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4818 Shevlin CtCity of Eaiall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 --6)1EIZE V7 JUN 1 4 2010 Use BLUE or BLACK Ink For Office Use p� Permit Fee: ,Staff:Permit #:917/1/11 o Date Received: 2010 RESIDENTIAL BUILDING PERMIT/APPLICATION Date: 10/11110Site Address: X �U \� //!� i Tenant: Suite #: RESIDENT / OWNER Name: U7gWn, Y) l01//eif Phone: Address / City / zip:`TY/�i% Q ilk,/G� Applicant is: Owner Contractor TYPE OF WORK Description of work: 1?-everf Q� D ve' Construction Cost: q 9 o Multi -Family Building: (Yes / No ) CONTRACTOR Name: cBudget Exteriors License #: CO CC® il Addres, 8017 Nicollet Ave S. City: Bloomington, MN 55420 ,_ State: 1-877-310-1742 F: 952-887-1659 Contac COMPLETE In the last 12 months, has No 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 Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as nonpublic if you provide specific reasons that would permit the City to conclude that:they are trade secru, 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.c:ot herstateonecalt.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Ja vii Ski/l/; Applicants Printed Name x Applicants Signature Page 1 of 2 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Single Family _ Garage _ Multi Deck _ 01 of Plea i Lower Level Accessory Building WORK TYPES New Addition Alteration _ Replace Retaining Wall Porch (3 -Season) _ Storm Damage Porch (4 Season) _ Exterior Alteration (Single Family) Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) Pool Miscellaneous _ interior Improvement _ Move Building Fire Repair Repair DESCRIPTION Valuation Plan Review (25%_ 100%_) Census Code # of Units # of Buildings Type of Constriction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In _Air Test _Final Insulation Meter Size: Siding Reroof Windows Demolish Building* _ Demolish interior Demolish Foundation _ Egress Window Water Damage 'Demolition of entire building - give PCA handout to applicant Occupancy Code Edition Zoning Stories Square Feet Length Width Reviewed By: MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final 1 C.O. Required Final / No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests Final Siding: _Stucco Lath _„_Stone Lath Brick Windows Retaining' Wall:_, Footings — Backfill Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge SSW Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 CITY OF EAGAIV SEWER SERVICE PERMR 383C °ilot Knob Road P. O. Box 21199 PERMIT NO.: ' ~ Eagan, MN 551?„1 DATE: ~-1 ~ ~ Zonirg: "1 No. af Units: p,~,,,~~; `~'ollefso~ 81drs Address: S~te qddress; _~2I$ Shev2ia Court L23 B1 Brfttan~ 4th Plumber: ~eril R:a:l ' . ~ 9-2fr-~3 38fi26 IQ0.~0 pd I prse to eomolp wiN~ ths Cihr of Ea~en Connection Char~pe: - 4 ~ S. ~ R ~ d ~i°O°~• /lccount Deposit: Permit Fee: 1 Q.O 0 Surchar+~e: .5~_.~ .i By Misc. Chorpes: Date of Insp.: Total: ~ Dots Pald: - - - - - ~..~-_sl~.?d CITY OF EAGAN ~ATER S~RVICE PERMIT 3830 Pilot Knob Road • ~ P. O. Box 21199 PERMIT NO.: Eagan,MN 55121 DATE: 10-i~-~>•~ Zoning; No. of Units: 1 p,~y~~; To le s+nn RI dra - Addross: Site Address: ~1.~~t'3Il in Cr•~,rt_1.L'~_SL_B.T~~C3,nX h Plumber: % Z`}'3'1 ~ = • NAeter No.: Connection Charge: 4 5~ ,!~0 P~ Size: Atcount Deposit; Permit Fee: ~ ' ' Reader No.: ~ , 1~gn~ to oanph? wiN~ !iw Ciep oF Ea9on Surchorge: Oedinena~. Misc. Charpes: GO OQ p meter Total: gy Date Puid: Date of Insp.: ~~P•~ r - - - - - - - CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 wsc tvao ROM / - . AMOUNT $ I & DOLLARS ~oo ? CASH ? CHECK FOR FUMD CODE AIA OUNT Tha k ou ~ • BY J White-Payers Copy Yellow-Posting Copy Pink-File Copy . .T.r~.•.R'r . . . . . . • . CITY Of EAGAN i ' ~ "_3 ~ ~795 Pilot Ifnob Road Eapan, MN SS122 ~ ~ PHONE: 454-8100 BUILDING PERMIT Receipt # ' ' - Te b~ wed fe. ~r nW~/r~ Est. Value ~'S3,~OU ~~e Se~tember 2h 19 °3 ~ ev n our , 3 51te Addreu Erect ~ t3ccuponcy Lot 13 Block 1 Sec/Sub. ~Clttariy ~+tti Alter ? Zoning 1'J-15003-130-flI Repoir ? Fire Zone ` Parcel ~k l.a e son u ~T& Enlorge ? Type of Const. nc Nome Move ~ # Storie Z 1655 Norwood Drive ,~d~~y Demolish ? Leng#h ~ C~ ~agan 55122 ~a~ 454-~G~73 Grade ? Depth 3`~ Sq. Ft. ~ Nome ~'~~r Approrals Faes 0 o~ Address Assessment Permit ~ ` u~ Cit P~~ Water & Sew. Surcharge t F`'.,. Police Plan check °C Name ~ Fire SAC 4~~,~~1 Nddress En9. Woter Conn. <W Ci Phone Planner Water Meter ~ Council Road Unit I hereby acknowladge thot I hove reud this opplication and sta~e that g~dg. Off, the intormation is torrect and ogree to tomply with nll npplicoble APC Total y ~ State of Minnesota Statutea and City of Eagan Ordinunces. $ipnoture of Perminee ers A Building Permit fs issued to: on the expross conditlon thn~ oll work shall be done in accordunce with oll opplicable State of Minnesoto Statutes and C+ty of Eoyon drdinonces. Buildinfl Officiot Y ' Permit No. Permit Holder Misc. Permit No. Holder Plumbin9 ~ (~Q ~nZ'~ ayt 1-71~ H.V.A.C. ~ I l 1~ I( Well , Weter DisR Sewer ' Electric ,.~'jr'J(D Q. ~ ~{~C~ ~ b'Z~'~ Inapectioo Date Insp. Other Footingt 'Z~'$ ~ Foundation Framinp C ~ Rouyh Pibg. Rough HVA Inaulation ' ~ Final Plba _ _ g ~ ' r~ Final HVAC _ ~ Ffnal ~ Water Describe Location: 1 Vlfall Sewer Pr. O'~sp. , ~ ~ C~ Receipt I G' ~ PLUMBING PERMIT Permit No. " CITY OF EAGAN ~ Ll •Y rJ ' ' t } .r <K LB8 ~ ~ ) $U Fill in numbered spaces ~ ~ Type or Prini legibly Tot. . 1. Date 2. Instal lation Cost ,_C ~~~f r~ L 3. JobAddres~s ~-'~~t?~.~/J ~Lot~~ Blk. ~Tract ! ' 1 ~ r~,,.+.--; , l 4. Owner 7 CJ ~ ~ ~ "~=4ri~ ~iL ~L~ 5. Contractor ~ Phone L{~ c.~ c/ 6~ Address ~~~7 y )G~~~~~ ~ T ~F~~~ ~ 7. CitY ~k'~`~ ~,r°~ ~~~ii,~-l State /11~7it/ Zip `a <"~-F~ i~ Building Type: Residential Q- Commercial ? Institutional ? 9. Work Description: New Add ? Alter O Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspoal/Drainfield Bath tubs Septic Tank : Lavatory Softner i Shower Well ~ Kitchen Sink ~ - ~ Urinal/Bidet Ot er ~ ~ ~ ~ Laundry Tray ~ ~ ~ , ~ ~ ~ Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above informetion is true and correct, and I agree to compty wiih ~I ordinances and codes governing this type of work. Signed ; ~~~il ~ / L ~i~(~ / --~f4 ~ : ~~,.-.--,-•~~--~r-,,..-~- for - ~ ~~ly/fl~. Aough F inal Inspections: Oate Insp. Date Insp. This is your permit when numbered and approved. Approved f{ , CITY OF EAGAN 454-6100 . Receipt J~; MECHANICAL PERMIT Pemtit Itilo. 1~ CITY OF EAGAN F~ . . ~ ; . Fill in numbered spaces S/C ~ Type or Print legib/y . Tot. - 1. Date 2. Installation Cost ~ ` , , % I . 3. Job Address ~ ~ Lot_~~Bik. Tract ' p f~ ~ 4. Owner • 'c-,-c,.- y'^^ ~ 5. Contractor • 1 Phone ~ " Y 6. Address ` ..±o'~-,~ ~k~!-~-...~ 7. CitY ~J~-4•-.,~-.~_.,,~ State t"^-' Zip ' 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New Q~ Add ? Alter ? Repair ? 10. Describe Fuel Type . :-r- 11. No. EauiRment STU - M. Ea. No. EQUiarmnt CFM ' Forced Air l Air Handling: Mfg. 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 corr~Ft, and I agree to comply with all ordinances and codes gpverning 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 CITY OF EAGAN Remarks Addition BRITTANY 4TH ADDN ~o~ 13 aik 1 Parcel 10-15003-130-O1 Owner Street 4818 SHEVLIN COURT state EAGAN MN 55122 - Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. j 82 452.94 90.59 5 STR E ET R ESTOR. ' GRADING 19$1 23.$2 1.$9 1$ ~ SAN SEW TRUNK 1976 173.90 11 .59 15 ~Y SEWER LATERAL 19$1 246.32 16.42 15 Z~ ewer Lateral tr 1983 133.33 ~ 8.89 15 WATERMAIN 2' S 1984 629.29 . 62.93 10 ie WATER LATERAL 19$j 1S WATER AREA ~ 19$1 229.95 23.~0 10 STORMSEW TRK 1981 596.40 39.76 15 1 ic STORM SEW LAT 19Hj 1S CURB & GUTTEFi SIDEWALK STREET LIGHT ~ ROAD UNIT 250.00 38826 9-26-83 WATER CONN. 4SO.OO BUILDING PER. SAC PARK Th;s e4~e= o~d ~o_zs L13~ 61 i B~~"~-Qx~. ~L'~'11 34 SaY 18 mon[hs fwm .ri .~i F'i Q. ~4 `S~ Reque.p[ Date-^ Fire No. RouOh-ii Inspection Hequ red? ~fleatly Now ~Will No[i~y, Inspec- 0 ' Yes ~No ~or When Neatlv Li~ensed EI¢cVical Convactor I hereb e y r quest inspeetion al abova ? Owner elec~rical work installad a~: Sveet Address, Box or Route No. City 1 ,S~ V ' ' c2~/L ecLnn o. Township Name or No. Range o. Coun R..~~ Occupunt ~)PNINT) Phone No. (~~/12.~.~d~ Power S~pplier Address Elecp~al Conttacmr ICOTDany Name) Contractor'.~ License C ~(pQ Maili Ap ess ICon[rac~or or Owner Makine ~nstallarionl ~ T - Authori Signawre ICOncractor Owner Makin Installation) Ph ne Number ~ ~ MINNESOTq STATE BOAND OF ELECTPICITV THIS INSPECTION NEQUEST WILL NOT Griggs•Midway Bldg. - Noom N•191 BE ACCEPTED BY THE STqTE BOARD UNLESS PHOPER INSPECTION FEE IS 1921 University Ave., St. Paul. MN 55104 Phone (812~ 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB•00001-0-0 . ~ ' See instructions for complating this form on back of yellow copv~ 1~~~~~ ""X'" Be/ow Work Covered by This Request 3q sa AA8 Nep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Wa[er Heater Lightiny Fiztures Apt. Building Dryer Electric Heatin Commercial Bldy. x Furnace Silo Unloader Industrial BIAg. Air Conditioner Buik Milk Tunk Farm O ~iv ~hm lSneufvl tier $peufy O Oth~r ompute lnspection Fee Below N Fee ServiceEntranceSi¢e IX Fee Faxders~SUbleeders k Fee Circuits / 0 to 200 Am s 0 to 30 qm s 0 tn 30 Am ~s Above 200 Amps 31 to 100 Ainps _ 0 31 to 100 q 5 Swinvning Pool Above 100-Amps Above 100_Am 5 TransYormerS. Irriyation Boorr~s Pdrtial%Other Fee Signs Speciallnspection S~r-D a TO L FEE Nerrarks _ `T Hough-in ' Dn~e'~ / the ec ncal n%pecbq hero6y certi/V ~het the abave Final '~ie inspection has been ~ ~ f inede. TNa requeal vaU 18 montl~e trom CITY OF EAGAN N° 8513 ` ~ 9795 Pilot Knob Rand Eagan, MN SS1Y] PHONE: 454-8700 j BUILDING PERMIT Receipt # To bs wed h. SF DWG/GAR Esr.Value $53,000 oate September 26 , ~y 83 Slte Addreu 4818 Shevlin Court Erect ~ Occuponcy R-3 13 BI«k 1 Sec/Sub. Brittanv 4th Alrer p Zontn9 R-1 Parcel # 10-15003-130-O1 Repoir ? Fire Zone NA Enlarge p Tyce of Const. V Tollefson Builders c Name Move ? # Staries ~ ~rcxi 1655 Norwood Drive Demoiish ? Length 48 EaQan 55122 ph,,,e 454-6873 Groee ? Depth 3$ Sq. Ft.- o Nome Owner ApDrovola Foes o~' Address Assessment Permit Z92.00 Water 8 Sew. Surcha~ge Z6. Cit Pho~e 146. ~0 G Police Plan check ~w Name Fire SAC 525.00 Addreu Enp. Water~Conn.4~5 <W C~ pha~ Planner Woter Meter Council Road Unit 250.00 I hereby acknowledge that I have read this application and stata that Bldg. Off. the inlormotion is correct and ogree to comply with oll applicable APC Tofal $1749.50 Stote of Minnetota $tatutes and Cily of Eogan Ordirwnces. $Ipnoture of Pertnittee To efson Bui~ rs A 8uilding Permit Is issued to: i on tha express caditlon tha~ cll work sholl be done in atcordanCe wlth nll appli le $tate f inneaota Stat s ond City of Eaqan Ordinonces. Buildirq Officiol RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN r` ~ ~ ~ 3830 PILOT KN08 RD - 55122 ~ ~ Q • V ~ U d" 651-681-4675 New Canstluction ReauiremeMa RemodeVReoair Reauirements • 3 registered site surveys showing sq. ft. of lot, sq. tt. W house; and all roofed areas • 2 copies of plan (20%mazimum lol coverage allowed) . 1 sel of Ene~gy Calculations for heated additions • 2 copies nf plan showing 6eam 8 window sizes; poured found design, etc.) . 1 site survey for exlerior addl6ons 8 decks • 1 set of Energy Calculations . IiMicale if home sened by septic system for additions . 3 copies of Tree Preservatbn Plan'rf lot platted after 111/93 • Rim Jaist Detail Options selec8on sheel (Wdgs vdth 3 or less units) DATE //-a~ o/ VALUATION <r'oo JOB SITE ADDRESS ~~/8 cS~/~e~i/,i~ C~ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER PS `<< Go~ ) p( TYPE OF WORK ~r~.olace FIREPLACE(S) _ 0,~ 1_ 2 APPLICANT ~~a~i'Cu~°~c G^s -~-d ~PS PHONE# ADDRESS v~of S~` ~~~~5 _ ZIPCODE ~j 8> PAGER #~~r~~ S~I ~!9/q CELL PHONE # 6'ro~- °~O~oa~l~ FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA Ri7LES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy E~velope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone Plumbing System Includes: _ Water Softencr Iawn Sprinkler Fce: $90.00 _ Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor. Phone # Mechanical System Includes: Air Conditioning Fee:_$Z0.40, Heat Recovery System n t~f~~;~~~, Sewer/Water Contractor: Phone ~j ~ I 1~I n~I • , All above information must be submitted prior to processing of application. - I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appifcant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated t/Dt OFFICE USE ONLY ? O7 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) O 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 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) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC Drain Tile Roof _ Ice & Water Final Other _ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fueplace _ R.L _ Air Test _ Final _ Siding Stucco Stone _ Insulation _ Windows (newlreplacement) Approved By , Building Inspector 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 Total ~ 09i=8•200'7 08:40 F1aGRN EN6+COM DEV ~ 9651~51'45 - N0.848 D02 ~ zoo~ RESIDENTIAL BUILDING r~arPr.tcaz~v' Q~~ ~ ~ ~ city oc~agao ~~I~~ 3830 Pilot Knab Road, ~:agan PY1lV SS122 ~ TelepLone # 6$1-675-5675 FA7r # 651-69~-5694 y~pmem,crmerteyyhafnent~ aemadeuRena~rR~nul~,sn~ om~useaay _'aJgA~f4~81I8S111~'65NWAl19SG.RWWL~+Y:~I.MA0113B.8M§~laMCd82B9 2~ofphdn~SMm'In9faoWgs,b~ms,laisla Cert~SSuiuoyReni _Y,_N I (207Eri~unum~aeat~re8ealoxred) tsetdEnagjca~adatb~7o7neatedadimcos sa~~tspo~t---- ,~y _N iSoBsREporIQP~W~dhulldlnB~Wheple~dm~hrtEeEsod 1'speg+nEY:fmaddA~.msddeilcs T~eaPres,P~iR¢td _Y _N. 2mpladPlaq~&haw6ig;beameednearslas,P~~dkuM~,eG. Adtlebn•do~el8kon-t~BSOOAcaY~em . OnaimSectl~~ ~y -N. ' .i,_jse[~n-€~4199:Calaleppig__-- . ~ Y~ . . 9 mya gFTree Pr~ervs6on Alen A lot a~ed aa11er7M~3 RMJmtAeYl aptiure'saledmn.fiheet (ou~nge wi9~ 3 o~~ese u~ - ~ ~ ~-Mmne~~hanrcalvenNaUOnfam ~ Plans are consfdered ub(ic infortnation uniess au state the ar~ trade secref and the reason. Att~ ~ / -~~~7 Conc[ruetlon Cost t~ g~~ Site3ddresa J,l P J~~ n ~ UuiUSte # I i _ Desci'Iptfon of Work ~ I~"" ~ ~ ~ Mul[I-Family 83dg _ Y ~ V Pireplaae(s} _ 0 _ 1_ 2 I Pruperty owaer ~-L~ ~~~`B,'!'~/~O'-' Gs-ux c`~ Telephoae t{ ((aS~ J 7°/5~ -9aS Com~actur `7~~~~,J ~.a~,i~>~:~s rr~~°jI~ i ~ddress ~q0 ~c'n e. ~.c.L~. ~c-GL ~~r-11 City G~ qan'~ I State ~ il~ Zip .ss/~f Telep6ooe #((Q$~ ),~fJ~ 0/OS ~ GO~MPL~T~ TH15 AREA ~NL.Y (F CON51'RlJCTING A NEW BUILDING - Minaeaoea Rules 7b70 Csxeorv ] Arnnecoa Rules 7672 i Energy-Coda Category . R~Identlal Ventilatlon Category 1 Work~eet • New Energy Cade Wakeheet (Js„mniss;oniypey sunnvttea sutn,itted . . Energy Emeelnpe Calarlatbns Su6mEtted ~ ~ Un rf i~ aasi 12 monffis. Fias fRe Ciry of Eagan issued p permit Fot a Ylmflar pion basetl on a mtlster plan2 _ v _ N IF yes, tlare and oatlress of rciosfer plan; iic~sed Plumber Telephone } 'Mechanical Contractor Teiephone } I Sewzr/Water Contractor Telephone # ~ J !I h~Feby ~pply for a Res~zdentisl Buildiag Pexmit and acktrowiedge that the infoxmation is complefe and accuia-e; ~ ~that the work will be in confom~ancc wi#h the ordinances and codes of the City of Eagan and the 5tate of M~T ~Stat.ites; I understand d~is ie not a permit, hut auly an apptioation for a permit, and wo " a ~ pe~.; tha[ the work will be in accordance with the appraved ~lan in ihe csee of work d apPao+.sl ofplane, ~C/~f.a-C ~g~vG f~~LLlCA DEC 0 5 2007 'ApFlicant's Printed Naine ApPlican['s 5ignatm~e By------- ~ ~o~t~c7 ~~to ~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION ~l~~.g ~ ~ a~ City Of Eagan w~ 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWUbn Reauiremenb RemodeUReoair Reauirements Oflke Use OnN 3 registered sile surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas 2 copies of plan CeA of Survey Recd _ Y_ N (20%marimum lotcoverage allaxed) 1 setof Ene~gy Calculatlons (or heated additlans Tree Pres Plan Reod _Y _N. 2 copies of plan showing beam 6 window srzes; poured found design, elc. 1 sBe suney for add'Nons & decks Tree Pres Requi2d _ Y_ N 1 set of Ene~gy Calculations Addition - indicafe Nor~sde sepfk system Onsite Septic Syslem _ Y_ N 3 coples of Tree Presanatlon Plan rf lol platted afler 7/1193 Rim Joist Defail Optlons selection sheet (buJd'mgs with 3 or less unRs) Date ~ / a~ / ~S Construction Cost Site Address ~ p d~~ K. ~v Kf~ UniUSte # Description of Work ~ n i5 ~ ~4 SP ~ e n~ ~JQ~rdo r''~ S Multi-Family Bldg _ Y x N Fireplace(s) ~ 0 _ 1 _ 2 PropertyOwner 15,~~ `k- s~t4n~lo+t Telephone#(~~ ) qyy-yas~ Contractor _~WYir ~ Address City State Zip Telephone N ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ . Residenlial Ventilation Category 1 Worksheet • Me~~ En ~oc~ l~rk~ (J submission type) Submitted Submitte` • Energy Envelope Calculations Submitted 1 S EP 2 1 2005 ~ In ihe last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a m ster p ~ _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone ~ Sewer/WaterContractor Teiephone#( ) 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. Appl' nnted Name 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 0 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eul. 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 (screenlgazebo) ? 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 81dg) - Give PCA handout to applicant Valuation ~ U~ d Occupancy ~ry~ MCES System Plan Review 100% or 25% Census Code ~~7 Zoning City Water SAC Units ~ Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs / Length Fire Sprinklered Type of Const ~ Width REQUIRED INSPECTIONS _ Footings(new bldg) FinaVC.O. _ Footings (deck) Y FinaVNo C.O. _ Footings (addition) Plumbing _ Foundation ~ HVAC Drain Tile Other Roof _ Ice & Water _ Fina] _ Pool Ftgs _ Air/Gas Tesu Final ~ Framing _ Siding _ Stucco _ Stone _ Brick Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: ~7 ~ 9~~ ~66 ding 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 ~SSa~ 3° 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION ~ ' ' ' City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 Please comple[e for: single family dwellings &[ownhomes/condos when pemvts aze required for each unit Date~~/1~/~~ '~$I ' h~. ~~n ~ ~ ~ ~~C(,4'1 ~~C~~ Site Address 6 ~ ~ Unit # Property Owner ~l~~ ~~(~l_A,I ~ Telephone # ( ) - ! Contractor ~ r~"'( J(~I ,n Qi~ l ~ 1) ~ Street Address I I ~ ~~'C C~~)1 N~, City ~f 1 I Y~IJ~ State ~I ~~~~(J~~ Zip ~~y_ Telephone# (~b3 ) J~ Bond Expires: The Applicant is _ Owner ~ Conhactor _ Other Add-on or alteration to eaisting dwelling unit $ 30.00 _ furnace ~Additional _Replacement air exchanger air conditioner New Re lacement other ~ l ~ I State Surcharge ~ $ 50 ~ U Toeai pU6 1 2~t444 S~ I hereby apply for a Residential Mechanical Pemnt and a owledge that the information is wmplete 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 applicarion for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in We case of work wluch requires a review and approval of plans. i,Sa ti- ~f~l,.G~,v~6 ~,a ~1Q.~~~ 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: commerciaUindusfial buildings multi-famity buildings when separate permits are not required for each dwelling uni[ Date / / Site Street Address Uuit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City SYa[e Zip Telephone # ( ) Bond Expires: The Applicant is _ Owner _ Contractor _ Other Wark Type _ New Construction _ Underground Tank _ Install _Remove *"see below Interior Improvement _ Install Piping _Processed _Gas Nature of Work: *'When installing/removing underground fank, call for inspection by Fire Marsha! and Plumbing Inspector Pe1'mit FC¢5: $70.50 Underground tank installation/removal $SD.50 Minrmuin (includes State Surcharge) or Contract Value $ x 1% _ $ PemutFee • If perntit Fee is $1,000 or less, add $.50 ~ $ State Surcharge If ermit fee is over $1,000, add $.50 for every $1,000 nernrit fee $ j(J ~~D Total Fee I hereby apply for a Commercial Mechanical Pernut and aclaiowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and cndes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an applicarion for a persnit, and work is not to start without a pemvt; 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 ApplicanPs Signature Approved By: Inspector Date: Za~~-~~ YG~r ~ ~ fn ~ ~I RESIDENTIAL u BUILDING PERMIT APPLICATION CITY OF EAGAN ? ~ 3830 PILOT KNOB RD, EAGAN AAN 55722 BS1-681-4675 New Constructlon BeoulremeMe RemodellReosir ReaulremeMs • 3 registeretl sile surveys 9howNg sq. ft of lot, 9q. il. OF house; and ~ raafed aree8 • 2 copies Ot plen (20% maximum bt coversge albwed) . 1 set ol Energy Ca~ulatbns for heatetl adtlillons • 2 capies of plan showing beam 8 windaw sizes; poured found design, ela) • 1 sile survey for exlefar aGd'dbns & Oecks . 1 set of Energy Cala~tbns • Indiqte N home served by septk system for atltlilbns • 3 copies of Twe Preservatlon Plen il lol p~tted afler 7/1/93 • Rim JoISI Detail Optbns seleclbn sheet (bklgs wiUi 3 or less untts) DATE ~~I~l VALUATION 1~~-- V" SITE ADDRESS ~ ~L ~ ~Ll ! f ~ ~ MULTI-FAMILY BLDG _ Y ~N TYPE OF WORK ~LP 1rDU~e C~S~~m ~Q~rr~L~[ FIREPLACE(S)~ 1_ 2 APPLICANT ~ O ~-P ~ ~~y`L , C~P ~ STREET ADDRESS ( dYY1 /Il~/LGQ. CIN GP/~ STAT, J~ ZI P~tT y TELEPHONE#~~ ~/o7~-~C~/CELLPHONE#61~3b`)~~/~C~ FAX# ~~.3-~~~'- 3,-ll Gou j~ ~ r PROPERTYOWNER TELEPHONE# a ~ COMPLETE THIS SECTION FOR ~~NEW° RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CAT$GORY 1 MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet SubmiNed • New Energy Code Worksheet Su6mittad • Energy Envelope Calculations Submitted Plumbing Conhactor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Contracior. Phone # Mechanical system includes: _ Air Conditioning ~ e2, ~'1~4~ n _ Heat Recovery System t5 ~~OZ ~I ,1UN 1 1 Sewer/Wafer Conhactor. Phone # q~-~---~~- I hereby acknowledge that I have read this application, state that the information is c re and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi nces. r Slgnature of Applicanf ....Y.Y.Y OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY , O 01 Founda[ion ? 07 OS-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS OGplex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIN ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi O 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O OB 04-plex ? 12 12-plex Plbg_YOr_N ? 25 Miscellaneous O 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding ~ 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Atteration O 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowsJ~oors 0 34 Replacement 'Demolition (EMire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bld~ _ FinaUC.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 _ Reta{nnig Wall Approved By , Building Inspector - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Pertnit ' License Search Copies Other Total ~~~111 ~ ) CITY ~ FACAN Inclucie 2 sets of plans, r_ ~,Q l~ 1 sit~e plan w/elevatio~n.s 6 BUII~ING PERMIT APPLZCATION 1 set of enetgy CalNlations. ~G~c- . zb Be ~sed For ; valuation 53, 6a 6 Date Zl , I~~ Site Address ~j~~ ,~~}p~Af~,/~~ ~ pF'FICE USE ONLY r~t t~ siorx 1_ s~./s~, r~ ~~t `X o~ray iP~ Parcel ID - I So o'3 -130 -o Alter Zonirg %P / , Pepair Fire Zone O.+ner: ~~'aoP~ ~JPi~OU) Elzlarge Rype of Const. Addness: Nbve # Stories narnlish E'mnt ft. City/Zip Code: Grade Depth ft. Ptione M : APPF2LNAIS FEEi r~; Assessrr_nts Pernut ~ Corttzactoi: ~ Pdciress: ~~j.`r~ GYI~i~/~, Water/Sc~aer Surchaxye ~l l~ ~ Police Plan Check ~7~ / City/Zip Cbde: ~ ' J, , Fire ~C ,~s' "s Phom Eng. Water Conn. ~,cs~d ~ Planner ' Wa r MetPZ /~n m' Arch./f:rx3.: . Council Unit ~~5~'1 ~ Sldg. Off. Pddress: ~ City/Zip Code: Phone tl : 7O'PAi. ~ l~ ~ 0. ~O r . y~`/ S~aB~ z~"~ J , loll~f~on 6uilders iac. Or.i1434 ' 183-77A . , JACKSON - SURVEYDO~S RLOIfT[R[D UMD[II LAW~ 0/ RAT[ OI YIMMVpT~ 36t6 EAST 55th STREET, MINNEAVOl15, MN 5y/17 7Z73f64 Surtupor'~ 6crtiti~atr / . Scale: 1",i0' ~1f • Denotes Iron ~ ~9.0 =L:i~ting Llev. = Drainage I ~ I J i ~ \ ~ j ~ k 1 I ~^~z L~ / t~~ j ~ ..1~~ ~ `a ~ c - ~ • Z3Y. 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T,`~ y ~ . ~ 1 .:T \ ~ V~ ' ` ~ N P ` ` y ' ' ~ ~ / ( A ' ~L~ (!1 ` ~tP r~+ ~ °111 ' .~,n ? ~ ~ ~ _ ~ ' . t ills , . .r3Y ' ~ . + . , r 1 K./~ ' ' ~ . . . . , ~ i ~ \ ~ ; ' k f ~ L e.~ - ~ ~ ~ ~ . .r . ~ i ~ . l~ ~t~•. ~ .ai~' t ~a # ' ~1 ~ - . ' . . ',r F 1~ . + CR~WiL-.~ ' 'lNSUL~p-~~C.~AI.LS J ~ "'k,. • ~ : . . ~ +.~y~ ¦~r-~l 9.- ~ . ~ l - r ~ t~Yfl- 1 Y~' tf 1 :r- : ; f r a . i y~ ~ , }''4 ~ ~ ~ h! i~ ~ TJ' ~ .Ir1 r ~ l~ ~ ~~l,GM ~ ..r, ~ J i'~ ~ • v . . ~ J _ f ~ ~ . > w y; • ~ / N ~L a ~ ~ ~ ~w + . . , l e ~ ~ 1 ? r . ,q ti.~ 4 t.a . f,t~F r'L ~ i .1I t ~}~J. ~Y['.~~r.i+~~y, i'lTI._. 1 . ' ,~ogr. ; ' ' : +_n~„` ,~7 . it ? tj'~',~.~ • ; ,y, } 14.r` :7,..~~~....~.~ ~2.~;<: ~ '2 ~T.Y ,~^r• °~r lrv`~r: t ~ f . ' . ~ ~ ~ ~ ' . ; . , ~~f a~ r+ . ^r+J . i ~ . 1 . b ' ' 1 ' - ~ ~ , . .4.F ~..v'1 ii~~~~1r~t'yS . ! ~Q'i -1~~~ ~.ti ~ .id~ 1.. L. . , ~ : r ^ . t. . .I... r ~ ~ ~ i~l ~v~~~~r ~~r,n ~ ~t fl.~N~. ~ . . t^ .w~.i~ t ,~r ~ ~ ~ ~ i. cY ~U.~#>>..:1w I~ h~~4 « ys.r~~'~.l~~:'~SJ.S.~_._~.6 ,t~~~+'.-xf,_. ~,Y.'tNrr-~•.~.+-t-_.++1~~Yda4~r~.u~y.':1~_.....~ i . . . . . . _ ' , ' . . . . . . , . . . , _ . , _ ~ _ . . . ~ ~,3~, 8~ ` . F , ~r~d . a~ zoo6 RESIDENTIAL BUILDING PEUn~T aPrLrcaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Naw Construction Reauirements RemodeUReoair Reaui2ments ORce Use Onlv 3 registerea sife surveys showing sq. It of l04 sq. ft. of house; and all roofed areas 2 copies of plan showmg foo6ngs, beams, joisls CeR of SurveyRecd . Y N (20°/ max'vnum lal coverage allowed) t set of Energy Calculations for heated additions Tree Pres Plan Recd Y N 2 mpies of plan shcwirg beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks Tree~Pres Required _Y _N 7 sel of Energy Calculations Add'dion - indicate if onade sepfic rysfem Oo-sife Septlc System• _ Y_ N 3 wpies of Tree Preservation Plan if lot platted atter 7/i193 Rim Joist D:tail OpGons selection sheet (buildings with 3 or less uniCS) ~ Minnegasco me:hanical ven[ila[ion form Date ~.S l Q~ Construc6on Cost ~ T / ~j 7~0 T Site Address ~~j~~~{~j Q. J( ~ r7 Lp ~iy' ~ UniUSte # C~, a'i'~ Z Z~ Description of Work ~P D~ .i~a ~)ry~S ~ R'[ulti-Family Bldg _ Y_Q Fireplace(s) _ 0 _ 1 _ 2 t / Property Owner ~,tL(, ~ ~{~(g,y~?1 ~ry U~,l,~ Telephone # (/ps~ ) 7 /'T" /o~~c~--- Contractor ~'1(~p~..l ~ne~y.)iI~S Address ~9(} L~:a e ~c.~ ~u-~ `Q 5/ City ~yQ~ State /1~ Zip ~ Z Telephone #(~o$~ 90,~~ ~ l O,$J COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submittea Submitted • Energy Envelope Calculations Submilted D~ In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master ? V~ _ Y _ N If yes, date and address of master plan: dY 2~~6 Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( J Sewer/WaterContractor Telephone#( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; Chat 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 ofplans. ~ P t~c~t-rv l 17~~~~f ~~«'r~-C Q~~t~'('~'~-~ Applicant'~ Printed Name Applicant's Signature DO NC~1' WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessor~ Bldg ? 02 SF Dwelling ? 08 06-plez ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - M~Iti ? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - Sr ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Muhfi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvemenf ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement *Demolition (Entlre Bldg) - Give PCA handout to applicant D25C~Iptl011: WaterDamage_Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) _ Sheeuock _ Footings(deck) _ FinaVC.O. _ Footings (addi[ion) _ Final/No C.O. Foundation HVAC Draio Tile Other Roof _ ice & Water _ Final _ Pool Ftgs Air/Gas Tesu Fina] _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ AirTest _ Final _ Windows _ Insulation _ Retaining Wal] Approved By: , Building Inspector Base Fee Surcharge Plan Review MClES SAC City SAC Utility Connection Charge S&W Permit & Suroharge - Treatment Plant License Search Copies Other Total 5 j. , I , : E , r , , DH-DoublEHung, PW-Picture Window„2TS _ Lite Slidet, 3LS03 3 Lite Slider, 1i3, 1/3„~ 1/3,'3L504 3 Lite ~ ar. J4, 1~2,T/4, 1~ C1R One Lite Casemrnt Right Hinged, CIL One Lite Casement Lefr Hinged, G2 Two Li[e Casement, 3C03 '['hree Lite Casemenc 1/3, 1/3, 1/3, 3C04 3 Lite Casement I i4, 1/2, 1!4, AWA? Awning, HOP Hopper, PAT Patio Door, BAYDH Bay w/Double Hung Flankers, Bay CAS Bay w/Casement Flankers, BOW 3 3 Lite Bow, BOW 4 4 Lite Bow, BOWS 5 Lite Bow, WINDOW CONCEPTS OF MINn'ESO,TA, INC. ~ DATE ~Cf "Q(p SPECIAL LNSTRUCTIONS CUSTOMF.A~~~~` ~~iJ C PROJECTION,CONFIGURATION,ETC. ADDRES{S- ~ R' / S~,c ~ E i~-C"i ~C ~ ~ S L ~ CITY~ U nrr~ STA7'E_~,"~'~_ ZiP_yj~i~.%.oZ l. ~\~,-,~G.S~j ,.~~.,h41} il'l ~i'~Nv HOMF PHON~( f~S'/~ )~pry~-~ a,~.5 ~ t woiucrNONE c~~'~) ~S- 1~,~7 A1r l~o~(~C. ~~`-"i F~AN~E ~ ~.o: , a ~ :~~rY kOPENINGS WINDOW COLOR WINDOW SERIES N'INDOW SERIES ~ OUTSIDE: INSfDE: ~,CONCEPT I ~ wx wrurE ~ `~7 ~ ll'H WHIT•E'~'. . OCONCEPTII 3 I~ ( l.~ ~~y0~ `9~`47'C{)NCEPTIII . ~ AL ALMOhD ~ ~ " CAPPING COLOR CO COCOA STAY CLEAN-' ~ CO COCOA ~ CASEMENT PARDWARE LT LT. OAK ~ ~'ES q. h~ ? FaldDown ~ . . ~ Standard DK DK. OAK ~~NO . 2~-S~OS ' Window Color Color Opening Sige,K OBS Glass R/R is Number STyle ~~de Outside W"idtli X Height ~ Location .Top Boti Tempered Screens Width X Heighf AC Commen[s ~ i~ S,~- i..:R~~..~ r ~ , ~ ~ ~ Y t ~ 1 . . ~ ' ( C> ~1 ^k ! f i'Y ¢ . 'v„ t~`~' ~ ~l-"`i m y ~ ~i 3 ~ ' ~ 4 . ~ . yFr~ ~ ; 1v' > ~ ~ 4J~ h1S ~ ~ ( - ~ " ` ' ;.r ~ J ; ~ ~ ~:s> r ~ r :.t ~ " ~ `i ~='q'' j. ~'r ' ~ ~ `.w. - - t, ' Ac . .'.Gr..;: 7.::~ ~ TO OUA CUSTOMERS: PLEASE REA~ THIS WOFK ORDER CANEFItLLY. By SICNVJG'I'HIS W ORK ORDFA. CL STOMFR ACKNO W LFD(:ES Tf IAT THE INSTnLLATION 1'ItOCE[~URE HaS . UEENOUTLINED'fOTHEMAND.~PPROb"ESWSTALLATION-nSDEi'.~VLEUAdOVE. ALLW'INDOWSINSTALI.[DMCUSTOMGN'SEXISTINGBUCKFRAMLS. ROITENW(XI~REP-nCME~T ASNEEDBUINCLUOGS:IIUCKFRAMH,OUTSIf]EANUIN$IDECdSfNG,INANDOUTSfOC50NIFqSNEEDED.ROTfENWOODREPLACEMENT,IS~NOTINCLllf~F.DDNM'SCONCEPI'lll ~ N9VDON' UNLESS SPECIFICALLY LISTGD ABO\'E. GNF~'THL PkOPERTY lY~ 6F.IMPROV[D h141' HAVE HIDDGN DEFFCTS "HOMLO0.'.NER(5)" AFO "W WDON CONCEPTS OP MN INC: _ AGRHE "W L\DO W CONCP.PTS OF MN 1NC.~~ W ILLPkOP~RLY NOT[FY' HOMFAW KHR(5) OF SUCH CON~ITIONS AND HOMEO W NER(S) AC[:NdW L~DGL "W LN W W' CONOEPTS UF MF INC."MA1'REQUGSTADDITIONALANDREn$ONABCP'COMP}TISATIOkAN~4UtQUA'fF,l_YRESPON~TOtipCHCONDI'CIONS. WlN~OR'CONCEPLSOFMKINC.WESNOTFr.INTOR~~. , STAIN AN1' wWUTHnTN.4Y 6E USEDN THF.INSTALLATION. 1F 1'OU IXl NOT PULL}• UNDENS'1'AND TIi15 N'ORK pNDER, PL[ASE ASK FOR CLARIFICATIOY HP. 2E SIGN Q f J, . ' / nr l,1 CUS70MF,R'SSIGhANRE MR.1~YI MRS. REPRESEt~TATIVEr" . - ' ' ~r ~ u~~d:aa ioroa ~i . ? ~ ~ ~~~.e~ ~ RECEIVED HOSPITALS AND C~INICS ~ 'qQn O ( (OOI of Minnazofa 2525 Chimgo A~enue SaNh ~HUNN Minneapolis, Minneso~a 55404 February 27, 2007 ENGINEERING DEPARTMENT 1612~ 813G100 ~ www.childrensmn.org Dakota Electric Company 651-463-6201 4300 220'" Street West Farmington, MN 55024 To Whom It May Concem: ~ Peyton Gould, infant daughter of Shannon and Bil( Gould, who reside at 481 S Shevlin Court in Eagan, MN, 55122 has a tracheostomy and requires frequent oral suctioning and standby oxygen and will require first priority in retention and restoration of all utiliry services and public works. She will afso require priority emergency response. If you have any questions or require further information, please do not hesitate to contact us at (6l2) 813- 7590. Thank you for your prompt attention to this matter. Sincerely, ~ ! ~ ' ~ l ~(~.~Lj~~ ~w~p ,~vy,,~L~z~(~N Mary Pylipew, MD Lmda Borgen, StaffNeonatologist Care Management Specialist cc: Excel Energy 1-800-895-4999 ~ 3115 Center Point Drive St. Paul, MN 55113 Qwest 1-800-573-1311 P. O. Box 2560 O &ha, NE 68103-2560 vEagan Public Works 651-675-5700 ~ 3830 Pilot Know Road Attn: Records Eagan, MN 55122 Eagan Fire Department 651-675-5900 3830 Pilot Knob Road Eagan, MN 55122 Eagan Police Department 651-675-5700 3830 Pilot Knob Road Eagan, MN 55122 ~t Ridges Hospital(and ambulance) 952-892-2000 201 Nicollet Boulevard Burnsville, MN 55337 ~ ~ Childreds - Minneapolis ~ ~ . ' . Children's - Sf. Paul ' . ~ ~ ~ ' ~ ' Children's Clinics - Woodwinds . . . . . , ~ . ~ Children's - Rosev~lle . ~ . . . . . Children's West ~ . ~ ~ ~ . . . . . . . . . ~ ~ ~ City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4818 Shevlin Ct Lot: 13 Block: 1 Addition: Brittany 4th PID:10- 15003- 130 -01 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Air Mechanical 16411 Aberdeen St Ham Lake MN 55304 (763) 434 -7747 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: William Gould 4818 Shevlin Ct Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA078255 06/13/2007 ePermit equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 $0.50 9001.2195 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Use BLUE or BLACK Ink r For Office Use '* City of Eaall Permit Fee: w - .5 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING- PERMIT APPLICATION Date: LQ .c9-1• I -7 Site Address: 4 ' 5 t iGv \1(\ Unit#: Name:• c-- \(\o.n)(Nef\( Gicr\kok �,� Phone: 314- I Resident/ //��� �y Owner Address/City/Zip: `-I-� b t n Ci' Applicant is: - Owner Contractor (� ��� Description of work: tY U)CQ„ 0-E- i K�v. 1 Type of.Work ; Construction Cost: .1 O Multi-Family Building: (Yes /No k ) 1 1 Company: 11 0.-- Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: E $ w..wwxw«'.avvw.imwwm.rr..wu:«rw..a.w+,wnwmww...mwmwwm,......w...»:.:.v.N.wn. 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-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours „4 before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior ., • k authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days o per Ali suanAl ok �� 1PlLr�/ x Se ct_(1r 1 e)0V_til-cii•-.67) Applicant's Printed N s m Applicant's Signature 11, Page 1 of 3 10/05/2018 10:11 952-935-9544 MN RUSCO PAGE 01/03 For Office Use . sae ��� 07C1 r°#.0 E AGAN a�•• °,, Permit OP; • Permit Fee: /0,-) d Date Received: ( 6 J '16' 3830 PILOT KNOB ROAD EAGAN,MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buiidinoinspections cr,citvofeagan.com L 2018 RESIDENTIAL BUILDING .PERMIT APPLICATION Date:______ V Site Address: 1-4 (g t a v' - Unit#: ' ' Name: L. nety y. Phone: (4 51- 53'Lo4h' c .Otivn'er Address/City/Zip: L( [1 OkeV wit • b Applicant is: Owner Contractor VOVy .'Typre.,o `Wolk' { Description of work: tace-LO LiJIndoo 1 0 f.?tt- n y. t gat. 0004-64 ^5 oo ik • ; Construction Cost r Mu!tI-Family Building:(Yes_/No A"') Company;Mtn t We-SD+C. LAS CO Contact Lilobtj :;,• 5©lO �u5 [(d1 I Y City: 1 to, ,; ,.,�,,;. ,;••.:,,r,;',, Address: State:L i4 Zip: 5'54 Ve Phone: 961-- , Email:Jfl1tfl(Lf4IfCLsO.cm , • 5641 License#: Ge-CD 21 13 Lead Certificate#:-A Pt 9-IAAS 9" If the project is exempt from lead certification,please explain why: 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'support/ng documents thatyou•submif are considered to be public Information..:Portlons,orthe,Jhforiaation maybe • c)a'ssified a ncr►pubile If y+ robtdespeclftc'•reasons that would permit the City to conclude that theyare,trede sb'Crets. , . 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 wvuw.cIbscribe. 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. Cali 48 hours before you Intend to dig to receive locates of underground utilities. www.00nherstatconcg,,a„tLorr, I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this Is not a permit,but only'an application for a permit. and work Is not to start without a permit: that the work will be in accordance with the approved plan in the ease of work which requires a review and approval of plans. App can/Printed Name f Applicant's Signature