3695 Falcon Way PERMIT # a ? -
J ' ` • MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3/ 10/ 86
3830 PILO T KNDB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PR ICE $17Q0.00 PHONE: 454-8100
5ite Address a con a '
TYPE WORK DESCRIPTION
LDG
Lot S Block 9
Sec/Sub_ .
XXX
xxx
m Name Wenzel Mechanical ' Res,
New
Add
m
Address
FO Kennebec Drive -on
Muft
c City Eagan Phone 452- 1665 Comm. Repair
Other
Name Frontier Compaiiiea
FEES
?
c
Address 3608 Sibley Memorial Hwy.
FiES. HVAC 0-100 M BTU -$24.00
? City Eagan Phone 454-0433 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air 80,000 M BTU 24 •00 COMM/IND FEE - 196 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outlets #
Other
FEE:
24.0
• 50 SIGNATURE OF PERMITTEE
S/C:
roTaL ?24.50 1
FOR: CITY OF EAGAN
, CITY OF EAGAN A
?- ?•n 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 11 `?' ??
' PHONE: 454-8100
BUILDING PERMIT Receipt #
7o be used tor SF DWG/GAR Est value $64,,000 Date FEBR[IARY 3 , tg -B-k
5ite Address 3695 FALCOt3 WAY Erect Llc Occupancy !l3
Lot 5 elock 9 Sec/Sub. LEX I[vGTOiv YL $ODmodel ? Zonina fil
Parcel No. Repair ? Type of Const v
Addition ? No. Stories
¢ Name F?}ZONTIcR Iw1Ii?WEST HOI?l"'.S Move ? Length 40
W ?E Demolish ? Depth 44
3 Address 390t3 SIB MEN, HWY Int. Impr. ? Sq. Fr
0 Ciry RA%AN Phone 4.54- 0 4 3 3 Install ?
o Name y?E APP?
=
OU
Address
Assessment _
~ City Phone Water 8 Sew.
c~i?
W W RICHARD CHARLIER
Name Police
Fir
14 0 GARD£NVIEW CT e
?? Address Eng.
432-5492
t?
V
i W City
'
' Phone Planner
VVUIIt+II
I hereby acknowledge that I have read this application and state that the gldg. Off. 1/ 31 / 81
iRformation is correct and agree to comply with all applicable State of
Minnesota Statutes and C'ry o( E n Or¢eriance,$.-' ?'_) APC
. ,
? - ; Var. Date
Signature ot Permittee 4:f=
FkONTIER^lIUWEST HOMES
A Building Permit is issued to:
all work shall be done in accordance with all applicable State oi Minnesota Sta
Permit $ 325.00
Surcharge 32.00
w 162.50
Pl
R
i
an
ev
e
SAC 575.00?
Water Conn. SQO . 00
Water Meter 63 . 50 1
Road Unit 290.00
Tr. PI.
Parks 156.00
,
Copies
T o t a l $ ?
2.10 4. U 0!.
on the express condition that
City oi Eagan Ordinances.
I - I PwmR No. I PermH Holder I DaM I Tdephons N 1
6 1 ry
Plbg.
Htg.
Plbg.
Final
Occ.
Dlsp.
wm
PERMIT # 2y o0
CITY OF EAGAN FEE
PLUMBING PERMIT
O
RECEIPT # . J
454-8100 S/C
` u MINIMUM RESIDENTIAL FEE - $10.00 + $.50
TOTAL
DATE MINIMUM COMMERCIAL FEE - $20.00 + $•50
1. Bldg. Type: Res Comm Inst 2. New ' Add Alter Repa+r
3. Totel Bid Price
3695
4, Job Address
L
? Bl
t
k?S r'"ont=er :1Iidwset
o
oc
e c
5. Owner
6. Contractor : 1
Iecn. 36-00 i:ni-alr?ot?r: Engan 551?",
? {
(Neme) - r (Street] (City) (2fp)
7. Contractor Phone # 4 r ? L-1r ? h ?
NO. FIXTURES NO. FIXTURES NO. FIXTURES
/ Water Closet - $3.00
TBath Tubs -$3
00 ? Laundry Tray - $3.00 _Well - $10.00
? Fl
D
i
$
50 P
i
Di
S
.
/ oor
ra
ns -
1.
vate
r
sp
yst -$10.00
Lavatory - $3.00 ! Water Heater - $1.50 ?Rough Openings w/o
Shower - $3.00 Whirlpool - $3.00 Fixtures - $1.50
/ - Kitchen Sink - $3.00 ? Gas Piping Outiets - $1.50
-Urinal/Bidet - $3.00 -Softener - $5.00
COMM./IND. RATE - 1% OF T OTAL BID PRiCE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: ?L for
?
Approved " I
Inspections: Date Rough Insp. Date Final Insp. ?
CITY OF EAGAN Remarks
, Addrcion Lexington Place South Loc 5 Blk 9 Parcel 10 45060 050 09
Owner Street 3695 Falcon Way 5tate Eag an, MN
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1 1 .? _
SEWER LATERAL 101 1996 1631.00 326.20
, 14,5.87
WATERMAIN 1985 $1 13.15 5 6s
WATER LATERAL 4 ! 17?4 . 6$
WATER AREA 48.74
A T-L A T--B E ?J_?0 11- 19 $ 111. 9 8 . 2 2• 3 9 S
ItOF4M $EYYlTR1c- Ql?? ` 1986 426.54 _ 8 5. 3 0 $
STORMSEWLAT I pl? ?. 1986 603.34 .k6;0.66 5
CURB & GUTTER
SIpEWALK
STREET LIGHT
3 86
WATER CONN. 500.00
BUIIDING PER. 11495
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NQ.:
Esgan, MN 55721 DATE= ^ k p?
?1 No. of Units: ?-
Zanirq: ?
Oyr,ner. FrOIIiieY ISfdwest ''io:i.es
Address:
Site Addi
Plurriber.
I wm te eol? wk6 tM Cily of lysw Corxwctla, Cl+arp. 474 (}On`
Owiw.neM. Atcount DeaWt: I 5. i3(2n,',
Pom* Fee: 1() _ C)nW'
SurcFaroe: _ 51-t-A?
gy Misc. Choross:
Dote of Insp.: Total=
InW: Doh Pdd:
PERMIT
CITY OF EAGAN WATER SERVICE
3830 Pilot Knob Road pE??T NO.:
P. O. Box 21199
Eagan, MN 5512DATE:
Zoning: ' No. of Units:
rront ier ".tidwest
Owror.
Addrow. 5 Lexins:ron
3. r,? - Fal P1. So.
S+te Addnss:
ar I'lur?., ?= '`` nical
P1umber. ?n
:
?
?6'7 S5?9f 500.OOpd
? - ?
?
Mrt?r No.:
15 . OOpd
', o?
`
s,?:
? ??
Raads No.: ?-?' if,.nopa
S?pd
1?M h oo??ip Nw w Surc?+a?flst .
15 f? ...)ilnij TP
N11sc. Cho?'Des:
??
_
Totol: er
!/V pote Poid:
B
Y
-
Dote of Irnp.: I^5L"
This repuest voitl
1 h r 3_17^ O/
K53 0 95 2 8 0 L s',
(0 0 573
A /J 7 d71
enu c uaie rire No. Houpn-in InsOec?yllan
? Requve ?Ready Nuw ?W*?I Noti?y. "5000-
I ? ?o tor When Ready
&1icensed EIacVlcal Coniracmr I hereby reqaest inspecHOn of above ? Owner electrical work installed et:
Street Address, Box or Rmte /Np'
? V V ? Citv ?J ^??
SIrMT on o. Townshi0 N2me or No. Range No. Cnunly
?
Oc - nt (PRINT)
- 2 n1 i iD 141 Phone Na.
- o
Power Su ier Address
:
Elac[rical Convactor (COmpanY Name) ' W's -cense No.
9
Ma ' E A a tbr? a ,ne Instailation)
.
14,940 PENNOCK LANE
Authorj?pYy?^iLp?u?yl?ort?a?{a?Olvlv1?r76ia l. tinnl
?? V H LL? 1 ltl Phone Number
MINNESOTA STATE BOAND OF ELECTRICITY TMIS INSPECTION PEQUEST WILL NOT
Griggs-Midwey Bldg. - Haom N-191 BE ACCEPTED BY THE STqiE BOAPD
1827 University Ave.. St. Paul. MN 66104 UNLESS PqOPEH INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
REQUEST FON ELECTRICAL INSPECTION
_ p ' See insimctions tor comoleting this form on beek of vellow copv.
? "X" Below Work Coveied by This Reqaest
of Building Apptianees WirW r-
E6-00001-04
y'.
(?0573
umant Wiren 1
I I I •I intlustrial tlltlp. 1 I Av Contlitioner ? 1 I Bulk Milk Tank 1
p Fee ServicaEntraneeSize # TFee Fxeders/SObieede,s N Fxx Circui[s
0 to 200 Am 0 to 30 Am s tn 30 Am s
Above 200
Ainps 31 to 100 qmps d 31 to 100 Am
J
Swimmin Po Above 100-Am s Above 700_Amiri
Transtormer.5 rrigation Boorc,s Partial-'Other Fee
1 Signs Speciallnspection S ?
Pe TOTAL\/FEE
I, tne Electrical
Inspector, hereby
certify that the abova
inspection has been
made.
ThIe reQuest voi0
383? Pilot Knob R dl P.O. BoE 2G-A1 9, Eagan, MN 55121 N2 11495
PHONE: 454-8100
BUILDINGPERMIT ReceiptN ??-3(,P
7o6euaedfor SF DWG/GAR Est.Value $64,000 Date FEBRUARY 3 ,1986
SiteAddress 3695 FALCON WAY Erect 125 Occupancy R3
Lot 5 elock 9 Sec/Sub. LEXINGTON PL SOlemodel ? Zoning Rl
Parcel No. Repair ? Type of Const. V
Addition ? No. Stories
' a Name FRONTIER MIDWEST HOMES Move ? Length 40
z 3908 SIB MEM HWY #E Demolish ? Depth 47
. o Address Int. Impr. ? Sq. Ft.
ciry EAGAN pnone 454-0433 Install ?
a SAME Approvels Fees
i F Name
0 a Address
? Ciry Phone
G
a RICHARD CHARLIER
w Name
_
nddress 14103 GARDENVIEW CT
a W City A. V. Phone -5
I hereby acknowledge ihat I have read this application and state that the
information is correct and agree to comply/with all applica e State of
Minnesota Statutes and Ci gacV ? ina
SignaWre of Permine FRONTIER WEST HOr
AiBuilding Permit is issued to:
all, work shall be done in accordance wv p able State of inne
Building Official ? ?Q -- -
Assessment _
Water & Sew.
Police -
Fire
Eng.
Planner-
Bldg. Of(.
APC
Permit ' "" ' '" _
Surcharg32.00
Plan Review??. 50
SAC ? . 00
50?
Water Conn. 00
Water Meter 63 . 50
RoadUnit 290.00
Tr. PI. 156. 00
Var. Date Copies
S Total 52,104.00
on the express condition that
Vt4" and Ciry ot Eagan Ordinances.
?
7985 BUZLDING PERMIT APPLICAYION - CIT7f OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED ifITH iHE CITY OF EAGAN
?)TA-FFoRP
COKKERCIAL
SINGLE FAMILY DiiELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS -
$2,000 LANDSCAPE BOND
(04lDOO
To He Used For: Single Family yaluation: 64-, 10e" Date: 1-29-86
Site Address 3695 Falcon Way
Lot 5 Block 9
Parcel/Sub Lexington Place South
Owner Larry & Chan-hui Willwerschied
Address 1435 W. Jessamine l/104
City/Zip Code St. Paul, MN
Phone 645-1764
Contractor Frontier Midwest Homes
Address 3908 Sibley Memorial Hwy. 11E
City/Zip Code Eagan, MN 55122
Phone 454-0433
Arch./Engr. Richard Charlier
Address 14103 Gardenview C[.
City/Zip CodeAPPle Valley, MN 55124
Phone ll 432-5492
Erect k
Remodel ^
Repair
Addition '
Move ?
Demolish ?
Int.Impr.
Install '
6PPROYALS
Occupancy
Zoning
Type of Const
11 of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer
? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off +-3 T- Treatment P1
APC Parks
Variance Copies
TOTAL
?
d?7
• _ V 1 Y
•`. ' ' . EX7, R10R EiJt'[LOPC ARnGf COrsiuTfl,lON
?- J -- - - - hl C' w?^J .
,,,:i,?
i,,.? OWt1E P,: ---- -- I;,'?71
SITE IIDDRESS: f'IiONc:
CON7RACTOR:
Cetermine working square foctage of each
1. Total exposed wall area..... I !)(cA, S sq. ft. x .11 = QI
2. Total roof/ceiliny area ..... 101(a _sy. ft, x.G2G =
Total exposed wall arca al,ove ilnor=
a. Total wall window area ...............
...............
............. I? J
b. Total door area ............... _
c
Tot
l ................
......
iidi
l
............. ? Z
. t s
n9 g
ass door arci '
d
Total
fi
l
ll
............ 4
7
-
, ace wa
rep
area .............
..............
........... q
e
Total
ll f
i ..
. wa
ram
ng area (average lOm) ............... ....... S
otal ri
i
t .
.....
. m jo
s
area .................
9
net
...
.........
w
ll
b
4
'
............. -L O
. a
area a
ove floor...Z`A
, , Cc't?c T?
;;!.
h•
wall area above floor..................... _? fL
i ...
wa11
6 .............
• area a
ove floor ......................
7
frame ..
wall
r ....
.........
,
. area at
ounciatior ...................... .............
Total expcsed foundation area= ? -Z:)
k. Total foundation window area ...........
l.
Total ............
net foundation area above 9rade ..............
Determine " u " value of each wa ll s?gric nt
(e.g. windovr, door, each separatc ?-+al I seciion)
? a• I ZS _ X "U"_
. b. q? a,u,l 45
. C. -? Z x u„
. -
d. q g a „u??
??0,a s X 'lu„ .05
-- ?
f. 1-2o x ,lul, 3
x„?„
. h, x „u., -
.i, x „U„ _
. ?, x „u„
r•
X
"U" If item #3 is the'same
as, or less than'item
? S
x , you have met,.ttie?%}
75 intent of SBC,.60067<(c)
_.. ??r. .
:nvelopc Avcr;qc "L"' Co;npuCnt:ion
Tota1 cxpo:;ed root/cciling arcE _ I C)l (O
Pngo 'l o: ?
m. 'lbtul s}:yli.qht area ............................ '...
n. Total roof/cciling framing arca (avcrayc lOF.).... C)f4,_Co
o. Total net insulated rooL/cciling area.... .......
i
• Determine "U" value for each roof/ceiling segment ? M. - X ..Li„
n, ? C)(,Cp a„U„ ,C)z A-- 2, 4 g
o- x "U„ , 07
4 ........................... 7bta1 5
Ii total of ;,4 is the same as, or less t:han i12, you have meL• the inCent of
SriC 60J6 (c) 1.
Alternate Buildinq Envel.one Desiqn ib ut.ilize tne total envelope 'system metiiod, tne valu°s estzblishecl by tlte s;un of
i_tems 0 and r;4 shall not be greater than the sum of items i;1 and 112.
1. ZICo.U-^j + 2. ?G. 4 f
3. + 9. zv,73 = 1 gCo, ?p
?
. . 11?1!• I, t,?'...?.: ????n
. , a.,
U:-r lyl:,.o?• ? ??.?n?u• v.?? i nCC.i Io l'
Gcd?Ll;ucl lun ?..'.n_.I:?i: • i_.?? f Vnl??.•
(a1ewLM
,?{ _? :. L ?• c?y ? Q'p
a. _ . --.. t*+ea
5406;.5 .. 41,vrn, .. . .... . ? Coal I
?.,. • G.? F.,:li?rii.r ii? ?i1•??. .. u.f.?
-? -?--- --- • -- .. . _.. . . .. . __ .... ._.._..i ?. ??
?i.t, ---_`n •?.?? .? i
? --= ?
,,..o?+-?-
?IG. G1 TUPVIEIV Oe
FIW4: liALf, . ll?trrl??t' ;i ? 1' : 1 1 ni 0. f+ll
z. f3' O - - -- --'4?
• . ?' ---.LI '.!?!K-?. _.?. ?18: -- ----- ? 3?°..?0 .
, • a 'L??? _nr?a..__.. . _---?---.._ .?._s?C?
,- ,
. ........... . . .,.61
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q?
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4.
ti?_.-al r1 - 3j 5. Eil?.Wn?_Sel.57lN(,Q---.-____----'-L'??
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?'G_.... ? ._CE4 .?.....
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ConstructSon R-Valxtc
1, Intcrior air filn 0.61 -
s. -- f3 G-( 3Z) , sg
3. W5o4L. • 44.Oa
;. Extcrior nir :i:n (sti11) 0.?
To tal (? ^ S pO
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I uP '
I'IC. 95 ?
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4. ,
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1. Ir.sidc air filin 0.61
2_
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F.C.qrt ?
1. Tnsidc air Total
. . ' '
filin .
• ' .
0:51
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$_ Outsidc iir filtn 0.17
,
Ynsidc air Total
filin •
0.61
2. .
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4.
5. CliLCidc ai.r filin 0.17
To Ca 1
R?_ec: Use aduitional nheets if morc Spaeo i:
needecl for dc:?:.ils and calcLlat3ons. -
• i.'J??:/CEILI::"
_; ? r lyt ?of rlfof loiq u,lli n;cn foi'
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N??"x'?"'n:-:'• ! • : . _ :.?r: .- .. . `.
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N? 7Y-00-00 tlUft CUI ¦ 0•00-0• 1
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SEIaVICEB
3908 Sibley Memorial Highway
Eagan. Minnesota 55122
Phone: 1612) 452-3077
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0 lknotes Irai Morwrteht
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004,4 lknotes Existirg Spot Elevation
044 "NL@notes ProposEd S/wt Elevation
,,---- Genotes Dra i nage D i rx t i on
-PAOPEKIY AESCRIPfIpV-
LOT 5 BLLL'K q
Lex I rJ Gi TON PL1? 4ZoU-f F#
accordirg to fhe recordEd plaf thereof,
County, Minraesota
V+iAYNc D.
LORi3ES
- i4675 -
?sg"-'»``?'j'PROPOSED GARAGE FLOOR ELEVATION= 90L4
PfOPOSED Top of 8lock ELEVATION =
PROPOSED BASfAIENT FLOOR ELEVATlON= 03. 1
W0
NOTE: Verify all floor heights with Final House Plans.
SUIdCM CERT I FICAT ICN-
I hereby certity ihat.thrs survey, plan or report
was prepared by +re or ixider my d i rec t superv i s i ar
ard that 1 am a duly Registered Larrl Surveyor
urder fhe laws ot the State ot Yinnesota.
. Date: lz-7 `X'
Wayre D. Cordes, Minn. Reg. No. 14575
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CITY Or EAGAN
aP-°I-1CATZON FOR PERUMIT
SEWER AND/OR WrITER CONNECTION
(PLEASE PRIHT)
PPCD--'`? AcDpES5= 3695 Falcoii Wa
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1'0='IE: Frontier Midwest Homes Corporation
ADDR=SS. 3908 Sibley Memorial Hwy. Bldg. E
S=7T=, ZIP- Eaqan, MN. 55122 •
454-0433
3) P=i? (PLE;.SE PRINTj faR CITY IJSE O
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NAME:
. Star Plumbinq ,
PDD?,ESS:
1018 Mound Springs Ter. PLU
N.BERS lICE45E:
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CITY, STA:'E, ZI?: Bloominqton, MN. 55420 0 ExPired
PF:O_dE: H?i?r.
884-4149 PLUMBEF LF[EUSE N 3329 Not af Record
• aSEr= ;n,ci„
1.7?,?_ Larry & Chan-h?uiLWillwerschied
ADDRESS: _3435 la-qgn"ino Jb10
CZ?"!, STATE, ZIP; St. Paul,MN
PfiO.`IE: H??S-?7H5
5) 12dpI= :VHICH PER-lIT IS BEING RFT;UESTM;
? Qc-NNECiIO:v 'Ib CITY Sti7rFR Please mail gold copy to
xy CCNtIE(7IIC:I i17 CITY WATER Wenzel Mechanical
3600 Kennebec Dr.
? ?72 (PI.L,-,SE DFSC.'PSEE) Eaaan. MN. 55122
o) u:s•
? PT-,?r.,'%SE 1?OLD nPFRCVE?J PERm.IT FOR PIGR-UP BY C:VE OF AEGVE
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WATE7. PEiLn1IT (2`:CLi;DE SuRC.°.ARGc',)
WATER METER/COPPE.°.HOP.N/OIJTSIDE REi;CE^
S^iATE° TAP (INCLUDE COR?ORATIO:I S'_"0?.)
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LaTER1,1, BENEFZT/TRli.`1K WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
P.IMOL'NT Pr'II7jREC°I?T n
DO: S UTILZTY CON:IECTION REQUZP.E EXCAVATZON I:1 PUSLIC RIGHT OF jdAY?
YES IF YES, THE:] n"PE?RMIT FOR 'AOR?: WITHIN
PUBLIC ROADWAY" MUST BE ISSliE? BY THE
Cj NO ENGINEERIDIG DZVISION. LIST AS A CONDI-
TION.
SUEJ£CT TO THE FOLLOWING CONDITIONS:
APPP.OVED BY:
TIT:,E:
DAT_° :
?@ OA iiY o? s 3al akA m!m @II ?bW G4.AY 04 O iV Fli OR/? R+? Ok?61 R??4 YFf? P!o ?4 \ Dl W J? A+t i?? D! bR7 ?1 a
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139188
Date Issued:10/12/2016
Permit Category:ePermit
Site Address: 3695 Falcon Way
Lot:5 Block: 9 Addition: Lexington Place South
PID:10-45060-09-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Brian J Gray
3695 Falcon Way
Eagan MN 55123
Gene's Of Apple Valley Construction Inc
17660 Kettering Tr
Lakeville MN 55044
(952) 892-0060
Applicant/Permitee: Signature Issued By: Signature
A
A
1
For Office Use
'5'7
,�` . , ,�, Nrcf *JLL)gr ::::
/
,„ , ., /Mt : /
Date Received:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspectionse,cityofeaoan.com L
20 8 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ` frJ )
i Site Address: . li,/'C. ) ' f-1 ii l tv LAJ '`%`1
Tenant: ''�, Suite#:
Resident/�lAi#1 r Name: 1 i Y c � �F Phone: '')2-I,,.JCI c-�' 1
Address/City!Zip:*'3'I ',c. I! w �i',Lib
11/4.'1
Name:,)�i h i� L License#: i•' C _ `1 :.....) ,
,.....,.,,,,„,,„„_ ,...,,,,,,., ... , „ /,
, , , .. „,
,, ,,
. .. „ , _ ,.....
Address: ;}� �� ) City: 'i Yd;-t-
State:..„uginiracturr, ,
) I Zip:,�':d� � ) / Phone: a,..t"' ) L.A. - . fi.
Contact: ,Y'1 L Email: ,✓l! ice'1 0- r171-r ► (cni
T _New X Replacement —Repair Rebuild Modify Space _Work in R.O.W.
¢ I .Ce eFr)fr -bov a,.` t'41.4 ' UAe,"t
Description of work: r /
' RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation( RPZ/ PVB)
Septic System Add Plumbing Fixtures( Main/_Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required) ‘00
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. vww.gopnerstateonecatl.org
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at rvww.citvofeagan.com/subscribe.
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 AL ,1'F x j
Applicant's Printed Name Applicant's na
i
FAIR OFFIt U: R *lew BYE , 3�
t ,
7 Y � �.e `� St 4 9 � � 7.
Required=Ins0lons: U44:4A0 ii Rough-in Air Test , as TIS F
z Meter Related Items: 'Meter Size:.,.;L ,:;!4400:0401n, :.Manom
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161885
Date Issued:06/16/2020
Permit Category:ePermit
Site Address: 3695 Falcon Way
Lot:5 Block: 9 Addition: Lexington Place South
PID:10-45060-09-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Grant C Bednar
3695 Falcon Way
Eagan MN 55123
(303) 819-0023
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161885
Date Issued:06/16/2020
Permit Category:ePermit
Site Address: 3695 Falcon Way
Lot:5 Block: 9 Addition: Lexington Place South
PID:10-45060-09-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Grant C Bednar
3695 Falcon Way
Eagan MN 55123
(303) 819-0023
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature