605 Middle LaneSEWER & WATER PERMIT
CtT1' OF?EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55]22-1897
SITE ADDRESS
LOT 1_BLOCK 5EC/SUB
APPLICANT: QIIrIS , ^;,t
ADDRESS:
CITY, STATE ZIP ?; • 1 `' '
--?-
PHONE:
PLUMBER:
ADDRESS:
CITY, STATE ZIP
PHONE:
OWNER: -
ADDRE5S:_
CITY, STATE
PH04VE: -
OFFICE USE ONLY
METER # PERMIT DATE
CHIP # WATER PERMIT # 1..1 L t 7
METER SIZE B.P. RECEIPT #
ISSUE DATE B.P. RECEIPT DATE 12111„1 1
- PRV - BOOSTER PUMP
ZIP
PERMIT REOUESTED
? SEWER WATER _ TAPS
? COMM/IND ? RESIDENTIAL
T_ NEW - EXISTING
hk
SIGNATURE WHEN
WfTH CITY OF
r?
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERIMG DEPT. APPLICANT AND PLUMBER WILL BE NOTIFIED WHEN PEFiMIT IS PROCESSED.
•,? .ZZ w . •
,.7r.s•?.4?„r-? ? i? l?"'? ,° ."H'. ?`'' ? .
?Citp of Olagan . `
?r uf Nu-OiitO jnwcrwu ,.
Thrs CernJ'uwie rssued pursuarr! lo t1w requucments of Sedion 306 of tlre Unifarm Building
Code cuufYyinB rhat at 1he iime o}issuance &is slructure wrrs in complicrnce with 1he various
onWnanca of !he ai1y regulaling bur7ding comvrrcclinn or use For the faUMng.
ir
Ux Ch?iatiaa a' M/CW F Bld?. ftrmit.No. r"54
0--p-WY TYM R3/14' Zoaing DiWicY Ri - _T?com ` VN
owwacawwn AL HEEMNAM OCNST. _Ad&= 535 3MNE RD, MEIDOTA IEM
W5 MTT"F. T ANR i, l_ R3 _ TwlIN7'R T,AKF ?,M
?
.
?
?.
.?? _.
S
?
POST IN A COHSPICUOUS PLACE ?
t
OF EAGAN
L1??SAS ?ON 68fi-9623 02/25/93 CITY }t? i A C? ??
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 i, S 7 I
PHON E: 681-4675 --
BUILDING PERMIT Receipt #
To be used for Sp DWG/GAR Est. value =9g 9000 Date tiEC 11 Site Addp
Lot
Parcel No
605 M DDLE LIV
Block 3 Sec/Sub. K?lft i.M 2lVD
Nat71B AL EiERAtlAM CARST
w qddress 53S 3'KkIE RD
? cfty [+IENDOTA HEIGHTS !tN Zp
Name
kiress
Y^^ ZP
I o I Licerse #
I hereby acknowlege 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.
Signature of PermRee
A 8uiiding Permit is issued to: AL HERRMNN COPiST
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statules and City ol Eagan Ordinances.
Building Official
OFFICE USE ONLY
R-3 M- 1 FEES
Occupancy
Z?
t?-_1
aa9. Pe?t 63 ?.?
(t+ctual) Const V=It Surcharge 49.50
(Allowable) V-N Plan Review 413.00.
# of Slaries
'
??
Licem
Length
Deplh SAC, City
t?•?
S.F. Tolal - MCWCC
SAC 650•00
S,F. Footprints - , 660.00
On Site Sewage _ Water Conn
On Site well
X water Meter 95.00
MWCC System
Ci
W
X
Acct. Deposit ??.?
ty
ater
PRV Required X_ S/W Permit 3o• oo
Booster Pump - S/W Surcharge .50
APPROYALS
Planner _
CounCil --
BIdg.OM. -
Variance -
Treatment PI 276•00
3 70• 00
Road unit
Park Ded.
Copies
3, 3? . 00
TOTAL
m 9 ?/3 93 tiFo V"O
• Permit No. PermN Ho{der Date Telephone N
sjw
PLUMBWG
P?. 7?r? .3 G?G-rG
HvAC
ELF-crRic
aFCTFIic
tapeeti- DeNe Insp. Comments
Footings I
Foundation
Framing /-z2-,qd b-S t? ¢S As,
Roofing
Rough Plbg. v 3 ? `a? ? ? ?J( ^-?7
Rough Htg. 3 3 92 a U...,.f --
isui. l- 2? a f5S
Flfepl8m
Final Htg.
Orsat Test ' ? -
Final Plbg. rOI plyy- Inspecyw - Notify Plumber
Cnnst. Meler
Engr./Plan --
Bidg. Final
Dedc Ftg. ? - - -
Dedc Final
Well
Pr. Disp.
SEWER 8 WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
OFFICE USE ONLY
METER # (/4"4-1 ? 7 ? PERMIT DATE ?i' Z 2 :' 9 1
CHIP #? Ql b? OQ a 1 WATER PERMIT # 1?4,' 7
METER SIZE 519 S'eN Su S B.P. RECEIPT #
ISSUE DATE ?
i'
B.P. RECEIPT DATE 191111
_L_ PRV _ 8005TER PUMP
SITE ADQRESS - i I)llI.E Lfv
LOT _BLOCK SEC/SUB L `!:i• ' -
APPLICANT: - - - r -
ADDRESS: . = ??--hy - ... _ .. .. . -
CITY,STkTE ZIP
PHONE:
PLUMBER: ,,.,, r i .....,.. ? ....
ADDRESS:
CITY, STATE ZIP
PHONE: 6 7 - `
OWNER
PERMIT REQUESTED
? SEWER ? WATER - TAPS
_ COMM/IND _4_ RESIDENTIAL
T NEW
EXISTING
1 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES:
l?"J ArV?,P Y
ADDRESS: SIGNATURE WHEN METER ISSUED
CITY, STATE ZIP
PHONE:
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT. APPLICANT ANO PLUMBER WILL BE NOTIFlEQ WHEN PERMIT IS PROCESSED.
CITY OF EAGAN No19954
3830 Pilot Knab Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 681-4675 Receipt ? 0, O U . 7?
Tobeusedfor SF DW6/GAR Est..Value $99,000 Dafe DEC 11 , 79 QJ-_
Site Address 605 MIDDLE LN
lot I
6tock 3 SeGSub. MANOR LAKE 2ND
Parcel No.
N2m0 AT. HF.RRMANN CONST
Z Add?55 535 STONE RD
3: City MENDOTA HEIGHTS MN Trp
cc Name SAMF
? Address
? CftY ZP
Phone
8 Licerue #
I hereby acknowlege that I have read ihis application and state that ihe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signamre of
A euiiding aermii is issued to: AL HERRMANN CONST
on the express condition Ihat all work shall be done in accordance with all
applicable State of Minnesota pStatutas anYdh Ciry of Eagan Ordinances.
BuildingOHicial
OFFICE USE ONLY
FEES
occupancy R- 3 ? 635.00
Bldg, PertnR
Zoning
(ACWaI) Const Y--$ Surcharge 49.50
(Allowable) V=N plan Review 413.00
.
# ofStories
Le„qtn 56' ucense .
oavth 46 ? snG cicy 100.00
S.F.TOtal - SAC,MCWCC 650.00
S.F. Footprinis -
660
00
On'Site sewage _ Warer Conn .
On Sile Well - Water Meter 95.00
MWCCSystem X
City Water
x
Acc?. Deposit 3n_n0
PRV Raquired siw aa,mn an _ nn
Bo03ter Pump - SNJ Surcharge • 5o
Treatment PI 276.00
APPROVALS RoadUnit 370.00
Planner - park Ded.
Council -
BIdg.Off. _ " Copies
Variance - r07nL 3,309.00
/050&!v£/O
p 7858'i
Reques! Date ire No.
2! O
1-0 Rough-in Inspec[ion
equiretl?
' ves G No
? Ready Now 01 Natity Ins o?
h n R
Y licensed coniractor ] owner hereby request inspection of above ele ical wor Q(7
Job Atlaress (Sireel. 8ax o?ROy{e NoJ
S ? Ci(y
Section No. Township Name or No. Fange No.
Oc P m IPRINTi Phone N?
o uDPlier ? Aatl ess y?
1 1
ConhacloriCOmpany Namej
d- ?-
e ?
; Co hactor5 License No.
-
r
Maieng Adtlress cOnvacar or Ownw Ma4iny Installation
.3,3 . ??s
AmM1Oirz w iCOnr rA ner Mdaing Iwt
,
,? . Pho?yp?.ber ?
MINNESOTA STATE BOA F ELECTPICITY ' THIS INSPECTION qWUEST WILL NOT '
Griggs-MiCway BIEg. oom S-1]] 8E ACCEPTED 8V THE STATE BOARD
tePt Ilniversity Ave., 51. Paul. MN 55106 . UNLESS PROPEfl INSPECTION FEE IS
Phone (612) 641-0800 ENCLOSED.
41,091 REQUEST FOR ELECTRICAL INSPECTION
? See Insvcctions lor compleCing ihls form on back oi yellow copy.
?.'?17 R.'?1 P "X" Below Work Covered by This Request
r .?
E6-00001-OB
,?
16 fG6 a 11 ewAddRep? TypeofBuiltling AppliancesWired EquipmeniWired
Home Ranqe Temporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer Other (Specify)
Comm./Indusirial Fumace
Farm Air Conditioner
Olharlspecity) Canirocmr's Ramarks'.
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps I SQQ 0 t0 100 Amps
Transtormers Above 200 _ Amps Above 700 _ Amps
Signs Inspector's use Onry: TOT
AL
90
Irrigation Booms ?
;.
7 s
i
Special Inspection rL c?J
Alarm/Communication ;
THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT
Other Fee
?
COMPLETED WITHIN IWONT"gy
1. the Electrical Inspector, hereby -
Rou9nin • Date
??G
certify that the above inspection has
been made. F;,,ai oa+e ?
OFFICE lISE ONLV
This reques[ voitl 18 montns Gom.
9 ?3 9 ? . iasv
c,..?-,- "i it?o o"
Reqoest Oa ? Fire . RougnFin InspeMion
RequireG?
1'es G No
? RBedy Now ?Will Notlly In3ped0r
VJhen Reatly?
IEl licensed contractor owner hereby request inspection of above electrical work at:
JoD A ress i${reeL Box or Rout .) Ci ?.
Sectio NO. Township Name or No. Renge No. Coul I (
Occu ant IPRINT)
II.?
/
?Y?? Phona No.' lg
Power p likddreas
Elacvical Con}v Iw (COmpany Nam 7
?I Comractor5 License No.
Mailinq Atltlress (COnMaclor ar Ownar Making Insfalletion)
aulhoriz a ignaWre Gonlracto n r [eking ?Inslallabonl ? Phone Nu
MINNESOTA STATE BOAPD OF ELE PIGITV THIS INSPECTION PEOUEST WILL N01
Grlgqa-MlGwey Bltlg. - Poom S-178 BE ACCEPTED BV THE STATE BOARD
1021 Unlvernity Ava.. St Poul. MN 55100 ;5h UNLESS PPOPER MSPECTION FEE IS
Phana(613)6444)800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION i-'oe//
? S9e in4huctions lor crompleling Ihis form on Oeck ai yallow ?ropy. 9Fy-
? ? ? 1 /
3 983 9 ??X° Be/ow Work Covered by This Request ?,r+
ew Atld ap 7 TypeofBuiltling AppliancesWired EquipmentWired
Home Aange Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer OMau(Specity)
Comm./Industrial Fumace
Faim Air Conditioner
Other sueciry) Conttacmr's Remarks:
Compute Inspection Fee Below:
# Other Fee # ServiceEniranceSize F # Geetlers Fee
Swimming Pool 0 to 200 Amps to 100 Ampa
Trenslormers Above 200 _ Amps Above 100 _ Amps
SignS Inwector§ llse Onry: TpTAL
Irrigation Booms ? O o?o
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITMIN 18 THS. /
I, the Elactrical Inspectoc hereby
if Rouyn-m , ate
,
^?
cert
y that the a6ove inspection has
been made. F;nei
oe?
OFFICE USE ONLY
Tnis request witl 18 montna 1rom
RESIDEIiT1AlL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conatruction Reauiramenta
• 3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roafed areas
t20% maximum lot coverage edlowed)
• 2 copies of plan showing 6eam 8 window sizes; poured found design, etc.)
• 1 set of Emqy CalcWatbns
• 3 copies of Tree Preservatian Poan H lof platted afler 711193
• Rim Jdst DetaJ Optiona selecBon sheet (61dga wilh 3 ar less uniLa)
DATE IGJ'OC? -OO?
C? w
RemodellRSnair Reauirements
• 2 cropies of plan
• 1 S81 ot Energy Calcufations for heakd addillons
• 1 sAe survey for exteror additions & decks
. Irxlicate it honee served by sepGC systan fw additbns
VALUATION )TFIJI.JIJm
SITE ADDRESS CQOS mic?G? I"Q. L&,v?SL MULTI-FAMILY BLDG _ Y X N
TYPE OF WORKT4S
APPUCANT
STREET ADDRESS _
TELEPHONE #
RMA HOME SERVICES INC.
Home Depot Installed Sales
3200 Cobh Galleria Pkwy., Ste. #200
Atlanta, GA 30339
763-542-8826
nr_70?6R257
FIREPLACE(S) _ 0 _ 1 _ 2
I STATE_ZIP
I FAX #
PROPERTYOWNER S0.'R&CA TELEPHONE#(QSI 'M •1055
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA HULES 7670 CA1'EGORY 1 MINNESOTA RULES 7672
(J submission rype) • Residentiaf VenUtatlon Category 1 W orksheet Submitted • New Eneryy Code W orksheet Submitted
• Energy Envelope CalculaGOns Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Conhactor.
_ Water Softener _
Water Heater _
No. of Baths
Air Conditioning
Hcat Recovery System
Phone #- =-?--E
Fee: $70.00
Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or i ances.
Signature of Apptlcant i Aa/n E?. ?a'?e1
OFFICE USE ONLY
Phone # CIV7 F-1?
Iawn Sprinkler ? Fee:
No. o E'R.I. Baths; ? ?CT 2 2 z?OZ I'? ?
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updatad 4/02
` OF"MCE USE ONLY I
O 01 Foundatlon ? 07 05-plex ? 13 18-plex ? 20 Pool II O 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
Q 03 01 of _ plex ? 09 07-plex ? 17 Garage ? ZZ Porch/Addn. (4-sel8.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened)I ? 36 Multi
? 05 03-plex 0 11 70-plex ? 19 Lower Level ? 24 Storm Damage
? OB 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvement ? 38 Demolish (Interior) I? 44 Siding
? 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration O 37 Demoiish (Bidg)* ? 43 Reroof ii ? 46 Windows/Doors
? 34 Replacement `pemol(Hon (Entire Bldg only) - Give PCA handout to;applicant
Valuation
Occupancy ?
MC/ES'System
Census Code Zoning City Water
SAC Units Stories 8oosfei Pump
Nbr. of UnitS Sq. Ft, PRV ,
Nbr. of Bldgs Length Fire Spirinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O. I
_ Footings(deck) FinaUNo C.O. '
_ Footings(addition) _ Plumbing
_ Foundarion HVAC I
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ A"u/Gas Tesu _ Final
_ FraminB Siding Stucco Stone
_ Fireplace R.I. Air Test Final Windows (newheplacement)
_ Insularion _ Retaining Wall
------------------------- Approved By I , Building Inspector
--
Base Fee ------ -------- ------________- _____ ____
--------------------------- ?
Surcharge ?
Plan Review
I
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant I
Plumbing Permit I
Mechanical Permit
'
License Search I
,
Copies
Other
Total p
,
Installed
Siding andhWMspOWER OR ATTORNEY
OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales located at 660 Mendelssohn Avenue North, Golden Valiey, MN
55427, having a license number of BG 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 and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Mintlesota for the installation, maintenance and
repair of windows and siding (the "Work").
'I'iie powers conveyed to the Agent by this Limited Power of Attomey are
liinited solely to the express powers delineated herein and apply solely to the Work.
This Limited Power of Attomey shall expire and automatically be revoked on the 30th
day of May, 2003, wkich date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attomey may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WITNESS WHEREOF this Limited Power of Attomey is executed this
30?day of Mh`f , 2002.
David . z
SWORN TO AND SUBSCRTBED BEFORE ME by David N. Katz on this
30`h day of May,
Notary blic in for the Stat of eorgia
My Commission Expires: January 21,.2006
396816 v3
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized coniractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984•0709 • Toll free (800) 79•DEPI
C r, ; CITY OF EAGAN
3830 PIIAT &NOB ROAD
EAGAN, MN 55122
PHONE: (612) 454 8100
1dL,G'"pwm"m
FOR CITY USE ONLY
PERMIT #
RECEIPT # D ??`O
DATE: / Cr 9?-
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST t?
ADD ON
REPAIR
OWNER NAME : (.C--(
SITE ADDRESS: 6 D,S
nd
LoT:? BLOCK 3 sUBD(?,,? a-
INSTALLER:
ADDRESS: I? `I YO ?e?tor..•.a? U'c..r _ _6.
CITY: ZIP: ?.9?_32-1--
PHONE #:
FEES
ADD-ON MINIMUM $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: $ 27•00
STATE SiR2CHARGE: .50
TOTAL: $?2 7-SO SIGNATURE OF PERMITTEE
C4ItP4E.R?IALf11`JDT?STRTAI.: PLEASE COMPLETE THZS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
------------
CONTRACT PRICE
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SiIBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINiMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
gm&SNG` Pk"ZT
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE: /
PLEASE COMPLETE UPPER PORTION ONLY FOR SZNGLE FAMILYDWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ ---------
WORK DESCRIPTION
NEW CONST
ADD ON _
REPAIR
OWNER NAME; ftI lilrlna'-.3-1 cc5o?S'f
SITE ADDRESS: L17oJ n?tc??`2
LOT :? BLOCK J SiIBL.
INSTALLER: ?Y?,?? P I? i?
ADDRESS: %C70 4'?i'r"? Cr?
CITY: D"(lW ZIP:
---- ---°----------------
CDMPLETE THE FOLLOWING: ------
N0. FIXTURES EA. TOTAL
ADD-d'N MINIMUM 15.00
1 SHOWER 3.00 3• od
2 WATER CLOSET 3.00 Cn-00
? BATH TUB 3.00 3•°6
Z LAVATORY 3.00
1 KITCHEN SINK 3.00 3•e?
? LAUNDRY TRAY 3.00 '6•00
NOT TIJB/SPA 3.00
I WATER HEATER 3.00 3•e?
f FLOOR DRAIN 3.00 3'0?
GAS PIPING OUT.
/ (MINIMUM - 1) 3.00 3.00
ROUGH OPENINGS 1.50 4-15-6
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL S J?, !5->o
ST. SURCHARGE .50
TOTAL: S Sbf Da
?iTMMERGiAL?INUbST&IALi:! PLEASE COMPLETE THZS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
Q?,T^?ER unMO:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE g $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
(:ONTRACT PRICE x ie
STATE SURCHARGE
TOTAL:
( S IGNATrJRE )
FOR: _
CITY OF EAGAN
#?( O2$ 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 35722
651•651-4875
New Cauhucflon aeaulremenh .,. (? 't ? ?G1Pt b ?- ? `.T'?? Rertwdel/Reoalr Reauiremenri
> 3 reglatered alfe wneYS showlny sq. H. of lot, s4 rt. of houae
and gp rooled areas G^A7. mtncimum loT covemoe dlowedl
> 2 coples of plaru (ahaw beam d wlntlow alzea; poured Ind. deslgn; etc.)
a 1 set of enerqy aileulaNOns
* J coples d hae preaervatbn plan H Id plalFed Cfi6r 711/99
oATE:
$Iq9.15
2 cOpl95 of pldn
1 se1 of energy cdeulaHOns ta heated additlona
1 aite wrvey far exfaAor addiHau 8 deCks
corisTRucnoN cosr:
DESCRIPTION OF WORK:
SiREET ADDRESS: (pd S /l?f. Jo??e ??T?r
LOT: / ` I BLOCK: ? SUBD./P.I.D. ri: )YIQnOY L0 KG 2%J
,p / ?
Name: O!`( _/1 Phone #:
PROPERTY Laaf Flrs1
OWNER SheetAddress: Lo 5 ? (a) ? -
ciri _ stare: vP:
. ComPcnY Phone q: Co/? ?????dy
' 71 ? (area code)
CONiRACTOR
sheer aadress: uc.r,se r2?YffS66Ecp.
ciry state: zff? ziP:
ARCHITECT/
ENGINEER Company: Name:
Telephone i: (
Sfreet Address: Re9istratio^ C
Ciry
Stafe:
Zip:
Sewer/water licensed plumber (If installina sewerfwater): Phone #: (?
1 hereby acknowledye Mat I have read Ihis application, date fhaF itre Infortnation is a compry wHh an app8cable State
of Minnesota Statufea and City of Eagan Ordinances. ?
Signature o( Applicant ?
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Rece(ved
Yes No
_ Yes _ No
- Not Required
Pz .itJp!
aFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 FaundaUon ? 07 05-plex ? 13 16-plex ? 21
? 02 SF Dwelling ? 08 OEplex ? 17 Garage ? 22
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23
? 04 02-piex ? 10 08-plex ? 19 Lower Level ? 24
? 05 03-piex ? 11 10-piex Pib9 Y or _ N ? 25
? 06 04-piex ? 12 12-plex ? 20 Pool ? 30
WORK TYPE
? 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
Porch (3-sea.), ?
Porch/Addn.(4-sea.) ?
Porch (sCreened) ?
Storm Damage
Miscellaneous I
Ac.cessory BkJg.
h
? 36 Move Bldg. ? 43 Reroof I
? 37 Demolish (Bldg)' O 44 Siding
? 38 Demolish (Inte(or) ? 45 Fire Repair '
0 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main Ievel sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water I
Booster Pump
PRV
Fire Sprinklered
?
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge ?
Plan Review ?
License ?
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded. I?
Other '
Copies ?
Total:
31 Ext Att - Muki
33 Ext. Alt - SF
36 Multi
SAC Units
% SAC
?
1991 BIIZLDING PF.?T qpLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
M[TLTIPLE DWELLINGS
COMMLRCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUtATIONS (CHECK WITH BLDG. DEYT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: 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 LOTS - CONTRACTOR/HOMEOWNER MUST 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 MUST SHOW A LICENSED PLUMBER.
To Be Used For: ?Valuation:
?
Site Address
Lot ? Block 3
Parcel/Sub mdMN
Owner
Address
City/Zip
Contractor At L?p?v f ,MA1&,v1-0 B,Cq
Address
City/Zip Code a
? z0
Phone CO
City/Zip Code
9ql OFFICE US
Occupancy -3M-1
Zoning 9-1 i
Actual Const V-N
Allowable V -M
# of stories
-
Length
Depth 5?fe
S.F. Total
Footprint S.F.
On site sewage_
On site well
rtwcc syscem ?
City water
PRV ?
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. ?Z'S?1/DS
Variance
;1z
2 g I°91 ;
Permit
Plan Review 41 S,va
SAC, City /00,00
SAC, MWCC (aS°0,0 Water Conn. /a0,00
Water Meter 5,00
Acct. Deposit 3a,oe
S/w Permit D,Do
S/W Surcharge 5D
Treatment P1. 0n
Road Unit 310,00
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL 7, ,M
agrees that all work shall be done in accordance with
Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
, ?ALU/??(?1??,•?',r
-----?-? „ ?,
?
Ct/?RAGC-
Z2.k?r yya ?_ G6oa
3?x2'L= ?60
-29 ?a ?? ?. sz$
/0 1C /q -- lao
N?ux.s= e
],/21C 30
'1'?y
f 3y i X I'+ =1B
,
? S -r rLO pr?,
??GwT- 13y !
zxli= Zz
Iu?: S
?3?I xs3= "1 ZG63
9 °?, boo?
• w
A ... ? ? ?
* ??QAiEER _ ?0.NO9VpVLVpHS??IV?I[ryy?NLL11L
,? eng?neer LANOpLNINERB - LANOlGwrG qRCNREC
ng ,..
** yf1?
2422 Entarprise Driva
Mendoia Haiphtf, MN 6$120
(612) 681-1914
Certificate of Survey for; Al Herrmann CQflStI'UCtlOn IYlC.
Model Name: Bur und
1 1 qc,i
V I ?
1 l '
l ?
1 ?
? i
30 ?
,a 5 89°z4'a?" w
101.61
?
1 1
? 3 8.99' ? .. ?N
?------- ?\?-------- ----
?i
?
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r
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ti ? ? ? `$\i1 II
, D
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r 'f
ol" Ot
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o?
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p gl
--ILL--
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i ?
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h L-43.73'
z0°14'28° r?
244.64'
i _
- - - ------
-' MIDpLE p
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9?,J
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i
y41.7-----
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-9367?--.._ ,
yr?s? ?l
. PROPOSED HOUSE ELEVATION
. soo_a penotes
. on
p
t Existing Elevatton
d
P Fourth Level Flaor Elevation:931.6D
.
eno
es ropose
Elevation Thlyd Level F"loor Elevation:93fi
5Q
_^ Denotes brainage & Uti!ity Easement .
Oenotes
Drainage Flow pirection Top of Blpck Elevation:939.70
.
-o- Denates Monument Garage Slab Elevation:939.37
-f.,q- Denotes Offset Nub gearings shown are assumed
OT 1, BLOCK 3 MAN
?RKO7A COUNTY, MINNESOTA -(??=?,
there6y certity that tnis survey, ptan ur repore was pre'ppprud py niz under my dir?t s&
unAer kne laws ol Me State of Minn¢sota. Dated chis....?i?..Ctfay al 1)e?(qcv? A.D. 79
Scale: 1 Lmh=30fw-,
_; .
[1 91528.00
?
?
CITY OF BUILDIN(3 DEPART14EIdT
EXTlRIOR ENVII,OPE AVPs12AGE ItUt' C0I4PUTATION r??•
. . (To be submittod ivith huilding pcrmit upplicntion) •. '
O?io or Two Family Dwelling ??
Owner f
All other Sfte Address ?-oT ?,? ,E- 3 "A
Contractor o? L,4tE .ZI
Date Phone
LINEAL FEET OF ' • •
EXPOSED V1AIS,
?r1e ft, abovo grade = ZOOz?:?>g .
TOTAL EXPOSED 1VALL AREA SQ. FT. ?
OPAQUE WAI,L CONSTRUCTION: l[U'l Va1ue x Area e
Detail"Ul' 0 -3 x SQ. FT, ?
reference ' "U?? ? ??it D (U) (A)
from -?IVV? npu ° 0 x SQ. FT. ? Pai ?U)(A)
attached nU,i 'n? x SQ.•FT, 2?ol --=?(U)(A)
sheete nUn x S@. FT. • _ (U)(R)
nUII x SQ. I'T. _ ?U) ?A) '
x Sq, FT.' _ (U) (A)
WINDOWS: "Ull Value x Area
Make & TyPe IAl-SvL, ({1?? :"U .?(9 •?? ?? X SQ. FT. +?J0 7. ZijI
nUnn x SQ. FT.----_
Uu x SQ. FT.'_ (U)(A)
??U?? (U) (A)
.., x SQ. I'T. _--??(p)(A)
DOORSt "U" Value x Area `
Malse & TYPe
u n ? nUn- J ? ..
n ?r uU?? aC 3R. FT. l? = i CP (U)(A) :
u` n uUu X SQ. FT. _ (U):(A) :E
_ U x SQ. FT. (U)(A)
ToTai.s 2,00Zr3v°sQ. F'T. (U)(a)
TO.TAI, (U) (A) VALUES AVERACIE npn ? ?U) ?A)
DIVIDED BY TOTAI? WpI,L pREA ?zY7 zi 7;
AVERAC3E- IlU ?115 dr less for r
r 1&2 family dwellinga ,
ROOF/CEILIN(} s ?
TOTAL 'AREA:. D.-L
Detail reference
from "'-^----IIU?iUI?I? r?Z x SQ. FT. d'Z. = ZZtO2
I
attached sheets, "?-- ?U??A)
Describe o -'-----_..IlU.' X SQ. FT. _ (U) (A)
in roof, peninga SQ. FT.- _ (U)'(A)
• ,_,.?_nUu x SQ. FT. X (U) (A)
TOTAL (U) (A) VALUES DIVIDED gy SQ. ?? ?U??A)
? rr?L5 -= 54?r .Z4(U?A>
TOTAL ROOF/GEILINa /?EA I
AVERA4E t1??p"2?T?
ar ventilnted roofa. / OZ
?
. ?
?
R
?
i
.;
X l ?i-+?# zc?f?) = Ceoo?o?
ZL4 + ?t?s+s-?,?) = 14cz?
30
7X 1M J' 10 AI
Gv?? N? = Z8?oX1 = Z"o,o
c?N ?c v= l?l15 X? ? I???
?wZ?3 = ??xl= ????
GWZN2-
Cw44, - ZZi 5XZ=
I sg, s
W I i.U J ?i = .
`-
`???t?
W? 5Xf osEP ZovZr ?v
CL?S coN?? ?8. `I?j
?IZZ?o ?
n u?
?" ?? _ q ZB?oo
I J-7 _1, 7,-5 *
it 8co- (et5
...
:;
aECPION--
? Determinina ?? lf
•;?"' „ U values at Roof,_ ....Wall, Rim, and Conc, Bloclc
_----. _..... .,..
% i I ¢
j ROOF/CEILING R VALUE?-
? 1. ) Interior Air E'ilm 0.61
2.) 5/811 ayn. Bd. .56
3.) Insulation 45M7 .
4.) .
5.) Dxterior Air Film .61 _
(STILL) -?-''
nUn = 1/R= ? OZ '1'OTAL (R)=40115 ,
V1AI,L (R VALUE
6.) Interior Air Film 0,68
7.) P GYP. Bd. .45 ?
8.) InsulAtion " lqfpo
9.)
t?1ltY?t'? ?
210
10.) Idasonite Siding 67
11.) Exterior Air Film ,17 ?
npu _ 1/R= 1043 TOTAL (R)= Z 77j&I
RIt•! -? -„ R VA
?
LUE
12.) Interior Air FiLn 0.68
13.) Insulation
14.) 2" Fir Rim Joiat 1,$$
15.) ?30If--r P-iT15 2I0'F
16.) Mayonite Siding . C7
17.) Exterior Air Film .17 -h°-.
nUn = 1/R= ;C40 TOTAL (R)=
FOUp1DATION
18.) Interior Air Film
19.)
zo. )
21•) 12" Concrete Blocit
22.)
23.) Exterior Air Film
'lUu = 1/R= ;070
r
R VALUE
0.68
rl,oo
1.28
.17
TOTAL (R)= I3,I3 ;
n
` '
REACTIVATE CITY OF EAGAN ?j L r) n,
PERMIT # 1993 BUILDING PERMIT APPLICATION
681-4675 FE9 2 2 Reco
1-13 x& r,nuw"j
SINGLE $ MULTI-FMIILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 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:
STREET SU[TE /
Tenant Name: (commercial only)
LOT ? BIACK .7 SUBD. P.Z.D. M
Descri tion of work: Sfr??rR-?GUo??C ?Y 1p1W'v1GVd
The applicant is: Owner ? Contractor ? Other com«;be>
Name L11S00 a5 Phone 74 '73
Property LAST FIRSi
Owner Address ??os `7r1i'da1e, 4"b
STREET STE 0
Zip ?sla..3
City Ea. ? State ?V!lV
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City 5tate Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this apptication and state that the information is
:orrect and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
3ignature of Applicant: Tlu»".arn 7uqh
OFFICE USE ONLY ? wO?i Af
?j
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
0 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? OS 8-Plex
O 09 12-Plex
? 10 Multi. Add'1
WORK TYPE
1 New
32 Addition
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
w?
2" O's %
, ?.
0 11 Apt./Lodgi? ?F16Ba ment Finish
0 12 Multi. Misc. ! ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 Fireplace ? 19 Comm./Ind. Misc.
0 15 Deck , ? 20 Public Facility
? 21 Miscellaneous
? 35 Tenant Finish ? 37 Demolish
? 36 Move
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage 5 sd 6lol? .
APPROVALS CA4"µs wni t.
Planning Building ?: . Assessments
Engineering Variance I
REGIUIRED INSPECTIONS
? Site ? Footing JZ Framing
? Wallboard Eg?Final ? Draintile
43
i
0
? Insulation
? Fireplace
Permit Fee 35, ov v,L,oc;o,,:
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.
Copi es 050
Other
Total:
SAC %
SAC Units
REACTIVATE ? r
PERMIT # ?
CITY OF EAGAN ??11. n ?
1993 BUtLDING PERMIT APPLICATION
681-4675
ff a 2 2 RRO
r,s
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 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 7 Valuation of work
-ydk
BS m
?
l
Site Address:
'
STREET SIIITE M
Tenant Name: (commercial only)
LOT ? BIACK ? SUBD. yy ,G`? ?l ( lr?r P.I.D. N
Descri tion of work:
The appl i cant i s: Owner ? Contractor ? Other (Describe)
Name NPh8+1 7_kpmlS Phone (?36-??23
Property LxsT FIRST
Owner pddress ?05 ?1?d4- z-el"?'r
STREEi SiE N
City F-Are?.tn State AIN Zip 55-123
Company Phone
Contractor Address License # Exp.
City 5tate ZiP
Company Phone
Archftect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this a lication and state that the informatian is
correct and agree to comply with all applicagge State of Minnesota Statutes and City of
Eagan Ordinances.
lu
m
Signature of Applicant:
?
?
OFFICE USE ONLY
'k
BUILDlNG PERMiT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
O 08 8-Plex
O 09 12-Plex
? 10 Multi. Add'1.
w" .? . . .,? . ;
?
? 11 Apt./Lodging ? lfi"`$asement Finish
? 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
?? 14 Fireplace h ? 19 Comm./Ind. Misc.
,19r 15 Deck i ? 20 Pub7ic Facitity
I ? 21 Miscellaneous
WORK TYPE
1 New
32 Addition
? 33 Alterations
E3 34 Repair
? 35 Tenant FiMsh I ? 37 Demolish
0 36 Move i
GENERAL INFORMATION
Const. (Actual) Basement sq. ft.
(Allowable) lst F1. sq. ft.
U8C Occupancy 2nd F1. sq, ft.
Zoning Sq. ft. total
# of Stories Footprint Sq. ft.
Length Z-Z On-site well
Depth On-site sewage
APPROVALS
Plannin Buildingb52-?3-93
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Eooting ? Framing
? Wallboard ? Final ? Draintiie
Permit Fee ,zS, oo wimcia,:
Surcharge Tp
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Capies .5?
Other
Total:
MWCC System
City Mater
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
4'.1MS
?j wNa
i
As iessments
I
r
°r-
i ? Insulation
i ? Fireplace
SAC %
SAC Units
J??r
, ?* *
* PIONEER ? 2422 Enre'prise Orive
LANOSUHVEYORS•crytLENGINEERS Mendo[a Heights, MN 55120
engh ryPP.rinf"?,IhNOPLANNERS•LANpS?q?EtlRCHITECTS
* ? ** ? (612) 681-1914
Certificate of Survey for: AI Hel"?"?T1(]nn Construction,
-- Inc
Model Nome: Burqundv I
? i -
1 4
1 Y Y
l 1
11 c 1
30 k 1 S 89°24'47" W
k ' 101 61'
? l 19y3.1 .
i ?
? ti
(P
1
U3
38.99' \
r-------?--------------?
O
O_
?
1 °13??G1 \ I
' m
` 1\
o ?
?
t
?31
?
.' ?
?
D 'b??ao 7°? ?h I
p ?
v
? I
II
II I .
0 S
i???' z
`a
o?
I
?
?
N? o
lp
o
???? s
f. 39 ?
W \
??
P?
J
(O cm \
?
I ? ti \
f ?
? I
\
!
i? r
D ? Yi6.7 • ,I ?
wav
f
?
? ?
?
ur
';0 cn11 ?:
\\ nc?
\ ? v
? 2
0 ?? ? ,
ol ? \ I
? / 1\ o j
i i ap -----i--- ? ---?-?
g41,2------
DeeR F-?reo.
>low\-, up cy;,.
Afexf ?aqe.
J
3
?
O LO
O
? e
o
O
? ?
z ? .2
93 y.1?
18.97'
?.7 - - --
L-43. 73' 5.00' )
?? t16 = 10W4'28" N 8°24'47 E N
R. = 244.64' --- "'
? ------
' --- -- --
' MlDpLE ---- _--
,
?' LANE ?
, , -
-----
, ? ---------
------
? ----
,
,
OD/?nnnr.. ?.....__ _
PLEASE COMPLETE FOR SINGLE FAMILY DWELLIt3GS. AI.SO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES
SHOWER
WATER CLOSET
BATH TUB
LAVATORY
KITCHEN SINK
- LAUNDRY TRAY
HOT TUB/SPA
WATER HEATER
FLOOR DRAIN
GAS PIPING OUTLET • minimum •
ROUGH OPENINGS
WATER SOFTENER
PRIVAT'E DISP. • nekcn. uc.
U.G. SPRINKLER • 6ome under consi.
ALTERATIONS • to cosiing
WATER TURN AROUND
SITE ADl
OWNER
WST
c Tai.
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
15.00
3.00
15.00
15.00
CTTY: ?- t,r? - STATE: ZIP CODE: a-
PHONE
L ?
SIGNATURE OF P RMTTTEE
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
STATE SURCHARGE .50
56)
TOTAL:
PLEASE COMPLETE FOR ALL COMMERCLAUINDUSTRIAL BUILDINGS. AISO FOR MULTI-
FAMILY BUP _DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH
DWELLING U: < <T.
_ NEW CONSTRUCfION
ADD ON
REPAIR
WORK DESCRIPTION:
CONTRACT PRICE: $
FEE: 1% OF CONTRACT FEE
STATE SURCNARGE: $.50 FOR EACH $1,000 OF PER]IiT{' FEE
MINIMUM FEE: $ 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
SITE ADDRESS:
$
$
$
TENANT NA111E: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
STATE:
ZIP CODE:
APPLICANT
1493 PLUMBING PERMIT (COMMERCIAL)
CI1Y OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
(X~
Use BLUE or BLACK Ink
~r ( I
-
For Office Use I
11 l I Permit
l
I
3830 Pilot Knob Road pPermit Fee:`~~/ j
Eagan MN 55122 RECEIVED I Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 DEC 0 6 2011 Staff::
2011 MECHANIC A
P IT APPLICATI0
i
Date: 1 I lSl Site Address: ® I
Tenant: Suite
RESIDENT/ OWNER Name:
Phone: - GG,
11
Address / City / Zip: ~v
CONTRACTOR Name: one ft( licQflM t\lr License
Address: I t04 yC1 i i t al i l)1 1 SieI +City: vAQS-HncAS
State: ~Zip: B055 3 Phone: ~(JtJ t ~ - -7 f ,~r~ `
Contact: ~o I f II a Liman Email: ~ 4 p• wcmu la1 ~wr 1r' a~m
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: 1
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE P~`RESIDENTIAL COMMERCIAL
.Furnace New Construction Interior Improvement
Air Conditioner Install Piping _ Processed
Air Exchanger Gas Exterior HVAC Unit
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:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ ✓ ✓ " TOTAL FEE
CO':'!I"IERC/AL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
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 mfl\j dla in t e case of work which requires a review and approval of plans.
x x
Applica is Printe Name Appli an Si nat re
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground - Rough In Air Test Gas Service Test -In-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116944
Date Issued:10/14/2013
Permit Category:ePermit
Site Address: 605 Middle Lane
Lot:1 Block: 3 Addition: Manor Lake 2nd
PID:10-47276-03-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Jarrod Stenzel
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Michael S Allen
605 Middle Lane
Eagan MN 55123
Schmidt Roofing Inc
3509 West Highway 13
Burnsville MN 55337
(952) 888-4889
Applicant/Permitee: Signature Issued By: Signature
Apr 291512:51 p AA Garage Door 651-702-0838 p.1
Use SLUE or BLACK Ink
�-----------------,
� For OFfice Use �
�l� 0� � �Il � � ������ ; ��
� � � Permit�:
I
j Permit Fee: �o S. �'� �
3830 Pilot Knob Road � t
Eagan MN 55122 � Oate Received: �
Phone:(651y 675-5675 ' �
Fax: �851)675-5694 � Sta1F. �
�-----------------�
2015 RESIDENTIAL BUIL ING PERM11�APPLICATION
Date: � ��� �°� SiteAddress• �}�`y� �(� 1'�— l..�I !� Unit#•
e
� Name: � ^�: �� I 1�C.� / � �i���.�'X/��r���� �
; Residenb ,;... _ Phone: _
� Owner Address/City I Zip: ..? _� ��f C r` �'� C.v�.���� :�4}�l �� .��%,?
t � �� �Applicant is: Owmer Contractor
EY �.i � 7�� ,r ,'-; ; -
� TYPe of Wo�k � Description of work: � �:S�1'��� I1�Vj I (��1,� �• ���L�,� •r,'�t' �
F •
; � Construction Cost:��Ci,'��.�'• �� Multi-F�amily Building:(Yes J No� �
� �� ! Comparry: "! ' ,�1,,�r�.�:G� ,, �� _,"•. �(_
� � Cflntact:_, � 1 �'J���'�.,
�
,�
' Contractor i Add�ess: � �`�f`I''i j�,`(�� ci�ry: �� � GL./� �d1��
� � � a —�`'�, �_�,�?�I.�l ���,
State:�Zip: �t—i..�(.�� Phone. (!i� t,/ � EmaiL• i �tc.�JE: ��� CfCc�����r,��: �y�`'C� 1��
� � � _ / '+
� � License#: Lead Certificate#:,1�� / y �i��� �
i If the project is exempi fram lead certification,please explain why; (see Page 3 for additional information)
I
� �
_ COMPLETE THIS AREA ONLY IF CONSTRUCTING�1 MEW BUILD NGI
f
� In the last 12 monlhs,has the City of Eagan issued a pertnit for a similar pEan based on a master plan? �
k _Yes _No �F yes,date and add�ess oi master plan; �
k
FLfcensed Plumber: F�hone• �
aMechanical Contractor: , �
- P hone: �
�
; Sewer 8 Water Contractor: P�hone:
t
y NOTE:Plans and supporting documents that you submit are considered!cr be pu6/ic information. Portions of
the information ma be classified as non- ublic if ou mvide �
� y P y p specifrc reasons that woWd permit the City to �
�, conclude that they are trade secrets.
CALL BEFORE YOU DIG. CaN Gopher State One Call at�651)454-0002 for protection agains;t u�derground uti6ly darnage. Call 48 hours
before you inlend to dig to receive locates of underground utilities. ivww.aophersta;eonecal:ora
1 hereby acknowledge fhat this information is complete and accurate;thai the work will 6e in confortrr�nce with the ordinances anti codes ot the City of
Eagan; that 1 unde�stand Ihis is not a permit, but oMy an applicaGon for a p�mit, and work is not�fo slart without a permit;that the work will be in
accordance with the approved plan in the case oiworlcwhid�requires a review and approval of ptans.
Exterior work authorized by a buiEding permit issued in accordance with Ihe Minnesoia Stafe Building Code must be cornp�aled within 780
days of perm�t issuanoe.
x IJ`�� :r"f��`G,�'� 1V•v...� x � �' .'li�.�'�l� �.i'�i�,`��r�l�,i'`f�r`✓_ [
t�
Appl�cant's Pr��l�d Name Applicant's Sigriature '
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146488
Date Issued:10/27/2017
Permit Category:ePermit
Site Address: 605 Middle Lane
Lot:1 Block: 3 Addition: Manor Lake 2nd
PID:10-47276-03-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Michael S Allen
605 Middle Lane
Eagan MN 55123
Claim Pro Roofing
14613 Glendale Ave SE
Proir Lake MN 55372
(952) 226-2280
Applicant/Permitee: Signature Issued By: Signature