3878 Newtown Ct PERMIT #
, I ?
•/? '? ?'? :, ?
? ?j?? ?, f F,? ,! MECHANICAL PERMIT
?? y:? C' - 7
RECEIPT#
f
: ,
,?` ?pyx CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?S16?
'
CONTRACT PRICE: Y. a u PHONE: 454-8100
Site Address `-,,' 7 '""t"?74--"' « BLDG. TYPE WORK DESCRIPTION
Lot Blo k Sec/Sub Res
L' New
.
? Name Mutt Add-on
Address Comm. Repair
City
Phone y r? ?
6 Other
Name ?"• f?- r??Q' ???¢? -
?? FEES
RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIMUM - 1 PER PEkPA1T) - 1
50 EA
TYPE OF WOFiK .
.
(
COMMlIND FEE - i% OF CONTRACT FEE
Forced Air M BTU APT BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON & .
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU $ f 2•? MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT -
50
Vent CFM ,
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # - - BEYOND $1,000)
Other
FEE J..)d
S/C: elGNAT P
TOTAL•
`. ? FOR: CITY OF EAGAN
.... . . .. c;r :n.?;.. . ,... .
PERMIT # _
PIUMBiNG PERMIT ,
- - ? .^ .., RECEIPT k -
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: _
PHONE: 454-8100 ?
Site
Lot .
a?
m
?
c
Name _
Address
City _
Name t t- nL( '`!S K , t 1
c Address
3 '
p City Phone
COMMIIND FEE - 1% OF COMTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.4U
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BLOG. TYPE WORK DESCRIPTION
Res. New ?
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONIY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Ctoset - $3.00 4
Bath Tubs - $3.00
Lavatory - $3.04
Shower - $3.00
Ki!ehen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
?Softener - $5.00 ,-? • L- Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
FOR: CITY OF EAGAN
r
STATE S/C:
GRAND TOTAL: _ --%+- ?-
K:ACTTVATE FLfR DECK-PLAN REVIEWEI) 7/22/87
M. 1•R?.R?C &PAULA ML??,?`?5? 7213 CITY OF EAGAN ?
,,•_ j83D-Piloi I?nob ftoad, P.O. Box 21-199, Eagan, MN 55121 N? M47
PHONE• 454 8100
BUILDING PERMIT . Receipt#i
Tobeusedtw SP D?+G/Gr'1R EstValue '38,000 Date JA:.dsJARY 27 ,19c37
Site Address 3878 NEWTOWN CT Erect ? Occupancy R 3
Lot 9 aiock 4 sec/sub. LEXINGTOiv Remodel ? Zonino Ri
Parcel No. $QUAR? 3RU Repair ? Type of Const ?
Addition ? No. Stories
e SCYIP?K HOMES II?C Move ? Length 3?
Name 4 h
= 8477 133iZt? CT Demolish ? Depth
o Address Int Impr. ? Sq. Ft
iCity A.V. Phone 435-2491 Install ?
o Name SAI?SE Approvaa
=
v ? Address Assessment
~ City Phone Water & Sew.
? ? Police
? Name Fire
=
x a Address E
o
z ng.
? W Ciry Phone Plann
r
e
I hereby acknowledge that I have read this a w
st , thal the
intormation is correct and a
ree oa Stat
of
r Council
Bldg. Off.
g
i a
e
Pj
?
Minnesota Statutes and City of ?n O ,- APC
' ` Var. Date
Signature ot Permitt4
A Buitding Permit is issued to: SC' :
all work shall be done in accordance with all applica
Permit ? 461.50
Surcharge 44.00
Plan Review 2 3 0. 7 5
SAC 625.00
Water Conn. 525 . 00
Water Meter 67 . 00
Road Unit 305.00
Tr. PI. 180. C lJ
Parks
Copie
2
' ` • 25
Total ,
INC on the express condition that
innesota Statutes and City of Eagan Ordinances.
Building
- ParmU No. P*mR Noldar Data Tdephom M
Plombin9
S.
H.VA.C_ ?
Ehmtft
SOMMN
Inapectlon Dsb leNp. Commenb
Foofinys I
FooUnpsll
Foundation
Framiny
RodMy
Rough Plbp. ' ?.
Rou9n t++g. ?oO
Insul.
Fireplsce y5??? 7 E^ ?,
Final Htp.
Flnal Plby.
&dq. Flnal
Cert. Oee.
Dock Fty. 5'/ /.c.lr p r? O-770 44/45'.5'
'
Docic Frmp. If f ?? ?/OT A?%?G S? " / Z?
W?N
Pr. Dkp. N P.?GJ'yOwS -
PERMIT # ? c>
PLUMBING PERMIT RECEIPT # 7%?1 7?-
CITY OF EAGAN ,
383U PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
DWAIJF• dSd_111M
Site
? name
a Address - J
t City Phone Name Ei
c Address
p City Phone
FEES
COMM/IND FEE - 1%OF CON7RACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCi-iARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYDND $1,000.00)
l
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 $
8ath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
? Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whiripool - $3.00
Gas Piping Outlets - $1.50 ?
Softener - $5.00
weii - $io.oo
Private Disp. - $10.40
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL• '
PERMIT#
MECHANIGAL PERMiT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
Site Address ? r ?• -'J?`" BLDG. TYPE ? WORK DESCRIPTION
Lot ?- Btock_ Sec/SubRes. New
-
Mult. Add-on
: ? ' ., .'•
m Name r? 46
Address Comm. Repair
c Other
City .:
e?;?cr -? Phone c
FEES
L Name (Z
-?
RES
HVAC 0-100 M BTU
$24
00
c Address .
ADDITIONAL 50 M BTU -
.
- 6.00
Q City !/ s Pho?1@ r3f (RES. HVAC WCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM
1 PER PERMIT 50 EA
1
)
- -
.
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air C?VI BTU APT. BLDGS. - CaMM. RATE APPLIES
TOWNHOUSE & CONOQS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODEI.S - 12.00
Air Cond. M BTU MfNIMUM COMMERCIAL FEE - 20.00
STATE SURGHARGE PER PERMIT - .50
Vent. CFM ? (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # / BEYOND $1,000)
Other
PEE:
S/C: A'_ SIGNATURE OF PERMITTEE
roTAL: r
FOR: CITY OF EAGAN
ftex#ifira#it uf (hruvanry
Citp of (Eagan
loPpartmmi of swldhtg jwrrfimt
This Certificate issued pursuant to the requirensents of Section 306 of 1he Uniform Buildrng
Code cemfying thar at rhe time of issuance this structure was in compliance wilh the various
ordinances of the City regu/ating bui/ding construcdon or use. For the following.•
Blas. PhYw Ho.
o-JP.ay rya R3 zonfm8 a,uicx 'ryro c?e
Owner o[ Bailding ., i Tl?aT_: F ri {'} s Addrms •i i t t:. ?' r. .-
Bw7d4 Addrts :1Tr'::;4 ?hty
Bwlding o1fKa.l ?
POST IN A CONSPiCUOUS PLACE
-. • ,?? Lt
3830 Pilot Knob R dl P.O. Box 2G-A799, Eagan, MN 55121 N2 13147
BUILDING PERMIT PHONE:454-8100 rteceipi p
?a)-
-?
??
To be used for SF DWG/GAR Est value $ 88,000 Date JANUARY 27 19 87
SiteAddress 387$ NEWTOWN CT Erect 19 Occupancy R3
Lot 9 Block 4 Sec/Sub. LEXINGTON Remodel ? Zoning Rl
$QUARE 3RD
Parcel No Repair ? Type ot Const. V
. Addition ? No. Stories
a Name SCHIMEK HOMES INC Move ? Length 37
? $477 133RD CT
Address Demolish ?
? Depth
f
S aF;
a
City A•V- Phone 435-2491 Int Impr.
Install O q.
t
o I Name SAME
0 Q Address
? City Phone
rQ
F W
Name
? ? Address
a W Ciry Phone
I hereby acknowledqe that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota StaWtes and ity o ag ry?rdi ces?
/J
Signature of Permitte ?
A euilding Permit is iss d to: SCIiI[9EK HOI?lES INC
all work shall be done i. accordance with all ap i able State of innesc
Building OHicial
Assessment
Water & Sew.
Police
Fire _
Eng.
Planner
Council
81dg. Off.
APC
Var. Date
Permit $ 461.5(
Surcharge 44.0(
Plan Review 230. 7_`
SaC 625.0(
Water Conn. 525.0(
waterMeter 67.0(
Road Unit 305.0(
Tr. PI. 180.0(
Copies
Total $2,438.
on the express condition that
Statutes and Ciry of Eagan Ordinances.
This reQuesl void/_ /?
18 months-tmm ?G
Request
? ate
k(`J
j Fir'e No.
? Nouqh-i?fins
ReQwred? mion
OAeady Nuw Q WilI Notity Inspec-
WA
? ? ?Yes Nn tor
en Feady
[Lfcensed ?fecVical ConVxctor I hereby re0uest inspection oi abova
Owner electrical work installad et
Street hd ess. Bos or Route o.
38??- ti.?AJ c0,u2r- Ciry
-79--
19-?`5/Z3
emion o. Township Name or No. anBe No. County
VA/<o
Occupnnt (PR NTi
Co<(
(
`
F'
?
? Phone Nn. 5(F -,] 2/3
-
G
?
c
2e
e ?Z3
s3as
Puwer Supplier
/9-k v7?4 C?ecfrL G Atldress
Electrical Contrac[or ICOmpany Namel Conh?cmr ?s license Nu.
Mailing Address 1 amractor or Owner Makiny inslallation
' /?^
J
3
7
1
-
? l
/ ,v a u i2 7
8
Aut a etl S- a re IC nnacio w r akiny 1n ta tion
` Phone Nu
s?
mber OGt 7 72
` 5 - /3
THIS INSPECTION flEQUEST WIIL NOT
MINNESOTA S ATE fiOARD OF ELECTR CITY
Gripgs-Midwey Bide• -?om N-791 BE AGCEPTED BY TME STATE BOARD
1821 Universirv Ave.. St Pnul. MN 55104 UNLESS PNOPER INSPEGTION FEE IS
ENCLOSED.
nn
E
. "X'' Below Work Covered by Ihrs Request
Hdd NeO Tyoe oi eund?ng Appliancne Wired EouiVment WireA
Home Ranye Temporary Service
'Duplex Water Heater Lightiny Fixiures
Apt. 8uilding Dryer Electrie Heahn
Commercial Bldy. Fumace Silo Unloader
Industrial Bidg. Air Conditioner Bulk Milk Tank
Farm 01n, pen v .?ner Isued??l
fMr Suecify t er Other
Comoute lnsoectlon Fre Below
p Fae ServiceEndanceSize B Fea feeders/Suhleaders b Fee Circuits
D to 200 Am s 0 to 30 Am>s 0 to 30 Am s
Above 200_Amps 31 to 700 Amps 31 to 100 A s
Swimming Pool Above 100-Amps Above 100_Amps
Transiormers lrrigation BoomS Pdrtial'0ther Fee
Signs
ertarks ??
?? Speciallnspection
?%(l7UAI F? N/{iH
TOTAL FEE /
- GU 0 O E?S.k?..??g
Rou9h-in ?n ?^ ¢ 1? .
D? the Elnc«ical
Inspectoq M1ereby
erlify thet the above
Final D'_e) inspection has been
REQUEST FOR ELECTRICAL INSPECTION pEBy-?0070?0/1-06
? See irehuctions for completirg this }orm on back oi veilow coDV. IJY'/"J"' o5
mla requwl vaitl
This reques[ voitl
18 months Irom . ?
C 4429-8/-9
?c?Q az7
?^ n? a? R?quiretl C]Aeatly Nuw W,II NotifY Inspec-
U? ?$ ?es ?NO ?or When Neady
? Licensed Elecvical Conlracmr I hareby raquest inspection ot ebove
?Owner elactrical work installad aC
Slreet Address, Box or Noute No.
7 Citv
ecuon o. Township Name or No. Hange No. Counly
OccuOnntIPRINTI ?
M, F(?edeQ ?c [,e? Phune No.
Power Sppl er //?p Address
Elechical Convac[or (COmoany Name) Cnnvactm's License No.
?-
M iline p.dJre.ss (Contract r or Ovn?Makine Instailationl
f G?h ?? f.,
7¢ U 4/
(2
Gf?
0 u rL
Auth i 5i n ture IC nttdctor ner ' p InESaliatio Phone Number
?
" THIS INSPECTION flEQUEST WILL NOT
MINNESOTp STATE BOAflD OF ELECTPILITV
Griggs-Midwey Bldg. - Noom N•191 0E ACCEPTED BV THE STATE BOAR?
UNLESS PflOPEN INSPECTION FEE IS
1821 University Ave.. SL Paul, MN 65104
P1?...a 16121 297-2111 ENCLOSED.
7 REQUEST FOR ELECTRICAL INSPECTION ee-oooqo1-oa
, Seednetructions for comPletinp this iorfn on Oeck ol vellow copy. 7'?°t
"'1(" Be/ow Wnrk Covered by lhis Hequest
t,ea Pep. Typa ol Builtline .4ooliencne Wiied Eauiumont wirea
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. 8uiiding Dryer Electric HeaUn
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tdnk
Ferm Other Dec, y .ther ISnecityl
t er GaciFy Other Other
ompute lnspection Fee Be/ow -
p Fee ServiceEnbenee5ize H Fea Feeders/Subfeeders N Fea Circuits
0 to 200 qm s 0 to 30 Am s 0 tn 30 Am s
Above 200 qmps 31 to 100 Amps 31 to 100 q
Swimming Pool Above 100_Amps Above 100_Am s
Transtormers Irrigation Booms Partial/O Fee
SignS 'SUeciai InSUectiOn
Herria.ks
.r^'1 n (
?v
TOTA FEE
l n .a?
1. roe eob
Jnsoectoq hereby
certi(Y that ihe abo%
inspecfion hes been
maaa.
Thlarequeatro1E18monihsirom
?O`d
This request void??/G7 7?yci?
18 months fram b
C 822294 9
Request
I Date FrteMo. ? Rough-i nsdection
AeOUf ? v
OFeatly Nuw
ill Notify lnspee-
es ? No tor When Heady
19<1censed Elec[rical ConVactor I hareby request insoection ot above
? Owner eleetricel work inslalled at:
Strea ddress, Boz Route ?No/. /j CitY
ection o. Town hip Name or No. ange o. Count
OccuOant IPf11NT1 Phone No.
Power Supplier Adtlress
Elec?J ic(a?l Contractor (Company Name) I
?L/ V`-/W ^ / ?L'?/ Contr //or's License No.
Mailinp AdJress 1 o
.38''? ntracior or Owner Ma BIn talla
L?icEt. Gc.w.?s .
7
Authorized ' natur tracto Owner kinB Installation ane umGer
Z- IS
MINNESOTA STATE B RD OF ELECTNICITY TM
Gripos•Mitlwav BltlB• - Noom N-197 BE ACCEPTEOINSPECTIBYON THE REQUEST STATE WIIL NOT
HOAqD
UNLESS PNOPEfl INSPECTION FEE IS
1827 Univsrsitv Ave.. St. Veul, MN 55704
Pnone16121662-OHOO ENCLOSED.
7 REQUEST FOR ELECTRICAL INSPECTION EB-00001'05
? , Sea inslrueliona lor completinq fhia form on beek of yellow coDV.
Q_ R97 rj (i "'l("' Be/ow Work Covered by This Request
ry.4ada1 xec.1 rwe oi auiieine I APCliOncea wiree I tqwpmenl Wir¢0 I
Li
Commerciai Bldg. fumace ? ?Silo Unloader _ J
r Industrial Blda. Air Conditioner Bulk Milk Tdnk
p Fee ServiceEntrenee5ize p Fee FeeOers/SUbieeders N Fee Grcuite
1 JY,U 0200 Am s
to 0 to 30 qm s Z 0U 0 to 30 Am
Above
200 qmps 31 ta 100 Amps 31 to 100 Am s
Swimming Pool Above 100-Am s Above 700_AmVs
Transiormers rrigation Booms artial.'Other Fee
Signs I I I Special Inspectmn IS
r
Houan.in
the Electrical
I?-sv Insoector, haraby
certity thet the aLOVe
Final /? J• DHne 2 ina0aetion hes been
!e moee.
rom 18
This reques[ void CY7y? Jr /
18 nwnlhs Imm
? 31809 ? a?
Requ¢st DBte F re No RouP?-in sVection
flequire ? ?Ready Now Q Will Notity, Inspec-
9/]_rj $$ ?Yes ?f No tor When fleatlv
Licensed Elec[rical Coniracmr I hareby request ins0ection oi above
? Owner eleclricel work installetl aL
Sveet Address, eox or Flowe No. Ciry
3878 Newtown Court Eagan
ecuon o. Township Name or No. Range No. Counry Dakni-A
OccuVnnl(PflINT) Phone No.
Frederick Mitchell
Power $upplier Atldress
Dakota Farmin ton
Electrical Conhactor (COmpany Name) Conlrar.tor's License No.
Hilite Electric, Inc. 04044 5
Maillnq AdJress ICOnhactor or Owner Makinp Instniletiunl
1953 Shaw ee Road
Aut etl SiAnatu re?t r/ wner Making Instnllation) Phone Number
?
V/U
MINNESOTA STATE BOARD OF ELECTNfCITY `THIS INSPECTION flEQUEST WILL NOT
Griggs-Midwey Bldg. - Room N-191 BE ACCEPTED BY THE STqTE BOARD
1821 UniversitV Ave.. St. Paul. MN 55704 UNLESS PNOPEN INSPECTION FEE IS
cn....e iatei Gao.rrann ENCLOSED.
11(p1$9' REQUEST FOR ELECTRICAL INSPECTION ea-aoooi-os
2 pn / See inshuctiuns lor comoleti _n this form on back ol yellow copy.
LS ?.•1 (YU 9 "X` Below Work Covered by 7his Request
p Fee Service EnbanceSize R Fea Fentlers/5ubfeeders N Fne Gircuits
0 to 200 Am 5 0 to 30 qm ps 0 tn 30 Am>s
Above 200 qmps 31 to 100 Amps
H 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Amps
Transrormers Irrigation Booms . bUl Pertial0ther Fee
Signs Speciallnspection $ TOTA 6;b ?
pemarks 19319
7637854937
OCT-9-2068 10:20 FROM:SMSM
7637854937
T0:6516755694 P.1/2
City of EaEail
3830 Plbt Knob Rpad
Eapan MN 55122
Phone: (651) 675-W5
Fax:(651) 675-5694
? PIeasre cNcj, l (
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?-----?-----------?
,_-
; remn rm: .s b
i .
i ?
? Oate Received: ?
? I
Lsran------------ - -:
2008 MECHANICAL PERMIT APPLICATEON
oam: tdY?-? sna s: S?1$ ?•t
Ta?n?: ?-?J?r
*:
RESIDEN7/ OWNER Name: "?ai?Yl (L? +P Mcl .. t- phone:
Address / Gry ! Zip:
CONTRACTQR Name: 6-• iry)Ca? d,)ee lloanse A:
Address: 49
t
'? 7
: 5 ?
S
fi?? l?
a
P
e:
Ciry:
..
yaj c-D 1 ' Y Y 1ayfd°
P
J
{ ? 50
"1
ersnn:
Confad
Phone:
-
7
TvPE oF woRK New _ L R??m?, ?. nacmo? _ana?eo? oema?e? ?sqo
m vma"v?
a?o
fleserlpUon m wvrt: ?t ?? ? W?'-? o7a`? G.
N07'E: Both roof mountsd snaf 4pround nYounted mecbrnlcat equ/prt?ent fa requlrad fo
be screened by CHY Cods. Plssss contact fhs AbChanlcaf drsPctor w one 0/ HM
Pie»ners fnr MlormstMn on P-a/tted scmwN msthods.
pER??,?P? AES1DFM/AL
? COMIMERCIAt
? ?^5??? l?oriq ImprovenwM
ace
Furn
-
air i'.nMitioner Insqll Pipirp _ PrOOesSed
-
Ap Exchanger _ G8s T ?w rlil9Amust be 6Creened
_ keat Pump Under t Mwe grvund Tank L- UistaA! _ Remove)
?
Other •• WYren in5tellinoremavinp lardc(S), cEll Iw Insp6Gbn 4Y Flra
___,_ AAUrshaF anEl P1um61
RESIOENTfAL FEF.S:
E50.50 [nlm m Add-on or alteratipn to an existing unit (Irk-ludgs $.56 Slate Surcharpa)
y90.50 Fire repair (replace humed an applhanow ductvwAk atc.) (incfudes $.50 State Surcharga)
$ TOTiu. FEE
COMMERClAt FEFS:
$70.50 Undorground tank ingtWlationhemoval OR Comract Yalue $ x 7%
550.50 Mlnlmum (includes State Surcharge)
= g Parmit Fee
- H L'9m111 E9S i6less Man i1.01113. surcharge is 5-50.
- I1 Permit Fgp is >$1,000, 9urthergB intreeses by 5.50 fW BBCh ?$ St8t8 SUfChalg9
$1,000 Pennit Feo (i.e. a 51,00142.000 Aeimit F9a requir9S e $7.00 euroherge). -
$ TpTAG FEE
I ne.eby sracnoWeKlge tnet mio iMOnnatian ill comMWe antl acwram• wat ma vanc wu ee in conrarmenw vmm ma wdirmntns ana coaasof .. Ry of Ea6anr mat
I undaremrw mie re mt a pamVlt, but only an aWICaNon fa a porrnl; aM work fa not W afat rAinout a portnk: lhet Me wrrk r+li ba In a011e11devlCO uMh the apqwad
dan in tho Gm ot wOrc wNch reQulres a revlew ard aPProval of dans. ?
x LA ir?& `J :
Appllcant'9 PHI1tBd N0111B M'9 SI W ?
flaquired Inspectlons: TUnder Ground _ Hough In ___Air Test _„Gas Servk:e Test -{n-floor Heat
AOT6: ALL C08TRACLORS MQST BE LZCENSED i1ITH THE CITY OF EAGAN
SIHGLS FA!lQLY DTiiE[.LIBGS
INCLUDE 2 SETS OE PLANS, 3 CERTIEICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
lIOI.TIPLS DTiiEEL.LING3 - HESIDENTIAL 9ENiAL OeRTS FOF SALS 08ITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRYEY - CHECB WITH HLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
C0M4fERCI9L
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
i SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
?'0c?o
To Be Used For.: Valuation: ? Date:
Site Address ?R"]R \eL0jnA.1 ('QLC±
Lot q Block -Ij_
Parcel/Sub S 7J ?yt,y oi.p..?
Owner Ci,o 4 rh .-? eL41.
9ddress &/'
City/Zip Code
Erect ? Oecupancy 2•3 .
Remodel Zoning RlI
Repair Type of Const S=
_
Addition # of Stories
Move _ Length
Demolish _ Depth qCp
Int.Impr. Sq Ft
Install
Phone L(
Contraetor
Address
City/Zip Code aP
Phone,
Mch./Engr. _
Address
City/Zip Code
Phone #
APPAOVAL4 FSES
Assessments Permit (vI . -
Water/Sewer Surcharge 44.
Poliee Plan Review 2'x0.'S
Fire SAC (o ZS ,
Engr Water Conn S ZS•
Planner Water Meter
Council Road Unit 305.
Bldg Off Treatment Pl
APC Parks
Varianee Copies
SOT9L
S'
90TEz 9DDSESSB3 FOR CORNER LOTS - CONTHACTOR/HOMEOBNER FIQST DESIGNATE i1HICH ADDRESS
IS DESIEED. NO CHANGFS iIILL BE ALLOiiSD OHCE BDILDING PSRMIT IS ISSIIID.
,
I`lx 3g= (?¢Cflx -S-b -
qcc) x 4?F =
3?4(ob . .,
l??ov
4?00
Z-7 l44
e) 7C) ( Z
I
PETERS, PRICE & SAMSON
LAND SURVEYORS. LTD.
12400 PRINCETON AVENUE SOUTH, SAVAGE, MINNESOTA 55378 • 612-890-9201
Certificate Of Survey For SCHIMEK HOMES INC _
G?8B2
?
?
O I
?
/o 1
DESCR7.P1'ION'
Lot 9, Block 4
LEXINGTON SQUARE 3RD ADDITION
Dakota County, Minnesota
Vs
'o
i
?160 c ` o v \
o \• , • o
o yo 1?
? o'Il?yo /
?
N
?
30"
\'?01 ae4.9 Oroinoge 8
? /i/y Eosement
\\
o Denotes iron Monument Set
• Denotes ir.on Monument Found
8850 DenoCes Existing Elevation
(885.0) Denotes Proposed i:levation
?
J5
?
We hereby certify that this is a Irue antl correct representation ol a survey of the boundaries of the above described land, and of the location of all
buildings thereon, and all visible encroaciiments, if any, irom or on said land.
As surveyed by uS ihis z/57 day ol 1g 87 L? ?L.S.
MinnesOla License No. 14890
- - S.F.
?. .
CITY OF EAGAN
EICTERIOR ENVELOPE AYERAGE 'U' COMPUTATION
OWNEA: 'Z5 c 14 1 M EL. 1-4 o M E5
SIIE ADDRESS:
CONSRACTOR: DATE: PHOfiE:
Determine working square footage of each:
1. Total exposed wall area ,. 2168 sq, ft, x.11
2. Total roof/ceiling area ... lQ-14 sq. ft, x.026 = 3??'.'+Z
Total exposed wall area above floor - 2 o4'4'
a. Total uall window area ............................
b. Total door area ...................................
c. Total sliding glass area ..........................
d. Total.fireplace xall area .........................
e. Total wall framing area (average 10%) .............
f. Total net wall area above floor ...................
g. Total rim joist area ..............................
Total e:posed foundation area
h. Total foundation window area ....................... ?
i. Total net foundation area above grade .............. °
2t 8 9 „
Determine 'U' value of eaeh wall segment:
x , u, .58 = 91.G4-
b. ¢o x 'U'
C. 40 X 'U'
?- 2Gl00
d, o x 'U' -
e. L8 j x 'U' -?v _ IB?Io
f. I(o Z x tU'
g• _1.4.4 x , p,
h. o x 'U' '
x sU' '
3 . ................................................... Total = 2 1 1 11 O
If item b3 is the same as or less than item 1l1, you have met the intent of SBC
6006(c)2.
Total eiposed roof/ceiling area = I 4'f 4
--
a. Total skylight area................................
k. Total roof/ceiling framing area (average 10:L) ..... L'?'?
1. Total net insulated roof/ceiling area .............. I
(OVER)
. ,
r • • ?
. ,?
Determine 'U' value for each roof/ceiling segment:
J. x oUt _
k. 141 x oUt oZ?G
1. 132'( X ,pt .0143 = 25.G1
4. ................................... ................... Total _ 29 ..G ?o
If total of 04 is the same as or less than 02, you have met the intent of SBC
6006(c)1.
Alternate Building Enrelope Design
To utilize the total envelope system method, the values established by the sum
of Items 93 and 94 shall not be greater than the sum of Items 111 and d2.
1. . 2. -
3. . 4. -
?
L ? BL 4 CITY USE ONLY RECEIPT #: CP,13 0 ( I b
SUBD. LelfiIlOrnh Jq_ u Q 4 RECEIPT DATE: S 3 I' U U
i PERMIT #
2000 PI,UMSING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, DIId 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required tor each unit
? backflow preventer for underground sprinklersystem
CIYTI IO FC
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet " minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tra 3.00 x = $
Lavatory 3.00 x = $
Se tic System newlrefurnisned `requires MPC Ifc. 75.00 x = $
Septic System abandonment 30.00 x = $
RpZ new installatioNrepaidrebuild 30.00 X = $
Rough openin
Shower 1.50
3.00 x
x =
= $
$
Underground sprinkler rf dwelling is under construc[ian
Underground s rinkler ifexisting dwelling
Water closet 3.00
30.00
3.00 x
x
x =
=
= $
$
$
Water heater 3.00 x $
Water softener if dwelling under consWCtlon 5.00 x = $
Water softener if exlsting dwelling 30.00 x = $
Water turnaround 30.00 x - _ $
State Surcharge
Total .50
-> ->
_> -> --> $ 50
g
Reminder. Call for inspections of aiterations, i.e. water heaters, water softeners, etc.
-------------- -- ------------------------------ •------- --------------------------• ---... --- --------------------------------------------
I here6y acknowledge Nat I have read this appliwtion, state fhat the information is corted, and agree to comply with all applicable City of Eagan ordinancas.
It is the applicanYs responsibility to notify the property owner that the Ciry of Eagan assumes no liability for any damages caused by the Ciry during its
nortnal operational and maintanance activities to the facilities constructed under Nis permR within City property/right-of-way/easement.
SITE ADDRESS:
`/
OWNER NAME: : I?F?DlE? /????tYE-?•L
STREETADDRESS: 7-96;0 TELEPHONE #: a 6-Z?) 7-3
INSTALLER NAME: /??? ? //vIC-
(AREA CODE)
TELEPHONE#: 7
(AREA COOE)
CITY: *0Z-M2Gl1-?y' S ATE: ZIP: yy/
SIGNATURE OF P /MITTEE
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*RYlP3: PAYMFTTf' OF FEE AT TIlM OF
APPLICAMON DOES NOr CONSTI=E
APPROVAL OF PFI2NIIT.
INSPDLTION OF SESdM ADID/OR Xk7Et
rnicrAr.raTrONS WIId, NpT BE SCHED--
nLn t7erru. PERMIT HAs sEW
p,2PxavED.
--------------------------------------
P ease Print)
1) PROPERTY ADDRESS: 3
LEGAL DESCRIPTION: "
Lot Block Subdivision or Tax Parce ID
IF EXrSTING STRCCZL'RE, DATE OF ORIGINAL BL?ILDING PERNIIT'ISSL'ANCE: '
i
Mon th/Year
PRFSENP ZONING/PROPQSID IISE:
? CONPERCIAL/REI'AIL/OFFICE
r7 INDL?STRIAL
n INSTI'!i'TIONAL/GOVEWRs'NT
UaIR-1 SINGLE FAMILY
Cj R-2 DOPLEX (ltao Pnits)
? R-3 Tt7WN-IOC?SE (Three + Units ) ( Dnits )
q R-4 APARTMENP/CODIDpMINILfi1 ( Units)
rAM:_ J 0 h n San, ?*40 ?`t ?
AnnREss: $Z? /? -?? <-•?-
czxY, sI-nikTE, zxp:
PHONE:
3)
- N71ME:
i
ADDRF'$$:
CITY, STATE, ZIP:
PHONE:
4) •?• • i?• .
rArE:_
- ADDRESS:
CIT1'. STATE, ZIP:
PHONE:
YllIIfIp2LS L1CPS15E:
t1V2
ExPired
Not recorded
Sta Snitlal
-5) u vi a• ?• : a • o• • a?
EaiCUNNE(.TION T0 CITY SE4JER E3-CONNpCTION TO CITY WA7ER ? pTfER '-
6)
2) ?
"~• ?•?• [? PLF.ASE HOLD APPROVID PERhffT'F'OR PICK-OP BY ONE OF ABOVE
Q? MAIL APPF?yID PERMiT TO 1, 2, 40 4. ABOVE
(Circle one)
m? 4i 5'i$'3
Lf !'/s -- % ?'7> MASTER LICINSE#
FOR CITY USE ONLY
PERMIT # ISSL'ED
??7Z
Pd w/Bldg. Permit FEES: ,
$ $ SEWER PERMIT (INCLLDE SURCHARGE)
$ $ WATER PERMIT (INCLUDE SC'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ 15- od ACCOLNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ 5 z>o-a $ n
w
.c
$ ? 2 S $ SAC
$ $ TRDNK WATER ASSESSMENT
$ S TRLNK SEWER ASSESSMENT.
$ $ LATERAL BENEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ lX ? U U $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ 1:2 6 $ 5-1, a' ? TOTAL
76 z S c 7.,7 S L
RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PIIBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TITLE:
DATE : ?jZ 7 /? 7
ao
For Office Use i
City of EI Permit ~
I ~I
3830 Pilot Knob Road I Permit Fee: I
I
I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 ff ,,11 1 Staff:
I/A G W tk) W
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: n
Site Rddress• 4-C.;-f. r
Tenant:
Suite
RESIDENT / OWNER Name: Ec CC lL ~Q Wk'k' x `Qhone: ~c-~
Address / City / Zip:
i -ae
Applicant is: Owner ~ntractor
TYPE OF WORK Description of work: rr~~
Construction Cost: Jc~tMulti-Family Building: (Yes I No )
CONTRACTOR Name: 2'~\`2 License C~
Address: ed -_4
City: State:~ip:
Phone: Contact Person: ib
I
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
(N( 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?
__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 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 a work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
IQ IQ r7e, Se~ t
Applicant's Printed Name plic is Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA077745
Eagan, MN 55122 . Date Issued: 05/15/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 3878 Newtown Ct
Lot: 9 Block: 4 Addition: Lexington Square 3rd
PID 10-45077-090-04
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Renewal Andersen Frederick M Mitchell
1920 County Road C West 3878 Newtown Ct
Roseville MN 55113 Eagan MN 55123
(651) 264-4777
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.
Applicant/Permitee: Signature Issued By: Signature
CITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road Meter No: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Owner:
Site Address:
Plumber:
Conn. Chg: Zoning:
Acct. Dep: No. of Units:
Permit Fee:
Surcharge: I agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter:
Misc.: By
WATER SERVICE PERMIT G Nsr
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilaf Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
B Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121894
Date Issued:04/18/2014
Permit Category:ePermit
Site Address: 3878 Newtown Ct
Lot:9 Block: 4 Addition: Lexington Square 3rd
PID:10-45077-04-090
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 .
Gavin Tugana
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Frederick M Mitchell
3878 Newtown Ct
Eagan MN 55123
Simon Construction
8200 Humboldt Ave S, Suite 205
Bloomington MN 55431
(612) 861-7000
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use ) I
Permit
City of Eanan I I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: 5 l7Z rl rt.~lS~vzT~ Phone:
Resident/
Owner Address /City /Zip:
Applicant is: Owner /Contractor
Description of work:
.P~llLlt'°' .~f►a~ .~y 6$~ dt/f~/a/ ~~/~1
Type of Work
I Construction Cost: 'P r6~ Multi-Family Building: (Yes /No
Company: ~re 'Ls ~ G - l/U Cntact: l
Contractor Address: City: State: Zip: 5 Phone: _Z/Z Z7l90W 010-e f~1J91 cF~Y
1 AIA7-
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 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 Buildi Cod st 00 Mm hin 180
days of permit issuance.
x 11~~-J" ,Aki,r°Z~~ x
Applicant's Printed Name Ap li n ' Sign ture
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family)
✓ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of - Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building 44 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 oo Occupancy t MCES System
Plan Review ✓ Code Edition Z06 7A4e.%XL SAC Units
(25%_ 100% Zoning / City Water
Census Code Stories 2 113A-1 Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction 6 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
Roof: -Ice & Water -Final Pool: Footings -Air/Gas Tests -Final
✓ Framing Drain Tile
Fireplace: -Rough In -Air Test -Final Siding: -Stucco Lath -Stone Lath -Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings _ Backfill _ Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee 55.15
Surcharge • Go
Plan Review 3 G. Z~
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL q$ •S't
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA123169
Date Issued:05/30/2014
Permit Category:ePermit
Site Address: 3878 Newtown Ct
Lot:9 Block: 4 Addition: Lexington Square 3rd
PID:10-45077-04-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Frederick M Mitchell
3878 Newtown Ct
Eagan MN 55123
(651) 454-7213
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
. 9/23/2015 2:29 PM FROM: Fax Standard Water T0: 1-651-675-5699 PAGE: 002 OF 00-0
Use BLUE or BLACK ink �
. ;Fo�ot��a�sa---------i c
Cl� O� LU Ull j Pertnit#: � s� � �
� � RECEIVED � Pertnit Fee: � � �� �
3830 Pilot Knob Road . 2�
Eagan MN 55122 � Date Recelved: 'a J I
Phone:(651)675-5675 SEP 'L 31015 I � `_ �
Fax:(651)676-5694 � i Staf�✓ �
�����������������J
2015 RESIDENTIAL BUILDIN PERMIT APPLICATION
Date: � C Slte Address: `���4 /!/C L(/ l�vf'f Unit#:
(� �/► ,./ /� / r�
. . , Name; ��!'P d /�I� T"'C l�/� • Phone: �7/'��S'��COd
Resident/ c� Gv � u�[ ✓�'/
�.Owner � Address/City/Zip, ��� ��
� - � Applicant is: _Owner �Contractor �
Type of Work Oescription of work: Q/�'L �
Construction Cost; ���� " Mul6-Family Building:(Yes s/No�
Company:d�1a'/ 1��A0�Lf�/Z j�y��� Contact: � (��
� �ont�actor Address: .�337 I.Gt ������ c�ty' ,
. ' State:�Zip:��� Phone.� 37 O`�E�aiL��/�3S�11�IAq/"!11()i o�D�',�� �,
License#: doC Lead Certlficate#:�/T T o( �`f�!0—�
if the project is exempt from lead certification,please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
� In the tast 12 months,has the City of Eagan issued a pertnit for a slmilar plan based on a master ptan?
Yes _No If yes,date and address of master plan,
Llcenaed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Wate�Contractor: Phone:
Flre Suppreasio�Contractor: Phone.:
NOTE;,Plans and suppoKing documents that,you submlt are consldered to be:publlc;/nforma;lon:.Portions of...�, .
the Infoimation may.be�c/asslf�ed as non pubirc`If.you provide spec/fic reasons tirat woujd peimlt Ebe City to .:.
� � conc/ude fhat the aie trade secrets.
CALL BEFORE YOU DIG. Cell Gopher State One Call al(851)454-0002 for protectlon agalnst underground utllily damege. Call 48 hours
be(ore you Intend to dig to�ecelve tocates ot undetground utllllles. yuww.00cherslateonecall.ora
I hereby acknowledge lhal this informatlo�Is complete and accurale;lhat lhe work will be In conlormance wilh the orcJinances and codes of ihe Ciry of
Eagan:thal I undersland lhis is not a permll,but only e�applicaUon tor a permll, and work is not to start wiihaut a permlt;Ihat the work will be In
accordance wilh lhe approved plan In the case ol work whlch requlres e revlew end approval oi pians.
Exte�lor work autho�lzed by a bullding permit Iseued In eceordance with the Minnesota 3tete 8ullding Code muat be eompleted withln 180
deys ot permit Issuance.
x����V '^ �.[1G U x ! i
Appllcant'a P�— i e�d Name Ap � s ature
Pege 1 ot 3
• 9/23/2015 2:29 PM FROM: Fax Standard Water T0: 1-651-675-5699 PAGE: 003 OF 009
��-7� ;� ` �� � o���-'
�E;��.� ��"� DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundatlon Fireplace Porch(3-Season) _ Exte�ior Alteration(Single Famlly)
� Single Family _ Garage . � _ Po►ch�4Season) _ ExterlorAlteratlon(Multl)
Multi Deck Porch(Screen/3azebo/Pergola) ^ Mlscellaneoua
_ 01 of_Piex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interlor Improvement _ Sidlog _, Demoilsh Building"
_ Addition ^ Move Bullding _ Reroot _ Demolish Inte�lor
Alteration Fire Repair Wlndows Demollsh Foundatlon
_ Repiace � Repalr _ Egress Window ,_ Water Damege
_ Retaining Wall "Demolltlon ot entire bullding-glve PCA handout M applicant
DESCRIPTION
Valuation 3Q�0 Occupancy yZ�'2�- MCES System -"'
Plan Review Code Edition / �' SAC Units ``
(25%_100%� Zoni�g �/� City Water --
Census Code � 3y Stories '-` Booster Pump ""
#of Units � Square Feet -1 PRV `-
#of Buildings � Length ""� Fire Suppression Required '—
Type of Construction � • Width '""
REQUIRED INSPECTIONS
Footings(New Building) Meter Size: ,
Footings(Deck) Final/C.O.Required '
Footings(Additlon) � Final/No C.O.�Required
Foundatio� HVAC_Gas Service Test Gas line Ai�Test
Roof: Ice 8 Water _Fina� Pool: Footings AiNGas Tests _Final
Framing � Draln Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retalning Wall:_Footings_Back�ll_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_final
Braced Walls Erosion Control
� � Other
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee g�
Surcharge
Plan Review �'?3� .
MCES SAC
City SAC
Utility Connection Charge �
S&W Permit 8 Surcharge
Treatment Plant �
Copies �-at3'
TOTAL
� Page 2 of 3