction Add-on furnace
_A_ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: '- c 5 ? ?J - 1 5' 7
FEES
? Minimum Fee: Add-on/Remodel (existing residence only 20.U0
? HVAG: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge C.
TOTAL C'?'
SITE ADDRESS:_?N??
OWNER NAME: zk? !?[/?.?fr C?? PHONE#:
INSTALI.ER NAME: GU ? RCmzE{IddIW"a{1NB-A'e nti? PHONE
STREET ADDRESS: 4131 OfdSiUICyMEmDI121NMgt M
CITY: (612) 894-91MIcTerc
KNIfL HEATING AND AIR CONDIIlONIN6
41310W Sibley Memonal Hwy. #200
Eagan, MN 55122
(612) 894•9898
7io.
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Date:
City of kali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
PR 06 2016
r
Use BLUE or BLACK In
For Office Use
Permit #:
Permit Fee: ,
Date Received: -f-
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address;
Unit #:
1'� I li!/ r` 63-1-
Address / City / Zip: g-3 r t&' -S ',Oro iO r
Phone:
Applicant is: Owner
Contractor
T e of Work Description of work: 1 b Ir a'" A G% ✓ 5> �) u
Construction Cost: a.-
l 0
Company:
Address:
Contractor �
1....... Phone:
NOTE: Plans and supportingdocuments that you sub
mit are considered to be public nt'ormat%n.-Fortidns 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.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 c•, pleted within 180
days of permit issuance.
State: Zip: bPhone:
License #: V T5 `).5"
Lead Certificate #:
Multi -Family E uilding: (Yes / No
�{► Contact:
V City:
Email:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor:
x
Appli ant's Printe. Name
x
Applicfant's Signat
Page 1 of 3
_ J .
3 r /�l"Giii40/ ' DO NOT WRITE BELOW THIS LINE
7(
SUB TYPES
Foundation
At Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% k )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
311
i
7,46
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test Final
insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
57 24 -
Siding
Reroof
Windows
_ Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
_ Demolish Interior
Demolish Foundation
kki. Water Damage
*Demolition of entire building - give PCA handout to applicant
fit G —1
fr
it-
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Pool: _Footings Air/Gas Tests Final
Drain Tile
Siding: Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In Final
Erosion Control
Other:
, Building Inspector
Page 2 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162475
Date Issued:07/15/2020
Permit Category:ePermit
Site Address: 3683 Greensboro Dr
Lot:8 Block: 3 Addition: Greensboro 2nd
PID:10-30901-03-080
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 -
Jacob Johnson
3683 Greensboro Dr
Eagan MN 55123
(651) 439-3331
Schwantes Heating
6080 Oren Ave N
Stillwater MN 55082
(651) 439-3331
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163643
Date Issued:09/09/2020
Permit Category:ePermit
Site Address: 3683 Greensboro Dr
Lot:8 Block: 3 Addition: Greensboro 2nd
PID:10-30901-03-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Jacob Johnson
3683 Greensboro Dr
Eagan MN 55123
(952) 356-3131
Carroll's Exterior Remodeling Inc
16402 Harvard Dr
Lakeville MN 55044
(952) 356-3131
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA171742
Date Issued:08/30/2021
Permit Category:ePermit
Site Address: 3683 Greensboro Dr
Lot:8 Block: 3 Addition: Greensboro 2nd
PID:10-30901-03-080
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Jacob Johnson
3683 Greensboro Dr
Eagan MN 55123
Mad City Home Improvement
5020 Voges Road
Madison WI 53718
(651) 500-0514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173628
Date Issued:11/22/2021
Permit Category:ePermit
Site Address: 3683 Greensboro Dr
Lot:8 Block: 3 Addition: Greensboro 2nd
PID:10-30901-03-080
Use:
Description:
Sub Type:Residential
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:
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 -
Jacob Johnson
3683 Greensboro Dr
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature