1628 Norwood DrCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
AMOUNT $ I & DOLLAR$
7oo
? CASH ? CHECK
.oR l ?
Thank You
['??? B Y
?. .
White-Payers CoPy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
3795 Pqef Kwob Rwd Eogan, MN 55122
PHONEt 454-8100
BUILDING PERMIT R??ipt #
? 7
Site /lddreu - Erect ? Occupancy
?
Lot Block Alter p Zoniny
Parcel # Repoir ? Fire Zone
E
l
n
orye ? Type of Const.
Name Move p ?k Stori
W es
; Addrcss Demoliah ? Length
b Ci p}one - Grode ? Depth Sq, Ft.
dy . Approrols f•es
p Name _
?
?' Address
Name _
Addrcss
I hereby acknowledge that I have re<
the informotion is correct ond agre
State of Minrxsota Stotutes ond Ci
Siynotum of Permittee
A Buiiding Permit Is iuued to:
oll work sholl be done in occordonce
Buildin9 Offic(ol
wlth all applicable
_ Assessment _
Water 8 Sew.
? Police
- Firo
- ErW
Planner
?
Council
thot Bldg. Off. _
oble APC
State of Minnesota
Permit
Surcharye
Plon check
SAC
Water Conn.
Wafer Meter
Rood Unit
Totol
on the express condition thm
and Ciry of Eoflan Orainonces.
Permit No. Permit Holdar Misc. Parmit Na. Holder
Plumbing
H.V.A.C.
E
Well
wac..
Disp.
S?wsr
Electric
Inspectioo Date Insp. Other '
Footinys
Foundation
Framinp
Rouph Plbp.
.
Rauph HVAC
Inwlstion
Final Plby.
Final HVAC
Final
W?r Deteribe Lotation:
YWII
u
Sswor
Pr. Difp.
• , CITY OF EAGAN
37!! Pilef Knob Rood Eegoa, MN 55121
PHONE: 454-8100
BUILDING PERMIT
Slte Address
Lot Block Set/$ub. '
Porcel #
ac Name
W
?
Addrcu
Ci Phone
Name
?
??
Address
? ri.., oL..__
I hereby ucknowledge that I hove read this applicotion ond state that
the iniormotion is correct ond ogree to comply wifh oll opplicoble
State of Minnesota Stntutes ond City of Eogan Ordinonces.
Siprwture of Pertnittee
A Buiiding Permit is issued to:
oll work sholl be done in accordonce with oll
Buildlrg Off{cial
Receipt #
Erect 0 Occupancy
Alter 0 Zoninp
Repoir Q Fire Zone
Enlarys ? Type of Const.
Move ? # Stories
Demolish p Length
Grnde ? Depth Sq. Ft.
Anoro vals F"o
Assessrnent PeRnit
Woter & Sew. 5urctaroe
Police Plon check
Fin SAC
Enq. Water Conn.
Planner Wuter Meter
Council Road Unit
Bldfl. Off.
APC Taol
on the express tondition thni
)licobla Stute of AAlnnesoto Statutes and City of Eaqon Ordinonces.
Psrmit No. Permit Holdsr Misc. Permit No. Hoider
Plumbing ?a-? ?nZ ? • (!._,?(_
f
H.V.A.C. ie,?n
wau
Wster
Disp.
EMctric MGISTf 1 -E(C( 3- (Z ` ? C+,,r?Ikp,
Intpaction Date Insp. Other
Footin¢t
Foundation
Framinp F
Rouyh Pib¢ ,2,10
Ro
uyh HVA
? -
Inwlation
Final Plbg. -? - w
Final HYAC ?
Ffnal
Water Describe Location:
YWII .
Sewer
Pr. Dbp.
Reoeipt
MECHANICAL PERMIT
CITY OF EAGAN
Fill in numbered speces
Type or Print /egib/y
?
Permit No.
Fee
S/C
Tot. ?
1, Date 2. Installation Cost
n .
3. Job Address -"'Lr6t Blk. Tract
-?
f
4. Owner t ?-?-
5. Contractor Phone
6. Address
? ? ' ` n
`':•._?`' ,>_..l
7. City - :-?--
--+4---?
State •' ? :^' . ?
___ . ` Zip
8. Building Type: Residential Q Commercial ? Institutional ?
9. Work Oescription: New El Add O Alter ? Repair ?
10. Describe Fuel Type
11.
No. Eauioment BTU - M. Ea.
Forced Air ' No. Enuipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outleu
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 Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fill rn numbered spaces S/C
Type or Prini legibly _
Tot
.
1. Date,/ -C L 2. Installation Cost f
3. Job Address %= ?' . ' . • ' Lot ( r Blk.
- . ,. r.- Tract
4. Owner
5. Contractor;' T 'L. 11 h2 • Phone
6. Address
7. Citv? ?? f ri, , -- ,•- I State I L"1 Ljj Zip _ C
8. Building Type: Residential JD Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Descri be
11.
No.
=> Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
/ Bath tubs Septic Tank
J/ Lavatory Softner
' Shower Well
Kitchen 5ink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
?' •;' =-
, ,. ?• y
,r _ !
. ,
12. I hereby certify that the above information is true and correct,anof Ir&l 0.
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.
Approved CITY OF EAGAN 454-8100
INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE: I r t EIr He,
3830 Pilot Knob Road Permit Number: °n:; 32
Eagan, Minnesota 55122-1897 Date Issued: u t J(7 F? ri r1
(651) 681-4675
SITE ADDRESS: APPLICANT:
:z1. ;.tl?i??i? ;i ?i I If i + t IJA1; I f MFtI 1:U10I
;r4, , i I . 1 acE" f: ! ! 49
-=_. . , . . .
PERMIT SUBTYPE: TYPE OF WORK:
. i i 1'ATR
REFtAf1F
Permit Holder Date Telephone li
SEWER/
WATER
PLUM8ING
HVAC
Inspectlon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING ?
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
CITY OF EAGAN Remarks
Addition 6RITTANY Lot 11 Bik 3 Parcei 10 15000 110 03
Owner??l? 5treet 1628 Norwood llrive State
Improvement ` Date Amount Annual Years Payment Receipt Date
STREETSURF. (Q3(e
STREET RESTOR.
GRADING ? - 2&.58 371. rj7 ° if
SANSEWTRUNK 83.50 it
* SEWEF LATERAL ?/ - 336.06 1 4368.77 it
WATERMAIN
* WATER LATERAL lQkl
WATER AREA /g 240.00 if
STORMSEWTRK S/ 32.83 / 42C.84 " "
* STORM SEW LAT iggi
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 185.00 #2918 3-11-82
WATER CONN. 335.00
BUILDING PER.
SAC
5, 9 0
PARK
cirY oF eAciaN WATER SERVICE PERMIT
3795 PIfot Knob Rosd PERMIT NO.:
Eugcn, MN 55122 DATE:
Zoning: ? - No. of Units:
Owner;
Address:
Slte Address: . , "; ' • . ,.. ' ? .. I. j ` ??' -
Plumber:
Meter No.: Connection Chorge: ?
Si=e: Account Deposlt:
Reoder No.: Permit Fee:
( egroe M oomplp with the Cily of Eegew Surchar9e:
Ordinonaa. Mlsc. Chorges:
Total:
BY Date Paid:
Date of I nsp.: I nsp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilof Knob Rood PERMIT NO.:
Fagan, MN 55122 DATE:
Zoning: - 7 No, of Units: ?
Owner: =rAddress:
Site Address: - ::; ' - ' ' "?- t' •:?t?
Plumber.
I e9ree to eompir wlth tbe Citr of Eagen
Ordinanaa.
Connedion Charpe:
Account Deposit:
Permit Fee: ' C),
Surcharye:
Misc. Charges:
Totol:
By
Dcrte of I nsp.:
CITY OF EAGAN .
9793 Pilaf Knob Rmd Eagon, MN 55122 N4?
„
7,526
PHONEs IS4Af00 _
?
??f y
BUILDING PERMIT Receiot #
Te 6a und fe. DECK Est. Value 1,200 Date 9-21 , 1982
Slte Address 1628 Noiwood Dr Erect ? Occuponcy
Lot 11 Block 3 soc/Sub. Brittany ? Alter ? Zoning
Parcel # 10-15000-110-03 Repair ? Fire Zone
E
l T
t
f C
n
arge ? ype o
ons
.
a Name Hai-t:V Fnng Move ? # Srories
; Address S'aiCe Demolish ? Length_
b
Ci phone
452_9809
Giade ?
Depth Sq. Ft.-
? id Gi
S
ti
D
3 Avvrovah Fees
nic
1 .tm
av
c
0I1
Nome
0
?u Address Rt• 1 Assessment Permit 20.50
Water 8 Sew. Surchorge 1•00
• c{t W2F1C'FPY SSORRP{wne 461-3483
Police Plan check
?
uw Nome
F
Fire
SAC
Z
Address Enp. Woter Conn.
<W ci phoM Plonner Wafer Meter
Councfl Rood Unit
1 hereby ocknowledge thot I have read this opDlitation ond slate that gldg. Off. DP 9/21/
the inlormation is correct ond ogree to comply with otl opplicable
APC 2l _5(1
Totai
$tote of Minnesota $totutes ond Ciry of Eagan Ordinnnces.
$ipnoture of Permittee
A Bullding Permit Is Issued fo: on the express condition tha+
o? ewith oll a? bl State of Minnesoto Statutes ond Gry of
oll xrork shall be done in occord Eagan Ordinoncea.
y
Building Official
,
CSTY OF EAGAN
U?
. BUILDING PERMPP APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations,
'Ib Be used For flle(- lk, valuation /.) o 0 Date S-F ey"" ) o
Site Pddress: a,?- /r/c'/'aJv??G' ?W( OFFICE USE ONLY
Lot /L Block Sec./Sub. ? Erect ? Occugancy
Parcel #: ? ?-/ rd o o-//D - 0 3 Alter Zoning
Repair Fire Zone
Owner: Enlarge - TYPe of Const.
Nbve # Stories
Ptldress: /G ? ? {+/aF,?s.??nC /?/j Demolish Front ft.
City/Zip Cocle: F61'Grade Depth ft.
Phone # : 4J`J- `
Contractor: 40A2rJ2,:?9 Sc yi.Jt?'? /? ld?c fr
Address: ??" /
City/ZiP Code: /,?r ? Si ? ?I 1.1/v? -.S5089
Phone #: v'4
Arch./Eng..
Pddress:
APPROUALS FEES
Assessments Permit
Water/Sewer Surcharge
Police Plan Check
Fire SAC
Fhg. Water Conn.
Planner Water Meter
Council Unit
Bldg. Off. ?
APC
City/Zip Cocle:
Phone # : 'mI'AL d l. S--6
CITY OF EAGAN No 7121
. 9795 Pllot Kneb Rmd U9an, MN 551I2 -
PHONE: 431-8100
?gVY3
BUILDING PERMIT Receipt #
Te 6a used fer 17 ]nC/CAR Est. Value $ 93,000 Date NlarCh 11 19 82
Site Addreu 1 h'JR ?hYWOpd DYiVe Erect
[t?
Occuponq ?
R-
Lot 11 Block 3 Sec/$ub. BriLt211y 'St Alhr ? Zoning R-1
porcel # 10 15700 110 03 Repair ? Fire Zone NA '
Enlarge ? Type of Const. Vn
rc Name Tollefson Builders Move ? # Srories 2
z Addrou 1655 Norwood Drive Demolish ? Length 68
ci Eaoan 55122 phom 454-6873 Grade ? Depth 26 Sq. Ft.-
? N e GAmer Appravalt _ Foef
p am
u?f
Addreu
Nome _
Mdmss
I hereby acknowledge thnt I have read this apDlicotion and stote ihat
the inlormotion is correct and agree to comply with oll opplicable
State of Minnesota Stotutes and City of Eogon Ordirances.
Sipnature of Pertnittea
A Building Permit is issued to: _S'Q
all work sholl be done in accordante with
Buildinq Offic{ol ?
Assessment Pertnit 419_nn
Woter & Sew. SurcFwrge 46.50
Police Plon check 206.00
Fire SAC 525.00
Eng. Water Conn. 335.00
Plonner WaterMeter 60"00
Council Road Unit 18
Bldg. Off.
APC To„i 1769.50
on the express condiNon thnt
sota.Shlutes ond City of Eogan Ordinonces.
REQUEST FOR ELECTRICAL INSPECTION J.Ee-00001 -03
T }? ? See insiructions tor completi•is form on back of yellow mpy.
n_ 3619l,
-lJ "X" Below YYiwk Covered by This Request
N Add PeV. Type ot 8uilding Ap0liances Wired Equipment Wired
Home Range Temporary Seroice
Duplex Water Heater Lightiny Fixtures
Apt. Buildiny Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloatler
industrial Bldy. Air Conditioner Bulk Millc Tanlc
Farm ? otner ISnectNl
thrsr Suecity r Oiher
C'ompute Inspection Fee Below I - -- -
N Fee ServiceEntrance5ize R Fee Fexders?SUbteetlers N Fee Circuits
0 to 700 Am s 0 to 30 Arn s 3?S 0 to 30 Am s
101 to 200 qmps 31 to 100 qmps St0 31 to 700 qm s
?Q Above 200 n \ Abave 100_Amps Abuve 700-A??PS
nsf rrn;rs .?? 1 ? RemoteControl Circ, ts-b
PartialiOther Fee
Speci pe n
S
A
Hercv? rks ???
r I `?' ,\?? • L FEE
T
'?' L?C rl /'1
?
HouAh-in ) (
? ?J,????
? 1 t e ec ncel
° 0
? •?? nsVeclor, herehy
ertitY?thet the above
Pinal
"
'J ispection has been
T
9 ? f?
f/ me e.
This request void
18 .,nn hc f-,
This request voitl S qQ
?j8 months hom
tl
8LvioS 5
LIl ? b3? ?r ?{+a1? j s? ???f•'Z 3
Ren??es D (/
X
? (
'
? Fire No. Rau h-In Insoectlon
fi a ireA?
IE]Readv Nuw? ill Notifv. ?nsoec-
t
Wh
P
Q
(,? ,Yes ?Nu or
en
oady
Gcensed Electrlcul Contracior
I hereby request insuection nl above
Owner . elactrical work insWlled aL
Street Address, Boz or oute No. City -
5
?yq z ?le A)m ?.? C
4
ecLOn o. Township Name or No. Rnnpe No, C nty
Occcya (PPINTI Phonc No.
) .L
Power $uppiier
? Address
Elecuical Co vactor (Company Nnmel Cnnh r.[o?'s License o.
? f.:/or,? f,
.'Yl
Mailin9 Jre+s (COntraclm or Owner M
aki
ny Ins[ailationl '
^
/
? '/`-)w bezi
uthoriz ignature
(COnvac or Owne? Ma inB InsWllaGon) Pho e N.um er
?
a G =??49
MINNESOTA STATE BOAND OF ELECTflICITV TMIS INSPECTION NEQUEST WIIL NOT
Grig9s-Midwey BId9• - Room N-197 8E ACCEPTEO 6Y THE STATE BOAqD
1821 University Ave., St Paul, MN 55104 . UNLESS PHOPEH INSPECTION FEE IS
e1_'_ 1.11, "y-t ?'ll ENCLOSED.
? REQUEST FOR ELECTRICAL INSPECTION R` ee-ooom-oa
w
- ?,C
' See mshuctions for comple,tin5? this form on back ol :'
yellow copv_
°? 79867
"X" Belaw Warl?,Caverbd by This Request
N Add R.N. Type of euiltliny Appliances Wired Equinment WireA
Home flange
7 Temporury Service
1
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Eleciric Heatinq
Commercial Bldg. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk TaN<
FaflYl Uther SpuuFY Other ISperity?
tha.l 1$pCflfY Onhc! Othl!
Canp14te 1nsUecifo17 Fee 8elow
p Fae ServiceEntranceSize # fee Fneders/5ubtaeders 4 Fee Circuits
0 to 100 qm s 0 to 30 Am s U tn 30 Am s
101 to 200 qmps 31 to 100 Amps 31 to 100 Am
Above 200 qmps Above 100_Amps Above 100_AmPs
Transiormers Remote Control Circ. PartiaL'Ot
Signs Special Inspection ?.
S
d
Remarks CI? ? TOTAL EE ?
Roa,h-in
Final
? D''te
U=iP
f I, the Electrical
InsUector, hereby
CC(?Ify l?lBL t?18 PbOVO
inspection has been
areae.
This «:u?est void 4/0.010 .
18 months from
rnls reamest voia
i8nwnffistmm
T 7986
-) q
ne.quesi t?ate t rire No. HouPh-'?? Insoection
?y Required7 DReatly Now Q Will Notify Insper,-
Z2> ((Q ?ves ?No mr When HeadY
? LicenscA ElecVical Con[ractor ' I hereby requyst inspection ot above
Owner electrical work installed aL
SVeut Address, eox or Route No. ^1,
• '?' GL t ?, Cit v
.
ecbM" o. Township Name or No: Range No. County'
Occop&ni(PR NT)? A
e;???11 Phone No.
P(\?w\erS?-?ppl
s-,,s?y(
I Addre?
,
W"`?"??K1 VVf?V\ ' /LN'W'?. y
Hec ical Conhactor (Companv Name) - Convactor's Llcense No.
R iitc?-t 4
Mailing AAdress (CnnVactor or Dwne(r? Makinp Installation)
Auffiorizec}rSignawre (ConrractodOwner Making Installation) P, pne Nurtiber
`?
? n
/?? ?
MINNESOTA 5 TE 80 RD OF ELECTflIC1TY - THIS INSPECTION REQUEST WILI NOT
G69gs-Midwa6ldg. - floom N-191 BE AGCEPTED BY THE STATE BOAAD
1821 University Ave:, St Paul, MN 55109 UNlESS PflOPER INSPECTIpN FEE IS
n!.....e I6111 '47_1111 ENCLOSEO. '
Z ,. ?ax
Cl'PY Cff' FAGAN p? Include 2 sets of plana,
?`Y V -??7t 1 site plan w/elevatirns 6
p/J J FUIIa7.IVG PERArT 1 set of energy calculatims.
/ Rb Be Ueed ?V luation Dabe
?
Sits Addrties '?>„?O-?.Lt(.ac.ec??g CFFIC'E USE LtJLY
, i,ot sladc 3 sec./sub. " iCj?ect CIOCupancy ?-3
i. Pat^oel 1: i0 1 Sac?a iib o-2 a- r,lter zoniny
' Repair Fi.Te Zorke
Owneri Eri1arge _ 'Iype of Oonst. .y--
' aaa:ess: mow M stories Z?
' 7f?ZiP Obde• r?ade?sl ?Frant 8" ft.
at
; ? t? ?ft.
P1nne N:
Oontracbc
1
' 11ddL+eaB:
, atY/ZiP Code:
j Phane ? z
! llydt./D'?g.:
? . JIddirBa: +
? atiY/Lip Qada:
Pl1o[te #:
Water/Sawer gurcha=y 'Ve
Pc?lioe Plan C7?eck ] p ?°
Fire SAC C- 7) ,1-^
EnJ • Water Conn,
Planner Wates Meter G Q _
CbunCil Ppad Unit
Hldg. OfF
ppC ,
70TAL u7` ?
-?
1/co RESIDENTIAL BIJII.DING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reouirements Remodel7Reoair ReauiremenGs Office Use Onlv
3 registered site surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Reod _ Y _ N
(201/o maximum bt coverage allowed) 1 set o( Energy Calculations for heated addifions Tree P2s Plan Recd _ Y _ N
2 copies of plan shaxing beam & window sizes; poured found design, etc. 1 sde survey for addNOns & decks Tree Pres Reqd _ Y _ N
7setofEnargyCalculations Adddion - indicatei(on-sitesepticsystem Oo-sileSepticSystem _ Y _N
3 copies of Tree Preservation Plan if lot platted after 717/93
Rim Joist Detail Oplions selection sheet (bidgs wiN 3 or less uniCs
Date Ci / ^3 / o3_
Site Address l62 8 Noe-wood Construction Cost "7, 200 ' 0 e)
0 r Cd Ad h UniUSte #
Description of Work ^
1Pd r O
Re roo
Multi-Faroily Bldg _ Y>c N Fireplace(s) _ 0 ? 1 _ 2
Property Owner T ed L-t v?r+. Telephone #(qf Z)`fR'?
Contractor Airo ca , rd•n
Address
State AA / J? L?
Zip 6-5'3f 3 City L7J?tCd l0
Telephone #( 763) 6`? Z' d Z 2?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Su6mitted
• Energy Envelope Calculaiions Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies. -?
22,, ?? 1
Licensed Plumber Telephone #( )
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pernut, but only an application for a permit, and wark 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.
:10-? n -F & r,- Y ?-?
Applicant's Printed Name plicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant .
Valuation Occupancy MC/ES System ?
Census Code Zoning City Water '
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
N6r. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED I NSPECTIONS ,
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
_ Foundation HVAC ,
_ Drain Tile Other
Roof _ Ice & Water _ F inal _ Pool _ Ftgs
Air/Gas Tests Final
_ Fraxning _
Sid'mg Smcco Stone _
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (newlreplacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Builtling Inspector
?
? V CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-7897
(651) 681-4675
PERMIT
PERMITTYPE: aurLuIivc
Permit Number: 03A332
Date Issued: O 1/0 (i / 99
SITE ADDRESS:
FaT.IV_ : 10--150 0 47-110-03
1.628 NORWOOD Dft
LOT: 11 6L04;K: 3
BRITTANY
DESCRIPTION:
r.o. & KFaooF
F?111 !.clin01_Permi.t: Type STOfrivl D61PqAGk
Puildino W`brk Tvpe REPAIR
%)Cen:,tjs Code ? 434 AL7. RES1DF_Ni'IAL
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REMARKS:
FEE SUMMARY:
CONTRACTOR: - AGplic,rc - sr. LIC. OWNER:
hC[UWE57 CFDAR 7-1MBERQUF 18051149 20147336 8lJl.GACH LTNDA
100:: CI.'LFF RUAU t; 1628 NORWOOD DR
BURNSVIILF MN 55337 EPGAN MN 55122
f 67.21 £10S-17.49 ( 6^51 ) 452--0854
I herebv ar knowledne t,hj t S havp rRad this ap. plico ?ion and s?.ate ti;1at Che
irito rmation i. s cnr- rer,T, o iici a4rBe '.:o eornUlv ',(d.ith a1l ao pl.icqbJ e S Ta t2 o 1- 414n.
SY_atutes and Citv ot Fiaan Ordinances.
IL
APPLICANT/PERMITEE SIGNATURE
2 A ¢/
UED BV: SIGNAT E
lqdi?
-1999-BVILDING
3ti33;;L
New Constcuction Reauirements
PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 65122
681-4675
RemodeVRaoair Reauiraments
? 3 registered sHe surveys
? 2 copies of plans (inGude beam & window sizes; pouretl fid. design; etc.)
? 1 energy calculations
? 3 copies af tree preservation plan H lat platted after 7/1/93
tequired: _ Yes _ No
DATE: L
DESCRIPTION OF WORK:
f
- r«0-r
STREETADDRESS: ,16 2$ orwoad
LOT: 11_ BLOCK: 3 SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHIT'ECT/
ENGINEER
? 2 copies of plan
? 2 site surveys (exRerior addRions 8 tledcs)
? 1 energy wlculations far heatad additions
CONSTRUCTION COST; --S ??. o Z
Name: Phone #: 4o'?2 6-c(-
Lar? Fust
Sveet Address: 1la z f5 No f wo 0 Dr_
City State: Zip: SS ?? z
(?
Company: f'u f.?( w¢,g? ! ;'M ? IrC70T Phone #:
Street Address: 1003 )S? C License # 2 047-MG
City 6c.CYNS 4?! llPi State: M/U, Zip; S`5 33 7
Company:_
Name:
Street Address:
City Sewer & water licensed plumber (new construction ony): Penalty applies when address ctaag
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with atl appumb1
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Recsived Yes
Phone #:
Registration
State: Zip:
BlIILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
13"02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
0 05 SF Misc. ? 10 = plex
WORK TYPE
P
< , -
OFFI CE USE ONLY
? 11 Apt./Lodging ? 1 6 Basement Finish
? 12 Multi Repair/Rem. ? 1 Ii7 Swim Pool
? 13 Garage/Accessory ? 2 0 Public Facility
O 14 Fireplace ? 2 1 Miscellaneous
? 15 Deck 1I
? 31 New ?33 Alterations ? 36 Move
0 32 Addition p,"34 RPpair n 37 Demolition
GENERAL INFORMATION
Const. (Actual) _ 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
MCM/S Sy;
City Water
Fire Sprinkli
PRV
Booster Pur
Census Co<
SAC Code
Census Bld!
Census Uni1
Engineering
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SM/ Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total;
- Sf??.?Valuation: $ S5 (v (a.Oa..
?"??
% SAC
SAC Units
xollefeon Buildera Inc. ? Or.11295
., 183-72A
F. C. JACKS ??IN 5=?c.?; :"=3a'
uNOSUaveroR ? • lROI•I
727-3484 6F n`• c „-, !V FL
RH6IPTBRHO UNOHR LAWY OR BTATE MIHNBtOTl1 E f%.f 7{j
LIC6NSt0 W?ORDINANC[ O/ CITY or wi?eu?oLn
oU'r'?'?`
e?63 ?Asr aarx STREET 'dr' ?i?/oJ.?.f m2???
j 55417
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Dakota Caunty,MLnneeo[s.
I5
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Or I
Prapoaed Garl ge Floor Elev. 100.0
Prupsaed Firet Floor Elev, 100.83
Prapoeed Basaarxnt Flsor filev.92.33
6
ill
w5 SURVEreO !r ME T„IS 4th_ OAY OF Marcn _A.D. 1982
10r??? .
F. GI JACKSON. 14 ?n ? A R[atsrru7wN. No. 3600
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SUBD.
CITYUSEONLY 0 ?
RECEIPT#: C3 7
RECEIPT DATE:
1998 PLUMSING PERMIT,(RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT IINOB RD
EAGAN, MA7 55122
(612) 681-6675
11
Piease complete for: D single family dwellings
D townhomes and condos when permits are required for each unit
D backflow preventer for underground sprinkler system
FiXTtiRES Er4CHi, #
Shower 3.00 x =
Water CloseE 3.00 ! x =
Bath Tub 3.00 ' x -
Lavatory 3.00 x =
Kitchen Sink 3.00 1 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00' x =
FloorDrain 3.00 x =
Gas Piping Outlet ' minimum -1 3.00 , x =
Rough Openings 1.50 x =
Water Softener " for dwellings under construction 5.00 x =
ater Softener ' for existing dwelling 20.00 p, x
U.G. Sprin c er " for dwelling under wnst. 3.00
U.G. 5pdnklef " for existing dwening 20.00 ' -
Alterations ' to existing residence 20.00
Water Turn Around 20.00
Private Disposal System ' MPC iia 75.00 ` _
(new and refurhished systems)
Private Disposal Systems'Abandonment 20.00 =
STATE SURCHARGE
TOTAL
TOTAL
ZD, c.-0
.50
?
- -------
---- Y --°-----9 • - -----ave - - - - ? - - - -'- °------•-------------'---...-•---°
-ordin-ances.-
- City M - Eagan-
I hereb acknowled e that I h 2ad this applicaGon, stete - that tAa iMOrmation - is - eo -° rted, - and - agree - to comply - with - all - applicable -
It is the applicanYs responsibiliry to notiry the property owner that the City of Eagan assumes no liability for any damages caused by tbe City during its
normal operational and maintenance activities to the facilities eonstruded under this pertnft wkhin Cily property/right-of-wayleasement.
SITE ADDRESS:
OWNER NAME:
tNSTALLER NAME: .
DBA
STREET ADDRESS:
ciTV:
MN
JSlFORMS BLDGIPLBG PERMIT (RESIDENTIAL) 1998
BULBACH, PHIILIP
1628 NORWOOD DRIVE
EAGAN, MN 55122
(612) 452-0854
TELEPHONE
enc
' STATE: ZIP:
CITY IISE O\LY
LOT A- BL ? RECEIPT #:
11
SUBD. Y1?'T F?,? RECEIPT DATE:
11
MECHANICAL PERMIT #
1999 MECHANICAL PEiMTf (RES1D£NTtAla
crrY oF EAsArr
3$30 PILOT KNdBi RD
+ fr4fiAN MN 5$122
tss» 681-4675
?
Date: 1: Complete this sectian onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occunied.
• HVAC: 0-100 M B T U $ 30.00
P.Ulll'1'1llNAL 50 Nl B'1'U ' 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
State Surcharge .50
Total $
i.
Complete this section onfv if you are remodeling, adding to, I'yor repairing an existing single family dwelling
townhome, or condo. Please indicate if it is a new item, alteration;, or repair.
_ New Alteration A Repair _ Other
Reminder: Ca11 681-46 75foninspectEons.
? Fumace
_ Air exchanger
SITE ADDRESS: I fO ?
- Au conditioning
Other
$ 30.00
? 3tate Surchazge
Minimum Total Due $ 30.50
rA
OWNER NAME: I P CY C?i f'YI YYl P PHONE #: ?
,ros?am.ansrn?s?_..?.?,„ . ;. ( c nE) -
INSTALLER NAME: ?? alnt?r?76aKE - 7F- PHONE #:
(AREACODE)'
STREET ADDRESS: aS2??'?"'S
CITY:
CITY USE ONLY
L _ BL _ RECEIPT#:
SUBD. RECEIPT DATE:
APPROVED BY: , INSPECTOR MECHANICAL PERM
1999 M£CHAIVICAL PERMIT (COMbiEfiCIAL) +
CITY dF EAHA1V `
3$30 P1LOT KNOB ftD
EAfiAN, MN 551 EE
(651) 681-4675 i?
Please comptete for: all commercialrndustrial buildings j
multi-family buiidings when separate permits are not required for each dwelling unit
DATE: CONTRACT Px2ICE:
WORK TYPE: _ New construction Install U.G. Tank
_ Interior Improvement Remove U.G. Tank (Minimum Fee)
Processed Piping (Nlinimum Fee)
"NOT'E: When installing/removing underground tank, call 651-681-4675 for inspec'tion by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK: „
FEES: 1% of contract price OR $30.00 minimum fee, whicbever is greater.
CONTRACT PRICE x 1%
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLI):
iNSTALLER:
ADDRESS:
C1TY:
ii
?
($50 per $1,000 of ggm?ii fee due on all pemvts.)
V
r?
PHONE #: - I
(AREA CODE) "
Y
PHONE #: - i
. (AREA CODE) 'i
STATE: ZIP:
Ij
SIGNATURE OF PERMI"ITEE i;
4'
-?-- ? ? I G
2006 RESIDENTIAL MECHANICAL rExMiT ArrLicaTlorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Piease complele for single family dwellings & rownhomes/condos when permits aze required for each unit
50
Date fF ( r1C7 / 0_G
(W`^COn
"
? C' Unit #
Site Address
Property Owner hwtL/1. " /," i2l Telephone # (&S/ )
Contractor STANDARD HEATING & AIR CDNDITIONING
4
StreetAddress MINNEAPOLIS, MN 55408
612 824 2656 City
StaYe Zip Telephone# ( )
?L 1 0559'191 i
E g 16'ou
Baod#: res:
xp
The Applicant is _ Owaer X
T? Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _,Additional &eplacement _ New
air exchanger
X air conditioner
heat pump
other
State Surcharge $ .50
$ ? 6'0
Total
I hereby apply foc a Residential Mechanical PermiC and acknowledge that the 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 Mechanica 11 t I understand this is not a
permi but only an application for a permit, and work is not to staR with t a e it; that th w w II in accordance with the -Ry appr d plan in the case of hich requires a review and approval o plans.
kM4A)
Applicant's Printed Name Applicant's
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA107285
Date Issued:10/03/2012
Permit Category:ePermit
Site Address: 1628 Norwood Dr
Lot:11 Block: 3 Addition: Brittany 01st
PID:10-15000-03-110
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:House
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 8,430.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Tedd W Lamm
1628 Norwood Dr
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170052
Date Issued:06/17/2021
Permit Category:ePermit
Site Address: 1628 Norwood Dr
Lot:11 Block: 3 Addition: Brittany
PID:10-15000-03-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Tedd W & Monica R Lamm
1628 Norwood Dr
Saint Paul MN 55122--275
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171076
Date Issued:07/29/2021
Permit Category:ePermit
Site Address: 1628 Norwood Dr
Lot:11 Block: 3 Addition: Brittany
PID:10-15000-03-110
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or
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 -
Tedd W & Monica R Lamm
1628 Norwood Dr
Saint Paul MN 55122--275
(651) 269-8545
Eagle Siding
1301 East Cliff Road
Suite 117
Burnsville MN 55337
(952) 746-3046
Applicant/Permitee: Signature Issued By: Signature