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3865 Dolomite DrCity of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 fririgE Permit #: L� C Permit Fee: Date ReceivtiG 24 2n09 Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: A ). 0 ° 9 Site Address: 4121 q /2 /I/ r L 'c. „s /,10 L S Tenant: c L' Sr NoL, Al Suite #: RESIDENT/OWNER Name: tie As See„}r.d../ Fi..)wa3C.4L "9 A.),t a Lps e-' Phone: 74, -Y9 /- 37x'2 Address / City / Zip: O. 0 ='K A S' S S /Z PIS 5 Y 1/ e Applicant is: Owner i< Contractor TYPE OF WORK Description of work: R e - (o , L d t L G Construction Cost: gi C'Gc- Multi -Family Building: (Yes X / No ) CONTRACTOR Name: q £ E x ,- LrZ,0 i2 /1l.•4 /”) 77". L'02 P. License #: XO 2 4'), 3 1 Address: `/L s'" (,. m 6c,' --c 57; City: /yl PLS , State: MAI Zip: 5S L// `% Phone: (>R- 8.6/- 6 217/ 3 Contact Person: b 44 N L 4 u Q 2,.3 COMPLETE Energy Code Category (4 submission type) In the last 12 months, has Yes If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 _ • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submitted the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of: the information may be classified as non-public if you provide specific reasons that would permit the City'to conclude that they are trade secrets ;�. _ 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 wor is not to sta out a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approv. of ans. x 1egc.'j b Y3iizai1 . Applicant's Printed Name x Applicant's Signature Page 1 of 3 r: SUB TYPES ❑ Foundation ❑ 05-piex ❑ Single Family ❑ 06-plex ❑ 01 of _ Plex ❑ 07-piex ❑ 02-Plex ❑ 08-piex O 03-Plex 0 10-piex ❑ 04-Plex 0 12-plex WORK TYPES ❑ New O Addition ❑ Alteration 1Q... Replacement DESCRIPTION: '/ Valuation 17( 0 0 Plan Review (25% 100% Census Code # of Units # of Buildings Type of Const. DO NOT WRITE BELOW THIS LINE ❑ 16-plex O Fireplace O Garage i* Deck O Lower Level ❑ Interior Improvement ❑ Move Building O Fire Repair ) Occupancy Code Edition Zoning Stories Square Feet Length Width O Accessory Building O Porch (3 -season) O Porch (4 -season) O Porch (screen/gazebo/pergola) O Storm Damage ❑ Miscellaneous ❑ Pool O Ext. Alt. — Multi ❑ Ext. Alt. — SF ❑ Multi Misc. O Siding ❑ Demolish Building* O Reroof 0 Demolish Interior ❑ Windows 0 Demolish Foundation ❑ Egress Window 0 Water Damage * Demolition (entire building) — give PCA handout to applicant Olio 200 7 REQUIRED INSPECTIONS Footings (new bldg) Sheetrock .7( Footings (deck) Final/C.O. Footings (addition) _ Final/No C.O. Foundation HVAC Drain Tile Other: MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Roof: _Ice & Water Final Pool: _Footings Air/Gas Tests _Final Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_ R.I. _Air Test _Final Windows Insulation Retaining Wall Reviewed By: , Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total 30 ( Page 2 of 3 .T lo.-dson Buiidera Inc. ♦= I. r- r1 5 /1 31K6 3e6ot �oloni i i --i F. C. 'JACKSON LAND SURVEYOR l% REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED IVY ORDINANCE OF CITY OF MINNEAPOLIS \` 721-3434 L� 3616 EAST 55TH STREET55417 c. .�:. /..c'T r ki y /e Y. (:).14-q. F-, r �t itiurbepor'g Certificate 1,( 1-1 Or.11270 183-71 /0 (D / 1 HEREBY CERTIFY THAT THE ABOVE IB A TRUE AND CORRECT' PLAT OF A SURVEY QF Lots 19,20,21 and 22,Block 1, Briar Hill 3rd. Addition, Dakota County,Minnesota. AS SURVEYED HY ME THIS 17th. Proposed Garage Floor Elev. 103.0 Proposed Basement Floor, Elev.103.37 Proposed First Floor Elev. 110.37' DAY OF August A D. 1981 SIGNED CITY Or EAGAN 3795 Pilot Knob Road PERMIT NO • Eagan, MN 55122 DATE. Zoning: No. of Units: Owner: Address. Site Address. Plumber. Meter No • Connection Charge• Size: Account Deposit• Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge• Ordinances. Misc. Charges. Total By � �/< Date Paid• Date of Insp.: 3 " Q 5 - r - Insp • WATER SERVICE PERMIT SEWER SERVICE PERMIT CITY OF EAGAN 1795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: I nsp.: Date Paid: 411/' City of Etat 3830 Pilot Knob Road Eagan MN 86122 Phone: (651) 675-5676 Fax: (651) 676.5694 • /i-•2- / Use BLUE or BLACK Ink 1 For °Moe Uae Permit*: I Permit Fee: (Q 00 Date Received: I a-1 a 113 Staff: Lie 2013 RESIDENTIAL BUILDING PERMIT APPLICATION • 3859, 3Sl(at1 ,3$G3, 1 Lr.,mrrL 62- Unita: a Residenti Dimer Name: c/o 4e i "1%44 6Z rt Z 47" ,.7.7a c_. Phone: 76 3 - S -I3 — 97 7 0 Address City / Zp: $So 6r corn) n) 2 4v, R) , 1 A Got. D E:1 1414.1 Y JFI SS' 4/.t7 Applicant is: Owner 2fContraCtor Typle.orvi rk ' Descrlpibn of work: Rs, -.-d 0 E. a. RE Pt. ott-f ' J• d / .•) b a F -ase..! 4 /h 8 rid L• Construction Cost: / y Y da • CIO Multi -Family Building: (Yes / No ___.) ConiratitorState: Company: 0 £) E,c r Cie, 02 19141 )'T - ev AA Contact b,4411 0 av/2-2L S Address: tip -r I•43 (ooh -!"- City: /21 PL 5 /490 Zip: 5"S'4// 9 Phone. (r,/ A- "0/-&21/3 Licensee: (- 2 Y/ / T / Lead Certlflcate #: If the project is exempt i)L4/0S. from Lead certification, please explain why: (see Page 3 for additional information) Q,,re.,.- Poe:' / S? r In the last 12 months, Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW VUILDING has the City of Eagan leeward a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: - Phone: Phone: NOTE: Tir �( �• CALL BEFORE YQU DIG, can Gopher state One Call at (651) 464.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive Locates of underground utilities. ww•mroherstateonecadorn 1 hereby edmowledge that alis information is complete and accurate; that the work will be in conformance with the ordinances and codas of the Cir of Eagan: t t I u the 8ppdp Ws Is p t anpermit, but e case twit wan pp1Lon far a permit, and work is not to start without a with: that the work wilt be in requires a review and approval of piens. Extortor work authorized by a building permit Issued in aocadsnee with the Minnesota State Sultding Code must be completed within 190 days of permit iesuence. x_§4.4 av,Q.,$ Applicant's Printed Name ZO/Z0 39tid INIvW 1X3 Iia Applicants Signature -779 Page 1d3 L9Z9I98ZI9 £6 :OT ETOZ/ZO/ZT 4111° C!tyofEaQaa 3830 Pilot Knob Road Eagan MN 56122 Phone: (661) 875-5875 Fax: (661) 675-5694 Use BLUE or BLACK Ink I. For Office Use Permit*: 16)(1 g5 asoma res: a� 7. Dale Res,eived: �7s l i c StafF 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: • F- c` site Address: 3VSq, 3g.J, 3 S1,3,3t6S IZSooLOo'TF 13IL. Unit 0: Name: d o ACT /4 i4. ) 4 6 L r►1 E N; �'a C Phone: 743 --s-f 3- 7 a Address / City / Zip: 'Sb 6 E G i4 r I i Q Av N / (.' KLF' Applicant is: Owner 2C, Contractor Description of woilc ..."7-£.14,2 OI a- a E - Construction Cost / / 9 CO 0!) Multi -Family Building: (Yes. / No _) Company: (iE 1 4. rc2ioR A'%iN • 6+214 Contact •knett,r d yv ft - r $ Ars SSYt 7 Address: 90 S cJ 6 City PL? state: ANZip: 3 9/ 9 phone: 'z - '6 J- G z ¥3 License #: Q C Pi)/ 3 / Laud Certificate #: lithe project is exempt from lead certification, please explain why: (see Page 3 for additional information) VS4 eaS 1.3 LI t.. RuIL: Posr J97 S' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit fora similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber Phone: Mllechanical Contractor. Phone: • Sewer & Water Contractor: Phone; "`1W it• .ty jk -:�1^Sf •Yµ.F.,�, 'ri ,�• t.. _ y, �C ALL Was you Intend to digto • Call Gopher State One Call at (651) 456.0002 for protection against utility dam receive locates of underground utilidea. ,www ooeheratateenepaa.orq 9 ui rtlaBround ub age. cat 48 taus I hereby admowledge mat this Information is complete and accurate; that the wed will be In conformance with the ordinances and codes of the City of Eagan: that I understand this is not 0 tarter, but only an application for a permit. and work is not to start without a permit: that the wait will be in accordance with the approved Wan In the ogee of wort welch requires a meow and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minneaota State Whin Code mget be completed within 180 daysofpermit immurca gQRR'$ Applicant's Printed Name D3 /-60 39tid 1NIVW 1X3 I38 x Applicant's Signature Pagel of s L9Z9T98ZT9 LO:t bTOZ/80/TO