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4070 Meadowlark LaneCITY EAGAN HTLLAADALE MEADOWLARK .RIDGE OwnP--n'?"rc",? Street A ,. Lot 110 pik 01 Pefcel 10-32950-110-01 4070 MEADOWLARK LANE 0,_,,, EAGAN MN 55122 L' r?IDO w,,.:j Bld .#b Unit #lU ?,, ; Sy3 5 im r? t e Amount Annual Years Payment Receipt Date STREET SURF, STREET RESTOR. GRADING SAN 5EW TRUNK de Orl inal rcel * SEWER LATERAI J WATERMAIN * WATER LATERAL 3 WATER AREA ZL 5 11. 39 .76 15 Park Donation j 1977 52.82 5.28 10 * STORM SEUY TRK 3 STaRM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC • PARK CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: ,. .i Mt AlriltiJl Af?t kU i I I nfdir(11 1 ? PERMIT SUBTYPE: }? () tl l f M q :CORD PERMIT TYPE: `'' • "' r?" Permit Number: a>,, •., : i? Date Issued: ? vQ" V f'' APPLICANT: ???i ?•;? ;?,?? ? ???. , I ????, ; s ,?? ( ta "L 460 TYPE OF WORK: f:FPniP F;I kr?t#t T?? Permlt No. Permit Holder Date Telephone 71 ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ! L ' y` /1413 ROUGH PLUMBING PLBG AlR TEST ROUGH HEATING GA5 SVC TEST INSUL GYP80AFD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL. BSMT R_I. BSMT FINAL DECK PTcl pECK FINAL ? yvgv 'ad'Pe..-? CITY OF EAGAN gjj,I,ANDALE ADD1q?emarks ,4ddition MEADOWLARK RIDGE C- P ' Lot 101 glk 01 Paral 10-32950-101-01 Owner, kv 0-7)- A js? zd': l 'U',Street 4088 MEADOWLAItK LANE statQ- EAGAN NIN 55122 •C(il IWL1E.l .?:.aFn L_ .iAnn Bldv_#6 [Init #1 L/li,.; t.i. - ,,, s<?d3< Improve ent Date Amount Annual Years Paymeni Receipt Date STREET SURF. a d STREET RESTOR. GRADING SAN SEW 7RUNK Paid UI1dE' ori inal C@Z • SEWER LATERAL 1973 PSid U11d@ 02' iIIBl Pe reel 7 WATERMAIN * WATER LATERAL 19T3 WATER AREA 7t 1975 10.89 . 15 Park Donation I101 1977 51.99 .20 10 lb STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONRl. BUILDING PER. SAC PARK ? CITY OF EAGAN gtLLppq???g ?])R marks Addition (P'IEADOWLARK RIDG? CO-OP l.ot 102 Rik 01 Percel 10-32950-102-01 Owner ??'?'?.lry•'.?',?' k ?lu:l?r #hwiu?tit vy 4086 MEADOWLARK LANE State o.a,p mU S Strest Ea,B 5122 L ? ?? ..- 4qi)O ;- . ltX Bld .# 6 Unit #2 • S1/ s Improveme t Date Amount Annual Years Payment Receipt Date STREET SURF, aid dC?' ori in ll.' STREET RESTOR. GRADING 5AN SEW TRUNK & Pid Ll t?.ET ori in &'C' 1 M SEWER LATERAL 8 id 11 CT 02'iri AY' 1 WATERMAIN ? WATER LATERAL 1973 WATER AREA '2 1 1975 11.39 Park Donation (/p 1977 52.82 .2$ 10 ? STORM SEVIf TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATEF CONN. BUILDING PER. SAC PAR K , CITY O EAGAN ??+E ?DRR rks ,,?MEADOWLARK , RIDGr CO-17P?? 103 Additio Lot Owne?,nkk6l(1).?qL* Street 4084 MEADOWLARK _81k 01 PBrcel 10-32950-103-01 LANE stete EAGAIV MIN 55122 j ; , : - cr N , , ? .F. Blag. ffb unit ffs Y ,, /?.' S ; 'j' Improvem t Date Amount Annual Years Payment Receipt Date STREET SURF, d uIIde ori ginal C@I. STREET RESTOR. GRADING SAN SEW TRUNK aid unde ori inal ce1 * SEWER LATERAL aid LLAC? C!' iI18.1 CC?. WATERMAIN ? WATER LATERAL 1973 WATER AREA 1975 11.39 .76 1$ Park Donafiion i 1977 52.$2 5.28 10 * STORM SEW TRK 1973 STORiU1 5EW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER GONN. 13UILDING PER. SAC PARK CITY O?f EAGAN HILI+AHIIALE ADDN emarks Additron l MEADOWLARK g?IDGE -CQ-UP? Lot 104 Rlk 41 Parcel 10-32950-144-Q1 Owne4 i:, -:o' `A fl-d, !t ?' Street 4082 MEADOWL.ARK LA1VE -Staze EAGAN MN 55122 c . ? o ? ; ? .?c; ;• G Bld , #5 Unit#4 L 3f SSS Im?ro?emq?t Date Amouni Annual Years Payment Re¢eipt Dete ' STREE7 SURF, i?j. (je OT 1 Ce2. STREEY RESTdR. CRADIIVG SAN SEW TRUNK Paid un,de OT' i11&l CC'.1. * 5E1MER LATERAL p a unde - al pi rcel WATERMAIN * yVATEFi LATERAL 1973 WATER AREA ? 1975 11 9 .76 15 Park Donation !IO 1977 52.82 2$ 10 iF S70RM SEW TF3K 1973 STORM SEW LAT CUR6 & GUTTER SIDEWALK S7REET LIGHT WATER CONN. gUILDING PER. SAC PARK / Ir ITY O F AGAN $II,LANDpLE ADDNR marM dditionME?OW?RK RIDG,E CO-OP? wner ?f?i ?takk Cd, ?,1?r.1&_Streetn fl, il,r., d Z - .f! uan', W.L. n -Lot 105 QIk 01 Parcel 10-32950-105-01 4080 MEADOWLARK LANE EAGAN hW 55122 B1dQ.#6 Unit #S Impr e nt Date Amount Annuai Years Payment Receipi Dete STREET SURF. STREET RESTOR. GRADING • 5AN SEW TRUNK gid la? ri inal CCl IF SEWER LATERAL WATERMAIN * WATER LATERAL 1973 WATER AREA 7-13 19 11.39 .76 Park Donation 1977 52,82 5.28 10 1F STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, BUILDING PER. SAC PARK ? CITY EAGANg?LTALgDMEADOWLARK ? T? C?wne?Nbj(Ot?e?.t,k Qdc. n TTi-? - 4078 Loc 1 01 10-32950446s01 EAGAN MIId 55122 t '• , a(.4 Bld . #6 Unit #6 4 t S 5 v'.5 Impr e Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRAOING AN E T S S W RUNK e or inal cel M SEWER LATERAL WATERMAIN ?F WATER LATERAL 1 WATER AREA Z l 1975 11.39 .'j6 ZS Park I}onation ,o 1977 52.82 5,28 10 ?F STORM SEW TRK 1 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ' WATER CONN, 9UILDING PER. SAC PARK CITY OF EAQAN VLARK RIXE CO-nP.-) - Lot 107 Qlk 01 parcel 10-32950-107-01 (L hilla-444i1'y street 4076 MEADOWLARK LANE stete EAGAN MN 55122 I?-p!l3u\ if_l. ?i a,_ lic 1 147 t.l._ tc/lr? r '4 Im o me?t i. Date uiu Amount V Vlll l. - / Annual Years J J Payment ? Receipt Date STREET SURF. STREE7 RESTOR. GRADING SAN SEW TRUNK 'a und OP ii1a1. Cel ? SEWER LA7ERAL undeK p WAFERMAIN * WATER LATERAL ]. WATER AREA 1975 11.39 i5 Park Donatian iip 1977 52.82 .2$ 10 * STORM SEW TFK 1973 STORM SEW LAT CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. BUfLDING PER. SAC PARK CITY OF EAGAN HTLLANDALE ADDNR a? AdditioAn ( ?ADOWLARK KIDGE CO-OP Owner lrlhlt&i11•lk fdci k, AW,•LJ)Street (/n 14 4 Ek ? I I 6L 3 VIIPV,. [icri) u Lot 108 Rlk 4074 MEADOWLARK LANE Bldg.#6 Unit #8 ?e....,? ?,? 10-32954-108-0 EAGAN MN 55122 Imp?? ve ent Date Amount Annual Years Paymeni Receipt Dete STREET SURF. aji ori inal C 1 STREET RESTOR. GRADING SAN SEW TRUNK Pq,j,d Lilld ori inal Ctl I iF SEWER LATERAL ' gid El Cl ? . i WATERMAIN * WATER LATERAL 1973 WATER AREA '7 1 1975 11.39 .76 iS Park Donation LLu 1977 52.82 .28 10 ?F STORM SEW TRK 1 STORM SEW LAT CURB & GUT7ER $IDEWALK STREET IIGHT WATER CONN. 9UILOING PER. SAC PARK ? CITY Lot 109 Rlk 01 Parcel 10-32950-109-01 MEADdWLARK I,A1VE state EAGAN MN 55122 ? . ,. ? ' D' Bld . # 6 Uni #9 `! r, , 5 5 Y 5s Im o m nt Date Arnount Annual Years Payment Receipt Date STREET SURF, STREET RESTOR. GRADING , SAN SEW TRUNK Q e • SEINER LATERAL r WATERMAIN ii WATER LATERAL .197-1 WATER AREA 'Z1j 1975 11.39 .76 15 Park Donation 1977 52.82 5.28 10 • STORM SEW TRK 1973 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAG PARK 1072 Payne Ave. St. Paul, MN 55101 651 /772-2449 LAST GAS WORK ORDER 410 W. Lake St. STANDARD b HEATING ?? Minneapolis 9 6 2/824 2sss?08 & AIR CONDITIONING A Blue Dof Service Co. EQUIPMENT INFORMATION FIRST D G?!L- T . . CITY ?,r+j ZIP 5 5 1ZZ HM PH (? I-, 1- "l'?l 442?,Jc WK PH TECH _Ti m ? DATE TYPE -- MAKE MOD ? /',? ;?,D /? _T SERIAL INPUT ORSAT TEST RECORD C02 . °r6 METERED INPUT Cfh CHIMNEY TYPE 02 ? 96 LIMIT SETTING ° FLUE SIZE in. CO 61?2 % PILOT OUTAGE sec CONNECTOR SIZE in. ! NET STACK TEMP Y 0 TOTAL CHIMNEY INPUT cb o btuh BUILDING PERMIT Te be nMd for Site Address Lot Block Parcel No. ? Name •}f ? Z ? Address City ? Name uu Address F C?? U cc ?W Name IZ Address C1TY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagae, MN 55121 • PHONE:454-8100 Receipt # ._.._.1..'.? c.? V..?... .`:i :, S 0?` n..•.. _ I.L."•i.l.:.l. EreCt U Occupancy _ Remodel ? 'S Zoning Repair ? Type of Const, Addition ? Movg; (i`? Demolish ? No. Staries Length pepth Int Impr. ? Sq. Ft. ? i hove read this ond a4ree to c Sipnoturc of Permittee A Building Permit Is' issued to: ? oll work shall be done in ocoordance with all epplicoble Stote of BuildinQ Ofilticl Aparovols Fees Assessment Permit Water & Sew. Surcharge - Polite Plan Review Firo 5AC Eny. Water Conn. Plonner Water Meter ? Council Aoad Unit ond stote that cll opplicoble gldg. Off. Tr. PL +nnc es APC Parks . . Var. Date C?ies Total on tha expross sondition {hot s ond Ciry of Eaqan Ordinonces. Pwmit No. Pernnit Holder Date Tdsphohe # Plumbinp N.VA.C. Ebctric Sokenar Irapsction Date insp. Other Footfnys I q/ ? g Footings ft Foundation Framing Roofing Rough Plbg. Rough Htg. Insu1. Fireplace Final Htg. Final Plbg. Final c. occ. Go ?Y ? ?.Gl.. . Water Dypihe Location: WNI Sewsr Pr. pisp. ; HOUSE HEATING TEST RECORD ADDRESS I(l I? ?? G(t.r!(?i?ll '- << r??? ? ??? APT. FLOOR CITY SUOURB OCNPANT OM'NER HEAT LOSS OATE HTG. INST SOLD BY INSTALLEO BY Eleeericol 1Vork'By Gos l.ino Br TVPE OF HEAT GA FA HMI STEAM SPACE HTR. _ GAS DESIGN AAAKE MAKE OF BURNER _ Mod•I Abd•I Smiol Max. BTU Ratina - IHPUT l-?MAKE OF FURNACE CONTROLS VTHERMOST T Heot Pluq alw ? ? Limif Limif Seffine Fan 5ettinq Pilot Typt - ' ? Pilo+ Mok. Pilor Mod.l Model Vent Si:• 1 KIND OF LINER SIZE NONE Dreft Hood Rpulowr Filtors Si:• ? ?<>--?'? Wu r Chfinney Locatien Inside Chimney Constwctien <7 Snwke Bomb wirin9 -- - ?? Pilot Timiny Orofr ? T*st Teo L.W. Cut Off T Dow Pressure Liyhflno Inst. Presswe Pereont C02 Doh Tested , L-? ,- Input CFH Porcenf 02 Coinpany Tesfing Stock Temp. Percont Cp ' Nomo of Toster - Form 235 ' UNIT HTR, OTMER CONVERSION CITY of EAGAN BUILDING PERMIT Ownex ..fl..-?-?? .-.?^L......? ............. ........ .... .'!./ ... . ... .. .....'? . Addrecs (Presenl) --rIn ........ Suilder Addreu DESCRIPTION s i• ° N° 3412 3795 Pilo! Knob Road Eagan. Minnesola 55122 454•8300 Dsla ........ _....... Siosias - To Be Used For r Fan! Dapih HeiBbt Esf. Coaf q400b ermi! Fea 3? ?5 Remarln &, LOCATION ' ?• 5lreel, Road or olher DasoripSion of LocalSon I Lo! 8 ock Addilion os Tree! w,?,z Q +d't--7-r oa? 0? ia 33950 This it does nof auihariza the use of slseels, zoadc, elleys or sidewalka aor does it give the owaer os his agsat the xig6 !o create any siYuaiion which is a nuisanee or which presents a hazerd !o the haelth, eafelp, convanienn and general welfate So anpone in the communily. ` THIS PERMIT MUST BE"?E?? ON RE E WHILE THE WORK IS IN PROGRESS. ? This is !o cerHiy, 3ha!_./.??s.??/?Gc.e.^. . .has perm4ssfoa fo arect a.... .P1... . . ..... . . y ... ......... .'° - -'- - ..... . ........_u on the above,deseribed pre+ry4 esupjlee3 fo the pxovisions of all applicable dinanees for ,7'ify of Eagan . CITY OF EAGAN N°_ 10 9 8 2 3830 Pilot Knob Road, P.p. Box 27-199, Eagan, MN 55121 BUILDING PERMIT - ? PHONE: 454-8100 Receipr # Te M wed fer REMODELING Est. Volue $2 • 500 pOfe SEPTEMBER 17 Iq 85 SiteAddress 4088 MEADOWLARK LN Erect ? occupancy Lot 10 elock 1 Sc/Sub. HILLANDALE ADD Remodel [AX Zonin9 Repair ? Type of Const. Parcel No. Addition ? No. Stories ? Nme MEADOWLARK RIDGE HOME OWNERSM'xtSOCO D h Length = ? Address em is SAME Int. Impr. ? Depth Sq. Ft. City vhone 452-1915 Install ? g Name SAMPSON-LINDGREN INC Avorovals Faas oll Address ZZZ8 E 35TH ST Assessment Permit ?38-50 u? City MPLS Phone 721 -5546 Water 8 Sew. Surcher9e 1_? ? ? Police Plan Review FW Name Fira SAC ia Addresa Eng. WaterConn. City Phone Plonner Council Water Meter Road UNt _ Tc PI. I hereby acknowledge that I hove reod fhis opplicotion ond stote that the intormation is corcect ond ogree to wmply wilh cll opplicoble State o4 Minmwto Stotutes City o Eogan Qrd nces. Signoture of PertniM A Building Permit Is issued ro: `-S SON-LINDGREN : all work sholl be done in accordance with oll a0 ' 61e State of i Bldg. Off. APC Var. Date Parks - Copies - ' rotal $40.00 _ on the exprcss wndifion tha+ ond City of Eogan O/dinonces. Bufldlny Official :e ???': ??a .:?'_Si':.' ?` }? ,. ' City of Eapn 9590 P"ilot Knob qaad Eagen MN 55122 Phone: (651) 675-5675 Fax:(651)675-5684 ? Faf Oflice Use .J v ^ I j PertniUk: i ? /, i i Permit Fee: ? E f ? Date Receked: ? I scafl: ? I -r--------C -.-k -- ? L ??" ''q?"'?1 2008 RESIDENTIAL BUILDING PERMIT APPUCnTioN ? ??-of?' . oate: of?_ f aa srce aoaress: -40 SCv J?'t 64on+.D t4m?,e1'- Ls 646A4 SS iaa suare a: pESIDENT ! OWNER mqNpr, m ? + Phone: l Sa - °I IAP :57575 addrowicay/zp: 7a75 Sv.SH LkkE Ro ED 4A mLl -51543cr Appppnt is: _ Owner X- Conlfac0or TYPE QF W{FX f011bFYV[Nk: DBSw M 1`?iC ?RAlt? N6 .S7+i ER-rNlN6-+ DP ,4 WAU-RC'PAJQS p Construction Cost: -LI g? MuRi-Famdy 8uilding: (Yes -)!(-/ No COFITRACTOR Name: 4`G_5 i A -+2 L`4PAS'r M ro M i ticense u: 30'2J4 '7 nddress:SI45 --,CDu3Ti2rtaL s`e Io3 City: ?12 C.? LA,N State: M?4 Zip: s?s?9 Phone: .5?KQ - 5.3 -'&SS ._ Contact Person : n1)Ar1F S AtJ ?aP- CpMPLE'fE THIS AREA ONLY IF CONSTFtUCTING A NEW BUlIDING _ MinneBOta Rules 7670 Cateao?Y1 _ Minnesata Rules 7572 gjnp1vy (,`pO@ . qesidentlel Y"letion Catagory 7 Workshast •NGW E^w9Y Code WoAcshcet Category Subi"VMd SWrreded (+) Subvnission tYPe) ' Emrgy Erwelope CalmAa0m Suunitted In the last 12 moNh% haslha QtY ot Ea9pn Wsuad a permk for a simiar Plan 6ased on a rtmster pmn? Yes No 1i yes, date and address of master plan: ucensod Plianbar: Phone: PFwne: ulechetdcd Comracta: PllOn9: gswer 8 Water ConVactor. I(QI[': PBIIS and supportrng domRmft t/19t rOf1 911j11I1fl BfBCDlIBfoBlBQ i0 OBWonV nrrvrn.Q Il ??il? Me kilonr?lw? rr? be cla?ll?ed ?+?^ P?Ik ?7?0u pmvlde apeclFic ree?sorrs tBaf woufd pe ?+Y ,..e.. e.e ...M ?al4ts _ OftY 1 herebg adoemOOCE00 7nt C+is infonna4on is oomPiee antl aodna9e: Mel ??aM wark estmt w tl?io anances a ffi tCod he wMc?rri11 be ? ?or r?+: y,? i?nd a,? rs r? a vemOrt. wd ony a? 0aw? ?ws wkh ths sPPw-d Plan m me case of wonc vmicn reqe+iras a reNew ana apamvai Ple? x SN ecLy LL-A N y nrs si? re ?i?? Npmp PaAe 1 of 3 6l'd 0099-6Lb-£9G jeAmeg auena dgg:ZO 20 ZO 1o0 Dp NOT WR{TE 6ELOW THIS LkNE B TYP ? Foundatlan n as-plex n 16pie: a acceaoryautlding 0 Poo1 ? Single Femlly ? 06plec 0 Fireplace ? Poroh (3-sasson) B Exl Att. - Mulii 9 01 ot lU Re: D 07-ple: O Gara9e ? Porch (4season) ? Ext Ate. - SF d 02filex ? 0&plex ? Deck ? Porch (sereeN9azebo/teruaia) 0 MYW Nisc. F-I 03,plax ? 10.Plax ? Lower Levek ? Storm Damege Cl 0443Iex ? 72pbx ? Ytsoallareous WORK TYPES ? Sicdng ? Oemolish Huiidfng• ? Now D M[ar{or ImproremerR Q Reroat ? pemdiah hiterior ? Addfflon ? ?w SWIdIng ? 1Mridows ? Oemolish Fwndation l7 /JMmOOn ? Fre Repeir ? 6gress Window 0 Waler Demage L7 ???? ' DemdiGiort (eM[re ddarg) - 9ire PCA harMOUtio applicazu D R N: ?u ancy 1,Rc- 3 yCES System = Valuation p d? Coiie Edi[ton SAC Units Plaa Review 100°k ? ' ZorinB n• ? 3 CktY YYaler (259 0_ PUm ? CensusCofle _ Al3y Storfes - P BoOStOr # af Unils i Squere Fcet PRV _ j Len9" " Fire SQr?nklers # of Bufldin96 TypoofConyl. 713_ Widtli . REQUIRED INSPEC7IQNS Poonngs (fww b1ldg) - Faotln95 (dec*) Foolings (adMa^) Fwndatbn DrBin llle ' FFOOh _loe & WateK ^Flnai ? Framing Flreplace:_R.L ,Air7est _Final - Msu{etlon Reviewed 8y: Sheelrock FlnalfC.O. ? FinaVNo C.O. wvnC ? ?Fnal ? PooL _FooGnBs AidGas Tests _ SWin9=UCCO tl? -Stone Lath _Br1 wmdows J Retafning Wal1 Building Irespecw? --------_.__? . UDfl?7L4L FE = ? ease Fee 3 9 sucnarga Plan aevtew e,IC/ES SAC Cily SAC Utgly Connaction CHarpe 5&w Permn & surcharse Treatment Plant q V'OpieS TOtal £Z'd 0099-6LA£9L page 2 of 3 aa,(meg euenp d8, ZD SO ZO P0 ry MECHAlVICAL (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Pleasecomplete£or: SingleFaznilyDwellmgs Townhomes and Condos when perenits are requ'ved for each unit j3aS7) Date ( e / I / O ? . Site Address 1- Uni[ # P Owner t Tele hone # ( ?S( ) `? ? - o roper y p Contractor $TANDARD , . . Street Addr?5? 410 WEST LAKE STREET IVII Ci?, IV State 612'894=P896 Zip Telephone# ( ) The Applicant is _ Owner 4, Contractor _ Other Add-on, modiflcaGOn or alteration to existiug dwelling unit $ 30.00 furnace replacement airexchanger air conditioner !. , l ? ? otner ey?? i i State Surcharge ? ----z $ .50 T t ] $ 3a . S o a I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and aceueate; that the work will be in conformance with the ordinances and codes of the ity of Eagan and with the Mechanical Codes; tha derstand Uus is not a p t, but only an app 'catio a p t, and work is not to start without e at the work be m ccordance with the p roved plan in the cas of r whic requires a review and approval of p G? / ApplicanYs Printed Name plicant's 5i MECHANICAL (COMME1tCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: commerciallindushial huildings multi-family buildings when separa[e permits aze not required for eaoh dwelling unit Date / / Site Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address Ci(y State Zip Telephone # ( ) The Appticant is _ Owner _ Contractor _ Other Work Type _ Newconstruction UndergroundTank _Install _Remove _ Interior Improvement Call for inspection during installation/removai of tank Processed Piping Nature of Work: Permit Fee $50.50 Minimum Fee (includes State Surcharge) Contract Value $ x 1% Permit Fee • If permit fee is $1,000 or less, add $.50 ? $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Pernrit Fee $ To[al Fee I hereby apply for a Commercial Mechanical Pernut and acl¢towledge that the information is complete and accurate; that the work will he in conformance with the ord'mances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, hut 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. ApplicanYs Printed Naxne Applicant's Signature Approved By: , Inspector Date: MECHANICAL (RESIDENTIAL) ( Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please comple[e for= Single Family Dwellings Townhomes and Condos when pemtits are required for each unit 2'36-.SD Date i Unit # te Address S Telephone # ((C?'S() Pro ert Owner t / p y i contractor STANDARD HEATIN6 8 AIR CDNDITI006 C0. 410 EST LAK Street AddressMINNEAPOLIS, MN 55408-2998 city, 612-824-2656 State Zip Telephone # ( ) h O ? ^ t er Conhxctor _ The Appticant is _ Owner 9-_ Add-on, modificatiou or alteration to existing dwelling unit ?' ???i ,?'V C y?? 30.00 furnace replacement ey K ? ' C ?1 ? air exchanger x air conditioner \\ \other ? State Surcharge $ 50 Total $ I hereby apply for a Residenfial Mechanical Permit and ac be in conformance with the ordinances and codes of the C pe but only an applicafion for emut, and work is ap ov d plan in the case)f wo, ic requires a review 'wledge that the information is complete and accurate; tUat the work will of Eagan and with echanical Codes; that nderstand this is not a to start without pe that khe work ?n accordance with the I approval of p ns. V n Printed Name MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephoue # 651-675-5675 FAX # 651-675-5694 Please complete for: commercial/industrial buildings multi-family buildings when separate pefmits are not required for each dwelling unit Date Site Address Uuit i{ Tenant Name (if applicable) Previpus Tenant Name Property Owner Telephone # ( ) Contractor Street Address CiYy State Zip Telephone # ( ) The Applicant is _ Owner _ Contracmr _ Other Work Type _ Newconstruction UndergroundTank _Install _Remove _ Interior Improvement Call for inspection during installationlremoval of tank Processed Piping Nature of Work: P¢1'IOi[ F¢¢ $50.50 Minimam Fee (inclu(ies State Surcharge) ContractValue $ x 1% _ $ PerailtFee • Ifpermit fee is $1,000 ar less, add $.50 Z* $ State Surcharge If pemnit fee is over $1,000, add $.50 per $1,000 Pemrit Fee $ Total Fee I hereby apply far a Commerciat Mechanical Pemvt and acknowledge that the information is complete and accurate; that tLe work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a pernut, but only an applicafion for a pernuy and work is not to start without a pernvt; that the work will be in accordance with the approved plan in the case of work which requues a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: Inspector Date: PERMIT # `S S `T ' v RECEIPT DATE. 8008 RESIDENTIAL PLU1fBIRH PEfiMiT APPLICATIOft crrY og KAea,N ssso PaoT xROa gn swsaa, asx 55122 651-691-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITE ADDRESS: 4 o -7 D l' 1.U0.plrL!_i 1vxt-? OWNER NAME: : ?nvY? ?111 ? a.Xl 7ELEPHONE#: ?4SoZ- IW ?5 -? J70 (AREA CODE) INSTALLER NAME: LFT= S-T U L.LTLU "• TELEPHONE #: -1(03 STREET ADDRESS: 1 -rjGj32, {.?('?i ?J?2?..•?t-l?? (AREA CODE) CITY: ???a ?--?S?t_.C,I? STATE: o"l 0 zIP: 55303 _ SEPTIC SYSTEM, newlrefurbished (requires hvo sets of p{ans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply . MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners a nd water heaters. $ 50.00 _ A6andonment of septic system. _ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: - Ilr, CCD 1 fl _ RP2: new installation/repair/rebuild u ? J 30.00 _ lawn irrigation system ?Y--- -- ReplacemenUadditionaL• _ water softener ? water heater $ 15.00 i IV 1 Z State Surcharge $ .50 Total $ I hereby acknowledge ihat I have read this appliption, state tha[ the information is wrrecl, a agree to complywith alippplicahle Cityof Eagan ordinances. It is the apphcanPs responsihili[y to noh(y the property owner that lhe City of Eagan ssumes o liabil'ty for any damag?l5 caused by the Ciry during its normal operetional and maintenance activiUes to the fzcilities constructed under this perm Cit pr yhightfhf-way! se } Y GNATURE OF PERMITTEE 1102 CITY USE ONLY PERMIT #: ? Lo ? S RECEIPT DATE: 2002 RYE.SIDENTIAL MECHANICAL PEftMIT AxPPLICATI0N Cl7'Y OP E4fiAN S$SO PILOT KNO$ iiD EAfiRN MN 55122 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: p? \9 SITE ADDRESS: q ij 1 a 1 1 IJLQAo_,o Uc? k bjk-z- OWNERNAME: I[)1'Yl Bul(kn TELEPHONE#: INSTALLER NAME: STREET ADDRESS: ?_?cu? ??. $ l ?? • _ TELEPHONE#: CITY: RffY7r_V? V) ky L STATE: H ?j_ ZIP: 55q 143 Place a check mark next to the permit work type ? Add-on, modi5catiop_4Lalteration to existin dwelling unit $ 30.00 ce repla cemen? • furna ? ? ? • air exc angeh r • air conditioner ? ? I = ( -- ? I 1 I (?? ? D , • other AUG 2 _ ?'Yl 0 nt L,P? . Nature of work: D 7001 _? 1 . . ! gy - k ---- _, ? State Surchar e $ 50 T t l $3L56 O a ,4? 2t SIGNATURE OF PE TEE 1102 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: 2002 COMbi£fiClAL M$C$A1VICPgL P$ft14I11' APP1.ICAT!ON CI7'Y Of EAfilkN S$SO PILOT KNOS iiD EAeAv, Mrl 551 22 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IPvIPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: TELEPHONE #: WORK TYPE: _ New constrncSion _ Interior Improvement _ Processed Piping STATE: ZIP: Install U.G. Tank Remove U.G. Tank Specify Nahue oF Work: When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1°/a of contract price OR $50.00 mioimuro fee, whichever is greater. Underground tank removallinstallation = minimum fee Contractprice: $ xl%=$ (BaseFee) State surchazge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/02 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILOING 026009 06/20J96 SITE ADDRESS: P.I.N.: 16-92951-040-05 DESCRIPTION: 4074 MEADOWLARK RD LOT: 108 BLOCK: 1 HILLANpAI.E R E R O O F ua.:leLz?ii?,?,tPermit T y p e %k Type ?' C€ F? ?'1$=k6`S ?G q Ct?B ??:^'e? i u S70RM DAMAGE REPAIR 434 ALT. RE5SDENTIAL t?M* uy Gy ik" -g'.? gfnF ?m'" ?°. =.A'?i °Y REMARKS: INCLUDES: 4076, 4078, AND 4080 MEADOWLARK RO L107 L106 L105 FEE SUMMARY: CONTRACTOR: - Applicant - OWNER: OVERHEAD CONSTRUCTION 14606277 LAKEWOOp CONDO ASSOC 17259 N CREEK DR MEADOWLARK FARMIN6TON MN 55024 FAftMINGTON MN 55024 (612) 460-6277 , . . - `. ' '° r .; . '-s iEr ' ' • _ " . ' • T her.!ebyacCcerQwl,?azlc??- read-?hlfs aRP11"catiwn ar'A staCs ?h?art infoi=anaoxt_1s ?x?i-rec? a?d a?r? Ct5 _c.%3?tk??,?1? appl=x"??I;?' ??t4_.?o f hlrt .. Sta?[?,tes e`hd:'"C'?t?. ?r?°E?gan Drd€rtar5aes:, _. _. .s:?. _ . ?_ . ea . .. r, .... "? e. _ .?_._ .. , .. x.. . .......... ?-?--?--?- APPLICANT/PEPMITEE SIGNATURE ISSUED : SIGNATURE , • CITY OF EAGAN ? 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 w ConsWClion Reauirements RemodeUftepair Reauiremen ? 3 regislered sRe surveys ? 2 copies ot plen ? 2 copies of plans (incNde beam 8 window sizes; poured tnd. dasign; atc ) ? 2 site surveys (exterior additions 8 decks) ? 7 energy calculafions ? 1 energy eakulations tar heated additions ? 3 copies of hee preservation plan H lot platted after 711193 required: _ Yes No &0 -? DATE; g -6 CONSTRUCTION COST: /9--?? 3 2???r" ? DESCRIPTION OF ORK: _LC? - ?CO 7 STREET ADDRESS:,or 105- 4407 -%4074 LOT / n BLOCK / , -e 4 4o7tsUob SUBD./P.I.D. #: PROPERTY Phone #: Ld6 OwNER ua* sin:. Street Address: City: State: Zip: CONTRACTOR Company: Phone #: lbd 7 Street Address:/2???'? License #: ? D 44 City:? State:,CLL- Zip: j;"D z qRCHITEC7! Company: Phone #: ENGINEER Name: Registration #- Street Address, City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot 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 Appiicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 5F Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF. Misc. ? 10 = plex ? 15 Deck WORK TYPE 0 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC OCCUp3RCY Zoning # of Stories Length Depth APPROVALS Pianning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering MC/WS System City Water Fire 5prinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Variance Permit Fee Surcharge Plan Review License MCMIS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Traits Ded. Other Capies Total: Valuation: $ % SAC SAC Units ?'qG),V/ - L?n ? BL ? CITY USE ONLY RECEIPT #: G/ { Ve? SUBD. /JK? DATE: 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on fumace / Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 - ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surchsrge •50 TOTAL os?4 .5 SITE OWNER PHONE #: INSTALLER NAME: STREET ADDRESS: MINNEQpf.l:Ig, . „ „ .. 6' cirir: PHONE #: ( a? STATE: ZIP: CITY USE ONLY L BL SUBD. RECEIPT #: DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681 -1675 Please complete for: ? all commerciaVindustrial buildings. ? multi-family buildings when separate permits are D-Qt required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ?$25.00 minimum fee Qr 1% of conVact price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of mi fee due on all permits. CONTRACT PRICE x 1% PROCESSED P{PING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: _ CITY: PHONE #: TELEPHONE #: > STATE: ZIP: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR '!,.;c n:@?G?:?;;<";'Y.K?'•?:?;.YEYfiX,: ::;t?Y:kV<nCi?)Y.;k.','Y.t:r>';Y,:i:<:ik';;•;;:::? C:.T" f_I'= :S^G4`+' C'A ,H7:LR: a ". GRh1,LNA,_ k0. 7551 Dt-tTG 36/1.0/39 TYr'I?t 320 300' '0088 tSFA'f:IUWLAf.'I: :2 ;.2'i 2155 9071 4011 MS:a,"!f7a..HFiI( 5.,0f1 ? Tot,', hecei.p': P.mour#, tE?L.25 CR 1 s. °.''ii:3'; _SEn , . Q*'y.?I }$Yr'? 'M::.4')YJ6?';';E::it;:'*Yf.Y`:6?F.w.?.M ?3F7?;'?.. iU°,.:, :C:>kYs?'$:kcii;",•'Y. 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction ReaulremeMs RemodeVReoatr ReauiremeMs > 3 regfstered sMe surveya ahowing sq. H. of lot, sq. M. of house and gfl roofed areas (20% maximum lot coveraae allowed) > 2 copies of plana (show beam 3 wlndow sizer, pourad (nd. design; efc.) i 1 set of energy calculatioro ! 3 coples of hee presenafbn plan H lot platted alfer 7/1/93 DATE: _ (o ` DESCRIPTION OF WORK: STREET ADDRESS: D Iff oL?) LOT: )i BLOCK: L _ SUBD./P.I.D. #: S`? Name: rr' Phone #: U ? / - 3) LasF Flrst a? 2 eopies of plan t sel of energy calculaHons for heafed addfflans i siFe suney lor exferlor addHions 3 decW CONSTRUCTION COST: z /0 t n,, i,' ?a. Q , -+- PROPERTY OWNER Street 7Si5O h<-e4m City 6 laoh"v+1 StaFe: V Zip: Company: ?'vl Vl'? ?o? ? `-O'?? ? Phone #: 6 1v2 / b l' Ra'i (area eode) CONTRACTOR 2 ?(? ?? 3??? j? Sheet Addreu: ? J J 6 J? `?z/'So vl License #?p• Clty It1'I ZC%c?JlJ r `.S $fat2: ?'?? /t/ Zlp: L7 ?J y lr --r ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street City Sewer & water Iicensed plumber (reauired for new construction onlvl: I State: Zip: penaHy applies when address change and lot change is requested once permit is issued. I h8reby acknowledge that I have read this applicafion, state that the intorma rrcf. cnd agree ta comply wNh all cPPOcabl Sfate of Minnesofa Statutes and Clty of Eagan Ordinances. Slgnature of Appflcant: ? - _-- OFFICE USE ONLY '1' 8 Regishation #: Certificates of Survey Received _ Yes _ No I , ----- -_.. _f___.. _• ? _ ' Tree Preservation Plan Received _ Yes _ No _ Not Required ?L OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace 0 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Acldn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool 0 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 Bldg.' ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to appli cant for demolition permit GENERAL INFORMATION Const. (Actual) (Aliowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. af Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge ?. U Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit 5!W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies ,-otal: l8"L . as Valuation: SAC Units % SAC ? 40;e /0-c/ 9 1985 BUILDING PERMIT APPLICAI'ION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COlRIERCI6L INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For:,Cg&Dnr?/gJ SINGLE FANILY DWELLINGS INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS . .4.T_5J Valuation: Date: &eZ 14, ?.? Site Address?Q?/?/?/?',q8a?a(?q,??,',, L.ot ( ? l Eloak / Parcel/Sub O•?asnd ,8ess JCF-F -1 Owner g?t,v,_9otilcAk& 9 ?456s No,o,s o?.oECS Ass. Address sp 70 /1?qlbtjGAF1+ 49.A City/Zip Code ,cA6?-if.v ,S',S'i,t 2/ Phone 76 2 Contractor ?,R/?Tp,f'o,?y _ /?,?.p6,e?i ??G Address 4E?Sr Q?,t-'n oT City/Zip Code//e4s /7& .5 S'</a? Phone 70'7/ ,- Arch./Engr. Address City/Zip Code USE Ereet Remodel Repair ? Addition Move ? Demolish Int.Impr. ? Install ? APPROVALS Occupancy Zoning Type of Const !! of Stories Length Depth Sq Ft FEES Assessments ? Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Treatment P1 APC Parks Variance Copies TOTAL ?iI Phone ll PERMITJk NNb73 RECEIPTDATE: V? T 1 ' U.SIDEN17AL PLUM$INfi ?ERMIT FtPPLiCATION crrY og EAsm 3830 eaor xivos Rn swswx, MIt ssiaQ 651-6$1-4675 Please complete for: ? single family dwellings > townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system SITEADDRESS: _ SIMACEK,JACALYN 4072 MEADOWLARK LANE OWNER NAME: :_ ee,t;Ard, NIN 55122 (651) 454-8041 INSTALLER NAME: --- STREET ADDRESS: NQRBL4M PLUi t,., -o - CITY: v (oi2; e?7- 23G5 G„?cFI-_ L6 , BlNG C0. U's3 VE. S4i?T. `1 Place a check mark next to the nermit work tvoe _ ?ELEPHORE #: (AREA CODE) " TELEPHONE #: (AREA CODE) STATE: ZIP: New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existinq dwelling unit, inciuding: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround Nature of work: 1N 4-h 40Vlf-, Septic System, newlrefurbished - $ 225.00 • inciudes Gounty & Consul±ing Ir.specfor iees • requires MPC license State Surcharge $ 50 Total $ .R'50 Reminder: 8e sure to schedule inspections of alteretions, i.e. water heaters, water sotteners, etc. I hereby acknowledge that 1 have read [his applicahoq state that the mformation is corcect, and agree to compiy with all applicable CAyof Eagan oidinances., It', is the applicanPs responsi6ihty to notify the property owner that the City of Eagan assumes no liabilily (or any damages caused by the Gtydunrig its nomiali operational and mainlenance acGvities to the facilities consVUCted under this permit within City property/right-of-wayleasement. ? I MAR 2 3 2001 OF PERMITTEE ! 3y - CITY USE O\LY LOT BL ? RECEIPT #: I I 0? ? 5 SUBD. \? IU1 ?/1(?`? ?" ? RECEIPT DATE: 1 0- aa -1I MECHANICAL PERMIT # 51?N (o ---5 1999 MECHAN1CAL PERMIT (RESIDENTIA.L) crrYoF EA 3930 Pv.or [cxos xn gA&AN AtN 551 EE 1 ? + ( ? Date: (651) 6$1,4675 I 1 Complete this sectinn orIv if you are installing HVAC in a single family dwelling, townhome or condo under construction and not owner /occuoied. • HVAC: 0-100 M B T U fwiDI;IQNAL 50 ,vi B 10 • Gas outlets (minimum of one required @$3.00 ea.) Complete this section anlv if you are remodeling, adding to, or repairing an existing single family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New Alteration X Repair _ Other Reminder. Call 681-4675 for inspections. X Furnace _ Air exchanger SI"I'E ADDRESS OWNER NAME: _ INSTALLER NAME: STREET ADDRESS: CITY: ( V'1 t ;A, C) $ 30.00 6.00 State Surcharge .50 Total $ ? Air conditioning Other $ 30.00 State 5urcharge .50 Minimum Total Due $ 30.50 PHONE #: ?IS 1 - 99 1 ? (AREA CODE) q / _ PHONE #: (o/ d-- ?? SS? ? (AREA CODE) STATE: ZIP: ? v? L BL SUBD. CITY USE ONLY RECEIPT #: RECEIPT DATE: APPROVED BY: INSPECTOR MECHANICAL PERMIT #: 1999 MEcHALvic,e?1. PERMrr (COrvuMEtcIAW CITY OF EAfiAN 3850 PILOT K1VOB RD £i4fiAL1V, bIN 55122 (651) 6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: !'nNTRA CT p,??('F: WORK TYPE: New construction Install U.G. Tank _ Interior Improvement _ Rernove U.G. Tank (Minimum Fee) _ Processed Piping (Minimum Fee) **NOT'E: When installing/removing underground tank, ca11 65 1-681-4675 for inspection by fire marshal and plumbing inspector. DESCRIPTION OF WORK: FEES: 1% of conuact price OR $30.00 minimum fee, whicLever is greater. CONTRACT PRICE x 1% PERMIT FEE _ STATESURCHARGE _ TOTAL _ ------------------------------------------°-------------- SITE ADDRESS: OWNER NAME: Se TENANT NAME (IMPROVEMENTS ONL7) ($.50 per $1,000 of Rgi3n-t fee due on all pemuts.) r #: 6-S f - q L. ? ? Z? (ARFA CODE) INSTALLER: E??,?rpat+s,ar..ak?r. _ 69 6?rSY?i'CC" DDRESS: ? A ps? PHONE #: - (AREA CODE) CITY: _ STATE: ZIP: _ ? . ?. SIGNA OI? PERMITTEE , ?CITY USE ONLY L l?/ 1 1 BL H RECEIPT #: SUBD. ?IIIQIIQQ?", RECEIPTOATE: I0'27^n i I PERMIT # U "JY 15(4 2000 PLtJM$INfi PERMiT (M1DEP17lkl.) cm'og $nGM 3930 eu.or xxoB Rn eAsnx, auN 55122 651-691-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? hackflow preventer for underground sprinkler system FIXTURES EACH TOTAL Alterations to existing dwelling - minimum fee Descrihe: $ 30.00 Bath tub $ 3.00 x - $ Floor drain 3.00 x = $ Gas i In outlet ' minimum -1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ I Laund Va 3.00 x = $ ' Lavato 3.00 x = $ SE tIC S stem new/refurbished ' re uires MPC ue. 75.00 X = $ Se tIC 5 Sfem abandonment 30.00 X = $ I RPZ new inshaltatlon/reairlrebuild 30.00 x = $ I Rou h o enin 1.50 x = $ I Shower 3.00 x = $ I Under round s rinkler if dwellin is under construccian 3.00 x = $ Under round s rinkler irexisen dwellin 30.00 x = $ ' W ater closet 3.00 x = $ i W ater heater 3.00 x = $ I Watersoftener ifdwellin underconseruction 5.00 x = $ ? Watersoftener Hexistingdwallln 30.00 x = $ I Waterturnaround 30.00 x ---- _ $ State Surchar e .50 --> ---> ---> $ .50 ToWI --> -? ----> --> $ Reminder. Call for inspections of alterations, i.e. water heaters, watec softeners, etc. -----------------------------•-•--------------------------•--.....•.--•------------•--------------------._.....------•-------...-----------.. I here6y acknowleCge ttiat I have read this applicatlon, stale fhat the informatlon is correct, and agree lo comply with all applipble City of Eagan ordinances. It is the applicanCs responsibility to notify the praperty owner Nat the Ciry of Eagan assumes no liabiliry for any damages caused by the City during its rwrtnal operational and maintenance actiyitie5_to Ihe facdi4eg_cgpstrud d un er_tttis.as[mit within Ciry property/right-of-way/easement. SITE ADDRESS: I SCHOMAKER, JEROME ' 4078 MEADOWLARK LANE OW NER NAME: : EAGAN, MN 55122 I TELEPHONE #: (AREA CODE) INSTALLER NAME. (651) 686-6626 I TELEPHONE #: (AREA CODE) STREET ADDRESS: GZA VEN7?9/APPP4UJANCE INWA4.LEFi3 CITY: 489 5TATE: ZIP: ZZ9@5OAR I 'LD AVE. $0U,TN6 MINNEAPOLI3, MN 55408 SIGN \ E OF PERMITTEE ?( O 1' 2005 RESIDENTIAL BUILDING PERMTl' APPLICATION ?' 2 g Z S City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsfruGlon Reauirements ' 3 registered site suNeys shovring sq. R of IoL sq. ft of house; and all roo(ed areas (20% maximum lof coverage a0owed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Celalations 3 copies of Tree Preservation Plan if lot platted a8er 711l93 Rim Joist Detail Options selection sheet (buildirgswifh 3 orless units) RemodeURe air Re uirements OfFce Use Onlv o/ 2 copies of plan w GS{?t =V"? ?oe.? ? d of Survey Recd _ Y _N 1 set of Energy Calcula4ons for heated addlFMS Tree Pres Plan Recd _Y _ N 1 sRe survey foradd'Nons 8 decks Tiee Pres Required Y N Addifion - indicafe if a+sde sepfk system On-sile Septic System _ Y_ N Date ? C / ? Construction Cost (o f Cm, co Site.Address bZo IVt?' ?s?v(?LO?(?- Lsf?. UniUSte # Description of Work ?F 4.4A-F4-Z;1C_7 Mufti-Family Bldg Y_ N Fireplace(s) _?, 0 _ 1 _ 2 Pro rtyOwoer ?i ?DD ?fL (40,_?AC? A-S°JUIi Telephone # ( i Go s 4"c., c4 lK5 -t.'Zd - C-? Contractor lide;rz24LL -A1.L 6cfY;bEd:"Tide4 Address 4M - 69_ ?o AS/tF . 1'4- City WMGL4_?} P`F St t At q 65??3 Zi Telephone# (7(p? 'f -2+ e / a p COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota RuleS 7670 CateeoN 1 rvimnesum nuics ro ia Energy Code Category . Residential Ventilation Category 1 )Aforksheet • New Enorkshei (Jsubmissiontype) Submitted Submitt • Energy Envelopa Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master Ian? sF? p_9 _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone Mechanical Contractor Telephone Sewer/Water Contractor 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 Siatutes; I understand this is not a permit, but orily 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. ie?ZuS L'qA-t34e Applicant's Printed Name Apphcant's Sig OFFICE USE ONLY Sub Types j ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? OB 06-plex ? I 16 Fireplace ? 21 Porch (3-sea.) . ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 05 03-plex ? 11 10-plex ?? 19 Lower Levei ? 24 Storm Damage ? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? I 35 Int Improvement ? 38 Demolish Interior ? 32 Addition ? 36 Move'Building ? 42 Demolish Foundation ? 33 Alteration O 37 Demo i lish Building" 0 43 Reroof ? 34 ReplaCement ' •Demolition (Entl2 Bidg) - Give PCA handout to appliwnt Valuatlon ? ?060-ba Occi pancy MCES System Plan Review _ 100% or _ 25% Census Code y 3 y Zoning City Water SAC Units Storfes Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Y6 i Width _ Footings (new bldg) _ Footings(deck) _ Footings (addition) Foundation Drain Tile Roof _?Q Ice & Water LKJ Final ? Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Pertnit & Surcharge Treatment Plant License Search Copies Other Total Building ? 30 Accessory Bldg O 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. fP] 44 Siding -S 0 45 Fire Repair ? 46 Windows/Doors i EQUIRED INSPECTIONS FinaUC.O. z° FinaVNo C.O. Plumbing HVAC Other _ Pool Ftgs _ AidGas Testr Final _ Siding P Stucco Stone _ Brick i _ Windows (Lxf,0 - _ Retaining Wall 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 _P,r2s. zs New Consfrudion Reauiremenis RemodeVReoairReauirements Office Use OnN 3 registered stte surveys showing sq. R of lot, sq. ft. of house; and all roofed areas 2 wpias of plan CeA of Survey Recd _ Y_ N Y N (20%mazimumlotcoverageallowed) isetofEnergyCalculationsforheatedadd@ions TreePresPlanRecd _ , _ 2 copies of plan showing beam & window s2es; poured found design, etc. 7 site survey for additions 8 decks Tree Pres Required t N S ti S _ Y_ N N Y lsetofEnergyCakulations Addi0on-iridkateifon-sdesep6csystem em On-s e ep c ys _ _ 3 copies of Tree P2servation Plan if lot platted aRer 711193 Rim Joisl Delail Oplions seleclion sheel (buildings with 3 or less uniGS) Date Construction Cost (0,ccv. Q7 Site Address Unit/Ste it Description of Work rZt ?-?"D Multi-Family Bldg Y_ N Fireplace(s) x 0 2 UQA'f ? ? ( ? ?t GL4 C ?"?OL Telephone # / Pro rty Owner I , U , co s1jLr? Contractor 1'?jy Z 4" ' = A?LJ-? , -4 ?LL?? Cit Address 4?2t • t y State dlil-M Zip ? Telephone #(7(?? Z " COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Enetgy Cade Category , Residenlial Ventilafion Category 1 Worksheet • New E y Code Worksheet (4 submissiontype) Submifted Submifted • Energy Envelope Calculations Submitled ????/ ? In The last 12 months, has the City of Eogan issued a permii for a similar plan based on a _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( 7elephone #( 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. Applicant's Printed Name pplicant's i ature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg 0 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 ofL plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Ak - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Muld Misc. O 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Stortn Damage O 08 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding -sr0A*e,-Z 0 32 Add'Rion ? 36 Move Buiiding ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration O 37 Demolish Building' qO 43 Reroof ? 48 Windows/Doors ? 34 Replacement •Demolition (Entlre Bldg) • Give PCA handout to appliwnt Valuation bi a00• v? Occupancy R_3 MCES System Plan Review 100% or 25% Census Code U 3? Zon'ing ? 3 City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaVC.O. _ Footings (deck) ? FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile ptheT Roof & Ice & Water Final Pool Ftgs Air/Gas Tests Final Framing _ _ Siding )d 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 --4I0I3 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reouirements 3 registered site surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas (20% maximum lot wversge allowed) 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 set of Energy Caiculations 3 copies of Tree Preservation Plan if lot platted afler 711193 Rim Joist Detail Optlons selection sheet (buildings with 3 or less units) -$ 12$. 25 RemodellReoav Reauiremenls Oflice Use Oniv 2 copies of plan Cert of Survey Recd _ Y_ N 7 set of Energy Calculalions for heafed additions' Tree Pres Plan Recd _ Y_ N i site survey (or adddions & decks T2e Pres Required _ Y_ N Adddion-indicafeifarsnesepticsysfem Onaite5eptic5ystem _Y _N Date q / 2_q / 0? Construction Cost (p? Ccv< &V Site Address L(?fj (`'i' ? 1- IN L01 Fj4- Uoit/Ste # Description of Work . An"'pLa?? e--? Multi-Family Bldg XY _ N Fireplace(s) ? 0 _ 1 _ 2 Pro rty Owner k0i4'{;p jJj (,"r= 1`4?5t C ?gaG : Telephone # ( Go 5c1L-T lKS -G'ZJ - C? Cootractor I''r ? ,t? r??L L ?E}-'f'(a4 -I?L , ? F Address ? I-?Tf?1-9f ? ,y ? rC ?? • 1?4- City ? State _At !V ZipC515? Telephooe# (7j:P37. ?2--4- - -rj?7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minne ules 7672 Energy Code Category . Residential Venfilation Category 7 Worksheet • New/'ne gy de,Worksh (Jsubmissionrype) Submitted S `bm(tt'ed /C q • Energy Envelope Calculations Submitted S+r p L? ?l 1Y/ In The IasT 12 monihs, has the City of Eagan issued a permit for a similar plan based on a _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Controctor Sewer/Water Contractor Telephone #( Telephone # ( Telephone #( ? plan? •9 20QS 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 wi11 be in accordance with the approved plan in the case of work which requires a teview and approval of plans. f.AzCS Applicant's Printed Name Applicant's Si ture OFFICE USE ONLY Sub Types ? 07 Foundation ? 07 OSplex O 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/oplez ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF O 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage O 06 04-piex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior O 44 Siding -STv cc o IZ+?Pfii r'Z ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building• I$ 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout W applieant Valuatfon (o j Da0•D a Occupancy R -3 MCES System Plan Review 100% or 25°h Census Code ?? Zoning 2 _3 City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const V /3 Width _ Footings (new bldg) _ Footings(deck) _ Footings (addition) Foundation Drain Tile Roof 4 Ice & Water ?Q Final ? Framing _ Fireplace _ RI. _ Air Test _ Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC Gity SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Ofher Total REQUIRED INSPECTIONS Final/C.O. ?o Final/No C.O. _ Plumbing HVAC Other _ Pool Ftgs AidGas Tests Final _ Siding ?Q_ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Building inspector 2005 RESIDENTIAL BUILDING PERMTT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 0 651-675-5694 $t28, zs New Construction Reouirements RemodeUf2eoairReauiremeMS Oftice Usa Onlv 3 registered site surveys showing sq. ft. of lot, sq ft. oi house; and all mokd areas 2 wpies of plan Cert of Survey Recd Y N (20°k maximum lot coverege allowed) 1 set of Energy Calculations for heated addNons Tree Pres Plan Recd _ Y_ N. 2 copies of plan showmg beam & window s¢es; poured fourW design, etc. 1 site suNey for additiois & decks T2e Pres Required _ Y_ N lseto(EnergyCalculafrons Addition - indicete'rfon-sitesepticsysfem On-site5epticSystem _Y _N 3 copies of Tree Preservation Plan Hlot platted after7liFJ3 Rim Joist Dehail Optlons seledion sheet (6uildings with 3 or lew unifs) Date q / ??-q / O?L Constructeon Cost fp E a_v< co Site Address L?1?2 M6 4a>01-4? CivfnLL..? UniUSte # Description of Work ?i?C,7 59a'iZ4G" . &XeLV?V Multi-Family Bldg Y_ N Fimplace(s) N0 _ 1 _ 2 Pro rty Owner ?/f (??IL ?-G f.? c Telephone # ( q`J'? Contractor 1, '? f??G7 = A"LL GC? ??p]-TID? ? ,{?, Address ?((?r - ? AvtF . l4. n City State_ia/q Zip457?; 4+5? Telephone#f-2+ -?j-zf 7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Code Worksheei (dsubmissiontype) Submitted Subml • Energy Envelope Celculations Submitted ?? In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a masterlp1/nBSFF' .9 9/ _ Y _ N If yes, date and address of master plan: ? 10nS Qy ? Licensed Plumber Telephone #( Mechanical Contractor Telephone #( ) Sewer/Water Contractor 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. Applicant's Printed Name ? pphcant's i ature 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 Firepiace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of L plex ? 09 07-plex ? 17 Garage ? 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 0 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous Work Types ? 31New ? 35 Intlmprovement ? 38 Demolishlnterior ? 44 Siding-o ,zePmR ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building' 0 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Enfire Bidg) - Give PCA handout to applicanY Valuation G? OU Occupancy -.Z 3 MCES System Plan Review 100% or 25% Census Code y.3 `f Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const 1/ /3 Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) ? FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC Drain Tile Other _ Roof t'C Ice & Water ? Final Pool Ftgs AidGas Tests Final 4L Framing _ _ _ Siding )0 SWCCO _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final Windows _ Insulation _ Retaining Wall 4 Approved By: ? /GY ---------------------- --- , 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 -41015 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Consfruction Reouiremen(s 3 regislered site surveys showing sq. ft. of lot sq. h. af house; and ?II roofed areas (20% mazimum lot wve2ge allowed) 2 cop'ies of plan showing beam & window s¢es; poured tound design, etc. 1 set M Energy Calculations 3 copies af Tree Preservation Plan'rf lot platted aftu 711193 Rim Joisl Detal Optlons selection sheel (buildings wiN 3 or less units) 4; 128, 25 RemodaVReoair Reouirements Office Use OnN 2 copies of plan CeAOfSurveyReW _Y _N 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N i site survay for addiGons & decks Tree P2s Requi2d _ Y_ N Add'Non - indicete if on-sile sepUc system On-sAe Septic Sysfem _ Y_ N Date CanstrucNon Cost (p ,Lm, Q? Site Address UniUSte # Description of Work Multi-Family Bldg Y_ N Fireplace(s) ? 0 2 Pro rtyOwner MQfir;p (/.J (??K_ Telephone # ? o G't??AS Go ??t-T6 ItiLS --r.ZJ - C?a Contractor Address 4?21 City ?7?LLZ.IlF State ?! V Zip C57?; 4+21_' Telephone # (7,3). ±:Z'4" " q4-7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Mlnne5ot3 RllleS 7670 C8[eQON l _ tnwucsuLa Au?iv in Energy Code Category • Residential Ventilation Category 1 Worksheet • New gnefgy,Co? eet (J submission type) Submitted SubmiVted ? • Energy Envelope Calculations Submitted ??' ? ~ FP 9 9 In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a mast?yplanB I? _ Y _ N If yes, date and address of master plan: /L' Licensed Plumber Telephone #( ? Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residenrial 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; ihat 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 ic s Si OFFICE USE ONLY Sub Types ? Ot Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bldg 0 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of L plex ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ext. Alt - SF ? 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) 0 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage ? 06 04-plex ? 72 12-plex Plbg_Yor_ N ? 25 Miscellaneous Work Types ? 31 New ' ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding -5iu «'. ? 32 Add Rion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion O 37 Demoiish Building' ffi 43 Reroof 0 46 WindowslDoors ? 34 Replacement "DemollUon (Entire Bldg) - Give PCA handout to applicant Valuatfon bj ???•Da Occupancy MCESSystem Plan Review 100% or 25°k Census Code q?q Zoning R- 3 City Water SAC Units Stories Booster Pump # of Unds Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Y!3 Width _ FooHngs (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof ? Ice & Water ?o Final `je Framing _ Fireplace _ U. _ Air Test _ Final _ Insulation , , • Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool Ftgs _ Air/Gas Tests Final _ Siding ? Stucco _ Stone _ Brick _ Windows _ Retaining Wall Building Inspector ? Io 1? 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 */28, 25 New Construcfion ReauiremeMS RemodeVReoairReouireme?ts Oifice Use Onlv 3 registered site surveys showing sq. ft. ot lot, sq. ft. of house; and all roofed areas 2 wpies of plan CeR of Survey Recd _ Y _ N (20% maximum lot wverege allowed) 1 set of Energy Caiculations for heated additions Trce %es Plan Reod _ Y _ N, 2 copies of plan stawing beam & window s'¢es; poured found desgn, etc. 1 site survey for additions & decks Tree Pres Required _ Y _ N lsetofEnergyCalculations Addilion-indicateifon-s(fesepiicsyatem OnstteSepticSystem _Y _N 3 coples of Tree Preservation Plan N lot platted ader 711/93 Rim Joist Dehaa Options selection sheet (buildings with 3 or less unfls) C / OJ Date q / ??- Constructioo Cost (O E C? , ? ? Site Address `'(E?6C7 Lat?_ UniUSte # & Description of Work EET e- 4A-Fg-z;,C_7 Multi-Family Bidg Y_ N Fireplace(s) jX 0 2 Pro rty Owner ?p {/ (i6??K_ (4 l_qC A-S`T06i Telephone k ( q? ^ ? O ? GD ?t' 4?t?T Gr.L "'? J - C-s Ek Contractor ??j12dL7 =A Y . (,6 9-_? E& Address ff-+TV? - ? , ? ? /'T?e5. f?. _p Ciry?Li.,ZiY? 04-1<&L State Telephone#(7,6:,? 2-- - COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING - Minnesota Rules 7670 Cate orv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilafion Cat gory 1 Worksheet • New Energy G de'W? she el` (d submission type) Submitted Submitted'/ l?' lN • Energy Envelope Calculations Submitted J? 2 ,9 In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master/plan? Z??S _ Y _ N If yes, date and address of master plan: ?t?"_ „.4s 1 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 5tatutes; 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. ??h2cS 6,Ap1e Applicant's Printed Name App icant's ture OFFICE USE ONLY Su6 Types ? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 ofL plex ? 09 07-plex 0 77 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-p{ex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous Work Types ? 37 New O 35 Int Improvement ? 38 Demolish Interior ? 44 Siding . R CPA' K ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' 8 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demoli8on (Entire Bldg) - Give PCA handout to applicant Valuation ?Aflo• co Occupancy ?.? MCESSystem Plan Review 100% or 25% CensusCode L? 7-7 Z Zoning CityWater SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinkiered Type of Const 1' Width _ Footings (new bldg) _ Footings(deck) _ Footings (addition) Foundation Drain Tile Roof 4 Ice & Water K_ Final ? Frammg _ Fireplace _ R.I. _ Air Test _ Final Insulaiion Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC lJtility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS FinallC.O. ?0 FinaVNo C.O. _ Plumbing HVAC Other _ Pool Ftgs Air/Gas Tesu Final Stucco _ Stone _ Brick _ Siding Y _ Windows _ Retaining Wall Building Inspector -?0939 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. sing(e family dwellings & townhomes/condos when permits are required for each unit Date-09 / "21 14005 Site Address 90A/ N( eo.dow I ark Lh. Unit # PropertyOwner V l.l 11 D ?J (.! A 5 e(.Q Telephone !# (65/ Contractor ?/?fJi IQ 2 5 m O S-? StreetAddress 0 p[o ' YY. CiTy State ? N Zip S501pk Telephone #(4p5l Bond Expires: The Applicant is _ Owner X Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 ? furnace _Additional X Repiacement air exchanger airconditioner _New _ Replacement other State Surcharge $ 50 T l $ ??• `?'`? ota I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work wil] be in conformance with the ordinances and codes of the Ciry 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 permit; that the work will he in accordance with the approved plan in the case oF work which requires a review and appro I I?ar,e?/Sererson./?•?- Lr,ortl;,?for ? Applicant's Printed Name Ap 'cant' ignature C-T 0 ?i 7005 I? '.? ? - 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciaUindustrial buildings multi-family buildings when sepazate permiu are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenan[ Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is _ Owner _ Contractor _ Other Work Type New Construction _ Underground Tank _ Install _Remove "see below fnterior Improvement _ Install Piping _ Processed _Gas Nature of Work: *`When installing/removing underground tank, call for rnspection by Fire Marshal and Plumbing lnspector Permit Fees: $70.50 Underground tank installa[ioNremoval $50.50 Minlmum (mcludes SYa[e Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If ep rMi[ fee is $1,000 or less, add $.50 State Surcharge If ep rmit fee is over 51,000, add $.50 for every $1,000 oermit fee $ Total Fee i hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes oFthe Ciry 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 permit; that the work will be in accordance wi[h the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: ,Inspector Date: Aug 20 08 11:27a Duane Sawyer ?,?y Of Baop 3gp p" Knob Road Eagan MN 55122 Plwne: (651) 6761r675 763-479-6600 p.8 ---------- ? FaOLicellae ? I ? ??j!y f j Penfd[S: ? p ??: LlD , a? ? I SIaAf: Faoc:(651}6755694 ---.,.------------ 2008 RESIDENTiAL SUILDING PERMIT APPLICATiON oate: ?? ? add''e?- YO5lo fJ7'0LYic._aLA?. Sulte ii: Tenamt' w i AES{DENT / OWNER Name= (:?qSSEJ! J?IGS/?7 ? nadressr cur iza Applicant is: _ Dwrm -contractor TYPE OF WORK Descri;36an ot woric ? i r a"'4 `" • -- ,! cansbwUon Cost 1, XL>o• Mufh-Family euildng: (ves !? 1 nfo I coNTRacroa Name: „ ??T ucerse u: nddress: 727C 1?4:5/f f ?tkE .?ta W. r."f, sca?: !/ _ ?rs:'. i?`r-?--- PFione: !J`'•??? - .s? CadactPerson- CpNpLETE Ti-11S pFiEA ONLY IF CONSTRl7CTiNG A NEW BUILDING M:nnesota Rules 7670 Caieaorv 1 _ Nlinnesota Rules21IZ? Energy Code . aaade" verdiMm caogwr + WafthoM • wew amW cocIe wa*shmd categ«y suomated g'bnnVed 81bIIIlSS1Oa IYPe) • EMW E^m&0138 CMMABffium Stftntwd , In tlie 6ast 12 monlln, hw the CItY of EWn bsued 8 fomfl for a shdFer plan basad on a rtmsler plan? Yes No it ye+, datvr and address of rtu-ster pbn. PFlone: Licensed Plum6er. Phone' RiechanicN CoMbaclor: Wro1tie: gerver & WaEar Con6ador: NOTE: PI?+s and s?porlfi?S d?umenft t[at Ya+ ?M+B ? fo be I?c h?fo?a??on' Pn?++s ot ? ? ?t wa?tNdp? ?+e ?' ? the Irrlom?atlau? maY be ? ? ? ??1?+?..:_.. ??i....y.:? - - ..s. t IaFbY adamWedge nwt this kdmTngbon is compkde ana ao=m: ????end? Ik isarerwi??iaut apom " mdmmm ? acocks i?lc be in F?rti tl?a2 1 undersfard ths is tl rYOiwhicic re?dew wd ?? ?qcaderce rr? N?e apP'?? d? M - x S?EzC? ZE9Hd ` ?? ?s w+?a ? I 'p ?? ?e 1 a 3 N ?---------------- ? I ; PerTnit #: K73g? ? ? Permit Fee: 14 ICJ • Jjz- ? I )/ I ? Date Received: I Staff: I ------' 20U8 RESIDENTIAL BUILDING PERMIT APPLICATION Date:1? SiteAddress: lt(ob 7qAo`."a, a/ Tenant:407e2?4t?'1`I, 4071,, [l!/D fb?H-dSa. 4C7S'-?i`f0x-?ul RESIDENTIDWNER Name:+i/?/ UsCI't Phone: Address/City/Zip: LVID Jr1CAJtlwL?tR.k- ?? p?92r- MN (9,1- Applicant is: _ Owner ?, CoMractor TYPE OF WORK Description of work: ? Q ??vCS ez?-D-F Construction Cost: -01T? -;3 S/0, 00 Multi-Family Building (Yes No ? CONTRACTOR Name: S itl C'? ?0- License #: 1?67)6,5) y5 y Address: ? d ? S 13L5 k1 GC&t 12- 0 Ciry: ? L7 i-ct. State: YYt (? Zip: ?S? 3 5 Phone:(,? yz) aS3-U-F35-- Contact Person: e (Y`-? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Catedorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category suemined sunmined submission type) • Energy Envelope Calculffiions Submiqed In the last 12 months, has the City of Eagan issued a permit for a simllar plan based on a master plan? _Yes _No If yes, date and address of master plan Licensed Plumber: Phone: MechanicalContractor: Phone: Sewer & Water Contractor: Phone: NQTE: All andSup?{tOr?iri,?Cfiitcumenfs tha??04-stibmftare eansirteredfiF'6e,pubitcin/?irmatfan PoFtians of the informatiarn.mak?Fia otas~,as nonrprtbtF? ttpoul??lde?sPe????reA?+s ffrat ?votild permif the City to ' : ?fcl?i??'hat:tlh ?are fea'd? s?t?ts,.- :,.:.I hereby acknowledge that this infortna6on is complete and accura[e; that the work will be in coniormance with the ordinances and codes of the City oi Eagan; that I understand this is not a pertnit, but only an application for a permit, and work is not to start without a permit; thal the work will be in acwrdance with the appraved plan in the case of work which requires ie?rae roval of plans. x Applicant's Printed Name Applicant's ' natur Page 1 of 3 VILLAGE OF EAGAN WATER SERVICE PERMIT 3/95 Piiot'Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.• Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the Village of Eagan Surcharge: Ordinan Misc. Charges: Total: / Date Paid: Date Insp.: f/ Insp.: VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 Pilot knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the Village of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: B Misc. Charges:-- --s' Date of sp.: Total: Insp.: Date Paid: . � Use BLUE or BLACK Ink r________________^ � For Office Use � � � Permit#: � �� Clt of �a a� � . �� Y � � Permit Fee: � 3830 Pilot Knob Road I I Eagan MN 55122 � � I Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I I � Staff: � �-----------------� 2014 COMMERCIAL BUILDING PERMIT APPLICATION Date: f �IS � Site Address: Tenant Name: �e�d\�Q v..� \�.�- �:�� (Tenant is: New/ � Existing) Suite#: Former Tenant: Name: {° �c scl�+•...�n�- X, r��o �� Phone: Property Owner Address i City�Zip:xl d�t7 . �' ra�2, ►t c�� o 't �� , 'iv��F. �t �7�t�, �( c�� ,�l �� i��(� , �� . �� Appiicant is: Owner Contractor � Type of Work ' Description of work:__s�. Y•t7 !t �r�N� � �t w1 t-^� Construction Cost:�/�.LW � Name: C� Y�vr�.c�� r� ` pv.��l��c.�w� License#: Contractor Address: Z �°7'� �/�'��,�,,,� U r. city: �; ,�q�,� State: �1 � Zip:_�S 3 r�' b Phone: G S� � �� — �ti � � Contact: %he �'�'� e� Emai�: .,. � ,� �nt� �O L_`�,�v..� Name: Registration#: �Architect/Engineer Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: 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.orq I hereby acknowledge that this information is complete and accurate; that the w k w I be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an ap c tionifor 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 r wh' h requires a review and approval of plans. X `� e ��-� gv� S �e`�) x Applicant's Printed Name ApplicanYs Sig Page 1 of 3 toisijEY-- 1( rr \ �,.,� 1 Use BLUE or BLACK Ink For Office Use I � 6 / 1 CityEapiiPermit8: /��/ ,of } Permit Fee: / % /` 4 3830 Pilot Knob Road 1 Eagan MN 55122 . Date Received: ( . F-1 11 Phone:(651)675-5675 ``�\A Fax:(651)675-5694 1,',, t StafT7 i ` i 2017 RESIDENTIAL,rBUILDING PERMIT APPLICATION Date: 7J7/1�2 Site Address:3 0 7 0 vow 4 A 1 Unit#: ;u<;;11 . ''.:•,::: k Name: j ulhW LJti?1' &2C.td+io A Phone: i 5ideg 1--(\1--(\"`>� '� c��, Address/City/T.tp: Y t!�� w� �!).) _ `: ry ..00 Applicant is: Owner Contractor ` v Stucco repair .►,—.:,�;, --aft) w t Description of work: ' y4 i wr - .l Y ', '-;-„';''..;',5414,. ..k.,,,-,;;71- Construction Cost: X41.0 Multi-Family Building:(Yes I No ) _. ,>� i Austin Remodeling Mike �. -�t , .i Company: Contact ,odd . 19306 Oelke Dr • City: Prior Lake r ' MN 55372 612-221-4429 mike@austinremodel.net Y State: Zip: Phone: Email: i� , BC664409 NAT-F158156-1 ,r : License#: ; 6-g -- L1/14 tfQ 7Q (GIAdo, DO NOT WRITE BELOW THIS LINE i 0166 , SUB TYPES _ Foundation — Fireplace ! Porch(3-Season) _ Exterior Alteration(Single Family) }( Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) ,_° Multi — Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex — Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ 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 t 0 Occupancy ,L 3 MCES System Plan Review Code Edition 0/16*,Qtj' SAC Units (25%_100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V 0 Width REQUIRED INSPECTIONS V V Footings(New Building) Meter Size: — Footings(Deck) Final/C.O.Required Footings(Addition) y Final/No C.O. Required Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding: x Stucco Lath Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings—Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan ,e�''"� Other: Reviewed By: ( (/ ,Building Inspector RESIDENTIAL FEES Base Fee Surcharge91/t 1 (/0 Plan Review (0441-1/"%i MCES SAC ri City SAC Utility Connection Charge S&W Permit&Surcharge /..-- 5 '" IP' Treatment Plant Copies TOTAL Page 2 of 3