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1067 Kirkwood Dr APR;05/20111TUE 12.45 N City of Eagan FAX No,651-975-5694 P,001/001, Use BLUF or BLACK Ink j-------_ - `bl l I City of EaLan I PermittF I Permit Fee; 1 3830 Pliot Knob Road p I I Fagan MN 55122 t~ 1 Date Received:. Phone: (851) 675-5575 Staff. Fax: (651) 675-5694 AP fl . [ )jj I l ! 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date. " f 5 ' ~ j Site Address: i D C,--7 Tenant: gp8p' RESIDENT l OWNER Name: ~ hone: Address / City I Zfp: CONTRACTOR Name:_ QL~t`TJ I~L11 a6 t`~~ l--l License* Address: l7 I ~°>f C City' A~~Lly State: Yh,S Zip: ~-'4_ Phone: -7 Contact: GC- V -A- Email: TYPE OF WORK _New replacement _Repair -Rebuild - Modify Space - Work in R.O.W, Description of work: e T PERmrr TYPE RESIDENTIAL Td (-E. i 'L~A ✓ ' ~ v~ `P ~ G ' ~ ~ c✓> Water Heater Water Softener _ r. I..awn Irrigation KPZ PV6} Add Plumbing Fixtures Main f t mwer;t suet; Septic System Water Turnaround New Abandonment RESIDENTIAL FEES' $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)' $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Ab L142nment, Water Turnaround" (includes $5.00 State Surcharge) "Water Turnaround (add $160,010 if a 5f8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, eto,) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454.0002 for protection against underground utility damage. Call 48. hours before you intend to dip to receive locates of underground utilities, www.Q0oher3tateo11e0alLoM I herebyecknowtedge 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 panntt, and work is not to start without a porml; that the work will be in accordance with the approved plan In the case of vmrk which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By:Date: F Required Inspectlons: _Under Ground Rough-In -Air Test Gas Test Final '~i MAR-31-2011 15:13 FROM:AIR MECHANICAL EAGAN 6514526925 TO:6516755694 P:2f3 Use BLUE or BLACK Ink ----------'Cl My 3830 Pilot Knob Road i Permit Fee: Eagan MN 85122 I I Phone: (651) 675-5675 Date Received: Fax: (651) 675-5694 ` staff: 2011 MECHANI AL PERMIT PPLICATION Date; Site Address: ` Tenant: (C~ Ll~Cld►Qsc. )1a#lE 1767c 06&jt- Suite : RESIDENT I OWNER Name: Phone: Address / City 1 Zip: CONTRACTOR Name: t icense # Address: City: State: _zip: ~ Phone: Contact: Email: TYPE OF WORK -Now -Y-Replacement -Additional Alteration Demolition Description of work: MOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Cade. Please contact the Mechanlca1 Inspector for informaTlon on permitttad screening methods: PERMIT TYPE [ RESIDENTIAL COMMERCIAL _ Furnace _ New Construction ^ Interior improvement -L Air Conditioner Install Piping _ Processed _`Air Exchanger _ Gas _ Exterior HVAC Unit - Heat Pump Under / Above ground Tank L- Install I_ Remove) tither When installinglremovmg tank(s), call for inspection by Fire Marshal and Plumbing I ctor RESIDENTIAL FEES: $55.00 Minim imum Add-on of alteration to an existing unit (includes $5.00 State Surcharge) d $95,00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE -.4LLA 75 (COMMERCIAL FEES: $75.40 Underground tank installation/removal OR Contract Value $ X1% $.,55.00 Minimum (includes State Surcharge) Permit Fee If the ,L'r°•.W!t EiIFA Is less than $10,010, surcharge is $ 5.00 - If the E9®Lt a Is > $10,010, surcharge inoreases by $.50 for each $1,000 Permit Fee $ Surcharge (i.e. a 570,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL-FEE CAk"F FARE YOU DIG. Call Gopher estate One Call at (651) 464-0002 for protection against underground utility damage. Call 48 horns before you Intend to dig to recelve locates of underground utlntles. www,gooherstateodecall.om I hereby acknowiedge that this lnformabon 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 vmrk is rjo to staut without a permit; that the work will be in accordance with the approvod plan in the case of work which requires a review and approval of plans. R Applican P nted N e A rlt' tune FOR OFFICE USE Revievmd By: Date: Required Inspections: ,Under Ground _ Rough In Air Test _Gas Service Test ^In-floor Heat _Final _ Exterior HVAC Screening Inspection CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 _ r+eceIveo AMOUNT $ I & DOLLARS 1 oo 0 CASH ? CHECK FOR /White-Payers Copy / Yellow-Posting Copy ? Pink-File Copy T1hAank You ( 7( e%'_ BY _i BUILDING z? o 7 ?'2 Receipt # Site Addreu 1067 Kirkwood Drive }($ Erect R-3 Occuponcy Lot 11 Black 3 Sec/g„b, Chea t4RY E. 18t Alter [] Zoning R-1 parcel ,# 10 17150 114 03 Repatr p Fire Zone NA Enlarge ? Type of ComY. Vn W Nome Josep:? N. Miller Const. , inc. Move ? # Stories z ,Address 18133 Cedax Ave. So. Demolish p Length?t`2 C; Fariaington phoM 454-4753 G.ade p Depth__3$_Sq. Ft.- Name O"'ner p Avvrovols Foe. ? u Address Assessment Permit 307•70 ~ Ci Water & Sew. Surcharge 29.00 Phone G? Police Plan check 153.50 ,,,W Name Fire SAC 525.00 ? ?Z Address Eng. Water Conn44(1 (1C? i'° ° Ci phone Planner Woter Meter 60. UO Council Road Unit 250-00 1 hereby acknowledge that I have read this application and state that gldg. Oif. the informotion is correct nnd agree to comply with all opplicable APC ? ?1774.50 rw State of Minnesota Statutes and City of Eagan Ordinonces. o 5ignofure of Permittee Joaeph P[. Mi21er Conet., A Building Permit Is issued to: Inc. on the express condition thnt oll work shall be done in accordonce with all o ble State Minn e W Stotutes ond City of Eaqon Ordinonces. Buildirp Officiol CITY pF EAGAN 9795 Pllet Ksob Roed Eagon, MN 55123 PHONE: 454-8100 Permit No. Permit Holder Misc. Permit No. Holder Plumbing /w H.V.A.C. ?`t l ???F S-?Q'61 Well Water Disp. Sewer Electric (A?07D7 M,-,ua?l?(u 5?7_? InspeMion Date Insp. Other Footings 943 Foundation Freming Rough P16p. Rough HVAC Inwlation ' Final Pibg. Final HVAC .$3 Final _5?,? ?'/ .y-? ' '- /•' ? Weter Da,-s?c?ri6?eJ Lo/tation: W811 Sewer . Pr. Disp• CONTRACT PRICE: Site Address , Lot Bloc PERMIT # ? MECHANICAL PERMIT CITY OF EAGAN RECEIPT # - 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE ownNF• esa_gien I ? Name r`'.='r' `e ',•r ? 'w" a? ? To Addfe3S I<,? ? r ?• ,'Sc City Phone .; Jyfn Name c Address II o c'ty TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other Phone M BTU M BTU M BTU 2 ' M BTU CFM FEE S/C: TOTAL• ? ? f SCRIPTI O ON BLDG. TYPE W RK DE ? ` New Res. k Mult Add-on ? A Comm. Repair ? , y... Other ? a FEES HVAC 0-100 M BTU RES .; -$24 00 ; . ADDITIONA4 50 M BTU . - 6.00 y (RES. HVAC INCLUDES A/C ON NEW j CONSTRUCTION) 7 PER PERMIn GAS OUTLETS MINIMUM ? - 1 50 EA ? - ( COMM /IND FEE - 146 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES . . ? ? TOWNHOUSE 8 CONDOS - RES. RATE APPL.IES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ; ? REMODELS - 12.00 ? MINIMUM COMMERCIAL FEE - 20.00 ; STATE SURCHARGE PER PERMIT 50 S/C IF PERMIT PRICE GOES ADD $ - .50 1 ( . BEYOND $1,000) j i ? -- ---- o 4' ? ' S UR , FOR: CITY OF EAGAN Receipt <J MECHANICAL PERMIT Permit No. = - . ' CITY OF EAGAN Fee " Fill in numbered spaces S/C ' Type or Print legibly Tot. L Date 2. Installation Cost 3. Job Address Lot?Blk. Tract / 4. Owner 5. Contractor Phone 6. Address I 7. City State Zip - , 8. Building Type: Residential El Commercial ? Institutional ? 9. Work Description: New 0 Add ? Alter ? Repair ? 10. Describe 11. Fuel Type No. ' Eauioment STU - M. Ea. Forced Air No. Epuipment CFM dli Ai H Mfg. an ng: r Boi lers Mfg, - Mech. Exhaust Unit Heater Mfg. Other _ Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for - ~ Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. ?' I • I ° CITY OF EAGAN F? ?,? Fill in numbered tpaces S/C Type or Print /egiMy Tot. %' ? ' •: 1. Date ; i'I? u?:? ; 2. Installation Cost ? I)c' Gi? 3. JobAddressi??'7 Ki"'? '-?-? Lot li Bik. Tract 4. Owner 5. Contractor c `.'rL'I8[, 5'7' r Phone 8. Address 20330 'IC`"" 7. City ;Il State Zip 5SJ•'`-'; 8. Building Type: Residential 11 Commercial ? Institutional ? 9. Work Description: New C7? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield i Bath tubs Septic Tank • , Lavatory Softner ! Shower Well -- ? ? Kitchen Sink Urinal/Bidet _ Laundry Tray - Other -==r<_:,= % Floor Drains ? , y Drinking Ftn. _ _ Slop Sink Gas Piping Outlets + 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and1codes governing this type of work. Signed• r'..,? y).n?._ f0r Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 INSPECTION RECORD CITYOFEAGAN PERMITTYPE: 0 1 N`; j I 3830 Pilot Knob Road Permit Number. ? Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 I SITE ADDRESS: APPLICANT: I I i PERMIT SUBTYPE: TYPE OF WORK: ar_w t nAs IN?',QttTfi.'IMt ) ', I f 1111ti11 1 N UE`+1KIP 1 I IiN Permft No. Permit Holder Uate TelepAOne N ELECTRIC PLUMBING HVAC InspecUon Dete Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST ?Ll FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Addition CHES MAR EAST FIRST ADDN. Lot 11 Blk 3 Parcel 10 17150 110 03 owne. Street106Z K1I'IfwOOd DTive State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. V141 1982 2622.14 524.43 5 1573.30 A012429 STREET RESTOR. GRADING SAN SEW TRUNK 112.00 A012429 7-12-83 *SEWER LATERAL 13S8.09 it 11 WATERMAIN *INATER LATERAL iggi WATER AREA /b 1 STORM SEW TRK tC9 140.44 A012429 7-12-83 ySTORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 4 O.OO BUILDING PER. SAC 515-00 n n PARK rOF EAGAN WATER SERVICE PERMR G Pilot Knob Roed PERMIT NO.: n, MN 55122 DATE: n9: No. of Units: sr: ess: Address: ber: r No.: Connedion Charge: No.: M eomply wkh !M Ciry of Eagan of Insp.: Account Deposit: Pertnit Fee: Surcharge: Misc. CFwrges: Total: Dote Paid: UF EAGAN SEVUER SERVICE PERMIT Pilaf Kne6 Read PERMIT NO.: MN 55122 DATE: • No. of Unirs: Address: 1:,r,7 K.ir{cvood i'r:; ••ar F=; iber: _ _,.?.+? ,_??}f..1T+i• a rocomPh wkb tM Clh ef Eagan Connedion Chorpe: laneot, Account Deposit: Permit Fee: Surcharpe: Misc. Charges: of Insp.: TMaI: Dote Paid: BUILDING PERMIT N° 7926 Receipt # To ba wed fo? SF DWG/GAR Est. Vo1ue $58, 000 pate A pril 18 1983 Site Address 1067 KirkwoOd DTive Erect U Occupancy R-3 Lot 11 Block 3 Sec/Sub. Ches Mar E. lst Alter ? Zoning R-1 Porcel # 10 17150 110 03 Repoir ? Fire 2one NA Enlorge ? Type of Const. Vn s Name JoSeph M. Mi11eY Const., InC. Move ? ,{k Stories w z Address 18133 Cedar Ave. So. Demolish p Length 52 Ci Farmington Phone 454-4753 Grode ? Depth 38 Sq. Ft.- ? 0 Name Owner Approvala Faes ? Address h ro..: - Nome _ Address 1 hereby acknowled9e that I hove reod this application ond state that the intormation is correct and agree to comply with oll applicable State of Minnewta Stotutes and City of Eagon Ordirwnces. Signoture of Pertnittee A Building Permit Is issued to: r.. .I. all work shall be done in accordance with clli Buiiding Officiol CITY OF EA6AN 9795 Pilot Knob Raod Eagan, MN 53122 PHONEs 4548100 Assessment _ Water & Sew. Police Fire Eng. Plonner - Council _ Bldg. Off. - APC ., Inc. Permit Jvi .vv Surcharge 29.00 Plun check 153.50 sAC 525.00 Water Conn450 _ (10 Water Meter 60 . 00 Road Unit 250.00 roral $1774.50 . on the express condition thm ond Giry of Eagan Ordinoncea. % .. ,1? Zb Be tTsed Fbr , ? Site Add=esa e V' c , CMY aF' FAGAN tacluclm 2 aofla P ' ; i asa pTar? w/ol•vatiar i , ?n,X; pE?QT APPi.ZC?UTL?I ? wt a! a?s1?1 aale???• ? ? Valuation D°b° . ?' ?1?.=----- ,__ - ?-?? n e . ? _ E•i-??s ? flr.rifeM?GV /C- ? KCtNVeu+-a ? .... . - `W• ASSSSN . ?.. ? ??? ? ?. _ ? Pazlvdt teiater/smor Poliae pIM OviCk - ?' SAC Wa?ber Caen'i• V t?l l BY' /9 Planrmer - aauncil , p ?lLbl? r4C8d "t XSQ B1dq. Of . ? APC ? zc?m t .?-c? . ; ,. ?raiftra#r uf Mrrixptturil Citp of Cagan Erpttrhnrnt uf Builbing Jnspedicm Thir Certif iCQLG Jl(1(C[I pflYSff[i#I f0 IIJC TC[INSTM1C111J Of Sertion 306 of the Uni/orm Building Code cntifying that at thr tirar of isruance tbis structu.e war in complianu witfi thc variour ordinances of tbe City rrgulating briilding conrtruction w ure. For tbe f ollouring: ty.n.me?nm SF DWG/GAR Mbremiier+o. 7926 OcmwmrTya R3 rywcmuwnm Vn Fim7 . NA z,,ft p;,,dc, Rl a.m,f Budi.,.Joseph M. Miller Addj8133 Cedar Ave. So:, Farm euaamgeaan. 1067 Kirkwood Drive L.WitYLot 11,Block 3,Ches Mar ? /}p pD? By June 29 East lst r4.?+LY ?eo? B? ??: , 1983 ?T IN A <ONBPICYWf rlACt ?YY?,'.?:h?7?.-:j.1?7;?yib)?:,..??..?.d;??_?•4, .e.?;Ti?LL..?f.o'.?*..?????jR??/':.'}:':t'?!::`?/.?;::y?' CIT'J OF GA(JI`}N f:;A`?!-CCI:i:F:;; M": r'lii:i?M}:NiiL i•.'CIt 2/1 .?1?"..r[.?„ ? ? ,_? ?i r)1.:,! Y.? I r?...? . . y?.;.n o 00508 .. Y a...: ... ?... L... , .. . 1' AP;Mli",. Si F1TI:i:!,.;:CDLi' f_'At3 S;ii'r?V:I'C....,.. .'::t`<C ( 32i.Q 9001 1067 K..?:.'j? y 1? f'?I:?l !`I r_t,l..?_ ? .??..)?._/_ 7 r.rr? .,...:. .a?..l:l. ini:,: :, _'1 1.:I!t?„ :' i.'L,._ .....??.!C? y. .. t.:.?,. 501 ?..i.._,..: ?.av :_? ' "-?'::.I d. i'ei.2].' ???; ?"d'id7?.?- iu 50.50 ?Yt ?i..lO?..?il)^I'• '._ ?.p .c ?.. f : f) ? , ,... ?.n J . ,.,,. ?if?!?;1...'l;•,I?? ,_i.=>?. ? This requesl void t,+/Od ?59?5 18 months irom ? ? E 27561 ,:.//. 12 2 CI?,r,.? ?jo °v Request Q@te ? ? Pire No. Rou h-in InsUe2;tion Required? Ready Now ?WiII Notffy Inspec- I ?Yes No Ior When Heady c Licensed Electrical Contractor I hereby request inspaction of above ? Owner electrical work installed at Slreet Address, Box or Route No. Crtv joco' r-,KtCw::co C6t;,0 ecUOn o. Township Name or No. Range No. County 1 a,3r1(-C 1 ' ' OccupantlPRINT) Phone No. ?iq Q to &-itii; fff in?rz Power Supplfer Address Electrical Contractor (Company Name) Contracmr's License No. GiifL e(-CCAIC I INC? C??`t?.•? (o( Mailing Address (Contrac[or or Owner aking Instailationl Auth ` ed ignaWre l ontr 'tor/0 ner Making InstallaLOn) ?-- ,?,t Phnne Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION NEQUEST WILL NOT Griggs•Midway Bldg. - Room N•191 BE ACCEPTED BV THE STATE BOARD 1827 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPEN INSPECTION FEE IS Phnnu(6771649-oena ENClOSED. REQUEST FOR ELECTRICAL INSPECTION . ee-oooot-os , See instructions for completing this form on hack ot yellow copy. " ?5''7 --7 5 E2 7`561 "X" 8elow Work Covered by This Request New .+dd 'D. -3vpe ot BuilAing AoCliantea Wired EquiUnien[ WireA Home Range Temporary Service Duplex Water Heater Liyhtiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bldy. Furnace Silu Unloader Industrial Bldg. Air Conditioner Buik Milk Tank Farm otn" pecifv otner isne,;fvi t er Speci(y t er Othr,r B //1SOBf./lOR hBB KBIRW M Fee Service EntrBnce Size R Fee Feeders/5ubfeeders t? Fae Circults 0 to 200 qm s 0 to 30 Am ns 0 to 30 Am s Above 200 qmps 31 to 100 Amps 31 to 100 Am s Swinuning Pool Above 100-Amps Above 100-AmpS Transiormers Irrigation Booms . S Partial-"Other Fee Signs Special Inspection $ iO S-0 TOTA E WO Remarks , ? I /'1 ? i v Rough-in Da1e I, the Electrical InSpector, heroby certity that the above Final A1e inspection he9 been S. r mede. his requesl void 18 montim irom This request void o'-k-I u? I 6 3 ? c,yL?s i1?t?r 18 months (rom l ` U, =1?1 785 c? l5= 3sTSI?5_ Reque? , ' a Fire No. RouOh•in inspection Fequrted? OReady Now &?WII NolifY. Inspec- ? «? 3 Zf 10'fes ?NO [or When Ready g'Ccensed Elec[ncal Contractor I hereby request inspection of above ? Owner electricel work installed aC Street Ad/dress, Box or Route No. r 164, 1 Cityr Q (L ecuon o. Township Name or No. Range No. CoAy nry ,s /?r.(3 A O /o Occupyan.-t(PRINT)??? l!- Phone No. Power SupDI? Address ? Electrical Co?ntracto/r (Company? Name) ??la?4 ?LeU .a s L / /JG C/oJntractor's License No. 7 ??O l0 ? ? Mailing Addre ss (Con,ractor or wner Ma in Inst ation) ? 0,3pb d?ss?l?sy/ao ?'? ? ?5'303 Authorized ignature (Con ractor/Owner Meking Installation) I Phone Number 7s3 MINNESOTA STqTE BOAflD OF ELECTflICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bide. - Hoom N-181 BE ACCEPTED BY 7HE STqTE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PNOPER INSPECTION FEE IS D1.--.. IC101 107 1111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION , See instructions for completing this form on beck of yellow copy. ""XBelaw Work Covered by,Thrs Request E8.00007.04 u:- 3s2??18_ Nemi Hdd Rep. Typ¢ of 8uilding Appliances Wired Equipmenl Wired Home Range Temporary Service Duplax Water Heater ightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. umace Silo Unloader Industrial Bidg. Air Conditioner 8ulk Milk Tenk Farm Other peci y ther ISner.ify) ther Suecffy Ot er 07her (.OIIIpUf@ (/1SpQCtIOn fEe KBIOW k Fee ServiceEntrencaSize p Fee fenders/5ubteeders # Fea Circuits T lo- aC 0 to 20? Am s 0 to 30 Am s IO S ? to 30 Am s Above 200 qmpy, 31 tp 100 Amps 31 to 100 Am s Swimming Pool Above 100_Am s Above 100_Am s Transiormers Irrigation Booms 5rp Partial%Other Fee Signs Speciallnspection o? S TO Rertarks 3',5:? l FEE ? _OVl Hough-in D?te ? I, the Electrical • ?j?/?? ? ? Inspectar, hereby CBlll} LM1 1 Lh M Final 7 .. x j y A e A IOVB insPection hes been 1 ?)A v ?vp r,?vlit.?? G ? d made. This reauwst roid 19 months irom CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: (Gfl5 TNSERT/LINE) k1.d1n4-?.,Permit Type FIREPLACE e,1diC1g°4J-§??r,? Type NEW n s us..C4cl??? 434 ALT. RESIDENTIAL 1067 KIRKWOOD DR LOT: 11 BLOCK:' 3 CHES MAR EAST 1ST p.I.N.: 10-17150-110-03 DESCRIPTION: ?. ? REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee , ? PERMIT PERMIT TYPE: Permit Number: B U I L D I N G 030766 Date Issued: s y /1e /9 7 a ,z? ? , `WI'? .,? $50.00 $.50 $50.50 CONTRACTOR: - applicant - OWNER: STATEWIDE GAS SERVICES INC 14674184 TNDERBRITZEN DAVID 14260 TACOMA AVE 1067 KIRKWOOD DR NORWOOD YQUNG AM MN 55368 EAGAN MN 55122 (612) 467-4184 (612)405-0996 f . , . ? her,eby Faeknnwl6 dge„ thi ` inform6?t3on is `corre-ct- i Statutas and City o'F„' ?ai a..,.. APPLICANTlPERMITEE SIGNATURE -Parla 641 rhA ISSUED :51 NATU E CITY OF EAGAN ?j'?j 3830 P1LOT KNOB RD - 55122 ?? D ?? 50146 1997 FIREPLACE PERNIIT APPLICATION 681-4675 DATE: 9OA7 PERMIT FEE: $50.50 DESCRIPTION OF WORK: CONSTRUCT NEW FIREPLACE r1LTERATIONS TO EXISTING ? INSTALL GAS INSERT ONLY ? INSTALL GAS LINE ONLY OT'HER: STREET ADDRESS: 106 7 t:?;,exc?po o 4?22 LOT ? BLOCK ? SUBD./P.I.D. #: APPLICANT: (circle one only) OWNER/''', 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. PROPERTY OWNER FIREPLACE INSTALLER GAS LINE INSTALLER Name: .SiSr4EJC?ITZF%? ? us? Phone #: Signature: Street Address: wda+ n L,e City: , State: fAI Zip: _ . . .a ? Company: Signature: Street Address: 3-y%2- G?Als??f City: Azd,e Gl? State: I&I Company: Name: Signatu Street A City: - State: Phone #: License #: ziP: ss3 Phone #: Zip: OFFICE USE ONLY BUILDING PERMIT TYPE 0 14 Fireplace WORK TYPE ? 31 New o 33 Alterations ? 32 Addition o 34 Repair GENERAL INFORMATION Census Code. 434 SAC Code 01 REMARKS Chimney/flue must be inspected before concealing. Certificate for: , ., Joe I+4111er Const. plan qp, 93035 •• : 18133 Cedar Ave. 30. parm#ngttm, M. 5 5 a2 4 ?- 64?/ ? DELMaR R sCHvaz . . " LAMO 6URYEV4? 'T??? 11?G • . . ' ppiibrr7 UnWr Lwnm Of TM itaq 0/ MMMq4 . 2978 - 746TH STREET W. - BWf 1M *09VACLUR, lanNOMA ? ??"?1765 Proposed garage floor VEVOR'8 CENTIF1CATff @Y6V. 9'J'20 t . o SCALSi 1 ir?ch ? 30 fe?et Propoaed top -of --- .??„c'g o Dsri.sa set iron pipe Poundation 9• . \ C]' D?r?e?t?ea ;aeti Kood hub 6 4/9.7D*nots? existing elev. Proposed =base?r??=? 60 / (DDen4tss Aropoaed qlev. iloor 92. •?_. ?a 3? ? ? ; " lS fi 'h??/\ ' ? ? ? ?Cr, h ro? Hua ?'v 0 ? ? ? o ?? ?c. ToPN0 y3. 0 . . c D nfv L- 6 B s G? 44inage & utility -ro easement ? ?• ?r^ az ti i r I hereby certify that this ls a t2'tte anQ ao=`r'@at ropr"ontation of the bonndariea of: • Lot 11, Block 3, CHB3 MAR 8A'3T BMT ADDMON., 8?"ordift tO the recorded plat thereof, Datota C+Dunt8, Ninn*00ta• ' Aleo showing the location of aXroposed house as stdke4 thereon. Aa surveyed by me this 24th day of 8eptember, 1982. Y8?6? MINNESOTA REGISTR TIOl . ?? EtiTERIOR ?NVrLOPF AVERAGE " MPUTATION ? I ?3?"J • ? ; . , ? , ., • ? OWNER: Jospeh M. Miller Const. Inc. DnTL - ;: $ITE ADURI:SS: 1067 Kirkwood Lane PIIONE: 454_4753 _ ---- WNTRftC'NR: 310F, M??-LEQ Detexminc ti+or.kinq squere footaqe of each 1. 7bCal cxposed wall area...... sq. ft. x .17 ; 2. 7ba1 roof/ceilinq area ...... sq• ft. x .05 ' . i' Total axposed wa12 area above floor a. 'I'otul wal; w3ndow area ................................. f^-?LaJ. c7oaf arc:a ....................................... c. ;otal slidirr;I qia=s dour area ......................... ? d. Total fireplar.e wali area ............................. o. Total wall £raininq area (average 10a) . ............... _1'70 f. Total'rim joist area .................................. (4 I .... g. r.al]. azea ebove floor....................... i. war?ll area above f.loor .......................... j. ? wall area above floor .......................... ` ? Total er.poseu foundation nzea 141°I k. '.bta2 fo,ii:dation window ar.ea ........................... 1. Total net £our.dation area above grade ................. e Detcrmine "C" value of each wall seqment (e,g, windcw, door, each separate wall section) ,. a. Izo x "v° .55 a !o!a -?- - b. 3e X„U„ • 55 m Z.o.9 _ C. 4v x .,u.l d , - .K - 1'70 X lsUll •0-7 a 1( .q e. _ ---- g I 330_ 7' ??U?? .44g = ;,. ? flu., a 2? . -- X ?full m ? Zf item U3 is the samA as j, X"U" _° -- or less L•han item $1.youu - IILV9 met the lntent nf, k. X „?,: - -- • St3C 6005 (c) 2. X q]?_ ? j ?- ? - - -• ? ry - Mi? h a ? • .. G?I ! MiC..,.. . . . - __.?.. ?........ .. r . . i , Paqe 2 of 4 ' utat•ion ?e "U" ComP - •' D:trrioi Cnvelope Avera7 ;+ - ToCal exposed roof/ccil9.ng area . ........ m. 'hital skyli.yht area • • • • - n. Total roof/ceilinq framing.area.(aveX'??le, 10e)... /?- o. Totul net insulated rooi/ceilin9 area......... .. 470_ Determine "U" valuc for cacli roof/ceiling segment , . .: , : . X u u n ? . - a ?=?? ' M. n.' ?. 108 X ,ull ,02"1,? _ 2•?_ o. ?1-10 X lull . OZ3 ° 2_.-Z"--3 - 4 ........................ Toeal = Z?y If total of,N4 is the same as, or less t:han NZ, you have met th?y inCent of SHC 6005 (c) 1. Tlternate IIuildin9 Envcl.opc Design Tb utilize the total envelopQ 'system metllod, the values established by the sum of S_tems 43 and #4 shall not be greuter than the sum of iteme #1 and #2. ' + S3,q 1. 324 •4 2 . ° 3. + 4. . 1 ? a? ?.. 1 ? l.wEAL FT, eXPosFo WALL , . ?j(_;QG ?C.' ? ZCo-t 38+2 (.Q +- 3 8+ I o= l38 . ± ' -- ? _ ?:ULL (, ? ??s+3 = 14, ?uLL Z ; _ tZ l t--M : _ ?4 ? r3Lo :K.', 1 33 EE 1::uLL F'uLL Z ? - 1 ?+ ? ? ?C?POSI K ,S X S x$ x .a k S ? ? I O=wD WA Ll.. Aiz.EA = 5 ?O - - - . '1-o-t-A L. ?1C?o5ED GEJI.IUC{ ?8$? 2z.5k??•S= 1a??, ? tu DxrS 2q 3 (a Za4 b ? 140 ? SL t r-t+j I I i -1-6 32 S 120 ? UaoQS ? z° Z8 1$ . ?AT 10 1 _o cv , M4 ¦ ?? DRS , ? U Li 14'S 38 A 6 ? ? - ? • ' ? ..? ? . • . .,. ?. . jtppC/CCSLI.IG ' • . r? ? -- y.' ; . . ? .. R_Va•l?fC ; • ?? ?on•:< ? ?.^et , , 1 Intcri<?c .?il • 3- --? ? 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' •' ? • • • a Cse additional sheetsiC ttotc S?uc??? • ?iQ:J-QQTZD . : • , ' pte?led LoY detsils ana .. . '•• a . . , _ ' • ? $eat . , . ° . _ . • ,. ; . i • • ilov up ? . .. • . : ? . ? ' . .? . . . .<,.... '.? . .. ?' R ?7! ? ? . . • . • ? ? . „ •, _ ?•:.I T. - • ? - i , ? , . , ? I ? i t: _:. ?___.=w. J.,.? - . . f ?.t? r•?1?::11 ?i?.; .?•?1 .. ? Film 1 ??:?.'Iti•?: • af? ,.?„n,?_? . • ? ?, • •-_ -'- - _.? di.*Iq _..? ...._.. (I) , . 4: D?. r7 C/ jiii. Tot.i?,?.t. 0 . 68 1A.' lnt•r.x.ior air 7. ,l. • • a. . - ; ' . 5. 514iNCa.-- ----._.. ---_.._ _ • : o.17 -'-----4 o tr.r.ior. 5ir film ? -- :??: - - 6. Fx _ ._....--------?7'ota'1 '?..-Z Z •.? L Mz 044 I - J ? _---.--U -. • 0.60 :n!ur_a,?r _ --•- ----? 3. 2X • ? ----•---- ,• ;..'i ( ?--..___. n ' n. i''.'L1:1??r2?._ __. __ ._....?= ? ?,• ? ? ?1;.-I'"/?.ll?--....._...--._.(i)_? .;• S?C?t1Jt-? .__ --• •_-.---..--- o. 1*1 -•? . ---- Zq: 3 ..?,?._ ..?/?•?AI ? _??; .'."__- '( ? ?Jl ? •cA,I . ... ??.._. , ' ?• ?(\? ...•L•!``••?''•?.?? 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J { � Use BLUE or BLACK Ink � For Office Use` � � I �� I Clty of Ea�a� I Permit#: , � � � � � �D � Permit Fee: � ; I 3830 Pilot Knob Road R�CiE,v � ""�f-��./ j Eagan MN 55722 � Date Received: ( � Phone:(651)675-5675 'u`� �1 1�� 1 I Fax:(651)675-5694 � Staff: � S I��J �/ �� A 2014 RESIDENTIAL BUILDING PERMIT APPLICATION t� �,�`� Date: � �'1 �� SiteAddress: � �t7 � l�l..--��../�at� �f'��t Unit#: 1�� r� Name. ��t �. ��S�lc� ��/C��tc.y Phone: Residentl p . Owner Address/City/Zip: I� ��f �i.-k�-a�� /"�•� Applicant is: �Owner Contractor Description ofHrork: 4..��vv�at y y�id��as � ��i �� fi Type of Work Construction Cost: ��, �� Multi-Family Building:(Yes /No � ) Company: �� (��'�'"C� �t Contact: �"��"� Contractor Address: �� ,/P��f�.�:�l�y�vi' City: ��'� State: v�%V Zip: � �� Phone:G�Z�-��'°'3�'n/ Email: License#: d )�7 Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) D COMPLETE THIS QREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: NOTE:Plans and supporting documents that you submit ane considered to be public informateon. Portions of the information may be classified as non-pub(ic if you provide specl�c reasons that wou/d permif the City to conc/ude that the are trade secrets. CALL BEFORE YOU DIG. Catl 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.qooherstateonecall.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 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 780 days of permit issuance. x /,d�1 dt.. � ( n�'rr�` x �� / Applicant's Printed Name Applicant's Signature Page 1 of 3 � . __ 1 �� Y k:��t � DO NOT WRITE BELOW THIS LINE ` �� SUB TYPES _ Foundation Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) ' _ Single Family � Garage _ Porch(4-Season) _ Exterior Alteration{Muiti) _ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Misceilaneous ' _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building ' WORK TYPES � _ New _ Interior Improvement _ Siding _ Demolish Building* I � Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage I _ Retaining Wall *Demolition of entire building-give PCA handout to applicant I DESCRIPTION Valuation � Occupancy «`iCG`_! MCES System � Plan Review Code Edition � SAC Units � (25%_100%� Zoning _�_ City Water "' Census Code y3�1 Stories / Booster Pump "" #of Units � Square Feet � PRV "" #of Buildings � Length sy Fire Sprinklers �-- Type of Construction Width li REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings(Deck) Final/C.O. Required � Footings(Addition) � Final/No C.O.Required � Foundation HVAC�Gas Service Test Gas Line Air Test � Roof:�Ice&Water �Final Pool:_Footings _Air/Gas Tests _Finai � Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath �Stone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector RESIDENTIAL FEES 3 a,l./ � Q �O —r�- I 3 D g�� Base Fee Surcharge /4�� U � Plan Review 19� ��'" MCES SAC � c�ty sAC f ?°g� Utility Connection Charge S8W Permit 8 Surcharge Treatment Plant Copies TOTAL Page 2 of 3 . ...�. .__ . ..- ^^ - .�,:"^??'�aa+n'f ai.�}�"p��is�.� ,s i!.'"'. �.,.:;:�: t'y�fws�tr„�Fsw,nt,cri'i:c.�'A�.s?�',`.. � . . `' ' C�rtificate for: � ` � a� �� " �. J�ie M,�.11er Const., , . Platz . 18133 �eda.r Ave. So. Aio* 9 .035-. F��ir�gton, Mn. 55024 ; ,� ._ : . � ' � ��/�� - � ' � . ��i�� F1i �Vt��-�i� . . ��. • U►t!�fiSUttVEYQRS��fil�, , . RpiitK�d UnaM l,�ilri OE TM$t�M of Mfon�sata • . . 2978— 146TH STREET W.— BOX M R08E�A01lNT.M�NNE�OTA Q60i� MK11ME�1��?i1768 Proposed ga�a�e f100T URVEYOR'S CERTIFICATE eleu. ,�3�'�` . . - o o SGALB:� 1 inch = 30 faet Proposed top.o��=�- -- �- `��w�d o; DrnQ.taa sat i�on pipe ,. �oundation 9 • . \ 0' D�not.t� ;seti r►c�od. Mub .. `. . ��- 9%9-?'Dhi�no�4� existing elev. "�'". 6 � _ ODen,�teft pro�sed elev, Propom�ed-?aa�ee�r��• o / •� Z o �3 f loor �9Z. - . � � x c i ��^:�N � � �,,� y�.�s � � ��°f� Q� ��.� ��Ew�� .��D � G x �� rP NUe �� . � ? '��. 5��51�, M' f� � ��' � �Z� p - �°`� ��' °� � , �,��, � ��jJ1 r/on� �°� � 6 -� . � �� '. .___ _ _ M \ � `.�'' ' ". '"6�?0�.� C1EVlalOia � M�� `• �,.1 0��.. ,3 �z,g� � �, � �; � �� \ � ;� � ro�NuB �� ti�- 6 �'h �, �:t'�'a�. . z Op / ':`< '9'-� '� ` 3 .\ ��,� � -- �s / 'a� - �� , . v' \ � � � o ,�, ,x �, _ ��' �n � y�r�fo � �o . � �� ^i �' yg \ �o' �-�h° 6, � ----�'' `�; � ,± � �►, . � �D ,s' . � � D. . 33y `�ro \ � 6'� . ��.I o �• . `6� � � 9�ug �� !� s-� �� ainage & utility �►�, � �. -- y � � T�'�,� � . easement \�, � 6 Zj �' . -� � . �z �-- .=--' � ' �rB/-!S �9� �_ 'ti 3v �, Z�. 3r / �6 d . � I hereby tlfy tha.t this is a true �trid �prrect rtpr�s�ntation of the boundarie$ of: � " Lot 11, Hlock 3, CHES MAR �:A3T FIR$T �lD��"�ON, a�o��ardln� to the r.ecorded plat thereo!', Dakota Cpunty, I�ll.nnesota. , . AZao showing the location of a �,ropQSed hou�e �as staked �hereon. Aa surveyed by me thie 24th day of Sept�mber, 1982. � „ - � - �r ��r✓,�,,1` �t MINNESOTA REGISTR TION NO.8625 �, e , Use BLUE or BLACK Ink "`_ �-----------------, I / For Office Use I + rt�n . . ._ , j Permit#: /� � �P�� i Cl�� Of��Ii � �d' , � � OCT 0 9 2014 � Permit Fee: � 3830 Pilot Knob Road I Eagan MN 55122 � ,� (� � , ; I Date Received: � / �� Phone:(651)675-5675 � I � .� Fax: 651 675-5694 1 � ) . � Staff. � _________________J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date:`��" 1"� -1 Site Address: �C.�D� �►r�� Tenant: Suite#: �� Name�0��1(� �� Phone: ��SIE��litE�@� %�� ' Address/City/Zip:� i � u./��.� �� ii. ��! ��j �� LIC@IlS@#:��L�� Name: � � i� �% ! � - %�� '�% � c1�3 �I��h �4�tC C�l c�t . �-iOlc��► VC,e11CY � i j� Address: y' �� SE��E'siG�C7C`�i � �-y/� / � ��j�� J-�� Phone: Ilp3��2- � � �lo �� j�� State:��Zip: � !�' � ��ii ,� i /�i�� i�� i� i� ��!i�� Contact: �(�� ('��11i ��G EmaiL•��Ci1,YG�01(��11(�9. r,Ol�►'1 � ° ,�,.,�i� — , „��, %%ii��/i%��i/%��: � New Replacement Additional �Alteration Demolition � ��i/i�j�i i�� Oi�/i� �i!i�: i i� �� Descnption of work U � � � �j /�., /, / �i�� / � % // !/i. , t:i/ /j ��. /// i � " i ii// i%/%% �� £�'��1�Et�c� � ��; ��i��l� ��;�� i// %, . � / �/iii �� i� ��//� �i/ �/� :. � ii �Ct�@ ��55��4[t�G��C�[t1�� C��l��t`�3'�E�Tt'�� f��1 t�t��8��%i ,�.': ,�,�, .�'� ,,,., �, .,,,,,,�,�, . , ..,��,� �„ ,,, ,,. ,�,; . „ �o-. �. ii, �. ��, �� i %i � �i ii ��i�p �� RESIDENTIAL COMMERCIAt � � i� �i� � � � �i � �% °i Fumace New Construction Interior Improvement � �i� ✓i��% — — — i"�'��'! ��i/ji ��,�� _AirConditioner Install Piping Processed �/��% � ��y� — — �� % i� � �� Air Exchanger Gas E�erior HVAC Unit %�i%i/ii�i i/�//�f� - _ ii' i/�//��j ��/ � Heat Pump _Under/Above ground Tank (_Install/_Remove) si� � i �i !�� '� ;j ; other 1�L.T��-ZNC9 ��:.�LT' ..��i.,:� ��.,,,, RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) / $100.00 Residential New(includes$5:00 State Surcharge) _$ (,_ob •0� TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee 'If contract value is LESS than$10,010,Surcharge=$5.00 � "'If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 -$ �� Surcharge'' "'If the project valuation is over$1 million, please call for Surcharge =$ � �� TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit,but only an application for a permit,and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x�_� � j ]\\i�l `J�l�I 1�� x • Applicant's Printed Name pplicant's S ature r �,;.i // i/oi / � � ii � %�' �i.��i�;://i �/%i� �� % � f .�„��- � ,��, r. � . � � � / ,< ��, ij �/�� /�/�/i ,�/ �,..i�/=;- i` �:� � i i� /i�i � i�: �. //�,�/ .��i/��:i i. ��Q�1`��',.�� /.. i;, /i ii��.: ��%%% �� i/:.:. i .i y;. i� ��%�.:�� i . i�: % � ii�� % i�� , � ! „ii /�i %� //�i /ii//. :� �p � �� i/ ��%��ii � � � �� !�� , � � � //�i%� � � �� „ ^�-..� .,€'� �.....r:� ./� ,' . ......i i��iii/ ..,. �� , .-,>, �// ,.. /i . � %...;: �.� :.i�i////%i % . ��.. 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