4797 Richard Lane- CASH RECEIPT
'
CITY OF EAGAN - „ 3795 PILOT KIUOB ROAD
• EAGAN, MINNESOTA 55122
D A T 19
CEIVED \__ _ ' •1 "Z.-??lJ..'?.y(..l..?i • ?._
/Y va?-?•
FROM
/
AMOUNT $ I
?
? CASH ? CHECK
FOR?- ??x d Y •r_ 1 . 'i !? ? •
_7?? - o?? - 6//" . . .J l..lti)f / 1(9-
FUND CODE AMOUNT
?
-71
S c.
40
?
Thank ?oi????/
???6
8Y ?? ? ? n
. .. 6 S5 D
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? Z???
?- -" PHONE: 454-8100
BUILDING PERMIT Receipt#
To be used for '+• "'/i' Est Value +' 144, l; U() Date IiC?'' 11 , 19
Site Address 4797 R ICI lA-Rp rAN E Erect Mx Occupancy _
? T T,TL,+:7 R!;;;
l Sec/S
Lot Block
b
Remodel ?
Zoning « 1
.
u
Parcel No Repair ? Type of Const.-Ytt
. Ac{dition ? No. Stories
a Name `l' r'?' ?'• : "?: : ? ° `4' Move ? Length 70
Z
3
Address ? . ? . - . - • ,
? an:? _? , t_,?:. i;:;. •`. ;'.r r Demolish ?
I
t I
? Depth 6 7
S
Ft
o
City
Phone y 54-64!y 3 n
mpr.
Install ? .
q.
o Name Approvo
0 i Address Assessment _
~ Citv Phone Water & Sew.
?a
VW
W
H W
U=
0
?W
t
Name pLeU1C0 INC Fire'
Address +
Ciri
Eng.
Planner
Police
Permit `'"s'' , ""
Surcharge 72.00
Plan Review?5c}
SAC ? ou
Water Conn. `' 0 . 0 (i
Water Meter 63.5U
flaad Unit 2 -) U ' U '
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg. Off. Tr. PI. 1$?.UI
information is correct and agre to comply with all applicable 5tate of
Minnesota Statutes and City of ?agan rdinan s. ? APC Parks
Var
Signature of Permittee,j . Date 5/ZS/?4 Copies
Total
A Building Permit is issued-to: on the expre?ondiUon tttat
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances
Building Ofticial
I I Permk No. I MrmH Nolder I o.a I TNephone M I
l1nuoectlon Dofs I Iraa- 11 Comments I
PIly.
Hty.
Flnal Plbg. ff S ?S -/O^ 1 / k),A.
Bldg. FMaI W I "l 11 ?i- LT 1 . ._, p
Disp.
. . ,
1
' /
PERMIT# 779-
MECHANICAL PERMIT RECEIPT #
' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE PHONE 454-8100
Site Address 473 T ?".r< < =,i1 BLDG. TYPE WORK DESCRIPTION
lot Block i Sec/Sub
R
N
Name 17,
. ,.
• es.
ew
M
lt Add
? Address `?`?30 i?eau D Rue lir. -on
u
Comm
Re
air
Lansi? ) 2
`1 ` -.: ? .
p
c _
City
Phone Oth
er
Name is'? . ivn.Ft l.:^c?
FEES
m
c ??55? I?az
Address k RES. HVAC 0-100 M BTU -$24.00
p City P hone '''j ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 196 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
IT P
1CE GOES
(ADD $.50 S/C IF PERM
R
Vent CFM BEYOND $1,000.00)
Gas Piping OuUets #
Other
FEE
- ?
. .. ' `
S/C: - SIGNATURE OF PERMITTEE
TOTAL•
FOR CITY OF EAGAN
r , .
. , PERMIT #
PLUMBING PERMIT RECEIPT #
GTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE _
cnWroarr ooic?• `t r' ,.. cunuc. a?u_a?nn
Site
m Name
? Addre
c City _
BLDG. TYPE WORK DESCRIPTION
llock ? Sec/Sub
• Res. New _
Mult Add-on
" '° ' ' `? ? •? Comm. Repair
Phone 'g ' Other
L Name j^'
; Address v
p City Phone
FEES
COMM/INO FEE - 196 OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOft CITY OF EAGAN
NO. FIXTURES TOTAL
' water ciosec - $3.00
? > r
Bath Tubs - $3.00 `
?Lavatory - $3.00
' Shower - $3.00
' Kitchen Sink - $3.00
Urinal/Bidet - $3.00 "
Laundry Tray - $3.00
? Floor Drains - $1.50
E Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
_Rough Openings - $1.50
FEE ?.-._
STATE S/C:
GRAND TOTAL• ?- -
CITY OF EAGAN Remarks I r- / '=
Addition HTLLCREST ADDITTON Loc 27 Blk 1 Parcel 10-32975-270-01
Owner Street 4797 RICiARD LAlVB State EAGAN NK 55122
improvement Oate Amount Annual Years Payment Receipt Date
STREETSURF, 26 1985 2450.15
STREET RESTOR.
GRADING
SAN SEW TRUNK 1976 183.08 12.21 15
*SEWER LATERAL 4- 19$rj 4361 . 74 8
WATERMAIN
*WATER LATERAL 1985
WATERAREA tp(p-6 19$2 294.33 19.62 15
*Services 1985
STORM 5EW TRK YloS 19$4 $Q4. rj6 160.91 rJ
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
' OF EAGAN 1NATER SERVICE PERMIT
I PNaf KnnbL Ropd
Box 21199 PERMIT NO.;
on, MN 55121 DA7E 11-1 7--PE?
n9. 1 No. of Unita: I
er. 3'ro: L ier *'i d?-e-t
Meter No.: Wfton Charge: 5[1C1 _ O!1PO
Size: 512 x .AGf.ouJlt.plw,S$: 15 f1n P_r1
Date of Insp.:
CITY OF EAGAN SEWER SERVlCE PERMIT
3630 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: ZoninD: - No. of Units: -
01M/M . ?'aCi::t?..•• „ .4i°`_
IIddR°SS:
$ite /lddress: `+ I 4 1 n1C ^ A r.
Plumber.
1 Nm h?sMlf? wllli !M CRT o1 imNs Cornedlon Charpr
OriiMSeM. AcaounR Depodt: ilct-x'
Permit FN:
Surdhorps: 5 n,.rr?
BY MisC. Gorpm
Dote of Irop.: TaM:
Ir+sP.: Datr PoM:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pllot Knob Roed •
P.O. Box 21199 PERMIT NO.:
Esgan, MN 55121 .1 °17 -`"?
DATE ]
Zonirl: '? 1 I
No. of Unfts:
Frontier Midrres[
Own
r -
.._
e
Address:
SiteAddess: 4797 Pichard Lane L27 n1 l'illcrest
Plumber. ?tirr Plungbin
Meter No.: Connec6on Charge: `•01- ?0pd----
Size: Account Deposit: 1.5-ooFd--
Reader No.: Permit Fee: 10 _ b?e d
I agree to comply wRh the CFIy of Eayan Surcharge: - 5??----
'
Ordinances. Mpd TP
Misc. Charges: 156_ i
Totai:
gy Date Pald:-
Date of Insp.: Insp.:
• . CASH RECEIPT •
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, M ESOTA 55122 -
DATE 19 ?
RECEIY (,`?J C?? ?
FROb_
AMOUNT
& DOLIA(i8
00
? CASH CHECK 1
White-Payers Copy
Yellow-Posting CoPY
Pink-File Coov
Thank You
a
N_ 68332
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121Np 12424
' ? ` PHONE: 454-5100 ?so 3
BUILDING PERMIT Receipt u
To6euaedfor SF DWG/GAR EatValue $144,000 pate AUGUST 12 ,1986
SiteAddress 4797 RICHARD LANE Erect ggx Occupancy R3
Lot 27 elock 1 Sec/Sub. HILLCREST Remodel ? Zoning Rl
Parcel No Repair ? Type of Const. yn
. Addition ? No. Stories
TIBERON INC Move ? Length 70
w Name
3908 SIBLEY MEM HWY Demolish ? Depth 67
o Address Int. Impr. 0 Sq. Ft
ciry EAGAN phone 454-6463 mstau ?
io Name_
? ¢ Address
Phone
1- ¢
Name PLANCO INC
w W
Address 3435 WASHINGTON DR
aw Ciry_EAGAN phone 452-0724
I hereby acknowledge that I have read this application and state that the
information is correct an agreg to ?eomplq?v?h all applicable State of
Minnesota Statutes n ty o fEagBq rdi an? s.
Signature of Permitte
A Building Permit is iss e to: TIBERON INC
all work shall be done in accordance with all aoolicable SOte of Minnesc
Assessment
Water & Sew.
Police
Fire _
Planner
Council
Bldg. Orr. 8/6/86
Var. Date 5/1 5/84
Permit $ 543.00
Surcharge 72 • 00
Plan Review 271.50
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63 . 50
RoadUnit 290.00
Tr. PI. 156.00
.,?0 0
Copies--a,. ?,4/1
on the express condition that
and Ciry of Eagan Ordinances.
8uilding Official
REQUEST FOR ELECTRICAL INSPECTION EB-00001-05
Ilt See instructions for compbtine this form on Eack ol Yellow coDV.
?-- c I Sr-y
/
C Q 7nQ ""X"' 8elow Work Covered by This Request l
MewlAAdl Heo.l Tvoe o1 Builtlinu I Aoolioneee WiuE I EquiVment Wired I
p Fea ServiceEntrenceSiae d Fee Fexders/SUbleeders % Fee Circuits
U to 200 Am s 0 to 30 qm s 0 to 0 Am s
3
Above 200 qmps 31 to 700 qmps 1 00 A
31t,
Swimmin Pool Above 100_Amps A6ave 700_Am s
Transtormers Irri ation Booms wdb Partial,'Other Fee
Signs Special inspection ?s
S TOTAL FEE ? ?'.
Nemarks
I1. the ElacVical
Insoector, hereby
certilV thet Ihe above
Final Date?j ins0ection has been
mede.
mh
This request void C S? Cr-J
18 months from ?
C 5 3 7 0 9`-_ C're S 1 L-
?uest 4ate ?
/ Fire No. Povgh-in Inspection
fleq red7
?ReadV Nuw? Will Nolil¢ InsDec-
? p es ?NO r When Neady
ensed Electncal Contractor 1 heroby request inspeclion ot e0ova
? ner elactrical work Installed at:
Street Add ss. Box or Route
/?/a? /
L Citv
D L G m
ecLOn o. Township Nam or No. Range No. Counry
OccuOnnt (PRiNT) Phone No.
'S-lr
Power $uDDlier
? AtlGrCSs
'
`
'
G
R? TM' G / FYYVVl!/I?
7?1?
Eqpum2t4&nttac o CorypanY Nem?I
? Comractor's Licen e No.
?yy?,?p,.r tE?rXrC ?OZIZ
Meilinp AtlJres`s ICOnVactor or Owner Ma in0 ?nstailatioN
Autho' ignaWra (COn w aking Inslallation) Phone Num¢¢r ?
7? /
MINNESOTA STATE BOAflD OF EIECiRICITV THIS INSPECTION NEQUEST WILL NOT
Grippa-MiAwey Bldp• - Room N•191 BE ACCEPTED BV THE STA7E BOAND
7871 Univereitv Ave.. St. Vaul. MN 65700 l/NLE55 PflOPER INSPECTION FEE IS
Phone16721642-0800 ENCLOSED.
116
?
1986 HQILDING PERlIIT APPLICATION -
NOTE: ALL COHTAACTOHS MQST HE LICSNSED AITH TH6 CITY OF EAGA6
COmmnCIAL SINGLS FAFIILY Diiffi.LINGS
INCLUDE 2 SETS OF ARCHITECTIIRAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 7 SET OF 1 SET OF ENEAGY CALCULATIONS
ENEHGY CALCULATZONSJ
$2,000 LANDSCAPE BOND
/4VD6)C7
To Be Used For: Valuation: :2 Date:
Site 9ddress Z{J 97 A-1c?iAA1 Zane OFFICB QSE ONI.Y
Lot ? Bloek Erect Occupaney _g3
Remodel Zoning 7
Parcel/Sub '/ /?,1/cr- "T 4*1W,7'ia.r Repair _ Type of Const ?
? Addition 6 of Stories
Owner Jp//y ? (V?a,e,p,FjyA Move _ Length
Demolish Depth 6:;;z
Address n 7/k ?j4?jqtQ ?4vf Int.Impr. _ Sq Ft
n install
City/Zip Code CT, f".R?1 ly//t S13NZ ----------°---°------------------
Phone 2 qa-O4F/.2 4SV - O Y33 APPROVALS FfiSS
Contractor 7"..(.tr,?.r . fHc
Address 3%y lj?ev
City/Zip Code $'S12- 2
Phone `{??{-
Areh./Engr• P1'4r7c6 ? /nC,
Address 3V,3s- (,?,4Sh,^,yfpM le:^,v.c
City/Zip Code ?r4qq..v , Srl?-> Z
Phone 0
Assessments Permit 5y3
Water/Sewer Surcharge _70
Police Plan Review 27/, D
Fire SAC
Engr Water Conn 5
Planner Water Meter
Council
Hldg O£f ? Road Unit
Treatment P1
9PC Parks
Variance /S Copies
TOTAL
80TE: ADDHESSES FOR CORHSR LOTS - CONTBACTOR/HOMEOWNEF MU3T DFSIGNAYS Y9ICH
9DDRESS IS DFSIRED. NO CHANGES TdILt HE ALLOWED ONCS BDILDING PERMIT
IS ISSIIED.
z.a ?c z77 x
52 ?'
2? ZZ = ?/cj? ? Z=??
tz? 33 ; 7?iX SE5
io/x so?-
16 Z? ?s 7f
iVS 306,0 00
? . y
)wne r
INt1E50TA
BA
HOQE
E E:IERGY CD
rl.m Cff?.?1..._
ALCULATiON$
LTION ?
. ? ?7 / -z
•
. . .. . _......?.?/./?`/? .
Phone ?a
iite Address • . •
:antractor
luilding Classification: Type Al (5ingle Family S Ouplex)--74?_Typ
(Uther) • (Over ] stories),_
1'cNEiAI 1NFORMATiON
(. Bullding Perimeter 4A1e-G(,b,t /-trt, , ??. Wall height (ground to eave) ft. _ . ' •
2 -:.. '.
3. 1, x 2. (above) gross wall ?rgA. ?SDI • ft•
ne
e A2 (Resldentlal
(3 stories ar ess
a. Building dimensions (L) -?' x(H) ¦T ]? ft.Z roof S flaor aren
5. Square fcot aren of rim joist - flaor jalst size (2 x/b ?' ) -
2
'/bt x Perimete?DRt? q,st area ¦ Z ft
6. Doars - Area • • • ' • •' Th1c nesc]-s ? n. aetor -
' Type of Construct an . . Permeter ft. •
Hanufacturer
"7. Total door's perimeter ft ' • ' _ 8. Nindows: Manufact er GS/I1 "(r' State approved
U factor_ , r .
TYPE ' SIZE AR:A (fi.Z) t1U4BER OF TOTAL fE:T Z
EACH UNlTS
See- l.ri?X1,??1??- , •
g, Total ft.z Glass ?r'7? • ' . '
.
10'- Fireplace area: Nidth 'x heiah! ¦ - z ? Ft.2
11:Exposed foundatioo: Hetght x Perimeter ? 71 xZ9'7 ¦ :?,5 Ft.2
:)FIPLETIOH OF 7HiS FORM IS REQUIRED FOR'ALL t1EU COtISTRUCTION, MAJOR REIi00ELItIG AND BUILDiNGS BE
1)V:0 MI!ERE EkERGY. OTNER THI1V iHE MIN[MAL COOE AILOI•lAt1CE, IS USED. • •
. • :,. 2.Xio
. •?;r, `. ?
1iA1L
SEC?IOH
wALc. - Ni e.u- R
? SNERTN WG
u rNLU[ l.Nl,IULNIIUM
R-VALUE U VALUE
Intid• atr film ,68
LiCtarlac xall ?j ({7a11) U - ? .
Inaulation
Shea[hing ?,pp • b?f]
Siding
OutsLda alr film .17
a rorAL_ ??:,.q 7
S'ND
SECTION
2ND S7ALL
SLC?ION
Inslda air fllm .68
Inteciar' wall .'?
4" .cua R' 40M(o.5'0 (Framing) U . I '
Sheathing (P.qp
Slding )(01 .d6q
?
Ou[slde a!r film .17
B TOTAL 14, 47
Iasida air lllm R¦ .68
Ia[evloi xall
sulatlan
.
Extezior vall czavat ng
Ezterlar air Ellm' R ..
(Nall ) U • R .
z
8 TOTAL
• •lnterlor alr film Re .68
EIH ?
? I
-
? " Ineulation ( .p
p
IA
JOIST ?F..`-?, • 1? lneh eoEt xood R*1.88 (Rim U:
r , doist)
Sheathln$ oD"39
Lxterlor wall eoveting o(o'I -?
• Extarloe air fllm Re ,17
? B TOTAL Z8,Q-p '
Inteclor alt film R° .68
` Inaulatlon
' a foundatlon ?2 g (Fdn
) U R¦
? L? Extacior air film R¦ .17 .
. S TOTAL
:cposed 9luck
.
w,
?,'??
. CEILIJlr atTH 'lEilT"cU ATi IC SPACE ABOVE
'R ::+Lt2r '/ lUE
FAAM IttG CEILUIG .
0.61 Air Film 0.61
? iZ•OO Insulation 5L?C0
doist
•? Ceiling
: -
,• 0.61 Air F11m 0.61
Total R 5OA
?
U ¦ T . ,019
F!AT RGOF OR G,3TIiEDRAI. CEILiPIG
R Ya ue R 9AlUE
FRAI•UNG CEILING
0.61
.
'
4.17
Inslde air film 0•61
Ceiling
Joist (stud
Insulation
Air space
Roaf decking
Insulation
Built-up roof
Outside air film 0.17
Totnl
1 u U
R
R
lindow infiltration .5 cfm/11nea1 foat of craclc,
(esidential door lnfittration 0.5 cfm/squara foot ar daor and minimum code requirement
Icn-residential daar infiltration 11.0 cfr/lineal foot of crack
)b 12" concrete block no lnsulatlon - .47 R 1.1
)b 12" cancrete black insulated cores ¦.26 R 3.8
lb 12" 1lghtxeiaht black •.32 R 3.1
1h 12" 119htiaeight block insulated cores a .12 R 8.3
1 single glass a 1.13; with storm.window .54
1 dou6le glass ¦ .55
1 Erlple glass = .41
S11 exterior walls and ce111ngs must hnve a vapor barrier (0.10 perm msx.).
;apor barrier must be an the lnside (heated side) of t,all.
tapor barriers af the polyethelene thin film havit na R value. •
.I'2. .f:'aining 'area ¦ 10% af gross wall areei
13. 6ross wall area 3J?'? l ft.Z •
Hindow area A 1970 ft.2 U wladows U x A¦?
Rim jo1st area A 7??(Q ft.2 ' U rim Jctst U x
.(p
A-
Oaor arg
A ?? ft.2 U door area ¦ ' ?? U x A¦
?
{?
.Etaepiaea area A Z52 tt.z .
u fireptace •?_ u x
A• _L6,44
Exposed founda N on-A s ft.2 U foundatlon ¦ ??Z U x A¦
Framing area A ' -3?? Zoft.2 U framing area •, D U x A¦ '5
Net wall area A ft. U wall ¦ ? ? U x A¦ 3.DZ
(138)
TOTAL.. . . . . , . . . . U x ?.
A ¦ 7??pi
14. Gross wall area x 0.11 (A-1 single famlly S duplex ¦ allowable U x A/Code
(13. above)
• x 0.23
A-2 other resldentla l)
x .23 Other hu11d1ngz)
l
x .28 3 stortes)
Over '
BTUH Must
. A x U?4_g?.? ¦ OZ,?o ?. 138 6e larger 1
above
15. Ce111ng framing area (Af) equals• lOZ of ce111ng area ' (.or tha same as )
15A. Gross ce111ng area ¦(L} x (V) • 5? ft.Z
158 Joist area (Af) ¦ lOX ce111ng area ?
- P-)_ ft.2
?
2
15C. Net ceiling area (AC) (15A - 158j ft.
U ce111ng x A c¦ x ?? ¦ TiO??J
U framing x A f• x' Aeg - 313(,00
150. TOTAL U x A ................. ....... .. -3!• -/ /
16.
Ce111ng area (15A), x 0.026 (A=1 singlfl famlly 6 duplex - code allowable U x A
x 0.033 (A-2 other resldential)
x 0.06 (ather)
/,?7? /'? ? BaIIH Must be lar9er than 150 (abo?
A(15A) f cp7 x ll fcodel= ?T5i J5 F. (or the same as)
. ? bZlO
NOTE; Use U aad'A vaTues ahtalned from pps 1, 3 and 4.
.
?
M
.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
xwx x x xF__=x.== ...;x . _
*ATF: PAYMFTTP QF M AT TIIE OF
APPLIcATIoN DOEs NoT aorsriTUM
APPROVAL OF PIItMIT.
nvSPnc,'riort oF sEWEx arm/CR M'mi
INSTALLAlzors wtrL Nar BE scHgn-
UI.ID DNPIL PFRNIIT HAS BEIN
APPR(JVID.
1) PROPERTY ADDRESS: ?j -
LEGAL DESCRIPTION: -4e`J`' 4
Lot B ck Subdivision or Tax Parce ID
If' E7QSTING SIROCILTRE, DATE OF OI2IGINAL B[IILDIIdG PERMIT ISSCAP]CE: " -
? -
P12FSIINr ZONING/PROPQSID LSE: Nbn eaz1
[l CU+MERCIAL/REPAIL/OFFICE
r7 INIDCSTRIAL
n INSTITOTIONAL/GOVEW1ENp
3329
2) ?
NAME: FRONTIER MIDWEST HOMES CORPORATION
ADDRFSS: 3908 Sibley Memorial Highway Bldg. E
CITY, STATE, ZIP: Eagan, MN. 55122
PHONE: 454-0433
3)
i
• u ?: ?• NAME: STAR PLUMBING
ADDRFSS; 1018 Mound Springs Terrace
CITY. STATE, ZIP: Bloomington, MN. 55420
PHONE: 884-4149 MASTER LICE[1SE#
4) o-m • i3-
idA.^E:
ADDRFSS:
CITY. STATE. ZIP:
PHONE:
Active
Expired
Not recorded
Sta Irutial
? R-1 SINGLE FAMILY '
Q F-2 DL?PLEX (itvv Units)
? R-3 1UWMOL?SE (Three + Units) ( Cfiits)
? R-4 APARTTENT/CONIDOMIPIIUNl Units)
2
"rj? 1 ?l Y• M' • 9' : 9 • ? ' ?i . .
Q COPSIDCTION TO CITY SEWII2 ? CpDSIDC,TION 10 CITY WATER OTHID2
6) ?? M'• r ? PL£ASE HOID APPROVFD PEEtMIT FC)R PICK-L?P BY ONE OF ABOVE
[] PLEASE MAIL APpROVID PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
7) r7 u• ???? ? l/- / 3-
/
. FOR -CITY USE ONLY
PERMIT # ISSDED
zi3
Pd w/Bldg. Permit FEES:
$ $ ?v •5-b SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLLTDE SURCHARGE)
?
$ ?- S? $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ / S'0-6 ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ Gi?6 - 4 77 $ WAC
$
eS 75 % D1
$
sac
$_ $ TRUNK WATER ASSESSMENT
$ $ TRLNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRDNK WATER
s_ $ WATER TREATMENT PLANT SLRCAARGE
$ $ OTHER:
S / Z tci' S O $ lj ?C/ D TOTAL
. ?.S50
RECEIPT • REC PT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSDED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SDBJECT TO THE FOLLOWZNG CONDITIONS:
APPROVED BY:
ti TITLE:
DATE :
SIGMA House Certificate For:
8UAVEYINO
SEFIVICEB Mr. JOHN
3908 Sibley Memorial Highway PARRANTO
Eagan, Minnesota 55722
Phone: (612) 452-3077
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_PAOPERTY DE5ICRIPrICN-
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accorrlirg to the reccrded plat theroof,
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PROPOSfO 6ARA6E fL00R ELEVATION= )00'l D
PFdOPOSED Top of Block ELEVATlON= IpU8,0
PROPOSED BASEMENT FLOOR ELEVAi1ON= G99,0
NOTE: Verify all floor heights with Final House Plans.
suMrarts cEwrrFrcaricw-
! hereby certify that this survey, plan or repa'1
was prepered by me a' u'der my d i rec t wpervis i on
arrl iMt I am a duly Regisfered Lard Surveyor
r the laws of ths Sfete of Ilimesota.
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--o.te: ???
Wayre D. Cordes, Yinn. Reg. No. 14575
Use BLUE or BLACK Ink
r________________�
i For Office Use i
Cl�t f c� c�n � Permit#: '/p�S�/V I
bY Ol �Cl�Clll ; . ,: r �-� �
�ermit Fee. �- i
3830 Pilot Knob Road � I
Eagan MN 55122 � Date Received: l I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 � Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �' �'7` Site Address: � `� `�'1 �f C�A �"� L��� Unit#:
� Name: � o v� ���l � Phone: ��� ' � �'�� 5��/�l �
Residenfi! / . l
Owner Address I City I Zip: � 7 `� 7 �� ��y,��� L. 1v
Applicant is: �Owner Contractor
Type of Work Description of work: r'C '� K���
Construction Cost: �G�, � C� C7 Multi-Family Building: (Yes /No
Company: I � � Ti� t2�� �`,v�a � �X��--r C3���. Contact: �.J G' �� r"�
c1 l�ti��-� ,� - �
Contractor Address: � � I 7 .�' � City: � ,4qA-�
State:,��Zip: .S�S 12 � Phone:C��Z S�J���ol Email:,�� �r+'i�^1('da�CpzvlCi9Sf • nF �
/� � �
License#:[��(p ����{S; Lead Certificate#: �
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) �
I'—��vi��. �v_' � � (� � � �� �
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City ot 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:
,
t
Mechanical Contractor: Phone: �
Sewer&Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of �
fhe information may be classified as non-public if you provide specific'reasons that would permit the City to °
conclude thaf 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.aopherstateonecall.ora
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. I
Exterior work authorized by a building permit issued in accordance with the Minne ta State uilding e must be completed within 180 I
days of permit issua e. I
x �� �� ������ X �
ApplicanYs Printed Name App ' nYs Signature
Page 1 of 3