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4076 Limonite Lane3830 Pilot Knob :iTY OF EAGAN id, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT ,L1kTTt3ki 4iF To be used for ;;sy(}p ;} Est. Value +I i1Q0 SiteAddress t-i;=r T ;l" L't Lot Y? Block ? Sec/Sub. Parcel No. ¢ Name W 3 Address 0 City Phone 'w 54- 5?.. t 's o Name _ =U Address Phone ? uW' Name ? ; Address a W City Phone I hereby acknowlege 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. Signature of Permitee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. Building Official Receipt # Date 19? r OFFICE USE ONLY Occupancy - FEES Zoning (Actual) Const - BIdg.Permil xfl„ (Allowable) - Surcharga # ol Stones - Length _ Plan Review Depth - SAC, City S.F. Total - SAC, MCWCC S.F. Footprinls - On Site Sewage - Water Conn On Site Well - Water Meter MWCC System - Accl. Deposil City Water _ PRV Required _ S!W Permit Boosler Pump - S'W Surcharge Treatment PI APPROVALS Road Unit Planner C il - park Ded. ounc BIdg.Off. - _ Copies a ' Variance - TOTAL Permk No. PermR Nolder Date Telephone # WATER SEWER ? PLUMBING H.V.A.C. ELECTRIC Inapection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. - Isul. Fireplace Final Hlg. Final Plbg. Const. Meter Pibg. Inspector - Notify Plumber Engr./Plan Bidg. Final Deck Ftg. Deck Final Wall Pr. Disp. ,S ,t CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 , PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Mr•CK Est. Value $1 0(m) Date =AY k4 . 19'3? SiteAddress 4076 L1Ht_l;'iiL Lf+ Lot 0 Block S Sec/Sub. CF?AR G+.C;VE 7Ti. OFFICE USE ONLY PflfCBI N0. Occupancy - FEES Zoning - W Name ??.:+:iX}?, .?f ?`SC:l?,?S;AJL (AcluaqConst - BIdg.Permif Z6+? Addf@s5 `'M.6 (Allowable) - • ? o Surcharge City gA".AK' Phone A54-5tJ14 #ofstories Plan Review Lenglh _ o Name 5AME Depth - SAC City Z , o¢ Address S.F. Total - SAC, MCWCC r Ci[y PhOf18 S.F. footprints Water Conn On Site Sewage - F W NBme On Site Well - Water Meter _? Address Mwcc system - Q= Acct. Deposit aW City PhOnB CiryWater 1W P i 5 PRV Required erm , t - I hereby acknowlege that I have read this application and state that the Booster Pump S,MI Surcharge information is correct and agree to comply with ali applicable State of Minnesota StaWtes and Ciry of Eagan Ordinances. Treatment PI Signature of Permitee _ ,":!:^' APPROVALS Road Unit A Building Permit is issued to: ^G.i1.fID? ?• i Planner - Park Ded. on the express condition that all work shall be done in accordance with all Council - applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg. pry. Copies Building Official i Variance - TOTAL 211 PermN No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection ate nsp. Comments Foofings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN Addition CEDAR GR 0v;?er?_ Lot l() Blk 5 Parcel 10 16706 100 05 4076 Limonite Lane State Edqanr MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 61 1970 58.18 2.08 ZB Paid * SEWERLATERAL 1971 20 WATERMAIN * WATER LATERAL jj?L 1971 1,615.00 80.75 20 Pd1d WATER AREA * STORM SEW TRK 131 1971 20 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 300.00 6347 8-29-72 BUILDING PER. sac 260.00 6347 8-29-72 PARK I ? ? I ? -, EQGAN TOWNSHIP BUILDING PERMIT Ownec - - - °- - - . ....................- .l''_ Address (PresenY) --??-- ? - - ..... ............ ?...................... Builder ..... Address .... .. DESCRIPTION Atto 283'7 Eagan Township Town Hell Daie .. ??.-. .? ?.. - -°-°- ------- .............. Stories l To Be Used For FronS Dep2h Heighl Est. Cos3 Permii Fee Remarka r ?,t,r--y •l. -'_ ?_ .- Y ? / - J L S G LOCATION A z !?-. - •---•------...--•°--.... Per - .... - ..._._--° ...._......_"e----..+,7.................. - .......................... -.. airman of Tnwn Board Suilding Inspecfor ? ? This permit does not auihoriae the use of sLreeis, roads, alleys or sidewalks nor does it give the owner or hia agent the righi !o create any siivaYion which is s nuisanca or which p:esents a hazard !o the healYh, safety, convenience and general welfare !o anyone in the communi2p. THIS P£RMIT MUST BE KEPT ON THE PREMI?SEWHI.?LE THE WORK IS IN PROGRESS. Y• thai - ? ?1 C . This is !o cersif -- as permission fo erect a.---? /--?. :'. . :C.:..;.`_ ?'`-='r=,?=`:-...r ...................•--._....... _??_". ..........._upon the above described premise subjec! !0 the provisions o! the Building Ordinance for Eagan T? nship efdopled April 11. 1955. CITY OF EAGAN N? 16303 3830 Pilot Knob Road Eagan MN 55121 P.O. Box 21-199 , , , PHONE:454-8100 BUILDING PERMIT Receipt # CJ O INSTALLATION OF 100 $1 , To be used for TIO D OR Est. Value Date , 19 Site Address 4076 LIMONITE LN Lot ? Block 5 Sec/Sub. CEDAR GROVE 7TH OFFICE USE ONLY P8YC81 NO. Occupancy - FEES Zoning - ¢ Name GORDON R SCHMIDT (Actual) Const - Bldg. Permit 28 • 00 w 3 Address 4076 LIMONITE LN (Allowable) - S h 1.00 ? City EAGAN Phone 454-5014 u ot Stories urc arge - Plan Review Lengih _ Name SA? Deplh - SAC City _? ?? Addfe55 S.F. Total , - ? Clty Phone S.F. Footprints SAC, MCWCC - Water Conn On Site Sewage _ ?w Name On Site Well - Water Meter _? Addf2SS MWCC System - c+u a W City PhOne Ciry Water Acct. Deposil - SIW Permil PRV Required - I hereby acknowlege that I have read this application and state that ihe Booster Pump SMI Surcharge information is correct and agr to comply with all pplicable S o Minnesota Statutes and Cit agan dinances. Treatment PI Signature of Permitee APPROVALS Road Unil GORDON R SCHMIDT A Building Permit is issued to: Planner - park Ded. on the express condition that all work shall be done in accordance with all Council - applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Ofl. _ Copies Building Otficial 11.[,?SlC? 1\J 1! d' i i 1? ? Varianca - TOTAL 29.00 i $UILDING PERMIT To be used for DECK Est. Value $1,000 N? 1651'7 Receipt # ` - Date MAY 24 1989 Sile Address 4076 LIMONITE LN Lot 12 Block 5 SeclSub. CEDAR GROVE 7TH Parcel No. ¢IName GORDON R SCHM7DT o Address 4076 T.TMON7TF. T.N City F.AC:AN Phone 454-5014 =o Name SAME g? Address ? City Phone ?¢ ?w W Name Address aw City Phone I hereby acknowlege that I have read this application and state that the information is correct and agree to comply with all applicable State of M9 nesota Statutes and?y of nces. _, // Si nature of Permitee %C ? A 8ulding Permit is issued to: U N 1C N'HM 1"I' on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building OHicial CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 i PHONE: 454-8700 Occupancy Zaning (Actual) Const (Allowable) # of stories Length Depth S.F. Total SF. Footprints On Site Sewage On Site Well MWCC Syslem Ciry Water PRV Required Booster Pump APPHOVALS Planner Council Bidg. ON. Variance OFFICE USE ONLY FEES Bldg. Permit Surcharge Plan Review SAC, City SAG MCWCC Water Conn Water Meter Acct. Deposit S/VJ Permit SNJ Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 26.00 .50 "lb. SO /C - 5 - '7 G , (?;' ?0 TOWN OF EAGAN 3795 Pilot Knob P.oad Eagan, P4innesota 55121 PEaIIT N0. 2111 The Board oE Supervisors hereby grants to Cedw Cr++Ctve CGTisti'uCtion COe of 73lL3 ConCOrd B1Vd. Ea-st. 3mth Str. Pmt7. 55D75 a HPAT7NG Permit, for: (Owner) Cedar Gr+VA r0nr)tr»rticm Co.. 4076. i.im0atte<10-5-7,,.)3941 -idverton 1-6-8, 1709 Montioello 2••6-83 aad at 1271, M nW_]ln 10.?8..8 , pursuant to application dated Fee PAid: T,An_[m Dated this 22th day of A3ijVigt? , 1??• 2eOD 8/0 Building Inspector -3 -,, TOWN aF EAGAN 3795 Pilot Knob P.oad Eagan, riinnesota 55121 PEMIT N0. 255 _ The Board of Supervisors hereby grants to ?. Cd, of ?.,t 3 .,.r__---i „-,__a -,. _a. n__..,r.i. na ne,i rrG?r a Permit for: (Owner) _ . `,!?a?6 7,1ffite 3 0•5- ,`_? 39?' ?. vertou 1-ci-8 1709 p.ontiO o 2-?b•8 at 4T.????$?? ??, ,? ? , purSuant to appl cation dafe? Fee Paid: $An ?nr? Dated this ? day of , 194.2-. 2.f30 c% Buii.ding Inspector ff- REQUEST FOR ELECTRICAL INSPECTION ? See instmctions for completing this form on back of yellow copy. 0 95926 'X" aefow Work Covered by This Request M- es-00001-07 u c1 ?'l 8?3- e - ep. Type of Building AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify)" Comm./Industrial Furnace Farm ' Air Conditioner Olher (speaty) ConirectorS Remarks: Compute Inspection Fee Below: # Other Fee # ServiceEniranceSize Fee # CircuiislFeeders Fee Swimming Pool ? 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps SignS Inspedor5 Use Only: " TOTAL S Irrigation Booms Special Inspection Alarm/Communication Other Fee i, the Electrical Inspector, hereby certit th t th 6 i i Rough-in eJ y a e a ove nspect on has been made. Final Pa?e ? - "" OFFlCE USE ONLY This request void 18 monihs from -- ??- C? 5926 Request Date - I Fre Na. Rough-in Inspec[ion I Required? y,,?? ? Ready Now idwill Notify Inspector es ? No ???hen Ready? 10 licensed contractor )(owner hereby request inspection'of above electrical work at: .bb Address (Street, Boz or RoNe No.) Ciry O-7 llmD.veTE L.)er C A4 Sectbn No. 7ownship Name or No. Range No. Counry --?.'q Lo!/T Occupa QRItJn °oaDonJ ? ??Nn•? i Q ? Phone No. 9'?5_51°- S"c'3lY Power Supplier Address AAfo; c--c.6eT,2fc Elecvical Contractor (Company Name) Contrador§ License No. Meiling Adtlress (Contrador or Owner Making Installazion) • o7 G Yk&/ 651z.Z Authorizetl S" ur oniract er Maki stal on) Phone Number MINNEDC'fGSTATE BOARO OF ELECTpICITY THIS INSPECTION HEQUEST WILL NOT Grig9s•Mltlway 61dg. - Room5773 BE AGCEPTED BY THE STATE BOARD 1821 UNversiry Ave., St. Pauy MN 55104 - UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. - 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT 651-68/ 551?2 46 5 / New ConsirucHon Reaulremenh D 3 registered sHe surveys showing sq. R. of lof, sq. N. of house and QII roofed areas L20% maximum lot eoveraae allowed) D 2 copies ot plans (show beam 3 window sizes; poured fnd. design; etc.) D 1 sef of energy calculaNons > 3 copies of hee preservaNon plan 61ot piaMed aRer 7/1/93 DATE: ? - t) -qq Remodel/Reoair Reaulrements 2 coples of plan 1 sef ot energy caleulaNons tor heated addiHOns 1 siFe survey for exterior addiHons t decks CONSTRUCTION COST: 40 DESCRIPTION Of WORK: t?wGV?'. r??RlnI(lxk_p STREETADDRESS: °?Jm ? bn'10??4? Ltd LOT: 10. BLOCK: S? SUBD./P.I.D. #: ? G Yv V? Name:_???IZCj YYI16-aej Phone#: PROPERTY Lon Flrst OWNER ` • I Street Address: tI0T LL-P4' Li i'-)d 4Q, LI? City State: Iip: 6 51 7_ 2 ?IZC' - lOLl Phone #: LQ Company: (area code) CONTRACTOR SheetAddress: ( o C??J? License #2A22E5 Exp?-51"ZOCC) City ?_.L.vJ'Q ICVcJ QS?,-4 State: !y'J 1U Zip: ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street Address: Registration #: City State: Zip: Sewer 3 wafer Ilcensed plumber (reauired for new consfrucHon onlv): PenalFy applies when address change and lot change Is requested once permff is issued. I hereby acknowtedge that I have read thls appllcation, state that the intormatton Is correct, and agree to comply wNh all appllcabl State of Mtnnesota Statutes and Cffy of Eagan Ordinances. Signature of Appltcan?-?L"`-a? a&z` OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received Yes _ No Yes _ No - Not Required RECEIVED MAY 0 5 1999 BY: N ,.. ?Y . 1989 BUILDIRG PERMIT APPLICATION CITY OF EAGAN 14511 SINGLE FAMILY DWELLINGS 2 3$TS OF FLANS 3 AEGISTERED SITS SORFEFS 1 SET OF EAERGY C6I.CS. MIDLTIPLS DiIELLINGS 2 SM OF FLA,NS flEGISTfiRED 3I'!6 SDR9E23 - (CEECg WITH BLDG DIV.) 1 3ET OF BNER6Y CALCS. COMMERCIAL 2 SETS OF AACHIlECTURAL 6 STBOCTIJRAL PLANS 1 3E! OF BPECIFICATIONS 1 3Ei OF EMRGI CALCS. lNLTIPLB DNELLINGS AENTAL IINZTS FOR SALE DNITS f OF UNITS BOTEs ADDRES3ES FOH CORNEE LOTS - CONTRACTOR/HOMEOWNER !lQST DESIGNATE iiHICH iDDAESS IS DESIRED. HO CHANGES WILL BE ALLOVED ONCE BUILDING PERMIT I3 I33IIED.. SEWE& 3 iIATER PERrSIT FEES AND ACCOUNT DEPOSIT FfiFS liIC.L 8E INCLtJDED iIITH THE BUILDINa ? PERMTF FEE. PSOCF.4SING TIM FOA SEWER AAD 1i9TEA PERrII?S IS TiiO DAYS ONCE A PERMIT HAS BEEN COP'1PLE'!ED INI1ICgTIRG A LICENSED PLUMBEA. _ PENALTY APPLIES WFIENt PERMIT IS NOT PAYD FOR YN SAP9E A90E1TH IT 15 REQUEST6ll. LOT CAANGE IS REQOESTED ONCE .P.EitlSIT" YS' ISSDED. MAY 24 *86 To Be Used Far: , L C /< Valuation: Dates S- Z3-0/ Site Address 'y!16//'I?O+t1 /T? ,Gf?oC? OFFICE OSS ONLY Ic. Lot jiiW Block _J? Occupancy FEF.S Pareel/Sub GI*AA 612tuG r?7H Zoning Actual Const Bldg. Permit Z(o, ? Allowable Sureharge ,SO OWner 00i2DUn1 ;Z) c5lf /qfYliDT # of stories Plan Review Length SAC, City Address 'yd 76 Ll-/mUN/rE 6AAJL Depth ? SAC, MNCC S.F. Total Hater Conn City/2ip Code Ei9G)AA3 15J'r / Zz- Footprint S.F. Water Meter Acet. Deposit Phone On site sewage S/ii Permit /? P 0 e 5 On site vell S/ii Sureharge Contractor LTD ., Gti1 J - C H/1?140T c MWCC Sqstem _ Treatment Pl. ,/ Address 7O24o L!/yl0&J/7-C- LflAle Citp vater FR11 required Aoac! Unit Park Ded. City/Zip Code Z,Z _ BOaster Pumgs i Copies 3QBTOTAL lPPAOVAY,S Penalty Phone Planner tOTAL I 1.7) Council Arch./Engr. Bldg. Off. ?5?L4 variance Address City/Zip Code Phone A .%? 1989 BIIILDING PEHNIIT 9PPLICATION - CITY OF EAGAN SIAGLE FAMILY DiIELLING3 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, 1 SET OF ENERGY CALCULATIONS AOTEs ADDEESSES FOE CORNES LOTS - COATRACTOA/$OMEOiiNEH 2ltT.ST DE.SIGNATE WHICH 9DDR&SS IS DESIRED. NO CHANGFS iiTII.L BE 9LLOYSD OD1CE HIIILDING PBAMIT IS I33IIED. KQI.TIPLE DWELLINGS EE19T9L DNITS FOH SILE OBITS f OF IIHIT3 INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SIIRYEY - CHECg iIITH BLDG. DEP?., 1 SET OF ENERGY CALCIILATIONS CONIlMERCIAL it/ ? ?04; INCLUDE 2 SETS OF ARCHITECTURAL & STR()CTURAL PL9NS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS T??s?r qcl To Be Used For: {',q-7-1 o 1c?9&S Valuation: A?/????r'? (go Date: - ,-. Site Address Lot _LO Bloek _.rL? Pareel/Sub CEI:>,kk GooUe- `7TH Owner L7'0P-Do'l) Address VeJ76 L1yylay17F (.'iQAIE City/Zip Code (6404AJ /VI, Phone Contractor CvPQpc%&) P 5CNMrD7- Address 'y0 `J/ 61/1fOst&M-: 41-A,'IJ L. City/Zip Code CAQ 4Au 5 51 Z? Phone 1/-S73I 5-0 /X Arch./Engr. Address City/Zip Code Phone # OFF'ICE USE OM.Y Occupaney FEE.4 Zoning Actual Const Bldg. Permit 2$,00 Allowable Sureharge 1,04 # of stories Plan Review Length SAC, City Depth SAC, MWCC S.F. Total Water Conn Footprint S.F. Water Meter Acet. Deposit On site sewage S/W Permit On site well S/W Sureharge _ MWCC System _ Treatment P1. City water _ Road Unit PRV required _ Park Ded. Booster Pump _ Copies TOTAL a ob APPR011ALS Planner Couneil Bldg. Off. Variance NOTE: Sexer & water Permit fees and account deposit Pees xill be ineluded in the building permit fee. Proceasing time for aewer and rtater permits is two days once a liceased plumber has applied for a permit at City Hall. .1 ?i ja-5-7 EAGAid 1C)WNSHIP 3795 Pilot ltnob Road St. Paul, Minnesota 55111 Telephone 454-5242 Date PERMIT FOR WATER SERVICE COPTNECTTON s . g L-!? Billing Name Owner:aej Plumber: ` s Residence Xx Multiple Ho. Units Cammercial Industrial Uther NO }Total Chg. Building is a: d Number: 963 .? . ,?- Site Address. O-/7o L( {'YY?)tli, IE' Billing Address ! 3 UJ (1j L- <??c S-r. cL u I J ht?50-I"S-, Meter No. iMeter Permit Fee 10.00 pd 8/29/72 Meter Readiag Dep. :rs pci 8/29/72 Meter Sealed: Yes lAdd'1 Chg. Inspected by Date Remarks: By: Chief inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordaace with the rules and regulations of Eagan Township, Dakota County, Minnes ta. gy; -Y Please aotify the above office when ready for inspection and connection. 'A -% lO-S-7 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454•5242 PERMIT FOR SEWER SERVICE CONNFCTION DATE: 54;D 6 NUMBER 7121 ? OWNER. YAddreae h PLUMBER ?? ?1 QIu }Yj I nci 1'ypE OF PIPE \ QC?_?I?O ! DESCRIPTION OF BUILUING Industrial' Commerciall Residentiai I Multiple Dwelling I No. of units Location of Connections: Permit Fee 10.00 d 8429472 .Opd 2972sc Street"Repairs ToCal Inspected bq: Date Remarks• Connection Charge 260.00 pd 8129/72 By Chief Inspector In consideration of the issue attd delivery to me of the above permit, I hereby agree eo do the proposed work in accordance with the rules aad regulations of Eagan Tonnship, Dakota County, Minaes By ,ao Please notify when ready for inspection and conaection and before any portioa of the work is covexed. MASTER CARD LOCATION OWNER STRUCTURE AND LAND USED AS Permit BUILDING I No. I?07 Issued ?- Issued To Contractor Owner PLUMBING zss CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING ? y I GAS INSTALLING ? SANITARY SEWER 'Z OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING -?y- ? SEPTIC FOUNDATION o ^ 10 ? CESSPOOL FRAMING TILE FIELD FT. FINAI ELECTRICAL HE,4TING O^?D` DEP7H OF WELL - GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING v WELL SANITARY SEWER (S tA) ? r &L,' Violations Noted on Back COMMENTS: . ? ?--- ! -- 2a Z . 4 2 -?-- / / LaTe /O TAk'??:L e ?c?EiZ ?i.CO?E 9? ?cel.vc.? 1 G^okOON } JAAlEL SCNMIL:T 4bLKe55: 11696 L/Monii76 LIINt EAgAN MN. ?51 Z Z 1)f1TE ? 5 - 23-gD I -c'ALt ? / /NCN = /O FcET ' - ?-_ I 1 zft?l O ? n ? I I For Office Use 1so I -qo-, ~ Permit l`~ City of Eata ll~' I Permit Fee: O I 3830 Pilot Knob Road I Date Received: Eagan MN 55122 1 Phone: (651) 675-5675 I I Staff: 1 Fax: (651) 675-5694 I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 40-7(o one- Tenant: Suite Phone: 41 RESIDENT I OWNER Name: Address / City / Zip: TV 7 I YIP- Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: ' J?R, Multi-Family Building: (Yes No CONTRACTOR Name: 6~h On jcense Address: tl ; te: UAN"Zip: 5S'T City: Phone: 1 ontact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission 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 plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a pe ; that the work will be in accordance with the approved plan in the case of work which requires a review and approv la s. Aemq Applicant's Pr ted Name Ap a 7!)12 Page 1 of 3 City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use 1v( Permit #: Permit Fee: Date Received: Staff: 7 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ?).—/V"-/ J Site Address: Unit #: Resident/ Owner Name: 7--fr/t,9,..30 ✓,..- ./ // Phone: 442? "7e, IJVCZ ,° /� Address / City / Zip: �® ,4' 2, rr zr�-•.--../ e- ./.srr Applicant is: Owner Contractor Type of Work - ,-z,► Description of work: ' ,�, 4-6 ,,---e, � _ Construction Cost: Multi -Family Building: (Yes / No>" ) Contractor Company: / r✓' -- - f ; raZ1,4 contact:vl- 74Se', Address: y® 8'C �`�i.e- �s• — City: 1V/ State: /.4r/ Zip: .��®_2":" Phone: License #: 2rZ / 77' 5/ Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 4,0>— 73�, Al/ Xi -v6) In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: NOTE: Plans and the information Phone: Phone: Phone: supporting documents that you submit are considered to be public information. Portions of 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 Sta days of permit issuance. • 7, 74: 7eft.,*/ re A p icant's Printed Name Applicant's Signature ode must be completed within 180 Page 1 of 3