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
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HOUSE HEATING TEST RECORD /
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ADDRESS ?4"Z'-0e e
V APT.- R . CI_TY
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OCCUPANT OWNER .? pJ
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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