566 Prairie Cir ECity of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
tIlqa11-
lb
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Resident/
Owner
Type of Work
Name:
l ' / C�Gev.
Address / City / Zip: �� (P
Applicant is:
yn q 6 fri • e- 6✓)
Phone: l) 6 m o�
Description of work:
Construction Cost:
Owner Contractor
/94 C `t G 40_,1Q 4 O
o00
Contractor
Company:
Address:
State: Zip:
License #:
Multi -Family Building: (Yes / No
Contact:
City:
Phone:
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
401A,e1M l4'l L or C'l-
Applicant's Printed Name
4/1111AApplicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112395
Date Issued:08/12/2013
Permit Category:ePermit
Site Address: 566 Prairie Cir E
Lot:3 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Ronald J Alcorn
566 Prairie Cir E
Eagan MN 55123
Elite Home Services Of Minnesota
217 Old Hwy 8
St. Paul MN 55112
(651) 631-2000
Applicant/Permitee: Signature Issued By: Signature
City of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA098242
Date Issued: 03/14/2011
Permit Category: ePermit
Site Address: 566 Prairie Cir E
Lot: 3 Block: 2 Addition: Country Hollow 2nd
PID: 10-18276-030-02
Use:
Description:
Sub Type: e - Water Heater & Water Softener
Work Type: New
Description: Water Heater & Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Gary Kes
32018 Dahomey Avenue
Northfield, MN 55057
507-645-4037
Fee Summary:
PL - Permit Fee (WS &/or WH) $50.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $55.00
Contractor:
Benjamin Franklin Plumbing Northfield Inc.
32018 Dahomey Ave.
Northfield MN 55057
(507) 645-4037
- Applicant -
Owner:
Ronald J Alcorn
566 Prairie Cir E
Eagan MN 55123
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
1N SYLU'1'lUN KLC; Ulll)
CITY OF EAGAN PERMIT TYPE: ,
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1697 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
-1
? J
PERMIT SUBTYPE: TYPE OF WORK: PATI
1 „ , , it fl (t i
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspectlon Data Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING ? •
?
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BIDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
I DECK FINAL I
INSPECTION RECORD
ClTlf OF EAGAN DEQC PLANS Si1HrIIT1ED 11/09/93 PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: o;,, ,; APPLICANT: ••?
• I'frp'lFt1f C.1R f? • ti;ll ikfl i it! IHN
I liIiN i iiY fifi1 I rit.l "N11 (612) 41,4-
PERMIT SUBTYPE:
:
TYPE OF WORK:
N,'U!: !f?
u ? /•r t
E ?.
? - .
?? .
INSPECTION .. . ..
i
/'e. i 1
fiV MAtt4fr+s FE('(=Ti'T 11 f'RV .`+F.W F'l.RF? MR1"T)1fiJ-1+AN1V.1.:
Psrmft No. Perm$ Holder Date Telephorle #
Sfff- ?r y ? 3-.3y3U
"PLUMBING
HVAC
ELECTRIC
ELECTRIC
Ir?spectlon WU Inep. Commenb
Footings I
Foundation
Framing 9)3
Rooting _
S
Rough Plbg.
V v
R°ugr' rn9. 3?4
lsul. /- 3
Fmpkkce
Flnal Htg. ?1?0 G?!rU
Oisat Test
Fnal Pibg. ?v e-I Plbg. Inspectar - Notify Plumber
Const. Meter
Engr./Plan
Bidg. Final
Deck Ftg. /L
Dedc Final
Well
Pr. Disp.
C44 u.1,11-f s.r' / d1193 ,"Ic/
* e - 4
• ?'+ ?
wertificate af cccupanc?
W" of Wagan
Me#arhncur oi Zui[bing 3nbocctien
This Cenificate issued pursuant to the requirements of the Uniform Building Code
certifying rhat at the time of issuance this structure was in compliance wirh tfee various
orrlinances of the City regulating building construction or use. For the following:
SF DWG 20276
use ciassificac,on: s?ag. Pftmk tvo.
Occup-cy 'Iype Zonin District Coau.
Qwner of Buildiog wKnm ? Address ?, WM
B 'ng Address Localiry ,` ,
Daie:
Bailding Officia
POST IN A CaNSPICUOUS PIACE
Requesl
Da e Fire No. Roq?i u9Crrtr speclion
?,
qe
? qeetly Now .?NIII NaM1ty Inspedor
L ?,J Ye G No When Reatly?
I G licensed contrecror owner hereby request inspection of above elecirical work at:
JoD Atltlress (SVeel. Box or Route No.) Cily
y
XLI, ? Arl'e Cir?rGl. ??I?JJ ? ?
Section No. Township Name or No. Farge No. Counry
Dqx-0
Occupant(PRINT) Phone No.
GJh,` 4' z -
Power Supplier Aatlress
^
Electncal GonLactor lCompany Name,
? Convactor§ License No.
'
?e ?; c c f
G Aoa ?
C
Maniog AOdress (COnvactor or 06ner Making Inslallationl
v
i v
a.
E V
t
.
aa
t s
-e r r
.
Authonxe0 S
rrOwner Makin nstallationl Phone Number
?
,??? ay i-cla3S,
Gr99h5M yT?T 9BOAp ?mF?6Y173 EC/fPICITY" - ? BEIACCEPTE?'BV THEO STAE 8'OARDi
1821 Unlverslty Ave.. 51. Peul. MN 55109 UNLE$$ PPOPER INSGECTION FEE IS
Phom (612) 602-0800 ENCLOSED.
?i4G/?? REOUEST FOR ELECTRICAL INSPECTION ?4
!{, ee ooom-0e
p ? See instruqions lor completin9 Ihis larm on sack W yelbw cOpy.
02153 "X" Below Work Covered by This Request
e Add' Rep, Type of Building AppliancesWired EquipmentWired
liome Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Othec(Speciy)
Comm./Indusirial Furnace
Farm Air Condifioner
Omer isyecity) ConVai Remarks:
Compute /nspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuds/Feetlers Fee
Swimming Pool O to 200 Amps 60 0 to 700 Amps ?
Transiormers Above 200 _ Amps Above 100 _ Amps
SignS Inspecror§ Use Only: TOTAL
p
Irrigation Booms S
Special InSpecti0n i1hr
V
Alarm/Communication ISCONN-PT-11
T1{IS INSTALLATION MAY BE ORDEIF N
Other Fee COMPLETED WITNiN 18 MO f
I, the Electrical Inspector, hereby Rough-in
certify that the above inspection has
been made. Final r??
OFFICE USE ONLY
This request voitl 18 monihs from
Address 566 rRaIIUE c= Easr Zip 5512 3
Lot 3 Blk 2 Sub cntirmzv Hrnuv 2nm
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: /Q Yes No Inspector: .?
Final grade (6" from siding)
Permanent steps (gazage) ?
Permanent steps (main entry)
Permanent driveway
Permanent gas j?
Sod/Seeded grass ?
TtaiUcurb damage ?
Porch
Basement finish
Deck p
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply W
the outside lawn feucet before freeze poten4al exists.
Contact engineering division at 6814645 before working in right-of-way or installing underground sprinkler system.
Whire - City Copy Yellow - Residem Copy Pink - Contracar Copy ?
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 ?
New Conehudion Reouiraments
. 3 registered site surveys showing sq. R ol lot, sq, fl. of hause; and all roofeE areaz
(20% maximum lot coverage allowed)
. 2 copies of plan showirg beam 8 vrindow sizes; poured found desgn, etc.)
. 1 set of Energy Calculations
• 3 capies uf Tree Preservatlon Plan if bt plaHed aRer 711/93
• Rim Joist DetaO Optlons seledion shee! (Mdgs wilh 3 or less unifs)
DAiE 9- 16 • 02.,
SITE ADDRESS
TYPE OF WORI
APPLICANT
STREET ADD
TELEPHONE #cl5.2 - 7 Sq :?'4D CELL PHONE #
?ULTI-FAMILY BLDG _Y
FIREPLACE(S) _ 0 _ 1 _ 2
FAX # 45a - ?? 994 Z
PROPERTYOWNER (?gl°C.? L1" iELEPHONE# b5l- L'id •O2arJ
------------------------------------------------------ --------- -------°--------------------..
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULF.S 7670 CATLGORY 1 MINNI:SO'CA RLJLI:S 7672
(J submission type) • Residential Ventilation Category i Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ___
Plumbing system includes:
Mechanical Contractor.
Mechanical system incIudes:
Sewer/Wafer Confractor:
_ Water SoRener _
_ Water Heater _
No. oF Baths
Air Conditioning
Hea[ Recovery System
_ Phone #
L.awn Sprinkler
No. of R.I. Baths
Phone #
Phone #
---------------- °--°--------°°-------------°°---°-°--------°-°------------....
I hereby acknowledge that I have read this application, state that the information is cc
with all applicable State of Minnesota Stotutes and City of Eagan Ordinances.
Signafure of Applicant
Fee: $90.00
Fee: $70.(30
3111 1 7 zQaz D
, and agree to comK
orrIcE usi. oNt.Y
RemodeVRaoair RaauirameMa
. 2 copies of plan
. t set of Emqy CakulaRons for heated additions
. 1 sile survey far BMerior addAians 6 decks
. Indicate'rfhwne served bysepticsystem foreddiGOris
VALUATION ??.C.bd. ?-
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFlCE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 31 Eut. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 36 Multi
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 66 04plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscelianeous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 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 'Demalidon (Entlre Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings(deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
CITY OF EAGAN PERMIT 01?06 3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55123 Permit Number
Date Issued:
(612) 681-4675
SITE ADDRESS:
565 PfiRT;?7E C1:R C
LO?: 0003 BLOCK, 0002
COUDITi7Y NUI_I,.OW 2N0
P.I.N. ? 10-1132?6- 03t7-G17
DESCRIPTION:
REMARKS
"Su?.idi.i9 Permit Type SF DWG
@??i1JI.-y?.W cr!: D:r
UF3c vocup?nty R -'s I'i-.t
i
Ccijstructiuri"lyipe
VIV
.'Lnn tnc. - R-1
. 8 uS. td:ng '_eny.rli G!-
BW114iYiC.+ W1GLt1 'I$
?
.? = .y._ ..? . ..
reE c€ii>r +t
i
P RV st.w PL B a - mniri,r,,1 nr-.r:r - i
FEE SUMMARY:
VFlLUATIOPI
^la;l heview
Si_ircharge
SF1C
S d'f C `.
SA(' Un.its
subrot.,!-
'.825. F)N
7 6 . 50
$750.G70
? i;? ({1
_'..._ 4.'.18?.75
$7.G3,G10()
mfSC !=t.1?5
1(0
,?? .y1
CONTRACTOR: - Ai)nli.e,,ny - s?. I.'rt:OWNER:
WNIT?'E'V NUME.? CREATIOPdS 7.454y1.5t? (90933911 WH7Ti\1 EY C12FA1"IOD!S ?A!f..
n1b'0 LA \l P=RH I !V "76t9 LfiN 7cRPd l Rh'L
E AGAN MN 5 612 FI1f3AN '?Py 5E12±
(692) 45'?-915U (61,-)45"9150
? hereby acknowledyn tYiat I hcive read Chi= ..rpli.c.t.i.u.. Ih,, I..
far-ni,.Llor, i? co; t ect ,.:, 10 sc;- ,- c to ;ump ly wiil?
S'ttur..a cl'^ ?C.i.'G,y o f E aga n Ordlriance s. ?
?cv ? V ?"l a..e._ -?n! l?v " ?"`?'??-!'
APPLI ANT/PERMITEE SIGNATUR „ ISSU BY: SIGNATURE
IN5PECTION RECORD
CITY OF EAGAN PeRnniT TYPE: r, uI L nT , 1 c
3830 Pilot Knob Road Permit Number vl v w 7 7?
Eagan, Minnesota 55123 Date Issued
(612) 681-4675
APPLICANT:
SITE ADDRESS: LOr o 0003 BLo c K e 0002
56G WRA7{@iE CI12 E IJI;I7MEY hI0ME5 CRFA"I'IONS
C(IUNTI2Y IiOLIOW 21VC7 (612) 454-916G;
PERMIT SUBTYPE:
sF uwG
TYPE OF WORK:
Nrw
INSPECTION
FOf7'I'ING D. .
FRAMTNG ..
INSUL.ATION FINAL
Pf REI'LFlCE
ftEiMARK3: RECLT,PT $
?
PFV S&W PLBR - MFll'"THE4J-ONML' I "'
?
REACTIVATE
PERMIT #
CITY OF EAGAN ?3 y 3.2 •Q, S ?
1993 BUILDING PERMIT APPLICATION
681-4675
JNN ? 6 RECD-
?? n-? L L ci '?? t
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of archit ectural & 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 ch anged or 3) lot change is requested once permit
is issued.
Date 3A N / a //993 Valuation of work ??? DOZ7
"
Site Address: 15 lv? a
• ; tC.' Ac ?
STREET Sl11TE I
Tenant Name: (commercial only).
IAT ? BIACK ? SIIBD. P.I.D. M
? .\ . ?.
o
Descri tion of work:
The applicant is: O Owner 0 Contractor <fs
Other (Deccribe)
Name Phone
Property LAST FIRST
Owner
Address
STREET STE Y
City State Zip
Company Xti . c- Phone
Contractor Address`t D c? oti L C_ Li ense 1#FZJOO831154 Exp.3
City 5tate _ Zip Ssi°z-3
I
Company L Do Phone s07 - -/0/9
Architect/
Engineer Name Registration #
AddresN. b. "z S4
City State Zip'ESD6, r?
Sewer & water licensed plumber uckA?'F « s Processing time for
sewer & water permits is two days nce area has been approved.
I hereby ack ledge that ave read this a liton and state that the information is
correct and agree to comply 't 1 pli e of M inn ta Statutes and City of
Eagan Ordin ces.
Signature of Applicant:
?
?
OFFICE USE ONLY
BUILDING PERMIT TYPE '
? 01 Foundation O 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
E'02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory 13 18 Comn./Ind.
? 04 Sf Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
031 New ? 33 Alterations 0 35 Tenant finish ? 37 Demolish
O 32 Addition ? 34 Repair O 36 Move
GENERAL INFORMATION
Const. (Actual) v- N Basement sq. ft. MWCC System YE.s
(Allowable) V-rr lst Fl. sq. ft. City Water ??es
UBC Occupancy R-3 M-1 2nd F1. sq. ft.. PRY Required Es
Zoning n-3 Sq. Ft. total Booster Pum p
# of Stories Footprint Sq. ft. Fire Sprink ler
Length bs1 On-site well Census Code idi
Depth 4a' On-site sewage SAC Code -0/
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED IN SPECTIONS
? 5ite ? Footing ? Framing O Insulation
? Wallboard ? Final ? Draintile ? fireplace
Permit Fee veiurecsd,: g 153, oov "-
Surcharge
Plan Review G AIiA6E:
- 32 K?y= 768
License i x iz= (12)
MWCC SAC
City SAC o- 6 /a = I Z oq?
)
a``'M7' 2„rz
=
?
Water Conn. o
4vo
33x3L= ?p?
Water Meter
Acct. Deposit 6 x 4= (24)
S/W Permit -(0(0_
S/W Surcharge lyqg x/s. zz,4'7o
Treatment Pl. IST Fi.ooa
Road Unit
Park Ded.
SSmT% (y96
Trails Ded.
Copies ?n 2 = ?
)s?y K53? ??, Zy2
Other Zryp ?'L??Z
Total:
21?K?o- Szo
SAC % Ot9
5AC Units ? lyKf3t.3= ?gG 3'7 y?`6
G X53=
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I hereby certify that this survey was prepared.by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the Laws of the State of Minnesota.
Date : '15.53 'k?? l/, Z'/",
I,eRoy HlBohlen
Registered Land Surveyor No. 10795
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LOT BIIRVEY CSECICLIBT !OR ItEBIDENTIIlL
?
SII2LDIN0 BERlSIT 71PPLIC7ITION
? PROPERTY LtGl1L•2
?
Date o! Survey s /z z
d
?NT STAliDARfla
8?,0 0
D •
• Regfatered Land Survayor signature aad company
F Building Permit ]1pplYcant
0
? • Legal description
G 0
Pll? D 13
0 •
• Address
L'I? 0
0
• North arrow and bar scale •
House type (rambler, valkout, split r+/o, split entry,
0??
0
• lookout, etc.)
0 H
?0
• Directionai drainage arrows vith slope/qradient i.
0?
0
D
• Proposed/existinq sewer and vater services
? Street name
LT 0 0 • Dziveway
ZLEVAT20N8
D 0?0
• Existinc
sewer service
00 D • Lot corners
? D 0 • Top of curb at the driveway
0 0 • Elevations of any existinq adjncent homes
4roDOaed
fd? D 0 • Garage floor
g 0 0 • First floor
• Lowest exposed elevation (walkout/window)
property corners
D 0 0 . Front and rear of home at the foundation
? 0 P9NDING AREAB (ir aDV13C ble)
Easement line
? f I3
0 ?
• NWL
tiwL
?
B • Pond # desiqnation
D Er rj • Emerqency Overflow Elevntion
e0
?
0
• a=rExsioxs •
Lot lines
2'
0
?3 0 • Right-of-way aad street width (to back oi curb)
El • Proposed home dimensions includinq any proposed decks,
overAangs greater than 21, porches, etc. (i.e. all
? structures requirinq permanent footiags)
D D • Show all easements of reoord and any City utilitias within
13'*/ 0 those easements
0 • Setbacks of proposed structure and setback of adjacent
0 ? D existing homes
•
- Retaining eguirem s, if any
- Reviswed:
Octobez 1992 Name ? e
,
JRN-26-1993' 09:47 FROM
TO 16126814612 P.02
" Lor 3/ BL.ocKZ, CounrTRY HoLLo(,i) SECON-D A'D17/Tlaly
ONE AND lVPO FAMI LY
ENERCiY CALCULATIONS - AYEpAOE "U" C4MPUTpTION
dHNER: WFIITNEY H17ME 817E ADOPESS: EAOAN DATE: 1-94-93
CONiRpctOH: WHiTNEY FIdiE CALCULATIONS Br: PHM1E: 451f0/B
0atermine workinp aquare feotapv o} aecM1 th at applia s.
I. Tatal 9xpoaetl wail area...----- ..... 2984 .6 nq. ft. x 0.7t0 =Z6Y.81
2. Total tocf/oeiiinp araa ........ ..... 1171 aq, ft. : 0.026 ° 88.82
3. Ploora over unhsatetl epace.......... aq. ft. x 0.050 = 0.00
4. Rool/oslllnp troa (no attle apace).. sq, ft. x 0.029 = 9.00
5. UnhoBtBE 8l00 on praCe .............. eq. ft. 7c 0.160 = 0.00
B. HaAtsd alab oh ptade................ eq. ft, x 0.128 = 0.00
T07AL WOOD WALL AREA
a. Talal wall windaw :rea........... 288.88
b. Tele1 deer are$ .................. 124.00
e. Total plass door arsa........,...
d. Total firsplace wsll ete9........
e. Total 11m Jolat arra ............. 282.82
f. Total wall traming area......... , f67.84
p. 7ots1 eet wall area aeova Iloar.. f808.58
TOTAL E%FOBEP FOIINDATION ApEA 77-17
n. Total }oundafion wln'dow a1ea......-....
I. Total net foVntlati4n area ebove ptade.. 77.17
J. Total unhBaSad elab on grade aiaa......
k. Total hsalsd eleb on pteda arOA....,.,.
Petermins "U" ralus of eaaM1 pall sepment
P- 289.98 % "V" 0.300 ° . 104.99
e. 124.00 x"U" 0.070 r 8.68
a. 3.00 x"11" 0.900 = O.DD
d, 0.00 x "u° = 0.00
s. 282.22 x"U" 0.043 = 11.38
f• f87,82 x "U• 0.108 = +7.11
p. f808.58 z"U" 0.048 = t26.18
n. 0.00 : •u• = o.on
I. 77.17 x "U° 0.002 = 4.77
?. 0.00 z °u• = o.oo
k. 0.00 x U" = 0.00
7 ................................ ......TOTAL
It lism N7 le the eame ae, oY Ib8• lhBn ilB111 #i , you hav e mest the
Intent o1 38C 6006(6)2.
qOTE: RWM7ATION WALLS
Full basaman! (RrmDlor) anttre eztorlor wali mu et be net laas t han
R-5.
Halt beaamant (8pllt Foyer) entire extertor wal l muat he nvt Io s•
tllan R-10_
pc,,. 1 ? 3.
V-fflIlNE? K04- C1C='-A -)1o0Sj WG-
LO T 3 8LaC_ z.
2-8?° 6?1J1?1?N
R=96% 01-26-93 09:51AM P002 #02
y SRN-26-1993, 09:48 FROM TO 16126814612 P.03
.
TOTAL E7(p03ED RCOF/CEILlNG AAEA 1474
I. Total ekyllpht area ....................
m: Total fOOt/cel.linQ lreminp atOA..___.,. 147.4
h. Total nst fhOYlatsd rvof/calllnp area.- 1828.8
patsYGltR6 'U"val4a fof saeh roaFlcaltlnp eaqmant.
1. 0 x"U" = 0.08
M. 147,4 x"U" 01088 = 1-19
n. 1328.8 x'U' 0.025 = 33.35
B .:............ ......................... Total = s7. 4
If t110 latal af pB le the eami Y8, of feea lhan 02, yoY haYS met
the Intent of SBC 8018(011.
To ulilixe !he totaf envalope ayetem method, the relves
estaplVrhed by tna sum ol 3tsme 07 and ike ahall not be
draator tfian tha aum of items 01 and *2.
WALL SEC71OIJ3 7/R
WALL PRpMINq AREA CONSTRUCTION R-Yalue
1. Intarlur Bir film 4.88
2. 1120 Gyp; Bd. 0.45
9. 5-1/21nahae Oalt woad 6.84
4. 7118" OSB 0.07
5. Vlnyl Sitlinp 0.62
8. ExFerlor BIr illm 0.17
Total 9.43
"U" Yalue 0.108
NET 1YALt AitEA A66VE FLQOR
1. IntsYior alr film 0.69
7. 1/2" 6rp, dq, 0.45
3. FJe IRO. 18.00
. A. 7/18" OS9 0.67
5. Ylnyl SldinQ 0.02
8. Ext0f10r aFt P11m 0,17
.
Tatal
21.58
"U" Value 0.040
RIM J015T AREA
1. lntsrlor air fllm 0.88
2. F/G Ins. 19.00
3, 1-1/II" sortwoo0 1.80
6: 7118" 086 0.07
5. Yinyl Bldinp 0102
9. Exteriar 8ir illm 0.17
Total 23.03
•U" Value p.oes
1)/ ? ? ?
R=96% 01-26-93 09:51AM P003 #02
:...
SRN-?6-1993, 1 09:48 FROM - TO 16126814612 P.04
FOUNCA710N AREA ABCVE GRAOE
1. Intsrlar eit film 0.98
2. F/d lnaul. 13.00
8. 10" Conc, Hlk. 2.93
4.
S.
0. Eaterlor alt film 9177 .
Total 18.78 '
"U" ValuO 0.082
Ii00FICE141NG FRApAIN6 AItEA
1. Intetlot afr film 0161
2. 6!8" Gyp. 6d. 0.58
9. Card depth 9-1/2" 4.38
4. Insulallon 29.R0
5. ExMrfor alr film 0.61
T0181 35.t8
"U" Yalus 0.02$
INSULATEQ ROOF/CEILlNG AREA
1. Interfor alr film 0.01
2. 5/8" Gyp. 6d. 0.58
3. Insulallon 138.00
1. Exlerlor air film 0.61
Tptal 89,78
"U" VaIUB 0.025
?q, 3 6? 3
TDTFiL P.04
R=96% 01-26-93 09:51AM PDOd #02
REAGTIYAT,:.f -,-TY OF EAGAN
PERMIT # 9 BUlLDING PERMIT APPLICATION
ww1
n NOV ua 19y3_-
qL --
---- --- aoI wviu
SINGLE 3 MULTI-FAMILY
- 2 sets of plans, 3 registered site surveys, l copy of energy
calcs.
COMMERCIAL 2 sets of architectural 6 structural plans, l set of
specifications, l copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of sronth.
in which request is made, 2) address is changed or 3) lot change i.s requested once permit
is issued.
Date Valuation of work
?
as
Site Address:
STREEi SU?TE 1
Tenant Name: (commercial only)
],p'?3 SIACIC ? SDBD. K,? , o aa p.I.D. N '
Uescri tion of work: 'A_ ! 4 /
The appl icant i s: ? Owner R Contractor ? OLII81' (Deseribe)
Name Phone
Property LAST FI0.5T
Owner Address
STREET fiE y
City State ZiP
Company Phone =S `?- 9/SO
C0ntf8CtOf Address {1v6 '%? Lice se # 9 3 `{ Exp. 3 9S
City State Zip 5S /?-3
Company s Phone
Architect/
Engtneer Name Registration 1`
Address
City State ZiP
Sewer d water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
J hereby acknowledge that I have ead this a lication a state t h tforrmation is
correct and agree to c m 1 with a 1 applicagR Stato Minnesota 5 Ci
n Ordi
ces
E
a a
nan
.
?
? "d
Signature of Appl icant: ?t
OFFICE USE ONLY
BUILDING PERMIT TYPE
D 01 Foundation
? 02 5F Dwg.
? 03 SF Addition
p 04 SF Porch
O 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? OS 8-Plex
? 09 12-Plex
? 10 Multi. Add'1.
? 11 Apt./Lodging
? 12 Multi. Nisc..
? 13 Garage /Acce s sory
? 14 Fireplace
Pt 15 Deck
O 16?elent'?Fish
0.p17 .Swtfd?* Poel.?,
? ]B CoRm./Ind.
? 19 Coron./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneuus
WORK TYPE
)4 31 New ? 33 Alteratlons 0 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair [3 .36 Move
GENERAL INF ORMATION
Const. (Actual) Basement sq. ft. MWCC 5ystem
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRY Required
Ioning Sq. Ft. total 8ooster Pum p
i of Stories Footprint Sq. ft. Fire Sprink ler
length On-site we11 Census Code %3y
Depth On-site sewage 5AC Code
APPROVALS
Planning Building Assessments
Englneering Variance
REGIUIRED IN SPECTIONS
? Site U Footing ? Framing ? Insulation
? Mallboard ff Final 0 Dralntile ? Fireplace .
Permit Fee v.wecion:
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Nater Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies.
Other
Total:
SAC %
SAC Units
:3L
PRA i2lE
ct Rc.LE
• g+,???'?^
_r7
r
0
"Y Q
-c.t- vr?
833•?O ?ry'
v
i?
?? LY..
R.re
•a a
N
.
3a\ 4 0
?y.
,
P4
? ?I2,D
c
\ ?Yeo
qI ? h
3z?o
0
'8- s3
?
1
40?
0
?
'N
'6t 82;,
•u
\.
$
,
.
Toa B?.oL?L E1..? 835.5
8?h6 MCr?T C l. 87.? ,T
byb?
?
.r o
. • 6'?
W dIU
?
I 9 '? IJ 1?
' Z I r
I qr
? J
I?° r
,
i,
I 1
?
?
?
w
r
? a
Qj M
<11
V
oll
Q?
?N?2;'7Z ??
589°3a?3?"c- ?
e
?V?:: 6EA.Rl+.?44 A44JMEO
°DE?j ?Rpµ MoNJME?,!"S'
Lo T 3 , eil. ac-?c_ ;L,
Cov??-??'t F+O??oW
SEGON? ADDt??o?.l?
?PK.OT?+. GOJNTY?
M?IJFyE
020270 2 hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the Laws of the State of Minnesota.
Date:J?A-4 ,g53 'RI
l/, l??P
LeRoy H Bohlen
Registered Land Surveyor No, 10795
?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: auzLorNG
Permit Number: 0 3 2 5 8 0
Date Issued: 0 7/ 17 J 9 S
SITE ADDRESS:
P.I.N.: 10-18276-036-02
566 PRAIRIE CIR E
IOTs 3 BLOCK: 2
COUNTRY HOLLOW 2ND
DESCRIPTION:
.? REROQF
8uil8iitg Permit Type
,6?aild.ing "aiork 7ype
?Census Code"`
?
?
?` .
,
,_ .
4....._ ?-
._ _ --,.
STORM DAMA6E
REPAIR
434 ALT. RESIDENTIAL
„
REMARKS:
FEE SUMMARY:
CONTRACTOR: - flpplicant - sr. LIc OWNER:
TOP LINE CONST & ROOFING 14328998 2010224 ALCORN RON
14541 EVERGREEN TR 566 PRAIRIE CIR E
APPLE VALLEY MN 55124 EAGAN MN 55123
(612) 437-8998 (651)686-0227 I hereby acknowledge Chat I have read Chis application and state that the
informatior3is correct and agres tp cnmply uith all aPRlicable StaCe nf Mn.
Statutes end City ofi Eagan Ordinances.
?
APPUCANT/PEFMITEE SIGNATURE
?
UED Y: SIGN E
UILDING
New Construdion Reauiremen[s
RemodeUReoair Reauirements
? 3 registered site surveys
? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.)
? 7 energy calwlations
• 3 copies of Vee preservation plan if lot platted after 711/93
required: _ Yas _ Na
DATE: 11c,, ? g
DESCRIPTION OF WORK:
STREETADDRESS: Jbb \;41' Y .
LOT: ? BLOCK: SUBD./P.I.D.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
? 2 copies of plan
? 2 site surveys (exlerior additions 8 decks)
? 1 energy calculations fcr heateE aCditions
r?
CONSTRUCTION COST; S, dV0Name: f-l4Coq-v-, 1\Dv1 Phone#:
Last First
Street Address: ?w NGt i f.t C;{
City ,C4,0.V-, State: ? Zip:
PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-4675
4 ?O°b m Phone #: 6/3 -?79
'ctm,Q, L • License # ? Oj
City State: Zip:
Street
City
Sewer & water licensed plumber (new construction ony):
and lot change is requested once pertnit is issued.
Penalry applies when address chanc
I hereby acknowledge that I have read this application and state that the intorm tio iS rre d agree to compiy witfi all applicahl
State of Minnesota Statutes and City of Eagan Ordinances. ,
i
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Phone #:
Registration
State: Zip:
Tree Preservation Plan Received - Yes - No ,_ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Dupiex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 5F Misc. ? 10 _-plex
WORK TYPE
? 31 New ? 33 Alterations
O 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actuai) _
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
O 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
0 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
_ sq. ft,
sq. ft.
Footprint sq. ft.
Building
Engineering
Valuation: $
??....
?
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinktered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
°k SAC
SAC Units
il
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf•
NO. FIXTURES -E8C--H
1 SHOWER 3.00 3.00
WATER CLOSET 3•00 9. 0 °
BATH TUB 3.00 (, v o
?
LAVATORY 3.00 1s '
-T KTI'CHEN SINK 3•00 3 ' ° °
? LAUNDRY TRAY 3.00 3. o 0
HOT TUB/SPA 3•00
WATER HEATER 3.00 3• o c?
° "
FLOOR DRAIN 3•00 '
?
GAS PIPING OUTLET • minimum - 1 3.00 •? v
ROUGH OPENINGS 1.50 +-t • 5 ?
WATER SOFTENER 5.00
PRIVATE DISP. • nat.cry. iia 15.00
U.G. SPRINKLER • nome unaa wnst. 3•00
ALTERATIONS • to aosting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .SO
TOTAL: 53. o 0
SITE ADDRESS: S 6 ` ?
OWNER NAME: t.J V,? r.?. i-?uvr..e,S
INSTALLER:
ADDRFSS: 1 S t? S Cu-v a?v c-S ? o-"
CITY: STATE: ZIP CODE:S 2 3
PHONE #: ( 60L 0
? 1993 PLUMBING PERMIT (RESIDEIVT'IAL)
CTfY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
?
PLEASE COMPLETE FOR ALL COMIIERCIAL,/INDUSTRIAL BUII.DINGS. ALSO FOR MLTLTI-
FAMILY BUII,DINGS WFEN SEPARATE PERMTTS ARE NOT REQUIl2ED FOR EACH
DWELLING UNTT.
_ NEW CONS7'RUCTION
ADB ON
REPAIR
WORK DESCRIPTION:
CONTRACf PRICI?: $
FEE: 145 OF CONTRAC'T'FEE.
STATE SURCHARGE: $.50 FOR
MINIMUM FEE: $ 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
EACA $1,000 OF ?"P!! FEE.
$
$
SIT'E ADDRESS: • •, z ?, a'
TENANT NAME: ' STE. #
OWNER NAME:
INSTALLER: '
ADDRESS:
CI1'Y:
PHONE #:
FOR:
CITY OF EAGAN
STAT'E:
ZIP CODE:
APPLICANT
1993 PLUMBING PERMIT (CObII1ZERCIAL)
CITY OF EAGAN
3830 PIIAT IINOB RD
EAGAN MN 55122
(612) 6814675
• ?-
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMFS AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf.
_Z?EW CONSTRUGTION
ADD-ON A/C
ADD-ON FURNACE
DATE ri "a 3- GI3
FEES
HVAC: 0-100 M BTU
ADDTTIONAL 50 M BTU
GAS OUTLETS (MINIMLJM 1 @ $3.00 EACH)
ADD-ON/REMODEL (EXIsTnvG CoNSTRUGTION)
STATE SURCHARGE
TOTAL
$ 24.00
6.00
$ 15.00
.50 _
4R, S-D
SITE
OWNER
CTTY•
TELEPHONE #: /A' ) y
•rELEPxorrE #:
??? r
ZIP CODE: _??-U7T
d
MECHANICAL PERMIT (RESIDIIVTTAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
I
MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL COMIlv1ERCIALJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIItED FOR EACH DWELLING UNTT.
DATE: CON'TFcFiC'fi' rRiCE: $
NEW BUILDING
INTERIOR IlviPROVEMENT
WORK DESCRIPTION:
FEES
1% OF PPMM FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDILFSS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IIvtPROVEMENTS oNLI)
INSTALLER:
ADDRES3:
CTI'Y
STATE: ZIP CODE:
TELEPHONE #:
SIGNATURE OF PERMITTEE CITY INSPECTOR
954870
>
COIINTRY HOLLOW 88COND ADDITION
PRESBIIRB REDIICING VALVS A(iREBMSNT
i
This agreement, , made and entered into the day
of 1990, by and between the CITY OF EAGAN, a
municipWty of the State of Minnesota, (hereinafter called the
City), and the Owner and Developer identified herein.
The terms "Developer" and "Owner" as used herein refer to:
PROGRESS LAND COMPANY, INC. whose address is 14300 Nicollet Court,
Suite 235, Burnsville, Minnesota 55337.
WHEREAS, the Developer has applied to the city for approval of
the plat or subdivision known as COUNTRY HOLLOW SECOND ADDITION,
iocated within the City; and
WHEREAS, the Owner and Developer agree to natify the proposed
potential buyers of all lots within COUNTRY HOLLOW SECOND ADDITION
that' Lots 1-4, Block 1, Lots 1-17, Block 2 and Lots 1-10, Slock'3 are
in a high water pressure zone and a pressure reducing valve shall be
installed in each home below the elevation of 875 feet. All costs
shall be the responsibility of the Buyer and shall be installed to
prevent damage due to high water pressure.
NOW, THEREFORE, the City, Owner and Developer agree as follows:
1. Recordina. This agreement shall be recorded with the Dakota
County Recorder so as to provide notice.to the owners of Lots 1-4,
Block 1, Lots 1-17, Block 2, and Lots 1-30, B1ock 3. The Owner shall
provide and execute any and all documents necessary to implement the
recording of this agreement.
?
?
2. Notice. The recording of this document shall constitute notice
to all owners and future owners of property in the COUNTRY HOLLOW
SECOND ADDITION subdivision that Lots 1-4, Block 1, Lots 1-17, Block
2, and Lots 1-10, Slock 3 are in a high water pressure zone and that
a pressure reducing valve shall be installed in each home below the
elevation of 875 feet. All costs shall be the responsibility of the
Buyer and shall be installed to grevent the damage due to high water
pressure.
3. Validitv. If any portion, section, subsection, sentence,
clause, paragraph or phrase of this agreement is for any reason held
to be invalid, such decision shall not affect the validity of the
remaining portion of this Contract.
4. Binding Aareement. The parties mutually recognize and agree
that all terms and conditions of this recordable agreement shall run
with the land herein described and shall be binding upon the heirs,
successors, administrators and assigns of the owners and developers
referenced in this Contract.
IN WITNESS WHEREOF, we have hereunto set our hands.
CITY OF A OWNER AND DEVELOPLR:
(Date: ' PROGRESS LAND COMPANY, INC.
z - ? ??-
gaf- . T mas A. By: IJ
Its: Mayor Its: PRcJiOEw t'
Attest: . J. VanOverbeke
Its: erk
Bv:
Its'
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this day of
Public within and for said
and E. J. VanOVERBEKE to
duly sworn, each did say
Clerk of the City of Eaga
instrument, and that the s
by authority of its
acknowledged said instrume
municipality.
1990, before me a Notary
County personally appeared THOMAS A. EGAN
me peisonally known, who being each by me
that they are respectively the Mayor and
n, the municipality named in the foregoing
eal affixed on behalf of said municipality
City CounciZ ar.d said Mayur and Clerk
nt to be the free act and deed of said
y •M.?r?e+,e:.ri.N.???at:?+?
....
STATE OF MINNESOTA )
) ss.
COUNTY OF 1),t i"', )
????' • . 7 ?
?-
I Not,ary A?ublic
;
? ?-
On this -vI? day of ?,1" , 1990, before me a Notary
Public within and fcir said County, personally
appeared ?.1; ;;.; 1-:_l Ci!` l':i I , and- to me
persona?l own, 1who being ?ael?-by me duly sy?orn, eaela did eay that
t?Sej?t'? resgeeti-velt the 11. Gl : i? t
arxd of the corporation named. in the
foregoing instrument, _ __ ..a_ ____ _^_ ________ t_ __. d
, and that said instrument was
signed ared-aen-ett on behalf of said corpora,T ion,L?y authoriiy of its
Board of Directors and said rrrS , d uit'
-ee"d- acknowledged said instrument to be the
free act and deed of the corporation.
?`-- ._.. .? ?..,.a:....??..,,.,,,..
_ . . ;
P ; rl(L,4 6i
Notary PubVic
APPROVED AS TO EORM:
? 14
f,?.tiV4 Q K'?ya
Public Wo s Department
Dated: J+.:?y 90
TAIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, WILCOX & SHELDON, P.A.
600 Midway National Bank Bldg.
7300 West 147th Street
Apple Valley, MN 55124
(612) 432-3136
MGD
olo (, -5'9s'1 lp-Q
APPROVED AS TO CONTENT:
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMTIS ARE REQUIItED FOR EACH UNTT.
NO. FIXTURES ACH TOT?
t SHOWER 3,00 3. ocz?
-T VvA l tt< CLVSE i 3,00 ?- o O
BATH TUB 3.00
? LAVATORY 3•00
KITCHEN SINK 3•00
LAUNDRY TRAY 3.00
HOT TUB/SPA 3•00
WATER HEATER 3•00
FLOOR DRAIN 3•00
GAS PIPING OUTT.ET • minimum - t 3.00
ROUGH OPENINGS 1.50
WATER SOFfENER 5•00
PRIVATE DISP. • Dak.Cry. lic. 15.00
U.G. SPRINKLER • nome under con:t. 3.00
ALTERATIONS • io oasung 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE
SITE ADDRESS
OWNER
TOTAL:
Ck
? ?.._
.50
a•S0
-?
INSTALLER: %
ADDRESS: ISl O ? u, < 4 ? >ay
CITY:??i'?STATE: Vr-f? ZIP CODE: S?`2(2y
PHONE #: (U L) ?EZ3 - 3? 30
CD,- &%-?
1993 PLUMBING PERNIIT (RESIDEN'IZAL)
CTIY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681.4675
1993 PLUMBING PERMIT (COMMERCIAI,)
CITY OF FAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL COMMERCIALJINDUSTRIAL BUILDINGS. AISO FOR MULTI-
FAMILY BUI: DINGS Wf-IEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH
DWELLING L'; , .T.
_ IVEW CONSTRUC710N
ADD ON
REPAIR
WORK DESCRIPTION:
CONTRACT PRICE: $
FEE: 1°k OF CONTRACT FEE.
STATE SURCIiAI2GE f.50 FOR EAC,i $1,000 OF p,£R1VIIT FEE
MINIMUM FEE S 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
SITE ADDRESS:
$
$
TENANT NAIVIE: S'I'E. #
OWNER NA117E:
W STALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
For Office Use
Permit #: q;917/1.6--
Permit
;917//
Permit Fee:
Date Received:
Staff:
L
2009 MECHANICAL PERMIT APPLICATION
Date: /9 - 3» 6' 9f Site Address:,5-6,akiriz,-e6'ie_e<z.
Tenant:
Suite #:
RESIDENT / OWNER
Name: 4 J / Cl' it /V Phone: 60- 9/f M
T
Address / City / Zip: ),4 fCFIJJI I 3/I'1 ccc
CONTRACTOR
Name: f id , V/k4* it Ji'6. License #:
Address: 7 ek//(' r � i , Ste,
City: , State: met Zip:..S-4(e7
Phone: (p 1, 0 g.0 a/Contact Person:
TYPE OF WORK
/New Replacement Additional Alteration Demolition
Description of work:
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
t/ Furnace
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Air Conditioner
Gas Exterior HVAC Unit
Air Exchanger
Under / Above ground Tank (_ Install / _ Remove)
Heat Pump
** When installing/removing tank(s), call for inspection try Fire
Marshal and Plumbing Inspector
/
Other r # et(
RESIDENTIAL FEES:
$50.50 Minimum Add-on
or alteration to an existing unit (includes $.50 State Surcharge)
out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ TOTAL FEE
$90.50 Fire repair (replace burned
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
installation/removal OR
State Surcharge)
surcharge is $.50.
increases by $.50 for each
Permit Fee requires a $1.00 surcharge).
pyt
Contract Value $ .. x 1%
_ $ Permit Fee
- If Permit Fee is less than $1,000,
= $ State Surcharge
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000
t-,
,—
$ 50 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 not a permit, but only an application for a permit, and work is not to start without a permi at the work will be in3ecordlance with the approved
plan ince case of work which requires a review and approval of plans.
x
App
icant's Printed Name
FOR OFFICE USE
Applicant's Signature
Reviewed By: Date:
Required Inspections: _Under Ground Rough In _Air Test Gas Service Test In -floor Heat Final
Exterior HVAC Screening Inspection
- - - - - - - - - - - - - -
For Office Use
`l'5S
Permit D I
City Oi Ea p
U ll~ Permit Fe 73 S~
e
3830 Pilot Knob Road I
AU G Q3 X009
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
L _ _ _ _ - _ -
2009 MECHANICAL PERMIT APPLICATION
Date: )_3/t Site Address: SI n Ia l `2 1 / e<
Tenant: Suite
RESIDENT ! OWNER Name: 7 7A41,A) Phone:
Address / City / Zip:
CONTRACTOR Name: Lk_ License ..nl w "a- Address: 4II'Z
City: Z I State: Zip: Sit
Phone: 4Contact Person:
TYPE OF WORK New V eplacement Additional Alteration Demolition
-A tj)ja
Description of work: L Z io' t A))T7j k21_1) ;r4.2 llk7 :2
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
/urnace New Construction Interior Improvement
f
V Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank L- Install / - Remove)
When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
Other
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TO EE
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Cit 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 perm' he work e in accordance the approved
plan in t case of work which requires a review and approval of plans.
x iN~~K. / v
Applicant Printed Name Applicants Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: -Under Ground Rough In _Air Test _Gas Service Test -In-floor Heat --Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144613
Date Issued:08/02/2017
Permit Category:ePermit
Site Address: 566 Prairie Cir E
Lot:3 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Pieter J S Breet
566 Prairie Cir E
Eagan MN 55123
Greenguard Construction Inc
2915 Waters Road, Suite 101
Eagan MN 55121
(651) 289-7000
Applicant/Permitee: Signature Issued By: Signature