672 Overhill Rd? CASH RECEIPT
` CITY OF EAGAN 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
. DATE " 19 _
eo
]M "
AMOUNT $ I
Q DOLLARf
1 oo
0 CASH FJCHECK
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
BLDG.
,
PERMIT N0. s
? r
0-Y-?210 "
Bldg. Fermi t
•
-
01-342t ?
''Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge ?
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3$68 Water Trmt. i `
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit '
79-3866 Sewer Conn. -
11-3855 Park Ded.
TOTAL - ? :??{
CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
mi111 r11?1^ nGnaIlT PHON E:454-8100 --'-'..
Est. Value
- -- - --?,---
Lot Block Sec/Sub. • `?""ry`
Parcel No.
a Name
= Address •. ?
o ' -- . .
City Phone
City
that i have read this application and state
Signature of Permittee
A Building Permit is issued to:
atl work shall be done in accordance wit
Building Official
On Site Sewage ? Occupancy
MWCC System f' Zoning
On Site Well ' Type of Const
City Water •` ?? (ActuaQ
(Allowable)
* of Storiea
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Assessments _
Water/Sewer _
Police _
Fire _
Engr. _
Planner _
Council _
Bidg.Off. _
APC _
Variance _
.. co
FEES
Surcharge
Plan Review
SAC, Ciry
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parka
Copies
TOTAL
9334f
11o2.aa
-- ;.r_
n
0
--rt-,-------
that
- Permk No. Prrmit Holder Date TeIephone ?
Plumbin9
H.V.A.C.
!- !-?L'
,/•', . ? ?' .
? :-3?h i
Electric
Softener
Inspection Dat* Insp. Comments
Footings I
Footings II
Foundation
Framing / ?uLl? /S ??-- ?f/•4ic, ?af
Roofing
Rough Plbg.
Rough Htg. y/ r7 lAgp
Isul. y?? - - -
Fireplace
Final Htg.
Final Plbg.
Bidg. Final
Cert.Oca Q?
Temp. LP
Deck Ftg. y 2 ? 9 ?ei?,eov?r ..?r,
Deck Frmg. /
W@ll
Pr. Disp.
1 ? CITY OF EAGAN
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt # ?
a(NT Est. Value $i ,5w Date AUG Site Address _4
Lot Z Block
Parcel No.
W Name ?AY BOLIN
3 Address bTZ OVSRHILL RD
0 City EAGAN Phone 686-8228
, o Name ?S'?R ??'???ION
? Q Address 21150 YYBt.BTH ST NE
? City C8DAR Phone 535-7214
?
yVjuW Name
? ; Address
<W City Phone
I hereby acknowlege that I have read this application and state that 1he
inlormation is correct arrd agree to comp ly with ali applicable State of
Minnesota Statutes and ty of Eagan Ordinapces.
Signature of Permit !
A Building Permit is sued to: ?ST ? R COpSTi?UCTIO11
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Ofticial
t??'= . . . . .?
16995
Occupancy _ FEES
Zoning _
(Actual) Consf Bidg. Permit 36'oo
(Albwable) - Surcharge 1•00
# ot stories _
Length _ Plan Review
Depth - SAC, City
S.F. Total _
SAC, MCWCC
S.F. Footprints -
On Site 5ewage _ Water Conn
On Site Well - Water Meter
MWCC System
City Water -
Acct. Deposit
_
PRV Required _ S/W Permit
Booster Pump - S+W Surcharge
Trealment PI
APPROVALS ? bolff-
Planner - park Ded.
Council _ '50
Bldg. Ofl. Copies
? 37.50
Variance -
?- TOTAL
Permit No. Permit Holder Date Telephone #
WATER
SEWER '
PLUMBING
H.V.A.C.
ELECTRIC
Inspettion Date /
Insp.
Commenis
Foolings I
U C/?i[/ - 6
Foundatron a - IOA
Framing f ?
Roo(ing
Rough Plbg.
Rou9h ?it9-
Isul.
Fireplace
Rnal Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Piumber
Ergr.lPlan
Bldg. Final
Deck Fig.
Deck Final
We0
Pr. Oisp.
'
? 77"
".
, • •
` PERMIT #
' • . MECHANICAL PERMIT ?
t,,_ ?•
CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 'f' PI?' r
CONTRACT PRICE PHONE: 454•8100
Site Address `'
t ? Bl
L
k -
? BLDG. TYPFi WORK DES?ltIPT10N
?
o
oc
, SeC/Sub Res. ?? New
Name Mult Add-on
°-'
?o
Address .
.; . ?? . Comm. Repair
Other
c City , Phone H r ?-
Name
Address
City
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
aner
M BTU
M BTU
M BTU
M BTU
CFM
1
FEE
S/C:
TOTAL•
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
GAS ?UTLETS (MINIMUM - 1 PER PERMI? I
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS ` RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
- $24.00
- 6.00
- 1.50 EA.
- 12.00
- 20.00
- .50
- i --? ?l' -
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
CONTRACT
'Site Address
? Name T?f?ff17L`?G-i/
-Fa Address - -
c City c Phone ?=? ?' ?? • _
. ? Name ? 'Y ,J? +t ??/i.cJ
c Address -?:1.+,?'
O City Phone ? _fl
APT BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PEfi PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
.,. ....?
PERMIT #
RECEtPT # 2 8l ?
DATE:
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mutt. ? Add-on
Comm. Repair '
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00
?
$
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki+chen Sink - $3.00
Urinal/Bidet - $3.04
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1 50
Whirlpooi - $3.40
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: • •' r f
STATE S/C:
GRAND TOTAL : ' r
CONTRACT PRICE:
Site Address ?
Lqt
(
- Name
o Address
c City j . .? . Phone
? Name
3 Address J
p Ciry Phone
FEES
COMM/IND FEE - 1°,6 OF CONTRACT FEE
APT BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMMIIND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
, f" • ? : a
?
SIGNAT E OF ?ERMITTEE
FOR: CITY OF EAGAN
PERMIT ?k
PLUMBING PERMIT RECEIPT 1 ? z
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: d? ?
PHONE: 454-8100
BLOG. TYPE WORK DESCRIPTION
SeciSub Res. New Y
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
-L-Water Closet - $100 $ ? 3 -
_LBath Tubs - $3.00 ? 3_Lavatory - $3.00 L ?
Shower - $3.00
1 Ki!chen Sink - $3.00 ? -
Urinal/Bidet - $3.00
? Laundry Tray - $3.00 ?
?Floor Drains - $1.50
z ?
Water Heater - $1.50 ?
Whirlpool - $3.00
i Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
?Rough Openings - $1.50 `?- ? -
FEE: ? 1 . .
STATE S/C: - ?
GRAND TOTAL• i ? ? '
? . . ?
. . ,. -
. ? (ltrfifirafr of (Orrupttnry
^ titp of eagan
Mr,prartateitf uf NuOtttg Auaprttinnt
Thrs Certifcate issued pursuant to the requiremenu oj5ection 306 of the Uniform Building
Code eertifying that at the time of issuance this structure was in compliance with the varrous
ordinances of the City regulatirrg 6uilding construction or use. For the following.•
v. ca.m;r.a. SF Dh1CAL'? ewg. Perinit rb. 13341
Oocu,.?? ? Zaing DWjic, ?CMU o
owwr ot Budding MM W?S MM. OO Add,,. 6521 S. RAY '.A-T Rt1AD. P.ACAN
BaiWing Addras 672 OVL.IV'M ivOrui 10=10n, i..'. , !?• i_ (YU0 t".y, : 1t1C?4 i m
Date:
Buftng Officid
POST IN A COMSPICUOUS PLACE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: f , APPLICANT:
tiVt kH I 1 I f HIr1q
PERMIT SUBTYPE:
f, J„ r6! , !ili,;I
1141.
IN f'1ltl1
MAkk'?: AFi AIt
F
L
TYPE OF WORK:
1 N'J11 A I ItiN
F lNAI
itil I i i? ? N6
it,'4 I N.
?
ni ii ilnI It?ni
RMl!'. AFt i0 1111I1;F11 l?#f; ti1VY t•I11{NI+1N(i Uk 1-1 1.4.litli/11 I.lilF;F
0
?
J
?
Permft No. Permft Holder Dete Telephone #1
SI1N
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon Date Inap. Commenta
Footings I
Foundation
Framing ??,
t
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Orsat Test
Flnal Plbg. Plbg. Inspector - NoYrfy Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp. .
CITY OF EAGAN Permlt No: Dats:
3830 Pllot Knob Road Meter Na 3 7G 1( , SG V3 giZe:
P.O. FJox 2ti199 Reader No: /7 N`j'D 4? Dat? -S Z
Eagan, MN 55121
Owner. -
Site Address: -r1:; i ? - -
? i • .?
Cann. Chg:
Acct Dep:
Permit Fee:
Surcharge:
Tr. Plant
Meter.
CA
with the City of Esgan
GBy
WATER SERVICE PERMIT
Pilot Knob Road Meter No: _
Box 21199 Reader No:
in, MN 55121
Size:
Date:
nn. Chg: 5?25--Qftd Zoning:
ct. Dep: 15. OQp,'. No. of Units: I
rmit Fee: ? ? • 00rd
rcharge: •5 O''? c'• 1 agree to comply with the CHy of Eagan
Plant • `? `?p`' Ordinances.
:ter. -
1- ild
WATER SERVICE PERMIT
F EAGAN SEWER SERVICE PERMIT
Ilol Knob Roed
?x 21199 r 7 n 1
PERMIT NO.:
MN 55121
1 DATE: -
j No. of Units:
Address:
agree lo comply wlth the Gty of Eegan Connection Charge:
wdinancea. Account Deposit: -
Permit Fee:
Surcharge:
y Mlsa Charges: -
late of Insp.: Total:
ioo.aopa
CITY OF EAGAN N° 13 3 41
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
BUILDING PERMIT PHON E: 454-8100 Receipt #
E ??
To be used fpr SF DWG/GAR Est Value $71,000 Date MF.RCH 13- ,ig 87
Site Address 672 OVERHILL RD OFFICE USE ONLY
OVERHILL FARM
Lot 2 Block 1 Sec/Sub OnSiteSewage Occupancy R3
.
2ND ADD MWCCSystem _X3C Zoning R1
ParCel No. On Site Well _ Type of Const
City Water 3(X (ACtual) V
c Name GRAND OAKS DEVEL CO (Allowable) v
w
=
Address 4521 SO HAY LAKE RD # of Stories
Length
F2
o Ciry EAGAN phone 452-8934 Depth 42
S.F. Total
0 Neme $AME Footprint S.F.
.
oa Address APPROVALS FEES
°
i
City Phone
Assessments
- Permit 402.00
+S
h
S $ Q
39
0 W Nelne Water/Sewer
Police urc
arge
_ Plan Review -
7 f11 00
?= Fire _ SAC,City 100 QQ
x- Address
?t7 Engr. _ SAC,MWCC Q
aW City PhoO@ planner _ WaterConn. _52 0
M
t fi7
00
Council e
er
r _
hereby acknowledge that I heve reatl this application and state B dg. Off. _ RoadUnt VU
thattheinformationiscorrectandagreetocomplywithallapPlicable APC - TreatmentPt ?An QQ
State of Minnesota Statute nd Ciry YEg? n Ordinances. Variance _ Parks
SignatureofPermittee ?'??f?' Copies
ro7aL
54
A Building Permit is issued to: GRAND O S PfVIEL CO pn the express condition that
all work shall be done in accor tance with all applica State of M innes.Ata Statu es and City of Eagan Ordinances
Building Official ?
BUILDINGP*ERMIT
io be used for BASEMENT
Est.Value $1,500
SiteAddress - 677 OVFRHT .
LOt 2 BIOCk _,,._ SeClSUb.OVERHT . FARM N
Parcel No.
w Name BARRY BOLIN
3 Address 672 OVERHILL RD
? CitY EAGAN Phone 688-8228
.o Name GIISTNER CONSTRUCTION
84 Address 2 150 EVELETH ST NE
m
- City CEDAR Phone 535-7214
N Name
P.ddf655
City Phone
Building OHicial ?Illl_R.p/ {? f I I n I..11 CITY OF EAGAN N2 16995
I hereby acknowlege that 1 have reatl Ihis a lication and stata that ihe
information is correct agree to coi pl th all applicable State of
Minnesota Statutes an it f Eagan Oces,
Signature of Permi e
A Building Permi? i issu o: GUS ER CONSTRUCTION
on Ihe express condi ion that all work shall be done in acwrdance wi7h all
applicable State of Minnesota Statutes and Ciry of?jEagan Ordinances.
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454•8100
Recelpt # ?
Occupancy
Zoning
(ACtual) Consl
(Allowable)
# ofStones
Lenglh
oePm
S.F. Total
S.F. Footprints
On Site Sewage
On Site Well
MWCC System
City waler
PRV Required
9ooster Pump
AP7ROVALS
Planner
Councii
Bldg. Off.
Variance
OFFICE USE ONLY
FEES
Bidg. Permit
Surcharge
Plan Review
snc, cny
SAC,MCWCC
W ater Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Trealmenl PI
Aoad Unit
Park Ded.
CoPies
TOTAL
36.00
1,0?
.50
37.50
This requesl void
9h2firms
206 z.-,? /d-
O 7a??Jr7l?
,cnnseo ueccncai ?onv»cior 1 hereby requeat inapection oi ebove
wner r eleetrical work imtalled at:
St/reet Adtlre^-s?s, Boz or PJou?fe No.
C9 ? ?C vUP?r? C?Ui ?vl • City
?Q
ecbon o. Township Name or No. R??Be No. Counry
OccuOani IPNINTI
a /'l-?d Phane No.
4/ Sc-?, - ? I (:?, -7
Power $upplier Yl _ L =
LJGC.• Atldress
Elecvic C&rhtractor?ft om0any N e)
00 o.a'1 ???'?. ?J'1 L. Contracmr's License No.
D`- l 9 S=
Mailinp tldr ss IContrector or Owner Making Instailationl
7L?,-ZS ? l3
Authori Sigoa?ure Con[rac Owner MakinB Installation) one Number/ /
qU' C?'E (cV
MINNESOTA STATE BOARD OF ELECTqICITV THIS INSPECTION qEQUEST WILL NOT
Gri90s•MidweV Bldg. - Room N-197 BE qCCEPTED BY THE STATE BOAND
1827 Universitv Ave.. St. Peul, MN SStOC UNLESS PflOPEN INSPECTION FEE IS
Phone (6121642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION 0 es-ooooi-os
1 See inatruetions 10r completiny this form on beck of Yellaw cooV.
r `-p-o "JC" Below Work Coveied by This Request
MwJAAnI Reo.l Tvoa oi BuilUinn 1 Aootiancea Wirotl i Equiument Wired I
ex
p Fee ServiceEMrenee5lze H fee fexders/Su?laedera u fee Ci?cuita
U to 200 Am s 0 to 30 Am s 0 t? 30 Am
Above 200 qmps. 31 to 100 Amps 31 to 700 A
Swimmin Pool Above 100_AmpS Above 100_/>m '
Transiormers ?rigation Booms Partial."Olher Fee
Signs Specialinspection TOT FEE
errerks /O
i-'E, n/
i. tni"Ele-cvicel
Inspector, hareby
certily that Ihe above
ina0ection has been
maao.
repuent
?jj//REQUEST FOR ELECTRICAL INSPECTION
? 9E!'?siniclldns for mmpletirg Riis lortn on beck ol yelbw wpy,
r- 14722 "X" Below Work Covered by This Request
e Add- Rep. TypeofBuiltling AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric HeaNng
Apt. Building Dryer Other (Spec'rfy)
Comm./lndustrial Fumace
Fartn Air Conditioner
Olher (speCXy) Conhaclw6 Remerks:
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Ciraits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above200_Amps Abovelo0_Amps
Signs Inspector§ use onry: TOTAL .
IrrigationBOOms ?In• 20.50
Special Inspection
AIarMCommunication
Other Fee ?
I, the Electrical Inspector, hereby
certity that the above inspection has
been made. RougRin
.?c
F;nei
? oat ?
oa
,
OFFICE USE ONLY
This requesl witl 18 monihs fmm
14? ?,
? 722 ? `
? .
?
av
Requesl Date
August 30, 1989 Fire No. Pough-in Inspection
Requiretl?
xYes ? N.
OReatlyNOw X WIINOfirylnapecla
When Ready.?
IK licensed contrector ? owner hereby request inspection of above electrical work at:
Job Addreas (Sbaet, Boz or Route No.)
41 Ciry
SeGbn No. awnship Na
No. Range No. County
OccuPani (PRINT) Phone No.
Power SuppliBr Aydress
Elenriral niraclw (Campany Neme) Conhacmr§ Licanse No.
Maiting AdNeFs (COnirada or er ing n e atbn
Aulhonzed 'g re tr or ner a"ng nsta tion l Pho-ne Num r
MINNESQ?fA STATE 90AqD OF ELECTpICRY THIS INSPECfION FEQUEST WILL NOT
Gtlgga-lAlErray Blag. - paom 5179 BE ACCEPTED BYTHE STA7E BOqRD
1821 Univenlry Ave., St. Peul, MN 55101 UNLESS PROPEfl INSPECTION FEE IS
Phone (612) 662-0800 ENCLOSEO.
- & ao? 9a-
4 5
8
? ?`s°°
J
2
??
Repuesl Date ?
? Fir No. Rougn-in Inspeciion
ReQuiretl? .
Reatly Now C Will Notily Inspeclor
Wh
R
tl
7
s,7 G Ve4 o en
ea
y
Icensed coniractor O owner hereby request inspection ot above electrical work at
Aob Adtlress (Slreet Box or Rovte No )
6 r7a o.// 110Q? Ciry
CA4I ?
Sedion No. Township Name or No. Range No. Counly
A
Occupant(PRIN Phpne No.
0
Power ppher -
., 4?5-10c.4-,c Atltlress
40rxo- o-oo ''? Jt 1?4
Erecvic mracior ICOmp ny? Convaclors License No.
eAOOa33
MaAin9 Aa pess (C.On7lrzclor or Owner Mek' Inslall uon) A??? ?? / ?,?>
Amho?izetl S re ICOnlracronOwner M'g Ins?allaiion?
,??? -G??,?-- - - --- Phone NumDer
9a- a42
MINNESOTA STATE BOARp OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-MiEway Bbg. - Room S173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Vaul, MN 55106 IINLESS PROPEF INSPECTION FEE IS
Plwne (612) 642-OB00 ENCLOSED.
REQUEST FQR ELECTRICAL INSPECTION ee-ooom??a
^ ?+
J?? ?? See instf?clions br>completing ihis form on back W yeilow copy. ?/O6".J?/ ]
??,
"X" Below Work Covered bY Thrs Re9uest ;V,?' y'
e d Repr TypeofBUilding AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heatin9
Apt. Builtling Dryer Other (Specify)
Comm./Indus[rial jl'urnace
Farm Air Conditioner
Olher (spentyj n actork flemarks:
Compufe Inspection Fee Below: -
# Other Fee # ServiceEnlranceSize Fee S Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers A6ove 200 _ Amps Above 100 _ Amps
SigpS Inspector5 Use Only: TOTA
Irrigation Booms ??
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE DR ONNECTED IF NOT
Other Fee COMPLETED WRHIN 18 MONTHS.
I, the Elecirical Inspector, hareby Rough-in
f oate
certify that ihe above inspection has
been made.
F;nai 713 o
OFFICE USE ONLY
Tnis reQUest voltl 1B montns imm
2007 RESIDENTIAL MECHANICAL rExMiT nrrLicaTroN
City Of Eagan
3830 Pitot I{nob Road, Eagan MN 55122
' Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes(condos when permits are required for cach unit
Datc 9_ 0-7
Site Address?2? ?, U V?.?L?11 L 1 ?? Unit #
12
?
) 1 Cl 'felephone # ( ?lc` ) &7 67-
.e.
Property Owner
G Y IC
L ,
z
TtIE SNELUN6 CGMFrWY, INC.
Contractor 1404 CO?ORDIA
ST. PdAJI, MN 55104
StrectAddress 651-646- 73E1 City
State Zip Telep6one# ( )
Bond #: a j 4-13 Expires:
Thc Applicant is _ Owner ?
Contractor _.Otber_ ,....
Fire repair (replace burned out appliances, duchvork, etc.) : S 90.00 -
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to existing dwelling wtit $ 50.00
4- furnace _Additional _Replacemenl _ New
air exchanger
air conditioner
_ heat pump
other ( Iul
?EP 0 6 2007 '
$ .50
State Sm'charge
57)
Total
I hereby apply for a Residential Mechanica] Pernut and acknowledge tha[ Ilie information is complefe and accurate; tliat the work will'
be in confornzance with tlie ordinances and codes of [he City of Eagan and witli the Meclianicai Codes, that I understand fUis is not a
permit, but only an application for a permit, and work is not to start without atatthe work will be in accordance with tlie
approved plan in the case of work which requires a review and approval of pla
Nh ? ? l{?? ?P ? ":y -
Applican 's Pnnted Naine App cant's Sign ire
.
S%R 1 C? RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Canstruction Reauirements RemodeVReoair Reauiremenls
3 registefed site surveys shaxing sq. ft of lot sq. ft of house; and all roofed areas 2 apies of plan
(20qo maximum lot coverage allaxed) 7 set of Eneqy Calculatlorro for heated additions
2 mpies of plan sfwwing beam & wiiMow sizes; poured found design, etc. 1 site survey for addNans 8 decks
1 set of Eneigy Calculatlons AddAion -iMicate ifonsite septic system
3 copies of Tree Pmservation Pkn if lot pWtted after 111193
Rim Joist Defail Options selection sheet (bldgs wNh 3 or less units
?
.
_
G\?
O(fice Use Oniv
Cert of Suney Rerd
Tree Pres Plan Recd
Tree Pres Not Reqd
_ On-site Septic System
5?5 CCIIA
Date OI` / ZZ / Qi Construction Cost (O 1 600
Site Address (Q77 ( j ?ie? ?jt? SVZ oc(') ?GGain itM f? 5-5- 1 z 3 UniUSte #
Description of Work exi sf'14 cQccl Cov:rAv..?A "Lt,J Lx l 8' AccL cxv,3 q-vcY
Multi-Family Bldg _ Y?j N Fireplace(s) X_ 0 2
ProperTyOwner ?G Jdi, h0\t1e Telephone#((ps1) t0Bg-g228
Contractor TNT ` Cou?'<<c??o?n Ci-eYilt?S t+2c 2o3Ny-73?Ps
C-ic- *=
Address '72G 1 (3i(4Cf L.<.f n
City tl?nccwto..?
State mN Zip s,?b(eP, Telephooe #((os( ) 3Z1 -q122-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Vendlation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Suhmitted Submitted
• Energy Envelope Calwlafions Submitted
Licensed Plumber
Mechanical Coniractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
nr• ..t. . _ .. I?
I hereby apply for a Residential Building Permit and acknowledge that the informatioYAs?c_gm*fe-aId_aeemiate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
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.
1 r,1Q? (? uuQS
Applic t's Printed Name
(a-„d -- ?-
Appl' t's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fifeplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 04 02-plex ? 10 OS-plex ;K 18 Deck ;K- 23 Porch (screenJgazebo)
0 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 MiSC011aneoUS
Work Types
.. A
O 30 AccessoryBldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
)< 32 AddiSon ? 36 Move Bldg. ? 42 Demolish (Foundatlon) ? 45 Fire Repair
? 33 AlteraGon ? 37 Demolish (Bldg)' ? 43 Reroof 0 46 Windows/Doors
? 34 ReplaCement •Demolition (Entire Bltlg) - Give PCA handout to applicant
Valuation 17?J Occupancy MC/ES System
Census Code J:It 12? Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const _ 14 /tJ Width
Foo[ings (new bldg)
? Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing- -
_ F'ueplace _ R.I. Air Test _ Final
Insulation
REQUIRED INSPECTIONS
FinaVC.O.
X FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool Ftgs Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review -
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
c?vr-IVL ro
10i'mv?
?6ucL
?
?? ? 2?
5 ?aa ?
RESIDENTIAL BUII.DING
Permit Applicatlon
City Of Esgan
3530 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
NewConsWctlmReauiramenb RemodeNieoairReauirements OlficeUseOnN
3 regiete2d site wrveys shawirg sq. R of kt sq. R of Iause; and II roofed areas 2 mpies af plan _ Cert of Survey Reod
(20% meximum lot mverage albwed) 1 sel ol Eneryy Cakulatioro fw Ietad addidons Trae Pres Plan Reod
2 mpies of plen slawinp 6eam & wintlow a¢es; poured fountl design, etc. t sile wivey for additloro 8 dedn _ Tree Prm Not Reqd
lsetafEnergyCakulatlons Add'Nan-'aMcateAansdeseqksystem _On-siteSe?SysOem
3 copies of Tree Preservation Plen fi bt plemed a1Oer 717193
Rlm Joist Oetail OpEOns selectlon street (Mdgs wiN 3 w Ims unib
Date D 3 Coastruction Cost (O ? ? ? " J?
Site Address (o -7 ;k, (7 V L'1-1-I f LL QZ A,0 Unit/Ste #
Descripdon of M'ork 0? ? lj J\ N\-( ?
Mu1N-Fatnily Bldg _ Y X N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 62t?? ( y'7' 1 tJ Telephone #
Contractor N01'f11818? FImA 'mn-8111
I
Address 8nF-
,
vbnPly th9 BBSf"
City
State ?? ??ip Telep6one # ( )
COMPLETE THIS AREA ONLY IF CON8TRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateearv 1 Minnesoffi Rules 7672
Energy Code Category
. Residenual Ventllatlon Category t Worksheet • New Energy Code woAcsheet
(J wbmission type) Submiked Submitted
, . • Energy Envabpe Calalatlons Submiried
Licensed Plumber ?? I1 y?l? 1 i? Telephone #(
U 1
Mechanical Contractor n?li(?ti' ? 5 Z??3 I Telephone #(
SeweNwater Contractor 1- J Telephone #(
I hereby apply for a Residential Building Pernut and acknowledge that the information is complete and accurate;
that ihe work will be in confomtance with the ordinances and codes of the City of Eagan and the State of MN
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
appmval ofplans.
Sww , ,
?
Appiicant's 'nted Name ApplicanYs Signa
OFFICE USE ONLY
Sub Types
? 01 Foundatlon ? 07 05-plex ? 13 18-plex O 20 Pool
O 02 SF Dwelling 0 08 06-plex ? 16 Firepiace ? 21 Porch (3-sea.)
?-03 01 of_plex O 09 07-plex ? 17 Garage ? 22 ParcNAddn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo)
0 05 03-piex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04plex O 12 12-plex Plbp_Yor_ N 0 25 Miscellaneous
Work Types
? 31 New
O 32 Addition
? 33 Alteration
? 34 Replacement
Valuatlon
Census Code
SAC Units
Nbr. of Units
Nbr, of Bldgs
Type of Const
O 30 Hccessory Bldc
0 31 Exl. Alt - Multi
? 33 ExL Alt - SF
C3 36 Multi Misc.
Siding
Fire Repair
V1lindoyvslDoors
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
_ Footings (new bldg)
_ Footings(dcck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Finat
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRGD urSFEC fIOPTS
FinallC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Smne
_ Windows (new/replacement)
_ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Pertnit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
O 35 IM Improvement ? 38 Demolish (Interior) O 44
O 36 Move Bldg. O. 42 DemoGsh (Foundation) ? 45
O 37 Demolfsh (Bldg)• O 43 Reroof 0 46
'Damditlon (EMire Bldg) • Give PCA handout to applieant
, t .
Occupancy MClES System _
Zoning City Water
PERMIT
--k CP1TYbF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
ck2qz4G
PERMITTYPE: euzLpznG
Permit Num6er: 024102
Date Issued: 0 7 J 13 / 9 4
SITE ADDRESS:
672 OVERHILL RD
LOT: 2 BLOCK: 1
OVERHILL FARM 2ND
P.I.N.: 10-56151-020-01
DESCRIPTION:
Building.,Permit Type
r/Building Woar_\ Type
J ,
? t 1
I ?
?.-
,,. ,
SEPARA7E PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
,-
.1r; r'
QIt?
REMARKS:
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
BASEMENT FINISH
ALTERATION
CONTRACTOR:
KROGH CONST
2836 29TH
MINNEAPOIIS
(612) 722-6509
- Applicant - ST. LIC
17226509 0003102
AVE S
MN 55406
I
OWNER:
BOLIN BARRY
672 OVERWILL RD
EA6AN MN
(612)688-8228
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 Mn.
Statutes and City ofi Eagan Ordinances.
APPLI T/PE ITEE SIGNAT
-fim ??l M
ISSl1E0 : SI ATUR
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: Lo r:
672 OVERHILL RD
OVERHILL FARM 2ND
PERMIT SUBTYPE:
BAS£MENT FINT5H
PERMIT TYPE
Permit Number:
Date Issued:
2 BLOCK: 1 '4PPLICANT:
KROGN CONST
(612) 722-6509
TYPE OF WORK:
suILozNG
024102
07/13/94
ALTERATION
INSPECTION
FRAMZNG DA .
INSULATION ..
ROU6H IN PLB6 FINAL
REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
?
F-
? J
i. ,? . , . ... ,
i- .
?
14101
CITY OF EAGAN
1994 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 plan ,ifiGEIVED
specifications, 1 copy of energy calcs.
J I I i 1 1'?^!?
Penalty applies: 1) when permit is typed, but not picked up by last ?kipg? Df.mon h
in which request is made, 2) address is changed or 3) lot change i ?2Zf"`bri mit
is issued.
Date Valu tion of work r?{ Q S?
Site Address:6
STREET SUITE k
Tenant Name: (commercial anly)
LOT BLOCK ? SUBD. ? ?)jVj j ? P.I.D. #
Descri tion of work:
The applicant is: ? Owner E'Contractor ? Other (Oescribe)
Name r f' Q-7tV Phone 68t g? r'? 1
Property LAST FIRST
Owner Address 6 7 cP
STREET STE 1t
City State Zip
Company Phone a- 6S o7
Contractor Address License # 9> ° -:Z Exp.
o?
City ,/,?9? State Zip??'W 6
Company Phone
Architect/
Engineer Name Registration #
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 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. El 10 Multi. Add'1. O 15 Deck
WORK TYPE
? 31 New Lf 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? .Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint 5q. ft.
On-site well
On-site sewage
Building
Variance
? Footing
L] Final
,E9 Framing
? Draintile
?a Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
vatuac; m:
701
El 16 Basement Finish
? ll Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc
? 20 Public Facilit
? 21 Miscellaneous
? 37 Demolish
Y
MWCC System
City Water
PRV Required
Booster Pump
fire Sprinkler
Census Code y3 v
SAC Code
Census Bldg ?
Census Unit
Assessments
SAC Y
SAC Units
CITY OF EAGAN
3830 PILOT RNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT #
DATE: Co
jgSiDg$1M YLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------------------------------------
WORK DESCRIPTION
NEW CONST _
ADD ON 4(L_
REPAIR _
OWNER NAME:.CJ'C/r" / `JO.Ci?J
SITE ADDRESS: '55z
LOT: .2 BLOCK L SUBD. ?ilrl?X r?t?t,
INSTALLER: /`1iL'5.EK ? -2
ADDRESS;??'Of /4
ci??k.?5TJ zir:?'V/
PHONE
? . //
OF
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
_ KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
_ HOT TUB/SPA 3.00
_ WATER HEATER 3.00
_ FLOOR DRAIN 3.00
GAS PIPING OUT.
_ (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00 3'ed
_ PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00
SUBTOTAL $ ST. SURCHARGE .50
TOTAL: S ?'??
PLEASE COMPLETE THIS PORTION FOR ALL COffi4ERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WNEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.SO FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL:
$
( S I GNATIIRE )
? . ;
SIIiGLE FAMILY DAELLIBGS
2 SETS OF PLARS
3 REGISTERED SITE SDAP&LS
1 38T OF EAERGS CALCS.
1989 BOILDING PERHIT APPLICATIOA
CITY OF EAGAN
1404946
D
2 SETS OF PLlN3
6EGISTfiRED SI7E 3IIA9E13 -
(CHEC% YIlH HLDG DIV.)
1 Sgf OF EMMBG! CALCS.
COl4'ERCIAL
2 SETS OF IRCHISECTURAL
8 STSOCTQltAL PLAN3
1 SET OF SPECIFICATIONS
1 3ET OF EAERGT ClLCS.
MTLTIYLE Di1ELL2NGS AENlAL QNITS P9H SALE OIRTS 0 OF UNITS
iOTEt IDDAESSES FOH CORNER L6TS - CO1PfRBCPOA/HOMEOiiNER !lDST DESIG8?iE iiHICH ILDDHESS
IS DESIRED. HO CH9NGFS iTII.L BE ILLOftED OHCE HIIA.DIHG PEAMIT L4 ISSOED..
SENER 3 iiATER PERMIT FEES l9D lCCOBNT DEPaSIT t863 iTII.L 88 IPCLIIDED MITH =HE HDILDINfi
PEEKTT FEE. PROCFSSING TIIM FOR SEWEA ABD ItATER PEAMI?3 I5 TiiO DAYS OICE ! PEAMIT HAS
BEEN COlPLETED IHDICATIAG • LICEN3ED PLtllBER.
PENALTY IPPLIFS HHENs PEHMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CH9NGE IS REQUESTED ONCE PERMIT IS ISSIIED.
To Be Used For: ValuaLion: Date:
Site Address 67? OVtIt1VlLL RD,
Lot z Block I
Parcel/Sub dvaRHiu r'rar-,,^ 2_Nn Annr
Ormer ??fLQRG. 130 ?/ '%/
/ ?
ladress 4 7 ? Ov-e'A, kA,
City/Zip Code
Phone 42 d ,? ? 7 Z
Coatractor Gus r??/'c? ??''t
Address-2//Sa C-7l-E197W dt ^`
Citp/Zip Code A/
Phone !!?--3,) -721
Arch./Engr.
Address
City/Zip Code
1 ?? °
Oceupaney
Zoning
Aetual Const
Allowable
1 of stories
Length
Depth
S.F. Total
Footprint S.F.
On aite aewage
On aiEe well _
MNCC System _
,City xater _
?fAV reguired _
Hooster Pump _
LPPAOYAIS
Planner _
Couneil
Bldg. Off.
Varianee
FEF.S
Bldg. Permit 36, Sureharge 1,0
o
Plan Revierr
SAC, City
SAC, MWCC
Water Conn
ilater Meter
Acet. Deposit
S/A Permit
S/ii Surcharge
Treatment P1.
tioad Uait
Park Ded.
Gopies D ?
SQBTOTiL
Penalty
t0lAL 3`7 . 50
Phone #
!
` ? ? ?
?
?
?
?II
? I
V ?
? ?) C
?
?
y-1
a
1gYlhOW
rr4, N
R D
s
gY -
?.
DATE -
?
i
?• *
w DZ3
??
402•OU+
' 35•5U+
201 -00+
625•OUi.
5L5•00+
67•00+
307•OU+
ip0•UU+
29340•?O k
? N 1987 BQZLDING PERMIT APPL CI ATION - CITY OF SAG9N
SINGLE FAMILY DWELLINGS
I9CLQDE 2 SSIS OF PL9HS, 3 CERTIFICAT6S OF SOEVEY, 1 SST OF ENERGY CALCULATIOHS
HOYE: 9DDRESSES FOE CORNEE LOTS - CONTRACTOR/HOHEOWNER HOST DESIGHATE AHZCH ADDRfiSS
IS DESIRED. NO CHANGfiS AILL HE ALLOWSD ONCS BDILDING PERMIT IS ISSOSD.
HQLTIPLE DHELLINGS - AFSIDENTIAL RENTAL DPITS FOR S9LE OHITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TS OF SDRVEY - CHECB WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COP4M6RCZAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 L9NDSCAPE BOND
To Be Used For: -5 X Valuation: ? (r 000 Date: ?- /2 -J?j
Site Address (?'? oot U?e?c?e:?Q(J?G
Lot Block a ?
Parcel/Sub
Owner ?
Address
City/Zip Code
Phone
Contractor ..G( ?
Address hz-'
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code _
Phone U
On Site Sewage_ Occupancy Q. 3
MWCC System Zoning 2I
On Site Well Type of Const
City Water ? (9etual) ?
(Allowable) ?
# of Stories
Length ?L
Depth 4Z
S.F. Total
Footprint S.F.
APPROV9I.S FEES
Assessments a Permit 40 Z•
Water/Sewer Surcharge 3S,sc
Police Plan Review ZO I.
Fire SAC, City I o0.
Engr SAC, MWCC SZS•
Planner Water Conn S 2 5,
Council Water Meter (01.
Bldg Off Road Unit 750S
APC Treatment P1 180.
Variance Parks
Copies
TOT9L .?,
2? ?4 z 2? 5a
,z& 7? 2? ` " Co Z ? x (2 - ??d8
,
.
?7o o Z4
__ _____ --- . _ _____.?
*AT?': PAYMFTlf OF EM AT TIME pF X
APPLICATION DOES NC7P QOTSTITU'lE *
APPROVAL OF PIItNIIT, ?
*
INSPDC,TION OF SEWNR ANID/OR FII,1ER
TTLS'TAi.iATTQN$ F7II.L NCYP SE SQHE9- *
ULID i7[JTIL PERNIIT
HAS BEE4 ?
.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
APPROVID. r
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF E7QSTING STRCCiS.R2E. Dp,TE OF ORIGINAL HL'ILDIM PIIlMIT ISSCANCE: '
(Mon Year)
PRFSENf ZONZNG/PROPOSID [75E:
? CONP4ERCIAL/RETAIL/OFFICE
Q IDIIN.'SIRIAL
rl INSTI1i'TIONAL/GOVEE21?,`NT
R-1 SINGLE FAMILY
Q R-2 DLTLEX (1wo CTnits)
? R-3 ZOWNiOUSE (Three + Units) ( L?nits)
? R-4 APARTMENT/COmIDOMINIUM ( Units)
2) ?
ADDRESS:
CITY, STATE. 2IP:
PxorE: tf5 ? _ X9 ?
. 3)
ruuME:
P.DDRFSS:
i CITY, STATE, 2IP'
PHONE:
MASTER LICENSE# p2IO7 ?YL
4)
•?• ? i?•
NA?Z:
ADDRESS:
CITY, STATE, 2IP:
PHONE:
active
FScpired
Not recorded
Sta f-Initial
•5) 577111 u• ? i a• • ?+• : z • ?? - a?
fl-eaqNEHIorr zv ciTr sEWM JD:??T?N To czTSC caATEa a oTHE??
6)
PLEASE HOLD APPROVID PERMIT FOR PICK-[JP BY ONE OF ABdVE
PLEASE MAIL APPROVID PERMIT TO 1, 2,(1 4, ABOVE
? n 1_ ' (Circle one)
FOR CITY USE ONLY
PERMIT # ISSCED
Pd w/Bldg. Permit FEES:
$ $
$ $
$ $
$ $
$ $
$ ? S ' GYD $
$ $
$ $
$ cyo $
S $
$ $
$ $
$ $
$ $
$ $
$ 0 LI) $
SEWER PERMIT (INCLODE SIIRCHARGE)
WATER PERMIT (INCLUDE SORCHARGE) ..
WATER METER/COPPERHORN/OC'TSIDE READER
WATER TAP (INCLODE CORPORATION STOP)
SEWER TAP
ACCOONT DEPOSIT - SEWER
ACCOIINT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATERAL BENEFIT/TRUNK SEWER
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SLRCHARGE
OTHER:
TOTAL
_ ??.5? ?
RE?CEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXEAVATION IN PC'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSL'ED BY THE ENGINEERI[VG
NO DIVISION: LIST AS A CONDITION.
SUBJECT TO THE FOLLOWIIiG CbNDITZONS:
J
APPROVED BY:
w7-,
TITLE:
DATE: ? ??i41
7
RECORD OF COMPLAINT
DATE: y- z Y-g_ 5
COMPL1lINT TAKEN BY: ?Q
NAME: ? 2 f?y e o( l ia
ADDRESS: (o 9? Over il%(JZr?
PHONE N0. :(? 8g" ? Z z? J w z
COMPL$INT:
0?-?
ACTION TAKEN: t
) y
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2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan 1
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 C? ."-a • 2?3??
New ConsWction Reaulrements RemodellRevairReaui2menk Otfice Use Onlv
3 registered site surveys showing sq. ft. of lat, sq. R. of house; and all roofed areas 2 wples of plan Cert of Survey Recd _ Y_ N
(20°b maxMum lot coverage allowed) i set of Energy Calculations for healed add@ions Tree Pres PIanRecd _ Y_ N.
2 copies o( plan showing beam & window sizes; poured found design, etc. t site survey for add'Aions 8 decks Tree Pres Required . _ Y_ N
1 sel of Energy Calculations Add'dion - irMkate 'rf on-sife septk sysfem Onstte Septic System _ Y_ N
3 copies of Tree P2servation Plan H lot pladed after 711193
Rim Joist DefaB Options seleGion sheet (buUdirgs wBh 3 or less units)
Date ? /
Site Address ? / Canstruction Cost
?//?/?P/???/ / /?Oa//'? UoiUSte #
Description of Work
Multi-Family Bidg _ Y.? N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # el ) ?JJ " "/?T(G
Contractor WIIIdOW COr?mls Of MInneSOICI UC.
Address
State 990 Lone Oclk
SuRe 114 Zip
E on, MN City
Telephone # (
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
. Residential Ventilation Category 1 Worksheet
(J submission type) Submitted
. Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a masTer plan8
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; ffiat the work will be 'n accordance with the approve lan in the case of wo hich requires a review and
approv 1 of plans.
m rnu,? ?-
ApplicanYs Printed Name 4 ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-piex 11 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Founda6on ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitlon (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings(deck) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
?' E Y O R' S C E R T I F ICA T E GRAND OAKS UEVELOPMENT C0. #444
? ? - -
13014D
OVERHILL ?
8=10°58,59° _ N88053'09"W TC9S3?g) ?^ I
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Is
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91.57
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? „ ?45Z.o)
? -?? N7804d
/ •- f.-??:;'?;
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--?-- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCII = 30 FEET
• UENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 9St,•3 FEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = y S 3,5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 9?f?l FEET
i fIEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. TNAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY Of T}IE DOUNUARIES OF:
Lot 2, Block 1, OVEP,HILL F{IRPiS SECONC ADDITION, according to
the recorded plat thereof, Dakota County, Minnesota.
AND OF TFIE LOCATION OF A PROPOSED DUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMEMTS.
OR ENCROACIIMFNTS, IF ANY, TIiEREON. AS SURVEYED BY ME, OR UNDER t1Y DIRECT SUPERVISION,
TI115 974 D/IY OF MAecGI , 1987.
S.IGNED: J?ME? R HILL, INC.
NOTE: GRADES SHOWN WERE TAKEN FROM
THE GRADING PLAN FOR OVERHILL FARM
SECOND ADDITION, PREPAREDY BY MINNESOTA ay:
VALLEY SURVEYORS INC., LAST DATED HIIROLO C. PETERSUN, LAPID SURUEYOR
MARCH 28, 1986. PIINNESOTR LICENSE N0: 12294
f'ROJECT NO.
87135
FIIE NO.
' FO.LDER
BOOK / PAOE JqMES R. HILL, INC.
Planners / Eng(neers / Surveyors
8200 Humboldt Avanue South
Bloolnington, Mn. 55431 812-884-3029
54.
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I S UttV E Y O R'S C E R T I F ICA T E GRAND OAKS DEVELOPMEN-f C0. #, 444
? I -
OVERHILL ? ROAD M
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PROPOSED
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-?- DENOTES PROPOSED SURFACE DRAINA6E
O DENOTES IRON MONUMENT SET SCALE: 1 INCIi = 30
• OENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 9 gc,.3
.XOD0.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = q S 3,5?
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 1.."?
I HEREBY CERTIFY TO GRAND OAKS OEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION Of A SURVEY OF THE DOUNUARIES OF:
Lot 2, Block 1, OVEP.HILL fARF15 SECONC ADDITION, according to
the recorded plat thereof, Dakota County, Minnesota.
FEET
FEET
FEET
FEET
AND Of TIIE LOCATION OF Fl PROP05ED DUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS,
OR ENCROACfIMENTS, IF ANY, TIIEREON. AS SURVEYED 8Y ME, OR UNDER h7Y DIRECT SUPERVISION,
TIfIS 9Tt+ DAY OF MA¢cU , 1987.
S.IGNED: C??ME? R HILL, INC.
NOTE: GRADES SHOWN WERE TAKEN FROM /
THE GRADING PLAN FOR OVERHILL FARM ???
SECOND ADDITION, PREPAREDY BY MINNESOTA gy; 'r
VALLEY SURVEYORS INC., LAST DATED HAROLD C. PETERSUN, LAND SURVEYOR
MARCH 28, 1966. • ? MINNESOTA LICENSE ND: 12294
PROJECT NO. BOOK / PA(3E JAMES R. HILL, INC.
87135
Planners / Engtneers / Surveyors
FILE NO. •
8200 Humboldt Avenue South
' FOLDER Bloolnln8ton,Mn. 56431 e12-e84-302e
40j°
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MAY 292012
r
Use BLUE or BLACK Ink
For Office Use
f DVrS7
I
Permit #:
Permit Fee: 122.61
Date Received: 41.
Staff:
�/�
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: X(2 Ati
23 Site Address: 472- 6vexli (( Rel Unit #:
Name: PL -j, Vey
TYPE,OF WORK
Address / City / Zip: ' (2 OVA' t,L; t l
Applicant is: %<' Owner Contractor
Description of work: z 7cij4SiOt +6 P 15+iu j C
Construction Cost: 4721-6)X11
Phone: ‘I2 C70 .-7,6ec-
iLIAI 55723
Multi -Family Building: (Yes / No >< )
CONTRACTOR
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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 documenfs that you submit are considered to be public information P,ortionsof
the information'may be classified as non-public you' provide specific reasons;#hat would permit the Cityrto
conclude thatthey 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.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.
Exterio k a j d by a building permit issued in accordance with the Minnesota Stat
days
days of�rmi e.
e must be completed within 180
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi 4. Deck
01 of _ Plex Lower Level
Accessory Building
WORK TYPES
New
/' Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
Interior Improvement
Move Building
Fire Repair
Repair
62
(25%_ 100%)C )
Census Code
# of Units
# of Buildings
Type of Construction
V6
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: Rough In Air Test
Insulation
Sheathing
Sheetrock
Reviewed By:
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
p c4
wit/2-027
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
?!', Final / No C.O. Required
�" HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: Footings Backfill Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
)(-(
2.0 v0
Page 2 of 3
fUVEYQR'S CERTIFICATE.
_,------- OVERHILL
ps:10058'59'
3 g ?0.1 I R=365.73 --
qs
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W
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•
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(000.0)
0
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GRAND OAKS DEVELOPMENT CO. #444
X72 (Dvetk )i 4
8 ROAD
N88°53'O9"W
- 2: 38 — _ 154•V
0
(1 to 0 3 (`1
—1E.—��-- — —
o IX
, X3.0
0.O•
/(754.0
6A 1'N
PROPOSED v
'41 HOUSE
N GAR.
4.0
0
) ^22.75 -�
52.0
(956.0)
LOT
Z.55
1,
1 r1
r‘r
2
t 5
DRAINAGE INCA 16 UT/Ur. E4SE'mENr<'' 5
91.57
1)
N 7804210 .1,14
r.silsiw
.DENOTES PROPOSED SURFACE DRAINAGE
DENOTES IRON MONUMENT SET
DENOTES IRON MONUMENT FOUND
DENOTES EXISTING ELEVATION
DENOTES PROPOSED ELEVATION
rn
l0
1
PiZ pa ,gA 4,/X/eAEc,06
AekirAv
(45"z. 0)
SCALE: 1 INCH a 30
PROPOSED GARAGE FLOOR = 9 5G,•
PROPOSED LOWEST FLOOR z q S 5,5
PROPOSED TOP OF BLOCK = g to.1
.,
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT CO. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 2, Block 1, OVERHILL FARMS SECOND ADDITION, according to
the recorded plat thereof, Dakota County, Minnesota.
Tz-
FEET
FEET
FEET
FEET
AND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS.
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
TIIIS 1Ti4 DAY OF Mtal c.►f , 1987.
-NOTE: GRADES SHOWN WERE TAKEN FROM '
THE GRADING PLAN FOR OVERHILL FARM
SECOND ADDITION, PREPAREDY BY MINNESOTA
VALLEY SURVEYORS INC., LAST DATED
MARCH 28, 1986.
S,IGNED:
BY:
E / HILL, INC.
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NO: 12294
PROJECT NO.
87135
FILE NO,
FOLDER
BOOK / PAGE
JAMES R. HILL, INC,
Planners / Engineers / Surveyors
8200 Humboldt Avenue South
Bloolnington, Mn. 56431 612-884-3028
To: Page 2 of 7 2013-09-24 13:14:11 (GMT) 17344680105 From: Harvey P-K
Use BLUE or BLACK Ink
ForCiffioe Use 51
0
City of EakdR Permit Permit Fee: A) "
3830 Pilot Knob Road
Eagan MN 55122 Date..Received: 9/2416
Phone: (651) 675-5675 t I
Fax; (651) 675-56S4 I Staff: I
1 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: °°~Vta'~l~` fi,~,i~P~~I 5S 02~ Unit
Name. Phone.
Resident/
Owner ' Address/ City/ Zip: 2 QI~,h r~~ ~,eu Kk, 5512
Applicant is: Owner l~ Contractors
Description of work: 1~ t~ Il. tt~ ~e.~ I C rA."S2 -tt
Type of Work
Construction Cost Multi-Family Building. (lies _ 1 No
Company'. lk. Pk 1~041N. , Contact.
4-1
Address: 19 50 tom. City. kJ 2N7~ s
Contractor 2 (f r 1 If ~r l_ C}
O E
State: C~51 Zip: Ga k1 1 Phone: 7 3 4 ~ Q Q - f 4 I 1 j
)
6LS-g2 l'L License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) W
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
3. In the last 42 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
x
Yes No If.yes, date and address of master plan:
F
Licensed Plumber. Phone- t
Mechanical Contractor: Phone:
f 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. tkmrw odnheistateoriecall.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 bya building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of perinit issuance.
Applicant's Pri ted Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use I
^u
t l-
I ) I
Permitt:
City Of Ea no
I Permit Fee l
3830 Pilot Knob Road I t
Eagan MN 55122 j Date Received I
I
Phone: (651):675-5675
Fax., .(651) 675-5694 I :Staff;
t
- - - - - - - - - - - -
21013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: " t Site Address 6T1 Q VL-W,~k `M\ G t- . (Al'- Unit # µ
t( Vpo Phone: Name:
Resident/
owner Address i City i zip....__. 2.•~ t.~1.,,,ju~ ? t?r~rarB~ 1"~r- i1~ K
_fipplicantts:. _ owner Contractor _
y µa
4 Type of Work Description ofwork: o"c o-s'i)!s'~~ _'•Nt ~...,.~.7 .rta+~c~ Ii7.t3
S 5
€ Construction Cost. _ Yw o. Multi Family Building (Yes No F Fw W ^w y
i iryCompany ~ ( ~ t3!f 4r-`1 Contact t 15Y<)-Z,t
' t
Address: ~ D so ~J L4)41 City: `xZf`
Contractor
So, -Zvi ,JG -ILO Lire
State: lip. Phone:
t
CLS 'fib,
Lead Certificate j
a License#.
,.•.w..~,_,,.,..,s.;;:.:~ ~..x~,~m v,~,,...„«~,.~,,~..,.~ ...,..r~„ a,_,...._...~.n.._..,M....,.__...~.W __.......r.._.~....._a..~,.,..._M~...•.~_~W..._,~,__o ,.~,~~,¢~~.a,Q,.~..
~
If the project is exempt from lead certification, please explain why. (see Page 3 for additional information)
r
COMPLETE THIS-AREA ONLY IF CONSTRUCTING A NEW BUILDING
I
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a.master plan? x
s _Yes _No If yes, date.and address of master plan
t
I Licensed Plumber: Phone:
Mechanical Contractor: Phone:
"s
s.
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
v.. mu~ rv ~~~y conclude that they are trade secrets a XU~. w~_.,.:u,z
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.ceceive locates of underground utilities. al+nnnr:oapherstateonecall.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.
J U\"
x X ~
Applicant's Print d Name Applicant's Signature
Page 1 of S
EAGANFor Office Use I C G
% tt /..'C VS
�. °� � „� :::::
...._
.--0
: /6? -
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-56751 TDD: (651)454-85351 FAX: (651)675-5694 Staff:
buildinginspections aC�citvofeagan.cam L
2018 RESIDENTIAL BUIL.DIN G/ PEMIT APPLICATION
Date: Z-Cd( Site Address: 6 77Z-- c `^/"J I"l 2-..4) Unit#:
Name: Sc^wl 4 /!pi/ l�S S Phone:
Resident/ / ,/� 1 /� 1
Owner Address/City/Zip: v 7z. 0 "`` c& ����// i CSIz3
Applicant is: Owner Contractor
s, Type of Work Description of work:
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XI)Construction Cost: c,00„,. ..... ,Multi-Family Building: (Yes /No /� )
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Company: t:e)Cit e Z-r'dv • _ wu Contact: —
Address: //3569 f4-(.4coe✓ / - City: �L-4-1)- i La..
Contractor _ / p
State: Zip: ��� 7 Phone: 6/Z Q`v-Z-�"lfEmail: /�X4/" �-cUc F->� ur-- 1t
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License#: c7 S& Z(o Lead Certificate#:
If the project is exem t fro lead certification, please explain why:
Att r 01O(l— acv( t tC U5e (.,, Q4-7
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 KNo If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
T NOTE:Plans and supporting'documents that you submit are considered to be public information. Portions of the information maybe
classified as non ublic if ou=rovitie ®ecific reasons that would ®ermit the Ci to conclude that the are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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.
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.00pherstateonecall.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.
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Applic nt's Printed Name App• ant's Signature