4245 Nybro Lane NCITY OF EAGAN Remarks
Addition WILDERNESS RUN 6TH ADDITION Lot 8 131k 3 Parcel 10 84355 080 03
Owner '?-?L -- i `0 i `v ` Street 4245 North Nybro Lane 5tate Eagan, Minnesota 55123
Improvement Date Amount Annual Years -Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN SEW TRUNK j 1973 161.21 8.04 2? ?j .43 colo -li-g
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 162.14 8'?C7 15 64,914, 11 11 8
STORM SEW TRK ? 7? 15 125.58 if -11-8
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LlGHT
WATER CONN. 500. 00 rr n
SUILDING PER. 0124
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Rosd, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
eUILDING PERMIT
T. ?a ur"ll" - -
Site Addreu 4 5 t•; i: ? Y??
Lot Block ub. Y`k'"D RI7N uT'{
Percel No.
.%, u.J vru:7 UGV1SLVt'P1C.N?r t.?_?
W Name
€ Addrets , _ , :? .?. ; ' , . . c,,-??• ? •a
b ? ?J
City Phone
? Name ?`il"E
Receipt #
\
Erect L.7, Occupar?ty s .$
Remodel ? 2oning
Rapair ? Type of Const.
Enlarge ? No. Stories
Move ? Lsngth ?'• r
Dsmolish ? Depth 7. r
Grade ? Sq. Ft.
? Assessment
? Addrm
C'ity Phone Woter 3 Sew.
PoHu
G? Name Fin
?3 Aedrea Eno.
u
tW City Phone Plonn?r
Council
1 hereby ocknowledqe thot I how reod this opplicotion or+d atote tF+ot Bldg. Off.
the inlormotion is oonect and ogree ta comply with oll applicable A?
Stah of Minnesotc Stotutes and Gity of Eogon Ordiror?ces.
Var. Oata
5iqnctun of Pennittw
A
Pem+ic J u
5urcharye ' U
Plan Review. ? 0
5^C ' a
Woter Corn. ? 0
Water Metar ?f
Road Unit
?•?
Totel
A Buildinq Pen»it is isswd to: I-• .) .. 1 - on the express conditlon tFw
oll work s?wll bo dorw in otoordaxt wlth all applimble State of Minneaota Stotutss ond Cify of Eaqon Ordinonua.
94Aldinq Officiol I
PKmit No. hrmk Holda DOW TNe hone ?
Plumbipo U r? C)I f o ?
H.VA.C. 515 6:
Ebotric 935 S/ , o
350` 5 15 .?? S
sottw..
Irnped{on Om Insp. Othw
Footinot f w
Founehtion
Fnmino ?
Aooflny
Rouoh Plbp. ,S Z f -QS
Rouoh HVAC ir?'S /Oz
in.ulation iy
Final Mbp.
Find HVAC 1 S jV
Fiml
c.,UOOO. s r,? ct, f ? ?(1 s
?ater Ohcribe Locatfon:
YWII
Sownr
Pr. Obp.
Roaipt PWMBIN(i PERMIT Permk No.
CITY OF EAGAN
FN
fill /n numbered s"ces S/C ?
Type or Print /egiWy -
T
ot
1. Date 2. Installation Cost '
3. Job Address Lot Blk. Tract
4. Owner t
5. Contractar Phone '
6. Addross
7. CitY StetB Zip ? .
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New F7 Add O
Alter D Repair O
10. Describe
11.
No•
- Fixtures
Water Closet No. Fixturea
l/Drainfield
Ce
Bath tuba sspoo
Septic Tank
Lavatory Sohner
Shower Well
Kitahen Sink
Urinal/Bidet Othe
-
? L.aundry TraY r _ . ? .
' Floor Drains
Drinkiny Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby oertify that the above information is true and correct, and I spree to
comply with all ordinances sptd codes governing this type of work.
Signed: ' "r ) for
Rouyh F inal
Inspections: Date Insp. Date tnsp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Reaipt !
MECHANICAL PERMIT
CITY OF EAGAN
Psrmit No.
Fas
? Fill in numberod spaces S/C '
Type or Print /egibly Tot
' 1. Date -?' 2. Insiallation Cost •
?
? 3. Job Address Lot Blk. Tract
? 4. Owner
5. Contractor ?'i -• -:=-r T, Phone I 7' 1
6. Address
7. City - State Zip '
8. Building Type: Residential ?D Commercial ? Institutional O
9. Work Description: New El Add 0 Alter ? Repair ?
10. Describe FueITYPe
11.
No. Equjpmeat BTU - M. Ea.
Forced Air No. EQUiement CFM
Air Handlin
:
Mfg, g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg.
Other
Air Cond.
AAfg.
? Gas, P'iping Outlets
12. I hereby oertify that the above information is true and oorrect, and I agres to
comply with pll ordinartses and:codes goveming this type of work.
?
5igned' ` - for
Rough Final
In:pections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved _ CITY OF EAGAN 46"100
CITY OF EAGAN SEWER SOVICE PERMIT
3830 Pilo: Knob Roed
P. O. Box 21199 PERMIT NO.: I
j J
Eagan, MN 55121 DATE:
? Zoning: No. of Units: 1
?,??, }?c-?a1 ?laics 1?7
? /lddress:
1Y° "fvbro Lane L8 Ti3 ',yf.lderness !?un .?
? Site Address: 4245
Plumber.
! I pm to aanPy w1N !IM Cihr of Ea'os
j Orain?nas.
By
Dote of Insp.:
1- - -
Connsction Charpe: 4 2 5. 00 pd
Aocount Deposit:
PermM Fee: Y; k. C
Surthorpe: ?
Miac. Chorpes:
Total:
Dots PoM:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Rosd
P. b. Box 211ev" PERMIT NO.:
Eagan, MN 5512? DNTE:
Zoning: No. of Units:
Owner; oya : aks ev
/lddrcss:
. o y ro ane . 7-1 ?ti <?.ernes ;.?:n 6
4245 Site Addrcss:
'??', _ . r ord
Plumber
.
Meter No.: Connection Charge:
Slu: Atcount Deposit:
Reoder No.: PermEt Fee:
?
1sgm to ooEplr whh !ho Ciey of Eaysn .
.
Surd+orge:
OedineeoM. Miac. Choryes: ` • ?
Totol: rd me.te
By Dcte Poid:
[)ate of Insp.: Insp.:
"
CiTY oF EAGAN WATER SERVICE PERMIT
3830 Pilot IEnob Road
¶P. d. Box 21199 PERMIT NO.:
#Eagan,MN 55121 D/?TE: 5-13-
'Zoning: No. of Units: ?
Uwner
.
•:/1dd?ess:
te Address: { ' •,? t, i n <L ` • i ' , ? ,? ra: - ?
u
b
m
er:
` Metar No.:
connecrior? Charge: '
`
' IZE: ?? R ? 1 J•'?1?•?
ACWUfIt DBpOSIi:
Reoder o.: n 4- ;?2. 6, a Z5
Permit Fee:
1 egme MCompy wif6 tM Ciryr of ""n Surchorga:
.0?a1 Mlsc. Charfles:
°
3
7
7
TotoL• p,j ,., p re r-
' gy . k?. ' Dote Paid:
[)ote of Insp.: I?+SP•:
5
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PIL-68O SR5 • 55122
651 ? 7f'1 d d
V
New Canstrudion ReauiremeMS RemodeVReoair Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. N. of houu; and all roofed areas • 2 copies o( plan
(20% maximum lol coverage allowed) • 1 set of Energy Calculations for heated additions
. 2 copies of plan showing beam & window s¢es; pouretl fourid design, etc.) . 1 sife survey for exlenor addNOns & decks
• 1 set of Energy Calculations . Indicale if home served by seplic system for additions
• 3 copies ot Tree Preservalion Plan if lot platted after 711193
. Rim Joist Detail Oplions selection shcet (bldgs with 3 or less unils)
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER &0n f c, 9I LI <J
TYPE OF WORK
APPLICANT r-?
ADDRESS 3
PAGER #
CELL PHONE #
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNESOTA Ri7I.ES 7670 CATEGOR 1
(check one) - Residential Ventilation Category 1 WorksheetYSubm IJ
- Energy Envelope Calculations Su6mitted
_ MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Water Softener
_ Water Heater
No. of Baths
Phone
Lawn Spruikler
No. of R.I. Baths
Fee: $90.00
Mechanical Contractor: ?j OP S d 2--CDY'Y! Phone # 75 ?JC- ?`Z?? ???.?
Mechanical System Includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor:
FIREPLACE(S) _0 =1 _2 _3
_ PHONE #
? /_ ZIPCODE ?533
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith
all applicable Sfate of Minnesotq Statutes and City of Eagan Ordinances.
Stgnature of Applicant
U
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
VALUATlON (EXCLUDING LAND) 92= ?
Updated 1l01
OFFICE USE ONLY A .
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02•plex
? OS 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Parch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. ,Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ,
? 32 Additlon ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg anly) - Give PCA handout to applicant
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addi6on)
Foundation
Dcain Tile
Roof Ice & Water Final
_ Framing
_ Fueplace _ R.I. _ Air Test _ Final
_ Insulafion
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
Occupancy
Zoning „
Stories
Sq. Ft.
Length
W idth
REQUIRED INSPECTIONS
FinaUC.O.
FinaVNo C.O.
_ Plumbing
HVAC
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new%replacement) ?
Appraved By , Building Inspector
I
CITY OF EAGAN N° 101 2 4
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55727
PNONE:4548100
BUILDING PERMIT Receipt #
T. M m?d fer SF DWG/GAR Et,yolue $66,000 pate APRIL 22
4245 NO NYBRO LN
Sim A
Erect C3C
Oavpancy R3
WILD RUN 6TH
La 61«k 3 &,/Sub Rmadal ? zoning R1
. Repeir ? Type of Conrt. y
Pueel No. Enlarge ? No. Stwies
ROYAL OAKS DEVELOPMENT CO Move ? Lan9th 48
? Name
O1 W 1ST ST.
STE 102 Demolish ? Depth 48
,
Add? Grade ? Sq.Pt.
city BLMTN Phwa 831-5330 inswn ?
SAME
N Ayyrorab F"s
?
ama
? Add
Assezsment
Permit O
ress Woter 3 Sew. SurcFwrqe 0
City Phone DoNw Plan Review 1 fi S_ 5 Q
?W Nama Fire $AC 5 21; fl0
?1 Address Enq. WaferConn. 5() n n0
° W City Phone
t Vlonner Woter Meter fj-1_0 0
CounGl Raad Unit *- .??./i
1 hercby xknowiadgs that I Mw rcdtl this opplicotionpnd smro that gldg. Off. 4 2 $ S T. P. 132.0
Q
1M inlormotion 7s tArred and agf,pe to. comply. it f all applicable A? Total ? l_ 7
A 9_ S 0
Stah of Minnesota Stctutes a e of Eaqa nts:. T
?_.? J Ver.Date
SipnMuro of Permittaa ;,
A Building iefmit Is luwd m: ROYAL OAKS DEVELOPMENT CO m the axprey cwwit?? ihat
all work sholl 6e dons in otmrdance with aIIADDIicobla 5?li" Minmaoto Statutn and Ciry of Ecpon Ordfnances.
euilana ariciol
REQUEST FaR ELECTRICAL INSPECTION EB'ao0°? ,
See instructiens tor compleximl this frcmpn Asck o/ yslla? eapy_
E3506 . ?"X? ? Be/ow Work Co've'red-byThis Request Ci,( 5'?5
Add Reo. Type ol Builtline Applienees Niriid. Equipmait qired
Home Range Tempurary Service
Dupie.x Water Heater Lfghting Fixtures
Apt. Building Dryer Electric Heatii
Gommercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Othet oeu y. .?hcr 6pe.:iry1
t? Specity Ot er Other
ompute lnspection Fee Below '
N Fee ServicaEnhaneeSize p Fee Feeders/Subfeeders # Fee Circuits
? U to 200 Am s 0to 30 A 0 to 30 Amos
Above 200 Am1u 31 to 10A Arry?s 37 to 100 Arnp,
Swimming Pool Above 700_Anrps Above 100_Amps
Transiormers Ivigation Boar.s Partial-'Other Eee
J /
Sigis Special fnspeMion TAL
Re?r4s . O
Rouah-in i fl o:Ite I_ the Elea
. nr.0a,:ls. ?r¢by
- dKih Wt ur abova
Finel ?
w`e { incVaclim hns been
. ) ??? ."-
tNampueatvoiU 18montlmtrom
This repuest wid
1^ O? ?,
S
,a 95
mo?cns e,om ?? t?$ g 3 w? l G? ?-•.. ?0 2 ?. o 0
lNuAR
NepIIe?St'+- Fire No. Rough-ln Inspectfon
Pequired? dv Now Q Wfll NotiTy I?pec-
,J ? ?.? ?Yes ?NO Oor When /leady
%Licensed Electti al Contrnctor 1 hembY requast imspec6oo o1 abova
? Owner ? - elec4inl rork i(slnlled at .
Street Address, Box or Roure No.
? Z V .Sy /Vn,e TH Ciry
A C ,?-?
e uon . Township Name or No. flange No. Counry
?
Occupant IP111NTI No_
Power SuDDlier Address
/\ ? ? ?'?^
IeoL+cal Contractor iComoa y Na 1
- J ? Cmvactor's Liceree No?
?
iliag AddreSS (Convacmr or Ownar Ma kine ImtailaM1ON
L i- L o C .., s'?" €7
Authori i Riture (Co clor ner Making Inscallationl Phme NuM¢r
MIN46OTp STATE BOANO OF ELECTRICITY THIS INSPEGTION BEQUESf NILL NOT
Grigps-Midway BId9. - poom N-197 BE ACCEPTED Bt lME bTAiE BpApD
1821 Univarsity Ava., SL Paul, MN 55104 UMlE55 PqOPEN INSPECTON FEE 6
Phorm (612) 2972111 ENCLOSED_
This r,lxiuest wid 5? 1 0 L(
18 n
?? ?? 5 L
ReqruTS1 Date G ?] [
?
' Fire No. fleqg `?7 nspection ?WadV Naw i Nolify 1ns0?-
tor When 9t
d
,,,J
„J zlYes ?NO ea
y
Q!J?Lifxnsed Elec[riial Contmctor 1 hpreby request inspee[im of above
? Owner electrical wdk fnstalled at
Sfreel-AOdrrss. Bo: or iiouke Na
2 vJ
?i,
???v L
?'
/?!? C+tv
??6-1•
.
.
o.?T?
, ?
ecLan No. Township Name or No. flangq o. CwnlY
^
0 ??TA2
Occupant (PNINT) Meoe No.
Power $upplia Address
s??c 07-0:4- e,?2
Elec ?cal ConvactwlGOnpany Namel , Gon:racmT'e Liceose No.
/
Mailinp Address ICOntracmr or Owner Makine losmllationl
2 2/ 4,le
AuMori SiBnawre (COMu,jod? AlakinB lnsWllation) om Nunbcr
? O02?L?
7PI
YI FSOTA STp7E BOARD OF EIECIRICITT . THIS INSPECTION BEQUEST WILI NOT
Grigps-Nidwey Bldp. - Room N-191 BE ACCEPiED ey iHE STqTE BpqRO
1821 Univarsity Ava.. St. Peul. YN 65104 UNLESS ?ROPEB INSAECTON FEE IS Ptwro /g121 2972111 ENCLOSfD.
IREnuESr FoR ELEcrwcaL inisrecrioro EB-00001A4
, See imiruet:orts for coWletim'ihis fmtl! on back of rellaw eopy. ?' 1?, G['
U5065 ""%" Below Work Covered by This Request 4?
udd ReDType ot Buildi'q aooiiances Mir.a Ew++iwmen: Wired
Si9U Un{Qader
Bulk Milk Tu.k
k Fp0 SMriceEntmnceSize k Fee Feeders/Subfeeders % fee Circui<s
D to 20D Amps 0 to 30 A 0 tn 30 Am
Above 200 Amps 31 to 100 Amps 31 to 100 A
Swimmi Pool - ' Above 100_Am s Above 700_-pS
Trarutormers irtigation Boorttc Partial: Other Fee
I InspeCtion ?3 ?.,
Final
0
ronify that the above
ircpection has baen
.de.
G bag
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single Camily dwellings & townhomes/condos when permits are required for each unit
?3().Yb
Date I Q/ / r( l Q?
Site Address X/U, /v, Unit #
PropertyOwner )04!5a/ Telephone#(
Contractor /7'&LQ / /,09-
St
tAdd o
w
'
ree
ress -
City /
f
State Zip ??".SO? Telephone #( aa
Bond #: Expires:
The Applicant is _ Owner Contracror _ Other
_7?.?
Add-on or alteration to existing dwelling unit $ 30.00
fumace _Additional ?Replacement
air exchanger
airconditioner _New ,/
l? Replacement
???
other.
S[ate Surcharge $ •Sa
Total
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
6e in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that [ understand this is not a
permit, but only an application for a permit, and work is not to start without a permit; that ql?e work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans. _
1'f}eU,?r (,e.J?l?if}eY15 ?? ?k.? ? on rz r
Applicant's Printed Name A1 Rlicant's Signature
JuL 14 2005
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. commerciaVindustrial buildings
multi-family buildings when separ2te petmits are not requned for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenan[ Name
Property Owner Telephane # ( )
Contractor
Street Address CiTy
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "*see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When lnstalling/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
P¢rmIY F¢¢S: $70S0 Underground tenk installation/removal .
. $50.50 Minimum (includes State Surcharge)
oY
Conuact Value $ x 1% _ $ Permit Fee
• If ermit fee is $1,000 or less, add $.50 => $ State Surcharge
If ep rmit fee is over $1,000, add $.50 for
every $1,000 ermit fee $ Total' Fee
I 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
?ot 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.
Applicant's Printed Name
Applicant's Signature
Approved By: ,Inspector
RESIDENTIAL
BUILDIIVG PERMIT APPLICATION
CITY OF EAGAN ??
3830 PILOT KNOB RD - 55122
657-881-4675
New Construction Reauirements RemodellReoair Reauirements
• 3 registered sNe surveys showing sq. ft of lot, sq. R. of trouse; and all roofed areas . Y wpies of plan
(20%mazimum lotcoverage allowed) • i sei of Energy Calculations for heated additions
. 2 copies of plan showing beam 3 window sizes; poured found design, atC.) • i site survey for ezterior addition.s & decks
• 1 set of Energy Calculations . Indicale if home served 6y septic system for additions
. 3 copies of Tree Preservatlon Plan'rf lot platted after 711193
. Rim Joisl Detail Options seledion sheel (61dgs with 3 or less unAs)
DATE _ 9-I g_0a VALUATION ? -7?100' oo
JOB SITE ADDRESS ya y s /U-_N r O G A n e
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY (
TYPE OF W(
APPLICANT
ADDRESS
PAGER #
FIREPLACE(S) _ 0 _ 1 _ 2
PHONE# 76 3' 67d--000f
CELL PHONE #
bJdecu
CODE S S `/a )
F,vc# -2 6 3-57?-oo 03
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNES01'A RULES 7670 CA'1'LC'?ORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submifted;l
- Energy Envelope Calculations Submi_tted-2 ?`? ?
l?'%'
_ MINNESOTA RULES 7672 0
- New Energy Code Worksheet Submitted`
Plumbing Contractor:
Plumbing System Includes: Water Softcncr
Water Hcater
No. of Baths
Mechanical Contractor:
Mcchanical System Includes: _ Air Conditioning
_ Heat Rccovery System
Sewer/Water Contractor:
All above information must be suhmitted prior to processing of application.
Phone #:
L.awn Sprinkler
No. of R.I. Baths
Phone #
Phone #
Pee: $90.00
P'ee: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with pil applicable State of Minnesota Statutes and City of Eagan Ordi ce ?
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan R eived _ Not Required _
Updated 2002
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace 0 21 Porch (3-sea.)
? 03 01 of_plex 0 09 07-plex p 17 Garage ? 22 PorchlAddn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deek ? 23 Porch (screened)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 30 Accessory Bldg
? 31 6ct. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
0 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV ? .
Nbr. of Bldgs Length Fire Sprinklered ?
I
Type of Const Width II
REQUIRED INSPECTIONS I
_ Footings (new 6ldg) _ FinaUC.O. ?p
_ Footings (deck) _ Final/No C.O. I
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other I
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Einal
_ Framing _ Siding Stucco Stonz
Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_
_ Insulation _ Retaining Wali ?
Approved ey
Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
RfSIDENTIAL
' BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstructionReaulraticeMS RemodeVRenafrReauiremeirts - """-- c,
• 3 registered sile surveys shovring sq. ft. of lot, sq. fl. M hause; and all roofed areas • 2 cropies of plan
(20% maximum lOt wverage allowed) . 1 set of EneFgy Calculations for heated additions
• 2 copies of plan showing beam 8 window sizes; poured found desigq etc.) . 1 site survey for ezlenar addNons & decks
• 1 set ot EneMy Calcvlafions . Indipte ii home s?ervced by sepiic sys^-ie7m for additions
3 copias of Tree Preservalion Plan if lot platted ailer 717/93 C?,?-?- '?J ?? y-Y 3; '/ s
• Rim Joist Detail Options selec6on sheet (bldgs wilh 3 or less units) b I J?l ?? O,OS !? 'r? ??
? g33 -y. ?
„
DATE ? . J 0C- VALUATION t'' f50C?V ? 00
? -?-l?. ?a r?4
SITE ADDRESS LJ45 ybro L-?Lri e? WMULTI-FAMILY BLDG _Y L?P4,
TYPE OF tiNOltK f 0 -y &d-Q FIREPLACE(S) X0 _ 1_ 2
?
APPUCANT 'g
STREET ADDRE3S
CELL PHONE #
PROPERTY
q5a M ?f151172-1=?'
Lio
TELEPHQNE# L-
-----------------------'----------------------------------°------------------°---------------
COMPLi?E THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MIESOTA RULES 7670 CAT'EGORY 1 _ MIN ?.?$ ?¢7?;
(d submission type) • Resi enGal Ventilation Category 1 Worksheet Submitted • Ne ?_Fgy ?,`bde?Wdrksf?eet?. EnergyEpvelopeCalculations5ubmitted p MAY 1 6 ZuOZ
Plumbing Contractor. Phone # ?
-------- ------------ gy- --c-
P lum bing sys l em inc lu des: Wa r So f tener L awn Sprin k ler c c: 0. 0 0
Wate Heaker No. of R.I. Baths
No. of ths
Mechanical Contractor: Phone #
R4echaaical system includes: !1ir Condition g Fee: $70.00
Hcat Rccovcry ystem
?
Sewer/Water Contractor: Phone #
--------° °-----------°----°-°--------------------------------°----------------°---------°----°---°---------------
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
._____._.°------°°----------....... ----__.................................................. ---------°-----------°
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
. ?.
? 01 Foundation ?
07
Orplex
? 13 16-plex
? 20 Pool ? .
30 !Accessory Bldg
? 02 SF Dwelling q 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-olex Plbg_ Y or _ N [3 25 Miscellaneous
i
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* 0 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System i
Census CoCe Zoning Ciry uVater P
SAC Units Stories Booster Pump ?
Nbr. of Units Sq. Ft. PRV ?
Nbr. of Bidgs Length Fire Sprinklered I
Type of Const Width I
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinatlCA. I'
_ Footings (deck) _ FinaUNo C.O. I
_ Footings (addition) _ Plumbing I
Foundarion HVAC
Drain Tile Othet
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining 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
V)134rh
Inspector
r.TTV aF earAN
r.ASi-I.T.Ch. S TL`.Iit1LNFlL NOe 771
DATE: 07/13/`33 TTt4f:_; 08:40:40
ID :
NAME: I:ATHL.EE:N B71..51'RUi1
34:30 9001 4245 NYRF't0 LN N 0.25
3210 9001 . 4245 NYI:;fiQ I_N N 60,00
'r?i:'i,`.i 9001 4245 NYBFiO LN p! 0.50
Tot a( F:PCn:l.pt Amount : 60.75
CR i i; 3537
USE:R SDc NANCY
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ?
?UQ i\V ? 651-687 •4675 ?o
!? ??€n? -A? ? ?,' ? ?
New Constmcflon ReaWremeMs Remodel/Reoair Reau
D 3 regf3fered sRe svrveys showirtg sq. fl. ot )ot, sq, tt, oF house
and all roofed areas (20% maximum lot coveraae allowedl
> 2 copies of plans (show beam 8 window skes; poured ind. design; e1c.)
> 1 sM ot energy calculaHons
> 3 copies tree reservatlon plan H lot plaHed affer 7/1/93
DATE: ?7
DESCRIPTION OF WORK:
STREETADDRESS: yZLK- yV- AJ,-.h4V
LOT: ? BLOCK: ? SUBD./P.LD. #:
2 coples of plan
1 set of energy calculations for heated addMions
1 sHe survey for exAerior addiBons 8 decks
?ISD, o?
Name: MA " !M De `1,Ac t Phone #: "F-????( a-?
PROPERTY Last Ftrst
OWNER
Street Address:
City f=:L-aa V\ State: '? ?l Zip: SS (2-3
Company: YV l?- Phone #:
(area code)
CONTRACTOR
Street Address: License # Exp.
City State: Zip:
ARCHITECT/ /
ENGINEER Company:- Name:
Telephone #: area code ( )
Sheet Address: Registration
City State: Zip:
Sewer & water Iicensed plumber (reauired for new construction oniv):
Penalty applies when address change and lot change (s requested once permit is Issued.
I rereby acknowledge that i have read this appllcation, sfate thal the inform n is correc , and ree to comply with all applicable
State of Minnesota Statutes ond City of Eagan Ord{nances.
` Signature of Applicanf:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No IL 6
Tree Preservation Plan Received _ Yes _ No _ Not Required -t?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-piex ? 11 10-plex ? 16 Fireplace
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex 0 18 Deck 57,ys
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level
O 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43
W 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44
? 33 Alteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(AllowabVe)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MCiES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Basement sq. ft.
Main level sq, ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code '4:3?(
SAC Code i 191
No. of llnits h O
No. of Bldgs ?
MC/ES System
City Water i
Booster Pump '
PRV i
Fire Sprinklered I
Building -&E Engineering Variance
Valuation: $
. _. ,
?
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
?
I
Siding/5offits/Fascia
WindowslDoors
Fire Repair
e
°la SAC
LEGAt- Diz-ScRiprioKt :
Lor . B a 6LocIG 3
W i toeR NesS RurJ 5&u"rN a.t
9A6An! , bAKO?n covW'Iy
0
kJ-qr E
rs-? r,
, ?.,.
? `
? ?
#j
dS6*
9\
?
Y ?
? l
`r
a
41,
0 30,?
?cY'y? 'C'Qo
8cs- S ?,r
9(oB.Y
?
A?OFti'i-} ?
Se^LE t (".30'-O?
?1
o• *
331 •00+
33•00+
165, •50+
525 -00 +
500•00+
63•00+
132•00+
1?749•50*
C4 a }
M aC17 3 1
. . . ;-.' ? A.:
S
;+ h•
:
1985 BUILDING PERMIT APPLICAYION--.CITY OF EAGAN
ALL CON?RACTORS MbST BE LICENSED YITH THE CITY OF EAG9N
.INCLUDE 2 SETS OF PLANS tg
3`CERTIFICATES OF SURVEY
"t BET OF.ENERGY CALCULATIONS ':?: -
Valuation: Date:
'0 'OFFICE USE ONLY
Lot: e?, Block -3
Parcel #
Owner
Address
City/Zip Code
Phone
Contra
Addres
City/2
.. Phone
Areh./Engr.
Erect
Remodel
Repair
Enlarge
Move
Demolish
Grade
APPROVALS
? Occupancy ?3
_ Zoning F--I
_ Type of Const sy:
_ # of Stories _
_ Length 4b
_ Depth 48
_ Sq Ft
Assessments Permit
Water/Sewer 5urcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Counci
Road Unit
Bldg Oy
V Pa rks
APC Treatment P1
Variance
TOTAL.
33f. "- ._
. ? ,
372
ICDS.S°
SzS: °°
5 OO , •?
fo '? ?
ZCp x 4z ? I ocl 2s 4- = S g11 c? 5
.,?. 4o x 4 t _. I c-o 4- cD ?... ?.
4
. w 5324- . ? ?
22 x22_= ???4 XI'l
(05? 3Z
LEGAL. Up-scaiprior.Y :
Lor _ fs , BLOCiG . 3
wIL-oerLr.iEsS avrJ surrN e,c
lM6An! t bAKo-YA covo.!^N/
WC sE R
,
9\ t
?
`1fs1',
a
?RO\
NoarH ?
exl5'Ci«?? SeALe.
?d(oB.Y
I l
,
ESOTA STATE E9rACY COOE CALCULAYIONS ?31f22D
K(,Y 1:0pe - Lytls EBiTLON c?` •
tun
_- .---?.
....__ . . .., .
- , - . _ ._.. , . . .. ",:T?` ,. ? .. . .
;y., :_, . . ..
. . . . . .. ... . . . . . . .::" ,.°. ,
- - . .. . .. ? ? , . ?' ?
" __.. ............
tuilding Classificat'Eon: Type A1 (SinqTe Family 3 Oupiex).. y_Type R2 (ResiQential?
(3 stories or ess
(Other)
a'cNERAI INFORMATION / IN CL , faYg?z
l. Building Per9meter ft.
?. Wall height (qround to eave) (Q-,/2 ft.
2
(Over 3 stortes)
3. i. x 2. (above) gross wall irgo 22ZS,53 ft.
4. Buildtng dimensions (l)4Z-_ x(N) Z 5
S. Square fcot area of rim jotst - F1oor joisi size
? x Perimeter
T
. S = 111' ft.2 rooF S flaor area
(2 x ID? ) .
= Rim joiT'L area ¦ ? ,a3 ft2
6• Oaors - area G6? 3U i- PAti b2 - 4o.t3? ' ' Thic ness ?factor Type of [onsiructian . . Perimeter fL.
. Manufacturer
7. Total door's perimeter ft •
8. 4lindows: Manufacturer State approved
U factor
TYPE SI2E AR:A (F,.2) "IUMBER OF TO;Ai FE:T Z
EACH UHITS
GL.taQ'C I"1,(a • 2 3?-2.0
I A,G o 1 1$. 6o
' 16 X-4! Ia,qO 2 • 2,S0
? z.4x3? 1 5,/00 ? -,?,p
?2d x 48 I?.4o I
17.cb
t3A`? c ? 2-2Ox 3& -21a_se ? 26_96
s
26 5$ Ss,[a ?- 55,?0
g. Total ft.2 Glass 1$2s, ,4,4
fireplace area: Width x heiaht = ? x s Ft.Z
11 . Exposed faundation: Heiqht x Perimeter Ft.2 .
' JMPLETION OF THIS FORM IS R:QUI3ED FOR ALL FlEil COfISTRUCTIOtl. MAJOR REti00:LING AHD BUILDiNGS BEING
1)V:D WY.£RE ENIERGY, OTHER THAti THE MINIMAL CODE ALLQ6lAMCE. IS USED.
c
+ = -
a ? a
?? ? . •
L
;? -
- ;- _
,
,. ..
,
!
L
Lf
E
11 LL I ff
I
,
I l U
f t t
vs ,
: ?
4t? 44. Ir 1 11 1 1 17 -L, L mffl i t1loij: Fk
IC
CeiSinq ?(p
:
/1 ? l1 n ... - M
• • bZ7
-
,• i : CEILING
;.
Afr FiIm Q.6i
Insulatiart 3?, QD
Jaist ; .
Ai.r EiTm "0.67
Totai 'R 3?. 7S
T ?
U''T • O??
.
F± 4' RCaF OR GirREDRaL CEIL I'zG
c 'ta ue
FR:URiPlG ;
.
w
.
.
.
.
-
• a.T7
-
.
R vatvE
CcFLING
Inside air fflm 0.61
CeiTing
3CTSt (St1tQ
InsuIatian. Rir saace -
Racf deckirtg
Insulatian
9uiTt-up raor
Outside air .fi1r? 0.
Tctal R '
R=U
Itratiort .5 cfm/Tirteal _f.oot cf crac'r • ? . .
daer infiltraticn 0.5 Cfm/Squar2 foat or deor and rttirtirsturt: code requlrement.
:ial daor infi7tration 11.0 cft/Tineal ?eat ag cracsc
:rete block no insulatfon
:rete block insutated cores
it"Neight bTock
_
.47 A 2.1
.26 R 3.8
.32 R' 3.1
.12 R 8.3
? .
a
?treight biock insuTate¢ cQres =
ss = I.13; wittt storm window .54
ss = .55 .
?c:L,Nr, :iI'H vE
?
,LL
CTI0N
ALUE
Insid* afr film 168
Iatasiot vall • `?S (Nall) t
Lasu Iati oa 1'3,00
Sheathing
5 id ing 6_7
Outs[de atr film .17
? roTiu. 2 q
LM
CTZOIi
Instde str film .68
Iateriae vall !+5
4" scud R= 4.38' (Franing) U
Sheaching ?p,ao
SLdtag 4-7 : .
Outside ifr film .17
& roTAr. 12.35
,
I WALL
,=ON
Instde air film Ru ,68
Interior rall -
Iasulation (p;ii ? t
?--• -- • ?
Extoriar rall eoveriag
Factar ior air f i Isa R..17
8 ?OTAI.
:ST
Sheath Lng (0•000
Exterior aall covering ,4,7
Exter ior air f i lm R. .17
. R TOTAL -21RI4o
taterior air film R= .63
Lusulacioa ? (9,00
IIh inch soEt aood R=1.88
(Rim
JOtSt)
Sh?,o,?'N ( NG?
tutng area ¦ lOx of qross wall area. -
.. 361
ross wall area Z225, tt.2
fndow area A sO ft.2 U windows ¦, SZ U x A
.
im joist area A I`19-,63 _ tt.2 U rim Joist 03S' U x A
z ?
ior area A (00. 30 ft.
Tto bt'Z,
A 4D, od tt. Z
;posed foundation A 'J(j 1 ft.2
,aminq area A ZZ2ft.2
?t wall area A 1442, 14- ft.
U door area a Il4 U x A
-a-am"moom- "-=ffi? u x
U foundation = . ?Q- U x
U frami ng area s?68_ U x
U wall = • d¢7 U x
(138) TOTAL . . . . . . . . . . U x
ross Nali area x 0.11
(13. above) .
x 0.23
x .23
x .28
(A-T single family b dupiex = aTtawabTe U x A/Code
A-2 other residential)
Other buildings}
(Over 3 stories)
BTItH Must b
222 S, 53 x u CQde_ t 1 = 2`t , vvr. 136 ab
?ilinq framing arEa (Af) equais tOx of ceiling area C or the s
tiss ceiTing area =(L) x(W)
?ist area (Ag) a lOp ceiling area = ((? ft.2
?t ceil ing area (AC) (15A - 158) • 000 ft.2
ceil f nq x A ce (bD6 x , D`z S : 21S,
framing x Afo x , QZ,`7 = 3
ITAI U x A ........................................ 2 S,0
Li
Iling area'(15A) x 0.026 (A-1 single family & duplex - code allowable U x A
x 0.033 (A-2 other residential)
x 0_06 (ntharl
1
'
f?-?"?•
?'
C 2/84
?
CITY OF EAGA:I
APPLZCATION FOR PERMIT
SEWER AND/OR WATER CONNECTIOTI
(PLEASE PRINT)
1) PP.OPERTl' ApDRESS : ?-"Zq5^ A/ u V 4j, r u LA? Y
r.FrAT DFSC2IPTICV:
(Lct/Block/StL,alvisicn or Tax Parcel I.D. NLarzer)
I'r' EXZS='=:G STRC'CTU<E . DAin OF 02IG^TAi., ;iiIi.DI_`:G : ?:•S? ISSUrNG?._
_e=;
P°ESLT =711r,/P7DPOS=? US: ? R-1 S'.?1',GL: rPYSLY .
R-2 DUPL."{ ('IWO UNITS)
? R-3 :CI.,,-NHCY?GE ('r'f?p, ZE + UNITS) ( UNITS)
0 tC-4 k?cu??'?+T???.?A•1T]?'?,t ? UNITS)
p CQNMERCLAL/RE:AII,/0'r'FIC::
? INCL'STRL3L
? TNSTI:LTIO:VP.L/GGV?:?ImM±E-'T
Z.) A?PLS= 1PLEASc PRINiJ .
(? ^
N1?ti1E: L..flR? ?• ?' ?'A
ADDRESS_
CTTY, STAT:,', zIP: Sf r?wwc:v A.N. y 5"v7-a
PHONE: ?53-y3s1
3) Fu:.iFEY
NAME 7 IPLEASE PRlNi)
(
FOA CITY I1SE 4NLY
: -..e ?? - I' o x a
ADDE2ESS:
yu 65- C•'?C/f PLUHBERS LICEYSE:
Active
?
CZTY, STATE, ZIP_ 47 S< -.) 7G Expired
.
PHODIE: '?53--y3S-1 PLUMBEH LILENSE q ?
Not af Record
a r nitia
F) CX.LUYAPI'P/C.T,y'PTER lrLCH?[ rHt;ll J
NAP'IE:
ADDRESS:
CITY, STATE, ZIP:
PFIONE:
5) INDZG'+TE W[-IICH PERMIT IS BEING REQUES'I'f;D;
? CO.INF.CPION 'I1O CITY SEDEYER
? CON,'dECI'IO;V TO CITY Tqp,TER
? di'ITR (PLI'A-CE DESCRZBE) 6) INDICATE C.+E: •
. ? PI.rASE E?OID APPROVEp PER"^ST FOR PICK-G'P BY ONE OF AHOVE
°LEASE 4?AIL APPF20VED PER:= TrJ 1, 2, 3? 4 AFC7E
(Circle one)
7) Sm,-j'ItiRE: / v cl? 1G ?'?? DATE: S ? ,'
MRRa:??w?s..s?a?sEr? ?' •?...
?u se ???a a=ra +s ? r.? rFSa:a:? a at ?.ab?r-?r? a a? s ar: ras.LSar r
F O R C I T Y U S E O N L Y
PEBMIT '-` ISSUED
F°ES: $ /6 .?7D
$
( ? ? CJ
$ ?P?i • c`?
S
S
S / "s vo
S
$
SZ5-v?
$
$
$
$
S
SEi"iL.°. PF,g"'1T_T (I_`1CL'uiE SU°C14?RGc.)
WATEit PERI1IT (INCiuDE SliRCHARGc',)
WATER METER/COPPEBHORN/OI7TSiDE REi,DER
WATER TAP (INCLUDE CORPORATION STOP)
SE:dER TAD
=cloL'_rr
ACCOUNT DFPOSIT - P7ATER
wac
SAC
TRUiIK WATER ASSESSD?ENT
TRli:IK SEWER ASSESS:lENT
LATERAL BENEFIT/TRUNK SE:dE?2
LATERAL BENEFIT/TRUNK P7AT°B
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
ANSOL'NT PAID/RECEI?T 4 JjS '7?/
DOES UTILITY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN n"PERMIT FOR Tr70RK WITHZN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVASION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLL064ING CONDITIONS;
APPROVED BY; I1.
TITLE:
DATE:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112678
Date Issued:08/21/2013
Permit Category:ePermit
Site Address: 4245 Nybro Lane N
Lot:008 Block: 003 Addition: Wilderness Run 6th
PID:10-84355-03-080
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Jayme Meyers
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 -
Dennis J Billstrom
4245 Nybro Lane N
Eagan MN 55123
Bayport Roofing And Siding Llc
10 South 5th St, Suite 700
Minnepolis MN 55402
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature