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1465 Skyline RdCity of hp 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: ri 12:D-- 1 Iv r Use BLUE or BLACK Ink Permit #:5 06-3 Permit Fee: .S, to Date Received: ` w Staff: 2010 MECHANICAL PERMIT APPLICATION Site Address: f4 6 (` ' n c 124 Px%c rs,rl Tenant: Suite #: RESIDENT / OWNER Name: rivesr'C i/1 S-11.4(0 L.0 c_C, j Phone: c C ( — 14 2,^ -�� 11 1 Address / City / Zip: ( _ t 11/1 24 E� r f/ V b I . CONTRACTOR ,) Name: License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: • •: ofm•nte • • n� a ease echanicat • • > e• i n r d . ins ® or orrr at ' • eco s ; nil toad PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement Air Conditioner N J Install Piping Processed ,z_, Air Exchanger "fie% -e Gas Exterior HVAC Unit Heat Pump SC)O c -Q . Under / Above ground Tank ( Install / Remove) Other ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $5.00 State Surcharge) $ cic - ,--)c_ TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation/removal OR State Surcharge) $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% = $ Permit Fee - If the Permit Fee is less than Fee = $ Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010-$11,010 Permit = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a pe with the approved plan in the case of workwhich requires a review and approval of plans. e c(u-to S/Ct Applicant's Printed Name codes of the City of will be in accordance INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: a 4 Eagan, Minnesota 55122-1897 Date Issued: ' 4 AB 14R (612) 681-4675 SITE ADDRESS: , r v1 raver R1 PERMIT SUBTYPE: ; it" I iNW., !' -III rl I I Clti I m 1 HI r„ , APPLICANT: 1. 11, 0 il 10 TYPE OF WORK: UPAM I N1i 1 1RFPI ACF j RU14ARVSe .A 51*PARATF PF'R11411 117. 111--017RFn POP ANY P1 t1148 TN8 OR fI PCIRIrAl WORK Pt AN RFVrf"WF0 VV MIEF MARCK t z ,>? rs J 31-7 t3 L - Permit No. Permit Holder Date Telephone N ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS 17 ?RRV???fffiiittu???? FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST 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 DECK FINAL 'CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS:' ? itl LII IIFIifl kI PERMIT SUBTYPE: PERMIT TYPE Permit Number: Date Issued: 010 01 APPLICANT: f t. i. 414'. ! TYPE OF WOPK: r,. Ia FIL1 1 I Il 1 N4 01 INSPECTION TYPE DDATE INSPTR INSPECTION TYPE DATE INSPTR. . I r.; ,ICI IF 11. 111 FIR Permit No. Penult Holder Date Telephone M ELECTRIC D9 PLUMBIN q 75 ?? HVAC d /91& ? 9 95 9? O?l? Inspection Date Insp. Comments FOOTINGS 93- FOUND FRAMING ,gyp DR?i,Lw kh,?Jkb i f0 ROOFING tm??//ls. uh t 1,-ma, A141 CNeiWe ?yp ROUGH PLUMBING F^ PLBG AIR TEST ROUG HEATING H GAS TEST VC INSUL - l/ GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG 71p, FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL KC L ilrk,.s law Wcrtificate of Cccupanc4 This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: SF DWG 25W I Use Classification Bldg. Permit No. 0mP-Y Type Zoning District R, Typo Cond. Ala? 305- Owner of Building Addrrss 450 E CIY RD D, LIME CANADA 1465 Slailm L-A it L ' B , 304AN Buildjpg Address 7i I? /Y Dam Building Official POST IN A CONSPICUOUS PLACE Address 1465 RMHE ROAD Zip 5512 1 Lot' - i Blk 1 Sub BRLMM THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 7 A/ ?k5 Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) V *1 Permanent driveway I/ Permanent gas Sod/Seeded grass Trail/curb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy (?624? 74 ? f?V4Z 7 A Req esl DetO _ ne No. Rough-I nspectlon Required (You m t inspector when reedy) es ? No Ins obon Other The Rough-In Ready Now II Notity Inspector Date Reatl 1 ? licensed contractor ? owner hereby request inspection of above electrical work at: Job Ad r a( root r Rout City g?f ctio No. ownship Na a or No. Range No. County Occup RIM) Phone No Pow Address EI r' I Contractor (Company N e r Con r' ense No. L2:5) 6 / // n p ress ( ac wner Mean ns ion ?h?? U Author ignalure (Contractor er eking Installation) Phone Numnr / MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grigga•Mldway Bldg. • Room S•128 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (6121642.0800 ENCLOSED S REQUEST FOR ELECTRICAL INSPECTION EB-00001-09 i .ys L7L jli? See instructions for completing this form on beck of yellow copy 0 2 7 ?, "X" Belaw Milk Covered by This Request 4V. us,. w dd Rap. 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) Contractors Remarks: s Compute Inspection Fee Below: ` t 3 a `Q, # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Am s D 0 to 100 Amps Transformers Above 200-Amps _Am s Above 'ADO Signs Inspector's Use Only TOTAL Irrigation Booms S ecial Ins action SE: Alarm/Communication ISCONNECTED IF NOT THIS INSTALLATION MAY Other Fee COMPLETED WITHIN 18 MONT I, the Electrical Inspector, hereby certify that the above inspection has been made. Roug"m i,nal Date Dale rP !/ _a - of OFFICE USE ONLY This request void 18 months from RESIDENTIAL 9 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681.4675 New Construction Requirements RemodegReoair Requirements . 3 registered site surveys showing sq. R of lct, sq. I of house; and all mated areas . 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy calculations for heated additions 2 copies of plan showing beam &window saes; poured found design, etc.) . 1 site survey for exterior additions & decks . 1 set of Energy Calculations . Indicate it home served by septic system for additions 3 copies of Tree Preservation Plan N lot platted after 7/1193 . Rim Joist Detail Options selection sheet (bldgs with 3 or less units) Boo DATE I 17 VALHATIQN JOBSITEADDRESS_ 1-16'rS S/IC7 i, /, /Z IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNE TYPE OF WORK APPLICANT// :// ADDRESS PAGER # 7`z-. 60 FIREPLACE(S) NO _ 1 _ 2 zl? PHONE# l?2 -?7?`7"S7q DA-2 /J?K S ?M/1 ZIPCODE CELL PHONE # FAX # 157 - l(S 3-3qSp NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor. Phone #: Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: _ Mechanical System Includes: Sewer/Water Contractor: - Air Conditioning - Heat Recovery System Phone # Fee: $70.00 Phone # 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 c t d agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordin a Signature of Applicant - Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex 0 13 16-pfex O 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex 0 16 Fireplace 0 21 Porch (3-sea.) ? 31 Ext. Alt - Multi 0 03 01 of - pfex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF 0 04 02,-pfex ? 10 08-plex 0 18 Deck 0 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-pfex 0 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg Y or_ ??? rrr N lat 25 Miscellaneous 0 31 New 0 35 Int Improvement 0 38 Demolish (Interior) ? 44 Siding . yq 32 Addition ` \ ?t 36 Move Bldg. 0 42 Demolish (Foundation) 0 45 Fire Repair 33 Alteration ? . 0 37 Demolish (Bldg)* 0 43 Reroof ?. 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation ??t UoU Occupancy MC/ES System Census Code 43 Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const V Width X x REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) PinaLTlo C.O. Footings (addition) Plumbing Foundation Drain Tile Roof _ Ice & Water _ Final Other Framing Fireplace _ R.I. -Air Test -Final Insulation ? HVAC Pool _ Figs _ Air/Gas Tests -Final Siding _ Stucco _ Stone Windows (new/replacement) Approved By Building Inspector Base Fee ? 9 ?j. 'a Surcharge 9z)( 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 " ( `D- .(p NA Al UhGfl EWSOM Ub . r.u V Idjaway 1.'= i o.i 0';MP, ad 331.1AAS S'idV TOOL SETA OF EGE QM .iiNIIANS id` 1T 00:6 i?Z'bE 00"`ii09 UM WIVE 1901 1006 OMF N di GE MOIST -.:1Y1:CI i UBO/& Wild NVOU JO AM SXlnhk?k%i.k<:i;?$?tae>k*A1>K?%:isk:MYC>h?h?kM:'?>%>fikni%tN:h??k%<;; ;k9?xc? CITY OF EAGAN .3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-15150-010-01 DESCRIPTION: IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK MIKE BARCK Bdlldin-?.-,Permit Type 'Building Wbrk Type Census Code °`.. P v yz ?` { SF ADDITION NEW 434 ALT. RESIDENTIAL E i.5 aL'? :" e P93 +'s?l Isr: u'.i Iii REMARKS: A SEPARATE PERMIT PLAN REVIEWED BY FEE SUMMARY: Base Fee Plan Review Surcharge Total Fee PERMIT PERMIT TYPE: BUILDING Permit Number: 031703 Date Issued: 04/08/98 1465 SKYLINE RD LOT: 1 BLOCK: 1 BROMAN VALUATION $606.00 $393.90 $27.50 $1,027.40 $55,000 CONTRACTOR: OWNER: - Applicant - STUBLASKI KAREN 1465 SKYLINE RD EAGAN MN 55121 (612)942-0490 I hereby acknowledge that I have read t44% application and state, that the information is correct.andragr,ee ;to comply with all -appli,cab-.e.State 'of Mn. Statutes and City of £aganOrdinances., P.. e - m APPLICA /PERMITEE SIGNATURE ISSUED Y: SI RE 031 1 03998 New Construction Requirements BUILDING PERMIT APPLICATION CITY OF ILAGAN 3830 Pn OT KNOB RD - 55122 681-4675 ? 3 registered site surveys ? 2 copies of plans (include beam & window saes; poured fnd. design; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan H lot platted after 7/1/93 required: _ Yes _ No DATE: °5 l 1' 0(96 Name: ZA-AL16k, 41rirfvt Phone #: "'LO 0 y l 3 Last First ado?r`b? l DESCRIPTION OF WORK: STREET ADDRESS: t_? s S ?? ??h e Pd cl_ ?aAy , 5?5`j Zj LOT: / BLOCK: SUBD./P.I.D. * 13,eei-ji o,-4 ? (7?1 av PROPERTY OWNER Street Address: 144 (.? S ((t' i hP> City State: rln N Zip: 5 c 2 1 Company: Phone #: (RESIDENTIAL) 41 4 It 011. 4 0 mud 4-2 Remodel/Repair Requirements ? 2 copies of plan ? 2 site surveys (exterior additions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST; CONTRACTOR Street City ARCHITECT/ ENGINEER Como License # State: Zip: Phone #: Registration #: Street Address: City Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. State: I hereby acknowledge that I have read this application and state that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ONLY Certificates of Survey Received _ Yes No Zip: Penalty applies when address chang 'L6 ;& G? MAR 0 11996 Tree Preservation Plan Received - Yes - No - Not Required and agree to comply with all applicabl OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex 0 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE ? 31 New ? 33 Alterations ,ZF 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Building Total: _. , % SAG I ?SAC_Unitr, -- - - ; ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition Lay ! '? ? . m 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. MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. ?13d SAC Code 61 Census Bldg I Census Unit MG Engineering Variance Valuation: $ S3--000 C'-auJI s Gc-e- '?nv2Z L.(,,0 IS{ i Z v -?-t- r 30'/22 - 4(.044WKL1' 35ibka,- 1X21. Sit ISM q sH,I j q hU 3621 L.. FOR GARDNER BROS. HOMES 1 HEREBY e WAS PREPARED BY ME OR UNDER WY DIRECT SUPERVISION AND THAT I AM A STOULY AY OCENSED LA?Q A SURVEYOR UNDER - r MINNESOTA LICENSE NO.ZOZ'to ON ED 'pQp a 2 s 0 a ?O 0 0; Gds o °CP /? Ose y 'v s W p r i rL'ek-L r^ if T s \ D(z,?? ? vJA`? ?x N 00002'07"W 275.92 0 20 SCALE IN FEET ir?6l ,geT a Is riI f1? I I o A / ? IF- ? In ILL ze.33 < w LIJ 19 4-- r`n•• r (1 r ??o ~ GISTERED' I CO m a J \J C _. I RzO?J TIJ IH m 0 7 O aoo 7 7v 1h.b'1. Corr O V Y'C ?„ L5. b7 M r0 m I . MJl ?;1TU?? " ?p.h ih J 1 ? S•3 L, 7 \v m_ - Zs.o - - Y, CP o THIS IS NOT A BOUNDARY SURVEY PROPOSED GRADES GARAGE SLAB TOP OF BLOCK BASEMEN FLOOR O I ?' I o _ Toe t4Vg-G-13.1 ._ ?-13?f3 4fl0??55' IK671 6Y,14Llhi jzD, LOT 1, BLOCK 1, BROMAN ADDITION DAKOTA CO., MN. 10??jI S 0'02'07"E p N IZ Q w 0. IQ cn 227.52 oSG 7. KURTH SURVEYING, INC. 4002 JEFFERSON ST. N.E. COLUMBIA HEIGHTS, MN. 55421 (8121 788-8768 FAX (6121 788-7602 DATE 5 - 9 -a 7 0 = IRON MONUMENT F or-40 BEARINGS ARE PER PLAT • SPIKE SET EXISTING ELEVATION f I= PROPOSED ELEV. F-- = DRAINAGE ARROW PERMIT wal CITY OF EAGAN f 3830 Pilot Knob Road PERMIT TYPE: ??? QJ Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 6 01 N G (612) 681-4675 Date Issued: 06/17/95 SITE ADDRESS: 1465 SKYLINE RD LOT: 1 BLOCK: 1 BROMAN P.I.N.: 10-15150-010-01 DESCRIPTION: Building`Rermit Type SF DWG Building Wor.k\Type NEW °,UBC Occupancy 't R-3 U-1 Construction Type V-N Zoning R-1 Building Length 45 Building Width 48 Building stories 4 Square Feet 1,557 REMARKS: S & W PLBR - FEE SUMMARY: VALUATION Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal $678.00 $440.70 $55.50 $850.00 100 $2,024.20 $111,000 MISCELLANEOUS $1,892.50 Total Fee $3,916.70 CONTRACTOR: - Applicant - ST. LIC. OWNER: GARDNER BROTHERS CONST 14819600 0002736 GARDNER BROS 450 E COUNTY ROAD D 450 E COUNTY ROAD D LITTLE CANADA MN 55117 LITTLE CANADA MN 55117 (612) 481-9600 (612)481-9600 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. Strat?uttesand City of? )Eagan Ordinances. o 1 APPLICA /PERMITEE SIGNATURE ISSUED SIG TURE I 1 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 025601 05/17/95 SITE ADDRESS:P-I•N•: 10-15150-010-01 LOT: 1 BLOCK: 1465 SKYLINE RD BRONAN PERMIT SUBTYPE: SF DWG 1 APPLICANT: GARDNER BROTHERS CONST (612) 481-9600 TYPE OF WORK: NEW INSPECTION TYPE FOOTINGS .DATE INSPTR. INSPECTION FOUNDATION DATE INSPTR. FRAMING ROOFING INSULATION FIREPLACE OUGH IN PLBG ROUGH IN HTG FINAL PLBG FINAL REMARKS: S & W PLBR - F L CITY EAGAN 11 0 3830 PILOT KNOB RD - 55122 1 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? - 681-4675 0 Gk New Construction Requirements Remodel[Reoair Reauireme nts ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (extedor additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 1 tree preservation p n if lot platted after 711193 required: _ es No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: SI N cotes ?+4m 1 6 ? ?I ??rJ ?'oN sT ?ucno/J STREET ADDRESS: ?y? `? S K?LI rC ) gD LOT BLOCK / SUBD./P.I.D. #: E;xOma,-pl ??D I Ti or- IO c7/ PROPERTY Name: Cor l? ?s . Phone #: OWNER ' FIRST Street Address City: G t'- Cfl nl n nh State: Zip: CONTRACTOR Company: s rims A-6 Phone #: Street Address: License #: City: ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #' Street Address, City: State: Zip: Sewer & water licensed plumber. change are requested once permit is issued. Penalty applies when address change and lot 1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY,/ajg5 Certificates of Survey Received Yes Tree Preservation Plan Received Yes yNo G?ECF5' JC=() --------------- OFFICE USE ONLY PII?7liTeU4.1JiIkS ;J ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? X02 SF Dwelling ? 07 4-plex ? 12 Multi (Misc.) ? ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? ? 05 SF Misc. ? 10 Multi (additional) ? 15 Deck WORK TYPE r1(- 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering V-N Basement sq. ft. q'9/ MCNVS System pe--_ 8-" Main level sq. ft. /.1495' City Water oG 12 sq. ft. /°/4 Fire Sprinklered sq. ft. PRV yL(VELS?pf sq, ft. Booster Pump yS sq. ft. Census Code. /o/ eller Footprint sq. ft. 5-s7 SAC Code 0L a v! f J rp G6 Census Bldg n Unit C e sus yo Building Y/1q.,v LL!/C rg (2W d3 A SIX 7 5 /O Z6 '- yo -/,0'/0 C•wr /•f x 7.5- 2 X ZZ /? Y /49>XSr/= i a ae 0 f-f ) Permit Fee Valuation: $ 00 Surcharge Plan Review License MCNVS 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 25'.33 x 2Z = &ey' 3- F`m'k 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Variance l3 5- 2Gx IS•S' = ?/x/t; 7 a/5' Z.s1xr.7-7 - y33 z2- / x /6.G7 = l 7 (o! x5'y ; i--l3g3 FOR GARDNER BROS. HOMES 1 HEREBY WAS PREPARED BY ME OR LNOER MY DIRECT SUPERVISION AND THAT I AM A DULY LICENSED LA/??Jpp SURVEYOR UDDER THE,4AWS OF TAE STATE OF. M1 MJ6SCl7A. MINNESOTA LICENSE NO.Soz.`to 0? S 6'jS°o CP /? Osc ? ' THIS IS NOT A BOUNDARY SURVEY ' PROPOSED GRADES GARAGE SLAB 81L1.D TOP OF BLOCK 1y ?•_7 BASEMENT FLOOR D X 4DDR?hS' (tip? t'KjuNL5 R-Pt LOT 1. BLOCK 1. BROMAN ADDITION. DAKOTA CO.. MN. N 00'02'07"W 276.92 I 0??-----, 20 SCALE IN FEET UI u w ?/ .00 ?r 1 ?? I r s /, N? a I z co w co 4: l°o i i6 (w ------ (n 0 CPS?k? ?` ?f ?? / a 8L ? ? ?ka?? A\ 1 i? ? ?Qy ry ? I zv.33 ¢ w 9 ^ 4 w : ? S 9rr ? } W?'I I 1 ;, PLO ,?ppmz,oJI'2 -T I I 9 O ?oN .] O 1q-bl_ r p?z y?WA?/ 7 t M Iw O/ (' rJ ?Q' h CD I Q ............... .. ...... ...... o J 0-- Ln - L8.0 - - _ ?-\ P TOP µV6=813,1 S '02'07"E 227.52 c-- . l4oo5c 11 KURTH SURVEYING. INC. 4002 JEFFERSON ST. N.E. COLUMBIA HEIGHTS. MN. 55421 (612) 788-9769 FAX (612) 788-7602 DATE 5-9 --q L> O • IRON MONUMENT PDQND BEARINGS ARE PER PLAT • • SPIKE SET = EXISTING ELEVATION 1 ) PROPOSED ELEV. F DRAINAGE ARROW LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ; i I PROPERTY LEGA •: 1?;e/ lrj6(1-?L ffz _ ?j < Date of Survey: DOCUMENT STANDARDS Fr'?0 0 0 0 Registered Land Surveyor signature and company Building Permit A 1'Y D D pplicant Legal description 0?0 D - Address !Y D D D 0 • North arrow and bar scale II House type (rambler, walkout, split w/o, split entry, e D 0 lookout, etc.) G? 0 D Directional drainage arrows with slope/gradient t. D? 0 Proposed/existing sewer and water services Street name D 0 Driveway ELEVATIONS V-13 0 - Existinv Sewer service a, 0 8'?0 D 0 • Lot corners O--n D Top of curb at the driveway Elevations of any existing adjacent homes -/ H 0 ? 0 - Proposed Garage floor D 0 0?'13 D D First floor 9' 0 0 Lowest exposed elevation (walkout/window) HAD D Property corners Front and rear of home at the foundation D e 0 PONDING AREAS (if app icab .1 Easement line D IY D D 0' D - HWL 0 ? D 5? D D - - Pond 0 designation Emergency Overflow Elevation D ' 0 DIMENSIONS Lot lines 6 -D 0 D Right-of-way and street width (to back of curb) D Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e. all D structures requiring permanent footings) W 0 Show all easements of record and any City utilities within D D those easements Setbacks of proposed structure and setback of adjacent D ID? D existing hom Retaining a rements, if any Reviewed: October 1992 N me / D to , \ r? '. }{{ 4 ?? ?fj./r?? } ,' .'v ?' '? , ' ?o d'.??ar ..., j '"..^hN ',. ,lan! '?}?%?? 1,. 'gin .dam ?. 1 a('Ti P? \i ? `d 11 1 t'r4 r i', r, 1: m U r ?' Cf +3- N?l t'` m b ? r? cit. tmrro t ? ,yf z • ,.,,. t., it C7 1 E,r, T f' i ^`? i. `? _?''>i,a.7 ^' -..,.? `I m H •i7 w-t r3 :00 I ! i l? (tl $ i v o v; ,y x. I „ t r G e» to 7 } ;,;; wf , \ I / r? 'q? R? 111 (1C I- M Iiz ?r la, ,y y, 1? l' ?e`1J (7 ?U F Py(yfi I 1?:? .:.nn w C'p?i•1,;'r' _? c? • e O C (t? :.,' Ih I EY ;../ t ?\• C ` r ' O Z c3 >s`,. :-; :C7 U 7,1 ;omen-FOR' pSr- OMPLIA I 10 C) .. i u 0 ?. t r L7 r >ts EAGAN FORESTRY DIMSiOYV :a RE190[i: E® - n r '? M M r n By l 10 ! DATE ?(' mo ;vs M, <'. <^ a'' t o?rC / fit M Z ` .''l'>tn-IT > 2w 1n 10 ni.'„?t3 . ... ? ? ? CJ mN mU E f?f? ti 1 T RIO47 !' Z -?l q•t'j v11Ti Irn ' r,? I..f m m a rn r \'t >1 r- x.1...1. TOTAL P.01 . 3 i ! ? ..? ? F i ? i .....e ?.......?..._ r,_..?.?,........?.•.......,...,. Planning Design Inc. 1611 Highway 10 N.E. Minneapolis, MN 55432 612-780-1920 COMM. NO. Minnesota.State Energy Code Calculations Based on Chapter 5 of the Model Energy Code 1983 Edition -- Adapted 1/1/84 Owner: GARDNER BROS. HOMES COMM. NO: Site Address: Contractor: GARDNER BROS. HOMES Phone: Bldg. Class: A-1 Al for Single Family/Duplex A2, residential ( 3 stories Over 3 stories Other GENERAL INFORMATION Note: The section designations ("Section A", "Section B" etc.) are for convenience in calculations only, and are not related from one set of calculations below to the next. 1. Bldg. Walls Perimeter x Wall heights, = Area ground to eave Section A : Section B : Section C : Section D : 44 10 = 20.5 168 = 72 19 = 0 0 = Gross Wall Area 2. Building dimensions Length x Width Section A Section B Section C Section D 44 24 0 0 0 0 0 O Total floor or ceiling area = 3. Rim Joist Perimeter = 136.5 Floor joist 2 by (8", 10", 12" or 16")): 10 Rim Joist Area = 4. Doors Area: 43.8 Thickness (inches): Perimeter (feet): 0 Type of construction: _5.Total --door's perimeter;,. 0 Windows. 440 3444 1368 0 5252 Floor or Ceiling Area 1056 0 0 0 EiY? Manufacturer: U factor: 0.52 State approved: YES Type Height x Length x Number = Total (inches) (Inches) of glass SgFt units EGRESS 36 28 1 7 EGRESS 30 20 1 4.17 EGRESS 40 24 3 20 GLIDER 36 16 2 8 D.H. 28 28 2 10.89 D.H. 36 28 12 84 0 0 0 0 0 0 0 0 0 O 0 0 0 0 0 0 0 0 O 0 0 0 0 0 0 0 0 0 7. Window glass area (Sg Ft) = 134.06 Type Height x Length x Number = Total (feet) (feet) units SgFt 8. Patio Door: 6.8 2.5 2 34 9. Atrium: 6.85 3 4 82.2 10. Fireplace area Width: 0 Height: 0 Total Sq Ft = 0 11. Exposed Foundation Height area A: 0.67 Perimeter area A: 136.5 Sq Ft area A = 91.455 Exposed Foundation Height area B: 0 Perimeter area B: 0 Sq Ft area B = 0 12• SgFt U factor U x A Gross wall area 5252 minus Window area 134.06 0.52 69.71 Patio door area 34 0.47 15.98 Atrium area 82.2 0.44 36.17 Rim joist area 113.75 0.041 4.66 Door area 43.8 0.14 6.13 Fireplace area 0 O O Exposed Found. 91.455 0.14 12.8 * Framing area 525.2 0.095 49.89 equals sr? ?"??safor.;?net.:ijall- -- 4227tS35" ?-.°O 0 3; 181-. Z8 ?-??} s = , . Totals for gross wall area: * Framing area is 10% of gross wall area 377.12 13. Gross wall area x factor below = U x A per code Factor is .11 for A-1 single family & duplex .23 for A-2 and other residential .23 for other buildings .28 for over 3 stories Factor is: 0.11 BTUH = 577.72 MUST BE > OR = 377.12 (calculated above) 14. Gross ceiling area = 1056 15. Ceiling framing ar ea (10% of ceiling area) = 105.6 16. Joist Area (10% of ceiling area) = 105.6 17. Net ceiling area ( Gross coil, area - Joist area) = 950.4 18. U ceiling: 0.021 x Net ceil. area = 19.9584 19. U framing: 0.024 x Joist area = 2.5344 20. Total of item 18 x item 19 = 22.4928 21. Gross ceiling area x factor below = U x A per code Factor is .026 for A-1 single family & duplex .033 for A-2 and other residential .06 for other buildings Factor is: 0.026 BTUH = 27.456 MUST BE > OR = 22.4928 (calculated above) CITY USE ONLY BL RECEIPT . t SUBD. DATE: 4,19195 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit X New construction Add-on furnace Add-on air conditioning Fireplace conversion (to existing fireplace) Date: June., S, (GCtS ? Minimum Fee: Add-on/Remodel (existing residence only) -$-20.e0-- H VAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @ $3.00 each) 9.00 ? State Surcharge TOTAL 50 33.56 SITE OWNER NAME: araper Bros. Hornes PHONE #: 491 INSTALLER NAME:DROoLi,3's ueafina At Conrlii-frnina STREET ADDRESS: 1'4 Cho Rd CITY: ?&rrn.SV31Ie. STATE: romJ ZIP: PHONE #: (10I ,) 8Q5- C)3tiz) U CITY USE ONLY L BL SUBD. RECEIPT #: DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. multi-family buildings when separate permits are not required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION DESCRIPTION OF WORK: FEES: $25.00 minimum fee Qr 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of Rermit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS:_ CITY: TELEPHONE #: STATE: ZIP: PHONE #: SIGNATURE SIGNATURE OF PERMITTEE INTERIOR IMPROVEMENT CITY INSPECTOR CITY USE ONLY L ? BL ? RECEIPT #: SUED. 1` ANY Z2w DATE: 61 9 95 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH NO. TOTAL Shower 3.00 x _? = 3 D d Water Closet 3.00 x r?2 - o0 Bath Tub 3.00 x = oD Lavatory 3.00 x - 04 Kitchen Sink 3.00 x = v0 Laundry Tray 3.00 x ?? = 3 DO Hot Tub/Spa 3.00 x = Water Heater 3.00 x = 3 DO Floor Drain 3.00 x = Do Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cry, license 20.00 = U.G. Sprinkler * home under const. 3.00 = Alterations * to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL u?0•?0 SITE AD OWNER INSTALL STREET CITY: PHONE #: fcirn?? ST F-F OFFICE USE ONLY L BL RECEIPT SUBD. DATE: _ 1995 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681.4675 Please complete for w all commercialtindustrial buildings. multi-family buildings when separate permits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? - YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE 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 p n339 fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: OWNER NAME: INSTALLER: ADDRESS: CITY: PHONE #: SIGNATURE: OFFICE USE ONLY STE. # STATE: ZIP: APPLICANT METER SIZE: DATE: INSPECTOR: îîÿ þ ý þýý üû ñû ú ùýýúüîøùð ô ÿ þý÷ üûúùø íèûô ÷ôùø ó ö ã íô ã ôüØ ã ôùø ã ûé ûô ü ô óû ú ò óû ú üØ ý å ô üûú ðßüù þ ýãó ô í Ý æêäêðä öù üûô ô íè æê ê ç û ê õøôø ÷óò øø å ô üûú ðßüù ò þ ãó ô úù ö ë ô øø éô ôô ô øùö øø ú ü éã ü û ñùéþ ìô ê øø õ ô ü ûô û ùü ûô ì ý ü þýüýû ÿþþ ýüûúûúù øýýþþù üøî ý ý ÿ ÿþõ úù ø÷ öó é á ùø÷ öø÷ öó é ô óéï ÷ý õù á ù íù÷ýø Üü úÞùý ì ÷â Þù ý æðý üóó÷ ü ûýððýü þ ÷ æáýððý ÷ ýð ýýæ áý ä ý Þù øýó ü ðýø æ ý çååæ åæå ôø úù ýü ý çæ ãæã Ûýùýûæ óò õñð ÷÷ý îý úù ý úø ï þýüýòô øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù ú ÿþ þýý üûûú ùýý ÿøùè ò þýö ýüûúùø÷ö õ üúùø ÷ ÷ö õ ôöõóøò ñü ü ðìüøù ïÿ ýîü òø ëò ò îü ò û ò êé ÿööøÿ þé é òÿ ý øêé é øé ê ûòè îü ûùö ÿéòùò ê íæðåæääêäêä õù ýü æêãêã çüðþê ôó öòñ øø óö å ýüû ãüùó÷ âýùó ó ë ôð ÿ ô àâßâ ûùöÿë øø é ò ÿ òøùöøøûý é ýü ùé ÿì ê øøõ òýÿü üùýÿü 411,11 Citof Eaoaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK ink For Office Use f Permit #: J (x i Il i -11,90,00 Permit Fee: CA 2011 RESIDENTIAL BUILDING PERMIT APPLICATION " Date: 1.' - Site Address: 1 C S $ i 1 Q-0 Unit #: Name: Vete-en b - Applicant is: Owner x Contractor Description of work:f"--010F Construction Cost 4 CI UDC') Company: Mufti -Family Building: (Yes 1 No _) AtANk - � Y L k -per CONTR C f OR G Address: L. vvt 1- Q r . [ 0 ( City: State: C 1 AlZip: 5 I `Z3 3 Phone: E S (- j 1-5-6 (19 License #: 2-O ( Z 'L . Z3 Lead Certificate #: 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: ►'TE. Pi e Info] CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground util r damage. CaII 48 hours before you intend to dig to receive locates of underground unities. www.gopherstateonecail.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the orclnances 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 work authorized by a building permit issued in accordance with the hMnnesota State Building Code must be completed w' in 180 days of permit issuance. x 1 CT �IrYYI kl`gi Appllcanrs Signature Applicant's Printed Name Page 1 of 3 411bb C!tyofEaQali Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use / Permit #: /O( " /'7 9 I Permit Fee: 70 .- 0 Sr - Date Received: Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION b(22112_ Site Address: 11 -(as SWiy e, ►�� Name: Ka (8 Std baIsk1 Address / City / Zip: 1 q45 I\cit Applicant is: Owner 1C Contractor Description of work: Construction Cost: 1 OM Multi -Family Building: (Yes _ / No X ) Unit #: Phone: 952- 786- /S ke- rock 36 3900 res Company: F-XeC.L)f fie- Ex -1n'; ofs- &• g,@moConWes F/o Address://ISO / SOOM �SAore_ A', 51,19t. //City PI /Y1007% State: 7/1/ t r " Zip: 5 `7 7 ! Phone: 763- 4/3 q6 / 7 License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: CALL BEFORE YOU DIG. CaII 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.org 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 work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Robe( Olson Applicant's Printed Name 6-12a_efh, Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink 1 For Office Use i City of Eapn ~ Permit , ' I Permit Fee: U• ~ 3830 Pilot Knob Road Eagan MN 55122 j Dale Received: - (S 2- Phone: (651) 675-5675 1 Fax: (651) 6755694 1 Stan: I I - - - - - - - - - - - - - - - J 2011 RESIDENTIAL 6UILI)ING PERMIT APPLICATION Date: Site Address: I S'"~ Unit Name: IVLSk/ / w /z-EM' Phone:,6 51- RESIDENT / OWNER Address/ City /ZIP:/ Lkof- S"/1j/C/N~ t 11D,, ~r A~ ~/tJ Applicant is: .Owner Contractor TYPE OF WORK Description of work: f ~~fftG ~ p Construction Cost: ±1D g7. G9~ Multi-Family B ilding: (Yes /No Company:`~u~ I,,L 6 laq al94q E VQ~R Contact: CONTRACTOR Address: 01 15e,-0gVC- AI)E i1.1. City: M10LL.5 State: / fii Zip: ~ Phone e15 - SW 73 Ucense L.3© 3 5 boSd I.salid CartNicate # 21A7~-_ 7, -7_3 -1 If the project is exempt from lead certification, pleaseexplain why' (88e Page 3 for additional information) COMPLETE THIS AREA 2 IN Y IF CQN_RUCTINA A NEW BUILDING In the last 12 months, has the City of Eagan Issued a permit fora 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: NOTE: Plans and supporting documents that you submit are cgnsklhred to be public Information. Portions of the information maybe c/asslfled as poll- atypo if y u pro ' do s r J~k rleasons that would permit the City to CoucludO ~iat;ttie . aro traaksecrt3> s." CALL BEFORE YOU Dig. Cog Gopher State one CsU at (04464wW W proteglOn igsinst underground utility damage. Call 48 hours before you intend to dig to receive locates of underground unlos. 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 pgrmit, but only an application for a permit, and, wprk 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 work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. x_ 7 Etl cS-17~bWY AVIE1 X Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA174731 Date Issued:02/16/2022 Permit Category:ePermit Site Address: 1465 Skyline Rd Lot:1 Block: 1 Addition: Broman PID:10-15150-01-010 Use: Description: Sub Type:Furnace & Air Conditioner Work Type:Replace Description: Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mitzi Tetzloff 1465 Skyline Rd Eagan MN 55121 (612) 701-0488 Holmin Heating & Cooling Llc 3432 Denmark Avenue, #228 Eagan MN 55123 (651) 405-3853 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA174914 Date Issued:02/28/2022 Permit Category:ePermit Site Address: 1465 Skyline Rd Lot:1 Block: 1 Addition: Broman PID:10-15150-01-010 Use: Description: Sub Type:Fixtures Work Type:Alteration Description:Multiple Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mitzi Tetzloff 1465 Skyline Rd Eagan MN 55121 Semlak Plumbing Llc 1406 Sophia Ave Maplewood MN 55109 (651) 770-4816 Applicant/Permitee: Signature Issued By: Signature