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1072 Hummingbird Lane ,. . _ 4 CITY OF EAGAN ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 -i ` PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for ?fi ?"=? •" -? Est. Value Date , 19 SiteAddress 1C72 Lot f Block ? Sec/Sub. Lr"111,"Tt?N OFFICE U SE ONLY Parcel No. Occupancy - FEES Zoning ¢ Name `•?' ?? Y F. ?L ?'? (Actuaq Const - Bldg. Permit W 3 Address ?C':'? ; :•i6 R n LN (Allowable) S 0 urcharge City ?- ? Phone # of stories - Plan Review Lenglh _ F Nafl'12 ? • `?'. "' Depth - SAC, City ;k o ¢ Address S.F. Total - u SAC, MCWCC ~ Clty PhOnB S.F. Faotprinis - Water Conn On Site Sewage _ ? ? W Name On Site Weu - Water Meter ?; Address MWCC System - a W City PhOne Ciy Water - Acct. De Sit ? it S'W P PRV Required _ erm I hereby acknowlege that I have read this application and state that the Boosier Pump - S!W Surcharge intormation is correct and agree to comply with ail applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unil A Building Permit is issued to: `_`AM y FA I.t` Planner park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. _ Copies 3` Building Oflicial Variance _ TOTAL Permit No. Permit Holder Date Telephone # WATER I SEWER • PLUMBING ? Y C? - LI ?y d H.V.A.C. ELECTRIC (-. Cc) Inspection Date Insp. ? f Comments Footingsl Foundation Framing -2/ v Ropting Rough Plb9 A+- Rou9hHt9. ?? ?? ? LOi1(6 'I1l OG Isul. Fireplace Final Hig. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr.lPlan Bldg. Final Deck Ftg. .Deck Final Well Pr. Disp. ACTIVATL FOR DECK 3/9/87 .R° ?ALK 681-9138 CITY OF EAGAN 12394 ??.?. , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 • s.- PHONE: 454-8100 BUILDING PERMIT Receipt # Tobeused?for' SF DWG/GA.R EstValue $61000 Date AUGUST 4 ,19 $6 Site Address - 1072 HUMMINGHIR D LN Erect gl Occupancy R3 Lot 10 Block 2 Sec/Sub. LEXINGTO Nt PLACFAemodel ? Zoning Parcel No. SOU7'$ Repair ? Type of Const Addition ? No. Stories ORRI?v THOMPSON HOMES ¢ Move ? Length 40 Name 1712 liOPKII3S CROSSROA ; I3 Demolish. ? Depth • 6 Address 0 Int. Impr. ? Sq. Ft City Phone --5,4 4- 7 3 3 3 Instau ? o Name ?PLMF, ? i Address ~ City Phone Assessment Permit Y Water & Sew. Surcharge Police Plan Revie Name Fire I hereby acknowledge that I have read this application and state that the information is correct and agr e to comply with all a plicable State of Minnesota Statutes and Ciry,E? inances ?J)' !Signature ot Permittee t? ?L N A Building Permit is issued to: ORRIN THOMP30N HQMSS all work shall be done in accordance with all Minnesota on the express condition tfiat oi Eagan Ordinances. Planner Council 4/? ? Bldg. Off. 8 Water Conn. ? utJ• tJu Water Meter 63.50 Road Unit 290.00 Tr. PI. 156 . 00 Var. Date I Copie Total ' wrmn Na wrmic Had« o.e. r.ap,«m ?? PlumplnA ? .?J?! ? _ ?, ?,? _•- ?. % U ? ? 0 ? MMA.C. 74/3 Electrlc Sofloner Inspecdon Date Inap. Commonts FooUnys I Footinys 11 Foundatbn Framiny RootiRg Nouqh Plbp. (l / Rouph Mt9. - r Insul. ? ? r ? FMeplace Final Hy. d •-- IFWW Plbp. , iJ &dp. Fhial Cert. Occ. ? /o !?J Doclc Ftp• ?IfZ? kj? r Dock Frmy. 1 1 /va W? Dne e Localbn: ?// ? ?? d Pr. DbP• PERMIT • ? MECHANICAL PERMIT RECEIPT # S CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: :OIYTRACT PRICE: PHONE: 454-8100 fte Ad.dress ' n d BLDG. TYPE WORK OESCRIPTION .ot Block ?k Sec/Sub ? t=-?' ?'tX? 7'() •v c .50 ? 77? ' Res. VI/ New V" ? Name Mult Add-on to Address Comm. Repair c City S Phone °R 3?/'y? pther m c 3 O Name 1 Address City _ TYPE OF WORK Forced Air BOIl6f Unit Heater 7-Si Oc7i.? Air Cond. Vent Gas Piping Outlets # Other M BTU M BTU IVI BTU M BTU CFM FEE c?S - SD S/C: ? TOTAL: FEES RES. HVAC 0-100 M B7U -$24.00 ADQITIONAL 50 M BTU - 8.00 ADD-Ohl AIR COND. 0-24 STU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/INp FEE - 146 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SUFiCHARGE PER PERMIT ? .Sd (ADD $.50 S/C !F PERMIT PRICE GOES BEYOND $1,000.00) , „. SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN , .. Site Lot _ y Name ? Addre c City _ PIUMBING PERMIT CiTY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 PERMIT # RECEIPT # ? a ? DATE: ^ / 8 '?/?/vv' /?J ?ANt BLDG.TYPE ? SeclSub °AhY_' r S O 0774 Res. ? Mult Comm. Phone 3 Other Name ; Addrass p City Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/INQ FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN WORK DESCRIPTION New ? Add-on Repair N0. FIXTURES TOTAL ? Water Closet - $3.00 - - $ 7 Bath Tubs - $3.00 - TLavatory - $3.00 Shower - $3.00 ZKitchen Sink - $3.00 Urinal/Bidet - $3.00 --7- Laundry Tray - $3.00 T Floor Drains - $1.50 = Water Heater - $1.50 Whiripool - $3.00 Z jw Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 - Rough Openings - $1.50 T FEE STATE S/C GRAND TOTAL• ? ? CONTRACT PRICE ' Site Addr?ss R Lot ?. ?r, - ? ? w ? PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE 454-81 Phone FEES COMM./IND. FEE - 196 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) For C PERMIT # _ RECEIPT # . DATE: _ Res. %O? New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ -Im Bath Tubs - $3.00 7- Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 UrinaVBidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 1Nhirlpool - $3A0 Gas Piping Outlets - $1.50 (MINIMUM -1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 PERMIT FEE: ? • ?? STATES S1C: ' ?7 u GRAND TOTAL: , 50 oFEaGaN Pilot k'-iob Road B4x 21199 i, MN C5121 No.. h eomply wilh !IN Gty of Eayes WATER SERVlCE PERMR C«+nection Char9e: Acwunt Deposit; _ Pe?mit Fee: SurcFwrge: Misc. Charyes: - Total: Date Paid: CITY OF EAGAN 3830 Pilot Knob Road SE" sERy lCE pERMR P. O. Box 21199 PERMiT NO.: Eagan, MN E5121 DATE: Zoninp: No. M Units: Owfl!?: AMfC55: ?'?'? _ _ . .. 5ite Addreu: . . . . . . . Plumbtr: 1 Mne te emnoyr wuh ey Cihr of 16008 Cor+necNon C]+orge: OrdiMams. Accoiint Deposit: j Pomdt Faa: j Surchoroe: 4 By Misc. Charges: ? Dote of Irap.: Total; Insp.: Dah Pcid: ? Y OF EAGAN yVATER SERVICE PERMI'E 0 Pi lot Knob Rosd . BQ? 21199 PERMIT NO.: an, MN 55121 DI?TE: iny: No. of Units: er: I ross: /\ddreas: ber. er No.: ?? ?`' Mo .?I ._ .-, _ _ 1. •_r ? . Read6r No.:U-b-8L'L.Q1 1 ogm 1e MMA whh Ib OrJiMnoM.1 le-? ey A/ ", ? Dote of I rup.: VIVCharpes: ? 5 F, , .- ?btnl: Dofr Poid: /0-6..r6 CITY OF EAGAN Remarks Addition Lexington Place South Lot 10 Rik 2 Parcel 10 45060 100 02 owner screet 1072 Humminghird Lane state Eagan. MN ? Improvement Date Amount Annual Years Payment Receipt Qate STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK ? j$ 247.64 16.51 15 . _ ` SEWER LATERAL 3 2 6 . 145.87 WATERMAIN 91/7 1985 65.81 1.16 5 WATER LATERAL " 174.68 WATER AREA 48 - 74 5 22. STaRM SEW TRK _ ''85.30 STORM SEW LAT 1b0. 6 6 CURB & GUTfER SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK CASH RECEIPT ? CITY OF EAGAN • r 3795 PILOT KNOB ROAD ° EAGAN, MINNES 55122 l? ? DATE AMOUNT • 'k f9 $_DOLLARS ?oe Ej CASH HE ?.c FOF ?/f? • ?? .LC/S //z FUNO COOE qMDUNT 60 CJ 00 Gj / Thank You By N_ 65725 zl-v_ ---ci White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN N9 I6069 3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 GJ (,';? • 4 L PHONE: 454-8100 BUILDING PERMIT Receipt# To be used for )?ASEMENT Est. Value $1, 500 patP tg Site Address 1072 HOPII4INGBIRD LN Lat 10 Block 2- Sec/Sub. T EX7NGTON PL.ACE OFFICE USE ONLY PefC21 NO. SOUTH Occupancy - FEES Zoning w Name GARY FALK (ACtuap Const - Bldg. Permit 36.00 Address 1072 HI7MMINGBIRD LN (Aliowable) - S h 1 00 o urc arge . City EAGAN Phone 687-9138 xof Stories - Plan Review Lenglh _ o Name SAME Depth _ SAQ Ciy , ?Q Addl'BSS S.F. Total - SAC, MCWCC ? CIIy Phone S.F. Foolprints - ?Nater Conn On Site Sewage _ ww Name OnSiteWell - WaterMeter w i? Addf05S MWCCSyslem _ ui Acd. Deposit e W City Phone ciry water - SiW Permit PRV Required _ I hereby acknowlege that 1 have read this application antl state that the Booster Pump - SiW Surcharge inlormation is correc[ and agree to comply with all applicable State of Minnesota Statutes and Ci oi Eagan Ordinance . Trealment PI Signature ol Permilee APPROVALS Road Unit A Building Permi[ is issued to: GARY FALK Planner - park Ded. on the express condition that all work shall be done in accordance with a11 Council -- 1 00 applicable State of Minnesota StaWtes and City of Ea an Ordinances. g?y, pry, _ Copies . a 38.00 Building OHicial 1 Variance _ TOTAL CITY OF EAGAN p - 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N- 123 94 PHONE:454-8100 _X . 2 J BUILDING PERMIT Receiptu IX! gaT- 000 SF DWG/GAR $61 86 AUGUST 4 , Tobeusedtor Est.value Date 19 SiteAddress - 1072 HUMMINGBIRD LN Erect 0 Occupancy R3 Lot 10 Block 2 Sec/Sub. LEXINGTON PLACSiemodel ? Zoning ?? $OUTA Parcel No Repair ? Type of ConstVn - . Addition ? No. Stories p ORRIN THOMPSON HOMES Move ? Length 40 i Name Demolish ? Oepth46 3 Address 1712 HOPKINS CROSSROAD ?nt. lm Pr ? Sq. Ft ° Ciry MTKA phone 544-7333 Inshall O SAME o Name i o¢ Address ? Ciry Phane a w w ? Name ?Q Address i Wz City Phone Assessment_ Water & Sew. Police - Fire Eng. Planner Council Bldg. Off. 8/4/86 APC Var. Date I hereby acknowledge that I have read this application and state that the information is correct and ag e to comply with all a licable State of Minnesota Statutes and Ci f E 'nance Signature of Permittee C? ??? A euilding Permit is issued to: ORRIN THOMPSON HOMES all work shall be done in accordance with all oi Minnesota Permit a J10.?u Surcharge . 30.50 Plan Fieview 158. 00 SAC 575.00 Water Con n. 500. 0 0 water Meter 63.50 RoadUnit 290-40 rr. PI. 156.00 Copies??00 Total - on the express condition that of Eagan Ordinances. Building This request void g- /S' -?? ?G s b? C 18 months trom . - 34456 Reques[J,lata? 5(' / Fire No, q.?gh-in Insp?etlion fleq red? Yes No Ready Nuw (Nill Noti}y InsVec- ? tor When fleady Licensed Elec«ical ConVactor I hereby requesf insoection oi ebove ? Owne, elec?rical work inatelled at: Street Atldress, Bax or Route No: 6 07?? ? a? ecbon o. Townsnip Name No. Hange No. Co n Oc uDantlPfllNTI Phone No. ?.. ?f 73.33. Po er Su00lier Adtl?reAss- E rical Convactar ICOmoanv N a m e l Licens o. C.mtractor's ? . / J ? ? ,? ? q??-.c'('? ?/'C/ 7 ?????? Mailina AdJr ss IContra ar or Owne?r/pp akin Installati I e 6 Q ?/ X Authorizetl Sig^xwre IConnactodOwn r Makine insWllationl Phon N!u? ber NESOTA STATE BOAXD Of ELECTfl THIS INSPECTION PEQUEST WIIL NOT rigBS•Midway Blde. - Noom N-191 8E ACCEPTED BY THE STATE eOAND 1821 UniversitV Ava., S[. Paul. MN 56104 UNLE55 PROPER INSPECTION FEE IS PAnne I6121 297.2111 ENCLOSED. HEQUEST FOR ELEC7RICAL INSPECTION kVk Ee•ooiwi.cu 1 Sea insbuctions lor comoleling this form on hack ot vellow covR Z 56 96 C-3-445 6 "X" Below Work Covered by This Request AAtl NeD•j 'HoTYpe of HuilOinp ? ADPlWncee Wirod ? Equipment Wired ? me Range Temoorarv Service ? I ectr p Fee ServiceEnhance5lxe tr Fee fexders/5ubfeeders N Fae Circuits U to 200 Am 0 Am s 0 tn 30 Am Above 200 100 Amps 31 to 700 q 5 Swinxning P n m e 100Amps Abave 100_P,m s Transiormer lboms tion Partial.'Other e Signs Special InsUectfon i, me Naruigerr Inspector, hereby CBlllty Lh8t L{1B Ab04 inspeciioi, has been mae. bJ7'" / / 9 90&34? N 95877 el-v Request Da[e Fire No. Rou = Inspedion R i ? ? Ready Now ?WIII Notiylnspector Yes ? N. When Reatly? ? I p licensed contractor owner hereby request inspedion of aboveelectrical work at: Job Pddress (54eet, 9ox or Route Na.) Ciry 7; unn iN R i, C i5fl&FFN Sactlon No. Tovmship Name ar No. Rarge No. Counry ` AAKoT)9- OCCUpenl(PflINT) Phone No. G?R R?ic 9?3 Power Supplier Address KDT L?C ? Eleciricel ConVepor (Company Name) Comraqar5 License No. Mailing Atltlress (Contraclor orOwner Making InsWllalion) 6t54AL 107 uMMIivG IRA /UE E H N. ss?a3 AulMnzed nature (COntr. r/ r Making InsWlla Phone Number MINNESOTA STA7E BOAHO OF ELECT ITV THIS INSPECTION HEQUEST WILL NOT Griggs-Midway BIEg. - Raom S1]3 BE ACCEPTED BY THE STATE BOARD 1627 UnNersiry Ave., SL Paul, NN 55106 UNLESS PROPER INSPECTION FEE IS Plwne (612) 802-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi a7 }.. ? See instmctiore Far completlng lhis form on beck ai yellow copy. M 95877- - X" Below Work Covered by This Request ew Adtl Rep. TypeolBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Waier Heater Electric Heating Apt. Building Dryer Other (Speci(y) Comm.lindusirial Furnace Farm ' Air Conditioner OIOer (speciry) Comractor5 Remarks: Compute lnspection Fee 8elow: # Other Fee # ServiceEnlrance5ize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers A6ove 200 _ Amps AGov 10 Amps SignS Inspectorg Use Only: TOTAL IrrigationBOOms Special Inspaclion Alarm/Communication / Other Fee 47 ) ? I, the Electrical Inspector, hereby if h Rough-in ? ? Da? -? y t at the above inspection has cert been made. Final r o e OFFlCE USE ONLY ? This requeat wid 18 monNS irom , . RESIDENTIAL ? BUILDING PERMIT APpLICATION SS?Q y-- EAGAN PILOT KNOB RD,EAGAN MN 55122 651-681-4675 Naw Construction Reauirements • 7 regrs[erec site surveys Showing sq. ft. of lot, sq. R. of house; and ail rooled areas (20qo maximum iot coverage allowed) . 2 copies or plan snowing heam 8 vnndow siz:s; poured found design, etc.) • 1 set of Energy Calcula[ions • 3 copies of Tree Preservation Plan if lot platted after 711f93 . Rim Joist OeWa Oplions selectian sheet (61dgs with 3 or less units) DATE _ V161d _ Water Softencr Water Heater No. of Baths SITE ADDRE55 I07e2 dumm lvc bmg,n MULTI-FAMILY BLDG _Y ? N TYPE OF WORK?x ?,Di/v* PIREPLACE(S) f 0_ 1_ 2 APPLICANT STREETADDRESSI.?o2y7 iUiGa?c.rf ?u??S CI7YSj? ? STATE_&&J ZrI?P?? TELEPHONE # CELL PHONE # FAX # PROPERiYOWNER 6,ll F,4_L.?/ TELEPHONE# ---------------------------------------------------- ---------------- -------------- -............ COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY cnergy Code Category _ MINNESO1'A RCIi.ES 7670 CA"CI:GORY I mIVNL•SO'G\ RCLf:S 7672 (v submission lype) . Residential Ven[ilation Category 1 Worksheet Submitted • New Energy Code Worksheet SuLmitted • Enerqy Envelope Calculatlons Submitted Plumbing Contractor: ____ Plumbing sys[em includes: Mechanical Contractor: Mcchauiic.il svstcin includcs: Sewer/Water Contractor: Phone # SEP 1 7 2002 ------------------------°-----°-----°---------°---°,° °-------°-•----------------°------°-°--------•-----°----- I hereby acknowledge fhat I have read this applicatron, state thot ihe anformation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinanc SlgnatureafApplicanf lJ OFFICE USE ONLY ? C?sS 7 ? RemodellReoair Recuirements • 2 copies of plan • 1 set of Energy Calculations lor heated additions • 1 site survey for extenor additions 8 decks • Indicate i( home served hy septic system for additions VALUATION 3 1; d Phone # -- Lawn sP,-inkler I D Vo. of R.I. Baths Phone # Air Condiuoning Heal Rccovcn' Svs[cm Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY - ? 01 Foundation ? 07 QS-plex ? 13 16-plex p 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 ? Og 07-plex ? 17 Garage ? 22 Porch/Addn. (4•sea.) ? 33 Eut. Ait - SF ? 04 02-plex ? 10 OS-piex ? 18 Deck ? 23 Porch(screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Sidinq ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)' ? 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. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Foorings (new bldg) _ Final/C.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ F inal _ Pool _ F[gs _ Air/Gas Tzsts _ Final _ Framing _ Siding Smcco Stone _ Firepface _ R.I. _ Air Test _ Final _ W'indows (new-'replacement) _ Insulation _ Retaining Wall Approved 8y 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 : Lll ? RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Now Conatructbn Neaulremants • 3 registered stte surveys showing sq, n. of lot, sq. n. of house; end gp roofed areas (20% mOmum IM covera9e albwed) • 2 copies of plan slwwbg beam & window sizas; poured IounO dasign, etc.J • 1 satWEnergyCakulatbns • 3 copies of Tree Preservation Plan il bt pleded atter 7l7/93 • Rlm Joist DBtail OptiOns seleGtbn Sheat (bMgS wlih 9 Or IeSS UndS) DATE (v/ 16 / O ?2 SITE ADDRESS /? rI ?? IIu z97 Irr i,tLc .?2 nLA) MULTI-FAMILY BLDG _ Y XN TYPE OF WORK ? f fL Pe-').Or ? FIREPLACE(S) _ 0 _ 1_ 2 APPLICANT STREET ADDRESS r7 kJ i L n ? c. t r CIN u /I-eSTATE nJ ZIP 5533 7 TELEPHONE # 9?Q-70 7- 6ELL PHONE # FAX # R? J?a(? g9-4? PROPERTY OWNER c.? r `!+ AL /1 TELEPHONE # K.SI -G OJ -W3? , ----------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR %•NEW,, RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (J submission type) • Residential Vanfilation Category 1 Workshset Submitted • New Energy Code Worksheet Submittetl • Energy Envelope Calculations Submitted Plumbing Conhactor: Piumbing system includes: Mechanical Contracfor. _ Mechanical system includes: Sewer/Water Conhactor: _ Air Conditioning _ Heat Recovery System Phone ri Phons # V SEp 1 7 2002 SUr I hereby acknowledge that I have read this appiication, state that the Information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of EcaOan OrrTu??n?ances. n ?t SignafureofApplicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ _ Water Softener _ Water Heater _ No. of Baths RemodeURepalr ReautremeMe /C? • 2 copies of plen • lsetofEnergyCatuletionsbrheatedaddAbns • 1 SAe sunrey lor exlerbr addttrons & decks • Indicata H home served Dy septk systam br atlAilbns O VALUATION Phone # _ Lawn Sprinkler _ No. of R.I. Baths UpEated 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 - Multf O 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuNi ? 05 03-plex ? 11 10-plex ? 19 Lower Level 13 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous ? 31 New ? 35 int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repeir ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof O 46 Windows/Doors ? 34 Replacement "Demolkion (EMire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code 2oning City Water SAC Units Stories Boaster 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) _ FinallNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC I7rain Tile Other Roof _ Ice R Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ Framing _ Siding Smcco Stone _ Fireplace _ RI. _ Air Test _ Final Windows (new/replacemettt) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Pian Review MC/ES 5AC City SAC W ater Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector . PERMIT # -su H C.? RECEIPT DATE: 2002 R£S&DENTIAL PLURdBING PE#tMI"f AGPPLICAT6ON crrY oFEAeAx S$SO f'ILOT KNOB RD EAsAN, atlu $5122 651-6$1-4675 Please compleTe for: single family dwellings, townhomes and condos when permits are requiretl for each unit, backflow preventer for irrigation system SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET ADDRESS: CITY: Y.CL(aU.li STATE: /Ul N ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply . MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ:newinstallatioNrepair/rebuild ? 30.00 _ lawn irrigation system A?1G ., 0 7002 ? ReplacemenUadditional: _ water softener ' water heater $ 15.00 State Surcharge $ .50 $ /E`5-0 Total I hereby acknowledge that I have read this application, statethatthe information is correct, and egree to complywith all applirable Cityof Eagan ordinances. It is the applicant's responsibility to notiry the properry owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activdies to the §cifities constructed under this permit wthin City ?pro?rtyl t-of-w ? I/ ?tA SIGNATUF? OF PERMITTEE 1 ? lr'?PX (,i FD 1 K ' J TELEPHONE #: 46/- 1A I- q LN (AREA CODE) RESIDONTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB R0, EAGAN MN 55122 651-681-4675 New Construction Reauiremema • 7 registered sAe surveys showirg sq. R. of lot, sq. ft. of house; and all mo(ed areas (20qe maximum IW coverege allawed) • 2 copies of plan showing beam 8 window sizes; poured found desgn, etc.) • 1 set of Eneryy CalculaGOns • 3 copies o( Tree Preservation Plan if lot plafled after 711193 . R'un Joist OetaJ Op6ons selech'on sheet (bldgs with 3 or less unifs) DATE q• AUq . O o`Z RemodeUReoair Reauirements • 2 copies of plan • 1 set of Energy Calculations for heated adtlitipns • 7 site survey !or eztenor additions & decks • Indicate if home served 6y septic system for additions VALUAiION 14 1 qt03151 SITE ADDRESS L0_a. ?C,?rc?ri+t?c?lolcd MULTI-FAMILY BLDG _ Y -L? N TYPE OF L+.5. APPLICANT STREET ADDRESS TELEPHONE # ??a35ti1'd?`??c RMA Horrie Depot Instal?eci Sates 660 Mendelssohn Ave. North Golden Valley, MN 55427 fiREPLACE(S) _ 0 _ 1 _ 2 STATE `ZI P FAX # PROPERTYOWNER 64tu ';0.A`f, iELEPHONE#LOSI•tagl''913$ ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ yIINNESOTA RliLES 7670 GCCEGORY 1 yIIV VLSO'fz\ RL LES 7672 (J submission type). Residential Ventilalion Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculalions Submitted Plumbing Contractor: Plumbing system includes: ? WaCer Softener _ _ Water Heater _ No. oF Baths Mechanical Contractor: Mechanical sys[em includes: Sewer/Water Contractor: Air Conditioning Hcat Recovcn 5ystcm ? Phone # Fee: $90.00 Fee: 870.00 1 ----------------------------•----...--°----------....._..---...°--------------.......-•------°------------------------- I hereby acknowledge that I have read this application, state ihat the information is correct, and agree to comply with all applicable State of Minnesota Stotutes and CitY of Ea9aXOnances. Signature of Appllcant 1A ------ ----------........... ----- -------- --------°-___--°°•------'-----°-'---------°----°----°------°--------- OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4,02 _ Phone # Lawn Sprinller No. oE R.I. Baths Phone # x t OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? ? 02 SF Dwelling p OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 0 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? ? 04 02-plex O 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? ? OS 03-plex ? 11 10-plex ? 19 lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-piex P16g_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 ? 33 Alteration ?? 37 Demolish (Bldg)' ? 43 Reroof ? 46 ? 34 Replacement 'Oemolition (Entira Bldg only) - Give PCA handout ta applicant Valuation Occupancy MC/ES System Census Code Zoning City Water ? SAC Units Stories Booster Pump N6r. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width 30 Accessory 81dg 31 Ext. Alt • Multi 33 Ext. Alt - SF 36 Multi Siding Fire Repair W indows/Doo rs .. ' , • . REQUIRED INSPECTIONS _ Foo[ings (new bldg) Final/C.O. _ Footings (deck) FinaVNo C.O. _ Foo[ings (addirion) _ Plumbing Founda[ion HVAC Dcain Tile Other Roof _ Ice & Water _ Fina] _ Pool _ F[gs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newireplacement) _ Insularion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply & Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Installed Siding andl*NUspOWER OF ATTORNEY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales located at 660 Mendelssohn Avenue North, Golden Valley, MN 55427, having a license number of BG 20268257; do hereby appoint, name anu constitute Elder-Jones Building Permit Service, Ina ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessazy and appropriate, in order to obtain the proper permit(s) from the City of Bagan; Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power of Attorney are limited solely to the express powers. delineated herein and apply solely to the Wock... This Limited Po«er of Attorney shall expire and automatically be revoked on the.30,' day of May, 2003, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Yower of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WITNESS WHEitEOF this Limited Power of Attorney is executed this 30N day of M R`j , 2002. David . z SWORIV TO AND SUBSCRIBED BEFOAE ME by David N. Katz on this 30`11 day of May, 682- Notary blic in for the Stat of eorgia My Commission Expires: January 21, 2006 396816.v1 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79•DEPOT , 1986 BOILDING PERHI" - CZTY OF HOTE: 6LL CONTRACTORS M[1ST BE LICENSED SiITH :HE CITY OF EAG3N SIRGLE FAMIILY DWELLINGS INCLUDE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS M[ILTIPLE DWELLINGS - RESIDENTIAL RENT9L IINITS FOR SALE UNITS IvCLUDE 2 SETS OF PLANS, CERTIFZCaTE OF SDR4EY - CHEC3 SiITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COHI'IERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 S$T OF ENEBGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: t Valuation: 1„W0_(ri Date: --- Site Address Lot 10 Block Z. v Parc?1/Sub? ??? Owner Address City/Zip Code Phone Address 1-112 L!h`i Cr0'r.??Ila-at City/Zip Code Phone c--544-?32>3 Arch./Engr. _ Address City/Zip Code Phone ik Ereet ? Occupancy Remodel Zoning ( Reoair Type oP Const Addition 4 of Stories ,rove Length Demolish Depth 410 Int.Impr. ? Sq Ft Install APPROVALS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review giro SAC Engr Water Conn Planner Water Meter Counc3l Road Unit Bldg Off Treatsent P1 APC Parks Variance Copies 1Y)TAL NOTE: ADDRESSES EOR CORNER LOTS - CGNTRACTOft/HOHEOWNER MIIST DESZGNATE NHICH ADDRESS ZS DESIRED. 'i0 CHANGES TiIILL BE AI.LOiiED ONCE BOILDIHG PERMIT IS ZSSIIED. [ ?,jnitn ernjInGaxl[vU (.'f_)MYANY e 1815 WAYZATA CGRTIFICATE OF SURVEY F'OR: ORRIN THOMPSON HOMES A Division of U.S. Home Corporation BENCH MARK: Top nut hydrant at Lot 9, Blk. 2 El. = 910.08 ft. (NGVD - 1929) PROPOSED ELEV.: FRONT GARAGE SLAB: El. = 909.13 ft. HUMMiNGBIRD M.D • MlhrrrEAPOLIS, PY7 • PHONE: 374-4740 Scale: 1" = 30' • Iron monument found ? Spike or wood stake set ?. .900.0 Existing spot elevation, oo.o Proposed spot elevation .?--- Drainage direction ?nNE 906.79 s?.zs -r.-.-_-: ?=8°24'12" 2'/S.Oo l= AI.? i?. \ _.' ?! c a ? v -" ? n a ? ,. %V ID O ? M 390Zi' S4" E 45•60 _ yze N ? '9e7,zA - zo.o --u•-- M io.n 1? m d' N ? ? uoVseioTz N .? z ` . LoT io V) Lot 10, Block 2 LEXINGTON PLACE SOUTH Dakota County, Minnesota I hereby cer[ity [hat thin is a true and correct represenGation of a survey of the boundaries of the land above described and of the 1«ation of all buildings, if any, [hereon, and all visible encroachmen[3, if any, from or on said land. I EurCher certify [hat this survey vas prepaced 4y me or under my direct supervision and tha[ I am a duly Registered Land Surveyor under the lavs o£ the State of Minneeota. tMl Reg. NO. /15?? Date ? Proposed House ?L As-BUilt House _ Drawn bv 0-?t'- Prniact nn_ 85LQ4 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I ?F+ oGq INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEYp 1 SET OF ENERGY CALCULATIONS NOTE: ADDRFSSE4. FOR CORNER LOTS - CORTRACTOR/HOMEOWNBR M03T DESIGNATE WHICH 9DDRFSS IS DESIRED. NO CSANGES NILL BE ALLOWED ONCE BUILDING PEAMIT IS IS311ED. M[JLTIPLE DWELLINGS EENT9L ONITS FOR SALE iJNITS • OF UBITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB AITH HLDG. DfiPT., 1 SET OF ENERGY CALCULATIONS COMMEACIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS j NvIsN1aG SM&ejoR To He Used For: GN L6"AC1: iIVEL Valuation: ? J b(D Iate: 1-20-87 Site Address /p7,Z Ammuit,R(RQ LJ7mz- Lot 10 Bloek z Parcel/Sub PLAGE JCJ. owner 2kY fi4l..l"', Address 167d f/((/btilq( lA1) LANC- City/Zip Code ,?FA64A/ ,MA/. js'/g Phone fngi =* 3fz? Contractor ?,?LK Address /G;?2 HI1M/Yt1f661R8 LANL City/Zip Code C-x4GAn/4 /YIN. S5I;z 3 Phone __6 I-9132L Areh./Engr. gT FALI? Aaaress i07a NwiMm-giw LoWL: City/Zip Code Phone S Oecupancy FTSS Zoning Actual Const Bldg. Permit 36.00 Allowable Sureharge J,DD # of stories Plan Review Length SAC, City Depth SAC, MWCC S.F. Total Water Conn Footprint S.F. Water Meter Aeet. Depasit On site sewage S/W Permit On site well S/W Sureharge _ MWCC System _ Treatment P1. City water Road Unit _ PAV required _ Park Ded. Booster Pump _ Copies i.ov TDTAL 9? o APPROVALS Planner _ Council Bldg. Off. Variance Council NOTE: Sewer & Water Permit fees and aceoupt deposit fees will be included in the building permit fee. Processing time for setiaer and vater permits is two days oncse a licenaed plumber has applied for a permit at City Aall. 1987 BDILDING PERMIT 9PPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 0 G' ? r-- INCLiTDE 2 SEfS OF PLAPS, 3 CERTIFICATES OF SOROEY, 1 SET OF ENERGY CALCOLATIONS AtOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEONNER MQST DESIGBiATB AHICH ADDRESS IS DESIRED. NO CH9NGE5 WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSIIED. MULTIPLE DWELLINGS - RFSIDENTIAL RENTAL ONITS FOR S9LE ONIYS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIR9EY - CHECB 6iIT$ BLDG. DEPT., t SET OF ENERGY CALCULATIONS COiMMRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Valuatior-fL??L s? LLL97 Site Address ?(}7rZ /?umh,???r? ?Qn•p Lot za Block ? Parcel/Sub Owner (°7-dhl?< 9ddress AQ',-J urrirn hc?JiFj L4i7 45, ) City/Zip Code Phone 9/3 j? Contractor? - - - -- -" Address City/Zip Code-- Phone Arch./Engr. Address City/Zip Code Phone /i On Site Sewage` Oecupancy MWCC System Zoning On Site Well _ Type of Const City Water ` (Actual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments Permit 22. Z-° Water/Sewer Surcharge ?. Police Plan Review Fi-re SAC, City Engr SAC, M47CC Planner Water Conn Council Water Meter B1dg Off Road Unit APC Treatment P1 Variance Parks Copies TOTAL ,.;2 3 I . ? ?D7? ? a ? r-I ti -? ? - - -- - ? ? 7 3, --- -- - ._- ? c , . . . A Gf1-Y OF L.FOUAN APPLfCATfON FOR PERMIT SEWER AND/OR WA7ER CONNECTION 3_C OP i?lil: lie 1'lI'91. UI, APPLICA7ZON DOES NCm CONSTI'1[TTE APPR0vAL OF PERM7.'T. INSPECPION OF SEF+ItTt AAID/OR yZ41ER TuG'i'1LTSATIONS WII,L NOT BE SQiFFD- ULFD UNTIL PERMIT AAS Bffi9 APPROVFD. (P ease Print) 1) PROPERTY ADDRESS: LEGAL D$SCRIPTION: tr vision or Tax Parce IF EXISTING STRLY.ZLME, DATE OF ORIGZNAL BL'II,DING pg?MIT ISSL'ANCE: ' PRESENP ZONING/PROPOSID LSE: (Mn Year) q ca?sERcIAu./xErpsL/oFFicE Q INIDC'STRZAI, INSTI'ISlTIONAL/GOVII2M?IENT 2) •? rSe.. K R-1 SINGLE F1IMILY ? El R-2 DL'PLEX (TWo Ctnits) R-3 7UWNEIOUSE (Three + Units) ( Units) ? R-4 APARTMEN'I'/COi?IDON1INI0M ( Units ) ; CITY, STATE. ZIP'&//(/NS76Nt(4 171 Nd PHONE: .Y<??/? 7 3) NAP]E: ADDRFSS: r CITY. STATE, ZIP: PHONE: /yr,l??//'Yy MASTER LICENSE# _ f ?%9pf 4) :om6w•:n NAME: ADDRE55: CITY, STATE, ZIP: PHONE: Plumbers License: ? ACtIV2 Ekpired Not recorded St Initia2 5) ? e v ? e;: ?• ' ? 9? •?o W"yua? • D4 CONNECPION 'Pp CITY SEWER ? CpNND(.'TION TO CITY WATER ? MM '. . 6) [l PLEASE HOI,D ApPROVID PERMIT FOR PICX-OP BY ONE OF ABOVE ? PLEASE MAIL APPROVID PERM.IT TO 1, 2,(D 4. ABOVE . (Circle one) Q ' 7) / r r. U• --A??PJ'L???? eU25 _ .?d- TOR CITY USE ONLY , PERMIT # ZSSUED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLODE SURCHARGE) $ 6j, 5Z $ WATER METER/COPPERHORN/OOTSIDE READER $ $ WATER TAP (INCLC'DE CORPORATION STOP) $ $ SEWER TAP $ $ ACCODNT DEPOSIT - SEWER $ $ ACCOL'NT DEPOSIT - WATER $ $ WAC $ $ SAC $ $ TRONK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRONR SEWER $ $ LATERAL BENEFIT/TRL'NK WATER $ ?? ? •U o $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ I ? LI 7 S? $ TOTAL RECEIPT RECEIPT DOES DTILITY CONNECTION REQLIRE EXCAVATION IN PL'BLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK LVITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING ED NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CpNDITIOt3S: 4 APPROVED BY: TITLE: DATE: ? . ? ? 7Co ?- ' . � � .�� yi.�d� N +��, '{"1 1 ✓ 7,� \�• { ', . . . . -r '`�" .i�• . . ' ., � , . � : ' ,�. .,',; . ' . . Use BIUE or 6LACK'ink � ' • . �------------ _,._ � : •.. . . � � . � For OtflCV Usv� . � ''((�� + I �Cl� of Ea a � .�. � � ��3 � ; v � Permil Y: . � .� � ' ' . , � ii 3830 Pliot Knob Road � � PeR"n Fee:— / v S�"� i Ea�an MN 65122 . . . . . . � � �ata Received: ' Phone: (6b1) 876-6876 . � i � Fax: (6b1) 6T6•b694 . � sien: ; ..,., � . � ��' ----------- � � 2011 RESIDENT,IAl. BUIL`t�1N.G,PERMIT APPLICATION Date: O I� site Addr�::: /"�a L� ':i�r�.t � � � k/rfd L.�v • Unit p; �C�1�4'Sl �� C.,�� . � . •,' .. r --__. Name; �' �! RFSIDENT I � ' Phone; CBJ�� lp�z� OWNER . Address!Cily I Zip; �• ! ,` • • ' i., �'��✓d •�. �/q �� /�? r � Appilcant is: .Own�er� �,Y_,;.Contrector• ' � .. � � � �I �;..�;; 7YPE OF WORK Descr(ptlon of work:_7��.�G�1�- �'I'��2.RL� �� Constructlon CosC ��.% �fJ' Mulq-Family B ildtng; (Yes i No� Company,''Ttr✓I�!'�7�l�' ,�1}(� �� . ct:�?�e�° �`�O��}��/jr - Conta CONTRACTOR Add�ess:_�I�� t/�,�UL�'� • ' ' City; _ �f�LS , � ' State._� . 7.1pf'�.3�� . .RhOr,18..��s/�.. ' �9 Y r�S�� ' � � u�an88�:_ �--�p 3r�'oo�'z.- � t�sa�cer�nc�c�#: ili'��= 7 ! If tha project is exempt,from lead certlflcatlo � � � � �� , , �v .,.,,:.. n, pleasa exp�aln�rtiy;(see Pa�e 3�for addit(onal informationj �� E'��' • : i� ,. .. t' ,.� � �4...�,,,g�.� , ', ..�. �r��i.:r:�Y,vi �.i . COMPLETE TNIS AREA ��N�IF�.C�NSTRUCTIN(3 A NEW BUILDING ;. , .. • , �. �-- In the last 12 montha, has tha City of Ea�ari ls�ued a pormit for.a almllanpia�based•on �mastar plan� __,_Yes _,No ff yes,date end address of mastetpian: � � �� . ;, �,]censed Plumber. . _ ' Phone: Machsnlcal Contractor. ' ' , Phone: � Sewer b Water Contractor: _ , ... .'; . � • : .: . : : : Phone: NOTE;Plans and supportlnq documsr� tha�yq.�.s�jbm/t��e0�/��to�be publlc Informat/on. Port/ons of . the lntormatlon may be�class�fl9d•�s:��{��t{4,1/C,lf vu Y. ' - • � • '. . ,�°cdrfcCt�'dA�'.�iatrtX e.�,��9'•��'�,Q reasons that would permtt the Clty to . . :�r�'txacf�•,seor.+ets:•::... �A.l BEFORE YOU 0�, Ca1l Oophar 8tit��Onv.CiUl}t(4b,��'<¢;•pppi'jpr ptp(pc�Jp�.;`' e,'In�E unde rourxi upitty damage. CaU 48 hours you InlenO W dJq to recalve locatea of undorqro�u�d uj!!�!!�t • . 4O na ry . �.4�r�H.r.�it�.`..!}.4�it�::�'+Mi�:1,`�1:A�WY 'k�i1r �� t�. ' . l f1elCby eCkllpwigd98 lhal lhlS 1t1I0RT18U0f�IJ COFTIPI9(8 8tld BCCUfB{8�She(�ttp yyptfc yrfp'�'�'�pn/pnpa�g��lhe ordlnances end codas ot the City ol Eagan: thal I understand U�1s ls not a pq'rmll, but oNy an$ppUcaUon lar e porrnit, sr�d„v,rqr� ls,not to atert w(thout e parml�, �hat the wonc w;n pe in accorQance with lhe approved plan In the'caaa of�ro�ic wtilch requlre:a ravlew and�epproval ot.pfans.� . Exurfor work authortxed by�bulldln .. f ,��.. . , . , .. �. . . . days of permlt issuance, 0 Permlt Itsuod In accordanco Wlth.the MIMe�ota$tato 6ulldlns Code muat be completed within 180 X Sf��G S�,QD ff/?Z�-��-/,� � . � Appiicant s Printad Name X \ Ap cant's Slgnature , PegC 1 0l 3 i V 1�^ � � i� J��J A �(�, Use BLUE or BLACK Ink Ir "l ----------------- V,. � For Office Use � � ' � j Permit#: � Clty of ��a� � � � � � Permit Fee: � 3830 Pilot!(nob Road / Eagan MN 55122 � Date Received: �/J�d'�� i Phone:(657)675-5675 � . ��.. ��.'�=' I /��f _ I Fax:(651j675-5694 1 Staff: ��r� � E .,: ";4�i14. � ( .e.. . . .� .:.��tu t��_`___�_�_�_J 2015 RESIDENTIAL BUILDING PERMIT APPi.ICATION ��,�� Date:_ Site Address: ��2�t11M r '�E�� 2�Unit#:,v n t�� p Name: �r��{ r��--� Phone: �S I � �J�J�"�p [ 2� Residenf! ... OW11@t' Address/City/Zip: C��I'� �UM�1 N�-�r P�A — � �ll `05123 Applicant is: �Owner Contractor 7.�e O�wOf'k Description of work: �2�t q C!ln A ti/�CF� �CYt �r Z'1� 24�1 vv Construction Cost: . "'"-"' Multi-Family Building:(Yes !No,�„_) Gompany: Contact: C011tl'aCt01' Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certiftcation, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDtNG I In the last 12 mor�ths,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If es date and address of a r I • _ _ y , m ste p an. Licensed Plumber. Phone: Mechanical Contractor._� _ _Phone:_ � Sewer&Water Contractor.__ Phone: NOTE:P/ar►s and supporting docum�nf�that you submh�re considered�o be pu�lic,ir�forma�on. Partians of the information may 4e classif�ed as non public�f you provfde spect'fic reasans t�at would per+tarit the Cfty to canctude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq f hereby acknowtedge that this information is complete and accurate;that the work wf II be in conformance with the ordinanc�s 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 accordanee with!he Minnesota State Building Cod�must be completed within 780 days of permit isauance. X �i��`� ��-� � _ _ Applicant's Printed Name Applican's Si ture Page 1 of 3 . DO NOT WRITE BELOW THIS LINE SUB TYPES � Foundation ^ Fireplace T Porch(3-Season) � Exterior Aiteration(Single Family) _ Single Family Garage _ Porch(4-Season) _ Ente�ior Aiteration(Multi) _ AAulti � Deck ` Porch(ScreaNGazebo/Peegolaj _ Miscellaneous 07 of T Plex Lower Level Paol Accessory Buiiding WORK TYPES � New � Interior improvement � Siding _ Demolish Buiiding* � Addition � Move Building � Reroof _ Demolish Interior _ Alteration Fire Repair , Window� _ Demolish Foundation � Replace � Repair � Egress Window _ Water Damage Retaining Wall *Demolition of e�rtire building-give PCA handout to applicant DESCRIPTION Valuation �� Occupancy ,�C- ! MCES System �"" Plan Review Code Editian � SAC Units -- (25°l0,100%�� Zoning /�'j� City Water -- Census Code �3 Stories -r Booster Pump —" #of Units 1 Square Feet "' PRV -� #of Buildings ( Length -^ fire Suppression Required --� Type of Construction �_ Width -� REQUtRED INSPECTIONS �ootings(New Building) Meter Size:_ _� Footings(Deck) Final I C.O. Required Footings(Additlon) � Finat/No CA.Reguired Foundation HVAC Gas Service Test Gas Line Air Test Roof:�ice&Water �Finai Pool:,�Footings _Air/Gas Tests �Final Framing Drain Tile Firepiace:_Rough In _Air Test _Final Siding:,Stucco Lath �Stone Lath _Brick Insulation Windows Sheathing Retaining Watl:�Footings_Backfilt�Final Sheetrock Radon Co�rtrol Fire Wails Erosion Control Braced Walis �...-- Other._�-- -�-��- , Reviewed By:_____� � __��__^__,Building Inspector il RESIDENTIAL FEES Base Fee 7 ?� Surcharge Plan Review MCES SAC City SAC Utility Connection Charge SSW Permit 8 Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA164800 Date Issued:10/08/2020 Permit Category:ePermit Site Address: 1072 Hummingbird Lane Lot:10 Block: 2 Addition: Lexington Place South PID:10-45060-02-100 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Gary A & Twila M Falk 1072 Hummingbird Lane Saint Paul MN 55123--223 (651) 354-6921 Rji Professionals Inc 6063 Main St Suite F North Branch MN 55056 (651) 674-5158 Applicant/Permitee: Signature Issued By: Signature