4564 Scott Tr C'' 7 OF EAGAN SEWER SERVICE PERMIT
8T95 Pilof Knob Rood PERMIT NO.:
Eogan, MN 55122 DATE:
Zoning: No. of Units:
Owner.
Address: -
Site Address:
Piumber:
1 a~ree to comply wifh the City of Eagon Connection Charge:
Ordinanees. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: . Date Paid:
CITY OF EAGAN WATER SERYICE PERMIT
~795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55124 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber.
Meter No.: Connection Chorge:
$~=e; Aocount Deposit:
Reader No.: Permit Fee:
1 ayres to oompfy wilh H~e City of Eagan Surcharge:
O~dinanees. Misc. Charges:
Total:
gy Dote Paid:
Date of Insp.: Insp.:
~ ~~~~"-IC~ '~'r?~~~~
~ ~ CITY OF EAGAN
` ' 3795 Pikt Knob Road Eogon, MN 55122 N~ 6 ~ ~ 6
. PHONE: 494-8100
'BUILDING PERMIT Receipt #
To be oaed for Est. Vulue Date 19
Site Address Erect 0 Occuponcy
Lot Block Sec/Sub. Alter ~ Zoning
pa~~ # Repofr ? Fire Zone
Enla?ge ? Type of Const.
W Name Move ? # Stories
Z q~~~ Demolish ? Front ft.
3
° Grnde ? Depth ft.
Ci Phone _
°C Nome App~ovala Fees
,O
o~ Address Assessment - Permit _
Ci Phone Water & Sew. Surchaige
Police Plan chetk
~W Name Fire SAC
Address Eng. Water Conn.
6W C~ pho~ Picnner WaterMeter
Council Road Unit
I hereby acknowledge that I hove read this opplicotion and state that Bldg. Off. -
the informotion is correct and agree to comply with all applicable APC Total
Stote of Minnesota Statutes and City of Eagan Ordinonces.
5ignature of Pertnittee
A Building Permit is issued to: on the express condition that
all work shall be done in acco?donce with all applicuble Stote of Minnesota Statutes and City of Eagan Ordinonces.
Building Officiul
•l ~
~~ea~k # pob Isr~d PMSitfM
Plumbing /99p /
Mechanical
~c' ~ .t~ ~ .x / ~ ~n-z ~.t~_ /
iNSPECTtONS DATE INSP.
Rouyh-In fincl
FoOtingS Date Inap. Dafe Inap.
Foundation _ Plumbing _7/'~ ~~--~4-
Frame/ins. ~y Mechanicol ~ ~ " "
Final / -~0
Remarks:
: , , crnr oF ~?~AN
3795 Pilot K~ob Roed
• ~se~, Mi~ae~ 55132 INSPECTOR NOTIFICAT?ON
No. Phone: as~-e ~ oo R E Q U I R E D B Y LAW
- PERMir FOR ALL INSPECTIONS
?-23--'>r ~
Date: Receipt No.:
Single I
Site /lddtess: ' ~ ` Residentiol
i'. Cec?ar C1iff I
Lot Biock Sub/$ec. Multi Res., Comm./Ind.
~ ' ~9 Z77C. ,
Name ~ New/Alter./Repoir
` `i7c;'~ ~'~tCtl@17. ::d.
~ Address Cost of Insfcllation
~rairie, `s, 4?7-~'~2'?
Ciry ~ Phone: Permit Fee
' ~?Z't' ~1~? !~'1'.L'~:;i~~E Surthorge
Nome
.
~ Address ` r' Q~;'_ ' _ . .
~ . : .
City Phone: Total
This Permit is issued on the express condition tha~ all work shall be done in acmrdance with oll epplimble Stete of
Minnesoto Statutes and City of Eogon Ordinonces.
Buildir?g Officiol
; , crnr oF ~?~AN
• 3795 Pilot Knob Rood
' Eosaw, AAin~esota 6S1z2 INSPECTOR NOTIFICATION
No. Pho~e: 4S4.s~oo REQUIRED BY LAW
FOR ALL INSPECTIONS
,'~.i n? PERMIT
Date: -~g-<~n Receipt No.: ~'?E.
Single I
Slte Address: * ~~ntt - " Residential
Lot Block Sub/Sec. . Multi Res., Comm./Ind. l
Nome =~~=1'.!~: . ~0=183 New/Alter./Repoir
~ Address ~~~~~0 ?2it~hell F:d. Cost of Instollation
Ciry . i"'~ irie, Phone: ~?3r~-`~%~''-1 Permit Fee
Name - ~ Surcharge ~
p~
'6
~ Address S'.j ::ltieF~E c~ ~te _
City ~ r ` ~ , Phone: ` • Total
This Permit is issued on the express condition rhat oll work shall be done in accordance with all opplicable State of
Mi~nesota Stotutes ond City of Eogon Ordinonces.
9_9 g~ ~--a~.~
Buildirq Officinl
~ CASH RECEIPT
~ ~ CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
D A'1' E 1 9
REGLIVE~
FROM
AMOUNT $ I
& DOLl.ARB
~oo
~ CASH ? CFIECK
FOR / ~ ~ ~ ~
FUNO GODE A1dOUNT
Thank You
, B Y
White-Payen Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addit~on ..d r.1 iff Addi _-t on _ ~ot 14 Bik S Parcel~~~~-
Owner Jt~ ~ , i i . ` /1' Street ~~~'--~'3~~V16p`$X3fii8 State Eagan,
U~ Lv ~ S~af-~ r r~ r
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 2 . . . ' '
STREET RESTOR.
GRADING t J$j $4j.3$ j~$.2$ 5
SAN SEW TRUNK ~r~ 42. 2(~ A00978 2
*SEWERLATERAL G i981 2541.01 5~8.2~ 5 2~32 81
WATERMAIN
i~ WATER LATERAL 198j
WATER AREA fi~ SO.66
STORM SEW TRK ~,r ~ 981 405 . 09 81. 02 5 324 . 08 A009788 12 9
* STORM SEW LAT j9Hj
CURB & GUTTER
SI~EWALK
STREET LIGHT
Rd. UNIT 185.~~ 20317 8/6/So
WATER CONN. 3Q5. 2~3j7 $~6~80
BUILDING PER.
SAC
PARK
~"°°~~J° .`1y~'' ~"1 `1~~" s~'° ~ '"4,+ . ~
~ ~ ~ ~ * ~ r T ~ ~~~`~~r~~~~
- .w. ~ - _ .,~i
~ I~~S.S~T~ 1 _"L__~ '__~~,.q _ ~..~~~-L-_ ~s ~4-~b
~_3.1;v'~"~C^j
~ ~ Y, - - - ~ I
~ '-1
~~r#i~tr~tt~e nf (~rru~r~nr~
.~.r ,~h'
~
f; ~Citp of ~agan ~
~'~r ~Bp~pttr#mPnt nf +~utldittg ~ns~rrtum ~
~
~
~ k•
~ ~ Thi.r Certificate issucd ~ur.rtrant to the requiremrnu of Srction 3W o f the U~ii f ofm Building ~
rr~
~Y
Codr entif~ing that at the time o~ lssuanct tbil ltrutture wrtr in com f~liUnct wilh i6e sarious
T~ 4,~
~ ` ~ , .
~6;i ordi~raACer a f tht City rtguluting brtilding con.+iructton ot t+se. For tht f ollou~»~g:
~ ~
~ " 6a16 : s~..
SF DWG B1dE.PemtitNo. j ~
~ ' ~i U~e Cl~of'iratim
M' ~„cu rra R'3 Typ cww~cm, ~ Fi~a zona~ 3 zati~6 nis~M~ ~ 'i
~ Zachman Homes ~~~7760 Mitchell Rd,Eden Prair~
o.~ocs~aa~ co r 1, , Ce ar li ~
~ r
&uldio~ Addrar l.oullty ~y4 > ~
~
~ " : .~-~a , o~.u. ].2-12-$Q :
yr ; eWw~,QOrr,~ ~-t't~i~ ~ ~
! ~i _ ~ iw w ed~sn<uou• ?ucs_ u _ _ _ ~ ~
' i~'L.:i:=.-ta-. - - hiL , _•~1:".1~'J
~ ~ J 3~~~ ~r~
r ~ ~ ~ ~ 7~
~ ~ ~ i.. ' , ~ . .
v
ry`~.~.~1•',~,'~~,~,.,"9rs/?~,a,~sa'.~-+~~L. ' `ses `.~"~1?',~ar'~~s~~,A.i•"~.~"~~'y`~''°~~~~
.
- ~_5~
This request void ~~~~.~J Cp~~~~( ~ ~ / ~a ~
18 months from L a~ 5
~ `7 Q Q
Date of this Request 12-18-8o Fire No. T J~~~+
I, as ~ Licensed Electrical Contractor O Owner, do hereby request inspection o( the above electri-
cal wiring installed at:
Street Address or Route No. 45h4 Scott Trail CityEa~an
Section Township Range County Dakota
Which is occupied by Zachman Home s
(Name of Occupant)
Is a roughin inspection required on this job? No O Yes ~ Ready Now ? Will Call ?
PowerSupplier ~akota Electric~ Address
Electrical Contractor Sunrise ELectric Contractor's License No. 3977g
(COmpany Name)
MailingAddress 4120 83rd Ave. Mpls, Minn. 55f+43
(Electrlcal Conttactar ol Owner Makin9 Thls Installation)
AuthorizedSignature Keith R Hesli PhoneNo. 566-8600
(Electrical Contla<tOf o~ Owne~ Makin9 This I~Stalletlon)
~q[~'~}
~ This inspection requast will nat 6e accepted 6y the
State Board unless proper inspection fee is enclosed.
minnesaca awie noara or uec[ncrt . . .
. ~ Griggs Midway Bldg. - Room N191 EB-00001-02
181l,Jniversity Ave., St. Paul, Minn. 55104 - Plpne 297-2117 n ifi'
.E~K. EE OW WORK CO EREDTBY' THIS EQUEST ION T 9 218
Type of Building New Add. Rep. Check Appliances Wi~ed For Check Equipment Wired Foi
Home ~ ? ? Range ? Tempo~acy Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bidg. ? Dryer ? Electric Heating ?
Commercial Bldg. ? Fumace ? Silo Unloader ?
Industrial Bldg. ? A'v Conditioner ? Bulk Milk Tank ?
p~ oList pList )
? ? ? Heiets) Heh[eers}
O[hei 7
COMPUTE INSPECTION FEE BELOW
Service Enhance Size: e Fee Feedeis&Subfeeders: # Fee C¢cuita: it Fce
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am res
I01 to 200 Am s. 31 to 100 Amperes 31 to 300 Am eres
Above 200 Amps. Above 1D0 Amps, Above 100 Amps.
Transformers Remote Control Ciic. Partial or other fee
5' ns 5 ecial Ins ection Minimum fee35:00-
Remarks ~ TOTAL E~~ .,~v~2 00
I, the Ele 'cal `s~ ~'~certify that ove ' 'o has ade: ~~d
(Rough-in) '
(Final) ~Y~~ (o- /7
This request void
18 months from
r,,al~z- c~ -,S
l!/ RESIDENTIAL BUILDING Up ~ ~ 3-
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemadellReoair Reouirements Offce Use Oniv
3 regisiered site surveys showing sq. ft. of l04 sq• ft. of hause; and all roofed areas 2 copies of plan CeR of Survey Recd Y_ N
(20%maximum lot covarage allowed) 7 set of Energy CalculaUons far heated additions Tree Pres Plan Recd _Y _ N
2 wpies af plan showing beam 8 window sizes; poured found design, etc. 1 stte survey foraddilions & decks Tree Pres Reqd _Y _ N
lsetofEne~gyCalculalions Add'dion-indicateifon-sdesep5csystem On-site5epticSyslem _Y _N
3 copies of Tree Presenation Plan'rf lot platted aRer 711193
Rim Joisl Delail Options selection sheet (61dgs with 3 or less unils
Date~__/.~/ ConstructionCost ~~00~ OD
SiteAddress !/~`G~/ ~°O~ ~l'Qi ~ Unit/Ste #
Description of Work pLC P~R~ cC J~nJ~ c~/1 GIo~ f~
Multi-Family Bldg _ Y c`l~ Fireplace(s) ~a - 1 _ 2
PropertyOwner ~A/~l~icr~.-~ _~liln~r~~t'~ Telephone#(G~) ~P~-~S'S'~r'
Contractor /+/r ~ Sc~~ ~
Address C<<3'
5tate Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan~ _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/Water ContracTor 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 the case of work which requires a review and
approval of plans.
~~/tR/+-t ~C 6~ /7 c~/ .?ri-^ ~i(/~D~-~'~7 c`~~~~
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 OS-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 WindowslDoors
? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to appliwnt
Valuation Occupancy MClES 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 bidg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addiaon) _ 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)
_ Insularion _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies '
Other
Total
CITY OF EAGAN
3795 Pilot Knob Rwd Eagan, MN 55122 N~ s ~ ~ s
, ' ~ PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
Te 6e otad for SF DWG Est.Value 35~000 Dote 8-6 ~9 80
S~te Address 45hG C~ ~ ff V~ w D . Erect ~ Occupancy R3 _
~or ~4 eiock 5 sec/S~b. Cedar Cliff Alter ? zoni~9 Rl
Parcel .fF' 10 16600 1l.0 05 Repair ? Fire Zone 3
Enlarqe ? Type of Conrt. V
s Nome 7.aehman Homas~ 7nc_ Move ? # Stories
~ Z Address 7760 Mltehell Rd. Demolish ? Front 47~ g~~ ft.
Eden Prairie pho~ 937-9520 Grade ? oevrn 3b f~.
Approvali Fees
p Name S27Ile '
Addrea Assessm0li~ ~O-~D. Permit l n5 _ 5f1
r Ci Phone Water & Sew. SurcFwrge ~ R-nn
Police Plan check 52.75
ww Name Fire SAC 525.00
f
~Z-u, Address Eng. WaterConn.30S.00
aW ph~ Planner WaterMeter 6~.00
Council Road Unit 1~°1.~~
I hereby acknowledge that I have read this application ond state that Bidy. p~p 7-30-SO
the infartnation is correct ond agree to oomply with oll applicnble APC Total 1~251.25
State of Minnesota Statutes and City of Eagan Ordirwnces.
$ignature of PertniMee
A Building Permit is issued to: Z2.CY1Iri3ri x01"Il2S ~ IriC. on the express condition that
all work shali 6e done in ordqance wit/F~/~p~ I a plicable S_tate /og Minnesoto Statutes and City ot Eagon Ordinances. ~
Building Offitlal . ~"L~ yv ~i ° °A ~?XJ ~ A ~
n l~ CI'TY OF EAGAN Include 2 sets of plans,
n, ?1
~ 1 site plan w/elevations a
~ BUIIaING PERt~IIT APPLICATIIXd 1 set of enezgy ca7culations.
Do se used For valuation 3~ 0 0 d Daate ?~ZS~/~_
Site Pddress: ~ Y-cuC/ ,QL- OFFICE USE ODII.Y
Lot sl«~c ~ sec./sub. d Erect occupanc.y !1'~ ~ -
Alter Zoning /
Parcel ~lj ~/o ~/J/3 ~/~D l/ T g~~r Fire Zone 3
Fhlarge 7ype of Const. S/
Nbve # Stories
Addres . ~ Demolish FYont y~ r~y ft.
Grade ~P~ 3G ~ ft.
City/Zip Oocle: 1~_
Phone # : ~
3 ~ ~ lSo2 ~ P.PP%NALS ~ I
7~
contractor: 1 t~R.1 assessre~ts ~ Pennit /GS. ~d ~
Water/Sewer S~~r9e / S. D v'
Address: Poliae Plan Check ,.r~ J
Ci~y/Zip Code; Fire ~ r. e u I
Water Conn. g Q c, o d
Phone ~r Wat~r Meter G~J oO
Crnuicil R~d Unit ~ RS, O d
~h.~g. Bldg. Off.
Pddress: ~ _
City/Zip Code:
Phone ~1'~'
CALWIN H. HEDLUI~ ~ 9609 Gfrard Avenus Sout~
BloominqTOn,Minnssota 55431
Land Surveyor Clvil Enqinesr P~one ~ 888-2080
surver~o?r`s G'ert~,~~cate
JOB NO.# ~590
SURVEY FOR~ Zachman Homes
DESCRIBED AS~I,ot 14, Block 5, CEDAR CLIFF, City of Eagan, Dakota County,
Minnesota, and reserving the easementa of record.
I
I
L. ~ J - ~
Ro3 906.6I qob.3
95.00
30
I
I I Top of Founda+ion = 9D5.9
~ I Basemen+ Floor = 402-7
I ~ Garaye Floor : ROS.S
~ ~
~ ~ ,w ~ Proposed E~ev.'S O
I 7 Exts+rng ~~ev.'s _
~I I "'o ~ Denoies Dro~ina9e -w
0 j ~
thl.-.. ~t. - • vi
N `:9os.z) ~ ~ ~ ~ ,
• I ~ ,x-,- I W
' `_~~.~r ~O - ti
, ;1._.t~ike~ ~>A~~ ~~rr: s ,o 5t~k~ti > . ~i.
~ n rq i" ~ ~l /•~~~1
~ ° °'o ~ ~ ` O.
- - _
~ - ; ~
~ ~ ~u ~ ~ =2
~ i ~
~ rr; ~
L- f, ! - _ ~ - i
~ T
9o2.g 95.00 " 30
qo4.i
m m
, ScoTT TRAIL 903.8
~ - - -
CERTIFICATE OF SURVEY
I hereby certify ihot on S4I~ 22, i9do I surveyed ihe property described obove and thot
the obove plot is a correct representotioa of said survey.
Z ~ a~.~'~ f~ . ~-3 -u~t.~~C
Colvin H. Hedlund, Minn. Req. No. 8942
CITY USE ONLY
L BL RECEIPT
SUBD. C~~Q~- s DATE: ~~/9S
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NO. TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3,00 x =
Floor Dra'rn 3.00 x =
Gas Piping Outlet * minimum - i 3.00 x =
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal " Dakoia Cty. license 20.00 =
U.G. 5prinkle~ ` home under const. 3.U0 =
Aiterations * to existing 20.00 =~~Fr~ueR R~+D .
Water Tum Around 20.00 W~~
STATE SURCHARGE .50
~
TOl'AL ~D
SITE ADDRESS: MRRT I ri STEVEH
4564 SCOTT TRRIL
ERGIiN , 55122
OWNER NAME: H 887-uG5y W
INSTALLER NAME:
DSA VE1iT001
~Y1N~E NNTALIERs
STREET ADDRESS: pg~~~~~'-~ -
MINNEAPOLIB, MN SB408
CITY: STATE: ZI P:
PHONE ( ) ~Z7-~33
OFFICE USE ONLY
L BL RECEIPT
SUB~. DATE'
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)681-4675
Please complete for. ~ ali commerciaVindustrial buildings.
~ mufti-family buildings when separate permits are p~ required for each dwelling
unit. . ,
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE TH1S INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1~a of contract price, whichever is greater. State surcharge of $.50 per
$1,D00 of ~ fee due on all permits.
CONTRACT PRICE x 1°k
STATE SURCHARGE
TOTAL
SITE AD~RESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: W OM~i~AW~ u~a~~^''_c~'~T4~; ZIP:
3'd
MM~1M KtM
PHONE#: MYI~E .~Yw3lf3L~A"fl•112Es
, . .n ' APPLICANT
OFFICE USE ONLY
METER SIZE: ' DATE: INSPECTOR:
RESIDENTIAL BUILDING
Permit Application
City Of Eagan ~ ~
3830 Pilot Knob Road, Eagan Mn 55122
~ ~ Telephone # 651-675-5675 FAX # 651-675-5694
New Construc6on Reauiremenls RemodeVReoair Reauirements Office Use Onh
3 registered sile surveys shaving sq. R of bt sq. ft. of house; and all rooted areas 2 copies of plan _ CeA ol Survey Recd
(20%maximum btcoverage allowed) 1 set of Eneqy Calalations far heated addiGons _Tree Pres Plan ReW
2 copies ot plan showing 6eam & wi~ow sizes; poured found design, etc. 1 sile suney for additions 8 decks _ Tree Pres No( Reqd
1 set of Energy Calculatians Add'rtian - irMicate if on-sde sepGC sysfem _ On-site Sepfic System
3 capies of Tree P2servation PWn it bt platted aRer 7/1193
Rim Joist Defail OpUons selecUon sheet (61dgs with 3 ar less unRs
Date / c~~ / 03 °O ? l7 tl~
C~/ Construction Cost J, ~ b
Site Address ~,5~p ~ ~J~OT/ ~/Zf}/ I UniUSte #
~ -
i ~ ~r
DescriptionotWork ~7OCLSF 9~ ~i'A~9~~ /Ffr/LDt~K ~F/1oaF lJ~uo ~.L(~E.~s
1
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner .,~U; ,SC~ n7 ( f IXC~ Telephone )
Contractor ~~~(lT KODfiat~ ZiJC
~
Address 3.3(a (,J (~y i~,~ S- City (
State ,yr~ ~r.,r ~ ~ /~/v Zip _~/o Telephone # ( (p5
~ 7 - CJ ~lo.l~ I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submilted
Licensed Plumber Telephone ~
Mechanical Contractor Telephone )
Sewer/Water Contractor Teleph ne ) II
~ ~
_ GL
I hereby apply for a Residential Building Permit and acknowledge that the information is complete d accurate;
that the work will be in conformance with the ordinances and codes of the ~~{ty of=Eagari an t e 5tate of IvPV
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
/~.,6~, ~ ~Ii _ .~a
Applicant's Printed Name ApplicanYs Signamre
' OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? D8 O6-plex ? 16 Fireplace ~ 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ~ 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? O6 04-plex ? 12 12-plex Pibg_Yor_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Additlon ? 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 appliwnt
Valuation Occupancy MClES 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
REQUIR~D INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Foorings(deck) _ FinaWi o C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Franung _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector '
-
Base Fee /~~.°25
Surcharge ~ ~
Plan Review '
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total ~.3. ~S
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117549
Date Issued:10/18/2013
Permit Category:ePermit
Site Address: 4564 Scott Tr
Lot:14 Block: 5 Addition: Cedar Cliff
PID:10-16600-05-140
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
William Schneider
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
William M Schneider
4564 Scott Tr
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature