3116 Farnum Dr
05/19/2010 WED 15:35 FAX 6514378831 IM002/002
Use BLUE or BLACK Ink
_ _
D~
City of Eaku i Permit: _ I
I ,
Permit Fee:
I
3830 Pilot Knob Road I 1
Eagan MN 55122 i Date Received: J
I J` I
Phone: (651) 675-5675 i Staff:
Fax: (651) 675-5694 I
2010 RESIDENTIAL PLUMB NG PERMIT APPLICATION
Dated Site Address: NA Yy~um
Tenant Suite
RESIDENT 1 OWNER Name: ILI Phone:
Address 1 City /zip: *d f'T y h uq1 '
CONTRACTOR Name:; [~(I ~'1.1ot clk i' 1( t.icense
Address: ~1b IJif'" Ii (?Y 1 MCiity:44tic, 1CtS
State:-#'-~ Zip: ; CJS 3 Phone (D91 ' LEO
Contactb('Q.!`1n Email: &
TYPE OF WORK -New Replacement -Repair _Rebuild u Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE R IDENTIAL
Water Heater Water Softener
Lawn Irrigation _,,,,Add Plumbing Fixtures
RPZ / _ PVB) Main - Lower Level)
Septic System Water Turnaround
New
Abandonment
'RESIDENTIAL FEES:
$50.50 Min m 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 518" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) O
TOTAL FEES •
GALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage.
Call 48 hours before you Intend to dig to receive locates of underground utilities. www.gopherstateonecali. r
I hereby acknowledge that this ' ormation is complete and accurate; that the work will be in rmance with the or ces and codes of the City of
Eagan; that I understand th' r not a pe i{ but only an application for a permit, and wo i not to start without ermit; that the work will be in
ae ce with the app e f in the c of work which requires a review and approv f an
r T1 x
App cant's Printed Name Ap lea t ignature 77
i_ , a ..r.. 'c-...s' t>a y ,r :v,. ct y wa rr ...F yeN..
OFFICE U$>Wt # s x Hf~,, f 3
WIN
fv ,lliAre In p C fQ 3s ~t3f .l~rt F t
R t~tr ire F r~~ahlr 7t y .:Gas Trot ) pl
PERMIT #
PLUMBING PERMIT RECEIPT # <E
CITY OF EAGAN
3830 PILOT KN08 ROAD, EAGAN, MN 55121 dATE
CONTRACT PRICE PHONE: 454-8100
Site Address ` `('"'`-" BLDG. TYPE WORK DESCRIPTION
Lot 01 Block? 0?-' Sec/Sub ?
CCcxC? r?-? l 1. r Res. x NeW
? Mult Add-on
2
? q cOlginr
Ave
. `G Camm. Repair
v Ci?, g, fvlinnes
ot, Other
- 80
NO. FIICTURES TOTAL
Name `
` ter Closet - $3
W
00 $
.
a
c Address
e Bath Tubs -$3.00
O C?1Y Phone Lavatory - $3.00
Shower - $3.00
Kitchen 5ink - $3.00
FEES Urinal/Bidet -$3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00
MINIMJM - RESIDENTIAL FEE _$10,00 Floor Drains -$1.50
MINIMUM - COMMIIND FEE _20 00 Water Heater -$1.50
STATE SURCHARGE PER PERMIT _ .50 Whirlpool - $3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50
BEYOND $1,000.00} =Soitener - $5.00 '-
Well - $10.00
? .
0 Private Disp. - $10.00
nin
s -$1
50
R
h O
1 g
.
oug
pe
SIGNAT E OF ERMITTEE FEE --?• ?`
r.
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL: r' ? 0
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
' CONTRACT PRICE: PHONE 454-8100
Site Addr `/e', f'4 BLpG. TYPE WORK DESCRIPTION
?ot ? 2 B1ock (--
? ,
?t ?Sec/Sub
? ?
r, (_: h +?,.- . c'_ r'\ l ?es.
New
? Name 6 ? ' Mult Add-on
/ ? ? l
? Addres ?? '
• Comm. Repair
c Ciiy Phone Other
I
'
Name
'?
?'??? NO. FIXTURES TOTAL
t - $3
W
t
r Cl
00 $
'" f .
a
e
ose
c Addr ' Bath Tubs -$3.00
p City Phone Lavatory - $3.00 ?
Shower - $3.00
Kitchen Sink - $3.00
FEES Urinal/Bidet -$3.00
COMM/IND FEE - 1°r6 OF CONTNACT FEE ?
Laundry Tray -$3.00
MINIMiJM - RESIDENTIA L FEE _$10.00 Floor Drains -$1.50 •
MINIMUM - COMM/IND FEE _ 20,00 Water Heater - $1.50
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADd $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlats -$1.54
' 8???fl $? ??'?? ?K SoRener - $5.00
Well - $10
00
.
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE
STATE S/C:
I
?
? Q
FOR: CITY OF EAGAN GRAND TOTAL:
,- .
CITY OF EAGAN ? 4
ut?-3830 Pitot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121
a PHONE:454-810Q
Recelpf
T& 6e w@W fw ". . Est. Volue i?"U i Do
Site Address - i - Erect
Lot Block Sec/Sub. Remodel
Repair
Percel Nc. ; - .
Addition
MOVe
W Name
; Addre
U '7
Name
u? Address - , -
1- City Phone ?, ;i 1 - : ? `, •'•
City
Phone
I hereby ack?tiawledps thof I have read fhis applicotion ond state thct
the informotion is Correct and ogree to tomply wirh oli oppiicoble
Stota of Minnesoto Statutes and CiFy of Eogon Ordinonces.._,
Sipnoturc of Permittes
A 8uilding Permir is issued ro:
dl work sholl he done in acwrdonce with all oppiiaoble State of Min
Demolish
Int Impr.
3uLY 2
L;?) Occupancy
? Zoning
? Type of Const.
? No. Seorias
? Length
? Depth
? Sq. Ft.
?
Assessment
t
3 S
W Permit
5urchar
e
er
ew.
a
P
l g
Pl
R
i
ite
o an
ev
ew
(}
. u
Plrt 5AC
00
Enq.
pl Water Conn.
Water Meter ' 3' C o
onner =?• ?• G 0
Council
'/.t "'_, Road Unit
QA
Bldg. Off. Tr.
PI.
APC Parks
Var. Date Copies
Total (J 0 .
on tM lxpress cordition Ihot
soto Stotutes ar+d Cify oi Eagon Ordirances,
Buiidinq Officiol
Permit No. PKmlt Hold er palr TolspAon? ?
Plumbinq ? ? L f i I? S
H.VA.C.
?f c_ ?
I? \ G
J
.-07 S? ?o yo
El.ctria ?vo1v Tk-,c u1 /? 5?.s d
sone(.. .
Impecti8n Date Insp. Other
Footinge l
Footings II
Foundation
Frominy
Rooting
Rough Plbg,
Rough Htg.
Insul.
F(repface
Final Htg.
Final Plby
Final
Cert/OCC. ??? ? Z l A
Water Describa Location:
? ?.a ?, I? L• -
(?C C.c?,F..?..-c?
Well
a
Sewer
Pr. Disp.
't'To-WN410liSE)
BUILDING PERMIT
Slte Addren --' ;
Lot Block 5eclSub. Parcel No.
W Name '-.}AC}1U-.N
Address ,
City Phone
Z? Neme
uu
Addreaa ,
CitY Phone
Name _
Address
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Phone
by ccknowled9e rhot I hove reod this
tormation is torrect and ogree to t
of Minnesota Statutes ond City af
Siqnoture of Pem+iftes •
A Buildinq Permit is iswed to:
dl work sholl bt done in oCtordonCe
9uildinp Oif{CiOt
and
all
opplioobl• Stohs of
30525
Receipt # ?r ,
Erect U Oceupsncy
Remodel ? Zoning
Repalr ? Type of Const.
Addition ? No. Stories
Move ? Length
Demolish ? Depth - .!
Int Impr. ? Sq. Ft.
Install ?
Approvels ie"
Assessment
WaTer b Sew.
Police
Fin
ErW
Plonner
Countil
Bldg. Off.
APC
Var. Dffie
on
r+esoro Stotutes ond City oi
Permit J 1 V . .,..
?...,.,....,,.. ", (? . 5 G
Plan Review
SAC
Water Conn.
Water Meter 6'' °
Roed Unit 2 80 ?
Tr. PI.
Parka
Copiea
Total I
he exprost tondiNon thot
Ecqon Ordinoncas.
PKmit No. Pwmit Holda 09b TeIephone t
Plumbing
r)g
H.VA.C.
?
Electric o0 0 6?
$ottwNr
Insqction Date Insp. Othm
Footinysl s w
Footings II
Foundatlon
Fnminy s W
Rooflnp
Rouqh Plby. oW,
- 20 -
Rouqh Hty.
Insul.
Finplaca
Final Htg.
Final Plbg. /Z
Final
COtt/OCC.
Watsr Dncribs Location:
w•u
Sswer
Pr. Dlsp.
? I
BUILDING PERMIT
CITY OF EAGAN 10 .;?13
..
3830 Pilot Knob Road, P.O. Box 21-199, Eagae, MN 55121
PHONE: 454-8100
Receipt #
61.000
Site Addreu lj•?, n
? ?
lot 4 Block ?/5ub. '•,
Parcel No.
? Neme =GACHT4ji,.i,
? AddfesS
? ?i-
City Phone
?O Nertle ? . i:-• • _, .
o
Address _
u
1- CitY Phone
Phone
I hercby acknowledya that I hove read this opplicntion and stote thaf
the informcFion is torrett ond ogree to comply with oll oppliWble
Stote of Minnesoto Stotutes and City of Eogon Ordinonces.
Sipnaturo of Permittes _
A Building Permit Is lsswd to:
dl work shall be dorw in xcordonce with all oppliwble State of Mir
Buildirq Offlcia)
Erect Ocwpancy
Remodel ? 2oning
Repair ? Type of Const.
Addition ? No. Stories
Move ? Length -
Demolish ? Depth
Int. Impr. ? Sq. Ft.
Install D
Asseument Permit y '' - " •
Wcter S Sew. Surcharge 30'
Police Plan Review 1 ? ? •
Firo SAC = ? 5 •
Enp, Water Conn. ? V ? •
Plonrer Water Meter 63.
Council Roed Unit C' •
1/11 7
'S r 13 i.
,
Bldg. Off. Tr. PI.
APC Pa?ka
Var. Date Copies
Total
•
On tFN fxprlfs COnditlOn lhot
wto Statutes a+d City ot Eopon Ordinonms.
Permit No. Permk Holder pab ToIsphone *
Plu"i.w
H.VA.C.
Elect.ic
Sottener
Impection aat* Insp. Other
Footinys 1 ? W
Footings II
Foundstlon
Frsminy ?O
Rooflny ? Z ? ?
Rou9h Plby. ,
Rouyh Htg.
Insul.
Finplace
Flnal Ht9. ?? I'-,?
Flnal Plby. ? .?
Final
Grt/Occ. ?-
Water Dheri6e Location:
Woll
Sewer
Pr. Disp.
d_ CITY OF EAGAN '1 .5 2 2
?~ r~ ? 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagsn, MN 55121
PHONE: 454-8100
BUILDING rERMIT Receia
To M rwd fer ..,` Est. Volue - Dote 19
Site Addrest - Erect 0 Occupency
Lot Blxk secf Sub Remodel ? Zoning .?;
ParcN Na . Repair ? Type of Const. ?;
Addkion ? No. Stories
,
` Move ? Length
? NaMe .
?.
. Demolish ? Depth
2 Addres s I
t I ? F
s _. n
mpc Sq.
t. ,--
? Nsme - ?,`,•, :l.;tv?T C(-)
?u Addreu ,
u?
Citv Phnno , .i i '- .? L `J•?
Name
Ftis
Assessment
Water 3 Sew.
Poliu
Fin
Enp.
Plonr?n
Countil
Permit
Surcherqe
Plan Review - ,
SAC I
Weter Conn I
Weter Meter
Roed Unit
I hercby ocknowlodpe thot I how rood this application and stote that Bldg. Off. ? Tr. PL ???•?
the information ia torcect and ogree to comply with oll applicable APC Parks
Stots of MinnesoM Stotutss ond City of Eoqan Ordinances.
Var. Date ?Pi?
Slpwtun of Permiftee ,
Total ,
A Buildinq Pennif is issued to: on tM express tonditlan thot
oll work sholl be done in ocoordonce with oll applioable Stote of Minriesoto Stotutes ard City of Ecpon O.dinarwes.
suildinp Offtaol
PKmit No. Pwmk Holdv Dob Telsphone s
?umbino .1)
H.VA.C. I.. _ , ..? . 1 r
i ,
EkcWc /
sofmw
Inspeetion Date Insp. Othw
Footinys 1 8 ?
Footfnys II
Foundation
Framing
Roofing
RouphPlbp. -G
Rough Hty.
Insul.
Ftroplaa
Final Htg.
Final Plby. ?
Finel
ClPt/OCC. - ?.].?c.. -T-2r? L? f'.) . .•'
Wstsr Dewi6e Lowtion: ?-
We11
Sswer
Pr. Dlsp.
Rnipt MECHANICAL PERMIT Parmit No. '
cirr oF EAcnN
Fw
fill in numberod arpices S/C
Type or Pr/nr hgib/y Tot
b
1. Dats 2. Installation Cost` '- ?
3. JobAddrels Y. elk. .r, Tract ?, •_
4. 01AR1lf for
+' i ¦ ? 'l?
5. Contractoc_:% ,,2?1: i Tl Phone.
B. Address '11 . -1
7. GtY. ?:-L - State Zip -
8. Building Type: Residential Cid Commercial O Institutional ?
9. Work Description: New ? Add O Alter O Repair ?
10. Deacxibe Fuel Type Y?; ,? -
11.
No.
? Eiluinment BTU - M. Ea.
Forced Air
i No. Eouipment CFM
Ai
H
li
Mfg. r
and
ng:
Boilers
Mfg. Mech. Exhaust
-
Unit Heater
Mfg, Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply wi all ordinances and codes governing this type of work.
_,..
Signed: ?` ::-•.?, e_ .? , - ? for0t:
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
pt PLUMBING PERMIT Permit No. )
CITY OF EAGAN
Fee 20 _ nn
?-
Fill in numbered spaces S/C _ 5O
Type or Prini /egibly ToL 20.50
1. Date SEf'T 9, 1985 2. Installation Cost
3. Job Address -31185 FARINUM XotBlkL 'Tr'act
)
4. Owner R0.? ?'WOOD Cc7f2F? ?`?`' ? J
5. Contractor St_HLiC.TTF_S P(dIMRTN(: Phone 786-4007
6. Address 8383 SUNSET RD. NE
7. City SFRING LAKE PARK State UN Zip 55432
8. Building Type: Residential IX
9. Work Description: New Q
Commercia? ? Institutional ?
Add 0 Alter ? Repair O
10. Describe FRAME DWELLIBG
11.
No.
-?' Fixtures
Water Closet No. Fixtures ?
Cesspool/Drainfield
Bath tubs Se
tic Tank
Lavatory p
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Oth
Laundry Tray er
Floor Drains
Drinking Ftn.
Slop Sink
Gas 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 :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
e
Receipt r ? rl ?
( 15
PLUMBING PERMIT
CITY OF EAGAN
FiII in numbered spaces
Type or Prrni legibly
?
Permit No,
Fee 20.00
S/c .50 Tot. 20.50
1. Date SF-PT 9, 1985 2, Installation Cost ?
3. Job Address 3118 FAEtNUM DR. Lot --T BIk. Tr?'set?
4. Owner RO`'EWOOD CORp Z4 ? .?
5. Contractor -0,MULTIE5 pLCA`'IDING Phone 786-4G07
6. Address 8383 S(Ji1j8ET RD. NE
7. City SPRING LAKE PARK State t'114 Zip 55432
8. Building Type: Residential t
9. Work Description: New [H
Commercial O Institutional 0
Add ? Alter ? Repair 11
10. Describe FRP?ME DWELLING
No.
?- Fixtures
Water Cioset No. Fixtures
Cess
ool/Drainfield
_L Bath tubs p
$eptic Tank
Lavatory r
S
ft
? Shower o
ne
Well
Kitchen Sink
Urinal/Bidet Othe
?
Laundry Tray r
J_ 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
MECHANICAL PERMIT Penmit No.
CITY OF EA(iAN
FM
, , .
fill in numbervd ipaca S/C
Typa or PrJnr /pib/Y Tot
1. Dste 2. Instalistion Cost%` /. '?' •
?
3. JobAddress:?Y Blk. Tract
4. O1M1lf ?T?..?ri?? j
5.
6.
c-
7. City State 2ip
8. Building Type: Residential Q
9. Work Description: Naw O
_?Ll • _ .?Ii 4.? ??J ?'fL? ?
Commercial D Institutional ?
Add D Alter O Repair ?
10. Descxibe Fuel Type
11,
No•
' Enuioment BTU - M. Ea.
Forced Air .- No. EQUioment CFM
Ai
H
li
Mfg. r
ng:
and
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, 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 . f0r ! ;•-? _-,. . . _ ! ?? /
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permii when numbered and approved.
Approved CITY OF EAGAN 454-8100
i, CITY OF EAGAN Remarks I' j "
I Addition COACEIdAN LAND CO 3RD ADDN Lot 4 Rik 6 Parcel 10-18152-040-06
? pwner street 3116B FARMIM DRIVB 5tate EAGMI IrIIQ 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 755 1983 754.17 irJ0.a3 5 D
STREET RESTOR.
GRADING 727 1983 173.26 34.65 S
SAN SEW TRUNK
fSEWERLATERAL 7 00 1983 1908.38 381.68 5
WATERMAIN
? WATER LATERAL 1983 $
WATER AREA
STORM 5EW TRK
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
BUILDING PER. 10622-10625
PARK
Receipt PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prinr legib/y
Permit No.
Fss
S/C
ToL
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner ?Q ot?
5. Contract? Phone a
6. Address
7. City Zip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New O Add ? Alter O Repair O
10. Describe
11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory ? Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
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 45"100
I
Receipt
i
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prinr legibly
Permit No.
Fee -
S/C
Tot.
1. Date 2. Installation Cost
3. Job Address - Lot Blk. ? Tract _
4. Owner r
5. Contractor P? ^ ? T- ?qne" - y .%
:- , , - • - _ n
?
6. Address
7. City $ate . ; Zip
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New D Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool /D rainf ield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough f inal
Inspections: Date Insp. _ Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Rocoipt MECHANICAL PERMIT
cinr oF enGow
Fill ln numbsrad tpecw
Typt or Print legib/y
1. Date 2. Installation Co:t le1'.
Permh No.
Fw •
S/C
ToL
?
3. .IOb Addrlq,jZ %? ,LOt Blk. 4",
4. Owner 2- l,e E?9---? fi•^- ? ?^?,G'?>.?,t, '
5. Contracto[ 7 Z .1?_ ?"Phone
, L,i
8. Addross
7. CitY ?r4 ,¢(,?-? Stste /,'i,i/, 2ip
s? .
S. Building Type: Residential ? Commercial O Institutional ?
9. Work Description: New 03 Add O Alter O Repair ?
10. Describe ?',C -cf.2t Fuel Type
r. a ?r
11.
No• Eauioment 8TU - M. Ea.
,.,
Forced Air No. Equiament CFM
Ai
H
dli
Mf9• r
an
ng:
BO1ldf$
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify tfiat the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
? T
Signed 1 ? r A , .? <,
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt r?'? 61PLUMBING PERMIT Permit No. ??-
/ CITY OF EAGAN
Fee '20_00
? Fill in numbered spaces S/C -.?
Type or Print legibty Tot. 2a _ Sn
1. Date 2/9/85 2. Installation Cost
3. Job Address 31 1611 FARNUP7 DRLot?BIR:" (Tract?
4. Owner ?pSEWppp QORp / ?, `f( --)
5. Contractor 3C1-IUL'1'IES YLUNiBIivG Phone 7u6-9007
6. Address
7. City SPRING LAKF. PARK State MN Zip 55432
8. Building Type: Residential 12 Commercial ? Institutional ?
9. Work Description: New k7 Add O Alter ? Repair O
10. Describe F'lZAME UWL•'LLIi4G-
11.
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
Bath tubs p
Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Othe
Laundry Tray r
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outtets
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 :
for
Rough " Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
R"ipt ?
1 I 1 /.' % " a
MECHANICAL PERMIT
CITY OF EAGAN
fil! !n numbered ?pscex
Typt or Prini /edib/y
1. Dste 2. Instaliation Cost ?
Permit No.
FM
S/C
Tot
v
3. Job Addresc i'//a? 7? Blk. Trsct
4. OwnN
5.
8. Addross T. •6?,?i
?-
7. City State Z; p -_:,T ? ? , S-•
8. Building Type: Reaidential ? Comrt?ercial ? Institutional O
9. Work Desaiption: New Add 0 Alter ? Repair ?
10. Desaibe ,?:??--41:-f,?'1r's; 1d_CZ- Fuel Type ii,': .
11.
No.
' Eauinment BTU - M. Ea.
Forced Air 7? No. Equiament CFM
Ai
H
li
Mf9. I,E A r
and
ng:
,
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
? Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply wijh all ordinances and codes governing this type of work.
Signed: 14- tor
Rough Final
Inspections: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PWMBING PERMIT Permit No. ' Y)/)
CITY OF EAGAN Fee 2n, O(1
Fill in numbered spaces S/C
Type or Prini legibly
Tot. 2_?
1. Date gjA/HS 2. Installation Cost
i
3. Job Address ' Lot Blk?'
4. Owner R06Eh100D CORP 3
5. Contractor s_xrtr.TTFS AiJiMIsjNC: Phone 1?6=40C17
6, Address 8383 sUNsE`l' KD. NE
7. City SPRING f.AKF.: p RK State MN Zip 95439- _
8. Building Type: Residential 87 Commercial ? Institutional 0
9. Work Description: New CR Add 0 Alter O Repair O
10. Describe i'RAME DVJF'LLlCJG
No. Fixtures
Water Closet No. Fixtures
l/Dr
field
Cess
o
i
Bath tubs n
p
o
a
tic T
Se
k
? Lavatory p
an
Softner
? Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and 1 agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Fiough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
I CITY OF EAGAN Remarks ZA
I Addition CQAGHMM LAND CO 3RD ADDN Lot '•j 131k 6 Parcel 10-18152-030-06
Owner Street 311b FARNUM DRIVfl State EAGAN M 55121
Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF. S - ? 2
STREET RESTOR.
GRADING 7 Z 1983 73 6 34.65 . ad
SAN SEW TRUNK -
* SEWER LATERAL 7.0 ?
WATERMAIN
* WATER LATERAL 1983
WATER AREA
STORM SEW TRK ?
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sc,c 525.00
PARK
CITY OF EAGAN Remarks L'( 'I - "'?) ?
Addition COAiCfKIN I.AND CO 3RD ADDN Lot 2 Blk 6 Parcel 10-18152-020-06
owner Street 3118 FARNUM DRIVE state EAGAN MQd 55121
' Improvement Oate Amount Annual Years Payment Receipt Date
STREET SURF. SS '
STREET RESTOR.
GRADING 1 1983 173.26 34.65 S ?-
SAN SEW TRUNK
* SEWER LATERAL 'f 2 83 1908.38
WATERMAIN
# WATER LATERAL 1993
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
$280.00 53849 7/22 85
WATER CONN.
500.00
BUILDING PER. 10622-10(25
SAC
PARK
CITY OF EAGAN Remarks L)I 1-
Addition COACI'MAN I.AND C0 3RD ADDN Lot 1 B1k b Parcel 10-18152-010-06
Owner Street 31188 FARNUM DRIVE State EAGAN MN
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF. 75 J!f'D • 25 R 3 ? ? _ / - ?
STREET RESTOR.
GRADING Z 1993 73 26 6
5AN SEW TRUNK
w SEWER LATERAL - '
t
WATERMAIN
• WATER LATERAL 1 9
g 3 5
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
BUILDING PER. L0622-1062
sac 525.00
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
f (612) 681-4675
I SITE ADDRESS: , , , ,
I Af<NIlr1 1lk
I :iiIilroiJ I rlfdll .k.+? ;ftll
I PERMIT SUBTYPE:
, r•, i , )
INSPECTION RECORD?
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
?,;, • ,,ra . i
1?? I. ? ?i S ? H I
TYPE OF WORK:
, . , 1 , k I I 1 i,
fsi.ll t t tt I N(,
0111 104
HhIH.'fU'i
I+F f'A I 1l
kE Pt_A(. E ft()t)F 114 91
I ! I N I1 I
kt MARk `.. : I Nt I Itlit
F
L
rr??
11?, l?. 311:t, f. '11 ltt-H 1=AI,MI1I01 (1F; lllfl`. 0. :&1.)
Permit No. Permtt Holdsr ' Oate Talephone #
SJW
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inapection Date Inap. Commerrts
Footings I
Foundation
Framing
Roofing !-23 ? 3 C m It a IN )+,,,,
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Finel Htg.
Orsat Test
Final Plbg. Pibg. Inspector - Notiiy Plumber
Consf. Melar
EngrJPlan
Bldg. Final
Deck Ftg.
Dedc Fnal
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: , . ;
T I ,? i , !tI:fJUhi !k
1-111 ilPllira ! ,1-111 i t) tkU
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE;
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
?I f i? t 14 N
dl:• 1 4iIt t
/e-, ts /"a:3
MAfrul' 1 I N!
Arii? r t r i1n
I ?,10 1 tw" 1 1 1 i I w3i
Permlt No. Permft Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRtC
ELECTRIC
Inspactlon Date insp. Commerrts
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Hig.
Orsat Test
Final Plbg. Pibg. Inspector- Notify Plumber
Const. Meter
Engr.lPlan
Bldg. Final
Deck Ftg.
Deck Final ?!?' ? L???? ?''
Well
Pr. Disp.
INSPECTIUN RECORD Control No. 1078
CITY OF EAGAN PERMIT TYPE: 'ju I I "I "p
3830 Pilot Knob Road Permit Number: 0014rq
Eagan, Minnesota 55123 Date issued: e9/ z i/ 92
(612) 581-4675
SITE ADDRESS: LbY t 4
'41i6- f{ rnkMuN aR
f.hql'HMIAN LAN11 C.O 3Ftb
al_ o("K APPLICANT:
VqGEL & CU I NC , A F'
(61.2) 719-66153
?_ - -_ • ? ? - - _ , _ , ;
..- . f... .. . . .... . .- . . . ._. _ . . _'_. 'F?.- . . . ..- . .. _._, .?.. _-? . . _ . -
? I
PERMIT SUBTYPE: TYPE OF WORK: ;
f tr,??? NFtJ nRSGRIPTiOM AN EXL$rINA DECK ,
wrmR wo. aeomn nador oaoa Tel.pt,ans •
SMl
PLUMBING
HVAC
ELECTRI
ELECTRIC
inspsation Oate Insp. Commenb
Footings I D
Foundation
Framin9
RoobV
Rough PI6g.
Rough Ht9-
k".
Flreplace
Rnal Htg.
Orsat Tesi
Final Plbg. Plbg. Inepectw- NOif(y Plumber
Const. Meter
E^9rJPlan I
Bldg. Final C' i - 0 ir
beck Ftg_
Dedc Flnal
Well
Pr. Disp_
r ^' ' INSPECTION RECORD
CiTY OF EAGAN PERNIIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4875
SITE ADDRESS: La I t 4 81, 0coc, APPLICANT:
31368 FARMUM DR wAHLi.CitRFT
COACHMAN LAMO CQ 3RCl 4612) 72!•--6li78
` PERN?T ?,ypTYPE: TYPE OF WORK:
t. ?? ,N `n? ?/ n ,?? ?ESCRI#?TItIN
Control No. 0866
.01347
ar/zo/92
NEW
UN E](fSTIiIA UECK
Fnorrrrr3 ..
.,, ,
f 11 aK7a6 ..
f I M A . ?-. ?.,
itl'_MARKSs ttEcE2pt #
SfEPARATE p4RMIT REQtilttEf] tOR ELECTRIGNI. W#tRi'
'{` ? ??/?? ? •:? -- S ? .? j`? - °
' . - ._ ._. .v. ?.. .': .+ci.. _ __ ? ? . -- 1?- . . ?', ?? F . ?? _.1.? .._:•• -.- + ? .- .- • - . ._ _ _
Permk No. Permit Holdw Date TweplwnaM
SJV1f
PLUMBINO
HVAC
ELECTRIC
ELECTRiC
InspwNon Daw Insp. Comments
Faatings I
FoundaUon
Framing
Aaoffrp
Rough Pibg.
Raigh Ftt9•
isui- ?
Fireplace
Fnsl Htg.
Orsat Test
Finel Plbg. Plbp. InspeCtor - Notily Phumber
Corsl. Meter
EngrJPlan
81dg. Rr191
Deck Ftg.
Deck Final
weli
Pr. DEsp.
This reques[ vaid C
IS nwnths 1mm
m 06399?. I 3 6 GoUcA ,,,cz
l0' f-SS
50-m
RequeStAate. .+
1?-3-1985 fire No.
I Rouph-in Inspection
Re4uireA?
[]Heady Nowj2WHl Notify Inspec-
? No tor When Featly
JiWt:ensed ElpcVical Contractor 1 hereby request inspection ol above
? Owner elecvical work installed ac
Street AAAress, Box or Noute No. . Citv
3Ti6 Farnum§ Drive Eagan
ecvnn o. Township Name or No. Range No. County
Dakota.
Occupant (PfiINT) Phone No.
Rosewood Bldrs.
Pa uoPller Address
Dakota Cty. Farmington
Elec[rical Contractnr (COmpany Nemel Cuntracmr's Lir.ense No.
O.B. Thompson electric Co. A40602
Mailinp Address (ConVactor or Owner Making Instailation)
12201 Mtkg'"Vlvd„ Mtka 55343
i
Ng lnstalldtion)'
Authorized Signature (5PnvactodOwv9r Mak Phone
N
umb
e
r
/
?
! ;'l S>'?? : ?
?? v?? 'V
!?
?
? f
?
/
?
0t?3-L5qd
G !
.
.
?
.
. . ?
? THIS INSPECTION NEQUEST WILL NOT
MINNESOTA STATE BOAND OF ELECTNICITY
C+HH9s-Mitlway Bld9. - Room N-191 BE ACCEPTED 8V THE STATE 00ANp
1821 UniversitV Ave., St. Peul, MN 55104 UNLE55 PROPEH INSPECTION FEE IS
Phane (612) 287-2111 ENCLOSED.
. ?? REQUEST FOR ELEC7RICAL INSPECTION EB-00007-04
' See instrvc[ions lor comoleting this form on back of yellow copy.
? f0-?i-$5
? n 3qq ?. . ' "%" Below Wwk Covered by This Request
Htld Rep. 7ype of BuilOing ApPliantea Wired Equipment Wired
x Home - Range 5.00 Temporary Service
Duplpx Water Heater X Lightiny Fixtures '
Apt. Buildinfl g Dryer 2,50 Efectric Heatin
Commercial Bldg, g Fumace 2,50 Silo Unloader
Industrial Bldg. g Air Conditioner 2 ,50 Bulk Milk Tdnlc
Farm Other oeatv Diher ISUer.ifvl
,,T snoC1 y x arnUis .nisn.s.oo
Compu[e Inspection fee Below p Fea ServiceEnfrenceSize tl Fee Feaders/SUbineders N Fee Circuits
0 G10 00o 200 qmps 0 to 30 qm 5 0 5.00 0 to 30 Am s
A6ove 200 qmpy 31 to 100 qmps -31 to 100 A s
Swimming Pool A6ove 100_Am s Above 100_P,mps
Transtormers Irrigation Booms ,50 Partial%Other Fee
Signs Specialinspaction
50
550 ?-1
TOT(
L
E
Aermrks Dan St4t
- . ?
?
od /
/
Rough"i^ i
h
e
t
?R ^'r,?
.
t
e
c
r
ca
Inspectar
hereDy
,
Fina1 certify that the abova
nsoec[ion hes been
? made.
mis reCUest voitl 18 montM from
6
-? ,
?
413
K
3
?
c3'
/
?IP5
R ues Date Fbe No. Rougn-in Inspection
I? ? Requiretl
6
e0Y Now ? Will Natih' Inspeclor
Whan Reatly7
? Ves
p
I licensed contractor D owner hereby request inspection of above electrical work at:
Job Aatlress IStreeL Box or Houte No.)
-
D CMy
??
-
v
(,.> r ?
4
Section No. Tavnshlp Name w No. Range No. C
W
Occyp t RINT?4 (? t/?I /l, V?
UJX? F?.? ? Plione Na.
Power Suppber Address
Ele ri I ontractor ICOmpany Namel .
?
- - -- C. -?-Y c.
C nVac?or§ License No.
A o i l R z.
Mailing Atltlre (COnvador or Ow r Making Installalion)
? D ! .' . LJ
Autho zetl? naNre 1 onl clorrOwnar Making Ins[allationl ._ Pho r
MINNESOTA STATE AF O EL CTRICITY THIS INSPECTION REOUEST WILL NOT
Grlygs-Midway BIOq - ulm BE ACCEPTED BY THE $TATE BOARD
1821 Universlty Ave., . MN 551pC UNLESS PHOPER INSPECTION FEE IS
Phone(612) 642-0800 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION 4 Ee-aooo1-os
% ? See inshuctions mr completing Nis mrm on back of yeuow copy. g
K 54136 'X" Below Work Covered by This Request
ew Add Rep. TypeofBuiltling AppliancesWiretl EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Ap1. Buiiding Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (syecty) Conlracfor's RemaMS:
Compute Inspection Fee Below:
# OUer Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 ta 200 Amps o to too Amps
Transformers Above 200 - Amps Above 700 _ Amps
Signs Inspecror's Use Only.
i TOTAL
'
Irrigation 8ooms ?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Ro?9h m
e oa?e,
certify that the above inspection has
been made.
F;,,,i
oayeq,
OFFIGE USE aNLY
This requeat voitl 18 months lrom
s reques[ void
mo ??7/1Q
nths Imm ?.l?
-0631999 Lq/5r
lQ-ci-8V
Nuwjd:Viil Notity, Inspec-
tor When ReaAy
icensetl Electrical Contractor I herebV requestinaDaction ot ebove - Owner electrical work installed aL
Sveet Address, Boz or Route No. GtY
3116 B Farnums Drive Eagan
ecuon o. Township Nama or No. RTnye No. Coonly
Dakota
Or.cupant (PRINT) Phone No.
Rosewodd Builders
Power Supplier Atldress .
NSP RR
Elec[rical Con[ractor (Company Namel Contrecmr's Lic(,-nse No.
O.B. Thompson Electric Co. A40602
MailinB Address (COnvactor or Owner Makinp Instailation)
1 201 Mtk . v. Mtka 55343
Authorizad Signamre Ionhacmr Owner Making?lnstallation) Phone Number
933-2521
MINNESOTA STqTE BOAAO OF ELECTftICITY J ?J THIS INSPECTION REQUEST WILL NOT
Griggs-Midwey Bldg. - Poom N-197 BE ACGEPTEO BV THE STqTE BOAFD
MN 55104 UNLESS PHOPEN INSPECTION FEE IS
1821 University Ave., St Paul, ENCLOSED.
Phone (612) 297-2111
REQUEST FOR ELECTRICAL INSPECTION ee•ooooi.oa
90
' See instruc[iens lor completing <his twm on Cack ot vellow copy.
p '"X:' Below Work Covered by This Request
f ?T9 9 9
Add Rep. Type ot BuilEing Appliancea WireE Equiument Wired
X Home X flange $.00 Temporary Service
Duplex Water Heater X Lightiny Fiztures
Apt. Buildinq Dryer Etectric Heatin
Commercial Bldy. g Furnace 2,50 Silo Unloader
Industrial BIAg. Air Conditioner 2.50
Buik Milk Tenk
Farm oiner pea v ntnA, (suvcifv)
t er Syecity Ot er Di Oth.,
Compute Inspecbon Fee Below _
p Fea ServiceEnhance5ixe H Fee Fantlers/Subfeetlers N Fen Circuits
0 10 () to 200 qm s 0 to 30 qm s 1 0 tn 30 Am s
Above 200 Arnpsl - 31 to 700 Amps - 31 to 100 Am s
Swinunin Pool Above 100_Am s A6ove 100_Am s
Transiormers Irrigation Booms .50 Partial%Othor_Fee
Signs _ Speciallnspection
5 / ?
TOTAV?EE
Rema.ks
Tlon Cmi hh 50.50 -/.? L
l \ Ll" ?i
Rough-in
I
th
F
i
t
l/
,
e
`ec
r
ca
Insp? ctor; f?ereby
e?eli?y that the above
Findl b a
te
?
, pec[ion has been
? s
P . y
IW?
O de.
ihie reqveat voi018 monUS fro.
-
1c?? rd /O 7 P5Y
5
3 0 3 w
3
Reque ate Fire No. Rougn-in lnsp '
Re,ulne
tl'
0 Ready Now ?Wll NOtity InspecWr
Wh
R
tl ?
?V s
No
?
en
ea
IX licensed contractor ? owner hereby request inspection ot above electrical work at:
JoD Atltlress (Slreet Box or Route No.) City
' 311(o Far u, L ?nve- €cLq?mn
Sedion No. Townshi0 Neme or No. Range No. County
Occupant(PfllNT) Phone No.
orrnu.
PowerSuoplier Adtlress
Elecvical Conhacmr (ComDany Name) ppnhacmr5 License No.
' n'S E i KI CAO 15'71
Mailing Mdress ICoNracmr or Owner Making Installaiion)
"750$ Dou, ls Drive N
r4i foi P?K Iy1r1I55
P.
tn ?ze0 SlgnaWre IConVac r wner Making Install on? Ppone Numbet
; (J I'?
MINNESOTA STATE BOAflO OFUCTHIqTY THIS MSPECTION REOUEST WILI NOT
Griggc-MiOway Bldg. - Poom S-178 6E ACCEPTEO 6V TME STATE BOARD
1821 Univerelty Ave.. SL Paul. MN 55100 UNlESS PROPER INSPECTION FEE IS
Phone(61P)66P-0B00 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
r ? See insvunions for completing tnis lorm on back ol yeilow wpy.
F ?
J y? ,?+ „?1 "X" Below Work Covered by This Request
E&00001-08
ew Atltl Rep. Typeof8uiltling ' AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer O[her (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other(sVecity) Contreatqrk Remarks
l?Uvre ? foli
Compute Inspection Fee Below:
# . Olher Fee # ServiceEntranceSize Fee # Cimuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
hanstormers Above 200 _ Amps Above 700 _ Amps
Signs inspector5 use onty: TOTp4
'?
Irrigation Booms Q0'0d r y
? J(J
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPIETED WITHIN 18 S.
I, ihe Electrical Inspector, hereby aouyn-,n yh
?rl / oa?e
certity that the above inspection has
been made.
yoo
OFFICE USE DNLY
This request void 18 months imm
This reuuest void ?p/_?
18 rtqnffis fmm ?/ I Q
' 064010 L
xequeoR. Uate Fire No. E]
HouHh-in Insuection
Reqwred7 Ready Now?j(Will Notify. Inspec-
10-3-1485 J&es ONO «f N1hen qeady
Micehsed Elec[rical Convactor I hereby raquest inspeciion uf above
? Owner electrical work instelled ai:
Streef Address, Box or Houte No. • . City
3118 B Earnums Drive Eagan
ectmn o. Township Name or No. Hange No. County
Dakota
OccuD'ant(PRINT) . Phone No.
Rosewood Bldrs.
Power SupPlier Address
NSP RR
Eiecvical Contracmr ICOmpeny Namel Cootracmr's License No.
O.B. Thompson Electzic Co. *AgkSx A40602
Mailine Address IConVactor or Owner Making Instailation)
12201 Mtka,Blvd. Mtka 55343 .
Authorizetl Sig{?etuie (COn[ractoJQwner Making Insia'ilaj'on) Phone. Number
t- e 933-2521
MINNESOTA STATE BOAND OF ELECTRICITY ? THIS INSPECTION REQUEST WILL NO7
Gr.iggs•MidweY gldg. - Room N-191 eE AGCEPTEO BY THE STATE BOAHD
7821 University Ava., St. Paul, MN 65104 UNLESS PflOPEH INSPECTION FEE IS
Phone 1812) 297$111 ENCLOSEO.
S? REQUEST FOR ELECTRICAL INSPECTION ,r- ee-ooooi.oa
' Sea instructions tor completing this form on back of yellow copy.
0 0640 .'"X"•' Below Work Covered by This Request
Wev4 AAd ReO. Typa of Building Appliantes Wired Equipment Wired
XX Home Range 5.00 Temporary Service
Duplex Water Heater X Lightin, Fiztures
Apt. BuilAing Dryer 2.50 Electric HeaLn
Commercial Bidg! X Fumace 2,50 Silo Unloader
Industrial Bldg. Air Conditioner Bulk Mllk Tenk
FBrm Othei peri y Dthnr ISpedfyl
t c Specify t h e I nis .nisn.5.oo Oth,;r ampuie /nspection Fee Below
p Fee ServiceEnirencaSize R Fee Feeders/Subfeeders # Fee Circuits
00 G10. 0 0 to 200 Am s 0 io 30 Am s 0 5.00 0 to 30 An!
Above 200 Amps 31 to 100 Amps 31 to tU0 A s
Swimmin Pool Above 100_Amps Above 100_Amps
Transiormers Irrigation Boorcis
? Partial; Other Fee
SignS SpeciallnspeCtion S ?
TO
nemarks
i 53.00 TAL F E
jo
D SYn
( -
)
Rough-in Oa the Elirical?
• ,
nsoectaq e
M ertity thxt thbove
Final p
74 nspec[ion has ee
This repuest vo1C 18 monihs irom
This reQUest void ?I?-/?, /??. o064000 ' f? L? a(? ?v GO a? Le...dJ ? 5?c7? ozJ
Rnnues[ Date Fire No. Hough-in Inspectinn
Required?
Ready Nuw?Will No1ity. Insper
?
10^3^1985 T?IvOs ?No wr whe:n Ready
ULicemsed Eleclrical Contractor I hereby request inspaction of above
? Owner . electrical work installed at
SVeet Atldress, eaz or Foute No. Ciry
3118 Farnums Drive Eagan
ection o. Township Name or No. Range No. County -
, Dakota
Occupant(PqlNT) Phone Na.
Rosewood Bldrs
Power $upplier AAdr¢ss
Dakota Cty. Farmington
Electriwl ConVector ICOmpany Name) Cont acmr's License No.
O.B. Thompson Electric Co. A40602
Mailin0 AdJress IConvactor or Owner Making Instailationl
12201 Mtdsa Blvd., Mtka 55343
Authorized SiBnamre (COnhactor Owner MakinB Installationl Phom: Number
f._r ..
rt ?, .
r.r
1?
.t-1..?521
MINNESOTA STATE BOARO OF ELECTRICITY f? THIS INSPECTION HEQUEST WILL NOT
Griggs-Midway Bitlg. - Xoom N-181 BE ACCEPTED BY THE STA7E BOARD
1821 UnivarsitV P.ve.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 29L2111 ENCLOSED.
5;?? $ REQUEST FOfl ELECTRICAL INSPECTION E8-00001-U4
' See instmc[ions lor completing this torm on beck oi yellow copy.
R.? 7
n?? n n o ?-x" Below Work Covered by This Request
AAd HeO. Type ot Builtlin9 Applianeee WinO Equipmenl WireA
I I I I Duplex I I Water Heater kx* Lightiny Fixwres J
o Unlo
Ik Milk
rm
ifu 1"
M Fee ServiceEnhance5ize B Fee Fexders/SUbfneders p Fee Circuits
10 UG o 200 Am s 0 to 30 Am ?s 0 tn 30 Am
Above 200 Ampa 31 to 100 qmps 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100_Ampu
Transiormers Irrigation Booms .50 Partial-'Other-fae
Signs SUecrallnspection i
Aermrks ' S 53.00TOTAL?E?^`J-S?
Dan 98ith ?7 r I
IFOUen-in //
.G + ? J/??i,, ? j
` " e?
.?" I. the Elactrical
?nsoector, ne?obv
e.i?tv «i ine aeova
rpi?l
I Date
? ?? insvaction has been
made.
( TOWNY.OUSE ) CITY OF EAGAN o
? 30 Pilot Knob Road, P.O. Boz 21-198, Eagan, MN 55121 N_ 10624
38
PHONE: 4548100
BUILDING PERMIT Receipt #
Te M mnd ier 1 OF 4 PLEX Est. Value $61,000 pO1e JULY 22 19 85
SiteAddrees 3118B FARNUM DR
Lo< 1 Block 6 Sec/sub. COACHMAN LAND
Parcal No. CO 3RD
e, Name COACHMAN LAND CO
z Address 1711 W CTY ROAD B
citv ROSEVILLAo.e 636-8050
o Neme ROSEWOOD CONST CO
?S qddress; SAME
? ciri Phone 631-3254
Name
?W
Uu Address
??.=i City Phone
I hemby ackmwisdga tFwt I have mad thia appliwtion and state that
fhe inlormolion is Gorrett and ogree fo comply with ull applicoble
State of Minnesoto $tafute ond ify of Eogon Ordin s.
Sipnofura of Permitt
A Building Pemlt Is issued to: ROSEWOO ONST CO
all work shall be done in accordonee v? ol pplimbla fate o {i
Buildlrp OfHcial a ?? L
erea k] oca,veocy R3
Remodel ? Zoning R3
Repair ? Type of Const. VN
Addition ? No.Storiec
Mova ? Length 46
Demolish ? Depth 24
Int.lmpr. ? Sq. Ft.
Install ?
Apyrovals i"s
00
Assessment Permit '
wemr a Sew. su.cnarge 30.50
158
00
PoliCe Plen Review .
Firo SAC 525.00
Erq, WaterConn. 500.00
Plonnar WaterMeter 63.00
Council Road Unit 280.00
81dg.Off. 7/17/85 TcPL 132.00
APC Parks
Var. Date Copies
Total s___r ?_, n n`S O
a+ ths axpmn eondinon tIw+
iasoM SMtutes and Gry o7 Eopon Ordinonces.
( TOWNI-iOUSE )
._ ,
BUILDING PERMIT
Receipf # ?
$61,000 p,te JULY 22 1q 85
sinaddress 3118 FARNUM DR
lot _2- siock 6 ?c/Sub. COACHMAN LAND
Percel No. CO 3RD
W Name COACHMAN LAND CO
? Address 1711 W CTY RD B
City ROSEVILLEphone 636-8050
? Neme ROSEWOOD CONST CO
Addrecs SAME
C Citr Phone 631-3254
FW Name
? I
Add
x ress
IW City Phone
I hereby ackrwwledge that i have read this apDiication and state that
the informofion is correct ond ogree to ComOlY with all applic ble
Srota of Minnesoro Stututay?qndgtfy of Eogen Ordinonces.
Slanoturo of PermiM `_ /?
A Buildinq Permie Is issued to: _
dl work sholl be done in acmrdance
Bu{Idirq Offieiol
CITY OF EAGAN N? 10625
3830 Pilot Krw6 Road, P.O. Box 21•199, Eagan, MN 55127
PHONE: 4548100 ' C;?
Erect LX Oecupency x3
Remotlel ? 2oning R3
Repair ? TypeofConrt. VN
Addition ? No. Stories
Move ? Length 46
Demolish ? DeDth 24
Int Imp[ ? Sq. Ft.
Install ?
Apprmah iees
Assessment
Water 6 Sew.
Police
Firc
Enp.
Planner
Council
BIdg.Off. 7 17 $5
APC
Var. Dete
Permlt r -' ?" . ""
Surcharge 30.50
Plan Revlew 158.00
SAC 525.00
water conn. 500. 0 0
wate. Mete. 63. 0 0
RoedUNt 280.?0
TcPI. 132.?0
Perka
Copies
Totel $2. 004.50
IM exprost tondition lhoi
Eopan Ordirqnces.
CONST CO
on
tatsi'77tMrrcaoro Semuta and Ciry o;
(TOWNAOUSE)
?
? .
CITY OF EAGAN N° 10623
3830 Pilot Kmb Road, P.O. Box 21-199, Eagan, MN 55121 -
PHONE: 4548100
BUILDING PERMIT Receipt # /
Te 6e wed #ar 1 OF 4 PLEX Est. Value $61, 000 pate JULY 22 1 q 85
SltaAddrefe 3116B FARNUM DR Erect 11 Ocoupencv R3
4 6 COACHMAN LAND
Lot Block SeclSub Remodei ? Zoninq R 3
. CO 3RD Repair ? Type of Const. `»,
Parcel No.
Addition ?
No. Stories
COACHMAN LAND CO Move ? tsnqtn 46
W
= Neme
1?11 W CTY RD B Demolish ? Depth 24
? Address Intlmpr. ? Sq.Ft.
City ROSEVILLE phone 636-8050 Install ?
ROSEWOOD CONST CO Aoorowtt Fes?
p Name
?? Addrass SAME
1- city Pnone 631-3254
Name
i? Address
tw City Phona
1 hercby ocknowledge that I have read this applicotion and state thut
the intormution is correct and ogree to wmply with oll opplic ble
Stota of Minoewta Statures ond Cjry of Ea9an 94i^onces.
Sipnofum of
A Bullding Permit 1: iuued to: _
dl work shall be dona in xmrdanee
Buildfnp OHiciol
ot
Asseysmmt _
Water d Sew.
Police
Firc
Enp.
Plannsr
Council
BIdg.Off. 7/17/8'
APC
Var. Date
Permlt =' 0(
Surcharge 30.51
Plan Review 158 . 01
SAC 525 01
WaterConn 500.01
water Meter 63 . 01
RoedUnit 280.01
Tr. PI. 132.01
Parka
Gopias
I rotel S?. 004 _ 51
_ on ths sxpreu wnditlan tha+
City oS Ecqan Ordironces.
( TOWNHOUSE ) CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 No- 10622
PHONE: 454-8100 1-g7
BUILDING PERMIT Receipt #
Te M wd fer 1 OF 4 PLEX Et, value $61, 000 pare JULY 22 1,085
Site Addrea 3116 FARNUM DR
Lot 3 eiock 6 ^ft/Sub. COACHMPN LAND
Parcal No. CO 3RD
W Narime COACHMAN LAND CO
z AddmS 1711 W CTY RD B
City ROSEVILLE phone 636-8050
o Name ROSEWOOD CONST CO
Address SAME
? c'ity Pnone 631-3254
Name
Buildinp Officiol 'C ?`&CErect ¢p Oewpancy x3
i? Adtlress
?w City Phone
1 hereby ackrowladge thot I hcve rcad this applicofion und atote that
fhe inlormntion is wrretf and ogree ta comply with oll apDlicable
Stota of Minnewtc Stotute a=Eago rdironce
Sipnoturo of Permit?G _
t - L_
A Buildinq Permit is iuued to: ROSEWO-W CONST CC
dl work sholi be done in xcordonea with oll.app(?' y1p? /S?(p/1?_ of Mir
Remodel ? Zoning R3
Repair ? Type of Conrt. VN
Adtlition ? No. Stories
Move ? Length 46
Demolish ? Depth 24
Int. Impr. ? Sq. Ft.
Install ?
Approralt Feas
Assessmmt Permit $ 316 . 0 10
Water S Sew. Surcharge 30 . 50
Police Plan Review 158,010
Flre sqc 525.010
Enp. WaterConn. SOO.OQ
Plonner WaterMeter 63.00
coumit Road Unit 280,010
BIdg.Off. 7/17/85 Tr. PI. 132,013
APC parky
Vec Date Copiea
7otal S?-nnd 50
m the expren conditlon tfw,
mota atutn and City o5 Enqan Ordirorxat
?? n5-z
2005 RESIDENTIAL BUILDING PERMTI' APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephoue # 651-675-5675 FAX # 651-675-5694
Telephone #(
New Conslrudion Reauirements RemodellRenair Reauirements Offlce Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all mofed areas 2 copies of pian CeR of Survey Reoi _ Y_ N
(20%mazunum lot caverege allowed) t setof Energy Calculations for heated additions Tree P2s Plan Recd _Y _N,
2 copies of plan showiig beam &window skes; poured found deslgn, etc. i site survey for addNOns & decks Tree Pres Required _Y _N
1 set of Energy Calculatbns Addflfon -indicate ff on-site sepL'c sysfem On-sRe SepOc System _ Y_ N
3 copies of Tree Preservatbn Plan'rf lot plaHed after 111193
Rim Joist Detail Options seleclion sheet (buldings with 3 or less uniLs)
Date ,$? /?-4/ /0?005 Canstructioo Cost
Site Address S // (o ?,? . l? Y'i J L UniUSte #
DescriptionotWork {' ;?? S?h r/t ?a_? t?i^ T4 oC ?• ??serl f' t?l
r
Mu1H-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1,)c 2
PropertyOwner ' Telephone # (6_5')
Contractor
Address Ci1Y J"ia+ .41a-
State Zip SSG?? Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilafion Calegory 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submltled Submifled
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
X7D , "
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.
6`/l 7o4W/lr0? G,ASj
ApplicanYs Prmted N e
'Appl?t's ignatur e
'
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types , R7D Faa 7`°; I19 S d' RB,# M
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building O 42 Demolish Foundation ? 45 Fire Repair
? 33 Altera6on ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement • 'Demolition:(Entlre Bidg) - Give RCA handout W applicant . ,
Valuation Occupancy R-3 MCESSystem
Census Code ? Zoning iz -3 City Water
SAC Units Stories Booster Pump .
# of Units Sq. Ft. PRV
# of Bidgs Length ' Fire Sprinklered
Type of Const 13 Width
REQUIRED INSPECTIONS
Footings (new bldg) _ FinaVC.O.
? Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Br ick
_ Firepface _ R.I. _ Air Test _ Final _ Windows
_ Insulation Retaining Wall
_
Approved By: Building Inspector
---------------------f - -------- ---------------------------
-------------------------
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? V -7?
2005 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reouirements
3 regisle2d site surveys showing sq. fl. of lot, sq. R. o( hause; and all rooted areas
(20% marzimum bt coverage allowed)
2 copies of plan showing beam & window saes; poured found design, etc.
1 sel o( Energy Calculations
3 copies of Tree P2servatian Plan if lol plafled after 711193
Rim Joist Detail Optrons seled'wn sheet (buildings wAh 3 or less units)
70 lJo
RemodeVRenairReauiremenls O(fice Use Oniv
2 copies of plan Cert of Survey Recd Y-- N
1 set of Energy Calculatbns for heafed additions Tree Pres Plan Recd Y_N
1 srte survey foraddMons & decks Tree Pres Requlred _Y '_ N
Addrtion-indicafeAon-sitesepticsystem Oo-siteSepticSystem _Y _N
q
Date` ?/ /oc,o2S` O
Construction Cost? ?a)
SiteAddress 13 1( lo (S F?Lpt,• rvn I. Unit/Ste #
Description of Work
Multi-Family Bldg ?. Y_ N Fireplace(s) _ 0 2
Property Owner Koa& P ,7 1, f3m
? l? Telephone #((o$! CD?
Contractor
Address ? City An A
State //[; n n p_L Zip. C ? Telephone ii (&57)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionrype) Submitted SubmiNed
. 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 comglete and accurate;
that the work will be in conformance wittt 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.
4 I l %i-
Applicant's Printed Name
Applicani<Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 77 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ NtQ`? 25 Miscellaneous
Work Types AZIP Fwo'T" i nq' 1-8,rlg/ns
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ?-46 WindowslDoors
? 34 RepleCement - ? . •Demolition (Entire Bldg) - Give PCA handout W applicant , .
Valuation Occupancy ? ^3 MCES System
Census Code ?13 4 Zoning City Water
SAC Units Stories Booster Pump •
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered ,
Type of Const IV 13 . Width
,
REQUIRED INSPECTIONS
Footings(new bldg) FinaVC.O.
?d Footings (deck) -,4 Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC '
Drain Tile Other
Roof Ice & W ater F inal Pool Ftgs Air/Gas Tests Final
? Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: & ? , Building Inspector
-------- - - - - --- - ------ - ------ - --------------- - - - --- - - - ------ - --------------- - - - -
----------------- - ------------
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
?----? `? ? 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when pertnits are required for each unit
Date 1D / 09 / r?b6`J
3I /
?6 ??
? ? ? ? Unit #
Site Address
lJ
•
G !?
(
P
t
O hone # ((pS() bO 1' (/ 7SC)
Tele
roper
y
wner p
Contractor lqg u 0 I
Street Address W City 11 /
?0 (D D Tele
hone #
Zi
S
t
p
ta
e p
Bond #• Expires:
The Applicant is _ Owner _?_<onhacror _ Other
Add-on or alteration to eaisting dwelling unit $ 30.00
? furnace _Additional _?Replacement
air exchanger
? air conditioner _New _4,-Re-placement
other
State Surcharge $ 50
Total NOV ti 5 2004 ?I?
?- $ b.s?
I
Lll?
I hereby apply for a Residential Mechaoical Permit and acknowledge
be in conformance with the ordinances and codes of the City of Eaga
ermit, ut only an application for a pemut, ancl work is not to start
ap ro d plan in the c w rk wre uires a review and approv
, i7?
qrmation is corrililete and accurate; that the work wili
khe Mechanical Codes; that I understand tlus is not a
pemut; that the work wil?be in accordance with the
ApplicanYs Printed Name V ApplicanYs Signature
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
--% tr?;-n .-)--C?-
Mew Cwis6uction Reoui2menfs RemodellRenair Reuuirements (7ffice lfsc QnN
3 registered site surveys showirg sq. 8. of lot, sq. ft of house; and all roofed areas 2 wpies of plan Golt uf Survey ReW ,_ Y N
(200% maximum lot coverage allaved) 7 setoF Energy Calculations for heated addPoons Ttrs+Pres plan Reoi _ Y _N
2 copies of plan showing heam 8 window sizes; poured found des'gn, etc. 1 site survey for addiUons & decks Tt" Pres Required _ Y _ N
1 set of Energy Calculations Add'dlon - fMicafe ifonsite sep5c system Qff'site Sepqc Sysfem _ Y _ N..
3 copies of Tree Preservatan Plan if lot platted after 717/93
Rim Joist Detail Options selec6on sheet (bldgs with 3 or less unifs
Date _!? /,;Z-) / 04 Construction Cost
Site Address 3 f -2? i /q /6 -;Ajy7vpn nJZ Unit/Ste #
S
DescriptionotWork oQ,I.L? _
Multi-Family Bldg X- Y_ N Fireplace(s) _ 0 _ 1
Property Owner-?& ? Telephone # ( )
Contractor
Address ,-
?)7
Ciry -
State Zip Telephone #((,5 1
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(d submission type) Submitted Submilted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
Telephone #(
Telephone #(
l SEP 2 7 2004
I hereby apply for a Residential Building Permit and acknowledge that the informati "`- p ete 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 pin the case of work which requires a review and
approval of plans.
Applicant's Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 08-plex EP 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building '? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
g 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant
ez)m •nn
V
l
ti O
J? t
-3 MCESS
a
ua
on
- ccupancy
= em
ys
census code 4
3 q zoning !Z "3 city water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ?N? Width
REQUIRED I NSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) r-?•,g 7%7 FinaUNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pod _ Ftgs _ Au/Gas T ests Final
_ Fzaming Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _
_ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: MA , Building Inspector
-------------- - ---- - - - --
---------
- ------------ - ------ - ----
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2004 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauiremenis RemodeVReoair Reouiremenfs Oifice Use Onlv
3 registered site surveys shaving sq. ft of lot sq. ft of house; and II roofed areas 2 copies W plan CeR of Survey Recd . _ Y _ N
(20% maximum lot coverage allowed) lsetofEnergyCalcuWtionsforheatedadditions TrsePresPlan'Recd _Y _N,
2 copies of plan shovring beam 8 window sizes; poured found design, etc. t sAe survey for additions 8 decks Tree Pres Required _ Y _ N
lsetofEnergyCalculadons Add'dion-irMicafeAOn-sitesepficsystem OnsiteSepticSystem _Y _N
3 copies of Tree Preservation Plan if lot platted afler 711/93
Rim Joist Defail Options selecGon sheet (bldgs wAh 3 or less units
Date ConstructionCost ff)
Site Address '31 1$ '5 1 If? ? Qrj UniUSte #
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _740
Properry Owner,?? Telephone # ( )
> Contractor '
Address City
State Zip,? Telephone #(?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential VenGlation Category 1 Worksheet • New Energy Code Workshaet
(Jsubmissiontype) Submitted Su6mitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #
Telephone #110) ? U
I hereby apply for a Residential Building Permit and acknowledge that the info ation is compIde'ana ccurate;
that the work will be in conformance with the ordinances and codes of the Cit ' ?--thea of MN
Statutes; I understand this 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 an in the case of work which requires a review and
approval ofplans. ,
Applicant's Printed Name Applicant'i(Mgnature
. -1-
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan (, s-s';?
3830 Pilot Knob Road, Eagan NIN 55122 ?
Telephone # 651-675-5675 61 -
Please comple[e for: single family dwellings & townhomes/condos when permits are required for each unit
nate 10 / Z 2- / 0 `t
Site Address Z. r" s •.•• Unit #
Property Owner "J 2-2_? Telephone #(
ConMactor
street Address RESIDENRIAI, FIEA1'INp & qiR, mc city,
?1 4191 ?t, Suite
?
State lulnrwarvolie
?Akl eein? w.?
P Telephone #( )
.rVTy/
'17?f[Q ..
(619'724-18W
'
Bond #: Expires: .
The Applicant is _ Owner ?Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
J
furnace _Additional _?Replacement (3
airexcha nger L(,- NNOY1 Gfrovrroza
aircondit ioner _New _Replacement
other
T 2 5 2004
State Surcharge $ 50
R
--
S 3 a'
Total
I hereby apply for a Aesidential Mechanical Pemut and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codas of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a ernut; that the wo will be in accordance with the
approved plan in the case of work which requires a review and approval of plans
ApplicanYs Printed Name Ap IicanYs Signature
6 C7 /3
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date lo Is) ! 6?z
i..? ?(? Site Street Address J ???a Q "fG? ll'?12zU?YY(J ' ?t?JJt,• Unit #
PropertyOwner A?hj ? Telephone# (b5J)??b??'D7
Contractor Telephone # (?5l )?G5 - I 3 S?Z?
Address .34. 90 0z" WaQ City 24 nir,11 State »• Zip.S$/.23
The Applicant is: _ Owner V Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required) •
Other:
Water Softener ' Water Heater $ 15.00
? replacement _ additional
Lawn Irrigation System RPZ_ new _ repair rebuild°?_
- ? $ 30.00
<S, !?
? StateSurcharge OCT j4 ? V
$ .50
? -,
Total
\
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
),nA-/4 V f&0_/.vts
ApplicanYs rinted Name
ApplicanYs ignature
PERMIT# `T 4 r-)--
RECEIPT DATE:
8008 RESIDENTlAL PLiJM$IRfi PERM1T APPLICATION
C11'Y Oir EAifiAN
5930 PILOT KNOB RD
gA6AN, M1V 551EE
651-6$1-4675
Please complete for. single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irtigation system
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
crrv: FC?G}GC?vt STATE: f"?GU ziP:5S1Z3
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repaiNrebuild $ 30.00
_ lawn irrigation system
ReplacementladditionaC _ water softener water heater $ 15.00
? ?n L
? 9 2?42
State Surcharge 0
?
50
JU?
Total
?y
I hereby acknowledge that I have read this applicaUon, state thatthe informafion is wrrect, and agree to comply with all applicable Cityof Eagan ordinances. tt
is the applicanPs responsihility to notity the property owner that the Cityof Ea9an assumes no liabi p for any dama e caused by the City dunng its normal
operational and maintenance acGvities to the Nacilities constructed under this pertnit within Ci' pe.rty/ri?t-of-w ! asen{?? M ?
?? ? vG-V'
SIGNAT E F PERMITTEE 110"
p? r ?7
l,? ? n-?v? ? CY.I.? ? TELEPHONE- #: (A I_ /y
?"I4- I J ? C?
?T-I (AREA CODE)
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRAC70R5 NUST BE LICENSED BITH 'IHE CITY OF EAGAN
I? W hf HDUS?
IoF4
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For;
Valuation• Date:
??.?..
Site Address:
?t CDALF{MMJ
Lot: ? Block (p Sect/Sub?D
Parcel /? ?_a??
Owner ? ?a--V-??/h2>,..z/h-PK ee
Address f 7 // et) e?e? n rd e
City/Zip Code ??1;zfJ,{J $,S//3
Phone 6,?6, Contractor
Address
City/Zip Cade
Phane 6-3 /- 3 o-
Arch./Engr.
Address
City/Zip Code
Phane #
OFFICE USE ONLY
Erect Y\ Occupancy (Z-3
Remodel ? Zoning L- '3
Repair _ Type of Const VF4_
Addition # of Stories
Move ? Length 46
Demolish ? Depth 74?
Int,Impr. Sq Ft _
Install
APPRdVALS FEES
Assessments Permit Ifv•?
Water/Sewer Surcharge 30.s'
Police Plan RevieN t5E.22-
Fire SAC SZS. °'
Engr Water Conn Soo. ?
Planner Water Meter (,3_?
Council Ro nit 28cz
Bldg Of? eatment P1 132.
APC Parks
Variance Copies
TOTAL
?
,•
/ a ? c a, 3
1985 BUILDING PERMIT APPLICATION - CITY aF EAGAN
NOTE: ALL CONTRACIYIRS NUST BE LICENSED 4fITH THE CITY OF EAGAN
T-wF4INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
I nF 4 1 SET OF ENERGY CALCULATIONS
To Be Used For:Valuation: (o 1,CX70 • ? Date:
Site Address: .311,6 Q
LGAC.FiMA+N
Lot; V- B1ock J(:r7 Sect/Sub 3N ?
Parcel /i 32W aZal?
Owner
Address / 7,11 e?,-)
City/Zip Code ????'J? 5S/!3
Phone p3(p -ck
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
Ereet X Occupancy
Remodel _ Zoning R-3
Repair Type of Const r ti!
?
Addition // of Stories
Move Length
_
Demalish _ Depth 2¢
Int.Impr. Sq Ft
Install
APPROVALS FEES
Assessments Permit 31(,.f
Water/Sewer
? Surcharge ? . sv
police Plan Review IS8- -
Fire SAC 25.
Engr Water Conn gpo, =
Planner Water Meter (03,
Council Unit ?•°
Bldg Off Treatment P1
APC Parks
Variance Copies
TOTAI.
U
1 4'
?
?D
7985 BUILDING PERMZT 6PPLICATION - CITY OF EAGAN
NOTE; ALL CONTRACTORS NUST BE LICENSED WITH THE CITY OF EAGAN
TowN i-Iol,,e
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
I oF 4 1 SET OF ENERGY CALCULATIONS
To Be Used For: A64 J4?xtQ, Valuatian: ?
(?J,OCo. Date•
Site Address: 1?111f 2AVy? /.?z .
CENtHMPN
Lot: ZI), B1ock (r-, Sect/Sub L?6j LO
Parcel /1
Owner cYa-a ep
Address /7,// LcJ_do(/G-j?B
m.u
City/Zip Code 5
Phone Cr,/.7-?
Contractor ?p'?.Qaylrpy-?
Address
City/2ip Code
Phone (?p,3,1 -
Arch./Engr.
OFFICE USE ONLY
Erect X Occupancy (Z-3
Remodel ? Zoning P-3
Repair ? Type of Const 2- 14
Addition U of Stories
Move _ Length 4b
Demolish ? Depth Z¢
Int,Impr. Sq Ft _
Install
APPROVALS FEES
Assessments Permit '31(c
Water/Sewer Surcharge --A0 .S-°
Police Plan Review 156. ?
Fire SAC 525,'?
Engr Water Conn cl.
Planner Water Meter
Council Road Unit 2b0.
Bldg Off Treatment Pl
APC Parks
Varianee Copies
Address
City/Zip Code
Phane #
TOTAL
?v
???
r / ' ?
1985 BUILDING PEAMIT APPLICATION - CITIf OF EAGAN
NOTE; ALL CONTRACTORS NUST BE LICENSED WITH THE CITY OF EAGAN
Towu i-ou-Aa
nF 4
To Be Used For; L_j1&1" 106fP?7 Valuatian:
Site Addresst 31,le B ?C?a.iy?cc,?iz. o,
CQxIaMAN
Lot: ? Block ? Sect/Sub`"P`3LP GO'
Parcel q
Owner 4cz?,W.e"
Address
-- ??
City/Zip Code 41uilyce.c.r, 27W
Phane (o /? 636` cF(J.SZ-?
Contractor
Address -.SGLln,R,J
City/Zip Code --0-) "(.cD
pnone ro3/-3?-sr"y
Arch./Engr.
Address
City/Zip Code
Phone #
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
?v1,ocv-->-(2? Date:
....7..
OFFICE USE ONLY
Erect x Oceupancy R•3
Remodel ? 2oning R-3
Repair _ Type of Const
Addition # of Staries
Move Length 4
?
Demolish Depth Z.¢
Int.Impr. ? Sq Ft
Install
APPROVAL.S FEES
Assessments Permit 3?& ?
Water/Sewer Surcharge 30.5°
Poliee Plan Review 15g'`°
Fire SAC 525.
Engr Water Conn t5cb.
Planner Water Meter Co3• °-°
Council Road Unit 2Q,o.'°
Bldg Off i re ent Pl
ApC Parks
Variance Copies
?OTAL
- iU
?aVI -
CITY OF'EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
g'
BUILDING
021043
05/28/93
SITE ADDRESS:
PERMIT
31188 FARNUM DR
LOT: 1 BLOCK: 6
COACHMAN LAND CO 3R0
DESCRIPTION:
r- ?-
B?u'ildin`g,_Permit Type DECK
Buildin blork TyPe ADOITION
'Huilding Len?th 22
?'8uilding Width?-10
? -?
(? \\? ?o?p l`?'/? g on
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR:
OWNER: - Applicant -
MARTIN MARCELINE
31188 FARNUM OR
EAGAN MN
(612)456-8038
I hereby acknowledge that I have read this
information is correat and agree to aompiy
Statutes and City of Eagan Ordinances.
L
?
APPLICAM/ ERMITEE IGNATURE
appiication and state that the
with a1P appi.tcable State of {An. ! fin 1 SUED B C I NA ?
REACTIVATE _
PERMIT? #
CITY OF EAGAN
1993 BUILDING P RMIT APPLICAT EC?C??D
s8y-as?5 p
MAY 2 0 1993
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1?--- ---
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty app7ies: 1] when permit is typed, but not pfcked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work
Site Address: _ 3119 , rIgemtAYYi AlzrU"
STREET SUITE M
Tenant Name: (commercial only)
IAT BIACK _?2_ SUBD.C???H?^AN
Descri tion of work: Gf.pu
The applicant is: 12 Owner ? Contractor ? Other coes«tbe>
Name q rznal rnA-T?N6-1_INE Phone - ?l f
Property LAST FIRST w
Qwner '
qddress ?IiR & 120rzA)urr) L2? de-
STREET ., STE M
City (?X)AnJ State Mn/ Zip SS/2?
Company .Gt?J112? Phone
Co ntractor Address License # Fxp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State ZiD
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to compl with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?•?
V
OFFICE USE ONLY
BUILDING PERMIT TYPE
: - r,
,
? 01 Foundation ? 06 ?,.•,- . ,
Dup1e'C. .
? 02 SF Dwg. ? 07 4-Plex
? 03 SF Addition ? OS 8-Plex
? 04 SF Porch 0 09 12-Plex
? 05 SF Misc. ? 10 Multi. Add'1
WORK TYPE
? 31 New ? 33 Alterations
?( 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length ?
Depth ?
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1, sq. ft.
5q. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
ffl'?Footing
'% Final
? 11 Apt./Lodging ,
? 12 Multi. Misc.
? 13 Garage/Atcessor
? 14 Fireplace
?15 Deck
? 35 Tenant finish
? 36 Move
" 0?16'Basemen Finish
0 U Swi'fn Pool ?
y O 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
O 21 Miscellaneous
O 37 Demolish
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code ?
SAC Code
/
0
Assessments
? framing ? Insulation
? Draintile 0 Fireplace
Permit Fee Zy? ?a
Surcharge ?
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
5AC %
SAC Units
veluec;m: $
FOUR OAKS COURT ASSOCIATION, INC.
AkCHITECTURAL/LAMUSCAPE ALTERATIUN
kEQUEST ANU APPROVAL FORM
All architectural and landscape alterations must be in accordance
with and be complimentary to the Master Landscape Plan and be
approved by Four Uaks Court Association Architectura7 Committee.
Date
Occupaht
Address:
Home Phone: _ g(Work Phone:
Homeowne
Address:
Home Phone: (p E- 5-Ell Work Phone • A123Z ()o 3tr
Uescription and reason for proposed alteration:
-?igItA Mu bcL Uu,f L(,thd M ?tJ
o?.?.,? fa,b.Q,e.v ia,i?.d, . 1n????? ?
Prop?? ed wo?chl coion dat ??;u?u,(.C? ?T?ru"?
Work will be done by : Q Self
check ane
-9cutside Contractor
Contractor's fJame: _
Address:
Fhone:
Please submit a copy of plans, ir applicable, with this fiorm to:
Agnes K. .iensen, chairpersor,
3105 Farnum Drive
Ea9an, MN 55121
Homeowner's SZgnature
VApproved ODenied for the
Occupant's Signature (if not
homeowner)
followin9 rea,?on=
Four/Uaks Court/AssoG-iation
Owners are responsible for compiiance with all Eagan building
codes
Tpffw-y
bNF
DO y?5
TocvN ffj/uF
.S I I? Is' ?- fllzlvuiy) bk? ??
???A?U, MN ssrz?
V
?
m
?
?
j
?
?
?
?
c?
?
;
v ___..
'Y OF EAGAN
,., Pilot Knob Road
rEagan, Minnesota 55123
' (612) 681-4675
. ON EXISTSNG DECK
Buildin-g Permit Type SF PORCH
8uilding`Work 7ype NEW
U8C Occuparfcy R-3
Building Length 12
Building Width---. 10
BUILDIN6
001479
09/21J92
SITE ADDRESS:
3116-8 FARNUM DR
L07: 4 BLOCK: 6
COACHMAN IAND CO 3RD
DESCRIPTION:
REMARKS:
C?
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search
Total Fee
?<'. ?'??'.?...?\?`?% r\..`?:y ?`UL?t? •'??Li ii't?
C Z0 01Z `)
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
VALUATION $3,000
$54.00
$1.50
Fee $5.00
$60.50
CONTRACTOR:
VOGEL & CO INC, R
2426 E 26TH
MINNEAPOLIS
(612) 729-6653
- Applicant - ST. LZ OWNER:
17296653 000248 HORMAN
3116-B FARNUM
55407 EAGNN
(612)456-9111
P
S7
MN
Control No. 1078
TIM
DR
MN 55121
I hereby acknowledge that I have read this applioation and state that the
information is correct and agree to comply with all applicable State of Mn.
SCatutes and City of Eagan Ordinances.
L -?-'??? /?//(J?Q? (///!?
APPLICANTlPERMITEE SIGNATUfi?E????---s-!/ ?- ? D B. SK NAT ?pI 1?I?
PEKIMt1 #° CITY OF EAGAN t*N-
?REACrIVATE 1992 BUILDING PERMIT ,
681-4675 ?? ?
8i992
?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site; , gy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit 1s issued.
Date 1Z /1'992- Yaluation of work 0(Q,QQD.4D
Site Address:_ 311(0gFAaAuim n^W?Q„
STREET SUITE /
Tenant Name: (commercial only)
T BIACK SUBD OP+C ? ?i.D. ik
Descri tion of work: SLrp-PIn Pi- c.? 1Q 1
The applicant is: O Owner NK] Contractor ? OtI1QP (Deeeribe)
Name RorM,a&) -J
-i vvt Phone ?l
S?n
Property ,
?
LAsT FIRST
Owner Address 3 I1t0 6 FflQAo,n'N vr
STREET STE 11
City KY*V6?u41%1 State 6\0? Zip SslA I
w
Company , u 4 ? =0 , ' n?_ Phone 'AC) - (o tPS?
Contractor Address aa? eE zco*$ ST License NOp°7-4T55 Exp. -3 9
City _R_r A State MvJ= Zip ?
Archttect/ Company Phone
Engineer Name Registration #
Address
City State Zip
Sewer 8 water licensed plumber Processing time for
sewer 6 Nater permits is two days once area as been approve . •
I hereby acknowledge that I have read this application and state that the
information is
.
correct and agree to comply w 1 app icabl State of Min ota Statutes and City of
Eagan Ordinances.
Signature of Applicant: .• , yQ f?
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
O 02 SF Owg.
? 03 SF Addition
tl 04 SF Porch
? 05 SF Misc.
WORK TYPE
Of 31 New
O 32 Addition
? 06 Duplex
O 07 4-Plex
O 08 8-Plex
? 09 12-Plex
13 10 Multi. Add'1.
? 33 Alterations
O 34 Repair
GENERAL INFORMATION
?
. ?. .
? 11 Apt./Lodging ? ? 16 Basement Finish
? 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 Fireplace O 19 Comm./Ind. Misc.
0 15 Deck O 20 Public facility
0 21 Miscellaneous
O 35 Tenant Finish O 37 Demolish
O 36 Move
Const. (Actual) Basement sq, ft.
(Allowable) lst F1. sq. ft.
UBC Occupancy R.3 2nd F1. sq. ft.
Zoning Sq. Ft. total
d` of Staries Footprint Sq. ft.
Length On-site well
Depth ? On-site sewage
APPROVALS
Planning Building
Engineering Yariance
MWCC System
City Nater .
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
?
REGIUIRED INSPECTIONS 769c" aN
O Site ? Footing ? Framing ? Insulation
O Nallboard ? Final ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Mater Meter
Acct. Deposit
S/N Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
54 , ?o I v.iuat;m_ g 3 o a o
l . so
SAC 96
SAC Units
EASIIME1vT AGREEMENT
THIS EASEMENT AGREEMENT, dated as of
1992, is entered into by and between COACHIKAN
Minnesota general partnershi • , PANy, a
single person ("Grantee"), p? Grantor ) and AMOTHyCHORKAN, a
RECITALS
Dakota.County,t Minnesotae 1glly ? decribed as e Lot 1r? Blok ln
Coachman Land Company Third Addition ("Property"). The
Property serves as common area for a certain townhome
development located adjacent to the Property.
Z• Grantee is the owner of Lot 9, Block 6, Coachman Land
Company Third Addition ("Improved Property"), located adjacent
to the Property. Grantee has constructed upon the Improved
Property a screened porch, which encroaches upon the Property.
3• Grantee has requested, and Grantor is willing to
grant, an easement for the maintenance of the porch onto the
Property, subject to the terms and conditions stated herein.
receiptW andTHEREF
suffO cE encor 9ood and valuable consideration, the
parties agree as follows; o£ which is hereby acknowledged, the
1. Grantor hereby grants to Grantee, his successors and
assigns, an easement for the purposes described in Paragraph 2
below, over the Property, to the eztent necessary for the
maintenance of the porch which encroaches upon the Property
from the Improved Property ('Easement Property"), Grantor
represents and warrants to Grantee that Grantor owns the
Easement Property in fee simple, free and clear of all liens
and encumbrances, and that Grantor has full power and authority
to enter into this Agreement and to grant the rights described
herein.
Z• Grantee shall be entitled to the eaclusive use of the
Easement Property for the location and maintenance of the porch
encroaching upon the Property from the Improved Property.
3• This Easement granted shall continue for so lonq as
the porch is in eaistence. Grantee shall maintain the porch in
good condition, at his sole cost and espense.
?E
A
m
(
ol
, I : - k
IN WITNESS WHEREOF, the parties set their hands as of the
date stated above.
GRANTOR: ,
COACHMAN LAND COMPANY,?-D1f&A)
ip
? ;C?N IL D.A" IGS Co ,.t A-T ASS a?G. ? T^G.
? By
•3LS dtn -le"ner/12E.3'LLn?1'-
GRANTEE:
/ Timothy Horman
STATE OF
C\ , ? )
COUNTY OF Ss.
The foregoing instrument was acknowledged before me
this day of ?, 1992, by LY/?„tr DljL'i S
?/?,p?_ya?ar??? _?___ ? COA HI+lAN LAND COMPANY? a litinnesota on b of the ??, ??
?r•• .. RUSSELL L. KELLER JR.
. v?? .'i•. N:^.1Rip.iU_L.'^...ldINNE50TA . ,.
? ;cuvrr
? A'q C..:mi;.ian ExPiras Mar. 2. t6Y5 y? t a ry Pub 1 i c%
?..'
L ?
1
STATE OF
COUNTY OF? ) SS.
)
The foregoinq instrument was acknowledged before me
this /j'!Z day of , 1992, by TIMOTHY HORMAN, a
single erson.
------------------
;t?•:... FI'S l_'SI.L L V71 I.rR JR.
•:2cOTA ? DAKG i ; : ..,:.;:NiY
My Commission Eapirea Mar. 2, tpp5 i. o a ry ub 1 i c .
THIS INSTRUMENT DRAFTED BY:
MOSS & BARNETT (MCR)
A Professional Association
4800 Norwest Center
90 5outh Seventh Street
Minneapclis, MN 55402-9129
Telephone: (612) 347-0300
-2-
? COACHMAI
'• - .-r i
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i?:....?r' . ? ? ? 1 ' ?? i ;`•
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S 890 57 ' 16" E
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60 -0
9> I, ?=-1 8 L 0 G K
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?.? g0.pp O J
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Sc58
O 00 3q1 ,js.,f 400U .n
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N .` -? ? ? N ? I v+ - 9?'J>'4n?•E ??'il???
?n
? EAST 96.00
` 4A00 J w o g 1 ?i p 1 15? 0 0 4 p ; ? %) Z W'EST n
ti ati ,
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INSPECTION RECORD C°nt °"°. 0866
CITYOFEAGAN PERMITTYPE: sutLDrNG
3830 Pilot Knob Road Permit Number: 001147
Eagan, Minnesota 55123 Date Issued: 0 7/24 /92
(612) 681-4675
SITEADDRESS: LpT: q
31169 FARNUM OR
COHCHMAN LAND CO 3R0
PERMIT SUBTYPE:
SF PORCH
BLOCK: 6 APPLICANT:
PAMELCRAFT
(612) 721-6628
TYPE OF WORK:
NEW
ON EXISTING DECK
DESCRIp7I0N
?
?
REMARKS: RECEIPT # SEPARA7E PERMIT REQUIRED FOR ELECTRIC,AL WORI
? - .
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
31168 FARNUM OR
LOT: 4 BLOCK: 6
COACHMpN LAND CO 3RD
BUILDING
001147
07/24/92
DESCRIPTION:
AN EXISTING DECK
-Build3ng Permit Type SF PORCH
` Building-\Work 7ype NEW
Building Len,gth 11
Building Width 10
,
. ,.
REMARKS:
RECEIPT # C ?)- DVq / 3EPARATE PERMIT REQUIRED FOR ELECTRICAL WORK
FEE SIJMMARY:
VALUATION $3,000
8ase Fee $54.00 CtlPIES $4.50
Surcharge $1.50 Total Fee $60.00
Subtotal $55.50
CONTRACTOR: - APPri
PANELCRAFT
3118 SNELLINO AVE 5
MINNEAPOLIS MN 65406
(612) 721-6628
cant - ST. lICpyyNER:
17216628 0002179 HORMAN TIM
31168 FARNUM OR
EAGAN MN
(612)456-9111
I hereby acknowledge that I have read this applicaYion and state that the
information is correct and agree to comply w3th all applicable State of Mn.
Statutes and Gity of Eagan Ordinances.
L
?.. '?.!-? : ?'1J--
PPLICANT/PERMITEE IGNATURE
ISSUED BY: IGNATURE
Control No. 0866
I
PERMIT N
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
' 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural.& structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 5'.A y- 9,?, / / Valuation of work .3$0 r,
Site Address: 3lIlo A F?a f^'ri u.Ya D p. 'Fa.quF,
STREET STE /
Tenant Name: (cortmercial only)
LOT `! BLOCK ?a SUBD. CDAGHMAN LAND ca, P.1.0. M
3RA, h??iv7.71?!
Descri tion of work: 3 56)q--?_.j po,e?i+ .? ?-urs? e-c?c
The appl i cant i s: ? Owner D? Contractor ? Other (Deceribe)
Name Nr)rma rt F) Yn Phone '?57? -?% l 7 1
Property LAST F1R5T
Owner qddress -3I I?v .R ?_orhu vn
STREET STE M
City ? oGi n State M {'1 ? Zip
r
Company Pan?.JIY`r.. ??- Phone 73
Contractor Address 311511 C l( 1 vv t_- License #oct?0) 7 9 Exp.
City Y?IF?I.S State Zip :5"S-:ZM?
Company Phone
ArchitecU
Engineer Name Registration N
Address
Lity 5tate Zip
Sewer 8 water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFiCE USE ONLY
BUILDING PERMIT TYPE '
O 01 Foundation ? 05 Apt. Bldg O 09 Basement Finish
? 02 SF Dwg. O Ob Garage/Accessory ? 10 5wim Pool
? 03 Two family ? 07 Fireplace 0 11 Res. Add.
? 04 Multi-fam. T.H. O 08 Deck W 12 Res. Poreh
WORK TYPE
I y
O 13 Comm/Ind New
? 13 Comm/Ind Add
Q 15 tortm/Ind Rem
? 16 Public Fac.
? 17 Agricultural
? 31 New ? 33 Alterations ? 35 Move
32 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL IN FORMATION
Const. (Actual ) Basement sq. ft. MWCC System
(Aliowable ) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump .
# of Stories Footprint Sq. ft. Fire Sprinkler
Length ? On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering - - Yariance
REQUIRED INSPECTIONS ?r_4Eaiiv o.ecH oN 9E)ris?'/A/c- D6-,A
O Site ? Footing ? Framing
O Hallboard /121 Final ? Draintile
?
? Insulation
? Fireplace
Permit Fee 5q,00 v.imc;d,: s 3000
Surcharge
Pl an Revi ew
License l b x// = //D J{ ?
MWCC SAC
City SAC
Yater Conn.
water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copi es
Other
Total:
SAC %
SAC Units
z'L ? cp
EASEMENT AGREEMENT
THIS EASEMENT AGREEMENT, dated as of ,
1992, is entered into by and between COACHMAN COMPANY, a
Minnesota general partnership ("Grantor") and T MOTHY HORMAN, a
single person ("Grantee").
RECITALS
1. Grantor is the owner of certain real property in
Dakota County, Minnesota, leqally described as Lot 1, Block 1,
Coachman Land Company Third Addition ("Property"). The
Property serves as common area for a certain townhome
development located adjacent to the Property.
2. Grantee is the owner oE Lot 4, Block 6, Coachman Land
Company Third Addition ("Improved Property"), located adjacent
to the Property. Grantee has constructed upon the Improved
Property a screened porch, which encroaches upon the Property.
3. Grantee has requested, and Grantor is willing to
grant, an easement for the maintenance of the porch onto the
Property, subject to the terms and conditions stated herein.
NOW, THEREFORE, for good and valuable consideration, the
receipt and sufficiency of which is hereby acknowledged, the
parties agree as follows:
1. Grantor hereby grants to Grantee, his successors and
assigns, an easement for the purposes described in Paragraph 2
below, over the Property, to the eatent necessary for the
maintenance of the porch which encroaches upon the Property
from the Improved Property ("Easement Property"). Grantor
represents and warrants to Grantee that Grantor owns the
Easement Property in fee simple, free and clear of all liens
and encumbrances, and that Grantor has full power and authority
to enter into this Agreement and to grant the rights described
herein.
2. Grantee shall be entitled to the eaclusive use of the
Easement Property for the location and maintenance of the porch
encroaching upon the Property from the Improved Property.
3. This Easement granted shall continue for so long as
the porch is in esistence. Grantee shall maintain the porch in
good condition, at his sole cost and egpense.
r
•713 Z 1'24
IN WITNESS WHEREOF, the parties set their hands as of the
date stated above.
GRANTOR: •
oi f7*)
COACHMAN LAND COMPANY,?
a-rrisnsasv c c aac..a ra i r-c c-czas..s.ti: i p
? ?JN /L U !FlGS C:a .t k? +l-s5 JC. ? Ti..[?
? By ! 1,14%
Its er?WC5,qCA.-
GRANTEE:
Timothy Horman
STATE OF
sS.
COUNTY OF
The foregoing instrument was acknowledged before me
this _43;!?_day of , 1992, by DAV I S ,
^COACHMAN LAND COMPANY` a Minnesota getiersl
Pa_rtitip, on of the .pa*6ftex=sjLip. .21L 0.4W
RUSSELL l. KELLER JR.
?••.:;: ., „ci ?^.. n.4WNESOTA
nO,.:qy ? .,_. ? -"'
- ?„: .-. , ccurarv
f kry C?.??mission E>pires Mef. 2. 19i5 ?ary Public--
?.
?,•
L
l
STATE OF l? )
ss.
COUNTY O??
The foregoing instrument was acknowledged before me
this? day of , 1992, by TIMOTHY HORMAN, a
sing e person.
.:;d;?:;_., f?•'S: ri.L L. Vrl.' ER JR. .
30TA 4o? Ltit DAK07,.ary ublic
IrU' My Commission Ezpires Mar. 2, I985
?
THIS INSTRUMENT DRAFTED BY:
MOSS & BARNETT (MCR)
A Professional Association
9800 Norwest Center
90 South Seventh Street
Minneapclis, MN 55402-4129
Telephone: (612) 347-0300
-2-
JAMES N. DOLAN, County Recorder
pakota County Government Center
11astings, MN 55033
Received of ?--
?n payment of tne following g
Na 1544IF2,
( lQ_- ------- 19-----
----- ----
Date _--- -
by law.
Totals
sI.oa
? ? - -
99na.8us?ness Recoms cor ?? ---- DPpllty
__"
By: - -
COACHMAI
II
i - - ? r•
?
S 890 57' 16" E
'-
060y BLOCK
5
. __ _? q ) f VU
Ik/ 6?1,'t
?u o _ ??, •`?,, o ?oo? , LOT 1
? ?
? N g7°OU?QO ?E
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ao
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9 p ? ? ? p
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ao.oo
3 ?
0 o 40.0 •? ?. 4
N o, ?
??n•, v? o.D efopp???„ W o
y, y Oj 80.00 'S ' Se ? n
'O r r ? ? .. ?9o T?
-?R'3640-0?).
r_.
Q ? •- ?' ,` ? ?T `- '-• 'n ,;,"??ocn --.. " S F.?•,r?,i',•?.
Ld
CV
tf Ensr 96.00
ceoo Qeoo ' i a' ;•', i? ' ",
? ? ti ...
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w ? a 1 ?j 2 A
D V , ? ?j ••
- co o - 3 26 ?
Q) 48.00
7 ae.c>o
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---
-- - 170
- - ---
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???
? C1TY bF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-18152-030-06
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
3116
LOT: 3
COACHMAN
FARNUM DR
BLOCK: 6
LAN? CQ 3RD
BUILDING / 7'J
021109 ?
06/02/93
DESCRIPTION:
ROOFING
MULTI. (MISC.)
REPAZR
i52)??L1L1 ?
,--? REPLACE
B,uilding).Perrn3t Type
Building Work Type
\
? i
?
\
; {
REMARKS:
ZNCLUDES 3116-B, 3118, & 3118-8 FARNUM DR (LOTS 4, 2& 1)
FEE SUMMARY:
VALUATION $6,000
Base Fee $81.00
Surcharge $3.00
Total Fee $84.00
CONTRACTOR:
HAUSE CONST INC,
1034 EAGLE
STILLWATER
(612) 439-0189
- Appli
J G
RIDGE CIR
MN 55082
cant - ST. LIC
24390189 0005350
OWNER:
FOUR OAKS
3116
EAGAN
COURT ASSOC
FARNUM f1R
MN
I hereby acknowledge that I have read this application and sCaCe that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ord3.nances.
L ?
?n??n ?a?a I ??l
APPLICANT/PERMITEE SIGNATURE ISSUED : SI NAT
REAGTIYATE _
PERMIT i
2J' O9
U11 Y Vt CAIaAiV
1993 BUILDING PERMIT
681-4675
APPLICATION
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month•
in which request is made, 2} address is changed or 3) lot change is requested once permit
is issued.
Dats?? ?01? Yaluation of work G U0
SiteAddress:?3l\L .?\\L C',, '31\9-1 .Z?1C?T5 V-:W?L-N j n\m.Q.
? STREEt ? ? SUITE N
Tenant Name: (commercial only)
IAT 2 BIACK ? SOBD. &
p_ ? TwT I.D. N
?1 Gl
t
Descri tion of work:
The applicant is: ? Owner Contractor ? Other (Deseribe)
Name .?"?rrh Oab (M?.? Oidfr. Phone
Property LAST FIRST
Owner
pddress
STREET . STE M
City State Zip
Companyl.? '(Z?l Phone UZ? ? n
Contractor Address \Lkn Ci CoiSAicense #C
?S
6 Exp
?U
LOC
.
.
.
,
City <n? l t_,.1--h?-,a. State M,)V + Zip
Lompany Phone
Architect/
Engineer Name Registration N
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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.
/
Signature of Applicant:
1999 BIUfLDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PI659•68046 5_ 55922 1..?1- ? l S-
, -C'
New Construcflon Reaulrements Remodel/Reoalr Reaulremenh
> 3 registered sMe surveys showing sq. tf. of lot, sq. H, of house
and ali roofed areas (20°6 maximum lof coveraae allowed)
> 2 coples of plans (show beam & wlndow skes; pouted fnd. design; etc.)
> 7 seT of energy calculations
> 3 copies of free preservatlon plan N lot platted atier 7/7/93
DATE:
- n ?
DESCRIPTION 01"?ORK: Lz,L°1 on ,.
SiREET ADDRESS. ? )cF::?,?l[fl.w, D'vi i/<
Name: &rA Phone #:
, L st Flraf
LOT: ? BLOCK: SUBD./P.I.D. #: LC3 Cs_.(' k VY`A r" uoi.ylc? C-U
PROPERTY
owNee
<:5l/
Street At
?a,,-n u?_ ?r ? ??
2 coples of plan
1 set o( energy calcvlaHons for healed addNions
7 aRe suney for exterlor addRions 8 decks
CONSTRUCTION ?OST:
n A City State:
Zip: /
Company: 1i'?rnW P v, a.,icPr Phone#: 6ro1- OCC?
CONTRACTOR (area code)
q Street AddressG : 66? ! S 7?? ? License # l71Exp.
/
City State: ? Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Street Address: Registration #:
City State: Zip:
Sewer & water Ilcensed plumber (reaulred for new construction onlv):
i'enatFy applies when address change and lot ehange is requested once permN Is Issued.
I hereby acknowiedge ihat I have read this appllcafion, state ihat the
%tafe ot Minnesota Stotutes and Cityof Eagan Ordlnances.
Certificates of Survey Received
Sign re of Appllcai
OFPICE USE
Yes X-
Tree Preservation Plan Received - Yes _ No _ Not Required
Nl<,: 11?° 7?/?z°P4c-4 "?
OFFICE USE ONLY I ?
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex A
18 Deck ? 23 Porch (screened)
O 04 2-plex ? 09 7-plex ? 14 Apartments ,
? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
` Give PCA handout to applicant for demolition permit
GENERAL INFORMAT ION
Const. (Actual) Basement sq. ft. Census Code
?kzz
(Allowable) Main level sq. ft. -
SAC Code ^/ L
UBC Occupancy sq. ft. No. of Units CJ
Zoning sq. ft. No. of Bldgs ?
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
?
Planning Building 410 Engineering Variance
Permit Fee I.?
? Valuation: $ 2c'
Surcharge
Plan Review
License DELfL - ?20? "`"
MC/ES SAC
city sac
5C2Etlld PoIU-.t
6C?C?
Water Conn. ( I ox 10)
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded. '
Other ;
Copies ?
Total: ? k 3 .-I 15?-
SAC Units
% SAC
:
i.
) , ` r
3
, 2
3 '2
3 : 3.
? 3
2 4, _` 3.2 14 `3
7-4 v 3 4 ??r,? ;y 4i1
,..
2 4A
?- .
' C ' ? c . , '? . . ? .1_. • • ?? ;?? I n\;' ? ?`_- ?
?
_. \ . -
.;
---
.
;; .
?- - ??
#Y 4 3
. ? .. /? ?'" , ? ? .,. ' - I• , "?`-? . ` ? _i
--
,
3
4
4 ? 3 2
,
, .
2
,... , . _ ._ _ ; . 3//
2 y _ '• --- :
?,
? 32 ?I
4,'
4 3 4
C;4
4 3 4 2 2 w 2
:
,
.
_,-. - _-..- -
.
?p(? ?Q ---- -
Alo_.
Coachman Land Company C1?t Additiorx B?
.
? BUILDING UNIT LOT BLK ??
RIIIL.DING UNIT LOT BLK r ADDRESS
? 'yo(
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
U CITY OF EACAN
? 3830 PILOT KNOB RD - 55122
? 657•681-4875
New Conshuctlon Reauiremenh RemodeUReoalr ReaAre
menh
4 11317 5
?aflcd 4 / I 7??
(41"
D 7 reglalered aNe wrveys fhowing aq, ll. of lof, aq. fl. of house 2 copiea of plan
and pJl rooled creas (M'A, moxlmum bt covemae anowe? 1 sel of energy CaleulaHOns tor heafed additloru
n 2 copiee of piana (ahow beam d windpw elzqy; poured (nd. design; efc.) 1 aite wrvey for exleAor addiHOns 9 tlecks
a 1 sel 01 energy caicWptlons
n 3 coples of hee preservatlon plan if lot platled cRpr 7/1 /93
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: -?(o ra-?A n at (Z -y)?C.
STREET ADDRESS:
F&-
LOT: BLOCK: CJ SUBD./P.I.D. Y:
?-iZt ,1-S!?Lb
Name:_aog[?? P,one #: G S'i ? 9?y ?7S/ a
PROPERTY taat Flrst
OWNER ? f? Sfreet Address:
city _4L_??-? Stata: vwJ na: S'Sl2l
Company: Phone #: ? ? 6(9,y-
(area code)
COMRACTOR
l y
Sheet Address: c!rc, 62 A) llcense 9 41 ExP• ?
Clty _ &6,0Stafe: ZIP:
ARCHIiECT/
ENGINEER Company:
Telephone #: (
Sheet
citY _ State:
Zip:
Sewerhxater licensed plumber (if installina sewer/water): Phone #: (?
I hereby acknowledge Ihat I have read Ihis applicalion, slate fhal the iMortnaHon is cortect, and agree to comply wilh oll applica6le Stafe
of Minnesoto Stafiifes and City of Eagon Ordinances. ?
Signalure of Applicant
OFFICE USE ONLY
CertiFlcates of Survey Received _ Yes _ No
Tree Preservat(on Plan ReCeived _ Yes _ No _ Not Required ?
Name:
ReglshaHon i:
OFFICE USE ONLY
BUILDING PERMIT SUBNPES
? 01 Foundatlon O 07 OS-plex
? 02 SF Dwelling ? OB 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex O 10 08-plex
? 05 03-plex ? 11 10-piex
? 06 04-plex ? 12 12-plex
WORK TYPE
? 31 New
? 32 AddiGon
A 33 Alteration
O 34 Repair
? 13 16-plex )K 21 Poroh (3-sea.)
? 17 Garage ? 22 Poroh/Addn. (4-sea.)
O 18 Deck ? 23 Porch (screened)
? 19 Lower Level ? 24 Storm Damage
Plbg _Y or _ N ? 25 Miscelianeous
? 20 Pool ? 30 ' Aa;essory Bldg.
? 36 Move Bldg. O 43 Reroof
? 37 Demolish (Bidg)• O 44 Siding
O 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) O 46 Windows/Doors
" Give PCA handout to applicant for demolition permft
GENERALINFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual) ./
(Allowable) V a
UBC Occupancy d,i y?
Zoning 113
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
3?If?a. rc.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Pianning _
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
J/0 -
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Building TR/L4 Engineering Variance
Vaiuation: $?-5
y°
:.
? 31 Ext Alt - MuIG
? 33 Ext. AR - SF
? 36 MuHi
LI?
y? yc?v
? ? , • < < ; ? 23' ,
? 3` i? '?.• 3 '2
k 4 3' 2
1 3 4?,
, 2 ? 714, ,, 16. 41
s
4 L1 3A
1 L
2
,.
I? ?g?
?? _
?
? r.
?-- „- i.
?• ?
? •? ?
3
l r
i , 2 •, y. ?" ? , . ?
3 `.. . .
3 2
3
4'
?.--?.: ? •' : . ``?- `? - '
f
;7 ° 1 4
v 3_
,
,
31 - ` .
2 y _. .,
Z
-?-?? - ? `• `. ? r? 3'2
i 4' 4
4' 3 4
1 4 1
2
? ?? • ? . , • '? ? ?, ? .. .. ii I ?, ?.?J
??IT1i T
,
2 4? I
? ly '
?r .
?-- _
I
i
?+?-- - ?
;
i ??
_ JI ? - _- _ ..J ? . " ?_-:?•+r'
----?-----
? !, ? _ _ . t ' 6uU
\ `, I Coachman Land Company AdditioM
Addo* "
I twnT I nT 1 BLK i
ADDRESS I
BLK ADDF
I
BUILDING UNIT LOT
-v r/
„ . , n . ,.
FFFI,?' 2/84
CITY OF EAGAN
A?PLICATICN FOR PEP3IIT
-' SEWER AND/OR WATER COiv'tiEC:IO;d
- (PIEASE PRIN7)
i) PPO?? ?DRE:.s: 31 ?
rFr?I. Dt'..CC'`?'T_C.'I_
(Loc/Blocic/Sl;;:.:ivisicn or M:t _ =scai _L.D.
ST._',.=c?:..I Dai-t. O° CR:.r]:?nL a11:.DI`.J ?. ?Svl,
`------, __."
P°=5?^ ..._. ^•???:'O5? PS"-': 12 2-1 S^:= -_?•rS__
0 ?-'J L`.LJPi=,•_ M'.? t.liimJ)
? ?-3 ("-'?='W - L`TITS) ( TJiI='=S)
? _.-1 :F. .--=7/C':ZCi'?_`1I:,:d
p L,'R.-m?T/o:-??.?
? ???-s?.LL
? I11jTI.i,TI^::,'-ki./Gvv.?: ?:•r?-1
2) IPLEAJ[ i"nl:ii)
HOSEWOOD CORP
PCDR=Ss= 1711 W. (O n R S rmF 00 SOUTH
C=, ==, ZTP: ROSEVILLE, MINNESOTA 55113 '
°HC-%,E= 631-3254
3) pU7:.T-?'? (PLEASE PH1tiT) FOR CITY USE 04LY
n?='!E= SCHUGTIES PLUMBING INC.
S:
8383 SIINSET RD. NE LU°BER$ ?4SE:
ctive
CI'P!, STA' ', ZIP: SPRING LAKE PARFi M. 55432 E p' ed
PcOVEc 7A?1:1
786-4007 PLUMaEa L?c:tue a 2658M9 of Re ord
ca
cj) -t?p?,^r/Cr:?.;<..-Z (PLEASE PRINi)
NPd"IE:
ADDRESS:
CI':"!, ST:.T'i', ZIP:
Pt'`NE:
5) IINpIG,TE ;:HICii PEP.'•lIT IS BEI\C RECUESTLD:
[L-1 c."'.`INF.CPION 'Iq CITI SE4I&'R
E] CbiSNr?I'ZCN 'IC) CITY t•7ATE??
? d'iiF'.cZ (PL.L't',SE D°.SC.'RIBE)
6) INGIG= C:.::
??I .rASE f?OLD APPRGZIEp PERti1IT :'C4 PZCN-L? BY O:IE OF :tiECVE
Q PT. E,St :-*_aII, ?4nP??G'?I'? PEIF.= TJ 1. 2. (3.) 4 P,BUVE
(Circle one)
7) SZC,:,TL:v
: , ?
. DATE: 9/9/R5
U ?
aft R a.al+ial?RSS ?.? ea !??au af s Is ?v m:'?sw a s? rFm ?m :v a? ?.c r?e s't.mse s:?f? fs a??i[ ?ar ?s?a,r:6ar .
F 0 R
PE°MIT °- ISSUED
I TY U S E ON;,Y
rcrs: $
$
$
G t:?-J
$
S
$ ?IGJ
$
$ j?,?DU
$
$
$
$ r3?.??,
$ C':'!LD nr?•.1T"^ ?T„^T"'t? D!'c-pn^?
$
W?I`rpa pT'RI`1'T (ii:CL"uDE -. .uRC'-?;sRCn)
W?.T°R METER/COPnEFHORN/OUTSIDE R?'i,DER
S•iAT°R TAP (INCLCDE COR?ORATIQV STOP)
5°SdER T.`.? .
: _??ti:._ ?... ?•S?_ - ?c:.=3
ACi..niLJVT DF.PCSIT ' Vli-.':r:C
w=C
T3uJIi: [•IAT°R ASSESS::E:iT
T3l:::K S-'.':LR
L:-,TI;?,nL BE:iEFIT/T U`]K SE??: R
L?,:E?.AL BEN"FIT/ P.liVR WF R
pmcEa
TOm:,L
t1".Oli?'.T Pr?ID,'H£_.:._?T n aG
/ ?o-
DOES UTILITY CONNECTION REQUIP.E E?{CAVATIOid IN PUBLZC RIGriT OF WAY?
YES IF YES, THE:I n"PE3b1ZT FOR 140RR WITHIN
PUBLIC RCADWAY" i]UST BE ISSCED BY THE
? NO ENGI;VEERICIG LZVISIO[V. LIST AS A CONDZ-
TION.
SGBJECT TO TEiE FOLLOLdING CONDITIO^:S:
APPROVED BY:
TI:LE:
DAT°:
Me dso Wss .e.. sw ocia rc ? re E? ec.? in a w s? ?sv r+r?? •sa?4 0? m? osw w.a ? m ia m?a w.a st? ra ar w?
? ... ' . ? : . . . , . . . ..
1 ?
?? .
?, ll CITY Or EAGA?1
No 2/84
? 17?
111?1 APPL •.CATI^v.N FOR PEPuMIT
SES4ER AND/OR WATER CONNECTIODT
` (PLEASE PRINT)
1) PP.OP= ACDRESs:
1 2
r.Fr.,L DE..???^_ICV:
(IqtBlcck/S u?ivisicn or Tati ?.:rcel I.D. i1t=.5er)
S_^.?:L? ;v.. Dlli 0F CR`_Gi^.7?I.
pRrcL.': 12 R-1 Sm,:GI.:
? R-2 CLIr7-:: ('?'.ip LNI^S)
? ?-3 2C'.,,1-c:rv.cE ('_^t_J - L:iTS) !, U:II^g)
? n-4 r`,cP.,=:-`-."?`/C'_'Ci.+rNIT?-;,I ( U.iI_S)
? CCtn1E.°.CLaS,/RE^'?I,/Or:I?:.
Q \'C::Si2iw
Q
2) rLpPLIC`--=? 1PLEHSE ?RltifJ
ROgF.GaMD CORP
ACLR""S'
1
12
1 W CO Rll B Si1TTF 300 SOUTH
CITY, S?':,' ?', ZIP: ROSEVILLE, MINNESOTA 55113 '
P?ONE: 631-3254
3) pL[m=-, ???. (PIEdSE PNIHT)
SCHULTIES PLUMBING INC. fOR CITY I1Sf.-04LY
PDD_F55: $383 SUNSET RD. NE PLUMBERS ENSE:
CITY, STAT', ZIP; SPRING LAKE PARK? MN. 55432 Attive
Eap' ed
PI:O`Ic:
786-4007 PLIIMBER LILENSE ,Y 2658M9
d
of R7r
`
rr a
tni:i
4) oLcu??m T/CT,':i:Ei2 (PLEASE PRINT)
NNME:
ADDRESS:
CIT'l. STi,TZ', ZIP:
Pfi0NE:
5) INDIC:,TE ;r7iIC:i PEfL•SIT IS BEI\C; RFX2UES'IM-:
FLI CC.NF.CtION Tt7 CITY SETAER
y? CON:VEcrIC:1 'Ib CITY wA'IZ?2
? dT[IEt (PI.CASE DESCRIIIE)
6) D:MG,:: C:-..
?°IE-7?SE f?OLD APPROVED PER,"^ST FO4 PICK-L'P BY O.IE OF A£M'E
Q PL.E?ASE :•7IL APP?20Vc:D PFR'•LLT 'PJ 1. 2. (3.) 4 ASOVE
(Circle cne)
7)
?
a! R O???f111lJO i? i f!l?:afl? ? i 1!'1tAiia ?f #f ??iii:? a S!!'l?'.f?l.fj'f? f? S?Sil4iiFY t
0 R
PERMIT " ISSUED
I T Y U S E O N L Y
$ 49-
$ /o-S u
$
$
S
$ /S.uo
$ l.S'aL
$ O-rJ
$
$
$
$
$
$ ???j. c,?•
$
5:'.'.'c.R ncR..1r'^ (I`;CL::DE SliRC;2,RGE)
WATEP, PERttZT (Z2:CLVDL SiiRC:iARGc.)
WATER METER/COPPEBHORN/OUTSIDE READER
WATER TAP (INCLL'DE CORPORATION STOP)
S°S•iE3 TAP
_ ._...?'i._;.'•..._.: r.c?. - ._-:.??
AC::OUNT DcPOSIT - WATER
WAC
Sr? C
T3GVK WATER ASSESS:?E::T
Tiiii:{ SES:ER =?SSESS:,?E?iT
Lt:TERnL BEiiEFI'T/TRU`IK SE?•7ER
L:;ic,R;L BENEF?`T/TRUtiiC ?4AT°R
OTHER ?
TOT?.L
r1-'-OL'::T PAZD; RECEI; T n 5 9
T-
DOES UTILZTY CONNECTION REQUIRE EXC:,VATION IN PUBLIC RIGHT OF WAY?
YES ZF YES, THE.1 A"PERMZT FOR [JORK WITHIN
PUBLIC RCADwAY" M115T SE ISSC;ED BY THE
? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUEJECT TO TEIE FOLLOWING CONDITIOIQS:
:.
APPROVED BY:
TI.LE:
DAT°
(
_:
.s aw ma=m wmm Oc,= mmw sum wr wvvmle ssa wso ^.a wtmwm--m w4w w.a wE ? s? ?? w?a ?c? w sr w?
1
2/84
? „aM 1
? ? jCITY Or EAGAN
?'
4?
?
? C.
/
.1U11 APP;,IC:,TIGN FOR PE°??1IT
-' SETIER AVD/OR L4ATER CONNECTZODi
- (PLEASE PFINi)
1) PF.OP&'R'?'`_' ?DRES5: 3
,
T,Fr=,L, D`;SC'r?r..?l.
v_ ' _?.' '
(Iot/Blcck/5u., sicn or ia.l rarce!-!4?-cj=zer) ?
? ='_i:, S'zC,^_'UT?.. DAT' 0° C:SG^;P,i, cuI?DTC:G =--'_•iT
p_c?^ ?^•i.:?;/^-?C)?Cs= L'--': l}? R-1 SD:GI : c.=:+_"fY .
? R-? i.r.7rl..-`" (T:;O L^.?I^_'S)
?
Y-3 TCi`.-NlHC.:GE ("_=:=- = L'::ITS) ! L'N=^S)
t?
LJ R-41 UIiT_S!
Q CCS_! ?LF-'.1-1T,/'R . tiT?G':'
? zz'CCST??%L
? I N STI'^uTIC::M ? i,/G=,P
Z) (PLE;.Sc ?RI7iT)
ROSEWOOD CORP .
A%CRESS: _ 1 711 W rO RD B Tm 300 SO TH
C=, ST,,^.'-?.', ZI?; ROSEVILLE, MINNESOTA 55113 '
° r.C`7: 631-3254
3) pa::.aEF), kPLEdSE ?NiNi) FOR C T-Y USE OALY
N;='IE. SCHULTIES PLU19BI13G INC.
, rE'-==s5' 8383 S[JNSET RD. NE !!BERS LIC:tiSE:
C Active
CIT!, STy TZ, ZIP: SPRING LAKE PARKr [4V. 55432 ? Expi d
?7-r.
PrONE= 786-4007 PLUM6ER LICENSc # 2658M9 of Recard
a: r :m.;iat
4) (PLEASE PR[t!i)
NF4^g'
ADGRESS:
CI:"!, ST?i`., ZI?:
Pf:aIE:
5} n1pIG.TE "tiHICH PE.R;•LIT IS HEZ\C RF?.')UEST:J:
ED CL`':.'NF.C.'I'IOV 'IYJ CITY SEF]E3
CO:.'ti'EC!'TC:] 'Ro CITY SVA=
? 0-'i'IEf2 (PI.I?-15E DFSCRIBE)
6) rIGIC,.:: C:.:..
? PT.Z`,SE f?OID 'nPP?OVED PMmST FC)F PZCR-LP BY 0NE OF e'1F,GUE
?°I.P:Sc :'_aIL APP!2ptJ', PEFMIT T`'J 1. 2. (3.) 4ABOVEr-
, (Circle one)
7) SIC --?TLi:: ?
. ? . D:.T7- Q/Q/R5
OR R ail?litA?Ja i i a l?gau a.? t r+t a.? s0.rtar +s s i risa?.a :s s at f.e /F1?-s?1 YHeyr s! eR! a wcmcar t
F 0 R C I T Y U S E Q N L Y
PEn+1IT - ISSUED
F°4S: $
/U-tiu
$
?
S
5
$
$ I>. v U
$ 5 -vCj-J"J
s
$
$
$
nr.a+.1r'^ (T_`ii:?l:i: J=c:1iC:L)
S•;ATt:R DFTIUMI_ (Z`:CLi;DE SiiRC:;ARG'a)
WATER M£TER/CO°PERHORN/OUTSID;: READER
W:\TZ'.°. TAp ( INCLCDE CORPORATION STOP )
S?t:ER Ty?
= -.,?'i._;.'•?.:.?r.c?= - 0_..=3
AC^OUVT D`:?OSIT - i-ir,"'9_2
ta=.c
s:.c
TR:;VF: t1ATER ASSESS::E:iT
i'Ruc;?C SESdER ASS..SS?lEEiiT
Lr,.ERyL BE:;EFIT/TDli`?i{ 5E:l_4
L;,^.ER1L BENEFIT//?TRlitiiC'S4AT°R
OT::ER
TOT'AL
tNou..T PazD/4EcZI:T R S3?j?i
7 ---
DOES UTILITY CONNECTZON REQUIRE EYC;,V?.TION ZD1 ?UBLZC RIGriT OF WAY?
YES IF YES, THE"I H"PEtZMZT FOR WORy WIT??IN
PUBLIC ROADL4AY" MUST BE ISSliED BY THE
? NO ENGI:VEERING DIV:SION. LIST AS A CONDI-
TION.
SUBJECT TO TEIE FOLLOWING CONDI':'IC::S:
APPROVED BY:
TI.LE: ?
DAT°_ :
MR fm W?• •e =ir mw? wt v.a w" a%•m Ptm m.xlvc ?pv at?w 04 Wsa ?ia w.a ac.m Oe sr m m
r?` 1 s
C
?
2/84
(F,?
?
CITY OF EAGtiN
APPLICATION FOR PEPMZT
SEWER AND/OR WATER CONNEC:IOD1
- (PLEASE PFINT)
1) PP.OPE.°.'P" r1CME:.5: 13
rFr=,L Drc=?'?'T_C`I: ?
(Lot/Blcrx/St:::ivlsicz or Ta:c ??-
? S^:i;'? 'C,;?., Dl' OF CRT_G=-'?L 'ciiIIAL`:G
P-.=54.^_ Lt ?': C? cZ-1 5'1:= F. _.tT?,Y
? R-2 CUPLE.: (T.-;D L^?ITS)
? 2-3 'IC?.?i..?:C?'?E (?"= • ? L_IITS) f L?I
? R-4 LTITSi
? C
C^?
i?
1?Cti _,/Oc?
T
?A
?
Q ?1\l?'1,5aa?'-:L
? IN'ST=TIC?Lm:- ICL'vr.:?:.IENT
Z) t`.y7pT,-,`..^ (?L`.ASc 'rRitii)
ROSEWOOD CORP
pzD-Rz`S: 1711 W. CO_ R B 7m 300 SOUTH
C='rnY, S-=-• ZIP: ROSEVILLE, MINNESOTA 55113 '
°EM+C: 631-3254
j) PyL;:?L (PL'cd6E PH1tiT) FOR CITY 115E ONLY
MA='!E= SCHULTIES PLUMBING INC. ,
8383 SUNSET RD. NE PL(1M6£RS l EtiSE:
I tive
CZTY, STAT, ZIP: SPRING LAKE PARK, hIN. 55432 Expir d
P?ONE =
786-4007 PLU.v6ER LICENSE d 2658M9 ?
oi Re ord
r; ini:t?
NFAME:
AODRESS:
CI?"!, STATL', ZIP:
PF"L"]:.' :
(PLEASE AHINi)
S) Ii1pIG.TE ;ti'HICii PEPMIT IS HEI\(; REC.'.UES'I'ED:
El C'U:`INECPIOY 1o CITY SEFIER
FXI CO:,NECTZOJ] 'IG CITY VIATL??
? diflER (P=-,SE DFSCRIEE)
bJ (i;..:..
7) SIC:,TLL,:
? P=;SE I?OID 'nPPROVID P&R•tIT :'CR PSCR-iic BY CNTE GF r1EC,UE
El P=-LSF.' %:3iL APPR= PE',•LLT TJ 1. 2. (3.) 4 ASUVE
(Circ1e cne)
DAZ%: 9/9/85
,
!?! olilaww?A:f? +1s a lamzu ! a Ie[ ?s sema rs +s s ?r:am:a:r a at m e[Jaf?e-sLrr s? ?? at s( ??ar .
F 0 R C I T Y U S E O N L Y
PEP`^.IT '-` ISSUED
`Frns: $ /Li?U
5 ?U-g2
S
S ?S:Lt?
S ??•UO
+S
$
?
?
S
S
` $ $:Yi?o Dr?qT'^ ?T?'^r"?? ^rc^-?
Wy,•E=DFD_11Tm (i?:CL'vDL JuI',CF?H3GL)
49AT°R METE.°,/COpFFRHOfZN/OL1JiJE R.`_.YL:.R
WATrD TAP (ZNC:.L'DE CORPORATION STOP)
5°i;ER T.=,P
AC.^_CUVT DF.FOSIT - Fii.TE:2
SV; :C
SAC
T3li^Ii: :4ATER rSJLJS[[E:.T
i_.U:.{ _...
m?•'•?'uR ?AS.:L......LJT
L.=,.E?.i,L BE::nFIT/TRU`IK SE?,:ER
LA:cRr.L BENEFIT/TP.U`iZ';•:AT
OTu?R _
TOTAL
t1:0i;::T PAID;'R:rEI?T ;ir 1?r4'
DOES UTILZTY CONNECTION REQUIP.:"'. E?CCAVATION ZN PUIILIC RIGriT OF WAY?
YES IF YES, THE:I H"PERMIT FOR hTCRK S4ITHIN
P(7BLIC ROaDWAY" MUST SE ISSUED BY TY.E
? NO ENGIUEERIDIG DZVISION, LIS'?' AS A CONDI-
TION_
SliBJECT TO TIfE FOLLOS4ING CONDITIO?:S:
AP?ROVED BY:
TI:LE:
DATE:
A?ia wis i o i? ?kta ?ts uN OV3s R@}o Rm w 49f mtfo WL?m eFi I4 R+37 m!% sFM sEgo 74 twi7 Pta R4lY sia ss m
?/A
73 K?
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWcfion Reouirements
3 registered sHe surveys shaxing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20%macimum lotcoverage albwed)
2 copies of plan showing beam & window sizes; poured found desgn, etc.
1 set of Energy Calculations
3 copies of Tree Presenafbn Plan if lot piaried afler 711193
Rim Joist Detail Op6ons seled'wn sheet (buildings with 3 or less units)
Minnegasco rccechanical ventila6on (orm
i67,?,6/
-
RemodeVReoair Reauirements OtfceAse.Onlv
2 copies o( plan showing footings, beams, pists Cert ot Suivey Recd =Y =N
t setoF Energy Calculations for heated additions Tree Pres'Plan Reoi
1 site survey for additions & decks Tree Pfes Reyuired ,,„, •Y _ N
AddiBon-iidicafeNon-s8esepficsystem 064siteSepticSy5lem
Date :9b-l ccv Construction Cost Do a. oCD
Site Address -3 1/ 63? -3 !l 1' { l z-,/3 }aln610n. bi " UniU5te #
Description of Work /Vc?.,
51 c fw?re- f? t? cK e
Multi-Family Bldg `y N Fireplace(s) _ 0 _ 1 _ 2_3
Property Owner Telephone # ( )
Contracror ' ?'?? f.'. ?y c .
Address / y 13 J?a City W, °/a
State Zip S- o Telephone #( 7l3) 7?-;? - 0 0 ?j 0
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residentlal Ventilation Category 1 Worksheet
(4 submission type) Submitted
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Su6mitted
In the last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, dafe and address of master plan:
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 far 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.
??? , G /? °??r-, ? , -,,
? Applicant's Printed Name
Applicant's Signature
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. O. Box 21199 DATE:
Eagan, MN 55121
No. of Units:
Zoning:
Owner:
Address:
Site Address:
Plumber: Connection Charge:
Meter No.: Account Deposit:
Size: Permit Fee:
Reader No.:
1 ogres to Comply With the City of Eagan Surcharge:
Misc. Charges:
Oral nco& /r Total:
G _ Dote Paid:
By C/ Insp.:
Dote of Insp.:
SEWER SERVICE PERMIT
CITY OF EAGAN IT NO.:
3830 Pilot Knob Road PERMIT P.A. Box 21199 DATE.
Eagan, MN 55121 No. of Units:
Zoning:
owfner:
Address:
Site Address:
Plumber:
i agree to Comply wit14 tb- GM Eagan dun i Deposit-
ordinances. Permit Fee:
Surcharge:
Misc. Charges:
133Y Total:
Date of lnsp.: Date Paid:
Insp.:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA120368
Date Issued:02/05/2014
Permit Category:ePermit
Site Address: 3116 Farnum Dr
Lot:3 Block: 06 Addition: Coachman Land Co 3rd
PID:10-18152-06-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Barbara L Lippert
3116 Farnum Dr
Eagan MN 55121
(651) 994-1512
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature