4321 Orion LaneCITY OF EAGAN
. ?•, 8795 Pikt Knob Rood Eogoa, MN 55122 N2 5018
PHONE: 4548100 .
?
BUILDING PERMIT Receipt
c,? r1„ c r,
12
Ts 1a uua inP ?. RJ??, ,r Parac>e Fet Vnlua . • I']nfo r).. 19 ] o
: ?
Site Address '` ?'' 1 Orion Erect Occupancy -'
Lot Block ? Sec/Sub. rAT Znd /11ter Q Zoning
Parcel .#
Repoir
p
Fire Zone ?
E
l T
of Const
n
onpe ? .
ype
oWe Nome '• PetPrson Crj^si:. IAC. Move ? # Stories
3 Address 4701 W. l 1 ntl-: ?Y. Demolish ? Front ' h.
-fnJ.s. 55437 `'P,4-5I44 Grade ? Depth ft.
?
0 Nana . "• ` ------
Assessment
? Addross _
? Water & Sew.
Ci ph?
H
Police
W Name Fi
F ne
_a /lddress Eng.
u
Z
aeu
, Ci phone Planner
Council
I hereby ocknowledge thot I have recd this opplicotion ond state that Bldg. Off. _
the informafion is correct and agree to rnmply with ull applicoble
$tote of Minnesoto Statutes and City of Eagan Ordinonces. APC
Signature of Permittee
Fees
Permit ' ' • ` I Surcharge " `? • n
Plan check
r,..- ?r
SAC ,
Water Conn.
?Np?Yer Meter ??
Q< .
Totol 6 4.
A Building Permit is issued to: ''- on the express condition tfiot
cll work shall be done in accordance with oll appliwble Stote of Minnesoto Statutes cnd City of Eagan Ordinances.
Building Officicl '
vamk # pah I.w.e hMkh.
Plumbing A-A/L -' -(. -?-?
Mechonicol Lj - 78 .Id
INSPECTIONS ? DATE INSP• Rouph-In Finol
Footings ' ? ? ? (? '? ? ? Insp. Date Irqp.
Foundation Plumbing -
Frome/ins. - Mechoniwl
Final
i
Remarks:
?.GO?C.?o-•? -?"?..?''?"?? c?L " .? -?o-?-e
CITY OF EAGAN
3795 Pilot Knob Rood
Eagen, Minnesofa 55122
Phone: 454-8100
?i-liaiNG PERMIT
Date: ` 1923-7
Site Address: 4321 orj"m
Lot - 1 1
INome
Block Sub/Sec. =
, . ^?'.t:ersm C:'} ?-70.
o -",7t??. ?•'. 1.1!1th St.t'e"t
e Address
3
O
5437
City ,
r.i,. Zrem_?
Phone: °R4-5144
Receipt No.: 121P1
Single I
Residentiol Y
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of I nsta I lation
Permit Fee 20.00
r?
Surcharge
? Address I4745 SU, fbbertt ?t-uI.
e
0
?i, 7,n
City " - Phone: Total
This Permit is issued on the express condition that oll work shall be done in accordance with oll opplicAble Stote of
Minnesota Statutes and City of Eagan Ordinonces.
No. 12.7$
Building Official
(Itrfifirttft uf (Orrupttnry
titp of (eagan
Eppttrfmmf nf Nicilding lnapPritm
Tbi.c CrrtincQtt t1SKUJ pllrtiutfit !O the rCqittfHltt?1tJ O f StctiOn 306 0 f the Uru f orm BuiJding
Codc art: f pn8 rhar ar the ri„+c o f iasuariu tbir ururturc wal in com pliarue with the varioru
ordinancei o f the Citr rrgulating Malding conttrxction or ute. For the follou7ng:
P.rft,No. sais
my:
April 4, 1979
Due:
.o., ,. . cq,.K? ..,,u
CASH RECEIPT
CITY 4F EAGAN
3795 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122
DATE
RECEIVED
19
AMOUNT $ I
v
& DOLLARS
+oo
? CASH ? CHECK
Tha You
?
??,-
V?
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
3795 Pilot Knob Road
Eogan, Minnesota 55122
Phone: 454-8100
PERMIT
` ?--? 3-'7$
Dute:
" '? ?) '1r7i1
l ?
Site Address:
'
Lot Block Sub/Sec'?lll?Iv33 ?'c'3: ?Il(?.
.
Nome -Pebeimm onnt' cb'
e Address st".
3
0 -??
City 55437 Phone: ^84-51 44
Nome
?
? Address . , . ? ? St`•. ??7i_ A?'F' , , , _
e
V .??ni{ - •,-.-. :C
City Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota Statutes ond City of Eogon Ordinances.
.77ON AIR ?'IF?
No.
11481
Receipt No.:
Single
Residentiol
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of installotion
Permit Fee
Surcharge
I Total '
done in occordance with all applicoble 5tate of
Building Official
19/?/t d
1
vb
?Fy,?a l
?
CITY OF EAGAN Remarks
10 84251 030 O1
WILDERNESS PARK 2Nn annrTr?1H Lot z BIk 1 Parcel
Addition
Owner??-4' k???f; st?ee? 4321 Orion Lane State Eagan, MN 55123
}
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
* STORM SEW TRK 1979
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit Ch . 75.00 10-12-78
250.00 1206$ 10-12-78
BUILDING PER.
SAC 500.00 12068 10-12-78
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
iri+ i i u i tv??
ci'+
SITE ADDRESS: J„ l
.; .. i .t: i"h f r?r?F
PERMIT SUBTYPE:
APPLICANT:
? I ,:;, ? ):Ic I I
i F. l:.} ) 891 • 49,4 3
TYPE OF WORK:
N t 4A
f)f '•?i'P? !!' f 1 i1N (!t[ I') At 1 N1, trt $1 Ilk"i K ?
INSPECTION .• • •A
?•i? I! 1;?, , I i?ii i
I? ! Ml+l<p I ht? ( Il1?1 ', 1? f f I ?S? I t??? 'I I 1? (N?, !?r???i.
r- 7
L I
Permit No. Permit Holder Date Telephone N
S/V+/
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inapectlon Dete Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Flreplace
Final Htg.
Orsat Test
Flnal Plbg. Plbg. Inspector - Notity Plumber
Const. Meter
EngrJPlan
Bidg. Final
?J
Deck Ftg. ?
DeCk Fnal ? 7 ?
?J
weli
Pr. Disp.
ta eomply wiH+ the City of Eogan
cirr oF eaGaN
3795 Pilat Knob Road
Eogan, MN 55122
Zoning:
Owner: '
Address:
Site Address '•T
Plumber: _
Meter No.:
Size- _
Reader No.:
i ogree to eomplr with the City of Eogan
Ordinanees,
Bv
Date of Insp.:
SERVICE PERMlT
Connection Charge: 4 .
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
1NATER SERVICE PERMlT
PERMiT NO.:
DATE: -
No. of Units _
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Totol: _
Date Paid:
.l').
cirr oF E?caN
9795 MIM Knob Read Eegan, MN 55712
PHONEt 454-8100
BUILD9NGTPERMIT APPLICATION
N4 5018
Receipt # ?'zc, (°°
T. ba used for SF Dwlg & Garag e Est. Volue 57,000. Dare 19--7-8._
Stte Address 4321 Orion Erecr [3 Occupancy 1
Lot 3 Block 1 Sec/Sub. WP 2nd _ Alter ? Zoning Rl
Porcel # Repair ? Fire Zone I
Enlor
e ? Type of Const
V
g .
? Neme S p aYarenn ('nn t TnC„ Move ? #"$tOries
; Address 4701 W. 110th St. Demolish ? Front fiF, ft.
? Ci Mpls. 55437 ph? 884-5144 Grode ? Depth /+R ft.
? Same APProvala ..... .. Fees
p Nome _
Zu
? Addren
? n..,
Name _
Address
I hereby ackrwwledge that 1 have read this application und state ihat
the informotion is correct ond cgree to comply with all aDPlicuble
State of Minnesota Statutes and City of Eapan Ordinonces.
SignMUre of Permittee
A Buflding Permit is issu
all work shail be done ir
Assessment _
Woter & Sew.
Police _
Fire
Eng.
Planner -
Councii _
Bldg. Off. _
APC
Permit t?i.vv _
Surcharge 28.50
Plan check
SqC 500.00
Woter Conn. 250.00
Woter MMer 60.00
Rd. Unit 75.00
Toml 1,064.50
on the express condition thnt
'Son applica6le State of Minnesota Statutes and City of Eagan Ordinonces.
Buildirg Official V?,
7'}us request void 18 months from / a 7.5-a
' R 21117
Date of fhis Request Uecemi)er 12, 1c'78
I, as 12 Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: L 3 6 ,tx) P ,2,?.
Street Address or Route No. 4321 Ori nn Ln _ City!KUn
Section Township
Range County Da};ota
Which is occupied by S*r nd F r m Con u i on
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes IN Ready Now ? Will Call 91
Power SupplierUakota Electric Asse. Address 821 3rd St, Fax•trunF?ton, idN
55024
Electrical Contractor Fien Sorenson Eleetric Contractor's License No. 35693
(COmpany Name)
Mailing Address 8070 12th Ave. So., Bloomington, IIIQ 55420
Authorized Signature
????? B&22D Qt?U
Phone No ,QSl-4(ZQ
This inspectian request will nat be accepted 6y the
StMe Board unleu proper inspection fee is enclused.
Minnesota State Board of Electric+ty
1954University Ave., St. Paul, Minn. 55104-Phone 645-7703
- RE06EST FOR ELECTRICAL INSPECTION
CHFJ'KyIELOW WORK COVERED BY THIS REOUEST
ia7.5 a
R 21117
Type oP Building New Add. Rep. Check Appliances Wved Fo+ Check Fquipment Wired Foi
Home 0 ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water HeateT . ? Lighting Fixtutes ?
Apt. Bidg. ? ? ? Dryer ? Eiecuic Heating ?
Comme[cial Bldg. ? ? ? Fumace (D Silo Unloader ?
Industrial Bldg. ? El ? Air Conditioner ? Bulk Milk Tank ?
Fazm ? ? ? List
I Dishw? List
Other ? ? ? }
Hehersl - p
HeielgI
COMPUTE INSPECTION FEE BELOW tth. '\A`
Service Entcance Size: p Fee F S • x Fee C'vcuits: # Fce
0 tu 1 Am s. , A res 0 to 30 Am eres
101 t mps. 31 VP0 Ares 31 to 100 Am eres
Above 200 Amps. Abov .. 0 Amps. Above IOQ_Amps,
Transfoimers RemoteControlCirc. Partial or other fee
S' ns Special Ins ection Minimum fee $5.00
Remarks
Cosyplete Hot1Se i:riring
TOTALF p,md
40,50
I, [he Electrical Inspector, hereby cerf h'at t e ifispection has 6een e.
(Rough-in) ?) 3 Date
(Final) Date
This request void 18 months from
0? 0?5 65 8 9 2 11
Reqvest p e Frce a. ough-In Inspactlon Requiretl ' Inspection Oiher Than Rou h-In
? (VOU must c.ll inspecto when reatly) ? Reatly Now JI Notity Inspector
0 Yes o Dat¢ Reatl
I licensed contractor ?owner hereby request inspection ot above electrical work at:
Job Atl
ass treel Box or FoNe No ) Ciry
2
V?I O W &? `)
Section No. Township Name or No. Ranga No. Coun
.
Occvpanf(PRINT) •
' Phone No.
v&.
D 64-$3X9
Powar Supplier
?a Atltlres
^
Electncal Conlractor (COmpanV Name) ConVachr's License No.
MOD-A)OAM4EAr o IC Uc- O
Mailing Atltlress (COnlractor or Owner Meking Installelion)
d??s at )
Aulho 'ze S In-
n? mber
?899uMiS?tlw?ayY AVe, StR. PeuS MN 8 51?00 1dT UNLESS ' T
CLOSE? OPER NSPECTON BOERO
Phone (612)692-0800 E
???/?s REQUEST FOR ELECTRICAL INSPECTION .`ee-ooooi-
, See inSlmctions for Completing this (? ' back ol yellOw copy.
0 066 8 9 2? ' l
. °X" Below Work? ?k
d by This Request
Ne Atld Rep. Type of 8uilding Appnces Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (S ecify)
Farm Air Conditioner
Dther (specify) ConVactor's Remarks:
te Inspection Fee Below: K,Jift New rlar 'Iz? 4 cWvi rEwce ? .
Compu
# Other Fee tt Service Entrance 5ize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps ?
Transformers Above 200_Am s Above 100 -Amps
SI I1S Inspecmrs Use omg TOTAL
Irrigation Booms j?'
?-
Special Ins eaion ?
?? ? Q
Alarm/Communication THIS INSTALLATION M ORDERED ISCONNECTED IF NOT
Other Fee ? COMPLETED WITHIN 18 HS. ?
, the Electrical Inspector, hereby
tif
b pough-In
Icii a
cer
y that ihe a
ove inspection has
been made. Final
?' . 7? f
OFFICE USE ONLV
This request voi0 18 months fmm
CITY O?EAGAN PERMIT
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
AdQ?? "?Q I a3
51(T1i q
PERMITTYPE:
Permit Number: BurLoiNG
0 2 4 5 3 7
Date Issued: 0 9/ 19 / 9 4
SITE ADDRESS:
4321 ORION LANE
LOT: 3 BLOCKc 1
WILDERNESS PARK 2NO
P.I.N.: 10-84251-030-01
DESCRIPTION:
r'?-... (REPLACING OLD DECK)
B;uilding-Permit Type pECK
Building W&r_k Type NEW
.\ _
,
?
\ /V
,; ?
REMARKS:
INCLUpES REPLACING SLIDING DOOR
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR: - Applicant - sT. LIC
VICTORY BUILDERS 18914543 0009331
14194 GARLAND AVE
APPLE VALLEY MN 55124
(612) 891-4543
OWNER:
MA7SON
4321 ORIQN
EAGAN
(612)452-$322
STEVE
LN
MN 55123
I hereby acknowledge that I have read th`is
information is correct and agree to comp,ly
5tatutes and City of Eagan Ordinances.
?
? 6?iNG-a--rs.
APPLI NT/P ITEESIGNATUR i.
application and state that the
with all applicabie State af Mn.
4 - / \ ! _..., 4 ISSUED 8 :5 NATURE
I
i4nq CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
f -5 Q, 11"o-
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site s r?aEft5W e ergy
calcs.
COMMERCIAL 2 sets of architectural & structural plahs,? l?set9of
specifications, i copy of energy cal ?______________
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of wor S--&b
Site Address:_13Z/ D/Lan/ i,?
STREET SUITE #
Tenant Name: (commercial only)
LOT --,I_ BLOCK ? SIIBD.
UJ ..,??,e.?_• P.I.D. #
Descri tion of work: AC/41C'a Aa:'x , 26.0c1c'- ,$"4Qi.?? Fbb/
The applicant is: ? Owner W Contractor ? Other (Describe)
NameC--?L14;rx a.J. PhoneFq?rg- $?ZZ
Property LAST I fIRST
Owner
Address _G/3 Z/ dRIo?) Z_?4J•
STREET STE #
City ??A.? State hA?. Z i p 1_1 3
Company V1c5;-t2Y i3d,,"EXS Phone 9'1/- yS `?3
Contractor Address /1-l/4?f aiaAcAw40 4YE_ License # 9J71 Exp. 3i-
City?a°?cE dA?-?eY State Zip 5S/zy
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber . Processing time far
sewer & water permits is two days once area has 6een approved.
I hereby acknowledge that I have read this aPplication and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
JOIN 1?DODNlIANCEeCO
Signature of Applicant:
J
BUILDING PERMIT TYPE
? 01 Foundation
13 02 SF Dwg.
0 03 SF Addition
? 04 SF Porch
M 05 SF Misc.
WORK TYPE
OFFICE USE ONLY
? 06 Duplex
? 07 4-Plex
? OS 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
r r x
? 11 Apt./Lodging
0 12 Multi. Misc. '
? 13 Garage/Accessory ^
? 14 Fireplace
EU 15 Deck r
? 16 Basement Finish
O 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition f$t 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd fl. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code 115 v
Depth On-site sewage SAC Code oi
Census Bldg i
APPROVALS Census Unit
Planning Building Asses'sinents
Engineer9ng Variance
REGIUIRED INS PECTIONS
?.Site OFooting Gn-kc-wr77)- ? Framing ? ? Insulatioo
El Wallboard M Fi nal O Draintile ? Fireplace
Permi t Fee veiuac;on: $ ^
Surcharge
Plan Review '
L9cense
MWCC SAC ?
City SAC
Water Conn.
Water Meter
Acct. Deposit S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies p
Other
Total:
SAC %
SAC Units , ;_3jv v,? v wm
. -?
lr. U 5y k., ?
?
;
,Oti C0113L[•?1C??011
(ItFi SI,I'i:eL
,t;ori, rfra 5,437 -
- DEIMAR H. SCHWANZ
LAND SUA`/EYGR
Reqiitere0 Under uws of TM Sub oi M1nMS0Ia
2970 - 166TH STHEE7 W. - BOX M flOSEMOUNT, MINNESOTA 66068
SURVEYOR'S CEpTIFICATE
1 ~ ;'/ rJ i )
!t ' i .. , .?I 1 - ID
r- I ?
pecK ~?
7
??_.? lM1 I I
.
:36:25
L
PHONE 812 123-1789
;J
\;
iJ
;./
)
I
i ?
I hereby r.er•tifv that thi?l;is a true anQ correct repreaentation of
a si?r•v?,y uf I.?t :i, Plock ?:li1, 4•Jild>c:RN£:SS BAAK SECOND ADDITION, Aakota
Cuur?C,y, Mlnricsot<?.
Alsc) 3ti)w3ng the locatlon vf a proposed house as staked thereon.
October 1t`, 19/+1
I
? %i' ?; ` /j 1'i f ':i;'!'.-?'?:•''?%/` •
MINNESOTA REGISYNATION NO.l84
.
?
? . DATE
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/e
? , ?
To be used far ?-
Site Addrest:
levations and 1 set ot enerqy calcuiations.
ap
Valuation ? ? ;?'OoO
Lot Block / See. Sub.????L Pax??cel 2Fumber? ?
O?rr?er?.?? /`???
Addtess z-7z7e^ /
M??s?;-?Y37
Contzactor
AZdrese l
i
Arch. /E7nq.
Address
Telephone f 'Y7 - `_277 4z V
Telephone
R+elephone
OFFICE USE
Erect [/
Alter
Repair
Pnlarge ?
ltove
Der.fllish
Gzade
Occupancy 1
Zoning
P1re Zone .3
lype of Const. 1/ -
$ of Stories
Front •' G'
DePth
OFFICE USE
Date of A roval & Eait'al
Assessment ? -e /f/7 R?
?
9tater/sewer
Police
Fire
En4 -
Planner
cvur,oil
Bldq. Off.
A.P.C.
FEES
Pezmit
Surcharge
`piaa Check
SAC - ?SOo ?
Mter Conn.. t?c50 `s'
F7ater Meter r
ev
- ?t7
- TOTAI,
L'f}-.+?l
?o.?-
-s-c a?/o
oarvey For:
:'vend Peterson Construction
41:.1 lJtr;t i1?Jth Street ,
Bl:o;nlr.gton, MN 55437
DELMAR H. SCHWANZ
lANOSURVEVOR
qaqistewC UnLSr Lawf Ot Tba Spte ot Minnasota
2878 - 146TM STHEEY W. - BOX M ROSEMOUNT, MINNESOTA 55088
?.'i
SURVEVOR'S CERTIFICATE
? ^4:rH?iG`
?ro
? ? G. J/.'.a5 r
l
I l
? I
`f C
N?ZL \ I
U
S
PIiONE 611423-1769
%) .
?
,
F.
r
?
I ( \ ?
I I
I I hereby certify that thta is a true and correct repreeentation oP
a survey of Lot 3, Block 1, IsIILD3RNFSS PARK SE.OND ADDITIOP:, Dakota
County, Minnesota.
Also showing the location of a proposed hourte as stak^d thercor..
October li), 1978
M1'IkNESOTA REGISTRATION NO 6826' ?
eL ? CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
(612) 681-4675 RECEIPT # d?%lzo
DATE /O S
RESIDBNTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------------------------------------------------------°---------°__
WORK DESCRIPTION
N0.
NEW CONST ? -
ADD ON
REPAIR
OWNER NAME: ? ??N STEUE
- 4321 Oi i Ofi LfJ1E -
' EFlKM , MM 55123 -
SITE ADDRESS: H 452-8329 U 726-9515 ?
INSTALLER:
Q°iw=??.?. L7 nr^,'lnnnar? _
ADDRESS: ?
CITY•
?
YHONE
COMPLETE THE FOLIAWING;
FIXTURES fiA.
REPAIR/ADD ON 15.00
SHOWER 3.00
WATER CIASET 3.00
BATH TOB 3.00
LAVATORY 3.00
KITCHEN SINK 3.00
IAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLAOR DRPIN 3.40
6A5 PIPING OUT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFfENER 5.00
PRIVATE DISP, 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
STATE SURCHARG
TOTAL:
TOTAL
E .50
s IX So
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE jj:
FOR:
CITY OF EAGAN
ZIP:
CONTRACT PkICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
? - - - -----------i
? ee?se I
I ?
? Permi[#: ?
I ?
? Permit Fee:
? I
? Date Received: ?
I ?
? Staif: ?
-----------------
? 2008 MECHANICAL PERMIT APPLICATION
Date: Site Address:
Tenant:
Suite #:
S
RESIDENT / OWNER Name:
Phone:
Add
i
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CONTRACTOR Name: e_!' License #:
Address: ?? ?3_ ? ?
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City:v(/1 1/Qnf {! S[ate: )W- Zip:_SS,?
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Contact Person: i
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TYPE OF WORK - New ? Replacement _ Additional _ Alteration _ Demolition
Description of work: ?
ND,TE• Both roof mounted and ground ?ttari?t?"?echamcal t -LrS rez(€?irE?? '
?e screened by CrtyG?tie Pl eass t?trrtai??lr?ha?a?lnt?ar one ofi t?? ?
'E
" P/iti?efor
?aht?o?e
RESIDENTlAL COMMERClAL
PERMIT TYPE v New Construction
Interior Improvement
Furnace _
-
AirConditioner _ Install Piping _ Processed
Air Exchanger -Gas 6cterior HVAC Unit
?'
_ HVAC units must be screened
_ Heat Pump Under / Above ground Tank L_ Instali / Remove)
Other "' W hen installing/removing tank(s), call for inspection by Fire
Marshal and Plumbin Ins ector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 FII2 1'2p8i1' (replace burned out appliances, tluctwork, etc.) (inClUdes $.50 State SUrChBrge)
? Q
TAL FEE
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5
$
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COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1°h
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is >$1,000, surcharge inereases hy $.50 for each =$ State Surcharge
$7,000 Pertnit Fee (i.e. a$1,001-$2,000 Permit Fee requires a$1.00 surcharge).
$ TOTALFEE
I hereby acknowledge that this inlortnation is complete and accurate; that the work will be in conformance with the ordinances arM codes oi the City of Eagan; that
I understand this is not a pertnit, 6ul only an application for a permit, and work is not ro start without a permit; that the work will be in accordance with the approved
plan in the case of work which r`quires a review and apprwal of plans.
xGe ?1L?)(??r ??Yl x? O&L,,. ?
AppllcanYs Prinfed Name Applicant's Signature °
Use BLUE or BLACK Ink
For Office Use
j Permit
Ila Permit
City of Ea
Permit Fee:
3830 Pilot Knob Road
1
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff.
2010 MECHANICAL PERMIT APPLICATION
Date: Site Address: / 0 c? Tenant: C...., euc- 6l Suite
RESIDENT /OWNER Name. A /i rho e- 4'o h Phone:
Address / City / Zip: jj
CONTRACTOR Name: oC 6001`7n , ' $ i` License YJ W6 2-
D;
Address: 8 S J 146 ~Z y City: 6141'11 e P_L.~
State: /4/tl/ Zip: 5~/J' Cf Phone: l51Zn -7~ 7Z qe, 7q7&
Contact: A f Email:
TYPE OF WORK New Replacement Additional Alteration 74 Demolition
Description of work: 1iiSd~l~ ~~_r~~J Uej? 0 //)e CCf'-9
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction _ Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas _ Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install / Remove)
~ When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) °
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ CU O TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
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.ora
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 fora 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.
x U r / S, x
Applicant's rin Ap s Si e
FOR OFFICE Psi~ Reviewed By: Date:
Required Inspections: -Under Ground Rough In -Air Test -Gas Service Test -In-floor Heat 11V Final
Exterior HVAC Screening Inspection
Use BLUE or BLACK Ink
For Office Use 1
I Permit q~
City of Eajan
1 Permit Fee: ` S a 1
3830 Pilot Knob Road
Eagan MN 55122 1 Date Received:
I
Phone: (651) 675-5675 1
Staff: I
Fax: (651) 675-5694 1
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: ,r
2- f [ v" 01,1 Tenant: l S S (/~~°tv` GC !/1 Suite
RESIDENT/OWNER Name: / SSA Phone: &/z - 3/0 Address / City / Zip: Ll~ 2 - `dy( 6
CONTRACTOR Name: ! Z /tom rr6.°r License 06~1 l _P10
Address: 9Oa Lelk /?^Crrrti AV- A) City:
State: /_;V~i Zip: l c ! Phone:
Contact: Rre d Email:
TYPE OF WORK - New Replacement _ Repair _ Rebuild Modify Space -Work in R.O.W.
Description of work: rZ ~iC 1-: k ►^e w /17 e,,(,d
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ / _ PV13) Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL 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 $166.00 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 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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.aopherstateonecall.or4
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 fora permit, and work is not to start without permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and appro I of plans.
Applicant's Printed Name App rcant's Signatu
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Sep,29, 2011 2:30PM Glertsen Company No.3136 P. 1
T
to
Use BLUE or BLACK Ink
For OfficeUs® / I
j Permit#:
City of EaEfln I ~0r
~ Permit Fee: I
3830 pilot Knob Road
bete Received: j
Eagan MN 55122 81
Phone: (651) 675-5675 1 staff:
Fax: (651) 675-5694 :3,7,5 p / j 1 1
2011 RESIDENTIAL BUILDING PERMIT APPLICATION L_-
Date: Site Address: 1 Unit
Name: phone: G c~I ' Z- t S 1 ~'J`~
..RESIDENT I
OWNER Address / City / Zip: 32-l
Applicant is: Owner contractor
TYPE OF WORK Description of work: .•~vv. ~oVs4- G~ tH5ti~v~~r~ l~
G.r-r
Constr r
uction Cost: - o Multi-)=amity Building: (Yes _ / No
` C 12-7a3 ~ 3/
Company: +3 A4~0 Contact;
CONTRACTOR Address: S'3 r - ~b` City: b
State: Zip: S S y j,`J Phone: 763 - 14 40 ` 16-7-
License Lead Certificate
If the project is exempt from lead certlflc4attlon, 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 permitfor 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:
NOM.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 dlg to receive locates of underground utilities. www.ctopherstateonecall.orn
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 Ste Bui in ode must be completed within 180
days of permit Issuance.
x
Applicant's Printed Name Ap tlcan s 81 nature
Page 1 of 3
Sep.29. 2011 2:30PM Giertsen Company No.3136 P. 2
Ll &A b, -
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation - Fireplace Porch (3-Season) _ Storm Damage
Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family)
Multi Deck _ Porch (Screen/Gazebo/Pergola) _ 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 _ Egress Window Water Damage
Retaining Wall 'Demolition of entire building give PCA handout to applicant
DESCRIPTION
Valuation 7C Occupancy 2 MCES System
Plan Review Code Edition SAC Units -
(25%- 100% k- Zoning City Water
Census Code 3y Stories Booster Pump
# of Units Square Feet - PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Drain Tile Other
Roof: -Ice & Water -Final Pool; -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath ,Stone Lath -Brick
Fireplace: _Rough In Air Test -Final Windows
Insulation Retaining Wall: Footings Backfill _ Final
Sheathing Radon Control
Shoetrock Erosion Control
I W,/
Reviewed By:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review G .A.~
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies TOTAL 1~ Page 2 of 3
Kr n/ ifu imi/mum iii. rs %,iI.v [7T raven r(1A wo nni-4in-nn4a r 11111 /11111
2012-10-2316:13 » 651975 5694 P 112
um mut or ul.AGK ink
- - -
My FW ollloe UN of Ea 707
1
p
; Parmh
Faa: 1
3830 Pilot Knob Road
Esgisl MN 5612 Dste Received:
Phone: (661) 675."75 1
Fact: (661) 67&6W I eta; I
L-------- ---------I
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
nn.: X31 site Addrssa: 3 I C`~ r► do Loan
Tenant: Sate
Nam -Phorwk
Addrew City i Zi : S« WIQ (1s S;~ e
` i
Nwm- Address' ~t 6 - J ' CKY
Sift: ~ Zip: Phone: Q Ia
Corded: Email:
. lew Replace wd Reoslr Rebuild _ Modify Space _ Work in R.O.W.
a Oeeerl on of work: L
RE81DENTIAL
water Heater
Lawn Irrigation RPZ I PV6) Water Softener
.c '
8yatem Add Phan Fb durss L_ Mein I _ Lower Level)
Septic
New Water Tumarormd
Abandpnmdrtt
RESIDEWnAl. FEES:
$0.00 Minimum Water Heater, Water Softener, or Water Heater Wo Saftemr (Includes $5.00 State Surcharge)
$80.00 Lawn Irtiigation (Includes $5.00 State Sur twp)
$80.00 Add Plumbing Fixbures, Smp9 Svstern Ab&ndonM ft Water Turnaround' (Includes $5.00 State Surcharge)
"Water Turnaround (add $189.00 9 a 5t8' maW is required)
5106.00 SapW $ymWM New ($10.00 per as bunk) (includes County fee and $3.00 State Surcharge)
TOTAL FEES =
CALL BEFORE YOU Qig. Can %pher stns One CNI at (601) 45"M for protection against underground uSUty damage.
Can 4e hour befrxe you ktiand to dig to -statue locator of underground uWa. wmcgmAwrmwonecwjmm
I hereby slalanowiedpe M M krlamellon Is Complete add aorauate; diet In work w01 be In corilmno a wth the aeirancn and codae of ttro City of
aumMeme WO the eppoved plan In the claws of work *kh mgMm a reWew and eppeoval of
y -
Appilatnt's PrInW Nsnte
1 v» ' ,r?;;,, 1-- .;:ice.. "'tid. AppK76N.- Signature
. .5p
41 :a;:` + >i., ,•~:•.~1%', i:.•}.:41:. .:y5 •f y;•►~-r:~..••f~
i; ~~IR!!r7~lAR~~r~ E •~1:..•::,.a•,^•.17GiC~,'.i'~:; =r~~.;;•%4:..C.~1r ".t,•. ~~iJ•.~ .A.w'~~:1-.~.:L:•-..3~X•:•• ~W~, ~Yu::'f.•;:}~~,~~r,..
..'.;Ar~,: :T ~"W~'i =,C~.~ .a.q'+: .I Iir. ~l~.v.. I `J,`.o-, e..
•.i •.e, J •r
/~prylf:. "{nl~; n.;a,~_ .yi _n'., ~,~1 r,, Q0 ;!{,Y'.~}^ ..r
dMMtlc :;r..•'.: 11rrger..Groiuiq-:„•,~;(n:`',... iTest'S5'a.t;a5,'e8 r•w~~:If1aI{d..•+. ; ~!:.=~i
Sep 10 13 01:33p Sunrise Remodelers 651-762-9395 p.1
Use BLUE or BLACK Ink
For Office Use t
t
Oil of EaRn I Permit 1141
buy O1 '
I 5 1
I Permit Fee:
3830 Pilot Knob Road I I
I
Eagan MN 55122 ~ Date Received:
Phone: (651) 675-5675
Fax: (6S1) 675-5694 Staff: I
L------
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Q' 6 -13 Site Address: 3 2- 4 f l t9 t/l Unit
Name:. Phone: 61Z - Z rJ - ZZ Sz
Resident/
Owner Address i Crty t zip: Lf3Z 1 0 on Lex~ EUat i /-1N 5S J7--3
Applicant is: Owner \/C ontracto r
Type of Work Description of work: Tcf e- (54 a 4) coo-F
Construction Cost: S IS; X77.4 7 ^ M M_ Muld-Family Building: (Yes ! No
Company: Sot'rls-e Rev4q OG&jP.x-`S Contact: Jol -Pe+e,--sov1
Contractor Address: 5 `t 76 I4D b e. Lave- city: -S41 l au I
State: )"Ilia{ Zip: Phone: 6 5 i /G Z ` ~I ZIT S
License C, Ro Si -5 f D Lead Certificate .IVA 22Q33 - o
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW 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 cig to receive locates of underground utilities.
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 wiYnout a permit; that the work vaill 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 ~G rn C~ ~C{ k Ot✓1.~I/j x lA w~-
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119924
Date Issued:01/02/2014
Permit Category:ePermit
Site Address: 4321 Orion Lane
Lot:003 Block: 001 Addition: Wilderness Park 2nd
PID:10-84251-01-030
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Steven A Madden
4321 Orion Lane
Eagan MN 55123--185
(612) 251-2252
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature
' � � Use BLUE or BLACK Ink
. . �----------------�
I For Office Use I
� � Permit#: �� l�p�✓ �
Clty of �a��� � � . - � �� �
Permit Fee.
3830 Pilot Knob Road I ,c� (y I
Eagan MN 55122 � Date Received: �V d I �
Phone: (651)675-5675 � �
Fax: (651)675-5694 I Staff: �
I I �
2014 RESIDENTIAL BUILDING PERMIT APPLICATION ��
���
Date: (� � - /� Site Address: � ��� ��iv.-cJ �� Unit#: �
Name: tfc�� 1��.� Phone:
Resident/
Owner ' Address/City/Zip:_ __ ��j��l ���p,� /f�
: Applicant is: Owner _�Contractor
Type Of Work ' Description ofwork: �G,�� ,,J�,,,� �� �
b�
Construction Cost: /,� '('CIO Multi-Family Building: (Yes /No�
Company:����,vr� _ �� Contact:
Contractor Address: ,���77 N>c��/. � �(1� City: , �,��s��i�/
' State:�Zip:__z�Z Phone: CJS1•,7��° �,ss°�maiL
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
1��� p�
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 maybe classified as non-public if you provide specific reasons fhaf would permif the Cityfo
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.qopherstateonecall.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 Buildi Code must be completed within 180
days of permit issuance.
x ��c�i� ���lr� x
App ical nYs Printed Name Applic Ys Signatu
Page 1 of 3
��.1 Or��� �
' ' � DO NOT WRITE BELOW THIS LINE �p ����
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) Storm Damage
�( Single Family _ Garage _ Porch (4Season) _ Exterior Alteration (Single Family)
_ Multi � Deck _ Porch (Screen/Gazebo/Pergola) _ 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 _ Egress Window _ Water Damage
_ Retaining Wall "Demolition of entire building—give PCA handout to applicant
DESCRIPTION /
Valuation ���� Occupancy �_ MCES System
Plan Review Code Edition Py�$'�(� 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
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
� Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: _Ice &Water Final Pool:�Footings +Air/Gas Tests Final
� Framing Siding: _Stucco Lath _Stone Lath Brick
Fireplace:_Rough In _Air Test _Final Windows
Insulation Retaining Wall:_ Footings_ Backfill Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee (�
Surcharge l 6 � 2'�•� � 3� l
Plan Review �O
MCES SAC � �( �� %
City SAC � ` �(2 � � �`� ,-
Utility Connection Charge
f �
�----
S&W Permit& Surcharge /� '� � C7 �
Treatment Plant
V�
Copies 1
TOTAL
Page 2 of 2
xrve� For: ��� � ��'�� �-�'�
:vend P'eL-ersott Construction
� r':! �Elr;t il Jth Street ,
31�omlr.gton, h�N 55437 �, ; ;; : , /�
» � � ,.-� � U
.
DELMAR H. SCWWAN� �-..,�-
I..ANOSURVEVOq ^—�
Regist�rpt!Under L+ws oi The Stita ot Minnuota i � /j/f�
/ tY
29Y6— 146TH STqEE7 W. -- g4X M R06EMOUNT,MINIJESQTA 55068 PttO1VE 61Z 473-1768
� svav�YOa'S CERTIFICATE
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I hereby cer�ify that thts is a true anc� correct repreeentation af
. a survey of Lcst 3, A].ock 1, I�IILDuRNESS PARK SE,OND AJDITIOA: � Jakota
Gounty, !'�iinnesata.
A�so shov�ing ths loca�ian af propased houBe as staknd the.r�or..
Octob�r lu, 1978
'VIEW
• f � � �
By.
��
Date: �0 � . "
.Eagan �uilding tnspecttons Divlsion
�f �
' � ,, .� � � i � � „�-
b".I1�NESOTA REG�$'f�IATtON NO 6875'�