1281 Raspberry LaneDate:
City of Eapil
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:
RESIDENT /r
OWNER
Name: (A a < Pcfcc Phone:
r...-.43
2-? I r Cy 1--.nt
Address / City / Zip: �
Applicant is: Owner )( Contractor
TYPE OF WORK
Description of work: D Cck
Construction Cost: LMLO Multi -Family Building: (Yes / No )
CONTRACTOR
Company: Def ak OS. P,i+`1 Contact: 6S h ycwf,-.
Address: I17 e z- Sa-< (f►- C.,"" City: t v'A
State: `Mw Zip:- S-6'1 t( Phone: C j 2 - _Sa C- 4( q ''
License #: -C3 (14' C C,SZ Lead Certificate*
Does this project require Lead Remediation? ❑ Yes ,No (see Page 3 for additional information)
If no, please explain:
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
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 maybe 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 appr. _ : ns.
x _z" -ask Lot -
Applicant's Printed Name
A. icant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
WORK TYPES
New Interior Improvement
Addition Move Building
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
XFraming
Fireplace: Rough In
Insulation
Sheathing
Sheetrock
Reviewed By:
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Air Test Final
Siding
Reroof
Windows
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Egress Window Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: Footings Air/Gas Tests
Siding: Stucco Lath Stone Lath
Windows
Retaining Wall: Footings
Radon Control
Erosion Control
, Building Inspector
Final
Brick
Backfill Final
I, :lr-KAA.c
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
CERTIFICATE OF SURVEY y5uk2-,
NNN
83-8
/„.2S- (1),,f7c:, , L)C--,12,12 Cl/ L.J'7,
Vs,
(
'0 41
85
vSo
F
84 • 0 .
4)
1?1?
84-0
85-5
a te vat i on s sh ..eewn are exist-
ing .r!l!,dor, and are assumed
dat U7
1 h.erePy certify that this is a correct reoresentaticn of a survey of:
7,(3t, 2C, 7,1°CDakota County, Minnesta, aoctrdi
the elat thereof on file and of reccre,
and that I am a duly registereC land arveyDr under' the laws e the State of Minn.
Dated this
2Cth day of Sept.,
ene L. Jacobson, ... Peg. No. 7734
DR. BY GLJ
SCALE — 40'
0 DENOTES IRON MON.
BEARINGS ARE ASSUMED DATUM
Prepared for:
Affwv41(
nap am
Dpn J2ndr,-In
7,unsh Su7p or,
1:_,17 1E7th St.
2.&
GENE L. JACOBSON
LAND SURVEYORS
LAKEVILLE, MINN. 55044
PHONE 469 —4328
CITY OF EAGAN Remarks
Addition HILLTOP ESTATES Lot 20 e1k 6 Parcel
owner!,l.:a>:'r Cc,O.ici,,cc, L: street-1231 Raspberry Lane State Eagan, MW 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. l' 1203.05
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 172.14 8.61 20
,t SEWER LATERAL 1980 3179.85 317.99 0 2861.87
WATERMAIN
* WATER LATERAL ? 1980
* WATER AREA
*
* STORM SEW TRK 980
* STORM SEW LAT 1980
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
514
2 5
SAC -
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
; „ f r: r''.t i:s d:1?Y
?t .t i 1 1 111# f !., iA r r: :,
PERMIT SUBTYPE:
, p:i 1 1 1
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
?, o I? I APPLICANT:
1 ANf: ro
4 ri c:E wy i
TYPE OF WORK:
W?iI i,iNis
0!, ?23 1 4
1{ F i' ik 1 k11.
10 ':; t: R 1 F' 1 I I) N ('; 'I t i 1 FJ [; )
INSPECTION .A • .A
?
Permit No. Permit Holder Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
7
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector-Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
? ?.--..?.-,?....-•r++..?:.?.r_--..,--?^-?; . . . . _ . : ; . . . . . . . , . . .. ?+?rs?^ ...
CITY OF EAGAN 2 0 ,?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? tri ?
PHONE: 681-4675
BUILDING PE ?ESIDEN'tIAL Receipt #
To be used for ggMQp$], Est. Value $1,700.00 Date HAR 4
Site Address 1281 RASpBBBRY LN
Lot 20 Block 6 Sec/Sub. HILI,TOi' E5'TATES
Parcel No.
Name ?u ARAMB
R
w Address 1281 itASPnRRAY LN
? citv E?GAN MN zP
m
0
f- Name A1.L.6p CMT
Address 04% PEN1IM iiAY
? Cfty EACAN Mt1 Zp 55122
Phone 688-8100
8 ucense # 0001062
I hereby acknowlege that I have read this applicati on and state that the
intormation is correct and agcee to comply with a IF applicable State of
Minnesota Statutes and City f Eagan Ordinances.
Signatureof Permitee -?"?-
A Building Permit is is6ued to: ALUN CM gT
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
FEES
Occupancy - 39
00
Zoning _ Bkig. PertnR .
(Actuaq Const - Surcharge 1.O?I
(Allowable) _ Otan Review
# of Stories -
License
5.00
Length -
bepth - SAC, City
S.F. Total - SAC, MCWCC
S.F. Footprints -
On Site Sewage _ H/ater Conn
On Site Well - Water Meter
MWCC System -
Acct. Deposit
City Water _
PRV Required - S/W Permit
Booster Pump - SNV Surcharge
Treatment PI
APPROVALS Road Unit
Planner - park Ded.
Council
BIdg.Off. _ Copies
45•00
Variance - TOTAL
.
Permit No.
Permit Holder
Date
Telephone #
S/W
PLUMBING 331-3911
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing ? '
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final --?" 3
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED
AMOUNT
?
" & DOLLARS
too
? CASH ? CHECK
?•
FOR
FUND CODE ? Ab10UNT
--'r------ -
--
_ -----
?
7L
/
,.
? Thank You
, ,.
' v BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy -?
r
CITIf OF EAGAN
,Y ' •. 8795 Pilot Knob Road Eagan, MN 55122 N2 5425
' PHONE: 454-8100
BU1LDING PERMIT Receipt
To be used for Est. Vnlue Dote , 19
Site Address 14A Erect ? Occupancy ?
Lot Blxk J?Sdc/Sub. Alter ? Zoning
Parcel # Repair ? Fire Zone
Enlarge ? Type of Const.
W Name Move ? # Stories
3 Address Demolish ? Front ft.
°
Ci Phone Grode ? Depth ft.
°C N Approvals Fees
ame
o? Address i ?
V Vi_ ?e'.. . .
Name _
Address
Assessment -
Water & Sew.
Police
Fire
Eng.
Pianner
Council
Permit _
Surcharge
Plan check
SAC
Water Conn.
Water Meter
I hereby acknowiedge that I have read this application and state thot Bldg. Off.
the informotion is correct and agree to comply with all applicable ApC Total
State of Minnesota Statutes ond City of Eogan Ordinances.
Signature of Permittee
A Building Permit is issued to: on the expreu condition that
all work shall be done in accordance with oll applicobfe Stote of Minnesoto Stotutes and City of Eagan Ordinances.
Building Official
r
A
,v
a
Permit # Daf* laued Psnnitfoe
Plumbin9 1,-5-10 // "?-7 r'7
Mechanical Q 1 1 - (. - `1 ?
11 -a G, - -7 9
?
INSPECTtONS DATE INSP.
Rough-In
Final
Footings
Foundation 9 p? ??
Plumbing Date Insp. Date Insp.
Frame/ins. Mechonical
Fina! ? ?1 /1'• ?9
Remarks:
-A-r- `°'a
? ?
CITY ?F EAGAN SEWER SERVICE PERMIT
9745 Pilot Knob Rood PERMIT NO.: -
'?agan, MN 55122 DATE:
oning: 1 No. of Units:
ner:
ddress:
ite Address: ??`t'_L'T 3.?_ r+ I11't0;. L.Gti9L:
lumber:
. .---
l. 00
agree to eomply with the City of Eagan Connection Charge: _' s-(}0
rdinunaes. Account Deposit:
Permit Fee: ?.r'
Surcharge: -
g1 Misc. Charges:
Date of Insp.: Totai:
Insp.: Dote Paid:
CITY '?F EACiAN WATER SEltVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
E7gan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber: -
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee: -
I agree to tomply with the City of Eagan Surcharge:
Ordinances. Misc. Charges
Total:
By Date Paid:
Date of Insp.: Insp.:
;
' CITY OF EAGAN
• ' 3795 Pilot Knob Rood
Eagan, Minnesota 55122
Phone: 454-8100
Date:
PLUMBLWI PERMIT
? 1 2-79
No
1510
Site Address: 1280 Fawpberry Couat
Lot 190 Block 6 Sub/Sec.??? ?Bt.-,y'm _
SL7Il8h].IIC.'. Ccrstl"L]G'1:f a['1
Name _
- 10I7 EaSt 157th Strr-et
3 Address
° R'vi1Le 55337
City - Phone:
Nome
LSt. ? i ?'•
P Address .2,
C
u 55;144 -? lD ?-?Jl
City Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota Statutes and City of Eagon Ordinonces.
Receipt No.: 16206
Single I ?
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installation
Permit Fee
c ?\
Surcharge
Toral
done in accordance with all applicable State of
Building Officiol
, CITY OF EAGAN
3795 Pilot Knob Road
' Eagan, Minnesota 55122
Phone: 454-8100
HOx= PERMIT
Date: Uy4-79
Site Address: 1281 Lot 71) Block 6 Sub/Sec. _HillbDp ESt8tt8
Name ? ?mtxuatim
e Address 1017 FaSt ?7?I ft.
3
0 City H E'ville 55337 Phone: 435-6535
Nome qbe Heatim Cmpanv
.
"0i62 - ?,r)Oth sr..
Address
e
0
City " Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota Statutes and City of Eagan Ordinances.
O(?R'IQ?1 AIR F?
No. Z6 113P
Receipt No.: 16534
Single
Residential ?
Multi Res., Comm./Ind. I
New /Alter./ Repair
Cost of Installation
?C.fl4
Permit Fee -
Surcharge ?
Tota I
done in accordance with oll applicable State of
Building Otficiol
CITY OF EAGAN
3830 Pilot Knob Road, p
P.O. Box 21-199, Eagan, MN 55121 NO'2 Q 186,
? PHONE:681-4675 Ca?/.??3? BUILDING PERMIT ' Receipt #
, RESIDENTIAL --
To be used for RRir([lT1Ri. Est. Value i1 , 7QQ Date MAR 4 1992
Site Address 1281 RASPBERRY LN .
Lot 20 Block 6 Sec/Sub. HILLTOP ESTATES OFFICE USE ONLY FEES
PBfC@I NO. Occupancy -
39
.00
Bldg. Permft
Zoning _
NaI'pe DALE BRANCH (qctuaq Const - Suroharge 1.00
Z 1281 RASPBERRY LN
Address (Allowabie) -
Plan Review
?
.7jp 55123
' EAG9N MN
(`,?{ # oi Stories
th
L
-
License 5.00 .
? eng _
Phone 454-7246 Deptn - SAC, ciry
? Name AT.T.F.N CONST S.F. Total - SAC, MCWCC
S.F. Footprints
? Address 4649 :16 PF.NKWF. WAY e
On Site Sewa Water Conn
g _
C,fty EAGAN MN Zlp 55122 On Site Well Water Meter
? Pholle 688-8100 MwCC system =
Acci. Deposit
O Water
City _
v License # 0001062 PRV Required _ S/W Permit
I hereby acknowlege that I have read this appli io state that the Booster Pump - S/W Surcharge
information is correct and ag to comply WRtY al a licable State of
Minnesota Statutes and City Ea an Ordi ces. Treatment PI
Signature of Permitee
- A N
=r- - -- APPROVALS Road Unit
l
A LEN ONST
A Building Permit is i ued to:
Planner
- park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. _ Copies
Building Official
Variance 45.00
TOTAL
Minnesota State Board of Electricity
, 1954 University Ave., St. Paul, Minn. 55104-Phone 645-77 03
, IkEQUEST FOR ELECTRlCAL INSPECTION ?
: 5ELOW WORK COVERED BY THIS REQUEST S
??
Type of Building New Add. Rep. Check Appliance? "'ired Fo: Check Equipment ' For
Home ? ? Range Li Temporary Wiring
Duplex ??? Water Heater ? Lighting Fixtures t_..
Apt. Bldg. ? ? ? Dryer ? Electric Heating ? .
Commercial Bldg. ??? Furnace ? Silo Unloader ?
Industrial Bldg. ??? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other ? ? ? ?ehers? Rehers ?
COMPUTE INSPECTIO N FEE B ELOW
Service Entrance Size: # Fee FeedersBcSubfeedets: # Fee Circuits: # Fee
0 ta? 100 Am s. 0 A eres 0 to 30 Am eres
lOl to 200 Amps. 3 0 0 er 31 to 100,Am eres
Above 200 Amps. 1 Above 100 Amps.
Transformers R ote ntr Partial or other fee
Signs Special Inspection Minimum fee $5.00
Remarks ? J??? '"'''?'''
• TOTAL FEE
I, the Electrical Inspector,iereby certify that the above insp,ection has been de.? ?d?'J (Rough-in)
(Final) ate J ^ 7 t'
This request void 18 months from
This request void 18 months from
Date of this Request
LtL
I, a-s'g Licensed Electrical Cont ctor 0 Owner; do hereby request inspection of the above electri-
cal wiring installed at:
? City
Street Address or Routq Nq. 2KO?1 ? WA
kar ?
Section Township ? I?C an *County
Whic}i is occupied byIL&ac? L;-(.'T)'1,?k
(Name of Occupant)
Is a rpughin ins ection required on this job? No ? Yes ? Ready Now ? Will Call ?
.
Power Supplie ? Address
Electrical Contractor KENDR TC`K ?l R?''?IG (????? License No.
14540 1'FI?`?a?l?mLANE API'LE VALLEY
Mailing Address
Authorized Signature
4,12 g T ?tpllation;
' ?lio?ne No.
(Electrical Contractor or Owner Making This Installatlon)
?ulaTE ??? ? ?? ? This inspection request will not be accepted by the
:p. State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
' REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WOI2K COVERED BY THIS REQUEST S
A /-C' e d 0
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? Range ? Temporary Wiring
Duplex ? ? ? Water Heater ? Lighting Fixtures L1d
Apt. Bldg. ? ? ? Dryer /
? Electric Heating ?
Commercial Bldg. ? ? ? Fumace -
L1d" Silo Unloader ?
Ind'ustrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other ? ? ? Heiers? ?eLers?
COMYUTE 1NSYECTIO N FEE BELOW
Seivice Entrance Size: # Fee Feeders8c Subfeeders: -# Fee Circuits: # Fee
0 to 100 Am s. 0 to 30 Am ereg'? ' 0 to 30 Am eres
101 to 200 Amps. 31 to 100 ¢ erev, 31 to 100 Am eres IT 20
Above 200 Amps. , 00.
= ' a?p;c:
?
Above 100 Amps.
Transformers R eCo fr 'r'c. Partial or other fee
Signs Sp ' Ins "" tion inimum fee $5.00
Remarks
s TOTAL FEE , ?
(Final)
This request void 18 months from
/0U-? Alo-a (?'o
/i/l-'-:2-/ 7 I
has been made.
Date d 0-"
gate
This request void 18 months from AO ge'ej
_ ' • n ?? ,, ?
Date VLiic s Reque st
2 ? / ol? _q Zf ZA ,? I, as ensed Electncal Contractor 0 Owner, o hereby request inspection of the above electri-
cal winng installed at: q?6
Street Address or Route No.
Section Township _
Which is occupied by
Is a rougt?ir? inspection required on this job? No ? Yes ? Ready Now O Will Call ?
Power Supplier Address ,
Electrical Contractor • 1K?bMV1?K ELL-Gt?trrac 4 e No.
' Com an ame
Mailing Address 14540 ?E??Tt)?K LANE APPg,E VALL]EY
( i I nt c?:fqi d:RTM9 41 Zs%aVrJ6
Authorized Signature Phone No.
(Electrical Contractor or Owner Making This Instaliation)
This inspection request will not be accepted by the
????E MORN COP'Y State Board unless proper inspection fee is enclosed.
CITY OF EAGAN C? Include 2 sets of plans,
y
Q 1 site plan w/el.evations &
1 BUILDING PERMI'r APPLICAION 1 set of eriergy calculations.
/, Od
'Ib Be Used For ?'(.s?.u.- '?o-•?- - - Valuation °? y"?`; o a" - Date
Site Pddress:
Lot P o Block ? Sec. /Sub.
Parcel #: ?D .33000 0?00 o b
Owner :
Address:
a
City/Zip C.ode:
Phone # : FO
Contractor: L--?
Address : / 0 i "7 - 51
?? T
City/Zip Code: . 1'
Phone #: Y 3 S-- .C 5 3 s'' ??.?
?Arch. /Eng. :
Address :
City/Zlp Code:
Phone #:
OFFICE USE Oti/
Erect ? Occupancy i?3
Alter Zoninq /
Repair Fire Zorie 13
Enlarge Type of Const.
Nbve # Stories
Demolish Front ft.
Grade Depth ft.
APPROVALS FEES
Assessments % Permit l Xvf' -"2 2
Water/Sewer Surcharge -? -7
Police Plan Check
Fire SAC ` 2.5` ---
Enq, Water Conn.
Planner Water Meter 4/'o ?
Council Road Unit 7s- ?
Bldg. Off.
APC --
Tar? I D-3 0 •?
CITY OF EAGAN
. 8795 Pilot Knob Road Eagan, MN 55122
I 4PHOH#: 4548100
BUILDING PERMIT APPLICATION $74,000. Receipt #
Est. Volue
Date September 26
79
Site Address 11`*?t xaspberry Ln
Lor 20 Block 6 Sec/Sub. Hilltop Estates
Parcel # 10 33000 20U U6
? Name Bob d. Connie Green
W
3 Address
o ,,.. Burnsvi 11 e .,,
0? Nome Sunshine Const..
z? 1017- E 157st
o Addre
?urnsvi e p?^^e 433-6-535
Name _
Address
I hereby acknowledge that I have read this application and state that
the information is correct and ogree to comply with all applicable
State of Minnesota Statytev-aqd City of ftan Y)rdinances.
Signature of Permittee ?
A Building Permit is issued to:
oli work shall be done in acco
Building Official ?
Erect ? X Occupancy It 3
Alter p Zoning Rl
Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Move ? # Stories
Demolish 0 Front 46 ft.
Grode ? Depth 43 ft.
Aparovals Fees
Assessment Permit 175.50
Water & Sew. Surcharge 37.00
Police Plan check 87.75.
Fire SAC 525.00
Eng. Water Conn. 270.00
Planner Water Meter 60.00
Councii Rd Unit 75.00
Bidg. Off.
APC Total 1230.25
SL. on the express condition thct
State of Minnesota Statutes and City of Eagan Ordinances.
N2 5425
16040
2007 RESIDENTIAL PLUMBING PERnniT APPLicATioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings. Do not combine inside and outside
lumbing on tne same application; separate applications ana pekmits are requirea.
Date 2D /
?
Site Street Address ?2?I eu.5 ?WN t an el Unit # !
Property Owner MarG Wper Telephone # (0;51) 9W ! •UV%
Contractor • ' 2 Telephone # (q ) uW• 49V J
Address CityStatelM_ ZipC6:1"
The Applicant is: _ Owner & Occupant Licensed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee applies when extensive plumbinq repairs are made to a building.
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. If you are
installing on/v a water softener and/or water heater, do not complete th' ionr
move to the next section and place a checkmark next to the appliance( LOEC
'? ? insta
lling. ? '' ??? 4 ?C Septic System Abandonment ?7 Water Tumaround (add $136.00 if a 5/8" meter is required)
Other: V Water Softener Water Heater $ 15.00
_ new Zreplacement
_ Lawn Irrigation _RPZ _PVB lnew _repair _rebuild $ 30.00
State Surcharge I $ .50
Total " $ M•?
I herebv applv for a Residential Plumbin4 Permit and acknowfedqe that the information is comp ete and accurate; that the work will be
in confonnance with the ordinances and codes of the City of Eagan and the piumbing 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.
,. x
lanaL
11111MV oF eagan
PAT GEAGAN
Mayoc
PEGGY CARLSON
CYNDEE FIELDS
MIKE MAGUIRE
MEG TILLEY
Council Members
THOMAS HEDGES
Ciry Administrator
Municipal Center:
3830 Pilot Knob Road
Eagan, MN 55122-1897
Phone: 651.675.5000
Fax: 651.675.5012
TDD: 651.454.8535
Maintenance Facility:
3501 Coachman Point
Eagan, MN 55122
Phone: 651.675.5300
Fax: 651.675.5360
TDD: 651.454.8535
www.cityofeagan.com
THE LONE OAK TREE
The symbol of strengch
and growth in our
communiry
August 26, 2004
MOUA VANG
1281 RASPBERRY LANE
EAGAN MN 55123
RE: BUII.,DING PERMIT #65760
Dear Moua:
Regarding the installation of egress windows in the two rooms in your lower
level, the City is just making you aware that the code requirement may require
that the furnace area be walled off.
If you have any questions, please feel free to contact me at 651-675-5697.
f
Sincerely,
lkwza-- ,
Tom Miklya
Building Inspector
TM/ld
cc: Dale Schoeppner, Chief Building Off'icial .
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
' City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
a -7 (), 0 ?
New Construction Reauirements RemodeVRepair Reauirements
3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roofed areas 2 copies of plan ?
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions ;
2 copies of pian showing beam & window sizes; poured foUnd design, etc. 1 site survey for additions & decks
1 set of Energy Calculations Addition - indicate if on-site sep6c system
3 copies of Tree Preservation Pian ff lot platted after 7/1l93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date
Site Address ? Z V RAs P9? Construction Cost Z ?owoi `
PY lA/ Unit/Ste #
Description of Work ( V zV**b&w
Multi-Family Bldg _ YXN Wri s c,v T (Eq sT) S /Q E ? N
Fireplace(s) _ 0 _ 1 _ 2
Property Owner *VA ?qN (.r Telephone #(?'? ) 3w - S 70-3
Contractor !i!?M 6STeI* i
Address 17M & A lR AVt
State A/y City ST. ?/7VL
Zip Sf 10 41 Telephone #(&V ) Z6? 9S/
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- 1vlinnesota Rules 7670 Categorv 1 _ Minnesota Rules 7672
Energy Code Category 0 Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(d submission type) Submitted Submitted
. Energy Envelope Calcuiations Submitted
Have you previously construcfed a buiiding in gc
fee applies.
ZO?
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
n with a similar plan? _ Y _ N If so, 25% plan review
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and*&owledge 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 pernvt, 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 wor which requires a review and
approval of plans.
00,0
Osrfe 1,
6k?E+/ ?
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
MCES System
City Water
Booster Pump
PRV
Fire Sprinklered
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
?, 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.) ex 33 Ext. Ait - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous.
Work Types 2- _ rz,?? 5
0 31 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Replacement
Valuation 1000
Census Code ti-54
SAC llnits
# of Units
# of Bldgs
Type of Const
c/0h,Q 0&X
Int Improvement ? 38 Demolish Interior ? 44
Move Building ? 42 Demolish Foundation ? 45
Demolish Building* ? 43 Reroof /11? 46
*Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
_ Footings (new bldg)
! Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
! Roof Ice & Water Final
Framing ^
Fireplace R.I. Air Test Final
? Insulation
F
Siding
Fire Repair
Windows/Doors ?
REQUIRED INSPECTIONS
Final/C.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool Ftgs _ Air/Gas Tests Final
Siding _ Stucco _ Stone ^ Brick
?C Windows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
Clty SAC
Utility Connection Charge
S&W Permit & Surchacge
Treatment Plant
License Search
Copies
Other
Total
6ktr's-e' ,
??-?
ODL
r
$'70
CERTIFICATE OF SURVEY
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DR. 6Y GL.1 SCALE - I"= 40' O DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM
Prepar r,d f'ur s ?
GENE L. JACOBSON
?YI?V?
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AKEVfLL.E, N11NN. 55044
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Dat-od thiII 20Yr.h dtLy of Ca'ot., 1973 GeXl6 L. olacohcar., i: •^"". 77:34
DR. BY GLJ SCALE - 1"= 40' O DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM
P-t3,rar{?d f pr. =
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GENE L. JACOBSON
?YI?V?'
??,?,??
????v? n LAND SURVEYORS
,t,I :? ? ?1? :;.:::.: ?•at:r; .?:- , LAKEV f LLE , MINN. 55044
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CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT # D
DATE:
??
.:
:::::
:
:::
: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
..
.............
..
..
.....
TOWNHOMES/CONDOS
WHEN PERMITS ARE REQUIRED FOR
EACH UNIT.
------------------------ -----
WORK DESCRIPTION ------------------------- ---------------------------
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTA
NEW CONST ADD-ON MINIMUM 15.00 /.S ?
ADD ON SHOWER 3.00
REPAIR _ WATER CLOSET 3.00
BATH TUB 3.00
9 & LAVATORY 3.00
OWNER NAME: 1L KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
SITE ADDRESS: ?e6- _ HOT TiJB/SPA 3.00
WATER HEATER 3.00
LOT: ? BLOCK C? SUBD.? _ FLOOR DRAIN 3.00
? GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
ADDRES S: P op ?j OTHER
10
5?zll 3 WATER SOFTENER 5.00
CITY:
7 ZIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE #: ? ?
SUBTOTAL $
?
? ST. SURCHARGE .50
S GNATURE OF PERMITTEE
TOTAL : S IS, Sv
?t?M1?E?;CTA??'iT!II?1]?TR?AL«: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
:.....:............
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTR.ACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
FOR:
CITY OF EAGAN
2.014
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
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 onc-e ermit is issued.
Date Val uati on of work
Site Location:___ 1,7 /?1•?a
STREET STE #
Tenant Name•
LOT BLOCK SUBD. P.I.D. #
Descri tion of work: `Q a.
The appl i cant i s: 13 Owner ajontractor O Other (Describe)
Name Phone -
Property LAST F1RST
Owner F_
pddress L7 6
1
STREET STE #
Ci ty State Zi p
Company -? Phone /W-=ffdd'
ContraCtor Address IxL A ? License # /DIvZ ? p?
City tate Z i p
?S'/?? •
Company ` Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been roved.
I hereby acknowledge that I have read this appli ti and state that the information is
carrect and agree to comply le e of Minnesota Statutes and City of
all appli
Eagan Ordinances. ?
Signature of Applicant:
O
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Garage/Accessory ? 11 Res. Add./Porch
? 02 Single Family ? 07 Fireplace ? 12 Comm./Ind. New
? 03 Two-family ? 08 Deck ? 13 Comm./Ind. Add
? 04 Multi-fam. T.H. 1:1 09 Basement Finish ? 14 Comm./Ind. Rem.
1:1 05 Apt. Bldg. 0 10 Swim Pool ? 15 Public Fac.
WORK TYPE
0 90 New
O 91 Addition
? 92 Alterations
? 93 Remodel
0.94 Repai r
11 95 Tenant Finish
GENERAL INFORMATION
0 96 Move
0 97 Demolish
O 99 Undefined
?.:? .
0 16 Agricultural
0 17 Building Move
? 18 Demolition
p 20 Miscellaneous
Occupancy Basement sq. ft. MWCC System
Zoning lst F1. sq. ft. City Water
Const. (Actual) 2nd F1. sq. ft. PRV Required
(Allowable) Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth
On-site sewage ?
SAC Code
APPROVALS
Planning Building 3-3-9 Assessments
Engineering Variance REQUIRED INSPECTIONS
? Site
? Wallboard
O Footing
11 Final
O Framing
? Draintile
? Insulation
? Fireplace
! 7 v ?
Permi t Fee 3 9 , L-z vaiuat;«n: $
Surcharge 1, o 0
Plan Review
License 5 , o0
MWCC SAC .
City SAC
Water Conn.
Water Meter
Road Unit
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
euzLorNG
023695
05i2s/9a
SITE ADDRESS: L 0 T: 20 B L 0 C K:
12$1 RASPBERRY LAIVE
HILLTOP ESTATES
PERMIT SUBTYPE:
sF (Mzse. )
6 APPLICANT:
SPtNDAU CONST CO INC
(612) 447-8001
TYPE OF WORK:
f2EPAIR
DESCRTPI'ION (SIDING)
INSPECTION .. . D•
FRAMING RQUGH TN PLBG
ROUGH IN HTG FINAL
e v e e a ,
?
,
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?a,.._?_...,? m '_ .. w.. .. _ _ . . .
_ ?
CITY 01: EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE: g?ILpING
Permit Number: 023695
Date Issued: 05/23/9q
SITE ADDRESS:
•?? ? TM? oROv-R dV'
P.I.N.: 10-33000-200-06
PERMIT c? 2Zz1.5
1281 RASPBERf2Y LANE
LATa 20 BLOCKs 6
HILITOP ESTATES
DESCRIPTION:
( S I D I N G)
51Ald1ri0k--P'ermit Type SF (MISC. )
w3.I`d"i r?gWbrk? Type REPAIR
?
? b
? e < x ?
. Aw"
4?.
? a e
?:- ?
REMARKS:
FEE SUMMARY
VALUATZON
Base Fee
5urcharge
Tntal Fee
$90.00
,$3.50
$93.50
+$ I p 0YJ PJ
CONTRACTOR: - A p p.1 i c a n t - 5 T. LI C. OWNER:
SANpAU CONST CO ING 14478001 0007251 BRANCH DAI.E
6885 BAUDIN ST 12$1 RASPBERRY LANE
PRIQR LRKE MN 55372 EAGAN MN
(612) 447-8001 (612)454-7246
?f hereackni?wledge that ?have' iread tFtis a?P{?116at.iah °aanc3;' st-ate that the
xn,ta„rma;tio36 ;?i.s ,:correct and agree' ta ?ampl:y w'itt?` a?pplioaka,1t 5'tatc =?s?F` ??1n%ta ?,ut s and ?Gi?G afi Eag.a n .qrd?r?ances `
/?
?laujn A-Pi?. I rr? -
SUED BY SI AT E?I
?
(5
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
$ ? 1.10
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Val uati on of work c' a (f r)
Site Address: /A??
STREET SUITE #
Tenant Name: (commercial only)
LOT ? BLOCK ?. SUBD.,#Jjj P.I.D. #
Descri tion of work:
The appl i cant i s: ? Owner [K Contractor ? Other (Describe)
Name 'Ory-,,,cti 'P ra-\e u ?p1s, Phone 4154.1- 7 zY?
Property LAST FIRST
Owner Address t??/ ?cILC Q
STREET STE #
City L-? Ct? u--, State Zip
Company Cu, . ? N c _ Phone c-! `l -7-
Contractor Address 65<S5- 7Y?o acQ5? Li cense # 7.2 5?' / Exp.
City Pr?o,- (I el k? State m 4---, Zip
Company Phone
Architect/
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 hav read this application and state that the information is
correct and agree to comply wit all ap cable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
oi
73 i 7c)-
2oos RESIDENTIAL PLUMBING PERnniT aPPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
v G>
ZZ
Lf
Date
I
1
Site Street Address Unit #
M
Property Owner
WV c- l Telephone #( )
H.P. PIPEWO Ka
Contractor 3670 DODD ROAD
EAGAN
MN Telephone #( )
6655123 City
Address State Zip
The Applicant is: _ Owner VI-Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing onlv a water soffener anc!/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
Septic System Abandonment W rE,
_ D
_Water Turnaround (add $130.00 if a 5/8" meter is required)
other: O1 2006
Water Softener ? Water Heater $ 15.00
_ new replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
L S Sb
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start withq+t-apermit and work will be in
a`ccordance withth6approved plan in the event a plan is reqyi,?to be ry ve AwI -"-?nd apprpJ^ed\."
pplicanYs Printed Narrie ?WcanYs Signa?
r<5- S0f?D
r
City of Etall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /0 CO 4/
Permit Fee: 1 7 °" • %° 1
Date Received: `- Z41 r
Staff: IC'^i
n 2013 RESIDENTIAL BUILDING-�PERMIT APPLICATION
Zq
Date: I' -7-01S Site Address: S Z_ I i\��
Unit #:
Resident/
Owner
Type of Work
Name: Marc �
Phone: (.c) 1 2.- 2-6Z - C't1'c50
MN SS 123
Address / City / Zip: 2-Y,1t
Applicant is: 0 Owner Contractor
Description of work: I -i-%t' Z ' I SLYV c,c4..QJ
Construction Cost:
Multi -Family Building: (Yes / No )
Company: Ih(Ac3i.3V\ \-1uAJ•&5 Contact: N
Address: Li 1-4 to i, hA �Jj r City: 3k.
All lI t\,)Zip: l 3�C
License #: 1 -761-7
{
Phone: (5I-- 2Lfi1 "' 1 Li
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
We S L f i9-11 -� (SVAlkint
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: Phone:
Mechanical Contractor: Phone:
Phone:
Sewer & Water Contractor:
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 CaII 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.00pherstateonecall.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.
x I V l ch() I aS TS 1 kokrSt,tA.
Applicant's Printed Name
x
Ao
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
1 7-- 3t
Fireplace
Garage
Deck
Lower Level
IR be icy L
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement Siding
Move Building Reroof
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% v )
Census Code
# of Units
# of Buildings
Type of Construction
rr
gsxv
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In _Air Test Final
Insulation
Sheathing
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
73 ?�
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
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
4_ Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Other:
Pool: Footings _Air/Gas Tests
Siding: _Stucco Lath _Stone Lath _
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
15-04s eto°/47
Final
Brick
Final
Page 2 of 3
City of Eaftau
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:
(D9 0-7 `1
Date Received: ' 1.6'- 13
Staff:
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: co"' Site Address:
Tenant:
RA5f , y Leo
P{ Pi
Phone:
Suite #:
Address / City / Zip:
Contractor
Name:
kuru fc-4gx
Address: t. 13
License* 5 LLr 6 _ 4) IN
city: VOL -LQ
State: f) Zip: S 5] a 4- Phone: '/ 7 0 I Q)
Contact: Co (\PE (} L\--C,S Email:
Type of Work
Permit Type
New Replacement _ Repair Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / T Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ C i) -
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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
c4e-A(-4.6-
Applicant's
pplicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: _Under Ground _Rough -In _Air Test Gas Test _,_,Final
Use BLUE or BLACK Ink
r----------------"--.
I For Office Use
Permit j
City of EnRu I Permit Fee:
3830 Pilot Knob Road I a I
Eagan MN 55122 Date Received: 3
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 3 Site Address:- Unit
Name: ~Pa--L C Gt rY Phone:
Resident/
Owner Address / City / Zip: ~i2z_
Applicant is: Owner X_ Contractor
Description of work:
Type of Work -
Construction Cost: Multi-Family Building: (Yes / No
t
Company: Contact:
Contractor Address:0~3 124A City: cl~ii'~°~-
State:f-- Zip: 5_~ Phone: Z r /
License b 3 93 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: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: 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 E
conclude that they are trade secrets. i
x - e z
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.org
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 compl thin 180
days of permit issuance.
x
A lic nt's Printed Name Applicant's Sig ture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA174621
Date Issued:02/08/2022
Permit Category:ePermit
Site Address: 1281 Raspberry Lane
Lot:20 Block: 6 Addition: Hilltop Estates
PID:10-33000-06-200
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Hannah Berkebile
1281 Raspberry Ln
Eagan MN 55123
(651) 373-6436
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature