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1387 St Andrew BlvdCity of Ea�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 L Use BLUE or BLACK Ink Permit #: Ch 7 Permit Fee: Date Received: Staff: INFLOW INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: /Z_ 9 i'd Site Address: 1 V P l cS - ill -n 2r -e c tf 13 iced 64(e-46 illn 6172-3 Tenant: S' -e", 6— 0 i, APe 4,4....y Suite #: RESIDENT / OWNER Name: 5 U Phone: ,s7 -6e-9 rdel c Address / City / Zip: /3 6 7 ST cIre j E t i t( 6461041,P /h. L CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK PLUMBING (Within the building envelope) SEWER ('' Sump Pump Repair Repair & WATER (Outside the building envelope) Other: Other: DESCRIPTION �D r f jA Description of work: iep JVtc' $ /L� / -e "i/ 1 SC) I)d p,, r if1,s'fITC FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ c5s' *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.dopherstateonecall.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 wo wich requires a revue / d approval of plans. Kdcf-li-er- Applicants Printed Name x Aplicant's Signature INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: I ' Eagan, Minnesota 55122-1897 Date Issued: I " (612) 681-4675 SITE ADDRESS: ` i It-p '600 OtO 0" APPLICANT: 11> 1 Itf nt ? i :tlllc-t tl Isl `,?li ;?,, ? ? ??RItAt,i UuUh I>>t?.4t.i1i flil i'• :.?, ? ,: Z 1f.:6 . J PERMIT SUBTYPE: TYPE OF WORK: . ; i F IWAT f t1N ,,; , ; ,i • 4AS FNSF RI Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date [nap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: " 1 1 111 "(r 3830 Pilot Knob Road Permit Number: 6 `? t? •' Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: I ' N 10 , „ I f{ 1 l;, r? APPLICANT: I ANUIZEW lit VI) I ..-I I N1. •r I,'1 M1+111 I INkl i ;+ 1 I;Ul+ FI 1 1 L `., I i. ? .' ) it., , 1046 PERMIT SUBTYPE: TYPE OF WORK: h! PAIR t+r ;:II I ++ r+ S1(1)N(J. ROOF VAlIEY Permit No. Permit Holder Date Telephone M ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: 411 Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: I I?! r t ftt.«ch , , ? AMIIH[ W BLVD , 7 f A IPWAY 1,11 I L` (61;?) s PERMIT SUBTYPE: TYPE OF WORK: V1 RA t ION L Permit No. Permit Holder Date Telephone M ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE p? d FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL • CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454.8100 To be used for Est. Value $105.000 Site Address 'AY I:iILLS Lot Block Sec/Sub. Parcel No. q Name w 3 Address city Phone c Name A-145; 0 Address P City Phone •- q ?w Name FW s a Address w City Phone 1 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. Receipt # Date 13717 ,19 OFFICE USE ONLY On Site Sewage _ Occupancy MWCC System _ Zoning On Site Well - Type of Const City Water (Actual) (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 Pt 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 and City of Eagan Ordinances. Building Official Permit No. Permit Holder Date Telephone >K S;lurribing fZ ?Y _ -2111 4 H.V.hC. C?6 7r ` f/"U / Y7 Electric Softener Inspection Date Insp. Comments Footings Footings II Foundation Framing _7-01 Roofing E Q Rough Plbg. X/ Rough Htg. Isul, Fireplace Final Htg. Final Plbg. ?? Bldg- Final Cert. Occ. -94 Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. 1%. . +. , . , ?. I.& Trxtifirat.e of (fir Citp of e arprimnd of wwlbtm 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 jollowing.- Use C1assirwation RdG/DWG/GAT Bldg. Rrmit No. 13717 Occup-Y Type R3 zoning Dia M ' Type Camt ?,.. , Owner of 1Nrilding S i T Ad W, ? s` Building Address L=Hty T 3, '' Date: _IIITST 28, 19f` POST IN A CONSPICUOUS PLACE CiTy (if EAGAN SEWER SERVICE PERMIT 3830 Plot Knob Road 1_Qt 10 P,O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: 7. No. of Units: A Hermann Const. Owner. Address Site Address: Plumber. inn nn?A I agree to comply with the City of Eagan Ordinances. By - Date of Insp Insp.: Eagan, MN 55121 A-1 '.ermavil C;Onst. Connection Charge: 525 CQPd -- Account Deposit: 15 OQ t Permit Fee: 10 ?i?---- Surcharge: 5 ?-- Misc. Charges: Total: Date Paid: vd. L3 B Chg: 5?-E Permit Fee. Z-w Etc. Tr %W S ?tmply with the City of Ej7 [l?nri RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 `-? 651-681-4675 New Construction Requirements RemodellReoair Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window s¢es; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations • Indicate if hone served by septic system for additions • 3 copies of Tree Preservation Plan If lot platted after 711/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE b? ZR'6 Z JOB SITE ADDRESS SI L IF MULTI-FAMILY BUILDI PROPERTY OWN TYPE OF 08 FIREPLACE(S) _ 0 _ I - 2 SELA ROOFING & REMODELING, Irur . APPLICANT 4100 EXISEe661GR BLVD. PHONE#?(Z _?!?(? ADDRESS ST. LOUIS PARK, MN 55416 ZIP CODE 1V #UUU1U*U PAGER # CELL PHONE # FAX # NEw RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) Plumbing Contractor: Plumbing System Includes: Mechanical Contractor. _ Mechanical System Includes: Sewer/Water Contractor. All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of Eagan Or< Signature of Applicant HOW MANY UNITS? _ MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: Water Softener _ Lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths No. of Baths Phone # Air Conditioning Fee: $70.00 Heat Recovery System VALUATION Phone 8 2002 comply Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 2002 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. Aft - 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 Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) Footings (addition) Foundation Drain Tile Roof _ Ice & Water _ Final Other Framing Fireplace - R.I. -Air Test -Final Insulation _ Final/No C.O. _ Plumbing HVAC Pool _ Ftgs _ Air/Gas Tests -Final Siding _ Stucco _ Stone Windows (new/replacement) 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 *************************************** CITY OF EAGAN CASHIER: JS TERMINAL NO: 691 DATE: 08/28/00 TIME: 07:48:29 ID: NAME: DOSCO DESIGN BUILD, INC 3210 9001 1387 ST ANDRW B 88.25 2155 9001 1387 ST ANDRW B 2.00 Total Receipt Amount: 90.25 CR136534 USER ID: JAN ************************************** CITY OF EAGAN CASHIER: JS TERMINAL NO: 691 DATE: 08/28/00 TIME: 07:47:10 ID: i NAME: DOSCO DESIGN BUILD, INC 3210 9001 1387 ST ANDRW B 9 Total Receipt Amount: 9.00 CR136533 USER ID: JAN a J3 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN () C? Z 3830 PILOT KNOB RD - 55122 I 651-681-4675 New Construction Reaulremenh > 3 registered site surveys showing sq. fl. of lot, sq. ff. of house and gQ rooted areas CM maximum lot coverage allowed > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) > 1 set of energy calculations > 3 copies of free preservation plan If lot platted after 7/1/93 DATE: ?T o2! -62 DESCRIPTION OF WORK: STREET ADDRESS: h) d' / LOT: BLOCK: Name: ZAtr J Ge-Y,?S Phone #: Lost First PROPERTY OWNER Street Re I/Reoalr Reaulremenh 2 copies of plan 1 set of energy calculations for heated additions t site survey for exterior additions & decks CONSTRUCTION COST: 0 0 SUBD./P.I.D. #: rq ,611 city f L6.6. / ? _. State: Zip: ss /et CZ_ Company, 2 t5i4l- Rat, 6d 7,6 Phone #: 9 - ?T7-d&a 7? (area code) CONTRACTOR / / 1 ' / Sheet Address: /O ?s 5 1W '- Ji7- k / Ucense # Y / Exp. J?c? City kOk /lle.lll 1/ State: zip: 5Slj- q I 'or/ ARCHITECT/ ENGINEER Registrc State: Sewertwater licensed plumber (if installing sewerfwater)I Phone #: (-? I hereby acknowledge that I have read this application, skate that Bte Information is correct, and agree to comply with a0 apPtica State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appllc OFFICE USE ONLY Certificates of Survey Received Yes - No Tree Preservation Plan Received Yes - No Not Required OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-piex ? 18 Deck ? 23 Porch (screened) ? 04 02-plex ? 10 08-piex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-piex Plbg _Yor_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 . Accessory Bldg. WORK TYPE ? 31 New ? 32 Addition ? 33 Alteration ? 34 Repair ? 36 Move Bldg. ? 43 Reroof ? 37 Demolish (Bldg)* ? 44 Siding ? 38 Demolish (Interior) ? 45 Fire Repair ? 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 sq. ft. sq. ft. Footprint sq. ft. Census Code MC/ES System City Water Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: 31 Ext. Aft - Mufti 33 Ext. Aft - SF 36 Mufti SAC Units % SAC LIT` O EVAN CAS-'It R: 12 ;'EF'MTN9", AA't"!= S I WOR/99 'lTMV II) NACDCE.FT3 T.N °..1VIK.. ( ejo 9001 1187 ST AMPEW 1=2 9009 133' ST ANCIR-111 2155 9M 087 SY ANDREN. ?a 690 04:55 292,25 19C .;l 9.on 700158 PEW Inc IAN *''*?? `X,.:kar?k??k{?v9*?Kr?Y,cwt%Kb9'?k?Y?'dh?k?>k?'*>!!%>k*? 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) OF EAGA ` 3830 PILIOT KN B RDN 55122 a 651-681-4675 New Construction Reaulrements Remodel/Repair Requirements D 3 registered site surveys showing sq. ft. of lot, sq. H. of house 2 copies of plan and Qii roofed areas (209 maximum lot coverage allowed) 1 set of energy calculations for heated additions D 2 copies of plans (show beam s window sizes; poured Ind. design; etc.) 1 site survey for exterlor additions s decks D 1 set of energy calculations ? 3 copies of tree preservation plan I lot plaited after 7/1/93 DATE: DESCRIPTION OF WORK: CONSTRUCTION COST: 3ln '/ STREET ADDRESS: ?O 7 rS? A/l? /c? /V LOT: BLOCK: SUED./P.I.D.#: l ?Cl Y ?0. w l?1 ?l S Name:gt? res7??/?G Phone #: 6if 1 ' 9Ys"? PROPERTY Last 2 j First /IJi1 OWNER Street Address:- 2-7 ST Arv JrL4j ii F1l , r City I& ?A 6 A'? i Stale: j? - Zip: - i-1 L2? -- ® 216f4 Company: L.O//? P/cS /ni ' tly -A Phone#: 41 ( CONTRACTOR ) q / area code) Street Address: F 13 7 / Q ? l C6/17" 4tleJ License # 2-66112 Exp. 4,10 city QLA-1-Ak,r Al 14r State: j4441 Zip: X5,5.33 ?7 ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street City State: Sewer i water licensed plumber (reauked for new construction only : r Penalty applies when address change and lot change Is requested once permit is Issued. I hereby acknowledge that I have read this application, state that the information State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required Registration #: Zip: and bgree to comply with all applicabl OFFICE USE ONLY BUILDING PERMIT TYPE 4 V ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage 22 Porc[VAddn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE 31 '\ New ? 35 Tenant Impr [3 39 Gas Line Only [3 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Census Code 21,211 Main level sq. ft. SAC Code sq. ft. No. of Units sq. ft. No. of Bldgs sq. ft. MC/ES System sq. ft. City Water Footprint sq. ft. Booster Pump PRV Fire Sprinklered Building f A-- Engineering Variance Permit Fee Q'J-a-j Surcharge 7-0-T) Plan Review ° C 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: L 1 g? Valuation: SAC Units % SAC r .10/07 99 17:46 FAX 1 612 454 6426 STOCK LUMBER-EG ® 002/003 CITY Or'two 1xTNRIOR gNrELOtE aYLRM our CMMATION / OWNERS / ..? l . ?? SITS 11DDR933: CONTRACTORS 6a e nab ry .7- uTzz Id-.7- 5? FROMt_ Dstermlae worsiog square restage of esobS t. Total exposed wall arts ..• 7.7 3 a a4- ft, - x •14 2. Total roof/eeiling area .. 54• ft. x .026 Tot al mposed well arm above floor ¦ Z 7 .......... ! a. Total wall window are¦ .................. b. Total door area ................................... e. Total eliding glass area ........................... d. Total fireplace well area ......................... _g e. Total wall framing area (average 10%) ............. f. Total net wall area above floor ................... a. .............? Totsl rim joist area ...... ........... Total eapesed foundation area a /093 h. Total foundation window are* ...................•••• i. Total net foundation area above grade .............. l Determine 'U' value of each wall aagsent. g• h? 1•. I 'v' s347 g 'U. xi? a 1, IS 0 U, x rut ., a x 'U' x U. s a IS lul OIL - o IS Out IS ' u' '? _ eyd 3 . ......................................•............ Total e 170 2 If item 43 is the 3aa* as or less than item 911 you have met the intent of 39C 6006(c)2. Total "posed roof/eailLeg area a / c .. J. Total skylight area ............................... C k. Total roof/ceiling framing area (average lot) .. 1. Total net insulated roof/ceiling area.............. .2/0{ OVEN '10/07/98 19:48 FAX 1 812 484 0028 STOCK LUMBER-EG @J 003: 001 Detersias OU• value for eeeh roof/ceiling segpeat: D i *Up r . ...................................................... Total 2 Z If total of i4 13 the 36016 sa Or leas than #2, you have met the intent of 30C 6006(0)1. Alternate Building Ehvelope bft31P To utilize the total envelope system methodr the values e306allshed by the SUM of Items 03 and er shall not be greater than the stns of Itema S1 and 02. 1. 2 2 J 1V07i98 13:48 FAX 1 012 484 8428 STOCK LLTMBER-EG . Leteradne Out value for each roof/ceiling s+egsent: J. D = out e O k. /L8 s our -- 1. gut pz5 : ??,,5 a . ...................................................... Total . 9 Z-Z l _ If total of 04 20 the same as or less than 02, you have met the intent of 3BC 6006(0)1. Alternate Building Envelope Design To utilize the total envelope system method, the valUes established by the sum of Items p3 and 04 shall net be greater than the sum of Items #1 and 02. 1. + 2. s 3. r. : L @?DD3lDD3 2 OBE CDHSULTEga Q,d LAHp SSUAVEY0E5 pIAHN ENGINEERING compaNY INC. 'i ! YINt{ES°7111 ? Moo >;JST (461 STREET, HL'RN?{L=?/•?/ y ov FAIRWAI' H/LLS, L?L nCJC7"'kf?ICrL-- LoT 31 BLOCK DAKOTA COUNTY, MINr\1E50TA Z 'Z z? M1I . sT? ?Pp . \ its"F i2O V `yam i=.e N a % Ge3Z •°. e °? / 5 Co?.e 2z `SE rO ? p ? ? yo F° ' ?sRati T 3 a< X93 F ??ti?'TG?9 mz\ S 6Q°?S?O 'h SC F3 F •a `q '. ;t v 41 SCALE 1 Ct' S? 30' FROAIT BUILOINE a. SETBACK LINE EXISTING ELEVATION;; DEMOTE.. ".; DENOTES PROPC=E7 ELEVA71`' INDICATES DIRECYION OF SURFACE DRAINAGE /oEZ.33 FINISHED 6AKA6E F ELEVATIOA/ pRAIWA6E AND UTILITY FIASEMEIJT 'Qogo •R.l x? reIIentation of 'tract of this is a t:se As and pccr:~ect rep thin /2r day of I heraby certify that rnPared by me on land'az aho+m'and described hertcn.• ?E.>?sr 19 8? ? /GogS }iinn. lies • N°'--?- r P4 AZZ-"no I{+:A'i°R,:'t+;OY$(:*>k ??• i raW}i!iliaN Uq Sf AND".'T. 0. 1 ,. ... .50 T(.,.,. 1'I. t?L:.r;;7ni r.} !'?R:C1?li YF ? 2':i 51) •+?Y a Yrt 4:rY:° N t'.. 9<7 r;?:r r)";Y,'r >,,.'t : ?Yk=M't PERMIT CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 029217 (612) 681-4675 Date Issued: 11/13/96 SITE ADDRESS: P.I.N.: 10-25600-030-05 DESCRIPTION: 1387 ST ANDREW BLVD LOT: 3 BLOCK: 5 FAIRWAY HILLS (GAS LINE) B' i1d r -_Permit Type Building Work Type "±Census Code r, . t s. FIREPLACE AL°rERATION 434 ALT. RESIDENTIAL C ppt REMARKS: FEE SUMMARY- Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - Applicant - OWNER: .MISSION MECH 15301432 ROTHER STEVE 6324 BOONE AVE N 1387 ST ANDREW BLVD BROOKLYN PARK MN 55428 EAGAN MN 55123 (612) 530-1432 (612)681-9451 I hereby acknowledge that I have read this application and state that the information is correct and agree to c-omply with all applicable State of Mn. Statutes and City of Eagan Ordinances. L _ J APPLICANT/PERMITEE SIGNATURE ISSUE ' - N ,t E Ia CITY OF EAGAN 3830 PILOT KNOB RD - 55122] Iq 21 q 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: Z q 10 DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE: _ WOOD BURNING ? GAS INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE INSTALL GAS LINE ONLY IN EXISTING FIREPLACE ROOM TO BE INSTAL STREET ADDRESS: LOT J' BLOCK SUBD./P.I.D. #: -=JV11 t - t l APPLICANT: (circle one only) OWNER CONTRACTOR 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. PROPERTY Name: I-d 1 ham / f24V-,9, Phone #: ' L I- 24 V OWNER FlR9 Signature: Street Address: City: State: Zip: FIREPLACE Company: ? Phone #: A 0- 14 3- INSTALLER - Signature: Street Address: ?? Gt License #: City: [uri !t Ql tt. State: Zip: 75 GAS LINE Company: Phone #: INSTALLER `` -- . Name:o / Signature: Street Address: City: State: Zip: OTHER: w OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Census Code. SAC Code REMARKS Chimney/flue must be inspected before concealing. CITY OF I: ALAN CASHIER: S 11-ERMINAL. NO, 25 rMs U/04/96 TTMIN 005:52 ?T?;: NAt4t:.AUIYU4MIC GARAGE T.,00h MO 9001 087 ST ANDREW 25.00 205 9001 M87 ST AN Filii'A 0.50 Tote? Receipt Ammun0- P5. 50 CRMAQ? 390 TV NANCY x C111111 OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDING 029165 11/04/96 SITE ADDRESS: 1387 ST ANDREW BLVD LOT: 3 BLOCK: 5 FAIRWAY HILLS P.I.N.: 10-25600-030-05 DESCRIPTION: (GAS INSERT) ermit Type FIREPLACE krk Type ALTERATION 434 ALT. RESIDENTIAL 3$ A? T} F =b a REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - Applicant - ST. LIC OWNER: AUTOMATIC GARAGE DOOR 15712525 0001990 ROTHER STEVE 220 77TH AVE NE 1387 ST ANDREW BLVD FRIDLEY MN 55432 EAGAN MN 55123 (612) 571-2525 (612)681-9451 I_hereliy ac"kh Information Statutes "and, APPLICANT/PERMITEE SIGNATURE OT OF EAGAN 3830 PILOT KNOB B RD RD - 55122 4:J 45 19% FIREPLACE PERMIT APPLICATION 681-4675 DATE: /L -?6 DESCRIPTION OF WORK: -CONSTRUCT NEW FIREPLACE: _ WOOD BURNING _ GAS INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: ROOM TO BE INSTALLED IN: STREET ADDRESS: IM 7 si A?u02L c? 8LVI) LOT J BLOCK SUBD./P.I.D. #: APPLICANT: (circle one only) OWNER CONTRACTOR I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER Fr$FPT ACE INSTALLER GAS LINE INSTALLER Name: P,r ST?Uf_ Phone#: U? Fl? Signature: Street Address: 13Y7 S7_ A iV D2EW 9 L VD City: (EdS C n Company: Signature: Street Address: a2a0 -- 7 7r/f State: M /j City: :?j State: Company: Name: Signature: - Street Address: City: Zip: 57/,,7 License #: )`F/`'Q Zip: S3 y3? Phone #: State: Zip: OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 32 Addition ? 33 Alterations ? 34 Repair GENERAL INFORMATION Census Code. SAC Code REMARKS .; 4 d' 9 Chimney/flue must be inspected before concealing. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT coz PERMIT TYPE: BUILDING Permit Number: 026962 Date Issued: 01/17/96 1387 ST ANDREW BLVD LOT: 3 BLOCK: 5 FAIRWAY HILLS P.I.N.: 10-25600-030-05 DESCRIPTION: i r' SIDING, Building Permit Type Building Work Type Census Code t ROOF VALLEY SF (MISC.) REPAIR 434 ALT. RESIDENTIAL f ? c 1 r I ? t REMARKS FEE SUMMARY: Base Fee Surcharge Total Fee VALUATION $29.25 $.50 $29.75 $800 CONTRACTOR: - Applicant - ST. LIC OWNER: SELA ROOFING & REMODELING 18238046 0001050 ROTHER STEVE 4100 EXCELSIOR BLVD 1387 ST ANDREW BLVD ST LOUIS PARK MN 55416 EAGAN MN 55123 (612) 823-8046 (612)681-9451 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 Mn. Statutes and City of Eagan Ordinances. PPLICANTIPERMITEE SIGNATURE ISSUED BY: SIG TURE J jL9C1 CITY OF EAGAN $A, V 3830 PILOT KNOB RD 55122 1995 BUILDING NG PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Reauirements Remodel/Repair Reouirerne ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design: etc.) ? 2 site surveys (exterior additions & decks) ? 7 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan N lot platted after 711/93 required: _ Yes _ No DATE: I III q G CONSTRUCTION COST: ?? ?o DESCRIPTION OF WORK: We7%Q ZW7-ALC- iVE-W ?/fL LI oy 11 Es'c' STREET ADDRESS: LOT ? BLOCK /337 sr ,tylj w R4l,19 ff SUBD./P.I.D. #: PROPERTY Name: 314/6 RdfiNFee PhoneM zo1-9151 OWNER Street Address- .3 6' 7 Ir 1tV,9 ?^^ 1?4z7`1? d v /' City: e?ngb-l itl State: A /V Zip: 5 5-1Z3 CONTRACTOR Company: Phone #: ? 2-3 ?DY 6 Street AddressT. Lc 4100 EXCELSIOR BLVD 'INC. ), Is p ARX 410,0 IS ro License #• 1050 ID# 0001050 City: State: Zip. ARCHITECT/ Company: Phone # ENGINEER Name: Registration M Street Address- City: State: Zip: Sewer & water licensed plumber. Penalty applies when address change and lot change are requested once permit is issued. 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. r Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No 4A" r OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: MCNVS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Valuation: $ % SAC SAC Units CITY OF EAGAN N_ 14 8 8 2 3830 Pilot Knob Road, P.O. Box 21-199, Eiaan, MN 55121 PHO N E: 454-8100 '::z I"'l I BUILDING PERMIT Receipt # To be used for DECK Est. Value $1,000 Date APRIL 26 -19 88 Site Address 1387 ST ANDREW BLVD Lot 3 Block 5 Sec/Sub. FAIRWAY HILLS Parcel No a Name STEVEN ROTHER W 3 Address 1387 ST ANDREW BLVD G City EAGAN Phone 681-9451 635-7395 Name o oa Addre. City_ r w W W Name F Address aw 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 q{ty pf Eagan Ordigagcel n, Signature of Permittee A Building Permit is issued to: STEVEN ROTHER. on the express condition that all work shall be done in accordance with all applicable State of Miin?n?esnota Statutes and City of Eagan Ordinances. Building Official 11lig I 'R % t„' OFFICE USE ONLY On Site Sewage _ Occupancy MWCC System _ Zoning On Site Well (Actual) Const City Water (Allowable) PRV Required # of Stories Booster Pump Length Depth S.F.Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit 24.00 Planner Surcharge .50 Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks 24.50 TOTAL 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN v 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 RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: Valuation: /(60 Date: C/?? ' ?r) t Site Address Lot ?.J Block Parcel/Sub ?a ?^p? t"? /d e OwnereuQn e/ ?Q n Address I^,?)m S7{ p th . A(\&reLL)f& 8lud City/Zip Code FfIGAi-?, P,.v) ,sYjl,-a Phone la'61 Contractor Yh V P? t Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone U On site sewage_ MWCC system _ On site well City water PRV required Booster Pump APPROVALS Engr/Assess Planner Council Bldg. Off. Variance .2v 00 ,Ji Occupancy Zoning Actual Const Allowable 11 of stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL CITY OF EAGAN N2 13 717 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ,f DTI BUILDING PERMIT PHONE: 454-8100 Receipt ik -1't' To be used for SF DWG/GAR Est. Value $105,000 Date JUNE 3 ,tg 87 Site Address 1387 ST ANDREW BLVD OFFICE USE ONLY Lot 3 Block 5 Sec/Sub. FAIRWAY HILLS On Site Sewage Occupancy R3 1 MWCC System Zoning R Parcel No. On Site Well Type of Const V City Water ?L (ACtuali z Name AL HERMANN CONST (Allowable) W z Address 8723 HIGHWOOD WAY * of Stories Length -Sr- c City A. V • Phone 688-0597 Depth 44 S.F. Total c Name SAME 431-1455 Footprint S.F. u< Address 688-0696 APPROVALS FEES P City Phone Assessments Permit $ 51$.50 h SO 52 Water/Sewer Surc arge . um Name Police Plan Review 259- 5 Fire SAC, City 100.00 Address Abp ?o Engr. SAC, MWCC aW City Phone Planner Water Conn. 525.00 67 n Council Water Meter - 0 1 hereby acknowledge that I have read this application and state Bldg. Off. Road Unit 7ng _ n0 that the information is correct and agree to comply with all applicable APC Treatment Pl -1$O .,.g0 State of Minnesota Statutes and Ci of Eagan Ordinances. Variance Parks Copies $2 225 53 Signature of Permittee 1 - TOTAL ., . NST b A Building Permit is issued to: AL H , NN C on the express condition that all work shall be done in accordance with all app State of M licible innf?sota Statutas and City of Eagan Ordinances. ^ _ Building Official p V f I 1987 BUILDING PERMIT 7PLICATION - 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 RENTAL UNITS FOR SALE UNITS OF SURVEY - CHECK WITH BLDG. DEPT., COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & ST RUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: a i -c' Valuation: Date: 138 Site Address OFFICE USE ONLY Lot Block On Site Sewage_ Occupancy ?Z 3 MWCC System ? Zoning (Z•? Parcel/Sub On Site Well Type of Const CC? ' City Water (Actual) Owner L-694 (Allowable) _ I Address t[0(0?- MS p? # of Stories Length 5Z Depth 4 City/Zip Code S.F. Total - Footprint S.F . Phone APPROVALS FEES C t t A it P S? -- 58 on rac or N? rN1ti Assessments erm . Water/Sewer Surcharge 5 ?-.O Address Police Plan Review Z 59?Es Fire SAC, City jOC. City/Zip Code jc) ?r( Engr SAC, MWCC SZ5 - Planner Water Conn 5- Phone ?pS?ij- Qty } Orj -1 FSS Council Water Meter b"1. P Bldg Off Road Unit 305 Arch./Engr. rely_? .- APC Treatment Pl ID• Variance Parks Address on-n Copies TOTAL ? o . City/Zip Code L'} \ Le Phone # { z ?, unp qp, 32X 26 ' ? 9) 0 s8 = ?S2gc? - 13? s?Z I? x22 ' 3O E> 4-4 50 ??v xc2 ^ ??2a w f I?) 4-qcl 2 ROB E N.AL ANIJ CO NST cOHSULTIHO ENGINEERS. "ENGINEERING PLAHHEAS and LAHD SURcomp ANY, INC. 1000 EAV 1"46A VRET, HL'AH-VIL'-Z, UINHENTA !123? P.! .000 Fa.' C??--Zfjz c?czze ,k'v {Y6 +x ?• / h o . •. ti LOT 3/ BLOCK DAKOTA COUNTY/ ?o ?/ _., . X32. d3 s;y ? J oo. S/ FAIRWAY HILLS, MINME50TA MF#i va. u ir,(G T: ST RNO ?L s so. ?o ?R- 65.? X3 Cz3 ao? F /o \ S Fo3? ?; ? i A /yo`1% p .. _ Se Ga 33 a , \ i F z9_° ro" °r I? r ?0\32. e) do U T r \D ?y ci's 69S ?F qTV ? ~~ F? tiT -F9 CZ' o \ SCALE : I"- 3C' 30' FRONT BUILD/NE SETBACK LINE I; (T:E)Z,D DEVOTE EXISTWC- DENOTES PRC(?ED ES IVAT0Aj E LEVA T /d l", ?- JMMCATES DIRECTION OF SURFACE DRAIMA6E /e3z.33 OA1159ED 6AKA6E &-W42 ' FLEVAT/OA/ 'r 6o°8s DRAINAGE AME) 2 ?O ,y UTILITY rA5EMrMT R- i, X? I her:by certify that this in a t:':e and ccrrect representation of A tract of land'as shown' and described herrcn.• As prepared by me on this 12rrf day of ?cIbJST , 19 ?? .. i= ri I Minn. IteE, Ho. /Gods `':; 1 J. 140.1 #= i 6 CITY OF BUILDING DEPARTHENT EXTERIOR ENVELOPE AVERAGE rrUrr COMPUTATION (To be submitted with building permit application) Two Family Dwelling- Owner ?Ta FEZ er for AG- 44Fi- I--, FVIALLOF / . ?`I/Olrr-r, 1` ft. Site Address Date Phone above grade z- r o,7 TOTAL EXPOSED WALL AREA Sq..FT. WALL CONSTRUCTION: rrUrr Value x Area Detail - flu I X SQ. reference + x sq, from: _ 1... f nUn__y7L? , . c'- x Sq. att;9c ed rrUrr I x sq. sire to r'U" x sq. rrUrr x SQ WINDOWS: rrUrr Value x Area I mal It -4 Type 1 /I?,I)1 ".IVI , ' rr - Trrurr j x 40 q . j- ft .. It flu n x SQ. rrrr q• nUn x Sq. DOORS.: rtu" Value x Area . K I•lalce,,& Type n q, rr to - 1 x SQ. rr ,. it x nUn 3 Q. rrUrr . ' TOTALS S Z IrlJ SQ T AVERAGE rrUrr OTALr- (U) (A) VALUES f(7?? ! (? j DIVIDED BY TOTAL WALL AREA 2.. ?ZO AVERAGE nUn ? - - •115-O less for 1&2 family ROOF,ICEILING TOTAL;?AREA: : I aJ dwellings FT. q9 (U) (A) FT. FT. _ -(U) (A) FT. _ (U)(A) FT. _ -(U) (A) FT. 117 ,'`= 7771770)(A) FT. (U)(A) (U)(A) FT. _ (U)(A) FT 4 FT: FT._ (U) (A) -(U) (A) FT. (U) (A) FT._ !?<7i(1 o (U)(A) Detail reference "from nUn Z - i4 27 ? rruri = (U)(A) attached sheets. rrUrr x SQ. FT. (U) (A) Describe openings nUrr x SQ. FT. _ (U)(A) in roof. "----- -nUn x SQ. FT. _ U) (A) x SQ. FT. (U)(A) TOTAL M(A) VALUES DIVIDED BY ;7: 7? I ?3 T rh?5 _LL_ .fr 2 0T. r x TOTAL ROOF/CEILING AREA 78>w OZ k AVERAGE rrUr .025 "fo ventilated roofe'; t- . r7oi x ' I =71 ? jr, gG7 /I lob X CS 2 -I-?Z-{- 3 Z ?- 32? =• I I z.. ? GW:??i?= Iz,2t?' ?w21?14 = ? ?, ?s LAX/4-H2- a2 62. n?a? (l1? I l ? ?"`? j L?i'T? Ia!"?' 1lr:? 1N?t_L 2511 /aJ /- C G'U v 91M ?V.J6111 Oz- vtl(-'//"_. ) rf;; `r L•-CJ .. ",i ñü ðø÷ þýýüûúÿú û ùüüýýûðïÿùüòñîü äïù õûã ïáäï þý ÿþýüûú÷õ à þüûú ÷ ÷õ à öõàëúó ãþ þ íäíåþúû ß ÿòþ óú çó ó òþ ó ý ó éæ õõú æ æ ó ý úéæ æ úæ é ýóè òþ ýûõ æóûó é ùêäâêììéïì éíìï öù ÿþ ê éïð é ðï Þþä é õô óò úú ÿ þóý ÿçÜë ðí ä äìÿ õç ÿþí öïï û öïïíì ñðïî á ýûõç úú æ ó óúûõúúýÿ æ ÿþ ûæå é úúà óÿþ þûÿþ ý ÿþ þý ÿþþ ýüûøüúûû ùþþû ïùð í ðþ ìþú â ÿþô üûúù ÷ìë ô üûúù ÷ ÷ìë á ìëø ùþ í ü ô üô óóïüùþú ò ñüþ íù ä í î îí ñü í þ íêþ ììù ýþ þí þ ù êôþ þù þ þþê ôþ íé þ ñü úþì þíúîí ê þ ð çæçååêåêóå óù ü îþ çêê èþüþýê òñ ôöð ùùþ üô ä õøî åàìúâåà ìä þì÷óÿþ þãá ßàÞâåóóâóà î úþì îþîþä þîþùùþþþ îþî íþ þþ íùúìîþþùùþ þ ã þ þü þôúÿþ þï þ ê ùùþë í þü ü ú þü Date: City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: Ea`'`t;" JUL 1 6 2012 Use BLUE or BLACK Ink For Office Use Permit #: e� co Permit Fee: Date Received: Staff: 2012 MECHANICAL PERMIT APPLICATION ((.R 1/2% Site Address: f 3( 7 SP -f a00/11/eC/0 R%VO, Suite #: Phone: 6,ai-(0&/- c2`/ / J Name: "I _ l t—L(j i 4- H L/0 Av, Zip: L S Contact: Lr'Yl C✓f t Email: Address: j State: 1�/) License #: New replacement Additional Alteration -� Description of work: Demolition RESIDENTIAL ✓Furnace k --Air Conditioner Air Exchanger _ Heat Pump Other New Construction Install Piping Gas COMMERCIAL _ Interior Improvement Processed Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) =$ b0.D0 TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) $60.00 Minimum (includes State Surcharge) - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) OR Contract Value $ x 1% _ $ Permit Fee = $ Surcharge _ $ TOTAL FEE CALL BEFORE YOU DIG. CaII 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.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pl s. Applicant's Printed Name Ok/D-1-h-Li A • Iicant's Signature 10/14/2014 16:45 5073566021 AMWW BB P�GE 02/06 . . , y Use BLU�or BLACK Ink � For�co Usa �� 1� I I C1t� 0��aIl ; Pe�„�#: �a � , �.�� (�� G�� 3830 Pilo!Knob Road ��." � �. � Permit Fee: � 7 • �" I Eagan MN 55122 � (�� t '��'��y j Oate Received: � �'�� Phone:(651)B7b�5675 i � Fax: (6b1) 675-5694 i Sfaff: i `..��___��___.�._ __�J 2012 RESIDENTIAL BUILDING PER��T APP�,icATioN ° �,�� Dat�: Iv �_l \ SlteAddress: JZ5 � c>T � �IU� , � .�4, Unit#: .., Name:� e c�nd�1e�e ��'�J� � �Gj i ,:i�ESIDEN�'` �� . Phon �...;.,,, ';O�IYNER�°� Address 1 City I Zip: �J c� W �j�v r � ; �,.;i � ' ti -- _�� Appllcant is: Owne� ��ontrackor ` Description of work: � , ;n�P�"oF�v��RK�� I 0� n '-``'� �``',�`� �7 � � Cvnstn�ction Cost�2 Multi-Family Building:(Yes !No -.�;,,;�: .-:-� Vkv r �. �:;:' ,:';' Company: V V �-c� ,',, ;;\; r Confact• G I 'C�I�TR�A�Y ...I ' Addrass: � 1 Y2 -� i M` ,A OR': City: ; � State:�1 � �p: � Phone: �r ��"1 a��L� (v��1�!;r;�.il,;.:" .' � _ , - ' � License#_� Jo��?j/� Lead CerCf � i icate#: �" � If the project is exempt from lead certlfication,please explain why: (see Page 3 for additional information) COMPLE7E THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In!he last 12 months,has the Clty of Eagan issued a permlt for a simllar plan based on a master p1an7� �Yes �No If yes, date�nd address of master plan: Llcensad Plumber. Phone: Mechanical Contractor: Phone: Sewer&Wat�r Contractor. Phone: � : :,.. ..,nro.r��: , ,. > ..,. ,,... .P/aits;a�.d:supQd.i�ti�g'.` oC!!i�e�its� `t�.;su ".' ,:...,;:.". .,.,.;..: ..;,. ..:............. . .... ... .......:.... ....,,.-.�,.:..;... ...,_:.:,.,;:;.r#ft ,��-�.,. ..brr�l.t'are:�COns�rlered�-ti�'b � ;��lie-►�t'orm ,. ,. ... „ ;�;: .��;F�! tl4n ons��. l�ma „,.. bli c`/n� .•� , ::,.,,,,. :_ . �� .,a�.��r � �>�� Qr;,.- .. .. .:...... .x ►�ed� - . .. .. ..,: : . . ,,. ..:, _ . s Itbn p ,;,,.,.• � ,.. :. ... , ._ ., :. .. . >._ .,.,,.-,.,...... ,. ,,.. .... . , . ......::..: ..: .0 ,bl�css�'yd,u•�iqvld ��Kl�:�`.` , , ... . .. , , �..,� .,� . ,., .. .,,, . ,. ei� `:ovra . . , .,. .. ,... : , . , ,, ., .,� .. _ :,. , ,,,. . .. ..... . .. . : ... . . - , .. . .� , , ;;;,_. 'stian�`'�ra��i�► ,�;��''trr�,�►r.y:�' : � -CO�alude�thai�th� .::ar�':trAbfe'sbciiafs� i • 4 � ,`' � . , , . ; , ,,,., �,;, " ,: , <. , :LL. . .;. ,: ,. C LL BE ORE Y U DIG. Cell Gopher S►a!a One Call at(651)454-0002 for protection against underground utility damage. Ca1148 hours before you intend fo dig to teceive IoC�tes of unqerground ulilities_ www, o her fateona ,or I hereby acknowledge Ihat thiS InfoRnation)g�omp�elg and accur��e;that the worlc will be in eonformanee with the osttinances and codes of 1he C{ty of E�gdn;that I understand this is not a permlt, but onty an applicatlon for a pertnit, and work is not to s1art wifhout a permit lhpt the work will be in accordance with the appr�ed plan in the case of v,rark y„hich requl�s a revlew and apprpval of plans. Extarior work dutf►orizsd by a bullding permit issued irt accordance wfth the Mlnnasota Stats Buildln o mus complefed wltltin 180 day6 of parmit i9suanCe. . �� X 1 ` � Appllcant's printed Nam X Appllcant's S u Page 1 of 3 10/14/2014 16:45 5073566021 AMWW BB P�GE 03f06 " ' > r `'�� ' �/�11��,��U lM^i �� y2 DO NOT WRITE 6ELOW THIS LINE I ��S J� 5�,�TYPES Foundation _ Flreplace Porch(3-Season) Storm damage � Singie Family � Garage ^ Porch(4Season) � E�cto�iorA(teration(Single Familyj � Multi _ Deck � Porch(Scre�n/GazebolPargola) Exterlor A1te�atlon(Mu)tij 01 of_Plex _ Lower Level _ f'ool � Miscellanaous _ Accessory Bullding WORK TYPES � N� ��'U�'�'��_ InteHor Improvement � Siding Demollsh Building" ,� Addltlon � Move Building � Reroof � Oemolish Interlor _ Alteratfon _ Flre Repair _ Wlndows Demolish Foundatio� � Rep)ace � Repalr � Egress Wlndow y Water Damage _ Retelning Wall 'Demolklon of enGre bullding—glva PCA hiandout to applicant DESCRIPTION � Valuatlon '2� Occupar�cy �,],��C. � MCES System Plan Review Code Editio� '2-c��Z rv�S j}(, SAC Units (25%�100%� toning �_ City Water Census Coda 3tottias Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers 7ype of Construction �` Width aE UIRED IN PECTION Footings(New Building) Meter Size: FOOtings(DBCk) Flnal/C.O. Required Footings(Addliion) � Flnal/No C.O.Required Foundation HVAC Gas Service Test Gas Line Air Test � Drain Tile Other:� Roof:`Ice&Water ^Final Pool:„Footings _Air/Gas Tests _„Final Framing Siding: Stucco Lath Stone Lath _Brick Fireplace:_ROUgh In Ai�Test `Final Wlndows Insulation Retaining Wall:,�Footings�Backfill Final Sheathing Radon Control � Sheetrock Erosion Control Reviewed By: � , Building Inspector RESIOEN7IA�FEES Base Fee ��l (� �� U � (A p� • . Surcharge �� `` 1 . Plan Review � �7 � MCES SAC Clty SAC Utllity Connection Charge 88W Parmit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA172164 Date Issued:09/16/2021 Permit Category:ePermit Site Address: 1387 St Andrew Blvd Lot:3 Block: 5 Addition: Fairway Hills PID:10-25600-05-030 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Steven G & Diane L Rother 1387 St Andrew Blvd Eagan MN 55123--215 Bison Builders Inc 10200 73rd Ave N, Suite 126 Maple Grove MN 55369 (612) 440-6000 Applicant/Permitee: Signature Issued By: Signature