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1423 Oster DrCASH RECEIPT ? CITY QF EAGAN» 3795 PILOT KNOB ROAD ? EAGAN, MINNESOTA 55122 DATE 19 R6C[IY6D PROM , AMOUNT ? I - 0a0 -01 & noLuRs ,oo ? CASM ? CHECK rOR ?...?'''?[ f .w.. / 1l "1 -n FUND CODE AMOUNT n ? Tha Au BY / White-Payers Copy V Yellow-Posting Copy Pink-File Copy . _ ...?. \ CITY OF EAGAN 17274 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt # ti lIREPLICE To be used fq?,.. Est. Value =1 ,000 Date NOV 3 , 19 $9 Site Address 1423 OSTBA Dit Lot Z Block i Sec/Sub. OsTn OF FICE USE ONLY Parcel No. occuPancy - FeFs - Name $jCHARD LrrZ Zoning (Actual) Const - Bldg. Permit 26'? ? Address 1423 OSTER Dii (Allowahle) - ? • 0 Surcharge City ?? Phone ?+?-2967 ,r or scories - Plan Review Lenglh K W DAl1!! CONSTRUCTION o Name oep,n _ snc ciiy = ?? 17 1t0006S C'f Address S.F.Total - , b ?? ? SAC,MCWCC ? City ? Phone S7"' Z 1 S F. Footprinls _ Water Conn On Sile Sewage _ ? ? W Name On Sde Well W M t ? _ _- Address - Mwccsysrem ^ aler e er a W City Phone ciry water _ ??t. ?epasit /W P f PFV Required - erm t S I hereby acknowlege that I have read this application and state that the Booster Pump - S+W Surcharge intormatlon is correct and agree to comply with all applicable S1ate ol Minnesota Statutes and City of Eagan C1ri;1i- ances. .?. Treatment PI 5ignature of Permitee APVROVALS Road Unit A Building Permit is issued to: K W DAH!! CXRIiST Planner - park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Otf. _ Copies 24?? Building Official .? Variance - TOTAL Permit No. Permit Holder Oate Tekphone k WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough PI6g. Rough Htg. Isul. Fireplace Final Htg. Fnal Plbg. ConsL Meter Plbg. Inspedor - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Ueck Final Well Pr. Disp. , CITY OF EAGAN 3795 PIIoF Knob Raod Eogon, MM 85122 ' PHONE: 454-8100 BUILDING PERMIT Receipt .# T. L. u?td fn? ?' f 1.'; i: %(' ", FM VnlnM ?.i ;, I?nte (C I? Q 1I C. I. 51fe Address L, Lot? Block 1 Sec/5ub. Porcei # 10-•554)0-J50--O1 W Name Z g llddre oc O O? u? ? Name /lddress 1 hereby acknowledge that I huve read this opplication and stote that the intormation is carrect and agree to campiy wiih oll opplicabla Stote of Minnesoto Stotutes and City oF Eogon Ordino Siynoturc of Permittee . , ` , . . A Building Permit is issued to: oll work sholl be done in occardonce wlsh all npplicable Bullding Offic{al Erect Occuponcy Alter ? -_ t Zoning . Repoir ? a Fire Zone Enlarpe ? Type of Const. ' Move ? # Stories Demolish ? _ Length Grode p Depth Sq. Ft. Approvals Fees Assessment Water 8 Sew. Police Fire Er+y. Pionner Council Bldg. Off. APC Permit Surcharge Plon check SAC Water Conn. Wuter Meter Rood Unit Totol on the express tondition thcir innesota Statutes and Ciry af Eogon Ordlnances. Permit No. Permit Holder Mise. Permit Na, older Plum6ing 3Q 0 p l , i H.V.A.C. 6 Well Wsier Disp. Sewer Ekctric (?7 f? ?? UJ 6 r 'f Inspection Date Insp. Other Footinpa /? Foundation Framing Rough Plbg. ? 4 Rough HVAC Insulation ? Final Plbg. Final HVAC Final Water Descrihe Lacation: UVell . , . Sevuar Pr. Disp. Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Filf in numbered spaces S/C Type or Print legibly ro:. 4. Date 2. lnstallation Cost 3. Job Address Lat ' Blk. 7ract 4. Owner 17 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. Type No, Eauinment 9TU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. 5igned : for Rough F inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved, Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT CITY OF EAGAN ? Fill in numbered spaces Type or Print legibly 1. Date °2, Installation Cost 3. Job Address Lot ° Blk. '2 4. Owner ? 1- C+ C_ CL Vl c? Permit No, 3 Fee ' S/C ? S v Tot. Tract d S' C (- 5. Contractor '0? Phone . 6. Address L, C. ? J? 7. City (? ?' '• ? State AA Zip 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New ? Add O Alter ? Repair ? 10. Describe 11. No. X. Fixtures Water Closet No. Fixtures Cess ool/Dr i field Bath tubs p a n Septic Tank .? Lavatory Softner ? Shower Wgll ? Kitchen Sink Urinal/Bidet Other ? Laundry Tray Floor Drains Drinking Ftn. ? Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinrces and codes governing this type of work. Signed : : %!. ?'_l for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved ?, ? _ ?? CITY OF EAGAN 454-8100 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SiTE ADDRESS: APPLICANT: (#yl <'' 1 442- 461 4 PERMIT SUBTYPE: TYPE OF WORK: 1): ,', I I' ; t ??t-t ? I trt1 11 1 11 tni, N.'H!:+I r • ? !aF'PATH ;rri I Nii /Rnnr rNci Pe?mR No. PermR Holdsr Date TMsptwne i S/{N PIUMBING HVAC ELECTRIC ELECTRIC lnspsction 08b Msp. Commenb Footings I Founcietion Framing Roofi"g R-0 Pft• %UO 1-ft- Isul. Fireplem Flnat Fitg. Orsat Test Flnal Plbg. Plbg. Inspec4or - Notffy Piurnber Const. Meter EngrJPlan Bldg. Final Dedc Ftg. Deck Final weli Pr. Disp. 11NSYL1:11UN KLt:UKl) CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: . ,, . It R otr. APPLICANT: , ? 110 . ?1 i 4,6 i,fi,s 161, ) : .0, s 'i 4 7 PERMIT SUBTYPE: TYPE OF WORK: (11".rIrrt, I ri?w till 1 ? 4i ! ?11j qR / 1 I 1 clf? + 141 ? ?r (It A i xON i1?IN11 t'nrlt 13t MARt.'.1• Pl RN ltFtltE4Ji t) BY MfKf RA111'1 Permit Holtler Date Telephone N PLUMBING HVAC 7g3'?Sj( Inapectlon Date Insp. Comments FOOTINGS FOUND FRAMING RpOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ? ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONOUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Addii+on OSTER ADDITION Lot 2 e1k 1 Parcel 10-`-$*00-020-01.4 Owner Street 1423 OSTER DRIVE state EAGAN MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1984 4446.25 889.25 5 3557,00 A01350 1-30-84 STREET RESTdR. • GRADING **SEwer Lateral $3'2- 1984 5581.04 1116,21 5 4464.84 A013S00 1-30-84 SAN SEW TRUNK D 1968 Paid und arcel 10- 0400 040-75 * SEWER LATERAL 1972 fr rr pf **Water Lateral 1984 5 WATERMAIN * WATER LATERAL 1972 WATER AREA 1984 277. 39 55. 48 5 221.92 A013500 1-30-84 **Stubs 1984 5 STORM SEW TRK $3 1984 487.58 97.52 5 390.07 A01354Q 1-30-84 **STORM SEW LAT 1984 5 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 250.00 39536 10-25-83 WATER CONN. 450.00 t? ?t BUILDING PER, 8006 SAC n t1 PARK CIYY Or EAGAN SEWER SERVICE PERNIIT 3$30 Pilot Knob Road - P. O. Box 21199 PERMIT NO.: Eagan, MN 55121_ DATE: a No. of Units: ? Zoning: Owner: z Tx"derirt eL;e? Addresr Site Addrcss: _14L? 5 ter r?riY?'- ? ` ? ' `• ? ; `? ?" - a?, .,,?.• • L_, :. I 1' 1? u ? I A9m t0 OORIpy HIkb 1`0 City OF EOsOw Ordlaenam By Data of Insp.: ClTY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55127 Zoninfl: Owner, i re?eric?l :ialrac Addross: 5ite Address: 142'3 JStBZ Jriv Plumber: rie%zcl ob Meter No.: c.-• yVlrcqyalon VIVrge: •4 [ J. r" ? ? 7 Q Accour?t Deposit: Permit Fee: Surcharqe: - Misc. Charpes: Totol: Date Paid: WATER SERVICE PERMIT PERMIT NO.: DATE: ' i - `13 No. of Units: 1 Connection Charge: _ Account Deposit: Permit Fee: Surchorge: - ., Miac. Chorpes: Tota1: Dote Paid: Reader No.: 1 a4ree to oomPlp wilh IM Gty ef Ee"a OrJineeaa. Hy Date of Insp.: 00 BuiLcING N? 8606 Reteipt # Sjte Nddress • 1423 Oster Drive Erect ? Occuporxy R-3 Lot 2 Block _I 5ec/5ub. Osrer addi ti on 111rer ? Zon;nq R-1 porcel # 10-55400-050-01 Repair ? F1re Zone NA E l v T f n or9e 0 ype o Const. W NOMe Frederick L. Helmer Move O # Srories z Addross 1362 Pleasant Ave. pemoli,h p Length 65-4 Ci St. Paul 55102 phone 224-4822 Grade p Depth 53-4 Sq, Ft. ? ?o OWner Name ApProvals Fees ? Address Assessment Permit 409.00 ? Ci Ph Woter & Sew. Surcharge 46.00 one 204 50 Police . Plan check ?W Nome F 525.00 S iro AC Address Enp 450. 00 Water Conn . . L Ci Phone Planner Woter Meter 60. QO CountVl Rood Unit 250.00 I hereby acknowledge that I have reod this applicotion ond stote thot Bidg. Off. the lnformotion {s correct ond ogree to comply with oll applicoble f Minne dit E dir St t ro St it t ^PC T?a? $1944.5? ? o e o w .u V.an y o j uW,- es. - Slynoturo of Permittee 4&:I ? ? ?'G 411444e reaeric?'- . A Building Pertnft Is issued to: oll work sholl be done in occordance with oll appliwble State iqne?f/? Building Offfciol ??/" CITY OF EAGAN 3793 Wlof Knob Road Eeten, MN 55122 PHONEt 454-8100 on the express condifion thni y of Ecgon Ordinances. BUILDING PERMIT N° 860b Receipf # , 2/r 1-3{' Te M wed fer SF DWG/GAR Est. Value $92,000 pafe OCtober 25 _, 1983 Site Addrew • 1423 Oster Drive Erecr Tj Occupancy R-3 Lot Z BlxkI_ Sec/Sub. nster addition Alrer ? Zoning R-1 parml ? 10-55400-050-01 Repoir ? Fire Zone NA Enlorpe ? Type of Const. V ae Name Frederick L. Helmer Move ? # Stories Z ? Address 1362 Pleasant Ave. pemolish ? Length 65-4 Ci St . Paul 55102 phone 224-4822 Grade p Depth 53-4 gq, Ft.- o Nem Owner ApOrorals Fees ? Address Assessment Permit ??a ? Water 8 Sew. SurcMrge 46.00 F Citv Phone Polica 204.50 Plon check Gw Name Fire SAC $25.00 rw ?? Address Enq• Water Conn. 450.00 iW Ci Phone Pianner WaterMeter 60:0? Council Road Unir 250.00 I hereby acknowledge thot i hnve reod this opplication and state thaf Bldg. Off. the in(ormation is corrett and agree to comply with all opplicable APC $1944.50 Totol f Eog es. Stat and ity o Minne State of wta . / {+, l ,.?%/?Ud1C?f- $i n t f Pertn iH ea g a ure o re eric ct-L -tie mer - A Building Permif Is issued to: _ i on the expresa condiHon thm all work sholl be done in accordonce with oll applicable Sfate i ne ' Ity of Eagnn Ordirwncea. Bufldinp Offlciol ` CITY Of EAGAN 3795 Pilot Knob Rood Fagan, MN 55112 CHONEt 434-8100 CITY OF EAGAN NO 17274 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 /J 1 BUIIDING PERMIT Receipt # C? TobeusedFIREPLACE Est.Value $1,000 Date NOV 3 Site Adyiress 1423 OSTER 'DR Lot Z Block 1 Sec/Sub. OSTER OFFICE USE ONLY PdfC@I NO. Occupancy _ FEFS Zoning _ w Name RICNARD LUTZ (AClual)Const Permil 26.00 BIdg 3 Address 1423 OSTER DR (Allowa6le) - . - O City EAGAN Phone 454-2367 xorsiones SUrtharge - Sn - Plan Review Lenqih _ o Name K W DAHM CONSTRUCTION DeOth snc crt ?Q Address 2217 ROGORS CT S.F.Totat , y - ? City MENDOTA HTS phone 457-0113 S.F. Foolprints _ SAQ MCWCC ' F On Si1e Sewage Nater Conn _ e= Name On Site Well - Water Meter AddfeSS MWCCSyslem _ ¢ W Clty Phone City Water _ Aut. Deposit PRV Required _ SM! Permil I hereby acknowlege ihat 1 have read Ihis application and state that the Booster Pump - SlW Surcharge intormalion is correct and aqree to comply with all applicable Stale of Minnesota Statutes and C{q oi Eagan QOrnances. Treatmenl PI Signature of Permitee _?? ?4 APPROVALS Road Unit A Building Permit is issued to: K W DA M ON Planner - park Ded. on the express condition that all work shall be done in accordance with all Council applicable State ol Minnesola Statutes and C it y ol /Eagan Ordinances. Bldg. Ofl. Copies y y ? , Builtling OHicial ? 1,q 01 ! ! 11 oU v Variance - TOTAL 26.50 . To Be Used For J Site Pddress CZTy pF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set c£ energy calculations. /adYUation??ia'i Date Lot 2 Block Sec./Sub. Parcel #: 10-55400-OS0-01 owmer: FMDFA'lGk" L ffALMER Acklress: Gity/Zip code: Phone #= Contractc Pddress: City/Zip Code: Phone #: Arch./IIlq.: _ Ptldress: City/Zip Cocle: Phone #: ' OPFICE USE ONLY rect y E Occupancy Alter Zoning Repair Fire Zone Enlarge , ? Type of Const. Nbve # Stories Dsnolish Fmnt ft. Grade Depth S3 - y ft. APPROVALS FEES Assessments Permit ?/D q - Water/Seaer Surcharge Police Plan Check ? O*/ Fire SAC S25" ? Eng. Water Conn. SU -- - Planner Water Meter (a D Council Road Unit Bldg. Off. APC ,l,OTAL l oo ? ? ? yo6 q y? c :4r1l REQUEST FOR ELECTRICAL INSPECTION ` ' See imiructions tot completing this torm on beck oi Yellow cooY. An74-76 "X" Below Work Covered by 7his Requesl EB-OOWpl-O4 04 Addl ReD. TyOe of 8uilding APPliances Wired Equipmenl Wired Home Ranye Terttporary Service Duple,z Water Heater Lightiny Fixtures Apt. Building Dryer ElectNc Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldy. Air Conditioner Bulk Milk Tank Farm orn'« oeaN otn.r ist,ornivl ther Suecifv thei otn,.r ompute lnspection Fee Below p Fee Service EntrencaSize k Fee Feeders/SuEteeders N Fee Grcuits 0 to 200 qm s 0 to 30 Am s 0 to 30 Am s Above 200 qmps 37 to 100 Amps 31 to 100 Am s Swinuning Pool Above 100-Am s Above 100_Amps Transiormers Irrigation Booms p Partial.'Other Fee Signs Specialinspection S TO A pemarks ba.s F ? Rough-in ? th oec tor, hereb A 4tify thnt tAe bve Final , pecHao has been ( -// de. TNarepuestvoitll8monthslrom ? This reQUest vai0 (o? 0 p 18 months tmm Arn-747,R) L cR OS+". A-dd . 40 6 f16 flequest Date Fire No. Rouph-in Inspection ? IsDec.- Fleyuired ? ? AenAy Now?Will Notify n l?(p Ye,s ? Nn mr When Peatly E] Licensed Electrical Contnetor I hera6v request insoection ot above 0 Owner eleclrical work instelled at SVeet AAdress, Boa or PoWe No. CitV 1y,23 DsTE"R ecuon o. iownship Name or No. Range o. County l?4Koif? Occupant(PFINT) Phone Nu. fRFAFkieL k a. a?-? Power $upu lier Address ' / Elecvical ConVactor ICompany Namol Gonvactor's License No. -* d w (s Mailinq Address (COntrar.tor or Owner Making Instailation) /3G c2 P.«'flSA/V T ss-1oz Auffi ed Si LurO I on[rac[o? Own e MinB Installation) Phone Number C THIS INSPECTION REUUEST WIIL NOT MINNESOTA STATE BOANO OF ELECTRICITV Griggs-Midwey Bld9- - Aoom N•191 . BE ACCEPTEO BV THE STqTE BOqRD ? `i^ University Ave., SL Peul, MN 55706 ENUNLESS CLOSEDOPEN INSPECTION FEE IS ? •+1 297-2111 ?. . . OFAOBE CONfUlTINO lNOI.HttAf PLAHHIAi and LAND ENGINEEAING N431-3000 IUJ{VtYOCOMPANY, INC: ,1000 WT 144A STRCCT, OUfIH3VILlC, 111HHC30TA 5SJ3T , Cc rzxz QhcttZr-lc4e1?'.3' Loi z st- oc?r / osTElZ ADP- ??ol. v DAKaT4 GoHNTY,, M/NNE'sCTi} ? o/ 0 - DENoT.E'S /RoN MoNNA4KNT sET ? o ?` y O AEN dT?s PRpibS?A ?I.,?Y?T/O?( ... DENcTES D/REGTJON- 'OF ,r ? ?\ sNRF/1CE DRA/NAloE , `? NoRTN I ? ?g F/K/SHEp G,4RAG£ F?-doR .?`?l? 30' 906,/ ToP B,coG,r ,e,t£Y, . :«. I ? ce ' -* t B."cARiNbs, 0 t \? yyr ? s*o wN 3 L nT 3 . i ARE L 0T Z AssY,NF? p ? . ? • ? ?, ? , ? ??'??? \ ? a. d j 30? fRONT ? ?HI<D/NG 4,ET&6 K: , Y . ? ,8 ? Q. L/hAE 40.0 ?. ? s . 0 %D ?.. „ ? .. ao„ . ? ry PRA/NAGE l/T/L/TY ;,EASEMENT •:?` w' , ? ?r? ' N 87 sz.'SO°yy h _- - I hereby certify that this is a true and?-IorreLt?representation of a tract of land as sho4rn and described hereon. As prepared by me on /this S day of &,hP&A,,., , 19 $3 . ? / ?mr++s /_]?...C•? ?;. Minnesota Registration No. ; --- '? ? EXTERIOR ENVELOPE f?VERAGE "U" COMPUT,0.TION ? OWNER ?SITE ADDRESS ;- ,,._. ? CONTRACTDR DATE PHONE ..- 4 ?. • Determine working square footage of each. F ; 1. Total exposed wall area ...... 23,351103 sq. ft. x .18 " 20. 5 ?•? ? 2. Total roof/ceiling area ..... , ly 38 sq. ft. x 04 Total exposed wall area above fioor =_20 ? a. Total wall window area...................:........ 2 3??3 b. Total door area ................................. c. Total stiding gTass.door area ............ ..... - ? d: Total fireplace wa]1 area........................ ` e. Total wall framing area (averagetOA)............ !L9 8,4 a: f. Total net wall area above floor ................. I Il9.?„9 g. Total rim joist area ............................ 193 'iatat exposed foundation area h. Total foundation window area...... ............... t. Taal net foundation area abpve grade ............ 1141.1 P, Dete;mine "U" vatue of each wa1] segment. a. 23q ? 15 X1, u„ 5 5)__ = 131, 5Z _ 6. 9 la X „u ll , 139 ? c. X llUii _ - -- a. ? g x'-ull . 3l0 - V R,Z e. I?ea•'?8 X „u„ , OIvJ f. I?Ilo•39 xltu„ , v3t,o = 54.5 9. i T3 x Uu,l '03 ? h. X nUn -- - r ;. 1 l??1 x "u^ 3 . ... .............. . 8.... . .Total = S 3, lo`I Ii it°m r3 is the same as, or 7ess than item -1, you have met the intent oi SBC 5006(c)2. w- Total exposed roof/ceiling area =`.? a3 8 Total gross roof/ceiling area = I y3 8 -. ? . . .. __ .. . . . . ? . ° . . ?-y . . ' . . .. . .- . . . J. Totat skylight area' .:..................... -- -. k. Total roof/ceiling framing area ............ I?, 8 1. 7otai net insulated roof/ceiling area..'..... IZ 9 4. Z Determine "U" value for each roof/ceiling segment. _.. . ,: ? ... - X llust ?- k. 14 3, S xltuil , 035 = 5, 03 i. I 29?f .? x„u„ toz = 3 8, Z 15 4......--•......._..?.`.'13 $.........Total ? f - ?y If total of #4 is the same as, or less than r2, you have met the intent of SBC 6006(01. - To utilized the total envelope system method, the values.estabtished by the sum of items 473 and #4 shall not be greater than the sLm of itens E1 and n2. 1. + 2. 3. + 4. MATERIALS Exterior Air Sidir.g Material Sheath'sng Insulation -- Sheatrock Interiox Air Studs P.im Conc. Blks. Therm. Eesistance "P," ,7T7 Li5 Eo ' ?,59 l.ZS CITY USE ONLY LOT ? BL ? SUBD. RECEIPT #: -( (o (c S I RECETPT DATE: p ' D-S ' ` ?, 1996 M£CHA1VICAL PEitMIT ($£SIDENTIAL) crrY oF ensAw 3$30 PILOT KNOB ltD £R&kP MA 55122 Date: ? I 1? ( q U (61E) 6$1-4675 Complete this section oniy if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied ' o HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas oudets (minimum of one required @$3.00 ea.) • State Surchazge: .50 . TOTAL: wtiiY ? leic ii:s 5ci:?ou Gr if J?- a'•_?, • .. .•:.•s .• : le f°..mi1•, .i. .,_ljy.,ac Jii diE 3'efTluuOilu a3Ci7Zi? ?O, C: rc}'iF.7.'".ia? C:v3?,.. 3.:g ? a-, townhomes, or condos. Note: Mechanical permit is not reauired for alteration/add-on to ductwork in existing residential units; but is required for the following: Install fumace _ Install sir exchanger, i.e. Vanee system, etc. -%, Install air conditioning Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surchazge . .50 Total: $ 20.50 SITEADDRESS: ctkA i.?C- OWNER NAME: (zl e 1 I 0 )OT--i " PHONE #: 1..7 ""i ?Z-?J lo ? INSTALLER NAME: 693LVISDY V AodL PHONE !l: ? ;.? - +54< STREET ADDRESS: CIT'Y: 0 LAI +V'I'/ STAT ;?l N ZIP: ? i F P RMITTEE / 1S/FORMS BLD/A?CH PERMIT (RL-5) - 1998 SIGNA L BL SUBD. CITY USE ONLY RECEIPT #: RECEIPT DATE: APPROVED BY: 199$ IYIEC*MICAL P£RMIT (CObIM£$CIi4L) CITY OF Ek&AN S$SO PILOT KNOB iiD E4fiAN, MN 551 EE (61E)6$1-4675 Please complete for: all commerciaVindustrial buildings muRi-tamily buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PRICE: WORK TYPE: NEW CUNSTRUCTION INTERIGR IMPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater. Processed piping - $25.00 CONTRACT PRICE x 1% r?o?ESSEv;-,r-rNG PERMIT FEE STATESURCHARGE TOTAL SITE ADDI2ESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLl): INSTALLER: PHONE #: ADDRESS: PHONE #: CITY: ($.50 per $1,000 of pe 't fee due on all pemiits.) STATE: ZIP: SIGNATURE OF PERMITTEE SINGLfi FAMILY DWELLINGS 1989 BLIILDIHG PERMIT 9PPLICATION CITY OF EAGAN ? ?2 #i MDLTIPLE DWELLINGS 2 SETS OF PLANS 2 3ETS OF PLANS 3REGISTERED STTE SURVEYS BEGI3TfiAED SIT6 SQR9EYS - 1 SET OF ENEAGY C9LCS. (CHECg iIITH BLDG DIV.) 1 3Ef OF ENERGY C9LCS. MfTI.TIPLE DWELLINGS RENT6L IINITS FOR S6LE IINTTS COtR7ERCIAL 2 SETS OF ARCHITECTURAI: 8 STHDCTIIRIL PL1NS 1 SET OF SPECIFIC6TIONS 1 SET OF ENERGY CALCS. # OF ONTT3 HOTEs ADDRESSES F06 CORNER LOTS - COPTRACTOH/SOMEOWNER MQST DESIGNATE iiHICH ADDRFSS IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE HIIILDING PERMIT IS ISSIIED.- SEiiEA 6 NATER PEtMTT FEES 9ND SCCOUNf DEP0.SIT F6ES i1ILL BE INCLODED iIITH THE BOILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMIIS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDIC9TING 9 LICEN3ED PLTJMIDER. PENALTY APPLIFS WHEN: PEAMIT IS NOT P9ID FOR IN SAME i,MONTH IT IS REQIIESTED. LOT CHANGE I3 EEpQESTED ONCE PERMIT IS ISSIIED. To Be Osed For: Valuation:??.ooa Date: l --v ? Site Address 7--1,z s '-3 tt' S7-9 /` [Jr OFFICE 0.SE ONLY Lot 2 Block C_ Pareel/Sub ? j ,?l-& Owner /?.', /& ? tl L w ! Z Address IL/ Z 3 d tc 57--e r City/Zip Code / 4 4?. sti- Pr,one ?IS q 6 7 Contractor t,2 /Ja /? ? C-o?,5 / ? 7? 6ddress 2- a / 7_ R. y ad'S C/ C3ty/Zip Code -;wr1,., d^ a/T/ Phone L/ J`-7 0/ / 3 Areh./Engr. 9ddress City/Zip Code Occupancy FEES Zoning ? Aetual Const Bldg. Permit ?(n Allowable Sureharge # of stories Plan Review Length SAC, City Depth SAC, MWCC S.F. Total Water Conn Footprint S.F. Water Meter Acet. Deposit On site sewage S/W Permit On site well S/W Surcharge MWCC System _ Treatment P1. City water _ Road Unit PRV required Park Ded. Booster Pump _ Copies Z p SUBTOT9L APPROVALS Penalty Planner TOTAL Council Bldg. Off. Varianee Phone # L BL SUBD. APPROVED BY: INSPECTOR RECEIPT #: RECEIPT DATE: MECHANICAL PERMIT #: 1999 biECHRNICl4L PERMIT (C016IMERCIRL) CITY OE' EkfiA1V S$SO PILOT KNOB iiD E,4GAN, MN 5518E (651)6$1-4695 Please complete for: all commerciaVindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PRICE: WORK TYPE: DESCRIPTION OF WORK: :dEW CONSTRUCTION INTERIORIMPROVEMENT FEES: 1% of contract price O/i $30.00 mioimum fee, whichever is greater. Processed piping - $30.00 CQiti ii....?, i i"aD J(.E XI% PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL -------------------------°--.._. SITE ADDRESS: OWNER NAME: TENANT NAME (IIvIPROVEMENTS ONLl): INSTALLER: ADDRESS: CITY: CITY USE ONLY PHONE #!: - (.anEa cou) STATE: ZIP: ($.50 per $1,000 of cermit fee due on all pemiits.) PHONE #: (AREA CODE) SIGNANRE OF PERMITT'EE CITY USE ONLY LOT ? BL ? RECEIPT U SUBD. 4? RECEIPT DATE: MECHANICAL PERMIT N c3 SC/ 1999 M£CfiANICAL PEftMIT (ftESII?F1VTIAL) CITY 0F EA6AN S$SO PILOT KNOB $D ER6AN MN 55122 ?fi?Z3 ??7°I (651) 681-4675 Date: Complete this section onlv if you aze installing HVAC in a single family dwelling, townhome or condo under construction and not owner /occunied. • HVAC: 0-] 00 M B T U ADDI'I'IONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 State Surchazge .50 Total $ _ Complete this section onlv if you are remodeling, adding to, or repairing an existing single family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New Alteration Repair _ Other Reminder: Call 681-4675 for inspections. Furnace Air exchanger _ Air conditioning ? Other UR.v.? ?cc?t •'r' `? ??""'? $ 30.00 State Surcbazge 50 Minimum Total Due 30.5 SITE ADDRESS: 1+z::?) br . t OWNER NAME: Lat -?' LRE f 9 0 PHONE #: lOS 1 (AREA CODE) INSTALLER NAME: Fi? 1 CKS?? P? C= PHONE #: lfl I Z-- STREETADDRESS: 14,qI (AREA CODE) CIT'Y: &L-I?trje STATE: M P: SS4??7 SIGNATL#E OF PERMITTEE C.T.TY 01= .F..AGAN (.'.AWEfi: S TrRMINAL N0: 770 DATEr 08/17/98 TIME: 15:52;44 IIl: NAME: E{LOM CUSTDM HOMCS INC 3210 3001 14E3 O5TEF UR 287.25 3422 9041. 1423 CISTER UR 186.71 215 i 9001 1423 OSTER DFi 10.00 To+,a7. Receip+, Amouri1;: 483.36 Ck09E.2fi 6 USER :[D: NANCY IPIT OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 FERMIT PERAAIT TYPE: Permit Numher: Date Issued: BUSLOING 032421 08/17/98 SITE ADDRESS: 1423 OSTER fJR LOT: 2 BLOCK: 1 OSTER P.I.N.: 10-55400-020-01 DESCRIPTION: ?_,? SOUND CONTROL B?tI d3n?=?nPermit Type 5F (MISC.) "-jt.t9si'td`U,6wk Type ALTERATIqN ,C2n?us tl?''' 434 ALT. RESIDEN7IAL 041 ? ?. % ,e+ - ?`?M , 4•?* . . s _ , j-? g ? £???' hc????g,? 3Mr 11 ..- u' F A ?' ft ki a9 ? a+ca ??ar a ;? ? ? ,i ?. i axn q1.M? ?na a ? , .£n? REM"M:REvzEwEO BY MIKE BARCK FEE SUMMARY: Base Fee Plan Revisw 5urcharge TotaJ. Fee VALUA7TON $287.25 $186.71 $1@.00 $483.96 $20,000 CONTRACTOR: - Applicant -- S1`. LzC. pWNER: BLaM CUSTOM HOMES INC 14353411 0001110 LUTZ RICHARD 16726 IREDALE PATM 1423 OST€R DR LAKEVIL.LE MN 55044 EAGAN MN 55121 (612) 435-3411 (612)454-2367 i, in "st ? _...? =1 ? Mct. ,. .. ? 998 New Construction Reouirements BUILDING FERMIT APPLICATION (RE$IDENTIAL) CITY OF EAGAM ? 3830 PII.OT KNOS RD - 55122 681-4675 ? 3 registered si[e surveys ? 2 copies oi plans (inGude beam & window saes; poured fid. design; etc.) ? 1 energy calalations ? 3 copies of tree preaervation plan 'rf lot platted after 7/7193 required: _ Yes _ No DATE: ? -3o- / ? DESCRIPTION OF WORK: STREET ADDRESS: RemodeUReoair Reuuirements ? 2 capks of plan ? 2 site surveys (ex[erior additions 8 deGcs) ? 1 energy celalafions for heated additions CONSTRUCTiON COST; LOT: li BLOCK: ? SUBD./P.I.D. #: T Name: ?&I?dl Phone#: PROPERTY Lmt First OWNER e„ Street Address: lf?' ,'a? ?5 //? ciri _ 251qr?t/ srate: z;p: Company: WW Phone#: CONTRACTOR ,,.,/ ' Street Address: P ?v Fi9Y? ?i//? License !! City State: ? Zip: ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street City State: 5ewer & water licensed piumber (new construction ony): and lot change is requested once permit is issued. Zip: Penalty applies when address chang :knowledge that I have read this application and state that the iniortnation is cortect and agree to Comply with all applicabt ity of Eagan Ordinances. Signature of Applicank y1tl 1 E USE ONLY _ Yes _ No Tree Preservation Plan Received - Yes _ No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE itimf ? 01 Foundation ? 06 Duplex ? 11 Apt.lLodging ? 16 Basement Finish ? 02 SF Dweffing ? 07 4-pfex ? 12 Muiti Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ?_ ,?„?.Public Facility ? 04 SF Porch ? 09 12-piex ? 14 Fireplace ?'1 Miscellaneous A 05 SF Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New ? 32 Addition 33 Alterations ? 34 Repair GENERAL INFORMATION Building Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq, ft. # of Stories $q. ft, Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Engineering MC/W5 System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bidg Census Unit Variance u !>r o/ n Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W 5urcharge Treatment PI. Park Ded. Traiis Ded. Other Copies Total: ? 36 Move ? 37 Demolition Valuation: $ 2-0 cxao, - % SAC SAC Units ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT ? PERMIT TYPE: Permit Number: Date Issued: ? (33/? , ,.. SITE ADDRESS: ?.cl DESCRIPTION: s: rL) 1, t0 6 11 1 z0 0 [ iH i; i i?. '?? ? r.•_? r ,' 7r v.,; `t REMARKS: FEE SUMMARY: CONTRACTOR: OWNER: , ., . , . . . . ? ?.. . .. .. . _ ! ? ' '! `• i. 4 1 i ? . !! S9 L U ? [) i i: !;. .; L t"'.1;,y r,t .,.'y7o.1J .;n= 1 .:fY c.u.fJr1 .3 tt h';l. j, d n tiz`.tt. f.h].n' fl i.) i:(bl?? t1;5;'Sd 1 (::..cs7y'?' Li.tl sia t;} Y5'tit.L, f.iirtt i,h£d: S t?1.{,-i,:I?'1 -f. .., .. .l ''..6:I L T q C{ (? ? ? ? ? ? ?r ? P LICAN ER ITEE IGNATURE ED : NA E 1F?'? IS CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (672) 681-4675 SITE ADDRESS: , PERMIT SUBTYPE: ? ? INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: TYPE OF WORK: ? ? REACTIVA7E PERMIT N cirr oF EAcaN ?i??,Dd 1993 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. 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 X&. / _-'29 / /w Valuation of work .?40 47??Oa ' Site Address: Z?a9 ?//.2&? STREET SUITE / Tenant Name: (commercial only) LOT ? BIACK ? SUBD. (W Fp - I.D. If Descri tion of work: fFcz ?P-e IGcL U;n ,i The applicant is: ? Owner is(Contractor ? Other co"«ibe) Name Phoneoz?& Property LTST FIRST Owner A 23 Address , STREEi ' STE M City JnWw State--?A• Z i p Company Phone Contractor / i Address /Oa?<S License #<7271'1'0 Exp.? City State twie. Zip SS3a? mpany Phone ArchitecU Engineer Name s ration # Address City -- State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. E3 03 5F Addition O 04 SF Porch ? 05 SF Misc. ? 06 Duplex ? 07 4-Plex • ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'1. WORK TYPE 0 31 New O 32 Addition ? 33 Alterations O 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REGIUIRED INSPECTIONS ? Site ? Wallboard r. s. ? O 11 Apt./Lodging 16 B:aseme„U.6-FFinish O 12 Multi. Misc. ?O 17 Swim Pool ? 13 Garage/Accessory ? 18 Comm./Ind. ? 14 Fireplace ? 19 Comm./Ind. Misc. ? 15 Deck O 20 Public Facility ? 21 Miscellaneous ? 35 Tenant Finish 0 37 Demolish ? 36 Move Basement sq. ft. lst F1. sq. ft: 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing ? Final MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Assessments ? Framing ? Insulation ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License 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 Other Total: valuecion: S SAC % SAC Units ? 2004 RESIDENTIAL BUII,DING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ?7o. aS NewConsWCtion Reaui2ments RemodeNReoairReauirements 3 reglstered site wrveys showing sq. R o( lot sq. R oi house; and a_Ij roo(ed areas 2 copies of pWn (20% maximum lot covenge albwed) 1 set of Energy Calculafrors fw heafed additions 2 copies of plan showing beam & Window sizes; poured found design, etc. 1 site survey tor additions 8 decks 7 setMEnergyCaloulations Additian-indicateifon-sAesep6csysfem me 3 copies of Tree Preservafbn Plan it lot platted after 7103 Rim Joist Defail Options selection sheet (bldgs with 3 or less uni6s Date _g? i?BDQy Construction Cost,9 M00 Site Address UniUSte # ? Descripdon of Work Multi-Family Bldg _ Y? N Ftireplace(s) _ 0_ 1 _ 2 Property Owner E ,C. (/ T,?7- Teiephone #((pFJ ) ys"Sj6? Coutractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - fvlinnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet ` • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculadons SubmiUed Have you previously constructed a building in Eagan with a similar plan? _ Y fee applies. Cicensed Plumber Mechanical Contractor Sewer/Water Contractor N If so, 25% plan review Telephone #( Telephone #( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information comple d accura ; that the work will be in conformance with the ordinances and codes of the City of Ea Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 2/?? ? I C-7 /- C/ TZ Applicant's Printed Name ?kpplicant's Signature ?- OFFICE USE ONLY Sub Types rl. , ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AR - Multi ? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex X 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? OB- 04plex ? 12 12-plex Plbg_Y or_ N 0 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolitian (Entire Bidg) - Give PCA handout to applicant Valuation ?ep Occupancy MCES System Census Code y 3 y Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const vtlj Width Footings (new hldg) 7x Footings (deck) _ Footings (addition) Foundation Drain Tile ? Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation REQUIRED INSPECTIONS Final/C.O. ? FinaVNo C.O. _ Plumbing HVAC Other _ Pool Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Approved By: 7 (i , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total ??zG/C- ? 7 v ? ?? t ? AOBE ENGINEEAING C?NaHiiini ndoIAHD =iUAV1Y0l4S I COMPANY, INC: .1000 W7 Iti{w STl1CCT, Ol7ftlf3VILL[, 11INHC30TA 5333T tH 43I-3000 lip?i?-I_...?'.S.r?L ?ort • [.oT Z 0s7-ER .4Dp, DAKOT/J CoyNTYJ M/NNESdTi! N ? .? %?p3p Bfi?hRWb s, sNoWN 3 ARE ko qssa,sEo p . ?. 4 O Y 0.? ? ? 899.0 ° ' ?.?NoTE's /RoV Mo,,yuMusNT sET 'v ? '. _ .' 06Na7?s EX/ 5T//Y6 ?1.?Y.4T1D?/ ?o ?` y O DENOTks PPOftSED E?JW,477dN DENaT,E?s piucrioN- of •? ? sl.JJ@F/;1?? DRAINAGE I \? 9asa f/A!/S?p 6,046X FLao,Q XAEIl, ? ? ? 9O61 GK F-iE'Y. .. ;. ' ? \w9 9 ^\? . _ . 0 I t v,9 , 6 3 ? L vT 2 ? ? I ? i ? y 3h ? K I ? I `J 40. o ? .. ?? DRA/NAGE AND UT/L/TY ;EASEMENT ? ? ? ? \ \ R1ra ? \ \ ? ` 30. FRDArr ? ? ?H/?-D/NG S.ETl3.4GK L/XE . . ??- - 2 p - ? y ?q 'h' ' •. a' ? w i o . - i 01 o ? / w y iti ?. s;a / ? ?'? ??\ - • ? .?6 . 4 ' N 87 s2.'SO"LY h - -- s.o7-? hereby certify that this is a true an&;:orce?t?representation of a tract of land as shown and !scribed hereon. As prepared by me on this s day of'of--a , 19 73 . ' _._?,i.u? Minnesota Registration No. /Coo$'S Use BLUE or BLACK Ink r For Office ~Use ~J Permit / j City of EaVd ~ Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: l ,2 3 S &r Unit Name: Di c- A Lu! f-7- Phone: RESIDENT / J y/ ~s ~ 5-~- j OWNER Address /City / Zip:/ E-or ar1 M Applicant is: Owner A Contractor Description of work: Re TYPE OF WORK s-+ Construction Cost: O Multi-Family Building: (Yes No~4 ) Company: P4 I 0k1 Contact:~6)14tGlO C (Ahlb- CONTRACTOR Address: City: ed.-n°, State: rl AV Zip: 44is 40 5 Phone: Lsa C), 1 0 Zf ! b License #:X013 o t 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 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.gopherstateoner-all.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 U G x Applica s Printed Name Applicant's ignature Page 1 of 3