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1565 Rustic Hills DrCity of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA095679 Date Issued: 08/30/2010 Permit Category: ePermit Site Address: 1565 Rustic Hills Dr Lot: 5 Block: 0 Addition: Rustic Hills PID: 10-65000-050-00 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Nikolay Kravets 1565 Rustic Hills Dr Eagan MN 55123 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. Applicant/Permitee: Signature Issued By: Signature Ity aI Eagan 3830 Pilot Knob Road Com. IU PJ CK199 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: b I?) I Use BLUE or BLACK ink Ft24tttit L F. yqO ,� Permit Fee: O I 1.74`te 1 e c vcii: i Staff: 2010 MECHANICAL PERMIT APPLICATION Site Address: 15�, Sic- PAS Tenant: Suite #: IRESIDENT / OWNER Name: ) i 'J gr % Je l -s Address / City / Zip: Phone: 3.4)- )9eiPP CONTRACTOR Name: ,I ; g . .Ser v : -- i License #: D 0 "/ - ))- Address: " p7 30 r- Cy„,„,43 4..e( b City �+ ,( - nwncr, State: / 7ri Zip:: T )1 -7 Phone: _ 441- lief i - %i'‘s'-S Contact: t.' Email: TYPE OF WORK _ New Replacement Additional Alteration Demolition Description of work: scr b Ct PERMIT TYPE RESIDENTIAL Furnace Air Conditioner _ Air Exchanger _ Heat Pump Other New Construction _ install Piping Gas COMMERCIAL Interior Improvement Processed Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) "When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes 5.50 State Surcharge) S) ° 50 TOTAL FEE COMMERCIAL FEES: $70.50 underground tank installationfremoval $50.50 Minimum (includes State Surcharge) OR Contract Value $ x 1% - If Permit Fee is less than $1,000, surcharge is $.50- - If Permit Fee is ' $1,000, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). = $ Permit Fee = 5 Surcharge _ 5 TOTAL FEE CALL BEFORE YOU DIG. Calf Gopher State One Calf at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecali.ore I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Citi 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. X IT iO4-1 h Applicant's Printed Name Applicant's Signature CITY OF EAGAN Y • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 120'78 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for S :) 6JG A'ru; Est. Value +' 11 b i U U U date 19 Site Address 1565 RUSTIC HILLS DR Erect C] Occupancy =?3 Lot Block UU SeclSub. RUSTIC HILLS Remodel ? Zoningl Parcel No. ADDITION Repair ? Type of Const Addition ? No. Stories s i 'i",;OUll REALTY & CONST Move ? Length W Name Demolish ? Depth p Address 5920 HARDSCRAJ3BLE CIR Int.lmpr. El Sq. Ft. City GIUUND Phone 472-5769 Install ? UQ W W Z ? U? ? W Asses: Water Police Fire 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 Permlttee 4WS XA/ - Planner Council s Bldg. Off. 6/2/8 APC Var. Permit ? 473.00 Surcharge 58.00 Plan Review 236.50. SAC 575.00 Water Conn. 50U.00 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156.00 Parks Cop ,es $2,352.00 A Building Permit is issued to: W b"1TVVVU1j tt t, ?.,? r x a t.v?V:J1 on the express condition that all work shall be done in accordance with all applicable Smote of Minnesota Statutes and City of Eagan Ordinances. Building Official . _ I Permit No. I Permit Holder Dote I Telephone M Electric 11.1 n t, I -j i CII I ( ' - r Ml", I/-_-) o of J f'/\- 1 Final Htg. Final Plbg. Bldg. Final Carl. Occ. Deck Ftg. Deck Frmg. Well Pr. Diep. PERMIT #© ' MECHANICAL PERMIT RECEIPT # CITY OF EAGAN DATE (- 3830 PILO T KNOB ROAD, EAGAN, MN 55121 CONTRACT PRICE: PHONE: 454-8100 Site Address TYPE WORK DESCRIPTION BLDG Lot. Block Sec/Sub'' . ? w R N m Name k es. e m it Add -on . Address R i C omm. r epa c City Phone Oth er Name rr FEES c Address :L a -'? RES. HVAC 0-100 M BTU -$24.00 p City E-ti p Phone t ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK _ GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other \ FEE S/C• TURE OF PERMITTEE TOTAL - FOR: CITY OF EAGAN 1 ??o Il///`l? G PERMIT # "PLU (i PERMIT °. ' CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: - nuTasr'r pAlr_F• DunYP• ARA-Alihn -SO Site Address `•' - 5 T ' `-'/< < % 4,"r. I BLDG. TYPE / WORK DESCRIPTION Lot Block Sec/Sub m Name Addre c City Name _ Address O City - Res. New _ Muit Add-on Comm. Repair Phone Other Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE _$10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF FOR: CITY OF EAGAN NO FIXTURES TOTAL _?-Water Closet - $3.00 /// $ Bath Tubs - $3.00 / _Lavatory - $3.00 ?!1 Shower - $3.00 _I-Kitchen Sink - $3.000 Urinal/Bidet - $3.00 Laundry Tray - $3.00 -r Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 t Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 1 Jl FEE STATE S/C: GRAND TOTAL T2 s? (Irrtifirotr of (Orrnvonry 4Citp of eagan Frvw:tMMt of 11didmg jnaprram This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.- SF Gw!;,,:Ali 12.3 Use Clawificum Bldg. Permit No. R R 1 V n Occupancy Type Zoning District TYPe C. - Owneror WE TtY_u;l'' ., .. :.'t Add= :)920 HAF,I Addf= t 5'65 '.testy ,,5, BOO, cii:STiC HILLS Aiiii Building Official. Date: POST IN A CONSPICUOUS PLACE Box 21 i, MN ! Address: SEWER SERVICE PERM PERMIT NO.: DATE: No. of Units: e i - to eeeuoly WINr the City of Began of Insp.: CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 65121 Zoning: Owner. Address: Site Address: Sr _c Plumber: Meter No.: Size: Reader No.: agree to eerePlir wldr the city of Iowa Connection Charge. Account Deposit: - Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: Connection Charge: Account Deposit: ' Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: 4 WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: CITY OF EAGAN Remarks Addition RUSTIC HILLS ADDITION Lot 5 Rik D Parcel Owner street 1565 Rustic Hills Drive State Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. Z13 2- 1980 1955-41 JAS-54 10 STREET RESTOR. GRADING SAN SEW TRUNK -46 1968 45.85 1.53 30 * SEWER LATERAL I 9jq0 34-9;4 - S6 7-30-30 is WATERMAIN WATER LATERAL 1972 179.98 8.55 20 WATER AREA 1977 79.55 5.30 15 • Water litteral 1980 STORM SEW TRK t STORM SEW LAT 1980 • Service 1980 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK REQUEST FOR ELECTRICAL INSPECTION ER-00001 on See instructions for completing this fpm on beck of Yellow copy. IfFS Q Q "X- Be/ow Work Covered by This Request 3 3 A of Sul ld ina 1 Appliances Wired 1 Equipment Wired Bulk Milk g Fee Service Entrance Size a Fee Feedersr8ubfeedera a Fee Circuits 00 0 to 200 Amps - 0 to 30 AMPS 0 0 to 30 Anij)s Above 200 Amts 31 to 100 Amps 31 to 100 Amps Swimmin Pool Above 100_Am Above 100_Am Transformers Irrigation Booms Partial/Other Fee I I I Signs I I ISpecial Inspection 12 S-9 -Di TOTAL FE Remarks t riREQ f%mNiE fU r_AC--r0A1/ Rough-in r Da the Electrica oectoq hereby .artily that the above Final - r ` inspection has been _eQ de. Thion,queetvoldlSmontMlmm vC? 11 _" "tom This request void % _ ) 2 r _ 3?1 3 18 months from t0 .J ?•?([7 I A J68119 L C3CD0 _P:l, A ? r) 5 Re uest Date o`/ 0 t Fire No. Rough-in Inspection Reeuired7 Ready Now y_Sl Will Nnlitv.lnspec- C ]Ready Wh Y ?t R tCJ o ?yes No pr en eatly CKLicansed Electrical Contractor 1 hereby request inspection of above Owner electrical work installed at. Street Address, Box or Route No. City 1563 eu.i'TrC lllt-41 >T. ?gGAN Section No. Township Name or No. Range o. County I -NKo7-A Occupant (PRINT) Phone No, c wFs; Woo 8 /{C-14 c7r co ,s 7- 5/72 - 76P Power Supplier Address SP 'fen iloc 3000 ?L4X L--' C-< C. C Electrical Contractor (Company Na") Contractorws License No. 77C , Cc i7Pi C oY /7 R9 Mailing Address (Contractor or Owner Me klig Irtsbilation) BS6 F?*? F,4-j0W7- ?E "''r' ?/J uc SS/ o f Auth?SiQnature (Contra for Owner Making Instaflation) Phone Number 7 -S6 8 Z THIS INSPECTION REQUEST WILL NOT MIN4ESOTA STATE 06AFID/F ELECTRICITY id 921 University Room , MN RE ACCEPTED R THE STATE BOARD 1 UNLESS PROPER INSPECTION FEE IS FEE IS 1321 Ave., St. Paul, MN 66104 Phnom 1918121 21 297.2111 ENCLOSED. CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road 7601 P. 0. Box 21199 PERMIT NO.: 6-24-86 Eagan, MN 55121 DATE: Zoning: Rl No. of Units: 1 Owner: Westwood Realty Const. Address: Site Address: 1565 Rustic Hills I Plumber: Westonka Plumbing _ Meter No.: pocf( Size: 4/1, Reader No • D 5 I some to eseply with rbe CRY of lease ordieeacm By Date ofe l Sf A(' ConneerIm Charge: 500.00p d Account Deposit: 15.00n d Permit Fee: 10.00D d Surcharge: .501 )d Misc. Charges: 156.00D d TP Total: 6'A %O p d ..later Daft Paid: CITY OF EAGAN C _ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N 2 12028 PHONE: 454-8100 BUILDING PERMIT Receipt If To be used for SF DWG/GAR ESL Value $116,000 Date 19 ?G Site Address 1565 RUSTIC HILLS DR Erect 10 occupancy R3 Lot 5 Block 00 Sec/Sub. RUSTIC HILLS Remodel ? Zoning R1 ADDITION Parcel No Repair ? Type of Const. Vfj . Addition ? No. Stories WESTWOOD REALTY & CONST Move ? Length 68 Name 5920 HARDSCRABBLE CIR 5920 Ad Demolish 11 Depth 26 dress o MOUND 472-5768 pi Impr. ? ? Sq. Ft Phone ty mitall o Name SAME Approvals Fees i ?W Address Assessment Permit 473.00 City Phone Water & Sew . Surcharge 58.00 5 Police Plan Review 236.50 G i Name Fire SAC 575.00 uo Address Eng. Water Conn. 500.00 <W City Phone Planner Water Meter 63.50 - Council Road Unit 290.00 I hereby acknowledge that l have read this application and state that the Bldg. off. 6 /2/86 Tr. PI. 156.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or noes. p a / 1 APC Parks 1 ? ?•'... //?/? % L?XIrZ(IN ?? Var. Date Copies--$7 - 352- 00 of PermitteeLLJ6 =o ' ' ???? Total - 1 . A A Building Permit is issued to: WESTWOOD REALTY & CO on the express condition that all work shall be done in accordance with all ap lic I to of Minnesot Statue.?C ity of an Ordinances. Building Official • CASH RECEIPT • CITY OF ,EAGAN 3795PILOT KNOB ROAD EAGAN, MINN 55122 DATE 19 ICEIVED /A 1 L _ ?0_ AMOUNT I $ s-l ?U &_DOLLARS roo ? CASH U_QC FOR /SZ !/) 1 FUND I CODE I AMOUNT cci Thank You BY N_ 63967 White-Payers Copy Yellow-Posting Copy Pink-File Copy t 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 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 sizes; poured found design, etc. 1 set of Energy Calculabons 3 copies of Tree Preservation Plan it lot platted after 711/93 Rim Joist Detail options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form _ RemodellReoair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addison - indcate if on-site septic system t'/;?9. vez6? C'M? Office Use On Cell of Survey'. Recd _y _N Tree Pres Plan Recd _Y _N. Tree Pres Required _Y _N On-sde Septic System _Y _N rr c? 1 Date 121 l ?_ l Construction Cost Site Address p lm (f I ' ?/ Unit/Ste Description of Work 'n A /t?CQ cow 961?'Ct r? 7y er1 9 L?RARC.?/? I+V /JI57G?•lei+f?M'T Multi-Family Bldg - Y N _ Fireplace(s) - 0 - 1 - 2 y - Property Owner M k l? f7 rayei s Telephone # 6_Q) c?e - y a?? Contractor Address City State 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 nD Telephone #( ) Mechanical Contractor Sewer/Water Contractor DEC 1 8 2006 Telephone # ( Telephone #( LL 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 a review and approval of plans. Az it co 0 K K2 AVE '-s ?n Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 02 SF Dwelling ? 03 01 of_ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Types ? 31 New 32 Addition ? 33 Alteration ? 34 Replacement ? 13 16-plex ? 16 Fireplace /11 17 Garage ? 18 Deck ? 19 Lower Level r„ . ? 30 Accessory Bldg ? 31 Ext. Alt- Multi ? 33 Ext. Alt - S F ? 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg) - Give PCA handout to applicant Description: WaterDamage.`Yes Valuation b l7 Plan Review 100% or 25% Census Code SAC Units # of Units # of Bldgs Type of Const V6 Occupancy Zoning Stories Sq. Ft. Length Width ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screen/gazebo) ? 24 Storm Damage ? 25 Miscellaneous MCES System" City Water _ Booster Pump _ _ PRV _ _ Fire Sprinklered _ - Footings (new bldg) _ Footings (deck) Footings (addition) Foundation _ Drain Tile Roof _ Ice & Water Final Framing Fireplace _ R.I. _ Air Test -Final Insulation REQUIRED INSPECTIONS Sheetrock Final/C.O. Final/No C.O. _ HVAC Other Pool _ Ftgs _ Air/Gas Tests _ Siding _ Stucco Lath - Stone Lath Windows Retaining Wall Brick 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 ? 07 05-plex ? 08 06-plex ? 09 07-plex ? 10 08-plex ? 11 10-plex ? 12 12-plex 2VDxIG = 3f?Iyo S Y CERTIFICATE OF SURVEY OL.ft? LAND SURVEYORS Zgt"ry R. J?64C&a, Pte4. 8713 DUPONT AVENUE SOUTH BLOOMINGTON, MINN. 55420 888-2084 +-? Survey for: WESTWOOD REALTY 799 T. / ZO, 00 11f /ram O % ai'aina ?aserperlf o /rcn aJ 61 i $p9 f /s r Azi 61, A0,7 805' !7 I l?n??l I ?j? `n1 /? N 68 ? 3 0l! Bi /? 1 ?f `1 • l ??"?? 86/6 ? h o °? /J (•?'?d' IY°n go9? o _ hyn. Ica/ec/"? ?D nol/ 9b ?a9y DESCRIPTION: V- °. L ?c?OO.v .ny ??r6 8oyz Ore Lot 5, Block t, RUSTIC HILLS ADDITION BoFS /5?? 5 - %E UST/C ?G G S Pkl VcE Proposed Grades: Top of Blocks g/o° Garage floor 9o9s Basement floor BflZs We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon and all visible encroachments, if any, from or on said J?nd. Dated this 30th day of May , 1986 , .-. ?J '?? ---.? No. Z?9-32 1986 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF KAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND ?! To Be Used For: Valuation: Date: V Site Address 1565 Rlt9irtC #taL5 OFFICE USE ONLY Lot S Block Erect x Occupancy k S' p Parcel/Sub Remodel Repair Zoning Type of Coast e Owner wr-s e wuop J?E11 L ry g colYs i Addition Move 0 of Stories Length Address 5g2-0 ffPfRp5;CR4PPL.E a/ 12 Demolish Int.Impr. Depth Sq Ft n,? City/Zip Code /v[014HP _ /#/y 557U'r _ Install Phone q2 2 - - 7 76,;Z7 ! APPROVALS Contractor 414xk Assessments Permit Water/Sewer Surcharge Address Police Plan Review Fire SAC 5 7S-- City/Zip Code Engr Water Conn Planner Water Meter 3..? Phone Council Road Unit Bldg Off Treatment P1 • Arch./Engr. APC Parks Variance Copies Address TOTAL Z3SZ. City/Zip Code Phone # NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. Zy')e 2t/r 5 7? iZ al/Z //?9vv ----------- - CERTIFICATE OF SURVEY r ? R LW 4 % LAND SURVEYORS z"; e"Apw. qua. 8713 DUPONT AVENUE SOUTH BLOOMINGTON, MINN. 55420 888-2084 Survey for: WESTWOOD REALTY S' /roH o ?s aiaina ?aSepIlf O 7 2-3 B? 9 G lV \? 809 I? $ /?'? ly -. ..- ? Un .x711 ?\ V \?N OP SO`S' AA 6B ? a 8i ?( ??"R l y" go9? o _ v h yn Y? oo`/ 9/'0 z ms's DESCRIPTION: Lot 5, Block 1, RUSTIC HILLS ADDITION 3.0¢ V- 8oF S_ Proposed Grades: Top of Blocks Garage floor 019y:r Basement floor 6azs We hereby certify that this is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon and all visible encroachments, if any, from or on said J?nd. Dated this 30th day of May , 1986 , ^ 9 -'-2 1? 239-3z ??Zu V irate, A, TFORD.WI. 54484 WISCONSIN ENERGY CODE Am - /5 65 HEAT LOSS CALCULATIONS n Dze WESTPORT 2ST6RY HOUSE SIZE 24X44 DATE 90 Design Temp, Difference Room & Si Di??ti6 Roof Floor Wall Window Door Raom 6 Roof Floor Wall Window Door ze Size Room Size Roof Floor Wall Window Door Room & Si Roof Floor Wall Window Door Room & Roof Floor Wall Window Door . FAMILY RM 1 ivy 1 Size k_L IIUY S S77WS Room & Si Roof Floor Wall Window Door Room & Roof Floor Wall Window Door At 30 Total Heat Loss Including- Ventilation Law" L_p_yf-_L up"MAWN Mb-61 BTU/fiR Size Ventilation Loss ___A _X BTU/HR 1.28 x b8 Cu. Ft../Z3R BTU/ *Ventilation = Z Ventilation Loss x x BTU/HR 1.28 x 909 Cu. Ft. • //6I BTU/Hl + Ventilation . /?JBZ Ventilation Loss x x BTU/HR 1.28 x c9O/ Cu. Ft.?-/,/025??BTU/HR .+ Ventilation - L1?-1 Ventilation Loss x x . BTU/HR 1.2.8 x 2_ S/ZCu. Ft. _ Z BTU/H + Ventilation : /oJIOQ Ventilation Loss x x ? BTV/liR 1.28 x 0-83-Cu. Ft. . //3d BTU/ + Ventilation • /4p Z, Ventilation Loss . x x BTU/HR 1.28 x ill3 Cu. Ft.- ZZ_ 31 BTUA + Ventilation 46f3? i Ventilation Loss x x ? BTU/HR 1.28 x Cu. Ft. . BTU/v + Ventilation . Q Page 1 Of 2 jStRATFORD,WI.W54484WISCONSIN ENERGY CODE HEAT LOSS CALCULATIONS _ 4 Sr'dRV WfSTPnL2EVE2 DATES 0 40 Design Temp. Difference Room & Size _ 18EMMM ttl [• 0?G?/ 1901 7fo5 Roof /-,;(o Floor Wall OS G Window • 8 - b O 8 '- Door Room & Size BF-bZ6A"4 fb2 Roof Ml 7 024, ?9,01 45 ire Floor /VA - - 9v Wall .0 .90 W indow 990 0 Door Room Size Roof Floor Wall Window Door Room & Stue prnR,31J/A ff,4 Itoof 24o .OZ6 9 56z Floor _AJA Wall 7 4S yD Window 9ra5 Door Room & Size CLMF- % vj 314 BA T4 Roof I D'7 ,OZ D 5-0 Floor Wall ,!ey) M 9-31 Window AM Door ivA mill i ran r.1 r? Ar'cT.r Room & S Roof Floor Wall Window Door Room & Size Roof Floor Wall Window Door At 30 Total Heat Loss Including Upstairs 1947'7 BTU/IIR SIZE LG X4 Ventilation Loss x x BTU/HR 1.28 x-&ky_ Cu. Ft.- ? t7 BTUA +Ventilation ] 6 -7 Ventilation Loss _X _X BTU/HR 1.28 x 1461 Cu. Ft.. 1890 BTU/H + Ventilation o X038 Ventilation Loss x x BTU/HR 1.28 x 1126 Cu. Ft.- L-Of BTU/HP + Ventilation Ventilation Loss X x -- BTU/HR 2. 2B x 63 Cu. Ft. 23x8 BTU/' + Ventilation . Ventilation Loss x x .. BTU/HR 1.28 x SLL-Cu. Ft. a3 BTU + Ventilation - Ventilation Loss. x x 0 BTU/HP 1.28 x /Z z3Cu. Ft.. 15*a5 BTU, + Ventilation 05/8 Ventilation Loss x x BTU/M 1.28 x '7?20 Cu. Ft. = BTU, + Ventilation ?94Z Isr sr??v 14os1 Znn sad PV iy4'77 aASfHEAtr Page a Of 2 T6TAL S7, 754 BEb rA8 .1 -t 3 Warr n M Andorson 10--65000-050--00 1565 Rustic Mills Dr. Fagan, MN 55121 June 27, 1991 Mr . CIerie, VanOverbeke City Clerk City of Eagan 31330 Pilot. Knob Road Eagan, MN 55121 Dear Mr VanOverbeke, RE: PROJECT 5.13R,SKYLINE ROAD O13JP,CTlON OF SPECIAL ASSESSMENT TO $1.,059.98 LOT 5 RUSTIC HILLS DR. We purchased our lot with a black top streetand a cement curb sncl gutter. Rustic Ili IIs Dr. blacktop street was originally connected to Sibley Hills Dr. with a Southerly outlet to Hwy-#13 and a Northerly outlet to Hwy.#13. Both outlets served us very well and we were very happy with the blacktop streets. When we lurchu:-.x1 tho lot we assumed the full cost of our portion of the street. curl, and gutter on our lot 5, and we are still paying our assessment portion with our taxes. We could only assume that it was properly installed. Now cote. along 2 developer:,- who want to subdivide each of their Own varcels into lots. Because of these developers the city says more and better street: have to be built. If more streets indeed have to be built because of their development than the developers should pay all the costs of the new streets. We residents on Rustic: Hills do not profit from the sales of the lots the luvelopers sell therefore we should not incur the costs of the trt?ets the developers need. flwrefore we. object. to it. 2 years ago at e objected at this final ul;ara, :3.iuce we do irnprovament to Rustic fact eliminated one of this road assessment. We also objected to ich meeting and we were told that if we assessment hearing the City would pay our not directly benefit and you made no Hills'Drive Plat. Actually you have in our accesses which makes us drive further. To: City of Eagan 6/27/91 Irr V,h I a L e 1970's I purchased 33 acres in Minnetrista and do,.valo[w!d it into 10 3 acre lots and I paid for all the roads myself and none of the neighbors paid any money for roads. In 1972. I. purchased 2 acres in Spring Park and divided that into 5 lets aril 1. paid fnr all the road costs. None of the neighbors I,aid xny mor,rry. In both cases neighbors benefitted from the roads I built and paid for. Why is Eagan different? At o tli(.-sc, 2 developers ''Good Old Boys" and Eagan is rewarding t:hum. i)y c,aessing the Rustic Hills residents to help pay their do velopmcnt. cost's? It doesn't seem fair to me at all. We ob:icct to the $1,059.98 Assessment. Yours Lruly, Weu ren and Dorene Anderson WMA/DA i 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: o I c?v J /? U S4f G 9( I (S LEGAL DESCRIPTION: C 1 ^ _' &oc- Z 2(js+cc Alts Mdr) (Lot/Block/Subdivision or Tax Parcel I.D. Number) IF {IST= :G STRUCTURE, DATE OF ORIGNAL BUI=" G PEP'.n T_SS' C ear) PRESET =72-r,/Pj?OPOSED USE: W?--l SIN= FP_,LTLY ? R-2 DUPLEX (TWO UNITS) ? R-3 TONNHOUSE (THREE + UNITS)( UNITS) ? R-4 APARTMENT/CONDOMINIUM ( UNITS) ? CON!MERCIAL/RESAII,/OFFICE ? INDUSTRIAL E3 INSTITUTIONAL/GOVERNMENT 2) APPLICANT ?? ?? (PLEASE PRINT) /? NAME: (C (8 G ADDRESS: 5-b C_D CITY, STATE, ZIP: v,4I +J rn 36 PHONE: L4-7 Z= _ ls-7 .- 3) PLUMBER NAME: r- `_ ,? PLEASE PRINT) We ?y. +VL (?e /}? FOR CITY USE ONLY ADDRESS: ! l?Sa I C O 2A , 5- PLUMBERS LICENSE: Q Active CITY, STATE, ZIP: rn OaK?-A ( j e. V? ?? ! Expired PHONE: }{A$ QS? PLUMBER LICENSE # (?C7y Q Not of Record aSf-fFTnif 1 a - 4) OCCUPANT/OWNER NAME: ADDRESS: CITY, STATE, ZIP: PHONE: C tJe si-wn 9d0 (PLE/lSE P NT) C 1<4 i .sc =r-- #I T5 7(o 8 5) INDICATE WHICH PERMIT IS BEING REQUESTED: 0j-C.'NNECPION TO CITY SEWER Eg-C.'ONNECTION TO CITY WATER OTHER (PLEASE DESCRIBE) 6) INDICATE ONE: E] PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE kPLEASE MAIL APPROVED PERMIT TO 1, 2,(@ 4 ABOVE (Circle one) / 7) SIGNATURE: ?X(MP? (' /C?7 LSc?¢-fit DATE: g -?!Q ......... mac^r?ar iii iss??.aa as sit rrrr?:?r?i?u? ? a s aswf s?sa?ir w F O R C I T Y U S E O N L Y PERMIT # ISSUED FEES: $ 1b, 5-0 $ M_ S $ _ Z5 -,O---6 $ s ?s ; o-a S $ /5-z SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SETVER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER ;7/o TOTAL $ ??S`/ • 5? AMOUNT PAID/RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE C? NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: ?t!+N*wwwwwamawwsaewso wawwwjqwm w_awtwses?wa?c?ws?w.. 4 LcS 6 ov Westwood Realty & Construction, Inc. 5920 HARDSCRABBLE CIRCLE MOUND, MINNESOTA 55364 (612) 472-5768 CONTRACT 8c MORTGAGE DEPARTMENT Property Address: 1565 Rustic Hills Dr.,Eagan, MN 55121 Legal: Lot 5, Rustic Hills Addition 0 STRATFORD,WI. 54484 WISCONSIN ENERGY CODE HEAT LOSS CA=UI ATIONS WFSTP8RT 7_ST6t?Y 0 44 Design Temp. Difference Room & Size Roof Floor WA11 5 0105. (70? "711 Window ( (,4b d SZZ Door IVA j Room & Size ki7_C1-1" Roof 12- 1b1\1A Floor p\JA Wall D Window 1?g ?. (Y.I(, yo 533 Door /y Room Size 'elz1511rly 1 AIA L Roof 1y/{ t yUVi W H 11 4? , .05Cm G> 3 - Window N/1 Door cRoom & Site . F4NIILy RM Roof Floor Wall Window Door Room & Size 'e, Rcof AJ Floor Vial l s > o yo Windrn? N Door p ?/ L _217, 061 Room & Size L/V/A16 RM Roof Floor Wall Window Door AJA Room & Size Roof Floor -- Wall Window Door _ At 300 Total Heat Loss Including Ventilati n LAWEI2 c P.VEL • l9D51 BTUAIR pe? REALTOR'``-' HOUSE SIZE 24x4-4 DATE Ventilation Loss _X _X o BTU/HR 1 .28 x qb8 Cu. Ft, a 123't BTUA +Ventilation = ?/ Ventilation Loss x x . BTU/IR 1.28 x p 0` Cu. Ft. BTU/III + Ventilation a /C/bZ Ventilation Loss -X-X-= BTU/IIR 1.28 x 90/ Cu. Ft.=/ .OZS BTU/FIR + Ventilation 28 Ventilation Loss x x . BTU/HR 1.28 x 25i2Cu. Ft. -32J,5 BTU/H' + Ventilation m Ventilation Loss x x = BTU/HR 1.28 x ?2 Cu. Ft. • 1130 BTU/ + Ventilation = X49°L Ventilation Loss X It - BTUI.I:. 1.28 x 17±3 Cu. Ft.= LLL BTU/H + Ventilation . 8? V-ntilation Loss -X-X-= BTUM.R 1.28 x Cu. Ft. • BTU/T + Ventilation m Q Page 1 Of 7 f Westwood Realty & Construction, Inc. 5920 HARDSCRABBLE CIRCLE MOUND, MINNESOTA 55364 (612) 472-5768 CONTRACT & MORTGAGE' DEPARTMENT Property Address: 1565 Rustic Hills Dr., Eagan, MN 55121 Legal: Lot 5, Rustic Hills Addition 1-1 REALTOR" S"'RATFORD,WI. y54484• WISCONSIN ENERGY CODE HEAT LOSS CALCULATIONS - LAX Z,>r4 2 HOUSE SIZE ST6R`/ WEST Pdel C/+A 7-71 F VEk DATE c;id 0 Design Temp. Difference Room & Size /dE1?12do/?I its Ventilation Loss Roof 1 5 ZG yo 5 x x BTU/HR y AIA U5 D ZL 6f Cu. D ].28 x r Ft.= 1`fq7 BTU/ wall Window 7 d• $ -Q6 D _ j Y6 AiL 6-7 -34 *Ventilation = Door Room & Size LEhjC4dM L Roof lq_, oz?, go Floor h wall 4 f 9D Window 90 o `D - - Door 13ED,r?oM ;?3 Room Size Roof Floor WAll Window Door _ ?? R ?LJM Y1a Room & Slue Roof 240 2 Z6.) ((0) S6? Floor Wall ?54 e yD Window 9G Door Room & Size CL-bSL 2 j/ASA TH Roof J017 (.,9Z 60 25? Floor AIA Wall (? Y3 Winda%i /V Door AIA Room & S Roof Floor Wall W indow Door Room & Size 'fAASE/I'TEN Roof ly-A 3 / P 3 I Floor TAM? Wall _ S Window Door A'A Ventilation Loss x x = BTU/HR 1.28 x ht6 Cu. Ft. _ /U?O BTU/1 + Ventilation = f0,38 Ventilation Loss. . x x = BTU/HR 1.28 x II26 Cu. Ft.= 1444 BTU/H'. .+ Ventilation e 2Jr?? Ventilation Loss X % r BTU/IiR 1.28 x463 Cu. Ft. BTU/ + Ventilation ??81 Ventilation Loss x x= BTU/HR 1.28 x 6S Cu. Ft. = 4 3 IIT1 + Ventilation m 2 D1& ventilation Loss X X ? fiTt7/11 1.28 x /2-23Cu. Ft. w ?SLS BTU + Ventilation = 0756 Ventilation Loss x x = BTU/1 1. 2.8 x 2 Lo Cu. Ft. = U3F1IITt + Ventilation o 1942 At 30 Total lieat??L?osss Including Ventilation MITI r 15T STL?l2y ? t?B1U/HR Upstairs !q j ?4l]7 ZllD STAL'V BAsf-AcAtT t 94 Z6 Page 3. Of 2 TDTAL S71 754 PLUMBING (RESIDENTIAL) Permit Application City Of Eagan //11 1 3830 Pilot Knob Road, Eagan Mn 55122 V " Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date/ Site Address l Sys 2GS;k'r'z- 1)15 dr, Unit # 15- Property Owner N I K O? Ct J/ /?rct l/ Telephone # (605 ?) Contractor Address City State Zip ( ) Telephone # The Applicant is Owner Contractor _ Other Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. AlteKajions To Existing Dwelling Unit, Including $ 50.00 1X Adding fixtures to lower levels or room additions, excluding water softener and water heater - Abandonment of septic system - Water turnaround (+ 518" meter if needed - $121.00) Other: - RPZ _ new installation _ repair _ rebuild $ 30.00 - Lawn irrigation system i - Water softener I Water heater $ 15.00 11. replacement _ additional ?i .50 State Surcharge 11, r` n B?r?? :;! Total ?I I hereby apply for a Residential Plumbing Permit and acknowledge that the infomratis complete and accurate? that the work will e umbmg ? oaes, mar-i-cmacrstand this is not a be in conformance with the ordinances and codes of the City of Eagan and with th tf 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. p Applic is Printed Name Applicant's Signature RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New Construction Requirements RemodeVReoair Requirements 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 1 set of Energy Calculations Addition - indicate if on-ske septic system 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units ao `10 Office Use Only _ Cart of Survey Reod -Tree Pros Plan Recd -Tree Pres Not Regd _ on-she Septic System o?,l a,1b VU? ? . Date Construction Cost Site Address Af.s/( n e kills 0 kI Y4- Unit/Ste # M Description of Work FI NI SW 01AS e4u eav r Multi-Family Bldg _ Y Fireplace(s) X 0 - 1 - 2 ?r ? Property Owner !tG 942KY-e- Telephone # (U/) q 7 ^1/40 gp8 Contractor Address City State Zip-- •- Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( ) Telephone #( n e.9 1` 'l 1 1, U Telephone # I hereby apply for a Residential Building Permit and acknowledge that the information y e e 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. L Ni Ko At/?Gt?/-P?3' 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 O 11 10-plex 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 'Siding ? 32 Addition ? 36 Move Bldg. ?. 42 Demolish (Foundation) ? 45' Fire Repair X 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation 9 L2 0 Occupancy u? MC/ES System Census CodeC Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) Final/C.O. - Footings (deck) Final/No C.O. - Footings (addition) _ Plumbing Foundation I-IVAC Drain Tile Other Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final Framing _ _ _ Siding Stucco Stone _ Fireplace _ R.I. -Air Test _ Final _ _ Windows (new/replacement) - Insulation _ _ Retaining Wall Approved By T-L Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total LL, ?J ly- Building Inspector ;?jOLo o *b City of Eaaall Date: /, 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or,BLACK-Ink For Office Use v ' Permit #: �C011<- Ili -D. Permit Fee: Date Received: 12l 3-1 Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION 0-5 ~ 2 -02 -Site Address:`q � Q je e (j Dette Unit #: Name: !j(`Le_d5, t'O7 Address / City / Zip: /J —i i°e Ae-e- -52 l' (C te1 Applicant is: Owner Contractor Phone: 6'57,m/49(40;e CONTRACTOR Description of work: k_R QQ,'9 Construction Cost: $ 6' '' v Company: (/ 7 xl e I �At Multi -Family Building: (Yes / No 4" ) Contact: Address: /O6 33 b Le- 57- NE City: ( 'e. State: Zip: _j fr Phone: "'J - License #:/,6/ 7/.f Lead Certificate #: 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: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 S ticng ode m st be completed within 180 days of permit issuance. X l yi/L / t.• 7 R.L.,4y t:_,5 74 /7 x Applicant's Printed Name Appy ant's Signature Page 1 of 3 Use BLUE or BLACK Ink � � � r----------------� I For Office Use I I p I Citof �a �� j Permit#: l°?O ��� � Y � � �y � � Permit Fee: {VS- I 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: 01— � Phone: (651)675-5675 I � I Fax: (651) 675-5694 i Staff: /�' i ---------------���M�' 2014 RESIDENTIAL BUILDING PERMIT APPLICATION � Date: Site Address: Unit#: Name:�l���E�=r—S� ����� Phone:��:G{J� � cY� Residentl '' / / �OWn�r � Address/City I Zip:���.��� �CtC� ��(�� ���� �� ���C "G�� ". Applicant is �` Owner Contractor Ty,pe of Work ' Description ofwork:_Sl��C�i �OQ'/�� ��.{/`o�'„�i' �� r �,a�x � � Construction Cost: Multi-Family Building: (Yes /No_) �°� �§ �� � ,�� ;�� � :' Company: Contact: Contractor ° Address: City: �._ � State: Zip: Phone: Email: � ,,`. �� License#: Lead Certificate#: 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 ;Pl�ns and support�ng documents#hat you.submit are'corrsidereal to be publi�information. Portion,s;of _ ;;:the�nfo"rmat�on maybe classified as non public;if:you provide specrfic ieasons that would-permit the.City.to: s. �. : .. � � � " ��; � .�t�„ cQnc(ude.�that.the`,are�trade secre,ts. ���; ,,.� , . � 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 Buildin ode must be completed within 180 days of permit issuance: n x C X ApplicanYs Pri ed Name A 1 anYs ignature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA144385 Date Issued:07/24/2017 Permit Category:ePermit Site Address: 1565 Rustic Hills Dr Lot:5 Block: 0 Addition: Rustic Hills PID:10-65000-00-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: 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. Contractor:Owner:- Applicant - Adam J Keyser 1565 Rustic Hills Dr Eagan MN 55123 (612) 715-7571 Home Depot At Home Services 2455 Paces Ferry Rd Atlanta GA 30339 (952) 345-6057 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA156472 Date Issued:07/01/2019 Permit Category:ePermit Site Address: 1565 Rustic Hills Dr Lot:5 Block: 0 Addition: Rustic Hills PID:10-65000-00-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 Total: 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. Contractor:Owner:- Applicant - Adam J Keyser 1565 Rustic Hills Dr Eagan MN 55123 (612) 715-7571 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature