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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 % rcrznrLr? /?.,.,iscr-/?2Ef ?r?J• ?v.ric.r?sc.ar `,?.r,... ?TUAnr [.?+w,aa?l? ', z x 5??,?, 8,_ ?o ? z Np ra ?(o =o ` ,t Z.?o.rrvcrs-os.+ r?"?? ? ZX ?/? /e? P. /o? /L x /lo ? /8? ? ? ? " .{ z? S )/?t-LO?,? ?i•?+af r'A T/cC7T-TL?o _ 390? - - ? . 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I Z¢?/•/)C/Obx?f7.L3? i.T4V?o> u . _ . . G.L, ? - 2Q? ?/?/'X/O? ?rJ7,b1? ?i x,Ld _ ..?9 .. _ f.oeJfe-ir.?.qTrdE GI?EG/L ?Z T/f, rG1LGDe.J •b . ?L.L. ? .v ?J ? ?..L. . ? . Z 3 ??1 = .. - ./L?? 1 - . . .. . . . . - . '- ? vfa- *-z su7//. yEZts?u! ?in?E. 2.X8?8'e6 aa- Oouac.6r .z-x6 ?/b o.c, -Trr?rso . . Fc.fsfs OA?o Gquca?- rrs /2.?f3 0 .Td_P_iz.bv?r_ lo?r?TEZ ?2o?a E•vrrf/zaNy Tff?c•?rve..lr a.? T.? f/vuscs ,aN? ?r3usi,vy ?7c=c.tY. Torcrs 5f,°ouLO EXTte% .c3ire.? eva?z 2.?re.nio?- ???.9rLi?vy /.rlRt.? i9•vo 6ES?i.?EO ro zx ia Fi.a?2- f/lT?. Iris.eEr-o??+'??Hso Tf/rrr ,?9i,v 4uTrE25 6 E in?r???O o.v G?/E _ D t/E/L ?EC.t . ._ , . •, 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 CerZZ}Z ctzZe SS?t-?--?'e t? aqcl .De4c2-t-e2iorL: LaT iz, BLacK /, F41RW.9>' HiLLS zNO AovirioN, G74ICOTA CDUA/TY, AVNN6_07A I ?o35,z? DRA?A-lAgE 1,KI,9 07-1117Y EASEM?NT--? O, ? /? ti0y o •cb ya?° ? `o ? `? • o .. J S o\ '? ?? \ ? ?• S60BS? ? ?A4 , ti F 69,?°'e>., S 6po ? Op `9 c < R\ )BS / ?R `0? ' Cj> ?•s?, ? / b e, ? ? r / , 6'v'p9 ?O 7 ? .r i , ? Q E?G6.? ?J`3(o.7 1 ?UV ,ED LLPT 30 j 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? ??????? ???? ?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. _ „ , 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