4636 Weston Hills DrCity of Eaaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 0, Site Address: We Ul/c'p s-1 ,✓#/5— d�
Tenant: a' 2
Applicants Printed Name
Use BLUE or BLACK Ink
vo Use
Permit 92 j 7
Permit Fee:
Date Received:
Staff:
Suite
RESIDENT OWNER
TYPE OF WORK
CONTRACTOR
Address City Zip:
Name:
Applicant is:
Owner X Contractor
Phone:
Description of work: -77;k1 Jz
Construction Cost: "O 3
Mekvi Multi- Family Building: (Yes No A
f de 74 fe/' /e/e/J
Address: fJt$7‘ /L�( /V/
City: G,vp
Phone: -fm--gy,
Name:
Contact Person:
License �OL5
State: /`'�loC Zip: 33
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?
Sewer
Yes
No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Phone:
Water Contractor:
NOTE: Plans and supp documents t iat you submit n public rnf 3
the information may be classified as nonpublic /f you prov ide co spe sidered cific reasons to be that .wo per m it the Pdt Ci ons of
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Cali 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.org
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 i the case of work which requires a review and approval of pis.
x 7 /g cra t
Applicants Signature
Page, 1 of 3
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ~`i
Eagan, Minnesota 55123 Date Issued: ~ ' ' • ' '
(612) 681-4675 ,
SITEADDRESS: APPLICANT:
1 (11 l l 1 , Ilf?
~('j2' 7L o ! P
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
I i~' tl1 il 1 I 1+13 I r f~il~
; a l 1 1'I R~ 1
, r7,.~ . , t ~ , ~~,a ~ ; ,
~ ~
~
, Pennft No. PermR Hokler Date Telephone 7i
. S/1N
PLUMBING ~ _1 ,3 9 • JW
HVAC
W
ELECTRIC
ELECTRIC
Inspection Dits Insp. CommsMs
F°°nngs ' 4.1Y~
Foundation
FremNv 7123 ~ItL Az
ZZ2
ROOfl11 J
Rough Plbg.
Rough Ht9
Isui. 7 # 3 7 Z Ap--
~
Frsoace 7~ ~ c.t~~ •
a7 ~ ~-L2 ~ -,rt 7
FWW rV.
Orsat Test
Final P6g. Plbg. Inspector - Notify Plumber
Const Meter
EngrJPlan
Bidg. Final ~J
Deck Ftg.
Deck Final
weu
Pt. oisc.
^~^T~ ^INSFECTIUN REC4RD~
CITY OF EAGAN PERMIT TYPE: 1:11
3830 Pilot Knob Road Permit Number: 0 n•
Eagan, Minnesota 55123 Date Issued: / ~ ~
(612) 681-4675
SITE ADDRESS: APPLICANT:
;M) iiiI I
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
I ~
~ ~
veol n rw. Poo,,,n t+okler nace Telephone #
S/w
PLUMBlNG
HVAC
ELECTRIC
I ELECTRIC
( Insp.etton o.b hap. commenes
Foalirqs I
Folxidation
~
Frarning
P40nf9
Rau9h Plbq•
Raigh Mt9•
isul.
. Flkepiaw
Final Hlg.
Oraat Test
Flnal Plbg. Pibg. Inspecta - Nortify Plumber
Conet. AAeter
EngrJPlan
Bldg. Final
°ix* Ft. ~C-
DoO FwW ~y
W~l
Pr. Dw.
SEDGWICK HEATING & AIR CONDITIONING CO. TESTRecoao JOBNO. v~QL
8910 WENTYVORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
ADDRESS ar,
OCCUPANT/I/~~~ OWNEF
SOLD BY LO ~ ~J ~Gl« INSTALLED BV
MAKE L~ MODEL V ~ " " ' C/ C.J - ? / I
SERIALNO J1G-2M OlO~ 93 INPUT 0-aO '
I^[I/ yA/
THERMOSTAT V zA VENT SIZE /l/ U C
VALVE O ne kLy e TVPE OF LINER ~ey, '~t I ~/H
LIMIT X~' ~ LINER SIZE w N
~-o
LIMIT SETiING - ~7`5 FILTERS: SIZE 5c) U CD
FAN SETTING ~ -p ~ [ WIRING
PILOTTYPE 7ESTTAG
IGNITION MODEL LIGHTING INST.
PILOTTIMING
PRESSURE ''O PERCENTCOz ~ ~(O DATE7ES7ED
^I Q COMPANY TESTING
CFH " ~ PERCENT Oz
INPU7
STACKTEMP ' PERCENTCO v 6 NAMEOFTESTER
FORM 2%(REV. 11I09) FORM OISTRIBUTIONNMITE COPY -JOB FILE YELLOW CqPY -QTV
wertificate of CccuPanc4
Ctitv of ~agan ~
Teyartment of 13uitbiag ~a3ycction
Tkis Certificate issued pursuant m the requirements ojthe Ursiform Buildtng Code
certifying that at the time of issuance this slructu'e was in rnmpliance with the various
~ ordiwnces of the Ciry regu(ating bui(dirsg constructiort or ase. For the fa(lnwing:
Use Clauificalion: SF DldG BMg. Pcmiil No 21214
MIMI ' V[1
Ottvpancy Typc Zomng Diwitl Type Consl.
OvnierofBuilding NMONM OCNST IIE Addic.¢ 1212 ffii1IDIIL BAY RD, fl"VIIIE
eui ng Addrexs TS l.acality L, W~~
i~/~/s=
~ A' - ~,e:
au,,dthOffieoij 4
POST IN A CONSPICUOUS PLACE
Address 4616 wFSirw Fm r S, nRrvF Zip 5512 3
LoI 5' Blk 2 Sub wESmtv HiLLs
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: M~ Yes No Inspector. ~
Final grade (6" from siding)
Permanent steps (garage) ~
Permanent steps (main entry)
Permanentdriveway ?
Pecmanent gas
Sod/Seeded grass ~
TraiUcurb damage
Porch
Basement finish ~
Deck
Please vcrify with the builder the removal of roof test caps from ihe plumbing system and Ihe shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Conlact engincering division at 681-4645 before working in right-of•way or installing underground sprinkler system.
White - Ciry Copy Yeliow - Residem Copy Pink - Conlractor Copy ~
PERMIT
CITY-OF EAGAN
PERMITTYPE: eurLoz
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 021214
(612) 681-4675 Date Issued: 06122193
SITE ADDRESS:
4636 WESTON HILLS DR
LOT: 5 BLOCK: 2
WESTON HILLS
P.I.N.: 10-83750-050-02
DESCRIPTION:
Building Permit Type SF DWG
Building lJork Type NEW
i'UBC Occupancy~\ R-3 M-1
~ Canstruction Type VN
~ Zoning R-1
~ Building Length ~ 68
' Building Widtih ~ 29
~
V! ~
•
\ ° \(.~:\`t.~?/ ~`,7J/ ~ ~.'J,.
REMARKS: '
S&W CONTRACTOR -
FEE SUMMARY:
VALUATION $132,000
Base Fee $751.50 MISC FEES $1,744.50
Plan Review $488.48 Total Fee $3,600.48
Surcharge $66.00
SAC $750.00
SAC % 100
SAC Units 1
Subtotal $2,055.98
CONTRACTOR: - Applicant - S7. LIC QNtER:
MCDONALD CONST INC 16887061 0002376 MC ALD CONST INC
1212 BLUESILL BAY RD 1212 BLUE BILL BAY RD
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 668-7061 (612)688-7061
I hereby acknowledge that I have read this applicatian and state thaC the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
L- ~ ~ ` {~II J
~ p~APPLICANTlPERMI EESIGNATURE (IS$IJEp P.T3~jGNAUR
REACTIVATE _ CITY OF EAGAN
PERMIY 1993 BUILDING PERMIT APPLICATION ~t
681-4675
SINGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
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 ance permfit
is issued.
Date S6y,.E / 'z?/C?~ Valuation of work I I 4, O o O
Site Address: ue
STREET SUITE I
nant Name: (commercial only)
ITBLOCK 2 SUBD. W e$ o" ~ l P. I. D. k
'I :scri tion of work:
"'The applicant is: ? Owner Contractor ? Other coe8«;be>
Name Phone
Property LAST FIRST
Owner Address
STREET STE M
City State Zip
Company ' Phone &F R- 70G(
Contractor Address (a l2 e(ue 62« QHY R c~ License # ooe237G. Exp.qc4
City 8uRmsuState lAr` Zip S5$37
ArchitecU Company Phone
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has 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 Appl icant: ~ n+ -~-O
OFFICE USE ONLY
. ,
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./lodging ? 16 Basement Finish
M02 SF Dwg. 0 01 4-Plex O 12 Multi. Misc. ? 11 Swim Pool
? 03 SF Addition O 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace 0 29 Cortm./Ind. Misc.
0 OS SF Misc. 0 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
M~31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair 0 36 Move
GENERAL INFORMATION '
Const. (Actual) V- N Basement sq. ft. MWCC System YE5
(Allowable) N lst F1. sq. ft. City Mater ~
UBC Occupancy -3 W1-1 2nd F1. sq. ft. PRY Required
Zoning 0._I Sq. Ft. total Booster Pump ~
# of Stories Footprint Sq. ft. Fire Sprinkler
Len th ~ On-site well Census Code 1_
Depth On-site sewage SAC Lode ol
~ .
APPROVALS j ,
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
0 Site ? footing ? framing 0 Insulation
? Wallboard ? Final ? Draintile ? Fireplace
Permit Fee v.i~oc;a,: S 132+000
Surcharge Qa~.1
Plan Review 30 ~t Z2 - 6bm '
License 2 x ~i = (zz)
MWCC SAC -
City SAC (~g1~y !6:
Water Conn. Water Meter
Acct. Deposit
S/W Permit x°>;' ~~`6 X I23 ~ 1Z/~S2y
S/W Surchar9e
Treatment P1.
Road Unit f3~~95~
Park Ded.
Trails Ded.
Lopies
Other
Total:
sAC x I0d
SAC Units ~
' 3Uh! iJ2 '93 14:22 Ti_i hlCPipdALU CiiPIST. FF.'ul9 F'F,'nE;E EhGIF1EER1I!G T-10~ F'.U2
. • c---_s~.-
r Z /IJC D~Nr1L0 C0.(~ST•('GL^T/!lt/ ,
COHSULTI110 (N6INCEIIS
~ rLnNr+ens ond Lnr+o 3unvEVOns ~5765.0/ 14
RoENGINEE-RING
COf~flP(~NM INC.
~ 1000 EA57 1461h 9T(1EE7, OURfJSVILLE, MINNESOTA 55337 F'll 432-3000
CERTiFICATE OF SURVEY '
Legal Description: _4?_,s~__a~K
DA.COTA GOUN73~ ~9/.VN~'07"A
(Y5sf4L) DENOTES EXISTING ELEVATION
( 956.0 ) DENOTES PROPOSED ELEVATION
INDfCATES DIREC710N OF SURFACL DRAINAGE
`1S6•33 = FINISIiEU GARAGE FLOOR ELEVATION
BA6[MEN-f FLOOR ELEVATION
~ 950. 65 = I'OP UF i-OUNUAI"IUN ELCVAI'ION
6F~t/CNiy1ll.e.C : 77?N ~ GoTS Z~ 3, B~'+~ Z.
acn~c : r- aa ~EY. = 9sd. G7
30 F`j. p,P,ONT 6411GO/NG
SErBACK L~NE ,
30.00 ~
9s~.E~r„a,s „o~:'r~weo NB9°¢Z'3oE ~9so,4~
m m /ysz.ec~s5.oo /55. ,
C F.e ~ 52'S7
~ ~ ~p (954_8 26.00 q5g.i)
O ~ ~ ~ ~956.0~ ~ L ~Q
~ ~ M I W`L j^' co I ~ ~ hJ
r O
(9s6,o N
~
a ~ 30.3~5~4 7c0
Z O~~~ ~ 0
~52.5~
/o,o~'o ~ ~N°v I ~1 J
N m h N I ` I ~ \
o
ss
Zo,OO
0 95F- 5.cao 1(!;>35-00 ~
r -qg- 8 ~953_7;
155,00 /
v ~952,6~ Nv8= 455.7n N 89042'30~ ,~5
-7' i ~ .
pRf7/N445~'E AND
;k= /~/TY r
No7E = STRtCT IS NaT ~STRU~D O
PROPOSED STREET CLEUflT/ONS _
SN~'v 4,05 1-11QL39i P,QO?647-
Co.t/ST~Fr/CT/aV PvN/• B - ~
gA~ ~ ~M~,a1fiT~'l9RIA]G PEPT
I hereby certify that this ie a trua and correct represetttation oP a tract o
land as shown and d l g y~ bed liereon. As prepared by mo this daY o
171nn, Rag. No. aB5'
, LOT SURVEY CHECRLIST FOR RESIDENTIAL
BIIILDINO YERMIT APPLICATIO
m y~
-J ~ PROPERTY LEGAL;,f- Z
<
Date of Burvey:
DOCUMENT STANDARDS
9~A 0 • Registered Land Surveyor signature and company
? 0 ? • Building Permit Applicant
0 ? • Legal description
0 9' ? Address
0 • North arrow and bar scale
C'l~ • House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
0^ 0? • Directional drainage arrows with slope/gradient
0 0~ ? • Proposed/existing sewer and water services
0~ 0 ? • Street name
~0 ? - Driveway
ELEVATIONS
Existing
0 0' 0 • Sewer service
CT" ? 0 • Lot corners
C 0 0 • Top of curb at the driveway
~ 0 ? • Elevations of any existing adjacent homes
Prouoaed
@' ? 0 • Garage floor
~ ? 0 • First floor
cr 0 0 • Lowest exposed elevation (walkout/window)
1, D 0 • Property corners
0 0 0 • Front and rear of home at the foundation
PONDINCi AREAB (if apDlicable)
0 cr ? • Easement Iine
? Ci' 0 • NWL
0 L 0 • HWL
o 6 0 • Pond 4 designation
0 2~ ? • Emergency Overflow Elevation
AIMEN8ION8
0' ? ? • Lot lines
@' • Right-of-way and street width (to back of curb)
CY ? 0 • Proposed home dimensions including any proposed decks,
overhangs greatez than 21, porches, etc. (i.e. all
structures requirinq permanent footings)
0? • Show all easements of record and any City utilities within
those easements
p- ? ? • Setbacks of pr osed structure and setback of adjacent
existing ho s
0 'a"D • Retainin r i ents, if any
Reviewed•
N e / a e
October 1992
MI[iNESOTA STATE ENERC,Y CODE CALCUL.ATIONS ~
) BASED ON CHAPTER 5 OF THE
MODEL ENERGY CODE - 1983 EDTTTON
Adoption Effective
owner \N ~~Tb~ CY ll r S 4~ Phone Date
Site Address Lo t5 BLoe.&_ 2 W 4.~ = rj ~j f Li- S
Contractor CIJ l~,~i~~ l~Clj~s~ IIVC~• Phone
r
Buildinq Classification: Type A1 (Single Family & Duplex) Type A2 (Residential, 3 stories or less) (Over 3 stories) (Other)
dOTE• Completa pages 3 and 4 first.
11
9ENEF2AL INFO MATrON
1. Building Perimeter ft.
T. Wall height (ground to eave) ~I ft.
1. X 2. (above) gross wall area sq.ft.
4. Buildinq dimensions (L) ' X (W) _ ~°OU sq.ft.roof & floor area .
5. Sq. foot area of rim joist - F oor joist size (2 X I U )
D X -744__'> (Perimeter) = ZI~J sq,ft.
6. Doors - Area 12
~
Thickness in U. factor I~ ~
Type of Construction Perimeter ft.
. . Manufacturer
7. Total door's perimeter ft.
8. Windows: Manufacturer ~~Tb LS~ ~CY- ~~'I'~ • State approved
U factor a2 6
TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL
~ EACH UNITS SQ FEET
~
9. Total sq.ft. Glass :ILL
10. Fireplace area: Width X Height = X = sq.ft. ,
11. Exposed foundation: Height X Perimeter'~-~ X~2 = Z73sq.ft.
COMPLETION OF THIS FORM IS REQOIRED FOR ALL NEW CONSTRUCTION, MAJOR
REMODELING AND BUILDZNGS BEING MOVED WfiERE ENERGY, OTNER THAN THE MINIMAL
CODE ALLOWANCE, IS USED.
-1- ,
12. Framinq area = 10$ of gross wall area,
13. Gross wall area 7 sq.ft.
' ~Z~
~ Window area A~sq. ft. U windows = ~ 31~ UxA = (U
Rim joist area A Z-sq.ft. L rim joist=_I Cl-t1 UxA =
Door area A S sq.ft. U door area= Il'-1' UxA =
Other doors area A_40 sq.ft. U other doore=ik] UxA =
Exposed fndn AtfM) eq.ft. U foundation= 10-76 UxA =
Framing area A1~ sq,ft. U framing area='0 UxA =
Net wall area AM1Jsq.ft. U wall= I~~ / UxA =
(13B) TOTAL . . . . . . . . . UxA
14. Gross wall area x 0.11 (A-1 eingle family & duplex) = allowahle xA/Code
(13. above)
x 0.23 (A-2 other reeidantial)
x .23 (other buildings)
x .28 (OVer 3 etories)
BTUN must be larger than or same
' A x U Code °F. as 13B above
15. Ceiling framing area (Af) equele lo$ of ceilinq area
15A. Gross ceilinq area =(L) x(W) boD sq.ft.
15B. Joist area (Af) = 10$ ceiling area ~6(-->_sq.ft.
15C. Net ceiling area (Ac) (15A - 15H) sq.ft.
u ceiliny x r,c = ao x o2 9
U framinq x A f = 1~v x ~ oZ =
15D. TOTAL U x A
16. Ceiling area (15A) x 0.026 (A-1 single family & duplex)
= allowable UxA/ C
jode
x 0.033 (A-2 other residential)
x 0.06 (other)
BTUH must be larger than or seme
A(15A) x U Code lD[X/ e (itC~ oF. as 15D above
NOTE: Use U anil A values obtained from pagea 1, 3 and 4.
_QERTIFI ATrON: I hereby certify that I heve calculated the "U" factors and
"R'O values hereln and that the buildinq here deacribed meets or exceeds the
state of Minnesota Energy Coneervetion Act.
Date 9lgnature
-2~
.i
' ~Z~
- - - - w0"60-
-
(o-7 x<4v f-q U-t
8,83x<38t3S-~-Z7,s~-z?,S)'~~~ Il5
- - ~ - - - 2~ 23
- - - ~o~ - ~ ooo.
~ _ II~Qo~S-
~
~0,S7 x2
S~k ' 3
- s -
QA-r?a DII-
o4 wrzsL---=
Z sTl, sg- 9,t-
.
ALUE U VALUE
_ , • • • ' ,
~ tnslde ait Ellm .68 '
~ NALL. Lntarloc::Mall ~ .45 1
• (Hall) U . R :
SECTION •
lnaulatlpn'
.
~hedthing Z :p(p
:f l
~lding
' o Outslde.air film .17 "
R TOTAL
I Iha.lde.alr film
~ .68
STUD . . Ihtetioc.'~wall
SECTION y" stud . " R= ~
, 44n (P,5 (Ftaming)U' R
~ Sheething:_
Siding
, • `
Outelde 'ir film ' .11
,J ,
lt TOTAL IO .
~
Ipterlor>wall
SECTION. . Insulatlon ~all ) U. R. ~
x i
xterlor.~,wall cover n ,
' £C
Exterloc''y'alr. Fllm' R ...ll .
: R TOTAL
. Interlor.s;alr film R- :68 A1PI
Inaula[lon 00 !
JO1$r Inch'ioft NOOd R°1.88. (Rim U Joist) ~ . Sheatlitng 2.0(0 . eA-I
~ y Exterlor?xa11 covertnglp1 ~
1
Eicterlor; a1r film R-
, •
R TOTAL
Xnterlor;~alr fllm R= .68
M-
lnaulaGlon 11,C7
\ ~bundatlon .~•Lg (Fdn.) U
~ .
, Exterloc; alr Elln R' :17'
~ .f'.
F TOTAL I 3~ ~ 3
~ \ T
~Exposedr,Bluck
'\';`,rade 3. ,
i
CFiILI11GIIITII EI1'1'ED ATTIC SPACE A@OyE
R V?.LUE R VALUE
FR?MING CEILING
_ 0.61 AirFilm 0.61
Insulation 5
' 4.3Q Joist
0.55 Ceilinq 0.56
0.61 AirFilm 0.61
Tota1R
~D23 u = I/x , b2. I
Window infiltration 0.5 cfm/lineal foot oP crack
' Residential door infiltratlon 0.5 cfm/square foot or door and minimum code
requirement
Non-residential door infiltration 11.0 ctm/lineal foot of crack
Ub 12" concrata block no lnsulation =.47 R 2.1
Up 12" concrete block insulated cores =.26 R 3.8
Ub 12" 1lghtweight block =.32 R 3.1
ub 1211 lightweight block lneulated cores =.12 R 9.3
U single glass - 1.131 with storm window .54
U double glasa = .55
U trlple glass = .41
All exterior walls and ceilings must have a vapor barrier (o.lo perm max.).
Vapor barrier must be on the ineide (heated side) of wall.
Vapor barriers of the polyethelene thin Pilm have no R value.
. - PERMIT cA O005
CITY OF EAGAN .61I01Qq
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 0 2 3 5 4 2
(612) 681-4675 Date Issued: g 5/ 0 9/ 9 4
SITE ADDRESS:
9636 WESTON HILLS DR
LOT: 5 BLOCK: 2
WESTON HILLS
P.I.N.: 10-83750-050-02
DESCRIPTION:
Building Permit Type DECK
Building Work Type NEW
~
i..
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR: OWNER: - npplicant -
SANFORD GREGORY
4636 WESTON HILLS OR
EAGAN MN 55123
(612)688-0968
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applica6le State of Mn.
Statutes and City of Eagan Ordinances.
- ~
L Nt,n R ri.r,l ~ Yh~~
VIPLICANT/PERNYTEE 5 NATURE -S UED B: S GNATURE
-
CITY OF EAGAN RECEgVED
~ 1994 BUILDING PERMIT APPLICATION
155 ~ 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
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 mct~ Q-~ Valuation of work
Site Address: ~~~~6 V.)ps'~ nr~ kA,`\O, O'C 'i U P.
STREET SUITE p
Tenant Name: (commercial anly)
LOT l_ BLOCK ~ I SUBD. )M P. Z.D. k
~A/
~ Descri tion of work:
The applicant is: Owner ? Contractor ? Other (Describe)
Name Phone b 88 - 0 9 b g
Property LAST FIRST
Owner Address A.11L ~K esinr\ ~P-L U s 'Vr i U
STREET STE il
City State ~ IU Zip
Company 5~l n 1~ Phone
Contractor Address License # Exp.
City State Zip
Architect/ Company Phone
Engineer Name Registration #
Address "
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to compiy with all applicable 5tate of Minnesota Statutes and City of
Eagan Ordinances.
y Signature of Applicant:
~
OFFICE USE ONLY '
. •
BUILDING PERMIT TYPE 'f c 4*. ~Y
O 01 Foundation O 06 Duplex 0 11 Apt./Lodging O 16 Erasemerir t , inish
? 02 SF Dwg. 0 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex 0 14 Fireplace ? 19 Comm./Ind. Misc.
0 05 SF Misc. ? 10 Multi. Add'1. ~15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
~31 New ? 33 Alterations O 35 Tenant Finish ? 37 Demolish
32 Addition O 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code ~
Depth On-site sewage SAC Code
Census Bldg ~
APPROVALS Census Unit ~
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? .Site ~ Faoting 0 Framing ? Insulation
? Wallboard Final ? Draintile ? Fireplace
Permit Fee vaimc;m: $
Surcharge
Plan Review
license
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC t
„ Q1 ^ " _ 'Li'- Z. ~igimr ' y~v: "nr~ 7fl;'^'••.r. . ';..:;'~.fil,'yi~
~.i
i't .in. .•.9«:.
iT',~ r.4• ,.+:..,a-v,;:; we;. ~i-C,.S'
3 ~ r N . . .
14:22 TO hhCPnP1ALG CQNST. FROM FROEE DIGINEERIPIG T-103 P.Oc
a p er '
~ ~ t..
Cavsr
~O~E consutri?io EN61NEEfIS ~'~'T/~/
~
PLtINNE(IS and LAND 3UIlYEYOIIS ~ S76S. D/ t,
Y
ENGINEERING . aK, i9s
~t COMPANM, INC. ~f,1i~ P6. ii ~
1000 EASi 1~61h 9iREE7, DUIINSVIILE, MIHNESOTA 66337 P11 432-3000
CERTiFICATE OF SUFiVEY '
Legal Description:
oa.v Mi,vni690rA
(74D_Q,) DCNOTES EXISTING ELEYA710N
( 956.0 ) DENOTES PROPOSED ELEYA7{ON
INDICA7[S D1REC710N OF SURFACE DRAINAGE
95'6• 33 - FINISNED GARAGC FLOOR ELEVATION
94-9, 65 = BASEMENT PLDOR ELEVATION
~ ,!7$8. 65 = 1'OP UF r-OUNUAfIUN ELGVATION
BCALE : 1' - 3o' B6VGN1y11),e,< ' 72VN 0~0TS Lf'3, 6at'X Z.
EdEY. e 9S616 7
3o Fr F?Dr~T Bv~~o~NG
5E7'BAC~C L/NE ,
30,00
~ "
N B9 e 4-2 34 E (9
m 0 55. 00 155,00
\ V ~y.. 4~. ~~~y .~170~ • • -
v N c~ EaJ1~^'^."FY OVFXF~u SW'4~E 1l1
M O ~ l~ N O \
f ^ ~C "7 Vi ~ uS M tp } ? DC~C ~Q
v Q
\I V I\ ~ ~~95610 ~ ~ ~ ~Q_,54 9 ~ ~ 1 I 3 Q4 \
~ v h L/a%o qo m~ ~ b ~ o I ~ l `J
~n r ~ z.ao kci
~ ~
`R
3 , ~ SbLo ~ ~ 35
lo g ~o
zo.oo
.
956.7s.m T6~35~ ~
016,00 HI18`955.~ N 89°42'30"~ C~53'9~
-7- .
TRCET f5 NOT GavSTKuCtt~~ ~
PROPOSEO STREET ELEYf1 T1ONS SNOJ~t~V ~1~ FiPGi'l-l PQO?ECT
MW31NEEERRINNGG' ~E NO7E S
CO.VST,PUCT/AN Plfk~. B g~~,~rr nEEr?
I hareby certify that tliis ie a true and correot repreeetitation of a trACt
land as shown and doscribed liereon. ns prepared by me thie Z~ip day
1993
~ . . • ' .
CTT'YMSE taNLY .
.
,
.
~
BL
. . . . . .
. . . .
. . : . . . .
':A Ji. : . :.d~• :i.:.;. `.:1(.
. . . ,
. _ <;
. . . . . . . . ,
_
, . ~ . . : . .
. . . . . . . :
. . . .
~.L. / . ~..c::`:.:.. :.:'..r: :'.:::C.. . ....T2YG.a..',~~:::[.:'::. .
y . .di.. . . . . T. .:i`v.....~...cvy....
. . . . ..n..._..' :...:....:.a.::`..~:C....,:T:L...........5:r..l.e .A.
` ~ a . ,
.:....:.:::.....:.:~.,..::~s::::::,
; .
t~,
~TBD. y,~,c.,~,.r,,;,..1~,~ ....R.....,.,.. . . . . ,..F.~.w•, ~ ~ .
.
1993 PLUMBING PERNIIT (RESIDENTIAI.)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMII,Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
- - - - - - - - -
NO. FIXTURES EACH TOTAL
SHOWER 3,00 , bo
_2 WA'TER CLOSET 3.00
= BATH TUB 3.00 3 d 0
LAVATORY 3.00 ,..19,00
KITCHEN SINK 3.00 __3 .00
LAUNDRY TRAY 3.00 6-on
HOT TUB/SPA 3.00 flo
WATER HEATER 3.00 on
~ FLOOR DRAIN 3.00 ~ Oa
GAS PIPING OUTLET • minimum - t 3.00 a'. GO
__3_ ROUGH OPENINGS 1.50 Y. '~;-0
WATER SOFTENER 5.00
PRIVATE DISP. • Dak.cry. uc. 15.00
U.G. SPRINKLER • home under eonst. 3.00
ALTERATIONS • to aosting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE 50
TOTAL:
SITE ADDRESS: 3 ~S tl I S
OWNER NAME:
INSTALLER: ~a r ?h Kl ~ /1. C./.
ADDRESS: fl/~ ? C7 ~
CITY: G0 ~qcl \ l Y' 0 VSTATE: M/I ZIP CODE: v S~
PHONE
SIG A RE OF PERMITTEE
.5r~_.m:,..,r..
.
~x......<...,. -
.
, ...:....BL
L;.::~.. ....o
.
. - , <w~~:~
, . ~r:;::.'. , .,4 .
. R . ..i +'i?T'~< ..Yk' •i1t.Etr
y...:: ~.n:..... ....t . . • . a.;`.:.. . .c%~~:.I. ..:3 <
`3:...
•....resr:n,•:;...,c.:.~:~.. . ,.x.... , n .a ' .Si:;.i~„~':~~' ct..i.:..STi~:...~...... .F....x
F. :,E~,-:';• c~c,'r..g..7;::..~:c^:x:a..: ...3:'i ..ti'w.s:c°F't ~-ci:.'> '.':sxy
. a
n ..DA
D.
~b[?B ~ 7'E'~
",i
>..._.......~,...~..,....,_.w.,.,.m.,,..~.,,..,..,~.~,,~...M....~:"~:,..~..,~z,.~....m...,,._.., ..............~„a.,
....S.SH:~....~....£. ».w::».. . . . :
1993 PLUMBING PERMIT (CONII1fERCIAL)
CTTY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMAERCIAL/INDUSTRIAL BUII.DINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMII'S ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
_ NEW CONSTRUCCION
ADD ON
REPAiR
WORK DESCRIPTION:
CON'I'RACT PRICE: $
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE SSO FOR FACH $1,000 OF PERMTf FEE.
MINIMUM FEE $ 25.00 mm
CONTRACT PRICE X 1% $
STATE SURCHARGE $
TOTAL $
SITE ADDRESS:
TENANT ti.'virlE: #
OWNER NAR1E:
INSTALLER:
ADDRESS:
CI11': STATE: ZIP CODE:
PHONE
FOR:
CITY OF EAGAN APPLICANT
..::........:.:;:.::..............:.:...~'1;'~tY
. .
.
. . . .
.
~L . • >_:~C~<#
.
. . -
. .:......r..;;:..;.
. . . .
':;~j~.`;:
. .
. . .
_ . . . .
.
r
.
.
. • .
. ,.~.,,:.,,.m....., , -
~...~,.,:,,._...~.._a.w_ ~ ~.N_
1993 MECHANICAL PIItMTT (RESIDENTIAL)
CTTY OF FAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNTT.
- - - - -
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@ $3.00 EACH) (~n
ADD-ON/REMODEL (EXISTING CONS7RUC717ION) $ 15.00
STATE SURCHARGE .50
TOTAL 33 _5d
STTE ADDRESS:_~Q ~<<~~ ~ 11 \ s
OWNER NAML~b~ 'l t~Q~,Yx~cn\ C+ ~_~ELEPHONE (Dcc~R' IO(c /
INSTALLER: C) C-
ADDRESS: 1~~ ~C! ~ai.~c~
CITY: V C~' STATE: ~ K~) ZIP CODE:
TELEPHONE
~SI NATURE OF PERMI7TEE
~.'-I1$E"ANt:'Y
y * ~-V..,e.,....
..,z:.:.
c.....,.< -~.r.. ' .a~..
L ~ ~L • ~ . :-..~.r<'4 S:z;, ~six3';x:.. _.>.i
. ~
_ ....`EY:... ~
`
5..:&~f~c.."~.,. . . . , ~ ~
~.5".f: • "..?ci's:._lr.. ~j':..«a~ ....1.:3.'~q~:i.. ..:5:~:0.:~~:iF:vi~.':i.~:::.!":::~~;...[.
. . ~ . ' , c . .
d
. .
. . _ . . ~ . . . . . . .
c . •.F..~ ' ...GS's°u>....:`a~ ~ •:..."a.~(Y.~~,:.'.~.: ' :.5..::_<,'. :
. . .:ay..
. . . . . . k.~..._. . .
. n..?
..;C•, ..3:-i
.
. . . ...~-e. . . .e,. f..kti. . .S~ v T ~ ..i::,
~u ix. ~vi •s., i., Z, E H..y : rs[~.. :.E..^ ~r~~,~'i;i.>~£! >.C?:~,
. .•o .i~~ .,...;.>..m..;v...:~o. ` pe
D ~
,
;...~a<......,.. % . ~..,Br,>, r;. ~ .;-:,~n• ~
..._....,...,.._.»,._w....w.~....,asz,.s;.F..,,.,...&...aw.:........a...:c3'.k 1xis..w:G:.,:. '~~,£:..ws... "...~:';~;;:..x...~:.i~.i..-: ^:.5...,«,...
1993 MECHA1vICAL PERMTT (COMMERCIAL)
CI1Y OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COr9vIERCIAi/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE: Cl ~ CONTRACI' PRICE: $
w-W-
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF CONTRACT FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PERMiT FEE.
TOTAL $
STTE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAh1E: (IMPROVEMENTS ONL2)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CITY INSPECTOR
.CW7~-o . o 0
2005 RESIDENTIAL BUILDING PERMIT APPLICATION C~ I l~ i?. jAJ
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construcfion Reouirements RemodeVReoair ReouiremenLs Offce Use Onlv
3 registered site surveys showing sq. N. of lot, sq ft. of house; and all roofed areas 2 wpies of plan Ced of Survey Recd Y N
(20 % maximum bt coverage allowed) 1 set of Energy CalcuWtions lor heated additions Tree Pres Plan Recd Y N
2 wpies of plan shaxing beam 8 window sizes; poured (ound design, etc. 1 site survey for adtlitwns 8 decks Tree Pres Reqmred Y N
1 set of Eneigy Calalations Adddion -indicate rI on-sile septic sysfem On-sRe Septic System Y N
3 copies of Tree PreservaGon Plan if lot platted after 711193
Rim Joist Detail Optlons selecGOn sheet (bmldings with 3 or less units)
Datc '4R__/_~ j(~/p' / Construction Cost
Site Address 'j'Cm p
Unit/Ste #
Description of Work 4~ca~-G 4w vk`~T~~~ c/~•.Y/~~
Multi-Family Bldg _ Y x N Fireplace(s) _ 0 X 1 _ 2 ~
Property Owner Role,~ /`/SCTI /f~~VQ!F Telephone # (`sl - -~OSI~~
Con[ractor
Address /P`~ U y ~GIJ~ City ~G State Zip Sd 7_? Telephone #(Gs~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672
(J submission type) • Residential Ventilation Calegory 1 Worksheet . New Energy Code Worksheet
Submitted Submitted
• 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 plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone #
Mechanical Contractor Telephone ~
Sewer/WaterContractor Telephone#( ~
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accura[e;
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 wark will be in accordance with the approved pla in the case of work which requires a review and
approval of plans.
App i anc tl 's Printed Name App ic ignature
~
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 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 Ot of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) O 33 Eut. Alt - SF
? 04 02-plex O 10 OB-plex O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex )0 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addilion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 AlteraGon ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCemenl 'Demolition (Entire 81dg) - Give PCA handout to appiicant
Valuation Z 0 0 0 Occupancy T2, 3 MCES System
Plan Review 100% or 25%
Census Code LqJq Zoning Ciry Water
SAC Units Stories Booster Pump
# af Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Y/3 Widlh
REQUIRED INSPECTIONS
_ Footings (new, bldg) _ Pinal/C.O.
_ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool _ Ftgs _ Air/Gas Tests Final
Framing _ Siding _ Smcco _ Srone _ Drick
,L Final _ Windows
_LO Fireplace ~O R.1. _~1AirTest '
~ Insulation c _ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date , ls, I d -
Site Street Address 7 l!~ 3~ ~~S I ~ K LL S 1/~ Unit #
Property Owner Telephone # ( )
Contractor V qG1 e ( ~_evTelephone #
/
Address 7.2-0 PG ot 4-c ac_i ~(Q L~ CityOkP<C Ao'r0. ~ State( _ Zip
The Applicant is: _ Owner ZsContractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
~ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. !f you are installinq on/v a water sokener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is required to rev,i nd approved.
4d/ , Q.,
Applicant s Printed Name Applicant's S gn re
~~-K-
~I o~ 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION 3 ~.S u
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
Please complete for: single famity dwellings & townhomes/condos when permits aze required for each unit
Date/_:~ / ( 25
Site Address / (2J Unit#
Property Owner Telephone # ( )
Contractar 7U 4, L-
Street Address 9'040 7Z- City F--~.
State Zip 556yV Telephone#
Bond Expires:
The Applicant is _ Owner _ Contractor _ O[her
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Additional _Replacement _ New
air exchanger
air conditioner
_ heat pump P~•'A
other rK ~gt C_ ~o ~4'~,r4146 e-- `
~
State Surcharge $ .50
Total $ 5~'SO
1 hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accura[e; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 cas/Q of work which requires a review and approval of plans ~
~~A~,-~~S ~/c~,vK`^Sp•-1
ApplicanYs Printed Name pplic ' Signature
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
Please complete for: commercial/industrial buildings
multi-family buildings when separate pertnits are not required for each dwelling unit
Da[e
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephane # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Instail Piping _Processed _Gas
Nature of Work:
"When insta!ling/removing underground tank, ca/l for inspection by Fiie Marshal and Plumbing Inspector
Permit FeeS: 570.50 Underground tank installation/removal
550.50 Minimum (includcs Statc Surcharge)
Of
Contract Value $ x 1% Permi[ Fee
$ State Surcharge
If ep rmit Cee is less than $1,000, add $.50
If pertnit fee is more than $1,000, surcharge
is 5.50 for every $ I,000 owed.
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; Iha[ Ihe work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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.
Applicant's Printed Name Applicant's Signature
Approved By: , Inspector Date:
Required Inspections: - U.G. _ R.I. - Air Test - Gas Service 'Cest - Infloor Heat _ Final
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4636 Weston Hills Dr
Lot: 5 Block: 2 Addition: Weston Hills
PID:10- 83750- 050 -02
Use:
Description:
Sub Type: e - Fumace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
equirements should be directed to Mark Anderson, State Electrical Inspector,
Owner:
Mark D Renze
4636 Weston Hills Dr
Eagan MN 55123
$50.00 0801.4088
$0.50 9001.2195
$50.50
Mechanical
EA082601
04/16/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature