2114 Jade LaneCITY OF EAGAN Remarks C2C13T GY'OYA ACCjlllsit,i0ri
Addition Cedar Grove #3 Loc 6 eik 2 Parcel 10 16702 060 02
Owneov f ? ri :0 ri .G e. Street 2114 Jade I.iBrie State Eagan,M[J 55122
Improvement Date Amount Annual Vears Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
#SEWERLATERAL {q 1972 1304.00 2,1 2 P31d
WATERMAIN
WATER LATERAL 1 2
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STFiEET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
EAGAN TOVO/N S 1-i 1 P
BUfLDINC PERMI'T
Ownex C.X-sLe?? ------- 6..? .
........_.__._.. _. . . J ? . / _..._._....
, . Address (Preseni)
Baiider _ ................ _...... ....... ........ . ? .
Address ---- ?-----......... ........ ...... .._-------- _.......__...........
__..-----
?tor?es 1'0 l3e Used For .- -- Froni -Depih Heighf Esi. CosS P rmif F
i 0
M ] 060
Eagan Township
Town Hall
Date _...... ?......._......._....._... _
LOCATION
- ? - - ----- - -
Sizeei, Road ar o2her DescripSion of Locafion '
- Lo! Ellock-I Addifiom or Trac1
I_
? ? -`-- q-:a- . ? ?' ?-- -- --- ----
,. i 7 - /e- ;LJ - !?i-? S"
-----
This ?e-cmii 'does noi auth- oi i?he use of slreels, roads, alle s or sidewalks nor does if
p y give !he owner or his agenf
S3xe xighi to creale any siiuafion which is a nuisance ar which presents a hazard to 2he health, safely, convenience and
general wc:fare to anyone in !he communify.
THIS PERMIT MUST BE KEPT ON THE PAEMISE WHILE THE WORK IS IN PAOG?R/ESS.
This is to eerlify, Shai.L`.-:yy .--1¢.au?--..-_-4_1 _..._.__.... _:has permission to erect a_
. . . ..,? . . ......
...
..upon
!he above described nremise subjecS to ihe pxovisions of 1he 8uilding Ordinance for Eagan T? nship? .ad'bpfed April 11,
1955.
•?..- G, i /)?/ +
?............. ...... ......... Lc4?._G .e:L.i ?at a. Per _
. ....._..._........................... _......_.......GC^?Li. .... <..___......._........................._....._.._..
Chairmen of Tnwn B?rd 7 Building Snspetior ?
?z / ?
void 18 months from C, ?o c?s 7L'39
9
r-c3iC?12)Q '.R 5304?
Date of this RequestJr- a p '? 7 y
I, as ? Licensed Electrical Contractor f}d'Owner, do here6y request inspection of the above electri-
cal wiring installed at:
Street Addiess or Route
Section Township
1Vhich is occupied
Range County ?-
(Name ot ottupanq
Is a roughin inspection reqmre ? No ? Yes ? Ready Now ? Witl Call,k
Power Supplier ddress
Electrical Contractor -? ' Contractor's License No. -
(COmpany Name)
Mailing Address
(Electriwl C nlractor o wner Makin9 This Installatlon) '-
Authorized Signature Phone No.37
(Electrltal C tractor
s Installatlon)
no ctian re uest will not 6e acce ted 6 the
'wr
?? A5? ?f E (?O??D ?O ?? St This ins eate Board unless proper inspectian feais en losed.
Minnesota State Board of Electricity
Unjversity Ave., St. Paul, Minn. 55104-Phone 645•7703
EQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
R 5304
Type of Building New Add. Rep. Chmk Apptiances W'ved For Check Equipment Wired Fm
Home ? 19 ? Range ? Temporary Wiiing ?
Duplex ? ? ? WaterHeater ? LighlingFixWres ?
Apt Bldg. ? 11 ? Dryei ? Electric Hea[ing ?
Commemial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditionei ?f'1.? Bk Tank ?
Farm ? ? ? List ?r? ? 15 ?
?.
Othet ? ? ? p
Hehc?S? ?
eh
COMPUTE INSPECTION FEE BELOW
Smice Entrance Size: ? Fm FeedersB.Subfeedecs: # Fm Cilcuits: # Fm
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am etes r
101 to 200 Amps. 31 to 100 Amperes 1 to 100Am ies -
Above 200 Amps. Above 100 Amps. Above 100_Amps.
TransFormers 1 1 RemoteControlCixc. Partial or other fee
C
Si ns Special Ins ection Minimum fee S5.00
Remarks ?
T 7 ?? f TOTAL FEE
I, the Electrical Inspector, hereby certify
(Finai)
This request void 18 months from
been e. -..3,-Y
e 7
e ? ?CT?
CITY of EAGAN
BUILDING PERMIT
Ownes ? ......1...."...'...?? .. .
.................. ..............
Addrecs (Pres !) .._ 1/..._J........ .
..?
Builder ................--........................-.-----..................
Addreu ......--......................................................................................
N4 4060
3795 Pilo! Knob Aoad
Eagem Minnesofa 55I22
454-8100
Dats
Bioriae To Be Used For Fron! Deplh Haigh! Esi. Cos! Perml! Fea Romarks
e
a? /?` a s `m
'L'?6_
LOCATION
Slreel. Aoad or olher ion af Loaalion
Deseri
pl I Lot Sloak dilfon or Tsac3
Ad
111?/ ?B? /
?
N ?..n / I G f? n
! l?e4(6(/[ 0,? -3
T6is permit dq6a aot euShorise the use oi slrcefe, soads, alleys or sideaalka nos doea it gtve !h6 owaer or his ageaf
the righi !o ereale anp siluetion whiah is a nuisanca or wh3ch presenls a hazard !o the .healf6, aefelp, eoavaeleaee aad
general welfara !o anpone in the eammunilp.
THIS PERMIT MUST BE jt. EP TJ?E PAEMISE WHILE THE WORK IS tN PAOGRESB.
Thia ia !o cerlifp. !hal... . ....?j'?? .:................has permissioa !o ereet a...... ..??f.-(.G-? ....?.._................._..._upen
the above deseribed pre ' sub'eat fo the provisions of al] applic es fo fh Ci .
..----°-°G`.-_-_• ........... ..'--• •---.... .._!?.......-_-'---........ Per ....... ._ . ...... --'°'...--'-.. ?:...................._.....
May Buildfny Inspxtor
f
.......
Eagan Township pERMIT NO.?a a..0
. Dakota Counly, Minnesofa De=0 ...... •...................... -""'_
• ? Applicalion for Bnilding Permit
Tppe of building or work eonlemplaYed. Circle correet descriptions.
Aes?dential Commercial Indusirial Oiher--.------------- ..-`--------- ....------- ......... ......................... --.°-....--°.--
v
Suild Enlaxge Altes Repsir Ins3a11 Move Wreck Oiher------- __--------------------------------- ............................
Dimansions__...SX--a-`-s-?-....----...... Cosf?...oCOOO...._......
DeYails or
Loeation
Number StzeeY Be.lween what cxoss sfreels Size Esi. ValuaYion
Of Il LI v Q6ti dr(A v1.V
LoY Bloclc Addition Rear:angement ox Traei
b a ? ? 19
.
Owaer .... "?_--J7..... `.'.?A(Y. ................. ..."--"-.--"'._. Add:esa ..- ; 2 ../,!.. _I.... - Ja_(L....?CJAILL.{...._\ L(aY-1................
Coniractor ----------- '--------- .........
d 12
U S??!
x-
S"'?
Tolal fee aollecied.
Permf4 fees are aot
sefundable.
Address
The undexsigned hereby makes application for a permi! !o
do work as herein specif?ed, agseeing fo do all work in strict
aceordaaee wifh 2he building oxdinanee adopled April 11, 1955
by fke Eagaa Township Boasd of Supervisoss.
Sigaed
RESIDENTIAL
BUILDINC PERMIT APPLICATION
p., CITY OF EAGAN
[3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construetion ReauiremeMs
• 3 reg'stered site surveys slawirg sq. ft of lot, sq. ft of house; and all mofed areas
(20% maxunum lot cove2ge allowed)
• 2 copies of plan showing beam & window srzes; poured found design, etc.)
• lsetofEnergyCalculalions
• 3 copies ot Tree Preservalion Plan if lot platled after 711193
• Rim Jolst Detail Optbns selection sheet (bldgs with 3 or less units)
DATE _
SITE ADD
TYPE OF
APPUCANT
RamodellReoalr RepuiremenM
• 2 copies of plan
• isetotEnergyCalCUlatansforheatedadditions
• i site survey for cclerior additions & decks
• Indicate if Iwme served by septic system for additloiu
iULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
VALUATION ?TO? ' °?
STREETADDRESS CITY.
TELEPHONE #k? ?S? 37k5 CELL PHONE #
PROPERTY OWNER
FAX #
?cl.a5
-1 ?c) a'
ZIP
?--
TELEPHONE #
COMPLETE THIS SECTION FOR °NEW" RESIDENTIAL BUILDINGS ONLY
Ener Code Cate9o ?????? I
9Y rY MINNESOTA RUI.ES 7670 CATL,GORY 1 MI 'S?O?T?yA RULL? S 767Y
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • Energy?C?eqV et
• Energy Envelope Calculations Submitted _
%?
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $90.00
Fee: $70.00
-------°----°-----°---------------------° °----°------°------------------°------°--------°-----------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
_ WaLer Softcner _
_ Water Heater _
No. of 13aths
_ Pt10nC #
Lawn Sprinkler
No. of R.I. Baths
_ Air Condiaoning
Heat Recovery SysCem
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
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MASTER CAftD
LOCATI ON
OWNER
STRUCTURE AND V ?
LAND USED AS ?49 -ox ? S 00
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS WSTALLING
SANITARY SEWER -
OTHER I
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING a-, SEPTIC
FOUNDATION CESSPOOL
FqAMING TILE FIELD " FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Ci
- ?- 'Al
?
?
Violations Noted
on Batk
COMMENTS: 1
-? 4
City of Ea�an
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE r BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
o r r
ra
7
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 2. •
Site Address: /%
Unit #:
Phone: • 1 — S ge—
Applicant i3
Owner Contractor
Description of work: (,-,f.. )
Construction Cost: . b (/(J Multi -Family Building: (Yes / N
Company: \.JvhD/Wi'1\ Y e -in t dpleL,'J4A( Contact: •. _ .. .
Address: 14'7 �' l:� V per. _( Ciry /7/ i�'c
Contractor
State: / i/ AV Zip: 55-0/ Phone: Phone: L-1" 6 O `-7 -- ' IRO
License #: i_ %Z. ) / 7 `t d Lead Certificate #: N 141g76 g76 &`-i- 1
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:
Plans and supporting documents that you submit are consideried"t be"publicm1tiiforl»atio
information may classi ed-asnon-public, if you provide:;sp c r> soris.;that.:t uid7per
conclude #hat ibe are trade secret
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. C II 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.oru
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and c• es 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 t - work will bein
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 b - compl = within 180
days of permit Issuance.
Applicant's Printed) Name
judy.h@customremodelersinc.com
X �
Applica 's Signature
Page 1 of 3