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4855 Richard Lane• T BUILDfNG PERMIT To be used tor I?BCK ..- CITY OF EAGAN f+a 18Z33 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # Est. Value Site Address "53 RICHMW LN Lot lg Block 1 SeciSub. gI1.1.CREST OFFICE USE ONLY PSfCBI N0. Occupancy - FEFS Zoning W Name `lE" d' LARa ? (Actual) Consl Bidg. Permit Zs?? Address 48SS RICliARD UI (Albwable) - - o City ?? Phone 6$"51 S # or stories Surcharge 213" Plan Review Lenglh o Name SA'? Deplh ? SAC Cit , y ?¢ Address snc, Mcwcc ? City Phone S.F. Footprints - Water Conn r On Site Sewage _ W W Name On Site Well yV M t t - er er a e i Z Addf@SS MWCG System _ a W CitY PhOne City Water _ Acct. Deposit PRV Required _ S11N Permit I hereby acknowlege that I have read this application and state that the Booster Pump - grW Surcharge information is correct and agree to comply with all applicable State ol Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee -! - •? / APPROVALS Road Unit A Building Permit is issued to: '?? ?R &Ma DM Pla""er - Park Ded. an the express condition that all work shall be done in accordance with all Council -- applicable State oi Minnesota Statutes and City of Eagan Ordinances. gldg, pff. _ Copies @jilding pfficial I ? Variance 25.50 _ TOTAL Permit No. Permk Holder Date Tetephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Raoling Rough Plbg. Rough Htg. Isul. Fiieplace Final Htg. Fnal Plbg. • Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Oeck Ftg. Deck Final weu Pr. Oisp. QUILDiNG PERMIT 1?7`? 9411 ? ? Receipt # L, ' Te N aud ier SF DWG/GAR Est Value $$2 i 040 pwe 'AUGUST 13 ly 84 SiteAddre?s 4855 RICHARD - Erect ?x Occupancy 123 Lot 1 Block S./Sub. 'MIM Remodel ? Zoning Parcel No. Repeir ? Type of Const. V Enlarge ? No. Stories W Name WM HUTTNER CONST Move ? l.ength bJL 960 WATERFORD DR W Demolish ? Depth 42 ? Address E GAN 452-308 8 Grade ? Sq. Ft. City Phone 9 Name S?r ?? Address Citv Name _ Address Phone I hereby acknowledge that I have read fhis opplication ond stote thet the inlormotion is torrect ond ogree to Comply with oll opplicoble Stota of Minnesota Stotutes and City oF Eagon Ordinances. Slynoturo of Permittea /1 Building Pertnit Is Issued to: WM oll work sholl be done in ac6ordanc4 Bulldirg pfficial -- - "?` CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199. Eagan, MN 55121 PHONE: 454-8100 Phone Approvals Fees Assessment Water & 5ew. Pol ice Fin En0• Planner Councii Bldg. Off. APC Var. Date 20' SFTBACK Permit • 00 SurcFarye 41 - OQ Plon check 189.50 SAC 525.00 Wnter Conn. 470.00 Woter Meter 63.00 Road Unit 260.00 Parks Total i - 0 t:01, c''.L on the expreff GwdiNor? Ihot bIp State of MinnesoM Statutes and City of Eapen Ordinances. PKmit No. Permit Holdw Dsu Plumbinq & S T- -40 oZ .3'37,3 H.V.A.C. `f O. 14 ? 4 Q IG m eiocmc Sohenar Inapection Date Insp. Other Footings Foundation ? Framiny > . ' Y1 Rou'ph P16y. Rough HVAC Inwtstion Final Plbq. Final HVAC ? F;nel os ? cwvoa. Water Dascribe Latation: Vlfall . Sewer Pr. Oisp. ' - INSPECTION REC4RD CITY OF EAGAN , PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 F i .; I ; , . , ''? j SITE ADDRESS: i„ f , , F, t 111F : , .: . . ,. . t 14AHto I nwE i . I , i , i PERMIT SUBTYPE: , , r plt . , APPLICANT: TYPE OF WORK: ? . ? . - '„; AN1O'I 1•J tk i I 1 Ha? I ON (cf r ?to I I I I Mi rtntIMM??,? ; INSPECTION .. . .. ? Ir) MR}tiiS: A SF.F'AfiAll: pVRqt ( 1'a i+f.t?ltlRf.fl FIiFt ANY 1`LllpltiNti (1R k l l I. IRXC.AI 4fl?fiF ? ? Permit No. Pertnlt HoIdK Dale Telephone 8 ELECTRIC PLUMBING ?/ 9(? (???-?1 PY/J HVAC inspectlon Daft Insp. Commenu FOOTINGS FOUND FRAMING h, /?7 ' ROOFING AOUGH PLUMBiNG ? PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLB?'a FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK Ff(3 DECK FINAL I R ? ?NN s CITY OF EAGAN addition HILLCRB.?'iT AL111ITION Remarks 1 Lot lg Ik 1 Parcel stre.t 4855 RIGHARD I.ANE state WAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 535 1985 2450.15 490.01 5 2450.15 C009626 10-10-84 STREET RESTOR. GRADING SAN SEW TRUNK 1976 183.0$ 12.21 iS 73.28 10-17-84 1985 4361.74 872.35 5 4361.74 C009626 10-10-84 *Services 1485 WATERMAIN *ATER LATERAL 1985 WATER AREA S? 1982 294.33 19.62 15 235.47 A014745 10-17-84 SEW TRK ?(cS 1984 804.56 160.91 5 643.65 A014745 10-17-84 ?A6TORM SEW LAT 1985 CURB & GUTTER SIDEWALK STREET LIGHT Road IInit #45423 8-13-84 WA7ER CONN. 470.00 " if BUILDING PER. It " SAC I' " PARK CITY Or- EAGAN WATER SERVICE PERMIT 38:su Pilot Knob Road P. O. Rax 21199 PERMIT NO.: Eagan, MN 55121 ' D^7E: ,. ZoninO: ?• No, of Units: Qwnsr, t - AddroSS: a s:?;y ;I ;: •,'ti? 3 ? \; ? t r r ite /lddressicfr,.- , t n 1 1 ,illcres:• Plumber: ? JKeter No.. Y O Connection Chorge: '! 3`j p C ??5iu• •r WwurM Deposit: i 7? Rea r No •- D y4 4 2.6D7 Pertnit Fee: 1sgew !o py wNk ebe ef Epr¦ Surchorge: Ordim Miac. Chorpes: - Totol: artu ho rn By Dote Paid: Date f Irap.: insp.: CITY OF EAGAN 3830 Pifot Knob Road SEWER SERVICE PERMIT 684I P. O. Box 21199 PERMIT NO.: Eagan, MN 55721 DATE: Zoninp: $1 -- - No. of Units: 1 pw,,e,; Wm H ttner Con mtviction ' Address: Site /lddress: ti Plumber: Star P c; 3/:?/F'4 +5423 100.00 pd IsyrM M eomply wilh !IN Cih? ef Eagsn Connectlon CFarpe: ?d3i? -- Ordine?, /looour?t Deposk: DtT pc' P.rmn Fee: 10.00 pe , Surchorye: ? gy Misc. Chorpes: Dote of Insp.: Totd: Insp.: Dah Poid: CITY OF EAGAN NO ? g233 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? PHONE:454-8100 MG BUILDING PERMIT ? Receipt # ?? 7o be used for DECK Est. Value $1, 000 Date AUG 7 , l9-9D- Site Address 4855 RICHARD LN Lo[ 19 Block 1 Sec/Sub. HILLCREST OFFICE uSE ONLY PBfC01 NO. Occupancy - FEES Zoning - w Name JEFF & BARB DUNN (ACtual) Const Bldg. Permit 25.00 o 4855 RICHARD LN (Albwa6la) - - 50 Surcharge . y EAGAN Phone 688-0515 City M of $IDries 2W4 Plan Review lengih F Name SAMF. DeOth 11d2 SAC Cit z a° a Address S.F. +Dter 4A , y ? SAC,MCWCC ? CISY Phone S.F. Footprints _ Wat r Conn On Site Sewage _ e • ?w Name on site weii - M l t W ?w er er a e x? AddfCSS MWCCSystem - ? AccL Deposil i City Phone City Wa1er _ W P PRV Required - ermit S/ I hereby acknowlege that I have read Ihis applicalion and state that the Booster Pump - S/w Surcharge information is correcl and agree to comply with all applicable Stale ol Minnesota Statutes and Ci[y ot Eaqan Ordinances. /1 Treatment PI ? Siqnature of Permitee ' ? 4R1)??! APPROVALS Road Unit A Builtling Permil is issued to: JEFF OR BARB DUNN Planner - park Ded. on the axpre5s condition thal all work shall be done in accordance with all Council applicable State of Minne s oia StaNtes and it C y of Eagan Ordinances. eldg. Orc Copies ? ? y j y ? BuildingOflicial L1H(T?(_?!J? Variance - 70TAL 25.50 r CITY OF EAGAN N? 9411 3830 Pilot Knob Road P 0 Box 21-199 Eagan MN 55121 PHONE:454-8100 BUILDING PERMIT ' Receivt # Te M urd fer SF DWG/GAR Est. Value +582,000 pate AUGUST 13 _ 19 84 SiteAddreas 4855 RICHARD LN Erect ? Occupancy R3 'I.ot 19 Block 1 Sec/Sub. HILLCREST Remodel ? Zoning -----RT- Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories W Name WM HUTTNER CONST nnove ? Lanyth 61- Address 960 WATERFORD DR W oemolish O Depth 42 ? Grade ? Sq. Ft. City EAGAN Phone 452-3088 o Name SAME ?? Address ? City Phone ta F. Name Z? Address ?w City Phone Avvrovals Feea Assessment _ Water $ Sew. Police - Fire Enp. Planner ? Council _ Permit ' • ' "" Surthurge 41 - 0Q Plan check 189.50 SAC 525.00 Water Conn. 470.00 WaterMeter 63.00 Rood Unit 260.00 Parks rotal 1,9 7.50 I hereby ockrowledge that I have recd this applicotion ond store thaf gldg. Off. fhe infarmafion is correcl and agree fo comply with oll applicoble AP? State of Minnewto Stotutes and City of Eagan Drdinoncez. Var. Date Sipnalure of PermiMee 20' SETBACK /1 Building Pertnit is issued to: Wri nu 1 i tvax l,vtvb1V on the express condition ihat oll work sholl ba done in orda w h all aD011 Sta-te of Mlnnewto Statufes ond Ciry of Eayon Ordinonces. Bulidinp Offtciol ?? _ , • ?II?Iq?CI ALL CONTRACTORS 90/, MUST BE LICENSED WITH THE CITY OF EAGAN To Be Used For: _ y Site Address: 4Y5'S jl,c%? Lh, Lot:/? B1ock:/ 5ect/Sub: Parcel #: Owner: Address: City/Zip Code: Phone #: Remodel: Zoning: }Z-? Repair: Type Of Const: Q' Enlarge: # Stories: Move: Length: (D? Demolish: _ Depth: 4Z Grade: Sq. Ft.: Contractor: 91, 4ay K-0 a *-, Address: %,) /L 1:0,WarJ Dr, llJ Assessments: Permit: 9.-? City/Zip Code: E ?4z U?w S-S/zZ Water/Sewer: Surcharge: 41.=° sc Police: Plan Rev.: so ? $91 Phone #: Z15-2 -30 Fire: SAC: 525" Engr.: Water Conn: ¢1o,m Arch./Eng: Planner: Water Meter (D3.0_i1 Address: Council: ? Road Unit: r ! 2(00.°° Bldg. Off.: . ?Parks: City/Zip Code: APC: i FTT- a7•$O Phone#: Var ance: 20' -'o'mp-t-K ' INCLUDE 0 SETS OF PLiNS., Q CERTIFICATES OF SURVEY Q SET OF ENERGY CALCULATIONS Valuation:_?s?o Date: $? 82,oa0. "° * ? ?? Erect: x Occupancy: ?-3 42x 2Co= 10?2 K 5¢ ? ?8??8 1? x 22 = Z?t? x s4 ? I 5444- ?ZZ x 2q- _ ?2? x 1 ? - 2-? ? I = 29 x g? 5 ?3?8 11 d? J---- o( 3C?8 ? s 31 0 9 '-' r . 0- 9 7004 - ?? ? Inspectlon fleqWred Ins eclbn Other Tha h-In Requs'?ale Fire No. ough-In mus pou call inspector when reatly) ? Reatly Now Will Notlty Inspemor ? ? Ves N. De?e Reetl I? licensed contracror ,Rowner hereby request inspection of above electrical work at: Jo0 AdGress (Strcet, Box or Route No.) Cily Section No. Township Name or No. flenge No. Cou?n\ry t Occupant (PRINT) Phone No. E?12 6;? Pawer Supplier AtlGress Elecltlral Cont2ctor (COmpany Name) ConVactors License No. ?? Ct tYl Cl- Mailing Atltlress (Contracror or Owner Making inslallalion) ?-s C-L k Yl Q_ AuNOr¢etl Signature (COnVacbdOwner Making Installation) Phone Number " , ) i?o-'1 ? MINNESO7A STATE BOARD F ELECTNICRY II THIS INSPECTION REOUEST WILL NOT GrIggsMidway 91tlg. - Room S12B II II I I I I I I II I I n I II BE ACCEPTED BV THE STATE BOAFD iBP1 UnlversLLy Ave., 51. Paul, MN 55106 II UNlESS PROPEfl INSPECTION FEE IS GMnn /R191 ftC9.ON0O . . FNC.I nRFn v' vv ' l t REQUEST FOR ELECTRICAL INSPECTION ? See instmclions for romyleling Ihis form on back of yellow copy. F¢ ea-aoooi-oe o^' . j f X" Below Work Covered by This Request ?,.. Ne Add Rep. Type of Building Appliances Wired Equipment Wired X Home Ranqe Temporary Service Duplex Water Heater Electric Heating Apt. 8uiltling Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Conhacror's Remarks: Compute lnspectron Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Am s 0 to 100 Amps Transformers Above 200_Amps Above 100 -Amps SI ns InspeaorsUSeonly: TOTAL Irrigation Booms ? O(?/ C C C I •_? ? Special Inspection Alarm/Communication EaD TNIS INSTALLA710N MAV BE ORDER ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. 1, the Electrical Inspector, hereby Rough-in- Date certify that the a6ove inspection has been made. Final ? Deu ? OFFICE USE ONLY TMS request vuitl 18 months from 1 r ? . 6 On 2004 RESIDENTIAL BUII.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NewConsWd'mnReauiremems RemodeVReaairReouirements . 910 An1 3 registered site surveys showirg sq. R ot lot, sq. fl. of house; and ?,II roofed areas 2 copies of plan Certof 5urveyReaJ _Y -N (200h maximum lot coverge allowed) 1 set of Eneyy Calculations for heated additions Tree Pres Plan Recd _,:.Y _, N, 2 copies ot plan showing beam & window sizas; poured found design, eic. 1 site survey for addNons & decks Tree Pres Reqwred ... .... _ Y _ N 1 set of Energy Calculations Addition - nrdkete if arsrle septic system Oo-site Septic System': .. _Y _ N 3 capies of Tree Preserva6on Plan N lot platled afler 7l1/93 Rim Joist Detail Options selection sheet (bldgs wBh 3 or less unils Date / / Site Address 1? / ?o`7 j 55 Jc /C?/?/?) E172 A?-) Construction Cost r/`?w ! L? UniUSte # Description of Work l? )7,?Lc C ? Multi-FamilyBldg _ YKN Fireplace(s) _ 02 PropertyOwner ' `oo Telephone#(?O0) Contractor Adaress -- State - 3E?;D c•? - ?-h-?`? c ? ? city Zip.?Z Telephone # COMPLETE THIS AREA ONLY IF Energy Code Category - Min°esota Rules 7670 Cateeorv 1 . Residential Ventilation Category t Worksheet (J suhmission type) Submitted • Energy Envelope Calculations Su6mitted Have you previously constructed a building in Eagan with a similar plan? fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone #( N If so; 25% plan review I herehy apply for a Residential Building 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 State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the c se , T:ch requires a review and approval ofplans. w 1 0,-k ? _ A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submiked ApplicanYs Printed Name OFFICE USE ONLY Sub Types ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration O 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg) • Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units . Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinallC.O. _ Footings (deck) FinallNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fueplace _ R.I. Air Test Final Windows _ _ Insulation _ _ _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W,Permit & ,Surcharge Treatment Plant License Search Copies Other Total Building Inspector RESIDENTIAL BUILDINC PERMIT APPLICATION I??D_71 01 I CITY OF EAGAN 3830 PILOT NNOB RD, EAGAN MN 55122 651-681-4675 Naw Constructian Reouiraments . 3 registerea site surveys showing sq, R. of ;ot. sq. R. of house; and all roofed areas (20 % maximum bt coverage allowed) . 2 copies of pian showirq beam 8 vnndow sizes; aoured found design, etc.) . t set of Energy Cakulations . 3 copies of Tree Preservation Plan if lot platted afler 111193 . Rim Joist DeWd Options selection sheet (bldgs with 3 or less unils) DATE :2- 2 ' 6 -?_ SITE ADDRESS TYPE Of APPLICANT MULTI-FAMILYBLDG _Y _N FIREPLACE(5) _ 0 _ 1 _ 2 SiREET ADDRESS CITY STAiEqa9ZIP TELEPHONE yo?5? CELL HONE #6'/o2-?S-`?i- 19 /2 FAX # PROPERTY OWNER TELEPHONE # --------------------------------------------------------------------------- COMPLETE THIS SECTION fOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ ??INvF;SO'C:\ RGLES 7670 G\"C1:GORY 1 MIVNLSO"fA Ri "L1:S 7672 (v submission [ype) • Residential Ventilation Category 1 Worksheet Submitted . New Energy Code Worksheet Submittetl • Energy Envelope Calcula6ons Submitted Plumbing Contractor: Phone # Plumbing system includes: _ 'vVater SoFtener Iawn Sprinkler Fee: S90.00 Water Heater vo. oF R.I. Ba[hs No. of Baths Mechanical Confractor: Phone # AIC COflC11U0I11Rg Xll'Chi1ILCill SVtiICIII IIlCilldt5: rlC: 570.00 _ _ Heac Rccovcn 5ystcm ? Sewer/Water Contractor. Phone ? .I1I1 0 9 2002 ------------------------- ---------------------------------------------------------------- i hereby acknowiedge ihat t have read this applicoTian, state that the information is correct, d agree to co ply wiih all applicable State of Minnesota Statutes and City of Eagan Ordinon p` Slgnature of Applicanf OFFICE USE ONLY ? Rertwdsl(Reoair Reouirements • 2 copies of plan • 1 set of Energy Calculations for heatea additions • 7 sde survey `or exterar addi6ons 8 decks . Indicate if hcme servea by septic system for additions VALUATION Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex 0 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.) ? 33 Ext Ait - SF ? 04 02-plex ? 10 08-plex ? 18 Oeck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 tp-plex ? 19 Lower Level 17 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED IN SPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings(deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ F inal _ Pool _ Ftps ? Air/Gas Tests _ Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ _ Final _ _ Windows (new/replacemenq _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: Ckszz.qj? BUILDING 026963 01/18/96 SITE ADDRESS: P.I.N.: 10-32975-190-01 4855 RICHARD LANE Lp7: 19 BLOCK: 1 HILLCREST DESCRIPTION: (BEOR00M/BATHROOM) Building Permit Type SF (MISC.) Ouiiding 416,r„,{c Type AL7ERATIpN ""'Cettsus Gdtlt 434 ALT. RESIDENTIAL ?• 4 - r G .. F...? ? 4 4..b C e ??IlNtk? 2t` ? i t Y C?t4 fil?d '",v REMARKS: A SEPflRATE PERMIT IS REQUZRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $99.75 ....$.2.50 $1@2.25 $5,000 CONTRACTOR: OWNER: - Applicant - MOON ANDREW 4855 RICHARD LN EAGAN MN 55122 (612)681-0867 I hereby acknawledge that I have read this egpLicat3on and staCe that thR information3s cQrrect andagreeto cnmp1,Y taith all applicable 3tate «f 44n.. ' StatuLdS and C3ty of Eagatr Ordinances«- ???.??k I rn?_? APPLICANTlPEFMITEE SIGNATURE IS UED BY: SIG URE r INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITEADDRESS: P•x•N.: 1e-32975-190-01 LOT: 19 BLOCK: 4855 RICHARD LANE HILLCREST PERMIT SUBTYPE: SF (MI5C.) APPLICANT: 1 MOON (612) 681-0867 TYPE OF WORK: DESCRIPTIpN BUILOING 026963 01/18/96 ANDREW ALTERATION (BEDROOMJBATHROQM) INSPECTION FRAMING .. . ROUGH IN PLBG D. ROUGH IN WTG FINAL REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WtlRK , -,- - T =- -'-- - - - , - --- - +t .r u I , . ' . ? . i , . , .'(Form Dcvcloped by thc 5[atc of ?iinnesota i.uiluiiig Godc D1vision) ^. • TO EE SIIB?tITTcD NITIt IIUILAIIIC PETURT AS'PLICATIOy EXTEP.IOR E:7VF:LOPE AVERAC,E "U" C(1`lPUTAtION I Oi,':7ER: SZTE ADDRESS: qe5S /Pl ? ? a?? ? vt , CONTRACfOR: /Jti?NG' C,o-roST _ DATE:?-?- P}IONE: HSZ-308`P` Detezmine working equare footage of each 1. Total exposed wall area......... i%?2C7 sq.ft. x ,/'?. ?.?ZOp1. Z= `? -\2. Total zoof/eeiling area..,....... sq.ft. Y. Oz? ? 36.s ?: 3.• Total exposed wall area ealculationas Total exposed va21 area abwe floos ? ?6 77; ' a. Total wall vindow'area' ............................ ...?:' ..- b:" Total door area ......................... .......... c. Total sliding glass door area ..:.................... -?d- '• = d. 2ota1 fireplaca wall area.:......................... ?' . ' G• TOt81 wall framing area (average 1O.Z) .r.r...???????• 0 ,.. fa Total net wall area above floor..................... g. Total riri joist area ........ .....:.................. ? • Total exposed foundation area ....?_ ` I b. Total foundatian vindov area ..................... i: Total net foundation area above grade................ :/;_ Determine "U" value of each wall segment .,' ' '• . , D, 7 • ? .•?. ,. . ' a. I L7 R. $@Uu "Z// z b. x svn , 31 ?b ., X .?Ull , • C. _ d . x uun • :1 ?n x $fu,l z - . e. . f. X ,fU° ,. o ? . ;y5 9 2. 9• ? x !'u.. . ,.n? . .. h. 3 F Rstuh , 5(1 • :. 138. x slu„ 13, 8'° 3. Torat If item 03 is the sama as, or less than item 91, you havo met the intent of ?. ? ' . . .. . , ? 1 4. To[al ex,osed roof/ceiling ealculations: Total exposed roof/ceiling area 51p ).-Tatal skylight area ................................... - k. Total roof/ceiling fzuming area (averuPe lOx)......... 1'90 1. ?atal net insulated roof/ceiling area.....:.......:...; !z (1 CP Detesmine "II" value for each roof/ceiling segment . x nIIn _ ? - x IluN 1. x,o„s. ?;;0 Z• . ? z?; 3'? ? - 4. -Toxas. V?" - If total of 64 is the same as, or•l.ess than 02? you ltave net the intcnt --'. of SSC 6006(c)1.. ? .. ' Alte:nate Building Fnvelope Desiga. ' ,.?_ .. .:. .. , . _, To utilize the total envelope sys[em method. the values establisbed by •' the sum of Stems 03 and d4 shall not be greater than the sum.of items 91 . and 02. . + 2. ? 3. - + 4. ? • . , . . ?. C E R T I F I C A T I O N I hereby certify that I have caleulated the "U" factors and R.values . herein and that the buildinp, here descsibed meeta oi exceeds the SCaCe bf • Hinnesota Energy Conservation Act. • • • ^ ?? ????? .---. ?. (Signature). . (Aate) ' . ' ?. ILLqL.3 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 41 10 1. 15 Cu_;Y ;d f-frr ? 3 regiaterod aita aurveys ? 2 copias M plan ? 2 wpies of plana (fndude beam & wintlow saes; poured fid. design; etcJ ? 2 site aurveys (exlerbr additions 8 dedcs) ? 1 enerpy calaletiom ? t enargy ealculations for heated additians ? 3 copies o} Lee proaervation plen if bt plaued aftar 711193 requiied: _ Yes _ No DATE: I - °> -9 6 CONSTRUCTION COST: 4300c) DESCRIPTION OF WORK: - ?G MO C e E, rD fZoo /n A, 71 P-O a t\`\ STREETADDRESS: /??5:? Rf G(*A'!2f) l N MM LOT IQ BLOCK I_ SUBD./P.I.D. #: PROPERTY Name: MG ON NQD(ZL-?V Phone #: G 12-Eg? -c??? OWNER ?* M•* StreetAddress* RI6-11119-6 Liv City: 0:? G? State: ?ln/?f Zip: Zz- CoNrw?CTOR Company: Phone #: Street Address: License #• City: State: Zip- ARCHITECTI Company: Phone #' ENGINEER Name: Registration #' Street Address• City: State: Zip• Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once pertnit is issued. I hereby acknowledge that I have read this appiication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 0-ov,, OFFICE USE ONLY Certifificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No ? ?????E] D ---- -------- .i A N 1 0 1996 OFFICE USE ONLY ??. BUILDING PERMIT TYPE _. , a 01 Foundation a 06 Duplex o 11 Apt./Lodging o 16 Basement Finish 0 02 SF Dwelling ? 07 4plex o 12 Multi RepaiNRem. ? 17 Swim Pool 0 03 SF Addition o 08 8-piex o 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch a 09 12-plex o 14 Fireplace ? 21 Miscelianeous z-?05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE 0 31 New ?33 Alterations o 36 Move 0 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actuai) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinkiered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. =7 Depth Footprint sq. ft. SAC Code I i Census Bldg i Census Unit o APPROVALS Pianning Permit Fee Surcharge Plan Review License MCNVS SAC ciry saC Water Conn. Water Meter Acct. Deposit S/W PermR 5/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: _ Engineering Variance Valuation: $ S a e o l Buifding % SAC SAC Units `CorCi(i.c:?te for: .76/67 Wi1Li.am HuLLner Cnnst. Co. I3Ic DELMAR H. SCHW+ANZ LFIVDSVRVEVORS, i&x, qe9isteretl UnOer Laws of The Stale ot Minnesola 2978 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769 SURVEVOR'S CEATIFICATE Scale: 1 inch = 30 feet ? Dcnotes set woud liub Q DenoL2s iron monument /cC'iti DenoCCS exi.sti.ng elevati-on -?, ?-jDenotes proposed elevation Proynscd garagc fl.oor eteration /4r0 fo?J?vi T?p(?Fd' .-l ? ?'l-,r?? ?ct'3 i, ,6 ?nn! ! • f ??f , ?f- ? n Z? ?. ` . 1 ?prainage and l'ti L ?_???o'%? ' ? >> ?• ity eziscmenC t ???' s, , , s: ;Z1 ? i' . ?. • , ??+F ?' ? ? ?? ? ,;,y.F , ? .. ?. ? ., ?- ? .r".. ? Z. ' ,q9 7 heroby certiCy Chat Chi.s is a true and corroct ropresentntion oC LoL 19, f3lock L, H]I.LCREST AD?I1'ION, accordi.ng Lo the recurded plat thereo[, DakoCa County, MimicsoCa. Alsu showing the locati.on of a proposed house as slakcd ChereoCi. Auhusc 6, 7984. !'1/JAY 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERG] CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED, NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For Site Address One . Valuation: ?DC'O ? Date: /3/C/&Yd zghc I OFFICE USE ONLY Lot lq Block _I Parcel/Sub A Oumer (iQ-M q ol''b I)Lp q Address IY955 /5 ckld zople City/Zip Code Arw/, , M/Y { jJfp?a ?-T Phone Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # FEES Occupancy Zoning Actual Const Bldg. Permit Allowable Surcharge # of stories Plan Review Length I ! SAC, City Depth 15 X/ 2 SAC, MWCC S.F. Total Water Conn Footprint S.F. Water Meter Acct. Deposit On site sewage_ S"/W Permit On site well _ S/W Surcharge MWCC System _ Treatment P1. City water _ Road Unit PRV _ Park Ded. Booster Pump _ Copies SUBTOTAL APPROVALS Penalty Planner _ TOTAL A..,, r Council Bldg. Off. (p Variance ,. , . ; . . , ?.; _. : . . . C0.1Cificate: foi-: .. ? ldillidm HuCtner-.ConsC. ?Co. ?k.7h/51 DELMAR `W SCH1NANZ j LANDSURV?EYORS, ?L?L, ? - - , . . . Re9istored Unaer Lawz of The State OI MinnasOta . . . ' - . 2978 - 145T4 S7REET W. - 80X M? ? ROSEMOUNT, MINNESOTA 55068 ' PHONE 612 423-1769 _. ' + SURVEYOR'S CERTIFICATE Scale: l. i.ncYi = 30 feet . 'A? ,.? p DenoCes sel'?wood huU . . .. ?`°.. ?' p DenoLes ironmonument? . . , ?„wa ? /=.v'%&Denotes exi_sting elevation .?\ ., ? ?DenoYes-proposed e7.evation Proposrd garaF;e floor.elevation---1?y_O "rc 096088. . ? .. . . . .. F,?._'v?. c,c?l.i3 \ 1061l-, ? . . . . . ? l ??-' Gl-y n.' . . ? ? _.._.?•--- qT .. ?I . _._- _.-- ?.__ .• "'.' __.?- ?l?, `. ? 1 ?o. _ . , ,. ' .?`? ? . ' /??ji?/ . }/? ' . . ? ??. _S'• .. ?? . . . ? ? \?`-Draina>e and 'JL'elity o,asen:ent ? .- ' .`, v \_) ? . . ?,'>' . . .?.... .. __ ----_.. __ . . _. ^, `., . , . ? .. . ...,?. . . . . ? ` _.. Z y'g? Nou$e `' I +r ? ' / .5•7 ? ? ' . _ .' . -r"•?.1?.- /;???'??? ` ? . . L r J '-- ??-' ? ? ' ? , . ? ?'' . .. ' . • . 1 lier.ebvi cerCi.f.y L- hat: thi.s i.s:l?i.rue and correcC represenP.ation nC L'ot 19, . ? - ? P1oc{c l, }3ZLLCREST AllD7'f7.0id, accoi'di.ng Co che recordad pl.i[ thereoL, Dakota ? ?. . . . CounCy, MinnesuCa. ? ? . ? . ? ... . . . -?Also showi.ng the locati.om of a proposed house as staicc:d tiieri`r ir'. ?. . . August 6, 1984. \ . \ . . , . . . . ., . -_ r j" ; - . . _ . - . . j ' , . • ;rt_nriesota 7leg. No. 862S , ? . . .. MEMO TO: RICHARD M HEFTI, ASSISTANT CITY ENGINEER FROM: THOMAS A COLBERT, DIRECTOR OF POBLIC WORKS DATE: MARCH 12, 1984 SLSJECT: MINIMLM SETBACKS - FRONT YARD VARIANCES At the March 6 Council meeting, the City Council auttorized a blanket easement for front yard setbacks for Lots"'`13-2Q?{ ock,? =1;? of the Hillcies€=;Addi`€ion ?subject to approval by''the Chief 'Building Offic'ial,'-Dale Peterson. In order to assist Dale in determining the minimum setback that can be approved due to topography, trees, etc., I would like to have you evaluate certain engineering limitations that should be taken into consideration as follows: 1. Reduced Right-of-Way/BOUlevard Widths There are certain areas where our right-of-way widths are being reduced from the previous standard of 60 ft. to the 50 ft. minimum. This reduces the boulevard widths from 13 ft. to 8 ft. This 5 ft. reduction should be taken into consideration when evaluating a variance to the front yard setback requirement in order to maintain adequate off-street parking in front of the garage without creating a potential vehicle obstruction for snow removal equipment. The previous 60 ft. minimum right-of-way with a 13 ft. boulevard provided for a 43 ft. setback from face of garage to edge of curb. This was more than adequate to provide for two off-street parking spaces (front to back) without encroaching in the public travelled roadway. In addition, on collector streets where there are sidewalk/ trailways, the boulevard area is not available for off-street parking due to the conflict with the sidewalk/trailways. Therefore, additional consideration should be taken in to maintaining adequate setback distances to provide the off- street parking needs. I believe this is why there is a greater setback required for property adjacent to collector streets (40 ft.) than minor residential streets. Because our major concerns pertain to off-street parking storage distance, our setback concerns should be addressed to the location of the qaraqe. 2. Driveway Slopes Many times, variances are requested due to severe topography. In these instances, the topography creates a similar problem for access into the property when the lateral distance is diminished but the elevation is not, creating greater slopes. Therefore, please establish an acceptable guideline/formula that can be used in evaluating requests. This should be based on the gutter elevation or sidewalk/trail as may be THOMAS A. COLBERT/RICHARD M. HEFTI March 12, 1984 Page 2 appropriate. The maximum driveway slope at any one point should be no greater than 14-16 percent with appropriate vertical curve transitions to prevent "bottoming-out". If you have any questions as to the intent of these design stan- dards, please review them with me during your preparation process. In addition, if you can think of any other major concerns that should be addressed by the Engineering Division, please mention them for further discussion. Director of Public Works cc: Dale Peterson, Chief Building Inspector Dale Runkle, City Planner TAC/jj/kf A 4• CITY USE ONLY r L BL ? RECEIPT #: J 5J SUBD. ,di!iV_4j DATE: 1996 PLUMB(NG PERMIT (RESIDENTiAL) CITY OF EAGAM 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please compiete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH NQ. TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 :c = Laundry Tray 3.00 ;c = Hot Tub/Spa 3.00 :c = Water Heater 3.00 :c = Floor Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 ;c = Rough Openings 1.50 x = Water Softener 5.00 x = Privafe Disposaf ' Dakota Cty. ficense 65.00 = (new and refurbished systems) U.G. Spflnkler' home under const. 3.00 = Alterations ' to existing 20.00 = 2D J Water Turn Around 20.00 STATE SURCHARGE .50 TaTAL 2O t?_U 51TE ADDRESS• 4' OWNER NAME: A - C. MbOl?l INSTALLER NAME.-? - C-Mdot-i STREET ADDRESS:- y' CITY: k?_A Cr-Aj STATE: Vw ZIP: Z2- PHONE #: ( 6 f z Kf - v ?- 6 -4 ?r , ?-'V U \ ,b11Y? • WG1TA OFFICE USE ONLY L BL SUBD. 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 P4ease complete for. • aN commerciaUindustrial buifdings. ? multi-family buildings when separate permits are Qpt required for each dwelling unit. DATE: WORK TYPE: _ NEW CONSTRUCTION DESCRIPTION OF WORK CONTRACT PRICE: ADD ON REPAIR IS WATER METER REQUIRED9 _ YES _ NO. IF SO, PLE4SE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS 70 BE INSTALLED? _ YES _ NO. FAILURE TQ PROVIDE THIS INFORMATION WIIL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALIING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 _ YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINF:LER PERMIT. FEE: $25.00 minimum fee or 1% ot contract price, whichever is greater. State surcharge of $.50 per $1,000 of oermit fee due on ali permits. CONTRACT PRICE x 1% STATE SURCHARGE TQTAI SITE ADDRESS: TENANT NAME: OUVNER NAME: INSTALLER: _ ADpRESS: _ ciTr: PHONE #: SIGNATURE: OFFICE USE ONLY RECEIPT #: DATE' STE. # STATE: ZIP: APPLICANT METER SIZE: DATE: INSPECTOR: CITY USE ONLY LOT I ct BL pERMIT #: SUSD. \A-\ k ` RECEIPT #: - Replacement _ Other RECEIPT DATE: ( _?-- U V 2000 MECHANICAL P£liMTf (RESIDEN17AL) crrY of Ensnx S$SO PILOT HNOB RD f.!?6AN MN 55122 651-681-4675 Date• Complete this section onlv if you are installing HVAC in a single-famiiy dweliing, townhome or condo under construction and aot owuer; oecunied. • HVAC: 0-100 M B T U ADDi"TTONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 State Surchazge .50 Total $ Complete this section m:lv if you are remodeline, arfding to, or renfacins an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or replacement. 'y New _ Furnace Air exchanger Reminder: Call for final inspection. SITE ADDRESS: OWNER NAME: ll[ INSTALLERNAM-E; ? atAMn AnD MEkA''i0l!'? f.!7 CO" STREET ADDRESS: etot'?r<3L'.:C?? CITY: Air conditioniLng / • ? Other ?514 (( GrS f ! 1'lAi `? G Wc?r Fee $ 30.00 State 5urchazge _?,50 Total $ 30.50 ? ?-------..> q'-f 09 0 PHONE #: ?<:;I ( .;' ?'I - O (AREA CODE) PHONE #: (AREA CODE) STATE: L BL SUBD. APPROVED BY: INSPECTOR PERMIT #: RECEIPT#: RECEIPT DATE: 2000 hiECHANICAL PEfiMI'f (COMhtERCLkL) CITY OF £A6M 3$30 PILOT KNOB f;D EAs.", MN 55122 651-6$7-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: WORK T7'PE: _ New consffuction _ Install U.G. Tank _ Interior Improvement _ Remove U.G. Tank ? Processed Piping Wlien installing/removing underground tank, cal! 651-681-4675 for inspection by fire marshal and ptumbing inspector. Description of work: Fees_ 1% of conhact price OR $30.00 minimum fee, whichever is grcater. Underground tank removaVinstallation = minimum fee Contract price: $ x 1%_$ (Base Fee) State surcharge calculate at $.50 Eor each $1,000 Base Fee TOTAL $ SITE ADDRESS: OWNER NAME: PHONE #: - (AREA CODE) TENANT NAME (IMPROj'EMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: CITY USE ONLY PHONE#: - „(ARFA CODE) STATE: ZIP: SIGNAT'[JRE OF PERMITTEE City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: RECEIVED SEP 302010 Use BLUE or BLACK Ink Permit #: Permit Fee: 00 Date Received: Staff: 2010 MECHANICAL PERMIT APPLICATION (C) Site Address: Tenant: 1 11 tlA 1 l (+ 1CrT Name: A-) °- LOr L J V t.{% PhoneOj I - kT3q9 RESIDENT / OWNER Suite #: -J Address / City / Zip: CONTRACTOR BURNSVILLE HEATING & A/C, INC r L Name: License #: 1 1( ' E 7/- u vi Address: Suite 120 City: State:urnsville, MN 55337 �--�, ( / p: Phone: �� L`{, cDos— Contact: ` Email: TYPE OF WORK New xr Replacement Additional Alteration Demolition la/jj-,�„�� Ye i ll(r' rliusL Description of work: PERMIT TYPE RESIDENTIAL Furnace Air Conditioner Air Exchanger _ Heat P p Other 0_ectirgi COMMERCIAL New Construction Interior Improvement Install Piping _ Processed Gas Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace bumed out appliances, ductwork, etc.) (includes $.50 State Surcharge) t 00 TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1% $50.50 Minimum (includes State Surcharge) _ $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ TOTAL FEE 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.gopherstateonecalLora 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 th a approved plan in thecaseof work which requires a review and approval of plans. ex �l Dd JAS Applicant's Printed Name Applicant's Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA147924 Date Issued:02/20/2018 Permit Category:ePermit Site Address: 4855 Richard Lane Lot:19 Block: 1 Addition: Hillcrest PID:10-32975-01-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Andrew C Moon 4855 Richard Lane Eagan MN 55122 (651) 681-0867 Tri County Water Conditioning Inc 325 Third Ave NW P O Box 65 Huchinson MN 55350 (320) 587-2950 Applicant/Permitee: Signature Issued By: Signature