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1651 River Bluff Ct41,1/1 City of Dian 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 J. / t- 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 4•(?D • c20// Site Address: )G,G/ f,-V>e,( R , tf Unit #: Use BLUE or BLACK Ink For ffice Use Permit #: ger)/ qi Permit Fee: '3,2 q .'75 Date Receii ed: ! 4— 1/ Staff: RESIDENT / OWNER Name: Dine yl � Nan Q�1r. 1l Address / City /Zip: Applicant is: Phone: 763 yy9 -WOO Owner x Contractor TYPE OF WORK Description of work: Re.,rp Construction Cost -r DI, 5023_ CONTRACTOR Multi -Family Building: (Yes aC / No ) Company:, con ' e.. ke V)(J d e.A3/ 4 c Contact: Address: 7 6 �( P C%,') City: 34-, Po u State: M /i Zip: .ars//O Phone: 66/ - 76Q1 - 9.7 License #: OS/5/g Lead Certificate #: NAT- 2a9 U-0 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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. Portionsof 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. CALL BEFORE YOU DIG. Call Gopher State One Cali 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. gopherstateonecall.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 in the case of work which requires a review and app vat x 30e,' Po-fPxxo-j Applicant's Printed Name nt's Signature Page 1 of 3 o yr 3vn . I P f .U( HOUSE HEATING TEST RECORD / o p / Z ADDRESS ?4"Z'-0e e V APT.- R . CI_TY ? S?J B URB OCCUPANT OWNER .? pJ ? /,®. __ ry PC HEAT LOSS DATE HTG. INST. SOLD BY // -- INSTALLED BY 4?. ee /7.a? Electrical Work By Gas Line By -???r? ?e- TYPE OF HEAT GA _ FA HW -STEAM SPACE HTR. UNIT HTR.?-OTHER /1 GAS DESIGN 1 CONVERSION MAKE I?/A/Z MAKE OF BURNER Model p 4,4f034 Q a Model / Serial f ??? ?? ?? _ Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS 0 3AA31A 33 THERMOSTAT Heat at Plug Vent Size Valve KIND OF LINER ?0 W E -NONE Limit Draft Hood Regularor Limit Setting Filters Size Number Fan Setting Chimney Location Inside Outside Pilot Type ?A7 7- Q" Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring v Pilot Timing Draft Test Tag r L.W. Cut Off Door Pressure Lig Ting Inst. - " l vi e Pressure Percent C0 Date Tested / fin= 2 InpuT CFH _? Percent 0 Z Company Testing -? 2 Stack Temp Percent CO a Name of Tester . _ Farm 235 CITY OF EAGAN 3795 Pilot Kpob Road Eagan, Minnesota 55122 Phone: 454-8100 Date: WATER SOE TI tTER September 20, 1977 PERMIT Site Address: L ??- 2haJZ Lot Block _ Sub/Sec. RZrle it hl 41/300 lJo d 1 No. 1 Receipt No.: 490 Single Residential Multi Res., Comm./Ind. Name °d Schwarzrock, New/Alter./Repair alteration Address It-151 Biverbluf f Ct. Cost of Installation an Ors City Phone: Permit Fee ;,later Conditioninki . S? ` Name Surcharge 15 Cedar Ave. S c,. Address e City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with oil applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official 1. Date st 3. Job Address 4. Owner MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly Fee S6 0 S,C Tot. 5. Contractor Phone 6. Address 7. City B. Building Type: Residential Z 9. Work Description: New ? State Zip Commercial ? Institutional ? Add ? Alter f Repair ? 10. Describe ,ter. ?•.- /rl:r Fuel Type 11. No. Equipment BTU - M. Ea. Forced Air i??6 ? ??`"• No. Equipment CFM Ai H dli Mfg. r an ng: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : - - for Rough Final Inspections: Date Insp. Dated a This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Permit No. EAGAN TOWNSHIP BUILDING PERMIT Owner ....4C!?'.`.'`.^ ...:................. . "-..-. Address (Present) :? . ................... ' ......... ........ Builder .......s!Q' "'."..`.R. ...................... Address DESCRIPTION N° Eagan Township Town Hall 2916 Date .."---_A7- 72- Stories To Be Used For Front Depth I Heigh! Est. Cost Permit Fee Remarks ??o?f3,ooo?2/St so of ?/7r L (may fem. 4 lee 196 72- LOCATION H x.- /- - Street Road or other Description of Location Lo! Block Addition or Tract //r Ni3Ge This permit does not authorise the use of streets, roads, allays or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that.° ...............'...._....?. .`.'! ................has permission to erect a...? g...!:? ....a...:...T the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955.1 ........../....`.:.:a'`.^.-:L...-....0."'. rr:....... Per ................... 11 .......... ........?' '-`•:o-^ ................................ 43 C..C rd. Building Inspector S to q (PO PLUMBING (RESIDENTIAL) S l 0 Permit Application City Of Eagan 3330 Nlot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwelling, Townhomes and Condos when permits are required for each unit Date /o / !? ( 03 BARRY, CHRIS Site Address 1659 RIVER BLUFF COURT Unit # EAGAN, MN 55121 (651) 454-8408 Property Owner _ telephone # ( ) A? ?i ?y? /rA Contractor NMLOM P?lH ING CO, (692) W-3 Address -GAWKS ? ?aV5GA ks'herIG Sa City . , State p Telephone # ( ) The Applicant is Owner '. Cort=actor Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPG license $ 100.00 Includes County fee. Additional consultant fees inay apply. Alterations To Existing Dwelling Unit, Including Adding fixtures to lower levels or room additions, excluding water softener and water heater $ 50.00 _ Abandonment of septic system - Water turnaround (+ 5/8" meter if needed - $121.00) Other: _ RPZ - new installation repair _ rebuild $ 30.00 _ Lawn irrig ;timi sgsien, Water softener X Water heater ( ? l5 P ( IS v $ 15.00 X replacement - additional D m3 7 - ---- -- _ , QCT State Surcharge $ .50 B Total $ is-,So r hereby apply for a xesidennal Plumbing Fernnt FnA acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes ci the City of Eagan and with the Plumbing 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 req,vies a review and approval of plan s. Applicant's Printed Name Ap Signatur ?g / 3q PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX 4 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit D / t 4- a e , f Si d N J (4- te Ad ress 1 Q Unit # r Property Owner ' l,C,i r f Telephone # Contractor I j Address ? City I N . ? p ?JI IN p } ? ( Q n State yy 1 ? ? IV Zip _ ? Telephone # J?j, D t 1?1? v?C The Applicant is Owner A Contractor Other Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 Adding fixtures to lower levels or room additions, excluding water softener and water heater - Abandonment of septic system - Water turnaround (+ 5/8" meter if needed - $121.00) Other: - RPZ _ new installation _ repair _ rebuild $ 30.00 - Lawn irrigation system Water softener _ Water heater -' ? - $ 15.00 ` -)(replacement _ additional ''\v 50 $ State Surcharge . T l y' ? ? ota ? ? $ 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 with the Plumbing 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 / pwhich requires a review and approval of plans. approved plan in die case (o(f?work ?1 ?(?T ? ?/? k Awn ' i {'C?y'l.'"Vch W r Applicant's Printed Name Applicants Signature OWNER MASTER CARD STRUCTURE AND TA LAND USED AS ((J (/ / cw Permit No. Issued ssued To Contractor Owner BUILDING 29.16 7Z PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING FOUNDATION •. r 3 •, , SEPTIC CESSPOOL FRAMING ? y-7 TILE FIELD FT. FINAL ELECTRICAL HEATING 7?,y•7 DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING $ WELL SANITARY SEWER f f.•?T so3?l? Violations Noted on Back COMMENTS: i COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. DATE OF INSPECTION ITEMIZED AND DESCRIBED AS NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REINSPECTION DATE OF REINSPECTION CERTI FI CATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected, ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE DAK 544 ZONING - NOTIFICATION OF INTENT Foster Family Homes Day Care Homes TO: ,3-)gs PI (04 Vnob Rk (Street Address) F-0 dCp?1 /U !J (City) (State) (Zip) FROM: Dakota County Social Services 357 9th Avenue North So. St. Pauul, MN 55075 r APPLICANT:.: iJ'C! (YUz (Gi A y? Cy M c C (1 CL P ?Yl (1 ! (? l? 1Y (Name) , (Str AA /0 Number of Natural Children under IS in home: 0 103 4 V (circle number) (circle number) DATE OF NOTIFICATION: - Number of Foster Children included in licenae:I 2 3 4 5 5 7 circle number) Number of Natural Preschool Children in Home: 0 I(?Z 3 4 5 (circle number) Number of Day Care Children included in license: 0 1 24 5 6 7 8 9 10 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: 12/29/72 (4/25/73) OWNER: Rivergate Villa -Bldg. 4 PLUMBER _ Berghorst Plumbing Co. NUMBER 1318 Address 1651-53-55-57-59-61 River Bluff Court TYPE OF PIPE heavy cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential I Multiple Dwelling I No. of units I I I xx I 6- townhouses Location of Connections: Connection Charge 1170.09,4/25/73 Permit Fee 10.00 'Pd 12426472 .50 pd 12/26/72 Street Repairs Total Inspected by: Date Remarks: By. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Tocroship, Dakota County, Minnesota By Please notify when ready for inspection and connection and before any portion of the work is covered. EAGA.N TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date:4/25/73 (12/29/72) Number: 1174 Billing Name: Rivergate Villa-Bldg. ! Site Address:1651-3 -55-57-59-61 River B1uffCt. Owner: Billing Address Plumber:Berghorst Plumbing Co. Location of Connection Meter Size/ a " Connection Chg. 0.00 billed 4/27/13 Meter No.-:P,.2P4114ao Permit Fee 10.00 Pd 12/26/72 Meter Reading Meter Dep. .50 pd 12/26/72 Meter Sealed: Yes_ Add 11 NO I Total Chg. Building is a: Residence Multiple X NO. Commercial Industrial Other Inspected by Date Remarks: tovmh j- ' \gNVR P By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Fagan Township, Dakota County, Minnesota. By: Berghorst Plumbing Co. Please notify the above office when ready for inspection and connection. r?l -70-?)Un 2005 RESIDENTIAL BUILDING PERMIT APPLICATION r -10 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 r, A k( New Construction Requirements 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 2 copies of plan showing beam & window saes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Remodel/Repair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on-site septic system Office Only Recd CedafSurvey Survey Recd _Y _N 1 Tree Pies Plan Recd _Y Tree Pres Required _Y _N On-site Septic System _Y _N Date io / J / 965 /c Site Address .1653 R t t1Q,R, L p lluT C Construction Cost _?Oft ? o U, B-t UnidSte # Description of Work ?Vlt wail -Fr ,-" mo al /200M Multi-Family Bldg y- N r Fireplace(s) - 0 r X I - 2 Property Owner DE. 'a ?o5 et2 Telephone #(6ia) R96-099 Contractor S? Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) 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 plan? - Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( Telephone #( I hereby 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 case of work which :requires w and approval of plans. ) ?PSr. T\ Y10. ?0 5?C? ? Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-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 01 of- plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ?j 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 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Plan Review 100% or _ 25% Census Code UW Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const 05 Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Final/C.O. Footings (deck) ?i Final/No C.O. Footings (addition) _ Plumbing Foundation ?C I-IVAC _ Drain Tile Other Roof Ice & Water Final Final Air/Gas Tests Ftgs. Pool _ Framing _ - = = Siding Stucco Stone _ Brick _ Fireplace _ R.I. - Air Test -Final - Windows 7° Insulation _ Retaining Wall Approved By: EL , 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 L- fey /Zr?a3??u ?? p a7 o 4/7 ( 2Es) nLw- -, ? r-re, zoo UILDING PERMIT APPLICATION 0 46 3l 1/ ?/' l 64 City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Plans are considered public information unless you state they are trade secret and why. • structural clans (2) sets • soils Report (1) • Civil Plans (2) • Certificate of Survey (1) • Certificate of Survey (1) • Structural Plans (2) • Code Analysis (1)" • Architectural Plans (2) sets • Project Specs (1) • HVAC units req'd. on bldg elev. / site plan • Spec Insp & Testing Schedule (1) " • Civil Plans (2) • Soils Report (1) • Landscaping Plans (2) • Meter size must be established • Code Analysis (1) " l • Energy Calculations (1) " d • Emergency Response Site Plan (1) 1 • Spec. Insp. & Testing Schedule (1) " d • Electric Power & Lighting Form (1) " 1 • Project Specs (1) 1 • Master Exit Plan (1) • SAC determination -call 651-602-1000 • SAC determination - call 651-602-1 000 • Fire Stopping Submittals • Fire Suppression/Alarm Form • Code Analysis (1) " • Project Specs (1) • Key Plan (1) • Master Exit Plan (1) • Energy Calculations (1) not always" • Elec. Power & Lighting Form (1) not always- • Meter size must be established-if applicable l l l l 1 • SAC determination -call 651-602-1000 Call MN Dept of Health at 651-201-4500 for details regarding food & beverage or lodging facilit ** Contact Building Inspections to see if it is required and for a sample. Permit for new building or addition will not be processed without Emergency Response Site Plan. Date S / 7 o7 Construction Cost ?? Site Address I 'V -e-2 116 u1-? F CT Unit/Ste # Tenant Name Former Tenant Name / La i63, l Lo 5r to 57 / (o ,,59 / (P (e / Description of Work W : eM o ws /` 7- , O p oat S Property Owner Telephone # ( )' Applicant is: - Owner Contractor Contractor J"l a Jc.w -t- W r`A) Jcl ?? Contractor Contact #: (?0 IL)- ?r? ???3 ?? Fe C) Address 37.3 9 /', U A? e-A a- - 4 I/ AE? City Z-S State ??pv Zip S$- Telephone #(6i (;L) ?o 11330 Arch/Engr Registration D CE CIS 1"/ Address City UAV State Zip Telephone # ( ) Licensed plumber installing new sewedwater service: Phone #: ( ) I hereby apply for a Commercial 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 case of work which requires a review and approval of plans. -- Applicant's Printed Name Ap s Signature City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED MAR (15 2012 Use BLUE or BLACK Ink For Office Use; Permit #: /a 3 � 9 7 Permit Fee: CGS or- 00 Date Received: Staff: !J p 2011 RESIDENTIAL PLUMBING PERMITAPPLICATION Date: of 2 ! r %a Site Address: 1 1)5(5� IR) ver au f/C 1 ' Tenant: Suite #: RESIDENT / OWNER Name: 1.<61,‘ SVv)Ifin Phone: 5 I - 717-- 7 41 Li 3 Address // City IZip: Same) 30.rI, YY1NI - 5 S Z) CONTRACTOR Name: Oran'? on `( 6 Vic! rhi Y�� License #: (O � -7 0 yP;, p; Address: TJ C; T i(i P.,(- • "CiA1 r"City: State: .1J. V) Zip: r "a12 2D Phone: () -2)(0 1.2DL) 0 Contact: Vir ( 5 Email: TYPE OF WORK New "Replacement Repair Rebuild Modify Space Work in R.O.W. — _ _ Description of work: ` lGICe. W a„,-Gle-z c -r tf PERMIT TYPE RESIDENTIAL Water Softener "Water Heater Add Plumbing Fixtures ( Main / _ Lower Level) Lawn Irrigation ( RPZ / PVB) Water Turnaround Septic System New _ Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation $55.00 Add Plumbing *Water Turnaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) (add $166.00 if a 5/8” meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ (00 ` �y� °V 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.gooherstateonecall.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 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. --sAnvis a . Applicant's Printed Name FOR OFFICE USE Required Inspections: Under Ground Rough -In _Air Test _Gas Test _Final x Applic9Sign ure Reviewed By: Use BLUE or BLACK Ink r_________________ I For Office Use � � / "� I C�� 0{' �n nn � Permit#: / iX ���� � y � a�a�� , �+, �,� � 3830 Pilot Knob Road � Permit Fee: V• I I � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 � i Fax: (651)675-5694 I � I Staff: '� I �-------- ----- —� 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applications. Date: ^Q ��° l Site Address: �(L��' �i11�� �/GL '�l �-� Tenant: �—` Suite#: ResidenUOwner Name: ��� � �3�� Phone: Address/City/Zip: ��� Name: ,l/'�S��G"L�- �y'1��������' S � License#: Address: f 7�� � °,�/'4rz�''S �� /1.%�City: ��1��.�:U Contractor '" State: ��7✓ Zip: 5�,�j C� C Phone: �� � J C�� ��l�� Contact: �i/�'1 Email: �L�S�`��� ^`�� �" �`�� New �Replacement Additional Alteration Demolition Type of`Work Description of work: r' !��'�= �r"�?cC��- 9`- �� NOTE: Roof mounted and ground mounted mecnanical equipment is required to be screened by City ' Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL umace New Construction Interior Improvement PePmlt Type ' Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit _Heat Pump Under(Above ground Tank �Install/_Remove) _Other � RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee *If contract value is LESS than$10,010, Surcharge=$5.00 =$ Surcharge* "'`If contract value is GREATER than $10,010, Surcharge=Contract Value x$0.0005 '"`"If the project valuation is over$1 million, please call for Surcharge = $ TOTAL FEE , 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 I with the approved plan in the case of work which requires a review and approval of plans. �� X Cr � ��._.S ��S��� � x � ---.. ApplicanYs Printed Name Applic nYs Signature FOR OFFICE'USE Required Inspections: Reviewed By: Date: Undergrau�d - Rough In ' Air Test Gas Service Test In-floor F��# Firr�l•��•M HVAG Screening Aug 18 1511:04a Sunrise Remodelers 651-762-9395 p.17 Use BLUE or BLACK lnic �----------------� I For Offlce Lise � I � ° j Permr#: /..5��� 1 C�t� o��a �� � Perm Fee: ���'�� � � rt I � 3830 Pllot Knob Road � Eagan Af3N 55122 � Date Received: � Phone:(fb7)575-5675 ,. � � Fax:�651�675-5694 � Staff: � 1 '-�'4'Vl�(.�� E `� � �f e�t l���+ C.;�.f c; �,�e"�� r� ,c�vr �----------------� 2o's ��s����Te�� s�«D��G �E�t-� A�PLrca�o� C-�d��,r� t3L���f= Tno��� ���c s-�s• �a4e��mm�r��I '� Site AdcEeess: 11P�� 1�'l�.V,�.�( L��v';�t�t ���yl� �.�-�/3!Uni�#: � RY. <�trl�-! uL'��5��:�C������o�"���,�����r�a ��t ���y...,.,x-..��.�,�..��e....�.... ; ; �lame: Phone: Resider�� �wn er : address�City�Zip: � _ ,_-.., ...._,.,.....-__-.<.,., ��icantis.� OwnerT �„Conuador.-..�.-r.-,�_-_-.._,:.._:.,:��..�,..,.�..�.-..,.,-r _�m�..�,.,_,�.�__-�-_.�.�,. �.�pe O'F 11VQ�'(K Description of work:_ �j+ CJ� n�\ � � � Cons6vction Cost: � 1 !� ���'•C� . _- Multi-Family Building:{Yes ✓ !Na_) ? . t..w..:....._..�.._,.:..._..,..:.�_...w,..,��_�,- ,..�_...�.w...... ..,.�..�.._�,�T.,,...:,._,.........�__._..__��.,...,.>,.......,v._,...�..._.,..�....,_.�_.,�..,....�.d�w_._:�..:__,,,_,<.: f ° Cosnparry:���1r1 �; S-� ��e w1 rx�-z_4-e:S Contaet: �G '�� ��;-c�.y- ,c�1 , � : ��ntra�tor � a,ad�s:c'� (c �—�t.��-e ��i ;n-e c�: S� . �.�1 i � ; Shate: 1?/1J Zip: � �� �V Phone: Email: i Y1 yZ.% �. S�-i Yr r� ��V��v+cc1-��;s, : � � �� �' � ;c�:�, � ._.. ...,w.�,�........,...,.._.....�.�License#_.._C�__._.�� ... n..E.�,.LeadCertificate#: ��T�_�����-3.�� � : ---,�--,�,� ' � If th�project is exempt from lead certification, please expfain why: �_..�.x�v�......_-�.��_.��_.�.�..a,�z.�.....�....-.�,� ..�,.�.�.,�_-.Y=,-�,_.�._... ; GON3PLETE'd"FlI��►6�EA�MILY�F CONS'i"RiJCT[�G�4 NE91�/BUIL�ING _ !n 4he last 42 months,has the City of Eagar�iss�ed a perm'rt fror a similar�lan based on a master plan? ' Yes No If yes,date and address of master plan: � � License�Plumber. Pfione- : Mechanicai Contractor: Phone; ; Sewer&Water�ontractor. � Phone: ; Fire S�ppression Co�tractar. p�aRQ; ;�...:...--....:�..v-o._._.._�,�_�,�.,�:_....._....,.,..__�..,�.x�.�,z._f,�,.:..,..x_.�.,...:....�..�,�r...,_..-.,:.,a,,,.,...�.�.�...,�...,.�.�.w_.--- ----:..,,......._<..:y....�.,�..e.e..�.�...� _.,,.�, _ ; I�OTE:PiaraS ardd sttppanis�g cfoct�me�nts�daag you sue�rrrit are consldereaP i�be pubiic informafton. Por#ions e�� Y ' - the ir�fa�t»atlo!r�ay be classi�re�as nan pubiic if�rou provfde specFfic reas�ns that wbulaP�enrrit the City tm- � ' __......��..._---�N,�p��nclude thaf tfreyare�de secre#s:, n�... ....:,.�.....:�4.�_�.,_�._�..y.�...�..._s_.�.r_.�..._.� CALL BEFORE YOU DIG. Calf GapherS4ate Oae CaIE at(651�R54-0002 for proteciion against�mderground utilitydamage. Cafl46 houfs befere you intend io dig to receive lacates of u�erground utiUfies. www.aooherstateonecail.ora I he�e4y acknawledge tbat this information is complete and ac�rate;that the work w�11 t1e in contom�ance wiU�the ordinances and oodes o4 the Ciry of Eagan; tnat 1 understand this is not a permit, bu#only an applicalion for a permit, and+nrork ts not to start without a permit;that ihe work vm71 6e in accoMance wiiE�Ihe approved pfan in the case of work which requires a review and approval of plaris. ExEerlorwotk authooized by a building perrni!issued in accardance witB the ARin�esota State 8uilding Cade must be completecf wi4hin 980 days of pennit issuance. _,_ X �� ���r, �� . , � � _...... � Applicas�t's Prmbed�Uame a 's ignatuee _ Page 1 of 3 Use BLUE or BLACK Ink r_______________s.� I For Office Use � • � Permit#: ��� �� I C��� �� '""�"� � I Permit Fee: !��' �� j 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 � Staff: I I � 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: { ��� �'�� ���� ��� `���U�nit#: � ���� Name: � Phone: Ftes,ic�ert�J � (���r Address/City/Zip: �L/�J� ��Vl.�alt,�f^P Cl� L�/�C�. 7'j'IN• 55��� ' Applicant is: Owner Contractor ' Description of work: �FPL+�CE � �� Typ� b��ar# w ' Construction Cost: '$ .3 Multi-Family Building: (Yes�,/No� Company: On� 66 d�4 L(.L Contact: �'TI�G[�3 ��5�� Address: ,35780 qD k �LtT City: (..�it�o� �i1'c.s-s CC�tl'�1'+�.C'C01' ' State:�N Zip: 5500 Phone:�..5/-a`�5- d3/I Email: SJoFFNsQ..i�Ci4�woN��'�'1 C�'� ,� �--- ' License#: /V 1R Lead Certificate#: N��l- ' If the project is exempt from lead certification, please explain why: No (,t,�.o P�Lss�rr 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: Fire Suppression Contractor: Phone: ; �Q7`�':P�ax�s a�d�u#��art�ng�a�c���ents t�iat yau su�r���are c�nsid�retl tos�be pr�btr,'c tr�fc�r�at�rrn, F�:���s;of :: t�ei��r�rr���or�m��r be cl�s�si��ed����on�itib�lc�',�o�p�ov�e spe�i�'fc r�asor�s��t t��d�erm��e Ci�,�t� 'ctrr�c�i��fe that t�e ar�t,rade;�cr,e#s. ' 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.qopherstateonecall.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 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x J1773iR'' �0/�-,�rS a-�J x Applicant's Printed Name Applic 's nature Page 1 of 3