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1084 Hummingbird Lane Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - For Office Ussee/ Permit* _71,/0 411b~ City of EaEd~ I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 20/11 RESIDENTIA/LV <7BUILDING PERMIT T APPLICATION Date: Site Address: /0 VM j / Unit M Name: J I-e9 A a < cJ Phone: RESIDENT / OWNER Address / City / Zip: 6-e0akl Applicant is: Owner Contractor TYPE OF WORK Description of work: AP7) 7z' Construction Cost: Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoi)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and Ark is not to start withou permit; that the work will be in accordance with the approved plan in the case of work which requires a review and apT Applica is Printed Name Applic is Signature Page 1 of 3 - 06/22/2011 12:57 FAX - Q0001/0001 JUN/22/2011/WED 01:57 'PM City of Eagan FAX No.651-975-5694 P.001 Use BLUE or BLACK Ink of Way aG~~ Pemtktt: I Permit Foe: ®V 1 3830 Pilot Knob Road / Eagan MN 53122 e)~{~ z 2 2d1j 1 Date Re J` 4 Pftoite: (651) 675-5675 Pax: (w) 675-5694 i t 2091 1?ESIDENTIAL PLUMBING PERMIT APPLICA N Date, Site Address: f C! . Tenant, Suite REStDENTjOWNER 'Name: Phone:-&-57 J/I"g, r Address / City ! Zlp: CORtRACTOR Name: MIUERT COMPANY INC.dba GAN WA_ TAR Address: 1801 SOT" ST EAST CmrV RgWM GROVE HGTS. State:' Zip: 55.077• Phone: 651'-.451-2241 Contact: Bn-L. MII,Baj'•, . Emalk TYPE OF WORK _ New eplacement _Repair _Rebuild Modify Space _ Wait M.R.O.W. Desert tlon o work;,, PERMIT TYPE RE$_WtiVTIAL Water Heater r- Water Softener t awn kilgatlon L RPt / PVB) Add Plumbing Fbdttres (T Main 1 _ Lower Level) Septic System - Water Turnaround New _ Abandonmt:M RESID&i lAL FEES: $35.00 Minimum Water Boater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn irrigation Oncbides $5.00 State Surcharge) $55.00 Add Plumbing rb tuttea, Septic system Abandonment Water Turnaround' (includes $5.40 State.Surcharge) 'Water Turnaround (a0d S1SE.d0 if a 6W meter is required) $105.00 Septic System VMj (510.00 per as built) (includes County fee and $5.00 State Surcharge} " $95.00 Fire Repair (replace bumed out appliances, ductmrk, eta) (includes $5.00 State Surcharge) TOTAL FEES S CALL. BI=FORE YOU Did. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 ttvura before you ants , to dp to receive knatesof underground utilities., www_gooherstateonecan.2W I hereby womtVl6die mat thla tnfpnnation is corn and acarratr, that the work V11 to in eiklorm ove with the ordinanwe and codes of the M cf Eagan; 0& 1 tend ft s is am a Pei" but y an application for a permlL• end work is not to start without a pmmk; that Ma wwk wik be, In accordance wtth the approved plea in 9 e Of v4ch roqubas afaviaw and appnuvat of pta-. z x i c~af{. 14Wi y~L~~ Applicant's Printed arse Applicanfai.Signaturs p 9 t I CITY QF EAGAN Remarks Addition Lexington Place South ?oc 13 aik 2 Parcel 10 45060 130 02 Owner Street 1084 Hummin?bird T.anP State Ea?an, NIN Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING Q.tl cL- SAN SEW TRUNK ? 1985 247.64 16.51 15 SEWER LATERAL 1 1 1986 16 31 . 0 3 2:6:. 2 0 5 Services 101 1986 729.39 145.87 5 WATERMAIN 1985 $1 1 . 16 • ? WATER LATERAL 1611 1986 873.43 ? 174 . 68 5 WATERAREA 1014 1986 243.73 " . 48• 74 S WAT LAT B N 10 1986 111.98 .22.39 5 STORMSEWTRK 101`1 1986 426.54 8_51:30 5 STORMSEWLAT lol 1986 803.34 - 160.66 5 CURB & GUTTER ' SIDEWALK STREET LIGHT WATER CONN. 9UILDING PER. SAC PARK CITY OF EAGAN ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 t•?-- IM5 • PHONE:454-8100 ? BUILDING PERMIT Receipt # To be used tor SF DWG/GAR Est value $68 ,000 Date A1'R I L 2 11g 86 SiteAddress 1084 HUMMINGBIRD LN Erect IN Occupancy R 3 LEXINGTOIV PL Lot 13 elock 2 Sec/Sub S(Femodel ? 2oning pl . Parcel No, Repair ? Type of Const. p Addition ? No. Stories nRR T N'f'FiOi iP SON AOMFS Move ? Length ¢4. W Name IIIZ ` ? Demolish ? Depth 4 ? 3 Address Int Im r ? Ft Sq 0 544-7333 MTKA . . p . . City Phone Instail O z F Narr+e 5A[-ik: I Oa Address ~ City Phone ?Q ? W Name- Lm ,z5 Address _ i W Cily - Assessment _ Water & Sew. Police Fire Planner I hereby acknowledge that I have read this application and statethatthe Bldg information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? APC. Signature of Permittee / !?- e4',, A Building Permit is issued to: ORRIN all work shail be done in accordance with all s Var. City of Permit $ 337.04 II Surcharge 34.00 i Plan Review 15$.50 sAC 575.00 Water Conn. 500.00 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156.00 Parks Copies Total '' , ' aQ ' that ' PermH No. PermH Hddsr Date TNephone # Plumbley F1.KA.C. Eleetric Soflener InapecUon Date insp. Cammenb Foodngs I FooNnge11 Foundatlon Framing . (y / Roofiny Rouyh Piby. Rouyh Htg. V4(r Iraul. Fireplace ?o Ffnsl Mtg. Final Plbq. l Bldy. Final ?j Co,. occ. Deck Fty. Deck Frmp. Well Pr. Disp. PERMIT # cz?) Z (3 MECHANICAL PERMIT RECEIPT # (a , CITY OF EAGAN 3830 PILOT KN08 ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE: PHONE: 454-8100 Site Address gILDG, npE WORK DESCRIPTION LotZ Block ? Sec/Sub 'k ? - ? New Res. m Name M l Add -on u t 3 Address Comm. Repair c Ciry Phone Other Name FEES c Addr G 1??? U? RES. HVAC 0-100 M BTU -$24.00 p >> City Phone ` ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK ? GAS OUTLETS - 1.50 EA. Forced Air i- M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 70.00 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 G Pi i O tl t # CFM ? BEYOND $1,000.00) p ng u as e s Other ? . _ ? ?/'i ? FEE • .- ? SIGNATURE OF PERMITTEE , S/C: TOTAL• / FOR: CITY OF EAGAN Cities DiQital Qualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. ? ? PERMIT # ? Site Add7%-Block Lot m Name ?o Addre .. c City _ - Name 3 Addre 0 City i PLUMBING PERMR RECEIPT # GTY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE ".? FEES COMM/IND FEE - 1%OF CONTRACT FEE I? ? MINIMJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) r , SIGNATURE OF FOR: CITY OF EAGAN 454-e100 y- -e -,,r4o BLOGI TYPE WORK DESCRIPTION Res. New ? Mult Add-on Comm. Repair Other NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Oudets - $1.50 SoRener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE S/C: GRAND TOTAL: ? ?' U CiTY OF EAGAN 3830 Pilet Knob R d WATER SERVICE PERMIT oa P. O. Box 21199 PERMIT NO.: Esgar.. PfN 55127 DwTE: ZOnI^D: Owner :,•::-_.r??.:? ::c?:.Ft:,?f - No. of Units: Addroas: SiM Addross: 108 HL:mFIlilS i, Plumber ?'?4??pson P1y,,,binp, Meftr No.: CannecYion Chorye: Stze: Aor.our?t DeposFt: Reoder No.: permit Fee: 1 pm te oow* wft !M Cihr ei LMlPw Surcharge: Orrlwwmew. ? fl" ' . ''•?_ 8y ' Oote of insp.: TaRal: ?. DarM P1oid: CITI' OF EAGAN 51.MIER SERVECE PERMIT 3830 Pilot Krwb Road P. U. o3or 21199 PERMIT NO.: Eaga n. IAN 55121 pATE: . Zontnp: No. of Un1ts; Owner: Addrcss: 51t! AddfASS: BF- ? - - -• r, n'? F L. Plumber: I *!ree te emplp wNb 1W Gyi of fepw Connrction Chorpe; . OrdinanoM. Acoount Depoait; ' P%rmit Fea: Surd+orpa: By Mist. Charpes; Dote of I rup.: ToMI: l^qx" Doft pald: ? CITY OF EAGAN ? yyATER SERVICE PERMIT 3830 Pibt Knob Road P. O, Box 21199 PERMIT NO.: , Eagan, MN 551?21 'DATE: Zonlnp: No. of Units: I Ownsr; - lompsan ; Addross: -151 Site Addrcss: -umm $ r`_ -:-''`*-. ? _ ,ex .ngton o ?un-ober, nom?+son I ? Meter No.: -2(1..? -5 .Sf IIp 4?' C Size: -f??? !?o N 61kif??`0? . rb ?R?'?"'.,..?f+. _ • ?P 1 pM te ampiy witfi ?M?` - I14ISC. Ch0fpB8: • •?vYu Lr Total: meter Date Paid: Dote of Insp.: l,?,; ?-y-g? CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 , PHONE:454-8100 BUILDING PERMIT Receipt k N0- 11715 To6eusedtor SF D4L3/GAR EstValue $68,000 Date APRIL 2 1986 1484 HUMMINGBIRD LN Site Address Erect Y] Occupancy R3 Lot 13 Block Z Sec/Sub. LEXINGTON PL SCRemodel ? Zoning Rl Parcel No Repair ? Type oT Const It- . Additian ? No. Stories ORRIN THOMPSON HOMES Move ? Length dd 6 Name Z Demolish ? Depth_46 3 Address ? 0 MTRA 544-7333 Int. impr. 5QFt. cih, phone Instan Q o SAME Name APPror ?a Atldress AsseSSment. " Ciry Phone Water & SEw ? Q Police - Name Fi _ i re ? -p Address E ng. a W Ciry Phone Planner_ Council_ Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. j information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry of Eagan Ordina nc e s. APC ? ? ? { ' Afar. Date- Signature oi Permittee ;,/, /s A a'id aermit i d t ORRIN THOM SON HOpES? w ?ng s issue o. allwork shall be done in accordance with all applicabpE$tate of Ciry of Fees Permit 337.00 Surcharge 34.00 Plan Review 168.50 Snc 575.00 Water Con n. 5 0 0. 0 0 Water Meter 63 . 50 Road Unit 290.00 Tr. pi. 156.00 Parks Copies $2 ,124-00 on the express condition that 8n Ordinances. Building REQUEST FOR ELECTRICAL INSPECTION ea-oooot-oa ? IP See inatructiona br campletinp this lorm on hack of Vallow capy. "'R"" Be/ow Work Covered by This Request 3,698 l OS ???eo. -{?oe ol 8uiltlina . Aoolian[es Wieed Equipmenl Wired e.x ce N Fee Service Entrence$ize A Fee Feadars/SuCleadars k Fee Gircoite .a0 Oto200qms .,V' 01230qms 0 to30Ams Ahove 200 qrppy, 31 to 100 Arnps 31 to 700 Am , Swimming Pool Above 10D_Am s Above 1'00_Amps Transiormer5 rrigation Boorc?s Partial-"Other ee Special Final i, me eiebf.i?rFi Inspector, hereby certity that the abov inspection has bean ! Thisrequestvoitl Gl?a ?!/p?? ,e manths ?sr !S .z, Ae uei'.'llate.. Fire No. Rou h-in InSVection ,?j n R Quired? OReady Now Ll/hWiil Notity. InsPec- ?.7 V 0 NO tor When ReadY Licensed Electrical ConVacto, 1 hereby request insvaction of ebove ? Owner alectrical work installad at: Stree, Mdress, o or Rome No. Cirv ecuon No. Township Name or anye o. Cow y ? Occupnnt IPRIN7 /U Phone 73-33 P er & VVlier ? Address ? - v zx) EI ncal ?ontractor (COmpany Name) Convaclor?s License o. Ma mg AdJr s( onVaclo or Owner M king Ins,ai tionl ? Authorize Signature IConvact r/Owner Making Inst Ila[ionl Pho?Nurrber ? r 61jrvrvESOTp STATE eOAND OF TflICITY THI$ INSPECTION HEQUEST WILL NOT Griggs-Midway Bldg. - Boo 191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. eul. MN 5510C UNlESS PNOPEfl INSPECTION FEE IS Phone 16121 297-2111 ENCLOSED. RESIDENTIAL ?S ? BUILDING PERMIT APPLICATION CITY OF EAGAN 47 3830 PILOT KNOB RD, EAGAN AAN 55122 657-681-4675 Naw Constructlon Pegulrementa • 3 replstered sRe surveys gwwing sq. ft of lot, sq. fl. of hause; and gLI roofed areas (20% maximum bt coverega albwed) . 2 copies ot plan showirig beam & window s¢es; poured Yaund tlesign, etc.) • 1 set of Energy Cakuletbna • 3 wples of Tree Preservatbn Plan tt bt Dlatled atter 7103 • Rim Joisl Deqll Optbns selecdon sheet (bldgs with 3 or less unils) DATE / `1I'L?2?- SITE ADE NPE OF APPLICANT STREET ADDRESS / L'1 `J / L?J7eKR- TELEPHONE # 66-ADZ -/'L/ CELL PHONE # AULTI-FAMILY BLDG _ Y XN FIREPLACE(S) _ 0 _ 1 _ 2 &Y--- STATE &&/ZIP ie? PAX # PROPERTYOWNER ?DYL? 17-? TELEPHONE# --------------------------------------------------------------- -------------------------------- COMPLETE THIS SECTION FOR °NEW- RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheat Submittetl • Energy Envelope Catculations Submittad Plumbing Conhpctor: Plumbing system includes: Mechanical Conhactor: Mechanical system includes: _ Air Conditioning _ Heat Recovery System Sewer/Water Contractor: Phone N Phone # Il? JUL 1 6 2002 ? Fee: I hereby acknowledge that I have read this appllcation, stat6 that the information is correct, and agree to comply wlth all applfcable State of Minnesota Stafutes and CiTy of Eagan Ordinance 4 SignalureofApplicaM OFFICE USE ONLY _ Water Softener _ Water Heater _ No. of Baths RemodeVReoalr ReautremeMs • 2copiesoiplan . t set ot EnergyCakulations forheated adtlAbns • isitesurv9yforealefwraddttions&decks • Indicate tl home served by septic system for addNlons VALUATION ?W 060 -? Phone # _ Lawn Sprinkler _ No. of R.I. Batti Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ uaaecea 4102 OFFICE USE ONLY ? 01 Foundation 0 07 OS-plex ? 13 16-plex ? 20 Paol ? 30 Accessory Bldg ? 02 SF Dwelling 0 08 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Poroh/Addn. (4sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (scraened) ? 36 Multi ? 05 03-pfex ? 11 10-plex O 19 Lower Level O 24 Storm Damage ? 06 04plex ? 12 12-plex Plbg_Yor_ N O 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 (Bidg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolltion (EMire Bldg only) - Give PCA handout to 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 W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siting Stucco Stone _ F'seplace _ R.I. , Air Test _ Final _ Windowa (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storege S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector i 7986 BOII.DIAG PERlII2 APPLICATION - CITY OF EAGAN HOTE: ALL CONTHACfpgS MOST BS LICENSED iiITH THE CITY OF EAGAH FL"-u 8s3 CONJ!lERCIAL SINGLE FAFIILY DiiSLLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET bF ENERGY CALCULATIONS ENERGY CALCULATIONS - $2t000 LANDSCAPE HOND To Be Used For: 45-JAy\-tal Valuation: 10?9,000 Date: -'? -2--I -? Site Address ??78? Am,?n 7 OFFICE DSE ONLY G ??"' Lot ? Bloek Erect ?C Oceupancy Remodel Zoning Q-I Parcel/Sub Repair _ Type of Cons t -v Addition # of Stories Owner Move Length 44_ Demolish Depth 44, Address Int.Impr. Sq Ft Install City/Zip Code ----°---- --- --------°-- ------- Phone gppgppALS g ggs Contractor mYri V1 ?QS 9ssessments Permit 0OU Water/Sewer Surcharge CC> Address MIZ 147-o kC-IC'-IS v nn oA Police Plan Review " City/Zip Code p ??? yLru tph 14 Fire Engr SAC Water Conn 1 p ?pp Planner Water Meter ? Phone CouneilI Road Unit L9D.op Bldg Oft?? Treatment Pl c_- Arch./Engr. APC Parks Variance Copies Address City/Zip Code Phone 0 TOTAL 2,a? NOTE: ADDRESSSS FO@ COHHER LOiS - CONTRACTOR/HOMHDWAER MOST DFSIGHATE HHICH 9DDRESS IS DfiSIRID. NO CHANGES WILL BE ALLOWED ONCE BpILDING PERMIT IS ISSIIED. • Gt315 WAYLA'1'A t1UULEVAKll • M1lVLVGAk'UL1J, M[d • Yt1UNG: ,i/4-4-/40 •CCRTPFICATE OF SURVEY FOR: ORRIN THOMPSON HOMES A Division of U.S. Home Corporation BENCHMARK: Top nut of hydrant at 3649 Blue Jay Way. Elevation = 905.46 ft. (NGVD-1929) FRONT GARAGE SLAB: Proposed el. = 908.03 ft. Scale: 1" = 30' 0 Iron monument found a Spike or wood stake set .eoo.o Existing spot elevation Draina9e ? L/ti%ify Easemen> S 89°13'OI"E 123.49 ? ; 2<.5 in ^N w I i m 4.H31n l I 0 ? LOT 13 i7.o a N W N O Z w I ?i z? M 8 0 m N '16° t5' Slo,• w o? I 5 Z?. ?? ? ',, 3 OO O?0 N Ir) I mo Ip? : n z ? -o- -- ? 4.? mNO -?- Q ,.4. , Lot 131 Block 2, LEXINGTON PLACE SOUTH Dakota County, Minnesota S hereby certify that [his is a true and correct representation of a survey of the boundaries of the land a6ove described and of [he location of all buildin9s, iE any, thereon, and all visible encroachinents, if anyo from or on said land. I further cectify Chat Chis survey uas prepared by me oT undor my dirnct sunervision and thet I am a duLy Aegistered Land Sucveyor under the lavs o£ Che State of Minnesota. tRV Reg. No. Date 13" ,?i7"8(!J Proposed House.?_S As-Built House _ Drawn bv P26A! 'prniact nn_85104 ? ° w ? Z J , a ? m ? T ? ? ?'. ? Cities DiQital Oualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. •?• ? • . •,. . ,• .• ..n?? ? ? ?? ?, . . ? ?Y 5` .?Y' a M`bz t A'°t'IJ ?? Y? 'Er }„a4W> ? t r ? je `C' . F'Z Pd'S ?. ?? S ? i ?,?y f ? 3Y!'AitYY ? ?' -<4n w?S+ lC S? '+S ?n ' Y '+F1 SE- Y ?,•yJ 2r . ' ": ,°•. "`" `. ? APPLICATIOI?I F ?t PERNIIT SE?'N?R ADID/OR WATER ?I?TION XUESS ................... ri? ......... ISSCANCE::: c-•--°,..A.,?._.,?`?-- i??z az?a? R Z' DUPLEX (ltao L'tv.ts) - R 37DWN[iIX:SE, (Three + C , ADDRFS'S ° ? 14 I mnni . LICETiSE. _':.•For City.Use Plianbers License '"'l Jkctsve - cr Expi:ied Q .Not;Reoorcl? 5? (y?y.1 C?iII?IDCTION TO CITY SENIER Y?CONNIIJCTION 20 CITSt F41TER ??-?????_ ia? _ ..?: :sa . . . 011MPlease nescribe) ?. -P ? ?. ,. :.: . .. .. , . , . :?. . _..... : . ' ' , ?6)-.r u • • i .-.. .. ,- .. .: _ ..... ?;:.= _ .._: - -.. .-. .. . .. - ?' ,??: . . .. . : ? ,. ,? ? PI.EASE fiOID APPROVID PEFthffT FOR PIQt-L BY ONE OF ABOVE " f ? . ? PI.EASE MAB. APPROVID PERNiLT SD 1n,? 2...,. 3. 4, ?1BOVE ? a .' , ..: ... :?_ i'Y:'' .r-r . .- ???. . . :. ';• N -. ?.a+?. OISE) a, ? . ? . `d a . -? it ? s a ? "'h?„' - . R ?G`:'F. F _ f.w '?'?"..aY'• ? d ..^ .. ? r?- sr x ar 5? am3>Yn? s??? s l' !- ?r i Uxyy,v yk ? .,,? .?r=+ +e ?* 9'? ""?,? ^ ' ' `.. • . n.?..: C I T Y' a%:U"S E T.?(INCiiiDE /COPPERHORi i .:>??_?,..:.. .. : z? ? z ?x ??x,{. ?,t -?. k. l3. r ? S,' .+. c r t.4:.N ? . . ? .. xa ?. s4 •02!F'+u ?'Fr+ - . ? a'rt'?, - $ ?•, r ? r.'.. ? ? :./-;\ 'FR6SDIK WATER ,AtSStSSilENT a,x z ;t UMi? ? ??YF ???.V . '• \ l4? :i 4 ? n *J? 24 T'? K ? _ ?'i ? ! \ { ?n : - ay ?_• T#2CrNK tSELt1ER AS3cSSMEJiT ?-'? ' ;$ r' ;.,...a ?v ?<: k., ? + ?? ..- ? ?1.. ai `•; ?r : c r : ? *`??s' . ?"yy?' `BF.?NEFZTVTRUNK. SEr'rv ,.? S ,- •:' ? " LATERr'?rL.$EN£ ' `j'RUNK LJATrR ` . .. .. . .....-.. rv ti-..:... ...._ . '- - '+,.'a ^ ? -r , ? ; _ ; WATER TREATMENT PLANT SURCHARGE " OT[iER: T9TAYr, ?' ?t -i-e *,` '" r? ?. . S ? 5 '. ? }.? ? ` M1 ? ': -' REC ?T -? ? r x ••- • ?? ? e .?{'a: as?`' 9 ?.4. ? °a i^? C4 -? ? :, { ; ? "??-?bES UTZLITY COAINECTION REQUIRE ?£XCAVATION .iN PUBLIC RIGdT t)F.WA ??`?+ ???? YES ??-a+at IF ,tYES,.. _THEN A` "QER!`P?IT. fOFt• WORK SdITHIN `??? MUST''BElS?iJED BY TI=E ' NO ENGINEERING yDIVISION LIST AS A CONDI, r m I SUBJECT TQ THE FOLL?JS4ING CONDITIONS: .: Tk'Si?:?skt `L.?`q»:u?aY' r s- '? ?P? ls-Z5 ?a mhG w' r e '?.e""',y?? g `„s . •: " ?' .'S?y'°?•3 -^i . ..t ?.• _ "' ' :. ?APPROVED SY » Y"J'?a r.'"' T=T r.E. ??. 3'7 DATr ??V?' /' ??'k?'??^?.?' .? r . .? x --? ' • "?' 3 i / s > r . S_J^,?LFIf, .. ,. .-:?• ,. ° ? ,.. .fi<..&?T. -? F, -'. ? ???,.A f ,._i:?.'.i?? x? ? 9 Use BLUE or BLACK Ink ForOffiee:Use ~ - Permit cad City of Eap 1 3830 Pilot Knob Road I Permit Fee. O~W I Eagan MN 55122 r` Date Received: G j Phone: (651) 675-5675 I Fax: (651) 675-5694 staff: j - - - - - - - - 2010 RESIDENTIAL BUILDING PERMIT APPLICATIO Date: ~-a- Site Address: Lead Cerf Net. Tenant: Suite W4- 1 RESIDENT I OWNER Name: 1'- G~ ye Z6 Qv) Phone: &SI. 699 - xbj Address / City ! Zip: 166 a Applicant is: Owner _X_ Contractor TYPE OF WORK Description of work: La"0, djx M C) S I; z- a M 4,7L Construction Cost: Multi-Family Building: (Yes ! No CONTRACTOR Name: ? License _ 7 VP Address: 1_/ l0 City: _ G~b State: Zip:u Ql `1 Phone: Contact: U( T/ C/ 77) Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A N V BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No if yes, date and address of master plan: Licensed Plumber: Phone: i Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Q'E, Plans anal supporting alooltbrt~'ts fat yQCr-sr1ilrb iate~sc in a riiinatoYn.F? oris of the/nfor►natfo».izrtaybe;afa sffeecf hon,pubffc°tfyou.pCoYibe ecific~e Qr1 'h~ t~ryR'Wd:pei.- ~'rrtih,City~to nl:lude tfra?t. tt;t _ :t n CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoDherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicants Printed Name Applicants Signature Page 1 of 2 PERMIT City of Eagan Permit Type:Building Permit Number:EA119274 Date Issued:11/21/2013 Permit Category:ePermit Site Address: 1084 Hummingbird Lane Lot:13 Block: 2 Addition: Lexington Place South PID:10-45060-02-130 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Kelly Meyer Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Karma Tsewang 1084 Hummingbird Lane Eagan MN 55123 Hause Construction, Jg P O Box 206 Bayport MN 55003 (651) 439-0189 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA140133 Date Issued:11/28/2016 Permit Category:ePermit Site Address: 1084 Hummingbird Lane Lot:13 Block: 2 Addition: Lexington Place South PID:10-45060-02-130 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - 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: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Karma Tsewang 1084 Hummingbird Lane Eagan MN 55123 (651) 331-1065 Kat Construction Llc 8833 79th St Annandale MN 55302 (320) 266-3455 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA140133 Date Issued:11/28/2016 Permit Category:ePermit Site Address: 1084 Hummingbird Lane Lot:13 Block: 2 Addition: Lexington Place South PID:10-45060-02-130 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - 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: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Karma Tsewang 1084 Hummingbird Lane Eagan MN 55123 (651) 331-1065 Kat Construction Llc 8833 79th St Annandale MN 55302 (320) 266-3455 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA164808 Date Issued:10/08/2020 Permit Category:ePermit Site Address: 1084 Hummingbird Lane Lot:13 Block: 2 Addition: Lexington Place South PID:10-45060-02-130 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 - Karma Tsewang 1084 Hummingbird Ln Eagan MN 55123 (651) 252-5101 Rji Professionals Inc 6063 Main St Suite F North Branch MN 55056 (651) 674-5158 Applicant/Permitee: Signature Issued By: Signature