The URL can be used to link to this page

4162 Meadowlark Way 08/28/2012 20:37 7637805011 INSTALLATION MASTERS PAGE 01/02 Use BLUE or BLACK Ink ) For Office Use I I V Pita se- ie!- I o~~ ~I~ I Permit I Permit Fee: City of Eap ' 3a30 Pilot Knob Road Date Received: I Sagan MN 55122 I Phone: (651) 675-SSTS 1 staff: I Fax: (661) 675-5694 I _ 2012 RESIDENTIAL BUILDING PERMIT APPLICATION e4dV W jam' Unit _q o z, M Date:, I Z Site Address: Phone. Name: _~U RESIDENT OWNER Address ! City / Zip: n Applicant is. Owner Contractor Iferca-fly TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes f No Company: ~btigtt: n La.41L*Iiali CONTRACTOR Address: ~~wTc7~ : State: ~ ZiP: Phone ~ i~-License M. Lead Certificate if the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? Yes __No If yes, date and address of master plan: Phone: Licensed Plumber: Phone: Mechanical Contractor: Phone; Sewer & Water Contractor: NOTE: Plans and supporting documents that you submit are consi a reasons t li Information. ~ m permit the City b the information maybe classified a conclude that you are trod secrets. CALL B FOR1= YOU DIG. Call Gopher State One Call at (651) 464.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utiCrties. Vwu AWhemt ~ l be n con wi hout a permit; that tohe work will be of and I hereby acknowledge that this not atioermlcomplete and accurate; application hfor a permit, alnd wlork iis~to stawith the Eabut gan, that 1 understand this is not a p k only an accordance with the approved plan In the case of work which requires a review and approval of plagsr 'fate Iding ust be co within 180 Exterior work stAhorized by a building permit Issued In accordance with the Minn / . days of permit Issuance. x__ nt's 9n re Applicant's Print Name Page 1 of 3 ? RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? 651-681-4675 New Construction Reauirements RemodeVReoair Reauiremeots • 3 registered site surveys showing sq. fl. af lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20°b maximum lot coverage allowed) • 1 set of Energy CalculaGons for heated addilions • 2 copies o( plan showing beam & window sizes; poured found design, etc.} • 1 site survey forexferior additions & decks • 1 set of Energy Calculations . Indicate if home served by sepfic system for additions • 3 copies ot Tree Preservation Plan it lot platted after 711193 • Rim Joist Oetail Optiwns selection sheet (bldgs with 3 or less units) DATE b VALUATION ? - v t" " JOB SITE ADDRESS 167 " yI (pd _Jw].,:' mt&&&)4dc1 IP MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY-OWNER Z-G.h Lv6J lDk)GL sS TYPE OF WORK E451d? Q( J`? U/ X F(REPLACE(S) X0 _ 1_ 2 APPLICANT ?? u- hti ? ?PtC PHONE#7? 317V` 775'?? ADDRESS C-1U ZIP CODE?? PAGER # CELL PHONE #toI Z 761" 9S? l FAX # NtIV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worlcsheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Mechaiu" c?l System Includes: Sewer/Water Contractor: Water Softener Water Heater No. of Baths Phone # Fee: $90.00 Phone Lawn Sprinkler No. of R.I. Baths Air Conditioning Fee: $70.00 Heat Recovery System F-P r? ? ??7 M (- l LI I I Phone # 116 11 All above information must be submitted prior to processing of application. I hereby acknowledge that ! have read this application, state that with all applicable State of Minnesota Statutes and City of Eagan 5ignature of Applicant correct, and agree to comply Certificates of Survey Received _ Tree Preservation Plan ft$eived _ Not Mquired _ Updated 1101 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const W idth REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) FinaUNo C.O. Footings (addition) Foundation Drain Tile Roof Ice & Water Final Other Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone Insulation _ Windows (new/replacement) Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage SB?W Permit & 5urcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.), ? 22 PorchlAddn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Muiti ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg only) - Give PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Fina _ UC.O. _ Plumbing HVAC Building Inspector RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAC,AN 3830 PILOT KNOB RD - 55122 651-681-4675 New ConsVuction Reaulrements • 3 registered site surveys showing sq. R of lot, sq. R. of house; and all roofed areas (20% maximum iol coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, elc.). • 1 set of Energy Calculafions • 3 copies of Tree Preservation Plan if lot plalted atler 711193 • Rim Joist Oelail Options selection sheet (bldgs wilh 3 or less units) DATE $ V, 00 $- 3 I -01 RemodeUReoair Reauirements • 2 copies of plan • t set of Energy Calculations for heated additions • t site survey for exterior additions & decks • Indicafe if home served by septic system for additiarts VALUATION 2,000.00 JOB SITE ADDRESS 41:625.MEADOWt!ARK WASf ''• ' :' " ` r';? .., , I IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER JAN DIETER TYPE OF {rilaRK REPLACE 0 ) PATIO DOOR &(1 ) INSWATED Glass plREPLACE(S) _ 0_ 1_ 2 APPUCANT MON-RAY, INC PHONE# 763-546-8625 ADDRESS 801 BOONE AVENUE NORTH GOL'DEN VAL'l'EY, MN 55427 ZIPCODE 55427 PAGER # CELL PHONE # BUSINESS PHONE: 763-546-8625 FAX # 7f 3_946_R 7q 7 NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINIVESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Workshe - Energy Emelope Cal;,i;lations Submitted MINNESOTA RULES 7672 _ ? New Energy Code Worksheet Submitted ?' 1s??1? ? Plumbing Gontractor. Phone Plumbing System Includes: ? Water Softener ? Lawn Sprinkler . . Water Heater No. of R.I. Baths Y No. of Baths Mechanical Contractor: Mechanical System Includes: Sewer/Water Contractor: _ Air Conditioning - Heat Recovery System . Phone # _ Phone # _ Fee: $70.00 All above information must be submitted prior to processing of application. 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 Or ' anc Signature of Applicant ? Certificates of Survey Received _ Tree Preservation Plan Received Not Required _ Updated 1l01 OFFICE USE 4NLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-piex ? 06 04-plex .. . ? 07 05-plex ? 08 O6-¢lex ? 09 07-plex ? 10 08-piex ° 0 11 70-plex ? 12 12-plex ? 13 i6-plex ? 16 Fireplace ? 17 Garage ? 18 Deck O 19 Lower Level Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchlAddn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous Y ? 30 Accessory Bldg ? 31 Ext. Alt - Mufti ? 33 Ext. Alt - SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) Q 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MClES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. RRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) FinaVNo C.O. ' _ Footings (addition) Plumbing . Foundarion - - HVAC . , • Drain Tile • . ` Roof ice & Water ? Final Other _ Framing Pool _ Ftgs _ AidGas Tests _ Final R.I. _ Air Test Firepiace _ Final _ Siding Stucco Stane _ _ Insularion _ Windows (new/replacement) Approved By Base Fee Surcharge Plan Review MClES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector ? RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN Vi, ?1"qqp 3830 PILOT KNOB RD - 55122 '? J 651-687-4675 New Construction Reauirements RemodellRepair Reauirements • 3 regislered site surveys showing sq. ft. ot lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20°k maximum lol coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window s¢es; poured found design, etc.) . 1 site survey ior exterior additions & decks • 1 set of Energy Calculations . Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted aHer 711193 • Rim Joist DetaB Options selection sheet (Gldgs with 3 or less units) DATE $ VALUATION b0G JOBSITEADDRESS_'-II7oZ ?PaG?OWL??lC l,I?? IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY TYPE OF WORK FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT rr"'a7 aoirn &fPrearS ?C PHONE# 765'`js3"Mjy ADDRESS+'f05'/-nexpnotiS 41 /I/o ZIPCODES?qY/ PAGER # 2 CELL PHONE # FAX # NE1V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 Plumbing Contractor: _ Pluxnbing System Includes: Mechanical Contractor: Mechanical System Includes Sewer/Water Contractor: New Energy Code Worksheet Submitted Phone #: Water Softener ? Iawn Sprinkler Water HeaCer _ No. of R.I. Baths No. of Baths Air Conditioning _ Heat Recovery System Phone # Phone # Fee: $90.00 Fee: $70.00 All above information must be submitted prior to processing of application. 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 ? Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1101 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const W idth REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addirion) Plumbing Foundation Drain Tile Roof Ice & Water Final Other Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone Insularion _ Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ? 07 05-plex ? 13 16-plex ? OS 06=plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchlAddn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg only) - Give PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered FinallC.O. _ FinaUNo C.O. HVAC CITY OF EAGAN Remarks Addition_ HILLANDALE ADDN. #2 Lot 4 Blk 4 Parcel 10 32951 040 04 owner st,eet 4162 Meadowlark -eoart LA)a.cJ state Eagan, MN 55122 Improvement Date Amount Annual Years ' Payment Receipt Date STREETSURF. STREET RESTOR. GRADING SAN SEW TRUNK S 1970 74.94 3.00 Z$ SEWER LATERAL * WATERMAIN ? 1973 189.47 12.63 15 * WATER LATERAL WATER AREA ' 1975 104.34 6.96 15 .89 * STORM SEW TRK ? 1973 430.49 28.70 15 sa? * STORM SEW LAT CURB & GUTTER • SIDEWALK STREET LIGHT Road Unit 260.00 #46413 -18-8 WATER CONN. 470.00 IT 11 BUILDING PER. ?i it SAC PARK CITY OF EAGAN Addition_ HILLANDALE ADDN. #2 Owner Lot 3 eik 4 Parcel 10 32951 030 04 street 4164 Meadowlark 6e+-e state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. STREET RESTOFi. GRADING SAN SEW TRUNK QS" 1970 74.94 3.00 2$ .2 I0 -/DcIo7o /D SEWER LATERAL * WATERMAIN 1973 189.47 12.63 15 ? C-/D 1,20 -/S-?S * WATER LATERAL WATER AREA 3 1975 104.34 6.96 15 -1C9d0 o- -P * STORM SEW TRK 1973 430.49 28.70 15 3-- ?- i o 9ao /o-/ - ?t STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT Road Units 260.00 47215 10-2 -8 WATER CONN. 470.00 11 11 BUILDING PER. n n SAC r, n PARK CITY OF EAGAN Remarks Addition . HILLANDALE ADDN. #2 1168 l.ot 2 Blk 4 Parcel 10 32951 020 04 Owner Street 4+66 Meadowlark 6eovt "It State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1970 74.94 3.00 25 SEWER LATERAL * WATEflMAIN 1973 189.47 12.63 15 * WATER LATERAL WATER AFEA 1975 104.34 6.96 15 I*sTORMSewTaK al),4 1973 430.49 28.70 15 ? STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 WATER CONN. 470.00 BUILDING PER. SAC n n PAfi K CITY OF EAGAN Addition HILLANDALE ADDN. #2 4 I:7 Lot 1 RIk 4 Parcel 10 32951 010 04 Owner Street *f-6-8r- Meadowlark 6e 5tace Eagan, "r+02 MN 55122 1 Improvement Date Amouni Annual Years ... Payment Receipt Date STREETSURF. STREET RESTOR. GRADING SAN SEW TRUNK US" 1970 74.94 -?633.5 C/- S SEWER LATERAL WATERMAIN 03 1973 189.47 12.63 15 25. 5 74-?5 * WATER LATERAL WATERAREA ?t STORM SEW TRK 1973 430.49 28.70 1 -? 0 ?4 ie STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit WATER CONN. 470.00 BUILDING PER. SAC n n PARK CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 RECEIVQD AMOUNT $ ? & DOLLARS +oo ? CASH E]. CMECK . ? FOR FUND CODE AIAOUNT Thank?0__) BY White-Payers CopV Yellow-Posting Copy Pink-File Copy CASH RECEIPT r CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 RECEIVED FROM AMOUNT ? E) CASH ? CHECK FOFl FUNO CODE AIAOUNT Than?ou I , BY & DOLLARS 1 oo White-Payers Copy Vellow-Posting Copy Pink-File Copy CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 RECEI V ED FROM AMOUNT $ I & DOLLARS I ?oo ? CASH ?. CHECK Fow White-Payars Copy Yellow-Posting Copy Pink-File Copy Thank P B Y PERMIT #_ PRICE: Site Address I ' ? Lot Block ? Name 1??^"ISnlr a? m Address 702 Ex elsi t Ave. [ c City Hopkins, Mirp?,? W??ti, 938-1860 Name ? -?- 3 Address - ? O 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 IF PERMIT PRICE GOES BEYOND $1 00.00) , SIGNATUR F PERMITTEE CITY OF EAGAN Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL -Water Closet - $3.00 $ _Bath Tubs - $3.00 _Lavatory - $3.00 _Shower - $3.00 -Kitchen Sink - $3.00 -Urinal/Bidet - $3.00 _Laundry Tray - $3.00 _Floor Drains - $1.50 -Water Heater - $1.50 _Whirlpoal - $3.00 _Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMI'n -Softener - $5.00 -Well - $10.00 _Private Disp. - $10.00 _Rough Openings - $1.50 FEE: STATE S/C: i GRAND TOTAL: ? PLUMBING PERMIT # CITY OF EAGAN RECEIPT 3830 PILOT KNOB ROAD, EAGAN, MN 5 5122 DATE: PHONE: 454-8100 BLDG. TYPE WORK DESCRIPTION ec/Sub Res. ? New , . GITY OF EAGAN 960 3830 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55121 PHONE:454-8100 <_.f'/j BUILDING PERMIT Receipt # / Te 6? wed for 1 OF 4 UNIT Est. Value $53 FO00 pOte OCTOBER 23 1984 SiteAddress 4172 MEADOWLARK 'WAY Erect ? Oceupancy R1 Lot 1 Block Sec/Sub. filLLA ' Remodel ? Zoning Parcel No. Repair ? Type of Const. V 1 HR Enlarge ? No. Stories ? Name michael COT1St Move ? Length 2 ; Address t SUITE 33-1- Demolish ? Depth 45 U City St 1OU15 PKone 9 - 2 Grede ? Sq. Ft. ? SAME App?ovab Faes ZO Name ? 0 uU Address Assessment Permit 6 ? Woter d? Sew. Surchorge 2/.5p City Phone 10 ?rc DU'I10NEUAUX & ASSOC Police Plon check 525 00 F W Name Fire SAG 470.00 i? Address _ Erg. Water Conn. <W City e ina phone Plonner WaterMeter?o Council Road Unit /2 I hereby acknowledge that I have read this appiication and stote that gldg. Off. 10 22 8 Parks . the informotion is correct and agr.ee to wmply with all cpplicabla APC Total ?7B775D State of Minnewta Statutes and;City of. Eagcyrf,(?rdinances. Var. Date $ipnoture of Pertnittee-- MICHAEL CONST /1 Building Permit is issued to: on the exprcss condition thai oll work shall be done in accordonce wij?r tt npplicobfe State of Minnewta Statutes ond City of Eogcn Ordinances. Buildinq Official n ? Permit No. Permit Holder Deta Plumbing ' % ?? ?? i• ? '' - . i- r' I ? _ T7 '? '`l ' ;' Tj _)( 1 ?(? ? H.V.A.C. ? LAJ Eleceric Softener Inspeetion Date Insp. Other Footings I Foundaiion Framing Rough Ptbg. ZS?? -?i Rough HVAC ,ls_? J.? ? ? Insulation Final Plba a Final HVAC g Final C..t/occ. c? g -?r - ? Water Descri Location: Wel I Sewer Pr, Disp. I Receipt ??I iF J PLUMBING PERMIT Permit No ?I -' )?( l, CITY OF EAGAN Fee Fill in numbered spaces S/C • r- Type or Prinr legibly Tn* 1. Date 2. Installation Cost 3. Job Address Blk. 4. Owner ? , 5. Contractar 1,li •I j7 1 ?._ ?_)i; Phone -4 i- 1, 6. Address ??I, 1-?1 ? ?-?E i J?i i. 1.I, 1, 7. CitY , ,,; ?. , State Zip ? 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New 'Q Add ? Alter ? Repair ? 10. Describe 11, No. 1 Fixtures Water Closet No. Fixtures Cesspool/Drainfield ! Bath tubs Septic Tank Lavatory Softner Shower Well _ ? Kitchen Sink Urinal/Bidet Other _ / Laundry Tray ; Floor Drains ? _ I 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 : ?t ? for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8700 Receipt MECHANICAL PERMIT Permit No. 'I -jdc' CITY OF EAGAN Fee Fill in numbered spaces S/C ='? Type or Prini /egibly /-/ p 4 f Tot 1. Date ? 2. Installation Cost 3. Job Address Lot?Blk. Traci` 4. Owner ,. / . 5. Contractor Phone s`_?,'-/c?c_•? 6. Address 3FD G' ?i . 7. City t > State f% ,, Zip 8. Building Type: Residential jig Commercial ? Institutional ? 9. Work Description: New ;K Add ? Alter ? Repair ? ? 10. Describe I 11, uel Type No. Eauioment BTU - M. Ea. Forced Air ?S O 0 0 No. Epuipment CFM Ai H dli Mfg. 7? _ r an ng: _ Boilers _ Mech Exhaust Mf9. . - Unit Heater Mfg, Other _ Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN . ' 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING rERMIT Receipt Te be Ywd fe. 1 Or' 4 YLI:X Est Val $53, 000 ? OCTOI3ER 2: Site Addr 4168 ss ue MEADOWLARK ?WAY Erect e C? occupa Lot ? Block 4 Sec/Sub. HILL71P1'JA1,r 2 Remodel ? Zoning Parcel No. Repair ? Type o Enlarge ? No. Stc W Name 14IClu m CoNBT Move ? Length Z Address o oulTz J31 Demolish ? Depth S s 935-4252 Grede ? Sq. Ft. City one c ,O SAM Name ADProvals u? A?fe? Asussment P ? City Phone Water & Sew. $ Pol ice P ?W Name DnOMMBiQAQX & ASSOC Fire 5 ?? Address Erq. V ?W City Pnone 928"6674 Plonner V Council a R ? ?7?7 1 hereby ackrwwledge that I hove read this opplication and stote that gldg. Off-???7??? °'? P the information is correct ond ogree to comply with a ll opplicoble A? ? Stote of Minnesota Stotutes and City o{• E$gan Ordinq ? ices. . Var. Date ( ?i / Siflnoture of Permittee '? . ( ! ? • / A Buflding Permit is issued to: on ihe oll work sholl be done in atcordance wlth all applicoble $tate of Minnesota Stotutes ond Ciry of Ec Buildinfl Officiol 9643 ?y ; , 19 &4 R3 V 1 ? theck $10782;-50 ress condition thai Ordinancea. Permit No. Permit Holdar Dtta Plumbinp z t3 ? I r ( H.V.A.C. 0 q w e-, Electric lo!? SoRaner Inspeetion Date Insp. Other Footings ? Foundation Framing RouBh Plbg. •7 S'p.s 4"'45 Rouqh HVAC Inwlation Final P16q. . Final HVAC Final p Cert/Oa. Wator Describe Loeation: Wall . $eWer Pr. Diap. . Receipt PLUMBING PERMIT Permit No.' CITY OF EAGAN Fee f, Fill in numbered spaces S/C ? Type or Piini /egib/y I Tot. ' 1. Date 2. Installation Cost 3. Job Address `ll I'll( Lot ` Blk. Tract ' 4. Owner l? ??l ..?? L.CiVt 5. Contractor W.F IIZe ( Phone I 6. Address --'l,lki 4j4 ? ii?a`)? i_ f ? 7. City L State Zip , - _ 8. Building Type: Residential m Commercial ? Institutional ? 9. Work Description: New El Add ? Alter ? Repair ? 1 10. Describe I 11. No. ? Fixtures Water Closet No. Fixtures Cesspooi/Drainfield _ Bath tubs $eptic Tank Lavatory Softner Shower Well ? Kitchen Sink Urinal/Bidet Other/ , /ci ! Laundry Tray , ?ii,?? 1 • ? Floor Dreins , . ., ; Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above informaiion is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspeciions: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I ' 04;? ? , 1. Date ,, ./ar'-,? Y/6 8 j/, 3. Job Address 4. Owner 5. Contractor MECHANICAL PERMIT CITY OF EAGAN Permit No. Fee :%l'l eL-) sic -<? rot. ;2 ^. '. ? _2. Installation Cost Lot .A' Blk. ? Tract??' Phone -, " - "F L- 6. Address cJ ??.? • ???/ 7. City State Zip 8. Building Type: Residential ?I Commercial ? Institutional ? 9. Work Description: New-ffl Add ? Alter ? Repair ? 1 10. Describe Fuel Type I 11. No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. r an ng: _ Boilers _ Mfg. ' _ Mech. Exhaust _ Unit Heater Mfg. Other Air Cond. Mfg. ? Gas, Piping Outlets ' 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. ?._ Signed : i,. for Rough Finel Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # Te be omd fer 1 OF 4 UNIT Est, Volue $53,000 Da1e OCTOBE 9642 / R 23 19 84 SiteAddrpu 4164 . MFADOWLARK W.4y Erect C? Occupency R1 Lot Block Sec/Sub. KILLANUAIm Remodel ? Zoning R3 Parcel No. Repair ? Type of Const. V 1 HR Enlarge ? No. Stor ieg g Name MICRAEL CONST Move ? Length ? 45- = Addres j `' A 938-4262 ? Demalish ? Depth Grade ? Sq Ft City one . . ? j jME O Name Apyrovols het pu A??S V§ Cit Phon Assessment Water 8 Sew. Permit ' ? 26.50 SurtFwrgs y e 146.00 GW DU MONEUAUX & ASSOC Police Plon check 525 00 rW Name Firo . SAC u? Address Enp. WnterConn. 470.00 _ ? W City Phone Plnnner Water Mater 63.00 Council Road Unit 260.00 1 hereby ockrrowledge that 1 have read this applicarion ond stare tFwt Bldg. Off. Parks the information is correct ond ogree to comply with all oppiicoble APC l ?3d T t $tate of Minnesota Stotutes, qn¢ City,of Eogon ,Ordinorpes., o a ' , ? i . / Var. Date / Sipnoturc of Permitfea t•9ICHAEL CONST A Building Permif is issued to: on the expreu conditlon thal all work sholl be done in accordonce with all applicabla State of Minnesota Statutes ond City of Eapan Ordinonces. Buildinp Officiol Permit No. Pxmit Hoider Date Plumbing -? /- H.VA.C. tJ Elearic Softenar Inspection Date Insp. Other Footings o Foundation Framing RouyhPlbp• _ O• -25-?'S C Rough HVAC Inwlation Final Plbg. Final HVAC Final a Cert/Oee. Water Destribe Locati n: We11 , Sewer Pr. Disp. • 1 CITYOFEAGAN ? ? Fill in numbered spaces Type or Print /egibly Permit No. f; ?r Fee 290•00 sic Tot. o"z lJ. %G 1. Date 2. Installation Cost 3. Job Address Lot .3 Blk. ? Tr?t, 4,7 ? 4. Owner 5. Coniractor <°-:?l`•, %e' f%LC?1!e" Phone I 6. Address F/ 7. City , fiG G, State Zip .? ?% - ? 8. Building Type: Residential Ef Commercial ? Institutional ? 9. Work Description: New E1 Add ? Alter ? Repair ? 10. Describe Fuel Type 11, No. Equiumenr 8TU - M. Ea. Forced Air o av No. Equiament CFM Air H dli Mfg. an ng: Boilers _ M f9' _ Mech. Exhaust _ Unit Heater • Mfg. Other _ ' Air Cond. Mfg. / Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. _?t' , ?, i'.•:: Signed : for Rough Final Inspections: Date Insp. Date Insp, This is your permit when numhered and aqproved. Approved CITY OF EAGAN 464-8700 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee t L'? Fill in numbered spaces S/C Type or Print legibly Tot. t. Date 2. Ins allation Cost ,?? 3. JobAddress ?L,?`k I?.'CllotBlk. 14 Tract 4. Owner 1?4'1 ? l??!?-, I ? ?-(; I 1?'f 5. Contractor 1_.6? I\LQ Phone .? 8. Address -) (J, (.1(1 7. City -- ,_? C? .k i \ State 1 N Zip 8. Building Type: Residential L? Commercial ? Institutional ? 9. Work Description: New C? Add ? Alter ? Repair ? 10. Describe 11. No. ?Z Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? ? Bath tubs - $eptic Tank Lavatory Softner Shower WQll ? Kitchen Sink -? Urinal/Bidet Laundry TraY O her L<)-C?t( f?l:'! ?? • ? Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : ?, ' I ` ` ? ? for Aough Final Inspections: 6ate Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 MECHANICAL PERMIT PERMIT # ?a^'?? ?Q¢.C • 7 -a -7 -d'g CITY OF EAGAN RECEIPT # ? 'A/D°0-3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: Site ? Name ? Addre c City ? Name 3k, ?? - Iti e t c Address ylL c? ll`;rCl.i[I? ?/ti 3 p J C4 F;1ijn I Phone0' r TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU AirCond. M BTU Vent. CFM Gas Piping Outlets # Other FEE: 5/C: TOTAL: BLDG. TYPE WORK DESCRIPTION Res ? New 111101 Mult Add-on ? Comm. Repair Other FEES RES HVAC 0-100 M BTU $24 00 ? . - . ADDITIONAL 50 M BTU - 6.00 ' ; (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS MINIMUM 1 PER ERMIT 1 - ) - .50 EA. ( P COMM/IND FEE - 13b OF CONTRACT FEE APT. bLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES 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) y ?I fI rl/ f?fegrt!g.? FOR: CITY OF EAGAN CITY OF EAGAN , 0641 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 BUILDINCs PERMIT ReceiPt # Te v wad f" 1 OF 4 UNIT FN v„i,,. Y53j,000 n_.„ OCTOBER 23 ?o84 SiteAddress 4162 i? EADOWLARR W}y Lot 4 Block Sec/Su6. fII D Parcel No. W I Name r1ICHAEL CONST. ; Addres£ i t b City S Phone 9-38-426-2 , o Neme SAME ou Address ? City Phone rjw DU'MONEUAUX & ASSOC F W Name _0 Address tW City Phone ? 1 hereby ocknowledge that I how read this opplicotion ond stote that the informotion is correct and agree to compiy with oll opplicabte Stote of Minnewta Statutes and City of Eagan Ordinances. $ipnoturc of Permittee Erect L'1 Occupancy Remodel ? Zoning R Repair ? Type of Const. V 1 Hll Enlarge ? No. Stories Move ? Length z Demolish ? Depth ? Grede ? Sq. Ft. Aoororols Fees wacer 3 Sew. Police Fire Erg. Plonner Council Bldg. Off. APC Var. Date Permit • 0 su.cno.fle 26.50 Plon check 14 6. 00 SAG 525.00 Water Conn. 470.00 w...e, u_.e. 63.00 Road Unit 260.00 Parks Total 1 ? 7 . 0 A Building Permit is issued to: / '`" i ' on ths expres condition that all work sholl be done in accordonce with all applicoble Stme of Minnesota Statutes and Ciry of Eapon Ordinonces. Buildirq Officiol Pwmit No. Psrmit Holder Date Plumbing H.VA.C. Electrie Softener Inspaetion Date Insp. Other Footinge a Foundation Framinp Rough Plbp. Rough HVAC f-lS P /y/-?' Z U? Inwlstion Final PIb9. Pinal HVAC ? Final Cert/Occ. ?- Wster Deseribe LocMion: VYell Sewer Pr. Disp. INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: I Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 ' SITE ADDRESS: ?!iI lFlu+F: Ft i f ! titfAlirtl Id:11I) 1 7 F iiM N,? . PERMIT SUBTYPE: I 141t,11-lNli ? 1i( ':f ia 1 t' i I 1lt1 ruiI t) f raf; Hr?99l Mn j:lfi/S)Fi fi+1 P A11d Fti)s)F i)AMR4Gf I'I MA f?Y'S : t Ni-1 UUt ', . 4 i 6+1 . 4 t 1,1+, AND el {;.' Mt A[SIN,11 (iNY 6lAY I 1 ; i ' t 1 i? APPLICANT: t 1 TYPE OF WORK: Permit No. Permit Holder Date 7elaphone # ELECTRIC PLUMBING HVAC Inspectton Date Insp. Commenta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK FINAL CITY OF EAGAN 3830 Pilot Knob Road SEWER SERVIC E PERMR P. O. Box 21199 PERMIT NO.: .7 0,11- Eagan, MN 55121 DATE: Zonirp: . P,4 No, of Units: 1 nf 4 nlex OwrNr. '-:ic;iael Cotiyt Addrcss: Sits Addross: 4172 -flo Meadoula rk _ .t,:L1 A4 Hillaudale 2 Plumber. + , i, .l 10-21-34 47212 . n I Mw b- opo-, wah IM COY of ypn CarweMon Chaeps: 425.00 pc OrJINnam AccouM Depoalt: 1:. 0i) p' Permit Fw: 10.00 nd 5u,cha.pe; .50 vd BY Misc. Chorpss: DaM of Irap.: Totol: In+R: Dote Patd: CITY OF EAGAN WATER SERVICE PERMIT 3830 PilofKnob Roady . P. O. Box 21199 PERMIT NO.: Eagan, MIV 5512,1 DATE: Z?l?G . No. of Units: o -?p?ex ,c:iae onst Owner: llddren: SiM Addrcss• 41 `- ?-ea o?a arr ' 4ns,. :,4 ii anua e_ Plumber: eter No.: AA Connedion Chorqe: i Size: Axount Deposit: Reader No.: Permit Fee: Iayiw te oowyly wilw 11r Ciey oi Eayen SurcFwrye: Ordinanw. Misc. Choryes: - Totol: BY Dots Poid: Date of Insp.: Insp : . . CITY OF ERGAN 3830 PilotlCnob Roa P. O. Boa 21199 E an MN 55121 d- PERMIT NO.: eg , DATE: Zoning: No. of Units: " p e? Owner. 1 AWKsr vv 14 K Site Addra?• B rr FF-??3? '°r ? ?s? ' nd a 1. e ,I Plumbe.: INetsr No.: -? -S?'? 8 Connechon Charge: C Size: a'k??R..?., ? RED _B,,?Avj)osit: ' : 0 3 m. SI Reoder No Z 03 permit Fce: . 1 yrM ft eanoly wi16 lM ifr of Eoyan Surcharge: ' Ordlneeoa. Miae. Chorflea: TotaL• By Dots Poid: Date oflnsp.: Insp.: CITY OF EAGAN SEWER SERVICE PfltMIT 3830 Pilot Knob Road pERM1T NO.: ?`9?O- P. O. Box 27189 f F i??, Eagan, MN 55121 DATE: ZoniM.: R4 No, of Units: 1 of 4 p. ex pw,Mr; Michael Const llddress: Sit, Addrou: 4168 ?f'ao Meadowlark :i?ai?c3'c L2 R4 H111andale 2 Plumber: "enzel Mechanicsl 10-23-84 47214 I pne M eewplq wNh Nw Cryr of 6Nw ddlessaw. By of Inap.: Connection Charge. 425.00 pd A«owrt Depoair. 15.00 pd Psrmlt Fea: 10•00 pd Surriarpe: p? Mix. Owrpea: Total: Dme Pold: TY OF EAGAN WATER SERVICE PERMIT 30 PAot Knub Road - - 0. Box 21199 PERMIT NO.: gan, MN 55121 ° DATE: ninfl: r4 1 af 4 l?x - No. of Units: P ,?,. :Jchael Const orw M oomply wifh flN Cify of Eayen Connection Charge: AccourM Deposlt: _ Pertnit Fee: Surcharge: Misc. Chorges: - Totol: Dote Poid: I rop.: CITY CF EAGAN WATER SERVICE PERNIIT 3830 Hlot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: 11'4 No. of Units: Owner. : tichae 1 Addrcss: , . .. _ ., , .., . Site Addrcu• 416 W1haJotiri:qrit 0,"k7 1',4 !J!"a:4ale 2 Plunber '-'ze'jfil? r AAeter No.: n Aarge; 470.00 pd ?yr? t3 ? 15.;??? c? Stze: r- R?- ccounr posir: p Reoder No.: tig,?Zg 70 Permit Fee: , r: I Nm es aonqlp wMM eiN Gry ef Eeyan Surcharge: OrJieanor. Miu. Chorpes: 63.00 ?r rre?-''r Totol: By Dote Paid: Date of Insp.: ???_ Insp.: CITY OF F,P GAN $@yl,r 2 SfRVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagsn, MN 55121 p^TE: i ? r a ZO?ing' P,4 No. of Unita: 1 of. 4 plex Ownsr: Michael Const Addrcss: Sire Address: 4164 So MendoWlark Road L? E4 Fillandale Z Plunber. n^L z} n cal Inc ?'?- 23-`?4 47215 100.00 I aane to eepy whA K. G'ity .f [ess¦ ConnscNon Chorpe: 425.00 pd Ordieenea. Accounf Deposih 1 r,• 00 pc By Dote ot Insp.: ? IrnP• ? Partnit Fes: Sureharpe: `.0 ad Misc, Garpes; Totol: CITY l3F EAGAN 3830 Pilot KnobBoad WATER SERVICE PERMIT P. 0 .9ox 21199 PERMIT NO.: Eagan, MN 55121 DATE 2oninp: 4 Owner: c;;ae „onst No. of Unirs: ? p ex Address: SiM Addrcss_ . ea ovwa r Plumber: ?'ec anic::. -r-? AAater No.: Size; Connection Chorpe: ' a Reader No.: Account Deposit: Permit Fee: ? Nro? te oonqy wiM !hs Ciry ef EsYea Surchorge: •.` pc, I O?din?aps, . Miu. Chorfles: ' P 1'!r'- e! I BY Total: Dote of Insp.: Date Paid: Insp.: I eYrm N eanpy wi1h tIN Ciry of Gyan OrAwonns. Surcharge: Misc. Ciaryes: "p "; e t e r ' By Totol: _ Date of Insp.: Date Poid: 9 / 7F ?& i„sp.:- ' EAGAN - 3830 Pilot Koob Road P. O. Box 29199 Eagan, MN 55121 Zonirp: R4 Ownsr. *t1Ciu Address: site; Add,aw; 4162 plumyer; 1`enzel 10-2: SEWEI! SERVICE PERMIT i PERMIT NO.: 7 oATE: - ; - ? ' - No. of Units: 1 of 4 p ex I gYne roeaval* wIN lM pry of Eays¦ Connsctlon Chorpa: O?Jimeep. Accoimt Dspoaif: _ Permit Fm: ? Surdwrps: Bv M(sc. Chorpas: - Dote of Irap.: Totol: I"9P•: Date Paid: FAGAN WATER SERVICE PERMIT -j Milot Kno6 Road 0. Box 21199 pERM1T NO.: sagan, IMN 55121 DATE: 1 of 4. ex Zoninfl: No. of Units: ic ?ael Co?sC Owner; r°?` l 2 d ll ,? 16 ,_ $p: hieaii ;, r . ? an a e 2,? Ni Address: Site ' , ?:!.;-,iC'' i umber. Metsr No.: -3`{9 o?S5? 6b /i R ? ? ConnectionChorge: 470.0?7 P?? { ?+i1: T I?O M. J ZQ: ?. - Uh _ i ? Reuder No.: 0 9?- ao ? 9 ' Permit Fee: ? 1 Nme te eonnohr wi1h tM Ciry of Eayon Surchar9e: - <,ter O?dieeMa. Misc. Choroas: Totul: By Dute Poid: ' Oate of Insp.: Insp.: 5 REQUEST FOR ELECTRICAL_ WPECTION es-oooot-oa See instructions for completing this fiorm on 6aek ot Vellow copy. A???R.1 A "X" 8elow Work Covered by This Request ?. AAd R p. Type oi Building Appliances Wired Equipmen[ Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures ? Apt. Building Dryer Electric Heatin i Commercial Bldg. Fumace Silo Unloader Industrial Bldg. Air Conditioner _ 8ulk Milk Tank Farm Other peu v t er ISpecifyl t ar Specify Ot er Other Comoute lnsoect/on Fr.e Belnw k Fee Service Entrance5ize k Fee Feeders/Subfeeders # fea Circuits U to 200 Am s 0 to 30 qm s .?.7iS"G 0 to 30 Am s Above 200 qmpsi 31 to 100 Amps, j p 31 to 700 Amps Swimming Pool Above 100-Am s Above 100_Am • Transformers Irrigation Booms ^ Partial%Other Fee Signs Speciallnspection $ TOTO " Rernarks "i rC E / Z' 4-o , Rough-in J I, ricel • InsDector, he?e6y certi( th t th b Final Q ??1e e e a ove v YFispection has 6een r. ? mede. Thie request void 18 months from This request void 18months from y,555 «--)- t?y/ / A I €; 2,63 8 Ll 6 L4 l+ Il 6,l 2_ 3 1. 5 e Fequest Date - Fire No. Reqghe??lnspeuion []Ready Now ill Notify, Inspec- '? y es ? N. tor When Heady M-elcensedi:lectrical Contractor 1 hereby request inspaction of above ? Owner .` eiectrical work installed at Stree,t Addiks, 9ox or Route No. [Aw- City ecUOn.. o. Township Name or No. Range No. County " OC Occupent (PRINT) . Phone No. Power Supplier AAdress l L n F f- z?F,4+4 o h EI@ctrical Cnntrector (Company Name) Contractor's License No. L l?le, ? o MailinB AdJress (Contractor or Owner Making Instailation) 36Q a n ? e- C Authori dBi awr (Contractnr ner Making Installetion) Phone Number C ? MIN?vESOTA STpTE BOAHD OF ELECTHICITY - THIS INSPECTION HEQUEST WILL NOT Grig9s-Midwey Bldg. - Room N-781 BE ACCEPTED BV THE STpTE BOAHO 1821 University Ave., St. Paul, MN 55104 UNLESS PPOPEH INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. REQUEST FOR ELECTIdCAL INSPECTION See imtruciions for completiRq this form m 6ec4 of vellur copY- A n2 ?' ??' ""X"" Beloiv W¢rk Covered fiy This Request EB-00001-W kem Add Re0• Type o( 8uitding _ Appliances Aired Equipment Wired Home Range Tempcwary $ervice Duplex iAlater Heater Lighting Fixtures Ap1 Building Dryer Electric Heatin Conenercia! Bldg. Fumace Silo Unloarler Industrial 81dg. Arc Conditioner Bulk Milk Tank Fafm Other i tAer Isoeciry! • t r SueCi Oth¢r (:omnute Insnection Fee Below k Fee ServiceEntance5"¢e A Fee Faeders^uLfasders• Y Fee Circuits ' Opy 0to 200 AnW 0 m30 Z..n 0 m30 Anms Above 200_qffqxi 31 tu 100 ArW / S"-r7} 37 to 1(iQ Anq)s Swimmirg Pool Above 100_ Above 100_Anw Transtwmers Ir?igation Boans ,STi Partial 'Other Fee Signs - Speciallnspection T Remsrks OTAL FEE '7 7 _ 17? y ? . Nough-in Date ?7 ? 1' the Eleenical , ? ?' / J I?vecwr. hereer Final Dnie certity thst the a6ova y 04 inqpectim Aas beao d 1 ma e- ,M.SqtleSt,Old,eoHNdhS 101 18imp ths from 1d ?? ? lp ? A 082G4 6 L16 1,r I4-; Request Date //? /? _ L?' l 0 Fire No. IOough-in Inspection uired? []Readv Nawti"ih. I?spec' I WhT IO ? ?yo rn en eady ,censed Electrical Contractor _ I herepy request inspecuon ot ahova ? Owner ' aleclriral Mark imtolled at_ StFeeLAddress, 8ox ?orI?° a^te`No./ Ciry e tion o. Township Name w No. Range No. - C y Occupent IPR TI ? ? F1iove No. ?-? C' Gti?tF 1 ? dL'?%!t/ ! Po wer PPlia Address Electri I Conir?c °` (CdiWanY Na 1 ? ? l Cantracmr s License No. ? G- fL c ? / / - ?lD Mailing Address (Contrdctor or Oxmer IMati InSmiWti on ? ? ?e ' IL' /V??P 1z--e AuMorized Sigiatu (Contractw r Yaking Installalionl Phone Nunber MINNEdOTA STATE BOARD OF ELEC7RIC171/ TMIS IMSPECTION REQUEST AILL NOT Griggs-IulidrreY Bldg. - Room N-791 BE ACCEPfEO BY 7HE STAlE BOAND 1821 University Ave.. SL Paul. MN 55104 UNlESS PROPER INSIECTION FEE IS ah....e IFn21 997_7111 ENCl06ED. REQUEST FOR ELECTWCAL IIYSPECTION Es-ooaoi-oa See instruttions tor compbti.g this form m hsck of "llow eopY- A ""X`P' Be/ow•Wnrk Covered by This Request NwA tAddi ReD. Type of BuilAing Aool:anceapirad Equipment Wired HomC Range Temporary Service Duplex Water Heater lighting Fixtures • Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Blda. Air Conditianer Bulk Milk Tank # Fee ServiCeEntranCeSiZe !i Pee FeeAsrs/SWdeeders 77 .Fee Circuits / ?'D U to 200 Am s 0 to 30 0 to 30 Am s Above 200 Am - 31 to 100 31 to 100 A s Swimning Pool j Above 100M?ps A6ove 100_Am s Transformer$ Irri?tion -p Pa rtial•'Other Fee L ? I 5'gis I I iSpecial Inspection Renerks TO,TALFE? ? J? C j . 1, the Elec'trica I Inspector, heraby 2pai(v ihat the above ire ection has been Final ?tf•4:j I made. fBquBSt v0M Thisrequestvoid'J?^?/ 16 monihs trom "l ? ?f ? ? ?? A n si 9 ra s 4, 11 Reqyest Date Fire No. Rouph-in lnspection S ? //- ? Hequired? []Neady Now (9-WitYNotitV InsDec- tor Wh R d es ?No en ea y ensed Elec[rical Contractor I hmeyy wequaist inspection ot above ? Ow;ier electrieal work imtalled at: Street Address, Bo?x1 o/r Houte No. I / 6O / '' ?/-? ?V 2'UC ^Y-/L/ !?-? Citv / ?J ?] ???1A?-' ff'/ ?/ ecUOn o. Township Name or No. flange No. Cou „ L L OccupantlPflINT1 l 4 Phanc No. coGsJ /` d? -P-? C2'cff a 4- Power pplier Afl Addness 77 Electrica Con rec or (ComDany Namel - Contractor's License No. __ •,? _? IZ! Mailing Address IContrector or Owner Making I2,mi "ml / .36 4 `? <vti r ? v , AuffiOriz 5- na uae.lC ntrector/ Ow r king I?Fallationl Phwoe miber j / ?" z ^ ? ?? J MINNI&OTA BTpTE BOAHD OF ELECTRICITY THIS IMSPECTION REQUEST WILI N07 Griggs-AAidway Bldg. - Room NA91 8E ACGEPTED BY THE STATE BOARD 1827 University Ave., St. Peul, MN 55104 UNlESS PROPER INSPECTION FEE IS PI.....e t6121 297.2117 ENCLOSEU. / REQUEST FOR ELECTRICAL INSPECTION „ Ee•ooooi-oa , Sea instructions Tor completing this form on back of Vetlow copW. ? A. "X" Below Work Covered by This Request . Add Rep. 7ype of Buitding ApPliances Wired Equi ment Wired Home Range Temporary Servige Duplex Water Heater Liqhtinu Fixtures l,ommeraal dldg. humace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm otner pec, v tner Isoer_ifvl H Pee ServiCe Entrence Size k Fee FeBders/5ubfeeders # Fee Circuits d BL' U to 200 Am s 0 to 30 Am s ?? 4 to 30 Am s Above 200 Amps 31 to 100 Amps / ?-6Z:1 31 to 100 A s Swimming Pool Above 100_Am s Above 100_Amps Transiormerg Irrigation Booms Partial;'Other Fee Signs Special Inspection $ Aerrerks ? TOTAL FEE ..?? .r-, .V / r ? 3 ?-J Noueh-in ate I, the Electrical ? . ' Inspector, heraby t th tif th b Final T te cer y e a a ove a ? inspection has baen a '1 ,? msde. . tMs repuest vofA 18 monlhs from This request void r J ?/? .a9 ? 78 months from ?! \(i ?( l 6 /Qi ? ? PRA4 L_ ? 3 (4 3'7 _;z Request Date r..?/ /- J? Fire No. Rough-in Inspection Re,-q,,w?re?d?' ?Ready Now e?V+H-Notify, Inspec- ?tor Wh R d / y?y-rts ONo en ea y ? ;icensed Elec[rical Contractor I hereby request inspection of ebove ? Owner electrical work installed et: Street Address, Box/or oute No. / 'SY CitV/?- acuon o. Township Name or No. Fange No. Co, nty / ? /?-'lw /-!T' Occupant (PRI T) -?^ ? CG??Dn? /cJ?tl? ?GS -e?a Pbone No. • Power plier- ?ze ,?- ? ?.u_ Addre s ??f/?f?i-? ?"G? ec[rical Contr 'ct (Company Name) Contractor's License No. Mailing Address IContractor or Owner MakinB Instailatian ? G GT3 N N-4-11.?? /L Authoriz d Sg tu Con ac[or Own r MHking Installation) Phone Number L- / J C ? MINNES(OTA SiqTE BOAND OF ELECTNICITV THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-197 BE ACCEPTED BV THE STATE 80ARD 1827 University Ave.. St. Pau1, MN 65104 UNLESS PHOPEX INSPECTION FEE IS e?__e tniii 7q-7_9111 ENCLOSED. This request void 18 monihs trom E _ 4 3O o O 70i Y A2.1n?t7l'l'.r ?i' _ ??? 1:70 Request Date - i , fre No. Rouph- inI nsUection Pequrted? ?Veady Now ? WiII Nnlify InsPec- C - /6 - ?d ?Yes '?No «r When fleady Licensed Electrical Con[ractor 1 hereby request ins0ection af e6ove Owner elecirical work installed at: Street Address, Box or Route No. Z/ /6 y /`?/.0- 4- pk w Citv ? 4--6::- 14 ecuon o. Township Name or No. Ranee o. Count ,a 7-40- OccuGao`Jt PRINT/)/ tz -Q? Phone No. Power SupPlier Addmss ntr ctor (ComDany Name) ? zgc?i?< < Contrar.tor's Liccnse No. D ya Mailing AdJress lContractor or Owner Makfng Instailationl S,? 4 ,- T U - ?- Aut d S?Bnature ( ractor/ ner Making InstallaUOn) Phone Number MINNESOTg(?STATE BOAflD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Micrway Bldg. - Room N-191 . BE ACCEPTED 8Y THE STATE BOARD 1821 Universitv Ave.. St. Pnul, MN 55104 UNLESS PROPER INSPECTION FEE IS o?.....e ra»l anzrenn ENCLOSED. REQUEST fOR ELECTRICAL INSPECTlON . ea-ooooi-os Ii, See instrucLionS tor comDleting this form on beCk of yeliow copy. a?.? L4 3S O S "X" Below Work Covered by This Request awi AAd Rep. Type oi Buflding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fxtures Apt. Building Dryer Electrie HeaUn Commercial Bldy. Fumace Silo Unloader Industrfal Bldg. Air Conditioner Bulk Milk Tank Fafm Other PerifY Other (Sverily) t r,r Sueci y Other . Olher lO/7 hBB HB(OW p Fee Service EatrancaSize M1 Fee Fexders/Subfexders N Fee Cfrcuit5 D to 200 Am s 0 to 30 Am s 0 m 30 !1m ps Above 200 Amps 31 to 100 qmps 31 to 100 A S Swimming Pool Above 100_Am s Above 100_Am s Transformers Irrigation Booms S Partial-`Ot ee Signs Special Inspection ?? ?v TOT ??FF Remarks . O Rough-in Da[e I, the rical InspeCtor, hereby Certlfy thflt the above Final ?OCd' /r inspection has been mede. Thie request voiA 18 monlhs tmm CITY OF EAGAN N° 9641 • 3830 Pilot Knoh Road, P.O. Box 21-199, Eagan, MN 55121 "'' PHONE: 454-8100 BUILDING PERMIT Receipt # To bs uasd for 1 OF 4 UNIT Est. Value $53,000 Drne OCTOBER 23 1y 84 SiteAddress 4162 SO MEADOWLARK QD Erect occupancy Rl Lot 4 Block 4 Sec/Sub. HILLANDALE 2 Remodel ? Zoning R3 Parcel No. Repair ? Type of Const. `J ]_ $R Enlarge ? No.Stories cc Name MICHAEL CONST Move ? Len9th Z -Z Address 8800 HWY 7, SUITE 331 Damolisn ? Depth 45 t City ST LOUIS PFbone 938-4262 Grade ? Sq. Ft. Zo Name SAME uu Address ? City - Phone FW Name DU'MONEUAUX & ASSOC i? Address ?W City Phone 926-6676 Approvolf Fees Assessment - Woter & Sew. Police Fire Eng. Planner Council Permit '? L74. V V Surchnrge 26.50 Plan check 146.00 saC 525.00 Water Conn. 470.00 Woter Meter .63. 0 0 Rood Unit 2 6 0_() 0 I hereby acknowledge that 1 have read this opplication ond stote that Bldg. Off. 10/22/$ the information is correct ond cgree to tomply wijh all aDDlicable AP? State of Minnewta $totutes n (ty o Ea? Qfdirronces. Var. Date Sipnature of Pertnittee A Building Permit is issued to: e ? 7- on thi express condition ihat Parks 7ota1 $1,782.50 all work.shall be done in accordonce wi oppliwble tme of Minnewta Statutes ond City of Eogan Ordinoncea. Buildir?p Officiul m C"'e't -1 6 ' • • ?i„i'41M ALL CONTRACTORS MUST SE LICENSED WITH THE CITY OF EAGAN UNIT ?j 41? ' INCLUDE 0 SETS OF PLANS, CERTIFICATES OF SURVEY I OF L? 0 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: 53ocn. - Date: Site Address: 4 1 (o???1-`fi?"7? • ? Lot:? Block: ?}- Sect/Sub: -?iLU?NDAl? 2`?Erect: Occupancy: ?-? Parcel #: Remodel: Zoning: R-? Repair: Type Of Const: Owner: Enlarge: # Stories: Move: Length: ? Address: Demolish: Depth: 45 City/Zip Code: Grade: Sg_ Ft.: Phone #: ? Contractor: Address: Assessments: Permit: Z`12.00 City/Zip Code• Water/Sewer: Surcharge: 2.c,.s° ° Police: Plan Rev.: ?Q(O.= Phone #: Fire: SAC: 525fo Engr.: Water Conn: 41p.°-° Arch./Eng: Planner: Water Meter (03,°° Address: Council: Road Unit: Bldg. Off.: y Parks: City/Zip Code: APC: Variance: ' ? 0 ?15Z• ? - CITY OF EAGAN No 9642 3830 Pilot Knob Fboad, P.O.'Box 21-199, Eagan, MN 55121 ''? PHONE:454-8100 BUILDING PERMIT Receipt * / J To ba wed ior 1 OF 4 UNIT Est. Value $ 5 3 ? 000 Date OCTOBER 23_ 1 y 84 Site Address 4164 SO MEADOWLARK RD Erect CN Occupancy Rl Lot 3 Block 4 Sec/Suh. HILLANDALE Remodei ? Zoning R3 Parcel No. Repair ? Type of Const.`J 1 HR Enlarge ? No. Storie2s ? Name MICHAEL CONST Move ? Length Z Address 8800 HWY , SUITE Damolish ? Depth 4 5- ? City ST L?UIS Phone 9 3 8 - Grade ? Sq. Ft. Z,o Name SAME u? Address ? City Phone Name DU'MONEUAUX & ASSOC Address city Pnone 926-6676 I hereby atknowledge that 1 hove reod this appiication and state that the information is correct ond a ree to com I th oll opplicoble State of Minnesota Stotutes a Cjt?/,bf E n J/? rdina .? Signoture of Permittea. MICHAEL CONST Approrals Foes . Assessment Water 8 $ew. Polite Fire Eng. Planner Councii 10/22/84 Bldg. Off. APC Var. Date Permit 0 Surchorge 26.50 Plan check _ 14 6. 00 snC 525.00 Water Conn. 470.00 Woter Merer 63.00 Road Unit 260.?0 Parks Total $1,782.50 /1 Buiiding Permit Is issued to: on fhe ezpress tonditlon that all work sholl be done in acrnrdance wj,t"ll oppliw¢le.,State of Minnesota Statutes and Ciry of Eagan Ordinonces. Building Officiol a ' • • • ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN ?/?, UNIT ? INCLUDE Q SETS OF PLANS, CERTIFICATES OF SURVEY IoF ? ? SET dF ENERGY CALCULATIONS To Be Used For: . • Valuation: Date: Site Address: 4t(c4 ?&MEp.muup,Q.K ?.?'f?? • • Lot: ?j Block: 4 Sect/SubAup,WpoLE 1?2 Erect: Occupancy: ?-I Parcel #- Remodel: Zoning: IZ-3 Repair: Type Of Const: ?HE, Or-iner: Enlargea # Stories: / Move: Lenqth: 2"I iAddress: Demolish: Depth: City/Zip Code: Grade: Sq. Ft.c , 'Phone #: Contractor: Address: City/Zip Code: Phone #: Arch./Eng: Address: City/Zip Code: Dh?nc$ - APPROVALS, Assessments: Water/Sewer: Police: Fire: Engr.. Planner: Council: Bldg. Off.: APC: Variance: Permit: 'L92-!? Surcharge: 2(0. S" Plan Rev.: 14&.-° SAC : S Z5 .°` Water Conn: 4"30 Water Meter fv3.°? Road Unit: ? P a r k s : 7147CM 1"182 =° x CITY OF EAGAN N? 9643 3830 PiP?ot Knoh Road, P.O. Box 21•199, Eagan, MN 55121 PHONE: 454-8100 7?'t j BUILDING PERMIT Receipt 7 # Te ba uud fer 1 OF 4 PLEX Est. Value +S53, 000 Date OCTOBER 23 19 $4 SiteAddress 4168 SO MEADOWLARK RD Erect LIC Occupancy R1 Lot 2 elock 4 Sec/Su6. HILLANDALE 2 Remodel ? Zoning R3 Parcel No. Repair ? Type of Const. V 1 HR Enlarge ? No. Storie ? Name MICHAEL CONST Move ? ? Lenyth i 8800 HWY 7, SUITE 331 Demolish ? Depth ? ? Address city st louis PAone 938-4262 Grade ? sq, Fc. o Name SAME Address ?- City Phone Approvals Faea FW Name DU'MONEIIAUX R ASSO(' ? Address u `W City Phone 926-6676 I hereby acknowledge that I hove reod this opplication ond tote that ihe informotion is correct ond ogr to tompiy with II pplicable State.of Minnewta Stotutes a,??ty o gan s. Sipnoture of PermitteetG( A Building Permit is issued to: MICHAEL CONST oll work sholl be done in occordorxe wi all pli? S ote f Min Buflding Officiot -k-t Asussment _ Woter $ $ew. Police Fire Eng. Plunner Council Bldg. Off.10/22/84 APC Var. Date Aermit 292.00 Surcharge 2 6_ 5 Q Plan check 1 4 6_ 0 0 sac - 52S-n o Water Conn. 470 _(1 Q Water Meter 6-3- n 0 Rood Unit 960 ? 0 Parks Total -- 1 , 7 82 . 5 0 on the express conditton thar Statutes ond City of Eagan Ordinances. ? • ' • • ? ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN 1'a? UN iT jf ?/ "7/? INCLUDE Q SETS OF PLANS, ?' Q CERTIFICATES OF SURVEY `oF 4 Q SET OF ENERGY CALCULATIONS To Be Used For: ??-???gQ• Valuation: 53,cco.? Date: Site Address: ?-I(vg "?:MEARSWi..?RK?. ? • ? Lot: Z Block: 4 Sect/Sub:A??L-/A.NG4.LE Z'??Erect: Occupancy: (2-I Parcel #: Remodel: Zoning: R_3 Repair _ Type Of Const : lH(L , Owner: Enlarge: # Stories: Move: Length: Z? Address: Demolish: Depth: 45 City/Zip Code_ Grade: Sq. Ft.c Phone #: Contractor: Address: City/Zip Code: Phone #= Arch./Eng: Address: City/Zip Code_ nhnnc$- APPROVALSI Assessments: Water/Sewer: Police: Fire: Engr.. Planner: Council: Bldg. Off.: APC: Variance: Permit: ?? 2 ^o . Surcharge : 2co . s° Plan Rev. : ? 4(V SAC: 525 •'= Water Conn: ¢1 a Water Meter (D3. Road Unit: lp1y? Parks: ? 1-I &2 • 5O ? CITY OF EAGAN N° 9640 3830 Pilot Knob Ri9ad, P;d. Box 21-199, Eagan, MN 55121 PHONE:454•8100 /y BUILDING PERMIT ? j? ? Receipt # < To be uaed for 1 OF 4 UNIT Est.Value $53,000 Date OCTOBER 23 1984 Site Address 417 2 SO MEADOWLARK RD Erect 11N Occupancy Rl Lot 1 Block 4 Sec/Sub. HILLANDALE 2 Remodel ?_ Zoning Parcel No. Repair ? Type of Const. V 1 HR Eniarge ? No. Stories cc Name michael COIISt Move ? Length 2 Z l Address 8800 HWY 7, SUITE 331 Damolish ? Depth 45 6 city st lOUis Pkone 938-4262 Grade ? sq. Ft. Zo Name SAME ?E Address ? City Phone ?W Name DU'MONEUAUX & ASSOC i? Address ?W cicy edina phone 926-6676 1 hereby ocknowledge that 1 hove read this opplication and stote that the intormotion is correct and a r e to comply it oll opplicable State of Minnesoto Statutes ity o Eag 00 inonces. Signoture of Permittee? - ? ? MICHAEL CONST Approrals Foes Assessment Woter & $ew. Police Fire Eng. Plonner Council BIdg.Off. 10/22/SAPC Var. Date Permit 0 Surcharge 26.50 Plan check 14 6. 00 snC 525.00 Water Conn. 470. 00 WaterMeter 63.00 Rood Unit 260.00 Parks Total $1,782.50 A Building Permit Is issued to: on the express wnditlon 1hat all work sholl be done in cccordante wiSh-pll?applicoble St6i'qf Minnesota $tetutes and City of Eagan Ordinonces. Buildirg Official ? ALL CONTRACTORS MUS'f BE'LICENSED WITH THE CITY OF EAGAN 'A' uw lT ?j ? ? ? INCLUDE Q SETS OF PLANS, ?`? ? - '?' CERTIFICATES OF SURVEY I nF 4 ' l .. . Q SET OF ENERGY CALCULATIONS To Be Used For: Valuation: Date: -- S,ite Addres?s- ?t . 1,,? ' ? i • • _ t Lot.? Blol:7!? Sect/Sub: NILt.AniGp,LEIN-°Erect: X ! Occupancy: Q-? Parcel #: . Remodel: Zoning: ?-? Repair: Type Of Const: j? N?Z, Owner: Enlarge: # Stories: ' Move: Length: 2 I Address: 3.-?>I Demolish: Depth: 4 y City/Zip Code: Grade: Sq. Ft.: Phone #: ci 3'6- 'q0-t=,J- Contractor: MvQ4P-'c.i_. 6-i;Nzi "i.K_'le,0 -?QJG• _ Address: City/Zip Code: 61f . ('jL;tli5 plTrLt Phone # : C3 Arch-/En9? = l '? Address: City/Zip Code: ti Phone#: (.,)., U- (o 7 4, Assessments: Water/Sewer: Police: Fire: Engr.: Planner: Counc i 1 : Sldg. Off.: APC- Variance: Permit: 2`4Z.22 Surcharge: Plan Rev.: 14(0.°= SAC: 52?. Water Conn: 4"1p. Water Meter fo3._' Road IInit: 2 Parks: ? `1 00Z -50 SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOBNO6 tI 8910 WENTWORTH AVENUE SOUTH • MINNEAPOl15, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS / I /tse.,lKrl OCCUPANT " SoLo BY- (?-i MAI(E ? E << j?k. SERIAL NO. eZ/ 6 C) ? C> L_ 57 , 3 6 THERMOSTAT I /1 +? oo "') VAIVE ?I oW't S? eG? LIMIT ?t - LIMIT SETTING ? 3 FAN SETfING 2 PILOT TYPE C IC>NITION MODEI PILOTTIMING PRESSURE ? INPUT CFH ? STACK TEMP. ,L•L_ PORM 235 (REV, 11/89) PERCENT CO2 4,.._. 4r PERCENT Oz PERCENT CO G CITY ?---+! K OWNER na `t. INSTALLED BY ?,? ? MODEL INPUT VENT SIZE NPE OF UNER ? LINER SIZE FILTERS: SIZE cZ ?r" ` NUMB R WIRING TEST TAG LIGHTING INST. DATE TESTED 7` / 7 - ? ? COMPANYTE571NG > NAME OF TESTER ?FORM DISTRIBUTION: WHITE COPY - JOB FlLE YEILOW COPY - CITY c??c RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Constructian Reauirements . 3 registered site surveys showing sq, ft, of lot, sq. ft. of house; and all roo(ed areas (24% maximum lot coverage allowed) • 2 wpies of plan showing beam S window sizes; poured found design, elc.) • 1 set of Energy Calculations • 3 copies of Tree Preservalion Plan if lot platted aRer 711193 . Rim Joist Detail Op6ons selectlon sheet (bldgs with 3 or less units) DATE 1? 0 - --3 • O 2 SITE ADDRESS 4- 1 7 Z. " I MULTI-FAMILY BLDG _ Y AN TYPE OF WORK C.arv_R ?% ft? ?la? a ?,e,cc ?o FIREPLACE(S) _ 0 _ 1_ 2 APPLICANT STREET ADDRESS Z•CK) (o '-7S AJ 1%3n CITY rrY- nLnhn STATE-bW ZIP S5RL}?1 TELEPHONE # 7(63 4Zh Zx?CELL PHONE # G612- 2223!-jSO FAx #'14-:2, ¢94 395 I PROPERTYOWNER-a..?? la van?r' ??e?r-?? o?,? TELEPHONE# 5,52- 92-7- 2-loO Q COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIVNESO"1':1 RC`I.I:S 7670 CA'CEGORI' l MNNES017:l RL"LES 7672 (J submission type) • ResidenGal VendlaGon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: ____ Pluiiibing system includes: Mechanical Contractor. _ Mcctivtic<il svstcm includcs: Sewer/Water Contractor: Air Conditioning Hcat Recovcry Syslciri Phone # Phone # Fee: Si0.00 I hereby acknowledge that I have read this application, siote that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant ? lo OFFICE USE OIVLY Water Softener ` Water Heater N0. of Baths RemodeUReoair Reuuirements . 2 copies of plan • 1 sei of Energy Calculaiions (or heated addi(ions . 1 site survey for extenor additions & decks . Indicate if home served by sepfic sys[em for additions _ Phone # Lawn Sprinkler No. of R.I. Baths VALUATION ? Fee: 590.00 Certificates of Survey Received Tree Preservation Plan Received _ Not Required _ - Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex O 16 Firepiace ? 21 Porch (3-sea.) ? 31 ExL Alt - Multi ? 03 01 of _ plex 0 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-piex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower levei ? 24 Storm Damage O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Atteration 0 37 Demolish (Bldg)' 0 43 Reroof ? 46 •WindowslDoors ? 34 Replacement •Demolition (Entire Bidg only) - Give PCA handout to applicant Valuation Occupancy ' MC/ES System Census Code Zoning City Water SAC t)nits Stories Booster Pump Nbr. of Units Sq. Ft, ' PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector ?jSr?(? , ?C COMMERCIAL ? 2002 BUILDIMG PERMIT APPLICATION CITY OF EAGAN 651-681-4675 Foundation Onf New Construction Interior Irn rovement ' • SVuctural Plans (2) sets . ArchitecWral Plans (2) sets • Architectural Plans (2) sets . Civil Plans (2) . Structural Plans (2) • Code Analysis (1) ** • Certificate of Survey (1) . Civil Plans (2) • Project Specs (1) • Code Analysis (1) " . Landscaping Plans (2) • Key Plan (1) . Project Specs (1) . Code Analysis (1) '• • Master Ept Plan (1) . Spec. Insp. & Testing Schedule . Certificate of Survey (1) • Energy Calculations (1) not always*" • Soils Report (1) . Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) notalways** . Meter size must be established . Meter size must be established • Meter size must be established -if applicable • ProjectSpecs (1) 1 • EnergyCalculations (1) '* d 1 • Electric PoAer & Lighting Form (1) '• ! 1 • Master Ept Plan (1) 1 d • Fire Protection Plan (1)" 1 ! • Soils Report (1) 1 . MC/ES SAC determination letter . MC/ES SAC determination letter • MC{ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 " Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Cali 651-215-0700 for details. DATE: t- 3U' UZ W ORK TYPE: _ NEW _?( REMODEL CONSTRUCTION COST: 2. ?, SITE ADDRESS: L"'I ?uZ' HI-I L. ' ?i1 bH) `41bV, TENANT NAME: SUITE #: FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK ' ^ t:^" P' y J0t4h ?,mA?°e' Name: L.Q,xfXl?.'tl 716vo`!`10nl'e F?SSPhone #: c 1,95" R qH " 0 L 1.9 ?"J PROPERTY Last First OWNER Street Address: City: State: Zip: company:?O()fS itt?l t Phone#: (q52 ) 1"IU?°b6()5 CQNTRACTOR -?- ,'? Street Address: I7 F? Z(? E°{?('?_? City: 5- 20topPt State: Zip: _653I 1) ARCHITECT/ ENGINEER Company: Name: Street Address: City: Licensed plumber installing new sewerfwater Phone #: Registration #: p ?? JT lJ p ? L' i t!, FEB 0 6 Phone #: ( I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. /) . . l] _,, State: Signature of OFFICE USE ONLY SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. 0 14 Apartments ? 27 CommerciaUlnd ustrial ? 32 Ext Alt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon WORK TYPE ? 31 New ? 35 Tenant Impr ? 42 Demolish (Foundarion) ? 46 Windows/Doors ? 32 Addition ? 36 Move Bldg ? 43 Reroof ? 47 Repair ? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization ? 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORMATION Census Code SAC Code No. of Units No. of Bldgs. Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. First Floor sq. ft. sq. ft. MISCELLANEOUS INSPECTIONS ? Gas Service Test 11 Heating APPROVALS Planning Building ? Insulation Engineering sq. ft. sq. ft. sq. ft. sq. ft. MCBS System City Wafer Fire Sprinklered C7 Plumbing ? Stucco/Stone Variance Permit Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S/W Permit S!W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies VALUATION $ % SAC SAC Units Meter Size Total COBUdERCIAL ANy ?- y t 6 ? BUILDING PERMIT APPLICATION '? ? M'a'. _ " 0 ? I 3 ? ? CITY OF EAGAN ??'`""`"? t 651-681-4675 ' Foundation Onl New Construction Interior Im rovement • SWctural Pians (2) sets • Architectural Plans (2) sets • Architectural Plans (2) seu • Civil Plans (2) • SWcWral Plans (2) • Code Analysis (t) '• • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Malysis (1) •' • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " . Certificate of Survey (1) • Energy Calculations (i) not always" • Soils Report (1) • Spec. Insp. 8 Testing Schedule (1) " • Elec. Power 8, Lighting Fortn (1) not aiways" • Meter size must be established • Meter size must be established • Meter size must be established - if applicabie • Project Specs (1) 1 • Energy Calculations (1) " 1 1 • Electric Power 8 Lighting Fortn (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (1) •' 1 i • Soils RepoR (1) 1 • MCIES SAC determina6on letter . MC/ES SAC determinaGon tetter • MCIES SAC determination letter call 651-602-1000 qll 651-602-7 000 call 651-602-1000 " Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submiried to Minnesota DepaRment of Health - call 651-215-0700 for details. DATE 64 ' J ? O WORK TYPE NEW K REMODEL CONSTRUCTION COST - - SITEADDRESS 1 /16 a' ? y/G V `11L73 - ql 7d--?J " "` dU o? TENANT NAME SUITE # ( / FORMER TENANT NAME DESCRIPTION OF WORK ?Q /Z I`'ame: Phone#: PROPERTY Last First OWNER Street Address City State Zip Company r- /1 4e, {t, 6 r Phone # ()!p 3 ,2:U=7?? ? CONTRACTOR ?y- StreetAddres- • I l ?/??' City COO/2. State Zip ARCHITEC'T/ ENGINEER Company Phone # ( ) Name Registration # Street Address City - State Zip Licensed piumber installing new sewer/water service: Phone #: i hereby acknowledge that I have read this application, state that the information i orrect, agree to compty with ali a ble State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated 1/0 SUBTYPE ? 01 Foundation ? 14 Apartments 0 15 Lodging ? 25 Miscellaneous WORK TYPE ? 31 New ? ZI 32 Addition ? ? 33 Alterations ? 0 34 Replacement ? OFFICE USE ONLY ? 26 Public Facility ? 30 Accessory Bldg. , ? 27 Commercial/In dustrial ? 32 Ext Alt - Apts. •. ' . ? 28 Greenhouse ? 34 Ext Alt - Comm. ` ? 29 Antennae ? 35 Ext Alt - PF 0 37 Nail Salon 35 Tenant impr ? 42 Demolish (Found) ? 46 Windows/Doors 36 Move Bidg ? 43 Reroof u 47 Kepair 37 Demolish (Bidg) ? 44 Siding ? 48 Authorization 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORMATION Census Code SAC Code No. of Units No. of Bldgs. Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. First Floor sq. ft. sq. ft. MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating APPROVALS Planning Building ? Insulation Engineering sq. ft. sq. ft. sq. ft. sq. ft. MC/ES System City Water Fire Sprinklered ? Plumbing O Stucco/Stone Variance . r Permit Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Qualiry Other Copies VALUATION $ % SAC SAC Units Meter Size Total ? , 4ev zr 57 , ; r?l ? ? ! i 1- c ? 'r 32951 HILLANDALE #2 . .. ?? . 4122/ 10 32951 01008 4124/ 020 08 4128/ 030 08 4132/ 040 08 4136 05008 4126/ 01009 4130/ 020 09 4134/ 030 09 4138/ 04009 4140 05009 4142/ 10 32951 030 07 4144/ 020 07 4146 01007 4148/ 10 32951 030 06 4150/ 020 06 4152 01006 4154/ 10 32951 04005 4156/ 03005 4158/ 02005 4160 01005 4162/ 10 32951 04004 4164/ 030 04 4168/ 020 04 4172 01004 4166/ 10 32951 040 03 4170/ 030 03 4174/ 020 03 4176 01003 MEADOWLARK WAY (5-plex) (5-plex) (3-plex) (3-plex) (4-plex) (4-plex) (4-plex) 8 : . . PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BuILDrNG Eagan, Minnesota 55122-1897 Permit Number: 9 2 7 9 A 1 (612) 681-4675 Date Issued: 0 6/ 18 / 9 6 SITE ADDRESS: 4162 MEADOWLARK WAY LLIT: A BLQCK: 4 HTLLANDALE ADCIITION #2 P.I.N.s 10-32951-040-04 DESCRIPTION: ROQF DAMR6E Permit Type S70RM DAMAGE V?rk Type REPAIR 434 ALT. F2ESIDENTTAL ? .t?+nTU 3x r?'Z ee ,.i21g, Dl3` ? 6?P $F 1'k"_ T?s(s,°?i QI'?5 ?weL (e?r?n.a ?, a+v"I H4G I'+i h'? ^Kdtrla`?l i?2'.: 6P?4T9??Tk'.urv °?1'l^£8y 4g?,2JRA ? ?I^2C?? REMARKS: INCLUDES: 4f64, 4168,.AND 4172 MEADQWLflRK WAY L3 L2 L1 FEE SUMMARY: I:VIVIt[AI:IUFf: - RppliCaY1t - ST. LiC.QWNEH: BANNER RQOFIN6 18888611 2001204 LAKEWOOD TQWNHqMES ASSOC 6001 LYNIJALE AVE 5 4162 MEADOWLARK WAY MSNNEAWOLIS MN 55419 EAGAN P1N (612) 888-8611 (612)452-5307 APPLICANT/PERMITEE SIGNATURE CITY OF EAGAN `? ?' 3830 PILOT KNOB RD - 55122 / 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 $gmodeVReoair Reaufrements ? 3 registered site surveys ? 2 copies ot plan ? 2 copies of plans (include beam 8 window sizes; poured ind. design; etc.) ? 2 siie surveys (exterior additions & decks) ? 7 energy cakutations ? t energy calculations for heated additions ? 3 copies oi tree preservation plan if lot platted after 711/93 requhed: _ Yes No DATE: CONSTR CTION COST: Op?n ?? ? DESCRIPTION OF WORK:. STREET ADDRESS: LOT ` 1 ? -I BLOCK 4-1 J. (c>). . y d Cy.'y f c? 8 L ? L 3 L 2 L./ , o?.?. ?-? SUBD./P.I.D. #: ???'"" ----r- o t,., Letri- fL t.4J 2?5,c.wT ,o?oay s??o.u.•- PROPERTY Name: lA",,.JaoQ 'r?b-j.alanM,c Assoc. Phone #: A-1 0 -7 OWNER "'" ""' Street Address• City: State: Zip: CONTRACTOR Company: A0A^J^44./' AOBf%,*Jcm CoRo° Phone #: $g$" Street Address: ( o o r LYWa A i& Ave. .s' License #2-ba ! a o y'/ Clty: I4^ f•JN/1aP04/S State: ,1-1 ,.vAl. Zip: 5S `I ! 9 ARCHITECT! Company: Phone #: ENGINEER Name: Registration #• Street Address• City: State: Zip: Sewer 8 water licensed plumber: . Penaity applies when address change and lot change are requested once permit is issued. 1 hereby acknowledge that I have read this application and state that the informati p-is correct and ree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ; Signature of Appiicant: OFFICE USE ONLY RECENED ? Certificates of Survey Received _ Yes _ No J U N a 6 199a Tree Presenration Plan Received Yes No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling o 07 4-ptex ? 03 SF Addition ? 08 8-plex 0 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE ? 31 New ? 33 Alterations o. 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth 16 Basement Finish 17 Swim Pool 20 Public Facifity 21 Miscellaneous Basement sq. ft. MCIWS System Main level sq. ft. City Water Sq, ft. Fire Sprinkiered gq, ft, PRV Sq. ft, Booster Pump Sq, ft, Census Code. Footprint sq. ft. SAC Code Census Bldg Census Unit ? 11 Apt./Lodging o 0 12 Multi RepairlRem. ? 0 13 Garage/Accessory ? ? 14 Fireplace ? 0 15 Deck ? 36 Move ? 37 Demolition APPROVALS Planning Building Engineering Variance Valuation: $ Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SIW Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units • ? ` I • ? 2/84 ? CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTIODT (PLEASE PRINT? 1) PROPER'PY ADDRESS: ? I?O`{ 11`lc-r?CLnc,•: ???? ???' ?7\L LEGAL DESCRIPTION: 3 ?I fl ? I?/P C?! IC` : . k1l (Loot/Block/Subdivision or Tax Parcel. I.D. NtBnber) LL ..?1JT? :) JlP=m:v / ?l _ `_..+ l1Tr.? ?,n _?D?r?\"f.? A?.'_ YI,J LiLL'Llm T l PRESE7T Z^i]IPX:/P?2pPOSED USE: U R-1 SINGLE FP_MILY L7 R-2 DUPLEX ('IWO UNITS) 1% R-3 TOIa'NFiGtJSE (THREE + tTNITS) ( c./ UNITS; ? R-4 APAR'1MENI'/CONIDOMIlNI[7M ( Wi ITS) ? CCMMERCIAL/RETAII,/OFFICE p Il`DUSTRIAL ? INSTITUTIONAL/GOVERNMENT 2) APpLICANT (PLEASE PRINT) - NAME' ADDRE55: CITY.. STATE, ZIP: ?f L?•«.', 1?ti•. ai1_,? -? ??i :?i ?,- PHO?'?: 3) PLEASE PRINT) PLLMBER FOR CITY USE ONLY NP.NIE : ??YVE1' ' ?'Ee " NI PLU ERS LICEHSE_ : ADDRESS: 3WQ KENNEBEC DAIVE, EAGAN, MINN. 55122 Active CITY, STATE, ZIP: 452•1565 Q Expired MASIER Q Not of Record , phONE= PLUMBER LICENSE # 001445M2 a r nitia ? 4? ?ANT/aq,?ER (F'LtASE PRINi) NAME: .`?DRESS ; CITY, STATE, ZIP: PHONE: 5) Ir]DIC'ATE WHICH PERMIT IS BEINC; REQUESTED: CONNECTION T'O CITY SL•Z^7ER ? CONDIFc`PION TO CITY WATER ? r1PfiER (PLEASE DESCRIBE) 6) IPIDICATE ONE: ? PLEASE HOID APPROVID PERMIT FOR PICK-UP BY ONE OF ABWE Q PLEASE MAIL APPROVED PERMIT TO l, 2,<3j. 4 ABOVE • (",, (Circle one) 7) SMANRE-? DATE : T-`:. ... ?'*3!! I ? e?!Ftis . ? ! ! .,. aG?a? - -. : • F O R C I T Y U S E O N L Y ` PERMIT " ISSUED FEES: $_ SEWER nTERMIT (I?ICLliDE SUP.CHP.RGE) , $- WATER PERA42T (INCLUDE SURCHARGE ) °--? WATER METER/COPPERHORN/OUTSIDE READER • $ WATER TAP (INCLUDE CORPORATION STOP) ? SEWEf2 TAP $ ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSZT - WAmER WAC , $ SAC • $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ ' OTHER , _ . w. _ .. ...,. _. $ TOTAL t?..? ` •, }i,..:-•• . • ? ?. -:-, ' f AMOUNT •PAID/RECS•I,PT?;s:# , , -----J DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ' ''C] YES IF YES, THEN A"PERMIT FOR WORK WITHIN ? PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING. DIVISIQN_ LIST F.S A CONDI- ' TION. SUBJECT TO THE FOLLOWING CONDITIONS_ APPROVED BY: :?w e-,,:> - TITLE: DATE : G .. . .. . . •ES?..i...t??..d.yrt??w?lw??t?lE?ws??a?,?rE?i"?l.. .. .. .... . iE??.?!•c:+irt? • . ? ?? .. ., ? s:? w .. ?, . ?• . ? 2/84 I . ? / CITX OF EAGAN P ? A PLICATION FOR PERMIT SEWER AND/OR WATER CONNECTIODi (PLEASE PRINT) ? 1) PROPER'PY ADDRESS : ? _ I G?? ?'l +-• r t??C, c^V.C? ?' 4? .?-`?-. IEC,AL DESCRIPTION : ?7T (Lpt/Block/Subdivision or Tax Parcel.I.D. Nisnber) v.{.?. ^ ?/r?'R. L' EYI ?_.: , S1'a;?_,'?L !ll?t^? v? yDT^\T.? ?TTTT???+ L?`? j.:L-•- , -?--- J= --?--- ?!.? ?'•?T PRES= 'Z^i1I`L1X',fPROPOSED IISE: Li R-l SINGLE FPmILY ? R-2 DUPIEX ('IWO UNITS) 7 $1 R-3 TOWNEICi]SE (TfREE + TJNITS) ( UNITS) ? R-4 APART4IIVrI'/CONDCNlIIVIiM ( LINITS) ? COMIVE32CIAL/RFTAII.,/OFFICE ? IMUS'I'RIP.L ? INSTITUTIONAL/CCUERNMENT ' 2) pppI.ICANr (PLEASE PRINT) NNE: ADDRESS: ' CITY, STATE, ZIP: =?l ?_c???', 'l?b?• ?1??. - :???F? ??- PHOLNE: 3) pT7NBER NAA4E: PLEASE PftINT) FOR CITY USE ONLY F+DDRESS: ?N"Et MECHANiCAL 3NQ KENNEBEC DRIVE. EAGAN, MINN. 55122 PLUM?3ERS LICEHSE: Active CITY, STATE, ZIP: 452•1565 0 Expired PHONE No' of Record ?? : PLUMBER LICENSE #001445M2 Statt initial 4) OCC[JPANT/GWDIER (NLtast PeiNr) r?r?: C.o( v; -f- ADDF2E5S : -?:- CITY, STATE, ZIP: PF-ONE: 5) IINDICATE WHICH PERNIIT .IS BEING REQUESTfD: CONNECPION TO CITY 5ES^lER ? CONNECPION TU CITY WATER C7I'HII2 (PLEASE DESCFtIBE) 6? IIVDICATE ONE: ? PLEASE HOLD APPROVED PERNLiT FOR PICK-UP BY ONE OF ABWE Q PLEASE MAIL AI'PROVFD PERNIIT TO 1, 2, (3'? 4AW7E (Circle one) k \ . 7) ;.SIQ?ATG'F2Ec??._r?S?-C????,-::. DATE: . ., , ,.•..' ,wc?e4?l.'??AAiC?ta?9YC:?:7? . _... .. .. .. .. .. .. .. . . .. . .. .. .. .. 3fnk ?f ?i . .? {q? #?r F O R C I T Y U S E O N L Y -- PERMIT " ISSUED FEES : $ ? d • r- ? $ (P,?-- s'-o $ $ $ - ? ?= • : -?, $ $ $ $ $ • SEWER n°RM2T (I.ICLliDE SUP,C?-iP.RGE) WATER PERA4IT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT CEPOSIT - SEWER ACCOUNT DEPOSZ'T.' - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL . ?... ,-, ,?,.• . _ ._ _ s?,= . $ ? ?,,..t, ..:?_.:,.•'?.. :.° •.;. ? ?: : _,: ; . , •.: AMOUNT Pp,ID/REGE-•IPT>.,?# -d7 .. : . DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MqST BE ISSUED BY THE NO ENGINEERING. DIVTsToN. L.T?ST F.S A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY : ?c??J DATE : 3q 2/84 CITY OF EAG AN APPLICATION FOR PERMIT / SEWER AND/OR WATER CONNECTIODi (PLEASE PRINT) , ^ 41/1 ?? a ?i 9_.c.? 1) PROPEIrPY ADDRESS: - 111??r?C?[?c; :L[°?? ? .• -?'-? IEGP,L DESCftIPTION: (Lot/Block/Subctivision or Tax Parcel.I.D. Nunber) 'T?'? i^ /TTR L' ?IS_--. , ST'?.i;?. ?':Z,, ?T\'T.T _i+Tr.? r--....+ ?.?.-?..? --•-- J: Cn_T..__.:? _..:.?.:'D;G _..=,.•!?.T I?:,.:=?•s?.: - (? :o: -,.i , PRESENT 'Y"i7IL\X:/P?20POSEJ LTSE: Ll R-1 SINGLE FAMILY ? R-2 DUPLEX (TWO UNITS) p R-3 ZCJriNNHOtJSE (THILF'E + LTNITS) ( ? UNITS) ? R-4 APAR7S4IIVT/CONIDCNLBVIiTi4 ( Wi ITS) ? CCMS'lEE2CIAL/RETAII,/0FFICE ? IINDUSTRZAL ? INSTI'I'C7TTONAI,/GOVERI\= ' 2) APpLICAN'r (PLEASE PRINT) NP.I`4E: 11/W'V ej `f- L ' .oc.s ? ADDRESS: : - CI'I'Y, STATE, ZIP: , PHONE: t; =; ?,' • U.,-j?lr- ?L_ 3) . pZUMBER NAA'IE: PLEASE PRINT) FOR CITY USE OH!Y ?NL'Gt 1VfEE`HAlVf "t PLUNBERS LICENSE: ADDRESS: m0 KENNEBEC DRIVE, EAGAN, MINN.55122 ? pctive CITY, STATE, ZIP: 452•1565 ? Expired Not of Record PHONE: PLUMBER LICENSE # 001445M2 • a tnitla 4) OCCCTpANT/a,7NII2 DIAME: (PLEASE PRINT) ADDf2ESSc ;>c<<k`?, a.,., CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH PF..RMIT IS BEING RDQ(JESTID: CONNECPION RO CITY SEWER Q CONNEC'PION TO CITY WATEF2 ? dI?HER (PLEASE DESCRIBE) 6) IA]DIC.ATE ONE: ? PL,EASE HOLD APPROVED PEFtMIT FOR PICK-UP BY ONE OF ABOVE Q PI.EASE MAIL APPROVED PERNLIT TO 1, 2, C3'? 4 A&7VE (Circle one) . 7) DATE: l ? -r-- -•? ?? ? y?i ?:a ?xa: ec[:?riy 34f L?If ?iti r?at?r . ., .. ., . .. . .. . • • ? F O R C I T Y U S E O N L Y ? PERMIT ° ISSUED ? ,...:_.. ?...... FEES: $ $ `O. ?r O $ $ $ $ $ $ $ $ $ $ • SEF7ER niRMT_T (IVCLliDE SUP,CHP.RGE) WATER PERP4IT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSZT - WAmER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNIi SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL . ;?.. .?? a-?? ' `' ?:;' `.:'•.;.- ?•; ' : ? .: ?r:; ? :?''.' : _' ?lu $ sr., AMOUNT •PAID/AECEZPT%.??# -z,l 7-4,Z ? 9 ., DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIG'riT OF WAY? . O YES IF YES, THEN A"PERMIT FOR WORK WITHIN ? PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING. DIVISIQN. LIST AS A COT:DI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: ,,: ....u.: _ .. ... ...... . . APPROVED BY: T I TLE : DATE : //- j? - Ot s.m awe ?.tai.e s.w art? ?t a.+? Ra+r i??,v?et . .. .. . .. . . .. . .. .. . .. .. . s-? !r?! !!?+! rt? ?rta?? .. .. .. .. .. .. Kas ftM..?•. yt? *? . ..?"t .. ?..?.. . .. .. .. .. ?oa ssM r? ? 2004 RESIDENTIAL BUII.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ? ?OO'a- New Constniclion Reauirements RemodellReoair Requirements O?fice I7se On 3 registered site surveys showing sq. it of lot, sq. ft oi house; and all rooted areas 2 copies of plan (:ed of SuNeyReal ?` ?`"Y ? (20% maximum lot coverage allowed) 1 set of Energy Calculations tor heated additions j*P?g * Re? '? 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks TreePre?R,e,?wred N 1 set of Energy Calculations Adddion - indicate if on-site septic system Orr s?e $eptic System!g., ?.^,Yx,_ N; 3 copies of Tree PreservaGon Plan if lot platted after 711193 Rim Joist Detail Options selaction sheet (bldgs with 3 or less units Date _;2 Construction Cost Yd a• O v Site Address ? UniUSte # Description of Work LeJ ;.?'i 4.? Multi-Family Bldg _ Y \ [ N S? ?? Fireplace(s) _ 0 2 # l h T Property Owner one ep e Contractor r?'E?2? 1?/J?tc y? ?'v?/I'??,8-/'?'? Address ?SJZ GG,?Gei/GW1? .Q ?.?!___/V• City State ?? - Zip $ S qZ-63 Telephone # (G14 /0'O +`? 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 Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with c fee applies. Licensed Piumber onnn ii?;i rr? r, ? Mechanical Contractor Sewer/Water Contractor plan? _ Y _ N If so, 25% plan review Telephone # ( Telephone #( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application 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. .S ?'P?-? ??" ?.?„4.,?..?. ? Applicant's Printed Name Applicant's 5ignature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 5iding ? 32 Addition O 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const . Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests Final _ _ Framing _ _ _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insularion _ Retaining Wall 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 Building Inspector 20061tESIDENTIAL MECHANICAL pFRMiT .aPPLicaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete tor. single family dwellings & townhomes/condos when pcrmits are required for each unit n???? ???( U A??_.??_?.. Date Site Address v?--? c 8w r Unit # Property Owncr A ? Telephone # '( Contractor STANDARD HEA7ING & AIR CONDITIONING ? 410 S`?-CAKE-$ RE Street Address MINNEAPOLIS, MN 55408 ---?2'?Z 4-?'6rJ u City State Zip _ Telephone # ( ) Bond #• F.xpires: The Applicant is _ pwner ? Contractor _ Other _ Add-on or alteration to ezisting dwelling unit $ 30.00 ? furnace _Additional /AReplacement _ New air exchanger air conditioner heat pump other State Surcharge $ .50 Total $ 3t) I hereby apply for a Residential Mechanical Permit and acknowledge that the infornnation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit but only an application for a permit, and work is not to start without a permit; that r be in accordance with the appAS4LO-' d plan in the case of?``?' hich requires a review and approval of pl C-/kIVI q-,l? cl._? Applicant's Printed Name Applicant's SjZn ture ?----__-_______--^ ? FQr,?C?ffice ils? ? ? Pertn it #: ? Permit Fee: ? Date Received: J/ I I ? I ? Staff: I I ? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ` Site Address: Tenant: Suite #: RESIDENT ! OWNER Name: d'I/1 H'e GfJ1 ov,.40 Phone: Address / City / Zip: f 11o Za.!L Applicant is: _ Owner ? Contractor TYPE OF WORK Description of wor ? ? m? Construction Cost: 11 "7 ,;'Y Multi-Family Building: (Yes No K-i CONTRACTOR Name: AtlL1 License #: 23?-;)-3?f? Address: ! 33vc.e At-W ?r795- City: /'g,vdxl ?df State: UV!/" ? Zip: Phone: 004-4; Contact Person: ???nG<!x ['n/d'tidl,(,t COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 CateqorV 1 Minnesota Rules 7672 Energy Code . Residential Ventila[ion Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master pian: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: , NOTE: Plans-and supporting documents that you submit are considered to be public information. Porfions of `` the information may?be classified as non-putilic if you provicle specific reasoris that rvould permit the eC?ty fo. ; conclude?that:?the-_are?tradesecrets. I hereby acknowledge that this information is complete and accurete; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a peRnit, but only an application for a pertnit, and work is not to staR 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. Sff 6 1 K"a. X ? .J pplicanYs Printed Name A plicanYs Signature Page 1 of 3 ?`t Uh ; Use BLUE or BLACK ink For Office Use t I I City of Ea an ; Permit L~ a I 0 u I A49- 3830 0 b i Permit Fee: I Pilot Knob Road 1 t Eagan MN 55122 Date Received: )3 ; Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: Z,rtf I I ION ? i 2013 RESIDENTIAL BUILDING PERMIT (APPPLICAT~te Date: Site Address: =11I~jC - q/ IO q - W 9'-7 /7 1' ( i Name: t El~Y1 f' itJb~CL - Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: I~ &,ME Yl' )yvr si 1 ki f jes Construction Cost: 0( o Multi-Family Building: (Yes X / No ) Company:lW w (%!OfS Aj SW _f AX- Contact: SfV' Affe-11 Contractor Address: 10701 `13 - A). City: AQ,(& 6-IDV£ State: MA) Zip:: ~ J(09 Phone: ~_~3 -3 is- 919' 0 License l_ J "tJ Lead Certificate NAT- ~2 2~110 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? =t i 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.gooherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State di C e u be completed within 180 days of permit issuance. x ~&s x Applicant's Printed Name Applic nt's Signat Page 1 of 3 r��° Use BLUE or BLACK Ink �; �-----------------, 9 �". . � For Office Uae � ;ri i f � ' �� I �l� O1 1� Z.l� � Permit#: GJ/ I y � v I � Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 I Date Received: � Phone; (651j 675-5675 I I � Staff: � Fax: (651j.675-5694 � � � I � ��__�__J 2014�RESIDENTIAL PLUMBING PERMIT APPLICATION Date• ' � � �� Site F�dd ess• r�,�l� ��r"c°\., d Tenant: 3uite#: � � p��g r � �� .�.��..�. �,�;, w;�' ��x�a��` ��Name: � "�� Resic�en�lOwner,�� ' Pnone�_ — `�6�,`��,�� -"��w�� q,� �:_.��5�'��;��w�i s Address�' ity/ZiP� � �N �r`��C��«��`�� F�`�' ' Mifbert ompany Inc dba Cullign Water �` t H,�i'ti4'4�#�t,+' �'C i ad�t.zp � z,�` � . 4 ��s�'��,x� ,�a�� G' Name: ��cense#: WC 4317G ; ��,�� t ��`�;��;��x��i , Add�ess: 180150.. $treet East c;�y: Inver Grove Hgts. -��,�4 o tractor ,,� � ;"x�'�`��`��`�`�¢Y� �' ;� state:. �M N � zip: 55077 651-451-2241 ,�f�thS��'��z,��"�;,�� Phone: �r �,� µ . . �y� '��'��7�:��,_,;;��%°�k COntal.l. WIIII�III' R.'MIII�Ert EmaiC ��.;��.:.��,�'4�y��r"�{ �y� �' : . . .. . . . .. . . . .. . . . ... . . . `�J.Fb14.�"��r�r �,�> �, . ��,�Type of Wor .`� —�ew Replacement _Repair _Rebuifd _Modify Space _Work in R.O.W. ?'��E� '�,,��,�� `� �,��?�.�'� � �'�'� � ��Descri tion o �work: � � ��!..$. E ..s P ��;��'�'�� '� ' �RESIDENTIAL � � ��s�M �,��,��~,� : u�t��1 � � . ;�� ,�F��rt�a .� Water Heater ��r�� '�,��» :k �,Water Softener ,{� ��.��$� x Lawn Irrigation(_,.�RPZ/_PI�L) ;��PerCn�t�T��p]' `',k� Add Plumbin/7 Fixtures ` $*� Septic System Main/ Lower Level ':t"!'u^.J "�m�' }A� iS'r"1��+'7 7�i�' .� � �J �. � / .. �';T'}i~t`�. i�iets�5 !P`�Y�" � • . ��'��# ` k�� New WaterTurnaround ��s�w"�� — ,��.�.��:�4.� �.�;. ;��.�� . � Rbaruonrr�nt � RESIDENTIAL"FEESs " _ $60:00 Wafer Heafer�1Nater Softener, or Water Heater and Softener(includes$5.00 State Surcharge) � $60.00 Lawn�lrrigativtt`(includes$5.00 minimum State Surcharge) $60.00 Add.Plumb�ng Fixtures, Septic Svstem Abandonment,Water Turnaround"(includes$5.00 State Surcharge) ,. "Water Turnaround(add$Z00.00 if a 5/8"meter is required) � $115 00 Septic Svstem New($10:00 per as built)(includes County fee and$5.00 State Sutcharge) ` � TOTAL FEES� CALL:BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. �,a11.48 hours before you intend to dig.to receive'locates of undergrourrd utilities. www.aopherstateonecali.org I hereby acknbwledge that this informa:ion-is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of ' �Eagar�;that I`understand fhis is not a permit buf only an application tor a permit, and work is not to start wkhout a pertnit;that the work wlll be In a�.cordance with.the approved plan in the case of work which requires a review and approval of plans. , ,. x l�l/ � !� � l� `�- x Applican.t's`,Printed Name ApplicanYs Slgnatu . y. 5 C� a��;.,�� ," ��. y..".,,� Gf.z��,..: v. .-::: ��i�,� � F r r ¢ ' � �q � 5�� ib °� �y �ro k��1`d�.�`�`Nh � 3 �4&µ J Y' '�a m ; .�� .-��' � �� 'W 5 � Ca. �i k �M1 `l�4�t�a Vr�a� �. FQR OFFICE'US �� ;��' "� � ��'>� �' � ;� � �, � ,r,� � '� Rev�a d � s �o Dateti � �. t"�� ,° ;:, �,x r � � �.c��.�,��h`� � �� r,'. � ....... �� , �.'� :� " �� .s� a�".�+ �, � ��7�„a �!r.q� Require'd In p cti�n,�,• c � � e; r�5! R� rt " ; r�e'.. � c s �� " �na�J �,; x '4�� }� �k �, �� 'Mehter�, ela �d��i ems ;Ni�ete �Siz- ~ h ��'r-,� � r �� . .�.� ��" � • ds.�1� � : a.�� . �� ,.,� m..,.,�.� . �� h�, �� .. ..� �,a.,� . �� , ` � __�_. . . � __ _ _ .... ..� �-�� r For Office Use „ •r� :: e:% ? .... ECEIVL. Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5 APR U 5 2019 I Staff: buildinoinspectionst citvofeagan.com 2019 RESIDENTIAL Blfl - IT APPLICATION Date: "I I M Site Address: P,- 4//(oz fi\e,A0,6e 4) Unit#: Name: Phone: Resident/ Owner Address/City/Zip: Applicant is: Owner Contractor Er liI i'C Description of work: u Cff Type of Work Construction Cost: 'd Multi-Family Building: (Yes /No A ) Company: 0 54.-'V,, OL-0 )71,11-2) Contact: (1A-4-Iv//J" 1 Contractor Address: City: U c,4^i State:!r'J Zip: 55 57Z-Z Phone: C q-2/0-Nrit Email: License#: (0) 0C3/ Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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 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 t to start without a permit; that the work will be in accordan with the approved plan in the case of work which requires a review and approv p s. X m Pahl) x Applicant's Printed Name Ap icant's Signature DO NOT WRITE BELOW THIS LINE (7/ & -- 4E14r (); PERMIT City of Eagan Permit Type:Building Permit Number:EA174803 Date Issued:02/22/2022 Permit Category:ePermit Site Address: 4162 Meadowlark Way Lot:4 Block: 4 Addition: Hillandale 2nd PID:10-32951-04-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Jan H Dieter 4162 Meadowlark Way S Saint Paul MN 55122--177 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature