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3620 St Francis WayCITY'OF EAGAN 3530 pilot Knob Road P.O. Box 21199 Eagan, MN 55121 Owner. Site Address: Permit No. Meter No: !7?p ? g Reader No:& {-9 9-D 7 3 Conn. Chg: ? , Ion 00p d Zoning: R3 Acct. Dep: No. of Units: f Permit Fee: 10 - 00Pd Surcharge: 50pri I agree to comply with the City of Eagan Tr. Plant ^ i nt7nd Ordinances. Meter. T, t .. ' f; . . Misc.: By WATER SERVICE PERMIT CITY E3f EAGAN 3,030 Wilot Kfiob Road 0 .0. Box 21199 Eagan, MN 55121 Site Address: K Permit No: B/P No: $17,06. ? , % 3 Date:- Size:. / o Date: I - / d/ - W I Date: 7-14-88 Date: d ? "4 $ 8,: 4th MWCC: -),Juu.U City Chg: 600.00pd Acct. Dep: Permit Fee: 10.00pd Surcharge: Pd y No. of Units: I agree to comply with the City of Eagan Ordinances. SEWER SERVICE PERMIT CITY OF EAGAN Permit No:_ 3830 Pilot Knob Road Meter No: _ P.O. Box 21199 Reader No: Eagan, MN 55121 Date: 7-14-88 Size: Date. Conn. Chg: 3 100 QM Zoning: -' Acct. Dep: No. of Units:' Permit Fee: 1.0. k-24 Surcharge: 5+3pd I agree to comply with the City of Eagan Tr. Plant 4 . C0 Ordinances. Meter. ?; 'r c l: er.?f_rt ' 352? Misc.: By WATER SERVICE PFAMIT CITY OF EAGAN Permit No. Date: 7-14- F 3839 Pilot Knob Road B/P No. Date: 3-4- °v P.O. Box 21199 Eagan, MN 55121 Owner. _ '? ihhe? ton :: t ,ta,v Site Address _' ?' '?? F St • vranc. is Wav T1 r?3 St. Fran is ri Plumber: ?iam - ing 4th MWCC: ?., 70s7 Zoning. City Chg: ?i11, :;OY No. of Units: f' Acct. Dep: 1 p - )'_ I agree to comply with the City of Eagan Permit Fee: Surcharge: - - Ordinances. Misc.: n BY SEWER SERVICE PERMIT CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE r f 19 11ECENED "cm AMOUNT ?- ? CASH k CHECK FUND OBJECT AMOUNT Thank You BY ??i4v1l. Sl & DOLLARS ,oo Whne--Payers Co" I?4 817 Yeiio?POStlrg Cop' Pink-File Copy BLDG. 01-3210 01-3422 01-3445 01-3446 01-2155 -H= 860 2 75 20- 865 20-3868 20-3716 20-2252 20-3713 20-3743 79-3866 PERMIT NO. Bldg. Permit Plan Check Surch./Adm. SAC/Adm. Surcharge Road Unit SAC Water Conn. Water Trmt. Water Meter Acct. Dep. Water Permi Sewer Permi Sewer Conn. Park Ded. u 44-3855 -? TOTAL CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT To be used for r, 1:011 M-11. Est. Value ?434,WO Receipt * Date IsL"Q 2 - ,198_ Site Address 3620 (A-Y) ST FRANCIS WAY Lot i Block 3 Sec/Sub.ST FRANCIS HOOD 41 Parcel No Name T1MUKTON CO. Vdress P.O. BOX 616 C City HOP`:INS Phone 933-7539 ow I Name _ o a Address H City W BRUCE LEHRER Name W N. _ Address a W 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. Signature of Permittee A Building Permit is issued to: on.Mhe express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official OFFICE USE ONLY On Site Sewage Occupancy R-1 MWCC System X Zoning k-4 On Site Well (Actual) Const Vn City Water X (Allowable) Vn PRV Required * of Stories Booster Pump Length 114 Depth 60 S.F. Total Footprint S.F. APPROVALS Engr./Assess. Planner Council Bldg. Off. Variance FEES Permit 1,060.00 Surcharge 217.00 Plan Review 830000 SAC, City 600.00 SAC, MWCC 3,3W.00 Water Conn. 3, 300.00 Water Meter 402.00 Road Unit 1.950.00 Treatment P1 1*224.00 Park topte TOTAL "1 - 541 CASH RECEIPT _ CITY OF EAGAN j830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE - I 19 REC:WZ - - AMOUNT $ / & DOLLARS too ? CASH CHECK { FUND O T AMOUNT I ??'`? Thank You BY 1 r f K J r rr`' r C J r r wnae--Payers Copy .. Yellow-Posting Copy i?? i ?` `? Pink-File Copy CITY OF EAGAN Remarks / Addition ST. FRANCIS W OOD 4TH Lot 1 Blk Parcel 10 65903 040 03 Owner Street 3620 St. Francis Way State Eaga n, MN 55123 . Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. , 1982 823.58 1 4.72 STREET RESTOR. a 86 2012. 134-17 1 GRADING SAN SEW TRUNK .463.25 0.$8 1 SEWER LATERAL 1980 J110.75 8 1 sew & wat lats 1 1 .00 29.00 WATERMAIN WATER LATERAL$ E N 101 19 8 6 12. 58 122 . 52 5 WATER AREA 7111 $ 325.98 65.18 STORM SEW TRK 1 $ 1 2. 9 5 2.86 1 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK //f/?J? /-y +1 This request void 18 months from D 79835?i.arar,c? Request Date "' T - qy Fire No. Re Inspection Ready Nuw ill Notify InsPec- for When Re d - a ?No a y Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City 3?-2o f 's wa Eo. Q Section No. Township Name or No. Rang No. County Occupdnt (PRINT) 1 Phone No. Power Supplier / Address ? 0. Ae F Electrical Contractor ICompa y N meI ,, , - Vigor-? Contract is License No. 33Z Mailing Address (Contractor or Owner Making Ins aiIation) F11) 4 1" I Authorized Signal IContr cto n Making Installation) Phone Number THIS INSPECTION REQUEST WILL NOT MINNESOTA STATE 96ARD OF ELECTR ITY BE ACCEPTED BY THE STATE BOARD Griggs-Midway Bldg. - Room N-191 1821 University Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS "'!1e ratot Raj.nann ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ?CJg o0o01-0e / See instructions for completing this form an back of Yellow cap V. ® 79835 "X'' Below Work Covered by This Request Ann nn. To..o ..6R?a wino Aooliancee Wired Equipment Wiree trio ton a Fee Service Entrance Size h Fee FBederSrSubfeadere q Fee Circuits ,Z U to 200 AM IS 0 to 30 Am s 0 to 30 Am Above 200 Am >s / 31 to 100 Amps 31 to 100 A s Swimming Pool Above 100_Am s Above 100_Am s Transformers Irrigation Booms Partia L'Ot Signs t pedal Inspection 812 s. TOT EE Remarks e ? t (J 1 ?? I, the ctrl / Inspector, ereby p -art ily that the bove Final n' / 4 inspection has been made. This request c HOUSE HEATING TEST RECORD ADDRESS V0APT. IT OCCUPANT OWNER HEAT LOSS D TE H G.ST. SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF E T GA _ FA HW -STEAM -SPACE HTR. _UNI . -OTHER GAS DESIGN CONVERSION MAKE. Model Serial _ INPUT MAKE OF BURNER _ Model Max. BTU Rating _ MAKE OF FURNACE Model _ CONTROLS THER TAT Hear Plug Vent Size Va IV. KIND OF LINER SIZE NONE Limit QJ Draft Hood t? Regulator Limit So I Filters Siva Number Fan Setfinq Chimney Location Inside Outside Pilot Type Chimney Construction ht+-a Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pre re 3• $ P tCO p? Date Tested y ?y _? r ssu ercen 2 t CFH .?S Po I te t O Tastin Com an npu r n 2 g p y k Te Sta ??? P t CO Name eF Tester mp. ercen c C/,?,f ylirc?r?e o G(/zt( 3 e/ HOUSE HEATING TEST RECORD g, ADDRESS SE f Clf'U- / -L.'S 241101_/ APT. FLOOR CITY SUBURB OCCUPANT OWNER HEAT SOLD B OSS n?? i7ATST. ?' INSTALLED BY Electrical Work By TYPE OF HEAT GA Gas Line By FA --V_HW -STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE MAKE OF BURNER _ _ Model ~ j Model Serial -S Max. BTU Rating _ INPUT ?; s, ? MAKE OF FURNACE Model CONTROLS ,," _,/ THERMOSTA Hoot Plug Vent Size .?J Va lva KIND OF LINER SIZE..ez -NONE Limit Draft Hood Regulator N tuber Limit Setting Filters Size Fan Setting r?8 Chimney Location Mside Outside Piloype -F/ ?/12l sU Chimney Construction ,2 Pilo: t Make -,e'14fel Pilot model $make Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut Off Doer Pressure Lighting Inst. ^! G? Pressure SrGI?G Percent CO2 Yp Date Tested Input CFH bi -Percent 02 v Company Testing Snick Temp. - ?/? Percent CO Name of Tester - CONVERSION ,31,?,F HOUSE HEATING TEST RECORD ADDRESSST '`y APT. 5..? FLOOR _ OCCUPANT OWNER CITY -SUBURB HEAT LOSS DATE HTG. INST. _ SOLD BY ?"2d h INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA _ FA _HW -STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model Model Serial Max. BTU Rating INPUT .4'.S MAKE OF FURNACE Model _ CO r/ ?t THERMOSTAT- ?Heatt Plug Vent Size Valve KIND OF LINER__ SIZE S NONE Limit Draft Hoed Regulator Limit Setting s' J Filters Size Number Fan Setting Chimney Location Insi Outside ?C? 1 Pilot Type Chimney Construction 7 77 A Pilot Make Pilot Model Smoke Bomb Witing Pilot Timing ? Draft ?_ - Test Tag L.W. Cut Off Door Prosswe Lighting Inst. _rtf'C f 7 a Pressure - Percent CO2 Date Tested Input CF Pereent OZ l .mod Company Testing Stock Temp. ?? Percent CO ?? Name of Tester CC r V/ HOUSE HEATING TEST RECORD ,# .311 e?' ADDRESS ?• C?l?+-?.?en L24t.?? APT. FLOOR CITY OCCUPANT OWNER HEAT SOLD YSS ref'-4+r??Tl>+ INSTALLED BY r? - Electrical Work By Gas Line By TYPE OF HEAT GA _ FA ?Z HW -STEAM -SPACE HTR. _ GAS DESIGN MAKE MAKE OF BURNER_ Model 1,2= Model Serial Max. BTU Rating INPUT n i: MAKE OF FURNACE Model _ CONTROLS THERMOSTAT Mocy Plug Valve Limit «• J Limit Setting Fan Setting Pilot Type Pilot Make Vent Size '/L T KIND OF LINER all _ SIZE. 5:-NONE Draft Hood Regulator Filters Size Nber Chimney Location Insirde :y/n utside Chimney Construction Pilot Model Smoke Bomb Wiring Pilot Timing 62-61r-1 Draft Test Tag .t' L.W. Cut Off -99,5z{J Door Pressure Lighting Inst. 0 Pressure Percent C02 / /'t Dos Tested _ 6 ` Input, CFH Percent 02 Company Testing c / Stock Temp. Percent CO A> Nome of Tow b ¢ SUBURB UNIT HTR. -OTHER CONVERSION HOUSE HEATING TEST RECORD 39 ADDRESS 2' 20 Sr APT. & FLOOR CITY - SUBURB OCCUPANT OWNER HEAT LOSS DATE}TG. t T. SOLD BY C/ -INSTALLED BY Electrical Work By TYPE OF HEAT Gas Line By GA _FA -,ZHW -STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE •??"'? MAKE OF BURNER _ Model t t %:7 ???z`?, <-.5- 0: Model Serial 51?xd'jL C) ?%ll Max. BTU Rating INPUT?S??? MAKE OF FURNACE -CONTROLS THERMOSTAT _ ,/ H t plug Valve Limit Limit Setting Fan Setting Gals o Pilot Type S El.`?Zt.?2-yL? Pilot Make Model Vent Size G/? , KIND OF LINER. SIZE 6- NONE Draft Hood Re iulamr Filters Size Number Chimney Location Inside Outside Chimney Construction Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L.W. Cut OFf Door Pressure Lighting Inst. 5 ? fit- 7/ ? ? D T d ' Pressure , • ' ? Percent CO2 ' ? ata este CFH } P Q? j? ? Tss ' C ? ?O Input ercent 0Q - ompany 7 Stack Temp. Percent CO (J Z Name ei Tas!? d" J CONVERSION HOUSE H?E?ATINGTRECORD ST ADDRESS APT. ?FLOOR n CITY SUBURB OCCUPANT OWNER HEAT LOSS ATE HTG. IN T. SOLD BY J INSTALLED BY Electrical Work By / Gas Line By TYPE OF HEAT GA _ FA HW -STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model (3?' /.0lY Model • 8? ?y??? Max. BTU Rating Serial 5 INPUT _5_t_ ^eAdt-0 MAKE OF FURNACE i Modal _ CONTROLS ?77 ? ? : THERMOST Heat Plug &T `7 Vent Sixe 7 y _ . j Valve ' ^52Z, ,- Z NONE KIND OF LINER !J SIZE. S Limit 7 ?" Draft Hood Regularor Limit S.ttieg ? Filters Size Number G?G? Fan Settin Chimney Location ins rd Outside - g Pilot Type SrJii -3'9 ---.^ i' Chimney Construction Pilot Make' Pilot Model 6 Smoke Bom Wiring Pilot Timing ( v Draft c? Test Tog x L.W. Cut Off Door Pressure Lighting Inst. lr ? d y T t rat' D . Pressure Percent CO e ate es Z Input CFH Percent OZ J a ° Company Testing rf2C! ?7GP> Stack Temp. °?"? Percent CO <7 Name of Taster ?! °? CASH RECEIPT q,l 7 CITY OF EAGAN .5-1 3830 PILOT KNOB ROAD A, ?. EAGAN, MINNESOTA 55122 DATE 1i 19 Z L' gecen¢o ?+ 1 _' li?l'??i'\ FI1????1 rxou ? AMOUNT 3 7V & DOLLARS qq ,y ioo ??(y•-R -73 CHECK -, n e / , PC FUND O T AM NT 20 :, ll? ILA 00 C)t ---5 (4 y5 o C)t '?? q? c? 1 380 CCU C,o r c Thank You 8562§-X? mit'paye.. Copy yellow poslin COPY Pink-File Copy 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 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 (20% maximum lot coverage allowed) 1 set of Energy calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design. etc. 1 site survey for additions & decks _ Tree Pres Not Reqd l set of Energy Calculabons Addition - indicate if on-sde septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date /C> / / Q 3 Site Address Z (o Q? Construction COS L/ tro ru •c - G LA 12V Unit/Ste # Description of Work ?7C I nlSn / n. ? ?r?C Multi-Family Bldg ? Y - N Fireplace(s) - 0 - 1 _ 2 } , f Property Owner Lt e, I ( e t S S Telephone # (66- 1) 1 - T20 <?- Contractor N &Yk cans 1' o?J Address 4r S"575` A-,,t State /'"l,? City lrt $ ?) Srk 4 - /? ?r? Zip $$L/ 3 Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeorv I - Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor I hereby apply for a Residential Building Permit and acknowledg rma ton 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 ' the se of work which requires a review and ,gy4l of Applicant's Printed Name pplicant's Si ature 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 EM. 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 Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) - 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) _ FinaUC.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 Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector CITY USE ONLY PERMIT #: RECEIPT DATE: 2002 MIDENTIAL MECIL4NICAL APP APPLICATION CITY OF EAGAN 3630 PILOT KNOB $D EAGAN MN 55122 651-6$1-4675 Please complete for: > single family dwellings J townhomes and condos when permits are required for each unit Date: / -a- /0 SITE ADDRESS: 3 OWNER NAME: Rr-k IL C L (G V\ t/ Cn TELEPHONE #: INSTALLER NAME: l-- Ct-, Co t.u- I( iel:? /- A47-1 TELEPHONE #: STREET ADDRESS: 6 J-:), CITY: a i C ( _?_; e (C - M:-,C7a STATE: (fir ZIP: Ss Ya3 ? ?(?-V Place a check mark next to the permit work type Add-on, modification or alteration to existin dwelling unit $ 30.00 • furnace replacement • air exchanger Q K• air conditioner , V I other p1 16 CO- Z ©r) O`??S`?-e f k 2p Nature o wor : C o> (' J ),1'IT By State Surcharge $ .50 S ' S O Total UVl/ln b'p-v? SIGNATURE OF PERM EE 1102 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: 8008 COMMERCIAL MECHANICAL PERMIT APPLICATION CITY OF EA&AN 5$80 PILOT KNOB RD EAGM, AIN 55188 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: TELEPHONE #: STATE: ZIP: WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: l% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: $ x l% = $ (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated l/02 CITY OF EAGAN N°_ 14 6 4 7 / 3830 Pilot Knob Road PO Box 21-199 Eagan MN 55121 r 1 PHONE: 454.8100 OI 7 O/ _, BUILDING PERMIT Receipt # Ou Y? To be used for 6 UNIT M. D. Est.Value $434,000 Date MARCH 2- ,19_$B__ Site Address 3620 (A-F) ST FRANCIS WAY Lot 1 Black 3 Sec/Sub.ST FRANCIS WOOD 4. Parcel No a Name TIMBERTON CO. 3 Address P.O. BOX 616 o City HOPKINS Phone---9-33-7539 c Name_ ou Address City_ Name BRUCE LEHRER Vya ?z Address 3908 GEORGIA AE z R 5352746 City CRYSTAL Phone - gw I hereby acknowledge that I have read this application and state that the information is correct and agree to comply wi h all applicable State of Minnesota Statutes and C aa'nn r 9 Signature of Permittlafl A Building Permit is issued to:_ TIMB RTON_C0. _ on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 10. Building Official_JC? OFFICE USE ONLY On Site Sewage Occupancy R-1 MWCC System X Zoning R-4 On Site Well (Actual)Const Vn City Water X (Allowable) Vn PRV Required * of Stories _ Booster Pump Length 120' Depth 60' _ S.F. Total Footprint S.F. APPROVALS Engr./Assess. Planner _ Council Bldg. Off. Variance FEES Permit 1,660.00 Surcharge 217.00 Plan Review 830.00 SAC, City 6D0.00 SAC, MWCC 3,3.00_00 Water Conn. 3.1.300.-.00 Water Meter 402-00 Road Unit 150,_0.0 Treatment P1 1.,224 GO Parks copie s 5U Torn 13,483_ «r + 1988 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 RENTAL UNITS FOR SALE UNITS 0 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: (- owir raw,vHaac'Valuation: `'" 7i ff _F Site Address G, Z(} S T. FRANCIS WAY OFF: Lot I Block 3 On site sewage- Parcel/Sub Sr. F2ANC, c Woos `!7H ADDN Owner Tunmea-rbu Co. Address P.O. gox (7/? City/Zip Code HopK1N5 553?I? Phone 9 33 - `15 39 Contractor S A Mc- Address City/Zip Code Phone Arch./Engr. .$121,1cg_ LF-HR&R Address 39 08 &eoR6ia Aam-Al MWCC system On site well City water ? PRV required Booster Pump _ APPROVALS Engr/Assess Planner Council Bldg. Off. Variance W90 JhN 1 ti Yft Date: Occupancy Zoning R- LI Actual Const V-N Allowable V- N # of stories Length-. 12o, Depth 60' S.F. Total Footprint S.F. FEES Permit M640 Surcharge ,217 Plan Review 830 SAC, City ro C'V SAC, MWCC 33 0 0 Water Conn - _9L 3o a . Water Meter 402- Road Unit / 0j5 p Treatment Pl a Parks Copies TOTAL 13 4R3.5 City/Zip Code CKYSTAc? MAI ssux1 Phone # 53S- ?'? 4L rE9tm17 FEE 1 sr loo/, 57 y - 331,1 X3,zs r 1 oya - 16 60 - SV RC4-Vq ?2G ?' Y3gooo x,00 = 21-7 PLALb1CZ K 1660 X 5?/ = k3o XTERIOR ENVELOPE AVERAGE COMPUTATION LOT I 3L QCK 3 * ST• FRANCIS W006 yth ,4D?*1? DETERMINE WORKING SQUARE FOOTAGE 1) WALL AREA: 5974 * .11 = 657.14 2) ROOF AREA: 4084 * .026 = 106.18 TOTAL EXPOSED WALL AREA 5974 A) WALL WINDOW AREA 358 B) DOOR AREA 240 C) PATIO DOOR AREA 340 D) FIREPLACE WALL AREA 0 E) WALL FRAMING AREA 597.4 F) NET WALL AREA 4438.6 G) RIM JOIST AREA 0 TOTAL EXPOSED FOUNDATION AREA 0 H) FOUNDATION WINDOW AREA 0 I) TOTAL NET FOUNDATION AREA 0 DETERMINE U VALUE OF EACH WALL SEGMENT A) 358 *U 55 = 196.9 B) 240 *U .07 = 16.8 C) 340 *U .55 = 187 D) 0*U0=0 E) 597.4 *U .097 = 57.94 F) 4438.6 *U .043 = 190.85 G) 0*U.187=0 H) 0 *U .55 = 0 I) 0*U0=0 3) TOTAL - 649.5 NOTE: IF ITEM #3 649.5 IS THE SAME AS, OR LESS THAN ITEM #1 657.14 YOU HAVE MET THE INTENT OF SBC 606(02 TOTAL EXPOSED ROOF AREA= 4084 J) SKYLIGHT AREA 16 K) ROOF FRAMING AREA 408.4 L) NET INSULATED ROOF AREA 3659.6 DETERMINE U VALUE FOR EACH ROOF SEGMENT J) 16 *U .55 = 8.8 K) 408.4 *U .026 = 10.61 L) 3659.6 *U .021 = 76.85 IF TOTAL OF #4 96.27 IS THE SAME AS, OR LESS THAN ITEM #2 106.18 THEN.YOU HAVE MET THE INTENT OF SEC 6606(01 ALTERNATE BUILDING ENVELOPE DESIGN TO UTILIZE TOTAL ENVELOPE SYSTEM METHOD VALUES ESTABLISHED BY THE SUM OF ITEMS #3 AND #4 SHALL NOT BE GREATER THAN THE SUMS OF ITEMS #1 AND #2. 1) 657.14 + 2) 106.18 = 763.32 3) 649.5 + 4) 96.27 = 745.77 0ua? y ?' 9e 0 `V ? ?a X00\?'? ? ? ^ ran J.;/ _ \ \ 4'III _4.3 Vo 2QO? l ?? ry ? ?? '? 1I Ih `?6'e.? e? Ol ? w ,UWL = 897.5 ti Nw== 879.5 .cncer .is n?aw wee CONSULTING ENGINEERS, ..ncO er re rO u.OU I.. Ouecr PLRNNERS end WNO SURVEYORS nesunenv,saw O y, ;1ING efin ......, a. ,.e ,..re INYT INC. .i 1461 STREET, B0RN5`/ILLE, MINNESOTA 55337 PH 432.3000 Li L 1 Eyp-3. wg. s) ?+fl/tiAac A/JO U7-/t/Ty EAS; /ac C` APPLICATION FOR PERMIT 1) PROPERTY ADDRESS: LEGAL DESCRIPTION *NOTE: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CON- i ' STITU E APPROVAL OF PERMT. s a i INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL. NOT BE SCEDDLED UNNL PERMIT WAS DEEN APPROVED. sst+frfaaartwtf+aas++esrrraar++xxrrrtwfi -F IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (month/Year) PRESENT ZONING/PROPOSED USE: Q COMMERCIAL/RETAIL/OFFICE Q INDUSTRIAL Q.INSTITUTIONAL/GOVERNMENT I_i R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) // R-3 TOWNHOUSE (Three + Units) ( /O Units) Q R-4 APARTMENT/CONDOMINIUM ( Units) 2) MMUNWE"Rok NAME: ADDRESS: O ( " CITY, STATE, ZIP: ill ( PHONE: ?I.7 ? y??"' ????? For City Use 3)NAME: Q/Uf?/eI Plumbers License: ADDRESS: AX 7 Active Expired CITY, STATE, ZIP: r E ( Not recorder PHONE: MASTER LICENSE # © i St Ia nitia? 4) • A •• NAME : ADDRESS: CITY, STATE, ZIP: PHONE: 5) s a •a o- .e ?• a CONNECTION TO CITY SEWER Q CONNECTION TO CITY WATER 0 OTHER 6) x * THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE METER PICK-LIP. * PLEASE ALLOW TO WORKING DAYS FOR PROCESSING. SOMEONE FROM THE CITY WILL CONTACT YOU IF THERE x * ARE ANY PROBLEMS. i SEWER AND/OR WATER CONNECTION of czag an FOR CITY USE ONLY PERMIT # ISSUED Pd W/Bldg. Permit S $ $ $ oQ $? o s o o 7o h RECEIPT FEES: $ In .SZ? s Q'73, do s S SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METERJCOPPERHORN+/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCCHHJARGE $/C1 . C7 Z) OTHER TOTAL RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ED YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: //C? ?3? DATE: ity of 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 April 26, 1989 TIMBERTON CO. 15705 26TH AVE. N. PLYMOUTH, MN 55447 TO WHOM IT MAY CONCERN: VIC ELLISON Moyor THOMAS EGAN DAVID K GUSTAFSON PAMELA MCCREA THEODORE WACHIER Coup ll Members THOMAS HEDGES City Admiohkof0, EUGENE VAN ONERBEKE CIN Cleik Please be advised that the city of Eagan does not issue Certificate of Occupancy statements on individual units of multiple dwellings. Once the building is completed, we will issue one Certificate of Occupancy for the entire building. At present, 3620 ST. FRANCIS WAY-UNITS E & F(LI, B3, has been inspected and approved by the City of Eagan for occupancy. ST. FRANCIS WOODS 4TH) Sincerely, Doug Reid Chief Build ing Official DR/3s THE LONE OAK TREE... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY /,1? 613, (, '7,t uj&CC 64 Ut!t OF 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (612) 454-8100 September 20, 1988 TO WHOM IT MAY CONCERN: VAC ELLISON Mo r THOMAS ELAN DAVID K. GUSTAFSON PAMELA MCCREA THEODORE WACHTER Council Members THOMAS HEDGES City Adminla or EUGENE VAN OVERBEKE City Cleric Please be advised that the city of Eagan does not issue Certificate of Occupancy statements on individual units of multiple dwellings. Once the building is completed, we will issue one Certificate of Occupancy for the entire building. At present, 3620 ST. FRANCIS WAY - UNIT D by the City of Eagan for occupancy. Sincerely, Doug Rei Chief Building Official DR/js has been inspected and approved ::THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY /I 1, X33; ?A 06."d '5z * of 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (612) 454-8100 August 31, 1988 TO WHOM IT MAY CONCERN: MC ELLISON Mavar THOMAS EGAN DAVID K, GUSTAFSON PAMELA MCCREA THEODORE WACHTER Cai it Viembcvs THOMAS HEDGES City A minisvatoi EUGENE VAN OVERBEKE City Clerk Please be advised that the city of Eagan does not issue Certificate of Occupancy statements on individual units of multiple dwellings. Once the building is completed, we will issue one Certificate of Occupancy for the entire building. At present, 3620 Sr. FRANCIS WAY - UNIT "A" by the City of Eagan for occupancy. has been inspected and approved Sincerely, Doug Reid E' Chief Building Official DR/js THE LONE OAK TREE... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY OF 31130 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 July 26, 1988 TO WHOM IT MAY CONCERN: VIC ELLISON MQ THOMAS EGAN DAVID K. GUSTAFSON PAMELA MOCREA THEODORE WACHTER Council Mem M THOMAS HEDGES CR, Admml,xalar EUGENE VAN OVERBEKE CM Cie* Please be advised that the city of Eagan does not issue Certificate of Occupancy statements on individual units of multiple dwellings. Once the building is completed, we will issue one Certificate of Occupancy for the entire building. At present, 3620 ST. FRANCIS WAY-UNIT C by the City of Eagan for occupancy. has been inspected and approved Sincerely, Doug Rei Chief Building Official DR/js THE LONE OAK TREE... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY --- oar (? t ._ 3?t? y iaj HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION MINNEAPOLIS. MINN. wutheruripa A37iV?1 Construction No. Insulation Culde Window Drwre II R<lerena I? Out. Wall Int. Wall Ceding Roo( Floor Kind Hour Applied- - Yes-No ea- 0 19_ 1 11 3 y width L Height aad Area air n 7 _ i He. Width- of MM N.Iekt of sales Me .1 L1. 1n. Ans rt. as Coe(: Btu _ Infiltration r z Q can Q Esp. wall Net a :p. wall C Ceiling Floor Total Btu. t 1 - Required req. ft. ED.R. or sq. init. W.A. leader area / Fl.1 Room Length 7,2-Width / Height Window sad Door--Cracksae and Area Mw lath N MM Nol(N .f Aso At of 14n1a ".wl ft. N erMY Afw oe. n. i Jofiltratian flan Exis. waU CA Net esp. wall Ceding Floor Total Btu. Required q. ft. ED.R. or q. ins. WA leader area I Door.-Crackage and Area lfa, ww,4 of". M.l(Ilt of Ms. M.. N list. LlYal fl. J.edeY Arw w n. Cwf. Btu Infiltretios G! am Esp. wgIL?L R. Net esp. waU L7 JaI_will?-lam - Ceiling Floor and Room and Area Nw Wldl• of ww MNd.t N Me$ Nw sf 1.,%I. Llnul fl. Tana as it. p. / v ' / / F? • ) I Cocf. Btu Infiltration Glass Esp. wall ?F f esp. waU r at. wall L Celina -Ho . Floor 7?: ? v r J'- t Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area 1 Fl.j fVt,e,.r " Room I Length 3 Width Height Window and Doors-Crackage and Area ^-2 fi l_--? , Nw Mldl. At a.w Mo1.M of p.no Me N 111YN Llnul h of r .ek Are. w rel. A, ???• Cftf. Btu Ilsfiltratioa I ? y t ? /a i' Glass c? Exp. wa e Net esp• Wsll 16/ .Z 'l G Istrwa6 : rr..) Ceiling all Floor .II t Total Bro. 1// 72(-) Required q. ft. ED.R. or sq. ins. WA. Leader area I Fl / Room ) I 1,, 3 Width ,;?-j Height `% Window and Doors Crackage and Area N* wldtY of Mu Md(a N Mw 00A 11(MO Ll.wl it. of v.tY At.. w. It. OF , ,. Coef. Bat Infilratua Glare Esp. wall - Net esp. wall lat-+Ya1L- F ? these] Ceiling Z Floor 4?, llr /e CZA p Total Btu. Taal Btu. Alf Required p. ft. E.D.R. Of sq• iris WA Leader area gepuired sq. ft. ED.R. or N. ins. WA. Leader area PERMIT # 1 ? "K -'? L( ')? RECEIPT DATE: I l - -'?_ ::1- d' MIDENTIAL PLUMING PERh[1T APPLICATION CffYof EAGAN 3$30 PNAT KNOB RD EALGM, MN 55122 651-6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system WERDAL, CURT SITE ADDRESS: 3620 ST. FRANCIS WAY #D EAGAN, MN 55123 OWNER NAME:: (651) 994-7231 'ELEPHONE #: (AREA CODE) INSTALLER NAME: STREET ADDRESS: CITY: Place a check mark next to the permit work type TELEPHONE #: STATE: ZIP: New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existing dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround , n ?p n n ?? Nature of work: ` re171 r u v V alff 1 /cU? _ Septic System, new/refurbished - $ 225.00 • includes County & Consulting Inspector fees • requires MPC license State Surcharge 0 $ ..5 5p $S Total Reminder., Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith all applicable Cityof Eagan ordinances. It is the applicant's responsibility to notify the property owner that the Cityof Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/rightofway/easement. SI kAY6?E OF PERMITTEE (AREA CODE) Updated 1101 sl ss-,/ PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit $ ? 5,. 50 Date 2 l b 3 Site Address (0 0 S(. T/1C'?/f &6 Unit# Property Owner Sli-S 0-4 ? 1 h So yU Telephone # (651 ) le k?e - 7 8? ? y \ - Vi Y- `\ n Q D z O t 0.)Y )L- - \ Contractor Address zq I y 9 l C1 1? ?J l t? J Au-e- City Z-,2, k)e-, \) e Vin State 1 r Yl rl ; Zip 556y Telephone # (0t/? 9- 9 9 9 The Applicant is Owner r' Contractor Other Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 - Adding fixtures to lower levels or room additions, excluding water softener and water h eater - Abandonment of septic system - Water turnaround (+ 5/8" meter if needed - $121.00) Other: - RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system 1 W r /! Rater softener ater heater - - ? ?, 4r, 15.00 V replacement additional ` _i $ .50 State Surcharge Total $ 1,5, 5 0- I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the worts will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; 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. Applicant's Printed Name App is Signature l©? RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 $,51o,. s- New Construction Requirements RemodebRegair 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 _ Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculafions for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate iforisde septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711 M Rim Joist Detail options selection sheet (bldgs with 3 or less units Date / 6 3 Construction Cost ?S Vt)e7 Site Address 3tP v?? 47 ?a W ri Unit/Ste # J ? S Description of Work It t ? /rc? Multi-Family Bldg 0- 1 - 2 _ V Y - N Fireplace(s) / ? , Property Owner f l t ?) b g& QX%,r l.t4`l'7 Telephone # ( ) s5 ? ? Contractor sm e / ?nr? ? hwN Address '?,s75-5- 4 r.. S o? City 1 .v State !n7 /l/ Zip L(3 I Telephone # OS1) 9W- y.1o't) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeory I - Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Licensed Plumber f C Telephone #( `I?C Mechanical Contractor 2 2N3 II Telephone #( Sewer/Water Contractor VW 1 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 th as of work which requires a review and ap 1 of plans. Applicant's Punted Name plicant's - ature 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_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - 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 _ F inal - Pool _ Figs _ 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 Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector g?(?? /sue 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. Do not combine inside and outside Dlumbina on the same aDDlication: separate applications and Dermits are required. Date 1 1 0 7 Site Street Address 3 L/? Unit # Property Owner IJ4 /771 ? S Telephone # ?) 4? -7z?,Y Gavic and Sons Plumbing Contractor 12725 Nightingale St- NW Telephone # (?6 j) 75J?-- 6o a Address Coon Rapids, VIN 560State Zip The Applicant is: _ Owner & Occupant Yicensed Plumbing Contractor Refurbished Submit 2 sets of plans and MPC license Septic System New Includes County fee _ - $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee applies when extensive plumbing re airs are made to a buildin . Alterations to existing dwelling $ 50.00 main level _ lower level. This fee includes Add plumbing fixtures to - installation of a water softeer and/or water heater at the same time. If you are n installing only a water softener and/or water heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $136.00 if a 5/8" meter is required) Other: _ Water Softener Water Heater I $ 15.00 r replacement - new e Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge 50 $ .5. Total i ?i $ I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete ana accurate; tnat the wo n be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I i, n awe ? but only an application for a permit, work is not to start without a permit and work will be in accordance rflS e I?% i?t ant a plan is required to be reviewed and approved. " A 2 8 2007 Applicant's PrintedName Applicant's Signature I � , � �G� Use BLUE or BLACK Ink � �--- I For Office Use � C• ' /� � � L.i'�-�'� I l6 Ol ��0�11 V1�l � �,`�I Permit#: � �/'�. � b ,� I S��1�' ` � Perrnit Fee: ��t � !� �� 3830 Pilot Knob Road � �a � l Eagan MN 55122 � � Date Received:�a�—/`�� Fax: (6 1)675-5694 75 I StaffCS I JUN231015 ► � ------------------- 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Addt�ess: ��n�� I • r�(�u�C �, �✓� Unit#:� �� �t �� ��� ' Name: °�e..II� "� �`^��c,hc..�-- . C�nh�ti�.,� Phone: T S� — L, ��! � �� ��'$������z� Address/Cit /Zi � T !��5 1 �( S � � -�- `�.1 S ��� � ����4� Y p� =s � Applicant is: Owner � Contractor Description of work�-��� �� �� �'�--�6 U� ����� �,� � Construction Cost: ����� Multi-Family Building: (Yes�/No� � Company: ���- �-d`$�C�- �tJ'-ti Contact: �� ��U��- �#���1"��bl' Address: �o�O�� �lvJ�-.c�.Fc�` G��J-� � City: ���$td`�c��.� : State:�/lJZip: �`S�b� Phone: �s����2"" E�S� ���, � ��y�-���r���rS .Co �� � ��c.��� ��� ��/- ��� �-_ ���� ,-: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: l� ,/'� ��}�� -��,� T G� v COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer�Water Contractor: Phone: Fire Suppression Contractor: Phone: �rL�� �l�n�ar�d���a���Iv����i�fl����,�#�e c�i�le�e�tv ii�p����'Qrr�a�,`��.�ort��s r�f -. #��r�or��c�n rr���a cl���sd��o�i=p�t�c�'l��'��+��'�� ,re�,sc����tt wor�1� `.`,��F�e��`y'tr� ;. �, � u� �.., ,�..: � ��c�d�i�ia�`� ��r���►�e�e��,s. 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.goaherstateonecall.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 X r Applicant's Printed Name ApplicanYs Signature Page 1 of 3