1322 St Andrew Blvdm°w? CITY OFEAGAN
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 454.8100
BUILDING PERMIT
To be used for
Receipt
Est. Value d Date
19 '
Site Address
Lot-?' ---Block Sec/Sub.
a
Parcel No.
a Name_
w
Address
o city
-
Name_
.o
ua Address
? City-
11W Name_
_ 'w
07
Address
V
aW City-
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.
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well Type of Const
City Water (Actuaq
(Allowable)
n of Stories
Length
Depth
S.F. Total
Footprint SF,
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Planner
Council
Bldg. Off.
APC
Variance
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
Copies
163
Y
37
54:i.s0
o3:W
-296Y5
_-121TUO
Q 657 5
Signature of Permittee TOTAL
At. 21Pnnf41{IN GONST
A Building Permit is issued to: 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
Permit No. Permit Holder Date Telephone #
PltLmbing
p
87( 9,2-
Fy C1iY _
???87
11N.A.C. 0'(,
Electric r(.`ZY, 7 ? IF, 7?; ?. ?. e'A • ???73 7 ''i 2 v
Softener
Inspection Date Insp. Comments
Footings 1 u,?
Footings II
Foundation p
Framing 7. L -
Roofing -,o-a7
Rough Plbg. _
Rough Htg. 6
Isul.
Fireplace 7 fo
Final Htg.
Final Plbg. 1 .? 7- 9,
Bldg. Final
Cert. Oca /YX E. f1• ?ra?s'f"? f
? crr
Temp. LP f 6c rd= d. ?s wi1en i 14-( is
Deck Fig. 7 - 7- T7
Deck Frmg. ,?c r
mac c_on.c,?I
rac?'c
?
Well !
-
, v. a T ran -F+a .v.
Pr. Disp.
?-io-r7 r.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
- PHONE: 454-8100
BUILDING PERMIT Receipt
To be used for Est. Value i Date_
Site Address
Lot Block_
W Name
3 Address
C City
c Name _
.o
0 5 Address
City _
W W Name _
F W
U u Address
`W Crty_
ST "DREW BLVD
... On Site Sewage
Sec/Sub. MWCC System
On Site Well
City Water
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 Permittee
A Building Permit is issued to:
all work shall be done in accordance
Building Official
• ,19
OFFICE USE ONLY
Occupancy
Zoning
Type of Const Is
(Actual)
(Allowable)
* of Stories
Length
Depth 37
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments Permit
Water/Sewer Surcharge _
Police Plan Review
Fire SAC, City IVY*
Engr. SAC, MWCC
Planner Water Conn.
Council Water Meter
Bldg. Off. Road Unit
b
APC
Treatment P7 U
Variance Parks
Copies 411.657. 5
TOTAL
on the express condition that
nnusota Statutes and City of Eagan Ordinances.
Permit No. Permit Molder Date Telephone s
Plumbing
H.V.A.C.
Electric
Y
Softener
Inspection Dote Insp. Comments
Footings I
Footings II
Foundation ? W '
Framing 7_
Roofing ,0-t7
Rough Plbg. ?Q
Rough Htg.
f7
/k/
6
Isul. IaA
- `
Fireplace 3
Final Ht%
Final Plbg.
Bldg. Final
Cert.Occ. irats c ' a t
Temp. LP f 6c rd e4- "(e --I ww0d'c- s
Deck Ftg. ro Ar/, e E A 7 - 7- 17
Deck Frmg. L c #c, r r c 'G? c. 4 LowC (-rn ,
Well .., • v • ` r, a rG1 ft c +V 0 I'-
Pr. Disp.
-7-? 0-17 .6 .
Site Address
Lot 1
a?
c
a)
C
3
O
Name :?g Ids " 4 ?' X21
Address air ; w : *? 4
City' Phone
Name -
Address
City
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 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
PERMIT #
RECEIPT # -'
DATE: -7// Z,5_F -7
BLDG. TYPE WORK DESCRIPTION
Res. k New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
n' Water Closet - $3.00 $?
--!LiBath Tubs - $100
Lavatory - $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 - $500
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
FOR: CITY OF EAGAN
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100
GRAND TOTAL `?
PERMIT #
MECHANICAL PERMIT RECEIPT # 77
CITY OF EAGAN
?? 7
3830 PILO T KNOB ROAD, EAGAN, MN 55122 DATE:'?! a
CONTRACT PRICE: PH E: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot_ _ Block Sec/Sub
Res New ).i
? Name
M ult Add-on
Ta Address Comm. Repair
C cit
6, Ph
V'1
" L 7- Oth er
6v
y e-
one
FEES
` Name
AL "eftakNIA-1 RES. HVAC 0-100 M BTU -$24.00
3 Address 417,2 3 4. 2L.'aft a /jaw ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDES A/C ON NEW
10
CONSTRUCTION)
GAS OUTLETS
MINIMUM
PER PERM
(
- 1
IT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air 100 M BTU APT. BLDGS. - COMM. RATE APPLIES
B
il TOWNHOUSE & CONDOS - RES. RATE APPLIES
o
er M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # 1 BEYOND $1,000)
Other
FEE i0 ?/' '_1 "
SIC: SIGNATURE OF PERMITTEE
TOTAL: O°
FOR: CITY OF EAGAN
i'fv y a.
Textif irate of (Orrupaury
Citp of (Eagan
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.•
Use Cww&=tkM 'p U/ GAR Bldg. Permit No.
O-UP--y Type R3 Zoning Dbwa Type ConlL
Owner of Wilding At LFMWT
BWWingAddrm -7 cs :y1:-'3tcly ih _ t
Buiiding
c '?.RM1AQV ?A IQRR
POST IN A CONSPICUOUS PLACE
CONTRACT PRICE
Site Address ,
Lot - Bloc
Name 7&34:,
Address 7ZC'
C City 5
Name QQ1
3 Address, '_-,'-'Z
0 City
-r
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 S/C IF PERMIT PRICE GOES
CITY OF EAGAN
PERMIT #-`?
PLUMBING PERMIT
CITY OF EAGAN RECEIPT #
_57,57,78-,
P
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3 00 $
Bath Tubs - $3.00
Lavatory - $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 - 510.00
Private Disp. - S10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL: " `"
CASH RECEIPT
CITY OF EAGAN •
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE "Z 19
RECEIVE.
FROM
AMOUNT
& DOLLARS
+oo
0 CASH 91 CHECK
FOR I 4 l
F?vli? Liv ??U
BY x
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
BLDG. PERMIT NO.
014210?.'B'idg, Permi
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
CITY OF EAt; N
3930~ Kn Road
P.O. Box, 2a 199
Eagan, MN 55121
Zoning: R1
Owner. Al !I(
Address:
17'f -2
Site Address:
Plumber.
SEWER SERVICE PERMIT
PERMIT NQ.: t 1 t] 5
8-18-s7
_ DATE: -
No. of Units: l
I agree to Comply With the City of Eagan
Ordinances.
By
Date of Insp.:
Insp.:
Connection Charge: ? _ OOni
Account Deposit: 15 _ 00P
Permit Fee: 10 00p
Surcharge:
Misc. Charges:
Total:
CITY OF EAGAN Permit No: 8-1$-87
3830 Wtot Knob Road Meter No.
P.O. Box 21191 Reader No:
Eagan, AN 55121
Owner. A.1 lier=nn Const.
Date:
Size:
Date:
Conn. Chg: Si255.00pd Zoning:
Acct Dep: 15.01Dp No. of Units:
Permit Fee: 10. Pd
Surcharge 00Pd 1 agree to comply with the City of Eagan
Tr. Plant . P Ordinances.
Meter. E 7 _ nnrui
Misc.: By
WATER SERVICE PERMIT
M
CITY OF EAGAN Permit Na
3830 Pilot Knob Road Meter No.,
P.O. Sbx 21199 Reader Na 6 70 .?1
Eagan, MN 55121
Owner. Al Hermann Const.
Site Address: 1322 St. Andrew Blvd. L2 B
Date: b-13-81
Size: of of
Date: V - Zl-g7
W
nn. Chg : 525.00pd • 7
I$?ir!
ct Dep: 1• `,,Q t g+n e 1
rmit Fee 10. `.' E. 1i`^' ??`/v
urcharge: 1 IWateeTo comply with the
a ED i1. ; ? of Eagan
Plant Ordinances.
Iq
GOLD COPY PERMIT RELEASE FORM bo
PERMIT #
ADDRESS /3 AA
PICKED UP BY
CITY OF EAGAN No- 13 718
3$30 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55-?121
PH ONE: 454.8100 / it ?(? (.
BUILDING PERMIT Recelpt# y `7 Y?
To be used for SF DWG/GAR Est. Value $130,000 Date JUNE 3 ,19 87
Site Address 1322 ST ANDREW BLVD
Lot 2 Block 3 Sec/Sub. FAIRWAY HILLS
Parcel No.
a Name AL HERRMANN CONST
z Address 8723 HIGHWOOD WAY
a City A•V• Phone 688-0597
c
0 Name SAME 688-0696
of Address 431-1455
CityPhone
a
m Name
Z Addre
E
Z City_
OFFICE USE ONLY
On Site Sewage _ Occupancy R3
MWCC System X Zoning R1
On Site Well Type of Const -V
City Water X (Actual)
(Allowable) V
n of Stories
Length 69
Depth 37
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments _ Permit 593. o
Water/Sewer Surcharge 69- 0
Police Plan Review 796.75
Fire SAC, City 1 on _ n0
Engr. SAC, MWCC 525.00
Planner Water Conn. 92s- 0
Council Water Meter 67.00
I hereby acknowledge that 1 have read this application and state Bldg. Off. _ Road Unit v .).vv
that the Information Is correct and agree to comply with all applicable) APC _ Treatment PI 1R0.00
State of Minnesota Statutes and Ct o agen Ordinances. Variance _ Parke
Copies
Signature of Permittee a - TOTAL 5
A Building Permit is Issued to: RRMANN CONST 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
REQUEST FOR ELECTRICAL INSPECTION eB-00001-06
If See instructions for completing this form on back of yellow copy. -75S?C?
® "'2607 ""x" Below Work Covered by This Request
Navy Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Omer ISO,,-if,)
mar is pecifvl
t nr pecify Other Other
Compute Inspection Fee Below
# Fee Service Entrance Size it Fee Feeders/Subteeders # Fe
n Circuits
-L-
15 42 0 to 200 Amps 0 to 30 AM DS 1 0 to 30 Amps
Above 200 Amps 31 to 100 Amps
4in 31 to 100 Amps
Swimming Pool Above 100-Amps Above 100-Amps
Transformers Irrigation Booms A'Q Partial. Other F--
Signs t"
Special Inspecn
$ t7
TOTA F
Remarks EE
oa
'
Rough-in
inal
74
Gq Date
2 4
0r
tI ?? 1. the lectri
Inspec eraby
certify.that the above
iirispedliou has been
made.
This request void is months from
6
I l /o- S?
Icensed Electrical ContrRCtnr
? Owner
?ROad, Now ill N.0f, Inspec-
No t" When Read,
MINNESOTA STATEAgRO OF ELECTRICII
Gri99s-Mid
I hereby request inspection of above
electrical work installed a t:
way Bldg. -Roam N•191 - "•°' `?' .+rv atu OEST WILL NOT
821 Univars itv Ave.. Si. Paul, MN 65104 BE gCCEPTED?
By THE STATE
1 BOARD
'hone 1672) 642-0800 UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
2004 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 RemodeVReoair Requirements brV
3 registered site surveys showing sq. it of lot sq. it of house; and all roofed areas 2 copies of plan D?ulh' Reo3 nY" ?-
2 aoples of plan showing eberage am all w rdow sizes; poured found design, etc 1 site s rveygfor additions & decks additions `T
I set of Energy Calculations Addifion- indicate if onsife septic system t5i)'v.?i $?P6 ,?p1 w ;:k
3 copies of Tree Preservatbn Pan ff lot patted after 711193
Rim Joist Detail options seadion sheet (bldgs with 3 or lass units
Date AL / / 04 Construction Cost 2. as
Site Address t5z-L ?? ? d-P??! F1L?Ca • Unit/Ste #
Description of Work 1_l XLA LX i T-t t.D 1. ) 1 yk--l &I r r 14
Multi-Family Bldg - Y '?0 N Fireplace(s) - 0 - I - 2
1 n? c?- f' ?\ Telephone # (051) 4/05 - /&YO
Property Owner
Contractor
Address
State
RENEWAL BY ANDRSEN
1920 COUNTY ROAD "C" WEST
ROSEVILLE, MN 55113
651-264-4777
LICENSE #20130983
City
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
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y - N If so, 25% plan review
fee applies.
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 a review and
approval of plans. ?/ 101) 11?
ppTicant's Printed Name Applicant's Signature
1 N
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 Parch (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 ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Yor- 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 `Demoliti6n (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# 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 _ HVAC
Drain Tile Other
_
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding _ Stucco - Stone - Brick
Fireplace _ R.I. -Air Test -Final _ Windows
Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
.^ve.,e, ae..•.a, auu za.ou cm (04 Oil '4400 tn;ntsnar, rxpgnU ,y
1
re al
June t 200)
MY of Eagan
3836 Pilot Snob Road
Eagan, MN 55122
To Whom it may Concern:
Elder Jones is authorized to pall building permits for Renewal by AndmmL plena allow.
Sidon Ion's to provide this service for us in Eagan. "ft mftxizftd*n is valid for any
date beyond 616101; until aonewal by Andersen Eaar xvresd y revokes it in writing
to the Cily-
I request this authorization be accepted expeditiously, as to not dela the
our building Permits any fordtor. Please call me If there arc; y in I assing of
contacted at 763-502-4706. a+Y quea [Iona.. T can be
r
Your imm9diate attention to this matter is a?preatrlL
Siu6ai y,
and R Rau
tistallation Manager
r
Renewal by Anderson Q'rPomdun
C:c??Ka?rn-?F]?ries I?n}nP?C?
s aka as
NCA"
Received Time Jun. 7. 117PM
W UU:
V RESIDENTIAL
if \-\?P BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-661-4675
New Construction Reaulrements
• 3 registered site surveys showing sq, ft. of lot, sq. a of house; and &U rooted areas
(200/6 mazinum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• I set of Energy Calculations
• 3 copies of Tree Preservation Plan 9 lot planed after 711/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less unrs)
DATE
6-7--/rli
SITE ADDRESS l322,- Si
TYPE OF
APPLICANT _ / y4-y ?61'tJ7--A?C-Ir/aJ
MULTI-FAMILY BLDG -Y N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS t37S ( 7e K rOr?sZ ?? 7L_ d (_ ao I CITY 6L6A;1J STATE %?ZIP S a-?
TELEPHONE # / ?fZ .1112-- CELL PHONE # 0/ L'ff 0 / 0 r FAX # I/JS I VS J ?oz3
PROPERTY OWNER `-!rn/8-y2- 6r6ff '12-Ah- #'L?
TELEPHONE #
-----------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR -NEW- RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor. _
Mechanical system includes:
Sewer/Water Contractor.
Air Conditioning
- Heat Recovery System
Phone #
Phone #
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the Information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. /I -
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Re T__,__
updated 4r02
Water Softener
Water Heater _
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodelRfeaelf Reauiremems
• 2 copies of plan
• I set of Energy Calculations for heated additions
• 1 site survey for erderor additions & decks
• Indicate if home served by septic system for additions
VALUATIONS 7
I ? 3 .??
Fee: $90.00
OFFICE USE ONLY
? 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 (screened) ? 36 Mufti
? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldgr ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code 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 _ HVAC
_ 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 , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
City of Eagan
Cash Receipt
Receipt Date 18/4/88
Time Printed 12:84:54
Receipt Number 1892
SELA ROOFING 8 REMODELING INC
1322 ST ANDREW BLVD
9881.2195 1.58
BP 43127
9881.4885 83.25
BP 43127
Total Receipt Amount 84.75
User NMCGRAW
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
* H3127
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
> 3 registered site surveys showing sq. ft. of lot, sq. M. of house
and gS roofed areas (24X_ maximum lot coverage allowed)
> 2 copies of plans (slow beam (L window sizes: poured Intl. design; etc.)
> 1 set of energy calculations
> 3 copies of Irea Preservation plan M lat plaited after 7/1/93
DATE: / 6 - `f- n-(7)
DESCRIPTION OF WORK:
STREET ADDRESS
LOT. 2.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
K15
2 copies of plan
150 Of energy caicWaMOna for heated additions
1 site survey for exterior additions 8 decks
CONSTRUCTION COST:
I Zc{ SO. °-6
13 ZZ ?-F ,?ra2rrews ?(val ' ,? '(? `mot
BLOCK: t3 SUBD./P.I.D. C fql l wav HISS
Name: (?' r Phone #:
Lost First
Street Address: <Jt5
CBy ?L?G Gv? State:
Zip:
SELA ROOFING & REMODELING, IN(, ?j
Company: 4100 EXCELSIOR BLVD. Phone #: (Z p Z7J' X50 ??o
ST. LOUIS PARK, MN 55416 (area code)
ID #0001050
O
Street Address: License # /D 57? Exp. r L
City
Company:_
Telephone #: (
Street Address: Registration #:
city
State: Zip:
Name:
State:
Sewertwater licensed plumber (if Installing sewertwater): Phone #:
Zip:
1 hereby acknowledge that I have read this application, state that the Information Is correct, and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Signature of
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received _
Yes No
Yes No - Not Required
c[c 40?.(
c?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of _ plea [3 09 07-plex
13 04 02-piex ? 10 08-plex
? 05 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
WORK TYPE
? 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.)
? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 18 Deck ? 23 Porch (screened)
? 19 Lower Level ? 24 Storm Damage
Plbg _Yor_N ? 25 Miscellaneous
? 20 Pool ? 30 Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair f
? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Engineering
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 EM. Aft - Multi
? 33 Ext. Aft - SF
? 36 Multi
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
SAC Units
% SAC
3
7/1
1987 BOILDING 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
INCLUDE 2 SETS OF PLANS, CER
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
RENTAL UNITS FOR SALE UNITS
OF SURVEY - CHECK WITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Us d For: Yt¢- Valuation: (?Jn'A
/3-p.a i T
Site Address )yam OFFI(
Lot ?i Block 3
Parcel/((Sub ' 1 u tea .. T??(? 9S (( rr\\
Owner LJc? i?„cam ou? rn TAe1 PnM?
Address
City/Zip Code
Phone
Contractor 5&L [mod-ayz?&O G r?? rCr
Address 2'72-h kL-Llo U .?
City/Zip Code SS i
1414
Phone (0?? -7n1c?1(o?690 72{ /w I-r
Arch./Engr. CAAW &c WJQAJ,
Address kC)nL
City/Zip Code +.hRSc1 U e c? 337
Date: S 7
On Site Sewage_
MWCC System _?
On Site Well
City Water s/
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Occupancy
Zoning ?.I
Type of Const
(Actual)
(Allowable) ]Z
# of Stories
Length (02
Depth YZ
S.F. Total
Footprint S.F.
FEES
Permit
Surcharge
Plan Review 2F .?s
SAC, City 100.
SAC, MWCC 2 -
Water Conn ?Z -
Water Meter b7.
Road Unit
Treatment P1
Parks
Copies
TOTAL
Phone # ?A 12 - ?, Ofd
aj-
L ,
2? x 40 " (22 ?c = 2420
21 22 = 2?'?D x ?2 ?? ? 2
X o = 2d x -:56 s 2 20
i 5 CZ&
95
I zo?7 z
ROBE
ENGINEERING
COMPANYt INC.
1000 EAST 146A STREET,
AL *RRMAU:V CcIJS',
iS,oS
COHSULTIHO EHOINEERS, ?RQ ECT No,
PLANNERS and LARD SURVEYORS
BURNSVILLE, UIHHE!CTA 5:337 Poi 43Z-3000
Cer?z`z ccr?e?y'e cY
acl .?escr,?iorLLOT 2, BLOCK 3, FAIRWAY HILL;
DAKDTA CDU/VTY, MINNESOTA
1 (2a :?T ¢ ST, ANDREW BOULEi
0
0
/Low ici
M S 890 48'
55.00
I ? ??oZ7g '_?7.c
/oZB,o? 028.33 /O?`
rL? •? 24.33
L°zB.c? S Ic.o
37.67 I P Q4RALE N
_ I N
$ youSE ?-- J I-
m .f pois.c 1
y I 40.0o r E.oo Lz3` I /
Iozo 0) `0. W, O. to 6)
l? ? QoT9,St /?9_gi
I `c I
? H
I I
f LOT 2
sI /v 1 Ili, / .
UJ L_ Is
- o
85, o ¢-??'
5 86c
I /1 !- IC-
I hereby certify that this is a true
land as shown'and described hereon..
.
A4Y „ 1987
SCALE : 1'> 30'
30' FfZOI/T AFUILDIN6
-967FACK L/NE
Q[az7=ab DENOTES EXISTING
ELEVATION
' C/ozg.0) DENOTES FROPOLED
ELEVATION
INDICATE5 DIRECTION OF
SURFACE DRAINAGE
/oz8.33 = F1NISNED 6ARA6E
FL002 ELEVATION
DRAlNAQE AND
UTILITY EASEMENT
Qoi7. 5?
and correct representation of a tract of
As prepared by me on this ./s! day of
Minn. Rag, No. 1600.-
• CASH RECEIPT •
CITY OF EAGAN
38307PI LOT kNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RE<EI V ED
FROM
gum;) NQ
AMOUNT $
FUND 000E AMOUNT
27 Z
L
Thank You
BY
No 80049 White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
&oDOLLARS
lo
CASH ?] CHECK
/ a- a/- ?;
?3za
QWOpUCTBC
O
a
e
3 Y
FIVE LOCATIONS TO SERVE YOU
15801 W. 78th Street Eden Prairie, Mn 55344
(612) 937.9666 WATS (800) 7528112
M llwaukee:(414) 781-0610
Sioux Falls: (605) 743-5333
Des Moines: (515) 278.9725
Kansas City: (816) 373.5614
i
I
i
- ---------- - ---- -
i
i
i '
............
i
cI'rY OF
BUILDING DEPARTI•IENT
kXTE1lION EIIVOP? A"VEHAOE huff U014PUTATIOB
4?•: (To be submitted ttith building permit application)
ono o%Two Family Dwelling
°- owner
All Okker Site Address
?r
Contrtlotor /nAY•
5 y Date Phone 1
LIIIbAGTrFc•r OF IV 2
BXIOSEb T1ALL it. above grade IZIO
TOTAL EXP08ED IYALL AREA sq. FT.
)PAgUN WALL Coil STRUC'riollt fluff Value x Area
betoll fluff
x Sq. FT. 2. lAt5- (u)(A)
re[aretioe L,/O r Iron
rram :r• f fluff x sq. FT. _ tu)(A)
attaelled nufr x Sq• FT.' 1?.? SU)(A)
x sq. FT. - U) (4)
slteete:. fluff
flUff x sq. FT.. _ (U) (Ay.
x Sq. FT.? _ (U)(A)
1111DOq$1 nUn Value x Aron
Inlto &?'rype 07tti
(/{?ffiM?nllfr
n .`', fr Itun t •uc - Sq. FT.-I r i'77 (U) (A)
x Sq. FT.
n (u)(A)
nun -
fr if mu ff x q. FT. (u) (A)
x s Sq. FT.
111,17 . U) (A)
XQo118t,-uUrt Value x Area
Itfite &iryPe ?!r)???
fr „ J fluff
_x sq. Fr. VXP (U) (A
rr Ai" ff L fluff
rrurr x sq. FT. _tu)(A)
f ?' n nUrf x Sq. FT.
? _(U) (A)
x Sq. FT.
_ (U)(A).
TOTALS Z07 »sq. 1'T. ZZZ, rj5 (u)(A)
OrAL (U)(A) VALUES -Z 7 AVERAGE nUn
- '--- ? 4
IVIDED;..DY TOTAL WALL AREA L(p??
VhNAG$„ ffu n
•115 or loon for I&Z family dwellings`
OOF/CEILINOI
OTAL AIIEAI f o(, O _--
a toil. refereuce
frofn fluff " . C>-
x
sq.
FT. d v -
ZZ Z-&(U)(A)
ttaclfed elfeets. npff x Sq. FT.
(U)(A)
eccribe openings fluff x Sq• FT._ (U)(A)
it roof. x Sq. FT.
TOTAL . (U) (A) VALUES DIVIDED
DY
Z21 7i((? x sq. FrT. - (U)(A)
7cT I ?j - 54)7 ZZf zo(u
?
r0'1'AL IIOOF/CEILING Al1EA I n/n . =
{
`'r
III
y. 4.
X87- 3-
X
Zo4
D
?I 2 (p72r(??r
7 144
SAX ?q4-
=.11?- 5z-
Zl?
?x? ? g,7?X 1= 87,
2- ?{8 = Z2.rj I ZZ i 5
lw&o Z4
z- r?X = I?sx I
s
r-jz
pmw In -%- 42dO
a
?s.Y14?ii I
•h is
i ,.
?r [°IN?F II?,52
" 476 y$ . ?1113??
t
1.
yi
Up Rims and Conc. Block
R90F/OEILIII( I R V U
1.) Interior Air rilm 0.61
2.) 5/811 Gyp. Bd. .56
30 Insulation
4¢
?
.)
4 ,
50 Exterior Air Film .61
(STILL)
11U11 a 1/R= X02-1 TOTAL (R)=,7$.
:r
WALL R VALU
6.) Interior Air Film
7.) 1" Gyp. Bd.
8.) Insulation
9.) bow-r-r-irE
10.) Masonite Siding
11.) Exterior Air Film
0.68
.45
19• oa
4
.67
.17
"U" = 1/R= . p4 -,, TOTAL (R)= 23.01
RIM
12.) Interior Air Film
130 Insulation
14.) 211 Fir Rim Joist
15.) EoltT-L'rTc
16.) Masonite siding
170 Exterior Air Film
R VALUE
0.68
19.00
1.88
2. 67
.17
"U" = 1/R= 004-o TOTAL W.
Z?•gT
FOUNDATION
180 Interior Air Film
19.)
20. ) P4 97k1P4,ED
21.) 12" Concrete Block
22.)
23.) Exterior Air Film
"Una 1/R= .0710
R VALU
0.68
11.c?
1.28
.17
TOTAL (R) = 13.1 ?,
I
20.0 4x1 3x4 3X4 6X4 6-10 3-4 4x2 3x5 4,3
23.'-0 4x12 3x5 315 6X6 6-1 315 4,2 31 X5 5X9
26-O -Ix12 3X5 315 x6 8-;2 9x5 4x2 3x6 5x10
Z9'-0 5.12 .3.6 3x6 6X6 814 3x6 4x2 5x5 0-x12
32 0 5x14 4X6 4x6 7.6 3x 4x6 4x2 5x6 6x12
35 ?0 5x15 4x6 4x6 746 8x 4X6 4xe 5.6 6x14
38L O 5 / 4X6 4X6 8X6 dX/ 4x6 4.2 5x6 rx
4l 4x6 Xo 8x6 8X1 x6 4x2 5X7 &1
A10.2QF, C -
19'-g z
30! 6 Zx?F
22! 0 2 x6
20- /-6 on, or report was prepared by.me or.
under my direct supervision and that I am
N0.20?.F. r
21 - 9
34 -O
25'-6
30'-6 e duly blistered Professional EnoTneer
under the laws of the Stare of Minnesota
NO I Dc
221-9
34 .
NOIDDF. 25,-01 3 7'-9, 29'-6 40'-6 1
r
25r - 6
3J-3
30 '-O
TO-;70-
Date ReeistratioR No. 1014111
V..SSLQF 2J'-o 40'-6 34'-O -
L T! £- WEBS 2x4 NO. 3 OF UNLESS/JOT£,0
MI1d1MUM BEARING 2X4
x4 - F0,9 SPAN
e 2Xstlc?D F
O O
/ 5 11
DIAGRAM
r
5
't13L 9h i
C + ?? C
G c _ Oi
`? SC,a,Sr'ao??f -n O N? a?
,2 O O
5 2
? J6 . J9
O
R=57L. ? F F_ ?IIAL f?A'iF?S = L
ATLAS 20 CA
Claa.lca, Illw , ease.
i'
1 -?
I SYM.! 46'r
?GI`r5of': '(?N55.. I?SFIst?E1?=--__
Fox... DeoPPEO - Gt4:-- ----
Ina da4a. tonlarel la IPI ? N{PA
s
ar Pl
a
40
o
ner t
ell be taalwd m hoID TOP CHORD It
PSP SPAN L
1-411 W uaer It all Imal Au sister am
dewdd l4 be watad a. "as". An
IOP CHORD OI /O PSP 9
PITCH ?G
eweswse la b rlulid bt the Ne4taeL
E
nqweer, se Bede.-CanraN4e weer to eat CHORD tt Q PSf SPAta11O
Ieseesere. AD eeAhpe vol," base. No .
hwN eNOwd as pm Wallowa Pd
BOT. CHORD Ol P
P -
A
t
Wesel b." laln I.,'&wq woo0 S Ou
A I iACTtl
,
Tweak. basa ftepy'H-jlappp ddr:: laTu leas .. ..-Jo" . -. - -
6PKP SCISSORS
DESIGNED Br -P9, AVI N
opawN Br _ q WC.
.?? ^CIAtE ?.?
?? a -oWGNQ ?v
MXC4 JOB NO. 850098. PAGE T OF 5
a TYI,t:MC 5VAN: 20 1 6IN bSX
' e w? FHEEL3'`` INLEFT.7SX IGH? YLAIES, X20. bAU?t:, HYUtct,i+ r
ri1612 5.0 ;
'2 2
CSI SIZE LUMBER I.15FH LCHII%F+ING_335'=2x9 "P5I'?MtCt FAIK
ToP r.,ta 2X 4 1650F1.5 1897 INCLUDES 15.0% INCREASE
b"i,tt n.o7 2X 4 UFN02 1650 ME-MUER FORCES (LbS) TENSION 864-553 PLI PER PAIk
rws n.Av 2X 4 DFSTAND 690 TON CHOkDS SHEAR 950-545 PLI PEH PAIR
EXCErTiotis: A-G = 1892 C U-H = 1401 C
b-ii 2X 4 DFI+02 165n H-1: = 216 C B-IJ = 216 C JT TYPE PLATE SIZE X Y
LUfabt:K STRESS INCkEASE - 15.0x. BO'IToM CHOHUS A SEE JOINT DETAIL
HcNETI11VE ltEt btH STRESS USED. A-F = 1746 T F-E = 979 T b 3001 4.50 X 4.00 C'I"R CTk
E-CU = 0 T CD 4000 1.50 X 4.O6. C1'k CTH
'.ATEkAL BRACINU: VILBS t 1070 4.50 X 8.00 :IH Clk
CUN"hII.UUUS - TOP CHORD G-F = 616 C F-H = 635 T F 1010 3.0n X 4.n0 CTR CTH
Coi4l II.000S - UTM CHOkU H-E = 1038 C E-b = 202 C 1001 1.00 X 4.00 CTk C1"k
U(:E b.iACE - 11-E E-B CU-IJ E-1J = 9b2 T CL-IJ= 1117 C H loin 4.50 X 4.00 CTR CTk
St%ACINU - 24.0 IN. IJ 4110 4.50 X 4.00 CTk C'lk
L'L+LL DLFL = 0.34" IN A-U SI IInO 3.00 X 5.00 CTH Clit
Lc, ALlr,t; 1. 1VE DL-AU (PSF) LL LLEFL= 0.29" LESS THAN Si360 S2 1100 3.00 X 5.00 CTk CTk
ION CHI) 4n.n 7.0 NOTESi JOW DETAIL
c"i"•. UHU U. 7.0 I. CONFORMS To TPI-7b.
-1OTAL 40.n 14.0 54.0 2. ENLi VEkTICAL(S) NOT
_ DESIGNED FOR Vt1NU EXilOSUkE.
Sl i-POki CHITERIA 3. PLATE VALUES ARE BASED 55x10 P?r?
Jl HEAL?'i '.NIL H JT HEACT V41DTH ON A LUMBER MOISTURE
Lbs Ir+-SX LBS IN-SX CONTENT OF 190' OR LESS
A 1117 3- n CL- 1117 3- b AT TIME OF FABRICATION.
_ T
EQUALLY DIVIDE PANELS FOR B 12
CHORD LENGTH MINUS SCARF IJ 5 ?-
e' DISTANCE UNLESS NOTED(*) 12 ?_ ? L????„ 2' -
r•'` 5 ?- H /' I
SL n*9
llicatlon
G I hereby c^
or report %nder my
I
direct Per"o^.ai supervision and that I am a
duly negistered Pro!emional Engineer un-
__ I Thomas IL %Taghgcn Reg of btinneeota•
Reg. IZo. 14920-
/I. A F 51 E x`p C D
'' L 19' - 5 t/4'I 1t A2 0' ,G•
SM& 1/40
r
- JAK-221995 '
Kr INEORMATIM '
`'T PI7B J.D. ADAMS COMPANY 'LUMBER-SAVER' ENGINEERING
k"
uy . OOPPT JrrT. L/4? I
-IN PNL 35
BE
G2 OPT. JT: O IN PNLib",
IC P IC
i
L/3
" SCARF L
SPAN
FOR SPAN 39'- 3' OR LEGS MINIMUM LUMBER TOP CHORD-2X 6 DOUG FIR-LAR fl
A- 3. 9X 9. O JT. AI-2. 6X I. 0 JT. 3-3. 914 5. 4 JT. C2-4. OX 3. 6
PLATE BQ IN- 266.0
ENT SPLICES JOINT AI-7. OX 5.4 JOINT C2-7. OX 9.0
ENT D-4,5X 5.4 JOINT E-4. 5X 3.6
BOTTOM CHORD-2X 6 DOUG FIR-
ALL WEBS-2X 4 DOUG FIR-LAN
WEB BRACES 1-0.2-0.
THE MINIMUM BEARING- 3.7 IN
FOR SPAN 36'- B' OR LESS MINIMUM LUMBER TOP CHORD-2X 6 DOUG FIR-LAR fi
JT. A- 3.9X 9.0 JT. Al-2,6X 1.8 JT.B-3. 9X 5.4 JT. C2-4. 5X 3.6
PLATE BO IN- 266.0
JOINT SPLICES JOINT Al-7.OX 5.4 JOINT C2-7.OX 5.4
JOINT D-4.5X 3.6 JOINT E-4.5X 3.6
FOR SPAN 34'- 2' OR LESS MINIMUM LUMBER TOP CHORD-2X 6 DOUG FIR-LAR 01
A- 3. 9X 9. O JT. Al-2. 6X 1. 6 JT. 13-3. 9X O. 4 JT. C2-4. 5X 3. 6
PLATE SO ]N- 266.0
NT SPLICES JOINT Al-7.0X 5.4 JOINT C2-7.0X14.40
NT D-3.9X 5.4 JOINT E-4,5X 3.6
BOTTOM CHORD-2X 6-DOUG FIR-LAR It
ALL WEBS-29 4 DOUG FIR-LAR BTU
WEB BRACED 1-0.2-0.
THE MINIMUM BEARING- 3.3 INCHES.
BOTTOM CHORD-2X 4 SOUTHERN PINMEE
ALL WEBS-2X 4 DOUG FIR-LAP StU
WEB BRACES 1-0.2-0. -
THE MINIMUM BEARING- 3.5 INCHES
4TF i'. FOR SPAN DO'- 3' OR LESS MINIMUM LUMBER TOP CHORD-2X 6 DOUG FIR-LAR U BOTTOM CHORD-2X 4 DOUG FIR-LAN 01
' JT. A- 3. 9X 7. 2 JT. At-I. 3X 1.8 JT. 0-4. 5X 3. 6 JT. C2-4. 5X 3. 6 ALL WEDS-2X 4 DOUG FIR-LAR 87V
218.9 WEB BRACES 1-0.2-0.
PLATE SEE IN-
JOINT SPLICES JOINT AI-7.OX 5.4 JOINT C2-7.0X14.49 THE MINIMUM SEARING- 3.5 INCHES
JOINT D-3.2X 5.4 JOINT E-4, 5X 3. 6
--«-_,
FOR SPAN 29'- 1- OR LESS MINIMUM LUMBER TOP CHORD-2X 4 SOUTHERN PINERID BOTTOM CHORD-2X 4 DOUG FIR-LAR fl
A- 3.9X 7.2 JT. AI-1. 3X 1.B JT.B-4, 5X 3.6 JT. C2-4. 5X 3.4 ALL WEBS-2X 4 DOUG FIR-LAR BTU
PLATE 60 IN- 218.9 WEB BRACES 1-012-0.
SPLICES JOINT AI-4.5X 3.6 JOINT C2-7.OX14.4S
D-3.2X 5.4 JOINT E-3.2X 3.6
THE MINIMUM BEARING- 3.3 INCHES
FOR SPAN 261- 4. OR LESS MINIMUM LUMBER TOP'CHORD-2X 4 DOUG FIR-LAR 61 BOTTOM CHORD-2X 4 DOUG FER-LAR
.A- 3.2X 7,2 JT.AI-1.3X 1.8 JT.B-4,5X 3.6 JT.C2-3.2X 3.6 ALL WEBS-2X 4 DOUG FIR-LAP STU
PLATE 60 IN- 180.0 WEB BRACES 1-0.2-0.
ENT SPLICES JOINT Al-4.5X 3.6 JOINT C2-3.BX 5.14 THE MINIMUM BEARING- 3.3 INCHES
ENT D-3.2X 3.6 JOINT E-3.2X 3.6 I
- -- -------- -----
FOR SPAN 24'- 4' OR LESS MINIMUM LUMBER TOP CHORD-2X 4 DOUG FIR-LAN MI
JT. A- 3.9X 5.4 JT. Al-1. 3X 1.8 JT.B-3. 2X 3.6 JT. C2-3. 2X 3.6
PLATE 90 IN- 162.7
JOINT SPLICES JOINT Al-4.5X 3.6 JOINT C2-4.5X 5.4
JOINT D-3.2X 3.6 JOINT E-3.2X 3.6
BOTTOM CHORD-2X 4 DOUG FIR-LAR SIB
ALL WEBS-2X 4 DOUG FIR-LAR STU .:.`1
WEB BRACES 1-0.2-0.'i
THE MINIMUM BEARING- 3.3 INCHES _•, _1
FOR SPAN 22'- A" OR LESS MINIMUM LUMBER TOP CHORD-2X 4 DOUG FIR-LAR 61
. A- 3. 9X 5. 4 JT. Al-1. 3X T. B JT. B-3. 2X 3. 6 JT. C2-3. 2X 3. 6
PLATE SO IN- 162.7
JOINT SPLICES JOINT Al-4.51( 3.6 JOINT C2-4.5X 5.4
JOINT 0-3.2X 3.6 JOINT E-3.2X 3.6
BOTTOM CHORD-2X 4 DOUG FIR-LAR .01
ALL WEBS-2X 4 DOUQ FIR-LAR BTU
WEB BRACES 1-0.2-0.
THE MINIMUM BEARING- 3.5 INCHES
`-r THE BEST RESULTS IN TRUSS FABRICATION ARE OBTAINED WIT" A MECHANICAL JIG THAT ELIMINATES HARMFUL STRESSED CAUSED. a
'. BY HANDLING. LACKING SUCH A JIG. GREATER CARE MVBT BE EXERCISED IN HANDLING THE TRUSS OR LARGER CONNECTOR PLATES
SHOULD BE SUBSTITUTED. J.D.ADAMS CO. BEARS NO RESPONSIBILITY FOR THE ERECTION OF TRUSSES. PERSONS USING TRUSSES
ARE CAUTIONED TO SEEK PROFESSIONAL ADVICE IN REGARD TO ERECTION BRACING AND PERMANENT BRACING. ALL JOINTS MUST
j BE ACCURATELY CUT AND FIT. DIMENSIONS MUST BE VERIFIED. ALL PLATES CENTERED UNLESS SHOWN OTHERWISE. PLATEB.ARE
MINIMUM BASED ON STRESSES. FABRICATOR MAY FIND FROM EXPERIENCE THAT SOME JOINTS MIGHT REQUIRE LARGER PLATES FOR
HANDLING. ALL CONTINUOUS BRACING ON WEBB AND CHORDS TO BE ANCHORED AT BOTH ENDS TO A SUITABLE SUPPORT.
:(ALL BRACING TO BE SUPPLIED BY OTHERS,) ALL WEBS 2X4 UNLESS OTHERWISE SPECIFIED.
' MULTISPIRE '(BY J.D. ADAMS CO.) SMALL BE MADE OF 20 GAGE STEEL AND PRESSED INTO BOTH FACES OF JOINTS.
N?
NOTE: PLATES WITH "8- AFTER SIZE - SPLICE PLATEI "H" AFTER SIZE - 16 94. PLATE
4 TOTAL SQUARE INCHES DOES NOT INCLUDE PLATES REOUIRED TO SPLICE A TRUSS 1 TRUSS LOADING
MULTIPLY SPAN BY FACTORSBELOW FOR STRESSES I ROOF
A-A1-122.03([) Al- 8-106.7210) A-C2-111 76(T) C2-CI- 79.69(T) AI-C2- 22.35(C) 1 LL- 40.00 PBF
B-C2- 31.79(T) - ' I DL- 5.00 PSF
1 CEILING
ALL BRACING- IX4 (USE 8'0.C.BRACING ON B.C. IF B.C. IS NOT ADEQUATELY BRACED) I LL- 0.00 PBF
FOR A MINIMUM BEARING GREATER THAN 3 1/2" BUT NOT EXC[:ED?p10 nU7IM'f rXI ?.N I DL- 10.00 PBF
ADD ONE BEARING BLOCK I d6f6, I % INCREASE FOR BTL-15
REQUIRED NAILS ON DEARTNQ BLOCK-IMIN. BRO.-0. 5)X 6.14 T SPACED AT 24"O.C.
n /P , PAGE S(0
DIVISION OF VIILAUME INDUSTRIES
292G LONE OAK CIRCLE
IT Phil[ MINN 551121
q
COPYRIGHT
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570
TOP 51.P =
5,00/12
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-01 SPCC= 2=0V-00 R-L"O rlGT 9-06-O1 Bp.L= 0.0 P111,
BCI1L= 10.0 PSF .
" 10rL= 6U,0 Pb/'
PI-79 1-10-92
TPS USED V05.42
Y APUVT Cl, CAHC
LM=1.15 67,0
SLOPE CNURO FORCE KOMNT WEB FORCE
L 112 LBS IN-LB LHS
1 5.00 C 1= -2127 6157 M 1= -759
6 5.00 C 7= -)519 6153 N 1= 942
6 5.00 C )= 0 6151 W 32 -1305
4 VERT C 4= -155 0
2 0 00
/TRUCTONAIL COafPONA Ni AO9P Y CO r P A MT
1010 North Q11, can,,ooft rii NEED""," 56J00
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s:
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k. CURB IAT C,COr'V[
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K 4 7100F-I,BE N SPF 0,915 N 0.207 ? 0.718 21011 1575 1700 It
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,.7X a 510 DRY V!' JOINT FE0.CT (Ltl) MEN B"( 10) - MILTON E•L 3
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PLAT M PLATEN SELECT 105L(CONFORMS TO VIII] TC5 I1,05,BUCA 40-84,ShCC 71121-78) •••s ,pNgL op?,
T LUC) iiON JUL"r ..I., I.I..,
PLATE SIZE DI PECT full X (1717 Y TYPE
2 1/7 X 9 PT PARA-AC CENTERED 1
1 1/7_X 4 VT PAPA-W5 CENTEREU 4
2 X 4 PT PARA-CU 4 2 1 hereby certify that Ihls Plan,
speciliuHnn, or report was preparod
1 X 3 PT PNPA-VC CENTERED 14 by me or under my dtrect st'Perxid0n
7 X 4 FIT PAPA-BC 1 1/4 3 15 and that 1 am a duly ReP,iltered
2 1/7 X 4 PT PARA-CU 2 1/7 7 1/7 S Prolessional ENNinoar under the laws
of the Stale of
ES-SLOTS PARA TO CMn(16FT, MAX GLIMMER)= ===_(PLATE NATInG5)====
2 1/2 X 4 Pt 70 GA, PT (146 -PSI GN57
2 1/2 X 4 Pr In GA, R (107 PSI NETT MAR1 2 198
., WIFE ?reBislration NO, 13552
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DESIGN Val1O ONLY FOR USt Witil NY0sO Ain(ONN[CTOAS THIS INUSSIS DESIGNED AFAR INDIVIDU41UIlOINr. COSVON(x11115 (p (Elb N0T(S. 1
L tV T AL I U E..EAS T04FAP r
1
F (pPPOAAi(n IYIO A IUIL DING nE51f.N At THE SIECIFICAPON III THE OESIGNFA OF THE IUILOINO. AP.CING SPECIFI(01"0 U](Pal SUG
CEYIFP RLAT
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1 +
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POPr OFI OIVID1A[ INIISSMIMP[PS ONLY, AnO11111YAL BRACING OF THE OVERALL STRUCTURE M.Y Or AIOUINfO FOR GtNFP.lGV10aryCF i
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4
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N YAf70 41117 1......1 nY p.,,i t COV [nnl V pn.If[ nfl laF RY tP`C PRY 1- I I V CIVG Of IPVSSE ]. CDt::IIT THE OU AIITY COII TPOI.4NV IaL• ax0 I. I• Dll "TO C-110 SPLICE
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HEADER P
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STEEL
ASH PIT ^R
CONCRETE RODS
HEARTH FOUNDATION
SLAB
STANDARD DIMENSIONS
,Model
Number A B
C D•
E F G H
I O.D.
Flue
34 21 24 40 34 30 28 531/2 12 9 1303
36 21 27 431/1 36 30 28 531/1 12 12 1303
42 21 32 48 4111. 30 28 5311 12 17 1307
' 48 25 37 54 47 34 31 581/2 16 20 17x21
'CON SULT LOCAL BUILDING CODES, OBSERVING MINIMUM MASONRY
THICKNESSES
"•
WARNING: This is an All Masonry Fireplace -
, not a Zero Clearance Unit. Read Installation
Instructions first
ICBO #3473 .
II ,t`k
n OTnuw. n..?..? w....
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
MOTO: P0MM4T OF FEE AT TIME OF
APPLICATION DOES NOT CONSTITUTE
APPROVAL OF PERMIT.
INSPECTION OF SUM AND/CR WATER
INSTALLATIONS WILL NOT BE SCHED-
ULED UNTIL PERMIT RAS BEIN
APPROVED.
-----------------------------------
(Please Print ?-
1) PROPERTY ADDRESS: LIZ LEGAL DESCRIPTION: e ,--j
sion or
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
PRESENT ZONING/PROPOSED USE: (Month/Year)
Q cag4MCIAL/RETAIL/0FFICE R-1 SINGLE FAMILY
Q INDUSTRIAL Q R-2 DUPLEX (Two Units)
Q INSTITUTIONAL/GOVERIzEw Q R-3 TOWNHOUSE (Three + Units) ( Units)
R-4 APARTMENT/CONDOMINIUM ( Units)
2)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE: - <D( ,q j,,
3) For City Use
NAPS: f ?? VVtO' ft (1 ?LJ"l l? 10 Plumbers License:
ADDRESS: j X12 Z SC 23" ,?.; )J ?_ Active
CITY, STATE, ZIP. L' Expired
J W7 c) . icba WI 1 y rf U I Not recorded
PHONE MASTER LICENSE# 2j?>(v5-
Staff IniFi-al
4) •• ?.iu:e?
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
CONNECTION TO CITY SEWER T CONNECTION TO CITY WATER rj OTHER
6) • 0 PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
7) ?i?-?
:FOR CITY USE, ONLY
PERMIT # ISSUED
O
Pd w/Bldg. Permit
C
S `7 0-O
$
$ a?ZS •a?
sfr Z,? <ro
FEES:
SEWER PERMIT (INCLUDE SURCHARGE)
$ ??> S--2)
Is WATER PERMIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
S e-0 ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ WATER TREATMENT PLANT SURCHARGE
7 $ OTHER:
$ 13J $ TOTAL
RECEIPT 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 ENGINEERING
NO DIVISION. LIST AS A CONDITION.
Q
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE: c `
DATE : ?} 1 le /,lre
VA'
HERRMANN
CONSTRUCTION INC.
"QUALITY BUILT HOMES"
A, 9-
/?
13 /o cl? 3
City of Eagan
3830 Pilot Knob Road
Eagan,Mn. 55122
To Whom it May Concern:
July 10, 1987
We are building a model home at 1322 St. Andrew Blvd in Fairway Hills
and plan to use the garage as office space. We have run transite heat
ducts into the garage in order to efficiently heat and cool the offices.
Upon selling the home we intend to fill the transite ducts with
concrete and disconnect the ductwork at the furnace. We will call for
an inspection prior to closing.
Should you have any questions, please call me as soon as possible.
Sincer ly,
Al Herrmann
President
AH/mt
8723 Highwood Way 9 Apple Valley, Minnesota 55124 0 Model 688-0597 0 Evenings 431-1455
I i
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
O-
Neer Construction Requirements Remodel/Repair Requirements Office Use Only
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cart of Survey Recd _Y _N
(20% maximum lot coverage allowed) l set of Energy Calculations for heated additions Tree Pres Plan Recd _Y _N,
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pfes Required _y _N
1 set of Energy Calculations Addition - indicate if onske sepfk system On-site, Septic System _Y _N
3 copies of Tree Preservation Plan If lot platted after 71V93
Rim Jost Detail options selection sheet (buildings with 3 or less units)
Date ? 0 Construction Cost f -! 1?
O C57
Site Address ` y? _ S
i 3a A S" - Unit/Ste #
Description of Work lace I S t n 5 t Y1 r 'P /`q 11
Multi-Family Bldg - Y _ N Fireplace(s) _ 0 - 1 _2
Own
P
t
S `TLS 's `1 "?
hone # tyv 1) qd' ` /67 (?o
Tele
roper
y
er p
RENEWAL BY ANDERSEN
Contractor 1920 COUNTY RD. "C" W.
Address ROSEVILLE, MIN 55113 City
State 651-264-4777 Telephone # ( )
LICENSE #20130983
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
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 MIN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
perm't; that the work will be in accordance with the approved plan in the case of rk which requires a review and
app Val of plans. f? f ' n h Ir J ?z
5 5
Applicant's Printed Name A icant's Signature u?
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 ? 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 Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) - FinaVC.O.
Footings (deck) - Final/No C.O.
Footings (addition) - Plumbing
Foundation _ HVAC
_
Drain Tile Other
_
Ice & Water
Roof Final _ Pool _ Ftgs _ Air/Gas Tests -Final
_
Framing _ _ Siding _ Stucco - Stone - Brick
R.I.
Fireplace Air Test - Final _ Windows
_
-
Insulation Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
••?. ..,, sn-.s iyc, %b. JV rne, tea / .
Df1 '4460 Kt!rvf`nAL BI-ANL1tf[taIM -
al
arexa??. - -
]'aite ? 2001
My Of 3836 PiloBagan
t Knob Road
Eagan. MN 55122
To Whom 7t May concern:
Elderlones is authorized to ptiUbudding permits forRenow el by Andersen Please allow
Elder )ones to provide this seri?icc for us in PAM. 'Mis authorization is valid for any
date beyond 616101; until a $$Rewal by Andes manager expmsdy revokes it in wining
to tha city.
woo
F'request this an6oduffou be
a
our building penults My &rd= ka dourly, as to not delay m the Promssing pf
contacted at 763-5o2_4106_ E'Ecasc can me If there arc any questions:. I can be
a _
Your imtnsdiate attention to Us matter is rfl A
Sincoialy,
ond-P- ?u
tistallation Imager
Renewal by Ands sen Corpotadon
C'r.: lCurn_Flder7nne? - .
Received Tfaae tun. 7. 1'07PM-
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1322 St Andrew Blvd
Lot: 2 Block: 3 Addition: Fairway Hills
PID:10- 25600- 020 -03
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Total:
Contractor:
Apple Lake Heating & Air Conditioning
207 150th Street West
Apple Valley MN 55124
(952) 431 -4328
ME - Permit Fee (Replacements)
Surcharge -Fixed
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
equirements should be directed to Mark Anderson, State Electrical Inspector,
$50.00 0801.4088
$0.50 9001.2195
$50.50
Owner:
Nels Offerdahl
1322 St Andrew Blvd
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Issued By: Signature
Mechanical
EA078309
06/14/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1322 St Andrew Blvd
Lot: 2 Block: 3 Addition: Fairway Hills
PID:10- 25600- 020 -03
Use:
Description:
Sub Type: e- Fireplace
Work Type: Gas Insert
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Fireside Hearth & Home
20802 Kensington Blvd
Lakeville MN 55044
(952) 985 -6675
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
434- Occupancy:
Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Andrew Hoffman
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total: $90.00
- Applicant -
Owner:
Linda S Unzicker
1322 St Andrew Blvd
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA082175
03/10/2008
ePermit
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.
Use BLUE or BLACK Ink
r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
I For Office Use
I
Z ZS 3) City O1 Ea Permit ~
Ilk
all I dS~ i
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
I
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 I Staff:
I 1
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SllZ~Cy Site Address: 13Z2- S71' . w ~ Unit
-
Name: ~OC~L S Q ~ti Phone: 76 3- ~Y77-0~Zo
Resident/
Owner Address / City / Zip: j 3Z Z- ✓'u^~^ J~ v~
Applicant is: Owner ~ Contractor
Type of Work Description of work: -z
Construction Cost: t2Jd Multi-Family Building: (Yes / No
Company: ~~~m tans ~rvcd~nti ~va`" Contact:
?t~L l
Address: (
Y City: Contractor
State: /t,24) Zip:: Phone: 4-1-'15"1G9iK
License &C 637,Y/6 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-ANEW BUILDING
I
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? s
_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. 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.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 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_ 5i3~-~'~ l x
Applicant's Printed Name pplicant's Signature
Page 1 of 3