1666 Oakbrooke CirAddress 1666 Oakbrooke Cir Z1[7 $5122
Lot ll Blk s Sub gakbreeke Tth
THESE TTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: i ?_ ? D- Dc) Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage) X
Permanent steps (main entry)
Perrnanent dmeway xl?
Permanent gas x
Sod/Seeded grass ?
Trail/curb damage
Porch
Basement finish '
Deck x-
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply [o
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in righ[of-way or installing underground sprinkler system. ?
White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
!_// p, e'2.??'?
Site address: 04jq?j??Lz Lot t BlockS Subd. 7/g ? lu. A
On Apnl 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 sWcture: is consVucted to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
? This sWcture: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater
MPL 2`/S
Fumace
,ar?
S-o yNA?o31Ab?b
S
Dryer
EXHAUST SYSTEM
LOGATION
TYPE
MODEI
CFM's VENTED
YES No
Kitchen kitchen
Bathroom 1
a u
U
? .
Bathroom 2 s S v sv ?
8athroom 3
Bathroom 4
Other
PIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
8TU'S VENTING
,;o1RECT ATMOS
&t-ozi &O"UD 0" . -?
I hereby acknowledge that the above information is correct and agree to wmply wilh the Minnesota Energy Gode antl Ciry of Eagan
requirements. A
/r go ?
Date
CompanyName
This form is the responsibility of the General Contractor.
_ L ` '1 1 I eL 5 CITY USE ONLY
SUBD. o YOOf k
RECEIPT#: C-r
RECEIPT DATE: "t
PERMIT# LI JUJ?
2000 PLUNIDING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT EINOB RD
EAGP,N, A47 55122
651-691-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? 6ackflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $ -
Floor drain 3.00 x = $ ?
Gas piping outlet * minimum - 1 3.00 x = $ 3?
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $ ?
Laundry tray 3.00 x = $ -
Lavatory 100 x = $ ? -
Septic System nawlrefurbished 'requires MPC ilc. 75.00 x = $
5eptic System ahandonmant 30.00 x = $
RPZ new installation/repair/rebuild 30.00 x = $
Rough opening 1.50 x = $ iK5
Shower 3.00 x = $ j ?
UndefgroUnd Sprinklef if dwelling is under construction 3.00 X = $
Undergroundsprinkler rfexistingdwelling 30.00 X = $
Water cioset 3.00 x = $
Water heater 3.00 x = $ ,3 -
Water softener If dwelling under consWction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water tumaround 30.00 x $
State Surcharge 50
Tatae ->
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--------------• --------------
------ ---------- - •------------ I -------- --
-- -- ---------- -acknowl- -- --- ? ---------------------- ------------------ -
I herebyedge that I have read this application, sfate that the infortnaGan is corcec[, and agree to comply with all applicable Ciry of Eagan ordinances.
It is the applicanPS responsibility to notify the property owner that the City of Eagan assumes no lia6ility for any damages caused by the City during its
normal operetional and maintenance adivities to the facilities conatructed und/e?r this permit within City propertylright-oRwayfeasement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
CITY:
TELEPHONE #:
, (AREA CODE)
TELEPHONE#: `>?2' yyZ'21a/
(AREA CODE)
STATE: ZIP:
C[TY USE ONLY
' LOT I L BL ? PERMIT
SUBD. _0Ab"ODYIL `l ` RECEIPT #: C? I?JFS U3 CJ
RECEIPT DATE:
2000 MECRAkNICAL PEfiMIT (RE,SIDENTIAL)
crrY oF Eask?v
3930 PILOT KNOB fiD
r.kCu" rax 55142
651-681-4675
Date:
Complete this section only if you are installing HVAC in a single-family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
--?Xpn
State Surchazge .50
Total $ 39• s ?
Complete this section onlv if you are remadelinp. adding to, or replacinp an eacisting single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alterarion, or replacement.
:
_ New
_ Fumace
_ Air exchanger
_ Replacement
Other
_ Air conditioning
Other
Fee
State Surchazge
Total
Reminder: Callforfinalinspection.
$ 30.00
.50
$ 30.50
SITE ADDRESS: l LpCS1CP QQ,Y,b(C?k2_
OWNERNAME: Jr6 V?- 4?"S PHONE#:
(A A CODE)
INSTALLER NAM??! TlS1J1?L9--?\ -Yk- 4"PA C-- PHONE -?4`t?6?3-
STREET ADDRESS: (aaEACODE) .
CITY:
STATE: ZIP: 3S?
- ?
F PERM EE
CITY USE ONLY
L _ BL
SUBD.
APPROVED BY: , INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
8000 MECHi4NICAL PEiM1T (COMI4IERCIAL)
C[TY OF E4fii4N
3$30 PILOT KNOB RD
EA8AN,MN 5518E
651-6$1-4675
Please complete for: all commerciaVindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE
WORK TYPE: New consffuction _ Iastall U.G. Tank
_ InteriorImprovement _ Remove U.G.Tank
_ Processed Piping
When installing/removing underground tank, culf 651-681-4675 for inspection by fire marshal and
plu»ibing inspectar.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaUinstalladon ° minimum fee
Contractprice: $ xt%=$ (BaseFee)
Srate surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SITE .ADDRESS:
O WNER NAME: PHONE #; -
(AREA CODEj
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE:
Z8:
?
:
SIGNATURE OF PERMITTEE
****?****?********??******************:
CITY OF EAGAN
CASHIER: JS TERMINAL N0: 769
DATE: 08/24/00 TIME: 07:03:09
ID: •
NAME: PULTE MASTER BUILDER
2252 9220 1666 OKBRKE CIR 30.0(
3210 9001 1666 OKBRKE CIR 1,144.9?
3866 9379 1666 OKBRKE CIR 100.0(
3422 9001 1666 OKBRKE CIR 744.2:
2275 9220 1666 OKBRKE CIR 1,089.0(
3446 9001 1666 OKBRKE CIR 11.0(
2155 9001 1666 OKBRKE CIR 0.5(
3743 9220 1666 OKBRKE CIR 50.0(
2155 9001 1666 OKBRKE CIR 63.5(
3868 9220 1666 OKBRKE CIR 492.0(
CR136328 ** CONTINL
USER ID: JAN ** CONTINL
CITY OF EAGAN V
CASHIER: JS TERMINAL NO: 769
DATE: 08/24/00 TIME: 07: 03:11
ID: •
NAME: PULTE MASTER BUILDER
3716 9220 1666 OKBRKE CIR 114
00
3713 9220 1666 OKBRKE CIR .
50
00
3866 9379 1666 OKBRKE CIR .
840.00
Total Receipt Amount: 4,729.17
CR136328
USER ID: JAN
-?
2000 BUILDING-PERMIT APPLICATION (REStDENTIAL) 1 , cirr oF E?caN
• 3830 PILOT KNOB RD • 85122
851-881-4675 GQfte d a/m/ab
> swegisterea sre suroevs a,orm,a 2% e. a wt, w. e. or na,»
antl gH roOfed Or604 QQX rtwXlMUrtI bf coveraae nllowedl
> 2 coples d Wans (ahow becun d window siaea; Poured hW. desiyn: etc.)
D 1 sat of 6nsryy culcultftns
D 3 coplea a hee prefervaHm plan H bf plaltad tftr 7/1/93
DATE: % 11// 7
DESCRIPTION OF WORK:
STREET ADDRESS
LOT: 1 +
Retriotlel/ReoairReaulremanh
s cople: w aan
1saf W energy cdadaHOnt lor healed add11ons
1 afte wrvey for.eztedor addlHau # decks
cosr: / Lftl Jaci
A
BLOCK: c-5? SUBD./P.I.D. C: Oh Kg??07JCT? g-th
PROPERTY
OWNER
last
FUaf
Phone M:
Sfreef Addresa:
citY
Sfate:
Zip:
Company:.UQ, ttAc6 (1000 Phone lf: ,?'l
(area code)
CONTRACTOR
meetAdaress:/3,?sA)5lUWl/es ucense r 13 ?l . ?''l ob1
cnr /A WOVAts s+ara: Ai/ ziP: ?W2 o
4RCHITECT/ .5???I??,s ?-y'6JV?
eNGMEER Company: Name:
Telephone C ( )
Street Addreas: Regisfratlon f:
CNy Sfate: Lp:
ewerlwater licensed plumber (iI installina sawerMrater):aIr-I /'" LVAu0U Phone #: t?( ,?Z 1 7?7 2? Z? L?
?e?ebY acknowledpe ihaf I have recd Ihis applicaNon, atate Hwl fhe infornwtion ic cortect, and apree b canply wflh aA appficable State
? Minneaota Stalufes and City of Eagan Ordinances.
Sipnalure of ApplicanY.
OFFICE USE ONLY
?
artiflcates of Survey Received ? Yes _ No RFCEIVED
AUG 1 4 2000
ee Preservation Plan Received _ Yes _ No ?lot Required ! •
BY: ?.J
r
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundation ? 07 05-plex
? 02 SF Dwelfing ? OS 08-plex
? 03 01 of _ plex O 09 07-plex
O 04 02-plex ? 10 OS-plex
? OS 03-plex p 11 10-plex
? OB 04-Plex ? 12 12-plex
WORK TYPE
(F 31 New
? 32 Addition
O 33 Alteration
? 34 Repair
? 13 16-plex O 21 Porch (3-sea.) O
O 17 Garage O 22 Porch/Addn. (4-sea.) O
O 18 Deck O 23 Porch (screened) Q
O 19 Lower Level O 24 Stortn Damage
Plbg _Y or_ N O 25 Miscellaneous
O 20 Pool ? 30 Accessory Bidg.
O 36 Move Bldg. ? 43 Reroof
E3 37 Demolish (Bldg)" ? 44 Siding
? 38 Demolish (Interior) p 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to appticant for demolition permit
GENERAL INFORMATION
SAC Code ?L
No. of Units ?
No. of Buildings
Const. (Actual) ?
(Allowable) UBC Occupancy R- 3
Zoning R-/?
# of 5tories
Length
W idth
Basement sq. ft.
Mai level sq. ft.
2--J-,/sq. ft.
Gao-aG? sq. ft.
MISCELLANEQUS INSPECTIONS
0 Stucco/Stone
2
va
ta
sq. ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning
Building GG Engineering Variance
Permit Fee Valuation: $ /„2 4_ Dpe-) V-'
Surcherge
Plan Revfew ? s J'
690
6,
License Go4a.? l5'?
/gi3?d
MC/ES SAC
CitySAC Lede-I
Water Conn.
W ater Meter el
4.z x-f q= Y6 F V
Acct. Deposit
5/W Permit 11
2 &-, e- ee I
S/W Surcharge S6? F?b
Treatment PI.
Park Ded. Ga ha6 ?
Trails Ded.
Other S?t klL : 5'•z4'? -
Copies
rotal:
31 Ext. Alt - Multi
33 Ext. Aft - SF
36 Multi
GDJ
SAC Units
% SAC
?
n
H
?
W
?
N
0
0
? a
?y ?
? ?
? ?
?
? ?
?n n ?
?
r't' ? ?
?
? ?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
TH
PROPERTYLEGAL (jAKRQGYv E 4' /
DATE OF SURVEY:
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyar signature and company
• Building Permit Appiicant
• LegaV description
• Address
• North arrow and scale
• House rype (rambler, walko4 split w/o, spld enUy, lookout, etc.)
• Directional drainage artows with slopeigradlent °k
• Praposed/exassting sewer and water services & invert elevation
• Sheetname
. Driveway
• Lot Square Footage
• Lot Coverage
EIEVATIONS
/ istin
m?? ? • Sewer service (or Proposed)
e? o o • Properly comers
?p ? • Top of curb at the dmreway
?? y • Elevations of any exdsting adjacent homes
??? Adequate footing depth af shuctures due to adjacent utility Venches
Praoased
to ? • Garage floor
o?? ?
'
? ? • Firstfloor
• Lowest exposed elevation (walkouUwindow)
? ? ? • Properly comers
?? ? • Frant and rear of home at the foundation
/
? PONDING AREA ('d aoolicaWe)
E
t fl
? ? ne
•
asemen
ee? ? ? • P1WL
Ea' o
? . HVYL
a
? • Pond # designacon
? q/ ? • Emergency Ovefiow Elevation
Y? o
m/ ? ?
p/ a a
?
O? ?
? ?
DIMENSIONS
lot IineslBearings 8 dimensiona
Right-af-way and strcet width (to back of curb)
Proposed home dimensions including arry proposed decks, overhangs greater than 2', porches, etc.
(i.e. all sVuctures requinng permanentfootlngs)
Show all eaaements of record and any Cily utiGtles within those easemen4s
Setbacks of proposed structure and sideyard setback of adjacent ebating structures
Retaining wall req
Reviewed:
.
Match 19BB
CRAKVBIWPRMf,FM
MRR-16-2020 10:28
P . ei2 'i;?
1+QTaheck COM82,IANCg gEBOAT
Minnsaota Bnergy Cpds Perm t#
t+aTcheck 3oftware Vereion 3.0
" C ecke by/DaCe
COIINTY: Dakata --
BTATg; Mislsieapta
20NE; Z
CONBTRUCTION TYpE: S171g1q Family
DATE: 3-16-2000
DA'P9 0F 1'I.ANB: 3/16/00
TITLE: FALKIFtR W/0 SL. #2
COMPLIAATCE: pA9SES
Aequired UA a S09 .
Your HomY = 407.
19.94 Hettsr Thpn Rodq
'
0; .p .
W? ? .
CAV?1tY Cqat. .
Glzzfng/D09r
Pe7C1mWt9x it-vaI.ue R Va1.ue U-Value
------r-e-a-----:-.--w--w--------..w---
-- - ..--r..---
CBILINCfB
__-_'_'_--__'-
WALLSi Wood Frame, 16° O.C. 1444
2327 44,0 0.0
19.0 2.0
wALL9: wavd Fratne, 161, O.C. 283 10,0 2.0
BSMT: Conc. 9.0' ht/8.91 bg/9.0f ineul 402 11.0 0.0
GLA.ZING: Windowd or poore, Above Orade 495 0.350
1
?ORS
FLOORS; Ovar Uncoaditioned space 38
352
38.0 0.0 0.350
HVAC EQUIpMENT: Furnsce, 92.0 Ae vE
COMPLIANCE gTATEMSNT, The propoe -
edbuilding deaignTdeecribed
here is - r
coneistent wiCh the building p1au?s, epeCiPicationa, and othex
submlttad wiCh calculatione
bhe pexmit apylics
dsaigned to m? tion. Tha propoqe$ building has bean
e Mi ota Etiexgy Codc.
Buildar/De9lgner '
'
' Da te
i'/
...,.
.??t,..y,.
roTFL. P.az
: JOB INITIATION ORDER
Pulte Homes of
Minnesota Corporation
1355 Mendota Heights Road, Suite 300
Mendota Heights, MN 55120.1112
Phone: (651) 452-5200 Fax: (651)452-5727
CONTRACTORlSU PPLIE R:
ai
JOB NO. 0320 ?' 11 1 05 LEGAL DESCRIPTION: LOT 11 BLOCK 05 UNIT
coMMUNirv: pakbrooke SF ADDITION: #xQ? 2,
BUILDING ADDRESS: -%,o Cin': Eagan STATE: MN ZIP: 55104
MODEL NAME: FeQ,ktrk..MODEI NUMBER: ? g65 )?- ELEVATION: 2 GARAGE: LEFT RIGHT
?
BUYER'S NAME: 6(y}" ? G- SW P"a4e*-.6-n DATE OF ORDER: . t? ?
CURRENT ADDRESS: CITY: ZIP: 55l yL
HOME PHONE:?51-G'QGj_)g'7?)BUSINESS PHONE: BUSINESS PHONE: (qGJ( -q pj -ZI I-7
SALES REPRESENTATIVE ?
'
.: , ;. .. ?
(3W0 1605 .
. -
BASE PRICE .
a2? 9R0
---- LOT PREMIUM Dp0
1 I D23 ELEVATION # 2 i S 00
1 aao3?i ' fe ? 1? ??75
v' • 0 3SaS
i'¢?:?'l
REM (Y} ,P >>V '
?+ =j : u:??1.
TOTAL
APPROVED BY BUYER(S):
?
APPROVED BY SALES: ?
RELEASED TO START CONST.:
This constitutes a contract between the Seller and the
Builder's License #0001371
?
?"y EQUAL HOUSING
oPPORruNiTv
rchaser(s) for the above items
CHANGE ORDER CONTRACT
Pulte Homes of
Minnesota Corporation
7355 MENDOTA HEIGHTS ROAD, SUITE 300
MENDOTA HEIGHTS, MN 55120-1112
PHONE: (651) 452-5200 FAX (657) 452-5727
-7?f- /
CONTRACTOR/SUPPLIER: 411 ?"VoW S
";?- /
JOB NO. 0 3 Z- V
/ O S
/ I LEGPL DESCRIPTION: LOT Z/ BLOCK ? UNI7
?? [
?
COM.4UNIN: ?F-CY7? C
o! ADDI7lON: -7
G-
BUII.pINGADORE55: CRY: STATE: In d ZIP:S5122
MOpEL NAME: ?? L KI ??-C MGDEL NUMEER: ? O U5? ELEVATION: ? GAFtAGE: lEFT RIGHT
BUVER'S NAME(S)•
DATE OF OROER: I
C
CURRENTADDRE55: ! V ? I/V-r7 l?
CRY:
HCME PHONE: ('e2f' ???'/ ?C0 ?? BUSINESS PHONE: SCIW - J" ' I / LD?
SAl£5 REPRESENTATNE: ? 1 Y?* CHANGE ORDER FEE: YES OR NO
eUS;NESSPHCNE: k)1-`305•z-Ia
PREVIOUS J.I.O. OR CHANGE ORDER: ._._; RRICE ;`
# 12 U TOTAL: D/' -A0
< QTY. OPTION ? '-DESCRIPilO1V QF CHYANGE
( ? I0 0 C?5 Gc_ C=2 ? C. ZSC?
?
.? cu C< ^' da?°? -773
? OU S? Cc c Z?d
11-7
i 32oz0
c&
?50
7000 l o0
S 350
?, . .:-.. ? _ :=,.....
1--)17 A.. TOTA/?
8ui;ders Licer.se #0001371
APPROVED BY BUYE
APPROVED BY SUPERINTENDENT:
RPPROVED BY SALES:
This constitutes a coniract between the Sziler and the
3 ?? ? ? ?
? Y o..s.,..
aser(s) for the above items.
Surveyor's Certificate
SURVEY FOR : PuLrE
DESCRIBED AS ' Lot 11, Block 5, OAKBROOKE 4TH ADOITION, City of Eogon, Oakoto
. ' County, Minnesoto Ond reserving easements of record.
,1gC?9?19-q
?
?.
?;..
f
LOT SQ. FDOTAGE = 17,740
HSE. SQ. FOO TAGE = 1,879
LOT COVERAGE = 10/'o
r
PoRoVo
Plon (J 18652
PROPOSED ELEVATIONS
Top of Foundotion = q51,o
Garage Floor = qgo.(,
Basement Floor =qa2.o
Aprox. Sewer Service =43c..2'
Proposed Elev.
Existing Elev.
Drainage Directions = -
Denotes Offset Stake = .
HEDL(JND
PLANN/NC BNCIN66RlNC SURV6Y/NC
2005 Pin Ook Drive
Eagon, MN 55122
Phone: (657) 405-6600
Fox ; (651) 405-6606
a
.$
SCALE: 1 inch . JO leel
I HEREBY CERiIFY THAT THIS IS A TRUE ANO CORRECT REPRESENTATION
OF THE BOUNDARIES OF THE ABOVE DESCRIBEO PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORi TO
SHOW IMPROVEMENT$ OR ENCROACHMENTS, EXCEPT AS SHOWN.
OATE
? i
BENCHMARK,
rNHG) %5
Eleo = q3q.39
MIN. SETBACK REQUIREMENTS
Front-25 House Side -
Rear -15 Garage Side -
JOB N0:
D. IINDCREN, LAkD SURVEYOR
iTA LICENSE NUMBER 14376
OOR-228
OAKBRDOKE
'??XZL-•
? Fk-Neir--
?-
- 6? 5
N61•282? ?
Use BLUE or BLACK Ink
For Office Use
j Permit
City of EaEd~
Permit Fee.
.
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: an; ~ Site Address: t 66 6v 4!F►~ ~ L 4l,< J 4 y,4~l Unit
Name: K Ee~1 S- w PUT-, Phone: G Id -3,?6 --/J y f
Resident/
Owner Address/ City /Zip: 1&6(o
~ ~ cat<E G)~ € N
s
Applicant is: Owner Contractor
9
Type of work Description of work: R6_A0Vrf'
' i Construction Cost: %dy Multi-Family Building: (Yes / No
. m..w__ _ i
Company: 1//i///r/ r~.+ r i/ 7 t Contact: /iVa> m IJJ
Contractor Address: Via/ 6c2~cy✓ City: IX, ifsy r rva~
State: 19W. Zip: Phone: e' , 7o5_
License cy0&3S-&_2_3 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
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 they 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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
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 Azee5w 19Q~I-ecW0 x
Applicant's Printed Name Applic is Signature
Page 1 of 3
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: (/i f .Zr?
a v
Permit Fee: �/" D
Date Received:
Staff:
1
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: : 2.4// / Site Address: < �` t 6 ✓Qy-p E- (CJ E
Tenant: Suite #:
Name: Phone:
Address / City / Zip:
Name: ill ` A S !!VYvI�� +�J �L� License #: 0606 6 " A41
a-5 0 5 Z2 3 rd
Address:
State: /t41U Zip: S 5o 1 ( Phone: '26 3- 07---S 8- 74. Tar
Contact: /14; t—f---- 1601' Email: /"L' -16-d•^/1 e_,1,0+Mae t , C-0
New Replacement _ Repair_ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: ��`'J LkJ* e— p d 7 Tay(c_7-- c( st,c-ie -
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
/ Water Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. CaII Gopher State One CaII 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.orq
1 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.
Applicant's Printed Name
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Applicant's Signature
FOR OFFICE USE
Required Inspe
Meter Related Items:
Use BLUE or BLACK Ink
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C�}� O� n���� � Permit#:
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3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (657)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ��'Z'L�/S� Site Address: / � �'� V Cl�Ja run�C ��I r . Unit#:
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If the project is exempt from lead certification; please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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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.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be co pleted within 180
days of permit issuance.
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App icanYs Printed Name Applica 's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA161919
Date Issued:06/18/2020
Permit Category:ePermit
Site Address: 1666 Oakbrooke Cir
Lot:11 Block: 5 Addition: Oakbrooke 4th
PID:10-53763-05-110
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kenneth Putt
10700 Sheridan Ave S
Bloomington MN 55431
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA161919
Date Issued:06/18/2020
Permit Category:ePermit
Site Address: 1666 Oakbrooke Cir
Lot:11 Block: 5 Addition: Oakbrooke 4th
PID:10-53763-05-110
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kenneth Putt
10700 Sheridan Ave S
Bloomington MN 55431
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature