1092 Northview Park Rd
Use BLUE or BLACK Ink
r I
For Office Use
I Permit
I ,
Io s ,
City of Eatd
R
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 j I
Fax: (651) 675-5694 1 Staff:
L-----------------I
2010 MECHANICAL PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: J f S tIk s- K-1 Phone: (jSl- 76-17- 9o it
Address / City / Zip: O 0e_~-,,v 1 Xj
CONTRACTOR Name: ta•w License
Address: Ll o'~:IJ O ✓'cll AJ City: S 1 (
State: _ Zip: b $ 2- Phone: 60--s-1 3 `1- 3 3
Contact: t n, Email:
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: iv s -t4 L ( a L /
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.
RESIDENTIAL COMMERCIAL
PERMIT TYPE Furnace New Construction Interior Improvement
-4Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install / _ Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.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 x
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
r- I CASH RECEIPT 'V•
CITY QF EAGAN
„ 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?
DATE 19
i
waeeiveo
AMOUNZ Is
7Tr.
a ooLLAes
loo
? CASH CHEGK
FOR ??'l?Y`-. :iLiL`/ ? ? - `/?/ ?I/ ?
LA
Thank You
g Y ? `-C?-
' `?"'r •' White-PaYera CoPV
Yellow-Posting CoPV
Pink-File Copy
BLDG. PERMIT N0.
JL 1?;1
01-3210 Bldg. Permit _
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
Q1-2155 Surcharge _
17-3860 Road Unit
QO-2275 SAC _
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
I
?.? _ l?
I ?7 C
t-I
GOLD COPY PERMIT RELEASE FORM
PERMIT # C/ l ` I
.
ADDRESS / o q ? - -- V\l 4-1l.
PICKED UP BY
v (x? ? 4 66-17
L ( ? 5
PLUMBING PERMIT
CONTRACT
PRICE
Site Addrpss
v??
1... _
? Add
? '
c City
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
?
c Address
? City Phone
. FEES
COMM./IND. FEE -19L OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APLUES
MINIMUM - RESIpENTIAI FEE $12.00
MINIMUM - COAAM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .? .50
(ADD $.50 S/C PEEi EACH $1,000 qF'?tF31ullJF?E)
Res.
Mult.
Comm.
For C
PERMIT # _
RECEIPT #
DATE: -
New _
Add-on
Repair
, RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
e ^ ?_ Bath Tubs - $3.00
Lavatory - $3.00
? Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $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 PERMI'T) ,
? Softener - $5.00
?
weu - $10.00
Private Disp. - $10.00
?- Raugh Openings - $1.50
PERMIT FEE:
STATES S/C: .?.??
GRAND TOTAL:
e ? .. :. .. -r'-C.'a?pFC?' ..-r,-,.y..- -. r? -- . T - . ..._ . .. . . . . . , . . . . . . • . -e?.
' .. . .. . 'J ? • CITY OF EAGAN
{? 1 ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 • w ??PHONE: 454-8100 _
BUILDING PERMIT Receipt # '
To be used fni ,'??M Fer uMiiip =1 ,?0 n?#o .I?11?Y 11 91
Site Add4ss 109= WORTRYiZi pARK ROAD
lot 2 , Block _1- Sec/Sub,
Parcel No. _
W Name S'RYL M?.TA
o Address SANK
City Phone 454-5847
, o Name sA!!E 736-i014
z?
COI a Address
? City Phone
? W Name
W W
H
?z
F, Address
i W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with aB applicable State of
Minnesota Statutes and City of Eagan Ordinences.
Signature of Permitee
A Building Permit is issued to: S?EV8 S'YDLPA
on the express condition thal all work shall be done in accordance with all
applicable State of Minnesota St tes and City ol Eagan Ordinances.
Building OffiCial
OFFICE USE ONLY
Occupancy : "FEES
2oning
(ActuaqConst . _
BIdg.Permit $3s.?
(Allowable) - 1000
Surcharge
8 ot stories -
Length _ Plan Review
Depth - SAC, City
S.F. Total _
SAC,MCWCC
S.F. Footpnnts _
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
Ciry Water _ Acci- DePOSit
PRV Required _ SNJ Pertnit
Booster Pump - g/yy Surcharge
Treatment PI
APPROVALS Road Unit
Planner
Council - Park Ded.
BIdg.Off. _
_
Capies
$ b .00
Variance - TOTAL
Permit No. Pern?it Flolder Date Telephone +M
WATER '
SEWER
PIUMBING
H.V.AC_
EIECTRIC a03/o2 kE'.(Yf.lJf"UIIT_
Inspection Date Insp. Comments
Footings I
Foundation
Framing ?
Rooting
Rough Pibg.
Rough Htg. ?
Isul.
Flreplace
Final Ht9-
O?stat Test
Final Pibg• Plbg. Inspedor - Notiiy Plumber
Const. Meter .
Engr./Plan O nja
Bktg. Final - e
Deck Flg.
Deck Fnal
Well
Pr. Disp.
.?.
? a
(Itrft#irtttt nf Orrupttnry
Citp of (Eagan
EppartritYltt Af s1tatlto jItwptfiDYt
This Cerdfwate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the Ciry regulaling buildirtg corrstruction or use. For the jollowing:
ewg. ftrn?t rro. 14122
oaw-cy tya mving Dke,;a I?; Tra C=KL
eWwing /+m? AMNIEW PARIL !Mi ; Lonliry I.2, B I, I.EUbLL'W Fxwa' '
pW: N7llPhitER 5, 1987
Bunld'mg OTIoW
POST IN A CONSPtCUOUS PLACE
` - - ? CITY OF EAGAN + ? -
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt ? To be used for Est. Value Date ''',?i ";? `"'-.;•. } ,19 .
Site Address 1 `) 14 2
Lot Block Sec/Sub. '-EK1NGTc'
Parcel No.
oc Name - ? ?N-Fi
= Address
° City ' Phone
¢
akO
Oi
U¢
. ?
Phone
_ Phone
that I have read this apalication and state
State of Minnesota Statutes and City of
Signature of Permittee
A Building Permit is issued to:
all work shall be done in accordance wit.
Building Official
OFFICE USE ONLY
pn Site Sewage OCCUpanCy
MWCC System _ Zoning
On Site Well _ Type of Conat
City Water _ (Actuan
(AUowaale)
# of 5toriea
Length
De
th
p
S.F. Total
Footprint S.F.
APPROVALS
Assessments
Water/5ewer
Police
Fire
Engr.
Planner
Council
Bldg. Off.
APC
Variance
FEES
_ Permit
_ 5urcharge
_ Plan Review
_ SAC, City
_ SAC, MWCC
_ Water Conn.
_ Wafer Meter
_ Road Unit
_ Treatment P1
_ Parks
Copies
roraL
`t
' U
c}
j{}
on the express condition that
of Minnesota Statutes and City of Eagan Ordinances.
Permit No. Permit Holder Data Tslephons i
Plumbing
H.V.A.C. 1 ,9119 /
Electric ' ?gg
Softener
Inspectfon Dats Insp. Commsnb
Footings I --9
Footings II
Foundation r
Framing
Roofing ? 1?p
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Fina1 Htg.
Final Plbg. -
Bldg. Final
Cert. OCC.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
- L
=
. , . PERMIT #
. MECHANICAL PERMIT
CITY OF EAGAN RECEIPT ?
?
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE _
Site
Lot.
Address i '
' 3 Addre
p City
? .?- Phone ?• ?
TYPE OF WORK Forced Air M BTU
Boiler M BTU $_
Unit Heater ' M BTU $,_
Air Cond. M BTU $_
?__. .:?.. ?.
Other $,_
FEE
S/C:
TOTAL• =?..
'a
?
-
BLDG. TYPE WORK DESCRIPTION
Res. New `
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
AODITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkilAln - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
REMOOELS - 12.00
MINIMUM COMMERCIAI FEE - 20.60
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
??r'° -
i.? .. . - . . . .. . . . . . . . .
' • ' PERMIT #
? .• ' PLUMBING PERMIT
?7 7
RECEIPT k
CITY OF EAGAN , p
3830 PILOT KNOB RaAD
EAGAN
MN 55122 DATE
f 1? J k
?
,
,
;
;
CONTRACT PRICE: PHONE: 454-8100
Site Address '
' BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub Res. New `
Mult. Add-an
?
m Name Comm. Repair
?o Address 7L,??
, Other
c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
` Name .. ? . __?-Water Closet - $100 $
J-Bath Tubs - $3.00
3 Address L
00
___?_
avatory - $3.
O C1tY Phone >
! i;
,( 5hatiier -$3
49*:
00
_ .
, _
.
_
---/-_Ki?chen Sink - $3.00 -
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE __?_Laundry Tray -$3.Q0 '
APT. BLDGS - COMM RATE APPLIES -?__Floor Drains -$1.50 /
TOWNHOUSE & CONDO - RES. RATE APPLIES -i-Water Heater -$i.50
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool -$3 00
MINIMUM - COMM/IND FEE -$20.00 ? Gas Piping Outlets -$1.SU
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
Rough Openings - $1.50
.._--
SIGNATURE OF PEfiMITTEE FEE: "
srarE sic:
FOR: CITY OF EAGAN GRAND TOTAL• •- ?'
CITY OF EAGAN Permit No: Date:
3630 PilotXneb Road B/P Na Date:
P.O. Ebx 21199 ?'•?: r •:• ',
Eagan, MN 55121 '
iller Const.
CC: Zl,.Qning. . .
Chg: ?, ._- ?st81? l0 8? U?iTeRS'b?Units:
:. D@p: nnir CI R? -lLN
nit Fee: I?"LtPI lVilt- ?I wTAfj to comply with the City of
SEWER SERVICE PERMIT ?
TY OF EAGAN Permit No: Dat? ?-'«-''S7
30 Pitot Kdob Raad Meter Na _?-S.3 ?? size:
O. 60k 21199 Rea
gan, MN 55121
ner.
l i:iler CAtst
e Address: iinrtl]i?leS;? Par'k n?,l i
mber. vi lnuth n7 um iin?
nn.Chg: wARUWN?7g
cct D P , , ..
? ?3Q??'S 1
ermit
ee:
Surchar
: ;0?8 8
? • ? E1C.
e
9 gree to comply with the City of Eagan
Tr. Plant Or n W
Meter.
Misc.: BvJ.l?.
? '??•?':?v?'>.
y
' OF EAGAN Permit No:
i Pilot Knob Road B/P Na
. ._. Box 211o9
Eagan, MN`t5121
Owner • - - '
Site Address:
Plumber:_
r Gottst.
Date: 3 n
7 77
Date: • ' - `' ?
r.v!.ew Paz1: I;o1d L2 fl? L
°?umb3ng
---------------
MWCC: ' ? • G?"- ' Zoning.
City Chg: QCpc!
No. of Units;
Acct. Dep: 15. QCpPermit Fee: 3??' •'? ?`' ?' I agree to comply with the CNy of Eagan
Surcharge: Ordlnances.
--? --- BY
SEWER SERVICE PERMIT
' CITY OF EAGAN Permit Na '? I 1
3830 Pilot Knob Road Date:
P.B. Box 21199 Meter No;
Reader No: Size:
Eagan, MN 65121 Date:
Owner.
Cbn t .
Site Address: I;??), 2 t
n? 'c ?:nn'? 7_?
E Conn. Chg: 2 5. OOpd
; Acct. Dep: 15. uOpd Zonin9:
? Permit Fee: No. ot Units: ?
? Surcharge:
Tr. Plant I??' , f,11 . ? a9ree to carnply with the City e} Esgan
Meter. _ Ordinances.
Misc.: ?-
By
WATER SERVICE PERMIT
- -- -
BUILDING PERMIT
io ba used for , B"'c'FMENT
Site Address 1092 NORTHVIEW PARK ROAD
Lot 2- Block 1 Sec/Sub. LEXINGTON
Parcel No.
w Name STEVE STOLPA
3 Address 5AME
° City Phone 454-5847
o Name_ SAME 736-4014
zr
g¢ Address
? Clty -
Phone
?w Name
Address
u
aW City Phone
I hereby acknowlege Ihat have read this application antl state Ihat the
iNOrmation is correct an agree to compl with applicable State of
Minnesota Statutes and Cf Eaqam m ?ces.
f
Signature oi Permitee
A euiiding Permit is issued to: STEVE STOLPA
on the express condition that all w rk shall be done in accordance with all
applica6le State of Minnesota St Wes aM City ol Ea n Ordinances.
Building Official MZ4L??-
-S
u
CITY OF EAGAN (1?0 1 g404
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 /1 ?
Receipt # ?J /
Est. Value -*k-'OOO- Date JULY 11 19 91
Occupancy
Zoning
(ACluaq Const
(Allowable)
M ofSmries
Lengih
Oepth
S.F. Total
S.F. Pootprinls
On Site SBwage
On Sile Well
MWCC Sysrem
City Water
PRV Requiretl
Boosler Pump
APPHOYALS
Plannar
Council
eltlg. OH.
Variance
OFFICE USE ONLV
- FEES
BIOg. Permit
Surcharge
Plan Review
SAQ Cily
SAC,MCWCC
WarerConn
Water Meter
Acct. Deposit
S/VJ Permit
S/W SurCharge
Treatment PI
Road Unit
Park Ded.
Copies
TO7AL
g35_nn
1.UU
*36.ou
CITY OF EAGAN N 0- 1 4 12,2 ,
' 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
BUILDING PERMIT PHONE:454-8100 Receipt # -7 .7(57e?r
Tobeusedfor SF DWG/GAR Est.Value $63,000 Date SEPTEMBER 3 1987
Site Address _
Lot I Block
Parcel No.
1092 NORTHVIEW PARK RD
1 SeGSub. LEXINGTON
a Name JOSEPH MILLER CONST .
= Address 18133 CEDAR AVE SO
o City FARPfINGTON phone 431-2001
..
¢Q IName SAMR
0? Address
? Cityphone
w W
F¢ Name
?
_g
Address
Q W City Phone
I
I hereby acknowledge that I have read this
that the information is cortect and agree to co
State of Minnesota Statu and City ot?
Signatureof Permittee.
A Building Permit is issued to: JOSEP]
all work shall be done in accorda ce with al
Building Official
on end state
all applicable
MILLEB CONST
ppliq&le State of)
OFFICE USE ONLY
Hpn Site Sewa9e Occupancy Rl
MWCCSystem ? Zoning PD
On Site Well Type of Conat y,R
Ciry Water -X_ (ACtual)
-
_
(Allowable) ?
# of Storles
Length
DePth 46
S.F. Total.
Footprint S.F.
APPROVAIS FEES
Assessments _ Permit $ 374.00
Water/Sewer _ Surcharge 31.50
Police Plan Review 187 .00
Fire SAC, City 100.00
Engr. _ SAC,MWCC 525.0p
Planner _ WarerConn.
0
525.0
council _ waterMeter 67_00
BId9.Oft _ RaadUnit _305 ?0
APC - Treatment P7 190
Variance _ Parks
Copies
' TOTAL $2.294.50
on the express condition that
innesota Statutes and City M Eagan Ordinances.
ThiS reques' void
18 months ptrom p ?°? O O 1? ?'^?f OJIG?
D 8 3 8 9 r? L_
Rem
i te
Fi No. 4/
FlouP InsVertion t-C.ii(i crT C.?
?
3
? flep r dP aAy Nuw D Will Nolify Inspec-
? es ?N tor Wh R d
!T' . .
?y??wnnseu uec[nca, c;onVactor -
? Owner I hgrebv request inspaction of ebove
elechicel work installed al:
SLeet Atldress. Box ar Raute No. ?J
` /G.? „G G
ecLOn o. Tow ship Name or No. Rnnge No. Coumy
?
OccupantlPRINTI Phone Nn.
aE' IE6 Lr? S?`r-v??-/On/ 1f /-ao
ower Supolier Atltlress
r?
Electtical Convactor Company Name)
?f
?
? Contracmr's Lic'e u.
.
? O
Ma ling AdJress ICoMractor or Owner MakinP ??stailationl
?f.?- a
3
Auth iz
etl SiPnature ICOnVactor?Owner Makine nla[ion)
Pone
e
I /C ?!/ O?
NNE50 STATE BOApD OF ELEGTqICITY THIS INSPECTION REQUEST WILL NOT
Giriges•MiEwey Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOAFD
1821 Univergity qve., St. Peul, MN 55100 UNLESS PROPEF INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB 00001-06
' See inshuctlons br compleling Ihis torm on back ol Vellow copy.
.83892 "X" Below Work Covered by This Request ?
as' AAd Reo. TYpe of Bullding Appliancea Wired Equiument Wired
Home Range Tem{mrary Service
Duplex Wa[er Heater Lightiny Fiztures
Apt. Building Dryer Electric HeaLn
Commercial Bldy. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm otne.i peci v Oihnr lsueclfvl
sue="v oine. nme,
om?ute lnsoection Fee Below
N iee ServiceEntrenceSize k Fee Faeders/Svbfeeders N Fee Circuils
U to 200 qm 5 0 to 30 qm s 0 tn 30 Am s
Above 200 qm ps 31 to 700 Amps 31 to 100 Am s
Swimming Pool Above 100-Amps Above 700_Amps
Transiormers Irrigation 8oo15 ? SO Partial-'Other fee
Signs Special Inspection
S
T E
Hertv?rk??? T? ?
?J ?? S
' ?
-OV
Nough-in `11e I, the Electric
Ins raby
certity cpef the above
Final ? ,te
C0-/ 5 inspection has baen
meda.
This reQuest voltl 18 moNha trom
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
? See insbuceions for campletin9 this form on beck ot yellaw copy.
D 41-89 3 "x" BeloW Wofk Covered by This Request
AdJ Rep. Jype o1 Bulltling ApOliances Wired Equlpmenl Wired
Home Ranye Temporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. BuilAing Dryer Electric Heatin
Commercial Bldy. Fumace Si!o Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm oU,er oec,v -ohe, IsuecHVl
Mh9, $UOC?(y [hd, 01he,
omuute lnspection Fee Below
p Fee ServiceEn[raneeSiie tl Fee Feedars/5ubfexders b Fea Gircuits
OO 0 to 200 Am s 0 to 30 Am s 0 to 30 Am s
Above 200 qmpy 37 to 700 qmps 31 to 100 A
Swimming Pool Above 100_Am s AAOVe 1(10_Amms
Transiormers Irrigation Booms O Partial.'Other Fee
Signs Speciallnspection
$
4
OTA
Xemarks
r A
?_. L €E?? ?
`T
flou6?-?^ ? Date 1,the Elec
Inspectoq hereby
certify that the nbove
Final 71e ins0ection has been
r lI meae.
thh repueat vo1G 18 monlM trom
?
This reqoes[ voiC /O/?/??
18 rtwn?hs trom
D 41893 4.2.
•°°•••`°' `°••°"1101 i hareby repuest inspaction of above
0 `9^ef elect(ical work ire<alled at
Street Address, 6ox u1 Rome No. City
ecuon o. ownsbip Name or No. qanBe No. County
OccuVani IPqINT) Phone No.
d! I- ?o
Power $upplier Atldress
rrrr SJ o a?(
Elecvical Contractor (Company Name) nntrar,tor's License No.
- ??G/o
Mailine A. dress ?Cmtracto? or Owner Making Ins,ailatloN
a? a- G./. Ga. rl t-/? < /£ v?? S.5 337
Auth ¢etl Signatura ( nbactor/Owner Making Installatinnl Phone Number
MI"ESOTAITpTE 90AAU OF ELECTPICITY THIS INSPECTION REQUEST WILL NOT
Griges-Mitlway Bldg. - Room N-191 9E ACCEPTED 0Y THE STATE BOAPD
1821 Univarsitv Ave.. SC Peul. MN 55104 UNLESS PflOPEN INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
(?o l 0
REQUEST FOR ELECTRICAL INSPECTION °? EB-00001-08
? See instmctions ror completing tnis form on back oi yeilow copy
e
_ . .2 R i? 7 P _ 'X: Below Work Covered by This Reques! ? ?
ew Add Rep. Typeofeuilding AppliancesWired EquipmentWired
Home pange Temporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Dryer Other (Specify)
Comm./lndustrial ' Furnace
Farm Air Condi[ioner
Diher(speciry) Contractork Femarltsr-3
srn-E•
Compufe Inspection Fee 8elow:
# Other Fee # ServiceEntranceS+ze Fee # CircuitslFeeders Fee
- Swimming Pool 0 b 200 Amps 0 ta 100 Amps
Transformers Above 200 _ Amps Ahove 100 -Amps
SignS Inspector5 Use Oniy: TO
TA
L SO
Irrigation Booms ? . ?
^
W
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OR ISCONNECTED IF NOT
011ier Fee COMPLETED WITHIN 18 MON ?
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. RO09"-'"
Final - °aAe ?T
?ate
OFFICE USE ONW ., . .
This request void 1B monihs 1rom .
/1
?
?
372
3
Request Oete?///? I•- - Fire . n-in Inspection
ea iretl? ?/ .
? Reatly Now/?Will NotiFj Inspeclw
? 0'/
R
7
5 ? pb hen
eatly
I.p licensed conhactor owner hereby request inspection of above electrical work af: -
.bb Ntltlress (Streei, Box or ute No Ciry .
C?9o2 ir?viarlG ,
Seclan W. Townshp Name or No. ' Range No. CouMy '
Ocwpa (PRINT)
S? Phone No.
OI G
VE
tE
Power Supplier Atltlress
Eleclricai Coniracta (COmpany Name) Caniredar5 Licenae No. '
mE v Lun
i ing Address (GonVaclor or p.vner Making InsWllalion)
o G/
Aut rizetl naWre ?ConVacbr/Owr?er M mg Installation) Phone Number.
"13 ? - ?! o
MINNESOTII STAiE BOAPO'OF ELECTBIdTY ? THIS INSPECTION REQUEST WiLI NOT
Grlgps-Mltlway BIAg. - Baam S113 - BE ACCEPTEO 9Y THE STATE BOAPO
18Y7 Univeretty Ave., SI: Paul, MN 55100 UNLESS PROPER INSPECTION FEEIS '
Plprw (612) 812-0800 ENCLOSED. -
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681•4675
New ConsWctlon ReauiremaMs
• 3 regislered site surveys sfwwing sq. ft. of IoL sq. R. of house; and all mofed areas
(20% manimum lot coverage allowed)
• 2 copies of plan showing 6eam 8 window s¢es; poured found design, etc.)
• lselofEnergyCalwlations
• 3 copies of T2e PreservaUon Plan if lol platted after 711l93
• Rim Jost Deiail Options selection slreet (bldgs with 3 w less unils)
DATE ?? f Yl6Z
SITEADDRESS 104A 10
TYPE Of
APPUCANT
STREET ADDRESS CITY f/Zyvv_f ? STATf?k ZIP
TELEPHONE # 763SY6/?m CELL PHONE #'9TZ '?O 3FAX ?G 062 3
PROPERTYOWNERS?"e' TELEPHONE#6'??
COMPLETE fOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RliLr-S 7670 CAT'EGORY 1 MINNESOTA RUI,ES 7672
(d submission type) . ResidenGal Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Coniractor: __
Plumbing system incWdes:
Mechanical Conhactor.
Mechanical system includes:
Sewer/Water Contractor.
_ Air Conditioning
_ Heat Recovcry Sys[em
Phone #
Phone #
Fee: $90.00
?`? f,?: U$ b oo p?
p1 OCT 0 4 2002
tfbp, inform tion is correct, a d agree to comply
I hereby acknowledge that I have read this application, state tha
with all applicable State of Minnesota Statutes and City of Eag n anc + n?
Signature of Applicant ,
OFFICE USE ONLY
? 4 4 . ?S?
RemodellReoair Reauiremenri
. 2 cropies of plan
• 1 set of Energy Calculations Mr heated add'dbns
. 1 site survey for ezteriar additions 8 decks
• Indirate if home served hy sepUc system for additions
VALUATION
-3Y60
MULTI-FAMILY BLDG _Y =14
FIREPLACE(S) 2 0 _ 1 _ 2
_ Water Softener
_ Water Heater
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundatlon ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. AI[ - Mutti
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 0. 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) ? 36 Mufti
? 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 Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entfre Bldg anly) - Give PCA handout to appllcant
ValuaHon Occupancy MC/ES Systemi
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV I
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O. ?
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation _ AVAC
_ Drain Tile I
Other
Roof _ Ice & Water _ Final _ Pool
Ftgs
Air/Gas Tests Final
_ Framing _ _
_
Siding Shtcco Srone , _
_ Fireplace _ R.I. _ Air Test Final Windows (new/replacement) I
_ Insulation _ Retaining Wall
Approved By ?
Base Fee?_???__?_?_??_?____?_---------------------------«
Surcharge I;
Plan Review
MC/ES SAC I
City SAC
Water Suppiy 8 Storage i
S&W Permit & Surcharge !
Treatment Plant
Plumbing Permit I'
Mechanical Permit
License Search I
Copies
Other
Total
Building inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
?? CL' ? CITY OF EAGAN
? 3830 PILOT KNOB RD, EAGAN MN 55122
651•681•4675
New Canslruction Reuuiremenh
. J registerea site surveys strowing sq. R. of IoC sq. R. of house: and all roofed areas
(200'a maximum lot coverage allowed)
. ? cocies oi plan showirg beam S window vzes; poured (ound design, etc.)
• 1 szt uf Enerqy Calalations
• 3 cooies of Tree Preservation Plan if lot platted attet 71193
. Rim Joist DeWil Oplions selectian sheet (blags with S or less units) DAiE ?
SITE ADDRESS
TYPE OF WO
I 0 c)
VALUATION
`Y\ Uv--?\v? -e? 06.fL
MULTI-FAMILY BLDG Y tr
_ fIREPLACE(S) _ 0 _ t _ 2
'i 3 c;-b
APPLICANT C rl ?-?SA-C>,( r,? 0 i--\
STREET ADDRESS CITY STATE ZIP
TELEPHONE # CELL PHONE # FAX #
PROPERTYOWNER 0, TELEPHONE#
-------------------------------------^--------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category
_ y([N\F;SO"1':1 R[.iLCS 7670 C.Cf'EC;ORY I MIVNFS01"_A li[ ?LLti 7672
(v submission type) • Residential Ven6lation Category i Worksheet Submitted • New Energy Code Worksheet SutmineC
• Energy Envelope Calculations Submitted
Plumbing Contractor. ___
Plumbin,- system includes:
Mechanical Contractor:
N[ech:mic.il svstem includes:
Sewer/Water Contractor:
Air Coiidiuoitin:;
_ EIrat Rccovcn Systcm
Fee: :s90.00
FIltll1 ?Phone ? 1 ? 2002,
----------°-----°-------------------------°---------------.._.. . .
I hereby acknowledge thal I have read this application, state that the informoti
with cll applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant d v
OFFICE USE ONLY
_ 4Vater Softener
Water Heater
\o. of Baths
Phone #
Lawn Sprinkler
No. oF R.I. Baths
Phone #
RemodallReoair Rauuirements
. 2 copies of plan
. 1 set of Eneryy Calculations for heated additions
• 1 sife survey for extenor aaaitions & decks
. Iritlicare ?(hcme>ervetl 6y seplic as?ystem for additiors
C7,-CX-?-
dz
--------------------
?---- ----
on is cor -
an a gree to compIY
4s a
Certificates of Survey Received - Tree Preservation Pian Received _ No[ Required _
Upda[ed 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 0 30 Accessory Bldg
? 02 SF Owelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O' 31 EM. Alt - Multi
? 03 01 of _ plez ? 09 07•plex ? 17 Garage I
? 22 Porch/Addn. (4-sea.) O
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
O 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Misceilaneous
? 31 New ? 35 Int Impravement ? 38 Demolish (Interior) ? 4I Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Aiteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 ' WindowslDoors
? 34 Replacement `Demolition (Entire Bldg only) - Give PCA handout to applicalnt
Valuation Occupancy MC/ES Syste I
I
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
N6r. of Bidgs Length Fire Sprinklered '
Type of Const W idth
REQUIRED fN SPECTIONS
_ Footings (new bldg) FinaVC.p. ,
_ Footings(deck) FinaWi o C.O.
_ Foorings (addi[ion) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other '
Roof _ Ice & Water _ F inal _ Pool
Ftgs
A'u;Gas Tzst's Final
_ Framing _ _
_
Siding Smcm Stone '
_ Fitepface _ R.I. _ Air Test _ Fina] _ W'indows (nzw/replacement)
_ Insulation _ Retaining Wall
------------ -------- ------------
--------
--- -------
---------- Approved By , Building Inspector
Base Fee
Surcharge
Plan f2eview
MC/ES SAC
Ciry SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
1 z--?
. ??
?
1987 HOILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLODE 2 SEfS OF PLANS, 3 CSRTIFICATES OF SQBtIEY, 1 SST OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MIIST DESIGAAYB WHICH ADDRESS
IS DFSIRED. NO CHANGBS WILL B6 ALLOWED ONCS BDILDING PERMIT IS ISSOED.
MOLTIPLE DWELLINGS - RESIDENTIAL RENTAL IIPdITS FOR SALE DHITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CI3ECg GITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COLVERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
7 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: ILLl,lJ 46r? Valuation: Date: b "'
3ite Address td
?
Lot Bloek pn Site Sewage`
MWCC System J
Parcel/Sub L'2_1C I?? ???(Q?,(}J On Site Well
City Water -T
Owner
6300 0 OFFICS USE ONLY
Address
City/Zip Code
Phone
Contractor CAU..ILLb 'N.
Address 4 R 1?3 Ud(xA ,do,
City/Zip Code'JOUffim S?
Phone `I? I 'a?0_l
Arch./Engr.
Address
City/Zip Code
Phone Ik
APPRO4ALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Couneil
Bldg Off 17TO 9 3
APC
Variance
Occupaney R -I
Zoning pp
Type of Const
(Actual) V-N
(Allowable) V-U
ll oF Stories
Length // ,p
Depth y6.0
S.F. Total
Footprint S.F.
FEES
Permit 37y.a0
Sureharge 31.50
Plan Review 17.00
SAC, City /00,00
SAC, MWCC 1 ,oD
Water Conn zJ5.
Water Meter b9, 00
Road Unit 03 5• 00
Treatment P1 190,00
Parks
Copies
TOTAL ,? .?LL
5 0
?
? m4 ati-r
22x22 = tiKvIXlz=580$
'SSmT.
3$x2v= 9?2Xfy= 12?G8
?5T ?LOCAQ
,IOXg
?OaZ
x yyz yyo88
,.. ;.
?
p r - 1:.OA,
' TRl-LAND C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE, ROAD
EAGAN, MINNESOTA 55122
SITE PLAN F4R:
JOE MILLER CONST.
LEGAL DESCRIPTION; LOT-2-,BLOCK i, 1.EXlNGTON PARKVIEW
ACCORDING TO THE RECORDED PLAT
THEREOF QAKOTiS, COUNTY,MINNESOTA
NORTHVIEW PARK ROAD
0
4zr
S 89° 43' 03" E
(84era) 85.00
5 J'4
?
w
?O
C.)
L:+'1 I $ o
e ?
O
Z
QV° ?0??
n
38
LOT Z
s
LD
r?
(avgXvl
wi?wgc n•IU{:i;1q Eo-rc.?+e
85.00
S 89°43'03"E
LEGEND
o DENOTES IRON MONUMENT
a OENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELE VATION
(90ofo) DENOTES PRQPOSED SPOT
ELEVATION
?- DENOTES DRAINAGE DIRECTION
1 hareby certify that this survey,plan or
report was prepared by n?s or under my
direct supervision aod that I am a duly
Rapistsred lond Survtyor under fhe
Laws of iho State of Minnesota
.C
, ,.?;,..?.:: I ,
9radley ; nsMn. Rep. No.15239
Dats ' (I ' tf !'j
3)
0
?
W
o?
a
kn$
O
Z
_I
h
! CII 3
Sco.le : 1"= 30'
INVERT EI..EVATION AT SERVICE EkTENSION=
PROPOSEO GARAGE FLOOR ELEVATION = ?
PROPOSED FIRST FLOOR ELEVATION = 901,3_
PROPOSED BASEMENT FLOOR =
ELEVATION
N07E * VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
g7'I '
' - t:JCrERZOR ENYFZOPE AYERAQE "U ° COMPIJTATION
(Sb be eubia3tted'dth.building permit application).
„ .?': ' .. .
,
Oae or Two Famlly Dwelling ? Oxaer
All Other 6T Z B??C ? ?_AViaa'?c,n ?ar?2u?e«J &ite Addreea ?
Coatractor }01u'E?L 60/i7ST,
$a-IdZ
Date Phone 3/-aao/
LINEAL FEET OF
'6// 1 BfiS Av
EJCPOSED YIALL ?? o?/?£ET ft. above grade o ) •
TOTAL aX.°OSED WALL AReJ1 SQ. FT,
0?AQUE W1:LL CONSTRU:TI01:: "U" Value x Area
netail F?'Rlw_ .043 x s2.
referenee ?%ok/C, 'n?!.? x S4.
fivm ' TZl N? t1(J14 . x SQ.
x SQ.
attached @lUll X SQ.
sheete uvlt x S
Q•
Y/INDO'HS: "U" Value x Area
PSa:ce & TYPe ..3thT 1rU" . S/ x SQ.
11 u vUlt x SQ.
11 ti - ,iIIll z sq.
u n - - -- -t`0„ Y SQ.
DOORS: "Ull Value x Area
Mate & Tyne
u u
n n
n u
TOTAL (U)(A) VALUES
DIVIDLD HY TOTAL 1lALL AREA
AtIERAdE "Ull 55 r leea for 1&2 femily dwellinge
ROOF/CEILIN(3 :
TOTAL,AREA: 1S4
FT. 0.2v. 3.Z1 M(A)
Fr. 1Zf3,Ro- 5.64(u)(a)
FT. - (U)(A)
FT. - (U)(A)
Ff. - (U)(A)
FT. 87•10 = . (U) (A)
FT. 107,90= q•SI (U)(A)
FT. (u)(4)
FT. - (U) (A)
FT. - (II)(A)
FT. .oo (II)(A).
FT. .o =-?(U)(A)
FT. - (II)(A)
F'T. - (Q)(4)
Ler. 16(a.44 (U) (A)
Dotail.refereace n0ll . •OL/ . x SQ. PT.
%
rrom x sQ. _
£T. ;:.
6Lt8C}l!d . Bh99LH. ' °U1e Y''SQ. FT.?_
Describe ooeninga SQ. FT.
in. roof. upu x.3Q. prp.,7
TOTAL (Q)(A) VALITES DIVIDED ,BY
20.03 T&TAtLZ7 9
a
TO±AL R003'/CEII.IT40 AktaA 9.!;741 :OZ
AVERAGE "U" A13)for ventileted roofe. r -
Ik,KVC, aU° ,14 x SQ.
b.CTio 47 z •SQ.
I'UII x SQ.
ttIIot x .SQ.
2OTALS /S S, 00 Q.
AVF.RAUE "U"
zo-es(.u)(A)
_ _(0)(A).
? .
E`- N; FT ' ? n3 to (A)
Detazmiaiag IOII'f valuee at Roof. Wsllg Rim, and Coae. Block
RoOF/CEIt,INU
t.) Interlor Air r'llm
z.) 5/8oo ayp. sa.
3.) Ineuletion
4.J
5•) Exterior Air Film
( STII.L )
R VALQE
0.61
-56
44.ao
.6t
"p" a 1/R= a`OTAL (R)=[??.?,78
WAI.L
6.) Interior Air Film
y,) 114 ayr. ad.
8.) Iasulation
9.) Za'aL" &Prcr-RirE
10.) Masonite Siding
11.) Exterior Air Film
R VALU
0.68
.45
M0o
Z,o¢
6?
.17
„U" _ ,/x= , 043 ToTar, (a)= Z3.01
?
?
RIM
12.) Znterior Air Film
13.) Insulation
1L.) 2" Fir Rim Joiat
15. ) z-;/3z" DOIe.r- ?rE
16.) Maeonite Sid?ng
17.) Exterior Air Fllm
(R) VALUE
0.68
l9.00
Z,o4
b'/
.17
1/R, .Ogp TOTAL (R)-N ?
?
FOUNDATION
18.) Interior Air Film
t9.)
zo. ) Fie?.? &.03,
21.) 12" Ccacreta 81ock
22.) ..
23.) Exterior.Air Film
(R) VALIIE
O. 68
//•oo
t . 28
.17
glU" 0 1/R' 'nl'rAL (A) °r3.'7
?
r
I •
' "? ?l.b? ?f??T 1l
??
l4.SoX ?27fL9+ 36 t36? ° /885. ar?-?
Co,oc.
•Co?1C (Z9t29t 5&t3Fv? _ $7.1 p ?
6-^S-e?r
• 83 )( ?ZYtZ9t3?-j6? - I07-90
Cc?t f?Dows
4.o x9X=
z•x3?= s.o- x G =
Z4 X 36 = (o•o X 4=
zo x46 _ (v,7 x 4 =
z4x48a 8.0 x 4 =
hvv?-C?-
3" sT/--
Z? ST?.
G-°PA?
Jf0,ev
30.00
7f}, o0
Z(v,So
3L . oc
--
?ta.? •. zs.oo
S,ez ? Zl.oo
r?o = 4z.oo
9/• ??
l?sr.;?v ?
/o 7,90
: •, lvD? . ` ?g, go - 414q. SO
i Aao,?S 4/.00 ?_
1,47o.z?k
?
I9 C/o
y
1991 BUILDING PERMIT APPLIC
CITY OF EAGAN
SINGLE FAMZLY DWELLINGS
MULTIPLE DWELLINGS
?
COt4MERCIAL ? S
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL /
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WEI$N: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MOST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING YERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS SEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
61t5 e+wpt13Lo JU L 05 R 0
To Be Used For: F%:'is Valuation: Date: }' 5"? ?
Site Address 10ai
Lot ? Biock ?
Parcel/Sub '?4' Pajt?itti?
Owner !S++vt Stoipra
Address io`+Z. No.i?.vzc? PlL20
City/Zip Code ?f??•?ti??M1?1 55iZ3
Phone L15'-1-5&LI-7
Contractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
OFFICE USE ONLY
FEES
Occupancy Sldg. Permit ':MOD
Zoning Surcharge ?
Actual Const Plan Review
Allowable SAC, City
# of stories SAC, MWCC
Length Water Conn.
Depth Water Meter
S.F. Total Acct. Deposit
Footprint S.F. S/w Permit
S/W Surcharge
On site sewage_ Treatment Pl.
On site well Road Unit
MWCC System _ Park Ded,
City water _ Trail Ded.
PRV _ Copies
Booster Pump _
AYPROVAIS
Planner _
Council
Bldg. Off.
Variance
SUBTOTAL
Penalty
I,ot Change ??
TOTAL
Phone #
j6t?-?agrees that all work shall he done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*K)T6: PAYMMs QF FEE AT TIM OF
apPLIcAzorr noEs riom CONSTITUTE
APPROVar. oF PERMrT.
nvsrncriort oF sEWER Arm/OR vATnz
TTiSTATSATTQjQ$ Wny NOp HE $CHED-
UI.ID UNPII. PERMLT HAS MM
APPRdVID.
P ease Print
1) PROPERTY ADDRESS: '-
LEGAL DESCRIPTION:
IF E7ISTING SiRL'CiLR2E, DATE OF pRIGINAL Bt)ILUING PERMIT ISSUANCE: ,
hbn ear ..
PRFSEUP 7ANING/PROPOSFD C'SE:
Q COMMERCIAL/RETAIL/OFFICE
Q INN.iSZRIAL
n INSTIZUTIONAL/GOVERNMENT
3' R-1 SINGLE FAFffLY
Q R-2 DL'PLEX (Zwo Onits)
? R-3 TOWNiOL?SE (Three + Units ) ( Units )
? R-4 APAR7MENTT/CONIDOMINItT7 ( Units)
2) ? -
NAP9E:?
ADDRESS:
CZTY, STATEr ZIP:_
. ?
PHONE: L?"S? oZOb/
3) • c?NAME. For City Use ..
Pltunbers License:
ADDRESS: 1VA2 f' ;?3i2-D A? Active
Ekpired
CITY. STATE, 2IP: }??TA-') Not recorded
PxorE: ,.S5"5?-367,? rAszm LIcavss# ?a?5 S??nitlai
4) •• ??.i.i?:
tuArE:_ Saruc
ADDRESS: .
CITY, STATE. ZIP:
PHONE: .
5) ?? r• • a• : a ? ??
B'CONNECPION 7O CITY SESM G;-S;OMII]CpION 7O CITY WATER ? OTEIER_-
6) ?? •' •• MPtE-A,qE HOLD APPROVID PEEtMT FOR PIQC-UP BY ONE OF AB(3VE --- ---
PLEASE MAIL APPROVID PEE2MIT TO 1, 2, 3, 4, AHOVE .
, „ _ (Ciscle one) ' , ' .
:-FOR .CITY USE ONLY
PERMIT # ISSOED
J// / -
Pd w/Bldg. Permit
s
s
$
FEES:
$ /n _ 5?
$
s
c
$ $
$
$ $ ?.zi • <9 Z)
$ ?i7S •?L? $
S
$ $
$ $
$ $
S
$ $
-- 7 -7a ?7 7y
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLDDE SURCHARGE)
11
WATER METER/COPPERHORN/OCTSIDE READER
?.
WATER TAP (INCLODE CORPORATION STOP)
SEWER TAP I
ACCOUNT DEPOSIT - SEWER
ACCOONT DEPOSIT - WATER
wac +
SAC
TRLNK WATER ASSESSMENT I,
TRDNK SEWER ASSESSMENT
?
LATERAL BENEFIT/TRUNK SEWER
LATERAL BENEFIT/TRONK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER: I?
TOTAL ?
!
RE EIPT RECEIPT
I
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION. I
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
v li '
DATE:
?,
LOT: BLOCK: SUBD./P.I.D
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
-#- y? 7'?. v
Name: J?OI p7Q v+?- Phone#: &SY 76T ?Q1/
aS} , First
New Construction Reauirements
? 3 regfstered site surveys showing sq. N. of lot; sq. H. of house
and all roofed areas (20% maximum lot coveraae allowed)
? 2 copies of plans (show beam 8 window sizes; poured fnd. design; etc.)
? 1 set of energy calculations
? 3 copies ot free preserva}lon plan if lot plaNed after 7/1 /93
)v Rim Joist Detail Options selection sheet (buildinas with 3 or less units)
?k ?g?°
DATE: 11??IoO CONSTRUCTION COST: Y
DESCRIPTIONOFWORK: ?- Pc?df ha?at JfmuHi-familybidg.,howmanyunih?
STREET ADDRE55:
PROPERTY
OWNER
Street
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
9z
City /a n State: A9vl-T_ Zip:
V'T/2T,
Company: artisfiNea- 0AI cOrf' Phone #: 703 yay.sY?L..-
(area code)
CONTRACTOR Street Address: License# 10`34p Exp. !410/
v IY??G
Ci{y ?j?bpfl? ? State: owol Zip: 5 J 7 y3
ARCHRECT/
ENGINEER
Telephone i: (
Street
CMy
1113' 15
Remodel/Repair Reauirements
2.copies of plan
1 set of energy calculafions for heated additlons
1 site survey for exterlor addiflons & decks
- Name:
_ Regisfration #:
State: Zip:
Sewerlwater licensed plumber (if installina sewerlwater): Phone #:
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnafure of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes - No _ Not Required
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 1 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 37 ' Ext. Alt - Multi
0 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 ? Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 361 Multi
? OS 03-plex ? 11 10-plex ?• 19 Lower Level 0 24 Storm Damage
? 06 04-plex
_ ?
.. 12 12-plex Plbg_Y or _ N ?_ 25 Miscellaneous '. ,
O 31 New ? 35 Int Improvement ? 42 Demolish (Foundation) ? 45.°Fire Repair
?. 32 Addition ? 36 Move Bldg. ? 43 Reroof ? 46 ' Windows/Doors
? 33 Alteration ? 37 Demolish (Bldg)• ? 44 Siding '
? 34 Replacement ? 38 Demolish (Interior) '
• Demolition (Entire Bldg only) permit • Give PCA handout to applicant '
VALUATION Occupancy MGES System I
Census Code Zoning City Water
SAC Units Stories Booster Pump ?
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width ?
INSPECT IONS REQUIRED
Footings New Bldg Insulation •` __ _ _ Windows - new/replacement
_ Footings: Deck _ FinaUC.O. _ Siding ;
_ Footings: Addirion _ FinaUNo C.O. _ Stucco/Stone
Foundation Fireplace: _ r.i. air test Final Roof: _ ice & water _ final
_ Framing Pool: _ ftgs _ aidgas tests _ Final ?
APPROVALS i
i
Planning Building Engineering Variance
Base Fee
Surcnarge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Park Dedication
Trails Dedication
License Search
Copies
Other
Total:
For Office Use Q I
• I Permit
Clt of ~a Qll NOV d 2009
I
3830 Pilot Knob Road I Permit Fee.
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I C~ I
Fax: (651) 675-5694 I Staff: L Z~
I j
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~ Site Address: ~ _r~, ~ CQ
Y~~U }L
Tenant:
Suite
RESIDENT / OWNER Name. Pho e:
Address / City/ Zip:
Applicant is: Owner ntractor
TYPE OF WORK Description of work:
r'
4~0 - 'A
Construction Cost: Multi-Family Building: es / No
CONTRACTOR Name: a(o_-License "I_C
Address: ,~Tqo Ln n) 62 oC_hk ed l
City: State: " ip: f a
Phone: Contact Person: Cy AP's
COMPLETE THIS AREA ONLY IF CONSTRUCTING
A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the "are trade secrets.
I (hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x~~~~~~ x
Applicants Printed Name ppl' n s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168695
Date Issued:04/29/2021
Permit Category:ePermit
Site Address: 1092 Northview Park Rd
Lot:2 Block: 1 Addition: Lexington Parkview
PID:10-45035-01-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Amanda Webster
1092 Northview Park Rd
Eagan MN 55123
(651) 408-3241
Archer Exteriors
820 N Concord St Ste 106
South St. Paul MN 55075
(651) 493-4156
Applicant/Permitee: Signature Issued By: Signature