2896 Highridge TerINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date issued:
(612) 681-4675
SITE ADDRESS:
I tHlI UhF
! (i'; ?f
PERMIT SUBTYPE:
r w?-• ?s rv ++ ? ea t+ ?
fF(1 i
. 1'
APPLICANT:
i r, 1.' ) -I •I E+ `+ =1 ?, 43
TYPE OF WORK:
IN
PE
TION
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a? ar F?? I I M wt1 14 , :I f Mt C 1tAW I.i AI
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Permit No. Permlt Holder Date Telephona ?i
ELECTRIC .jl??l&
PLUMBING / 9 7 ?r'Jd ` $v g
HVAC
Inspecdon Ingp. Comments
FOOTINGS 71y
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING ? ?
PLBG
AIRTEST
-?? ?
ROUGH
HEATING d
GAS SVC
TEST
?G
? 7
?
60
INSUL ?'JJ
GYPBOARD
FIREPLACE
FlFEPLACE
AIR TEST
(T ?/
FINAIPLBG
FINALHTG rp?? ?y
!°- !
ORSAT
TEST
BLDG FINAL
L?ZJ
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
?5/ao/9 -7
452-11f-
? E , REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board ot Eleclricity
1821 University Ave., Am. 5-128, Si. Paul, MN 55104
Phone (672) 642-0800
Home Duplez Apf. Bldg. Other: New Addn
Commerciol Indushial Form Remod Re ir
P Air Cond. Htg. Equip. Water Htr. Load Mgmt Other.
I Dryer Ronge Elec. Heoi Temp. Service
"X" above the work covered by rhis request. Enter remorks in ihis space and on fhe back of fhe whife copy only.
c--z - ? '--?
a.CD
Colculate Inspection Fee - Tfiis Inspedion Requesi will not be occepfed wilhouf the cs
Other Fee # Service Entrance Size Fee ri Circui[s/Feeders Fee
Mobile Home Pork Stall O to 200 Amps p? Q 0 to 100 Amps
Streef Lig./Tmllic Siq. Above 200_Amps A Amps
Transformer/Generator INSPECTOR'S USE ONLY TAL
$ign/Outline Lfg. Xfmr.
Alarm/Remae Confrol
Swimming Pool
f he.e6 ce?ti thot 7 ins md ihe viml msmllmior? on ihe da?es strn
Irriga}ion Boom RoogMn Date
eciollns
ecfion
$
p
p
Investigotive Fee Final D
THIS INSTALLATION MAY BE ORDERED ISCONNECTE NOT COMPLETED WITHIN 18 MONTH .
S d' D (1 ? OPFICE USE ONLY This reqoesl void 18 momhs hom validotion dote prinled in Pois 6ox.
I^ ? ? ? ?.- o+
I IIII I III II III II III II I I II III II III I? I I III I I?I??? C?\? ?V ?
* 0 4 5 2 1 1 6 7* PLEASE PRINT OR TYPE
Requesl Dale
- J- ?? Rwg6in inspection reqvlredE Yes ? N.
(You muet mll ?he inspecbr when reody? Inspecllon Oiher ihan RougMn: ? Ready Now Will Call
Cate Ready:
licensed controctor ? owner hereby request inspection of the above electrical work at:
lob Pddrezs 151reei, Box, or koNe No.?
? 96 Ciry 1 Zip Cada
Secfion No. Tovmrhtp Nnma or 14o. Ro No. Fire No. C.urt'
+
Occupa one No.
PowerSoppl Addrees
Eleco- C roct« (Canpony Name) Conhacror Ucense No. Moster Lic No. (Plant EIM. Only)
MoNing Address (Co ctw a Ormer Perfurmfing In?stal]hlion) i .
AWhwized ignoNre Canhocror ar Ownar Peifwming Ins1a11o1ion) ' ? Phone No.
?
E &ODOGIAl 1 8(96 g7pTE BOI1B0 COPY - S INSTiUCT10N5 ON BACK OF YELLOW COPY
Addres¢ 2846 tIIaIEUDCE TERRACE Zip 5512 I
I.ot z Blk 1 Sub
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON.
Date: Yes No Inspector: r
Final grade (6" from siding)
Permanent steps (garage) ?
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or instaRing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
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PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 6 2 7
(612) 681-4675 Date Issued: 0 3/ 2 4 J 9 7
SITE ADDRESS:
2896 HIGHRIDGE TER
LQT: 2 BLQCK: 1
DELOSH
P.I.N.: 10-20300-020-01
DESCRIPTION:
B:uildin'i?-,Permit Type
+Buil.dirlg 44r,k Type
U^BG Qccupancy'.,
Construct'-ion 7'yp.e
Zoning [.._„
Su3ltling Length - `
Buildin.g Width
6uild?ng,?rstories
xS d 4a, r e F se't e-
SF DWG
NEW
R3/U1
VN
R1
6m
35
2
1,658
434 ALT. RESIDENTTAL
?
REMARKS:
S & W PLUMBER:
D C MECHANICAL
N ?
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
5urcharge
SAC
SAC ?
SAC Units
Subtotal
$1,107.25
$719.71
$72.00
$950.00
100
1
$2.845.96
$144 000
MISCELLANEOUS $1?639.50
Total Fee $4,388.46
CONTRACTOR: - Applicant - sT. LIC OWNER:
KEY LANp HOMES 14409400 0001553 KEYLAND HOMES
17021 FISH POINT RD SE 17021 FISW POINT RD SE
PRIOR LAKE MN 55372 PRIOR LAKE MN 55872
(612) 440-9400 (612)440-9400
?
I hereby acknowledge that I hav'e read- this appl3ca;Cion and stats that the
a,nt'armation _is c4rrect anct agree. to 'comply wlth aJ..l aPPlicable, ?State of Mn.
SCatutes and City o'F Eagan OrdiYiance5<
ficxw
APPLICANT/ ERMITEE SIGNATURE rIB3U ID Y SIGNRT?R I?
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
5830 PILOT KNOB RD -55122
' 681-4675
Now Construction Reauiremants RemodeVReoair Reauirements
? 3 registered aite aurveys ? 2 copies of plan
? 2 copies of ptens (indude beam 8 window sizes; poured fid. deslgn; etc.) ? 2 site surveya (extenor adtlttions 8 Eecks)
? 1 energy calculations ? 1 energy ealwlatlons for heated addkions
? 3 wpies of tree preservation plan H lol plattad after 711/93
requiretl: _ Yes _ No -
DATE: CONSTRUCTIONCOST:
DESCRIPTION OF WORK:
STREET ADDRESS: LY?`ll
LOT 2 BLOCK
PROPERTY Name:
OWNER
SUBD./P.I.D.#: ?aL-J_,>S-? ?Vq>«k0"
?..
..,
Phone #:
Street Address:
City:
CONTRACTOR
ARCHITECT!
ENGINEER
State: Zip:
Company: ,'V?SiL?+4k-1D LMS.S Phone#: ?40'94bQ,
Street Address: I70Z1 fiS? rf>T RD. 5? License #I55-12
Ciry: FQ Iotz- L.A4E- state: M til • Zip 55 3`) 2._
Company: _
Name:
Street Address:
City:
State:
Phone #:
Registration #:
Zip:
Sewer & water licensed plumber (new conshuc6on only):P• ?- • I" l?L,ttAF-????41.. . Penalry applies when address change
and lot change are requested once pertnit is issued.
I hereby acknowledge that I have read this application and state that the infortnation is corre n agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECETVED
Certificates of Swvey Received r.Yes _ No p?AR 19 1997
Trce Preservation Plan Received _ Yes - No 1, Not Required
BY:?
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
Jz( 02 SF Dwelling o 07 4-plex
0 03 SF Addition ? 08 8-plex
0 04 SF Porch ? 09 12-plex
a 05 SF Misc. . ? ' 10 _ plex
WORK TYPE
0' 31 New o 33 Alterafions'
? 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actual) V ?I
(Allowable) J nl
UBCOccupancy R-3,u-?
Zoning 2-i
# of Stories z
Length Go'
Depth 3 s '
0 11 AptJLodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace
?
? 15 Deck ? 36' Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
asq. ft.
? sq. ft.
L) sq.ft.
sq. ft.
Footprint sq. ft.
APPROVALS
Planning
Building . MAS
, ? .•'ri 6 ??.. ,
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
t it.8 MC/WS System ?
? 1-19 City Water ?
c,09 Fire Sprinklered
sio PRV
Booster Pump
Census Code. ?0 i
ry a 3 SAC Code tn i
Census Bldg I
Census Unit i
Engineering Variance
Pertnit Fee Valuation:
Surcharge gQ s? M?,-f
Plan Review
License 3c? ? 28
MCMIS SAC ?y " ` z
City 5AC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge ---
Treatment PI. 3? K 2 a
Road Unit
Park Ded.
4?"?`1G
Trails Ded.
Other Z1. t-7 Y ?4
Copies
Total:
$ t4q,pDQ-'
??08
Y ?s=
,i4. v
.o.t.7
ii-7 f - G 7 1Pt??1=
r,3oS 6 4 SY =
«, s z0. ?
5ql L!3 Z. -
d.?
sio lbl? '4' ?
1 413. CiZo
I
% SAC
SAC Units
* PIOi II
? u-n =9n
* * *
p422 Enterprise Drive
Mendoto Neights, MN 55120
avlL (812) 681-1914 FAX:681-9488
EhGNfFNS _ _ _
W+D PIMINE0.5. w+osc.rc uRcniTCCrs 625 Hignwcy 10 N.E.
Blaine, MN 55434
1(612) 783-1880 fAX:783-1883
Certi.ficate of Survey for: 6CEYLAND HOMES
R? IrA 67-?j A r_v 2896 HIGHRIDGE TERRACE
U° CMKEWED
BY ti( ?
DATE 3-iq-q7
BUILDING INSPECTIONS ')EPT.
BENCN MARK
TOP OF PIPE
ELEV.=877_39 ?._
I 11 13 I
? 30 1??1
Ui
a?
(X
wl
F?f
WI
a)
873.4
872.9
II
i
C.B.
872.3 ?
872, 7
30
0
0
0
O
•--
134.19
878.4 879.6
4' a,? 1 41S
?et / ?
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pa-
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374.8?"- ? L--- mr-^--.---- ---
10 oi oii ?
22..35`0 ^-?i ?
PpRI?WAYD ?
/ I .EY
? 876.9 \
` SERVICE i w
INVT NOT AVAIL?''? n C)
? i ? n\ao
? i
87(7.2 28.33
; ? ml
878.5 x 579.4
3607-II-A
S6*.p)
887.6
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h pQ ?w R
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411-. I N
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aa {
% $7S.B PW I
7
877 Z
. I
/
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?J
N?----- --?-
30.Oa ?. ):>W,7 877.5
?g73.o) Sl69°45'26"W
11 131 ,'
,
BOPCOFMP PE ?
ELEV.=876,94 NOTE: PRaPOSED GRqDCS SHOWN PER GRnDINC PLAN BY: DEVEILOPInEr+T ENG.
NOTE BUILDING OIMENSiON5 SMON'N wRE fOR HORqONTAI AND VERTICPI IOCATION
OF 57RUCTURES ONIY. SEE ARLnITECTVAL PlANS FOR BULDING nND
fpUNDAiION DIMENSIONS
HOTE: NO SPECIFiC $OIlS INVESTCATION HAS BEEN COMPLETEO ON rHIS LOT BY THE
SuRVE1'Oft. TnE SUITABILI7Y OF SOILS TO SUPVOnT THE SPEqFIC MOUSE
PROPDSED IS NOT THE RESPONSIBIUTY 0F THE SuRVEYOft.
689.4
? 0l I
DZ'+'PT.
LOWEST FLOOR ELEVATION: 870• Y
YOP Of BLOCK EIEVATION- g 72'0
GARAGE SLA6 ELEVATION: U 77 -2-
NOTE; THIS CERTIFlCATE DOES NOT PURPORT TO SHOW EaSEMEN75 O1MEFi 7HAN X 000.00 DENOTES E%ISTING ELEVATION
7MOSE SMOWN ON iHE RECORDED PLaT. ( 000.00) DEN07E5 PROPOSEO ELEVAl10N
--- OENOTE$ ORAINRGE AND UTILITY EA$fMfNT
NaTE CONTRACtOR MUST VERIFY DFIVEWAY OESGN.
OENOlES ORAINAGE FLOW DIREGnON
NOT£: eEMINGS SHONN ANE BASEO ON AN ASSVUEO DATVM a OENOTES MONUMENT
?B- DENOTES OFFSET HUB
WE HEREBY CERTIFY TO KEYLANO r+OMES TriqT THIS iS A TRUE nND CORRECT REPRESENTqTION OF A
SURVEY OF THE BOUNOARIES OF: LOT 2, BLOCK 1, DELOSH ADDiTION
DAKOTA CQUNTY, MINNESOTA
IT DOCS NOT pURPORT i0 SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYEQ BY ME OR
l1NOER MY DIRECT SUGERVISION THIS 10'iH OAY Of MARCH, 1997.
SCALE : 1 INCH = 30 FEET
SWK
e-
Z0'd
• . LOT SURVEY CHECKLIST FOR RESIDENTIAL
QIdILDiNG PERMIT APPLICATION n
• PROPERTY LEGAL: 6zzez=4=:i.A ??'`? _
? ? DATE OF SURVEY: j O
LATEST REVISION:
?
s
z m
? DOCUMENTSTANDARDS
2"113 1
? • Registered Land Surveyor signature and company
• Building Pertnit Applicarn
0-'0 0 • Legal description
e? ? ? • Address
G;K, 11 ? • North arrow and scale
2?"0 ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
Er-'o ? • Directianal drainage arrows with slope/gradient %
El-' ?
O'?o 0
? • Proposed/existing sewer and water services & invert elevation
• Street name
ET' ? ? • Dfireway
ELEVATIONS
Epstlng
13 0"? Ll • Sewer servica (or Proposed)
0' ? 0 • Propeiiy comers
e ?
? ? • Top of curb at the driveway
c 13 • Elevatlons of any exasting adjacent homes
Prooosed
¢z 0 0 • Garage floor
13" 0 ? • Rrst floor
q-- 11 ? • Lowest exposed elevation (walkouUwindow)
Cr' ?
Er ? ?
? • Property comers
• Front and rear of hame at the foundatlon
PONDING AREA frf aoolicable)
13 Cr 11 • Easement line
? e' ? • NWL
0 m' 0 • HWL
? a
13 O
13 • Pond # designation
• Emergency Overflow Elevation
DIMENSIONS
o' 13 o • Lot IinesBearings & dimensions
e o ? • Right-of-way and street width (to back of curb)
z' ? ? • Proposed home dimensions including any proposed decks, werhangs greater than 2',
porches, etc. (.e. all structures requiring permaneM footings)
• Show ali easements of record and any City utilities within those easements
ca-, o
'? ? • Setbacks af proposed structure and sideyard setback of adjacent ebsting structures
'
0 2r ? • Retainingwallrequirements,
rfany
Reviewed: -3
January 1996
CRAIG10BdBlDGPRMT. FM
,
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TYPICAL
1 4" PVC SDR 28 SOIL PIPE
Sox 4* WYE
t' COPPER TYPE 'K'
1'x 1' CORPORA'T10N
CURB STOP BOX
18' SEPARA710N (VERIICAL)
15' TAiIS ON WATER dc SWR SERVICE
STD. PLATE 300
HIGHRIDGE TERRACE
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DATUY AZ&'Y
EXIST)NG GRADE
PROPOSED GRADE --i
.
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7.5'
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LOW PqINT CI,.EV .• 873.48 IT ` - ?
LOW POINT 'STA 2t50 ` f?;',', Tk :- i; i._.
PVI STA R 2+50
PVI ELEV m 873.02
? 100,00' VC ?
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' EXTERiOR ENVELQPE AVERAGE "U" COMFIITA'fION
OWNER:
SITE ADDRESS: 2g? {?1?(.-.t}? l??'p6L T•
CONTRACTOR:?EqLAiJ? T??ME-S
1
2.
nnrr: 3-18- (=l"-I
Prso^iE: ?-c`?-q4oU_.
PLAN r
Determine working square foota9e of each
Total exposed wall area.:... 2SI 46. q- sq. ft. x .11 = 285.16
Total roof/ceilir,g area..... II(c14 sG. ft. x .026 = 3?•2
Total exposed wall area above.floor= ZZ(o?j
a .
b.
c.
d.
e.
f.
9•
h.
i.
J•
Total wall window area .............................:............. 2JD4. 4
Total door area .................................................. SS - 1
Total sliding glass door area .................................... 31t) • 9
Total fireplace wall area ........................................
Total wall framing area (average 10%) ............................ 2Zlo,.9L,
Total rim joist area ........................................... :. 229 • 2
net wali area a6ove floor ............... :....................... 1-142-- 8
wall area a6ove floor .....................................
wall area z6ove floor .....................................
frame wall area at foLLndation ....................................
Total exoosed r"oundation area= IOIZ
k
1
Total foundation winda.a area.......................
Total net foundation area above grade .............. (p?, Z
Determine "u" value of each wall segment -
(e.g. window, door, each separate wail section)
x
b. SS, ? x
C. z
„U" ,q"?a = ?1?•O
?, ? ? ? 9'cP = I ?, g?
d. - r. lluii
e. 2Z(v. g X
f. ZZ.`i . z x
9. I-7?Z.e) x
°r
„U„ . 04?- _ `1(o.co
h. x 'lull
i . X 11 UTi
x 11 u 11
k. X u
'?• IC)?.Z x. U„ 08?
3 . .................................Tot41
= 2???$
If item s3 is the sz,
as, or less than ite:
rl, you have me*_ the
intent of SBC E005 (
}.. T MTAL EXPOS:p ROOF/CEILING CAICUlA710iIS:
? . • Totzl exposed
• 'roof/ceiling area.....,.. ?i64 sq ft
: j) Tocal skyliaht area....... -'` sq f[ x"U" °
k) Total roof/ceilinq franinq
"
"
zrea (Averaae 16 )..... sq ft x
U
1) Totzl net insulated
f
?
"
"
? Z? I
?
2
roo
/ceilinq zrea...,.. ?(p sG `t x
U • `•
=. . TOTAL j) thru 1 ) z9'.?p
; cotzl o: =1F is the sane as, or less than r'2, you have met the intent ol
? •<C?_i 1.16008 a-nd 0.
• AITERt;ATE BUIl01hlG ENVELOPE (7E5lGN
To utilize the :otzl envelope systen me[hcd, the values estzblished by the sun
or i,en; and :=4 snall not he nrez[er than the sum of iCems fl znd .•'-2.
?. 2`b5,eb + z. 30•? = 31?n
?' T
; - ?
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:' No?: lkse (-st o= cpn4ue Lwl 1 arcro CT-)r
firame 4r6EruGe 'ku?
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R- VALUc.
CONSTRUCTIONP,_ FRAMING - -
1. INI'EEtIGR AIP. FILM 0.68
2. 2 GYPBD .4
3. 5 1 2 SOFT WUOD 6.87
4. 25 32'_ gJ?vR?TE •oc>
6. LKITYIOR IR FILM 0.17
R=
U- ID.44
oRS
hEI
1. ITvTERTOR ASR FZLM 0.68
3. 1i2 GYPBD .45
3.
4• F3??vRirr - 2.ocp
5. I ING - VjnlY` .21
6. _ EXTERIOR R. CI, 0.17
TOTALT _ Z'L. Sl
- U=
: •044
1. IN'-'ER.IOR AIR FILM 0.68
2. 6 INSUL. 19.00
3. 2x10 RIM JOIST . ?
4. '?+/3z' 6uLOiUTE 2.otc
5. SIDING - ViNYL. •21
6. ZOR AIR FILM . 7
24.0{
U= .b41
BLDCK
1.
2.
3.
4.
5.
6.
SLAB ON GRADE
INPERIOR AIR FII1d 0.68
1.28
U7???Yf I Dy1 10.0
SPRArY - Foa?M
EXMRIOR A F
TDTAL R= I7-13
U= . o aZ
,
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=l
lfll
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ii ff??.. • ,
{i I
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.
< _^
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I*1DICATE i^!?E, ??R" VALUE. D?='? --'?-
?iP.CE?'N'?' 07 INSULA'?'ION.
j?Z4t1E WnLL
ROOF-CEILIN6
A f?'`AT FT(JW
uUP
FIG. #5
TZ-VALIJE
1. i? t?.crr_i.,rr -f1tZ rt?-M , Cv ?
2. 58
3. - fl
4. ?,efsnl?. ?irc- fii.r-t TOTALS
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2.
3. ? -t- l+.lsu[,ATorl 35.6
4. 18 PI'-
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FIG. # 6
2.
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4.
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1. TOT1?L.
U =
"
2. ?
3.
4.
5. '
'
1. U =
2.
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4. ?
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NOTE: USE ADDTTIONAL S= IF 2V1tE S-°F?--"F I-`-
=ED FoR D-=LS a.tM cAta.rLa-'''Toxs•
FIG. =7
NUN-VLN1J "? ?'
HEF,T FUJW L1
.. U?
2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
arY oF eacara F.: 4 /? s(-)
?? y? 3830 PILOT KNOB RD - 55122
-? 851-881-4875 r C-a?( dC?
I - ??-
New fanshucMon ReadremeMS cl?/)7j)URgmo(1gi/Reoalr ReaWrertanb
D 3 replateretl ilfe wrveys showinD W. 8. W bt w. n. ot nou:a 6-15- a v a eoWea w qan C a,J-Le.e) 3-06
aid g1 rooled areas W%mmdmum br coveraae aibwedi t wr ot energy ealaAaMOna tor heated adtlitlons (9'7-vo
D 4 copies of plant (show beam & wintbw sizes: poured trW. detlgn; etc.) 1 dle wrvey for extedor adt811au 9 HecW
> 1 tet of enerpy talcWallpin
D 3 copiea of hee Preaervalbn plan H loT ploRed aRer 7/1/93
DATE: I -aC9-f-0 CONSTRUCTION COST:
DESCRIPTION OP WORK: Ft n?a, //->- c7x, &'ue Al?-
SiREET ADDRESS:
4.4-
LOT: ? BLOCK: SUBD./P.I.D.
raorErm
owNee
Name: ??GZ ' f Gtf?/Clak
lASt Flrtf
rneet
Cly
Phoneu: ? Sl-6? 8-3 /l7"?
?? CcG.?, •,?
State: J7-1 k-\- Lp: S S
le M:
(area code)
CONiRACfOR
State:
Lp:
ARCHITECT/
ENGINEER
Company:__ ? Name:
Telephone C: ( )
Sfreet Addresa: Reglshatlon #:
CitY
Lp:
Sewer/water licensed piumber (if Inatallim sawer/water): (N s-o C-)--? Phone #: ( G`1`4- ) yc- 9^ y0-6-b
I herebY acknowledpe that I have read this applk:albn, *te Mwt 1he infamalion b
of Minnesota Stahutes and City of Eagan Ordinanees. ?
Slgnalure of
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
llcense M Exp.
and agree to comply wNh a0 appOcable State
2 E
_ Not Required ?
dty Stute:
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundatfon O 07 OSplex
? 02 SF Dwelling ? 08 06-plex
0 03 01 of_plex 0 09 07-plex
? 04 02-plex O 10 08-plex
O 05 03-plex ? 11 10-plex
? 06 04-Plex ? 12 12-Plex
WORK TYPE
O 31 New
? 32 Addition
33 Alteration
? 34 Repair
O 13 1&plex ?
? 17 Garage ?
O 18 Deck O
? 19 Lower Level O
Plbg _Y or _ N O
? 20 Pooi O
21 Porch (3sea.)
22 Porch/Addn. (4-sea.)
23 Porch (screened)
24 Stortn Damage
25 Miscellaneous
30 Accessory BWg.
13 36 Move Bldg. O 43 Reroof
O 37 Demolish (Bidg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair s
O 42 Demolish (Foundation) O 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMAT?N
SAC Code
No. of Units
No. of Buildings
Const. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
Ciry Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning
Building T Engineering Variance
Permit Fee Valuation: $?
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
? 31 ExL Alt - Muld
O 33 Ext Aft - SF
O 36 Mutti
iz?
CITY USE ONLY
L 4:-11- BL ? RECEIPT#: ?aa76*5
SUBo. ? Q CR<1??. nA(I)1 RECEIPT DATE: ? I- nO C?
PERMIT #
2000 PLUMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, bQ7 55122
651-661-4675
Please cromplete for: ?"? J single family dwellings
townhomes and condos when permits are required for each unit
? backflow prevenler for underground sprinkler system
FIXTURES
EACH N
TOTAL
Alterations to,gxisting dwelling - minimum fee
Describe: 1-?QJ1?VY`A w? ?l ni -c ? $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet " minimum -1 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newlrefurbisned • requires MPC lic. 75.00 x = $
Septic System aeandonment 30.00 x = $
RPZ new installation/repaidrebuild 30.00 X = $
Rou h openin 1.50 x = $
Shower 3.00 x = $
Under round sprinkler if dwelling is under consWdion 3.00 x = $
Underground sprinkler ff existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwening under coruwctlon 5.00 x = $
Water softener H existlng dwelling 30.00 x = $
Water turnaround 30.00 x $
State Surcharge .50 -> --> --> $ .50
Total -> -> -> --> S 3
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
----------------------..._...------------------------•-•... ----•--•-------- --•------ ...------------------- ------- -••--•------
I hereby acknowledge that I have read this appliqtion, stste that the informetlon is correct, and agree to comply with all appliwble City oF Eagan ordinances.
It is the applicant's responsibiliry to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during ds
normal operational and maintenance adivities to the facilitias constructed under this permd within City prapertylright-ot-way/easement.
SITE ADDRESS: I e- C -9,
OWNER NAME: : l6?I 1 /(-`c r h0 J I
INSTALLER NAME: A LC Y'<Ll tte, U rhh )/`? 4
STREETADDRESS: 7- 27 a b Q 1 ?j e u-}
TELEPHONE#: ?S 1^ ?? -?;f / 1
(AREA CODE)
TELEPHONE#: U I z 76 ?-Z? Gn
r q i I (AREA CODE)
cirr: STAIE- ZIP:??ZN
SIGNATURE OF PERMITTEE
? C5
L CITY USE ONLY RECEIPT#: / ry//
? BL ?
SUBD, kd" RECEIPTDATE: 7" g/?7
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 56122
(612)681-4675
Please complete for w 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: `1 --), -? 1
I9
? 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 Surcharge . .50
TOTAL 3?J S?
SITE ADDRE55:
OWNER NAME: PHONE#: L O'?q OO
INSTALLER NAME: nR\?'r?? PHONE#: \A kA ` ?ol
STREETADORESS: cGf'_?-
CITY: Q C \ 611 STATE: ZIP:
SIGNATURE 0 PERMITTEE
CITY USE ONLY
L BL
SUBD.
RECEIPT#:
RECEIPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for.
DATE:
CONTRACT PRICE:
iNORK IYPt: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: P $25.00 minimum fee Qr 1% of contract price, whichever is greater.
. Processed piping - $25.00
? State surcharge of $.50 per $1,000 of oermit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE#:
TENANT NAME: (iMPROVennerars oNLY)
INSTALLER:
ADDRESS:
cirv:
PHONE #:
• all commerciaUindustrial buildings.
. multi-famity buildings when separate permits are= required for each dwelling
unit.
STATE:
ZIP:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
?
CITY USE ONLY h
L ? BL RECEIPT#: 7o?I?Pv
SUBD. AS? RECEIPTDATE: ?(1S1R
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681r1675
Please complete for: . single famity dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
Shower
VJater Ciosat
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet ' minimum - t
Rough Openings
Water Softener "for dwellings under consWCtion
Water Softener ' for existing dwelling .
U.G. Spfinkl8r ' for dwelling under const '
U.G. Sprinkler ' far existing dwelling
Alterations ' to existing residence
Water Tum Around
Private Disposal System ' Dek Cty lic.
(new and refurbished systems)
Private Disposal Systems' nbandonment
EACH
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
20.00
3.00
20.00
20.00
20.00
75.00
20.00
STATE SURCHARGE
TOTAL
ND.
X 79- _
x
x
3 =
x
x t =
x =
x
X T =
x
x
x =
x =
TOTAL
,E, •d0
q.o6
6,00
q.bo
y?o
3, ob
•6n
3:m
4 To
.50
,53. od
I hereby acknowletlge that I have read this application, stffie that the informetion is corteU, and egree to compry with all applicable City
of Eagen oMinances. It is the applicanYs responsi6ility to notify the property owner that the City of Eagan assumes. no liebility for any
damagesaused by the City during its normal operdtional aM meh+tenance aGiAes to Mefaalities construded under this penniCwkhin
City propartyfrightof-way/easement. , , t r r--?
SITE ADDRESS: a. Y9 ?
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
cin:
? TELEPHONE#: 3!zb
fx. • _ A?- . _
STATE: ZIP:
SIGNATURE RMITTEE
. . ' . '?Ir . ..
' • . `I' . ' .
. - , ?.. . IV. .
? '. CI7YOr ?S`AfAN
t A'FiN'EC:Fi: J; TERM.L?dAlKj P2..$
PA"fE. 43730139'r'TM7. ik'a26;41
p
iJATSF' ? F'A7`YW Il ,i, G4RftiQLI
321,li 9L1C7i'21376 N?GPPPGF T4a ' bC1.U0 '
2^_?i"5 14001. .?396 H7L;HQDGE T ?i . 0.,50
,. ? ? . ...
. ?4
.:;. .. . .
. . ' . ?i ?. . ..
11
u
Ta+al FieC?a pt A?uc,I?.?t a ri E,C}. ?[I•
.9.4 II , TM
U3M Yfii: JAN
!
, ? .
• '? 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
dew Conatructlon ReauiremeMs
Remodel/Reoah ReauhemeMs
D S regkfered site surveys showing sq. B. of lot, sq. H. d house 2 eoples of plan
and QII roofed areas l20% maximum lot eoveraae ailowed) 1 set of energy calculaflom for heoted addXlons
D 2 coples ot plans (show beam 8 wintlow skes; poured tnd. detign; efc.) 1 sBe funey for exferior addNtons 6 decks '
D 1 set M energy catculatfons '
? 9 copies W fiee preservation plan @ lot plalFed aHer 7/7 /93
DATE: 9 - I?'<? q CONSTRUCTION COST:
DESCRIPTION OF WORK: C1 Ad ch C: n n-P Ct LP CI(--
STREET ADDRESS:
i
LOT: a BLOCK: ? SUBD./P.I.D.bPI OSh t'1C1d(?qOV1
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: CC'?-1- v- d ? I RJ-?LC (C),- Phone #: CQ 5 l??
last FiM
Street
?
dL
City State: In/L /ii Zip: S S 1 Z ?
Company: VA UYUIQ'
Sheet
City
License # Exp.
State: Zip:
Company: Yi 61o---? Name:
Telephone #: area eode ( )
Sheel
City
State:
Sewer d, water Ilcensed plumber (reaulred for new conshuction onlvl:
PenaNy opplies when address change and lof change Is requested once permM is issued.
Zip:
: hereby acknowledge that I have read this applicatlon, sfate that fhe informaFlon is cortecf, and agree fo comply wHh all appUeabl
State ot Mfnnesota StatWes and Cify of Eagan Ordinances.
SlgnaFure M Appiicant
OFPICE USE ONLY
Phone #:
(area code)
Regfstration #:
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes, _ No _ Not Required
OFFICE USE ONLY
BUtLDING PERMIT TYPE
... .
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex A 18 Deck ? 23 Porch (screened)
O 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
)S? 31 New ? 35 Tenant Impr ? 39 Gas Line Only O 43 Siding/Soffits/Fascia
O 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 applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC :
Cfty SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
S? 4-
+
Basement sq. ft. Census Code
3
Main level sq. ft. SAC Code a I
fL• 3 sq. ft. No. of Units ?
sq. ft. No. of Bldgs ?Z
sq. ft. MC/ES System
sq. ft. City Water
Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
. Building ? Engineering Variance
?
IWO
Valuat ion: $
SAC Units
% SAC
. w w
? 2422 Enterprlse Drive
??c ** Mendoto Heights, MN 55120
* PIONEEA w?o ?+?,o?s . n?n, c?w?cm5 ?812) 6?1-1914 F/4X:681-9488
* eng nae:r ng I.AmD PUNNEM1S. qmox.rc Auaurzca 625 Hig?woy 10 N.E.
F3loine, MN 53434
(a?z) ?-taefl Fax: 733-1ea3
Certificate of Survey for: KEYLAND HOMES
2896 HIGHRIOCE TEftRACE 3607-11-p
BENCH MARK
70P OF PIPE
EIEV,=877_39
I 301?
873.4
W i
U?
a
a 872.9
W1
CW7I
0
C.s..
? i 872.3 ?
= C.B.
?
872.7
30
(q-734 co n
i
1 13
i
,
I '
BENCH MnRK /
70P OF PIPE
•'??
ELEV.=876.94
NOTE; 7ROPOSEO GRADES SMOYM PER GRn01NC PIAN BT: DEvELOPµENT ENC.
NOTE: BU11,DiNG OEbEN510N3 SHOwN ARE FOR HOR120NTAl AND VERT1CAl IOCAi10N
OF STRUC7URES ONL1'. SEE nRCMITECNAL PlANS FOR BU401NG ANO
fIXINDA710N DIMENSIONS. NO7E: NO SPEqFiC SOILS IN4ESTiCAT10N HAS 6EEN CONPLE7E0 ON TNIS LOT BY THE
SURVMR. TnE SUITABIU7v OF SOILS TO SUPPOrsT TME SPEClFIC HOUSE
PROPOSED I$ NOT 1HE RESPONSI9IUTY OF 7FIe SURVEYOH,
NOTE: THIS CERrFlCnTE DOES NO7 PURPORT TO SHOw EaSEMENTS OlHEA 7NAN X 000.00 OENOTES ElI1STING fLfvAT10N
1MOSE SHOWN ON THE RfCORDEO PLaT. { 000.00 ) OENOTES PROPOSED ELEVA710N
NOTE: CONTt7ACTOR MVST VERI1"Y DRIVE%AY OESiGN. --- DENOTES DRAINACE AND UTLITY [45EMfNT
-?- OENOTES ORAINACE FLOW DIREGnON
NOTE: BEARiNCS SHOWN AR6 BASEO ON AN ASSVwEO UATUM ' DENOTE$ MONUMeNT
• -E3- DENOTES OFFSET HUB
WE HEREBY CERT1FV TO KEYLANO HOMES THAT iHiS IS A TRUE AN6 CORRECT REPRESENTATION OF A
Sl1RVEY OF THE BOUNDARIES OF:
LOT 2, BLOCK 1, DELOSH ADa3TI0N
OAKOTA COVNTY, MINNESOTA
iT DOCS NOT PVRPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYEE) HY ME OR
UNOER MY OIRECT SUPERNSION iH15 10iH DAY OF MARCH. 1997.
SIGKEU: 1 bIONEER Ek'CINEERHVG. P.A.
SCALE : 1 WCH = 30 FEET
Larson,
3
,3
??d1 9gg°45'26"W 134.19
30.00 ? 35.33 870'4 879.6
874.8 ?
----^---
r-- oi-'--' WT - - 5
10 , oi
872.1 877.9 ^? ? I
Q -^-i
O 2p,33.o i ?
i J
O PRO?OSED ? n 878.5 X 579.4
py
DRIyEWAY n Q a i 13.00
%?9
R\ 876.9 2 :00-
?
? ?`I SERVICE i w o h \ ?? I
e INVT NOT AVA,L,M f. o mi?? ?a I
qt i i di a0
tp i op \ ; ia a? ?
^r' i ZW
? ? 87?_2 28.33 ` x 878.6 ew ?
Z ? 877.7 4 I
?? ? ?i oi ?'?
.87a.t 0 1 878.4 877,5
133.92
ge*.o)
889.6
O
O
O
O
•--
?O
N
t?
?
O
Z
889.4
(568,0)
PRQPOSEO HOUSE FLFVA710N
LOWEST FLOOR ELEVA710N: S70• 9
TOP OF BLOCK ELEVATION: 8 71'6
GARAGE SLA6 ELEVATION: U 77 Z
Z0'd
?
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Conslruction Reauirements RemodeVRmair ReauiremeMs Officel)se OnW
3 registered sife surveys showing sq. fl. of IW, sq. ft. of house; and all roafed areas 2 copies ot plan CEd oi 5urvey Recd _ Y N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated addilions NB PirES PIBn Recd "Y _ N'
2 copies of plan showing 6eam & window sizes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Reqwred YN
1 set of Energy Calculations Addifion - indicate if on-site septic system Orts?(8:3ep??cSyste(n ,.? Y_ N_
3 copies of Tree Preservation Plan if lot platled afler 7/1l93
Rim Joisl Detail Options seleclion sheel (buildings with 3 or less unils)
Date ? / I2 Constructian Cost ?/ ? ? ?
Site Address ?^25 (/! 1/? dc? C, T-CA Gl C-C. UnidSte #
N S ?Z
Description of Work cj?Ct?VIGt _-
Multi-Family Bldg _ Y *JV Fireplace(s) _ 0 2
PropeMy Owner (AYV-Di' Telephoae #( I751) IO S 3- I I-I ?
Contractor V V1 6 01/i W
Address Nl,fpUt t Je .-YV . City
State Q[? ? Zip 5S4 lq Telephone #( b( 7j $LS Z? O U
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 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
In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pernut, 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. ? ,/ ? j
Y4YS tf ?? ?5lri v?v,-MGtVl
Applicant's Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ect. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applieant
Valuation Occupancy MCES System
Pian Review 100% or 25%
Census Code Zoning City Water
SAC Unfts Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUII2ED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings(deck) _ FinallNo 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 Tes[ _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Suroharge
Treatment Plant
License Search
Copies
Other
Total
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2896 Highridge Ter
Lot: 2 Block: 1 Addition: Delosh
PID:10- 20300 - 020 -01
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
All Pro Exterior
11235 Eastwood Ave SE
Watertown MN 55388
(763) 315 -4245
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Patricia A Carroll
2896 Highridge Ter
Eagan MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Building
EA082654
04/21/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
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For Office Use
::t:e;
E.� 5( 1)2>)CDC C'
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Date Received: (0'11)"(_l
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694
Email: buildinginspectionsa,citvofeagan.com Staff:J "`
Commercial Plan Submittal: eplansCcr)_cityofeagan.com L -'
2019 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: l3-�aO/ Site Address: 491.€3910 t+i�kr 2 7-2r ra
Tenant: Suite#:
Resident/Owner' Name: . o.Ni , (r'ets Phone: /2- • �///
Address/City/Zip: 4 t,Tdi q1040, J °L
49.c39— cuo
� t Name: LL. )14 �—i` a!' /4"24=tegryse#: 0413 CD3�3I
Ofd i 4 Address: . 6 FJ3cfc17 City: Q`' e
State: MI-$ Zip: S5b Phone:
q c 985- -#73
Contact:�-u fit- Email: JC,K ttuar,r„,,:ite7vq:
k RESIDENTIAL
A/Fumace
/Air Conditioner
Fermin` .
,c-,„ Air Exchanger
Heat Pump
;z ; _Other
New X Replacement Additional Alteration Demolition
Type of Work
Description of work: trbtenctce. g /dC° 3r
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$_O TOTAL FEE
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.citvofeaaan.com/subscribe.
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of
the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that
the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
X Gu R�- /44,i/ I X ��
Applicant's Printed Name Ap ' is Signature
FOR OFFICE �P N n " 7x ` 1t„ III
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- Service� `In- rHeat
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