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4859 Sheffield Lane ITY OF EAGAN WATER SERVICE PERNIIT 830 Pilot K~ob Raad • P~RMIT NO.: ~ O. Box ~.99 ` 21 - ' ~ Eagan, MN 55121 DATE: RI No. of Units: 1 Zonin9: Tollefso*~. Iil[lre ~F,; /Iddrou: ^ ~ Stte Add~_. 4 e d Lane 8 B BrittAnv 5t ~ I ~umber. ° ~ir~ ~t';_jl ! ' . ~~?Rs ter No ~ ` L~Connectian G~or~e: 1 4 ~ 0 0 oiJd ~ ~ c,;~J.~ _ , v ~~~nt Qeposit: r~ S ~IE: _ P~ 4.~ 4 1~ l I ~ 11~-~ . Reader o ~ ~ ~ i: Pem+it Fee: - ~ wi11~ IM Cih sf E~Yo~ Surcharge: . 5 0 1~: ~ 63.00 d meter~ 0 c/ a ,~C- Misc. Charqes: I , ~ Total• I y ~ pcte Paid: Dote of Insp. I CITY OF EAGAN SEIKER SERVICE PERMR 3830 Pilot Knob Road p~y~T NO.: ~ P. O. B=-. 21199 p Eagan, MN 55121 ~~TE~ Zoninp: £`1 No. of Units: 1 - Tollefsen Dldra Address: Siro Addre~`. 4859 Sheffie2d Lane L3 B B itt~nq th Plumber. r'C17 R 3fl y J ~ ~ ~ ~-ii-84 43354 ~~~S.OJ >d I M~w to ean~lq ~?NI~ tM Ck1? ef MOe¦ Connaction Ow~ys: Atoount Depoait: 1~ f1 n~„ Ordinaee~s. ~ ~ ~ _ Pen»k Fee: - Surcharoe: ~ - ey Misc. Choros~ Date of Insp.: Total: Intp.: Date Paid: CITY OF EAGAN WATER SERVIGE PERMIT 3830 Pilot Knob Road P. O. Bo•' 21199' PERMIT NO.: ~ Eagan, MN 55121 DATE: ~ - ~ Zonin~: iZl No. of Units: 1 Owner. Tollefsofl Bldrs Addroas: Site Address: 4559 Slieffield Lane Lf3 B Erittan Sth Piunber: Z `;~t ~~1 Meter No.: Connectio~ Chorfle: . 00 Size: Acoount Deposlt: ' ~ Re°d°r No.: Permit Fee: ~i1 1~9~ to oompl~r wlth l1~~ Ger of Ep~~ Surchorge: : ~'di"°°o~. Misc. Charges: • P~ meter Totol: BY Dats Paid: Dote of Insp.: Insp.: ~ I w~ _ CASH RECEIPT ~ ~ ~ CtTY 4F EAGAN ~ ~ P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 DATE ` 19 rtecs~v~o ~ FROM AMOUN7 $ . & DOLLAR5 ~oo ~ ? CASH ? CNECIC FOR. J v `l~ . `.1/~"" ~ 1.~~~ / _ _ FUND CODE AMOUNT ~ Thank You ~ ~ BY . C ~ • ~ t 1Nhite-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN Remarks ~r 1~ ~J ~ Addition ~ITT~Y ~D~ Lot 8 Blk 1 ParCel 1~15~~ Owner Street kas9 sHEFFTBLD State ~ 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK M SEWERLATERAL 760.30 A014399 8-9-84 WATERMAIN 1F WATER LATERAI 2 WATER AREA 122.26 A014399 8-9-84 STORM SEW TRK 1 S2 ~6.6 2 1F STORM SEW LAT 1~2 S CURB & GUTTER ' SIDEWALK STREET LIGHT Ro 260.00 ~~43354 5-17-84 WATER CONN. 4~0.00 " BUILDING PER. ~~9OH1 " sAC 52 „ PARK CASH RECEIPT ~s ~ ~ CITY ~F EAGAN ~ P. O. BOX 21-199 EAGAN, MINNE~OTA 55121 c. DATE • 19 wece~vfin , ~ FRdA ( AMOUNT $ ; _ ~ . I j...% ~ , ci'~ , , ~ ~ DOLLARS f 00 ~ CASH - CHECK FOR ~ ' r .J J/I• i. r `J ~ ~ _ ~ _ ~'~,~~,e~ FUND COOE ANIOUNT - / ' ) ) ~ C ~ ) ~ . / . ~ Tha ou ~ - > ' BY White-Payero Copy Yellow-Posting CopY Pink-File Copy 1 y0 Receipt ~ r PLUMBING PERMIT Permit No. 7 ~ _ ; CITY OF EAGAN F~ ~y J ? ~1 . Fill in numberied spaces S/C t Type or Prini legibly To~~~_ : ~ ' ' 1. Date ` 2. Installation Cost ' r r, 3. Job AddreSS / Lot ~ Blk. j Tract t~ ` r 4. Owner ~ . 1~~` ~u c.' i~ f 5. Contractor ~ ~ ~/t y ~ ~ ,J Phone ~ [ < ' 1l ' f ` / 6. Address ~ i - . ~ ~ , ~ ~ ~ L 7. City • ~ ~ ~ ; .J,~ ( State /1'~ Zip - ~ .r C_, 8. Building Type: Residential Commercial ? Institutional ? 9. Work Description: New Add ? Alter ~ Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield ~ Bath tubs Septic Tank Lavatory Softner i Shower Well ~ Kitchen Sink Urinal/Bidet Other - Laundry Tray f Floor Drains Drinking Ftn. Slop Sink ~ Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and co.des governing this type of work. Signed : ' ' for ~ Rough Final ~ Inspections: Date Insp. Date s. ,w,. This is your permit when numbered and approved. Approved CITY EAGAN 454-8100 , CITY OF EAGAN ~ 3630 Pilot K~ob Road, P.O. Box 21-199, Eagan, MN 55121 ~ ~ ~~~i 1 PHON E: 454-8100 ~ BUILDING PERMIT R~~~ # J ~ - ~ Te M w~d fer SP D41G/rAF_ Est. Value 0 U U ~e :~1AY 17 , 19 u 4 SiteAf~ dress ~~~7 CfMl~l ~yT_1:~~L~ Tir~ E~~ Il3 i~; ..lrl'l'i1i~Y J U ~CCUpOf1Cy Lot ~I O k.`) $ub.Q 1 Alter ? Zonirq 1 Parcel No, U Repoir ? Firc Zone ~ a ~F t1 ~ Enlorye ? Type of Const. W Name Move p # Stories~ - ~ Addr ~ ~ ~ Demotish p Length - Cit t i • Phona ` - ~ ~ s C~rode v D Depth Sq. Ft. o Name ii: Aov~~~~ Fees =u Assessment Permit ' J • ~ u~ Address .00 ~ City Phone Water b 5ew. Surchcrqe , O Police Plon check ~W Name F1ro SAC ' 0 Address Erq. Water Conn, • U 0 V ~ W ChY Pha^e Plcnner Woter Meter • U 0 Council Rood Unit ~ ~ I herc6y acknowledga that I how reod this application ond stote that B~ ~ the informofion Is wrrect and ogree to comply with all opplicoble ~ r ~ Stote of Minnesoto Statutes and City of Eogon Ordinonces. Taa~ 5iflnoturc of Permittaa A Bullding Permlt is issued to: `.'(%~,1~, ~:1~'; ;C?i ~ I:T,I~PS express condition ihar all worlc sholl be done in accoMance with oll opplicable Stere of IWnrxwM Statutes ond City of Eoflon Ordinances. / Buildi~p Offitiol ` Permit No. Permit Holdar Mise. Permit No. Holder Ptumbing 4 3 ~ ~ ~P h 2 ~ ( ~ ~ ~ H.v.A.c. y~p 3~-1 C,-~,, 2 P~ ~-z 8-6 Y Wall Wetsr Disp. Swver E lectrie ~ D 5/~ ~ 5 ~ ~ D l~ . S~ Inspeetion Dats Insp. Other Footingt S /Q Foundation Fnminy Rouph Plbp. ~ Rouph HVA -I~~' Inwletion Final Plbp. ~ Finsl HVAC Final ~ ~ / Water Describe Location: YYell SevKr Pr. Dhp. ~ ~ ` ~ / ~ CORRECTION NaTICE . ~ ~ DATE: ' Address Site Name ` Owner/Agent Telephone Owner/Agent Address Ordinance Nos. and Corrections - Correct By ~ ~ ~ e o P ~ ~ ~ 1 ~ 1 e ~o a K _ c~ ~ c l~ For reinspection Eagan Dept.oflnspection Inspector: 3795 Pilot Knob Rd. Eagan, Minnesota 55122 asa-s ~ oo Dept.: Receipt S MECHANICAL PERMiT Permit No. y~ 3~ ~ g_ gs CITY OF EAGAN F~ ~o o a Fill in numbered spaces S/C . S~ Type or Print legibly To~ 7~,~d 1. Date gc,o 2. Installation Cost ~ B~~~ 3. Job Address yg~9- ~~e/~ Lot_~Blk. / Tract 4. Owner -/a//~~~p,._, ~p,c,~ ~ 5. Contractor ..U~+-,~ ~ Phone y~ 3-/i yy 6. Address _ / y7 5/~ ~ ~~C~'~'~ ~~1~ 7. City ~d~JNT State ~i~.~ Zip .f,~!>l08 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New ~ Add ? Alter O Repair ? 10. Describe Fue~ Type 11. No. ~~ui ment 8TU - M. Ea. No. EQUipment CFM Forced Air Air Handling: Mtg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. ~ Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 INSPECTI4N RECORD ^ CITY OF EAGAN PERIIAIT TYPE: 3830 Pilot KnOb R08d ~ ty r Permit Number: Ea an, Minnesota 55122-1897 9 Date Issued: (612) 681-4675 ~ I t; ~ 47 SITE ADDRESS: , „ ~ ~ t , APPLICANT: , ~F•Tri r~ i nt~r , „ . , i : r 1 1 ! . . i ; . ; ~ , . i ~ , PERMIT SUBTYPE: TYPE OF WORK: : . . ~ ~ ~ ~ Permk No. Parmi! Holder Date Telephone N ELECTRIC PLUMBING HVAC Inspectlon Dete Inap. Commenta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.1. BSMT FINAL DECK FTG DECK FINAL _27 ~1 ~.P ~p+ 3~9~ G~~ } 5~ ~5~~ 525~ o~,~ } 0 63~ ~~~~k 26 ~~~~C* ~q2 , CITY OF EAGAN ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 NO A Q~ t PHONE:454•8700 ~ ~ BUILDING PERMIT Receipt # Te 6a u~ad foe $F DWG/GAR Esf. Volue $82i 0~0 Date ~Y 1~ , 19 84 4859 SHEFFIELD LN R3 Site Addreas Erect QK Occuponty Lot 8 B~ock ~ Sec/Sub. BRITTANY 5 Alrer ? Zon'viq R1 Percel No. lO-ZSO~O4-080-0~ Repoir ? Fhe Zone N/A Enlarge ? Type af Const. V ~ Neme TOLLEFSON BLDRS. Move ? # Stories Z Address 1655 NORWOOD DR Demolish ? Length ~r~-- ~ citv EAGAN pno~e 454-6873 Grode ? Depth~$ Sq.Ft.- Approrab fee~ o Name SAME o~ qddress Assessment Perrr~ir 379.00 u~- City Phone Water&$ew. Surcharge 4~-•D0 Police Plan check 189 . S~ G~„w Name Fire SAC 5z5.~~ Address Enp. WaterConn. 470.00 ~,Zu City Phane Plonner Woter Meter 63. 00 Councll Road Unit 26D.00 I hereby ackrwwledge that I hove read this avclicotion ond stote that gldg. Off. the inlormotion is wrrect ard agree to wmply with oll opplicable APC Toto~~' S0 Stote of Minnewla $tatufes and City of Eogan Ordinonces. Signcture of Permittea A Building Permit is issued to: TOLLEFSON BLDRS on the expreu condition thwi oll work sholl be done in atcor onte i oll~ ppli le $fa Minnesota Stafutes ond City of Eogon Ordlnances. Bu{Iding Officiol s = ~ ~0 8/ ~ z ~ p~, , . 1 site plan w/elevatiane i " , HUIL~TNG PEPMQT APPLICATION 1 set of er~etgyr Ci?lac+:.tiGns. . 7a &a Ue~a F~or n - 'val~arirn 8~~ narr nNnV I J~,~IG~i~ ~ ~~s • ~FICE USE Q~LY ~ Lot Blo[~c SeC./SUb. ~3w'~ F~-ect Ox~~anry IZ-'J j P~roel i s / 4- ~ S o a`~ ~ o~ o - 0*Atter zonirg R- I . Aepair Fire 2one N ' Odner: SeE ~°~ninl ~ rhl.arge _ 7ype of Cbnat. ~ lbve N Stories , Dennliat~ Front . atx/ztp ooae: - c,~aae - o~tn a tc. ~ ~ rha~e ~ APPAC7VATS f~'S ' oontractor: IDl•le~t-i P~,~iId~XS Assessmnts P t 3~9 ~ addresa: I l~55 fJDYWlXa~'1 1~VJ 1/~ WatPS/Sa+er Susrlwt+ge 4 l- ~ Polios Plan Q~eclt I t39 ~ . City/Z1P C1~de: ~fiGG,vl.~ ~5/~~ Fire SAC 525'> i Ptnna t: 4S~ - 6~u~ p~ia ~nner w rex Neter~ 4~~- ~ O~xvv~cil Aaad Unit ~ ' Bldq. Off. I Addteaa: • APC j~zi coae. 4,; ,~A ~ ' l l zomnr. a 7' S C~ 25.c~~ x 3~ 2y-. ~2 x 14 = q~~o3 `Z 5 j~ i 2= 30o x 5`fi = 4~ Zac> , IZ~ x- 54 ° ~~d4 ) 4 x °i ` a.~v7 ~ ~.S ~ ~~1 x ~ ~F ~ 30 44- Z4 33 ~ 22 33 = 54~+X ~I - ;Iq2~, ~g 2oDa ~ , aa es o;d 3 q a~ ~(,1 18 months 1rom A ~5335 ~g,~ L~; 5 ~f .y6 Reque t Oa~e Fire No. Ruuph-i spection n re ~Neady Nuw ~i11 No~ity Inspec- ~'~y ~Yes ?NO [arwnenneoav Licensed Electrical Contractor 1 hareby reQUest inspection ot a4ove ~ ? Owner eiacnieel work i~ielled et ' Street AdEress, Boz or Route No. Ci~~ S~~/ ecuon o. Township Name or No. Ranee No. Counry OccuPant fPpINT! ~C~ Ph {w y~ ~ 1 TS ~.J Power Sup0/l~iar~~ Adtlress IL-.L-/ Ele trical Contractor (ComOany Namel ~~~Y Conirar.tor s Lice9nse No. ~ --~~li • ~ ~l S ~ Maili Address (COntractor or Owner Makine Instailationl SS~' C'.~ m"' .,G ./~'J SS.3 ~ Authorizetl ignature (CO racto OQer Makinerl tallalion) PJho/ne /N/u~mbJer 7T / ~~~J MINNESOTq STATE BOAPD OF ELECTPICITY THIS INSPECTION REQUEST WILI NOT Gri99s-Midwey BItlB• - poom N-181 BE ACCEVTED BY THE STATE BOARD 7621 UniveraitY Ava., St. Paul, MN 66704 UNI.ESS PROPEN INSPECTON FEE IS Phone (612) 297.2Nt ENCl0.SEO. ~7~~~ ~ REQUEST FOR ELECTRICAL INSPECTION p~ o~~~~~Sea instructions tor como~e~irp this form on back oi Yellow copy. l(~'~I p~ p "'X" Belew Wo~:c,C~ve~ed by This Request Add Nep. Type ot Builtli~g AOOlianees NitW Evuiomsn~ Miired Home Range Temporary Service Duplex Water Heater Lightiny FixmreC~ ApY. Building Dryer Electric Haetin ' Commercial Bldg. Furnace Silo Unloader Industrial BIAg. Air Conditioner • Bulk Milk Tank Farm tne.r peci v ~her I5cedry1 t.r VeciFy Ot er ~~M1ar ompuie Inspection Fee Below # Fee ServicaEnt~encaSiza k Fee Feadars~Subfeedars k ~ Fea Circuits 0 to 200 qm s Z- 0 to 30 qm s 0 to 30 Am Above 200 qmps - 37 to 100 qmps 31 to 100 Swimming Pool Above 100-A s Ahave 700-A Transtormers Irrigation Booms Partial: Other F Signs SVecial Inspection SS~°6 TOT FE a~,ks ~ ct~f-ra RouBh•in f Oate Electrical ~ ~ oaccw, neree~ ~.uW rne~ ina aeo.a Final ' 9~ tiw Aas Oeen ( e. T~b mpuest rolU 18 montM Irom , ~G9 8~S 2005 RESIDENTIAL BUII,DING PF.RMIT APPLICATION ~`~'ly . a S City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 CCL~.j--~-C~ ~f Telephone # 651-675-5675 FAX # 651-675-5694 New Conshuctbn Reauirements RemadeVRenair Reauirements Office Use Onlv 3 registered s8e surveys showing sq. tt. of bt, sq. h. of house; and ~ roofed a2as 2 copies W plan CaR of Survey Recd . _ Y_ N (20%maximumlotcoverageallowed) 15elMEnergyCalcuW6onsforheatedaddNons TreePresPlanRecd ~ _Y-_N. 2 copies of plan showing beam 8 wifMOw s¢es; poured found design, etc. 1 sRe survey for addNOrz & decks Tree Pms Required ~ _ Y~_ N lsetofEna~gyCalculations Add~ion-'mdicateAonaResepticsysfem OnsHeSepOcSystem _Y_N 3 copies of Tree Preservatlon Plan'rf lot platted afler 711/93 R6n Joisl Dehail Oplions selection sheet (buldirgs witli 3 orless units) Date ~ / ~s / CoostructionCost //3~' Site Address `T£~51 Srl~"'FtezO UniUSte # Description of Work kYn~"~ -f- G~ 1,/i r) f)l~f, Multi-Family Bldg _ Y~ Fireplace(s) _ 0 _ 1 _ 2~ Property Owner 1o2E7o $ oir0~~lL Telephone #(~l ) 4~' 9~~ / Contractor C f7~ ` Address 52 City fh/ T7N State fJ i~ 12'!~ Telephane # ~ ~3~~~ COMPLETE TIi1S AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ven6lalion Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitled ~ . Energy Envelope Calculations Submiried Have you previousiy constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber n R elephone J ~ v Mechanicai Contractor ~ . ~~~5 lephone # ( ) 5~ ; -1 Sewer/WaterContractor ~1j~ Te phone#( ) \VU I hereby apply for a Residential Building Permit ~ 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. Ga~ s~.~~~2~~ ~ Applicant's Printed Name p' t' S' ture OFFICE USE ONLY Sub Types ? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ~ 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt-Multi ? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 D8-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 0 12 12-plex Pibg_Y or _ N ? 25 Misceilaneous WorkTypes , . ~ , ~ , . _ +1 r_ ~t J'~ ~ _ l. 1`it:~J ' . • . _ o; . ~ r•~ _ ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ~ 44 Siding O 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement `Demolltlon (Entlre Bldg) - Give PCA handout W applicant Valuation ~~i 0 d~ Occupancy MCES System Census Code L~i L Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const ~ / ~i Width REQUIRED INSPECTIONS _ Footings (new bid~ FinaVC.O. _ Footings (deck) X FinaUNo C.O. _ Footings (addition) T Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final ~t Framing _ Siding _ Stucco _ Stone _ Brick Fireplace _ R.I. _ Air Test _ Final _ Windows ~ Insulazion _ Retaining Wal] ~ Approved By: ~ ~ , Building Inspector Base Fee Surcharge ( '7~~ Plan Review I ~I~ / MC/ES SAC ' ~/U d~ r~r-, r i ~~r,.~ _ c~ty sAC / - Utility Connection Charge . / ~ / ~ ! c~oo!~~ S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ] „ 1 ~ ! .,Gj PLUMBING (RESIDENTIAL) ~,S'~ ~ ~'E~ Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pemuts aze required for each unit Date~/~/~ ~ Site Address 1 2 U\ Unit # Property Owner l~-l~e-~ ~QL1 ~~i ` C1 J~7,`U~ ~L Telephone k(~p'S l)~ L~~ ~g -1 ~ Contractor ~.bl~__~~Y~~__ Address S~~ City L~~1)~~~ State ~ 9~~ Zip Telephone ^IY Q-^.~-V lU~ The Applicant is _ Owner ~ Contractor _ Other Septic System New _ Refurbished Submit 2 sefs of plans and MPC license $ 100.00 Includes County fee. Additlonal consulWnt fees may apply. Alteratioas To Existing Dwelling Unit, Including $ 50.00 _ Adding fiMUres to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water tumaround 5/8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system ~ _~~~t~ v~ , ~ 1~~~ ` ~ Water sottener _ Water heater ~ 0~~ ~ ' $ 15.00 ~ replacement _ additlonal ` ~ P'~ ~ $ .50 State Surcharge Total $ ~ I hereby apply for a Residemial Plumbing Permit and acknowledge that the information is complete and accurate; that the work wIll be in confoxmance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application For a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work wlilch requires a review and approval of p . ~ 1l CVM ' ApplicanYs Printed Name pp icant's Signature ~X~~erRNc%~ X~~Fk:kc~kX~X~ %~X~~kSc~~~ %~~k ~C>;cW~kre ~W ~k~rcW ~kk~~:X~Y~ w r.,7:7Y OF ~~!;Flt~ CAFii-I:f.1-Re £:i TF.::F;~fIN6il_ Np: i'0 n~,7~a v,io~i~., ~..z~sr_.,: ~s;i~.~~s ID:, NAhfF e IiFlWN M SCHOL.FhOC.f; ~c10 `JOpi 4C~~35`~) 5Ht_'1=F-TEI...L~ S!]~00 '21.`lJ 3ClCJj 4p`.!`'~ ~iNE:.FFlk.~_II ~3,.J0 ~ tiU~!;:~:1. FY,Er•~a7.~:i1: AIYipF.lni;" Fi(].:iC1 r.F~~~~ %~:~-ra. us~_:4? .r.ns t~r~r?.r,v r~ ~Y,<~ kc?k~%1~~kY~ %~?X ~ ~F m?# ~ #%k?'~. ~k~k:X~k~~kX~ik~k ~k ~.Y,:~e ~%~kra%c i~ J . ~ PERMIT CITY OF EAGAN 3830PilotKnobRoad PERMITTYPE: euz~ozN~ Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 3 7 7 (612) 681-4675 Date Issued: 0 7/ 0 7/ 9 7 SITE ADDRESS: 4859 SHEFFTELD IANE LOT: 8 BLOCK: 1 BRITTANY 5TW P.I.M.: 10-15004-080-01 DESCRIPTION: B;ciilding~~Permit Type DECK ~fqi,lt~ing W~;rk Type NEW ~~Census Cade~`''~ 434 ALT. RESIDENTIAL ~ M,~ ~ . - ' "~.~~z~ l ~ f ~ \ f~ ~'4;_.. ~ (v~ . . ' _ ~ . i r-. ~ ~..TM. ~i. \ . 'ti _ k b t~'_ ?j )i ~ ~ ' : ~ / ~ r ` f' , ii , ; l Iyi y il 't ' ~ s€ 'o-.~'i . TMe ~"_l e v ~ ''j`~ i; v ) REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Tatal Fee $50.50 CONTRACTOR: OWNER: - APPlicant - SCHOLBROCK GREG ~ 4859 SHEFFIELD LANE EAGAN MN (612)405-9871 ~ I I hereby acknowledge that I have read this application and state that the information is correct ~nd agree to comply with a11 appl3'cable 5tate of Mn. Statu[es and City o'F Eagan Qrdinances. ~ , ~ ' < ` _ AP l C /P EE S ATURE ~SSUED BY: GNAT 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~J~ ~ ~ d ~ ~ > CITY OF EAGAN ( 5830 PILOT KNOB RD - 55122 ~ 681-4675 ~ New Construction Reauiremenfa RemodeVReoair Reaui~emerns y/ . ? 3 registered site surveys ? 2 copies of plan 7 • 2 capiea of plans (Indude beam 8 window aixes; poured Mtl. desipn; etc.) ? 2 afte suneys (exterior addRions & dedcs) ? 1 energy calculations ? 1 enerpy celculationa for heffied eddkiona ? 3 eopies of tree preservation plan H bt platted eRer 7/1f93 requlred: _ Yes _ No ' DATE: 41I~.~I~~~" CONSTRUCTIONCOST: ~145~ DESCRIPTION OF WORK: --~~~K C A~ I~Gti1~~ STREETADDRESS: ~~5~ ~~ti~~~'~ L t , n ~ . , / c7 W `S'''~ LOT Q BLOCK SUBD./P.I.D. , s c:L~~ ( brOG/L PROPERTY Name: ~ ~u'^ ~~:cb Phone owNeR u.. Street Address: 5`'~ S'~ ~ ~ City: ~ State: Zip: ~°S ~ Z 2- CoNr~?CTOR Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer 8 water licer.ged plumber (new construction only): . Penalty applies when address change and lot change are ~equested once permft is issued. I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicable State of Minnesota Stawtes and City of Eagan Ordinances. SignatureofAppticant: ^ n ~ /`~'~~N;'I - OFFICE USE ONLY V RECEIVED CertificatesofSurveyReceived _ Yes _ No 27 ~gg~ Tree Preservation Plan Received _ Yes _ No _ Not Required BY~~ OFFICE USE ONLY ~ BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling o 07 4-plex a 12 Multi RepaidRem. ? 17 Swim Pool 0 03 SF Addition o 08 &plex n 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex ? 14 Firepiace n 21 Miscellaneous ? 05 SF Misc. 0 10 = plex ~ 15 Deck WORK TYPE 31 New o 33 ARerations o 36 Move ~0 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. Cfty Water UBC Occupancy sq. ft. Fire 5prinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump ~ Length sq. ft. Census Code. ~'i' Depth Footprint sq. ft. SAC Code Census Bldg ' Census Unit ^ APPROVALS Planning Building ~l1 Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Other Copies Total: SAC SAC Units ~ ~ or.lis2e ~ ~ 188-3 JACKS~Ac\SURVEYOR5 Scalt: 1"~30' 11e6MT[~[O uroa~ uw~ es n~ r~rwoor~ D.o o Dtnote~ Ir~n : ~ ~ D =Dreinage _ =Drainage ~ UL1]~Lj~ ~~6EAfT55t1~SSqEE7,MINNEAPOIIS,MN55~t7 727.1161 . E~~tMOt /9 `5~.3':..._ ~ ' ~ C - ~ Yxisting Llev. ~)!~p~p~•Y~mj~ P /~(,L~ i' ' ~ ~ ~ ~ ' ~ i' / ' c ' y ' \ ~ P''~' ' ~ ~ ~ ~ ,~i / e S~, 1 ~ i y. ! i~, a 7~ f l;o~ 22~ 2~ 3 ~ ~ ~ ~ ~ ~ ~ i LC~ / T' ~ ~ ~,i:~~ / sY I:S. ~ / ~ / ; 4 ~ • v/, r~ ~ i\ o-: r , , , l ••F- ~ i r~. f/ !I ~"+n /G~ i . /v-. r I ~ ~ y I % / ~ ~ ~ - ( ~ ~ , ~ - j ~ ~ ~r. - i G~_f ~ ~ ~ J- ; - ~ ~ ~ , _ ~ ~ I i~. -r I 1 MCR[~Y C[RTI/T TMAT TM[ ~BOV[ 1/ A TRU[ AND CONRtCT PLAT OF a SURY[Y OF ~ ' ~ ~ ~ Loi S,Slock 1,Brit[any Sth. Addltion, Dakota C~unty,Minnesata. Proposed Carage Floor Elev.. Pr~p~sed Firit Floor ~lev. Propa~ed Saiceen[ iloor Elev. , lOth. !!~y 19tl4 , A~ W11V[Y[O \Y Y[ TMI\~ dY OI •.O. s10N[ n F. C. JA C~ON. M~M • R~ 011. NO• ~ 00 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~3~3 111 CITY OF EAGAN I ~!5 5~ ~ V~ 3830 PILOT KNOB RD - 55122 65'I-68'1-4675 New Construdlon Rea~iremen}s ~ Remodel/Reoair Reaulremenh ? 3 registered sBe surveys showing sq. M. ot lot, sq. tt. of house 2 copies of plan and all roofed areas (20% maxim~m lot coveraae allowed) 7 sei of energy calculatfons for heated addttions ~ 2 copie: of plans (show beam a window sizes; po~red fnd. desfgn; etc.) 1 sNe survey tor exferior addHlons 8 decks > 7 set of energy calcuiations D 3 copies ol hee preservation plan tl lot plaffed aMer 7/1/93 DATE: ~~~r'J CONSTRUCTION COST: DESCRIPTION OF WORK: ,/P~~ ~OOL` `~~I~D YY~ ~A ~~'~G~~ STREETA DRESS: ~fF,' a~ L 10T: ~ BLOCK: ~ SUBD./P.I.D. Name: Sc~oL~l.~.~ (~Rel~ Phone#: GS/-y~-!$7/ PROPERTY ~o$} F~m OWNER Street Address: ~rrfh ~1 ~a ff~'e~~ City ~~~.~.v State: Zip: 55 /Z2 Company:~zT~ ~D~/- %~*-G Phone#: /Z - 5-00~/O (area code) CONTRACTOR Street Address: /~`i g3 ~ud/a(1 ~Ji1 _ license # 20/3`//YO Exp, City ,,~jji2w r~/ ~~~i! State: ~ Zfp: 5 h~,3 3~ ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer 8 water iicensed plumber (reauired for new constructlon oniv): Penalty applles when oddress change and lot change Is requesled once permit Is Issued. I hereby acknowledge thaf I have read fhis appllcatlon, state that the Information Is conecl, and agree to comply wNh all appilcable Sfate of Mlnnesota Statutes and City of Eagan Ordinances. Signature of Appllcant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No 7 1~ ~ J Tree Preservation Plan Received _ Yes _ No _ Not Re quired ~ OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 03 1 of_plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) O 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ~ 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous , WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bidgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit ' S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC ~ ~ ~ ~,J 188-3~ . • ~ JACKS~SURVEYORS _ ~ ~ Sule: 2"~30' wconTC~io u..oa¦ uw~ er ~r~~ r~rrooT~ D,o o Denote~ Ir~n , ~ D =Dreina8~ . ~ _ = Drainage 6 U[11~Lj~ ~~6EA¢T55thETAEET,MINNEAPOUS,MN65A17 727•348~ La~resent r~ -S`~~ . ~~~-f- , ~ Exlstiog Flev. ~"i ~~~gurb+cpor'~ ~tttiGtdtt C/T j r`° ' = l L ~ ~ ~ J~r ~ Y ~ r; % 3 y- ~ ~ ~ . - , ~ ' \ y ~I ~ 1 ~ / ` ,i ~ ~r~ c~,. 1~1 ~ ~ ~ ( S._ ~r'• i ! l ~ ~ q r/ ~ \ ~ ` ; i ~ ~ ~2~' ~ • ~ i ~~r,~,,~'/ G-~ ~ ~ ~ ' ~ ~ , ~ -jsr~ 1 . i , / / ~ ~ l.:/ , r,s ~ ~i / \ ~ ~ ~ ~ C / ~ y ) ~ ~ ~ ' ~ . ~ _ ~ n' r. JJJ, ~ i~' ~ ~ ~ ~ - - ~ 1~ / r ~ ' ` ' ~ ~ ~ ~ -Jt~~^ ~ , ' ! ~ ~r, ~ ~ ~ ~ ~ , y~ ¢P V ; _ ; k q~a ~4 % ,~s_~_ - - ~ , ~G . \ so U PV 1 M[RL~Y CUTIIY TMAT TN[ A80V[ 1~ A TpU[ AMD CORR[CT rLAT OI A SY11VC1! OF ~ ~ ~ - ~ I`~~ ~5~°~. 2 G' S~ ~ Lot B.Slock 1,Brittany 5[h. Addition, ~a 5 Dakota C~unty,Minnesota. ya-\ i Prapnsed Carage Floor Llev. ~ Propaaod Fir~[ Floar Llev. Propo~ed Baseeen[ Ploor Elev. , / lOth. !!~y 19tl4 \ w~ w~v[rco ~r r~ iMU_ wv o~ -.o. ~ ~ - s~s~c x ; C. JA ~ON. Mu~ • . /b. j~. i _ - _._T-~~.'.-..~.._..,....... . . . . . . . ' . - _ _ . - . _.t , toilef~on 8u~lderr Inc. a~ Or.1i528 • 7. 188-3 ' JACK -SURVEYORS ~ Sc~ls: 1"z~O~ , I~f31~T[11[D. UMD[I1 u~w~ w ~r~ r~wwoor~ D.° o Denote~ Iron ; „`~iIY ~ 1 ~ _-f =Dratoagt ~ 0616E r55thETJlEET,MINNEAPOLIS,MN66117 727-YI&t . ~ ~ ~ " - _ = Drainage'6 Utllity P1f ~ Ea~c~sent -s''--~:-` C ~ EYi~[ing Llev. ~Surlupor'r'IGtCti6tatt P ~ / ~ ; ~ ~ .C_r ~ , ~ E , ' y, ~ ' ~~~J~~ ~ o , ~ 7`~•»- . - . ~ , ~y a . _ ~ , K,.. q~, f r ~ s ~ , a ~ ` } o~ ; /I ; a r , ~ ~x~ ~~~13 ~ c^ c/ ~ 3~ ~ ~ L' % ~ ` ,~v ~ ,s ~ ~ i. i J' \ ~~i ~ ~ ~ ~ s, / ~ ~ ~ o-' , ~ sF ~ ~ J°' f % , ~ ~ r J ~ _ ~ /r/ . 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' . ~ ~ ,[fr ' 4.. t 1~ . ~ •~7 ~~I4~ tl.rlf M ` ' ~ , ; ~ ' Q ~'~~.~..:a ~ ~ 'Z~~TY "!~T lrv"•r.. ; ~ ~ 1 • r . ~ . . . ~ r.. 1~ . . • ~ ~J~, . i~ 1,.... tr-y ~ ~ 1 ' . . . ' . . . i rl ~'ii~~~y~r4~~~~a'...~•~.~TYi ~ . ~ ~ . ~ l~ .i ~ ~ 1~: ~ ~ . . i. . ' ! . t ~ . t . S/ v ' I M~ ~Y.r +'r ~ ,t l ~ ~ ' ' ~ ~ ~ ~aiL .C~a f~ ..M . ~ 1~ -i ~.a .1~ ~ J~ ~ , cy~, ~u .'.j~':.. 1 ~w ' b~t l ~ ~ ~_.1~::S.~T:.~s:~.1.'S"~~t'._..1~' . ~ Z ~I~ 4w~J.~~'.._J.n.r__.;1f3y •~rL13L~'.t.~~:u.,~._ _ _ _ i ' . ~ _ ~is4 ~ ` CITY OF EAGAN ~ ~ - ~~111' APPLICATION FOR PERMIT ' SEWER AND/OR WATER CONNECTION .~.~'po~~ IP SE P. N ) , - O 1) PF.OPII'TY ADDRESS: '-7~o'~ri ?i • ~ n ui - /r..._, ..a r.Frai, o~Tpricv: ~,T~''~' S~K i '~iP/77'i~N~' ~''~4 f~D~~ (Lot/Block/Subc~ivision or Tax Parcel I.D_ Nu~-nber) l: ~{I;':'= :G .,~L'CIT..^,2E, DaI~' G_' CRIGi dAL':.iiILCI.`;G P~:•?IT ISS~?\C°: FP.=~4- ~,..~.a.. '~R-1 S~'GLE r^P`~.LLY , ~ . ,~.-.~C)°C~.,:~ i~j~: ' ~ t_ ? R-2 DUPT~.'Y {'n~p U~]ITS) ? R-3 ?C7•v'I~THOi;SE (TfT~2E;"' + UTIITS) ( INI':'S) ~ R-? PPARIT.~`:T/C~^.~:DC1~1S7I[.'~I ( [NITS} Q CC1~~'fERCiALJREI'AIL,/OFFICE ? Iti'DUSTRL~I, ? INSTITUTICN.=,L/GC~~\•t.EN'I' 2) p~n1,rC ~-p _ (PLEaSE ?RIYi) NA~~1E: TOLLEFSON BUILDERS, INC. • ADDI~SS: 1655 Norwood Drive CITY, STaTE, ZIP: Eaqan, MN 55122 ~ P~~' (6121 454 - 6873 3~ P~-.~~ (PLEASE PP1NT) FOR CITY USE ORCY N-'~`~= GENZ-RYAN PLUMBING AND HEATING - PIUH PS LILE45E: ADD~SS: 14745 South Robert Trail Active CI:"!, STATE, zIP: Rosemount MN 55068 ~ Expired PHO~~IE: ~t,. 0 Nat of Retord (6121 423-1144 PLUMBER LICENSE k 1849M ~O`J~ arr ~nitiz: 4) OCY..'LTPti'P/C?•TiI~ (PLEASE~ PRINi) SAME ADDRESS: AS CZTY, STA'I'E, zIP: (~BAVF PEfO^7~: 5) Ii7DIG:i~. WHICH PEPNLIT IS BEP:G RD~UESTEp; [X~ CC:~NF'.CTION 'ID CITY SEYIER ~ CO:,~'IGN 'IC~ CITY WATER ? OT?'~2 (PI.F115E DESCPSBE) 6) ~.~IG; ~ C:~.: _T ? PI, _'SE 1:OLD APF.RWEp PER~IZT FOR PIC:~-[.P BY 0;~1E OF 7~6G~ ~ ~°I.~'.:.~ '~IL r~PPRO'.'u7 F:;ri~~T :t7 1, 2. 3~~4 APA'~c. (Ci;'-ie one) 7) s:c.-x~.-~: ~,,~~e'~~~s'~'~ oN~r': .S 9 ~7 c^-.Q:t.' ~,-...a.:ea.iai e~~cs:t~~+.e aa's~:a~:~a ~ ~s G'.W vr[:a:tis:a:~s tR iitl;~:lYl:7~i01~ ~!Sl~FiJeFi~O FOR C ITY U S E ~ONLY - _ . PERNIT " ISSUED F°ES: S ~o. S~ SE:":ED DCD\iT'y^ (I~;CT_.~D~ ~liRCH?r':GE) $ io'. S a WATER PERf1IT (INCLLDE SURCHARGE) $ G-~ WATER METER/COPPERHORN/OUTSID° RE~DER $ WATER TA? ( Ii;CiiJDE CORPORATION STOP ) S SE:~EB ?'An . $ i-~%"-s ACCOUNT DEPOSZT - SE;:ER S "--a~ ACCOUNT DEPOSIT - WAT~R $ -s~7 Q • '~J WAC S ~s sac $ TRUNK ?JAT°3 ASSESSi~:E:IT S TRLiNK SE[+IER ASSESS.IE~iT $ LATEP~L BE:v'E:'IT/TRUNK SEI•:ER $ LATERAL BEVEFIT/TRUNK WATER $ OTfiER , $ TOTAL $ ~G~ ~G ANiOUNT PAID/RECEIPT ~ ~`~/8 9 DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGriT OF WAY? ~ YES IF YES, THEN A'"PERMIT FOR WORK WITHIN PUSLIC ROADWAY" MUST BE ISSUED SY TYE ~ NO ENGINEERING DZVISIO[V. LIST AS A CONDI- TION. SUIIJECT TO TEI~ FOLL0:4ING CO:VDITIO:`TS: APPROVED EY: TTTL~: vL. C_~FL/ o:;•:_. v ~ ~G ~i iii Cif~ c1 ca ii o i.7 Yk s}~ ~l~ P! ~ M fJ4 OI RO R+J PF~ /f a~ PJa !F RlA Gl:~1 C! 4~! ~I 1~ RESIDENTIAL BUILDING Permit Application City Of Eagan L ~ ~ ~ 3830 Pilot Knob Road, Eagan Mn 55122 y~-~~,~,~ ~ Telephone # 651-675-5675 FAX # 651-675-5674 I~-v3 New Conshuction Reauiremenb RamodeVFteoair Reauirements Olflce Use OnN 3 registered site surveys showirg sq. ft of bL sq. fL of house; and a~ rooted areas 2 copies of plan CeA of Survey Recd (20°k maximum lot coverage allowed) 1 set af Eneryy Ca~ulations for heated addifions Tree Pres Plen Recd 2 copies of plan showing beam & window sizes; poured (ound design, etc. 1 sde survey for additions & decks Tree Pres Not Reqd 1 set of Energy Cakulatbns AdU'NOn - indicate Honsite sepNc sysfem _ On-sita Septic System 3 copies ol Tree Preservatlon Plan'rf lot pWtted after 7/1/93 Rim Jois~ Defail Options selettlon sheet (bldgs wiN 3 or less unils Date Z / ~~A / a3 Construction Cost £ST. ~ 3S0<7 Site Address 7~~ S 1'~EFfir"LD LGy"~ ~t~b l}Y~ Unit/Ste # Description of Work ~f ~'"1 /vt SM Multi-Family Bldg _ Y_~ Fireplace(s) 1 PropertyOwner GR~G SC.f-tOLP~UGK Telephone#(~5~ ) ~OS-98~~ Contractor ~I~~ Address City S[ate Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventiiation Category 1 worksheet . New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculatlons Submitted Licensed Plumber Telephone ) Mechanical Contractor Telephone r v I, I_I `J I-` I ~ D I ~ l" ~ , Sewer/Water Contractor Telephone # ( ~ FEQ1d~ U I hereby apply for a Residential Building Permit and aclrnowledge that the informat 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. GRF.~~Y SGnag,eocK ApplicanYs Printed Name Apgticant's gnature OFFiCE USE ONLY Sub Types ? O1 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg JI~J. 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 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 (screeNgazebo) ? 36 Multl Misc. ? 05 03-plex ? 11 10-plex ~ 19 Lower Level ? 24 Storm Damage ? O6 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ~ 0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair /~\1 33 AlteraGon ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors 34 RBplacement ~ 'Demolitlon (Entire Bldg) - Give PCA handout to applleant ValuaHon Occupancy MGES 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 Corist Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings(deck) ~ FinaUNo C.O. _ Footings (addition) p~~~g _ Foundarion ~ HVAC _ Drain Tile Other ~ Roof _ Ice & Water _ Final = Pool _ Ftgs _ Au/Gas Tests _ Final Framing Siding Stucco Stone Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement) 1( Insulation _ Retaining Wall 7` Approved By T Z , Building Inspector Base Fee Surcharge ~ ! ~ ~a /r Plan Review ~ MC/ES SAC ,~"y~ City SAC ~ .a-M, Utility Connection Charge 1'~ S&W Permit & Surcharge Treatment Plant License Search Copies Other Tatal , 5~ ~ ~ ` p~ ~ ~ RESIDENTIAL BUILDING ' S~ • . \ Permit Application City OfEagan , 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion Reaui2menls RemodellReoair Reau"vements Office Use Onlv 3 regislered sfle surveys s~owing sq. ft. oF lot, sq. R of housa; aiW all roofed areas 2 copies of plan CeR af Survey Recd (20°k maximum lol caverege allowed) 1 set of Eneryy Calculations for heated addiUons Tree Pres Plan Recd 2 wpies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey far additlons & decks Tree Pres Nol Reqd 7 se1 W Energy Caltulations AddiGon - inditate i/onsife septic system _ On-site Septic System 3 copies of Tree Preservalbn Plan if lat platted after 7M/93 ~ Rim Joist OefaJ Options selection sheet (Ndgs with 3 orless unBs S ` Date ~ / Z~{ / ~~3- Construc[ion Cost SiteAddress 7u~-/ -~h~7?~D ~-~t UniGSte # Description of Work r7C~"~`~ ~ U~a~ L~I S~l ~q d.~ L~ Multi-Family Bldg _ Y_~ Fireplace(s) _ 0_ 1 Property Owner l~l~£b S fi~ G~-~p,o~ Telephone #(~q5% )~DJ ' 9~ ~'I Contractor ~"j~ ~ Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate o 1 _ Minnesota Rules 7672 Energy Code Category entiaPVenmatibn-Gategory t~ orksheet • New Energy Code worksheet (d submission rype) • S bmitted ~ I_L' Submitted • E .ergy~Envelope CalcutaUons Suq ~ itted : . 2i~ "T~11 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 pl in the case of work which equires a review and approval ofplans. S~ p I b~~ ~ G~-bo~r ~ s~ozd~~ 2 Applicant's Printed Name plican s' ature OFFICE USE ONLY .~z . , . 1 ~ Sub Types ' ~ ? 01 Foundation ? 07 OS-plex ? 13 16-plez ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 O6-plex ? 16 Fireplace 'CI 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 (screenlgazebo) ? 36 Mutti Misc. ? 05 U3-plex ? 11 1D-plex ? 19 Lower Level ? 24 Storm Damage ? O6 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ~31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 ~emolish (Founda5on) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/~oors ? 34 Replacement ~ '~emolitlon (Entire Bldg) - Give PCA handout to applicant Valuation ~~1.1 Occupancy ~,3 MClES System Census Code ~ 3 N_ Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. Footings (deck) FinaVNo C.O. ~ Footings (addirion) T~ Plum6ing , Foundarion HVAC Drain Tile Other Roof Ice & Watex Fi~al Pool Ftgs Air/Gas Tests _ Final Framing _ Siding Srucco _ Stone _ Fireplace _ R.L _ Air Test _ Final _ Windows (new/replacement) _ InsulaHon _ Retaining Wall Approved By r Z. , Building Inspector Base Fee Surcharge ~L~~~r'{~J A~,G,6~ Plan Review ~ MC/ES SAC ~~~,SA~ ~3~ ~r 3~ ~ 7, I yo Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies -oZ~ Other Total JACKS~, SURVEYORS •vY r ~ : e: 1"..30' iuai~ri~tc uroa~ urw er r+~r r~w~oo~~ ' D ~ noter Ir~n . :Disinage • DTi1A~ t~ Ut111L ~~6 EAjr55~ T.MINNEAPOIIS,MN55r17 7Z7~ R Y / Euenent ia \ 'r~-.9:... 1~~7 . Extsc ing Elev. "i r~ ~urlupor'f ICttti6[att J'` j P/~ ~ L a ; , ; ' ~ s , , c . ~ ~ , U~~~~,` ~ j C ~ \ ~~~~~i ~ , :y a , % t = ~<< ~i cy"s. ~ ~ ~ ~ t ` ~ J,; ,C~'qr' ~ ! ~"1 ) ~ • Y j ~~j.` "Z^ ' ~ \ \ ' ! • : 1 / 3K \ . • 1 . 1 ~ ~ ~ S' (A ~ ~ ~ ~ , y ~ ~ U lc ~ ,,'i e, ~ l , ` ~ ~yy... , . zc ; YY ~ ~ ~F ~r. V~ ~ , ~oy i, ~ ~ l~ ~ . ~ Y, ~ V l ~ _ / ~ ~ ~ i~ ~~r ~ : f! ~~r~~ 3. ~ ~ ~ ` ~ I . ~ • J . ~ i . ~ ~ ^ ~ ~ - - - f 1 N[R[tV C[IITIFY iMAT TME AlOV[ 1~ A TIlU[ AND CORq[CT rLAT Of ~ sYAV[Y O? ' ' ~ Lot B,Slock 1,Brittsny Sth. Addition, Dakota County,llinnesota. Prop~sed Carage Floor Llev.. Prapased Firit Floar E1tv. Propo~ed Ba~e~ent ilocr Elev. lOth. tLy 1984 w~ W11v[YtD ~r r[ TMU- r o~ ~.o. K fiawa ' C. 1AQ MIMM • Ry~ ~ , . . _ _ ._,..._-'-r: - . ' . . . . _ ~ f'°" ~ : ISSUEDBY: GNAT • . .z ~:s~ , . i For CJffce,,,~;ts~ ~ C7~~j OT ~•(~~(~n j Permit# ~ j i y r~. i 1 1J 1 I I J I Pertnit Fee: ~ 3830 Pilot Knob Road I ~ Eagan MN 55122 ~ Date Received: ~ Phone: (651) 675-5675 ~ ~ Fdx: (651) 675-5694 i Statf: ~ 2008 RESIDENTIAL BUILDING PERMIT APP~ICATION Date: 7 Z O Site Address: ~ s~ie tt"i~/~ L~ Tenant: - ~Suite RESIDENT / OWNER Name:~yc l~f~~.Y~C~ Phone:~/Z 2~~ S~~f' Address ! Cily / Zip: / S.~T S~ i°~Fi~1.` L OU ~,~~,qay Applirant is: _ Owner ~'Contractor _ TYPE OF WORK Descriptian ofwork:T~~~ ['~'J,~,~ CC/9~ Construction Cost: / ~ ~ Multi-Famity Building: (Yes _ / No CONTRACTOR Name: W~S/~7~N 9~J.~/N ~'S~.D/AJt~i License#:~J/ SSS/,~ Address: ~4d T~' ~ t/~ /U City:/~~y ~/l' +~f/ state: ~ Zip: y7/ / Phone: Contact Person: 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 Subrtlission type) . . Energy Envelope Calculations Submitted In the Iast 12 months, 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: SewerB WaterConVactor: Phone: ~ NOTE• Plans and suppoifing;documents thaf you submiCare consrdered to be pubhc informat~o,n. PorGon`s of; the mformahon may be class~~ed as'iion public if you piovide spyecrfrc reasohs thaf ?qould permif the C~ry fo , m, r w.;conclude thaf the are trade sec[ets. . I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the Ciry of Eagan; that I understand this is not a pertnit, but onty an application for a pertni[, antl 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. x. r6e~CtoJ4'~!/j~i~/~//.~P~ X /e.~s~,,~' .~Y//f~~'~- ~ h~pplicanYs Printed Name ppl~gnature Page 1 of 3 õ÷õ úï þýüýû ÿþþ ýüûùúûúù øýýþþïüø÷ ýö åýø å ÿ ÿþõ úù ø÷ ìùý öø÷ ô ó ìùý ßù üýü ý÷ Þù ù òý ûúý þ ý ÷ û þ ã å Ý üøú å ãú ðð ý òþ ì ëï ÷ý ç æåæåå ôø úù ýü ìä çæ ãæã óüòü õñð ÷÷ý Ý üøú å ãú ðð ý þýüýòô øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA137718 Date Issued:07/19/2016 Permit Category:ePermit Site Address: 4859 Sheffield Lane Lot:8 Block: 1 Addition: Brittany 5th PID:10-15004-01-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Reid Larson 4859 Sheffield Lane Eagan MN 55122 (612) 234-7343 Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460-6022 X253 Applicant/Permitee: Signature Issued By: Signature