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3771 South Hills Dr t x j1 d{ _ 4 r t Y CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: _ Plumber: _- 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Kuob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner. Address: - Site Address: Plumber: Meter No.: Size: Reader No.: 1 agree to comply with the City of Eagan Ordinances. By Date of Insp.: Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: - Date Paid Insp BUILDING PERMIT To be used for EAS UMNT Est. Value 91&5W Site Address 2771 l.' LL3 m Lot 5 Block I Sec/Sub. SOUTH 1111.1-C 2S Parcel No. W Name ]2AV; SNGI Address 1377-1 6LIL H itI LL3 DR o City s.AGflla Phone o Name K&RTIN A h'-i'rLLz, R 0004 Address 665 18TH AVE F City LT PAUL Phone 457-3665 ss Lu EE a I hereby acknowlege that I have re information is correct and agree to Minnesota Statutes and City of Eaga Signature of Permitee A Building Permit is issued to: } on the express condition that all wort applicable State of Minnesota Statute Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # Phone application and state that the y with all applicable State of ances. in accordance with all r 19.8 OFF ICE USE ONLY Occupancy FEES Zoning (Actual) Const Bldg. Permit 36 • t10 (Allowable) Surcharge 1.00 # 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 SO Permit Booster Pump S/W Surcharge Treatment PI APPROVALS Road Unit Planner il C Park Ded. ounc Bldg. Off. Copies 37.w Variance TOTAL Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC p L O (:1 1*2199 7p Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Pibg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final -G Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN Additinn SOUTH HILLS 1st 3771 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. - - -- ' GRADING ? 19 73 5bl .88 58-19 10 232.80 SAN SEW TRUNK J 87.90 A005493 1/24/78 * SEWER LATERAL 1683.23 A005493 7 WATERMAIN • WATER LATERAL 1975 15 WATER AREA /'5'7 lQ72 239-22 11-96 20 155.50 A005493 1124178 STORM SEW TRK • STORM SEW LAT 1 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 230,00 7820 10-21-77 BUILDING PER, SAC Al7r, nn 7R9,0 10-21 77 PARK 11)n nA 7890 in-21-77 CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT $63,000. Receipt # To be used for Dote %'i l 19 Site Address Erect -E] Occupancy Lot Block ? Sec/Sub. Alter ? Zoning Parcel ## Repair ? Fire Zone Enl r e of Const T ge a Q . yp W Name Move ? .#' Stories z 0 Address Demolish ? Front ft. '.... Grade fl Depth ft. p Name ?;^hOL1S?+Z--fiLdrs, u? Address ?7 ' % o. tli2ls rlr. ri.., «; , p},nnp y54-5918 Name 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. Signature of Permittr- A Building Permit is is! all work shall be done Assessment _ Water & Sew. Police Fire Eng. Planner Council Bldg. Off. - APC N2 4541 Permit ?? _ Surcharge n sf' Plan check SAC Water Conn. (1 _ nr Water M ter Total ' +)93• r'n to: ! i rnhor. l i "." ?:l ijT<:. on the express condition that :cordance with all applicable State of Minnesota Statutes and City of Eagan Ordinonc-s. Building Official ON- Perk # Deft lamed Pwaln" Plumbing Mechanical INSPECTIONS DATE INSP. Rough-In Find Footings Date Insp. Date Imp. Foundation _ Plumbing - ) I-Aor4 Frame/ins. Mechanical 1Z .3o - -20-7p Final Remarks: ? / ? ? AA???-¢? ..E2%p, v "?`Q'ucOk O-'+l OS d? ' CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT No. Date: roveml)er 22, 1977 Site Address: 3771 So. hills Drive Lot 5 Block 1 Sub/Sec. So. Hills 1st Name • 3 Address C City ^`?.4en - Phone: Name Spetz S Berg Inc. u Address 6021 Tyndale Ave. So. 0 t7 '?rls. 55411? City Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. Receipt No.: -" Iqr Single Residential Multi Res., Comm./Ind. I New /Alterd Repair ew Cost of Installation Permit Fee 20.00 Surcharge .5o Total 2 -'). "i done in accordance with all applicable State of Building Official r CITY OF EAGAN ` 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT No. 1041 Date: November 22, 1977 Receipt No.: 08171 Single Site Address: J771 South lfills I'rivc Residential Lot _ Block l Sub/Sec. Sam Multi Res., Comm./Ind. Nome ' Voigiit - Timberli;, New/Alter./Repair new Address Cost of Installation C City Fagan Phone: Permit Fee 2 0. 00 Binder & Son Inc. - ?" `Name Surcharge ress 1.20 E. Butler dd Ve? St. Paul ;. 50 //a I 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 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED FROM AMOUNT I DOLLARS goo CASH ? CHECK BY NUMERICAL FILE COPY CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS• INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: I (i 1 : S lit lit',I I Itt t It It I I 1 S OR fill i it II i I I PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: [111 I } [? 1 r1?, IM. id.•li 04 t.1t; 144 L W MAf?lK : ^.t VA1,,A I I 1'1 UPI 11'. Ati1 Iil UII1Ill 11 1 Ill, AN'i I I t 1: I N I i Al Il?lt 1. Permit No. Permit Holder Date Telephone k S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Z " L Roofing Rough Plbg. Rough Mg. Isul. S? Fireplace Final Mg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter EngrJPlan Bldg. Final 5? D Deck Fig. G Deck Final Well Pr. Disp. INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: "' ! !' I MI, Pagan, Pilot Knob Road Permit Number: Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: lo 101 o o APPLICANT: E? 1 1! !! 1 1 L `> iiR 'H1.41 I I N1, I Ni fill/ PERMIT SUBTYPE: TYPE OF WORK: frill, INSPECTION DATE INSPTR. • TYPE DATE INSPTR. I.. ?9 c " ? Ai? J Permit No. Permit Holder Date Telephone ! ELECTRIC PLUMBING FlVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 4541 PHONE: 454-8100 BUILDING PERMIT APPLICATION $63,000. Receipt # 7$70 To be used for Sine Fam Dwle. 3 Gare. Date October 21, 19 77 Site Address 3771 So. Hills Dr. _ Erect (a] Occupancy Lot 5 Block 1 Sec/Sub. So. Hills 1st Alter ? Zoning Parcel # w Name jarnes 3 Address 0 o Name Timberline Sidra. ?? Address 3707 So_ Hills Dr ri; . Eaean pi,,,,,0 454-5918 Name _ Address 1 hereby acknowledge that I have read this application and state the Information is correct and agree to comply w'th appli( State of Minnesota Statutes gnd,)City ofiEagM O?d non . /, Signature of Permittee? 1 A Building Permit is issued to: In I all work shall be done in ccc once rih a • appl Building Official < Repair ? Fire Zone _ Enlarge ? Type of Const. Move ? .{# Stories Demolish [] Front ft. Grade ? Depth ft. Approvals Fees Assessment Permit 159.00 _ Water & Sew. Surcharge 29. 50 Police Plan check -475- D0- Fire . SAC Eng. Water Conn. 730. 00 Planner Water MUer 60 nn Council De r4 on 170.00 Bldg Off. . APC Total 1073 50 Arc, on the express condition that of Minnesota Statutes and City of Eagan Ordinances. ?? CITY OF EAGAN N4 16164 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # C 101.!i To be used for BASEMENT Est. Value $1,500 Date MARCH 2 1g 89 Site Address 3771 SOUTH HILLS DR Lot 5 Block I Sec/Sub. SOUTH BILLS 1S Parcel No. w Name DAVID SHORES o Address 3771 SOUTH HILLS DR City EAGAN Phone o Name MARTIN A KELLER $a Address 465 18TH AVE S uX City S ST PAUL Phone 457-3665 ww Name u8z Address aw City Phone I hereby acknowlege thatI have read this application and state that the information is correct and agree to comply with all applic Is State of Minnesota Statutes and City of.Fagap Or_dwmT9m.. Signature of PerrnirF?? ' v 64 K A Building Permit is i sued to: MARTIN A KELLER 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 Occupancy Zoning (Actual) Const (Allowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance OFFICE USE ONLY FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit SAN Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 36-nn 1.00 3/.VU 1 CO 5- 141 ?, ? Reaues{Da - T ire No. Rough-In Inpsecnon Required (YO ust II inspector when reatly) InspeMmn OfM1er T an ough-In ? Ready Now ill Natty Inspeetar Yes ? NO Date Ready ?Irlicensed contractor Downer hereby request inspection of above electrical work at: Job See (Street. Box or Rou]a,(JOJ 71 J7 7 CC1l f Z13 City 'zy? Section No. Township Name or No. Range No. Co Occu en PRINT( Phone No. ' Es O 6 Po r uppller Mdress Eledr ConVaapr (Company Name) Contra is License No. Mailing s IConlractor or Owner king I allation Z -1 d S6?ll whorizea Signature (Contract /Ow listionl Pbconee Number MINNESOT BOAR; OF ELECTRICITY ..? THIS INSPECTION REQUEST WILL NOT Grigg wey Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55106 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.OB00 ENCLOSED. REQUEST ELECTRICAL INSPECTION If • See insfruMiohe mpleting this form on heck of yellow copy. 4 i 15 "X" Below Work Covered by This Request 6 New Add Pep. , Typeof Building Appliances Wired EquipmenlWired 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'. J/?J?'?JE?.(?t . /r A ??i Compute Inspection Fee Below: v 'L ?, # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps to 100 Amps Transformers Above 200 Amps Above_ 100 Amps Signs Inspectors Use Only, TOT Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY B DER D CQNNECTED IF NOT Other Fee COMPLETED WITHIN 18 S. I, the Electrical Inspector, hereby if Rough-in ' S-T"Yf cert y that the above inspection has been made. Final , ate rf'^ 3 OFFICE USE ONLY This request void 18 months from 8 8 6 8 0 -5 Request Date 2 / ? ?O 6 Fire No. Rough-in Inspaotion Rs uired7 ? Ready Now Will Notify Inspector Wh R d ? pJ 7 Yes ? No en ea y I licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Streaq Box or Route No.) 3'J7/ at z)r - City PP GR a , s r ue Section No. Towrehip Name or No. Range No. County U T/4 Occupant (PRINT) k ?ld Phone No. 4 57- 366' w . ma T, . Power Supplier A..d??tl//ress 0-300 ,S Neck G iaVVw IN SSoa Electrical Contractor (Company Name) Connaotor5 License No. D,14- to LIZ a d o Mailing Address(contractorr or Owner ? ggMaking Installation) d D ^ A YIvL t,QY Cryce14 " n OUe? 30 Authon ignature ( C o m b o Or/Ow er Makirg i l l atlon) Phone Number 7s4- 39}39 MINNESOTA STATE BOARD OF ELECTRICIII THIS INSPECTION REQUEST WILL NOT Griggs-Mldwey Bldg. - Room &173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55161 UNLESS PROPER INSPECTION FEE IS Phone (812) 64248M ENCLOSED. r3li ?l/ 4 REQUEST FOR ELECTRICAL INSPECTION E"0001-07 ? See instructions for completing this form on back of yellow copy. 89680 "X" Below Work Covered by This Request New Add Rep. T of Building j)l Appliances Wired Equipment Wired Hom d 2 MgVM Range Temporary Service Duplex hl FI' Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (speci(y) Contraclor5 Remarks: 3©' Compute Inspection Fee Below: }yY' # Other Fee # Service Entrance Size Fee #11 ircuits/Feeders Swimming Pool 0 to 200 Amps J Aj&J O to 100 Amp Transformers Above 200 Amps A "1J Signs Inspeclorb Use Only: Irrigation Booms 9 Special Inspection / Alarm/Communication Other Fee Y ! I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in Final Date- Data OFFICE USE ONLY This request void 18 months tra. PP void 18 months from U 7?? .c.< S O 85646 Date of this Request October 27, 1977 I, as I?Xljcensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street A d ess or Route No. 37 South s Drive CityELgan C?r ?r xg:? i _77- Section Township Range County Dakota Which is occupied by New House - Timberline Builders ' (Name of Occupant) Is a roughin inspection required on this job? NoX3 Yes ? Ready NowU Will Call ? Power Supplier Dakota Electric Assn. Address 821 Third St., Farminaton Electrical Mailing Address Authorized Signature Contractor's License No. 34716 No. 933-0141 Minnesota State Board of Electricity . ,q54 University Ave., St. Paul, Minn. 55104-Phone 645.7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST D 79?5? O 85646 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. ? El 11 Dryer El Electric Heating 11 Commercial Bldg. ? ? ? Furnace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Fwm= ooList ll rs} e p erList J} e s Other E] E] ? H re f H COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeede Fee Circuits: # Fee 0 to 100 Amps. 0 to 30 0 to 30 Am eres 101 to 200 Amps. 31 to 100 MA-mp z 31 to 100 Am eres Above 200 Amps. Above 10 O . Above 100 Am s. Transformers Remote Cob I Partial or other fee -50 Signs S eL sp'ecfion Minimum fee $5.00 Remarks TZKPORARY SERVICE Y TOTALFEE .110 I, the Electrical Inspector, hereby certify fhat the above inspection has been made. (Rough-in) Date (Final) o f Date -?? This request void 18 months from c.i T I& request void 18 months from .11b-O D ?e ? i " O 85657 Date of 11iis'Request 7 1, as IkMeensed Electrical Contractor Owner, do hereby request inspection of the above electri- cal wiring installed at: „ Street Address or Rout No. ?/ Segtion Township. Which is occupied by (Nar Is a roughin insp Power Siipplier Electrical Contract r mpany Na e) Mailing Address lectrl I ont for or C Authorized Signature Range County Z ect re fired on this job? No 0 Yes ?yA ry Ready Now ? Will Call ? Addrecc Get/'? .J i!%? Minnesota State Board of Electricity ' 1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST ? =A oS=3z/ a O 85657 Type of Building New . Rep. Check Appliances Wired Fof' Check Equipment Wired For Home Euplez 11 ? El ? 1:1 Range Water Heater Temporary Wiring 'Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer LG -Electric Heating Commercial Bldg. ? ? ? Furnace Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner Bulk Milk Tank ? in F El 1:1 ? List ppthers? List Others t or ? ? ? Here Here COMPUTE INSPECTION FEE BELOW r f rv? M\ -M SFrvice Entrance Size: # Fee Feeders&Subfeeders: Fee 0 to 100 Amps. 0 to 30 Am eres 0 to 3 Am eres 101 to 200 r 31 to 100 in eres 1 to 100 Amperes Above 2 ' Amps. 4 Above 100 Amps. Above 100 Am s. Transformers Remote Control Cire. Partial or of ee signs 7- 1 1 1 Special lns ection Mimmu ee 00 Remarks TOTAL EF ? W, If C/1 5"D 1, the Electrical Inspector, hereby y t b&e i ection has bee>f_ ad . (Rough-in) /?? P Dated a (Final) Date o;2 - a r This request void 18 months from 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 # 113 -,1? -MVSO" "t ('cv New Construction Requirements Remodel/Repair Reeuirements Office lke Oiif4 3 registered site surveys showing sq. ft. of lot, sq. ft. of house, and all roofed areas 2 copies of plan Cent of Suntey Recd -` Y N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pies Plan Real • -i Y _ N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Ties Pres Repmred Y _N l set of Energy Calculations Addition - indicate if on-site septic system On-sde SepfiSyslem ?. `Y.„--;N 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet, (bldgs with 3 or less units Date H / / ? Construction Cost Site Address Y SDUTf( A/ .)k Unit/Ste # Qv! AIAII SS-/a3 Description of Work Multi-Family Bldg - Y IN Fireplace(s) - 0 L 1 - 2 Property Owner ? JUG 1 S n t'7 (LrG?? Telephone # (6 $ /) 3`f &9 S Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. f3o2(s ????? Applicant's Printed Name Applicants 9iindfure OFFICE USE ONLY i Sub Types ? 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 6d. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) • Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ 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 -Brick Fireplace _ RI. - Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector ! . " 377/ SO &L- _S All- , (a& /! 3 Permit Number REScheck Compliance Certificate 2000 Ntnnesota Energy Code REScheck Software Version 3.6 Release la Data filename: CA\Documents and Settings\Owner\Desktop\mine.rck PROJECT TITLE: 4 season porch expansion COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family WINDOW / WALL RATIO: 0.22 DATE: 11 124/04 DESIGNER/CONTRACTOR: Self/ Homeowner - Boris Axelrod COMPLIANCE: Passes Maximum UA = 105 Your Home UA = 95 9.5% Better Than Code (UA) Checked By/Daze EAGAN REMEWE EV r) E 10 LIIlIIa®I(NCa INS PP EE I00 N1S 9EQT. Grass Glazing Area or Cavity Cont, or Door Perimet R-Value R-Value U-Factor 31A Ceiling 1: Cathedral Ceiling (no attic) 330 38.0 0.0 Wall 1: Wood Frame, 16" o.c. 160 19.0 0.0 Window 1: Above-Gtade:Wood Ftame:Double Pane with Low-E 16 0.350 Door 1: Glass 36 0.350 Wall 2: Wood Frame, 16" o.c. 180 19.0 0.0 Window 2: Above-Grade-.Wood Frame:Triple Pane with Low-E 24 0.350 Window 3: Above-Grade:Wood Frame:Triple Pane with Low-E 24 0.350 Wall 3: Wood Frame, 16"o.c. 36 19.0 0.0 Wall 4: Wood Frame, 16" o.c. 108 19.0 0.0 Window 4: Above-Grade: W ood Frame:Double Pane with Low-E 16 0.350 Window 5: Above-Grade:Wood Frame:Double Pane with Law-E 16 0.350 Wall 5: Wood Frame, 16" o.c. 120 19.0 0.0 Floor l: All-Wood Joist/Truss:Over Outside Air 464 38.0 0.0 Furnace 1: Forced Hot Air, 90 AFUE Proposed and Maximum U-Factor Averages Proposed Average U-Factor Maximum Allowed U-Factor 9 6 6 13 8 8 8 2 4 6 6 7 12 Above-Grade Windows and Glass Doors 0.350 0.370 1 Includes Foundation Windows > 5.6 12 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheck Version 3.6 Release la (formerly MECcheck) and to comply with the mandato requiremen I' ted in the RES check Inspection Checklist. Builder/Designer Date Z + 2004 RESIDENTIAL BUILDING PERMIT APPLICATION j City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 L Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reouirements Remodel/Repair Reouirements Office Use CnN Cf T . 3 registered site surveys showing sq. ft. of lot, sq. ft. of house. and all roofed areas 2 copes of plan Can of Swvey Recd :.Y,-1.N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pies Plan Redd y _N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Prey Regtiired Y. ,,, N I set of Energy Calculations Addition - Wicaterfonsite septic system O.R 1lS $epflc System _.Y _N. 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date ?/ Site Addr`?ss 3T ga n 207` -? Construction Cost J LJV? ??S /? Q Unit/Ste # Description of Work 4 3 9-e $m, ?° r? F D c G Multi-Family Bldg _ Fireplace(s) - 0 X I - 2 Y Q N __ Property Owner Bou S 4xr L,,y-oA Telephone # (6 51 ) 3'79 ?A'f' Contractor Ste( 9? Address State City ( ) Zip Telephone At COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 - Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? fee applies. r, ? 7771 n nn R ?1 Licensed Plumber Mechanical Contractor Sewer/Water Contractor - Y _ N If so, 25%a plan review Telephone #( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. &als A£l elid Applicant's Printed Name Applicant's Signature OFFICE USE ONLY J. I Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace K 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 (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor-N A 25 Miscellaneous Work Types Z,P-m DV e Roo-E an EIS: } t. ? a /zc t4 To r1j0 CA ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) -Give PCA handout to applicant Valuation J-5- CEO O, d D Occupancy X -3 MCES System e 3 y t Cit W Census Cod er y a Zoning SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const l? Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Final/C.0- Footings (deck) Final/No C.O. Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile Other Roof )? Ice & Water Pool _ Ftgs _ Air/Gas Tests _ Final X Final Framing _ _ Siding _ Stucco -Stone -Brick Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: , Building Inspector ---- ------------------------ - - Base Fee ----------------------------------------------------------------------------------------------- ??? ?? Doecr+ 2aX/(2x40.,;? 17"800, Surcharge 1 SC? l R i (?ccl? 16X?(? - 1 i?TFee ;2,?n°.' 1yo3 ev ew P an ,. MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total '? ?? . ? 019 VIA: - w vy fl Gltfr[iQ • tdINNL`::OiA VALLEY ev SURVEYORS ENGINEERS CORP.• f ., -Rs £ Certificate of Survey for n P ?l/SrAFSON H/LLs { t 7 I ? d•3132'20' /ZO.Gb ,p ? I9? TPl l7 i M !i y i:s ?i?° e f.Nr ?L > Zo G? 2.5.4 t?6 Lot 5, Block 1 South Hills First Addition Ilan A1lunesota Palley Surveyors & I h. r.l+y a.rlily Ilse, +hh i, e Ln. end ae....r .....+.n+e EnglnFers, Cq P el a ,e••.y of ?,v Lv..n J„ri.+ el ,h. ebe.v d.+a l,bvJ lunJ, / ?, /,,/r~ R L S onJ el Jv loleli?n el ell b."J.-j , Ihe•enn nJ all .I+i bl. by- r o e y !.1 (n n. 12eg. No._ _Pa-+e.r`ye+l by -e U. 197-1 . .. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-70790-050-01 PERMIT PERMIT TYPE: Permit Number: Date Issued: 3771 SOUTH HILLS OR LOT: 5 BLOCK: 1 SOUTH HILLS Ck ar?a? BUILDING 023428 04/28/94 DESCRIPTION: 011 din;gl,Permit Type SF PORCH uilding Work Type NEW rye 9> t REMARKS SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $81.00 3.00 $84.00 $6,000 CONTRACTOR: - Applicant - ST. LIC. OWNER: KELLER BLURS, MARTIN 14573665 0004970 SHORES DAVID 1149 16TH AVE N 3771 SOUTH HILLS OR S ST PAUL MN 55075 EAGAN MN (612) 457-3665 (612)454-8052 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. AP (CANT/PERMITEE SIGNATURE D BY.' SIG ATU E J INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: LOT: 5 B L O C K : 1 APPLICANT: 3771 SOUTH HILLS OR KELLER BLORS, MARTIN SOUTH HILLS (612) 457-3665 PERMIT SUBTYPE: TYPE OF WORK: SF PORCH NEW BUILDING 023428 04/28/94 REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL WORK CITY OF EAGAN - 1994 BUILDING PERMIT APPLICATION 681-4675 2 2 144 t1' Ef??? >?-2 ?? 4, 00 --------------- SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date - - L- / 2Z / qq Valuation of work /Z QQb Site Address: L5771 ?0%/,,//,5 vravG STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. P.I.D. # Description of work: The applicant is: ? Owner Contractor ? Other (Describe) Name (.'SfiO,C??rS /Wy/,D Phone 4S- -60CTZ Property LAST FIRST Owner Address 377/ S. A1,115 Liz. STREET STE # City 62Q,161 State IA-1 Zip Company /y1,4,??iLl /d?2 5 Phone 457 -3000x4 Contractor n/ Address J JW3 1&4h Hvef oAJ License #=49ZO Exp33 3r 5 Cityc,^?c)I_A .j51 Ylavl State /77A-/ Zip ?5074?' Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all a icable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory R?0_4 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations 03'32 Addition ? 34 Repair GENERAL INFORMATION ? 35 Tenant Finish ? 36 Move' W k ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code pis Depth On-site sewage SAC Code o./ Und C APPROVALS ensus it 6 Planning Building Assessments Engineering Variance REQUIRED INSP ECTIONS ? .Site 0 Footing ET Framing ?`Insulation ? Wallboard Final ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: valuatim: S (p 006. SAC % SAC Units J U MINNCSUiA VALLEY SUFiVEYURS (NGIN EEFtS CORP. E.n1N IYENUE SO.I., " H: 9Elf. NINNESOT4 SSDE 9L\ :Rg.EN 4fSOi? Certificate of Survey for . JrV1 f f /20 00 ?Q ^v '1 Ile Ufi/i'` FasP 20.. 6A i v I M I I '\y r Lot 5, Block 1 South Hills First / Addition ILL_ '- G5.OD I n.r.ny a..luy Ir,e1 .n111, o ..,,. end ......l ...... nlel?en Minnesota VA11,Y Su[VCYorf Q' F.ngIneers, CR.;p J of a .wwy o1 .Lu L??uJm?el of the ebor. d.uNLeJ land, _ ???' vnd el m. lea a..l..n a,l nn bu.IJing., rn....?, nd en .?.?nl. SY R L S .nu eea6m.n n, J nr, 1. . . on r .d IunJ? ? A. V. 19 Z1. M (nn. Reg. 5 dam/ I Date: //F ? BUILDING PERMIT APPLICATIOU y // ?? LOT BLOCK ADDITION`7? 071 IZ/ IS PARCEL & SECTION NUIIBER IF U17PLATTED ADDRESS OF ZONIOG OCCUPANCY COST OTATER COIdTR-%CTOR ADDRESS s ells ?- [ I M: USE TELEPHONE NO. TELEPHONE :30. I?I/ I L r i2 idoter. Include site plan, building plans, and energy calculations with this application aLs 0, 4q- OFFICE fSigned USE VALUATIOi.! SAC VATER CO`INECTIO T WATER METER BUILDING PERL41T FEE SURCHARGE FEE PDUI CFXCK FEE PARK DEDICATION FEE OTHER X73 a o ?d ?0 _ ?Doo ?S9 e0 z9 =° A-9 S? TOTAL* APPROVALS: ASSESS14M\TT CLERK BUILDING DEPq!:?:?LICE DEPT. ^TATER & SMMR DEPT. FIRE DEPT, PARK DEPT. I 2? ??Ir. SURVEYORS & ENGINEERS CORP. Ov 2 ? "S 1 ter' < N C ?'- ? .w OMN Ff]TN AVENUE SOIILN - IYMX:'ILLE, MINNESOTA SA)I 9G?,Y "'y G?2W r,...:. roensa Certificate of Survey fori & TAFSOl ?+ •( {} : , e... ;.....•`OV! I' ..d"3d'32'20' 410. Lam' Zb? go... , '!fl'' 69 CD <A 4 5 , I of S, Block 1 / South Hills First Addition 1 M?S07Areby q ur ify thot thi> it a - MINNESOTA VALLEY IOTA V4 ` G5:00 t uee and < or.ert repre<entntien 1:'t(nn[SOfB ??8 ( (By Surveyors 'j ^ p of a wrrey of thw 6ewndwrie> of the where dey<r:bed land, Eng i netrs, C P R L S pndal tb of all 6uHding>, rherewn, and all viable by d lo<wtiwn l.e? _ enerow<hmmt>, it onp bwm or on >wid Iwnd. . As. wrrayed by me n.!]/_r dny aL?EVr. A. o. Ie74 9t nn. Reg. No. Q??-?- } , 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I 1 T 4 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: ozl?Tx Valuation: Date: 0 Site Address 3771 S /??? DRt+? Lot -S Block Parcel/Sub Saw"f!,/,4.11ug 1? AUAN Owner 1JAL/ I,U SNO 4ES Address 5,Q mzf City/Zip Code Phone Contractor Address 14vp ? Code 51, _ /`?L/' m? City/Zip 4:57-39 Phone Arch./Engr. Address City/Zip Code Phone # ®;-ps Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System _ City water PRV required _ Booster Pump APPROVALS Planner _ Council Bldg. Off. Variance Council FEES Bldg. Permit Surcharge I . f? Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Copies TOTAL NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. X12- 79 3 7, ?s CITY USE ONLY L .5 BL ? RECEIPT SUBD.? I DATE 3?ia/yC? 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? town homes and condos when permits are required for each unit New construction AAd-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: ,??z FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @ $3.00 each) ? State Surcharge 50 TOTAL SITE ADDRESS: 377/ OWNER NAME: z?? PHONE #: INSTALLER NAME: STREET ADDRESS: CITY: STATE: PHONE #: { ) / Add-on furnace ZIP: 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 = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: .FEES: $25.00 minimum fee 2r 1% of contract price, whichever is greater. Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL -_ cTC nnnnre?.e. OWNER NAME: TELEPHONE #: _ TENANT NAME: (IMPROVJ21VIENTS ONLY) INSTALLER.; ADDRESS: CIT.. STATE: 'Z1.P;. PIi?9Nl= 9 SIGNATUR : " 17- SIGNATURE OF PERMITTEE? CITY INSPECTOR DATA r. 05/12/98 TIME: 004:82 M E:I trA?4E: c P{ f; L_ file P`i('.:III?.I_T'?! 3°_if, 900i 37M S0 I-:!...I_6 ..I:•.. !.., t .....'51 1205 9061 3771 90 HLL.S '.R 4„00 3130 9001 3771. SO HL_L& DR 5.017 T.,,.a r 25 y 1, ?[:??if''1,0.{ (ti1iOlR'':° 146.25 ib.r. C ;091641 .7.(?J.°,Y,(Y,i ,?<'i?;i(?I•' .Y,.$i'„7(?. ?{.a e,L4t>?•??JOFS(•. .,. .;.;{.. ... CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILDING 032002 05/13/98 SITE ADDRESS: 3771 SOUTH HILLS OR LOT: 5 BLOCK: 1 SOUTH HILLS 1ST P.I.N.: 10-70790-050-01 DESCRIPTION: (ROOFING) ermit Type SF (MISC.) Type REPAIR t$434 (ALT. RESIDENTIAL REMARKS: PERMIT c of FEE SUMMARY, VALUATION Base Fee Surcharge Lic. Search Total Fee $137.25 $4.00 Fee $5.00 $146.25 $8,000 CONTRACTOR: - Applicant - ST. LIC OWNER: H & L REMODELING INC 17226717 0004374 SHORES DAVID 5021 15TH AVE S 3771 SOUTH HILLS DR MINNEAPOLIS MN 55417 EAGAN MN 55123 (612) 722-6717 (612)454-8052 '' b' r6kn6W16 t-qi t narrt?`Tprrecl SC1 Utnit; C,it 0 .ut v APPLICANT/PERMITEE SIGNATURE ISSUED Y: S NAT E 32001 98 BUILDING PERMIT APPLICATION (RESIDENTIAL)'t? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 New Construction Requirements # 3 registered site surveys # 2 copies of plans (include beam & window saes; poured intl. design; etc.) # 1 energy calculations # 3 copies of tree preservation plan K lot platted after 7/1193 required: _ Yes _ No DATE: 1 2 1-Y)AC1 18 Remodel/Repair Requirements # 2 copies of plan # 2 site surveys (exterior additions & decks) # 1 energy calculations for heated additions CONSTRUCTION COST; '160- o? DESCRIPTION OF WORK: TW OGF ? 2GbF Hc?v5i; STREET ADDRESS: 3-)7I , too-rg PtL-f-5 I 72 • r pn LOT: f BLOCK: ?_ SUBD./P.I.D. #: .11, ?'jj) w PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: 510/t r-S 1) but Phone #: 4-S4 -8SOS 2- Last First Street Address: '3-)-)1 S OV Yk thus X City FA?tll.? State: /n A/ Zip: 51 123 Company: s l f<yM //?ti- 1 NG • Phone 4: 2 2- 7 L 7 3?3//mini Street Address: S62[ < V-T h( License # 37 City W State: -/'Y}N Zip: SS'gC? Company: Phone #: Name: Registration #: Street Address: City State: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. Zip: Penalty applies when address chang 1 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. Signature of Applicant: ff -40 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 ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning 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 Total Building 1d7 c?5 Ofd $, 0 0 04y , a5 MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Valuation: $ C3 ?? % SAC SAC Units RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 d a ?? 651-681-4675 New construction Requirements Remodel/Revair Requirements . 3 registered site surveys showing sq. ft. of lot, sq. It of house; and all roofed 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 Calwlatom . Indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan if lot plafted after 711193 . Rim Joist Detail Options selection sheet (bldgs with 3 or less units) tr7. sy?/. 70 DATE G --2D - oc;- VALUATION # JOB SITE ADDRESS 377/ ?y 41 N //S Jar-. IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER 77z1ViJ SkkOi-f S TYPE OF WORK S r' FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT l?_ SL a fem. 12A A? PHONE# S ySy- go5a ADDRESS 37 _,7V S PAGER # CELL PHONE # ZIP CODE FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I (check one) - Residential Ventilation Category 1 Worksheet Submitted - 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 # 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 t for ation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan rdin es. Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 r Water Softener Water Heater No. of Baths _ Phone #: Lawn Sprinkler Fee: $90.00 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_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning _ City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) Footings (addition) Foundation Drain Tile Roof _ Ice & Water _ Final Framing Fireplace _ R.I. - Air Test -Final Insulation _ Final/No C.O. _ Plumbing HVAC _ Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ?Ml4 RESIDENTIALBUILDINGm City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 9 651-675-5675 FAX 4 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roofed areas (20Y maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan If lot platted after 711193 Rim Joist Detail options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form RemodellReoair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate d on-ske septic system Office Use OnN Cart of Survey Recd 'Y _N Tree Pres Plan Reod Y N Tree.Pres Required _Y _N On-site Septic System. -Y N / 0 C Date o 5 Construction Cost 00 ? g C? ` Site Address S-41-1 Sot T}( i LLS `1> Q. Unit/Ste # M t s s 123 Description of Work c,dJ"F ) Multi-Family Bldg - Y _VN Fireplace(s) - 0 _ 1 - 2 Property Owner )?o A2 ty K EG/e? ? Telephone # ( 6S7 ) 39 g JZ6 37 Contractor ?' Iff Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 3o R )s Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ? 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 (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Sheetrock Footings (deck) _ Final/C.O. - Footings (addition) _ Final/No C.O. _ Foundation _ I VAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing Siding _ Stucco Lath _ Stone Lath -Brick - Fireplace _ R.I. - Air Test - Final Windows - Insulation Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector ? 7G 3," 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas (20°k maximum lot coverage allayed) 1 Soils Report if proposed building is to be placed on disturbed sal 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan 'd lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form RemodeVReoair Requirements Office Use Only 2 copies of plan showing footings, beams, joists Cert of Survey Reid _Y ^N 1 set of Energy Calculations for heated additions Soils Report _Y _ N 1 site survey for additions & decks Tree Pres Plan Recd _Y _ N. Addition-Wiicate ifonslte septic system Tree Pres Required. Y N On-site Septic System Y - N Plans are considered public information unless ou state the are trade secret and the reason. Date 03 / 2,0 / O -?L od Construction Cosh Site Address 33-7/ ? ? H(A _/2: Unit/Ste # Description of Work / Vaje, (C3"'yeh71 J F?i2P?CP Multi-Family Bldg - Y Y N Fireplace(s) _ 0 - I k' 2 Property Owner T'O Q 1S ITriK ?.?> Telephone #(6 S/) 39 ?" 9245- Contractor S41 Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( apply for a Residential Building Permit and acknowledge that the complete and accurat e; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 13oe/S xc 20? c Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ? 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 01of_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 (screen/gazebo/pergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bld g) - Give PCA handout to applicant Description: Water Damage_ Yes _ Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Sheetrock - Footings (deck) _ Final/C.O. - Footings (addition) _ Final/No C.O. _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests - Final _ Framing - Siding _ Stucco Lath _ Stone Lath -Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MCIES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector ------------- I F ,C-L!f' use -- -, I I Permit Permit Fee: - ?D I I Date Received: 1 I Staff: 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION TII CCS ?2 Date: -7I :I /0 g Site Address: Tenant: y>0 (2- f S' Suite #: RESIDENT I OWNER Name: -?o ? 15 c-tzz t) Phone: lo?? 3?? ??65? Address / City / Zip: S f-(lls CONTRACTOR License #: Name: (( I 11 Address: City: State: Zip: Phone: Contact Person: TYPE OF WORK New Replacement _Repair _Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater -Water Softener Lawn Irrigation _Add Plumbing Fixtures L RPZ / -)9 PVB) l- Main _ Lower Level) _ Septic System _ Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in contormance with the ordinances and codes or the ury or Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to tart 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 n x Uo2iS P? ('C e??p x - Applicant's Printed Name Applicant's Signature For Office Use City of Eaafl Permit I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff. 2009 RESIDENTIAL BUILDING PERMIT APPLICATION J Date: y Zof~ Site Address: Tenant: Suite t" P-10Lb RESIDENT / OWNER Name: Phone: Address / City / Zip: T T/ r 4& D4 Applicant is: J Owner Contractor TYPE OF WORK Description of work: y12l,~i/* e 2/7 s Construction Cost: 4,04-D0 Multi-Family Building: (Yes / No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted 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: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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 plan Ix 00ed Axe; - I n x Applicant's Printed Name Applic nt's ignature AUG 0 9- 200s Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace Porch (3-Season) Storm Damage Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family) Multi _ Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex _ Lower Level Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows _ Demolish Foundation Replace _ Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION 09 Valuation Occupancy MCES System - Plan Review Code Edition c7 SAC Units (25%_ 100%z", Zoning P/) City Water - Census Code 1-1211 Stories Booster Pump - # of Units Square Feet - PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final I No C.O. Required Foundation HVAC Drain Tile Other: Roof: Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: _Stucco Lath -Stone Lath Brick Fireplace: _Rough In Air Test Final Windows Insulation Retaining Wall Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL F ES Base Fee 30 Surcharge r~- Plan Review q% MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2of3 = Voigt & Associates, Inc. I STRUCTURAL ENGINEERING SERVICES 4635 NICOLS RD. SUITE 204 EAGAN, MN 55122 PH. (651) 686-7727 FAX. (651) 686-8444 Thursday, July 30, 2009 Mr. Boris Axelrod RE: Enlarged opening in bearing wall at 3771 S Hills Drive, Eagan Dear Mr. Axelrod: As per your request on Tuesday, July 28th, I evaluated the effect on the foundation center beam of enlarging a door opening in the center bearing wall on the main level of the house. You proposed to widen the existing 4 foot opening in the center bearing wall towards the middle of the house to not more than 12 feet. Based on the detailed information you provided and supplemented by our phone conversation, I've determined that the existing beam can carry the new distribution of loads without modification, supplement or additional bearing. The information and opinions contained herein are based upon the limited investigation described at the beginning of this report. No warranties are expressed or implied regarding the existd ce of other unknown conditions not specifically addressed. Our work is in accordance with generally accepted engineering standards and is not intended to be relied upon or transferred to individuals other than the addressee. Should information or conditions become known which differ from the discussion herein, they may alter the opinions or conclusions of the undersigned. Please call if you have any questions. Sincerely, P0L hi.v Paul W. Voigt, PE I Hereby Certify That This Plan, Specification, Or Report Was Prepared By Me Or Under My Direct Supervision And That I Am A Duly Licensed Engineer Under The Laws Of The State Of Minnesota. .hi.0 Paul W. Voigt Date 3/19/2009 License Number 20705 Use BLUE or BLACK Ink r Permit c l/ 0 t-oyosewom Cit. of Eaali Permit Fee: 4 3830 Pilot Knob Road Eagan MN 55122 Date Received: I 0 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: r t n Site Address: J T 1 S T►! Z f 13t 1 V Tenant: Suite RESIDENT OWNER Name: &&I S 1 11) Phone: C r/ -IV-. 263" Address City Zip: S 1 Applicant is: 7 Owner Contractor TYPE OF WORK Description of work: D ;,--e V 41-62.— Construction Cost: Multi- Family Building: (Yes No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: 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: NOTE= Plans and supporting documents that you submit are considered to ub!ic information Portions o the information maybe ciassi as non public if you Pro speci rea that'wouli p� the City to conclude that they are trade secrets= 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 n•' 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 approv of p'- n x J fl� 1s ''xcLc�?� x \,.1'� Applicants Printed Name Applicants Signature Page 1 of 3 1,11/1' City of Eaau Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAY r Use BLUE or BLACK Ink For Office Use Permit #: 11G�c21 ��'�'I Permit Fee: A . ''J"'J Date Received: ¶J I (4,73 Staff: 2013 RESIDENTIAL BUILDING//PERMIT APPLICATION ° 5/% /b /%2a3 Site Address: 3 -7-7( S M/4 ©i' Unit #: Name: Address / City / Zip: 3 4-7-1 L,' 1V Q Applicant is: )( Owner Contractor Description of work: t/fc76 U Construction Cost: Phone: 6s7 -39P X26r Multi -Family Building: (Yes / No x' ) Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 1°D SW 19T7 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: • Phone: 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.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Build' g Code must be completed within 180 days of permit issuance. &,Is 44XcrZ Applicant's Printed Name x Applicant's Signature Page 1 of 3 377/ %,t4-1,‘ H71 I s DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Porch (3 -Season) Exterior Alteration (Single Family) Single Family Garage Porch (4 -Season) Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of _ Plex Lower Level Pool Accessory Building WORK TYPES New__Interior Improvement Siding _ Demolish Building* VAddition Move Building_ Reroof Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 3 000 Occupancy ,7 C - — MCES System Plan Review Code Edition 2..c27 SAC Units (25% 100% v) Zoning /?a City Water Census Code 11 3 4 Stories Booster Pump # of Units i Square Feet ) g 2 PRV # of Buildings i Length / ,t Fire Sprinklers Type of Construction 12 Width /G REQUIRED INSPECTIONS Footings (New Building) Meter Size: 9(4 Footings (Deck) Final / C.O. Required Footings (Addition) 4. Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: Ice & Water Final Pool: Footings Air/Gas Tests _Final ,4 Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: Footings Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL g /9L46' /5-433 Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA145433 Date Issued:09/08/2017 Permit Category:ePermit Site Address: 3771 South Hills Dr Lot:5 Block: 1 Addition: South Hills 1st PID:10-70790-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Boris S Axelrod 3771 South Hills Dr Eagan MN 55123 (952) 292-9210 Smart Builders Inc 11672 Butternut St NW Coon Rapids MN 55448 (763) 691-5021 Applicant/Permitee: Signature Issued By: Signature