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.
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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
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