1365 Interlachen Dr
Use BLUE or BLACK Ink
r For Office Use C~
I Permit I I
City of Eajan I
I Permit Fee: a I
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
1 r
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
S-Y
Name: 'U Cal14 S U 0, `C Phone:
Resident)
Owner Address / City / Zip: 13L.6 7 e_, o c~- I
Applicant is: __y_ Owner Contractor
Type of Work Description of work: ~ -.f> ( P~ W r~.-~_aw ~
Construction Cost: ~~1 000 Multi-Family Building: (Yes / No
Company: Contact Q V~'
Contractor Address: City:
State: Zip: Pho:
License _Wt)(i( :6 (o f ~ 4;(eA e 6 ~ Lead Certificate l b
snn •t
If the project is exempt rom lead<cD ertification, please explain why: (see Page 3 for additional information)
Q. r -13'
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. Pordons of
the information may be c/assfed as non-public if you provide specific reasons that would permit the City to
conclude that they 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.oopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x~- VC x (~G'(
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK ink
For Office Use I
a
non V r
AY ! 8 RECD Permit 1
City of EaV 1 3 .vim
1 Permit Fee. I
1
3830 Pilot Knob Road I
Eagan MN 55122 1 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address `(D~ -~V Ctt✓1 IQ (mil
Tenant: (1 / Suite
RESIDENT I OWNER Name: Q T V ~ Phone: qy l[P~4
Address ! City I Zip: S(1A VLSI a-bar p,.,
CONTRACTOR Name: 1,i ~ (M'1A j A a pp License 6 ~ 132 3
Address: 9 S- . Su 1>1 C. City: ~ \OTA Q ✓1
State r V Zip: Phone: (Q. 11 - ZL9 -q I(7~-.
Contact: Email:
TYPE OF WORK New _ Replacement Repair _ Rebuild Modify Space Work in R.O.W.
Description of work: )
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ / PVB) Main _ Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation includes $.50 State Surcharge
( )
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
'Water Turnaround (add $166.00 if a 518' meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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.
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 1 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 ~10'
.Applicant's Printed Name licanlr ignature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In _Air Test Gas Test Final
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT
To be used for
Site Address
Lot ' 2 E
Parcel No
Est. Value $142.000
1365 IN'TERLACHBN Djt
Sec/Sub. FAIRwAY NILLS 2Np
oc Name A4 1??_;i??NACVH i;0i46T
3 Address p i f' ?!i l.; k{1,Y; l1C ','A Y
0 City ' v vk.Lj;Y Phone
°oC Name _
.
?Q Address
? City _
a
W Name _
Z Address
?
Z Cit?j_
W
I hereby acknolnledge that I have read this application and state that the
information is cerrect and agree to comply with all appiicable State of
Minnesota Statutes and City of Eagan Ordinances.
ySignature of Permittee
A Building Permit is issued to:. '•+• "?•nF ,`.:iif:` +
on the express condition that al I wo?k shall be done in accordance with all
applicable 5tate of Minnesota Statutes and City of Eagan Ordinances.
Receipt
NE 30
I A% "8 41
,79 1Lb
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System ? Zoning
On Site Well (Actual) Const
City Water I_ (Allowable) y"y
PRV Fequired # of Stories
Booster Pump Length 70 1
Depth 38,
S.F. Total
Footprinf S.F.
APPROVALS FEES
J`0'00
Engr./Assess. Permit
Planner Surcharge 71 ' 60
Council Pian Review 355.00
Bldg. Off. SAC, City l(i .()Q
Variance SAC,MWCC 550.00
Water Conn. 550.00
Water Meter 67• UO
RoadUnit 325•W
Treatment P7 204•00
Parks
TOTAL `?00
. m.a -
• ? CASH RECEIPT ?
CiTY OF EAGAN
?
3830 PILOT KNOB ROAD
EAGAN, b11NNESOTA 55122
DATE
J;EFVFD '1 I 1-? ? ' r
PROM
AMOUNT $
& 00 DOLLARS I
? CASH C? CHECK I
wa
FUND OBJECT AMOUNT
I
? J ?,4_ 11 1
U
Thank You
sv 1--- , .
„ White-Payers Copy
2 ?? Yellow--Posting CoPY
Pink-File Copy
'
, . ,... _ , .
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
` • 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
? CONTRACT PRICE PHONE: 450-8100
I _
i Site Address ?'f .• ?•'?a '' ?-
BIDG. TYPE WORK DESCRIPTION
Lot ?_. Block Sec/Sub Res. New ? r
M ult. Add-on
y Name Comm. Repair
Address Other
c City Phone RES. PLBG. ONLY - COMPLETE THE FOLIOWING:
NO. FIXTURES TOTAL
? 4-
Name Water Closet - $3.00 $
Bath Tubs - $3.00
3 Address L
t
$3
00 '
ava
ory -
.
p City Phone Shower - $3
00
{ .
Kitchen Sink - $3.00
p FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50
TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12. 00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20. 00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PEAMIT - . 50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Weil - $10.00
, Private Disp. - $10.00
/ ? .
. , ?
, - Rough Openings - $1.50
SIGN?tUNE OF PERMITTEE FEE:
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
1 •. CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
To be'lrsed for Est. Value •
e Address
Lot Block Sec/Sub. ? -
Parcel No.
s Name
W
3 Address
O (?i1v ' Dhnnc
Name
City
I hereby acknowledge that I have read this appiication and state that the
information is correct and agree to comply with all applicable State of
' Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to:_
on the express condition that all work shall be done in accordancewith all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
R?iliiinn llf/:n;nl
Recei pt
Date _
+04
Urricc ust unLr
?1 I ?11o seM,age
MWCC System Occupancy
Zoning
On Site Well (ACtual) Const
City Water (AllowaWe)
PRV Required # of 5tories
Booster Pump Length
APPROVALS
Engr./Assess.
Planner
Council
Bldg. Off.
Variance
Depth ?
S.F. Total
Footprint S.F.
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
Psrmlt No. Permit Holder Dats Telephone ?f
Plumbing
H.V.A.C.
Electric
Softener
Inapection Date Insp. COmments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Pibg. ?y.y??
Rough Htg.
Isul. /Ldf
Fireplace
Final Htg.
Final Plbg.
Blda Final
Cert. Oca
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
. ._. .
. 'r?w.,e... ?- .. , ._ . . ? -
PERMIT #
, MECHANICAL PERMIT
RECEIPT
+
#
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address <+% ? gLDG, TypE WORK DESCRIPTION
Lot Siock _ ?. Sec/Su Res. New '-
._
C t (3 ' ., k Muft Add-on
Name
1 Comm. Repair
?
c Addr s
_f 1* ? Other
-?
Ci 1
ty ?- Phone
FEES
Name
RES. HVAC 0-100 M BTU -$24.00
c Addresg ADDITIONAL 50 M BTU - 6.00
p City -L 2 4-
• . X? Phone ?? U? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
50 EA
GAS OUTLETS (MINIMUM - 1 PER PEktAl7) - 1
. .
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
FOfCed Alf ??TJ M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - AES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SUFiCHARGE PER PERMIT - .50
Vent. CFM
PERMIT PRICE GOES
D
Gas Piping OuUets # BEYOND $1,000y
Other $
FEE ? ' ? . i
?,t
? :--' %`U???h /!•t7
.
.
S/C: SIGNATURE OF PERMITTEE
'1 GB
TOTAL•
FOR CITY OF EAGAN
CITY OE. EAGAN Permit No: Date: '_i 9-a8
3830 Pilot Kn,ob Road g/p No; Date: P.O. Box 21199
Eagan, MN 55121
Owner. -?`? ???? cona[,
Site Address: - ? =nter schen Trt.vp
Plumber: ?tt'wuth PIurhin _ ? I
nnwcc: 550. Ot}pd
City Chg: 200. t?Chsc?
Acct Dep: 15. 0
Permit Fee: '
Surcharge:
Zoning• - No. of Units:
I agree to comply wFth the City of Eagan
Ordinances.
SEWER SERVICE PERMIT
CITY OF IEAGAN Permit Na 27s *
3830 Pllot Knob d Date: : , 19•-Z8
Meter No: Sfze:
P.B. Box 21199
Eagan, MN 55121 , Reader No: Date:
1:3
%.unn. L;hg:
Acct Dep:
Permit Fee: W nn.._ +
Surcharge; ,
Tr. Plant
Meter. '
mISC.:-i..",i_e?+w?« ... ....._?___
CITY OF EAGAM
3630 Pllot Knob Road
P.O: Box 21199
Eagan, MN 55121
Site
Zoning: _
No. of Units:
I agree to comply with the City of Eagan
Ordinances.
Permit No: 47R 1
Meter No4L76t-0 / Za,
Aeader No: zu:? ?
mn. Chg: ?
ct Dep: ?
rmit Fee:
Plant ..,.. Zoning: _
rcharge: c
No. of Units:
Date: ' -19-88
Size: p
Date: - C ?
I agree to comply wiih the Cffy of
Ordinances. i-
BLDG. PERMIT NO. • ' ( ? '? ? ?
1?0'f- I Z 6 I OG1t.
401-3210 Bldg. Permit
?
? 01-3422 Plan Check
01-3445 Surch./Adm. ?
? 013446 SAC/Adm 5 S C'
? 01-2155 .
Surcharge
v 75-3860 Road Unit 3 -P S cc;
? 20-2275 SAC 5? y ? o
20-3865 WaterConn. 55 e oc,
203868 WaterTrmt. (D OC)
? 20-3716 WaterMeter b-I 00
?
? 20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn. C' C) C)
28-3855 Park Ded.
TOTAL ?' ? ?? ??
CITY OF EAGAN N° 15 2 8 4
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
p5 a ?
BUILDI PHONE:454-8700 Receipt n o
f?G PERMIT
To be used for SF DWG/GAR Est. Value $142, 000 Date JliNE 30 ,1988
Site Address 1365 INTERLACHEN DR
Lot iZ Block 1 Sec/Sub.FAIRWAY AILLS 2ND
Parcel No.
OFFICE USE ONLY
On Stte Sewage _ Occupancy
MWCC System X_ Zoning
On Site Well _ (ACtuep Const
City Water x (Allowable)
PRV Required _ # of Stories
Booster Pump x_ Len9th
Depth
S F. To[al
Footprint S.F.
: Name AL HERRMANN CONST
= Address 8723 HIGHWOOD WAY
3
°
CityAPPLE
VALLEY phone 688-0696
p Name SAME
?a Address
m
P
City
Phone
r?
All,
U y?
=i
x Z5
U
WI
a
Name_
Address
CItY _
I hereby flcknowledge that I have read this application and state ihat the
mformation is correct and agree to co nply with all applicable State of
Minnesota Sta[utes and Ci o..f?Ip?gan,? tl ces
Signature of Permittee _ , ` ?
A Building Permit is issue to: AL HER MANN CONST
on the exDress condition that all work shall be done in accordance with all
apphcable State of Minnesota Statutes and City of Eagan Ordinances.
BuildingOfficial D?,Al:! k1l ITV.
- , ?
APPROVALS
Engr./ASSess.
Planner
Council
Bldg. Oft.
Vanance
FEES
Permil
Surcharge
Plan Review
SAC, Gity
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P7
Parks
TOTAL
R-3 M-1
R-1
V-N
V-N
70'
38'
/10.00
71.00
355.00
100.00
550.00
5$0.00
67.00
325,(10
204.00
2,932.00
This rnquest vontl
18 rtqnths trom ?"
E 2as99
Pequev Uate Pnre No. Ro -in Insper,[ion
He red?
[]BoaEy Nuw ill Noufy InsPec-
n (? 8
? d'?' Q es ? No tor When Rgady
El-Cfcensed Eleclncal Convactor I hereby repuest insDection oi above
? Owner electrical work inslalleE at:
Sveei Address, Box o. Roufe No.
L 3 Co I??'? G*y
L--7 4
ection o. Township Name or No. Ranqe No. CoZ y
OccuGa I IPRINT) Phone No.
,/I
Power SuDDhe'
f-'a v-,j 'rA Atltlress
f-?, 0
Electqcal ?Conlractor (Compeny Name)
`
IJ ConVar,tor's License No.
'
S
?? ELCL
r7?/ C I C_ O
O ?
Mailmg Address ICOn[racmr or Owner Makmg Instailatwnl
3 7 y Vr- c v`G -so.
Authonze Si ar Con act Owner
? akmg Instnllalionl Pho e Number
9ySi
MINNESOTA STATE BiD OF ELECTNICITY TMIS INSPECTION NEQUEST WILL NOT
Griggs-Mltlway Bldg. - Aoom N-797 BE ACCEPTED BY THE STATE BOAND
UNIESS PqOPEfl INSPECTION FEE IS
1821 Univarsitv Ave.. St. Paul. MN 65104
an,...e ieigi ae9.nann ENCLOSED.
.; sQUESTuFOR ELEC?TR?1 CA e INSPECT?IONck of veuow ooov. ' Es-00001-06
E2'0 6 9 9 "x BeloW Work Covered by This Request
Noiv F Rep. Type ot auiimnn Aoolencee Wned En.wro,nl w,en
Home Range Teniporary Service
Duplex Water Heater Lightiny Rxtures
Apt. Bwldin9 Dry¢i EIeC[nc Heatin
Commeraal Bldy Fumace Silu Unloader
Industrial BIAg. Air Conditioner Buik Milk Tank
Farm Otn, peci v ,ihpr ISnr.citvl
mer nthc.
Comnute Insnecuon fee Below
N Fee ServweEnVanceSae n Fea Fexders/5ubfeeders k Fen Cucurts
0 to 200 qm 5 0 to 30 qm s Z? 0 to 30 Am
Above 200 qmpy 31 to 100 Amps 31 to 100 Am s
Swinmifng Pool Above 100-Amps Abave 100_Amps
Transrormers Irrigation Fiooms Pertial.'Other Fee
Si
S
Final y(?? ' certify thet the abova
C JarsPeccmn has bee.
**********?*******t********************
CITY OF EAGAN
CASHIER: JS 'TERMINAL NO: 781
DATE: 09/07/00 TIME: 15:05:19
zn:
NAME: RALPH HANSON CONSTRUCTION INC
3210 9001 1365 INTRLHN DR 60.00
2155 9001 1365 INTRLHN DR 0.50
Total Receipt Amount: 60.50
CR137151
USER ID: JAN
• 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122 0
651•881-4875 q- 1-0 D
New ConthueMOn Reauiremenh Rertadel/Reoadr ReaWremeMs
? 3 reglstered slte wneys showinp aq. fl. of W. aQ. 8. of house
and gH rooted areas (20X rtimdmum bf coveraae albwetll
> 2 coplea of plana (show beam & wlntlow sizas; poured tnd design; etcJ
>' 1 aef of energy calculaHOna
> J coples o/ hee preaervalbn plan H lot plalted alter 7/1 /93
DATE: ?K 13 d 6 O
2 copiea of plan
1 set of energy cdculailons tw healed addlliona
t siTe wrvey fu exlerbr addlHOna & decks
CONSTRUCTION COST:
DESCRIPTION OF WORK: a° c.PG
STREETADDRESS: 13?oS ???4erlAch-e? ?YZ?v?¢- ?c?9.av? ?S? ?-?
LOT: ? BLOCK: I SUBD./P.I.D. #: v
Name:?/r1 rea COA- J24?? Phone N: I-q 5(4-- 1 Cl
PROPERIY tast Flrst
OWNER `
Sfree1 Address: 13 G,-r- ?-
ciri ('- re %? sfare: 14!? zip:
Company: QAc-lP (A 4649JSdVI C'47l ST. ? Phone #: 6o 7 L7
(area code)
CONiRACTOR SheeiAddress: PO llcense M ExP•
Clty 1'T'@a?p4isYl State: Zip: 5523 1
ARCHITECT/
ENGINEER Company: Name:
Telephone #: ( )
Sheef Add[eas: Re9istratiO^ ?:
citY
State:
Sewer/water licensed plumber (H Installina sewer/water): Phone #:
Zip:
I hereby acknowledye that 1 have read this apPlkaNon, stWe that Ihe Infomwlbn is corred, and agree to comply wHh atl appacable S1ate
of Mtnnesofa Stalutea and Cify of Eagan Ordinancea.
Signalure of Applicant
OFFICE USE 0
Certificates of Survey Received
Tree Preservatlon Plan Received - Yes - No
_ Yes _ No
- Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling O OS 06-plex ? 17 Garage O 22 PorchlAddn. (4-sea.)
? 03 01 of _ plex O 09 07-plex 0 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Stortn Damage
? 05 03-plex ? 11 10-piex Plbg _Yor_N ? 25 Miscellaneous
? 06 04-plex O 12 12-plex ? 20 Pool ? 30 Accessory Bklg.
WORK TYPE
03 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition 0 37 Demolish (Bidg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 WindowslDoors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code ,g/
No. of Units ?
No. of Buitdings /
Const. (Actual) S-7
(Allowable) 77?
UBC Occupancy 3
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
MISCELLANEOU3INSPECTIONS
? Stucco/Stone
APPROVALS '.'n
Planning Building !? Engineering
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 Ext. Alt - Multi
? 33 Fxt. Alt - SF
? 36 Multi
17? 7'
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation:
SAC Units
°k SAC
aosE
ENGiNEERING
COMPflNY,
tOpO EAST 1461n
A HEKRMR.t/.l/ Cou,ST
A& /552-0/
COHSllL71H0 EH61HEfR5
pl11NHEt1S ond LfIHD 3UAVEY0f1S
INC. \
STAEET, Hl1flHSYtLL£ . tIINHES07.1 5=337 PH A:2-3060
CL•'TZ dZCLZze 9-3?r?.ey
LOT BLOCK /, FA/Rj'1??1>' `IILLS 2N0 ADD/T/O/i/
a4Ko7,4 COUn/TY, M/NNES97A I
(1, oiS- Z?)
DRA/AlAGE Ati/D UT/UTY
? V
\
\\ /
r? °? ? 'ray\
? -•-g?. .
MM `?'Q.{c? ?+s S 600..
? s? ??9r???43F
? "`° ?s
LoT
o °3g.
v
e,? : a
? ?6\ 60? ao
E?
a
A
. j
?
A F)'r)a_7
v? ?
$y_? ? --
Da!Ole
f ^^
a va? V
. ??`?•?'
5eAtE • /" - 3o'
ogi,o7 DE/JOTES EX/ST/"G
ELEVA T/dN
(1043 0) DE,VOT?S PRaPoSED
EC5t/s?T/Oti/
/n/D/G472F5 D1REC7-1oA/ o%
Su)CF4CE o,e,4i,u46E
1043.33 = FiN/SNED 6A,P.qGE
FLOG12 ELEWT/O/V
30' FRONT BU/LD/N6
?? ) SETB,9CK L/NE
BOOSTER PUMP
REQUIRED
I her:by cartify that thia ia a t.-ue
Iand as sho+.n'and deacribed hernon.-
r 19 8 8.
and eflrTact rspreaentitiafl of 8VA&Z og
Ae prapared by me on thfs ,(Dm da1 pf
i? ? Hina. Re?? Fdao /?, 6_ogs
_ _ „
? gi
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN -
SINGLE FAMILY DWELLINGS r .5 ^ t El
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS 0 OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH HLDG. DEPT.,
1 SET OF ENEAGY CALCULATIONS
CON4fERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: ? Valuation: 1-_ Date: !?'a?o?/O ?
Site Address
Lot ZA_ Block / OX-A •
Pareel/Sub?,?'/j',(?/,(/dG/ Wd&-,V-
Owner tq
Address
City/Zip Code
Phone
Contraetor,
(.G? ? ' ?L?tJ(-?jl?L •
Address o IN
121
gak
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
r??-y orri
/ ? OOO ^ -
On site sewage_
MWCC system 1/"
On site well
City water
PAV required
Hooster Pump ?
Oecupaney R-3 M-I
Zoning (t-1
Actual Const V-N
Allowable \/-
# of stories
Length 7°?T'
Depth 3 7 - `
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit 710100
Planner Surcharge 'll.?
Council
Bldg. Off. / Plan Review
'
??qt9SAC, City Ss.oo
DO•oo
Variance SAC, MWCC 550,00
Water Conn 530.00
Water Meter ( 7,D0
Road Unit ?,oo
Treatment P1 2 04,oo
Parks
Copies
TOTAL C233D
Phone #
UALuAMON
G?R-aG?
loxzo : Zo?
Zv?c22 = Yyo
..?r'
?$
1'?SmT 6l4o?` 19
72
1120
1192 X 13 = 15 N9L
? 5 r F??2
119 2
a x 7 = ? `?
??D X y9 = 59r?c6o
?----- -
2Bxyo- (120
t X l2,_ ?`
? Y
? I(oy 1C 4g - 5 9 03?
._---
IqI2?Z
rw
r '
CITY OF EAGAiV
APPLlCATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*TOTS: PAYMFTIi'' QF £EE AT TIME OF
APrLxCATIoN noEs Mr CONSTITUTE
r,pPxwAr, oF PErruT.
INSPF)GTION OF SEFFIIII2 INID/OR WA'lEEt
IL'STAU_ATTONS WIId. MP BE SCEIID-
tLED vrrru. PERMIT H+s BEEv
APrROVFn.
P ease Print
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
(t,ot/etocK/SUpaivision oY Tax Parcel iD #)
IF E7QSTING ST72C'CtURE, DATE OF ORIGINAL BLILDING PERPIIT ISSC'ANC.E: .
(MOn Year
PRESENf 7ANING/PROPOSID LSE:
q corMEaciai,/xErAxL/oFFzce
Q IPII)[.'STRIAL
a INSTZZSJTZONAL/GOVERNb1EN'P
? R-1 SINGLE FAMILY
? R-2 DUPLEX (1wo L?nits)
? R-3 10WPIIi0I?SE (Three + Units) ( Units)
R-4 APARTPaq/COAID(k'iID1ILT1 ( Units )
2)
NAME:VL-? IMC) Jl" ?-? ?L.. U i'Yl R 1? C>
p,Dnxsss:cl 2_C4 0 Ac.N A,? t?; c
CITY, STATE. ZIP:_y)n/-1 Pt : 6 2 c-, o 6 1/11 J?? S s 3
PHONE:?Ci,2; - 2q 7?
s) NAM:IPL?Wozrr4-r PLuWtS; ?Q(-.
ADDRFSS:
CITY, STATE, ZIP:
PHONE: L,L.I/3 - 211 MASTER LZCENSE# ?U(oS
Active
YScpired
Not recorded
Sta f?7ni'tial
4) !!? •a.? u..iu?; ' /
IvAME:_,4L- H? 21Z a? f} /?-J??J ?'_o ti51
_ ADDRFSS: -TS7Z7S 1-11614C--: ,t)17 L-'r'J
ci1^r, srATE. ZIP: fAf IPL E- !/Ac_C ?? i'Y/ /v. ?? S/ a</
PxorE:6o S,,? -
5) n a• • ?• : a • • - 01
CONNECPION TO CITY SE.WFR FV( CONNE7LTION TU CITY WATII2 ? M'HER
6) '? • •?• ?y` PLF,ASE HOLD APPROVF9 PERMZT FY)R PICK-UP BY ONE OF ABOVE
T?.
? PLE'.ASE MAIL APPROVID PERMIT TO 1, 2, 3r 4. ABOVE
?? ?/ (Circle one) 7) -7 / ? k lk k
. FOR -CITY USE ONLY
PERMZT # TSSUED
Pd w/Bldg. Permit FEES:
$ S lB•.S--D SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLDDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLODE CORPORATION STOP)
$ $ SEWER TAP
$ $ C» ACCOUNT DEPOSIT - SEWER
$ ACCOONT DEPOSIT - WATER
$ WAC
$ (O ? O • U-7? $
SAC
$ $ TRLNK WATER ASSESSME[VT
$ $ TRIINK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRLNK SEWER
$ S LATERAL BE[VEFIT/TRUNK WATER
$ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ I`1 7 TOTAL
- a s- 2
RECEIPT RECEIPT
DOES OTILITY COIVNEC TION REQUIRE EXCA VATION IN PLBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MLST BE
DIVISION
LIS ISSOED BY THE ENGINEERING
.
T AS A CO[VDITION.
SUBJECT TO THE FOLL OWING CONDZTIONS:
APPROVED BY:
TITLE:
DATE :
cirr use oNLv 6
L BL RECEIPT#: IVag7?-
SUBD. RECEIPT DATE: ?l0 9 Q
1999 P1-uM$iNfl PEfiMIT (aS1Dm'IAL)
crrY oF Eftsex
3630 PaoT Kxoa gn
EAsAu, hfrr 55122
(851) 681-4675
Please complete tor: ? single family dwellings
? townhomes and condos when permits are requlred tar each unit
? backflow preventer for underground sprinkler system
PIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot TublSpa
Water Heater
Floor Drain
Gas Piping Outlet ' minimum-1
Rough Openings
Water Softener ' for dwellings under constructlon
Water Softener ' for existlng dwelling
U.G. Sprinkler ` tor dwellinp under const.
U.G. Sprinkler ` for exlsting dwellinp
Alteratlons ' to ezisting residence
Water Turn Around
Private Disposal System ` MPC Iic.
(new and refurbished systems)
Private Disposal Systems ' Abandonment
RPZ (new installationlrepair)
Reminder. Call 881-4875 for {nspectlons of water heaters,
water softeners, alteratlans, etc.
EACH . #._ TOTAL
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x
3.00 x =
3.00 x =
1.50 x =
5.00 x =
30.00 x =
3.00 =
30.00 =
30.00 =
30.00 =
75.00 =
30.00 =
30.00 =
STATE SURCHARGE .50
TOTAL 30• 5D
....................... . ..........• •• • • •---•--...--•• -•• •• ••- •--• •• •---•• •-----..............--•---.... _._........... •---...--• •-•••---- ? ---..
I hereby acknowledpe that I have read lhis appllcatlon, state Iliat lhe in(ortnatlon is mrtect, and agree to comply with all appllpble Cityof Eapan ordinances.
It is Ne appllpnYs responsibiliy to r- ? - "- s no Ilabillry for any damages caused by the Ciry dunng its nortnal
operetlonal and malntenance activit VARELA, JEFFREY i City property/ripM-oLwayleasemenl.
13651NTERLACHEN DRIVE
SITE ADDRESS: EAGAN, MN 55123 .
(651) 454-9364
OWNER NAME:
INSTALLER NAME: KI3 -OM &UIUI P>I A4 TELEPHONE #: 927-/:?D33
STREETADDRESS: ? /O 'rJ ??F/?Lb f7dE ?
CITY: STATE: A0_ 21P: S 08
SIGNA4URE OF PERMITTEE
CO/PERMIT FORMS/RPLBG PERMIT (RES) • 1999
• ' ?X'i'EltI012 EIIYF;LOP-'?p pygljnpEUi14°° iDHU llFPAR17IG11T
C01IPUmATIpN
(To'be submittad vith builditig permiE applicatio.u)
One or 7'wo Family llwell.ing 0 wner
All Otlter Ukto Addi•oee
Coutraok,or rALT7 Data Vtioiie '- ''-4554v,
LIIIEAL FEBT oF .. N
EXIIOSEU Y1ALL
------=--i-' ? i t. sbove grade in
. ' TOT11L EXPOSEU WALL Ai2E(l SQ. FT.
OPAQUE WALL CotiB'1'riUC'rSVli t ?lUll Vatue x Arect •
Ue tail nuu, /F'1j
?? FT, (IJ) (A)
reCerenoa 8 FT.
r??am R• ?cU?c??r :
attaclied npn_.??,(' x 8Q. E"C.,_.?J_ql`iZ=-(?'. ?n 1U)(A)
R• FT.
sltevt? npu - U)(Q) ,
x sR. FT.. - (p) (n} .
x 8q. FT. _ (U)(A)
YiI11 mfYgI "Ull VaYue x Aroa
P{nlce & TYpe l?iJyl,ln? IOpll ? .?// ??
n n n x SQ. F1'. 1 .
of u x 8Q. FT. °-1.LI1.Lo)(A)
?? ???lf R ?s. F'r. - (u)tA)
x ss. Fm. ? tu)(n)
Dootlst value x Area .
(Inlce & Type
npn ,^ x 8Q. ? (U) (A)
n ?? npn x SQ. FT.--?=-
np?? R aR. FT. - (U)(A)
- x Bq. FT. _ (U)(A)
rornr,s Zcva?2- se I-T. ZZ ZC2'5 (u) (n)
Tomni. (u)(n) vnLuEs l z nv?ini I?ii??
n / 0
UIVIDLll 6Y TOTAL TIIILL AItEA Z,0-7)-2-
AVE1tAt1L "U" ?y •115 or leos [or 1&2 tamily dti7ellinge
I20oF/CEILIIlU t •
TOTAL AIiEA! IQr` ?
betail keference nUII ^ . C>Zl trom il?,? x SR. FT. d(rLv - ZZ??(!1(?????
ttEtached sheete. iIUII x$R• FT. ,. (U)(A)
lleoctibe oi>eningd Ilufl x sQ. FT. ., (?)(n)
in root. • `.._._..?°pn R sR. F'T.?r- (A)
ToTIIL (U)(A) VALUEg bIVIllliU 9X x gR• F'T•? _ (U)(A)
Z. ZI 2(O , 7?1A??V -1-?2 Sq.rT ZZ) Z?
''1'o'1'AL l20oF'/CEILIIIU AI2EA '
AvENA011 l'U?l ,025 ior velikilnEed roofe.
a?0
r
r
v1
III
" ?1,??k
491`? w ? I
z?)=
1 ?
?
? U1 , 647 =`llo, 48
x I44-
?E,o
'_,N? s
I?I I
? I? ? ; 32u 2q ??d = I 9 ? 2 s? ?=? q S, o
24xA8 = 22, zz
I ? q-zov&o = 4? ?o
Z? ??X?& = la?s X I= lo? ?
?---
!
_ ,42oO
9ov
I;
i
L,
??'YYI? lg w?OD
4i- Lz-?-?
? 4OV-1 r,46
glm, 111472
4Vr-O)G I`1li5
" qS 9s
Zc? 32??
3? ?c
_-1
2lF?J??
, --WALL SECTIOB--
' Dete:mining 11U1, values at Rooft Wallo Rim, and Conc. Block
ROOF/CEILINQ
1.) Interior Air r'ilm
2.) 5/8,1 (3YP. Bd.
3.) Ineulation
4.1
5.) Exterior Air Film
(&TILL)
x vat,v?
0,61
.56
44.co
.61
"Un n 1/R= iOZI iOTAL (R)=
WALL
60 Interior Air Film
7.) 1" ayp. ea.
8.? Insulacion
9.) bvIL-r-P-ITE
10.) 1•tasonite Siding
11.) Exterior Air Film
R VALU
0.68
.k5
19•vo
Z 674
.17
npii , 1/R= .O4-._-,
TOTAL (R)=Z3.of
RIM
12.) Interior Air k'ilm
13.) Ineulation
14•) 211 Fir Rim Joiet
16.) Pfaeonite Siding
170 Exterior Air Film
A VALUE
0.68
19,00
1.88
Z,oq.
.67
.17
l'U11 = 1/R= .O4-p TOTAL (R)=
_-
_?-
FOU2iDATION
18.) Interior Air Film
19.)
20. ) ?-r/ 5 TklPr?D
21.) 12" Concrete Block
z2.)
23.) Exterior Air Film
nUn = 1/R= ,07(b
:EE?
R VALU ..
0.68
// , co
1.28
.17
zoTai. (x)= 13.?z?
I
/ f3- ee
h?r?us? ¢r 13d?,5-ay% 4- h1d=n9RN _ C????'T/+i/GTivN G? .
C?c.cuc.?rro.vs ?o.?. 6' G9?/TiLEdETLF? pEG,?-
o`F r!'lAsr?- ,6?vz.oon?
LUf U )eck l
71,9/ce
I hereby certify that this ptan, sneri!icai?o-i or
repcrt was prepared by me cr ur.d; 7y Cirect
supervision and that I am a duly registA;-ed
engineer under the laws of the State of
Minnesota
Reg. No. Vj?5-? Date %/
Signed /? -??c?<-G? ? ?
This stemp and signeture?eppltes anly to?the
structural aspects-of the buifdLng'cont5l-ned -
.: ,.. ? - --
t rP n Y mPIfes- -an know-- ",:-?
ladgeor rosponsibl l Ity ofor_anyothar Parts o;?, , - ---- -------- - ----- - - - -
r
- ' - --
portiaas oi 1I{?e bui ldtng, or for prcbiY_.ectpral_?.
? ...___.
` - -
leyout and feetures etther general or spec-l-f-lc,'--?
._---....-------?--
. -- -?-
or compllence wfth mechanical, elactrical, ?
'' _ _ ----'--------- - _._.- -.- __ . . .
plumbfng and flre codes rhlcA?ara constdered-"-,
to be the responsibtlity of others.? ?- ?--.' ?---? -?--?
- ? - - ? - --- -- . .. .
RICIiARD E. ECKROAD INC.
CONSULTING ENGINEER
10130 36th PI. N.
Plymouth, Minn. 55441
r?tewTn?7
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ZX ?/? /e? P. /o? /L x /lo ? /8? ? ? ? " .{ z? S )/?t-LO?,? ?i•?+af r'A T/cC7T-TL?o
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u>E 19e-7-U.444y N.qpSr Lx iv Toisfs IN Tble-
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EiOBE
ENGiNEfRING
COMnRNY, INC.
? 1000 ER57 146tff STAEET,
A HeVznWr,v
\ .,6?- 1s52.01
GOHSlllT1H0 EH61HEfS5
piri}il7EIIS and LANO JUAVEYOQS
BURNSYILLE, WINHESOTa 51337 PH 4:2°3000
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Giogi, 07 DENDTES E"X/ST11V6
ELEV/dT/oN
DENOTES O.POPOSED
? r E[.El/s?TlOnl
1N01G97E5 91R46C7_10N or
SuRFW?5 D,e41.u46E
1043.33 = FIiviSf/FO 642qGE
FLOOR EGE!/f7T/ON
30' FRONT 5U/CDIN6
5E7'94CK L /NE
i
i?
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?EWRED
I her:by cartify that thia ia n t:,.Ie and carrsct raprceentition cs# s'trRr't Of
Itnd as thovn'snd deacribed herson.• AQ prsparsd by me an thfa .4D? daf cif
Ju,ve , 19 8g.
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5-o 150
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Plcase complece foc Single Family Dwellings
Townhomes and Condos when permits azc rcquired for each uni[
Date -2-
1-2
? it #
U
Site Address
I(.J n
t
Own
r
P
e Tele
hone M ( b?;(
y
rop
r
e p
Contractor
urnsville Heating & A/C, Inc.
Street Address 12481 RhOde Islanri Ave
--
- S-
City
.
S??
,4e. MN 55378-1122 .
St
t
Zi
Tele
hone # ( )
a
e
p p
?
The Applicant is _ Owner Ll_
Contractor _ Other
Add-on, modification or alteration to existing dwelling unit $ 30.00
f/ furnace replacement
air exchanger
/
1/ air conditioner
other
State Surcharge $ .50
I,iil FE.6 2 5 20 13
I'? l
I hereby apply for a Residential Mechanical Permit and acknowledge that the informatio is complete and accurate; [ the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mec pical Cod?s;XlTat=I and this is not a
permit, but only an application For a permit, and work is not to start without a permit; t t the work will be in accordance with the
approved plan in the case of w1o,r,k /w?h,ich- requires a review and approval of plans. ?jRAJrWY1
Applicant's Printed Name A licant's Signatut
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA166569
Date Issued:01/20/2021
Permit Category:ePermit
Site Address: 1365 Interlachen Dr
Lot:12 Block: 1 Addition: Fairway Hills 2nd
PID:10-25601-01-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Jeffrey J & Terri L Tstes Varela
1365 Interlachen Dr
Eagan MN 55123
(612) 868-1687
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature