1624 Norwood DrCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
onTe
19
wecsivuc
PROM
AMOUNT $ I
DOLLARS
1 oo
? CASH ? CHECK
F D11
`a
. . j?=Y-'.?..• , - ? aa4-..:-"__sa
FUNO CODfi AMOUNT
Tha; , ou
i ' BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
` ? - ? - CITY
3830 Pilot Knob Road, P.
F'HOI
BUILDING PERMIT
T.. F..: ?.n...l in. D+M
kN ;?,t3!
199, Eagan, MN 55121 18903
.
)0 ?
Receipt #
Date APR 16 . 19 91
Site Ad?lTss 1°&' ?'?'Am UK ?I'C!'
? OFFIC
Block Sec/Sub.
Lot
Parcel No. occuPancy -
??? ? ?OHKWN Zoning ?
W Name (nocuaq consi ?
; Address (Allowable) -
0 City EAGAN Phone 653-0770 # ot siories ?.?
F
Name S? Length
Devin
-
?
?Q Address S.F. Total -
? Clty Phone S.F. Footprints ?
On Site Sewage -
U?
Name
on sife weu
-
W W
,,-
? Addr@SS MWCC 5yslem -
<W City Phone City Water ?
PRV Required _
I hereby acknowiege that I have read this application and state that the Booster Pump .?
information is correct and agree to compiy with all applicable State ot
Minnesota Statutes and City of Eagan OrdinanEes.
Signature ot Permitee APPROVALS
? ? JOHNSW Planner ?
A Building Permit is issued to:
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. Bldg. Oft. -
Building Ofticial Variance ?
FEES
25.00
.3a
Conn
nent PI
Unit
so
--Y6-.00
:='?
Permit No. Permk Holder Date Telephone #
WATER
SEWER
PLUMBING
H.VAC.
ELECTRiC
Inspeetfon Date Insp. Comments
FooGngsl
Foundation
Framirig
Roofing
Ragh Plbg.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Fnal
Dec* Fts. r e - .e or o urt?e
Deck Final ?b ? f ( ' SS ? 9 ~ _? . ?i/ •
w.Mi
Pr. Disp.
BUILDING PERMIT
SF r)t•lr/rF n Est_ Velue '• 71.000
Receipt # ?Z/ fi 0
Site "ross ` • , - " , , , j -' .` "
' Erect Qccuponcy
Loc 3 r r+ 7 mr-, ;n •,?. 1 c- m
BI«k Sec/Sub.
? ,• 1 r ^ ? n _ , ^ ^ ? ^
Alrer
p
Zoniny
NIF
Porcel # Repoir p Flrc Zone
Enlorge ? Type of Const.
oWC Name r^0 r T,*?^??,*T -?.T 1'!1?
''
Move
p
Stories
? Addross I r ?nr.f n? n? ?r Den,olish p Length
m- 454-6 R7 3 Grode ? Depth 17 Sq. Ft.
g Name _
F
uU Addrass
Name _
AddresS
I hereby acknowladge that I hovs read this opplication and state that
the inlormotion is correct nnd ogree to comply wlth oll opplicob4e
Sfote of Minnesota Stotutes and Ciry of Eogan Ordinonces.
Siynoture of Permittee
r .. r r
A 8uilding Permit is iuued to:
oll worlc sholl be done in xwrdante witfi ell opplitoble_Sltlte of Mir
?
8uilding Offlciol
CITY OF EAGAN
3795 Pikt Kiwb Reoa Eayan, MN 55142
PHONE: 454-8100
Assessment
Water a Sew.
Police
Firo
Enp.
Plonner
Counci I
Bldg. Off, ? ? I p' 1
APC
Permit ,
SUfChWlqQ ^ r ? ^
Plon check
SAC Woter Conn.
Woter Meter
-+-n n.j
Rood Unit .
11. 1 1 q r ^
TOfOl W
on tha express condition thal
ond Ciry of Eapan Ordinonces.
Permit No. Permit Holde? Misc. Perm
it No.
Holder
V
oisp
Sewer
Elect.;c p-%ssv E?6 L? az ?
Inapection Date
11 Insp. Other
Footinyt I ?
Foundstion
Framinp 5,1
?
Rouph PIlq. -? j ?It
Rouqh HVAC
Inaulation
Final PI6q. ed
Final HVAC
Finsi
. ?
Water-- Describe Location:
VIlsll
5ewsr
Pr. Disp.
Receipt MECHANICAL PERMIT Parmit No.
CITY OF EAGAN
Fee
fill in numbered spaces S/C ?
Type or Prinr legibly
Tot
1. Date 2. Installation Cost
3. Job Address Lot?• Bik. Tract
4. Owner
5. Contractor , Phone
6. Address `
7. City ` State Zip _
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New O Add O Atter ? Repair O
10. Describe
I 11.
Ty pe
No. Equopment BTU - M. Ea.
Forced Air No. Equipment CFM
dli
:
Ai
H
Mfg. r
an
ng
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes gaverning this type of work.
Signed : for
Rough Flnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN Fee "
Fil1 in numbered spaces S/C
Type or Print legibly Tot.
_ _ . ? ..
1. Date -' 2. Installation Cost
3. Job Address Lot Blk. ` Tract
?
?
4, Owner
5. Contractor
6. Address -
7. CitY
/
8. Building Type: Residential
9. Work Descriptian: New ,q,
Phone
State Zip
Commercial ? Institutional ?
Add O Alter O Repair O
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs 5eptic Tank
Lavatory Softner
- Shower Well
Kitchen Sink
Urinal/Bidet
Laundry Tray Other
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Aqproved '-` i CITY OF EAGAN 454-8100
-Y. -_
1ANYLl:1 lUlN KL(.; VKIU
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
y.t'?hN l
1 o /Nti /s4f3
SITEADDRESS:! N,: 1a - l•s AHH 1 .0 -A
lrir: t: Eiltlc.ii
iiilirLit}(t(1 I1P
PERMIT SUBTYPE:
?+ I
APPLICANT:
TYPE OF WORK:
1.? rnI i
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FQUND
FFAMING
ROOFING
O?
ROUGH
PIUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition I3RiTTANY Lot 12 Blk ?
Owner Street 1624 Norwood Drive
Improvement k Date Amount Annual Years Payment Receipt Date
STREETSURF. 1127.96 C008770 6-7-84
STREET RESTOR.
GRADING 1981 428.73 8• 314.41 C008770 6-7-84
SANSEW TRUNK 1976 156.51 10.45 15 62.64 C008770 6-7-84
*SEWERLATERAL 1981 5040 8 ?36.06 3696.67 C008770 6-7-84
WATERMAIN
* WATER LATERAL 1981
WATER AREA 6-1 -i 1981 300.00 30.00 180.00 C008770 6-7-84
STOFiMSEW TRIC If 1981 492.50 32.83 361.18 C008770 6-7-54
* S70RM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 450-00 tt
BUILDING PER.
SAC 525.00
??
??
PARIC
CITY OF EAGAN
3830 Pi{ot Knab Road WATER SERVICE P
pERMIT NO.: ERMIT
P. O. F3ox 21199 :
Eagan, MN 55121 DATE:
?
Z
:
in No. of Unin:
g
ort
'I' f ?1: 'rs i
Owror:
Ilddrosr. ?or?rood
:?
1 .`
ti??
Oriv?: LI:- ?rit
' 1st
Site Addross:
Plumber. ' ` •1 ? 0 . 110 l; u .
Connection Chorge: ?
Meter No.:
Acoourit Deposft:
Size: Permit Fee: 10
Rwder No.: ' „tl
1 yrN to oowvlf wkb 1M Cihr of L aws SurcF?a?yer .,ci
Misc. Charoes:
OrdiwenoM.
Totol:
B Dota Pold:
y
aore of Insv.:
irep.:
TY OF EAGAN SEWER SERVICE PERMIT
30 Pilot Knob Road pERµIT NO.•
0. Box 21199 DATE:
igan, MN 55121 ?
Mina: No. of Units:
I i9?M 1'O 00111Pti ? ? C??1 ? N?A /?? _
LrNI?lTObti? Ldlame:
Ordineaa?s. /lccount DePosit: ? .
Permit Fee:
5urchorqe:
By Misc. G+crom
Dote of irnp.: Total:
I nsp.:
Doh Paid:
? ciTY oF eACaaN WATER SERVICE PERMR
3830 Pilot ,fnob Road 5307
P. O. Box 21199 pERMIT NO.:
2-23-84
Eagan, MN 55121 DATE:
1
Zoninfl:
Owner: No. of Units:
A,ddrosx
Si Addm; 1624 Norwooor ve zs1Z B3 Britta?y ist -
umber. Genz R at?
5` S 9 450 00 pd
nection Chorpe:
C
r No.: 33 7> Co on
Stu. i, v? K
? AO
? 8 Aooount veposit: 10 00 ?_
Permit Fee:
.
Reader No.: ?,
I .lne to oamrh? wft th• uRr'f E°w" s"rchome:
63 . 00 pd met3
Misc. Chnroes:
n Total:
?
? pcte Poid:
l ` r S' ? InaR:
Dote of InsD.: ?
BUILDING PERMIT
SiM Addreu
Lot 12
Parcei # -
w
9
0
Zu
r
CITY OF EAGAN
9793 Vtlet Knob Rmd Fagan, MN 55122
PliONE: 454-8100
Blxk " Sec/Sub. "`
10-15000-120-03
N° 8780
Receipt * / d U
'000 Dote JANUARY 25 ,iq 84
- --eriae )[7 o«uPoncr R3
r - - Alter ? Zoning Rl
Repair ? Fire Zone H?A
? Enlorye ? Type of Consf. V
Name TOLLEFSON BLDRS. Move ? # Storie:
Addreu 1655 NORWOOD DRIVE Demolish ? Length 69
Nama SAME
Address
Name _
Address
I here6y ocknowledge thot I hove read this opplicotion and stare ihat
the In(ormotian is corretf ogree fo wmply with oll applicoble
Slate of Minnesoto $tat esf??ond Ciry o??f E,?pga Ordiran s.
Signafure of Permitfee ?`•' ?
A Building Permif iz issued to•$?N :
oll work shall be done in acmrdonce wli?t, II ap li le?
Building Official
6rode ? Depth z 5 Sq. Ft.-
Avvrorols Faes
Assessment
Water 8 Sew.
Police
Fira
Enp.
Plunner
Councll
BIdg.Off.l 24 84
APC
vermit ? 346.00
su.cno.g0 35.50
Plon check
-- 176•00
5-25
00
SAC •
Water Conn. 4 S 0 . 0 0
Water Meter 63.00
Rood Unit 250•00
Toral $1,845.50
_ on the exDress wndiNon ihai
ond Ciry of Eupon Ordirwnces..
CITY OF EAGAN
ND
18903
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 454-8100
Gl
BUILDING PERMIT Receipt u C - ?a
?
7o be used for DECK EsL Value $1,000 Date ApR 16 . 7991_
Site Address 1624 NORWOOD ?R
Lot 12 Block 3 Sec/Su6. BRITTANY 15T OFFICEUSEONLY
Parcel No. occupancy - Fees
Zoning _
p Name DONALD E.IOHNSON (ACtuaq Const - Bldg. Permit 25.00
w
3
Address 1624 NORW000 DR
(Allowabla)
-
har
r
a
S
.50
° CitEAGAN phone 683-0770
y .r oi siodes g
u
c
16, Plan Review
length
o Name SAME oevLh 12? SAC,city
}
$? Address S.F.TOtal -
SAC,MCWCC
? City Phone S.F. Footprints -
S Water Conn
On Sile
ewage _
?
ww
Name
On Sile Well
-
Water Meter
zz AddreSS MWCCSystem -
u i Acd. Oeposit
aw City PhOnO Citywater -
S/W Pamit
VRV flequired -
I hereby acknowlege ihat I have read this application and state Ihat [he Booster Pump - S/W Surcharge
inlormation is correcl and agree ro comply with all pplicable State of
Minnesota StaWtes a??of Eaga
n Ordinancgs? , 7reatmem PI
W
Signature ot APPROVALS Road Unit
A Building Permi[ is issued to: DONALD E JOHNSON Pla^^af - ParkDad.
on the express condition tha[ all work shall be done in accordance with all Cauncil -- 50
applicable S1ate of Minnesota Statutes and City of Eagan Ordinances. etdg. Off. - CoP1B5 .
Builtling Otticial Qt? Variance - TOTAL 26.00
f^?qREQUEST FOR ELECTRICAL INSPECTION
^ ' See instruclions for compleling this torm on back ot yallow caOV-
? "X" Below Work Covered by This Request
ea-oooot-oa
ylL417
AAtl
Rep. 1 !CO
TSPe ol Boiltling
Apaliances Wiretl
Eqvipment Wired
tipme ' Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. BuilAing Dryer Electric Heatin
Commercial 81dy. Fumace Silo Unloader
Industrial Bldy. Air Conditioner Bulk Milk Tnnk
Farm V) Othe.r (Specify)
t e? Sueci y r Oihur
ComUUte lnspection Fee Belaw , N Fee Servica Enhence5iza k Fee Feeders /S ubfeede rs N Fee Clrcuits
cJ Oto200qms- 0 to30Ams ? 3a 0 IO30Am>s
Above 200 qmpy 31 to 700 Amps ? S- 6 37 to t UO Amtts
Swimming Pool Above 100-Am s Ahove 100_Am)s
Transtormers Irrigation Boorrs r SL` Partial:'Other Fee
LI ISigns ? ?- ISpecial Inspection ?S?p ?ITOT FEFq,•A
Remarks ? 8{? X
1, the ElecVical
InsOectoq heneby
5ertify thet the above
(ns0ection hes been
meda.
Thle request voi0/8 montlia lrom
, iz e4 o;d
18 r
th
f ?^Z s_8 y . y
. s o
iqn
s
rom
A
LI'4. 3
i7FH-AJ ?
I Sr
Request Date
n
?•y
.
? Fire No. R.ugh-in Insoection
R q ired?
Dfleatly Nnw? Will NotifY InsPec-
?
/
(
Q( yes ?No ?? ?or When Reatly
Licensed Electrical C onVactor I heraby requast inspection of abave
Owne' electrical work installed at:
Stre
et Address, Box or Route No. Ciry
j
V ic
ecLOn . Towns ip Name or No. Range No. Count
Dccupant (PFINT Phone No.
f?
Power SupPlier Address -
q-k-
Elec ical Coptractor I qmpany, Name)
r4C/ CoMractm's Lire,nse No. -
Ma
ilin p'Add (C ntrac[or or ier Makin Instailationl
^
?
?
/
Authorized Signature ICont tor/Owner kine
Ins[allatinnd Phone Number
,
MINNESOTA STATE BOARD OF EIECTRICITV THIS INSPECTION REUUES?T WIIL NOT
GrieSS-Midwev Bldg. - 0.oom P1•791 BE ACCEPTED BV THE STATE eOAND
UNLESS PqOPEFl INSPECTION FEE IS
1921 Universiry Ave., St Peul, MN 55104
Phnnw 16121297.2111 ENCLOSEO.
2005 RESIDENTIAL MECI3ANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when perrni[s are required for each unit
Date L1 l Ly / 0 5
Sit
Add
I lL 9A Nry Uad ? Y
e
ress • Unit #
Property Owner Telephone #( 10
Contractor 1-e (i(,n
k4' I Y I
StreetAddress I1-I?415 QjJL U rl
I-QS(1T CJI
Cit
State ' ' f I V .
.
Zi
C! y
i
Tel
hone # ( ?`? I ) JI ? ? f ? `1 `?
p ep
Bond #: Ezpires:
The Applicant is _ Owncr _?ZContractor _ Other
Add-on or alteration to esisting dwelling unit $ 30.00
? furnace _Additional _Replacement
air exchanger
air conditioner I
_New `y- Replacement
other
State Surcharge $ 50
50
a)
Tat?, .
$
I hereby apply foc a Resideniial Mechanical Permit and acknowledge that the infortnation is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with [hc Mechanical Codes; that I understand this is not a
permit, but only an application for a pernut, and work is not lo start without a permi[; that the work will be in accordance with [he
approved plan in the case of work which requires a review and approval of plans. ?
Applicant's Printed Name Applicant's Signature
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comple[e for: commerciaUindustrial buildings
mu16-family buildings when separate pemuts are not requ'ved for each dwelling unil
Date I /
Site Street Address Unit #
Tenant Name (if applicablc) Previous Tenant Name JI!
Property Owner Telephone # ( )
Contractor I
StreM Address City
?
State Zip Telephone # ( )'
Bond #: Eapires:
?I
The AppGcant is _ Owner _ Contrac[or _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see be/ow
_ Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"*When insfalling/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
PC[D1i} FCES: c79.50 Underproundtank ins[zlation/remeval ?
'..
$50.50 Minimrun (includes State Surcharge)
or
ContractValue $ x 1% _ $ PemutFee
• If aermit fee is $1,000 or less, add $.50 => $ State Swcharge
If ea rmit fee is over $1,000, add $.50 for
every $1,000 De Illlit fee $ Total Fee
[ hereby apply for a Commercial Mechanical Permit and acknowledge that lhe information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
noi a permit, but only an applicaUOn for a permit, and work is not m start without a permit; that the work i ill be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
ApplicanYs Printed Name
ApplicanPs Signahue I
Approved By: Inspector Datc:
<
.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
FERMIT '
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDSNG
0335$1
10lm5/98
SITE ADDRESS:
1624 NORWOOD DR
LpT: 12 BLOCK: 3
BRI7TANY
P<T.N,t 10-16000-120-03
DESCRIPTION:
RERQOF
ermit Type STOftM DAMAGE
9?rjh? TYPe REPAIR
8'..? -"434 RL7. RESIDEiVTIAL
-n 11i -
'? - T{?¢? ?" ? } ? ?
?ece? a? ?wi 3v?t '%?m*?' ;a? `?'.?k'h?s a? a? ilg° a,
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applinant - s7. Lzc. OWNER:
TOP LZNE CpN5T & ROOFING 14328998 20102247 JOHNSQN DON
19541 EVERGREEN TR 1624 NORW00D DR
APPLE VAI.LEY MN 55124 EAGAN MN 55123
(612) 432-8998
APPLICANTlPERMITEE SIGNATUFE
I UED BY: SIGNATU E
= 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-?75 j o
New Construction Reauirements RemodeUReoair Reauirements
? 3 registered sde surveys
? 2 copies of plans (inGwfe beam 8 window saes; poured fid. design; etc.)
? 1 energy wlculations
? 3 copies ot Vee presonatlon plan if lot platted aRer 7/1/93
required: _ Yes _ No
DATE: i 0
DESCRIP OF WORK:
STREET ADDRESS: _Lk
CoST; 3?0p°.?
LOT: } a- BLOCK: ? SUBDJP.I.D. #: P-j
Name: lVLif1('OJV 6 vr - Phonett:
PROPER71' 1.est First
OWNER Street,s.ddress: ?6C?"1 IU4(L1IOfId bc?
City & ?,Cl?V) State: Zip:
Phone #: t7 )a " y 362 ' M
()
CONTRACTOR
ARCHITECT/
ENGINEER
Street
City
• T copies of plan
? 2 site surveys (exterior adOkions & decks)
? 1 energy calala8ons for heated add'Rions
YZI_ License # ? ?? 0e??/
State: ///? v Zip:
Company: Phone #:
Name:
Street.
City .
State:
Zip:
Sewer 8 water licensed plumber (new construction ony): . Penalty applies when address chang
and lot change is requested once pertnit is issued.
1 hereby acknowledge that I have read this application and state that the infortna o is corr t an a ree to comply with all applicabl
State of MinnesoW Statutes and City of Eagan Ordinances. ,
Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No Not
Registation #:
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
O 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition O 34 Repair
GENERAL INFORMATION
OFFICE USE ONLY
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 73 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Const. (Actuai) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
Zoning sq. ft.
# of Stories sq. ft.
Length sq.ft.
Depth Footprint sq. ft.
APPROVALS
Planning Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SMl Pertnit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Engineering
Valuation: $
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water ,
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
i
Variance
:
% SAC
SAC Units
? I1403
1991 BU ING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF YLANS 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 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 IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED 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.
c?
To Be Used For: peCK Valuation: Date: L)/- I j '2 (
Site Address jL- ;? y-/ .10e1.()Ge1J f96e.
Lot I Z Block 3
Parcel/Sub FR 1T(& qy
Owner'7cW44.L7 i.F. -5-01-1.'JS6W
Address%6; ?-/yUQ(a?'?G:? --ofe.
City/Zip Code iZ?GqAl Ss 12 Z-
Yhone ?-S 'D 7 ?
Contractor ?MEDWqQf'
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
OFFICE USE ONLY
FEES
Occupancy Bldg. Permit Z S.vo
Zoning Surcharge „$ o
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 P1.
On site well Road Unit
MWCC System _ Park Ded.
City water Trail Ded.
_
PRV _ Copies e$?
Booster Pump _
SIIBTOTAL
APPROVALS Penalty
Planner _ Lot Change
Council TOTAL 2.L,00
Bldg. Off. O9/bg
Variance
agrees that all work shall be done in accordance with
(Signature o.?/C`ontractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
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JACK50N - SURVEYDRS
?. ? DE1.?OTLS IRAN
VV c KYitTiA[O YMO[II LAM O/ WtAf[ Ow Mf1NNOTA
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M16 EAST 66th f7REET, MINNEA?OLIS, MN 65417 7774{04
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I H[R[DV C[RTI?I' TMAT TIS[ IJOVl 10 A TRUL??ANp CORA[CT RATOR A fURY[r p
Lot 12,Elock 3,Bzit[any,
DakDt• County,Minaeeota.
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HUIIDING PEWII'C APPLICATION 1 eet of enecyy calculaticsi6,
_ Valuatiai eq? Date P
I?l'I ?PJ ' OE'FICE USE ON[.Y
FSrect
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Ae{?air Fire Zone
"lYCe of. (bnst.
Move N Stories
DOmlish Fmnt l ? {{,
Grade r 13ept1 ,?.? ft.
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'uJT JACKSON - SURYEYOR8
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361B EAST 65M tTNEET. MINNEAPOUS. MN 66417 727.7464
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Lot 12,Block 3,Brittany.
Daicota County,Minnesots.
Propoaed Gazage Floor Elev,
Prnpnaed Fire[ Floor Elev.
Prop2sed Basememi Flaor Elev.
ws supvtrgo w ri TNM sth. av a Jaa. ..s. 1984
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For Office Use
City of Eaail Permit ~
Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 L Staff:
2009 MECHANICAL PERMIT APPLICATION
Date: Site Address: ~02'(l
Tenant: Suite
RESIDENT I OWNER Name: Phone: U1 21 . 1o 63. U3-4T
Address/City/Zip: 2j iC~ 1~r 1yim.
CONTRACTOR Name: _7cnZ- t ~t License _ yC(
Address: L ct j
City: B L 12- Il ,l State: Zip: (S'S J'Y+
Phone:q 2' 1I6 - 67TO Contact Person: ) ~ IQ
TYPE OF WORK New l Replacement Additional Alteration Demolition
Description of work:
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for Informaltlon on permitted screenin methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE Furnace New Construction Interior Improvement
,Air Conditioner - Install Piping - Processed Air Exchanger Gas Exterior HVAC Unit
_ Heat Pump -Under/Above ground Tank Install/_ Remove)
When instaling/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) Sr-Tj
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
_ $ Permit Fee
- If Permit EM Is less than $1,000, surcharge is $.50.
- If rnf Fee Is > $1,000, surcharge Increases by $.50 for each = $ State Surcharge
$1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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
App rcant's Printed Name A nt'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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171983
Date Issued:09/09/2021
Permit Category:ePermit
Site Address: 1624 Norwood Dr
Lot:12 Block: 3 Addition: Brittany
PID:10-15000-03-120
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Matthew R & Lisa Gullickson
1624 Norwood Dr
Eagan MN 55122
(507) 469-8665
T 10 Construction Services Llc
16754 US 10 Bldg 2
Elk River MN 55330
(612) 254-8060
Applicant/Permitee: Signature Issued By: Signature