1658 Mallard Dr
CERTIFICATE OF SURVEY JUL 19 986
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DAXE:
TIONS DIVISION
DR. By LJ SCALE - l" = 30' o DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM
PREPARED FOR.
JACOBSON SURVEYORS
_1,.?~1P<<'il =,i~[iatrltc't= - 1
LAKEVILLE, MINN. 55044
` PHONE 469 - 4328
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Use BLUE or BLACK Ink
r
For Office Use 1
1 I J/ V
Permit#:
City of EaEdfl 1 I Permit Fee: /~m
1
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 AU L
-5 2011 1 Staff: 2011 RESIDENTIAL BUILDINGPERMIT APPLICATION l
Date: Site Address: Unit
Name: t4 /S kfN W / l!n Cl cdYl\- P h o
~CJ I - (g 0 a -~L
RESIDENT
OWNER Address / City /Zip:
/ o _ ivCg ~~4 t ~/✓S
Applicant is: C Owner ! Contractor
Description of work: + i c E' C-/Z
TYPE OF WORK
Construction Cost: Multi-Family Building: (Yes No X
Company: 4 ~ l i Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: 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 they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoi)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.
x~l 6~ (IJ~!4 x cxy, 4~, ~`t
Applicant's Printed Name Applicant's Signature
Page 1 of 3
' ll t DO NOT WRITE BELOW THIS LINE lot) q-.5 g,
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
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
Valuation Occupancy /Lc - MCES System
Plan Review Code Edition ;161-V? SAC Units
(25% 100%-Z) Zoning City Water -
Census Code /I A Stories _ Booster Pump
# of Units - Square Feet ~0/ PRV
# of Buildings Length Fire Sprinklers
Type of Construction- Width / g
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
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: Footings _ Backfill Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
f 64 J4
RESIDENTIAL FEES 3/ 7" fJf~G~~ n4 /j = 3~fG
Base Fee W 3 7 / 7
Surcharge
Plan Review ~y ?
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
I
Use BLUE or BLACK Ink
.__________..___w__
~ For t,~tFme U'
j Permit AY17 -1
I I
V I Permit Fee: ^ YO10 i
3830 Pilot Knob Road ~j I I
Date P ` I
Eagan MN 55122
Phone: (651) 675-5675 J` 1 Sta 1
Fax: (661) 675-6694
-
2011 RESIDENTIALe BUILDING PERMIT APPLICATION
Date: S l- r' Site Address: 1 5 t M 1I Cep Unit
Name: -Thor 6 VI st-/- S o V-X Phone: ~ 5/- LC6 - q 157
RESIDENT ~ ,nom
OWNER Address /City /Zip: ae- < I
Applicant is: Owner Contractor / c
TYPE OF WORK Description of work: !\2 i `ti ogre 6G Tic > h
U
}
/
Construction Cost: Multi-Family Building: (Yes No
er d
Company: l c2Y1,0- S- Ce Contact: Mik-C 60-9 o-vd
CONTRACTOR Address: V/ / 4 * le~5'k city: /t"a - 45,p- State: 1h/ Zip: aark Phone: 0-f - (/L/- 7y2
License r~ Q b Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a similar plan rased on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer S Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portilms of
the information may be ciassftd as nonpublic if you provide specilk rosons that would permit the City to
conclude but Via,
are bade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464-001)2 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.-gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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.
Applicanrs Printed ame Applicant's Signature
Page 1 of 3
CITY OF EAGAN
Addition Mall.a_d gark geEe?d Additie;T-Lot 6 aik 2 Parcel 10 47251 060 02
Owner Street 1658 Mallar'd DriVe Stace Eagan, MN 55122
J
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ? 7?D• J
STREET RESTOR, 276
GRADING
SAN SEW TRUNK
*SEWER LATERAL Z , (q
WATERMAIN
* WATER LATERAL
WATER AREA p ?),
STORM SEW TRK 1981 445.37
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
;. CITY OF EAGAN 1 -
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, M N 55121 ?`? 2 12369
z -
' PHONE:454-8100 BUILDING PERMIT Receipt #
To be use? tor SE DWG/GA?2 Est. Va?ue $107 , 0 0 Date JULY 29 1g 8 6
SiteAddress 1658 MAI,LARD DR Erect IN Occupancy R3
MALLAJ2D
Lot d Block 2 sec/sub PIC ZND Remodel ? Zoning
Parcel No. .
Repair
?
Type of Const. VR
Addition ? No. Stories
Name M.W. ?7QI3NSON CONST INC Move ? Length 68
=
o
Addres 14251 CEDAR AVE
s Demolish
Int Impr. ?
? Depth 7 Q
Sq. Ft
City -'A-V• Pnone 432-6838 Instau ?
Name Approvals
= o ST?i"!E
0 ¢ Address Assessment
~ City Phone Water & Sew.
F W Name PHILLIPS PLAN S£RVICE Foece
_ ? Address Eng.
i W city Pnone 4 3 2-2 04 4 planner
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State oi
Minnesota Statutes and City of Eaqan Ordinances.
Signature of
A Building Permit is issued to:
all work shall be done in acco
Building Official
Bldg.
, Var. Date
Ct??T IiJC
Permit '`''V •''v
Surcharge .50
Plan Review225.25
Water Conn. -1 "" • "" ,
'
Water Meter 0-. 50
Road Unit --2!vo--.00
Tr. PI. T-56 • 00 4
Parks
?
Copies 112,3i3;75
- on the express condition that
Eagan Ordinances.
PormN No. Pormfl Hddor Dale Tibphons t?
Plumblnp 3C
.,,
H.V.A.C. 7 7/4! 7! ?
El.ctric _ 19 131
4 7
c C,
softe,a
Inspectlon Dab Insp. Commanta
FooNnytl p ?
Footlnys 11
Foundatbn
Framtr?g
HooNny
Rouyh Plbp. 4? ?
Rouyh Mlq. ad JP° i•1r?
Ingul. ?
Flroplace
Final Nty.
Finsl Plbp. ? - ?
81dy. FinaI O ?j
Cwt. Occ.
Dedc Fty.
Deck Frmy.
Wdl DetcrIW Locatlon:
Pr. Dbp.
p . . , PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAhI
PILOT KNOB ROAD, EAGAN, MN 55121 DATE _
Site
? Name _
?o Address
c City '
L Name
? Address
p c;iy ?4 - l/-
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMfIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BLDG. TYPE ' WORK DESCRIPTION
Res. ? New ?
Mult Add-on
Comm. Repair
Other
FIXTURES TOJAL
_.:;?Water Closet - $3.00 S? ?•
°-'- Bath Tubs - $3.00 ?
?Lavatory - $3.00
?Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00 ?
Floor Qrains - $1.50 Water Heater - $1.50 Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
,,-Private Disp. - $10.00
} Rough Openings - $1.50 'FEE l/l. Sv
STATE S/C • ?
GRAND TOTAL: 1 ?` p
FOR: CITY OF EAGAN
., ,
• . PERMIT #
MECHANICAL PERMIT RECEIPT # X v ?
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PFiICE PHONE: 454-8100
Site Address BLDG. TYPE `lWORK DESCRIPTION
Lot Block ? Sec/S u &
R
?
N
, . es.
-
ew
m Name lt Add
M
-on
u
R Address Comm. Repair
? City Phone pther
L Name FEES
c Address RES. HVAC 0-100 M BTU -$24.00
p City Phon4- ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air M BTU ' COMM/IND FEE - 196 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/INQ FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outtets #
OthBf
FEE
SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
,-. _ ..
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE• 454 8100
BUILD.IfqG PERMIT . Receipt 4k
To be r?sted for ^0101TION
Site Address
Lot Block Sec
Dornul?hl? .-. .
$8,'404
a Name -, . l
W PFtV Required
2 Address ; .in - c+.) BooaterPump
° City Phone
. o Name .. , t . • ;. ?
o ` Address L': :. . . r? ! ?' •'
UI- City Phone
ua
yJ WW Name
_ ? Address
Q W City Phone
n and state that the
applicable State of
Signature of Permittee
A Building Permit
19
OFFICE USE ONLY
Occupancy
Zoning
(ACtuaq Const
(Allowable)
# of Stories
Length
Depth
S.F. Total
FoOtprint S.F.
APPROVALS FEES
Engr./Assess. Permit '
Planner 5urcharge '
Council Plan Review
Bldg. Off. SAC, City
Varlance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment Pi
Parks
Building Official__ _ I TOTAL
Permit No. Permit Holder Dato Telophone s
Plumbing
• ------------
H.V.AC.
Electric
Softener
Inspection Dste Insp. Commsnts
Footings I "/
Footings II
Foundation
Framing aG
Roofing
i
Rough Pibg.
Rough Htg.
Isul. ?-
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. OCC.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
CONTRACT PRICE
Site Address ?
Lot C?Bloi
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KN08 ROAD, EAGAI
PHONE: 454-8100
? Name < < ? ?
?o Address " L
c City Phone ?
.,
Name r° r
? 3 Address
p City Phone
FEES
COMM/IND FEE - 1°rb DF CONTFiACT FEE
APT BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAI FEE - $12.00
MINIMUM.- COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
{ADD $.50 S/C IF PERMIT PRICE GOES
`
? SIGNATURE OF PERMIT'
II FOR: CITY OF EAGAN
PERMIT #
RECEIPT #
MN 55122 DATE:
BLDG. TYPE . WORK DESCRIPTION
Res. V" New
Muit. Add-on U'
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.60
Floor Drains - $1.50
,,Waler Heater - $1.50
Whiripool - $3.00
Gas Piping Outlets - $1.50 ? -=
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - S10.00
Priuate Disp. - $10.00
Rough Openings - $1.50
FEE: -
STATE S/C: ' -
GRAND TOTAL: ' ? ? '
CITY OF EAGAN WATER SERVICE PERMIT
; 3830 Pilo. Knob Road
I P. Q?-Box 2" 199 PERMIT NO.:
? Eagan, MN 55191 DATE:
?
irg: F` No. of Untts:
,,?. ,". ,... ,. . .? -
r,
row:
117
/lddrest: . r j_vc: a , 7.1 <<1'd . .
, umbac
I,
r No.: 3 0. ? 3 rys: l;
.
::
ze: de. r,o. ?6 5 0 d+ ??,?, Eic
.,m te oo.Py wwo er. citr .p1i0NE s, . .?
`a.. u (? ceVn e .
' To°"fal:
Dcta Paid:
of Insp.: insp.:
/'
CITY OF EAGAN SEWER SERVlCE PERMtT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zonin0: - No. of Units: -
,?
Owner: •?:
/lddress:
•-
Site Address:
Plumber.
I yrw fe ee?npbr wNi !V Cihr oi lNew Connsctlon dhoroe: - G; 5. iiVp<i
o.am?e... Aecour+t Depoaic:
Permit Fes:
?.
x ' ^ . 002'
StJ1Cf10YQ0:
Br Miac. Cho.oes:
Dcte of Insp.: Totoi:
Insp.: Dats Pald: _
CITY OF EAGAN WATER SERVICE PERMR
3830 Pilot Knob Road pE??T NO.:
P. O. Box 21199
Eagan, MN 55121 DATE:
Zaninp: No. of Units:
Ownsr.
Addross:
? 5 ., T?c'1
;
Sita /lddrcss:
plur-ber.
Mat?r No.: Connection Qwr9e:
^ccrount Deposit: _
Stze:
Readar No.: Pem+it Fee:
1 Nno h oow* wIb !Iw C.ity of lmps Surchorge:
OAiMwow. Miac. Choroes: -
Totol: -
pcft Poid:
By
Dote of Irsp.: Irnp.:
RESIDENTIAL
BUILDING PERMIT APPLICATION -S
?? O g? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651•881-4675
NewConstruelion Reaulrements RemodeUReoair Reauirements -
• 3 registeied site surveys showing sq. fL of bL sq. fl. W haue: and Lil rooteG areas . 2 topies of plan
(20% maximum bl coverage allowed) . 7 set of Eneqy Calalations for heated addNOns
• 2 mpies of plan shaving beam & windax s¢es; poured found design, etc.) . 1 site survey for exterior additlons 8 decks
• 1 sel of Energy Calaiauau
• 3 oopies of Tree Preservation Plan if lot plaried aker 7/1193
• Rim Jdst Detail Opiions selettion sheet (bidgs wRh 3 or less unifs)
DATE ? ? ))? "'G 1 VALUATION (EXCIUDING LAND) -7 lOO
.,JB SITE ADDRESS 16 5`6- ?'?1 q I)eArd P Y-
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER J??"'? S? ?r ?e 5
TYPE OF WORK IC?V'o? 2«ao10- FIREPLACE(S) _0 _1 _2 _3
APPLICANT _ 9ELA ROOFWQ & REMODEUNG- 1,\- PHONE #
4100 EXCELSIOR BLVD.
ADDRESS s? LOU'e PARK, 65416 ZIPCODE
PAGER # ?D4M10FPIONE # jSa-ca'23" '9-0116 FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1
(check one) - ResidenGal Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbing S}'stem Includes:
Mechanicol Contractor:
Dlechanical System Includes:
Sewer/Water Contractor:
_ Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: 590.00
Fee: $70.00
All above Information must be submitted prior to processing of applica6on.
I hereby acknowledge that I have read ihis appiication, state that ihe information i
ail applicable State of Minnesota Statutes and City of Eagan Ordina ce /
Slgnafure of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _
_ Water Softener
_ Water Heater
_ No. of Baths
Phone
Iaivn Sprinkler
No. of R.I. Baths
r
Not
Updated 1l01
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multl
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) O 36 Multi
? 05 03-plex ? tt 10-plex ? 19 LowerLevel ? 24 Storm Damage
0 06 04-plex ? 12 72-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New 0 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 AddiGOn O 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire 81dg only) • Give PCA handout to apptleant
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 ot Const Width
REQUIRED INSPECTIONS
_ Footings (new bidg) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation _ Windows (newlreplacement)
P,pproved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Pertnit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
' CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12369
PHONE: 454-8100 /_?iC L3
BUILDING PERMIT Receiptn (
7obeusedfor SF DWG/GAR EstValue $107,000 Date JULY 29 jg 86
Site"Address 1658 MALLARD DR Erect ? Occupancy R3
MAI+LARD PK 2ND
Lot.6
Block 2 Sec/Sub Remodel ? Zoning RI
-
.
Parcel No Repair ? Type of Const. Vn
. Addition ? No. Slories
W Name M.W. JOHNSON CONST INC Move ? Length FR
z 14251 CEDAR AVE oemolisn ? oepth2y
o Address Int Impr. ? Sq. Ft
ciN A.V. Phone 432-6838 install ?
a
O
z?
°u<
a
G?
W W
FZ
¢z
aw
Address Assessment
Phone
Water & Sew.
Police
Name PHILLIPS PLAN SERVICE Fire
City Phone 432-2044 Planner
I hereby acknowledge that I have read this application and state that the
information is conect and agree to comply with all applicable State of
Minnesota Statutes aryJ City_of,fagan Ordinanqes.
Signature of
Council
sidg. oa. 7/24/86
APC
Fees
Permit $ 450.50
Surcharge 53.50
PlanReview 225.25
SAC 575.00
Water Conn. 500 . 00
Water Meter 63 . 50
RoadUnit 290.00
Tr. PI. 156.00
Copfes-VZ-,TE3-. 7 5
A Budding Permrt is issued to: - • M. W. -JUA*30W`CON-ST INC on the express condition that
all work shall be done in accordance with all applicable State o innesota St utes a C' of Eagan Ordinances.
Building Official
CITY OF EAGAN N°_ 'I 4 4 O O
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMtT PHONE:454•8100
Receipt# O /
7o be used tor ADDITION Est. Value $$.900 Date NOVEMBER 10 1 9 87
Site Address 1658 MALLARD DR
Lot 6 Block 2 Sec/Sub. MALLARD PARK 2ND
Parcel No.
ir Name 1IM JEFFRIES
; Address SAME
0 City phone 681-1843
o Name DURABILT ASSOC INC
?Q Address 4601 EXCELSIOR BLVD., #302
? City ST. LOUIS Pi{zhone 938-9350
1- a
Uw Name
W W
i? Addre
aw City_
I hereby acknowletlge that I have read this application and state that the
information is correct antl agree [o comply wit all applicable State of
Minnesota Statutes and C?,? o?f?E?a?g,a.,n Or in s.
Signature of Permittee ?cT?1?Lf - TA
A ewlding Permit is issuetl to: DURABILT ASSOC INC
on the ezpress condition ihat all work shall be done in accordance with all
apphca6le State of Minnesota Statut and City of Eagan dmances.
Buildmg Ofliaal m
v
OFFICE USE ONLV
On Site Sewage - Occupancy
MWCCSystem _ Zoning
OnSiteWell _ (ActuapConst
Ciry Water _ (Allowable)
PRV Required _ # of Stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS PEES
Engr./Assess. Permit $86.50
Planner Surcharge 4.50
Council Plan Review
BId9.Off. ' SAG City
Vanance SAC,MWCC
W ater Conn.
Water Meter
Road Unit
Treatment P1
ppG*(copy) 1•50
TOTAL 492.$0
I hpreby reQuest inspection of abova
eleetrieal work imtalleA at:
Streel Ag Bax of Roa[e No. City
P
?
ecLOn Tawnship Name or Na. Range No. C ny ?
OccuOan[ (P21NT) I ??? ?yy2 4y
n-d61
` ? 'Ph..e No.
"
C)h
. ?D N
Paw¢ Supplier l AAAre
Ele c oMracmr (Cny Name) ` -- o acror's License No.
C t :,
ilinB Address (COntrac r Owre,Making 1 ilatio . .
C 7 A --?
Aulhor?x nawre (Co ctor r IAak' p Irefallatian) 'Phone Num r
?
MINNESOTA STATE BOAPD OF Ei11CITY I THIS INSPffST10N REUUEST pILL NOT
v IECT
Grigqs-MiAwey Bldp. - Room N-791 ? AGGEPTED BY THE STATE BOpRD
bp 55704 UNLESS PROPER INSPECTION iEE IS
1821 University Ave., St. Paul,
?-4....e 1.n4t 29]?1H ENCLOSED.
? ,13_?j REQUEST FOR ELECTRICAL INSPECTION 0 EB-000°I '04
' Sea imtructians (w comulating xhis ircm on back of. yollaM wDV. +
B 19131 .•x.. Bela„ wa,k Cave,ed bY Th;s Reques. &36)-7 (,-,t
Riew4Addl Rep.I Tvua of Building I APPIiBKeE Wii.0 i Epeipmenl Wiied I
p Fae Se"iceEntreneaSize k Fee Fqetlars/5ulfeeders N Fea Circmts
0 to 200 Arrkps 0 to 30 Anws .v 0 to 30 Am
Above 200 Am u 31 to 100 qmps ,p 37 to 100 Amp,
Swimming Pool Above 100_Amps Above 100_A
Transfortners mgation Boorns 4 Partial'Offier Fee
L I ISigns ? I ISpecial inspecLOn 'S
y7 y TOTRL F
pe?rks u? ??
RouBh-in . r Dat I. Ne lectri
? ? I?pee a. reby
canify the[ the ahova
Final ' r ^< <,
? f 'repection Aas eeen
maaa
.
IM revueatvdAtBmonvehom . +b `?•- '••,-? Y"W
This request voitl lC?6L?np"b , e
1 B rtanths, from • '
C 56526
qequest Date '
?T p
b?
? fire No. Rough-in Inspeciion
Reqwretl> . `
?]Ready Nuw?ll Nnuty, lnspec-
? Wh
R
/
V es ?NO en
eqdY
uKicensed Electrwal Contrector ' I herehy repuast ms0ection of above ffOZ=wIw--- ? i, electricel work instalted a1:
'St ?fYlress, Box o, Route No. GtY
S 4,:., z ?
ectmn o. TownsAip Nam or o. Hanae No. Counry
Occupant (PflINTI "* .
/ Phone Nn. '
1Oh ?,l v ? ?,
In,
• -
Power Suppher
J
y/-?,
- Address
. L
,' t "_ L '
l ?
f ??
Electncal Coniractor IComoany Name) Gontracmr's Lwense No.
,? e
hTg lin0 ddress IConVact or Own¢r Ma mc? g Inst IlatwN ?
?
v) 7 ?
Author¢ed 5' nawre IConlwctor Owner Maki Installatmnl Phone Number
' y'
J
MINNESOTq ATE BOARD OF ELECTqICITY + THIS l P C ON 6EQUE6T WIIL NOT
GriyOa-Midway Bltlg. - floom N-187 'BE ACGEPTED BY THE STATE BOAND
1831 UniversHr Ave., St. Poul, MN 55106 UNLESS PXOPEH INSPECTION FEE IS
Phonef6121fi42-O800 "I ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-05
, See inslraetwns lor complaline this lorm on back of Vel low coov.
r "R" Below Work Covered by 7his Request
+
RIavAAAtlI 11e0.1 - Tvoe o/ BuJtlina 1 Aooluancea WireJ 1 EquipmenA 16'ired _ I
i emporary
"
1- 1 Liqhtinu Fi
L• I . II Lommercial Bldg. ? Fumace . ?; ? siIo Unloader ?
Industrial Bida. . Air Conditioner Bulk M?Ik T&nk
?p I Fae.• 'Ser'viceEnVenteSize" N fee Fendem/Subleeders ; N Fae ' G.rcuits
Q(0 200•Am s 0 to 30 qm s ' 7 0 to 30 Am s'
' -A6ove 2 0"_Amps 31 ta 700 Ainps , 31 to 100 A s
Sviinimirg Pool Above 100_Am s Above 100_Am?s
Transfortners ? Irti ation Booms Partial.'Other Fee
•Signs ' Special Inspection S Y7TOTALFEE J
gmarks ' ?
( p ???? I the E}sGhj?Al
' ' Inspecto?, he?eby ,
c -'1ily thet tha abova
Final Pection hee baen
de.
; SQUESTVFOR ELEC?TR?ICAL?INSPErC ooOnack o, vallow coov. EB-OOVU.-., jV% ?-
--D-.41 09 0 "X" Be/ow Work Covered by 7his Requesr
A Nep. ' Type of Bwltling Aoolmncea Wiretl Eqmpmem MreA
Home Range Temporary Service
Duplex Water Heater Liyhtiny F?xtures
Apt. Bwldinq Dryer Electri, Heatin
Cominercial Bldy. Furnace Silu Unloader
Industnal Bldg. Air Condiuoner Buik Milk Tenk
Farm omrr Pe<:, v nme, ?Snec,tvl
Ncr Other
ompute lnspecuon Fee Be aw
k Fee Service EnLanceSixe k Fae Fenders/SUbteeders N Faa Circwts
0 to 200 qm s 0 to 30 qm ps 0 tn 30 tlm os
Above 200 qrnp5 31 to 100 qmps 31 to 100 q s
Swimming Pool Above lOQ_Amps Above 100_Amps
Transtormers Irnga[ion Booms ? Partial-"Other
Signs Speclal InspecUOn
$
Hemarks - TOTAL F E
I?r
flough-on Oate 1,the Elac '
Inspecloq hareby
1er?ilv tha? the above
Final D ??j tea? mspectmn hes been
pG d "? matle.
TMw rwnuwnt veia 1a monlM trom
TAis request vold 18 mont hs Irom O O
D 4109
°??Crsr?? 64,
I AQ ? tUa'e /?
? ? Q
i
(r Fire . Rouph-in InsVer.uon
Reqwred/
?fteady Now i11 Noutv InsVer
1
. ?No ? Whn.n Ready
censed Electncal Contractur I hereby request insoaction of above
? Owner
electncal work instelleE at
Street A dress Box or o e No.
5'' l
f? Gt
-
?`
v
a ?
?q-
ectmn o. Townshi0 Name or No.
Range No.
1
County
Occuuant(PRINT)
Tmwc Qvl:?C?cs Phone Nn.
Power Suoolief AAdress
Elec[ncal Conv!a?ctor ( p y Nam I
? * 'l- " &c c- CnnhacSmr's I.?cense No.
Mailinq Aless ICon_trTr.tor o owner Makin stallauonl
r' 7 LIr ? YK ?/
Aut orized 5? n re (COnvactor Ow:er kinp Installauo Phone Nuinber
3 ?
" a )&
MINNESOTA STATE BOAPO OF ELECTNICITV THIS INSVECTION flEOUEST WIIL NOT
Griggs•MiEway Bitlg. - Room N•191 0E ACCEPTED BY THE STqTE 90AHD
1821 University Ave.. St Fwul, MN 55104 UNLE55 PqOPEN INSPECTION FEE IS
Phone (612) 642-0800 ENCL SED.
,
. ? ?.
1987 BDILDING PERMIY APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF S[TRVEY, 1 SET OF ENERGY CALCULATIOHS
&OTE: ADDRESSES FOR COBNER LOTS - CONTRACTOR/HOMEOSiNEE MIIST DESIGPATE HHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCS BQILDING PERMIT IS ISSIIED.
MOLTIPLE DWELLINGS - RFSIDENTIAL RENTAL ONITS FOR SALE OHITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SDRVEY - CHECg HITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
C0iMMRCIAL
INCLUDE 2 SETS OF ARCHITECTUE7AL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
? $2,000 LANDSCAPE BOND
[?
To Se Used For: Valuation:-??)''??- Date:
Site Address 1(055??AAff
d Z?1 . , ... OFF
1 -
Lot LD Block tD_ On Site Sewage_
mIoSd n_k ?`,l MWCC System =
Parcel/Sub ?jJ(? Z?F-E?r}'a On Site Well
Owner :.? , m City Water _
Addressvp!-?8 ?kd&(y ?,?U?.
City/Zip Code (1? _ 5"S1zz •
Phone (D p(" I v`'fJ I APPROVALS
Contractor ?)UC C?YJ1 l V ?X_??A?.11f K. Assessments
Water/Sewer
Address Police
Fire
Cit
Y/ZiP Code 7?l-?IIR.S??FS.J?i-t10 Engr
(?, (y? Planner
Phone Council
Bldg Off 1=1 ?p
Arch./Engr. APC
Varianee
Address
City/Zip Code
Occupancy R' 3
Zoning
Type of Const
(Aetual)
(Allowable)
7k of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEFS
Permit
Sureharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
?a
• ??
Phone U
4/AI.?A'T?qN
18 X /S° ?= 2 9 0 ?ro ---
I
Cities Di ., ital Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
?.?
3'? CERT1 FI CATE
...9
:z:, *^ ?'lq?LqRD 89 n
r .
?? 5 g2°?9'zg•?
0 0
0
m ^
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Yz_e 1 I 9 i I M
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a?
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arn ;
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89 . 80
? FJ 89 ° 2S' 3 [.:' ? OF SURVEY
ul
Q ?
?
?
4 ?
?
U? c
- r
i?
JUL 19 i986
?:1•?:::iL.., <ii,.vn ai*.. .+.i-:ir._ :;ra.^."_;
7n.t .lr., ?.?;unel d:'LUn.
pv pt, ,.. ii t,or l..-. _,2, 1
.iCl-W- t?cil??C' ?:f?'•?C:'?? _ ;,"P.•gLl
?u!";1;?• b::'.C •: Cuu ?t .
i ,,.,.•:,•. _,:?:::, L r,d c cit t _- .. I
„ „ ..
-'? r'? ' '?? '• -. •..;..:_? .:.?.: ? , :?:,_
?.il' Co L fl., T•.C.'1':itJ e ".'_
,...:, ,.
u'. ._ _,;[-:-•. _?::?:!
n,
.r•C? I. : It'r i)i '?
?-
;1?{C
DR. BY GLJ S C A L E -?= 30' o DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM
PREPARED FOR: JACOBSON SURVEYORS
J,Ih„n.,,n ':?,n --. rr.i Cu•'r.
in a,:t ""'?r?'l LAKEVILLE, MINN. 55044
v.tttc1, Nc. 55:
PHONE 469 - 4328
, , ? -?
'j. #
I2346•00 +
12218•00 -
128•00 *
0• ?
450•50 +
53•50 +
225•25 +
575•00 +'
500•00 +
63•50 +
290•00 + -
156•00 +
2313•75 *
g• T
45D•50 +
53•50 +
225•25 +
575•00 +'
500•00 +
63•50 +
290•00 +
156•00 +
2313•75 a
.. ? l?
/
1986 BDILD G PERMIT APPLIC9TIOH - CITY OF EAGAN
HOTE: ALL CAl1TRACTORS MQST BE LICSNSED WITH THE CITY OF EAGAP
3IAGLE FAMMY DWELLINGS
,? 3?CERTIFICATES OF SURVEY, 1?ET OF ENERGY CALCULATIONS
INCLQD 2 ETS OF PLANS \?'
l.
M[lLTIPLS DWELLINGS _ pggIDENTI9L RENTAL ONITS FOH SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVSY - CHECB iflT$ BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
/6%WO
To Be Used For: L,-, -e,ynL Valuation: Date:
Site Address z-. ! OFFICE DSE ONLY
Lot 4 Block q
Parcel/Sub //7A/ktr.l?tiA 5-0n
Owner.
`
-7 ?
Address
Ereet ;e Oecupancy K3
Remodel Zoning
Repair ? Type of Const
Addition U of Stories
Move ? Length ?
Demolish ! Depth ?
Int.Zmpr. _ Sq Ft
City/Zip Code
Phone
Contractor ,/7).0j. ?p{?/t50Y1 &/is4
Address owc" Are . N0.6
City/Zip Code /-tmk_?cU,{ Ti (rv? S-s7 2-4
Phone 452- -(-$ 3 3
I.I -°-r-
Arch./Engr, 0?A.tt6 ?ts-t?
Address
City/Zip Code
Phone # 143 -2--W4-4
Install
APPROVALS FEES
Assessments Permit
Water/Sewer Surcharge ?3 • SO
Police Plan Review 2 5•Z
Fire SAC I57r. 00
Engr Water Conn SQp. oA
Planner Water Meter (Z T. 40
Council Road Unit 290,?
Bldg Off y- yq-?Treatment P1
APC Parks
Varianee Copfes
'IOTAL
j
7?
.
.
NOTEt ADDRBSSES FOR CORNER LOTS - CONTRACTOR/HOlIEOIiNER MOST DESIGHATE NHICH 9DDRESS
IS DESIRED. NO CHANGES fiILL BE ALLOWED ONCE BQII,DING PERMIT IS ISSOED.
;
/0457AV. 00
Cities Digital Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
CERTI FI CATE OF SURVE Y JUL 19 '986
..E?•9
MA?LqRp &9.o pi2?v? a9.s
re, 582-°E?-
S
o 0
0 -
o S
M r-
m l ? p - ?
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m ?5 M
? Gjl.. ? ?897 ??q3
_ vz_e i 9? i C"+
??0 3Z d' fa_ " 37'g ,
lo '
I m ?RGpC,SE? 9
I
?
` C' y L7
Y
s ?
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p -T-
I =,
?W
?
'
L- -- -- -- --
? -
- - - ?? 89 8 0
FN 89 ° LS? Z5 ce' ?-
W
U' c
- ?
I1
Q
J
..•i+b:• drllo [,• 'tl-..YL?c•n ..- ?. `P??cC?
cha[ clii - - " -:I
" rr. ?. . ?ai .?•at,.?i?,n ?. . . u:.? . .?t
! , .O
r: I. .. 1c.
n..???.[a
7.iJr.;• Ih.
DR BY GLJ SCALE - I" = 300 DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM
PREPAREO FOR: JACOBSON SURVEYORS
J,,;,n ;,,,, Co„:L ,.I c - ;.,
t' o. ;;w:; ''a,`'' LAKEVILLE, MINN. 55044
•,;,i;t V.111:\, ?r. ;?311?.
PHONE 469 - 4328
? . ,_ . .
- - - -- _ ' ° / . - " - - . .
? ?- •? , EXTERIOR ENVELOPE AYERAGE "U" CQMPU7ATFON
+•:.-- ?
OWtl'cR -- - - - '
- - ? . :?-::= - -- - - - - - - : •- -- . _ - _ . :_ ? :-_ -- .
i•.' SITE ADDRESS ' - _ -
. C0147RACTOR NI V?I. rJSo?) _'ti?3St DATE PHQNE
• Determine working sguare footage of each.
1, Total exposed wall area ...... 'Z3ZG.l..oy sq. ft. x •ll. ° Z? l?•Z
2. Total roof/ceiling area .... ? I LP sq. ft. x •a2lo:
Total exposed wall area above floor = 1 G'--Q 6
a. Total wall window area,,, ,,,,,,,,,,,,,,,; I?iZ.3
b. Total door area .. ... ........................ 3 8
c. 7eta1 sliding glass door area ...................
d: Total firenlace wall area ........... .........
e. 7o4a1 wall framing area ( avera4_10%)...'.........
f. Total net wall area abov° flaor ................. I?5 Z9,'13
g. 7cta1 rim jcist area .... ........................ -? Le D
Total exoos=d fcunda;.ion area = f=-'I Lo,-l
h. Tc:a1 `oundation window arez.....................
{. IG3l il°_t tOUT7untl0n dl'°d dDOV_ G^dG?' ••••••-••••• I:7j+?'u
pe±=_rnine "Un Vdlll°_ 07 °_a::1 wall
h 3? x„?,?
? X
c. -v `i
- ? ?
d. --- X „U11 ? _ -
E'. x uUu toGi4p - ?Li."J
n?r uVu i1l13 c LG' J 7 I
! ?
g. 21?C X flWl ?'??I1 = IC?Ir•ln
h. x F,U11 ?--
;. ! G! , ?-4 X iiuii
3 . ......................r.:
s3 15 ;fl°_ Sh° ci, :'r 1=5i ?..cil l:-°T :?• 'a .._? if.°_ 1!li.°_???
?1 .:J:. ?Jr?.7'?••J?• ,
?
/
? . r---• . - . ,
Total exposed roof/ceiling area =ClI 4P
Total 9ross roof/ceiling area = Cli lo .
:j. Tota1 skylight area ........................
k. Total roof/ceiling framing area ............ ?-(a
1. Total net insulated roof/cei7ing area....... B 2 4.4
Deterznine "U" value for each rooP/ceiling segment.
x [lull
k. lo x liufl .o'L9 = 2.cL5
1. eZy,q X iluli ,n25 = Zo,lnl
4 .................?.?.L-0........... Total G ? ta .
If total of u`"4 is the same as, or less than `2, you have met the intent of
SBC 6006(c)1.
To utilized the total envelope system method, the valu°s established by the
sum of items Q3 and #4 shall not be greater than the suri of items i1 and ti2. •
1, + 2. _
3. + 4. _
MATERIALS Therm. Resistance "P."
Ezterior Air
Siding Material
Sheath'ing
Insulation -
SheetroCk
Interiox AiT
Studs
P.im
ConC. B71cs.
. I ?
ti5
iq
?
I?7.F'i
CITY OF EAGAiV
APPLICATIOI* FOR PERMIT
SEWER AND/OR WATER CONNECTION
'***************?ftY*Yt*??**?>?*t* #
*TOTl: PAYMMC OF F'FE AT TZME OF *
*
APPLICATION DOFS NOT CONSPZZLTiE *
APPROVAL OF PER141T. *
INSPECTION OF SE4nI2 ADID/QR WATE2 *
*
IIISTALT,ATIONS WII.L NOT BE SCHED- *F
UI,ID UNi'II, PEE2MIT HAS SEIN *E
APPRC3VED. r
*
?
?
•
• "Y!Y!'Kf]Ff'YI']FYtA'Y[T'YtXYIxRI[R][Filfixi][RSZi?cacxi
P ease Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
LOT r? BLOCK --:Z
or
,5-
IF EXISTILVG STRL'CTL'RE, DATE OF ORIGZNAL BPILDING PE(2MIT ISSL'ANCE:
(MOn Year)
PRFSErIP 7ANING/PROPOSID C'SE:
0 COhII?7EE2CIAL/RETAIL/OFFICE
F-1 INIDCSTRIAI,
C] INSTITL*f20NAL/GpVIItDAETpr
Qj(R-1 SINGLE FAMILY
? R-2 DCPLEX (Ztoo Onits)
?f R-3 ?UWPII-IOUSE (Three + Units) ( t?nits)
? R-4 APARTT'ENT/COAIDOMINILTI ( Units )
2) ?
NAME:
ADDRESS:
M. W, JOHNSON CONSTRUCTION
P. 0, BOX 24389 ..
CITY, STATE, ZIP: Apple Valley, MN 55124
PHONE: 432-6838
3) ?
NAME:
PDDRFSS:
CIT7, STATE, ZZP:
PHONE:
Genz-Ryan Plumbing and Heating Co,
14745 South Robert Trail
Rosemaunt9 MN 55068
423-1144 MASTER LICCQdISE#
1849M
4) eea • e i?•.
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
-5 •
) ? a• i i a
, • ?• : o • oa ;ti o-? . .
QxCONNECTION TO CITY SEWER gU CpNNECrION ZC1 CITY WATER
Active
H E?cpired
Not recorded
StaT Initial
? d!'fiIIt
6) ?? •':? o r ? pI,F'.ASE HOLD APPROVID PERMIT FOR PICK-UP BY ONE OF ABOVE "
? PLF.ASE MAIL APPROVID PERMIT TO 1. 2, 3 4. AHOVE
(Circle one)
7) rr• •- ? ??/
FOR CITY USE ONLY
PEP.MZT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ Id %O SEWER PERMIT (INCLUDE SURCHARGE)
$ $ /G-,S? WATER PERMIT (INCLDDE SURCHARGE)
$ G73 ' S-D $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$
$ r-,
??S • ?d
ACCOC'NT DEPOSIT - WATER
$ A>(JO• P??J $ • WAC
$ ?7SOZ? $ SAC .
$ $ TRCNK WATER A$SESSMENT -
$ $ TRL'NK SEWER ASSESSMENT
$ $ " LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRONK WATER
$ AsZ - O L" $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER: -
$ $ SI' (fIJ TOTAL :.
RECEIPT RECEIPT
DOES LTILITY CO NNECTION REQUIRE EXCA VATION IN PUBLIC RIGAT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
ROADWAY° MOST BE ISS[7ED BY THE ENGINEERING
Q
NO
DIVISION. LIST
AS A CONDITION.
StiBJECT TO TAE FOLLOWING CpNDITIONS:
APPROVED BY:
TITLE:
D ATE : 713 ZJ - w- ?
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
$ r4a . 75--
NewCansWCdonReauiremenLS RemodeVReoairReauiremenfs Qffice UseOnH
3 registered site wrveys shawing sq. fL of lot, sq R. of house; and all mafed areas 2 copies of plan _ Cert of Survey Real
(20% maximum lol caverage allowed) 1 sel of Eneigy CalcuWtions for heated additions _ Tree Pres Plan ReW
2 copies of plan showing beam & wiMOw sizes; poured faund design, etc. 1 stte survey tar additions & dedcs _ Tree Pres Not Reqd
1 set of Energy Calculations Add'NOn •'vMicafe i/on-sBe septic system _ On-site Septic System
3 copias W Tree Preservadon PWn if bt platted aRer 711/93
Rim Joist Detail Options seletbon sheet (bldgs wBh 3 or less unils
Date I o'Z /kk)_ /-ca Construction Cost (0.5a 9Ly
Site Address UuiUSte #
Description of Work N-,p0p ,(A cplnr?- 0010 •
Multi-Faroily Bldg _ Y _ N Fireptace(s) _ D_ 1 _ 2
Property Owner ?N-Q_ Telephone # ( )
RMA AOME SERVICES INC.
Contractar Home Depot Installed Sales
Address 3200 Cobb Gallena Pkwy., Ste. #200 City
Atlanta, GA 30339
State 763-542-8826 Telephone # ( )
BG20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 CateQOrv 1 innesota Rules 7672
et) (!' ?? r? New Energy Code Worksheet
• Residenfial Ventilation Category 7F?Iltted
(d su6mission rype) Submitted , ?' Submitted
• Energy Envelope Calculatlons Sub ? E; 2 1 ZO
D3 ?
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
I hereby apply for a Residenrial Building 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 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 approved plan in the case of work which requires a review and
approyal of plans. f n ,
_ Telephone #
ApplicanYs Printed Name ApplicanYs 5ignature
OFFICE USE ONLY
Sub Types
.-,-,
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Ait - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) O 36 Multi Misc.
? OS 03-plex 0 11 10-plex ? 19 Lower Level ? 24 Stortn Damage
? 06 04-pleX ? 12 12-plex Plbg_Y or _ N ? 25 MiSCellaneouS
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 , Siding; ,
? 32 Addition ?'36 Move Bldg. ? 42,- Demolish (FOUndation) 0 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement
" •Oemolitlon (Entire Bldg) - Give PCA handout to applicant
'
, , . .
Valuation . . .
Occupancy ' , .. '
MC/ES System
Census Code Zoning City Water
SAC Units Stories T Booster Pump
Nbr. of Units Sq. Ft. PRV'
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED I NSPECTIONS
_ Footings (new hldg) FinaUC.O.
_ Foohngs (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Fi nal _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
TreaVnent Plant
License Search
Copies
other Total
Building Inspector
Installed
Siding and?MRsPOWER OF ATTORNEY
OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales located at 660 Mendelssohn Avenue North, Golden Valley, NIlV
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attomey-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 municipaiity) 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 apply solely to the Work.
This Limited Power of Attorney shall expire and automatically be revoked on the 300'
day of May, 2003, which date is one year from the execution hereof. Ftirther, the
powers conveyed by this Limited Power of Attomey 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 WITNESS WHEREOF this Limited Power of Attorney is executed this
30"? day of MA-`f , 2002.
David . z
SWORN TO AND SUBSCRIBED $EFORE ME by David N. Katz on this
30`h day of May, .
Gxe
Notary blic in for the Stat 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, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA083569
Eagan, MN 55122 . Date Issued: 06/16/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1658 Mallard Dr
Lot: 6 Block: 2 Addition: Mallard Park 2nd
PID 10-47251-060-02
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Permit expired without required inspections. Letter sent 2/18/2009 CE
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Action Roofing & Siding LLC Thurston W Anderson
1315 Southview Boulevard 1658 Mallard Dr
S St Paul MN 55075 Eagan MN 55122
(651) 457-2642
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA088932
Eagan, MN 55122 . Date Issued: 04/28/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1658 Mallard Dr
Lot: 6 Block: 2 Addition: Mallard Park 2nd
PID 10-47251-060-02
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: huprovements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Home Depot At Home Services Thurston W Anderson
656 Mendelssohn Ave. N 1658 Mallard Dr
Golden Valley MN 55427 Eagan MN 55122
(763) 542-8826
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA097752
Date Issued: 01/18/2011
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 1658 Mallard Dr
Lot: 6 Block: 2 Addition: Mallard Park 2nd
PID: 10-47251-060-02
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Home Depot At Home Services Thurston W Anderson
656 Nlendelssolm Ave. N 1658 Mallard Dr
Golden Valley NIN 55427 Eagan MN 55122
(763) 42-8826
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA153359
Date Issued:12/13/2018
Permit Category:ePermit
Site Address: 1658 Mallard Dr
Lot:6 Block: 2 Addition: Mallard Park 2nd
PID:10-47251-02-060
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Thurston W Anderson
1658 Mallard Dr
Eagan MN 55122
(651) 357-2138
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA165132
Date Issued:10/19/2020
Permit Category:ePermit
Site Address: 1658 Mallard Dr
Lot:6 Block: 2 Addition: Mallard Park 2nd
PID:10-47251-02-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Thurston W Anderson
1658 Mallard Dr
Eagan MN 55122--255
(651) 357-2138
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature