3640 Falcon Way
Use BLUE or BLACK Ink
Fore/9
City of Eajan p I Permit#:
I'G~ I Permit Fee: $ O r ` t
3830 Pilot Knob Road C Cf~ t t
Eagan MN 55122 i, Date Received: j
Phone: (651) 675-5675
Fax: (651) 675{,694 ®G Staff
J
2011 RESIDENTIAL BUILDING PERMIT APPLICATION [il
Date: Site Address: Unit A-11
Name: tz4r~.! Phone: x'_129 _n9r i - ~rdst
RESIDENT /
tr wr
OWNER Address/ City/Zip: !r_f„QD mjEjt;ft=CLJ
Applicant is: Owner ✓Contractor
TYPE OF WORK Description of work: did S7'nLL_ NK:(-J : t _ L. c C) -r-- -PO SL(-V_
Construction Cost: '9 koo Multi-Family Building: (Yes / No
Company: ~t t~ ►~a2 ~iELI~~G` Ponta
CONTRACTOR Address: ~ 6 SpR-L,s~ s t City: 'fit ~~4t.J
1 -Z3a3 -~aS
State: kA yJ Zip: S S 17- Phone: - ` !J zz
License 7 _b3e n 035 Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
L' Cis Gt is t4 i f fL I970 P S Y(-~•~ ~ ~
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 S Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classed as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Calf 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 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 appryval of plans.
X v~ U Y`a l kLNLc- X 1-4
Applicant's Printed Name Appli nt's Signature
Page 1 of 3
DO T WRITE BELOW THIS L ~~J V
SUB TYPES
Foundation _ Fireplace Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family)
Mulct Deck _ Porch (Sc ) _ Exterior Alteration (Multi)
_ 01 of Plex _ Lower Level _ Pool _ Miscellaneous
_ Accessory Building
WORK TYPES
New Y Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fine Repair Windows Demolish Foundation
Replace Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation DG'la Occupancy MCES System
Plan Review Code Edition JR-.4,0? SAC Units
(25%100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRY
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C' 0. 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
-ir Insulation Retaining Wall: _ Footings _ Backfill Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: 1 Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
1 1
q-4N
I
City of EaRd an I Permit
I
Permit Fee: • I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 1 Staff: I
Fax: (651) 675-5694 1 -
------J
010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: -3 4eO
r,
Tenant: Suite
RESIDENT/ OWNER Name: 4-1 fyo-r 4-TT/;f Phone:
Address / City / Zip: 3 51'0
CONTRACTOR Name: License
Appliance Connections Inc
Address: City:
State: Zip: Shakopee, NWS6379
Contact: 1952-44ra.48m
TYPE OF WORK -New 4(Replacement _Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment ~-C C- ~ ~•Q/c'
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
'Water Turnaround (add $166.00 if a 5/8" meter,is required)
$100.50 Septic System New ($10.00 per as built) (inqudes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) S
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/af underground utilities. www.oooherstateonecall.ora
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 k permit, but only an application4MM permit, and work is not to start without a permit; that the work will bg in
accordance with the approved plan in the case of wbrk whibll requires a review and approval of plans.
f
Applicant's Printed Name A is Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
I - I Pwtnit No. I Permit Holder I Dste I Talephone N I
Mty.
Plbp.
Final
Occ.
Dfsp.
_ .. _ . . ._ ,. -,-- .
CITY OF EAGAN ?????
3830 Pilol Knab Road, P.O. Bax 21-199, Eagan, MN 55121 -
PHONE: 454-8100
BUILDING PERMIT Receipt#r'
Tnhnitanelinr 51-7 DWG/GAR FQ+vai„P $68,000 nA+P JANUAI2Y 27 ,o $ti
Site Address 3640 FALCON WAY Erect CIX Occupancy R3
Lot 11 Block 5 secISub. LE?iINGTOP7 PL SOmodel ? Zoning R1
Parcel No. Repair
it ?
? Type of Const. 'V
i
Add
ion No. Stor
es
FRniJTIFR MIDWEST HOMES CORPMove ? Length 40
¢ Name
Z
; 3948 SIBLEY MEM HY+iY. ?
Address ?g Demolish
I
I ?
? Depth- 46
°
City EAt.?APd phone 454-0433 nt.
mpr.
Install
0 Sq. Ft
Z o Name
0 ? Address
? r?n, Phnna
of BIdg.01
Police
? W Name KICHARD C?Ii?RLIER Fire
?; Address 14103 GA?3tDENVIEW CT Eng.
< W city A•4r,or,e 4 3 2- 54 9 2 Pianner
Council
I hereby acknowledge th
information is correct ai
Minnesota Statutes and
Signature
A Building Perm
all work shall be
Building Official
Assessment
Water & Sew.
Var.
H4MES CORP
Permit =. GO
Surcharge 34.50
Pian Review?F• 50
SAC ??• o o
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.04
Tr. PI. 156.00
Copies
Total • . • SO
? on the express condition that
Minnesota $tatutes and City of Eagan Ordinances.
PERMIT # 1-
• MECHANICAL PEiiMIT RECEIPT # -'' `-' J 3?
CITY OF EAGAN 2/ ? 8?
3830 PILO T KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: $ 2100 . 00 PHONE: 454-8100
Site Address 3640 8 con a BLDG. TYPE WORK DESCRIPTION
Lot 11 Block 5 Sec/Sub k t_
? ?
Name ?NZEL MECHANICAI. New
Res.
Add
M
?c
Address 3600 Kennebec Drive -on
ult
Comm. Repair
c City EaRan Phone 45Z -1565
Othgr
Name Frontie7r Co mpanies FEES
c Address 3908 Sibley ,(emorial HW . RES. HVAC 0-100 M BTU - $24.00
? C?ty Eagan Phone ?+54-0433 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
` TYPE OF WORK
80
24
00
GAS OUTLETS -
1.50 EA.
Forced Air M BTU . COMMIIND FEE - 1% OF CONTRACT FEE
, Boiler M BTU
-It MINIMUM - RESIDENTIAL FEE - 10.00
- Unit Heater
: M BTU MINIMUM - COMM/IND FEE - 20.00
_
Air Cond. _ -
N MATU
STATE SURCHARGE P-ER PERMIT
- .50
(ADD $50 S/C IF PERMIT PRICE GOES
Vent
? CFM BEYOND $1,000.00)
Gas Piping Oudets #
Other
24.00
FEE
S/C: .50 SIGNATURE OF PERMITTEE
TOTAL $24•SO
FOR: CITY OF EAGAN
PERMIT # CITY OF EItGAN FEE a 7 00
PLUMBING PERMIT U
RECEIPT # - 454-8100 . S/C ?
MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL
DATE 3 MINIMUM COMMERCIAL FEE -$20.00 + $.50
1. Bidg. Type: Res ?Comm Inst 2. New Add Alter Repeir
3. Total Bid Price A. JobAddress 3640 raiCOr: rJiiy
X U;1tY?:" i''t c??n1"
St
Lot Block Sec 5. Owner
6. Contractor ' -.o^1i. 36UU r: ?,-?•??c :)r. 551'?"
(Name) ? ? . , . (SVeeU (City) (Zip)
7. Contractor Phone # F?•- -1 ) o -,''
NO. FIXTURES
NO. FIXTURES
NO. FIXTURES
1 Water Closet - $3.00
--7-Bath Tubs - $3.00
! Lavatory - $3.00
-Shower - $3.00
-LKitchen Sink - $3.00
-Urinal/Bidet - $3.00
?Laundry Tray - $3.00
? Floor Drains - $1.50
! Water Heater - $1.50
Whirlpool - $3.00
?Gas Piping Outlets - $1.50
_Softener - $5.00
_Well - $10.00
Private Disp Syst - $10.00
_JL-Rough Openings w/o
Fixtures - $1.50
COMM./IND. RATE - 19'o OF TOTAL BID PRICE PLUS $•50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
?
Signed: for
Approved ? Inspections: Date Rough Insp. Date Final Insp.
0 Pilot Knob Rwd
. Box 21199
r,w_ner: Y OF EAGAN
an, MN 55121
r?
rg: ,-,.- i
Addnesa:
' Siro Ilddres: Pluriber. Marer No.: .3?? S.SO 3
Slze: ,•
Reode IVo. :e2/.? L s.. 3
1 yne 1e "implY Mr" tlN
O.dim.me.a.
st
WATBt SERVICE PERMIT
PERMIT NO.:
DATE:
. No. of Units: ?
8
Y
DoM of Irrp.:
CiTY OF EAGAN
3830 Pilot Knob Rwd
P. O. Box 21799
Eagan, MN 55121
-W__,--
/lddross:
"Pw !v "at* wMh fM Ciy Oi iyo¦
of Irap.:
1VIIsc. Chorpss:
Total:
Dote Paid: _
PERMIT NO.: _
DATE:
No. of UnNs; _
{.OflflK'tiOfl Ch4?pf;
Aecount Depowt: I
PrnnR Fie:
Surchoroa:
Miac. Choross;
Totol;
Dob Peid:
?
156.
er
CITY OF EAGAN Remarks
Addition Lexington Place South Lot 1
Owner Street 3640 Falcon
5 Parcel 10 45060 110 OS
State Eagan, MN 5 S t 2_3
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK m 6 ?
SEWER LATERAL 1011 1986 16 31 . 0 0 ?T2 6• 0 5
Services 1015 1986 729.39 145.87 5
WATERMAIN 5a 65 S g 6 .a, -
WATER LATERAL 1011. 19 8 6 8 7 3.?+3 1 • 8 5
WATER AREA 101lk- 1986 243 . 73 .48 • 74 5
' WAT LAT BEN 101 1986 111.98 22•39 5
STORMSEWTRK 1014 1986 426.54 85.30 5
STORMSEWLAT 101b 1986 8d3.34 160.66 5
CURB & GUTTER '
SIDEWALK
STFEET LIGHT
WATER CONN, ?? n
9UILDING PER.
SAC 575.00
PAR K
CITY OF EAGAN
- 11476
?-. 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 5512, Np
PHONE: 454-8100
BUILDING PERMIT qeceiptp o 9 ? I/ D
7oheusedlor SF DWG/GAR Est.Value $68,000 Date JANUARY 27 1986
3640 FALCON WAY R3
Site Address Erect ? Occupancy
Lot 11 6iock 5 Sec/sut. LEXINGTON PL SQemodel ? Zoning Rl
Parcel No. Repalr ? Type of Const. V
Addition ? No. Stories
? FRONTIER MIDWEST HOMES CORP Move ? Lengtn 40
i Name Demolish ? Depth 46
o Address 3908 SIBLEY MEM HWY., #E
City EAGAN phone 454-0433 Instampr. O Sq.Ft
i o Name SAME APProv:
,°? Q Address Assessment _
i- City Phone Water & Sew.
W W Name RICHARD CHARLIER
1-; nddress 14103 GARDENVIEW CT
aw Ciry A.Vphone 432-5492
I hereby acknowledge that 1 have
inlormation is correct and agree
Minnesota Stawtes and Cjq?
Signature of
A Building Permit is issued to: all work shall be done in accordance with all
9uilding Official
Police
Fire
Eng.
Planner-
Council_
>nandstatethatthe 1/23/8f
epplicable State of Bld9' off.
APC
• 00
Permit
Surcharg ?4.5 0
Plan Review 00
SAC
500.00
Wa er Conn.
Water Meter 00
--29-ff
Road Unit .
Tr. PI. 156.00
Vac Date I Copies?? ?Q
DWEST HOMES CORP Totat '
on the express condition that
State o( Mi nesot Statytes and City of Eagan Ordinances.
? Y
s
RequeS Daie Plre No. Fougn-in Inspection
FeQUiretl?
?Reatly Now ? Will Notily Inspeclor
Yes $ No H'hen Reaoy?
I -V- licensed contractor ._] owner hereby request inspection of above electrical work at:
A
Ja
tltlress (le No-I Ctty
3c,ya iw.lcor? ?t? ??-
Section No.
TOwnship Name or No. Range No. County
I
-?--- Lk, kato?
OccupantlPRINTI PhomeNo. w_;?s _3e32
AGFs6.soz?
Power Supplrer --
Aaaress
ecmcal Conlracto? ?COmpany Name? ConVacror§ Llcense N.
Ei .
T CqozZGy _
----
- ---
MaAmg Aaaress (COmractor or Owner Makmy Instaliaton?
? 50905
------ --- ---- - --
AWhodzaC Srgnawre iCOnvacmnOwoer Making instellelion) Ppone Number
?
C..tVL7.t4 -.1e MDU'Vk, 6"Z-72/-6466--
MINNESOTA STATE BO/.PD OF ElEOTRIqTY ' .
Griqgc-MiEwey Bldg. - Room 5473
1821 Univeraity Ave.. SL Paul. MN 55104
Ppone (612) 662-0800
THiS INSPECTION REpUEST WILL NOT
BE ACGEPTED BY THE STATE BOARp
l1NLE55 PROPEF INSPEQION FEE IS
ENCLOSED
.
351?? REQUEST FOR ELECTRICAL INSPECTION
? ? Sea insln¢tions for compleling ;his brm on back ol yellow copy.
5 ?j3Q, C1C3 -- "X"Delow Work Covered by This Request
-`.'? ee-oooo,-oe
eW1 Add Rep: Typeofeuilding _ AppliancesWired Equipmen7Wiretl
Home
Duplex Range
Water Heater Temporary Service
ElectriC Heating
? ? jApt. Building
Comm./Industrial Dryer
Fumace Other (Specify)
? Farm 5{' Air Conditioner
Omer (syecily,
Compute lnspection Fee Below: Gontraclork Remarks: A " ??a? } fai'?Q (
? Other Fee # Sermce EntranceSize Fee # CircuitslFeeders Fee
? Swimming Pool 0 to 200 Amps / 0 ?0 100 Amps , o D
?Tfansformers A6ove200_Amps Above-1 0_Amps
Sig05 Inspectorls Use Onry: 1
? TOTAL
-Irrigaiion Booms
L r
?J -? ?.S.,rj0
?Special Inspection
Alarm/Communication THIS INSTALLATION MAV BE ORDE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
1, the Electrical Inspector, hereby Ro.qi , Dat
certiry that the above inspection has
been made. Foai
t? ,y
OFFICE USE ONLV
Tnis :eyuest voitl 18 monIDS Imm
This reQUest void /` p
?J C dQ
PL?raonths ? 0??5256 k1) , 8 s; /
, e,f Pl Sa , ?aoofj
Request Date
9? Fire No. Houqh-in Insuec?ion
Requ r
'
?fleady Nuw ill Nntifv. Inspec-
Iq es ? No lor When qeady
PLlcensed Electrical Contrac[or I hereby reuuast inspection of above '
? Owner - electncal work instelletl ar tet Atldess, Boz o Route No. City
/l
? T Lo ?
ecbon o.
• Townshio Name or No. Ran No. County
?-+V ? -11 ? ? C. J ? Phon JNo. p
? ? 0
Power plier . Atldress?
Elacttical Coniractor (COmpany Name)
T° . ?TR C Contracmr's License No.
(D t/7? 9
MailiT ' dress-1 ontractor or Own r ? Iqs a.latioN
14540 PEti
AuthorizAdl9 t e tia wn i. bN
if'11 I Phonc Number
MINNESOTA STATE BOARD OF ELECTNICITY THIS INSPECTION NEQUEST WILL NOT
Grie9s•Midway Bltlg. - Boom N497 gE ACCEPTEO BY THE STATE BOANO
1827 University Ave., St. Paut, MN 56106 VNLESS PPOPER INSPECTION FEE IS
Phona 1612) 297-2117 ENCLOSED.
p??a S/I?G REQUEST FOH ELECTRICAL INSPECTION . ee-oooovoa
See instructions (or complei this torm on back o1 Vellow cooY. /
p " "X" Below Work Covered by This Request WC..P ve
A-CLd Pap. Type oi Builtling Appliancee WiraA Eauipment Wi.eJ
- -- Home Range Temporary Service
Duplex Water Heater ightin,y Fixtures
Apt. Building Dryer Electric Hpatin
Commercial Bldg. umace Silo Unloacler
Industrial Bldg. Air Conditioner Bulk Milk Tank
F2fm Other Peci y ther lSper,ify)
t er Sueci y Oiher 01h¢r
Compute lnspection Fee Below
'N Fae Servica EnbanceSize M1 Fee Faeders/5ubfeeders # Fee 'C.ircuits
0 to 200 Amps 0 to 30 Am s 0 to 30 Am s
Ahove 200 qmpy 37 to 100 Amps 31 to 100 Am s
Swimmin Pobl Above 100_Am s Above 100_Amps
. Transformers rrigation Boorr?s Partia6'Other fee
Signs SUecial Inspection y1 ?
q/
TO
Pemarks
'?" TAL EE
Hough-in
Final ?
c.iiiiii
p
J???•O.LJ
I owe?
f.?
Dxte.
YaY? I, the Elac -
Inspector, ?ereby
certity that [he above
inspeetion has been
Thic request raitl 18 monttb Irom
• ?" ? ??/
1985 BUILDING PERMIT APPLICATION - CI17 OF EAGAN
NOTE: ALL CONTR$CTORS MUST BE LICENSED NITH THE CITY OF EAGAN
LPNCAs-rt-?z
C014IERCZAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
SINGLE FAMILY DYfELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
G S, Ooo
To Be Used For: Sinrzle Familv Valuation: *3;996 Date: 1-22-85
Site Address3640 Falr_on Wav
Lot 11, Block 5
Parcel/Sub LexinQton Place South
Owner Michael & Diane Ciardelli
Address 2400 W 102nd St. #337
City/Zip Code Bloominatont MN 55431
Phone 888-4870
Contractor Frontier Midwest Homes-Corp.
Address 3908 Siblev Memorial Hwv. IkE
City/Zip Code Eagani MN 55122
Phone 454-0433
Arch./Engr, Richard Charlier
Address 14103 Gardenview Ct.
City/Zip Code AnplP Vaj,]„gy, MN 55124
Phone 0 432,-5492
Erect ?
Remodel ,
Repair _
Addition ^
Move ,
Demolish ?
Int.Impr. ?
Install ?
APPROVALS
Occupancy
Zoning
Type of Const
U of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr Water Cqnn
Planner Water Meter
Council Road Unit
Bldg Off /•Z - reatment P1
APC Parks
Variance Copies
TOTAL .
?
1.
. 0 I A
L -11L11', .IV L 1 L
. _ gv?s,
SI TE ADDR ESS: - -
CONTRl1C?O R: ????T'+,C^."'??•
Getermine working square rootoqe ?f ea;h
?. Total exposed wall area..... rr. x.1: _ Z Z ? GS8
2. ?otai roof/cei;iny arca.... r: .026 = z5• 3?
? icta?i exnosed i??all area ?i?.nvc floor= '?P?? i???
a. Total tval iwirdow area ........... ........... ..
...............
..
? 7?0. ?
b.
Total
door area ................ ..
c.
Total .......
.....
sliding alass door area...........
................. ? Z
....
-
d.
Total
.
;ireplace ivall area ..........
................. ? Z
....
e.
Total ....
wall framing area javerage 10'';j .......
......
r-
f_ Total rim joist area........
... ........... .... Zcm6
•
s'
!'
net .....
wall area above floo?•,T%¢;?_,,,.,,.,, .................
.
.............
?
...
•
wall area above floor .........
. .
i. .
.....
wail area above fiocr..... ..... .
..........
...
j. frame wall nrea a? ?our?a-_icr ............... ................. ....
IOtdl °SuOSed i-C:l(iG.?±1"J!1 dl'Eu= ?ly PJ
r., Total foundaticn windeti5 area......
l.
Total ..........
net foundatior, ar;a Sbo;e g:ade ....... .......
.......
• ,
Detei-n?„r.e "u valt;e of eac'r?? wa
l ? seyment
s(2ccior
6.??.Cm _ X
c
d . ?? s,
e. f ?.. _ x
C)S;i
h.
i.
,7 .
K.
-1--? ? --- a ?-LL
co, ?> 4
rj r -
12,
X. _
Ix li? -' _
x ,1 u 1, _
n
3 . .................................Total = J??• J?
if i4em n3 is the same
as, or less than`item
rl, YOu have mPt tne'-
inter,t of 56C 6006
lvi .•.? vC1v??V. n-:.._ ?. ... ? .,?.....?, .? ". : _?
...
? . . .. . . . .. .. ... . . . . . . . . . . . . . . .
n. ^ctai roof/cci
-_ _-aming a_-oa ;; n;e 10?)...
0. ?OCuI .^.C= _.:?.._c._?.. _G::1/CL'il l:lg L ___..........?
, Dete:?r.'_ne "U" value Loi' caci: rcof/c_ili t:cy Ssg?ie::t `_
m. _
o. `??i• ?-
ei ....................
If tOt.ll G: iiv 15 tIiE
SuC 60C'o ,^.) 1.
;; 'U'
_C..
0
.^, t d 1 s
?
OS iL55 t:}12:L
'ib u`.ilize tne tota1 envelope sys*_em ;1^ciio3, *_; c v:lu•^s est.!)lisY.ecl by i:;ie s:i.:. of
iteir.s 01 Lnd ;';C snil1 not be nre.:ter ch-an tn-- su:n c,,- _zcm^ 41 anc ;r2.
, . C 7,-. 2 . ? ?- 47 = ??.,.
3. +
.- ?'?•?? = t i?t?
?
.?-
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• . :;?,,, o?;? 1
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acdn:?lruc;lun .. . . ... .
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?.?_ ? _'__ _' _.... . .. ..... . .. .. ._ ..._....._..
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CITY OF EAGAN
/
IItU APPLICATIGN FOR PER:tilIT _ .. ,
SEWER AND/OR WATER CONNECTIODI
(PIEASE PRIHi)
1) PFO°=ACDRESS: 3640 Falcon Way
rFrAI. DESC.?S?TIC:I:
( 1 v sicn or Tati Parcel I.D. NunSer)
1 u:7_.L ST.fl.j.?':C.r. Di1T-- OC CiIRICa=AL LUI:,D=?G ICJUYNCZ:
- az;
P ?CLT U'SZ: A R-1 S-Z.7C1.:.
? R-z rUP= (7;0 tmITs)
? R-3 TC;,i?:rV,?E ('?'I-= = L'_`IITS) ( L'ii2_5)
? R-4 U1.ITJ)
? CCin1EPCL=iL/f=_AII?OcrIC::
? mLSlTZTI,Ia -
Q
2) APpIZ= (PLEASE PRINi)
.
tVVdE: Frontier Midwest Homes Corporation
pDDRESS= 3908 Sibley Memorial Hwy. Bldq. E
CST-= , ZIP: Eaqan, MN. 55122 -
PF01,M=. 454-0433
j) pu,:=-,
?`?? (PLE;.SE Pfl14i)
Star Plumbinq fOR CITY USE 04LY
PDLRESS: 1018 Mound Springs TEI'. PIUHBERS LICEUSE:
Active
CITY, STA?'E, ZIP_ gloomington, MN. 55420
- ? EzPired
PHOVE: -mH3iLr.
884-4149 PI.UNBEA LICENSE q 3329 [?] Not of Recard
' dit tn1:i3
`fJ lC_L.IiYAC7i/(]'/l:'Z jYLGASt YH1flI)
N1k'`'1E: Michael & Diane Ciardelli ADDRESS: .2400 102nd W '
CITY, STA'lE- , ZIP: Bloomineton MN 55431
PI-iCFIE: -
_ --588-4$?f? .
5) INUIG,TE :a[-IICH PElZ•tIT IS SEIhG REC[JESTL•p:
? CC`tNF.C.TZO-4 TO CITY S-7•;ER Please mail gold copy to
? CO:?,'ECTZGN TO CZTY ;4ATER Wenzel Mechanical
3600 Kennebec Dr.
Q 071E2 (PLG`-SE D,SC;tIBE) Eaaan, MN. 55122
6) C:+c:
7) SIcz„-,TL-Rc,:
? PL-rNSE f?OID APPRGUEp ?ERMST FOR PZCi:-[ic BY CNE OF r1B(11E
19 °I-C-:,S,- :rl? t1PP??C7V'"r.il P&?_-1IT T`'J 1. 2 3, 4 AFC7Vi
_ , ?n (Cir _e one)
, DATE:
.
??1
?! RAia1lfRas! i q E?:af.c?! sAS7ga?a? ?s i srFSa?:aa a r?4r-a?l?}?s ? rslYa?aair .
FOR CITY U S E ON:,Y
PERKI^' n ZS$VED
:?°-S: $ A) 57)
. o
S:.?L.. i ..i.L SL...? ?:..GL? . .
$?l/%' S--b WATER PER,*iT_: (I1:CLUDE SVRC?i.`vIRGL)
$ (-3 S? WATER METER/COPPERHORN/OUTSID: R:i,DER
$ WAT°R TAP (INCLUDE CORPORATI0N STOP)
$ 5`.:dER TAP
ACCOUNT DrP('SIT - WATEF
$ 5?rz; • o- c? wac
$ S 75-, Cr-C) SP.C
$ TRli`IK SaATER ASSL.; S:i°_27T ..-.-
$ TRG:1K SEWER =,SSESS?tz'ciT
$ L`nTERAL Br.ivEFIT/TRliNK SF.::TE"-,
$ /<"7.- • aJ n LaTERrIL BEVL.FIT/TP,U`7K I•7AT'P,
$ WATER TREATPtEh'T PLANT SURCHA£.GE
$ OTHER:
$ TOTAL
$ Ai`!0[I:.T PAIDj=°iPT n 5 ?Ll/O
D0:5 UT:LZTY CON[VECTIO[V REQUZRE EXCaVATION IN PUBLIC RIGiiT OF S9AY?
? YE S ZF YES, THE N ;y "PERAIIT FOR `AOR?C WITHIN
PUBLIC ROAD WAY" MUST BE ISSpED BY THE
? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION. -.
SUEJECT TO THE EOLLOLJING CONDITIONS: - '
APPROVED SY:
TS::.E: .
DA'?'?' :
/ ..
i? A vi? aR ? f/ 4 tJ !40 4?l! EO wF ?/B ?iC ?lf? R? ?FO H?1? PRi i?Y i4
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?-----------------
i Fo%oihce,u? ?
? Pertnit#:
?
? Pertnit Fee:
I
? Date Received: ?
I I
? Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT
??/
Date: '2? SiteAddress: WlAL/
Tenant:
Suite #:
RESIDENT / OWNER Name: /o tq Phone: C? s1? ?-1007
Address / City / Zip: JV ?Q r0. ?L--, .1 011
v? dt'rs??SS-?? 3
v,
Applicant is: _ Owner _X-Contractor
7'YPE OF WORK Description of work: b--/b o?
?
Construction Cost: S??=
Multi-Family Buiiding: (Yes No ?
CONTRACTOR Name: Z-e?-- 67 Z;"+cLicense#: ,?2
Address:
City: State: ? ? cv Zip:
Ph
?? 3 T3( ?`?? `
4elz?
r
,4z L
one:
Contad Person: .
.
_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
COtCgOry Submitted Submitted
(4 submission type) • Energy Envelope Calcuiations 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 Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: phone:
NOTE: Plans.and supporting documenis that you submit`are considered !o be public,,information. Portions of r
` fhe information may be classifedasnon-public if you provide speciric reasons that would permit the City to
= conclude that the are tradesecrets. -IF
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance 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 pl ns.
x C?"'?YX
Applicant's Printed Name Applicant's Signature
Page 1 of 3
APPLICATION
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY aF EAGAN ?
3830 PILOT KNOB RD - 55122
651•681•4675
New ConahucNon ReaulremeMs Remodel/Reoah ReauhemeMa
D 3 reglitered alFe surveys showfng sq. R. o( iot, sq. tt. W house 2 coples of plan
and gll rooted areas f20% maximum bt eoveroae allowed) 1 sef of energy calculaNOns fw healed add(fiona
? 2 coples ot plans (show beam i window sizer, poured ind. desfgn; eTc.) 1 sile survey tor extefla adtlHlons a decW
? 1 iet of energy colculalions
? 9 coples M hee preservatbn plan H lot plaMed aHer 7/1/93 ?r
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: 1/?VI?ce S ij,
STREET ADDRESS: 5OVU
LOT: BLOCK: SUBD./P.I,D. #:
PROPERTY
OW NER
Name: ??OCA ?Lvi+1 Phone #: CeSI ` ? ?Q - ???
Las1 flrst
Sfreet
l0
CONTRACTOR
ARCHRECT/
ENGINEER
Sheet
City
Company: Name:
Teiephone #: area code ( )
Siredt
City
Sewer S water licensed plumber [reauhed for new consiruetion onN):
State:
PenaHy applles when address change and lo} change is requesfed once permB Is Issued.
Zip:
I hereby acknowledge that I hove read lhis appllcaHon, state that the In(ormoNon Is correct, d ree fo comply wNh all applicabl
Sfo4a M Mlnnesota Statutes and Cffy of Eagan Ordlnances.
Signature of Appikartt
OFFICE USE ONL
Certiflqtes at Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No ^ Not Required
Registratlon #:
ciri ?? ??l stare: ??' zip: Ss ld 3
SIt3NlA
suRvEYinvG
SEAi/1CES
3908 Sibley Memorial Highway
? Eagan, Minnesota 55122
Phone: (612) 452-3077
?iGA LE'. I "=4p'
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3
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6
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MODEL.: LA.f.l
°+ °% o ?
N
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SE CERTIFlCATE FOR;
lh? MCNAFBUIt-0FH? .
m L?ooeAi:Wta,
PE Ai Lu(i5
?r
COl41PAN1ES
?
,
?
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?
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DRpI IJACaE ?
U'f tLllY ?
?,
.4V
LOT ;2 ?
?
?
? v0
WAYNE D.
CORCES
- 94675 -
_LEGEND -
O Lenates lron Alonwent
n Lenotes Waai Hub Set
x qp7JypQenoles Existirg Spot E/evation
?n wo-t
Llenotes Proposed Spot Elevation
?-- Llenotes Drarnage Direction
-PFWEftTY [.ESCR I PT I pV -
LOT L , &GCK 5
LEXINGTON pLAGE Sor.J'fM
accordrng to the reca'ded plat thereof.
D DTA Camty, Minnesota
PROPOSED GARAGE FLODR ELEVATION= q02-1
Phi0PO5ED Top of Block ELfVATION= q09•D
PROPOSED BASf11ENT FLOOR ELEVATION= 00,0
towe.- Le,,a easc»,G.! = 59s,0
NOTE: Verify all floor herqhfs with Final Hcuse Plans.
SU? CERf I F 1CAT f(W-
1 hereby certify that thrs survey, plan or report
was prepared by me or under my direct supprvisiai
arel that I am a duly Registered LaM Surveyor
,uder the laws of tip tate oi Yirnesota.
r
I 1 'I
QAJ-?•?_. ? Date: (? ??O
IYayre D. Cordes, Minn. Reg. No. 14675
LOT iO
\6 9°
PERMIT
City of Eagan Permit Type: Plumbing
Eagan. Permit Number: EA099624
Date Issued: 06/17/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 3640 Falcon Way
Lot: I I Block: 5 Addition: Lexinaton Place South
PID: 10-45060-05-110
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Second Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: anthony haben
5730 170th In my
anoka. mn 55303
763-245-9049
Fee Summary: PL - Permit Fee (miscellaneous) $50.00 0801.4087
Valuation: 500.00 Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Professional Plumbing Solutions LLC Anthony L Mania
5730 170th Lurie NW 3640 Falcon Wad
Anoka NIN 55303 Eagan NIN 55123
(763) 24-9049
I hereby aeknowledae 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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108197
Date Issued:11/26/2012
Permit Category:ePermit
Site Address: 3640 Falcon Way
Lot:11 Block: 5 Addition: Lexington Place South
PID:10-45060-05-110
Use:
Description:
Sub Type:e - Furnace & Air Conditioner
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, (952)
445-2840
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Anthony L Mattia
3640 Falcon Way
Eagan MN 55123
Holmin Heating & Cooling LLC
900 Park Knoll Drive
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124220
Date Issued:06/25/2014
Permit Category:ePermit
Site Address: 3640 Falcon Way
Lot:11 Block: 5 Addition: Lexington Place South
PID:10-45060-05-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
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 -
Anthony L Mattia
3640 Falcon Way
Eagan MN 55123
(651) 405-0437
Sears Home Improvement Products
1024 Florida Central Pkwy
Longwood FL 32750
(407) 551-6000
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
�---- — ___—_-.
-- ____
I For Office Use / �
. � �� �I � I
� Pertni##: �
City of �a aIl ; . . l v�� . ;
� Pertmt Fee.
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: ' �
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: � `� /� Site Address: ���� t� G'C�j�ll [.(/B�� Unit#: +
Name: '�,�� /��'�'�� /�— Phone; ��I— '�O� �e./37
Address/City/Zip: 3��l b �f�►L�' �G��}� ��=1���," f�``�z.3 G-/z.. � �j 77— 5��.5�
—T
APPilcant is: Owner Contractor
Description of wo�k: �� ��--� ' C��� ��
Construction Cost: � ���.3• C� Muiti-Family Building:(Yes l No�
Company: 6w / �trQ L�O�''� Contact:�?��C/L��9'IM0.�-/��'"
Address: '��� 5 ��� �v�?• �� City ��js
State�d�Zip: �7'�� Phone: 2 7" .mail:
License#: G 30��"oo�'+2 �eaa c���cat�#: �✓.��"'- 7 2���-�
If the project is exempt from lead aertification, please explain why: (see Page 3 for additional'informa�on) '
6��°' �Q cj i
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING II��
_
In the last 12 months,has the City of Eagan issued a permit for a simllar plan based on a master plan? I
,�,Yes _No If yes,date and address of master plan: '�
�icensed Plumber: . Phone: . li
Mechanical Contractor. Phone:
Sewer 8�Water Contracto�: � Phone:
CALL BEFORE YOU DIG. CaU Gapher Stats One Cali at(6S1)454-000�for protection against unde►grou�d utllity damage,'Cali 48 hou�s
before you intend to d�ta rec�ive locatea of underground util�ies. �y,�(reo�#14�t,�ttonecail.oro
I hereby acknowledge that this information is compiete and accurate;that the work will be in confortnance with the ordinances and codes of the Gity of
Eagan; that I understand this is not a permit, but only an appiication for a permit, and work'is not to start without a permk; that the work wiil be in
accordance with the approved plan in the case ot work whlch requires a review and approval of plans.
Exterior work authorized by a bullding permlt issued tn accorcl�nce with the Mi�nesota Stata Building Code must be ompieted withln 180
. days of permit issuance. � '
•' .: '
X �Sfv� r►� � � X .� ,
Applicant's rinted Name Applicant's S(gnature •
. Page 1 of 3
�, ..- . . �. . - . .. � � . � . . . i....... . � , � �
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171047
Date Issued:07/28/2021
Permit Category:ePermit
Site Address: 3640 Falcon Way
Lot:11 Block: 5 Addition: Lexington Place South
PID:10-45060-05-110
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
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 -
Anthony L & Ellen S Mattia
3640 Falcon Way
Eagan MN 55123
(612) 720-6281
Minnesota Exteriors Inc
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178375
Date Issued:08/15/2022
Permit Category:ePermit
Site Address: 3640 Falcon Way
Lot:11 Block: 5 Addition: Lexington Place South
PID:10-45060-05-110
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Anthony L & Ellen S Mattia
3640 Falcon Way
Eagan MN 55123
Minnesota Exteriors Inc
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature