4028 Northview Ter INSPECTIC)N RECORD I Control No. ( A1
CITY 4F EAGAN ,/'? PERMIT TYPE:
3830 Pilot Knob Road Permit Number: Oa?a T? ti
Ea gan, Minnesota 55123
? Date Issued: eb Ji 6 I9;?
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOr , 10 "10(: h: 1 ?
4028 NORrHVIEw rER ? t t Ff*iFBR llai'T
1.FX PARif1/.IF.Ia ((54 ?: ) 199b-•9696
PERMIT SUBTYPE:
NA'iF.IdF /il F iNISH
F
L
TYPE OF WORK:
AI: 'tFFtAFiON
if111r1kka: kfi:t 1C+f * SEPARArF PFNl1.lTS REL?UIRrtl FOR ELPc b F•I.Hh
Permft No. PermR Holder Date Telephone N
S/VN
PLUMBfNG ? G ?a
HVAC
ELECTR<
ELECTRIC
Inspection Gate Inap. Commenta
Footings I
6C? C?L/7 /r' a0/L
Foundffiion
Framing
Roofing
Rough Pibg.
Rough Htg. q !i
Isul.
,
Fireplace
Ffnal Htg.
Orsat TeAf ?
Flnat Plhg. Plbg. inspector - Nolity Pfumber
Const. Meter
EngrJPlan
Bldg. Flnal
Deck Ftg.
Deck Ftnai
Well
Pr. Disp.
? ? * • CASN RECEIPT
?.
CITY OF EAGAN .
3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 • r
f J ?.
C.?
DATE-
•i
, AMOVNT
8 DOLLARS
,oo
? CASH Q CHECK
r
i i
C' ?U
UJ .
f ??__T ] .7 ,?i I. t 0, J
FUND OBJECT ? ` • T AMOUNT ?
Thank You _
BY
C ? ?
Pir*-FWe Copy
i BLDG. PERMIT NO. ? . .. ? . ?,g d'
01-3210 Bldg. Permit co
01-3422 Plan Check ?G
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge V,
75-3860 Road Unit
20-2275 SAC
?0-3865 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.
28-3855 Park Ded.
TOTAL
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for 51 !: ' '? ? •:?t'+1` Est. Value w y 5+ Ci ` ' G Date r• • ? LS-. 21) , 19 ?Site Addr?ss _?2$ NQRTFiVIEW TEI2ztACL
Lot Block 3 SeclSub. LEXI«GTON
Parcel No.-
"g?? bIL?R CONS7I?LtCTION
?.'?
W Name J ?'?.?
o Address 1a13? ?D?` a? 5
City FARMINGTON Phone 431-2001
cc Name SAl• ?.
,o
?¢ Address
? City Phone
v¢
WW W Name
? ; Address
? W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Miqnesola Statutes and City of Eagan Ordinances.
Signature of Permitee
A Building Permit is issued to: J0S '.°tl N:I LLEF? Cviv?T
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
Occupancy R-j 1+- 1 FEES
Zoning pL &-1
(ActuaQ Const 'N Bldg. Permil 6 1 `; • Uo
(Allowable) V-N Surcharge 47.50
# of srories -
???
Plan Review 309.00
Length
Depth 36' SAC, City 100.00
S.F. Total - SAC, WICWCC 575.00
S.F. Footprints -
On Site Sewege
_
Waler Conn 580.00
On Site Well - Waler Me[er
MWCC System -XK. -
1
'
3L`
City Water ?? Acct.Oeposit ,
..
PRV Required _ SM! Permit ?U• ?
Booster Pump - S+W Surcharge 2•00
Trealment PI 228.00
APPROVALS Rnad Unit 3?Q `'ln
Planner - park Ded.
Council -
BIdg.Off. _ C°pies
?
Variance - TOTAL
SEWER & WATER PERMIT
CITY OF EAGAN --
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
r; •.?
SITE ADDRE SS f }
LOT _&OCK .
APPUCANT:
ADORESS: '
CITY, STATE
PHONE:
OFFICE USE ONLY
? 2qf;`i')
PERMIT DATE
WATER PERMIT # r?c /' SEWER PERMIT #
METER # B.P. RECEIPT # ?w 1294
READER # B.P. RECEIPT DATE
METER SIZE
ISSUE DATE - PRV - BOOSTER PUMP
PERMIT REOUESTED
ZIP
PLUMBER: /?' "? •' ? ?? '` ` ? ?
ADDRESS:
CITY, STATE ZIP
PHONE:
OWNER: -
ADDRESS:
CITY, STATE ZIP
PHONE:
ySEWER X WATER _ TAPS
- COMM/IND - RESIDENTIAL
? NEW - EXISTING
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES:
. , --•--
?
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERIAITS, CONTACT
ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
SITE ADDRESS _
LOT _BLOCK
OFFICE USE ONLY
PERMIT DATE 3/29/ $`?
WATER PERMIT # SEWER PERMIT #
METER # B.p. RECEIPT # 1-1 1294
?EABEPB.P. RECEIPT DATE 3 ! % 2189
METER SIZ?
ISSUE DATE - PRV - BOOSTER PUMP
APPLICANT:
1
ADDRESS: ' r ?33 dfi
CITY, STATE n/% -62-i"] Zlp
PHONE: , . ci OL%
PLUMBER:
ADDRESS: ',?/ CITY,STATE -It.liG%.&?L..i /?9AV ZIP `
PHONE:
OWNER: _
ADDRESS:_
CITY. STATE
PHONE:
ZIP
PERMIT REQUESTED
? SEWER ? WATER _ TAPS
- COMM/IND
? NEW
_ RESIDENTIAL
EXISTING
I AGREE TO COMPLY WITH CITY OF
EItGAN ORDINANCES:
r ;
i -?--?
? ?-1•Lt? ?. ,?-' / ? - ,;i., :?-.--0
SIGNATURE WHE METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMfTS, CONTACT
ENGINEERING DEPT.
?aT?? ? 562+/?/? CIT`r OF EAGAN 16230
• ?. 3830 Pilot Knob Road
P
O
Box 21-199
Eagan
MN 55121
.
,
,
.
,
PHONE: 454-8100
BUILDING PERMIT Receipt # ?
To be ged for --F f'?/GAK Est. Value 495100C Date !1ARC H 1 g f:9
Site Address 402` 7'r".1tP.ACE
Lot Block ? Sec/Sub. LLXINGT'Ur OFFICE USE ONLY
Parcei No. occupancy a"3 M'"1 FEES
PL N-1
Zoning
Name ?US?Pli ?.:ILLER COlKSTRUCTIOl? (,4ctual)Const V"4 BIdg.Permit 618.Q13
W
o Address 1$133 CELAtt AY:.? S (Aibwable) V-V
47. ?jQ
S
h
urc
ar
ge
Cit FAR''-`Y?TON PhOlle ?+31-ZOCi 1
Y # of Stories _ 3
9
? Plan Review
Q
+?
length
p Name L'A 4X E Depth 361 City 100•00
SAC
Z ,
o
? Address S.F. Total 57
5
00
u SAC, MCWCC
.
5
? City Phone S.F. Footprints -
1Nater Conn 580•00
On Site Sewage _
?
W W
Name
On Site Well
-
Water Meter ?- ?
r=
Address
MWCC S stem
y
3
?
? Z
a W City Phone ciry waler X 0•
Acct. Deposit
S/W Pe
it ?
PRV Required _ rm
I hereby acknowlege thai I have read this application and state that the Booster Pump - SMI Surcharge 1•oo
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. 12$ ??t3
Treatment PI
Signature of Permitee APPROVALS Road Unit 340•M
A Building Permit is issued to: US'-V °•t ?LLL7. CONST Planner park Ded.
on ihe express condition that all work shall be done in accordance with all Council _
applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. gldg. pff. _ Copies
2,938.50
Building Officiai
Variarice
-
TOTAL
Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING d?? ,V3
H.V.A.C. It?v a? o
ELECTRIC n
Inspection Date Insp. Comments
Foolings I
Foundalion
Framing
Roofing
Rough Plbg. - _ r A
Rough Htg.
Isul. AP
Fireplace /' ? S
Final Hig. - J`?Yt7 z5
Final Plbg.
Const. Meier Plbg. Inspector - Notify Plumber
Engr.lPlan
Bldg. Final
Deck Ftg.
Deck Final Z
Well
Pr. Disp.
?
..?. .:
•.?.
y f 'M /
f ?
. ? (Itr#if trate uf Mrrupanry -
.
titp of (Eagan
arpartmmt ? lutiabv 3wPrrim
This Certficate issued pursuant to the requiremenls of Section 306 of the Uniforrn Builrling
Code certifying that at the time of issuance this struciure was in compliance wilh the various
ordinances of the City regulakng building construction or use. For the following.•
ux cUWrx.aon or L""?ttliM amg. ttm
0-uw-Y TYx R3/M1 zmiins nWna ?? ? iM
ow= or Bwlding .TtE IrQLiER OGMT. Addrm 18133 CE]AR
awkhas Add= 4028 NDRMIVIW IERRACE ,,,ity L 10, B3, LE
-
n,te: MAY ?k, 1989
? B '
L wldi°8 0t5 -
POST IN A CONSPICUOUS PLACE
No. 16230
1%
..1
• • • PERMIT # ? J
MECHANICAL PERMIT
' RECEIPT # -•' • . CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 ?
Site Address • . ' '? ?• ? , `1. ? ? `-?? . ? . -' - ' ; = BLDG. TYPE WORK DESCRIPTION
Lot!r_ Block Sec/S?b
-tf J i G v? Res. ? New Mult Add-on
Name
Addre?ss yC 1 '_=t Comm. Repair
Other
c City Phone --
Name A`? , FEES
? RES. HVAC 0-100 M BTU -$24.00
c Address - ?' i_?tj l_U ' ?? A It, ADDITIONAL 50 M BTU - 6.00
O City ' --1 S C.Y'i, I1?ti ? Phone ? ' ? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIn - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU '`F. GC,? APT. BLDGS. - COMM. RATE APPUES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. - M BTU $ MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
'Vent T CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other ?
FEE
S/C: `SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
??a.
PERMIT # !` -
' • PLUMBING PERMIT RECEIPT #
CITY OF EACAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT`PRICE: PHONE: 454-8100
..
Site Addressry Z. t' - ' c
Lot ' Block ? Sec/Sub
m -??- :.., t?r !x L .,,_,
Name ? "f •
,
? Address
c Ciry '! -?t7 Phone ?
. Name 7
,
3 AddreSS
p Ciry
-E> Phone7 _
?
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
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE. - WORK DESCRIPTION
Res. New .T_
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO.1 FIXTURES TOTAL
,y Water Cfoset - $3.00 S '-
__TBath Tubs - $3.00
?_Lavatory - $3.00
--- /-Shower - $3.00
_LKitChen Sink - $3.00
Urinal/Bidet - $3.00
?Laundry Tray - $3.00
Z_Floor Drains - $1.50 f' -
? Water Heater - $1.50
Whirlpool - $3.00
=Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
DATE:
3/39/89
4028 tdORTHVIEW T6RR., L10, B3, LExINGTON PARKVIEH
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.PYSLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
r. •
- YB% $ewer & Water Permit for the above property cannot be completed for the following
° reasons:
e
t•
Vour Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notlce.
COMMERCIAL PROJECTS ONLY: Please pay for meter at Ciry Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors -454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REDUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
DATE:
3Ja9189
4028 N0$THVIBW YEH&.. L10, H3, LEXIPi610N PAHKVIBW
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
CpLL Pl2BLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Y •
_ Your Sewer & Water Permit for the above property cannot be completed for the following
`- reasons:
_ Your Sewer & Water Permit forthe above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size musl be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES-TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT POR WATER TURN ON POLiCY.
Secretary, Building Inspections Dept.
CITY OF EAGAN N? 16230
3830 Pilot Knob Road P O Box 21-199 Ea an MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
Tobeusedfor SF DWG/GAR Est.Value $95,000 Date MARCH 29 1989
Site Adslress 4028 NORTHVIEW TERRACE
Lot 10 81ock 3 SeGSub. LEXINGTON
Parcel No.
WlName JOSEPH MILLER CONSTRUCTION
o Address 18133 CEDAR AVE S
City FARMINGTON Phone 431-2001
Name _
Address
City _
Phone
r
ww Name t
x= Address
aw Citv Phone
I herehy acknowlege that I have reatl this application and state that the
information is correcc and agree to compty ith-ell applicable Slate of
Minnesota Statutes and ' of Eag,an Or " nces. tiM1w`??
Signamre of Peimitee ? et'Ll
A Building Parmit is issued to:
on the express condition Ihat all ork shall be done in accordance wi[h all
applicable State oi Minnesota Statutes arndry Cy?iry f Eagan Ordinances.
8uilding Otlicial Q a f?. ! I r I?I
r t
OFFICE USE ONLY
Occupancy R-3 M-1 FEES
Zoning PD R-1
lActuap Const V-N Bidg. Permit 618.00
(Allowable) V-N Surcharge 47.50
# of Stories -
309
00
Lengih SjA-, Plan Raview .
oepm 36 sac,aiy 100.00
S.F.TOtal - SAC,MCWCC 575.00
S.F. Footpnnts -
On Site Sewage - Water Conn 580.00
On Site Well - Water Meter on _ nn
MWCC System _xX- 3
XX ?+cct Deposil 0. 00
City Water
PfiV Required _ SIW Permit 90.00
Booster Pump - SM15urchargB 1.00
Treatment PI 228.00
APPFlOVALS Road Unit 340.00
Planner - park Ded.
Council -
&dg. Off. _ CoPies
938.50
2
Variance - TOTAL ,
7 ,
?
,
Request Dafe Flre M. gh-In Inspeclion
(iqpuiretl?
? Reatly Now II Will Notily Inspector
4- 6- 8 9 plras ? rro vmen rteaM?
nlicensed contractor ? owner hereby request inspection of above electrical work at:
,bb Atltlress (SVee6 Bon ar Route No.) Liry
4028 Northview Terrace Eagan
SeIXion No. iownship Name or No. RamJe No. County
Dakota
Occupam (PRINT) Pho. No. '
Joe Miller Construction Co. 431-2001
Power Suppiier Addrass
Dalctoa Electric Farmington, MN 55024
Electrical Contrac[or (Company Name) CaMractor§ Licansa No.
Midland Electric Inc. 041610
Mailing AOCress (COMractor or Qwner Making Installatlon)
14055 Grand Ave So, Suite E, Burnsville MN 55337
Aul?orizeE Si nature (COriltedotlOwner Making InsYallaGOn) PhonB Number
892-6688
MINNESOTA STATE BOARD OF ELECTRICfiV THIS INSPECTION REOUEST WILL NDT
Grlggs-Mkhvay Bltlg. - Room 8.173 BE ACCEPTED BY THE STATE BOAPD
1821 Univarairy Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
PMne (612) 602-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
li? See Ins4uclions br completing Ihis fortn on back ot yellow copy.
? '8 57-9 0 `X" Below Work Covered by This Request
..•
ii?? ?'
'7?'? $?9 Y
ew Add Rep. Type of BUilding AppfiancesWired EquipmerkWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm ' Air Conditioner
Olher (apecity) ConVatlorS Remarks:
Compute lnspection Fee Below:
# .Other Fee # ServiceEntranceSize Fee # Cirouits/Feeders Fee
Swimming Pool 0 to 200 Amps O Io 100 Amps
Transtormers Above 200 _ Amps Amps
Signs ' Inspemor§ Use only; TOTAL
Irrigation Booms /
()0
?
Special Inspection
AIarMCommunica[ion
Other Fee
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Pough-in
F;oei oa ? ?
oa
3
OFFICE lISE ONLY ?
This request vdtl 18 months iro.
? .
?
?
??793
f
? $30
3
•
Request Date/
LO /
!`/?
L ire No.
Rough-in Inspection
Re 'redY
? Reatly Now Will Notity Inspedor
V
O s G No hen Ready'!
I i] licensed contractor )<owner hereby request inspection of above electrical work at
Job Atltlress (Sireet Box or Route No,l Ciry
?
Section No. Townshi0 ame or No. Range No. Counry
OccupanllPRINT?
?.G?' E 2
No
Phone No.
Power SupOlier Mtlress
EleMncal onVador IGompany Namel ConVactor5 License No.
SoconsJe
Mailing Atltlress IGOnVanor or Owner Making Instellalion)
--.? Y`
Aolhorize0 ' nature IConh Ownar Making Installalion) P?one Number
MINN TA STATE BOAPp ELECTRICITY THIS INSPECTION REQU T WILL NOT
Grigge-MiEway Bldg. - eum Si]] BE AGCEPTED BY THE STATE BOARO
1821 University Ave.. SI. l. MN 5510G UNLESS PFOPER INSPECTION FEE IS
Phone (612) 642-0000 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-0000'1-/O8 ? ? See Iretmcfions br completing this form on back oi yellow copy. ?
?
- 427 9 ? ?"X° Below Work Covered by This Request ?•?.4:lewAdd Rep. TypeofBUiiding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric Heating
Apt. Building Dryer Other (Specify)
Comm.llndustrial Furnace
Farm Air Conditioner
Other(specifyl ConVamor marks'? /^/ /
Compute lnspection Fee Below.? r "??? "
k . Other Fee # Service Entrance Size Cimuits/Feeders Fee
Swimming Pool 0 to 20Amps ft j 100 Amps
;
TranSformers Above 200 _ Amps L 100 _ Amps
Signs Inspector3 Use Only: OJ Tp7pL jcp_
' Irrigation BoomS -zQ
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MJ:INTHS.
I, the Eledrical Inspector, hereby Rougb-in
i
certify that the above inspection has
been made.
/
OFFICE USE ONLY This requesl voia 18 monfhs irom
b(pq3(
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
/5.so
Date ? 1 -?:4 0 1 a
Site Street Address qba'R r10r ff^?vIeA,t1 7errnrQ. Unit #
Property Owner 172l/LL aiO Telephone #0S1) b? -a?PRln
Contractor a. XYI/A11 i r r' L o Telephone #('71S) -398 lo - $l0(07
Address [O Ciry A Jd4/°t/'1 StateJAT Zip r^.?ID/(o
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
f
-1/ $ 15
00
water So
tener
w _ Water Heater .
_ replacement additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
0
Total \?1 SEY $Jlri?
I hereby apply for a Residential Piu , mit and acknowledge that the information is compiete
and accurate; that the work will be i conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work ill be in accordance with the approved plan in
the event a plan is required to be reviewed and appro?d. ? j
J; m Scbc)k)ej2.. `
ApplicanYs Printed Name A I ar
RESIDENTIAL
507 BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
851•681-4875
NawCansirucflon ReoufremeMe
• 3 reglSlarBd sBe 5urveyS ehowirg sq.8. of bt, 9q. k. of nouse; and all roofBtl areas
(20% maximum bt coverage alhwed)
. 2 copies of plen showing beem & window s'uss; poured touM tlesign, etc.)
• tsetofEnergyCaCulatbns
• 3 cople5 of Tree Preservatbn Plan H lat plettatl efler 711193
. Rlm Joist Detail Optlpns seledbn shaet (bldgs wRh 3 or less unNS)
DATE
Water Softener
_ Water HeaCer
_ No. of Baths
7ULTI-FAMILYBLDG _Y XN
FIREPLACE(S) ;0? 0 ,9 1 _ 2
APPLICANT?r a-s l nc •
STREETADDRESS I ,?-S`17 N lto/%}'l?vc. So. CITY5vr J/svr//c STATEAIA/ LP 55 337
TELEPHONE # 952 -7v7-G?is 9 CELL PHONE # (o t0V-9/j- FAX # 9S?-70 7' ?2f-
PROPERTYOWNER biGislG O t1"C TELEPHONE#65/- J?as -JD6?
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDIN6S ONLY
Energy Code Category _ MIIVNESOTA RULFS 7670 CATEGORY 1
(4 submission typa) • Residential Ventilation Category 1 Workshaet Submitted
• Energy Envelope Calculations Submitted
JUN 0 4 2OO2
Plumbing Conhactor: _____
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovety System
Phone #
Phone #
Submitted
Fee: $70.00
- ° ------ -------- °-----°--°-----------------------° ° ----------°°-------------------------------------------------
I hereby acknowledge that I have read thls applicatlon, state that the information fs correct, and ngree to comply
w(th all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Appticanf
OFFICE USE ONLY
Phone #
IO'b L ?)' s
pemotleVlleoaU Begulrements
• 2 wpies of plan
. 1 setM Energy Cakwlatlons for heated additions
. 1 stte suNey tor eAerior aGdAbns & tlecks
• Indicete M home senred 6y septk system tor atldttions
VALUATION l$
_ Lawn Sprir
_ No. of RI.
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation O 07 OSplex
? 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
? 37 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr, of Units
Nbr. of Bldgs
Type of Const
,
? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 16 Fireplace ? 21 Porch (3sea.) ? 31 Ext. Alt - Mulli
? 17 Garage ? 22 Porch/Addn. (45ea.) ? 33 Ext. Alt - SF
? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 19 Lower Level O 24 Storm Damage
Plbg_Y or _ N O 25 Miscellaneous
Int Improvament ? 38 Demolish (Interior) O 44 Siding
Move Bldg. O 42 Demolish (FOUndation) O 45 Fire Repair
Demolish (Bidg)' ? 43 Reroof 0 46 WindowslDaors
"Demolition (Erkire Bldg only) - Give PCA handout to appliCant
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth I
I
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation _ HVAC
Drain Tile Other
-
RooF _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas',Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) `
_ Insulation _ Retaining Wall
APProved BY Buildin9 InsPector
?
Base Fee
Surcharge
Plan Review
MGES SAC ?
City SAC Water Supply & Storage S&W Permit & Surcharge
Treatment Plant
Piumbing Permit '
Mechanical Permit
License Searoh '
Copies
Other
Total
INSPECTION RECORD I C°"t °"°. 0636
CITYOFEAGAN PERMITTYPE: auiLozNG
3830 Pilot Knob Road Permit Number: 000775
Eagan, Minnesota 55123 Date Issued: 06 / 15 / 92
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 10 BLOCK: 3
4028 NORTHVIEW TER FELHOFER MATT
LEX PARKVIEW (612) 895-9696
PERMIT SUBTYPE:
BASEMENT FINISH
TYPE OF WORK:
AL7ERATION
?:tai.REMARKS: RECEIPT M SEPARATE PERMITS REQUIRED FOR_ELEC-8 PLBG'." "'.
F
L
? PERMIT ? ' Controi No. 0636
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BuzLoiNG
Eagan, M in nesota 55123 Permit Number: 0 0 0 7 7 5
(612) 681-4675 Date Issued: 0 6/ 15 / 9 2
SITE ADDRESS:
4028 NOR7HVIEW TER
LOT: 10 BLOCK:-3
LEX PARKVIEW
DESCRIPTION:
'Buflding, Permit Type BASEMENT FINISH
? Building"41prk Type ALTERATION
't
Y1
,• ,???.-r ;i`, .?? ?f °„ `:±` ?7?" . ?.._.?.,r °'??'
,S
REMARKS:
RECEIPT 80- ('? ICII-1 C?l SEPARATE PERMITS REQUIREQ FOR ELEC S PLBG
FEE SUMMARY:
Base Fee $36.00
Surcharge $.50
Total Fee $95.50
CONTRACTOR: OWNER: - Applicant -
fELHOFER 69ATT
4028 NORTHVIEW TER
EAGAN MN
(612)895-9696
I hereby acknowledge tha:t S havo read' tM3:s s°ppkication and stste that the
informati-on Se aa.rraoC and agree co campiy with ell app21ca61e StaCe of 14n.
Statutes antl City of Eeg,an Ortlfnances.
? -
t !1 ll,C-
AP ICANTlP RMITEE?$ NATURE y ? ISSUE YIGNA RE
/
PERMIT #• ' CITY OF EAGAN P? S. S O
REACTIVATE ?? 1992 BUILDING PERMIT APPLICATION
681-4675 e"110??k44?
Ju w o ? REC?
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
specifications, 1 copy of enerqy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Address:_ 6t'o 28 /C/o,- 7,4e?. I erruz, e
STREET , SUIiE R
Tenant Name: (comnercial only)
LOT _? BIACK-? SUBD? ?n /J " _ 1
?/?2L(i1NP. y? p , i , D . #
Descri tion of work: r;l %s ,(jG,}Cvv? Pe+ {
The applicant is: 12fOwner ? Cantractor ? Other (Deseribe)
Name fe 161n 1?c, IA_? ff Phone ?%S = 96 9 6
Property LAST FIRST
Owner
Address 4/°29 /va, fti %err& G t
, STREET STE N
City _ ?u2?n State d`'r P" Zip Ssl Z 3
Company Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Reglstration #
Address
City State Zip
Sewer 5 water licensed plumber . Processing time for
sewer 8 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 Statutes and City of
Eagan Ordinances. -
Signature of Applicant:`
OFFICE USE ONL1l
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ,U 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory 0 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 5F Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
0 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 38 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst Fl. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
;Y of Stories Faotprint Sq. ft. Fire 5prinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS '
Planning Building Assessments
Engineering Yariance
REGIUIRED INSPECTIONS
? Site ? Footing p Framing ?0 Insulation
? Wallboard J!? Fi nal ? Draintile 0 Fireplace
Permit Fee veiuaeid,: g
Surchar9e
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Nater Meter ;
Acct. Depasit '
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other `
Total: ?
SAC %
SAC Units
SINGLE FAMILY DWELLINGS
?Ru(A"I v J 'e
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
14? 23?
LTIPLE DWELLINGS
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISSERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET QF 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 WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST'IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: p QC- ?? Valuation:
KSite Address
Lot _0 10 Block _5
Parcel/Sub L&xvNc-7bN PAp-KVje.,j
? dwner
Address QC 7-6 Iyoia7NUlt-Gc1 1?7Qi2AE.?:
City/Zip Code 5S I'Z -2,
Phone
f( Contractor S?iF
l?
Address
City/Zip Cade
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Date: 4? ?-C? (--)
OFFICE USE ONLY
COMMERCIAL
FEES
Bldg. Permit
Surcharge
Plan Review
144 70 SAC, City
r4'or7woN1#,SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
On site sewage_ S/W Permlt
On site well _ S/W Surcharge
MWCC System Treatment P1.
City water _ Road Unit
PRV _ Park Ded.
Booster Pump _ Copies
SUBTOTAL
APPROVALS Penalty
Planner _ TOTAL 4c,_
Council
Bldg. Off. ????
Variance
fRl-LAND C0.
SURVEYING
SERVICES
1260 EAGAN?,N LE ROAD
MINN SO A55122
SITE PLAN FOR:
JOE MILLER CONST.
LEGAL DESCRIPTION: LOTQ,BLOCK 3, I FXINGTON PARKVIEW
ACCORDING TO THE RECORDED PLAT
? THEREOFDAKOTg.- COUNTY,MINNESOTA
I S
Scale: I" = 30' 1 e
.n
L _k J I
??
?
? ?M1
l5'?(D 1?[
w 1
m'
i,
F?• ?
GAit
a
z4 15' O .
?
4°4b w •. ?
a N N
?
__--
? 10
ZI
OD
O
(?jl 5'
(J?
01 ?
? ti96
n 49
-l0
p
.19tiry ?
?
REYI^`? WU?
P N?SE ?
r2
? 0
?rys 1?
?? 2 W ?• ?-?'
GPR. N
-I
I ? I
I ? iC
N
I ?
OD
I ?
N
I5-
_ °'1zsa. m
I ?
? Z
II
?i
? I . '4p
Q
%-
'.
k,Ac,nlV ENGINk:E?iiP1, I?d;?„A4 W
? N0RTNUrE?OFFSETS NOT 70 SCALE
LE6EN0 ?INVERT ELEVATION AT SERVICE EXTENStON=
o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION = 93i. ?
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION= 93?
DENOTES EXISTING SPOT PROPOSEDBASEMENT FLOOR = 9Z3
ELEVATION ELEVATION
DENOTES PROPOSEO SPOT
ELEVATION NOTE'• VERIFY. ALL FLOOR HEIGHTS WITH
?- DENOTES DRAINAGE DIRECTION FINAL HOUSE PLANS
I hxaby cenify fhat ihis survey,plan or h J-
reporf was prepcred by me or undar my
direct supervision ond fhat 1 am a duly Bradley J. nson, Mn. RaQ. No. 15235
Reqisfered Land Surveyor undsr ths
Laws of the State of Minnesota. Date.31zLle9
ERGV. 3/z-?-/Dy rlousE c??• ? OFF56TS
o•*
F1s•oo+
47 • 50+
3U9•OiJ+
?k 1964•OD*
2,933•50*
?
618•UU+
47•50*
309•Oil+
1?9n4•OU+
`L938•50*
1`989 BIIILDING PEffiMIT APPLICATION - CITY OF EAGAN
SIIdGLE FAMILY DWELLIN68 14 L30
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/BOt9'sOWIdER MOST DESIGN9TE WHICH ADDRE6S
I3 DESIRED. NO CHANGFS WILL BE ALLOWED ONCE BDILDING PERMIT I3 2330ED.
M[Ji.TIPLE DW6LLINGS RENTAL UNITS FOa SALfi 1JNITS # OF UNIT3
INCLUDE 2 SETS OF PLANS, CEHTIFIC9TE OF SIIRYEY - CHECB WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
CONAfERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS MAR 2 d 1989.
To Be Used For: Valuation: ? Date: 3-67-82
Site Address "Mig N?rGfi-{/C?PJ /-f'i1/ta-C?3 ?6 oo,y OFFICE OSE ON[.Y
Lot l0 Bloek 3
Parcel/Sub U ?CP.Ldt'
Owner
Address
City/Zip Code
Phone
Contracto
Addres
J? City/Z
Phone 'tn I -?) UU i
Areh./Engr.
Address
CitylZip Code
Phone O
Oecupaney R-3 M-I
Zoning P D 2-I
Actual Const y-N
Allowable V-M
# of stories
Length fo4 -
Depth ?
S.F. Total
Footprint S.F.
On site sewage
On site well _
MWCC System ?
City water
PRV required _
Booster Pump _
6PPROVAIS
Planner
Couneil
Bldg. Off.
Variance
Council
?
Bldg. Permit G 18, U u
Sureharge ?
Plan Review
n
30910
SAC, City 100,0
SAC, MWCC S op
Water Conn
o
4-80.0
Water Meter ? o , O9
Aect. Deposit .o
S/W Permit 7-a,o?
S/W Surcharge P,o?
Treatment P1. 2.K.0
?
Road Unit S 4g,ov
Park Ded.
Copies
TOT9L
NOTE: Sewer & Water Permit fees and aecount deposit fees xill be included in the building
permit fee. Procesaing time for sewer and rater permits is two days onee a licenaed
plumber has applied for a permit at City Aall.
1/',4 Lu ATlO Q
?ARA6-Gr
2 2? 2.2 = L/ 4s'4 k I5 ='7 2(aO
? a ust
?2.y
_._----
136o X
c1 LI 3 u v
.?
TRI-LANO C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
?
1
2 1
a ?
W 5?
W
LEGAL DESCRIPTION; LoT4.,eLoCK 3, LEXINGTON PARKVlEW
ACCORDING TO TH RECORDED PLAT
THEREOF?S?? _ COUNTY,MINNESOTA
1 I1?ir I M'
$C018; I" = 30' ?`, f ll? I„
I?
SITE PLAN FOR:
JOE MILLER CONST.
--
N
10 I ?
N
? m
O ?
?
?
9
l5'?O) f
?
m1
GA? FL. 1
92 x? 15' 0 .
?
?? ? ??E Li
e I5 ?
fAry96 I ~
?
0
?
PN?SE
? - I .?
1 GAR
? ??-
?t?4b r ?
?2 I
1 /
?
l1 `
i 4 W.V. ?
? - - ?e
?
9ry
.
EAGArr ENGINE'??P?? w T?RRRG?C
i.EGcN3 J NOTE OFFSETS NOT TO SCALE
o DENOTES IRON MONUMENT PROPOSED GQARAGE FLOOR E EVAT OIN=
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = 3-
DEN07ES EXISTING SPOT PROPOSED BASEMENT FLOOR = 9z3
ELE VATI O N E LE VAT I ON
DEN07ES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION NOTE ' VERIFY ALL FLOOR HEIGHTS WiTH
FINAL HOUSE PLANS
I heraby certify fAot tAis survey, plon or
report was prepared by me ar under my
direct supervision and fhat 1 am a duly
Reqistered Land Surveyor under the
Laws of the State of Minnesota.
Bradley J?,$0,6nson, Mn. Rap. No. 15235
Date' 31zi /ev
^ I
,.,
??
12.54' ?
II
i?
raoB
RN. 3/z2/py Hwse Ec.cv. ? OGFS675
CITY OF BUILDINa DEPART14ENT
EXTERIOR ENVII,OPE AVERACiE "Ull COMPUTATIOft
(To be submitted with 6uilding permit application)
One or Two Family Dwelling Owner I
All Other Site Addresa
Contractor ? '??U'E32' Gp9s"r Date Phone
LINEAL FEET OF Nk
EXPOSED VIALL t. above grade iI(p
TOTAL EXPOSED WALL AREA SQ. FT.
OPAQUE wALL CONSTRUCTION: "y"_Value x Area
Detail °Un ,O¢3 x SQ. FT. / , /.41?7T (U)(A)
refereace ' Uti X SQ, FT, (U) (A)
from "u b F?f. - ?U)(A)
attached " x SQ.
"U?? x Sq, FT, = M(A)
sheets "pu x SQ. FT. - (U)(p)
npu x SQ. FT. _ (U) (A)
WINDOWS; "U" Value x Area
Make & Type N?`q
n 'ta?]L.. GVarI1n?unUio ?Q(,p X SQ. FT. Ir?S_ I.F'/r5c' (U)(A)
Un
u „ x SQ. FT. _ (U)(A)
??Qu x SQ. FT. _ ?11)(A)
npo X SQ. FT. _ (U)(A)
ORS c "U" Value x Area
2•talce & TYPe u u Q. ,
U_ ,47 x g FT• ?f 6-0 (U)(A)
/ n n' n Q. FT.? ?p?
n
? M 0+ (U)(A)
U X 3Q. FT. a (U)(11)
uuu x Se. FT.--?- M(A)
TOTALS CO?gQ. FT. I ?0('/? "?(,CJ (U) (A)
TOTAL (U)(A) VALUES '510 AVERAaE IlU
DIVIDED BY TOTAI, WALL AREA I(9 S41 ILO
AVERA4E ItU?^^--??
115 0? lesa for 1&2 faraily dwellinge
ROOF/CEILIN2
TOTAL AREA:
Detail refereace "Ulf /D7-1
from u x.gQ, pT. 317?i(U)(A)
, Un
attached x.SQ. FT;
. . itUtl (U)(A)
sheete . e.-
Deacribe openings up,O x 8Q. FT (U).(A)
in roof..' iruit X SQ. FT, , _, ?U)(A)
x SQ. P+T. (U) (A)
TOTAL (U) (A) UALUES DIVIDED BIf L7 -73 ToY1?L5??.? z '73CVy?\
3
TOTAL ROOF/CEILINCi pREp
AVERAfIE ItUti ,p? ?or ventilated roofe. Jd
:.r'r"
I
Wo
4-
?`?4 z9 +2-,9) =
?.
,co7? t-? = i?U,gDe?).4-
?
,?I-74= 14(4P,47..k
w rNr?s
?
3w - 24x ?S
Zw -- w?(3ta
zw u 24x+5
?W 4 = 3(a.a
75`
14,axI - 14,o
?Jv Sn.- 1'(d- '?NI ?-. = Z?r O
??.
2_ x ? 4
2
i ? >I =
12 ?
Nox
l 1 ?0
E5Z;vous
20) 5/8 " QYP. Bd.
3.) Ineulatiatt
4.1 .
5.) Exterior Air Film
, (BTILL)
I?U?i tt 1/Ra I ?zr
BI VALUE . .
0.61 '
56 ,
44, Oc>
.61
?p
'1'OT11L (R)= 1t.s',TJ
WALL
60 _Iaterior Air Film
7.) P aYr. Ha.
8.) Insuletion
9.) T,0rtV-PjT-6
10.) F(aeoni,te Siding
11.) Exterior Air Film
R VALUE
0.68
•?15
19,00
2,o
7
•t7
upu a 1/R?...?i TOTAL
--
AIIi
A YALUE
12.) Interior Air Film 0,68
130 Ineulation jq,op
14•) 211 Fir Rim Joiet 1,88
15. ) XvI(,T' P,T,5_
164) Hesonita siding Z 6?
?
17.) Exterior Air Film 17
•?valuae nt Roofs Wallt Rlmp and Cono, Hloclr
ROOF/_ Og_ ILINp
? I.) Interior Air P'ilm
•
uU1•1 e IIRn
•Qjo
?
TOTAL ,i
(R)=Z?7`,•
.
FOUtfDATION
18.j Interior Air
19.)
Film R YALU
0.68
20.)
214)
22.) K-11
12" (Jonorete Blook /ldo
??pg
23.) Exterior Air Film
IIUII &07(C) Torni. M° /3 1 J
•
.. .- »_.?__.-.._.. ,.
I.L_flo BL '3 CITY OF EAGAN
PLiIMBING PERMIT
SUBD.C2?' (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE e $.50 FOR
EACH $1,000 OF PERMIT FEE.
WORK DESCRIPTION .
N0.
NEW CONST _
ADD ON
REPAIR
owrrEx NAME HaF?2 _
:
SITE ADDRES S: ??Z ? L1/6? ???,-c-•? ? rG_c ?.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
•' ?,-'???Lf -Fcre%?`"
$25.00 MINIMUM FEE.
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. AL50 FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
CITY USE ONLY
RECEIPT # C-' 0 Icl
DATE 777,77
ALSO, FOR TOWNHOMES AND CONDOS
COMPLETE THE FOLIAWING:
FIXTURES SA. TOTAL
REPAIR/ADD ON 15.00 /?a?
SHOWER 3.00
WATER CIASET 3.00
BATH TUB 3.00
IAVATORY 3.00
KITCHEN SINK 3.00
IAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER AEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OllT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFfENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W..TURNAROUND 15.00 _
STATE SURCHARGE .50
TOTAL: $ /S S-6
$
$
(SIGNATURE)
I
CITY OF EAGAN
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