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1518 Lakeview Curve? • CASH RECEIPT , CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE r ? 19 NECEFvEO FROM ? AMDUM $ 8 DOLLARS iro ? CASH Q CHECK wn y Q? ., _ FUND OBJECT AMOUNT ' .. Thank You BY Whne-Payers Copy Yellovv?-Poatf^9 CoPY Pink-Flle Copy i CASH RECEIPT CITY OF EAGAN 1 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 i DATE 19 ' I IECENED . - ? FROI/ r 1 ? tMOUNT $ ? ? CASH C] CHECK eY DOLLARS ioo W,ne--Peyars Copy Ye1low-Postin9 CoPY Pink-File Copy Thank You CITY OF EAGAN 3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT To be used for S'' i??I? Est Value ?'6y,? Receipt * Date Sin i 19 Es SiteAddress 151$ LAXYVIBV CURWH Lot 3 Block 4 SeclSub. MNSY POIPdT Parcel No, m Name CUI.LtGIK CIZY CQ11SZ'RUCTiOl1 3 Address .= (yr) # - IST S? W 0 CityA1'Pt-.e Phone 43 _? -• 1211 , a fvame SAM 0 ¢ AcWress ? Citv Phone Name._ Address City _ I hereby acknowledge that I have read this application and state that the infarmation 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: ?UI.L.[.(',.E C I'."`[ _ Cvh"ST on the express cond ition that all work shall be done +n accordance with all applicable State of Minnesota 5tatutes and City of Eagan Ordinances. Building OHicial ' OFFICE USE ONLY On Ske Sewage Occupancy MWCC System X 2oning ?-? On Slte Well (Actual) Const v-? City Water X (Aliowable) PRV Required x * of Stories Booster Pump Length 42' Depth 421 S.F. Total Footprint S.F. APPROVALS FEES 4?2'? Engr./Assess. _ Permit Planner Surcharge ? Council Plan Review ? Bldg. ON. SAC, City ?' Variance SAC, MWCC ? Water Conn. 67 • 00 water Meter RoadUnit 3145•oo 204•W Treatment P1 Parks TOTAL 2 ?? - CITY OF EAGAN , ? -? 3830 Pilot Knob Road, P.O. Box 21-1 99, Eagan, MN 55121 PH ON E: 454-8100 ? BUILDING PERMIT Receipt ? SF DWG1GAIL $62*OOC T d f b l 'EPT i D 96 1 e use or o Est. Va ue ate , 9 1 Site Address 1518 LAlGEYI?W ::'UF.1lK OFFICE USE ONLY 4 sTMY POINT 3 On Site Sewage Occupancy ft` 3 j''"' 1 Lot Block Sec/Sub. X MWCCSystem Zoning ParCel No. l v'N On Site Well (Actua ) Const GULt EGE CZn CONSTSVMCfi Cirywater Y (Aliowable) V"N a . Name z Address 6970 1515'? ST V PRV Required x # of Stories 42/ ; a ? ?tr City?r !'LE vALLEY Phone 431-1211 Booster Pump Length Depth ?? ; °? O Name S A M F S.F. Total . ? Q Address Footprint S.F. r°C- City Phone APPROVALS FEES d ^ ? z Engr./Assess. _ Permit ? ? µ ' Planner _ Surcharge =Z ress Add ? L) v Council Plan Review Q W City Phone Bldg. Off. SAG City I hereby acknowledge that I have read this applicatfon and state that the Variance SAC, MWCC ?' intormation is correct and agree to comply with all applicable 5tate of Water Conn. ? Minnesota Statutes and City ol Eagan Ordinances. Water Meter Signature of Permittee Road Unit 'LZI.'1'L?'i" C1'??k "(??'+iT ? } A Building Permit is issued to: Treatment P1 ? on the express condition that all work shall be done in accordance with all Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. ?? TOTAL ? Building Official--- Permit No. Permit Holder Date Talephone it Plumbing C/C/ C?•?, cir/ F`?/(^:,'° /C ??,;??' H.V.AC. Electric SJ Softener Inspsction Dnta Insp. Comments Footings I ? Footings II Foundation Framing ?.2 Roofing Rough Pibg. O-/ ROUgh Htg. Isul. Fireplace Final Htg. ?= r ?-- ' Final Pibg. r --? Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. CONTRACT PRICE: r Site Address Lot Black ? Name ' Address c Ciry- ? -? a- c Name Address O CitY' MECHANlCAL PERMIT 3830 PILOT RECEIPT # MN 55122 DATE: - / I TYPE OF WORK Forced Air =5 ~ M BTU Boiler M BTU Unit Heater M BTU Air Gond. M BTU Vent. CFM Gas Piping Oudet s # i Other I 01 FEE: S/C: TOTAL• ? } .' . ?. :. BLDG. TYPE WORK DESCRIPTION Res. f New ?--' Mult. Add-on Gomm. Repair Other FEES RES. HVAC 0-100 M BTU - $24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEkMln - 1.50 EA. COMMIIND FEE - 1% OF COiVTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APP4IES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) SIGNATURE OF PERM1TfEE i , .?.....+V?•?. 'r-.? ... ....-.-.... i. ..-. . .. .... ?.... ?..q , ....e..y_ :,» rya...+.e .?.. ? .. . .. ._ PERMIT # ' PLUM8ING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNQB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 ? Site Address ' Lot Block Sec/Sub .i.?'- Name m ? , Address c Ciry Phone Name c Address p City PhOne FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE BLDG. TYPE WORK DESCRIPTION Res. New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 R ? Bath Tubs - $3A0 1 Lavatory - $3.00 Shower - $3.00 . Kitchen Sink - $3.00 Urinal/Bidet - $3.00 i Laundry Tray - $3.00 ? Floor Drains - $1.50 ' Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: ' STATE S/C: GRAND TOTAL: IF EAGAN (gertifir??it of (Orrupttnry Citp of (Eagan arprbunt uf Naming Jnprctin» This Certificate issued pursuant w the requirei?ients of Section 306 of 1he Uni, f'orm Buildtng Code certifying tlrat at the time of issuance thrs suucture was in compliance widt the various ordinances of the City regulaling building carstruction or use. For the fo!lowing.uW cinnfic.am `7r TWGAR swe. rtnWt rro. 15554 occw.-r Tym Zonins nLa;c+ rya 9N . ownu oc euWam !??F? ?•;??i `.Z?';.'? ? Addnass A.rr ," HuildingAddress t5l? ?•r?.a'?? - ?i'?''.i', larlity i•:, Wi1 '.'..+ Dslt: Building Oiricial POST IN A CONSPICUOUS PLACE 'OFEAGAN i pibt knoD A Box 21199 3n, MN 55121 Permit IVo: B/P No: - Date: -2 -?-?4 Date: 9 :.C: `50. nOP;i Zoning• ? '?`? • `??' No. of Units: Chg: . Dep: I . ? .. ?,; I agree to comply wffh the City of Eagan ?it Fee: Ordinances. , ;harge: ,.. ;:•• p r *'Z #4' i BY SEWER SERVICE PERMIT j CITY OF EAGAN ` Permit Na `'?C3 Date: 3830 PUof Knoti Fioad Meter No: Size: ? P.O: Box 21199 Reader No: Oate: ` Eaaan, MN 55121 Conn. Chg: Zaning: Fs Acct Dep: No. of Units: 1 Permit Fea 1;1„s'Ylpd Surcharge: I agree to comply with the City ol Tr. Plant Ordinances. - - - ' OF EAGAN Permit No: 0 7 Date: 9-8-88 ? i Pilo1 Knob R'oad Meter No: W!V 7.3 '79' Size: oc Box 21199 Reader No: l0 Oate: 1o1-6 -kft m, MN 55121 Con Address: 1518 Lakeview Curve' L3 B4 5 . Chg: _449.Q8,pd Zoning: _ Dep: _ No. ot Units: t Fee: _tP..(aQ,Pd 1 agree to comply with the City ot Eagan CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 15559 ' ' BUILDING PERMIT PHONE: 454•8100 Receipt #S --? I I ? To be used for SF DWG I GAR Est. Value $62, 000 Date SEPT 1 1988 Site Address 1518 LAKEVIEW CURVE Lot 3 Block 4 Sec/Sub. STONEY POINT Parcel No, x Name COLLEGE CITY CONSTRUCTION ,z, Address 6970 151ST ST W ° CityAPPLE VALLEY phone 431-1211 a Name_ 0 ?a Address ? City_ . Ww Name_ FW i z' Address aw GitY_ I hereby acknowledge that I have read this appiication and state that the information is corred a re o comply with all applicable Stale of Minnesota Stetutes d City f an ances. Si9nature ot Permittee • ? A Building Permit' ed to: COLLEGE CITY__QONST- ontheexpressc n ionthatallworkshallbedoneinaccordancewilhall apphcable State oi Minnesota StaNtes and City of Eagan OrOmances. Bwlding Ofhcial OFFICE USE ONLY On SRe Sewage _ OccuDancy MWCC System X Zoning On Site Well _ (ACtual) Const Ciry Water X_ (Allowable) PRV Required X # of Stories Booster Pump _ Length Depth S.F. Total Footprint S.F. APPROVALS Engr./ASSess. Planner CouncJ Bldg Off Variance FEES Permit Sumharge Plan Review SAC, City SAC, MWCC Waler Conn. Water Meter Road Unit Treatment P 1 Parks 70TAL R-3 M-1 R-1 V-N V-N 42' 42' 422.00 31.00 211.00 100.00 550.00 550.00 67.00 325.00 204.00 2,460.00 BLDG. PERMIT NO_ t5 L,o-l- 3 61 c-,t S S'4 ?e"V-Au -? 01-3210 Bldg. Permit 01-3422 Plan Check C q , , 013445 Surch./Adm. L0C . ? 01-3446 SAC/Adm. ? 01-2155 Surcharge 3 x 75-3860 Road Unit -D?S 0 c J 20-2275 SAC q ? .? ? 20-3865 WaterConn J50 oO ? 20-3868 . WaterTrmt ? 20-3716 . Water Meter Lo OC ? 20-2252 Acct. Dep. w 20-3713 Water Permit to 20-3743 SewerPermit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL o.? ? ? O O REQUEST FOH ELECTRICAL INSPECTION 0 ea-ooooi-os 1 See inshuc?ons lor complebng Ihis torm oo back ot Yellow copy. Fgi al/ -rJ. O "X" Below Work Covered by 7hia Request ana aeo. Tvoa oi auimine Aonliuncee WireA Enuiument wi Home Rmige Tempurary Service Duplex Water Heater Lir{htiny Fixture5 ApL Bmldlng Dryer Electnc HeTtin Commercial Bldy. Pumace Silo Unloader InAustnal Bldy. Air Conditioner Bulk Milk Tank Parm O1nvr oaci v Oihcr ISUCi.,tyl t er SyeuW 01her Other Compute lnspection Fee 8elow - # Fee ServiceEnhenceSize M Fee Feetlers/SUbieeJers N Frze Circwls 0 ro 200 qm s 0 to 30 Am s .2 0 tn 30 Am s Above 200 qmps 31 to 100 qmps / y- 31 to 100 Am s Swimming Pool Above 100_Am s Above 7(10_AmPs Transiormers Irrigation 8oorris SO Partial- 'Othe r Fee Signs Spectal Inspection ?D / ? TOTA FEE^IC Nertmrks ? ? ? y r,..? BouBh-in Da?e ? ? tpe Ela Inspectoq ?eroby eridy ??a? ihe above Flnal nspection has bee. • ? ?T matle. Thln reauesl voiE 18 monitre Irom ?1 Th,s reauest vmd /C^?/^/„/ ? 0 16 nwmhs fmm ?7 ?j" E 132 50 ?.-q. PW?-?? Ra?uesl Date Fire N RmHh-m InsVection RequireA? DReatly Nnw?W,ll Nuufy Inspec- /? `a? );a1'es ?NO 101 When fleadY WLi ce.sed Elecvical Convacmr I hereby reGUest inspaction of above ? Owner elactncal work instellad af: Street AAaress, Boa or Noute No. City Sr Lm - e, -4 €a) ecuon o. Townshi0 Name or No. qange No. Cwnty pbKoT? OcwUent IPPINTI Phone No. C • Gr , ir? ? ?' Power Sup0lier Atldress Tw Lee..T?i.?G F'642uhiAiG-' N / Electncal Contractor (CompanY Nomel Cnprractor"s License No. lYl/.c9ST?? ' -<l Mailing Address IConVactor or Owner Makiny Instailatmnl a snr Authonzed nature 1 nvactar Own Mak g InstallaLOnl Phonc Number ? ? 36i- Fr MINNESOTA STATE BOAPD OF ELECTRIC THIS INSPECTION REQUEST WILL NOT CrigBS•Midwey Bitlg. - floom N•191 BE ACCEPTED BY THE STATE BOAND 1821 Universitv Ave.. St. Paul, MN O6 UNLESS PNOPEN INSPECTION FEE IS ......... i aezrwnn ENCLOSED. 198$ BUILDING PERMIT 9PPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCL E 2 S TS OF PLANS, 3 CERTIFICATES OF SURVEY 1 OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HO ER MIIST DESIGNATE WHICH 9DDRESS IS DESIAED. NO CHANGES WILL HE ALLOWED ONCE HOILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL IINITS FOR SALE UNITS 8 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALC[1LATIONS CO[•MERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: al m) f Valuation: Date: (3 '? U- Site Address }h 1 ? za J(tve ?r ?urV` Lot -3 Block A-1 Parcel/Sub S70 n cry_ C j v, ? ? Owner Address City/Zip Code e;.Z Ob0 On site sewage Occupancy R M-I MWCC system ? Zoning R-I On site well Actual Const V- N City water _47Allowable V-N PRV required ? N of stories Booster Pump ` Length [U ' Depth S.F. Total Footprint S.F. Phone Contractor Address 697a -Is) r? S City/Zip Code(f(w(e.. !/?11fe" ?S)?Y Phone -/_Z 2 - f..Z)) Arch./Engr. S"? "I r qJ C Orl Address City/Zip Code APPROVALS Engr/Assess Planner Couneil Bldg. Off.?i Variance FEES Permit 2?'00 Surcharge 31 D o Plan Review D-O SAC, City Ino,Oo SAC, MWCC SSn'Ofl Water Conn .SSD, o0 Water Meter brJ, o, Road Unit 392s.00 Treatment Pl o .OD Parks Copies TOTAL Phane # .UAt..uAMOO GrAIPA-P?-? •.---- Zc;lX2rp, 'fC? a XiN'- s?oa ?Sna7 Lfo 0 20 x ?a = zon r?9oy ?y ouSE ZZ?t34= `7ye i 7 10%)( l4 = lyo ?%z? ?6Y7 z 5?? ? ?y X 49 = ?!'? `? 2 ? ?/230 t, y, , •?, ?: -, •?.?{ ??i i •u, . , * ** * * pIon * engir *,? ** 2422 Enterprise Drive Mendota Heights, MN 55120 :ering.. 11 (612) 681-1914 Certificate of Survey for: COLLC GE CI { Y CONST ? NoRtN ?J 00? /?99 L o T Z ?pKE D'?1• ?i ? ?' 9, / o0 0 \ 8f(3?hi ' `? ?/ ?? ? va 2 °n \ 3 \ k",;" ' •, b. ? tiy,' ? ?.a} '• tA° ?F€rorbs?D? \> \' HeusE ? / t?o Z tiA ?' ryN ? L. o T \ i v ? R C V E- D N J.,AC?.r.t±T paRMo REQMORIE a • 900.0 Denotes exislino Flevafion ? . 900.o Deno{es propaMd Elevolion ---- -- Denofes Orarna?e ? Ufrlr IJ' Easement benotes DrUma eFlow Arrows o Denoies monumenf 8 e4rint shownnre assumed PROPOS£D NOUS£ ELEVA710N5 LowesP Floor flevalion = gkg,b Top or 8/ock Elevafion = 8?2.0 G'arpfz 5lab Elevafion = 611, 7 LOT 3, BLOCk 4)$rONEy I?OIN7" DQKOTA COeINTY, M/NNESaT<1 SUBJEfJ TD EASfMENTS OF/jfcORD 1 here6y cerNTy that this survey, plan or reporl wae pre red by ''``?? or under/ my direct supe?rvfis?ion and that I em Auly Registered Land Survayor i under the laws of tha Stete oi Minnesote, Oated thlsday of AL'i ycet A.D. 19 Scale: 1?n?h= 40gell ,? ? ?? ?I I, I ROBERT B. SIKICH L.S. REG. NO, 14 91 / / / v .titi 2n E'Y'.R10R El' -LUPE AYERAGE "U" GUIr 'IAIIUN ? oVrNER e_-_ • C-. ? v SITE AOURESS ? q iC1 •e Y, e u/ ?? r? e LONTMGTOR eocLCGF G!T'Y ?nM%r-DATE o"???b'S( PfIONE l ? - ?/ ??onQy o; n? Uetermine working square footage of each. 1. 7otal exposed Yiall area ...... Z,,?os4- sq. ft. x_,11? a- 2. Total roof/ceiling arca ...... 1$'10 sq. ft. x 104110 Totai exposed wall area above flour = a. Total wall window area ........................... 'Z 7- 3 b. Total door area ................................. c. Total sliding glass door area ................... p d. Total fireplace wall area ........................ ? o e. Total wall framing area (average 10%)...:........ _ lT O . f. Total net wall area a6ove floor ................. ?2 00 ?u•=• g. Total rim joist area ............................ 19 2. p` . Total-ekposed foundatton area ? (o 4- , h. Total foundation window-area ......... ............ o i. Toal net foundatlon area above grade ......... ... lo h- Detennine "U" value of each wall seyment. ? a. ' '2'Z •n X ;,U?? • a. b; G75 z nun C: ? X "U" ?iZa ° 7•a4- O n C d. O X "U" O = ? e. ?'70 X"U" , 092. ° ?5• e4- f. (Zk.,O X "U° y, lq 2 x ilu° h. 0 ' X aun i . 10 A- X "U" ?h3 ? • 5?.?? .O/1-1 = 7. 91 'p t O 3 ......................6 ..............Total Tf j?nm #I is khn Same a5. )r 1r55 tfidn itrm P1 von r hwe mPt' }h- 1??t-0 }, t Y.: . .. ?p Total..exposed rnof/ceiling area = 17 S.G? J. Total skyliqlst area .....:....................... O k. 7ota1 roof/ceiling framing area (average lOX)... 179, l. Total net.lnsulated rooF/ceiling area............ ?,,,r,-<f- Oetetmine "U" value for each roof/ceiling Segment. l1 Y 11u11 O 6 O k. (18 x'Hu,.?,_____ xioull 4 ............... ........ ............ 7ota1 =• Z.•Fc:T, If tatal of 14 is the same as, or less than 12, you have met the intent of S[1C _GOOi+(c)1. • Alternate Bullding Envelope Design To utilize the total envelope system metliod, the values established by the' sum of ltems 13 and 04 shal,l rtot be qreater ttian the sum of items al and 12. 1. + 2. _ 3. + 4. F? _. ; ---?- - : K MD LC VA L l1E A NA !. Y 5 i 5 Of L Q_ y' D ; L AZ EO A Rr-A5 VYINDGW AIMA : TYpE OF W 1 N1JOW i Tue N.v,,.c+o.u uuirs 14AVL gii../ Tisre'G /04 "R=VA&-µi, TM{Y A:c nM L.,sIio aBoJc qV0 iyay 41 I55i441EO A OCJi4,V Cs.rc) Vw"..Lc. oF z'&<T 14CLuDING AIR IrILMS, 4'??RSi =? _ fDOtwqLZZ3 '4'foeTA4¦ ? - ZZ j FOUNI7AT ION yVlNOOW /'1R.FA : TyPE oF ?ti???DOW : TjIE VViNODW U+?jr+/a4 if&. aG" r'ESrCP FoR *lZ: VAA"C? THLY ARL AS l. .7LG AGey? ALLO M9y' 8? ASIIC, NLOA L?l.S1yP4 V/.Rt-D VAI.uC (Mr- `[t"r ?uC4.?+0IA/Cr Ai.4 PILrns , Uqz: I/r?.. • Foorn44 + FaornqC m Q SLIbINi; <?LASS Dba1Z ARfsA: TyPc oa Doort: St. iD+4<4 Gj l. 0?59 l700R S?II•V L O iR -{ 76}T 4C Fo R"R= v4"Kr-, THCY &BL '.a L-IAr+c F' ADOt'L AtJO MA.y 6? ?SS?yHtiQ A VASJ4ZrNG3Af[) yw".4G oK•k"• i .410 FILt'LS i-ly; . IJ"4i = 1/ _ T====:l Foori+4r- DooR ARa A : TYPG oF DovR : paaQ UNiYS HAYG LrcN Tr-srtp ANO Kouyp ro HAVC AM 'R'-VALi.IA Of '1.HI JNCL+NO/NCf AIII P14.M3. I/rtdi = I /! ' v J? = •i.? FOOTACt IL= 5PEcIqLs : TYPE. ' y ?I tbRM L_/ !s?lh4? I?rE',73U 1?1.^ SYrq E ? r AND • yVALUy q?JAVYZIS oP•??t ?F? -?"ic. .??..?,...?.? J JaiST/FRAMI ro G AREv, •R•. YA LU. E - 'b 1 1N7?RiaR AIR FILM 3 Z- Soprwooo ?? ?GYPS?.M N/?LLbcn4D t NTER iOa, AIR F?t-M Z?Z?- ? TOTAL "Ft?..i VALU.E. . ?--?--??--? u.?? . ? / ?? ¦ 1 / ._ - _ •1.?`'?--? ,. 'L7:73S , 7'oTAl. poor?.Gi - ?7? ?NSu.LA7Ea aRta B?fW?tN THE v0?STS R• - ?/n?u.e IIIJTERIOR Ala PILM VAPa2 DaIt Ric2 ` ••I ? il ? r? ? iNreRiollr, AIR fit-M J roTnL "R..?:• vaL u.?. u,•? . ? /a.,,, ? I / 'FS • 3(0 = ? ?-z- oM1 11 ti i o/nI'!b ity 1brA6 pATf/ I "?4IyNfb ? , _r,. !\• AlVIJ t-c, YAL4' ANAL.YSIS pF NqLL SEGT/ONS Sru o / FkAM INt; ARI. q ? . .. R... vA L ue .._bl-IyrmoR A/K F?N1 y,? ? , - ? G?o.suM wA??ao?eo Sor r yvoeo / .I Z.Ok z' 2-SHlArN1 NCr i)rC.IV-/7? ----- ?!c"1 ? S,oIuc, r L.. . ? '- - vAFk?e aAaR,La. ?t KrcRioR, n##r. r,L- M Jo.Y?3 ?orn?? R...; I/ALaIL ".i = I/"-ti • 1 iI o.'d3 s.u z kt / TornL roorAuc I-7L, ?N5 lL1..ATr-D l1Rc A B&TWLaN STU05 "rj"- VALU. L .bt rureaioa ,?oot. rit.M ?7• ,1 4YP3uM ydA??.6eqe0 - ?q.c ?M INSLL?AT ION (R,,? ) -Z•??O ? SN6? TN ?N4 •DUf L.1?r ?1:_ . b7 r?P ?L?i o Iu4 r yA oo N. 1;1A ?crt-? C[, • L17 cAraR.irFx ^in. riLw1 Z_ Z9L-XDTAI. Nw.. YALHC. p-'r,•Lx-%& . ( ?22.`j1o. ? ToTAL rootA4L / ??IcO M?i ?a?vx.rt. • UArc7 iv.SG'y. au..o_ ???.-. (-\ AN u u. YqL u t R? M ?70? S T AN.avysi!p 01 WAL-r 5[c.Tin.?/5 aRL A : "R' - VAL uE •(0__I nliERlof, ,11rZ I'IL M 110 - " IU5UlA7')pN CR.i`t ) 2.00 %-SHcar Sior?i c,_LA P _ I'h-" SoFrwooa •?7_E,<TfR.IOR A 19- P:It-Nl 24-.3`j To7' A L' cj..?' 1i.4(?,[.L ?1.,? . ? /a.3 . ? '24-• ? • . ? o i Totn??r?c,? ??1Z? r ouNi O q'r' IoN V-JALL. ARE.n CABovr, CqRworc.D ,. R•• vA L u. E, INfER10R AIR Ht-?1 CoNCR r rc (;LOCjG r( ?I?Illl?) I. oo s' F? r "z- w&A r(R. `_?EXT?KIO? AIK FII.M l 2 •?c3 -j-orAL FJ„4 VnL u.E- uu?a Il? Q ?? ? ??1?? ]-OTAI FCX3TAvc?aE, ma., e-i ia>v??Ry `c4- pRIrcE0 1??a I ... .. , . . --- ---- APFLICATION FOR PERMIT INOTEO pAYMFNP OF FEE AT TIME OF ? ; rsrLtcrMoN ooES rOr car ; szz?cme nergc?nv, oF PMuur. ; . . SEWER AND/OR WATER CONNECTIO : Ir?'rM°r' oF s?+ ^rm/ox c,mT°t * ; xtzsruuTTazs w¢.t Nar eE scEYJtm : . . t I37CIL PIItt4T HAS HEESd APPROVID. ? dtV f#k'1?lR!*Y41ftf1r?4! 4'ifefMfllfi#ltifll OF CC'iCjC8n (PLEASE PRINT 1) PROPERTY ADDRFSS: T.FY;AT, DESCRIPTION: IF EXISTING STRL'CT[JRE, DATE OF ORIGINAI, BLILDING P°,.E2MZT ISSIIANCE: PRFSENT ZONING/PROPOSID LSE: Q CODM'IERCIAL/RETAIL/OFFICE Q INDL?STRIAL a INSTI'IVTIONAL/G0VERPIIMENT 2) ? NAME: ADDRFSS: CZTY, STATE, ZIP: PHONE: Nbnt Yeaz IZ R-1 SINGLE FAMILY ? R-2 DL?PLEX (3+.vv C'nits) Q R-3 TOWDIIIOL'SE (Three + Units) ( Units) Q R-4 APARTMENT/CONIDOMINIUM ( Units) ,Ltmioers iacense: I? Active Expired Not recordec St Initial 3) NAME: ???^n 4 ADDRESS: !b l B CITY, STATE, ZIP: -RI60/4, PxorE: 4) C_w •,?a •.u?• ADDRFSS: CITY, STATE, ZIP: PHONE: ? ? u. _ o?, • ?: u &?':SaTii?'..e? : o,n. ?i ?? 5) g?fCONNE)CTION TO CITY SE44ER Ej CONNECTION TO CITY WATER O 0'IHER 6) -7`W :r*****************?***'?,r?*?**??*******?*+*******?*?*+?**,r*,?*?**?*?*******?++?**?+*x?********?**? * TI3E GOLD COPY OF THE PII2MIT WILL BE SIINr DII2FX.TLY TO PUBLIC WORKS TO FACILITATE MEl'ER PICK-OP. * PLEASE ALIiOW 'iW0 WORKING DAYS FOR PROCFSSING. SONIDONE FROM TM CITY WILL ODN1'ACT YOD IF 7Y]ERRE 'f * ARE ANY PROBT,EMS. + ???* x?****r e**** r*,r,r,e ****,rt*+*+?+,r**,tr+r,r**?t**?**+??***?*****?**,+r*,tt****,t*+**t**** ?+****,t**?***?**; FOR CITY USE 4NLY PERMIT # ISSOED G 7 ' . Pd w/Bldg. Permit FEES: $ $ /G' 5--2:) SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SC'RCHARGE) $ (n 7'U Z) $ WATER METER /COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLDDE CORPORATION STOP) $ $ SEWER TAP $ $ I??•p? ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ SS 0 g--6 $ WAC $ $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRONK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREAT MENT PLANT SURCHARGE $ $ OTHER: 7 $ S?- U J $ - TOTAL (5; 711 l f 72 z3 RECEIPT RECEIPT DOES DTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGI[VEERING NO DIVISIO [V. LIST AS A CONDITION. SOBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: