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1056 Northview DrCASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD ' • EAGAN, MINNESOTA 55122 ' DATE RECEN? ? ? L/ AMOUNT $ ?? c3 & DOLLARS 0 CASH f?t'CHECK 'o" FM FUND OBJECT AMOUNT of ? Q? c a ,? / ?o ? Thank You BY While-Payers CoPY ? n9 CaPY ?? ? a `-' ? , ? Pink Ffle CoPY CITYOFEAGAN ; ,041 3830 Pilot Knob Road, P.O. Box 21-139, Eagan, MN 55121 PHONE: 454-8100 , , .. , BUILDING PERMIT Receipt # :M ," To be used for qf' bi`'l:l G;'.s' Est. Value $d4+0Cj0 Date Y'AY 20 ,19 §JB Site Address 1056 NOitTHNI i?'w nR Lot Z" Block 3 SeclSub.LBXIt1GT0AI PARKVIEI Parcel No. z Addameress WILLIAli E!U''tiF.R CONSTBUCTIOti m N W bU WATFTiY,')Rn ,)F id oe CitY Phone Name City ? yVj W W Mame _ ? _ z, Address U a W CItY_ I hereby acknowledge that I have read this application and state that the information is coreect and agree to comply with aN.appljeerLile State of Minnesot8 Stetutes and City of Eagan Ordinances. Signature of Permittee - ihM itG1'TtiER C4N3'C A BuiRiing Permit is issued to: on Ihe express condition that all work shall be done in acCOrdance with all applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. Building Official OFFICE USE ONLY On Site Sewage Occupancy R'3 M"i MWCC System x Zoning pL) R-i On Site Well (Actuaq Const v-m City Water k (Allowable) V'N PRV Required # of Stories Booster Pump Length bl ? oeptn 36' S.F. Totai Footprint S.F. ' ? ? APPROVALS FEES Engr./Assess. Permit 514.00 Planner Surcharge 42.50 Council Plan Review 257.00 Bldg.OH. SAC, City 100.oU Variance SAC, MWCC 550.00 water Conn, S 50 - 00 WaterMeter 67-00 RoadUnit 3.1.5•(X) ''' 04•00 Treatment P1 Parks 2-160v.-50 TOTAL - ? ?` CASH RECEIPT ;? i .. CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE ? 19 ' RECEIVED ? ff00G1 AMOUNT ? CASH CHECK DOLLARS ,oo Fl1ND ' O&IECT ! I f AMOUNT Thank You BY ?? ?310,29 , F. White-Payers Copy Yelbw--Posting Copy Pink-Fle Copy j?LEACTIVATE FOR DECK-PLAN REVIEWED 6/2/OF EAGAN IlM t X1?V : ??tAINB(?d -452-8466 C I TY r 3830 Pflot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt To be us?d fbr Est. Value Date_ Site 1056 Lot Block ? Parcel No. rc rvame ' W = Address ' ° City Phone °C o Name , ? ? Address P City Phone Address City Phone 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. Signature of Permittee A Building Permit is issued to: on the express condition that all work ahall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building iSO41 . OFFICE On SRe Sewage USE ONLY Occupancy f ,• MWCC Syatem ' Zoning On Site Well x (Actual) Const City Water (Allowable) PRV Required * of Storiea Booster Pump Length •.,_ . Depth S.F. Total Footprint S.F. APPROVALS FEES EngrJAssess. Permit • 1 • • Planner Surcharge Council Plan Review ? % ? • Bldg. Off. SAC, City Variance SAC, MWCC s' Water Conn. Water Meter ? • Road Unit Treatment P1 " -? Parks ? ? ?? TOTAL ., Psrmit No. Permit Holdsr Dste Taisphone # Plumbing H.Y.A.C. y. O Electric 6zpK c Softener Inspsctfon Date tnsp. Comments Footings I Footings II Foundation Framing Roofing Rough Pibg. . d Rough Htg. 1? ., r' ,U/l?? s ?e?e.l/* ?ii ?s • f eK ISUI. Fireplace Final Htg. A Final Plbg. x,/;?z Bidg. Final cert occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. 4• : + (gex#ifir?tit of (Orrupttnry titp of eaga» Epparimrn# of Iuil.ding Juprrtiam This Cenificate issued pursuant tn the requirementr of Section 306 of ihe Uniform Building Code certifying thar at the time of rssuance this structure was in compliance with the various ordirrances of the City regulating building construction or use. For tlre following.BWg. Pe,m;t No. 15043 Occupancy Type Owner of Buildin Dak: ?Ij= 18• 1988 POST IN A CONSPICUOUS PLACE PERMIT Ik PLUM8ING PERMIT RECEIPT # CITY OF EAGAN ? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: E;jT=4 CONTRACT PRICE: PHONE: 454-8100 Site Address f-''??/? ?'% ' !'? • BLDG. TYPE WORK DESCRIPTION Lot ?Block?- Secl$ub Res. New •'? Muit. Add-on Name 'i + ' !L •` ; :, ?. ,. -'/ 1 : :_ Comm. Repair ?n Address 2? Other c City ?- ' Phone 1''" =_l J-- RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TpTAL Name ?Water Closet - $3.00 $ ?-Bath Tubs - $100 ? Address ator 00 La - $3 2 3 . v y - - p Ciry Phone4?111Z ?-Shower - $3.00 % Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/INO FEE - 1% OF CONTRACT FEE ? Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - St50 MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - S300 `? ? MINIMUM - COMM/IND FEE -$20.00 =Gas Piping Outlets -$1.50 J• STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 ? Private Disp. - $10.00 . $ ' ??' 7- . - ,f..; 1.50 ?• Rough Openings - - SIGNATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAI: `?• ???n _ .,.? .,. ?, .. PERMIT # • MECHANICAL PERMIT RECEIPT # CITY OF EAGAN ?? 1 3830 PILOT'I(NOB ROAD, EAGAN, MN 55122 DATE 6' •??'r? /S?K :ONTRACT PRICE: PIHONE: 454-8100 ;ite Address g? , n E WORK ES IPTION ot Block - Sec/Sub Res. New Mult ? Add-on y Name Address ? Comm. Repair c Ci1y Phone ? aher FEES Name RES. HVAC 0-100 M BTU -$24.00 c Address ? ! -r ADDITIONAL 50 M BTU - 6.00 p City Phon ?'-? (RES. HVAC INCLUDES A/C ON NEW TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent. Gas Piping Outlets # Other M BTU M BTU M BTU M BTU CFM ? FEE: S/C: GAS OUTLETS (MINIMUM - 1 PER PERMIT) i COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES MINIMUM RESIDENTIAI FEE - ALL ADD-ON 8 REMODELS - 12.00 - 20.00 - .50 i OF 1.50 EA. TOTAL• .i"% -?"II FOR: CITY OF EAGAN ?t PERMIT li A' 5' a ? PLUMBING PERMIT ?j' ?7?:• Gi ? CITY OF EAGAN RECEIPT # / 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?? -? C4NTRACT PRICE PHONE: 454-8100 Site AdqreSs 1' :??? I A ?` ; e* ? Lot Block. -? Sec/Sub 4 Name'' i o Address • C Cl?l r=c1 C.1!r7.'? T? V. . 4 Name c Address - - ? ? p City Phone- `?-- FEES COMM/IND FEE - 1°Yo OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/1ND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIG ATURE OF PERMITTEE FOR: CITY OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. ? New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Ki!chen 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 PERMIn ; -L-Softener - $5.00 -% • ? ?!' Well - S10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: -%?-? GRANQ TOTAL• - " ? CITY DF fAGAN Permil No: Date: 3830 Pilot Knob Road Meter No: Size: I - P.O. 8oz 21199 Reader No:? Date: Eagan, MN 55121 ;v_Tttner Canst. Owner. ,..: T ?n n3 ;,e7ciZeton Pa?t= Site Address: 1056 ,. ., y- Plumber. Conn. Chg: KSE) rIn^fl - Zoning: Acct Dep: No. ot Units: Permit Fee: i n Surcharge: 4r ' - I agree to c mply with the City oi Eagan Tr. Plant Ordinanc . Meter. CITY OF EAGAN 3830 Pilo*, Knob Road P.O. Box 21199 Eaaan. MM 55121 :.C: 550.()OP,.e Chg: 1.00 .001)d _ I 5 . OOp?3 . Dep: c. ? nit Fes: .._ .r,, .?.,._,.,.. CITY OF EAGAN Permit No: 9 3830 PilQt Knob Road Meter No: P.O. Box 21199 Reader No: Eagan, MN 55121 Owner. ',j,,L f_70P1' Co-,18L - Sice Address: ' r`r . 6 `T"rt}'°ier Dri°e ry(Conn. Chg: S%Q ^^"d Acct Dep: i.` OOP.? Permit Fee: Surcharge: Tr. Plant Meter. Misc.: ey _.? WATER SERVICE P RMIT Permit No: B/P No: No. of Units: I agree to comply with the City ot Eayan Ordinances. Date: 5--2'88 Size: Date: Zoning: - No. of Uniis: I agree to comply wfth the City o1 Ordinances. WATER SERVICE PERMIT y RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Conslruction Reauirements • 3 regfstered site surveys showing sq. ft. of lot, sq. ft. of house: anll roofed areas (20% maximum lot coverage al6wed) • 2 copies of plan showing 6eam & window sizes; poured found desgn, etc.) • 7 set of Energy Calala6ons • 3 copies of Tree Preservation Plan if lot platted aker 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less uni4s) DATE /U JOB SITE ADDR IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWN RemodeilReoa irReauirements . 2 copies of plan • 1 set of Energy CalalaUOns for heated additions • 1 site survey for ezienor additions 8 decks • Indicate if home served by septlc system for addilions VALUAfION c 0 , -7 CoQ . "v TYPE OF WORK Tcct,r L -PIP ;t K_r? .- f ho ss' FIREPLACE(S) _ 0_ 1_ 2 APPLICANT na( cnSfru ? i o?n ??d?? v?a PHONE051P $?_.;?OSS ADDRESSq07 's+- __3 ZIPCODE ?Sq,;2?'J PAGER # CELL PHONE # Co/a S FAX #`/.S? NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category _ MINNESO'1'A RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category t Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNI:SOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Plumbing System Includes: Mechanical Contractor: Meclilnical System Includcs: Sewer/Water Contractor: _ :1ir Conditioning Heat Recovery System Phone # Phone # Pee: $90.00 Pec: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read ihis application, state that the informati 's conect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances: Signature of Applicant _ NVacer Softener Waler Heater vo. oF Baths Phone #: I.awn Sprinller No. oF R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ updated 1101 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace' ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) FinaUNo C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile Roof Ice & Water Final Other Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone Insulation Windows (new/replacement) Approved By Base Fee Surcharge Plan Review MClES SAC City SAC Water Supply & Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinaVC.O. Building Inspector PERMIT N4 /, / LAO 01-3270 Bk@. Permit 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 75-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 203868 Water Trmt. 103716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 203743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. /eO 14a TOTAL CITY OF EAGAN N! 15 0 4 3 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:454•8100 Receipt # 23 pa9 Tobeused[or SF DWG/GAR Est.Value $$4,000 Date MAY 20 ,79 88 Site Address 1056 NORTHVIEW DR OFFICE USE ONLY LEXINGTON PARKVIE Lot 20 Block 3 Sec/Sub OnSiteSewage _ Occupancy R-3 M-1 . MWCCSystem X Zoning pD R-1 Parc01 No. V-N On Site Well (ACtual) Const a Name WILLIAM AUTTNER CONSTRUCTION cirywater X (pllowqplg) V-N 2 Address 960 WATERFORD DR W PRV Required _ # of Stodes _ 1 ; 0 Citv EAGAN Phone 452-3088 867-6523 Booster Pump Length - 61 Depth 36? p Name S.F.7otal , ?Q Addfess FootprintS.F, _ s City Phone pPPROVALS FEES ? s ?w Name Engr./ASSess. Permit _514-QQ Planner Surchaige 42,511 i- Address Council Plan qeview _25LQQ a W City Phone Bldg. Off. _ SAC, City 1QIL,DQ I here6y acknowledge that I have rea this application and state that the Variance SAQ MWCC _SSD..OQ information is correct and agree to mply with i,?pIje?61e-State of Wa[er Conn. ?,j(L,.QQ. Minnesota Statutes and City o O`Ji. r AA Water Meter __6?,.(J(? - ?f =? Signature of Permittee ---- _ C-_ -- ---- - Road Unit -3-25?9Q A euilding Permit is issued to: WILLIL,t1 HUTTNER CONST 7reatmem Pi 204.00 on the express condition thal all work shall be done in accordance with all Parks applicable State of Mi'n,nesfojta Statutes and City of Eagan Oitlinances. BuildingOfficiaLLll?AlL1i.1J??? TO7AL 1,609.50 This repuest voitl ?p? 18 npnths Irom n 0 26828/a/) 85`J?a`-- ??3 enaesi uaie - rira rvo. qe? e0? nsUCr.bon E]qeady Now?ill Nolity, InsDer es ?NO ?r When Ready rJ Licensed ElecVicai Conlractot I hereby reQuest inspec[ion ol above ? Owner electrical work instelletl at: Street Atldress Boa or floate No. Giry ection o. Township Name or No. qan9e No. C Or.cupy/rt/ IPRIJtl? /? ? P one Na. Power Sup r Atltlress / 1 Elec I Con actor Iany Namel . .11 ? Contra,tor's License No. 1 ? 4t ? M lin ACJress IContra ctor or Owner MakinB Instailatfonl q ? / Authorized t re lConvacmr?Owner Makin Installationl Phone Nu r j9p t'Y MINNE50T STATE BOARD OF ELECTRICITY THIS JNSPECTION BEQUEST WILL NOT G,i99s-MiAwey Blde. - floom N•191 BE ACCEPTEO BY THE S7ATE BOAflD UNLESS PpOPEN INSPECTION FEE IS 1821 University Ava.. SL Peul. MN $5104 Phone (672) 642-0800 ENCLOSED. REQUEST FaR ELECTRICAL INSPECTION ?.. - F See instmctions br completin0lhis form on back d yellow copy. "X" Be/ow Work Covered by 7his Request Frld Pep. Type of BuilEing APaliancee Wired Enuiumen? WireA Home Ranqe Temporary Service ? Dupiex Water Heater Ligh[fny Fixtures ? Apt. Buildinc7 Dryer Electric Heahn ? Commercial Bldy. Fumace Silo Unloader ? Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Ner veu v ?n?, Isnccuryl t .r Succrty ther Othcr omoute lnsoection Fee Below p Fee ServiceEntmneeSize n Faa FeAdmS/Sub(Betlers u FFa ci.oju: U to 00 qm 5 0 to 30 Am s 0 to 30 llm os Above 200 qmps 31 to 700 Amps 37 to 100 Am s Swinmin Pool Above 100_Amps Above 700_Am s Transiormers hriyation oms Partia60ther F $igns Spe 4 I spiIf`ttiun TOTAL Pemarks C . ?j • 1. ma e,a', 1 ai Nougb-in Insoector, hereby certify the? Ne above Final inspection has 4een mada. fltle reauest void 18 monlR+from c w?r? 3INGLE FlMILY DiIELLING3 2 SET3 OF PLANS 3 HEf3ISTERED SITE SDRQEYS 1 3E1' DF ENERGY CALCS. 1989 HQILDIAG PERMIT APPLICATION CITY OF EAGAN tlULTIPLE DWELLINGS 2 3ST3 OF PLlN3 HEGISTfiRED SITE 30AVE?S - (CHEC6 iiI'PH HLDG DIV. ) 1 3Ef OF EAERGY CiLC3. COl84ERCIAL 2 SET3 OF lACHIlECTURAI. 8 ST90CTQRlL PLAN3 1 3ET OF SPECIFICATIONS 1 SET OF EAERGY C?LCS. !lULTIPLB DiiELLIHGS RENTAL UNITS FqH 39LE V11ITS 1 OF D9ITS BOTEs ?DDAES3E4 FOA CDRASR LOSS - COATR6CTOR /SOMEZniNER M[IST DE3IGNAiE YHIC9 ADDAFSS IS DFSIRED. a0 CHLNGFS NII.L BE ALLOWED ONCE BDILDING PERMIT I3 ISSIIED.. 3EilER 8 A9TEA PERMIT FEES AND ACCOOAT DEP0.SIT FBSS iTIl.L B8 IHCLIJDED f1ITH THE BpILDIN4 PERMIT FEE. PAOCFSSING TIHE FOR SEWEA AAD IikTER PEAMITS IS TiiO DAYS ONCE l PERMIT SA3 BEEN COMPLETED INDICATIPG A LICENSED PLMOER. PENALTY APPLIES 6dHENs PERMIT IS NOT PAID FOA IN 3?ME MONTH IT I3 REQUESTED. LOT CAANGE IS REQIIESTED ONCE PERMIT IS ISSITED. ' AMY 3 i 1989 To Be Used For: Valuation: 49?"-- -? Date: / Site Address ?1y; G Ne+`fl"viu.' ?1- OFFICE 05B ONL2 l.ot 0P0 Block .3 Parcel Oimer j? i A 1 ef'v?,^S lddress 105? City/Zip Code Eai,uo Yhone tlun.z 61er!( q ZZ"51? ? Contraetor t-it UJI 0oL-AcuN Li461d+riC Address f : C) 6ok If?Z QL;_ Citq/Zip Code tVY3ntCt , Si 5 1i 'I APPAOVALS Phone '7Sz" Planner _ Couneil Arch./Engr. S+IJc' ??1+llr.r^ Bldg. Off. Address q5 ?? _??J ? r,tti Uc.50 Variance Oecupancy Zoning Actual Const Allowable # of stories ? Length Depth ? S.F. Total Footprint S.F. On site aewage On site vell _ MHCC System _ City vater _ PRV required _ Booster Pump _ *15LI V3 FSES Bldg. Permit s°ok.? Sureharge Plan Aeniew SAC, City SAC, MWCC Water Conn Aater Meter Acet. Deposit S/W Permit S/i1 Sureharge Treatment P1. Aoad Unit Park Ded. Copies 3tJBTOTAL Penaltq TDTAL City/21p Code Phone 9 0? j`IOF v I 4 lJ•!iU+ 431 •Uu+ J1U-Utl: c ? U • :,: 51 4 'UU? ?2?Y•Uil+ ? ?7 9,LJ li. 21 60) .•,ii:: 1988 HOILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLING3 ¦ 5O q3 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICA ADDRESS IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: Site Address Valuation: ? ? S? ?/"' OFFI Date: t?'w C t?'"' ? / 198$ s-/6'ye < < Lr+ VJG UIYLl -? o r di vlev fl ?/ova Lot ? Hlock J On site sewa e 8 Occu ane Parcel/Sub Owner ? Address City/Zip Code Phone Contractor W ' ? ?? ; ?Ovl Address I" City/Zip Code Phone qQJtJff:. SZ1765-2->' Arch./Engr. Address City/Zip Code Phone # _ P Y NII+1CC system r/ 2oning On site well Actual Const City water v Allowable PRV required _ ll of stories Booster Pump _ Length Depth S.F. Total Footprint S.F. -3 M-? I Y-N V-N ? APPROVALS FEES Engr/Assess Permit 51 tf.ot7 Planner Surcharge yZ, ,d Couneil Plan Review 2 ,00 Bldg. OPf. SAC, City loo.oo Variance SAC, MWCC OASO .ap Water Conn 0.00 Water Meter (,n' O Road Unit _%& 75 Treatment Pl , Oc Parks Copies TDTAL vALUA-TidN GA=-? 2z.xZy= SZS x ly.'?342 6ASEMENT .?-----? 1Z1= ZSZ 26 X 36 = 9_? I !88 ? 13 = ls?wy Ho%tsc asmT = !I ? 8 zx? :? iy Zn?3 = 2G ? 225c X y9 =(ob 172 s 83oog ? 88-076 TRI-LAND C0. SURVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 SITE PLAN FOR: HUTT,NER CONSTRUCTIO LEGAL DESCRIPTION: LOT2Q,BLOCK_3_, LEXINGTON PARKVIFyy ACCORDING TO THE RECORDED PLAT ? THEREOF DAKOTA COUNTY,MINNESOTA NORTHVIEW DRIVE 309A84 90&24 79.C. T.B.C. 90944 S 49°I2'33" E 85.00 -? w.v. r a ----? ? ., w , 012• SCALE: L".30' (D 12- I 3. .. - I I ? GARAGE I I p PROPOSED N HOUSE I ) i7 HUB EL. • 909q4 i q aD (.0 US 0 N 90 906014 W ?.?.. ., ;? ? 1.1. ? 1 N N f? ? 0 0 d' LOT 20 61' ?, ° D, pR? ?- - - - - - - - -? ' ? ?-'-?''" ^ LEGEND °"`°° o DENOTES IRON MWJUMENT o DENOTES WOOD HUB SET DENOTES EXISTING SPOT ELEVATION OENOTES PROPOSED SPOT ELEVATION ? DENOTES DRAINAGE DIRECTION I hereby certify that this survoy,plan or report was propared Dy me or under my direcf supervision and thai 1 am a duly Reqistered Land Surveyor under the Laws of the Stote of Minnesota. 906k34 Bradley J/Stir4nson, Mn. Rep. No. I5235 v?/ Date A 6 .1 W N N P- e 0 ? l. ? v. Y ?? -'(-, INVERT ELEVATION AT SERVICE EXTENSION= PROPOSED GARAGE FLOOR ELEVATION - G PRaPOSED FIRST FLOOR ELEVATION= PROPOSED BASEMENT FLOOR = ELEVATION NOTE ? VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS . -, .. .... .. TO EE SU9.`lITicD L;ITkI IIUILDIliC PLMIT APPLICATI01 OI;tiER: S£TE ADDRESS CANTRACTOR: DATE: 5 _4 4d P}IONE:'?iT2-s'4IT ?"G7 ? ?'z? Determine working equare footage of each 1. Total exposed wall area......... 2-0 f?( sq.ft. x 2. To[al roof/ceiling area......... / Z SO sq.ft. x+ 3. Total exposed wall area calculations: Total exposed wall area above floor - /g,36 a. Total wall vindow area .............................. 1L81 b:-, Total door area .................................... 3_ c. Total sliding glass door area ...................... .910_ d. Total firep2ace wall area ........................... - e. Total va11 framing area (average 107.) ................... 79-3- f: Total net wall area above floor ..................... !38 g. Total rin joist area ................................ !09 Total expoaed foundation area - .//L h. Total foundation tiaindow area ........................ -' i. Total net foundation area above grade ............... //2.. Detezmine "U" value of each wall segment ' a. x „U„ A ? u. 3 '?l X „U., . C. 8o X „u,. ,55 _ qge o d. ?---- X BlUff .?.. ? .....-, r . E. ?/3 X glUl$ i 0/ ? 13, 5^I f . l 3 g 7 x „U„ , 0q r(I X .,u„ , n4 3 Z ' h. x $lUte -, i. X l,U,. / A L ~? • 3. • TOTAL ~ • . ? I Z, ?S . If ttem 03 is Che same as, or less than item 91. you havc met the intent of SIIC 6006(e)2. • FJ:TEP.IOR i:tiVF.LOPE AVERACP. "U" COI-PUTATION ' _ L. Total ca,osed roof/cciling calculations: Total e;cposed roof/ceiling area = /Z So J. Total skyligh[ arca................................... k. Total roof/ceiling framing area(averap,e 107.)......... /-- 1. Total nei insulated zoof/ceiling area ................. 112 Deternine "D" value for`each roof/ceiling segaent _ J. ? . X nIIn ?-- ? - k. r ZJr X llOn 1. I(z5' R„U„ S. 4. 'TOTAL . L,O O If total of t`4 is the sarae as, or less than 02, you have net the intcnt of SBC 6006(c)1. AZternate Building Envelope Design To utilize the total envelope system method, the values establislied by ' the sum of iteas 03 and D4 shall not be greater than the sum of items 41 and 02. 1. 3. + 2. ? + 4. - C E R Y I F I C A T I O N ---------- -- I hereby certify that I have calculated the "U" factors and R values herein and that the buildinp, hera described meeta or exceeds the State of Minnesota Energy Conservation Act. (Signature). ? ?W . (Da[e) ' •?.? : . - w,?i.L ?r?•i:c:::s I L`0'i'C; [tr-c 30': ot np-iqur wi11 arci for ' tr.amc conrtroctiun F.RT.t:E l4ALL Conntrticrion R-ValUc W.oIt"( " & 1L . .4 7 1. Y ior ?air fi]m 0.60 2. 1,41 " "il':r'?,,?r,v 3, o?^ inches sofr wond "+ S•'.> Q, 5. illrr?? 6. Exterior air film : 0.17 ` Total J? y-j r ri/l.L`. .0'7 1. Intcrior air film 0.60 2. (-,C) 3• 00 4. ..,'.,=.v'i? 2501 4•OU •5. r ??n?(? i , 0S ? 6. - EsCerior air film 0.7.7 Totai K = 21.9f r l. Interioz ais film 0.68 '? 1 1. ?U 3. 1'IL" SOF1j,L'COb 1 v? A. '! ?, !: Z. S U.'r;? ? i0& 5. />! 1,95 6. Er.terior Pir film 0.17 • Total i- Au . Interior air film 0.68 ?• ?_v?G( i,Z1.. Z •, • ? 1. ? ?1• 2. ? . • 4. 5. ' G. ?. st,As o:r cnau=.: Exterior air film 0.17 'rotal `l, G• > V ? . I0 ,. :IG. N3 o ? ?1fJ ` • • , b , • ? O ? ? /L ? ? • •? ? .?' : P . ' •/ • ? b ' 6 . ?. • ? ?. , L--j I ` b -6`: ji FIG. 114 NOTC: -- ., ? . • _ Ir( ? ? ? ./!I ? . ?? • : ? ? ? !i/i , t ?k • •;t ?i? a •, o,? ii r? /!f c. Irr ?. lir ; fndicatr. tync, "II" valuo, dc:rth and pYacenent of insulatloti. FOOI'/CL'ILI17G l.:yC 'i'(::Cc Con:'.tr.uction R-Valne f?' 1 ('1 ? 1 ' VEM cnted Li ticsc tlt,t: up 1. Interior ai.r filre 0.61 2. " Sa C? Y I-, A? l, • , 9 3. Gv 4'. Txtcrior 7ir film (s:t.ill) O.G i Tocal k. q?,61 r•7c. tls 1n?.?,alM.??'????TA4^•=.??%f`,?=` tCn?!'?{1V.?1 -==-_ --_ =--- _.? l:eat flocr up ???????? ??[7i?N l?`V;.., _ ?v>r (7 1. Interior air film O.G1 2. r7wtlLc. •y? 3. 4. Er.teriur air film still ?.ST Total U '7 1. Inaide air Pi].m 0.61 2. . 's. 4. 5. Outside air Piltn .0.17 Total Wotc: Ua:c addiCional shcets if more EpdCC i: needed for details and cnlculations. , . .vented - .? .?Vn-Yl:lIl2L . • y /+ . . Hent LJ flov up F.T.r,. ?07 ? APFLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION OF eC1gC8n 1) PROPERTY ADDRFSS: .. ; „ .. ?N07'E: PASM4I7f OF FEE AT TIME OF T* ; r,eeLIcATIoN ooES Nar cnrr ; ? STI7SflE APPR('iJAL OF PIItDIIT. : 4 k INSPF]CPIOP7 OF SESd32 APID/OR WATIIt t ? INSfAidATIOCLS WII.L N(7t BE SCFDUIkD +*. ?[RSCIL PFI7MIT HAS BM APPROVID. t •?a?+ttf:?xr+art+«fff#rt??k?:yw+att>fr r,Fr;AT• DESCI2IPTION: . Lot B ock S division or Tax Parcel ID ) PRESENT ZONING/PROPOSID USE: Q CONA7ERCIAL/RETAIL/OFFICE Q INDC?STRIAL Q INSTITOTIONAL/GOVERNMENT IF EXISTING S1RL'CPURE, DATE OF ORIGINAL BC!II,DING PERMIT ISSLANCE: Mont Year CITY, STATE, ZIP: PHONE: I? SINGLE FAMILY ? R-2 DGPLEX (34.v C'nits) ? R-3 'POWNHOC'SE (Three + Onits) Q R-4 APARTMENT/CONIDOMINI(;M 3) ? NaME: J ADDRESS: CITY, STATE, ZIP: PHONE: MASTII2 LICENSE # ?' 3 29 4) e i•• • ?• NANIE: ADDRESS: CIT'Y, STATE, ZIP: PHONE: 5) 0? sBHT' I.lyEig9109SUMIS..5'13C .?0 . EZI CONNECTION TO CITY SE,WER gl-CONNECTION TO CITY WATER O OT13ER ( Onits) ( Onits) ,lunuers License: j Active Fxpired Not recordec Nt-afF Initial 6) c'A j?i A / w-,vv-m 4 ^ /- ****?:t,t*****?,r*,tx:r*+:K?itaY******,t**,t*t*:t**,tt?**?**,t*********:t*,t,?***?**,r+*??:t**?*??*******:t*?*t?**,t*?y ? * TfE GOLD COPY OF THE PERNIIT WILL BE SENf DIRECIZY T0 PUffi.IC WORKS 7q FACILITATE MEIER PICK-OP. y * PLEASE ALJAW 'iSN WORKING DAYS FOR PROCESSING. SOA'IDDNE FROM TfE CITY WILL COISPACT YOL IF TIIERE .', * ARE ANY PROSLETIS. ; '?****?*****?******+?*********+**,r************************?***************?**+*?***«**?**+*****?****; FOR CITY USE ONLY PERMIT # ISSDED ??•?c? Pd w/Bldg. Permit FEES: S ? ' S $ " ? ' ?- /t)• SEWER PERMIT (INCLDDE SURCHARGE) $ $ l0' WATER PERMIT (INCLCDE SORCHARGE) $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (2[VCLDDE CORPORATION STOP) $ $ SEWER TAP $ ACCOLNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ SSZN ' C1 L) $ WAC $ (i,S? • (?-v ? SAC $ $ TRD[VK WATER ASSESSMENT $ $ TRLNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRONK WATER S o?L??/'cr T $ WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: $ I ?'I ' e -n $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNEC TION REQLIRE EXCAVATION IN POBLIC RIGHT OF WAY? a YES IF YES, THEN A"PERMIT FOR WORK 69ITHIN PUBLIC Q NO ROADWAY" MUST SE ISSUED BY THE ENGINEERI[VG DIVISION LIST AS A CONDITION . . SUBJECT TO THE FOLL OWI[VG CONDITIONS: APPROVED BY: TITLE: DATE : ? ? ?? ? 01/02/2008 08:59 6513488293 TCHRLLC City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 PAGE 02/08 Use BLUE or BLACK Ink For Office Use Permit #: ' ®- t `� Permit Fee: "J t-19-.1.-5 c I.___ ot) Date Received: Staff: r 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: y^11-13 Site Address: /D56--) /io 1-tVl E `i) ZAi UL Unit #: `fype:of :WOrk Name: 3.-I/ / e. /eONPhone:?L'/ /1)6174. 11l 6-1-1) cig, 'ntractor Address / City / Zip: Applicant is: Owner Description of work: _ PEIVIod 6L Construction Cost: r ig, v7So 13irmi Company: /Gt)/'V e Address: AND fAm «1i /f,' t Multi -Family Building: (Yes / No 3720 Gc..> mac) ' . Phone:_ 3—f 7 —25 � Lead Certificate #: /Y4'- Flag(^ / �'Ctffitact: �� jil -/Edit/ City: AciA/ .e A State: /flit/ Zip: ,c67/ License#: t3C&55-906 If the project Is exempt from lead certification, please explain why: (see Page 3 for additional information) \t 1.)(-V6IV 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 the are trade secrets. CALL BEFORE YOU DIG. CaII 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.gophgrsteteonecail.orq 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 o ��l 141. A/4 -4/11x /7I � -✓ Applicant's Printed Name App nt's gnature Page 1 of 3 0549 ►lwl-kyit a DY DO NOT WRITE BELOW THIS LINE (m3-1 SUB TYPES Foundation Single Family Multi 01 of Plea Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% y) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level r Porch (3 -Season) Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) _ Pool Interior Improvement Move Building Fire Repair Repair 1�S�S1JJ Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior _ Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant Occupancy Code Edition 04/1.4.-) Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final x Framing Fireplace: Rough In Air Test _Final X Insulation Meter Size: Reviewed By: C MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final 1 C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL r(( 5q9 0 Page 2 of 2 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA110023 Date Issued:04/18/2013 Permit Category:ePermit Site Address: 1056 Northview Dr Lot:20 Block: 3 Addition: Lexington Parkview PID:10-45035-03-200 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fixtures:Water closet, shower, Lavatory Patrick Semlak 1406 Sophia Avenue Fee Summary:PL - Permit Fee (miscellaneous)$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 - William L Persons 1056 Northview Dr Eagan MN 55123 Semlak Plumbing 1406 Sophia Ave Maplewood MN 55109 (651) 770-4816 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA112021 Date Issued:07/23/2013 Permit Category:ePermit Site Address: 1056 Northview Dr Lot:20 Block: 3 Addition: Lexington Parkview PID:10-45035-03-200 Use: Description: Sub Type:Residential Work Type:Underground Sprinkler System Description:PVB 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. Jason Larson 25 S Sutton Lake Blvd Jordan, MN 55352 Fee Summary:PL - RPZ/PVB/Lawn Irrigation $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 - William L Persons 1056 Northview Dr Eagan MN 55123 Jay's Plumbing 25 South Sutton Lake Blvd. Jordan MN 55352 (612) 868-4102 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA119551 Date Issued:12/04/2013 Permit Category:ePermit Site Address: 1056 Northview Dr Lot:20 Block: 3 Addition: Lexington Parkview PID:10-45035-03-200 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fixtures:Kitchen sink, ice maker line, gas line Patrick Semlak 1406 Sophia Avenue Fee Summary:PL - Permit Fee (miscellaneous)$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 - William L Persons 1056 Northview Dr Eagan MN 55123 Semlak Plumbing 1406 Sophia Ave Maplewood MN 55109 (651) 770-4816 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA121688 Date Issued:04/11/2014 Permit Category:ePermit Site Address: 1056 Northview Dr Lot:20 Block: 3 Addition: Lexington Parkview PID:10-45035-03-200 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 . Kelly Meyer 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 - William L Persons 1056 Northview Dr Eagan MN 55123 Hause Construction, JG P O Box 206 Bayport MN 55003 (651) 439-0189 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA127277 Date Issued:09/25/2014 Permit Category:ePermit Site Address: 1056 Northview Dr Lot:20 Block: 3 Addition: Lexington Parkview PID:10-45035-03-200 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 L Persons 1056 Northview Dr Eagan MN 55123 Hearth And Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 Applicant/Permitee: Signature Issued By: Signature 11/07/2014 02:51 6513488293 TCHRLLC P�GE 02/02 Use BLUE or BLACK Ink � For Of(9ce Use � • � ��-��v ► C�ty of �a�a� , p��#: � 5 , , .a , � Permit Fee: � � 3830 Pilot Knob Road Eagan MN 55122 j oate Racelved; j Phone:(6S1)6753675 I Staff: I FBx;(651�675-5694 � � �-------__._�...._...�__.a 2014 RESIDENTIAL BUILDING PERMIT APPLICA�ION Date: � Sita Addr�sc: IO�fv /Vo►r�r+1/%'f'�-� L'"�✓`� Unit t�: Name� � II � � ��Y �'er�a"5 Phone.�'J'�2-4�"3/O� Resident/ owner Address/City/�iP:f�.�CQ I�Oor`�+v',��+��v�a �aaaN �Sl�3 Applicant is; Owner Contractor Type Of WOt'k Description of work: ��ACe '7'_W.i r+c��w� �� P��a d°��S . Construction Cost: �� 2� Multi-Family Bullding:(Yes /No ) Company: W�v.�:'� 6u�e �yQ wo��. �c� Contact; ��'1 ��'r'1° Cp�it�CtO� Address; Y`c+ �'L ev,.a•f � Cj�Y;/-�-��-f �(I�a ti $ 3 1 State: /�'r�Zip:s�✓/I'Z-- Phone_�DS—3 mail: •. ow,e�+Pw�d��w� .� h� l.icense#: C�O Lead Certiflcate i�_ lV��/�1 F7 f g l� 1 If the project is exempt from lead ce�tification, please explain why. (see Page 3 for addittonal information) COMPLETE THI9 AREA ONLY IF CONSTRUCTING A�IEW 6U�LDING In tne Iast 1�months,has the Gity of�agan issued a permit for a similar plan based on a master plan7 Yes �No If yes,dete and address of master plan_ Llcenaed Plumber: Phone: Mechanlcal CoM�actor: Phone: 3ewsr 8 Wabs�Contracto�: Phon@: NOTE;P/ans and supporting documents thar yau submit are considered to be public inforn►afion. Pordons of the�nformaUon may be cless►fled as non public if you provide specNlc reasons that would permit tha Clty to conclude that U►e are b�de secrets. �ALI BEFORE YOU DIG. Call GopfwY Stafo Ono Call at(851)b51-0002 for proteation aeainat underground utiYty damage. Ca1148 hours beFore you infend to dig to receive bcates of underground uUliUes_ www.twoharstateoneceu,ora I hereby acknowledge that this information is co�nplete and aCcurate;thet the Work Wlll be Ih coniormance with the ordinances dnd Codee of the City of Eagan;that I understand this Is not a pert»it, but only an appflCAtlon for A pePmlt,and wortc is not to sta�t withoul a peftnlY that the wak will be in accordance with the approved plan In the case of worlc which requires a review and approval at plans. Exterlor Wortc authorized by a building pemtit issued in accordance with the Minnasota Sfafe Bullding Code must be ca►npleted wlthin iS0 days of permit issuance. x �°N Y' AppllcanCs Printed N e icanrs Sig re Page 1 of 9 02/25/2016 03:47 6513488293 TCHRLLC PAGE 02/02 41* City 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 875.5675 Fax: (651) 675-5694 RECEIVED FEB 262016 Use BLUE or BLACK Ink For Office UBe Permit #: Permit Fee: Data Received: Staff: L 2016 RESIDENTIAL BUILDING PERMIT APPLICATION U Site Address: \I9A4A'1h1P1►-1 bf Unit #: Resident/ Owner Name: 1;'* *Yell 'tC 1s Phone: — j •2 °�O 1 Y Address i City / Zip: 1 N' b e.l'5AgcLA m n CS t2 Applicant is: Owner Contractorw 14 c 0 COQ Type of Work W IoWS '. Description of work; [ a l g m► ' . r - 0.40 t� t ' It: k, - Li. !.._ °� S Construction Cost: i 1 a ' 0 Multi -Family Building: (Yes / No Contractor CompanytiA (% Cikb t O( l Contact: 3o w kVIKI V 1 Address- QJ -lhr ( City: BUJ Z to •Y1 "-- State: 14.41I Zip: 151Y112.. Phone: '33 •SS mail: ti License #:13CI055J00 Lead Certificate #:l 0 lq -- If the project is exempt R II 11.11 II from lead certification, please explain why: • In last 12 months, Ye No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed tuber: Mechanical Co Sewer & Water Cont Fire Suppression Contrac Phone: ctor: Phone: ctor: Phone: r: Phone: NOTE: Plana and supporting documents that you submit are considered to be public infomrat/on. 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before you Intend to dig to receive locates of underground utilklas. www.00pher ttiteonecalLorq 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. ICoi4s4N Applicant's Printed Name pl ' ant's Sig Page 1 of 3