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1041 Kenneth St1INS CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: "{'' _ Eagan, Minnesota 55122-1897 Date Issued: "' t`' ?? f'} p (612) 681-4675 . <._ , , . . SITE ADDRESS: ? ; I HkIF ?li ?! M? k t E PERMIT SUBTYPE: I , I,t rHI &f3/yi f i. t 14A1tK S: FtF RQOF (iltt t C? '. ( iIF: M C?AMAiif ; APPLICANT: ii,i;. TYPE OF WORK: nt.rn I I 1? I I 1[ C1H RE r+ooi . F x •,4? ? t? `? ? .. . . " . .:. . . . , .. . y. Permit Holder Date Telephone #I PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING RQOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYOROS7ATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL I f CITY OF EAGAN 1 3830 Pilot Knob Road r Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: , „ i , ? 1 l+d 1 'r f f'1?I! 1 Ii `, I i PERMIT SUBTYPE: ECTION RECORD ? PERMIT TYPE: ?i,'B?±SA Permit Number: Qate Issued: APPLICANT: . 4??N . I i ?fi I 1 ??t{ 1 fJ? ( 61 : ) Hf. 4 8 F44 TYPE OF WORK: jrPpTrnN ,?, .i ;: +; ; ; , r: r-inr. s0UM0 i:UMfkt?1 INSPECTION .. . D• ?? lilil?l? 11+i ?I I li I ? WFtI - - I ? RFMAFtKS: 14f'AilA1F lJ kMl1•. PhVitlHl(, I-IIH AN1' hti'i (k1t'A! 1)I? 1'111Ml;CN?i WOftIK. ? ? ??9 p4 ? J ? PermR No. Permit Holder Dste Telephone 1F ELECTRIC PLUMB{NG HVAC Inapection Data Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST fNSUL GYP BDARD FIREPLACE FIREPLACE AIR TEST FlNAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Addition McKee Addition #1 Lot 3 Bik 1 Parcel 10 47750 030 Ol Owner M ,• d' 1 AfFf.l7- E1J? Street 1041 Itenneth 5tate Eagan, MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STFEET RESTOR. pavin 1969 311. 50 31.15 10 PAID GRADING SAN SEW TRUNK 140 1968 100. 00 3. 33 30 PAID * SEWER LATERAL 1968 ZO WATERMAIN WATERLATERAL &$ 1968 854.00 1F2.50 20 PAID WATER AREA STORM SEW TRK 403.00 C008623 10-14-83 STORM SEW LAT CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. $200.00 722 4-15-68 gUILDING PER. sac 200.00 722 4-15-68 PARK I I BUILDING PERMIT Tn 6w u?d fer l' " r 8gE $4?? Receipt # v • 5ite Address I 'Go 4 1 KEFtt7et'? Lot -? Block Sec/Sub. `9rKao iat_ Parcel # cc Name J ack 3ensen Z ?(??4? ?:<?tyrz.:•t?s Address O , f , -4-54- 2045 Cit Phone ? Nome ou Address 3 ''ri:? u ? ` Cit -?3 ::1 Phone,- t u? Name ?- _? Address I hereby ocknowledge that I have read this application and state that the information is correct ond ngree to comply with a!I applicobfe Stote of Minnesota Statutes ond City of Eogon Ordinances. Signeture of Permittee - ' S I G `:"'] N2 4266 ? :. V 3.. 3 77 ] Erect [n Occupancy ? Alter ? ?i Zoning Repair ? Fire Zone Enlarge p Type of Const. Move ? # Stories Demolish ? Front ft. Grode ? Depth ft. Approvols Fees Assessment -- Permit Water & Sew. Surchorge `•`??? Police Plon check Fire SAC Eng. Water Conn. _ Plonner Woter Meter Council B!dg. Off. APC _ _ Total + 7 • G0 A Building Permit is issued to: Usse O. on the express condition that all work sholl be done in accordance with all applicable State of Minn=s=ta Statutes ond Ciry of EaSon Ordinances. Building Officiol -- - CITY OF EAGAN 3795 Pilot Knob Rood Fagan, MN 55122 PHONE: 454-8100 Pomk # pah IwMd prwNfM Plumbing Mechanical INSPECTIONS DATE INSP. Rouph-In Find Footings Date Inep. Dats Imp. Foundation Plumbing Frome/ins. Mechanical Final ? Remarks: EAGAN TOWNSHIP BUILDING PERMIT ?- ,? . ownar ?-?-` ?-? ?-?--? ---'-^ °-----.. _;'-----=....................... .------...----_ .i • ?--- Address (Presen2) 1 --_..:`:':::':C:7.:5. Builder ....... ?.=.:..:.::..... -.---...__ Address DESCRIPTION N° 1935 Eagan Township Town Hall Dale ! // ? IG /• .............----..........---------°-'----' Sfoxies To Be Used For Froa2 Depfh Heigh2 Esf. Cos! Permii Fee Ramasks l /i e ..: < . J- SII2@I. A08Q DL OIIICI D65Cl1pIlOT OS LOC823on I LD2 Izs10CY I AGQ1IlOII OI 1S8CI 3 I 1 This pexmit does aot aufhorize the use of sireeis, roads, alleys or sidewalks nor does it give the owner or his agen! the righ! !o creafe any situalion whic6 is a nuisance or which presenls a hazard !o the healih, safely, conrenienee and general welfare fo anpone in the eommunify. THIS PERMIT MUST BE &EPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. ? ?- ..""'"..........""'........."""''_l7OA ' eree!-a>_'?`:_,.:::..... '"-{-•' CP This ia !o eartifp. !ha!__? cf'. '''f"'_ ""_".." I-'-!' " ? ........................ hes pexmissioa !o the above deuribed premise subject fo the provisions of the Building Ordinance for Eagan Township adopled April 11. 1955. . , ? C ' f%.?.. Pez ?.,_,e--r.?.?e_. .......____'__""""'_..."._'........_...'__'......"__._'.... .." .......................".............."""'.... .g ._.... p..."._.__"""'....._"_"... .%Chairman 'of Tnwn Board, " Suildin Ina ecfos CITY OF EAGAN 3795 Piloe Knob Road Eogon, MN 35122 • PHONE: 454-8100 BUILDING PERMIT APPLICATION ReceiPt # Gara e $4?000. To be uwd for g Date Site Address 1041 K2nneth St. Lot 3- Bbck I_ $ec/Sub. MrR_ c j c r Parce l # w Name Jack Jensen Z 1041 Kenneth Address ----- - - o aga? 434 - 7043 Cit Phone ? 0 Ncme - usse CO. ? Address 1850 COtflo Ave. ? Cit St. Paul2 phone 645-0331 H? U , Name , „ rZ ir, Address I hereby acknowledge thot I have read this applicatian ond state thot the information is correct ond agree to comply with all applicable State ot Minnesota Statutes Qnd City of EogarA Or,dinansqs. Signoture of Perm A Building Permit is all work shall be d`o? Building Official /` N4 4266 5634 Erect [Ill Occupancy 1 Alter ? Zoning Rl Repair ? Fire Zone _ Enlarge ? Type of Canst. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Aoorovals Fees Assessment _ Water & Sew. Police Fire Eng. Planner _ Council _ Bldg. Off. APC Permit La•vv _ Surcharge 2•00 Plon check SAC Water Conn. Woter Meter Totol 17.00 sel Co, on the express condition that kl oll apDlicable State of Minnesoto Stotutes and City of Eagan Ordinonces. CITY OF EAGAN N9 16529 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 BUILDING PERMIT?r PHON?454?-8100 Receipt # 8'C' _ Ct?/ 9'7 To Est. Value Site Address 1041 MCKEE ST Lot 3 Block 1 Sec/Sub. MCKEE 2ND Parcel No. w Name VINCENT ALLEN LACROIX o Address 1041 MCKEE ST City EAGAN Phone 452-3719 Name _ Address City - Name _ Address City _ Phone I hereby acknowlege that I have read this application and state that the inbrmalion is correct and ?giree to comply with 11 applicable State of Minnesota Statutes and Ci of Eagan (fin ce . ? rn Signature of Permitee A Buiiding Permit is issued ro: VI LNT AU EN on Ihe express condition that all work shall be done in accordance with all applica6le State of Minnesota Statmes and City of Eagan Ordinances. Builtling ONicial I' ,??1.?1 ?!?t„ I yp Phone 19 89 OFFICE USE ONLY Occupancy M--1 FEES / '? z Zoning R-1 - (ACtual) Consi, V-N Bldg. Permit 208-190 (Allowable) V-N 8 ?B # of stories Surcharge ?? Length 32 ' Plan Reviaw 3?Xt-•B8 Depih 3-z SAC, City S.F. Total SAC, MCWCG S.F. Foolprinis _ On Site Sewage _ Water Conn On Site Well - Water Metet MWCCSystem _ ACCt. Deposit Ciry Water PRV Required _ SNJ Permit Booster Pump - S/W Surcharge Treatment PI APPROYALS Road Unit Planner - park Ded. Council BIdq.Otf Copies Vanance - TOTAL 2 (v (e ` ?/ REQUEST FOR ELECTRICAL INSPECTION ,?-,, EB-00001-03 ?/n+? 4 0 634 ? Sea b insvuctions r completin9 this form on beck of yellow copy. '4(",-Veh5w Work Covered by This Request 37O S Q ew Add Nep. Typa of 8uilding Applioncea Wirad Equipmant Wired Home Range Temporary Service Duplex Water Heater Lightin Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace - Silo Unloader Industrial Bldg. Air Condi[ioner Bulk Milk Tank Farm Other Paci Y ihor?SUecifyl 1le, Speci y [ cr Othar Compute lnspecriodFee Below q Fee 9erviceEotranee5ixa k Fee Feeders//5ubfextlera N Fee Circuits 0 to 100 Am s 0 to 30 Am s JC, 0 to 30 Am s / 101 to 200 Amps 31 ta 100 Amps / 31 to 100 Am s . Above 200 qm s Above 100_Am s Above 100_Am s Transiormars Remote Control Circ. Partial/Other Fee Signs Spaciallnspection S '3 TO 7A'V ? Hemarks ' 1.? . F ? ? .?1 Final /Q '0 Inspec[oq herehy certliy that the nbova spection has bean OL 0 da. This request va 18 months (rom mid ?-l1 3805 l5 3'-7. op ._-.__'_ __ ^? ?j " O I.J .... .._. ..__.... ... ... Re??uiretl7 Yes ,.-_.._.. ? ?Ready Now !or ill Notif¢ Insoeo- When Reatly icansed ? Owner ElecVical Conhactor I hereby raqueat inapecdon of ebave electricel work inatalled et . Svea[ AdCress. Box ar Routa No. LDU G I 19:?GN.G L 1-4 S T City " A6'4G N ection o. ownship Name or No. fianBe o. Co y S / OccvpantlPRINTI `S a l Z?Ie ' Phone No. AY!;-y - !Y 3 ) . -. $ ?N -e - Fo ppliet A...'"V 4-W Addre;g, - ? A?Q-1vatN fV{?'U Y„ ?? Electr cal onVactor ICOmpany Namal- E G t + ? ' Comracmr's License No. c W- k MailinB Atltlress iConUactor or Ownnr MakinB 3(? ? 1Le N nstailetioN 1 Auihori ed "p atu (Co ttactor O n MakinO Installationl Phone Number J MINNESCITA S7ATE BOARD OF ELECTRICITY THIS INSPECTION PEQUEST WILL NOT Grig9s-Midway Bldg. - floom N•191 BE ACCEPTEO BY THE STATE BOARD 1827 UnivaraitYp.Ve., St. Paul, MN 66704 UNLESS PPOPEfl INSPECTION fEE IS ea.,,,,e 19111 107_1111 ENCLOSED. PERMIT #: CITY USE ONLY RECEIPT DATE: 2002 RESIDEPTLAL M£CELALNICAL PEitMIT APPLICATIOft crrY og EALsax S$SO PILOT KROB RD E4HAA MN 55t E2 651-6$1-4675 Please complete for: ? single family dwellings lownhomes and condos when permits are required for each unit Date: (o ` \ v -a- SITE ADDRESS: OWNER NAME: TELEPHONE #: ?J (- ? ? INSTALLER NAME: ?6 \C? TELEPHONE #: n --? . STREET ADDRESS: 21oca S S k' _L"-? ' CITY: STATE: l` vU ZIP: S5U(2"G4?-i5 Place a check mark next to the permit work type Add-on tieativrroral4e tion to existin dwelling unit $ 30.00 • furnace re lacement • air er a ir ditioner :co o Nature of work: AU( 3 0 2002 I U i State Surchar e ' $ "- - -$- _?-rG Total SIG? kA4" l/ t ioz LOT: / BLOCK: I SUBD./P.I.D #: 'Mc Lee/ 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? ?3bn CITY OF EAGAN 3830 PILOT KNOB RD - 651•881-4675 New Construction Requirements ? S regfsfered sife surveys showfng sq. ff. of lot, sq. H. of house and all roofed areas (20% maximum lot coveraae allowed) ? 2 coples of plans (show beam 8 wintlow sizes; poured tnd. deslgn; etc.) ? 1 set of energy calculationz ? 3 copies of hee preservation pian ff lot plaMed after 7/1/93 ? Rim Jolst Detail Options selection sheet (butldinas wRh 3 or less units) 55122 + 0,25 Remodel/Reaair Reauirements C0.1W ii-i'oo 2 copfes of plan 1 sef of energy calculations tor healed additlons 1 sMe survey for exterior addHions 8 decks DATE: ?3 /- d7r_w<?9 CONSiRUCTION COST: L?dC C) ?n DESCRIPTIONOFWORK:,Y(?G[bAn&,?>>TTOnJ IfmuRi-familybldg.,howmanyunits? STREETADDRESS: /0-l r Name: 7??rJZS onJ ?/ ilq-l Phone #: PROPERTY Last Flrs? OWNER Street Address: /0 41 City 1?7fi6' 0`f7J State: / ? l AJ Zip: Company: 1/i4l f??G? ?1 J?Sj-m€,(l`/7 Phone #: la.5--l ( CONTRACTOR area code) Sireet Address: - CL ( F? license # ?? L( / Exp. _L City Stote: ///( 4,1 Zip: ARCHRECT/ ENGINEER Telephone #: ( Sheef CHy - Name: _ RegisNatton #: State: Zip: Sewerlwater licensed plumber (if installina sewerlwater): Phone #: I hereby acknowledge that I have read fhis application, state that the informatian is correct, and agree to comply with alt applicable State of Minnesota Statutes and Ciof Eagan Ordinancest 5lgnature of Applicanf: OPFICE USE ONLY Certificates of Survey Received _ Yes ? No "?L?zr-vj? Tree Preservation Plan Received _ Yes _ No _ Not Required OCr 3 ! 2000 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accsssory Bidg ? OZ SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage W 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ?p 31 New ? 35 Int Improvement ? 42 Demolish (Foundation) ? 45 Fire Repair ? 32 Addition ? 36 Move Bldg. ? 43 Reroof ? 46 Windows/Doors ? 33 Alteration ? 37 Demolish (Bldg)' ? 44 Siding ? 34 Replacement ? 38 Demolish (Interior) • Demolitlon (Entire Bldg only) permit - Give PCA handout to applicant ? D5?f ? VALU ATION ? i Occupancy ? MC/ES System Census Code Zoning R-1 City Water SAC Units ? Stories Booster Pump Nbr. of Units ? Sq. Ft. 100 PRV Nbr. of Bldgs ? Length ?P Fire Sprinklered Type of Const Width INSPECT IONS REQUIRED Footings:NewBidg Insulation _ Windows-ne wheplacement 'v Footings: Deck _ FinaUC.O. _ Siding ? Footings: Addition ? Fina]/No C.O. _ Stucco/Stone Foundation Fireplace: r.i, au test fmal Roof: _ ice & water _ final Framing Pool: _ frgs _ air/gas tests _ final APPROVALS Planning Building r,?N Engineering Variance Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Park Dedication Trails Dedication License Search Capies Other Total: VK o <d n k s Y? Syo? ?? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 1041 LOT: MC KEE P.I.N.: 10-97750-030-01 DESCRIPTION: PERMITTYPE: BulLn=NG PermitNumber: 032715 Date Issued: 0 7/ 2 9/ 9$ STORM DAMA6E REPATR 434 ALT. RESIpENTIAL ? :.i ...?r ... _ 4 4? + . _. ..... ? _ _' PERMIT KENNETH ST 3 BLOCK: 1 REROOF Bti'i?I din'g-,.yPermit Type 6uilding Work Type jCensus Code `L , _- ? , _ - g _ ? REMARKS: REROOF DUE TO STORM DAMAGE. FEE SUMMARY: CONTRACTOR: - RIGHT WAY ROOFING 1200 E. 79TW ST BLOOMIN6TON MN (612) 553-0049 Applicant - S7_ LIC OWNER: 18530049 0003999 PE7ERSON LINDA 1041 KENNE7H ST 55425 EAGAN MN 55121 (651)454-1239 I hereby acknowledge that I have read this infi'ormaCion is correct arnd agree tp cnmply Statutes and City of Eagan Ordinanees. APPLICANT/PERMITEE SIGNATURE application and state that the w%th all appJ:icabJ,e BtaCe pfi Mn. ? 0" I -?1 SUED BV: SIGNATURE I 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN I? 3830 PII.OT KNOB RD - 55122 J 681-4675 Naw Canstruction Reauirements RemodeVReoair Reauiremen4s ? 3 registered aite surveys ? 2 copies of plan ? 2 copies of pians (inGude beam 8 window sizes; poured (nd. design; eta) • 2 sde surveys (exterior add'Rions & dedcs) ? 7 energy calculations ? 7 energy calwlatlons for heated add'Rions ? 3 copies oT tree preservation plan if lot plalted after 711193 , Y N reqw es o DATE _ ? CONSTRUCTION COST; DESCRIP ON F WOR . CI?) C? fon- & O,k.&v? C?Q STREETADDRESS: ?? LOT: 3 BLOCK: t SUBD./P.I.D. #: ? ?-,A L U'L Name: L/ ?( Phone #: b-M? PROPERTY OWNER Street csty L. srau: yl zip: ; CONIRACTOR Street City ARCHITECT/ ENGINEER Comp Name Smet City State: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the State oi Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Registration #: Zip: -U 04 Penairy applies when address chang is correct ano agree to OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No Not t Phone #: `??15 - i License # L.Z State: ? ? t ! \ Zip: Phone #: with all applicabl ??_??- OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Altowabfe) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? ? 12 Multi RepaidRem. ? ? 13 Garage/Accessory ? ? 14 Firepiace ? O 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Faciiity 21 lMiscellaneous Basement sq. ft. MC/WS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bidg Census Unit Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SIW Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units ;.fK'l,'.h°.H:Y6 (('1,(:Y.XOX??;$:'i,:$; i;( i'?(;d ?,4:FY„i::YS.:;:i,O?N,,:::;5;-U;' );C::)` `,:'•'S:,e;U'< .1 " ..)y i?F..ini\I lL. u?.. A` i v1) ? TT? ? \'?-??:'?: ?.q,ni'(ii ZI('??•,iiJ?.?l?(irv:l :yn ?rp.F:J?; cl;!'^C`?;Si.C . ?'Pr?r?i;7...•.. . _ ..?.__.., . . ,.. i i ^ . .... V . ??..)..?. .. ,r.?.i..,, .,...... '':q>.. ,),:??'??..,... 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1--? o U 851-681-4675 New Canafiucttan ReaWremenfa Remodel/Reoalr ReauiremeMS C) ? ? 9 reglstered Yfe wneys ahowiny sq. H. of lot, aq. tt. ol twuse 2 coPies of plan antl gp rooled areat (20X maxlmum lot covemae alloweN 1 aei of eneryy cWculaNats for healed adtllHOna ? 2 wplas ot pkms (ahow beam 8 wlndow slzea; poured fitl. tleslgn: etc.) 1 aite survey for exfedor adtlitlona R decka ? t set Of energy calculaXOn! ? J Coples W hee preearvallon plan H lot pWlted aHer 7/1/93 DATE: C) CON3TRUCTION COST: W FA 0 DESCRIPTION OF WORK: I\ E S U??? (-e /-E o? }- ? STREE'f ADDRESS: LOT: --,_ BLOCK: I SUBD./P.I.D. N: fy` C_ Name:? Cvv,1? L.r- V'0-/0d L?Phone?: 370 pRQpERTy Last Flrsf OWNER ? ? A? Street Address: ? ? ?- ? City Stctte: Zip: Company: Phone (area code) CONTRACTOR Street Address: Llcense M Exp. City ARCHIiECT/ ENGINEER 4 State: Company: Name: Telephone #: ( ) Sheet Address: Registratlon q: Cly Sewerhvater licensed plumber I hereby acknowledge fhaf I have read Ihis applicaNon, stafe thal the of Minnesota Statutes and Cily of Eagan Ordinances. Signature of Sfate: OFFICE USE CertifiCates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No Y - NOt Required Iip: Zip: ro State ;?IAk 2 I OFFICE USE ONLY BUtLDING PERMIT SUBTYPES ? 01 Foundation ? 07 OS-piex 0 13 16-plex ? 21 Porch (3-sea.) ? 02 SF Dwelling O 08 06-plex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex 0 11 10-plex Plbg _Y ur _ N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex [3 20 Pool D 30 Accessory Bldg. WORK TYPE ? 31 New ? 36 Move Bldg. 0 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code No. of Units No. of Buildings Const. (Actual) (Allowabie) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. Main level sq. ft. sq.ft. sq. ft. MISCELLANEOUS INSPECTIONS O Stucco/Stone APPROVALS Planning Building Engineering sq.ft. sq.ft. Footprint sq. ft. Census Code MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance ? 31 Ext. Alt - MuRi ? 33 Ext. AR - SF ? 36 Mufti Permit Fee Surcharge ? Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Suroharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: 113 ? `-::) Valuation: $ SAC Units % SAC ? 1986 BOII.DING PERFIIT APPLICATION - CITY OF EAGAN HOYS: 9LL CAATRACTOES MUST BE LICSNSED IiITH THE CITY OF EAGAP SffiGLE F9FIILY DfiELLINGS INCLUDE 2 SETS OF PLANSt 3 CERTIFICATES OF SIIRVEY, t SET OF ENERGY CALCULATIONS MULTIPLS DiiE[.LI9G5 - HESIDENTIAL RfiNYAI, DNITS FOH SALS ONITS INCLUDE 2 SETS OF PLANS, CSRTIFICATE OF SQHVEY - CHEC[ WITH BLDG. DEPT., 1 SET OF SNERGY CALCOLATIONS COlAIERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: y? O Valuat ion: Date: Site Address ? ,oT _ OFFICE DSfi ONLY Lot •? Block 1 Erect Occupaney 1?3 k _ Remodel Zoning Parcel/Sub ? ?., Repair ? Type of Const Q? 7 Addition # of Stories Owner l?i?tiC.? /a 1" 6 -oZ4 Move Length _ _ Demolish Depth Address Int.Impr. Sq Ft ' _ Install City/Z3p Code Phone APPROVALS FEES Contractor c Assessments Permit Water/Sewer Surcharge ? Address QS Police Plan Review ? Fire SAC City/Zip Code Engr Water Conn Planner Water Meter Phone Couneil Road Unit Bldg Off Treatment P1 Arch./Engr. APC Parks Variance Copies Address TpTd[, , p City/Zip Code Phone # AOTE: ADDRESSSS FOR CORNER LOTS - CONTRACTOR/HOHEOWNER liOST DESIGNATEiiHICH ADDRESS IS DSSIRED. NO CHANGES iiILL HE ALLOTiED ONCE BOILDffiG PERMIT IS ISSIIED. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT , PERMIT TYPE: Permit Number: Date Issued: ? BUILDING 028668 es/zsi96 SITE ADDRESS: P.I.N.: 10-47750-030-01 1041 KENNETH ST LOTe 3 BLOCKt 1 MCKEE DESCRIPTION: MAC SOUND CpNTROI Permit Type 5F (MISC.) '??yark Type ALTERA7TtlN 434 ALT. RESIDEN7IAL a sij"..' r IV ? sa s@ ? ' P GyL % ?g. ? 49"1ffi iV ?4wm.IAvF?e¢2133 ? ry?'?x.mC..°-«? 3p REMARKSARArE PERMI7S REQUIRED FOR ANY ELECTRICAL pR PLUMBING WORK FEE SUMMARY: BaSe Fee Plan Review Surcharge Tatal Fee VALUATION $149.75 $74.88 4.50 $229.13 $9,eee CONTRACTOR: - flpplicant - 5T. l xc.OWNER: KATWY'S CONSTRUCTION INC 18545884 2004502 PE7ERSON JAMES 1621 E 79TH ST 1041 KENNETH ST MINNEAPOLIS MN 55425 EAGAN MN 55121 (612) 854-5884 (612)456-9858 ?T,.hsr,e;by, ecl informati°on- Statutes an? -.TSSU BV: SI TUR 3830 PIL'OT KWOB RDN 55122 1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL) 681-46T5 New ConsWclion Reouiromenta RemodeVReoair Reauiremenh ? 3 repistered aite eurveys ? 2 copke of plarre (Mdude beam 6 window sixes; poured Ind. design; elc.) ? 1 energy calculations ? 3 copies of dee presenatlon plen M bt platted efter 7/1/93 required: _ Yes 7 No 'A ? 2 copies oi plan ? 2 ske surveys (exterlor adddions 8 decks) ? 1 energy ealculeUons tor heated addftions DATE: Z?1 ?( ?Q CONSTRUCTION COST: $8>858.00 DESCRIPTION OF WORK: STREET ADDRESS: BLOCK Migc. Alt. ( 150 Sound Insulation Program) 1041 Kenneth Street ? SUBD./P.I.D. #: PRDPERTY N8r1'18: Peterson, James and Linda PhOn@ #: 456-9858 OWNER • ",^ '"", Stfeet Addfe5S' 1041 Kenneth Street City: Eagan State: MN Zjp, 55121 CONTRACTOR COmpany: Rathy's COnstruction Inc. Phon2 #:6Sa-854-5884 5treet Address: 1621 E 79th St, suite 120 License #20045023 City: Minneapolis State: MN Zip• 55425 ARCHRECT/ Company: D°°°lis Johneon & Ruggieri Inc. phone #- 871-6009 ENGINEER Name: Registration #• Stfeet Address' 1121 East Franklin Avenue Minneapolia MN 55404 State: City: Zip: Sewer 8 water licensed plumber. . Penalty applies when address change and lot change are requested once pertnit is issued. I hereby acknowledge that I have read this application and state that the ini9 ?rm„a,h'on is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ^,? ? ,,„, Signature of OFFICE USE ONLY CerfiRcates of Survey Received _ Yes _ No • AUG rt ? ??96 Tree Preservation Pian Received _ Yes _ No --------------- OFFICE USE ONLY BUILDING PERMfT TYPE o ,B1 Foundafion ? 06 Duplex er 02 SF Dweliing ? 07 4-piex 0 03 SF Addition o 08 8-plex 0 04 SF Porch o 09 12-plex 0 05 SF Misc. 0 10 = plex WORK TYPE 0 31 New 0 32 Addition ra' 33 Alterations 0 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging o ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? 0 15 Deck ? 36 Move 0 37 Demolition Consk (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth ' Footprint sq. ft. - -?.• , . APPROVALS Planning Building Permit Fee Surcharge ' Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S!W Pertnit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Totai: 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MGWS System City Water Fire Sprinkiered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering .. Gl.vov,- Valuation: $ Variance 41-1? ?- 413 I/ c?L _L r? % SAC SAC Units ? ? Date: ? /a->) sulr_=W?;v r_s?:?iia P:PPLSCaTZON 1 ?' .'LJD? _ Lr,:_?? Pz.ocr __---t ADnI:.:o.r-??%P .l` .- =r'..Y.CLL S, C>E,^.^Z02I :d:Si4P.E'? IP Ui;:PTA'i•xPD ADDRr.Su Oz ?';??•7.;:: ._?.._????_ <4-?i!'IA2.2iS-r? :6v? --?_.'-_'--??.___.__. ..o???:.,c...._?_?____.? occ-?n•r-sac3 J vsE-- E,;T':i:•ib1T;3li CO:oti G?/ ? -- -- TEi,^FF'Ci1;: i?'0 • _ . ..__. .? ___.... --- co?ai?-"c.un mELEsIIotar. :r:y. AllDZLiS --., /9 sQ &ly? 0 33/ kdotr.= Ii:c1???3«_ ?:?:a 3:.lar., htxil.li_,? plans, and eni ercyy calcule?cions witi: thzs aPplicncion ??? 5igned _.__ . .. ? VA_T,UNi_U!d. Se'1C -- ?? i'itli'I:it CO:7i:^.^.`?TC?ti iJATER !:;:TE;?2 BUILDITdG PPPJeS?.' Frr, SuR:i'.?E:Gi:.. ':"E PL'E1PI CF.3CK Fi;x: PARK DY.'DSC.AiSC"?.A PT?t: 07';IER •PO^11?L* AJ ? APPFtOV'[aLS : ASSES3i+lEC72 CLfiRIC BUILBIIJG DEPT. POLICE DEPT. OPrTCE UuE <iAiF'R g S.L'E7L;IR DEPT. FI*_L DLPT. PARK DEPT. , SUSSEl6AR?SES SV6SEl?COMPPrvV.INL Permit 6y _ Legal Description Lot Blk Atld'n L pe Canst. 4-0n=?, SLA: -? . ;?By SUSSEL ' ?By Owner Approx. . ?In 2-STARTINGS_PDINTSONLY . ? .,.. S.P.L. S. S. P. L. R. P. L. Alley House . F. Stree d'?;?it Ta' PI`Zk Ua Other ? SquareWith ? Rods ' . ?Mesh - - - ?SodRem.-By ?USSG? ? 5-Bag Mix ?6-Bag Mix ' Tamping 9) No Tampin? . C] A.e.U. Z ? . ? OGrade Point tE1 Conduit - ? Blocks El BVOwner?BySussei ?Maintain 8' 7otat Wall - , . Height including Blocks CIMaintain 8' Wall Height on Top of Blocks Other O.H.DrOffset. - VS.D. Location ? Att Gar Roof Tie-in Drawn on attached pictures _ Existing garage: . No ? Detached ?Attached ' Ye5 Size of existing:- x - Existing garage will be: ? Left as is ' - ? Converted to L.S. - ev owner ? Removed By' Owner ? l?unk Must Be Remaved By Ownerl ?Specify removals by Sussel ' orowner-vees.6ushes,etc. - El Show approx. dist. garage to house and all prop. lines . Stakes visible - _0 Yes XNo -Survey availa6le = O Yes .? No ? Special instructions from owner. o.a WORK C?RDER HOMEPHONE?SU? NAME *7L?-K D-f` N7 C- N BUS. PHONE:?"_-XZ_ JOBADDRESSto _; I Kr 'j ^'° TH BLDG CODE AREA A "J SALESMAN ko` ?' CONTRACT DATE SIZE zIX '217' FOR OFPICE USE pNLY S^/? CONTRACTOR S?O?G /C JOB # . , ,. r..:rrv nF F_ArnN c;As:,wr.Fr;: s rEr:MIn!ni_ Nn: ea DAr'E : oe/28/96 TIME:... i.5;;:1.7.2.9 ID:, NAME, hATHY`S CONSTF-;UCTION IrC 3210 :JQ(.li 282r FiWY :iS %.'.24,.75 3422 9001 2£32c'_ hi14Y 53 112.38 205 JQf.)t 2E322 1•1F4V i, 7..50 32irl 904)1 045 HCt:FE Si 237.24 :1422 9001 iQ45 Mf:ttE:E ST 3.l8. 63 2?..``; 9001 1045 h!CKFE= 57 8.00 _i;'r'.'.!J 9001 1047. ICENNF:T'H ST 149.75 3422 9001 :!.041 ItF."NNl::fl°I ri'( 74„8s c.'.:I.`.'i:'i 9001 1I741 I:.f::NNF:i'H iT 4,.50 3210 9001 050 I:F.NNE:iFI tiT 262.25 CFtO61480 KK±X CDNfINUG lJf;i"!, LD: NAP3.r,Y #* C:f.1N't INUf" ???:NCRc?Crkk?#*N?%kXc?rk?C?C*???k?X?Xs:?#?#%??? CDNT'7NUF: C::I:'i'Y pF rFa[;AN F'A!i4A:!:Ehg S 1'1=Fii°iSTlAI_ NO° 24 Dr,'T'F.::;, C1f3l2m6 7TMI-s 007:31. IIi „ raAM,-:, aArHv 's coNSlru.r... r ran iNc 3422 9001 1050 {CF:NNI=P41 S7 Q7..7.3 205 9001 j.I.]JO I':IE'.NNI::lH Si' 9.00 inta:I. I;.ece:i.pt Ainount: 1,340a01. CFiC?6348C1 !JSLR IDE NOiNCV ERGHN DDidN^uHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 P$RNIIT FOR SEWfiR SERVICE CONNECTION DATE• April 15, 1968 OWNER: Jack J. Jensen NUMBER 149 Address 1041 Kenneth St. j _ / PLi?, 17 PLUMBER A11 State Plbg. TyPE OF PIPE cast iron DESCRIPTION OF BUILDING Industrial( Commercial[ Residential i Multiple Dwelling I No, of units x Location of Connections: Connection Chasge 200.00 Pd. 4/15/68 Permit Fee 7.50 Street Repaira ToCal 207.50 Inspected by: Date Remarks• Sy Chief Inspector Ia consideration of the issue aud de2lvery to me of the above permit, I hereby agree eo do the proposed work in accordance with the rules aad regulations of Eagan Township, Dakota County, Mianesota By .? , .? , .-?-- Please nntify when ready for inapection aad connection and before any portion of the work is covered. EAGF.N TOWNSHIP 3795 Pilot Xnob Road "uY. Paul, Minnesota 55111 Telephone 454-5242 PERPIIT FOR WATER SERVICE CONNECTION Date• April 15, 1968 Billing Name: Jack J. Jensen Ocaner: above Plumber; A11 State Plbg. Number: 80 Site Address: 1041 Kenneth St. °a Billing Address . 200.00 Pa. 4/15/6 PSeter No, I Permit Fee 7.50 _ Meter Reading Meter Dep. 15.00 Pd. Meter Sealed: Yes_ lAdd'1 Chg. NO ITotal Chg. ppp _So Building is a: Residence___Z,_ tiultiple n'o, Units Commerc ia 1 Industrial Other Remarks; By: Chie£ Inspector In consideration of the issue and delivery to me of the above permit, hereby agree to do tYm proposed work in accordance with the rules and regulations of Eagan Township, Dakota ^-u-t._ ,,.:___.._«.. By: Inspected by Date I Please notify the above office when ready for inepecCion and conaection. ?J: i ZC?: ?4v•U?S;:: ?onsultant:_ :1omo Phona: : i$: YING CllS70FAcRS S;,VCe 7915 A,?cro.,: ;b?'.1 l: E_NNE'Tt_t -- Ciry: Phor,a: I 0 SPELIL1yA11CN5 AS OUTLINED IN OUR ZROCHUFc I I e ALL ITEldS LISTED BELOW COVERED 8Y OUR cXCLUSIV'c WRlTT£N GUARANTEE "FOR :-.S LONG AS { YOiI OWH YOUft HOME" _ ?_= l - s ' --------?". --, S . s F F- :; + ?_"c ' wa , 3 uc r cc:]LGCR ?ONCn'i BRICN WAL:.FI%TURE CONVENIEACE MLRTXEPPFOOF UTILITY SINGLE 3-WAY WA'-l FAN OPf.rvirvG pOTLET OUiLET OUTLE• SWITCX SWITCH OUPLE• : :`:a:?? T?-=?•';._- 1 ? -_ ? ? ? O cEL;HC C) PS - ? NLVt N0.LL L%.'NTIL qEMOVEO M1EPT OVCT ?OLOPIp LEIIING FAN il%TURE CEILING pULI ?l4LING 'RtTUFN OUTLET O?ENING SWITCM RECESSED FIXTURC SuSP, CL4:1. ? `2x2? G2?r?? CtI LtNC7' Ss;?r2cktG V . l \ i' \. . • . / c?lti' • fltS?k 4 .: 4 coGt= . 2 ? . x ?I ? . i ?? - 7 i I i ? ???CcZEI?TION ? I , ??OM WaLu CE1 c_, ?..GC.lti.n •1 ... ? a= _tarvh HT ., ? ?- ?- I ? ? \ ? I I f `?`1 ( ? ? ? ? I Sq271p { ? i - I?I uw \ 1 ? ? _J ? ? E-NI-W ,:f?, : ; N; '• i? .H ;(__ ? ? .? , ? ??- . '• :.r' '??? ?- ---,-- --- ? ? ? ? ? ?Z2 i , - 17oCM GJEST \Vk1_` _ ?UtdFiN1541EO? : ? ? I ? -^ ' ? S.CL C EIC ? , .. . . . SHu . . . _ i ,;•II C?? . . . . . ; ' ._ 1 ????. ... :_. . . \ J x ?i ,?? \`lllV Oo?y U> i, ? v \ , , . . . ?` . .. .. --? --- f:v • ED T=1C J , ? _»S sz acctc 9,0 , ?u UV t ??p /?oX /ZFIdvL. Y? 40' ? e? -n ? i ? G ? ? ? h ?v uS ?e ? ?.v? ?-?v i ?-?'?v-? ?%rr,? P/2,0P L 16:23 SEP 20, 2004 ?/!/???J\?J ? C..??? MUNICIPAL NOTICE OF WELL PERMIT APPLICATION DATE: September 20, 2004 TO: Tom ColberUWayne Schwanz (EM) RE: WeIlPermit#: 04-1-1227557 Municipality:. Eagan ENVIRONMENTAL MANAGEMENT DEPARTMENT GROUNDWATER PROTECTION SECTION 14955 Galaxie Avenue • Apple Valley, MN 55124 952.891.7557 • Fax 952.891.7588 • www.co.dakota.mn.us FR: THERESR SCHOSTRG #6122 PAGE: 1/1 Fax #l: (651) 675-5694 WellType: Domestic Environmental Specialist: Rutten The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described. If you require fur[lier review of the applicauon or if you have any questions or concems about it, contact the Environmental Specialist listed above or our office at (952) 891-7011. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the pemut. Please note that peanit issuance is always conditioned on the permit applicant's observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Thein Well Company 9/9/2004 Time: Time: Property Owner: Well Owner: WELL LOCATION: Jim Peterson Jim Peterson PLS Coordinates: 1/4, NE 1/4, NW 1/4, SW 1/4, Sec 02 Town 027 Range 023 Street Address: 1041 Kenneth ST PIN Number: 104775003001 WELL INFORMATION: Diameter. Casing Depth: Total Depth: Static Water LeveL• Aquifer: COMMENTS: Ege ?dik View Taols Applications Hs1p __ __. __ _,._ ? .?.. ._ ...,?.. _..,? . .._ . __ ,.. _ ? _..,.?. _._ __....._. ?? ?? Connectian I Comments I Eagan Building I Eagen [levelapmsrrk ? aermits Ownef ?Eagan AssesetSales I Eagen Property I Eagan Patcella 104775003001 Address 1fl41 KENNETH ST KENNEfM,ST Qwner 1 PETEFiSpN JAINES A ,°: 1041 KENNETH 5T EAGAN MN 55121 i _... Owner 2 PETERSON LINDA 0 1041 KENNETN ST _ EAGAN MN 55121 OWt18C 3 ? . ? , . ? . . Parcel date wpdaked August 27, 2004 t _. @ j ... . .. _. k ?Zazrrly 4ini ira 1041 KEdNETH rtJ' * re' [ A& I 09:99 JRN 06, 2005 C O U N T Y ? ? ENVIRONMENTAL MANAGEMENT DEPARTMENT GROUNDWATER PROTECTION SECTION 14955 Galaxie Avenue • Apple Valley, MN 55124 952.891.7557 - Fax 952.891.7588 • www.co.dakota.mn.us MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION DATE: January 6, 2005 TO: Tom ColbeiUWayne Schwanz (EM) RE: Well Permit #: 05-1-1227557 Municipality: Eagan FR: THERESR SCH05TR6 012209 PAGE: 1i1 Fax #: (651) 675-5694 Well Type: Domestic Environmetttal Specialist: Rutten The Water and Land Management Section of the Dakota Counry Environmental Management Department has received the following pemut applicaUOn for the well described. ff you require further review of the application or if you have any questions or conceins about it, contact the Environmental Specialist listod above or ow office at (952) 891-7557. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on the pernut applicant's observance of and compliance witlt all applicable state, counry, and municipal laws and codes. Well Contractor: Thein Well Company 9/9/2004 Time: Time: Date Application Received: Anticipated Drilling Date: Anticipated Grouting Date: Property Owner: W ell Owner: WELL LOCATION: Jim Peterson Jim Peterson PLS Coordinates: 1/4, NE 1/4, NW 1/4, SW 1/4, Sec 02 Town 027 Range 23 Street Address: 1041 Kenneth ST PIN Number. 104775003001 WELL INFORMATION: Diameter: Casing Depth: Total Depth: Static Water Level: Aquifer: COMMENTS: Fi1e Edit Visw Tools Applications NQIp ........ .... __.__..__ _____ ?rR?y?????? R;?????? ? ?I;?,?? ? ,? °• Connectian ? Comments ? s.' > ?,qy Eagan Building ? Eagan Ueuelopmer? ? permits Eegan Owner ? Eagan AssesslSales ? Prvperty' ? E?gan ParcellD 1&775003Q01 . Address 10d1 KENNETH ST Owner 1 PETERSON JAMES A • 1041 KENNETN S7 EAGAN MN 55121 , ._ Owner 2 pETERSON LINiJA a? 1041 KENNETH ST ' EAGAN MN 55121 R -76?6?0() 2007 RESIDENTIAL SUII.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Caahuctim Reouumi2ik 3 m9Mered sb movefi shoviln9 $9. fl. of b[, s9. R af hase: aM a-0 roofed areas (20%mmomwn btcwerz9e a6ow¢A) 1 Sals Repat if prqrosed Wuldmg is M 6e plared m dshubed sad 2 capies d plm shavimg beam & xmMOwsizes: paved faund tlesign, ek. 15elof Erogy Calctdatlprs 3 ropies d Tree Pmma6on plan if lot platted aftzr 711133 RimJanDeW Options selectimsheet (buNngswqh3orlessunits) h6megasco rtredwKai ventilabon form Rarbdel7Rmau ReaiienceMs 2 oopies oFplan dwrig boVi9s. bmm.loiZ 1 set af Fscvgy Calcula6onsfaheahed addi0iais 1 sde snvcy Madkbps 8 dedcs .Wdtw, - ngcaie a oasda mpdc systm I ot-?) I 90, Q? Olfice lhe OnN CatofSweyRecd _Y _N SohRepart _V _N TmtPmsPlan RHb _Y _N , TreeResReqmed _Y _N On-deSepficSyshnn _Y _N Plans are considered u6lic information unless ou state the are trade secret and the reason. Date 4V'___ /-t / 6-1 Site Address tQ/y-) y - -?- Coostructioo Cost gLTCj C-00 '?;Y? 5-? Uoit/Ste # Description ot Worlc VC/Y-06 MWri-Family Bidg _Y N Fireplace(s) 0 _ 1 _ 2 PropertyOwner ?C/W?Jts ptl,'iC?r Se /1? Tekphone#('?I) 4s'+-IDan Contractor Address Z> " Stste M City ( 4o tC3 Zip Telephone COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Mmnesota Rules 7672 Energy Code Category . Residential ventilatim Ca(J submission type) ?bm?? teaIXr t w«ksheet . rlew Eneryy coae worksneet Submitled • Enetgy Envebpe Cakvla6oiu Submilted In The last 12 months, has the City of Eagan iswed a perm"rf for a simi7ar plan based on a master plan? _ Y _ N It yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( s nereny app"sy =or a i:esidenfia[ Building Permit and acknowledge that the information is complete and accurab snaF me wt rk witt be in contormance with the ordinaaces and codes of the City of Eagan and the State of MN 5faieEtes: i andersfand 'chis :s =iac a nermit; bisc onic an appiication far a pe3Ynif, and 4vorx is net to start wiinattt a yermit; that the tuc.rk wi;. : e in accorvaree with the approveci ptan in ihe case ot work w c i requires a review and aE;enva" .i pian;_ ripnf'sL'arkY`N F-=7iiizi+ ii ;mc : ?n-;i;c_:;n?'. DO NOT WRITE BELOW TEIIS LINE Sub Tvoes ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 OFsplex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt- Muki ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Att - SF ? 04 02-plex Q 10 OB-plex ? 18 Dedc ? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Stortn Damage ? 06 OA-plex ? 12 12_plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Intenor ? 44 Siding ? 32 Addition ? 36 Move Buildirg ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Atteretion ? 37 Demolish Building' ? 43 Reroof 13 46 Windows/Doors ? 34 Replacement `Demolilion (Engre Bldg) - Give PCA handout to appllwM D28C1'ipLlOfl: WaterDamage` Yes Valuation Occupancy MCES System Plan Review _ 100°k or _ 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Width REQUII2ED INSPECTIONS _ Footings (new bldg) Sheetrock _ Footings (deck) FinaVC.O. _ Footings (addition) FinaUNo C.O. _ Foundation HVpC _ Drain Tile pther Roof _ Ice & Water _ Final Pool Ftgs Air/GasTes[s Final - Framing ' _ Siding Stucco Lath Stone Lath Brick _ F veplace _ R.I. _ Air Tes[ _ Final _ Windows _ Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other ToWI RESIDENTIAL BUILDING PERMIT APPLICATION . CITY OF EAGAN I I/ 3830 PILOT KNOB RD - 55122 T?? ?•V ?o ? 651-681-4675 NewConstruction Reauirements RemodellReoair Reauirements • 3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas • 2 copies of plan ? (20°k ma)imum lot coverage allowed) . t set of Energy Calculations for heated addiGons? • 2 copies of plan showing beam 8 window sizes; poured found desgn, etc.) . 1 site survey for exterior additions & decks • 1 set of Energy CalculaUons . Indicate if home served 6y sep6c system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs wilh 3 or less unils) DATE 1-16- 0 / JOB SITE ADDRESS /o C-i44/V/,) 41 A,? 5?5_1-;?- / If MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWPIER ?An?/?5 Yr? tr-?25oJ?/ TYPE OF WORK FIREPLAGE(S) _ 0_ 1_ 2 APPLICANT cTig/i'l,C A??7??.LSfJ/I? PHONE#lo?/= 'ys? ?23g ADDRESS ZIPCODE S??/-ZI PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY __----------.? Energy Code Category MINNESOTA RULES 7670 CATEGORY (check one) - Residential Ventilation Category 1 Worksheet Sub??ted D - Energy Envelope Calculations Submitted ?,, ,,1 } i?- ?(p 2t? MINNESOTA RULES 7672 `f?I'`? ? - New Energy Code Worksheet Submitted !c?v _--------- Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Mechanical Systcin Includes: Sewer/Water Contractor: Phone # Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant b, .2 Z Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 Water Softener Water Hcater No. of Baths VALUATION Phone #: Lawn Sprinkler No. of R.I. Baths Phone # _ t1u- Conditioning _ Heat Recovery System F'ee: $90.00 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex 7 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ...? ? ? 30 Accessory 81dg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding X 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 2A_" Occupancy MC/ES System Census Code ? Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs I Length Fire Sprinklered Type of Const W idth ? Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approved By ? Z , Building Inspector REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) FinaUNo C.O. Footings (addirion) Plumbing Foundation Drain Tile Roof Ice & Water Final Fraxning Fireplace _ R.I. _ Air Test _ Final Insulation Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinaUC.O. ? HVAC ? ?? ? ? ? ~Q1 \ r _ _ Use BLUE or BLACK Ink _ V For 0-11-c-9 Use \f V Qd My I Permit of Eajan A~k I I Permit Fee. I 3830 Pilot Knob Road I L 13 I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 "Iet ~ I j--}~ I Fax: (651) 6755684 1 Staff. 1 ' I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11112//-3 Site Address: ) v4l ho,-ine-+h gpA nit Name:1 oYl Phone: G S I -all /q Resident/ 1 l Owner Address/City/Zip: lor' "1l rlen~~' 1 i. cokT4n,MN SSIZ Applicant is: Owner Contractor Description of work: f a~ Sq OE I)f1 I St cl if CL M Type of Work , Construction Cost: S,d6 Multi-Family Building: (Yes J No Company: rA1S-+QVY') P1Qknd &14eK ~~C. Contact: 1.211 Contractor Address: A 06 116 D~ City: L1f/1~0r 7 - ~t0 "1(n a, State: Zip: SS a Phone: i D ~ 1 (7 - License CK(b 1'7q i~ Lead Certificate* LAI 2 0 l 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 b Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public inf urnadon. Pordons of the Irtfonnat/on may be classified as non-public it you provide speciflc reasons that would permit the City to conclude that they 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.oooherstateonecall.ora 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 1 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 work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X E>- ' x Applican Printed Name Applican gna Page 1 of 3