1671 Norwood DrCASH RECEIPT
CITY QF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
R6C CI V 6D
FROM
AMOUNT ? 17
& DOLLARS
7oo
E]CASH Q CHECK
rOR
?
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
,. .
{ cirr oF EA"N
3795 rtlot Knob Rm1 Eogaw, MN Sl12= ?ft? /
PNOME: 454-8100
BUILDING PERMIT Reeeipt # _ :3 4-7 3 3
Site /lddrcss 1671 Norwood llTive
Lot 2 Block Z Sec/Sub.Brittsny lst
parce, # 10 15000 020 02
? Na,T,a Tollefson Builders, Znc.
? 1655 Noxtii'ood Dcive
Address
Ci Eagan 55122 phone 454-6873 Erect 1]
Alter ?
Repoir ?
Enlnrge ?
MO1Q ?
Demolish ?
Grode ? OccupaMY R--3
Zoniny R
Firc Zone NA
V
Type of Const.
# Stories
Length 74
Depth 34 Sq. Ft.
? Owner
o Ncme Approrals Foes
O' Addrass Assessment Permit 2•
u? C? Ph Water 8? Sew. Surcharge 48.50
? Police Plan check 2112.00
kW NO^1° Firo SAC 525.00
?? Address Enp. Woter Conn?+50.00
tW Ci phone Plonner Woter Meter 60. 00
Council Rood Unit 250. 00
I hereby acknowledge thot I hcve read this opplicotion ond state that
the intormotion i
ll
ii
able
orrect ond a
ree t
om
l
ith gldfl. Off.
g
p
y w
opp
s o
o c
o
c
State of Minnesota Stotutes and City of Eagan Ordirances. ^PC Totol > 1969 . 5?
Siqnature of Permittee
To lefson Builders, Inc.
A Building Permit is issued to: on the exprcss wndition thno
all work shall be done in acoor once ith oll opplioabla Stote of Minrxsoto Stotutes and City of Eoflan Ordinonces.
--?-.
t
1
?
,_-
Buildinp pfficiol Y?CLL %
10?/0
-
Permit No. Permit Holdar Misc. Pwmit No. Holder
Plumbinq 3 3025 C-.IkAz-
H.V.A.C. < t C It / (
Wsll
Weter
Disp.
S?vwr
ENetric WO?D(b.'Z ? E 6<< q-I -??
Impectioa Dm InsP. Otha?
Footings 3-3{ b, 6L-
Foundetion
Fnminy
Rouyh Plbg. ?? ?
d-
Rouph HVA ::?_/ ,? z4f
Inwlation
Final Plbp.
Final HVAC
Final ?
Wear Describe Location:
11Vrll
Sewer •
Pr. D'up. -
r
Reoeipt - - '
CITY OF
Fi!l in
or
1. Date - ? 2. Insta
3. Job Address 4. Owner
Permit No.
Fes '
S/C
Tot. -
Iw- TractZ' -
5. Contractor Phone
6. Address t
r
7. City .:.1---•'-w' ' State Zip
8. Building Type: Residential OCommercial O Institutional O
9. Work Description: New El' Add ? Alter ? Repair ?
10. Describe Fuel Type - '?
11.
No. Equioment 8TU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. an
ng:
r
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
oomply 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
- .- ? -
Receipt PLUMBING PERMIT Permit No. -? --
CITY OF EAGAN -
. Fee Fill in numbered spaces S/C -
Type or Print legibly ToL
1. Date ? 2. Installation Cost
!J/1 l I ' / -` / • .?r'/
3. Job Address 7/!?/?!
` -"Lot41t_Blk. Tract
• _ .
4. Owner
5. Contractor % ?1L???!/i?rv Phone
6. Address L/ 741 c?1
7. CitY ? t-'J °f7lJC? ? State ?r1 IV 2ip
8. Buifding T ?
ype: Residential ? Commerciat ? Institutional O
9. Work Description: New UY- J Add 0 Alter ? Repair O
10. Describe
11.
No.
- Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
' Bath tubs Septic Tank
Lavatory Softner
/ Shower Well
Kitchen Sink
Urinal/Bidet Other
?
-?--- Laundry Tray
_L 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 aad /cades governing this type of work.
Signed : Z.
Rough Ffnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-189
(612) 681-4675
:SITE ADDRESS:
i}? LJIIUf? 11H
!,I ? I I 9P! PERMIT SUBTYPE:
I1 \Si LUr,ION ?LU???
PERMIT TYPE:
Permit Number:
7 Date Issusd:
tl 1 0 4. IC ; . APPLICANT:
th;rl i ...'a.' !;'.;:t
TYPE OF WORK:
,,i ,, 2• 11 i « 11h
H" /Nti/t+r
k' ! 1
F
L J
V t Mr1F1K?.: 1'i Ahl RF Vl I tif 17 1'1 Y f kA l ii td0VAt* 17YK .
Permit Holder Date Telephone N
PLUMBING
HVAC
InSpection Date Insp. Comments
FOOTINGS ? 4 O
O
FOUND
FRAMING
ROOFING
F10UGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST ?S > > cl?vt ?? -? ??
INSUL i
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
?ECK FTG
DECK FINAL
-Ai?-
CITY OF EAGAN Remarks
Addition RRTTTANY Lot 2 Blk 7 Parcel 10 15000 020 02
Owner Street 1671 NO.C'WOOCI DT1V@ State
Improvement ' Date Amount Annual Years Payment Receipt Date
STREET SURF. , (? 1982 2819.87 563.97 10-11-83
STREET RESTOR.
GRADING SoAO 1981 428.73 28.58 ?r 342.99 A012908 10-1143
SAN SEW TRUNK 73.07 A012908 10-11-83
:r SEWER LATERAL ,T17
1981
5040-87
_..33 .06
4Q3g.7Z
??
-, t? . _
WATERMAIN
* WATER LATERAL 1981
WATER AREA .5 ! 210.00 _ A02908
?
STDRM SEW TRK iggl 492.50 32, $3
I
05
3940 ?1
A012908
-20-11-83_
* STORM SEW LAT 1951 _
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT
WATER CONN. ?l 50.00
BUILOI NG PER. 782
SAC
PARK
No.:
!o somply with !hs City of Eagan
CITY OF EAGAN
3795 rilat Knob Road
Eaysn, MN 55122
Zoninp: ,
Owner.
Address:
Site Address: °iorwr.c,<.'
Plumber. : ` ` • -
1 egree to eemply wilh f6e City of Eagow
Ordinaneos.
Bv
Date of Insp.:
WATER SERVICE PERMIT
PERMIT NQ.:
DATE:
Connection Chcrge:
Account Deposit:
Permit Fee:
Surcharge:
Mlsc. Chornes:
Total:
Dote Paid:
SEVNER SERVICE PERMIT
PERMIT NQ.:
DATE:
No. of Units:
Connedion Charye: Actount Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
Date of Insp,: Insp,; I
BUILDING PERMIT
N° 7827
Receipt
Te be wed fer SF DWG/GAR Ert,yalue $97,000 Dme M arch 10 , I 9-B3_
Sita nddress 1671 Norwood Drive
Erecf
g)
Occuponcy R-3
Lor 2 Blxk Z Sec/Sub.Brittany lst Alrer ? Zoning R-1
Parcel {k 10 15000 020 02 Repair ? Fire Zone NA
Enlarge ? Type of Const. V
m Name Tollefson Builders, Inc. Move p # Srories
z Address 1655 Norwood Drive
DemoHah
?
Length 74
Ci Eagan 55122 Phom 454-6873 Grade p Depth 34 Sq. Ft.-
? OWiler Approvals Feof
p Name
?
Z U Addreu
r:.., eL___
Name _
AddrCSs
I hereAy acknowledge that I have reod this ap0licotion and state thaf
the inlormolion is correct ond ogree fo compiy wifh all opplicable
Stofe o4 Minnesota $tatutes and City of Eagan Ordinonces.
Assessment _
Wafer 8 Sew.
Police -
Fire
Erp.
Planner _
Councfl _
Bldg. Off. _
APC
Permit `*?'+• vv
SurcFwrge 48.50
Plan check 212.00
SAC 525.00
Woter Conn450.00
Water Meter 60.00
Road Unit 250.00
Torol $1969 . 50
Slgnofure of PermiMee T011 I
A Building Permit Is issued To: 0fSOri Bu11dET'S? IriC. pr? the expresa condiNOn Ihwr
oll work sholl be d ne in accorA?)pnce ith all oppliwblo State of Minnesoto Statufes and Ciry of Eagon Ordinancea.
BWlding OtfiNol ? r,,?71/k?
CITY OF EAdAN
3795 Pilef Knob Rmd Eagan, MN 55122
PHDNE: 4548100
? REQUEST FOR ELECTRICAL INSPECTION
r' See inslructions br compleUn9 this tqm on back of yellow copy.
'.X1" BelZork'eo' ? ved by This Request
EB-00001.04
u.
New AAtl ReD. Tyoe of Buileing Applinnces Wired Eyaioment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fiztures
Apt. Buiidin9 Dryer Electric Heatin
Commerciai Bldg. Fumace Si!o Unloader
Industriai Bldg. Air Conditioner Bulk Milk Tank
Farm ? lher Isnecifyl
[ er 1 ueci y Oiner
Compute Inspection Fee Below ' q Fee Servica Entrence Siae k Fee Feeders/Subtaeders # Fee Circuita
0 to 200 Am 5 0 to 30 qmps 0 to 30 Amus
Above 200 Amps 31 to 100 Amps - 31 to 100 A s
Swimminq Pool Above 700_Am s A6ove 700_/am s
Transrormers Irrigation Boon-?s ' Partial-'Other Fee
Signs Special Inspectlon $pp
Remarks , ,
.i TO LFEE
1. th?`E111rroe1
Inspecbq heraby
certify tMt the above
inspection hos been
mede.
This reyuest void La ?13 ,;;z ' 3 sb S q
18 nionths from
W066210
Request Daie Fire No. Rough-in Inspectian `
Re u,retl? Ofleady Now TJill No?ify Insper.-
3 [}?J Vus ?NO ?or When qeady
? LicanseA ElecVical CanVactor I haraby raquesi inspection oi nbove
Owner electrical work instelletl aY
Street Address. Box or oute No, City ?
'
ec ion o. Township Name or No. -
j i, o. Coynry
Ocr.upantlPRINTi Phone Ne.
Power SupOlier Address
T?
Elecir' ?al Cnnvactor ICom any Namel
` Contracmr's License No.
C 0?1?03-
Mailinp A Jrass (COnVacmr or Owner Makine In tallntion)
?
?
Aufhorized SiBna nVactor Ow r MakinB Installa[ionl
?o? Phone Numbar
- W9
MINNESOTA STATE BOAND OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bitlg. - Noom N-191 BE ACCEPTED BV THE STATE 90qqD
1827 University Ave., St. Paul, MN 55104 UNLESS PPOPEfl INSPECTION FEE IS
e1___ 1e.11 1n, I.« ENCLOSED.
(?rr#ifirtttr of (orrupttnry
Citp of (Eagan
Dr}tttrimrnf of Buililing Jnnyrrfiim
Tbir Catificate irtutd pursuaru m thc reyuiremenu of Section 306 o/ thr Uaiform Builrling
Code cati fying rhat at tbe timr of itJrutrue tbit rtrurturt wut in rom pliance wirh tht vuriout
ordinanrcr of thr City ngulating building ronnruction or ufr. For tbr folloevinb:
vxc1.:t.u. SP DWG/GAR Nas.hmnNO. 7827
O-O?YTY? TyP^CouWC4mV_FiRzo-a NA zom, a,ma R'I
I671 Norwood Drive ,M•RLot 2,Block 2,Brittany lst
Addrm
By:
p« September 12, 1983
'2?
.o., ?. . ?«..?wa,. ..,?.
,.?s<.
rzlv nF r_AraN
CASHTE:fic S TEF:MIiQAL. N0: 796
Dr17E? 09J014/913 t'f.ME: 15:51a06
ILs r.
NAMC;, 7OWN AND COLINTf;Y F'OOL & Sf'A
3210 9001 1671 NOGiWUfM DR 224.75
205 7001 077. NORWOULi Dk 7.50
Tota7. RF;+ecipt Amnunt: 232.25
CF:CI97i.84
U5ER 7:D: NANCY
FERMIT
CIT?Y OF EAGAN
t 3834Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE:
guzLozNG
Permit Number: 033136
Date Issued: y y/0g f g g
51TE ADDRESS:
ssTS NnRwnno DR
LOT: 2 BLUCK: 2
BRITTANY
P.I.N.: 10-15000-020-02
DESCRIPTION:
IN-GRqUND
ermit Type
6*rk Type
r
?, w ,:6e" ?'a?•?i`'a
?a?r
'
i rE .e
+ :,aa =Lt s . v
? ,a?i
SWIM P001.
NEW
329 NQNBLD6 STRUCT.
?v
REMARKS:
PLAN REVIEWED BY CRAIG NOVACZYK.
CAII 445-9840) RFGARfITN[; FIFfTBTCAI PFRMTT ANt7 TNSPFCTTONS_
FEE SUMMARY:
VALUATION $15,000
8ase Fee $224.75
Surcharge $7.50
Tatal Fee $232,25
CONTRACTOR: - flpplicant - ST. I.IC. OWNER:
4,051) WN & COUNTRY PpOL & 5PA 12221233 SpECIAL MCBRSDE []AVE
8 LINCOLN flVE 1671 NORWOqO OR
PAUL MN 55105 EAGAN MN 55122
222-1233 (651)905-8956
2. kt?.F.eh:Y° aCkr?avEledg? "?k
` ?n'?tsrr?aCiar?-`is`,car.r=?ct=
APPLICANT/PERMITEE SIGNA RE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681.4675 New Construttion Reauirements
RemodeVRenair Reauirements
? 3 registered sRe surveys ?2 copies of plan
? 2 copies oT plans (inGude beam 8 window s¢es; poured fid. dasign; etc.) ? 2 site suneys (aRerior addkions 8 deeks)
? t energy calcuiations ? 7 energy calwlations for heate0 a0tlitions
• 3 copies of tree preservation plan if IM pWUetl aRar 711193
required: _ Yes _ No
?
DATE: S '(q CONSTRUCTION COST; 1 S?ow
DESCRI IONOFWORK: ?NJI?Il?rF??? oG Zr-hrt?wcd S l :aM%?+ A?1
ST TADDRESS: ?io'II /vo.?u???,c-? ??C.• _
LOT: 2 BLOCK: Z SUBD./P.I.D. 4/l?-?uPk4
Name: Ar- 6A;A2i Quve? Phane #: 10S-- b' 9SCo
PROPERTY Lwt First
OWNER
StreetAddress: i (o `f I ?0tiwc:L,vl
City L- f}GA/J State: Zip:
J?*- v i 'o
Company: JowN 4 Py•-L t Sp,E} Phone V5f -Z2z -/L`3 3
CONTRACTOR
Street Address: f Z? Lt,-GVIN &E License #
City SLI,¢&,{, State: ^h1N Zip: .rJ'! 4.r
ARCHIT'ECT/
ENGINEER Company: Phone #:
Name: Regisuation #:
Street
City
State:
Zip:
Sewer & water licensed plumber (new construction ony): . Penaity applies when address chang
and lot change is requested once permit is issued.
i hereby acknowledge that I have read this appiication and state that the iniortnation is correct and agree to comply xrith all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature af Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation O 06 Dupiex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
0 04 SF Porch ? 09 12-piex
? 05 SF Misc. ? 10 _ plex
WORK TYPE
,k 31 New O 33 ARerations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
i7epth
APPROVALS
Pianning
O 11 Apt./Lodging ?
? 12 Mufti RepaidRem. X
? 13 Garage/Accessory 0
O 14 Fireplace ?
C] 15 Deck
? 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
MC/WS Sy.
City Water
Fire Sprinki
PRV
Booster Pui
Census Co(
SAC Code
Census Bld
Census Uni
Engineering
Basement Finish
Swim Pool
Pubtic Facility
Miscellaneous
? ?a9
D
v
Permit Fee
Surcharge
Plan Review
License
MCIWS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SMI Pertnit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: S /5?000
% SAC
SAC Unks
_. ?.
ilders Ine. ? Or,1I380
?
JACKSON - SURVEYORS 183-74
,
, NH.1(TiR[O UND[R LAYY{ pi fTAT[ OI YINMCtOTA
3616 EAST 55ih STREET, MINNEAPOLIS, MN 55477 72736&i
% e: f = S?.
*UCI3[?+OI's C[LtITlLBtt t _ ?.. G ??J `\,
- - _ L'r.rr??:fis.- -!'•7ri'.?:j L-'u`=-,?,:,....
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1 ItEREBY CtRTIFY TMAT TMt ABOV[ IY A TRUE ANp CORNlCT PLAT OF A SURV[T OI
i I L
Lit 2,92ock 2,Srjitany,
llaki[a C3unty,i1innesota,
Ptopoetd Csrag¢ Floor Elev. 101.5
Prop:,eed Firat F13or Eiev. 104,5
Przop3sed Basement Fl?por Elev. 97.5
r
A! {U/eV[Y[O BY M[ TMI?-_Z.SCI1._OAV pF Feb. _A.o._
CITY O[' rAC',AN Iriclude 2 sets of plans,
1 site plan w/elevatians i
BUIIDZNG PCfC-IIT APPLICATION 1 set of eir sgy calallatlam.
C?0. C` S
'
'11D Be [laed Fur valua '«n 9 7, GZl7? nate -5 Z3
Site AWrm8 OFFIfE USE ONLY
la: a Block ? ?.?5?. ,i- -'3
??,
. POrOB1. #: I L 150 O CO 020 G 2> AltEr ZOnll14
taepair F'ire Zone
Q?w?CS Fnlarge _ 7ype of Const.
11ddre88: lbve A Stotie.4
- lish Fm ft.
CitY/Zip Oude• _
Grade ?
?P ? ft.
Phone M:
Oantracm
Jlddreses
CitY/2iP
PtYOne /:
Astitt./F7r.j. s
Addiues: •
at5f/Zip Cude:
Ih0r1B #:
Water/Sewer Studkarge k '
Pnlice Plan C]ieck ,2 12 a?t
Fixe SAC 7-
Erig. Water Cotu1,
Planner Water Metet
Cnuncil iioad Unit
Bldg. Off,4
Ai'C
'lrri`AL ? I q l0 c{ i?('"?
eo
5-(2
? d
? 7q? g
` ?allefr;on Builders Inc. Qr,I1380
183-74
JACK5t7tV. - SLIRVEYC3RS
_ . . . ;; . : . ? ..
r, -
? ` , . ; .;. .- . .:
ABfi1iTFR[O UIiDtR I.AWt L1F 8TAT[ Of YINIi[lOTA 3616 EAST 55ih STREET, MINNEAPOLIS, MN 55417 727t9464
. ,.:' . , . - . . . .
' . . ??. . ? , . '??. ? ??,°: 1??-?.J? ?ii
&uctupor'g Ccrtitiiate s = ,,? r o r7 ?? •'
s:
-j e ..
/
r
z 6= /tir
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f! !' q ? ?'._"'}?-? ? t ? ??
,
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? ? ? ? ? ??II ? ??-1°__?3^'s« . ? ??`? ? ?.,;
? ?2G,o' ,°;` i
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1 NEREYI' C[RTIFY TFfAT TML ABOY[ IB A TRUE AMO GORplCT P"T OF A SUMYK OF
Lot 2,B1oek 2,BrIYtany, ,
llakota Caunty,Minnesota.
lYropoeed Garage Yjc+ax__Elev, 101.5;
F'ryp^aed Firat F1oor Etev. 204.5 :
Proposed Baeement Floar Elev. 97:5. '
,
4&
? . .. . . ? ? .?. ? ? , - F. G. JI?KSON. ?MIMN? ?tTM7I01t: NO.;?b600
.
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Use BLUE or BLACK Ink
r-----------------�
I For Office Use �
�(� I
� � Permit#: � " �
City of ���a� -
i �U�a i
� Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �� � Site Address: �� � � `���"'�V�ca� �6P` Unit#:
Name: � t���o�°' � � �G L• V'1 Phone:ce����S��
ReSiCl�tl�, � t�
Ow�le�' Address/City/Zip: �G�c,c.�,� ���7( ��c�„v� f. )r•—
� Applicant is: Owner �ontractor
Description of work:�.� (!��
Ty�e �f WOrk `,
) �o
-ti,X, Construction Cost: t � � � ("'—�'' Multi-Family Building: (Yes /No�
Company: �`�r-�S�c-. �C� Contact:�c��e C�l o��C�3�,�1 S
Address: � �� �v �b City: v����v� ��
COilttll��Q�', ��,
� � �" �'�
p��� � ���, Stat�Zip:�� Phone����(3�Email:
, i��,�" g�
n'� ,y License#: ��j�� Lead Certificate#:1���� ��3' (
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:Plans�nd�t�pp�rfing�tcrcu►ner��s�h��a,�au sub�r#�ar.��onsiaiered t���z p�rbfic informa#ican. Pc�rtfons n� :
#ite ir�formation r�ay ibe'�t��,sa��'al as rrvr�,�p.�i�7i�rf�rq�u�ra�r�de�,����f��i��a�c�n�fha#wr�ul�1°�ermit the C��Y fo
�. ; dr��clrrde� ��t1�ey are��raa�'e��e��t�.
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. wvuw.qopherstateonecall.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 sota State B 'Iding Code ust be com leted within 180
of permit issuance.
Ul� ���2(/4,,�l��,/ � X�
A plicanYs Printed Name A plica t's Signature
Page 1 of 3
I—For Office Use
Permit#: �(--/ 1
Permit Fee: off
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections( citvofeagan.com
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 06/23/2020 Site Address: 1671 Norwood DR Unit#:
Name: Booker Hodges Phone: 612.275.5030
Resident/ 1671 Norwood DR
owner Address/City/Zip:
Applicant is: Owner Contractor
Type of Work
Description of work: 20 SQ Vinyl Siding Tear off wood siding
Construction Cost: 12,800 Multi-Family Building: (Yes /No ✓ )
Company: Minnesota Window and Siding Co contact: James Pope
Contractor
Address: 8609 Lyndale Ave so4. /2 =J/1 -011-7-2City: Bloomington
State: mn Zip: 55420 Phone: 952.292.4660 Email: spreeman@hotmail.com
License#: CR609812 Lead Certificate#: R-I-74543-19-00367
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submitare considered to be public information. Portions,of the information_may be
classified as non-public if you provide specific reasons that would permit the City to conclude',that they are trade secrets;
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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.
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.ctopherstateonecall.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 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.
xAnn McCarty
Applicant's Printed Name Applicant's Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA171080
Date Issued:07/29/2021
Permit Category:ePermit
Site Address: 1671 Norwood Dr
Lot:2 Block: 2 Addition: Brittany
PID:10-15000-02-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Booker T Iv Hodges
1671 Norwood Dr
Eagan MN 55122
(612) 275-5030
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature