3640 Pinecrest CtI
SEWER & IrYia rErt PERNH
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
f ,
?
DATE 05/16/90
1. ?A
r OFFICE USE ONLY " .
METER #y/J 7 gga a PERMIT DATE 05/ 16/90
CHIP #DO 7A m ? / PERMIT # 11391
METER SIZE ?? orA B.P. RECEIPT # C 7300
ISSUE DATE ' 6- D B.P. RECEIPT DATE dS 14 q0
- PRV - BOOSTER PUMP
SITE ADDRESS 3640 PIrrLc,REST CT
LOT '7 RLOCK 1 SEC/SUB PINECREST OF EAGAN
? ,..
APPLICANT: r/? ` -` ?I i
ADDRESS: 4 U '
CITY, STATE ZIP '-
PHONE: ? l iO er
PLUMBER:
ADDRESS: 1018 MOUND SPRINGS TEI?
CITY, STATE ' ? ? {? , I'N ZIp 55420
PHONE: $84-4149
h,
OWNER:
ADURESS:
CITY" STATE ZIP
PHONE:
?
PERMIT REQUESTED
- SEWER
- COMMlIND
- NEW
WATER _ TAPS
X RESIDENTIAL
EXISTING
Lawn 5prinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WII.L NOT be giv n fo [1educt Meters.
1 AGREE TO COMPLY WITH CITY OF
EAGAN, ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WOkKIN D l?S FOR PROCE$SING. CALL 454-5220 FOR INSPECTIONS. FOR STOpM
SEWER PERMITS, CONTACT EpGINEERING DEPT. .-
. .. . - ?
t
?`?"'r'??'""yy?:?. . . - . .?,-r ... .. . . -. _ . .y?-. - ? ,...,rc?..,?v- q•,qr,?•,R.-?t?.,.,, .. . ,
a -. _- :?' CITY OF EAGAN ;?fl
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ??
PHONE:454-8100 , BUILDING PERMIT Receipt #
To be used for ?? ?/0" Est. value =i i ?,000 Date MAY 14
17865
90
Site Adie?ss 3640 PIlaCBEST GT
Lot Block Sec/Sub.
Parcel No.
W Name _
? Address
Name _
Address
CIty _
Name _
Address
{nZ.I.IA!! gIJTTM:R
QA'PERFORD Dl
ZAGAN Phone
sAM
Phone
I hereby acknowlege that I have re ad this application an state that the
information is correct and agree,to com ly with all a lica Ig ?State ot
Minnesota Statutes and City of FgAga n fanances. ,
Signature of Permitee
A Building Permit is fssued to: '---- -- ?--?- --??- -
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City ol Eagan Ordinances.
Building OffiCiel
OFFICE US E ONLY
Occupancy R-3 M-i FEES
Zaning
b? ? ?
(Actuap Const
l ? Bldg. Permit 38
50
(Allowab
e) - Surcharge .
# of swries -W 454.00
Lengih P?? Review
1?000
Oepth SAC, City
S.F.Total - 5?.oo
SAC,MCWCC
S.F. Footprints - 625•00
On Site Sewage _ Water Conn
???
On Site Well ? Water Meter
MWCC System
?
ACCt. Deposit ???
City water - 30
00
PRV Required
P _ 5/W Pemtit .
• 50
ump
Booster - S/yy Surcharge
252oOD
APPROVALS Treatment PI 3ss*00
Road Unit
Planner - park Ded.
Council
BIdg.Otf. _ Copies
3,294.00
Variance - TOTAL
'- Permit No. Permit MoWer Date Tekphone 8
WATER
SEW6A
PLUMBING
H.VA.C.
ELECTRIC
Inspection Date Insp. Comments
Footings I S CCJ
F«,r,aalion S- z? 0 l?ys
Framing Z O ?O .SS
Raofing
Rou9h PIb9•
Rou9h Htg.
Isul. Z? e
Freplace - li '9Q 'C 7?
Final Htg. z 3 2i - i'? .•
Fnal P16g. ?
Const Meter Plbg. Inspeclw - Noti(y Plumber
Engr./Plan
Bldg. Fnal /-C bS
Oeck Ftg. ?
Deqc Rnal
Wep
Pr. pisp.
+ A
Trrfif irafr af (Igrrupttnry
Citp of Cagan
Mitparhnrat u# suild'a1g im.prrtina
771is Certificate issued pursuant l01he require?nents of Secrion 306 of the Uniform Building
Code certifying that at rhe time of issuance thir structure was in compliance with 1he various
ordinances of ihe City reguiating building construction or use. For the foHowing.•
usecumr,mbw SF I1f+1G/GAR eMg. Pem,;, No. 17865
ooc,w.m Tw R3/"11 zonieS nW;a R ? Type c? VN
owmrorBuaa*4MUM HITI1NM M1ST. Add,,.960 WATWM I7RIVE W., L+A('?AN
Add. 3640 P'IlNECFEST rJ0[JRT Loc.Ijy L 17, B 1, FIlFJMST Ck EA['?AN
? - (o„w. AU= 23, 1990
; BuMM OMW
POST IN A CONSPICUOUS PLACE
?-; . _ _ . . .
:
• ?
PERMIT # ? 3=' _'t' ?z
?
' MECHANICAL PERMIT
RECEIPT #
CITY OF EAGAN 1 f? v
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE
CONTRACT PRICE: PHONE: 454-8100
Site Address
_
7 : T BLDG. T1(PE WORK DESCRIPTION
Lot/
Slock
, ? Set/Sub
Res NeW r
-? Mulk Add-on
? Name - tSLA
'
P
Comm. Repair
«
c Address
City
rr-'S phone _
-
Other
? FEES
Name << ?? T RES. HVAC 0-100 M BTU -$24.00
3 Address ??- _? ? r?) . ADDITIONAL 50 M BTU - 6.00
O Cjty =_ s' _,f....i PhOnB (RES. HVAC INCLUDES A!C ON NEW
' CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERMIT
50 EA
-
(
) - 1.
.
TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE
Forced Air LQ ,2rZ M'BTU rn APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
8oiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M 8TU REMODELS -- 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM PERMIT PRICE GOES
C
Gas Piping Outlets # ? SD BEYOND $1 p
pp)
Other
1
FEE
S/C: S SIGNA7URE OF PERMITTEE ?
TOTAL
FOR: CITY OF EAGAN
_ . . 'F.,*"Rr'6'v. •
KUMBING PER . ..
?
IIOT . RIFTTIF"
For City Use Only
CITY OF EAG AN PERMIT #
CONTRACT 3630 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT#
PRICE PNONE 45481 00 DATE: EZ 2d
Site Address w t", ; BLDG. TY?A WORK DESCRIPTION
?
Lot Block ? Sec/Sub " Res. New Const.
Mult. Add-on
a?
Name
I/V Comm. Repair
?
?
Address
7 1 Ajuf
, ather
. RFC DI R(: ANI V. CA111P1 FTF THF FA1 1 AWWr•
Cay
?`. FEES
COMM.AND. FEE - 196 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
i STATE SURCHARGE PER PERMIT .50
(ADD $* ?/C PER EACH $1,00qOF PERMIT FEE)
NQ. FIXTURES
pZ? Waber Closet - $3.00 TOTAL
$ ?
?.., Bath Tubs - $9.00
Lavatory
- $3-00
?
Shower - $3.00 3 r
Kitchen Sink - $8.00
. UrinaVBidet - $3.00
Laundry Tray - $3.00 ?
Floor Drains - $1.50
? Water Heater - $1.50 .-3
'
J_ Whirlpooi - $3.00 - ?
L_ Gas Piping Outlets - $1.50 .;
(MINIMUM -1 PER PERMIT-NEW CONST.)
Softener - $5.00
? Well - $10.00
Private Disp. - $10.00
3 Rough Openings - $1.50
l
'
N.?
U. G. Sprink
er System - $12.00
PERMIT FEE:
STATES S/C: s'
GRAND TOTAL: --} ?• c' .
SEWER & WATER PERMIT
CITY OF EACfAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE 05/16/90
METER #
OFFICE USE ONLY
CHIP # -
METER SIZE
15SUE DATE
PERMIT DATE 05/16/9(i
PERMIT # 11391
B.P. RECEIPT # C 7800
B.P. RECEIPT DATE r5 14 90
_ PRV - BOOSTER PUMP
SITE ADDRESS 3640 1'IHBCREST CT
LOT 17 BLOCK I SEC/SUB pINECRSST OF LAGAN
APPLICANT: ADDRESS:
CITY, STATE ZIP
PHONE: ? •' f?';
PLUMBER:
ADDRESS; 1018 !lOU1dD SPRINCS 7E"
CITY, STATE ? <, "' ' r . + MN ZIP 55420
PHONE: 884--4149
OWNER: -
ADDRESS: _
CITY. STATE
PHONE: _
ZIP
PERMIT REGIUESTED
- SEWER WATER - TAPS
- COMM/IND X RESIDENTIAL
- NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FaR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
DATE:
RE: 3640 PIAIECREST CT
OS/16/90
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannat be compieted for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued ar occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIREO BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
DATE:
RE:
3640 PINBCREST CT
Q5/16/90
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above properiy has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DtGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETG.
- REOUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLIGY.
Secretary, Building Inspections Dept.
,?!!.,ll, j?+ ?Yfi1? _ , . . . . . . • • . • . ?
CASH RECEIPT ?
.
CITY 4F EAGAN
3830 PILOT KNOB ROAD 4L
EAGAN, MINIVESOTA 55122
DATE 19 //???
._.?._SL_
? • i ?
r j - -- i
'FROdA f :_;" ,y, ? -,; , . •
AMOUNT $ J
& DOLLAIiS
too
? CASH ? CHECK
..??
?/..s
C 7$00 ?'COPY
amk-Fne copy
Thank You
BY
INSPECTION RECURD IControl No. j, J?'-.
CITY OF EAGAN PERMIT TYPE: 11401101N"
3830 Pilot Knob Road Permit Number: *r Vb'? 9
Eagan, Minnesota 55123 Date Issued: 06j12197
(612) 681-4675
SITE ADDRESS: 1071 17 BLnCk :! APPLICANT:
1SK?? PtNECitEST rT fTClttsQN MAR1t
P1NECREST Of EAOAM (612) 681-0+169
¦
PERYIT: PUBTYPE: TYPE aF WORK: ? f??
PermR No. Permk Fiolde? Date TNephons i
SIIN
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Msmirtlon Dete insp. CommeMs
Foolings I
Foundation
Freming
Roolin9
Rough Ptbg.
Rou9h HoB.
IsuL
Flreplace
??..?
Final Htp.
Orsat Test
FnaI Plbg. Plbg. Inspector - Notiy Ptumber
C.onst. AAeler
EnprJPlan
Bldg. Fknal
DedcFtg. ` 2 ?,ZIiO Na? y2"
DeClc Flnal
?
Well
Pr. Diep. .
i:?,
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
? fIL ?. RI 'I ? 1
PERMIT SUBTYPE:
1., .
PERMIT TYPE:
Permit Number:
Date Issued:
F; i u(. r ? APPUCANT:
E I? I? 1'.+stJ r?r?s I
TYPE OF WORK:
iv,/.•i
F
L
?
PermR No. Permk Holder Date Teisphons ?i
S/W
PIUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectbn Dab Insp. Commenta
Footings I
Foundarion
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace Z
Fnal Htg.
Orsat Test
Fnal Pibg. Plbg. Inspector - Notily Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675 SITE ADDRESS:
, r10 1•1
?Vi
?! rii I k ! :, t nr FAAAN
1-
PERMIT TYPE:
Permit Number:
Date Issued:
i P 11 , i rdt;l
11 tst Ocx > ± APPUCANT:
t+?r I t t; 1 14 c;
Nh /: 1 /96
«
-1
? J
PERMIT BTYPE: TYPE OF WORK:
, ? ? , , I rfRA r TI,N
c?, ., ; ri 1 1-0 1.1: I/_.+: FRON f l)F tIOMI
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inapection Date Msp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUM8ING
PLBG
AIR TEST
RaUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARO
FIREPLACE
FlREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I
BSM7 FINAL
OECK FTG
DFCK FtNAL
013950L/ ?.
-AA
Fepuest Date
? - ? Fire No. Rougp-in In ion
equired?
? Reatly Now ?iMll Natily InspectOr
s ? No When Reatly?
I,Aiicensed contractor ? owner hereby request inspection of above electrical work at:
Jo? nOtlr s ? ireeL Bo oyte No.)
3 (i
??
C
3 Ci
ry
?a- QY?
S dro N?? Township Name or No. Range No. Co
?
Occupa ?IPRINT) Phone No.
Power Supplier qtltlress
f ?
Electtical ConVactor company Name) ? ConVacror's License No.
Meilin tldress anVdClOr or Owner M In9 I stall ion? .? ?? r•??
f1
/
AuIDOnze re IContractonOwne ang I ali Phone N er
i
MINNESOTA ST PO OF LE PEGTI?N FEOVEST WILL NOT
G?Igga-Mitlw 8 - Room E ACCEP V THE STATE BOARD
182t Ilniveroky Ave., SL Peul, N 55104 UNLESS PfiOPEfl INSPECTION FEE IS
Phone(61])893-0800 ? ENCLOSEO-
?jlfj?j'p REQUEST FOR ELECTRICAL INSPECTION ?s?a ee-aoooi-o7
? Sestmctions for completing this torm on beck ot yellow copy.
? ?„ 9j??
? 1 3n J 5? 'X" Be/ow Work Covered by This Request '?
ew Ar7d Rep. - Typeof6uiltling AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Ap[. 8uiltling Dryer Other (Specify)
Commllndu5trial Fumace
Farm Air Conditioner
Olher (spacify) ConttaMOrE /RemIerks:
Compute Inspection Fee Be/ow: ?I.-Acs ?-
# Other Fee k ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimming Poal 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps A6ove 100 _ Amps
Signs inspecmr§ Use Onty, TpTAL ?
Vrigation Booms
Special Inspec[ion
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M?WHS. / t
I, the Electrical Inspector, hereby Rough-in ie ??-
certity that the above inspection has
been made. F;nai r
dZ, oeie (? / G
a" 6
OFFlCE USE ONLY VQ_WiiiP
This request vaitl 18 momhs irom
?.
- CITY OF EAGAN
3830 PILOT KN08 ROAD
EAGAN, MINNESOTA 55122
. . , onre ?)
rna.
AMOUNT ?. I $ . ?n IQ?'1
G/
8 OOLtARS
yCASH ? CHECK, ?
CASH RECEIPT
?
C 9496 ?1, ? ?,
? Pmk-flla Lopy
Thank You
0Y ?-?-??
CITY OF EAGAN NO ? ?565 "
3830 Pilot Knob Road, P.O. Box 21-1 99, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est Value $117 , 000 Dale MAY 14 . 1922-
Sita Address 3640 PINECREST CT
17 1 PINECREST OF
Lot Block SeGSub. OFFICE USE ONIY
Parcel No. EAGAN acupancy R-3 1f-1 FE ES
R
1
Zoning =
w Name WILLIAM HIITTNER CONSTRllCT70N (AClual) Consl ?-N 81dg. Permit 699.00
o Address 960 WATERFORD DR W lalowable) V-N
S
h 58.50
urc
arge
EAGAN
City Phone 452-3088 # oi stories
50 '
Plan Review
454. 00
Length
F Name SAME Depth 501 SAG Ciry 100.00
}
g$ Address S,F.TOtal - 600
00
SAC,MCWCC .
? City Phone S.F. Footprints -
Water Conn 625- ?10
On Site Sewage _
?
W w
Name
On Sita Well
-
Water Meter
90.00
tI
? Addf65S MWCCSyslem ?
30
00
z
gw City Phone City waler XX Aect Deposit .
SAN Pa
mit 30.00
PRV Required _ r
I hereby acknowlege that I have read this an an slate that the eooster Pump - gM! Surcnarge - SO
information is correct and a
a cabl State of
Minnesota StaWtes and Ci
Etm _ Treatment PI 9 59 _ 00
SignaWre ot Permitee AVPROVALS Road Unit 3 55 _ OQ
WILLIAM HUTTNER CONST
A Building Permit is issued to:
Pla^"ar
-
ParkOad.
on the express condition that all work shall be done in accordance with all Council
applicable Sta1e ol Minnesote Statutes and City of Eagan Ordinances. Bldg. Olf. Copies
Building OHicial T? J?lfl .??.?? I Variance _ TOTAL .s,294.00
I
I?( CITY 6F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRE55:
DESCRIPTION:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
3640 PZNECREST CT
IOT: 17 BLOCK: 1
PINECREST OF EA6AN
Building Permit Type DECK
Building`Work Type NEW
UBC Occuparicy R-3
Building Leng'th 32
Building Width)_ , 16
,_.
?
~
v ?
REMARKS: Lp 1$7 19jj)
?C I
BUILDING
006620
05/12/92
FEE SUMMARY:
8ase Fee ;25.00
Surcharge $.50
Total Fee ;26.59
CONTRACTOR:
?
OWNER: - pPPllcanc -
ETCHISON MARK
3640 PINECREST CT
EA6AN MN 55123
(612)681-0459
I hereby acknowledge that I have read this application and state that the
information ie correct end agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATUIE
En
?
ISSU D BY: SI ATURE
Control No. 0422
I
PERMIT #
? ?O
cmr oF eaGaN
1992 BUILDING PERMIT APPLICATION
681-4675
, MAY 7 hco
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 when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Yaluation of wark
Site Address: ?6$41 i?;,,.e c.•?s? e-T
STREET STE ?
Tenant. Name: (commercial only)
?oT ?L eLaK J_ suso.
r
P.I.D.
A
Descri tion of work: pecit
The applicant is: 0 Owner 0 Contractor ? Other coes«;W
Name C-1G?, Phone
Property LAST FIRST
Owner qddress 36 s?a ??,•???? s? ? i
STREET STE /
City State ?,17.- Zip Sfi z3
Company Phone
Contractor Address License # Exp.
City State Zip .
Company Phane
Archi tect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
' OFFICE USE ONLY
BUILDING PERMIT TYPE
? Oi foundation ? 05 Apt. Bldg ? 09 Basement Finish
? 02 SF Dwg. E106 Garage/Accessory ? 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add.
? 04 Multi-fam. T.H. YX 08 Deck ? 12 Res. Porch
WORK TYPE
9 31 New ? 33 Alterations ? 35 Move
? 32 Addition 0 34 Tenant finish ? 36 Demollsh
GENERAL INFORMATION
Const. (Actual) Basement sq. ft.
(A1'fowable) lst F1. sq. ft.
UBC Occupancy ? 2nd F7. sq. ft.
Zoning Sq. Ft. total
i of Stories Footprint Sq. ft.
Length 3 2, On-site well
Depth 16, On-site sewage
APPROVALS
Planning Building ?5Lp2
Engineering Variance
REQUIRED INSPECTIONS
? Site 0 Footing O Framing
? Mallboard ? Final 0 Draintile
? Insulation
? Fireplace
Permit Fee r.iuac;d,: s
Surcharge .So
Plan Review
License
MWCC SAC
City SAC ,
Mater Conn.
Water Meter
Acct. Oeposit
S/W Permit -
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other Total: ?
SAC % `
SAC Units
r
? 13 ?? ew
? 1$`?mm/tdd
? 15 Comn/Ind Rem
O 16 Pubtic Fac.
? 17 Agricultural
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code w_ 34
SAC Code
Assessments
TRI-LAND C0.
SSRVEYING
ERV1CES
1875 PLAZA DRIVE
EAGAN, MINNESOTA 5512
CERTIFICATE OF SURVEY FOR:
HUTTNER CONSTRUCTION
LEGAL DESCRIPTION: LOTIZ,BLOCK..L, PINECREST OF EAGAN
ACCORDING TO THE RECORDED PLAT
N THEREOF DAKOTA COUNTY,MINNESOTA
SCALE; I"=30'
? CRESTRIDGE
LANE ?
m
m
I
30
?
cr_
0
U
U) w
W N
? O
U OD O
y O
U)
61y????
? I1 I
IEGEND
I,?y
I
e ?
T
1
I ?
.aa
07.o ti
V 2Z.ii N
3+.00 ? 50. ?o ? I
S89°49'37"E ?Y
v D
MA - AN
o DENOTES IRON MONUMENT
4 DENOTES W000 HUB SET
DENOTES EXISTING SPOT
. ELEVATION
DENOTES .PROPOSED SPOT
ELEVATION
?- UENOTES DRAINAGE OIRECTION
1 Mnby certify thot fhis survey,plan or
reporf was preparaA by ms or under my
direct suparvision ond that I am a duly
Reqisterad Land Surveyor under fhe
Laws ot fhe Stafe of Minnesota
G?•
?n
N
O
0
O
e
0
?
PkoPosEO FULL BlaSuMENT - FoV2 l$(EL '
iM1iVERT EIFVATIGfd AT SERVICE EXFENSION=
PROPOSED GARAGE FLOOR ELEVATION=?
PROPOSED FIRST FLOOR EIEVATION = a7a?.
PROPOSED BASEMENT FLOOR =
ELEVATION
NOTE ' VERIFY ALL FLOOR IIEIGHTS WITH
FINAL HOUSE PLANS
p 4 a,y d?yx?? LOT 17
A N
T
Paopos??
?£
Brodley wenson, Mn. Rep. No. 15235
Date - ?? /y /To
bbOlz 7 PLUMBING (RESIDENTIAL)
J Permit Application
City OfEagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits aze required for each unit
LT 5-Z). SD
Date 6 / ,?O / 63
Site Address 3 6,1 6 117: , e e ?a 3? e 7-. Uni t #
Property Owner nJ}e-&- r, S o? Telephone #(C 51 517
Contractor /t7/}-2.?
Address ??V? J?.tie cveS ? ?T, City ?GQ
? /fyJ
State Zip S 512 ?i Telephone #(Z S4 - 6 b?- S s
The Applicant is 'C Owner _ Conhactor _ Other
5eptic System New _ Refurbished Submit 2 seLs of plans and MPC license $ 100.00
Includes Counry fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Includiug Pp, d?
? Adding fixtures to iower levels or room additions, excluding water softener and water heater $ 50.00
_ Abandonment of septic system
_ Water turnaround (+ 518" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
1f ` ?
_ Water softener _ Water heater
1 ? . 15.00
_ replacement additional
S[ate Surcharge
- _ .50
L---
Total g ?. ?
I hereby apply for a Resideniial Plumbing Pemilt and acknowledge that the information is complete and accurate; that the work will
be in conformance wi[h the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
pernut, 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. Applicant's Printed Name
O..L ?7' 6?;V . sc?
ApplicanYs Signature
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: L0 7: 17
3640 pINECREST CT
PINECREST OF EAGRN
PERMIT SUBTYPE:
FIREPLACE
PERMITTYPE: suiLoiNG
Permit Number: 022281
Date Issued: 10 / 21 / 9 3
B L 0 C K: 1 APPLICANT:
ETCNISON MARK
(612) 681-0459
TYPE OF WORK:
NEW
INSPECTION .. . D•
FIREPLACE
?
?
x CItY d"F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
SITE ADDRESS:
P.I.N.: 10-57600-170-01
3640 PINECREST CT
LOT: 17 BLOCK: 1
PINECREST OF EA6AN
DESCRIPTION:
B,u?Ylding_Permit Type FIREPLACE
pulldzng l:Jork Type NEW
\.
f ?
?
?
1'a
?C3
?'? s
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$25.00
$25.5@
CONTRACTOR:
c
X?jJ?? ?
r
BUILD NG
022261
ia/zi/9s
OWNER: - APPlicent -
ETCHISON MARK
3840 PINECRE5T CT
EA6AN MN 55123
(612)681-0459
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicbble Stete of Mn:
Statutes and City of Eagan Ordinances.
?c??r Rs? I rn?f
APPLICANT/PERMITEE SIGNATURE -?SSlI-ED e: SI NATURL
-
REACTIVA7E _
PERMIT ?"
atilt I
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION
681-4675
SINGLE 3 MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs. ,
COMMERCIAL 2 sets of architectural 5 structural plans, 1 set of
specifications, l 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 i.s requested once permit
is issued.
Date Valuation of work
Site Address: s ? ?'T,
sraeer wiTE r
Tenant Name: (commercial only)
IAT lq_ SLOCK _L
??ry&J
SUBD •?f? . dt*v qj VV?
P.I.D. N
Descri tion of work: B IA e Y
The applicant is: CxOwner ? Contractor ? Other (Decertbe)
Name ,???1Wror ^'?e Phoned;1/-&V t9
Property LAsT fIaST
Owner Address 0&,Vo 11 e T
STREET S1E Y
City L`'4-9 4.. State Zip St/? "3
Lompany Q
Contractor Address ense # Exp.
U State ?.? Zip ?i2-
Company Phone
Architect/
Engtneer Name Registration #
Address
City State tip
Sewer & water licensed plumber . Processing time for
sewer 8 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 appllcable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:a'4 '?_ee
OFFICE USE ONLY
BUILDING PERMIT TYPE
O Ol Foundation ? 06 Duplex ? 11 Apt./Lodging . 0 1 6eBa8lNnen4"Finish
O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. O 17 Swim Pool
D 03 SF Addition ? 08 B-Plex O 13 6arage/Accessory ? 18 Comn./Ind.
? 04 5F Porch ? 09 12-Plex ? 14 fireplace O 19 Coiom./Ind. Misc.
O 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations O 35 Teoant Finish ? 37 Demolish
? 32 Addition C! 34 Repair ?_36 Move
GENERAL INFORMATION
Lonst. (Actual) Basement sq. ft. MWCC System _
(Allowable) lst F1. sq. ft. City Water _
UBC Occupancy 2nd Fl. sq. ft. PRY Required _
Zoning Sq. Ft. total Booster Pump _
Y of Stories Footprint Sq. ft. Fire Sprinkler _
length On-site well Census Code _
Depth On-site sewage SAC Code _
APPROVALS
Planning Building Assessments
Engineering Variance
REGIUIRED INSPE CTIONS
? Site ? footing ? Framing O Insulation
? Wallboard 0 F inal O Draintile ? fireplace
Permit fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Oed.
Copies
Other
Total:
v.w.tcon:
SAC %
SAC Units
/??6 4?-
SINGLE FAMILY DWELLINGS
1990 BIIILDING PERMIT APPLICATION
CITY OF EAGAN
MULTIPLE DWELLINGS
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WFiEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: ? /? Valuation: Date: ? v /o
Site Address 31? c,-/,--7 Cf,
Lot jj_ Block (
Parcel/Sub
?
Owner
Address
City/Zip Code
Phone
Contractor ) ? 6?? ??
Address ?'90 City/Zip Code
Phone / SL 7'O?b /?3 ?i6 ?
Arch./Engr.
Address
City/Zip Code
I I9?dO0 ' OFFICE USE ONLY
'Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
'R 3 M- I
?_
?-
$O'
OT
On site sewage_
On site well
MWCC System ?
City water ?
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off
Variance
._.?
COMMERCIAL
FEES
Bldg. Permit G'11'?Ou
Surcharge 58,50
Plan Review q$14,p0
snC, City 100,00
SAC, MWCC (eCO,OD
Water Conn [025,00
Water Meter QO,oo
Acct. Deposit 30,00
S/W Permit 30.Oo
5/W Surcharge ,SO
Treatment Pl. 252,00
Road Unit 3$57.00
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL ?
Phone tt
VAL-uA-riotJ
?2XZ2 =LISN ?c?s= ?z?o
?smT
ZZX2y= S2S
?3X 28 = ?y4
it?2 x I?}= 16408
Nousc
?ri23 s y4
zx? : IG
?
I23q x 5? = 6293y
? I b
.
o•;
l,99'UU+
5ti • tiU '
Gji+'U11'
? 'l"UU•OU
6 i5•UUr
? y0•OU7
?,u • ?u r
r'1 22 .ui,i-r
/ 3:97•UU*
?? 3,294•UU"
TRI-LAND C0.
SURVEYING
SERVICES
1875 PLAZA DRIVE
EAGAN, MINNESOTA 5512
CERTIFICATE OF SURVEY FOR:
HUTTNER CONSTRUCTION
LEGAL DESCRIPTION: LOTIZ,BLOCKI , PINECREST OF EAGAN
ACCORDING TO THE RECORDED PLAT
N THEREOF DAKOTA COUNTY,MINNESOTA
? SCALE: r_ao-
ESTRIDGE LANE ?
m
m
1- ? O
? ? I N
O
W.V. ??ah ? LOT 17
PHa'sE ? p
U
000
W ?v C?nrz. ? p
Z O I Z6 I 7. a 1? 3h o
EL 0 .ai iffi 0
(A - 8 ? ?,.? (? , (A
S89°49'37"E $v ? .00 ?
-- ? p?
? V r
a?: PLOCIK 12A : Am
LEGEND
o DENOTES IRON MONUMENT
a OENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
I herehy certify Thot this survey,plon or
rsport was preparsd by me or under my
diracf supervision and that I am a duly
Reyistered Land Surveyor under tha
Laws of tha Stute of Minnesota.
PRopoSEO FuLL 8A56NENT- F-aJR L'$(EL. -'
INVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION= 87
PROPOSED FIRST FLOOR ELEVATION = a7?
PROPOSED BASEMENT FLOOR = ?1=
ELEVATION
NOTE'• VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bradley ,3:,/,S,wenson, Mn. Req. No. 15235
Date -
• (Fo:-M Dcvcloped by tac Sta:c of Y.inacsota :.uilc:iig Cocc UiV:sio:i)
TO EE SU9:SITTcD NII'Fi BUILDII:C PEMMT I.PPLICATIOy
j - • •
" F7(TE^IOR FyVELOPE AVT'RACE "U" C(1:`3UTATION '
l OWtiER:
SLTE ADDRESS: 50 `t"[J 1!'IL(?&UV_ri l L.•? ?
CONTRACfOR: ?„- ?h?f DATE: S-0 ?9U PFIONE: qSz_Ja88"
7a,-? '
Determine vorking aquare footage of each
1. Total exposed wall area......... aq.ft. x?? ? 2D ?2S
_. >
2. Total roof/eeiling area......... /z-S-5- sq.ft. x+OZ.3 Z70
3.• Total exposed R+all area calculations:
Total expased wall area above floor - /)-?g
a. Total wall vindov'area .............................. /.l$
b:" Total door area .....................................-r 7_
c. Total sliding glass door area ....................... ?f0
d. Total fireplace wall area ........................... -
e. Total wall framing area (average 107.) ............... /7 6
f: Total net vall area above floor ..................... /Z3q
g. Total riri joist area ................................ /z'/
To[al exposed foundation area - //,6.
b. Total foundation windov area ........................ -
i. Total net foundation area above grade ...............
Detezmine "U" value of each wall segment
a. I` Zfl R
$Bu.l . ? ', .
? b. s? X
C. y?0 x oluel z'z. a ?
d. „ X
"U° - • ,_..._
. e. 17O x °U,l •07 - 1 Z,3 z
f. I z3 `? X „u,l 934
g, x „v„
• h. g out., i 5& ? ---
s. //;L X „U„
rTQrz
3. • TOTAI. .-
If item 03 is Che same as, or less ihan item O1. yau hnve mct the intent of
SSC 6006(c)2. '
Total ex,osed zoof/ceiling calculations:
Total e:cposed roof/ceiling area C? ?S
- J. ?otal skylight arca............ .................... ^
?
k. Total roof/ceiling framing area•(averap,e 107.}.........?
1. Yotal net insulated roof/ceiling area .................
Detexmine "II" value for each.roof/ceiling segment
' . `----? . X nue$ --
.
k. R,.U.o ? 0 Z.• . Z, S Z
1. I I Z? x„U,. ,??... - Z Z, 54. ' 'TOTAL
If total of C4 is the same as, or- less than 02, you have net the intent
of SBC'6006(c)1.
Alternate Building Envelope Design
`'??.'?. ... . . : . . .
To utilize the total envelope system method, the values esiablislied by "
the sum of itens 03 and 04 shall not be greater than the sum of items 01
and 02.
1
. + 2. ?
3. + 4. ?
CERYIFICATIOt7
I hereby certify that I have calculated the "U" factors and R values
herein and that the building hera described meeta o= exceeds the State of
• Hinnesota Enezgy Conservation Act. . • ?? `????
(Signature).
. (Aate) '
:
'?? : .
t;A1,L
1e±c ]0': of n?-?quc +:i?1 arca for
dramc conr.;tructiun
TOPVIEt4 eF
F?iT1:E EALL
Constri+ction R-Valuc
;i• ,
...
' ?l L L.
'
,
1. JpYCrior ir fi)m
a 0.60
2. tl^ , , _. .
3, i.nehes soft %:-nnd _
5. ?;, ..,,_ •
6. Exterior air film : 0.17
Total
#tJ?? '. 1..._1.? ? , ' •O
1. InCcrior air filn 0.68
2. u.. - -
3.
9. c
5.
6. kxterior air filn 0.3.7
Tota1 z 1. 4 f
?;,? \ . •
?
1.
Interior
air film
O.EB
2.
3.
5.
6. Er.terinr air film 0.17
?y
1VtQl I?
,
? ?
? '
1. Interior air film 0.68
2• ?IJ'•(? N? ?.tii ?l?i`i??. ' _
, 3. , .? .. ,
• n.
s.
' 6. Exterior air film 0.17
Total . ?• ?
. ? . .
ST,nB O:d GRAll24
_?IG. #3
? `••p,bl?
. • u ? ' ?+- '
. •• ` ? • :
v? •' -! • • b '
?t I? « •[ ? • ? ? ? '• ? -
•
??? ?^ . • ? i
/( ( ? ? ? • • . '
1 I 1 =
's Xi
..? . • ?/!I^ ,1 `?
FSG. 04 ' ?C • ' ' ? ' ?. ///
!fl ? • o
^ `
? .c • X ?C ? ? ???
' (! ( _
NOTG: Tndicatr L-ync, "P." valun, denth and
, placenent of insulation. .
;?.
?
?
t. :
?
Conrtr.uction R-Valne
1. Interior ai.r film 0.61
2. --
3. I t? :,`r ,? :•?? `?,:,
4. Txtcrior air film (sf.ill) O.G
- "oCa1 _ C ?
1'ente3
F7G. 115
Ecac ilov
up
1+1! .?ntV..^'1!1'T.?l'::': A60.•?5?^t •r1 .> nl
J ]:eat floty up
Y1. Intcrior air film 10.G1
2. s. 3?e-,. _,;!..?,ai? .?•:.-;
4. Er.teriar air Pilm still ?. T
7'otal . • `? ? , il _
' ? „ ..
1. Inside air fi].m O.Gl
2.
3.
9.
5. Outside air film .0.17
Total
Notc: Usc addit•ional ::liects if morc: sF+ar.c i:
needed for details and calculations.
.
, R001'/CL'ILI;7G
? vented
.? :....-.,....?... ? .
. HcnL
' , . flov up ?
p7r,. ?p7
.. /
i
Ko
' ? Z .... Sow"*
a5 1
I I i
C'-L o,.?`j?-
?z' ?
t5', ? .
70
m
N
?
?
4
?
a
,
,
,? y: S"
PERMIT CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 0 3 7
(612) 681-4675 Date Issued: 06 /21 /96
PROJECT NBR: 0
SITE ADDRESS:
3640 PINECRE57 CT
LOT: 17 BLOCK: 1
PINECREST OF EAGAN
P.I.N.: 10-57600-170-01
DESCRIPTION:
?--g BRICK FRONT OF
r ?.ld?rfg,'Permit Type
ildirfig Gkork Type
Cen'suS Cod434
t4
?.
HOME
SF (M2SC.)
ALTERATIQN
AL7. RESTDENTIAL
r
? ?pi
REMARKS
FEE SUMMARY:
Base Fes
Surcharge
Total Fee
VALUATION $1,500
$48.50
$49.25
CONTRACTOR: OWNER: - APPllcant -
ETCHISON MARK
3640 PINECRES'f CT
EA6AN MN
(612)681-0459
I hereby aaknouletlge that T have reard this appiication and state thst the
information is carrect and agree to comply with all applic:able State of Mn.
Statutes and C3ty ot Eagan Ordinances.
L _ J
APPLICANT/PERMITEE SIGNATURE
ISSUED :SIGNATURE
A Ow _ CITY OF EAGAN ? 0 C? ?
2 3830 PILOT KNOB RD - 55122
CS;V v? 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Conslrudion Revuirementa Remodel/Reoair Reavirements
w 3 registered site surveys ? 2 capies of plan
s 2 copiee of plans (indude beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks)
? t enargy plculatlons ? 1 energy wleulaUons tor heated additions
? 3 copies of hee preservation plan iT lol platted after 7/1/93
required: _ Yes _ No
DATE: C- ;Z(- 9 L CONSTRUCTION COST: ?? SvU U?
DESCRIPTION OF WORK: °'' 40? ?? A(e) w Sse:e
STREET ADDRESS:
LOT ? BLOCK ? 6`/u `d- , e s
( SUBD./P.I.D. -L Ld T_
#:
PROPERTY Name: G, r/-d Phone.#: 6?? -v ?/ S 4
OWNER *
Street Address,
City: &o- s?- State: «^?. Zip: SS?y ?
coNTRAC7oR Company: Phone #:
Street Address: ? License #:
City: State: Zip:
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #
Street Address*
City: State: Zip:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this applicadon and state that the information is correct and agree to comply with all
i applicahle State of Minnesota Statutes and City of Eagan Ordinances.
' Signature of Applicant
OFFICE USE ONLY
of Survey Received
Preservation Plan Received
_ Yes
Yes
_ No
_ No
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ?
? 02 5F Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ?
? 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ?
? 04 SF Porch ? 09 12-plex ? 14 Firepiace o
)a;?05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE 4; c%, ?/ /n vs Q
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering
Permit Fee
Surcharge '7
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
_- .
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MCIWS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
y3 y
O?
?
% sac ' 9.a5
SAC Units
s'l?O?C N.roJ Gvil:t ,?Fjf
? RESIDENTIAL BUILDING
.' Permit Application /
City Of Eagan
?17U? 3830 Pilot Knob Road, Eagan Mn 55122 uI ?
r
Telephone # 651-675-5675 FAX # 651-675-5694 /1/03
NewConsWClionReauirements RemodellReoeirReauiremerrts 9ffce UseOnlv
3 registered site surveys showing sq. ft. of lot, sq. R of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% maximum lot coveraqe allowed) 1 set of Energy Calculafions for heated addNOns Tree Pres Plan ReW
2 copies ot plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & dedcs Tree Pres Not Reqd
1 set of Energy Calculations Add'rtan - indicafe if onstte septic system _ On-site Septic System
3 copies of Tree P2servafion Plan if lot platted after 711193
Rim Joist Detail Options selection shcet (blGgs with 3 or less units
Date (o 03
SiteAddress 26`fo Prue ¢•-?5?
?
C.7'. ?v
ConstructionCost ? ?uv
UniUSte #
Description of Work Ale w 10vu 1 1'4dc. S?
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner MR 12)e- L. +- roa? ?4 5 vt?:5 Telephone #(?5 t) ? j?/ ' Oq f17
Contractor L: ,h Pe?q y T• C fc.l?+'Soi-
Address 3 6 y0 r-2. o-e e ?e s? c
State /i? /" . r_
Zip 5t'! l? csTy
Telephone 1t (6 St )d'/ - vL/ S?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catesorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category t Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Su6mitted
Licensed Plumber /y1Ae-lc }-; phone #(6 9) 6 S'! - c5t/ S5'
?
Mechanical Contractor
Tbie?hone # ( )
Sewer/Water Contractor Telephone #( )
I hereby apply for a Residential Building Pernut 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; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
177412,L L. h"iteA Jsv.v ?Gy??tt,-7_- Az •
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
t
Sub TypeS
? 01 Foundation ? 07 05-plex ? 13 76-plex ? 20 Pool ? 30 AccessoryBldg
? 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 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plax Plbg_Y or_ N? 25 Miscellaneous
Work Types
x 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation //009 Occupancy U-/ MC/ES System -
Census Coae IY 34? Zoning /Z-/ City Water ?
SAC Units - Stories / Booster Pump -
r
Nbr. of Units Sq. Ft. ? PRV
Nbr. of Bidgs Length ?i Fire Sprinklered
Type of Const ?LlAi Width
REQUIRED INSPECTIONS
J( Footings (new bldg) FinaUC.O.
Footings (deck) ? FinallNo C.O.
Footings (addirion) _ P1umbin8
? Foundation _ HVAC
Drain Tile
Roof Ice & Water Other
Final Pool _ Ftgs _ Air/Gas Tests
_ Final
?- grdnllllg _ Siding Stucco _ Stone
R.I.
Fireplace _ Ai r Test _ Final _ Windows (new/replacement)
_
Insularion _ Retaining Wa11
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
, * .I-LAND C0.
SURVEYING
SERVICES
CERTIFICATE OF SURVEY FOR:
HUTTNER CONSTRUCTION
1875 PLAZA DRIVE
EAGAN, MINNESOTA 5512
LEGAL DESCRIPTION? LOTIL,BLOCKJ_, PINEGREST OF EAGAN
ACCORDING TO THE RECORDED PLAT
N THEREOF DAKOTA COUNTY,MINNESOTA
SCALE; 1"=30'
? CRESTRIDGE
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e OENOTES WOOD HUB SET
DENOTE$ EXISTING SPOT
ELEVATION
OEN07ES, PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
I Mnby cerfify ihat tAfs survey,plan or
reDat was prepared by ms or under my
direet suparvision an0 that I am a duly
Repistered Land Surveyor under ths
Lawa of the State of Minnesota.
RiOpoSEI:?, FULL Bfi?56NENT- F'oVR LV(EL lNVFRT ELEVA?!ON AT SERVICE EXTENSlO"J=
PROPOSED GARAGE FLOOR ELEVATION = 8'7
PROPOSED FIRST FLOOR ELEVATION = 876
PROPOSED BASEMENT FLOOR = ?-
ELEVATION
NOTE ? VERIFY ALL FLOOR HEIGHTS WITM
FINAL HOUSE PLANS
Bradlay $.?#wonson, Mn. ReQ. No. 15235
v
Date ? 4? ? I So
RESIDENTIAL BUILDING
Permit Appticatiou
? City Of Eagan
? Ca~ql q? 4 3830 Pilot Knob Road, Eagan Mn 55122
< < Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion ReQUirements RemedeVReoair Reuuirements Office Use Onlv
3 regisrered sile surveys showing sq. lt. of bt sq. N. of house; and all roofed areas 2 cop'es of plan _ Cen of Survey Reod
(20% mazimum bt coverage allowed) 1 set of Energy CalalaGans for heated addiUons _ Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey for additlons & deck9 _ Tree Pres Not Reqd
1 set o( Eneyy Calculations Addition - indicate iI on-site seph'c system _ Oo-sile SepUc System
3 copies of Tree Preservation Plan il lot pWtted after 711193 1 1 }? O
RimJoistDelailOptionsselectionsheet(bldgswi03orlessunits ,??J3.US
Date (U 1P?_ l b?
Site Address ?J Construction Cos1/Sf Cco?
Unit/Ste #
Description of Work I-qr?LGTx? 442 ?-
Nlulti-Family Bldg _ Y? N Fireplace(s) _ 0 2
Property Owner Z ?G?lSO--Z Telephone #(65^0?
Contractor AQ?f776,j-:- 1495W-- 5
Address % 17C
State <f?-4YJA p
Zip SS/ / City
?T ?--
Telephone#(??)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1
Energy Code Category . Residential Ventilation Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope CalculaUonsSubmitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Minnesota Rules 7672
• New Energy Code Workshee!
Submitted
Telephone #(
L )i Telephone #(
- N ?----=J 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; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Ar1??.?2Z
Applicant's Printed ame ApplicanYs Signatuy
?
OFFICE USE ONLY
Sub Types
O 01 Foundatlon ? 07 05-plex ? 13 16-plex ?& 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screenlgazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex pibg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New ?
* 32 Addition ?
? 33 Alteration ?
? 34 Replacement
l
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const ?
_ Footings (new bldg)
_ Footings (deck) .
_ Footings(addiaon)
Foundarion
Drain Tile
Roof _ Ice & Water Final
_ Fratning
_ Fireplace _ R.I. _ A'u Test _ Final
Insulation
W idth
REQUIRED INSPECTIONS
FinallC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
? Pool ? Ftgs _XAir/Gas Tests X Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By 1 -7 , Building Inspector
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
,. 0
? 30 ~Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 MWti Misc.
35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repair
37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
'Demolltlon (Entire Bldg) • Give PCA handout to appliwnt
Occupancy MClES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
root.
?s,???
; PODL PERMIT - APPLICATION SUBMITTAL REQWREMENTS
m
? GENERAL INFORMATION
?
o u
z e
? ? Applicant - name, address, phone & fax numbers, signature
? ? Property owner name
?d ? ? Legal description and address of property
?-/? ? North arrow, scaie (1" = 30' or 40') and date
Isd ?
? ? Location and name of all streets adjacent to properry
tD
? ? Site Plan drawn to scale showing location of house, pool and other existing or proposed
tLr ?
? structures
Directional drainage arrows (euisting and proposed)
ELEVATIONS
Existina
? ? House comers
? Property corners
/O ? On property lines at point of ineasured dimension to pool (see below)
f!? O? If applicable, ground elevation at each end of retaining walls and at wall's greatest height
Prooosed
Ud O/? Finished pool deck comers
?/ E3 ? Top of retaining walls (if any) and at each different elevation (if it changes)
Q O? Pool bottom (or max. depth)
DIMENSIONS
Existin9
Ef'/ ? ? All pmperty/lot lines
Prooased
? ? Pool
0 Poot plus integrated deck/patio
?? Shortest distance from outside edge of pool deck to lot lines and house
Reviewed:
Date
G:/1'ECH/JR 2002/POOI Pemtit Checklist
?LAND C0.
SUR:VEYING
SERVICES
1875 PLA2A DRIVE
EAGAN. MINNESOTA 5512
N
LEGAL DESCRIPTION; LOTIZ,BLQCKI , _PINECREST OF EAGAN
ACCORDING TO THE RECORDED: PLAT
DAkOih4? COUNTY,MINNESOTA
1?ThfE'f?E F r'1
??
. j.
SCALE; I"=30'
a:.^G?N I;I4GINEEIiRiGDEPZ
F-
?/d?101r+??M? /t'N?M??"
y. Pa..l 0 Is ?s ? 0????
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CRESTRIDGE
LANE S*vt
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CERTIFICATE OF SURVEY FOR:
HUTTNER CONSTRUCTION
G?.
r;; S89°49'37"E B;
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"cn I rnUrvstu ti/vcAtit rLVUii ELEVATION ¦_V-L
SET PROPOSED FIRST FLOOR ELEVATION = 87i
SPOT., . PROPOSED BASEMENT FLOOR ¦ .?d`
ELEVATION
'SP07
NRECTION NOTE' VERIFY ALL FLOOR HEIGHTS WITH
':"'•?"' FINAL HOUSE PI.ANS
;Plon or
inAer my
a duly BraAlsy . wonson. Mn. Rep. No. 13235
or the
Date.
_ „?..?:,?•i?k?t::.c;?:;";'`,a;";;y
2006 RESIDENTIAL PLUMBING PeRMIT aPPUCarioN 3
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ?. I
Site Street Address 3 6 y d /° %rJ z e r e s Unit #
Property Owner /11/t'?4Y s 0 ? Telephooe #(65 /) 6 k 1- ??f S7
Contractor u?. Telephone #(( Sr ) 6?'9? /z 3 2
Address /???- l'• ? ja -'' l?{-??z City SFi?L ? State{21N . Zip SS/vs
The Applicant is: _ Owner ?L Contractor _Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license InGudes County fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water soRener and/or water
heater at the same time. /f you are ittstalling onl a water soitener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment '
_Water Tumaround (add $130.00 if a 5/8" meter is required)
Other:
IL
Water Softener Water Heater $ 15.00
_ new _ replacement
? Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total ?
1 hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that tne
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.
/u,?. f- G- . 6- f e- ? ,- sC, N -?VaZ4 -,F"
ApplicanYs Printed Name ApplicanYs Signature
City of Eago
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
DEC 2 9 2009
Sib
Permit Fee: Jam -3e
Date Received:
Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION L("(( `46
/ 7 -icy
Date: /L - a2q -09
Tenant:
Site Address:
3 4Y '% <'Ne vn (+-
Suite #:
RESIDENT / OWNER
iName: 4E . 11,9 7 k S oaf
Address / City / Zip: '3640 g/ ie e C 1- er
Applicant is: '( Owner
Contractor
Phone: 6 5 /-
G`cte��x� S.tIL �
TYPE OF WORK
Description of work: L° ✓deo/ (
Construction Cost:.149/ CIO U
Multi -Family Building: (Yes / No )
CONTRACTOR
Name: License #:
Address:
City: State: Zip:
Phone: Contact Person:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:,
NOTE: Plans and supporting documents that you submit are considered to' be public information.:
the information may be classified as non public if you provide specific reasons that would permia
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. www.qopherstateonecall.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.
x ih t-1'LiL L, fc, L s G y -j
Applicant's Printed Name
X
Applicant's Signature
Page 1 of 3
3611g 6 �, DO NOT WRITE BELOW THIS LINE
SUB TYPES
iundation Fireplace
ingle Family Garage
_ Multi Deck
_ 01 of Plex Lower Level
Accessory Building
WORK TYPES
New
Addition
VitIteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% el
-
Census Code
# of Units
# of Buildings
Type of Construction
_ Interior Improvement
_ Move Building
Fire Repair
Repair
_Ic9U v
y3+
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
1
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: _Rough In Air Test
Insulation
Meter Size:
Reviewed By:
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
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
Occupancy TRG — 2
Code Edition 2019
Zoning
Stories
Square Feet
Length
Width
Final
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC I,vGt, ,has 4,,v6
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
4 ;( 7�s'r
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
IDq, &L-7
Page 2 of 3
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Of
Permit #: £c7 5/
19
Permit Fee:
Date Received:
Staff:
L
L 4 f I(<.C46
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION /. ---7 _/o
Date: /a -,024' % Site Address: L'f b c -el 4"Cfi
Tenant:
Suite #:
RESIDENT / OWNER
Name: /1/L d- P !.%1-C ( SG Phone:
Address / City / Zip: 3 to b 7il is it, 42- eY ei `If' C r . 9c, 4N 5-c / ).- 43
CONTRACTOR
Name: License #:
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK
_ New x Replacement _ Repair _ Rebuild Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation '( Add Plumbing Fixtures
( RPZ / PVB) ( i 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)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $165.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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.qopherstateonecall.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.
x/ /1-E-1 L, 15_71-c, kS o A
Applicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE.
Required Inspections:
Under Ground
Rough -In
s Test.
Final
09/07/2017 09:15 6516464532 BOEHM HEATING CO PAGE 02/02
Use BLUE or BLACK Ink
r
For Ofltce Use
City of Eaafi Permit#: LI5 31
3830 Pilot Knob Road Permit Fee:
(e C.
Eagan MN 55122
Phone:(651)675-5675 Date Received. ! /
Fax:(651)6755694
7 2017 �Statf:
2017 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
DateNt * 17 _Sfte Address: 30 O Pi 1r-1e:crest CQL,rt
Tenant: Suite t
Resid�rwl�lOw ods::,y, Name: 1114Yk i y E-Fr hi5o : 4:304.‘—36,3 -emote
"'•' h Phone.
•
' Address I City/Zip:
Name: c3OG , I rr3 CbirPa r"7r License#: VII CO333343
Contmc ar Address: 1S9$ S by AVe city: 5t Pc►LL
State: win Zip: St�SIQy Phone: , —/1410
Contact Se t ► f50 4)171 Email:0 CRcE @ b rvIle Fait Plied) coy'*
New Replacement Additional Alteration Demolition
Typeof o►1t ';<` Description of work: 12.aPlace. .(=u1-pnCICC. q r c AG
RESIDENTIAL COMMERCIAL
"-Furnace New Conshudfon _Interior Improvement
,Permit; ',. ✓Air Condhloner _Install Piping _Processed
;,:• % Air Exchanger Gas Exterior HVAC Unit
u;:,, z. Meat Pump
• � '.•,;:;,``'�-� Under/Above ground tank (_Install l�Remove)
;,,;•a.': �,.,"'" —_—fir
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge (CO$100.00 Residential New,includes State Surcharge =$ CO TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minlnritural,
$75.00 Underground tank Instailadon/removal,includes State Surcharge =$ Permit Fee
Surcharge=Contract Value x 60.0005 ^$ Surcharge
If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE
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 nota permit.but only an appllcetlon ter a permit,and work la not to start wlatout a permit;that the worts will be In accordance
with the approved plan In the case of work which requires a review and approval of plane.
w O f'j'9 x AW.
Applicant's Printed Name Appl 1, ttire
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FOR 4F�E�USE' �rr.;,�:1�4+• „•.•.;.�, �=,•;r�% �" Y rw a•:u�
�y,,,r `�i""�',:�?,•�:yi,{' n,.'tF`•.� p,. rl,a .sf.. ^.hr�11.,"�nay'awy i�,.. "Favor '�)' Y` •ry4�' fFW �`•o��{ i• 1t,,, > '1.. 1
aired ifl9 .....:,�c•r rt"�4r�,• ,� , .,. i:•Y�.,,,: � { a.. '�• Y 5K w �ki ':uJ,w',
I i �:rhrJ u.AJ••' Y '� .1� � ''',•M , '• J.` y'�c. :,=*
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.miler fl ittfpd Yiirv,r (Tilt W.y :,• is/� A rv�1r..I•, ' I�1Ir h1Vp PW dl�h fX 4 N D r h 1
,..•: r :• Y'w� .:4733f1:. y J t�ll, tie!.