1847 Pumice PtKNLJTSDN MORTGAGE DETACH AND RETAIN THIS STATEMENT
THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW.
AND FINANCIAL CORPORATION IF NOT CORREGT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DESIRED.
MINNEAPOLIS, MINN. 55401
8-25-70 70 1305 Sewer and Water Laterals Sp. Assessments
28/2/CG. #7
Nielsen, Roger #13267
1,705.44
/ mt
CITY OF EAGAN Rema
Addition CEDAR GR(JVE #7 Lot 28 B1k 2 Parcel 10 16706 280 02
Ownel + ? Street 1847 PumiCe Po31lt State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 58.18 2.08 28 Paid
* SEWER LATERAL 1971 ZO
WATERMAIN
* WATER LATERAL (Z. 1971 1,615.00 80.75 20 Paid
WATER AREA
* STORM SEW TRK ? 1971 ZO
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 230.00 2334 4-27-70
BUILDING PER.
SAC 200.00 2 114 4-27-70
PARK
INSPECTION RECORD I Control No.
CITY OF EAGAN PERMIT TYPE: U.'" 1 1?' ?"ti
3830 Pilot Knob Road Permit Number: 0004114
Eagan, Minnesota 55123 Date Issued: Ot' / ?6 /42
(612) 681-4675
SITEADDRESS: LpT* 20 aLpCK APPLICANT:
1t3A7 F't1MfiCE P7 OEME'S HOt1E 1':11RE A REPAtR$
CEOAR OiiQVE 7rN (612) 464•-3402
PEffp .!T V97FA TYPE OF WORK:
aLTERATIOp
DESCftYP1 XOM! RE--RtlORZ11O
PermR No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Commerrts
Footings I
Foundation
Framing
Roofing
9
Rough Plbg.
Rough Htg.
isul.
Fireptace
Final Htg.
Qrsat Test
Final Plbg. Plbg. inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
Weli
Pr. Disp.
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ..... dl.? ... --•- ?.=•?'•`-...-?!?c?.•-G'_ •-••••---••
Address (preseni) ._ ?_:_____"'e?..?_._?i_`.^''".`.J __..
Builder ............ ,4.1 ... ........
Address ..................................
DESCAIPTION
N ° 2211
Eagan Township
Town Hall
na:e --'????-l?°------------------------
53ories To Be Used For Fron! Depth Heigh! Est. Cost 'Permit Fee Aemarks
6 ? az? ?,4[ o, .-n-? / 7D • '--? ?o ? ?t- ?'? ?^A
LOCATION
Street, Road or other Description of Location ` L Block Addition or Trac!
? a,
This permii does noi sulhorise the use of streets, roads, alleys or sidewalks nor does it give the ownes or hfs agen!
!he right to cresie any situation which is a nuisance or which presenls a haaard !o the health, safety, conveaience aad
general welfare to anyone ia the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that-•-.4--..,..._&._-•._...Lr..t._-._...-?.?.,..................... has permission to erect a---..?a ............. ?• -`. ........... .:.. . upon
!he above described premise subject to ihe provisions of the Building Ordinance for Eagan ownshipd April 11,
1955................ .. Per
............... ........:`.'?"::-..-•••._......••-..__. lY .
. .....-?----?-?--- ?-?- e.?...? ::.--........
•-•--
- ? .............. ....
Chair an of Tnwn Boardt'3 , Buildin Inspector
zi--
TOWN OF EAGAN
3795 Pilot Knob F.oad
St. Paul, Minn. 55111
PERMIT Id0._ 80
The Board of Supervisors hereby grants to Seasonal Control Inc.
of 407 South Jackson, Hopkins, Minnesota a AIR CONDITIONING,
Permit for: (Owner) Roger Nielson at 1847 Pumice Point,, St. Pa+al 55122
, pursuant to application dated March 2. 1971 .
Fee Paid : S,5,t 00 Dated this ` 2nd d ay of March , 19 -1.
Building Inspector
?.
TOWN OF EAGAN
3795 Pilot Knob Rcad.
st. Paul, Minn, 551 11
PtRMIT NO.: 16
The Boaxd of Supervisora hereby grants to Cedax' Grove Construetian
of So. St. Pgu_,_Mtvloso-ta a Plunbing_
Permit for: (Owner) Gedar (3rove Constiructicm at 1347_Pumi.ce Point 28-2-9
pursuant to application dated Aprxl 24 ` LW?-_ _,.
Fee Paid: 620.00 Dated thie 27th day ef April , 19 74.
----
Building Inspector
TOWN OF EAGAN
3795 Pilot Knob Rcad
St. Paul, Minn. 55111
PERMIT NO.s 15
The Board of Supervi.sors hereby grants to CWd.£r Crove ConsGauctic>n
of wo. St. ?'?t.al, a '.?eating._
Permit for: (Owner) Cs-{.ar Giove Cor_?s,,-Iruetion at 1647 Pu7?ice Poin 22-4Z&7
??.` _,.
_._._...__?.? Pursuant to application dated April. 249 1970
Fee Paid: ?120.00 Dated this 27"th day ef Afix=+-I , 19 70.
~ Building Inspeetor - r `
CiTY USE ONLY
1. ? BL ?
sueo. C-?,C-06Y G rn ) 7
RECEIPT #: ? ? / : ??lJ
RECEIPT DATE:
PERMIT # O 7"'?
8000 PLiJ16I$INfc PERmIT (RESI]wNTIAL)
C1TY OF E1fiAN
3$30 PILOT KNOB fiD
KAfiAN, MN 55188
651-6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
civTiiocc
E4CH
#
TOTAL
AVI\?.V
Alterations to existing dwelling - minimum fee
Describe: '---
$ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas i in outlet * minimum -1 3.00 x = $
Hot tubls a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
S@ tIC S St2R1 new/refurbished ' requires MPC Ilc. 75.00 X = $
Se tIC S Stem abandonment 30.00 X = $
RPZ new installation/repaidrebuild 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round S rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $ ?
Water heater 3.00 x = $ 22, 490
Water softener if dwelling under construction 5.00 x = $
Water softener itexiscin9 dweuir,9 30.00 x = $
Water tumaround 30.00 x ---- _ $
State Surchar e .50 --> ----> ----> $ .50
?
Total --> --> ----> ----> $ -Sc-?
-qo Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
------ --------------------------------------------------------------------------------------
i hereby acknowledge that 1 have read this applica6on, state that the information is coRect, and agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER
STREET ADDRESS:
NIELSEN, ROGER
1847 PUMICE POINT
EAGAN, MN 55122
(651)454-4730
TELEPHONE #:
(AREA CODE)
TELEPHONE #:
(AREA CODE)
NORBt OM PL STATE: ZiP:
CITY:
(S12) 6 _7-4033 '
:2905 GARFiELD AVC. SO. .
LTMEAPOLI`', MN 55405 SIGNATUR ;ERMITTEE
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
1./z J?JJ /?? 3830 PILOT KNOB RD - 55122
?? "/ ?/ 651-681-4675
Reauirements Glhdl Vl(, i) V1S Wp°h'(jvl
? 2 co ies ot lan
p P ca r p?l ( ?j c1 ? 1 U ?4 V_ j ?
DATE: 1(r ? CONSTRUCTION COST: r? a
DESCRIPTION OF WORK: ?E Ff A? f Sl-J a?F ?.E ?? If multi-family bldg., how many units?
INDICATE THE FOLLOWING E6IUIPNIENT TO BE REPLACED AND BY WHOM:
Plumbing ? Homeowner gi Contractor Name
_ Mechanical Homeowner g[ Contractor Nome
**Note: If somebody other than the homeowner is performing plumbing or mechanical work, they mustapply forappropriate
permit. Only 1lcensed plumbing contractor or homeowner may complete plumbing work.
STREET ADDRESS: r?4 --? Vu 04 l6E V`
LOT: BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
?
V 7 3 ?
Name: - 00(? e f? Phone #:
Last Flrst
CMnnf Arieirnee• U? t Ll
city state: zip:
Company: S?4 - Phone #:
(area code)
Street Address: License # Exp.
City
State:
Zip:
L DL?(?(?fl w I
JAN 16T001
By
I hereby acknowiedge that I have read this application, state that the information is correct, and a ith all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: Lor:
1847 PUMICE RT
CEDAR 6ROVE 7TH
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
zs BLOCK: 2 APPLICANT:
Control No. 0393
BUI.LOIPIG :
00@479
05/06/92
GEPIE'S HOME CARE & REPAIRS
(612) 454-3402
171e
e e
PERMIT SUBTYPE: TYPE OF WORK:
RES. ADDITIOPI ALTERATION
DESCRIPTION RE-ROOFING
? .
.X CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date issued:
Control No. 0 393
BUILQING
000479
B5/06j92
SITE ADDRESS:
1647 PUIqICE PT
. EOT: 28- BLOCK« 2 ,
CEDAR 6ROVE 7TH -
PERMIT
DESCRIPTION:
---, RE-RQOFING
"4l4.???t ? Permit Type
- 1duflcf3:rthg ?Work Type
. ?.'UB>e
qGC.l?t?anC1??.
R:ES. ADDITION . ,
AlTERATION
R-3
r, ?
?
'?e?a? ??
? ???.a
2-1
REMARKS:
FEE SUMMARY:
Base Fee
5urcharge
Total Fee
VALUATION
$54.00
$1.50
$55.50
$3,000
CONTRACTOR: - Applicant - sr. LIC. OWNER:
GEIVE'S HOME G/iRE & REPAZRS 14543402 0002715 NIELSEN R06ER
2017 FLTNT LN 1847 PUMICE PT
EAGN MN 55122 EAGAN MN 55122
(612) 454-3402 (612)454-4730
PERMIT # q ,q
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
fi81-4675
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.
Valuation of work 54<ev
Date
Site Address:JF?.?
• STREET STE #
Tenant Name: (commercial only)
LOT BLOCK SUBD. P.I.D. 0
? ??? c• • ? /z?p_,"` s????'"`? 3 ?'+?•``?° vx',? ?' ? ????
Descri tion of work: f???? ?ag .,????^'? ?,? ?:???- • ?
The applicant is: ? Owner 19 Contractor ? Other (oes«;be)
Name Phone
Property LAST FIRST
Owner qddress 1?317
STREET STE #
City State Z i p 515
Co??pany ???' A.?? Phone
Gontractor Address License #, Exp.
C i ty State '"V Z i p
Company , Phone
Architect!
Et7g111eE1' Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time far
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
le State of Minnesota Statutes and City of
correct and agree to comply with all-app
Z
Eagan Ordinances.
Signature of Applicant: ?"---`
,
_zz
OFFICE USE ONLY
BUILDING PERMIT TYPE
D O1 Foundation ? 05 Rpt. Bidg
? 02 SF Dwg. - ? 06 Garage/Accessory
? 03 Two family 0 07 Fireplace
L7 04 Multi-fam. T.H. ? 08 Deck
? 09 Basement Finish
D 10 Swim Pool
E3 11 Res. Add.
? 12 Res. Porch
WORK TYPE
? 31 New 0 33 Alterations
? 32 Addition ? 34 Tenant Finish
GENERAL INFORMATION-? ?Const. Actual) Basement sq. ft. ;
?
(Al owable) lst F1. sq. ft.
UBC Occupancy 2nd F1. sq. ft.
Zoning Sq. Ft. total
# of Stories Footprin t Sq. ft.
Length On-site well
Depth On-site sewage
APPROVALS
Planning Building
Engineering ° Variance
REQUIRED INSPECTlONS
El Site ? Foating .
? Wallboa•rd. 0 Finai
? 35 Move
D 36 Demolish
D Framing
? Drainti]e
O Insulation
D Fireplace
Permi t Fee veLust;«,: s3. ?Q
Surcharge rT
P1anrReview .,
License MWCC SAC- - City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/w Surcharge
Treatment P1.
Road Unit
Park Ded. .
Trails Ded.
Copies
Other . Total :
SAC 96
SAC Units •
„
? . ?•f°
013 Comm/Ind New
? 14 Comm/Ind Add
C] 15 Comm/Ind Rem
016 Public.Fac.
017 Agricultural
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
LOCATION
OWNER
STRUCTURE AND
LAND USED AS
MASTER CARD
•+ !.
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING ?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER ??!'??•
4t;
OTHER -
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING ?I• rZ' ?'7 ? SEPTIC
FdUNDATION .. ?, CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL DEPTH
HEATiNG OF WELL
GAS INSTAILATION
.
SEPTiC TANK
CESSPOOL
DRAINFIELD
PLUMBING
?-
WEIL "
SANITARY SEWER ? ? 'i?' V
jr:1,1 I 7 /J
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1-1 NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIOfVS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed. to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABIY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
23
& 49 -'
EAGF.N TOWNSHIP
3795 Pilot Knob Rosd
St. Paul, Minnesota 55111
Telephone 454-5242
PER141T FOR WATER SERVICE CONNECTION
Date• 4/22/70
Billing Name:Cedar Grove Constr. o.
Owner: Same
Plumber; Stein, Inc.
tion of Connection
Number: 427
Site Address: 1847 Pumice Point 28-2-7
Billing Address 7343 Concord Blvd. E.
South St. Paul
Minnesota 55075
Meter Size Coanection Chg. 230.00 pd 4/27/70
Meter No.
_.? l Permit Fee 10,00 pd. 4/27/70
Meter Reading {Meter Dep.
, I Meter Sealed: Yes lAdd'1 Chg.
NO iTotal Chg.
Building is a:
Residence xx
tqultiple Lo. Units
Commercial
Industrial
Other
Inspected by
Date
Remarks:
By:
Chief InspecCor
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulatioas of Eagan Township, Dakota County, Minnesota.
By:. Cedar Grove Construction Comvanv
I
Please notify the above office when ready for inspection and connection.
.
. .
EAGAN TOWNSHIP
3795 Filot Knob Road
St. Paul, Minnesota 55111
Telephone 454•5242
PERMIT FOR SEWER SERVICE CONNECTiON
xx
Location of Connections:
Connection Charge 200.00 pd 4/27/70
Permit Fee 10.00 pd 4/27/70
Street Repairs
Tota 1
Inspected by:
DaCe
Remarks:
By
Chief Inspector
DATE : 4 72/7 O
OWNER: ('.Pdar C'?rmy,Q r. „Gt,-_ r.n
PLUMBER ?S t P.]-lTni' -
NUMBER 577
(Lot 28, Block 2, Cedar Grove #7)
Address 1847 Pumice Point
TYPE OF PIPE Cast Iron
DESCRIPTION OF BUIIDING
Industriali Commerciall Residential ` Multiple Dwelliag i No, of unies
In consideratioa of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance wiCh the rules and
regulations of Eagan Toimship, Daltota County, Minnesota
gyr Cedar Grove Construction Company•
Please notify when ready for_iaspection and connection and before IY portion
of the work is covered.
MUNICIPALITY OF: Egan Township
RE: 28/2 Cedar Grave No. 7
Enclosed please find check in the amount of 1,705.44 , for
payment of special assessments on the property described above.
Please refer to our file no. D13354 when returning receipt.
Thank you,
,jpK.IEDWEST TITLE GUAR.ANTEE COMPANY
MIDWEST TITLE GUilRANTEE Cn
211 East Thirci S#reat
HASI?NQS,, MINNESOTA 550*P'-x??????)5&&ffi
- gy Donna Klotz
??.
? ?.
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
New Construction Reauirements
3830 PILOT KNOB RD - 55122
651-681-4675
? 3 registered sffe surveys showing sq. ff. of lot, sq. ff. of house
and all roofed areas (20% maximum lot coveraae allowed)
? 2 copies of plans (show beam 8, window sizes; poured fnd. design; etc.)
? 1 set of energy calculations
> 3 copies of tree preservation plan if lot piafted affer 7/1 /93
DATE: _/ -Z(r 9
DESCRIPTION OF WORK: /-< rd OP Skn ? le s
S
,
r w\, w-?
c
STREET ADDRESS: ? ?'?? 1? r`-?
LOT: D ? BLOCK: SUBD./P.I.D. #: ? SLP? ?Y- Uo
Name: /Y i-QLS-tn Phone #: 115"y4-73 0
PROPERTY Last First
OWNER
Street Addresrj ?i-q7 N
City 6Cii G,/\ State: 141 Zip: ?
Company:ga,l?? ?/l???Ccf"OTS Phone #: 1-2, 707-b
(area code)
CONTRACTOR L /?,
StreetAddress:? ?Z?? f7???? License#U/,673k3 Exp.-3°7-006
City gKfhsv?14e. State: IAI W Zip: 1"037
ARCHITECT/
ENGINEER Company:
Telephone #: area code (
Street Address:
City
Sewer 8 water licensed plumber (reauired for new construction onlv):
r
,6 #
Remodel/Reaair Reauirements
2 copies of plan
1 set of energy calculations for heated addffions
1 site survey for exterior additions b decks
CONSTRUCTION COST:
Name:
Registration #: _
State: Zip:
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that 1 have read this application, 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
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Firepiace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ piex ? 08 6-piex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43' Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert 0 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Planning
Building Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation: $
% SAC
RESIDENTIAL BUILDING
, q Pertnit Application
City Of Eagan ?
3830 Pilot Knob Road, Eagan Mn 55122
Tetephone # 651-675-5675 FAX # 651-675-5674
New Construction Requirements RemodeVReoair Requirements Office Use OnN
3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Reod
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate if on-site sepfic sysfem _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 7/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date
-2, a?
Construction Cost ? J // ?D
Site Address ?
?y7 n r
f/J!/1,,r7f ,_-E
Unit/Ste #
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address f 771_5? /2i-?"- 1*-L ,qJ, City 4f?
State /?%`? Zip .?.?y y 7 Telephone #(p12
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
? --
???
I hereby apply for a Residential Building Permit and acknowledge that the informa is?mnl_f-±?_and-asdurate;
that the work will be in conformance with the ordinances and codes of the City o agan and the State of MiN
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.
Applicant's Printed Name plicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling 0 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 Porch (screen/gazebo) ? 36 Multi Misc.
0 05 03-plex 0 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 13 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Oemolish (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 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) FinaUNo 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)
_ Insularion _ Retaining Wall
_ Approved By , Building Inspector
------------------------- - ------ - - ----- - --------- - -- - --------------- - - - ------------------ - -------- - -------- - ------ - ---------------- - ---- - -- - ------ - -
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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