2089 Pin Oak Drr.: •, r CITY OF EAGAN
` -+3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121 -
PHONE:454-8100 ?
BUILDING PERMIT Receipt4k
To be used for Est. Value ?' •? Date ,19
Site Address
Lot Block SeclSub.
Paroel No.
a Name
W
z Address
O oti.,..e
, o Name
? ` Address
I' City Phone
W Name
"W Ly
?
=a Address
` W City Phone
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 Permittee
A 8uilding Permit is issued to: applicable State of Minnesota Statutes and City ot
Building Ofticial
OFFICE USE ONLY
On Stte Sewaye Occupency
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required * of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bidg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
?- Permit No. Permk Holdsr Date Telephone ?t
Plumbing
. _ `
H.V.A.C.
Electric
Softener
Inapection Dete sp. Comments
Footings I ?? fl
Footings II
Foundation l,
-
Lnz
Framing
Roofing
Rough Plbg. . ?
Rough Ntg.
Isul.
ST z
Fireplace
Final Htg. ? -;?,C Q ?
Final Plbg. ?- ?
Bldg. Final ?? cr
Cert. Occ.
Temp.lP
Deck Ftg.
Deck Final
Well
Pr. Disp.
* ??+?• •
fEtrti#iratt of (Orrupanry
titp of eagan
191,parwpnY Lif sidlding 3wrrtinn
This Certifrcate issued pursuant to !he requirements of Secrion 306 of the Uniform Building
Code certij'ying that at the ame of irsuance this structure wws in compliance with rhe ?+arious
ordinances of the City regulating buifding carslruction or use. For the jollowing.•
? ?;?„? :?F I7WG/1Q1R Bw n,.,;, N.. 14553
OWUo•-r 7Y119 R3 Zoniq DWAa Pi.) ii 1 Tya COWL Vn
Owner o( Building FUTS DMQN ?, 13130 I?1IX,IE1CE AVE., APr'?_
9uilQingAddres W, D?'T`^. Lan6ry LBt BI, vD2M ti'OODS
Dste: JUNE 3, M8
Bw7dina Oefae7
POST IN A CONSPICUOUS PLACE
.., . •• r
Site Addres;
Lot
? Name
s Addrs
c City '
Name
3 Addre
p CitY -
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: " ? BLDG. TYPE WORK DESCRIPTION
Block Sec/Sub Res. _ New -
... ? Mult Add-on
Comm. Repair
Other
_ t n?..__ . . . . .
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM
1 PER PERMI'T) -
-
COMM/IND FEE - 1% OF CONTRACT FEE
' M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
M BTU REMODELS •
MINIMUM COMMERCIAL FEE •
M BTU
STATE SURCHARGE PER PERMIT •
CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES
EEYOND $1,000)
1.50 EA.
12.00
20.00
.50
FEE ` S/C: ' SIGNATURE OF PERMITTEE
TOTAL• '
FOR: CITY OF EAGAN
Site Ad-dress
Lot t „ Block ?
? Name
?q Address
c City
m
c
3
O
PERMIT q
PLUMBING PERMIT RECEIPT t# -
CITY OF EAGAN - -
3830 PILOT KNOB ROAD, EA(iAN, MN 55122 DATE: '
PHONE: 454-8100
?"R? BLDG. TYPE WORK DESCRIPTION
Sec/Sub Res. New
Muit. Add-on
Comm. Repair
Phone
Name _
Address
Ciry
Phone
FEES
COMM/IND FEE - 146 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
_5'_Water Closet - $300 $
'
? Bath Tubs - $3.00
-? Lavatory - $100
? Shower - $3.00
?
Ki?chen Sink - $3.00
Urinal/Bidet - $3.00 '?'•"•
? Laundry Tray - $3.00
? Floor Drains - $1.50
? Water Heater - $1.50
? Whirlpool - $3.00
? Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - 510.00
Pnvate Disp. - $10.00
Rough Openings - $1.50
FEE:
FOR: CITY OF EAGAN
STATE S/C: -
GRAND TOTAL:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT
To be used for . ' L
Est. Value 3?100000
Recefpt
,19
Lot Block t Sec/Sub. Y 1??A UIOP=•
Parcel No.
a Name I.LV I ,.104`*i12pN
z Address ' ,. . , ' : t 1W
° City Phone 471..1'
. o Name ' : A? i .i
? q Address
? City Phone '
Name
City
I herehy acknowledge that I have read this application and state that the
information is correct and agree to compy with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: h/FATY%
on the express condition that all work shall be done in accordancewith all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
On Site Sewape Occupency
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required * of Stories
Booster Pump Length
Depth
S.F. Totel
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
Psrmit No. Parmit Holder Date TeIephone x
Plumbing
H.V.A.C.
Electric -,?C tf ` " 7 do C- "
Softener
Inspection Date Insp. COmments
Footings I ?-. ?
I
Footings II
Foundation
Framing ,
/ - 2
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg. ?
L
Final Plbg. -
Bldg. Final
Cert.Occ.
Temp. LP q -40 ?- ? -
Deck Ftg.
Deck Finai
Well ?G?''??? G.? f'??G1. ? ??' ?Z /?
Pr. Disp.
D. OE"
CITY OF EAGAN Remarks
Addition VIF.NNA WOODS
Owner
0 81950 080 01
Street ZOHg Pin Oak Drive State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. Im . SO 19$1 _ 2834,45 2$3? 5
STREET RESTOR. ^
GRADING LJ6/' 1981 " a.73 58.77
SAN SEW TRUNK 1973 129.78 8.65 15
• SEWERLATERAL ,ry 423.23 10
* services 1981 lU
WATERMAIN
* WATERLATERAL jJ$j jO
* WATER AREA 1981 j0
* STORM SEW TRK 1981 LO
* 5TORM SEW LAT 1981 jfl
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
7?
DAY /DATE :
ADDRESS:
TIME:
??,?,?
FTG [?????Q? ??? ? FINAL HTG .
W
DECK FTG. ? kJ
FINAL PLBG.
FDUNDATION FINAL/C.O.
FRAMING ? FINAL/DECK
lx_ ROOFING ' ADDITION
INSULATION FIREPLACE
R.I. HTG. POOL
R.I. PLHG. GARAGE
OTHER
. ?
FO ??
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E: 454-8100
BUILDING PERMIT
To be used for SF DW/GAi!
Site Address _
Lot a Block
Parcel No.
W Name
z Address _
3
0 City A pII
1
Sec/Sub. Y?VM WWDS
1
, o Name
? Q Address ?
? City Phone
Ua
W W Name _
F W
Address
Q W City -
I hereby acknowledge that I have read this application and state thaf the
informat+on is conecf apd agree to comply with all applicable State of
Mjr?nesota Statutes and City of Eagan Ordinances. r
Sighature of Permittee ?? ? • ?
'A Building Permit is issued to: ''rf` 1 S {lC??LL
on t1fewcpress condition Ihat all work shall tre done in accordanCewith all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
49 pin aAc
Receipt # ? ?--c ` 1
Est. Value $IO$,UDO Date MUCH 4 ,19 4k
OFFICE USE ONLY
?-3
On Site Sewage Occupancy
MWCC System X Zoning P11'fl-1
On Site Well (Actual) Const Vn
City Water (Allowable) Yia
PRV Required x * oi Stories
Booster Pump length bZ'
Depth 48'
S.F. Total
Footprint S.F.
APPROVALS
Engr./Assess.
Planner
Council
Bldg. Off.
Variance
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
594.00
g,1.OQ
297.04
100.04
550.00
550i00
67.00
32 5. 00
1,740.00
:&1.C
:
?
CASH RECEtPT
`CITY OF EAGAN 3830 PILOT F!B ROAD
• EAGAN, MINNESOTA 55122
• /? FI ' 1 - DATE ' ,F? 19 /?t • > i
r*c!vm
! AMOUNT $
& DOLL4RS
,oo
? CASH Q?CHECK
l?
wa
(
Slfi? ? ??P?,a? ?,,
lo%? COPY
Pink-Flle Copy
Thank You
BY
BLDG. PERMIT N0.
,
. a1-3210 Bldg. Permi t
+01-3422 Plan Check '?-
01-3445 5urch./Adm. C.UCt
01-3446 SAC/Adm.
01-2155 Surcharge
- 14-3860 Road Unit
v _7 J
20-2275 SAC
20-3865 Water Conn. G Lt)
20-3868 Water Trmt. Cy
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
-', 1-Y-3855 Park Ded.
TOTAL
t Copy.bffice
•2 copy: crew cnief
3 Copy: Municlpality
4 Cqily: Cusirher
Brooklyn Center Store
4321 - 88th Ave. No.
Brooklyn Center, Mn. 55429
(560-6442)
CREW CHIEF
Equipment Needed
? Back hoe O Bob Cat
? Cat ? Truck
? Snow Fence ? Uni-Loader
Pacific Pool & Patio
A Minnesota Package Products Company
No. St. Paul Store Burnsville Store
6922 - 55th St. No. 1278 W. Co. Rd. 42
No. St Paul, Mn. 55109 Burnsville, Mn. 55337
(770-13131 (435-35001
Inspections Contract
? Walls
O Plumbing
? Footing
O Before Backfill
10,000.00 B.P.
5-200 F.itten
175 Heate)L
Ridgedale Store
12500 Wayzata Blvd.
Minnetonka, Mn. 55343
(541-9180)
ACCOUNT NUMBER OOL SIZE DATE
1
7chnAovz
NAME ? HOMEPHONE
:0'B 9 PFn Oafi Rd.
STREET WORK PHONE
STATE
Diagram pool site in relation to house, garage, property line, and wires. (Allow 3"
111
?
\
?
?
la Mark location of filter and/or heater by (#2).
d;lndicate deep end by (X).
O Does Customer wish to retain any or all dirt from pool
excavation:
? Will any obstructions be encountered - such as trees,
clothes poles or power/phone lines etc.:
? evation from location marked "A" in diagram:
' Show ' r
' rype and location of slide if applicable:
0
Or Location for disposal of diri
. .. .i?
?
0 Pacific Pool & Patio recommends that customer install
(As soon as possible tollowing pool construction);
1. Rain gutters adjacent to pool +
2. Retaining wall where diagramed "
3. Run off control or drainfield
4. Permanent or temporary fence
*** CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLOWING
Normal Excavation time using a back hoe and dump truck is less than one day. X ,
Ii Limestone, Sandstone, Shale or any unusual substance, like constructlon debrla or backfill materlal that ie unuseable ln the cqns?uction
of this pool, the customer is responsible for the cost of removal and replacement of suitable materiala X -r:'.{?
L
Ifremovalofdlrt requlrescr i-IoaderoranyapecialequlpmentcustomerwillbeahargedbythehourtortheextreNmeandequipraent
used. X '
Treas and or tree atumpa are tha responaiblUty o} the customer and must be removed before constructfon begins. X ,
Some damage may be done to the yard end/or drlveway entering and leaving the yard durfng construction: Initial .
Custoiner assumes reaponaibility for electrical wiring and groundlng of the pool (Includinp permit If requlred): Intdel
Customer asaumes rbsponsibllity for the pea inetallatbn oi heater.if applicab{e (Including psrmft if required): Initial
If debris, structures, or subatance forefgn to normel soil should be encountered while excavating which requirea abnorrtf4 handlinq
and/or disposing - Cuatomer shall essulns reaponslbflity if any extre coats are incurred. Initiel .
If you wish to chanfle: fllter posltlon, slope ot land, or anything elss ateted in thls outilne, please call our oftlce - 770-1313.Crew chiefa are not euthorized to change an hing orylhq Job or make any promises for work to be done by th?rfi. Any cl#nges thet are not
authorized by the ofNce will bs cherged,eta a?d r?? - no excepNon
?
Paciflc Repreaentative Slpnsture ? Customer
Pacific Pool & Patio will make application for and pick-up your swimming pool building permit. fElecirical, gas, fence or other permits are the
responsibility of the contrpclor doing the work).
The actual cost of the DeIrmit is the rLsponsibitityetth?me owner and Pacific Poc' 3? Patio will expectto be reimbursed forthis permit cosi
within 30 days of Sning tMe permit for you.
Sianed f Date ? ?'O?
CITY 00 EAGAN Permit No: Date: "
3830 Pibt IEnob Road B/ P No: Date: ,
P.O.t `ox21799
? Eagan, MN 55121
Owner. "'ocus ?'eR3gn
Site Address: 40;9 Pfl' 1),uk ?trive I ]"1 9ier.aa " . .
Plumber. '??ncstF; .-'1umbinQ
.
MWCC: :7` ?•')Opr Zoning•
CitY Ch9= No. of Units:
Acct. Dep: 5. 00p I agree to comply with the Cfhr ol Eagan
. ? n.
Permit Fee: Ordinances.
Suroharge:
By
SEWER SERVICE PERMIT
; ..?. .
' OF EAGAM Permit No: C1475 Date:
i p14ot Keob Road Meter No: Size:
Box 21189 Reader No: Datw.
in, MN 55121
,s.. ocus resi?.zl
°tn Oak nrive LR B1 N?fe:ina ?100c18 ;,. ;•,tith PlunbinF
nn. Chg: ? `'s • . "ad Zoning:
ct. Dep: 15. nood No. of Units:
rmit Fee: 10 ? 002d
rcharge: . SOpd I ayree to comply wfth the Clty o? Eagan
Plant ? j'=+ ??0j2d Ordinances.
Meter.
j MisC.: 'Irr*r-- ; Tr.?" BY
? WATER SERVICE PERMIT
? - --- - -
ITY OF EAGAN Permit No: Date:
830 FIlot Knob Road Meter Na 400 42 0 a 7 Size:
.O. Bux 21199 Reader No: 7 9 3 F Date:S?-/?" F 9'
_ agan, MN 55121
onn. Chg: t)c?.ir?.o .?t ....:.... ....l
CCt Dep: ? ? rmit Fee:
urcharge: ?
. Plant ?i14 - ?
eter.
WATER SERN
-- ?'? ? '--- -
wiM the Ciqr ot Eayan
PERMIT
CITY OF EAGAN N2 15 0 5 4
3830 Pilot Knob Road, P.O. Bax 21-799, Eagan, MN 55121
PHONE: 454-8100 '8L?
BUtLDIW'G PERMIT Receipt#
To be used for POOL Est. Value $10,000 Date MAY 23 ,19 88
Site Address 2089 PIN OAK DR
Lot $ Block 1 Sec/Sub. VIENNA WOODS
Parcel No
? Name LEVI JOHNSON
? Address 2089 PIN OAK DR
o City EAGAN phone 423-5528
OFFICE l1SE ONLY
On Site Sewage _ Occupancy
MWCC Systam _ Zoning
On Site Wall _ (ACtual)Const
City Water _ (Allowahle)
PRV Required - 7t of Storles
Booster Pump Length
Depth
S.F.TOtal
Footprint S.F.
,o Name PACIFIC POOL & PATIO
oa Address 6922 SSTH ST
a pity OAKDALE Phone 770-1313
ua
W W
'- z
U?
a=
aW
Name_
Address
City _
I hereby acknowledge that I have read this epplication and state that ihe
informaiion is correcf and agree to comp ith all applicable State of
Minnesota Statutes and City of u-0 ? es. ?
Signature of Permittee 1 " "
A Buitding Permii is issued to: PACIFIC POQL_. _PATIO-
ontheexpressconditionthatallworkshallbedoneina ordancewilhall
applicaGle State of Minneso(tja ?S?[aItutes and City o( Eagan Ordinances.
8uildingOfficial?r\DAlA J)??L
APPROVALS FEE5
Engr./Assess. Permit 106.00
Planner Surcharge 5.00
Council Plan Review
BIdg.Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Roatl Unit
Treatment P7
Parks
TOTAL 111.00
CITY OF EAGAN N2 14 6 5 3
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
? PH ONE: 454-8100 sV I?i1 r `
UII?ING PERMIT Receipt# O `t o
1 beusedfor SF DWG/GAR Est.Value $106,000 Date MARCH 4 ,19 88
Site Address _
Lot 8 Block
Parcel
1
Sec/Sub. VIENNA WOODS
m Name FOCliS DESIGN (Kris Howell)
w
z Address 13130 FOILAGE AVE
°, CityAPPLE VALLEYphone ?11-29AQ
,a Name 3AMF
? a Address
m
P CityPhone
ww
F, Name_ _ SAME
?
Address
I
aw City Phone
I hereby acknowledge that I have read this application and state that the
information is correcl and agree to comply with all applica6le State of
Minnesota Statutes and City of Ea an Ordinanc s. n
SignaWre of Permittee (2?Y ?
A Building Permit is issued to: KRIS HO LL
on ihe express contlition that all work shall be done in accordance with all
applicable State of (M?i,nnesota S/ta?tutes a?ntl Qity of Eagan Ordinances.
Building Official_67Lli?.?-
T
2089 PIN OAK DRIVE
OFFICE USE ONLY
11-3
On SRe Sewage _ Occupancy
MWCCSystem ?LZoning pD,R_1
On Site Well _ (Actual) Const Vn
Ciry Water ?y'_ (Allowable) Vn
PRV Required _X- # of Stories
Booster Pump _ Length 62 '
Depth 48 f
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Permit 594.00
Planner Suroharge $3.00
Council Plan Review 297.00
BIdg.OfL SAC,City -I49--Q0_
Variance SAC, MWCC 550.00
WaterConn. _550-00
Water Meter _ Sj.Z.- Q11
Road Uni[ _32,5-0(1
Treatment P1 704-QA
Parks
TOTAL 2,740.00
This reauest voie
18 nwnths from
D 6245048
flst Date -
eque
?
? Fi
77 -in Insuec?wn
N
PReadY Nuw Q Will NntifV. InsP
ec-
??
/s ?s lor When Readv
Licensed Electrical Conlnctor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Address, Boa or Foute No.
aa ff ?Dlri D&(e
Dnou, Citv
? 4h
ecuon o. Townshfo Name or No. Fange No. Counly
I ? 7-6,-
Occup,ntIPRINTI
L ,e'?r Phone No.
6 i7
Power Supp?lJiar ,
K?jl'w FleGvl/"/U Address
Electrical Cnn[ractor IComvany Namel _ ontractor's I.icense No.
? I' ??? ?./? /'/ L -? ' /7 C? v CJ Z?1S-?5-
Ma inB AdJress (ConVacmr or Own r Making Instailation)
?
s
T?3 7$
?
ti
u? .
e?. SCuJ v
/
Aut Signature Vacior Owner
P ? RinB Installa[ionl
? Phone Number
a?y s?ys
.
?u
MINNESOTp STATE Bf3PxD OF ELECTNIGITY THIS INSPEGTION PEQUEST WILL NOT
Griggn-Midwev Bltlg? Foom N-191 BE ACCEPTED BV THE STATE BOAND
UNLESS PROPER INSPECTION FEE IS
1821 Universitv Ava.. SL Peul. MN 65104
Phone (612) 642-0800 ENCLOSED.
?/?//REQUEST FOR ELECTRICAL INSPECTION EB-00007-08
' See instructions ior campleting this form on beck af yellow copy.
L) 6 2 4 5 0 -'X" 8elow Work Covered by This Request
M iea ServiceEntmnca5ize n Fee Feeders/SUbieeJers u Fny Circmts
00 0 ro 200 qm s 0[0 30 Am s 00 0 to 30 An s
Above 200 qmps 31 to 100 Amps 31 to 100'Am s
Swinming Pool Above 100_Ainps Above 100_Am s
Transiormers Irrigation Booms Pdrtial"Other Fee
Signs Special lnspection S ?50
TO F€E.
Ae?*?a rks
_ _ 1 I .r
?.,h?.,cal
Inspector, hereby
¢erlily Ihqt Ihe nbove
InsOection hes been
maae.
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD • 55122 ??
O 65'1-68'1-4675
?2
New ConslrueNon ReauiremeMs Remodel/Renalr ReculremenN ??jO ?
? 3 reglitered sBe surveys sAowing sq. H. of 101, sq. B. ot house 2 coples of plan
and all roofBd areas (40% moxlmum lof coveroae allowed) 7 set of energy calculalions fa healed addBlons
D 2 copies of plans (show beam 3 window alxes; poured Ind. design; etc.) 1 sNe suney lor extedor addlMons d. decks '
D 1 set W energy calculationa
? 3 copias of hee preaervaXon plan M lot plalfed aHer 7/1/93
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREETADDRESS: Z04;,4
LOT: ? BLOCK: SUBD./P.I.D.#: V J. A 01 V?o Wfi o (?p
PROPERTY
OWNER
Name: ???AG Phone
Last Firsi
Street Address: 20/J/ Ol.? m?e o
City es-Z?e? State:
Zip:
Company: W6??U? Phone#: U O`I
(area code)
CONTRACTOR
5lreet Address: 1lcense # Exp.
Clty Stute: h? Zlp: jJ-ZS? V7i/
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Sfree't Address: Registration #:
Cffy State: Zip:
Sewer & water flcensed plumber (reauired for new consirucHOn oniv):
PenaNy ppplies when address ehange and lot change is requested once permH is issued.
I hereby acknowledge that I have read th(n appticaHOn, sfafe that the InformaHon Is cortect, a?? n gree fo comply wRh alI appllcabl
State W yVlfnnesota Siatutes and Cify of Eagan Ordfnances. i
Signature of Appllcont: A
OFFICE USE ONLY
Certificates of Survey Received _ Yes
_ No
Tree Preservation Plan Received _ Yes _ No _ Nof Required
d?1
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling . ? 07 5-plex fl 12 12-plex 0 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plez ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
woaK nrPe
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 5iding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interiar) ? 42 Reroof
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC :
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Ofher
Copies
Total:
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
_I 3?. a5
i1? a.?l 5
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
_ Engineering Variance
Valuation: $
SAC Units
% 5AC
..f,l_•it?? ',.- 1:."r??'?nt:
..:.-?niT•?/??
...r, _t F?.
Jp17G /riq
f?:?
? .JJ ._'j?I. C,O:]J
?
I
;l
.. ,... ? ....n? ? SJ .... ? n ...2 , i n. .. ... 'i?? r
RECORD OF COMPLAINT
DATEs
COMPLAINT TAKEN BY: IL -, le
NAME: -{?
?JD,4n.f(?rs
ADDRESS: ?D89 PiH DAK
PHOxE NO.: ?-yy _ 88y6
COMPLAIRTs
(.?J?f-er Leak
Dp,
tl, k,
6CTION TAKEN: f?? ??
1- ?ah}a /-/ e" ,,,?, C'„s?. l .,4", oN 9-2'-??
c
-
Q y-o6hr 0,,a.S oy t?< J o6 si9e /-o Co?rec? t'6„c P.b 61P.-, o., 1,4<7' ,Sa_,
7 by,.n,$ L
li /°/C+?i?N_
T`Oa.rp.$Bh
CT
?Liwif
f h2 Gt?a,`.?? e. (
p„ fA L i a fer;o? O't?"
tl c ho '
s e we?/cQ ?6e
.
one G,e¢,t. .
COhAiENTSs `
TYPE OF BUILDING: Sr b
LEGAL DESCRIPTION:
• SICNEDt
?v%
.
RECORD OF COMPLAg1S
DATE:
COMPLAINT TAKEN BY: y?? ?C-°-2-c-Q??L
NAME: Q?
ADDRESS: ca?c 6`7
P80NE NO.t j V v
COMPLAINT z F,Q,-Pi, L'ol'"hu ./Zf?t?j;;C _ Q?? Ce?1?c-c ' 7L-=
?
6CTION TAgEN7
Z^'?
V
COtMSENTS: ? ?L?i?c ?? f? ?,L
TYPE OF BQILDING:
V
LEG6i. DESCRIPTION: (/-La? Y9`'? ? d
, SIGNED: (>(??,W/? &?
4
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
I L ? 53
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
M[JLTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMA7ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
r ep J A rd 2 0 1988
To Be Used For: Valuation: S I--?'?-(?P9°I?Date:
000 ? OFFI
Site Address 10(
?
Lot ? Block ? On site sewage
.,Ir MWCC system /
Parcel/Sub V?'y:7,k>R A-O,MA6 On site well
? City water i/
Owner ,(A?C?ho PRV required tz
Booster PumP
Address
City/Zip Code
Phone i - ) ,
Contractor'
Address J 51--w
City/Zip Code Annic il rU
Phone Lf,?i/ 176 .7
Mch./Engr. sc? ?y»
Address 1` t`
City/Zip Code
APfROVALS
Oecupaney R-3
Zoning PD R-I
Aetual Const V-N .
Allowable V-N
1F of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Engr/Assess
Planner
Council
Bldg. Off. 62t27-(,
Variance
Permit 5914, ?2-0
Surcharge
Plan Review n1,'7
SAC, City lDO. °0
SAC, MWCC :5SD,°°
Water Conn 550. °=
Water Meter 67. °=
Road Unit 3,z5. °=
Treatment Pl 7pW, °+
Parks
Copies
TOTAL 0C "? U 0 Phone #
Va L ua-rlaN
------
ZN x22- 528 x iZ = 633E,
. .?
. .
BAs?EAt,E NT .
I?l Xq2 = SSg
ZG X Zo = SZv
..?--
110?
MAiN F?o u&
yoXyv - 00
/ox 2?? = 4vv
ZX
J ? I - Z f
Z x ?y = z?
----
__
? y?l ?vv= 6?
/OS93Z
,
z
,
?.
F A 3T ,
IDI,°?Z
;. ? w
?
,.
.
u?
?ti'? q?a9 SI T ?RS?N T`. 'S F?a. 939??."
?> UTILIT (?4hE/vyEN.r ?
I v?a* y 4, ' ?,,,w I
Cy„
i i
W
}.. ,o I _ •
? N .L.- N ? ?40. r-- ,,, • N
4t4KA4EI N
O N
9 i S?A6 ??` ? ' 0
, ?r,, L - - - -- _ '^ _ 5
N y3 w
4 o o
L= 9Z.T"1 A s4 t 2.' "" .
R-s 12caS.49
o ?
m i,G.
9 3?t? ?b
-? PiN
n laK?
t?_ ?_?GS?, 1 PT IoN
L o T B1 5 L.ac.?4 i j
YIENq4 ?t4ooesj
'..?'tr'i-.C'f'A. GGU?.i'CY?
W Pd t+l W-=5 0-?- A
K D R..'T 1^E
??A?.E 1??=3a? ,.
Au.. e?Eta&sNLRi A?juMEti
a O?oT?j I?ohL. hnpNuME?•lT
. I hereby certify that this survey wae prepared by me or
under my direct supervision and that I am a duly Regiatered
Land Surveyor under the lawa of the State oP Minnesota.;
Date:y?
LeRo,y }[. ? ohlen
Registered Land Surveyor No, 10795
s
4,
.•,
4..I
.?
---^--?-•--s`
93?v??i7
. ?` .
EXTERIOR ENVELOPE AVERAf3E "U" COMPUTATION
` OWNER LEVi 6?21j
,ilsoo
SITE ADDRESS
CONTRACTOR P,6u7?l -A- DATE ZZ PHONE 3 t) 3 d
?4oME Y 3 r - 4.707
Determine working square Pootage oP each.
1. Total exposed wall area .... sq. ft, x'
Ba.(o
2. Total roof/ceiling area .... sq, ft, x-19.5.
Total exposed wall area above floor a
I 2
a. Total wall window area ....................... /0619
b. Total door area .............................. Zq, 3
c. Total sliding glass door area ................ 3 9. L"
d. Total fireplace wall area .................... /?.D
e. Total wall Praming area (average 10%)........
P. Total net wall area above floor .... ..........===???
g, Total rim joist area.........................
Total exposed Poundation area 3.,5,-
h. Total foundation window area ................. D
' 1. Total net foundation area above grade........ G7. S
'. Determine "U" value of each wall segment.
S. I Ue" 25 7( nUn
b. Z9.3 x tou"
0. 3914 g nUn
d. f ,O X "U"
@. X nUn
f. X nUn
g'--?G{ X nUn
h. X "U"
X "U"
/.O 2 . 7
? f?? • ? . 3
. SS . 3. 3
. s?r- - Y, rl?
3................................... Tota1
IP item N3 is the same as, or less than item`#-1., you have met the
intent of SBC 6006 (c)2.
;
?r . . * .
.
.• _
. ' ` Total exposed rooP/ceiling area ? /9Sfl?
Total skylight area......:................... -
k. Total roof/aeiling Praming area (average lOx)?
1. Total net insulated roof/ceiling area........ L 71z
?
Deterraiae "U" value Por each rooP/ceiling segment.
i
X "U" • ?-
+ k. X "U"
i 1, l??Z X°U" , 02rr_ • . 35, ?
i ?
? 4 .........................................Total ? O, ?., ,
/
IP total of p4 is the same as, or less than 02, you nave met Lhe
intent aP SBC 6006(c)1.
Alterttate Building Envelope Design
To utilize the total envelope system method, the values established
by the sum oP itema H3 and M4 shall not be greater than the aum oP
itams N1 and #2.
, 1. ± 2. .
• 3. + q.
.
.
I ,
APFLICATION FOR PERMIT
SEWER ANQ/OR WATER CONNECTION
;. .
NOTE: PAYF? OF FEE AT TIME OF
; nretaCATIau ooes rar corr ;
; sriTUM Arrxcvnr. oe PmFrzr. ;
. .
,*k TNSPECI'fON OF SESdM A!ID/O2 WA4ER .*?.
i INSfALS.A1'IIX15 WILL M71' BE S[`Evtrcn ?
f['CICIL PFIRAffT H1lS HE@/ APPAOVID. a*,
•f?*?rex:afsa??a?3+?x?fiWa?at?s?wtt:x+?
of eagcsn
1) PROPII2TY ADDRFSS: .. 20 F$ 9 }7 I 1..y
DESCRIPTION; 1_OT
a l,Jo0p5
k1.oL/alocx/.?twaivision or rax rarcel lu A
IF EXIIISTING STRL'CZY.?RE, DATE OF ORIGINAL BLILDING PERMIT ISSOANCE:
PRESENT ZONING/PROPOSID USE:
Q COrM9ERC2AL/RETAIL/OFFICE
Q INDT-ISTRIAL
a INSTITUTIONAL/GOVERNMENT
IXI R-1 SZNGLE FAMILY
Nbn Year
? R-2 DL'PLEX (Twv L'nits)
Q R-3 TOWNHOTISE (Three +.Oqits) ( Units)
Q R-4 APARTMENT/COAIDOMINIUM ( L'nits)
2) NAME: PlL-lWIOJrli
AnnREss: G2'?o Zacr???? L?d. hlo
czTY,i? STATE, ZIP: rn{{PLe- ??eau? VYI r?_ 553??,
PHONE: C4 C( 3- 2i1-1 Cl
3,
For City Ose
NAM= _ 7L ?, YV?CJ ?? PL U WI.t? I?1 ? Plumbers License:
; ADDRESS: Active
Expired
I?
CITY, 3TATE. ZIP: Not recorded
I: PHONE: 2tG 3-202 L? MASTER LICENSE # Zd (e S
Sta In€? it^ial
4) ? ? ?•
NAME: r4L ?IC??uvlIqflr,4 C.0 tiS'[e c.lC-tldF?
r,onREss: 8-123 44rE,++woon wAi
clTY, sTAZ'E,. z2P: -APP«Z ?14LL!W V? l.l. S5l Z?
I PHONE: tp& (C^ (?)(OCt (,
5)
CONNECTION TO CITY SEWER M CONNECTION TO CITY WATIIt O OTfM
6)
21w, -S.FS
???xx,?,xxx,xxx,,????,???,.??,????:??:x**?????***?***************************,?**?*****?***,?*****?*****
TAE GOLD COPY OF 'tM pERPSIT WILL BE SE[JP DIRECPLY TO PUSI.IC WORKS 1U FACILITATE MEiBR PICK-UP. *
PLEP„SE P,LS.OW 'IWO WCIRKING DAYS FOR PROCFSSTNG. SOMEONE FROM THE CITY WILL CONi`ALT YOU IF THERE *
ARE ANY PROBLENIS. *
FOR CITY USE ONLY
PERMIT # ISSUED
j)e/ 2 S
Pd w/Bldq. Permit
s
?
$ CG 7 ClQ
$
FEES:
$ $
?C? • 5?
$
$
$ S SEWER TAP
$ $ ??5 B? ACCOUNT DEPOSIT - SEWER
$ ACCOONT DEPOSIT - WATER
$ WAC
$ ?5-0 r Ud $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ f? ! I, l3z? $ l?Ii Gr7? TOTAL
- $ /-6 V(G
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TITLE:
DATE:
?
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SDRCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
,
1988 BIIILDING PERMIT APPLICATION - CITY OF EAGAN
15v3q
C
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs IIADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHIGH ADDRE55
IIS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSUED.
MULTIPGE DWELLINGS RENTAL ONITS FOA SALE UNITS # OF UNITS
11
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECg WITA HLDG. DEPT.v
1 SET OF ENEAGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECT[IRAL & STRUCTURAL PLANS,
1 SET'I; OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: Valuatlon: ? Date:
Site Address O'`fJ6- y T/dCJ C.fj?
Lot ig Hlo k ?
Parcel/Sub
Owner II?!/?/ •.)C??(iUSd
Address
City/Zil p Code 1a? ¢
Phone f:
Cantrac?tor
Address
City/Zil?p Code
Phone U-/IL
Arch. /Ei r ngr.
?
Addresslj
City/Zi'p Code
Phone RI,I
? OFFICE USE ONLY
On site sewage _ Oceupancy
MWCC system Zoning
On site well Actual Const
City water Allowable
PRV required _ # of stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit 161:?
Planner Surcharge S
Council Plan Review
Bldg. Off. SAC, City
Varianee SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
-
I TOT6L
,7?7
,-
Date:
Tenant:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit x:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
3 Site Addless:c208q fru cork ter.
t_) -cm e"\ ALV•02-1‘
Suite if:
RESIDENT 1 OWNER
Name: 2'`' (--h(.+,rd Ni t\-0,01 Phone:
Address / City / Zip:,.k)A \ cimv..: et,A,.. 'cX
CONTRACTOR
Name: tHrigl P t)amlrSl_'SycCr License it:
AddressOlOc_jq Pt i\er',r 6a Y.A
Gy: (-Ileo State Zip: Ego
Phone: 1p 1'? L6— S`-LLrn Contact Person: ..)c -kr c.._1() Clog,\- x
TYPE OF WORK
New Repla-cerment Repair Rebuild Modify Space __ __ Work in R.O.W.
_____ _ _
Deacti ►+ of work: V� it%if
PERMIT TYPE
RESIDEN77AL
XWater Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
_
( RPZ / PVB) ( Main Lower Level)
_ _
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water
Heater, Water Softener, or Water Heater and Softener (includes $_50 State Surcharge)
(includes 6.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround' (includes 6.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
'Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(add $165.00 if a 5/8• meter is required)
New ($10.00 per as built) (includes County fee and 6.50 State Surcharge)
burned out appliances. ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $ . 30
I hereby acknowledge that this Information o complete and accurate; that the work wiN be in conformance w th the ordinances and codes of the City of
Eagan; that I understand this Is not a permit, but only an application for a permit, work is not to start wi.. `r permit: that the work will be in
accordance with the approved plan in the case of work which requires a review and : • . - of
X SC.L.r0JM t�
Applicant's PrIntededime
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: _Under Ground Rough -In „Air Test _Gas Test _Final
l/l d
17695 SL9 159 « EtLSI917Z56
SZ VI LE -80-6002
SEDGWICK HEATING AIR CONDITIONING CO. HEATING JOB NO. o VD F
8910 WENTWORTH AVENUE SOUTH MINNEAPOLIS, MN 55420 (952) 881 -7739 TEST RECORD
ADDRESS 21
J3 !J OPAL On- CITY
OCCUPANT v .G OWNER 1 i. L Jj I
SOLD BY 0/ 1 1 J E 1 E-. V LLED BY Q1� k
i f� V V
1
Et. t I V im' 1 vL 3%� &,3 (,.�^l
MAKE LE mil. c 4 v a I L V (DK J D
l 1 1 V 3 a�
SERIAL NO. fi INPUT FPg.
THERMOSTAT PDDD VENT SIZE A
VALVE TYPE OF LINER T to
LIMIT I y1G,Q LINER SIZE li Lt
LIMIT SETTING n 0 FILTERS: SIZE 1 A 1 4 (0 NUMBER 1
FAN SETTING i 7rn I u_
I WIRING .bv'I 4 v
PILOT TYPE 0 TEST TAG
IGNITION MODEL 14 r LIGHTING INST.
PILOT TIMING S /My 2 w Q DATE TESTED 0 8 I �T
PRESSURE 3 ►y� PERCENT CO2 8 /6
INPUT CFH PERCENT 0 4 'Q COMPANY TESTING
STACK TEMP. 305
7 PERCENT CO NAME OF TESTER (5 0
FORM 235 (REV. 6/08) FORM DISTRIBUTION: WHITE COPY JOB FILE YELLOW COPY CITY
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2089 Pin Oak Dr
Lot: 8 Block: 1 Addition: Vienna Woods
PID:10- 81950- 080 -01
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Richard A Mitchell
2089 Pin Oak Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA090890
08/27/2009
ePermit