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4680 Penkwe Way,. --V BUILDING PERMIT cirY oF EAGaN 3795 PUot Knob Road Eagan, MN 55122 PHONE: 454-8100 SiM Address Lot Block Sec/Sub. Parcel W Name _ ? Address 0 0: 0 Z u?v ? Nome Address Nume I hereby acknowledge that I have read this application and state that tha information is correct nnd agree to comply with all opplicable State of Minnesoto Statutes and City of Eogon Ordinances. Receipt # N° 5823 Erect Q Occupanty Alter ? Zoning i Repair ? Fire Zone Enlarge p Type of Const. Move ? # Stories DemoNsh ? Front ft. Grade p Depth ft. ADVrovols Feee ASSesSment Wuter & Sew. Potice Fire Eng. Planner Council Bldg. Off. >L APC Permit - Surcharge - Pfan check _ 5AC Water Conn. Woter Meter Rood Unit _ Totul 1 ,? Slgnature of Permittee I A Building Permit is issued to: on the express condition that oll work shull be done in accordance with all opplicoble State of Minnesoto Stotutes ond City of Eagan Ordinances. Building Official Pennk # Oa% ha wA PKmlft" Plumbing a Mechanicol 7 t1 /Z INSPECTIONS DATE INSP. RoupMln Final FOOtings d Date Insp. Dote Insp. Foundation Frome/ins. ?/ ; ? ? . Plumbing Mechonical ? ?? Final Remnrks: (, -/Q- ?O .e*-v?XA,A"'' No. ' ?? rm'r3IAJr? Dete: ?. _ CITY OF EAGAN 3795 Pilot Knob Read Eagen, Minnesota 55122 Pboee: 454-8100 PERMIT . •?Z:.,'r? Site Addreu: Lot Biock Sub/Sec, Jhrq,Ck,R1dBe +?rrin Thompson Nome ? 1712 :iopkine C?'oss^oad e Address -.OTL}{8 , Ciry Phone: P1 Nome . ? "' - .nI Kenr.ebec : ?"i VP } Address e V '?.2_; : ?? ??., / x" •1.:'?? ? City Phone: This Permit i s issued on the express condition thot all work shall be Minnesoto $tatufes and City of Ecgan Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: 1q32`' Single Residential Multi Res., Comm./Ind. I New/Alter./Repair. Cost of Installation 20. Permit Fee Totol ^done in occordance with all cppliwble State of Buildin9 Officiol No. ''r4 Dote: - 1- SRe Address: Z..'; i30 P9I1}CS7@ d cinr oF EAGaN 3795 Pilot Knob Read Ea9ow, Minneioto 65122 Phone: 454-8100 PERMIT Lot = elock 2 Sub/Sec. 10 3`1370 Ot5`0 02 Na,,,e Orrin Thomason fiomnes . ? Address 1712 ? Hopkins Cmearoad City -' L11lIlet,Qnka , '_ tr.. Phone: 544-7333 Nome :-av ','Velter Fit;;. . ? Address City Phone: This Permit is issued on the express condirion thot ail work sholl be Minnesoto Statutes ond City of Eogon Ordinonces. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Singfe I Residential Multi Res., Comm./Ind. I New//11ter./Repoir. Cost of Installotion Pennit Fee • ' Surcharge Totol ' done in accordance with all applicable State of 8uildinq Officlol CITY OF EAGAN 3$?D.-?'ilot Knob Road ?Eagan, Minnesota 55122-189 (651) 681-4675 SITE ADDRESS: , ;.•:+It't tt ? ? ,. PERMIT SUBTYPE: INSPECTION RECORD PERMIT TYPE: Permit Number: 7 Date Issued: APPLICANT: TYPE OF 1NORK: r- L -1 J r,a I ;I P 1 1-1 r 1r,r-i IrI r.t?r?F??•,EI?IWIii•,??, r I i Permft Holder Dete Telephone # SEWCR/ WATER PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING RdUGH PLiJMBING 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 CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG OECK FINAL CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT $ , I & DOLLARS +oo E)CASH ? CHECK FOR " - O ? White-Payers CoPY Yellow-Posting Copy Pink-File CopY Thank You ? - BY V__111 ? CITY OF EAGAN Additfon aOH*X GAU RO6$ AD?,jnMN Lot $ Rik ,a Parcel 10 39800 080 02 Owner 1h:' ' ?, • ` ''?, " ~t1'? Street 46$0 pEtIIkN8 ]bv State p8gSI1- MN 45122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 5;215' WATERMAIN * WATER LATERAL iggi WATER AREA ] - STORM SEW TRK S" * STORM SE1N LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CaNN. 9UIlDING PER. SAC 52-5 - 00 19019 5120180 PARK CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: togan, MN 55122 DATE: el Zoning: No. of Units: Owner, Address: Site Address: Plumber. 1 agree to camplp wlth the Citp of Eogan Ordinaneea. By Dote of I nsp.: ? CtTY OF EAGAN 3795 Pilot Knob Road Eogon, MN 55122 2oning; Owner: Connection Chcrge Account Deposit: . Permit Fee: Surchorge: Misc. Charges: - Total: Date Paid: WATER SERVtCE PERMIT PERMIT NO.: DATE No, of Units: Address: Site Address: Plumber: Meter No.: Size: Reader No_- _ 1 ogree to tornplr with the CiFy of Eqgan Ordinonees. Bv Date of Insp.: Connection Charge: Actount Deposit: _ Permit Fee: Surcharge: Misc. Chorges: - Totol: Dote Paid: Insp.. Minnesota State 8oard of Electricity Griggs Midway 81dg. - Noom N791 ? 1821 Universiry Ave., St. Paul. Minn. 55104 - Phone 297-2117 ? FtEQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST r ? ??0oz S 72040 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home Duplex ApL Bldg. ? CoriSmercial Bldg. ? lndustrial Bidg. ? Faim [] CYther ? 11 ? ? ? ? ? ? ? ? ? ? ? ? ? Rxnge Warei Heatec Dryer Fumace A'u Condi ' er pList Hehe's? A?t r?? ?p- ? Temporary Wiring ? Lighting FinWres Elec[ric Heating ? Silo linloade[ ? Bulk Milk Tank ? pList Here is? COMPUTE INSPECTION FEE BELOW Seivice Entrance Size: # Fee Fceders8r.5ubfeede . ; F Cixcuits: # Fee 0 to 100 Am s. I ,4 0 to 30 Am eres 0 to 30 Am res 70 0. 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am res ? Above 200_Amps. Above I00_Amys. Above t00 Amps. Transformeis 1 1 Remote Control Ciic. Partial ot other fee J S' ns Special ins ection Minimum Cee Remarks TOTALF I, the Electrical Inspector, hereby cer at be've inspection has been m?dQ ? (Rough-in) Date . ?', v (Final) t Date This tequest void C o 18 months from This request void ?? ?°2 " ??'?""?"?"` ?'• ) ?l ?o?s 18 monthsTrom Date of this Request Fire No. S 7204" I, abQLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal b(inng instailed at: Street Address or Route NoA6S6 a'?+ "J&V"E WAY C;tv Chiad Sestion Township Range County Vf011"'"?I't 1Vhich is occupied by Is a roughin inspection required on this job? No O Yes$A,_ Ready Now ? Will Callj2l? Power Supplier Address ?,N?IvAl Electrical Contractor B EL?" E?"CT??G Contractor's Licrnse N?3?? I lqlI lG?pany Name) ^?, Mailing Address !\ ontra r or Ownar Making This Instellatlon) l?? Authorized Signature (ElolR al Phone No. lqD I S I? (Electrical Cantractor or Owner Making Thls Installatlon) N j;?? D CC,V This inspection request will not be accepted 6y the ? !r State Board unless proper inapecNon fee is enclosed. ('j ]`-REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os f' l ? See Insimctlons for crompleHng this form on Eeck oi yeilow copy. ' ,,/ T? ??Q ??ll/95 "X" Below Work Covered by This Request - Ne Add p. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Du lex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Speciry) Farm Air Conditioner O[her (specify) onl or's Remarks: Compute Inspection Fee Belaw: # Other Fee # Service EMrance Size Fee # Circuits/Peeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers A6ove 200 Amps Above 0_Amps S19(IS Inspetlor's Use Oniy: TQTAL Irrigation Booms ? Special Inspection AIarMCommunication THIS INSTALLATION MAV BE O D DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 78 MONTHS. I, the Electrical Inspector, hereby Rough-in oa?e certity that the above inspection has been made. F??a? ? OFFlCE USE ONLY This request voitl 18 monthe imm u- ?, O 7 5 A Z °? b S & B? Ck Request l Fire No. • Foug.i- nspection iretl Ins c n Olfier Than Rough-In 5 (VOU must call inspe when reatly) ?Reatly Now ? Will Noli(y Inspaclor ? ? Vos N. Dele Reed Iicensed contrador ?owner hereby request inspection of above electrical work at: Job Atl,tlre1ss (SVeet, Box or RfZN No.) T City 1 V, s V W Section No. Township Name or No. Fange No. Counly J 0 panl(PRINT) ? 1 V l Phona No. O ? ? Power SuDpller Atltlress Electri I Contraclor (Company Name) ConVaclor'S License No. ? e qgy Meiling Atldress ICOnVact r Owner Meking Inslallalion) 0• Auth ' etl Signature (GonVacmr/Owner Making Inslellation) one Number b o-Y - V MINNE50 A S TE BDAHO OF ELECTpICITV Gri e-Mltlwa Bltl - p 5428 I I O T E gg y 9. oom I ? I I I I II I? I I I I ?? T F 1921 Unlveraity Ave., SL Paul, MN 55106 1 ? ?N?ESS PROPER INSPEC ION EEIS Phonel6121602-0800 + . ' r .. i FNCLOSFD. 0 9-,???3 ?7 1b He Used Fb • C3Ty pF EAGAN Include 2 sets of plans. ' % 1 1 site plan w/elevations & SUILDING P?P APPLICATION 1 set of enesgy calculations. r Rts%oEwce Valuation Date Q? 00030 site Address: 4 6ab PeNrud PJAI Lot a Block -k Sec./Sub. soHNNY CAxe Parcei #: /D mv ??o DeL R?nGE Oaner: Pddress: City/Zip Code: Phone #: Contsactor: Addx'eSS: a Division of U. S. Home Corporation 3-732 HQf44iN6 6RessRO,;B City/Zip Cod2: _?NETOQII(A, MINN. 55343 Phone #: S411-1333 Arch./Eng.. Pddress: City/Zip Code: Phone #: 1w4i._3t 1480 OFFICE USE ODII.Y Erect Occupancy Alter Zoning gepair , Fire Zone -3 Enlarge _ 7yPe of Const. !/ Nbve # stnries Demlish Front ft. - Grade ft. Depth ,3 APPROVAIS fEES 5 ?p Assessments Peunit Water/Sewer POllOe Fire En4• Planner Council Bldg. Off. . 8' ftD APC Surcharge 30 Plan Check j ?-o $Ar t ?a6 °-? Water Conn. 3 -2 Water Meter (olJ =a Roaa unit J Ss-? TOTAL I 3 3?p,7.5 CI7'Y OF F,AGAN " 3795 Pilm Knob Road -01?ean,;,MN 53742 PHONE: 454-8100 BUILDING PERMIT APPLICATION Site Address Lor g Parcel # - w Nome z g Addre Block 2 Sec/Sub. NKKEBE 10 39800 080 02 JhnLY•Cake Rdg. 1712 Hopkins Crossroad ne o a, 544- 0 o?__e ? Nome _ ?- Address 1- r.... Name _ Address I heieby acknowledge thot I have read this application and stute that the information is correct oo agree to apnpiy with oll applicable State of Minnesota Statutesi5nd City ofsEa9an Ordirances. Sigrroture of Permitte A Building Permit is issued to: OTT: oll work shall 6e done in acmrdance with Building Official ? N° 5823 Receipt # Erect ? Octupancy -R3 Alter ? Zoning Rl Repair ? Fire Zone III Enlurge ? Type of Canst. V Move ? # Stories Demolish [] Front 54 ft. eroae ? oePrh 3'n. Apprmals Feea f\SSESSment Woter 8 Sew. Police Fire Eng. Planner Council sid9, ofe. 5 8 80 APC Pertnit 1,14- Jv $urcharge 30• 00 Plan check 77.25 snc 525.00 Water Conn 0 .00 Water Meter 60. 00 Rood Unit 185.00 Totai 1,?336.75 on the express condition thot Stotutes and City of Eognn Ordinonces. ' 4680 ---- ? C. R. WINDEN d, ASSOCIATES, INC. IAND SURVEVORS Tol 643•3646 1381 EUSTIS SL, ST. PAUL, MINN. SSIOB For: ; U. S. HOME CORPORATION Scale: 1" = 30' O Denotes Iron EI ? ? ? io? ?------?ro N (1J I cq? 46.3 3/ J9 ? \l ? ? o cs C? ti b ,r • \ c'r^.3 . . Q \ ( C- C - ! C i ( Lot 8, Block 2, Johnny Cake Ridge Addition, Dakota:County, Minnesota ? J? wE MEREBY CERTIFY THAT TMIS IS A TRUE AND CONRECT REPRESENTATION DF A SURVEY Of TME BOUNDARIES OF THE IAND ABOVE DESCpi6ED AND Of THE LOCATION Of Alt 6UIlDINGS, IF ANY, THEREON, AND All VISIBLE ENCRQACHMENiS, IF ANY, FROM OR ON SAID LAND. Do1ad eAis '5'4h day of1L6,X A.D. 1980 C. R. WINOEN 6 ASSOCIATES, INC. br Surrorer, Minnewre Royisirafion No.77? :X:'r•?X?oyx:-r:;rrlcm.;;;:oav,cX;;:r<;,Y.czr?rr';c?;re;g>,o:nt;zo}?;ci:k:;:::,v. , , c:, rv r.:ar- i-:Acn=•a cnSHt,-r;:: s 7-:::f='147:?vAL h0e 7:;5 'iiCiY'_::: 1?/;+,.t:,/98 T7:M[:° 0:2058 IIi e RAt^Ee Ii!.JCiGE:? EXTf::=?:i:O^F3 .'.:NC: 320 3001 462(] F'I::Ni(i,.![' PI=1Y 20.,25 2155 9:30i 4d680 F'EC?Klti'; llAY 7=CICI To{:a]. fierr!irrF, ,?mountr. s.'L'3..?5 CR :I . Di [:l?r?t? . UaER .T.:ne NA':r,'., ..!X?; ...;7." z:'f.Y, .. ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILD I N G 034237 12116/se SITE ADDRESS: 4580 PENKWE WAY L07e 8 BL.OCK: ? 70H NtVY CRKF hTOGt P.T.N.: 10-398 0 8--P80-82 DESCRIPTION: RERUpPASI0TNG1'SOFFIT Bu(iA Cl.inq`-['ermit Type SF (M:CSC?1 B?,(ldinq ldk? 'I"ypa REP1?Th d??erfsuS Co2ie ._.\ - 434 ALT. RESTDENTIAL f i re ,r ? r ;J Y ?...,, .?..? ` REMARKS: FEE SUMMARY: VALWRTION Base Fee 5urcharge TotaJ. Fee $212.25 __$7._Vif7 $219.25 $7.4,e00 CONTRACTOR: - Apalicanr. - sr. t.[c. OWNER: Bt,ID6E7 EXTERIOR5 SNC 18871613 0006564 Nf3UYEN HIEU 5017 NTCOL.LET AVL- 5 46530 t'ENKWE 1.1FlY MMIIVGI"ON MN 55420 EAGAN Mi'd 55122 12) 887-169.3 (661)681-8262 I hereby aCknowisdoe ttjat I have read this applicatian and state Chai, ttie intcrmat3.ort is correct and aqree to cotnoly wifh all applicable Srat¢ of hin. statutes and Gity;ofi Eaoan Ordsnanees. APPLICANTrPERMI7EE SIGNATURE ? "- I,- ? o ISSUED BV: SIGNATURE , ?92? ? _. . -•49ff BUILDING PERMIT APPLICATION (RESIDENTIAL) cirr oF EAcaN 3830 PILOT KNOB RD - 55122 t 681-4675 ?Jg?v C st? i? umeMs RemodeVReeair Reauirements pC (?- ?? ? 3 ragistered site surveys ? ? 2 copies of plans (Include beam & window a¢es; poured fid. design; etc.) ? ? 7 energy calculations ? ? 3 copiea of tree presenation plan i( lot platted after 711193 required: _Yes No . 1 1 ?' ?5 1711 2 copies of plan I a- ? t? '" O 2 site surveys (exterior additipns 8 decks) 1 enargy calculations for heated additions DATE: cx - I I ' j CONSTRUCTION DESCRIPTION OF WORK: Si H I n Q ,?t ?+. ICcxp STREET ADDRESS: LOT ? BLOCK PROPERTY OWNER CONTRACTOR SUBD./P.I.D. #: - ? ? Name: /+I 2(,l loG t,l C J P(/l Phone #: 6gy -(;;? -)/-a I Street Address?6 k c.?e. C,ity: &d61-cw-\ State:M r) Zip: ? raa ^ Company: ?-! 1 or- S Phone #: 2?7 /g? Street Address: SS'e'17 ?JlCallf 4 License #: I City: ? State: Zip: ?5w?90 i ArtcHITECT! Company: ENGINEER : N'ame: I Phone #: Registration #: Street Address: i Ciry: State: i Sewer 8 water licer.5ed plumber (new consWction only): and lot change are, equested once pertnft is issued. I hereby acknowledge that I have read this appiicatlon and state that the infortnation is correct State of Minnesota Statutes and City of Eagan Ordinances. ? I Signature of Applicant: I OFFICE USE i NLY Certificates of Survey Received Tree Preservation Plan Received _ Yes _ No _ Yes _ No - Not Required Zip: Penalty applies when address change all applicable :.. .. . _ .... .. , ...._.:.-.. . . ? ; OFFICE USE ONLY BUILDING PERMIT TYPE i 0 01 Foundation ? 06 Dupiex o 11 Apt./Lodging o ?02 SF DweUing ? 07 4-plex o 12 Multi Repair/Rem. ? ? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory o 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? ? 05 SF Misc. 0 10 I -plex ? 15 Deck WORK TYPE ? 31 New ? 32 Addition ? ? ? 33 Alteretions ,fif,-34 Repair ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Misceilaneous GENERAL [NFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Sto(es Length Depth APPROVALS Planning _ Basement sq. ft. MC/WS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance Permit Fee Valuation: Surcharge Plan Review License MC/W5 SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ;) I Qt . a? $ ?IoO % SAC SAC Units 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date??l?[Q_I p5! Site Street Address 41"b Unit # Property Owner Telephone #{?/ ) 60/" Contractor _4-? ..4.e.{ Address 6-?L .Lj s-LKz City . Telephone # (?' S( ) ??oJ ??c35? .n.?J State I'Yln" Zip-KS/otZ The Applicant is: _ Owner ? Contractor _Other Alterations to existing dwelling _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _WaterTurnaround (add $121.00 if a 5/8" meter is required) Other: $ 50:00 Water Softener ? replacement _ ,?Water Heater additional $ 15:00 Lawn Irrigatlon System RPZ_ new ` repair _rebuild $ 30.00 State Surcharge $ 50 Total $?-J: I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumBing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. ApplicanYs Printed Name I s 41? City of ? ----------- ? Fo! DtficetOse ? I j Permit #: ?47,23 j ? Permit Fee: ? Date Received: 1 StaB:^.:_._.. I J ` 2U08 RESIDENTIAL BUILDING PERMIT APPLICATION ... .Date Sille Address: y"p ?V/ Tenant: t) r Suite If: RESIDENT.! OWNER. Na II e: P eC-fc{ /?< Phone:: Address / Clty / Zlp: Appllicant is: _ Owner _ Contractor TYPE OF WORK Deslcription of work: a ? ?r 6 , Conlstruction Cost Multi-Family 8uilding: (Yes No ___j I CONTRACTOR Nae: ? License #: ZG13O> 9Y e Addlress: ,7 va'' y & ?j Cityl: LC? q? /?' State-" -a"°"' Zip: ?Y? Ph Ine: 0- _q7 ?U "? Contact Person: i COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING l-Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 J • New Energy Code Worksheet Energy Code . qesidential Ventilation Category 1 Worksheet Category submitted submmed (4 submission type) • Energy Envelope CalculationsSubmined .. ldthe last 12 inonihs, has the City ot Eagan issued a permit for a similar plan based on a master plan? , . _Yes _No If yes, date i nd address of master plan: Licensed Plumber: Phone: Mechanical Contractor: I Phone: Sewer & Water Contractor: I Phone: NOTE: Pfans and;supporting documents that you submit are considered to be public infoimation. Portforts ot the iMormation m,ay be classifred as,non publTc N:you provide specific:reasons that would perinit theCity to G coriclude that the ,are Gade.secrets. • I hereby acknowledge thffi this inbrmation is complete and accurate; Ihat the work will be in conformance with ibe 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 ihe approved pian in the case of work which requires a review and approv of plans. x J;S,ti X , l`' X ? ApplicanY Printed Name I A icanYs Signature Page 1 of 3 Use BLUE or BLACK Ink ------f For Office Use Permit qc2- City of hicin 1 e1 b 1 Permit Fee: ~9 0 3830 Pilot Knob Road 1 I ~ Eagan MN 55122 Date Received: 11-30 Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 Staff: I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: L-e- V Tenant: Suite M RESIDENT/ OWNER Name: cYyt Phone: 6 J ~a `1 2 Address / City / Zip: 5 z / Applicant is: Owner Contractor TYPE OF WORK Description of work: ~A/ ;joy,, . Construction Cost: S l 74 77 Multi-Family Building: (Yes / No ) CONTRACTOR Name: ~r5~ 0 ' C License h 30:3 ( Y Address: ! voi ~/L/ City: LA StateJ1W Zip: .(~6 / / n Phone: 611, s ! / l ~ Contact Person: b 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x OI(JC ✓ 'I, x L'tt Applicant's Printed Name Ap cant's ignature Page 1 of 3 Use BLUE or BLACK Ink I For Office Use I Permit r I City of EaMI~d 1 I Permit Fee: 06 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: 2012 MECHANICAL PERMIT APPLICATION Dater 7 / Z Site Address: 44 to $a P2 A k tj e, td a (r Tenant: Suite M RESIDENT / OWNER Name: G v) 57 r~ Phone: ~0 5 ~3 ~O - 1 3 a Address / City / Zip: ?i1~ t~ a W C- V Name: KU e--. License CONTRACTOR Address: i ox '?`1 City: L &Kav ))-.e State: Vt't N Zip:5t/t/ Phone: Contact: C/ /S_b !44- Email: -3- C. J-f uLGA 0 F-)~QttTI twW~f New ,!°_Repiacement Additional Alteration Demolition TYPE OF WORK Description of work: ✓ e " NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement PERMIT TYPE -Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) f,, $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) _ $ U . B Q TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010411,010 Permit Fee requires a$ 5.50 surcharge) TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www_.gopherstateonecall.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. x C'kcfs 14-// x ~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening