1578 Murphy Pkwy INSPECTION RECURD Control No. 11 6D 5
CITY OF EAGAN PERMIT TYPE: B «i I t'j144
3830 Pilot Knob Road PeRnit Number: 0616916
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: Lof 1 2e iRt oc rc i i APPLICANT:
14•iss MURPHY PKtJY NORTHERl1 Cl.AS3IC HOMES
HLA(:kHAbt? pt1Nf1 ' (612) 440•-7150
PERMIT S,y'BTYPE:
TYPE OF WORK:
m
INSPECTION
r-0nrI t,:. .• .
r i,A MI M'i
rN",111 a? 1iiN FtMAl.
F TnC pt Ar.F '
Rf MAR103! PttV S& W C(lNT#tAC TOR -- K IflNM Mfeii
Psnnn r+a Per,nlt Moider o.a Tole,none R
S/1N
PLUMBING
HVAC
ELECTRIC
EIECTfi1C
hwpect{ort DaM Imp. Commenta
Footings I
Faundation ??y/rs? cJ,B
Fra,,,ng
pmfiN
Bough P1bg.
Rwo ft.
isul. . 2?Z S
FreplaCe 11 ?
r ?
Finai Htg.
orsat Test
firtal P9bg. Plbg. lnspector - Notity Plumber
Const. Meter
F-WAna^
BId9• Fkml
Deck Ftg. a,?3 -92 Qs
oeck Fnel
weu
Pr. Diap.
?S a?! 3
INSPECTI4N RECaRD
CITY OF EAGAN PERMIT TYPE: i;0 I I t? 11440
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
10
SITE ADDRESS: „ f
APPLICANT: '
Ihll}tl? }1'r f? ?l•!Y 1., i. ?9', !'. I 1 I
til rt? Y Il?t!-.It t ??MU ? (t.l. 1 E.'?. r?•:q,'
PERMIT SUBTYPE:
TYPE OF WORK:
I IFItA t itlN
INSPECTION •• • D•
i?1?;?,!! ??? i f l;?? I rrr•,I
Permk No. Psrmit Holder Date Telephone M
ELECTRIC g Q ?
PLUMBtNG
HVAC
Inspectlon Date Insp. Commenta
FOOTINGS
FOUND
FHAMINC3
ROOFING
ROUGH
PLUMBING
'j•• J
PLBG
AIR TEST
ROUGH
HEATING U U n?
7. y ?
GAS SVC
TEST
INSUL
t•
GYP BOARD
FlREPLACE
AIR TEST FIREPLACE ZS _3,:?? S ,
FINAL PLBG
FINAL HTG --
ORSAT
TEST
eLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Wertificate vf CccupancV
W44 of Cfagan
2coartmcnt of tmtbing 3460cctivn
This Certificate issued pursuant to the requiremeRts of the Unifornt Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construcrion or use. For the following:
` SE DWG 1596
QJse ctassiscatio,L 91dg_ Rennil Mo.
0ccnpanc11Y ,rype mpmmw lmm? m_n,g District PD e?' _ VN 3152 i?rr?its ?
LAKE
Owner of Building ?y Address f f
Buildin ddress -'----7 p?Y ??ity - 1578 ? 12/18/q2
?-? -
Date:
Bnilding Official
POST IN A CONSPICUOUS PLACE
50 52 ,v??
Request Date Fire No. Rough?in Inspection
OCt. 2.1 1992
, Required9 ?ReadyNOw rJ}yillNOtifylnspector
1
G 1'es n N. Nlhen Reatly?
I ?13 Iicensetl contractor ? owner hereby request inspection of above electrical work at:
Job Atlaress (Street Bax or Route i Ciy
1578 Murphy Pkwy. Ea an
Seciion No. TownsM1ip Name or No. Range No. Counry
Dakota
OccuOam (PRINT) PM1One No.
Northern Classic Homes 440-7150
Power SupOfier Atlaress
Dakota Power 4300 220th Farmington 55024
Eieancal Comractor ICOmpany Name) ConVactor5 License No.
Sk Electric, Inc. CAP 1982
Mailing AOtlress (COnVacmr or pwner Mekinq Installa9on)
11210 Washburn Ave, So, Bloomington MN. 55431
AvlM1Or Sgnalu IConVactor,'0 Ma bg Ins ion) Phone Number
888-1736
MINNESOTA STATE BOAHO OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Grlggs-Mitlway Bldg. - Room S-173 6E ACCEPTEI) BY THE STATE BOARD
1821 University Ave., SL Peul. MN 55104 UNLESS PFOPEP INSPECTION FEE I$
Vpone (612) 64E-0800 ENGLOSED.
REOUEST FOR ELECTRICAL INSPECTION E13-0000 -OB
0, w tSee insL•yEtions for completing this lorm on back of yellow ropy.
??Qg?(?p 0
6 "X" Be/ow Work Covered by This Request
ew Frtid Rep. ? TypeofBuilding ApplianteSWired EquipmentWired
X Home g Range Temporary Service
Ouplex Water Heater Electric Healing
Apt. Building Dryer Olher (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Omer (syeciry) ConVaclor5 qemarks:
Compute Inspection Fee Below:
# Other Pee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool X O to 200 Amps 1$ 2 0 to 100 Amps $$
Transformers Above 200 _ Amps Amps
SignS Inspector5 Use Ony? TOTAL
trrigation Booms 106.50
Speciallnspection
Aiarm/Communication TMIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITMIN 18 MONTHS.
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rough-in ? r
F;nai r Date GV y ?
d
e
OFFICE USE ONLY
n ,
This request witl 18 months irom
61U J_C,3g1REQUEST FOR ELECTRICAL INSPECTION es-ooooi-os
? Sea instmctions far completing this tartn on back ot yellow copy.
y /
/?/9'rJ " "X" Below Work Covered by Thrs Request
Ne Ad ?4e . "Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heatar Electric Heatin
Apt. Building Dryer Load Mana ement
I Comm./Industrial Furnace Other (Specify)
Farm Air Contlitioner
Olhar (specify) ConVeclor s Remarks:
Compute Inspection Fee Befow:
# Other Fee # Service Entrance Size Fee
# Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps to 100 Amps
Transformers Above 200-Amps Above 100,_Amps
$I 115 Inspector's Use Only: QTAL sO
Irrigalion Booms . / ??
S ecial Inspection ZV
Alarm/Communication THIS INS7ALLATION MAY BE ORD ONNECTED IF NOT
Other Fae COMPLETED WITMIN 18 MONTHS.
I, the Electricai Inspector, hereby
certify that the above inspection has
been made. Rou9n-in
Fmei o e ?
J
OFFICE USE ONLV
This request void 18 monlhs from
0-
1
0
0 3 8
?
?
5
49
Req est Date Fire Na. Rough.ln Inspaction ReqNretl Ins edion Other Than Roughdn -
ustV
ll inspector ? whan reatly)
(YOU m a Peady Now ? Wiil Notify Inspecroi
?
e
N. ?ete ReflG
I? licensed contractor owner hereby request inspection of above electrical work at:
Job Atltlress (Strcet, Box ar Route No.) Ciry
?
Section No. Township Neme or No, Renge No. County
? ,7')
Occupant(PRINT) Phone No.
sa-as?
Power SuppllBr tlGress
Elactrical Contrecmr (Company Name)
? CoNra<tofs License No.
Malling Addrass (ConVactor ar Owner Meking Inslellation)
Aulhonzetl Sre (COnlrect Owner Mekinq Ins allation) Phone Nu r
~ ? - ?• ,?02
IdTV
O
I
I OT
I
4 9
I
6
?
B II I I I II I I I ? I I ( I I I II?
E
Unlv
e1Ty
MN
S70C
Ph
A ee.
S
P u
7 OP ER INSPECTIONF EE
?
z Ep,
EN
C OS
.Address: 1578 NIIP_2RiY pARKWAY I.ot 20 Blk ] Sec/SubgLAgai,qW ppND ZIP• 55122
These items were/weze not complate at the time of the final inspection.
Date: 12 18 92 Yes No
Finalgrade (6" from siding) V
Permanent steps - garage ?
Permanent ateps - main entry
Permanent driveway ?
Permanent gas ?
Sod/seaded grass
Trail/curb damage
Porch
Basament finiah
Deck
Please verify with the builder the removal of roof test oaps from the plumbing
system and the shut-off of vater supply to tha outaida lavn faucat before
freeze potential exists. ?
Kcnm.iu
Wttite - City copy Yellow - Reaident copy Pink - Contractor copy
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
? 651-675-5675
Please complete for modifications to existing residential dwellings.
Date
Site Street Address 7": !Gl //?`?'?- ' Unit #
. ,
?
L
Property Owner C/ Telephone #
Contractor Telephone # ( )
Address City State Zip
The Applicant is 4-10wner _ Contrector _Other
I Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener /iWater Heater $ 15.00
I/ replacement _ additional
Lawn Irrigation System
RPZ_ new _ repair _rebuild i
$ 30.00
State Surcharge $ .50
Total
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not.a1permit, but only an application for a
permit, work is not to start without a permit and work will be irvaccordance with the approved plan in
the?evant a plan is required to be reviewed and approved.
//?,/ ?
?
/ ?-<?-
,
ApplicanYs Printed Name Applicant's 5ignature ? -----
,, ? ?l i5
?J'
?I NOV 1 ' 21304
-. - .?1
? C!T-Y OF EAGAN PERMIT
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Control No. 1165
PERMITTYPE: suxLozNe
Permit Number: 0 015 9 5
Date Issued: 10 / 0 9/ 9 2
SITE ADDRESS:
1578 MURPHY PKWY
LOT: 20 BLOCK: 1
BLACKHAWK POND
DESCRIPTION:
jBui].d%h.g Permit Type SF DWG
' 6uilding''Work Type NEW
UBC OccupanGy ft-3 M-1
Constructioni"fype V-N
' Zoning PD R-1
Building Length 70
?
Building Width 36
--
, ?
r-
(
?
L; _i
REMARKS: C O aI aaq
PRV S & W CONTRACTOR
- KLAMM MECH
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
5AC
SAC ?
SAC Units
Subtotal
$2,225.80
$167,0410
MISCEILANEOUS $1,610.50
COPIES $1.00
Total Fee $3q837.10
CONTRACTOR: - Fl p p 1 i c a n t- OWNER:
NORTHERN CLA55IC HOMES 14407150 NORTMERN CLASSIC HOMES
3152 BUTTERNUT CIR 3152 BUTTERNUT CT
PRIOR LAKE MN 55372 PRIOR LAKE MN 55372
(612) 440-7150 (612)440-7150
I hereby acknowlecJge ihat I'have read thss applicatian and state tihat the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan prdinances.
? l
!? 11 %i ?IC-C4 .2 / c?? '"'a
I APPLICANT/PERMITEE SIGNATURE -- -- ISSUE Y: SIGNATURE
VAI.UATION
$874.00
$568.10
$83.50
$700.00
100
1
PERMIT #
REACTIYATE ,_
CITY OF EAGAN $3,??J??. i"
1992 BUILDING PERMIT APPLICATION
681-4675
OC7 Q S RECD
Cl AG( I'O-i
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 capy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date /e ?2- Valuation of work
Site Address:_ i_5"7?
STREET ? SUITE /
Tenant Name: (commerclal only)
IAT ?20
I
BIACK
SUBD.
P.I.D. 1F
K
Descri tion of work: SfuGt g FAni/i _C,1:34 ?
The applicant is: Owner O(Contractor ? Other coe8«iee>
Name _NO.o.I? cwstz k4py( Phorie
OVO --71 5'o
Property ,
u5T ?IR:T
Owner Address &5-LZ9Wyvr ??: ?
STREET STE N
City &149r ,L40 State M'V Zip 5r3__)2-
Company s4MJ gS A-&vvi- Phone
Contractor Address License # Exp.
City State Zip
Company /_gtf-2s2 Phone S3i -a7yL
Architect/
Engineer Name Registration #
Address 3fDS &pa14 AvP N.
City (}t/?5??? State N41tl Zip
Sewer 3 water licensed plumber "/yM Processing time for
sewer & water permits,is two days once area has een approved. •
1 hereby acknowledge that Iifiave r atl this application and state that the information is
correct and agree to comply wit pplicable State of Minnesota Statutes and City of
Eagan Ordinances. !
E
Signature of Applicant: J
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation ? 06 Uuplex ? 11 Apt./Lodging
002 SF Dwg. ? 07 4-Plex 11 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'7. ? 15 Deck
WORK TYPE
?31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair El 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft.
SAllowable) h lst F1. sq. ft.
UBC ccupancy 2nd F1. sq. ft.
Zoning Pa iZ-i Sq. Ft. total
f of Stories Footprint Sq. ft.
Length y/z' On-site well
Depth ,g r,.' On-site sewage
APPROVALS
Planning Building
Engineering Yariance
REQUIRED INSPECTIONS
O site
? Wallboard
? Footing
? Final
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Nater Meter
Acct. Deposit
S/M Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Tatal:
SaC as , jvo
SAC Units I
v.ti.c:a,:
GARA6t ?
C3.StYlT;
I I,6r
? Framing
13 Draintile
s 16"1 oao
30 X 3LI /t,3S
6,1`/)
r?nly'lZ = Cf7LI)
07 2.
.30 xz?` 106c?
1,14x/?'?z=
Izxiv,/z =l"74
? r3<?r+? i= I 2-h o
r ? ¢ = .-?-
l?c-s n?3=?.'?ZV?a
ZivO }z_•oh :
a x1 v -
171-f
7T? x 5^3 ? ?7,c?9b?
+N+:• ? Y • y ?.. ?
?? 16 Ba`sement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
O 20 Public Facility
O 21 Miscellaneous
? 37 Demolish
MWCC System Yts
City Water TEs
PRV Required y CE,5
Booster Pump
Fire 5prinkler
Census Code ?
SAC Code
Assessments
/t- ?-, =z??i
- EXTERIOR ENVELOPE AVERAGE "U" LOMPUTATION
04!FI E R :
7E AOORESS:
CONTRACTOR: DATE: PHONE:
DETERMINE YIORKING SOUARE FOOTAGE OF EACH:.
l. TOTAL EXPOSED 4tALl AREA, ,,,,,,, sq f t x"U"
2. TOTAL ROOF/CEILING AREA,,,,,,,. sq ft x"U" ? 02-Co .. a?3
3• TOTAL EXPOSEO NALL AREA CALCULATIONS:
Total exposed wall ,
area above floor,,,,,,,, "
_2kna(n sq ft
a) Total wall wtndow area: --(t)
?+b1? 9lazed...... 3a.0 sq ft x"Un •`-1? • 13`1•Co?
9lazed...... sq ft x "U"
.
6) Total door area ,,,,,,,,. 3Y?. sq ft x"U"
AT(??rxN?
c) Total s-i-i4}ny glass door area:
glazed...... y0 sq ft x"U" • 1? -L-
9lazed......
sq ft x "U" .
d) Total fireplace wall area L1 cg sq ft x"U!'
e) Tota) wall framing area
(Average 15X)........... 14 C?? sq ft x??U"
f) Total net wall area above
floor (Insulated)...... sq ft x"U" s9?
g) Total rlm Joist area...... \? v sq ft x"U"
Total foundatlon
area (Exposed).......... t? Z`?-- sq ft
h) Total faundatfon '
wtndow area............. sq ft x "U"
I} To[al net foundatlon
area above qrade........
3co sq
ft
x"U" ?
DL1:?
3' TOTAL a) thru I)
If (tem 93 fs the same as, or less than item F1, you have met the In[ent of
2 rtcAR 1.16008 p and o.
Page 1
4. TOTAI EXPOSED NQOF/CEILINf, CALCULATIONS:
Total exposed
roof/celling area........ k sq ft
J) 7ota1 skyltaht area....... sq ft x"U"
k) Total roof/ce(llnq framing
aroa (Averace lOR),,,,,, sq ft x"U" °d?g
1) 'Total net insulated
roof/cet 1 ing area....... sq ft x"U"
4. TOTAL J) thru 1`)?1F-
2 If total of 14 fs the same as, or less than A2, you have met the tntenL of MCAIt 1.16008 A and 0.
?
, ALTERNATE BUILDIi1G ENVELOPE DESIfN
To utilTze the total envelape system method, the values established by tha sum
of items P3 and A shall not be greater than the sum of items dl and #2.
i . + 2. m
3. + 4.
C E R T I F I C A T I 0 N
I hereby certify that I have calculated the "U" factors and "R"
values hereln and that the hutldinq here described meets or exceeds the Sta[e
of Nlnnesota Enercy Conservatfon Act.
Siqnature
(Date)
Page 2
-. , ? .
;. . _
NSTRUCTION R VAIUE
AHING SECTION:
Intcrlor aIr fflm 0,68
?d
ti /'?inches soft waod ?.?
-,? -, ?-k_ _ . %,
J % c? k ?j - . 1-ilJ
Exterior air ' f-pim n.t7
IUTAL K =
U = 1/R = . 1?
• 14ALL SECTION (INSULATED)
1 Interlor air fllm
% 2 !?2 ?? Shqo?R<
4 _.. ...
terlor air''f'llm
n
IUIHL K.a
v
U = .1/R
? _ .. .. ...- -
p A 14
?.r
A.
•
d • 4.
A --a,
RIM JOIST SECTIqtI:
--(1 Interior air film n.(,R
------------------ {?i wu? \
5
6 Exterior air film 0,17
FOUNDATION INSULATIO
P! REQUIRED: 70TAL
•
Min. R-5 on entire wall OR
' U=)/R =O
Min. R-10 down to frost d
epth
fOUNDATIO !! SECTIOtd:
1 Interior air film
2 ? !?.' ?. ? • ?SV . 1
3 -
%-? ,?
'
4 .
?,z?,-
E ??5?
P,,?n,•? f • '7
xterior air film p 17
TOTAL R = .y
? U = 1/R = .QY]
SLAR ON GRADE
?
• ?6' a , U ,.a a.
>1 4 'i.r .•;.?°? a,', . '?,
?ti ?•?o' '' ? , ? A
. ? Heated Slabs:
'?'.?? ,.•?' Minimum R = 8.5
v
, , ?1; ;•-4. Unheated Slabs: .
Minimum R = 6.2
Q• .q ,• ? : ?4? ,
a,,o,4 a ?• q ?
?
?'•r , ; °
'
?'
?
a
'
?
"4'?.
?
?•••?4 • I
4.=
•
f
. . ,,
? t
. ,
;
? •- ? .?•
;
a:
???.
'
4
? ,
a
?6
4
L
'
- Pa zP ?L
.. ? .
CONS7RUL71oN R VnLUC •
F
G
?
AIR
LOW
. .
VENTED
CEILINf. SECTION (INSULATED):
1 Intr.rlor ilr fllro (l,f.l
2 ?, .
; \ ?1 ?W0 4vL '-77
4 Exterlor alr fllm• still) 0.f, 1
TOTAL R = y ? ?
U = IIR = ?0
CEILING FRAMINf, SECTION: .
1 Intertor atr film • 0.61
2
3 S
4 Interior air film stil rY. 0.61
5 ly.inches soft wood TOTAL R
U = i/R
CEILRIG SEf,TION (IFlSULATED):
1' Interior air film 0.61
2
3
4 F.xterior air film still 0771
TOTAL R =
U= 1/R=
CEILItJr, FRAMIHG SECTIOH: .
1• Interior air film 0.61
3
4 Exterior air film still 0.61
5 inches soft o-iood
TOTAL R =
. U= 1/R=
1 Instde air film O.FI
2
3 •.
4
5 Outside alr film n,17
TOTAL R =
U a 1/R =
Pann G
VENTED
? CITY OF EAGAN
3830 Piiot Kno6 Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
G2t) Ak571el -,
BUILDING
026032
07/19/95
SITE ADDRESS:
P.I.N.: 10-14395-209-01
1578 MURPHY PKWY
LOT: 20 BLOCK: 1
BLACKHAWK POND
DESCRIPTION:
BASEMENT FINISH
ALTERATION
'.. ;
'?
BL(ilding`.Permzt Type
9uilding Wo'r.,,k Type
t(
REMARKS:
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
CONTRACTOR:
OWNER: - npplicant -
LARAMY BILL
1578 MURPHY PKWY
EAGAN MN
(612)557-4847
I hereby acknowledge that S have read this
ih'Formation is correct and agree ta comply
Statutes and City of Eagan Ordinances.
L
A ICANT/PERMITEE SIGN/jLtl E
?
application and state that the
withal.l applicebEe Stateof-Mn.
tin .9),ry ISSUED BISIG UR --
CITY OF EAGAN
a\0 ? 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
Name: G-4RA-/11 V 3 / Phone
IAbi iW6T
Street Address I S 7? IM u 2.gLw h' k..caxe
? 3 regfsterod aite surveys ? 2 copiea of plan
? 2 copies at plerre (indude beam 8 winEOw sizes; pouied fid. design; etc.) ? 2 site surveys (axterior atlditions & decks)
? 7 snsrgy cakulations ? 7 energy calwtations for heated addkions
? 3 wpbs of 4ea proeervation plan if lot platted eRer 711/93
required: _ Yes No
DATE: I -8? 4?5?: CONSTRUCTION COST: fW-ft -7'73/cb=
DESCRIPTION OF WORK: 3?4SE;uS.? T F'w iSk
STRE DRESS: 15 76 I1^uR
LOT 2- 0 BLOCK ? SUBD./P.I.D.
PROPERTY
awNeR
CONTRACTOR
License #•
City: E?.4i.? State: N? Zip: ?S?zZ
Company: 4_. Phone #:
Street Address:
City:
? S ?s o
5
t/f
-
????
y
Zip.
State:
ARCHITECT/ Company: 1s'14-r4AAr- '
ENGINEER
Name:
Phone #•
Registration #•
Street Address-
City: State: Zip:
Sewer & water licensed plumber: Penaity applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is ct and gree to comply with ali
applicable State of Minnesota STatutes and City of Eagan Ordinanoes.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
_ Yes _ No
-------? __- =
6664 £ t i I i I'
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
0 02 SF Dwelling o 07 4-plex
0 03 SF Addition o 08 8-plex
0 04 SF Porch o 09 12-plex
n 05 SF Misc. 0 10 = plex
WORK TYPE
0 11 Apt./Lodging ,[? 161 Basement Finish
0 12 Multi RepaiNRem. 0 17 Swim Pool
? 13 Garage/Accessory o 20' Public Facility
0 14 Fireplace o 21 Miscellaneous
0 15 Deck
? 31 New /6 33 Alterations o 38 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy . sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit CJ
APPROVALS
Planning Building Engineering Variance
Pertnit Fee Valuation: $
Surcharge
Pian Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5!W Permk
S/W Surcharge ?
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total: •
% SAC
SAC Units
r.,rr,f, n!- rr-?rr-,ra
:is rt:.hrtzNai._ na;; 891_3
nnrt::r 08i:3099 rIMr:;; 00706
ZLi o
'iilAPiEe hiGRS7.01! EX'ii":RTOItSy I...1_C;
32i.0 9001 078 14Ufif-'11Y PRIA! !.r'.25
?
2155 90(:)1 078 Pf!..1';iF'HY F'2W 4,50
I
Tot;]:I. F;:(?cei.pt, Amoun'.:a 171.75
CFiiL237
l:Sl'-R 7:Lir, JAN
l? 1.'15
New Construction Reaulrements
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
?3?•?`?
Remodel/Reoair ReaulremeMs
3 regisfered sMe surveys showing sq. fl. of lot, sq. R. of house
and all rooted areas (20% maximum lot coveraae allowed)
4 copies of plans (show beam 3 window sizes; poured fnd. design; etc.)
1 aef of energy calculatlons
3 copfes of hee,preservaTion plan ff lof plaMed affer 7/1 /93
DATE:
DESCRIPTION OF WORK: 11111X 04-L C f.fL.'
STREET ADDRE55:
LOi: 'D'0 BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
2 copies of plan
1 sef of energy wlculafions for heated addNions
1 sNe funey for exterior addNlons 3 decks
CONSTRUCTION COST: -1 (?v SlJ • ?5 'T
Name: Ir-.Ol U.1 i lU ?1 11
Last Firsf
Street
City
Phone#:&a +44f5Z rZ5?0
Compan)r - Phone #:
i Horizon Exteriors ' (areo code) `a? o1
1333 Larc Industrial Bivd.
CONTRACTOR ?
Burnsville, MN 55337 I License #? Exp.
Street Address: ? (612) 890-3900 ,
City
ARCHITECT/
ENGINEER
Teiephone #: area code (
Sheet
Cffy
Sewer 8 water Iicensed plumber (reauired for new conshucNon oniv):
State: Zip:
Name:
°egiStia':On N:
State:
PenoNy applles when address change and lof change Is requeafed once permM Is issued.
Zip:
I hereby acknowledge that I have read this appllcaHon, state }hat Me infor aHon Is conect, and agree To comply wRh all applicabi
State of Minnesota Statutes and CHy of Eagan Ordinances.
, Signature of Appllcant
OFFICE USE ONLY REi CEIV ED
Certificates of Survey Received _ Yes _ No AUG 3 1 1999
Tree Preservation Plan Received - Yes - No _ Not Required
BY:
BUILDINC PERMIT APPLICATION (RE51DENTIAL)
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ' ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ?'25, Miscellaneous
woRK nrPe , p
? 31 New ? 35 Tenant Impr, ?'39 Gas Line On ly -? 43 Siding/Soffits/Fascia
O 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.` ? 41 Wood Stove ? 4$ ? Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
*
Give PCA handout to applicant for demol
ition permit
GENERAL INFORMATION ?
r • a
Const. (Actual) Basement sq. ft . Census Code
(Allowable) Main level sq. ft . ' SAC Code
UBC Occupancy sq. ft. No. of Unifs'
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES Sy'sfem
Length sq. ft. City Water
Width Footprint sq. ft . Booster Pump
PRV
Fire 5prinklered
APPROVALS
Planning Building Engineering Variance
c `° ` -
Permit Fee ?' -.
Valuation: $Y ?8
?
Surcharge '-l SZ) i? I
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit r
SNN Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies . Total: I ]I .- i_5
SAC Units
% SAC
t
CITY USE ONLY
LOT ? v BL RECEIPT #: ?6
SUBD. RECEIPT DATE: o/9 ?
, ?1996 MECHAN1CAL P£gMIT (iiESID£NTIAL)
crrY oF EAsAN
/y/. ??
S$SO PILOT KNOB iiD
EkfiAN MN 55122
.? p
Date• (sta) 681-4675
Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under
construction and not owner /occupied '
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
. Gas outlets (minimum of one required @$3.00 ea.)
• State Surchazge: .50
• TOTAL:
Complete this section onfv if you aze remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanical permit is not required for alteration/add-on to ductwork in
existing residential units; but is required for the following:
_ Install fumace _
? Install air exchanger, i.e. Vanee system, etc. _
Minimum fee applies to all remodel or add-ons of existing residences
5tate Surcharge
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
Install air conditioning
Other
$ 20.00
Total: $ 20.50
PHONE#: -r59'2S?pJ
PHONE #: i7 J "[eQlni 5
_ STAT ? ZIP:!6_20
C J
G ATUAE OF PERMITTEE
1S/FORMS BLD/MECH PERMIT (RES) - 1998
CITY USE ONLY
L BL . RECEIPT#:
SUBD. RECEIPT DATE: _
APPROVED BY: ,INSPECTOR
199$ M£CH1R1V[CAL P£RMIT (COMM£ftCIRL)
CITY Of £14fiAN
S$SO PILOT KNO$ RD
ERfii4N, MN 551E8
(61E)6$1-4675
Please complete for: all commercial/industrial buildings ,
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE: '
WORKTYPE: NEW CONSTRUCTION INTERIORIMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater.
Processed piping - $25.00
CONTRACT PRICE x 1 %
PROCESSED PIPING
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLI):
INSTALLER:
ADDRESS: PHONE #:
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
($.50 per $1,000 of peRnit fee due on all permiu.)
PHONE #:
C1TY OF EAGAN
L ?O B MECHANICAL PERMIT
SUBD. (612) 681-4675
RESIDENTIAL
RECEIPT # ?Z%J ( V? g
DATE 1 ??
PLEASE COMPLEfE UPPER PORTION DNLY FOR SWGLE FAMIIY DWF.Li.IIdG3. ALSO, COMPLElE FOR
TOR'NHOMES/CONDOS R'HEN SEPARATE PERAIITS ARE REQUIRID FOR FACH DWELI.WG iTNPf.
OR'NER: p FEFS
STTE ADDRESS:
n ADD ON/REMODEL (E7C[STING
CONSTRUCl'ION ONM $ 13.00
INSTALLER: HVAC: 0-100 M BTU 24•00
PHONE #: p p ADDITIONAL 50 M BTU 6.00
ADDRESS: r1 l GAS OUTLEfS •?IINIIKUM 1@ $3 EA. oQ)
CI1Y: ZIP: SURCHARGE: $ .50
,
SIGNA
TOTAL:
$ a'-l •?
COMMERCLAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIIINDUSTRIAL BUII.DINGS. ALSO COMPLEfE FOR
APARTMENT BIIILDINGS OR OTAER MULTI-FAMILY BUILDINGS R'HEN SEPARATE PERMTI'S ARE NOT REQUIRED FOR
FACH DVYELLING UNTT.
R'ORK DFSCRIP170N:
CONTRACf PRICE: f FEES
196 OF CONTRACf FEE. ?
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMTf FEE. $
PROCFSSED PIPING •, $23.00 Fs
MINIMUM FEE • 525.00
OWNER:
SI1'E ADDRFSS:
7'ENANT:
SUiTE #:
INSTALLER:
ADDRFSS:
C11T:
PHONE #:
SIGNATURE:
TOTAL:
7,IP:
CITY SIGNATURE.
L--?90 Bl
? CITY OF EAGAN
PLUMBING PERMIT
/?
SUBD. (612) 681-4675
REBIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST ?
ADD ON
REPAIR
CITY USE ONLY
RECEIPT # O
DATE O Ff
ALSO, FOR TOWNfiOMES AND CONDOS
COMPLETE THE FOLIAWING:
OWNER NAME : &-e' '44xe?
SITE ADDRESS: 1-57f /?? ??t-.Eiv4GrsS
a
INSTALLER:
ADDRESS: /aS?09
-?
CITY: ?G¢ur./,LG ZIP:
PHONE #: 1? 90-?fA; S'
SIGNATURE OF PERMITTEE
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15,00
/ SHOWER 3.00 3.0e)
? WATER CIASET 3.00 •oo
/ BATH TUB 3.00 3.00
? IAVATORY 3.00 /Soo
1 KITCHEN SINK 3.00 3.00
L IAUNDRY TRAY 3.00 3.00
/ HOT TUB/SPA 3.00 .3•06
WATER HEATER 3.00 3-ao
/ FLOOR DRAIN 3.00 3.dv
GAS PIPING OUT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50 /-rv
_ OTHER
_ WATER SOFfENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
STATE SURCHARGE .50 So
TOTAL: $ ' COI+MERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDDSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR: _
CITY OF EAGAN
CONTRACT PRICE:
1% 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)
k'.?
? r, " ? r ?' ly '?, r
y. _ .
?. . : ." '> t . `+.? ?,.. , . .
d ? r ? ? e . ! ? ,. . ??.. ?? .?. ° i ItP?? . ?:6. ? . a. ±3,
1 A
x+ ? p 5 y, a?+ ? a?.i ? ? -7k?.*.. ?.
s ? .^?_.: , ...ti::?., s. . ?.._,?d,i..?????.. ?t.:?'.d`=.i? . _kr:?al.s?<+:Mi
CITY USE ONLY
. SUBD [yClCQC.JQY1G.wiP 96L-rd
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 687-4675
Please complete for: ? single family dwellings V?
? townhomes and condos when permits are required
- ,:
?e?.,.,> '., 9g? ?
5 QZ?? .r
FIXTURES EACH NO. TOTAL
Shower 3.00 x
Water Closet 1 x
Bath Tub 3.00 =
Lavatory 3.00 x =
Kitchen Sink 3.00 x ? -
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x,;:. --
.
..,Floor D'a"in'
.
3:00:.
x -
,
w
, ...
, , . ,.
Ga5 Plping Outlet `•:minimum =-1 vi' ,
•'`" ? :' °` ' 3.00
Rough Openings 1. x
Water Softener .00 x =
Private Disposal ' Dakota Cty. license 0.00 =
U.G. Sprinkler * home under const. 3.00 =
t,,Alterations'?to?existing? ,. ,. • . ;,-; . . 206,00- . ??fr??
Water Turn Around 20.00 ;
?
STATE SURCHARGE .60J
TOTAL 740-? ae
SITE ADDRESS: 1578 MURPHY PARKWAY
OWNER NAME: RrLt T ARAMY -
r.
- STREET A[
rnn: ? ?• _" 4? _L'.,?" ,_.. .. ._. . . ..?A??, ?q
CITY: RIiRNSVTT.T.F. STATE. MTNNF.Cl1TA ZIP: §333;
PHONE #: ( 612 ? 890-4868
?
SIGNATURE F P
RECEIPT #: 41170-14-
L BL
SUBD.
CITY USE ONLY
RECEIPT #:
DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are = required
for each dweiling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON ' REPAIR
DESCRIPTION OF WORK:
FEE: $25.00 minimum fee or 1% of contrect price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:.
CITY:
PHONE #:
STATE ZIP:
SIGNATURE:
APPLICANT CITY OF EAGAN
'OCT-07-192 4ED 08:18 ID:JAMES R HILL INC TEL N0:612 890-6244 tY715 P02
wi fs ,
SURVEYQR'3 CERTIFICATE NORTHERN CLA$$IC HOMES
J ,
i )?7 c
AIEERIAIG DEPT
H07E+ BWLDiNO pMEN4i0N$ SHpWN ME
FOti F?Po20HfAl 9 VENTKAL LOC-
A710N OP .1TRUGTtq16 ONLY. SCC
ARCHITHCTUAL PI,ANS tCR 9UIlDINO
6 FWNDATION DIMENS10N9.
NOTEj NO SPECIFlC 90tl9 IyVE9TqAT10H
HA8 9MN CDNq.E1'Ep ON TNq
wT mr THE sunvHroa nre
9UITABILITY OF 400.,3 1b SUPPOqr
THE 4'ECnC FIOt18[ PRp ?
IS NOT TFE RF9PONSIB?IT ,? OW?
91
TMP 9UNYEYpR. ??-?"
•+ DENOTES pROPp&ED 5URFACE DRAINACiE
O DENOTES IRON MONUMENT SET
• DENOTES IRON MONUMENT FpUND
X000.0 DENOTES ExISTING ELEVATION
(OOO.U) DENOTES PRbPOSED ELEVATION
SCALE:IINCH - 30 FEET
PROPOSED OAHAQE FLOOR -<fG G- 4 FEET
PROPOSED LQWEBT FLOOFI -$S''9- Cn FEET
PROPOSED TOP OF BLOCK -ac r• 7 FEET
WE HEREBY CEATIFY TO NOR1'HERN ClA3SIC HOMES THAT THIB IS A TRUE AND CORRECT
REPRESENTA71bN OF A SURVEY OF THE BOUNDARIES OF:
Lut2D, Block 1, BLACKHEANK POND, occarcling to the recorded plat Ihereoi,
Dokato County, Mnnesota.
IT DpES NOT PURPOqt TO SHOW IMPqOVEMEN7S OR ENCROACHMENTS, EXCEpT AS SHOWN. AS
SURVEVED BY ME OR UNDER MY DlqECT SyyEMSION THIS 24TH QAY OF SEPT , iggp,
PqOP09ED OflADHB $?tpWN yygqE
TAIf[N fADY 714E DEVmAPMD1T
PLaM Foe eLAcautwK pao
PnirAR[b Br PIDNIMR 5/9.,
LABT DMlD I8-9-E8.
? e L--.-?
JOHN C. LARSON, LAN SU RVEYt?R
MINNESOTA LICEN3r: NUMBEp /9828
James R. Hill, inc.
PLANNERS / ENGINEFRS / SURVEYORS
2800 W. CTY. Rp. 42 a 6UpWSVILLE, MN. G6987 0 612-890-8044
R-95% ]AMES R HILL INC 10-07-92 08:20AM P002 #06
HILL, INC.
? OCT-07-192 4ED 08:18 ID:JfMES R HILL INC TEL N0:612 890-6244 #715 P03
S U R V E YO R' S G E R NORTHERN CLA931C 140ME9
•? MURPH pqRkWAy 0,.g
eess &.-?
O
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BEnCH MARN
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' 6642 !
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James R. Hill, inc.
PIJANNERS ! ENGiNEER5 ! SURVEYORS
2600 W. CTY. RD. 42 • BURNSVILLE, MN. 66337 • 812-890-69q4
1 r
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A-95% 3AM6S R HILL INC IO-0'i-92 08:20A?f f003 906
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108173
Date Issued:11/20/2012
Permit Category:ePermit
Site Address: 1578 Murphy Pkwy
Lot:20 Block: 1 Addition: Blackhawk Pond
PID:10-14395-01-200
Use:
Description:
Sub Type:e - Furnace & Air Conditioner
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, (952)
445-2840
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
William G Laramy
1578 Murphy Pkwy
Eagan MN 55122
Pronto Heating & Air Conditioning
7588 Washington Avenue South
Eden Prairie MN 55344
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r------------------�
I For Office Use �
� � Permit#: i �V� �
Clty of �a��� ; . �,�� ;
Permit Fee: �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 � �
Fax: (651)675-5694 I Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: b�3'�Y SiteAddress: �J �� ��� � Unit#:
:� (
, � ��� n� �. �` �,��� � � p �/— �`
.r� Name: �7/�� L�rG{ Phone: a�s ��027
Resr,d�rit/ � �� � �? K �1 Q,�
�,Qy����f �.=� Address/City/Zip: �y
�"�"
`' Applicant is: Owner �Contractor
Description of work: �^� �������q�'e- ���Q� I �/'�1i(�Q 3 s f c�ef
Type �f W�rk �
: Construction Cost:��i�D� Multi-Family Building: (Yes /No K�
��i� � Company: ��l� I.��'�� �+'►'L�- Contact: /���� �1���
�� ��4 ilh�" : ��
���, ��,���� ��u��«��� ��6g �odd /�d �1.�,d� �
r� Address: Cit �
G�,�#�a�f�#r � Y'
��'ih��?°',` � '��iu
- Statei �/N Zip: S���$ Phone: '�'��^3��1�9y��mail: '"'��I`e �T� �• ���
License#: B C�O b SZ� Lead Certificate#: � 2� �y�" —�
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
�'�C�,rv�� �A�/t 6�r' 1� t��t �.G� a-�e.� f �'�`a
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:
Nl)TE;Pl�r�s and supporting dc��c�m+er�ts��h��yau s���S`rr'trf are�,��rsf�t�red t��b��pu'btic irr��rma.tiart, Por#ir�rr�c�f
the�nfarm�frc�,.n r�ray�e�1a�;s�fie�C��,���t�p ��ii���'ya����r�aV`i'i���p����f�c r����n�that,Mrc�UCd p!�rm�t t��C�t,�ta
_��''��;, 4 �� i °�-' Gi�f?� i'�i�@��'Ic'i��`ffi,mP�". c�f�'�1'�C��.��Cl��. :
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.aopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
� Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. '�
x r�C.Q 1`��P'� ��C
X
Applicant's Printed Name ApplicanYs Signature
Page 1 of 3
Use BLUE or BLACK Ink
r----------------�
I For Office Use o� �
� ! I
� � Permit#: ��� I
�lty 0� ����Il '
i G� i
� Permit Fee: �
I �
3830 Pilot Knob Road �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 I �
Fax: (651) 675-5694 I Staff: I
�-----------------�
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: (� " 1 1 � �� Site Address: } ��� /"\t,'� �w
\ } � _ )
Tenant: � ` l�c�,�(1�✓� ` � Suite#:
, j � f
Resident/�wner Name: � ,1 l�L�f'tJ�v�,�, Phone: (��� - �� -L���
Address/City/Zip: � �v��'' �
Name:__ `;� j� � � �w.�,,�c� � l. C License#: �L �(����i �
Contractor Address: ��L� (,�. �����h � rr�.��ity: 00��` �ll _
: State: M [V Zip: j S -( �� Phone: �'(�� - �`�(`_�-- SO b v�
�'
° Contact: `� � EmaiL
Type Of WOt'k —New _Replacement _Repair _Rebuild �Modify Space _Work in R.O W
Description of work: f - �U`S`1��� ���f`��r"�, 'r 4-1��C��`
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation�RPZ/_PVB)
Permit Type
Septic System Add Plumbing Fixtures �Main/_Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Ir�igation (includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
'`Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built) (includes County fee and$5.00 State Surcharge)
TOTAL FEES $
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.qopherstateonecall.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 o ns.
x �� G.w�� ` �CTPn��r�l x
ApplicanYs Printed Name App ' anYs ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: . Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer :Staff:
Use BLUE or BLACK Ink
r
For Office Use
I
:::
#: 6 % / CC
011. City of Eagans--Fee: ��
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING
i/BUILDING PERMIT APPLICATION
Date: <� 1-'( Site Address: i S7 p cf hr f k-wy Unit#:
Name: l.)i i l ...Ltk _. Phone:
f 4_ S 2S� 1
t
Resident/ ��L.i' e'—'
1 owner Address/City/Zip: f �� J /
I
Applicant is:
Owner X- Contractor
Description of work: �C,e 0- `
Type of Work
Construction Cost: Multi-Family Building: (Yes /No ) f
Company �' ��;AA• �i�. .. �M. Contact: ,r ( i e
�/ 1
Address: nbE 170cid Rd City: /VIeint � 1-fi '
Contractor s ( I
State: N Zip: �S�r 3 Phone: 3,`t—('l`'(0 Email: A )C1 t-t-t C g }0/16" i
License#: P C. L- ) I Lead Certificate#: (✓ �'
If the project is exempt from leadertifi
p cation, please explain why:
I
_ �
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING � ���� ._�N�� �
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:
I
Sewer&Water Contractor: Phone:
t i
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of I
the information may be classified as non-public if you provide specific reasons that would permit the City to
wbF. conclude that they are trade secrets. �A.. . I
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.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
(e Gy" Kit----x !AN x
Applicant's Printed Name Applicant's Signature
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