4276 Maclaren Pl
Use BLUE or BLACK Ink
F o r Office Use.
City of Ea Rd ~ I Perm it#:
C~
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /0 Site Address: ZG -v /.;rr -G-
r~
Tenant: Suite
RESIDENT/ OWNER Name: Phone: C~a
Address / City / Zip: 4~z --7-4 "111J",ti / ~*-c-r--
Applicant is: Owner X Contractor
TYPE OF WORK 4
Description ofwork:,,,&~~Is-,^~.
Construction Cost: Sam `J Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address: ~ n Z / 30 City: „0<4e/1 V
State: /Zip: 47 X21 Phone:" zZ~
Contact: ;e Email:
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 z " , x
Applicant's Printed Name Ap licant's Signature
Page 1 of 3
All,
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 ate
Valuation OOD Occupancy At - I MCES System
Plan Review olt Code Edition 2467N5$e- SAC Units
o_ Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings / Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) final / C.O. Required
Footings (Addition) ~inal / No C.O. Required
Foundation HVAC
Drain Tile Other:
/Roof: -Ice & Water -Final Pool: Footings -Air/Gas Tests -Final
V/ Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: - Footings - Backfill Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
.MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
For Office Use
Permit
City of Ea a~
I permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff: I
I
6
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /d Site Address:
Tenant: d~~,t u>Soe^ Suite M
RESIDENT / OWNER Name: )Phone:
Address / City / Zip: `J7- g ,1~~ J~Grti O / a c
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: S'°"Aoo Multi-Family Building: (Yes / No L~_/)
CONTRACTOR Name: ,c License Z41- 380. 5^
Address: 1''7x- " 7_41 0 City:
State: Iw/U Zip: 04 Phone:
contact: e/ iQ Z'),s' Email: w
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.
Applicant's Printed Name Ap cant's Signature
Page 1 of 2
CASH RECEIPT
s ?.
f ? CITY OF EAGAN P. O. BOX 21-199
EAGAN, MINNESOTA 55121
owre 19
RGCi1V6D
FROM
AMOUNT
$
& DQLLARS
+oo
? GASH ? CHECK
FOR
FUNG CODE AIAOUNT
E?
Than k
u
? 13Y
f
I
White-Payers CopY
Yellow-Posting Copy
Pink-File CoPY
No.
PERMIT
r w d
Biock5-Sec/Sub. NARTEiVSSIi 14P!_A11Q
Name w88L81 C:VP15T!(U%:T1VX i?IC
? Address 9401 XYLON 11VE 80
City BL?" Phone 944-76-92
? Name SAM
Ri Addresa
Name _
Addresa
.? CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 4548100
Phone
9854
/
Receipt #
Erect ? Occupancy 2
Remodel Zoning ii1
Repair ? Type of Conat. b
Enlarge ? No.Stories
Move ? Length Ly.
Demolish ? Depth
Grode ? Sq. Ft.
Install ?
Assessment
Woter 8 Sew.
Police
Firo
Enp.
Plonner
Council
Permit !
$urchorye _
Plan Review_
SAG
Water Conn.
Rood Unit
I hereby ockrawledfle fhat I hove read this opplication ond state that Bldg. Off. 1 14 8S T.p.
the inlormation is correct and ugree to comply with oll opplicoble APC Total ?
$fata of Minnewta $tatutes and City of Eogan Ordinonces.
Var. Date
Sfarwture of PertniMee
N Building Permit is iss„ed ro: MaBI.$Y CODISTRdCT20N IIIC on eha express c
oll work shall be done in atcordonce with oll applicable State of Minnesoto Starutes and Ciry of Eapan Ordii
8uildinp Offidol
Phone
- Pwmk No. hrmk Holdw Dob TNepbom i
Plumbhp c '?
, ? -
H.,,A.C. 5? Se
E?o ?olo Jj? - Tec,?
sofc.n.r
Inppeetion Dab Insp. OthM
Footinf
Foundation
Fnmhq ^,? _? ?
RooNny
Rough PIbF
Rough HVA -fW-JF6 4D/l [.i?.i• ?`' ..tuft?
Imubtfon
Find Mby.
Fiml NVAC
Find 42?-Y;' "Ne
(:wt/Ooe.
Wwr Dweribe Loution:
Wrll
Sfw*r
Mr. Dhp.
.. . .. , ...•r,c.r, `}y`:' .
CITY OF EA
i- •=? 3830 Pilot Knob Road, P.O. Box ;
PHONE: 454•
aUILDING PERMIT
To be used for BAISDM FIMSH Est. Value $1,500
Site Address 4278 MACI.ARBN PL
Lot 7 Block S SeciSub. NORTNVIEN HEADOW;
Parcel No.
w Name DAVIll A LAHR
o Address ? N PL
City Phone 454-0706
, o Name ? Ci.ASSIC B[lILDERS
Address 1489 HOL?ON ST
00141
City ST pAUL Phone 642-0128
Ww Name
uW
'; Address
¢_
a W City Phone
I hereby acknowlege that I have read ihis app
information is correcl and agree to com ply w
Minnesota Statutes andCiry of Eagan Ordininc
I ?
SignaWre of Permitee _??"
tion and state Ihat the
all applicable ?tate of
t E]Eir C1.ASSIC !
A Building Permit is issued t6:
on the express condillon lhat all work shall be done in acapplicable State of Minnesota Statutes and City of Eagan
Building Official
Eagan, MN 55121
Receipt #
n..+., OCT 18
; .? t846Z
,
with all
OFFICE USE ONLY
Occupancy - FEES
Zoning - ?
35•?
(ACluaq Const - Bldg. Permil
(Allowable) -
Surcharge ?
1'00
# of Stories -
Lenglh _ Plan Review
Depth - SAQ Ciry ?
S.F. Total - SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC Syslem -
aca. Deposit ?
Ciry Water _
PRV Required _ S/W Permit 9
Booster Pump - SiW Surcharge ?
Treatment PI ?
APPROVALS Road Unit ?
Planner - park Ded.
Council
C 2.50 ?
eia9. on.
- opias
t; . 5(?
?
3
Variance - TOTAL
r
, Permit No.
Permit Holder
Date
Telephone #
WATER
SEV&EF '
PLUMBING AG a*?
?.
?(
s 8 °x?
?
H.V.A.G ? C i(1
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framirg
Roofing
RoughPlbg.
Rough Htg. ?G S y^ .
Isul.
Fireplace
Final Htg.
Final Plbg. Q
Const. Meter Plbg. Inspeclor - Notify Plumber
Engr./Plan
BIdg.Final 4?c ttD/0 %7?7U?C-
Deck Ftg.
Deck Final
Well
Pr. Disp.
Receipt MECHANICAL PERMIT Permit No. ?,_,?;_T
CITY OF EAGAN
Fee
fi!l in numbered spaces S/C
Type or Print /egibly Tot. 1, Date " 2. Installation Cost
3. Job Address ? ZLot Blk. Tract
. .. .. i` .
4. Owner
5. Contractor Phone
`?7
6. Address
7. City. State Zip ..
8. Building Type: Residential Commercial 0 Institutional ?
9. Work Description: New a/ Add ? Alter C1 Repair ?
,
10. Describe. ,'-?^. ? - : : 'F •:,??, , ` c . Fuel Type .; -
71
No,
?-' Eauioment BTU - M. Ea.
Forced Air No. Equiament CFM
Ai
H
dli
_
Mfg. r
an
ng:
;
Boilers
_
Mfg. _ Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
_ ?
i' 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
PEFMIT
MECHANICAL PERMIT RECEIPT # ?
CITY OF EAGAN C
3630 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
PHONE: 454-8100
Site
Lot.
ffi
?
y
c
..
m
c
3
O
?
?- !v
d6ress `y s_ ?c? : ,?•; rvc f_.U71 " Yc.r BLDG. TYPE
,Block -T Sec/Sub Res.
e.l`ZE.L_ E_G1J{lA)!C l,. Mult
Name
Address A14jWA_)C_t_ p Comm. -
Ciry .=s1!•ia.ti? Phone"S2. /? T- Other _
Name
City
Phone
TYPE OF WORK
Forced Air M BTU
8oiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other ri!?fALAI'f
FEE:
TOTAL•
WORK DESCRIPTION
New
Add-on
Repair
FEES ?
RES. HVAC 0-100 M BTU -$24.00
2-- ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMin - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00 ?
MINIMUM COMMERCIAL FEE - 20.00 ?
STATE SURCHARGE PER PERMIT - .50 =
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
?
f2 ?, ry ,
? ? SIGNATURE OF PERMITTEE ?
; Z, So
FOR: CITY OF EAGAN
Receipt PLUMBING PERMIT Permit No. V/
CITY OF EAGAN ?-T
Fee.
? Fill in numbered space.s S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
I.'7 A oT < a (r
3. Job Address'% )-7? /') C L J1('A"L0t ? Blk.,j Traci f/' -,- ,'-
„
4. Owner
5. Contractor /3/1 tl /it 1?-t / . Phone
6. Address Q / ? ^ ? ? ? (. r t `? '
7. City??/ (1 fTr( Sf? / State ??/A" Zip 8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New k Add 0 Alter ? Repair ?
10. Describe
it.
No,
? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
? Bathtubs Se
ticTank
= Lavatory p
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 Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
a PLUMBING PERMIT For City Use Only
', , •, • '' CITYOFEAGAN PERMIT#
CONTRACT. 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT#
PRICE PHONE 454-5100 DATE:
[ Lot
nre? L3/
? Address !W 7(ielac.4
c City Phone
Oc Address y, 7Ej r•a- LnrA- !>/...
8 City Phone
FEES
COMM./IND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT 50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
FOR:
BLDG. TYPE WORK DESCRIPTION
Fes. _y New Const.
Mult. Add-on ?e
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
I Water Closet - $3.00 $
Bath Tubs - $3.00
_ Lavatory - $3.00
_ Shower - $3.00
Kitchen Sink - $3.00
_ UrinaVBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whiripool - $3.00
_ Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT-NEW C!DNST.)
Softener - $5.00
Well - $10.00
PrivateDisp. -$10.00
Rough Openings - $1.50
_ U. G. Sprinkler System - $12.00
PERMIT FEE: /??
STATES S/C: 150
GRAND TOTAL: /02 S0
' INSPECTION RECORD
CITY OF EAGAN ' PERMIT TYPE:
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
,t t ?a,{ N f'I
. . . , i! i.l' ..; i•PERMIT SUBTYPE:
'. I 1 nll?i 1 Ni?i!
Permit Number:
Date Issued:
APPLICANT:
„ tt
TYPE OF WORK:
, i i? I t "?i
lttS } { {I f Nf-
i9::SH$N.".
HT 11 1 f??J
ML+::i1?EE aIz r? t I i n N
ur c-l al•r }. t NtAttE
Permit No. - Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Comments
FOpTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PL6G .
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FlNAL
OECK FfG ,1,(r1f-z
DECK FINAL ??/
Cirv oF e,aG,aN WATER SERVICE PERMR
3830 Pilot Knob Road
P. O.. Box 21199 PERMIT NO.:
EaW, MfN' 55121 DATE:
Zoning: No. ai Units:
Ownar:
/lddrcss:
Size: . L-11/ly " NR?ae? nia.: 0 9 L aio 71
1syret M oemplr wMh !M City ef Eeyen
Orlieanat
By
DMe of Insp.:
3?13/ l?5
Permit Fee:
Surchorge:
Misc. Charyes;
TotaL•
Dute Paid:
Insp.:
I CITY OF EAGAN SEWER SER.'ICE PERMIT
? 3830 Pilot Knob Road
I P. O. Box 211'::9 PERMIT NO.:
Eagan, MN 55121 DATE:
?
Zoning: 1 No. of Units: ?
? Owner• ;f'-siea ,3 •i:;t
?
i
Address:
1.7 P5 ;crtl-iie*.a '?eadows
Site Address: `
? Plumber: rsc::m_^
I agre? M eomPy wiN? Nhe Ciry ei Eagae
Ordinanees.
w
Date of Insp.:
Connsction Charpe:
Account Deposit: V
Permit Fee:
.?:
Surcharpe:
Misc. Charpes:
Total:
Date Paid:
CI7Y OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 217'99 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: - No. of Units: ?
Owner: .e9i??:7 Ccr?iSt
AAd?GSS:
Site Address• ,'7; '<flc,.srei: i ?,' cri.:zv#ex, "r_•F?;oirs
Plumber: ?el"3ar ,
AAeter No.:
Connection Charge:
Size: Actount Deposit: ? -i ,
Reader No.: Permit Fee: 1''
1agne M eanPl?r wilM H?e City of Eayan $urcharge:
Ordinanew. Misc. Chorges: 1 32. ;1r1 n-i
TotcP ??d s.?.,ter
BY Dote Paid:
Dote of Insp.: I?,;
y7•.?.3? ConnedionCharye:
a-??ti. , ' Arrnunt D'nrieir• . . ..
CITY OF EAGAN Remarks
Addition NOR7'HVIEW MEADOWS Lot 7 RIk 5 Parcel 10-52100-070-05
Owner
street 4276 MacLAREN PLACE Scate EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1984 76.7$ ;L-." 10 (jl 1 A015345 -1 -8
STREET RESTOR.
GRADING
SEWER LAT S 1981 15.89. .79 20 11.94
SAN SEW TRUNK 1981 13$.48 6.92 20 103.88
SEWER LATERAL TR W 1984 .275.22 18.3+ 1-8.rJ 1$ 238.54
?
?
SEWER LAT ? ? 1981 22.28 1.48 }:4-+ -mi5 1.88
WATERMAIN W7 1984 70.67 4.71 15 61.2
WATER LATERAL ZJSS SH.G$ 1,24 12.45
?
WATER AREA 1981 138.48 6.92 20 1 ,$$
WATER LAT J3 1982 29.52 I•41 1-:48 20
STORM SEW TRK 1984 392.32 '18,¢b 49-s^"3? ""5 2 .40
STORM SEW LAT
DRAINAGE 1984 33.9 339 27.1c)
CURB & GUTTER '
SIDEWALK
STREET LIGHT
Road Unit 280.00 #49055 1-17-85
WATER CONN. 500.00 11
BUILDING PER. #9854 If
SAC 525.00
PARK
CITY OF EAGAN N0 18462
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
-7
BUILDING P.FRMIT PHONE: 454-8100 Receipt # cd m 1 /
To be used for B&MM FjNISI'1 Est. Value $1, 500 Date OCT 18 , 1990
Site Address 4276 MACLAREN PL
Lot 7 Block 5 Sec/Sub.NORTHVIEW MEADOW OFFICE USE ONLY
PBfCBI NO. Occupancy - FEFS
Zoning
W Name DAVID A LAHR (Actual) Const _ Bldg. Permit 39. nn
o Address ?+276 MACLAREN PL (Allowable) -
1
00
City EAGAN Phone 454-0706 # of Stories .
Surcharge
-
Plan Review
Length _
F Name NEW CLASSIC BUILDERS Depth - SAC
Cily
=
Q
O AddreSS 1489 HOLTON ST S.F. rotal ,
-
U SAC, MCWCC
? City ST PAirL. Phone 642-0128 S.F. FootpriMS -
W
l
C
On Site Sewage er
onn
a
-
?? W Name On Site Well - W
l
M
t
?;
Address
MwCCSystem a
er
e
er
Q=
aW
City Phone
cirywater Accl. Deposit
-
PRV Required _ S/W Permit
I hereby acknowlege that I have read this application and state that the aooster Pump - S/yy Surcharge
information is correct and agree to co ply w th all applicable State of
Minnesota Slatutes anVity of Ea n O din n s. Treatment PI
Signalure of Permitee APPROVALS Road Unit
A Building Permit is'ssued t: NEW CLASSIC B IL RS Planner - park Ded.
on the express con io that all work shall be done in ac p?rdy^nce with all
li
a
bl
St
f M Council
2
50
i
C
pp
ca
e
ate o
in esota Statutes and City oi Eagan OTdinances. Bmg. Ofl. .
op
es
_
Building Official ?M4 A,Q,df? nX Variance _ TOTAL 38.50
CITY OF EAGAN N 0- 9 8 5 4
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
DUILDING PERMIT Receipt # -
Tk bN wad im SF DWG/GAR Est. Vniue $ 61 ,0 0 0 pate JANUARY 17 , 19$,L
4'276 MACLAREN PLACE
Site Address
Erect 6a
Occupancy R3
NORTHVIEW MEA
Lot 7 Black 5 sec/Sub DS Remodel ? Zoning Rl
. Repair ? Type of Const. V
Parcel No.
Enlerge ? No. Stories
Move ? Length 4 7
? Name ?^1ESLEY CONSTRUCTION INC
D
h ?
h
D
=
9401 XYLON AVE SO emolis ept
_4 A
? Address Grade ? Sq. Ft.
City BLMTN phone 944-7092 Install ?
? Name SAME ApProvals Fees
•
F -
Address
? City _
?W
?W Name _
zZ Address
Phone
City Phone
Asseument _
Water 8 Sew.
Police
Fira
Eng. _
Plonner
Countil
Permit
Surchorge -4 () -S 0
Plan Fieview 1 5 R_ 0 Q
snc s2r; _n0
Water Conn. S (1(1 (1 p
Woter Meter 6-4 ? 0
Rood Unit 980 n p
1 hereby acknowledge that I hcve read this opplicotion and stote that gidg. Off. 1 14 85 T. P 132 _ 00
the inlormation is correct and agree to wmply with oll applicoble
APC Total $9_ f1(1 d_ S fl
Srote of Minrxsota Stotutesy of Eagon Ordinonces. Var. Date ??
/
Sipnoture of Permittee
A 8uilding Permir is issued to: WESLEY CONSTRUCTION INC on the express condiHon that
all work sholl be done in accordance with all opp' able State nesoto Statutes and City of Eayan Ordinonces.
Buildiny Officiol + o ? -ll ?
???S'
7/?/5?.. REQUEST FOR ELECTRICAL INSPECTION „ ee.ooooi.?
/ , See instructions for completirg this form on 6ack of Yellow copy.
t 44345 Ja Below Work Covered by lhis Request
AAd Rep. Type of Builtling Appliaocea Wired Equipment Wired
Home Range Temporary Service
Duplrx Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatm
Commercial Bldg. Furnace Silo Unloader
Industrial Bldy. Air Conditioner Bulk Milk Tank
Farm OLnNr veci v +hc, isnr.r.iryl
1 rr Uecafy Othcr 01her
ompute Inspection Fee Below
M Fee ServiceEntranceSize q Fae Fer.ders/Subtaeders # Feu Circuits
0 to200Am s 0 to30Am s 0 to30Am s
Above 200 qmps? 31 to 100 Amps 31 to 100 A 5
Swimming Pool Above 100_Amps Above 100_Amps
Transtormers Irrigation Booms Partial-"Other Fee
Signs SUeciai Inspection S
TOTAL F
Remark
;7U * J
Houeh-in D
?
e I, the Electrical
?? ? e
s
!T InSPeclor, hereby
certify that the above
Final ! Date inspection has been
?? "
• de.
??'l . ?
r d0
Thfs repuest void 18 monthe Irom
This request void
18 mon(hs from . ?
44345/-7??
Rnquest Uatr Fire o. RouPh-in InsVection
?/????? Rr,q?uired? ?Aeady Nuw ? WiII Notify, Insuec-
yes ? No r?' to< <'llhen Ready
[:1 Licensed Electrical Contractor I hereby requestinspection ot above
ROwner electricel work instaliad at:
Stjeet Address, Boz or Route No. City
4+;z 746 ?? ct--,
ecLOn o. Township Name or No. Ranee o. Count
S lo? 4? O O n'? Ac
Occupant(PRINT) Phone No.
.? lJ -i? Yf1N6s5A 1,411,0
Powe?r. Supplier Address
,4/iKoT.4 E.4€G-r72r,-- ?4 ,? ??
Electrical Contractor (Company N&me) Cnntractor's License No.
MailinB A.ddress (Con[racior or Owner MakinB Inst ailation)
4a7L L,o,e, /°?? ? F NrA- s5-Ia.3
Authorized Si ature
q tractor/Owner Makine I??stal tion)
(Co Phone Number
`
n
0 +"?-1
MINNESOTA STATE BOAflD OF ELECTNICITY THIS INSPECTION REQUEST WILI NOT
Griggs•Midway Bldg. - Hoom N-197 BE ACCEPTED BV THE STATE BOARD
UNLESS PROPEH INSPECTION FEE IS
1621 UniversitV Ave., St. Paul, MN 55104
pk- 16121 297 2111 ENCLOSED.
C? 3 35 98
REQ?T FOR ELECTRICAL INSPECTION
r yee in3imc?'8ns for completing this form on back of yellow copy.
"X" Below Work Covered by This Request
Es-00001 -07 '
ew
A tl -
kep. ?.
TypeofBuilding
AppliancesWired
EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer III= Other (Specify)
Comm.llndusirial Furnace k
Farm Air Conditioner
Olher (speay) Contiactor5 Remarks:
Compute lnspection Fee Below:
?F Other . Fee # ServiceEntrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Abo Amps
SIJf1S . Mspector's Use Only: / TO AL
Irrigation Booms /J • ? /? ?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DiSCONNECTED 1F NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
th Roogn-m Date
certify
at the above inspection has
been made. Finai oatq-7? /
OFFICE USE ONLY +
This request vold 18 months irom
/a-//v''71gC2 ^ ?`\- •
" ?y.s ??• C?``????
d3 33598 7 -
Request Date
^ Fir o. Rouqh-in Inspection
Required?
?Reatly Now ? Will Notrfy Inspecror
Wh
R
d
?
O?? ?Ves o en
ea
y
I? licensed contractor IgZwner hereby request inspection of above electrical work at:
Job AtltlresS (S?i7reel, Box or Route Na.)
6 A Ciry
T?T `
E'2
Section No.
6?? tv Township Name or No. Range No. Coun
d?
Occupant (PRINT)
64il Phone No,
443-1F-G?c-4
PowerSuppiie??
? qddre? ?
O^h?l
Electrical ConiraMOr (Company Name) Contrector5 LlcenSe No.
Mailing Atltlress (COntrector o ner Makinq Installation)
Authonzetl Sig (Centrattor/0 er Making I alt n) Phone Number
MINNESOTA S7ATE BOARD Of ELECTHICI7Y THIS INSPECTION REOUES7 WILL NOT
Griggs•Midwey Bldg. - Room S•173 BE ACCEP7ED 6v THE STATE BOARD
1821 Universiy Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTtON FEE IS
Phone(612)642-0800 ENCLOSED.
This request void `K/?i/P c7
18 n,on(ns rrom
? 6621?
!
Aa(* n.u
-?
r33
??l? S??-
?enuest uat
Fi e No.
??/[7t>)
?lL7 - - -
Rouph-in InsUection
Requiretl? - - ?-?-
Ready Nuw Q Will Notify Inspec-
licensed Electrical Contractor rIN
_ _ [ . .... wti_.. ..
???y
9zOwner
I hereby request inspection af above
Street Address, eox or
Route No. electrical work installed at:
`f ? 76 i"1?:?. f ??e C ity
F-? ?.?-,
ecuon o. Township Name or No.
?'r?i--lv
flange No. ,
Count
OccuGent IPRINT)
Q
/
Phone No.
.
?
J
P
ower Supplier Address
r r-G(h'''1Lk
Electrical Contractor (Company Name)
Contrnciur's Liccnse Na.
-Szlkl? . _. ._.....e ....,.o.,a.. v. u --1
nsta
MINNESOTp STqTE 80AflD OF ELECTqICITY
Griggs-Midway Hldg. - Xoom N•181
1821 Universitv Ave., St. Paui, MN 55104
'hone (612) 642-0800
`fJ-`( " 07(56
7HIS INSVECTION HEQUEST yyILL NOT
BE ACCEPTED BY THE S7qTE BOAHD
UNLESS PNOPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-0?0?001 06
.? See instructions lot complxting this form on back o1 yellow copy.
[0- 6621 l7 "X" Below Work Covered by Ihis Request
aw rAddl Rep] TYPa o} Building ApPliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
? Apt. Building Dryer Electric Heatin
' Commercial Bidy. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm oiner ne?, v otnrr (srn!,:,rv)
I r.r SVeeify Ot er Othor
omnute lnsoection Fee Below
p Fee Service EntrenCeSizB H Fee FePders/$u6feeders # Feo Circuits
0 to 200 Am s 0 to 30 Am ps 0 tn 30 An s
Above 200 qmps. 31 to 700 Amps 31 to 100 rAm s
Swimming Pool Above 100_Amps Above 100-Amps
Transiormers Irriyation Booms Partial."Other Fee
Signs Speciai Inspection S TOT FEE
flertyrks
9 ? n
/Y
Rough-in Date! I, th Eiectric
10 Insvec e,e6y
cerlity thel the nbove
Final ' e inspection has 6een
made.
Thls requeal void 18 months Irom
p1-REQUEST FOR ELECTRICAL INSPECTION . EB'9000I1 -04?
..: ?
See instrucilons for completing tbfe form on back ot vellow copy.
A???? "X" Below Work Covere?by This Request
d Rep. ' Type of Builtline AppliancesWirad Equipmen[ Wired
Home Range Ternporary Service
Duplex Water Heater Lightin, Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tenk
Farm Ot er Pea y t er (Specify)
t er SUeufy Ot ef Olher
(.0I71put2 lpSpECtIOn l-@E 6B/OW
# Pee ServiceEntranceSize tl Fee Feeders/Subfeedera M Fee Circuits
0 to200qms 0 to30Ams 00 0 to30Ams
Above 200 qm ps 31 to 100 Amps d? 31 to 100 A
Swimming Pool Above 100_Am s Above 100_Am s
Transtormers ' Irri ation Booms Partial- '
Signs Special Inspection g J),...dc) TO
P
Rerrwrks ,' ?
?E_
`j
Rough-in Date
, the Electrical
!' ??sDector, hereby
certif at the above
Final ?q -
? P{ D.rte
Z
r. ? 'spe
ction has been
de.
This requesi void 18 montlre irom
This request void ?14 5 ?.J al ?1 ? 5
18 months irom V
A - 1 1-1 M 10 L°1 g o v ? ?,?,,r wo-ilf-, Lk q. 5 a
Raquest Date Fire No. RouBh-in Inspection
7 Feq ireA7 DReady Now ill NotffY, lnspeo-
pl ???,? Yas ?No lor When Ready
?Licensed EleCtric3l ContraCtor I hereby request inSpBetion of ebovB
]bwner electrical work instelled et:
S7r
UAd dress, Box or te No.
7 6 /?lt.?'?c.tww
City
6
ecuon o.
I
Township Name or No.
Range o.
County
Occupant IPRINTI
W ? ?--
? ?
Phone N 70
? "4?--
e? PD?er Addres5
EI al C tractor (fsmpany Na e) .
? - l s?. C nvactor*s License No.
a 3 rS3?3
Mailine Address (Contracmr .Owner Making Inst ilation) ` 4.L.lL_ „ ? ?
l / 3?7
\.JC? ?
Authred Sig ture (Contrecior/Owne aki n allation) Phone Number
S o -3 l??
MINNESO A STATE BOARD OF ELECTHICITV y ' I THIS INSPECTION REQUEST WILL NO7
Grie9s-Midway Bldg. - Hoom N-191 . BE ACCEPTED BV THE STqiE BOAflD
1821 University Ave.. St. Paul. MN 55104 UNLESS PROPEN INSPECTION FEE IS
Phone 1672) 297-2111 ENCLOSED.
t
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construction Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted afler 711193
• Rim Joist Detail Options selection sheet (bidgs with 3 or less units)
DATE ??
SITE ADDRESS MOU
TYPE OF WORI
APPLICANT ??' "k)Cj -L"211 '
ULTI-FAMILY BLDG _Y N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS??a.?'? N1C?i?? PSV2. C?UIM?V] CITY?'???? STATE ?'NZIP;-1OJ3 I
TELEPHONE ??1`0"?ICELL PHONE # FAX #?Z'??7TtlCJ
PROPERTYOWNER?? P??h TELEPHONE??--'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(J submission type) • Residential Ventiiaiion Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _____
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
------------------------------------------------------------------------------°------------------°---------°-----------
I hereby acknowledge that I have read this application, 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 ? ly4 &V? u
............... ---------------- -------------------- ------- _-------------------------------------------------------------------------- ------------------- ...........
OFFICE USE ONLY
_ Water Softener
Water HeaCer
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodellRepair Reauirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for exterior addifions & decks
. Indicate if home served by septic system for additions
VALUATION? 62)010?
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
^1:T'V 11l- f:::(-1(;Aht
C?SH.CEn. a 4 TERM.[NAi_ NOt 347
DAfE,: 07/11f97 T.E.MI_.: 000:38
T.D ,.
NAM'r_.u rti:!::I-IrllI-1_ ".:: MraOriY
:3i :l.t? 90()1. .ii_''i'F P1rd'I...iaRc:?S 1.=' 50.00
2?..`°! 9001 4276 MA(;1.±AFi{::N t°' 0„50
?
'
?"crta:l. i?????::o-??:i?:?E. (tmount"? 50v50
(;{1it_}78407'
USER ID: NreN{.,Y
%?'t.??.T.?:?'M1•T')?,f??????f+y?.4i:y.?i+.T.? n????*R:?+SI?)i
PERMIT
'CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT TYPE:
Permit Number:
Date Issued:
4276 MACLAftEN PL
LO7: 7 BLOCKs 5
NOR7HVTEW MEADQWS
A.I.N.: 10-52100-070-05
DESCRIPTION:
REPLACE & ENLARGE
ermit Type DECK
?brk 7ype ADDITTON
V434 ALT. RESIDENTTAL ?.,
A?a
?A'r 030 ?N-,wx, ?:s"}'9
'
REMAFdKS:
FEE SUMMARY:
Base Fee
5urcharge
Total Fee
$50.50
BUTLtlING
030405
07f11/47
CONTRACTOR:
F?
!
I
OWNER: -- Applicant -
moonv MICHAEL
4276 MACLAREM PL
EAGAN MN
(612)541-9575
Az? ,
ISSUED . SIGNATURE
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)?
CITY OF EAGAN
3830 PILOT KNOB RD - 65122
681-4675
New Construetion Reauirements
? ?,? • S?
1 `o?
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (inGude beam & window saes; poured fid. design; etc.) ? 2 sRe suneys (exterior additions & dedcs)
? 1 energy calculations ? 1 energy calalations for heated addkions
• 3 copiea of tree preservation plan if lot platted eRer 7!1/93
required: _ Yes _ No -
DATE: 7/2/ 97 CONSTRUCTION COST:
DESCRIPTION OF WORK: EEPt.r4c6 C-x6'r'144 D&U, t,qc,be,-, Ct?W- p£cK
STREETADDRESS: r?-Ae
I '- 1,4,??
LOT BLOCK s SUBD./P.I.D. ??-`??????a,:-???
PROPERTY Name: _1 ' 66y iY `Ic.r".t, ione
OWNER ,M„
Street Address: yZ?6 rnA?Cl4Zr RAO-
City: E4.6aJ State: Zip; .55123
CONTRACTOR Company; Phone #:
Street Address: License #:
CitY: State: Zip:
ARCHRECT/ Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
CitY: State: Zip:
Sewer & water Iicer.Sed plumber (new conshuction only): . Penalty applies when address change
and lot change are iequested once permit is issued.
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 :ZF]
Certificates af Survey Received Yes No Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
.
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
? 03 SF Addition o 08 8-plex
0 04 SF Porch ? 09 12-plex
a 05 SF Misc. ? 10 _-plex
WORK TYPE
,Z31 New n 33 Alterations
o 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length
Depth
APPROVALS
0 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
? sq.ft.
Footprint sq. ft.
Planning Building 4A,-0-
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded. I'
Other
Copies
Total:
? 11 Apt./Lodging ?
0 12 Multi RepairlRem. ?
? 13 Garage/Accessory ?
0 14 Fireplace ?
z" 15 Deck
16 Basement Finish
17 Swim Pool
20 Public Faciliry
21 Miscellaneous
MCNVS System ?
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. ,147.4
SAC Code /1L
Census Bldg ?
Census Unit ?
Engineering Variance
Valuation: $
ti
% SAC
SAC iJnits
F Y'.
fqlqt2
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 5ET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 5ET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNEA MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
j3f?5g?,rr iAJisH 9': , OGT RECD
?
1 Date : 9??IS O
To Be Llsed For; ;/rt .?GC? Valuation:
Site Address rfa% f(a.c?¢ti/D?ic.e
Lot ? Block b'>
Parcel/Sub i'1,? 1Fi?AA) T?,Q,OflmK" 11A
Owne r A111'1,-co A- /-Q Ad-
Address ?F?2 ?6 /`(qr ?c,r i,,.., ?ac e
City/Zip Code
Phone ?,??'0706
Contractor /??cr-C-lc??SrC ?cu`?GQ2P`S`
Address `0 r?, 5?
City/Zip Code 0C?p
Phone f? ' de?
Arch./Engr.
Address
City/Zip Code
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off. la/l
Variance
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit'
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
.? ? C70
---/?Q ?
20,5'-0
3.0
Phone #
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL COHTRACTORS MUST BE LICENSED HITH TBE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: S•F?? % Valuation: (ol,ocJD• '= Date:
Site Address: OFFICE USE ONLY
Lot: ? Block S 5ect/Sub???? Erect X Oceupancy (Z-55
Remodel Zoning Q-I
Parcel # Repai.* _ Type of Cor.st ?
Enlarge dk of Stories
Owner -Move , Length
Demolish Depth q-?
Address 9??fJ/ Grade ' Sq Ft
City/Zip Code ? - ---------------------------------
Contractor
Address ( `4 ?Z'
City/Zip Code
Phone #
Arch./Engr
Address
Phone #
APPROVALS
Assessments Permit
Water/Sewer Surcharge
Police ?
Plan Review 158. =
Fire SAC
Engr Water Conn ?.=
Planner Water Meter Ca3.?
Road Unit
Council ,
? ZSO.°
Bldg Off ?V?? `
?/,Q
yjjParks
APC Treatment Pl l32•°?
Variance
TO7AL
.. •
. ....?„R'.` ..
?
?, ..
1
?
F..
,t
S I TE ADDRESS
CONTRAC70R PFIQNE
Reterinine working square `f!ootage of` pach. `. `
1. To#aT expased "Al l area ... .. , sq. f,t. x ?-31_
2. Total roof/ceitirig:a.rea ...... sq. ft. x_626
Total exposed wall area above
a. Total wall? window area........... ...::... `.......
b. Total door area ..... .. ...... ?. ' ...... 7
.. . . . . ; . . . ??
?L,
7
.
_.
c. Total sliding glass door area .. ., ...... ..
d. Total fireplace wall area........
................
e. Total wall framing area.(average 1QX).............
f. Total net wall area ebove floor :.,..... :......;
.
g Total rim 3ot . /??
st area ............ ..:..., :.... .
Total exposed foundation area 118y
h. Total faundation window a,rea..,...., ,. .....
i. Toat net foundation area abowe grade .. :..... ,
, .. . .. . ,.
Oetermine "U° value cf each ?valt segment.
a. x liusi .27
b. i? X „u„ , I.23 _= y Gs
C: 6a X „u„
d. X uUu
e. x „u„
?
? f. /ol/, 5 3 x IluN
g• X "U"
h? ? X nVn _
x „ti,l°?
3: ...... . .......> ................ .
' • .-; 4 . ^ ? r d i d'R
( .?? 4 y ' j+fA S . ?IY y?ty ry . P
'
! ` C
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l
?
• Me iJ%, 0i
. .
Th
>
. ?
f
.
fratsie tCit?isti"s6tiaiti . .;.
??-
_-
R-Value
?
?
;
,,
.
?_
. , ?
?• ; .
, 2 •
3.
-
eAsic
: wALL Total
. r >r _
? .
? FIG. #1 ?
. ? ?? . -. .
,
S
r.; .
. - _. , .. . . .
FRl1t?- iiAyL ?
l. : r?ar .at r fil.an 0.68
:.
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wa. ?r.??w
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,
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c: a 1 ? ^? ,,
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' ?' -4-;'-^•%?
-•=- ' ? erior air film
1. Int 0.68
,
W,aiDATICN '?' ,
• A p •'
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: k?4
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•':
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-
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. t,O'1`Es' Indich,te typ@. value
;. _.. - ?.
' , depth and
?
' "
K. «
, • insulatiorf.
g3,acoment ; .
?
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,
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vmrr
,
;w?
, Fxc. #s •
?
1. Interior a film 0.61
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J CITY OF EAGAN
% APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIODI
(PLEASE PRINT)
1) PROPERTY ADDRESS: 'T L 76 /? C? - 44
LEGAL DESCRIP`I`ION: 1-0' ,?L,J G,? ?-.?' ,rrr2?.1T"'
(L ot/Block Subdivision or Tax Parcel I.D. Nunber)
iF EZI ;'?"= :C STRLC'?"u:?, DATE Oz' ORIGILIIAL BUI=L`,'G F;-:1i' I55v'Ai`;
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R-'1 S! IGL,"r., FP',TT
? R-2 DUP=1? (`P.VO i.i:ITS)
0 R-3 'IGFr1?IOiISE (THI2EE + t7N2TS) ( UNITSj
? R-4 APARrn1ENT/CONDCbIINIUM ( UNITS)
? COMMEF2CIAL/=AII,/OFFICE
p L1DC'SZ'RIF1L
p INSTITUTIONAL/GgVERDIMENT
2) AppLICANr (PLEASE PRINT)
NII1ME: tVE.SL ; '..-,/?[d ?' O1Io'
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ADDRESS : '7 / (/L` i
CITY, STATE, ZIP: 73,40or,1 f?'% Zd A/ /?/I/' J-z-r ?
PHOiQE: ?7"?- ?D9Z
3) PiumER
ruME: PLEASE PRINT)
46 lE
C! C k' l!'I [ at i L E72 PL
04 FOR CITY USE ONLY
ADDRESS: .
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? M 3 /?? PLUMBERS LICENSE:
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CITY, STATE, ZIP: ,?1G?T
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PHONE: ?
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? 7?J^ L PLUMB E R LICE N SE # Rei?rd
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q) OCCJpANT/OWNER NAME (YLLq?t YK1N1)
:
ADDRE55:
CITY, STA'PE, ZIP: `
PHONE:
. 5) ITI[)IC'11TE WHICH PERNiIT IS BEING REQUESTID:
CONNECTION 'IC? CITY SETr1ER
CODINfX.Z'ION Tp CZTY WATrZR
dPEEt (PLEASE DESCRIBE)
6) II4DICn"-E ONE:
F-I PLEp,SE HOLD APPRC7VID PERMIT FpR PICK-UP BY ONE OF ABC}VE
? PLEASE MAIL APPROVID PERMIT ? 1, 2.? 4 11BOVE
(Circle one)
7) SZGNANRE: DATE: z
.
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. . . . . . . . . . . . . . ? . . . . .. . ? . .
F 0 R C I T Y U S E O N L Y • "
PERMIT ii ISSUED
F°ES: $ SEWE.°, PERMIT (I`1CLUDi SUP,CHARCE)
$ WATER PERMIT (INCL'JDE SURCHARGE )
$ ?-? WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ S?7;vER TAP
S /-??-?---d AC:.OUNT DEPOSIT - SE?4ER
$ /-?•e'---? ACCOUNT DEPOSIT - WATER
WAC
SAC
$ TRUNK WATER ASSESSPQENT
$ TRU-NK SEWER ASSESSidENT
$ LATERAL BENEFIT/TRUNK SE:4ER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ TOTAL
$ ??15 d AM0UNT PAID/RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
L? YES IF YES, THEN A"PERMIT FOR WORK WITHIN
? PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CO[VDITIONS:
APPROVED BY:
T I T LE : ...??le?
DATE : /_- ? ? 975_?
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City of Gahan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: c 7
RECEiVD
APR202016
Use BLUE or BLACK Ink
For Office Use
Permit*: L 34 15-
Permit Fee:
60G
Date Received:
Staff:
/1L
2015 RESIDENTIAL PLUMBING PERMITPPLICATION
Site Address: 4a o' -C It
4,.."„
RESIDENTIAL FEES:
Name:
Address / City / Zip: 4 l '1C
Nanie: 'Dtilbert Company Inc Oa Culligan 55077 Water WC641376
License #:
Address: `1.801 50th St East City. Inver Grove Hgts.,
`
State:
Phone: zip: 651-451-2241 •
Contact: William R Milbert
Email:
Suite #:
1
New Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn*Irrigation C_ RPZ / PVB)
_ Septic System
_ New
Abandonment
XWater Softener
Add Plumbing Fixtures (_ Main / Lower Level)
Water Tumaround
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation ('includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Wafer Turnaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) / O
TOTAL FEES $ to V ,
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig•t'o receivo'Iocates of underground utilities: •www.000herstateonecall.orq
1 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 whl h requires a review and approval of plans.
1 I re/ifY\-
Applicant's Printed Name
x
Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164772
Date Issued:10/07/2020
Permit Category:ePermit
Site Address: 4276 Maclaren Pl
Lot:7 Block: 5 Addition: Northview Meadows
PID:10-52100-05-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Sharon M Paulson
4276 Maclaren Place
Eagan MN 55123--195
Roofs R Us
941 W 80th St
Bloomington MN 55420
(612) 282-8092
Applicant/Permitee: Signature Issued By: Signature