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1970 Safari TrCASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED FROM jj AMOUNT I & DOLLARD loo ? CASH ? CHECK BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You BLDG. PE?P.MIT NO. 01-3210 ' Bldg. Permit 01-3422 Plan Check _-s 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit <?t} ? C? ?J 20-2275 SAC '• ! r r 20-3865 Water Conn. ?; ?`v c} 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL J r' I .) CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-189 (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: I APPLICANT: TYPE OF WORK: t INSPECTION TYPE DATE INSPTR- INSPECTION TYPE DATE INSPTR litl I ! 1? 1 N+a 1lWy.'•. A " PARAI1 1'I-I:MI 1 I-, III I (pti.pI fl 1.014 ANY HIIM111Nf, Tilt 1`11'1 IIr11.AI 1111, 1:1 L Permit No. Permit Holder Date Telephone 4 ELECTRIC Q X 9 ? f? ? o• yiG iUG7 ,%9l?'j ?o PLUMBING / HVAC Inspection Date Insp. Comments FOOTINGS tlj1 ' FOUND 2 QS? /? ? e DY d*` u F7 FRAMING ROOFING ROUGH PLUMBING S S ?L zu v PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE N FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. P vag d BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN ??!! 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 f V B PHONE; 454-8100 WILDING PERMIT To be used for SF DWG/GAR Est. Value $136,000 Site Address 1970 SAFARI TRAIL Lot l.. Block 2 $ec/Sub. SAFARI 3RD ADD Parcel No. W 2 3 0 ¢ ow U< Name City 0 A reu i. Phone r -?u-7u i i t") Name SAML 227-5411 (H) F ¢ W Na, HI a Address 470 i W City 61PLS Receipt # 13321 MARCH 9 87 Erect 1? Occupancy R3 Remodel ? Zoning R1 Repair ? Type of Const. V Addition ? No. Stories Move ? Length 71 Demolish ? Depth 3 5 Int. Impr. ? Sq. Ft Install ? A pprov als Fees Assessment Water & Sew. Police Fire Eng ISO . Planner Council Permit 611.50 Surcharge b8.00 Plan Review 3500 SAC Water Conn. 525.00 Water Meter?'? Road Unit 3000 I hereby acknowledge that I have read this application and state that the 180.06 information is correct and agree to comply with all applicable State of Bldg. Off. Tr. PI. Minnesota Statutes and City of Eagan Ordinances. APC Parks Si t f P Var. Date Copies S2 1 ? t5 gna ure o ermi ttee , . Total A Building Permit is issued to: ROBERT BILL on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Date Telephone 0 Plumbing IMM.A.C. F69,2 61-:?-')197 Electric l y / ?T 7 tfiL 5 I Softener Inspection Data Insp. Comments Footings 1 Footings If Foundation Q Framing S?S . n Gar 0. ?. S ?? 6G 7rca 4e Roofing ? ?? '?' 7 LL °ifr e ?R • s Rough Pibg. C T? 52X110 QLI/c U? s Rough Htg. d 11 A 7 s ?t 1fi R a e C /? Insul. Fireplace Final Hig. o / 7 /'+0 Final Plbg. oar Bldg. Final Cori. Occ. Deck Fig. Deck Frmg. Well Pr. Disp. CONTRACT PRICE: Site Address Lot Bloc m Name Address 41a c City . Name-14 C Address 3 p City PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PERMIT # RECEIPT # DATE: '' BLDG. TYPE WORK DESCRIPTION Sec/Sub Res. _)!I? New- Mult. Add-on c Comm. Repair Phone Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE -$12.00 MINIMUM - COMM/IND FEE -$20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNA OF Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES Water Closet - $3.00 TOTAL S -LBath Tubs - $100 <- `lLavatory - $3.00 -Shower - $3.00 _/--Kitchen Sink - $3.00 / Urinal/ Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 -Water Heater - $1 50 ?Whirlpool - $3.00 -Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: r STATE S/C: GRAND TOTAL: CONTRACT PRICE: Site Address _ m ratan Add c City PERMIT # 3'7 - MECHANICAL PERMIT RECEIPT # /?-? CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE G PHONE: 454-8100 Sec/Sub Phone BLDG.TYPE Res. Mult Comm. Other WORK DESCRI ON Nev ?- Add-on Repair FEES Name RES HVAC 0 100 M BTU $24 00 . - - . c-. Address ADDITIONAL 50 M BTU - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS MINIMUM 1 PER PERMIT 50 EA ( - ) - 1. . TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air _ M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond 7 M BTU $ MINIMUM COMMERCIAL FEE _ 20.00 . 5 STATE SURCHARGE PER PERMIT .50 Vent CFM (ADD $30 S/C IF PERMIT PRICE GOES Gas Piping Outlets # y,5) BEYONQ.$T;000) Other FEE: ?l / T # i t J : am : - S/C: IiN SIGNATURE OF PERMITTEE TOTAL FOR: CITY OF EAGAN A j (gprtifiratr of (Orruvaury aCitp of eagan lorp"bu tf of adihv jwtrttmt This Certi, ficate 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: Use cundiiodw S MIGNS Bldg. Permit No. 13321 O-P-Y Tyw Zoniq District Type Coral OwoerofBttilding `''1• , Addres l31C rZll?;r"Li ST. PATI, 11WIding AddRes lt)7(I !+ r. i" ,,;rLI.L Loulity L4, B2. SAFARI D Bw7diog OfcW POST IN A CONSPICUOUS PLACE CITY OF EACgAN SEWER SERVICE PERMIT 1 3830 !Plk Mob Road ? 7 5 7 P.O. Box-21199 PERMIT NO 4-6--, 7 Eagan, MN 55121 DATE: 1 Zoning: R - No. of Units: Owner Robert 8it1 Address: c1 970 Safari Trail L4 B2 Safari III Site Address: ?..,.? Y- ?-n-r7 71:3~9 I agree to comply with the City of Eagan Connection Charge: 525 00 Account Deposit: 15,00nd Ordinances. lt) QOp_ Permit Fee: Surcharge:. 50_ By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN Permit No: ?6C Date: 6-37 3830 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Clwncr O%?•:?- Bill -In A nn. Chg: 525..00p,' Zoning: :t. Dep: 15.40pd No. of Units: •mit Fee: 10.OOpd charge: • 50 pd I agree to comply with the City of Eagan Plant 180.00pc Ordinances. ter. By WATER SERVICE PERMIT CITY OF EAGAN Permit No. 8606 Date: 4-6-87 3830 Pilot Knob Road Meter No: -?--C .7 ?D Size: 5,4ff P.O. Box 21199 Reader No. b -r-F 62 19 Date: 7-L fir? Eagan, MN 55121 .. Robert Bill Conn. Chg: 525.00pd Zoning: Rl Acct Dep: 15.00pd No. of Units: Permit Fee: 10.00pd Surcharge: . 50pd I agree to COMM with the City of Eagan Tr. Plant I80.00pd Ordina s. Meter. 67 00p Misc.: By WATER SERVICE PERM OFFICE USE ONLY This request void 18 months from wlidation dale printed in this box. G? -2- 1 a" IaOlllilllllllllilllllllllllllllllllllllil?y?°?r? PLEASE PRINT OR TYPE Request Da q ,+ t, 1 1 Roughin inspection requiredY ? Yes No Inspection Other Than Roughln: Ready Now Will Col10 l ( / IYou must cdl the inspo mr when ready) Date Ready: ?• p7 Q', 97 I, ? licensed contractor -owner hereby request inspection of the above electrical work at: Job Address ISheeh Box, or Rare No.) city Zip Coda Sedan No. Township Name or No. Range No. Fire No. Count'%J ?j Occupant Phone No. Power, Supplier Address age, 'C? Eled iwl Cmnador (Cwnpony Nome) Cons r Dceme No. Master Lic. No. )Plonl Elect. Only) y llUleU?P Mailiig Add. (Commdor -0- r Performing InstaOotion) 9 3? Authorized Sgralureactorp Owner P rfamiitg InsMilos an) Phone No g 6 1 EM"IA-11 8/96 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY 416-166'E REQUEST FOR ELECTRICAL INSPECTION g Minnesota State Board of Electricity 1821 University Ave., Rm. S-128, St. Paul, MN 55104 Phone (612) 642-0800 Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm 11 1 Remod N Re it Air Cond. Htg. E ui Water Hir. Load I'm Other: Dryer Range Elec. Heat Temp. Service "X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only. a5£ ??< ?c'i) g- /45 R4 rp?t (o?e.?r D - /co -99/ dXcl ,3 Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other Fee a Service Entrance Size Fee 0 Circuits/Feedem Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Traffic Sig. Above 200_Am s hove I00_Amps Transformer/Generator INSPECTORS USE TOTAL }1 Sign/Outline Ltg. Xfmr. i Alarm/Remote Control Swimming Pool i he. ? th?linspe?d a e6mmi i"smn?o" dernlud ham" o" *< dares ,rerea Irrigation Boom Ro Wn Uale Special Ins ection p Investigative Fee e? THIS INSTALLATION MAY BE OR RED DISC CTED IF NOT COMPLETED WITWN 18 MONTHS. u ®? 91 ?cu r s? Request Crate, 1 Fire No. Rqugh-In Inspection wired (You sl ='erspe when ready) Inspection Other Tha?n vo?u1gIh-In Ready Now ....I Notify Inspector Yes ? No Date Reatl I ? licensed contractor owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) 9 70 Oily s 1 Section No. Township Name or No. Range No. County Occupant (PR11)T) / /// Phone No. C rF OO & QS ?gsa Power Supplier Address ? fA L?fGY?iP/L ??R/1l/N /a?? Electrical Contractor (Company me) AVA) -e : Z t -/ 6 Comrac[oi's License No. D £Q Malting Address (Contractor or Owner Making Installation) ANhorizetl netu (Contactor/Owner Making Installs' ) 3 Phone Ier _a $ ab / $ U 7 1 a8 g MINNESOTA STATE BOARD OF ELECTRICITY Griggs-Midway Bldg. - Room 5.128 II II ( I I I II I I I I I II II I II THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 Phone (612) 642-0800 UNLESS PROPER INSPECTION FEE IS FNCI nBFn. lo-loo-fl/ ? !3 95 REQUEST FOR ELECTRICAL INSPECTION # ee-o oot-os loo see instructions for completing this form on back of yellow copy. 3 90? 40 "X" Below Work Covered by This Request "V Ne Ad .R9p. -• Type of Building - Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management CommAndustrial Furnace Other (Specify) Farm Air Conditioner Other (spec ) Canuestors Remarks: LL Compute Inspection Fee Below: rf"{o KFI° A?dl P On # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimmin Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200-Amps Above 100-Am s Signs inspector's use Omy. TOTAL S Irrigation Booms `? •?? Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORD ED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby th tif h b i Rough-in Date cer y at t e a ove nspection has been made. Finai / ` `$ Dal •?_ /f OFFICE USE ONLY This request void 18 months from This request void 'J ? s 7 1 / -7-.Y& 7zl 8 months from C 9728 I Request Date - ? Fire?lo. (? Rough- re i it it ?Inspection R i Ready New ?I Insoec- R - $ -.l 5 Yes QNO [or When Ready iial Licensed Electrical Contractor 1 hereby request inspection of above Owner electrical work installed at: Street ddress, Box or Route o. /?70 err Tr al / City ea zzi,7 ection NO. Township Name or No. Range No. county, 4761 Occup' I (PRINT) - Kb ??!l Phone No. '236 -?677 Pow r Supplier L?akafa, ?/P? Address ?3aa ?o`F'h Elec n al C ntractor IC mpany Na el -TeGfv ?l l Contractor's License No. 4?/b/o?a re eG a Mailing Address (Contractor or Owner Making Instailation) asoo W rPd ?a 13uv-n-,, yr l ?en, Authori Signature (Contraclo,l er Making Insta l lalion) Phone Number e - 96 tl MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Origga-Midwav Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1621 University Ave.. St. Paul, MN 66100 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION V!k E7B-000011--05 IlO See instructions for completing this farm on back of yellow copy. / Q? 7 A Q "X.. Below Work Covered by This Request Nerd Addl Rep.1 Tvoe of Buildino 1 Appliances Wired 1 Equipment Wired I R Fee Service Entrance Size n Fee F6eders/Subleeders N Fee Circuits .01) 0 to 200 Amps 0 to 30 Amps w 0 to 30 Am Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100-Amps Above 100_Am Transformers Irrigation Booms Partial- Other Fee Signs Special emerks Inspection ]sS0• TOTAL "' f (_,(yt I, the Electrical OV Q' Inspector, hereby ?) certify that the above Final /?, inspection has been z- ?d mace. This request void 0-10 0=995 , dd R guest Da a II}}!y / ?s H Fire No. Rou Mn Irispectip)Req d ou must call inspector an ready) inspection Other Thg/?nRp?.u?gh-In Inspector ? Ready Now N? ill Notify Q ? Ves No Date Read 1 ? licensed contractor /owner hereby request inspection of above electrical work at: Job'Address (Street, Box or Route No ) a 5` /9- Q City 1 WI 2 Section No, Township Name or No. Range No. County Occupan,(PRINT) I\ SIC T C//~?/ Phone No. Pawer SHrol.r Address / 'ygx I LA:j A*V Electrical Contractor (Company Name) Contractor's license No. OWv E Mailing Address (ContractoWe r Making stallation) / 9 Authorizetl Sig re (C ntractor/Owner Making Install ati ) NUmber Phone Q BOARD ELECTRICITY II THIS NSPECTON REQUEST WILL T III Room 6 v B I ' I f I II I I (I II 7 11.1 BE ACCEPTED BY THE 1111 T 5104 2 9 University A e, St. Pa, MN ' I II ION FEE S UNLESS S PROPER INSPEC 7 N 1 Phone (612) 6420800 P I r 1 ^ I EN q?1? REQUEST FOR ELECTRICAL INSPECTION lw EB-00001-0e Ill see instructions for completing this lone on back of yellow copy. 10CP "X" Below Work Covered by This Request r Ne A?t l Fi'ep. " Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Fumace Other Specrf • Farm Air Conditioner Other (specify) Contredo' Remarks: ,c 1° 19110` ?mF rE /,/ /Z Compyte Inspection Fee Below: R )1 X06) # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Summing Pool 0 10 200 Amps 0 to 100 Amps Transformers Above 200_Amps a 100 Am s Signs inspector's use Only: T0T11L_ ? Irrigation Booms ? (C//N Tb Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certity that the above inspection has been made. Rinat Data ?7 F/ OFFICE USE ONLY This request void 18 months from • CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD • n & DOL. ABs roo F] CASH CK FUND Co.. AMOUNT r ? < v Thank You By N_ 72160 White-Payers Copy Yellow-Posting Copy Pink-File Copy EAGAN, MINNESOTA 55122 CITY OF EAGAN N2 13321 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, M N 55121 PHONE: 454-8100 BUILDING PERMIT Receipts 35R SF DWG/GAR $136,000 MARCH 9 87 Tobeusedfor Est. Value Date tg Site Address 1970 SAFARI TRAIL Erect LJ Occupancy R3 Lot 4 Bloc k 2 Sec/Sub. SAFARI 3RD ADD Remodel ? Zoning RI Parcel No Repair ? Type of Const. V . Addition ? No. Stories Name ROBERT BILL Move ? Length 71 w 1310 PLEASANT Demolish 1:1 Depth 35 o Address ST Cit Int. Impr. ? 736-9677 (W) PAUL Ph ? Sq. Ft y one Install = Address Assessment City Phone Water 8 Sew. Police 8 Name- MILES HOMES Fire u 8 Address 4700 NATHAN LN Eng a w City MPLS Phone 553-8300 . Planner Council I hereby acknowledge that l have read this application and state thatthe Bldg. Off. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan O ipan s. rd APC Or if y F Var. Date Signature of Permittee /D ^-'"' o Name SAME 227-5411 (H) Approvals Fees A Building Permit is issued to: ROBERT BILL all work shall be done in accordance with all applicable of Minnesota Permit $ 611.50 Surcharge 68.00 Plan Review 305.75 SAC Water Conn. 525.00 Water Meter 67.00 Road Unit 305.00 Tr. PI. 180.00 Parks Copies zpz, 25 on the express condition that City of Eagan Ordinances. Building 1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. 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, $2,000 LANDSCAPE BOND ?+ oo To Be Used For: ?Fi Ji v? m,-z/ Valuation: t&e ? Date: Site Address /97o Y*4#d; (.EAc l Lot K Block Z, _ Parcel/Sub 17f SA?rt2i ?JP.[ Owner A62tf Address /3/0 AWA*d City/Zip Code R40/ ,' /03 Phone 22 6-V11 -- ;? 3& -9(c77 Contractor pov49e0e& Address g, We City/Zip Code Phone Arch./Engr. /,(i/ey /4m&.7 Address Y760 IUw-IAAvZ& City/Zip Code 44 S3 yya-7?1,f Phone # X33 - 8300 OFFICE USE ONLY On Site Sewage_ Occupancy ?2. MWCC System ? Zoning 2•( On Site Well Type of Const City Water ? (Actual) (Allowable) # of Stories Length 1 1 Depth 3S S.F. Total Footprint S.F. APPROVALS FEES Assessments Permit Water/Sewer Surcharge o8. Police Plan Review Fire SAC, City C-O. Engr SAC, MWCC 525 Planner Water Conn 1- Council Water Meter (07. Bldg Off Road Unit s. APC Treatment PI 100, Variance Parks Copies TOTAL 7? = Co 33? ri l2x (2 = I ?4 x 44 120 ? ?? " ?g Co C? 37 Sb 3g ? z? ?'- x 3r712, r 2- ? 4- cl 22 X 23 ? ?cc? X-(2_ - GO`12 [ n 44 ' 70( 2 ¢q-- ` 3 4gge) CERTIFICATE OF SURVEY N 't i° 2-8' Z (." t= 13Z. r.`7 9s _N DRAIUAQ?E fi UTILITY EASV-"F-AT ul Ab A•, Q LA 866 0ri-t N1 N io 0. L OT 4 -? M nQ' 91 1.2 qY r` 47.33 ?J 9 0 0 p PROPOSED 12 30 O I J ? (j 902 a O ^ HOUSE 15.3 9 20.6 .D 12 '? M 6 A AND N pRopey G r IR a a>9Z GAR ^ az?v?vAY N •z- J --_-9J 22 -y l 0 n 9 ___?3p O Q oP 6 Qb a ° 1 o dN 0 BLOCK 2 '? 9 V? 93.1 / A:60 S J to Q cs. 2g \o\--? ? ? 1 `a o a° C ?Oq/ 95 VRB q$"9y 64.47 Nho R=561.70 6=6°34'34" ?e Q a V1 9 S A FA R. 1 T A I L 96$ 97.8 99.E 94.6 14levations shown aro existing grades and are assumed datum. Proposed garage floor elevation = 95.5 Arrows denote proposed direction of surface water runoff. I hereby certify that this is a correct representation of a survey of: Lot 4, Block 2, THE SAFARI THIRD ADDITION, Dakota County, Minnesota, according to the recorded plat thereof. and that this survey and certificate was prepared by me or under my direct supervision and that I am a duly registered land surveyor under the laws of the State of Minnesota. ro ( I «'%?- vLtY?/ Dated this 8th day of January, 1987 Gene L. Jacobson, M n . Reg. No. 7734 DR. BY G j1 SCALE I" = 30' O DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM. PREPARED FOR: JACOBSON SURVEYORS Robert Bill 1310 Pleasant Ave. LAKEVILLE, MINN. 55044 St. Paul, Minnesota 55102 PHONE 469-4328 1 1 .. CITY OF EAGAN EXTERIOR ENVELOPE AVERAGE 'U' CONPUTATION OWNER: SITE ADDRESS: CONTRACTOR: PLyAOd DATE: PHONE: 2 3G 94, Determine working square-footage of each: 1. Total exposed wall area ... 33m. ! sq. ft. x .11 = 3 4 ?P• 3 Q 2. Total roof/ceiling area .. /3 sq. ft. x .026= Total exposed wall area above floor = _426-07-5' 20 CO a. Total wall window area ............................ 0 b. Total door area ................................... ? - ?N c. Total sliding glass area .......................... 1/.7 d. Total fireplace wall area ......................... -a ` e. Total wall framing area (average 10%) ............. O. 7 f. Total net wall area above floor ................... fo. g. Total rim joist area .............................. 3O /. 7 Total exposed foundation area = /,? G • X h. Total foundation window area ....................... f ] 77 i. Total net foundation area above grade .............. C Determine 'U' value of each wall segment: a. D/O x 'U' b . x ' U' c. A1 t x 'U' d. . ` _ -p . x ' U' e . ..t Q-2 x ' U' f . U' g• 3 6 x I U' h. x 'U, i. 10!g. 7A x 'U' 9G.Ja. 2/.'7 7' - 7 - .7 3 . ................................................... Total = 366 .AS- If item #3 is the same as or less than item #1, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = 1 3 j. Total skylight area ............................... k. Total roof/ceiling framing area (average 10%) .... .. 1. Total net insulated roof/ceiling area .............. 11 9 /.fp OVER Determine 'U' value for each roof/ceiling segment: j, D x fu, k. 1322 q / x 'U' 1. // V. b x 'U' D _ p 3.97 • ass ? 9 .?4 4 . ...................................................... Total - 3 3.7 If total of #4 is the same as or less than #2, you have met the intent of SBC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of Items #3 and #4 shall not be greater than the sum of Items #1 and #2. 1. Ao!p . 32 + 2. 3q. y;t = ?? • 8/ 3. .300- S + 4. 3 3- ?Co - 3 3?1• ?`f 2 PERMIT 61TY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612681-4675 u-A 41 ? PERMIT TYPE: BUILDING Permit Number: 0 2 5 3 8 9 Date Issued: 04/13/95 SITE ADDRESS: 1970 SAFARI TR LOT: 4 BLOCK: 2 THE SAFARI 3RD P.I.N.: 10-75852-040-02 DESCRIPTION: B;Ulldin,g`-.permit Type Building Wrg(C Type tonstruction Type Zoning Building Length `- Building Width t ' SF ADDITION NEW V-N R-1 22 51 2 2,377 e €o 5} E"' 'r Phi y 7 S (;,A? ?' a°^° 'y ,}; "tea nj C5 M.,,.i??x 4 LVZ a t REMARKS A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION Base Fee Plan Review Surcharge Total Fee $772.50 $502.13 $69.00 $1,343.63 $138,000 CONTRACTOR: OWNER: _ Applicant - BILL ROBERT 1970 SAFARI TR EAGAN MN 55122 (612)828-2928 I hereby acknowledge that I have read this application and state' that the Information its cornett and agree- to comply faith all applida,ble Stato of Mir.; "Statwte!s and `city of Sagan '(irdin aces.,. APPLICANT/PERMITEE SIGNATURE ISSUED-BY SIGMOTURE- CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) SITE ADDRESS: LOT: 1970 SAFARI TR THE SAFARI 3RD PERMIT SUBTYPE: SF ADDITION INSPECTION RECORD PERMIT TYPE: Permit Number: 7 Date Issued: APPLICANT: 4 BLOCK: 2 BILL ROBERT (612) 828-2928 TYPE OF WORK: NEW BUILDING 025389 04/13/95 INSPECTION TYPE FOOTINGS DDATE INSPTR. INSPECTION FRAMING DATE INSPTR. INSULATION FIREPLACE FINAL REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK X39 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 41,343.u W' WA SINGLE & MULTI-FAMILY 2 sets of plans, 3 registers ffpy ?r?ey' c of energy talcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy talcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. ' Valuation of work -1 r Date 3 / a2_1 / 24 . /T Site Address: /?,?o SAYyhe% 74X STREET SUITE # Tenant Name: (commercial only) - -? J LOT BLOCK SUBS Description of work: The applicant is: Owner Contractor ? ?+her (Describe) Name L'ei'// .p .e Phone G 88-oi 8'cf° Property LAST FIRST v 'x Owner Address SAyaw STREET STE # City ard24 ? State il7.d Zip 5rl t.L Company _ a`~_ & Phone Contractor Address License # Exp. City State Zip Company 00"x : D,Q&"j f ,sop Phone Architect) //1? '/ T Engineer Name IAriz /"A A" Registration # Address City AiAt",I M,, State MA,' Zip 11171 Sewer & water licensed plumber 4A('W'CW_ Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add11. ? 15 Deck WORK TYPE ,,?,31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) M Basement sq. ft. MWCC System (Allowable) Ist F1. sq. ft. City Water UBC Occupancy 6"" 2nd Fl. sq. ft. PRV Required Zoning ?"! r ?ar14 Sq. Ft. total Booster Pump # of Stories z F., Footprint Sq. ft. 2,s77 Fire Sprinkler Length ?L On-site well Census Code Depth si kA>z''` On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? ,Site ? Wallboard ? Footing ? Final ? Framing ? Draintile [/3 f _ C2_ ? Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units lre` ?, 4I66 Z, 6 (7 ' ' Acr. w fT/ia cfuRC ?1'? r7 _q.e 0 .7-77 0 A fro' 23 K?• ` = 27a /Y F 37.33 (074 Z x 27, /7B 9.33 K/y 17 E-' . / tss valuation: $ / 3 ,?57 0040 Z2xs-/ !12- 2 xSY = 6b, 5-5 6 Z N_- JT/n.T ?I aCli UNC?LR [i/+??r? r 830 CERTIFICATE OF SURVEY B6 A 86.8 ? i N !7¢gtuA?-,E i U-_tLt"l"Y E :?EME in 91 0 to 1 o N s N LOT M ^I m ft F "r 7j 9 1 . b R..: P(••ewi:" ?RoP f a ?l 90 30 (?/ 0 O p PROPOSED % 1pP?2 O j- o S' A W 'i0 2 G N HOUSE 5.3 W ?, x o p b ivy e 9 20.8 `a, 12 to ^ a m A n ?ti ?K t J o n 92 Gq O W f' 32,2 _ J ! o y y rR. lY? N wti O L ,1 B oip?. 30 6 0' 0 \ 93 -, 93.1 o M BLOCK 2 Ras S?. 10 n / I( ?p-? ? ? 404 g5 _? P- m VI*'6 \4S?a5 - - -- - N go 64.47 R=561 70 603434 ?a Q /t 4.?4 J? ?? 1 l V) 5AFA R I T?AI? 966 97a 46y? 94.6 1T a4s1ir; •?? '.ti!.'r. (0 Pro •os,,d z:iravr JI Arrows denote proposed iira,ri ?n r)l surf-,cu water runoff. I hereby certifv that this is a correct representatit,n of a survey of: Lot 4, Block 2, THE SAFARI. ThIRD AMITlON, Datota county, Atiuncarta, arc,,rding to the recorded plat thereof. and that this survev and certificate was prepared by me or under my direct aupervisi..)n and that I am a duly registered land surveyor under the laws of the State ,f 4inn.,sota. Dated this 8th day of January, 1987 9M?l Gene L. JacobsonRe g. No. 77"14 DR. BY Czj SCALE = 30' 0 DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM. PREPARED FOR: ,?// JACOBSON SURVEYORS gay aga8?w ? LAKEVILLE, MINN. 55044 PHONE 469-4328 A CERTIFICATE OF SURVEY N ?z.°7-8'z?'>? (3Z.?"7 / / 0 neA%MAC,E I 3 00. j -1 0 a N z 93 N I -32.2- - p O o ? 12 U"i 1'?\TY EA?Ennr?NT in 0? ^Q VI io a N LOT / 4 D 1 M? " J 0 S Q 9 47.33 10J 30 1 ,. PROPOSED 12 HOUSE 15.3 1 FRoPO3 O 2 8 n AND n n 9 1 aii ^ GAR "' hR\JE.yyq 7t 22 ?- Y m a b 0 91 BLOCK 2 I / R.6 s? 10 C V 4 1/4 R8 S g5 64.47 R=561.70 0=6°34'34 b5 9 SA FA R I T2A1- %6 978 94.6 86.8 J 90 2 93-1 L IInQ V/ 9g\ '; levaLi. ons shown are ?,•:isting ;radrs an,i ar • assured taturi. Proposed garage floor elevation - 95.5 Arrows denote proposed dirc.ti in of surf„ce water runoff. I hereby certifv that this is a correct rcpresentatfoon of a survey of: Lot 4, Block 2, THE SA ARI THIRD AODITI0\, Dakota County, Minnesota, arcordin^ to the recorded plat thereof. and that this survey and certificate was prepared by mu or under my Jit'ert ;uperviei m and that T am a duly registered land surveyor under the laws of the ?Lnto of ^linm•sota. Dated this 8th day of lanuary, 1987 \ i _.E-LS?`?,•'3' one L. Jacobson, MINN. 2eg. No. 7714 I DR. BY GO I SCALE I" = 30'1 0 DENOTES IRON MON. I BEARINGS ARE ASSUMED DATUM. FOR: Rnbrrt BiLI 1110 l'l,,aaant Ave. St. Paul. Ninnr;oLa 55102 W ? Q 6 CO Q o , o , N ? y ? - ? ?0 P h P. bp ? N BOO ra JACOBSON SURVEYORS LAKEVILLE, MINN. 55044 PHONE 469-4328 CITY OF EAGAN EXTERIOR ENVELOPE AVERAGE VUI COMPUTATION OWNER: SITE ADDRESS: 7 Q 74,e CONTRACTOR: JwAJd? DATE: ?-Z •9S PHONEf(e$S• AFS-00 `"' g d.8'rc9 d g' Determine working square footage of each: 1. Total exposed wall area ... '1& sq. ft. x .11 = 391- 77 2. Total roof/ceiling area .. sq. ft. x .026 = -Z9 -/7 Total exposed wall area above floor = 3 / a 3- S"" .? a. Total wall window area ............................ b. Total door area ................................... -o c. Total sliding glass area 3i. 7 d. Total fireplace wall area ......................... - o - e. Total wall framing area (average 10%) ............. 3i,2 3S f. Total net wall area above floor ................... -2'7 ? g. Total rim joist area azs?- S Total exposed foundation area = --O - h. Total foundation window area ....................... -6- I. Total net foundation area above grade .............. --cam - Determine 'U' value of each wall segment: a. /r x b. _?- x C. x d. - x e. ?i2.3s x f. 24// X g. P-5(.• V x h. --Cl- x I. ®- x I UT 30 - 4/ 9. -24 gut out IUT 'Ul c8r - X65 f 'U' 'U' 0y4 - i1• SS ' U' s- 3 . .................................................... Total = a X.5- 0 If item 03 is the same as or less than item 01, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = / 1-2 p J. Total skylight area ............................... k. Total roof/ceiling framing area (average 10%) ..... // ?. 2 1. Total net insulated roof/ceiling area .............. OVER Determine Out value for each roof/ceiling segment: J. x , u, ?- -- ?o2r o-$ o k. x Out 1. X Out 4 . ...................................................... Total = O.'9 5- If total of 94 is the same as or less than 92, you have met the intent of SBC 6006(01. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of Items 03 and 94 shall not be greater than the sum of Items 41 and 02. 1. 3 9/ ?7 + 2. 02 9F?7 yao- 9y 3. 5 + 4. 30- SS = ASS 8S 2 June 6, 1995 XW 1:WG1 gEERINGt,sac. MARSCHALL ROAD BUSINESS CENTER 327 MARSCHALL ROAD SOUTH, SUITE 200 SHAKOPEE, MN 55379 612-445-7993 By MAIL AND FAX Mr. Joe Voels, Building Inspector City of Eagan 3795 Pilot Krob Road Eagan, MN 55122 Re: Foundations for Addition to Bob Bill Residence, 1970 Safari Trail, Eagan. Building Permit No. 025389 Yesterday, I inspected the excavation at the above address and also the plans for single family residence addition. The lower floor on the new addition is to be a 4 stall tuck-under garage. The first question was whether or not to maintain an additional 42 inch depth of foundation around the walls of the garage even though they are more than 5 feet below grade. As I indicated to you this morning by phone, the additional depth would not be necessary if the following items are in place- • The concrete floor is to be underlain by two 1 inch layers of Dow (Manufacturer) polystyrene insulation (blue gray in color). • The footings below the apron face of the addition should be a minimum of 42 inches below the existing grade (as originally planned) and as well as the returns at this level at least 4 feet to the southwest before stepping up the footings to remain at 48 inches below grade measured to the bottom of the footing from grade. • That similar 2 inches of polystyrene (Dow) insulation be placed from the footing up to the sub-driveway level on the outside of the footings below the garage doors and around the return wall for 4 feet as described above and for 4 feet below grade around the balance of the exterior block footing walls. • Remaining footing may be place immediately below the garage floor. The owner tends to heat the garage, but if for some reason the garage would not be heated, the insulation would prevent the encroachment of frost below the footings. On the house side of the garage, the placing the footings at an additional 42 inches below floor level, would compromise the existing house footings at the addition and create an unstable condition structurally. At that point, the additional 42 inches of footing depth would be unnecessary. I therefore consider that this design more than compensates for any possibility of frost encroachment under the garage. Mr. Joe Voels, Eagan Building Inspector - 2 of 2 - June 6, 1995 I am enclosing a brief resume of my background including my engineering structural and soils background. If you have any further questions, or if I can be of any further assistance, please do not hesitate to phone or write. I hereby certify that this letter report was prepared by me and that I am a duly Registered Professional Engineer under the laws of the State of Minnesota. Sincerely, ITASCA ENGINEERING Lawrence E. Samstad, P.E. Registered Professional Enl Minn. Reg. No. 6220 cc: Mr. Bob Bill Enclosure: Brief Resume of Experience BRIEF RESUME: as of 6/1/95 LAWRENCE E. SAMSTAD, PROFESSIONAL ENGINEER (Reg. No. 6220, State of Minnesota) (Reg. No. 8449, State of Wisconsin) ITASCA ENGINEERING Suite 200 327 Marschall Road South Phone No. 612/445-7993 Shakopee, MN 55379 Consulting Civil Engineer Registered Civil Engineer since 1959 (State of Minnesota) also have been registered 6 other states as necessary. Work Experience: 1960 to Present Owner and Chief Engineer for Itasca Engineering a Civil Engineering Consulting Business. Supervised and headed firm for 351/2 years. Consulting Engineer for the Lower Minnesota River Watershed District for the past 35 years. Categories of Work: Watershed and Water Management Engineering Drainage, Water Control, Siltation Control, and Project Landscaping Structural Designs Soil and Foundation Analyses and Designs Project Development Mapping - Surveys - Reports Designs for Water Mains, Sanitary and Storm Sewers, Roads and Streets Contract Documents Permit Handling Construction Inspection of all types Forensic Drainage and Structural Consultation Environmental Real Estate Investigations Jurisdictional Delineation of Wetlands in Minnesota Litigation - Trial work as expert witness. Work with Federal, State and Local Agencies as required. 1952 to 1959 - Worked full and part time for the University of Minnesota Physical Plant as Engineer on new construction, new designs, drafted plans, wrote specifications on new work and also on maintenance and renair of buildines and infrastructure of th ' T of M. EDUCATION: 1953 Univ. of Minn. Degree - B.C.E. with Distinction B.S.C.E. (Honorary) with Distinction 1955 Univ. of Minn. Degree - M.S.C.E. Major: Structural Engineering Minors: Soil Mechanics & Aeronautics 1955-59 Univ. of Minn. 3 Years Post-grad Major: Civil Engineering Soil Mechanics work on PhD Minor: Geology Course work completed but not thesis and languages. 1953-1955 Taught Structural Engineering (3rd yr) at Univ. of Minn. Life Member in Chi Epsilon (Civil Engineering Honorary Fraternity). .eJ L BL CITY USE ONLY RECEIPT #:394 ?? SUED. ? 3r? DATE: 42L3 95 'IVWD PLUMBING PEKMII (KhblUtNTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH NO. TOTAL Shower Water Closet Bath Tub Lavatory Kitchen Sink Laundry Tray Hot Tub/Spa Water Heater Floor Drain Gas Piping Outlet * minimum - 1 Rough Openings Water Softener Private Disposal * Dakota Cty. license U.G. Sprinkler * home under const. Alterations * to existing Water Turn Around 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 1.50 5.00 20.00 3.00 20.00 20.00 X X X X X X X X X X X X STATE SURCHARGE TOTAL =o .50 SITE ADDRESS:--L9 0 5'4 6?' f% OWNER NAME: ,e A-11 INSTALLER NAME: -51)74£ STREET ADDRESS: l 9 -70 5.4 4& 14?4 / CITY: STATE: ?N ZIP: PHONE #: (G/(;L) (o S aSS? N 4! a`b .?9a8 SIGNATURE OF PERMII I Et: OFFICE USE ONLY L BL SUBD. 1995 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: . all commercial/industrial buildings. multi-family buildings when separate permits are aW required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? - YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW. GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: OWNER NAME: INSTALLER: ADDRESS: CITY: PHONE* SIGNATURE: OFFICE USE ONLY METER SIZE: DATE: RECEIPT #: DATE' STE. # STATE: ZIP: APPLICANT _ INSPECTOR: CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTF•: PAYMENT "OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTAra.ATIONS WILL NO BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. - ------ ------- Please Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRU'CIURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Mon Year) PRESENT ZONING/PROPOSED USE: M COPM4ERCIAL/RE`TAIL/OFFICE r7 INDUSTRIAL Q INSTITUTIONAL/GOVERNMENT R-1 SINGLE FAMILY R-2 DUPLEX (Twv Units) C( R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) NAME: T n 1 a r a.l E7Ac t ,j6 i ADDRESS: CITY, STATE, ZIP: PHONE: q-fl f q y O 3) a . 37 NAME: ADDRESS:_ )a 6 D oe-..Pk f- ? CITY, STATE, ZIP: Q?wr y,%?p 2,r/"L, PHONE: off af._ OT3-6 MASTER LICENSE# CIO-22 7 6 M y 4) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: P z 7- S t! f Active Expired Not recorded Staff THIFTal CONNECTION TO CITY SEWER CONNECTION TO CITY WATER ?( OTEIEIt ' 6) b Y b • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, lye' ABOVE (Circle one) • 7) r ? u• FOR CITY USE ONLY PERMIT # ISSUED of Pd w/Bldg. Permit FEES: $ $ A%'?? U SEWER PERMIT (INCLUDE SURCHARGE) $ $ 8 -3 D WATER PERMIT (INCLUDE SURCHARGE) / $_ lG 7'U a $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ $ S lY ACCOUNT DEPOSIT - WATER $ ? z S d $ WAC $ 42 i Z S ' U $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ Lid (J e $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL ? W 7Z/4, c RE T RECEIPT DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST AS CO D N . . A N ITIO SUBJECT TO THE FOLL OWING CbNDITIONS: APPROVED BY: TITLE: DATE: r/!C f 7 Use BLUE or BLACK Ink � r----------------� I For Office Use � � � Permit#: � � �� ` � � Clty of �a�� ; . 1�� ; Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: (�^�� `�% Site Address: �� D �,li�Y��1'-�r� ��c�`/ Unit#: � . : Name:�d(��i�'� f.7r`� Phone: �J�� 02$�``' �R�s�dentf /�^�. � � �/� /� � �2 3`r� �� Qyyn+�C' 4. Address/City/Zip:__ _f < �� y!�i�� t""�/,1�`/ ' Applicant is: �Owner Contractor T +�#?f lA(prk , Description of work: ��' 4� Y� / c� Construction Cost: /�v� ' Multi-Family Building: (Yes /No� , ; , Company: ��'� Contact ;- � �Otl�k'�CtQC Address: City: ��i� � � � � '� �_��"!E'� State: Zip: � Phone: Email: �,. .�r� ��. ; 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: NC1TE:Plarrs anal sup�arting.,tic��u+r�ents tha#yc�u�ubrrii#�fe�c�nsid�ar�d,�v l�e pu�rlic�rr�t�rma#ion. Portivr�s Qf th�infr�rmat«n may b�c�ass�fied a�non-pub��+c if you prouid;�:sp��re�a��rr�s t��#wc�uJd p��rmi#the City to � �F�, : � �ati�!,�� ; �c��ci ��t#he�'a�.��r'ade s��refs�°� � u� ��w�� - �.�; � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora 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. 7C- _/�`�ts�/C� ��yt / 7( � . Applicant's Printed Name App icant's Signature Page 1 of 3