1966 Glenfield CtCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1966 Glenfield Ct
Lot: 39 Block: 4 Addition: Diffley Commons
PID:10- 20450- 039 -04
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Dianne M Miller
1966 Glenfield Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA088227
02/18/2009
ePermit
SITE ADDRESS
L B ? Sect./Sub.
Unit # Permit #
INSPECTION INSPECTOR DATE COMMENTS
,
qt?-
lzS *2
. ?
-30 ?
? q7t ?r
13 ?-? 2
?
INSPECTION INSPECTOR DATE COMMENTS
304r yd - 6F- 70 , 7a - 76 ,.
fls z 5-,PZ
,? cp -.6- 1y
9 Y'- To - Z ? S? -
S Z? a 00?/
i90-7? 76,7y-7o-x -70-6,f 6o?
\ I 49 K R
.
?
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE I )_ L' 79
fEf?IVED'_T : 1
_
AM(JUNT a
?J&t u t 1?D DOLIARS ILY
?CASH ?C XCHECK
Thank You
/
eY
C o 16048 Yellow--postlng Copy ?
Pink-File Capy
t`? G?? -? yg? ?J?if ?? 1 i! C -F
.??,. _.
'[AWRIOIJSE
...,....,
BUILDING PERMIT
To be used for 12-PLEX
v . CITY OF EAGAN 1
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
\
r ??
Site Address j.9-W;?1y
Lot ? Block _Z SE
Parcel No.
W IName TEIE l?01TLUND CO IliC
o Address 5201 E RIVER ItD
City ":IDI.EY Phone 571-0304
H
Address
? City Phone
?
W W Name
? ; Address
a W City Phone
I hereby acknowlege th t I
information is correct tl
Minnesota Statutes an ih
Signature of Permitee V '%4
read Ihis application and state that the
to comply with all applicable State ol
:`:? I ISO 3
Receipt #
-?
Date-. OW 4 , 1991
_
E USE ONLY
Occupancy ?1 J*=_1 FEES
Zoning PD -R--&
(Actuaq Const YL--U gidg. permit 2. 313.00
(Auowaele) V Ln-1113 9
5
M of Stories
-2- 5.
0
Surcharge 2
Lenglh 160 ' Plan Review
Depdt ZL SAC. City 1T200.00 ;
S.F. Total 16,WD
SAC
MCWCC 7?iQQ
S.F. Footprints 9??lQQ ,
On Site Sewage _ Nlater Conn 7,920.
0o sice wan Water Meter
MWCC System x_
City Water x Acct. Deposit
PRV Required - S/W Permit 30•00-
8ooster Pump _ ?? ' 1
S/4V Surpharga__ •
_
?
Treatrt6nt PI 3,312.
APPROVALS Road Unit 4-QJn-?
A Building Permit is issued to: TRE IltOTTLUND CO INC Planner - park Ded.
on the express condition that a11 work shall be done in accordance with all ?uncil -- ?? 20*0
applicable State of Minnesota Statutes and Ciry of Eagan Ordmances, gldj, plf. _
Building 011icial Variance - TOTAL 28, 04• 00
,f(ec! gi3 Y d 70(,7
1113838 alotvjO ('I/,?&35 a/1.'lo $1-2 °o
' Pe?mit No. PermR Holder Oate Trlsphons k
WATER M14/0
PLLIMBING
Cp, ?, / 9 9?' ?S eo
H.v.n.c. ? - / 9?
11
?ec??ic !J ?'
/ 9, °°
Inspection oate Insp. Comments
Footings I
Foundation
Framing
Roofing
Rougn Pibg. „ -G_ -
Rough Htg. _ 9
Isul.
Rreplace
Final Htg.
Orstat Test
Final Plbg. plbg. Inspector - Notily Plumber
Const. Meter
EngrJPlan
Bldg. Final
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
ef fzd- //4/fZ - Ce"
,9/3844 3 `t6a Q-*, 9 /38q-'l 4'6,? °-•
,
. ?. ?,._.. ? ?-..? :.,. ..... -..? ?. _. .? ?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: t?11 a
3830 Pilot Knob Road Permit Number: +? •' ?`? 14
' Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT•
•
Ij, f '• ESl r)k f
t , . i 1 NI• li 1 I) ? i N?. i r, I haf.
I ?? E f f l. l'1 t i?mld(IN '-; ' a c, l.' ?/ E:N _ y4 1 1 . I
PERMIT SUBTYPE:
) si: N , . r+',#,!
TYPE OF 1NORK:
1tEPAlft
W '>('FifC'Ttl'iN •:iCl(tpt pqhlt?6¢
INSPECTION .. • .A
Rt MlnfiP.lNt I 110F ?,. 1.916 8. 19 7H. 1 9T2
G 1.Lt,'NF.1 r liy t r
114tf4. 19H6. t'+;t
LI
1974_ 11976. 1978. 1qF3H. tOt3
L5 i? fA6
..?
Permit No. Parmit Holder Date Tetephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Inap. Comments
FOOTf NGS
FOUND
FRAMfNG
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TES7
BLDG FINAL
BSMT R.I.
B5MT FINAL
DECK FfG
aECK F1NAZ
Ut tAGAN METER # PERMIT DATE 12I 04I gl
Pilot Knob Rd.
i, MN 55122-1897 CHIP # PERMIT # 12419
METER SIZE B.P. RECEIPT # c Q16A1+8
ISSUE DATE B.P. RECEIPT DATE 11 4 91
_ PRV _ BOOSTER PUMP
NE:
S BLOCK ? SEC/SUB
_ICANT: Thw? unt r 1ns1o Co. Ip"
'IESS: 5201 A_ Rivar R.pad
, STATE Fridley• Mri. ZIP 515491
NE: 571-0304
ABER: v a 1 1a., v 7 riat, irg
RESS: 61() Creo.k i.anin
,STATE dordsn, M,n_ ZIP '-•5,35;.
PERMIT REGIUESTED
1L SEWER X WATER - TAPS
- COMM/IND X RESIDENTIAL
_X_ NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead, of Domestic Meters on Water Line.
Cr@dp 1JU,LL NOT be g?n for Deduct Meters.
EAGAN
WITH CITY OF
ZIP 59421
SIGNATURE WHEN METER ISSUED
: ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
PERMITS, CONTACT ENGINEERING DEPT.
-._WER & WATER PERMIT OFFICE USE ONLY
rY OF EAGAN METER # PERMIT DATE 12 / 04 ,'t ?
30 Pilot Knob Rd.
gan, MN 55122-1897 CHIP # h a?? PERMIT # 12419
METER SIZE f B.P. RECEIPT # c 016045
ISSUE DATE B.P. RECEIPT DATE i 1/04 91
TE pRV - BOOSTER PUMP
1968, 1970, 1972, 1974, 1916, 1978
E ADDRESS IW.. ' Wi,IW. ?? Ylan-vm CT PERMIT REDUESTED
r.= Ffl nc. f?
r?BLOCK SEC/SU ??_. ommon s X SEWER X WATER - TAPS
_ICANT: +" A+ R n t Y] i•I n r C` n l'n r
RESS: ?20? A' :vpr Rr=r?
, STATE H'r- 3fl e y, '7 ii . ZIP 57114 21
.1- r, 1 _'? a.?",d
BER: ? ° 1 ' ay Pl »m?hi ng
ESS: (} t`+- a 0%1- '..A nn ?
STATE jor<aan, :vln _ ZIP
E: 42-2t 1
_ COMM/IND
X NEW
X RESIDENTIAL
_ EXISTING
Lawn Sprinkler Meters are to be Installed
Ah of Domestic Meters on Water Line.
CrILL NOT be g?n for Deduct Meiers.
I AGREE TO COMPLY WITH CITY OF
OWNER: M.}?R ' otz l,T Ge.. i . _ EAGAN ORDI ANr,ES
l
ADDRESS: ?;..2071 E. R?yer--a --
CITY, STATE F'' • i r:?TMin ZIP $ r4/1 11
IGNATURE WHEN METER 1 ED
PHONE:
PLEASE AILOW TWO WbRK1NG IbAYSFOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. ,
I DATE: DEC 4, 1991
RE: 1966 1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 QIINFIFTn CT
(111E RL7rfi]IDID CO INC)
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) un(il the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the follo.wing
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
_ COMMERCIAL PROJECTS ONLY: Please pay for meter at City HaII. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspeclors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
7t74A4KlUSE FOR-SAiE i7NITS
CITY OF EAGAN N? ? gg43
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
7o be used for 12-PLEX Esl•Value $ 591, 000
SiteAddressf9Pl1;?82; iN;iwl 1Q119
Lot _5 Block _2- Sec/Sub. DIFF ..Y O[?4ION
Parcel No. ..
w Name THE ROTTLUND CO INC
o Address 5201 E RIVER RD
City FRIDLEY phone 571-0304
Name _
Address
Ciry -
Phone
ww Name
?? Address
aW Ciry Phone
I hereby acknowleqe t I have read this application and state ihatthe
informatwn is correc[ n agree to comply wiffi all applicable State of
Minnesota Statules an it of Eagan f in?an?ce?sh
Signature of Permitee
A Buiiding Permit is issued to: E ROTTLUND CO INC
on the express condiUOn that all w rk shall be done in axordance with all
applicable Slate of Minnesota Stalutes and Cily ot Eagan Ordinances.
8uilding Ofticial ;o1k1?, V
1 ?
Receipt# GGIVD5L2(
Date -" -^ NOV 4 1991
OFFICE USE ONLY
Occupancy R-1 M=1 FEES
zoning PD R-4
(Attuaq Const V 1---U Bitlg. Permrt 2, 313.00
(Allowable) V 1-HR Surcharge 295.50
# ol5rone5 2.
Length 160' PlanReview 1, 03.00
Depth ZL SAC, City 1, 200. 00
s F. rotai 16 ,.49D SnC
ctCwCC 7 800. 00
S F. Faotprirns 9 'fiQD ,
On Srte Sewage _ Water Conn 7,
0
920.0
On Site Well _ Water Meler
MWCC System X
Ctly Water X Acct. Deposn
PRV Reqwred _ S/VJ Pertnit 30.00
Booster Pump - S/W Surcharge • 50
Treatment PI 3,
0
312.0
APGpOVALS RoadUnil /• • •U nn
Plenner - park Ded.
u
n W6KPenaltY 20.00
Ofl.
d
9 _
Variance _ Tp7qL 28,
0
834.01
SEDGWICK HEATING & AIR CONDITIONING CO. HEaTiNG JOBNO. ?l y9 y
8910 WENNJORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
AODRESS Z ? 6d GGG?./'Y CITV ?GAN
OCCUPANT OWNER L?<4 py.A)? L?'?
SOLDBV ?
?A LA, INSTALLEDBY APr'? ? •• ?III1'I MAKE
SEHIALNO. 5??9AAO3ya
THERMOS7AT ? ? V `?-?
VALVE
LIMIT
a•
IIMiT SETfING- l?S
FAN SETTING _J ?2h'd
f
PILOT7VPE PFr Y'nw/C
IGNITION MODEL ?
PILOTTIMING I?).S 4n T
PRESSURE S.?"Q C PERCENT COz Gp
INPUT CFH GC PERCENT Oz °
STACKTEMP. 3A I ^ PERCEN7C0
FOflM2%(flEV 11189)
7j?/a'l N VJ D AO 7O
MODEI r
INPUT lacgl?
,,
VENT SIZE y
NPE OF LINER
LINER SIZE
FILTERS: SIZE (JpXd?X l NUMBER
WIRING SudG,Z4
TEST TAG
IIGHTING INST.
DATETESTED? -)f
.JK( %
COMPANY TESTING
NAME OF TES?
FORMDISTflI&1TION' WHITECOPY - JOBFILE YELLOWCOPY - CItV
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
s ?o1/ PI°
New ConsWCtion Reauirements RemodebReoair Reouiremenls Offce Use Onlv
3 2gistered site surveys showing sq tt of lot, sq. ft. of house, and all raofed areas 2 copies of plan Cerl of Survey Recd _ Y_ N
(20°k maximum lot coverage allowed) 7 set of Energy Calculations forheated additions Tree Pres Plan Recd Y N
2 copies of plan showing beam & window sues; paured found design, atc. 1 site survey for additions & decks Tree Pres Required _Y _ N
1 set of Energy Calculalions Addltion -indicafe "rfon-sde septic system Onsite Septlc System _Y _ N
3 copes of Tree Preservatlon Plan ii lot platted atter 711193
Rim Joist Detail Options selechon sheet (6uildings with 3 or less unils)
?f
Date ? / `1 s
/ CJ ?
` 2?J l
Construction Cost (
Si[e Address [9 v` " ?
L r4(;/\o {` ) Ll- / J c f Unit/Ste #
Description of Work
Multi-Family Bldg _KY _ N Fireplace(s) _ 0 X 1 _ 2
+?
Property Owner /w1 ,' Telephone #((?'7/j Z7'-3 ' S1I?
Contractor
Address City ?vL(;l
State lu^'? Zip 'jS)7 ? Telephone # ( °f i-/)
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
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y ` N
fee applies.
Licensed Plumber Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the informatiortis_eamglp-te:??ace?ske;
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 f9[ a permit, and work is not to start without a
permit that the work will be in accordance with the approved lan i' d?he case f?v rk which requires a review and
approval of pl s.
?;31 1-1 o
Applicant's Printed Name Applica ,Ys Signature
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
4gq•?S
New Cons6uction Reauirements RemodeVReoairReauirements O(fice Use 0nlv
3 registered site surveys showing sq. iL of IoL sq. ft. ot house; and all roofed areas 2 cop'res of plan Cert of Survey Recd
(20% mazimum lotcoverage albwed) 1 setof Energy Calalatlons for heated add'Nons Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey for additions R decks Tree Pres No[ Reqd
i set of Energy Calculatlons Addifion - indicafe i/on-sde seph'c system _ On-site Septic System
3 oDpies of Tree Preserva6on Plan'rf bt platted after 7/1/93
Rim Joist Defail Options selection sheet (bldgs vnih 3 or less unfts
D
t
a
e Construction Cost
Site Address UniUSte #
Description of Work / (? OF)f '2/r 2 (7
Multi-Family Bldg _ Y? N Fireplace(s) ? 0 _ 1 _
Property Owner - Telephone # 05f ) (Qbb -70_10
RMA HOME SERVICES INC.
Cantractor
_ Home Deopt Installed Sales
Address _ 3200 Cobb Galleria Pkwy., Ste. #200 City
Aflanta, GA 30339
State 763-542-8826
Telep6one # ( )
BC-20268257
COMPLETE THIS AREA ONLY IF
Energy Code Category - M'n°esota Rules 7670 Cateeorv 1
• Residential Ventilation Calegory 1 Worksheet
(q submission type) Submitted
• Energy Envelope-C?lations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
• New Energy Coda Worksheet
Submitted
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 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 ? the case of work which requires a review and
approval of plans. ? -
Ap icant's Printed ame Applit"anfs
. .. i
Installed
Siding and Windows
L;IMITED POWER OF ATTORNEY
Cvi3NTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sa1es loca*ed at 660 Mendelssohn Avenue North, Goldea Valle.u; rhN-
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attomey-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (tfie "yVork"). •
The powers conveyed to the Agent by this Limited Power of Atterney are
limited solely to the express powers delineated herein and apply,solely to the Work.
This Limited Power of Attomey shall expire and automatiaally be revoked on the 21st
day of May, 2004, which date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principat's death,
disability, incapacity or incompetence.
IN WZ'I'NESS WHEREOF this Limited Power ofAttomey is execi.rted this
21 st day of May, 2003
.
David R. Katz ,
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21st day of May, 2003.
Notary P ic in for the State o eorgia
b4y Commission Expires: January 21, 2006
396816.0
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
1991 BIIILDI!VE.iRMN IPPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
140LTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PLANS
1 SET OF ENERGY CALCUI,ATIONS (CHECK WITH BLUG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
L# OF FOR SAI.E UNITS
PENALTY APPLIES i1HEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. IHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: "- F
gMjLY. Valuation: Date: 1r/261q1
1966? 1968, 1970, 197Z? 1e7y, 1976, 1v7e, 1980
Site Address /qSZ 198'-{y 1986y (98R
GLEN FIQD cuURT
Lot 5 slock 2
Parcel/Sub e:"nC+gr,
Owne r 7fiE 17?aT r ?cr?-1f.? if,,r .?
Address EVIL.tEi' 2•0?>
City/Zip Code MEj?4'21
Phone ?'-''}?-???{.
Contractor 579}jjE'_
Addres
City/2
Phone
Arch./
Addres
CityfZ
Phone #
Sewer/Water Licensed Contr.
SR Ij 001) - OFFICE USE ONLY
oceupancy R'1 M -)
Zoning
Actual Const (•HP
Allowable
# of stories Z
Length 160.42
Depth 70,'75
S.F. Total 1?? ?00
Footprint S.F. 600.
On site sewage_
On site well
MWCC System ?
City water _ /
PRV _
Booster Pump _
APYROVALS _
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit .23 13, DO
Surcharge 2.45, 50
Plan Review 15030 00
SAC, City lZDD.oa
SAC, MWCC 7UD • o0
Water Conn. ?92U?b0
Water Meter ^--?
Acct. Deposit -
S/w Permit 3 G,oD
S/W Surcharge 15D
Treatment P1. li'31Z.oa
Road Unit W'40.00
Park Ded.
Trail Ded. --
Copies --
SIISTOTAL
Penalty
Lot Change
TOTAL 29- Q1q. ao
4 agrees that all work shall be done in accordance with
ignatuiie ? of Contractor)
all applicable State of Minnesota Statutes and C3ty of Eagan Ordinances.
• '?,?Y s.
f ' • EXTERIOR .EWELOPE AVERAGE "U" COMPUTATIVN
OWNER T?-( ?_ ?','? ? l?')F-i L? ??: ?. `•_'i:.i! ,
SITE ADDRESS LDT S. ILDt.dC Z. L?IFF{.EV CoIMFM9OMS
CONTRe1CTOR I
DATE
PAONE
J 7/'? ??04
Determine c;orking square footage of each.
1. Total exposed wall area ..... sq. f[. x .//? = 2L2 .-7c'7
2. Total roof/ceiling area ..... sq. ft. x r026
= 2?•`:
Total exposed wall area above ?
floor =.l 7 2-5
v
a. Total wall window area ......... ................... ^?.
b. Total door area ................ ...................
c. Total sliding glass door area .. .................... ??•?
d. To[al fireplace wa11 area ...... .................... -=-
e. Total wall framing area (average 10%) ................
£. Total net wall area above floor ................... Lt=:I.C:
g. Total rim joist area ........... ................... 2-Ic.?1
S
Total e:cvosed foundation area = S
h. Total foundation W1RdOW area ........................
i. Total net foundation area above grade ............... C^, ?
Determine "U" value of each wa11 segment.
a. g lfUll
b. a?.V X "U"
c. .?.v X „U„
. O"7 = Z: G?o
?/) = - I' J ?
s ? . •- .??
d. X "U"
e. ??.i.? X "U" •
F. I G? g stU" ? O4z = C-/),
g. 2lG,0 X „U„
h. - X IlUff
i. X ?TUFT ? ?7C?; _ ?CG
3 ......................................Tota1 ° /...,-) .-?_,
If item # 3 is the same as, or less than item U1, you have met the intent
of SSC 6006(c)2.
:
(
?
Total exposed roof/ceiling area =
Total gross roof/ceiling area
j. Tota1 skylight area ..............;?....... =_T
k. Total roof/ceiling framing area ..::......... [? .'c?
1. Total net insulated roof/ceiling area ...... ?_?Z!c
Determine "U" value for each roof/ceiling segment.
R nUn - v --
k. X 'lUll
X nUn
4 ..................................... Total = Z l.Zx
If total of ll4 is the same as, or less than f12, you have met the intent of
SBC 6006(c)1.
To utilize the total envelope system method, the values established by the
sum of items tl3 and ;14 shall not be greater than the sum of items lil and f(2.
+ 2. 3. ; .? i ;? +
coiist? n
InL•crior air film 0.G1
2. $/?" f.- ; /' /3/' /?. •
3. F?(?,C.lt?=1? ?` ?.r/•.;t? L •?'G?
U.G
q. Exterior air film (still)
... Tataz r- -_ 39 115-1
. • • ?l- v?s
Venced Heat flow ?
up . .
_ ? ,. .
• I , .
FTG. 115 i '
i .
. ? ?
.. ? ? • ^
?
,,,?., ..,?•u :.,;1__???'-_-a;,_??'_`?°y'=1
p I2 f16c'? . .
0.61
1 Znterior air film
.
2
S/b".C->`%!' !3!C !? ,S ?
,
3. .2x ti 7'Rv-.;
4. E>:terior aiL £i.lm 51 ?a1 ?? _ ??•?y
. . • ? : :: , u?."/
a
\z-
?
g_cc flov up - ? .
. ?
..FIG. i16...'...
.-vented
. ., .•
• '? ' ', .\' ' : '' ? . .
• 2;0,17-Vi= • , •
? ' . }1eaC , .
flov tsp •
, .. r'
crr A7 ? •
U.61
1. Insi.de ai.r Lilin
?..
3. ' ..
4.
5, Outside air. fillit Tota1
pote: Use additional sheets iL- more cPaco in
reedecl for del•ails and calculal•ians•
" xoor•/csiLSric
IJIlLL S1:C'1'lUNS
1'G: Use 102 ot opaciuc wall area for
irame construction
vaye s o1' 9
Construction • . . R-Value
1. Interior air film ? 0.60
2. ??Z•?G,TP GK:D. ."S
3. ZT"f 5T1/05 /?e..io/C L/o3r?S
,9. 31-r"FUA"1 >xre- G-,oU
5.
6. Extermr air film _ 0.17
Total k =12
1. Interior air film 0.68
2.
3. ?UL C WAt L/fr.5[iC. / 3.OU
9. OU
s. 0
6. Gxterior air film 0.17
Total /Z = 2 1.5-0
Interior air film 0.68
2. S?D?u/,?I[[ /n-SCJL ???.OO
3. 2 X_-. f7 /n? /: S u
9. 3/"1.
5. n
6._ Exterior air film 0.17
Total JZ = .27,cr?
' U= ?v`l `(
1, Interior air film 0.68
2.
/N- L
v /U.OO
. 3. y'?wiDFCU?-? cv/tR3tuUc .yy
9. -
5.
6. Erterior air film 0.17
Tota1R'- -? 1•2
. v- e a ss ?r
. ' ? 6 • r •. • ` y
•Sfr ?rI?fT
'• ?? ;?
_
•
/1/
`_ . ,
• .
,
? ?
? •
`?
l
I?(? ? ?
/
/1 ? V ' • ?
r. , • .
?ti . • , . . : -- !?'.
FIG 114
: ^
• -:
/ i ? X ? r??
,;. 113 /?-
I!_ ` • •O ` t -T • .
' --.
--
E%TERIOR . EWELOPE AVERAGE "U" COMPUTATION
OWNER T?a ''-I , ? __i LD . ._L /-I C. I
SITE ADDRESS .;0 0 A3 L- ro %in
CONTRACTOR SA.\A (= DATE PHONE
Determine c:orking square footage of each.
1. Total e.eposed wall area ..... /eJC_?B sq. £t. x./// = 2?='•7 7
2. Total roof/ceiling area .... .6 22? sq. ft. x r02(o _ IG?•1 11
Total e.eposed wall area above floor = +
a. Total wall window area ....................... ...
b. Total door area ....................................
?
c. Total sliding glass door area ...................... "?;•C
d. Total fireplace wall area ......................... ?
e. Total wall framing area (average 10%) .............. I 5 Z?
?
f. Total net wall azea above floor ................... 13
g. Total rim joist area ...............................
Total exposed founda[ion area = ? ?
h. Total foundation window area .......................
i. Total net foundation area above grade ...............
Deteraine "U" value of each wall seoment.
a. ? •? X "U"
b. ??'J' •? X "U"
c. o?•? X "U"
d. ? X "U"
?vr
e. • X "U"
x „U„
; ?.
g X flU[,
h. -"
. -4-7 = 14 ,4?
.O-7 = 2, p'-4
. 41 = l ?o?r 2
.087 -u
042 ?= i . 1 '2•
. ---
.
x nUn
X nUu . 0-(--
(o _ •, z• cl=
?
3 ......................................Tota1
If item U 3 is the same as, or less than item 111, you have met the intent
of SBC 6006(c)2.
Total exposed roof/ceiling area =
Total gross roof/ceiling area = -7'?
j. Total skylight area ................, t? ...... '-
k. Total roof/ceiling framing area ...:?:?..... `1=: ?7 Z
1. Total net insulated roof/ceiling area ..... -I I Ca.4:7n
Determine "U" value for each roof/ceiling segment.
- X nUn
J•
k. X trUlt
X,lU„
4 ..................................... Total
If total of fi4 is the same as, or less than l12, you have met the intent of
SBC 6006(c)1.
To utilize the total envelope system method, the values established by the
sum of items Il3 and !i4 shall not be greater than the sum of items lll and #2.
+ 2.
3. ? I , °' ? + 4. i i = ! ;
Const? n R=,Vn1_ ,le
1, InL•crior air film 0.61
------------
2. 5/r..? ? ?r ri/' n.
3. F1 P.>(=ICC-r 1_A-.`
4. Exterior air film (still) U.G
r- Total ?: -. 39StU
. ' (f= ,OJS
Venred
Ileat flow
up
,
FIG. f}5 i
i .
' . vented•
Y.eat flocr up i .
FIG. i!6 ? .' .. . . ' ?. . .' .
yC lZ fli(/?=
1. Interior air film 0.G1
2. 13 Y / , • S ,
3.
4. E>:tcrior aii fi.1m, (still ' ?'• r
' ['.. .cQ
U.61
1, Inside ai.r filin
?..
3. ' .
4 ?, 17
5, putside air film Total
v : . v .
? fi02J-C?h'TED • .
flow ap • '
Note: Use additional sheets it• more sPace is
needed for details and calculal:ions.
ROOF/CEILTNG
- - ?_.____------??r------r
' " W/?LL Sl>U'1'lUNS
tiU7'G: Use 102 of opaque wall area for
, frame construction
FZG. ?I1
! L 1SCr L:
i.r5eral
TLI.
E. FRAM SIALL
.el - ?.
. ?
.??
u •
11) ?!r` ?i??
??? . .
rEiye d oL 4
Construction c R-Value
1. Interior air film 0.68
2. GYE'. CGC- D? .?S
3. zx-l` 57v05 2 v
6. Exter.-br air film 0.17
Total u -12, SS
1. Interior air film 0.68
2. 112"G-Y!' L5/r'/). 1 y j
3. F'v« WALL <vc. ! 3,'!Jo
4. 31y" 1--vA111 5t?7C- 6.00
s, s/u"n?r?:??eo?? L•?h S-n?:.?- /,?O
6. Dcterior air film 0.17
Total /2 = 2 IeSU
v= . .U47
1. Interior air film O.GD
2. e- L
3. 2 X? ta??
9.
5. 'S/cf n?E'OcvOC%i> % «
6. Exterior air film 0.17
Total n _ .27,cr ?
I/= ovLl Ll
1. Interior air film 0.68
2. F014"
3. ?1"wioFCO.?.c cvicn?cocic vY
9. -
5. -
6. Exterior air film 0.17
Totala '? ?•2 '
• v- avK?,
.I e . . .
r ` 4
l(l ,-
Fzc. 114
0
? 6 • ?
. ?
0
(!t .
k •?
I >
.
W ,
ir r -E
?
ric -?-
Ill =
- ?
ic. Va ` y o (?
?l y - . ` . ?.? ? .
, .. PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 027914
(612) 681-4675 ' Date Issued: 0 6 J 17 / 9 6
SITE ADDRESS:
P.I.N.: 10-20450-039-04
1966 GLENFIELp CT
LOT: 5 BLOCK: 2
DIFFLEY COMMONS
DESCRIPTION:
,.-, STORM DAMAGE
9i.iilding, Permit Type STQRM pAMAGE
?8uilding Work Type REPAIR
t" Census, Eode 434 ALT. RESIDEN7IAL
?- , . . . , . 3
? •_ - . . . `.Jr.x y . , ' j'-q%?
{
i
? a
;3r zI, 7,
-Al "„ap: ?'J 6 !
REMARKS:
INCLUDES: 1968, 1970, 1972, 1974, 1976, 1978, 1980, 1982, 1984, 1986, 1988
GLENFIELD CT
FEE SUMMARY:
CONTRACTOR: - Applicant - sT. LIC.OWNER:
DU ALL SVC CONSTR INC 17889411 0003178 HOMEOWNERS ASSOCIA7ION
636 39TH AVE NE 1966 GLENFIELp CT
COLUMBIA HTS MN 55421 EAGAN MN
(612) 788-9411
? . I
I hereb? acknowledge that I have read?this,applkcatipn and etate that.the
ingoi^maYion is correct and,agree,tp comply with_all applioable State o,f Mn.
Statutes and City of,Eagan prdinances. •
L
APPLICANT/PERMITEE SIGNATURE ISSUED ' IGNATURE
CITY OF EAGAN
I r.Y` •` ? 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
RemodeUReoair Reauirements
? 3 registered ake surveys ? 2 coptes of plan
? 2 eopfes af plans (include beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additlons 6 decks)
? 7 enargy calculations ? 1 energy calculations for heated additions I?
? 3 eopies of tree preservation plan if lot platted after 7/7/93
required: es No
DATE: CONSTRUCTION COST:
I(\ ' ? A 1) /1-
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT 5 BLOCK
PROPERTY Name:
OWNER
U51
i1R81
Phone #:
Street Address•
City:
State:
CON7RACTOR Company: ou ALL iElYR? lNC.
636 ?9th AVENUE NE
COLUMBIA ?612M788941I
Street Address:
City: State: _
ARCHITECT! Company:
ENGINEER
Name:
Zip:-
Phone #:
License #: 3 ? 7 8
Zip:
Phone
Registration #:
5treet Address,
City: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the information is correct an e to comply with all
appiicable State of Minnesota Statutes and City of Eagan Ordinances. ??,v???
Signature of Applicant: r?
OFFICE USE ONLY
Certificates of Survey Received _ Yes
No
Tree Preservation Plan Received - Yes - No
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
3 - :-1 „ 9?--
onre
?cEI?o
AMOUNT V
i
?LLARs
O CASH
Thank You
?
,
?
C 017585 '?t?ayers CWY
r?coar
?._.Fao cavr
dj? F-)t?
&-t7
r a
RESIpE'NTStsb;:._
CITY OF EA6AN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100 aip
?4?,G3?t1?Cl17:;'??,ttMl'C IrS?,
.:...
FOR CITY IISE ONLY
PERMIT #
RECEIPT #
DATE:
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST X
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:_
CITY:
PHONE #:
ZIP:
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $
STATE SURCHARGE: .50
TOTAL: $
SIGNATURE OF PERMITTEE
qpM24WIA,tj2?DU$TItZAY::? YLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-__--___-°---°-----------°_-_____---__•
CONTRACT PRICE:
OWNER NAME: 2?Y1-1l l?
r -
SITE ADDRESS: zG ?r'Y_ J 'Di
LOT:? BIACK _,)_ SUBD
INSTALLER:
nnnRESS: 9303 PI mouth Ave?No. Golden a ley, M. 55421
CITY: ZIP:
PHONE # : 15?k1 cp -
FOR:
CITY OF EAGAN
?Ji -k?c t?r¢.55 :
FEES I D Pi
18 OF CONTRACT FEE.
STATE SURCHARGE e $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
Of-I
$?
$ !0_0
TOTAL: $?sU 1S1
(.IGNATUR )
?
G?Enn-???dC?-???-
01 70,Ia,"
?n, r,?n .s5 ia3
CITY OF EAGAN
.' ` 3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
V;"i$"
FOR CITY USE ONLY
PERHIT #
RECEIPT
DATE :
j`??S:IDENTZAXqY PLEASE COMPLETE IIPPER PORTION ONLY FOR SZNGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
I'
OWNER NAME: bN \-- ?
SITE ADDRESS: MG' YY
LOT: -5 BIACK 12 SUBD. ?
INSTALLER: vJ1??c., ? I ? ?
ADDRESS : C n?? lC l_
CITY: J. 2 e? ? ZIP: 3 S?
PHONE #: "?`0 ' J ` a i
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00
i?. WATER CLOSET 3.00 3t,-
L BATH TUB 3.00 J i.
LAVATORY 3.00 Jl.-
QL KITCHEN SINK 3.00 Zt,
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00 Jl,-
? FLOOR DRAIN 3.00 5b-
GAS PIPING OUT.
(MINIMUM - 1) 3.00 -36 "
ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL $
ST. SURCHARGE .50
TOTAL: S
COMMERqI?.I:jINDUST?IAL:, PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS A
? MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNZT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT:__ BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP: _
PHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
CITY U3E ONLY
L .? BL RECEIPT
SUBD. DATE:
tv Q
1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? ail commercial/industrial buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
DATE: f^ 3-l CONTRACT PRICE:
WORK TYPE: r NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: o $25.00 minimum fee QC 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of pgrmit fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS: zaz /lf'7d 19 77, ap? (?''x ?l C'cw''f.
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
TELEPHONE #:
INSTALLER: -VAa
?
ADDRESS: ?3 r 54'
CITY: 54 4?•'s ,ft?'&A-lk STATE: kv_ ZIP:.?L
PHONE #: ke`C)
SIGNATURE:? 1QZ4- //J--;'? L2CL=??
IGN URE OF PERMITTEE CIN INSPECTOR
03114 ? 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
??5 fi?!
Date 0-/ DICKINSON,KELLY
Site Street Address 1986 GLENFIELD COURT Ufllt #
? EAGAN, MN 55123
(651)688-7060
Property Owner Telephone # ( )
.
contractor (612) 827-4033 Telephone # ( )
,4ddress 2905 GARFiELD AVE. $O. City State
I Zip
MINNEAPOL
S,
The Applicant is: _ Owner L-Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener ? Water Heater $ 15.00
? replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total $ 1!;,. 5-0
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
NI"T bLc,?
Applicant's Printed Name
Q ??y? ; - --- - -- - - -
;A pli s Signature -?
u IJ?
;o' ??o • ?°
? RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagau
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reawremenis RemodeVReoair Reauiremanls INfice Use OnN
3 registered site surveys showing sq. ft. of lot, sq. R of house; and all roofed areas 2 copies of plan CeR af Survey Recd _ Y_ N
(20°k maximum lot coverege allowed) i set of Energy Calculations (or heated additions Tree Pres Plan Recd _ Y_ N,
2 copies o( plan shawing beam & window s¢es; poured found design, etc. 7 site survey for addNons & decks 7ree P2s Required _ Y_ N
lsetofEnergyCalculallons Addi6on-indiceteif on-siteseptx system On-sileSepdcSystem _Y _N
3 copies of Tree Preservatian Plan if lot platted afler 711193
Rim Joisl Delail Opfions seleclion sheet (buildings with 3 or less units)
Date (?2 /,aq / u`(-' Construction Cost Oan
Site Address 1R7? C-AWNA Q y, d iz.?r Unit/Ste #
Description of Work N_??Q___ ?'?,? Y-0. _
Multi-FamilyBldg K Y? N Fireplace(s) _ 0_ 1 _ 2 D???SOnn
L%
Praperty Owner l ?l t out
Telephone #( 0 6 2
Contracror
Address ?2 I LP 01.??Oc? t I'
?Y F
? R.tlt City ST ?u
State \ \?J I
ZipF&u2(4v Telephone#
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy COde Category . Residential Venlilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously ccnstructed a building in Eagan with a similcr plan? _ Y _ N !f so, 25% plan review
fee applies.
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Telephone # ( J
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 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 ttyt case of work which requires a review and
approval of lans.
Applicant's Printed Name Appl' ant's Signature
Clty Of EaiaIl
3890 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
i ------- --,
? 's? i
j Permk b
MAR 12 2DO9 ; Pe?,h F?: SI ? D v I
I ?
1 Date Received: ?
i ?
? Staff: ------ J
2008 MECHANICAL PERMIT APPLICATION
Date: '4-,ZZ - 0 79 SlteAddress:????_f
Tanan}•
3uite #:
RESIDENT/OWNER Name:,64:r/Ag1?izx,2F' ?/?+a1F Phone:dri ??s-.??3?
Address / City / Zp: / ' "
CONTRACTOR Name: Age? - dwwl'' ?i'- ?cense #:
Address:
? city. State: AV,rl Tap: 57,1?I1
Phone: - - Contect Person: Ze,?29S?-
TYPE OF WORK -New ?Replacement _Additional _Alteration _Demolition
Description of work:
Both; ib01 inounfed a`ntl„giound moUnted mechenToal equiPment !s reqolred 10
r•<NOTE:
,
Fl?se cor?tact the A?Aechanlcaf?nspector or.one of the -
Cada
be screei?ed by ?lt y
s
,
.??P(anners:far.'lhfomifatianorirmltted-screenlri ?m+ethods.1'>
RESlDENT1AL COMMERCIAL
PERMIT TYPE New Constructan Interlor lmprovement
Fumace
? -
Install Piping _ Processed
Air Conditioner _
EMerior HVAC Unit
G?
Air Exchan er
9 _
-
• HVAC units must be screened
_ Heat Pump Under! Above ground Tank (_ Install /_ Femove)
Otner " When inslallinglremaving tank(s), call }or inspection by Flre
- Marshal and Plumbin Ins ectw
RESIDENT/AL FEES:
$50.50 Minimum Add-on or atteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fife fEp3ir (replace bumed out appliances, ducMrork, etc.) (inGudes $.50 State Surcharge)
$ ?? • ?? TOTAL FEE
COMMERCIAt FEES:
$70.50 Underground tank installation/removal OR Contract vaiue $ x 7%
$50.50 Minimum (includes State Surcharge)
Permit Fee
• If Pertnit pg.@ is lesa than $1,000, surcharge is $.50.
=$ State Surcharge
- If Pe i E22 is > $1,000, surcharge increases by $.50 for each
$1,000 Permi[ Fee (i.e. a$1,001-$2,000 Permit Fee requlres a$1.00 surcharge).
$ TOTALFEE
;
I undersisnd this is rrot a pertnit, but only an applkation ta a partnit, arnd vrork is not to start vrithout a permft; that the work will be in acxorclance wiM the approved
plan In the case of »oAc whioh requlrea a revlaw and approval of pans.
%(?/J"?/,? X
Applleant's Printed Name Appli Slgnature
FOR OFFI¢E USE. .,: Revlewed By = ?e
- ReqWred Inspections: Under:Ground 44,Rough fn' ? Air Tes[ Gas Service Test In-filoor Heat _ Final
6_?7 9 -1,64
?---------------- ;
? Permit#: 7725 clp /O j
I
? Pertnit Fee: • i I
? Date Received: APR. 0 3 ZOVJ 1
I Staff: I
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION C2t&d q17
Date: q'3'07 SiteAddress:
Tenant:
Suite #:
RESIDENT/OWNER Name: Phone:
S51
?
Address / City / Zi :
Applirant is: _ Owner _xContractor
TYPE OF WORK Description ofwork:
Construdion Cost: rAq,Multi-Family Building: (Yes _ 1 No ?
CONTRACTOR Name: --t? ?- i License #:
Address: g3g.3 ?b? ?•
City: 4e'`-c" -V "* State: Zip:
Phone: Contac[ Person: L ?? -6)e
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 CateqoN 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
CategOry Submitted Submrtted
(4 5ubrt11ssiDn type) • Energy Envelope Calculations Submitted
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 8. Water ConUactor: Phone:
NOTE: Plans and supporfing documents that you submit are considered to be public infor`mafion. Portion"s of"
the inforroation may be classified,as`non=pu61icifyou provide specifc,reasons that would permit the.City,,Xo
co»clude that the are trade secrets, '. °
I hereby acknowledge that this information is wmplete and accurate, that the work will be in confortnance with the ordinances and codes of the Ciry of
Eagan; that I untlerstand 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.
X Z_CO`/LD ;E,?. ?-_^/GE? x_ ?S_ Fezi
ApplicanYS Printed Name ApplicanPs Signatu
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
? Single Family
Multi
_ 01;ofPIex
_ Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
DESCRIPTION
Valuation
Plan Review
(25%_ 100%_)
Census Code
# of Units
Fireplace Porch (3Season)
_ Garage _ Poroh (4Season)
Deck Porch (ScreeNGazebo/Pergola)
_ Lower Level _ Pool
Storm Damage
_ Exterior Alteration (Single Family)
ExteriorAlteretion (Multi)
_ Miscellaneous
_ Interior Improvement _ Siding _ Demolish Building*
_ Move Building _ Reroof _ Demolish Interior
-x Fire Repair _ Windows _ Demolish Foundation
_ Repair _ Egress Window _ Water Damage
`Oem olition of entire 6uilding - give PCA handout to applicant
?f7 Occupancy ?& 4- MCES System
Code Edition
?1 ?.>0--d7 SAC Units
Zoning
Stories
# of Buildings
Type of Construction
Square Feet
Length
Width
REQUIRED INSPECTIONS
_ Footings (New Building)
_ Footings (Deck)
_ Footings (Addition)
_ Foundation
Drain Tile
Roof: Ice 8 Water Final
? Framing
_ Fireplace: _Rough In _Air Test _Final
? Insulation
Meter Size:
Reviewed By:
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
? Final I C.O. Required
Final 1 No C.O. Required
? HVAC
Other:
Pool: _FOOtings _AidGas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
_x Windows
_ Retaining Wall
Erosion Control
Building Inspector
RESIDENTIAL FEES
6ase Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
Copies
TOTAL
P'n?Ti
? 60?x
??/ , 2 Vv
v
??' (p 7C'? ?
Giertsen Company
Restoration Specialis[s Since 1918
Recap by Category
O&P Items Total Dollars °/a
APPLIANCES 111.02 0.38%
CLEANING 1,999.82 6.85%
CONTENTD'fANIPULATION 615.04 2.11%
GENERAL DEn10LITION 2,954.62 10.11%
DOORS 1,438.32 4.92%
DRYWALL 2,285.45 7.82%
ELECTRICAI. 1,142.56 3.91%
PERMITS AND FEES 540.00 1.85%
FINISA CARPENTRY / TRIMWORK 1,723.51 5.90%
FINISII FIARDWARE 152.52 0.52%
HEAT, VENT & AIR CONDITiONING 354.38 1.21%
INSULATION 733.97 2.51%
LIGHT FIXTURES 809.68 2.77%
PLUMBING 1,406.77 4.82%
PAINTING 5,145.47 17.61%
SIDING 210.00 0.72%
WINDOWS - VINYL 884.08 3.03%
MNDOWS-WOOD 114.40 039%
Subtotal 22,621.61 77.44%
BaseServiceChazges 1,171.44 4.01%
Mad Sales Tax Reimb @ 6.7500/o 409.88 1.40%
Overhead @ 10.0% 2,420.29 829%
Profit @ 10.0% 2,420.29 8.29%
O&P Items Subtotal 29,043.51 99.42%
Cleaning Sales Taac @ 6.750% 168.73 0.58"/0
Total 29,212.24 100.00°/a
DIFFLEYCOMMONS_1972 4/212009 Page:19
RESIDENT / OWNER
Name: f 20PERrY r...- IA. Phone: 651-- SS'/ 9941
Address / City / Zip: Po. Box 212S Ali/b72 G2ovr > &H-rs /VIN S So 76
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: KEMOVE /kV 0 kfrakE gthiv &zero Qppf
Construction Cost: til .2 9, 00 0 Multi- Family Building: (Yes / No
)
CONTRACTOR
Name: 13 E1 EicirT.(o/2. A,tp -I NT. Cole P License #: 20 V{7/ 3/
Address: q0 W. 60 srnEer City: �cAfN�c�/JGJ'
I
�
/ n
State: N Zip: 5T5t1/ 9 Phone: (01 — g(o/ - 6 2 3
Contact: P,4- f L H. Email: MA {a bel,c M . CO ryt
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit fora similar plan based on a master plan?
date and address of master plan:
_Yes
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
Date:
Tenant:
City of bpi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicant's Printed Name
Staff:
Use BLUE or BLACK Ink
EarOffcr~11�
Permit #. �(U✓
Permit Fee:
Date Received:
/ 0016 47
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
ezi)
10 /20 //o Site Address: 1%,/9 ;s; 70 7 76, 7S bs''O 82 86, 88 Cver
Suite #:
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.gopherstateonecall.orq
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 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.
C,4',e /S if/451.T0i/ /
Applicant's Signature
Page 1 of 2
06/17t2014 15:05 Les Jones Roofing,Inc. �AJI�528817009 P.006/020
Use BLUE or BLACK(nk
�-----------------
� For OHlce Uce �
� j Permtt#: 6 �� j
C�ty of Ea�a� � � � �� �
� PermN Fee: �
3830 pilot Knob Road
Eagan MN 66122 � Dala Racelved: �
Phone:(661)6765675 I I
Fax:(661)875�5694 . j S��• 1
�������������.�.�.�_J
2014 RESID�NTIAL BUILDIIVG PERMIY ApPLICATION
�9G*6- /9b� /9�0-/97.2-/97� /9'7����'I8'
�ate: / SlteAddress:198o-/��2-/98y-�98�-/9�� l�En.F�Ez,o C��Q u�it�:
�li.': /�'�.:: :1 .�`.�::A.+�;
` !13..•;.'�:.`;t:�c'.�rJ� .
: �,:;:.;;,:.,...,,;;,�:;�;:<;�::,�;:�:� Name: ya P�oPa2rY c�a-�� 6/�c.. Phone: �v�!- s.s�/- 9q'y�/
. ..�,,,j;�,,5t;�'�.,.,,..�.. �.:�.<,
'I,;,�r.. , �•,1•;..y_,,..:.�:-.�
.:'�:;;;�;��,$�(�.Qllt/-,;;:<:;';;;; ,/
;, ,'�, NvEJ�t.C�72o �S f,/TS: /L1sl� �.� '��e
`'''�;';:��/��j�r't:;•":'`: Address/City I Zip: �o. BO k 2i 2 5 / +�� /�
1;;<�... ��� ";'.,:., ,';:,;,:�`
;.�;y::, ��'r��; :-i.; ,,�,
�'�'`:'","I,�`�;:�;`��'"���''' ApPlicant is: Owner x ConVector
Y l . ':.i:.
�.�.-; ',.,;;>..�;:".:�., ,�.,.y:�....,.
,..,..,,:t�� �::.. �.,.i �.',.:`.::r1:�.
.� �r'.F:;,�r,: .,,��r,.i:. ,.�.)'. C�
,;,;:;'s ;J�,;:.r If �e D�Nb-.
�'i�:L�_ .�Y .0"'1'-'j.i��^'�;tr',;!�,;.� Descripdon of wo�k:_ly�/l/l0�/� .�� [L�iQ � S/
;:•��������f aW,��'{�'.,":; � '
�:;;-;=;;"''""�."''��`-�'�`�` Constructlon Cost: � 2�v D D� ? 4 X
'�1'�X''�:�'��• ;'`1���+:Rti MUItI-Family Building:(Yas /No�
n'(•"��; .�A',::
. i.�f�/,.�t.,,ti����.T:.:�:i:�i����`1.��'�r.��:'�:
:{' .' �f����.�r�1�`W�:� ��',,.-I /
�'�`- ������,"';,�:�z°�"";;�`>'; Company: �E'S �ToNE3' RADFfi✓G- /NG , r� �Q�-ivor�2so�/
;,s',f\:'�.. :...:::......:_ Confsck G .e�s
�i::�i';?'''�`<r,';�,.;`; ��';�,':S;i,>(;:>��:
: . . ';� .. •�';
�;'��"%`�M�'F�:�::,:�'��r`�'a!�s:���,� Addrass: 9K 1 W. 8'D� .f7�2�L'7" City: ��.a.u6i►'ai✓
:,,, .� ,;r
,�:; ;�ari'�ra;�t�'r���;;::
� :<�;r-'�;��,;:'•%' �:�� :�`<'',� State:�zip: ,�,��E�D Pho�e: �5�- yrc 7-�8/9
t:' ,,:;,S;.;J:.c, ,:;'.
'+° '.ji;.tli. :����„�' ��:�����
�''�1'��:� •::iit.'.- � ,��'� ,
� '".•' �`.it. ':'�r'�'__'.
�"�' ''� �'''`` '°` ��cenae#: �S�roO �ead�ert�flcate#:
�;a::'� ,;R�, ;';�,.; .vA�� �f o 3 9.?-/
';�:.. .�...
If 1he project is exempt fram lead certlficatlon, piease explein why: (see Page 3 ior addiE(onal information)
COMPI,ETE THIS AREA ONI.Y IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the Clty of�agan Issued a pennit for a simllar plan based on a maater plan?
Yes _No ff yes,dete end eddrae8 of master plan:
Llcen9ed Plumber: Phone:
Mechanical Contractor. Phone:
Sewer 8�Water Contractor: Phone:
'i� .�.. _ - q::. „c..��w: ��.�� .�p.��,w.s.0 ,q• .,n oa�,:,,{.�:�- ,';i
;w,��'KOTL�,i..I�ris�an`-�' <'��!. 'rid'�ie�"ryj '�tli"f�' ur�ii ;�a�� ,.cb s 'e'�' �'°'�� ''� I � t o'" a o
<, .,�.Q.,.,;��:�, ��,;.,�'P�,;.,1�ri�►f ,.�� �l!��s, ,�t,,..Y.qr,,,.. .;�►ta r'� .,n ;T�I.,�r�4�:t°����!�1,��., r�#.���„,�, n ��"�;�i n�, �,��,;
*�i `r �y- {�" '�"S, ' t / A' i, a 1 � I / �+, � n.�„ J�,%.y��'„ ��j ; � � s�p� �i
'��r�°f�e;l�io�atl�1�? 8�/���4C�a�5`,��?f�,d.�S�'l�.Qhir,jl����f ��j�1)'p�/�:����!'�'���e��'+' Q , �,Sr .�,�51;{r��IF7:� ��St�a „�F .�b�rJ'i
� j� , ,H � r, V�� . 2�. aA'.l u�s•,4..0� � �,7 a �P'.:s(':"b•��� � �•,;�i. ^t�. �,7�� ��� „r;.,e:,,%�� ,�;s�.i l. ;.�
��,t.�i r ���y^� !.a Yv � J.'ti� s �� r Q �i� � iK,�..-t'x,y.r�j� i
..
. � . .c,
.
�
, •
�.. ....� , y ... �,.. �..,en�......!n:t. ��i�., ..^�i,�o�n.:,`'. Q.u..�.5 ��t Q. ;7�. a.. .�iS ���!- `F SrL°;!�'� 4...,�.� :_i�'y�� .�,�'� J.� �I
CALL BEFORE YOU DIG. Call Gophar Stato Ono Call at(661)464-0002 for protectlon agaln5t underground utlllly damage, Ce1148 hours
before you Intend to dfg to receive locates of underground ulllltlea. www.gopherstateonecall.ora
I hereby aeknowledBe ihef thls informallon Ia camplete and accurete;thst the work wlli be In co�ortnance with the ordlnancea and codes of the Gly af
Eegan;thet 1 understand thls Is not a pertnit, but anly an applicallan far a pertnit,and work Is nol to Start uAthout a permlt;thet lhe work wlll ba In
accardance wilh Ihe approved plan In lhe case of work which req�res a revlew and approval ot p1an8-
Exterior work authorized by a bullding parmit Issued In accordancs with the Mlnnesota Stata Building Code mual be completed wllAln 160
days of permlt Issuance.
X Gµk�s �4�rDE�sa,�/ x ��� G���
Appllcant's Printed Name Applicant's Slgnature
Page 1 of 3
02119/2014 12:33 Les Jones Roofing, Inc. �AK�528817009 P.0061020
� Use BLUE or BLACK I�k
�-----------------
��C������ � For Offlce Uso �
� ' FEB 1 9 71114 � pa"„��'�: ���� ;
C�ty of �a�a� � ���
� Permlt Fee: �
3830 Pilot Knob Rosd
Eagan MN 6b122 j Date Recelv�ed; j
Phone:(661)675-6875 j S��_ I
Fax:(661)67G-569a .
� I
���.__�----------�a
2014 RESIDENTIAL BUILDING PERMIT APPLICATION �f
�4��, �q�s,�9�0, �9�a, i 9�y i9��
Date: 2 �9 � SlteAddrees: 1478 /98 /9�1 1985/ ♦ � �Unit#:
.. ,�,,.�.,; ....,.,,C
A._..,,..,�..,,�. :�_ i:
, `�;��})';�.�r� a,� `ti��u`.�'''''�',' Name: yo P�20P�Ty GA-�'E �NG. Phone: �vs/� 5'S�/- p9�1�
" �.i�•r -r,�; -;:.:I::� ;
�S �'R .� � .
w � �
?.�;��� ^ :t�.
� •>��'�;° - ,�p•;'r;•�.'�M1 Address/City/Zp: �O. �30� 2►2 � /NaElL�,o✓d �'S� ��o
.�. <;r. ; ��^¢'Y.•:.�:..�
�S��M>;��• �%�� � �`���'�`��� X Contractor
G�.•���:�� ,�y��'�,p,.�b.���;+� ApPllcent le: Owner
�
,n::. ..-' .:. ,:�' ..,,x����, ,,�;;�.
� ', ,,.;� s ;;.,, ` �2 p
�1� „.��, ;�f'+ �;: Descriptlon ofwork:��D�E A�/VD d"TCPLlff.S //a»P �� ���2-�4�'i�r ��
�`�Y��';Of 11V,Q�±IC:�; .
"� � �' ""� "� "a �`= 1''� Canstructlon Cost: � / � 7� Mul6-Family Building:(Yes X 1 No�
�;. .�3�6,.:,? r,�:;,:�i?„
.....�'r,•.�Y ..F'- ..:y..�M,� ••T:
r.,.,�_;Y.".�.�I�� .���Y�.: ; :�,.�
;,�;. .�:� ;a���:�,;lr'"?���;�v�-;� Compeny: �E5 �7'oN�S RaiDfs�/b- /•vG contact:c'�•e+s A-,vn�.son�
i � ;� ., ,;r��.,:• �
;�;�C;.' Y :I�, x .:�di• -/
.;r,..�..;�.:��y��,.�( �.,....•'•i� ' /� ,���,.�.» �GYlGCA�TTYaN
dp:,".�,h;....��,�.ri�s�.. ���i �d(8S$. '7�� w �d� �/�G i Cil�l:
:�;�L,qr�4r��t�,i?�, o
'_' -�...��.,�;��'1,x..r`:,.,;n��;; State:�zip: ,�,t'k�2o Phone: 9'SA— 7�7- a?8/7
N1�''�✓'� ���1C�(.�J;;.�°I, ..^�V.� .
' � '�;,r`a:M La^:.T'�'�' � '• �J�D �
��a":A �v�cy ��,fi,, ^��' Llcenee#: Lead CertNlcate#: �l/,4� � � ��—(
.::'�:.:_ .krf... ',�..e�....
If the project is exempt from lead certlflcatlon, pleese expfein why: (see page 3 for additional information)
C�MPLETE THIS AREA ONL.Y IF CONSTRUCTING A NEW BUILDING
In the lest 12 months,has the Clty of Eagan Issued a permk for a slmllar plan based on a master plan?
,_,Yes �No If yes,dete and addrees of mastar plan:
Llcensed Plumber: Phone:
Mechanlcal Contractor: phone:
Sewer&Water Contractor: Phone:
i:' � t.'..I, r����' „1'�', -a�,�.��.1�1,'t�ftiia�-t',Q�'' �b��+� �:�'��°�l�f�.H'Cryz tbe°"ubll"in'�:Q�" �'E�{:i,S;h-�`IxQ;��"�i►s�,offt„
.,�'`��� •�.,^ '�a1:i�t :� �'' a� 1.';�`.y,Y'�4� �" ;�"°.' r .1 �� �?,�.W-�cc �� �.� �(:.,lr.. .��t ha+ �r •
�a.�'n ��rr�,�, �yy'i�n�r.t�� ,�b��-b�s� s��``��' �e Q� �i�l.. �t', /��r�ra+�,��� o�fi � ����+.�. ��a:�p, r,�►�:'t��o��p< }��...>�g
a..� '�`�` !Y� J' .�X � � i! � �:7 r�. �,� � �..'� ff�� �. 3 r. � � r^+•�lf�',.w
1. ..,M�y�y�� 7,.1.7 ;4.�. . h,� '�.r �k'• w �� �.,IM� �.� �: vr� �,d - L �5:�.:dt.:.. '�?
, ,f... Q�.
� , �j g�, ,�
, . . xN H
t1fu..,i:��l,...�,:,,«�.b.�t'�,.�i?;. ..;.u�t. .:,,. : "�•i �...... .(�.::.�:a;...:G.(�.IC.��+.�m�1��91 [����.r.:?fr.",x. f:..�....� gi .ii.a�� ...F;: i�..c�C�; :� 'M iCl,.�r: r_'it�`� u
.� ��: ..Y.
CALL BEFORE YOU DIG. Call Oopher 9tata One Call 6�t(661)464-OOOZ for protecflon agalnat underground uUllly demage. Call 48 hou►s
before you Intend to dlg to recelve locatee of underaround utllltles. www.aonher9taleoneca��.nrn
1 hereby ackno+Medge that thle Info►matlon Is complete and eccurate;that lhe work wlll be In canformence wlth the o�dlnancee and codee of the Clty of
Eegan;thet I underetand thla le not a permlt, but only an appllcatlon for a permlt, and work le not to stert wilhout e permlk that lhe work w111 be In
eccortlence wllh the epnroved plen In the caae of worK wntch requlree a revlew end approval of ptens,
Exterlor work authorized by a bullding permlt lesued In accordance wlth the Mlnnesota State Bu1lding Code mu9t be complated wlthln 180
days of parmlt laeuanca.
x Gµ,@tS �4AlDEl2,�o^/ ��lr�� .G�s�s��'
x
AppllcanYs P�Inted Narne Appllcant's 3lgnature
Page 1 013
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA169232
Date Issued:05/19/2021
Permit Category:ePermit
Site Address: 1966 Glenfield Ct
Lot:039 Block: 04 Addition: Diffley Commons
PID:10-20450-04-039
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Dianne M Miller
1966 Glenfield Ct
Saint Paul MN 55122--215
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature