3643 Falcon WayQUILDING PERMIT
TY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt #
tes 10899
:7
Site Addreu
, Erect U Occupancy •
Lot 61ock 13
Sec/Sub. T ' Remodel ? Zoning
Parcel No. Repeir ? Type of Const.
Addition ? No. Stories
,
Name Move
lish
D ?
? Length
h
Z emo Dept
? Address ' Int Impr. ? Sq, Ft.
City Phone Install ?
? Name Apvrovols
Address Assessment
u
City Phone Water a Sew.
? Police
?
?,WU Ne^'?e Fire
u? Address , . . . , Enq.
? Z. City ' Phone Planner
Council
1 hereby acknowlsdpe thot 1 hove reod this opplication ond stote that Bldg. Off. 'the information is torrecf ond ogree fo comply with all applicoble APC
` +tate of Minnesoto $tatutes ond City of Eagan Ordinonces.
Var. Date
?+ Sipnaturo of Permittee
???, • .
A Building Permit is issued to: .'? . ` on
oll work sholl be done in atcordante with all applicoble State of Minnesota Stotutes and Clty o{
? Buildfnq Offlciol
?
Fees
Permit J e- :% . •:
Surcharge s 2 . `•%
Plan Review - ' ? •
SAC ' -
Water Conn.
Water Meter ? .? . ,.
Road Unit ?. Ll u' • l
Tr.PI. 132
Parks
Copies
Total
the txpress cadition thoo
Euqan Ordinonoes.
Pwmit No. Pormit Ho1dK Date Telaphons #
Plum,in, G o o '1 IJ a,. 1 ?s-
H.VA.C. : UJ 0-, ro?
Ebetric S y g ,? ps z) o-d
Saft.,,..
Inapsction Date Insp• Othor
Footinys I
Footinys 11
Foundation
Framiny
Rooting
Rouyh Plby.
Rough Hty.
Insul.
Flnplace
OCC ?-yS1 t.
Final Htg.
Final Plbp•
Final
Oof/OcC. 1.2
WM? Wscribe Location:
WeII
Sswsr
W. Disp.
PERMIT
,?,? ??. $l? jSS MECHANICAL PERMIT
CITY OF EAGAN RECEIP-
? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE _
PRICE: PHONE: 454-8100
, sLoG. TYPE v
_ Block, Sec/Sub Res. ?
-
. J- Muft a
m Name
Address Comm.
y C. Other
c ity • Phone -
f
Name
'
?
c
p Address
City
Phone _
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent. CFM
Gas Piping Outlets #
Other
FEE
S/C:
TOTAL:
RES. HVAC 0-100 M BTU
ADdITIONAL 50 M BTU
(RES. HVAC INCLUDES A/C ON
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER
COMM/IND FEE - 1% OF CONTRP
APT. BLDGS. - COMM. RATE APP
TOWNHOUSE 8 CONDOS - RES.
MINIMUM RESIDENTIAL FEE - AL
RE
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE G
BEYOND $1,000)
<<
164
FOR:
)n -a
r ?
. ?
- $24.00
- 6.00
EW
EFirAIT) - 1.50 EA.
T FEE
ES
4TE APPLIES
ADD-ON &
IODELS - 12.00
- 20.00
- .50
• i
M E
?
?
Reaipt _ MECHANICAL PERMIT Permit No.
CITY Of EAGAN
. ' , Fw QQ
Fll/ in numbersd spsces S/C
Typt or Print legJbJy ToiL ;2 ?.`- .
1. Dab 2. inttalistion Cost -
3. Job Address '" 4? : Lot Bik. Traci
4. Owrwr -
5. Contnctor ' ":uT: ' Phone ,•
8. Addreu
7. City State Zip
8. Buildin9 Type: Residential G7'?: Commercial O Institutional D
9. Work Description: New Add ? Alter ? Repair ?
10. Descxide ?L s. - Fuel Type ,
11.
No.
• ? Eauinment 9TU - M. Ea.
Forced Air - - - No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers ?
Mfg. Mech. Exhaust
Unit Fleater
Mf9• Other
Air Cond.
Mfg.
Ges, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
Rough
Inspections: Date Insp.
for
F inal
Date Insp.
This is your permit when numbered and approved.
Approved C1TY OF EAGAN 454-8700
Receipt ? PLUMBING PERMIT
CITY OF EAGAN
Frll in numbered spaces
Type or Prrnf legibly
Permit No.
Fee '
S/C
Tot.
t. Date 2. Installation Cost
3. Job Address /Lot ? Blk. Tract
4. Owner ?
5. Contractor Phone
6. Address itk Kerri
7. City State Zip
8. Building Type: Residential 0 Commercial O Institutional ?
9. Work Description: New O Add E) Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Ces
o
l /D rai
f ield
Bath tubs sp
o
n
Se
tic Tank
Lavatory p
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
i_ Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections:. Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
NSPECTIO
i,,l I ? "1
ITY OF EA AN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: "y
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
E ADDRESS:
tJA't
I,, I C f 1. I 1, I'? i' I?1 F 1 . 1 I 11 ? 11
? PERMIT SUPTYPE:
ci Et i r?r. K - ? APPLICANT:
TYPE OF WORK: „a I' l
? ; ! , ; I i , , , ;, ; I tz001
Permlt Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUNO
FRAMING
ROOFING lO , ?/Q
(/`{J
ROUGH
PLUMBING
PL.BG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARO
FIREPLACE
FfREPLACE
AIP TEST
FINAL PLBG
FINAL HTG
ORSAj
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METEF
FLUSH
MAINS
coNoucTiviTv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DEGK FTG
DECK FINAL
CITY OF EAGAN ' WpM SER
3830 Pilot Knob Rw VICE PERIWT
d
. O. Box 21199 PERMIT NO.:
Eagan, MN 551.21 DATE:
Zonirg: N0. of Units:
? Owrwr:
/Iddr?ss: :
Sib Add?oi: " ?' CO_^. .... ..
, PlunblC
Meter N0.: . ..
COIIflBGtiO?1 QfOfQl:
SiZE: er ACCOtJfM DBpOfit: ? • ,• J
Reoder No. _?.?L?'1' j Parmit Fee: . .
1 qrm M oow* w" !Iw Cihr ef Ekyon Su?chorgs: • 7 `i
Y????. bUfC. C?IDroQf: • , J C.
Totoi: • ?' ?*.:' 1*te A^
By , Dott Roid:
Dote of Insp.: Intp.:
CITY OF EAGAN
3830 Pilot Knob Road
P. 0. Box 21199
Eagan, MN 55121
Zonlnp:
Owrwr. '` LE
1lddrcss:
Site Addron:
Plunber.
SEWER SERVECE
PERMIT NO.: %7r^7
DAl'E:
.
No, of Units:
I "M h eMphr wft fw Ciey daaM¦
Ordi
By
Dote af Intp.:
ConnecNan Cho?pe:
/looount Deposit;
Pemnit Fm: -
SurrJwrpe:
Misc. Chorpes:
Total:
Doh Pald:
CITY OF EAGAN Remarks
Addition Lexington Place South Lot 8 aik 4 Parcel LO 45060 080 04
Qwner Street 3643 Falcon Wazj State Eagan, MN J Jr? ?3
Improvement Date Amount Annual Years Payment Receipt Date
STR EET 5UR F. ,ear
4
STREET RESTOR.
GRADING
5AN 5EW TRUNK 1985 247.64 16.51 15 ? 5 b-a - g
SEWER LATERAL 101 1986 1631.00 326 . 20 5 13 0 *D M 7 /.2 -S-fJ
? Services 101 1986 729.39 145.87 5 --83.51- 0//37 ?L-5--fY-
WATERMAIN 1985 65.81 13.15 5 --5-
WATER LATERAL 1 Q 12- 1986 $ 73.43 - 1 7 4.(7 $ `J •5' G? // 7 Z- -
WATERAREA lOli.l 1986 243.73 ` 48.74 5 %9 . Q1/.37
WAT LAT BEN 101 1986 111.98 22.39 5 ?. Od//j?
STORM SEW TRK 101•'1 1986 4 2 6.54 8 5.30 5 .? /• ot d1137 /z
STORMSEW LAT 101 k, 1986 803.34 :16.0.66 5 0/ 4-12, -7 /i -s :irs?
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 280.00 55138 9 5 85
WATER CONN. 500.00 IT
BUILDING PER. 10899
SAC
PARK
CITYOFEAGAN N°_ 10899
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
?J ? 2
BUILDINC PERMIT PHONE: 454-8100 Receipt # / ?
SF DWG/GAR Fsr. Value $64,000 pma SEPTEMBER 510 85
SitaAddrece 3643 FALCON WAY
Lo< 8 elock 4 sec/sub. LEX PL SO
Percel No.
? Name FRONTIER MIDWEST HOMES CORP
= Address 3908 SIB MEM HWY $E
9 City EAGAN Phone 454-0433
g Name _
80 Address
City ,
Phone
GWINme RICHARD CHARLIER
i?z-, address 14103 GARDENVIEW CT
Z. City A.V. Phone 432-5492
Erect Ixl Occupancy K3
ROmodel ? 2oning Rl
Repair ? Type of Const. V
Addition ? No. Stories
Move ? Length 40
Demolish ? Depth 47
Int Impc ? Sq. Ft.
Inatall ?
Approvab Faes
Assessment -
Water & Sew.
Police -
Fire
Enp.
PIOIIMf -
Council
I hereby aCkrrowladge flwt I hava reod fhiz apPlicotion ond state thof gldg. Off. 9/3/85
fhe inlormotion is correct ond agree to wmply with all oODlicable APC
Srate of Minnesota Stotutes und ity of Eo? n Ordirwnces.
Var. Date
Sipnoture of Permittee
A Bullding Permit is issued to: FRONTIER MIDWEST HOMES
all work shall be done in attordance with nll aooliwWe Stete ot MI newta _
Permit $ 325.00
Suroharee 32.00
Plan Revlew 162.50
SAC 525.00
Water Conn. 500.00
Water n4eter 63.00
RoedUnit 250.00
TcPI. 132.?0
Parks
COplee
I 7otal $.2+ O 1 9_ 50
CORP on the exprcss conditlon that
ptutes ond City of Eaqen Ordinances.
Builditq Oificial
61aU16 ty
C? 56150?
,
Reques( Date .
7-1-9-8 Fire No. R -in Inspection
R ired? '
?i Ready Naw ? Will NoMty Inspedor
Wl
R
d
?
? Yes o ian
ea
/
I1? licensed contraclor ? owner here6y request inspection of above elearical work at:
Job Atltlress reeq Box or Route No.)
? '?3 -?,?-/c ? ,? w,q y Ciy
:
Secfion No. Township Name or No. Range No. Counry 04 A{
OccupaM(PRINnQ
^l/ C z--l M ;4 "j PMne No.
Power Supplier Adtlress
ElecM1ical Contrecior (Campany Neme) i
L ConVactor5 License No.
D`
/
G
t rA- ?
Maiiing AEdress (COnVactor or Owner Malnng InslallaNOn)
i a-7 5W 3,f'14- c T A
AutM' re(Comrec[aJOwner?Making Iietbn)
/ '
!
Pho. Nu er r^ ??7 4-1
LJ U
NINNESOTA ST BOAHO OF ELECTRICRY THIS INSPECTION REQUEST WILL NOT
Griggs-Mitlway Skig. - Room 5773 BE AGCEPTED BY THE STATE 00AR0
1627 Unlvenity Ava., SL Paul, MN 55109 UNLESS PqOPER INSPECTION FEE IS
Phone(612)892-0800 ENCLOSED.
g,/?0/?'b7 REQUEST FOR ELECTRICAL INSPECTION Esooom-m
? See instruMions br compkGng this form on back of yellow copy. pI'1? h/
?'+?
? J(1 1 50 X" Below Work Covered by This Request
ew Adtl Rep. Type ofeuilding AppliancesWired EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer O[her (Specify)
Comm.lindusirial Furnace
Farm ' . Air Conditioner
Other (specity) onheclor5 Rem&ks:
Compute lnspection Fee Below:
# Other Fee # ServiceEnUenceSize Fee # CircuiWFeeders Fee
Swimming Pool 0 to 200 Amps . 0 to 100 Amps
Transformers A6ove 200 _ Amps Above 100 _ Amps
SIg05 Inspector9 Use Ony: TDTAL
Irrigation Booms ?!? • ? ?
Special Inspecfion
AlarmlCommunication
Other Fee s ? v
I, the Electncal Inspector, hereby
f R°"qn-in oare
certi
y thatthe above inspection has
been made. F;nai
OFFICE USE ONLY This request wi0 18 months from
This reques[ void ? Q IO ?q S
16 monffis fmm
0 059895
AeYDat , Pire No. Ro Bh-"n nsuecUon ? ,?,?
Reqwr Reeady Now ?nriil Notify Inspec-
?' ?? u es ?NO ror When HeatlY
Liwnsed Elecuical ConVactor I hereby reques[ inspection of above
? Owner electricel work installed ar
Street Address, Box or Ro e No. Citv
ecUOn o. TownshiD Name or No. RanBe No. County uL
O
• ,?`c an RINTI
?
Phone No.
Power pplier
? AAtlress
Eleetrical Convactor Company Namel
I'CT??Tr
1S.v.._ii 1?.-. . ... .l .. Conhar,mr's License No.
C?
?
Mailine Address 1$orfhACf rortE)W?L¢F Makh+?'I'ng"?;?(la?rort? ?. '
3.?Li\?iIk.J :S\.
?
M
Authorized S? r( a t r aki t.
i Phone Number
MINNESOTp STATE BOARO OF ELECTRICITY THIS INSPECTION REQUEST WILI NOT
Grig9s•Midwey Bldg. - floom N-197 0E ACCEPTED BY THE STATE BOAHD
1821 University Ava.. St. Paul, MN 55704 UNLESS PNOPEN INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
v REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi:oa
See instrue[ions lor completi?g this torm on back of Yellow copy. o O??? 9 5 "'X" Below Work Coveied by This Request 161,
tld p¢O. TYOe ol BuildinB APplienceS WirBtl Equipment WireA
i ? Home Range Temporary ServiCe
Duplex Water Heater' 1 ightiny Fixtures
Apt. Building ryer Electric Heatm
Commercial Bldg. j umar,e Silo Unloader
industrial BIAg. Air Conditioner' Bulk Milk Tank
Parm otne, o.,i v Oiher ISUerifvl
l1P.I $TCGlfy }h()f 01hL'I
Compute lnspectron Fee Below
p Fee ServiceEnVenceSiie tt Fee Faeders/Subfeetlers B Fee Circuits
0 to 200 qm s- 0 to 30 Am ps C' 0 to 30 Am s
Above 200 qmps, 31 to 100 Amps 1 , UD 31 to 100 Am s
Swimming Pool Above 700_Amps Above 100_Amps
Transiormers Irrigation &iorris Partial,'Other Fee
Signs Specialinspection S ?
?
TQTAL FEE
Ae 'rks l
t ?
Nough-in D?f /
// , H pe?Electrical
?/! Inscttlhereby
1 Final ?te erlity thet the above
insoection hes bean
? ;6 ? made.
Thls reaueat voi0 18 monlhs trom
D %
1985 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CON2RACT0@S M1ST BE LICENSED WITH THE CITY OF EAGAN
?T.&F Fc4?-D INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
Co4OC'?,
Ta Be Used For: S;nq_ . Fami1v Valuatian: t2790111 Date: 8-29-85
Site Address; 3643 Fajc,pn iaX
Lot: 8_ Block / Sect/Sub
Parcel S L_ PXinatnn P12ce Soyth
Owner Ron and indyLj,gdm n
Address 1427 Lone Oak Rd.
City/Zip Code Eaoan. Mn 55123
Phone 452-9248
Contractor Frontier Midwest Homes Coro.
Address 3908 Siblev Mem. Hwy. IkE
City/Zip Code Eaq.an,, Mn 55122
Phone 454-0433
Arch./Engr. Richard Charlier
Address 14103 Gardenview Ct.
City/Zip Code Apple Vallev. MN 55124
Phane # 432-5492
OFFICE USE ONLY
Erect X Occupancy Z-3
Remodel Zoning ?-I
?
Repair _ Type of Const ?
Addition 11 of Stories
Move ? Length 4-0_
Demolish Depth 41_
?
Int.Impr. Sq Ft
Install
APPROVALS FEES
Assessments Permit 325.
Water/Sewer Surcharge
Police Plan Reviex 62.5°
Fire SAC 525 °°
Engr Water Conn Soo.
Planner Water Meter °-
Council Road Unit
Bldg Off . ?-Treatment Pl
APC Parks
Variance Copies
TOTAL ?y? 50
" .' ..,
_-;
_ awNER:
rnye L UT 4
fXTERI02 ENVLLOPC nvcanr,r '11° cnru•urnnoN ^
---- -- f)AT r
SITE ADDRESS: I'!IONc;
CONTRACTO R:
Determine working square foo tage of each
1. Total exposed wall area....._ ?!(VQ.s sq. ft. x.1:
2. Total roof/ceiliny area..... 101(a sy. ft, x.G2G = Z(m 4q I
- Total exposed wall area abovc flno r=
a. Total wall window area...............
...........
..............
b. Total door area ...............
c
Tottl ..................
lidi
l
l ....
............. 4 Z.
. s
ng g
ass i
onr arca ................... ....... -
-
d
Total
fi
l
ll ..
........ 4
z
-
. rep
ace wa
area ....................... .....
e
Total
w
ll f
9
" ....
........
. a
ram
ng area (average 10,
0) ........... ................. e? 5 -54
f. Total rim joist area............
9.
net ..... .....
wall area above floor...??4
?? ................. ?
r• ,
.
wall area above floor ....................
...
?•
wall
6
fl .
.............
area a
ove
oor .................
...
....
j.
frame wa11 a
a
t f
d .............
re
a
oun
ation .................. .......
Total exposed foundation area=
k. Total foundation window area.........
..
.
l.
Total .
.....
..
net foundation area above grade ........... ...
... 1:5
Determine "u" value of each woil scymenC
(e,g. windovr, door, each separate Yrall section)
? a• I ZS x "U°_
. b. q 7_ X "u„ 45 ;
_
C. ? Z X liu„ ?.
- d. ? g x ,.u,? , 3(0 ?-1
?
.
e. I C(io,?{ S X„ull I S? 7/
-f• I ?o x Hul,
03 = -7
. _
?g? x 'l U,? .03
h. X ?. ul 11
t._ x „U„
?• x °u
r.. x „u
1._ CP S X Ilu„
.. ................... . ...........TOtal
If item q3 is the samt
as, or less than'item
H1, you have meE.ttie
5 75 intent of SBC...600
??
Pa[j!rloz Envelopo nve:nge "U" Coml?util:ion ' Png? 2 of A
a.-' , . ' , . . . .
Total expoued rooC/ceiling AYCA
m. 7btu1 skyli.gltt area ............................
n. Total rooL/cciling Eranning arca (nvcrayc 10¢).._. ? p(o
o. Tol-al nct insulated roof/ceiling area...........
, Determine "U" value for each roof/cciling segment
M. -- X "U" _ --
n 1 O
x ,.U., Z
........................... Zbtal
I: total of 44 is the same as, or les; t:han 112, you hnve met the i.ntent oi
ShC 6006 (c) l.
Alternate Buildinq Enve).one Desiqn
i'o utilize the total envelope 'system method, the values establisheu' by tlle s:un of
i.tens 0 and i;9 shall not be greater L'han the sum of itcsns I'rl and 412. 1. 21 cD.09 + z. ZG. -14I = 24z,s
.
3. __ r;5i CJ-1 + 9. ?,7J = ???, Lp
?
. . . . ? . ? .!$;r.
y ?A
?..Urr pSt ul? r??nn?ut v.ill nrvR [or ??.DIS?1?`?
-, ft;inv: r.c.nf.trvcilvn ::vnt,?•:.
_ ___..?s -? ?, -{i) i. ??<<•; .,? qte A`L?i+'M..
-'?- --?-0 '• ?+?`'._ ?-y f? Q'p . .. _ . . ..g.S
0V"%°"a_ 7vo
_ ? _ . _ ..,. . .
,..
i:C ---• G. F.y.:crivr iii iil•r, " V?
-;,>
_' ? ^ _'_"'_'_'_ .. ..... . . ...._... __..___..._._._
clp, pl TOPVI119 OF
°ltAtt}i WAL1, ? 1nCrri, ir ;i ir :llw .------- O:f?ll
S'?_-- - --- -_s!4s
?? _ ? T ? a• ?e?e?v. __. . ..---._? __._ .?._SaG?
?__?' '• ___.-L? 5.
F.Awm>;L ..Stra??g ---------?-(?!
ori??i? i?ii Lilie q.l'I
FIC. 112 'Put.nl Z,1 Ci'
!O .
'.•'.•i ?..--?,? 2. '?.??1!h.. . ...-?----------...-'?.G?.?
_---_? ???,_ ?,_?_? 3• _?s':N?vti-_? _ r+?? _ _ ._ _ _- .._1_?'?? ISrR .x
C_
al
}.xt!,rl.or nir I i Irn
a.?t. ,:--'' . _ . I -- 'J -----------._ _-.«,?::?t -.._ L?{• ? ?
.
: --_-
?-- ,- ---------.? ?1.c?1c.
.
? ;2??'-:--:-- -----'--?-? l. inirli•,[..._'I,-
,:u?Clt ,?. -°' ----•-----(? a '- n _ _ : ? . ?.-----------
• Li• • o' _ O • n. . PL'6rrra_'c??c... ?t??.tc??...._ ..._.....--
?
. . ? - ? - -- ?--- ---- -----°-----------.._.
? •. _ • `?
... ?
G. -----0_17
.._..--------
?
• ?? . ??
s?.nn c?pt ?;nnue
I 41? . _ - .. .' - -- - I ---- --- ------...... .?
C. ,3 C .
_C•il?i? _.?%?i `? . . __ •,x - ,
.
??ll .
/(t y .? ' . • ? !(!
F1c:. ilA
i
(l( ) ?.-- ? .--. 1 - --?{ "_?•?:? ?r(
???9'C: iwil?:ar.. ty ?:. 'i ?lm 4? nC1? nnd
?, - r=,r•/cE-iLiNc . •
? ,. .
? • ???/ Construction R-Valuc
y
Intcrior air fi2m 0.61 ?
1 tit?5u c. . 44.
??`I `1IIll I(l ?? . 4. Extcri.o: air filn (still) O.o
Total
(Z its??
?-1, 4 .. • = ? ., ., . ? -_ ?roz . ?
- ' ? F?.r•? ? .
HeaC flow ? 1• Interior nir film _ 0.61
:nted 2_
! uP . ' 3. ? c .?1.j5uL 3Q.3s
, • 4. F_xtciic=_ ir fi l? (st.o
. ? ? - - Total 2 - qo.rS
F'IG. 05 ? '
. . . . . . . U - . oz?..
- - ' COA.SrR?CT/ mp`_ '. '
....,..-.-.-.,, .•,.?--.?-..i?-..,,-....a?..??.?
_ _._ --_ -- ---?T l. Insidc air film 0.61
% • {?j?j 4_ _ ' .
?':/y (1}l(I'jy?I'}?/1,` 5. Outsidc air filro 0.11
Total
, .
(02? ?3 ? 1_ Insidc air Yilin 0:61
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p I Conotructwn No. I Inaulation
_ Guide ?
?;ndowe ? Doon Rcference :' Out. Wall Int. Wafl Ceiling Roof Floor Kind How Applied
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ry
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PERMIT
CITY-OF EAGAN
3$30 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-45060-080-04
DESCRIPTION:
e
PERMIT TYPE:
Permit Number:
Date Issued:
3643 FALCON WAY
4QT: 8 BLOCK: 4
LEXINGTON PLACE SOUTH
REROnF
Permit Type
14'ckrk Type
STORM DAMAGE
REPAIR
434 ALT. RESIDEN7TAL
?=u __
x?
? f "aF
,,;
r?.K p?a.3
1.1, W
Zo
o
1*
µg.
? WM' U
SfS PL&A
BUILDING
033374
09/22/98
?
Susla f
REMARKS:
FEE SUMMARY:
FU'S70M"'COTN'C'EPTS CONST Hppi11898729@ 20142417 OIVERSON: WNER ROBERT
16540 KENRICK LOOP/STE 8 3643 FALCON WAY
LAKEVILLE MN 55044 EAGliN MN 55122
(612) 898-7290 (651)454-4176
this 'aPpla.tati'on and ,state '-tb ?wt the
3mpty iwi'CM
?SUED B RE
1998 BUILDING PERMIT APPLICATION (REBIDENTIAL)
CITY OF EAGAN
L J'3 3830 PII.OT KNOB RD - 55122 G7
681-4675 q - IS
New Canstrudion Reauiremente
? 3 registered site surveys
? 2 copfes of plans (includa beam & window s¢es; poured Pnd. Cesign; etc.)
? 1 energy calculations
? 3 wpies of tree preservation plan rf lot pWtted after 711/93
required: _ Yes _ Na
DATE: "t " I 6 -9 t?
RemodeUReoair ReQUirements
? 2 capies of plan
? 2 site surveys (e#erior ad0itions 8 decks)
? 1 energy calculatians for heated atld'Rions
CONSTRUCTION COST;
DESCRIPTIQN OF WORK:
STR EET ADDRESS:
LOT: BLOCK: ? SUBD.IP.I.D. #:
Name: Phone ^W
PROPERTY 1-ast Firsc
OWNER
StreetAddress: ??.f/l^^D
-?
Ciry State: Zip:
Company:c c C-4 ( rlL ? Phone 9: 75 ? ? ? 2 C)
CONTRACTOR /
Street Address: 16 q??C, d? License --/ ZY
Ciry r?? p Stare: fkzlz Zip:
?
ARCHITECT/
ENGINEER Company: Phone t#:
Name: Registration #:
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address chan(,
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this applica6on and state that the infortnafion is correct and agree,to-ply? II applicac
State of MinnesoW Statutes and City of Eagan Ordinances. ?c Jf,(? ? ?
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
L-? .? .
Tree Preservation Plan Received _ Yes _ No _ Not Required
I
,
C • ? , 2/84
CITY OF EAGAN
APPLICATIvN FDR PERiMIT,
SEWER AND/OR WATER CONNECTIODi
. (PlEASE ARINT)
1) PROPERTY p,CDPZSS: 3643 Falcon Way .
IEC1L 8 / 4 Lexin ton Place South
(Lqt/Block/SuCcLivisicn or Tat ?arcel I.D_ Nu^?er)
? iS?RCCVTv.. DAT' O° CIZTGiAL uiI'yDI.`:G ISS??G:
P•°=5L"-" Z^.:7rr,/?'ROPC57 C'S: ?
R-1 Si:GL: :??i
S
LY .
y
?
/? ^ S?
U -? LU?Ty'11 (T?V L?iI1TS)
? R-3 :Cf.,i,.vrv?cg (mr= + L"]2Tc) ? WI':'S)
? 'r.-4 C.iITS)
? CCin1E.°.CT_?I,/.4f.'T?SZ,/CF:'IC::
? 11Mcs-171Las
?
Z) pPPISc7?,?,7 (PLEASc PRiNi) .
Frontier Midwest Homes Corporation
ADD2F55: 3908 SibleY Memorial Hwy. Bldg. E
CI'I"_', STrT3, ZIP: Eaaan, MN. 55122 -
PFO"E: _454=0433
3) pu7.?-=?
' (PLEASE PRiNi) FOR CLTY VSE 04LY
NA1
''?= Star Plumbing
P.CCRE55:
1018 Maund Springs Ter. PIUHBER f!iSE:
, Act3ve
CIiI, STATE, ZIP_ gloominqton, MN. 55420 ? ExP ed
P ed
PHO'IEn H?icr
884-4149 PLUN6EA LFCENSE N 3329 / of R card
` Z4-_
4J CX„L:7PANT/(,?•41IE,t"2 1YLtA5E P81141J.
NArtE: Ron and Cindy Liedman
P.DDRESS: 1427 Lone Oak Rd.
CITY, STATE, ZIP: 77 Eaqan, Mn 55123
PIiO`rE: 452-9248
5) II1DIG"aE W[-IICH PERi•IIT IS BEING REQ[JESTM:
CONNECi'ION Tb CITY ScrIER Please mail gold copy to
? WN;v'E?PIGN 'IO CZTY t,TRTER Wenzel Mechanical
3600 Kennebec Dr.
? 071ER (PLE''SF DESCIUBE) Eaqan, MN. 55122
7) SIca1L,:
? PL-r-ASE F?OID rIPPP,WID PFS?."^.IT FOR PSCs:-L'P BY OiVE OF r1BCiVE
Is??-D!1I 'APPRO'VF'D PEP`LIT TrJ Oe 3, 4 I?IE?
(Cione)
, . ?. ? . . ,
_ A -
DATE:
MR "l 04-10Li?fYJY f i Q??:a6fl?! t nt p?y# ?? YS ?FSi?:? a?!! Rfl?!0'fif? f? f? 1Sli R?[?? ..
F O R C I T Y II S E O N L Y PE^M2T " ISSUED
rr ES : $
$ rlc-iv
$ L-? ,,n
S
S
$
$
/S-Gp
$
?oc?.uu
$
S
$
$
$
$
$
$
$ _lG'7G. S G
SE::E.°, T_?E$31TT lZ_I\?.,,.yL.. ? r",?-, JUorcl.-or..?L^
`a..._.)
WATER PEi2rtI: (Ii7CL'uDE SliRCHAaGc',)
WATER METER/COPPERHORN/OUTSIDE REr,DEg
WAT°R TAP (INCLL'DE CORPORATION STOP)
SE:dER TA°
_...,?`?:._ .,=.=r•S?= - a_:._?
ACCOUNT D£PC'SIT - S9A-T-ER
wac
SP.C
TRliNK WATER ASSESS:+.E:iT
TRCi:IK Sr.t•IER n55:S5.'•IENT
LATEP,AL BEivEFIT/TP.UNK 5^:-R
LATERr1L BEDIEFIT/TRU:IK S•7AT°R
WATER TREATMENT PLANT SURCEIARGE
OTHER:
TOTAL
r'utilOL'J;T PAIDjqEC°I?T i ?7
DOES UTILZTY CONNECTION REQUIRE EXCaVATION ZN PUBLIC RIGHT OF WAY?
L, YES IF YES, THEN i+ "PERMIT FOR 'AORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISZON. LIST AS A CONDI-
TION,
SUEJEC.T TO THE FOLLOWZNG CONDITIONS:
APPROVED HY:
PLUMBING (RESIDENTIAL) L116'sD
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dweliing:
Townhomes and Condos when permits aze required for each unit
Date/I C)
Site Address te 43 ( Q Unit #
Property Owner Telephone #?j?
Contractor ?+ P
PIzWnRvc
.
3870 DODD ROAD
Address
^
Pd--55123
EA6A City
nr,,a
r
(651) 365 1340
State
Zip Telephone #( )
The AQplican*_ is _ Owcer ? Contractot _ O[her
Septic System New Refurbished Submit 2 sefs of plans and MPC license $ 100.00
Indudes County tee. Additional consultant fees may apply.
Alterations To Eaisting Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
141 Water softener _ Water heater $ 15.00
Y/ replacement , additional
Ii7 ?I
$ .50
State Surcharge ?i
?
T
t
l ?Y--- -- - .__- J $
o
a
I hereby apply for a Residential Plumbing Pernilt and aclmowledge 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 with the Plumbing Codes; that I understand tkils is not a
pemut, 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 casg of work which cequires a review and appcoval of plans. „
Applican's'P ' N'azne `%/ " ?/r \ A?pficant's Signatiare
f/
2004 RESIDENTIAL BUILDING PERMIT APPLICATION ? 7 O
City Of Eagan ? .
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
New Conslruction Reauiremen4s RemodeUReoair Reauirements Qtfiee Use:Onlv
3 registered site surveys showing sq. ft. ot lot, sq. ft. of house; end all mofed areas 2 copies of plan Ced Of SuN§y Real _ Y_ N
(20% maximumbtcoveregeallmved) isetofEnergyCalculationsforheatedadd'N"ons Tree?PresPlan:Recd Y N
2 copies of plan shawing beam & window sizes; poured found desgn, etc. 1 sile surveyfor additions & decks Tree?Pres Required _ Y_ N
lsetofEnergyCalculations Adddron - indkateifonsifesepficsysfem On-sAeSepticSystem _Y _N
3 cflples ot Tree Preservation Plan if lot platted a@er )11193
Rim Joist Detail Options seleCtion sheet ibldgs with 3 or less unAs
Date ?_ / ? / (Q? ?' d?
Construction Cost i C/v
Site Address 3ja t/ 3i?a&, v01? WLn .Jr?r f-L 3 UoiUSte #
?-
? CJ'
Description of Work
Multi-Family Bldg _ YN Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner (9-tl'Y'? ? Telephone k (&5J ) :33
Contractor
Address 55 Q City
State 7YAM Zip s s H a 9 Telephone #('763) S'
0 900
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 9670 Catecorv 1 Minnesota Rules 7672
EnEfgy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) 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
Mechanical Contractor
Sewer/Water Contractor
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 plan in the case of work which requires a review and
approval of plans.
.?-
AppIicant's Printed Name Applicant's Signatur?
S 1 G IVIA
SUPlVEYIIVG
SERVICES
3908 Sibley Memorial Hiqhway
? Eagan. Minnesota 55122
Phone: (612) 452-3077
?GA LE :
I'' = 4a?
/?
House
CerttfJcate For :
FrOd1$i@r MIdiN!'st
Corporatlon
MDDf-L'r;?TAFFof;.D
LGU't :O
LOT "
?
0
WAYNE D.
CORDES
-- 94675 -
,
-L END -
O Lenotes Iran Monixrent
° Denotes Woai Hub Set
x 903.$ Lenotes Existirg Spot Elevation
(„N°y??4 Genotes Proposed Spot Elevation
,?- (knotes Orainage Directicn
-PFiOPERTI' OESCRIPT 1 pV -
LOT 8 , BLGCK
LE)(INCtTON PI.Al.? youTN
accordirg to the reccrdEd plat thereof,
DA ACamty, Minresota
PROPOSED GARAGE FLOOR ELEVATION= 90'15-
PROPOSED Top of 8lock ELEVAIION= 40$•g
PROPOSfD BASEMENT FLODR ELEVATION= 4100,8
NOTE; Verify al/ floor heights with Fina/ House Plans.
,S1Hd?EYGRS CERTIFICATIpV-
f hereby cerJify that this survey, plan or report
was pepared by me or iwider my direct suFrrvision
aM that 1 am a duly Registered LaM Surveyor
uMer the laws ofi the Stafe of Minnesota.
_?r?1. ?t?- Date: 8 13r8S
Wayne D. Cordes, Minn. Reg. No. 14575
PERMIT
City of Eagan Permit Type: Plumbing
Permit Number: EA106571
Date Issued: 08/28/2012
Permit Category: ePermit
Site Address: 3643 Falcon ~Vay
Lot: 8 Block: 4 Addition: Lexington Place South
PID: 10-45060-04-080
Use:
Description:
Sub Type: e -Water Heater
Work Type: New Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Kris Oien 3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary: PL -Permit Fee (WS &lor WH) $55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: -Applicant - Owner:
Champion Plumbing Gino T Luu 3670 Dodd Rd., #100 3643 Falcon Way
Eagan MN 55123 Eagan MN 55123--248
(651) 365-1340
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.
ApplicanvFermltee: Nignature issued tiy: NIgnature
�
Use BLUE or BLACK Ink
�----------------��
� For Office Use �
����� /� q I ��� � �� I
���(��4�� ��Y � � L��� I Permit#: i �
�� i Permit Fee:� / ! � ! � I
3830 Pilot Knob Road
Eagan MN 55122 � Date Received:� — �� i�� I
Phone:(651)675-5675 I _` — I
Fax:(651)675-5694 I Staff:`� I
� ---------- �
2015 RESIDENTIAL ` � �� ''
BUILDING PERMIT APPLICATION �,�,��
Date: Site Address: Unit#: ��`�,
Name: ���C� ` �-F+�[-�y �MR�n-��r-� Phone: ���i—'3 �CJ S��
R��1��'t1� -
Qyy��r �, Address/City/Zip: ��F�{3 f"r4-L�c N �vA�f �l�i A�f'it /t'�,1� SS���
' Applicant is: �Owner Contractor
; Description of work: �j C-��'/`�� (��RC�
Typ�of War�€
Construction Cost: � ���� Multi-Family Building: (Yes /No�
Company:_ l.l�� ��✓�r%�vl�l ({"""`�'��Contact: ��s, ��sn-s���
�OIt�CaC�t3t` Address:_�v�� � ��jc�,� 1:�.��„� City: �oc �-n
� = 7
„ State: �� Zip:5S (at� Phone: �lc; �3c:;5"�C1�Email: t,,.�e.�r�r�e,,��-s���°��il-C�
: License#: — - Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) �;
1�
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 8�Water Contractor: Phone:
.- :
N�'3TE:f'lar�s�nd sup�,art�ng d�cu�nenfs%tl�at�rcii�se�brr�it ane ct�rts�dered t�5e publi�ir�i'€�rmat�on: Prrrtior�s��af .;
the informat�an may be class�ea�as,;norr-pu6�r��fyour�provid���crfic r��tsr�r��tha�rva�rld�ermrt�he Ci#�r#o
: _ � , ;..
_ ; , � , ,,,,
' conc%tde�tti�t the'"ar��fra�te�+ecre#s `
...... _
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.popherstateonecall.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 buildin ermit issued in accordance with the Minnesota State Building Code must be completed within 1
days of permit issu .
x �''�J..-. . X �yqb�� �f`�fJ��7L'�'('i'
ApplicanYs Printed Name Applicant's Signature
Page 1 of 3
/ ` �
3(P Gl, �� ��in W'� •_ .
�NOT WRITE BELOW T S LINE �� C L�
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 _ Interior Improvement _ Siding _ Demolish Building*
X. Addition _ Move Building _ Reroof _ Demolish Interior
T 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 � Occupancy � MCES System
Plan Review Code Edition 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
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
� 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: / ��, Building Inspector
RESIDENTIAL FEES
� ����
Base Fee f, �'
V �
Surcharge !�
Plan Review � �
�����
MCES SAC
City SAC
Utility Connection Charge "")
S8�W Permit 8 Surcharge �� �� ��� � � � � �`�'
Treatment Plant
� j �
Copies
TOTAL
Page 2 of 3
� '� " � � � � � � C- C(�
. S 1 t3 I�IA Hou.se
8 U RVEYt N G Cetflfieof� Fvr : `�,
SERVICES `
3908 5ibley Memorial Highway ������� ������
Eagan, Minnesota 55122 ������Q����
Phone: (612) 452-3077
Mop���. �rAFF�p
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` � _ = CORD�S _
" = 14675 �r�,�
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air��i��m+
-�E�- PROPOSED GARAGE FLOOR ELEVATION= nlp3,S
O Lienotes lron Monurr�nt PFi10POSE0 Top of Block ELEVATtON= 0 •
� Uenotes Wocd Nub Set • PROPOSED BASE�IENT FLOOR ELEVAT ION= OD. '
x�03.� L�notes Ex i s t i ng Spot E l eva t i on
NOTE; Verify a!I floor heights with Fina( Ho.use Plans.
(xN°,�,pti,k,y Denotes Proposed Spot Elevation
�..-- D�notes Dra i nage D i rec t i on ��� �Rj�F 1 CAT 1 C�V-
_P�� ��,�'�_ 1 hereby certify that thi�s survey, plan or report
was prepared b y me or �cier my d i rec t superv i s i on
LOT 8 ,BLGICK_� ard that I am a duly Registered LaM Surveyor
LEX ING�'�O N P LIAG►� �pU TN �+�der the 1 aws of the S fia te of �l i nnes ota.
accord ing to the recorded plat thereof,
� �oate: � �3�85
CaAl�yO'rA Camty, Minnesota • Wayne D. Cordes, �linn. Req. No. l�5575
For Office Use
441.P/I' � �'} /
:::t:e.I
/ !City o Baan 3830 Pilot Knob Road
Eagan MN 55122 .; °IVDate Received:
Phone:(651)675-5675
Fax:(651)675-5694 ./Ayt�
M !C f '2617 Staff:
J
2017 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
Date: 3//51/7 Site Address: 36y3 rmco� (.JA•j
Tenant: 'DQ`4+> 5e$ Ka-2— Suite#:
%j' /} D 'j;// 5Aw Phone: Sol- zit) - S7
Name: /'Ii se_i ke.2i y
930 a ,§
404% /4,7';;;AFPz %i;� Address/City/Zip3 b y 3 �.4lco� (� f:A 4q,u ,n4 it.) 5 Si i 3
,r',///,
///i„A EKN jP/ Name: WeAt.vi or CADUA.3 CD.ut�.1 t,4,,,tt License#: tM 8 6 9 a 73 7 •
,&
g,NO”'Zmgvir,z;i Address: /o/B/ Bo.r4 ST Our' City: /uo4a�i 'e/d
/%/ / /%/jj
/ ' / State: Gti'!N Zip: SSo.�7 Phone:
0 /,,,,,, % �q in-z.- ��/- S/0 0
//'s/ // // //
! / / %im/ / Contact: 3L If HA‘6 Email: HGG oaYsu/t4."13 a i.ul''EisRf} Q.t
. ,u
i�/�� ,/ ,6�// /; New Replacement Additional Alteration Demolition
//i + i6i0, Description of work: Rep Ilk e Bo'10 .a 4- >Cu.•4✓✓-1c.v-
l 4
; . d . ;rc7,/4;30
// / mB te . Al s . d'
c oi. $ ..
/�/; oRESIDENTIAL COMMERCIAL
*WV// /, /% X Furnace New Construction Interior Improvement// %'/ p
sBrf3i +, //� _Air Conditioner Install Piping Processed
7,' /,, , %j —Air Exchanger Gas _Exterior HVAC Unit
i,///// wm _Heat Pump _Under/Above ground Tank ( Install/_Remove)
/'// / ,/ Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ 60. 41'9— TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee
=$ Surcharge
Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
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 c5C0tr. J- /7i4Ss xno r h'itgo
Applicant's Printed Name Applicant's Signature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163665
Date Issued:09/09/2020
Permit Category:ePermit
Site Address: 3643 Falcon Way
Lot:8 Block: 4 Addition: Lexington Place South
PID:10-45060-04-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Cole W Langsdorf
3643 Falcon Way
Eagan MN 55122
(507) 210-5714
Keystone Builders Inc
11670 Fountains Dr, Suite 200
Maple Grove MN 55369
(763) 280-0568
Applicant/Permitee: Signature Issued By: Signature