1470 Kings Crest
MAR/02/2011/WED 03;58 AM FAX No,952 854 4909 P,002/005
Use BLUR or BLACK Ink
For Office U5eej
Gx l ( ~
e i Permit
City of EI Permit Fee;
I I
3830 pilot Knob Road
Eagan MN 55122 ( I Date Received: !
Phone: (651) 675-5675 i Staff, !
Fax: (651) 675-5694 MAR 0 2 2011 ~ J`_----
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 9 Site Address: 070 e l) Q s P4
Suite
Tenant;
RESIDENT 1 OWNER Name: ✓ C t f ~l n Phone:' t ~b `q0
Address / Giry /Zip: _ N70 k 1 ~ L C $ L'
Applicant is: Owner Contractor
- aPcp,n¢ L a~1 141
TYPE OF WORK Description of work: + -joint s(tA yl)) r p' 6 A 0 f !f lid It Al
Construction Cost: /6 '719 Multi-Family Building: (Yes /No CONTRACTOR Name: _ Pella Windows & Doors _ License
Address: 16300 25th .Ave N. Ste 100 City;
Pivniouth, MN 55447 _ . U .
state: Lic # 20165884 Ph. 7631745-1400
It1~[ 0 I} l S b
Contact: b [7~1, ~j 5~$ 4 5 ~r17 Email: co
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes !No If yes, date and address of master plan:
Licensed Plumber. Phone;
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone: -
NOTj~: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU L)IG. 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 oo herstateonecall.org
I hereby acknowledge that this Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Z-r 19 S1- AI nk
K__
Applicant's Printed Name X_Plicant's 9:e
Page 1 of 2
-70
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi)
_ 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES I>'
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
- Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION qj;~ A
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final i C.O. Required
Footings (Addition), Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests Final
Framing Siding: -Stucco Lath -Stone Lath -Bruck
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: - Footings _ Backfill _ Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee FA J4
Surcharge
Plan Review
MCES SAC v L
City SAC i)
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant'"`
Copies
TOTAL 0~
agke-10 f2
M
- ....._ ? ?
(lex#if tratir of (Orrupanry
Citp of (f agan
iorprarlntrrA of swldiag jtaprrtimt
Tbts Certlfrcate lssued pursuant to the requijrenrents of Section 306 of the Unifornc Bufldircg
Code cerGtfyfiag 1lrat at tlie time ojissuance thds stiuclune was in enmpliaace w*h the mrious
ordinarraes of the City regula&g bui/ding consbucdon or use For the followfng.?
we ammmso. S F DWG/GAtt Mg. fanit xa. 443
O-W-CY7* - - ?t3 I zmiog Dbftict Rl - - Tm OWAL 1VN
LoalkyIb, BI, KDWWOM 41i
-om 7/24/q2
POST IN A CONSPICUOUS PLACE
N?
INSPECTI4N RECURD
CITY OF F-AGAN u.AcIVAmD FOR DECK oe4/01/93 :• PERMIT TYPE:
3830 Pilot Knob Road BRLICE JOHWCN 686'9967 Perrnit Number.
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
Control No. 0370
I+U 1 I tr t N1i
a*e q 43
ab/04/v2
SITE ADDRESS: t_ Wr _ 6
? l+If0 KINAS CREfiT
' Y, 1 Nt:+'A.IOtit3 +I f }I
PERMIT SUBTYPE:
? , I 111.?6
APPLICANT:
aQHNSVrv sNUCt
(612) 686-9967
TYPE OF WORK:
NCW
INSPECTION
•, i t t• ..
t'flt}1"1146 .A
f FaAM f Nii I MSUT AT rOM
F ThtMt FIREPLAct
? Nf MRJ"1 =;: REr:[ If•t #
rF ? rY??j
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Permit No, PermR Haklsr DaEe Telephone ie
8NV
PLUM81fVG
HVAC
a.
ELECTRICC '--
ELECTRiC
Mspectlon Date tnap. Commertta
Footingsl ???9L ? 1
V
Foundation •CT /? ? ?` ? Z Daj ?. p UJ
F?aming ly di?pa
! ju?
Ruoting
Rough Plbg.
R°ug" Ig.
Is,l. , ?
Freplace a
Flnal Htg. ? ?
orsat rest
Flnal Plbg. Pibg. Inapector - Motity Plumber
Corosl. Meter ?
EngrJPlen ?
Bldg. FWmi , z ,G po
Deck Flg.
Qeclc Finel
Well
Pr. Qisp.
7 2i ,?? a
?Y- '
Addcess: 1470,KINGS C_REST Lot 6 Blk I Sec/SubKIWSWppD 4TH
These items were/were not complete at tha tima of the final inspectlon.
Date: 7 24 92 Yes No 'r
Final grade (6" from slding) v
Permanent steps - garage ?
Permanent steps - main entry
Permanent dtiveway
Permanent gas V/
Sod/seeded giass
Trai1/curb damage
Porch V
Basement finish l?
Deck V
Please verify vith the builder the ramoval of roof tast caps from tha plumbing
system and the shut-o£f of water supply eo tha outsida lavn faucet befora
freeze potential exists. ?
.?ow..
White - C1ty copy Yellow - Resident copy Pink - Contractor copy
REQUEST FOR ELECTRICAL INSPECTION Ea-ooom0
?? S instmmmns for compleUng ttns brm on back of y¢Ilow wpy
X, Be/ow Work Covered by This Request
9d2„
e Add fiep Typ oie ntlng ' AppliancesWired EquipmentWved
Home Range Temporary Serwce
Duplex Water Heater Eleciric Heating
Apt. Bwlding Dryer Other (Specity)
Comm./Industnal Furnace
Farm Air Conditioner
Olher(syeciNl ConVachor5 Remarks
Compute Inspechan Fee Below:
# ' Other fee # ServiceEnlranceSae Fee # Qrcuits/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Abov Amps
SignS Inspettor's use only: d TOTAL @ 40
Irriga(ioneooms
Special InsDechon
AlarmiCommunicatwn THIS INSTALLATIO ?BE QERED DISCO EC ED IF
Other Fee COMPLETED WITH O , S a
I, the Electrical Inspector, hereby
tif
th
t th
i
b Rotiqn-m
t
?P S 6
y
a
ove
cer
e a
nspechon has
been made. I
,
oaI
-- ?f ?
OFFICE USE ONLV
This request void 18 months irom
J ? i ? ? d.7 aD
Repuest Oate Fire N Rougbin Inspe[tion
Ra w
Yesretl, 71 N.
Reetly Now AI o ect
?
z2aw
Iicensed contrector p owner hereby request inspection of above
ctrical w
Job Atleress ISVeet. Box oi Route No 7 ?
lCf
70
Sectmn No TownsM1ip Name or No Range No u ?
OccuOant INT) Ph ne N.
Powe pLe, Atlaress
Elect mai ConVacmr ( Oany Namel Contraclor5 Licens¢ N.
Mailing Aaaress t n racYOr or er Makmq nsWllaOOn)
AutnaWrelCO acto, irn'stall n)
_ PM1On NumbOr ?
/
Ll
MINNESOT0. STATE BOARp OF EIECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitlwey Bltlg. - Room 5493 BE ACCEPTED BV THE $TATE BOARD
1811 Universiry Ave., St Paul. MN 55104 UNLESS PROPER INSPELTION FEE IS
Ppone (612) 642?0800 ENCLOSED
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when perrtti[s are required for each unit
3b, 60
Date o(o / -/&_ / //
Site Address O e ? / 854 Unit #
? ??n Q y
Property Owner ? Telephone #
Contractor
Street Address M p &c,- City ?
State / J I o' Zip __!5? Q?Q(YTelep6ane # (&51)3aa _ S
Bond i!: Expires:
The App(icant is _ Owner ?Contractor _ Other
Add-on or al[eratioo to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
.? air conditioner _New Replacement
other
State Surcharge $ .50
Total $
i hereby apply for a Residentiai Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with [he ordinances and codes of the City of Eagan and wi echanical Codes; that I understand this is not a
but only an application for a permit, and work is not to start witho a per it; that the wor will be in acc rdance with the
apd plan in the cas"wo;k which requjres a review and approval of.plat? ? j `j
7
Applicant's Printed Name Af5plicanYs Signature
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for commerciaUindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone k ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "'see befow
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
'"When installing/removing underground fank, call for inspection by Fire Marshal attd P/umbing lnspector
Permit Fees: $7050 Underground [ank installation/removal
$50.50 Miximum (includes State Surcharge)
or
Conteact Value $ x 1% _ $ Permit Fee
• If aermit fee is $1,000 or less, add $.50 ? $ State Surchazge
If ermit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I here6y apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in acwrdance with
the approved plan in the case of work which requires a review and approval of plzns.
ApplicanYs Printed Name
ApplicanPs Signature
Approved By: , Inspector
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwetlings & townhomes/condos when permits aze required for each unit
MM
Dafe
/ it #
U
Site Address
1 T n
er
O
P
t 9 ? ( d
Telephone # ( ? ) qS;j
wn
roper
y _
Contractor 1f a
Street Address l J±& 1• W. City 1
t
St
(nu• S G?
Zi 1S Telephone # O /02&
a
e p .
Bond #: Er.pires:
The Applicant is _ Owner -Arcontractor _ Other
Add-oo or alteration ta eaisting dwelling unit $ 30.00
? furnace _Additional k-ifeplacement
air exchanger
airconditioner _New _Replacement
other
State Surcharge $ .50
r
?
T
r
?V
$
a
o 1 S 2004
NOV ?
I hereby apply for a Residenrial Mechanical Permit and acknowledge that
be in conformance with the ordinances and codes of the City of Eagan ar,
, but only an application for a pemut, and work is not to start wit
ap r ed plan in the of work hic requires a review and approval4
_[?11T _
n??`t'i?aiy.eomp -aattaccCtraie; that the work will
wrth e Mechanical Codes; that I understand tlris is not a
ut a ermit: that the.kvork will be ip accordance with the
App?icant's Printed Name ApplicanYs
2004 COMMERCIAL MECHAIVICAL PERMIT APPLICATION
City af Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. commercial/indushial 6uildings
mul[i-family bui(dings when separate permits aze not required for each dwelling unit
Date / /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address CiTy
State Zip TelepBone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _ Remove **sea below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When installing/removing underground tank, ca!l for inspection by Fire Marshal attd P/umbing lnspecfor
Permit Fees: S70.50 Underground tank insffiIlation/removal
$50.50 Mtnimum (includes State Surcharge)
or
ContractValue $ x 1% PermitFee
• If ep rmit fee is $1,000 or less, add $.50 State Surcharge
If pe rmit fee is over $1,000, add $.50 for
every $1,000 ermit fee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a permit, but only an application for a permit, and work is not to start without a permit that the work will be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
ApplicanYs Signature
Approved By: , Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConsWCtion Reauiremenls
• 3 registered site surveys showhg sq. ft. of lot, sq. k. of hause; and all roofed areas
(20% maximum lot croverage allowed)
• 2 copies of plan showing beam & window sizes; poured fouM design, etc.)
• 1 set of Eirergy Calculations
• 3 copies of Tree Preservation Plan if lol platted after 7l1193
• Rim Joist Detail Options seleclian sheet (hldgs with 3 or less units)
DATE X-S, 2 3 ) 0200'-
SITE ADDRESS _ tLI"?O
TYPE OF
APPLICANT
k, s
RemodellReuair Reaulrements
• 2 copies oi plan
• 1 set of Energy Calculations for heated addNons
• 1 site survey forexterioraddihons & decks
• Indiple if home sened by septic syetem for additiore
VALUATlON
10) oC30 '
MULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
STREETADDRESS o25rIS CIn No s--Pn4 STATEWI1 ZIP
TELEPHONE#46I•1'"11.6948 CELLPHONE# 611,G'g1•D`IS FAX# 6S3 1?11 •(o`?`-PS
PROPERTYOWNER CuiL-k,S ?,Ocua F_ TELEPHONE# ?Sf.?lSa.°129g
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNFSOTA RiJLES 7670 CATEGORY 1 ?5 7672"
(4 submission lype) . Residential Ventilation Category 7 Worksheet Submitted D e orksheet Submitted
• Energy Envelope Calculahons Submitted AU G 2 3 20G? :
Plumbing Conhactor: Phone #
Plumbmg system includes: Water Softener _ Lawn Sprinkler ?Fe: $90.00
_ Watcr Hcater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor.
Mechanical syslem includes:
Sewer/Water Contractor:
Phone #
I hereby acknowledge that I have read this application, state that the i lirmation' correct, pnd agree to comply
with all applicabie State of Minnesota Statutes and City of Eagan Or i ances.
Slgnature of Applicant
OFFICE USE ONLY
Phone #
Air Conclitioning Tee: $70.00
Heaf Recovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 27 Porch (3-sea.) ? 31 6ct. Alt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Nt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg only) • Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings(addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
RooF _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Frazning _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
INSPECTION RECORD Control No. 0370
CITY OF EAGAN PERMIT TYPE: BuI LDING
3830 Pilot Knob Road Permit Number: 000443
Eagan, Minnesota 55123 Date Issued: 05/ 09 / 92
(612) 681-4675
SITEADDRESS: LoT: 5
1470 KINGS CREST
KINGSWOOD 4TH
PERMIT SUBTYPE:
SF DWG
BLOCK: 1 APPLICANT:
JtlNNSON BRUCE
(512) 686-9967
TYPE OF WORK:
NEW
INSPECTION
SITE rA .
FOpTING D•
FRAMING INSULATION
FINAL FIREPLACE
REqARKS: RECEIPT p
F-
?
S&W PIBR. s SHIELDS CONST.
-1
?
? CITY O,F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
PERMIT PERMIT TYPE:
Permit Num6er:
Date Issued:
1470 KZNGS CREST
LOT: 6 BLOCK: 1
KINGSWOOD 4TH
BuYldin'g Permit Type
¢uildirtg Wqrk Type
; UBL Aocupancyy,
_ Construction Type
Zoning ,
Bwilding Length ?y
Building Width "
SF OWG
NEW
R-3 M-1
VN
R-1
68
41
:F=
?'?"y);?.?'t'?.tib ,? •t, r`"?,l(?'Y?'"r--?S%?"??:r,?+
BUILDING
000993
@5/04/92
REMARKS:
RECEIPT g C OI6 601 S&W PLBR. m SHIELDS CONST.
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC $
SAC Units
SubtoCal
VAIUATION
$877.50
$570.38
;64.00
$700.00
100
1
$2,231.88
=168,000
MISC FEES $1.610.50
Total Fee $3,842.38
CONTRACTOR:
OWNER: - applicant -
JOHNSON BRUCE
3509 FEDERAL DR
EAOAN MN 55122
(612)686-9967
301
2 hereby acknowlsdge that I heve reatl' thfs applfcation and state ChaC the
informaCion is correct a•nd agree ta comply with ai), applicable StaLe of Mn.
Statutes and Eity of Eagen Ordinamces.
, APPLICtNTlPER ?TEE SIGNATURE
?.nt,n R.a,ul.l m11
issuEO ricNdru??
Control No. 0370
I
PE2MIT #
cinr oF eac,aN
1992 BUILDRNG PERAAIT APPLICATION
681-4675
4 3 k yc). \ 3s?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COhP1ERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last xorking day
of month in which re uest is made lot chan e is re uested once ermit is issued.
Date - -4;/_ / 21 Yaluation of work /2?'o/Y?. ?
Site Address: 6"s7-
, STREET STE i?
Tenant Name:3r((cP_ ? JhiYle?u 6fC)fl1zo 4
LOT ? BLOCK L ?,m .,(?NGSw?? P.I.D. 0
Descri tion af work: L
The applicant is: ? Owner ? Contractor ? Other coescrsbe>
Name ?i1S?Y1 73Y`JicE, g :Sket_ic
y Phone 6$la -996 7
Property .
LAST F1R5T
?
Owner Address 3509 /; eVrz ? D'rYre 0
32/
STREET &TE /
City State ? Zip
Company ? as' e Phone
Contractor Address License # Exp.
City ? State Zip
Company
.Swe as aArg-- Phone
Architect/ _.
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber ' ???tSrl?'C!C/J6ll . Processing time for
sewer & water permits is two days once area has een approved.
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.
Signature of Applicant:
?
vrri" uaC vnLr
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish
002 SF Dwg. ? 06 6arage/Accessory ? 10 Swim Pool
? 03 Two family O 07 Fireplace ? 11 Res. Add./Porch
? 04 Multi-fam. T.H. ? 08 Deck O 12 Comn./Ind.
WORK TYPE
0 31 New
? 32 Addition
E3 33 Alterations
? 34 Repair
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
? 37 Demolish
? 99 Undefined
i
? 13 Public Fac.
O 14 Agricultural
O 15 Miscellaneous
tonst. (Actual) Y-N Basement sq. ft. MWCC System Ye::5-
(Allowable) V-N lst fl. sq. ft. City Water yEr=.
UBC Occupancy -K 3 M_( 2nd fl. sq. ft. PRV Required
Zoning Q.1 Sq. Ft. total Booster Pump
# of Staries Footprint Sq. ft. Fire Sprinkler
length ?` On-site well Census Code ?o I
Depth 141• On-site sewage SAC Code ?
APPROVALS
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
? Framing
? Draintile
? Insulation
? Fireplace
Permit Fee ?`7'7, ?s L
Surcharge 1+,e.c•
Plan Review
License .
MWCC 3AC
C i ty SAC
Nater Conn. C- 9p C)c
Water Meter en
Acct. Deposit no
S/W Permit 0 o
3/W Surcharge ,-?
Treatment Pl. . ct?, nv
Road Unit o,c o
Park Ded.
Trails Ded.
Copies
Other
Total: ?ifrd'a.
SAC % IOC,
SAC Units
wltot;an:
64 ?1: oZ3X3Z.=
-7r 2
RSmT:
---
aBx 3Z= Sq(o
1z3
`?l ? ???r7T
?»r= f ?'??¢ X ,S 3 ?
Z N?_?z ? ?rL
iz3y
6'1> RZY = I l -_
?s?ycz
) J` L- Y X 7-? -°/ 7Z.
lI,392
i6 '-?/ t?96
PETERS, PRICE & SAMSON
LAND SURVEYORS. LTD.
12400 PRINCETON AVENUE SOUTH, SAVAGE, MINNESOTA 55378 • 612-890-9201
-K !
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!,?, 3 a?N/ ` 0'/ \b?
D S 0
/
0
i
?Y1 5 F!
a
Y?
Certificate Of Survey For_ xRrir.F _TnHNSnx
N G S 903.34 /
9oa 7 DESCRIPTION
C R E S T s6g? Lot 6 Block 1
I I /9c
l
906.
w
o-
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0
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za
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m
SCALE
f It= 30?
g?r ? 12
6a?' ?' /
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,
?
KINGSWUUD 4TH ADDITION
Dakota County, Minnesota
? y
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p¢o / S ??
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892.4
I1VG DEPT
? Denotes Iron Monument Set"
•Denotes Iron Monument Found
sos.9 Denotes Existing Elevation
(eio.o)Denotes Proposed Elevation
(906?) Top of Block Elevation
W8.5) Lowest Most Floor Elevation
(906.0)Garage Floor Elevation
We hereby certify that this is a true and correct representation ot a survey of the boundaries of the above descriGed land, and ol the location of all
buildings thereon, and all visible encroachments, if any, from or on said land.
As surveyed by us this Z/ f? day of L.S.
Minnesota License No. /-4Q3 C70
Site Address
Ccntractor j
Suildfnq Type
EXTcRIOR EMVEL,OPE T '9AL tBANStlIT_TANGc
STANDARD WORKSHEES
Owner ?10hlN4aot1
Phona CA Date .4' ?C7•?{Q
( 1. 1"Al" Residential ?"AZ" e. 3 stocies OtSse[
Aasembly (bescri6e cyp4 from TaEle 3 or Area (A) U-Value • U x A
shav ealculations on Page 2) (Sq Ft)
Inaulated Area
a Framing Area ' 0 3 p 2.7
,
m Sk Ii hts T e
?
.. Other (deatribe)
a?
U -
1 Totals *-W? ?5 •?7
2 Avera e U-Valus. fIIsA7/fA1 from Line 1 0
3 F.eauired U-Value (from table) pQ(p fifiik*+3
Insulated Arez 270 ? 044
??
Fra:.in Area , O 2? .
Windovs, TYPB 4k&A •30
t
, Door3, ?'y a ???1" ?EMVA
•2
??•3
Rim Jo33t Area 2N° fr
.4 Fire lzce Irlall -' ?
.?
s
Foundation t•lali t2beve ar=_da)
eJ
? 0072
?'J,
y Foundation :Jinda::s, Ty e?=*' , iloev •O { 0•4r3
a other (deseribe)
`_' " T?t ? ? 015?' ?? em lZ 5 ' p11'l '1.2
??. •
4 'fotals 3°1 33 •02 5
5 Average U-Va2ue. (UxA}/(A) tram Line 4 ???+;?' •? ??'????
b Hequired U-va.iue (from tabla) ?*?#'?'? • ?*""?"
line 2 is cr•ater than Line 3, oi Line 5 greater than Line 6, complece
? !.`.e follrn+fnq to determina reduetien af U%A needed to meet code.
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z:`
? larea (L1ne 1) - Area (Line 4), -
? 8
?
1 U x A i Line 17 ? UxA (Line 4),
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a
a
9
Ares (Line 1) z ll-9alua(Lir.e 31 x
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°
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0
Area (Line i) x U-V21ue(Line 6)
? 1 2udg=t, Line 9+ Line 10
.ti
?
17-
jActual (Line H) - 3udssL(Une 11)
` kZf 1?r._ 12 is greatar thaz 0, xdjusz asse^blies to reduc4 _ s:o=? '-e=s
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L0'd aQI d8 ONIINI2td dId Z0:0I Z6-97.-b8
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kssemAly U-value (Enter on Pg. 1) I.Q?gJ
,I .
M3embl WAVI. C% 1N G
!ateria ast." e ic.SSess R-Va ue
tAA60*OlkTe,
P-ga
2.0
t,ATT fNS11, lol
C?wD. 1/2' .45
Interior f-V ue • .Lo
?xcerior - a ue .l
Iosal Assembl Thetmal Resietaace 2
qssembiy U-Va1ue Enter vn P. 1
V-uA iti? i
?7 1 '?\s? 1 fy 4
!iateria2 escribe Stsi nass - aluc
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eA .
25 "
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O - f21M OtSr
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5,r2"
1
ir.cerior f-Valua .Go
Exsarior f-Yalua .t
Sctal Ass¢mbl e esiscanca 2.
Asseablv U-Vaiue Eater on P. 1
;re-:or
7uc3i : ss
338.,1^ ' 7
E0'd
e
;z 17)- 2? 7
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I
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Te
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8 tt
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on Ps:
i: Cer on 2.g. 1) 1 I I43seT.%Di_:
C•IT^-TAD 7111TTAOC 'f/1mV?_ t-
=ClI
-r ?he-zal Reaistance
lue Eater on ?'g. 1)
d3 2NISNI2Id dId E0:0i Z6-BZ-bO
L ? gL ? CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUBD.(612) 681-4675 RECEIPT
DATE S o'019.2-
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLIAWING:
? N0. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON 15.00
ADD ON I SHOWER 3.00
REPAIR WATER CIASET 3.00 R
v2 BATH T[TB 3.00 7;
? IAVATORY 3.00 19-
owxEx rrnME: .Rruce..a ohnSor / KITCHEN SINK 3.00 3
Iy7
'
'
?I
C
?
N
Y 3.00
?
SITE ADDRES S:
O Y.2S
?
V1QS TUB/SPA
OT 3.00
? WATER HEATER 3.00 ?
? gr pnv D:L4I*? 3.00
?
GAS PIPING OUT.
INSTALLER: "?? L+& (MINIMUM - 1) 3.00
? ROUGH OPENINGS 1.50 ?
ADDRESS: Io Z?OSI zOV71 +t1 Pt•S,s'jC..IIO _ OTHER
WATER SOFTENER 5.00
cixY: bur n5vill2 N1/q ZIp; 55'53-) _ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE 940 -.377R _ W. TURNAROUND 15.00
STATE SURCHARGE .50
SIGNA E OF PERMITTEE-.y.?. TOTAL: S y7
coMnaExexaL ....``. .
YLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR M[TLTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION
OWNER NAME:
ZIP:
GufliktiCl riciGE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:_
ADDRESS:_
CITY
PHONE #:
FOR:
CITY OF EAGAN
$25.00 MINIMiTM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL: .
(SIGNATURE)
CITY OF EAGAN
L la B ??
SUBD. MECHANICAL PERMTf
_ (612) 681-4675
RESIDENTTAL
RECEIPT # /0 (a??P ?-
DATE o
PLEASE COMPLE7'E UPPER ppRTION ONLY FOR SINGLE FAMII.Y DR'ELLINGS. ALSO, COMPLE!'E FOR
TORNHOMES/CONDOS R'HEN SEPARATE PERMTi'3 pRg ]tEQiJIItE]) FOR EACH DWELLING UNTP.
°WNER- grLtcjL 3ohn son FEEs
STfE ADDRFSS: I 4-10 K11r1 S CirQ$?'
9 ?D ON/REMODII, (EXISTING
CONSTRUCfION ONLI) $ 15.00
uvsTni,t,Ex: ?l+Cc L+-d• avnc: aioo M sTU 24.00
PHONE #: t4L{Q 37-)(9' ADDITIONAL 50 M BT[7 6.00
nnnxFSS: IQa(oo VYl ushtOl,)n oad cns ou?s - Hmvn?tvM i C? ? Ea.
c?: Pr ior? lzIr:5537a SURCHARGE: ?-- $ .?
SIGNATURE: , j TOTAL: $ 3A
COMMERCIAL
PLEASE COMPLETE THIS POR7TON FOR ALL COMMERCLWINDUSTRLIL BUILDINGS. ALSO COMPLETE FOR
APAR1'MENT BUILDINGS OR OTHER MULTI-FAMILY BUII.DINGS WHEN SEPARATE PERMIT3 ARE NOT REQUIItED FOR
EACH I1WEI;I:IA1G UIVIT. ,
' . ,' ' „ ' . . . . ., .
WORK DESCRIPTTON: CONTRACf PRICE
1'Ao OF CONTRACT FEE. FEES
STATE SURCFiARGE IS $.50 FOR EACH
S1,000 OF PERMIT FEE.
$
PROCESSED PIPING - S25.00
? ??
?l?ln1V ?y r•'.e•. - Yli.l.yy
$
OWNER: TOTAL: $
SITE ADDRESS:
TENANT:
SUIT'E #: .
INSTAI.I.ER:
ADDRESS:
CITP: ZIP:
PHONE #: CITY SIGNATURE:
SIGNATURE:
?
k
X
X
Icinr oF EAcaN
REACTIYATP0043
1993 BUILDING PERMIT APPLICATlON
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date -3 9Z Yaluation of wark
Site Address: 11470 ?-r'Yie ?PeSf
STR SU1TE t
Tenant Name: (commercial only)
IAT l BIACK I_ SOBD.
J ti'±,a
Descri tion of work:
The applicant is: J3 Owner 0 Contractar ? Other (Describe)
Name a-)kY1?>I C-- Phone lafi'(o-ffl67
Property LAsT FIRST
Owner C?'e
c
t
t
'
/q
s
vtG
,
qddress
i
.7
STREET STE #
City L4avl State M0
Company Phone
Co ntra ctor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City 5tate Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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
Ea9an Ordinances.
i
?
- Signature of Applicant: ??
>
OFFICE USE ONLY
BUtLDtNG PERMIT TYPE
? Oi Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 fireplace
WORK TYPE
0 31 New
O 32 Addition
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
?& 15 Deck
? 35 Tenant Finish
D 36 Move
R
,? . .? .?
01t8`asem4n Fi'a.iafi::J,'
? 17 Swim Pool
0 18 Comm./Ind.
? 19 Comm./Ind. Misc.
0 20 Public Facility
? 21 Miscellaneaus
? 37 Demolish
Const. (Actual) Basement sq. ft.
(Allowable) lst F1. sq. ft.
UBC Occupancy rz"? 2nd Fl. sq. ft.
Zoning Sq. Ft. total
# of Stories Footprin t Sq. ft.
Length i? On-site well
Depth ? On-site sewage
APPROVALS
Dlanning Building
Engineering Yariance
REQUIRED INSPECTIONS
? Site ? Footing
? Wallboard P?Final
MWCC System
tity Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code y3?
SAC Code
Cc- erSW[S b 11? ?
Cy-145usS uvrl'1f?
?--
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permi t Fee N/e- vea„t;,,,: g
5urcharge
Plan Review
License
MWCC SAC
City SAC
D6?Lv-, ?S sHOu%^-' d?,j
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded. CX?ST/fYG ?
Copi es
Dther
Total:
SAC %
SAC Units
Use BLUE or BLACK Ink
� r-----------------+
I For Office Use I
� � Permit#: � v I
Clty of ����� ; . ���
Permit Fee: �i7,�� I
3830 Pilot Knob Road � I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �y�v( Site Address: ! ���� l�'I `� G�S� unit#:
Name: �d� ,�F'�1'� Phone:�1��1�` /L'��
Residentl y p. � �1 .� C��' '� � ��
Owner ' Address/Cit /Zi / _9 N gL('
,'
Applicant is: Owner V Contractor I
) � ^ � ;�
Type of Work Description of work: � � � (f.tC 12 � 6 '/�r � �� '
5
Construction Cost: � /'��� Multi-Family Building: (Yes /No�
Company: _��`�C`��P � (_,�L'�� Contact: �/4�l �J�/e
Contractor , Address: ��� 1�i�'1S/c'�k1 ����• city: ���'o -r'(1J/
State��Zip: �� Phone: -�b�'� �SEmail: �(�U����S1jL.,�'rGr'�f�'.�'�d?��� ,�1
License#:JJG b���"I� Lead Certificate#: ll/ "''�� '�-
If th project is exempt from lead certification, please explain why: (see Page 3 for additional information)
i "� �
�-n�- �✓� � i� �r�
COMPLETE T S AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:Plans and supporting documents thaf you submit are considered to be public information. Portions of
the information may:be classified as non-public if you provide specific reasons that would permit#he City to
' conclutle that they are tratle 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.00pherstateonecall.org
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. _
ac� 4��� � �� s°��:�r� .....�...
App icanYs Printed Name ApplicanYs Signature
Page 1 of 3