1594 Rustic Hills Dr
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City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /l A e' 7 Site Address: /5 gc, 677c /1/S d7
Tenant: 04 b-2 355p-7
r
Use BLUE or BLACK Ink
Permit 7(2 OSS"
Permit Fee:
Date Received: f
Staff: L�
Suite
RESIDENT /.OWNER
TYPE OF WORK
CONTRACTOR
Name:
P Jd ^/nSo} -7
Address City Zip: 1J�yy �QvS77c I i //S /7/-
Applicant is: Owner yContractor
Phone: 65
66 6///
Description of work: /Qr P/
Construction Cost: dt%
Multi- Family Building: (Yes No
Address:
Name: g/r zy/ Cc9J7,57: License
3 3 /L-•.d-
City: a Y L /r-
Phone: X3 769.
State: 1 1 7 7 Zip: 3 3 2
Contact Person: Oar) Pe!'/
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:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions o
the information► may be classified as non- public if you provide specific reasons that would permit the Cit
conclude that 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.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 with mit; that the w. ?will be in
accordance with the approved pl. i 'n the case of w• rk which requires a review and appro ns.
Ap•'lc s Print Na e
X
Appli ant s ignat
Page 1 of 3
CITY OF EAGAN Remarks ?p
Addition RUSTIC HILLS ADDITION Lot 15 elk Y Parcel 10 65000 150 00
Owner
Street 1594 Rustic Hills Drive
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1980 8 185,54 10
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 45.85 1.53 30
* SEWER LATERAL 1980 3454,56 230.30 is
WATERMAIN
WATER LATERAL ? 1972 170.98 8.55 20
WATER AREA 1977 79.55 5.30 15
t Water bitprial 1980
STORM SEW TRK 1979 412.59 41.26 10
• STORM SEW LAT 1980
• service 80
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
INSPECTION RECORD
CITI OF EAGAN PERMIT TYPE: 1 1111'
3830 Pilot Knob Road ' Permit Number:
Eagan, Minnesota 55123 Date Issued: '
(612) 681-4675
SITE ADDRESS: , „ 1 I,, 1;1 APPLICANT:
:!t 1 .. 1111 1 . IIr
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR.
Hf MARK5: , S S W PI UR -- I AR'.,ON F-11 lit,
,? f
Permit No. Permit Hokler Date Telephone N
S/W
PLUMBING
HVAC 3 93
ELECT 9 O ?9 Qv-
ELECTRIC
Inspection Date Insp. Comments
Footings 1
7
u- C 2 ?-e2 -rt.?r.?r
2 LY3
Foundation / ! eO?J LC'"l?? Ib
Framing
"? K Rop
tiff" T?"S v? 7-1
172- -
Rooflng 1„
Rough Pibg. G,
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final D? 3
Deck Fig.
Deck Final
Well
Pr. Disp.
46
N-
4
of cccoanc?
Witio of Vagan
Ztlsrbntnt of '$xii * 3ndotctian
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use as adiication: SF DWG Bldg. Permit No. 2140
om,p,wy Type R3/141 ' Zoning Muria RI Typc Const. VN
Owner a Building - PROPERTIFS Add,,. 4068 MGENT PDM I BR MA PK
B AddtJ 594 RUSTIC HU1-5 DRIVE Locality L15 RUSTIC HIILS
Date:
Budding Official
POST IN A CONSPKAMS PLACE
Address 15% RUSTIC HILLS DRIVE Zip 5512 1
at • 15 Blk
Sub
RUSTIC HILLS
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: // o 0! Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy -
/O o281 i?f
M 1 421 /J&
Request Date "w t-
OC Fire No. Rough-in Inspection
Z
FIZZ? NOTICE: You Must Call Electrical Inspector
If A Rough-In Inspection
I
- (3 NO Is Required.
I licensed contractor, owner hereby request inspection of above electrical work at:
Job Address (Street, Box br_RO'ute INo.) City
1594 ?? ?? Qr• t
Section No. Township Name or No. Range No. County
Occupant (PRINT) Phone No.
Power Supplier Adtlress
Electrical Contractor (Camips* Name) Contractora License No.
Mating Address (COOaaglCf or Owner Making Installation)
- ?`' ?r m?I
Authorized Signature (COMratdoi/Owner Making installation) hone Numhar
S?3
--r 601M
O
MINNESOTA STATE BOA D'OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Gdggs-Midway Bldg. - Real an S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., SL PadiLMN 55106 UNLESS PROPER INSPECTION FEE IS
Phone 4612)5e2-0800 v ' ENCLOSED.
REQUEST FOR ELECTRICAL IN?PEL?T6N
? See instrudions for completing this form on back of yellow copy.
13423 •x' Befbw lw`crk Covered by This Request
rk E&00001-0B
/5/*7 7
New dd Rep. Type_ of Building Appliances Wired Equipment Wired
Home ' Range Temporary service
Duplex y:'' Water Heater Electric Heating
Apt. Btiildirig Dryer Load Management
CommAndustrial urnace - Other (Specify)
Farm Air Conditioner
Other (spedw Contractors Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool; 0 to 200 Amps Jr) 0 to 100 Amps
Transformers _ Above 200 _ Amps ov Amps
Signs -
_ Inspedor5 Use Only: If- it, I TAL
Irrigation Booms.
Special Inspection',?- ,
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONT S.
I, the Electrical Inspector, hereby Rough-in
lJ`? Date Q ?i
L
D
certify that the above inspection has
been made.. Fine, oa e
'p
& -/ 3
OFFICE USE ONLY
This request void 18 monttis''fran
PERMIT
?j CITY`OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
021990
09/21/93
SITE ADDRESS:
1594 RUSTIC HILLS OR
LOT: 15 BLOCK:
RUSTIC HILLS
P.I.N.: 10-65000-150-00
DESCRIPTION:
BvAldirig} Permit Type
? SF DWG
#uilding
Work Type NEW
rV BC Occupanb , R-3 M-1
/'Construction Type V-N
Zoning R-1
Building Length ) 74
Building Width 34
U W ? r, dun
REMARKS:
S & W PLBR - LARSON PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Lie. Search Fee
Subtotal
VALUATION
$790.00
$513.50
$71.50
$750.00
100
1
$5.00
$2,130.00
$143,000
MISCELLANEOUS
Total Fee
$1.744.50
$3,874.50
CONTRACTOR: - Applicant - ST. LIC. OWNER:
FRANCIS PROPERTIES INC 14256239 0002493 FRANCIA PROPERTIES
9068 REGENT PKWY 9068 REGENT PKWY
BROOKLYN PARK MN 55443 BROOKLYN PARK MN 55443
(612) 425-6239 (612)425-6239
1 hereby acknowledge that I have read this application and state that t'he
information is correct and agree to comply withall applicable State of Mn.
Statutes and City of Eagan Ordinahces.
L-
APPLICE MITEE SIGNATURE ISSUED Y: SI URE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: LOT: 15 BLOCK:
1594 RUSTIC HILLS DR
RUSTIC HILLS
PERMIT SUBTYPE:
SF DWG
BUILDING
021990
09/21/93
APPLICANT:
FRANCIS PROPERTIES INC
(612) 425-6239
TYPE OF WORK:
NEW
INSPECTION TYPE
FOOTING .DATE INSPTR. INSPECTION
FRAMING DATE INSPTR.
INSULATION FINAL
FIREPLACE
REMARKS: S & W PLBR - LARSON PLBG
F
ED CITY OF EAGAN t
.FERMI 1993 BUILDING PERMIT APPLICATION z 5 j • 4. ro
REACTIVATE ; :7----
i P 93 681-46
75
gill- ;)YIAW Q- I L
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
talcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work lz-S,? pd
Site Address: kW,rt<< HC Irs ?R??6
STREET SUITE K
Tenant Name: (commercial only)
LOT IS BLOCK SUBD.?ufJ?? l?`lf P.I.D. M
00 l? G(`
Description of work: SlN toe q\M well
The applicant is: ?
Owner W Contractor ? Other (Describe) " F 2
II
Name °.lo+T vf?? ?FE?F Phone 696, 011-7
Property LAST FIRST
Owner r
Address 7 LL-` R4 y LJ?
T
REET STE Y
S
City A J State Zip
Company FRA rJ c t S o 12 T e r r r. Phone ``?S 2 3
Contractor ee ^J t ggaVwA-J License #d L113 Exp.3
Address ID 6k f4
_
City ?U ) 1 A? 1 State ,4,J Zip
Company -J° ti ?2kz??? d ?Ke? Phone `f2_4- 97? 2
Architect/
?? ?
(?
Engineer aAc
ea Registration #
Name b
Address 3 D Y j A71;:? ?f
City ?fs4a State' Zip 536-7
Sewer & water licensed plumber 6/;y!j Processing. time for
sewer & water permits is two days once area as been approved.
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.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? OI Foundation ? 06 Duplex ? 11 Apt./Lodging
[x, 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
O 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
0( 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V-N Basement sq. ft.
(Allowable) V-N 1st F1. sq. ft.
UBC Occupancy R-3 M -I 2nd F1. sq. ft.
Zoning RR-1 Sq. Ft. total
# of Stories Footprint Sq. ft.
Length -7q-r- On-site well
Depth On-site sewage
APPROVALS
Planning Building
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing
? Wallboard ? Final
.nw. 1? Alq y, w
TO 16, BabemehtO`tnish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System YES
City Water y Crp
PRY Required
Booster Pump
Fire Sprinkler
Census Code of
SAC Code of
i
r
0
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % (o?
SAC Units T
? 6vtx ag:
z'?z x n
7k
14ul )S;j g 146 ?
6 27
a7
0 v)
valutian: $ ycI 1q3,620
g?:
xiy -
y6X 30= i3frc
a x /y = Cz?)
7- Y l ?
ivszxCS? zjr7rco
t?iA124VE r
2" x2K = 5Gd K.id = 896 0
/5T
Zvti_ i? 33,bg6
?I iNz, u?
U
1, o .
J W
in
W
J
A F
z?
PROPERTY LEGAL:
?? ? Registered Land Surveyor signature and company
0 ? Building Permit Applicant
0'r0 ? Legal description
? 400, 0 Address
2'? ? ? North arrow and bar scale
B'? ? ? House type (rambler, walkout, split w/o, split
lookout, etc.)
8'?? ? Directional drainage arrows with slope/gradient $.
? C30o'? Proposed/existing sewer and.water services
? ? Street name
'? 0 0 Driveway
Existing
? C? ? Sewer service
ef• ?
? ? Lot corners
C
0
, ? Top of curb at the driveway
0
0 ? Elevations of any existing adjacent homes
Proposed
[a'? ?
? ?
? Garage floor
i
rst floor
F
0 0 Lowest exposed elevation (walkout/window)
?j ? Property corners
?
V 0 Front and rear of home at the foundation
PONDING AREAS (if applicable)
entry,
? -0 Easement line
? ? NWL
? 8` 0 HWL
? fd? ? Pond # designation
? 9? ? Emergency overflow Elevation
DIMENSIONS
f
? 0 ? Lot lines
P- - o 0 Right-of-way and street width (to back of curb)
_ ? ? Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
? ? Show all easements of record and any City utilities within
those easements
0 ? Setbacks of proposed structure and setback of adjacent
'-? existing homes
?e
? Retaining yLa-l?
Pregt?iremoets, if any
/
Reviewed:
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUI
October 1992
Date of Survey: W7-J1X=E
John Broclle? ;r
309 - 1 st AVENUE N.E.. OSSEO. MN 55369
Bus: 61 2%424-9772
Plan *'- 21 :L S Date
Owner
Contracton
Site Address: t-OT IS e"-°'-'k !<4 ific N I?.S PHONE
i)TOTAL EXPOSED WALL AREA 2 35 s% ft x`U", 'Z-
b
' 2)TOTAL EXPOSED ROOF/tEILINO AREA 2 s% ft. x"U"A23LOF
WALL AREA CALCULATIONS: q
TOTAL WINDOW AREA sq.ft.x U' a_=_1.1`
GLAZED
TOTAL DOOR AREA
TOTAL GLASS DOOR AREA
(7Z sq.ftx'U"??-?
GLAZED
TOTAL FIREPLACE WALL AREA
TOTAL WALL FRAMING AREA
NET INSULATED WALL AREA
TOTAL' RIM JOIST AREA
TOTAL. FOUNDATION AREA (EXPOSED)
tq sq.ft. x IUD'
sq.ft.x`U" vg= 12tZ
(Z L?ZP sq.ft. x U" .00c- 1 , 7-
1 I S sq. ft. x "U" 0 0f- = 1"
TOTAL FOUNDATION WINDOW AREA sq.ft.x"U"
3} TOTAL
If item 3 is the some as, or less than item /,you have met the intent of
2 MCAR 1.16008 A and O.
ROOF/CEILING CALCULATIONS%
TOTAL SKYLIGHT AREA
TOTAL ROOF/PEILING FRAMING AREA
NET INSULATED ROOF CEILING AREA
sq.}tx"U"
tq.fi.x"U" l7ZCo= ?7,
?? sq.ft.x`U"tdZ?
'4)TOTAL 2+
If item 4 is the some os,or less than item 2, you have met the intent of
2 MCAR 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the sum of Items 1 and 2 shall
be greater than the sum of items 3 and 4.
1) +2)
3) +4)
I hereby certify that the building here described mee or exceeds the State of Minnesota
Energy Conservation Act.
CONSTRUCTION
CEILING SECTION (INSULATED) .
(I inferior air film 0.61
{3 u.., 1 ?? 44
(q exterior air film (still) 0.61
TOTAL Rs2
U = ._IZR -02Z
--CEILING FRAMING SECTION
(1!nterior air film 0.61
(2 B Strr??roy r; &LO
(.3-
(4 • a?I f w? 33 '
(4 interior air film 0.61
(5 winches of soft wood
TOTAL R?+! 3
_U. I/R +DZIo
CEILING SECTION (INSULATEDL
(I interior air film 0.61
(3
(4 exterior air film (still) 0.61
TOTAL R'
U. = 1/R'
VENTED
_ CEILING FRAMING SECTION
('I.interior air film 0.61.
(2
(4 inferior air film 0.61
(5 inches of soft wood
TOTAL R'
U = I/R
EXPOSED BEAM CEILING SECTION
(.I interior air film 0.61
(2
(3
(q .
(5 exterior air'film 0.17
TOTAL R
U = 1/R
CONSTRUCTION
WALL !FRAMING SECTION
_'interlor air film 0.68
2 { Yak stjt2lrpE
$ 5>' -inches of soft wood +3
q as/3 z i6LXem;s 2 ?lP
5 Siyi. ca tot
g exterior air film 0,17
0, bs-
TOTAL R I
-- - U = I/R .Q
WALL SECTION (INSULATED)
-? I :interior air film
---(2
3
-44
--( 5
-? S iexterior air film
U = i/R rC7
TION SECTION
interior air film 0.68
exterior air film
0.17 '
TOTAL R ?' 1
U = I/R ) .. ..
U = I/R r?
ST SECTION
?- 6Z /5
AND 10-65000-150-00
Rustic Hills Limited Partnership
1565 Rustic Hills Dr.
Eagan,MN 55121
June 27. 1991
City of Eagan
Mr. Gene VanOverbeke
3030 Pilot Knob Road
Eagan,MN 55121
Dear Mr. VanOverbeke,
RE; PROJECT 543R, SKYLINE ROAD OBJECTION TO SPECIAL ASSESSMENT
$1,059.90
We object to this road assessment since the lots have already
been assessed for road, curb and gutter when the road was built
that affects these lots. We believe the two developers should
pay the cost of the roads that are connected to their development
and not connected to these lots.
Please be notified that this Partnership objects wholeheartedly
and will further object to this assessment of $1,059.98 against
each of the above mentioned lots.
Yours truly,
Warren M Anderson
general partner
Rustic Hills Limited Partnership
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES EACH TOTAL
a2 SHOWER 3.00 (O
WATER CLOSET 3.00 /
BATH TUB
3.00 _
/ -
LAVATORY 3.00
-
/12
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00 -
3.00 3 -
-7- WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS p;IPING OUTLET • minimum -,i 3.00
.Aw ROUGH OPENINGS 1.50
-
Z WATER SOFTENER 5.00 -
'6
PRIVATE DISP. • Dekay iic. 15.00
U.G. SPRINKLER • home under coost. 3.00
ALTERATIONS • to eristing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE 7 / .50
TOTAL:
SITE ADDRESS: / 5 g `/ - ?'e- Q- Aji
OWNER
INST.
o91-'-
P3
ADDRESS:
?3o
CITY: STATE: n ZIP CODE: S S3 0 ?
PHONE #: (biz) `/c'
91 ATURE OF ERMITTEE
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 6814675
1993 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN S5122
(612) 6814675
PLEASE COMPLETE FOR ALL COM[MERCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UN 7.
NEW CONSTRUCTION
_ ADD ON
REPAIR
WORK DESCRIPTION:
CONTRACT PRICE:
FEE: 1% OF CONTRACT FEE
STATE SURCHARGE: S.50 FOR EACH $1,000 OF PERMYf FEE
MINIMUM FEE S 25.00
CONTRACT PRICE X 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN
APPLICANT
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE J/?-,g L R3
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ 53.00 EACH) 4UM'1CItR./
ADD-ON/REMODEL (EXISTING CONSTRUCnON)
STATE SURCHARGE
TOTAL
SITE AD
v ER
*7N
INSTALI
FEES
$ 24
6.00
,DO
$ 15.00
.50
pk.
i ELEr^HOidE #:
CITY: ii / TATE: JA ZIP CODE: S 3?
TELEPHONE #: 4q 3-2q "7:J
SIGNA U E OF PERMITTEE
1993 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 681-4675
rA
PLEASE COMPLETE FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF Cf7NTRAg FEE $_
PROCESSED PIPING: $25.00
CONTRACT PRICE:
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PERMTT FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY:
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
1993 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
Established in 1962
LOT SURVEYS COMPANY INC. INVOICE NO. 34918
F. B. NO. 596-62
LAND SURVEYORS SCALE I" = 2?- D-
o Denotes Iron Monument
REGISTERED UNDER LAWS OF STATE OF MINNESOTA p Denotes Wood Hub Set
7601 - 73rd Avenue North 660.3093 For Excavation Only
IICMES BY FRANCIS Minneapolis, Minnesota 66428 x000.0 Denotes Existing Elevation
E Denotes Proposed Elevation
Property located in Section ftruppro YYps?e?tW QIE- Denotes Surface Drainage
4, Township 27, Range 23,
Dakota County, Minnesota J$/.Z Proposed Top of Block
Proposed Garage Floor
5Z Proposed Lowest Floor
Type of uildinq -
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No determination has been made as
to depth of sanitary sewer service
cam: 7 Development plan not available
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o Lot 15, Block ?, RUSTIC HILLS /1DDITICN
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Proposed building Information must be checked with approved building D
plan before excavation and construction.
The oniy easements shown are from plats of record or Information provided by
client
Vue hereby certify that this Is a true and correct representation of a survey of the
boundaries of the above described land and the location of all buildings and via-
ible encroachments, it any, from or on said land. Signed (! 1 P
Surveyed by us this 9th day of Se btemer is 93 Raymo A. Prasch Minn. Reg. No. 6743
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