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4779 Richard Lane" CITY OF EAGAN a--? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, M N 55121 PH ON E: 454-8100 BUILDING PERMIT Receipt # To be used for R??)Y FINISR Est. Value ;l r s00 Date fQV 30 ,t 9? Site Address 4779 Al:.ilA" Lri Lot ? Block I - Sec/Sub. auoul Parcei No. IC4-8-1300-0$0-03 a rvame_ ; Address 0 CitY - , o Name 5^M=- ? Q Address ? City Phone ? yVj W Name _ W _ g Address U tyZj rilty- I hereby acknowledge that I have read this application and state that the information is correct and agree to compiy with ail applicable State ot Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee __.-- A Building Permit is issued to:-.. ??TI - tZ k` ``E. GUT.TZl.,.lP on the express cond ition 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 On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Const City Water (Allowable) PRV Required # of Storles Booster Pump Length Depth S.F. Total Footprint S.F. APPROYALS FEES Engr./Assess._ Permit 34•00 Planner Surcharge 1•00 Council Plan Review Bidg. Off. _ SAC. City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks ( ? TOTAL Permit No. Permit Holder Date Telephone x Pluipbing H.V.#-C. Electric /LD ? Softener Inspsction Oate Insp. COmments Footings I Footings II Foundation Framing ? f Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Dfsp. 4 • -- 9 ,. ? BUILDING PERMIT for CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 (?10 118 '3 Receipt # Date ' -' ? ? • ? Q .19 t; h 5ite Address 4779 RZClllux`) LN Erect M Occupancy R3 Lot ki Block 3 Sec/Sub. 1.'1ALi7EiV ti'rS 1S'i' Remodel ? Zoning Parcel No. Repair ? Type of Const Addition ? No. Stories W Name Uz4TVF?22?;AL BLDRS Move ? Length 5 6 Z 4731 ?vt?,UEN DR Address Demolish I I ? ? Depth Ft S o City EAG" Phone 454-0982 mpr. nt. Install ? q. Q = o Name- 0 ¢ Address F W rvame G"Y TURPENINA a ASSOC ?a Address- ;1;ii2UNAVF'.11 !'t;# 4W city u11P:; ,"„Pnoft&' 435-5354 I hereby acknawledge that I F information is correct and ai Minnesota 5tatutes and Ciry Signature A Building Permit is issui all work shall be done in Build'+ng Otticial Assessment Permit ? 319 . fl 0 Water & Sew. Surcharge 31.00 Police Plan Review 159. $0 Fire SAC 575. UO Eng. Water Conn_ 5u • OU Planner Water Meter63• S 0' Council Road Unit 290 . 00 BIdg.Off. 4/303 Tr. PI. 156.00 APC Parks Var. Date Copies T„f, I I •O O IEiZSAL l3LllRS on the express condition that all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. .j I I PormR Na Prrmit Holdsr Deta TNaphons # I PlumbMg ? ! - IHMA.C.' (J (O I Electrlc I i Soltener Inspectlon Dete insp. Commsnb Footlnqs 1 ?? a"? G? ? ?c rt cw?-'? FooNngsll Foundatlon Framing Roofing Rough Plbg. - ? Rouqh Htg. Inaul. Flreplace Flnal Htg. Final PIb9• Bldy. FMeI -7, 0,(L & c t ; . Cert. Oee. r - ZY Dack Ftq. ? Deck Frmy. w.n Pr. Disp. . INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: Itll i 1 11 1 Nli kl.'000)r, ? I ! i 'rl I '4 (612) 681-4675 ? I ti: ?. •.??? ??,, .. ?., . SITE ADDRESS: , „, . , ,,,?,,, ? APPLICANT: ' I ' ItatrP 1 ANt ,- : \ PERMIT SUBTYPE: TYPE OF WORK: i?r I I INSPECTION D , ? , - I ?i,? Permit No. PermR Halde? 6ate' ' Telephone # ELECTRIC PLUMBING HVAC Inspection Dab Insp. Comments FOOTINGS ? FOUND FRAMINQ ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FlREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLOCi FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ?` •?? 9s ? CITY OF EAGAN Remarks t), 1 ' ?` • 1 ; =_ '?)'`f ;- Addition WALQEN HEIGHTS 1 ST ADDN Lot 8 Rik 3 Parcel 10-83300-080-03 Owner street 1482 THOMA.S LANE 5tate EAGAAI MN SS122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK d 1976 153.31 10.22 15 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 22- 1980 206.50 13.77 jrj STORM SEW TRK b5 1984 673.75 134.75 5 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CIT.Y (,. '! GAN sown SEVI(;E 'ERM 3830 Pilot i oob Road P. O. 6ox 21199 PERMIT NO.: Eagan, MN 55121 D/1TE: - r- Zoninp: No. of Units: Owr»r. • ?v?_r?sAl +' . Addrosc . - Sih /lddross: ° n •, i r h? ' Plwnb+r. I Mm [o N?Ip willi 110 Cft of se"n CorrNCtlon Charye: -{) lir^1 ' owiM AoODtlI1t Daposif: PeRllit FN: t"t' : i SVICf1mol: T ? 8y Misc. Chorges: ? Dote of Insp.: Totol: Irup.: Dote Pbid: 1''Y C. 'AGAN WATER SERVICE PEItMIT 0 Pilr?t Krwb Road . O. BOx 21199 PERMIT NO.: agan, MN 55121 DATE: ?i?; F'1 No. of Unirs: ' ?. -:iiversa? Eui'.?c:.•: ss: Addren: 79 T' i ehard Ia " ? .s ti v.R?. `^., umber: a r.. r No.: W Q ?i153. )Gpc' ?r ZE: fl??qa der ? _.t;ILS Ett.' 'o"' '°"'PIV"'hO u" PIY O ;W" - - ?= J Tatal: •. ^, ' By Dot. Pctd: Date Irnp.: Irnp.: ?- / 8? CITY OF EAGAN 15919 • ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 ?r l?? . PHONE: 454•8100 BUILDING PERMIT Receipt# C? 1 To be used for ROOM FINISH Est. Value $1, 500 Date NOV 30 ,19 88 Site Address 4779 RICHARD LN Lot 8 Block 3 SeGSub. i n(1 v? Parcel No. 10-83300-080-03 a Name CATHERINE GUETZLAFF 3 Address 4779 RICHARD LN ° City EAGAN phone 456-0056 681-3608 ¢IName SAME 0 ?Q Address m P City Phone W W Name_ w i Ez5 Addres5 aW City I hereby acknowletlge that I have read this apDlication and state thaf ihe informalion is correct end agree to comply with all applicabjg State of Minnesota Statutes antl Ciry oi EAgan Ordinances. / Signature of Permittee -.- A Buiming Permit is issued m: CATHERIHE-. II AFF on the express condition ihat all work shal I Ge done i n acwrdance with all applicable State of innesota S.t?a.WI[es andpCity ol Eagan Ordinances. BuildingOfficial_??/A. OFFICE USE ONLY On Site Sewage _ Occupancy MWCCSystem _ Zoning On Site Well _ (ACtuapConst Ciry Waler _ (Allowable) PRV Required _ n of Stories Baoster Pump _ Lengih Depth S.F. To[al FootDrinl S.F. APPROVALS FEES Engr./ASSess. Permit 34.00 Planner Suroharge --- J._00- Council Plan Review Bldg. O1L SAQ City Variance _ SAC,MWCC water Conn. Water Meter Roatl Unit Treatment P1 Parks TOTAL 35.00 CITY OF EAGAN N p 11873 . 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT qeceipt#-?? ? Tobeusedior SF DWG/GAR Estvalue $62,000 Date APRIL 30 19 86 SiteA91 ress 4779 RICHARD LN Erect ?.7 Occupancy R3 3 WALDEN HTS ST Remodel ? Zonin Rl Lot Block Sec/Sub. Parcel No Repair ? Type of Const 11 . Addition ? No. Stories a UNIVERSAL BLDRS Move ? Length SA i Name 4731 WALDEN DR Demolish ? Depth36 ; Address Intlmpr. ? S Ft ° ci?, EAGAN phone 454-09 2 Insrau ? Q i? Name SAME Approvale Fees $? Address Assessment Permit $ 319.00 ? City Phone Water & Sew. Surcharge 31 . 00 Police Plan Review 159. 50 Name GARY TURPENINA & ASSOC Fire SAC 575.00 ?a Address 14500 BIIRNHAVEN DR Eng. WaterConn. 500.00 aW Ciry RiiRNRV???„F 435-5354 Planner WaterMeter 63.50 Iherebyacknowledgethatlhavere dthisapplicationandstatethatthe Bld .Off. 4/30/8E information is correct and ag. e comply with all applicable Stete of 9 Minnesota Statutes and Ciry f agan Ordina c s. • APC Signature of Permi ? „?tar. Date UNIVERSAL BLDRS RoadUnit 290.00 Tr. PI. 156.00 Parks Copies--,,- UTr 00 . A Bwlding Permn is issued to: on the express condition that all work shall be done in accord with all 80 p' able State of Minnesota Statutes and City oi Eagan Ordinances. Building Official ?:'Oe ? REQUEST FOR ELECTSICk WSPECTION f EB-00007-06 / See instr?rctiens lor comoletinq'?his form on back oi veilow coOV. '? E"TT?? 32 "R" Below Work Covered by This Request Fdn aeo. TVpa o1 Builtling Aooli.ncxa wiree EnLliuPlenc wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures ApL BuilAing Dryer Electnc Heatin Commercial 81dy. Furnace Silo Unlonder Industrial Bldg. Air Conditioner Bulk Mllk Tank Fapn Oihxr Speci v ?her ISper?fyl ? ei ueci(Y the, Olhi;r Campute lnspection Fee 8elow p Fee ServiceEn[ranceSize B Fee Feeders/Sabfeeders # F5rt Circuits 0 to 200 qm s D to 30 Amps 0 tn 30Am> Above 200 qmpy 31 to 100 Amps 31 to 100 qm § Swimmfng Pool Above 700-Amps Ahove 100_P.mps Transiormers Irngation Booms Pdrtialbther Fee Signs Special Inspection S?J ' 70TAL Remarks Lv o., ...,..d...,. _..._ ? thn Ele InsOec?or, hereby d-Zi-14 1 -artify thet the above Final - Dxle inspection hes been ?? /? / P ,?de. TMerepuestvoiClBmontlrefrom V?:-?? W/? S This requnst voitl 111JC,1yS1 18 months from Q? ? Dy E 14 0 3 2/- 86.3. C.e7oUu, JA, 1 Nequest Oai r 1t ? (? Fire No. I ion I Dqoady Nuw ill Notify, InsPec- Im Wh R d C? 5 ?V]Yes ?No en eu V ? censetl Electrical Conlractor 1 hareby repuest inspaction of ebova wner elactrical work installed et: Sveet Address, Box or Roate No. 477 Ci[y ecUOn o. Townslfo Name o. No. Range No. County Occupant (PflIN7) Phone No.' Pawer SupVlier Atldress Eleclrical Contractor ICompany Namel Confractor?s License No. Mailing Address IConVaclor or Owner Making Inscailation) Aothorized Sienature lConaactor wne akine Iristnllalionl Phnne Number MINNESOTA STATE BOAND ALECTRiCITY TNIS INSPECTION PEQUEST WILL NOT Grig9s•MidwaV Bldg. - Noom N-191 BE ACCEPTED BY TME STATE eOAflD 1821 Univarsilv Ava.. St. Pnul. MN 56104 UNLESS PflOPEN INSPECTION FEE IS P6rine16121562osOO ENClO5E0. RESIDENTIAL ? ? ? y BUILDING PERMIT APPLICATION CITY OF EAGAN ? 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Coneuuctlon Beaulremente RemotleVRaualr NeaulremeMs • 3 repMereO sAe surveys showing sq. fl, of bt, sq. tt. ol house; and I roofad areas • 2 coples ot plan (200% maximum bl Coverage albwed) • t Setof Enargy Celculationsfor heated addttbns . 2 copies of plen gwwYig beam S wlrMow sizes; poured found design, etc.) • 7 site survey br ex1erar addRbns & decks • 1 set of Energy Cebuletions . Indlrate 8 home served Gy septb system for addtlbns • 3 copies ol TrBB Pteservatbn Plan N bt platted eker 711/93 . Rim Joist Detail Options selecllon aheet (bld9s wHh 3 or less unfts) DATE SITE ADDRESS t / / NPE OP WORK(-f - APPLICANT L MULTI-FAMIIY BLDG _ Y _ N _ FIREPLACE(S) _ 0 _ 1 _ 2 STREETADDRESS 12?X c,,.., L?\ CITY STATE _ZIP TELEPHONE # (,GI-`A-`bOl ({ CELL PHONE # 4tZ"' QH R (Z? FAX # 6V' LI `( I _bS-7 5_ PROPERTY OWNER Pe T('r' l(K rc' \I TELEPHONE # COMPLETE THIS SECTION FOR -NEW• RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I ??S (d submission type) • ResidenGal Ventiladon Category 1 Worksheet Submitted ? eq?,E,?e,rgXCQdQ00l . Energy Envelope Calculadons Submitted IYIAY b U l Plumbing Conhactor: Plumbing system includes: Mechanical Conhactor: _ Mechanical system includes Sewer/Water Contractor: _ Air Conditioning _ Heat Recovery System Phone # Phoni Fee: $70.00 I hereby acknowledge that I have read lhis application, state That The nformatio is cor ect, and agree to comply with all applicable State of Minnesota Statutes and Cify of Eagan Or nances. Signature of Applicanf OFFICE USE ONLY _ Water Softener _ _ Water Heater _ _ No. of Baths Phone # 1- Lawn Sprinkler Fee: $90.00 No. of R.I. Baths VALUATION s-S OO, p 0 Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4l02 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex O 13 lfrplex O 20 Pool O 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) O 31 Ext. Aft - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) O 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screened) O 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement O 38 Demolish (Interior) O 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windavs/Doors ? 34 Replacemenl *Demolition (Ent(re Bldg only) - Give PCA handout to applicaM Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Boaster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) Fina]/C.O. _ Footings (deck) FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Suppy & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector INSPECTION RECORD CITY OF EAGAN PERMIT TYPE 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 026696 11/14/95 $ITEADDRE$$: P'I.N.: 10-83300-080-03 LOT: 8 BLOCK: 4779 RICHARD LANE WALDEN HEIGHTS iST PERMIT SUBTYPE: DECK 3 APPLICANT: RHEIN CONST C0, RANDY (612) 461-3336 TYPE OF WORK: NEW ? J . --? ITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT "Aqqq-? PERMITTYPE: BuzLorNG Permit NumBer: 0 2 6 6 9 6 Date Issued: 11 J 14 / 9 5 SITE ADDRESS: 4779 RICHARD LANE LOT: 8 BLOCK: 3 WALDEN HEIGHTS 15T P.I.N.: 10-83300-080-03 DESCRIPTION: BOi1d3ngb,permit Type DECK ouiLdirr,9. Wbr,k Type NEW ... :»;nt»?g a ¢ ? ?? ,Gt R_, ??"P?•u .?1 z I REMARKS FEE SUMMARY: Base Fee Surcharge Lic. 5earch Subtotal $30.00 $.50 Fee $5.0@ $35.50 COPY $.50 Total Fee $36.00 CONTRACTOR: - RHEIN CONST C0, RANDY 8600 237TH ST"E LAKEVILLE MN (612) 461-3336 Applicant - ST. LIC 14613336 0003311 55044 OWNER: GUETZLAFF CATHY 4779 RICHARO LN EAGAN MN 55122 (612)456-0056 I.heraby aCkrrvwledge Chat I have re?d this infctrmatio? is corr4ct and eypee tP camPlY , Statu s and CiCy of` Eagan ordirianoes-. ? c APPLICAN RM EE SIGNATURE eppkication andstatethat Cha with al`1 appl.icaab7.e Stats af 4n, ISSUED YJSI URE CITY OF EAGAN ItOL1995 5830 PILOT KNOB RD - 55122 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ? ? ? 3 iegisMmd site aurveye 2 coPies of plam (indude 6eam 8 window aaes; pourod fnd. desgn; etc.) t onarpy plWladons 3 copies of hee presenetion plan if bi platted after 7/1/93 raquired: _ Yes _ No DATE: ?2 copies of Plan ? 2 ske surveys (exterfor eddRions 6 decks) ? 1 energy celaledons Tor heatad atldRions CONSTRUCTION COST: ??? 0'l DESCRIPTION OF WORK: b>c-- 'K STREET ADDRESS: /7 /???m?'o '?V LOT 'K_ BLOCK SUBD./P.I.D. #: PROPER7Y Name: lpa ?,wFG Phone #: OWNER ? °"• '• Street Address, 4LZ7`L L41` City: efl-OM4 State: _(= Zip: 5;;-? y z- CONTRACTOR Company: _,./ n? i Phone #: ??/25336 Street Address: 401J 23 S)t 4. License #:? 3?f City: L&•&UrLl£. State: mll/- Zip•_ ARCHRECTI Company: Phone #• ENGINEER Name: Registration #• Street Address, City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lat I hereby acknowledge that I have read this application and state that the intormation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY CeRificates of 5urvey Received _ Yes _ No r?r s? 0 1 1995 i Tree Preserva6on Pisn Received _ Yes _ No BUILDING PERMIT TYPE ? 01 Foundation o 06 Duplex n 02 SF Dwelling ? 07 4-piex 0 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex 0 05 SF Misc. ? 10 = plex WORK TYPE New ? 33 Alterations n 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actuaf) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning OFFICE U5E ONLY ? 11 Apt./Lodging ? ? 12 Multi RepaiNRem. ? ? 13 Garage/Accessory o ? 14 Fireplace o ?15 Deck 0 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building .w u y 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code oi Census Bldg / Census Unit 0 Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Suroharge TreatmeM PI. Road Unit Park Ded. Trails Ded. Other Copies . LSO Total: % SAC SAC Units 4 Valuation: $ l2-C-0 ^ J1 1 A -Jo + 7J=?.?i ^DD+ 63--0+ 29J°';0+ 156=-10+ 23-94°-0;: ? /P3 _ ? ` 1986 BDII.DIAG PERlIIT 9PPLICATIOA - CITY OF EAGAN 80TE: ALL CpIiT[tACTpRS MQST BE LICffiQSED i1ITH T8E CITY OF EAG68 COlIl+ERCI9L SZNGLE FAMIILY Di1ELLINGS INCLUDE 2 SETS OF ARCHITECTORAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENEAGY CALCULATIONS ENERGY CAI,CULATIONSJ ? $2,000 LANDSCAPE BOND ?Ocr)o To Be Used For:??Dej-,x? ValuationDate: 4-9"c?a 4??9 ?r?RO 44. 3ite Address OFFICS USB 0NLY Lot ? Bloek 3 Ereet ? Oceupancy -?? Remodel Zoning Pareel/Sub IsE.j, Repair _ Type of Const ? / Addition # of Stories Owner Move _ Length ? Demolish Depth ? /Address Int.Impr. Sq Ft Install City/Zip Code /?T`_--------- ---------------------- Phone 4S4.^ Qz; APPROVALS FESS ?.-..Contractor???j/,???„?l??/., Assessmenta Permit Water/Sewer Surcharge Address Police Plan Review , ?!J ? Fire SAC City/2ip Code Engr Water Conn 5(JU Planner Water Meter Phone Council Road Unit ? Bldg Off S Treatment Pl /?YJ Arch. /Engr•e-;Yw2 ?/ Ti(Zy?.?`y??, d'v9v,$Ap APC Parks Varianee Copies Address ?Oa .?S'jL??NyfiP.rf?f7L? TOTAI, ? ? City/Zip Code?,l?lSd.s?iy?r,_,+? Phone # 413 ' ? .. ? f ? NOTS: ADpRB3SSS FOR CORAER LOTS - CONTRACTOR/HOMEOiiAEH HQST DFSIGNATfi WHICH ADDRESS IS DESIRffi. NO CH6NGES iiILL BE ALLOflBD ONCE BDILDING PER!!IT IS ISSUED. 3,,? ,? l3 = ?a5B - 27/ ?/? - // l'o'??ll ?5x /L/ r ?V ?- (/?/ L? / 32 x 2? _ ?r? ?c /z = 7 C-?,? RU ? ?/,5%2 OIiNER: ? SITE ADDRESS: CONTRACTOR: ;6fae= -./ =Y's-44 PHONE: -K4--dE?-P, 1. Total exposed wall area .. Z'7? ,' Z? sq, ft, x.11 2 Total roof/ceiling area .. 9 3lo ,- sq. ft, x.026 = Z4.??.4 Total exposed wall area above floor - 1-7 -7¢7.5>a a. Total wall window area ............................ 4.1 b, Total door area ................................... 3 7,8 Z c, Total sliding glass area .......................... 7 Z d. Total fireplace wall area ......................... !&, e. Total wall framing area (average 10%) ............ ?.3 Z?JUZ f, Total net wall area above floor g. Total rim joist area .............. Total exposed foundation area = 9 Z h. Total foundation window area ....................... 119"? i. Total net foundation area above grade .............. q,:L Determine 'U' value of each wall segment: r?2 Z?°`' \ r` CITY OF EACAN EICfERIOR ENVELOPE AVERAGE 'U' COMPUTATION a, 1-Al x IUI 5lb _ 'Q1.?S b. 3,).82 X 'U' 4(0 = i7 4Q c. '7Z_ x 'U' ?l, d. t Ig X ' u' ?.Q^! = 1. 1Z e. 232.?.- x 'U' .iF? _ 95 f. 1'1-2,1.zat x 'U' a. tis JkP x IuI 3 s4 h . ?- x ' U' - _L1- i, x 'U' ,OS = A.lo[7 . . .............................................. Total = Z Z ? ,c{'9 ? 2f- tem Il3 is the same as or less than item 111, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area _ 9s(? j. Total skylight area ............................... 4 ?SS k. Total roof/ceiling framing area (average 10$) ..... T31(o 1. Total net insulated roof/ceiling area .............. lkiz,, (OVER) Determine working square footage of each: . ? Determine 'U' value For each roof/ceiling segment: j. ?.g5 x 'U' 16$ _ 2,8 k. 93.c? X 'ut ,o? - z,8( 1. X 'U' RZ = Z 4 . ...................................................... Total 7 If total of 1l4 is the same as or less than it2, you have m intent of SBC 6006(c)7. Alternate Building Envelope Design To/titilize the total envelope system method, the values established by the sum o Items /k3 and lI4 shall not be greater than the sum of Items #1 and 112. ,. IqA,Z1,, + 2. 7-4. 34 = 2(9 , 1b 3. zZZ.q4R + a- Z-4, S 7 = 7-oi-7, 35 ? . ._ • . _ ,!' . DECLARATION OF ACCESS EASEMENT THIS DECLARATION, made [his jJ " aay oP , 1986 by ana between ALVIN P. LeCOCQ ana KARLENE J: LeCOCQ, hus and and wife, and SIENNA CORPORATION, a Minnesota Corpora[ion, RENNETH W. WASON, a single person, ana JILL A. AABECR, a single peraon, (hereinafter referred to as "Declarants"); 1. The parties have an in[erest in anjoining real estate situatea in ehe City of Eagan, County of Dakota, State of Minnesota, and aescribed, respectively, as foltows: Lots 17 ana 18, Slock 4, Twin View Manor owned by Alvin P. LeCocq and Karlene J. LeCocq, husband ana wife; ana Lota 7 ane S, Blocic 3, Walaen °eights Firat Aaai:iaa owned by Sienna Corporation; ana That part of Richara Lane, as aelinea[ed and aeaicated on the plat of Twin View Manor, accoraing to the recoraed plat thereof, now vacatea, lying easterty of Lots 7 and 8, Block 3 Walaen Heights First AAdition. 2. The parties to this agreement desire to create a ariveway for the benefit of the present ana future owners of Lots 7 ana 8, Block 3, Walaen Heights First Aaaition. 3. Alvin P. LeCocq ana Rarlene J. LeCocq, husbana and wife, desire to continue to own Lota 17 and 18, Block 4, Twin View Manor as one parcel of property wi[h one awelling unit whereby the extension 'of Richaru Lane northward Deyona Delores Lane with utilities will never become necessary. The parties agree as.follows: Easement Number 1 A perpetual ingress and egress easement for the benefit of Lots 7 ana 8, B1ock 3, WALDEN HEIGATS FIRST ADDITION, accorning to the recoraea plat thereof, Dakota County, Minnesota, overana across tnat part vr Richara Lane, as delineatea ana eedicatea on the plat of TkTIN VIEW MANOR, according to the recorded plat thereof, Dakota County, now vacatea, lying southwesterly on a line aescribed as follows: Seginning at a point on the south line of saia vacated Richard Lane, a aistaace of 16.97 fee[ easterly from the southeasterly corner of said Lot 8; thence northwesterly a aistance of 23.72 fee[ to a point on the east line of said Lot 8, a aistance of 16.97 feet north from saia southeast corner, anA there terminating. Easement Number 2 A perpetual ingress and egreas'easement for the benefit of Lot 7, Block 3, WALDEN HEIGHTS FIRST ADDITION, accoraing to the recoraea ptat thereof, Dakota County, Minneso[a, over and across the easterly 12.00 feet, as measured a[ right angles, of Lot 8, saia Block 3. The owners of Lots 7 and 8, Slock 3, Walden Heights First Aadition shall share in the costs of construction, maintenance, repair and snow removal of an asphalt ariveway over ana across the above aescribed easement in the following manner: Tue owner oi Locs 7 shali be responsiole for sixty percent (60%) of said costs. The owner of Lo[ 8 shall be responsible for forty percent (40%) of saia costs. They shall use the righta gran[ea above with aue regard to each other's rights and their use thereof, and shall not use the driveway in any way that will impair the rights of others to use it, and shall not obstruct passage thereon. The easemen[ aescrihed herein is to and shall run with the land, ana shall be for the benefi[ and use of the owners of Lots 7 and 8, Slock 3, Walaen Heights First Aaaition, their heirs ana assigns. IN WITNESS WHEREOF, the parties have heretofor set their handa: STATE OF MINNESDTA ) ) ss. COUNTY OF DAKOTA ) On this day of , 19 , before me a Notary Pubiic within and for saia Coun[y, personally appeared Alvin P. LeCocq and Kailene J. Lecocq, husband ana wife, to me known to be the persons aesccibea in and who executea the foregoing instrumen[ and acknowleagea that they executed the same as their free act and tieeA. Notary Public ,. F? . r STATE OF MINNESOTA ) ) ss. - COUNTY OF DAROTA ) On this aay of 19 , before me a Notary Pubiic within and for said County, personally appeared Renneth W. Wason, to me known [o be the person describea in and who executea the foregoing instrument ana acknowleaged that he executea the same as•his free act and aeed. STATE OP MINNESOTA ) ) as. COUNTY OF DAROTA ) On this aay of , 19 , before me a Notary Public within and for saia County, personally appeared Jill A. Habeck, to me known to be the person aescribed in ana who executed the foregoing ins[rument and acknowtengea that she executea the same as her free act ana deed. STATE OF MINNESOTA ) ) sa. COUNTY OF DAROTA ) The foregoing instrument was acknow eageA Cefore this 15?AG&y of 9 fG by (name) -Z>h/4.? jA ZfDL, (title of offi er) '7 enna Corpora[ion, a Minnesota corporation, on behalf of the corporation. No ary Public This aocumen[ araftea by: HAUGE, EIDE & KELLER, P.A. 1200 Yankee Doodle Road Water View Office Tower, Suite 303 Eagan, Minnesota 55123 (612) 456-9000 ?-?.,o LESLIL- A. DAVISON NOTARY PUOIy COMINNESOTA U TY FiE1VN.- ?? MY Com??jOn Expires ?l 11, 79? 1988 BUILDING PSRMIT APPLICATION - CITY OF EAGAN ?. . SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MU52 DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENT9L UNITS FOR 59LE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONIIMERCIAL INCLUDE 2 SSTS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used ror: VZ? ?7i,A Valuation: Site Address -=? ;7 ?1 f?. i Lot ? Block A Iji Parcel/sue (D-MU0-0$0-Q9 Owner 6 i. '04, I a E? !(,e,+(n Sr r r ' k ? Address 47??7 1Zic.?na?,-? ?•TV.? City/Zip Code Eo c, Tct Phone Contraetor _ Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # Date: li/3V orrlL;h ush UNLY On site sewage_ MF1CC system , On site well _ City water _ PRV required _ Booster Pump _ APPROVALS Engr/Assess Planner Council Bldg. Off. Varianee Occupancy Zoning Actual Const Allowable 4F of stories Length Depth S.F. Total Faotprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL ?? ?, 3vA -11 ? Q0 : City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: Tenai ? ?a[Eow [E? DCT 0 S 2008 -- ------------- ? Fo'r:Of?ce,.Use ? j Permit#: ? PermitFee: lt ? `I ? Date Received: j , I ? I Staff: I I RESIDENT / OWNER Name: Phone 1 - 50 Address / Citv / Zip -??P?d,V`?Il (A l?'?1 ? V C ontractor Applicant is: _ Owner TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes No _iwo? CONTRACTOR Name: License #: ?L\ & 1;Q-1 0 EI E l A ? -- Address : ? . _ _ . Zi : i p ty: C Phon : ? ? . Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _; Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted . Submitted (4 8ubmission type) • Energy Envelope Calculations Submitted 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: P?ans and supporting documents that you su6mit are considered to be pu6lic information. Portions of the Information may be classified as non-public !f you provide speclfic reasons that would permif the City to conclude that the are irade secrets. I hereby acknovAedge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ci[y of Ea an; that I understand this is not a permi[, but only an applica[ion for a permit, an work is not to start without a permit; that the work will be in acco nce with the approved plan in the case of work which requires a review and appr I of plans. x 0 -aw UN x ApplicanYs Printed Name App Ys Signature Page 1 of 3 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Clty 0f EapIl 3830 Pllot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 i ---------------, i i i Pertnitit: ? Permit Fee: 50-so ? I I Date Received: i ? Staff: Ja1N 2 o 2oos ? 1 _________--------- I 2009 RESIDENTIAL PLUMBING PERMIT APPIICATION oate: i- f lo '0 9' Site kQY0( L-aNL) . FaUaAA Tenant:12lxVid Qv?G( LUN"Q Allein ..... Suite#: RESIDENT ! OWNER Name: D/.1 Vi A Q1.td Lmmo e A I ( e 1.1 Phone: ?! ?J' 1 CP8 QJJ (O 15 C) Address/City/Zip: ??7? K+G?avd L-aIne- EQ QN ,5?jj CONTRACTOR Name: Lv rGli in Pr 0 License #: D6 O(D 13 PM Address: VV I? ZQ q'?4 ?. w. c;ry: L-o-Ice,0I l e state: Phone: 6152- L?&l &qqq ContactPerson: TYPE OF WORK _ New /X Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Descritlon of work: PERMIT TYPE RESIDENTlAL 71X- Water Heater _ Water Softener Lawn Irrigation Add Plumbing Fixtures ? RPZ PVB) Main _ Lower Level) Septic System Water Turnaround New _ AbandonmerK RESlDENTlAL FEES: y50.501iAinimum Water Heater, Water Softener, or Water Heater and Softener (inciudes $.50 State Surcharge) E30.50 Lawn Irrigation (includes $50 State Surcharge) $50•50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) ' Water Turnaround (add $165.00 if a 5/8" meter is required) $100•50 SeptiC System New ($10.00 per as built) (includes County fee and $.50 StaTe Surcharge) $90.50 Fire Repair (replace 6urned out appliances, ductwark, etc.) (includes $.50 State Surcharge) TOTAL FEES $ JGO •SD _._... .. . .... . . ----• -------_- •°-• •°° •^•-^^?,.?..., ??"r=,? a,? =??a?a, ???a.? uro worR w?n oe m comormance vmn me ommances ana cotles ol ihe Ciry ot Eagan;ihat I understand ihis is not a permit, but only an application for a permN, and vrork is not lo start without a permR; that ihe work will be in accordsnce wNh the appmved pl in the case ol work which requires a re ' d approval of plans, x,?-?i?_?- x Q? or a k (? r5 0?, ? TV y JEYOR'S CERTI.FI-CATE uNI.YERSAL BUILDERS . ?.. ,.a..?: . . .. - ? ,. ° . ? 3a .: , _.. _.. .._.. .?...?....:...,, v r 2 ,? o` > ,: , ? ? . ?. _ t. .? 3 .J. . .. a';. ' ? v J • o N , I ?RC?E`d`INGRESS 9'E6R ?' f53 - ?,???_ EASEMEN7 FOR LOTS 7 8 8 r? RICHARD . v?ii? A i i_L/ ? . ` LANE?' .. ,?, S!°I S 22 W 4a/_Gr44z.9 98,6e945.1 r/*+ ?Y/do3.3 ' _ _ 34.Or?? ?? 1L I . / ROPOSED IN6RESS / 3030??EGRESS EASEMEIVT ? 29•34 . i FOR LOT T i " / ? Qql.7 t_?9.9I_--? 39. '^•EXIS7I0 NG o OARAGE o xg4/.B ?1 alV / 10a ia.o io ? 16.0 - O /XlS71NG ? o HDUSE ti NO M " ? 36.0 ? 5e z ? ( ? . oT I 0 ? O wZ M Q' ? Rp ?Sto x `??!3 /9 ?• 92 g? PROJECT N0. 86408 FILE NO. 'FOLDER , `?4SEM?Nr FR r?? ?T a r ? C4r 4o ? ? °v j=?t8.87 '?I C? ? r? I =? . 0 9\ 0 .? r,. < . n481•9 / 8 i 0° I 1-, -7- ? . y '\10 v \A D,. ? s S REVISED 6-13-86 TO SHOW DCISTING HOUSE sooK i pnce JAMES R. HILL, lNC. I 531;4 planners / Engineers / Surveyors 8200 Humboldt Avenue 5outh Bloolnington, Mn. 66431 812-884-3029 , SURVEYOR'S CERTIFICATE * UNI4ERSAL BUILDERS DENOTES PROPOSED SURFACE DRAINFlGE O DENOTES IRON MONUMENT SET SCALE: 1 INCIi = 30 FEET • DENOTES IRON MONUMENT FOUND fROPOSED GARAGE FLOOR = 9 BS.3 FEET XOU0.0 UENOTES EXISTING ELEVATION PROPOSED LOlJEST FLOOR = 98 2? FEET (000.0) DENOTES PROPOSED ELEVATION E OF POS P RO E BLOCK =?$b- FEET. ? ? ? . oUS I IfEREE3Y CERTIFY TO THAT TIiIS IS A TRU E AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNUARIES OF: Lot 8, Block 3, h'ALQEN HEIGHTS FIRST ADDITION „a.ccording to:the recorded plat thereof, Dakota County, flinnesota. AFID OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO 5110bJ 1hiPROVEMENTS OR ENCRDACHMENTS, IF ANY, THEREON. AS SURVEYEO BY ME, OR UNUER MY DIRECT SUPERVISION, THIS STH- UAY OF M4.2ZH , 1986. SIGIJED: JAt4ES R. NILL, INC. 'REVISED 6-13-86 TO SHOW EXISTINGHOUSE - BY: HqROLD C. PETERSOIJ, LARD SURVEYOR MINI4E50TA LICENSE 110. 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 86408 /53154 planners / Engineers / Surveyors FILE NO. 8200 Humboidt Avenus Souih FOLDER Bbominglon,Mit 65431 012-804-3029 . SURVEYOR'S CERTI.FICATE uNIVERSAL BUILOERS cn 3a LLI W ? I ? a -j Q J N N N ^ O `r Ma /0 0 7. PROPOSED INGRESS 6 EGRESS N Z , ?-? ^„ I? ' ? n ??_ i/-11 ?J l_/-1?V1_ EASEMENT FOR LOTS T 9 B? RfCHARD ? LANE M ? ? SI018 22 W 49/. X - x49x.? 9$.6 4S.t ? " 003.3 16.87 $ ' `- --?- -?- T i pROPOSED INGRESS ? I , <\ / 3R3019IEGRES3 EASEMkeNT ? ?•34 ? Ni FOR L07 7 i"gnI ---- ?: EXISTING o /N xg9/.8 _... I 41W 18.0 GARAGE 16.0 . ,O ?XISTINCa- I / o HOUSE ^ ? ?. m , ory ae.o " /`? ? / x x98c.7 ' ?'o ll ?0 ?s5,t , ? C.j r982.9 / -`- 1?1-- ou i W o ?J , ? ; r- r\ ?. o40 ? s[ ? ?ASFNQGF ? \ MFNTQli / \ 'OCqr a \1o j o ? ' Ra3'uojF29 .l : R ?/.3 % •. %° PAOJECT NO. 86408 FILE NO. ' FOLDER S S -b° BOOK / PAGE ! 531,?-¢ °v . ,. ',• < ,ti ? REVISED 6-13-86T0 SHOW IXISTING HOUSE F25H JAMES R. HILL, INC. Planners / Engineers / Surveyors 8200 Humboldt Avenua 5outh Blootnington, Mn. 66431 812-884-3029 SUR.VEYOR'SCERTIFICATE ' .-*-_ DENOTES PROPOSED SIIRFACE DRAINAGE O UENOTES 1RON MONUMENT SET • DENOTES IRON MONUMENT FOUND Xp00.0 UENOTES EXISTING ELEVATION (UOU.O) DEIJUTES PROPOSED ELEVATION UPIIVERSAL BUILDERS SCALE: 1 INCH = 30 FEET f'ROPOSED GARIIGE FLOOR = 985.3 FEET PROPOSED LOlJEST f100R =982-? FEET PROPOSED TOP OF BLOCK = q$?-fEET AT NouSC. I HEREI3Y CERTIFY TO THAT THIS IS A TRU[ AND COf2RECT REPRESENTATION OF A SURVEY Of THE E30UNUARIES OF: Lot 8, Block 3, WALDEN HEIGHTS FIRST ADDITION,.accor:ding to the recorded plat thereof, Dakota County, Minnesota. A(•IU OF THE LOCATIDN UF A PROPOSED BUILUING. IT DOES NOT PURPORT TO SH04! IPiPROVEMENTS OR ENCROACHh1ENTS, IF ANY, TfIEREON. AS SURVEYED BY ME, OR UtJDER MY DIRECT SUPERVISION, T111S STM- DAY OF MAY.C-N , 1986. SIGIiEU: JAMES R. HILL, INC. BY: IIAROLD C. PETERSON, LAtID SURVEYUR MIN11ESOTA LICEIJSE I10. 12294 PROJECT NO. 800K / PAGE JqMES R. HILL, INC. 86408 I53154 Planners / Engineers / Surveyors FILE NO. 8200 tlumboldt Avenus South FOLDER Bbotnington,MiL 55431 012-884-3029 , SVRVEYOR(S CERTIFICATE n II1111 I? I l.? I I/"l ? J %V/-lC/ 11 1_IJ pi '1? s?c'o i 0 ?Qm coA? / ^ ?• . ? or ? ? FoR4jN r S/ ?SF qGF Mo QQ ?? ? 47°? ?/. ?%9.. xy 2 p. PRUJECT NO. 86408 FILE NO, ' FOLDER A??TY .a ? / (o N ,?a• ? 33 W I ? . o ? J ? N N Q PROPOSED INGRESS d EGRESS N z i ? Y,_ EASEMEN7 FOR LOTS 7 9 8? r? - RICHARD ANE St°18,22W X m 9T > 16 98.66 . X ' oo3.3 --rs.s7 . S, 1? 5 I ? --_ PROPOSED INGRE'SS r Gi ? I d EGRESS EASEM&NT % 4?a? FOR LOT Q;? ?\ 1 r 71.11 Q:sy . .? zoo ` 'o) Noo) v, / . . .?g ry GQ?'•??b q? 1 '.p A r ? ?O• ? ?p?S ``?? 2•O FO 0 ? 6?O •fi / 36 ni???` g?• /??8?'?)!9R . ? A ? 8 SOOK / PAGE 15315.¢ UNIVERSAL BUILDERS q• , -.; ? ? A1 b??-? @ V 3 , r- 5 \i ?S \ Op ? t?, -7- ? t_ 1/ I ... ? SHEET 2 OF 2 SHEETS JAMES R. HILL, INC. Planners / Engineers / Surveyors 8200 Humboldt Avenue South Bloofnington, Mn. 55431 812-884-3029 PERMIT City of Eagan Permit Type:Building Permit Number:EA109951 Date Issued:04/16/2013 Permit Category:ePermit Site Address: 4779 Richard Lane Lot:008 Block: 003 Addition: Walden Heights PID:10-83300-03-080 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Window or Door:REPLACE BACK DECK PATIO DOOR Perry Firkus Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - David M Allen 4779 Richard Lane Eagan MN 55122 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature *City of Eaaall Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Reel f1, Owner Type of Work Contracts Site Address: Name: A l))4 t". Address / City / Zip: (T l Applicant is: Description of work: Construction Cost: Owner 7`1 i �cti�Y G, nJ Phone: Unit #: Contractor Company: ft j w9e 1" ! ✓� 7 9 7 6 / /. Address: %L �1v'r� L� 7li Multi -Family Building: (Yes / No ) Contact: j c Fi /0 City: ±moi- Oa f4 1l Stated /1 Zip: 6--c---1Z-a- Phone& / 761-c1: jeX r .e% rig tel s License #: c Le 7? Lead Certificate #: If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE: Plans and support ing,docuri etas that you submit are considered to be public information, Portions the information may be classified as non-public if you provide specific reasons that would permit the City conclude that the ; 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. wwwgopherstateonecall.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 Minne •t days of permit issuance. of to Applicant's Printed Name Code must be completed within 180 A • • icant's Signa ure Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA136386 Date Issued:05/10/2016 Permit Category:ePermit Site Address: 4779 Richard Lane Lot:008 Block: 003 Addition: Walden Heights PID:10-83300-03-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - David M Allen 4779 Richard Lane Eagan MN 55122 (612) 205-0109 Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 Applicant/Permitee: Signature Issued By: Signature