1575 Clemson Dr BRESIDENT OWNER
NameS✓ S a r1 0 v n Q- r Phone: 6S'1 772-- 6 (3
Address City Zip: 15?S 8 C (2 rrts orl On 1 tr e.
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: J e C
Construction Cost: 6 01 O 0 0 Multi- Family Building: (Yes r4 No
CONTRACTOR
Named -Q-c -k i Do oR. Co F°Ke License J -7S
q 5, ,4 O O
Address: 6 l c IS/ ST iv
City: /Q P 0 1 e 10/4/ State: V I A i zip: S.S/ a l l
Phone: C 7-5 02 S$3 7 al Contact Person: Vet /1 I I 1 fee r
2../14. -�.ci Sl /1-1c1 it fe1 2. -9$ pr.� �J
COMPLETE
Energy Code
Category
(4 submission type)
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Submitted Submitted
Energy Envelope Calculations Submitted
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer Water Contractor:
Phone:
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.
4 CityofEaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
For Office Use
Permit*. C c (CJ
7
Permit Fee:
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION 41, co
Date: /7/09' Site Address: /575 6 C' Le- m so
IDr(ve- 621liat e-ii 6' p'e9
Tenant: Suite
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 pl
X Ssz.11 v
Applicant's Printed Name
Page 1 of 3
7 Ck Az,
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
Fireplace
Garage
Deck
Lower Level
(25 100%
Census Code
of Units
of Buildings
Type of Construction
Interior Improvement
Move Building
Fire Repair
Repair
V
REQUIRED INSPECTIONS
Footings (New Building)
X Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice Water Final
Framing
Fireplace: Rough In Air Test Final
Insulation
Meter Size:
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit Surcharge
Treatment Plant
Copies X 1 r
TOTAL
DO NOT WRITE BELOW THIS LINE
Porch (3- Season)
Porch (4- Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
Building Inspector
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
9(64
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
'Demolition of entire building give PCA handout to applicant
Sheetrock
Final 1 C.O. Required
?C Final 1 No C.O. Required
HVAC
Other:
Pool: Footings Air /Gas Tests Final
Siding: Stucco Lath Stone Lath Brick
Windows
Retaining Wall
Erosion Control
Page 2of3
X 93 TX.
/7 L /&ii YAW,
t}-& HN tNa +LUI1 i.J V i e"J d4idb43G
ti
0 Denotes Iron Monument
Denotes Wood Stake
XOOWA Denotes Existing Elevation
(000.0) tomes Proposed Elevation
Denotes Direction of Surface Drainage
V f B G
L 9.14. X 9961 T.0 X 9.64 Em
McCOMBS- KNUTSON ASSOCIATES, INC.
risamit0 mown woe sruvivas in twitted
+•+wra+aw w M TV tw wwva
934 5
4
l (9360) ‘A a
4. .1
Air
"x 4,9
740
t
Proposed Top of Foundation Elevation=
Proposed Garage Floor Elevation= .9 38.5
Proposed Lowest Floor Elevation= 939.0
Paul A. Johnso
Land Surveyor. Minn, Reg. No.10938
NU.'(+17 Vidd
BUILDING 41 ,e4-
0i7-2 el 19
7 1 C 1EaSaii DI,
itxia gErto tt.o
0)C
4r
1 hereby cordfy the etas is a true and correct representation of a survey of the boundaries of
Lots 37, 38, 39 and 40, Block 2, THOMAS LAKE REI(;HTS 2ND ADDYTION,
Dakota County, Minnesota
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land_ It also shows the location of the stakes as set for a proposed building. AS surveyed
by me or under my direct supervision this 2nd day of April 19 86
CERTIFICATE OF SURVEY
for
HORIZON HOMES
City of Eaaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ��Z5/7 Site Address: 6 p i er) DZ.
Tenant: J R_
A plicant's Sign ure
Use BLUE or BLACK Ink
Far Use
Permit (3/736/ 9'
Permit Fee:
Date Received:
Staff:
Suite
RESIDENT OWNER
TYPE OF WORK
CONTRACTOR
Name: 5 J& V 7•-k t ea—
Address City Zip: /6 75 5 C,L
Applicant is: `owner Contractor
Phone:
61 Z67 512
Description of work:
Construction Cost:
/1757 �l tis sE C cCQ tirV 6.e i 1 l S sr.
Multi Family Building: (Yes t'< No
Name: (Jt 5 c \-4 tN� License 5 (0
Address: Z7oo 1 i f 1 w 4v
City: !Le— State: /vjcr Zip: c5 J 3
Phone: (Q 7 (p 53 Pc--/Z Contact Person: g L'
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 classified as non public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 withoutrrnit; 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 /)197 '7 G-
Applicant's Printed Name
Page 1 of 3
CITY OF EAGAN WATER SERVICE PERMIT
3830 Picot Knob Road
P. O. Box 21199 PERMIT NO.•
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. , Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.•
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot ..Knob Road
P. J. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
, ..
i4(
.,..... ,
\
,„:,\,
j ........________________-_,----------
,
,,
i
\\ ____I_________=-----'
-,...... ,..;,
Use BLUE or BLACK Ink
i For Office Use
j Permit ~I ILD p
i a l i
My of Eapo 4 5~ • a
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 ~ Date Received:
Eagan ~4 Al
Phone: (851) 675-5675
I I
Fax: (651) 675-5694 1 Staff..
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 - site Address: is 1 ! 19, 131
Name: Yz- 4zn_~s____ Phone: (V-2- 72, - S a~
Resident/
"Owner Address / City / Zip:
Applicant is: _ Owner Contractor
Description of work:
Remo F n -
T Kleof Work
Construction Cor, `'?.l_& C5 Multi-Family Building: (Yes No
Company: C PJI'3 VC Contact: 2~f en
%_.1 1LJ
ContractOr Address: City: ~ ~IaRA~Jfc~.s
State: ML Zip: Phone: mac? ZS -
License SC - 210 6 2- 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 informatVon. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the Clty to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hairs
before you intend to dig to receive locates of underground utilities. www.uoohen3tate2ne0ll.or_Q
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.
xfr_ rn_a en x
Applicant's Printed Name Applica s Signature 49
Page 1 of 3
Use BLUE or BLACK Ink
4000, For Office Use
City ::ze:
of EaQali / 1'
3830 Pilot Knob Road -7—/c/-17'
Eagan MN 55122 ^"^,r ret- Date Received:
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
JUL 1 4 2017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7//a /7 Site Address: l C75 8 tte44-t c["' )' Unit#:
Name: /744,707*., //,�t,�$ /O 'we AJ5'e . Phone:
Resident(
owner Address/City/Zip:
Applicant is: Owner /( Contractor
pa.
Description of work:_ /0 1f �� J /te , ,;i
Type of lift* Construction Cost: 0 Multi-Family Building:(Yes )C /No )
Company: Ayr 7 Ice 2PL Contact: 8,W-- M F ft7y r
Address: /674X 6 )ler--t /-Ve-- City: flip"V? b`! t-t
CItrcr ; //
State:Oita Zip: 5'57J-if Phone:467-01-‘14 V Of Email:#.�tu.a19/r+�Y rtecriate lNws
License#: �(22-9ff.Z'Z Lead Certificate#: Itotr F I1)-014f
If the project is exempt from lead certification, please explain why:
A r� 7&
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:
Fire Suppression Contractor: Phone:
NOTE: x s s ar ; § a ,Sublnit ..?+z i s 3 a _t & 8 t 1 & s z
the
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.gooherstateonecall.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 '1-te Building Code st be completed within 180
days of permit issuance.
y�
xt lit. x r /... . LL'
Applicant's Printed Name Ap'icant s Signature r
Page 1 of 3
ts7c (b -.oson Qf
. DO NOT WRITE BELOW THIS LINE wlf �.c /
.
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family Garage — Porch(4-Season) — Exterior Alteration(Multi)
— Multi Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of_Plex Lower Level — Pool _ Accessory Building
WORK TYPES
New _ interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
)+1' Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION ,�¢
Valuation `P 3. cot). Occupancy ,,,,j�.5C -3 MCES System
Plan Review Code Edition A+7 Zojs SAC Units
(25%_100%0 ) Zoning t?P City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Z-�` Fire Suppression Required
Type of Construction VO Width /
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings(Addition) (Q Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool: Footings _Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: f O 011- ifil I I7/9 , Building Inspector
RESIDENTIAL FEES ,w, 41Base Fee / 3 . fl S9 •
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3