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1516 Oakbrooke LaneClty of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651) 675-5694 2008 RESIDENTIAL BUI Date: Site Address: Tenant: Suite #: RESIDENT / OWNER Name: Phone: / Zi : Address / Cit p y ApplicaN is: _ Owner _ Contractor 1"YPE OF WORK 6on ofwork: ri D p esc Construction Cost: Multi-Family Building: (Yes _ I No CONTRACTOR , Name: License #: Address: 7 City: State: Zip: Phone: 6onfac-f'Person: l Jh-11 / Lj COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheef Cat@gOry Submitted Submitted (4 submission type) • 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 plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer 8 Water Contractor: Phone: NOTE: Plans and supporting documents ihat you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurete; that the work will be inconformance with the ordinances ano co?es ui iile Oily v? Eagan; that I understand this is not a pertnit, but only an application for a permft, and work is not to start withoul a pertnit; that the work wdl be in accordance with the approved plan in the case of work which requires a review and x )/?Te) „ r\ s O 6Aj ApplicanYs Printed Name '----------------i I Fo_r Offoe Use I ? Permit#: ? I PermitFee: 70?0 G7 I I ? i ? Date Received' ? I ? ? Staff ? I ------------------ G PERMIT APPLICATION / Site address: ??LiJ Lot ? Block -' Subd. C. On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 ? OR `-This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFAC URER MODEL BTU'S 4ENTING TYPE Water Heater ? onl xqlOSZ .? Fumace Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED rES NO Kilchen kitchen 6E ---J-IJ3Z7X Bathroom 1 16d ?5- '" [`?.S ?rQ v? ? Bathreom2 v- QS v s-? Bathroom3 u, gro? ?/-?_s0 SO Bathroom 4 tca s v Sv Other LOCATION I GAS I WOOD DIRECT ATMOS I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. , iz9o? T (.? ??? !/Oh1G5 Date CompanyName ' This form is the responsibility of the General Contractor. ??-- 1 1 6 I o 3??- TIAL?Yl 60 s°?a_9 I SID? 0 ??Y BUIL ING PERMIT APPLICATION ' CITY OF EAGAN 3830 PILOT KNOB RD, EACAN MN 55122 9 v? 651-681-4675 New Construction Reauirementa RemodeVReoalr ReauiremeMs • 3 registered site surveys shaxing sq. %. of lot, sq. ft of house; aM all roofed areas • 2 wpies af plan ???? ' I I (20%maximumlotcoverageallowed) . 1setotEnargyCalculalionsfoi(ie`aYBCkaCditians • 2 copies oi plan showinp 6eam & window s¢es; poured found design, etc.) • 7 sRe survey for ezteriar additions & decks /? • 1 set of Energy Calculations Indicale'rf home served by seplic system for additiore -7- • 3 copies of Tree Preservatbn Plan 9 lot platled after 711193 e30-2-s' . Rim J oisl Detail Options seledion sheet (61dgs with 3 or less uniLS) DATE I'& 'OZ. VALUATION O/50,DOU SITEADDRESS ???? ?LG Zx...lP MULTI-FAMILYBLDG _Y CN TYPE OF WORK )1ICeJ Aonr. 0?+_,Sz",t FIREPLACE(S) DZ 0_ 1_ 2 APPLICANT STREET ADDRESS 01,7 /VOP"rha,Je.S-e / CELL PHONE # &1Z_)36I'17ZZ PROPERTY e!j4c, ---STATEA62ZIP CJ TELEPHONE # -----------------------------------------------------------------------------------------°---- COMPLETE THIS SECTION FOR NNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNI:SOTA RUI.CS 7670 CATEGORY l _L/MINNF.SOTA RULES 7672 (J submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted . Energy Envalope Calculations Submitted Plumbing Contractor. _ Aki- Phone # ? Z/.? / __ Plumbing syslem includes: _ Water '"ener _ Lawn Sprinklcr Fee: $90.00 / WaLer Heatcr ? No. of R.I. Baths .3 No. of Baths Mechanical Contractor: oz(??G llN? Ph OF:l 8y? ?c < Mechanical system includes: L Air Co oning Fee: $70.00 _ Hcat Recovery Sys Ll F.? "I ', ?? "I _n Sewer/Water Contractor: -----------------------------------------------------°-------._-------------------°---------- I hereby acknowledge that I have read ihis application, state that the information is conect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan nces. Signature of Applicant ? OFFICE USE ONLY Certifcates of Survey Received ? Tree Preservation Plan Received _ Not Required ? Updated 4/02 ? ? 01 Foundation A 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex' ? OS 03-plex ? 06 04-plex ? 07 05-plex ? 08 O6-plex ? 09 07-plex ? 10 08-plex ? 11 10-plex ? 12 12-plex OFFICE USE ONLY ? 13 16-plex ? 16 Fireplace ? 17 Garage ? 78 Deck ? 19 LowerLevel Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous A 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Alteration O 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 6 7av Occupancy -3 MC/ES System Census Code IOl Zoning 1:2- D City Water SAC Units C7T' Stories ? Booster Pump Nbr. of Units Sq. Ft. ce,2 PRV Nbr. of Bidgs Length ?f9 Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS ? Footings (new bldg) FinallC.O. _ Footings(deck) FinaUNo C.O. Footings (addition) _ Plumbing ? Foundation HVAC X Drain Tile Other Roof Ice & Water ? Final Pool Ftgs Air/Gas Tesu Final x Framing Siding Stucco Stone Fireplace R.I. Air Test _ Final Windows (new/replacement) Insulation _ Retaining Wall 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 Approved By ? 30 Accessory Bldg ? ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Building Inspectar 9An,?J,a jL ?w??? 5!- RESIDENTIAL .? . ' • ' ` BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New ConsWCtlon ReauiremeMe • 3 registered site surveys shmMng sq. ft of IM, sq. R of house; and J ioofed areas (20% maximiun lot coverage allowed) . 2 copies of plan showing 6earn & windav saes; poured touml design, etc.) • tsetofEneqyCalculaUons • 3 copia W Trae Preservadon Plan'rf lot platted aRer 711/93 • Rim JoislOelaJ Options selection sheel (bldgs wiTh 3 w less unils) DATE JOB SITE AODRESS Oalt'?rot IF MULiI-FAMILY BUIIDING, OW MANY UNITS? PROPERTY OWNER?s??.. ?+'? TYPE OF W? K N2W ?`? APPLICANT `\IN\\,.a. ADDRE55 PAGER # CELL PHONE _0K 1_2 W21° ? -q54 -uml +v: ? - FILL OUT Energy Code Category (check one) Plumbing Confractor. ? Plumbing System Includes: Mechanical Contractor. Mechanical System Inch Sewer/Water Contractor. _ MINNESOT RULE 670 CA' - Reside I Ventilation C egory 1 1 _ Fnor Fmrolnna R.Irulnii e Cnhi w"' MINPVESOTA RULES 7672 I -Ts New Energy Code Worksheet Sub itted Pnon #:?Z•- 4?t- Z\Z\ Water Softe _ Iawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths ti54m-4" P h o n e # ?`aL???y - Qm)? _ Air Conditioning Fee: .00 _ Heak Recovery System 4CC ?f i?2Cc? Phone #??.,? All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state th he informati ' correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eaga ?nances. ? Signature ot Applicant Certificates of Survey Received '4- Tree Preservation Pian Received _ Not Required ?b ,?R ?,( ? Updated 2002 b? RemodeURaoalr ReauiremaMS 9m • 2 copies of plan c • 1 set of Energy Cakulahons for healed add'rtbre • 7sitesurveyforexlenaradditions8decks - • Indicate'rf lame served by septic system for additiais , \l 0? VALUATION ..?e.. L4 ? ? g 3, (h?uvlt? Co ` L ?h 63, gL s5a?? 173on. 53 mE 5s a-? ? `+o . 5-° 'Pt Ssa? ? q13 . Sc7 CODE S'-' \ Zt FAX # OFFICE USE ONLY .. . ;. f•-• _.. ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg x 02 SF Dwelling ? 08 OB-plex ? 16 Fireplace ? 21 porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. AR - SF ? 04 02-plex ? 10 08-plex ? 18 Dedc ? 23 Porch (screened) ? 36 Multi ? 05 03-plex p 11 10.plex ? 19 Lower Level ? 24 Starm Damage ? 06 04plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous X 31 New ? 35 Int Impravement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair 0 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroaf ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation G11,Qo t'7 Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories ? Booster Pump Nbr. of Units Sq. Ft. ? PRV VA:6 N6r. of Bidgs ? Length Fire Sprinklered Type of Const -[ 1 Width G ?'^ ? ? ? Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice & Water Final Framing Fireplace $? R.I. "Vir Test XFinat Insulation _ Other _ Pool Ftgs A'v/Gas Tesu _ Final _ Siding Stucco Stone Windows (new/replacement) Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8, Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total REQUIRED INSPECTIONS ? FinaVC.O. FinaUNo C.O. _ Plwnbing _ HVAC c??? X ?s - /D, 3? ('J/?'? k 2r = A S--f = 71?? rs X / `f 0/ 9-,-? o MNr.hPr.k CnMPLIANCE REPnRT MinnPSnta EnPmv CndP MNr.har.k Snftwara VPrsion 30 i i i 'PPrmit # I Ghar.kpcl hv/DatP I" I I 1 CnUNTY: Daknta STATE Minnesota 7_nNF' 7 CONSTRUCTION TYPE: Single Family DATF7 1-11-2002 DATE OF PLANS:7/25/00 TITLE: Oakbrooke Sterling with Lookout COMPLIANCE: PASSES RanuirPd l1A = .ri3? Ynur Home = 403 24201, RPttPr Than CnHe Area nr Cavitv Cnnt GlaAnn/Dnor PPrimetPr R-Value R-ValuP U-Value UA ------------------------------- --121 R 39.0 0.0 37 CEILINGS 2B73 19A 20 150 WALI S. Wnod FramP 1R° O-C. 61 BSMT? Cnnr.. 9.0' htlR_3' ha/9.0' insul 1(147 11 0.350 141 C?LAZIN(?: Winrinws or Dnnrs- ??hnvP rraclP 4n ?5o 13 Dn(]RS . ? FLOORS7 Over OutsidP Air 49 38_0 00 HVAC EOUIPMFNT Fumar.e. 92-0 AFUF COMPI IANCF STATEMFNT- The nrnnosed buildino dPSi°n dPSr.rihed here i5 cnnsistent with the huilrlinn nlans- snecificatinns. and other r.alr.ulatinn5 submitted with the nermit annlir.atinn. The mmnnsed huildino has heen designed to meet the?eApirer,nts ohe?eso Energy Code. ?_ lj- ! /'// // 77 7- DatE. p LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL: L U DATE OF SURVEY: ? c m L U Y ¢ a o z a U/ ? ? 4X u G ?? ? ?/? u E?/ ? ? I2'/ ? ? L? ? ? ?? G ;//? ? ?i ? ? C7 J? c ?? G ? LATEST REVISION: DOCUMENTSTANDARDS W,•i-s,a-; • Registered Land Surveyor signature and company • Building PertnitApplicant • Legaldescription • Address • NoRh arrow and scale • House type (rambler, walkout, spiit w/o, split entry, lookout, etc.) . Directional drainage artows with slope/gradient % • Proposedlexisting sewer and water services & invert elevation • SVeet name • Driveway • Lot Square Footage • Lot Coverage ELEVATIONS -/ Existinst ?y ? ? • Sewer service (or Proposed) ? ? ? • Property comers ??/ ? • Top of curb at the driveway and property line exRensions ? H/? • Elevations of any existing adjacent homes ? a?/ G • Adequate footing depth of structures due to adjacent utility trenches ? rJ ? . Watenvays (pond, sUeam, etc.) Pronosed 14' ? . Garage floor ? o ? • Basementfloor va?;7 ? • Lowest exposed elevation (walkouUwindow) i?4• G • Property comers yt7 C • Front and rear of home at the foundation PONDING AREA (if aoolicable) u ? ? • Easement line ? ? . NWL ? C? ? • HW L ? W, ? • Pond # designaGon ? C? D • Emergency Overflow Elevation C9' ? ?p p?n :?0 DIMENSIONS • Lot Iines/Bearings & dimensions . Rightof-way and sVeet width (to back of curb) • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent faatings) • Show all easements of record and any City utilffies within those easements • Setbacks of proposed structure and sideyard set6ack of adjacent existing sWCtures • Retaining wall requirements, " G ? ? ? G r Reviewed: Surveyor's Certificate SURVEY FOR DESCR(BED AS A 51 O00 oA0B A?E 94?•? ? ? qq2 5 PULTE HOMES :Lot 11, Biock 3, OAKBROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving eosements of record. SEP 16 REC'D 940I Ga'o9e I ? i ? i i ? ? ? ?i '9a2s qQl9,11 o A I j? V o lf ? / J 942.1 ER.iIdG vE' A sea °? ?? c? 3:1 MBXhIm sgqm o y WeilWtll B8 Requlred m I ? N ? I O I 00 ? I I i I ? ? z ? i ? ? ? L____'_ 993? ?? ? <. L9 \ ? cq ' \ . ? V (? ` l+7 ? . Z ? I o °y*} ?------------J.o N ? Q N89°42'35"E 50.0 ? =1 ? < ` 4 M?i ? s L 0 T SQ. F00 TA GE ? o = 23, 877 HSE SQ. F00 TA GE = 1, 789 ? o _____________? ° LOT COl/ERAGE ="-?77o y 18232 N89°42'35"E 98.46 r PROPOSED ELEVATIONS ?? ?? a BENCHMARK, ..?? Top of Foundation = aaa o ce ?4003 Garage Floor =aa3.o i?? Ieo = 492?3 E Basement Floor =q3c?.? Aprox. Sewer Service =a32 os Proposed Elev. MIN. SETBACK REQUIREMENTS Existinq Elev. _ Drainage Directions Front - House Side - Denotes Offset Stake = • SCnLE: 1inc Uj,p?.ear - Garage Side- n = ao r'i7 „ tV f- '•;:?y? ? ? > JOB N0: •.. F ? : re?r?srE?E I HEREBY CERlIFY THAT THIS IS?A TRUE ANDaCBRRECT REPRESENTATION PROPERT`C"AS:SURVEYED Of THE BOUNDARIES OF THE A9fZVEIDESCR19fD 02R-536 HEDLUNQ j ? \ 'AND DOES NOT PoPORT TO BY ME OR UNDER MY DIRECT SIYPERVI510N BOOK: PAGE: SHOW IMPROVEMENTS OR ENC OACHMENTS, E?SCfFP?7 AS SHM- PLANN/NC fiNG7N6BRINC SURVdYING 2005 Pin Oak Drive Eagan, MN 55122 7? DATE ?/4?/Q Z CAD FILE: Phone: (657) 405-6600 Fax: (651) 405-6606 dD?gJN,P6REN, LAN URVEYOR MIN OTA LICENSE NUMB R 14376 OakbrOOke 6 vv? _ ?ll?)q(6 . 4VV-?5?0 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ,/42 I 3 / I 69S'- Site Street Address el Unit # Property Owner Telephone # (4:57) 991/-4?W7 Contractor ?M10/D/Q Telephone# (9s:?) -3?5u=222e Address /QLa?? City LL State-2ML Zip'-?Z The Applicant is: _ Owner Contractor _Other Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes putting in a water softener andlor water heater at the same time. ff you are insta!lina onlv a water soffener and/or water heater, do not complete this section. Move to the next section and check the appliance(s) you are installing. _Septic System Abandonment _Water Turnaround (add $125.00 if a 5/8" meter is required) Other: ,KWater Softener _ Water Heater $ 15.00 _ new ? replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 rotal $ I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand?this is not a permit, but only an application for a permit, work is not to start without a„permitiand yvqrk will be in accordanc with the approved plan in the event a plan is required to be reviewed and appII?Iove ??1 I,G'?? ? 2 1005 ?JI G?K pA pli anYs Printed Name AAplicanYs Signature i"•Y- -_? -_-__ - ?----------------- ? - `0ffi--?" ? Permit#: City of EaiaIl I Pertnit Fee: 3830 Pilot Knob Road Eagan MN 55122 ? Date Received: Stan: ? Phone: (651) 675-5675 Fax: (651) 675-5694 Q?_ UGy /1 ?j ?u 1 r c ?----------------J 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: SiteAddress: Tenant: Suite 619 ?? //r ?k Ph RESIDENTlOWNER one Name: C!C Address / CiTy! Zip: ISlo /M/fG Glc??? Applicant is_ Owner ? Contractor TYPE OF WORK Descnption ofwork: /'/itJl?? /?GSc'??!'a.?? Construction Cost: e? e!z5a Multi-Family Building: (Yes _/ No CONTRACTOR Name /1POO?-ifcy?+?e- ?Jy?p"r1,S License# Address: ?L?LIY C?/? ?lr'h/f? 9/??L Cdy ?? Q.J State: /"-'l/? Zip: Phone 1,? - - 6"[S6oO Contact Person COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residenhal VenUlation Category 1 Worksheet • New Energy Cotle Worksheet COtegory Submitted Submined (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contrector: Phone: Sewer & Water Contrector: Phone: NOTE: Plans and supporting documenu that you submit are considered to be public informafion. Portions of the information may be classffied as non-public if you provide specific reasons that would permJt the City to conclude that ihe are trade secrets. I here6y acknowledge that Ihis information is complefe and accurate; that the work will be in confortnance vrith the ordinances antl codes of the City oT Eagan; that I understand this is not a permit, but only an application for a permil, and work is nol lo start withoa?permit; that the work wnll be in accordance with Ihe approved plan in the case of vrork which requires a review and approval of plans ? x Qal7a( LG•.lSaJ Applicant's Printed Name Page 1 of 3 15 /U 6&4rwV.-& 1-Ajo---- DO NOT WRITE BELOW THIS LINE Fq-19-1 ? SUB TYPES _ Foundation _ Fireplace _ Porch (3Season) _ Storm Damage _ Single Family _ Garage _ Porch (4•Season) _ Exterior Alteration (Single Family) _ Multi Deck _ Porch (ScreenlGazebolPergola) _ Exterior Alteration (Multi) _ 01 of _ Plex ? Lower Level _ Pool _ Miscellaneous _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building" Addition _ Move Building _ Reroof _ Demolish Interior ? Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ EgressWindow _ WaterDamage Retaining Wall *Demolition of entire bu(Iding - give PCA handoutto applicant DESCRIPTION Valuation T( V? Occupancy VV_J1-- MCES System Plan Review Code Edition WN? SAC Units (25%_ 100%'/ ?) Zoning City Water Census Code ? Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction ? Width Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final ? Framing Fireplace: _Rough In _Air Test _Final Insulation Meter 5ize: Sheetrock Final / C.O. Required ,?)t Final ! No C.O. Required _77? HVAC Other: Pool: _FOOtings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Erosion Control Reviewed 8y: -r -L- , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit 8 Surcharge Treatment Plant Copies TOTAL Page 2 of 3 City of Eapn 3830 Pilot Knob Road Eagan MN 55722 Phone: (651) 675-5675 Fax: (651) 675-5694 ?------, - - - - - - - - - - ? ?oroftice`""?,Use ? ? Permit #: I permil Fee: I ? ? Date Received: I I ? i ? I Staff. ? L ----------------- 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: '- .7 70 Site Addre,": ?S / h ? a K 81DO IC-P L/'- Tenant: Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: CONTRACTOR Name: J/C°?///-? License #. Address: - city: Pr 1lF ? State: -Z?'Izzip: Phone:'?S 7'2 42- 7S3 I Contact Person: TOIM TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild V Modify Space _ Work in R.O.W. Descri tion of work: PERMIT TYPE RESIDENTIAL Water Heater _ Water SoRener Lawn Irrigation Add Plumbing Fixtures (_ RPZ /_ PVB) Main _ Lower Level) Septic System _ Water Turnaround New Abandonment RESIDENTlAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 state Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge) "Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $50 State Surcharge) $90.50 Fife Repaif (replace burned out appliances, duclwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ i nereny acKnowieage tnat mis mrormanon is compie[e ann accurace; mac me worrc wm oa in conronnencn witil Lilu .,llu ......- .., ,- ...v -Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permd; that the work will be in accordance with the approved plan in the case of work which requires a review and approva of plans , /' Xor? P??G/JZ?_ x ?? ??'..? ApplicanYs Printed Name App ant's Signature FOR'OFFICE USE =. _ Reviewed By:. Date: Required Inspections _Under`Ground -_Rough-In _Air Test, , _Gas Test , _Final Use BLUE or BLACK Ink r________________---. I For Office Use I nnn Permit I 11q95 City of EaRd I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: U Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Oak b L Unit I- . . &k-- Name: r FF~~arl Ak Phone: Resident/ ~JA V1 6512- Owner Address / City / Zip: KZ(2 L11 Applicant is: Owner Contractor Type of Work Description of work: e RP r®Qf ,~s'j( vii Construction Cost: /YOpa Multi-Family Building: (Yes / No ) Company: Contact: i Contractor Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING i In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.om I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X_ k x Applicants rin ed Name Applicant's Signature Page 1 of 3