1033 Kettle Creek RdT?.?:" ,? " .-. .. .v. ?... . -.'-.-:?•?w. . . . . .i
y"j1 CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
; DATE ?19 ` -
?
RiCE1VED t ' FROM
y_
AMOUNT
IUN CODE AMOVNT
I,
i ._
r .
Q _
r
7 4' . ri
?-
Thank You
BY
61S93
/
White-Payers Copy
Ye11ow-Posting Copy
Pink-File Copy
Ec DOLLARS
Ioo
? CASH -E] CHECK
CITY OF EAGAN Remarks r" J i',I j;?r a 1-?4
Addition LEXINGTON SQUARE Loc ZZ aik 2 Parcel 10 45075 220 02
owner street 1033 Kettle Creek Road State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK qAl 1985 254.53 16.97 15 254.53 C009731 10-12-84
SEWERLATERAL ben tr 1986 173.65 11.58 1 173.65 C010075 1-28-85
WATERMAIN 1986 68.3 4.56 15 68.33 C010075 1-28-85
WATER LATERAL
WATER AREA 1986 286 19, 15 286.43 C010075 1-28-85
STORMSEW TRK 1986 501.29 33.42 15 501.29 C010075 1-28-85
STORMSEWLAT p7 1986 513.81 34.25 15 513.81 C010075 1-28-85
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUII.DING PER.
SAC
PARK
PERMIT #
PLUMBING PERMIT RECEIPT #
qTY OF EAGAN
3830 P ILO7 KNOB ROAD, EAGAN, MN 55121 DATE n
CONTRACT PRICE: PMONE: 454-8100
Site Address LL?- ? L BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. ? New ?
Name Mult Add-on
Addresa, Comm. Repair
c o_
Ciry
_j
Other
?
Name °- HO. FIXTURES
f Water Closet -$3.00 TOTAL
3 Address ? y 3 /_Bath Tubs -$3.00
O City 2r ? Phone 5 71 - 0 30 1 Lavatory - $3.00 5<'
Shower - $3.00
I Kitchen Sink - $3.00
FEES
COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet -$3.00
/ ?undry Tray - $3.00 1
3` ^
MINIMUM - RESIDENTIAL FEE _ $?p,pp ? Floor Drains -$1.50 ?
MINIMUM - COMM/IND FEE _ 20.00
__1_-Water Heater -$1.50 s()
STATE SURCHARGE PER PERMIT _ ,50 Whirlpool - $3.00
(ADD $.50 S/C IF PERMIT PRICE GOES _t Gas Piping Outlets -$1.50 ?'?'
BEYOND $1,000.00) _Softener - $5.00
Well - $10
00
_
.
Private Disp. - $10.00
-? - i G??s,•? _.i?_Rough Openings - $1.50
SIGNATUflE OF PERMITTEE FEE:
STATE S/C:
RAND TOTAL: 2 "' ?- ??
C
FOR: CITY OF EAGAN a
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ity Control
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, • • P?yFF# ?C? I 3
' MECHANICAL PERMIT RECEIPT #
CONTRACT
Site Address
Loi ??
8 Name _
m Address
c City _
3830 PILOT KNOB OAD, EAGAN, MN 55121 DATE S-a
_ PHONE: 456-8100
Block _c>S, Sec/Sub ?
°'----
Name
' ?
c Address
p City Ph6ne _
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
' Vent. CFM
Gas Piping Outlets #
Other
1. <
y l
/•
FEE
S/C:
TOTAL•
"BLDG. TYPE WORK DESCRIPTION
/ ?
"
Res.
New
Mult Add-on
Comm. Repair
Other
' FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - ?
6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
. ' CITY OF EAGAN - : ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?• 117 33
PHONE: 454-8100 ,
BUILDING PERMIT Receipt #
Tobeused`for Sr' DwG/GAR EstValue $107,,000 Date i"PFt.IL 1 19 66
SiteAddress? 1033 KETTLi: C1tLi.K RD Erect Ox Occupancy A3
Lot 22Bbck 2 Sec/Sub. ',LXINGTON $Q Remodel ? Zoning lcl ,
Repair ?
Parcel No Type of Const V
.
Addition ? No. Stories j
i TIiE ROTTLUND CO Move ?
Name Length
,
W
z F.O. BOX 3$? Demolish ?
3 Address I
I
? Depth
S
F
nt.
mpr.
0 City O`'SEU Phone 571-0304 Install ? q.
t.
o Name Approva ls Fees
o i Address ASS8SSR1Bf)t P@fFfllt +' 450. 5 J
c
Ciry Prione Water 8 Sew.
Sureharge 53.50
? Q Police Plan Review 225.25
F W Name Fire
;
SAC 575.00
Z
a Address
Eng.
0 0. 0 ?
Water Conn.
i W City Phone Planner ?
Water Meter 63 . 50
h
Council
?
Road Unit 290.00
? Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe 3
` 81dg. Off Q ? I
?r Tr. Pi. 156.00
information is correct and agree to comply with all applicable State of
f Minnesota Statutes and Ci .pf Eagan Ordinances. APC
? ?
Parks
Var. Date
SignaWre of Permittee ? Copies
??7 5 I
Total '
A Building Permit is issued to: Tf;E; ,HO TLUND Cl) on the express condition that I
all work shall be done in accordance with all applicable (8te of Minnesota Statutes and City ot Eagan Ordinances. ?
Building Official ? r ' - I
fk"4! J.y00,
I I Permfl No. I PermX Holdar I Defe I TNapM1one K I
I n? sra -7 I X.. __ _.' , I s/i /PL Ig.C17 ,- I
n Date
I
11
Plbp.
Mtg.
Final Htg.
Flnal Plby. -- ? (j f/, .
81dy. Flnal ?,._•
CerL Oca _ ?? d4
Ftp.
Frmp.
DbP.
CITY OF EAGAN 14$03
• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt #
To be u$ed lo? Est. Value 5: ,:••?" Date
1 ,19416_
Site Address^t' , ' L- I O FFICE USE ONLY
Lot ' Block ? SeclSub. 1t4r:2J': S OnSiteSewage Occupancy
- ,
Parcel No. MWCC System Zoning
On Site Well _ (Actual) Conat
c Name "E VA r; y?,;, ,t i :,1 Ciry Water _ (Allowable)
W
2
'?? -? ?--
Address ? `3
PRV Required
S of Stories
;
° ,
City A'..:y.v Phone 4`i?+?-211f
Booster Pump
Length
Depth
, p Name •°' S.F.Total
? i Address Footprint S.F.
? City Phone APPROVALS FEES
~ a
WW Name En r/Assess.
9' Permit z`" ' y
Address Planner Surcharge
< W City PhOne Council Plan Review
Bldg. Off. SAC, City
I here6y acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: jA,_i)ifl' 1 ?. '! Treatment P1
on the express condition that all workshalf be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. parks
BuiidingOfficial TOTAL '
,y
Permit No. Permft Holder Dato Telephone ?
Plumbing
H.V.A.C.
Electric
Softener
Inspection oats Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg.
Deck Final
well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Kno6 Road
P. O. Bax'21199
Eagan, MN 55127
Zo?irg:
Owner:
/lddrcss:
Site Address: -
Plumber.
CITY OF EAGAN WATER SERYIC E PERMIT
3830.Pito3knob Road
P
O. Box 21199 PERMIT NO.:
.
Eagan, MN 55121 DATE:
Zoniny: 'l No. of Units:
Owner ;ott ?;ur;d .ii1v _
llddross:
?
SiM /lddrcss• 'r ;' ;'<'ttle "rc•:;': -
Plumber: 301
Meter No.: ? ?roe:
Size: D?'L ?eposit: "q
Reader Per?i?li? : I
!
I
t ?+??9s
Nrw
e oy
{y??
.
g
Misc. Chorpes:
Totat: r
B Dots Paid:
y
Date of sp.: Insp.:
A
SEWER SERVlCE PERMR
PERMIT NO.:
OATE:
No. of Units:
K,: &
!O Ph Wkb the Qy of laY011 COflMdiWl C}IOI'Q!:
OrliMne,M. Account Depotih
Psrtnit Fee:
Surdwr9e:
gy Miac. U+aroew
Dote of Insp.: Total:
Insp.: DoM Pold:
OF EAGAN WATER SERVICE PERMR
Pilot Knob Road
Box 31199 PERMIT NO.: 7? 3 Z
i, MN 55121 DATE:
7: No. of Units:
Mdrcss:
ber. _
r No.: _
er No.:.
fe eeseply ahh !M Ciry of EagOe
of Insp.:
L22 42 Z.eainntnn
Connettian CFwrge:
Aceount Deposit:
Permit Fee:
Surcharge:
Misc. Charqes:
Total:
Date Paid:
;
CITY OF EAGAN N p 117 O 9
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121? -? .
PHONE: 454-8100
BUILDING PERMIT Receipt#
7obeusedfor SF DWG/GAR EstValue $107,000 Date APRIL 1 19 86
SiteAddress- 1033 KETTLE CREEK RD Erect
L3' Occupancy R3
Lot 22 Block 2 Sec/Sub
. LEXINGTON SQ Remodel ? Zoning Rl
Parcel No. Repair ? Type of Const. v
Addition ? No. Stories
¢ Name THE ROTTLUND CO
3 Address P.O. BOX 383
° City OSSEO phone 571-0304
SA[KE
a Name
=
o¢ Address
~ City Phone
?Q
F W
Name
c Address
U
a Ciry Phone
I hdreby acknowledge that I have read this application an d state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ci f Eagan Ordinances.
Signature of Permitt
eP?
A Building Permit is issued to: T$E ROTTLUND CO
all work shall be done in accordance with all WKcable te of Minn sc
Move ?
Demolish ?
Int.lmpr. ?
Install ?
ApprovF
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner-
Council
Bldg. Off. 3
APC
Fees
Permit $ 450.50
Surcharge 53.50
Plan Review 225. 2 5
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63. 50
Road Unit 290.00
Tr. PI. 156.00
Var. Date I Copies
T,,,,, 2, 31 . 7 5
Length
Depth
Sq. Ft.
on the expieA condition that
City of Eagan Ordinances.
8uilding Official
CITY OF EAGAN N°_ 'I 4 H$ 3
3830 Pilot Knob Road, P.O. Box 21-199; Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # s 3 a"`' ^7
'1 /
To be used for" DECK Est. Value $1,000 Date APRIL 26 ,1988
Site Address 1033 KETTLE CREEK RD OFFICE USE ONLY
Lot 22 Block 2 Sec/Sub. LEXINGTON SQ On Site Sewage _ Occupancy
MWCC System _ Zoning
Parcel No
.
On Site Well _ (Actuaq Const
c Name DAVID SANDQUIST City Water (Allowable)
W
z
Address 1033 KETTLE CREEK RD
PRV Required #
of Stories
? City EAGAN Phone 454-2218 887-3276 BO°Ster Pump Length
Depth
.5 Name SAME S.F. Total
? Q Address Footprint S.F.
a City Phone pPpROVALS FEES
;y W
Name Engr./Assess. Permit 2?+.00
_? Address Planner Surcharge .50
?=
w CitY Phone Council Plan Review
a Bldg. Off. SAC, City
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and aqroc-V comPly with ail aPPlicable State of Water Conn
Minnesota Statutes and C. of E an Ordi anc
Water Meter
Signature of Permittee _ Road Unit
A Building Permit is issued to: DAVID SANDOU_ T Treatment P7
on the express condition that all work shall be done in accordance with all
I
applicable State ofM
innesota St
atutes and City of Eagan Ordinances. Parks
?
?
f TOTAL
Building Official?.
I
REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi -oa
IP See instructions for ComDleting this form on beCk of yellow copy.
r 7R R7 "'X" Below Work Covered by This Request
AAd 8ep. Type of Building AppliHnCee Wired EquiVment Wired
Home Aange Temporary Service
Duplex Water Heater Lightin,y ffxtures
Apt. Building Dryer Electric Heatin
Commercial Bldy. Fumace Sil.o Unloeder,
Industnal Bldg. Afr Conditioner 8ulk Milk Tank
Farm Oine, peW[y - Oine, (snemN)
t er SuecifV Other Other
ompute Inspecrion Fee 8elow
M Fee Service En[rBnCeSizB R Pee Feedars/Sabfeeders # fee Circuits
? to 200 qm s 0 to 30 Am s to 30 Am s
Above 200 qmps? 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Am s Above100_Am js
Transiormers Irrigation Booms Partial,"Oth
Signs Special Inspection S Hema,ks ? OTA FE?A !1
RouBh-in ' Date
? 1 ih leclr - I
4 InspeCtar, hereby
? cer[it
thet th
ab
Final
Daye y
e
ove
inspection has been
.? ?
?- made.
Thfsrequeslvoidl8monihsfrom
C C / w fe.?.i?.
This request void ?^
78 mon[hs irom Q
C 7887
Request Date Fire No. Rough-in Ins ction
qufred? ?-,??.f
?He Now ?plll Notity Inspec-
s ?No O«Or When Ready
? Licensed Electrical Convactor I herabv request insDection of e6ove
? Owner elactrical work installed at:
Streei Address, Box or Ro ute No.
?Lg ???? City
86-
ection o. Township Name or No. Range No. C nry ?
?
antl I Tk?
?\?Y l? Phone No.
Po er SupDligr
I Address
Elecirical Contractnr (Company Name) .
? Contractor's License No.
Mailiddress (Con actor?r, -wner Makfng InstailatioN
3 ' o-e n 4
p?q?lr aed Signatufe (Contrac
or1 wner Making Installation)
111-9
l
Phone Number e? \
MINNESOTq STATE BOARD OF ELECTRICITY THIS INSPEC710N REQUEST WILL NOT
Griggs-Midwey Rldg. - Hoom N-191 gE ACCEPTED BV THE STATE BOARD
1827 Universitv Ave., St. Paul, MN 65104 UNLESS PROPER INSPECTION FEE IS
pti--e IF171 997_2111 ENCLOSED.
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
?dm CITY OF EAGAN 7 5
3830 PILOT KNOB RD - 55122 }
651-681-4675
dew Conshucflon Reauirertents C??1 -?617 fj Re lReoair Reauirementa
? 3 reglatered dte surveY6 aho`rAng aq- fl. ol lot. aq. k. 01 houae -O o 2 copies o( plan
and gR rooled areas (2496 maxlmum bt coveraae WbwedS t set of energy cafcuiations 1or heated addNiona
? 2 coples of plana (show bepm & window slzes; poured fid. deslgn; 9tc.) 1 sNe survey tor exfedor addiHons 8 decks
? I set of energy calculallons
> 3 coples of hee preiervaHOn plon H lot platted aRer 7/1/93
DATE: O1 3? Z-C.Xk) CONSTRUGTION COST:
DESCRIPTION OF WORK:
?
STREET ADDRESS; .inF,-3
LOT: BLOCK: SUBD./P.I.D. #:
PROPERT1f
OWNER
Name: ? m I I n ? V CQn Phone lf: ( n6t (Qg S 092-&
Lasf Fint
Slreet Address:
City ? a Wn Stafe: Zip: 65123
. Company:1(,\ 1 Y1Q.. . Lh o Phone Z
CONTRACTOR code)
Sheet Address: 2? ?qS? C?"? c? I (area IC.. s Lkense # Z? 94. 0310
Ctty 1?Y1 qtate: m ? Zip: ?? ` ?
ARCHITECT/
ENGINEER Company:
Telephone #: (
Name:
Street Address: Regislraflon #:
City
State:
Sewerlwater licensed plumber (if instailina sewerlwaterl: Phone #:
Zip:
I hereby acknowledge ihat I have read ihis applicaHon, state fhat Ihe intomnation is cortect, and agree to comply wilh aq applioable S1aFe
ot Mlnnesota Statutes and City of Eagan Ordinancea
Signature of ApplicanY.
?
OFFICE U3E ONLY
Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No ? Not Required
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-piex
? 02 SF Dwelling ? 08 06-plex
O 03 01 of _ plex ? 09 OT-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
D 06 04-plex ? 12 12-plex
WORK TYPE
? 31 New
O 32 Addition
? 33 Alteration
? 34 Repair
OFFICE USE ONLY
;
? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext Alt - Muki
O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 19 Lower l.evel ? 24 Storm Damage
Plbg _Y or_ N ? 25 INISC81I2f180US
? ZO Pool ? 30 Accessory Bidg.
?, 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' C] 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to appltcant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No, of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVAL3
Planning Building
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MClES System
City Water
Booster Pump
PRV
Fire Sprinklered
Engineering
Variance
Permit Fee ?
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
SAC Units
% SAC
?
1988 BUILDING PERMIT APPLICATION - CITY OF EAGk2I
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/$OMEOWNER MUST DESIGNATE WHIC$ ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE HUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL IINITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.t
1 SET OE ENERGY CALCULATIONS
COhIIMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STAUCTURAL PLANS,
1 SET OF SPECIEICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: Ue ` < Valuation: Date: a ?j-
Site Address 463.3 ,C??/e Lr?erK
Lot o? ';?Block ;?- ,
Parcel/Sub
Owner ? .Sa n r? a1J-?-
Address ke- -?-t/2 C!1C
City/Zip Code 2E- 41 J
w?--K
Phone G/Sy -Z L/ ??,. 8? Ja76
Contractor s e. / )?
Address
City/Zip Code.
Phone
,
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
On site sewage _ Oecupancy
MWCC system _ Zoning
On site well Actual Const
City water _
_ Allowable
PAV required # of stories
Booster Pump _
_ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit ?2y.° °
Planner Surcharge , SJ
Couneil Plan Review
Sldg. Off. =,4/u SAC, City
Variance - SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAI. ?? S
F ;a
I
0 v .
0
1985 BUILDING PERMIT APPLICATIOH - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For ? Valuation: te:
00
.-
Site Address: 6;JL ti OFFICE USE ONLY
D ?
Lot:o`Zv? Block o? Sect/Subci?j???iaw2Erect X Occupancy (Z.3
Remodel Zoning ?.?
Parcel # Repair _ Type of Const
Enlarge 01 of Stories
Owner `?_?? Move Length
Demolish Depth
Address ??. E¢Y? Grade Sq Ft
City/Zip Code Q j`?jeC) ?4'q ---------•
Phone 4.5 -7' - t03Q!l APPROYALS
Contractor 1'jy,?
Address
City/Zip Code -
Phone
Arch./Engr.
Address
City/Zip Code %?
Phone 4E
Assessments Permit 4-SD.?
Water/Sewer Surcharge 5 -3 so
Police Plan Review 1,.25. z=
Fire SAC 5-75-1
Engr Water Conn 500.
Planner Water Meter ?3 s=
Council9 Road Unit VCjD.
Bldg Off3zo.e450 Parks
APC Treatment P1 ?.
Variance
TOTAL 2?13.
?
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C•rtiiicat•
Nom OnKa 571 6088
6876 HpIwaY No. 65 N.E.
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""' --- - Denofes Orainoje ¢ WiIi? Easemen}
Starlnqs ShoWn are Assuad. pppppS?D ELEYAT[OIIS
o Derates Iron tbnunent.
o DerwLts 10'm Foundntion Top ot Block
Corner Stake. Lowest Floor
s9oo.00enotta Exlsting Elevation. 6arage Floor 89(P 3
,0-- O0otes OtrOction of SuKace Dralnaye.
LoT-z-z , gLocx z
LEXINGTON SQ UA RE? DAKOTA CQUA/lr, M/IVN.
5ubj ecf fo d?-qinage 4 uti li f? easemenfs
1 IuroYy fordly sAe? MIe b•frw Mr to"etl N?"p11N1lM d isvvq N eA* YwwdaNs Ntb sle"
Mpr1bM Mw1, sM M tAe, Ioeatbw *1 a11 6w11d1 IA• ?aU rl?l N1/ aq., Inw r?
MII bwr. Ao wrvereI Yy wo tA1s ?My o1 ?R A.O. l?j
? ?/? 8 {I?Nt?A NOtN N IMC.
?/Cn. I"'?(? S 1 s L/ ??t ???0r ? re r!n
?,R/ ??
PhN IyW11lyd: All plMn
?
r,/f /o s/ y ts (0 UYO
?yY
?42 w #f la v (at
EXTERIOR :ENVELOPE AVERAGE "U" COMPUTATION
OWNER ? O TT LV ti/ D L O.
SITE ADDRE55 rt'??'«?j ".{-j?;;?cQ.?•.;G't.f?P:??.-f? ?G-?4L'?.>
CONTRACTOR SA(?4k ? DATE 371/76(0 PHONE
Determine working square footage of each.
1. Total exposed wall area ...... Z`+?f '7 sq. ft. x Z 77, 17
2. Total roof f ceiling area ...... ? Usq. ft. xs0z6 =;2 lo, `G 3
Total axposed wall area above floor = ? I q- /
a. Total wall window area ..................... ......... `T
b. ToCal door area .................... ....••..........
c. Total sliding glass door area ....... ............. ---'
d. Total fireplace Waii area ......... ................ -'
e. Total wall framing area (average 10%) ...............
f. Total net wall area above floor ......... ,........ 17/S
g. Total rim joist area ..... ....................... 2.1?-
Total exposed foundation area = G Z
h. Total foundation window area ............._..,••,••e• G%
' .,
i. Total net foundation area above grade .......,....••.. 5 3
Determine "U" value of each wall segment.
a. g flUll
b. S ? x "u"
C. - x "u"
d. - X "U"
e. x "u"
f. R. nUn
?
g,
z
X
„U„
h. ?J X "U"
i. 5 3 X "U"
aS q = 1a2o0C=,
,07 = 3.G Z
3 6v
3 ......................................Tota1
If item # 3 is the same as, ar less than item #1, you have met the intent
of SBC 6006(c)2.
. ,..
h
.y?
Tota1 exposed roof/ceiling area = / U 3 Z
Total gross roof/ceiling area = /G 3?
j. Total skylight area ........................ 6
k. Total roof/ceiling framing area ............ 6 2
].. Total net insulated roof/ceiling area ...... ?16 q
Determine "U" value for each roof/ceiling segment.
j . ?o X viUii ?06 `7F
k. x IlUit
X flUn aQ2S = 2z'/'nlU
4 ..................................... Total = 2- 0.`-/ (
If total of 114 is the same as, or less than #2, you have met the intent of
SSC.6006(c)1.
To utilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not be greater than the sum of items #l and #2•
1. 27?0l7 + 2.
3. li-5 + 4.
2?,`63 = 30?/oD?
2O•Y1 = 2,et3,2?
FIG. fi1
1. ?Ser, C
?'' ? `•'a-1 ] ,,.. ?
xCn i• ? •?
? ? ?T°
U
. ,
.
o?,'?? , •'
.
E'LLYu .1 0l' 4
Const? n . ' ' . . , .
? 1;•.<.. ' R-Va].ue
1. Interior airfilm 0
68
.2• Y L1?C?YP 13 R l7 .
? 4 S
. 3. 1 x ?, sTUa S ? .
, 9. 25-132 s1-rrC,-
2„bG .
5. ?/U/-lirs Ut?C/? FELr / a 2?
6: P.xterior air film 0.17 •
Total %/, s"
aO`a? .
Intera.or air fi1.m 0.68
2. ve"G.2'/? 132 D o S!S, . ..
3. FUL L JG!/.?l e e' ' e
4• 25 13L Sh'TG- 2 fJC-? '
5.
6. Exterior air film 0.17
' Total .Z 3, 6 Z '
1, Interioz air film O.GB'
2,
3. ' 2 X-ta'i r it ,
4. 2 S t-I'?G?-
5. ?6•2 ?
6. Exterior air film 0.17
• Total 2 S•O 5-
'
? r • ? . O `f- C?
.
1. Interior air film 0.68
2.
3. 2?1 Fu2 2? tv v .
4. . /Z /3 C?C (L ?aZ ?S
5.
6. Exterior air Eilm 0.17
Tota1 /3,/3
s0•7(o
, . ., ., .
r ,
. ? ` • a ? `' e.
• S?'f.'? ?T?f? k . ' • ? , r ' . i r'
1! (" " ` . . • ` ?
. ? ,
/l ( v . . %
? ? • ? ' b . ', ? ? 11! r?
,. 113 --• , . . FIG. I14 ,
r.----r L-.o?? ... . : .
? • ? _
TOPVIE[I OF
F2211tiC llALL
? • •;
• ?,
??j\ •
v? . •
;J . , .
. ?. .. . .' r
? r i k .? r'', • '(' ' ? i?l ,./ I ?
. .=. • >' ?? ? ?
, w1,Li, sLCrl?,. ,
11uT?; U'se 10% oL• opaque Wall area foz'
. ixame construction
? r t
?'.ROOP'/CEILING
i . .
i ? .
; ?["j`• , ConstrucL•ion ' 12-Va1110
?--
?!?" 1, ? Interior a9.r film ? . : 0.61. '
2. ?' s" C7Y ? 'j-"!, ?-_O o S8 .
3. r3?or.?.v .,?.sv? 3?,oG? ,
4, Exterior air film (still . 0.
? ?
• VF.i1T 2
.?? '•: ._._...,__...?. ota.t 3Cfo8o. ,
• '
, ? `i ? ?. ?--0 .? '•',` ' ? . ? • ? . • ' . U = s025-
, . •?
? • . . • • ? .
• ' .? ? , , , .
; .. .
Vented Heat f1ow.' ? ' . . • ' . ? . . ?
. ? . up • . , ' • ' . , ''i i . . .
. ? . , ?
? . I I . ? i.? ? ? '' 11' • ?_ i ,
. ? ? .
1"TG. #k5 ?' ? ' ? • ' , ; ,
. . . . • , ?.
? .. `?
. i. . . . . .
].. Interior. air film 0.61
,,,,_r?j•,:,,?,,..,?c,s+i..?r._'•-LtiL/M_-;?nr.?ntie?e? . 2. 5;Ap7 • C?Y? I?.a?0 ?
. V I? ? 3. /i?S!/L ovC-rc rizus,? • 3?1 ?G? -.? .
4., Exterior air Eilm sti 1l
i/.? . ? • . , Total• 3(0?-7
r
.,
,? ? , I ? ? ? ? ? _ ? ?f . . ? , . . . .
. . . .. ? ? . . .
. ? . . . . . : . . . .
1 2 ? 3 4 ? • . ., . ? . ' .,? • . . .
. . .. , .
, . . . .
• ,
Y.°_nt flow uP . ? .•vented . ? ? • ;
. . i .. ,,' ;; '' ' •,• ' . . , ' ..
• , ,FIG. 1?6....I., . ?r? ' !? . . , .
•;. ,.. . . . . ? -
' •- • : . ___.. _+?_','•' , .. . . . . . .
, 3 ? . . . ., . ?.. . ?
FT 1. Insi.de ai.r film O.G7.
• . . TI . ?nl _a?°sr?`??.°.5.:'.•1._,Q•^r,s."?i : 2. ,
• , vn?9:it }? ':r=?-' ? .i. . .
•
.. a [ ?. . ?? ? ? : • •? ? ?. ? 4.
Outsi.de air. Pilm 0.3.7
'?-? . I • To tal
, ' ,? i ? ? ? r ' . . , i . ' +. . . • • .
. . I . ' ??? .C' , . • .
, , ? , i.. • , .
„ . ,
• ?.NOi1-?,°?g,p? ,' ' Note: Use add3.tional sheets •ii more ?-paco .is
.., .., ,
• ? " ? • needed for dei:ails and calculai:ians. ?
. HeuC ' • . . ? . • ? !
' . : ? ?flow up • ' ' . ' ? . • • .
1. . . • .
, ., . . . . , ,
. .
' fiTr,, ??? ? ' . , • .. :? ? .
., ,
,
CITY OF EAGAN
APPLICATION FOR PERMIT
. ..
SEWER AND/OR WATER CONNECTION
****************#*ft*****###****#y
*10'PG': PAYMENT OF FEE AT TIlME OF
APPLICPMON DOFS NOP CONSTITITPE
APPROVAL OF PF.RNIIT.
itusPncrroN oF sEWER AND/oR rnATM
rNSrALLUroNS wnL Nar sE sc.iEn-
ULID []NM PERMIT HAS BEIN
APPROVID.
.. _ . •xxxxx???,xx,,x?x,xx?,xx?xx?x?????,:
Please Print)
1) PROPERTY ADDRESS :
LEGAL DESCRIPTION: -
. Lot 81ock Subdivision or Tax Parcel ID )
IF EX25TING STRCY.`iL'RE, DATE OF ORIGINAL BLILDZNG PERMIT ISSL'APICE: `. -
? (Nbn Year )
PRESENr ZONING/pROPOSID LSE:
? Ca"AMCL?L/ORETAIL/OFFICE ? R-1 SINGLE FAMILY .
r7 IPIDL'STRIAL ? R-2 DLPLEX (Ztvo Lnits)
INSTI'IL'TIONAL/GOVER[ENT ? R-3 ZOWNEiaT-ISE (Three + Units) ( Linits)
. ? R-4 APART'MENT/COAIDOMINIL'M Units )
2) ?
ADDRESS:
CITY, STATE, ZIP:
PHONE: // 3 ,; '-
3) ?•
NAMEe
ADDRESS :
i CITY, STATE. ZIP:
PHONE:
PHONE:_ 6-7 rlut[tc,t?LS L.iCBI25E':
4) •.« • • i?+•
rrAr?:
ADDF2FSS :
CITY, STATE, ZIP:
ACt1V2
Ebcpired
Not recorded
Staff Initial
•5) ? r• i ? a: • ?• : a ? ??
? CONNECTION 70 CITY SEWEft 1?1 CpNNDC,Z'ION TO CITY WATIIt ??'HER ' .
l?=a
•J MASTII2 LICENSE#
6) '? .•?' [? PLF.ASE HOLD APPROVID PEf2MIT F'OR PICK-L?P BY ONE OF ABCNE -.-
? PLEASE MAIL APPROVED PERMIT TO 1. 2p)3, 4, ABQVE
7) r ? 1, le one ) _ ? ?d ?s..• ??.iii'ia L ' (lr ,v•?_
f
FOR CITY USE 4NLY
PERMIT # ISSL'ED
?
7,33
Pd w/Bldg. Permit FEES:
$ $ j0 S G
$ $ /19 s?
$ ? 3 - ssc% $
$ $
$ $
$ $
$ $
$ $
$ -2 7s. o r? $
$ $
$ $
$ $ .
$ $
$ l -`?7L ' CT ? $
$ $
$ 42l 1/`
. 6 /G &/,,
RECEIPT RECEIPT #
SEWER PERMIT (INCLLDE SURCHARGE)
WATER PERMIT (INCLL'DE SL'RCHARGE) ..
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SEWER TAP ACCOUNT DEPOSIT - SEWER
ACCOONT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRt'NK SEWER ASSESSMENT
LATERAL BENEFIT/TRC'NK SEWER
LATERAL BENEFIT/TRC'NK WATER
WATER TREATMENT PLANT SLRCHARGE
OTHER:
TOTAL
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
r--j YES IF YES, THEN A"PERMIT FOR WORK iVITHIN PUBLZC
Q
ROADWAY" MUST BE IS5UED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
?HEAT LO55 CALCULATI
cuttomw Nam. _(i-5±h(i1G( Ntto jogot 65ri?.-to(
citv
o«i.. Name.?LA?RE HEATING & AIR n?vnirin?w? >>r
StrMt ---???etlHj?gbhn Ay8 N0.
City __-O9lelen Valls?w, NN13044i?n'55422
Room j Length 3g Wkith o? S.
and Door:-Crsekae.,r,cf srs¦
wa „wo ?n? or n?. i?.ni. ' ol?ne r' ? N.
2 $ r7
? Coef. Btu
Inf iltration O O / Z O(D
Glau / 00
Exp. wall
8
b
Net exp. wall a
Int. wall
ceuiny 3 Z
Floor 3 Z
7ots1 Btu.
?..3LIL
1 FI.I L.'?jrZ Roomllength 141Width (L, Htid+ -
Windows Ad Ouor s-Gack ape and A rM
No Wldtn
o1 aM ti?Hn?
01 ?M No, of
L 1? LinftN It.
Of er"Y Aw
q. ft.
Cwi. Btu
IMatntion 3 0 (3100
Gi+u a 14 oU
Emr,. wall 30 8
NtH eao. wall Z B'
Int. wall
coilng !qx / Z z
F loor ZL
ToulBtu. 1 y3?Q
Room I Langth 11. S WidM 1( ihiaht
Wt nd Ooas-Gackaye od Arr
w? w?n.n H.pn?
/1? /NM I?I MA? Me. er
L }? LuMN it
.
O? CIKY
A.w
p. ??.
y
o ? a a- z z
Coof. Btu
IMiItrahon 2Z O o
G1azs v O
E¦p. W,611 a sxe so -
Net exp. wall (o q
IM, wall
cemng I f a
Florr 1Z
roul atu. I ;Cy }I 01-
ON CJv ° TEMP. Dlff,
TYOe Condtnution
Window? Storm SMh
waUe . Ins.
Gilirq Iro.
f loor
Sr
Windowt and Doo?s-Cnckpe wnd ArM
Ne. Width
W MMNht
M m Ns. W
L n LiMd h.
sf ami! NM
. h.
a
?
1 3 a
Coef. Btu
Infiltntion t{D Z Q
Glau Z- I o C.)
Exp. wall I 'l, k
Nst axp. wal SQ Z..C.,> C...)
?nt. wall
Ceilin9 ( l, S k f 3. 2
F low i rl Z- Z?
ToUI Btu. I 1_;? 9
Room I Lwqth Width I 7 H"t AY
Windows acid Doors-Gadcap wd A?M
01 M NoMIor
N M Ns.e1
lohb LI/MMh,
1 s/NL Aw
.??.
Z
1 5a as Z zo
Co0. Btu
Infikntion {po U Z DO
Glatt Z 400
Exp. wall 30 Ic 8 Z i?
Nrt exp. wall 1?2 r7Zg
Int. wall 't4 y?° cK c- C3C7 c,l
Ceiling (3)c Z? ? 4Z
Floor 2,2L? Z__ c{
Total 8tu. ?j I Z
SrFl.) ?q Room ( LoVh ?. WidM 9 HNyht
Windows wib Doas-Gadcapa and ArN
M.;?t Ne. of L~. An.
Zo
1 Z fo 1 g
cwf. ecu
I nt iltntwn a.- Z,:F0
Gtm 2 '570 /3oc>
Exp. wN1 Y yc L,
Not ex0. wall (p(O (t
IM. wall
C..l,ng r y. s)e ? 2- z? z
F? 12, 1 e? L
Totai Btu. 1 _3 q (ag
i"q J? Z.
? HEAT LO55 CALCULATION ?...L_° rtEMP. DIFf..
N. ? t
Y -
•iw Name _
Str«t
City --
r Room j Lenqth ' 15 yyi
and Door:-Gaekao and Arp
No W'Oth
n1 o?q H??ynt
ol MM No, ol ? linMl lt.
4 nts ei e/wek ArM
N. h.
? c ZU
.
2?( Z Fl 'Z ! /
Cosf. Btu
Infiltration rj d 1 80
cl..: vv
Exp.wall (O)c fj
Net eap. wall
Int. wall
Ceiling 15-X l() O Z ?jp?J
F low C? L
2
otal Btu
FiA mas+-& BeJr+oom I L.rgtn I `7 w?
Windows and Daors-Crsekap Jnd A?m
i Mopn1 No. ot
L tt Linee111.
01 t/M A/M
. ?t.
t T
Cosf. 8tu
Infiltrstian p O Itooo
claa 3d 50 !(oov
E¦p. wall 30 x
NeM exp. wall Zo? 3
Int. wall
Ceil+ng 117 13 1 241
f l«x 1 2-Z( L Z
rnui sw. ? S 13'7
Room f L h ?lp Width Height
g
WmAnws amt Doors-Gackape and A?N
Nn WrArk Hophl
oN p.n? n/ M? Ne, e/
l L L111M1 N.
O/ l/KY AIM
W. h.
,1
CoN. Btu
Inhltratron - ? U 1a O
cia" y aD
Exp. wall rJ-' x
Not txp. wall f
Int. wall
c???iny lco x
ilwn q 72 f'f
total 61u.
a IF 3
TYm Comuuetion
Window? Sto?m Smdh
Walls . .? Int.
Gilirq Ins.
Floa
f
Windows and Doors-Gadepp and ArM
Ne. WINI?
m
Devig l
? NO, s1
l p Llwrl ff.
N vivivoi AIY
.1t.
CoN. Btu
Infihratan
Gla»
Exp. wall K ?
Not eap. will
Int. wall
Ceiling (p }c ? Z
Floa U g
Total Btu.
Windows and Ooort-Gsdcap wd A?M
No. width
Of ?M N*yM
f M Ne, d
Lww LI"M1 h
O/ NNh AN?
•„?
Coed. YlY
Infihwtan ? G LC)
Glas / U 8
Exp, wall ??p yC Q tJ?
No1 azp, wall
Int. wall
Ceiling J , /o
Floo. 33
Tots1 Btu.
( v. wsden t. S B'
Roan I LwVth
Wirnlom and Doort-Gadcep and Arm
Nn. Watti
N goino qeMt
p1 some Ne. ef
L 1o LMW h.
M NM" ?w
. n.
Cod. Btu
Infikration J
Glau G?
ExO. wa11
Not ONp. well TRT rl
Int. wall
Cal„g o, sx r t
Floor
Total Btu. ? Z(:?/: 2°r
„n,.? N,m. Hko 2ul nr ?
? HEAT LOSS CALCULATION
lit r--
mIr Nama
ShM1 _
City
ZWf I.I,W"91? y Room iLength l"( WidtA
Winflowt and Oaors-Crsckago ind Arw
No Wp rw
nr ?n? we.ant
01 Ne. of ? LinMl It.
l u o? eneM I.rM
84.91.
- 7 1- Z O .Z
Inf iItretfon
Glasi
Exp. wall ?a• s X l?
Net exp. wall ?
Int. wall
Cailing )C ? . s (
Flow 2.( 7
Totsl Btu.
Btu
FI.1 RoomlL h WidM Hi t
Windows and Oiwrs-Gsekagtand Arr
O? M OI iM No.OY
L A LiAMIN.
Of tIe" AfM
Caof. 8tu
Inliltration
Glsu
Eap. wall
Net exP. wall
InL wall
Ceihrg
F loor
Teul Btu. ?
_ Ft.l-- Lwigth WidM ' t
Wirxkows anA Doors-Gackpe wd Arr
Nr. W?row wNwt
??I INM .I MM 04e.01
L n Lowl ry.
of anck ArM
. N.
CoM. Btu
Intiltration
Glass
Exp. wall
NR erp. wgll
Int. wall
Ceihng
ilon?
Tobl Btu. I
57°l?l?
94) ° YEMP. DIFF..
TVDo Comdw.tion
Windowt Stwm Snh
w.u.. in.. Gilinq ino.
Fba
Windows wd Doo?t-Gadtep ud Arm
Na. wan.
ot pow
ot w? Me. ef
L u Linwl h.
of a ArN
. h.
' Cwf. 8tu
Inf iltration
Glaet
Exp. wall
Not exp. wall
Int. wall
Ceilirg
Floor
ToUI Btu. I
F1.1 HoomI Lsrqth Width ' t
WindDwf and Ooas-Gackap Md ArM
Ne. ? ael'
pwo aNMM `e. M awrl ` A n.
CoN. Btu
Ifl?lKfitqfl .
G1m
Exp. wall
Not exp. wall
Int. wall
Ceiling
Floor
Totel Btu. ?
FI.I Lysith Wichh t
Windowt wd Doors-Gadcsp wW Aw
? w,Nl% INI?IN Ne. s/
L a lhrN h.
N
I
B{Y
Intihntbn
GIm
Exp. wall
Nat mP. wall
Int. wall
Gilirq
Floor
Total Btu.
Cbhviec.-I-e l OP
g? ?'rL5 h? i r t?r ?'?'
RESIDENTIAL BiJII,DING
Permit Application
City Of Eagan
3530 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshudion Reauirements
3 registered si[e surveys showing sq. ft of bt, sq. ft of house; and ?II roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set o( Energy CalculaGons
3 copies of Tree Preservation Plan i( lot platted after 711193
Rim Joist Detail Op6ons selection sheet (bidgs with 3 or less units
RemodeUReoair Reauirements
2 copies of plan
1 set of Energy Calalations for heaied additions
1 site survey for additions & decks
Add7tion - indicate 'rf on-sfte septic system
Telephone # (
Date / / Construction Cost ?? ( J oo -
?a 'f
Site Address ? . UniUSte #
Description of Work 'Q?,. e L.l?l.
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Pro
ert
Owner Tele
hone #(461) l(? O D--6 9eFb
p
y p
Contractor RMA Home Denot Installed Sales
- 3200 Cobb Galleria Parkway Ste. #200
Address Atlanta, GA 30339 CiTy
State 763-542-8826
Telephone # ( )
_
License 4BG20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
ONice Use Onlv
Cert af Survey Recd
Tree Pres Plan Recd
Tree Pres Not Reqd
_ Onsite Septic System
Telephone # ( J
Teleph"
. 0 N A
I hereby apply for a Residential Building Permit and acknowledge that the i prmatio?is_.com leand accurate;
that the work will be in conformance with the ordinances and codes of the Eity oflagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approve plan in the case of work which requires a review and
approva of plans.
?
Applicant's Printed Name Applicant's Signature
OFFICE_ USE ONLY
Sub Types
0 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
0 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ?
? 32 AddiGon ?
? 33 Alteration ?
? 34 Replacement
Valuation
Census Code
SAC Units -•
Nbr. of Units
Nbr. of Bldgs
Type of Const
35 Int Improvement ? 38 Demolish (Interior) ? 44
36 Move Bldg. •.' , ? 42 Demolish (Foundation) 0 45
. :
37 Demolish (Bldg)* ? 43 Reroof ? 46
*Demolition (Entlr€BIdg) - Give PCA handout to applicant
. ? `
Occupancy ' MC/ES System _
Zoning City Water _
Stories Booster Pum
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - 5F
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
p. a
Sq. Ft. PRV '
Length Fire Sprinklered
W idth
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Watec Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ 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
Total
?
..
Installed
Siding and Windows
LIMITED POWER OF ATT.QRNEY .
CO[3NTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of M,ontgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales located a# 660 Mendelssohn Avenue North, Golden Valley, MN
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power of Attorney are
limited solely to the express powers delineated herein and apP1y solely to the Work.
This Limiied Power of Attomey shall expire and autorriatically be revoked on the 21st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WT1'NESS WHEREOF this Limited Power of ASterney is eaeci-itcd this
21 st day of May, 2003
.
David . Katz
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21st day of May, 2003.
cp
Notary P ic in for the State o eorgia
My Commission Expires: January 21, 2006
396816.v3
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, 5uite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPO;T
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1033 Kettle Creek Rd
Lot: 22 Block: 2 Addition: Lexington Square
PID:10- 45075- 220 -02
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: Replacement
Description: Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437 -0338
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
equirements should be directed to Mark Anderson, State Electrical Inspector,
Owner:
Evan M Smith
1033 Kettle Creek Rd
Eagan MN 55123
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA079087
08/01/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136770
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 1033 Kettle Creek Rd
Lot:22 Block: 2 Addition: Lexington Square
PID:10-45075-02-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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 (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 -
Evan M Smith
1033 Kettle Creek Rd
Eagan MN 55123
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:EA136770
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 1033 Kettle Creek Rd
Lot:22 Block: 2 Addition: Lexington Square
PID:10-45075-02-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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 (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 -
Evan M Smith
1033 Kettle Creek Rd
Eagan MN 55123
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:Mechanical
Permit Number:EA150153
Date Issued:06/22/2018
Permit Category:ePermit
Site Address: 1033 Kettle Creek Rd
Lot:22 Block: 2 Addition: Lexington Square
PID:10-45075-02-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Evan M Smith
1033 Kettle Creek Rd
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
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s
Homeowner Address ; 4. __L—'),„„_.1 �. ,
Date of 1ntaU9atrnn: a 1,
'��` � Other
Type of Heater: (circle one) I. 'F rced err , Hot Water 3. Space HT 4. Unit
. . �rrpt�t: =E
Make: i
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Phot Type: 2____
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Temp: 4 CO: ),
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6' Cif Sate Tested:
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Company: Haley Comfort Systems ,, . Technician:
; N
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163747
Date Issued:09/11/2020
Permit Category:ePermit
Site Address: 1033 Kettle Creek Rd
Lot:22 Block: 2 Addition: Lexington Square
PID:10-45075-02-220
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Evan M Smith
1033 Kettle Creek Rd
Eagan MN 55123
(651) 261-1665
Schmidt Roofing Inc
3509 West Highway 13
Burnsville MN 55337
(952) 888-4889
Applicant/Permitee: Signature Issued By: Signature