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3752 Greensboro Dr• CASH RECEIPT ? CITY OF EAGAN 3830 PILOT KNOB ROAD FAGAN, MINNE50TA 55122 • - , DATE - 19 ' RECGIVEO j FROM / ' - AMOUNT $ y? •1 I dc DOLLARf 7oo ? CASH b CHECK f J ? 1 FOR s v wnice-Pavars coay Yellow-Posting Copy Pink-File Cnpy Thank You SLDG. P,E"RMIT N0. ,a?. ? J, _ ?L..C ?r4?. • . ' • _ I 01-3210' ? s1dg. Per i?"' 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road U nit 20-2275 5AC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewez Conn. 11-3855 Park Ded. TOTAL " ' ' ? CUSTOMER'S DEPOSIT Joe Miller Const. . ,• j S 30.00 Depositur L 3752 Greensboro Drive Account No. RECOAD OP TRAHSFERS keceipt No. 72088 New Addresc Date Acccunt Nc. Applied on account $ Re funded $?_ 19 Checlc No. BAGAN WATSR AND SBWBx DEPARZ?IENT ? CASH RECEIPT • CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 . LIATE 19 weceiveo FROM AMOUNT $ _, I J de DOLLARS 1 oo ? CASH CHECK Pott FUND CooW6 AMOUNT ; Thank You B Y White-Payers Copy Yellow-Posting Copy Pink-File Copy PERMIT # h ? C I ' . c MECHANICAL PERMIT ?? RECEIPT # -- . CITY OF EAGAN n -7 3830 PILOT KNOB ROAD EAG/4N MN 55122 D CONTRACT PRICE: , , ATE: PHONE: 454-8100 Site Address --' '? - BLDG. TYPE WORK DESCRIPTION Lot t ? Block Sec/Sub - ? Res. Y New `-? ? m Name ' Mult Add-on A ? -? r C Comm. Repair m c ddress City Phone , .Omer ? ? Name Add ; 1 FEES ? RES. HVAC 0-100 M BTU -$24.00 c ? O r@SS Ci ADDITIONAL 50 M BTU - 6.00 (RES HVAC INCLUDES A/C ON NEW h' Phone . ? CONSTRUCTION) ? GAS OUTLETS (MINIMUM - 1 PER PERMin - 1.50 EA. TYPE OF WORK ? COMM/IND FEE - 1% OF CONTRRCT FEE ? Forced Air _jy? gTU APT. BLDGS. - COMM. RATE APPLIES Boiier - M BTU — TOWNHOUSE 8 CONDOS - RES. RATE APPUES MINIMUM RESIDENTIA L FEE - ALL ADD-ON & Unit Heater M BTU $ REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 ' STATE SURCHARGE Vent CFM $ PER PERMIT - .50 (ADD $.50 SiC IF PERMIT PRICE GOES Gas Piping OuUets # Oth ?_ - BEYOND $1,000) er FEE: S/C: " r SIGNATURE OF PERMITTEE ? TOTAL: t FOR: CITY OF EAGAN :•4...._ _ . ?____ ?, u .._.. __,. _.?,? _ h . . .. . . . . . . . . . .. . . . -_- . _?.. PERMIT # PLUMBING PERMIT `?- ' • CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: Site Addr ss • BLDG. fYPE WORK DESCRIPTION Lot ?_ Block Sec/Sub Res. • ? New ?- - •4 f J Mult. Add-on ' ` '' L -! Name ' '" - -• Comm. Repair Address 0? Other c City .?Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO,, FIXTURES TOTAL Name -?Water Closet - $3.00 S-? - Address Tgath Tubs - $3.00 00 ? eL t $3 ; - ava ory - . p Cily Phone *44 4 4 4 Shower - $3 00 - _ , , . ? Ki?chen Sink - $3.00 ::: FEES Urinal/Bidet - $100 = COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00 - APT BLDGS - COMM RATE APPLIES ?Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPUES Water Heater -$1.50 MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 -7 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 . ------Pnvate Disp. - $10.00 h O s - $1 Rou enin 50 - - g . g p SIGNATURE OF PERMITTEE FEE: - ? STATE S/C: - ti FOR: CITY OF EAGAN ,- GRAND TOTAL• --? %-' CITY OF EAGAN : . 34g 3830.,Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH O N E: 454-8100 BUILDING PERMIT Receipt ? To be used for Esk Value Date 52 Lot Biock Sec/Sub. On Slte Sewage MWCC 5ystem _ Parcel No. On Site Well City Water = a Name W z Address 9 C:itv Phnnn .7 t. ? k:.; Occupancy Zoning Type of Conat (ActuaQ (Allowable) * of Storles Length Depth S.F. Total Footprint S.F. APPROVALS FEES that I kave read thfa application and state State of Minnesota ; Signature of Perrrrfi A Building Permit is is all work shall be done ,%It S 503.50 on the express condition that Statutes and City of Eagan Ordinance& Assessmenta _ Permit Water/Sewer _ SurCherpe Police _ Plan Revlew Fire _ SAC, City Engr. _ SAC, MWCC Plenner _ Water Conn. Councfl _ Weter Meter Bldg. Off. _ Road Unlt APC _ Treatment P1 Variance _ Parks Copiea TOTAL r Permit No. Pormlt Holder Dsh Ttlephono ? Plumbing H.V.AC. Electric - C. C' Softener Inspectlon Oste Inap. Comments Footings I Footings II Foundation Framing Z pp Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. •„-? , , Bidg. Finat cert ooo. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. TY OF EAGAN Permit Na RT)2 Datec 7 j,Fr ii 0 PNo1n?nob Road Meter No: -3 ? Size: ? .O. Box 11199 Reader No: ? g Date: an, MN 55121 ?. P . I' ner. J:?? "'.ii:.er !:onst. iteAddress: T'Z CreenSbora 1)rive I Y Cr c.enshoro lst lumber "L ; :'=out h Plumb tn: nn. Chg: 52 5. 00c: ct Dep: ? . oJpu iv- W"CS rmit Fee: 10. 04pk' EiC. ??? GA? urcharge: LFb1?e?e tq c r? wfth the City of Eagan r. P lan t '`' •' "i L c Q r c? a K' eter. ?f \ iart • Bv / - _ i WATER SERVICE PERMIT 3e30 PYot'lCnob Road ?+-- -• - --- • - • -- - -- ----- - p.p, g9x-71 199 PERMIT NO,: ) Y 52 Eagan, MN 55121 DATE: 5-6- ^7 Zoning: ' No. of Units: ?- Joe ";11er <;oast. Owner. Address: Site Add B3 Greensboro lst Plumber. . yym.,u", 3-1'- 77 140.00pd I agree to oomply wlth tha c???ften g 0g000ea?i4A?h1lWS9e: 5'? 5_ tl[lpCi ordtnances. TELEPHONE - E0?5"0L**?? nnl,rz Permnit Fe REQUIREDir?9? By Misc: Charges: Date of Insp.: Toteh " - Insp.: Date Paid: --?-? CITY OF EAGAN Permit No: Q7102 pate. 5-- 6- g 7 3030 PIFaCKnob Road Meter No: Size: P.O. Box 21198 Reader No: Qate: Eayan, MN 55121 ?....,,,_ .Toe ':il ?lsr Const. Site Address: 3 /51 Plumber. ' A `''S. Conn. Chg: -" Acct. Dep: T7.- Permit Fee: Surcharge: Tr. Plant Meter. •7_ Zoning: No. of Units: 1 I agree to comply wilh the Cilp of Eayan Ordinances. By WATER SERVICE PERMIT ? qTY OF EAGAN SEWER SERVICE PERMIT ? 3830 PlRat Knob Road PERMIT NO.: °P52 P.O. Qoxi21199 , _ _77 'Uggn, MN 5512? DATE: .? Zoning: No, of Units: ? !Oe Mil !!r GOriS[ . ,-PL- ,r i t.. . comply wRh the City of Eayan of Insp : Connection Charge: Account Deposit: - Permit Fee: Surcharge: Misc. Charges: -- Total: Daie Paid: f EAGAN i MIT ? SEINER SERYICE ??R, i C rry p osd 3830 P{bt Knob A PERMIT NO: y--? I P.O. Box-21199 DATE: 1 ? Easan, tAN 5512p1 No. of Un'?ts: Zoning: A Ja? fi?ler Const. Owner. . ?3 Cxeerssboto Tn'iv9 114 Address: 37'52 G=eensb ' SiteAddress: _ ji?tnerE? oTO fan Plumb pflpd Plumber. 7 71 5 5 1 ?' ? ??Z " " c? nl??ction Cherge: j? ? 1 e9?° to comP?11 wllh Ihe CItY of E s9an oslt: Account DeP . Ordinanew permN Fee: y Surcharge: Misc. Charges: gy Total: Date of Insp.: Insp.: Date Paid: ? :? . . s -- CITY OF EAGAN Permit No: ' 599 pate 4-2-$7 3830 Pllol Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner. Joe 2'il1.ez ('anst. SiteAddress: 3752 freensisoro L`rive L4 "3 Cr-;?ensboro Plumber. AtI uer iiessisn Plurabi y Conn. Chg: 5 -' 5• Of) Zoning: Acct Dep: 15•??o c1 N. 0 1 Permit Fee: 10• 0ord Surcharge: •?°'? tj 1 a9ree to comply with the Cfty ot Eagan Tr. Plant 1?fl.???L Ordinances. Meter. 67- 0dpd Misc.: By WATER SERVICE PERMIT ? - - - - - - -- -- -- -- -- - ------- - -- . ___--...? 4 CITt OF EAGAN N? 13 3 4 9 3830 Pilo;Knob 4toad, P.O. Box 21•199, Eagan, MN 55721 PHONE:454-8700 k5ff BUILDING PERMIT aeceipt x Tobeusedfor SF DWG/GAR Est.Value $100,000 Date MARCH 16 ,19 87 SiteAddress 3752 GREENSBORO DR OFFICE USE ONLY Lot 4 elock 3 Sec/Sub. GREENSBORO 1S onsitesewa9e Occupancy R3 Rl MWCCSystem Zoning Parcel No. On Site Well 7ypa of Const City Water X (Actual) V m Name JOSEPH MILLER CONST (Alloweble) 17 w = Address 18133 CEDAR AVE S. # of Stories Length 3? ? City FARMINGTOVhone $92-1010 nePtn 34 S.F. To[al 0 NamC $AME Foofprint S.F. . ?Q Address APPROVALS FEES w P City Phone Assessments _ Permit 503.5( h 50 0( Water/Sewer arge Surc ' ? W Name Police Plan Review 2 51 _ ] [ z Fire - SAC, City i n n. p( i Address 57S ( . Engc SAC,MWCC 0 aW City Phane Planner _ WeterConn. 59S Q( 7 Council - WaterMeter Q( G ? I hereby acknowledge that I have read this application and state Bldg. OH. _ Road Und ? n S 0( thattheinformationiscorrectandagreetocomplywithallapDlicable APC _ TreatmentPt 1 Rfl State oi Minnesota Statut and City of Or 'nancas. Variance _ Parks Copies ? SignetufC Of PermitteB TOTAL 2! A Building Permit is issued to: O EPH MILLER CONST on the express condition that s and City of Eagan Ordinance& all work shall be done in accorda e with all applicabl ,$tate of Minnesp?e Stat ?? t' y?? ? Building Official X-? `-??" /'-C-GS?' REQUEST FOR ELECTRICAL INSPECTION Ee-00007-06 IP See iretruclions br wmpleling this /am on beek oi yellow capy. ?_:?6 "X" Below Work Covered by This Request 7 7?3 ? 6dd Rep. 7v0a ot Bu.ICinO? /?CVliancea WirsE Equiumen? Wired ? ' Home RanAe Temporary Service Bulk p Fea ServieeEntrencaSixe M Fee Faetlers/3ubfeadera N Fee Gircuita , QO 0 tp 200 Am s 0 to 30 Am s 0 M 30 Am Above 200 Amps? 31 to 100 qmps 31 to 100 A s Swimmm Pool Above 100-Am s Above 100_Am s Transformers Irrigation Booms Partial•'Other Fee Signs SUecial Inspecuon g f i - TOTAL ' Pemarks ? r[,C, l .5 ` ? D ?ot1 Noueh-m Do1e I, the Electncal Insoeebr, ne.eby certify that the above Finel Onte ?? inspection has bean • ? ? mede. Thle reQUeat valO 78 monUe Irom s , .,-? raW This re0uest void ,?.? " j, ? ?9h7f214 Raquest Date F.re No. Nough-in Inspecvon 7 Re wred? Ofleatly Now ? Will Noufy, Inspec- ""'?p Y¢s( ?.N tor When Paady ? Lmensed Elecvical Contrnctor , I hereby requeat inepoetwn oi ebova ? ? Owner elactrical work instelled et: ?'? J Street Address, Boz or Boute No. 75 reev?sbaro L?r?v? Gry ?a. an ection o. Towns?,o Name or No. RanBe No. County 46ak Occupant IPPINTI J ll M Phone No. er c, + Power Supoliar Qk0 EIee- Address Electn al Convactor ICompany Name) /l??d(av?d Elee-lrt? Contrar.mr's Lmense No. ?«ro -a. Mailing Address IContractor or Owner Meking instailaUanl a-soo W C'o iqd 4..z BGtrhs vr (le, AuMoriz S,enat re IContrac?o ?Owner MakinB Installationl Phone Number ?5v MINNESOTA STATE BOAPD OF ELECTRICITY TMIS INSPECTION qEQUEST WILL NOT Gri09s•Midwey Blda. - Noom N•197 BE ACCEPTEO BY THE STqTE BOAPD 7821 Univeraitv Ave.. St. Peul, MN 66104 UNLESS PNOVEP INSPECTION FEE IS Phone(6127642-OBOD ENCLOSED. SINGLE FAMILY DWELLINGS )33V IHCLDDE 2 SEfS OF PLANSO 3 CERTIFICATES OF SQRVEYt 1 SET OF ENERGY CALCOI.ARIOHS HOTE: ADDRESSES FOR CORHEH LOSS - C09TRACTOR/HOHEOfiNER IiQST DESIGHATS WHICH ADDEESS IS DESIRED. HO CHANGSS WILL BE 9LLOTiiED ONCS SUILDING PfiRMIT IS ISSDED. MOLTIPLE DiiEI.LINGS - RFSIDEN'fI9L RENTAL OAITS FOR SALE i16IiS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SDRVSY - CHECB iTlTH BLDG. DEPT., t SET OF ENERGY CALCULATIONS C0M4lERCI9L INCLUDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND 1 ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND' & STRUCTURAL PLANS, SET OF To Be Used For: Valuation: Site Address 37'Jrc) OA.lh,Cl(l/92/) iCJ'1, F- Lot i'G Bloek ? Parcel/Sub , sC//ty?iYLCLf9'l9'I,? ?? Owner Address City/Zip Code Phone ContractorC? Address 7Q/ ? Z W&a aItiP_ City/Zip Code A/J/h Phone P 91;-) -1,916 Arch./Engr. Address City/Zip Code Date: 3 '13 -e? On Site Sewage_ Occupaney ? 3 MWCC System ? Zoning (2 1 On Site Well Type of Const ? City Water ? (Actual) (Allowable) :sz` 0 of Stories Length SI Depth 34 S.F. Total Footprint S.F . 9PPROV9LS FEFS it P E303 Assessments erm Water/Sewer Sureharge Police Plan Review 251, ? Fire SAC, City 100 Engr SAC, MWCC SZS. Planner Water Conn Council Water Meter (a 7. Bldg Off Road Unit 305. APC Treatment P 1 1 O• Variance Parks Copies TOTAL 0 7, a s- Phone # 6( S ? Z7 " ?a? ?- S-b 2 ZK 22 " 4?? x(2 - .??? ?2XBLD =37 (G C) ZS :` a?"gK44 - 117f 2 67,??vgro g7-7o ? TRI-LAND C0. SURVEYING SERVICES 4655 NICOLS ROAD EAGAN, MINNESOTA io CROSS O? W IV A;?4? 3 ?I cn W ? ? 00 ap O N ? b30 0 . „ 9g6 I = y, J LOT 4 I ?. o .d Q'9 ??y I r • `? ??. J r n ?w? uf;/,•ly Gnse.nent ? I? I I 141.20 _ N 8?°31'56"E .? I?. , )- °,? ?y ?_?.I ROAD 3 N SCALE : I" = 30' 3 d' 00 m oV O Z rz o? I PROPERTY DESCRIPTION WT-4-, BLOCK3 , GREENSBORO IST ADD. aeordinq to fhe ncaAad plat ihsreof DAKOT4 Z«uay, mi:,neaolla LEGEND o DENOTES IRON MONUMENT o DENOTES WOOD HUB SET 09784*140TES EXISTING SPOT ELEVATION 968.6 DENOTES PROPOSED SPOT ELEVATION ? DENOTES ORAINAGE DIRECTION I Mnby certify that this aavey,plan or r?Dort wos prepared by ms or unaer my diroct suparvWon and thot 1 am a duly Repiatered Lond Surveyor under tho Laws of ths Stats of Minnesota Swuerf - PROPOSED GARAGE FLOOR ELEVATION ¦ Y?OS PROPOSED FIRST FLOOR ELEVATION = J? PROPOSED BASEMENT FLOOR ELEVATION NOTE ' VERIFY ALL FLOOR HEICaHTS WITH FINAL HOUSE PLANS Bradley J. giens/o,,n, Mn. Req. No.15235 Dare : 142 55122 SITE PLAN FOR : JOE MILLER CONST. ? N N 89° 31' S6" E 121.20 o _ e¢ ?o I ,o I - c.urAUuic r;liVF;l,OYB AYE1tAQfi l'Utf COIlPUTATION ? --"-:' •. (To be eubmiCted witn buildidg permit application) one or Trvo Family Dwelling Oxner -' _-- Illl oElier 8fte Addreee Coutraobor bNc? y pate T Phone LItIE/1L PEET OF EXPOSED YlALL fte above grade e Z4 1041 1 ??,rjj • TOTAL EXPOSED NALL AREA SQ. FT. OPARUE WALL COMSTRUO'fIUNo "U" Value x Area Detall flpn x 9Q, referenoe ? IluLO x SQ. Irom flU, x $Q. attacited °U" x $e, slleote °p° x sq. t1U11 X $Q. YlItiDOWBt "Ull Value x Aroa Hnlce & Type /NSVLl G ;-r +Ipn x sq. IOUll x s u Q. n n upn X 8Q. IIpti x 8Q. DOORSt flUff Value x Ares . FT. (U) (A) FT. (u) (n) FT. _ U)(A) FT. = ? U? FT• a (p) (A). (U) (A) FT•_Tsz9. ,rlO (U)(A) FT. ? (A) FT. - (U)(A) FT. = (U) (A) Flnlce & u Type n lj p?o n??? • 1q- x 8q. FT. ra = f0i? (u)(A) x 8Q. FT. Z o? I'??7? (U)(A) n n n?u x sq. FT. - (U)(A) x sq. FT. ? (U)(A) TOTAL9 Z jM 3Q. FT._ 2 Z 71-b4- (U) (A) TOTAL (U)(A) VIlLUE9 ?7 AYERACIS f'Ufi ZL?? .rl DIVIDED BY TO a TAL CIALL AREII ZQ-?'p9j? r Z . AVENAQE "Ulf . 115 or leoe for 1&2 tamil d l i y Ne l nge ROOF/CEILINOi • TOTAL AREAS I Z?"?'?iD Detail reference irom x sq. FT. L'?1???? 11)(p) attaclled slleete. nuse x sQ• FT• = (U)(A) Deocribe oponinge upn x S@• FT• _ (U) (A) ln roof• • ??U?? x BQ. FT. s (U)(A) 7C sq. F`P. a (U)(A) TOTAL (U)(A) VAa,UES DIVillED " ? BY , e 2'r9 ? ? ? - ?rf'ltL4j,(???•????lLUy,\ l?? ) fOTAL ri00F/CEILIIIQ AE1EA 115'7 1 n Z? AVERAafi 'Wll ,025 tor ventilnted roofe. _? 9,54 x l 4e5; t4,5 +z7,stZ7 ,s) = 8,83K ( ?i2t17 Zi ?Zy,S-F2ys = Go v, 7x 83x I 45= ?f ? ? b - z4x48 - I I I Z- ZoX 48 = ?I Z - Z?X4E> - I ? 3 Zo Xl? = ? 1-zy. ?bL, ? f i-z4x4a = I ?v83?3 l0?,09 - z ?09? 11? Tc?'AL 3???s x I = 3?,1s ?qrSX'? = S?i? -7 s Il?u x I = Il,z \Al/5?, ?- 0 4q,a Z ??R.? ?? ?, =ZI,b I?o 3Z X zg1XF = 9l2, a ?.--- F ,ti ? ? rz?vwLs 4?6r=- vwaLL txPMMP GE? ?-?V? ?!'7? ?5 t? ?IM 12?3? n WANS) 22?j?5 /9?? --n aA 01Ai'A?1VO- ' Determining IO0'l vsluee st Roofg Wall. Rims, and Coaa. Block , ROOF/CEILINa R V U 1.) Interior Air !'i1m 0.61 2.) 5/8*t ayp. sd. .56 30 ineulation 44,eo 4.J 9.) Exterior Air F'i1m .61 (BTII,L ) nUu a 1/Ra •02r iOTAL M= .- -7g , i. WALL 6.) Interior Air Filrq 7.) }n QYp. Bd. 80 Inaulatiott 9.) &utLT-f?qrE 109) Masonite Siding 11.) Exterior Air Film R VALU 0.68 .45 19•00 ? 674 .17 l'pn a 1/Ra • O`?'3 TOTAL (R)= 23.01 .?- gI?. R VALU 12.) Iaterior Air Film O.68 136) ineulation !9•00 140 211 Fir Rim Joist 1.88 15.) gu,UT-PiTG 2.04 16.) Maeonite siding .67 17:) Exterior A3r Film .17 n1Ju e 1/Re 0,44p TOTlIL (R)= J.¢•,?I- FOUNDATIOK R V U 180 Interior Air Film 0.68 19.) 20. ) ?-rJ 57kIPr?D 21.) 12" Oonarete Bloak 1.28 22.) 23.) Exterior Air Film .17 nun e 1/gs .07(O TOTAL (R)= )3.lzi ? CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTE: PAYMEENT OF F'PM AT TIME OF aPpr.zcATIoN ooFS Nar mNsMMM AePxovar, oF sJMM. nNSPECTIort oF sEWER r,t,ro/at MM rnSrAr.ramrONS WII.L NOT BE SCHED- tLM tMu. PIItruT HAs BEM APPROVID. - - - P ease Print) 1) PROPERTY ADDRESS: 37S Z /..o '- LEGAL DESCRIPTION: y Lot' Block Subdivision or Tax Parcel ID ) IF EXISTING STRtY.'iL?RE, DATE OF ORIGZNAL HC?ILDING pERMIT ISSL'ANCE: : Mon Year .. PRFSENf ZONING/PROPOSID C'SE: COhl?1ERCIAL/REPAII,/OFFICE [El-R-1 SINGLE FAMILY r7 IfIDC'STRIAL Q R-2 D[:PLEX (1wo L?nits) INSTIT[,'TIONAL/GOVII2NMEN'p ? R-3 TOW[gIOUSE (Three + Units ) ( Lhuts ) p R-4 APARTI?=/CONIDOMINiUM ( Units) 2) NF1ME: ,_!B c. ?;L/[f' ! B.GS ? AoDRF-ss: IB133 ??r??- %ac_ CITY, STATE, 2IP: ?jlr?yi?•?_r4i.? ,. PHOM: ?Ia.? ID?U 3) • u ?: ?• For City Use NAME._ 'P/-7 dKou.y(4 plumbers License: ADDRFSS: /Y?-zb? ?3 2D ?ired CITY. STATE. 2IP:_ V?a Not recorded PHONE: S.Sy- 3!0?S"? MASTII2 LICEDISE# fNdo( S qta Inlt?.al 7.1 4) •?• • • i?- rA.E: ADDRESS: ' CITY, STATE. ZIP: PHONE: • •5) ? v ? r: • ?• : ? • a? - a? - Q--'?ONfIE(.TION 70 CITy SEWEE2 C'ONNDCi'ION M CITY WATER 0'nIER ' . 6) DAIMO(GO-Al 6- • r PLEASE HOLD APPROVID PERMIT FCYZ PICK-OP BY ONE OF ABOVE ? PLEASE MAIL APPROVID PERMIT TO 1, 2, 3, 4, ABOVE . I (Circle one) " 7) c?? ?• -?1?P./?a?-? ?? s s-s7 ?1 .-FOR CITY USE ONLY r- PERMIT # ISSOED Pd w/Bldg. Permit FEES: $ $ J D- 57? SEWER PERMIT (INCLUDE SURCHARGE) $ $ h," S Z% WATER PERMIT (INCLODE SL'RCHARGE) $ $ WATER METER/COPPERHORN/OCTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOPNT DEPOSIT - WATER $ ? ZS 'O a $ WAC $ $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRDNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRO[VK SEWER $ $ LATERAL BENEFIT/TRC'NK WATER '$ 19D, $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ - O e TOTAL RECEIPT ?73i S?/ RECEIPT DOES UTILITY CONNEC TION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY? F__j YES IF YES, THEN A" PERMIT FOR WORK 6VITHIN PUBLIC Q NO ROADWAY" MUST BE DIVISIO ISSC?ED BY THE ENGINEERING N. LIST AS A CONDITION. SOBJECT TO THE FOLL OWING CbNDITIONS: APPROVED BY: TITLE: DATE : c=1 16 /e , CITY OF EAGAfV APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION ?.. _. . ..__..__.. . ___"'_. F*ATS:, PAYW-Xr OF FF.E AT TIIM OF F Aeris?oN noFS rM CONMzcM ; ?ROVa% oF PERMuT. r F INSPDGTION OF SEWNIt ADID/OI2 WATER i I?r.raTTOKS WIIS, bl(Yf BE Smm- F ULID I7NtII. PERMIIT HAS . APPRWID. .-_,.,,._..___..__-.,----____ ? 1) PROPERTY ADDRESS: •^ LEGAL DESCRIPTION: IF EXiSTING STRi:ClLR2E, DATE OF ORIGZNAL B[.'ILDING PERMIT ISSL'P.A1CE: " ? (Nbn ear PRFSENP ?ANING/PROPOSID L'SE: ? COI"7"EE2CIAL/REr112L/OFFICE ? R-1 SINGLE FAMILY 1-7 IML'STRIAL ? R-2 DL'PLEX (Ztao Onits) ? INSTIZSJTIONAL/GOVERNMEN!' ? R-3 'lOWNHOOSE (Three + Units) ( Units) R-4 APARTMENT/CANIDOMIDTIOM ( Units) 2) .•• r'T ?. ? ?^ NU4E: ADDRESS: I ( F/ .? CITY. STATE. ZIP: ?A,11?-4 PHONE: - ? / 3) • u . a• ? NAME: ADDRESS: ? CITY, SPATE, ZIP: PHONE: ZPIJ 4) •?. • i?• I _ ADDRFSS:? l C`?? ?J CITY. STATE, ZIP: PHONE: !"' ? '") ? ?e sn riumoers La.cense: ActiVe EScpired Not recorded t?itlal ? .5) ? v• i a• •?+• : a • a? - a? ? CON[gCPION TO CITY SEWII2 r?r CONNEGTZON 1U CZTSt WATER ? OTEIER ' . 6) " •-??' ? PI,FIISE HOI,D APPROVED pERMIT E'OR PICK-UP BY ONE OF ABOVE ----- `-- PI,EASE MAIL APP77o T? 1. "? 3. 4, ABOVE r ? ? ?/7 (Circle one) 7) . .r ,ST-,s a 1??e- r? . : FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ s /'? • ? SEWER PERMIT (INCLUDE SL'RCHARGE) $ $ WATER PERMIT (ZNCLODE SORCHARGE) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ?.j 6? ACCOLNT DEPOSIT - SEWER $ $ /S ACCOC'NT DEPOSIT - WATER $-.?j $ WAC $- ? ZS!$ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRONK SEWER ASSESSMENT $ $ ' LATERAL BENEFIT/TRL'NK SEWER $ $ LATERAL BENEFIT/TRL'[VK WATER $- $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ TOTAL RECEIPT # RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WISHIN PUBLIC Q ROADWAY" MUST BE ISSLED BY,THE ENGINEERING, NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY; TITLE: DATE: _ _ ?? ? , 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 (651) 681-4675 New Construction Requirements RemodellRepair Reauirements ? 3 registered site surveys ? 2 capies of plans (indude beam & window sizes; poured fnd. design; etc.) ? 1 energy wlculatians ? 3 copies of tree preservation plan if lot platted after 711/93 required: _ Yes _ No DATE: S ` I S - I 7 DESCRIPTION OF W STREET ADDRESS: ? 2 copies af plan • 1 site surveys (exterior addkions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST: 5'1 'DOO LOT: ? BLOCK: 3 SUBD./P.I.D. #: C?V?e o? ??S? - Name: `? Phone PROPERTY Last First OWNER n y? Street Address: .7 ?? City G A f°t b Stare: I-! 1? Zip: S? Company: SCHO M A &?-PGI , Phone #: V ? ? ? ? ? ? (73S CONTRACTOR ` r- C--,?n Street Address:) voo ?] l", ! ?? ??-? T _ License # ds Exp. 3? 9 I City U Y IMbfa` C-t ? qiS State: Zip: 1 ARCHITECT/ ENGINEER Street City Sewer & water licensed plum6er (new construction only): _ change and lot change is requested once permit is issued. I hereby acknowiedge that I have read this application, state that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY I Certificates of Survey Received _ Yes _ No is correct, I Tree Preservation Plan Received - Yes - No - Not Required Phone N: Registration #: _ State: ZiP: Penaity appiies when address agree to compiy with all applicable D?I E?p ?????LE!,?)J? I?; ? OFFICE USE ONLY 3UILDING PERMIT TYPE 7 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 14 16 Basement Finish 7 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool 7 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 1 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Misceilaneous 7 05 SF Misc. ? 10 = plex ? 15 Deck NORK TYPE 7 31 New ix 33 Alterations ? 36 Move 7 32 Addition ? 34 Repair ? 37 Demolition 3ENERAL INFORMATION :onst. (Actual) ? Basement sq. ft. Census Code ? (Allowable) ?Main level sq. ft. SAC Code JBC Occupancy [L ?? sq. ft. Census Units '_oning ? sq. ft. Census Bldg 6 d of Stories - sq. ft. MC/ES System .ength - sq. ft. City Water Nidth - Footprint sq. ft. Booster Pump PRV Fire Sprinklered \PPROVALS 'lanning Building ? Engineering . Variance Permit Fee Valuation: Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY USE ONLY L ? BL ? RECEIPT #: C-IQ I O 5263 SUBD. A,?R?-?-'?-? RECEIPT DATE: 4" a 9') 1999 PLtrH[$uvs PERmrr (FxsmE1vT[AL) Cff]' OP gAfi14N 3$80 PILOT KNOB iiD EAeA1u,MN551 as (657) 6$1-4675 Please complete for: D single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system ??__???_____??----????_????--------- FIXTURES -------------? -- EACH --------------------- # --- TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ' minimum - 1 3.00 x = Rough Openings 1.50 x = WBtef SOftCnef ? for dwellings under construdion 5,00 X = Water Softener " for exisling dweiling 30.00 X = U.G. Sprinkler " fcr dw21!ing under const. 3.00 = U.G. Sprinkler ' for existing dwelling 30.00 = Alterations ' to existing residence 30.00 WaterTurn Around 30.00 = Private Disposal System * MPC iic. 75.00 = (new and refurbished syslems) Private Disposal System5 ' abandonment 30.00 = RPZ (new installation/repair) 30.00 = STATE SURCHARGE .50 Reminder: Call 681 d675 for inspections of water heaters, water softeners, alterations, etc. ? 3 0 TOTAL • - s-. •------------------------------•-•--------------------------------------------------------...-------- -------- -- -- I hereby acknowledge Nat I have read this application, State that the information is correG, and agree to compty with •all applinble•City-- of Eagan -ordinan-ce it is the applicant's responsibiliry to notify the property owner that fhe City of Eagan assumes no liability for any damages pused by the City during its nortnal operational and maintenance activities to the fadlities constructed under this permit within City property/right-of-way/easement. SITEP.DDRESS: ?? S-?-- OWNERNAME: SK?I`A- INSTALIER NAME: ?/?`t ?Ivir, d ?? o TELEPHONE #: dJ I 7 7 1 r 7 Yv C-? ??r,???-- L1?G?/? STREETADDRESS: 7T/6 cin: &Lk'sraTE--OZ? ziP: SS?ZS? I- TURE OF PERMITTEE CD7PERMIT FORMS/RPLBG PERMIT (RES) -'1999 A PERMIT City of Eagan 3830 PILOT KNOB RD EAGAN, MN 55122 (651) 681-4675 Permit Type: Building Permit Number: EA034772 Date Issued: 03/23/1999 Site Address: 3752 Greensboro Dr Lot: 4 Block: 3 Addition: GREENSBORO I ST Description Sub Type: Lower Level Work Type: Alteration Description: Census Code: pddition/Bsmt fm/Decks/Porch UBC Ocwpancy: Construction Type: Zoning Squa?e FeeY: Remarks: Plan rmev,•ed by Craia Novaczyk. Separate permit required for any plumbingwork. Call (612) 445-2840 regarding electrical permit and inspections. Fee Summary: State Surcharge - Fixed Permit Fee - Fixed 0.50 60.00 $60.50 Contractor: - nppi;caac - Owner: Schomaker Construction St. Lic.: Joe Skora 1400 Clement Street 3752 Greensboro Dr Mendota Heighu, Mn 55118 651-457-2939 Eagan, MN 55122 651-681-0553 I hereby acknowledge that I have read this application and state that the information is wrrect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: 5 ignature Is d By: Signature Use BLUE or BLACK Ink - - - - - - - - , 1-77 For Office Use I I City Ea nI Permit#: of ~iUllll I Permit Fee: ~ I 3830 Pilot Knob Road j I Eagan MN 55122 1 Date Received: In Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: In 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: T0-'( Site Address: 7-S 2 ~ r'tcv~s ~o ra 'i Tenant: J Qc- -Wrieg Suite RESIDENT / OWNER Name: SI'~er's, Phone: Address / City / Zip: e7 Zr 2 Coe& w ~ o'o ~.~.~.~.e CONTRACTOR Name: 1M"4k?-VC- 49- G"sV I'✓ ~t c+A-iLrLi License O G~03P;-o# 4 01 Address: V296 6e' ,-qW%, A Kek AJ City: State: 0 Zip: C./17-.r Phone: Gf f S$ z^ 7 9 J 9 Contact: S Gtk& Email: ,47. G. ov4,sp- t'7rs . C d`y TYPE OF WORK _ New - Replacement _ Repair _ Rebuild (-,Q~Iodify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation RPZ PVB) ->Gdd Plumbing Fixtures Main / Lower Level) Septic System Water Turnaround _ New _ Abandonment RESIDENTIAL FEES: i i $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) 'Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ 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 of plans. X J '?%A f x Applicant's Print d Name A ant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In Air Test -Gas Test -Final Use BLUE or BLACK Ink r For Office Use I Permit -70 I' City of Eap Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION CAC I I Date: Site Address: 4)0 £ bra ra Unit Name: )a S V0 (+tt Phone: 45/ 0 SS 3 RESIDENT / OWNER Address / City / Zip: 3 7S Z G re e-, 5 tiara r. Applicant is: Owner ~G Contractor We ) Bag re,-.4W TYPE OF WORK Description of work: if 'Construction Cost: 1200 Multi-Family Building: (Yes / No L Company: uint 64 r,14,-, J-1,c_ Contact VC a 414P •f Y a t CONTRACTOR Address: g 8 W• SIr e City: V• ,p 4 i State. M Zip: sS/oz Phone: 6 V- 2 7 Y-5•98 f i License #:20L 3763 (5 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 ANEW 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' Faris 'and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. 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 completed within 180 days of permit issuance. X1 : C ok- V, ~10 ).am Applicant's Printed Name Applicant's Sig ure Page 1, of 3 ~r`66NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi 01 of Plex _ Lower Level _ Pool _ Miscellaneous _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ®QD Occupancy 1G - 7 MCES System Plan Review / Code Edition A40? SAC Units (25% 100°!° V) Zoning f j~ City Water Census Code Stories - Booster Pump # of Units - Square Feet PRV # of Buildings - Length - Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES /`Z iL/,ne Aa Base Fee 73, Surcharge Plan Review ~7 9y MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA116326 Date Issued:10/07/2013 Permit Category:ePermit Site Address: 3752 Greensboro Dr Lot:4 Block: 3 Addition: Greensboro 1st PID:10-30900-03-040 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Elizabeth Hess Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Joseph A Skora 3752 Greensboro Dr Eagan MN 55123 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK-Ink For Office Use *) of E Permit#: City a �il Permit Fee: &6') 0 0 3830 Pilot Knob Road Eagan MN 55122 �. � �6 Date Received: Phone: (651) 675-5675 Staff: Fax: (651)675-5694 2016 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 11/28/2016site Address: 3752 Greensboro Drive Tenant: Suite#: Resident/Owner Name: Maria & Joe Skora Phone: 651-681-0553 Address/City/Zip: 3752 Greensboro Drive / Eagan /55337 Name: US Patio Systems License#: PC 708206 Contractor Address: 218 N River Ridge Circle City: Burnsville state: MN Zip: 55337 Phone: 952-314-9885 Contact: Ray Madden Email: asnook@uspatiosystems.com Type of Work New V Replacement _Repair Rebuild Modify Space Work in R.O.W. Description of work: Bathroom remodel RESIDENTIAL Water Heater Water Softener Permit Type Lawn Irrigation( RPZ/_PVB) yp ✓ Add Plumbing Fixtures(V Main/ Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$60.00 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 plans. X Wendy Rache x j r•-• r f Applicant's Printed Name Appliatiit's Si naturej, , FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test _ Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: Use BLUE or BLACK Ink For Office Use c /1019011 Cityof Eall Permit : �. �4 Permit Fee: / ' 67q 3830 Pilot Knob Road G Eagan MN 55122 ,, r 2 8 2 Date Received: /r'? Phone: (651)675-5675 't *":"I Fax: (651)675-5694 Staff: 1 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11/28/2016 Site Address: 3752 Greensboro Drive unit#: Name: Maria & Joe Skora Phone: 651-681-0553 Resident/ 3752 Greensboro Drive / Eagan / 55337 Owner Address/City/Zip: g Applicant is: Owner X Contractor Type of Work Description of work: Bathroom Remodel-see attached drawing Construction Cost: $6792.80 Multi-Family Building:(Yes /No X =_ Company: US Patio Systems Contact: Ray Madden 218 N River Ridge Circle Burnsville g City: _-_ Contractor-- ::-=- Address: MN 55337 952-314-9885 asnook@uspatiosystems.com _ State: Zip: Phone: Email: License#: BC661813 Lead Certificate#: If the project is exempt from lead certification, please explain why: built in 1987 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: 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. %w.iw.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 of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code mEfst=be completed within 180 days of permit issuance. I tlE Y x Wendy Roche x, . , v L- r Printed Name Applicant`s"Signature 11 Page 1 of 3 1 . a 2 7 6 D'- 6,e.66/6,b72-0 O NOT WRITE BELOW THIS LINE / / U l'2q SUB TYPES _ Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration (Single Family) ?� Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi _ Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex — Lower Level _ Pool _ Accessory Building WORK TYPES _ New b Interior Improvement _ Siding _ Demolish Building* _ Addition — Move Building _ Reroof _ Demolish Interior Alteration — Fire Repair _ Windows _ Demolish Foundation _ Replace — Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation Z.,c>9£1 ` — Occupancy ICC-C-) MCES System Plan Review Code Edition j zo I5 SAC Units (25%_100% Ne5 ) Zoning P a City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Q3 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) to Final/No C.O. Required Foundation ' HVAC_Gas Service Test Gas Line Air Test Roof:_Ice&Water Final Pool: Footings _Air/Gas Tests _Final Framing Drain Tile Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick tO Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: 7-61472 Reviewed By: /�rs 2,.it''%.1 , Building Inspector RESIDENTIAL FEES 4,�s r Base Fee • Surcharge Plan Review ;4,`,77 4)m fee MCES SAC 2, Dav City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 For Office Use ,„ „ , ;„, :::: 19 7 . ... : RECEIVED Date Received: (0 —'()_'( 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 JUN 12 2018 Staff: buildinginspections(i?3.cityofeagan.com t_ 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ki. —()."'t b Site Address: 3 7 Sr.e.t.hcberb Dr- Tenant: Suite#: - Resident/Owner Name: 5 4.b ref Phone S 7 �'/ - ('5'S 3 Address/City/Zip: 75-f.... f' . Cep on ✓Cc — Name: f C0 AJQ /� t' V (45, License#: Pe 4 Y. 5-6 6. Contractor Address: �/ a t (/a /'c rid 3t./ ... /. City: (, P2 / z State: / 'j41 Zip: 55 ll 9 Phone: t' `J t - 73 X 'f FZ- Contact: Email: ,f®�...'f 4 (el r4/ ' 04.7yyt /14 Type of Work —New _X.Replacement _Repair/ Rebuild _Modify Space _Work in R.O.W. Description of work: � ,�g ;��f'' RESIDENTIAL N. Water Heater Water Softener Lawn Irrigation L RPZ/_PVB) Permit Type Add Plumbing Fixtures( Main/_Lower Level) Septic System New Water Turnaround Abandonment — RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.00nherstateonecalLorq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. I_hereby acknowledge that this information is complete and accurate;that thework 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. x T» .1 t—.4e.r ti/t-1 i1.1 x /Applicants Pn tedName Appli nt s Signature FOR OFFICE USE >tiReview By; Required Inspections: ; Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer " Staff. /O e- (le � k/i el s 1'M L zQ S GL;P ) J� C eYl S pc) fo G�e Co4nec /- 0 //,/ �J (2 • Use BLUE or BLACK Ink 311,c,d 14 REC EVER For Office Use � 44!Ii JUN 072018 �City of Eaaall :::ee : / �i 4cc 3830 Pilot Knob Road (' ,.1 Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 0 1 i7 2015 RESIDENTIAL BUILDING PERMIT APPLICATION 616) l� .-Y-15). G Fee., �b Date: Site Address: �ve Unit#: Name:i Q e <Cc at - Phone: Address/City/Zip: J 10A C rcc \ rc t 1` Applicant is: Owner X Contractor Description of work: z C ' e 6.eI Construction Cost: j 7 5V Multi-Family Building:(Yes /No ) Company: Ae�� b (9 K ECSC, T' c �C�a Contact: { J Address: \ Vs. 1111 reCf City: St, PG 4! State: 14ty Zip:S 102 Phone:`OSI ()nil License#CR C7,30 3 Lt Lead Certificate#: /A-7 1 O‘0 9 Q 2 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) f9 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 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.gooherstateonecall.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 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. xrA k SArd k s6"` x Applicant's Printed Name Applicant's Sig ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE /' /'7(3 SUB TYPES � omJ/2f, Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) tt,. Single Family Garage Porch (4-Season) Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement Siding _ Demolish Building* Addition Move Building Reroof Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION C Valuation ` Occupancy ,<.L4 MCES System Plan Review Code Edition 0- `)0 i SAC Units (25% 100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction ( Width REQUIRED INSPECTIONS V Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings(Addition) Final /No C.O. Required Foundation HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool: Footings _Air/Gas Tests Final N. Framing Drain Tile Fireplace: Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall: _Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: BuildingInspector Y � p RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC , „\.N. City SAC (. Utility Connection Charge S&W Permit&Surcharge °` fi Treatment Plant ( Copies ;'� . TOTAL I '`, ;`. . ' 1 Page 2 of 3