1855 Red Fox Rd*6
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
Date: ~lT�
Tenant::
Use BLUE or BLACK Ink
;:::
Permit Fee: , c)O Li L—
Date Received:
Staff:
2010 MECHANICAL PERMIT APPLICATION
Site Address:
Suite #:
RESIDENT / OWNER
CONTRACTOR
Name:
Address / City /
(ASI , Y//
6 � Phone: ee/t4
Name: Ot f ot1 n b►- PI itis k'U+-]'� t .tow/ ? �-cense #:
Address: 19 04 v P_i/Ml 11i �^`�' ' pity:
I � H115+111
3.1 -CState:. Zip: - '3 Phone: (D5) - 43'1 -
Contact:
ontact: bf ne Email:
s
TYPE OF WORK
New Replacement
Additional Alteration
Description of work: c,t / `I ,altar` -
-
Demolition
PERMIT TYPE
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
RESIDENTIAL FEES:
New Construction
Install Piping
Gas
COMMERCIAL
Interior Improvement
Processed
Exterior HVAC Unit
_ Under / Above ground Tank C _ Install/ Remove)
"When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.60 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
55t4)
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 J4linirnum (includes State Surcharge)
- If Permit ,egg is less than $1,000, surcharge is $.50. _ $ Permit l=ee
- If permit Fee is 5 $1,000, surcharge increases by $.50 for each = $ Surcharge
$1,000 Permit Fee (Le. a $1,OD1-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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 utihtles. v ww.poaherrtateonecait.ore
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with
Eagan; that I understand this is not a permit, but only an application for a permit, and work iy'yiot to start without a
with the proved plan in the case of wo w ich requires a review and approval of plans.
x 1 iCiA IYI - 71511S
Appl' nt`s Printed Name 1
AP
ordinances and codes of the City of
mit; that the work will be in accordance
- - INSPECTION RECORD
? _.
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
F;t, ? ?c! f1 I 11r. kU
Ffl.ACkl•IAW FtIRES7
PERMIT SUBTYPE:
, APPUCANT:
, ? ? ? ? •; ,
( e..i .' ) 9.1 J. - L.' I I
TYPE OF WORK:
iifrXt1itwa,
0.'?HHN
pn f:?" /u l
INSPECTION ., . .•
iqiM?,
t t'I!}?
RENaRVs: PRV '1; & u Nt fif
- ? ?
F
? ?
Permlt Nu. Pertnit Holder date Telephone #
ELECTRIC °O
PLUMBING _ y JIf 7 43 -//I/
HVAC . 5 9
Inspectlon ctoe I sp. Comments
FOOTINGS
!
FOUND
FRAMING -S
ROOFING
RDUGH
PLUMBING
,>r/ /?
/,?
&4
PLBG
AIR TEST
11-f / rf
14K
ROUGH
NEATING S'?
/? y
.?j
GAS SVC
TEST
7l
INSUL Ae
GYP BOARD
FIREPLACE ????t7 C
FIREPLACE
AIR TEST /
7 ?7
FINAL PIBG
?
?cuv
FINAL HTG /( L(
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAI
Jh
WerttfiCRte Df CCCIipQIiC?
%fitv of ftgatt
?artmcut of SKiliing 3us30ectiun
This Cenificale issued pursuant to tlre nquirements of the Uniform Building Code
cerrifying that at the tiine of issuance this stnucture was irt tompliance with the various
ordinances of rhr Cery regnlating building constructrar+ or use. For rhe following:
u- ct-irwaiow SF DWG ea& pcrmit rb. M00
omP-r rra R3/U I ,.jog o:seia Ri TyK conq. VN
o,„Kr or B„iw;,,g O"JLIEM CIIY H24ES INC Add,es3 14750 GAi.AXIE AVE, APPIE VALZEY
suiwfinS Aaaress 1855 FED FM BD Lma;ty I3, B I, BI.AQM FOE.ST
_ f JDae:
Buildiog Olfrial
POST IN A CONSPICUOUS PLACE
?
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j
. CI?V r.lE EAGAN
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452-117 C5
REDUEST FOR ELECTRICAL INSPECTION, / r/---Minnesota State Board of Electriciry `
1821 Universiry Ave., Rm. S-728, St. Paul, MN 55104
Phone (612) 642-0800
Home Du lez Apt. Bldg. Olher: Naw Addn
Commerciol Industrial Farm Remod Re air
Air Cond. Htg. E ui . Woler Hh. Load Mgmt. O?er:
Dryer Ron e Elec. Heal Temp. Service
"X" above the work covered by this requesf. Enter remorks in fhis space and on rhe back of the white copy only.
g-7
Colculofe Inspection Fee - This Inspeclion Request will not be occepFed wifhout?rect ie
Other Fee # Service EMrance Size Fee # Cirmits/Feeders Fee
Nwbile Home Park Stall 0 ro 200 Amps ' 0 to 700 Amps
-
L?D
Sheel Ltg./TroAic Sig. Above 200_Am s m s
Tmnsformer/Generator INSPECTOR'S USE ONLY
( TO L-?
$ign/Oudine ltg. Xfmr. ? `?
Alarm/Remote Conhol
Swimming Pool
I hme rnn t I ins the elecVic ' dexr bed herein on the doies s
Irri9o?ion 8oom Roughan Dole?
Speciallnspection ?
•?
Investigative Fee Final D
THIS INSTALLATION MAY BE OR ED lJISdSNNLVTth I T COMPLETED WITHIN 8 M NTHS.
?`? Q O?? OFFlCE USE ONIY This reqoest void 78 momhs 6om volidolion doM prinkd in Ifiix box.
?? ?1/? ?%?ri
41-2e1lb?
IIIII IIIII IIII) IIIII IIIII IIIII I III IIIII III) I I'?? (V?? I o" V
/? ?
* 0 4 5 2 1 L 7 5* PLEASE PRINT OR TYPE /D
R<7"es?Dat° 7-?
?? ? Rw3hin inspalion required2 Yes ? N.
?Vau must wil ?he inspeclw en reody? Inspecrian O?er Than RougMn: ? Ready Nax f?Will Call
Dala Reody: ??
I, icensed conhacfor 0 owner hereby requesl inspection oF the above electrical work at:
kb Addmss (Sheet, Box, w Rou1e No.)
/ Ciy Zip Cade
SecNon No. Township Name or No. Ramga No Fre No. Cou
?
Occ?panl
U Phpre No.
Povrer Su dreas
E ko nhodor (Compony Nom
eezC'k I Conhocror Lirense No.
a" OD 94
1 ster Lic. No. (%oM EIM. Only?
hbflilg Address (C hacror or (vmer Performing Inswlktion)
764-5-
? ?
?
Aulhon Si
w O.vner Perferming Insbllmton) ul
L?V
Ph°
XN(y
V / O ??
Address. 1855 xID FUc !toan Zip 5512 2
L.ot 3 Blk 1 Sub BLAClQ3AiaZ FoRESI'
THESE 11'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: (( a
!P 9 f
Yes
No
Inspector:
r
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry) ?
Permanent driveway
Permanent gas r/
Sod/Seeded grass
TraiUcurb damage ?
Porch
Basement finish ?
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze polential exists.
Contact engineering division at 6814645 before working in righlof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Conlracror Copy
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERIVIIT
PERMITTYPE:
BuILpING
PermitNumber: 029800
Date Issued: 0 4/ 2 2/ 9 7
SITE ADDRESS:
P.Z.N.: 10-14325-030-01
1855 RED FOX RD
LOT: 3 BI.OCK: 1
BLACKHRWK FORES7
DESCRIPTION:
Build3ncy-,f!ermit Type
iBuilding W`ao ? Type
UBG Occupartcy -?_ .
Cor?structian tiypLe
Zoning
"l 6uildang Length
Bui:ld;ng Widttt ?
Bi'fd7,ng stories
? 9:t+%?J^ e F e e t? °?: ?:,
C e`rt? u??:'=;? o`d e
ft,
SF DWG
NEW
R-3 U-1
V-N
R-1
65
60
L
2,691
101 1 - FflM. DETACH
? F
f?''i..'P,y
L
{." _.. .? r.?.? _?..
REMARKS:
PRV S & W PLBR -
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC ?
SAC Units
Subtotal
$1,122.25
$729.46
$73.59
$950.00
100
$2,875.21
$ 1 A 7 , 0 0 0
MISCELLANEOUS $1,539.50
COPY _2 5.
Total Fee $4.414.96
CONTRACTOR: - applicant - ST. LzC OWNER:
L`OLLEGE CITY CONSTRUCTION 14311211 0001209 COL4,EGE CITY HOMES INC
14750 GALAXIE AVE 100 14750 GflLAXIE AVE
;4`PPLE VNLLEY MN 55124 APPLE VALLEY MN 55124
(612) 431-1211 (612)431-1211
T hereby acknowl ge that I hava readtMis application end statethat the
infiorma on i rrecC and agree Cea c9mply w3.th all appl3cabLe State ?7f Mn.
? Statut?and c' y cafi Eag;an Ordinances. _
EOB. AU E
-i ?
CITY OF EAGAN
D0 3830 PILOT KNOB RD - 55122
qf1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
?
681 -1675
New Gonslrodfon Reauirements RemodeVReoair Reaufrements
? 3 registered sile aurveys ? 2 eopies of plan
? 2 eopies of plans (indude beam 8 window sizea; poured fid. design; etc.) ? 2 sHe surveys (exderior add8ions & dedcs)
? 1 energy eakulallona ? 1 energy caleulations for heated edditions
? 3 copies M hee preserveFon plan H lot platlad efter 711/93
iequired: _ Yes _ Na
DATE: CONSTRUCTION COST:
? i I . T
DESCRIPTION OF WORK:
STREET ADDRESS: I
LOT ? BLOCK
SUBD./P.I.D. #:
PROPERTY Name: Phone #:
OWNER
Street Address•
City; State: Zip:
CoN7RacTOR Company: r n1IDRO ??,, ?m? ? ii,v1C• Phone
Street Address: License #•
City: ???? \, 114Aa1 State: M. Zip: 55 2
ARCHITECT! Company: Phone #ENGINEER
Name: Registration #•
Street Address•
City:
State: ZiP:
Sewer 8 water licensed plumber. l 61 l\'M . Penalty applies when address change and lot
change are requested once pertnit is issue ?
I hereby acknowledge that 1 have read this appiication and state that the
applicabie State of MinnesoW Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
Signature of Appliqnt: ?
?l r
U
V Yes No
_ Yes _? No,-)r ?
and agree to comply with all
APft 1. 6 1997
OFFICE USE ONLY
BUILDING PERMIT TYPE
?•'j? ` ?i• 4;
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
io' 02 SF Dwelling ? 07 4-plex o 12 Muiti Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex o 13 GaragelAccessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
g( 31 New ? 33 Alterations o 36 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
J d
v 7-
R-I
i
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building / IA B
1152- MC/WS System ?
zov3 City Water ?
G $ 4 Fire Sprinklered
PRV tic
Booster Pump
Census Code. iol
2(- SAC Code ?
Census Bidg i
Census Unit ?
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
aner
Copies
Total:
°k SAC
SAC Units
Valuation:
i2y4
v sv v
ia uv
L?=-
?4"'-e ?at?s
ioYicl
-7 v
?
aoK 3L.
z.vr Z v. y
g 1 111, Ooo. 1
7L
iso
i3a3
?3z
S7 1l
i8sa.?! dS? is=
ISSa.v
?40
?.?--
2003 t -9 s
G:v?.B -
Ga'7.` ?l61? _
z7. -23&. -
iv8 1s&..&0
!1 , UJI, U
i'/ t,. I q v'/, 2
Surveyor's Certificate
ISURVEY FOR
DESCRIBED AS
N
COLLEGE CITY
Lot 3, Block 1, BLACKHAWK
County, Minnesota and
LOT
PROPOSED ELEVATIONS
Top of Foundation = 815.(o
Garage Floor = 813.8
Basement Floor =306.8
Aprox. Sewer Service = ?483
Proposed Elev.
Existing Elev. _
Drainage Directions =--
Denotes Offset Stake = .
iw
?
? FOREST, City of Eagan, Dakota
? reserving easements of record.
SQ. FOOTAGE _
SCALE: 1 Inch - 30 feet
????N
111'-v .?
%t.cvl ?- L fj C.T
BENCHMARK,
MIN. SETBACK REQUIREMENTS
Front - zn House Side - io
Rear -is Garage Side-'
N0:
liAEADLuNAD
PL,lNNfNG ENCINh'14'R/NG SURVBYING
2005 Pin Oak Driva
Eogan, MN 55122
Phona: (612) 405-6600
Fax: (672) 405-6606
I HEREBY CER7IFY 7HAT THIS IS A TRUE AND CORRECT REPRESENTATION C)7(2_pqg
OF 7HE BOUNDARIES Of' THE ABOVE DESCRIBEO PROPERN AS SURVEYEO
BY AIE OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PA<
SMOW INPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN.
DATE j/Z-3/y7 CAD F[LE:
? F Y D. UNDGREN, L?ijID SURV£YOR
i MI ESOTA LICENSE NUMBER 14376 CC47
15, 798
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION A
.
PROPERTY LEGAL: J '
? ? DAT OF SURVEY:
IATEST RE1/ISION: _L
? ? m
?
DOCUMENTSTANDARDS
? • Registered Land Surveyor signature and company
?' ? • Building PermRApplicaM
0 • Legaidescription
? ? • Address
? ? 13 • North arrow and scale
?0 ? • House type (rambier, walkout, split wlo, split eMry, lookout, etc.)
CY? ? 13 • Directional drainage arrows with slope/gredient 96
3-,? ? • Proposed/exassting sewer and water services & invert elevation
0"?a ? • Street name
?--'13 ? • Driveway
ELEVATIONS
Exastina
er'? ci • Sewer service (or Proposed)
EY' ? ? • Properly camers
1 ? • Top of curb at the driveway
?? 0 0 • Elevations of any exasting adjacent hames
Prooosed
?d ? • Garagefloor
0'13 0 • First floor
fl? ? ? • Lowest exposed eievation (walkout/window)
o • Property comers
d ? ? • Front and rear of home at the foundatlon
PONDING AREA fif aoolicable)
? 0-'0 • Easementline
? Er- ? • NWL
? .? ? • HWL
? ? • Pond # designation
? ? • Emergency Overflow Elevation
3 0
? DIMENSIONS
1 • Lot IinesBearings 8 dimensions
42r, O ? • Right-of-way and street width (to back of curb)
.e"- ? ? • Proposed home dimensions including any proposed decls, overhangs greater than 2',
porches, etc. (.e. all struchires requiring permaneM foo6ngs)
?? ? • Show all easemenis of record and any Ciry utilitles within those easements
?? ? • Setbacks of proposed structure and sideyard setback of adjacerrt eristlng structures
?0-?' 0 • Retaining wall requirements, if any
27? ??
Reviewed:
N? ! Dat
January 7996
CRAIG799eftDGPRMf.FM
\\ ?
?
8° X 6° TEE
?TE'VALVES -
ATE VA L E _
2
tr 22 1/7 BEr,os
DLVL.C\
3
WYE
5-0+45
EL798.3
64.+
WYE EL0+23A?° x.
31
0.7
WYE
1 s-1+Sa
EL?8+6
794.",
WYE Ot80 ?
Se+ee - `
??- ?
790.40 6 /
?
?- Ec. HrO ti `
.
NSTRUC7 MH 11 OVER
STING 9r VCP SAN. SWR.
INV 7e5.86 (VERIfY PRIOR
CONSTRUCTION)
ifORE ROBIN IMIE
DfISiING STREET
:7'ION
2331 TYPE 41 wix
BtTUAlINOUS YYE1itING COURSE
2331 TYQE 31 AIIX
BtTUMINOUS BISE COURSE
CL S(AqDIFlEO) 100X
CRUSHm QUARRY STONE
rz4.
? ? -
/ oA
4;A
? A 1+
?
, Qks
UTILITY
?
Q\CQNDUIT
s - -? ? -
ccF ??o ?
A\
74,
?R
• , -- _ .
<3 XS-SkC,
°? f?PU?"iNG IT SHC)i.PLD V
IN'= Wi:<'I'A:610;d 0N THESITE.
TLOTIBLKI-801.03
?
qr?r4?1,q,N \
\ \
\
CONNECf T ?-"-
AAH AT INV 78
(VERIFY PROIR
ONSTRUCTION)
Z+60
WYE
5-0+52
EL806.C
WYE
5-0+3,5
EL797.4
WYE
s-e*9o- o+as
EL-79t:9- 790.65
22
21
E)(. SAN. WR &
?- WATERMIJN ERVI
20
...............?{......:.........It?.,................. ............,...... ........
I. ?
. r, • ' TERIOR! lELOPE AVEaAGE "U" CC UiA7I0f
_ .v U41NErZ C.oL:C.C0G UC::770A
SITE ADDRESS I SSS ?2d ?UX V-OO?C`
CON7MCTOR eoCL.FGG G!nY 011TE
petermine working square footage of each.
PIIONE
l. Total exposed rrall area ...... ZooA- sq, ft: x,1L ° Zzo.
2, Total roof/ceiling area .... 1$`70 sq. ft. x?o?b = ?8•? .
Total exposed wall area aUoVe floor ='
a. Total wall window area ...........................
...
b. Total door area ..............................
c, Total sllding glass door area ................. r•
d. Total tireplace wall area ....... ... .. .........
e. Total wall framing area (average 10%)............
f. Total net wall area above floor ...............'..
g. Total.rim joist area ............................
. a
Total'ezposed foundation area ? (O Q-
h. Total foundation window'area ...........:.......... o
1. Taal net foundation area above grade .......::... l0 4?_,,.
Determine'"U"'value of each wall segment.
y.ib_
a. ' 'ZZ3a? X ??U" `l _
f1• 55 p? X uun 4' 1Z-l6 ° 7' 04-
C: d. •X NUn 'O a O
d. o x
e. .,u„
r /
µ 1 1 o A NUU ! 0( L p J-,?-
? f. 2b0 g "U"
9. 4q 2 ? x Pull
' h. p g l,u„
i. ?od- x liuit
.oA-{ ° 7. 13 7
'o = D
,O? ° 8.G'li
3 ....................... ............Total
luvo
If item 03 is the same as, or less tlian item 11. you have met the intent
of 5IIC 6006(c)2. ,
• 4L , ; . , I • . •
.?
•: 7otal..expased roof/ceiling area = IJS.o
J. 7ota1 skyliqht area...... ........................
?
• k. 7ota1 roof/ceiling framing area(averagel0%)... 1-79,
' 1. Total net..insulated roof/ceiling area...?........
' peGermine "U" value for each roof/ceiling segment. .
.. ' J. a ? • Y OIv111 O a . 0
?
k. (18 x '"u"_ . o.4- = 7 .1? ,
1: 'I(OOZ X„uit. a zz.. '= 3.?
4 .................................... Total
. • ? '
lf total of #4 is the same as, or less than ;2. you have met the intent af
5UC:GOOG(c)1. .
Alternate Duilding Envelope Design
To utilize the total enveldpe system mzthod, the values established by the'
sum of items A3 and #4 shal,l not be greater than the sum of items ;1 and g2.
1, + 2. ? ' .
3. . . + 4. . , . .
VA L U
. .. ..
INlNDoW AREA :
A NA L YS15 OF I )UP.S. ,^_J?? L AZ ED ARAA5
TyPjE OF W f N.UOW i
7ue N.vi.voow Vuirs /./Avc Brct/ Ti3TKU FoP, "re'=vA""i, tNtY Asc na Lislto
ABOJc qy0 /H45/ 4[ rasiyybd A OtaigN ('sArc) Vw+..tt.F- oF Z•lBg
IqGLNDIyG Ai/l I4LM5,
4 L. zZ.J +FoeT4QA
fboT w
FOU NDAT I ON W I N Ao W/412EA : ! yPE op ?ti?r r/DOW :
TNE. vviNOOiv u+!IrsNNVE E3tu/ TESrCD Foa'R= V.ruWc,THLYa4t As L-s*to nCbva. wua
M4Y 8r AsfityniLu,v piLsiyrJ(llwvLa VAA.uc bA •j('•• ruc??D/NSr
A1Q P1LM7 . . .
L?2= 1?lsu • 1/ sr-= FoorA44 i FppTAGf a Q
Jc LIr)1Nq (?JLASS DooR qR4q % IYPL PP Daort: _
Sl-#DINKj QL.499 000lz6 N.,vIC i+ILiP4 t4s'?40' Foa"2= YA"Kry TNCY AaL ? wArED
ABO%OL AtJO MAy 80 AJJrIcONtiQ A VlBIGr.11GiAfl[.) VALNGO0L•R,"• ?Y4LYD/?u
,410 CII.wIS
uy;? . ?J'ha = 1! _ ?-
DOoK ARZA: IYPG oF lJovR S
DOOQ UNIYS NqYL 6'Lfnl TLSrCp ANO Rouyp To NAVC AN
*R7-VA4L4A Dr `1.19I JNCi.NO1 Nfj AIp OIi,.Mi,
4a : 'IRd, c I/.J_ F=ODTACcL?. 55
5PF-CIALs : r„PE :
rbaM a•1 ,DAJ„I.%- ?r?•,'7-30 L 0 g?NEc
. . . ? ?
8 8y- S3ti I
.. . ?
f•iTy OF E.AGAi': .
CP.S;iT!_R: JS 71c°::M:[idAL. nn:; 78'
DA't5?a 03/06/00 ili1:_y 09;57:03
ID r
NAMr: C.;OL.LEGE G:CT'Y HbNiE8
3210 9001 iB55 r<ED ;-o;, RD 60.07
2t55 9001 :i.85S r,:eD t OX RD 0,50
Ti7tFil ReCa:iP4, P^1ni ini; : C?0 '3f1
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US.ir,i ID: JAPd
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
Q?/, ?JT 3830 PILOT KNOB RD - 55122
9 O
? 651-881-4875 ??
Naw Can ehucMon ReaWremeMa Remodel/ReCalrO ReaulremeMS 3?j (j
D 3 repistared tlfe wrveys dhowlnp aq. R W bt, p. fl. of house 2 eopies of plan
and gU rooled areas t20% rtw)dmum bt covemae Wlowecb 1 set of enargy cdcukffions lor heated atlclllarn
D 2 coples ot Plarq (ahow beam a window iixes; Pared Ind. deslgn, ete.) 1 tlfe wrveY for exteAOr additlona 3 decks
a 1 let ot enerpy cdculaHona
a S coWes ot hae PreservaMan plai U loi plaMed aller 7/1 /93
DATE: CONSiRUCTION COST:
DESCRIPTION OF WORK: r} f15 eh, e h"?
srnEErannREss: 18 SS Re(zl po)c RVAd
LOT: 3 BLOCK: SUBD./P.I.D. r: /J / AGk 4.s ?.r Fo? e s?-
Name: Tv??e Qo 6 ?' Phone#:
PROPERiY last Flnt
OWNER
Streef Address:
CHy State: Zip:
. Company: C01 le 4 2 C4? I?v,., e 5 Phone o: 6 /-Z y6 9-? yv o
(area code)
COMRACTOR
Sheei Address: -7 q? ? e,4 kc //e ? license AL-Lo 9 Exp.
city Lrflt e v, `/(e- State: MnJ Zip; SSO `/?z
ARCHITECT/
ENGINEER Compuny: C oIle l4m eS Name:
Telephone M: ( )
Street Address: Realstraflon Y:
Cify State: Zlp:
Sewedwater Ilcensed plumber tif Installina sewer/watetl: PMne #:
I 4rereby acknowledfle lhot I have read this applicafion, sfate thaf Ihe fntortnaNon k cortect, and agree to comply wHh aA appRcoble Stcle
of Minnesota Sfatutes ond Ciryr of Eaqan Ordinances.
. Sipnature of ApplicanY.
OFFICE USE ONLY
CeRificates of Survey Received _ Yes _ No FEB 2 9
Tree Preservation Plan Received _ Yes _ No _ Not Required ?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
? 02 SF Dwelling ? OS 06-plex
? 03 01 of_plex ? 09 W-piex
p 04 02-plex ? 10 08-plex
O 05 03-plex O 11 70.plex
? OB 04-plex O 12 12-plex
WORK TYPE
D 31 New
? 32 Addition
A 33 Alteration
? 34 Repair
? 13 1&plex ?
? 17 Garage ?
? 18 Deck ?
19 Lower Level 0
Plbp _Y or _ N ?
O 20 Pool ?
21 Porch (3-sea.)
22 Poroh/Addn. (4-sea.)
23 Porch(screened)
24 SWrm Damage
25 Miscellaneous
30 Acxessory Bldg.
? 31 EM. Att - MuiG
O 33 Ext. Alt - SF
? 36 MuRi
? 36 Move Bldg. ? 43 Reroof
? 37 demolish (Bldg)' ? 44 Siding
O 38 Demotish (Inte(or) ? 45 Fire Repair
O 42 Demoiish (Foundation) O 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code --OL
No. of Units
No. of Buiidings
Const. (Actual)
(Allowable)
UBC Occupancy 91-
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS ? ? ?
Planning Building
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Engineering Variance
Permit Fee Vaiuation: $ze
Surcharge '
Plan Review
License
/ _ /e?fu;k
MC/ES SAC ?V
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Traiis Ded.
Other
Copies
Total:
,o.s--v
SAC Units
°k SAC
? CITY USE ONLY
suBO. .?ICtA aLA 1 br .' I?
REceiwr a: 1 a?-? Ld I
RECEIPT DATE:.
PERMIT& 7 l? 0 f2000 PLL7MBING PERMIT (RESIDENTIAL)
. . . CITY OF EAGAN
3830 PILOT IQIOB RD
? . EAGAN, M 55122 . . .. .
651-681-6675
Please camplete for: D single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
FIXTtJRES '
EACH fl
TOTAL
Afterations to existing dwelling - minimum fee
Describe: ?_?Fm?nT ?AIfZ I?' $ 30:00
Bath tuh $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet " minimum - t 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic S stem newrrefurbisned ' requires MPC Iic. 75.00 x = $
Septic System abendonment 30.00 x = $
RPZ new installatioNreQairlrebuild 30.00 X = $
Rough openin 1.50 x = $
Shower 3.00 x = $
Underground sprinkler fidwelling is under construction 3.00 x = $
Undergroundsprinkler ifexistingdwalling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwelling under eonstruction 5.00 x = $
Water softener ifexisnng dwemng 30.00 x = $
Water tumaround 30.00 x $
State Surcharge .50 -> -> -> $ .50
Total -> --> -> ---> $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--• •-•-•---•--•-----------------------•-••---------------------------------------------------?--------------------------------------•--
I hereby adcnowledge that 1 have read this applipdon, stete that the iMormation is correct, and agree to comply Hrith all applicabla City of Eaganortlinances.
tt is the applicanfs responsibility to noti(y the property owner that the Ciry of Eagan assumes no liability for any damages caused by the: City during its
normal operetional and maintenance adivities to the facilities consWcted under this permi[ within City property/right-of-wayleasement.
SITE ADDRESS
OWNER NAME: : (-'t-Y)l TELEPHONE #; tot rL 1-Ilo9 -[09Cv-)
(AREA CODE) INSTALLERNAME: I??YI7- ?11-44TELEPHONE#: 10S-I CFZIt> -I/W
"
STREET ADDRESS: (AREA CODE)
CITY: ? /6] 1 -r'!T STATE: ZIP:,2ELL?
;- .. . _SIGNA RE OF PE ITTEE
CITY USE ONLY
L ? BL / RECEIPT #: ?u?oZ 145
SUBD.?.l?a.n.?Y?lLo.t,crY2_ ? RECEIPTDATE: `5151g7
9997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 65122
(612)881a1676
Please complete for. . single family dwellings
• townhomes and condos when permits are required for each unit
New construction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: 20 2`7
[JAZN
. Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required Q$3.00 each) ?
? 5tate Surcharge .50
?5
TOTAL . V
SITE ADDRESS: ??_/5?5_ Aoeu rz2X
OWNER NAME: PHONE#:
INSTALLER NAME: GENZ-RYAN HEATING PHONE #: 423-1144
STREETADDRESS: 14745 So Robert Trl
C(TY: Rosemount STATE: MN Zlp; 55068
??IlYi ? .
GNA RE OF PERMITTEE
L BL
RECEIPT#:
RECEIPTDATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
? ali commerCiaUndustrial buildings.
• multi-family buildings when separate pertnits are Bgt required for each dwelling
unit.
SUBD.
Please complete for.
unTE:
WORK TYPE:
ciTr use orav
i.vNTRAc. 1'i=rciCE.
NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: P $25.00 minimum fee Qr 1% of contract price, whichever is greater.
. Processed piping - $25.00
. State surcharge of $.50 per $1,000 of permit fee due on all pertnits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE#:
TENANT NAME: (innPROVennerars oNLv)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE
CITY 1N5PECTOR
- - ,
L CITY USE ONLY o? BL ? RECEIPT#: .y
/? W
SUBD. LC2?GG??2YLQ.u? t ?? RELEIPTDATE: A9::1?
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for. . single family dwellings
• townhomes and condos when pertnits are required far each unit
. backflow preventer for underground sprinklersystem
FIXTURES EACH ?
Shower 3.00 x =
Water Closet 3.00 x
Bath Tub 3.00 x • _
Lavatory 3.00 x ? =
Kitchen Sink 3.00 x I =,
Laundry Trey 3.00 x
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x =
Gas Piping Outlet `minimum- 7 3.00 x
Rough Openings 1.50 x
Water Softener ' kr dwetlings under construction 5.00 x =
Water SOften2F ` for ezisting dwelling . 20.00- x -- " '- " - "-'
U.G.Spfinkl@f 'fordwellingundereonat. - 3.00 = --
U.G.Sprinkler 'Porezistingdwelling 20.00' _
Alterations. ` to existiny reskJence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` Dak Cty lic. 65.00 =
(new and refurbished systems)
Private Disposal Systems' Abandonment 20.00 =
STATESURCHARGE
TOTAL
.50
I hereby adcnowledge that I heve read fhis application, state that the intcrtnatlon i3 cortect, end agree. to compry with all. applicable Cily
of Eagan oMinances. R is the appllcanYs responsibillry to notiy the property owner that Ne CAy offa9an assumes no liabiliry#or any
damages dused by fhe Ciry during ifs nortnaloperational antl maintenance activities: to the faalities consWCted under this pertnit within
City propertylrigM-of-wey/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: GENZ-RYAN PLUMBING TECEPHONE #: 423-1144
STREET ADDRESS: 14745 5o Robert Trl
CITY: Rosemount STATE: MN Zip; 55068
? -
SIGNAT E OF PERMITTEE
OFFICE USE ONLY
SUBD.
CITY USE ONLY
BL I PERMIT #:
l (Xl?'1G ?? ? RECEIPT #:
? RECEIPT DATE:
000 MECfiANIt'.AL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT IQNOB RD
EAGAN 2Mi 55122
Date• LQ 651-681-4675
Complete this section on[v if you are ins ling HVAC in a single family
construction and not owner/occunied.
• HVAC: 0-100 M B T U /
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
Complete this section onl if you aze remodeline.
townhome, or condo. Please indicate if it is a new itet
I New _ Alteration/
Fumace
Air exchanger
Reminder: Call for inspections
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: / C'X?l/7 7 -
STREET
CITY:
/ ^3?1l?10-0
V'?
_ ir conditioning
er. ?E7WC_2
L?t/e.Q ?N??sh
Fee $ 30.00
State Surcharge .50
Total $ 30.50
PHONE #: (-0 12 -
(AREA CODE)
PHONE #: b 571 3-
(AREA CODE)
Surcharge
townhame or condo under
$ 30.00
6.00
.50
$
in to, or rypairing an existing single-family dwelling,
alteration, or re ir.
_ Repair \ _ Other
STATE: A/_ ZIP:_15M (ac?_
SIGNA OF P 17TEE
L BL
SUBD.
CITY USE ONLY
APPROVED BY:
INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAL PERMIT (CO2+MERCIAL)
CZTY OF EAGAN
3830 PII,OT lINOS RD
EAGAN, I+N 55122
651-681-4675
Please camplete for: all commerciaUindusVial buildings
multi-family buildings when separete permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction Install U.G. Taolc
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
R'hen ins[alling/removing underground tank, call 65I-681-4675 jor inspection by fire marshal and
plumbing inspector.
Descriprion of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL a
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IIviPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AAEA CODE)
STATE:
ZIP:
SIGNANRE OF PERMITTEE
as0ys
A- 90,00
City of EapIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
-----------------?
? ,
j Pertnit #: ?
I
? Permit Fee:
? Date Received:
i ?
i siatt: i
?----------------?
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress: ?U`??J ?2Ep Y?6X I?t?
Tenent:
Suite
RESIDENT/OWNER Name:lJbl.lc? `: JE11l"11FE12. pI(-Ae- phone: "rJe)q a
Address / City / Zip:
Applicant is: _ Ovmer X-Contractor
TYPE OF WORK Description of work:
Construction Cost: _I Z, "I 15, oU Multi-Family Building: (Yes No ?
CONTRACTOR Name:-U?6" abUAKD ai'1SM(JC-i'-)of') License
Address: t5tDAI I-1 ENl LZAL n V'e N
City: it I ? L.SGL'te?c State: nZip: ?
Phone:LE-4"n `113;,J r-pntactPerson:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Catagory 1 Worksheet . New Energy Code Worksheet
Category subminea Submined
(4 Submis3lon type) • Energy Emelope Calculations Submitted
In the last 12 months, has the City ot Eagan isaued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanfcal Contracior: Phone:
Sewer & Water Contractor: Phone:
?
.,
I hereby acknowledge that thig iMormatian is complete and accurata; that the vroik will be in conformance with the ordinances sntl Cotles of the Clty of
Eagan; that I understand this is not a pertnlt, bul only an epplication for a permiL and xork is not to start without a permii; tliat the work will be in
accordance with ihe approved plan in ihe case W work which requires a review and approval of plens.
x M • L a M r'1u (,A x)A •?'lvvvu,:.t.cs-
ApplicanPs Printed Name ApphcaM's Signature
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