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1634 Norwood Dr Use BLUE or BLACK Ink I For Office Use 1 1 ry l< (✓l City of Eajan ; Permit I I Permit Fee: 3830 Pilot Knob Road 1 Date Received: j Eagan MN 55122 I Phone: (651) 675-5675 C~ j/C I Staff: Fax: (651) 675-5694 L -----------------I INFLOW & INFILTRATION PERMIT APPLICATION ✓Plumbing / Sewer & Water C-11 12-1 Date: / Site ddress: w-p o C Tenant: ~ Suite Name: Phone: RESIDENT / OWNER Address / City / Zip: Name: ~a c ~~tiv - License 3 "a G Address: \ CjO-\ City: CONTRACTOR State: Yt 3 Zip: Phone: Contact: \ Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK imp Pump Repair Repair Other: Other: Description of work: (9_~ 2 d DESCRIPTION FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.aopherstateonecall.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 a cation for a permit, and work is not to start without a permit; thaljhe work will n accordance with the approved plan in the case of wor ich requires a re . and approval of plans. x x Applicant's Printed Name Applicant's Signatur FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground _---Rough-In -Final 'N CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE neceIvea 19 AMOUNT $ I IJUOd ' ?OU O E? DOLLARS IOO ? ? CASH ? CHECK FOR ' Tha ou ? BY ? White-Payers Copy Yellow-Posting Copy Pink-File Coov . BUILDING PERMIT r_ 1- ..._.A i__ Sr _)T? ;/GAF. ._ $67 , 000 Receipt # 9 ._ ' Site Address 10i4 _VOI'[+*QOG lirlve Erect $: Octuponty ?-3 Lot 10 3 ;rittan lst Blotk Sec/5ub. y Alter ? Zaning R-1 Parcel lU 150?? 10{? a$ # Repc?i? ? Fire Zone Enlarpe ? Type of Const. v ? Na? o e son u ers, nc. Move ? ?A•` Stories ? I655 ?Torwood Drive Addross Demolish Q ? Length ? I:agan 55122 454-6873 Grode ? Depth ? Sq. Ft. Ci Phone p Nnme .? .. .. _ _ ? Address Nome _ Address I hereby acknowledge fhat I have read this application and stote that the information is correct ond agree to comply with nll opplicabla Stare of Minnesoto Stofutes ond City of Eagon Qrdinances. Sipnctare of Permittee ? :H _ ;:., /1 Building Pertnit is issued to: oll work shall be done in accordance with all oppHcable Stote of AAir Buildinq Officiul crnr oF EAGAN 3795 Pilet Knob Rood Eogan, MN 55122 PHONE: 454-8100 Assessment Water 8 Sew. Pol ice Fire En9• Plonner Couhcil BtdQ. Off. APC Permit Plon check ' SAC ` . Water Conn. Water Meter Rood Unit J Total _ on the exprcss condition thai City of Ea9an Ordinantes. Permit No. Permit Holder Misc. Permit No. Holder Plumbing ?7a? ?_( H. V.A.C. t 3- ? ?'l ?- 2g -?3 weu Water Disp. Seuver t ' Electric woqn3Sg F;q ?F.C? Q Q-? Inspection DaM ns Other Footings _t? g - Foundation d Framinp Rouph Plbp. 7- 12' . Rough HVAC ./ - Inaulation Final Plbg. Final HVAC Final Water Dascribe Location: Well , Sawer " Pr. Disp. Receipt MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spacea Type or Print /egib/y 1. Date 2. Installation Cost 7TFZ .. 3. Job Address r,LotIC) Bik. No. 3 8??r Fee S/C Tot ' , • ' Tract 4. Owner 5. Contractor,!:" 6. Address 7. City r-- ? , _114C . f/ 8. Building Type: Residential E) Commercial O Institutional 0 9. Work Description: New Add O Alter ? Repair ? 10. Describe Fuel Type 11. No. -J Equinment 8TU - M. Ea. Forced Air No. - Equipment CFM Ai dli H Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. 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, gotiqrqing 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 454-6100 Receipt PWMBWG PERMIT Permit No. CITY OF EAGAN - ? Fee Fill in numbered spaces S/C Type or Print legibly Tot. '-'- -r ; 1. Date 2. Installation Cost 6 3. Job Addr?ess Lot fc ? Blk. ? Tract ? ?- 4. Owner 5. Contractor Phone 6. Address y f 7. City ' State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: Newotl- Add ? Alter ? Repair ? 10. Describe 11 No. Fixtures Water Closet No. Fixtures Cesypoot/Orainfield Bath tubs Septic Tank _ Lavatory Softner t ? Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets _ 12. I hereby certify that the above informatian is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for , ., c ' • - Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? CITY OF EAGAW ' 3830 Pilot Knob Road Eagan, Minnesota 55123 ' (612) 681-4675 SITE ADDRESS• INSPECTION REC4RD PERM,?T TYPE: Permit rTumber: &'• ?I Date Issued: • 1 4) i: NKW 1.14 11, + 11 f, ? i; ?. 1 I f lk ti '?' PERMIT SUBTYPE: . i 4 ri : . I I APPLICANT: ? _ - TYPE OF WORK: .: I I rl 1 1: i I?1 ? r?? 1 t??rl i(fit? l?1:},qlt.' INSPECTION I , I-'J I :s?. •• • , 1 i .. rA ? I kl'MARK:ys `.,i•PAf,'AIF" PtI1MIl`: FciQ0lli{- 1) 1 w1p I-1 1 1 1 k tCA? !. WLll?l4lNii LltiRn' Permit No. Permk Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Pibg. Rough Hlg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector- Notlty Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN Remarks Addition BRITTA3vY Lot 10 aik 3 Owner ' '/=a i Street 1634 Norwood Drive r i ? Akt i ?„j L4 Improvement ` Date Amount Annual Years Payment Receipt Date STREET SURF, 1982 2819.07 563.97 STREET RESTOR. GRADING 1981 428.73 2$-.5 L 314.41 A013458 -16-84 _ 5AN 5EW TRUNK <<, 1 1976 156.51 10.45 15 62.64 A0134 8 1-16-84 * SEWER LATERAL 51 11981 5040.87 - 336 3696.67 it n WATERMAIN * WATER LATERAL 1981 WATER AREA 6- r 180.00 S -1 -S STORM SEW TRK h/S, 1981 492.50 12 83 ? 361.18 A013458 1-1E1-84 * STORM SEW LAT 1981 - CURB & GUTTER SIDEWALK STREET LIGHT AD IT 250.00 37950 8-9-83 WATER CONN. 450.00 of it BUILDING PER. SAC it of PARK TY c F EAGAN 130 Pi14t Knob Road 0. BOX 21199 gan, MN 55921 No.. to cmply with !Iw City of EMyew WATER SERVICE PERMIT ocouIT ConnectiOn Charge: Atoount Deposit: _ Permit Fee: Surcharge: Mlac. Chorges: _ Totol: Date Pcid: Box 21199 PERMIT NO.: i, MN 5512t, DATE: 0: o e'?oti $ ra No. of Units: h aanoly with tre CiFy of Ea'oe Connscclon Chorqe: 425.00 -,u .3 Account Deposit: Permtt Fee: Surcharpe: • ?{? ;' _ Misc. Charpes: Totoi: Dote Pcid: CITY OF EAGAN , s 9795 Pilof Knob Read Eapan, MN 55122 VHONEs 454-8100 BUILDING PERMIT SF DWG/GAR $67 Sita Address 1034 ivorwooa urive Lot 10 Block3_ See/Sub. Brittanv lst Parcel # 10 15000 100 08 rc IN.m. Tollefson Builders, Inc. W Z qddresy 1655 Norwood Drive p Name_ ? ?U Addrass ? n... Nome _ Addreu I here6y acknowledge thut I have read this applicotion and state that the inlormation is correct ond agree to comply with oll applicable Stofe of Minrrewta Statutes and City o4 Eagan Ordinunces. Sipnofure of Permittee o e son Bui ers A Building Permir is issued to: / oll work shall be done in atwrdance with all ODDI1CAMb S te of / Buildiny Official Receipt # N° 8370 ? -7/V 8 Erect ? Occuponcy R-3 Alter ? Zoninp R-1 Repoir ? Fire Zone NA Enlarge ? Type of Conrt. V Move O # $tories Demolish ? Length 62 Grade p Depth 34 Sq. Ft.- Anvrovela Fees Asussment pemit »'+.vu Water 8 Sew. Surchorge 33.50 Police Plan check 167.00 Fira $AC $25.00 Enq. Water Conn. 450.00 Plonner Woter Meter 60.00 Council Road Unit 250.00 Bidg. Off. APC Total $1819.50 . C. on tha express tonditlon thm ?p.5t6futea Ciry of Eagan Ordinances. y 9 a9 ?4 ,Cld 6 3 ReuestD?te FireNO. uqh;irttruspection quiratl? ?Reatly Now O Will Notiy Inspectar c YeS NO WhenReatlyT I 0,licensed coniractor ] owner hereby request inspection of above electrical work at: Jo0 Atltlress (Street Bos ar Roule NoJ Ciry i' C sY dQ ru. <3 4a r . F. .r e7i-xv Sectian No. Townshlp Neme or No. Range No. Counry I / 124) U -61 Occupanl(PRINT) Phona No. 13e ' rrC Power SuOPlier AOtlrew EI ? 4t P 4 ? L . M G V Eiemncai Gonvacior(Company Name) ConVamorS License No. ': fti'4 C?,., ??n ?f C ? ej. Mailing Atltlress iCOnldor or Owner Making Inslsllation? ali 7/ r n F,T dvr s- -=-< Authorize0 Slqnature.fE radouOwner Makmq Installation) Phone Numper ?/ Q.n / ?.a?- ?C !'+ 7 ! MINNESOTA STATE BOAPU OF ELECTHICITY TMIS INSPECTION REOUEST WILL NOT Gtlgqe-MltlwGy BIOg. - Room 5-173 BE ACCEPiED 8V THE STATE BOARD 1821 Unlversity Ave.. 31. Paul. MN 551pG UNLESS PROPEP INSPECTION FEE IS Phone (612) 842.0800 ENCLOSEO. 9/,29/?y? REQUEST FOR ELECTRICAL INSPECTION n Iyr?A , See ins1mMions lor compleling ihis form an batk ot yetlow coOY. II. 01 L-47 "X" RPlow WorJs Covered bv This Reauest ee.ooooI+f- 14 : . ? ? ? S: 'w.» r - - :.-s - - -- --__ ew Add Rep. TypeoBuilding AppliancesWired EquipmemWirad Home Range 7emporary Service Duplea Water Heater Electric Heating Apt Building Dryer Other-(Specity) Comm.lindustrial Fumace Farm Air Conditioner ONer specity) Convaaorg RemaBS: , f / ?`rt 4eA?•. ? ca Compute lnspection Fee Below: ' ??`pr ? P0` ?? + ° ?`"" ? "?Di?<`? # Oiher Fee # ServiceEniranceSize Fee # Circuits/Faeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps TranslOrmers Above 200 _ AmpS ve 100 _ Amps Signs Inspecm.'S use onry: ? 707AL Irrigation Booms Special Inspection AlarmlCommunication THIS INSTALLATION M E OR RE'DDISCONNECTED IF NOT Other Fee COMPLETED WITHIN 78 MONTHS. I, the Electrical Inspector, hereby f Rough-in oate certi y that the above inspection has been made. F;nai i oa??y OFFICE USE ONLV ? This requast voitl 18 months 1mm Thisrequestvoidq-? 18 months fmm k W09038$ " qq,so Renuest Dale ?'?' Fire No. Rouph-in Inspection fteqwratl? . ?. []Ready Nuw ? WiII Nntity Inspev tnr Wh R Yas ?NO en eatly ? licertsetl ElecVical Contrector I h¢raby requast inspec[ion o{ above ? Owner electricel work ins[alleE et: Sveet Address, Box or Route No. Giy ecunn i'i". Township Name or o. enae o. Counry I Q tZA-__. Occapent (PflINT , ) Phon¢ No. -S;? y Power Supplfer Address Elach' sl Convactor ICompanv Namel Convar.tor's License No. 0. La tcPa?- ? [ Mailinp Ad "' ss (Convactor or Owner MakingIn\staila\tionl ?..JS ?? ' 1V W 0-E Authorized SiB^aWr nhecmr/Owner Ma ine Installation) e (C o P ho ne Number ? y J lt ?e. ( ? p' l!J ' O MINNESOTq STpTE BOAFO OF ELECTftICITY THIS INSPECTION REQUEST WILL NOT GrigBa•Mitlwey elde. - floom N.191 BE ACCEPTED BV THE STqTE BOAND 1827 Univarsixv Ave., St Paul, MN 561D4 UNLESS PPOPER INSPECTION FEE IS ow.._.. 1a111 ew??'ll E NC LOSED. REQUEST FOR ELECTRICAL INSPECTION klIft Ee-ooooi-oa u: ' SBe instructions for completinp thia form on beck o1 yollow copy. "X"? Be,90w Work C'overed by This Request Y 3_$ r'j 36 New AAd Nep. Typa ol Building ApVliencxs Wired Equipment Wirea? Home Range Temporary Service Duplex Wa[er Heater Lighting Fixtures Apt. Building Dryer Elec[ric Heatin Commercial Bidg. Fumace Silo Unloader Industrial 81dg. Air Conditioner Bulk Milk Tank Farm v ine, isw3drvl l a.! UCUIy OI O1M1Lf Compute Inspection Fee 8elow - - q Fae ServiceEntrenceSize d Fee Feedars/Subteedars # Fea Circuits ? to 200 qm s 0 to 30 Am s ,3C2•SO 0 ta 30 Am Above 200 qm?y 31 to 700 qrnps ) S 31 to 100 q 5 Swimmin Pool Above 700_Amps Above 700_Amps Transiormers Irrigation Boorc?s , Partial'Other fae Signs Specialinspection 5 T Hemarks OT RouBh-in Inspector, heraby , CBfllfy tM181 S?IB flbOVB Final Optq ? ?? inspection has hean ? ?0 meda. Thla reauast void 18 months irom J 57?74 cA?io 13 Request Date - -' Fire No. Rough-in Inspaction ? ?- ?3 -I 2 Requiratl? XReatly Naw ? Will NoNy Inspecror Wh R tl ? - ? Ves No en ea y I licensed contractor ? owner hereby request inspection of above electrical work at : Jao Adaress (Streel. Box or Route Na.) Ciry LU 4 E n $ection No. Township Name or No. Range No, County OccupantIPRWT) Pho o. David Benke Power Sapplier . Adtlress Dakota Electric Farmin ton Electr¢al Comractor Company Name) Comractor5 License No. Maili ess nra , or ne, aM xing Inslallation) 14811 Endicott way Apple Valle , Mn. 55124 Aur,.ze35q alure IGonlractou r Mdking I tallaiionl ? Phone NumOer 423 -4328 MINNESOTA ST4TE BOAPO OF ELECTRICITY THI$ MSPECTION REQUEST WILL NOT Gtlggz-Mitlway Bltlg. - Room 5473 BE ACCEPTEO BV THE STATE BOARD 1821 Universiry Ave., St. Paul. MN 55106 UNLE55 PROPER INSPECTION FEE IS Phone(611)60Y-0800 ENCLOSED. 2 Ja2. REQUEST FOR ELECTRICAL INSPECTION See instructions tor completing Ihis torm on Dack ol yellow mpy. J57574 "X4 $e/ow Work Covered by This Request EB-00001-08 ^?l?l0 9L.? ? ???:I,.V ew 4dq Rep? TypeofBuilding AppliancesWired EquipmeniWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) • Comm./Industrial Furnace f ed Met2r Farm Air Conditioner Olher (specily) Gontractor's Remarks: Compufe Inspecfion Fee Below: # . Other Fee # ServiceEniranceSize Pee Jt Circui[siFeeders Fee Swimtning Pool 0 to 200 Amps 0 ta 10o Amps Trensformers Above 200 _ Amps Above 100 _ Amps Signs Insoectors Use Only: OTA tr rigation 6ooms J p T ?_ r5 ? Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDE ONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Elecirical Inspector, here6y ti( h h Rough-in oare cer y t at i e above inspection has been made. Finai ? Date ' _eG OFPICE USE DNLV ? This reqoest witl 18 months Imm C?t.rr#ifirtttr nf (Orrupttnry Citp of Qfagan 11rpttrtmrni nf +.?uil,bing 3naprrfiuri Tbir Cati fitate ilturd purruant ta the nyuitemantr o( Section 305 of the Uru form Building Codr mti f ying that at tbr time of iunanrr thit rtrHrture mat in camPliante witb the variowr ordinanca of the City rtgulating buiklirsg rmutruction or xte. For the follaving: U. cldfi?tlm SF DWGIGAR Maa.hmmt NO. 8370 o=warTYw R-3 iywc?? V Fl.zm NA zonwwcdaR'1 o?.ffta"Jollefson Bldrs.,aa., 1655 Norwood Dr.. EaQan ?GdJwAad? 1634 Norwood Dr. ?yLot 10, Bl. 3,Brittany lst 74'a 1 nri. 9Y: B.dd?oMW - P17F- o„,, October 28, 1983 ;7 CIZy CF FAGAN Irclude 2 sets of plans, 1 site plan w/elevations & BUIIDING PEIai2T APPLICATION 1 set Of efiergy Ca1NldtLOns. 1?I _fi? Rb Be Used Fbr ?- Valuation ? 7 ?? -i Site Address ?Lo? Gv UI ^ 1 ,?i Lot Block ? Sec./Sub. Rv ? Paroel 6 1 S60 (Oc-) 0 ? Gwner: Addx+ess: City/Zip Code: Phore # : aantractor: Ac3dr+ess: i(-?? I?G'VtA1GGY? 1)(Kiw, city/zip (bde: 2 ?510 Phore M : Arch. /Bng. . Ac3dress: City/Zip Code: Pha1e # : ? (7F'FICE USE ONLY Exect D? OccupanCY Alter Zoning F4-pair Fire Zone - Enlarge _ 7ype of Const. Nbve # Stories Derolish Fmnt G z ft. Grade Depth 3 Y ft. APPImVPSS FEES Assessmrtts Perntit ?.? 5? °-° Water/ScivPS Surchdtq2 Police P1an Check J /? Fire _ ?- SAC gng, Wat,er Conn. Plarvier ' Water Meter ?O ?- Council Road Unit V"5v Bldg. Off • ? - '? APC 'IO'PAL -t t S.l -l ' S? roiie;soa nuiioe e tae. 't:?' ---- __' JACKSON - SURYEYORS SCALE. IRS4O p`pIST[RFD UMO[R LAIY[ OF STAT[ Of YIMf1MOTA O DEtuflTL.S iRau OOO.O E X f ST" tN G E L. K'ii6 EAST 55M STHEET, MINNEAPOLIS, MN 55417 7273484 oRaIKAt?F- A $?nrbtpor's dcrtftitatt \ ? .? ? - ?? .05 v \ Se??? /g.5 y? • 'iop0 . ? /?? ? 1 I OQ• 9?' J? . N .sf??,AL? Ol 10 ? C ?e 1 N V r N m 1 `05 e U,"i*Y J ! w? L L L ??o?"' /?s' ??• Z 13'YS4 I ? d ? 700.I " 31.on 99. , 3 0 ? ? ? I MFREYY C[RTI?Y T/fAT 7NE ABOY[ le A TRtl[ AM6 CORR[CT PLAT OF A SUIEVK Oi Lot 10, Black 3, Brittany, ?aketa Couoty, kioaesota Ot'. 11452 i83-60 Progased Garage Ploor Elev. 102.0 Praposed Ffrst Floar Elev. 102.8 Propoeed Barsment Flnar Elev. 94.0 -1at. Anguo[ 19&3 As wRv[rtc W Ms rNte owv or D. i $1pM[ F. G. iACKSON. RLOIRMTIOM. MO. 5600 Cities Di ital ? Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. -•?:? < 1?, v. 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' • ? yq-.Y: iuAU:S ?. ?.,? t " . . ?. f. f¢r?...• ?'17y.Z,.`.?` :?. ? n ?? -? , ?? ;:?A1''?I 'I?`L?:1 ? Tt .. ?. .1 ?r ? ' ? •. ... ,? a?'(`} i ?? ' e'? ,.?.?e?S?aZ.?t ? • ' ?^ w?.i• ?t ??f' yfa.r??S:..1_ral??s.1 .1,._ .k?,? . ?+r '(ii.y_.?.,..t..:_.?3"?•L ,. . , . . .. . : . . . ... ? ...._. ' ?' • r , , af??! ? `• ?? l?f,?t"??..`?-. s.v -_-?, • ? ? . n 2004 RESIDENTIAL BUILDING PERMIT APPLICATIQN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ? lJ Y-7 <-?3U Telephone # 651-675-5675 FAX # 651-675-5694 Nem!ConsWctionReouirements RemodeVReoalrRequirements 3 registered sde surveys showing sq. f4 of lot, sq. R of house; and all roofed areas e alYsxed) 20% maximam loi mvere 2 copies of plan Calwtatlons for heated additions 1 set of Ener ?? iu?' g ( gy 2 copies of plan showing 6eam & window sizes; poured found design, etc. 1 site survey for additions & decks 7 set of Energy CalculaUona Addmon - iiMkate iionaite septlc sysfem 3 copes of Tree Preservation Plan H lot plafled a8er 711193 Rim Joist Defail Options selettion sheet (blcgs wBh 3 or less uniis Date 44_ / ou / C)q Construction Cost '1 ,.:;z S SiteAddress I h?? Nc?? yD onA 1,--) r i Ve- UniUSte # Descriptlon of Work a Multi-Family Bldg _ Y_X, N Fyrepiace(s) _ 0 _ 1 _ 2 PropertyOwner `12 r ?;c 1 ? t,t h e?1 a Telephone 9 (fC5 1) tc3(?- (o Ll I b Contractor n ?\ S Address CiTy State Zip ?? I l 4 Tetephone #((051 ) 025 5"o-'5LFq COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Enefgy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted . Submitted • Energy Envelope Caicufations Submitted Have you previously constructed a building in Eagan with a similar plan8 fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Y_ N If so, 25% plan review Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and aclnowledge that the T is complete and that the work will be in conformance with the ordinances and codes of the City of E ?-?MN 3tatutes; I understand this is not a permit, but only an application for a pemut, 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. G C, vl? I Y lvc\ r,c? Applicant's Printed Name ?a ) pA.,,? ApplicanYs Signature OFFICE USE ONLY Sub Types .} ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBidg O 02 SF Dwelling ? OS 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 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screeri(gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ' ? 06 04-plex ? 12 12=plex Pibg_r or _ N ? 25 Miscellaneous , Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors ? 34 ReplaCement 'Demolition (Entire 81dg) - Give PCA handout to applicant ' Vafuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump ` # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered i Type of Const Width REQUII2ED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addirion) _ Plambing Foundation HVAC Drain Tile Other Roof Ice & Water F inal _ Pool _ Ftgs ` Air/Gas Tests Final ^ _ Framing _ _ Siding _ Stucco _ Stone _ Brick F'ueplace _ R.I. _ AirTest Final _ Windows _ _ Insulation _ _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector -? qnO7 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN .. .... ._ , 3830 PILOT KNOB ROAD, EAGAN AflN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. + ?L ` S te Street Address ?? ( Vn (vvOod lJL iJnit # Property Owner hG Telephone # ( ' ') 851-365=1340 Contrector 3870 Dnm 'R #19e' Telephone # ( ) ? Address ??* ? `?5123-133g+ City State Zip The Appifcant is: _ Owner ?`Contractor Other Septic System _ New _ Refurhished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-buitt $ 10.00 Alteretions to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee Includes installation of a water softener and/or water heater at the same time. If you are installinq onlv a water soffener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. _Sep6c System Ahandonment _Water Tumaround (add $130.00 if a 5/8" meter is required) Other: \ j Water Softener Water hleater $ 15.00 _ new ? replacement Lawn Irrigatfon _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge , $ .50 Total JUL 2 6 2007 S(5?0 I hereby apply for a Residentiai Plumbing Permlt 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 plumbing codes; that i understand this is not a pertnit, but only an application for a permit, work is not to start without a permit and work wfll be in accordance with the approved plan in the event a plan is required to be eviewed and approved. c7 _ ApplicanTs Printed N me ApplicanCs Signature zN965 SA(S ? fiorOtficeA9se --------- - ? Permit #: L / I Pertnit Fee: ? `vV I I I ? Date Received: ? I ? I Staff: I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 'Vid I08 SiteAddress: 1&P3`f rjarwOOC( Qr- Tenant: Suite #: RESIDENT! OWNER Name: Ly116h Phone: (65l) [+3&-4,410 Address/ City /Zip: I& ;N Norwooj 71r lEaaa.. . Applicant is: _ Owner X Contractor TYPE OF WORK Description ofwork: Tcar //ZcraoF Construction Cost: 5300 Multi-Family Building: (Yes _/ No ? CONTRACTOR Name: tveryru,. Cons+. License#: aos4 -7,X0 o Address: q70 2"mone( Avz City: .Si- Pav f State: m,J zip: Phone: C. S?] a-oq - 3j36 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Mlnnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 Submi55ion 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 plan7 _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Condactor: Phone: Sewer & Water Contractor: Phone: ?NOTE: P)ans and supporting documents thatyou submit are considered fo 6e public information:. Podions of ' ou provide specific reasons that would permii the City, to the ittformation may be classiFted as non-public if y N ?$, I hereby acknowledge that this informetion is complete and accurate; that the work will be in confortnance 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 Nµfe N?nSO4 X ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 3o.Sa 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION Cty Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ? Telephone # 651-675-5675 Please complete for: singlc family dwellings & townhomes/condos when permits aze required for each unit Date 7_ / ?M / zq"? Site Address ll 3?I &r// aDG?Unit # Propcrty Owner ?Q/" Telep6one #(6,y/ ) /n 3l ' lv qI(J Contractor SEpGWICK HFCTINI` R AIR PONIIRIONING LLG' 8910 Wenhr-nh Ava So StreetAddress M?p nni 5,49n City State (952) 881-9000 Zip Telephone # ( ) Bond #: Expires: The Appticant is _ Owner ?Contractor _ Other Add-on ar alteration to eaisting dwelling unit furnace _Additional ?Replacement0?//!'Y/(d, &wq1a4 $ '5b 30.00 air exchanger V airconditioner _New L./ Replacement4J'1iJjfJy zt?,V, other State Surcharge $ .50 Total $ 6,1?a I hereby apply [or a Residential Mechanical Pemut and aclmowledge that the informauon is comple[e 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 not a permit, but only an application for a pernut, 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 appcoval of plans. ? SOMCK HTq. & AM XW. 4C Applicant's Signature ,T-, r? (,-A T"r(4 JUL 2 1 2005 ? Applicant's Printed Name 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagaa 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 li Please complete for: wmmerciaUindustriai buildings multi-family buildings when separate pernuts are not required for each dwelling unit Date i Site Street Address Uait # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) d ? Contractor Street Address ll City State Zip Telephone# ( II) Bond #: Expires: The Applicant is _ Owner _ Contractor _ Other Wark Type ji _ New Construction _ Underground Tank _ Install _Remove "'see below _ Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: i "When installing/removing underground fank, 11 call for inspection by Fire Marshal and Plumbing /nspector PCI'tllit FfQS: $70.50 Underground lank inslalla[iudremoval ?I $50.50 Minimum (includes State Surcharge) or Contract Value $__?____ _ x 1% _ $ PeruutFee • If pemut fee is $1,000 or less, add $50 => $ State Surcharge If nermit fee is over $1,000, add $50 for ?I every $1,000 cernut fee $ Total Fee i nereuy appty tor a uommercial Mechanical Permit and acknowledgc that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of [he City of Eagan and with the Mechanical C'odes; that I understand this is not a permit, but only an application for a peanit, and work is no[ to s[ari without a perntit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. I Applicant's Printed Name Applicant's Signature Approved By: Inspector RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 ? I 377 S 651-681-4675 NewConstructionRaouiramenb II? RemodaUReoairReuuirements • 3 regislered sde surveys showing sq. ft. ol'ol, sq. ft. of house; and A mofe0 areas • 2 copies of plan (20°6 maximum bt coverage aIlowea) 1 set of Ener9y Calculations for heateG adtlitions . 2 copies of plan showing heam 8window ;izes: poured found tlesign, etc.) • 1 site survey lor extenar addi6ons 8 decks • 1 set of Ener9y Calalations li , Indicate if home served by seplic system for addilions • ] copies of Tree Presarvation Plan if lot plattetl aker 7l1199 . Rim Joist CetaB Op6ons selection sheel i bldgs with 7 or less unils) DATE VALUATION 5 ? 017 Z7 SITE ADDRESS /(v3 y AJO&J,00'd DW-- I _ MULTI-FAMILY BLDG _Y ?!N TYPE OF WORK P B ? /-A-,nn ?cL FIREPLACE(S) _ 0%1 _ 2 APPLICANT STREET ADDRESS /1/9/LcN?B c? (.?P'l CITY??% STATElMti11PS.S1 ZZ TELEPHONE #657 -?Z 702Z-CELL PHONE # FAX # PROPERTYOWNERf /?-y?/'L ?/?dL1D/ V/??D TELEPHONE#W- ?2L-702Z ? COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Cate9ory - }[[N\'1:50'l'.\ RUL1;S 7670 G\7'L:G0RYI111 ,vIINNESO'1':\ Ri: LL•:S 7672 (v'submission type) • Residential Vendlatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _____ Plumbing system includcs: Mechanicai Contracfor: ?[cch.unic:tl sr',lcm includcs: Water So(tcner ? Water Heater _ No. of"Badis Air Condiuonin- 1-[cal Rccovcn' Sy'slcm I.iNm Sprinklcr "No. oF R.I. Baths Fee: $90.00 AUG 2 9 ?QOZ . $70.00 Sewer/Water Contwctor. J Phone # ? I hereby acknowledge ihat 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. Slgnature of Appl(cant (.U? ---- ---_--------- ----- ---._---------- ___------- ----------- -------- ----___------- '---•----'-'--------------------°.-"-------------- ---_ OFFICE USE OtVLY Pfionc # Certificates oF Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool I ? 30 Accessory Bldg ? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multl ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea:) ? 33 Ext. Alt - SF ? 04 02-plex 0 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multl ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Intedor) O 44 Siding ? 32 AddiGon ? 36 Move Bldg. p 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof O 48 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - 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 !i Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPEGTIONS _ Footings(new bldg) _ FinaVC.O. _ FootinBs (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC _ Drain Tile Other Roof _ Ice & Water _ F inal _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stoneil i _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retauilng Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC ' ? Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search ? Copies Other Total --?-CITY OF EAGAN 3F,II0 Pilc? Knob Road Eagan, Niinnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Datelssued: BUILDING 024504 09j09/94 SITE ADDRESS: P.I.N.: 10-15000-180-03 1634 NORWOOD DR LOT: 10 BLOCK: 3 BRITTANY DESCRIPTION: ? {?f1? uJ ?j ? r- ?- ? FIRE REPATR Building?-.Permlt Type SF (MISC.) 8uilding Wo?rk Type REPAIR \ % J ?- ? ? - r REMARKS: SEPARATE PERMITS REQUIRED FOR ELECTRICAL & PIUMBING WORK FEE SUMMARY: VALUATION 8ase Fee Plan Review 5urcharge Lic. Search Total Fee $198.00 $128.70 $9.50 Fee 15.06 $341.2@ $19,000 CONTRACTOR: - Applicant - s7. Lzc. OWNER: DU ALL SVC CONSTR INC 17889411 0003178 BENKE DAVID 636 39TH AVE NE 1634 NORWDOD DR COLUMBIA HTS MN 55421 EAGAN MN (612) 788-9411 (612)454-5997 I hereby acknowledge that S hawe read this 'ipplication and state that the information is correct and agree to comply with all applicable 5tate of Mn. Statutes and City ot Eagan Ordinances. I l, . t -j APPLICANT/PE MITEE SIGNATURE ISSU D BV: SI ATURE C;?" S CITY OF EAGAN ? 1994 @UILDING PERMIT ?APPLICATION ? ? ? L-0 681-4675 „ SINGLE & MULTI-FAMILY ?i 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`energy calcs. ll Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or I1) lot change is requested once permit is issued. Date Val uation of work Site Address: STREET SU1TE # Tenant Name: (commercial only) LOT BLOCK J SUBD. 'I4 P.I.D. # Descri tion of work: ?2?t The applicant is: O Owner 0"Contractor ? Other'I<oe5cr;be> Name L7e4? l?m DikV i D l? Phone ?l 5?` 5q97 Property owner LAST FIRST I r63q No"ood Dr. j? pddress STREET II STE # ? R? City J Sta'te Zip , Company Dv ALL ?U 1 GF- -4 v\G Phone 7W`"9ti H 3 9S OCL 31-79 ? 3 ? - 3 ? 4? KT I Contractor EXp, ? Address _ License # I c;ty col?mb;A- rQ, h+s ?;Stat rn!v Z; Ss?lZ - e ' P a ? b - bo Company ll Phone Architect/ En9ineer Name , Registration # ? Address Ci ty Sltate Zi p ; Sewer & water licensed plumber ? Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a plication and state that the information is correct and agree to comply with all ap lic le Statej?of Minnesot Statutes and City of ag an Ordinances. ' gnature of Applicant: Li `"1' OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? il Apt./Ladging ? 02 5F Dwg. ? 01 4-Plex ? 12 Multi. Misc. ? 03 5F Addition ? 08 8-Plex El 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ,E] 05 5F Misc. ? 10 Multi. Add'1. ? 15 Deck WOR K TYPE I C (? ? lY "f ? 31 New El 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATIO N Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ? Site ? Wallboard Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Oeposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: Basement sq. ft. lst F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing 1El Final v¦Lmc;m: k;] Frami ng O Draintile , , ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facili;ty ? 21 Miscellaneous ? 37 Demolish MWCC System City Vlater PRV R ?quired Boost er Pump Fire ° Sprinkler Censu 's Code SAC C" ode Censu' Censu" s Bldg ? s Unit Asses? sments EY Insulation ? Fireplace SAC q SAC Units ti L t'. . ?... ;, STATE OF MN DEPT. OFCOMMERCE ?. .... ! 133 East Seventh St 5t. Paul, MN 55102 Y ? ??> (612) 296-6319 ? ? BUILDING CONTRACTOR ?tl ID#0003178 RESIDENTIAL CONTRACTDR CORPORATiGN Issued: 01/27/92-03/31/95 GARY A DOpNER DU ALL SVC CONSTR INC ' 636 39TH AVE NE, I!`MPLS MN 55421-0000 e i PERMIT City of Eagan Permit Type:Building Permit Number:EA170743 Date Issued:07/15/2021 Permit Category:ePermit Site Address: 1634 Norwood Dr Lot:10 Block: 3 Addition: Brittany PID:10-15000-03-100 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 - Cheryl A Lynch 1634 Norwood Dr Eagan MN 55122--275 Estate Claim Services Llc 6701 Penn Ave S, Suite 201B Richfield MN 55423 (651) 309-1114 Applicant/Permitee: Signature Issued By: Signature