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500 Severn Way . . ~ INSPECTION RECORD ~ CIT'1~ OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ~ Eagan, Minnesota 55123 ~ Date Issued: " ~ (612) 681-4675 SITE ADDRESS: , i; t„~ APPLICANT: t~Ay ; ~ i ~ ~~,~i~ ~ ri~ . ~;~f i.' t I~, ! r. i' 1 , I r9 tcy~~ ~ PERMIT SUBTYPE: TYPE OF WORK: . i i~:~. r,~ • • ~:~i I i t~7i~' ~,II~JI~~. ~ ; • . 1 ~ ~!1 { N~~ ;=11i11 i S'd~: ~ I~'.~II I ~ ~~I~~f ~ I t~t 1•~ . ~~~~I~~l! I td ~ i'~i~li,l', ~ i' :I ' ~ ~ 1~+ f;:, i Ii~dt~,l ! 7 i r ~ F . ~ . , I ~ ' ~ ~ 1 I I ~ ! i I i , ~ ~ ~ J ~ Permit No. Permit Holder Date Telephone # SNV ' PLUMBING 9 ~ HVAC ELECT ~ $Q ~,a ~ ~ EIECTRI ~ ~ ~ ~ "p Inspection Date Insp. Comments Footings I 2 3 Q ~ s ~ Foundation r7 ~ ~ Q~y~ - J Framing Roofing Rough Plbg. Rough Htg. ~ ~ ~ Isul. ~ D f Fireplace 3 Fnal Htg. c.~ , Orsat Test s.~z - - 7~ ~T~/ Final Pibg. Pibg. Inspector- No2ify Plumbar Const. Meter Engr./Plan Bldg. Fnal Deck Ftg. Deck Final Well Pr. Disp. ~ ~rt{> O r ~i y~'• ? 0 ~erti~icate a~ ~ccu~anc~ ~it~ o~ ~agan ~c~a~ext ~ ~x~tbiug ~a~~recraa This Certifecate issued pursuant to the r~equirerrterrts of the Uniform Buildrng Code certifying that at the lime of issuance this structure was in compliance with the various o~rlirtances of tlie City n.guiating building construction or use. For the fo1lowing: Use Classifitalion: Bldg. Permit No. _~~3 Ooaip+ncy 7ypc ~!M ~ Zo~inE Distria ~ Type Cons~. ~ Owoer of Suilding 1~ ~UI~IT1~NIl m T11?': Ad~ess .~1 ~ FitTTI S7'V e„~w~Rg ~aa~ 500 S'~vF.[dd wAY ~.«~?~~y L2'~, R2, CXlPF1~'X PA~-~?'~i Y.,~ , a~: Q~ 18 j94 i Building Olficiai POST IN A CONSPICUOUS PtACE 1~ ~ : J ~ ~ . , . _ r~ c ~ ~ ~ INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: i?~ ~ ra+~ 3830 Pilot Knob Road Permit Number: i.` ~c Eagan, Minnesota 55122-1897 Date Issued: ~w~ ~ yfi• (612} 681-4675 SITE ADDRESS:' ' ~ ' ~ 4'~ ~ `y APPLICANT: t n I: 1 t ( t t. [?1. 1. • ~ .Jf't?N t.IAY . ~ t ,.h, ~ ,r' . I i ~ i , , ~1 I ~f i i ! ~ . 1:. PERMIT SUBTYPE; TYPE OF WORK: I.~ I c i ta !,Ii i i. I+~IJ • r~ • r• ' ~ I;I ~+f i I ~~i`i J ~jj'~tQ~G''"j.lJYi~/"~ ~d- , ~ I r•1 n ~ ~~J~ . ~ ~ ~ g7. ~ ~ ~kt MARK',: A s:~~~AkAT~ 4'~RMT f f•~ I;l ul)llrt:l+ t~jl, ANY 1~L~fMH1N~: ~~I; f 1 T~' Ik l~'A1. Wr?R?' ~ ~ ~ J Permit No. Permit Holder Date Telephons i ELECTRIC ~3~a~ 9~ pO PLUMBING a~~~ HVAC Inspaedon Date Insp. . Commenb FOOTINGS FOUND FRAMING ~ ~ ~ ~ ~ J j"~ ys //i ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL ~~5 f- GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FlNAL HTG ORSAT TEST BLDG FINAL I I BSMT R.I. BSMT FINAL DECK FfG DECK FlNAL N wr~r. Address 500 SEVatrr waY Zip 5512 3 , . Lot 23 Blk 2. Sub COVENTRY PASS 41H THESE I1'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECfION. Date: /8 y Yes No Inspector: Q Final gtade (6" from siding) Permanent steps (garage) Pertnanent steps (main entry) Permanent driveway f Petmanent gas v' Sod/Seeded grass ~ TraiUcurb damage ~ Porc6 V Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shuboff of water supply to the outside lawn faucet before freeze potential exisu. Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~ ~ White - Ciry Copy Yellow - Residcnt Copy Pink - Contractor Copy . 0- ~ ~209 ~ 3 ~ ~ Rep De Fire No. R gh-i ~ equiretl Inspeclion Other T~ugh-In (YO s all in o~ when reatly) ~ Reatly Now Will Notify Inspector S es ? No Date Featly I~licensed contractor ~owner hereby request inspection of above electrical work at Job Atlpyr~55,q (61rBet Box o te No.) Gity ~1~'» U~./~/ Section No. Township Name or No. Range N C Occupe (P WT~~ Pbane N~ ~ ~ Pawer Supplle~ ACtlress _ Elecvical ctor (COmpeny Neme) Cont or's License No. 1 b/ Meilin ess (Contraclor or Own a ron uthodzetl SlgneNre (Co M' Installation) Phone N ber ~5/~3 S' Pho~ne M 2) mB 900SH Pm SMNB5510Q ITY I II I~ I II~~I I I I I II I I I I III EN EOSPDOP ER 1 SPECTIONBOERDT u ~~~i 5~81~a3 ~3a av . ReQUesl Dale ~ Fire o. . Rovg n In sectian FeQUiretl In50ection Other T~en Fouqh-In ~1'ou II Inspeclor when rea0y~ ~ qeydy Naw ? Will No~Hy In9petlor Yes ? No Da~a ReaE I p licensed contractor ? owner hereby request inspection of above eiectrical work at: ~ Joe Atlaress (Sireet Box or Rome No.l Ciry ~ Do ~.~..e~r h a ,~A6A1~/ Senion No. TownsMp Name or No. Range No. Counry Occup PRINT~ P~one No. Gwn x~ m~ Power pllar~~ _~~/a ~~p/• Address (~'ICY'J ~ ~C..J~~.~ Eleclrical Conlracto~ ICOmpany Name) Contxctor's license No. MaiLng Ad~sa4nl~~~pq ~~dLTj ation) 81~'~J~H ul~. ~lT~u IUZ'd ~JJ~~ Rul~onietl ure ~COnv onOwner Maki g Ins~allaoon~ Phone Number ~J MINNESOTA STRTE BOAPD OF ELECTRICITY . TMIS INSPECTION REOUEST WILL NOT GriB9n-MiCway Bltlg. - Room 5-1)3 BE ACCEPTED BY THE STATE BOaRO ' 18Y1 Unive~elty Ave., SL Paul. MN 55104 UNLESS PROPER INSPEQION FEE IS Pho~ce(61P~64]AB00 ENCLOSED. y/~/~ REOUEST FOR ELECTRICAL INSPECTION ~~-~~'eR~ EB OW01-08 ? See insimctions lor completing this form on back ol yellow cropy. aaosg 11 81 ' ~ X" Below WOrk CovBred by This Request e Add Rep. TypeofBuilding AppliancesWired EquipmeniWiretl Home ~ Range Tempo~ary Service Duplea Water Heater ElactriC Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (SpeciTy) Farm Air Conditioner OIDer ~syecity) Contreamr5 Remarks: Compute Inspection Fee Below.~ # Other Pee # Service Enirance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps o to 100 Amps Translormers Above 200 _ Amps 6ove 100 _ Amps Signs inspector's Use Onry: \ TOTAL lv` 6 Irriga~ion Booms ~ ~~r Special InSpection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTEU IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rougn~in oa~e certify that the above inspection has p;,,ai - oa~e~c~,~y been made. OFFICE USE ONLV ' This rapuest witl IB months irom ~ RE~UEST FOR 1AL INSPECTION ~x° ~`~~w ' es-oooai-os ~ ~ a ~ /rr~~ g/~,C~~S ' ~ See ins~mctions lor r* irm on back ol yellow copy. U~j9O "X" Be/ow Wor d by This Aequest '"~:•~c• ~ ~Ne Add Rep. Type of Building Appliances Wired. Equipment Wired ~ Fome Range ~ Temporary Service Duplex Water Heater Electric Heating . Apt Building Drye[ ~ ~ . Load Management Comm./Indushial Furnace ~ ~ Other (Specify) Farm Air Conditioner Other (speciry) Conirac/tor's RemaMS: y^ Compufe Inspection Fee Below: ~ L~~~ ' # Other ~ Fee # ServiCe Entrance Size Fee # Circuits/Feedars Fee Swimmin Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200_Amps e 100 -Amps $I p5 Inspecror's Use Only: ~ T ~ Irrigation Booms ~ , OU l S ecial Ins ection AlarmlCOmmunication THIS INSTALLATION MA ED DISCONNEC7ED IF NOT Other Fee COMPLE7E~ WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rougm~n oace - 4. certiy that the above inspection has been made. F~nei oa~e 1uY OFFICE USE ONLY /J Tnis requeat voitl 1B mont~s Irom C3 ~ s£ 4/~s/9~f a7~Y~7~ o?o~i ~v ~ 1 ~ a~-~3a ~ ~~a ReQUest Oate Fire o. Rough-In In ti n Repuirea In50eIXbn Ot~er T~an R (YOU m II i peclor w~en reatly) ~ qe~y Na Will Notity Ins Mo~ Ves .NO OateReaOy I~ 2nsed contractor p owner hereby request ins tion of a` b~ov~ lectrical wor Jo~ AtlCress ~Stree1, ar Raute No.) Ci a l ~9- ~ Sedion No, Township Name or No. ange No. Coun ~ ~ Occ p ~PRINT~ A~ C Phone No. ' ~ %,/J PowerSUpp~ier ~ Atltlress ~iL_ Elearical Gonbac~o~ IGOmpany Name~ Convatlor5license No. MeilingAaeress o ~SfM~tlaalpsta~lation7 H gT R~~% INC. w.,' F caoo AvlM1Orizetl S~ rano ner Making Ins~l~~nj~8 S~Q24 P~one Number ~ YO MINNESOTA SiATE BOARO OF ELECTqICITV THIS INSPECTION REOUEST WILL NOT Gtlgpa~Mitlway eldg. - Room S1]3 ~~~r~,J BE ACCEPTED BV THE STATE BOARD 1821 University Ave.. SL Vaul. MN 55104 UNLESS PROPER INSPECTION FEE IS PMne (61Y) 602-0800 ENGLOSED. /t~ ~C~ REQUESTFORELECTRICALINSPECTION ~~,,l"'s~`'{~,y, eeooomoe ? See insimCians for comdeting Ihis lortn on pack W yeliow copy. +1~h'"~ I~O G~ O Q / . i a~ O X" Below Work Covered by This Request ew tld Rep: TypeoiBuilding AppliancesWired EquipmentWired ~ Home ange Temporery Service Duplex Water Heater Eleclric Heating Apt. Builtling Dryer Load MenagemeM Commllndustrial Furnace Olher SpeciTy) Farm Air Conditioner Otnerlspecily) Conhactor5 Remarks~. Compute Inspectian Fee Below: # Other Fee # Service EntranCe 512e Fee A CirCUits/F6eders Fee Swimming Pool 0[0 200 Amps 0 to 100 Amps Trenstormers Above 200 _ Amps ve 100 _ Amps SignS Inspector's Use Onty: TAL C!'1 Irrigation Booms ~ , Special InSpeclion D~L ~ ~O L~ Alarm/Communication ~ ' THIS INSTALLATION MAY BE DERED DI C~EC~F NOT Other Fee . COMPLETED WITHIN 18 S. I, the Electrical Inspector, hereby Ro~,qn-m ~ ~ ~Y,h cenity that ihe above inspection has Final o been made. OFFICE USE ONLV ' This repuest voi0 18 monlhs imm - S ~ 6 RESIDENTIAL BUILDINC PERMIT APPLICATION GTY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 / L, d 7 ~ New Construction Renuiremenn RemodellReoair Reouirements . J regislered sile suneys showirg sq. fl. of lot, sp. R. o( house; and all moled areas • 2 copies of plan (20°b maximum lol coverage allowed~ . i sM of Eneryy Calculations for heateC addilians • 2 copies of plan showing beam 8 window sizes; poured found desgn, etc.) . 1 site survey for ezterior addiUons 8 decks • 1 set of Energy Calculafions . InCicate if home served by se0~ic system for additions • ] copies o(Tree Preservation Plan if lot platted aRer 711193 • Rim Joist ~etail Optlons selection sheet (bl0gs with 3 or less units) DATE I O I~~6 2' VALUATION ~(O ~~Z ~ SITE ADDRESS S~ S 2V2f UIZ MULTI-FAMILY BLDG Y N TYPE OF WORK ~ 22~ o~-F ~n~ e(bo~ FIREPLACE(5) _ 0_ 1_ 2 APPLICANT TW~ `h'G-~Fz Ia .1nC . STREETADDRESS zSo1-1S~A~e S~ CITY~D~S STATE~LZIP ~ U TELEPHONE #C6fa)~29-(3y9 CELL PHONE # G~a.- y°Jo-~ t~~- FAX # PROPERTYOWNER ~riisr~ ~c ~eP TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ ~II~VI•:SO"f.1 Rt.`I1:5 7670 G\"fEGORI' l b1I\NF_SE>T:1 RCLFS i6i2 (J submission type) • Residential Ventilation Category 1 Wo~ksheet Submitted • New E~ergy Code Worksheet Submitted • Energy Envelope Calculations Submitted . f ' ^ Plumbing Controctor: _ Phonc # ~ Plumbing system includcs: _ ~Vater Softener _ La~m Sprinkler Fee: 590:00 Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Contractor: Phone # ~[ccli~u~iril s}~slcm includcs: .~ir Condilionicig r«: s~o.oo Hc<a Rcco~~cry Systcm Sewer/Water Contractor. Phone # I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagon Ordinances. Signature of Appllcant ~ ~ ~C~c~~~4 - ~ OFFICE USE OVLY Certificates of Survey Received Tree Preservation Plan Received _ Not Required _ - UpCated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 1B-plex ? 20 Pool O 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multl ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multl ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? O6 04-plex p 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addidon O 36 Move Bldg. ? 42 Demolish (FoundaGon) ? 45 Fire Repair ? 33 Alteretlon ? 37 Demolish (Bldg)• O 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (EnUre Bldg only) • Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinallC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas Tests _ Final _ Framing _ Siding SNCCO Stone _ Fireplace _ R.I. _ AirTest _ Final _ Windows (new/replacement) _ [nsulation _ Retaining Wall Approved By , Building Inspector Base Fee ~ Surcharge Plan Review MC/ES SAC Ciry SAC Water Supply & Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN , MAKE CHECK PAYABLE TO: SUBiJRBAN EXTERIORS 7466 WASHINGTOPi AVE S EDEN PRAIRIE MN 55334 LOCATION: 500 SEVERN WAY RECEIPT #/DATE: 31195 7/16/02 REASON FOR REFUND: CONTRACTOR REQUEST PERMIT 53057 VALUATLON: $11,000 TYPE OF REFUND: Plumbing Permit 9001.4087 $ Mechanical Permit 9001.4088 $ Building Permit Fee 9001.4085 $ 195.25 Plan Review Fee 9001.4222 $ SAC (MC/WS) 92202275 $ SAC (City) 9379.4681 $ SAC (Admin) 9001.4246 $ Water Connection 92203865 $ Sewer Pemvt 9220.4532 $ WaterPemut 9220.4507 $ Account Deposit 9220.2252 $ Watei Meter 9220.4509 $ Water Treatment 9220.4685 $ Surcharge 9001.2195 $ Oveipayment 90012250 $ Curb Box Deposit Refund 92202253 $ Cons~uction Meter Dep Refund 92202254 $ ~ Othez $ TOTAL $ 195.25 I declare under the penalties of law that this account, claim, or demand is just and that no part of it has been paid. ~ 11/18/02 SIGNATURE DATE city oF e~gen PATRICIA E. AW.4DA Mayor PAULBAKKFN eECGYC~usorr. November 18, 2002 CYNDEE FIELDS MEGTILLEY M~"~ SUBURBAN EXTERIORS 7466 WASHINGTON AVE S THOMAS HEDGES EDEN PRAIItIE MN 55344 CiryAdmu~~ara~or ATTN: LAURA BAKKEN RE: BUILDING PERMIT 53057 - 500 SEVERN WAY BUILDING PERMIT 51312 - 4530 GREENLEAF DR E Municipal Center. 3830 Pilot Knob Road D83T L3UT3: Eagan, MN 55122-1897 As requested in your letter dated November 15, 2002, the City is canceling Building Pho~e: G51.681.4600 permit #53057 and sending a refund of $195.25 to you under sepazate cover. The 5.50 Fax: GSI.681.4612 state surcharge is non-refundable. TDD: G51.654.8535 In July 2002, as we discussed, Building Permit #51312 was changed fi-om 4530 Greenleaf Drive W. to 4509 Alicia Drive and the check you submitted for 4509 Alicia mt~.u,~,« e~;Gry: Drive was returned to you; therefore, a refund will not be forthcoming for this permit 3501 Coachman Point number. See copy of letter attached. . Eagan, MN 55122 This letter is also meant to advise you that effective January 1, 2001, the City of Eagan's Fee rho~e: GSi.GSt.43oo Schedule assesses a$50.00 fee to refund permits that have been processed and receipted. As a F~: GSi.GSi.43GO courtesy, we are infomung con~actors of this policy and issuing a full refund, minus the state surcharge, for a canceled permit on a"one time only" basis. TDD: G5t.454.5535 If you have any questions, please feel free to give me a call at 651-681-4695. ~„w,M,~~ryo~.~m incerely, l~ - ~-t~v~r~ an Severson Office Supervisor THE LONE OAK"I'RF.E cc: Dale Schoeppner, Chief Building Official The symbol of nrength and growth in ouc ~ wmmuniry +9s2eeie2~ NOV-16•d002 11:A9 FRON-SIIBURBAN EIfTERI0R5 E +Y52B818232 T-212 P.001/004 F-431 To the City of Eagan, These jobs were cancclled by our customers request. We aze requestin~ a refund for the amaants below, because these pernuts that were not used. If you have any questions ar need any further documents please contact Laura ac 952-881-8232. Thank you. Sincerely, Lauxa Bskketi Suburban Exteriors 7466 Washington Ave N Eden Pisirie, MN 55344 *Attached it the copy ofthe permit Sryan 7 McGee 500 Severn Way ~agan, MN 55123 Amoum $200.75 Permit # EA053057 Walcer G TCrawza 4530 Crreenleaf Dr E Eagan, MN 55123 Amou~ $171.75 Pesmit # EA051312 I ~ ~l I / $~6Z , RESIDENTIAL ' BUILDING PERMIT APPLICATION ~ 3830 PILOT KNOB RDE EAGAN MN 55122 ~ a~' ~s 651-681-4675 New Construction Reauirements RemodallReoair Reauirements • 3 registered site surveys slrowing sq. of IoC sq. fl. of house; and all roofed areas • 2 copies of plan (20%maximum lot coverage allowed) . 1 set of Energy Calcul ons for healed addilbns • 2 copies af plan showing beam 8 window es; pouretl found design, etc.) . 1 site survey for eate or additions 8 decks • 1 set of Energy Calculations . indicate if home se ed by sepGc system for additions • 3 wpies of Tree PreservaGon Plan if lol platteC r 711193 • Run Joiffi Detail Options selection sheet (bldgs with or less units) DATE ~-C~ VALUATIO ~o555.a7 ~ SITE ADDRESS MULTI-FAMILY BLDG _Y ?N TYPE OF WORK ~ FIREPLACE(S) 1_ 2 APPLICANT ~1" STREET ADDRE55 7 CITY ..~~,a~. ~b~~ STATE~IP ~ TELEPHONE # 9.5,~-RR'/- ~,~~~CELL PHONE # FAX # 95a-ss-~ - s~i~ PROPERTYOWNER TELEPHONE# ~n,~/-18~~YQ7 COMPLETE THIS SECTION FOR NEW" RESIDE TIAL BUILDINGS ONLY Energy Code Category _ ~4IVNl:SO"l'A KliI.F 7Fi70 CrYI'I:C;ORI' I NII\Y1:S01':1 RUI.liS 7672 (J submission type) • Residential Ven6lati Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted . Energy Envelope Iculations Submitted Plumbing Contractor: Phonc # Plumbing syslcm includcs: _ Watcr Softcncr I.a~v~i Sprinklcr Pcc: 590.00 Watcr Heatcr No. o(' R.I. Baths No. of I3aUts Mechanical Conhactor: Phone # V[ccl~o-miril systcm includcs: _ Air CnndiUoning Pcr. ~70.00 I-fcal Rccovcrv Systcm Sewer/Water Contractor: Phone # i- ~ r ~I p ~i~~ - -------------~k - I hereby acknowledge that have read this application, state that the information is c t; ~bNd gg9e y with all applicable State o Minnesota StatuTes and City of Eagan Ordin nces. Signature of Applicant Y OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 OS-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 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 78 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' 0 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings(new bldg) FinaUC.O. _ Footings (deck) Final/~fo 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 (ne~c/replacement) _ Insulation _ Retaining Wall Approved By , Buildinglnspector Base Fee /9.S , a S Surcharge 5- b0 Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total aCJU. 7 ~J PERMIT ~~~~s ~ CITY OF ~AGAN PERMIT TYPE: ~~z i~I N~ 3830 Pilot Knob Road Eagan, Minnesota 55723 Permit Number: 0 Z 1 y q 3 (612) 681-4675 Date Issued: 0 2/ 14 / 9 4 SITE ADDRESS: 500 SEVERN WRY LQT: 23 BLOCK: 2 COVENTRY PA55 4TH P.I.N.: 10-184P~3-230-F12 DESCRIPTION: Building~_Perm.i.t Type SF DWG h3uilding Wd~,r_k Type NEW ;~UBC Occupancy~\ R-3 M-1 ~ Construction Typ,e V--N Zoning ~ \ R-1 / Building Length I 68 ' Building Width ~ 36 1. B~ildirtg storiesl~~~ 2 `.^-._.,~~lUj'. ~ . ~ ~ . ~ ~-7 \ ~ ~ ~ C~ ~J ;~I V LI 4x.'3 l/ !;1 2~ a=-~r _c:i-`~'-t. REMARKS: S& W PL[3R - VALLEY PLBG FEE SUMMARY: VALUATION $163,090 Base Fee $86P~.m8 MISL'ELLANEOUS $1,828.50 Plan Review $559.00 Total Fee $4,129.0H Surcharge $81.50 SAC $$00.00 SAC ~ 100 SAC Units 1 5ubtotal $2,360.50 CONTRACTOR: - uPplicant - ST. ~zc. OWNER: ROTTLUN~ CQ INC. 'iHE 15710304 0001335 THE ROTTLUND CO INC 5201 E RTVER RD 5201 E RSVER RD 301 FRSDLEY MN 55421 FRIDLEY MtJ 55921 (612) 571-@30A (612)571-0304 2 hereby acknowled9e that I have read this application and state that the informatian is correcT. and agree to comply with all applicable State oF Mn. 5tatutes and City of Eagan Ordinances. ~ ~ ~au~ R~~~t.l APPLICAN7/PERMITEE SIGNA7URE ~SSUED Y: GN TU E INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ~ i.~ I n z N c 3830 Pilot Knob Road Permft Num6er: 0 2 2 9 4 3 Eagan, Minnesota 55123 Date Issued: 0 2 j 1. 4 J 9 4 (612)681-4675 SITE ADDRESS: i_ o T: 2 s s ~ o c K: Z APPUCANT: 5A0~ SEVERN WAY ROTTLUND Cp SNC, THE COVEMTRY PASS 4TH (612) 571-0304 PERMIT SUBTYPE: TYPE OF WORK: 5F DWG NEI„~ . . FOOTINGS FOUNDATION FRAMING ROOFING INSULATION FYREPLACE ROUGN TN PLBG ROUGH .T.N HTG F]:NHI. PI.B6 FTNAI REMARKS: S& W PI,Bft - VALLEY PI.BG r . . _ . . . . . ~ ~ I ~ ~ CITY OF EAGAN ~ z'~.~0 ~ 1994 BUILDING PERMIT APPLICI~ION °-"L='`~'~6 ~ 3 681-4675 F E 8 0 8 1 ~ ~ 994 ; SINGLE & 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: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 2- Valuation of work Site Address: ~U~F~'?'~ t~lal~( STREET SUITE A' Tenant Name: (commercial only) ~ '~c~tU?'1~ ~-~C~• IAT BLOCR SUBD. ~ P.I.D. # ~ Descri tion of work: °h The applicant is: Owner ontractor ? Other (Oescribe> Name Phone ~ Property LAST F1RST Owner Address 52p l~~~ l?~ ~~'-~m ~ STREET STE # City ~r~~ State . W~ Zip Company ~'a N~-e- Phone Contractor Address License # ~33s' Exp~~~ City State Zip Company l~d-iY- Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has een approved. 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 Applicant: . » P -r...~ OFFICE USE ONLY ~ ~ ' ~ BUILDING PERMIT TYPE ` Y ~L ~ ? O1 Foundation ~ O6 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ~ 02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. O 17 Swim Pool ? 03 SF Additlon ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. ? 04 SF Porch ? 09 12-Plex O 14 Fireplace ~ 19 Comm./Ind. Misc. O 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Fac9lity ? 21 Miscellaneous WORK TYPE ~ 31 New ? 33 Alterations O 35 Tenant Finish ? 37 Demolish ? 32 Addition ? 34 Repair 0 36 Move GENERAL INFORMATION Const. (Actual) V Basement sq. ft. 12 MWCC System ~ (Allowable) ~T lst F1. sq. ft. ~ City Water ~ UBC Occupancy R"3 M"i 2nd Fl. sq. ft. ,~zs"z PRV Required Zoning R-/ Sq. Ft. tatal Boaster Pump # of Stories 2 Footprint Sq. ft. Fire Sprinkler Length b~ On-site well Census Code io i Depth ~.a On-site sewage SAC Code ~ APPROVALS tensus unit i Planning Building Assessments Engineering Variance REClUIRED.INSPECTIONS ? .Site ~ Footing ~ Framing - 1`7 Insulation ? Wallboard Final ? Draintile O Fireplace Permi t Fee ve~~ip,: g G 3 O0o Surcharge f3S~..t~/s ~ Plan Review G~ License 3~ ~ Z~ `~~y .Z o:k 3D :(~oa MWCC SAC t~ ~2 - ~Gg City SAC ~Z 2~- 2v = `10 Water Conn. ~,i. S ~ ~ ~ Water Meter Acct. Deposit lzyyX69~• &S ~3G ~~/o,F-/~ = I02yo S/W Permit ~ ~ S/W Surcharge 2~= Treatment Pl . 3~'~+' z~' _ ~/D6 y Road Unit Park Ded. ~ y~' ~ z- _ /~8 Trails Ded. ~ ~(Z ~o~~/ Copies /~3'2,r51~'~ Ir~ z&~ Other Total: SAC % 5AC Units ' -i ~ * * 2422 Enterprise Drive Mendota Heights, MN 55120 * PIONEEF! ~µp SpRVEY0R5 • qNL ENpNEERS ~6~2J sB~-~9~4•FOX 68~-9458 eng~neer~ng UND PUNNERS • LAN~SCAPE AFtCHIlECTS 625 Highway 7D Northeast Blaine, MN 55434 ~ * * * (612) 783-7880•Fax 783-7883 Certificate af s~~~ey fo~: The Rottlund Com~an ,Y inc• P~House Address: 500 Severn Wa Ea cn MN I ~ Model Name: Mad'son , ~ 516~oJ r9t9~j I r 9,8.5 2 2 ~p ~.~'1 # Y 9~ r V ~ 3yzs 917,1~ 13.96 N 7J•~9, I J ' D y~59 ye,, \ ~23.,345' t'~' ~ / / ~1^' ` ~ o, r~~ k91B.2 ~ ` 9i8,o9 I S/-`'~,re~ - ~ ~ ? / ~ x / ~so.oo / / ry~' ?e~ ~ry00°~ ~ ~ \ _ ~ n 9lG.6 1 9p 'e 2 ~ ~ ` 1 916.3 ~ \~3P ''y,) ~ ~~i~q •~~?4' x9~6.3 N \~2 41T d0 60~ e~'~O~y 0p~'' I ~ ~ . 6 4. \ ey0' ~ ~3~?~' .i~ X ~ ~ Oo ~ GP~Q,~f' >,`LC. hp,y~y~'L 1 C/~8~~ I / h J I 9i~.3x , .~9i6.S y"~' ~ y Sr9,4 ~ 5 5 ~ ~'pD) , 8 u~ dB~ ~ . ~ \ x91b,b / 5i~ ~ \ / ~ ~ °~~ryrytim,y ~x5,e,y ; ; , ~ 91032 ~ ~ _ N o ~ , ~ N N . . ~ ip "sb~s. S ~ ° o ~ I ~ ti ~ ~ ~ 5 o~ a~, 2 3 i ~,s S ~ ~ ~ ~ ~ ` f ~ ~ E.~GAN ~ i ~ 2q- REVI~W~Q BY %Da p~.~ Z- y ~.~A~ 1V IIVEERIN DEPT. . eoa.o Denotes Existing Elevation PROP05ED HOUSE ELEVATION . soa.o Denotes Proposed Elevation - Denotes Drainage & Utility Easement Lowest Floor Elevation:912.05 Denotes Drainage Flow Direction Top of Block Elevation:920.16 -o- Denotes Monument Garage 51ab Elevation:979.83 Denotes Offset Hub Bearings shown are assumed LOT 23, BLOCK 2 COVENTRY PASS DAKOTA COUNTY, MINNESOTA 4 TH A D D I TI 0 N I hereby certify that this survey, plan or report was prepared 6y me or under my direct supervision and that I am duly Registered Land Surveyor under the laws of the State of Minnesota. Oated this~_day of ~~~~~_o~ A,~, 19~y-. p~,da~ e~e:s~-~ elev ~-.Z~-9~{ Seale: 1 inc =30feet -~°o ~ ~ ROBERT B. SIKICH L.S. REG. NO. 14891 ~~5 I 92526.24 " ' LOT SIIRVEY CHECRLIBT FOR RESIDENTIAL ~ SIIILDZNG ERMIT 71PPLICJ?TIOH W ~ PROPERTY LE(iALS `T ~ ~ ~ ~ ~ Date of Surv~ys T- ~CIIMENT BTAND7~A~8 ~.c-J',' I/~~/ g c~/ Q' 0 D • Reqistered Land Surveyor siqnature and company / E~ ~ 0 • Buildinq Permit Applicant ' IY 0 0 • Leqal description C~ 0 ~ • Address 8" 0? • North arrow and bar scale 0~'~ ~ • House type (rambler, walkout, split w/o, split entry, lookout, etc.) 0~'0 0 • Directional drainage arrows with slope/gradient t. 0 C~ 0 • Proposed/exfsting tewer nnd water services 0~ 0 ~ • Street name [YD D • Driveway ELEVATIONs Exiatinc I] I~'0 • Sewer service ? 0 • Lot corners ~ D 0 • Top of curb at the driveway ~ D • Elevations of any existing adjacent homes ProDOaed 0~D 0 • Garage floor 0' ? 0 • First floor 6~0 0 • Lowest exposed elevation (walkout/window) L~ ? ~ • Property corners LJ/0 D • Front and rear of 3~ome at the foundation 40NDSNG AREAS (if aovlicnble) fl C~ D • Essement line O fY ~ • tawL o ~ n • xwL 0 F~~ 0 • Pond N designation 0 f,Y 0 • Emergeney Overflow Elevation DIMENSIONS 8~D 0 • Lot lines C~ D 0 • Riqht-of-way and street width (to back of curb) ~0 D • Proposed home 8imensions iacludinq any proposed decks, overhangs greater than 2', porches, etc. (i.e. all f structures requiring permanent footings) D 0 ~ • Show all easements of record and any City utilities within those easements ,~0 0 • Setbacks cf proposed structure and ~etback of adjacent existing ho D~" 0 • Retai irements, if any Reviswed: ~ N me / ate October 1992 t~7•Fr,ieR f:r+vr•.r,rn~t' nvr:~;nr;r: ^it^ curmu~rr,•rin;~ /jj~;s~'I. • o~aivL.n - . ~ ' gZmE ADDtiESS . ' CONTRACTOn I~7r~~n~o G~ ~ D.~TF. pE{qN~ Deter~in vorkinr; squnre footai;c of each. Z. lotal exposec vall s~ea 20~~. 2 sq. ft. x = 3~`b.g . • 2. Total roof/ceiling area ~ Z~ 7~ sq. ft. x e~0?6 _ 3Z,c~ • ~ . zotal exposed va'll are3 nbove floc~r = 2!J 2-- a. Total v211 rindou erea 3'D , ~ b. Tote1 dao~ ~rea ~e~.¢ 2 c. Total sliding glass ~oor area ~ d. Total fireplece va11 erea ~ e. Total ~r211 framing a^ea (avera~e lOP) ~2'Z(~~,~~ Y. Total net vell area nbove i'loor Z p~j ~(r • 6~ Total rin ~oist are~ 'Lfe ~J'~ Z . Total exoosed ~ni:ndation arca = ~ ~r6~ , _ h. Total foundetion vindov z:ea • i. To~al net foti:ndzt;on area above grade Z~• ~ • De~er.r,ine "U" calce o: esch vall ,ec^nent. . . a. 307~ 5°v Y„U„ D.¢Z = l2 `l. l~ b. G~, ~-Z X „U„ o,(3a = ~,33 . - c. x .,U~~ _ d. + X . _ . e.. 2 2~4. x.~~u,~ ~.Q ~ f = 20 . ~4- r. ~0 37. Co X„U.. p, 0 43 = S 7• Cr , g. GG3, X °lP~ O-D~`FI = !D. ? `j . h. / ~ x~~U~~ ~'OZ, _ ~ Z . ' 1. ~ r/~/ r ¢ nUrt ~ DII ~ _ ~~c ~V ~ 3 . . . = 277. ! 4~ If item H3 is the saJne as, or les~ !.t~:,n iter~ /!1, you nave met the intent of SBC 6oo6(c)2. , ~ Totnl exposed roof/ceilinG Are~ _ ~ ~ ~ `i . ` . . ' Totel gross rooP/ceilin~ are:s = . . ' ~ ,j. Totel skyli~nt area k. Totai roof/ceiling framing area / 2~~ 7 1. Total net insulated roof/ceilinF area ~i'~D.~Ci _ • Detc^ine "U" value for ench ruaf/cci I in~; seF,•mcnt. - X ~~U~i _ ~ . ~ k: ~Z~o, 7~ X„~„ D.az'7 = 3:¢Z ~ ' 1, Il~~ ~G X„U„ O.p2Z = Z'~,o~ ~ 4 . Total = 2 ~ ~ t/~-. If total oP H4 is the s~-ne rs, or less than N2, you have met tY~e intent of s3C 6oo6(c)1. . . To utilize the total envelope syste= method, the values establi_hed by the s~sa of ite~s N3 and B4 shall not be 6Teater.thxn the sum of items N1 and d2- 1, + 2. _ _ ' - g~, L. _ _ . ~ , T . • , . e . . _ . ` e ~ . . . . ~ c ~4-n~ -4i, ~.1 DETAILED REF'ORT FOFi EP~TIRE HOUSE F'rEpared For: F'repared Ry: h1. W. 6uerre Finre Heating , Mn Jat~ Name: Custom House ~*#k:~CX~*##~S:~:W~*~~~8c~~~~*#MC%****#~c*~*##*"4~:%c####**##Ai*A(k~c~*#.:tX~*#~~T#~TW~#'~"~ EXF'OSURE GLFSS NC~iiTH SOUTH EAST WEST NE/iJW SE/-^~+W HOF.'Z . TOTtiL AF;EA 1 67 ~ 27 ~ 2~jC+ ~ 114 ~ ?8 ~ 22 ~ 0~ 4bY 1 COOLING i 1~~~99{ 6~9~ 5,26:~1 .°i,~9G~ ^0791 1,1031 C~( 1d,~101 HEnTING ~ 2,96~}~ 1,194~ E,d4e~ S,C~-+^<~ 1. 3^c~ 1.~-''oi C>~ ~:1.524~ P=LC4; WFLLS ivORTH SOuTH Er^,ST 41cST ri~iri;.~ 5E/SPl G~~DE TOTAL AF.EF f L1~~ 0~6~ 7oirl 8431 <p~ 2~:; i>1 3~29~( COr! iiJC' ~ 74'2l 77it( 6?d; 774i i^o~ 18~ 0~ 3.027~ HEAT I NG ~ r i~7b I . 16~ i . Bb^o I . 1 c^2 ~ 7~ i 75 I 7. 422 I 1'~ . 8'c~~ ~ DQQRS ~•;QRTH 50UTFi EAST WcST NE/IVW jGIjW TOTAL A~;cFI ~ 1^0~ ^cs~1 i8~ C~1 0~ ; 50~ COGLIfdG 7 !i; ~~i1 ~7^a~ ~51~ i>; i~; ~ 78t~~ HEATING ~ i~~ i,~>':~f 1.14~~ 1,G"Crp 01 ~ .=,2i>5~ FLOOR i=ncA COOLIPJ~ HEFTFPJ6 _________1____________'____________________________________ Y.= i i C~ ~ ~~'1 % CEILINu AREA COCLIPJr HEATIP~G ~.~9 I 1,IS7 ~ ^,b~c^ MISCELLAiJcOU~ COOLIPJG LOt~DS F'eople SensiblF Loau I,12~ Lrter~t Lc~ad :,~C~~ Ligl-its F: Appi. Lo~u 1,145 L~tent S~fety ctuii 'i` 'Jentila.tion Load 1,2b5 Duct He~t 6nin i> InfiFtratien Load 91~! ~e-~~iGle Safet'y Rtu~~ 1,3'~C~ TCTAL ScfJS I RLE LL1'+P 29 ~ 143 TOTriL LATENT LOi=+D '~~~'.^o = Summer nCH ~~.07 Te~r~p. ~wing Muit. l.tii> Total Ceo=ir.o Lond =:,i~^o~ PTUH Or =.C%9 Tons MISCcLLAPJEOUS FiEi^+TING LQADS In4iltratien Load 7,579 Ventila=ion Load 5,~:~ D!tct 'r-le~.t Lo=_5 U ScITCtY Rtuh 12.'_+ WintEr ACH i~.l~ #T* Tot~l Heatir~o Lo~d 65,~~' PTUH . p4-~ ~ = -90 ' . ~.1 SUMMAnY REF'ORT F'reF~r.red. For: Prep~red fiy: M.W. Guerrc . Flare Heatinq , Mn Job Name: Custam HGLtSE °F°d%n%nBiY*%n*TT°d*#:r.m#*W.*#*,°n:n~*W"~~*~k~i.er~WYc*M~#*%r+.#~**#T:~~B:.n.n~*%n%*~~~T`rm#~%X*#*h:# DESiGN CQidDITIOhJS 4or DUTDOCR INDOOR S~J~~P1EF. WIPJ'c=: S~_~MMcFi v~iIPvTcn Dry Ptti!'i 9~ -^c5 72 7i 4;et P~!lb 7:, " e7 Daily fiznge 2~i Daily Swing 3.C~ Latitude 44 Elevation 822 Snfety Factor t%) ~ LatGnt Facter ('1.) ~7 **rmmmm*:nT~T%n`m~.%%rk.~"'nmMX,.7,($*w$T°r.*$*M(**XT*$%t~T'~F:n'~F$%n'~~.mYC~C***~(~(~C:K~~nn.%Km.i.T~.~n****~+M~~.~%n SE~t51t~lE F.C~Grti I-iEdtlnC~ Ht~n.tlr~C~ Cs7ollno CGClii:p Pda.me $TUH CFM RTUN CFt1 ----6--- ~cISCIT{Crl t S 7~ OYO fi7~ 1~ G~E'Y S~ Grent F.GORI ~JJ 47 2,874 145 Dine±t~ 6, 12~> ^o'o '.4=~i 170 r•:it~nc„ 6,798 95 i4=r 15'? Dining F.oam ,^0-;5 40 1,99~ l0i F~~yEr ,.~i , ~'b 7S , 4C%•: i %2 Gffice Den 4,=r~~ 62 il^c Pedroom 1 4,bb~i b~ ~,7i: 1~? nathro0i7i 4,='6~ b~ .b?Ci i'~ Master Fcdr~c~~n 4,~>~1 ~c 2,4!?1 l~i Bedro=,ri ~ -.6c~ ~1 ~.~OZ 11'c b`.~'~: 917 cS.l~^c 1,~^75 HEATiNC- DELTA T o~.p CCOLIPJG DELTn T i^c.0 PJDTE: k*~. C~lculr'ted Airflc~w is Ga=~d u~~~~n load req~!ire~~~ent=. 'verif~ that air~low crlculated is comp~tit~ie with selecteu ~qui~,ment rzquir~ments. , . PERMIT G~~~~ ~ ~ CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U T D I N G Eagan, Minnesota 55122-1897 Permit Number: 026178 (612) 681-4675 Date Issued: 0 8 J 0 9/ 9 5 SITE ADDRESS: 500 SEVERN WAY 107: 23 BLOCKs 2 , COVENTRY PASS 4TH p.I.N.: 10-18403-230-62 DESCRIPTION: ,~~.d ~ ~xn~, By~`~9,1ti~+7g"=#~,ermit Type BASEMENT FINI5M ~1a3,~c~;~r~g Wo~~Type AI.TERATION ~ ~ ~ r:` _ ~~4 ` ~ ~ ~ ~ ~e~,: ,P~- - .z.~ - i,:i~.:, y# ~ ~5-'~3 '~~.v ~ f a a.~..i'^~ °A:a ~ °;~,k~"' i; q ~ y~ F ~ s,~., ~ k " ~,y ~~~i sy""inti ~ f~`~ r'~ *z sbi +:a~ %:d y~}...P }aq~ r~,.f~'.a p .,..,7\'"'y'.73 ~~;i ~~atz.~~.i ~.i '~t4c,-.-;~y^,.a,;•.-;b=~iw C . REMARKS: A SEPARATE PERMI7 SS REQUIRED ~tlR flNY PLUMBIN~ OR ELECTRICAL WORK FEE SUMMARY: 6ase Fee $35.00 Surcharge $.50 Total Fee $95.50 CONTRACTOR: OWNER: - ppplicant - KRANK PAM 560 SEVERN WAY EAGAN ~1N 55123 (612)666-4748 4 T~hQreby ~~kn+aktledgq that ~ heve rsatl Chi~ applicata~bn aOd std`~~ ths~ ~~Ve ' ~t~fs~rma:tzbrs i5;~orre~t a~d= dc~ree to comp~;t ~iCh eI1 aPpl~,~'ab~a Sx~~,s af i~nk ~tat~'te~ ~n.d !~it~ a~ ~agart €}rdzn_~noes.~' ~ ' ; (~e e_ _ " ~ ~ ~ ~ . ~ ~ ~ ~-ss- APPLICANT/PEFMIT E SIGNATURE ISSUE BY: SI RE INSPECTION RECORD CITYOFEAGAN PERMITTYPE: euz~ozN~ 3830 Pilot Knob Road PermitNumber: 026178 Eagdn, MinnesOta 55122-1897 Date Issued: g g~ 0 g~ g~ (612)681-4675 SITEADDRESS:P.~.".: 10-1ea~s-z3m-~z APPLICANT: I,OT: 23 BLOCK: 2 50~ SEVERN WAY KRANK GAM COVENTRY PFlSS 4TH (612} 686-4748 PERMIT SUBTYPE: TYPE OF WORK: BASEMENT FINI5H AITERATION . . FRAMING TNSULATION OUGH IN PLBG FTNAL REMARKS: A SEPARATE PERMIT YS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK . r _ , ~ , ~ ~ ~ ~ ~ . ' I~ CITY OF EAGAN ~ ~ 3830 PILOT KNOB RD - 55122 ~ 1995 BUILDING PERMI68 ~~15ATION (RESIDENTIAL) A~ 3 P.GL New Censtrueflon Reaufrements RemodeVReoair ReauiremeMs ? 8 rogiete~ed sRe aurveys ? 2 copies of plan ? 2 wpiea of piana (indude beam 8 window saes; poured fid. design; etc.) ? 2 aite surveys (ezterior additions 8 dedcs) ? 7 enerpy ealalatfons ? t eneigy ealwlatlons tor heeted additions ? 3 copbs M tree preaervatlon plen if lot plalted aRer 7/1/93 ~equired: _ Yea _ No DATE: _7C~iI4S CONSTRUCTIONCOST: ~8$00 DESCRIPTION OF WORK: ~~N is ~t ~ ~`w`~TT STREET ADDRESS: ~a ~ S~ ~`~'`E ~f~"6 x^' Mr~ S~7 7.3 LOT ° BLOCK ' SUBD./P.I.D. ~T~T~T^~~ ~rnk'm,ITi,l~ n,l,L 4-~~ PROPERTY Name: I~ RnN 1~ Phone $ 3-oy q~ OWNER ,a.. ~~-y~y~ x3 Street Address• Sfl o 5 q~ L.~~t`1 4~ ~i City: State: r` ~ Zip: S S ~ Z3 CONTRACTOR Company: Phone Street Address: License City: State: Zip• ARCHITECT! Company: Phone ENGINEER ~ Name: Registration Street Address~ City: State: Zip: Sewer 8 water licensed plumber. Penalty applies when address change and lot change are requested once permR is issued. I hereby acknowledge that I have read this application and state that fhe infortnation is corred and agree M compiy with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applican : ~--r OFFICE USE ONLY ~ u ~ 3 1 1995 Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No OFFICE USE ONLY q „ ~ , , ~ 1~'' . BUILDING PERMIT TYPE y " 0 01 Foundation o O6 Duplex o 11 Apt./Lodging ~~-16 Basement Finish o 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous 0 05 SF Misc. 0 10 _-plex o 15 Deck WORK TYPE ? 31 New ~~33 Alterations o 36 Move 0 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const (Actual) Basement sq. ft. MGWS System (Allowable) Main level sq. ft. City Water UBC Oecupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. y3 r/ Depth Footprint sq. ft. SAC Code Census Bldg i ~ Census Unit o APPROVALS Planning Suilding Engineering Variance ti Pertnit Fee Valuation: $ /S~~ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY USE ONLY L ~ BL _ Z RECEIPT ~ ~ ~ SUBD. otJ R.aA~ 'Y'~ DATE: 9'S 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 Shrwer 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 Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal Dakota Cty. license 20.00 = U.G. Sprinkle[ * home under const. 3.00 = lte~ations * co existg"~ 20.00 = a er um r~- 20.00 ~f,(1e,~/ C~,~ ~ STATE SURCHARGE .50 ~IL' ~ TOTAL _,2 SITE ADDRESS: 500 SEVERN WAY OWNER NAME: PAM KRANK INSTALLER NAME:GENZ - RYAN PLUMBING & HEATING C0. STREET ADDRESS: ~a~a5 SO TH ROBERT TRAIL CITY: ROSE~40UNT STATE: MN ZIP: 5~068 PHONE ( 61P ) 423-1144 ~ - - OFFICE USE ONLY ~ L BL RECEIPT SUBD. DATE:~ 3~~'S 1995 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681-4675 Please complete for: ~ all commercialfindustrial buildings. ~ muRi-family buildings when separate permits are p4S 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 INSTALLED7 YES NO. FAILURE TO PROVIDE THIS 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 5EPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,00~ of pgCmit fee due on all permits. CONTRACT PRICE x 1% ~ STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: APPLICANT OFFICE USE ONLY METER SIZE: DATE: INSPECTOR: ~~~~~3~ ~ d ~ ; . ~-'.~N~ ~t~~ $s G~ Fs ~ ~~'s''~~ F de ~C'.r.~F~~e`~•zt~~a~'3~<,c~~~° Acek~~ai~.~ki~~ .~~s~¢~§<o~~'~w~~~~4~Y~~~>y h ~'.~i, ~ ,c k~ ` ' ~ ~.'t~?~a~~s~~~`F~~~~c ~ ~ ~b~, ~ ~ ~ ; ~ ~ p y 9; s'a 3 a ~l.T~~ ..•'Fas `"~~.f '~S p<a~ 6N C iSk k{ R,c£ e~£s ~f 3. a u~ ~a~ ia£~c : e ~s sz e r' .a y . $ ..r as: ~".~r.... SN~.°,'`s,.~.,~.~,s~,a~sKw~'~a„ A$..>rh;:~~. wro.>.,~~~..b~~.p..~~..w~.~9~~,.~...:t ...,....a. 1994 MECHANICAL PERMTT (RESIDENTIAI,) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMTI'S ARE REQUIRED FOR EACH UNIT. ~ NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE FIREPLACE INSERT DATE FEES HVAC: 0-100 M BTU $ 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (EXISTING CONSTRUCT1oN) $ 20.00 STATE SURCHARGE .50 TOTAL a1 ~J~ SITE ADDRESS: OWNER NAME: TELEPHONE S"\\-'~"s~ INSTALLER: ADDRESS: 93d~ ~ GofAe111hiley? CITY: STATE: ZIP CODE: TELEPHONE ~~C. `t~~_A~~,`1 SIGNATURE OF PERMITTEE ~t'~ ~~~~1~CJG'~ ~.~F ::~a,aho-t ~e ~x~ ~ c~w.~ c4?~ac~~i,o~i+.~~' A~SB~w~ x s ~ s ~raw w xsu x av ~ ` 'T ~i~~~a~ 2.>:~ L".,~"S~i~ bs.p i1 stxi ~~"ro°~°o`''c~e.~y'"~i ~4 a."`~@`~.7'i ~ r.a °~'a' s . ~Z~¢~~'~1 ~4£€~f~M.~a`~.,T~•,.y~~y.YiYf.:f~~~~R'~ai3! L ~C~'4f ~3~~...5~.F13~hk, ''~bT 333 Ld~ ~f'; . Y F~S. E~~~~3¢E ~ ~t i £e~ Sf H C+ ~ -s .kr ~.,~.x 3'w~"~.~L r.~u..$ fau ~.A° a~~8 i iF; ~x..r~3aex'~~s.~s.aT rs t' ^3g i$4~a.'~,~.''~~ ~z~tir x~~ r 3, xt ys ~ s, il~~ '~I.;~~tk~.xa~ti~°'~&laa3~3~.~'"°F.~~i^N'^ s.~ ~''`~,h '~zg;s ~xa~~aisr~`£~i>Y~.~§.~S~P~'~~~a `4~~",~'a3~~~`~ ; . ..A::Wax.:o.w.c, i: 3~ .4)A>5>..~....~.~.L... a~k . ~r....aS.Sa.3i a. 3~ t L >?:v.w'.~',£.il r r~...~.,5~f . c 1..~.. k 3 AS...we...3a Y. ~....a... . 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN NIIV 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. DATE: CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF C~Nx"RA,(,"1" FEE PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF ~~t~v11'f FEE. TOTAL $ SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONL~I .,~~,]y'k ~ (y ~ ~~n INSTALLER:_ . (qi,~~9~f~w_ • . ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE SIGNATURE OF PERMITTEE CITY INSPECTOR 7~ ~ ~~s-+~'~`' w . k E°*D~,~NI.Y y'i'~W ~y~fW 1+ _ DL"'t~~»w~roq ZS. '}~.p'~a. r .~y41 £ ~ °.~,3 g ~~7.~,F'+li ¦ ~x~ 3l'kT~ ~ ~LBD `-M`~~~' N ~~~'`~•d a~s~~^~a ~~~3.`~ ~ ~($Q a r . ~.A~ Tlt k ~ ~~w~.~~i°'4.."'..1~hFYSr'~~~e~~~.v.r...~..~.._....... a 1994 PLUMBING PERbIIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf. NO. FIXTURES ~ACH TpT,~I, ~ S:30V?ER 3.00 3 - 3 WATER CLOSET 3.00 w- 3 BATH TUB 3.00 c. ~ 3 LAVATORY 3.pp 9 - ~ KTTCHEN SINK 3.00 3- -I_ LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 _L. WATER HEATER 3.00 3 _ FLOOR DRAIN 3.00 ~ - GAS PIPING OUTLET • minimum • t 3.00 ~ ROUGH OPENINGS 1.50 4. ~ ~ WATER SOFTENER 5.00 PRIVAT'E D1SP. • net.c,y, r~ 20.00 U.G. SPRINKLER • nome uneer wnsi. 3.00 ALTERATIONS • ~o ~:~NB 20.00 WATER TURN AROUND 20.00 STATE SURCHARGE .50 TOTAL: y 1 - SITE ADDRESS:_ 500 ~,eJc i., 1..~ q,~ OWNER NAME: I~nNI•-c~ INSTALLER: V~ 1~~., 41 c, _ ADDRESS: (,f~~ L2~~~c L- CITY: ~o <<IA STAT'E: ~P1~ ZIP CODE: Ss3> > PHONE ( ~ yq~- a ~a i C=,~ ~.G~- SIGNATURE OF PERMITTEE ~j 'y/E ~75~ t'31~.~' y~~./~*.+ LI~~ ~ ~~.C ~~~'~~~^J'x 5 ~k'%~~~~ pt~` RQ f 92ff ~~..'Z ~~A i. ~ 3~r `%a@ kd'y _ ; r5 ~ n z~a~ ~F~~ S~A ~a ~ ~yi~ . ~b ' i a :?a <s r ~8 ¢°~~C'Z a=h:x~i`^~a~:s#'~'bsti~~~~yp'~d~~kx~ ~ h, .~`s.u~~x ~x~~.`6`~~s~~~ ~ i ~ ~ ~r ~,~~.:`~~°~'?".t> g ,~,F a 'b~illS 3 ~~i~ ~~~~r..?~~x4:F.S~t~;2~`~.&cC`.~~ S<~`;`~'?Y~" ~.;:R«:'~ezk~S~','aaski~~x£ '~~£~.~x~Me.~..,.. ~ ~~.,a~x~~~,~s:z' x.<.,.arv~.,,"w< , 1999 PLUMBING PERMIT (GOMMERGL4ti)~, ' CITY OF EAGAN 3830 PIIAT KNQB RD EAGAN MN'r 5'S.122 (612) 681-46,75 PLEASE COMPLETE FOR ALL CQMMERCIALIINDWS'TRI"AL BUILDINGS. ALSO ,FOR MULTI- FAMILY BUILDINGS WHEN SEP.ARATE RERMITS .ARE\NOT REQiJIRED FOR $ACH DWELLING UI~}TT. ~ _ NEW CONSTRUCTION ~ ADD ON _ itEYAiYt WORK DESCRIPTIUNe CONT$ACT PRICEe $ FEC: l%a OF CONTRpCT FEE. < STAT~ SURCHARCE: '$y50 FOR EACH SI,000 OF ~~RT~+~ FEE. RtINI11fUM FEE6 S 25:00 " GOhTRACT PRICE X 1°!0 $ STATE SURCHARGE $ TOTAL $ . SITE ADDRESS: . TENAN`7' NAA1Er ST'E.:# , . OWNER NAME: INSTALLERt ADDRESS: _ CITY: STATE:, ZIP CODE: . _ PHOT'E _ FO'R: CITY'OF EAGAN . APP,LICANT L o?3 a ~ SUBD ~y ^I'~ NEW RECEIPT !i p~7~/ 7 V RECEIPT DATE U'~- r DAT'E J ~ °t Y ~ T'0 ~~t."""" JOB ~ OtiI2iER PLFJ~SE BE ADVISED THAT T}~RE IS A FEE SHORTAGE ON T}~ ABOYE i ~ II.ECTAICAL IISTALLATION IN 14IIi AMOiJNT OF s /J ' SHORTACE NtST BE PAID MHITHIN 14 L1Y5. RE!lARKS D a~ ~ -0 to 30 amp. circuits= ' r- 31 to 100 amn. circuits= 7~ 0 to 100 amn service= ' ~ 101 to 200 amo. service= ~ 0' ~ TOTAL FEE DUE= au LESS F£E RECIEV£D /I~//!~~ aa' ~ ~ cd TOTAL F££ SHDRTAGE DUE e ~.S ~ PERMII~I /~([,r~' ~ ORIG. RECEIPT~f a0(G7~ RECEIPT DATE ~J' ~`f'~~ RETURN A COYY OF THIS FOBM fiITH REMZTTAN~E. PERMIT City of Eagan Permit Type:Building Permit Number:EA119121 Date Issued:11/15/2013 Permit Category:ePermit Site Address: 500 Severn Way Lot:23 Block: 2 Addition: Coventry Pass 4th PID:10-18403-02-230 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. 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 - Kunal Sen 500 Severn Way Eagan MN 55123 Snap Construction 8200 Humboldt Ave S Bloomington MN 55431 (612) 360-1033 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use Permit#: �� Cityof EagAll Permit Fee: - b 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 I. 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: -( 7 Site Address: 5' �� 1h Tenant: /C_c,-i /-z .l Suite#: Resident/Owner Name: h t:( S h Phone: Address/City/Zip: c ci S r - z Name: � k yC t c:"C. /'l6-1_ 4/45 License#: 4 5 c- Contractor Address: 2 ? 4 �z C. r /-V,City: Z.:.A �✓�7( State: A-2/1 Zip: $5 - ''e( Phone: ( � 2G Tc 7 2- Contact: -Contact: Email: Type of Werk — New Replacement Repair _Rebuild _Modify Space Work in R.O.W. Description of work: /, �� f�c>A .� �- -r �i�1o( RESIDENTIAL �Y Water Heater Lawn Irrigation( RPZ/_PVB) Water Softener Permit Type Add Plumbing Fixtures( Main/ Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ 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.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. th7 4 Applicant's Printed Name Applicant's Signature FOR::OFFICE USE Reviewect,By.,. .. Date: Required inspections: Under Ground RoughAn ti� Air Gas Test Final Meter Related Items: Meter Size Radio Read ManometerStaff PERMIT City of Eagan Permit Type:Building Permit Number:EA150849 Date Issued:07/26/2018 Permit Category:ePermit Site Address: 500 Severn Way Lot:23 Block: 2 Addition: Coventry Pass 4th PID:10-18403-02-230 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Kunal Sen 500 Severn Way Eagan MN 55123 (651) 239-8059 Hoffman Weber Construction Inc 3515 48th Ave N Brooklyn Center MN 55429 (866) 970-1133 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA164462 Date Issued:09/29/2020 Permit Category:ePermit Site Address: 500 Severn Way Lot:23 Block: 2 Addition: Coventry Pass 4th PID:10-18403-02-230 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Kunal Sen 500 Severn Way Eagan MN 55123 (651) 239-8059 Elite Restoration Pro 1120 E 80th St, Suite 201 Bloomington MN 55420 (952) 322-7773 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA170368 Date Issued:06/29/2021 Permit Category:ePermit Site Address: 500 Severn Way Lot:23 Block: 2 Addition: Coventry Pass 4th PID:10-18403-02-230 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Kunal Sen 500 Severn Way Eagan MN 55123 (651) 239-8059 Lofgren Heating & Air 5708 Upper 147th St W Suite 106 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature