4266 Sandstone Dr a7Y oF EAGAN Remarks Cedar Grove Aequisition
Addition Cedar Grove #2 Lot 19 Bik 1 parCel 10 16701 196 01
Owner (y~ ''IrI(r'n 10 S[reet 1+266 Sandstone Dr. State Eagan, MN 55122
Improvement Date Amoun[ Annual Years PaYment Receipt Date
STREETSURF. PF6 1985 1266.95 54.46 1
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWERLATERAL 1972 1304.00 2.1 Z
WATEflMAIN
WATER LATERAL 1972
WATER AREA
STORM SEW TFK STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PEF,
SAC ~
PARK
i
EAGAN '8°0WNSHIP
BuILDo~~ ~~~~IT N° 1 061
~ Ownex .._4.?~-z~-~.....A.~..f...~/-../4'-_!'-~~__~x.e- . 4an Township .
; Addreac (preseni) .~_,...e~';:..~c•r,,.e.~~ Town- Hall
~ Builde I
Dale-
. 6.~---'----_.......... ; Addres§
. DESCRIPTION Siories , To Be Used For Fron! Depih He3gh! Esi. Cost Permii Fee Aemarks
; - /O
LOCATION ~
Slreei, Road- or other Descripiioa of Location Lo2 Block Addiiion or Tracf
. , g~f2_ 3 134 #
Thia permit does nof auihorize the use of slreefs, roads, alleps or sidewalks nor does it give the owner or his. agenf
the right fo ereale any sifuaiion whiah is a nuisance or which presenis a hazard. !o fhe health, safely, convenience -andqeneral welfare !o anyone in the communify.
1 THIS R I ERMIT MUST BE KEPT O THE PAEMISE WHILE THE WORK IS IN PROGRESS.
(Lo Thia is ito cerlify, ihaf...C?....~=-...'..... s1.,....`51.............. _..has permission 2o ereai a_ /L?.
. . -__..'........_._„~~..upon
' the above descri_ad premise subjeci io the provisions of the Building Ordinance for £agan 'lr6wnship adopie~~ April 11,
. ~ .~.-.-..w...4..---'. ~ Per - - ~!~X.~L4Y.C.!(:...-
. " - - ....:'S L ! L!X~..r...........
..Chairman of Tn ~ Bod < ' in Inspector
CITY OF EAGAN (y o- 14 617
~ . 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
. PHONE:454•8100 (7 ~
BUILDING PERMIT Receipt# d
7obeusedfor FIREPLACE INST.ESt.Value $1,000 Date ,19:u
Site Address 4265 SANDSTONE DRIVE OFFICE USE ONLY
8 2 CEDAR GROVE 2ND On S~te Sewage _ Occupancy
Lat Block SeC/Sub. MWCC System _ Zoning
Parcel No.
On Site Well _ (ACtuap Const
a Name BILL MADONI Ciry Water _ (Allowable)
3 Address 4265 SANDSTONE DRIVE PRVRequired _ #ofStories o city EAGAN Phone 688-0977 Booster Pump _ Length
oeptn
, o Name HEAT--GLO FIREPLACE S.F. Total
oa Address 3850 W. HIGHWAY 13 FootprintS.F.
~ City BURNSVILLE phone 890-0758 qppROVALS FEES
~ W Name Engr./ASSess. Permit $ 24. 00
W i- Address Planner Suroharge .90
i
aw City Phone Council PlanReview
Bldg. ON. SAC, City
I here6y acknowledge Ma[ I have reatl this applica[ion and state ihat the Variance SAC, MWCC
information is correct and agree to compty with all applicable State of Water Conn.
Minnesota Stalutes and City o( Eagan Ordinances.
Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1
oniheexpressconditionthatal workshallbedoneinaccord ewithall
applicable State of Minnesota Statutes and City of Eagan O inances. Parks
SO
BuildingOfficial TOTAL 24.
__~/A'i'•Z/ fa,~
•r
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ,
3830 Pilot Knob Road Permit Number: ,
Eagan, Minnesota 55122-1897 Date Issued:
(612)681-4675
, , j , i . , -1, 1: :
SITEADDRESS: +ill- 1 '~Im; I APPLICANT:
,11!1)'.1 iM! ii:. I 'W
PERMIT §VBTYPE: TYPE OF WORK:
1!•1.1 1110 , .
INSPECTION .
~ m . _m. . . .J
Parmit No. Permlt Holder Uate Telephane M
ELECTRIC
PLUMBING
HVAC
Inepecdon Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMe1NG
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GVPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINALPLBG FINAL HTG
ORSAT
TEST
BLOG FWAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTIUN RECUKll
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
, aaan, Minnesota 55122-1897 Date Issued: '
I-E
(651) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
~ . . I . . . , I ,
F
J
L
PermR Holder Date Telephone tl
SEWER/
WATER
PLUMBING
HVAC
Inspectlon Date Inep. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR 7EST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIF TEST
FINAL PLBG
FlNALHTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
MEfER
IRRIGATION
METER
fLUSH
MAINS
CONOUCTIVITY
TEST
HVDROSTATIC
TEST
BSMT R, I.
BSMT FINAL
DECK FTG
DECK FINAL
fZ865/104
Repues, Oate Fire No. Ropgh-In Inpaection Repuiretl Inspecion OIDer Then Rough-In
I ~VOU muel wA~nepeelor en reaEy) 0 qeady Naw Will Nptily Inspetlor
• ~ - 1 ~ cl ~ ? Ves No Oate Reaa
IA licensed conVactor ? owner hereby request inspection of above electrical work at:
Job AOOress IStreet Box or Rout~ Ciry
&
SecFlon No. TownShip Name orNO. Range No. County
Occup ntlPRl T) n e Phone Nyo. /
~S`t - ~(3/4
P upPl r PdOress
/ ,
al Con ac,or(CNem ~ n ConhacMr's license No.
~~r-", ~
Mailing AtlCress (Contr or or Owner Making Inslallation)
I( 3 CT- urLwa.~~ ~ 3
Aumon Sign ure (COmmcmvOw g In tallapon~ Pnone Number
o -3/e2 S-
MIN TA STATE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WIIL NOT
Grlgqc-MlEway Bltlg. - Paom Sd73 BE ACCEPTED 8V THE STATE BOPRD
1821 Unlverslly Ave.. SL Paul. MN 55100 UNLESS PROPER INSPEGTION FEE IS
Phone (BtY) 6424N800 ENCLOSED.
60 7 „/pS REQUEST FOR ELECTRICAL INSPECTION *q es-ooooi-0e
W Sae inslmqions lor completing Ihls form on back of yellow copy
p7~
6 186 "X" Be/ow Work Covered by This Request
p~
e Ao~ 7ypeot3Uilding AppliancesWiretl EquipmeniWiretl
Home Range Temporery Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm.llndustrial Furnace O[her (Specify)
Farm Air Conditioner
O!her (syecity) Comrador's Remerkr
vL
Compute /nspection Fee Below: lv~
iF Other Fee # ServiceEnira ceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 0 Amps
Transformers Above 200 _ Amps Above 1 Amps
SignS InspectorH Use Only: TOTAL
- Irrigation Booms p
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNE IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certity that the a6ove inspection has F;nai oe~a
been made.
OFFICE USE ONLY
This repuest voitl 18 momns imm
4/2747
~ ~
Request Da Fira No. Rough-in Inspection
ReQUiraO? etly Now ? Will NoYfy InspedOr
? VBS ? No Vdhen Reatly?
I.(icer}sed contrador ? owner hereby request inspection of above elecirical work at: .
JoEAtlO ~s Street. oKOrROU NoJ Cily
Sectbn No. ownshi eme or No. Range No. Counry
Occupant P NT) PMne r
Power $upptier AdOress
Elecl' tractor Company Conlr80or5 License No.
Mailing Atldre s(Contraclor or Oivner g Ins Ilabron) ~
1
Aut orizetl ~ (C mracmq0 ner Making Insl on) Phone Number
/d
MINNESOT BOAPD OF ELECTNICITY THIS INSFECiION FEQUEST WILL NOT
Griqga-Mltlway BIEg. - Room S1173 BE ACCEPTED BYTME STATE BOARD
1821 Universlly Ave., St Peul. MN 55104 UNLES$ PROPER INSPECTION FEE IS
Phone(8t2)802-0800 ' ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
~r~
/ bo SBe inslif:cti:ys ror complenng mis lorm on back of yellow copy.
5Z75
X" Below Work Covered by This ReQuest ~ dm•.
a 747
ew ep: 7ypeoBUilding AppliencesWired EquipmentWired
Home lDryer nge Temporary Senice
Duplez ter Heater Eleciric Heating
Apt. Building Other (Specity)
Comm./Industrial ' Fumace
7~A
Farm Air Conditioner %ORDER Olher (specity) Convector 4i/
Compute InspectionFee Be/ow:
# Olher Fee # ServiceEntranceSize /Feetlers Fee
Swimming Pool 0 to 200 Amps ps
Transformers Above 200 _ Amp_ Amps
SignS Inspector§ Use Onry: TOTAL
Irrigation Booms Special Inspection
Alarm/Communication THIS IN5TALLATION MANECTEO IF NOT
Other Fee COMPIETED WITHIN 18 MONTHS.
I, the Electrical Inspector, herehy Rouyn-in oate
certify that [he above inspedion has F;,,ai ( oate
~
been made. 4.7
OFFICE USE ONLV ,
This requesl voitl 18 moMhs trom
4734 ~
Requast Deta Fire No. Rough-in InSpectian
I Fequiretl? ? Reatly N. ill NoHTy Inspeclor
? Yes N. ~en ReaOYT
I licensed contractor O owner hereby request inspection of above eledrical work at: Job Pdtlr ss6 ~
(Sireal. Box r R gI&No.) w~1• n ~ Ciry
Seclion No., Township Narne or No. Range No. Counry
i
Occupen~Rl Phone No
Power plie r ~ Atltlress
E cal Conv cmr (COmoanv Neme) Conbactor's Licanse No,
- I ~.a 32S53
Mailing qOtlress ICOniractor or Own aking InstallatiQn) ~ .{~i7
` . U~ 3 3
Aullwrize0 gnalure 1 nVacroq ner Making talla ) c Phone Number
<
C3 "1
NINNESOT BOARD OF ELECTPICITY iHIS INSPECTION FEQUEST WILL NOT
Gr199"id^'ey BIAp. - Room S173 BE ACCEPTED BY THE STATE BOARD
1821 1lnlveralry Ava., SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
PMna (812) 842-0800 ENCIOSED.
G Q REQUEST FOR ELECTRICAL INSPECTION ~,,!'P"~9 E&00001-OB I
/ ? See insvuclions for completiig ihis fortn an back of yellow copy,
~
U y
w 4,2 73 4- _ X" Below Work Covered by This Request
e Ad3 Rep Typeofeuiltling AppliancesWired EquipmeMWired
Home Range Temporary Service
Duplez Water Heater Electric Heating
Apt. Buildinq Dryer Other (Specify)
Comm./Industrial ' Fumace
Parm Air Conditioner
Olher(specity) rk meMS:
Compute lnspection Fee Below: -
# Other Fee # ServiceEnt nceSize Fee # Cirads/Feeders Fee
Swimminq Pool 0 to 200 Amps 0 t0 700 Amps
Transformers Above 200 _ Amps A ve 100 _ Amps
Si9nS Inepecta5 Use Only: TOTA
Irrige[ion Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE OROERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rouyn-in oate
certity that [he above inspection has F;nai oare
been made. OFFICE USE ONLY
Tnis request vpd 18 months 1rom
g/'p ~ A q~/
a 4274 ~
Request Data ire No. RougRn Inspection
CA / Required'+ ? Reatly Now ill Noti(y Inspector
_b
C~ ~ ? Ves o hen ReadY?
/
I01 censed contractor O owner hereby request inspection of above electrical work at Job FtlAess (Stree6 Box or oute No. ~ v 1/,~ Ciry y/ ~(O~ . u ~s~'~-_ ( r'-~
Seclion No. TownMip Name or No. re W. Counry ~
ac.o~~~i~C'-~"'U~ a Pna~
P plier /7 AtlEress n
1 1~ ~ l T./I~,YZ,~/} L
ElecVi racror (COmvany Nam2L ConVaCOr's License Na.
~ C_ 0 .3 Z S~~
Mailing AUtlress (ConVador or er Makiig Inslallation)
,(~J 7~ ~ c-1-
Authorrzed Sigrm ~Conraclor/Owner Makinq In IIeL ~ Phone NuFr,
~
MINNESOT/ STATE BOIIRU Of ELECTRIdTY U THIS INSPEGTION REOl1EST WILL NOT
Grlpgs-MWway BIOg. - Room S173 ~ BE ACCEPTEO 9Y THE STATE BOARD
1821 UnIVBrNty Ave.. 51. Paul. NN 55104 UNLESS PROPER INSPECTION FEE IS
Phona(61t)841-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-08
fii~ I
S. insWCtionS br compleling Ihis form on beck of yellow copg ~ e'k~/O a S'
/
w ` X" Below Work Covered by This Request
4.2 40 - ~A
ew Atltl Rep. TypeofBUiltling AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Wa[er Heater Eleciric Heating
Apt. Building Dryer Other (Specity)
Comm./Industrial 'FUrnace
Ferm Air Conditioner
Other (speciry) Corqract k RemaMSL
Compute Inspection Fee Bebw:
#Othei Fee # ServiceEntrance5ize Fee # CircuRSiFeeders Fee
S`imminq Pool 0 to 200 Amps 0 to 100 Amps
Trans(ormers Above 200 _ Amps 100 _ Amps
Signs Inspector§ use Ony: OTA
Irrigation Booms ~
Special Inspection l~
Alarm/Communication THIS INSTALLATION MAY BE ORD CONNECTED IF NOT
Other Fee COMPLETED WRNIN 18 MONTHS.
I, the Electrical Inspecto5 hereby RouBh-in osta
certi that the above ins tion has
~ ~ Finel , ate l
been made.
OFFICE USE ONLY
Tnis requBSt witl 18 moiNhs firom
?@ p L-) Y. i ll7 #
3c C r_ Rl ~
~ ~ ttirt, ~
~ il #
# #
~
~ z z
#z s - ~ _u-
4 i= z C
3F C3 y C i- ~
'r'r- _ - + x
t-
#
~ Y' ti 1:1 r ~
~ L: C'i L .Z T
~ i-' --i -i li -
?F C d = L' [:1 #
# W i•l i. . ~
9E ' ~
# ' W C C' ',s
~ - '1 Li i:
# G 4 u ti
c^
:;~:Y,t~~~C~:kxcX~7SYdXcXcXci~~akae%~M~;~>X:X~c~%~kkcY~~„ex„~C~r„ ~ev~
CITY OF £AGAN
C;FtENIGR: S T'ERMINAE_ M02 780
D!§T[:^ 10/20/98 1SMG.^ i:L.?056
ID".
KIF1MEe I"'ANL'I...f.,ftAf`T t:lF MN .T.Nf'
::3210 9001 4266 sAnDSTONE 11'r?.25
805 9001 4266 sni.Dr:>rOraE 3.00
'T'4ta1 Rr.r`:31prF Amnun+9 115.25
CFi 03i iS41
lIBER 1Da NAMf;V
l+mMMMTr1mT'ITTT'1~~*MMI~~~~~~~~mS~TT'f~I`~~`TmT~i MMM
- PERMIT
C~YoOFEAGAN pERMITTYPE: guzLozNe
Permit Num6er: 0 3 0 5 2 5
Eagan, Minnesota 55122-1897 g y/2 5 /g 7
(612) 681-4675 Date Issued:
SITEADDRESS: 42e6 SANOSTONE DR
LOT: 19 BLOCK: 1
CEDAR GROVE 2ND
P.I.N.: 10-16701-190-01
DESCRIPTION: S I D I N G
Bui3~&3ng Permit Type SF (MISC.)
B'uilcfirtg~WOrk Type REPAIR
Jcemsu5 Cndii-,, 434 ALT. RESIDENTIAL
~
i
e
l..
a
~ _ .
REMARKS:
FEESUMMARY: vALvArzoN $5,000
Base Fee $99.75
Surcharge $2.50
Total Fee $102.25
Rp pp ican n~/NFp
P~AN~~L-C~RA~~RBF MN INC 17216628 0002179 TiUBE~tT50N JANICE
3118 SNELLING FlVE S 4266 SANOSTONE OR
MINNEAPOLIS MN 55406 EAGAN MN
•(612) 721-6628 (612)454-4316
I herehy acknowledge that I have read this ap'plication and state Chat'tlte
information is correot and agree ta comply with a1f app2icabfe-State a:f Mti.
Statutes and Ci.ty s?f Eagarn C1rdi`nances. ~ . .
APPLICANT,PERMITEE SIGNATURE - ISSUED W. SIGNATURE
CITY OF EAGAN
~3 v S ~S 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)%f
6e1-4675
~/02. ZS
New Construelion Reauirements RemodeVReoair Reauirements
? 3 regislered site surveys ? 2 eopies af plan .
? 2 copies of plans (include beam 8 window sizes; poured Ind, design; etc.) ? 2 site surveys (exterior additions 8 decks) .
? t energy calculetlons ' ? 1 energy caiculations lor heated addilions ,
? 3 wpiea of tree preservalion plan if lot platled aNer 711193 ,
required: _ Yes No
DATE: ~'ZZ~7 CONSTRUCTION COST: ~~~~7'
DESCRIPTION OF WORK:
STREET ADDRESS:
? ~ Q,i, _ _ 2~
LOT BLOCK ~ SUBDJP.I.D.
PROPERTY Nam~~d~/~ Phone
OWNER
Street Address: L7~'i~/ se (/Q44s~Cl'I.U
City: Ct/t State: AIN Zip:
coN7rtACTOR Company: 660ao*VleAA Phone
Street Address: ?~l/ U/!~/~%L/ ~`~Y v License a~~9
City: AA~ ~~iD4t& State: Aa Zip: ' y~
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
5treet Address:
City: State: Zip:
Sewer 8 water licensed ptumber: Penalty applies when address change and lot
change are requested once permit is issued.
1 here6y acknowledge that I have read this application and state that the information is correct an agree to comply with all
applicable State oF Minnesota Statutes and City of Eagan Ordinances. ,
Signature of Applicant:
~~Z
OFFICE USE ONLY -
. Certificates oi Survey Received _ Yes No
Tree Preservation Plan Received _ Yes _ No
OFFICE USE ONLY - -
BUILDING PERMIT TYPE
v 1 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
2 SF Dwelling ? 07 4-plex a 12 Multi Repair/Rem. ? 17 Swim Pool
? 03. SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
0 31 New ?~3 Alterations a 36 Move ? 32 Addition ~~34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Bas2ment sq. ft. R4CMIS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV .
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code Census Bldg
Census Unit
APPROVALS .
Planning Building Engineering Variance
Permit Fee Valuation: $ . ov-
Surcharge
Plan Review
License
MGNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total: loG • G+~
% SAC
SAC Units
~ PERMIT
: CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 7 3 4
(651) 681-4675 Date Issued: 10 /2 0/ 9 8
SITE ADDRESS:
4266 SANDSTONE DR
LOT: 19 BLOCK: 1
CFDAR GROVE #2
P.I.N.: 10-16701-190-01
DESCRIPTION:
REROOf=/FASCIA
Buiiding'Permit Type SF (MZSC.)
Biiilding War,k Type REPAIR
~Census Code 434 ALT. RESIDENTIAL
/
. i
~
. . . ~ , _ . , _ .
REMARKS:
FEE SUMMARY:
VALUATTON $6,000
Base Fee $112.25
Surcharge 3,00
Total Fee $115.25
CONTRACTOR: - Applicant - ST. l.zc. OWNER:
PflNELCRAFT OF MN INC 17216628 0002179 ROBERTSON MRLCOLM
3 18 SNELLING AVE S 4266 SANDSTONE DR M EAPOLIS MN 55406 EAGAN MN 55122
( 2) 721-6628 (651)459-4316
I hereby acknowledge thaC I have read this application and state thet the
information is correct and agree to comply with all appliceble 5tate of Mn.
Statutes and City of Eagan prdinances.
~ -
A-IC~4i A o A~ A~'
APPLICANT/PEPMITEE SIGNATURE ISSUED BY: SIGNATURE
~,-}-dBUr..~~IDINe` GP` ~~~Ihr I~~ ao
3~ 9 APPLICATION (RESIDENTIAL)
CIT'Y OF EAGAN
3830 PII.OT KNOB RD - 55122
sa i-as7s
'ew Construction Requirements RemodeVReoair Reauirements
? 3 registered sde surveys ? 2 copies ot plan
? 2 copies of pians (inGude beam 8 window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & decks)
? t energy ealculations • 1 energy ralculations for heated add'Rions
? 3 copies of tree preservation plan H lot platted after 7I1193
required: _Yes _ No
DATE: CONSTRUCTION COST; 3cl 7~
DESCRIPTION OF WORK: ~i~~•ci,~c c7 u tt~
STREETADDRESS: Lf~Gb ~/yc~~~Z~~zP.
LOT: ~ BLOCK: 5UBD./P.I.D. CA k0u,,- G V ci\J -e 4:~~
Name: 9&LM%!iti-N-o rL / ~//,vc &4nC.. Phone
PROPERTY ~ Last First
OWNER •
Street Address:
City CLGJilirL~ State: R-71, Zip:
Company: &V 4 ,~-~7 • Phone n: 7
CONTRACTOR ~J
Sveet Address: License #
City ::Z~7.iin ~r~n~ State: Zip:
ARCHITECT/
ENGTNEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer 8 water licensed piumber (new construction ony): . Penatry appiies when address chanc
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is wRect and agree to comply wRh ali applicab
State of Minnesota Statutes and City of Eagan Ordinances.
?
Signature of Appiicant: ~-~t`~~ •
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No DCT
Tree Preservation Plan Received _ Yes _ No _ Not Require
OFFICE U5E ONLY
BUILDING PERMIT TYPE ~
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 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 Facifity
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE ,
? 31 New ? 33 Alteretions ? 36 Move
? 32 Addition O 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Aliowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code ~
Census Bldg
Census Unit
APPROVALS
Pianning Building Engineering Variance
Permit Fee ~ a 5) Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/V1/ Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Totai: /,S•a~
% SAC
SAC Units
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
GTY OF EAGAN sd'UI n'~
3830 PILOT KNOB RD - 55122
651-681-4675 q ~
S~S-ct I
New Consirudion Reauiremenls Remodel/Reoalr ReautremeMs
? 3 registered sMe surveys showing sq. M. of lot, sq. fl. of house 2 coples of plan
and all roofed areas (20% maximum lot coveraae allowed) i sei of energy calculations for heated addBions
>2 copies of plans (show beam 8 window s@ea; poured tnd. design; efc.) i sRe survey for exlerior addittons 8 decks
: 1 set ol energy colculatlons
> 3 coples of hee preservation plan N lot platted after 7/1/93
DATE: 5'" II '5 9 CONSTRUCTION COST:
DESCRIPTION OF WORK: 5a
STREET ADDRESS: -Z(PLo JA-'--ek~ Ql (y ~
LO7: BLOCK: I SUBD./P.I.D. LSL~7l OA n l~ ~O U-c
Name: ALC.+*'tt'?'1 frIo.(GdPhone#:
PROPERTY Lan First
OWNER
Street Address: UZ[v (.o
City State: Zip:
Company: A-f=4?'~L /W?"' 10nL Phone
(area code)
CONTRACTOR - ~ dCy~~ 8'~ ~
Street Address: ~K/
I ~ License # Exp. b
City A- V ' State: AL_ Zip;--~
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip:
Sewer 8 water Iicensed plumber (reauired for new conshuction onlv):
Penalty applles when address ehange and lot change Is requested once permit Is Issued.
I hereby acknowledge thot I have read this applIcation, state that the Information Is conect, and agree fo comply with all applicable
State of Minnesota Stafutes and City of Eagan Ordlnances. /
Signature of Applicant:
61
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes - No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 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 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-piex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.` ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (lnterior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review ,
License
IVI(:(EJ JHG
City SAC
Water Conn.
Water Meter
Acct. Deposit -
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded. ! b .
Trails Ded.
otner co Al,-&~cJtrti
Copies
Total:
SACUnits
% SAC I ~ (;-0/~
Use BLUE or BLACK Ink
r
For Office Use 1 I
Permit 6
non
City of EaEd ~-5
Permit Fee.
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: ~t ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
- - - - - - - - - - - - -
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
cJ a o stir s,J nJ
Name: Phone:
Resident/ ~~n ~S ~J r11r
~ Owner Address /City /Zip: '
Applicant is: Owner Contractor
i
Type of Work ' Description of work: ri
Construction Cost: ~ 0c) I Multi-Family Building: (Yes / No )
Company: 01
~ Contact:
Address: v 0 L_ U city: 3 rf
Contractor / ~ _
Stater Zip: ~Sf/~ PhonefOZ 6 z -/T9,0 y
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorize uilding permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance
x C/th~l f J x
7fil d Name s nature
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