1027 Northview Park Rdr - • V ?
? CASH RECEIPT
CITY OF EAGAN `
38340 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
flECEI?V?E61
? ? ..
l :
AMOUNT V S ? ?J_ - --
`_i?: ? ? -
& DOLLARS
iOG
p CASH Q CHECK
rl.:..i
?
wnne-Pavom Covy
` vellow-Pos6ne Covr
Pink-File Copy
Thank You
BY ' '
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
OFFlCE USE ONLY
PERMIT DATE
WATER PERMIT # 10 3 rl 7 SEWER PERMIT #
METER # B.P. RECEIPT # ? 17 52
READER # B.P. RECEIPT DATE 51V8?
METER SIZE
ISSUE DATE - PRV - BOOSTER PUMP
SITE
LOT.
APPLICANT:
ADDRL2'SS:_
CITY, STATE
Z1P
,STATE
ZIP
i i
CITY, STATE
ZIP
? PERMIT REQUESTED
T SEWER - "? WATER _ TAPS
?
.7 - COMM/IND lRESIDENTIAL
NEW - EXISTING
i AGREE TO COMPLY WITIi CITY OF
EAGAN OEIDINANCES:
\~ ,==? ? -?
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT.
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN
PERMIT DATE
3830 PIIOt K110b Rd. WATER PERMIT # 1 SEWER PERMIT #
P.O. Box 21199 METER*2a. 53B.p. RECEIPT #L; 1752
Eagan, MN 55121 _ 4 I
R# B.P. RECEIPT DATE _/ / 8?r
METER SIZE
ISSUE DATE ze2 -S?`I - PRV - BOOSTER PUMP
s i •
SITE ADDRESS% PERMIT REOUESTEO
LOT -BLOCK t SEbSUB
?SL?r.yyL.e3 t' ?'SEWER""' "', WATER -TAPS
APPLICANT: . =?'
ADDRESS: COMM/IND `y?• RESIDENTIAI
CITY, STATE !ZIP
PHONE: NEW _ EXISTING
PLUMBER:
ADDRESS: U?! r`f??"`'?.` _ I AGREE TO COMPLY WITH CITY OF
CITY, STATE `ls .-Zip E4GAN9RDINANCESy'
PHONE:
OWNER: -2
ADbRESS: SIGN RE WHEN M I UED
CITY, STATE ZIP ?
PHONE:
PLEASE ALLOW TWa WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMfTS, CONTACT
ENGINEERING DEPT.
, . ,.
CITY OF EAGAN
?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be us ? d for ,"?'r DkC f" 'z Est. Value Date ??'ly S , 19
Site Addvess 1027 A.7n:(,VI.t?Y+d frj,.y RU
Lot Block 2 Sec./Sub. LEF 11iMZJ SQ 4T4" OFFICE USE ONLY
Parcel No Occupancy R-3 P-i FEES
. ?D R- 1
Zoning
W Name ?'.? k?1 ii
; n"??y
(Actual) Const v"N
Bidg. Permit
??•?
3z Address 14450 W!t}?SlYjl.j,E PKW'Y (Allowable) S
h 44
° City ??RNSd1LLi Phone $94"2636 #otstories - urc
arge z95
?
` p?Review •
Length ?
o
Name SA'E `
Depth
SAC
City
1?•Q0
,
?Q Address S.F. Total - ,
75
00
S
SAC, nnCwC •
C
? City Phone S F. Footprints _ 5
110
00
Water Conn .
,
On Site Sewage _
?¢ Name On Site Well Wate? Meter 9?• pQ
W W
`=
?
Address
MWCC S stem ?
?
0
'
,
0 Accl. oeaosa .
a W City
Phone ciwater
?'
S/W Permit ?
2 j•00
PRV Required _
I hereby acknowlege that I have read this application and state that the Booster Pump - S,W Surcharge i•00
information is coRect and agree to comply with all applicable State of ? l???
Minnesota Statutes and City of Eagan Ordinances. Treatment PI
Signature of Permitee f APPROVALS Road Unit 340•00
A Building Permit is issued to: !.G YL ANI) Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council -
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldy. pff. _ Copies
2.893.50
Building Official Vanance - TOTAI
` Permk No. Pe?mft Holder Date Telephone #
WATER
SEVIIER
PLUMBING
H.V.A.C. ?? .
ELECTRIC
Mspectlon Date Insp. Comments
Footings I
Foundation
Framing (. ; 4
Roofing
Rough Plbg.
Rough Ht9. I P S?
iS,i.
Fireplace
Final Htg. - -?
Fnal Plbg. - ?
Const. Meter Plbg. Inspeclor - Notify Plumber
Engr.lPlan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
?
fgtrti#trate ,a# (Orrupanry
Citp of (Cagan
Drparbnrnt of luiibing JmWrrtinn
This Certtftcate usued pursuaxt to the requirements of Section 306 of the Unijorm Building
Code certifyrng that at !he time of rssuance this structure was in compliance with dJre various
ordinances of the City regulnting burlding construction or use. For the following:
use Claseificatian _-SF DWG?GAR Ndg. prraiit No. 16381
o-up.ay. Tya R3 /M I Zo,,;ng Dnuia PD / R 1 Tm Cow, V$
o. or swkhn nea. 14450 B' VIIIB PA1Y, B' VIIIE
BW7aing Aea,m 1027 R74tUiVM PARK RDAD ,,a,titY L2, B2, IEUNG7M 9Qw 6IH
i
Dau: AIUJsr 9, 1989
Bw7din8
POST IN A CONSPICUOUS PLACE
CONTRACT PRICE
PERMIT 1?
PLUM8ING PERMIT RECEIPT It ' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-9100
Site Address
Lot e'"-Block , ?'--- Sec/Sub
'? • ? -
m
Name
m Address
c City Phone
Name
3 Address
O ?
City Phone?
FEES
COMMlIND FEE - 196 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
BEYOND $1,000.00)
r_? ( j ,,•
- - - e-
'r -
r
SIGNATURE OF PERMITTEE
FOR CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
M u It. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NS?. FIXTURES TQTAL
'? Water Closet - $3.00 $
Bath Tubs - $3.00 c C'
Z- Lavatory - $3.00 c
?Shower - $3.00 ? • r=' ?'
Kitchen Sink - $3.00 ? u v
Urinal/Bidet - $3.00
Z Laundry Tray - $3.00
? Floor Drains - $1.50
^
?Water Heater - $1.50 % ?
v
Whirlpool - $3.00
=Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
?-
O
' ? U
Rough
penings - $1.50
FEE: ?
STATE S/C:
GRAND TOTAL: ? ' ? t'
. ,,. ?. ._ .
PERMIT #
J
L' ?
• . • MECHANI CAL PERMIT RECEIPT #
?
CITY O F EAGAN f"7
3630 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHO E : 434-8100 For Office Use Only:
Site Address - '1\1 '?%i ` ;' '` " ' gLpG. TYPE WORK DESCRIPTION
Lot Block P/Sub
S ?
? & Res. New
.
D Name
I Mult Add-on
` ? ? Q( Comm. Repair
y
c o
Addr,ess
:
CitO' ?j_
Phone ; Other
Name ` -M"-! s?. ? '- -? ,? .' _. FEES
RES. HVAC 0-100 M BTU - a24.00
c Address ADDITIONAL 50 M BTU - 6.00
p City a - Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERMIT
1
50 EA
(
-
) -
.
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air
?
M BTU
a? APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
i
U MINIMUM RESIDENTIAL FEE - ALL ADD-aN 8
n
t Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAI FEE - 20.00
Veni
CFM @ STATE SURCHARGE PER PERMIT - .50 -
'
{t _ T (ADD $.50 S!C IF PERMIT PRICE GOES
Ges Piping Outlets # BEY.pND $1,000) ?
n
Other
;
?"t'
a
{
<
FEE: , . y ?' r`'
'
-
(1?^.?
:?.?". '?.f .!'
S/C:
? .? SIGNATURE OF PERMITTEE
TOTAL: ? FOR: CITY OF EAGAN
DATE: S/2/89
1-
RE: 1027 NORTHVIEW pARK ROAD, L2, B2, LEXINGTON SQ 6th
XX Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
t Your Sewer & Water Permit for the above properry cannot be completed for the following
reasons:
? 4A c
-?a-
Your 5ewer & Water Permit for the above property has been compfeted, but the meter cannot
be issued or occupancy allowed until further notlce.
COfIAMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confim*d by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) befOre issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REOUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
s
4t
Secretary, Building Inspections Dept.
DATE:, 5/2/89
1027 @lORTHVI@F! PARK RpAU, L2, H2. LER1NGtON SQ 67H
XX Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meier is picked up. BE SURE TO
CALL PUBLIC WORKS (4545220) FOR YOUR PERMANENT WATER TURN ON.
! Your Sewer & Water Permit for the above property cannot be completed for the following
• reasons:
? •? _
., '
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or accupancy allowed until further notice.
,` ,
- COAAMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirwied by Bill Adams or Dirk House (Plum6ing Inspectors - 4548100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
. ?
Secretary, Building Inspections Dept.
BLOG. PERMIT NO. ? ?? 331
L.c I- z k i_ce,x
01-3210 Bldg. Permit
01-3422 Plan Check
0
01-3445
Surch./Adm.
01-3446 SAC/Adm.
? 01-2155 Surcharge
? 75-3860 Road Unit C°f %
- 20-2275 SAC ? LC r •? ?
?
,
20-3865
Water Conn.
C(?-
?
? 20-3868 Water Trmt. ? '-D cx'
T,
?
20-3716
Water Meter
tJ
? 20-2252 Acct. Dep.
20-3713 Water Permit i<, no
r
r? 20-3743 SewerPermit 10 n(-)
? 79-3866 Sewer Conn. 1 c? c r c
28-3855 Park Ded.
TOTAL -t? 'y 0
BLDG. PERMIT NO. ? <<
j -c•1'? _i?>4c-c.-4Z ??. ! _?: f!)'?
?o (o-I??
01-3210 Bldg. Permit 6"
07-3422 Plan Cheok
? 01-3445 Surch.lAdm.
I 01-3446 SAC/Adm 7 J
01-2155 Surcharge
? 75-3860 RoadUnit
? 20-2275 SAC
? 203865 Water Conn. n< -,
20-3868 Water Trmt.
I?
20-3716
Water Meter
?l C)
c??
• 20-2252 Acct. Dep. ?3 c C C.
20-3713 Water Permit I C C> c:
"
? 20-3743 Sewer Permit
79-3866 Sewer Conn. 1 C Cs C`C %
28-3855 Park Ded.
TOTAL ? ? ? '? l'c"
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721
PHONE: 454-8100
BUILDING PERMIT
To be used for ' SF DWG/GAR Est. Value $89,000
Site Address 1027 NORTHVIEW PARK RD
Lot Z Block 2 SeGSub. LEXINGTON SO 6TE
Parcel No.
w Name KE7CI.A1`1D HOMES
? Address 14450 BURNSVILLE PKWY
City BURNSVILLE phone 894-2636
Name _
Address
City -
Name _
Address
Phone
Phone
I hereby acknowlege ihat I have read this application and state [hat the
information is correct and agree to comply with all applicable State of
Minnasota S1atNes and Ciry f- agan Ortlina/n?es.
Signamre of Permitee
A Building Permd is issuetl to: KE}
on [he express condition that all work shall he tlone in accordance with all
applicable State of Minnesota Statutes and City oi Eagan Ortlinances.
Building Oflicial
N4 16381
Receipt # C ? ? 5 z
Date MAY 1 , 19 89
OFFICE USE ONLV
Occupancy R-3-IL-1 FEES
Zoning PD R-1
(ACtuaq Const V-N Bldg. Permit 590.00
(Allowable) V-N Surcharge 44.50
# of Slories
295
00
Lergth __?Q' PlanReview .
Depm +81 SAG City 100.00
S.P. Total - SAC. MCWCC 575.00
S.F. Footprinls -
580
00
On Site Sewage _ Water Conn .
On Site Well Water Meter 90.00
MWCC System xx ACCt Deposil 30.00
City Waler 7{g
PRVRequired - SiWPermit 20.00
Booster Pump - SM! Surcharqe 1.00
Treatment PI 228.00
APPROVALS Road Unit 340.00
Planner - park Ded.
Council
BIdg.Off Copies
Vaiiance - TOTAL 2.893.50
? 21211
Request Date
6/ 8/ 8 9 ire No. Rough-i specibn
R ui ?
v? ? No
? Ready Now W iil Nolify Inspedor
/ wnai Raaava
Ilicensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (SYreet, Box or Route No.) Ciry
1027 Northview Park Road Eagan
Seclion No. Township Name or No. Range No. CouMy
Dakota
O¢upanl(PRINT)
Key Land Homes Phone No.
A 894-2636
Pawer Supplier
Dakota Electric Mtlress
Farmington, MN 55024
Electrical CoMractor (Company Name) Conhgctor§ License M.
Midland Electric Inc. 041610
Mailing Adtlress (ConVactor or Owner Melting Installetbn)
14055 Grand Ave So, Suite E, Burnsville, MN 55337
re (Coritrectw/Owner Meltin Ins[allation) ' Phone Number
892-6688
MINNESOTA STqTE BOAHD OF ELECTBICRV L THIS INSPECTIONREOUEST WILL NOT
Gtlggs-MWway Bltlg. - Poom S-173 BE qCCEPTEO BV TNE STATE BOARD
1821 UnivarsVM Ave., SC. Peul, MN 55/M UNLE55 PROPER INSPECTION FEE IS
Plrone(812)BC2-0B00 ENCLOSEp.
P 21211
REQUEST FpR ELECTRICAL INSPECTION
? See insbuaions fo?%ompleting this form on Eack of yellow mpy.
X" Below Work Covered by This Request
/EB5-0000q14)7
Ne% Atld Rep. TypeofBuilding AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Healer Eleciric Heating
ApL Building Dryer Other (Specify)
Comm.llndustrial Fumace
Farm Air Conditioner
Other (spaciry) Comractak flemarks:
Compute lnspection Fee Below:
# Other Fee # ServiceEnlrence5ize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Trans(ormers Above 200 _ Amps Above 100 _ Amps
SignS Inspena§ Use Only: TOTAL
Irrigation Booms ,
Special Inspection
Alarm/Communication O • U
..._..,.?..:.:,
Other Fee --- -
I, ihe Electrical Inspector, hereby
certity that the above inspection has
been matle. Rough,in ?e
-
OFFICE USE ONLY ' ..
TTis requasl witl 16 monms Irom
**********?«************??*************
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 794
DATE: 09/28/00 TIME: 14:30:54
ID: •
NAME: SELA ROOrING & REMODELING
3210 9001 1027 NRVW PK RD 139.25
2155 9001 1027 NRVW PK RD 3.50
Total Receipt Amount: 142.75
CR137975
USER ID: JAN
2000 BUILDlNC PERMIT APPLICATION (RESIDENTIAL)
?3 o2-b
New CafitntcMon Reaulremenh .
cinr oF IIacaN
3830 PILOT KNOB RD - 55122
651-881•4875
$ 1u21s
n 3 reglsfered tlfe wrveya showlnp sq. H. d lof, aq, lt. of house
antl 91 roofed areas @076 maximum bt coveraae allowedl
? 2 coples of plana (ahow beCm & window sim; poured Intl. deslgn: etc.)
> 1 set of eneryy calculatlau
> J coples of hee Preservafian pton tt tot plaMed afFer 711199
DATE:
DESCRIPTION OF WORK:
STREEf ADDRESS:
LOT: BLOCK:
2 coplea W pWn
1 setof energy calcWaMOns for heated addiliona
1 site survey tor extador add(Nau & deeks
CONSiRUCTION COSi:
?l K-rJu?
SUBD./P.I.D. #:
Name: 5 14t S R!/I /a !?( ? Phone ?1:
PROPERTY l? , ` Flrst
OWNER
Sheet
CNy
State:
LP:
. Company. SMA ROOFING & REMODELINd, INC. phone #: ? v; 7
4100 EXCELSIOR BL . (qrea code)
CONTRACTOR ST. LOUIS PARK, MN 55416 -?\ 3?
Sheet Addros: ID #0001050 LJcenss # ?C? Exp
? a
CI1y
Stafe:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: (
Streef Address: Regisfration #:
City
State:
Sewer/water Ifcensed plumber (jfyinstalltna sewerlwaterl: Phone #:
Zip:
Zlp:
I hereby acknowledge lhat I have read this applicaHon, sfate tthal ihe fnfortnaib ?d ree to compy wilh aU applicable Stafe
of Minnesota Stalutes and City of Eagan Ordinances.
Signahue of Applicant
OFFICE USE ONLY
Certificates of Survey Recelved
oa?
Yes No
Tree Preservatlon Plan Received - Yes - No - Not Required
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
WORK TYPE
O 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
OFFICE U3E ONLY
p 13 16-piex ? 21 Porch (&sea.)
? 17 Garage ? 22 PorohlAddn. (4-S ea.)
? 18 Deck 0 23 PorCh (sCreened) ",
'
? 19 Lower Level ? 24 Storm Damage
Plbg _Y or N 0 25 Miscellaneous
0 20 _
Pool ? 30 ' Accessory Bid9•
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (81dg)* ? 44 Siding
11
? 38 Demolish (Interior) ? 45 Fire Repair '
? 42 Demolish (Foundetion) ? 46 Windows/Doors
' Give PCA handout to applicant for demotition permit ,I
GENERAL INFORMATION
SAC Code # of Stories SQ• 1
No. of Units Length 54-1
No. of Buildings Width Footprint sq.
Const. (Aclual) BasemeM sq. ft. Census Code
(Allowabie) Main level sq. ft. MC/ES Systen
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklere
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Engineering Variar
Permit Fee Valuation: $
5urcharge
Plan Review
License
MC/ES SAC
City SAC
water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Traiis Ded.
Other
Copfes
Total:
? 31 Ext Aft - MuIG
? 33 Ext AR - SF
13 36 Multi
SAC Units
% SAC
1 . 4
1989 BDILDIAG PERMIT APPLICATION - CTTY OF 6AGAN
SINGLE EAMILY DW6LLIW(iS I L 5 j
INCLUDE 2 SEPS OF PLANS, 3 CERTIFICATES OF SURVEYp 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSE4 FOR CORNER LOTS - CONTRACTaR/HOMEOWNfiR MUST DESIGNATE WEfICH ADDRESS
IS DESIRED. NO CHANGFS WILL HE ALLOitED ONCE BUILDING PERMIT I3 I330ED.
MULTIPLE DWELLINGS RENTAL tTAITS FOR SALE UNZTS i OF [1WIT3
INCLUDE 2 SETS OF PLANS, CERTIEICATE OF SURVEY - CAECR WITH BLDG. DEPT.0 1 SET OF ENERGY
CALCULATIONS
CONR9ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTUAAL PLANS,
1 SET OF SPECIFICATIONS AD 1 SET OE ENERGY CALCULATIONS APR 2 5 iy8.
To Be llsed aluation: ?c1?Ot?0' Dates
Fo .
f
Site Address/.O 2-7
Lot C;?',Bloek ??.
Parcel/?u?
` ?.??
Owner ?
Address
City/Zip Code
Phone
Contraetor
?
Address
?
Oecupancy -3 M-1
Zoning R -1
Aetual Const V- N
Allowable V-&/
# of stories
Length 50'
Depth y$'
S.F. Total
Footprint S.F.
On site sewage,
On site well
MWCC System
City water !
PHV required _
Booster Pump _
FEG3
Bldg. Permit 590-00
Sureharge 14 q, 50
Plan Review 295, 00
SACp City
D
/0010
SAC, MWCC "MS,OD
Water Conn SRO. 00
Water Meter 90,00
Aeet. Deposit 30-QO
S/W Permit 2O'Cb
S/W Sureharge ,oD
Treatment Pl. 2.28,00
Road Unit 3 NO.oo
Park Ded.
Copies
TOTAL , ( jr
-? 5? GJ
City/Zip Code
APPAOYALS
Phone Planner
Couneil ?!
Arch./Engr. Bldg. Off. _? 4-7lo
Variance
Address
City/Zip Code
Phone ll ! . ?
NOTE: Sewer & Water Permit fees and aecount deposit fees will be included in the bailding
permit fee: ProQessing time for sexer and irater permits ia tvo day8 once a liceneed
plumber ha8 applied Por a permit ab City Hall.
Y , I
C AU-?
?? yWO xl?= 6?oc? s
$SE'?'1T'
oZcpX48= 1248 x lu= Iny'72
H ou 5E
f?Sn?? = I 2 U g
I'i2X 13 = ao
(,yoou
__----
_
? ?
FEB-21-189 TUE 17:04 ID:JAMES R HILL INC TEL N0:612 884-9518
?&f
#279 P02
- IU»7 A(ORTMV/dW P./d!K MAD 4r 34/O-IT Ei.CV C
SURVEYOR'S CERTIFICATE KRYu?Na-40111W
REVISED 2-2-89 1p SNOW
NEW MDUSE
? )
?- (,1 ?? L_
I i? ?^) rt
?
?
? ("
I ??\J I ?.. 1 I L_?.. I
? r `-l-
?_?_? ?
e
Y
NORTHVIEW
g
w DENOTES PROPOSED SURFACE DRAINAGE
0 DENOTES IRON MONUMENT SET
• DENOTES IRON MONUMENT FOUND
X000.0 DENOTES EXiSTING ELEVATION
(000.0) DENOTES PHOPOSED ELEVATION
SCALE: 1 tNCH - 30
PROPOSEO QARAGE FIOOR ? 817.1 FEET
PROPOSED LOWEST FLOOR - aDq,µ FEET
PROPOSED TOP OF BLOCK -eq7.s FEET
WE HEREBY CERTIFY TO KEYLAND HOMES THAT THIS IS A TRUE AND CORREC7
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
LOT 21 BLOCK 2, LEXINGTON SQUARE 6TFI ADDITION,ACCORDING TO
THE RECORDED PLAT THEREOF,DAKOTA COUNTY,MINNE50TA.
iT DOF_S MOT PURPOR? TQ SNCW !"APRC`dEMENTS CFl L-P:CROACHME1vTS. 'cXCEPT AS SHOWN. AS
SURVEYED 8Y ME OR UNDER MY DIRECT SUPERVISION THIS 297H OAY OF DQCEMBER , 1988
PROPOSEO ORAD[! SMOWN Wg11C TAKLN
fliOM Tf! DCV[LOPM[NT KAN MOR
LEXIIqTON aOUAlK {1'M AODRION?
' PRHPAR[D 8Y OUYUl1/AN LNOINE[RN6
it+a, LAST oATao 11-17•87
SIGNED: JAM . HILL, INC. ny??
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HAROLD C. PETERSON, LANp SURVEYOR
MINNE50TA LICENSE NUMBER 12294
James R. Hill, inc.
PLANNERS / ENCINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMiNOTON, MN. 66431 • 612-884-3029
?
I
SITE ADDRESS: SQMd.AA.6F PHONE:
CONTRACTOR: 1'E,ULA1.l? PLAN #
EXTERIOR ENV[LOPE AVERAGE "U" COMPUTA7ION
.,
OWNER; f1ATf ; 1 7_ -!B,.
1
2
a.
b.
c.
d.
e.
f:
g.
h.
i.
.7•
k
1
Determine working square footage of eacB
Tota] exposed wall area..... (S `I3 sq. ft. x .11' = zpZ?73 ?
„
Total roof/ceiling area..... iZ4?-1 sq. ft. x.026 =
?- 32?°1y??
Total exposed wall area above_floor= lLol$
Total wall window area ............................ ... .. '.
Total
.
door area...................................... ....:...'...
.
3 S
Total sliding glass door area .................................... " 3 Z?. .. .. ,:•.1.;`r
Total firep7ace wall area .......... . . . .........................
?
Total wall framing area (average 10%) ........ :....:........ ... . .r :. 1cel.YS
Total rim joist area ............. .......:. '"
net wall area a6ove floor ......................... . :.... !Y SC?17-
wall area above floor ..........................
wall area a6ove floor .................... .......:...
.
frame wall area at founoation.................................... .
Total exposed foundation area=
Total
foundation window area ....................... '-' .. .
-•` '
Total net foundation area above grade .............. ?
Determine "u" value of each wall segment
(e.g. wi'ndow, door, each separate wall section) .
,-
13??IN x??u,? , y7 = 4?.?-(??
a
,
b X uii t3Z = ?Z. ?(p
u
3z.y X l,ui,
C.
>.
d ? X llut, ?-
e. K ??ull
.?.
. f x „u„
9. z „ui, . ?37
h. X liuii
? X lull _
,
J•
X "U"
k. X lluii
x ilu„
3
.................................Total
= F?z,83
?
If..item i3 is the ?
as,`or less than..i'
31,'`you have met''f"intentof SBC'6006?
- , ?
?
' .,
? 3??? ?
Total eaposed roof/ceiling area = IZCo ? '
.
? ! ?.
?. *_al skyli.ght area .................... .....
n. Total roo_`/ceilin, fa-aming area (:ivcraqc 10%) ;.; ?Z4 ?-
,..
?
o. ^otzl net i.^.sulatc3 rooE/ceiling area....,.:...•.:? . 1. O, ... - .
Determine "U" value Eor each roof/ceiling segmeirt .
n. X flU,l _ • _ .
n.
c. I I?lb .3 " X 'lU,l
. .
,
............................ sbtal = 2
?
,
. . . . . ? .
-:r
:: to_al c` 14 is the sane as, or less i:han Q2, you have met the intent. of .
SBC 50D5 ic? !.
Altzrnate Buildin Envel.ope Desi a
^o _tiiize the totzl envelope'system method, the values established by the s•ar,i o£ ..'
itans :3 znd r4 shall not be greater than the sum of.itiems 01 and n2. ?
1. + z. Z3s ?co'7
3. I jZ.%'3 +
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* LINEFIL FEET E}POSID WALL
at,ocx: i Es + Z c a+ 4!Fs + z(,? = i y$
MIEE:
w:o..
FULL i
FULL 2:
'Z?tzcpt 3p , ?Z-
FZREPLACE:
. .
- . . . . . k ?i {f<S
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SQVl1f?L+ )???? ?+?/??+ !+l1CVJ3+1J {? ?ALL L]lLLdl ???/?
*. LLC?l
-
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., .?.?
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BIACK: x .5
KNU: ?y X s = Lt
W.O. c, X $' .v..
FlILL 1: ? S I x 8= IZo%'
FULL 2: x 8
-
FIREPLACE: > ..e.,; .
xIM: X 1-
TOTAL
* SQUARE FEbT EXPOSED CEILING l Z
_ e 't,:
SECTIONS
/?'USE 10$ OF OPAQUE WALL AREA FOR
-FRPME CdNSTRUCfION
il (D
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WALLC ?!
+------- b?
?2.?rrrrL'. •1. INTERIOR AIR FIIM
2.
3.
4.
5.
6.
?R A R I 0.17
,
, ToTAL
?j = . dto'7
INTERIOR AIR FILM 0.68
. ..
fYc>+LM???PoL 'cZo
MTRMOA-AIR FILM
MTAL ZC° . 9
L{
INT'ERIOR AIR FILM 0.68 1.
2.
3.
4.
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6.
FI6. ?1 TUPVIEW OF
FRnrE wALL
F'I6. #2
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SIAB ON GRADE
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IX
u
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A FFAT FI`A?ri
UP
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FTG. #S
I I iEEAT FIAW UP
FIG. #6
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VENTED
i-IFAT FIAW
UP
_. . _...........?...- _? tL_/o ?" ? ; . . ...?i.
; r-`•,
CONSTRUCTION -' R-VAI.UE
77777777
AIR FILM 0.61
..
2. ?j$" . ., .. , ._ .
3. INS - ,
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4.
U = p2 .'.
'X
FRA I`'E
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CONSTRUCTIOH
1.
2.
3.
4.
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INSIDE AIR FIIM
+
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7 ,TOTAL'
77 4, -
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ESIN ID AIR FILM
•
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1.
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INSIDE AIR FIISt 0:6
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NpTE: USE ADDITIONAL SHEI'S'IF:M0RE SPP.CEI
DETAILS AND CAL,C(1LATTDNS:
FOR
NEEDED
.
,_
. /- _. • ....--__ . _.....-----
? ROO-F_CEILING
,r NON-VENTED
Hfi1T LbSS CALCt1i,AtiC1NS
WeatherslriQ: AA•?V?E•
Guide
?Vindows ' Doors Referente I OuL Wall
res-No ? Yes-No 19_
? F?•I Fp.rG(? Roam Le?eth /(o Wid?h
Windowa and Doors-Crackage and Area
tPW1h ilelpht f:n.o( L?nealh. Are•
No. nr oanc or pnnl h
boe •s? --i-i-T, z
Infiltration
"1aaa
Fxp. wall
nel exp.,
In& ++ell
Total Btu.
Reqvired sq. ft. E.D.R. or sq. ins. W.A. I..eader area
5.1 'f
J????iJ -?? m Lengt6 I L Width t?
Wmdows and Doon---Cretkage end Area
WId?? Hel?pt Llnul(t. Arot ?
No. ofoine No`of
nin.... .
Claet
Exp.
Net exp. wall
Btu
Btu
?.
SO
. ._.?...
Windowa a . ..° . F ...... I
d Doors-Crackage and Area v •??pm
Na. WIJIh
ef oins I4 e4KFt
of pane Na, ot
?Rhl• Llne?l tl.
af rrL[k wre?
p, fl.
0 o y, 3a,4
i
Coei. $tu
Infiltretion /Ob(o
Glaes ,Y St) /b'? a
Exp. wall / la
Net exp. wall 35
fnM++AF' )P /A7 7 Od
Ceiling ? g jp ,30 90
.wee...
?
wtai estw 135
Required sq. !t. E.D.R. or sq. ina. W.A. Leader erea
e7''°Fl.I?µ?µWyjfp11 RoomlLenBth /L Width ?jj Height?
Windowt and Doors-Crackaae and Are.
N0d WIAtp
et Dftn, HelI h-,
et Oans No.ef
tl[?{? Llneq fl.
ef er?cM Area
?y. C(. -
o s Q
ef. Btu
Inbllntion 0?
Glssa - 16
?..,d
YO
FsP. w.lt to x el Nf 4 IJ
Nec e:p. wall ,21,;L '?Z (.06
.lat.w.ll ,M _
lis. y
Ceiling ?d
Kequired sq. (t. E.D.R. ar sq, ina. \j7 A L.eader area F
`F1• ?tvfv Room 11.ength p Width Height
Windows and Doora---Gackage end Ares
Wl f ndu?h. H<??ht Ne. e[_ Ineal [t, Ares
Vo. e ..r...?? ' . _
Btu
;laee ,
:xp. wall
Jet exp. I
'otal Blo.
k. C.I?.R. or tq, ine. W.A, l.eader uea
.-.. _ .__ ------
--- 3 5 70 Y ,= - 70
?
/a?7 A-br)Avic=w
DEPAI2TMENT OF BUlL.DINCS ?
Conslruction No.
? C??Yy?OF Bl1RNSVILLE
(
Insulalion
Wall f,ulmg Roof Floor II?Kind ? How AF
Hnqht / IIIIS" FI.I/ ?ti.nw R.,..- I1..,,.tl. i s vi:.t.L ,..
lolal Wu.
Required rq, ft. ED.R. or p. im. W.A.
Leader sres
rt?r ?•? M ASk?1 RoomlLength Width /(o Heightg
Windows and Deers-C.aA ... ....7 e.?.
Ne. W IdM
ef v&no Nelght
of p Ne. ef
IItr1s Llnul (L
et ttack Ares
sq. [t.
?
opn
Coef. Btu
Infileration a 0?
Glsu
Exp. wsll { I(o x ,7d
Net ezp. wall y ;-
464"u-I?11), 34 G a
Ceiling
,Fleer-.
T _
wcai viu. 7 L1 0 5-cs
R•q?iirrl sq. It. f:, b.R. or aq. irs. N.A. I.ta.4I atta
v; ??.
Slo `7 20 )64;?31
_. _.... . _ _ .,._..._ _. .. .... __ - ---
HEAT LOSS CALCULAT10N5 ' DEPARTMFM OF BUlLDINCS arv oF euRNSViLL[
Wl3th[fi( lA•S.H.V E
--
Vi
d P-3 -- Guide Conetruction No. Insulation
n
ows
I Doors Re{erence I I Oul. Wa11 Inl
Wall Ceilin R
f II
f?s-No '
Y?e-No
I9 . g oo Floor Kind
How
_
d Room Leng?h Width
Windowe a
d D Height
II FI•ItN{- RoomlLengih a(@ Width
n
oon-
-r Crackage and Area
,,.. _, .. Windowe and Doars-Craekaor .nd n,..
Inhltration
Glas1
Fxp. wall ?
Nel exo. wall
Ceiling
Rvor-
Total Btu.
Required sq. It. E.D.R. or aq. im. W.A. Leader area
?hr7,l v Ti Room (.ength / Wid?h ?
_Windows end Doore--Crackage and Ares
ecu
Btu
;Iass
:xp. wall p y N? 1 k !
Jet exp, wall `
nL wall (Z 1 r" 1 ?
.GIlI08 13XIO
:laas--
atal Blu. -
lequired sq. ft. E.D.R. or eq, ins.
FI. r ?voAk. Room I Lenatl
Area
ilau ,
xp. wall
lel ezo. Wall
?ols? Btu.
;equired ?q. (t. E.D.R. er sq, ins.
area
Btu
No. WIJIM1
af D??e ?e1Fht
ef pnne No. o[
IIRhu Line?l fl,
otcrAvM Aret
?q. (t.
3 ? bo yS,b
Coe(. Btu
Infiltution /a0 44 / 4/D
CJea y r6 sk tpato
Exp. wall ?7G (. ? )e (ye7 -
N<<<YP.Weu a89
Al+-
Floor X 7?
wta[ ntu. ; 8 ,i,?0
Required sq. ft. E.D.R. or sq. ine. W.A. L.eader ares
F7•1 Room I L.ength Wideh Height
Windows end Uoors_Cr.A,.e. ....1 A...
Na WIEIh
ef Dang Helght
ef Dan* qa. o[
IIgTt. Llnnl ll.
at eraek Area
p, ((,
f. Btu
Tnfiltration
Gle»
E=p. wall
Net esp. wall
IIII. WIIII
Ceiling
Floor i
lotsl t1tu.
Required sq. ft. E.D.R. or eq. ina. W.A. Leader area
F7•1 Room I L.engih Width HeiBht
Windows and DoorF-(',rackage and Area
GIe.s
Exp. wall
Net exp. well
Inl. wall
otal Btu. --'?"
epmred sq. ft. E.D.R. or eq, ins. WA. Leader area
Btu
Illillb City of ?apn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
? For Uftice lJSe I
? Permit #:
/?
`fV
I Permit Fee: I V` ?
? Date Received: j
? I
I Stafl: I
I ------ -J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Uate:
Tenant
Suite #:
RESIDENTlOWNER Name: FfCI LF}-SH (cJ4fA1cT1q- Phone: 6SI--? 23-5'?/n
Address/CirylZip? l0 2 7 I\J 0 47-HL ( C; tj 1"A-12- k- `Kn
V
Applicant is:
Owner _ Contractor
TYPE OF WORK Description of work: k) E'W S! -7) /,A,/6
ir
0) 5 Ub - 3O 0 0 Multi-Family Building: (Yes No
Construction Cost:
s
CONTRACTOR ek¢s' License #:
Name:
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitled Submitted
(4 Submission type) • Energy Envelope Calculations Submitted
In the last 12 months, fias 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 submlt are consedered to be public informatlon. Poetions of
the lntormation may be classified as non-pu6lic ff you provide specific reasons that woWd permit the City to
concfude that the are trade secrets. I
I hereby acknowledge that this intormation is complete and accurate; that the work will be in conformance with the ortlinances and codes of Ihe 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; ihat the work will be in
accordance with the approved plan in the case ot work which requires a review and approval ot plans.
X S?Lr u-r ti-sH 3tsA bc72,? x
ApplicanYs Printed Name Appli an't's Signature
Page 1 of 3
Site Address:
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Use BLUE or BLACK Ink
t
r I For Office Use
j Permit #:q7 j
City of EaEdIl RECEIVED I Permit Fee.
3830 Pilot Knob Road I I
Eagan MN 55122 MAY Q 8 ?17 j Date Received: f 3 j
Phone: (651) 675-5675 14
I I
Fax: (651) 675-5694 1 Staff: I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Jysk dSo C- U'gx- Phone: & J l ~ 2'49 32
Residentf /ice
Owner Address / City / Zip: ZU ` /~a~T P O
Applicant is: Owner contractor
Type of Work Description of work: eZA-$ t m I-, L/ I-- /&/ft o a£ t-
Construction Cost: Multi-Family Building: (Yes / No Y0
Company: (DA) t ~f/C L i9V7-5 LU Contact: I P&N, J?X (tC.d
Contractor Address: City: -S ST t ~t-
StateMIk' Zip: Phone: (.Ola-o- (mail: i f,C9 V f
License #:C, Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12` months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes e 7~IVo 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 speck reasons that would permit the City to
conclude that the are trade secrels.
CALL BEFORE 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.oopherstateonecall.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 worts 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 din e t be completed within 180
days of permit issuance. t
xjA^f 5 ~.l~fLtL!or1~GC x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
1 - DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace T Porch (3-Season) _ Exterior Alteration (Single Family)
_ Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Multi)
T Multi _ Deck T Porch (Screen/Gazebo/Pergola) Miscellaneous
_ 01 of Plex Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New Interior Improvement ` Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace - Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation 171po o Occupancy MCES System
Plan Review Code Edition SAC Units
(25%, 1009/.-~j Zoning t~Ae City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Roof: -Ice & Water -Final Pool: Footings Air/Gas Tests -Final
Framing Drain Tile
Fireplace: -Rough In Air Test -Final Siding: -Stucco Lath -Stone Lath -Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings _ Backfill Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By:T Building Inspector
RESIDENTIAL FEES
Base Fee`
Surcharge
Plan Review "
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
r
Treatment Plant® r j
Copies
TOTAL
Page 2 of 3
Receipt#326745 I�I'I�I IIIII I'lll IIIII II'll IIII�I'lll'III I'll
� ���t�� � ABSTRACT FEE $���� 3012496
ATT COPY $4.00
JUN 0 �} 2014 Recorded oBY3STG,Deputy25:08PM
BY: �
Return to:
GTY OF EAGAN �
3830 PILOT KNOB ROAD Joel T.Beckman Coimty Recorder
MUNICIPAL CENTER
EAGAN,MN 55122 Dc1�Ot1 C011ll�,MN
,� � �� �
� � �
CERTIFICATION OF PURPOSE OF SECONDARY
KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING
I, Joshua Koller, duly sworn and under oath, certify that I am the Owner of the one-family detached dwelling as defined in
Section 11.30 of the Eagan City Code located at 1-027 Northview Park Rd legally described as Lot 2; Block 2, Lexington
� Square 6th, PID#10-45080-02-020.
A building permit application has been submitted on my behalf to the City to enlarge, alter, improve, remodel, and/or finish
the above-referenced dwelling, or a portion thereof, to include the installation of facilities for a secondary kitchen within the
dwelling.
The secondary kitchen facilities to be installed under the building permit are for the sole purpose of providing cooking and
food service facilities for private entertainment of guests by the property owner at the dwelling.
I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit to
serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the installation
of the secondary kitchen facilities under the building permit is not for the purpose of providing a second complete,
independent and separate living and/or housekeeping unit within the dwelling.
� G�'�
Dated: May 23, 2014 �- ' �
ner's ig �ure
Subscribed and sworn to before me this �.3 day of � �, , 2014.
. SARAN JEAN BRANpEL
�. Notary Publio-Minneeota
ota ry P u b I ic '�,r.,�, My commiss�on�e.�st�2oto
I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities within Single Family Dwelling
was recorded at the County Recorder's Office on , 2014.
By:
its: ',
THIS INSTRUMENT WAS DRAFTED BY:
City of Eagan ',
Community Development Department '
3830 Pilot Knob Road I
Eagan, MN 55122
Use BLUE or BLACK Ink
. r_________________
I For Office Use �
. I • 1 GY�/�� j
C�}� 0� nn�nn � Perrnit#.
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� Permit Fee: t,(6"V4 �"�' �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: 3 �
Phone: (651) 675-5675 � �
Fax: (651) 675-5694 i Staff:_---_ .----_--i
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: �-G'�`r � Site Address: ` D�� �v�������� ��
Tenant: Suite#:
Resident/Owner Name: -�$�/ �a�-�ii� Phone: �o.S�/- .Z y�'-39��
��� Address/City/Zip: ���� ���'-/. U �l� {��'� ,�,
Name: N/E�aF� /'" C°��'�N�i License#: �(O 7���
C�ontractor,
Address: (�b�Z� �r.✓rN�l'/� f�(�� City: //�G�it- �7y'2�ii�` ���j',S
State: N� "' Zip: ��� Phone: �S!� �'J `�` ` ���
0. �
` Contact: ���� Email: I ���� ��'L-�'��� ���
Type of Work � New _x Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
' Lawn Irrigation�RPZ/_PVB)
Permi#Type
Septic System � Add Plumbing Fixtures�Main/�Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (inciudes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8"meter is required)
$115.00_Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
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ApplicanYs Printed Name A i t's Sig re
FOR OFFICE USE ' Re�iewed By: Dafe:
Required Inspections: ' Under Grountl Rough-In Air Test Gas Test: : Final
Meter Related ifems: Meter Size Radio Read Staff:
Use BLUE or BLACK Ink
� � � � � � � . � r------------�-----+
I For Office Use �
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C� O� � � j Permit#: �-�-�� ;
�� � � � I Permit Fee: � `f' I
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I �
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
y �
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� : �as� ��1��,
���� �e� `� Name: � Phone:
�� �
Address/City/Zip: '��� I��V f��'la'�- �,
s � '`����
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���� � � .: Applicant is: Owner��Contractor
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�� �= Description of work: �lG 1� � �d�1�.q
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��� ' Construction Cost: ( ` ��� Multi-Family Building: (Yes /N�
� ��,� � `� ��� Company: �1alY'1 �'`O �t�S1�r�lG.,',` 1� Contact: �otV� ,�2ha�
�; � ���� ����
�� ' ��`«��`�� ^�
� Address: �� t g ��A� ��• City; �V�1`
,� ��� ,,_p
"�� �� ` State:��Zip: �53�g Phone: �5� (�SD O�)EmaiL•
� � ��
��� a�' � Lead Certificate#:
, �, , License#: `0���C�Oa3
�
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
1n 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:
Fire Suppression Contractor: Phone:
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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.popherstateonecall.org j
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of '
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
X �� �c q X
Applica t's Printed Name ApplicanYs Sign ture
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