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
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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
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Cities DiQital Oualitv Control
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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) -
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ADDRFS'S ° ? 14
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LICETiSE.
_':.•For City.Use
Plianbers License
'"'l Jkctsve
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5? (y?y.1 C?iII?IDCTION TO CITY SENIER Y?CONNIIJCTION 20 CITSt F41TER ??-?????_
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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