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991 Northview Park Rd Apr, 5. 2011 5:51PM 5072821338 K S HEATING No,0117 P. 1/1 Use BLUE or BLACK Ink 17 ------i I F~r,f9(Hce, I z City of EaRdR I permit: ll`D-/ I I 3$30 Pilot Knob Road Permit Fee: o Eagan MN 55122 I I I Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: 1 2011 MECHANICAL, PERMIT APPLICATION Date: 3-,;29-1/ ! Site Address: _ Tenant; Sulte RESIDENT I OWNER Name: t& U te - Phone: Address 1 City/ Zip, CONTRACTOR Name: License /J& - Address: City. C,,.4lrak,7'+1"'- State: zip; phone: 6a t7 t cMZ Contact: 1' ~"il/7 Fall: TYPE OF WORK -New ~Repleoement ,Additional ~Alteration Demolition Description of work: _ NOTE: Roof mounted and ground mounted mechanical equipment Is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL XFurnace _ New Construction ` Interior Improvement Air Conditioner Install Piping -"Processed Air Exchanger Gas _ Exterior HVAC Unit - Heat Pump Under/ Above ground Tank Install / _Remove) " When installfng/removing tank(s), call for inspection try Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55,00 Minimum Add-on or alteration to an existing unit (Includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 5L 0ZITOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x 1 % $55.00 Minimum (includes State Surcharge) _ $ Permit Fee - If the Permit Fee Is lass than $10,010, surcharge is $ 5.00 - If the Permit Fee is;- $10,010, aurcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge (Le. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) _ TOTAL FEE CALL 13EFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.nopherstateonecall.om 1 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 wo(k which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date. Required Inspections: -Under Ground _ Rough In Air Test Gas Service Test -in-floor Heat -Final Exterior HVAC Screening Inspection CITY OF EAGAN 15440 3830 Pflot Knob Road, P.O. Box 21-199, Esgan, MN 551 21 PH O N E: 454-8100 BUILDING PERMIT Receipt? To be used for n= Est. Value ' Date - ,19 Site Address OFFICE USE ONLY 1 4 L . • ?..k • .i.: Lot 81ock Sec/Sub OnSiteSewage OccuPancy • ',- ? . MWCC System ? Zoning ? K"1 Parcel No. On Site Well (Actual) Conat m Name Ti! BFkWC?r.K .; ''•, t, ,i-;?•- ? City Water (Allowable) v-'` z Address `I PRV Required # of Stories il: ° ti?`• ?-?1 1?: City ? Phone Booster Pump Length , 4 u Depth 52 ` , p Narhe ' S.F. Total oQ Addrpss Footprint S.F. P City Phone APPROVALS FEES ~ ¢ yVj W Name Engr.lAssess. Permit 546.00 ` fl 1 = Planner Surcharge `?' ? Address 273.00 ?ZW City Phone Council PlanReview ? 1? Bldg. Off. SAC, City • I hereby acknowledge that I have read ihis application and state that the Variance SAC, MWCC 550 •00 informetion is correct and agree to comply wkh all applicahle Sfate of Water Conn. 550' 00 Minnesota Statutes andCity of Eagan Ordinances. fi7 v0 Water Meter . Signature of Permittee - Road Unit 3 2.5•vc' A Building Permit is issued to: tS?'? ?. Treafinent P1 2 0 L . 0o on the express condition that all work shal I he done in accordance with al I Parks appJicable State of Minnesota Statutes and City of Eagan Ordinances. t ' 1 ' 5d Building Official TOTAL CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 79 RECEIVEO , , . FqOM AMOUNT $ & DOLLAFS iao ? CASH C] CHECK I . , 1j E ? ?1 4 1 ? . BY White-Payers CopY Yellow-Postirg Capy Pink-File CoPY Thank You CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS• INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: • 1 011 ; I I ril 114.r , ;t?it (I??V I k.4! 1'AFta NC? PERMIT SUBTYPE: fitl l! ft I Nfi 3.P., dA/11/174 APPLICANT: TYPE OF WORK: NJ 1.1 I 7 Pertnit No. Permit Hotder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Fooiings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Freplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final /r 9 j-- weli Pr. Disp. CITY OF EAGAN , 4 4 0 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# To be used fpr ? Est. Value Date ,19 ? Site Addr6t8s r1l S2K Eii OFFICE USE ONLY Lot ` Block ` Sec/Sub. I'? Xp'?jGTJ?; :it: On 31te Sewape Occupancy ^ ?'1 Q I MWCC System Zor?ing Parcel No. . On Site Well (Actual) Conat ir Name i"1C City Water k (Allowabie) V'"N W Address ` j PRV Required # of 5tories 461 o ?_D 11 ? City ' Phone 8ooster Pump Length ? ? , Depth ¢o Name S.F. Total , ? ` Address _ Footprint S.F. ? Ciry Phone APPROYALS FEES v ? . JU ''4 Q WW Name Engr./Assess. Permit ? g Address Planner Surcharge ?? `W City Phone Council Pian Review -T-V7-1. Bidg. Off. SAC. City ? ? I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC . information is correct and agree to Comply with all applicable State Of WetefCOnn. ?? Minnesota Statutes and City of Eagan Ordinances. Water Meter 67.00 Signature of Permittee Road Unit 525.00 w.: A Building Permit is issued ta _ Treatment P1 -104.00 on the express condition that all work shall be done in accordance with all p applicable State of Minnesota Statutes and City of Eagan Ordinances. arks TATA1 2,6W.35 Building Official Permit No. Permit Holder Date Telaphone i? Ptumbing <? H.V.A.C. f E lectric Softener Inapsction Dats Insp. CoMments Footings I Footfngs II Foundation Framing Roofing ?V Rough Plbg. 9? 11 Rough Htg. IsuL F ireplace Final Htg. l F ? Final Plbg. . .?' ? Bldg. Final cert oco. Temp. LP Deck Ftg. Decfc Final Well CP??G?? i/Z ?l ^ 2-? r-T?' /i? Pr. Disp. !..• „ v (gex#if iratit af (Orrupttnry (Citp of (Eagan ap#iorhilMlf Df lLttlbttlg ji1B,pPtfintt This Certrcate issued pursuant to tlie requiremenls of Section 306 of tJre Unijonr= Building Code cernj'ying that at the time ojrsstrance this siructure was in compliance with the vanous ordinances of the Cuy regulating 6uilding construclion or use. For the following.• use C1essiGnrioo SF DW'LCAR Bwg. Rmvi No. 15440 p-W-YTYPe ?mi Tooingpist:iu PD/RI 'lypeComt_ VN Owner of Bw7ding fDORM40RKS M.r? , PC• Addrtss 1821 WALM YAM, ' WIS a,wahng adaress 991 IJOI.MtVII?{+I PARK F40AD LmlitY L 11, S2, I.EAiIUM 9(7lIARE IH : JUNE 14, 1989 POST IN A CONSPICUOUS PIACE . . .. .- .1'tiY` . . _. . - , . . . " • ' •~; ' ' - PERMIT # - ' MECHANICAL PERMIT " , • ` ' CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE CONTRACT PRICE: PHONE: 454-8100 Site Address ?? ?• ?= ' BLDG. TYPE WORK DESCRIPTION Lot Block ?- Secl?ub . , Res. New - ? ?. Name • , j%__, ,. _ Mult Add-on m Address Comm. Repair Other c Ciry Name ' 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 PEka+AlT) - 1 50 EA . . TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE BLDGS - COMM RATE APPLIES APT Forced Air M BTU . . . TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RE5IDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM $ - (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping OuNets # BEYOND $1,000) Other ? FEE: S/C: -? SIGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN ities Diizital Oualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. PLUMBING PEIiM1T CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN $5122 Site Address ' 'I `' I Lot jl Block -? Sec/Sub ? Name ? Address c Ciry Phone ' - . ,.. Name ? - - - ' ? c Address p City Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES SIGNATURE FOR CITY OF EAGAN PERMIT # Jn GY ? RECEIPT # DATE: BLDG. TYpE WORK DESCRIPTION Res. ?? New E Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL D Water Closet - $3.00 $ LBath Tubs - $3.00 ? Lavatory - $3.00 Z 1 Shower - $3.00 Kitchen Sink - $3.00 UrinallBidet - $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 Well - $10.00 Private Disp. - $10.00 =Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL: •' ' ^x p p ' 4W`°rV'gW"" v PLUMBING PERMIT For Offic, CITY OF EAGAN PERMIT# -L CONTRACT PRICE Site Adss Lot , --?? - Name ? Addre, ? City`- ?C5 Add 8 cRy 3830 PILOT KNOB ROAD, EAGAN, MN 55122 I RECEIPT # , . PHONE 4548?f O0 QATE: - SeclSub Phone FEES COMMJIND. FEE -196 OF COMTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAI FEE $12.00 MINIMUM - COMM.IND.IFEE $20.00 ST?TE SURCHARGE PER PERMIT .50 (AD'DA.50 S/C PER EACH $1,OOQ OF PERMIT FEE) BLDG. TYPy WORK DE5GRIP111 Res. New Mult. Add-an Camm. Repair RES. PLBG. QNLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAI Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Ktchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outtets - $1.50 (MINIMUM -1 PER PERMIT) ? Softener - $5.00 Well - $10.00 Private Disp. -$10.00 Rough Openings - $1.50 PERMIT FEE: ? 5TATES S1C: GRAND TOTAL: 5 • JU _ ?: . _ ? CITY OF„EAGAN Permit No: Date: ` 3830 Pilot Knob Road Meter No: ///40 11 elO Z3 Size: -?? P.Q. 6ox 21199 Reader No: Date: Eagan, MN 55121 vwrinr: ;Mharsanrka Kni ? ? rt; Site Address: '<<, 1 Alc•rtt1t7icw Dar4 gnad ? j' 1:.7 OiPlumber. ;;@; 1 PT ?1whi n-f fOh1iA'7II E'5CC Conn. Chg: Zoning: Acct Dep: - No. of Units: Permit Fee: Surcharge: 1 agree to comply with the City of Eagan Tr. Plant_ ?• • kl)Opa Ordinan ? Meter. Misc.: Br ? WATER SERYICIE PERIUII'I'J f CITY OF EAGAN Permit No: Date: 3830 Pilot Knob Road _ B/ P No: Date: ? r-.' IR ? P.O. Box 21199 ? Eagan, MN 55121 By SEWER SERVICE PERMIT Eagan, MN 55121 Permit No: Date: Meter No: Size: Reader No: Date: Cann. Chg: _ 550.00p2 Acct Dep:_ _ 15 .OOpd Permit Fee: 10. Surcharge: - • 50PKI Tr. Plant_ - Meter. ? Misc.: Zoning: No. of l I agree to comply wiih the City of Eagan Ordinances. ey CE PERMIT ? MWCC: ' ? ` • '?"`? Zoning• ", City Chg: r,, •-, No. of Units: 1 Acct. Dep: Permit Fee: I agree to comply wifh the City of Esgan . . Ordinances. Surcharge: • CASH RECEIPT • CITY OF EAGAN . 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 5 122 DATE 18 ? 1 $ a oow,as ,m ? GASH U CHECK FUND OBJECT AMOUNT oe? ?? !l ?j ? a< << Thank You z BY N? 86715 , Whle-Payera Copy Vellow-POSG'g Copy Pink-File Copy BLDG. PERMIT NO. ? d LtmA?tU & &. 01-3210 Bldg. Permit 01-3422 Plan Check 01-3445 Surch.iAdm. 01-3446 SAC/Adm. 01-2755 Surcharge 75-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3$68 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. 60, TOTAL 'CITY OF EAGAN ?? 15440 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:454-8700 qeceipt x &D5??L4 To be used for SF DWG/GAR Est. Value $93,000 Date AUGUST 15 ,19-8&- Site Address • 991 NORTHVIEW PARK RD Lot 1'I Block 2 Sec/Sub. LEXINGTON SQ 6TH Parcel No. a Name - TIMBERWORKS BUILDERS, INC ; Address 1821 WALSH LN ° CityMENDOTA HGTSphone 681-0112 a Name SAME ?0 a Address ¢ City Phone City I hereby acknowledge that I have read this application and state that the information is correct and agree lo comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permitteese?.-•? A Building Permit is issued to: TIMBERWORKS BUI ERS on the ezpress contlition that all work shall be done in accordance with all applicable Sta[e ot Minnesota Statutes and City of Eagan Ordinances. 8uildingOflicial -t,d2y.? T?-uM._I OFFICE USE ONLY On Site Sewage _ Occupancy R-3 M-1 MWCCSystem X Zoning PD R-1 On Site Well _ (qctuaq const V-N City Water X (Allowable) V-N PRV Required _ # of Stories Booster Pump _ Length 461 Depth 52 ' S.F. Total Footprint S.F. APPROVALS FEES Engc/ASSess. Permit 546.00 Planner Surcharge 46.50 Council Plan Review 273.00 Bldg. Off. SAC, City 100.00 Variance SAC,MWCC $50.00 Water Conn. 550.00 water Meter 67.00 Roatl Unit 325.00 rreatment Pi 204.00 Parks TOTAL 2,661.40 II II II ?!I II II I II I I? II _REQUEST FOR ELECTRICAL INS ? UF Minnesota State Board of Electncrty 7821 UmversAyAve Rm S 128 St Paul M 0 3 2 L 4 2 5 2Phone (612) 642-OB00 ome Duplez Api. Bldg. Oiner: '-' New Addn mmerciol Indusirial Farm Remod Re ir I Cond. Htg. Equip. Wafer Wr. Lood Mgmt. Other: D er Ran e Elec. Heot Tem $ervice e "X" above fhe work mvered by this request Enfer remarks in this space and an the back of fhe whife ropy anly. Colcula}e Inspedion Fee - This Inspecfion Requesf will nof be accepfed withouf fhe corted fee: Olher Fee # $ervirn EMrance $ize Fee # Circuils/Feeders Fee Mo6ile Home Park $tall 0 fo 20Q Amps 0 fo 100 Amps Sfree} lfg./(mHic Sig. Above 200 Amps Above 700 Amps Tronsformer/Generator INSPECTOp'SUSEONLY TO AL $ign/Outline Lig. Xfmr. d Alarm/Remofe Conirol Swimming Pool ? I hereb ceni 1 t I Inx etled Nie elednml tnslollarion descnbed hereln on ihe dare Irriga}'?on 8oom R«gh-In ? tc $pecial Inspedion , ' Investiga}ive Fee Fino?? ? ?'/t `?t? Dore THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 7 MO THS. 32 O- 4 2 5 0 OFFIC USE ONLY This reqoest void 18 monihslmm validvlion dole pnntad in thi, b. c?+ 6a G PLEASE PRINT OR TYPE Request ote Roaghin inzpetlion reqolred2 ? Yes InxpMian Olhcr Thon Rough-In: R dy Now Q?II Call ? a ?Yov musf call the Inspeclor when reody) Dare Reody: I, Wcensed contmdor ? owner here6y requesf inspeciion of fhe a6ove elecfrical work af: Job Mdresx (Streel, Box, or Raute Na.) Gty Zip Co§51zz Secrion o Towmhip Name or No. Ronge No. Fire No. Counry ? Occupant Phone No. La ? L Power $opplier Addraz Eletlncol Conhador (Compa, Name) Conrcador Liceme No. Mashr Lic. Na (Piam Elea. Only) 1 a iZ3 Mailing Addmi (Convoaor or pwner Pedo Insmllalion) Auihon nawre?Co r r0+ er AorminglnsklMNan) ?r ?_ Phone NO. ? 1 I?L?Zi EB-00&34,JV6/95 `J STATEBOARqCOPY-Ift,1NSTflUCT10NSONBACKOPYELLOWCOPY _.9/??gs E ?42 1"f` 37 REQUEST FOR ELECTRICAL INSPECTlON Ee-ooooi-os 1 See instructions for complating Ihis form ort back of yellow copy. "X" Below Werk Covrred by This Reqiiesf AAtl Nep. Tyoe of Bailtline Applinncea Wirad Equiu.+ent Wired Home - Range Temporary Service Duplex Wate, Heater Ligh[iny Fixtures Apt. BuilAing Dryer Electric Heabn Commercial Bidg. Furnace Silo Unioader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othxo pou v OlFer ISp??cityl me, suefv omi. an,;, Compu[e Insoeciion fee Below p Fee ServiceEnhanca5ize H Fee Feadere/Sublenders b Fex Circuiis % 0 ro200Ams 0 to30Ams Z 0 tr;30Ams Above 200 qmps 31 to 100 Amps 37 to 100 Anyd s Swimming Pool Abave 100_Amps Ahove 1Q0-Amps Transformers Irngation Booms Pertial-0th Signs SUecial Insuection TOTAL F ' Nerr v?rks ?y , E Cd,?5? HouBh-in ? Da" 4)-ntp he Elec<icl ' ecxr, nreev thet the above I Final %'?paclion has been de. sTOis repuesl voiE 18 manUS Iro. This reques? void 9j?Q/?? 18 momhs from E 2 1 7--? 71 ji lzo ??y ??ce??sea ?iecenca? ?,unuacwr I hereby repuasl inspection oi ebove \ ? Owner elactricel work inatalled at: Slreet AAA e]ss, Box or Ro le N / / ? CitY j ( O ir- ectron o. Township Name or No. Range o. Cou ? OccuV IPR1INi) ) Yf?V?L1-VL)6Y" `?, ? - ? T ?`?CMY? Pho./? o. ^/ ( ?C.^ o 0 ul rer ` Address ? C ElecUi a Con ractor ICOmpany Namel Conhaclor's L- .ense Nn. a? Mailinp Adrdress (Con[ractor or Owner O \ - -1 ?'/Z l9 aking Instailation ) ?T " ed $iB`[ur Contr tor er xki Installation) Phone Num I er_' 0 ] MINNESOTA STATE eOAND OF?{LECTHICITY THIS INSPECTION flEQUEST WILL NOT GrigBS-Midwey Bldg. - Room a 197 BE ACCEPTED BY THE STATE BOARD 1821 Universitv Ava.. St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS an....e faili anI_nann ENCLOSE?. RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 17_?'? 3830 PILOT KNOB RD, EAGAN MN 55122 651-681•4675 New Construction Reauirements • 3 registered site surveys showifg sq, fl. of lot, sq. ft. of house; and all roofed areas (20°h maximum lot coverege allowed) • 2 copies of plan showing 6eam & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted aRer 711193 • Rim Joist Detail Opt selectan sheet (bldgs with 3 ar less unRs) DATE SITE ADDRESS TYPE OF ??UA,P" t( ar 7q0?0 . ev MULTf-FAMILYBLDG _Y _N _ FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT 0 ?" l(/ L? 2 Q STREET ADDRESS ? I71 glINA CITY 10 STATF,ft?ZIP gm TELEPHONE # Z- 4Z 70S CELL PHONE # OI2 ',7736" FAX # 9??- gfZ -5705:?" PROPERTYOWNER 1411CYIG &I 4?7 TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RULES 7670 CATEGORY 1 MINNESOTA RiJLES 7672 (4 submission type) . Residential Ventilation Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includcs: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor. Water Softener _ Water Heater _ No. of Baths Air Conditioning Heat Rccovcry System Phone # Phone # Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is cd', ?? ?c???rje+"?td ? Iy with all applicabie Stote of Minnesota Statutes and City of Eagan Or i an es. I I ? ?' AUG 2 6 ZOD2 Signature of Applicant ?l ---------__..-°-----------------------____--. ------------------- ---- __---------------°---------- y -- -------°-..._---- -- ------- - OFFICE USE ONLY --??- Certificates of 5urvey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 RemodeVReaair Reauirements . 2 copies oi plan • 1 set of Eriergy Calculations for heated additbns • 1 site survey for eatenor additions & decks • Indicate if home served by septic system tor additbns VALUATION _ Phone # Lawn Sprinkler No. of R.I. Baths I S `7 Fee: $90.00 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-seaJil ? 33 Ext.Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ij ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage l ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? i 25 Miscellaneous II ' ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 II Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 48 Windows/Doors ? 34 Replacement *Demolition (Entire Bidg oniy) - Give PGA handout to ap Ip, Ilcant Valuation Occupancy MC/ES S Ist , em i Census Code Zoning l City Water , ?i SAC Units Stories Booster Pii mp Nbr. of Units Sq. Ft. , PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinallC.O. I'I _ Footings(deck) _ FinaUNo C.O. _ Footings (addirion) PlumUing il _ Foundarion _ HVAC „ Drain Tile Other il Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas? Tests _ Futal _ Framing _ Siding Stucco Stone ? _ Fireplace R.I. Air Test Final Windows (new/replacement) I _ Insularion I _ Retainivg Wall ' II l i Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B u zLn z N e 3830 Pilot Knob Road Permit Number: 0 2 3 2 7 5 Eagan, Minnesota 55123 Date Issued: 0 4/ 11 / 9 4 (612) 681-4675 SITE ADDRESS: Lo r: 11 B L 0 C K: 2 APPLICANT: 991 NQR7WVIEW PARK RD BLACKMtlN LONNIE LEXINGTON SQUARE 6TH (612) 686-8618 PERMIT SUBTYPE: DECK TYPE OF WORK: NEW INSPECTION .. . .. FOOTINGS FINAL ? 7 ? ? ? CI7Y "OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-45080-110-02 DESCRIPTION: PERMIT PERMIT TYPE: Permit Number: Date Issued: 991 NpR7HVIEW PARK RD LOT: 11 BLQCKe 2 LEXIN6TON SQUARE 6TN ?.. _. Buildin:g'.Permit Type pECK Su3lding WYSrk Type NEW 1 ? ( ( 4 l 4 ... ... ../' _ J . ? ..:??_^.....e'.?1P??.. ' . . . -..F/. . ?? suxL z{?G' ( 023275 04J11J94 4 11, ?. 4 , r REMARKS: FEE SUMMARY: Base Fee $30.00 COPIES $.50 Surcharge $.50 Total Fee $31.00 Subtotal $39.50 CONTRACTOR: OWNER' - APPllcane - LACKMON LONNIE 91 NORTHVIEW PARK RD AGAN MN 55123 612)686-8618 I hereby acknawledge Chat I have read t'hi& infiarmaCaon ie correct and agi-ee ta comply SCatutes attd' C pf Eagan Ordinances. L APPUCANT/PERMITEESIGNATURE ? application and state that Lhe With ali appliealsls State of Mrn, (RA pid, -IS EO B SIG ATUR'?- -1 ? ?q-6 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 P/1 a r(t- i? 0 $3I.00 _----------- SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specificatians, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date i Valuation of work %?L)D./Jl3 Site Address: xled'?? l//CG'i le?le /rW / 14.daa,-/ 5-5-12 ? STREET ? SU1TE # Tenant Name: (commercial only) LOT ? BLOCK ? SIIBD. ? Ze P.I.D. # ? Descri tion of work: jlori The applicant is: Owner ? Contractor ? OtI181" (Deseri6e) Name Phone el,/2 D Property LAST FIRST Owner 0 2 pddress g?l / X : STREET STE # City L'4a State ;6'biX/ Z i p Company C?A-J, e- Phone Contractor Address License # Exp. City State Ziq Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota 5tatutes and City of Eagan Ordinances. Signature of Applican . OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ? 02 SF Uwg. ? 03 5F Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE 31 New 32 Addition ? 06 Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex 11 10 Multi. Add'1. ? 33 Alterations ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # af Stories Length Depth APPROVALS ? 11 Apt./Lodging ? 12 Multi. Misc. ? 13 Garage/Accessory 14 Fireplace 15 Deck O 35 Tenant finish ? 36 Move Basement sq. ft. lst F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Planning Building Engineering Variance REGIUIRED INSPECTIONS ? Site 6 Footing ? Framing ? Wallboard Of Final ? Draintile :?E_E ! -2 ? Insulation ? Fireplace Permi t Fee vei,mc;m: g I?, Surcharge " Ptan Review License MWCC SAC City SAC 'i Water Conn. Water Meter Acct. Deposit , S/W Permit S/W Surcharge Treatment P1. 'Road Unit II Park Ded. aG Trails Ded. ? Copies Other II Total: SAC % SAC Units ?i ?I . '% ., ?0 15 Basement Finish 0 17 Swim Pool IO 18 Comm./Ind. ?iO 19 Comm./Ind. Misc. ;i? 20 Public Facility O 21 Miscellaneous 37 Demolish MWCC $ystem City Water PRV Required Booste'r" Pump Fire Sp'rinkler CensusCode SAC Cad'e Census Bldg Census Unit Assessments ? ,I ?? £ 3 ? ? .? -?Z ? ? -- --- „? - , - .? !? ? --- ` ? I ?? F?? ? v ?? i ? , ?U ? ? ?? , I ? ? I ? i , ? ? ? ? ?? j? , 1 s?' ` ?f ?' ?G ? ? ?? ?Y J I ? ` 1 ? ? !?, ? ? ? ? ?? ? X i ?? ' ? '7 ?I ?? j ? '? i ? I ? ' ? `? ? I i `J I ; ii ? ? ?i ? ??? i ?---?--{ ; ? i ? ? ? ; ? ? i i ( I? - ?1iI?-_-___ ? , ? ? ? ? -s? £S ,I ,? i _?? ? ? ? ? ?,, I Y? \ \ . -_?-?-y ? ? -F-'L? ? i I ? Y . ? ? + I L ? i ? ??i - ------ ' h V ? ? r ? ? ?,,, ? ? L ? ? , ; ?- ? ?, ? I ___ \?pa ? - 4 ''r ut y ? . -----_ ? v - ? ??1 (/ i Cn? ??'?n"?? ??? ?_ ? w, /I ? ?/` W / o- n S;F?,•iiu <,;..;u+ ,?'j i • li il + I,?rs?;•uu+ . 1988 BUILDING PERMIT APPLICATION - CITY OF EAG9N SINGLE FAMILY OWELT.TNA3 ¦/ I I D , INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OE SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH 6DDRESS IS DESIRED. NO CFIANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS P OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITA BLDG. DEPT.r 1 SET OF ENERGY CALCULATIONS CONMERCIAL I INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS; 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: 51„IbLE )C;lw?aluation: c?3, 00, ? Date: Site Address 191 /vO,z77Ju/S.a P n OFFICE USE Lot " Block .L Pareel/Sub 574)1JA1tE f2 Owner / /•?f?L-G?oi1?4S 13e1464eS ??/ Address /?Z1 (Nq-tSlf I-,tAE City/Zip Code I{?/G/QOT7h Phone - / /a Contractor 1'1m3F't1JJnrLr_S AdiclJAir- ..-? - Address City/Zip Code Phone Arch./Engr. .57o/f,.l 13A-rE.OcFH T.NG Address 3/3/ Lq.r?e City/Zip Code MN ,SS Phone # ) - 9617 0 On site sewaget _ CC system ? n site well City water r PRV required _ Hooster Pump ` 8 APPROVALS , Occupaney R-3 M-I Zoning Pp Q-I Actual Const V-_N_ Allowable ? N tk of stories Length ? Depth S 2` S.F. Total Footprint S.F. FEES Engr/Assess Planner Council Hldg. Off . ?1?i5 Variance Permit ,S 6, oD Sureharge -/C , So Plan Review o2Q,3, eZ1 SAC, City /00, 00 SAC, MWCC g? rn? Water Conn , oo Water Meter 67 °`I Road Unit ;32c;,all Treatment Pl t2 o 4 ?oa Parks Copies TOT6L ? !o ,5n Gs1 r??? e ?. ' p , . ? • .v.? ,,,,; . % gs? , 728 xq(?= i z as s x? ; ?o _?-- 13z? x r3 = I`126? B mT5 22 = •?2' i?- I X ( ? _ 3n.- I3KLu '-l5= G7?lK ?Z3-7 `f ? Certificate for: Meritor Development DELMAR H. SCHWAN2 Book Page uwo aunvcvoa. nrc. Mpbtw?! WMn ? d 1M M d Wnn?ol? 14750 80UTH ROBEHT TRAII ROSEMOUN7. MINNESOTA 56M 614/473-t7lY 3URVEYOR'S CERTIFICATE 81Z8 89a.7 r5 $?3.1 ?0 ? ? ?- 613.YD O Z Scale: 1 inch = 30 feet rr? m? Denotes iron monument AW ? ? ? Denotes set wood hub ,`?C.YI.O Denotes existing elevations CDenotes proposed elevations ? ? from development plan ? Denotes direction of drainage ? 1 ? ( Drainage & Utility Easements LoT I, UG Z ?rqr ENY.» ilon ?/ , $9y p N I I ? JI O M ? ;R?Z7 /0 /V r\ 00 ? 18 p'j 6Ar-- Z ?j ??P Cwea = gy2.3o /YoQr?JVi?vJ ?AizK Lot 11, B1ock 2, LEXINGTON SQUARE 6TH ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. 1 ? ?P _ 9y; 79 _ Y N Jo I Ta°C?ea = 89z-81 Also showing the location of a proposed house as staked thereon. I heroby certffy thtl UN suney. Plan, or ropoR was propare0 Ey me or undx my dlrsctsupsrvfabn an0 that I am a duly Rplatsrod UrM Surwya unOSr. Ms lavn ol 1M StNa o/ Minrnaotm. oatw 5-5-/988 1 ? DEI_ti!AR FI. = Jv rlVinNL :?/?;• ,e i DNmw M.achwwu MNmMOb N -, , bn Ib. l11P6 . Bradley - ?rchitecturo?!? consultants ? .?. ?._. ... oma UK ..D.. .H. (")-494-972 -- -- Plan DO te t{ - r?k/C-L n rn Slte Address: 1)TOTAL EXPOSED 1MALl AREA . ? 2 3 Z- s4ft a"U"sLI.. 2)TOTAL EXPOSED RQOF/tElLIHO AREA s4 ft.:"U° ' 02(.= iMALL AREA CIALCULATIONS: TOtAL?•W?I?N?DOW AREA GLAZED TOTAL DOOR AREA TOTAL GLASS DOOR AREA -• nb?- GIAZED TOTAL FIREPLACE WALL AREA TOTAL WALL FRAMING AREA NET INSULA7ED WALt AREA TOTAL RIM JOIST AREA TOTAL FOUNDATION AREA(EXPOSED) TOTAL FOUNDATION WINDOW AAEA 1-7-7 sq.ft.x,U', .41 = 72.s? '4 2 eq.ttxv°_4L= La ,ZZ Sq.?G X ?IJ° ? J ? r I:o ? 1q.tt.X?IJo ??. ' I 2,.BP? ZCo2 _ sQ.ft.xU`? !P?= ? O' 4B aQ.iLS"U° !?= 3) TOTAL ? H ifem 3!s ihe same as, or less thon item l, you have mel ihe lntMt of 2 MCAR 1.I6006 A ond D. ROOF/CEILINO CALCUlAT10N3? TOTAL SKYLIGHT AREA TOTAL ROOF/S.fILING FRAMING ARfA NET INSULATED ROOF CEILING AREA - ,a.nx'u" -0 _ ' 12 5 3 sq.Ri U' :g?z= 2? 4} TOTAL . .?. !I i?sm 4 Js the aame oa,or ?ess Ihan 1lsm 29 rou Aovs met }he JnfaM ol Z MCAR 1.16008 A an0 0. ALTERNATE dU1WfNe ENVEIOPE DEStON To ufiJizs Hw totat a+v"pe sysNrn rrNMod, fAe sum af 1rorns f ond 2 sholl be preatx thon fM sum of items J and 4. S1 +4) _ r ns?ok ea.+rrr mm n?e arndrny n.r# aeacrraea xwft or oxceaft na staro ot ANnne:oto EWOY ConrervaNon Ac?. ?? ? F' .n.' . . .. . ' "?.r . . . ? ' CEIUiIi KCflON ( IMSULATEDI ? O ?lt?rfa eir /i!m 0.6t N-F. .5(0 (S 54.0%,? 1aS .a (4 ilxfrfa alr tJlm (sHlf) Q.61 . . TOTAL N:±2.$ , . U • 1/R .oZL t C£ILIIG rRAMtNG SECTION l?9falot oir rlm ? ac.o,....., ??...?s (4 faH?fa o(r /7fm I (S VzWtAts ol loH 0 .TOTAL N ??•''? y s i /N • oz(d I CEIUNG SECTION (INSULATEDl 0.61 ( ? lnt?rlw atr /ilm _ (Y (3 (q ute?iw aJr tlfm istll!) O.W TOTAL R . U ¦ I/R CEIUNG FRAMIHG SECTION • O_61 ( ?,fnt?rla atr film . te /tlm ' (4 ifllorla oTr 0.61 in'cMs of soN rood - . _TOTAL R p(p05,£D eEA1N CEILINB`SECTlON v (pf ?- ehr !Um 0.6 • It . {3 (4 ` 0.11 (a a?i<rt? s(r ft TO?AL R ?_- y s J/R I - YENTED . op . , AL " • ?; FRAYINfi 5ECTIOM . ? ?lor atr Iflm 0.88 i ; ' n s 1 aoft w od ?"? ' 4 ? 32 P?I?Dp-?tEr z l?Ea 5 0+!fLrior oir film 0.17 TOTAL R ? ? •?I' U = 1/R.? SECTION (INSULATED) I lnferlor air film 2 s!L ; Sn f'?S 4 f??Lm?p--4 E.- 5 g ?af?rior ofr lilm z Tor,?' u' r??-va ,j. .. . . ?? ? . . ? . : . _ ? ' _. ... ' ,. . ST SECTION ' feri i ir fflm 0.68 , !=foriot oir film 0.17 ' TOTAL U ¦ I/R 'D TION 9ECTION tnfHfor air film I.- 1- YR[?, , .a IZ c. * a?' : ? .ZS :- tat?d?r air film t,; ti . 0.17 TOTAL R_.SWi! 3 ' U U.1 /q.. .. ' l! . :Fy .?. __ • ?h? ^' ? , , J 1 ? -? ? i ? APFLIC?ATION FOR PERMIT SEWER AND/OR WATER CONNECTIQN 1 R-1 SINGLE FAMILY ?R-2 DUPLEX ('itvo C?nits) Q R-3 TOWNfi0U5E (Three + Oraits) ( Onits) Q R-4 APARTMENT/CONDOMINIUM ( Units) OF czCIqcPi r nr nr nr. nr?Tnvn 1) PROPERTY ADDRFSS: T,FGAT• DESCRIPTION; IF EXISTING STRL'CTCTRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Nbnt Year PRESENT ZONING/PROPOSID USE: Q COn'IERCIAL/RETAIL/OFFICE Q INDL?STRTAi• Q INSTITUTIONAL/GOVERNAETIT 2) '?"'' NAME: JWnJd^ -,--A ADDRESS: 10.Pd S" (V't _? l . ?NOTE: PA)2IINf OF FEE AT TSME OF ; nrrr.icazzoe ooFS rrUr corv- ; ; sriivre r,rrxcrni. or eERnuT. ; . ; tNseECTIaa oF sE?Ix t+nD/ox wnTm . :. ; nNsra[a.r,rioNS wII.r, rrur ee scmttnm ; w['NfIL PII24IIT HFS HE@] ApPROVID. : •x?w?rt???sa?x??ats,tii?fya+,?e?+?++ta:tw CITY, STATE, ZIP: vr r /^ev e_ A47T--D 7 S? PHONE : 447/ - 4" jF a 3) NAME: Plumbers License: ADDRESS: Active Expired CITY, STATE, ZIP: Not recordec PHONE: MASTEE2 LICENSE # Sta Initia? 4) ? '• ?• rtn,rE: ADDRESS: CITY, STATE, ZIP: PHONE: 5) ? ? ` a a?• • ?r .r ?? C2j_CONNECTION TO CITY SEWER EZ`CDNNECTION TO CITY WATER O OTHER 6) (?r -IO rtl ip *?*?,r?*******?*********.???*?**,?*,r****+******???.*****??**?*??**********??***?t***?*******?***?**?,?X * * THE GpLD COPY OF 7i]E PERMIT WILL BE SENP DIRFX'1Z,Y 'PD PUBLIC WJRKS 'IO FACILITATE NIEPIIt PIQC-DP. t. * PLEA.SE ALUOW TWO WORKING DAYS FOR PROCESSING. SOMEONE FROM Tm CITY WILL COLVr7ILT YOL? IF T4IERE ;i * ARE ANY PROBLk21S. ? FOR CITY USE ONLY PERMIT # ISSDED xf 7, . Pd w/Bldg. Permit FEES: $ SEWER PERMIT (INCLUDE SURCHARGE) $ $ ?D • ??? WATER PERMIT (INCLL'DE'SURCHARGE) $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ i $ ACCOUNT DEPOSIT - SEWER , $ $ ACCOQNT DEPOSIT - WATER $ SS0 $ WAC $ ?i,? • GrD $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRO[VK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRDNK SEWER $ $ LATERAL BENEFIT/TRL'NK WATER $ $ WATER TREATMENT PLANT'SURCHARGE $ $ OTHER: $ I`i" V` ?n $ TOTAL ?& 5-?p c/ 8 E7?s RECEIPT RECEIPT DOES DTILITY CONNEC TION REQUIRE EXCAVATION IN PDBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK 6VITHIN PUBLIC ROADWAY" MUST BE ISSLED BY THE ENGINEERING Q NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLL OWING CONDITIONS: APPROVED BY: TITLE: DATE: --? PERMIT City of Eagan Permit Type: Plumbing Eaaan, Permit Number: EA093416 Date Issued: 04/12/2010 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 991 Northview Park Rd Lot: I I Block: 2 Addition: Lexington Square 6th PID: 10-45080-110-02 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Kris Oien 3670 Dodd Rd Eagan, mn 55123 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Champion Plumbing Mark D Rehm 3670 Dodd Rd., =100 991 Northview Park Rd Eagan NIN 55123 Eagan MN 55123 (651) 365-1340 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 Citv of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Use BLUE or BLACK Ink For Office Use I I~ City of Eapn I Permit Permit Fee: C v I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 j Staff: Fax: (651) 675-5694 L--------------- INFLOW & M111-TRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Site Address: Tenant: Suite RESIDENT OWNER Name: a?A- or- S OSr.n Phone: f S ~r $ Address / City / Zip: T ° MV~y w I"~ K~ ~trA S~ `3 Name: Q U License p4 CONTRACTOR Address: R t2 ' S~ r'~ City: - State: MN) -S ISQ S Phone: ~S 5~~ 133 Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: ' ~C U I " b a ~xl E ri o f DESCRIPTION FEES $60.001 Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeacian.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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. X #1 ~r~_ D, X Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final PERMIT City of Eagan Permit Type:Building Permit Number:EA130477 Date Issued:04/27/2015 Permit Category:ePermit Site Address: 991 Northview Park Rd Lot:11 Block: 2 Addition: Lexington Square 6th PID:10-45080-02-110 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 . Description:Re-roof house and attached garage 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 - Jesse J Madsen 991 Northview Park Rd Eagan MN 55123 (612) 825-2800 Ungerman Construction Company Inc 4450 Nicollet Ave S Minneapolis MN 55419 (612) 825-2800 Applicant/Permitee: Signature Issued By: Signature