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1718 Forssa Way - _ __-Use BLUE or BLACK Ink For Office Use CRY ~ r I Permit I y~ I ~J I Permit Fee: ff'C I 3830 Pilot Knob Road I I Eagan MN 55122 !'J 2 9 2-11 Date Received: Phone: (651) 675-5675( 1 1 Fax: (651) 675-5694 1 Staff: I i 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7`9 Z1 Site Address: 71 o Tenant: Suite RESIDENT / OWNER Name:--L l ~ -7-, Phone: f Sz- - vs-y- 07 9 Address/ City / Zip: 11 G ,ZIS j1f Applicant is: Owner Contractor TYPE OF WORK Description of work: CP~ /~~'f /ti~l11 Construction Cost: Vct Multi-Family Building: (Yes /No CONTRACTOR Name: Jhn License I.ead Address: 6 City: GLc% AT ` j. -1 State: Zip: r Phone: J/ - Contact: J/xJ'!( MYM Email: In the- last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes -No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: 'Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you,provide specific reasons that would permit the City to conclude that the are trade secrets.. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall org 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. X_ X Applicant's Printed Name Applic nt's Signature Page 1 of 2 CITY OF EAGAN 3795 Nlot Keeb Read Eoqon, MN S5122 PHONt: 454-8100 Bl71LDING PERMIT SF DWG/GAR Receipt # S1te /lddress Lot Block Sec/Sub. Porcei # oc Noma W ; Addross b Ci Phone °L Nome ?F ?? Address F- r:... oL___ Nome _ Address I hereby acknowledge thot I have rend this opplicotion and state thot the inlormotion is correct ond ogree to tomply with oll ppplicOble State of Minnesota Statutes ond City of Ea9on Ordinances. Sipnafurc of Permittee A 8uilding Permit Is issued to: oll work sholl be done in accordarxe with oll oppliooble State of Mii Erect ? /11ter ? Repofr ? Enlorpe ? Move ? Demolish p Grode fl . 19_ Octupanty Zoninq Firc Zone Type of Const. * Stories Length Depth Sq. Ft. Faes Assessment Water 8 Sew. PoliCe Firo Enp. Plonner Counci I Bldy. Off. APC Permit Surchorge Plan check 5AC Water Conn. Woter Meter Road Unir Totol on the expreu tor+ditlon thal ond City of Eapon Ordinances. BuJldinq Officfal Pamit No. Permit Holdar Misc. Permit No. Holder Plumbinq ?jU12 ?J??? H.V.A.C. f" Well Water Disp. S?wsr Ekctric ?EVC. /-f- 8'Z ? Irupeetion Date Insp. Other Footingt g Foundetion Frominp Rouph Plhp. C Rouqh HVA Inwlation ? Final Plbg. . Final HVAC , d &J Final ? Wow Demi6a Location: VUell - Sewmr l , Pr. Disp. ' Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee ' Fi/I in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost i -- 3. Job Address Lot Blk. ITract 4. Owner - 5. Contractor Phone -• 6, Address 7. City '- ? • State Zip - 8. Building Type: Residential ? Commercial ? Institutional ? 8. Work Description: New 0 Add 11 Alter ? Repair ? 10. Describe it 1i ___. 1- - Fuel Type , 11. No. ? EQuioment 8TU - M. Ea. Forced Air No. EQUiament CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. ? 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 Ins¢. This +5 your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt ' flrL Data 9- 14- 8? 2. Installation Cost 3. Job Address ?!:, ; Lot Bik. ` Tract 4. Owner N"u I WTHUMPSON 5. Contractor u)ENZEL MECrf. Phone 452-1565 6. Address 3600 !:QJ2Yteb2C V)C 7. City riu-im State ZiP S51*79 8. Building Type: Residential 13 9. Work Description: New El 10. Describe 11. Commercial ? Institutional El Add ? Alter El Repair O No, ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield r Bath tubs Septic Tank ? Lavatory Softner Shower Well ? Kitchen Sink Urinal/Bidet Other 1 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 Flnal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C rype or Prini legibly ? ' ,,' - . TOt. CITY OF EAGAN ,4ddition Ri dgecl; ff F; rct pddn Lor 8 eik is Parcel#jQ 63920 nQn 13 Owner Street 1718 Eorssa - Way _ Suje Eagan, MlV 55122 Improvement Date Amount Annual V+se+e Payment Receipt Date STREET SURF. STREET RESTOR, GRADING SAN SEW TRUNK 1982 298.08 5 12-23-81 SEWERLATERAL 1982 _ _ WATERMAIN WATER LATERAL 1982 1260.79 12-2-1-81 AREA 982 98 12-23-91 STORM SEW TRK 1982 638.24 5 638.24 C007616 L2-23-81 LAT 1982 955.45 5 955.45 C007616 12-23-81 Services 1982 637.75 S 637.75 ---CO07616 12-23-81 CURB & GUTTER SIDEWAIK STREET LIGHT 24o.0o 1811 -1 -82 WATER CONN. 420.00 6UILDIPIG PER. SAC PARK GTY OF EAGAN WATER SERYICE PERMIT ! 3795 P11ot Knob Roed PERMIT NO.: Eagow, MN 55122 DATE: Zoning: , No. af Units: Owner. . _ , . Address: Site Address: ' . - . , - . . Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I Q9rm to comPlg wlth fhe Cify of Eeqon Surchorge: ? I Ordlnonees. Misc. Chorges: `: vr; TotoL• BY Dote Paid: Dute of Insp.: (nsp,; CIT1f OF EAGAN SEVIIER SERVICE PERMIT 8745 Pilet Knob Roed PERMIT NO.: Eogon, MA! 55122 DATE: ZoninQ: No. of Units: Owner. - Address: i1Site Address: =1'3st? j,a?f - ii'e ? Plumber: I ayrae !o eemol?r with the Cifp of Ea9on Connedion Chnrge: .0';? Ordinonees. Account Deposit: Permit Fee: Surchorge: ?Y Misc. Charges: Date of Insp.: Totol: nsp.: Date Paid: This request void 78 months from 'Td 21196 3z?U6 30o0 Reques[ Date 0? l Z Rre No. Roaqh-in Insuecunn Re rted? 013cady N. WiII Nmify InsAer w % ?? g 1, Ves ?No [ur hen Reatly Licensed ElectNCal ConV. ctor .'I hereby repues[ insoec[ion of above Owner electncal work installad aC et Address, Box or Route No. UtV ntS pg-ss(a ? EVIA ecUOn o. Towns1-i0 Name or No. Rangc No. Cow rt y ( ? ',,? D?9? rv Occuoan t (PR WT) Phone Na. ????p?. p ? ? b1"('"?t4 Power Suppher Atltlress ? F-{dRM 1KG i0N' Electncal Contrector'ICOmDanY Namel Convacior'S Lrcense No. Be - Mading Adtlress lConvactor or Owner Making Instailatuonl Authorrzed S?d?at IC hacm wner Making Installauonl one umer ? :71--r,_,_: 890-5505 MINNESOTA STATE BOAND OF ELECTRICITY. THIS INSPECTION HEQUEST WILL NOT Grigps•M,dway Bldg. - iioom N-191 BE ACCEPTED BY THE STATE BOARD 1621 UniversitY Ave., St. Paul, MN 55104 UNLESS PNOPEN INSPECTION FEE IS o?._..e 19191797_9111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ,r Ed-oooui.ea ' See uisRoctions tar complehn9 [his form on bock ot yellow copy. C",? 21196 ,' t/ '"X'" 8e??r L"rort. Covered by This Request. 3 Z7 '[ n e Atltl ReD. Type oi 8uilding Appliances Wired Epuipment W,rod Home Range Temporary SerJlce Duplex Apt. Building Commercial Bldg. Water Heater Dryer Fumace Lightiny Fxtures Electric HeaUn Silo Unloader 71 Industrial Bldg. Air Conditioner 8ulk Milk Tank Farm Othcr pem v Oihai (Saomfy) thcr Vec, fy ONCr Othrr Compute liispection Fee Below q Fee ServiceEnNenceS¢e tt Fea Fneders/Subteedxrs N Fee Qrcuiis 0 to 100 Am s 0 to 30 Am s 0 to 30 4m s 101 to 200 qmps 37 to 100 Amps 31 to 100 Am s Above 200 qm s Above 100_Amps Above 700_Am s Transtormers Remote Control Circ. > Partial%Other Fee Signs SpeciallnspecLnn TOT L FEE Hemarks ,.v ll Rough-m th E lecttmal e tor pa c Ins, hereby certity thet the above Final ? e? ? „lnspection hes heen mede O , . ? JV . This repuest voitl 18 manths fiom CITY OF EAGAN 9796 PIIM Knob Raad Eegen, MN S5122 N? 7513 PHONE: 4546700 ' . - BUILDING PERMIT ReceiPt # Te be und fer SF DWG/GAR Est. Value $61,000 Date .4eP tember 13 1 982 Site Address 1718 Foi888 FRly (P18A 108) Erect (3 Occupanq R-3 Lot 8 Block 13 $ec/Sub. Ridgec11ffE 1St Alter ? Zoning (pD) R-1 Parcel # 10 63980 080 13 Repoir ? Fire Zone NA Enlarge ? TvPe of Const. V c Name ?'rin ThOIDp80II HOID28 Move ? # Stories Z Address 1712 Hopkln8 CroaSTOSd pemolish p Length 62 ? Ci MtkB. 55343 phom 544-7333 Grade ? Depth 26 Sq. Ft.- p Name Obn@Y' ApOrovah Faea 0V Mdrass Assessmenf Permit 316.00 V? Water & Sew. Surcharge' 30.50 Ci Phone Police Plon check 158.00 ?W Nome ?Z Fire SAC 525.00 ?? Addross Erq. Water Conn, 420.00 iW Ci Phone Planner WarerMeter 6D.00 Council Road Unit 24n_nn 1 hereby acknowledge thot I hove read ihis opplication ond sfafe thot gldg. Off. ihe inlormalion is tArre[t and agree fo comply with oll applicoble APC $1749.r?? Total Stote of M,nnesota $tatures and City of Eagan Ordinances. Signoture of Pertnittea A Building Permil Is issued to: Olr? "gtmpson HOM)AS on the express condition Iha+ all work shull be done in accordanCe with oll p Stafe In tufes ond Ciry of Eapcn Ordinances. Buildirg OFficiol < / ? CI'I'?'OF f,AGA.^I Include 2 sets of plans, i? 1 site plan w/elevations S BUII-DINC PF..Rh11T APPLICATION 1 set of energy calculations. sF????Go??^ .4: <p OOv - 'Ib Be Used For V? P- ??-,-tc_ Valuation Date Site Pddress: ?? ? a Fo?sa Ww,? ? Q?no. ) OFFICE USE ONLY Erect Occupancy ? Ipt g Block Sec./Sub. %e Parcel IO $o 0 11? D (3 F`??st Alter zoning F' Zo O.mer: Address Repair ire ne Enlarge _ 'Iype of Const. Nbve # Stories Demolish Front (p ? ft. City/Zip Code: Grade • Depth 269 ft. Phone #: Contractor: f1R R S Address: a Division of U. S. Home Corporation --------4712-„ePfE+PlS-E12633RBkH City/Zip Code: MiNNETONKl, MiNN. 5S143 Phone #: 54 a- 7 333 Arch. /Eng. : Prldress: City/Zip Code: Phone #: APPROUAIS FEFS Assessments Peimit R'ater/Sewer Surcharge 30 Police Plan Check Fire SAC ?S`c2S ? Enq, Water Conn. d 'f?' Planner Water Meter ( n ?- Council Road Unit Bldg. off. APC `PdTAL Vl l 1 50 -1718 'e ?? pak •C. R. WINDEN 3 ASSOCIATES, INC. LAND SURVEVOAS Tel 645•3648 IJBI EUSTIS ST., Si. PAUL, MINN. 53108 FOR: U. S. AOME CORPORATION ? C OVI N GTO N L A NE Scale: 11' = 30 1 O Denotes Iron 145.4 1 0 0 10 ? ??? ? ? 22.3 I ? Q I ? v - ? 4 , Q r_3G L- _/ I ^( ?^ ((? u? I I ? N O ?? G3 ' O 110 ,n i 10 - ? ? 130.76 ?b Lo*_ 8, Block 13,Ridgecliffe First AddiLion, Dakota County, Minnesota. WE MERE6Y GERTIFY THAi TMiS IS A iRUE AND CORRECT REPRESENiATiON Of A SURVEY Of THE lOUNDARIES OF THE IAND ABOVE DESCR16E0 AND OF THE LOCA710N OF Atl sUIIDINGS, IF ANY, iMEREON, AND ALL VISIBIE ENCROACMMENTS, If ANY, FROM OR ON SA10 lANO Detad rhisday oi SePt. A.D. 1982 C. R. WINDEN 8 ASSOCIATES, INC. br Sur.aror. Minnesoto Raqisrralion No 112fa NT$19 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN ?-/ 3830 PILOT KNOB RD - 55122 2,6 651-681-4675 L i New Conshucilon Reauiremenls Name: T4T/?11 't,°A //?y Phone 0:Iv5l "?.5Z-,?9 7,P d Last First D 3 registered sRe sLprveys showing sq. H. of lof, sq. lf. of house 2 coptes of plan ond all rooFed areas (2D% maxtmum lot covmaae aflowed) 1 sef ol energy calculotions for heated addmons ? 2 coples of plans (show beam 3 window sizes; poured fnd. design; etc.) 1 aRe survey for exterior addNions 6 decks ? t se1 ot energy ealculations ? 3 copiea ot free presenotion plan X IW plotted aHer I/1/93 DATE: -n CONSTRUCTION COST:' ? S3 7S °? DESCRIPTION OF WORK: STREET ADDRESS: LOT: c? BLOCK: 13 SUBD./P.I.D. #: PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Street Address: / 71Il ?? Y CHy fi46,/9A/ State: Z'f?v Zip: z- Company: G??? Phone#: C?/ `7`??? /?DU (area code) Street Address: G gaR ucense # o/ xp. City ?/??? State: /4-/zip; S.?J,2Z Telephone #: area code ( ) Remodel/Recalr ReaulremeMs Name: Street Address: Regisfration #: City State: Sewer 3 water Iicensed plumber (reauired for new conshuction onN): Penalty applles when address change and lot change Is requesfed onee permR is Issued. Zip: 1 hereby acknowiedge thaf I have read this application, state ttfat ihe In(ormation Is cortecf, and agree to comply wfth all appllcabl State of Minnesota Statutes and CfFy of Eagan Ordinances. i Signature of AppllcaM: "2C2:2g OFPICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No _ NotRequiredj_._..__. - - ?- ---- - 1'0: L(JItN71 OLSON, iTPILI`I^L L'ILLl^IG CLL;Ri: DP.TL PLTERSON, QjIII? BUILDITI? OF'FICIAL, BILL IIRANQi, SUPERINTL'NDETdT OF PUBLIC WOI2KS FRON1: THOh1A5 A. COI,BERT, DIRECIbR OF PUBLIC L40RKS DATE : NOVFSIBER 17, 1981 RE: RIIXMCLIFF'E 1ST ADDITION - SELti'ER AND W11TER CONNECtI0NS On Septemier 10, 1981, a nmmo was distributed listing several lots in the Ridgecli£fe lst Addition which would not be issued sew2r and water permits imtil sanitazy sewer service had been made avai.lahle. Because it is not anticipated that gravity sanitary sewer will be available to provide service to the affected lots until July/August of 1982, Orrin Thonpson xocres has agrced to install a teirqorarv lift station fran Man- hole No. 37 to the 4" senrioe line for I,nt 8,.Block 9, Ridgecliffe lst Addition. Attached to this meiro is a copy of the letter we received from Orrin Thompson Homes whereby they indicate that they will perform the installation, msintenance and liability of this terrporary lift sta- tion/force main sanitary sewer until such time gravity sanitary sewer can be extended across the £uture I-35E during the spring of 1982. There- fore, with this tenporary systen being installed and maintainecl bv Orrin Thompson Hores, the terv_?rarv hold on se:aer and water pennits and occu- pancy for the follcwing lots has naa been lifted: Lots 1-9, Block 7 Lots 1-6, Block 8 Lots 1-7, Block 9 Lots 18-23, Block 9 I.nts 10-16, Block 10 I.nts 1-10, Block 5 Lots 1-4, Block 6 Lots 1-6, Block 12 Iots 1-17, Block 13 This tenporazy sanitazy force main will still not nrovide service to the following lots: Int 1, Block 8 Lots 1& 2, Block 9 7rots 18-23, Blodc 9 Lots 11-17, Block 10 Therefore, the restrictions as referenced in my previous mPJro will still apply to these lots. These lots are referenced on the attached map for your information. If any problems arise pertaining to sanitary sewer availability, back-ups, etc., please reLer those calls directly to Orrin Thcs*pson Homes for the proper resolution. If you have any cnzestions to this release of the re- striction on the building and sewer/water permits, please oontact me. Please insure that all personnel in your departnent are aware of these restrictions. TAC/jach cc - Bob Carlson, Orrin Thca.pson Homes ?: LORNA OLSON, LTPILITY BILISN(, Q.ERK DALE PLTERSON, CHIEF BUIIDING OFFICIAL BILS, BRANCH, SUPERINI.'IIVDENT OF P[IBLIC WORKS FROM: THQMM A. CbLBERT, DIREC'I'OR OF PL7BLIC [^ORKS 61tl DATE: NOVENIDER 18, 1981 RE: RIDGECLIFFE 1SP ADDITION - SE(4ER AND WATER CONNECTION RESTRSCTIONS On Noveiber 17, 1981, anpja was fonuarded listing several lots within the Ridgecliffe lst Addition that had restrictions plaoed on the issuance of any sewer, water or occuoancy pennits due to the imavailability of sanitary sewer. There appeared to have been a duplicaticn of lots that were refer- enced for future restrictions as coapared to those whose restrictions had been listed. Please be aware that the follaving lots only will have re- strictions placed on the issuance of sewer, water or occupancy permits: Lot 1, Block 8 Iots 1& 2, Block 9 Iots 18-23, Block 9 Lots 11-17, Block 10 Please insure that these referenced lots are not granted any peiznits that wuld allaa their occupancy or use of the sanitazy sewer system. Please insure that all personnel are made aware of this correction as stated in this irew. TAC/jach cc - Bob Carlson, Orrin Thcsrpson Homes LS( Dr3, ?c ( 1O: LOfM OLSCN, UPILTI"! BILL.II4G CCE.'4K BUIIDING IIZPE4Z'I(Id DEPAMENT BII.L BRANQi, SL'PER71`IrETIDFNf CF PUBISC SdORKS FRCM: TiQ,TAS A. CCISERI', DIRFX'1t7R OF PL'SISC WqRKS ?Cr .. DATE: SEPPIIMIDER 10, 1981 ' , .. RE: RID=SFF'E 1S'I' ADDITIIN Because the follo,ainy list of lots in Ridgecliffe lst Addition does not have gravi.ty se«er outlet at this time, the follawing prooe- dures will be initiated tmtil further notice: Ui`ILITY BILLING No water tum-ais will be allaaed prior to 8-1-62 or iastil seaer is available in these azeas. " BUILDLvG nSSPF.CPICN Building pezmits can be isswad for these lots, but the builder should be infoxr.rd at time of pexmit issuanrn (perhaps stamping the building peanit with "NO OCC[.PA'vCl PRIOR 40 8-1-82 OP. UNTIL SEWER IS AVAIIABLE") the restrictions ai sewer availability. MiLV'PEqAN(E DEP.4RrnSE.^IP See both utility billing and build.ing jTspection above. The lots with these restrictions are as follaas: Lc7i5 1-9, B= 7 LC1I5 1-6. BIOCK 8 LC7I5 1-7 B7A.'?C 9 LUIS 18-23 BLOCK 9 IlJi5 10-16 BLOCK 10 I[7I'S 1-10 BLOCK 5 L(77P" 1-4 BIlJCK 6 LCJfS 1-6 BIl,XSC 12 LO'I5 1-17 BLOCK 13 and are also indicatEd an the attached maps. : jac Use BLUE or BLACK Ink F-For- O-ffi-ce- U - se----------- I j Permit My of Eab`-n I Permit Fee: ZZ Z~ I 3830 Pilot Knob Road I i Eagan MN 55122 I Date Received: Z j I Phone: (651) 675-5675 I 'dCJ Fax: (651) 675-5694 1 Staff: --d 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ! /c,) Site Address: < l D ICJ Unit Name: Phone: W/ -Z-X ` ,O 71 RESIDENT r ~ Address OWNER / C/ Zip: 1719 G~l'J dY Applicant is: Owner V- Contractor Descri tion of work: Y ) - TYPE OF WORK P Construction Cost: 16-0l ©DD ' Multi-Family Building: (Yes /No Company: LIZAM OLL" 4vLc Contact: Address: q7 City: CONTRACTOR - 1 -a / 40 Stat Inn Zi Phone: License 1, 0020 / , 74E Lead Certificate /y AT ~ 7 G/ 4 `"I / If t project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE. Pigs and supporting documents that you subn3 tare considered to be public infortrra0m. Portions of the information maybe classified as=no»-pubfc it yt p~ ide spesift reasons that w( the y to conclude that die able trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.oro 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 permitw--that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must b completed within 180 days ormit issuance. X x V~.J Applicant's Printe Name Applican s ignature Page 1 of 3 Use BLUE or BLACK Ink r For Office Use { Permit j City of EaI , I Permit Fee: l 3830 Pilot Knob Road Eagan MN 55122 Date Received: I I Phone: (651) 675-56759' I I Fax: (651) 675-5694 i Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11-20 Site Address: 17/<6 Unit Name: i " J 4 +A rc t Phone:,f_1 ~5/ RESIDENT / OWNER Address / City / Zip: f ~S?Lh Par 4 Ot Applicant is: Owner Contractor TYPE OF WORK Description of work: Dtf c i t✓ wry Construction Co ®n r Multi-Family Building: (Yes / Nox Company:~i Contact: -F !W Address: q7VAOllo bn -e City: G- /7'1 U /G 1 C CONTRACTOR State: /rr Zip: ~o / Phone: -7 R - 9o _ License #:C C 17 Lead Certificate ko, I 2-7d I If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) / COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.org 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. Exterior wo authorized by a building permit issued in accordance with the Minnesota State Building Code must be comple d within 180 days of it iss a ce. x x App cant's Printed Name Appli a Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation Fireplace _ Porch (3-Season) _ Storm Damage Single Family Garage Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level Pool _ Miscellaneous Accessory Building WORK TYPES - New _ Interior Improvement Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION ~jQ f Valuation j, ✓ ° Y Occupancy MCES System GT Plan Review Code Edition SAC Units (25%_ 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: (Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows C Insulation Retaining Wall: _ Footings _ Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: ~ L , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review J~ MCES SAC City SAC Utility Connection Charges S&W Permit & Surcharge _ _ Treatment Plant ~ 0 ox /6, Copies 4~F TOTAL► Page 2 of 3 Located in the NE 1/4 of Certificate of Survey for. Sec. 32, Twp. 27, Rge. 23 } CUSTOM REMODELERS, INC. House Address: 1718 Forssa Way, Eagan, MN / / °Pgn I nil vL' 112 / /lnv\~ I 1p N _0` R~ 1~y• / N 0 CD ~N \ - ~s k rn TV + / crop / / / a\ CEO / \ - ® / is \ 5 V5 \ tb Stop \Np + / x / / / p OpRVE`~P~ \ O \ + TB o o 9L `°f \ cry 1p \ ao q O ! fn \ o~ \ f p s °o 91 ~ -Setback Lines 9 9a-- Np - o \ ry o (G \ \ 15p pG ~ \ \ 8 \ '0 O ~ \ M / o cs , ' / 00 3r? \ \ pP / / 00 ° 0 O + / 1 3 \ a / toe e \ J V 1p s .y6 A// Z' LEGEND X - Denotes Existing Fence PARCEL DESCRIPTION: Denotes Drainage & Utility Easement Lot 8, Block 13, RID,GECLIFFE FIRST ADDITION, (per recorded plat) Dakota County, Minnesota. Denotes Found Iron Monument GENERAL NOTES: EB ❑ Denotes Electric Box N 1. Building Setbacks - Per the City of Eagan: 0 Denotes Cable Box ,B Front: 30 ft. Bearings shown are assumed ❑ Denotes Telephone Box Rear: 15 ft. GRAPHIC SCALE Side House: 10 ft. 0 10 20 40 Side Garage: 5 ft. ~N~~ Side Street: 30 ft. (IN FEET) 493 3926.001 MLF Carlson I hereby certify to Custom Remodelers, Inc., that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly licensed land surveyor under the laws of the State of Minnesota. McCain Dated this 12th day of April, 2012. Signed: Carlson McCain, Inc. ENVIRONMENTAL " ENGINEERING o SURVEYING 248 Apollo Dr, Suite 100, Lino Lakes, MN 55014 By. Aac-'Cz ze", 49i~~z Phone: 763-489-7900 Fax: 763-489-7959 Revised: Deck & Porch Dimensions 4/17/12 Thomas R. Salluff, L.S. Reg. No. 40361 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167284 Date Issued:03/08/2021 Permit Category:ePermit Site Address: 1718 Forssa Way Lot:8 Block: 13 Addition: Ridgecliffe 1st PID:10-63980-13-080 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 - Timothy & Naomi Tatarek 1718 Forssa Way Saint Paul MN 55122--265 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA170547 Date Issued:07/08/2021 Permit Category:ePermit Site Address: 1718 Forssa Way Lot:8 Block: 13 Addition: Ridgecliffe 1st PID:10-63980-13-080 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Timothy & Naomi Tatarek 1718 Forssa Way Saint Paul MN 55122--265 Pattim Llc 400 Lyman Blvd Chanhassen MN 55317 (952) 220-4568 Applicant/Permitee: Signature Issued By: Signature