4241 Limestone DrCITY OF EAGAN
3795 Pilof Knob Road Fagan, MN 55122 N2 4386
PHONE: 454-8100
BUILDING PERMIT S4, 0"1u. Receipt #k - ?•?`?--
To be used fo? Atii'tn tp hc;:':, Date , 19
Site Address Erect ? Occuponcy _ i
Lot Block Sec/Sub. Alter ? Zoning
Parcel # Repair ? Fire Zone
l
r
e ?
E e of Const
T
n
g
a .
yp
w Name ,?., ,
•
- Move ? # Stories
Z
3 Address `
t
-
.. _ .. .
+ Demolish ? Front ft.
0
City 1
s
Phone Grade ? Depth ft.
? Approvals Fees
o Name _
?
?Q Address -
w
~ Citv Phone -
' I hereby acknowledge that I have read this application and
the information is wrrect and agree to comply with-ull
State of Minnesota Stat-ites,and City of Eagan Ordinanc
Signature of Permittee --?-
c^?, Assessment --
Water & Sew.
I. Police
- Fire
- Eng. -
Planner
Council
le BIdg.Off.
APC
Permit - -'' _
Surcharge - _-?`-%
Plan check
SAC
Water Conn. --
Water Meter
17 .
Total - f?P„•'
A Building Permit is issued to: `1'42?`""t'?'-" on the express condition that
all work sholl 6= done in accordance with all applicable State of Minnesota Statutes and City of Eogan Ordinances.
Building Official --- --- -
PeemM # Dete lawad PpMktw
Plumbing
Mechanical
INSPECTIONS DATE INSP.
RougMln
Pinal
Footings Date Insp. Date Inep.
Foundation Plumbirg
F rame / i ns. Mec4wnical
Final
Remarks:
.s . . . .. . . . ? . .... +RTlY. . .. . . . . . _ .. .. . .. .-. ,..__ ?
PERMIT #
MECHANICAL PERMIT
CITY OF EAGAN RECEIPT # / ?
3830 PIL07 KNOB ROAD, EAGAN, MN 55121 DATE: -7-°?
CONTRACT PRICE PNffNF• d4A.9100
5ite Ad ress Ys? 4/
Lot Block
y Name i, ,JS iL-L ` (- ,-7 A- c 1"/
m Address ? V
c City ,t?-?nni?J«L: Phone -°-`Lf
Name _
c Address
0 City c
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
M BTU
M BTU
M BTU
M BTU
CFM
FEE
S/C:
TOTAL:
BLDG. TYPE WORK DESCRIPTION
aes. ?` New
Mult Add-on x
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
5 L ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
? SIGNATURE OF P MITTEE
FOR: CITY OF EAGAN
CITY OF EAGAN
Remarks
'Cedar
R 6 Parcel 10 16701 040 06
Addition Cedar Grove #2 Lot 4' Ik
1.?1' .
Owner 4??-d v? StreetJ.}?l L;mestone Dr, State FaganjM[d -r?51
6 ll!"//f/,I J!'r-?l 9 Improvement Date Amount Annual Years Payment Receipt Date
STFiEETSURF, 88 S 1985 1266.95 84.46 15 1266.95 C009835 11-2-84
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1972 1394.00 2,16 Z
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CUR9 & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. G`U
8UI LDING PER.
SAC - j
PAFK
+r CITY OF EAGAN
? 3795 Pilot Knob Raad Eagon, MN 55122 N2 4386
PHONE: 4548100
BUILDING PERMIT APPLICATION $49000. Receipt #k 6532
Ta he usa for Addn to home Date Ti,*+a 20, 19-3-7-
Site Address 4241 Limestone Di. _ Erect ? Occupancy I
Lot /y Blxk 6 Sec/Sub. GG--2-
Parcel #
W Name
o Address 4241 Li8l/.asel •• .T-_
Alter [?F Zoning Rl _
Repoir ? Fire Zone _
Enlarge ? Type of Const. V
Move ? .# Stories
Demolish ? Front 10 ft.
Grade ? Depth 14 R,
A rovals Feea
°` N vn
p
? ame
E $O
Address i na?s
nxhorough A
Assessment _
?
? _
.
.
Cit BloominipXsq 888-2225 Water & Sew
Police
?
FC, w
Name
Fire
?? Address Eng.
¢'" Z Cit Phone Planner _
Council _
I hereby acknowledge that I have read this application ond state at Bldg. Off. _
The infortnation is correct an agree comply _a' coble
State of Minnesata Stat'ute ,nd ity nc APC
Signature of Permittee
A Building Pertnit is issued to: ekk@ti LS
all work shall be done in occ dance ith all oble State
i
Building Officiai
Permit 15.00
Surcharge 2.00
Plan check
SAC
Water Conn.
Water Meter
Total 17.00
on the express condition that
Statutes ond City of Eogan Ordinonces.
EAC„4N 'rOWNSHiP
B l.J I LD N G PERbI l'r
Ownee ? : -- ?
--/-`-T-!...... - . - - - -- '- ----...r..
- - --
Address (preseni)
?-°• -.° - ?-° - ,
......
, .??.? -- ?-
Suilder ..... - --- --------..... Addxess .....
DESCRIPTION
N2 404
Eegan Township
Town Ha11
. .
Date .- - ??/ - `-.: ----°•--.-
sxoraes To Be Used For Froni DepYh Heighi Esl. Cosi Permi! Fee Remarks
l ^ I
oYher
LOCATION
?aainon or iraci
?1? ;?.?????-__ ?
This permit does noY aufhorize Yhe use of sireeis, zoads, alleys or sidewalks nor does it givs the owner or his agent
the righf io creaSe any si3uafion which is a nuisance or whiah presents a hszard to fhe health, sa£ety, convenience and.
ganeral welfare io anyone in the community.
THIS PERN[IT MUST B ?' P'E ON T?E, PR? MISE WI-?ILE THE WOAK IS IN PAO?yGAESS
This is 3o certifp, !ha _. r.¢'t_?y? .----has Permission fo erect .............. ? ?-T-- .upon
the abobe described premise eci !0 the provisions ef the Suilding Ord"ar.aace fos Ea,an Towns p adonled Ap:il 11.
1955. '. ?_..._ r
? a
..... . `.- S?j?- ?
. .. ......-- - Per
-- - - - -..... - ---- - - ...........
Chairman? ? o Board - - . _ ---- .
£suilding InspecYor,
•
?? ?? ?? 1? ? I ?
?i,.?ILD1?9G I?ERNfI°i'
Owner ._.?"'1--"?/?/,!-•----??di?E???- -?-'. -?`?--- -...-?---- ------°----
Address (Presentl ---•---7"?-!??---•--?K??G,yt?¢4G?I,2?}J--?l?.
Builder ------°??G1-----"-V?'-'???,,s,?-?--?°-...---
Address °-°.-???f?--._...-?b?t?ld.-v--,-°4;.G?,???.°--°---
DESCRIPTION
liT° . 741
Eagan Township
Town Hall
Daie/???..°?{----------?/ ---°
Siories To Se Used For Fron! Depfh Heighf Esf. Cosi Permi! Fee Aemarks
? I q l?_ I `C? C?Z ? ??? l
??-
or
LOCATION
I Lot Rlock I AddiYion or Traci
? 5? ; ? ? ????? x????
This permii does no! authorize !he u?e of streets, roads, alleps or sidewalks nor does i! give Yhe ownea or his agent
the righ! to creaie any si3uaYion which is a nuisance or which presents a hazard Yo ihe healYh, safeiy, convenience and
general welfare to anyone in Yhe communifp.
THIS PERMIT MUST BE T E EMISE WHILE TFIE WORK I5 IN PROGRESS.
This is Yo cer3ify, thai--- .•??????E???...----has permission 3o ereci a----•--------- -- --- --- •....----upon
the above described premise subject io ihe provisions of Yhe 8uilding Ordinance for Eag Townsh' adopisd April 11,
1955. .
•••---....?'?Jl..+rl-+??^----°???<Yl.?---°-------.....-- . Per ._._. ..?_ .?_ ,?..??ti_'_.---- - -•? -------••••••----------
Chairman of Tnw Board Suilding InspecYor
,? ? ?? ??,
This request void (?'j
monihs from ?7'
° 100,017 ' L ff U
Reque??. Date Fire No. Rough-in Inspection
j'/ Required? \? ReaAy Now Q Wi I I NotifV. Inspec-
Ij) ? ?/n .?UC.fJ ?Yes pQNo tor When Ready
? Licensed Electrical Cnnlractor ?
1 herebyrequest inspection of above
? Owaer - •electrical work installed at:
Stre [ Address, Box or Route No.
4 1 ,?,.?,s -+? ??? ?
a
Cit .
?4,
ecUOn o. Township Name or No. Ranpe No. County
Occup?nt(PRINT) Phone No.
D
Power Supplier . Address
trical Contractor (Compa ?me)
Ilk ?? 1 0 Cont?tor's Licens? No.
J-v g1-1
ailinp Address ( ntre tor or Owner akfng Instailation)
'
(
-
D
r,
c 5 56
h v?
rs
Auth i Signature (Contra'torlOw Mp?ing Installationl Phone Number
? Y - ?63-7
MINNESOTq SIA BOApO?F ELECTRICITY THIS INSPEC710N REQUEST WRL NOT
Griggs-Midway 9 dg. -loom N-191 . BE ACCEPTE? BV THE STqTE BOAHD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297-2117 . ENCLOSED.
REQUEST FOR EIECTRICAL INSPECTION es-ooooi-or
' See instrmtions for completing lhis form on baek of Vellow copy. /3 ! '-7?iC
? ? n II li ? 1 1 'X'" Below Work Covered by This Request ?G 7
P4aw4 Adc:j Rep.I Type oi Building I Apvliancea Wired I Equipment Wired I
Du lex' ' Water Heater Lightin,y Fixtures
Ap2. Buildinq Dryer Electric Heatinq
?I ' Commercial Bldm Fumace Silo Unloader
Ot
M Fee Service EntranceSize k Fee -? Feeders'lSubfeeders 4 Pae Circuits
U to 200 Amps 0 tp 30 Am s 0 to 30 Am )s
Above 200 qm)5; 31 to 100 Amps 31. to 700 q rnps
Swimming Poot Above 100_Amps Above 100_Am?
Transformers Irrigation Booms Partial-'Other Fee
I Signs I I ISpecial Inspection 'S S7?
? O FEE
Remarks
w
Rough-in D3te
?, e Ele al
Inspec or, hereby
cerlif
that the ab
Final 1e/7 y
ove
spection has been
? made. cor
fTAIS request void 18 months from •
?
? c .
f this, Req
I, as J? Liceesed E2e ca]
electrical wmng instded at:
?,-J
Street Address or R
04/A O6 ? O? 96 r?
?'d ?.co? N 66538
tractor, r, do hereby request inspection of the above
411, o
?
L°Gi/(i'
Which is oceupied y/"??.?-?,?
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes
Power Suonlier //r/ r+ Address.
Electrical
Mailing
_ (Company Namc)
(rC/ e a .
Contrattor or Owner Making
Ready Now )( Will Call ?
4 ,
License No
Authorized SignaturP A-e67a^-e? e?y C62?k?phone No • ????
(Electrical Cont'ac[or or Own<r Malting This Irotallatlon)
Minnesota Sta+e Board of Eleefricity
1954 Elniversity Ave., S+. Paul, Minn. 5,5 104---Phone 645-7703
` REQUEST FOR ELEC7'RICAL INSPECTION
CACK BELOW WORK COVERED BY TH[S RE9UEST
? G? ??s538
Type of Building New Add. Repeir Check Appliances Wired For 1 1 Check Equipmen[ Wired For
Home 0 [:] Iiange El TempotaryWiring 0
Duplex F-I 1:1 Water Heater El Lighting Fixtures
?
Apt. Bldg. El Dryer El J:lecttic Aeatini(
Cammereial Bldg. C] El E] Furnace 11 Silo Unloader El
Induetrial Bldg.
- 11 El El Air Conditioner D Bulk Milk Tank ?
Farm? List Lis4 l
Other` ci
? ci
? Ei
? Olhers
Here Othere }
Here J
COM('UTE INSPECTION FEE BEI.OW
ServiCe Entrance Sise: $? Fee Feeders & Sub[eeders: }j Fee Circuits: .}j Fce
0 to 60 Amperey 0 to 80 AmDeres 0 to 30 Amperce J?
61 to 100 Amyeres 31 tu 100 Amperea T? 31 to 100 Amperee
107 to 200 Amperea Above 100 Am Above 100 m
Above 200 Km s Remote Contr treui? ?, ?SiRne
Transformen SDetisl Ina ? io V Psrtial or other fee," - Q•
Remarks ?
rIEII
ToTwL:i
?
I, the Electrieal Inspector, Itereby c T that e ol+e inspection ha?been m?a'de?, 'o
-
(Rough-in)
(Final) ? Da 2 7"
-?
??. ?
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauirements RemodeUFtepair Requirements Oifice Use Oniv
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cerl ot Survey Recd _ Y_ N
(20°h maximum lot coverage allowed) 1 set of Energy Calculations (or heated additions Tree Pres Plan Recd Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Reqd Y_ N
1 set of Energy Calculations AddBion - indicate if on-site septic system Onsite Seplic Syslem _ Y_ N
3 copies of Tree Preservation Plan if bt platted after 7/1193
Rim Joist Detail Options selection sheel (bidgs with 3 or less units
Date -/o-/ 7/ o-3
5ite Address ?-?, V Construction Cost 7 Z?
Unit/Ste #
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address ??'(? W•2ir?? ? y'
State l?i ,?-?? 4J City
Zip Telephone #(?j? ) Faa[?'L?7 c3 ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone # ( )
?
Mechanical Contractor "Telephone # (
Sewer/Water Contractor (1 Telephone #(
I hereby apply for a Residential Building*,,ernut-and aeicn'owledge 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 NIN
Statutes; I understand this is not a permit, but only an application for a pernut, 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 Applicant's Signature
e ' ?%
/- /-? 6 K
Date :
BUILDI:?G PERi°1Ii P.,PPLZCATTON ?
LOT ? B:ACK ? ADDTTIOii
PARCEL & SECTTOI7 H[3iiDER IF Ul]PL:'1TTED
AnuREss
7,Oi3MIG
.-?
OCCUPA??CY ?. USE
k'iSTL'?51iTE'ip CO?;'?LC.;
Oy.ilEi2-.LL11X1! 4L- Q-4.
ADDRESS
COTy]TP.-*>CiOR
ADllcZESS
TELEPHOb]E N70._
TELEPF'sOME :?O. Z(, Z -,,2;2c2,
tdote-: Include sit2 p1an; building plans, ana enercry calculations v3ith
application
Siqned
OFFICE USS
vAr.un^ xoi: 4 D O? ??
s-Ac
Y:?'?i'ET_Z C02Ii3EC2T_Q'r'
@]ATER ?rSETER
v?
Bazi.nzrrc pr:rr,sT FEE
suacxARGE Fr:F T?
PLiiii C;u CK F?E ..
PAF1C DEDIC:',T2W? FEE
OT..'"r.R
fiOTF.L* - -
APPROVALS »
ASSESSHEa1` CLERK BUILDIidG D )n PQLIC$ DEPT.
?,1AiEIt & S+.?WE:t2 DFPT. FIUr--DEP'T. PA.`2I{ DSPT.
??? q?
2007RESIDEN'I'IAL BUILDING rERMiT nrri.icaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 .
New ConsWcfion Reauirements
3 registered site surveys showing sq. R. o( lot, sq, ft. of house; and all roofed areas
(200/6 ma)dmum lot coverage allowed)
1 Soils Report 'rf proposed building is to 6e placed on disturbed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculabons
3 copies of Tree Preservation Plan'rf lot platted after 711193
Rim Joist Detail Op6ons seleclion sheel (buldings with 3 or less units)
Minnegasco mechaniral ven61a6on tortn
Remodel/Reuair Reauirements
2 copies of plan showing foofings, beams, joists
1 set of Energy Calculations for heated additions
1 sfte survey for addi6ons & dedcs
Addition - inaUcate if on-site sepfic sysfem
5;?2 66
Office Use OnN
Ced of Survey Recd _ Y_ N
$oilsReport -Y N
Tree Pres Plan Recd _ Y_ N.
Tree Pres Required _Y _ N
On-site Septic'System _ Y _ N
Plans are considered ublic information unless ou state the are trade secret and the reason.
Date QB I7 Construction Cost
Site Address Z7 Zql Unit/Ste #
Description of Work
Multi-Family Bldg _ Y?X N Fireplace(s) _ 0 2
Property Owner Telephone #
Contractor
Address 37911Ir?jIVAZ*_
State /Yk) Zip ???/C"3 City
Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CateQOrv 1 _ Minnesota Rules 7672 .
Enefgy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet
(V submission type) Submitted Submided
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permiT for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor D LC E FIE J
Sewer/water Contractor ?-q PICJV 0 -i ?007 Telephone # (
Telephone #(
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 p(an in the case of work which requires a review and
approval of plans.
??-
ApplicanPs Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE
S u b Tvaes
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Tvpes
? 31 New
? 32 Addition
? 33 Alteretion
? 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 LowerLevel
? 20 Pool ? 30 Accessory Bidg
? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 23 Porch (screenlgazebolpergola) ? 36 Multi Misc.
? 24 Storm Damage
? 25 Miscellaneous
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building• ? 43 Reroof ph 46 Windows/Doors
•Demolltlon (Entire Bldg) - Give PCA handout to applicant
DCSCrIqti011: WaterDamage`Yes
Valuation ?? DQ? • ?
Plan Review 100% r 250X
Census Code -
SAC Units
# of Units
# of Bldgs
Type of Const
Occupancy 01 MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
? Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
Sheetrock
FinallC.O.
Xo FinaVNo C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
_ 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
? 07 05-plex
? 08 O6-plex
? 09 07-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
------------------
? For-?ffice?.l'se I
I ? 7 ?
j Permit #:
I ?
? Permit Fee: ?
n I
? Date Received:
I Staff: I
I ?
`_____ _J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
? Lb hn ,e. ,StaN? /? r-
q
Date: 1 Site Address: )4Zq/
Tenant:
Suite #:
IDENT
OW A " ? Phone=0 335 9 7,1 ?
N
RES
/
NER ame:
Address / City / Zip:
Applicant is: _ Owner Contractor
TYPE OF WORK Description of work• =j1 O.l??? '(sj k-
Construction Cost: ?. ec Multi-Family Building: (Yes No ?
CONTRACTOR WePL• License #:
,
80 QQKJspedar Ave. S S4e. 919
Mpls MN 554 ic.
Ph: 6 ti2/74-6943 Fatt: 952-405-6906 State: Zip:
ervaail: newilifecon4racQing@yahoo.com
I Phonp;ndw JOP1nSOn Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submisslon type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan7
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOtE; Pians and supporting docu?ne'nfs that you submit are"considered to be p'ublic intormation " Portions of '
the information may be cJassified as,nonpu6/ic if you, proviple'specific? reasons that uvouid permrt the City to °`
?
`
' are trade secrets. C<?
'cbnc?'lude ?that the'
-
I hereby ?c'r??rcat[ t?ft?rrt??tibf??scomplete and accurate; that the work will be in conf nc with the ordinances and codes of the City of
Eag8Q?tQ?i RA'%4en&BAfiml,1:& only an application for a permit, nd work is o tart without a permit; that the work will be in
??n" ?tl?4?r? ?la,i i?9$Ic which requires a review and app s.
Ph: 651-274-6943 Fatt: 952-405-6106 ?
@mail: newrlifecon4racQingQyahoo.com
ApplicanYs PEAnvfliNhulU'130n ApplicanP ' natur
Page 1 of 3
I*)
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
q 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: (1 f izo j 3 Site Address: 9� if/ (/ Kroh Ii D%-2,.
Unit #:
Resident/
Owner
Type of Work
Name: VQJ ff LAI/ley
Address / City / Zip:
Applicant is:
Contractor
Phone: 4'S) • 338. %a/
Owner V \ Contractor
Description of work: 'Poor f -F -P(./ /EI%T-
Construction Cost: 605 0 • 00 Multi -Family Building: (Yes / No )
Company: 1N6004P-/ t 55 Yj rpt I LOPS Contact:_c#,treAipal( 1 l C -re -
Address: Z �� l �"
� .sj (5Wf)1— City: OM
Contractor
/9 -
state: _ Phone: 40 7 y. U S� S—
License #: f3(G (0* ( Lead Certificate #: /t/ t f
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. 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. v, �ww.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.
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Applicant's Printed Name
Applicant's 'gnature
nature
Page 1 of 3
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SGL. 40 `` '/`' vo. _ .2e'rLe7YLC'O ° I
BY:
D
SMOKE DETECTORS ARE REQUIRED
ON EVERY LEVEL OF THE HOUSE AND IN
EVERY SLEEPING ROOM AND IN EVERY
EAGAN HALLWAY LEADING TO A SLFRPING ROOM
REVI WED
HCTION DIVISION
Sto9q9
City of Eagan
PERMIT
41' City of Eaan
Permit Type: Mechanical
Permit Number: EA151828
Date Issued: 09/14/2018
Permit Category: ePermit
Site Address: 4241 Limestone Dr
Lot: 4 Block: 6 Addition: Cedar Grove 2nd
PID: 10-16701-06-040
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
Surcharge -Fixed $1.00
0801.4088
9001.2195
Total: $60.00
Contractor:
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
- Applicant -
Owner:
Joshua C Lauby
4241 Limestone Dr
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA165410
Date Issued:10/30/2020
Permit Category:ePermit
Site Address: 4241 Limestone Dr
Lot:4 Block: 6 Addition: Cedar Grove 2nd
PID:10-16701-06-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Joshua C & Tania L Lauby
4241 Limestone Dr
Eagan MN 55122
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature