3925 Mica TrCITY OF EAGAN Remarks * Cedar Grove Acr;uisition
Owner
Street
1.5 Bik 7 Parcel 10 16704 150 07
:a Trail State Ec-t9?, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK Z, 1 6'T 100. 00 .00 20 Paid
SEWER LATERAL 196T 1.2 26. QA Paid
WATERMAIN
* WATER LATERAL 1972 607.00 24.28 Zs
WATER AREA
STORM SEW TRK 1974 70.00 4.66 5
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC 200.00 452 10-25-67
PARK
CITY OF EAGAN I?R ??
3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121 12430
PHONE: 454-8100
BUILDING PERMIT Receipt #
Tobeusedtor 3-SEA PORCH Est.value $$.000 Date AUGUST 12 ,19 A-k
SiteAddress 3925 MICA TRAIL Erect ? Occupancy R3
Lot 15 Block 7 Sec/Sub. CEUAR GRUVI: STHfiemodel ? Zanin
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
¢ Name M. DOUGLAS PARI{ER Move Length 16
z SAr,?F Demolish ? Depth 1 d
o Address Int. Impr. ? Sq. Ft
City Phone Instatl ?
o Name N4RTHWESTERN BLDRS ApProvab Fees
?¢ ,4ddress 8053 L BLOOI?INGTON FRWY Assessment Permit $68. U
? BLMGT 884-8868 .oo
Ciry ?Phone Water & Sew. Surcharge
? ¢ Police Plan Review
? = Name Fire SAC
= n Address
u Eng. Water Conn.
i W City Pnone Planner Water Meter
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Council Road Unit
gldg.Off. Tr. Pl.
information is correct and agree to comply with all applicable State ot
Minnesota Statutes and City of Eagan Ordinances. APC PBfkS
?
Signature of Permittee Var. Date Copies
,,,--- Total $ 72 . 50
A Building Permit is issued to: ? NORTFf WESTF.RN BLD?S on the express conditlon mat
all work shall be done in accordance with atl applicable SSete of Minnesota Statutes and City of Eagan Ordinances.
Building Offic+al -
?
Permlt No. Pormil Holder Date Telephone q
Plumbing
M.V.A.C.
eianic
Sollener
InapeeHOn Dale Inap. Commenb
Footings I ?
Footings II
Foundalbn
Framing
NooHng
Hough Plbg.
pough Htg.
Inaul.
Fireplace
Pinel Hlg.
Final PI6g. -
Bldg. Final
Cert. Occ.
Dttk Flg.
Deck Frmg.
Weil
Pr. DISP.
EAGAN TOWNSHIP
L Road. ot
N° 14'76
Eagan Township
Town Hall
Date .5?..?
U
or
This pexmit does not aufhorise the use of streefs, roads, alleys ox sid`ewalks no`r does if give the owner or his agent
the rigStfo creafe anp sifuation which is a nuisance or which pxesents a hasard !o the healih, safely, convenience and
general welfare fo anyone in the communiYy.
THIS PERMIT MVST BE?11K?EP"T ON TQg,?E PREMISE WHILE THE WOAK I5 IN PROGAES?S. c/?Q
This is !o ceriify, Shaf._ts?,c.._.../.f-t...?._...has permission to erecf a._..!?:.'.?...?_?.?_?? ..Q.... ........_?."........_upon
the above dcscribed premise subjeci fo the provisions of the Building Ordinance for Eagan 'Rdwnship adopied April 11.
1555.
............. ..._....?4?!?'..(?-J__J..?1"!"-..._.,_------ Per .?.._'......__..
. Chairman of Tnwa Hoard . Building Inspecfor
6_ Q
LOCATION
/312? I"' x.),
8?9
C? 498?5 i? ?' o
ReQUesl Date /?- .
_{n ?
`j ire No. RouBh-In Inpsection Fequiretl
(YOU must call InaOedor when reeEy)
? Ves ? No InsO?ion Olher Tnan Raugn-In
? qeady Now ? Will NaVly Inspeclor
pale Reatl
I*censed contractor ? owner hereby request inspection of above electrical work al:
Job Aearess (StreeL Box ar Powe No.1 , n
? `V?.ll?. Ciry ?
Sec ion No. Townshlp Name or No. . Range No. Count? 011?_
Occu a t PRINTI ?? Phone
Li°5 a a-) s
Power Sopplier ? tlress
EI I Convac r ICOmpany ame) C ac $ LI n e
Maii m tltlre s iConVac!op? Owner Making Insta ation)
i?
Autho zetl Si .amre iCO v cto:lOwner M g I stallaLO
. t? PM1On um er
MINNESOTA STA4E BOAflD OF ELECTRICITY p. THIS WSPEGTION REOUEST WILL NOT
Gtlggs-MlEwey Bltlg. - Roam S413 V 8E ACGEPTED BY THE STATE BOAFD
1821 Univereity Ave.. SL Paul. MN 55100 UNLESS PqOPER MSPECTION FEE IS
Phone (612) 662-0800 ENCLOSED.
g,9/g,/ REQUEST FOR ELECTRICAL INSPECTION
, ? See insimctions lor compleling this Porm on back ot yellow copy.
?I 4 8 5 5 `'X" ENow Work Covered by This Request
EB-00001-08
dtl 4 7ypeofBuiltling AppliancesWired EquipmeniWired '
. Range Temporary Service
Water Heater Elactric Heafing
ding Dryer loaC Management
ndustrial Furnace Other (Specify)
Air Conditioner
oify) nlractor§ Femerk
Compute In specfian Fee 8elow.R?
# Other Fee # ServiceEntrance5ize Fee # Clrcuits/Feeders Fea
Swimming Pool 0 to 200 Amps D to Amps
Transformers Above 200 _ Amps 100 Amps
Si9n5 . Inspector§ Use Only: TOTA
' Irrigation Booms
+
Special lnspection ? v
AlarmlCommunication THIS INSTALLATION MAY BE O ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby R°°9n-m D.I.
certify that the above inspection has
6een made. F;nai
f oa?a q
OFFlCE USE ONLV
This request voia 18 monihs hom ?
CITY OF EAGAN
• 3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121Np 12430
PHONE: 454-8100
BUILDING PERMIT Receipta
Tobeusedlor 3-SEA PORCH EstValue $$,000 Date AUGUST 12 19 86
SiteAddress 3925 MICA TRAIL Erect ? Occupancy R3
Lot 15 Block 7 Sec/Sub. CEDAR GROVE STHRemodel ? 2oning
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
? rvame M. DOUGLAS PARKER Move Length 16
W Demolish ? Depth-d
o Address SAME Int Impr. ? Sq. F1
City Phone Install ?
a NORTHWESTERN BLDRS Aoorovals Fees
i o Name
$? Address $053 E BLOOMINGTON FRWY
, p;ty BLMGTNpnone 884-8868
w W Name
?
vo Address
a W Ciry Phane
1 hereby acknowledge that I have read this application and stale Ihat the
information is correct and agree to comply with all applic State
Minnesota Statutes and City of Ea an O?di ances.
Signature of Permittee
A Building Permit is issued to: NORTHW STE BLDR:
all work shall be done in accordance with all applica te of Minnesz
Building Official `
Assessment
Water & Sew.
Police
Fire _
Eng.
Planner
Council
Bldg. Off. 8/11/8 E
Var.
Permit 'l U Uo J V
Surcharge 4.00
Plan Review
SAC
Water Conn.
Water Meter
Foad Unit
Tr. PI.
Parks
Copies
TOt81 $7Z•50
on the express condition that
and City of Eagan Ordinances.
i • .. ? ?
1. .
-
? Perrnit#:
? Permit Fee:
I 2 I
? Date Received:O??;JO'OS ?
I ll? I
? Staff: I
I I
------------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I C7 Site Address: ? r`1 ? C Cn -l-f'0.1 ? '-?'" °?r?s??i? ? `??
Tenant: Suite #:
RESIDENT I OWNER Name: t d n..,,n 5 L.u cti .-\ Phone:
Address 1 City 1 Zip: 3 Iq 2 5 w? r o? -?-v-? I l
Applicant is: _ Owner -y-Contractor
TYPE OF WORK Description of work: r3 c.-1-? ?n a w-. i wj +° C 4 f' G r r 4< k?y, ) f
-Zr
Construclion Cost ro(9 r) , o(J Multi-Family Building: (Yes No ?
?-
CONTRACTOR Name: r P P r P_o License #: .?? ?? l? S- I 3
Address: l?;z
Qn..n
,
City: l,-J p,5 4-r-c- State: N?u?_ Zip:
Phone: &.1 2- 74 D - fo 1?2 Contact Person: (,p h 4 rn. v? 55
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 monttis, 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 Piumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
-
.and supporting. documenEs tHaf ydn submit'are°consideced to be public informa'ion[ Portions of =
NOTE: Plans
,
-_the information may be classifieal as non-public rf yourprovide specrfrc reasons t?iaf wpuldQertttit the=Ci#y fo
_ conclude that the ?'are,tratle>s`screts.?:
I hereby acknowledge tha[ 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 permd; that the work wiil be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x?oip in, rwlC7 V+'5.,?,?.5 ?Y\, r? /?/?
ApplicanYs Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
' SUB TYPES
? Foundation ? OS-plez ? 76-plex ? Accessory 8uilding ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3-season) , ? Ext. Alt. - Multi
? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multf Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building*
? Addition ? Move Building ? Reroof ? Demolish Interior
X Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? EgressNVindow ? WaterDamage
' Demolition (entire building) - give PCA handout to applicant
DESCRIPTION
Valuation 3000 Occupancy Re -2 MCES System -
Plan Review 44&- Code Edition SAC Units -
(25%_ 100%)k-) Zoning CityWater -
Census Code 613y Stories ? Booster Pump -
# of Units ~ Square Feet " PRV ?
# of Buildings Length ? Fire Sprinkters
Type of Const. Width -?
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addition)
? Foundation
Drain Tile
? Roof: Ice & Water Final
? Framing
Fireplace:_R.I. _AirTest _Final
? Insulation ?
Reviewed By:
Sheetrock
Final/C.O.
? Final/No C.O.
? HVAC
Other:
Pool: _Footings AirlGas Tests _Finai
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
/ 30OL
Page 2 of 3
411? Clty of Eapn
17 ? FO?+O?ce1115"e', - /--- ?I
/\(?-
? Permd#* v? 4 I
I Permit Fee: ?
I .
? Date Received ?
I ?
I ?
I Staff: ?
L_----____- ---_
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:a(?r r-4 Jf6 Site Address:
Tenant:
Suite #:
RESIDENT/OWNER Name: Phone:
AddresslCitylZip: 3qd-5 Mil(-R +f l
CONTRACTOR Name: License#:;?75
Address:
City: State: /Ik,- Zip:?S3
?
Q
Phone: ConiactPerson: IJAf'ti!')
TYPE OF WORK _ New Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater _ Water Softener
Lawn Irrigation Add Plumbing Fiutures
? RPZ /_ PVB) (_ Main _ Lower Level)
_ Septic System _ Water Turnaround (? ?1
New
=
Abandonment
RESIDENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
"WaterTurnaround (add $136.00 if a 518" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
1 here6y acknowiedge that this information is complete and accurate; that the work wifl be in conformartce with tne ortlmances ano coaes or me Ciry oi
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 Ihe approved plan in the case of work which requires a review and approval of plans.
X sl 5A-? x u
Applicanfs Printed ame ApplicanYs ggnature
FOR OFFICE`USE " ` Reviewed By: Dafe ?
k '
?
.
`
Required I,nspections: ' Under Ground` Rqugh In _Air Test;; Gas Tesf t? Final
. ?...
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWdton Reuuirements
• 3 regislered site surveys showing sq. ft. of lot, sq. ft, oF house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set W Energy Calculations
. 3 copies of 7ree Preservation Plan i( lot platted aker 7l1193
• Rim Joisl DeNail Opbons selection sheet (hldgs with 3 or less unifs)
DATE _2_?B ` 02--
51TE ADDRESS
TYPE OF
RemaJeURensir Reouiremenis 1 '?? (u . D L?
• 2 copies af plan
• 7 set of Energy Calculatians for healed additions
• 1 site survey for ezterior additions & decks
. lodicate it home served by septic system for addifions
VALUATION ? S ?09 " `°
c- MULTI-FAMILY BLDG Y ?N
V'2S\ F REPLACE(S)?)<'0 _ 1_ 2
APPLICANT Catastronhe Rectoration SPrvirec Inr
STREETADDRESS 94$9 Rice St Suita 70 CITY R0,ai?je STATE__?MZIP 55113
TELEPHONE # 651-734-9433- CELL PHONE #
FAX # r4si-463-0=19
PROPERTYOWNER TELEPHONE# L?S?' Q5? sb2?
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSO"1'A RUI.LS 7670 CATEGOHY 1 MINNESOTA RULN:S 7672
(4 su6mission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
Phone #
Phone #
l+ee: $90.00
ree: $70.00
'i
ALIG 9 : ;?? ;
I hereby acknowledge that I have read this application, state that the information is
with all applicable State of Minnesota Statutes and City of E°pan Ordi nces. , j
Signature of
orFzcE usE orri
Water Softener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
_ Air Conditioning
_ Heat Recovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
I
? Ot Foundation ? 07 05-plex O 13 16-plex ? 20 Pool li ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage I
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous '
? 31 New ? 35 Int Improvement ? 38 Demofish (Interiar) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundatio I ) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout t I applicant
Valuation Occupancy MC/ES System
Census Code Zoning City W ater
SAC Units Stories Booste ?r Pump
Nbr. of Units Sq. Ft. PRV I
i
Nbr. of Bldgs Length Fire S prinklered
Type of Const W idth '
I
REQUIRED INSPECTIONS I
II
_ Footings (new bldg) FinallC.O.
_ Footings (deck) _ FinaUNo C.O. ?
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water Final Pool
Ftgs
Au/ Gas Tests Final
_ Framnig _ _
_ _
_
Siding Stucco St one _
_ Fueplace _ R.I. _ Air Test _ Final Windows (new/replacement) ?
_ Insulation _
_ Retaining Wall
APProved BY II Buildin9 InsPector
,
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
CITY USE ONLY
PER'vIIT #: RECEIPT DATE: ? O
MIDENTiAL MECHi4RICAL PEftMIT APPI1CATION
crrY oF ewswri
3950 fILOT KAOB RD
$asnp Mu ssisa
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: I U I?-?-- I 0 1
SITE ADDRESS: 2?? ?-
OWNER NAME: TELEPHONE #: (495
(AREA CODE)
INSTALLER NAME: ?C)?? ?'?1L v? TELEPHONE #: (oSI -,322-8,q'Z.(,
(AREA CODE)
STREET ADDRESS:,4.sa-s
CITY:
STATE: M/?j ZIP: ?SG?9Qi'Uy?x?
Plate a check mark nest to the ePrmif wnru tvne
_ New residential dwelling unit under constructionand not owner/occupied $ 70.00
_ Add-on, modification or alteration to exlstina dwelling unit
` • furnace replacement
Trex an
• air conditioner
• other
Nature of work: ? 50.00
,
State Surchar e $ 50
Total $ "q-j c5d
Reniiuder: Ca!! for inspections.
5-?- (Ai • , _?_
SIGNA r F PER'vIITTEE
UpdateA 1/0 1
PERMIT #: _
APPROVED BY:
CtTY USE ONLY
RECEIPT DATE:
I
INSPECTOR
COMMEitCIAL MECHANIClkI. PEfiMIT APPLICATION
CCCY OF E4&AN
S$SO PILOT KNOB EiD
EAs", aalv 55 i Qs
651-681-4675 '
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #t: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TEtiANT IN THIS SPACE? Y N. Iv'AME:
INSTALLER:
ADDRESS: PHONE #:
(ARF.A CODE) li
CITY: STATE: Z1P:
WORK TYPE: New consuuction Instal] U.G. Tank
_ Interior Improvement _ Remove U.G. Tanl:
_ Processed Piping
SpecifyNature of Work
Wheir instal[ing/removing undergrouiid tank, call 651-681-4675 for inspectiaie by Fire MarsJm/ aerd
Pluixbing Iinspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minunum fee
Contract price: $ x 1%_$ (Base Fee) ?
State surcharge calculate at $.50 for each S 1,000 Base Fee
TOTAL $ !
SIGNATURE OF PERb11TTEE
Updated I/01
7986 BOILDING PERMIT APPLICATION - CITY OF EAGAN
NDTE: ALL COBTRACPOHS MOST BE LICfiASEA NIT$ THS CITY OF BAGAN
SINGLS F9lffLY DflEI.LIIPG3
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE Dii6LLINGS - HLSIDfiNT2AL
ZNCLUDE 2 SETS OF PLANS, CEH
1 SET OF ENERGY CALCULATIONS
COMAIERCI9L
R6NTAL [INITS FOH SALS QtiITS
OF SIIRVEY - CBECg iiITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCAITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: ? 0r91 ? Valuation:
Site Address t
Lot ?-s Block ?
Parcel/Sub
Owner r, CbL)eLAA
-f---
Address ;3QZ S' I.e(.1?. 'T1ZAi L
City/2ip Code
Phone
Contractor LaDa?UyJ . I 1522,5
Address A2r.3 ;E
City/ZiP Cade ??
ftpomt.il i II&3 tti.
Phone A04-f??&Pj
Areh./Engr. l.?d,I,ME
?
Address :5,d„ytt&
City/Zip Code
Phone !i
G
r
A:X,) ` Date: $'"S-"CS ?.
OFFICB QSS ONLY
Erect _ Occupancy ?
Hemodel Zoning
Repair Type of Const
Addition ? # of Stories
Move Length ?
-
Demolish Depth
Int.Impr. _ Sq Ft
Install
APPROVA[S FEFS
Assessments Permit ?
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Boad Unit
Bldg Off . .. ?Treatment P1
APC Parks
Variance Copies
TOTAL ?
1'e? -
?Gea-.lJ
NOTE: ADDfiESSBS FOR CORNEB LOTS - CONTRACTOR/$OMEOWNER MOST DESIGNATE WHICH ADDRESS
IS DESIHED. NO CHANGFS BILL BE ALLOHED ONCE BIIILDING PERMIY IS ISSOED.
l?yn??/?= fSs?
RESIDENTIAL BUMDING
(o I '"?? ? Permit Application
City, Of Eagao
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
S t11+o6
?' - 19_03
Nevr ConsWction Reauiremenls RemodeUReoair Reavirements Oifxe Use OnN
3 regislered site surveys showing sq. ft of bt sq. fL of house; and all roofed areas 2 apies of plan Cert of Survey Recd _ Y_ N
(20% maximum bt coverage allowed) 1 sel of Energy Calculations for heated additions Tree Pres Plan ReW Y N
2 copies of plan showing beam & window sizes; pou2d found desgn, etc. 1 site survey far additions 8 decks Tree Pres Reqd Y N
1 set of Eneigy Cakulafions Addi6'on - indicate ilonsde septlc system On-site Septic System _Y _ N
3 apies of Tree P2servation Plan'rf lol platted afler 7/1l93
Rim Jast Detail Oplions selection sheet (bldgs wiN 3 or less units 10 -V-\, 2 Q ?O 0. ?M A- J,. 1 40
Date ?/? Construction Cost r/T?tt,L/?
Sit Address ? ??'r? ? UniUSte #
ep( et ah R
! ?
Desttiption of Work ?40 f?ari na, l2e?/ !I'Qy qlckJy'
Multi-Family Bldg _ Y g N Fireplace(s) _ U _ 1 _ 2
PropertyOwner RU99L Ddvq padf-li°Y` Telephone#(6S) ) q>7
Contractar Qr4tM• lJV`-" 1
Address
State e ? Zip?? City 6*k'o Vt')AL-
Telep6one # (6?
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Categorv 1
• Residential Vantilatlon Category 1 Worksheet
(J su6missian type) Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code WoAcsheet
Submitted
?
??
?
Y N If ' 25% plan review
, ,
I??? ? 6 Z00? I
1J;
ephone # -
Sy-__- '
ephone #( ?
Telephone # ( J
I hereby apply for a Residential 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
approval ofplans.
Jetevvly 60bei
Applicant s Printed Name pplic Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 0 1 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch(screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Pibg_Yor_ N X 25 Miscellaneous
Work Types
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair
? 33 Alteratiun ? 37 Demoiish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement •Oemolitlon (Entire Bldg) - Give PCA handout to appliwnt
Valuation 5) oo n pccupancy ?z -3 MC/ES System
Census Code ?{3 ?f Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const 1f 0 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaVC.O.
_ Footings (deck) e FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundarion HVAC
_ Drain Tile pther
Roof _ Ice & Water _ Final _ Poo] _ Ftgs _ Air/Gas Tests _ Final
FIamu18 _ Siding Stucco Stone
_ Faeplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Rebining Wall
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other .
Total
_ 341
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - i
v
_ I For Office Use
Permit ' ✓ "J l/'
City of Eainga~ I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone:
I Resident/
Owner Address / City / Zip: //alz 2
Applicant is: Owner Contractor
Type of Work Description of work: 0 /
Construction Cost: Multi-Family Building: (Yes /No
Company: Contact:
Contractor Address: City: ~~Qi•~
State: 61 Zip: 55,o ~ Phone:
License #:C ! Lead Certificate ~7:VJ
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 g
conclude that they are trade secrets. s
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.gor)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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
ermit issuance.
days Pf
UCe r t r~5"ivt~ x
X -I
Applicant's Printed Name Ap ant's Signature
Page 1 of 3