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3034 Sibley Memorial Hwy421 111-1 "1 E6.00001-0e f REQUEST FOR ELECTRICAL INSPECTION / Poo See inshmolons for complebng this form on back of yellow copy. /4/aglis rx' Below Work Covered by This Request er Ne Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Cont??GtjGJfs Ramer Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps OD Transformers Above 200-Amps Above 100-Amps Signs Inspector's Use Only: TOTAL Irrigation Booms .D Special Inspection Alarm/Communication THIS INSTALLATION MAY BE CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby if h Rough-In Data cert y t at the above inspection has been made. Final Dat 1 OFFICE USE ONLY This request vold 18 months from 0 - o z5 4 9 1- . ?i aU 5 2 0 Reqate 7d ?? Fire No. Rouge-m yECtion Re 0 (You must call inspect. featly) tspeclion Other Than Rough-In Ready Now ?tiVill Notify Inspector El Yes No Date Reatl I licensed contractor ?owner hereby request inspection of above electrical work at: Job Atltlress (Street. Box or Route No.) ry? I City 30 /e mwue? Section No. Township Name or o. Range No. Coumy Occu ant (PRINT) Phone No. Gtr?u me_ 2f5 0S Power S ier Address Electrical Contractor (Company Name) Contractors License No. ?c G 60G-7a Mag Address Contractor or Owner Makin stall l rich)^(? - ?y A.`?JV?}, o ?.?5. I i n t, Y i -S Auncul3etl Sig ure ontra r her Ma ng Inm a0on) Phone Number !``! STATE BOARD OF ELECTFI 1CRY THIS INSPECTION REQUEST WILL N OT Griggs S oP SMN8 ni v II I II I I II I I I I I I I I I I BE ACCEPTED BY THE T F 6 u e , ersity A 55106 1821 U U ION EE N LESS PROPER NSPEC Phone (612) 642-0800 ENCLOSED. CITY OF EAGAN Addition MCCar Lot 2 Blk 1 Parcel 10 47700 020 00 iibley Hwy. State Eagan,MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1968 100.00 0 Paid * SEWER LATERAL 1972 351414 2 Paid - WATERMAIN * WATER LATERAL 1 2 20 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 2 9-1-71 BUILDING PER. SAC 240.00 020 9-1-71 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: + 1(11. H i LOCI i APPLICANT: Mt.t A14I14Y kIWill(b4?'? '.H?• >st..'tr floill lilt 1 Ili I N$ 1 1 fpf 1 !<)F PERMIT SUBTYPE: TYPE OF WORK: 11 RAI IIIN +I + I• I + i I ++ii 11111 ti'. W I NUl)415 ) Permit No. Permit Holder Date Telephone s ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLSG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL EAGAN TOWNSHIP BUILDING PERMIT Owner /.?[.... 1/... ---J---°°?----------------- *--------- - Address (present) v ......... .... --`- --..-?"?,"_..........---®®®- Address .ba.7..,/....... 3:?--"c!'.`.. ........ ? Y/ .. - DESCRIPTION N° 1370 Eagan Township Town Hall Date .."/lB_?:SS.- .............. Stories Used For To Be Front Depth Height E Cos! st.. Per m il Fee Remarks p ? ? _ 7 / l ? / Street, Road or other Description of Location I L02 I J310Clr I Addition or Tract Q This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE_XEPT ON THE PREMI{gE WHILE THE WORK IS IN PROGRESS.p ... ..? ...............has permission to areal-a..s .I.-... ..--upon This is to certify, that.-A, the above described premise subjec fY o the x provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. /? ,rrp ..... .................. ....._...... ... ............... Chairman of Tnwn Board Suildin9 Impactor 4 6 o l gq 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 0-0 o. C?? s/z?jos -atJ New Construction Requirements RemodeVReoaif Requirements office Use Only 3 registered site surveys showing sq. ft. of lot. sq. ft. of house; and L roofed areas 2 copies of plan Cad of survey Reod -Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd ' ` - Y- N. 2 copies of plan showing beam & window saes; poured found design, etc. 1 she survey for additions & decks Tree Pres Required - _Y _ N 1 set of Energy Calculations Addition - indicate ff onske septic system On-site Septic System _ Y -N 3 copies of Tree Preservation Plan ff lot platted after 711193 Rim Joist Detail options selection sheet (buildings with 3 or less units) Date 4 Constru tion Cost 6 Oo f oo Site Address L 4?, Unit/Ste Of Description of Work VYL ll Multi-Family Bldg _ Y 4 N Fireplace(s) _ 0 _ 1/'? 2 Property Owner Telephone # ( ?) 8-L? 6> Z S OC Contractor N - Ktl? Address VI/ City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category i Worksheet • 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 Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( 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. (? Dn Alle Applicant's Printed Name Applicant's Sig ature OFFICE USE ONLY Sub Types ? 01 Foundation 13 07 05-plex ? 13 16-plex 13 20 Pool ? / ` 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 3B Demolish Interior ? 44 ? Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 33 Alteration ? 37 Demolish Building" ? 43 Reroof 46 34 Replacement *Demolition (Entire Bldg) -Give PCA handout to applicant Valuation Occupancy X -j MCES System Census Code 1 131Y - Zoning R -/ City Water _ SAC Units - Stories Booster Pump _ # of Units Sq. Ft. PRV _ # of Bldgs - Length - Fire Sprinklered Type of Const _ Width - Footings (new bldg) - Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof _ Ice&Water _ Final - Framing - Fireplace _ R.I. -Air Test -Final Insulation Approved By: _ Base Fee v r Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Siding Fire Repair Windows/Doors REQUIRED INSPECTIONS Final/C.O. _ Final/No C.O. Plumbing _ HVAC Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone _ Brick Windows Retaining Wall Building Inspector 2004 RESIDENTIAL BUILDING PERMIT APPLICATION \ City Of Eagan % c? U S (e `? 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements office F3sebw 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Certaf Survi¢ Recd Y .._ N (20%,mwimum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres PIBq ReW ,_ Y _ N; 2 copies of plan showing beam &window saes; poured found design, etc. 1 site survey for additions & decks I& Pres REquuad , Y j l set of Energy Calculations Addition - indicate if on-site septic system OnsrteSeptic System t_Y _.N. 3 copies of Tree Preservation Plan if lot platted after M193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Q Date Site Address e, 0 L71 3!t S ( b l {./ t'/ pnt Construction Cost ah-,g 1 (T Cy./ Unit/Ste # Description of Work eo, ? O I' -r O.0 -9 Multi-Family Bldg - Y _ N Fireplace(s) - 0 - 1 - 2 / T c U Property Owner S-??i /? ?/ (` Telephone # ( ) Contractor / an L 1 h C_ Gy f O ?? ?' Address O state w-c S4 19 ?? 1r City 1-067--7 (k?!? 47Z, zip SS 420 Telephone#(9S2) E8/-2015 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet 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? fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Y _ N If so, 25% plan review Telephone #( Re rT q I hereby apply for a Residential Building Permit and acknowl 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. lcI--e Applicant's Printed Name Applic s Signatu e OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 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 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 ? 06 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 Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width - Footings (new bldg) - Footings (deck) - Footings (addition) _ Foundation _ Drain Tile Roof _ Ice & Water _ Final Framing - Fireplace - R.I. - Air Test _ Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUERED INSPECTIONS Final/C.O. _ Final/No C.O. Plumbing _ HVAC Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco -Stone -Brick Windows Retaining Wall Building Inspector _3CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: CCOAl 9*72/ BUILDING 026659 11/01/95 SITE ADDRESS: P.I.N.: 10-47700-020-00 3034 SIBLEY MEMORIAL 14WY LOT: 2 BLOCK: MCCARTHY RIDGE DESCRIPTION: WINDOWS) SF (MISC.) ALTERATION j (EGRESS Btfildinq.Permi.t Type $uilding tdbrk Type i W REMARKS: FEE SUMMARY: VALUATION $3,000 Base Fee $74.75 Surcharge $1.50 Total Fee $76.25 CONTRACTOR: - Applicant - ST. LIC. OWNER: MON-RAY WINDOW & DOOR 15468625 0005111 STATE ADMIN/BLDG CONST 8224 OLSON MEMORIAL HWY 50 SHERBURNE AVE GOLDEN VALLEY MN 55427 ST PAUL MN 55155 (612) 546-8625 (612)215-0138 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'Mn. Statutes and City of Eagan Ordinances. 'n(tton ??.f yh ?- APPL ANTIPERMITEE SIGNATURE SSUEDBT. SIGNATURE' INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 0 2 G 6 5 9 Eagan, Minnesota 55122-1897 Date Issued: 11/01/95 (612) 681-4675 SITE ADDRESS: P.I.N.` 10-47700-020-00 APPLICANT: LOT: 2 BLOCK: 3034 SIBLEY MEMORIAL HWY MON-RAY WINDOW & DOOR MCCARTHY RIDGE (612) 546-8625 IF_ L PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) ALTERATION DESCRIPTION (EGRESS WINDOWS) CITY OF EAGAN ill ?F' 3830 PILOT KNOB RD - 55122 l• 1409,995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681.4675 ? 3 registered site surveys ? 2 copies of plans (include beam 8 window saes; poured fnd. design; etc.) ? 1 energy calculations ? 3 copies of Use preservation plan if lot platted after 7/1193 required: _ Yes _ No DATE: 10 / 27 / 95 CONSTRUCTION COST: DESCRIPTION OF WORK: ? 2 copies of plan ? 2 site surveys (exterior additions 8 decks) ? 1 energy calculations for heated additions Enlarge three (3) windows to meet $2,689.00 U.B.C. Egress STREET ADDRESS: 3034 Sibley Memorial Hwy. LOT BLOCK _0 SUED./P.I.D. State of Minnesota Mike Fitzgerald PROPERTY Name: Admin/Building Construction Phone #: 215-0138 OVMER " T `"" Street Address' GIO Administration Bldg., 50 Sherburne Ave. City: St. Paul State: MN Zip: 55155 CONTRACTOR Company: Mon-Ray, inc. Phone #: 544-3646 Street Address: 8224 Olson Memorial HwyLiCense #: 0005111 City: Golden Valley State: MN Zip. 55427-4713 ARCHITECT/ Company: Phone #• ENGINEER Name: Registration #• Stri:< t AuLl City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot I hereby acknowledge that I have read this application and state that the infonnati 6 collect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No O C T 3 0 1995 Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ;?-05 SF Misc. ? 10 = plex WORK TYPE ? 31 New Ge 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMA1 iON Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS ? 11 Apt./Lodging ? ? 12 Mufti Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee Surcharge Plan Review License MCMS 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: MCNVS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit O Engineering Variance Valuation: $ C o a % SAC SAC Units STATE OF MINNESOTA Department of Administration PLAN REVIEW / BUILDING INSPECTION AGREEMENT COPY TO BUILDING OFFICIAL: Reid, Douglas Michael To imp°orrovve the e the quality City of Eagan and productivity 3830 Pilot Knob Road of Minnesota government. Eagan MN 55122 Project Title: 4 Bed SOCS Home Alterations Date: 2/9/96 Location: City of Eagan Description: Install exterior fence/smoke detectors/egress wind Date Received: 1/22/96 Assigned Project Number: 960045 Dear Building Official: Attached is a copy of the notice to the Architect / Designer of the project described above as to the agreement reached between the Minnesota Building Codes and Standards Division and City of Eagan delegating building code administration to your office as per our agreement on this project. Yours truly, BUILDING CODES STANDARDS Stephen P. Hernick Supervisor, Plan Review SPH:p Attachment PaFormR1 Building Codes and Standards Division, Facilities Management Bureau, 408 Metro Square Building, Seventh and Robert Streets, St. Paul, MN 55101; Voice: 612 296-4639; Fax: 612 297-1973 TTY/TDD: Twin Cities 612 297-5353 or Greater Minnesota 800 627-3529 and ask for voice number EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: September 1, 1971 NUMBER 867 i OWNER:Kenneth H. Keegan Address 3034 Sibley Mem. Hwy., Eagan 55121 PLUMBER Wiereke Trenching TYPE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial+ Commercial Residential ` Multiple Dwelling No. of units xxxx Location of Connections: Connection Charge 240.00 pd 0 9/1/71 Acct. Dep. 15.00 pd 9/1771 Permit Fee 10.00 pd 9/9/71 .50 pd 9/9/71 Street Repairs Total inspected by: Date Remarks: sy Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Totmship, Dakota County, Minnesota By, , Wier a Trenching d Excavating Cliff Road. Eagan 55123 Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St..Paul,-Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: September 1, 1971 Billing Name: Kenneth H. Keegan Owner: same Plumber: Wiereke T enching Number 706 0l A. lt?l Site Address: 3034 Sibley Mem. Hwy., Eagan 55121 Billing Address same .7RO.00 Pd 9/1/71 Is not connecting to water at this time but is bringing wate up to the outside of the house Water will be turned off at curb. He will be connecting to the water in a year or so and has paid for the meter on this date 9/1/71. Building is a: Residence Multiple No. Units Commercial Industrial Other Meter No, Permit Fee 10.00 pd 9/9/71 Meter Reading Meter Dep. .50 pd 9/9/71 Meter Sealed: Yes_ jAdd'1 Chg. NO I Total Chg. Inspected by Date Remarks: By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County Minnesota. By: Wiere Trenching d Excavating Please notify the above office when ready for inspection and connection. MEMO MEMO TO: Peggy Reichert, Community Development Director FROM: Erik Slettedahl, Planning Intern DATE: November 7, 1995 SUBJECT: ? 3034 Sibley Memorial Highway On November 7, 1 received a call from Mike Fitzgerald of the State Human Services Department concerning the property at 3034 Sibley Memorial Highway. Under the Data Privacy Act, he could not give out any specific information regarding individuals moving into the group home; however, the home will house two mentally retarded individuals who are coming from the Faribault and Cambridge Regional Centers. The individuals will have 24 hour supervision from a licensed care provider and will participate in a work day program during the day hours. Mr. Fitzgerald was very accommodating and said he would answer questions that residents may have concerning this home. He also mentioned that their department has information regarding property values near these types of homes that is available to anyone concerned about this issue. They also will, on occasion, have a neighborhood open house so that the residents have a chance to meet the individuals who eventually move into the home. Also, they are under contract with Anchor fence Co. to build 43 feet of six foot privacy fence. If the fence is over six feet high he would like to be contacted. 0$ o 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit 97-3o ,lo Date 0, / C/ / A!?O ' Site Address 3b3 , q cl S?b /i?c_ / m V Unit # Property Owner ? 1 J V Telephone # (l(/5? ) t/?OO /3&r;t- Contractor / l? __ j// (U Street Ad d re ss ?^ /t1??/ w ' City l / -r ?J -- 5-7-. ? ?/? ?vUn ? / y ? State Zip Telephone # q Bond #: Expires: The Applicant is Owner _A;-Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 1.e?furnace -Additional 2eplacement air exchanger air conditioner -New -Replacement other State Surcharge $ .50 Total $ C-30 W I hereby apply for a Residential Mechanical Permit and acknowledge that the i rmation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan Vw Mecha nial Codes; that I understand this is not a but only an application for a permit, and work is not to start witmit; that work will be in accordance with the appr ed plan in the cakgf work which requires a review and approv f n f h Applicant's Printed Name Applicant's Signature 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City. State Zip Telephone # ( ) Bond #: Expires: The Applicant is Owner Contractor Other Work Type - New Construction - Underground Tank Install -Remove **see below Interior Improvement - Install Piping - Processed -Gas Nature of Work: "When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minim" (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If permit fee is $1,000 or less, add $.50 => $ State Surcharge If uemiit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical 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 with the Mechanical 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 which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: 2005 RESIDENTIAL BUILDING PERMIT APPLICATION 1 + City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 a5 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas RemodellReoair Requirements 2 copies of plan .., ........_ Office UseonW CedoF $nney Recd ' ,,, Y _.N (20% maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Recd TYee Pres Ptsq £ree Pres Ret ai red _Y ?.N 1 set of Energy Calculations Addition - indicate if onsile septic system orkile SappcSyslem 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail options selection sheet (buildings with 3 or less units) Date 7 _ y Construction Cost 700w ^ Site Address _3e) Pi S ; e`v 14777 z 1- i Y Unit/Ste # k Description bf Work J _ v?g -d-- Multi-FamiJJly Bldg - Y - N Fireplace(s) - 0 - 1 - 2 Property Owner 5? 4'?l'.e .u Y a r o Telephone # (/ F7 ?) 582- -IDLYJ Contractor 1gVA VEer-U 1? , .s l E ? +` , Address 1160p State ?c?.-72Jc?zr? A erc` f?? .(? Zip Z s2 city/ V_o&Zmt AA74 Telephone # 7) 4 (- o 75:7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 - Minnesota Rules 7672 Energy Code Category • Residential ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted in the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( 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.. A _ ,Q I LLt04-sn., C/- q Coif i Applicant's Printed Marne Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 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 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 ? 06 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 Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) -Give PCA handout to applicant Valuation Occupancy MCES System Plan Review _ 100% or _ 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Unts Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile _ Other Roof - Ice & Water _ Final _ Pool _ Ftgs Air/Gas Tests Final Framing _ _ _ Siding Stucco Stone Brick _ Fireplace _ R.I. _ Air Test _ Final _ - - Windows _ Insulation _ _ Retaining Wall Approved By: Bu ilding 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 PERMIT City of EaganPermit Type: Building 3830 Pilot Knob Rd ' '' Permit Number: EA153953 Eagan,MN 55122 E AG N Date Issued: 02/05/2019 (651)675-5675 www.ci.eagan.mn.us Site Address: 3034 Sibley Memorial Hwy Lot: 2 Block: 0 Addition: McCarthy Ridge PID: 10-47700-00-020 Use: Description: Sub Type: Single Fam Construction Type: Work Type: Day Care Inspection Description: Adult foster care Census Code: - Occupancy: Zoning: Square Feet: Comments: Adam Gregg 952-303-1614 Fee Summary: Total: Contractor: Owner: - Applicant - State of Mn 444 Lafayette Road St Paul MN 55155 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. Applicant/Permitee: Signature Issued By: Signature