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4235 Nybro Lane NCITY OF EAGAN Remarks Addition WILDERNESS RUN 6TH ADDITION Lot 12 a1k 3 Parcet 10 84355 120 03 Owner ?? ?•i1 fL'0L' P1- '''+ ,:' ; Street 4235 No. NY-bra Lane State Eagan, Minnesota 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREES RESTOfi. GRADING SAN SEW TRUNK 1973 161.21 8.04 20 104.79 A007455 2-26-79 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 162.14 15 129.74 A007455 2-26-79 SEW TRK 3 40 8 g 239.20 A007455 -- STORM SEW LAT , CURB & GUTTER SIDEWALK STREET t1GHT WATER CONN. 250.00 12484 11-22-78 BUILDING PER. . #5059 SAC 1^ZZ-78 PARK , • ' CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DA7E 19 RSC6IVED FROM AMOUNT $ I Ac DULLARS ?oo ? CASH EICHECK RUND CODE AMOUNT - ;f ? ? 6• !. . Thank You B Y Jd White-Payers Copy Yellow-Posting CoPY . . Pink-File CoPY CITY OF EAGAN 3795 Pilet Knob Road Eogan, MN I PHONE: 454-8100 BUILDING PERMIT ]? ,.K To be uted for '1, ? Est. Volue Site A14?ess Lot Paroel # - W Name z t Addre: p Name ZF' ?? Address ? r..., Address I hereby ccknowledge that I hove rend this the information is correct and agree to c Stote of Minnesota Statutes arid Ciry of Signuture of Permittee i 1_I.Srt_'.1" A Building Permit is issued to: ctl vvork shc4f be done in cccordonce with Building Officiol of Erect ol Alter ? Repoir ? Enlarge ? Move ? Demolish Q 6rade fl N2 5059 # ? 1 ...^n 7r1 19 Occupancy ? Zoning ? Fire Zone Type of Const, # Stories Front ft. Depth ft. Fees Woter & Sew. Pol ice Fire Eng. Planner Council Bldg. Off. APC i Permit 7h?c, ? Surthorge Plan check s nn r1n SAC ^1 Water Conn. Water Meter Total . F. J.. 7., on the express condition that and City of Eogan Ordinances. PennM Oefs fared PaenMtar Plumbing 4/--7 , Mechanicnl 7 Q. ?- ?c?c ? INSPECTIONS DATE INSP. Raugh-In Final FoorFrrqs Date . sp. Dnte Inap. Foundation Plumbing Frome/ins. Mechaniovl Final ? ? Remqrks: ?1)041 ? /YO?c o-t , CITY OF EAGAN 3830 Plloi Knob Road, P.O. Box 21-199, Eagan, MN 55121 '`-• _ 12258 PHONE: 454-8100 BUILDING PERMIT Receipt#., - To be used for ADDLTZON Est Value $17,500 Date JULY 10 19 $ 6 site ,4ddress 4235 NO NYBRO LN Lot 12 slock 3 sec/sub. W;LUEf2NESS R(TN Parcel No. 6T}l W Name DI;y1`11:i PFiELUb ; Address 0 City Phone 454-0908 = o Name SAt'JE 0 ¢ Address ~ City Phone Ga TA:'-lYE DESIGN SERVICES I hereby acknowiedge that information is correct and Minnesota Statutes and C? Signature of DENNIS PH] A Building Permit is issued to: all work shall be done in accordance with all applicabl ? Erect ? Occupancy Remodel ? Zoning Repair ? Type of Const Addition ? No. Stories 24 Move Demolish ? ? Length Depth Int. Impr. ? Sq. F! Install ? Assessment _ Water & Sew. Police Fire Eng. Ptanner State of Bidg. Var. Permit 'i?a,& v 0 ?v _ Surcharge 9.00 _ Plan Review 64.25 SAC _ Water Conn. _ Water Meter _ Raad Unit _ Tr. PI. Parks _ Copies 1.00 Total $202.75 on the express condition that an Ordinances. I I Permit No. Pormft Hold*r Dato Telophons k Wumbiny Q ? IHMA.C. IEI*ctric ) t' / Q,% cS / J o7L . C`: c^, Soflet? inspecdon Dete IMp. CommM?b Faofts 1 ? 118' ? Footlnys 11 Foundatbn Fnminy Roofln9 • ? ` Rouyh Plbp. ?- , Rouyh Htp. ln.ul. Fireplac• Flnal Hty. Flnal Plbq. ISIdg. Final CNt. Occ. I Dsck Ftq. Deck Frm9. I w.u Deuribe, L.ocatloe: Pr. Disp. 1 1 TN'NW PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 Site Address Lot Block m Name ? Addre c Ciiy _ L Name 3 Addre o City 1 FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - MINIMUM - COMM/1ND FEE - STATE SURCHARGE PER PERMIT - (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) V OF FOR: CITY OF EAGAN PERMIT # RECEIPT # DATE; BLDG. TYPE WORK DESCRIPTION Res. New Mult Add-on X Comm. Repair N?. FIXTURES TOTAL Water Closet - $3.00 - $ ? Bath Tubs - $3.00 -TLavatory - S3.00 / Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 Softener - $5.00 Weil - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE 3/C: GRAND TOTAL• ' c- rV oC CA,r-A?N SEWER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NO.: Eogan, MN 55122 DATE: Zonirg: No. of Units: Owner: _ e ?-1.---• Site Address: vi?,.,,?.• . . ''7 • OC? pe! I agree to comply with the Cifr of Eogan Connection Charge: - F'_ Qq p Ordinenees. Account Deposit: - Permit Fee: Surcharge: By Misc. Charges: Dote of Insp_: Total: Insp.:_. Date Poid: CITY OF EAGAl1 8795 Pllot Knob Rood Eagon, MN 55122 Zoning: Owner: aAa.e- Site Address: -,- -s.- •.n•?=-? L Plumber: Meter No.: -- c:..e WATER SERVICE PERMIT PERMIT NO.: _ DATE: No, of Units: Reader No.: 1 agree fo comply wif6 fhe City of Eagan Ordinanees. By Connection Charge: L,, Citl -.i Account Deposit: Permit Fee: Surcharge: Misc. CFwrges: .Q11 Total: Date Paid: CITY OF EAGAN ' 3796 Pilot Knob Road Eogan, Mlnnesoto 55122 Pbone: 454-9100 PERMIT Dote: t'eeenber 14, 1978 Site Address• -'' 2.'' '' ?' • !?h?t?Y!7 ?2le Lot Block -? Su6/Sec. INome n ?icwne& In?.' .I m e 3 O . ? u ? ? e uI No. Receipt No.: 12 5 97 Single Residential g Multi Res., Comm./Ind. ? New/Alter./Repoir. ' Address `'27 go• SnniXin`3 r'vr• Cost of Installation City -?&Ul 5511G Phone: Permit Fee 2A. nC! Nome '' - Bj.AdQt & Son • I; tV. Surchorge • 5 ? Address -20 go Elut1eZ AvE, ?:. .. City '' • ? ' - u _Phone: Total ? • ? Permit is issued on the express condition that all work sholl be done in accordance with all appliwble Stote of inesota Statutes and City of Engan Ordinances. Buiiding Official CITY OF EAGAN 3795 Pilot Knob Rood Eagan, Minnesota 55122 Phone: 454-8100 •-e ? ; : ? •i ..Y. PERMIT Date: '-4-79 Receipt No.: Single " r' ' ?` • '?'?ab rs?'bE Residential Site Address: - Lot ? Block 3 Sub/5ec. ?ildexwms lftm 6th Name 'rilam f3ones e Address ?. Snp-11ir< 3 O . Paul 5512r= City Phone: Name . Address ? e ?j c•o .. : ,_ ,_i+-.,. = n,,.-. L,?' • ? ""..?`•. City Phone: This Permit is issued on the expres5 condition that all work shall be Minnesoto Statutes and City of Eagan Ordinances. Multi No. 1292 12942 X New/Alter./Repuir Cost of Installation Permit Fee . ?? Surchorge ?t?, Sfl Tota I done in accordance with all applicoble State of Building Official l0?61 ??'lt REQUEST FOR ELECTRICAL INSPECTION ee-ooooi.oa ?.. 'IP See inu<ructions for campleting [his form on beCk of yellow copy. `? vs? p. n???2.1_ =- "?X'" Below Work Cavered by lhis Request ? ? AAtl NeO. Type ol Builtling Appliances WireA Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures A. 8uilfling Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk T&nk Farm ocne, pt?,fv omt:r (si,M;tv) t er ueci y Ot er Othi;r ompute Inspection Fee Below N Fee ServlceEntranee5ize k Fee Feetlers/Subfeetlers # Fee Circuits 0 ro200qm s 0 to30qm s 0 to30Am s Above 200 qin>s 31 to 100 Amps 31 to 100 A Swimming Pool Above 100_Amps Above 10?1mps Transiormers Irrigation Booms Partial-'Other Fee Signs Special Inspection $ 7 flertwrks 0TAL F6?? fll7 flough-in inal d C`/ Dale .i? D:'i 1, the ElecVicel Inspectoq hereby certity thet the above speetion has been de. Thle reauasl vola 18 monih6lrom . cin oF Er+c,AN N4 5059 9795 Pitot Knob Road Eagen, MN 55122 PHONB: 4548100 ' BUILDING PERMIT APPLICATION Receipt # To be uaed for SF EWlq & Garage Est. vai„Q 45,000. Dote 11-22 -' ? q 78 -- Site Address 4235 No Nvbm Iane Erect Occupancy L {.ot 12 Block 3 Sec/Sub. W11d2L71ESS RlIl1 6t11 qlte, ? Zoning Rl porcei 10 84355 LO 03 Repair ? Fire Zone 3 # Enlorge ? TYPe of Const. V c Name Nornian WlIIl1ElZ0Y . Move ? #-Stories i Addr 1505 Bu??sville Pkwy #319 pe?.wlish ? Front 50 rt. ess ? ?,,,,Burnsville 553W,,,,p 890-1890 Grode ? Depth 24 ft. g zt'i Nom S' 1? w„„Aa Sn211i.nq 627 SO Asseument ?< ? . Address 698-5501 St. Paul 55123 ph Water & Sew. o.e Ci Police ?w Name Ffre Address En9. <'_" C( Phone Planner Council I hereby acknowledge that I hove reod this cpplicotion ond state that gld9_ p{f, the information is correct and agree ro comply with oll appliwble APC StaM of Minnewta Stotutes and Ciry of Eagan Ordirwnces. Permit ico.vv Surcharge Zz • 50 - Plan check SAC 500.00 Water Conn. 2500Woter Meter 60.00 7oral 960.50 $Ignmure of Permittee ' issued T11Se11 S on the exprea condition that A Building Permit is otl work sholl be done In dance with II- ?plic-able S?tate of?A innesota Statutes and City of Eogan Ordinances. Building Offitfal N2 G A ' 12258 3830 Pilot Knob R d P.O. B x 2 - 19, Eagan, M N 55121 PHONE: 454-8100 / BUILDING PERMIT Receiptp z ? y]C'J Tobeueedfor ADDITION Est.Value $17,500 Date JULY 10 19 $6 Site Address 4235 NO NYBRO LN Erect ? Occupancy Lot lZ 81ock 3 Sec/Sub. WILDERNESS RUN Femodel ? Zoning Parcel No 6TH Repair ? Type of Const. . Addition 181 No. Stories W Name DENNIS PHELUS Move ? - ? 24 Length h 14 D i Demolish S?E ept o Address Int. Impc ? 5q. Ft. ciry vhone 454-0908 Install ? =o Name SAME $ ¢ Address ? Ciry Phane a Name TAMPE DESIGN SERVICES F w Address iw city MPLS Pnone 784-2065 Iherebyacknowledgethatl6haveead applicatio tatethat the information is correct and lyth all p le State of Minnesota Statutes andi dinanc Signature of Permittee A euilding Permit is issu to: DENNIS PHELUS all work shall be done in accordance with all app' te of inne c Building OHicial . ? Assessment Water & Sew. Police Fire Eng. Planner Council Bidg. Off. 7 /9 /8 6 APC Var. Date Permit $128.50 Surcharge 9.00 Plan Review 64.25 SAC Water Conn. Water Meter Road Unit Tr. PI. Parks Copies 1.00 Total 5202_75 on the express condition thet City of Eagan Ordinances. TisIY€quest !Ml8 months from. fa C/o '/? T" ' R 41826 Date of this Request 11-30-1978 I, 00 Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: L()- 6-3 ?J Rb Street Address or Route No, 4235 Nybro Lane City?F ,ggn Section Township Range County $enneDin Which is occupied by Tilsen Homea . (Name of OcCUpant) ls a roughin inspection required on this job? No ? Yes gc Ready Now ? Will Call G[3c Power Supplier Dakota Cty. Address FarmirLe'ton Electrical Contractor O.B. Thomgson Electric Co. Contractoi s License No. A3635 12201 MWX"JnVVa'natxa 55343 Mailing Address Authorized (Elxtriwl Contractori,or O?f MW tl ? DUfItSD Phone No. 011.9r1' . This inspec6on request will not he accepted by the State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity 1954Uaiversity Ave., St. Paul, Minn, 55104-Phone 645-7703 - "--.REQUEST FOR ELECTRICAL WSPECTION CHECK BELOW WORK COVERED BY THIS AEQUEST / o? 4P 44-:f3 R 41826 Type of Building New Add. Rep. Check Appliances Wired Foi Check Equipmenl Wired For Home tiC ? ? Range :12 TemporarY W'ving ? Duplex ? ? ? Wa[et Heater ? Lighting Fixtures ? Apt. Bldg. ? 0 ? Drye: ? Electric Heating ?. Commerciel Bldg. ? ? ? Furnace IN $ilo Unloadei ? Indus[rial Bldg. 0 ? ? Aix Conditio t? ? .. ? Bulk Milk Tank ? Farm ? ? ? List Y L ist Othec ? ? 0 p Hthers ?. . ? XX p pehe?s? COMPUTE INSPECTION FEE BtOV) ?v Seevice En[rance Size: # Fce 'eis ubteedeis: x Fee C'vcuits: # Fee 0 to 100 Am s. 0? 30 Am res 0 to 30 Am eres I01 to 200 Amp.? UG 31 to 100 Ampexes Above 200_Amps. Above 100 Amps. 6Above Transforme cs RemoteControlCirc. U Signs Speciall Remarks $3.],j - ? - EJ(V. TOTA 40•5 he Electrical Inspector, hereby cri?tha e ue ins tion has beennade. I, t (Rough-in) r Date /1 ?G-? ? (Fina!) c? ---- Date This request void 18 months from This reouest voitl /? jG J I??O Ifi-monffis fmm ? A C.'7 a 50 ?? $' --Vc - e;a --?-- -- .... ..... .......... ... ......_....,... ReyuireA? (:)Ready Nuw Will Noliiv Inspec- ?Ves ?No tor When ReadV ? Licensed Elec[rical Contractor I hereby request inspection of ebove -A-Owner electrical wotk installed at Stwet Address, Box or FoWe No. ? ' CitV (' li ?l ? ?lz- Y'?\j ?.1 ecuon o. Townshi0 Name or No. No. flanee Coun1Y Q,ccupant - 1 Phone No. ?? ? ? rab1 > ? ? ° ?1 fpp`\?w\er SupDlier Adtlress Electrical CnnVactor (COmpany Name) Con[rac[or's License No. Mailin8 Address tCon[racmr or Owner Mnkiny Instailation) Y?,/? ?/? ? ? „z . " ` v ? ? ?S ?". G 1 `\v- luTl?C'? ? Autbo zed ignaIDre ICo tia tor er MakinB ?nstallatinnl Ph ne Number MINNESOTA STATE BOAflD OF ELECTNICITV THIS INSPECTIDN REQUEST WILL NOT Griges-Mitlway Bldg. - Poom N-791 BE ACCEPTED BY THE STATE BOARD 1821 UniversitY Ave., St. Peul, MN 56704 UNLESS PflOPEN INSPECTION FEE IS Phone (612) 287-2111 ENCLOSEO. 2006 RESIDENTIAL BUILDING rERmyr nrrLicnTiox City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction ReauiremenLs 3 registered sRe surveys showirg sq. R of lot, sq. fl W house; an0 all roofed areas (20°k marzimum lot coverege allowed) i Soils RepoA H proposed livilding is to be placed on disfurbed soil 2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 set of EneTgy Calcula4ons 3 copies o( Tree Preservation Plan N lot platted a%er 711193 Rim Joist Deteil Options seledion sheet (buildings wiM 3 or less units) Minnegasco mechanical ventiWtion form RemodelA2eoair Reauirements 2 copies W plan shovnng foo6ngs, beams, joisLs 1 set of Energy Calalations tor heated addiGons 1 site survey for add'Nons 6 decks AddNOn - iMicate Non-sde septic system d -Ioco Office Use OuN CertofSurveyReM -_Y; _N Soils Report ! Y i _N Tree Pres Plan Recd ;._Y'... _N TreeP2SREquired _Y. _N On-sde5epticSystem - - Y-' _N Date -/ / 3J ./ 6(o Construction Cost Site Address y ' ` !".? UniUSte # Description of Work M7 1hk 61+5 64,) C? Multi-Family Bldg _ Y_ Fireplace(s) _ 0 K_ 1 _ 2 O P o t Telephone i3 ((051) 73? ? 0Z wner r per y Coutractor ? r n a l i? n w? r tiaM? 111wN? Address ? ? ? Nc d ro a 8 iionN cir u y - Iff4l ? State ?OSeZ ? Zip Telephone # ( CT it 6 COMPLETE THIS AREA ONLY IF - Minnesota Rules 7670 Cateaorv 1 Energy Code Category . Residential Ventilation Category 1 Worksheet (4 submissiontype) Su6mitted • Energy Envelope Calculations SubmiHed A NEN! BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: 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 permit; that the work will be in accordance with the approved plan inAe case offiork which requires a review and approval of plans. Applicant's Printed Name Appli t's Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt- Multi ? 03 01 of _ plez ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo/perola) ? 36 Multi Misc. ? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building O 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolition (Entire Bldg) - Gi ve PCA hantlout to applicant DeSCrlptlon: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length ?eS?rirl?d a ito Mbr -` ? Type of Const Width Spf?Bc. ?u ? REQUIRED INSPECTIONS :81 _ Footings(new bldg) Sheetrock _ Footings(deck) FinaVC.O. _ Footings (addition) FinaUNo C.O. _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tesu Final _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ insutation _ 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 Copies Other ToWI 2005 RESIDENTIAL BUILDING PERMIT APPLICATION I_ o? City Of Eagan 1I 1' 3830 Pilot Knob Road, Eagan MN 55122 ? Telephone # 651-675-5675 FAX # 651-675-5694 New Consfmdion Reauiremenls RemodellReoair Reauiremenls CertoF Swvey Rectl Y _M1I. 3 registered site surveys shawing sq. N. ot lot, sq. ft. of house; and 1roofed areas 2 copies of plan 1 set oF Energy Calculalions for heated addilions Tre2 FreS iIen:Recd - Y N: (20% maximum lof coverage ailowe? 2 copies of plan showing beam & window sizes; poured tound design, etc. 1 sile surve/ for addtians & decks f i Free Pres ReCloired .. (hr-steSepNc?ystem Y N N lsetofEnergyCalculations em csys Addition - indicateifon-sitesept . 3 copies of Tree Preservalion Plan if lot piafled afler 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) 7,77O t1 s Date (0 / 15 O rJ Construction Co ?? Q vW S te Address ? , ? ? 'm'y1 Unit/Ste # /, 1`5 C! r 5 - I f4Q VC Q - Description of Work ? (? Multi-Family Bldg _ Y 1 N Fireplace(s) _ 0 v _ 1 _ Z -3-Oh n Telephone # ?OQ) ( 9q Property Owner Contractor Lifetime Sidin & Remodeling, InC. 78 6 Address 11825 Point Doug as r. . City h # b (/ O r T l State Z}y one e ep COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category t Worksheet • New Energy Code Worksheet (J su6mission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 257o plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/ W a ter Conhactor 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 permit; that the work will be in accordance with the approved plan in the case of work whic equiresasy? ew, nd approval of plans. jari° II t 2005 ? II I 's Printed Name PP ' an 's Signature J Applicant ` OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interiar 1>3"Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg ) -Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq, Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Foodngs(deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & Wa[er Final _ Pool _ Ftgs _ Air/Gas Tes[s Final _ _ Framing _ _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ 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 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 ?1> "7 U ,7? S (c ca" New Construction ReauiremenGs RemodeUReoair Reauiremenls Oifice Use Oniv 3 registered site surveys shmving sq. tl. of lot sq. ft. of house; and all mofed areas 2 copies of plan Ced of Survey Recd _ Y_ N (20°k maximum lot coverege allowed) 7 setof Energy Calculations for healed addiGons Tree Pres Plan Recd _Y _ N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey (or addilions 8 decks Tree Pres Required _ Y_ N 1 set of Energy Calculations Addifion - indkate if on-sRe sepfic system On-site SepGC System _ Y_ N 3 copies of Tree Preservatbn Plan if lot platted after 711193 Rim Joist Delail Oplions seleclion sheet (bldgs with 3 orless units Date 05 / GS Site Address 9 / a 9" 23Y /U' N? Construction Cost ?, o C) fb,?U LLt4le- Unit/Ste # Description of Work Multi-Family Bldg _ Y V'N Fireplace(s) ?0 _ 1 _ 2 Property Owner cJ067 l?Ylq2rvi? Telep6one#(65'I Contractor G?C#20 4(a2??2- Address ? State Sl2 ( J2 ? M? (s Zip S5-3'7 2 City T)vi?- Telephane #((y/L ) SS'I J'Z 51- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672 Enefgy Code Category . Residenfial Venlilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor N If so, 25% plan review Telephone # ( Telephone #( ? Telephone #( )II?I AUG 1 2 2004 I hereby apply for a Residential Building Permit and acknowledge that the information i' accura e; 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 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. ? ? joky-\ M0.? Applicant's Printed Name Applicant's Signatu OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01of_plex ? 09 07-piex ? 17 Garage ? 22 PorchlAddn.(4-sea.) ? 33 Ext.Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 AddRion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish 8uilding* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Valuation -0), L) o ao ') Occupancy \2 -? MCES System Census Code L? Zoning R^l City Water SAC Units Stories Booster Pump # of Unds Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const v ?v Width _ Footings (new bldg) _ Fooflngs (deck) _ Footings (addition) Faundation Drain Tile Roof Ice & Water Final ? Framung - Fireplace _ R.I. Air Test Final p Insulation Approved By: = Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Pertnit & Suroharge Treatment Plant License Search Copies Other Total REQUIItED INSPECTIONS FinallC.O. ?d FinaUNo C.O. _ Plurobing HVAC Other _ Pool Ftgs Air/Gas Tests Final _ Siding _ SNCCO _ S[one _ Brick _ Windows _ Retaining Wall Building Inspector Z s?we 2 / eJe ? f Fe e ? # RESIDENTIAL BUILDING PERMIT APPLICATION ciTV oF eacar 3830 PILOT KNOB RD, EAGAN MN 55122 657-681-4675 NewCanetruction HenulremaMe • 3 registered s8e surveys showing sq. tt. of bt, sq. tt. ol house; entlAU roofad areas (20%mauamumhtcoveragealbwed) -• 2 copies of plan &howkV heam 8 wuidow s¢85; poured tound desgn, etc.) . 1 set of Energy Cekulatlons • 3 copies of Tree Preservatlon Plen tt bt pqtted afler 711193 . Rim Joist Detail OptWns seledbn sheet (bklgs witti 3 or less unhs) DATE SITE ADC NPE OF APPLICANT AULTI-FAMILY BLDG _Y ?I FIREPLACE(S) _ 0 _ 1 _ 2 STREETADDRESS ?? GLQ2._. CIiY GiY1i TATEWZIPSS VIP TELEPHONE # W_ff? CELL PHONE #?0/1' 3?0 - 79cP? FAX # 25-2 -SlS' efVk( ) PROPERN OWNER ( /7?P.(/.Qi TELEPHONE # 65I- y2`300 ?o COMPLETE THIS SECTION FOR -NEW- RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 1670 CATEGORY 1 D?'131INN@SdTAI2L4i (J submission rype) • Residantial Ventilation Category 1 Worksheet Submittad •MG@yr F{?9S9v?.od6 AT 3 V "CUUc . Energy Envelope Calculafions Submitted Ptumbing Conhactor: Plwnbing system includes: Mechanical Conhacfor: Mechanical system includes: Sewer/Water Confractor: _ Water Softener _ _ Water Heater _ No. of Baths Air Conditioning Heat Recovery System Phone #:=_ Lawn Sprinkler No. of R.I. Baths Phone # Phone # Fee: $90.00 Fee: $70.00 I hereby acknowledge ThaT I have read mis application, state that the informa ' is corcect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi nc Signature of Applicant OFFICE USE ONLY 1 ??. ,a S BemodaVNeoairNeoulrements , .2coplesofplan . 1 set of Energy Calculetbns for heated addilbns • 7 sitesurvey(orexteAOratl00bn58deck5 • InOicate if home served by septk system for adtl0bns VALUATION DDD Submitted Certificates of Survey Received _ Tree Preservatfon Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY II ? 07 Foundation O 07 05-plex ? 13 16plex O 20 Pool O 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. A@ - Multi ' ? 03 Ot of _ plex ' ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4sea.), .. ? , 33 6ct. AR - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) •i ? .36 Multi . ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Misceilaneous ? 31 New ? 35 Int Improvement II ? 38 Demolish (Interior) ? 44 Siding ? 32 Addilion ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" 0 43 Reroof IO 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA hamfout to applicarH Valuation Occupancy MC/ES Slystem Census Code Zoning City Water SAC Units Stories r Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS II _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) - i Plumbing Foundation HVAC _ Drain Tile O[her Roof _ Ice & Water _ Fina1 Ftgs Air/Gas Tests Pool Final _ Framing _ _ _ _ Siding Stucco Stone _ _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulauon _ Retaining Wall li 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 y ? _ . • ' \d??? 1986 BUILDING PEAlSIT APPLICATIOH - CITY OF EAGAN NOTB: 9LL C06TRACT09S MOST BB LICENSSD BIT6 THE CITY OF EAGAB SIBGLE FAPIILY DWELLINGS INCLUDE 2 SETS OF PLANSp 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MfJLTIPLS DWEI.LINGS - BESIDENTIAL BEN'f9L QNITS FOH SALE QNITS INCLUDE 2 SETS OF PLANS9 CERTIFICATE OF SDRYEY - CHECB fiITH BLDG. DSPT., 7 SET OF ENERGY CALCULATIONS COM!lERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND _ To Be Used For: ?w'\"7\4? : ? Date: -7 Site Address k1-S 0 Lot \2 Block ? Parcel/SubW??.z?.?.lsL$? Owner Address ?"L?7S 1J `N?b? ?.'o City/Zip Code Phone Ik5? Contraetor S-&L,.z Address City/Zip Code Phone 9rch./Engr.?Prn'['-'e_. Q-2S\Ccr1??S Address Erect Oceupancy JP3 - Remodel Zoning ?r Repair Type of Const ? Addition ? # of Stories Move Length ?v Demolish Depth Yr Int.Impr. Sq Ft Install APPROVALS FBFS Assessments Permit Water/Sewer Surcharge Police Plan Review( Fire SAC Engr Water Conn Planner Water Meter Couneil Road Unit Bldg Off 7-9-91 Treatment P1 APC Parks Varianee Copies YOT9L City/Zip Code M Phone # ? l?a? vJ ? AOTE: ADDBESSES FOR CORNER LOTS - CONTRACTOR/HOMEOANEB MOST DESIGNATE WHICH 9DDRBSS IS DESIRED. NO CHANG&S iiII.L BE ALLOWED ONCE BOILDING PERMIY IS ISSDED. ,P_En.2 ORoOeA TY Lvv4'-,14 .??? ? L?_, U ?? ?• . ? r ,; ry 7 i ,?--- , - I ., \ rl ? Nol I !1 ? ry LiN? ?fa35 `?• `yU--? ?`c??-- ? I , ea-ct,,,l,, . I ? LoT ?/?'o?] BLQGk ? ? ?•-??ti.fh?u:?/J `7?'-u-"i ?f'?' ' c?JL cJr? • 1 ? PRcsi?F&TY ._LING ? F ti 4LUT -PLAN ,.,?. ,4?z'<7 nATe q- 13-'7 S BUZLDING PERMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. To be used for Site AddresE; rID. ? 'ce) fa 3 Lot Block See. Sub, Valuation -xsUA 60 ? 3G30 ? (-Ax,vyt, & 'tA-) Parcel Number 1,4 Owner "?,[ f/Yr??thJ Te2ephone r+ddress /' ? n,n n/_r_i AG o #3/9 5533'7 r_ontractor V C?C1'1'S'?-Q?0 TeleQhone Co g Q- 5 V ?? Address ?C ?'7 Arch./Eng. Address Telephone OFFICE USE Erect ? Alter Repair Enlarge Nbve Demolish Grade OFFICE USE pate of Ap proval & Initial Assessment ? R • /?y/> ? F7dtex/Secaez Police Fire Eng. PlanneY councsi Rldq. Off. A.P.C. Occupancy ? Zoning ? Fire Zone ?7- Type of Const. # of Stories Front DePth FEES Permit la- 5r ?---- ?`¢ Surchar9e --- . rian Check SAC 1.7ater Conn. la, r Meter 4 Pn ra TOTAL q?o. so .4 /e0 I (?b I ? ( (? ? , ? ?o ?,t??y??2. ARoAF?eTY r Li ? S ardt ' Zo --' I -Aaa.-cry uN? Q U I ?I ?z E? ? ??OpEk rY LINE E=i D ? .? LoT ? BLack EM I rRonsT'.._?ROPFfZTY ..LINE ,AU ; A0 `' /.? (?Lc? ? /A-A/ F? LC]T ?PL AN I? I? } ? , ities Digital Oualitv 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. i i?V f lwx? ?'?•' 15ve" S1S'?. ' r?c ?,, y? .?.J' „K ?` ? ?Y? P'? ? ar [! .k??:• r,y,._? r N y 1 ? . ? ?am?r !V. •??y? t I • Y It iv' {}.? C'`8 Q, ? S. ?.r pj. J . ? ' ? . . . ? . . ` ? ,. p. p ? 4 ? Y?rT ?4 r5??i ? ? ?tt q? 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'r} . r= IM7 If eroiago bn1uas as eaimfloted ctc" 4o goe /N! tlm imtw Gie t«olswaR??i , CYa "AlWrtlrRm H --7eloN Dmsir o" ss c tafned ifl SOC 6006 LSI W! Mf' sp/. Additf?rl' ` ? ?ats qr+y ba uc? co aEw coLw-',?@ac-im. • ? ?• ?.. .? •'`?.y`••z? . . ?? y..._ . • ?1. , ' .? ? i ' ' u a x ' ? L ?+? ti.. •t^! . . ' n_ ..?1 . . . ' . • . { `rCy 3 r 4 ' J 5.. V . ?. . C?'..?. ? . .. ` , } ' . ` ?.??J. Y.. ? i'• _ '."?i? ?:i ? ? " 'J Sk . Y.? >. . ` t . 41? N ,,'o ? 6?.uy\ M? 3795 PILOT KNOB ROAD. P.O. BOX 21199 BEn BLOMIXnSi EAGAN, MINNESOTA 55121 ^^w°f PHONE: (612) 454-5700 THOMAS EGAN JAMES A SMIiH JERRV THOMAS THEODORE WACHTER Council Membel5 ° s March 23, 1983 c?°n??n ao - EUGENE VAN OVERBEKE . Ciiv Clerk SUBURBAN COASTAL ATTN: CINDY 7300 METRO BLVD SUITE 560 EDINA MN 55435 Re: ?4235 Nybro'Lane North, Eagan, Minnesota Per your telephone request, the above-referenced parcel is lo- cated in a"No Special Flood Hazard Area".as indicated on the attached map. If additional information is needed, please feel free to con- tact me. Sincerely, I)Wkle Dale City Planner DCR/jach enc THE IONE OAK TREE. ..THE SYMBOL OF SiRENGTH AND GROWTH IN OUR COMMUNIiY ? - ? ? COflPONA1 Ccurn-a ? ty-Panel' Nta-ber ••• • •• 270103 OOOi B / •:r:': 5:;:?::?r::;;?r / C, • 's S ?/ ?, . . •:?:$,'r:. _::}::•:}•:i?:???:?:$?: . ' ? f' • y ?o : ' . . ? ? ;::}::•,::ti:.}}:i :?i:??i::.ti1}_? . .? ; • - . .. _ ? ? . . • . 1 .......... •'?.`:?..'?. ??':':'?''{::;•}•:':;':;' < ' • ? . }:}:•i::•i:::::: i.:::. ' . ?, . . . // ? :?:i:$•i:•i:;iiiii ••::::? •:titi? ti•i:?:•:::' • . ?.? .. I .. _..,?!:+ Q!i:?:?: :: , ,":ti':>iT$?: '??,•,• . . 7 ..y.}?: d &?E C ? . '.. ?.ti:r.:;r'.. . 9 ?•••••:•:??ti::••. :o:;:;"?•?.:;:::•••.•.: .r• ??}~.; : ? ::$ti: Z ? ? ?•;':'•;:' +v?L, '- .: . ? !. p?'i*y?:v;?i:?y'%:i ?:•:?i:::?? . ' ? ? ?A ?.; `. ??:•.?.?'`.uy Y . Q 0 .. :•:ti?{TiY:::i:. ?..... • ... . f . y .?...yy,r:'•ii;k•. :;:•:'-? '4'' ??y . Z G ..? . ?:?:}?y......'ri? :•.:.?i:''4-'S'.; .:,'y. . . , . ? . 44 4Y z. :vi:•.. ? 0 -:?a v.?Trr{•• : . . . • ..;R I?Y . . . W • 1Y?. ? . I.'? .* • ? .. . • .. ?' _ ='?O ••V?'?'!i X{?? ??? ??? • • • ' • ... ', ie ?'}::?',.•:;•':??r:; T' • . . . • . . * 70103 0002 B M.•. .?. .. ? . . . _ '. . ' 4;1. W I . ~ M ? ?y ? • '• ? ' .t.? a? •? : . . . I . . .. i'. C 31 q+ ? ? .. j"_ _ i •.?P?koX ? ?a ? ,?OC.4T/oN ? .__ I ` tw I I CtlFP ROAD ? ; , _._....? ?. u *rrar PRrNrEO (rao sPSCVU._ Fz.oM tpWD r.RFA) ; Zone Svrftol R- Area of soecial floocl hazarcis (,SFH) arx3 i,rithout base flood elevations detezmi.ned 2one Symbol C -• Area of mininml flood hazards 2004 RESIDENTIAL MECHAIVICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single famity dwellings & townhomes/condos when pemtits are required for each uni[ Date ? / ac) / ' f _ SiteAddress a a.??6 t-,l . ?Jy brn L-Yl ' Unit# Property Owner 06__Nr) C(?2c=?1 Telephone #(COSI Contractor ?- - - - i Wohlers SOUthside Htg. & Air, Inc. ' 6950 W. 146" St., #106 ' Street Address _ Apple Valley, MN 55124 ? CitY I (952) 431-7099 ? State i Telephone # ( ) Bond `--?'1 Q- - ' 0?J-T -7 q 8 Expires: -?I Q- ?? ?'?l U The Applicant is _ Owner Ike Contractor _ Other Add-on or alteration to eaisting dwelling unit $ 30.00 furnace _Additional _Replacement air excha nger airconditioner _New ?_Replacement other Sta[e Surcharge $ .50 Tatal I hereby apply for a Residenrial Mechanical Pemvt and acknowledge that the informarion is complete 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 pernilt, 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. tan vif! ( ?. . i-??Ie.rS 0 Q /Z c.ejw-c?? ApplicanYs Printed Name Applicant's Signature 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commercial/industrial buildings mulfi-family buildings when separate pcrmits are not required for each dwelling unit Date Site Street Address Ulnit # Tenant Name (if applicable) Previous Tenant Name I. ' Property Owner Telephone # ( ) ? Coniractor Street Address i? City State Zip Telephoue # ( ) Bond #: Expires: II The App6cant is _ Owner _ Contractor _ v Other ?I Work Type _ New Construction _ Underground Tank _ Install _Remove "see below p _ Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: ? *"When installing/removing underground lank, cal! for inspection 6y Fire Marshal and Plumbing lnspector Peflltit FeC&: $7050 Undergound tank installalion/removal . ? $5050 Minimum (includes State Smcharge) Oi ContractValue $ x 1% _ $ I PermitFee • If pemut fee is $1,000 or less, add $.50 ? $ State SwcUarge Ifnermit fee is over $1,000, add $.50 for every $1,000 pernIIt fee $ II Total Fee 1 hereby apply for a Commercial Mechanica] Permit and aclmowledge that the informarion is comple4e and accurate; that the wo;k will be in conformance with [he ordinances and codes of the City of Eagau and with the Mechanical Codes; that I understand this is not a pemut, but only an applicarion for a permit, and work is not to start without a pernut; that the work will be in acwrdance with the approved plan in the case of work which requires a review and approval of plans. I Applicant's Printed Name Applicant's Signatwe Approved By: , Inspector 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when permits are required for each unit J06 cd) 50 Date Site Address C/[G)'Yr'i L s' h.L f V Unit # Property Owner Telephone # ( (Q ,? 43o?- Contractor ?' `iVl C_ Street Address - --^ City ??a S ? G1 y( Q State Zip ?o?S Telephone # ( (p?? ) '/ O ? -_ ?(t Q Bond #: Expires: The Applicant is _ Owner 7XContractor _ Other Add-on or alteratioo to existing dwelling unit $ 30.00 ? furnace _Additional .,&Replacement ' air exchanger airconditioner _New _Replacement other StateSurcharge $ 50 Total :.; :,. ?:":•? : -'P.I'a'.. "55-: ,? ? ,, vt.., . $? I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and acwrate; 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 permit, and work is not to staR without a permir, that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pl . ?? ? ) o e A Q .i JCt xj ApplicanYs rinted Name Appl' ant's Signature 'l 9 ?OOS ; ,. ? ? t. 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: wmmercial/industrial boildings , multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenanf Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) I Contractor ' Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is _ Owner _ Contractor _ Other Work Type i _ New Construction _ Underground Tank _ Install _Remove *`see below _ fnterior Improvement _ Install Piping _ Processed _Gas Nature of Work: '"*When installing/removing underground tank, caff for inspection by Fire Marshal and Plumbing Inspector Permif Fees: $70.50 Undergmund tank installationlremoval $50.50 Minimum (includes Sta[e Sureharge) or ContractValue $ x I% PermitFee • If en rmit fee is $1,000 or less, add $.50 => $ State Surcharge If emit fee is over $1,000, add $.50 for every $1,000 oermit fee $ Total Fee t hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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 woFk will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name ApplicanCs Signature Approved By: , Inspector PERMIT City of Eagan Permit Type:Building Permit Number:EA115951 Date Issued:10/01/2013 Permit Category:ePermit Site Address: 4235 Nybro Lane N Lot:012 Block: 003 Addition: Wilderness Run 6th PID:10-84355-03-120 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. 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. Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Steve N Hennen 4235 Nybro Lane N Eagan MN 55122--174 Bayport Roofing And Siding Llc 10 South 5th St, Suite 700 Minnepolis MN 55402 (612) 235-7663 Applicant/Permitee: Signature Issued By: Signature