1555 Skyline TrS7,
EWER & WATER PERMIT
C7 OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
1UNE 25, 1
OFFICE USE ONLY
METER # 07 85-- PERMIT DATE 07/0101
CHIP # 7 PERMIT # 12110
B.P. SIZE B NSu
.P. RECEIPT #
ISSUE DATE - B.P. RECEIPT DATE
XY PRV - BOOSTER PUMP I
SITE ADDRESS PERMIT REQUESTED
LOT II BLOCK 1 SEC,SUB PgETTFMAIN HEIGHTS
SEWER WATER - TAPS
APPLICANT: THOMAS .J t4AURER
ADDRESS: 15013 STEVENS AVE Sn
CITY. STATE BIJPNSV1 V,LE ZIP 553.',7
PHONE:
868-6579
PLUMBER: STAR PLU14B? NG
ADDRESS: 1018 HOUND S PR-l ';G TER -
CITY, STATE BLO )Ml N:,T')t?. ZIP 55420
PHONE: 4_ 16 c
- COMM/IND
X NEW
S RESIDENTIAL
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
'7`V' /4
1 AGREE TO COMPLY WITH CITY OF
OWNER: SAME AS APPLICANT EAGAN ORDINANCES
ADDRESS:
CITY, STATE ZIP
PHONE: SIGN URE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITYOF FEAUTAN
3890 Pilot -Knob Rd.
Eagan, MN 55122-1897
DATE JUN 25, 1() 91
OFFICE USE ONLY
METER # PERMIT DATE 07 i 011: 1
CHIP # PERMIT # 1 ? 1 t
METER SIZE B.P. RECEIPT #
ISSUE DATE B.P. RECEIPT DATE G(k f3/9 I
X PRV - BOOSTER PUMP
SITE ADDRESS 1555 ,?I.iL_NE TRAIL
LOT-L'-BLOCK 1 SEC/SUB PRETTYMAN HEIGHTS
APPLICANT: THOHAS _I MAUkER
ADDRESS: 15013 STEVENS AVE SO
CITY, STATE BURNSVILLE ZIP 55337
PHONE: 868-6579
PERMIT REQUESTED
X SEWER x
- WATER _ TAPS
COMM/IND A RESIDENTIAL
X NEW - EXISTING
STAR PIAM114C Lawn Sprinkler Meters are to be Installed
PLUMBER: Ahead of Domestic Meters on Water Line.
ADDRESS: 1018 MOUND SPR1NG TEk Credit WILL NOT be given for Deduct Meters.
CITY, STATE BLOOMINGTON ZIP 55420 l f
PHONE: 884-4149
I AGREE TO COMPLY WITH CITY OF
OWNER: A'49 AS A}'P' j IE N EAGAN ORDINANCES
ADDRESS:
! CITY, STATE ZIP
PHONE: SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
:-;
to -
i RE:
JUL 1,
DATE:
1555 SKYLINE TR (THOMAS J
X ?t Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
CASH RECEIPT } •
CITY OF EAGAN
R
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE --- t9_ _
nECENFO -'"
FROM
AMOUNT $ _ 1
? CASH A, CHECK
DOLLARS
1w
con
BY 1`-
C 14221
While-Payers Copy
Ye
Ye1bPOSUng Copy
Pink-Re Copy
Thank You
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
B&LOING PERMIT Receipt # -
To be used for ST WAIGAR Est. Value ;145,000 Date Jul
Site Address 11
Lot 11 Block
Parcel No.
W Name TOO"A8 J NAURn
o Address 15013 STEVENS AVE SO
City SURNSV1L" Phone 868-6579
Name
Address
City Sec/Sub
Name _
Address
I hereby acknowlege 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 Permitee ? ?.
all
?J
OFFICE USE ONLY
Occupancy R-3• M-1 FEES
Zoning a--l-
(Actual) Const VJL-- Bldg. Permit
(Allowable) - Surcharge
f of Stories
Length Plan Review _
Depth _ SAC, City
S.F. Total SAC, MCWCC _
S.F. Footprints -
On Site Sewage Water Conn _
On Site Well Water Meter
MWCC System _
City
Water Acct. Deposit
-
PRV Required YL S/W Permit _
Booster Pump S/W Surcharge _
Treatment PI _
APPROVALS Road Unit
Planner Park Ded.
Council -
Bldg. Off. Copies
Variance TOTAL
91
Permlt No. Permft Holder Date Telephone #
WATER Q
SEWER
PLUMBING n :. ??y ?a7 3 -??5'
HNA.C.
ELECTRIC q4
Inspection Date Insp. Comments
Footings I
Foundation
Framing 7a6 AP/
Roofing
Rough Plbg. )?
Rough Htg.
Isul.
d19 I'd
Fireplace
Final Htg_
7/
r
1
Orstat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final ale
Deck Ftg.
Deck Final
Well
N. Disp.
M
Q-11rftftraft of (Orrnpanry
Citp of Cagan
i9ppata[m of %CiW" "timt
?Iris Cemfwate issued p=uant to the Muirements of Section 306 of the Uniform Building
Code certifying that at the tune of issuance this mftcture mw in compliance with the various
ordinances of the City regulating building consM lion or use For the following.
tke anacuio* SF M/CAR WAI& P Wk Na 1932$
OaaWaeey Type ` a? Disuirt Cast Ulm J.
15013 Owns of TMX Add= A?)E SWM s
-- - s >
POST IN A CONSPICUOUS PLACE
.Address: 1555 SKYLM TRAIL Lot 11 Blk ] Sec/Sub pRRTT'9MAN HEIGM
These items were/were not complete at the time of the final inspection.
'Date: 8/22/91 Yens No
Final grade (6" from siding) '
y
Permanent steps - garage
Permanent steps - main entry Y
Permanent driveway
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.
PfMEEO fIRP
White - City copy Yellow - Resident copy Pink - Contractor copy
CITY OF EAGAN N2 19328
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454.8100 /? 4001
Receipt # V
N
To be used for SF DWG/GAR Est. Value $145,000 Date JUNE 25 ig91
Site Address 1555 SKYLINE TRAIL
Lot 11 Block 1 See/Sub. PRETTY14AN HEIGH
. OFFICE USE ONLY
Parcel No. Occupancy R3, M -1 FE ES
THOMAS J MAURER Zoning R1 00
$ 797
M Name (Actual) Const kA Bldg
Permit .
3 Address 15013 STEVENS AVE SO (Allowable) - . 72.50
o City BURNSVILLE Phone 868-6579 #OfStories Surcharge
Plan Review 518.00
SAME Length 6? 100
00
F Name Depth 4 SAC
C
t .
? -
5 ,
i
y
u? Address S.F. Total 650.00
City Phone S F. Footprints SAC, MCWCC
C
W 660.00
On Site Sewage ater
onn
ame On Sit e Well 95.00
19,90-w Add
ress MWCC System XX- Water Meter
Acct. Depose 30.00
ity Phone City Water X?..
30
00
PRV Required XX- SAN Permit .
1 hereby acknowlege that I have read this application and state that the Booster Pump SNJ Surcharge 50
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI 276.00
Signature of Permitee l-? APPROVALS Road Unit 370.00
A Building Permit is issued to: T OMAS J 1URER Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statt and City of Eag 0 crin c s. Bldg. Off. Copies
599.00
X3
Building Official
-? Variance TOTAL ,
f//V/
p 19546
Request Data Fire No Rough in Inspecnon
Required,
- ????''
a Ready Now I C11 Noll Inspector
When Read
?
es
No y
11
I Atnensed contractor ] owner hereby request inspection of above electrical work at:
Job Address (Street B. or Route No I
?SSS' City
/Ae . • "t ah
Section No Township Name or No Range No County k_1 A
-A
"
, p
Occucant(PRINT) /,//j/?
/ ? r"JoIl ? ?0 /
T Phone No
p / -q
a 6 .?? f
Power Supplier
' /V 5 ?° Address
300
4 // ?-
Ele,cI'I Contractor (Company Name,
1 Contractor's License No
6
Y/cwr iiieiv? .
23
Mailing Address IConlractur or Ow r Making Instellanon)
S
s
/fi
SSr 3
.S/.
:? , . c
t?.a < r -
7
Aulhonz6o goal a fOOnnaciq','Dwnar Making Ins( Ilanon Phone Number
t
9" ?-
0 4
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Midway Bldg - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave. St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 6424)800 ENCLOSED
.711.0 REQUEST FOR ELECTRICAL INSPECTION
? see iastmdions br1omplenn9 hill loan on pack of yellow copy
1 R"14 6 "X" Below Work Covered by This Request
ES 00001-09
ew Ad6 ? Type of Building Appliances Wired EgwpmentWlred
lie"
I Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Budding Dryer Other (Specify)
Comm /Industrial Furnace
Farm Air Conditioner
Other (specif)•1 Containers Remarks
Compute Inspection Fee Below •rG
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspectors Use Only TOTAL
Irrigation Booms / ?j •? '?; ,}?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Roughen r Date cy?-
9
certify that the above inspection has
been made Final D
OFFICE USE ONLY
This request vain 16 months tram
9 Y6 y RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 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 plafted after 7/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE
JOB SITE ADDRESS Z5?5 .54 iK .P :7I
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNERLQyOII-C? Sh es ?( I ?1?
TYPE OF WORK %er?ti. UJy "r,- r- eG 7 ti FIREPLACE(S) - 0 - 1 _ 2
APPLICANT
nn PHONE# 95a 89L1gZq
ADDRESS 9?? ??/!?/t° /J,P ZIP CODE SS/?2 L/
PAGER # CELL PHONE # C/o lo? -760-7 FAX #
NEW RESIDENTIAL BUILDING ONLY -FILL OUT COMP I [
'
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I MAR 2 9 7007
(check one) Residential Ventilation Category 1 Worksheet Su ed
Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor: _
Mechanical System Includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $,90.00
Fee: $70.00
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 Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
Water Softener
Water Heater
No. of Baths
RemodeflReoair Requirements
2 copies of plan
1 set of Energy Calculations for heated additions
1 site survey for exterior additions & decks
Indicate if home served by septic system for additions
VALUATION 6_-;l00
_ Phone #:
Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor- 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
Nor. 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. - Ai r 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
Total
Building Inspector
CITY USE ONLY \\
PERMIT #: a RECEIPT DATE: a " - y
USIDENTIAL MECIANICAL PERMIT APPLICATION
crrY of EAHAN
3$30 PILOT KNOB RD
EAGM MN 55122
651-681-4875
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ? I _aq (7
SITE ADDRESS:
OWNER NAME:
TELEPHONE M CQJ? C1[9_S99_9GJ
(AREA CODE)
INSTALLERNAME: i)QYI?!\?? ?(w?T(ZC LTELEPHONE#: q6& MMD?J
(A
J
__ REA CODE)
STREET ADDRESS: 19 a l ? f cQ D ?S)ry1c? nn?? t? S .
CITY: S(l s7Q? STATE: mc{ ZIP: JS?? p
Place a check mark nett to the nermtt work tune
4
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modification or alteration to existing dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
Nature of work: C? b?SL I\ ?
State Surcharge $ .50
Total $ S'D'sn
Reminder: Call for inspections.
SIGNAT RE OF PERMITTEE
Updated 1/01
PERMIT M
APPROVED BY:
CITY USE ONLY
T DATE:
INSPECTOR
COMMMCIAL MECH"CA L PEf MIT APPLICATION
CITY OF EmAN
3630 PILOT KNOB RD
F.A(LU, MN 551 ES
651-661-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
WORK TYPE:
New construction
Interior Improvement
Processed Piping
Install U.G. Tank
Remove U.G. Tank
Specify Nature of Work:
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing linspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removal/installation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
PHONE#:
(AREA CODE) ;
u
STATE: ZIP:
Updated 1/01
1991 BUI NG APPLI N
L] RERHIT
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
I SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
V /Lo Be Used For: Si r? P Fe '?y Valuation: a e: b
V
Site Address /S SS ,Si y?i°Irp r
Lot Block /
Parcel/Sub
Owner PIA -V ?/'e
Address 3/ d 3i
City/Zip Code ! y L r ?/??
Phone
Contractor-7% , -- a s -j-P t7&&rf)r-
Address / S} i. 3 S t1e, y.v/?. ? / vV' S6 .
City/Zip Code /_? u r Y ; v rrl?
Phone r?"? k' G '5-7'
/Engr. /Z a, r- G»
Address
City/Zip Code a K)'z
Phone # ' .5" ) - c,
OFFICE USE ONLY
f y5, 0,00
"
Occupancy R'3 M'1
Zoning R.--I
Actual Const V-N
Allowable
# of stories
Length
Depth 5
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System L_
City water
PRV ?
Booster Pump
FEES
Bldg. Permit 7Q7.00
Surcharge 2, O
Plan Review 100
SAC, City 100100
SAC, MWCC 0100
Water Conn. i(70
Water Meter 00
Acct. Deposit 130t
S/w Permit 30,00
S/W Surcharge 'Z7
Treatment P1. Z Coi00
Road Unit pD
Park Ded.
Trail Ded.
Copies
SUBTOTAL
APPROVALS Penalty
Planner Lot Change
Council TOTAL C.
Bldg. Off. bT67?-5$/
Variance
W
1/, 42 agrees that all work shall be done in accordance with
(Signature of C ntractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
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f
SIGMA
SURVEYING SERVICES INC.
3730 Not Knob Rood
Eogan. MIMBS010 55122
(612) 452 - 3077
House Certificate for:
THOMAS J. MAURER
CONSTRUCTION
OOAO,AO[ AND 0T14TT [AS[AYOTS AO[
SHOWN TH".
4
KING 5 T[[T 1M 14 YNL[SS OT r
0,01OAT[O,AUAOA01Mla LO,Ss OT A 1y }? ?,
W p[[T N, 4'IOTM AMO A10P%IN6 S16 MO
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tiUT iU
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kol0 T.- - - IV Y1
961.6 _r
s/
Cr 7v44 a
r_
Scale-
P r
-LEGEND-
o Denotes Iron Monument
a Denotes Wood Hub Set
x 863.•f Denotes Existing Spot Elevation
1Y?4•I) Denotes Proposed Spot Elevation
-?? Denotes Drainage Direction
-PROPERTY DESCRIPTION-
Lot 11, Block 1, PRETTYMAN HEIGHTS,
according to the recorded at thereof,
Dakota County, Minnesota?a`y 5
............ .
N RYLrN "
Ar? T-
EAG ? ?f
PROPOSED GARAGE FLOOR ELEVATION= 8b? L
PROPOSED TOP OF BLOCK ELEVATION=
PROPOSED BASEMENT FLOOR ELEVATION= SS9.0
*NOTE: Verify all Bldg. Dimensions and
Floor Heights with Final House Plans.
-SURVEYORS CERTIFICATION-
I hereby certify that this survey, plan or
report was prepared by me or under my
direct supervision and that I am a duly
Registered Land Surveyor under the laws of
the State of Minn sota. rr
Date: ?' iS(9
Wayne D. Cordes, Minn. Reg. No. 14675 _,0
::rl0- 3L-??
MINNESOTA STATE ENERGY CODE CALCULATIONS
BASED ON CHAPTER 5 OF THE
MODEL ENERGY CODE - 1983 EDITION
Adoption Effective
Owner A6_4i Phone Date
f Type A2 (Residential, 3 stories or less) (Over 3 stories) (Other)
,NOTE: Complete pages 3 and 4 first.
GENERAL INFORMATION
N V%
1. Building Perimeter'i?, Wo?.k_ t.
e?rrY
2. Wall height (ground to eave) %84WD' ?#T ft.
3. 1. X 2. (above) gross wall area sq.ft.
4. Building dimensions (L) - X (W) sq.ft.roof & floor area
5. Sq. foot area of rim joist - Floor joist size (2 X ??
1 X (Perimeter) _ J_(0. sq.ft.
12
6. Doors - Area P IL,{? ? a (? A
Thickness in U. factor0
Type of Construction Perimeter ft.
TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL
H EACH UNITS SQ FEET
9. Total sq. ft. Glass ZC??-'
10. Fireplace area: Width X Height = X = sq.ft.
11. Exposed foundation: Height X Perimeter 16-17 X 105- = /0,SS sq.ft.
COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR
REMODELING AND BUILDINGS BEING MOVED WHERE ENERGY, OTHER THAN THE MINIMAL
CODE ALLOWANCE, IS USED.
7. Total door's perimeter ft.
NSU? , '
. Windows: Manufacturer State approved
8 U factor
-1-
Building Classification: Type Al (Single Family & Duplex) 'X£'
zP y,/) 3z3
12. Framing area = 10% of gross wall area.
13. Gross wall area sq. ft. L?r 2
Window area A Zlo? ? sq.ft. U windows = +3CO UxA = + ?is
Rim joist area A0 5'JS7
sq.ft. U rim joist= 1E?1 UxA =
Door area A Zip sq.ft. U door area= 114 UxA = JqqJ??
Other doors area A ' csq.ft. U other doors= + 7 UxA = I
Exposed fndn A I ?'? ? sq.ft. U foundation= + 2 UxA = v ' I
r^7
Framing area A?-U framing area= 2'?5 UxA
Net wall area A ZII sq.ft. U wall= ' 0 J UxA = _...
(13B) TOTAL . . . . . . . . . Ux -AL
14. Gross wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code
(13. above)
x 0.23 (A-2 other residential)
x .23 (Other buildings)
X 28 (Over 3 stories)
?? D ?+? BT°UH must be larger than or same
A51 YI U Code All =? F. as 13B above
15. Ceiling framing area (Af) equals 10% of ceiling area
15A. Gross ceiling area = (L) ?- x (W) = H 1I? sq.ft.
15B. Joist area (Af) I.eiI
15C. Net ceiling area
U ceiling x Ac
U framing x Af
15D. TOTAL U x A.....
= 10% ceiling area = sq.ft.
(Ac) (15A - 15B) sq.ft.
o2z x ? I?? _ ,?J
OZ '2
x ?1 =
................ --
16. Ceiling area (15A) x 0.026 (A-1 sifamily &'duplex)
allowable UxA/Code
x 0.033 (A-2 other residential)
x 0.06 (other)
dz BTUH must be larger than or same
A(15A) I ( 3x U Code OF. as 15D above
NOTE: Use U and A values obtained from pages 1, 3 and 4.
CERTIFICATION: I hereby certify that I have calculated the "U" factors and
"R" values herein and that the building here described meets or exceeds the
State of Minnesota Energy Conservation Act.
Date
gnature
-2-
o'er
s
OIZZ =? Xo'll = a?Xa2 II
o' x? g ??cX l(II
us2?ll
ee ?bI
412-04
WALL
SECTION
Inside air film
Interior wall
Insulation
Sheathing
Siding
Outside air film
R TOTAL
R VALUE
:68
.45
19.0
L.?
.(01
.17
L3 , 0 3
U VALUE
(Wall) U - R
.043
STUD
SECTION
Inside-air film .68
Interior wall • +7
4" stud R= -&:T (o.' (Framing) U - R
Sheathing Z'00 ,,.pp,.•
Siding G7? I?
Outside air film .17
R TOTAL 0), S 7j
SECTION.
Interior wall
Insulation all) U R .
Exterior wall cover-TR?
Exterior air film R - .11
R
RIM
JOIST
Interior air film
Insulation
I§ Inch soft wood
Sheathing
Exterior we I cov
Exterior air film
R= .68
19.0O 1
R=1.88 (Rim U R =
Joist) '
2.0(0
ering .(01
R= .l1
RTOTAL 2,4. 4o
Interior air film R= .68
Insulation 1(,0
Foundation (,La
Exterior air film R' .17
R TOTAL ) 3. 1 3
Exposed Block
rade
3.
1
(Fdn.) U - R =
. O7(p
'FILING WITH VENTED ATTIC SPACE ABOVE
R VALUE
FRAMING
R VALUE
CEILING
0.61
0.61 AirFilm 44.0
-Na- r Insulation4.38 Joist -------
0.56 Ceiling 0.56
0.61 AirFilm 0.//661
42-1 I 'P TOta1R
OZ?j U=1/R o2Z
Window infiltration 0.5 cfm/lineal foot of crack
Residential door infiltration 0.5 cfm/square foot or door and minimum code
requirement
Non-residential door infiltration 11.0 cfm/lineal foot of crack
Ub 12" concrete block no insulation = .47 R 2.1
Ub 12" concrete block insulated cores = .26 R 3.8
Ub 12" lightweight block = .32 R 3.1
Ub 12" lightweight block insulated cores = .12 R 8.3
U single glass = 1.13; with storm window .54
U double glass = .55
U triple glass = .41
All exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
Vapor barrier must be on the inside (heated side) of wall.
Vapor barriers of the polyethelene thin film have no R value.
SEVERSON, WILCOX & SHELDON, P.A.
LARRYS SEVERSON'
JAMES F. SHELDON
J PATRICK WILCOX'
TERENCE P. DURKIN
MICHAEL G DOUGHERTY
MICHAEL E. MOLENDA-
A PROFESSIONAL ASSOCIATION
ATTORNEYS AT LAW
7300 WEST 147TH STREET
P.O. BOX 24329
APPLE VALLEY, MINNESOTA 55124
TELEFAX NUMBER 432-3780
(612) 432-3136
PAUL J. STIER
KENNETH R. HALL
"'SCOTT D JOHNSTON
JOSEPH P. EARLEY
MARY L GOLIKE
LOREN M. SOLFEST
'ALSO LICENSED IN IOWA
''ALSO LICENSED IN WISCONSIN
...ALSO LICENSED IN NEBRASKA
October 10, 1989
Mr. Gene Vanoverbeke
Eagan City Clerk
3830 Pilot Knob Road
P.O. Box 21199
Eagan, MN 55121
RE: Pressure Reducing Valve Agreement and
Access Easement Agreement
Prettyman Heights Addition
Our File No.: 206-7108 (OOE)
Dear Gene:
OFCOUNSEL
JOHNE VUKELICH
In connection with the above matter, I enclose original recorded
Pressure Reducing Valve Agreement - Document Number 905746 and
Access Easement Agreemen?- Document Number 905747 for the
official City records.
To ?kca?
If you should have a question, please feel free to contact me.
Thank you for your consideration and cooperation in this matter.
yours,
, WILCOX & SHELDON, P.A.
Roxann Duffy
Legal Assistant
RSD/djk
Enclosure
PRETTYMAN HEIGHTS
PRESSURE REDUCING VALVE
TF).S1/,AGREEMENT, made and entered into the / eZ-day of
u' , 1984, by and between the CITY OF EAGAN, a
Munici#ali? of the State of Minnesota, (hereinafter called the CITY,
and the Owner and the Developer identified herein.
The terms "Developer" and "Owner" as used herein refer to
SKYLINE HEIGHTS PARTNERSHIP whose address is 1480 Skyline Drive,
Eagan, Minnesota 55121.
WHEREAS, the Developer has applied to the City for approval of
the plat or subdivision known as PRETTYMAN HEIGHTS, located within
the City; and
WHEREAS, the Owner and Developer agree to notify potential
buyers of all lots within PRETTYMAN HEIGHTS that all lots (Lots 1
through 18, Block 1, Lots 1 through 4, Block 2 and Lots 1 through 4,
Block 3) are in a high water pressure zone and a pressure reducing
valve shall be installed in each home below the elevation of 875
feet. All costs shall be the responsibility of the Owner and
Developer and shall be installed to prevent damage due to high water
pressure.
NOW, THEREFORE, the City, Owner and Developer agree as follows:
1. Recording. This agreement shall be recorded with the Dakota
County Recorder so as to provide notice to the owners of all lots
within PRETTYMAN HEIGHTS (Lots 1 through 18, Block It Lots 1 through
4, Block 2, and Lots 1 through 4, Block 3). The owner shall provide
and execute any and all documents necessary to implement the
recording of this agreement.
2. Notice. The recording of this document shall constitute
notice to all owners and future owners of property in PRETTYMAN
HEIGHTS that all lots (Lots 1 through 18, Block 1, Lots 1 through 4,
Block 2, and Lots 1 through 4, Block 3) are in a high water pressure
zone and that a pressure reducing valve shall be installed in each
home below the elevation of 875 feet. All costs shall be the
responsibility of the Owner and Developer and shall be installed to
prevent damage due to high water pressure.
3. Validity. If any portion, section, subsection, sentence,
clause, paragraph or phrase of this agreement is for any reason held
to be invalid, such decision shall not affect the validity of the
remaining portion of this .ontract.
4. Binding Agreement. The parties mutually recognize and agree
that all terms and conditions of this recordable agreement shall run
with the land herein described and shall be binding upon the heirs,
successors, administrators and assigns of the owners and developers
referenced in this Contract.
IN WITNESS WHEREOF, we have hereunto set our hands.
CITY OF E GAN o
(Date: o • )
l ?By:
Its Mayor
Attest: Sj *
Its erk
STATE OF MINNESOTA)
By:
COUNTY OFI )) ss.
On this Y-7-YVday of -? , 1989, before me a Notary Public
within and for said Count pe sonally appeared VICTOR L. ELLISON and
E. J. VanOVERBEKE to me pers ally known, who being each by me duly
sworn, each did say that they are respectively the Mayor and Clerk of
the City of Eagan, the municipality named in the foregoing
instrument, and that the seal affixed on behalf of said municipality
by authority of its City Council and said Mayor and Clerk
acknowledged said instrument to be the free act and deed of said
municipality.
?. MAFI! \91 L WUCHERPEEINN! G
SO?A
F", n N07ARY PUCUC
DAKOTA A COUNTY
?j{ J Y My Com?•?°°'?n Exp F.b B 1!33 Z
N?ItRMMITHr??!: t ! fti [!H.' SNd
_'l
ublic
OWNER AND DEVELOPER:
SKYLINE HEIGHTS PARTNERSHIP
STATE OF INNESOTA)
) SS.
COUNTY O )
On this day of , 1989, before me a
potary Pub,Lic w t }? nd for said ounty, personally appeared
f-11-`7`,C??E l • ?l?t(?7 to me
personally known, who, being aagh} by me duly sworn to bPbpartner of
the Partnership named in the foregoing instrument, 14-11
r--seal-e€-s a id_nar tnersiip and that/'
a€ area- t o ? - ? a + n ? ?+me at is tie
said instrument was sign d and sealed on behalf of said Partnership,
by said 6FCch? I ,, ?.l /L?LCZT -and-
and /the?y' acknowledged said instrument to be
the free act and deed of the Partnership.
CENISE J KOENCK
M
Igf+ FLUX DYw Co,". Om
My Co.w.ien 9. Fr a +/q
APPROVED AS TO FORM:
At
APPROVED !t$ TO
6'z? =
Public Works Department
Date:
THIS INSTRUMENT WAS DRAFTED BY:
MCMENOMY & SEVERSON, P.A.
7300 West 147th Street
P.O. Box 24329
Apple Valley, MN 55124
(612) 432-3136
MGD
-3-
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # o y?
1{EC1Ha2?ICATj ,YERMTT DATE:
ItESIAE3?TxAZ_'
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------
WORK DESCRIPTION
NEW CONST _?
ADD ON _
REPAIR
DWELLINGS &
FEES
OWNER NAME:
SITE ADDRESS:
LOT:/_ BI
SUBD.
1-111AId Y_
ADDRESS:J/ / YS?y?r, y/lp,?? v??
ZIP:
CITY: /aaf<?? ,/L/
PHONE #: Gir? 4R 3 - // 7 1
g9MMERiTA INDUSTRIAL; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD,
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00 .?
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $_?
STATE SURCHARGE: .50
TOTAL: $ ! .
SIGNATURE OF PERMI EE
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
ZIP:
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
.....:......
H«
FEES
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON _
REPAIR
OWNER NAME: 7o-, Yn
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER: GENZ-RYAN PLUMBING & HEATING CO.
ADDRESS: 14745 South Robert Trail
CITY: Rosemount, MN ZIP: 55068
I::ONE #:
-1
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
_,-------- ----- -------°._--------------^----------------------°-----------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
FOR CITY USE ONLY
PERMIT #
RECEIPT #?
DATE:
COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
t SHOWER 3.00 3 °v
_,3 WATER CLOSET 3.00 T9
BATH TUB 3.00
3 LAVATORY 3.00
7 KITCHEN SINK 3.00
LAUNDRY TRAY 3.00 a
HOT TUB/SPA 3.00
T WATER HEATER 3.00 Z
FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUM - 1)
3.00 y
3
ROUGH OPENINGS 1.50
_ OTHER _
_ WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
??
SUBTOTAL $ 7 r?
ST. SURCHARGE .50
J
TOTAL: S
(SIGNATURE)
CITY OF EAGAN
1139494
DRAINAGE AND UTILITY EASEMENT
1
day of ,d 1992, between
Sherburne, husband and wife, herein
referred to as "Landowners" and the CITY OF EAGAN, a municipal
corporation, organized under the laws of the State of Minnesota,
hereinafter referred to as the "City".
W I T N E S S E T H:
That the Landowners, in consideration of the sum of one Dollar
($1.00) and other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged, do hereby grant and
convey unto the City, its successors and assigns, a permanent
drainage and utility easement, over, across and under the following
described premises, situated within Dakota County, Minnesota, to-wit:
THIS EASEMENT, made this _e
oralle D. Sherburne and Patty L.
That part of Lot 11, Block 1, Prettyman Heights,
lying northeasterly of the following described
line: Beginning at a point on the east line of
said Lot 11, 41.00 feet distant from the northeast
corner of said Lot 11, thence N 280 44' 27" W a
distance of 59.80 feet to a point on the northeast
line of said Lot 11 and there terminating.
See also Exhibit "A" attached hereto and incorporated herein.
The grant of the foregoing permanent easement for drainage and
utility purposes includes the right of the city, its contractors,
agents and servants to enter upon the premises at all reasonable
times to construct, reconstruct, inspect, repair and maintain pipes,
conduits and mains; and the further right to remove trees, brush,
undergrowth and other obstructions. After completion of such
construction, maintenance, repair or removal, the City shall restore
the premises to the condition in which it was found prior to the
commencement of such actions, save only for the necessary removal of
trees, brush, undergrowth and other obstructions.
And the Landowners, their heirs and assigns, do covenant with the
city, its successors and assigns, that they are the Landowners of the
premises aforesaid and have good right to grant and convey the
easement herein to the City.
072393
T. a
' L
W
O
rTI
of
V)
00
50.00
-mac :tee
L=6&J5 ,? GJ
L NOG -4
870. N ?i-
o { L¦66 725-
`?S 8!•32'07" E ?
V ? ? 1
V
G=50•OcJ53" 1
La 71148 I
%? ,,c
\C*
7,,i!
i
r?/o I 7h ?
+? W / N
i
&Ifsa-.7a 7i
L.63Ja
,t
Al
UTILITY EASEMENT
I* 0
r
4 4
A• _ 14071 I
W'6 jr
..
T' > o _
,r D -' 4' ?7s'o i
Kt a Exhibit "A"
/r
Qq6r
s879w3y
-41
?L
iro- ---TRAIL
14
_
i
CONSENT OF MORTGAGEE
TCF Mortgage Corporation, a Minnesota corporation, as Mortgagee
to the foregoing easement premises, hereby consents to the grant of
the foregoing easement as of this 13th day of Mai , 1993.
TCF MORTGAGE CORPORATION,
a Minnesota corporation
¢c
By:
Its:
By: Dahra A_ Hancnn
Its: Asst_ Vira President
STATE OF MINNESOTA )
) ss.
COUNTY OF Hennepin
The foregoing was acknowledged before me this l-1±h day
of May 1 1993, by Dmiglas I pinndnrf and nahra A_ Hansnn ,
the Sr. Vice President and Asst_ Vira President of TCF MORTGAGE
CORPORATION, a corporation under the laws of Minnesota, on behalf of
the corporation.
of ry blic
r DAWN L ROATH
*10 NOTARY PUBLIC-MINNESOTA
ANOKA COUNTv
My ? ommission Expires DP, r 1996
•W.n gnN1lgn nn. n.,i r. 'NT
IN TESTIMONY WHEREOF, the Landowners have caused this easement to
be executed as of the day and year first above written.
r1tt:?J" Z)?' .
Oralle D. Sherburne
Patty . Sherburne
N
a
N
NO
STATE OF MINNESOTA )
).:s.
COUNTY OF RAMSEY )
The foregoing wds acknowledged before me this __ day
of 1992, by ORALLE D. TTY L.
SHERBURNE, husband and wife. l Courier
` - NCI• n IU04IC.MINNCSOTA
, C7
COUNTY
?. ]NV COMM+_s+<?--=aesJAN. 29, 1997
Notary Public
APPROVED AS TO FORM:
// Q7
Cit Atto n 's ffice c7
Dated: geese Z 15h l .-,
H
APPROVED AS TO CONTENT:
94=-rtment
Dated: ID? 3. f41y
THISUMENT WAS DRAFTED BY:
SEVE SON, WILCOX & SHELDON, P.A.
600 Midway National Bank Bldg.
7300 West 147th Street
Apple Valley, MN 55124
(612) 432-3136
SDJ
~za j .7 ?
an IRT o ¢
zo -- fJ? h $ w
T
cL o M Cn
A ??
w ?.. =
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fr
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1Yand PEas
erEntered
day of 19? `
r county Audi .. Dakota Co.
JJ
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r
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,,
c
1104664
DRAINAGE AND UTILITY EASEMENT
THIS EASEMENT, made this ?. I day of zld? 1992, between
Oralle D. Sherburne and Patty L. Sherburne, husband and wife, herein
referred to as "Landowners" and the CITY OF EAGAN, a municipal
corporation, organized under the laws of the State of Minnesota,
hereinafter referred to as the "City".
W I T N E S S E T H:
That the Landowners, in consideration of the sum of One Dollar
($1.00) and other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged, do hereby grant and
convey unto the City, its successors and assigns, a permanent
drainage and utility easement, over, across and under the following
described premises, situated within Dakota County, Minnesota, to-wit:
That part of Lot 11, Block 1, Prettyman Heights,
lying northeasterly of the following described
line: Beginning at a point on the east line of
??\1 said Lot 11, 41.00 feet distant from the northeast
v corner of said Lot 11, thence N 280 44' 27" W a
distance of 59.80 feet to a point on the northeast
line of said Lot 11 and there terminating.
See also Exhibit "A" attached hereto and incorporated herein.
The grant of the foregoing permanent easement for drainage and
utility purposes includes the right of the City, its contractors,
agents and servants to enter upon the premises at all reasonable
times to construct, reconstruct, inspect, repair and maintain pipes,
conduits and mains; and the further right to remove trees, brush,
undergrowth and other obstructions. After completion of such
construction, maintenance, repair or removal, the City shall restore
the premises to the condition in which it was found prior to the
commencement of such actions, save only for the necessary removal of
trees, brush, undergrowth and other obstructions.
And the Landowners, their heirs and assigns, do covenant with the
City, its successors and assigns, that they are the Landowners of the
premises aforesaid and have good right to grant and convey the
easement herein to the City.
Tr, s"?_ F?atai-ad This J'Yb(/
e -,m 9Lzi, D? Co.
S wit
dr-
w
0
rT1
I
1
1 1 0 L1KY MY 7Q
1..a6.83 f L• 8
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/s•"••"'??1j?_
i ju=a7•25 11-1p
I L=66.13 / ? wp ION? stl .w?f
s7t.
"I
al L ss 72 'lo??
Q,
,
?,pcK l
3 81.32'07"
83.47` ?•.
UTILITY EASEMENT
r
,
N
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\ NcP,`
00
y
\\ 4=50'0933°? 1 4 \? a
L 7Q49
L /;04 24 57 ?? 4`'33.3 „
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V
?6=p \\ \°8T ?' '8821
-164 S, t '9f ? j N 89.33';
/ - r t> - 4 .90 8.43-.ems _
y /? ?l ? / N • L=f 4 7?
v - / _ 4, _ zoo
yO' / N ?7\? D Exhibit ..A.. t8O2?".?? -? _ .
IN TESTIMONY WHEREOF, the Landowners have caused this easement to
be executed as of the day and year first above written.
Oralle D. Sherburne
(? " 'z
Patty Sherburne
STATE OF MINNESOTA )
ss.
COUNTY OF RaNSFV )
The oregoing was acknowledged before me this ? day
of Au ? 1992, by ORALLE D. SHERBURNE and PATTY L.
SHERBURNE, husband and wife.
^^^??
C,Ctie (JOutie*
-, r'° NGT?RY RUtLI C•M I NNEROT(
g0.M 5EY COUNTY
My CJM A'ISSInN E}ptRE9 JAN?997
cum GYta? -
Notary Public
APPROVED AS TO FORM:
l
City Attorrey' Office
Dated: ece• z I".,-
APPROVED AS TO CONTENT:
c?
Public Works Department
Dated:
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, WILCOX & SHELDON, P.A
600 Midway National Bank Bldg.
7300 West 147th Street
Apple Valley, MN 55124 c
(612) 432-3136
SDJ
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Use BLUE or BLACK ink
� � �r—————————————————+ .
I For Office Use �
I - ^+ �� I
' � Permit#: j
�lt� 0� ����Il � � ���, ;
� Permit Fee:
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651 j 675-5675 I I
Fax: (651)675-5694 I Staff: I I
�----------------� I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION �,
Date: Site Address: Unit#: I
a �
�� �� � � a7�y 5 /-�� 6� �n� �'�� G�3 `��-g9
�� ,� a Name: , Phone:
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��� ��" � �� �
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Description of work: �U�i� .
:T�fp����1��r1� _,
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����, ,; �;,, Construction Cost: �� Multi-Family Building: (Yes /No
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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 8�Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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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.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.
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ApplicanYs Printed Name � ApplicanY Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA148965
Date Issued:04/30/2018
Permit Category:ePermit
Site Address: 1555 Skyline Tr
Lot:11 Block: 1 Addition: Prettyman Heights
PID:10-58800-01-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Patty Tste L Sherburne
1555 Skyline Tr
Eagan MN 55121
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature