1051 Hummingbird Lane? CASH RECEIPT .
CITY OF EAGAN
V 3830 PILOT KNOB ROAD
EA6AN,MINNESOTA55122
o'hze ; i •' ? ? e _
RECEIVE? ' ?
FPOM
AMOUNT „Q / I
& DOLLARS
C] CASH Q CHECK 'ao
.• ? ? (
FOR • 1 '
! . '
BY ,
.,,.. ? ,
? -
White-Payers Copy
Vellow-Posting Cop
Pink-File Coov
Thank You
CITY OF EAGAN Remarks
Addition Lexingtnn plaEeSetitil - Lot-4 Blk ?-Parcel 1..0 45060 040 gl
Owner 5treet 1051 NtImmins?ird_Lane State Fagan, MPd
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
th.t
SAN SEW TRUNK ? 1989 947-64 1
--
SEWER LATERAL 0 1986 16 31 . 0 3 2 6. 2 0 5 `
rv' 1015 1986 729.39 14:5.87 5
WATERMAIN 1985 65-81 11 16 5
?
WATER LATERA L 10 1
1986
87 3.43
174.68
5 J y
WATERAREA 19 243.73 48.74 $
w T LAT E 01 1986 111.98 22.39 5
STORMSEWTRK 101t 1986 426.54 85:30 5
STORMSEW LAT 1016 1956 803.34 160. 66 S
CURB & GUTTER '
SIDEWALK
STREET UGHT
WATER CONN.
BUILDING PER.
SAC
PARK
I
?_- . .? ..? .?. ..
CASH RECEIPT i ;
EITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
o?,`8rze . , g
REG EI V ED FROM
AMOUNT $ I
Q DOLLARf
?oo
? CASH E]CHECK
?' .
FOR -?'
r
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy ?
Thank You
BLDG. PERMIT ti0.
01-3210 kdg.'Permif - ?
,.
01-3422 Plan Check
01-3445 Surch./hdm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
CITY OF EAGAN h ?
12875
'f?
3830 Pilct Knob Road, P.O. Box 21-199, Eagan, MN 55121
-
? PHONE: 454-8100
BUILDING PERMIT
, Receipt #
;
To be used for SF DWG/GAR Est. Value $ 61, 000 Date NUVEMBER 17
19 d6
,
_
Site Address 1051 HUMM IIdGBI RD Lii Erect X3 Occupancy R3
Lot 4 Block 1 Sec/Sub. I,EXINGTON PL SnRemodel 0 Zoning R I
Parcel No. Repair ? Type of Const
Addition ? No. Stories
W Name ORRIN THOMPSON H0MFS Move ? Length dn
=
o 1712 IfOPKINS CROSSROAD Demalish
Address I
I ?
? Depth 46
F
S
mpr.
nt
City HTKA Fhone 544-7333 Install
? q.
t
= o Name S?E Approvala
$ ¢ Address Assessment
~ City Phone Water & Sew.
Phone
I hereby acknowledge that I have read this
information is correct and a to comp
Minnesota Statutes and CiW of aqan Op
Signature of
Police
Fire
Eng.
Planner
Council
ation d state that the BIdg.Ofl.ll/17/86
all app able State of
es. APC
., Var. Date
Permit $ 316.00
Surcharge 30.50
Plan Review 15$.00
SAC 575.00
Water Conn. 500 . 00
Water Meter 63 . 5
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
T iol / • OO
A Buflding Permit is issued to: U-MVi lv A CI V:'lY J V!? nv?11r o on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
I I PwmM No. I Psrmit Holdw I Dtlo I TelsphoeN N 1
0
Hty.
Mty.
Plbg.
Final
Occ.
DUp.
PERMfT # ` • ? ??
MECHANICAL PERMIT RECEIPT # ?
• CITY OF EAGAN ?. eC??i'?er.
3830 PILOT KN08 ROAD, EAGAN, MN 55121 DATE ?-- , 19£?n
CONTRACT PRICE PHONE 454-8100
SiteAddress =,umr,ting i.i•d r..ane
BLOG. TYPE WORK DESCRIPTION
Lot Block 1 Sec/Sub /
, x'n t o f? Sau tn LI/
R
? N
ew
es.
m Name GAnZ-Ry an M
l
Add
-on
u
t
? Address ' Trail Comm. Repair
c City Koeemou nt. MWhone 423-1144_ Other
Name U5 Hames - Orrin Thompson FEES
?
;
Address 1712 Iio
pkins Crossroad
RES. HVAC 0-100 M 8TU -$24.00
0 City N`innebDri}:a , MN phone 544-7333 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK _ AQDITIONAL 6 M BTU -
GAS OUTLETS - 6.00
1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM
? BEYOND $1,000.00)
Gas Piping Outlets # ?-
Other ? • ._.
FEE:
SI(3NATURE OF PERMITTEE
S/C: •
TOTAL• 26, &D
FOR: CITY OF EAGAN
? V
Site Address _
Lot '
m Name _
m Address _
,r
c City
- Name -
3 Address _
0 City Mir
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE - $10.OU
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
OF
FOR: CITY OF EAGAN
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
PHONE 450-8100
PERMIT #
RECEIPT #
DATE:
1986
Lane 11 BLDG. TYPE
Res. "
Mult
Comm. _
Other
WORK DESCRIPTION
New
Add-on
Repai r
N FIXTURES
? TOTAL
Water Closet - $3.00
? Bath Tubs - $3.00 t ?
? Lavatory - $3.00 ?
Shower - $3.00
/ Kitchen Sink - $3.00
Urinal/Bidet - $3.00
? Laundry Tray - $3.00
? Floor Orains - $1.50
_LWater Heater - $1.50
Whiripool - $3.00
-TGas Piping OuUets - $1.50
Soitener - $5.00
wen - $1o.oo
Private Disp. - $10.00
=Rough Openings - $1.50 ?-' 'F'
FEE `
STATE S/C: 5 ?
GRAND TOTAL:
?\
? '2
NSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ' s itt li 4
Eagan, Minnesota 55122-1897 Date Issued: tti t'`? I"R
(651) 681-4675
I SITE ADDRESS:
?N0i0N PLqi:E S011I1-1
! PERMIT SUBTYPE:
4? 4tR? O,rr- APPLICANT:
RIKF'
TYPE OF WORK:
PAI P
n, ?t It f k01.11
INSPECTION .• . DATE INSPTR.
F
?
? ?
Permk Holder Date Telephone #t
EwEw
WATER
PLUMBING
HVAC
InspsMlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING •
GAS SVC
TEST
INSUL
QYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BIDG FINAL
DOMESTIC
METER
IRRIGATION
MEfER
FLUSH
MAINS
coNOUCnvirv
TEST
Hvoaosranc
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
?
.
..
Ter#iftratr uf Mrrupanry
titp of eagan
lr}artmrttf u# luilbtttg JttspPtfimt
Thfs Certifcate issued pursuant to the requrrements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the folJowing.•
ux ci.u5maon `Z IIfJJG/GAR e4. r? No. 12$75
oxupa-r Trx R3 Zooing D;sraicxx h; 7y,a Ca?. y
owoerot9uildiog`-r:7?'? ?+.'''i._ Add,cui712 HOFfMZ QT'.'1?S+"1) ?LW1;
Bw'lding Addrem L1P-a lool;ty Ilr, B f , I.IX]'1`r,'T(N .u"i, st,
E„,: tTZMW 27. 1qC,,7
Ikuldmg OMcW .
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninp: Na of Units:
Owrwr. - _ "
Mdress: .-
Sita Addrost
Plumber. -
' ' .. . .. ,
1asm bseNllr wMb IIw Cily d 11116"¦ Connsefion Charpe:
OrIIMwoM. AooounK Oepoeit: ` ' -
--' ?
Permit Fee:
Surdwrpr.
BY A+Sisc. Chorpes:
Date of Inrp.: Totol:
Insp.: Doh Poid: _
CITY OF EAGAN
3830 Pibt Knob Road
k P.O. Box 21199
? Eagan, MN 55121.
! Zonin
i 9:
Owner. -
Address: _
Site Addes
Plumber. _
Meter No.:
Size: -
WATER SERVICE PERMIT
PERM?T NO.: _
DATE: ?
No. of Units: 1
Connection Charge:
Account Deposit: -
Reader No.: Permit Fee:
I agree to comply with the City ol Eayan Surcharge:
Ordinances. Misc. Charges: -
Total:
CITY OF EAGAN WATER SERYI g ?ERMIT
?
3630 Pilot Krrob Road =1 ,
-
`
P.O. Box 21189 7
PERMIT NO.: '.
'. ?
Eagan, MN ?1121 DATE: a
Zoning: No. oi Units;
ompson omes
Owner. _
Add ress:
' Site Addi
Plumber:
-- -
? Meter
' - q
oopd
?e.
?
„
/f T
Size: Ei ? .
bl)kt???
. oopuj
Reader No.: ,
?r
e:
rc ar
1 ayree to compFy with ih* o a a g
.
I Ordlnancos. Misc. Charges: 65.50pd
Total:
? B
, Date Paid:
y
f Date of Insa.: InsP•:
??
?-.,,
• CASH RECEIPT •
CITY OF EAGAN
, • 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 /
REC6IVEO
AMOUNT
//0V.
PUN ? • )fka
t?
Q
?A
Thank You /-??
No
6 9 5 9 4 White-Payers Capy
Vellow-Posting CoPY
Pink-File Copy
I CITY OF EAGAN
Np
12875
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
. PHONE:454-8100
?
X
BUILDING PERMIT
Receipt #
?
To 6e used for SF D4"rG/GAR est. value $ 61, 000 oate NOVEMBER 17 , ig 86R
SiteAddress 1051 HUMMINGBIRD LN Erect X7 occupancy R3
Lot 4 Block 1 Sec/Sub. LEXINGTON PL SORemodel ? Zoning p,1
Repair ?
Parcel No Type of Const.v -
.
Addition ? No. Stories
a Name ORRIN THOMPSON HOMES Move ? Length dn
?
o 1712 HOPKINS CROSSROAD Demolish ?
Address
I
? Depth46
Ft
S
Int.
mpc
ciry MTKA phone 544-7333 Instau ? .
q. ,
"
SAME APProva
i o Name
$ ? Address Assessment _
' Ciry Phone Water & Sew.
F W Name
s a Address
a W City Phone
I hereby acknowledge that I have read this
intormation is correct and a to comp
Minnesota Statuies and Ci of agan OA
Signature oi
A Buildinq Permit is issued to: vn¢
all work shall be done in accordance with all
Building Oflicial
Police
Fire
Planner
Council
Permit 316.00
Surcharge 30.50
Plan Review 158. 00
sAC 575.00
Water Conn. 500.00
Water Meter 63.50
RoadUnit 290.00
Tr. PI. 156 . 00
all appllCable State of Bldg.
APC I Parks
Var. Date I Cop tal ies
To $2r•00
'S on the express condition thet
Statutes and Ciry of Eagan Ordinancea.
•"- Tnis rn0vest voia
, a .nms o-om
C 6iiW ,l ,// ??/ 7,-1_1Y9y)
Co 95<?v
Repuest Date
?
' Fire No.
J RouBh-in InSPecUon
A wretl? '
?fleady NuwA..Will Notify, Insoec-
?or Wh
R
d
/ ?No
s en
ea
y
Licensatl Electrical Contractor 1 hereby request inaoeetion of above
? Owner elactrlcel work inatelletl et:
SUeet Atldress, o or floute No. Ci
D5?
Ae?
aclion o. ownship Nem r No. ange No. Cou y
Oc upunt (PRINT) Phone Np.
` S?14? 733 3
Pow r SuDGI?er Adtlress `,?
/
EI rica Contractor (COmvanv Name)
- Conttactor Lica ' e No.
L?
O
{<-(J •
? 3
/
MailinB AdJr s( onvac r or wner king Instailat1
l0
Au
ized Si a re (Con ctor ner MakinB Installation) Phone Number
?
6iFNESOTA STATE BOARD t{'LECTRICITY THIS INSPECTION REQUEST WIIL NOT
Orippn-Miewey BId9• - Nooifi 181 BE ACCEPTED BY THE STATE BOAND
1821 Univeraitv Ave.. 8t. Paul, MN 56104 UNLESS PflOYEF INSPECTION FEE IS
Phona(612)642-OB00 ENCLOSED. I
REQUEST FOR ELECTRICAL INSPECTION EB-0000L05
? Sea inatruetions for completinp thls form on bnck ol Yellow copy.
X" Below Work Covered by 7his Request
?:,/ ?
lyYd ReD. Tyoe of BuilCing Applioncea WiraA Equiumant Wiren '
p Fea Serviee Entrance5ize # Fee Feeders/Subfeedera b Fea Circuite
Oto200Am s
t Oto30qm 5 Oto30Am
l
Above 20 _qm?s
p?
roQ 31 to 100 Amps 31 to 100 Amps
Swinmin Pool Above 100_Am s Above 100_Am e
Transrormers rngaiion Booms Partial.'Othor Fee
Signs Speciallnspection
g TOTAL FEE
emsrks
Lo
?
flouph-in Data
?
1, the ElecVical
Insoacbr, heraby
cer
fy that fhe ebove
Final ?
ina ection has Eeen
thb repuwt voltl 18 montlm trom
y?00
RESIDENTIAL
? ?r?3? BUILDINC PERMIT APPLICATION
?r CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWction Reauiremants
• 3 registered site surveys shovring sq. ft. of lot, sq. R. of house; aM all roofed areas
(20°,b macimum lot coverage allowed)
• 2 copies of plan shovring beam 8 window sizes; poured found design, etc.)
• isetofEnergyCalculations
• 3 copies of Tree Preservation Plan if bt platted after 711193
• Rim Joist Detail Op6ons selection sheel (61dgs vrith 3 or less units)
DATE 7 `0-v9'- 6 Z
SITE ADC
TYPE Of
APPLICANT
STREETADDRESS b.s .?.G?V4/A ' !un
TELEPHONE #9?-?i7Y-?3"a33' CELL PHONE #
IULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S) _ 0 _ 1 _ 2
FDf.U /9P4ikiE STATE/9 A/ ZIP"5,5,3y(e,
FAX # sYa- 2 7y- 4sev
PROPERTY OWNER 141guT J.g.,vse/? TELEPHONE #/bSl- Vo?- 6,2 '/3
------------------------------------°°-------°----------------------------------------°----
COMPLETE THIS $ECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNGSOTA RULES 7670 CATEGORY 1 MINNFSOTA RULF.S 7672
(d submission type) • Residential Ventilatlon Category 7 Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted '
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system uicludes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Fee: $90.00
Fee: $70.00
T ?
Phone #
?
-----------°--------------° ---------° °---------•--------------°--°-----------------°-° °---- °----°--------------
I hereby acknowledge that I have read this application, state that the information is conect, and og[fle_tn comply
with all applicabie State of Minnesota Statutes and City of Eagan Ordinan?c/es.
Signature ofApplicant ??s?.?/
OFFICE USE ONLY
? Water Softener
_ Water Heater
_ No. of Baths
RemodellRanairReauirements .
. 2 copies o( plan
• 1 set of Energy Calculatiois for heated additions
• 1 site survey for edenor addNOns & decks . Indicate if hame sened by septic sysfem for additbns
VALUATION ? I OO •?
_ Phone #
_ I.awn Sprinkler
? No. of R.I. Baths
t I ,,
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 ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 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 Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout ta applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bidg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
RooF _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemem)
_ Iusulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
ciry sac
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
PERMIT
GITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
SITE ADDRESS:
P.I.N.: 10-45060-040-01.
PERMIT TYPE:
Permit Number:
Date Issued:
1051 HUMMINGBIRD LANE
LOT: 4 BLOCK: 1
LEXINGTQN PLACE SQUTH
BUILDING
@33854
10/29/98
DESCRIPTION:
REMARKS:
STORM DAMAGE
REPAIR
434 ALT. RESIDENTIAL
-17
_ ? t'?
Buif dincj-jPermit 7ype
8ui.lding Wer,k Type
,6??ensus Code ? ?.
? -
i !
i
:
?
l? u
T.O. & REROOF
FEE SUMMARY
CONTRACTOR: - APplicant -
BflRC .IND DOOR WINOOW STORE 14409730
17001 FISH P7 - RD S.E.
PRIOR LAKE MN 55372
(612) 440-9730
ST. LIC.
8680
OWNER:
JANSEN PAUL.
1051 HUMMIN66TRD LANE
EAGAN MN 55123
(651)
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply wlth all applicable State ot Mn.
Statutes and City ofi Eagan Ordinances.
L
APPLICANT/PERMITEE SIGNATURE
J
S ED 6Y: SIGNATU E °
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAH
3830 PII.OT KNOB RD - 65122 ( o. 3a -??r
681-4675
New Construction Reauirements RamodeVReoair Reauirements
? 3 registered site surveys
? 2 copies of plana (inGude beam 8 window saes; poured fid. aesign; etc.)
? 1 enargy calculations
? 3 copies of tree preservation plan B IM plattetl after 7!1/93
require0: _ Yes No
DATE: ?G I_?Iq.Y
? 2 copies of plan
? Z ske surveys (exterior additions & dedcs)
? 7 energy calculations for heatetl adEkions
CONSTRUCTION COST; S?, y69. °Z
DESCRIPTION OF WORK: T?ar o-Fr •Re --r.o*(
STREET ADDRESS: -J OS
v Y I C? C.? S? ?
LOT: ? BLOCK: I SUBD./P.I.D.#: L?XIV?? h
Name: --,-u Irl C,-t Phone #:
PROPERTY 1-sst First
OWNER
Street Address:
STo?2wl ciTy
?AY??A G E
State:
zip: S f -2r 3
Company: .??A 9 (, In J vs fi"i es Phone #: '7 ,11D ' 9 73 O
CONTRACTOR
Street Address: 17()01 1-i;s 4 Pot a 5E. Svjf r IU°I License # 369v
cicy Pr1-or ?a ke State: Zip: S53 72
ARCHITECT!
ENGINEER Company:
Street
City
Sewer 8 water licensed plumber (new construction ony):
and lot change is requested onee permit is issued.
Phone tt:
Registration #: _
State: Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the infortnation is cortect and agree to comply with all appiicabi
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No
_ Not Required i
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition pg 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
13 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Buiiding
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Pertnit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
r
16 Basement Finish
17 Swim Pool
20 Public Faciliry
21 Miscelianeous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
% SAC
SAC Units
.?
1986 BIIILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALI. CONTRACTOHS M[TST BE LICENSED [iITH THE CITY OF EAGaN
SIRGLE F6NIILY DWELLINGS
INCLUDE 2 SETS OF ?LANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
M[TLTIPLE DiIELLINGS - RESIDENTIdL RENTAL ANITS FOR SALE ONITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECa SiITH BLDG. DEPT.,
1 SET OF ENERGY CaLCULATIONS
COMRlERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 Se.T OF SPECIFICATIONS AND 1 SET OF ? (5,51
ENE3GY CALCULATIONS, L? $2,000 LANDSCAPE HOND
To Be Used For: ?CS i". H1ce Valuation:
Site Address ??J ? ?MM?aJC?31217?
Lot `_( Block ?
Parc°1/Sub P1iCLG .r'a.uJ4
Owner
Address
City/Zip Code _
Phone
Contractor C?
Address 1717 'f'tt5el'.INS CQ.(WU/h7
City/Zip Code 041h F 1`AkJ .s.s31-S
Phone S?- 7S5 -1)
Arch./Engr.
Address
City/Zip Code
°hone ll
OOU Date:
Erect ?
4emodel _
3epair _
Addition
Move
Demolish
Int.Impr. _
Install _
APPROVALS
Occupancy
Zoning ? I
Type oi Const 'V:
It of Staries
Length 4a
Depth 4C.
Sq Ft
FEES
Assessments Permit &,DU
Water/Sewer Sureharge 3 o•Su
Police Plan Review .5•w
Fire SAC S'715.Du
Engr Water Conn S00.0u
Planner Water Meter 3,SD
Coune3l Road Unit 9? O, uo
Bldg Off Treatment P1 /S4,.00
APC Parks ?
Variance Copies
?OT9L ZOg vo,
?10TE: ADDRESSES rOR CORNER LOTS - CGNTRACTOR/HOMEOiiNER IiIIST DESIG,7ATE HHICH ADDRESS
IS DESIRED. 10 CH9NGES STILL BE ALLOSiED ONCE BQILDING PERMIS ZS ISSDED.
CLARK RJGINEERING COMPANY • 2815 WAYZATA BOULEVARD • MINNEAPOC,IS, MV • PHONE: 374-47
CERTIFICATE OF SURVEY FDR:
ORRIN THOMPSON HOMES
A Division of U.S. Home Cocporation Scale: .1" = 30'
` • Iron monument found ?
PROPOSED ELEVATIOIJ: PvCI/6WOOa ° Spike or wood stake set
FRONT GARAGE SLAB: Aot vE •900.0 Existing spot elevation,
E1. = 908.93 Ft. PrOP°$? gPot elevation
9- Drainage direction
Sa9021'54^E 60,00
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? 1 LOT 4 !
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N 89° 21' 54" W 60.00
HUMtv11NGBIRD LANE
- - - -------?e
Lot 4, Block 1,
LEXINGTON PLACE SOUTH
Dakota County, Minnesota
I here6y certify thaG thin ia a[rue and cocreet representation of a survey of the
6ourdariea of [he land above desccibed and of the location of all buildings, if any,
thereon, and all visible encroachments, if any, Ecan or on said land. I turther
oectiCy that th'ta aurvey vas prepared by me or under my direct supervision and thaG I
am a duly Registered Land Surveyoc under Ghe lavs of the S[ate of ninneso[a. KJ Reg. No. l?z?A Da[e
Proposed House...X As-Built House_ Draan by kAE project no.B4,eO
a
Ui f Y O1' E!"iG/-iN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*KYi?:: FAYMENC OF }•`i;Ii Iifi TIi•R? 02
APPLICATSON DOES NC7P CONSIZ1TfPt:
APPROVAL OF PERhffT.
nasPncrzorl oF sEWM Arm/at M'rIIz
rnSTAr.ramrpNS WTI,L NOT BE SQED-
ULID []NM PERMIT AAS BFMS7
APPF2C3VE9. .
. . ^ 1"Rf}lt]t]'I['Ri'R91xiFii[)flfl[iill[][tlff'R'
?y P ease Print
1) PROPERTY ADDRESS: LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parce ID )
IE'' EXISTING STRCY.`IS)RE, DATE: OF ORIGINAI, BOILDING PERMIT ZSSL'ANCE:
PRESEKP 7ANING/PROPOSID OSE: (Mon Year}
C) M'44ERCIAL/RETAIL/OFFICE
1`7 IAIDL'STRIAL
n INSTI'IL?TIONAL/GOVERIZ4.R•Pp
UTJ?f
? R-1 SINGLE FAhIILY
Q R-2 DLPLEX (44.v L?nits)
(J R-3 TUWbIIiOC?SE (Three + Units) ( Dnits)
? R-4 APARTAENT/CONIDOMINILTf { Units )
2) ?
rtArE:0f?f?/AJ 7??}Oe7'1P50? ? h9 E,i
?DREss:/7Q /{OPKIiu S (>.?Pass?o.¢,??
crTY, sraTE, ziP:?1/?v?tJ?7GUJK? PxorE:_,°r4l4e- 73g 3
3) a i: ?• /?r,,? ?j?/ For City Use ..
?'_i?L?/ ?- K 1/4'/t) PjIy Pliunbers License:
ADDRESS: Active
Expired
CITY, STATE, ZIP: Not recorded
rxorE: n°;2,3-ii-W rAsTER r.iceNSE#
StaFf initial
4)
e aa • ?
NAME:
ADDRF_SS:
CITY, STATE, ZIP:
PHONE:
.5) i :? r• ?•i a: • ?• : ? • ?• - 5-b .
? CONNECPION T0 CITY SESQER Cg CpNNEC'pION 1U CZTY WATER
? ??-?
6) PLFASE HOI,D APPROVID PERMIT FOR PICK-UP BY ONE OF AB(3VE .
? PLFASE MF1IL APPROVID PERMIT TQ 1, 2r?4. 1?VE
(Circle one) "
7) 10 ?IAo.
.. FOR C1TY U_SE ONLY
, PERt9IT # ISSOED
' Pd w/B1dg. Permit FEES:
$ $ '1d • S O SEWER PERMIT .(INGLUDE.'SURCHARGE)
$ $ /0- WATER--PERMIT (INCL-LxDE- SU RCHARGE)
$ $ WATER METER/COPPERHORN/OU;TSIDE READER
$ $ WAT$R _.TAP . ( INCLC'D,E.,.CORROR,ATION STOP )
$ $ - SEWER TAP ,
?
$ C) • r? ?
.. $ C9.o.
$
S
$ ?j? • Li ? ACCOLNT DEPOSIT - SEWER
$ / ?j • l?G ACCOLNT DEPOSIT - WATER
$
wAc
$ SAC
S "TR[:lNK WATER`:.1kSSESSMENT
$ ".TRLNK-SEWER ASSESSMENT
$ $ ' LATERAL BENEFIT/TR[!NK SEWER
5?$ •, LAPERAF;? ?BENEF.ITfTRLNK `WATER
WATER -TREATMENT PLANT SIIRCHARGE
_..:'aTHER: ..
S /? S?
S ?.._I ?..C _TOTAL
RE EIPT- - RECEIPT - " DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F__j_ YES „ IF_YE$, T$EN...A :'PERMI.T FOR WORK WITHIN PDBLIC
ROADWAY'_'..MUST_BE ISSUED BY THE ENGINEERING
? NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED SY:. vC.•C_?? ?(s-z?1-z.?-,
TITLE:
DATE• I ? /O Q
. __?