1674 Norwood DrCASH RECEIPT
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE
19
AMOUNT $ I
& UOLLARS
ioo
0 CASH F? CHECK
White-Payers Copy
Yellow-Posting Copy
Pink-File Coov
Th You
,1 ' BY
.
r '
BUILDING PERMIT
To be wW for S C I
S ite Address
? 167?
Lot slock 3
Parcel No. 10-15t
oc Name 'rOLI
= Address 16 5 `_
? City i'ACiAN
o
? Name
dd ''A`,
?
r- re
A
Citv sa
u?
y?W Name
?-_? Address
u
a W City Phone
I hereby acknowtedge thct I hove read this application ond stote that
the intormntion is correct and ogree to tomply with all opplicoble
State of Minnesota Stotutes and City of Eaqcn Ordinonces.
Siqnaturo of Permittee
/1 Building Permit is issued to: `OLTXP?;nr? BLD:;S.
oll work shall be done in accorda*e vrith Wi oppliwble _54ate?At Mii
Buildtnp Official - ' -
_ ?..i
CITY OF EAGAN N? ggi ?
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ,
Recelpt # .
Erect yX pccuponcy 1 ; 3
Alter 0 Zoning
Repoir 0 Firc Zone
Enlarpa p Type of Const. v
Move ? # Stories
DemoNsh
Q 5 6
Length
Assessment
Water 8 5ew.
PoUce
Fire
Enp.
Plonner
Council
Bidfl. Off.
APC
Sq. Ft.
Fees
Permit U
:.UG
Surcho rge
Plon checkI? • `io .
SAC 525.00
Woter Conn. 4 7 0. 00
Water Meter 63.00
Rood Unif 26Co00
Tocol $1, E97. 50
on the expnu condition that
Statutes ond City of Enqan Ordinances.
Permit No. Permit Holder Misc. Psrmit No. Holder
Plumbing
H.V.A.C. I<?
Well
Water
Disp.
Swver
Electric 5a5 L42er R01, ?- b-gf
Inspeetion Date Insp. Other
Footinpt
Foundation
r
Fnminy fv
Rouyh P16p. -$; Cf
Rough HVA
Inwlation ,/•?f'l ?
Finel Plby.
Ffnal HVAC
Final 4? (?_FIY? ?.,-:? - •
Wstsr Describe Locatio • 7
YYell
Sswer
Pr. D'ap.
Receipt MECHANICAL PERMIT Perm it No.
Ct'rY OF EAGAN
Fee -
Fill in numbered spaces S/C
Type ar Print legibly
T
ot.
1. Date 2. Installation Cost
3. Job Address Lot Bik. - Tract
4. Owner
5. Contractor - Phone
6. Address - ' ?- ?
1 3-
7. City State Zip
8. Building Type: Residential ? Commercial O Institutional ?
9. Work Description: New 11 Add ? Alter O Repair ?
10. Describe
11.
Ty pe
No. Equipment BTU - M. Ea.
Forced Air IVo. Equipment CFM
Ai
H
l
Mfg. r
and
ing:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Qther
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 464-8100
Receipt
i PLUMBING P RMIT
CITYbF EA?AN Permit No.
Fee ?/ -
Fill rn numbered spaces
Type or Print legibly S/C ?
7
1. Date
J 2. Installation Cost ot.
r?------
3. Job Address Lot Bik. ? Tract
4. Owner %Glc < <` 1=.50 k'l /?? / d- A?>'-
5. Contractor L??- ?`?' • ? ? Phone
6. Address
7. CitY Siate Zip -
8. Building Type: Residential !?` Commercial ? Institutional 0
9. Work Description: New t?
10. Describe
11.
Add 13 Alter O Repair ?
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs 5eptic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet
Laundry Tray OtherL--?
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
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
CITY OF EAGAN
Addition BRITTANY Loc 2 Blk .3 Parcel 10 15000 020 03
Owner 'Street 1674 Norwood Drive Scate
LIt1f1" 1, J
Improvement Date Amount Annual Years C Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING 1981 .429-7-3 28. S8 1 285.83 A015239
SAN SEW TRUNK 1976 156.51 10.45 15 52.21 ft
* SEWER LATERAL 336.06 1 ii
WATERMAIN
* WATER LATERAL
WATER AREA / it ii
STORM SEW TRK / 1981 32.83 1 285.83 11 it
* 5TORM SEW LAT 19$1 `
CURB & GUTTER
SIDEWALK
STREET LIGHT 38 -2 -
260-. 00
WATER CONN. 470.00
?9
BUILDING PER.
sac 525.00 -
PARK
CITY OF EAGAN
3830 Pilot Knah Road SEWER SERVIrE41. ?
' P O Box 21199 PERMIT NO.: g 5
' Eagan, MN 55121 DATE: `'' I%' P,`'
Zoning: •?.A No. of Units:
? Owr,er; Tnllefson Eldacs
? Addresr "
' Sire Address: ' r' `1 Norwood Drive L2 B3 Brittanq 1at
Piumber: '.YBtu
3-29-34 42238
1 agrea to canPhr with Nhe Ciyr of Eagee
Ordlnaneas.
r BY
Dete of I nsp.:
? Insp..
Connection Charpe:
Akcourrt Deposit: _
Permit Fee:
Surchorpe:
Misc. CJhoryes: _
Total:
Dota Paid:
CITY OF EAGAN
3530 Pilot K61nb Road WATER SERVICE PERMIT
P. O. Box 21799 PERMIT NQ.:
Eagan, biN 55721 DATE:
ZO?ing' = No. of Units: ?
Owner: - '."nT 1 AFaon Rldz:3
Address:
Stte Address: '?:74 '?otn.•or,c -? 713ritt:ari}• lst
Plumber.
Meter No.: Connection CFwrge: 4:7s? r'cx
Slze: Account beposPt:
Reader No.: Permit Fee• 10.00 pd
1 aym h eosply with tiM Citp of Eagew Surchnrge: . 5n *rd
Ordiwenw.
Misc. Chorges: ,:. ;.) ri n?? ;, e t A,-
Total:
BY D
P
Dote of I nsp.: ate
oid:
Insp..
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Kr,ab Raad
P. O. 6aox 21199 PERMIT NO.: '
Eagan, MN 55121 DI,TE: • -
2oning: No. of Units:
Ownar.
Add?ess:
Site Address: r , :z ? . ,. r
•".. :r :.` r ?, P!nection Chorge: 470.170 pd
Q?Apc?unt Deposit: 13.00 pd
No.: - a''a4'o2'r, 'e"it Fee: ? i. 0U pd
TT7Eagem Surchorge: . 5(? d
Misc. Charfles: ?? 3. QO pta met
Total:
Dote Paid:
ot
BUILDING PERMIT
N? 891s
Receipt # &-4-39
To 6s wed fe. SF DWG/AND GAPEst. Value $ 76, 000 Date MARrfj 7g_ , 19-BA_
Siteo,ddress 1674 NORWOOD DR Erect 7ffX Occuponcy Rl
Lot Z Block 3 Sec/Sub. BRITTANY 1 Alter 0 Zonin9 R1
ParcelNo. 10-15000-020-03 Repolr? ? FlreZone N/A
Name TOLLEFSON BLDR4 _
Address 1655 NORWOOD DR_
City EAGAN phone 454-6873
o Name SAME
?
Address
8?
? City Phone
uw Name
i? Address
?W City Phone
I hereby ackrwwledge that I hove read this oppiication ond stote thaf
the information is correct and agree to comply with all applicoble
$tote of Minnesota Statutes ond City of Eagan Ordinonces.
Signoture of Perminee _
A Bullding Permif is issued to:
oll work sholl be done in ac?
Buflding Officiul
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Enlarge ? Type of Const. V -
Move ? * 5tories
Demolish ? Length $6
Grade ? Depth 44 Sq. Ft.-
ADDrovala Feea
Assessment _
Woter & Sew.
Police _
Fire
Eny.
Planner
Cauncil
Bldg. Off.
APC
Permit $ 361.00
$urcharge 38•00
Plan check 180.50
SAC 525.00
Wofer Conn. 470• 00
Water Merer _63- 00
Road Unit 9?60-0 0
Totol $1_?897.50
on the expresg cordition thm
Sfatutes ond City of Eapan Ordinances.
cITr cr EArAN imi? 2 sets of plane,
T0 8e Lteed fbr
&ite Mdrere II
site plan w/eleVatiane i
&1TIDIM PEFhQT APPLICATION 1 set oE enexW calailaY3pna,
-Valuatiort M74i da a Date
1dt _--?_ 81odt y3 SeC./Sub. &4
racnel r: /U -/,So o D- oz v
Owneri
JlddseQa:
CitY/Z1P Oode:
Fhane 1;
OonXractc
Jlddtesa:
«tY/ZiP
Pttir1B 1:
Ard1./FY1rj.: _
Addresat •
C1ty/Zin COd@; ' !a
- 9
Phaie'i:
?
OFF'ICE USF. CtJl.Y
-.---_..-?.
?
'?- z
F1epaix Fire 20na
Fnlarge _ Rype of Cbnat. ?
Move 1! Storiea
Demoliaf' Front
crade - nepth yy ft.
Water/Seoer gurq?aa?e ? ?
Police plan Ch?CJ[7/;p
Fire SAC
ErN4. Water Ccm. Al ?70
P1aruker Wates Metgt /?,7
Ca.InCil
' Nuad Unit
Hldg, Off.
AAC
i
1
` z+arla.
.
\J
? ?'\ v. .?
v 4
? `N
? ??
? ?p ?1
fi ?1??'?-
REQUEST FOR ELECTRICAL INSPECTION es-oouot:cw
, See inatructiona for Comoletin9 Ms iarm on bnek of yellow copy. L.f i] b o
7
A {ir'n ul; "X"" Below Work Covered by Thrs Request
b.4Atldl Rao.1' .-fvoe o1 8uiltlina I Aooliance9 Wiretl I Equipmen[ Wiretl I
Water
8ulk Mi Ik
p Fee ServieeEntranceSize M Fae Feeders/Suhteedars k Fee Circuits
21 0[0 200 qm s 0 to 30 qm s 0 to 30 Am s
Above 200 qmps 37 to 700 qmps 37 to 120Arnf;s
Swimmin Pool Above 100-Am s Above 700_Am '
Transiormers Irn ation Booms eL/ Partial,'Other Fee
I Signs SVecial inspectlon S? ,fiC?ITO7A E ?
Rpmarks
_ O../
^pOe^"'^ ? /?
41
? the Elacvical
.J .? , "'?" ?' Inspecloq hereby
ertiiy thet ihe abova
Final Da?e ?
Ja? naPection hes Daen
'
?? ,?da.
This request wid ?
18 months tram '??y '? 5 ? -3a-8
A 050505 ?nL 6 q51)
Bepueat Date fira No. FouPh-in Insper.tion
qu?ired7 Peatly Nuw Will Nntify, InsOec-
Yes ?No ?ur When Ready
1(1 Licensed Eleclrical Contrer.tor I hereCy request inspection ot above
? Owner electricel work insielletl at:
SVee 'Address, Boz,or Route o. Ci1Y ,
,? `-
tctoon o. ownship Name or No. . FnnBe o. iCounly
OccuDantl NT) Phone No.
Power uP0lier yJ AEdress
i"T
Elechical ntractar IComueny Name) p Contractor's Licens .
? %
E' ' C
?<
a?Y
e j 7
Mailinp Add1
_
5 I Contrac or or Owner
q
gMekinB instailati7
3 z
?
i
. ?iJ ?
??'!V 11
5 //? -,
?
Authoriz gna re IConvact r Owner Makinp Installationl Pnone Number
MINNE80TA STpTE BOAflD OF ELECTRICITV " TMIS INSPECTION REQUEST WILL NOT
Gtigpa-0.Aidwey Bldg. - Room N-197 BE ACCEPTED 8V THE STA7E BOAPD
'
UNLESS PNOVEX INSPECTION FEE IS
1821 University Ave.. St. Peul, MN 65104
ow....e ra'nl 197111, v __ ENCLOSED.
143059 IIMUEST wR ?? INWMBoa
' See "rotruefions for completinp Nis tnm m 4eek d NIMw eop?.
A p5p8.8a -..%.. ?B-elow Wark .: +vered by 7his Request
Adtl NaD. Troa of 9uiMim t Aeoliancsn OimO ??1Cfuipmani Wirad
F Fee SBrvieeEnLameSFZe # Few Feeders/SWfaWers i iee Circuita
- 0 to 200 AnIPS _ 0 to 30 Anips 0 m 30 Am
Abpve 200 Amps a? 31 to 700 Anqis 31 to 100 Amps
Swimmirg Paol AGove 700_ ADove 100_Am "
Trarsfomier5 ltngation B? .3"G Partial.'OUier Fee
tRa,erts (Sigts ESpecia{ I?tspection TOTA
Rouph-in Date
?
"? y p 1-ttm mI
I?spactur. AarebY
mrlifv tAet tM ebove
Firel co-o -ww
J ?°k
.Z.? i?pection Aas baen
imads
? .
- rn:s reauest wia y 3059 5,) ?? y
la monms trom
A? 053888 Lo t(.).au
..PJaquest Date Gire No. Rouyh-in I?pad " ?'? y.q ? ' fleauired7 QlteadrNow?Wiil Notify. InsPec-
O ?!¢s ?f?. m When IieadY
Licenmed Electrical Cdnractm
I bMebf n9uscc iosoectim ot aEove
? O?a ' alae4ieal anvt iusOllsd ac
Streec AAdress, Boa w Route Na Ci
?
S. ion Town.l+ip Nameor Plo. Ra[qe o. Couw1Y
Occupam IPRINTI
7'^ .C3c,o.e, s Pbonc No_
4?T y- 4'?8
PbwYr Supplia pddr¢5s
Elech cal Contrecim ICOmVaM D1ame) CmvaeMt s Lic¢ns¢ No.
:f? ?,-
? GU ? d?s -
Yailinp dress (Contracmr r Owrter Maki?p Frttaiiatioq!
AuMorizM Sipnature ICoMractar Makine I?sbliat:m1
1,
r
Rw?e Nu?L¢r
Y _-
1tA
MIMME40TA STATE BOAfl6 OF EIECTRICITY TMb INSPECTION pBQUEST WILL NOT
GriWS-YiA+'eY Bldp. - Noom N-141 aE ACCEPIED 8? TNE SfAIE BOAPD
7827 University Ava., St. Veu4, MN N10C UNlbSS P40PER INSPECAON FEE IS
W....e /8f2129'1.21t/ EMGLOSED_
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
A?DRESS ? ??q ?9C? ""'
CITY
OCCUPANT
-?
SOLD 8Y
MAKE /
SERIALNO.J 106006 THERMOSTAT
VALVE ??/1WCI
LIMIT
I 0
LIMITSETTING •A ?
FAN SETTING
PI LOT TYPE _
IGNITION MO[
PILOT TIMI NG
PRESSURE
PERCENT
INPUTCFH 1AI?-- PERCENTOz
STACKTEMP. ?,? PERCENTCO
FORM 235 (REV. 11189)
HEATING JOB NO. S?+ ? Z
TEST RECORD
OWNER ?`-'tNSdJII
INSTALLED BY
CS C?? Nv 36? d??
MODEL
IPIPUT ??l 000
-
j(
C
VENTSIZE
TYPEOFLWERp
LINER SIZE
IV
?
FILTERS: SIZE
el ry NUMBER
WIRING
TEST TAG
LIGHTING INST.
DATETESTED
?
COMPANYTESTIN ??> U
?_1 /
NAME OF TESTER.
FORMDISTPIBUTION: WHITECOPY - JOBFlLE YELLOWCOPY -GITV
City of Eaian
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
------------------
? ?or ice us I
j Permit M: C?- j
? Permit Fee:
j DateReceived:
I StafF: I
?-----------------
2008 RESIDENTIAL BUILDING PERMtT APPLICATION
Date: ??q .10 g SiteAddress: I v1-7 q ROfbl)0017 W.
Suite #:
RESIDENTIOWNER Name: ?0--f7l t K.u/1ldA4 C-'nqs64 phone: 157' Z40 - 3(-73
Address/City /Zip; 104 kOfWU'Ob PQ,
Applicant is: _ Owner -X-Contractor
TYPE OF WORK Description of work: 'T2LLY D? ?12,q- - ?m-P
Construction Cost: S o?70 T. ? Multi-Family Huilding: (Yes_/ No
CONTRACTOR Name: fTGeC% &141nq ? l.px S fr'?? 6'1`L License #: 010 13 R ILE D
Address: 4105 bJ 0 /*"?e- jQ
City: ?YDOK-14v1 rOU'k- State: Zip:
Phone: Z(e3-315- 0R30 ContactPerson: t?l'?rf5 <l
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilafion Category 1 Worksheet • New Energy Code Worksheet
Category Submitted submined
(4 5ubmission type) • Energy Envelope Calculations Submitletl
In the last 12 moMhs, 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 and supporting dacuments (hat you submit are considered to be public information. Portions af
the informatlon may be cfassified as non-pubJic if you provide specitic reasons thai woNd permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with ihe 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 starl without a permR; ihat the work will be in
accordan with the approved plan in the case of work which requires a review antl approval ot plans. xj- X 9?/ L!? ?tc.?L i R k S
? /L
Applicant s Printed ame ApplicanYs Signature
Page 1 of 3
2007 RESIDENTIAL SUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsW cbon Reouiremenfs
3 registered site surveys showing sq. ft. oi b[, sq. ft. of house; and all rootetl areas
(20%mazimum lat coverage allowed)
1 Soils Report if proposed building a to 6e placetl on dislurbed soil
2 copies oiDlan shaving heam & vnndowsizes; poured tound design, elc.
1 se[ of Energy Calwlations
3 copies NTree PreservaNon Plan Nlot platled after711193
Rim Joisl Detail Oplions selecfion sheei (buildings with 3 or less unils)
Minnegasco mechanical ven6lafion form
RemodeVReoair Reouirements
2 copies of plan showing footings, beams, joaGs
1 set of Ener9y Calculafions for heatetl addifions
1 site survey for additions & decks
Addifion -indicate i/on-site sepfic syslem
Office?UseOnlv
Gerto(SurveyrRecd _Y?_N
Soils Repott Y -'_ N
Tree Pres Plan Recd .Y -=_'.N,
Tree Pres Requiretl Y? N
Oo-sileSep4cSyslem , _Y ?N
os}„e ? ..,,.,c:Ae.oA nuhiir infnr.,,ar;n„ „nJpss vnu state thev are trade secret and the reason.
.u..? u.. ...,.............. .._ .... ..........__
Date
l
? Construction Cost 45 1 ,° a?
Site Address
I(p ?
4 4 n ti^wePm UniHSte #
C
Q
° +e
P '?
Description of Work Y ?S'Fc?J`cs.l'??i -
`-"" %Ans"
?1?'
'? r ?
Multi-FamilyBldg _ Y_ N Fireplace(s) 0 _ 1 _ 2
PropertyOwner ?q y?1 k"VW5 ? Telephone#(?-09 9yC7 - 3<r?73
Contractor lJ a`?o Y v?C-c-, V,
Address o0 '?/?
/1-? City f? ? i M?12A (Jm ?r 5
State 11Y) IL J Zip 6!j tI op Telephone #((o l o'-lrl5? ?t l 1?
COMPLETE THIS AREA OPOLY 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
(J submission type) Submitted Submittea
• 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 planZ
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
a Residential Building Permit and acknowledge that
is eomplefe and accurate;
that the work will be in conYormance wrth me oramances ana coaes oi Lne UiLy UJ nagau
Statutes; I understand this is not a permit, but only an application for a permit, and wor s
permit; that the work will be in accordanee with the approved?an in the cas/ of work w ch
approval of plans.
la? 1_rx??,,r1/"?
Applicant's Printed Name 4Aplicants Signature
and the State of MN
not to start without a
requires a review and
" DO NOT WRITE BELOW THIS LINE ,
Sub Tvaes
? 01 Foundation ? 07 OSpiex ? 13 16-plex ? 20 Pool ? 30 Accessory 81dg
A 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch (screen/gazebolpergola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Wark Tvaes
? 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 Bldg) - Gi ve PCA handout to applicant
DCSCrIOtion: WaterDamageX,Yes
Valuation Og?pancy MCES System
Plan Review 100% or 25% (
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addi5on)
_ Foundation
Drain Tile
Roof Ice & Water Final
? Framing
_ Fireplace _ R.I. _ Air Test _ Final
x lnsulation
REQUII2ED INSPECTIONS
_ Sheetrock
Final/C.O.
?C Final/No C.O.
? HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucca Lath _ Stone Lath _Brick
Windows
_ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Capies
Other
Tntal
I
I n/?1??' L
V-
?
-0A
?i
?noo ou u uacm anc.. . vc. i4J
. ? 188-7
I JACKSON - SURVEYORS
RmIrrwto uMOM uwG oI SiAr[ oI YIMM[/OTA SCALE". i": 40'
' O dEN D7?S i ROhi
3878 EAST 66t1i STREET, MINNEAPOLIS, MN 86417 7773484 ooo.o EdISTiNG ELEV.
?lbtpOl?tl ?lCtKftBlt ??. p R Ai N?G ?
\ ` . 4,
?
y ? 34
/ A.
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? °h'za Rlvg
V .? rtV' \ ? \
-f•?Ly? 30 / / ,??sv r`Y??
q(a o? l00.
0
?? ? a? ryti? s? ,?r r
?
I
Pr.3posed Gazage Floor Eisv.
Propoaed Firs[ Floor Elev. .
Propoaed Basement Ftaor Blev'. ?
l00.5 4v?
i
??? .?'.
-?.._? q k •
z,B
I HHREYY C[RTIFY TNAT TX[ ABOYi H A TRO( ANG CONR[GT PLAT 0/ A SURV[Y/Of
/
/
Lot 2, Block 3, Brittany,
Dakota Couwty, Hinneaoia
Af sVRV[Y[D mY ME TMif DAt 0? -bJ@r^~ 11.D. ??y?-
F. C.
) 9 i
No. 7d00
Cities Digital
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? 2/84
CITY OF EAGAPJ
APPLICATION FOR PERMIT
' SEWER AND/OR WATER CONNECTIODi
(PLFCSF 09TNT)
1) PROPER'Iy ADDRESS:
r.FrAi. DF_5C2IPTICN:
1= E:43='2:G STRUCP":2E, D?.IY G? QRIGii1AL cvILL`l"IG r:i_.!Im -rcSU?1G:
R-1 SLJGLE L AMffLY
_ p -R-2 DUPLEX ('Ih"O L1iIIT5)
0 R-3 ZY'i[v1,EDiiSE (THREE + UNITS) ( INImc)
? R-q pPAgma-7/COND?yLLNIU:vl ( iNITS)
? CQ'..'?2CIAI,/F2ETAIL?OFFICE
? LMoszRIAz
? r.vsTZTTTzoNu./cc???.TMErr
2) APDL7CANT (PLEASE PRIYT) ---
NAME: TOLLEFSON BUILDERS, INC.
ADDRESS: 1655 Norwood Drive
CITY, sraTE, ZIP: _ Eaqan MN 55122 -
PHO?IE: 612 454 - 6873
3) Pj,L^.1aa (PLfASE PRINl]
NA'`E= _ fENZ-RYAN PLUMBING AND HEATING
, ADDRESS: 14745 South Robert Trail
CITY, sTA'IE, zzP: Rosemount MN 55068
PHONE: S I t
(612) 423-1144 PLIIMBER LICENSE 1849M
4) OCa7P??/cr,';,\TER NAI"IE: CAM[ASE PFINi)
ADDRESS:
CZTY, STATE, ZIp:
PH(}:IG:
FOR CIiY USE 08LY
PLI1!!BERS LIC;95E:
? Active
? Expired
Q Not af Record
?r init?a
ST 1NDIG;TE Wt]ICH PEPT•1IT ZS BEIiv'G RDQ[IESTID:
[X_?h Cti.,TIELTION 'IO CITY SEWER
? CO^,SYmPIGV TC) CITY WATEF2
? C71'F'.II2 (PLEA5E DESCF2IBE)
o/ 1-.u1G?;?t V:'.t;:
? PLEASE EiOID APPROVIIJ pER,+LiT FOR PICi:-UP BY ONE OF ABO`.'E
?°LEASE MAIL APPR01,r.'"D PERItIT TO 1, 2, (3) 4 AB(7VE
?., (Circle one)
7) SIC?'IL'?E: ? 7 ? OC
?__
N D'nTE: tsL
. FOR C I TY [1 S E ONT,Y
, . ? .
PERMIT " ISSUED
-
F°ES: $ _fO.Sn ' SE?'iEn D?Al1T'y^ N(I;;CLiJD : QUPCH?RGE)
' $ (O•t;() WATER PERf1IT (INCLUDE SURCY.ARGE)
$ (p3-?? WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TA? (I.ICLGD-. COR?ORATICN STOP)
$ SE:aEF Tno
$ ACCOUNT BEPaSIT - SEi:'ER
$ IS.v? ACCOUNT DE?OSIT - WATER
$ Z170- 00 WAC
$ sac
$ TRUNK :OAT°3 ASSESSt4E:IT
$ TRGNK SETaER ASSESSME:IT
$ LATEP,AL BENEFIT/TRUNK SE[•:ER
$ LATERAL SENEFIT/TRUNK WP.TER
$ • OTHER -
$ TOTAL
$ AAIOUNT PAID/RECEIPT
DOES UTILITY CO NNECTION REQUIRE EXCAVATION IN PUBLIC RIG:IT OF WAY? •
C YES IF YES, TH EN A"PERMIT FOR WORK WITHIN
PllBLIC ROA DWAY" MUST BE ISSUED BY THE
? NO ENGINEERIN G DIVISION. LZST AS A CONDI-
TION.
SUBJECT TO TFiE FOLL0:9ING CONDITIONS:
APPROVED BY:
TZTLE:
DATE: y'a rm Nw wcm w. sa NP:m wPa eEa RW wRP w40 04 aia nc W ya ai+ NELa ntm nt W-M M m
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, . _ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)?j
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-687-4675 r(? .?- c( ?
New Consfivctton Reauhements qemodel/Reoolr Reauiremenfs
D 3 registered sMe surveys ahowing sq. fl. d lot, sq. tt. of house
and oll roofed areas (207, maximum b1 coveraae a0owed)
? 2 copies of plons (show 6eam 6 window sKes; poured fnd. design; etc.)
D 1 sM of energy calculaHons
D S copies W hee preservaHon plan H bl plalfed aHer 7/1 /93
DATE: 0 GT N f 11 9q
2 coples of plan
1 set of energy cakulaHons for healed addHions
1 sMe suney lor erztedw addlNOns a deeb CONSTRUCflON COST: 93CC9•
DESCRIPTION OF WORK: SrjjPys Hr,sF
STREET ADDRESS:
LOT: 'D BLOCK: ? SUBD./P.I.D. #:
Name: Rt n9 ?v l{ir r?.? v Phone #: bs! -- /? 5?l - G? rG 3?
PROPERTY ?a? ???
OWNER
Street Address: 167 ? No17'yvo c) Or'
City -5a (,Un/ State: ?y7h ZIp:
Company: Gi^O 55 R r? 0Lo(_e(he n7 Ne,l 6,4 oPhone #: ?1"2 - r7 7 7?
(area code)
CONTRACTOR
streetAddress: 500 9TravvLF;- ?AL -0500 llcense#.2DISSjSS Exp. 3131 o6
CNy 6L, rA1S Vil1. P State: J?In Zip: 5 5 33 2- 6Ce9D
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Streel Address: RegishaHon
City State: Zip:
Sewer 8 waFer Ilcensed plumber (reaulred for new conshuctlon onlvl:
P?naNy applies when oddress change and lot ehange is requeated once permH is issued.
6,jhereby acknowledge That I hove read fhis applfcafion, state that the informotion Is correcf, and agree fo comply wRh ali appllcabl
Sfate of Mtnnesota Statufes nnd CFIy of Eagan Ordinances.
Slgnature of Applitant: ?--
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
LL. !
Tree Preservadon Plan Received _-Yes _ No _ Not Required Q?
? "?
OFFICE USE ONLY
BUILDING PERMIT TYPE
'i
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? ? 21 Porch (3-sea:)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-piex ? 13 16-plex ? 18 Deck j ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 1 Siding/Soff
O 32 Addition ? 36 Move Bldg. ? 40 Gas InseR ? 44 1 UHindowslD
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 i Fire Repair
? 34 Repair ? 38 Demoiish (Interior) ? 42 Reroof !
* Give PCA handout to applicant for demolition permit ii
GENERAL INFORMATION
Const. (Actuaq
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Cod
SAC Code
No. of Units
No. of Bldgs
MC/ES Systi
City Water
Booster Purr
PRV
Fire Sorinkle
Permit Fee
Surcharge
Plan Review
License
MGES SAC ?
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: 1 ? l
Valuation: $
? tl
i
SAC Units
% SAC
2007 RESIDENTIAL PLUMBING PeRnniT aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings. Do not combine inside and outside
qfumbinq on the same application: seqarate aoqlications and permits are required.
Date I I
o
, Unit #
Site Street Address t
Property Owner ! S,6L Telephone #( )
7elephone # (3a0 S]g 7 - 62 360
Contractor / 1,L%Yl A! /1 Ci IiL/rf'5'r 121L
/
Address ,' j4(/ City State,OLAL ZiP-?$j
The Applicant is: _ Owner & Occupant Z Licensed Plumbing Contractor
Refurbished Submit 2 sets of plans and MPC license
Septic System
New Includes County fee
_
_ $ 100.00
Per as-built $ 10.00
Fire Repai? (replace burned out fixRures, eu.) $ 90.00
This fee a ies when extensive lumbin re airs are made to a buildi .
Alterations to existing dwelling $ 50.00
_ Add plumbirg Poctures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. lf you are
insfalling on a water softener and/or water heater, da not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment
_WaterTumaround (add $136.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
Lawn Irrlgation _RP2 _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $
I here6y apply Tor a Residential Plumbing Permit and adcnowledge that the infortnatlon is complete and acwrate; ma[ me wonc vnn oe
in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I undersland this is not a pemiit, but
only an application for a permit, work is not to sNart without a permit and work will be in axordance plan in the eveM
a plan is required to be reviewed and approved. A -s t-e_t-Z- lY'G rR 91'7 ry
ApplicanYs Printed Name ApplicanYs Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1674 Norwood Dr
Lot: 2 Block: 3 Addition: Brittany
PID:10- 15000- 020 -03
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mar k Anderson, State Electrical Inspector,
952- 445 -2840. Crystal Gemuenden 8910 Wentworth Ave S Bloomington, MN 55420 952- 881 -9000 Crystal.Gemuenden
@ServiceExperts.com
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Randy P Ringsby
1674 Norwood Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$30.00 0801.4088
$0.50 9001.2195
$30.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA074640
08/07/2006
ePermit
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137133
Date Issued:06/17/2016
Permit Category:ePermit
Site Address: 1674 Norwood Dr
Lot:2 Block: 3 Addition: Brittany
PID:10-15000-03-020
Use:
Description:
Sub Type:Residential
Work Type:Underground Sprinkler System
Description:PVB
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 - RPZ/PVB/Lawn Irrigation $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 -
Gregory A Piatz
4143 Barrow Ct
Eagan MN 55123
(651) 452-8351
Drain Pro Plumbing
8815 - 209th Street W
Lakeville MN 55044
(952) 469-6999
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143267
Date Issued:06/08/2017
Permit Category:ePermit
Site Address: 1674 Norwood Dr
Lot:2 Block: 3 Addition: Brittany
PID:10-15000-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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 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: 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 -
Gregory A Piatz
4143 Barrow Ct
Eagan MN 55123
(651) 452-8351
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150167
Date Issued:06/22/2018
Permit Category:ePermit
Site Address: 1674 Norwood Dr
Lot:2 Block: 3 Addition: Brittany
PID:10-15000-03-020
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: 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 -
Gregory A Piatz
4143 Barrow Ct
Eagan MN 55123
(651) 452-8351
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA159314
Date Issued:12/10/2019
Permit Category:ePermit
Site Address: 1674 Norwood Dr
Lot:2 Block: 3 Addition: Brittany
PID:10-15000-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater & Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Gregory A Piatz
4143 Barrow Ct
Eagan MN 55123
(651) 356-4844
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature