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1477 Lake Park Cir 2011-08-0816:08 77 651975 5694 P 213 Use BLUE or SLACK Ink U" For 0111cie Use I I 1 Perrtit i City of Eap Permit Fee: (f~ 1 3834 Pilot Knob Read v` j oats R ~ I , Eagon MN 53122 I Phone: (651) 675-ST5 I I staff Fax: (651) 676-M94 1_, - 2011 $i2011 RESIDENTIAL PLUMBING ERMIT APPLICATION -7:7 /1 ko t Site Address: r OA r Date: Tenant: suite 0: - - RESIDENT I OWNER Name: Phone: Address / City I Zip: CONTRACTOR Name; I License _ Address: a.5 `a j: y, City: 36n3&*i State: r v zip-, :5 Phone: La t o 9VE 241c a Contest: 306orl Email: TYPE OF WORK )a_ New Replacement Repair Rebuild Modify Space _ Work in R.Q.W. Description of work: A .43 PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation („r, RPZ /)a PV13) Add Plumbing Fixtures Mein Lower Level) septic System _ Water Turnaround New Abandonment RESIDENTIAL. FEES: $55.44 Minimtatt Water Heater, Water Softener, or Water Heater Wrt,d, Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround" (includes $55.00 State Surcharge) 'Wader Tumaround (add $196.00 if a 5Rr meter is required) $105.00 Septic System New ($10.00 per as built) (includes County No and $5.00 State Surcharge) $96,00 Fire Repair (replace bunted out appliances, duetwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL.@EFOg Y6u Dig. Call Gopher State One Cavil at (661) 454.0002 for protection against un&rground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.goi)herstalteonecall.orc I hereby acknowiedge that this information is complete and amurals; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a peomit, but only an appaa-atim for a permit, and work Is not to start without a`permit; that the work will be in. accordance with the yappproved plan in the ccase of work wNch mquires a revlow and approval of x ti 0 11 Ld_A, ^C,[_)V t x Z/ /,2 Appllc,rnre Printed Name Applicant' lgnaturie FOR OFFICE USE Ravlowed 13y: pate: Required Int pocdontt: -Under Ground -Rough-In Air Test -Gas Test Final ~y ? CASH RECEIPT ? . CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE - 19 eacarvac - FRpM AMOUNT $ ? r & DOLLARS ?oo 0 CASH E] CHECK `-7 ^ J '?I 1C t"l?. t?/? ?/ f. -f`? l .?•/' t? . FUNO CODE AfAOVNT 1 .r?'! ?C. . '. ? .'?.! . 7 /Ci ` v Thanku (/?`?- ./? cJ - C•,i?, ? i- BY White-Payers Copy Yellow-Posting Copy Pink-File Copy ?• - BUILDING PERMIT ?e L. uud in. •.. , 1, - --?.? ----z----F,-,,? CITY OF EAGAIV _ 9StL? 3830 Pilot Knab Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 • . i Recelpt ?F tx?`t=u?n $150.000 ,,,,,e SEPTEMBER 19 34 Site Address t-s r? i,rAC, re LOt 4 Block 1 Sec/Sub. Parcel No. W Name ? Addre ,? Name ?§ Addre h Citv SAiME Phone Nfame Address City Phone of Siqnature of Permittte JAMES A _` .:t A Bullding Permit Is issued to: oll work shal l be done in accordance pl+ooble Sta?te of? 11Aii Buildinq Qfticial ? Erect ? OccupaRCy R3 Remodel ? Zoning Repair ? Type of Const. V Enlarge ? No. Stories Move ? Length 8 Demolish ? Depth 46 Grade ? Sq. Ft. __ Assessment Woter & Sew. Police Flro Pionner Council 9 6 84 Bldg. Off. APC Var. Date Pe?mit ,- ....g., -.T Surchorye 75, ?a Plon check 279, 0 S,e,C 525.00 Water Conn. _470,40 Woter Meter 6"A..9 0 Road Unit 260- p Parks rotai _ S2, 230 .50 on the express tonditlon thoo and City of Eugan Ordinonces. Pxrrtit No. Parmi t Holdw Dsts Plumbing rn 5 ?3, ? ''a,.?( H.v.e?.c. eNce.ic Zo T cs0 $ottener Inspettian Date 1nsp. Other Foatings l -f `) , ¢? a -3 Foundation 4 -a? Sc? <„ Framing Rough Plbg. ITIII 47-2S_ Rough HVA C Inwlation Final Plbg. Final HVAC Final Cert/Occ. Ow KJ Vyster D Lacation: Wetl 5ewer Pr. Disp. ` Receipt '( ?)I 7 MECHANICAL PERMIT Permit No. ,/ CITY OF EAGAN F? `f ll in numbered spaces S/C or Print legibly Tot. 1, Date - ,?Dype 2. Installation Cost ?Oo c 1W 1 L?tK,E 1-?-?,21= ???.L-E 3. Job Address , Lot Blk, Tract 4. Owner? ? "'??? ' ?• ` "' ? ? ` ? 5. Contractor J ?J Phone 8. Address \IG 7. City U State Zip? 8. Building Type: Residential ? Commercial ? Institutional O 9. Work Descri tion: N " LT Add Alter ? Repair ? s Ns?\ ??. ,-E ?.,?? ? c- ?? 10. Describe ?? , '? Fuel Type 11. No. ? Equeoment 9TU - M. Ea. Forced Air No. EQUiament CFM Air Handling: Mfg. Boilers ,p? E h Mfg. Mech. aust x Unit Heater Mfg. Other Air Cond'?"?"' Mf9• Gas, Piping Outlets 12. I hereby ce'fy that the comply with ordinan ? Signed : Rough Date InsR• is true and correct, and I agree to ning this type of work. for Finel Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt Io1S4q 1. Date 3. Job Address _ 4. Owner 5. LUMBING PERMIT Permit No. -' CITY OF EAGAN Fee ill in numbered spaces S/C ' ype or Print legrb/y Tot. ?LIi . Installation Cost ' Lot?_Blk. Tract 2hone ? - / ?6. Address 7. City State, = %Z i p 8. Building Type: Residential-El"- Commercial ? Institutional O 9. Work Description: Near•rr--?Add ? Alter O Repair ? 1 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? . Bath tubs 5eptic Tank -r %L 1 Lavatory Sottner ?1 Shower Well f Kitchen Sink Urinal/Bidet Other ? Laundry Tray ? Floor Drains Drinking Ftn. Slop Sink ' Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: , for Rough - Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarks Addition Thomas Lake Addition Loi 4 Blk 1 PS,cei #10 75900 040 01 owner Street 1477 Lake Park Circle state Eagan, NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ('Q 34 1982 2 b.31 591.31 11$2,63 C009422 -13-8 STREET RESTOR. GRADING ,sGl, 146,39 C009422 -13-84 SAN SEW TRUNK `3Cy 1976 273.90 24.93 15 109.56 C009422 -13-84 *SEWERLATERA? _6-C 1258.35 C009422 -13-84 WATERMAIN ,t WATER LATERAL WATERAREA 51 1977 250.80 16.72 15 117.04 C009422 -13-84 STORM SEW TRK 1660 496-54 9931 99.34 C009422 -13-84 * STORM SEW LAT CURB & GUTTER SIOEWALK STREET LIGHT Road Unit 260.00 9-19-84 WATER CONN. 470.00 ? BUIlDIP1G PER. SAC 595.00 t PARK -T. TY OF EAGAN SEWER SERVICE PERMR 30 Pilot Knob Road 6,, 2 0 0. Box 21199 PERMIT NO.: igan, MN 551Fl DATE: ` ++rr+0= No. of Untts: ?r, a?:c_s 1? ???rt n Address: -Ir.-L-11 i I.N.. ee .a.* vd& K. City ef Mw¦ CoroocHan Choops: `+ L.D• u u a ? pMnsna.,, Acoount pep"t: I5.0 pd ? ' P.m,tt F«: 10.00 pd ? Surcharge: .50 nd BY Misc. Chorprr ? date of leup.: Total: ? InsP.: DoM Poid: lZPCITY OF EAGAN 5830 Pilot Knob Road . O, Box 21199 Eagan, MN 55121 oninp: Owner: 4 ?!arti.l ? 1lddresa: , Sice Addness: 1477 Lake Park. Plumber. [L'hompsoii Plb? r Matsr No.. 51u: Reoder No.: I "l" to aae* WMr Nw Cky ef Edw¦ Orriw- ne, ey Dete of Insp.: ilot Knob Road ox 21199 MN 55121 Jdii!NR Add?tss: 14 Size: /I , Recde No.: -0?? I "!m te oMPlp MM& 11w OediNneM. / WATER SERVICE PERN?R ERN PERMIT NO.: 5 7 30 D^TE: o-- 24 -34 --- No. of Units: 1 Q Connection Charpe: _ 4 0.00 ,Lad Aocount Deposir. 00 nd Parmet Fee: Sundhnrye: 5Q ? Miac. Charper. _ F 3.??J nd meter Tofal: Data Poid: Irttp.: WATER SERVICE PERMIT PERMIT NO.: DATE: • ` ? ? * - No. of Untts: 1 Z Connection Charpe: _ 470.00 » d ? ? Acoo" 4)ePOStt: 15. 00 pd ; ? Pe?mit Fee: - 10.00 Ad Surchorge: nd Miat. Choryes: D d mz ter Total: ?Dots Poid: Insp.: ? _ ? ., .- ?c CITy pg EAGAN Include 2 sets of plans, 1 LI ?? ?? ?? 3 Gertificate of Survey &' BUILDING PERMIT APPLICATION 1 set cf energy calculations. 11 GAR.uation -A ?rO ?OO . 00 Date Zb Be Used F? ? ? w a ?N Val Site Address tMDMaS?AKe 490SOFFICE USE ONLY Lot ? si«-x sec./sub. 2dZ??? Erect )<_ ocuupancy -- R-3 Parcel #: Alter Zoning ?- I Owner:?eS • ?"`???? Address: \?>D b ? ? '18?` ?- • . ?'Dl City/Zip Code: Prwne #:WK, d8j-j8a1 Aes 169-4g1qi Contractor: Pdclress: City/Zip Code: Phone #: Arch./Ehg.. Address: City/Zip Code: Pnone #: Repair Enlarge _ TyPe of Const. ? Move # Stories Damlish Front ft. Grade _ Depth ft. ?qater/Sewer Police Eire Pexinit Surcharge 1 S. =° Plan Check SAC gg, Water Conn. 4-70 ? Planner Water Meter (o 3 . % CouncilRoad Unit 2 -b0 --f'- Bldg. Off. LOPY APC TriPAL e2 1 a 3 6' J 0 ???. ?- I 4oc?) x s4 - (L:,4 x 54 ? IZ£? ?- 4( Z??5b - l q Go X 4 ? - . -7 (c:,oo 3 45co 5Z4E) G864 5"1400 2?24- l5 r, i?12 ? CITY OF EAGAN N? 9514 3830 Pilot Ktrob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454•8100 [??$2 BUILDIN6 PERMIT Receipt # 1 _ l Te b uted fw S'' DWG/GAR Est. Vnlue $150,000 pate SEPTEMBER 19 1984 SiteAddress 1477 LAKE PARK CIR Erect IN Occupancy R3 Lot 4 Block 1 SeclSub. THOM LK ADD Remodel ? Zoning ?- Parcel No. Repair ? Type of Const. V Enlarge ? No.Stories ? Name JAMES A MARTIN Move ? Lenyth 82 = 1306 E 78TH APT ST. 201 Demolish ? Depth 46 ? Address CitV RICHFIELD phane , 869-4879 c.ade ? Sq.Ft. o SAME 881-7891 (W) Avvo•als Fe.• , Name z , O?u Address ? City Phone ~W Name c Address U ?w City Phone I hereby otknowledge that I hava read this application and state thot the inlormation is correct and ogree to comply with oll opplicoble Sfate of Minnesota Stotutes ond City of Eagan Ordirances. Sipnoturo of Permittee A Bullding Permit is issued to: - ull work sholl be done in accordance Bufldinq Officioi JAMES Assessment Woter & Sew. Police Fire Enq. Planner Council em9. off. 9/6/84 APC Var. Date Permit --- ° Surchurge 75.00 Plan check 279 - 00 snc s2s_no Water Conn. 470 _ OQ WarerMeter (; -4 - ?0 Road Unit 260 ?0 Parks rotei $9,930_50 on the express cordifion Ihnt Statutes and Ciry of Eagan Ordirwnces. ?° ?Q REQUEST FOR ELECTRICAL INSPECTION - s O22 7? SeeNstrucUans tor completmg thl9 krm on baGk of yallow coOY eao'ooo/1 "X" Below Work Covered by This Request e Add Rap. Typa oi Building Appliances Wired Equipment Wired Home Range Temporary Sarvice Duplex Weter Heater ctric Heatin Apt. Building Dryer iw? Load Management Comm.Andustrial F ace Other S pecity) Farm ir Conditioner Other (sOecifY) Cont2clor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Clrcuits/Feeders Fee Swimmin Pool 0 to 200 Amps 0 to 100 Am Transformers Above 200-Am s Abova 100 -Am s SI nS Inspactors Use Only ?'7 ? > TOiALJ Irrigation Booms , .J6? ?? ? v S ecial Ins ection ?v Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTH5. I, the Electrical Inspector, hereby Rough-in oate certity that the above inspection has b00n f118d@. Final Date 2. ,. L?C OFFICE USE ONLV ? This requesl voW 18 mon[hs trom Q 02 6271, a? ? ? ?o Requast Oate Fv No Rough-ln Inspeciion Feqmred Ins ecll OIherThan Roughdn ? (VOU mustcallinspector,.!?heJn eaRy) ? aetly Now ? WIII NoY Inspactor - Y - ? ? Yes ? RO Date Rea _ Ia?ricensed contractor ?owner hereby request inspection of above electrical work at: Job Adtlress (Streel, Box or Route No ) Qy ?C 2,-? g eqion No. Towns ip ame ot No Range No County Occupent (PRIM) P one No. l ZL? ? Power Supplier Ka".. Aatlress Eleclncal Conlreoor (COmpeny Neme) ConUectofs Ucanse No ing Adtlress (COnVactor or wner Makmg Installalmn) ? ALIC. , Au onze ' naNre (Contractor/ n Making Installation) Phona Number IdNWESOTA STqTE B ARD OF ELECTP RV THIS INSPECTION REOUEST WILL NOT Grlggs-Mltlway 91tlg. - Raom 5-128 O r BE ACCEPTEO BV THE STATE BOARD 7821 Univeralty Ave., St. Paul, MN 5510C UNLESS PROPER INSPECTION FEE IS Phane (612) 692-0800 ENCLOSEO /•„Fq REQUEST FOk ELECTRICAL INSPECTION pEB-0000/1-04 ? V? ? 9 ' See instructbn„forAlIntaileLng this form on baek o1 Yellow copy. An 7"1 R`Y "X" 8 elow Work Covered by This Request ? Navy Hdd FeP. Type of Buildrng APPliancea Wiretl EquiUment Wired Home Range Temporary Service Duplez Water Heater Lightiny Fixtures Apt. Bwlding Oryer Electnc Heahn Commercial Bldg. Furnace Silu UnloadP.r Industnal Bldg. Air CondiLOner Buik Milk Tnnk Farm Othei peuly Othe, ISt?eu/y) t er SUecity Dt er Othcr Comnute Inspec[ran Fee Below p Fee ServiceEnhanceSiza F Fenders/Subfeeders N Fee Qrcuits 0 to 200 Am s 0 to 30 Am s 0 tn 30 Am s Above 200 qm ps 31 to 100 Amps 31 to 100 Am s Swimminy Pool Above 100_Am s Above 100_Am s Transiormer5 Irrigation Booms Partial.'Other Fee S i gns Speaa I I nspecLOn SS? ? TOT R¢rrwrks y FF?- ? Rough-in th Elacvi' .. ? Inspe eby ? certity that the above Findl ^ ? ?pecpon has bean 11? ?? n 1 Riie reauast vmd 18 montOS irom This request void ?/ ? ? 9 18 rtronths from ?(J / An75G9 Lq 1?r 7?s? L. I Fenuesta e ? r1] Fire No. RouAh-?n Inspecbon fl9piired? ?Aeatly Now Will Nobfy InsOec- 1or Wh R ? yj?? ? q] es No en eadY ? - i ? ?Licensed Elec[riwl ConvacIor I hereb rey quest insOection of ebove Owne? electrical work mstalletl et Sveet Address, Box or Route No. A 1 ?A 4 C?Zc+.f. C tY ? ?R eCLOn o. Township Name or No. Fanpe, No. County ? Oc(;u?i IPPINTI A '?'? 2 ¢09? Vo. 1 ??? ?r> ? a0 PowerS PPher -IU 4 i Address l.E 0 Elec[ncal Contractor ICOmpany Namel Convar.tor's License No. ? P, Mailme Address (Conhactor or Owner Makinp InsiailaLOn) Authonze ?gnamre ICOnVa or er M2 i e InstallavoN Ph ne Number 9?l lgoltwiq MI JESOTA STATE 80ANO OF ELECTNIC,TV THIS CINSPECTION?EQUEST WILL NOT Grig9s-Midway Bldg. - Room N-191 BE ACEPTED BY HE STqTE BOAqp 1821 University Ava., SL Peul, MN 65104 VNLESS PNOPEfl INSPECTION FEE IS Ph.nw 16121 297-2111 ENCLOSED. . G'j :'t'«I..^.u.T..° P:JP: ti - ,?.S2to M:1rit7 t 4?1 Wc:,t "-34th 3trret B1ooMlnr;tc:n f55410 ,, r n DELMAR H. SCHWANZ LANOSURVEVORSI IA1C, RlqiStBrotl Un0<r Liws Of Tlla Sblb Ot MinnasOtt 2978 - 145TH STREET W. - BOX M RQSEMOUNT, MINNESOTA 55088 PHONE 612 423-1769 ' SURVEYOH'S GERTIFICATE ? f . 3CALE: 1 3,nch - 57 feet a boY//? 7 Elevatf.on; :?hoan aa^c: exictY3.ne; , U Ik:notea aet wooti hub ' o L'enotes iron pipe ; ? i 47j ? I Dra3nage . ` ? Eaoement Propoaed gar3ge flonr i ` alevatlon ? ; ? i ' ? I ir \ w J? \ I r ? I e Q 9+?0 N71-7?.qt?? . I 30 I4^,? '-hp SEp '? ? I horeby certi fy that thia 1 c a true ar.d as? s;? ? ? ?'' pPNJe correct reprenentztion of Lot 4, Block l, TN.OI:AS LA::E ALT?'M, accordin?: to the recarded plit therco:, Dakota Count.y, i ? ' QqR ?4 t:inneoota. y? ? ?6 ryp e HJ0 plao ahowing the location of a propoced 1 99g ?o ? oJ,tO° houae as etaked thereon. rl ? ti N:?i Dated : Aueugt 2(i, 1964 ? I ? Drai7age i utility eacctlent ? 7 9b I ??a <? 5.? 1' j?' ?GC . a_/ "LL.Lc 'a ?/? ?I - ?7.?' • i,??.- ?s? MINNESOTA REG75TRAYfON N0.8625 . .. ?s= ? - s a LEVA7'og S ?^V-. F¢.oa1T 930.0 KEn.f- 930•33 F125T FL. q3d. CP?O 5o?.,5e M6+aT `{ZI. Cv ? ----. ? _ .•; . ? ? \. ? % I ? ~ \ \\?\ ` \1 F l ? \ `? 1 ,• ?1 1 1 , ? J - \ ?? ,? \ ,?1t \ ? 7 INI \? I 1 I I? 1?• \\ \ SM ? vE?- «-T" j I. ALL Gf2A?E5 ? Ll?i?l ?E \ ? ? ; 1? ` ?.\• .? ? ?\ ? ? Z a I 2. AflAqveeE SoIL ; .- - ? } ?. , ,- ,77 , t 36. 3 } ? ??`\\ 1 ? k ? ? A?"/ l ? LoT 13 -' RASMUssEf.-l p?ao. q? k MAR-TIEJ (L.?S. ?' T'}+oMA-S ?1c.E ? r i x . \ ? ?\ ? ?dR T--- •-= `-LJ v "ko? n? -k- CT'r'? fl;-' ; ?'FyMi,• ,'Ic?IT I_ F'7,?t_"!!)1 '•c21.0 '2Il[la. .'477 Lr^:?:.=: f'li Cl. Af?.F':1 ..,?:'" .tE?'_'lr .?.:?L_iil V. . ? :r; ,;'{,:N::, "k;k'...>... ??r?-..;,.;:? ?., ,.?? „ . .... ? '•?. 3g 2Co? 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4875 New Conshuctlon ReaulremeMs > 3 registered sNe surveys showing sq. R. of IoL sq. R. ol house and gQ roofed areas (20% maximum lof coveraae allowed) D 2 coplee of plans (show beam 3 wlndow slzes; poured tnd. design: efc.) ? 1 set of energy calculafions > 3 coptet ot hee preservaHOn plan H lof platled after 7/1/93 DATE: DESCRIPTION OF WORK: STREET ADDRESS: LOT: _t PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER 1?L Remodel/Reoalr Reauirements 2 copies of plan 7 set of energy cakulations for heafed addHlons 1 sRe survey for exierlor addiHons 3 decW CONSTRUCTION COST: BLOCK: ? SUBD./P.I.D. #: ?O Name: S?w? ? ? ?Ii?l Phone #: ?? I "1 "/2? Y12??0 Last Flrsf Ciiy F'.?An State: V Y 4 Iv Zip: ?,l22-' Sfreet Company: ????!?r? "???" "-' ?' ? ?,' "` Phone #• (area code) Sheet Address: license # ExP• City State: Company: Name: Telephone #: area code ( Shee't Address: Registration #: Ci1y Sewer & water licensed plumber (re+uired for new conahuctlon onlv): State: , Penaly applies when,address change and lot change is requesFed onee permN is Issued. Zip: Zip: I hereby acknowledge that I have read fhis appllcaflon, state that the Information is cortecf, and agree to comply wffh all applicabl State of Minnesota Stafufes nnd Clty of Eagan Ordinances. , Signature of Applicant: 1/14 OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _, Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool V 25 Miscellaneous WORK TYPE 9 r ? '& ,5 ? 31 New ? 35 Tenant Impr ? 39 Gas Line On ly ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.• ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demol ition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code 6)/ UBC Occupancy sq, ft. No. of Units ? Zoning sq. ft. No. of Bldgs _[L # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinkiered APPROVALS Planning Building ? Engi neering Variance Permit Fee Valuation: 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: SAC Units % SAC iqa 9 4099-BUILDING New Construction Requirements PERMIT APPLICATION (RESIDENTIAL) CITY OF EAC}AN 3830 PII.OT KNOB RD - 55122 ?- ,rJ_01 c;,681-4675 ? RemodeURepair ReCUirements ? 3 registered site surveys ? 2 copies of plans (inGude beam 8 window sizes; poured fid. design; etc.) ? 1 energy wlculations ? 3 copies of tree preservation plan if lot platted after 711l93 required: _Yes _ No DATE: DESCRIPTION OF W T?.?\:i STREET ADDRESS: ? 2 copies of plan ? 2 site surveys (exterior additians 8 decks) ? 1 energy ealculations for heated additions CONSTRUCTION COST; LOT: L1 BLOCK: l SUBD./P.I.D. #: O VV\-Pti n U4 a Name: Ca bW- Phone #: tcs?- ?-Jsa- joc "rJa PROPERTY Lazt First oWNER 1?l l a? ?k C?t ?.l? Street Address. (?i._ City r5li,G AState: Zip: Company: QY\C-Y ` iY?.1 pfione tt: CONTRACTOR I StreetAddress:c-?17q ?i(?Q.\?l L0, Ck :? - License# bbC7 ( Q?.? ?Ij City I 1\?,S State: /)-mo Zip: d ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street Address: City State: Zip: Sewer & water licensed plumber (new wnstruction ony): and lot change is requested once permit is issued. Penalty applies when address chang I hereby acknowled9e that i have read this application and state that the information is coRect and agree to comply with alt applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant ? ?^x - ?• ? ? OFFICE USE ONLY RECENED Certificates of Survey Received _ Yes _ No MAY 1_ 2 1999 Tree Preservation Plan Received - Yes - No _ Not Required gy; /.?SDO CITY USE ONLY V- L BnL J RECEIPT #: 1OSOOI3 SUBD. TIW? 4? RECEIPTDATE:4a?S Ls 1999 PLUM$IN@ PEtMIT (RE.SIDENTIAL) C[1'YOf £AfiAN 3830 fIu.or xxos Rn EAflAN, MN 551 22 (651) 661-4675 Please complete for: i single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system Alterations to existina residence 30.00 = Water Turn Around 30.00 = Private Disposal System ' MPC iic 75.00 = (new and refurbishetl systems) Private Disposal Systems ' aeandonment 30.00 = RPZ (new installation/repair) 30.00 = FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ' minimum - t 3.00 x = Rough Openings 1.50 x = Water Softener ` for dwellings untler construction 5.00 x I _ ap. 00 U.G. Sprinkler ' for dwelling under wnst. 3.00 = STATE SURCHARGE .50 Reminder: Call 681 -4675 for inspections of water heaters, water softeners, alterations, etc. TOTAL 30, 50 -----------------------------------....-- ----------------------------------------- --------------------------------------------------- I hereDy acknowledge that I have read this application, state ihat the informahon is cortect, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner thal the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities,to,lhe facilities constructed under this permit within Cdy property/right-of-way/easement. SITE ADDRESS: OWNER NAME' INSTALLER NAME: C111T\nRSO-1('l. lLk7d.Qt '1G.Q(lATT14JIM- TELEPHONE #: l fl5- aa'ZO'al STREET ADDRESS: 1 P1-3A, NOWY)&I9.. B1V& CITY: coOYl RGDIC{S STAT?(l • " '.ZIP: ? • SIGNATURE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 G. TURF'EIVING °< ASSOC.. LTD. BURNSVII_LE, NIN 55337 JIM h1ARTIN FtESIDENCE ENERC,Y CALC;ULAT I Onl SUMMARY OF MN I TEI`1 LOCATION DEGF;EE DAYS DEGFEE HOURS F'R T NC I F'AL. I-IEAT COST OF HFHT FFtRMING LLJhIBER WU PURN. ( PLJILDiNG CODE 8/4/E34 EAGAN, h1N 8200 157440(65 NATlJRAL GA5 DEG.F 20% C:REDIT FOR INTEk.GAINS) .09 u. 25$JMl"I E+TU F+ASE 2X09II' $/PD FT .38 O) 0 NONE. .5 OCCASIONAL, 1 LIGHT, 2 HEAVY FiEQUIFiEMENTS CODE 6006 (C)2 6F LJ CLDE _ -°--------•-•-----------...----------__..__. UNITS= SF*U (IN RTU/DEG. F RELDW 65) CLDE (MAX) DESIGN bJA(_LS 7955.00 .11 4'5.05? 410.13? Ft00F 1529.00 .026 39.75X 44.69x UNDER r LOOR .00 .08 .00 • 00 - F'OUNDATION ,00 .SO .00 MIN R10 TOTAL FOR ALTrF:NATE I"ICTHOD 474.78 454.82 (CNVCLOFE DESIGIU) % OF CODE flLLOW .46 AREA CAL.CULATIC]h15 -WALLS----------------- W------ H (effec)---- SF------- U------ SF*U 50 21.5 1075 '.._ 25.5 f•S 16 _2 22 704 °,t i 27.2 1360 C, 0 ir O f) Q 6RC.1S5 AFEA 3955.00 WINDOWS ;' FANE (2 F'flnlF 50UTH) 459.44 .36 163.28 DOORS 153.48 .45 69.06 NET WALLS 3341.58 .05 i 70. 27- 5k:YLI6HT WLLLS see note below 7.56 C(]MFCIS I'1"E 3955.00 410.13 UNDEFiFL00R AREAS SF=== HEF-1TEf), INSULATED AS FOLL6W5 -AT WALLS, R19 BAT?S AND VAF'OF PAFRIER -AT FLDOR, 1" STROFOAM AND VAPOR BARRIER COMTO. C(1LCULAl'IONS --ROOP------------------ W----------D---------- SF------- U-------- 5 50 28 1400 ii 8 16 128 ci C) n 0 q FOOF GfiOSS 152f3.00 , 0ti Sf::YLICHT'3 15.12 .50 7.56 IVET 1512.8t3 .0245403 Z7.13 --UNDER FLCIOh------------ W-------- D-----------SF------- U-------- SF*U FIEATED CFAWL SF'ACE .00 .00 .03 .00 .-E}:TER. DOOR5-----NO. ------W---------H---------SF'------•--U---------SF*U CRACt:' F7 56 _ 2.67 6.67 53.43 19 1 3.00 6.67 20.01 51 2 6.00 6.67 80.04 TOTAL E, 152. 4e. --WINDOWS-------tJO , ------W ------H ---------- SF----------U-------- SF*U cfiAcr: FT 77 4 12 47. 14. 0 C) 16 36 .00 24 2 ICJ JJ 12.22 34 4 24 _S 23.-3 45 4 24 4:7, 28, 67 105 EJ 24 JJ 73. _.. 46 _ 24 67 33.50 42 4 2Ei '5 27 4? 4 25 4' 37 277 20 2e 55 217.89 127 9 23 67 104.22 ?OTAL5 bl 459.94 -SF: YL I GI-ITS---- ----tJQ. -----W--- ----H---- ------- SF 24 ... 1.8O 4.20 15.12 tl Q 3.33 2.00 iJc> TOTALS 2 15.12 SI:YLI6HT WELLS 6" FGL,3/4"syrafm 240.00 WALL SECTIONS b" STUDS @ 24" INt:IDE AIR e68 1 /:: " GY'F' .45 Z/4 STF:d F'OAM - u"ETUDS 22. 34 .63 fi19 FCL 77.66 14.75 25/72" ItJSUL_. SHEATH IN(i 2.06 CEDFiR SIDING .84 OUTDnOR AIR .17 tot crac4:s, FT 9'7, B9 Gi_ nR --(J-------- SF *iJ 00 I)fI 50 7.56 05 12.86 COST 5P=== .26 2.10 • --------- TOTAL5 19.63 .0509421 2.69 ROOF TFiUSSES •7 24" 0. C. 5F=== INSIDE AIR .68 8/£3" GYF' .56 3/4" STYRO FOAI`1 - 4"bOT70N OF TRUSS 6.25 1.40 R=40 LiLOWN INSLIL 9l, 7., 37.50 F'ENALTY AT ED6E OF ATTIC N.A. AIfi IN VEPIT ED SPACE .61 PLYWOnD - ROUFING - TOTALS 40.75 . 024.°,4U' , 0i) i rc N- Ric Z?a? x % g- ' ?',.? ' OF EAGAN CITY ? APPLICATION FOR PERMIT S£SJER AND/OR WATER CONNECTIO.T ? -,z 7 '7 ---= ,? Ea "I T) ' _,.?/ ? 1) PP.OPE.T'?'I'Y ACDRESS: - ? ' r.Fr=.L DF.SCZI°T_C:I: , O? -71 (I0 t/31ock/SubcLi7,isicn or Tax Parcel I.D. :I=ber) i: =;:'= :G ST_ :CCT :c: , DAT' G:' CRIGi.:AL =iili..^.I.`:G _ =:•1T ISw?.NCE: , • :lr•-- " ------' -_- . I F?:S'- CYR-1 SZiGL:. FpyI:.Y ? R-2 CITP= (11V0 UNITS) ? R-3 'ICF,%-L\IIICYJSE (TIL`tEE + L'NImS) ( iJ'% I^S) ? R-a n??,q'^•c,;•;/CC`?Ci LIIL:1 ( LtiI? ;i p c?-11IIERcz=,;,,REraii?oFF?CE ? 2mUsTRL-%L Q PISTITUTIO.\?L/GvV?c_?nIEV•l• 2) AF?LI= ? E'SE PRI, , NF1??,?: J / (??/ AnnREss: ? CrI:', STu:.', ZIP: PY:O`E: (? - 3) PL'v:ffiz"? NAi•W: (PLEA'E' t FOR CITY USE 09LY ADDF2ESS: (J /?t?? ,{] PLIJHBERS LICEYSE: 0 <- , Active - CITY, STATE, ZIP: L] Expired PHOiVE: PLUMBER LICENSE ,ii E= Not oi Record arr ?nicia 4) (X'C'JPP_7I'/Cf.•7?I?2 NF4ME: ADDRESS: CITY, STATE, ZIP: PFIONE: (YLtF?t YH1NfJ S) INDIC= SdHICfi PEP;4IT IS BEP:G RDQLT=: ? CC`,=.ION `IO CITY SE*r7ER ? CC:.:QECiZGD1 'Ib CITY WATER ? di'[-E2 (PL:A.SE DESCP,ME) b) L':U1C.?1L; U:,:.:: 7) 5?(M=RE: ? PL: `SE F?OLD i1PPRpt/ID PgZ•LiT FOR PICi:-U'P SY ONE OF P.BC7,'E ? °IZaS-- MAIL APPRM/c"?. PFRHIT :D 1, 2.6, 4 ABd'IE '-n , / /-) (Circle one) ?TE: 9 /9 ?? MR w M awa?":Mm MMWLN?" ae ir rr r r?? ?r ? ev? ? ?asaaa e R C I T Y U S E O N L Y ? . PERMIT - ISSUED F°ES? $ /O - 5` ? SE?•iE3 nz-o}(ri '; *-•-_ o(•??-.r... ?__C. . . 5? ) $ .. ? . ..?.-•-..._.. WATER PERf4IT ( IL:CLtiDE SURC::yRGE) $ G? ? , .•-----c) WATER METEP./COPPERHORN/OUTSIDE Rr ,DE3 .. ? WATER TaP (I:VCi.UDE COR?CRaT=CN S^C2) $ S°:;E3 ,••• n $ ACCOII.]T ^uEPOSIT - SEiiER $ -CJ ss ACCOliNT DEPOSiT - WA';°Y $ 1? ?'tr ' WAC $ sac $ T4U:IK WATER ASSESS:IE.iT $ TRCiV:: SE:vER ASSESS"tr-VT $ LATE°AL BENEE'IT/T4UNK SE:•:ER $ LATERAL BENEFIT/TRU:]'s: WATER $ ' OTHER $ TOTAL , $ A-MOU:1T PAID/RECE:PT ; -7 DOES UTILITY CO NNECTION REQUIRE E XCAVATION IN PUBLIC RIGi3T OF tvAY? YES ZF YES, THEN A"PERb]IT FOR WORK WITHIN / PUBLIC ROADWAY" MUST BE ISSUED BY THc ? NO ENGINEERING DIVZSION. LIS?' AS A CONDI- TIOIV. SUIIJECT TO TfIE FOLLO:•7IDIG C0:IDITIOUS: APPROVED DAT° : ? OR fi+ ws ?? ir as ?c? +ia ?w ?t+ ?? w s.s? wf? w? wt? w? r sr? wi? a4 ? s? aw ?aa w?? w? ???. ? qw_ 3 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Nevr Comlruction ReauiremeMs 3 registered sile surveys showing sq, ft. of lot sq. fl. ot house; and ?II roofed areas (20% maximum lot coverage allowed) 2 copies of plan showing heam 8 window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan'rf lot platted afler 71193 Rim Joist DetalOptions selecfion sheet (6uildings with 3 or leu units) RemodeliReoalr R¢aulremeMs •/ 2 copies of plan ?11 set of Energy CalculaGons tor heated additions ? 1 sile survey fir addNons & decks Additron - iridicafe d on-site sep6c system * 4aa oP Otfice Use Onlv CeAOfSurveyRecd _Y _N Tree PRS Plan Recd _ Y_ N. Tree PresRequired _Y _N On-siteSeptlcSystem _Y _N P a 4?-W.An, Date?/ ConstructionCost J??r.= -1-:0- Site Address 27 1,,ar4 e?? UniUSte # _ N n ..$-s-/ v7 Description oF Work `/ ` S2aSG`s; k Multi-Family Bidg _ YX N Fireplace(s) _ 0 tx 1 _ 2 PropertyOwoer /SlClnart) d- Jerr' R,,rtqolJ J Telephone#(?S?) 7,/?'GaS? Contractor 1 '?iWel V( lIL° -L+''C ' J Address JrgA AI?r'!?y VAz-' -?? State ?AJ S/ Zip City Xaaa .- Telephooet????3 ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Categorv 1 ? Rules 7672 Enefgy Code Category . Residential Ventilation Category 1 Worksheel eW cRg de Worksheetn (?submissionlype) Submitted ubmitt'@? ? • Energy Envelope Calculations Submitted (' ??? T2 ? In the lasT 12 months, has the City of Eagan issued a permit for a similar plan _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( ? I hereby apply for a Residential Building Permit and acknowledge that the infortnation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application fox a permit, and work is not to start without a permit; that the work wili be in accordance with the approved plan in the case of work which requires a review and approval of plans. 4 I to -I, Z*ke- Ze.llher Az.???? Applicant's Printed Name ApplicanY ignature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg t] 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage 4 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex A 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex 0 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior 0 44 Siding 0 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alferation ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout W applicant ? Valuation //?Lz Occupancy MCESSystem ' -'- Plan Revlew _ 100% or _ 25% Census Code 43?{ Zoning -? City Water ? SAC Units - Stories / Booster Pump - # of Units Sq. Ft. ?2 .2 PRV # of Bldgs ` Length P/ Fire Sprinklered Type of Const Width _16_ REQUIRED INSPECTIONS Footings (new bldg) FinaUC.O. ? Footings (deck) ? FinallNo C.O. _ Footings (addition) Plumbing _ Foundation ? HVAC Drain Tile Other Roof y Ice & Water ? F inal _ Pool _ Ftgs _ Air/Gas Tests Final Framing Siding SNcco Stone Brick ;f Fireplace -k A.I. ,VAir Test Final _ Windows ? Insulation _ Retaining Wall Approved By: , Bu ilding Inspector ? Base Fee ? Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Planf License Search Copies Other Total .Z.2 y ? / g-;L 4-j ftllS0,v /J %C K ? CiGl3 `? iy6 96 % - rti?ficate,?Porti w, im, Marn ,401 ? West.: BRth?,',,Streets; f B1oomingtan, I±fi. 55420 DELMAR H:'. SCHW1ANZ I.ANOSURVEYORS? `uG, ,.. Registeretl Untler Laws 0f'Tpe Stat<of Mmnesota -, . 2978 - 145TH STREET W. - BtlX M' ROSEMOUNT, MINNESOTA'66068 " - . . SURVEYOR'SC,,,ERTIFICATE /zo.c•?? 55=y-?-33?=- /I i? ? ? (? i1 V? ? ?' 2,.? j'?J ? a•??_ 7??_ Lrrainage Easement I ? - N 4. I ? ?m o F?' Y?;> .,..r.:" 44? ?Yxi3 e ?m tim ` so?9 ? Q!q ? So?s6 0'Oo >S ? L- { ? ,-1- ? ?f? PHONE 672 4231769 SCALE: 1 inch - 50 feet Elevatinns shown are existing ti Denotes 3et woocl hub o Denote3 iron pipe ProF>osed garage flnor elevation ------..-.--- ? . I hereh;J <:e,rt l fy t nat t,`Li:: i3 a true ar,d cqrreci, rentatl?r. af Lot 4, Hlnck iHOt? A.i IAKE 4I'L2`t'3J?d, ?.ccorc':lnfr to t;'r-e qR ?'v q?n{ ; ecorded p1;a.t *hereoa ,-Dakot;a Gcunf;:i, G 9 i N.j.;"l!le`.SOi.2? . J0 99? " VO? 9 ??? ? f j I rv, I! . i N? „rainaP'?: I.t;y , ea;`.cmc:?`•. ? s?- I .+ Also LAr!owinE tna_ laea±:I.un of a propo:;ec hou3e a3 stakod i;h^rt3on. Da:.e?:: ALA?.-ust ? 3, ] 9r" r. :.- ./I ? COMPLIANCE: 4MU4- Required UA = 66 Your Home = 89 1.8?s Better Than Code ?- --------------- CEILINGS WALLS: Wood Frame, 16" O.C. GLAZING: Windows or poors, Above Gr GLAZING: Skylights FLOORS: Over Outside Air HVAC EQUIPMENT: Furnace, 90.0 AFUE HVAC EQUIPMENT: Air Conditioner, 12 -------------°--- Area or Cavity Perimeter R-Value ------------------ 252 50.0 919 19.0 ade 115 16 252 3?8.0 0 SEER Cont. Glazing/Door R-Value U-Value UA ------------ 12..0 6 0 23 0.350 40 0.550 9 2.0 6 -------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed buildinq has been designed to meet the J:quiremenjs of the Minnesota Energy Code. Builder/Desig Date s -? ? ?? ^%- u s P Corporate Office STRUCTURAI. 14305 Southcross Drive, Suite 200 • Bumsville, MN 55306 ? CONhJECTORS' 800-328-5934 • 952-898-8772 • Fax: 952-989-8683 AcA`"¢U naU5tM COurANY/%? www.USPconnectors.com • e-mail: info@USPconnectors.com Mazch 27. 2006 Ron Shimanski Littfin Truss 555 Baker Ave. W. Winsted, MN 55395 RE: MSH422 Adjustable Strap Hanger Ringold Addition -1477 Lake Park Circle - Eagan, MN Mr. Shimanski: I have recalculated the load capacity of our MSH422 Adjustable Strap Hanger based upon the following information. • The top 3" of the M3H422 flanges have been removed. • The supported member is a 20" truss with 4x2 SPF bottom chord. The hanger was fastened to ihe truss with 6- l Od box nails. • The MSH422 is fastened to a 2x10 SPF rim joist. The top of the floor truss and top of the rim joist are assumed to be flush. This allows for a maximum of 8 nails (4 each side) to be driven into the rim joist. The hanger was fastened to the rim joist with l Od box nails. „ Based upon this information, the downward load capacity of our MSH422 installed in this fashion is 630 pounds at 100%, floor loading. The position of the rim joist, if not flush with the top of the tnxss, may allow for more fasteners to be driven into the rim board. This wil] proportionally increase the load capacity of the hanger. t If you have any questions regarding this mattet, please call. Sincerely, Steven A. Brekke, P.E. Engineering Operations Manager USP Structural Connectors EAC3AN ?R?,E,?,VIEVVED BY:/? t :r.? ?(/' oaTE: .,o fo BUILDiNG NS'r.u50NSDM510N J 2895 RESIDENTIAL MECHANICAL PERMIT APPLICATION d' r?? City Of Eagan rO 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when perxnits are required for each unit Date vZ / G / V ? site Address IL?7 7 unit # Property Owner ? ,", Telephone # ( i? 5 4. S (- Contractor 1;Fi t dIRF 1NP 12253 afcoaet a,renue souQt ? Street Address 8Lmmi111L AAN55'?,7 r City TBIe hOBe: 952-Td6-52011 ?ar 9?9.7dR.FQ? State Teleptione # ( ) Bond #: J g O S 6 7 Espires: 9 u! ° ? The AppGcant is _ Owner _--c-ontrac[or _ Other Add-on or alteration to existing dwelling unit $ 30.00 v"?' furnace _Additional ?eplacement _ New air exchanger air conditioner ? heat pump , ? other- ; q?AL C) Y1 r (-I? 14tq+ S 1-Y S Y'o PareL ` Mau e_ Ut ei U¢ lif.` I State Surcharge $ 50 g 3 D, SO Total J I hereby apply for a Residential Mechanical Pemut and ac}nowledge that the informafion is complete and accurate; that ihe work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permi[, but only an application for a pemut, and work is not to start without a permit; that the work will be in accordance writh the approved plan in the case work which requires a review and apprrnal of plans. /L-- I?J Applicant's Printed Name Applicant's Signature 2005 COMMERCIAL MECHANICAL PEAMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciaUindustrial buildings multi-family buddings when separate peimits are not required for each dwelGng unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor R," E?-rw,??1 A ? ? ... .: -rb. ? StreM Address Pnt+ir•? ?iS???'Y':?1 State rn? ? ??- ? P? Zip , ., ,_?Telepho?g# ( ) v- Bond #• Eapires: The Applicaut is Owner ConVactor Other Wark Type _ New Construction _ Underground Tank _ Install _Remove "*see below _ Interior Improvement _ Install Piping _Processed _Gas Nature of Work: *'When installing/removing underqround tank, call for inspection by Fire Marshal and Plumbinq lnspector PC1'rtlit F¢C3: $70.50 Underground tank inatallatiodremoval $50.50 Minimum (includes State Swcharge) or ContiactValue $ x I% _ $ PermitFee $ State Surcharge If peimit fee is less than $1,000, add $.50 If emvt fee is more than $1,000, surchazge is $.50 for every $1,000 owed. $ Total Fee 1 hereby apply for a Commercial Mechanical Permi[ and acknowledge that the information is complete and accurate; that the work will be in conformance wi[h the ordinances and codes of the City of Eagan and with the Mechanical Codes; tha[ I understand this is not a peanit, but only an application for a pemut, and work is not to stazt withaut a permiY, that the work will be in accordance with the approved plan in the case of work which requ'ues a review and approva] of plans. ApplicanYs Printed Name Applicant's Signature Approved By: . Inspector Required Inspections: _ U.G. - R.I. _ Air Test _ Crds Service Test _ Infloor Heat _ Final 7aW3 2006 RESIDENTIAL MECHANICAL rExivuT Arri,icnTiort City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit 30. <5f,) Date L_?' ! 47;7?LfiXe- ? ^1"`C r-r-r+? Site Address Unit# ? Property Owner Telephone # ( ) Contractor \ Street Address c City State Zip c?? - .,_)-'Telephone # (?D ) 7?? ` ?C9 ? Cn Bond #: ? Expires: / // ?I Q The Applicant is _ Owner ? Contractor _ Other Add-on or alteration to existing,dwelling unit $ 30.00 _ furnace ?Additional _Replacement _ New air exchanger air conditioner heat pump 1 other ?- State Surcharge ? .50 Total $ I hereby apply for a Residential Mechanical Permit and acknowledge that N be in conformance with the ordinances and codes of the City of Eagan and permit, but only an application for a permit, and work is not to start with approved plan in the case of work which requires a review and approval of ation is complete and accurate; that the work will Mechanical Codes; that I understand this is not a ?will be in accordance with the ApplicanYs Printed Na ? RESIDENTIALBUILDINGm City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reouirements 3 registe2d site surveys showinq sq. fl. of lot, sq. tL of house; and all mofed a2as (20°h maximum lotwverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc 1 set of Energy Calculations 3 copies of Tree Preservalion Plan if bf platled aRer 711193 Rim Joist Detail Options selection sheet (buildirigs with 3 or less unifs) Minnegasrq mechanipl ven6lation form RemodellReoair ReouiremenLs 2 copies of plan showing foo6rgs, beams, jois5 1 set of Energy Calculafwns for heated addNOns 1 site survey for addi6ons & decks Addifion - indicafe if on-sde sepfic system -? C?R . aS Office Use Oniv CeA of Survey Recd _Y _ N Trce Pres Plan Recd - _ Y_ N. TrcePresRequired _Y _N On-site Sephc System _ Y_ N Date /K / Site Address - li h '/)L Construction Cost 14j?? UniUSte # Description of Work 5i'd1n1 G-rd L??ioOUWS C! ??Y /??f? ?`°fejl Multi-Family Bldg _ Y? N Fireplace(s) _ 0_ I _ 2 Property Owner Z Cka/d c}' ? Telephone #( -ad S] l Contrac[or #71,11L °/ !/"lle .1nC Address /.566 State Al/t/ V CU3' Ehcw''"dr Zip Telephone # ( 6/a ) ]d/- 7/3 7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Su6mitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has ihe Cify of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pemut, but only an application for a pernut, and work is not to start without a perxnit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Xke ??ell#el ApplicanPs Printed Name Applicant' gnature