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601 Middle Lane.(,* . `- 0", I / d (grx#i#'tra#t of (Orru?auxy Citp of cagan Npatum of Nurld'utg itcs.pPrtirni ,r Tlrls Califuate asuMptasuant to the requis+encena oJSecdort 306 of !he Uniform 9uilding Code cem; fyrstg 1ha! at the time of {ssuaitcse this sbuciure mas in complianae with the various ordinances ojlhe Crty regulating building rnnsrnuxion or use- For the following. SF D,1G/GAR 1q221 [xe caLliricatioa Bag. ftrzaic No. O-V--Y rrK TVO ow= of euaa„ng Aee= Li, bl, / Ad&= Lo-ri 8/23/Q 1 , BumiDs oTidar? POST 1N A COr1SPICUWS PLACE pqw \.I 1 T Vr CAl7H1V 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDINCi ?JERMIT PHONE: 454-8100 Receipt # To be used.for sR ?/GAR Est. value =135,000 Date 1um 10 19 91 Site Address 601 M1DDL8 WIIiB Lat Block L Sec/Sub. ??R LM 3ND W Name °""'+D"1' ? rNunsRS aaa 3 Address 0 City n'Vil.L8 Phone 895"9855 ;? Name 'fOP VALUB NOl?S ; Address 2500 W CTY BD 42 ¢ 1- City D'Y1LLB Phone 894-6345 y. I hereby acknowlege that I have read fhis intormation is correct and agree to comp Minnesota Statutes and City of Eagan Ordir Signature of Permitee ? i and state that the applicable State of and 6uilding OffiCial OFFICE US E aNLY O R-3• N'i FEES ccupancy Zoning $-1 (Actual) Const V111- Bidg. Permit s S72.OD (Allowable) yu__ $urcharge 42.50 # ot stones 372.00 Lenglh 52_ Plan Review Depth *2._ SAC, City i?000 S.F. Total - 650.00 SAC, MCWCC S.F. Footprints _ 660•00 On Site Sewage _ Water Conn On Site well water Meter 95.00 MWCC System 4- 30.00 City Water ?_ Acct. Deposit 30•00 PRV Required ? SnN Permit Booster Pump - S1W Sutcharge • 50 Treatment PI 276•00 APPROVALS Road Unit 370L00 Planner - park Ded. Council BIdg.Oft. _ Copies V i 33,148.00 ar ance - TOTAL Permit No. Permit Hol der Date Telaphone # WATER SEWEii PLUMBING / f 9Q - po8 H.V.A.C. ELECTRIC 00 Mspsction Date insp. Comments Footings I Foundation Framing ? Roofing Rough PI6g. -? ? Y?/' 9 C CJ Hough Htg. Is,i. ?7 z.s P . .-40 c«c%- - u 1-1 / Freplace Final Htg. _ -e Z?, f Orstat Test Final Plbg. Plbg. Inspeclor - Notify Plumber Const. Meter Engr./Plan sldg. Final Ds Dedc Ftg. Dedc Final Well Pr. Disp. ?S . SEWER 8r WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE _ r3UNF. ic, 1991 QFFICE USE ONLY MEIER # ??uV6 $ 7? PERMIT DATE ??10/41 CHIP # 0161 PERMIT # 12137 METER SIZE p'? uS B.P. RECEIPT # 2j ISSUE DATE ?? - B.P. RECEIPT DATE 5/ 13/91 _ PRV _ BOOSTER PUMP SITE ADDRESS 601 '' ,`%"I.E I.ANR LOT I BLOCK 1 SEC/SUB "ANOg LAI(F 3F'.D APPLICANT:`! ADDRESS: _ t CITY, STATE _ ZIP " PHONE: PLUMBER: hl::nER1IOTT PLB^ ADDRESS: 12350 RI'll"R 101`)G?? 3LVo CITY, STATE B' V1L1,E ZIP PHONE: R n-90,34 OWNER: TOP VALUE HOMES ADDRESS: 2500 W:;Tl' RD 42 CITY, STATE B' V1LLE ZIP 55337 PHONE: 994-6345 PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SEWER PERMITS, CONTACT ENGINEERING DEPT. PERMIT REQUESTEO Y' SEWER Y WATER - TAPS _ COMMrIND Y RESIDENTIAL x NEW - EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL. NOT be given for Deduct Meters. I AqJ14E TO COMPLY WITHf? ITY O'F f?AGAdJ ORDINANCES / / ? SIGNATURE WHEN-METER ISSUED CALL 454-5220 FOR INSPECTIONS. FOR STORM l-` SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knotr Rd. Eagan, MIy55122-1897 DATE JUNB lil, 1991 SITE ADDRESS 501 FlIDDLE [.ANE LOT I BLOCK 1 SECiSUB r+ANO APPLICANT: , ADDRESS:_ CITY, STATE PHONE: - PERMIT REQUESTED X SEWER `WATER - TAPS - COMM/IND Y RESIDENTIAL , x NEW PLUMBER: MCpERMOTT gLBG ADDRESS: 12350 RlYr:F R1JGE BLY" CITY, STATE aI??E ZIP 55337 ? PHONE: OWNER: TOp vALiIE HOMES ADDRESS: 254(? W L'TY RD 42 CITY, STATE R' V].LI.E Zip 55337 894-6345 PHONE: OFFICE USE ONLY METER # PERMIT DATE CHIP # PERMIT # 12137 ZE R S RECEIPT # P B I METE . _ ISSUE DATE B.P. RECEIPT DATE 6/ 13 /`• 1 K y; - PRV _ BOOSTER PUMP EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. l -r I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANCES SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWU WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. INSPECTIDN RECORD CITY OF EAGAM PERAAIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 t=t? t t ?s ? r?r; SITE ADDRESS: , „ r t i ;.; I i liNl PERMIT SUBTYPE: .. vt> Ei I i I:: I'>11 f H L U?. t , APPLICANT: , I ct TYPE OF WORK: t4 1 1 ilFtt ! A I i t!r A i 1 (04 ? - RF MARIi S.. ';F.i'11R ATt P 1 11 Mfi 1 Nti & E lt 1; I!?:iCAt PF RM 1. Tf,' N I 4)li I pC'1.) • r -) b - - Permit No. PermR Hotder Date Telephone M SNV { PLUMBING Ff' / 9 ? HVAC ELECTRIC ?? 0 / 9 g?• ?a ? ELECTRI Inspectlon Date Insp. Comments Footings I Foundation Framing XiA? xzg Roofing Rough Plbg. i Rough Htg. Isul. Fireplace Final Hig. Orsat Test Fnal Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. ?E 7-D rnO +&X OOC TH-rS /S Deck Final 77,#6 1?600 At,& Well Pr. pisp. ? ? -c? -? Ff? ? 0 38552 Pequest Date F No. Rough-in Inspection Requiretl? gReatly Now ? Will Notify InspBCror '?Yes p No aeady? When IX licensed contractor D owner hereby request inspection oF above electrical work at: Job Atltlress IStrees. B. or Route No ? 6 0/ M.e Lqn?e pry Fa9as'/ Seclion No. Township Name or No. Range No. Counry G ? ?Q ?? R Occupam (PRINTI To ?r,? o r+ eS Phpne No. - 3fS Power Suppiie^r / 4 J/ Atltlress , C o + PC? c? r i , ?J ElecVical ConSr ctor ICOmpany Name) 1 17 e Comrector5 License No. 6 ?Z Meiling Atldrass IConVaCOr or Owner Making Inslallation? AWM1Onzed Siqnalure tCon ct wner Making In ' Oon) PM1One ?Nu/mber MINNESOTA STAE 80ARD OF EI.ECTHICITVi THIS INSPECTION REQUEST WILL NOT ? Grlggs-Mitlway Bltlg. - Room 5113 ?. 6E ACCEPTEO BV THE STATE 80AR? 1821 Oniverslty Ave., SI. Peul. MN 55104 UNLESS PFOPER WSPECTION FEE IS Vhone (612) 643-0800 ENGLOSED. ?i'? .? I/ REQUESI?iH ELECTRICAL lNSPECTION ?/a ?'? / ? See mslmctions lor campleliny Ihis forrn on back oi yellow mpy. Q'.? R 5 52 "X" Below Work Covered by This Request TM ?i? EB-O O ODI -a8 I ?;?•?z,.: /? I" /? C Q/ /? `W?o? ?4;ia4yy , ew Add Rep. ?? TypeafBUilding AppliancesWired EquipmenlWirad Home Fange Temporary Service Duplez Water Heater Electric Heating Apt Building Dryer Other (Specify) Comm./Industrial Fumace Farm Air Conditioner Omer Isyecity7 Contrecmr's Remarks'. Compute lnspec?ion Fee 8efow: u Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 2BB-Amps / ? /,S? J 0 to 100 Am s p ? p Transformers Above 200 _ Amps Above 100 _ Amps SiqnS InspectorsUSeOnry. TOTAL Irrigation Booms Special Inspection AlarmlCommunication THIS INSTALLATION MAY BE ORDEflED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, ihe Electrical Inspector, hereby Rooqn-,n ( Oale N??Q certify that the above inspection has been made. Fi11e1 r oaie l OFFICE I15E ONW Tnes request mic 18 monIDS trom Rep ast DaL. ? Fire Rough-in In eclion fieQUhetl? ? Reatly Now III NoNry lnspeetar R ? ?t] L l? \ s ? No en eatly I? licensed contrector 0%,owner hereby request inspection of above electrical work at: Job Aatlress (SVeeG Box or Route No ) Ciry `E: 6 G Secnon No. Townsni0 Name or N0. Pange No. Counry --S)fa? lto V Occupant(PRINT? ri, ) C_- HPt?. ? t{ ??. ?+v Phone No. a i- -? c'D Power Suppfrer ? I?E c R Atltlress 'Pr 2vn (3 `Tr? I\j Eledrical Conlra ?Company Name) Conlracto?5 License No. e__. Mai?ing Atltlress 10OnGaotw w Owner Meking lnstaiiation) Aulhor' S'i oeWre Convan?er ?k' g Ins?allatlo? PM1one Number ? _a MINNESOTA STATE ByARD OF ELECTpIpTY THIS INSPECTION REOUEST WILL NOT Griggs-Nidway Bltlg. - Poom 5193 M?` c 6E ACCEPTEE) 6Y TNE STATE BOARD 1821 Universlty Ave., SI. Paul. MN 551p0 ?f• • J1,? J? UNLESS PROPER INSPECTION FEE IS Phane (613) 642-0800 ? ?' ENClOSEO. REQUEST FOR ELECTRICAL INSPECTION 8-0h0001-08 p b? p ? See inslmclions !or complelinq Uis lorm on beck of yellow copy. . ?I??d fjs L? j? O 3 2 "X'-'BsroW`Work Covered by This Request ew AtlA Rep. TypeofBUilding AppliancesWiretl EquipmenlWirad Home Range Temporary Service Duplez Water Heater Electric Heating Apt. Building Dryer Other--(Speciy) Comm./Industrial Fumace Farm Air Conditioner Other (specHy) ConVactor's Remarks'. . Compute lnspection Fee Below: # Dther Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 - Amps Above 100 _ Amps Siqf15 Inspecmis Use Only. T AL C Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDEBED DISCONNECTED IF NOT Other Fee COMPLETED WtTHIN 78 M .. S. ? I, the Electrical Inspector, hereby Rouyn-m ?- ,. ??? ly . ' ,+ _ ? , ? f M o? ,?' ! certity that ihe above inspection has 6een made. ?f9' OFFICE USE ?NLY TM1is reQUest void 18 mant?s imm 6 ? 7?1 ?7 ov 06 47 C? 0 ReOUest Date ? Fire Rovghdn In ection Requiretl (YOU mu9 II inspedou wlren ready) Inspecllon Other Than Ougbdn 11 Reatly NOw Will Notity InaOeqor Ves - ? N. paleflead I p licensed contractor 92(owner hereby request inspection of above electrical work at: Job Atltlress (Sfreel. Box or ROU ? City Section No. Township Name or No. Range No. County Oc ant(PRINT) Phone No. ?.r e. Power $uOPller . Atltlress Elearical ont clm ?GOmpany Name, ConVeciwS License No. 0 ???.1! /I vf Miuling Atldre I ontramr or pwner Making Installation) f.. Authorize0 ig ture ICOnhaoto ner Ma¢ing stallelion, Ppone Number MINNESOTA STATE Bl OF ELECTirCITY J THI$ INSPECTION REOUEST WILL NOT Griggs-Mitlway Bltlg. - Room 5193 K• ?r BE ACCEPTEO BV THE STATE BOARD 1821 Univorcl[y Ave., SL Peul, MN 55104 C15 UNLESS PROPER INSPECTION FEE IS Vhone (612) 602-O800 ?? , ENCLOSED. 4 yZ ov 647„Q6 REQUEST FOR ELECTRICAL INSPECTION ? See inslructions lor completing this form on ba<k o1 yNlow copy. 'X+Below Work Covered by This Request Ea-ODDo,.oa e Ad Re„.. TypeoBUilding AppliancesWired EquipmentWiretl , Home Range Temporery Service Duplex Water Heatei Electric Heating Apt. Building Dryer Load Menagement I l Comm./Induslrial Furnace Other (Specify) Farm Air Conditioner OlhersVecify) ConVactor5 Remarks: /JcM N?..? %1rS Compute Inspection Fee 8elaw: . M Other Fee # Service Entrance5ize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Afips Transformers A6ove 200 _ Amps Above-100 Amps Signs inspea«'s use onry: GJ f 7pL ? Irrigation Booms / • Zv D Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDEF?ED DISCONNECTED IF NOT Other Fee COMPLETED WITFiIN 18NTXS. I, the Electrical Inspecror, hereby certify that the above inspection has been made. Rough-in F;?ai ^ oaie ? X '-v o ? ? OFFICE USE ONLY . This mquesl voi0 18 months Irom ;;1 CITY OF EAGAN Np 19221 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55127 BUILDING PERMIT PHONE:454-8100 Receipt # l? 39/? ?ZC)G7 TobeusedOr SF DWG/GAR EscValue $85'000 Date JUNE 10 19 91 Site Address 601 MIDDLE LANE Lot 1- 81ock 1 Sec/Sub. MANOR LAKE 3RD ParCel N0. Occupancy w Name MIDDLEMIST PROPERTIES Zoning (pqual) COnst ? AddfESS (Allpwable) ° CitY B'VILLE phone 895-9855 xoistories lenqih o Name TOP VALUE HOMES DePth ?a Address 2500 W CTF RD 42 S.F.iotal ? City B' VILLE phone 894-6345 S.F. Footprints On Site Sewage F W w Name on sae weu w ? AddreSS MWCC System 2 a W City Phone ciry waier PRV Required I hereby acknowlege that I have read this application and state that the Boosler Pump iniormation is correct and agree to comply with a11 applicable State ol Minnesota Statu[es and City of E inances. SignaWre of Permitee ? APPROVALS TOP VALUE HOMES A Building Pefmit is issued to: Plenner on the express condition that all work shall be done in accorCance with all Cancil applicable State of Minnnesota taWtes and City E gdn?/eQ inances. a gl?, pp, ? ? Building ONicial i? i? Variance ? OFFICE USE ONLY R-3, M-1 R-1 FEES 572.00 42.50 VI1 Bldg. Permit ViL_ 52 49 XX $X_ X7L Surcharge Plan Review snc. cny SAC,MCWCC Water Conn Water Meter Acct. Deposit S/W Permit SNJ SurCharge Tieatmem PI Road Unil Park Ded. Copies TOTAL 372.00 100.00 650.00 660.00 95.00 30.00 30.00 .50 276.00 370.00 $3,198.00 5-ce -) ?? 0 RESIDENTIAL BUILDING 12_43.2S Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New ConsWdion Reauirements RemodeUReoairReauirements Olfice Use OnN 3 registered site surveys showing sq, ry, of IoL sq. ft of house; and all roofed areas 2 copies af plan Cert W Survey Recd (20% mazimum lot cover$qe allowetl) 1 set of Eireryy CalcuWtions for heated additions _ Tree Pres Plan Reod 2 copies of plan showiig beam & window sizes; poured found desgn, etc. t site survey for additions 8 decks _ Tree Pres Nat Reqd 1 set ol Energy Caiculalbns Addifion - indirate if onsite sepfk system _ On-site SepGC System 3 wpies of Tree Preservation Plan 'rf lol platted after 711193 Rim Joist Detail Options selection sheet (bidgs with 3 or less uni45 Date LG /I l / c7 3 Coostruction Cast FJL 4CXl.?V? Site Address l j)D 1 M t Ci C[ IP_ ? n a UniUSte # Description of Work -T / r --? i` a? ?' Multi-Faroily Bldg _ Y_ N (?0_ 1 _ 2 Firg?fl e / ? Property Owner i I I ?\;-» 2.g /11'elephone #( ) LD ?'C 1 ?}q ?=1 ln Contractor 1'1 x Address 'g q e1 f; t>>?.??a?? ? S,y1 /? City lN-l fl c'a C? ? Vj TV State Mfl , ef Zi? ?if f? 1 "1 Telephone #( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Catesoro 1 _ Minnesota Rules 7672 . Residential Ven0lation Category 1 Waksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculatlons Su6mitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and aclmowledge 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 oniy 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. ?h 2.rrc? ??-tlk_ i Applicant's Printed Name ApplicanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? OS 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_v or _ N ? 25 Miscellaneous Work Types ? 30 Accessory Bldg ? 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) ? 45 Fire Repair ? 33 Alteration p 37 Demolish (Bldg)' O 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolitian (Entire BIdg) - Give PCA handout to aoplicant _ Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIREDINSPECTIONS _ Footings (new bldg) FinaVC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) plumbing _ Foundation HVAC _ Drain Tile Other Roof - Ice & Water _ Final Pool Ftgs Air/Gas Tests Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ _ Fiaal Windows (new/replacement) _ Insulation _ Rataining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit 8 Surcharge Treatment Plant License Search Copies Other Total , Building Inspector , CITY OF EAGAN k 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 51TE ADDRESS: PERMIT ae< PERMIT TYPE: Permit Number: Date Issued: 601 MIDDLE LANE LpT: 1 BLOCK: 1 MANOR LAKE 3RD P.I.N.: 10-47277-010-01 DESCRIPTION: nj' Permit Type ng`'3t'o,?k Type ! : ? ? r-??? i? y _ BASEMENT FINISH ALTERATION /'V ,S _5 2a5-9-5 BUILDING 021795 08/19/93 ? ?UI REMARKS: SEPARATE PLUMBING & ELECTRICAL PERMZTS REQUTREO FEE SUMMARY: Base Fee $35.00 Surcharge . $.50 Total Fee $35.50 CONTRACTOR: OWNER: - Appzicant KLEIN MICHAEL 601 MIDOLE LANE EAGAN MN (612)221-2407 I I hereby 8cknaw2sdg,e tltat r Y+a+.+e reracF th1% 8ppliaatioh and sCate that the ? SnFormatiort is carrect and aqree tp cvmRZY vith ail app3icabke S'tate uf Mn. Statutes and Cfty nf Eagan Ordinaness.' ?. . _. ? APP A/PERMITEE SIGNATUIiE ISSUED SIGNATURE REACTIVAJE PERIIiIT dt -:) 17%s cIrY oF EAcaN 1993 BUILDING PERMIT APPLICATION 681-0675 Llb-&a t1? SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, RECEQV °: calcs. COMMERCIAL 2 sets of architectural 8 structural plans, 1 s0t9fl p 4993 specifications, 1 copy of energy calcs. Penalty appTies: 1) when permit is typed, but not picked up by last working day of month- in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work Site Address: 6C, WAa?c LGAe STREET SUITE / Tenant Name: (commercial only) IAT ? BIACK ? FSUBD. R?Gnu; ?c!,ke ?j P•I•D. N 10 y12l -1 GIC t-? escri tion of work: The applicant is: Ly Owner 0 Contractor ? Other (Deecribe) Name K.l eiA c?ae l Phone H')z"HO-7 -('4) Property L•Sr FIRST -I76I LwJ Owner qddress Lane STREET STE X City State Zip s5)23 ? Company SePhone Contractor Address su+"L us Fl?Ye License # Exp. City State ZiP Company N JA, Phone Architect/ Eng(neer Name- Registration # Address City State ZiP Sewer & water licensed plumber M1a. . Processing time for sewer & water permits is two days once area has been approved'. I hereby acknowledge that I have read this application and state that the information is f correct and agree to comply with all applicable State of Minnesota Statutes and City o ? Eagan Ordinances. 1? i ? z 5lgnature af Applicant: ?? .? - - w ? OFFICE USE ONLY BUILDiNG PERMT VPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. . O 07 4-Plex ? 12 Multi. Misc. ? 03 5f Addition ? OS B-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex O 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE 9 1 New O 33 Alterations ? 35 Tenant Finish 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. (Allowable) lst F1. sq. ft. UBC Occupancy -? 2nd fl. sq. ft. Zoning Sq. Ft. total B of Stories Footprint Sq. ft. Length On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REQUIRED INSPECTIONS ? Site ? Footing ?Framing ? Wallboard ?Final ? Draintile ?.16 Basement Finish ? 17 Swim Pool ? 18 Comn./Ind. 019 Cortun./Ind. Nisc. ? 20 Public Facility ? 21 Miscellaneous ? 31 Demolish MWCC System Lity Water PRY Required Booster Pump Fire Sprinkler Census Code SAC Code Assessments t 3` T v ? Insulation ? Fireplace Permit Fee 3S.00 vatwcrd,: S Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Totai: SAC % SAC Units 20OU/ING PERMIT APPLICATION ITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS 3F OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WEiEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MITST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT M[TST SHOW A LICENSED PLUMBER. 4--? JUN p fi RECO To Be Used For; 41ew' /4/ ?u*y?,0aluation -Q-? Site Address ? Lot ? Block ? JN ? Parcel/Sub Owner /rlIA? Address v /- ?°- City/Zip Code Phone ? Contractor Address _ '2??? City/Zip Code Phone Arch./Engr. Address /Tl'?-/ City/Zip Code ? Date: L-? -e? - (/' ?SDOJ r OFFICE USE ONLY Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S. R3 M-i R- I V- N V-N 52? 42' F. On site sewage_ On site well MWCC System ? City water / PRV ? Booster Pump _ APPROVALS Planner _ Council Bldg. Off. p?9( Variance s 4 FEES Bldg. Permit 572, Ao Surcharge 92,570 Plan Review 3 2 dp SAC, City 106100 SAC, MWCC SO, D d Water Conn. (0100,00 Water Meter $,VO Acct. Deposit , 30,0 O S/w Permit q0,0 S/W Surcharge ,.Sp Treatment P1. A96,00 Road Unit 7o,ou Park Ded. Trail Ded. Copies ` - SUBTOTAL Penalty Lot Change TOTAL ?c ftVvW"&CL Phone # ? " ??''??p agrees that all work shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. V?4 ?l.l AT10 N GArZA.&a ZzK?2 ? LAq I o X2-o ? zao _.r ??4 X!5= f p Z6 0 1-SsMr; .?.- y3x."Ar.= 860 '6 X ?-o = 1 b o ?OZO X 1q- ly2reU l57 FLOon- .QS?I = 1020 Z?C1 u: ? e???Z3%' t14 -2n14: 2 ea ax 113 0 x 5-3 = 5Cr 539 r, Y `t Ouu3,? 0!2 75, C?vv, I . , If'* ** 7177FntfrprizcUnve *. Mr,ndoia MriqhCs, MN 55120 ? 1,ANp 9URV EYOfrs• CI V Il ENGWEERS PIONEER ' _ , .. . ....._...._.. c.._-^ w Q.ng( S?PerS?C?i ,• LAfIOPLAYiNERS•L/??uO,u?acEan?i.??rr?':i.: (u1L' pp VJ1-1914 •k .? +f _--- To? ?.? L r? ? CetrificaYe o1 Survey for: l NOq1F( ?t/89°Z4 ?47 `? Ra?,o $b.d0 5° ? -- s? ?Q I ? 9R3.o ? I ? rn =4 Iso ? N V) Q I M .: 43?0 o MTi6.oI q M ptioeoSEP F?ovS? '^ IV I^ - °. ? N k I ga.o 9'6 v 6 GR(?, o- " 9 ID.6 IO.o ?? _ ? Ri.o ry 16.D ? $ a? o Ls o 93Ty o 0 f ?: 3 a M/DpG E ???? r , C.at'biN ENUiA4EEPiING Z`ir1.FT1 x 9uU.o ner?ntes Exisr`rn Flevc?liar? Prrav05FO f-lousE F1.fV.tr?a ? • oo.o Ue1?o1esPr-opm4d£leva1fan Lowes !oc>rE7evey inr? _°?1^ 16 -----"_° QPI70feSUrrYnJd?s? eiufili?ly lasemerif ropOf?'Block"El?valic?n -?---.- L7ei7o1es Dna'ind` FlorrJ'Direclion (arXx?P .`?la() Flevat/()rl _lc?/}a3, $> -r>c?rl d L?et7v??s ??b o Uenales Manu, ent Bear•+r)?s 5f?nwi? crre ass( ?? GL07"__1?8LOC'K?_.. . NI,?n?o,? LQKE 3Rt? .?pairidN COUnrTY, MINNESOTA 1 hereby certlfy that this survey, pIen Or rppOrt wa6 p?r/nparad bv me vr under my direct super?vls?lon 5nri ehg, I ym dvly Reyistcrc?J Land Su.veyor vmAr,. thn Iaws oi tN? Seare oi Mlnnesota. Onl:erl this.,-"A?.E7... daV Jf 7G(3L- A-P- 1'?-/-/a- 2 / n ? C/'?/O ?t? ?rl O?.O+ Fri EAT H. Sltti_H 1.5. REr3.?11? 14851 ??L.,.. :K ??- (l ENERGY CODE DESIGN BY ACCEPTABLE PRACTICE 'lb Determi n e O a t Q l i ance w i t h t h e M i n n e s o t a F h e r g y C o d e (Section 602 of the Sta6e Amended 1983 Model Energy Code) This form is cnly applicable to detached one-anci two-family dwellings. The requirements hereir are based cn Table No. 6-11 in lieu of the criteria specified in Sections 602.2.1, .2 and .3. Suilding Addre Contractor ar Buildi.nq Element "R" Values Area (sc7 ft) 8 of Ect. Walls Ceilings Design!2.e?eq'd 38 Walls (exberior) Design 2i •iv Req'd 20 i? Floors (over unheated spaoes) Design 2i,10Req'd 20 (w/o fdn) *Windows (in bldgs w/o Design Req'd 12 sliding glass door) (glass) *tVirdaas (in bldgs with a 1?2- DesignTl.l Req`d 10 sliding glass door) (glass) Fbundation Walls Design t J.2-Req'd 5(when i.nsulating full depth of foundatirn wall) Design Req'd 10 (when insulating only to frost depth and frootings extend below) Slab-cn-grade floors Designl.Z!? Req'd_(See Figure No. 3) **Doors (1-3/4" metal faced) Design745 Req'd 3 * All windows shall be double glazed ar have storm windows ** Oonventional doors other than metal require a storm door CERTIFTCP,TION I hereby certgY that I have ocnplebed the above inforniation and that it ornQlies with the Minnesota Statd F.nerav,Code_1 . Signature Date ",j0 ML?Y91 HCSD 3-89 OC/SM/6593 - - ' CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 9"MBpo"m PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST X ADD ON REPAIR OwNER NAME: Top Value Homes SITE ADDRESS: 601 Mi.ddle Lane LOT:I, BIACK -4- SUBD. Manor Lake 3rd INSTALLER: M3Dex'mott Plumbing InC. ADDRESS:12350 River RidRe Blvd FOR CITY IISE ONLY PERMIT # RECEIPT DATE: COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 .1 ? SHOWER 3.00 3 "' ? WATER CIASET 3.00 3''=°' ? BATH TUB 3.00 3 `ro ? LAVATORY 3.00 3, J° ? KITCHEN SINK 3.00 uu ? LAUNDRY TRAY 3.00 ? HOT TUB/SPA 3.00 ? WATER HEATER 3.00 t? ? FIAOR DRAIN 3.00 3 `YD GAS PIPING OUT. /. (MINIMIIM - 1) 3.00 -3 W ? ROUGH OPENINGS 1.50 77-7T _ OTHER WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL $ ST. SURCHARGE .50 TOTAL: $ ? PLEASE COMPLETE THI5 PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: IAT: BLOCK SUBD. INSTALLER: ADDRESS:- CI11': ZIP: PHONE #: FOR: CITY OF EAGAN FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: (SIGNATURE) CITY: Burnsville zrr: 55337 ' - CITY OF EAGAN ' 3830 PIIAT RNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 "9"NICA3? FOR CITY USE ONLY PERMIT # RECEIPT # DATE: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ? ADD ON _ REPAIR _ OWNER NAME: Top Value Homes SITE ADDRESS: 601 Middle8 Lane IAT:_t_ BLOCK SUBD. Manor Lake 3RD INSTALLER: HIcDermott Plumb3ng Inc, A?DRESS:12950 River Ridee Boulevard CITY: Aurnsville ZIP: 55337 PHONE #: 890-90814 FEES ADD-ON MINIMi)M $15.00 HVAC 0-100 M BTU 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $°?/I- STATE SURCHARGE: .50 TOTAL: i?' iP? i ?, ? SIGNATURE OF PERMITTEE ???k4EkGIALf?N11VSx?t?A7.';'. PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDU5TRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING i1NIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BIACK _ SUBD. INSTALLER: ADDRESS:_ CITY: ZIP: PHONE #: TOTAL: $ (SIGNATURE) FOR FEES 1$ OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT F3E. PROCESSED PIPING = $25.00 $25.00 MINIMLTM FEE. CONTRACT PRICE x 18 STATE SURCHARGE CITY OF EAGAN CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN MN 55122 PHONE: (612) 454-8100 PI.tI?6?NG„P FOR CITY USE ONLY PERMIT # RECEIPT #/0 ? 42S DATE: PLEASE COMPLETE UPPER PORTZON ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOB EACH UNIT. WORK DESCRIPTION NEW CONST _ ADD ON ? REPAIR _ OWNER NAME: l 1/dl4E1 lLLEI.,I SITE ADDRESS:?fl/ ?/,?J,tJLE 'Z/S ? LOT:? BIACK ? SUBD. ? . / INSTALLER: IvlrLc??R? C_4t ADDRESS :?o,7/ / ' ?,f4 Av,,,rr CITY: L' 1 ? GI J ZIP: `?i?`?? ? PHONZ #: SIGNATURE ---------- -------------- COMPLETE THE FOLLOWING: ------ N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 SHOWER 3.00 WATER CIASET 3.00 BATH TUB 3.00 LAVATORY 3.00 _ KITCHEN SINK 3.00 _ LAUNDRY TRAY 3.00 _ HOT TUB/SPA 3.00 _ WATER HEATER 3.00 _ FIAOR DRAIN 3.00 GAS PIPING OUT. _ (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 OTHER ? WATER SOFTENER 5.00 _ PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 SUBTOTAL ST. SURCHARGE ? .50 TOTAL: $IAL?: PLEASE COMPLETE TAIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND 'MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACN DWELLING UNIT. -----___________________________°--------_-__________-°---------- CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LQT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: YHONE #: FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL: (SIGNATURE) $ $ CITY OF EAGAN PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMFS AND CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNTT• NO. FTXTURES C SHOWER 3•00 WATER CLASET ? 3•00 BATH TUB 3.00 LAVATORY 3.00 KTTCHEN SINK 3•00 LAUNDRY TRAY ? 3.00 HOT TUB/SPA 3•00 WATER NEATER 3•00 FLOOR DRAIN 3•00 GAS PIPING OiTTL.ET • ?? - ? 3•00 ROUGH OPENINGS 1.50 WATER SOFTENER 5•00 PRIVATE DISP. • DakCry. lia 15.00 U.G. SPRINKLER • home under mnsi. 3.00 ALTERATIONS • w aascing 15.00 ? WATER TURN AROUND 15.00 STATE SURCHARGE .50 TOTAL: iS- s () SITE JD OWNER NAME: kIl Cppg- INSTALLER: ADDRESS: ?O ??II?OZ? L?/v? CTI'Y: STATE: ZIP CODE: PHONE #: (C0?2) ?S.'?' -XIC? ? ??4 ? ?'?6? SIGNATURE OF PERMITTEE 1993 PLUMBIIVG PERMIT (RESIDIINTIAL) CITY OF EAGAN 3830 PILOT KNUB RD EAGAN MN 55122 (612) 6814675 1993 PLUMBING PERMTf (COMII4.RCIAL) CITY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCLALlINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUP:.DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING Ui:,'T. _ NEW CONSTRUCfION ADD ON REPAIR WORK DESCRIPTION: CONT'RACf PRICE: $ FEE: i% OF COA"fRACT FEE. ST-ATE SURCHARGE E.50 FOR EACH $1,000 OF J'ERMrT FEE MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% STATE SURCHARGE TOTAL SI1'E ADDRESS: $ $ TENANT NA111E: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: PHONE #: STATE: ZIP CODE: FOR: CITY OF EAGAN APPLICANT 0??? I - 2005 RESIDENTIAL BUII,DING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConstruUion Reouirements RemodeVReoair Reauiremenis 3 registe2d sile suneys showing sq. ft. of lot sq, k. of house; and all roofed areas 2 cop'es of plan (20°h maximum lot coverage allowed) 1 setof Energy Calculations forheated addi6ons 2 copies of plan showing beam 8 window slzes; poured found design, etc. 1 site survey for addilions & decks 7 set of Energy Calalafions Addifion -indicate ilon-sife sepfic system 3 wpies of Tree Preservation Plan'rf bt platted after 711193 Rim Joist Defal Options seledion sheet (huldings with 3 or less units) ) C-D ? ?????•° I IQw„ C;r. omre use OnN d^? Cert ofSurveyRecd-. _Y,_N Tree.P2s Plan Recd, :? .. _Y _ N. Tree Pres Reqm2d _Y=N Onade Septic Systein ?. : _ Y_ N Date q l? JV? Construction Cost I 11 0 J1 ^ Site Address (9 a` ?4C]fl Yc ?Q?Q_ __ UniUSte k -k ? a A kS ? S Description of Work nn_ :[ 0 t,Ln c\ CAJ f 1 1 D? ?.LJ ! Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owoer W , 1, k Q y)-t -5a MQrj Telephooe #6S 1) (o 91'`1-l l V7 The Home Depot A.H.S. Inc. Contractor 3200 Cobb Galleria Pkwy. Address Atlanta, GA 30339 _ Cih' State 763-542-8826 zlephone # ( ) License 420268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted ' Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone # ( N If so, 25% plan review 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 vvithout-a permit; that the work will be in accordance with the approved pl in the case of work whi6h1re'quires;a ?evi ?a?d? ap7aln of plans. 12 2005 I plicant's Printed Name ApplicanYs Signature I 0 VI ` OFFICE USE ONLY Sub Types O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 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 (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex O 19 LowerLevel ? 24 Storm 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 5iding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish 8uilding' ? 43 Reroof ? 46 Windows/DOOrs ? 34 Replacement "Demolitlon (Entire Bldg) - Giva PCA handout to applicant , - Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump ' # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utiiity Connection Charge S&W Permit & Surcharge Treatment Piant License Search Copies Other Totai Buiiding Inspector Installed Siding and Windows LIMITED POWER OFATTORNEY CviJNTY 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 Serviccs, Inc., DBA Home Depot Installed Sa1_es loca+ed at 660 Mendetssohn Avenue North, Go:de^ Valley, M1V 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 attorney-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 municipality) a permit application, or any other instrument(s) which may be necessary arid 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 "IVork"). The powers conveyed to the Agent by this Limited Power`of tlttorriey are limited solely to the express powers delineated herein and appl_y solely to the Work. This Limi*ed Power of Attomey shall expire and automatically be revoked on the 21 st day of May, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the PrincipaPs death, disability, incapacity or incompetence. IN WI'I'NESS WHFREOF this Limited Power af A?±emey is e:>ecuted this 21 st day of May, 2003 . David N. Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. Notary P ic in for the State o eorgia A1y Commission Expires: January 21, 2006 3968I6.0 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 2007RESIDENTIAL BUILDING rERMiT arrLicaTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construdion Reouirements 3 registered site surveys shaxing sq. il of lot, sq. ft of house; and all roofed areas (20% marzimum lot coverage allowed) t Soils Report if proposed building is to be pWced on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. i set of Energy Calculalions 3 copies of Trce Preservation Plan if lot platted after 711/93 Rim Joist Defail Op6ons selec6on sheet (buildings with 3 or less unAS) ?136-0° Cac-c?- RemodeVReuair Reauirements ONice Use Onlv 2 copies of plan showing footings, beams, joisis Cert of Survey Rerd _ Y_ N 1 set of Energy Calculations for heated addifbns Soils Report _Y _ N tsitesurveyforadditions&decks T2ePresPlenReW _Y _N, AddRion - indicate if onsde sep6c system Tree Pres Required _ Y_ N On-site Septlc 5ystem _ Y_ N Minnegasco mechanical ven61a4on form 07,03 /?? 6 ?_ Plans are considered public information unless you state they are trade secret and the reason. Date 7 / 7i SiteAddress (.Q / 02 ol /1/?t?"•e Lc Construcfian Cost Z I'O . o c? .-Yv2 UniUSte # Description of Work ? I.e 'n2, Multi-Family Bldg ? Y _ N Fireplace(s) QV 0 r X 1 2 Property Owner t -? c?-t sf)&Ak5; Telephone # ((q(2 ) -`-'r-[q ' (01 4'3 Contractor R.Q vA"e, Address State ?? . ..a Zip ,51S-/2 ? `?? ` City W Du p"? q Telephone #(1oS( ) S?j 2' 7 3 Z{p COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Catesorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet ' • New Energy Code WoAcsheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( Telephone #( I herebv avply for a Residential BuildinQ Permit and acknowledQe that the information e; 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 pernut, but only an application for a pernut, and work is not to start without a permit; that tt)e work will be in accordance with the approved plan in the case of work which requires a review and approv f lans. p[? ?EQ?/ E D I?!'?--- ? JUL n r?nm D - ? LVV? Applic? s Printed Name ApplicanYs Signature DO NOT WRITE BELOW THIS LINE t Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF ? 04 02-plex ? 10 08-plex y 18 Deck ? 23 Porch(screen/gazebolpergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding /?r 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration O 37 Demolish Building• ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg) • G ive PCA handout to appliwnt D25CrIptlOf1: Water Damage _ Yes -0 Valuation b 0 Occupancy MCES System Plan Review _Y100% or _ 25% Code Edition Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Width • _ Footings (new bldg) ? Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation REQUIREDINSPECTIONS _ Sheetrock FinaUC.O. ? FinaUNo C.O. HVAC Other _ Pool Ftgs AirlGas Tests Final _ Siding _ Stucco Lath _ Stone Laffi _Brick _ Windows _ Retaining 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 0 6A,, t L 3 ? 0?9 ? .. . ** 4aHDSURVEYOrfS•CIV1lENGINEERS 14M6 FLANNCR9'LAnp.,cr.neF an(?n?iCCT? Ceriificate ot Survey fnr: ? /vS9704'47`?- A,y.ao o ? oi < `0 u 1?3 (°? /I v 0 ? 7,777 Ent,r,rp!izn C)rive Mendv(a Hciqhts, AqN 55120 (612) 681-1914 TP ??L a -E t-/oM E - 5 ( ? 9 ?.o ? I O M : O u, .. 43,0 ?iE.el D M • I ptioPvs&p m wev5? " ? ? ? N ?? -- q o I N zo.o f, . c G a T 19.o I ? 2L.o n ?n 9 I . ., sL ? va ..?. ?o a?.go 1 IS o `f' A o ?} ? ? A.?. . N89°Z?f? 47??? 4 y M?t?DG ? LQn/?? ,l P ?',? .. .? ... .''.?'.?<a'v » 9oU•o Denotes &is1m¢ Elevafia» PRvpos?'o Hous? ?? EV,4"0,%f • oo:o 0eno1esProf)n9En'Flevafioo LOWeS %vrE%vo i_no -----"-- penates Drrxlncr¢ciUfilily [asemenf 7?013 otr'Black'f/fvr?iion ?---? Dei7ales DrxrinC?¢P FlornYDireclion 6;'arr4 e S/crf) F./eVati01-7 _q,a.3, as o Derlofes ManutnPnt Q?arrn(?5 5howi7 vrE a55c?irr?? ?s Dfrrv?es o? ?.s??i6 ? LaT__1 B,LQCK Z__ , M.4/Vo,C LAxE 3,e1) AppIrinN _ COUNry? MlNNESOTA 1 herehy cerNfy that thiz survey, pl3rc or rP.port was preparud by ms or under my direct supervlslpn ynri eh3i I am dUly RpqistRrsd Lo,d Su.veya* undPr tFe laws of thp S[ate of Minoesata. Dn[erl 0his_-JF/4 day Vf ?7F?ny( A.0. 19_qj_ , / . 'f Z ,Cd? -^--f_--,=- . 15?4 RO car e. sixWN L.s. REr,. roo. 1eeW i 91(es, ar NORTH ?- -- 1 ? ?- 2007 RESIDEN'1'jAj, ]V?.'r CHAjvjCAL pERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-567$ Please oomplete for: single fhmily dtwllingr & townhomea/condon when peimits ace required fw eadi anit So- sd DaCe 31te t Unit # Pro=yO ? T elephone i! (??? ) .?f1S? ?.S?1S? Contreetor ? $treetAddrose J ? W+ aty State ZiP S??Z Tdephone# Boed#:_J J? E:pFres: The Appticant lv Owner ? Contrector Other Fire repair (replace 6araq! oat appllances, doUaork, etc,) .. T " $ 90 00 . his fee applies when exte?sive mechenfcal repaira ere made to a building. Add-m ot altereHan to exisqog dwellipg anlt ? funwze -?fflonel Replacement N $ 50.00 _ ew air exchanger alr condMloner heat pump _ otlher Stau 3nrcharge I II) .50 ? ? Total ? ? NOV g i herebW apPlY for a Reside?Gal MIcchanical Permit end acknowledge that tha infamatlon is complote and acc?trate; thet tle work will be in confammnce wtth the ordinaaces and codes of the City of Fsgan and wkh the Meclianical Codes; that t undeisland this is not a Permir, but oniy an application for a permi; and woAc is na to stazt withou[ n permi; that the work will be in aceordenee with tlhe ePProved plen in the ceae ofwork which requims a rev[ew and approval of plans. Ziffu 1<-Lr ff-W ArP%iw4arrID[C(1N81i1C appllcanr tgnan,re Fo411100 r Office Use GhV l C~ City of EatdR 1 Permit I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 staff: - - - - - - - - - - - - - - - - J 2009 RESIDENTIAL BUILDING PERMIT APPLICATION c>!~ Date: Site Address: ~~t~~ ~'Z L► ' Tenant: Suite RESIDENT / OWNER Name: Phone: Address/ City /Zip: &Q I t'l # MI-e- L/ 'r7&hl S_~~ Applicant is: Owner Contractor TYPE OF WORK Description of work: am`` a"j d r E" "qo Y Construction Cost: j 4jg d Multi-Family Building: (Yes / No CONTRACTOR Name: ?6+5 61V-e-9 4-140 ik, TWt/--License Address: 7 U9 - - 1)- % 60!3 , Ft City: Frh'V' 't" Ty✓ State: _ n-) Zip: .5-5-4-2 aJ t-Y Phone: pb7 1- 75- 7 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _~es _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 maybe classified as non-public if you provide specific reasons that would permit the City to conclude that the 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 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 {s CAL OWE Applicant's Printed Name kp7li Antfs ignature ~ 2009 Page 1 of 3 JUN 2 jAle'~ DO NOT WRITE BELOW THIS LINE t l~ 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* D( 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 (D~ ~D Occupancy -TA2 6 - MCES System Plan Review Code Edition ~Las7 SAC Units (25%_ 100%Z Zoning City Water Census Code A13~ Stories / Booster Pump # of Units Square Feet Hd? PRV # of Buildings Length A01,0i, Fire Sprinklers Type of Construction Width Z~` REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: ;0 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 Meter Size: Erosion Control RNpvn/ c&I-moL Reviewed By: aYYA Building Inspector RESIDENTIAL FEES 0,5 Y7 Base Fee 8oZ'y 3~, ~8 a= Surcharge 85 Plan Review 5 3y 3 2C MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ctcl ( c~ . LLL 247.2 Enterprisre Drive EER ~wn0SURVIEYOPM-CIVILENGMICE,RS fVlerrt{©te fiti91,t9. KIN 55120 iine 'P'ii"i~ t-AMGFLAM41ERS- t AMCPS PC AI c941TceTS {6 12) 68I-19 4 Cettificate of Survey #nr: 70P AL Ui~ f -~C~NI ~Y~ r NORTH • X89°Z~t 47 ~ cr` - V1 TIC0 l you s N N ~Y o - - 9: K. ~ P d' ~ Y n a ts_o 2L.c r U z ~ ~ 435 6 4f.-k ~ ( o M Q ~ ~3h.aa .3 yNr ~ .~r. Rk. ,P. LA-Al 11 • ~ ' ~ ~ ' ~ ~ ~ tr ~ ~ fix' . " / y l ` --900.o Denotes lkl, 7 E1e vah'On PRoPa rg I-Yvas 6 EUM rlQAl- O- l)enale-; Pr-opoe' £1evaf ion Lowes7l r Vevtl Yost cr 5+1 /b ;Denotes DitirOa e 'U1.1,1y [asprrren/ Toga of 'Block'1-/r, ation Dendes Dtvfi7cY `RotA'Direclion 0 Derioleg - Mono nt - ge<yre:n s sf)own pyre as..,;flrrt DFr~o b LOT &LOCK I COUMTY, MPV1Yr5oTA I hereby certify that this survey, dlsn or report was preparad by ms or under my direct supervision orid thin 1 am duly RePistgred Land Surveyor under the taws of the State of Minnesota. Dated this 6-" day of ( A.D} 19-~,L. r^ l r-)J:h 4 1 k( C111 B R015 -RT B- Sit[, f t L.S. Rfto. riq. 14$91 Ewa I l 200 I Permit City of Eap 6D r it l Pe m Fee I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I - Fax: (651) 675-5694 Staff: - - - - - - - - - - - - - - - - - J 2008 MECHANICAL PERMIT APPLICATION Date: CU Z, Site Address: 601 Middle Lane Tenant: Kathryn Jones Suite RESIDENT/OWNER Name: Kathryn Jones Phone: 612-805-1535 Address/City/Zip: 601 Middle lane Eagan 55123 CONTRACTOR Name: Ron' s Mechanical Inc License Address: 12010 Old Brick Yard Road City. Shakopee State: MN Zi 55379 Zip: Phone: 445-8585 Contact Person: Linda TYPE OF WORK New ✓Replacement Additional Alteration Demolition Description of work: k 71 PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement - Y 'Air Conditioner - Install Piping - Processed - Air Exchanger - Gas Exterior HVAC Unit HVAC units must be screened Heat Pump _ Under / Above ground Tank Install / _ Remove) _ Other " When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90-.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ ~.Gb TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) - If Permit Fee is less than $1,000, surcharge is $.50. Permit Fee If Permit Fee is > $1,000, surcharge Increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 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-Ertda _V_rra,e x QVX Applicant's Printed Name App cant's Signat re FOR OFFICE USE t ' Rtp/M~ l~~GtlOtls: ti7~~fAQ A~1 , 1. Yrt s'~'~~r1p h F T~.1w ,.tom 1111 For Of icc, Use City of EaEdIl i Permit 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: (2.-- j 0 ~ Site Address: (oU ~ Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: ,o CONTRACTOR Name: License Address: 7- City: State: ~ Zip: SGt v"? Phone: ~;L -3 Contact Person: TYPE OF WORK -4 New _Replacement Repair -Rebuild - Modify Space - Work in R.O.W. Descri tion of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation A Add Plumbing Fixtures RPZ PVB) (_Main k Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL 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) *Water Turnaround (add $165.00 if a 5/8" 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 $ 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. x1 C I x ` Applicant's Printed Name App icant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final I PERMIT City of Eagan Permit Type: Plumbing Eaaan, Permit Number: EA099631 Date Issued: 06/17/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 601 Middle Lane Lot: I Block: I Addition: Manor Lake 3rd PID: 10-47277-01-010 Use: Description: Sub Type: e - Water Heater & Water Softener Work Type: New Description: Water Heater & Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Oien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Valuation: 1,000.00 Surcharge-Fixed $5.00 9001.2195 Total: $».00 Contractor: - Applicant - Owner: Champion Plumbing William Jones 3670 Dodd Rd., =100 601 Middle Lane Eagan NIN 55123 Eagan NIN 55123 (651) 365-1340 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 Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature I I Use BLUE or BLACK Ink For Office Use W~ Permit City of Ea 5) y i Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 ( I I Fax: (651) 675-5694 I Staff: 7 I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION ~a VPN Date: 2 - Site Address: i Unit Name:. ~ Phone: 6u, SCVl- ILl RESIDENT / OWNER Address/City/Zip: 60t 1M;all~e ~2~►e `L~~~... AJ S Applicant is: Owner -IZContractor TYPE OF WORK Description of work: \us ~z lz~ i~•. y A- a- c, 1"Gb t Construction Cost: -7; Multi-Family Building: (Yes / No Company: Contact: V Is CONTRACTOR Address: City: L 4!g IJ,' ( \e State: fV,,_M Zip: C ~Z3~ 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 ore considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the a trade secrets. I CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-00 2 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. gopher tateonecal1.or 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 p rmit, 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 thje Minnesota State Building Code must be completed within 180 days of permit issuance. 2 X \ `~2►~ \ 1~~(~~ S X Applicant's Printed Name App i ants Signature Page 1 of 3 ~I DO NOT WRITE BELOW THIS LINE IDS-N 3 " SUB TYPES ~ 0 I 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 ~•„j 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 0 C~ t --2 Occupancy MCES System Plan Review Code Edition All IL,,,4 SAC Units F I I PE (25%-100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) 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 Lad Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings - Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review ,(]0~ MCES SAC City SAC C90; Utility Connection Charge I S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 POOL PERMIT - APPLICATION 'ISUBMITTAL REQUIREMENTS Address: 1 Cddle- ],"e- Applicant Name: Wl/J'0-4wl N GENE!3AL INFORMATION x o z ❑ ❑ Applicant name and contact information ❑ ❑ Property owner name ❑ ❑ Address of property ❑ ❑ North arrow, scale (1" = 30' or 40') ❑ ❑ Site Plan, drawn to scale showing location of house, pool, and other existing or proposed structures, including retaining walls and fe' ees. ❑ ❑ Location and name of all streets adjacent to, property ❑ ❑ Directional drainage arrows (existing and proposed) ELEVATIONS Existing ❑ House corners 0 ❑ Property corners ❑ fd ❑ If applicable, ground elevation at each end of retaining walls and at wall's greatest height Proposed ❑ ❑ Finished pool deck corners ❑ fZf ❑ Top of proposed retaining walls (if any) and at each different elevation (if it changes) ❑ ❑ Pool bottom (or max. depth) DIMENSIONS Existing Jdr ❑ ❑ All property/lot lines ❑ ❑ All Easements on the property Proposed 2 ❑ ❑ Pool ❑ Z ❑ Pool plus integrated deck/patio ❑ ❑ Shortest distance from outside edge of pool, deck to lot lines and house Reviewed: Nam Date GTORMS/Pool Permit Checklist/02-13-07 I i • l o 3 ~f )t• 2472 Enterftrisr. Drive PItNEEIF _ Me►Idvta aicights, MN 55120 LAND eO1rS-CIVIL ENGI NEB 1engineering.. LAND PLAr Ww RR! -~nNO~sCAPE c•n.EC~,.. (612) 681-1914 Certificate of Survey fir. IIAL. W'rr E 1400 u.~ ,G~ NORTH s I 3n ~ ~ as ~ d Ifx~o M 434 trf.o C) M ~ ~ ptioevs~a a d' , to aV S45 N I r" s~ tV n ~ Y 0 N i 4 lo.o L o ( ` 4 Ii n P kEi W EAGAN ENGINEE UNNG LfT- L* „xr NEE yet t,,., ~ . r bJ,~~ T R, ao•la Lienoles P4 C. Elevafian towe ~r E~/evt~ lt7r) - = Denotes nr1a inuo i UN1.1 I d5emer~t ap < Black Beva can q q 4.,l_ _s Denoks DM;?cY~0~ee ~I0W Oireclion ;aj-o,e Slab trlevatiof7 ~17 . 3r ~ o Denoleg Monurfienf &Wrin s shown p'r'e U'S.St-~t37ed dDeno es q J e tbb LOT_ 1~ ' OCK I , /14MOR LAKE RP APPIT101Y COUNTyt MIAIM5 7-A i hereby certify that this survey, plan or report wad prepared by me or under my direct supervision and that 1 am duty Ftegistered Land Surveyor ~ . unrjer the laws of the State of Minnesota. Dated this-.. day of -A-D.19 j . lin-Ph t 401,21( p / R4 ERT B. Slat H L.S. R~Ca. Mt}, t469t Use BLUE or BLACK Ink r For Office Use I City of Eano n Permit F~ I Permit Fee: 3830 Pilot Knob Road I / 7 Eagan MN 55122 Date Received:l Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: 00 I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: - t~e~ l~c ~2w. J~✓`QS Phone: ee19 -6S09 LD kaAkEsta Resident! 1 ` Owner Address / City / Zip: L_/s) MrJ 5503 1 Applicant is: Owners ontractor Type of Work Description of work: G .P- 010(7- Construction Cost: CP C"00 Multi-Family Building: (Yes /No K) Company: C je ~t~5 G~~l~6~ Contact: ...1c+tiN_ Address: ~)o s.,e City: Contractor State: J~ rJ Zip: 45;~ l c2S_ Phone: License 6LI 4p a y 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.gopherstateonecall.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 co ed within 180 days of permit issuance. Applicant's Printed Name Applicant's ignature Page 1 of 3 , Use BLUE or BLACK ink r-----------------+ � FOf�flC@ US@ , I � � Permit#: � W � - ��, Cit of E� a� � � �- � � � • � Pertnit Fee: �J� _ '� 3830 Pilot Knob Road � —� c�� Eagan MN 55122 � Date Received: � Phone: (651)675-56T5 ' � � Fax: (651)675-5694 I Staff: • � I � 2015 RESIDENTIAL BUILDING PERMJT APPLICATION Date: �l --1�y] �� Site Address: l�C�� !� �''CCG��`k"_ �"t-�, Unit#: . , I _ Name: I.�l.r�+�` t Li.� �„�„�(1,�-S Phone: �/L� Ss`�i�j �"��' Address/City/Zip: �C31 ✓I�,`��Q �Si�. Applicant is: ' Owner �Contractor Desc�iption of work: �t� ��-� ��� �� Construction Cost: "'Z. �� 3 l� Multi-Family Buiiding:(Yes /No Company: , . . � � ara �� Contact:�����0.�/�►�' G� � Address:���� E.��iC�� �vl�' �i ' City: !/�"�l��•S State��Zip: �7i�� Phone• � � maiL• uce�se#: G,3o ��oD�3�-- �ead certificate#: /✓��`= 7 2 �7�— 1 , If the project is exempt from lead certiflcation, piease 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 Piumber. Phone: , Mechanical Contractor: Phone: Sewer&Water Contractor: . Phone• CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protectlon against unde�ground utpity damage. Call 48 hours before you intand to diy to recelve locates of undarground utll�ies. yaww.aooherstateonecatl.ora . . i hereby acknowledge that this information is complete and accurate;that the work wili be In conformance with the ordinances and codes of the City of Eagan; that I understand thls is not a permit, but only an.appifcatlon for a permit, and work is not to start without a permit; that the wo�k wili be in accordance with the approved plan in the casa of work which requires a review and approval of pians. Exterior work authorized by a build(ng permit issued In accorda�ce with the Minnesota 3tate Building Code must be ompleted within 180 days of permit issuance. . �, , X � �'►4 �' X.. �..� ` � ApplicanYs rinted Name AppllcanYs Signature � � Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA157647 Date Issued:09/03/2019 Permit Category:ePermit Site Address: 601 Middle Lane Lot:1 Block: 1 Addition: Manor Lake 3rd PID:10-47277-01-010 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - William Jones 601 Middle Lane Eagan MN 55123 (612) 805-1535 Kings Plumbing & Home Services Inc 4600 Hampton Rd Robbinsdale MN 55422 (612) 244-5414 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA168081 Date Issued:04/08/2021 Permit Category:ePermit Site Address: 601 Middle Lane Lot:1 Block: 1 Addition: Manor Lake 3rd PID:10-47277-01-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater 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 - William & Kathryn M Jones 601 Middle Lane Eagan MN 55123--216 (612) 805-1535 Bonfe's Plumbing & Heating 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature