3886 Newtown Ct
Use BLUE or BLACK Ink
I-----
r f3 I Fnr Office Use I
Ci of Eajan Permit#: U I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: " f
Phone: (651) 675-5675 I
Fax: (651) 675-5694 New Staff:
-----------------I
2010 MECHANICAL PERMIT APPLICATION
Date :r^J 1 10 Site Address:W ~1~ J 1 L. (I ~i d
Tenant: a in A-1 N1 Suite
RESIDENT / OWNER Name: Phone: V[~~ ~-t J { ~~(~~l
Address/ City/ Zip: J C~
CONTRACTOR Name: SURNSVII-LE HEATING R A/(' INC: License ~-t ~ ~~s JC t Ld 1(~
Address: 3451 W. Burnsville Parkway City:
Suite 120
State: ZBumsville, MN 55337 Phone: q._"Gum
Contact: 6 ~ ff- Email:
TYPE OF WORK New _K Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mainted and ground mountedmechanical equipment IS reoited to be4creened by City
Code. Please; contact,the-MechanicaI Inspector for nformation on' permitted sCre± iiild rmgttiods,
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace _ New Construction _ Interior Improvement
X Air Conditioner Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
_ Heat Pump Under / Above ground Tank L_ Install / _ Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ O-. C TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
= $ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 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.aonherstateonecall.orm
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
witl~yttjie approved plan in the case
y~o}f~work which requires a review and approval of plans.
x ~1 4 ~t `lJ~ x
Applicant's Printed Name Apph ant's Signature
FOR OFFICE USE Reviewed By: Date;
Required Inspections: _Under Ground Rough'ln Air Test Gas Service Test In-floor Heat Final
Exterior HVAC Screo'ning Inspection
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: i+' `? ?. ?'•
(612) 681-4675
SITE ADDRESS: ? ? 7 ? APPLICANT:
Ni l•ll nl?IN ?: 1 ?rf ,?.?; ???? •, I t???1.
.011nRE :34 1
PERMIT SUBTYPE: TYPE OF WORK:
; r, r 14
?
?
• I"o I`SL'RTF'T1(IN
Permit No. Permit Holder Date Telephona #
ELECTRIC
PLUMBING
HVAC
Inspection Dats Insp. Commsnts
FOOTINGS
FWND
FRAMING
ROdFING
RDUGH
PLUMBINCa
PLBG
AIR TEST
ROUGH
HEATING
C3AS SVC
TEST
INSUL
GYP BOARD
FIREPLACE ,
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FlNAI
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: `? j 4
Ea an, Minnesota 55122-1897
9 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
.. . t,: iaIrIu" cY
f, r',!, r) T 4iFi • 1:sA I
f i x 1 NEi f otN tiQllARf' 3k0
PERMIT SUBTYPE: - TYPE OF WORK:
., rt PAl' R nN
(;A!; 01RF.C1 VFNT)
Permk No. Permit Hoider Dats Telephone r
ELECTRIC
PLUMBING
HVAC
Inapection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIF TEST
ROUGH
HEATING
GAS
EST VC
7-3'7t
?
&QS I n?. ?J
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST '
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
: .-5...--.. . . _ .. . ..:.r. _ .. . ?? '...? '`.
boi :41 ?[" Ir ..- .7 - ..? ,.
PERMIT # ?J
Q. ?GG4S MECHANICALPERMIT
CIN OF EAGAN RECEIPT #
3830 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE: 7-31- 17
NTRACT PRICE: /.1 t?, ? PHONE: 454-8100
Site Address
? Name JtUUYYiI.rIF%
m
? Address "
i
c Ciry mrm
? Name _
3 Address
0 C'ty -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
Sec/Sub
M BTU
M BTU
M BTU
M BTU
CFM
BLDG.TYPE
Res. ?
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on ?
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADOITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
FEE
S/C: • S v SIG R F MI E ?- '?'>??J
TOTAL:
FOR: CITY OF EAGAN
ti -. z.-a
, • (Itr#ifiratit uf Orruvttrtry
?-
titp of eagan
arvarttuettf nf luilb'tng 3wPttimt
This Cerdficate rssued pursuant to the requiremenu of Seetrorr 306 of ihe Uniform Building
Code certifying that at the time of issuance this structure was in complFance with the various
ordrnances of the City regulatixg building conslruerron or use. For the fo!lowing:
U. clsis"an `'' sias. nrma nra. ?
Otroupeacy Type Zaning District Type Const
s„aaingneam '"88E+ N8'dTOWN COnT L7, B4; ',,EaT1+IGTOti 9(2 3RD
1. -on7r ' c tr.o-
Bw7ding OEficial
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN 1?[ ±3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N2
PHONE: 454-8100
BUILDING PERMIT Receipt #
i3i84
SF DWG/GAtZ Est Vaiue $91,000 Date FFBRUARY 6 19 87
Site Address 3 886 NEI+r" TOWN CT Erect IN Occupancy R3
Lot 7 Block 4 Sec/Sub. LEXIiVGTON Remodel ? 2oning K1
Parcel No SQUARE 3RD Repair ? Type of Const. y
. Addition ? No. Stories
? Name COLI,Et;E CITY CON$T Move ? Length 42
_ BOX 309 Demolish ? Depth d d
o Address I
I ? S
F
7.JORTHI'TA?
ci
507/645-6648 nt
mpr.
? q.
t
?, ?nstall
= o Name SAME
? ? Address
W W
u?
rc=
? W
Name -
Address
Assessment Permit $ 472.00
Water & Sew. Surcharge 45.50
Police Plan Review 2 3 6. 0 0
Fire SAC 625.00
Eng. Water Conn. 525.00
Planner Water Meter 67• Da
I hereby acknowledge that I have
f Council
r¢ad this application and state thatthe gldg. Off .
Road Unit
180.00
Tr
PI
in
ormation is correct and agree .
to comply with all applicable State of .
.
Minnesola Statutes and City of E agan Ordinances. APC ParkS
•
Signature of Permittee { ?,?
Var. Date
-`
Copies
'
0
. „y
Total , J.
A euilding Permit is issued to: GOLLEGE CITY CONSTRUC'i tON on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City 00
305
oi Eagan Ordinances.
Building Official
Permlt Na Pemdt HWder DoN TeNphone M
Plumbiny
H.V.11_C.
EkcvFc
Softener
Inspeetlon Dab Insp. Comments
FooUnys I
Footfnps II
Foundatbn
Framiny 4e)
RooNny
Rouph Piby. . L'
Rouph Nt9• ?-
Iruul. 2 p
Finplace
Final Hty. ?f ?;• • s J t?.
Final Plby.
Ney. Fi,ai ?-,29. r7 E. ?? .
c.d. occ. ?- ty. x 7 257?•
Deek Ftg.
Deck Frmy.
YVell
Pr. DNp.
' PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Site Address • } ')
Lot ?Z Block
? Name
7i6 Rddress
c Ciry ?
? Name
3 Addre
o ?ity ?
Phone
Phone
COMM/1ND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAI FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR: CITY OF EAGAN
, o
PERMIT fk
RECEIPT #
DATE:
BLDG. TYPE
Res.
Mult.
Comm.
WORK DESCRI?
New ?
Add-on
Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING
N FIXTURES OTA,rL
Water Closet - $3.00 -
Bath Tubs - $3.00
Lavatory - $3.00
??.Shower - $3.00 ?Kitct@n_SinlC - $3.00 ;? . _ ? `-=?:•., -?'"
jWater UrinaliBidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50
Heater - $1 50
Whirlpooi - $3.00 "
?Gas Piping Outlets - $1.50 %
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
^
FEE: J'z
STATE S/C:
GRAND TOTAL: ? F'
? = J y. . . . J/ . .
PERMIT #
'
' ' • MECHANICAL PERMIT RECEIPT # 1" -7
CITY OF EAGAN o
3830 PILOT KNQB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: ? f'•-?J •,?.J PHONE: 454-8100
Site Address ? BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub '
? r - Res. L-
New
,
? -
Name -
' Mutt. Add-on
?o
Address ? I ? ? Comm. Repair
c City `?Xbi +L o_ Phone Other
FEES
? Name L..1 • RES. HVAC 0-100 M 8T11 - - _$24.06
? A,ddr +-= • C? '- - ADDITfONAL 50 AA BTU - 6.00
p City -'? Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIM
M
PER PERM
(
- 1
U
M - 1_50 EA.
TYPE OF WORK COMM/fND FEE - 1% OF CONTRACT FEE
Forced Alr M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU 95 TOWNHOUSE & CONDOS - RES. RATE APPLJES
- MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent
CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # i ?S BEYOND $1,000)
Other
FEE:
" . J
J '
S/C: SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N-° 13184
PHONE: 454-8100
BUILDING PERMIT Receipt#
Tobeusedfor SF.DWG/GAR EstValue $91,000 Date FEBRUARY 6 ?g87
SiteAddress 3886 NEWTOWN CT Erect At Occupancy R3
Lot 7' Block 4 Sec/SUb. LEXINGTON Remodel ? Zoning R1
SQUARE 3RD
Parcel No Repair ? Type of Consl V
. Addition ? No. Stories
COLLEGE CITY CONST Move ? Length 42
W
z Name
BOX 309 Demolish ? Depth dd
3
° Address
CiryNORTHFIFW
507/645-6648 Int.lmPr
I
t
ll ?
? S Ft.
Q
e ns
a
i o Name SAME
$ a Address
c
? City Phone
?Q
? w Name
-z
Address
i W Ciry Phone
Iherebyacknowledgethatlhav eadth" tion and state that the
information is correct and a to co pl ith a I applicable State of
Minnesota Statutes and f Eaga O na es.
Signature of Perm ee
A suilding Permit is issued to: OLLEGE CITY CONSTRI
all work shall be done in accordance with all applicable State inneso
Building Official
Fees
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Var.
Permit $ 472.00
Surcharge' 45.50
Plan Review 236. 00
SAC 625.00
Water Conn. 525.00
Water Meter 67.00
Road Unit ' 305.00
Tr. PI. 180.00
Copies
Total $2.455.50
on the express condition that
City of Eagan Ordinances.
--e
REQUEST FOR ELECTRICAL INSPECTION . ee ooooi-os
'J 11, See instructlons lor comoletirq this form on bsck o1 Vellow copy.
?rf //J 7 ?' 7S l I S
D 3 016 3-"x' BeloW Work Covered by This Request
AAd NeD. Type ot BuilCing ApPlancns Wiied EquiVment WireA
;C Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Bufldinc7 Dryer Etectric Heabn
Cominercial Bldg. Fumace Silo Unlpnder
Industrial Bldg. x Air Conditioner Bulk Milk Tank
Farm t^e, uen v (hner ISn.>cHyl
Ter SVeci y Other Oth.r
Compute lnspecfian Fee 8elow
M fee ServicaEntrence5ize tt Fee Fexders/5uhte0Aers N Fee Circmts
0 to 200 Am s 0 to 30 Am s 0 to 30 Mn Cs
A6ove 200 qmps 31 to 100 Amps 31 to 100 qm s
Swimmfn Pool Above 100_Amps Above 100_Am s
Transiormer5 Irrigation Booms Partial,bther Fee
Signs $pecial Inspection S TOTA
f??
NerrW rks p A/ ?,? `o?o
y
)
- v
Rough-in Dnte I, the echi
Inspector, ereby
certity tnat the above
Final !c[ ?? /?? D'nle ?spection hes been
rn?..vnme? vnlellx mnnlM im.
This request voitl ?/n '
18 rtpnths tmm ?` 7/,5
D 30163 ?- '?`
75Si 9
R?ques Date '
?j ?/ ??
t Fire No. Poup.- Insuer,tion
fleqmred? ? v
Reatly Now ? Will Notity Inspec-
.-r . . ? Yes No ??r When ReaEy
?ucensetl hlec[ncal Conlrxctot 1 hereby request inspaction ot ebove
? Owner elec«ical work instellad ai:
Slreet Adtlress,?B/o` or Rou?/N°
/ 1-QG(] / IZU71 ? Ciiy
?Cl Cl/!'lJ
ecLOn o. Townshio Name or No. RanBe No. County
Occupnnt(PRINT) Phone No.
v,vE
Power Suupller Addre.ss
Electricxl Contracior ICompany Namel Conrcactoi's License No,
Harrison Electric Inc. 421867
MailinN AAdres jCOntractor or Ownar Making Inslailationl
4 Mor an ve No. Mpls. MIlV 55412
Au orize Si t ntrac d wnor Making Installnlion) Phone Number
52 1-0520
MINNESOTq STATE BOApD OF ELECTpICITY ????'? THIS INSPECTION NEQUEST WILI NOT
GrigBS-Midway Blde• - Room N•791 ? e BE ACCEPTED BY THE STATE BOAHD
821 Universitv Ava.. St. Paul. MN 55104 UNLESS PHOPER INSPECTIpry FEE IS
Phone (612) 642-0800 0 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-oaooi-oe
?+' ?'?? 8D S
. ?Sae inslmetiens lor completing Ihis torm on beek ol vellow eooV.
1t.-7 1 fl "X" Belowaillilk Covered by This Request
pilopElIrk-P.I Type ol BuilOine ? IMOPNI§Ibw Wiretl I EquiVment Wired I
Commercial Bidg. Furnace Silo Unloader _f
Industrial Bida. Air Conditioner Bulk Milk Tenk
N Fee ServiceEntrenceSize p Fee Feeders/5ubfeeders It Fee Circuits
4 cl U to 200 qm s - 0 to 30 Am s 0 m 30 Am s
Above 200 Amps 31 to 700 Amps 31 to 100 Amps
Swimmin Pool Above 100_Am s Above 100_Am s
Transformers Irrigation Hooms JG' Partial-'Other Fee
L f _ I Signs ISpecial Inspection ?$< (J _7?TOTAL
Femarks ' v /.? ?' I ,f?
d•, ••
? /? {
' O 1. the EleclriCSr
?? . ? Inspector, hera?y
cariity ihet tha nbova
iinal Dxte
i?reaeotion ne: naan
thls raqueat w10 t8
This re0uesi void ? ?? 1;1 ? 7? ?O 09
mo91.rr1. 10 ques: Daie ' Fire No. " ouph-in Inspection 11 Re mr e d? / ?Ready Nuw Q Will Notify. Insaec-
Pe3-/
e' - for Wh
F
tl
-
2 Ves . ?NO en
ea
y
K Licensed Elecvical Con[ractor I heraby request insDection o1 above
Owner electrieal work inslelled at:
Street Address, Box or ?Hou/le
No.
g? CitV
e.
/Vui 4 A-,
ection o. Township Name or No. anBe No. Coun
Occupant N20 ? Phone No.
Powet pplier ' y-
l
I
? Adtlres .,[ /.
??
l? C> L
p
C/
IL
Electr,icJ I Contractor (COmpany Namel
?l
? Con ctor's License No.
/•/ e nn 8.1,
?v r.
Mailinp Address IC nVactor or Owner Making Installation)
.3ou ?'?- )e,o YI n-
Authuriz 5' namr . (Contraclor Ow r Making Installalion)
/? Phone Number
`
?-
MINNESOTA S ATE BOARD OF ELECTRICITY TMIS INSPECTION PEQUEST WILL NOT
BE ACGEPTE? BY THE STATE BOARD
Grippn-Midwey Bldp. - Room N-791
1821 Universitv Ave.. St. Vaul, MN 55704 UNLESS PROPER INSPECTION FEE IS
Phnnnlfil2lRflJ_(WOO ENCLOSEO.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstructlon Reoulrements RemadellRepair Reauirements
• 3 registered site suneys showing sq. ri. of bt, sq. ft. of house; and II roofed a2as • 2 coDies of plan
(20% maximum lot coverage allowed) . 7 set of Ene[gy Calcula6ons kr heated additions
. 2 copies of plan showing beam & window sizes; poured found desgn, etc.) . 7 site survey for extedor additions & decks
• i set of Energy Calculations . Indicate rf home served 6y septic syslem for additions
• 3 wpies of Tree Preservation Plan if lol platted after 711193
• Rim Joist Detail Oplians selection sheet (hldgs with 3 or less units)
DATE I I ' u'° z VALUATION ?`1 g? 7< o 0
SITE ADDRESS MULTI-FAMILY BLDG Y X N
TYPEOFWORK W?nC?o? ?anl??e?^+en+ C?'? FIREPLACE(S) _0Y 1 _2
APPLICANT
STREET ADDRESS lS:
TEIEPHONE # 763 -7
ve
E#
PROPERTY OWNER ? P V a n cL i SZ A?-n ? -TELEPHONE# 6Sl - yS4/- P? 2/
?
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CA`I'F.GOBY 1 MINNFSOTA RLiLES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ___
Plumbing system uicludcs:
Mechanical Contractor.
Mechaiucal system includes:
__ Air Conditioning
??vT.?-+k STATE Mn7 ZIP S?1Y
FAX # 763 ->y.f-- / Vq /
Phone #
Tee: $90.00
ree: $70.00
_ Heat Recovery System !' - „
)!'?..
Sewer/Water Contractor: Phone #1 ?? . . ?
.?. I
IJ I
ly VI
I hereby acknowledge that I have read this application, state that the information is correct, agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. --
SignatureofApplicant
OFFICE USE ONLY
_ Water Softener
_ Water Heater
No. of BaThs
_ Phone #
Lawn Sprinkler
No. of R.I. Ballis
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
S 57 S? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Constmction Reauirementf
• 3 registered site surveys showing sa. F.. ol lot sq. ft. of house; and all mofed areas
(20°6 maximum iot coverage allowetl)
. 2 copies of plan showing beam S winaow sizes; poured found desgn, elc.)
• i set of Energy Calculations
. 7 copies of Tree Preservatian Plan if la[ plaCed aXer 711193
. Rim Joist Detail00tions selectian sheet (Eldgs vnth 1 or less units)
DATE
51TE ADDRESS 34? 1?
TYPE OF
APPLICANT
J'lq, 0Ao('?
r
ILYBLDG _Y ,::4
FIREPLACE(S) _ 0 _ 1 _ 2
STREETADDRESS 3sS ?? Sy se eCITY /VeL' "'t STATE ZIP S??SS
TELEPHONE # S? - 68 V7 CELI PHONE #?6 9"&21d FAX # 4?5c?1
C/ - ?/
PROPERTYOWNER TEIEPHONE#_/??"
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01':1 RC;LES 7670 C:1'CI:GORY 1
(J submission type) . Residential Ventilation Category 1 Worksheet Su6mi[ted
. Energy Envelope Calculations Submitted
Plumbing Contractor: ___
Plumbiiig systein includcs:
Meehanical Contractor:
Mcclrutic.il systcm includcs:
Sewer/Water Controctor:
f11i COIldIL10111I1-,
Hcat Rccovci}' Systcm
I hereby acknowledge ihat I hove read this application, state that the
with all applicatale State of Minnesota Statutes and City of Eagan Or<
Signature of
OFFICE USE ONLY
Phoi
rin • cr Fee: -'.il 0.00
_ Water Soltener I..uvn 3p
R.I.
_ 1rVater Heatcr _ No. of
No. oF Badts
a1s ?
RemoAellReoair Reauiremente
• 2 copies o( plan
. 1 set af Energy Calculatrons for heated adeitions
• 1 site survey `or extenor additions & decks
• Indicate if 0ome served 5y septic system `or additions
JI 2?6
VALUATION
?h c..e -
MIV?IL•'SOT.A RCLL:S 7672
• New Energy Code Worksheet Submittetl
ff-I;
i J I? I I,
1? ? 5EP 2 6 20D2
Phone # _
s
Pce: 3 i 0.00
Phone #
rriation is correct, and agre¢ to comply
.?
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updaletl 4102
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date issued:
SUILO.CNG
83825?
9r6(16J'97
SITE ADDRESS:
3356 NEWTUWN CT
LOT: 7 SLtlCK: 4
LGXIIdG10Pd i(IUHn.E 3F2D
P.S,N.: 10-450 77-..0 70-04
DESCRIPTION:
(GAS)
ermit Type FIREF'IRGE
krk Type NE41
?A34 flLT. RESrDENTIAL
?A?''??: 41 n
?
REMARKS
FEE SUMMARY:
Base Fee $5m.om
Sui°char•ge o.5d
Tota]. Pee ?64?.50
CONTRACTOR: - appl.icant - sT. Lxr.. OWNER:
(:ORONADO STt7P!F 17862341 0007850 AUNE BRYAN
82?2 AR7HUFY 57 PJE 3886 NCWTL1WN CT
SPRING LAYG PRftK MN 55432 - EAGAN AtIV 55123
(6`12) 786-2341 (612)454--9ezi
?n"forrnat? 0 rt 3.?x?m??? ??wlt?
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APPIICANTlPERMITEE SIGNATURE 'LMa R,pm.l m?-
ISSUED B SIGNATUR
UZI CITY OF EAGAN
iQ97 3830 PILOT KNOB RD - 55722
#9J5-FIREPLACE PERMIT APPLICATION
681-4675
DATE: ?k- ? e I I I91 7
DESCRIPTION OF WORK: ? INSTALL NEW FIREPLACE: _ WOOD BURNING
_ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
INSTALI CaAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN:
STREET ADDRESS:
LOT I_ BLOCK _4_
APPLICANT: (circle one only)
SUBD./P.I.D. #: ?; ?TqAM4J?
OWNER CONTRACT6R-.
I hereby acknowledge that I have read this application and state that the information is correct and agree to
comply with ali applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY
OWNER
FIREPLACE
INSTALLER
GAS LINE
INSTALLER
Name: .? ??a? `r L ?5 a Phone #: S?F - o,?
usi iIa8r
Signature:
5treet Address* S-4 b6ve- -
City: ? St te: ZAtl Zip: <-FL5123
,Corort do -??one
Company: Phone #:
Signature: ,/ " 1' e
Street Address:
Company:
Name: -
Signature:
$-?OZQ
? GAS
ea+ I`f ?? ? °
jk-32 5
#; nn795a
State: Apf Zip;:l-'5-?
Phone #-
Street Address,
City:
State: Zip:
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILQT KNOB RD - 55122
651-681-4875
C) -
New Con s h u c t t on Reau lremeMs R e m o d e l/ R e o a i r R e a u i r e m eMs
D 3 regirtered sNe surveys showing sq. ff. ol lot, sq. (1. of house 2 copies of plan
and SLI rooled areas (20% maximum bt crneraae allowed) 1 set of energy calculaNons for heafad addiHons
? 2 copies ol plans (show beam t window sizes; poured (nd. dealgn; eTCJ 1 sGe suney fw exterlor addRions 6 decks
D 1 aet of energy calculaHons
D 9 copies d hee preservaHon plan C bt plaHed after 7/1 /93
DATE: CONSTRUCTION COST: 7??? (o`
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: r BLOCK: _?j SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
S
Name: ??n -c lJY i C. ?1 Phone #: C'a O Z
Last FIM
Sheet Address: C+-
Ci1y ?Gw--\ State: 2ip:
Company: n Phone ('_ Z Z5-?v ?3
(area code)
Sfreet Address: y9 51-7 w v?1c ?n?l S4 license #76)3-7b' -75 Exp. 326
Ciiy ;a?? State: Zip:
Company: Name:
Telephone t area code (
SheeR Address: Registration #:
City
State:
Sqwer L water Itcensed plumber [reauhed for new consfructfon only
PenaMy appUes when address change and lot change h requested onee permN Is Issued.
Zip:
i
I hereby acknowledge that I have read thls applicaNon, sfate that the informaflon is cartecf, and agree to eomply wBh all applleabl
Stafe of Minnesota Sfatutes and Clty of Eagan Ordinances.
Signcture of Applicard: ??L ?--
OFFICE USE ONLY
Certificates of Survey Received _ Yes, _ No
Tree Preservetion Plan Received _ Yes _ No _, Not Required
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRE55:
LEGAL DESCRIPTION:
.
*XYrF: PAYM!TP' OF F8E AT TIME OF
APPLICATION DOES NOT CONSTITUIE
APPROVAL OF PEEtMIT.
1NSP?x.-rioN oF sEWM ArID/oR MTM
rnSrAr.ramrONS WII,L Ndf BE SQHgD--
?I,ID UNIZL PEEtMIT AAS BE@I
APPROVID.
, IF EXISTING SIRCCiL?REr DATE OF ORIGINAL BIJILDING PERMIT ISSL'ANCE: , -
i
(Mn Year)
PRESENT 7ANING/PROPOSID L'SE:
q caUMciar./REraiL/oFFice
? IDIDC?S2RIAL
n INSTITL'TIONAL/GOVERNMEP7T
2)
NAM:
ADDRESS:
CITY. STATE, ZIP:
PHONE:
3) u ?: ?• ?ME. -- For City Ose .
Plimbers License:
ADDRESS: Active
E3spired
CITY. STATE, ZIP: Not recorded
PHONE: MAsiER r,zcENsE# 3S?o di( Staff Initl*ai
G) __ • .i?+•
tuAME:
ADDRESS:
CITY. SI'ATE, ZIP:
PHONE:
•5) ? r ? r. •?• : o - a? • a.
?CONNEC.TION M CITY SEWII2 ? CONbgX.TION RO CITY WATER ? p7'HER '
6) u • • r
? R-1 SINGLE FAMILY
R-2 DL'PLEX (4+Ho Units)
Q R-3 1t7W[+IIiOT-ISE (Three + Units) ( Pnits)
q R-4 APARZbIWT/CODIDOMINIDM ( Units )
a PLEASE HOLD APPROVID PII2MIT FY)R PICK-UP BY ONE OF ABdVE
YIEASE MAIL APPROVID PEEtMIT TO 1, 2, 3, 4, pBpVE
r, /j1 „ /? (Circle one)
'If
. FOR CITY USE 4NLY
PERMIT # ISSL?ED
q .e)
Pd w/Bldg. Permit
$
e
$
$
$
S
$ 5? 2 5'C3-6
$_ /oZ?•?
$
$
$
$
s ?gOna
$
FEES: $40• S v SEWER PERMIT (INCLLDE SURCHARGE)
$ WATER PERMIT (INCLUDE SL'RCHARGE)
$ WATER METER/COPPERHORN/OC'TSIDE READER
$ WATER TAP (INCLI]DE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ /5,0'0 ACCOC'NT DEPOSZT - WATER
$ WAC
$ SAC
$
$
$
$
s
$
TRL'NK WATER ASSESSMENT
TRL'NK SEWER ASSESSMENT
LATERAL BENEFIT/TRLNK SEWER
LATERAL BENEFIT/TRDNK WATER' I
WATER TREATMENT PLANT SURCHARGE
OTHER:
$1.3 7, ?' ? $ TOTAL
_ O Sz
? _?0 lP 3 C?
REC+EIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK 6VITHIN PLBLIC
Q ROADWAY" MLST BE ISSUED BY THE ENGINEERI[VG
NO DIVISION. LIST AS A CONDITION.
$UBJECT TO THE FOLLOWING CbNDIT20NS:
APPROVED BY:
,
TITLE:
'
DATE: 7
-
• ` ? ?
J3 ICO"
1986 BQII,DING PEIt?IIT APPLICATION - CITY OF S9GAN
HOTB: ALL CONTRACIOBS MOST BE LICSNSBD IiITH THE CITY OF EAG9N
SINGLE F9MffLY DiiELLIRGS
INCLUDE 2 SETS OF PLANS, 3 CEHTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DNEI.LINGS - RSSIDENTIAL RENTAL i1dITS FOB SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SQR9EY - CHECB fiITH BLDG. DSPT.,
1 SET OF BNERGY CALCULATIONS
C014lERCIAI:
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
9 ?,?
To Be Used For: Valuation: Date:
r-
Site Address 3 8 8? A/E'G17AU1A/ Gt. OFFICE IISE OALY
Lot Block y? Erect ? Occupaney
Remodel Zoning rL•?
Pareel/Sub 1CA %AIq-)?DAJ Repair _ Type of Const TL
-0 Addition # of Stories
Owner Cy1LE4E co.lsr,eucTi Move _ Length 4L
0 Demolish Depth 44-
Address QOX 309 Int.Impr. _ Sq Ft
Install
City/Zip Code nloR7/}F1EL D SSOS7
Phone So '7 6?/S- 6 G?/g AepxovAIs FEEs
Contraetor Assessments Permit -7Z.
Water/Sewer Sureharge 4s,
s?
Address Police Plan Review 2?. .
Fire SAC ? 25 City/Zip Code Engr Water Conn 525.
Planner Water Meter (D7.
Phone Couneil Road Unit '?vS.
Bldg Off Treatment P1 1&0,
Arch./Engr. APC Parks
Variance Copies
Address TOTAL Z455, $D
City/Zip Code
Phone lt
HOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNEB HDST DESIGNbTE AHICH ADDRESS
IS DESIHED. NO CBANGES flILL BE ALLOHED OPCE BQILDING PBRMIT IS ISSIIED.
22 x 30 ` ?6O x s8 = 38 ze?c-)
l? x 14 ` ZSZx I??((b
qc5 n S? = 232c)
2? ?c 22 ? SZ?) xcz = ?33?
'3o x 2 Z-G(?>o x 44 -- 2,?0jo
,j 0 S(-?l z
TRI-LAND C0.
SURVEYING
sERVicEs
NICOLS ROAD
L MINNESOTA 55122
SITE PLAN FOR:
COLLEGE CITY
140 10
0 57F96
NEWTON CT /
A=42°0I'01" ?
R=60.00
44.00
• a !? / AB J?'"`t`?" .'
? V6 , • W . ?
' " „? , ? , ;?? •? o
we, ----
?
Lti I
7 \
L
,-o3"i
N 89043' 03" W!
141.90
PROPERTY DESCRIPTION
1.0T2, BLOCK-4,,
xcordn4 to tM neaded plot thsroof
DAKOTA euunty, Minnesota
L N
o DENO'TES tRON MGNUMENT
o DENOTEB WOOD HUB 5ET
DENOTE8 EXISTIN6 SPOT
ELEVATION
OENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINA(iE DIItECTION
rs? ??spa td by this
or yu?r my
dfrecf wpwhian and that I am a duly
Reosued Land Surveyor unMw tM
laws of tM Stata of Minmesota.
yo
N
SCALE : I"= 30'
PROPOSED GARA6E FLOOR ELEVATION • 102.56
PROPOSED FIRST FlOOR ELEVATION=
PFiOP08ED 9ASEMENT FLOOR = o
ELEVATIOM
NOTE ' VERIFY ALL FLOOR MEIGHTS WITH
FiNAL HOUSE PLANS
Dofe
J. grf}fi'son, 1Ae. Rtq. No.15't35
< . ? .
• E%TER10n :NYEIOPE AVERAGE "U" C011PUTATIt WESnUNSTER
OWNER Sftm ? ?rs cn,d rg • ,
\
S1TE ADDRESS 38,P 6 NEtr/T/?/,tJN L
LONTRAC70R , lou.Er,,S- Ct"N GDOtt? DA7E
,
. .
PNONE 7 /, ys= L6 dP
Determine working square footage of each.
1. 7otal exposed wall area ...... Z3$-I,zS sq. ft: x,?,?
2. Total roof/ceiling area ...... 1173.0o sq. ft. x,,??Y?
7otal exposed wall area abave floor = -
a. 7otal wa11 w9ndow area........................... 1?5 n IZ
b. 7otal door area ................................. . L 3 7.7$ .
.0.?
e. Total sliding glass door area ................. f. 4
d. 7otal fireplace wall area ........................
e, Total wall framing area (average 10%)...:........ 2•3?_?25•`
f..Total net wall area above floor ................. tq oZ.A?Z
g. Total, rim 3oist area ........................... I k,-t.a zt .
Total-eicposed foundation area
h. Total foundation window area ...........:......... -
..... .BbZ_
1. Toal net foundation area above grade .......
Determine "U" value of each wall segment.
? a. 1b5.0 17- X"U" .34b ? 57.09°1-
a: 37,-r g xolu„ , Iz8 ,. 4.635-
__---r-
e
c: 40.00 'x "u^ .346
I
d. -• X.nUu - a -
e. 238.7Z5 X "U" .09Z ? 21.°Ib3
f• I 102. V?? X??Un ???TJ _° U ?.DZ?
9, l b-r,R z ? x„u,, , 0 4 I = b.884--
. n. z Mu„ - ? _
8 8 Z X"U" , O-M = 7, B I
............... * .,...Total
If item 03 is the same ass or less than item #19 you have met the intent
of 58C 6006(c)2. ,
. ..
, , , . • , ,. ;, ,
Total..exposed roof/ceiling area =., .
' J. Total skylight area.:...................... ... .
k. Total roof/ceiling framing area (average lOx).., liy. 3 0
1. 7ota1 net.insulated roof/ceiling area..:........ IO ?5.70
' Determine "U" value for each roof/ceiling segment.
. ??
IIII a .
A V MV
k. ' ?(.7'?Q x pUM.. 1-14^ a Zo.4-to .' 1IOS ,.7o g„Up' , 02Z e Z3.z2s ,
4 ..................................Total
lf tatal of 14 is the same as, or less tban €2. you have met the intent of
, SBC.6006(c)).
Alternate Building Envelope Design
To utllize the total envelope system method, the values established by the'
sum of items 03 and 04 shall not be greater than the sum of items :1 and e2.
1• + 2.
. n .. .
, 3. + 4.
. ?.
, ? ... . . . ... • __
W/NDOW ARE.A : TYPji oP VvINDQW S.
d/e" lNSt'L 60 Ss
Tue ?.v?NOO.u vuirs NArt Bs1'.,J 7isra0 roR. tN@Y Aec Aa 416110
ABoJ[ ,qv m4y. O8 ,4ssi4MR47.1A Orsi4N [SArcl VA4N.R oi .,K-s Z•81
?
(MC?MD?uri A1l{ lrILMS ". .
ootwqL.4-fosrwam - ...,
FOLfNlaA71oN yVINPVW ARrAS TYPL of W1040PW :
TNL VViNOOW U#JtIS/a7M Q[4+./ j"ast[D fol4'Q` V^I,+ac, TN6YAR1L Ai O.Ib+Fp AO&VR AYO
M4r.9r.A68 IyNLU/1 atbltp4 OA04J VALAA L bK *jt*• ll.iCF40?1/?/
AI$ #ILMi
l?te I/Iso, • ?? s??.,.? - FoerA4R 4 FoorA9c •
.'>LIDNq (?LA55 Qooit ARIrA: TYpL oP DooRt
. ?-- 5/g jNSvL_&,L'
yi-oDj?Iq 4Q1.189 OOORS NjAVC OLR,4 tLS7t0 FoR"R= V44.Nff,y THCY "L?.1 L-la?so
ADo?t A+JO M-1y 60 Ass*4NfL-p A DtsJW14G54N3 yAL&tG o1"1¢,"O
Al0 fILA'tS
uq) • V R9J
DoaR /JRa ^ :
7YP e o F LAOR 3
"j-Keo*AA TccU
(]OOfj UNIYS HAVL DLCM TLlT[D APIP ReuyO TO f/AVL AF/
*Fl'-VAYNA Of ANfj Ai• RII.M.f, .
./Z8 '
yd, : P/Rd, L FmrncaXz.
SPecIqLs ;
.
rYp,L •
FCRM C-1 ,OAwl.%
h ?
4
RiM
So, s r Arz i. A:
,"R`- VALUE
'.•b? -- i Nt ERIOK AI2. /'IL M
90 6H IusuLAT?cN 049 )
2 .ob z 3z sHEA riNy uw-r-.IZi-rF-
.io"1 IAP gioill 4_lZ" _
1.08 j,h.'. soF rwooD
. 11, E,ctfp-io R AiR.. ?14-01
24.39 Tor A ?• q.-?? VAr?.c
, r0rn6r+0r.,ti&
FoUnl O A7 IoN WALt- ARE./. CA6oVc CVRNOALD
„R., ?A L u. E
-101 ?NfER1oK, Al1Z ftL-'1 .
?
. S . $ ?oNea r rr ?..ocK
?I• Zt 4- 1 S ?ll21FLV
Q C `R. `
J
• I:Z EXTLrIOR, AiFL /ILM
12.63 -rornL q,,,,* rALwW-
ro,,,L "?Ac4L
IbAw 9•6 10#VN?lO DAtt t 914ut0 _
Sru rD / F/KAM „Nqq ARIL ON :
h
? "R"• vALue
WINfeKjoR ?l/R fit-N
?,rv.fuin w?LL. *04 ea.
/.r? ?
. / 875? So? r wo.o
? Z.0 b Z ZSHt??H+N4 ? 'Q -ti. ..
•? ._. _e-r ? ?:RP sioiuc, YZ??
_ _
vnwe aAMM
. ?. ?fpftL+t)oR Airt POL-M
? • I/'-? = 1 / 0.93s .?
1orAL noorAac'
INSU.I.ATLo ARlA B&TW[a&l StuDS
, „R.. vALu.1.
lureeioa AI+e. /MM
i
• ?? ?'1 GYPluM h/AL460qe0
19,0 ?? IuSUtwT 10N COL119 )
Zii5 SNRa TM/Hfj SUIL'r,?j'tV,
$1 a 104 G ?P
-` ? vA v o K. *., w.R. okM
. 'AtLS1aM AM 146M,
ZZ. O f A L. Wwl. VALNIL
?•w..
jOjA L rbOIA41:
NLi Iq„+M.rb
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
199 F P AC 681-4?T APPLICATION
50544
DATE: -[P ?7
DESCRIPTION OF WORK: _ CONSTRUCT 1M FIREPLACE
_ INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTfiER:
STREETADDRESS: Da!N
LOT ? BLOCK ?
-?
4-6D.ff fl
PERMIT FEE: $50.50
X ALTERATIONS TO EXISTING
RLrPL0,GG- z C w0vD8Uku6-yL
W f )TH z.G 6A s P ?ROO- ??)) .
SUBD./P.I.D. #:
F1 ---?
PiLiCAtvT. '(:IiI:IE OliC OIIly} v vVS'ER " idTicrlC i? i
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.
PROPERTY
OWNER
FIItEPLACE
INSTALLER
Name: _14_u.k(.e- Phone #: 90-2. 1
Signature:
Street Address: 8 8
c,ty:
Company:
Signature: ?
State: Ad
+T?
StreetAddress: 81-Sa At-?r c'Sd-. /OF
City: i i [ State: _aZ
GAS LINE Company:
INSTALLER
Name:
Signature: _
Street Address:
City:
z,p: , 551z3
Phone #: *78/-- Z 3 41
License #: 007950
Zip: 66 4dc}
Phone #:
State:
n/?/?'?, .I'r A Q/?!(?(? CLAIM VOUCHER - REFUND REQUEST
?JV?J`? `? CITY OF EAGAN
G? ¦ ?
? MAKE CHECK PAYABLE TO:
ADDRESS:
LOCATION: 3 q17/ Io r4iM LYn 4?I h?AARY! 14 5Nl,r,
RECEIPI' #/ DATE 1 U1 J. VALUATION
REASON FOR REFUND fi. I l E l f lt _ l t, ;?( vtt
TYPE OF REFUND ELECTRICa,L PERMIT 3211-9001 $
PLUIvtsING PERMIT 3212-9001 $
MECHANICnL PERMIT 3213-9001 $
BuII,DrNG PERMIT FEE 3210-9001 $ .?Q. 00
PLAN REVIEW FfiE 3422-9001 $
snc (MCnWs) 2275-9220 $
saC (CtTY) 3866-9379 $
saC/nDNtnN 3446-9001 $
WATER CONNECTION 3865-9220 $
SEWERPERMIT 3743-9220 $
WATERPERMIT 3713-9220 $
ACCOUNT DEPOSIT 2252-9220 $
WATER METER 3716-9220 $
ROAD LTNIT 3860-9375 $
wn'rEx'rxEA'rMErrr 3868-9220 $
SuRCHARGE 2155-9001 $
UTILITY ACCT OVERPAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTRUCTION METER DEP REFUND 2254-9220 $
WATER USAGE CHARGE 3711-9220 $
TOTAL $
I declaze under the penalties of law that this account, claim or demand is just and that no part of it has been paid
Signature? Date ' ct.AIm.vou
?
7a6,9'z
2006 RESIDENTIAL MECHANICAL rERMiT nrrLicnTCON
City Of Eagan
3830 Pilot I{nob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits aze required for each unit
,3 v,st
Da[e J l al l 6-2a
Site Address 3g() 1,p /V ew?y zvl? Unit #
Property Owner ,/?lfj)-? Telephone !i ( ?p ?J' / ) `757 - 7 ?•??
Contractor a '/ I I?'?
StreetAddress
State Zip Telephone tf "/ ' U u u S
`7 6-1a' /
Bond #: d 5-
Expires:
l?U 119
The Applicant is _ Owner _ Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
? /
furnace Additional
? air exchanger V
Replaceme nt New
air conditioner
heat pump
other
State Surcharge ci? FE $ .50
Z0?6
Tota? $ 30.5 D
I hereby apply for a Residential Mechanical Pennit and acknowledge tha[ the in£orma[ion is complete and accurate; Ihat the work will
be in conformance with [he ordinances and wdes of the City of Eagan and with [he Mechanical Codes; tha[ I unders[and this is not a
pemrit, but only an application for a permit, and work is not to start without a pertnit; tha[ [he work will be in accordance with [he
approved plan in [he case of work which requires a review and approval of plans.
ac4-h M;c%kel1/SGl7 &Q'Yt ?,] 1 &k-2Y'
ApplicanYs Printed Name Applicant's Signature
I
kw6-q.?
2006 RESIDENTIAL PLUMBING PeRnnir aPPUCarioN
CITY OF EAGAN
,__, .._.. 3830 PILOT KNOB ROAD, EAGAN MN 55122
657-675-5675
Please complete for modifications to existing residential dweilings.
15160
Date 14 1 0l? 1
o '-7 VA. vi?? ?
O
Site Street Address Unit #
Property Owner Telephone # (0aW?L- 5d'S?k
Contractor 3 mi fi<? Telephone #?5j )3 (69- 134 Q
Address?a n bf (J P City C State_&,L) Zip
The Applicant is: _ Owner ?Contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes Counry fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dweliing $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. li you are insfalling on/v a water softener and/or wafer
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Tumaround (add $130.00 if a 518" meter is required)
Other:
? WaterSoftener -WaterHeater APR 3 O 2007 $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
T
t
l
o
a
I hereby apply for a Residential plumbing Permit and acknowledge that the information is complete and accurate; that the
work wiil be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accorlaryce wth the approved plan in the event a plan is requirecFto?b? r?viewe ? nd approved.
/ // /
ApplicanYs Printed Name Appliafnt's Signature
_ ?
CITY OF EAGAN WATER SERVICE PERMIT
3630 Pilot Knob Road
P.O. Eox 21199 PERMIT NO.:
Eagan# MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Addess:
Plumber:
Meter No.: - Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances, Misc. Charges:
,,l Total:
By Date Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P.O. Sox 21199
Eagan,WN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
' Permit Fee:
Surcharge:
By isc. Charges:
Date of Insp.: al:
Insp.: Date Paid:
Use BLUE or BLACK Ink
r
For Office Use I
City of Ea nn ~ Permit
6 I I
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
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Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: - 1~ Phone: (tJ'~ J
Resident/ ~ l l
Owner Address / City / Zip: J w cr.~~ L'T
Applicant is: Owner VI-Contractor
Type of Work Description of work: r -O-
Construction Cost: 0 C)o Multi-Family Building: (Yes / No
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Company:
`y`Sd roc c~\ Contact: ~cS C~9
1 f G.vc_
°s°~ how-
Contractor Address: City:
State: Zip: So tc45 Phone:
License #:BC- fig -,t -A a Lead Certificate
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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
i conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name Applicant's Signature
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