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4323 Fox Ridge Rd ti Use BLUE or BLACK Ink For Office Use. 11~ j Permit / &L/ City of Ed~ I Permit Fee: cl 7, ~ I 3830 Pilot Knob Road Eagan MN 55122 u P F7 I t A Date Received: 4,~- ` M/ j Phone: (651) 675-5675 I I Fax: (651) 675-5694 AP? 0 4 2011 ~ Staff: ~ 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1 L1 /dot / Site Address: 3 ~rP c P-. Unit Name: 19 r~ k \-C A Phone: RESIDENT / OWNER Address / City / Zip: L4 3 3 ressz Z ; o(ae 2u(. p~ca~ 1; S I a. Applicant is: Owner Contractor TYPE OF WORK Description of work: -X z1y Ir.) e ck, Construction Cost: tii C, Multi-Family Building: (Yes / No Company: S, C,),\ [O&A&,VA_V< SQP-) L14-c- Contact: jw t1:rt,,. CONTRACTOR Address: City: M`c.. C_J State: hN Zip: 5537 6 Phone: 6 1 a _ -,va-.)-488 License *;)o 6388-71 Lead Certificate Does this project require Lead Remediation? ❑ Yes C90"No (see Page 3 for additional information) If no, please explain: 0,44 ejc 3 ZlK E 1 d-er-- bo COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical, Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x -.lf ot.) ~Ays,4, x i" lfv Applicant's Printed Name Applica s Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES - Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage - Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) - Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex _ Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ~2000 Occupancy 7/u MCES System Plan Review Code Edition -k4-,?7 SAC Units (25%_ 100% Zoning /oCity Water Census Code Stories _ Booster Pump # of Units Square Feet 9_ PRV _ # of Buildings Length / y Fire Sprinklers Type of Construction ~i Width 40 REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector l RESIDENTIALF ES ,4JC,LO~AxcfL~G Yo~~~ Base Fee Surcharge 70 Plan Review 7G MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 4323 Ae • ~Q C. R. WINDEN S ASSOCIATES, INC. V LAND SURVEYORS Tsl. 645.3646 1381 EUSTIS'_ ST. PAUL, MINN. sSlOd FOR: GRAND OAKS DEVELOPMENT UtGA4_ ' RE W~ ED NOTE: BY. O Denotes Wooden Stake G ~1 Y Proposed Garage Floor El. = 911o, ti d~ `.T~' (9/b.t) p ` ~ '_TIONS DIVISk!Wjle: 1"=30 t Denotes Proposed ' Finished Ground E1. O Denotes Iron --a*- Denotes Direction Monument Of Surface Drainage Bearings Are Assumed Vertical Datum - N.G.V.D. 1929 O9 Q r. , 1 4 , 0e, _Tle OK Pf Lot 15, Block 31 SUN CLIFF FIFTH ADDITION, Dakota County, Minnesota. WE HEREIY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF All BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS. IF ANY, FROM OR ON SAID LAND. De►sd ►bi• z 2 day LL Z9 A. D. :185 C. R. LADEN 6 ASSOCIATES, INC. Surveyor, Minnesota Rpistratiom Me. 777-4 u~.s CITY OF EAGAN Remarks A --- SUN CLIFF FIFTH Owner Lot 15 sIk 3 Parcel 10 72979 150 03 Street )4323 F[oc Ridge "rl. State F,ax1, M[V 55122 ? Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 5 •3 • 3 15 . J.rs - 01,5 /0 "f:145 STREET RESTOR. - O D- (7 "FS GRADING a 3. -5 oa.s? - 0 -17 SAN SEW TRUNK • /g. OG C' 10 /S /U- rY-? SEWER LATERAL 1985 257.00 51 . S, ? v v - /v 9 6 ? -? 7j?? WRTERMAIN 60.02 - WATER LATERAL WATER AREA av/ 1973 68-60 4.58 15 ./9 0- 0 / - 4 S ' ? - STORM SEW TRK 1,05 - b.13 -?o 5-3 5 v ? STORMSEW LAT 19$5 $6.95 5,80 1 /. /IO v v CURB & GUTTER SIDEWALK STREET LIGHT 1637 a - RnAti llnit- 280.00 94097 ±7 WATER CONN. 500.00 11 11 BUILDING PER, 10669 n n SAC 575 PARK I Y OF EAGAN Remarks Additio SUN CLIFF 2nd Owner Street 4321 Improvement Date Amount Annual Years Payment Rece' Date STREETSURF. 1985 369.37 24.62 15 STREET RESTpR. GRADING SAN SEW TRUNK 1970 48.64 1.95 25 SEWER LATERAL 5-1-12 WATERMAIN 1-1 WATER LATERAL WATER AREA 19] 62.3[F STaRM SEW TRK 1971 1Fj1. $,09 STORM SEW LAT 954* CURB & GUTTER 7 SIDEWALK STREET LIGHT WATER CONN. 9UILDIN R. SAC Pd? K CITY OF EAGAN 3830 Pilot Knob Rosd, P.O. Boz 21-199, Eagan, MN 55121 PH ON E: 454-8100 BUILDING ?ERMIT ae«ia ? TO Ir Iwd lar • ts; Ed Vnluw _, , , _ .. , fL.e. • . Site Addrea , ' . :'• Lot Block , i • , - ? Sm/sub. Percel No, ? Nan;e 1?-- _.VF;LOPMEt,:'.." 61 ; .": 17f:'- ?: C, `I' Address ` City '?' l Phone ` 5 'j g? Name u i Addreas ?- city d WW Name Phone I hercby acknowled9e thot 1 hew reod this applicntion ond state thot ths information Is correct ond ogree to comply wifh o!I applicabl* Stote of Minnesota Statutes and City of Eaqon Ordinancss. Slqrwturo of Pemwtta A BuHdiny Permit is isuxd to: oll woric sholl be dona in caordante with ot 8uildtnp Offkiol 10652 Erect Ll Oxupancy Remodel ? toning Repair ? Type of Contt. Addition ? No. Stories Move ? Length t Demolish ? Depth Int Impr. ? Sq, Ft. Install El Aporovals F•es . Assessment Permit +' .. U Z. U I.i ' Woter b Sew. Surcharge 4.'8•00 ? Police Plan Review 15?1 . 50 Fi? snc ?? 5. t? 0 Enq. Water Cann. `? 0 Ci G 0 { Pionner Water Meter = ? - oo Cow+cil Road Unit Bldg. Off. Tr. PL APC ? PerRs- Var. Date ? Co fes P , .. • - ! Tatal on the *xprqs cwwNtlon thai >licable State of Minnesata Statutes and City oF Eopon Ordiewncea. Pwmit No. Pwmlt Holda DaN Telephone #t Piumbinp it/Et--) ? q oIa H.VA.C. _6"y -I ENeMe I _ - 1 ?1 i _ Wfte1w1 InspeMion Oab Insp. Other Footlnya 1 - Footings 11 Foundation Fnming Rooflng - Rouyh Plbq. - ¢? Rouph Htg. Insul. Finplacs Final Htq. 1140 Final Plby. l - -/ • ? Final g Csrt/Occ. ?- ? Watw Dejiflbe Location: Ws11 / a I Sewer ?9 I? W? rtc.GC ? Pr. Dlsp. Reoeipt ' MECHANICAL PERMIT Psrmit No. CITY OF EAGAN Fes • ??,? r) I 4? Fill in numbered spacea S/C ? v -- TYPe or Prinr legiblY Tot 1. Date 2. Installation Cost 3. Job Address- k- Lot BIk. ? Tract `"'• • ? ' 4. Owner 5. Contractor Phone r ? .•-_ "?' ? .'_ . 8. Address <k. `; • i ic , „ ? ? ? 7. City I , ., r- ? K L State -•? ? Zip ` _?, l 8. Building Type: Residential 11. Commercial ? Institutional ? 9. Work Qescription: New >C9. Add O Alter ? Repair ? , 10. Describe ? M • Fuel TYpe 11. (--) n , . No• Equi.pmsui STU - M. Ea. Forced Air" `!C. No. Enuipment CFM . Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg, Gas, Piping Outleu 12. I hereby certify that the above information is true and correct, and I agree to comply vuith a11 ordinances and des governing this type of work. Signed : ? ? =---i-? for ` Rough ? Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 Reaipt PLUMBING PERMIT Pormit No. CITY OF EAOAN Fw flll !n numbered spmaces S?C Type ar Print legib/y TOL 1. Date 2. Installation Cost 3. Job Address ?? '• Lot Blk. Tract i 4. Owner ? r 5. Contractor Phone `' - -J 6. Address 7. City ir , State ? Zip 8. BuildingType: Residential,Q Commercial ? Institutiona) ? 9. Work Description: New tQ Add O Alter ? Repair ? 10. Describe 11. No, ? Fixtures Water Closet No. Fixtures l/D i fi C ld Beth tubs ra n e eSSpoo $eptiC Tank ? Lavatory Softner Shower W ll Kitchen Sink e Urinal/Bidet Oth Laundry Tray er ? Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets E 12. 1 hereby cartify that the above information is true and correct, and I ayree to oomply with all ordinances and codes governing this type of work. Signed: T for Rouqh Final Inspsctions: Oste Inap. Date Insp. This is your permit when numberod and approved. Approved CITY OF EAGAN 4544100 1 CITY OF EAGAN 3830 Pil t K WATER SERYICE PERMIT o nob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: ZoninQ: . No. of Units: Owner: Address: Site Addrcss: Plunber. AAetar No.: -- Connedian Charge: 1e' *r .?coount Deposit: ' ' • Reader No.: Permit Fee: Igone fe aowqly +?Nr fw City of Eown Surcharge: OrAwono». Misc. Charges: - - Totol: . . By Darte Potd: Date of Insp.: Inan.: TY OF EAGAN 30 Pilot Knob Road 0. Box 211q9 gan, MN 55121 yrM to eanPlq wil6 !w Ci1p oi Eegow By Dcte of Inap.: 1..... • SEWER SERViCE PERMR PERMIT NO.: DAl'E: . No. of Units: Connection Chorpe: "' - Account Depostt: Porrrdt Fae: Surchorpe: Misc. CMrpes: Totol: Dots Pold: CITY aF EAGAN WATER SERVICE PERMR 3830 Pilot Knob Raad P. 0• Bri,i 2ir199 ' PERMIT NO.: Eagsn, MN 55121 DATE: Z°hi^D: _ No. of Units: Owner. - Acldr+eaa: Stte Addross: ?.i. ? ` ? ? .. ,? • ? Plumber. j-: • n r 3 S" x iLltlC: 1 L ` , Meter N o.:? S Cormection [?wrge; Size: AcReacler No.. M ?1 ' ' OOUn? Depa?it: 4 Permit Fee: aNM h amlo? wNl? 1iR ?ih ?n Su?chory?e; ? ry e ` 1O°0? Misc. Chorpes: ? ?TotoL• By Dote Paid: Daee of Inap.: Irop.: I r ` sr. - ` CITY OF EAGAN N° 10 6 5 2 . ?? 3830 Pilot Kerob Road, P.O. 8oz 21-199, Eagan, MN 55121 lt?, PHON E: 454-8100 BUILDING PERMIT Receipt it Te M wW !er SF DWG/GAR Est. Value $56,000 pam JULY 29 19 85 Sitenddreu 4323 FOX RIDGE RD Lo< 15 Block 3 c.ISub. SUN CLIFF STH Parcel No. Nan;e GRAND OAKS DEVELOPMENT CO ? Addrms 1881 SUNRISE CT city EAGAN Phone 452-8934 0 EV uS? f Neme SAMF' Name City Phone Phane 1 hereby eckrrowledge rhat I Iwve read this opplication and state thae the informofion is correct and agree to comply with all aODliwble Srota of Minnewta Stotutea and City,oR Ea9nn Ordinances. Sipnaturo of PermiMee r ' ? `?- A Bu+lding vermir 1: +ssoed to: GRAND ,t5 dl work shall be done In accordonee wit pp' i 5 of Buildinp Officiol e.ea 91 aoocancv R3 - - Hemodel ? Zoning RZ Repair ? Type of Conat. V Addition ? No. Stories Move ? Length 46 DemOlish ? Depth QQ Int Impr. ? Sq. Ft. Install ? A00/oralf Fees Assessment Petmit a -? v?. Uv Wafer 8 Sew. SurCharge 28.00 Police Plan Review 150.50 Firo snC 525.00 Enp. WaterCona 500.00 Plonnpr WaterMater 63..00 Council Road Unit 280.00 Bidg. Off. 7/29/8 rJ Tr. PI. 132.00 APC Parks Var. Date Coples rotal $1a Q 79 - 50 ENT CO on ths axprcsf conditlon tMi j?ka S tutes cnd Ciry ot Ecpan Ordirwncet. Thfs request voitl ia rrionths (mm . - L-15.3 3 S Reques[ ate . ?f Fire Na. Rough-in InsUection R qwretl? fleady Now'Jill Nolify InsOec- E] / ? Yes ?NO ?nr When Feady VLicensed Becvical Con[ractor I hereby request inspection of abova ? Owner eleclricel work installeE at - Sueet Address. Box or Foute N c,? ?3a 3 o /? / Cfty C-7 .e / K aa cZy 'g e A.` ecLOn o. Lo f Township Name or No /5 l.5lk 3 S an e o. q - s Counry Da /a ?•? OccuV??? IPPINT) ? Phone No. 2-f93y y5 a a s ; Pov,?ae SuPVI/er ? , Ic a U. Address F o t ?,y ElecVicaJ,pqpUaoy mpapy Na oJ/ ??/ C?r'nct?r's Lic?n No. ? ?r ? ; 3 / Mailmg Addrass (Con[ractor Owner Ma ng In /?yG 7 staila[io S ? a AutAori SignaIDt (Contr?ng Installation) Phon Number MINNESOTA STATC.QOARD OF ELECTRICI? THIS INSPECTION qEQUEST WILL NpT GriB9s•Midwav Bi? - fioom N491 // BE ACCEPTED BV THE STATE BOAftD 1821 Univarsity Ave., St. Peul, MN 551U6 UNLESS PROPEN INSPECTION FEE IS Phone (812) 2972111 ENCIOSED. REQUEST FOR ELECTRICAL INSPECTION - Ee-ooooi.oa Sea instmctians lor comoletin9 this form on back of yellow copy. u: .? •?1 v??' ?? ,i ? "X" Below Work Ce?py?? This Request tl Nap. Type of Builtling AoPl.oncea Wired Equipmenc WireA Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Bullding . Dryer Electnc HezLn Commercial Bldg. Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tank Farm ther peci y ?hF:r (SUecifvl Ihe, UecIfy t er Othor Compute InspeCtion Fee Below N Fea SarviceEntranceSize q Fea Peaders/SUbfeeders N Fee Circults4 D to 200 qm s 0 to 30 qm s ZZ 0 tn 30 Am - Above 200 qmps 31 to 100 Amps 31 to 100 A s Swimming Poof Above 100_Am s Above 100_Amps Transformers Irngation 8oom6 PartiaL'Other Fee Signs Speciai Inspection 5 / TOTA Remnrks ? ? L FEE ? RouBh-in Date ? ` ? /i?y , the Elecgq Inspecbq certilv tha 1 Final r ? Dnte,?C 16 ?./' spection ma0e. this requeat roltl 18 monllu from C. R. WINDEN & ASSOCIATES, INC. IAND SURVEYORS iei 646•3644 I39I EUS715ST., 31. PAUI, MINN. 85108 FORS GRAND OAKS DEVELOPMENT -304') NOTE: O Denotes Wooden Stake Proposed Garage Floor E1.= 9/G,q (9/6.1) Denotes Proposed Finished Cround E1. --10*- Denotes Direction - ? Of Surface Drafnage Vertica2 Datum - N.G.V.D. 2929 S .112 0 'v ? x 49 n'? ? O / . .4- ?y . ? - U ? Q\ \ ti IV ; ,. . ?? ? 1 i? % i Bearinga Are Assumed Scale: 1"=30' o Denotes Iron Monument ? ?v6,, ? - Fo s o /?? e°6 •• ????',?r I w 1 0 'y \ oGS 40 ? ? 4?1 l ,,e 5..? \ iQ / ?? ?' ? / ? tv N 41 v \O Lot 15, Block 3, SUN CLIFF FIFTH ADDITION, nakota County, Minnesota. V V? ? WE ME*EI11 CERTifY TNAT TMIS IS A iRUE AND CORRECT RfPRESENTAf10N Of A SURVEI' OF TNE WUNDARIES Of TME IAND A60VE OESCRIBEO AND Of TME LOCATION Of All WItDINGS, If ANY, TFIEREON, ANO All VISIStE ENCROACMMENTS. II ANY, FROM OR ON SAIO LANO. Deled t6n-z Z=-dey ef?A.D. 100S C. R. NDEN i ASSOCIAIE; INC. br SyrrorN, MinotoNN RO'Ifl/OIIM No. 7714. ?3dti ? A-6-1 /6 6 V 0-? O 6 I1985 Bl1ILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS 14UST BE LICENSED WITH THE CITY OF EAGAN ? n ? INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: Date: ? 26 -6?.5 Site Address: ? ?USE ONLY Lot: P5 I Block ?j Sect/Sub S Erect x OccupancY Wi Remodel Zoning ?-? Parcel Ik Repair Type of Const 7T Enl arge _ o Stories 1d Owner ?? ? -?yXY?/,?4. ? Move _ --T?7 Len gth Demolish Depth 4p Address Grade Sq Ft City/Zip Code Phone Contractor Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone ll APPROYALS Assessments Permit ?p I. °° Water/Sewer Sureharge 13-a."' Police Plan Review ?Sp.SD Fire SAC 525.!-D Engr Water Conn S Planner Water Meter (03.°? Council Road Unit 20C'.= Bldg off7 arks APC Treatment Pl Variance TOTAL ??, S Cy EXTERIOR ENVELOPE AVERAGE 'U' COMPUTATION GRAND OAIC5 DEVELOPMENT COMPAIVY MODEL N2 AREA U U X AREA REQUI RED 1. TOTAL WALL AREA 1600 X.ii ' 176 2- TO7AL ROOF AREA 924 X.626 24.024 ACHIEVED • AREA U U X AREA A. WINDOW AREA 123.77 .17 44.r4Wd B. DOOR AREA 39.8 .077 3.0646 C. SLIDE GLAS5 AREA 13.44 .48 6.4513 D. FIREPLACE AREA. O O O E. WALL FRAME RREA 160 .041 6.56 F. NET liAtL AREA 1070.94 .049 52.47851 c'. R.N 1c?IST Ae+'£R 106.24 .0436 4.63--t}64 H. FOUND WINDGd AR£A O O O 1. FOUND A90VE GRADE 85.76 .135 11.5776 3. TOTAL WALL AREA 1600 146.6490 J. SKYLITE 0 . 0 O K. ROOF FRAME 92.4 .032 2.9568 L. NET ROOF AREA 831.6 .025 20.79 4. TOTAL ft00F AREA 924 23.7468 SUM 1.+2, ? 200.024 SUM 3.+4. 170.3958 I ' 2/84 CITY OF EAGAN 1uu APPLZCATI0,7 FOR PERMIT -"' SEWER AVD/OR WATER CONNECTIODi (PLEASE PRINi) 1) PP,OP= ACDRESS: N ? 7? 3 ?D'X ? t ' _ c \ c Cl Ac? c? c Q =AI, DE_.S?'I'ICV: SC"nC?i?? S (Ict /Block/Su;ciivisicn or Ta:ti rarcei I.D. NL:. Der) ' I'r' E:IS'::::, S??=^;'tF., G.ai?. 0_° Ci2IGi^.L7?L uUI`uP.L`:G =%'Ill ISSI:?\C?: R-1 SZ:CL: :?•.r1LY ' ? R'2 CLY?? (T'a L21I--S) ? r't-3 ':Ci•.1?-(vrcr (rzT.:?c.? + L:i^:S) { tti?"'c) . ? '.'.-4 Lv?: .m`G?`?:T?/?:J..l?,i.7T?^'1.1 ? ?JiVi_?/ Q CCi-Ly=RCT_:-S.i^.2E:csI:?OcFIC: ? ?MUs; Ps: L ? ?:SiI ?'?'I??ia2./G?v.=.: ?n?;: 2) A7P?.IC_1.7i IPLEdSc ?Ritif) NPl•?' ? ra ar-D?.ss: ig C CITY, ST,=-, ZzP: ??G?„ ?nh s-s`?? a PHoNE: y - - 3) PI.c-s?..? ?1 "- •?'.ir?rlli?'IN I ?" FUR CITY USE GtiLY ADDHESS•? 4.???? I'?} ?•? "" PUJMBER -LICE45E: CITY. STA:'E ZIP l Activ E ' d .. _ , z re . PHOVE:- ; .?{ y ? t of Record u ? ? ' dtT :n1S1ai ql TgiiIIE: ADDRESS: CI?"S, STATE, ZIP: tYLLHJC YNliil) PF:O`IE: 5) INDZG.TE :dHICH PE.Ri•1IT ZS BEI.:G REQUESTID: =+^IF.CPIOy TO CITY SETrIc"f. ? Cl7_::IFFCrIC:I 'i0 CITY S•TAT'T2 ? ='fR (PLG'LE DF CRIBE) 7) SIC7,2L-RE: Q P*.---?SE f?OID r1PPP,01ED PER."^ST FOR PICi:-Uc BY CNE OF AEGVE 7 ?RO1iMJb.ssi?rtal??sfcA??a'+t -. .•. S. • o? ?ia? N? If is ?i'.i a! Y[l?a? eyls ?I'I?I IQ ti[ ???? F 0 R C Z T Y U S E O N;, Y P' p??jm u TSSUED . F°::.S : $ p Sl? $ $ (? n ?J $ $ $ A? , $ / \^GJ s ? ?,,?• s $ $ $ $ $ $ Lp c^- o r?c-?..Tm T,•,..--'?? o?_•?^ E) .ic.. ..__ ' ? -:i_.......,... Sli..?...._.., WATE7 PE:2;lT? i, ?:D: SuRC?:l:Gci W.1TER METER/COPF°-::ORN/OUTSID° REA:JER SdATER TAP (ZNC:,L'DE CORPORAT_O:I STCP) 5: WcR TA? ACCOuNT D.°P^SI'^ _ :.:A'^=R Wac sAc TRu?Iti C7ATE3 ?,5SE55:'.E::T TRu:4K SE:':c3 >S:ESS}i°Ji:' LnTE3.iL n[.:vE:I`I'/m?L':lK SEt-= LA:cR-lL Br.Vc,:IT/'.^nU:1K i,iATz'R WATER TREATMPNT PLANT SURCHARGE OTHER: TOTAL AMOlit'T PA1."i/Rzr=y= _ n _. DOES UTI:.ITY CON:IECTION REQUZRE EXCaVATZON I;I PUBLIC RIGHT OF SQAY? -YE ? ZF YES, THE:1 A"PE3b1IT FOR ^70Bi: WITHIN PUBLIC ROADWAY" MUST BE ZSSL'ED BY THE ? NO ENGINEERZNG DIVZSION. LIST AS rl CONDI- TION. SUEJECT TO THE FOLLOL•7I.IG CONDITIONS: APPP.OVED BY: TI': Lc : • DAT° : .o t=?m o"m wm w w'" w w oc+ wEft pe W-M Ia04 §'tm wF = sa loj+ w? RM ia ar m m For Office Use j Permit O 7 j City of Eap I I I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: J 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: U y 9 Site Address: X Tenant: Suite - RESIDENT / OWNER Name: ei Phone: Address / City / Zip: l~ 3~J~ Applicant is: Owner Contractor TYPE OF WORK Description of wor~~~ ` KQ~I~'e2 Construction Cost: 0&0 Multi-Family Building: (Yes / No CONTRACTOR Name: License#: e2®.~;' 6se7c) Address: City: Q 1e~ State: Mpu Zip: !~z /3 Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x rz~' e Applicant's Printed Name Applicant's Signatur Page ,1 of 3 Use BLUE or BLACK Ink I For Office Use p a er. { I City of Ea P mit a~ J E I Permit Fee: 3830 Pilot Knob Road { Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Tenant: l"!v'~y Suite RESIDENT / OWNER Name:, ; 1/'c ' i\ 4w L. Phone: Address / City / Zip: 51 Applicant is: ;X Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: j71 License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 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. ( ? ``7 X X Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink r For Office Use Permit 13 . l` 13q City of Ea Edii ; Permit Fee V/ 3830 Pilot Knob Road I 1 Eagan MN 55122 I Date Received: 1 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - ' ~1 Site Address: "t 3 ! ; X K%~ Unit ~I Name: eN~~~~r fir' ~Z Phone: (05~ fo2 ~7 -a118 Resident/ Owner Address/ City /Zip: T~7 K a vt Apt a V_ C/ Applicant is: Owner u Contractor ~e - ~r e ' J! C Q e ~r atSU ti S' Description of work: Type of Work Construction Cost: ©D Multi-Family Building: (Yes / No Company: Phe5Tde/ ll-Vct.1 lAr•S~~~CNc~. ► Contact: 12uxscal • `e(AKA ✓-S Address: l )k±0401 / "-C /V City: ins/ Cj' a t Contractor 01 State:- ' Zip: Phone: -7~p "'t 70 License 1 J Ci (9 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x PAJIX 11 VAt J Lwe V's x Applicant's Printed Name Appli ant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA137623 Date Issued:07/13/2016 Permit Category:ePermit Site Address: 4323 Fox Ridge Rd Lot:15 Block: 3 Addition: Sun Cliff 5th PID:10-72979-03-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jennifer N Portz 4323 Fox Ridge Rd Eagan MN 55122 (651) 214-8984 Holmin Heating & Cooling Llc 3432 Denmark Avenue, #228 Eagan MN 55123 (651) 405-3853 Applicant/Permitee: Signature Issued By: Signature