1375 St Andrew BlvdKnob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt #
To be used for t'J?JI';d , Est. Value 94,000
Site Address
Lot Block Sec/Sub.
Parcel No.
Name- ?! fii:RttMAi?iN
Address
City Phgpe
o Name >t:-:)u iu
0 Address
I City Phone
UW
WW Name
Y- W
Address
a m City Phone
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.
19
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well Type of Const
City Water (Actuary
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC, City
Engr. SAC, MWCC
Planner Water Conn.
Council Water Meter
Bldg. Off. Road Unit
APC Treatment P1
Variance Parks
Copies
Signature of Permittee TOTAL
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 ;:d City of Eagan Ordinances.
Building Official
Permit No. Permit Holder Date Telephone iF
Plumbing
Electric
Softener
Inspection Date Insp. Comments
Footings 1
Footings II
Foundation
Framing ?, bs'IO2 /YD God
Roofing ;7
Rough Pibg_ ip rv ?l T
Rough Htg_ j/!5
Isul.
Fireplace
Final Htg, ?7 ?fJ
Final Plbg.
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg. .
Deck Frmg. */r AV I
Well
Pr. Disp.
I I _ #I-,
Trdif irotir of (Orrupoury
Citp of eagan
Mr}mrtmrnt of ludbWg lWertinn
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.-
Ux Clamifinrioo DNG/(X ems. ems, No. 13811
00-pa-Y T w R3 7ming District Type Cone L
Building Addrm
building OwbCw
Due: `' R !&, 1987
POST IN A CONSPICUOUS PLACE
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100
Site
Lot.
Name `- c j a C ?ceY PI u
'v Address = . 1 t 4 t
c City C `Phone -J 5- 3 7
Name ! v ?, „r
Address
O 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)
FOR: CITY OF EAGAN
177
PERMIT # RECEIPT #
DATE: '34 7
BLDG. TYPE WORK DESCRIPTION
Res._ New K
Mull. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
2- Water Closet - $3.00 $
1 Bath Tubs - $3.00
2 Lavatory - $3.00
I Shower - $3.00
1 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 SIC:
GRAND TOTAL: ?'G
PERMIT #
MECHANICAL PERMIT
??
RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address 1131 -C '54. Q-4umn u' BLDG. TYPE WORK DESCRIPTION
Lot_6'C lock Sec/Sub
Res. ^><? New
Mult Add-on
Name r
°-' Comm. Repair
?j Addres ' N
Other
City t 6'r_ L . i Phone - g JiN
+ FEES
Name
fmjv l
f??
'01U
RES
HVAC 0
100 M BTU
$24
00
c Address 207" 11 ( / . .
-
-
ADDITIONAL 50 M BTU - .
6.00
p City l?? lbl?./w,a Phone "45'T (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 ,b
?QL'1 K 4 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. 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 # $ BEYOND $1,000)
Other
FEE: S• 10 r
SIC: a SIGNATURE OF PERMITTEE
TOTAL: ab
FOR: CITY OF EAGAN
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
~ DATE << _ " t 9
RECEIVED
FROM
AMOUNT $
a DOLLARS
too
CASH b CHECK
POR !
XI:
BY L_ fetif
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
BLDG. PERMIT NO.
.-
01-3210 Bldg. Permit
01-3422 , Plan Check ?y" '
01-3445 Surch./Adm. c
01-3446 SAC/Adm. 1
01-2155 Surcharge C
17-3860 Road Unit
20-2275 SAC S
20-3865 Water Conn.
20-3868 Water Trmt. C)
20-3716 Water Meter (- 7
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL c? 7
7 Date: `
CITY OF EAGAN Permit NO;? 2 - Size
3830 Pilot Knob Road Meter No: 4 Date:
P.O. B&, 21199 Reader No.
Eagan, MN 55121
Owner. _-? ? !'.ernann Coast .
1375 St, \ndrew Blvd. Lb B5 Fairway
Site Address:
No. of Units:
Connection Charge: • "
Account Deposit: 15 OOvd -
14 OO2d
Permit Fee: SO?d
Surcharge:
Misc. Charges:
Total:
Date Paid:
M
P.O. Box 21199 Reader No:
Eagan, MN 55121
Date 1r... 07
Size:
Date:
Site Address: -
P1 uth Plumbing
Plumber 525.:?t?pd Zoning: 1.
Conn. Chg. 5.000 No. of Units: 1
Acct. Dep: 10 , ?JOpd
Permit Fee. 500
Surcharge: T 1 agree to comply with the City of Eagan
Tr. Plant 1. O.OOpd Ordinances.
Meter.
Misc.: By
WATER SERVICE PERMIT
Conn. Chg: 525.
l5 ,
Acct Dep: 10
Permit Fee:
Surcharge:
Tr. Plant 1 `'
Meter.
.... n ill -Viki&
CITY OF EAGAN a
3830 Pilot Knob Roid
P.O. Box 21199
Eagan, MN 55121
Zoning: . fi
ii
Owner. 4 -AI
Address: 77 13 7 5
Site Address: Plyn
Plumber: . _,
ly with the City of Eagan
btBy
l?7ERM11T
IcSEWER SERVICE PERMIT
IG10
PERMIT NO.:
I agree to comply with the City of Eagan
Ordinances.
By
a te of Insp.:
LD
nsp.:
CITY OF EAGAN Permit No.
3830 Pilot Knob Road Meter No:
- - - Lfrq ? o_
Renewal By Andersen
350-73rd Ave. NE
Fridley, MNi 55432
763-502-4777
#NW20130983
RESIDENTIAL
11LDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New construction Reauirementc
• 3 registered site surveys showing sq. ft of lot sq. % of house; and311 roofed areas
(20% maximum lot coverage strived)
2 copies of plan showing beam & window saes; poured found design, eta)
1 set of Energy Calculations
3 copies of Tree Preservation Plan U lot platted after 7(1193
Rim Joist Detail options selection sheet (bldgs with 3 or less units)
DATE
/°-a3.0(
RemodeUReoairReoulremems
2 copies of plan
I set of Energy Calculations for heated additions
1 site survey for exterior additions & decks
Indicate U home served by septic system for additions
VALUNION
JOB SITE ADDRESS 131'cj S4 k\A(4,i.J5 'bkOa -
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY
SS *o'
TYPE OF WOR'K%L re ? u hV '? LLAiit&;.," ,..LrY;S?1
APPLICAN.A G? a&U
ADDRESS
PAGER #
CELL PHONE #
FIREPLACE(S) _ 0 _ 1 _ 2
PHONE# 95a395•(CQ94
CODE
FAX #
NIEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I
(check one) Residential Ventilation Category 1 Worksheet Submitted
Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor. _
Mechanical System Includes:
Sewer/Water Contractor.
Water Softener _
Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
Fee: $90.00
Phone #
Fee: $70.00
Phone #
All above information must be submitted prior to processing of application.
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 O,rPmancess..
I MS
Signature of Applican„ A 1a
t hi;
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required)
IUpdated 1101`
Phone #:
Lawn Sprinkler
No. of R.I. Baths
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 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 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 (Bldg)- ? 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 Bidgs 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
Roof _ Ice & W ater _ Final Other
- Framing _
- Pool
Ftgs
Air/Gas Tests Final
Fireplace _ RI. - Air Test _ Final _ _
_
Siding _ Stucco _ Stone -
- Insulation - Windows (new/replacement)
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
This rogues: ntfom o?X void
18 rtl ;X ?/ 7 715' 2/ /
1) 2614 r. r, Ll1_rv , . n , , s 17 0-,3
Request Data Fire No. Routh- n,lnspectwin
1
- 2/
Regvi tl Ready Now iNotify Insp
e
7
2-019
7 es ?NO trrr When Ready
Licensed Electrical Contractor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Address, Be. or Route No. City
ecUOn o. Township Name or o. Range No. County
Occupant (PRINT) Phone
N
A/ hl?erw"
Q
8 C
61/6 -QdL7
9
Pp Supplier Address
?Y E/e rte, CLr
Ell e ical Contractor (Compa ny Name) Contract
o
r's License No.
-1 11?4
rJf,' 1 4z ,) w !J • /
'
L/ S?
Mallinig da ess (Contractor or caner Ma k
u
J? Instaflation)
f
?
ig ure I ant rtor r Making Installation) Phone te Number
C 8 s?9s
MINNESOTA STA eBOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Peal, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone 1612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-0000p1-06
c See instructions for completing this form on back of yellow copy.
7 1 A "X" Below Work Covered by This Request
IJrrwtAddl Rep.l Type of auild.nit 1 Aooliances Wired 1 Enoioment Wired I
Heater
Bulk Milk
If Fee Service Entrance Size a Fee Faeders/Subfeeders N Fee Circuits
40 0to 200 qm s 0to 30 Amps 4 2.5 0to 30 Amos
Above 200 hips' 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100-Amps Above 100 Amps
Transformers Irrigation Booms 50 Partial Other Fee
Signs Special Inspection S l
enia rks OTAL F // CI
/? w ? r rA?•
(?C'./i WJGVj?L((f ^j ?O I I, the Elec'r7
L fl^ L Inspector, hereby
certify that the above
Final II?? ??D,nte y`1I inspection has been
JJ r? /11 Y/ 0 / I made.
This request void
v4 ac??4
?C?l
a?
RS[F 1 7 7r
I )'urbffic-- (X-/--/-'-7----
j Permit #: / 0
Permit Fee: x-
Date Received:
I I
I Staff: I
I----------------1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ?J 0 D Site Address: J? J 3 ,- 4\ `'l?J?.I?J 111
Tenant: Suite #:
RESIDENT IOWNER Name:,\ALaiU G-" up, , Phon >I? V `ox
/
'
Address
/ City/ Zip: 13 _7`5 04 P V
Applicant is: _ Owner 1L_ Contractor
TYPE OF WORK Description of work: '
Construction Cost: Multi-Family Building: (Yes No
CONTRACTOR Name: n ?p License #:
Address:
nn//^
City:
Q ` Sta : -at zip:
?S IIV
(
Phon /
:LGP 33 / - / J ?I t
-5 5 Contact Person: ang - Q
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateoorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • 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?
_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 the are tradesecrets. '.
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 1 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
a ordance with the approved plan in the case of work which requires a review and a laps.
x x to
AppY'cant's Printed Name -Applicant's Signature
Page 1 of 3
6-7?3G
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
s?z
Date / 1) / 0'
Site Street Address 13"75 k. 4n!!tn v -?S llk? Unit #
Property Owner
(
Telephone #
)
pp
Contractor Telephone # g6l (^,Plr (O?i lG
Address-30q2- 1h . t c city _(: t kn state Zip .5-ZT123
The Applicant is: _ Owner contractor -Other
Alterations to existing dwelling $ 50.00
14 Add plumbing fixtures (excludes water softener and/or water heate r--complete next
section if installing these appliances).
-Septic System Abandonment
-Water Turnaround (add $125.00 if a 5/8" meter is required)
' r
rr?N•st,
Other: ?,cSerw??n? 1nti 1.t'
?
-
Water Softener Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $ J • J
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be.in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
Applicant's Printed Name Applicant's Signature
65-?9 z 3
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone At 651-675-5675 FAX # 651-675-5694
-R7U
New Construction Reauirements Remodel/Repair Requirements Office Use Oniv
3 registered site surveys showing sq. R. of lot, sq. N. of house; and all roofed areas 2 copies of plan Cart of Survey Recd _ Y _ N
(20% maximum lot coverage allowed) 1 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 Pres Required -Y _ N
I set of Energy Calculations Addition - indicate H on-site septic system On-site Septic System _Y _N
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Date / 2 ao? S Construction Cost , JJ d
Site Address [ 3-7y x n //??
Aod1lec,.1 llfyii7 . Unit/Ste #
A?
Description of Work ?d S e1-e.'1
Multi-Family Bldg _ Y N Fireplace(s) _ 0 + 1 _ 2
Property Owner
?P ?/
/?
1"jr V r?
Telephone # (6S?) / ?' qQ? D
Contracto r' ! vQ/? C??StIt C T or
Address 26? 95- 5e, M .,?rJL,?dr n/ 1 City lAkle"114
State 7' 7?? Zip Telephone # COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Category I
• Residential Ventilation Category 1 Worksheet
(,1 submission type) Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Y _ N If so, 25% plan review
Telephone #(
Telephone # (
Telephone # ( l U') u v
I hereby apply for a Residential Building Permit and acknowledge that the informati n is complete and acc rate;
that the work will be in conformance with the ordinances and codes of the City of ri lr? MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name
Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01of_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 OF 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v 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 Buildin g" ? 43 Reroof ? 46 Windows/Doors
? 34? Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code ? t Zoning R -? 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) t& Final/No C.O.
Footings (addition) _ Plumbing
_ Foundation _ HVAC
Drain Tile Other
_
Fi
Roof
Ice & Water nal _ Pool _ Ftgs _ Air/GasT ests _ Final
_
_
Xi Framing _ Siding _ Stucco -Stone _ Brick
Fireplace p R.I. 16 Air Test w Final _ Windows
j Insulation Retaining Wall
Approved By: Bu ilding Inspector
------ - ------------ -------------------------------- - ----
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
J $ RESIDENTIAL f a
BUILDING PERMIT APPLICATION
CITY OF RAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-881-4875
New Construction Reaukertrems RemadeMeoslr Reguirements
• 3 registered site surveys showing sq. R. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage slowed) • 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 she survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate 0 home served by septic system for additions
• 3 copies of Tree Preservation Plan h of platted attar 711193
• Rim Joist Detail Options selection sheet lodge with 3 or less units)
DATE uI a g1 I D Z VALUATION tQJ
SITE ADDRESS - 'f 61-VL MULTI-FAMILY BLDG ?Y _N
TYPE OF
-Q-u0`F
0 1 2
APPLICANT ?? ?L 2 `?"
STREET ADDRESS 03105 C-A-r,-kBwoGt s(4gLQ( CITY g7, w rF PAUacSTATE IAa ZIP 55`f-l Co
TELEPHONE #
CELL PHONE #
PROPERTY OWNER t L? S'T Ik
FAX #
TELEPHONE # L952 a T_43_?>I'T
COMPLETE THIS SECTION FOR feNEWee 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: $90.00
Fee: $70.00
------------------------------------------------------------------- ------------------------------------------------------
I hereby acknowledge that I have read this application, state that the Info ion nd agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or
Signature of Applicant 1 11
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
Water Softener
Water Heater
No. of Baths
Phone #
Y Iawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 06-ptex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Mufti
? 33 Ext. Alt - SF
? 36 Multi
? 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 (Bldg)" ? 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
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
Building Inspector
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Cf / S, so
ct.', ia89y
Date ,?-1-1 / I I ! ()S 51+
Site Street Address I ?, S 'r'1 dt'e W r-3 1 ?CA Unit #
PropettyOwner .)'ew'es-4 C-7V-eInV"C Telephone# (Sl) 33 473
Contractor { (I? R)'s2 W U V Telephone (ixr> 1) 3 bS 12) U U
Address 3b-70 Dodd City ?G«+ State M N Zip fS J 2 3
The Applicant is: _ Owner Contractor -Other
Alterations to existing dwelling $ 50.00
Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
-Septic System Abandonment
Water Turnaround (add $125.00 if a 5/8" meter is required)
Other: ?.
_ Water Softener 'Y Water Heater $ 15.00
- new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
$ 1SS-U
Total
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
1 C:t t of Ham- owf c-aL M -t--
Applicant's Printed Name Ap cant's Sig ature
Ski' F J _. .
198T BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES 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,
o $2,000 LANDSCAPE BOND
To Be Used For: Valuation:
c e. 4.tlrl.
Site Address
Lot __(a Block
Parcel/Sub ?aoru'y&. ,lls
Owner -E
Address ?1a3?? eo Cwe,S
City/Zip Code
Phone Q Zo - (0 0 I
Contra
Addres
City/2
Phone
Arch./
Addres
City/Zip Code CJ U u A I A As S?Q 12
94,000
bzi Date: i g
On Site Sewage_ Occupancy ?• 3
MWCC System ? Zoning R I
On Site Well Type of Const
City Water ? (Actual)
(Allowable)
# of Stories
Length
Depth 3(0
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments
Permit sa
gig
Water/Sewer Surcharge 4-7.
Police Plan Review
zs
24 f.
Fire SAC, City 100.
Engr SAC, MWCC S Z5
Planner Water Conn S LS
Council Water Meter (0'7.
Bldg Off Road Unit 30 5.
APC Treatment P1 150.
Variance Parks
Copies
-
TOTAL 017 77
A,l
75
Phone 0 ?} 3Z (7c7
2 ? n Z2--
I s4- />,- (2-
Z6 x 'L CC)
5220
5808
Z ?< 4-4 3 2-03 2-
'15 40 4-
I ) 1
Al HERRMANV
ROBE COHSOLTIHC EENGINEERING nwaiEAS and LARDS,11MV61IS CON S
ENGiNEECOMPRNY, INC. 39-7 .01
?• 1000 UST 146M STREET, BURNSVILLE, YINHESOTA 55337 PH $:25000
C?r?z}i ca?`e ?S?c?Ye c?
Legal I.Ie?Cr442fon. LOT G, BLOCK 5, FAIRWAY PALL. S'
CAKC;71 ^ COUNTY, N'T+NN Via ,4;
(to33.6:1 mac. ?
ST
<ioy?•2? S6 ? ?O?
30 FRONT BUILDING S? 8S?2yQ• v?? rte{
S" EACK, LNG (103455) 7(Tn
/ .? 8O o .O rN
b pO /00 /p3 /S (1035.0 I
J 0
? 9T o9i• x O ? .0 N S
i ? c. ? / ? 31r ? 1 .V i
eGF \.\
E?yrc,?` ,
!T ?r
J ,
C-)
j
C /035.D ? DENOTES
1029.2) r 103-7.6 ) DENpT?S
INDICATES
DRAINAGE
?io3 z? FINISHED
?103?•1? 103?.83 ? -
ELEVAM(
S hereby certify that this is a true and correct represent
land as shcwn'and described hereon.. As prepared by me on
19'9
SCALE= I •'= 30'
EXISTING ` ELEVATION
PROPOSED ELEV/4TII\1
DIREC70N OF SURFACE
GARAGE FLOOR
ion of a` tract of
is " 3eo -:day of
r Two Family
ther
l:?Fc!:x0 -411
CITY OF BUILDING DEPARTMENT
EXINRI0R ENVilOPE AVERAGE ffUff COMPUTATION ?eltll?z'
(To be submitte with building permit application)
Dwelling Owner
fort ?? GOIr
FEET OF 0 ?- }}
WALL ? Vio ft.
Site Address
Date
Phone
above grade = Z 1-74 1 7b
TOTAL EXPOSED WALL AREA SQ. FT.
OPAQUE WALL CONSTRUCTIONs fluff Value x Area
1.4
'fu rrUrr 10 ><3
llelail x SQ,
reference ll ! Q_ x SQ.
_4a from ffUfr r O?FC7 x SQ.
attached f'Uff x SQ.
shs to 'full x SQ.
rrUrr x SQ
IWS: 'lull Value x Area
& Type 1 NSV1., (A4<, nurr
ff rrUrr /- x SQ.
it x SQ.
u rrUrr x SQ.
rrUrr x SQ
It fluff Value x Area
Maki."& Type u n
ta, x SQ.
rr url x SQ.
a 'run x SQ.
nun x SQ.
TOTALS a
' AVERAGE 'fUfr
TOTAL': (U) (A) VALUES COZ,
DIVIDED BY TOTAL WALL AREA 2'"?/?s7G
TT
AVERAGE "U, } 1 less for 1&2 family (dwellings
FT. 6j*,57.0,0 (U) (A)
FT.?]?-_ (U)(A)
FT. FT. ? ° j (U)(A)
(U)(Q)
FT. _ (U) (A)
FT. (U)(A)
FT. FT?Z l (u) (A)
(U) (A)
FT. _ (U)(A)
FT. _ (U) (A)
FT. i0 = r CA (U) (A)
FT_ (U) (A)
FT.
(U) (A)
FT. (U) (A)
FT. LI?sV? -(U) (A)
ROOF/.CEILING:
TOTAL: AREA:
Detail reference rrUrr , a7? x SQ. FT. /?'? Z r2
from ,furl f 0 - I (U) (A)
attached sheets.. rrUrr x SQ. FT, . (U)(A)
Describe openings rrUrr x SQ. FT. (U)(A)
in roof. nun x SQ. FT. _ (U)(A).
x SQ. FT. -U) (A) Me
TOTAL (U)(A) VALUES DIVIDED BY ZI,Lq TT-AE; ZIf L'
(L)YA 4.
i
T0, ROOF/CEILING AREA ,i
0/
6'Lj rcf7
AV OE n ,o25-fo Ventilated roofe. r f'
t t
^? .:
vK
? I ?/ 4}5ixi
X83 x C ?zB-F•2c?-?,2?? _...
?
2174-/ 7C.o ??- y
t
i
(P7 Y-, IZS q?
f 4
<??? ?
4W w]?hp = 44- 44-, o0
7
15"
i t 2 w- Z-X 4= 7,,2sV S-
S 228 LSk
PRI
wow 2!74/7
/2X 'l g r 2 l!n ? ? CoN?? BS'?ylo
RIM.
2S
ZZ?1
5
.UH
!Ili Rim, and Cone. Bloch
ROOF/OEILIRU
I.) Interior Air Film
2.) 5/811 OYp. Bd.
30 Insulation
11.1
5.) Exterior Air Film
(STILL)
suu = 1/R='foal TOTAL (R)=¢S-?g
Alf
WALL
GO J11terior Air Film
7.) }n UYP. Bd.
8.)
• Insulation
9•) .-01w--PIM
10.) lasonite Siding
11.) Exterior Air Film
R VALU
0,61
.56
44, 00
.61
R VALU
0.68
.115
l9.ov
1.6q•
.1777
nun a (91Z TOTAL (R)= .p f
M R VALUE
12.) Interior Air Film 0.68
13.) Insulation Igev
111.) 211 Fir Rim joist 1,88
15. ) vft,T-'Er7'? ??
16.) Haeonite Siding .6T
170 Exterior Air Film .17
uua Q 1/R= TOTAL M.
FOUROATI011 R VALU
18.) Interior Air Film 0.68
19.)
20.) 9-11 srR,rr? o
21.) 121' Concrete Block 1.28
22.)
23.) Exterior Air Film 17
nun TOTAL (R)
GOLD COPY PERMIT RELEASE FORM
PERMIT # M77
ADDRESS / 5 /.,?r ji,
PICKED UP BY vtl?
C
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NOTE: PAYMENT 01F FEE AT TIME OF
APPLICATION DOES NOT CONSTITUTE
APPROVAL OF PERMIT.
INSPECTION OF SEWER AND/UR WATER
INSTALLATIONS WILL NOT BE SCHED-
ULED UNTIL PERMIT HAS BEEN
APPROVED.
-----------------------------------
(Please Print
1) PROPERTY ADDRESS : A j j e a?_,' ? 9 L- j p -
LEGAL DESCRIPTION:
Lot Block/Subdivision or Tax Parcel ID
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
PRESENT ZONING/PROPOSED USE: (Month/Year)
0 COMMERCIAL/RETAIL/OFFICE R-1 SINGLE FAMILY
Q INDUSTRIAL Q R-2 DUPLEX (Two Units)
f-I INSTITUTIONAL/GMMU4ENT Ej R-3 TOWNHOUSE (Three + Units) ( Units)
R-4 APARTMENT/CONDOMINIUM ( Units)
2)
NAME:
ADDRESS:
CITY, STATE, ZIP:_AAPPLE- 1i,ALV&4 VIAL), ,S.'a(2.y-
?r? K - L (p C?
PHONE:
3) ?::?• For City Use ..
NAME: _PL ?Os3Ti4d PC-yvyLDa? Plumbers License:
ADDRFSS: _4 Zs' Z:?>,?- 0 4vr Active
CITY, STATE, ZIP: Expired
-PL-4 I? to SCE 1 V11 JJ `?' j 1(? (? Not recorded
PHONE: 5?Yj-jA(c? MASTER LICENSn# _ZCJCv5` St?fa -Initial
4) •• • N /
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
S) u a •a• :a •o• - 0
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER
6) • r PLEASE HOLD APPROVED PERMIT FOR PICK-Up BY ONE OF ABOVE - -
PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
7)l1?
FOR -CITY USE ONLY
PERMIT # ISSUED
%-L
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE) „
$ $ ?D " S b WATER PERMIT (INCLUDE SURCHARGE)
$ l'O Z? $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ S'Cr-D ACCOUNT DEPOSIT - SEWER
$ $ L-D ACCOUNT DEPOSIT - WATER
$ S Z_ .S C $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
p
$ 4fy `" $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ //
/ 9 7rC9t? $ 6-1, el-?) TOTAL
?4-9 7 3 . 'Z- .s
RECEIPT 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
. A
N
ITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: A_t? ?O-r tJ yLy
TITLE:
?/? d 7
DATE:
ities Digital Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
..3.....r ? ? ?s a ??=x.r? ?t ? fy_ 7 Y: ?.. ? 1 - . rt Ya.?n ...?' ? - ?•7`4 ??^ .
' =19_88 BUILDING PERMIT 'APPLICATION CITY OF SAGAN - G =-'
SINGLE FAMILY DWELLINGS
r=, INU_UDE 2 SETS DF PLANS, CERTIFICATES OF SURVEYt4 SET OF ENERGY'; CALCULATIONS
s 1,, 'c Kih '.a` > t' .+n-l: .?'rflxu !' st;
3tINCJ.DDE 2. SETS ?QF PLA?1
„? ' 1 ?-SET OF :ENERGY CALCUI
., -' COMMERCIAL s
sINCLUDE 2 f'SETS OF
a "'S$T` OF SPECIFICAT
€? To Be Used For
??ite, Address ,A,a
) y
tat Block
11 .0. f 1f, I
)arcel/Sl
hrner s
City/Zip
Phone ,
tsA
'ECTURAL 6 'STRUCTURAL! PUN5? N p p b5 p xF *
AND,;, a SET OF BNEAGiT- AI.GULATIONS r- t
t }y-i'?„ >? 2 x`c???,,.?
.m.:+'~k 4 .7R?bd'.4;'? ``t,1 'may a t?,. ?` !!'f'?yj
°Igluation 4' Dates ° -?
1 ,wOFFICE USE ONLY
z ?' VI
z u .On site ewage_ Ocoupangq ,sue z ?'
MWCC :."system Zoning
u ...,: I-O&Vsite Well Actual On$
Citiy hater Allowabl
5 c` PR%?zoequired' k s of stor""18sk
-Pump Lengths ?M
-Depth
S.F Total 3
(?.?.' ?S !23 s" ? " t Footpri'A S.F
U M. b 1 y r :
r g r PROVALS r t FEES nt X,
?+F
t'Permit1
E 4f, ?
Treatment?Pl
Parks f?F: r? c
t '.'! x??ra?? ems" + ? F l ak' M1}'?'? +.ryfa'F''' =TOTAL ? ..: f )
J :,.4 "", ? 1i:.; 1:••
r k..,iyrL. - .sa,,r 1. vwre'
ice:. ..,i 7 , ?.•,..: 9} ` h.•? -°?^?^W _x'?'? 'GS. s ? c '_) a? as?..ie ?v3- r?
}$°
'?'•"?$'r'?'"!
i i ? k y. H Y4f k t t T .l r ^..
y` >r .r?a. t!.ds v y`%.,?a?,r >r. e}' xa„}.y., 'r'anr '` ,"•>? a. r °? r•!+§
y'tSi'? ,+, ?? 5 N'.te? ? ? L ?i ?+- P; r a -•. ) r. mix '?F
-r? riy vtY pa r. ..?3 v x s-' '-•" yk t 5 y" #x ?. ?:
t
AI NERR?r1ANN
COHSUL ma aNG"IffRS C,ONS7
CNGINEEnING esRr+rtens and tRHD 3uavEYOns
COMPRNY, INC. 3s?01
1000 LAST 146Cf STREET, BURNSVILLE, NINNESOT,1 5:.337 pH 4]2-5000
Cy7`-Zft crzj`e gy c?
Lggsz 0"Crt c2icn: LOT G, BLOCK ET.. FAIRWAY H?LL.S,
(io33.6e?
PONT BUILDING
:ACK U11E ?
(103•t. ?-?
/ -
S
? s
/
CID
o
2 ,y
s
i8 J
0
O
3° ao BOO c
N pOS. , o
arm 4(,?, FO ; ? ?•
os.e) 5?? O
7
, •`?
O
x'
?\O
(ia35•?
,3- (lo?`•
G' C`103F )DEMOTES
SGALEi1 30•,
EXISTING ELEVATIGW
DENOTES PROPOSED EL -VAT1C11\1
m? SEO 49
INDICA-rES DIREC-nON OF SURFX_
DP AINAG E
w3-7.83 F!N1511ED GARAGE f LOOR
ELEVgTION
,reby cartrfy` that'?his ira true and correct representation of a tract of
I li shovn' qed desqMbed'iereon.• As prepared by Ina on this 3?' day of
9-67 •-'.? :r.no :.tjn try.,.
IOU
e;. Ho.` /Gosrs
. ' ??/??--?t Nian. -It
iuale-Peck
1375 51a AndrewtW
k&,B5s FeLirw4y#//s
G11S/188
-?, ?........ .,av a<. ov rn too all 4400 I=IPIRAL riY° 9nU151(.'SC1V
Onew
June 7, 2001
City of Eagan
3836 Pilot Knob Road
Eagan, MN 55122
To Whom It May Concern:
Elder Jones is authorized to pull building permits for Renewal by Andersen- Please allow
Felder Jones to provide this service for us in Eagan. This authorization is valid for any
date beyond 616101; until a Renewal by Andersen manager expressly revokes it in writing
to the City-
I request this authorization be accepted expeditiously, as to not delay in the processing of
our building pcmlits any further. Plcase call me if there arc any questions. I can be
contacted at 763-502-1706.
Your immediate attention to this matter is appreciated.
Sincerely,
0ymond R. Rau
nstallation Manager
Renewal by Andersen Corporation
IWUU2/UU2
C'r.: Kara-F]der.Tnne_a
GHADA M.
^OtarY Pua1GAMAl
Nr eo --ftlo„"nesot
Eroiresln, m, zws
Received Time Jun. 7. i:07PM
`7 7c s ?--
2007 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
:6 ? 6
Date ! 1 -7
Site Street Address k-c- ? BI Vd - Unit #
L'tb?rrt,5? RT` "?-[ ?tzYr qsa Yam ?s ?
?1
Property Owner tQ /? Telephone # ( )
, /
Telephone# c1na'Y410 77?
Contractor
Address City State Zip
The Applicant is: _ Owner Contractor - Other
Refurbished Submit 2 sets of plans and MPC license
New
Septic System Includes County fee
_
- $ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) - $ 90.00
Alterations to existing dwelling $ 50.00
Add plumbing fixtures. This fee includes installation of a water softener and/or water
_
heater at the same time. If you are installing only a water softener and/or wafer
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
Water Turnaround (add $136.00 if a 518" meter is required)
Other:
Water Softener `Water Heater M
D r? V D
5
$ 15.00
new _ replacement Q7
Lawn Irrigation _RPZPVB new -repair -rebuild $ 30.00
State Surcharge $ 50
$ ?So'?Z
Total
I d urate that the
I hereby apply for a Residential Plumbing Permit and acknowledge that the rnformabon is compete an acc ,
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a p rmit work is not to start without a permit and work will be in
accordance with the a proved plan in the event a plan is requi to be rey*ewpproved.
.r /fit: /A /'4A /
....r ..+?c o??.,+o? ni?..,o ,AnrjliranT's Siartafi fra
Use BLUE or BLACK Ink
For Office Use I
D 13
I ,
City of E*,u I Permit#:
Permit Fee: I
3830 Pilot.Knob Road I
Eagan MN 55122 I Date Received:
Phone (651) 675-5675 ,
1 Staff: 7~ 1
Fax: (651) 675-5694 !
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: f'fYf6 YZIM 2j1 Vyf
Tenant: Suite
Resident/Owner Name: 'l/r~C/ V (1yt_cI W Phone: (,1131-ZJ q:j
Address / City / Zip:
Name: Wenzel-Plymouth Plumbing, LLC License#: 061555
Contractor Address: 1710 Alexander Road City: Eagan
State: MN Zip: 55121 Phone: 651-452-1565
Contact: Carl Michels Email: cmichels@wppmn.com
Type of Work - New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: Demo Pressure Booster
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation RPZ / _ PVB)
Permit Type Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
X Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ N/A
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.got) herstateonecal 1. oLg
I hereby acknowledge that this information is complete and accurate; that the worts 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 pl
x Carl Michels X_
Applicant's Printed Name A ant's gnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In _Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145788
Date Issued:09/26/2017
Permit Category:ePermit
Site Address: 1375 St Andrew Blvd
Lot:6 Block: 5 Addition: Fairway Hills
PID:10-25600-05-060
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeremy K Greene
1375 St Andrew Blvd
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA159568
Date Issued:12/31/2019
Permit Category:ePermit
Site Address: 1375 St Andrew Blvd
Lot:6 Block: 5 Addition: Fairway Hills
PID:10-25600-05-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeremy K Greene
1375 St Andrew Blvd
Eagan MN 55123
Diversified Plumbing & Heating Inc
125 E Railroad St
Norwood Young Americ MN 55368
(952) 583-9646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159569
Date Issued:12/31/2019
Permit Category:ePermit
Site Address: 1375 St Andrew Blvd
Lot:6 Block: 5 Addition: Fairway Hills
PID:10-25600-05-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Stove
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeremy K Greene
1375 St Andrew Blvd
Eagan MN 55123
Diversified Plumbing & Heating Inc
125 E Railroad St
Norwood Young Americ MN 55368
(952) 583-9646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159576
Date Issued:12/31/2019
Permit Category:ePermit
Site Address: 1375 St Andrew Blvd
Lot:6 Block: 5 Addition: Fairway Hills
PID:10-25600-05-060
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeremy K Greene
1375 St Andrew Blvd
Eagan MN 55123
(952) 492-9276
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162027
Date Issued:06/23/2020
Permit Category:ePermit
Site Address: 1375 St Andrew Blvd
Lot:6 Block: 5 Addition: Fairway Hills
PID:10-25600-05-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeremy K Greene
1375 St Andrew Blvd
Eagan MN 55123
(651) 334-4783
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature