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1376 Sigfrid St E46 City of Eaali Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: r Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Suite #: RESIDENT / OWNER 11 `kV"? Name'V I 'e L tea• A. L,Sre.tr) Phone: ! \ .a .011.:,, --"T AG-tcwU, � %t2Z, Address / City / Zip: , . • Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: - — (\O ‘,3',.,.6.4.) Multi -Family Building: (Yes / No X ) CONTRACTOR Name:E.t. ...`�►.c vAoQ.S efV- %N.J . License #: 2t(0 -M ti 13 Address: 'SW.... 0..). Lt.) Sa 3 ob City: "SC • ki3citca V tA.t,.icEc State: VJA,' • Zip: SS ' Phone: 6 2. - lc6c6 "RSR` Contact: V �lc.,AAioe+.i Email: Q eQ-a S ‘A'» ► Kt COMPLETE In the last 12 months, has If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _Yes _No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information.,Portions of the information may classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. ° ' cry 4 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.gooherstateonecall.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, a.d ••rk is of 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 ap •'1•v 1 \of , \a x&TR�`iibRSb t• x \ ilLz-...� Applicant's Printed Name Appli ant's Signature Page 1 of 2 VILLAGE OF EAGAN 3795 riot knob Reed Eagan, MN 55122 Zoning: RIM Address: SEWER SERVICE PERMIT PERMIT NO.: 7497 DATE: q.12n/75 No. of Units: Site Address: 1!376 F- nigfr._A Plumber: Thetnp9gon Plumbing [b_ I agree to emply with[the VNIMp of Eagan Connection Charge: 415 00T Ordinances. Account Deposit: Permit Fee: 10.00 Pd Surcharge: .50 Pd By: Misc. Charges: Date of Insp.: Insp.. Total: Date I VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Rood Eagan, MN 55122 PERMIT NO.. -1_75 Zoning: DATE: -IUm X20/75 Owner:_3tmv-e,i> No. of Units: Address: - Site Address: Plumber: _J Meter No,:-Ls Size: Reader No.: 4 a- U O ff , L"WIY with the village of Eagan By ?'?C Date of Insp.: Connection Charge320.00 od_ Account Deposit: Permit Fee: 10. so 4 Surcharge: Misc. Charges: ??- eo Total: Date Paid: Insp.: INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ` 1 0 t 3830 Pilot Knob Road Permit Number: "? ??'> Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: 1.+1 I tst i,rlt 1;I.+N I tI ! rir. i 5191. PERMIT SUBTYPE: TYPE OF WORK: AI TFRAII(IN (itScIt1PTrON ( ti A I H ti (p o 04 ) INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit No. Permit Holder Date Telephone # ELECTRIC eja PLUMBING /D/?? SlJca. HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ' /ghl ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPSOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS:; APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: NIA I I r1 r N11 0 4 tt 7 y 1 z F permit No. Permit Holder Date Telephone it ELECTRIC PLUMBING HVAC Inspection Date Insp. comma FOOTINGS FOUND FRAMING ROOFING i N? TC7' Nv0 O ROUGH PLUMBING (rJ y G/J-GL PLBG AIR TEST 2 r.10, ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG 5 7//5 0?1 DECK FINAL Cf a O I / ? ?f C f- P INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: II ' 1 It ) W 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ti' ' F "1 (612) 681-4675 SITE ADDRESS: '1 d APPLICANT: 1.111. t,l fit ; e "144FRID 5F f t: is ?? ,; ire wi l OF FtNe tiff I?11N h1 N (h 1..t) ii4A- 3`?8i9 PERMIT SUBTYPE: 01 , TYPE OF WORK: RFPAIP. ROW- I NO ,_u Permit No. Permit Holder Date Telephone k ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments 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.I. BSMT FINAL DECK FfG DECK FINAL la S-q'5!5(4 nzc 02 ,6) e--T- CITY OF &, C-AN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERP4IT NO.: 565 The City of Eagan hereby grants to Thnm7ann alnmhina rp, of 19901 Minnat-onka A1vA_ a OT.TTMATMC Permit for: (Owner) Maroll rVfn Atnin inn 1366, 1355, 1347, and at 117E c_ R;nPr;A , pursuant to application dated R114/75 Fee Paid: $nn nn dated this 90 day of M=jz r 1*5 2.00 Building Inspector Mechanical Permits: Bid Total: C) -C? w. ,z S/ J `e PERMIT NO.: 680 The City of Eagan hereby grants to CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 of 4677 Gfica3c AVG So , Dlpla S5d07 a Permit for: (Owner) D10=611 rnnatsvctinn at 147A v_ riafrid , pursuant to application dated 5/19/75 Fee Paid: $2n-no dated this day of may , 19 75 .50 s/c Building Inspector Mechanical Permits: Bid Total: CITY OF EAGAN Remarks Addition Wilderness Run 5th Addition Lot 2 Bik 2 Parcel 10 84354 020 02 OWner&OCP 4 4)7AUUf YI"N Street 1376 E. Siqfrid 5' \- ` State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK )?D\ 1973 132.60 6.63 20 PAID SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA PAid with wate connection STORM SEW TRK ;'n 19$1 245,00 16.33 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $320.00 325 6-3-75 BUILDING PER. #3593 325 6-3-75 SAC 5.00 325 6-3-75 PARK ///-,/)F { OFFICE USE ONLY This request void 18 months from validation date grin in this box. 3 -7157 Q , A Ba, PLEASE PRINT OR TYPE Request Date ?' 7 required? No h =:= nshaction Other Than Ragh-Im ? Ready Now Will Call pector w en tl . Date, Ready. I, licensed contractor ? owner hereby request inspection of the above electrical work at: J61, Ad ress IStre Box, or R e No) / r --p 3 7 ?" 1 City i " & Zip Cade , . t Il Section No Township Name or No. Range No. Fire No. County -yam rJ/?/ti' Occupant (// des Pone No? y S/ 5 Power supplier e / Electrical Contractor (Company Name) Sp- (rn I eC-- Contractor License No. blaster Lic. No. (Knot Elect Ony) Mating Address Contractor or Owner Pedormirg Installation) l 30 ©k S? S. Auttwrized Sg ntract or Ow r dprmirg Insta a tionl Phone No 3? EB-OlNJ01A-11 8/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY *0357,7434* REQUEST FOR ELECTRICAL INSPECTION 90 Minnesota State Board of Electricity 1821 University Ave., Rm. S-,,128,$t. Paul, MN 55104 Phone(612)642-0800 Q I/? Home Duplex Apt. Bldg. Other y/? . P? New Addn Commercial Industrial Farm ? ,, 8nrDG?-' ?" / Remod Repair Air Cond. ' Htg. Equip. Water Htr. Load Mgmt. Other: Dryer Range Elec. Heat emp. Service "X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct tee: Other Fee Service Entrance Slze Fee Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Traffic Sig. Above 200_Amps Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLY TOTAL/ Sign/Outline Ltg. Xfmr. S(7 Alarm/Remote Control Swimming Pool I hereby cer s, cted the elydrica tion des ,bed herein en t. 411.s /ated Irrigation Boom Rough-In Oa? S i l I ti / pec nspec on a Fin l Investigative Fee a THIS INSTALLATION MAY RE ORDE D DIS NN ED IF NOT COMPLETED WITHIN 18 MONTHS. v ti CITY of EAGAN N? 3593 ? ? BB BUILDING PERMIT Owner .1:N..i C7L`. Address (present) ....._..P.... `i ..r.......... Builder ................................................................................................ Address .............................................................................................. 3795 Pilot Knob Road Eagan, Minnesota 55122 454-8100 Dale .....S7. ?:. _74 ... . ........... Stories To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks .?, 1R 39 LOCATION // e4_1.C"19 This permit does not authorize 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 KEPT ON THE PREMISE WHILE THE WORK IS IN PROG§ESS. This is to certify, that...-. .......... ..has permission to erect ? .......... ................... ,.................. `??............._ p the above described premise subject to the provisions of all applicable Ordinances for the City of?EagarL 7- ...... ---'-...=.y .... .............................. Mayor \ Lot block Addition or Tract A 1 ^^ p Per .......................... I P...... ? ..? ......................... ` Building Inspector -s6 SANDRA POLLOCK St. PAUL TITLE INSURANCE 7900 Xerxes Ave., So, Bloomington, Minn. 55431 9-4-5 City of Eagan Check enclosed for assessments due on Eagan, Mn, parcel Thank you. Sandra r full payment of special n 1376 East Sigfrid Street 10-84354-020-02 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 'U,-7Cl OC? New Constmction Reauirements RemodeVReoair Requirements Office Use OnN 3 registered site surveys showing sq. ft of lot sq, f . of house; and all roofed areas 2 copies of plan _ Cart of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate d onaife septk system _ On-site Septic System 3 copies of Tree Preservation Plan Slot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date / /3 Site Address S-I 1 Construction Cost oC(}O?J ?P I'1?e S-C, UniUSte # Description of Work U Q 1 P q Multi-Family Bldg _ Y N ferslfiNcd tyh. 9Y Fireplace(s) _ 0 & I ?_ 2 Property Owner 2 UJ 1 C ioo // Telephone # (c -,51) ?S'f,j - ry / 7 9), Contractor 1 d 9 `a -0 C :9 a M / Address ?n ?? t/ ??j • 1y il. rA State n I V s V City Zip J? Jr ?? Telephone # (q_'6t) COMPLETE Energy Code Category (J submission type) Licensed Plumber Mechanical Contractor Sewer/Water Contractor THIS AREA ONLY IF CONSTRU.CTI A NEW BUILDING r? X411; ?? Minnesota Rules 7670 Cate Q?j Minnesota Rules 7672 • Residential Ventilation Cate Works eet r. .:?? 1 1 • New Energy Code Worksheet Submitted 11\ SUN '- 0 1- Submitted • Energy Envelope Calculadons'6ubmitted 1 e Telephone #Y59,)9,9() -d2,L-6 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. oct U ,^I :T, IBC) 044- Applicant's Printed Name OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 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-plea ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. ? 31 New ? 35 Int Improvement ? 36 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to 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) _ 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 _ Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) _ . Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total S3S-1 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq, ft of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 7/1193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE SITE ADDRESS TYPE OF APPLICANT L4 c' P1 FIREPLACE(S) _ 0 ?1 _ 2 STREET ADDRESS I -S 2 (?P F 5-r :???,?(Cmr an STATE/411 ZIP 5"?1z3 TELEPHONE # CELL PHONE # FAX # 7 '? I Z' 1,;7 S?7 PROPERTY OWNER TELEPHONE# 0 ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • rtdgvn?YfF 11 ?u L[ • Energy Envelope Calculations Submitted I-'C IUI 2 4 2002 Plumbing Contractor: --- Plumbing system includes: Mechanical Contractor. _ Mechanical system includes: Sewer/Water Contractor: - Air Conditioning Heat Recovery System Phone # Phone # Fee: $70.00 I hereby acknowledge that I have read this application, state that the information i orrect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordina Signature of Applicant OFFICE USE ONLY ?3 ?Co E 5rc I ? ? )_2? * / 2 Remodel/Repair Requirements • 2 espies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic ternforaddifion add VALUATION t) A ?" i? S-1- MULTI-FAMILY BLDG -Y ? N Water Softener Water Heater No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths Certificates of Survey Received - Tree Preservation Plan Received - Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of - plex ? 04 02-plex ? 05 03-piex ? 06 04-plex ? 07 05-piex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-piex ? 17 Garage ? 10 08-piex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or_ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt --SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)- ? 43 Reroof ? 46 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 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 _ Fireplace _ R.I. _ Air Test _ _ Final _ _ _ Windows (new/replacement) - Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Building Inspector Total rk>kM?t„rk?krkM%t"e?C?i?d%?ie,tin:?n: tx: ;eryr;e8o?;?;rXr}.r';x i:trei?ti;gX<::,tt CITY OF EAGAN CASHIER: JS TERMINAL NO: 748 DATE: 08/30/33 TIME: 1015000 ID: NANEI; BRUCE. A. B0DFI-SON 321.1:) 9001 1376 E SIGFRI:D 60.00 3430 9001 1376 F SIGFRID 0.25 205 900i 1376 E SIGE RID 0.50 3430 9001 LF FORM 1.00 Total. Receipt Amount: 61.76 Ci21.i.E:, O USER I% JAN ?k??F#:?trkYFXt?trkMY,<Y,crnXtY,c>XrY?>k;:t ?rY?Y?;??cr?rk?8cr,t;??:rXX^:t>XaY 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN s 3830 PILOT KNOB RD - 55122 3t ? 651.681.4675 New Construction Reaulreme?s ? S registered site surveys showing sq. ti. of lot, sq. ff. of house and gel roofed areas (20% maximum lot coverage allowed) D 2 copies of plans (show beam d window sizes; poured fnd. design; etc.) D 1 set of energy calculations D 3 copies of tree pres rvatio plane I lot platted after 7/1/93 DATE: 5/?L417 g ` DESCRIPTION OF WORK: STREET ADDRESS: f Company: J-01 Phone #: (area code) LOT: BLOCK: SUBD./P.I.D. #: w x CAA yl L I? u ?` Name: Phone #: PROPERTY Last First J OWNER Sheet Address: 13 ?? f 9? 1 G City .? h State: / r 1 1't zip: '*c_l CONTRACTOR Sheet Address: License # Exp. City ARCHITECT/ ENGINEER State: Company: 4 in., '? - ,,a Wk Telephone #: area code ( ) Street City State: Sewer a water licensed plumber (required for new construction only : Penalty applies when address change and lot change is requested once permit is Issued. Zip: 10 K e, 1Ve-4L;4dj I hereby acknowledge that I have read this application, state that the Information Is correct, and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 10 0 /y OFFICE USE ONLY tl`!t{r /?/ Certificates of Survey Received V Yes _ No Tree Preservation Plan Received - Yes - No .-s(V?5 Remodel/Reoalr ReaulremeMs c 2 O? 2 copies of plan O " J - l 1 set of energy calculations for heated additions 1 site survey for exterior additions t decks 'RUCTION COST: ne_ Su 96 460 OP r f to !5 ;gfr, ;d -:S4 i/Not Required AUG L 7 Zip: Name: Registration #: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? ? 02 SF Dwelling ? 07 5-plex ? ? 03 1 of _ plex ? 08 6-plex ? ? 04 2-plex ? 09 7-plex ? ? 05 3-plex ? 10 8-plex ? WORK TYPE RED I PJ? I PTr-, ? 31 New ? 35 ? 32 Addition ? 36 YK 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) • P4 (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning 11 10-plex ? 16 12 12-plex ? 17 13 16-plex ? 18 14 Apartments ? 19 15 Lodging ? 20 Fireplace ? 21 Garage ? 22 Deck ? 23 Lower Level ? 24 Pool 25 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft, sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Porch (3-sea.) Porch/Addn. (4-sea. Porch (screened) Storm Damage Miscellaneous eJ Permit Fee (0 0. DO Valuation: Surcharge 5n Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit l , 00 E:P FOl?-M SM Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: L U ?5 Engineering I Pew fie- -gup c e_- $ Coo SAC Units % SAC ities Di ig tal Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. .7z- 3,S 9,3 a 5. a .4:.T '9P f °S+R F? a AS r m, §C":?. .. 'RL -31'1 f-n ? .y •. 1 1. .: R' w.r M ([y I P 55 02 SCHViANZ l0.NO SVRte YOi ' _. _ „n fvpatKM :/?0er aawr or Tea 511ta of, NUM41Qta t?3h MAIN ST +E T P.O. 9t;X M • ROSES'OUNT, MINNESOTA E5068 • PHONE 612 423.1769 SURVEYOR'SCF.RtlFICATE F h ti [ r. ; 4 r l t ,t "h Ivy: R V "t yt 2FT t'] s . ?.qv? v" ? g. 6 - 1 'Lr ' " f a? 5 ? fiTY it w r $ i Y 4- 's i:.y ' .? t eu _ ,? J" 4ti t : M s , it 1. IN 4 y J' al 1 t - CAL 1'a`?Ot 7 f a a a ?a a i r§ It, yy . i c F r r , h ,;. clil Dfl EOTIQN; EE'1 s 1 b 'r. T her^!; R rtifv }h8+ TTtl^ is a tr:e Sti(jpy orr?ct repr^es++at,tt3?a of ot 2s' ' r:y\ 3s c i P;t1 Q`T { rla?a.2! a L^1 .`r Rr%. 'a'nlT dDDITIC f• :kata CountP? Nir.:lesotaa s - Al:'..9 E`+?Tf :(,a t.. ®":.t7CAtion ?!'.2 nr DCS ? ? r= '? r s'n Sr' r r v?. ? Ya-: ?ys-cg r ' = T 31-74 n i ? r !? ? ?, H k r 70 TT?'T?RTT?T•?N TKTTTT4T/.?T?TTTTlTTTTTTZ?MA?TT os•C9 ASNWN :Q: h-M 9SDE9i3?i :+?enowy }aTaaaa I?""-o1 Wo 13 OASIS 9LET 00'09 1S al-wz)I3 SL£T DJ ANDO S1N3N1SMNI A3TWA TZ+6Z-IST =3WIi L6/£T/TG Big =0N VNIM831 S Toap SSTZ TDD. yse +41 x 31WA J 2OIHSdo NVW3 30 AlID ?Y?Ick%C?*?K?kA??X#*%?Tnk?uK%c?C*?wk?:k*Ac**Ic?:kx*x?c?gK CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: BUILDING Permit Number: 0 2 9 4 0 5 Date Issued: 01/13/97 SITE ADDRESS: 1376 SIGFRID ST E LOT: 2 BLOCK: 2 WILDERNESS RUN 5TH P.I.N.: 10-84354-020-02 DESCRIPTION: (BATHROOM) Building`-Permit Type „wilding Work Type Census Codes t ? 17 BASEMENT FINISH ALTERATION 434 ALT. RESIDENTIAL ?} 1 t REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee i $50.00 $.50 $50.50 CONTRACTOR: - Applicant - ST. LIC OWNER: VALLEY INVESTMENTS CONST 14545191 0004241 BODELSON BRUCE 2401 LEXINGTON AVE S 1376 SIGFRID ST E MENDOTA HTS MN 55120 EAGAN MN (612) 454-5191 I hereby aoknowliedge 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. APPLICANDPERMITEE SIGNATURE ?MII i,?lm.? 'ISSUED : SIGNATURE 7 BUILDING PERMIT APPLICATION (RESIDENTIAL) 4,?Q ff o n4V; CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; eta) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted after 7/1/93 required: _Yes _ No ' PFi DATE: /-7-177 CONSTRUCTION COST: 0 C, ? DESCRIPTION OF WORK: STREET ADDRESS: LOT j_ BLOCK mono 6L 44".5-27W4- B ---In r- ?B-Af t 13-76 ,S / b FR--s P- E _ SUBD./P.I.D_ #: PROPERTY Name: 1ei70--FLs0/V Phone#: OWNER .. ... Street Address: 7(= GF r City: r,4,7 /? State: Zip: CONTRACTOR Company: V {???Fzti, -?V J?SIniEN r Phone #: Lam/ Street Address: LC-yCi. License #: City: 0 / I N fJd ?6*7e State: nj A/ Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): W FW 41a ( . Penalty applies when address change and lot change are requested once permit is issued. agree comply with all applicableagreeo comply with all applicable 1 hereby acknowledge that I have read this application and state that the in7:2 State of Minnesota Statutes and City of Fagan Ordinances. Signature of Applicant: OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No JAN 0 7 1997 Tree Preservation Plan Received Yes - No Not Required By. BUILDING PERMIT TYPE OFFICE USE ONLY ? 01 Foundation ? 06 Duplex ? 11 ;Aat./Loftna 0"?16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08.8-plex ? 13 . Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14' 'Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _ plex ? 15 Deck WORK TYPE ? 31 New Ef'?'33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCIWS 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 Basement sq. ft. MC/WS System _ _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. a 3,{ _ Footprint sq. ft. SAC Code o i Census Bldg Census Unit D Building B Engineering Variance Valuation: $ ?X? ???:K?kXt?Y %ic:?CTC???ac??K?CrX?;rkW??h?k?kk:##Xc*?K%c?K?X?k?k?C%c CITY OF EAGAN CASHIER: S TERMINAL NOu 351 DF,TEa OS/J.4/96 TIME: 09^36-.32 III NAME: HORIZON COMPANY ROOFING 3210 9001 1376 SIOFRID ST 37.25 205 9001 1376 SIGFRID ST 2.00 Total Receipt Amount. 69.25 CRO629t5 USER ID; NANCY CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDING 028553 08/14/96 SITE ADDRESS: P•I.N.: 10-84354-020-02 DESCRIPTION: 1376 SIGFRID ST E LOT: 2 BLOCK: 2 WILDERNESS RUN 5TH (ROOFING) Buildng.tiPermit Type SF (MISC.) Building Work Type REPAIR Census Code 434 ALT. RESIDENTIAL 7 `r r ? r flr) REMARKS FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $87.25 $2.00 $89.25 $4,000 CONTRACTOR: - Applicant - ST. LIC.OWNER: HORIZON ROOFING 18903900 2001279 BODELSON BRUCE 1333 LARC INDUSTRIAL BLVD 1376 SIGFRID ST E BURNSVILLE MN 55337 EAGAN MN 55123 (612) 890-3900 (612)454-7412 e 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. L APPLICANT/PERMITEE SIGNATURE Ay 14 ISSUED BY: FIG NATURE ?._ CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ?e6A 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Requirements Remodel/Repair Requirements ? 3 registered she surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured Ind. design; etc.) ? 2 she surveys (exterior additions & decks) ? t energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation pion if lot platted after 7/7/83 required: _Yes _ No ?9 d DATE: -9-96 . CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: LOT BLOCK I SUBD./P.I.D. M PROPERTY San Name: _/ / Phone #: yJ 7 ???? OWNER Street Address may d SY/P-? City: State : '"} Zip- 171G 6Z6,?7 7 ? A-2 Phone* M- Aa oo CONTRACTOR. , Company: 1 2 Street Address: /3? cyCo/ x795 Z? License # City: ZSUeO--'i //e State: -;'l zip. SJ ?? 7 ARCHITECT/ Company: Phone M ENGINEER Name: Registration # Street Address, City: Sewer & water licensed plumber: change are requested once permit is issued. State: Zip Penalty applies when address change and lot 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. 1 Signature of Applicant: C? c n ?y?s OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No AUG 1 .a 1995 Tree Preservation Plan Received Yes No BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex 0 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex a 05 SF Misc. ? 10 _ plex WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION OFFICE USE ONLY ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolitiqn Cont. (Actual) easpment so. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MCWS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Meter Rueter Acct. Deposit SAW Permit SAW Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units / L ? BL CITY USE ONLY RECEIPT#: SL- ?p ?,, V _ J, Z -F7 SUBD. Lluzztl? S DATE: LIO 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 6814675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH ?Q. TOTAL Shower 3.00 x _ Water Closet 3.00 x _ Bath Tub 3.00 x = Lavatory 3.00 x _ Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 ;< _ 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 65.00 = (new and refurbished systems) U.G. Sprinkler' home under const. 3.00 = Alterations ' to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL c20•Sfl SITE /3 OWNER INSTALLER NAM STREET ADDRESS: Z Z5:9 08- CITY: P udm STATE: /",)A/ ZIP: PHONE #: (6 /,L ) 4/S - 1,5615 (JiGte7? v TT OFFICE USE ONLY L SL SUBD. RECEIPT #: DATE 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: . all commercial/industrial buildings. k multi-family buildings when separate permits are W required for each dwelling unit. DATE: WORK TYPE: _ N:?W CONSTR!UCTION DESCRIPTION OF WORK: ADD ON REPAIR IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO. FAILURE TO PROVIDE 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 SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE z 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: OWNER NAME: INSTALLER: ADDRESS: CITY: PHONE #: STE. # CONTRACT PRICE: SIGNATURE: OFFICE USE ONLY METER SIZE: DATE: STATE: ZIP: APPLICANT _ INSPECTOR: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: -&Vlgs ? '5Izly BUILDING 025648 05/22/95 SITE ADDRESS: 1376 SIGFRID ST E LOT: 2 BLOCK: 2 WILDERNESS RUN 5TH P.I.N.: 10-84354-020-02 DESCRIPTION: Building Permit Type Building Work Type 4 ?y- DECK NEW REMARKS: FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: BODELSON 1376 EAGAN - Applicant - BRUCE SIGFRID ST E MN IL I hereby acknowledge that I have read this application and state that the information is orr ct and agree to comply with all applicable State of Mn. Statutes n' ,it `A Eagan Trdinances. Jlu ISSUED 8 SIGNATUURE ? f INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: P • I . N .: 10-84354-020-02 APPLICANT: LOT: 2 BLOCK: 2 1376 SIGFRID ST E BODELSON BRUCE WILDERNESS RUN 5TH PERMIT SUBTYPE: TYPE OF WORK: DECK NEW L BUILDING 025648 05/22/95 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 _,- New Construction Reouirements RemodellReoair Reouirements ? 3 registered site surveys ? 2 copies o} plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; eta) ? 2 aite surveys (exterior additions & dcs) ? 1 energy calculations ? 3 copies of tree preservation plan iF lot platted after M/93 required: _Yes _ No / DATE: ?:/ & CONSTRUCTION COST: DESCRIPTION OF WORK: r ` e.,yla e- I N p Oe ee k STREET ADDRESS: L/ LOT C)-O BLOCK SUBD./P.I.D. #: S PROPERTY OWNER CONTRACTOR Name: Phone #: ?/p} FW6T Street Address- City: S i a -:" %, l I'S '' State: Zip: Company: S e- 14 . Phone #: Street Address: City:. License #• State: Zip: ARCHITECT/ Company: ENGINEER Name: Street Address, City: Sewer & er licensed plumber: chang re r quested once permit is issued. State: Phone #• Registration # Zip: Penalty applies when address change and lot 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. /o Signature of Applicant, GAG OFFICE USE ONLY U3ECENED Certificates of Survey Received _ Yes _ No MAY 17 1995 Tree Preservation Plan Received Yes No --------------- BUILDING PERMIT TYPE 0 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 .-6? New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning OFFICE USE ONLY ? 11 Apt./Lodging o ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? 15 Deck oia? ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SM Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ /Z as y { fC ? 1 j .. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. Y3Y SAC Code O/ Census Bldg i Census Unit o % SAC SAC Units 1 I ?; I I I; ,, I j I I i I I ? I i I I I I I ? I I I ? I I ( I ? y h - ? I I I ! i I I i I I I i ? I l 1 I T I' i I I i I i l !! I I I I I I i I!! I I I I l i ! I II I I i i l I I I ! i i ! f i l l I I I ? I I i : ! 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[i tlLl 4 r f t Lam. ,>?,'4 f b• - '? c ,?a A k ua .Z .`,? yy .S.k ,,t y; : < '? r. ` ?! ,> ?/^a• ft, 'f !tf o..f. .t f4 ,. :? +^ u r F. wt"?[ a. a - ' ti, ctn. i ? -• 'y' + ?? ! 3? „ •; ?st ? ? ?? :•.,r i ,.ti ? a• < f- r; ? ? •? s is.;", , ,?`; t? Sir. ffp? hem 7 ub4 ei?`?' f? ? ..,? Fri t! r - ? r '• ,? ? ?, :f • ? t ,u l ?_,? - ?Y "??r,.•? y ? ??. 10 - ?' fi ?`' } ?'s, ?' ? 9 4?L? *?ti?`- 1. >. ?'. 'a"i: R.?};'k.a .?!1 7•?- ?. :f v ??, 4 ?-ir`.y -.r ?' ?, Y + 'too 4` 1J yam`[ ;' '(' .!A.R,. -f.- lF 7, j.?'? fi,Y, ."A 'h y:• 1 .1 s ??,i{ . f i? - '?- - `ti ? -?' j -? 1k-, . 7.,''Qa r.? „ ? 1.-? ?: 'rf?•?_ ' t>. - ...,?'"L?F r ' - •N.ra t 4, P ;r k .4 I"'heM«:t±y c .rt{fy ?hjt .tbls Ir &trii au orrect rcp seatatinn of? 4; " L*?Ef'. :RN 'IFT"rf ADDTTIO kota Count, r? M n.?Fr1o e? ; F `` ??l:?c?..?6horti ?,? tt:d1IoC4tioA o!'.'-3 protic54 bAld3.r3g tFesrccxi? r 1 1-7 f w f ;!' 1?•'? ?' ? >,. • ru•.]T.A/ ?.??1-L ? Tr`?? ?tt•i?? !, !'. f :u'?v J ?i -.1J ... _ ?'?:. MASTER CARD OWNER STRUCTURE AND LAND USED AS Permit No. Issued Issued To Contractor Owner BUILDING PLUMBING ?7 5 // ?AmwlrOJa Y-- CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING /te SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING tkatthe SEPTIC FOUNDATION ?. I ]S CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL ' SANITARY SEWER Violations Noted , on Back COMMENTS: t COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CE RTI FI CATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING I COMMENTS: . za PERMIT City of Eagan Permit Type:Building Permit Number:EA114940 Date Issued:09/20/2013 Permit Category:ePermit Site Address: 1376 Sigfrid St E Lot:002 Block: 002 Addition: Wilderness Run 5th PID:10-84354-02-020 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Matt Czech 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 - Bruce Bodelson 1376 Sigfrid St E Eagan MN 55123 Pineview Builders Inc 2201 Lexington Avenue N, Suite 100 Roseville MN 55113 (651) 489-3696 Applicant/Permitee: Signature Issued By: Signature For Office Use Us � f "` et Permit#: � �( � w„ txa� „ ,„, EAGAN ic,3,) Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(&cityofeagan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Li/Date: �—It,ii; I Site Address: 13 `>' / '`--c-/1 ' Unit#: Name: 1 0 4G eAc..�*:?. I S5/ t Phone: ,,2-7----- 24-f'-- �7` J a 7 Resident/ r 41 ; .� 5-i- owner Address/City/Zip: ! � � �-, � i5 ���� Applicant is: Owner /Contractor Description of work: 1 `�l d �l`�f �' ��4 /1 Type of Work 7 v Construction Cost: 3d Multi-Family Building: (Yes /No ) ' Company: Contact: Contractor Address: City: State: Zip: Phone: Email: 1 License#: Lead Certificate#: I If the project is exempt from lead certification, please explain why: 1 : COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: • Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: , Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-.ubllc if •u •rovide s•ecific reasons that would •ermit the Cit to conclude that the are trade secrets You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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.ora 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• tart w'hout a permit that the work will be in accordance with the approve plan in the case of work which requires a review and approval of plans. / / x g IN111 e---e- i" eA e I 4" x , .. Applicant's Printed Name Applicant's Signature