951 Savannah Rd cmr eF E~o~N SEWER SERVICE p~p MIT
3630 Pllot Knob Road ~ 1~'.?~.~,
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55Y21 DATE:
Zonin
9~ 8hlo, of Units:
arv n eorge _ c r
Owner.
Address:
Site Address: avanr~ , ~
Plumbec ~ ~ um p,
•
I a roe to com wlth tha 52 5. OOpd
g pry Cify af Eegan Connection Charge:
Onilnances. Account Deposit: ~
Permft Fee: '
Surcharge: - - -
By Misc. Charges: ~ A
Date of Insp.: Toial:
Insp.: Date Paid:
. .
CITY f~F EA(idN Permit No: ~ Date: "
3830 Pllot Knob Roeid Meter No: S 7 U z~ Size: " s•~(
P.O. 8~,; tit99 Reader No: ~ Date:
Eagan, MN 55121
Owner. ''1ar.s~i~~ ~'eors,e L'Ic'rs.
SiteAddres~ ~~I ~av~nnai~ ;?oa1 L1 i~:•.i:~ ~~t;~!: ti~
Plumber. :~tar F].~.r-~t~i1~:
i' t'
Conn. Chg: c, ~,,I,~, ~ J~~~ L ZOr~I!'~,~;2~-
Acct Dep: C3,~ ~~j~,
.TF;:;. . U
Permit Fee:
Surcharge: ~a~ oplt~ply wlth t Cfty of Eagan
Tr. Plant ~ ~=QT_ rd
Meter. ~ ( l
Misc.: -1` ' gy ) 4
WATER SERVICE E ~ IT
cmrnF ~c~?N ~ SEVbER SERVICE PERMIT
3830 Pibt Knob Road - - , , ~
P.o. Box ~t~se ~ ~ PLI~M1T9~c~:-, ~
Eagan, MN 55121 DA~ 1
Zoning: ~'1 No. of Unita 1~
Owner. '`~arvin Ceor^e Bldrs . _
Address:
SiteAddress: ~S1 Savannah P.oa~'. I,1 B? Te:,in~7ton Sq I~'
Plumber. Star Plumhir,^
?-1'=.-B7 70 100.~4p~
1 agroe io comply wlth the Clty ot a ~It~e?ge: 5-^f1~~i
o.aMs~~.. Before ~ii~~~g ca~Y ~~uENx: ~ 5_ n~-
TELEPkIOf~E - ELE~~'~c Fee: ~
UIR~[~`~~` ' s~a~
I~~na tv 1~.llona
gy RE MisC: Ghargea: Y T~-
Date of Inap.: TotaC ~ -
Inap.: DateJ~aid: ~ ~
, . . .rC . . . T - ~ .
CITY 6F E/kGAN Permit No: t714 Date: 5-$-S7
3830 Pllot Knob Road Meter No: Size:
P.O. Box 21199 Reader No: Dat~
Eagan, MN 55~21
Owner.• `~r~~ ~~r~.e Bldrs.
SiteAddress: ~S1 Savannah F.oad Ll B2 Lc:x.L•_;;t~n
Plumber. Star P1~~bis~~-
Conn. Chg; ~5' j.~~r` ~ Zoni~g: rI
Acct Dep: 15 •~`3~"~ No. of Units:
Permit Fee: ln , ~~~p :
Surcharge: 1 agree to cemp#y wNh the City of Esqan
Tr. Plant I ~ • Ordlnances.
Meter. ^
Misc.: n<nilt~ li~. Op~a gy
WATER SERVICE PERMIT
~
- ~ CASH RECEIPT
. CITY OF EAGAN
• 3830 PILOT KNOB ROAD
• EAGAN, MINNESOTA 55122
~
DATE ' ~ f9
a
~ ~ ~
RtCHIVEO ,
FROI~ ~
AMOUNT $ ~ I
& DCLLARS
_ ioo
~ CASH ~ CHECK
~ y
ron ' ~ ~..1. ~ S" ) , ,
~ _ -
FUNO CODH pMOUNT
l 'l
Thank You r'~-f;'
B Y f i
I White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
BLDG. 'PERMIT N0.
• _ M1\-~,.~ : ~i ` , J '
01-3210 ~Bldg. ,Permit ;
01-3422 Plan Check
01-3445 Surch./Adm. ~
01-3446 SAC/Adm. F~ ?
01-2155 Surcharge ~
~j ~ C.~
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt. 1`
20-3716 Water Meter r:~- ~ :
20-2252 Acct. Dep. ~
20-3713 Water Permit I
20-3743 Sewer Permit ~
79-3866 Sewer Conn. ' Ir
11-3855 Park Ded. {
~
~
I
I
TOTAL - ~
, ~ CASH RECEIPT
CITY OF EAGAN
' 3830 PIL~T KNOB ROAD
` EAGAN, MINNESOTA 55122
~ DATE ~ 19
REC6IVED • / ~
FROM ( ~ ~r
AMOUNT $ I
& DOLLARf
foo
~ CASH ~CHECK
. .e
FOR . i.;/ ! ~ _ / 'L~~.,_~..~~
r , /
, .
_ ;
FUND CODE AMOUNT
~ '
; _ ,
~C ' -
c...~ " j '
;~rr
; i~l~j ~ .Z
Thank You
BY -
-1 , ~
. White-Payers CoPY
Yellow-Posting Copy
Pink-File Copy
:~"VA~ r~Olt ~-PLAN~ ~ff17FD 3/25/a7 CITY OF EAGAN . . . , .
. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~A i3234
PHONE: 454-8100 ~
BUILDING PERMIT Receipt #
Tobeusedta `'~`'~=1t Estvalue ~~2,U00 Date cEf3RUA~tY 13 19t~7
`.~1 `~.~V:1CdP;yi; ~:J ~ Occupancy
Site Address Erect
Lot ' Block ~ Sec/Sub. LE:{ I~+G`1'ON SQ Remodel ? Zoning it 1
Parcel No. 4~ T}'. ADU Repair ? Type of Const t1
Addition ? No. Stories
Q :i~,2sl7;k i~~ORGi: ~2Li7'r2S Move ? Length ~~U
W Name • t j. ~~~K Demolish ? Depth 3~
3 Address Int. Impr. ? Sq. Ft
O {~•~h/ i!'..~:~0~18 S 1~3t811 ?
= o Name ' Approvals F~es
~ i Address Assessment Permit $ ~ a U.:.~ u
~ City Phone Water & Sew. Surcharge 41. 00
Police Plan Review L 2 U. 2 5
F W Name Fire SAC 2 5. 0~
_~~-y Address Eng. Water Conn. 5Z 5•{JG
~
i W City Phone Planner Water Meter 67 . 00
Council Road Unit U d
I hereby acknowledge that I have read this appiication and state that the gldg. Off. Tr. PI. i ~ U J
information is correct and agree to comply with all applicable State of
Minnesota Statutes and CPty af,~~gan Ordinance~ APC Parks
/ r/ r t.r^~ Var. Date Copies ~
Signature of Permittee~~~~,j~-~ ~ 1 Totel
A Buildin Permit is issued to: ~"~V IN GF;Q12~~E B DRS
9 on the express condltion that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Oflicial
- Wrmlt No. PsrmN Hold~r DsN TM~phon~ 11
Plumbiny ~ ~>~.l ~i:', / ' i
N.V.A:... r~~'?` ~O -yt~ ~ ~t/ ~l~,%
c.
El~etrie i ~f :3~~,j~.
i ~~~.SG
,
SoKensr '
Inspsction Dsb Imp. Commanb
Poolinys I
Footlny~ 11
Foundatbn
Framiny 3'_ ~ 0.,4' L'
Roo8n9
Rough Plby. ' ;
Rou~h Htq. g-~7 ?r~-C .ywa'f'
Insul. ~l~o L .
Flreplacs ~f~/ %
r•~i.-+ .v~ c I'~ C vt ~ o~~ f! c~'~'~..
Finsl Htq. Y~. i-. lyG~Yc~,r yl~C r:~ 6~.
Finel Pibp. ' F., 1Qt ~ ~crc G y' ~'~7 C~ , ~ -
s~aq. F~n.i ~ D/r- s ~-O
c.re. occ. ~7 ~G ~
Deck Fty ~ qV0% ~ ' /Vb /~T~ G'2
D~c D S aC ~/7CiG/a~
/L /~'?1 ~7lC~'s-
Wsll ! Z7J~7- /'/9
Pr. Dfsp.
r ~fr~ ~a o~vw~'/~- ' - I ~ ~
^/~~Js /iindr p•a - 7 f`~.
~ :tr , r . . . . . . . . . , . . : . ~ ,~,:'~„1~~~, a,
. PERMIT #
~ ~ • ' • PLUMBING PERMIT RECEIPT # 7~y
CITY OF EAGAN _ ~ . ;
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PH~NE: 454-5700
Site Address S 4J°-~~• ~ ~ BLDG. TYPE WORK DESCRIPTION
Lot ~ Block a SecrSub 4 s
y Res. ~ New
~ Name ~ ~ ~'b Muit Add-on
d
~ Address ~ ~ • ^ ~ ~ Comm. Repair
c Ciry S ~ ° - Phone ' ' ' ' ' ' Other
1 q a . . ~ ~ , ; NO. FIXTURES TOTAL
~ Name ~ Water Closet - $3.00 s -7 -
; Address li ' ~ ~ Bath Tubs - $3.00 ~
~ City ~ 0. ~ . ~ i , Phone ~ ~ , ~ ` Lavatory - $3.00
Shower - $3.00
~ Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.d0
COMM/IND FEE - 1% OF CONTRACT FEE ~ Laundry Tray -$3.00
MINIMUM - RESIDENTIAL FEE -$10.00 ' Floor Orains -$1.50
MINIMUM - COMM/IND FEE - ' Water Heater - $1.50 ' '
STATE SURCHARGE PER PERMIT - Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES ' Gas Piping Outlets -$1.50
BEYOND $1,000.0~ Softener - $5.00
Well - $10.00
' Private Disp. - $10.00
w h ~Rough Openings - ~1.50 " ~
SIGNATURE OF ERMITTEE FEE ~ ~ ~
STATE S/~
FOR CITY OF EAGAN GRAND TOTAL•
'~u.... '~i `~Y4;', E~-~...~ . . . . _ . . . . . ' ~
~ ' PERMIT # ` ~
~ ~ , . , MECHANICAL PERMIT RECEIPT # ? ~ ~ ~
' ~ ' CITY OF ~AGAN ~ ~
00 3830 PILOT KNOB ROdD, EAGAN, MN 55122 DATE
COdTRACT•PRICE ' PHONE:454-8100
~ite Address ~ ` gLpG. TYPE WORK D RIPTION
Lot ~ Block a Sec/Sub : Res. ~ New ~
~ Name ' ~1 cc; , ~ A ~ Mult Add-on
m Comm. Repair
Address ~b~.ti t••~ ~ tiU(
c City ~ ac Phone U ~ y 'Other
:
FEES
L Name ~ ~~a RES. HVAC 0-100 M BTU -$24.~0
c Address Y`+•. ` ADDITIONAL 50 M 8TU - 6.~0
p Ciry ~r - t~~.- Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMI~ - 1.50 EA.
TYPE OF WORK o COMM/IND FEE - 1~/o OF CONTRACT FEE
Forced Air M BTU a~ APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLJES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADd-ON 8~
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent ~ CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # ' BEYOND $1,000)
Other
FEE ' ` ~
~ . ' , ' ~ ~ ~ 1.~~c f- : r. ~ .
S/C: SIGNATURE dF PERMITTEE
op
TOTAL•
FOR: CITY OF EAGAN
INSPECTIUN REC~RD ~ Control No. i~i ~
CITY OF EAGAN PERMIT TYPE: ~ui LDZ~~
3830 Pilot Knob Road Permit Number: g~i
•!1 26 92
Eagan, Minnesota 55123 Date issued: l
(612) 681-4675
SITE ADDRESS: t u i. ~ w ~ u c~~ z APPUCANT:
9151 SAVANNAN Rp AMERICAN R~11tlO~RIMA YNC
lEXYMHTOM SQUAl1E ?7'H (f12) 663--~~20
PERM~.T ~5~~.}TYPE: TYPE OF WORK: ~EP~~~
DE';CRIP110N sTCfINQ
. •
F #NRt
y.xt . 'S } 'j~• ' ~ rL,~7C'~~ .Y 'sY-'~ ~ j = f { ' ~ 7.. ~ -~W~' ~ ~ r ~ , ~o''- f ~*w x~
~ 1~ t ,1- ` -M ~ ~L y~y ~SY ~ . . ts, p3~
~-.L ~ ~ - ~-'`Y . _
ti~:~ F _ 4n ",.4 . ~ ~ s`7 ri ~ ~ , y,,i~ _-v ~"'F'~„~ ~ •y Y~r.. ~.M,
_ . X ~ ~ s.'''fi f'~\K-u'. . . j~
. _ ~ ~ ~~~n,:~~- ..r~: ~.f ...^-~ts;f ~i`~t~'S~~• - . . . - ~
P~rmtt Mo. . Psrmk Ho1dR Dab Talepfqne s
SJ1N
PLUMBING
HVAC
ELECTRIC
ELECTRIC
InapeCtlo~ D~te Insp. Commanh
Fodings I
FaubeNon -
Ftaming
Roofing
Rough PIb9•
~ ~9•
tsul.
Flreplsoe
Final Fftg.
Oreat Test
Fnal Plbg. Pibp. IrtspecWr - Notily Plumber
Const. Meter
N
EnprJPlan
i.r s
e~. F~,ei 7 _
~ea~ ~a.
oeck Pina~
Well
Pc Dbp.
RESIDE~IYIAL
B~ti1La1NG PERMIT APPLt~~t7~1~1~ ,
, crr~r o~ - ,
~ ~ 9830. PILOT KN09 RO - 551~ ~
~ ~ 651~681-4~75. - ~ . - _ ~ i
I _ ~ ~ t_~~
. . .
NNr.~Paa~CUCitaroRbuireuf~i~ls / ,e~ I
k 3 regia{~d s~e suiveya ~4uiri~.aq,~ I~:b~ i~,.09. R txllquse: and_~±ophd ~re~s. +?CUpI~€:oFpteR ~ .lort~t:~ ~
(2Q9G tt~inwln:lat t~arage aAoWedf . 1 S9ioEEae~gy:~ ~ et~o~s -
• . 2 co~s:of ~~len sho~r~ ti~m~&wfnilow ~aaed :tound ~eaign. e~.} • i; aiteaurrgy 1~rentt~iqr~ddiGtils~~ ~b~lcs : ` ~
a~t of Enerpy Gakuletio~s . In~de~s Yhome aetvdd t~~Aioas: ~
~Y ~aYE~etn~
• 3~0piescf~Tte8Wa6a~ir~lonPamN~loEp[at~9dafler~l'li'93 ~ I
•~t~m Jast D~eil Qpli~xis sielscqan sf~et (bk~gs w.qb 3 or lasa;ur~tlsy .
-
l:~f~ , ,
~ ~ ~ ~ _ I
DAt'E: ~ _ _ I V~?1:U~4'r'ION /~r~ ~C~ : _ _ ~ . . ~
~og srr~~~~~~ss :~~"I .S~ v~ nrn~ ~ . - ~ _ _ - - _ _ .
lF MU~'F~-~AMIL-Y BUILDINC~ FlQV1[.MANY l~t~t1'~? i
,
PR{1PEk'iY ~W~1 ~ F1' , ~c~ f ~ o _ -
_ - _ ,
x1f PE OF tNQRK _ ~ . , ~v (.i1 ~vevs _ F~R'~~l,4GE~S) ~v.' ~ -
. ` . _ ~
.~kPPL1~AN'f ~ ~f 3'S ~ nt~ . .S ~ ~ . ` PHON~
- - _ - - - -
~avR~: ~ - ~ ~ .~t ~ f i~~` _ _ t~~
_ !
- - . . - ,
'P`AGER ~ . . . .C~L~ PHONE:.~ - - ~ - Fi~lE' ~ _ ` _ _ _ ,
- - ~
i
- - - _ - ,
- - ~
' I~I~V RESID~EtVTIAL BUILQlNG ONLY - Fllt OUT ~~11AP~~'t'~L~~ ~ ~ - ~
. ~ , ~
, ~
Er~er~y.~ode ~~egary _ ~?11~tF.SQTA RUL~S' 767~};CA1'~GORI~ 1 - ~ ' ` I
(~tiedc. o11g) F3e~identia~i Ven.~l6~ioct,.CategOry 1 WaFta811E8! ~brM1L~d~~ r '
- F~tergy ~nv~elope, ~alculatic~ras:~brnitt~i ~ :
` 11~IINNE.SaTA~~titLFS 7.~~4 [ ,
-
- ~Naw ~r?~rgy Cade 1M1l~edcshaet S~wh~mitEed
Plumbing Contrcctor _ _ F1~c~~ - , -
I't~tmbit~, Syst~m'In~uc~~s. ~'t'~- Sol`tener _ C~a.~ 5p~er ~ee; ~ ~9d.06 ~
- j
W~r I~eater i~o. of ~2~~Ir Ba~
- -
~ ~14. c~f Batl~s
, - ~
.
' •AAechaniieal Co€rlractor: Phan~ ~ . _ - - - ~
11+ieel~ni~~ S~em~Lncludcst~ _ Air ~and~ti~anirig = F~~ec_ $~7U:0(_) ° -
_ Heat Reca~eF}? ~ysC~~ - ~
i~
~ ~
Sewerf~lVafer~C:ont~o~or.. P~one~F ~ - I
. _
- - - - - - ,
Ail abave in~ur~tatior~ must be s~ubm~tted Pria' ~a;Pr~ssing: of. aPpiicatton. _
i t~~eby acktittvr~gdge th.oi i hav~ r~oCJ this,dppiicatian; s#at
_e fhat fhe inforrnc~it~ri is ct~'r~C~ti~d agl~.ft~. ~pty I
v.~itE~ op o~~F?lica(al~Stdte~+~f Min~esata Sfiatutes ond Ctty~a# Ea~ c~t'~t e~. - ~
. .~r ,
Signatuceof~Appflcant - _ - . _ ' i
. ~
- , i
~Ce,[tifi~tes o~ S~tvej~~Rec~eived ; 7~ee Preserva~o~ Pfan~Rec~~ved i W@t. ired
Upt~t~ed j~Gt~
~ ~
oFFrcE us~~ oN~~
.
Q'O~i fioc~nd~tion O 07 45-p1ex L7 13: ~6-pl.ex. :O- •2(? 'Poo! C7 30: Acx~essornY ~9
0 02 SF D.walling C7 O8. 06-plex ? 1'B Fireptaee E3: 21 Ac~rch (3ysea:~ t] 31 .~~cE. A11t~:Mu~
Q 03 0.7 ,of _ plex ~ 09 QT-plex .Ca ,.1:7 Garage 0. 22 Fo[chtAddn;. Ea-sea.:) ~ 93 ~itl..A~t:- ~F
t7 t?4~ 02-plex ~3: '!0 0.8-p{e~c ~ 18 Deek ~ 23 P~r~h.{scraened) O 36 h?luld
f~ 05~ Q3~Ptex D i i' • 1'0-plex 0 1'9 4ow~ L~vel ~.24 ~5iorm f7~ama~±a
~ O6 ~A-plex D; 12 12-ple~c Ptbg~Y or _ N O. ;25 ~,Mis~etl~neous.-
+I
~~1 N.eYV 0 ~ 35 Int~ rmpro.verr?erit C]_ ~8 D~maltsti ~Inferiprj .44 ~iaiiir~p.
D a2~ Atldf~on O'~ ~NSove Btdg, ~ 42 `Demolieli (F~undaCion). O~15 Fice °f~epair
D' 33 AI'kecat4on O 37 DsmolisFr {Bldg)". O d3 RetQO€ ,C`! 4~ 1~11indowslDo4rs
L] 34 R~pla~emenf ~ "D~molitl~d (~trtt~a ~id'g ~~tyj -(~Ne PCA h~do,4i1~ to. applicant. ~ I
~
Vaiuattnn Occupancy
NtC/ES Systerrt
C~sus Cocte 7~oning ~~y VVafer
~SAC'Uriits- Sto~~s _ ~OOSte~,~'ump~
Nbr, af Unils 5q.. Ft. PRW'~
Nbr: crf B1dgs~ Lertigfh ~ ~ire~Sprinklersd ~
Typ.e ~f Const V1/idth
REQU(RED: I~iSPECTiQNS
~ Pootings (new bidg~ Fina~l7C.Q:.
Fc~otings :(dec#~) _ FinaUN~ G:lJ:
_ Fuotl~gs (~ddatio~} ! Piwnbia~g
RozuulatiaA H1~AC
_ _ i
Drain T'~Te:
Raof Fee~&.VW~Lesr Final Othcc
^ ~:iaming- - _ 1'00] ~ Ftgs _ Au'/G~s Tests _ Fu~t I
~ Fiieplacs _ R.L _ ~'Test _ ~it~ _ Si~.ng ~tWCCo Stot~e
_ xnsul~ttion _ _ Wi~do~+s ~~ew/rcp~se~at)
.
~Apprs~v~i.By~ , ~uilding ~nsp~or
Base Fee
3urcharge
~Pl~n Revievv .
MCIE~ SAC
~C~. ~C .
~~1later Supply &:Stor~ge _ ~ ~i
~&1V11 Per~r?It $ ~ur~t?ar~e
T'~eaitmerri PI~nE
~Ptumbing Permft
rMe~hanis~l Pecrr~it
~Li~ense ~.earch
Co~'res
Okher
Ttzt~l
This repuest void ~j~/~ ~ ~ $~~,fO~ff'~ . '1',J.O/.1 ~ ~,p2~ zl~j"
78 months trom
' ~r ~,~.~~i~
~ i. ,
Raquesi Date ' Fire No. / Rouph-'-Insuec[inn
~ ~O• ~ Peq ' ed?G ~ftcatly No Wili Notitv.Insoec-
Yes ?No ~or When Ready
- icensetl Elecvical Contractor - L
. I hereby reqvest inspection of abov
? Owner electrical work installed at: ~ s~
Sireet Adtlress, Bux or Houte No. CitYr
95~ .5~v2nnc~/7 ~ 4LtCR''7
ecl~on o. Township Name or No. Rxnga Nn. C ty
.~z koz~i~
Occupent (PRWT) Phonc No.
'YY2~r..-~,'n. 6E~rE~, /.~w~ld~~3 33.~ -~.3~
Power pplier - - Addrr,ss '
~Q~~P{A ~ ~-Q i r>v~n f('i n .
~ ElecRic I Cnn[ractor ( ompany Namel Comrar,tor"s LicenseNO.
~~.1 ~.CL`h~~~ ~C. C..F7 • ~ 4~ ~ ~ • - zT
Mailing Address (CoMractor or Owner MakinP Ins[aila[ion)
,a . ~L~1~. ~f71 d~ ~?~,SL~i~~c.°.
Autho~ized Sign ur0 ICOnUactor/Owner MakinB Installatlnnl _ Phunu Number.~ /
Q ` "rS~S~
MINNESOTA STpTE BOAHD OF ELECTflICITY ~ THIS INSPECTION NEQUEST WILL NOT
Griggs-Midwoy eldg. - Room N•191 . BE ACCEPTE~ BY THE STATE BOAHD .
762'1 Vniversity Ave.. St. Peul, MN 55104 UNLESS PNOPEP INSPECTION FEE IS
Phone (6t2~ 297-2177 , , ENCLOSED.
~ i.... ' , ~u l~J
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_ ' ' . ~ _ , . ~ . - , . 1
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/J/(o~,Y7 REQUEST FOR ELECTRICALINSPECTION _ Ea-ooooi.o
'~,~.2-2~
_ - ' See instrucpons for completing ihis form on back of yellow~copY.
~ L~-~ '"X" Ae/ow Work Cavered by 7his Request .
A~1p Rep. TyOe of Builtling Applioncee Wirad EpuiUment Wired
Home ~ F4ange Temporary Service
Duplex Water Heater ~ LiGhtiny Fiztures
Apt. Buildin~ ~ Dryer ~ ,Elec[nc Heatin
Commercial Bldg. Fumace Si!o Unloader
InAustrial Bldy. - Air Conditioner Bulk 61i1k Tank
Fa~m ~ Othm ISpeci y Othor ISUecityl
~her Simnfy O!her ~ Oihi.~
ompute lnspectian Fee Below
p Fee SarvicnEntrancaSiie p Fee ~ Featlers~SubfeaAars # Fen Circul[so
~ 0 to z~0 Am 5 0 to 30 Am~s 0 tn 30 Am s
A6ove 20D q~nps~ 31 to 100 qntps 31 to,100 Am ~s
Swimming Pool Above 700_Amps . Above ~100_AmVs
Transformers ~«~gation &~orr~s Partial; O!h
Signs Special hispection °
~ ~ RerrNrks . S[f[j,~ TOTAL rF~
0 ;J ' i
Roogh-in . , ~`~~~p, I, the Ela .cal
~ - iJ~7 'Insoector.M1e~eby
~ cerliiv that the above~
Final '
~~~C nspection has been
~ V made.
70isrequestvoi418moNhalrom ~ ~
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CITY OF EAGAN ~
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55,2, N- 13234
PHONE: 454-8100 ~7 ~J
BUILDING PERMIT ReceiptR B
7obeusedfor SF DWG/GAR Esiva~ue $$Z•000 Date FEBRUARY 18 1987
SiteAddress 951 SAVANNAH RD Erect ~ Occupancy R3
Lot~ Block 2 Sec/Sub. LEXINGTON SO Remodel ? Zoning Rl
Parcel No. 4TH ADD Repair ? Type of Const V
Addition ? No. Stories
w Name MARVIN GEORGE BLDRS rv~ove ? Length 60
Demolish ? ~epth?
Q
p Address P' O. BOX _ Int. Impr. ? Sq. ft.
Ciry PRINCETT~IbVne Instau ?
o Name SAME Approvala Fees
Address Assessment Permit ~ 440.50
~ City anone Water 8 Sew. Surcharge 41. 00
Police PlanReview Zz0.25
Fi Name Fire SAC 625.00
Address Eng. Water Conn. 5Z 00
< W c~ry Pnone Planner water Meter 67 . 00
Council Road Unit 305.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. Tr.PI. 180.00
information is correct and ag~e to comply with all licable State of
Minnesota Statutes and t~7 n Ordinance~. APC Parks
~ Signature of Permittee Vaf. Date CopiOS~r,~ 5
Total ~L 4U.S
A Building Permit is issued to: I~]ARVIN GE RGE BLDRS on the express condition that
all work shall 6e done in accordance with all ap 'c ble State of Minn a Statutes and Ciry of Eagan Ordinances-
8uilding Oflicial -
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~~~7rr Control No. • 0 9 g 0
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~ CITY C)F-~AGAN
3830 Pilot Knob Road PERMIT TYPE: g u i ~ q x Ne
Eagan, Minnesota 55123 Permit fVumber: 0 013 21
(612) 681-4675 Date Issued: 0 8/ 2 5{ 9 2
SITE ADDRESS:
951 SAVANNAH RD
~ LpT: 1 ~ BLOCK: 2 .
LEXINGTON SQUAf2E 47H
DESCRIPTION:
{ sxoxa~
~~8u3~1c~`iTng Permit 7ype SF (MISC. )
~ BuY*ltlin~~~Work Type . REPAIR
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REMARKS:
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FEE SUMMARY:
VALUATION $9,000
Base Fee $108.00
Surcharge $4.50
Tatal Fee $112.50
CONTRACTOR: - Appl~cant - ST. ~I OWNER:
AMERICAN REMODElIN6 INC 15530020 000240 JEANSELME BRAD
37@0 ANNAPDLIS LN 951 SAVANNAH RD
PLYMOUTH MN 55447 EAGAN MN 55123
(612) 553-0020 (612)686-0928
v + , e. ~ _ e~,
~ ~ X hei^eby acknowledge Yhat T ha~e reatl this applica*tion and state thait'the
,x : infor.matzorn.~is correet~a;nd eg,ree.to„e;bmply,.vwith a11 appxl3cab,le, State~~o~ Mn:~^;"
Statu;tes anii C~ity.~;'of E~agan; Or.d~°inances;~ t ~
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A~T/PERMITEESIGNATURE ~ -~SSUED Y: IGNA RE
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CITYOFEAGAN PERMITTYPE: BuI~pIN~
3830 Pilot Knob Road Permit Number: 001321
Eagan, Minnesota 55123 Date Issued: 0 8/ 2 5/ 9 2
(612)681-4675
SITEADDRESS: ~or: i a~ocK: z APPLICANT:
951 SAVANNAH RD AMERICAN REMODELING INC
LEXING70N SQUARE 4TH (612) 553-0020
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) REPAIR
DESCRIPTION SIDIN6
~~iC~' O.~ OfiE'''Gi~' QQ.'~50
FINAL -
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PERMI7 # CITY OF EAGAN /O~ D
REACTIVA7E Y 1992 BUILDING PERMIT APPLICATION
. ~ ' 681-4675 /1 . ~
SIN6LE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of.
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date / /7~ Va~~ation of work Q8
Site Address: c=~~t~2,c-~C~ /2e~
. STREET SUITE /
Tenant Name: (commercial only)
IAT J_ BIAdR SUBD. P.I.D. k
~,I!Q,(,pl~ ~ U2tt ~
Descri tion of work: /L ' j
The applicant is: ? Owner ~ontractor O Other (Deseribe)
Name C~it~~.°//lri~ ~7Cc~Q Phone r~~o•L'~9~~ .
Property. - F~RST .
Owner Adaress ~va-,~~cQ~ JLa'
STREET ~ STE N
City _~Qa,Q-~(- State Zip ~~~•3
Company 7ri E~~,C a4~~l~,ta,' Phone ~020
Contractor Addres~~od ~~~a-~~o /~~~L.~ License #
~N~
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City ~C~~~l state ~ Zip ~~`~s/`~
Company Phone
Architect/
Engineer Name Registration N
Address
City State Z;p
Sewer 5 water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the ioformation is .
correct and agree to comply with 11 applicable State of Minnesota Statutes and City of
Eagan Ordinances. C-~
Signature of Applicant: ~
' ~
OFFICE USE ONLY III, _ ,
BUILDING PERMIT TYPE II , r:~
? Ol Foundation ? 06 Duplex ? 11 Apt./Lllodging ~~>"`-0~16"Basement finish
? 02 SF Dwg. p 07 4-Plex ? 12 Mu1ti.~~Misc. O 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage%Accessory ? 18 Comm./Ind. ~
? 04 SF Porch ~ 09 12-Plex ? 14 Firepl~ace ? 19 Comm./Ind. Misc.
O 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
' II ? 21 Miscellaneous
II
WORK TYPE iI ~
? 31 New ? 33 Alterations ? 35 TenantlllFinish ? 37 Demolish
? 32 AdAition ? 34 Repair ~ 36 Move ~I
GENERAL INFORMATION II
tonst. (Actual) Basement sq. ft. II' MWCC System
(Allowable) lst F1. sq. ft. I City Water
UBC Occupancy 2nd F1. sq. ft. j~ PRY Required
Zoning Sq. Ft. total ~I Booster Rump
/ of Stor;?s Footprint Sq. ft. Fire Sprinkler
Length On-site well I~ Census Code
Depth On-site sewage Ij 5AC Code
APPROVALS I!
Planning Building . Assessments
Engineering Variance , ~I
iiEG1UIRED INSPECTIONS If
, il
0 Site ? Footing O Framing ? Insulation
? Wallboartl ? Final ? Draintile~ ? Fireptace
• II
Permi t Fee - v.i~cs«,: g
Surcharge I~
Plan Review II
License
MWCC SAC II
City SAC II
Nater Conn. I
Mater Meter . I~
Acct. Deposit II
5/W Permit
S/W Surcharge ~ I~
Treatment P1. I'
Road Unit ~
Park Ded. '
Trails Ded. (
Copies
Other - i ~
Total: ~ II
SAC % II
5AC Units !I
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*?aCYl^?: PAYMENt' OF F'F~ AT 1~ OF *
C I T Y O F E A G A f~ *
, APPROVAL OF PF~2PffT. r
APPLICATION FOR PERMIT * *
* INSPFXTION oF ~ES~i AAID/~t 4~TER z:
x*. IASrAr.ramr~NS FTII.L NOT HE SCFIF4 *
SEWER AND/OR WATER CONNECTION P~T ~
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**************.*k.**x***x**.#*~.****~
~ P ease Print)
: ~ 1) PROPERTY ADDRESS : ~ ~ ~(i U Q a I ~ -
LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parcel ID
IF' EXISTING STF2C'C1i72E. DATE OF ORIGINAL BC~ILDING PERMIT ISSI'ANCE: ' -
~
Nbn YearT .
PRFSII~lr ZOTIING/PROPOSE~ LTSE:
~ COP4~RCIAL/REPAIL/OFFICE ~R-1 SINGLE FAMiLY
~ IPIDCSTRIAL ~ R-2 DL~PLEX (Rt~,a Onits)
~ INSTITL'TIONAL/GOVEk~NT ~ R-3 ZUWDII~iOL~SE (Three +'tlnits) ( Lnits)
q R-4 ApARTN~IT/COPIDON1tNIUM ( Units )
a) ~
Nl~I~]E: ^ G 6- ~ U~ C
• ADDRESS: 3 0'
~A~. Z~: ; 5'SS3 7
~7 ~J
PHONE:_ ~ 3d~ ~:5 7
• u~: NAh~: J frt For City C~se
v/~.~ " ' P1umUers License:
ADDRESS: p I ~ ~ d ub\~S ,v Active
.^_ITY, STATE, ZIP: ' ~pired
i;; ( o U c~ ~Sq~
4~ tvot recorcle3
PHONE: ~
j ~ MASTER LICa1SE# ~ St~a
f~initial
2.
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NAPIE' ~r'' ~ a~
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_ P,DDRESS:. p ~a_
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CITY, STATE, 2IP:r Y`~Vl' ~ ~
PHONE:_ ~ ~ d. ~ ~
V ~5) u a.. ~ a: • : a • a• •
CONNECI'ION 7l~ CITY SEWE~2 ~CObIIdF7GTION 1U CITY WATER ~ OTf~R .
6) r ~ PLEASE HOLD APPROVID Pfi'RMIT FOR PICK-PP SY ONE OF ABOVE
~ PLEASE L APPROVID PERI~IIT TO 1, 2, 3. 4, ABOVE
' (Circle"one) `
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. F'OR CITY USE ONLY ~
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- PERMIT # ZSSL'ED ;
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Pd w/Bldg. Permit FEES:
$ $ (G~ S~ SEWER PERMIT (INCLUDE SURCHARGE)
I~
$ _ $ ~G " ~_z% WATER ,PERMIIT (INCLGDE SL'RCHARGE)
$ ~ 7•U~' $ WATERIMETEi/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ SEWER TAP ~
$ S /`.S ~ Ci
7~ ACCOUNT DE IIOSIT - SEWER
e
~ ' $ S ACCOL~NT DEPOSIT - WATER
$ .`a 7 S ~ /~7~ $ WAC
S ~z~~~ ~
$ SAC ~
$ S TRL'NK WATER ASSESSMENT
$ ' S TRC~NK SEWERI ASSESSMENT
$ $ LATERAL BENEFIT/TRL~NK SEWER
$ $ LATERAL BENIEFIT/TRL'NK WATER
$ WATERITREATMENT PLANT SLRCHARGE
I , I~ - ~
$ $ ,~C?. U OTHER: ,~1'_ ~c-L'~~ z+Z C~-~r~,,c~
~ ~ ,
S I'> ~ I 'o-~ $ C~C.' TOTAL ~-ft~~ _ o~ _ '
y 73z-~~~/
RECEIPT RECEIPT V
~
DOES UTILITY CONNECTION REQLIRE EXCAVATION ZN POBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
~ ROADWAY" MOST BE ISSL~ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
1
SOBJECT TO THE FOLLOWING CZ~NDITIONS: I i
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APPROVED BY: ,Q~~,~,J ,~C1_~~~~ I
TITLE: I II
DATE: _ ~`7~~~~ ~ (
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1987 BQILDING PERMIT APPLICATION - CITY OF IIAGAN
SINGLE FAMILY DWELLINGS
ffiCLQDE 2 SEPS OF PLANS, 3 CSRTIFICATSS OF SOSVEY, 1 SST OF EDiSRGY C9LCDI.ATI08S
NOTE: ADDRESSES FOR COBNEH LOTS - CONTRACTOR/HOHEOWNEH HIIST DESIGHAT6 WHICH ADDSESS
IS DESIRED. NO CHANGES iiILL BS ALLOWSD ONCB BDILDING PERMIT IS ISSOED.
MOLTIPLE DTo1tELLI~GS - RFSIDENYIAL EENTAL ONITS FOR SALE OHIYS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF Si1RVLrX - CHECB iiITH BLDG. DEPT.~
1 SET OF ENERGY CALCULATIONS
COI~IlI6RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2~000 LANDSCAPE SOND'
~Z~ ~x~
To Be Used For: 4.G ~-2 ~'M~~~valuation' Date: ~ 1 6~
Site Address ~-rj J SGgVl~I6Jl~U~4N R OFFICE QSE ONLY
Lot ~ Bloek ~ On Site Sewage_ Oceupancy ~~3
I~,, MWCC System ? Zoning (Z~~
Pareel/Sub ~--e,~`•~.a -7~V, On Site Well Type of Const
1~,,n City Water ? (Actual) ~
Owner r"~ ~KU~~ (~{~~c~ ~ ~~j~ ~~-p C (Allowable) ~
PO C1^ ~ # of Stories
Address I,CI- Length Co0
Depth 3g
City/Zip Code ~~j~(~p~[(7~:~~~ J 3~~ S.F. Total
2~1 (C Footprint S.F.
Phone ~ J o~`~~ APPROV9IS FSES
'^q,, So
Contractor l~~S ~ Y/Q V"e Assessments Permit 9'~}~, -
Water/Sewer Surcharge 4
Address Police Plan Review 2 Zo.?S
Fire SAC, City IDO.
City/Zip Code Engr _ SAC, MWCC S 25.
Planner Water Conn 5 25.
Phone Couneil Water Meter ~n~.
B1dg Off Road Unit 305.
Arch./Engr. APC Treatment P1 I`b0.
Variance Parks
Address Copies '
TOTAI. G7.r/03.
City/Zip Code ~
Phone ~l
2~ x 3~ ~ l o~ 3 x 58 r v 7~- i rr A~ r.,~
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C•rtiticst• oi 1~nrvey for MARVIN GEORGE BUILDERS
~
Searings Shoan are Assu~ed ~ ~
o Denotes Tron Monument
o Denotes ~ Foundation Corner NuD PROPOSED ELEVATIONS NORTH
+ 9ao•o Oenotes Existi~g Eleration ~
oo•~ Oeiwtes Proposed Elevation 7op of Block gq;,o ~
Denotes Direction of Surface Drainage Lorest Floor 8as.o
Denotes Drainage and Utility~Easem~ntb ~ Garage Floor 892,~
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MINNESOTA STATE BUILDING CODE DIVISION
EXTERIOR ENVELOPB AVERACE "U" COMPUTATION
- ~ ' -
(iWNER_~AR~1iN CnP~7K C'>~ ~ ~-O~_ ~
SITE ADDRESS
CONTRACTORMIh~VS(~•_) (~a*^~?l~~ [~itt'~d~SDATE YHONE
Determine working square footaRe of each:
1. Total exposed wall area..... Qd sq. ft. x~= 1 9 S•~~
p r-`.
2. To[al roof/ceiling area..... ~a,'~~ sq. ft. x'Qy~ =j;) p~~.__
.~a ~
t ~v~p~ . ~
Total exposed wall area above floor =
I
a. Total wall window area . . . . . . . . . . . . . . ~ pSo'
b. Total door area . . . . . . . . . . . . . . . . . . . ~--f'~
c. Total sliding glass door area. . . . . . . . . . . .
d. Total fireplace wall area . . . . . . . . . . . . . . -
e. Tota1 wall framing area (average 10%). . . . . . _~La
f. To[al net wall area above floor. . . . . . . . . . . 11 y ~
g. Total rim joist area . . . . . . . . . . . . . . . . ~~a
~~To,tal exposed foundation area = ~ ~ ~
h. Total foundation window area . . . . . . . . . . . . 'z
i. Total net foundation area above grade.
Determine "U" value of each wall segment:
a. ~~5~0 g~~U~~ , 3`~ = 3. a l
b. ~ a X .,U„ , ~r3 = c~ ~
y 2- X „U„ , `1 ~ _ ~ .
d . X _
e. ~a-O X~~U~~ , ~ ! = I~
f. ~5_ X~~U~~ i d 1 = S. O~
;
~
,
~
,
3
{
l
r_ 8: i a.a X.,U„ , oy 1- S, c~
,
~ n. - X ,.U„ - . -
~ I 1~ A 11U11 ~ V l-%~ y
~~L~
O
3. TOTAL . . . . . . . . . . . . . . ~ I ~ o.RD
[f item A3 is the,same as, or less [han item U1, you have met the intent of SBC 6006(c)2:
Total exposed roof/ceiling area = I~ vJ oZ
j. Total skylight area . . . . . . . . . . . . . . . . . D
k. Total roof/ceiling framing area (Average 10~) - a~`,
1. Total net insulated roof/ceiling area . . . . . . . . ~
De[ermine "U" value for each roof/ceiling segmenCt
j. x,.U„ , 3~ a a. c~~l i
k. ias X „U„ ,aa(o 3.aS
~ ~ a~ X„U„ -o~a a~I - 8 y -
'v. TOTAL . . . . . . . . . . . . . . ~ O ~ ~
~f total of item !i4 is the same as, or less than item If2, you have meE the intent of •
SP.C 6006(c)1.
Alternate Building Envelope Design
'":'o utilize the to[al envelope system method, the values established by the sum of; itema
d3 and ~14 shall not be greater than the sum of items O1 and 112. ~
1.. ( L~/~D +2. 3a.~~ ° V`~V•~ ~
3. I~ca.~o +4. 30 ~3 = ~ 7~.53
, . .
~
I
I
`I 153y ~ ~ ~
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Piease complete for modifications to existing residential dweliings.
Date / / c~ ` n,,(
Site Street Address 15 I ~?~(l ~/l K<1 • Unit #
Property Owner ~ ~ulJ `~0.~. Telephone # ( (~I ) a ~I ~ 1 ~ ~J~I
Contractor ~~T~11J1S W~'Q'~jE Teiephone# (ialal~~-~~~
Address Loi~l (~Uf S\r..) c~cyH ~C~+v~SC~'t _ state~"~~ z~p5535D
The Applicant is: _ Owner ~ Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (exciudes water softener and/or water heater--complete next
section if instailing these appliances).
_Septic System Abandonment
_1Nater Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
~awn Irrigation _RPZ ?PVB ~ew _repair _rehuild $ 30.00
State Surcharge $ 50
Total $ ~3 , 50
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be..in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
' ~
: 1
~ ~ _ ` ~
ApplicanYs P~inted Name ~ ApplicanYs Signature
~ ~,:ov 1 w ~~05 U
4"~ 1
Jr r _
~
I
~
~
~
i
~
. i }~-~~i,
Clt of Ea~a~ ; Permit# ~ ~
~ ' I 3s
r 7~" ~
I Pertnit Fee: ~
3830 Pilot Knob Road ~ i
~ Date Received:
Eagan MN 55122 i i
Phone: (651) 675-5675
~ staff: ~
Fax: (651 ~ 675-5694 i _ _ _ _ _ ~
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~-I' a 2- U~ Site Address: ~ <<~/~ " "
~
Suite
Tenant:
RESIDENTlOWNER Name: r~R~ Phone: ~f~ 2~9 ~O
. Address / City 1 Zip: 7 rl S~ +~c> h ~ ~ 1 ~ -
Applicant is' _ ~~er Contractor
TYPE OF WORK Description ofwork: ~.~cu~ ~~~C O~ ~r` r=r i
c r~->~^c~
Construction Cost: ~T oG Multi-Family Building: (Yes _I No~)
CONTRACTOR Name: Tr~r/r ~ License 2 0( 7~
Address: ~ ~
City: /n - State: _,M Zip: ~ S ~
-
Phone: - 3 3~ - C
I/ ~ Contact Person: _,%-(c!
~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 mo hs, has the City of Eagan issued a pertnit 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}~tlocume»ts that~you submit~ are consrdered to be
publ~c~
farmaf~on
~iiPnrt~ons of
; th`e m`formatron ~may be class~~ed as non
public
~af you'prov~de spe~ic r~~easons that w;
~u
Id p~? ~K+~~ ~$!'~o
,I 'd ~ i ( I ( ~:~u m ~ ~3La~-~~..-~~i,_ a,_,+a
~ . f ~ ,~i ~conGucie tFat~the are fraale
secrets.~~~-
~ I hereby acknowledge that this information is wmplete and accurate; that the work will 6e in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a pertnit, but only an application for a permit, and work is not to start without a permd; that the work will be in
acwrdance with the approved plan in the case of work which requires a review and approval of plans.
x ~ X
ppp~'s Printed Name ApplicanYs Signature Page 1 of 3
~
~
For Office Use
~
Permit Uc,g
City of Eapfl Permit Fee: 36-, 767
1
3830 Pilot Knob Road
Eagan MN 55122 Date Received: /
Phone: (651) 675-5675 I
Staff:
Fax: (651) 675-5694 I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: a 2 C> Site Address: U / < e-i 1/-'
Suite
Tenant:
RESIDENT I OWNER Name: 4&42 Phone: ~f/ 2 ' 7cs .I'9
Address / City / Zip: 7 1/ e. ici h 1~ ~=1
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 6 C27~~
Construction Cost: F U G Multi-Family Building: (Yes / No
CONTRACTOR Name: 7 e1-eJ' License 10 ?c'7 a l
Address:
City: ~1/r "fir, r State: A Zip: 5'503
Phone: Contact Person: ~YCr-_1-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 mo s, 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.
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.
App rcant's Printed Name Applicants Signature
x~ x
Page 1 of 3