2065 Pin Oak DrCITY OF EAGAN Remarks
Addition VTF.NNA TnTnnnS Lot Blk 1 Parcel 10 81950 12
Owner street '206SPin Oak Drive State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. TIIIp._)Y?;? 1981 " 10
STREET RESTOR.
GRADING /)/J 1981 u587.73 SS.77 0
SAN SEW TRUNK 1973 129.78 8.65 15
* SEWER LATERAL A'
* 5e2' 1
WATERMAIN
* WATER LATERAL ICIRI
* WATER AREA
* STORM SEW TRK
* STORM SEW lAT 110
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
SAC
PARK
bl(
CITY QF EAGAN
INSPECTION RECORD
PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? i r.? i " ? ? + • , ? ?? r • a c?-?
SITE ADDRESS: APPLICANT:
iIi N oAF Iof. MI ia;
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .• . .•
F
L
?
Permlt No. Permit Holder Date Telephone A
ELECTRIC
PLUM8ING
HVAC
Inspectlon Deta Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
(3YP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTI4N REC4RD
??TY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
.? n a ,..-
PERMIT SUBTYPE:
TYPE OF WORK:
INSPECTION D. . ..
?A1 4 x? •?i? `ti?il? S? i:?l:(?{{ ? fi?. .; i a l lti I? ;i) ??i i:f9 i 7 i10 :,
F
L
7
Permit No. Permit Holder Date Telephone #
ELECTFIC
PLUMBING .
HVAC
Inapsctlon Date Insp. Commente
FOOTINGS
FOUND
FRAMING
7/
I?Yfl
ROOFING
ROUGH
PLUMBING
Q j
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL ? •
GYP BOAFO
FIREPLACE ?
FIREPLACE
AIR TEST /f A.
FINAL PLBG
FINAL HTG
OR5AT
TEST
SLDG FINAL
BSMT R.I.
BSMT FINAI
OECK FTG
DECK FINAL
-CiTY,?OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
I. . ? rd •:,; 1,!
V 11 !•IPalk 1}i(i',
PERMIT SUBTYPE:
, A,,,
INSPECTIUN RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
?*
i. 4 ? t ??4k : . - , APPLICANT:
,, „ ,•? ??; .?
.,
? .?,y ,. , :? •%
TYPE QF 1NORK: ?-
f. '
INSPECTION .A . .A
?,??;.i; ? n i i i,?. ;,?ir?,?t i ?? ?i i,?
I IIlr?l {?? ls?, ? IMlli
NF MARk:;r f'RV b W 4114314 ? !. M
`:AWf fAR V 1'.I1( I It1N MHY iiE l;f q11 lliF=fi (u '.1- FtVls F NA`;f Ml N{
I --I
? ?
Permft No. PermR Ho {der Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTFiIC
Inspectfon Date Insp. Comments
Footlngsl
Foundation
Framing
Roofing
Reugh Plbg.
Rough Htg. z' I 9
ISUi. l Zy? ?1 L
Fireplace ?
Final Fltg. ?
Orsat Test ?( (r
Final Plbg. Ibg. nspector - Noti Plum ber
Const. Meter
EngrJPlan
Bldg. Final
r
q
Deck Ftg.
Dedc Final
Well
Pr. Disp.
?
..?;.,
?.
.ee?• ?
. ?+
W-vt*ftCQf¢ 0f cCClivQ1iC?
(AM of Cfagatt
#!e}?arta?e?t ef ftriliiug 3860ection
71us Cerlificate issued pursucrnt to the requiremeRts of the Uniform Building Code
certifying that at the iime of issuance this structure was in campliance wirh the various
orrliriances of the City regulating building construction or use. For the folfowing:
Use C7astificYion: SR lM Bldg. Permit No. 24617
Occupaocy Type R3/ml ZoninE District Type Consc. ?
Ownerof Buildio Ad*ess4-158 MM-?v'
6uildio'g Addiest S Do IIAY TOTM Locality Ta 1.2, B?-?--? A crvrY
; J
Date-
Buddmg official
POST IN A CONSPICUOUS PLACE
Address 2065 PIN OAK DRIVE _ Zip 5512 2
L.ot ' ' '12 Blk i Sub
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: / 9,5 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanentdriveway
Permanent gas ??-
SodlSeededgrass
TraiUcurb damage
------------
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply [o
the outside lawn faucet before freeze potential exists.
Contact engineering division at 661-0645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
1??fie!4/ NL
VUeU.y14 1i;Z4'614 ' IX//D?v
Rapuest Oate Fire a. Rough-In Inspectlan RequireE
(YOU vs all inspector wh¢n reatly) Inspection Other Than RougRln
? Reedy Now ? WIII Notity Inspcctor
Qy Vef _ Q No Date ReaE
IA licensed contractor ? owner hereby request inspection of above electrical work at:
Job Atltlress (SireeL Bon or aute No.) /
?cUlv - rN V Aic City
CAI?.?
Section No. Township Name or No. Range No. Counry
H-x o r?
Occ nt(PRINT)
?
D Phane No.
?'? -ZOO
(LJTOr+l
ES i6n /J «pr Rs
Powe upP(iar Atltlress
F
Ko LcC?rc RA?in?TOrv
Elect I Comrncror (COmpa
ny Nam¢) GaniractoPS License No.
C
fR = LL<cr2rc -Livc.. ?fT Z
Mailing dtlress (C bactor or Owner Making Installation)
?
?
,D.
PP?E Y 5??z
2LI06 i
Authori SignaNre (COnirectoqOwner Making Installation) Phone Number
953 G?i??
MINNESOTA STATE BOANO OF ELECTNICITY
Grlggs-MlEway Bldg. - Hoam S•128
1821 Universify qve., St. Peul, MN 55109
Phone(812)642-0800
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOAFD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
0?2 69? 4 REQUEST FOR ELECTRICAL INSPECTION
10- See instrucGOns for completing this Form on back of yellow copy.
c? "X" Below Work Covered by This Request
s?
EB-00007-09
-??? ??j,47
Ne% dd Rep. Type of Building Aptilliances Wired Equipment Wired
Home Range " Temporary Service
Du lax Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other S ci )
Ferm Air Condi6onar
Other (specify) ConVadofs Ramarks:
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 1 U 0 to 100 Am s ?O
Transformers Above200_Amps A 70D-Ams
SI 115 Inspeclors Uae ONy: TOTAL
Irrigatlon Booms
S ecial Ins ection ?
Alartn/Communication 7HIS INSTALLAT MAVE?i?D??CONNECTEO IF NOT
Other Fee COMPLETED 78 I?(?JfWB:'?' `
I, ihe Electrical Inspector, hereby
cerlify [hat the above inspection has
been made. RO1g""l"
Final
r
~
Osle
1-.+k•`?
OFFICE USE ONLV
This reQuesl voitl 18 monihs Imm
loy8,a q \,
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 U I I L( 1
Site Street Address aa05 PUn DO-K
?y?
Unit #
Property Owner Telephone # ( )
Contractor Telephone#
Address (tty ?J ?VQ S City -vk State (Ie?a) ?O? 5a?a
6AQ ZipbS?)?
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 _ Water Heater
_ replacemerit _ additional $ 15.00
ILawn Irrigation System RPZ_ new? repair _rebuild $ 30.00
State Surcharge $ 50
? Total $?, 50
°Lr .._. ----
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 Applicant's Signature
C;ITY OF FFlGAN
CASNTER: S TEftN]:Alpi... Nf7. 759
DATC:: 02109/98 TTMl=e 15:20s57
'fP.
NFlt1F_a JP.,N G NEWFI_I_
32:10 9001 2065 PIN OAi: LiR 50.00
205 9001 cUti`.i PIN OAK DR 0.50
320 9001 2065 PIN Oni; Dr; 20.00
?(.?').1.JJ 9001 2065 PIN onf; DR 0.50
Tnl;al. Receip?F Amounk: 0.00
CFiQB67.U6
USER IDe NANCY
4
?? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: euzLorNG
Permit Number: 031395
Date Issued: 0 2/ 0 9/ 9 8
SITE ADDRESS:
2065 pIN OAK DR
LOT: 12 BLOCK: 1
VIENNA WOODS
P.I.N.: 10-81950-120-01
DESCRIPTION:
B,uildin:g',..Permit Type BASEMENT FINISH
Buildirtg W'tark Type ALTERA7ION
Certsus Cnde 434 ALT. RESIDENTIAL
x.
t
j:
;-
M
i?
14 ?i
?1•?' \'??,,,,?
[] 6'
?
t? j ( t
}IJ
REMARKS:
PLAN REVZEWEO BY MIKE BARCK. SEPARATE PERMIT REQUIRED FOR ANY PLUMBIN6
WORK. CALL 445-2840 REGARDING ELECTR.ICAL PERMI7 AND INSpECTIONS.
FEE SUMMARY:
6ase Fee $50.00
Surcharge $.50
Tptal Fee $50.50
CONTRACTOR: OWNER: - Applicant -
? NEWELL JON
? 2065 PIN OAK DR
EAGAN MN
' (612)405-0675
I hereby apknow],edge that I have read thi5 appiicatian and state`that the
3nfarmation ks eorrect aqdagree Ca comRYy wi;th all 'applioaEr2e Stats a. Mn. Statutes anq City of Eagan Ordin$nces,,
?
?
APPLICAN /PERMITEE SIGNATURE ISSUED Y: SIGWUM
1998 BUILDING PERMIT APPLICATION (R.EBIDENTIAL)
crrY oF EnG?x
aeao pu.ar xivos xn - ssiaa
681-467b
New Conshuction Reouirements
? 3 registered site surveys
? 2 copies of plens (IncluCe beam & window saes; poured fid. design; etc.)
? 7 enerpy calalations
?3 copies of tree preservation plan N lot pletted after 711193
required: _res _ No
DATE: I^ 3 O" !2S(
RemodeVReoair Reauiremenls
? 2 coPies oT plan
? 2 sRe auneys (exlerior eddkions & tlecks)
? 1 energy calculations for heat9d additions
CONSTRUCTION COST; o ID
DESCRIPTION OF WORK: ? A 5 G Vb, i?-n! T? i NP S e-f- 'C\`f'C4
STREET ADDRESS: Z ??o S? ? ?^} ? A lc- V?
LOT: BLOCK: / SUBD./P.I.D. V
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: /\jCWCL L- -Nb wJ Phone it: (oI 2` LI O1- LfZS
Last First
Street Address: 4?,O (o 5 ?tbF 1it- 1) 2 1 11 G,
City Jk(,> Pc4\1 State: V%N(O Zip: ? S 1'2- Z
/.
Company"?D ? ? y ???? C?/ LL- Phone #: ? I ?` Y O S-Q? 7S
Street Address•. 2b (0',1r ? `I ( #J 4 :p, w- & License # - ' -
SS' ?2 2-
City '? ?'..14Co /k+'j State: 'W-, 'l.) Zip:
Phoae #:
Name: Registration #:
City
State:
Zip:
Sewer & water licensed plumber (new construction onty): . Penalty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge fhat I have read this application and state that the
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applipnt:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
correct ar}q agree to compy with all applicabl
Tree Preservation Plan Received - Yes - No - Not Required
c
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
O 02 SF Dweliing ? 07 4-plex
? 03 5F Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New
? 32 Addition
?33 Alterations
? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging 21"' 16 Basement Finish
O 12 Multi Repair/Rem. ? 17 Swim Pool
? 13 Garage/Accessory ? 20 Public Facility
? 14 Fireplace ? 21 Miscellaneous
? 15 Deck
0 36 Move
0 37 Demotition
Const. (Actual) Basement sq. ft. MC/WS System ?
(Aliowable) Main level sq. ft. City Water ?
UBC Occupancy sq. ft. Fire Sprinkiered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 41 314
Depth Footprint sq. ft. SAC Code v I
Census Bldg I_
Census Unit v
APPROVAL5
Planning Buitding
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Cann.
Water Meter
Acct. Deposit
SIW Permit
SIW Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
?
°k"SAG
!r; SAC Units
t1,1& Engineering
Valuation: $
a.ri a. vr? -?l ? _ . .,., . . .
i - _
PLEASE COMPLETE FOR SINGI.E EA1kIIL.Y DWELLINGS. ALSQ, FQR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQ.IJIRED FOR- EACH' IJNTf. '
NO.
FIXTIIRES
S3'IOV4'E°R
WA'I`EI2 c.O?T .
$ATI? LAVATORl' ?
KiTCI-IEN SINK
HOT TUS/SPAr ?
WATER HEATER '
FLOOR DRAIN
GAS PIPING OLITLET -
ROUGH OPENINGS
VJATERSOFTE'NERi
PRIVAT'E DISP: - netay. uc.
U.G. SPRINKLER • n? ?au oo?;
ALTERATIONS - co adaun8
WATER TURN";AROUIVD
STATE SURCHARGE`
TOTALs
F.ACH I ._?__ - ,
3;[L0, _
3.0(!)i
mQ0;
3i00'
3.00 ' '
100
3.00 '
3.00
3:OQ:
3:00
1.50
5.00
20.00
3:00
20.00;
20.00
.50
SITE ADDRESS: L? aY
OWNER NAME• Cvs???.: Dcs=g ? -
INSTALI.ERc
ADDRESS: 'loo Q ? Qk< ?1 e
CTI'Y: STATE; _ INi ? ZIP CODEs, 5- s.3 ,-?
PHONE#:(
SIGNATUR , OF PER16fITI'EE:
_ _
1994 PLU?MBIlYG PERM'IT (RESIDENI7AL)
PLEASE'COMPLETE FOR ALL
FAMILY BIIILDINGS WI-IEN
DWELLING UNIT.
CONTRACT PRICE: a
FEE: 1% OF'CONTItACI FF.E,
STATE SIIRCHARGE $.50 FOR EACH $1,000 OF ?? ?,
MINIMUM FEE $ 25.00
coxTxacr riucE x i%
SZ'ATE SURGHARGE
TUTAL
SITE ADDRESS:
$
$
$
1L+Nt11\1 Nt11Y(E.' 4c?e ?µ ..,' . ' .
°.
OWNER NAME:
INSTALLER
ADDRESS:
CITY:
PHONE #:
STATEd ZIP CODE:
FOR:
CITY OF EAGAN APPLICAIVT
1994 PLUMBINC PERMIT (COIKMERCIAL)
CI`TY OE EAGAIV
3830 PILOT KNO$ RD
EAGAN MN 551122
(611) 681-4673
? ;?925
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIl2ED FOR EACH UNTI'.
X NEW CONS'IRUCTION
ADD-ON A/C
ABB-ON FUP.?1ACE
FIREPLACE INSERT
DATE _ I2'01-q4
FEES
HVAC: 0-100 M BTU $ 24.00 ?
ADDITIONAL 50 M BTU 6.00
GAS OLTTLETS (MINIMUM 1@$3.00 EACH) CU •(m ,
ADD-ON/REMODEL (ExlsruaG coNST[tUCTtorr) $ 20.00
STATE SURCHARGE .50
TOTAL ? 3(° •bo
STTE ADDRESS: .20bGJ D+Yl (Dgx '6r •
OWNER
INST.
CITl':
TELEPHONE #:
TELEPHONE #: 6 $g _1210?
J
STATE:U I1 , ZII' CODE: ??
?
SI ATURE PERMITTEE
1994 MECHANICAL PERMIT (RESIDENTTAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTI'S ARE NOT REQUIRED FOR EACH DWELLING UN1T.
DATE:
CONTRACT PRICE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF Q0FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PSLMT?' FEE.
,....s.<..
TOTAL $
STTE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (MPxovEMErrrs orrr.Y)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE #:
SIGNATURE OF PERMITTEE CITY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
?CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minhesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-81950-120-01
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
2065 PZN OAK DR
LOT: 12 BLOCK: 1
VIENNA W0005
Ok 32 ? S3-
BUzLD=N?-?7-4y
024607
09/26/94
DESCRIPTION:
Building'?Permit Type SF DWG
Building WoICk Type NEW
?-UBC Occupancy?\,, R-3 M- 1
? Construction 7ype V-N
Building Length 58
? Building Width ; 40
Building stories J
i 2
?
5q,uare Feet f 3,002
?, G 1
REMARKS:
PRV S& W PLBR - C& M
RANT7ARV FIFfTTf11y PIIMD M8Y RF REQVT,REE) T0 CyER,/IrE EAS€M€NT
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC ?
5AC Units
Subtotal
$755.00
$490.75
$66.50
$800.00
100
$2,112.25
$133,000
MISCELLANEOUS $1R828.50
Total Fee $3,940.75
CONTRACTOR: - Applicant - ST. LIC. OWNER:
CUSTOM DESIGN BLORS 16882600 0008547 CUSTOM DESIGN BUILDERS
1579 MALLARD AVE 4158 KNOB CZR
EA6AN MN 55122 EAGAN MN 55123
(612) 688-2600 (612)688-2600
i hereby acknowledge that T have read this application and state that the
informa 'on is correct and agree to comply with all applicable State of Mn.
L Statute and C'ty of Eagan Ordinances. J
??{lli D
APPLIC PERMITEE51 TURE ISSUED IG AN E
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: Lo T: 12 B L 0 C K: 1 APPLICANT:
2065 PIN OAK OR CUSTOM DESIGN BLDRS
VIENNA WOODS (612) 688-2600
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
BUILDING
024607
09/26f94
INSPECTION
FOOTINGS .. .
FOUNDATTtlN .A
FRAMING ROOFZNG
INSULATION FIREPLACE
ROUGH IN PLBG ROU6H IN HTG
FINAL PLBG FINAL
REMARKS: PRV S& W PLBR - C& M
SANITARY EJECTION PUMP MAY BE REqUIREO TO SERVICE BASEMENT
1- 7
? ,_ ?
CITY OF EAGAN -tg `?49• `Lr
,? 1994 BUiLDING PERMIT APPLICATION I?I?C?E?M(??
681-4675 S E P 1 11994
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 Valuation of work )
Site Address: t1
h ;^ L" STREET SW TE #
!. v
Tenant Name: (commercial only)
LOT _LZ BLOCK ? SUBD.r
?J / l?iVl UY P.I.D. #
Descri tion of work:
The applicant is: Owner E;tContractor ? Other (Deseribe)
Name W Phone??? f.?8
Property LaST FIRST
Owner Address t/ l _SR- lC"
STREET STE #
City State jgt?- ' Zip ?J7z?
Company Phone
Contractor Address License # Exp.
City State Zip
Company - Phone
ArchiteCt/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber ccJ Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have ead this application and state that the information is
correct and agree to comply :ait 11 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 Sf Additian
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
OFFICE USE OfVLY
? 06 Duplex
? 07 4-Plex
? 08 S-P1ex
O 09 12-Piex
O 10 Multi. Add'1
? 11 Apt./Lodging
? 12 Multi. Misc.
O 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
^ t y. W y?wM
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public FaCility
? 21 Miscellaneous
Ak 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) /? Basement sq. ft. 100.7 MWCC System ?
(Allowable) lst F1. sq. ft. po City Water
UBC Occupancy {k •r 2nd F1. sq. ft. PRV Required ?
Zoning Sq. Ft. total -gc Booster Pum?r '
# of Stories ?.. Footprint Sq. ft. it.,?5?a Fire Sprinkler
Length -5-6- On-site well [?r7 Census ioi
Depth ? On-site sewage SAC Code -0)
Census Bldg ?
APPROVALS Census Unit ?
Planning Building Assessments
Engineering Yariance
REG1UIFiED INSPECTIONS
? 5ite P Footing Pe?Framing ?Insulation
? Wallboard ? Final ? Draintile ? Fireplace
Permit Fee vaiuac;a,: g ! 3 3,?,0
Surcharge
Plan Review S?
License
MWCC SAC
City SAC ?2x/o.??
2 Z. 33 x7? _
Water Cann. ?/m ,r
Water Meter ?o X 3
l?,33
Acct. Deposit _
S/W Permit 3?, y? 33x q.G7
?z ,c /6 s3 ?
S/W Surcharge ?/v x a. as yVsx
Treatment Pi. ?1/. u
S& i,
F2,v7 I, 33 "irs?
Park Ded. r00 ?0kry=?s`?i`''?`r??-l
Trai 1 s Ded.
Copi es _r
= i.??.?c= 135?
other /&.47x 38
Total: roo?b?x/S
/y.JY X z? _
SAC % >i 7.6>> -1,/5/U2. GC?
SAC Units ?- - "
,?IxsY_,s3,371.98; ?-?AC= 0z,f57y
. 7
.
COHSUlTINO iNGIN6EBf ?r? Cf/3TOM DE$/6.VED ;
R06E PIRHNEqS ond LpND fUHVEVORS #6539.??
?,. 3K, z/s
[JeNGINOERING
COMPANY, INC. pe.'/
L 1000 EAST N61h STREET, BURNSVILLE, MINNESOTA 95337 PH 482-3000 '
CERTIFICATE OF SURVEY
Legal Description: [.oT i2, aLvcK ? 1//ENNA wooos,
DAKDT•9 CDUN7Y ?LI/NNE.S'T
r-
(g,'z,o=o ) DENOTES EXISTING ELEVATION
( 935• z) DENOTES PROPOSED ELEVATION
r INDICATES DIRECTION OF SURFACE DRAINAGE
935.50 = FINISHED GARAGE FLOOR ELEVATION
Zh, = BASEMENT FLOOR ELEVATION
939-83 = TOP OF FOUNDATION ELEVATION
BEUC? n?A?.ic :. 5AN. MN AT /NT£?zS?T??iv oF piN LtAL' o.c'l)1E
SCALE: i' 30' AND K;N&S k-OqV. ToP= 939,00
= .
AoDQE55: 206- PIN oA& R44L"'
?EAST (923,z
?93i, 6; ?923_2,
76. 79
' ? -a-- ?
.. i ? ? 0RA/1V46E ANO
r
Jr ? L-?? UT/L/TY EASEitq,?it/T
1
ED LoT 12 ?
DE
?
FAA.GA2\ ?4vec' Jt
I ?
• ; il f? ?? ?I f.? ?
N
?92?5FBwo .9244;
(-? a I? ----- - 6-?.=---
/7,33 8 a ?gro•oo
f?OU<,? ? I 035.0? ? `? n' 11? EKiSTfN
(
izi
PRopasED o " HouSE
17,o I.66 2o.a?-? HoVSE N
i ? ? l2.0o jz.
26,0
937, Od, Hug = 93Z.45 /,ODAN19 voit I I6. cn m?926_i,j Hug = 920.93 ?
?935.z
- Q26,05
3oF-r. F,eon,r ?? 00
5 ua 9 I S E 'y ?y G,n N:93?o7$E7Q4CK LlNE ?935,z??
C3? ? •. ?9?.5? I I R E V i EVt' ?L,__
(937,3}
?9.g(ri,6? _ p Setiev?cE -?I7Ep r--
---45.l----?. ? • ?37._?Y_?_i?? . __.
p k? 1- =77. / </20549 9.79 . j'r' l/Sy
I
IWEST DAT'.?
?.
? _ ?----
?936•.54 ? ?
? m m
U-'?NIrR" '?Jcea?.e??? ?vMr rlAx ?3t ?taWr?Ga '1?
7C xra.v04L, laACe""10.0?' I
I hereby certify that this is a trua and correct representation of;a tract of
land as shown and descr bed hereon. As prapared by me this 2/5T day of
SEPTEp9?Z- , 19 '
? ?
Minn. Reg. No. (pOgS
„ U LOT SURVEY CHECRLIBT FOR RESIDENTZAL
? BUSLDING PERMiT 7?YPLICATION
PROPERTY LEGALt
Dats of Survsys
DOCIIMENT 8TANDARDB
e 0 0 • Reqistered Land Surveyor siqnature and company
IY 0 0 • Building Permit Appl3cant
8?k-?8 0 • Legal description
i' I3 D • Address
G-?n D • North arrow and ber scale
• House type (rambler
split v/o, split entry,
walkout
,
,
lockout, etc.)
0?0 0 • Directional drainage arrows with slope/qradient $.
0' 0 0 • - Proposed/existing sewer and water services
ido D 0 • Street name
?0 ? • Drivexay
ELEVATIONS
20
0
• Existfna
Sewer service
V?0 0 • Lot corners
0-?0• 0 • Top of curb at the driveway
2`0 0 • Elevations of any existing adjacent homes
prooosed
B 0 • Garage floor
P 0 • First floor
0 e Lowest exposed elevation (walkout/window)
94 0 • Property corners
3 D • Front and rear of home at the Poundation
pONDINO AREAS (if ai)Dlicablel
0 ?13 • Easement iine
o t? 0 • xwL
D D • HwL
• Fond A designation
D H? ? • Emergency Overflow Elevation
P1"0 0 • Lot lines
0?.CY 0 • Right-of-way and street width (to back of curb)
8" 0 D • Proposed home dimensions includinq any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
8?G
0 structures requiriag permanent footiags)
f
d
d
i
i
hi
• recor
an
any C
ty
Show all easements o n
t
utilities w
L? D
0 those easements
d
d
t
t
t
tb
f
k
• se
propose
s
ruc
ure an
Setbacks o ac
of adjacen
_/ existinq homes
? 0K 0 • Retaining wa;A:xaguirements, if any
OCtobei 1992
. ?...-.. .
?
8+02 8+86 9+74 10t62 11+50 2? +34 13+18 14+ 0
7+16
, 11 12 13 14 15 16
10
8 O 9 6°x6-1 TE
-
?
?6x6 T E , 40. ' w2
??
112 s
S
e
52
3
EE
'
113 4,
2s.7'
' HYD.
n ?
6 x 6 T ?
E
? sX
T
,?
.
--
1
YD. ,
I
A
'
' 318A
,\
G
A ? V a
^
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?
HY 75 z
A /
\ B? BO \ - 6' I
?
? c.,
.4 r/y3?
--28
ivc.
,
/ MH -i 5 . ? .
260'- 8'
10' -\MN•6 258'1-e'ev.C. o .
--
133' MH-15
MH-1'?
?y/ ?Vx\ I {? \? / ? ? \ l 30.5', _'-31
N33 6 525 7 y43' 55.2'8 y 611 V \V/ 1J I
I I_
-73.2 9 913I O 7f ' ? ?
?
7+06 St04 gtgg ? (D o O
9 * 84
10+74 3
30-
?
3 ? ?
_
See Shee? 4 Scale: 17=10(
MH-6
940. DR I V E B M93gp 10,
9377
pP H DO MFi-15
1 MH-5 i ? - - -
- - ? 934.8
--
936.4
?
'i -- - -1? -- - - _l -- -- - -? -- -
!
- ? :
I i
I ?
? ;
i ? ra 0.87258'-8"P.VC. a
1 o.
? !260 - 8?? P? ?-• I.i23 .
133'- 8n o
PV
0
44 /o ?
,5.,
? .
i
?
?C• I ? j • ,
?.I•-•,:
? ?? i'Y Cirt??i'GPN UvlE J V ..I I :l '. I':
iY2 A^CLIrA-CY OF TILI5'Y t.0 AiiC),','j ?-
' ?i fvR ?J0r? EtE1/ATIOIVS. ITHIS Dl?if:iu 1=09
'
I
' Q' ??, m ?
n
NFr?^:.
.A1
I?i? PURPO,SES OP!L`r? APJD ! -
N? , ri
'c
IRSOi?!S 511VG IT SFNOULD VEFI =V ?"Fic
ID
+?
?`?
?
I?t!:=Or?Z?iA?'Ii?fV O(V THE SITE
? ?. N z
I
.
,
I
i
I
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i i I I
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---- i '
?
CO
i.. I N I I I ? a.
u) f?
tt) ty? l
l4 N .. I I cV cq i i NcV N
? Qi? `t (1)
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12 13
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_
, - -. -? ? ".- -- -- I I,--- - - - _ . -
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- - - -
-
- - --
? .
. ----
--------- .
i`
'-SEP-21-1994 10:35 FLRNcn, ]th-, 1 612 45- 3655 r.0 =;0E
MINNESOTA STATE ENERGY_CODE CALCULA'PIONS
, BASED ON CFtAPTER 5 OF THE
MOAE.L ENERGY CObE - 1983 EDITION
Adoptioh Effective
owner
-_-Phone__-Date
Site
Contractor (.-V7 104"1 VG71 LfPVI":;+? (??___Pnone
Building Classification: •rype A1 (single Family & Duplex)? -
Type A2 (Residential, 3 stories or Iess) (OVer 3 stories)__(other)
NOTE: Complete pages 3 a[td 4 first,
GENEl2AL INFORMP.TIQN ?? ?,r??
1. Building Perimeter ??W??? ft.
2. wall height (ground to eave) v __ft.
3. 1. X 2_ (above) gross wall area 3sq.ft.
4. Building dimensions (C.)___ - X (W) - =?J? sq.ft.roof & floor area
5. Sq. foot area of rim jnist - Floor joist size (2 X l`? }
4 0- X .-,Z5-[,(Perimetet) - _sq.Et.
6. Doors - Area 12
?J
Thickness_._ in U. factor,,;_`T7
Type of construction i Perimeter ft.
Manufacturer
7. Total door's perimeter ft.
9. Wlndows: Manufacturer?f?SUL. r_._ State approved
U factot' C-o'
TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL
c+ ? u EACH UNITS SQ FEET
??_.?????`??='r -- ------ -
-?---T--
9. Total sq.ft. Glass Z7 Z
lo. Fireplace area: width X Height X___,_ = sq.ft. .
11. Exposed foundatfon: Height X Perimeter'(,-77 XE48=?sq.ft.
COMPLET'ION OF THIS FbFM IS REQUIR£D FOR ALL NSW CONSTRUCZ'ION, HAJ0R
REMODELING AND BUILDINGS SEING MOVED WHERE ENERGY, OTHER THAN 'tHE MINIMAL
CODE ALLOWANCE, IS USBD.
-1-
' SEF-21-1594 10:3- PLRNCO, IhJC. 1 612 45-D 7=59 F.03,0e",
12. Fxaming area = 10$ of gYOSe wall aTen. I4 4 4 Z,
7 -.?
13. cross wall areaJ__ J -? sq.ft.
Window area A--???! sq.ft. U wfndows =
Rim joist area A Z sq.ft, u rim joi;>t=
boor area A-_Tjsq.ft. U door area=.14`
Other doors area A?sq.ft. U other doors=_._, 47
Exposed fndn A?-1 sq.ft. U foundation=iU761-
Framing area A.?< <5 sq. ft. U£rs ning area= 'C-fi'-5
Net wall area AZO 351 7 sq.ft. U wall= __043
( 17B) TO'TAL . . . . . . . . .
UxA = 16
UxA = 1 Z,-
UxA = `
UXA =
UXA = t43_
UxA
UxA
UxA = J?_
14. Gross wall area x 0.11 (A-1 ginqle family & duplex) = alZowab2e UxA/Code
(13. above )
x 0.23 {A-2 othor reeidential}
x .23 (other buildings)
x .28 (over 3 atories)
d BTUH must be larqer than or ssme
A 3` !3 x U code °F. ae 13B above____?
15. Ceilinq framinq araa (Af) equale lOt of ceiling area
15A. Gross r.eiling area >(L) -~ x(W) 1?-n sq.ft.
158. Joist area (A f) = 10* celJ.ing area 15C. Net ceiling area (A.) (15A - 158) _?•?/ sq.ft.
U ceiling x Ac _?:/? ?d xi,0,=?.
u framing x A? = ;7
15D. 2'OTAL U x A .............................
16. Ceiling aren (15A) x 0.026 (A-1 gingle femily & duplex)
s allowable UxA/Code
x 0.073 (A-2 other residentia2)
x 0.06 (other)
p-_?? ? 7 a=` BTUH must be larger than or same
A(15A}?D X u coa? r.? OF. as 150 above
N02'E: Use U anil A values obtained from pages 1, 3 and d.
CERTZPICATION: I hereby certify that I have calculated the "U" factqrs and
"RII values herel.n and that the building here described meets or exceeds the
StaEe of Hinnesota Enetgy Conservation Act.
Date
Siqnature
-2-
cirv nF rAcaN
r_ASHIE:ke S 7FhMINAI... N0: 46
DA7F..- 06/13/97 T:LMC:: 15:06,:33
IL+::
NAMEc 70N C NF_'1ALLI._
:3?:tU 9001 2065 F'IN OAF: LiR 50.041
21.55 900:l _CIE,` PIN OAt: Dli f].`ip
r
7e'tal Receipt, Amount e 50.50
CFO'S?12
lJBF_'R ICi: NFlNCY
1kYd?X ?F?%Xt?X7R?kXokXc??X>X7X>X%??'FRC?kCX??k?k7k?kh`P61%?kM9F??Yb??X(
?'V
CIT'Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
p.I.N.: 10-81950-120-01
PERMIT
PERMITTYPE: auzLozNs
PermitNumber: ?30225
0 6(13 / 9 7
Date Issued:
2065 PIM OAY. DR
LOT: 12 BLQCK: 1
VIENNA WOODS
DESCRIPTION:
V[RIFY f-TG
LOCRTION
DECK
NEW
434 AL7. RESIDENTIAL
BuildirM, Permit Type
Fluijdirt6"W rk Type
i
,-ten6us Code
?-
l k
/i
ti
t
't- J
REMARKS:
FEE SUMMARY:
f?a..., ? .^.--
Surcharge
Totel Fee
;;,C 0 .0 0
$50.59
,
CONTRACTOR:
,0
'>-
A?/?J? - Rpplican
R L ' J O N
2665 PIN OAK OR
EAGAN MM
(612)405-0675
I 2 faereby aciinowledge tHat S ha-ve re?ad this appl%catibn ,.nd sYate that thc
in'Fnrmation is porroct atid agree to comply wittt a11 ap}t2icabl.> St.,;i:e of Mri.
5tatutes and Cfty of Eagan or-d5;crances.
L ,
APPLIGANT/P MITEE SIGNA7UR ?ISS ED eY: SIGNATURE
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EfiGAN
3(? ?? tp 3830 PILOT KNOB RD - 55122
681-4676
New Constrvdion ReauiremeMs RemodellRaoair Reauiremarns
? 3 regiatered sita aurveys ? 2 copies of Plan
? 2 copies of pfana Qndude beam & window sizes; poured fid. desgn; etc.) ? 2 site surveys (ezte['ror addklarre $ dadcs)
? t energy wlwlations ? 1 erreigy celculadona far heated atldiNnns
? 3 copien W tree Presservalion plan if bt platted after 711/93
required: _Yes No '
DATE: q -J CONSTRUCTfON COST:
OESCRfPTION OF WORK: IE c- K
STREET ADDRESS: ZO ?o ? ?f eL1 Q,k ic ?? I Q f-
LOT BLOCK ? SUBD./P.I.D. #: ??? L4=zLit
PROPERTY Name: To ti I.KSAy , VElnJ I?l.l- Phone ?(Z"40 !?- o lo7S"
OWNER
Street Address: Z0 (05 TtN (DAd- ? R •
City: !"lkti1 State: ak? Zip: `?S I Z Z-
cON7rtaCTOR Company: Phone #:
Street Address: License #:
City: State: Zip:
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration #:
' Street Address:
City: State: Zip:
5ewer & water licensed plum6er (new construction anty): _
and Iot change are requested once permit is issued.
I hereby acknowledge that I have read this applicadon and state that the
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
Gertificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
. Penalty applies when address change
is cortect and agreelqcomply wlh aj) applicable
JUN 0 9 1997
Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex ? 11 AptJLodging o
? 02 SF Dwelling ? 07 4plex o 12 Mu(ti Repair/Rem. ?
? 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ?
0 04 SF Porch ? 09 12-plex ? 14 Fireplace o
? 05 SF Misc. ? 10 _-piex ? 15 Deck
WORK TYPE
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
?mp" ' ??lv? ?olia&
GENERAL INFORMATION
Ot2 t-0GemUrJ OF loip-OPO-'TY
Const. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Staries
Length
Depth
APPROVALS
Basement sq. ft.
Main levei sq. ft.
sq. ft.
sq.ft.
sq. ft.
sq. ft.
Footprint sq.ft.
Pianning Building
Permit Fee
Surcharge
Pian Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Traiis Ded.
Other
Copies
Total:
661, Engineering
Valuation: $
MCMIS System
City Water
Fire Sprinklered
PRV
Sooster Pump
Census Code. ?
SAC Code OI
Census Bldg f
Census Unit 0
Variance
°k SAC
SAC Units
.
? CONSULTINO iHGINEEflf
410 BE PLpHNEfli and li1ND fUflVEY08f
NGINEERING
COMPANY, INC.
? 1000 EAST 1461h STREET, BURNSVILLE, MINHESOTA 63337
C!/9TOM DES/6A/ED
#6539. 0/
f?K. Zi8
P6. 7/
PM 432-DO00
CERTIFICATE OF SURVEY
Legal Description:
SCALE : 1' = 30'
(931,0
ED
E.&GILN,
EX/iSTiiuG
f-?xx"t
3o FT. FZDNT
SE78acK LiuE
"ll
0
('? 0 1?
1 i ? a
???
? ' ?
v
NUg =
/
(g?oEo ) DENOTES EXISTING ELEVATION
(935• Z) DENOTES PROPOSED ELEVATION
._.-- INDICATES DIRECTION OF SURFACE DRAINAGE
3•50 = FINISHED GARAGE FLOOR ELEVATION
2 , = BASEMENT FLOOR ELEVATION
5. 3= TOP OF FOUNDATION ELEVATION
Beuc" MAZK :5AN. MN 4 7 /N7E/25E=71cW eF piN a9L' o?-'??E
AND Ki/+&S P-Oqp. ToP= 939,00
AoDRE55: cVS PiN oAK Ra4D
45AST
1? L- ?- •_ i 1 i
LoT 12
) I . ,
f
(9 35, o?
?26?T ?oo
G4RA6E
S ? W r ?YZ4'
7.33 eba$lo.oo
N N
PKopaSED ?
-I FIoUSE N
S
?
° ?i7v??oJ •,?[a.a?
5 935.2 L ?--
?936.6 i o s?w? -( o
---45.1----°
-77. i = i2os 49
d = °qa,
? • - '936.54'
M.H.
(923. z
?923, 2.
ORA/A146E AND
U7-IL17Y EASEit'IE?/T
Ql j
o h i
192i ' ?9
EKiS71NG
NouSe
Nue = 920.93
PL viEV:'_ L,
?937,3} -- -= -
s37. 88 ?
014
REO
.41N ? r?t +?-rJ tJ ceTiua ?MMr r4,4 r fJe tCaw r!c.c,o 'ra
,?? ?.? ?? z a.?,?? M w?• ,
I hereby certify that this is a true and correat representatiott of;a tract of
land as shown and dascr bed heraon. As prepared by me this 2/Sr day of
SEyIE??I?
'
? 19cillv
? ?
Z?.- ??'z""40 Minn. Req.
No. /p085
. / L Jg CITY USE ONLY
v RECEIPT #: ? ?•P ?"
SUBD. ?.tLrvN.? I ? Wlow-l-k RECEIPT DATE:
1998 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, MA7 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
-- - - - - - - - -
FIXTURES --------
EACH - - - - - - - ---- - ---- - - - - - -----------------
# TOTAL
Shower 3.00 x l -
Water Closet 3.00 x ? - 3
Bath Tub 3.00 x -
Lavatory 3.00 x
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - t 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
Water Softener " for existing dwelling 20.00 x =
U.G. Spfinkler " for dwelling under const. 3.00 =
U.G. Sprinkler ` for existing dwetling 20.00 =
Alterations *toexistingresidence- _20.00 _ _zCG'aC
Water ur-T n-APoun-d- 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems * Abandonment 20.00 =
STATE SURCHARGE .50
TAL ? ? o ' s?
T
O
--- • ------------ --- --------------- -------------- -th --- --- •- • --- ------------------- ? • -- • -- • • -------------- ----- • -- • ---------
1 hereby adcnowledge Mat I have read this applica6on, state Mat the information is cortect, and egree to compy with all applicable City of Eagan ordinances.
k is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any dameges caused by the City during its
nortnal operational and meintenance activities to the facilkies wnstructed undar this pertnk within City propertylright-of-way/easement.
SITE ADDRESS: qJ O?K-- jD/L 1 1/ L
OWNER NAME: IV ?t.? C, L(-
INSTALLER NAME: ? u\J litA- Sf?`/ NC?--? ?1,L-TELEPHONE #: ?Y ? Z k0 .? U?7 S
STREET ADDRESS: ?!?J ? A- K- SZ?2 t UJ:
CITY: !?^ C9 A-ti1 STATE: ?n 1j ZIP: l? 1 2 Z_
OF
JS/FORMS BLDGlPLBG PERMIT (RESIDENTIAL) 1998
5/1 90
2007 RESIDENTIAL MECHANICAL rEUIVtIT arrLicaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
"0-.I?D
?Date C)?/
Site Address ??' n??? !./' Unit ?t
Property Owner ?tl ?4' L?J x Telephone #t{/1 C? L/ (? d
Contractor
QifPtG&-AdC
M G
;
.
Street Address 3451 W. Bumsville Paricway
city
State Bumsville, MN 55337 Zip Telephone #?)?(GL
Bond #
9 I (YX?? 2)
' 1
?
:
Expires: V
The Applicant is _ Owner _K Contractor _ Other
Fire repair (replace burned out appliances, duchvork, etc.) $ 90.00
This fee applies when eutensive mechanical repairs are made to a bu ilding.
Add-on or aiteration to existing dwelling unit $ 50.00
? furnace _Additional X Replacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ 50
Total $ ?
I hereby apply for a Residential Mechanical Pertnit and acknowledge that the infonnation is complete and accurate; [hat the work will
be in conformance with the ordinances and codes of t6e City of Eagan and with the Mechanical Codes; [hat I understand this is not a
permit, bu[ only an application for a permi[, and work is not to staR without a pevni[; [hat the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
_,", , a ?,??e?I ???/J
Appl anYs Printed Name Applicant's Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2065 Pin Oak Dr
Lot: 12 Block: 1 Addition: Vienna Woods
PID:10- 81950- 120 -01
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments: Expired Permit - Closed w/o Required Inspections. Letter sent. 12/10/2008 pf
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Questions regarding electrical permit requirements should be d
952- 445 -2840.
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Corey L Cox
2065 Pin Oak Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
ected to Mark Anderson, State Electrical Inspector,
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA083117
05/20/2008
ePermit
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118939
Date Issued:11/12/2013
Permit Category:ePermit
Site Address: 2065 Pin Oak Dr
Lot:012 Block: 001 Addition: Vienna Woods
PID:10-81950-01-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Reinaldo Cintron
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Corey L Cox
4333 Woodgate Ln N
Eagan MN 55122
Ralow's Roofing
4351 Parklawn Ave.
Suite 108E
Edina MN 55432
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature