3780 South Hills Ct SEWER SERVICE PERMIT
CITY C:' EAGAN
3745 Pilot Knob Road PERMIT NO.:
5
22 DATE:
1
Eagan, MN 5
Zoning: _ No. of Units:
-- -'
Owner: -
Add
ress:
Add
Site
ress:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
ordinances. Account Deposit: -
Permit Fee:
By
Date of Insp.:
Insp.:
CI'-Y C)F EAGAN
3745 Pilot Knob Road
Eagan, MN 55122
Zoning:
Owner:
Address:
Site Address:
Plumber: --
Meter No.
Size:
Reader No.:
I agree to comply with the City of Eagan
Ordinances.
By
Date of insp.:
Surcharge:
Misc. Charges:
Total:
Date Paid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges: r
Total:
Date Paid
Incn
1N SFEU ION REUOKI)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ri i' 4 ca
y i
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
A ills; CT All
.?ct?lll it!! t'. tt,l?•> i<' i .'{j lE?i
PERMIT SUBTYPE: TYPE OF WORK:
: , f-r f?a f 19) N % X11 1 i ; t 1 , (1 ! kOof
Permit Holder Date Telephone IV
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential O Commercial O Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe Fuel Type
11.
No. Equipment BTU - M. Ea.
Forced Air ?`?C << C- No. Equipment CFM
Ai
H
dli
.
Mfg. toe an
r
ng:
Boilers
l `Z7
Mfg, Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final I
Inspections: Date Insp. Dated f!! V Insp. 4r
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
.,.r uF EAGAN Remarksn-?O?) C,? ?17?C'cttIA(>,
Addition Lot 18 Blk 2 J Parcel If) 70790 100_02
Owner' !+?` Street 3780 So. Hills Court State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK IS1 IQ71 I 4f; - 4A 7-142 211 7.1-26 A00886S 2
16/90
* SEWER LATERAL ` .
WATERMAIN
* WATER LATERAL
WATER AREA
STORM SEW TRK
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
N. it it
BUILDING PER. 5478
SAC
16391
PARK 120.00 16391
??
IF
CITY OF EAGAN
8795 P1W Knob Road Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT Receipt #
To fia U "A for ` 2Y Fef Vn610 ? r)nfo
Site Address
Lot Block Sec/Sub.
Parcel #
0: Name
W
Address
0
Name
,o
uu Address
F' city
WW Name
H
iZ Address
N2 5478
Erect ? Occupancy
Alter ? Zoning
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
Approvals Fees
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner
Council
Permit _
Surcharge
Plan check
SAC
Water Conn.
Water Meter
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
*. 1
Permit # Date laved In"
Plumbing /off aZG
Mechanical 5- / 7 7 5
INSPECTIONS DATE INSP. Rough-In Final
Footings ) Date Insp. Date Insp.
Foundation
Frame/ins.
- -8
?? ?
W4ea
s? Plumbing
Mechanical
-?
al!
4`
V
Final
Remarks: ??`
i . _ 1
? .r
HEATING
CITY Of EA"N
3795 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT
No. 1645
12 ^ /
Date: Receipt No.:
_ i i r` Single
Site Address:
Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind.
_
Name /Alter
/Re
N
air
.
p
ew
.
_ --
3 T;
Address Cost of Installation
City Phone: Permit Fee
C'
Name Surcharge
Butler
Address
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. -
Building Official
?. •%'?" ' = ' CITY OF EAGAN
3793 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-8100
PLUMBING PERMIT No. 1552
Date: 12/20/79 [Receipt No.: 17190
Single I
Site Address: 3780 SC' Hills Ct.' Residential Y
Lot a Block ? Sub/Sec. _ ?• fills 18 Multi Res., Comm./Ind. I
Name Timberline Builders New/Alter
/Repair W
.
Address 3707 So - Hil1A D'• Cost of Installation
City Eagan, ='Oi Phone: 454-591S Permit Fee ?' "Y)
Name 3err Inc. Surcharge ' S
6021 Lyndale =ve. So.
Address
City Phone: ' l Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
T,ertifiratr of Mrruvaurg
Citp of eagan
lorpartmrnt of luildmg Insprdion
This Ceti fitate issued pursuant to the requirements of Section 306 of the Uni form Building
Code certifying that at tbt time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For thx f ollouing:
. . SF Dwlg/Garage 5478
&d`, pemut No. UN cr.+r
Rd.
or. February 8, 1980
pea:
roes IN w eor Uooe race
.er
? .. CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 1.1101
19
REC6IVEQ f, -
FROM
AMOUNT $ I!
& DOLLARS
Ioo
CASH CHECK
T
Thank You
f BY
FUND CODE AMOUNT
t
1
-
7
7 7
White-Payers Copy
9 t ?} Yellow-Posting Copy
A J r Pink-File Copy
CITY OF EAGAN
3795 Pilot Knob Rood Eagan, MN 55123
PHONE: 4548100
BUILDING PERMIT APPLICATION
T. L. ,,,A sar SF Dwlg & Garage c.+ v.,,. 64,000.
Site Address .3/au x7. 1711-115 wuiZ
Sec/Sub. $OUtYI Hl S
10 Block c
parcel # 10 70790 100 02
rc Nome v=ial `ya,,o.,.i
Z Address 677 McNight Rd.
.... St. Paul 55119 ... _
ffi Name Tinberline Bldrs., Inc.
Address 3707 So. Hills Drive
n«, Eaaan 55123 u:,,,.,e 454-5918
Name _
Address
N2 5478
Receipt # / C;? 9i
r,- 10-23 ,a79
Erect EK Occupancy R3
Alter ? Zoning PD
Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Move ? # Stories
Demolish ? Front 52 ft.
Grade ? Depth 62 ft.
Approvals Fen
Assessment Permit 160.50
Water & Sew. Surcharge 32.00
Police Plan check 80.25
Fire SAC 525.00
Eng. Water Conn. 270.00
Planner . Water Meter 60.00
Council PlOad Unit 75.00
I hereby acknowledge that I have read this application and state that Bldg. Off. ark Ded• 120.0
the information is correct and agree to comply with all applicable APC Total 1.322.7
State of Minnesota Statutes and City of 'pp an rdinances.
Signature of Permittee
A Building Permit is issued to: Til[b l BldrS., Inc. on the express condition that
all work shall be done in accordance with all licable State of Minnesota St utes and City of Eagan Ordinances.
Building Official
CITY OF EAGANInclude 2 sets of plans,
1 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of energy calculations.
To Be Used For "r 1) ex1?° valuatio Date /D - -7-1
7ffa ? • i
Site Address te-r Ic SDK. 7-- OFFICE USE ONLY
Lot ?o Block ? sec./sub. s?`?'k ; S`T-
- Erect X Occupancy /I3
Parcel #: b 7/3 & /DO 19.-4- Alter Zoning
Repair Fire Zone 3
Owner: V 6r4-t, LA-er ? 57-L Enlarge _ Type of Const.
Move # Stories
Address: ?'j'J M?I'I! F iT Demolish Front ,S cz ft.
City/Zip Code: 15•r. ? nu L-M ti', Sl t `t _
Grade Depth eft.
Phone #:
Contractor: Y lr?R>i2U u? S" i L-Dg24 i 1Qr-?
Address: 370.7 5v FE i wS P P-+'J 6:-
City/Zip Code: a??_? S Z3
Phone #: q S-+- -TI (a
Arch./Eng..
Address:
APPROVALS FEES inn
Assessments a2 Permit
Water/Sewer Surcharge 3R
Police Plan Check -
gar'
Fire ?t
SAC .7o2s
Eng. Water Conn. 70
Planner Water Meter 46
-
?
Council Road Uni
lz_-r
Bldg. Off.
AFC
City/Zip Code:
Phone #:
TOTAL 3 Z2
This re,ua,y, d ?/2
-7
18 months frA?
76465
Lla(B?c ?. {??I(s (st 2X f0 3/'
/6r0(D
Mouest Oat. Fire No. Rouph-i Inspocuon
Req U i red+
Ready Now ? Will Nnllfv Inspec-
1-82 ?yes E] No I When Ready
N Licensed Electrical Contractor I hereby request inspection of above
6wner electrical work installed at:
Street Address, Box or Route No. City
3780 South Hills Court Eagan
eelmn No. Township Name or No. Range No. `IY'd. Eta
On:upenl (PRINT) Phgne Nn.
Veral Campbell 452-7154
Power Supplier Address
Electrical Contractor (Company Name) Contractors License No.
Fosso °, Inc. 40828 8
Mailing Address (Contractor or Owner Making Installation)
P.O. Box254 Lake Elmo, Din. 55042
Au or .ed 'gna cure (Contractor/Owner Making Installation) Phone Number
7M 770-5046
MIN SOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1,J21 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Pf.... (6121 297-2111 ENCLOSED.
_r ??-a/?yyy?1? REQUEST FOR ELECTRICAL INSPECTION ER-01x101-03
T ..I .:UX' 5 ? See instructions for completing this form on back of yellow copy.
",V Below Work Covered by This Request
Ne Ara Rep. Type of Building Appliances Wired Equipment Wired
g Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner BUlk Milk Tank
Farm Omor pea v then Isuecilyl
l her ISpocity thor Other
Compute Inspection Fee Below
k Fee Service Entrance Size H Fee Faeders/Sobfeeders N Fee - .Circuits
0 to 100 Amps 0 to 30 Amps 0 to 30 Amps
101 to 200 Amps 31 to 100 Amps 31 to 100 Amps
Above 200 Amps Above 100 -Amps Above 100-Amps
Transformers Remote Control Circ. Partial.'Other Fee
Signs Special Inspection
50
10 T
Remvks . OTAL FE
Rough-in Data
I, the Elects cfll
Inspector, hereby
Final
Ual ce rtily that the above
. lj action has been
made.
This request void
18 months bom
This request void 18 months from
*4 /-7 zi 4&/
/? r? 26"'C
of this Request_ ?./ )C-:- G, S
1, as Gj Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wit9'ng installed at: 3700 ""t y
Street Address or Route No. 50, Ni ??5 CG ?(r / City 4 4 tti
Section Township Range County & ee) f"
Which is occupied by
Is a roughin inspection required on this job? No D Yes
Power Supplier D&6/rk Flee-b-i'C. Address
Electrical Contractor?1) e:' ?,-/ rl"c Iri e- _7-6v <
I (Company Name) 'A?
Mailing Addresss'? . Z Oe //. 1 R:r z - poi
Authorized Signature
Ready Now ? Will Call R
10. -Z,2e 12' 57;
Contractor's License No3Q837
rcj, Ofn. ?33c{3
Installation) _
Phone No. 3 J7? Q
50Z/?150 seat contractor or owner maemg ( ms mstananon)
S U M E O „ ? This inspection request will not accepted the
?f (,a ?f Q 'U"? State Board unless proper inspection fee is enclosed.
Minnesota State Board of N§ zctricity
1954 University Ave., St. Paul, Minn. 6?'?,.Phone 545-7703
REQUEST FOR ELECTRICAL"fNSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
/73Gyt
S 7 100
Type of Building New Add . Rep. Check Appliances Wired F ' Check Equipment Wired For
-QWO.
Duplex
? ?
? ?
? Range
Water Heater lir Temporary Wiring
Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer L*f Electric Heating
Cpmmercial Bldg. ? ? ? Furnace l Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner Bulk Milk Tank ?
Farm List ) List
Other -
O
? ? ? y
pp
HerersI Reheers
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee
0 to 100 Amps. 0 to 30 Am res 0 to 30 Amperes ,
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes 3
Above 200 Amps. Above 100 Amps. Above 10 _Am
s.
Transformers Remote Control Circ. Partial or other fee
Signs Special Inspection Minimum fee $5.00
Remarks
TOTAL FEE
?
I, the Electrical Inspector, hereby cer i 4at tl}Efab r ins a ion has been de 10)
(Rough4n) (//?. tt ((// Date 1 90'
J
(Final) Date a
This request void 18 months from
This request void 18 months from
Date of this Request S `'' P 4
1, as I kicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wrung installed at:
Street Address or Route No. •7096 ?S'e A /J1`/!S r/ City 2
Section Township Range County
Which is occupied by
Is a roughin inspection required on this job? Nol-, Yes ? Ready Now ? Will Call
PovSer Supplier A4A'67" E-ls:4ric AM. Address *160 Z&14.??
Fw.rm; n 6?paV
Electrical Contractor-T/nPaiemt &chzc _02rc Contrac is License No..,:IM. 7
_ (Company Name)
Mailing Address
Authorized
SIM RD
or
an? v ?v
rr or Ow r Making This Installation)
Phone No.,5ZTO-/7sy
Making This Installation)
This inspection request will not be accepted by the
State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
"IVv1 University Ave., St. Paul, Minn. 55104-Phone 645.7703
F : REQUEST FOR ELECTRICAL INSPECTION
C&CK BELOW WORK COVERED BY THIS REQUEST
ie,' GS` /
25K.
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? LList L
ist
Other ? ? ? p
Herers? p
Hehers
COMPUTE INSPECTION FEE BELOW /,
Serviceantrance Size: # Fee Feed ' -Pfeil s: # Fee Circuits: # Fee
0to100Amps. '7 M11o 3b Aiav ergs 0 to 30 Amperes
101 to 200 Am s. I10O0 , iaperes 31 to 100 Amperes
Above200_Amps. -tios/e`'i01) Amps. Above 100 Amps.
Transformers ote Control are. Partial or other fee
Signs Special Inspection Minimum fee $
d
Rtmarks 7 7 TOTAL FE ?• ??
/ LL/'t.
I, the Electrical dspecto2r, h eby certify that the above inspe ion has been made.
(Rough-in) Date
(Final) ) Date
This request void 18 months from
4
?ESOTA ?'( ?.??? r- MINNESOTA VALLEY
2'.? ?,. SURVEYORS & ENGINEERS CORP. ?aEfOTA(i"<
N
11000 E.111N arlMUE fWiM .NN. •IaLE, .WNFf01. 5vT
E.s.s: 11e111E - P4FYOR5 Ee,G`??.
ORS.EO
: A/ 6761$7 SON
-A F
Certificate of Survey for .
' . iss8q zoo i ' ? -
_40
i 60
u` v W
SOUTH
_ b T
1-04
COURT
01
r If J, ?
Lot 10, Block 2, South Hills First Addition
!?o.by gorily IN.- 'his is.".. ..a .on..s rePru.nlesi.n Minnesota VaIIt y surveyors
s f a w...y.0 IN. b.ond.ri.. al IN. b... d..o:b.d land, Engineers, Corp.
add el IN. 1....i.../ .11 b.ildinq., ?Nu.on, and .11 .is;bl. by _ ?-. _? • R _L S
.na re.aNm.n.., H sny, Lom co. ar . d load. /?"°"
A. .e..q.d by m. iN..LSr Its, oil •. o. 19 p Inn. Re>q. Yo. 9292
t
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
04lNER 46-r-kL?_GkMr-SOA-- G-11 r4colffir (ZD - ST J*ul? rl s''? c13 c
SITE ADDRESS V&r
Io _$rK. Z So1MN +11?L? SIT' -kyDhfl?N __
CONTRACTOR TMIKT u?lr gulL;WZK,, t4e-. DATE 1o-10-?9 PHONE t 5'-'6916
Determine working square footage of each.
1. Total exposed wall area ..... yq-°s9 sq. ft. x 17 = tl'?.6
2. Total roof/ceiling area ...... 4o sq. ft. x .05
- T9
Total exposed wall area abovL floor = 2.2.65 rr; -
a. Total wall window area ........................... 119 Fr'
b. Total dear area ....... _ 61 rr
P«'.o'
c. Total °'; door area ................
d. Total fireplace wall area ........................
e. Total wall framing area (average 10%)...'......... Igo rr'
f. Total net wall area above floor ................. 1-1rr'
g. Total rim joist area ............................ is
Total exposed foundation area = *6 1?r'
h. Total foundation window area ...................... -<n -
i. Toal net foundation area above grade ............ _ 5?6 Pr*
Determine "U" value of each wall segment.
I . ,+ %
°% N ECrr' I.°Ss
a. 119 X lull ST ° YN.o
b._ . bl X "U" ab = 15.9 -7.1-%
C. ITO X "Un ti4_ = HN.>, CulA9tTU) 19.9%
d. X ,,u, ?-
f. 1-106 X I Ul 03 t = _63.1
9--
-
X
uUu 9
?}.
Z 2
°?
h. _o- X hull
7. 5t? X Hull I-0,0A
3 .....................................Total =
If item °3 is the same as, or less than item #;1, you have met the intent
of-SBC 6006(c)2.
4.g%.
Na,9%
/y 13
113
41
Total exposed roof/ceiling area = 154-0 rr-
j. Total skylight area ....
k. .................
Total roof/ceiling Pray ing area (average
-
lO%*)'- 1TV FT'
1. Total net insulated roof/ceiling area....
W
II .......
o i t+r zs?.re/
M^ ToTAV^
.T
V kN TED
"
Determine
U" value for each roof/ceili ng segment.
)lf ?rJ? X IVI •OZ f ?i.? I i1 '/a
LL
R• ?. IOIM? X "U" .oL7r 2a.3 e
10
o I
.
°
Y IV, .'7
WA X
4 ........ ......
....................Total -
If total of ,?4.is the same as, or less than '2, you have met the intent of
SBC 6006(c)].
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items #3 and A4 shall not be greater than the sum of items fl and 7#2.
1. t1?.4.3 + 2._ ».? = yq?.63
CITY 0 TAGPN
J.:'AM t=om' 2/i8 TIME::;, . eGR C
3240 9001 3780 5 HILLS CT 50.75
''W Amnnnt5" G!,
W_.. il, iif-rRY
PERMIT
CITY OF EAGAN
38°A Pilot Knob Road
EaNn, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: BUILDING
Permit Number: 0 3 2 2 4 0
Date Issued: 06/12/98
SITE ADDRESS:
P.I.N.: 10-70790-100-02
3780 SOUTH HILLS CT
LOT: 10 BLOCK: 2
SOUTH HILLS
DESCRIPTION:
REROOF
tFildkt=' Permit Type
f3u 1, ding'Uork Type
pSF (MISC.)
??5 ,E"mow
ALTERATION
434 ALT. RESIDENTIAL
M
?3 1 M t ai ??I i Y t*4
%k" 3t ?y 4?? ` p[A
" LW$ Sf$ 3T(" p"C?f^ 'M?.F 0" .&..n °M' +?{i3£ vµ- Y} o.§
REMARKS
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
VALUATION
$56.75
$.90
$57.65
$1,800
CONTRACTOR: OWNER: - Applicant -
CAMPBELL VERAL
3780 SOUTH HILLS CT
EAGAN MN 55123
(612)723-2090
I hereby acknovAedge that I'have 'read this application n,d-state that the
1i4fprm titsn correct and atlree to cgmply with all applttoble State of Mn
?k 5t U>ke..arrd,'Xlty of Eaga/h Ordi anew,.
L;
DMA
APPLICANT/PERMITEE SIGNATURE V SSU OB: GNATURE
APPLICATION (RESIDENTIAL) ?j Vj
3 Z O M 1998 BUILDING PERMIT CITY OF EAGAN
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window saes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks)
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan N lot platted after 7/1193
required: _ Yes _ No
? .k 3830 PII.OT KNOB RD - 65122
681-4675
New Construction Requirements Remodel/Repair Requirements
DATE: 4!! / a CONSTRUCTION COST; y! X00. "6
DESCRIPTION OF WORK: Te q,- v 6f a No/ N e - rag 7'?
STREET ADDRESS: 3 ?80 So, Ili /l s C _f -
I ?) BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
Name: Co romp 6e // f/e/-o l Phone #: /a 7- Q? 20(723- 20Q0
Last First
Street Address: 3 784 So, H //S (-7/.
City EQ 9 4 N State: tIN Zip: ,i ?5- /,0
3
Company: /1a or a aw x e k" Phone #:
CONTRACTOR
Street
City
ARCHITECT/
ENGINEER Comc
License #
State: Zip:
Phone #:
Name: Registration #:
City
State:
Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address Chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. ?/ y
Signature of Applicant 6?. e _e-?"
OFFICE USE ONLY
Certificates of Survey Received - Yes No
Tree Preservation Plan Received - Yes - No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual) _
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Variance
Permit Fee °/J`
Surcharge 90
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SAN Permit
S/W Surcharge
Treatment Pl.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $ /&90
• rJ ?
4
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
% SAC
SAC Units