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1668 Norwood Dr - Use BLUE or BLACK Ink -For--Offi-ce--Use- I I City o Eajan Permit#: I Permit Fee: I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff INFLOW & INFILTRATION PERMIT APPLICATION Plumbing I Sewer & Water Date: rx Site Address: 16 ~ Xv,, ff WG~C 1/ ( n~'1 42," -,2;2 2 Tenant: Z-"~rl- Suite RESIDENT /OWNER Name: Phone: Address/ City/ Zip: Z66 S N 2 Name: A6144e /J l~ L~YLIZy' License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: 5%l~// ✓)iGJ~ ~i ✓~,r°11~1 J'3/i'1 DESCRIPTION 41 FEES $56.00 /Each (includes $5.00 State Surcharge) (Rev. 6-30-10) 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.gopherstateonecall.org 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 ao V, v lt~r X J~~' Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground -Rough-In -Final ? CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 ncceiveo FROM AMOUNT $ ? Ae DOLLARS too E]CASH ? CHECK FOR FV ND CODfi AIAOUNT Tha k ou ?' ' ? BY yGC. White-Payers CopY Yellow-Posting Copy Pink-File CopY CITY OF EAGAN ?T , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1? ? 8903 PH ON E: 454-8100 BUILDING PERMIT To be u"d for Site Address 1668 PdOR?irQOn DR Lot I) Block 3 sec/sub. nR T Parcei No. 10-15000--030-03 Name TOLLEFSnr7 BLDR ; Address 1655 NO 1;1?T('i0I} D b City T'lCI-,?'d Phone 4 o Name ?? Address F- City Phone H F W Name Address s- W Citv Phone I hereby ocknowledge thot I hove the informotion is correCt ond a Stote of Minnesoto Statutes and Slpnature of Permittea A Building Permit ia issued to: atl work sholl be done in o i Buildirg Officiol ?.i Receipf # i , ~?il ? ?0(1 Dare :?Li}'.CII zl `: 1t3 Erect Occupcncy Alter 0 Zoning Repoir ? Fire Zone N/A Enlarge ? Type of Const. 'J Move p # Stories Demolish ? Length ? Water & Sew. P li o ce Fi re E ny. Pl anner :ation and stote thot Council gldg. Off. with oll appiiccble Ordinances. APC Permit ' 00 surcha.ge 40.50 Plon check 18 el• () 0 snc 525.00 Wcter Conn. 470.00 Water Meter 63.00 Road Unit 260.00 Totol 51 , 9 ?. 2 . `. ? ^ on the express condition thar ond City of Eoqan Ordirwnces. Permit No. Permit Holder Misc. Permit No. Holder 002 W Disp. Sewar Electric pection date Ins Insp. Other Footingt af Foundation Framing ? Rouph Plb9. I Rough HVAC ",' Insulation ? Final Plby. Final HVAC ? Final c? Water Dsscri6e Location: _ Well Sewer - Pr. Ditp. MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KN08 ROAD, EAGAN, MN 55122 PRICE: PHONE: 454-8100 Site Address Lot V ? Name _ ["?as, dir H1 ? Address LG t1 c City 1r L,? ff •r ? Name 3 Address iLc. , NL U1 p C;ty TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other ? BLDG. TYPE WORK DESCRIPTION Sec/Sub Res. V New Mult Add-on ? Comm. Repair ? ?- i_-, i ci fa O1hBf M BTU M BTU M BTU ?M BTU CFM FEE: S/C: TOTAL: ?y.., . . .. _ ?r ? _,.... ; PERMIT # RECEIPT # DATE: FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. COMM/IND FEE - 14b OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCiAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) .. ? i , • ? c. ,w SIGNATUR OF PERMITTEE 711s87 FOR: CITY OF EAGAN Receipt MECHANICAL PERMIT CITY OF EAGAN .,,.,_.. ?,.w.. FiII in numbered speces S/C _ Type or Print /egibly Tot. 1. Date 2. Installation Cost i 3. Job Address Lot "- Blk. Tract ? 4. Owner 5. Contractor Phone 6. Address 7. City " State Zip 8. Building Type: Residential O Commercial ? Institutional ? 9. Work Description: New 2" Add O Alter O Repair ? I 10. Describe Fuel Type I 11. No. Equinment BTU - M. Ea. Forced Air No. EQUiament CFM Ai H dli 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 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 464-6100 Receiot C, PLUMBING PERMIT ?_ . , r_ . CITY OF EAGAN Permit No, f Fee Fill in numbered spaces S/C Type or Princ legibly Tot. 1. Date 2. Installation Cost - 3. Job Address Lot Bik. i-l Tract _ r - •?--' / „ - 4. Owner -- 5. Contractor 4?'VL -/C 6. Address ? 7. City ? State 8. Building Type: Residential L i ; 9. Work Description: New A 10. Describe 11. Zip Commercial ? Institutionai ? Add ? Alter ? Repair O No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner 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 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. Approved - CITY OF EAGAN 454-8100 Phone ? CITY OF EAGAN Remarks Addition BkITTAlvY Loc 3 sik 3 Parcel 1?? ?gnn nzn nz Owner Street 1668 Norwood Drive State Vlli UEl.! L4. Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ?,L 1127.96 A014041 6-2-84 STREET RESTOR. GRADING ?G 198 428.73 28.58 ? 384.41 't SAN SEW TRUNK Jc ? 1976 156.51 1 62.64 " " • SEWERLATERAL 336.06 3696.67 " WATERMAIN * WATER LATERAL 1991 WATER AREA -5/ 1$0.00 14014041 6-2-84 STORM SEW TRK s rY 1981 492.50 j2 .$3 351 , 1$ A014041 6-2-84 * STQRM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 260.00 3-21-84 WATER CONN. 470.00 't BUILDING PER. 890 sac 525.00 " PARK 3830 Pilot K;;ab Road r55U P: O. Box 21199 PERMIT NO.: Eagan, MN 551,21 DATE: Zoning: ` No. of Units: Owner: 8 'SOn ?' _?KS Address: Site Addreu: 1 6 . oraroo . r ve ?,_ ..r. tt?ny s Plumber: f?Fn2 RV an - - 0 14 1 . p 425.00 pd 1 egrea to eemply wieh /ie Ciyr of Eayon Connection Charqe: Ordinencas. Accourit Deposit: 'sc r • } Pertnit Fee: ? •.?1L?: Surchorge: ` By Misc. Chorges: Date of Insp.: Total: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot f' nab Road P. .O. 6ox 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: No. of Units: Owner: ' ;,.letson Bldrs /4ddress: Site Address: 1668 *iorwood Drive L3 B.y ::xtetar. y lst Plumber: f -.er-,'r. :^.vgn Meter No.: Connedion Chorge: t' 7?J `00 v`? :t S. 0[ ; n?_; 5ixe: Accourff aeposit: 10.9 0 -?d Reader No.: Permit Fee: 1sgros to oomply witb lIM Gry of Es4en Surcharge: 'T) d 63.00 ?7d meti Ordinosua. Mlsc. Ghorpes: _ Totol: gy Dote Paid: Date of Insp.: Insp.: CITY OF EAGAM WATER SERVICE PERMIT 3830 Nif ot r' nob Road P. O. Box 21199 PERMIT NO.: ,, Eagan, MN 55121 DATE: _++.{ " Zoning: No, of Units: 1 ? Owner -`0l efsou Bldrs f Address: , 7, '_ Stte Address: 5$. ??orwo ve :3 B3 Brj.ttanv 'st iomber: - ' : ? ? ( ? ter No.: ` ?l l ? - ' f1V t nettion Chorge: 470.90 p' - ' Stx. 4 ?urrt Deposit: 15. 00 pc ? Reader No.: o Permit Fee; 10.00 pd f-f 1 a9re* to hr wlek ity of a Surcharqe: . 5(l n? O?dina . Misc. Gwrges: r j. 00 Total: By Date Paid: Oate of I nsp.: ? ? I nsp,; CITY OF EAGAN '?j Q 3830 Pilot Kno6 Road, P.O. Box 21-799, Eagan, MN 55121 i` • 8903 PHONE: 454-8100 BUILDING PERMIT Reteipt # ???L(/1 ?- To ba uwd fer SF DWG/GAR Est,yalue $81,000 pate MARCH 21 1y84 SiteAddress 1668 NORWOOD DR_ Erect 2SX Occupancy R3 Lot3-81ock 3 Sec/Sub.BRTTTANV qlter ? Zoning RI Parcel No. 1 0-1 5000-030-03 Repoir ? Flre Zone N/A Enlarg0 ? Type of Const. V W Name TOT.T.F.FSnN RT.nRR_ Move ? # Srories Z Address 1 6 55 NnRWOOn T]R _ --- Demolish ? Length7(L_ ? City F.A(]AN Phone 454-6873 Gmde ? Depth._3D-Sq. Ft.- Approrala Feea o Name S?E ? ?? Address r City Phone ?w Name _? Address u ?W City Phone 1 hereby acknowledge thot I have read this oppiication ond store that the inlormation is wrrect ond agrea fo comply with all opplicable Sfate of Minnesola Stafutes ond Cify of Eogan Ordinancet. Signoture of Permittee - A 8ullding Dermif is issued to: oll work sholl be done in acw Assessment - Water & Sew. Police - Fire Eng. Plonner _ Council _ Bldg. Off. _ APC Pe.,l,ct $ 376.00 Surchorge 40.50 Plan check 18$.00 SAC 525.00 Water Conn. 470 _ 00 Woter Meter 63 - 00 Rood Unit 7Cn 00 Totol '<_?2., rj0 TOLLEFSON BLDR. on the ezpress condition thnt e wilh al aDCliw e Sfate of Minnewto,5tafutes and City of Eapon Ordinances. Building Officiol SEDGWICK HEATING & AIR CONDITIONIN 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 887 AODRESS t 6???D??' Ok - OCCUPAN7 SOLD BV 'S O-?? ?\ MAKE ?k SERIALNO, ,q ? -?j? ?'? THERMDSTAT b ?1' 6vvv VALVE LIMIT LIMIT SETTING ?00_-0"F FAN SETTING A- PILOTTYPE ? IGNITION MODEL PILOTTIMING ? PRESSUR i ! ' PEFCENT COz INPU7 CFH ` ? /? PERCENT Oz STACKTEMP. I_1PERCENTCO FORM 235 (REV.11I09) GopCpO? qTY HEATING S `&OO TEST RECORD JOB NO. Cb ?p ? - OWNER - A"'"(" INSTALLED BV - 01 MODEL "-' "oU.oo(`G i` INPUT 7???-n/ VENT SIZE TVPE OF LINER /? r ? LINER SIZE L? FILTERS: SIZE WIRING TEST TAG LIGHTING INST, DATETESTED / 112714?1 ? COMPANV TESTING NAME OF TESTEfi FORMDiSTRIBl1T10N: WHITECOPY-J09FILE YELLOWCOPV - CITY /?/,?y r ti?i^?- Rb 8e [laed Fbr 40 Site Addree6 U--)W, Lct ? 81odc ? Poiml 1: / J Sec./Sub. clTSr cr• F1AGAN Ir,cluae 2 sers of p?iansp ??03 1 site plan w/elevatians i I HUIIDING PEEihII'P APPLICATZCIN 1 set c,f etecgy Calt,ylatlang. j ?-valuatiai Date dLI,!/(,i/1 CFF'ICE? USE RNI.Y Erect ? oocwPancY ; 47J d- 03 0- C7_ nlter zonir?q Owtlers ?,- {jE'Q(}ll) ?e Fire 2one _ 'lype o£ oonst. ??? Move M Stories Derolish Fxont 7p f{, CLtS'/Z1P Cade; Grade Dq->tli .3o ft. Ptnna # : aaare$: 1 ? c ah+/xiP Qade: ptwne o: _ 45 ]1idi./FS'iq. s Addieae: • citx/zip ooae: rhom t: APPIiWALS FEES . Assessmnt8 Permtt 37 Water/5ewer Surcharge yh Sn_ Police Plan C1erk ? Fire SAC .?-a,g- g. ? water Conn, P1any1C Water Met1's /03 2? Ocx.tncil Road Unit Bldg. Off.' ? APC 3-??1??l pp? z+arnL I ; ?l a a ?5 ? „ , ?a.9 . . RESIDENTIAL BUILDING PermitApplication City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New ConsW cibn ReauiremenCS RemodeVReoair ReauiremenCs 3 registe2d site surveys shovring sq. ft. of lot, sq. ft. of house; and II roofed areas 2 copies of plan (20°h maximum lot coverage albwed) 1 set of Energy Calculations for heated additions 2 copies oi plan showing beam & window sizes; poured tound design, etc. 1 site survey tar addifions & decks 1 set o( Energy Calalations AddiG'on - irMicate Hon-site sepfic system 3 copies of Tree Preservalion Plan if lot platted atter 711193 Rim Jaist Detail Options seledion sheet (bldgs with 3 orless units ? ?C) oe `Ue g 1 ?' Office Use Onlv Cert ofSurveyRecd _Y _N Tree Pres Plan Recd _ Y_ N TreePresNotReqd _Y _N On-sde Sepbc System _ Y_ N Date Q? Site Address ? n{ Lko' Construction Cost ?i 6?C?CJ Unit/Ste # Description of Work ?C?y?l?iPP*wvt f ei ('?p,.sAqq (Vf'r it/ Multi-Family Bldg _ Y? N ? Fireplace(s) ? 0 _ 1 _ 2 Property Owner ?, ?Y ?e,IKICI? Telep6one # Contractor ?i0 (-LaEt Lf (-Tfiv 4 Address State Zip City Pt.?) ! r Telephone #((?js') ) -Sf COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Catesorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a fee applies. ?1`G 11'1 Iti - ? ?? pUG 12 2103 plan2 _ Y N If so, 25% plan review Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( 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 permit, but only an application for a permit, and work is not to start without a ,V(n the case of work which requires a review and permit; that the work will be in accordance with the approved pla approval of plans. ?crc ????sh;Ff /, ,- Applic t's Printed Name p ca 's signaturii/ OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace 0 21 Porch (3-sea.) ? 31 Ext. Alt - Multl ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF O 04 02-plex ? 10 OS-plex )e 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_vor_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 Alteratlon ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors X 34 Replacement `Demolltlon (Entire 81dg) - Gfve PCA handout to applicant Valuation ,Lpew Occupancy R_-? MC/ES System -- Census Code j/ 3 Zoning /7`/ City Water SAC Units Stories Booster Pump - Nbr. of Units ? Sq. Ft. PRV ? Nbr. of Bidgs Length i? Fire Sprinklered Type of Const Width ? REQUIREDINSPECTIONS Footings (new bldg) FinaVC.O. ? Footings (deck) ?- FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof Ice & Water Final Pool Ftgs Au/Gas Tests Final ? Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insularion _ Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S8W Permit & Surcharge Treatrnent Plant License Search Copies Other Total / 0 ? i C)? 0 a ? J V . t 4?? I M[R6tT Cl Or.11495 , ? tee-7 JACKSON - SURVEYORS R[61/T[R[O VND?R LAWS O/ KATt M YIMNtpTA 3616EAST55thSTREET,MINNEAPOLIS,MN55417 727348q Snchtpor'Ii dccNtuat , ?/ . ?? { N \• •-}? e, / z1? .?? 2?" yl l / 1 Or,,; e ry N _ /N N e• ??0/? ;, ? N i Tf` ` • 116 , ? j,? ?-~ ?i Scale: 1".30' •=Iran ? --?= Draioage OOO.04xistiag Elev. =Draiaage 6 Utility Easement ?'. \ s. 22 ; ' \ D ? ., s o ' {7 M1 rNAT TX[ ABOVt 18 A TRU[ ANC CORR[GT rLAT W A SUIIY[Y OF 3 1 Proposed Carage Floor Blev, I.ot 3,Block 3;Srir?Cany, ?opoeed Firet lloor Elov. Dakota Caunty,Minneeats. propoaed Basement Ploor Elev. . . ? RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN (Y f 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Constructlon RenulremaMe . 3 registered sile surveys showing sq. R. of lot, sq. tl. ol house; and all roofed areas (20Yo maximum lut coverage allowed) • 2 copies ol plan showing beam & windax sizes; poured found design, etc.) • 1 set of Eneyy Calalations . 3 copies ot Tree Preservation Plan'rf lot plaHed after 711193 . Rim Jaist DeWtl Optwns selection sheet (Mdgs with 3 or less units) DATE 9)' 'A ` 02 _ Water 5oftener _ Water Heater No. of Baths SITE ADDRESS IllOLp t? wbRv.?f4i7'O D R MULTI-FAMILY BLDG _ Y kN TYPE OF WOR&R06V 'MACZ (DFF L SbbtNL?tiV,, FIREPLACE(S) X 0_ 1_ 2 APPLICANT QµF 2lci_" Q? ?oi+.t C? C.DNiRA GT? dZ.S STREETADDRESS WC0% Ncctwavr DdL CITY GAG,l•1a STATE N0 ZIP 55_1, 27- __ --- - /? -------- TELEPHONE # ORRMLI&CELL PHONE 4 ' FAX # 4152-1u'1-loei54 ? PROPERTYOWNER n?Q.GvLoQI B%,Lt-csG.IC TELEPHONE#aS2-(o*8'7•1202-- . ------------------------------------------°--------°------------°--------------------------- COMPLETE THIS SECTION fOR "NEW" RE5IDENTIAL BUILDINGS ONLY Energy Code Category _ MINNlSO'PA RULI'S 7670 CATEGORY 1 MINNFSOTA RULF,S 7672 (J submission type) • Residenfial Ventilation Category 1 Worksheet Submitted • New Ener9y Code Worksheet Submitted • Energy Envelope Caiculafions Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mcchanical system uicludes: Sewer/Water Contractor: Phone # Phone # ? ??,F?k: u $'? nl AUG 2 12002 ---------°----------------------------------°---°--°---°-°--°-°---------°--°----------°-° °---------° --°---- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances Signature of Applicant D1?? Z'r_OL? OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Upda[ed 4102 1 7 j. /s RemodellReoair Reauiremenls . 2 wpies of plan . 1 set of Energy Calculatbns for healed additlons • 1 site survey for extedor additions & decks . Indicate if home served by sepfic system for additions VALUATION Phone # _ Iawn Sprinkler _ No. of R.I. Batt Air Conditioning _ Heat Recovery Sys[em ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bidgs Type of Const , OFFICE USE ONLY ' ?I ? 07 DS-plex ? 13 16-plex ? 20 Pool 13 30 Accessory Bltlg O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea J ? 31 Ext. Alt - Multi ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea; ) ? 33 Ext. Alt - SF ? 10 08-plex ? 18 Deck ? 23 Porch (screened) II ? 36 MuRi ? 11 10-plex ? 19 Lower Level ? 24 Storm Oamage ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ; P ? 35 Int Improvement ? 38 il Demolish (Interior) ? 44 Siding ? 36 Move 81dg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bidg)* ? 43 Reraof ?I? 46 Windows/Doors ? 'Demolition (Entire Bldg only) • Give PCA handout to appBcant Occupancy MC/ES System _ Zoning City Water _ II Stories Booster Pump _ Sq. Ft. PRV Length Fire Sprinklered _ W idth ?I REQUIRED INSPECTIONS il _ Footings (new bldg) FinaUC.O. _ Footings (deck) - FinaVNo C.O. 'i _ Footings (addition) _ Plumbing Foundation HVAC _ Drain Tile Other ?i Roof _ Ice & Water _ Final Pool _ Ftgs Air/Ga's Tests Final _ Framing _ _ _ _ Siding Stucco Stone, _ Fireplace _ R.I. _ Air Test Final Windows (newheplacement) ' _ Insulation _ Re[aining Wall Approved By 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 Building Inspector •9'ollefson Buildere Inc. ., r . r-• Or.11495 ? 188-7 . JACKSON - SURVEYORS Ri61iT[N[D UMD[R LAWf OI RAT[ OI YINNifOTA 3616 EAST 55th STREET, MINNEAPOLIS, MN 55417 727-3484 ScaLe: 1°n30' / ? a l. 3 $utbtpo['! 6tTtititstt •:Iroo ? --->= Dreiaage ? OOO.O?xiating Flev. =Draiaage 6 Utility Easement , Zp f?? ZB" `'1 io •3 ? zz: ; 7?/? / p o - -(I_ li%? ° t \ =-3i 7-r ze' 'ri /h N G. .S' e 7 1 ?-- q?? 1 X[REBY GRRTIrI'` TXAT TN[ ABOY[ It 11 TRUt AND CORR[CT PLAT OF A SURY[T OF . I.ot 3,Block 3;SriKtany, Dekota County,Mlnneeota. As el1RV[`/[D BY M[ TNIf 6Ch. l4rch ? p 1"4 Proposad Garage Floor Hlev. Proposed Firet Floor Eiev. Prupoeed Saeement Floor Slev. r[ F. C. JACKYON. MIMws T RmHTMT1oM, NO. 3000 i z/a4 ELD C ITY OF EAG?'?N APPLICA'PION FOR PER'?IIT SELVER AND/OR WATER CONNECTZOAT (PLEASE PPIHi) 1) PF.OP??T`! AGDRESS: r Fr.,L, DESCR?i'TIC:1: (Lot/Block/Subdivision or Tax Parcel T.D. Ntmr'.er1 i: =ST= :i, ST'.2UCP :2E , De?T' GF CRZGi :AL :.iiII.L`L`:G F_=:'ST ,- -'-° -_- , ?R-1 SUiGIv- cpLIILY ? R-2 GUPLE{ ('IWp UNITS ) Q R-3 ZCiv-1\IItC(JSE (Tf-r-,r:; + U?IITS) ( INZTS) ? R-? Aon.R?*rcnt/C?:L+?Cx`??II'i.'.i ( L`Li I:Sj ? COvTMSE_?CLaI,/'tr ETAII,/OFFICE _ ? LmUS'i'Ry L _ Q INSTI'IL'I'ICN'1L/GOVM?,MQvT 2? APDi_T= (PLEASE PRI4i) ? nkIE: ?rar..i_c--Fso,j Ovri-Dew's - ADoREss : crrY, sTaTE, zIP: PHOtNE: 3) PLomER LE rySE FOR CITY 11SE OHIY NPa '? : / l r7?I?C2 V1? N +'TT? ADDRESS: PIUNBERS UCE4SE: Active - CIT1', STATE, ZIP: 1,4NW Expired •- PHO?= ?l?/? MKSit:t _ ?f PLt1MBER LICENSE i/ Hat af Recard - - arr initia 4) OCCL*PpNT/uy?? kYLtAy??b YNINTJ ?'?: G ADDRESS: .G-S CITY, STATE, ZIP: Reo PFK}:IE: S) LNDIG=+TE S+iHZCH PEPMIT IS BEING RFQUESTfl7: .12t Cb u^VEC'fION 'Ip CITY SEL'IER ' 0C0'NDCPIGN TO CITY SVATER ? CI=(PLFASE DESCF2IBE) 6) L:IJ1G?i:.i O::t:: ? P=E F?OID APPE2dVID PER.+IIT FOR PIC?:-UP BY ONE OF ABOVE ? PLEr1SE N*AIL APPROVID PIIRLLT M 1, 2, 3, 4 1aEWE (Circle one) `[?T(? J1lS??-ZG {? ,_a.. . , . _. .. . D.?,11L: 310 ??/Y (ry 7/ -? Y ? R ?!_alia 4Pl :to .T9 la v:l?ac? a? aq R s:ss'.a a? r?i ma ?o: s?: i:? ??t n.t n.r.s.? rr 1?-s?ia ?.Ia a4 e? ??sa ac• ee F 0 R C I T Y PERNtIT = ISSUED F°ES: $ zd ? $ $ $ S $ $ S $ • S U S E O N L Y .... T IJ?..?D? ." li..,.._t.:..J . WATE2 PER"1IT (INCLL'DE SURCHARGE) WATER METE.°./COPPERHORN/OUTSIDE REnCER WaT^R TAP (I.iCL'JDE CORPORATICV S:CP) SEWEo mAn ACCOUVT GEPOSIT - SEi•IER ACCOUNT DEPOSIT - WATEB WAC sac TRUNR ?dAT°R ASSFSSME:IT TRliVK SE[dER ASSESSMENT LATE°,AL BENEFIT/TRUNK SERTER LATERAL BENEFIT/TRUNK WATER OTHER TOTAL AMOUNT PAID/RECEIPT #_L,L?/ DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGriT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE [VO EIVGINEERING DIVISION. LIST AS A CONDI- TION. SUIIJECT TO TFIE FOLLOSdING CONDITIONS: APPROVED BY: C? ,&? f--g TITLE: DATE:p?- ? ?"? w'? •? ?• s? ?ci+ ?c? ia W.w mtm w W w wjg w" Ra wt+ w w ?n Wsm w_a MWsft W_j+ 94-50 0c00MW" r = PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA079997 Eagan, MN 55122 . Date Issued: 09/25/2007 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1668 Norwood Dr Lot: 3 Block: 3 Addition: Brittany PID 10-15000-030-03 Use Description: Sub Type: e - Furnace & Air Conditioner Work Type: Replacement Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840. Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Sedgwick Heating & Air David W Bullock 8910 Wentworth Ave S 1668 Norwood Dr Minneapolis MN 55420 Eagan MN 55122 (952) 881-7739 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA080054 Eagan, MN 55122 . Date Issued: 09/27/2007 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1668 Norwood Dr Lot: 3 Block: 3 Addition: Brittany PID 10-15000-030-03 Use Description: Sub Type: e - Fixtures Work Type: Replacement Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: LILLY OLBY 3260 GORHAM AVE ST LOUIS PARK MN 55426 Fee Summary: PL - Permit Fee (miscellaneous) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Vogt Heating & Air Conditioning David W Bullock 3260 Gorham Ave 1668 Norwood Dr St Louis Park MN 55426 Eagan MN 55122 (952) 929-6767 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. Applicant/Permitee: Signature Issued By: Signature *City otEapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED JUN 242013 Use BLUE or BLACK Ink For Office Use / L L Permit#: 1 I i"ld 1 Permit Fee: ':) 1 • I Date Received: 1>k- 113 Staff: ,jam 20132RESIDENTIAL BUILDING PERMITpAPPLICATION Date: f 'f" d U /3 Site Address: L & 8 /1/0-41/00 +'nf —, U,5 Unit #: Resident/ Owner Name: £2 V 5 4 11ff f/VG1v.ac-- Phone: (-6,,) ben — -F zei Address / City / Zip:_ IIIOfl ved0 ,PAiv6 b,9$4A Mi / 55/2L , //Owner Contractor Applicant is: i."".. Type of Work Description of work: f?Z # /40,0ea/Y6 Construction Cost: (r15'.4616i) Multi -Family Building: (Yes / No 1/ ) Contractor Company: &ib /14#4512-- Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 6..i,1\ - WO 412e. Ndr ac6EU 6N7M f-5 2- I 1rf In the last 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasonsthat would permit the City to ,! . conclude that they are trade secrets. 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.gogherstateonecall.orq 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Printed Name X 6-''t A g Applicant's Signature Page 1 of 3 1? -'v SUB TYPES Foundation Fireplace it Single Family _ Garage Multi _ Deck 01 of _ Plex Lower Level DO NOT WRITE BELOW THIS LINE (0(s IJo vv°" V. Accessory Building WORK TYPES New — Interior Improvement Addition _ Move Building J/ Alteratione Fire Repair Replace — Repair Retaining Wall DESCRIPTION Valuation Plan Review (25% 100%� Census Code # of Units # of Buildings Type of Construction ti311 Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final At Framing X Fireplace: 14- Rough In Air Test A4 Final Insulation Sheathing Sheetrock Reviewed By: Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation _ Water Damage *Demolition of entire building - give PCA handout to applicant 1-FZG MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Air/Gas Tests _Final Stone Lath Brick Pool: _Footings Siding: _Stucco Lath Windows Retaining Wall: a Footings _ Backfill Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Final /d too Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA112053 Date Issued:07/25/2013 Permit Category:ePermit Site Address: 1668 Norwood Dr Lot:3 Block: 3 Addition: Brittany PID:10-15000-03-030 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Tim Shimek Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - David W Bullock 1668 Norwood Dr Eagan MN 55122 (651) 282-8645 Glowing Hearth and Home LLC 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA139239 Date Issued:10/14/2016 Permit Category:ePermit Site Address: 1668 Norwood Dr Lot:3 Block: 3 Addition: Brittany PID:10-15000-03-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - David W Bullock 1668 Norwood Dr Eagan MN 55122 (651) 341-3502 Jake The Plumber 255 Roselawn Ave E, #43 St Paul MN 55117 (651) 212-5253 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA152958 Date Issued:11/13/2018 Permit Category:ePermit Site Address: 1668 Norwood Dr Lot:3 Block: 3 Addition: Brittany PID:10-15000-03-030 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. Valuation: 4,000.00 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 - David W Bullock 1668 Norwood Dr Eagan MN 55122 Craftsmans Choice Inc 5680 Quam Ave NE, Suite A St. Michael MN 55376 (763) 276-7465 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA169828 Date Issued:06/10/2021 Permit Category:ePermit Site Address: 1668 Norwood Dr Lot:3 Block: 3 Addition: Brittany PID:10-15000-03-030 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David W & Lori L Bullock 1668 Norwood Dr Saint Paul MN 55122--277 (651) 702-1300 Built Strong Exteriors Llc 2215 Quebec Ave S Lakeland MN 55043 (651) 702-1300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA171445 Date Issued:08/16/2021 Permit Category:ePermit Site Address: 1668 Norwood Dr Lot:3 Block: 3 Addition: Brittany PID:10-15000-03-030 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - David W & Lori L Bullock 1668 Norwood Dr Saint Paul MN 55122--277 Roelson Plumbing Services Inc 10924 Pioneer Drive Burnsville MN 55337 (952) 288-1486 Applicant/Permitee: Signature Issued By: Signature