4665 Stratford Lane
~ r~ (
~ ~ ,.i'"
C~~i~tCQ.~e 0~ ~CCli~Q1iC~
~it~j o~ ~agan
~~p~e~r ~ ~x~u~~
,
This Certifcate issued pursuant to the r~quirements of the Uniform Building Code
cer~efying that at the time o.f'issuance fhis structure was iM compliance with the various
o~inances of the City regulatrng buildireg consrructiore or use. For the fallowrng:
Use Qassificatian: Bldg. Permit No. ~ I3
pocupancYType ~~M~ ZoningDistrict R~ TypeCans~. ~
Ownerof Building ~ Addcess 1702 ~'~a~ I~
Building Add~ass ~F~~ ~~A LA~ Locality ' Z~ ~.S @~~
.
~ ' / ~/7~y
i -
B~~ o~~r
POST IN A CONSPICUOUS PLACE
~ ~ INSPECTION RECORD ^
~ CITY OF EAGAN PERMIT TYPE: ~ ~ ~ ~ ? ? „ ~
3830 Pilot Knob Road Permit Number: ~i ~
Eagan, Minnesota 55123 Date Issued: ~ ~ ! ' ~
(612) 681-4675
SITE ADDRESS: ; , , + , ~ ;1 , , , ; ,a APPLICANT:
I,.i. . . ~ ~ I t!~i~l~ 1 nPfl I I. ~ r~~il~ 1{~~1y1
~i.~~~ i ~?n~ i i ~ :•ni, ~ f, ~ . ~ ~t~i~~ •an~W ~
PERMIT SUBTYPE: TYPE OF WORK:
~ I~i~
1 I
• •
~7~. i 1 t,il. • ~ i~ill~;~ . i ~ t.ll
1 i~::f~lll,i!~ fillll~ Ih~it
ir~•,~~i ~st i„ra t i~;i ~ i,~~ ,
'~ttll~l! f 1`~ i'I !1(~ I iiil~,il 1 II I! I~
; I r~;; I 1( 1:1+ I 1 h'f r~ I
f~l MIiN~.',: F`!tV l-I I~I E~1 1~ ~ ~fi ~~l
~ ~
~ ~
~ Pem~it No. Pem~ft Holder Date Tetephone 0
' S/W
4 ~ PLUMBING e y/~ ~~Q'g~~'~
HVAC , O ,/G ~
ELECTRIC a , 9
ELECTRIC
Inspection Date Insp. CommeMs
Footing5l
Foundation v
Framing
Roofing
Rough Plbg. , oSA
O/
Rough Htg. , o~~ _ ~j'~ ~
7
IsuL
Fir~lace
Finai Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Finat f
Deck Ftg.
Deck Final
Well
Pr. Disp.
:7N~ ~ /4'QYf~
o'o2~r~z . , ~ ~~s~
Fequesl pa~e Fire . Roughdn Inspeclion Requiretl Ins ectlon Ot~er T n ug~-In
(Yau us call inspec1or when reaEy) ~ Reetly Now WIII Notify Inspec~or
~ ~ Yes ? No ~ale Reatl
I~jlicensed contractor ?owner here6y request inspection of above electrical work at:
Job ABdress ($Ireel, Box or Route No.) Clry
SediOn No. Towns~ip Name ar Na. Ranga No. Caunry
Occupam ( RI Phone No,
Powat up 'r AdEress ~
Eleciric ont2ctor (Company Nam Conlradors Lkens o.
r ~
Mailin Atltlress ( nVactor or Owner Making Installetion)
/
Amhonzed Signa re(COniracmr/Owner Making Instal tion Phone NumOer y
D~ J
MINN TA STATE BOAFD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Mltlwey eltlg. - Noom &128 BE ACCEPTED eY THE STATE BOARD
7821 Univerally Av¢., St. Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS
Phone(61R)842-OB00 ENCLOSED.
yo2~! REQUEST FOR ELECTRICAL INSPECTION ~"~"`y~ ee-o'
O 7 8~ 2, See instructions For comple~ing this lorm on back of yellow copy. ~`H'~~~'
a ~
` 'X" Selow Work Covered by This Request
Ne Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
~ ~uplex Water Heate~ Electric Heating
Apt. Building Oryer Load Management
Comm./Industrial Furnace Other 5 eci )
Farm Air Conditioner
Othar(apeciry) Contrectots Remarks:
Compute Inspection Fee Belaw:
# Other Fae # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps - 0 to 100 Amps
Transtormers Above 200 Amps Above 100 -Am s
$I 11S Inspecmrs Use Only: .TOTAL ~
Irrigation Booms ~S
S ecial Inspection ~ ~
Alarm/Communication THiS INS7ALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1B MONTH3.
I, the Electrical Inspector, hereby Roug~-In oa~ c~
certify that ihe above inspection has F~~ai ~ oe~e
been made. ~-Y
OFFICE USE ONLY i
This request voitl 18 monihs Irom
3 2 9- 6 3 0~ OFFIC USE ONLY This reqoest roid 18 months (rom wlidanon dak pdnkd in Poia bo. O
~~~/s~ ~ s~
P6EASE PRINT OR TYPE / n ~ ~ ~
Requsst Dah Rough-in inspeclion reqWred2 ? Yes Inspetlian OMerThon Roogh-In: eady Now 0 Will Coll
(Yau must mll the inspedor when r<ady) ~ Dale Reody:
I, icensed conirador ? owner hereby request inspec}ion of ihe above elecirical work af~
Jo6 Pddrcss ~Slrce~, 8ox, or Rouk N~ Ciy I~P
/
G /r6~ c~ r~ ,L ^ t~
Sedion No. Township Name or No. Range No- Fire No. Cou~~ ~
4 6 ~.L
p~WPa~~ PhoneNo. ~
: ~ l m,~ ys'z - 4~ Y
Power Sapplier Mdmm
EI«tnml Canhocm (Companr Name~ ~ Convodar limnse Na. Masbr Uc No. (Plant EIM. Only~
Awc r,c ~/z ~ /J ~ ~~~i
Moiling Address r or Owner Pe inq Imlallafion) ]
- ~ a z z r,~~~~ f1 ~rd
Authorized Si bre ~Co dor Pnner edorming I Ilafio f Phone No. ~
n ~ ~
EB-OOOUlA-10 6/9 STATEBOA C -3EEINSTRIICTIONSONBACKOP~ELLOWCOM
III II II I I I II II II I IIII III~ I~II - d21~U'o
e sity Avea Rmo T'~RI~ATy~PauP MNT55O104 ~ tl ~
s' U 3 2 9 6 3 0 8 s Phon,=_ (612) 842-0800 9~ /"f C~
Home Duplex Apf. Bldg. Ofher: New Addn
'~~Commercial Induskial Farm Remod Re air
ir Cond. Hig. Equip. Wolei Htr. Load Mgm}. Other;
D er Ran e Elec. Heof Tem .$ervice
"X" obove the work covered by this requesf. Enter remarks in lhis space and on ihe back of the white copy only.
Calculate Inspection Fee - This Inspection Requesf will not 6e accepfed without the correct fee:
Olher Fee 3T Service EMronce $ae Fee ffi Circuih/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Streei Ltg./IroHic Sig. Above 200 Amps Above 700 Amps
Transfortner/Generobr ipspECTOa•su oq~v ~ ~ TOTAL ~
Sign/OuNine L}g. Xfmr. z~ ~
Alarm/Remote Control
Swimming Pool I hereb caai at l Ins echd elMn insmllaHOn descnbed herein on Ihe daka sakd
Irrigation Boom eo~ph-i~ ~t~
Special Inspedion
Finol Dma
Investigativa fee
THIS INSTALlJ1TION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
,~ddress 4665 S1'~~n~oRn ~ Zip 5512 3
I.ot 2 Blk 4 Sub wEStnN xu:LS 2rID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON.
Date: C~ Yes No Inspector:
Fina] grade (6" from siding)
Pemianent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas ~
Sod/Seeded grass
TraiUcurb damage
Porch ~
Basement 5nish
Deck
Please verify with [he builder the removal of roof test caps from the plumbing system and the shut-off of water supply ro
the outside lawn faucet before freeze potential exists.
Contad engineering division af 681-4645 before working in righhof-way or instalting undergraund sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
~ CITY U3E ONLY 7y~p
L ~ BL I RECEIPT I"~' t( U~
suso. ~(V~S~11Y1 ffl~~.C~nd RECE(PTOATE; ~-~`'J~GO
~ PERMITi/ ''~I"tC~I~
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD ~ .
EAfAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventerforunderground sprinklersystem
FlXTURES EACH # TOTAL
Alterations to existing dwelling - minimum fee ~ $ 30.00
Describe: ~aa~inen.f ~~`I~lr~~~
Bath tub $ 3.00 x = $
Floor drain 3.00 x = S
Gas piping outlet "minimum-1 3.D0 x = $
Hot tublspa 3.00 x = $
Kitchen sink 3.00 x = $
laund tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newlrefurbished ' requires MPC lic. 75.00 x = $
Septic S Stem abandonment 30.00 x = $
I~pZ new installationlrepair/rebuild 30.00 x = $
Rough openin 7.50 x = $
Shower 3.00 x = $
Undefgf0undsprinklef ifdwellingisunderconstruction 3.00 x = $
Underground sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = S
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 3D.00 x = S
Waterturnaround 30.00 x _ $
State Surcharge .50 $ .50
Total $ 30.5'0
Reminder: Call for inspections of a(terations, i.e. water heaters, water softeners, etc.
1 hereby acknowledge that I have read this appliption, state that the infortnation is cortect, and agree M compty with all applica6le City of Eagan ordinances.
It is fhe applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its
normal operational and maintenance activities to the facilities constructed under this permit within City propertylright-of-wayleasement.
SITE ADDRESS: `Z'tp~ ~ ~f~L~'~~dR ~ L/3-/~IE
OWNERNAME:: ~/vP~SCSY1 TELEPHONE#: S! ~fS'2~'~f3~~5~
(AREA CODE)
INSTALLER NAME: ~ TELEPHONE
(AREA CODE)
STREET ADDRESS:
C~Ty STATE: ZIP:
~
SIGNATUR PERMITTEE
y PERMIT ~~"~2 ~,,a ~
J`~ITY sOF EAGAN PERMIT TYPE: ~S~
3830 Pilot Knob Road B u i L o I N
Eagan, Minnesota 55123 Permit Number: p z q q 13
(67 2) 681-4675 Date Issued: g g~ 2 5~ g q
SITE ADDRESS:
4665 STRATFORD LANE
L07: 2 BLOCK: 4
WESTON MILLS 2Np
P.I.N.: 10-83751-020-04
DESCRIPTION:
r
e}iilding'~P~ermi[ Type 5F ~WG
Building kJar~k, 7ype NEW
~'U$~C OcCUpandy R-3 M-1
;!f Consti^uction Ty'~5~ V-N
i~ ZorSing R-1
Building Length ( 58
Builtl~ing 'Width 42
By~ilsii:rvg $`tories f. 2
_ >
~ r'~
,t~'('~{.
n'.,;j
V
/rl \ i 4.J ~'s~~~ ~~'1 ~ ~ L~ V~ii 4~~~ ~la!
f L
, i:.:~ ~ S.~l
REMARKS:
PRV S& W PLBR - D C MECH
FEE SUMMARY:
VALUATION $140,00@
Base Fee $779.50 MISCELLANEOUS $1,828.50
Plan Review $506.68 Tatal Fee $3,984.68
5urcharge $70.00
SAC $800.00
SAC & 100
SAC Units 1
5ubtotal $2,156.18
CONTRACTOR: - Applicant - sT. ~IC. OWNER:
KEY LAND HOMES 14409400 0001553 KEY LAND HOMES
17021 FISH POTN7 Rp 17021 FISH POINT RO
PRIOR LAKE MN 55372 PRIOR LAKE MN 55372
(612) 440-9400 (612)440--9400
I hereby acknowledgs that Y have read this application and state that ths
infiormation is correct and agFee to comply with ~11 aµplicable St:ate of Mne
Statutes and Gity afi Eagan Qrdinances.
~ _ J
[~/~%9~ G~. ~
APPLICANT/PERMITEE SIGNATURE ISSUE BY SI URE
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: aui~orru~
3830 Pilot Knob Road Permit Number: 024413
Eagan, Minnesota 55123 Date Issued: 0 S/ 2 5/ 9 4
(612) 681-4675
SITE ADDRESS: ~ o T: z 9 l 0 C K: q APPLICANT:
4665 STRATFORD IANE KEY LAND HOMES
WESTON HILLS 2ND (612) 440-9400
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
. .
FOOTZNGS FOUNOATION
FRAMIN6 ROOFIN6
INSULATION FIREpLACE
ROUGH IN PLBG ROUGH IN HTG
FINAL PL9G FINAL
REMARKS: PRV S& W PLBR - D C MECH
~ ~
~ ~
, . CITY OF EAGAN
~ 1994 BUILDING PERMIT APPLICATION
681-4675
~.lX ~ -
SINGLE MULTI-FAMILY 2 sets of plans, 3 registered s , 1 y of energy
calcs. ~:UG 10 199~
COMMERCIAL 2 sets of architectural & struc ural plans, 1 set f
specifications, 1 copy of energ '
Penalty applies: 1) when permit is typed, but not picked up by last working dey of month
in which request is made, 2) address is changed ar 3) lot change is requested once permit
is issued.
Date ttt.Ca Valuation of work fL~Q~GIa~~
Site Address: ~'~(a~.~ STT~~,-"~1=p4~ L~~~
STREET SUITE #
Tenant Name: (commercial only)
LOT BLOCK ~ SUBD.vY~S~o~ u''s P.Z.D. #
!
Descri tion of work: ~ S/ ~+Ad9'111. ~
The applicant is: ? Owner ~ Contractor ? Other (Deseribe)
Name Phone
Property LAST FIRST
Owner qddress
STREET STE !1
City State Zip
Company m Phone ~O -~p C~
Contractor Address ~~~70ZI }~'f. R,A~ License # 5S3 Exp3-31-
City~240~ ~KE State i?4i~ , Zip ~J'J3~7
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
5ewer & water licensed plumber C- ~ C1.~l~ ~L . 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 wi a71 p icable State af Minnesota Statutes and City of
Eagan Ordinances.
C-f~'di1
Signature of Appl icant: ~ g^ ld
OFFICE USE ONLY ~ :
BUILDING PERMIT TYPE ~ ~ ~
O O1 Foundation ? O6 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? ll Swim Pool
O 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory O 18 Co~n.iInd.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc.
~ 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
~i'31 New ? 33 Alterations ? 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) //r,' Basement sq. ft. dc~9 MWCC System '
(Allowable) ~ lst F1. sq. ft. City Water ~
UBC Occupancy ~i 2nd F1. sq. ft. ' p PRY Required ~
Zoning N- % Sq. Ft. total Booster PumP
B of Stories 2 Footprint Sq. ft. Fire Sprinkler
Length ~ On-site well Census Code /D /
Depth ~ On-site sewage SAC Code ~L
Census Bldg i
APPROVALS Census Unit
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? .Site ~ Footing C~ Framing ~@ Insulation
? Wallboard ~ Final ? Draintile ? Fireplace
Permit Fee vei„Bt;o,,: g~ ov ot7
Surcharge ~ ~-d-wi~:,,
Pl an Revi ew "Z~,- Z~ ~ ? O~ z Z r>
License ~
MWCC SAC z o~ ~Y ~ 7~o ~
City SAC /3,5~ ~ - ' 9G.
Water Conn.. - ~ -
Water Meter /p ~ ~ l~
Acct. Deposit ~9k~ 9~ ~s/Y/_
S/W Permi t 3 6
SJW Surcharge ~
Treatment P1. ~ ~ ~
Road Unit r~ q l p~
Park Ded. ~ / ~
Trails Ded. 2~,(-~6~ %22 ~ _
Others ~ ~ z~-
Total:~ ~~J,~Sy ~
SAC %
SAC Units
P.01
~ ~ ~ 2441 Enterprlee Drlve
Mandpto Neights, MN 85ipp
~ Pl~~l~! sim.s . aw. nmx~n: (a1'~) 881--1814 FJUC 6t91-9488
~$A rfs~r np u~ ~a. uwosare u~n+acre 82S Hlghway 14 N.f.
.k ~ ~ 8loine, MN 55434
(a~a7~~a3~~eeo F,~x~~a~.-~~
Certificate of Survey for: KEYL~4ND Hi~M~~
4B8~ STRATFORD LANE 38g2~ N
R~V•l~~WED
N54°2d51'~ 98.6i N89°42'3D"E fqS~sY
9.31~~ -
o ~952.2
~,m~ 949.~' b ' \ DAT - ~ Z~~
i e ~aear~~a unuTV ,~/T
EA9E PER PL'AT 1l
` G ` ~
~ 1 ~ {~F~ . g 983.4
3 5
~ 1 uf
y ~x953.1
~ ~ 9 87,95 s, ~
~~rR .5) esa.s ~Q,
~A 4 3.9 ~ q 4a~ i3 ,1 W
~ 955ti I ~p ~
F:AGAIV 1VGINEE o~ p~o~~~ tao m
z~~ ~w~~ ,
`3 f~ N x w 7.3~ ppRAGE ~ i~
~ f
955.5 ~ 8~'ak~ pQR~H o 7 ~ ; 2~ sE~ MARK
3 x TOP QF HU6
N 10~~ ~ `~5~~---968. ~~56~7~ ~ ~ LLEU.=95fi~7
~c ' ' ` ~ ~p~~S~Y 5 n+ I,..-TV. PED.
955.b ~ oo~` ` o I~~l~~
T~ H,~O y~ ~~'~~,V
5~q ` _ r sss5
ELE11P985.U0 `ry?' Oe 41~rc' `~r =N 954.9„_,.~.
9° 3(1
54;5ia~c ~RsAgS.'~'A'saax a+
r6 L ~N . ~
ELEC. & TEI.E. PEDS''- 53•8 ~
p ~ Cr~~
. ~
~!n~ 1 r
rwPOSEO cr~oES stwxH rrn art?nwa ruu+ er._. PROBE ~NG. 'O~ . e 4! l~ ~ G^~ J
ND7E; 9UILOINO DIYFf/SIOHS SHOVM ARE FpR MOpRDNTAL AIIO VQR7ICAL ~
LOCATOW OF STNUC7lAtES ONl.Y. 6EE ARpUYECTUAI PLANS FOR BUAOWO
nrao rout~unr.w pueus~orrs.
NO~E. COM'tRAC70R lW5T YENIFY ppIVEWAY OE9GN. ipS CCR7~Alf ptE6 N01 PURPIXtT 7tl SNtlW EASQAENTS
NUIE~: HO SPEOFlC 5d15 INVES71CA710N NAS BfiOi C061P1.f7Ep pN 7Fy5 OINqt THAN MOSE ~IOWN pJ 7ME 1~CORpfp pLqY.
LOT BY TNE SURMEVMt. 7HE &IITABIUIY OF SOILS 70 SUPpORT '(HE p~,~Qq ~py~ ~ A,yq~~b
SPECIKIC F10tI5E PROPp$EO IS NOT 1HE f~5PON518111N ~'{yE SUR6£yyt.
PROPOSE~ HOUSE El.EVA110N
X ooo.oo Denotes Exisiing ~lewtion
( ooo.oo ) penotea Propoacd Elevatlon Lowast Floor Etevatlon: g
Danoies Grcinage k utpiiy Eossment
Oenotas ~rainago flow Dlrection 7op oi Block ~le+rotlon: 'S'f3~y
---a~- Uenotes Monumeni
Oanoies OftseS HuD Qqroge 51a6 Elevatton: ~'J'~~~J'~
L~~ 2 ,~3LOC{~ a w~smN HILLS 2N0 ADDIi"ION
DAKOTA COUNiY, MINNESOTA
Wa heraby eerliry tnot IMe e~rrey, plon a repqt xoe prepored Dy ma or Vnder 1ny dlrsc! euperWion ond lnvl I cm dwy reg;eterd lond Swvayor
u~tr ~he Iavs o! ~h0 51ale ol NW~HCh. DOded (N~f day o( ~U~~ itp- 79 /~J ~
f~V~ED HpUSE 8-1~94 p~VIS6~ &-IB-94 3HOW. EXISt. HOUSE N f~°ibP1EER EN INEfRI G. P,A,
S~ale: 1 inch = 3o feet s'~-
a~46xo~ ~ ~.5, Na, rsa2a
R=969d OB-IB- 4 . P001 #35
LOT BIIRVEY CHECRLIST FOR RESIDENTIAL
~ ~ SUILDING RMIT APPLICATION
W PROPERTY LEGALS ~
~ ~ m
~ Date of 8urvep:
-a.r_
~ DOCIIMENT BTANDARDB ~ ~ / ~ 9~ ~
~ 9~r
8~ 0 0 • Reqistered Land Surveyor signature and company
0~ D ~ • Building Permit Applicant
0~ 0 0 • Legal description
0~6 ~ • Address
Q/b 0 • North arrow and bar scale
6' D 0 • House type (rambler, walkout, split v/o, split entry,
lookout, etc.)
~D 0 • Directional drainaqe arrows with slope/gradient
~ ~ 0 • Proposed/existinq sewer and water services
Ci' 0 0 • Street name
~ 0 0 • Driveway
ELE9ATIONB
Existinc
Q~0 D - sewer service
~ 0 0 • Lot corners
-L~/ 0? • Top of curb at the driveway
C~ 0 D • Elevations of any existinq adjacent homes
~lODOS@C
fd~ 0 0 • Garage floor
B~ ? 0 • First flooz
Q' ~ 0 • Lowest exposed elevation (walkout/window)
C'~ 0 0 • property corners
~ D 0 • Front and rear of home at the foundation
PONDZNO AREAS [if aoDlicable)
~ I~ ? • Easement line
0 Q' 0 • NwL
~ CI' 0 • HWL
0 [Y 0 • Pond $ designation
0 D~ 0 • Emergency overflow Elevation
DIMENSIONB
~ 0 0 • Lot lines
0~ 0 0 • Right-of-way and street width (to back of curb)
e` D 0 • Proposed home dimensions inclnding any proposed decks,
overhangs greater than 2', porches, etc. (i.e. all
structures requirinq permanent footings)
D~ 0 0 • Show all easements of record and any City utilities within
those easements
0~ D 0 • Setbacks of proposed structure and setback of adjacent
existing hom
D[3~ 0 • Retaining reQu ements, if any
Reviewed:
Na e / t
October 1992
r ~ ~ ~ /
/ ~ ~ ~ \ \
' 1 ' ~ ~ y% ' 34
~ Lb~ ~ ~ ' u, ~ ' i i
, i i ~ ; i i ~
Z ~ WYE 1+40 / r
J ~ ~1~~ / ~ ~ I I 1 w
~ SAN ELEV. @ PL 947.62 y I ~ I I 1 ` SAN ELE
\ \
_ _ ~ I I ~ ~
/ ~i ` ~
~ ~ ~ WYE 1+87 ~
~ WYE 1+55 SAN ELEV. (u? PL 942.78 ~
~ v ~ ' SAN ELEV. @ PL 945.38 ~ ~ ~ "
~ ' ~ ~ L I I '
g.~~PVC`~SA _ i / j ~
~~?S ~ • o1P 8' r 7a L ~
~
5 59' - BENU ~p~
1~.~ ~ 1 ,q z; H 8 ,,c
v - VAIVE t y . ~7 ry~
2 - - _ - _ _ - ~~~OfP g~~'.Y~PVC SAN > ~ ~ ~
~ / ~ ' ` ° U 178' " 71P
N a I l l• r ti~u _ n
~ STRATFORI) a a ~ ~ ' ~ ~
~ ! 6" HVORANT ^ y'~ / r- ~ -n ~ ~ ' WVE t
~ I ~ 6"X6" TEE ~ laj ~ / / / ~o I~ ~ ~I ~ ~ _ _ ~ _ _ ~ ~ ~ 1 SAN ELEV. Cn~ ~
(n ~ 11' - 6" DIP ~ ~ I- , r I 1 ' 6' HVDRAN
= I ~ ~ I / J WYE 1+68 ~ ~ I I WyE 0+08 ~ 1 6"X6' TEE
Q 2 / / / SAN ELEV. `.d PL 946.11 i W YE 0+85 9' - 6' DIP
Z ~ - v¢ /l O
I fl / ~ ~ ~ SAN ELEV. la~ PL 946.50 ~I ~ SAN ELEV.(~ PL 943.21 ~
Q
~ ~ - ` ~ ~ /•Q / ~ ~ I I ~ ~1
o ~ ~ I / ~ ~ STRATFORD LANE STA. 1+76.35 = 1
~ I X/ / ~ ~ WESTON HILLS DRIVE STA. 13+91.40
o/ ~ , ~ ~q
o _ ~ ,o %r / j ~ `L ~~I'~ 3 ~ L
,
C~- ~ ~ ~i ~
~;la
~ ~
y w~ ly ! i g~~ ClTY OF ~ACaAN DOES ~UA`~A~~' ~IO
W~ ! ,~'FiE ACCURACY OF UTILI`fY I_QG.'>i;^~
( BENCHMARK-SPIKE IN POWEfi POILE 00 FEET NORTH OF ~`ya~~r~ ELEVATIOf~S. 1'HiS DYi~%~•
CL1FF'"ROAD ON THE EAST SIDE OF T.H. NO. 3-ELEY. 931.6P~c~~~~~qTIOIV PURPOS[S L~.~~'~ f~+''~
P~l9SQi~S U.~ili~1G IT SHOULt7 ::i-
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S?7E ADORESS: `~~'Y~+'s~ ~ ~ LI-~ ~ PNONE:
~~J/
CONTRACTOR:~f YC ~~~'7 ~/0~' PLAN r~ 7loLPZ
Determine working square footage of each
1. Total exposed wall area..... 7_~tvS sq. ~ft. x.11 = .~~~9~ ~S
2. Total roof/ceiling area..... /77'~ sq. ft. x.026 = ..3 (~F~Z
Total exposed saall area above.floor=
a. Total r;z11 window area /3~
b. Total door aFea 3
c. Total sliding 91ass door area............••••-••••••••••••••••••• o
d. Total fireplace wall area
e. Totzl wall framing area (average lOK)......._...-.•••••••••••-•••
f. Total rim joist area _
g. net wall area a6ove floor 1~1 7!0
h, wall area a6ove floor.......-•••••••••••••••••••••••••••••
i. . wall area a6ove floor
j, frame wall a~ea a~ io~ndat_on.......-..•••••••••••••••••••••••••
Total exposed foundation area= ~<1
k. Total foundation window area............~.......... ~
l. Total net.~foundation area above grade /,/.r
Determine "u" value of each wall segment ~
(e.g. window, door, each separate wail section) •
a. /~i X~~~~~ . 7 = 3, S ~
, b. 3~ z .3/ = i7,~~]
' p x - _ ~
• d. - X - _ - :
~ x O7 = ~ 3~
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g.
h. X _
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r ~ X„~„ / O~ as, or less thar.
F1, you have me:
X"U"~ 9•~ intent of SBC oC.
1. ///O
3 . .................................Total = ~~,aTi . .
-..~.__._.__.......~,c..-._..-.,..~~.-,.
4, ,TOTAL EXPOSED RQOF/CEILI~IG CALCULATIOtIS:
. ~ ~ C~..S
. ~ , Totzl expnsed ~'`r Gy'` ~-w~ C.`'~.
roof/ceilin~ area........ Q~fA D sq ft ~
: j) Tocal skyliaht area....... sq ft x"U" °
k) Tocal roof/ceilinq framing
area {Averaae lOry)...... ~~r ~i sq ft x"U" r~~ ~G~~~ z~L~ ~ ~
1) Total net insulated J
roof/ceiling area.......r~~/ ~~19 sq ft x"U" rp~ ~Z~Z Jr~'~
TOTAL j) thru 1) ~~~~`i'
If tocal o` '4 is the same as, or less than (',2, you have met the intent of
• 2 ~!C1~7 1.16005 :4 ard 0.
. ALTERNATE BUILDIPIG ENVELOPE ~ESIGN
To utilize the total envelope sys[em method, the values established by the sum
of items '3 and :~4 shall not be ~reater than the sum of items Nl and y2.
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DATE: 10.~Fs/9y TtfSEa . Q9:E?:48 .
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VAhFce CORY.L. 14ELSO~V
3L'!.0 "3;i01 466°, STR'AiF'~:~Ri1 ~ 67.Op
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999 BUILDaNC PERMIT APPUCATION (RESIDENTIAL)
~ CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conslruetion ReaukemeMs Remodel/Reoair Reauirements ~
D 3 registered sile suney~ ahowing sq. k. of lot, sq. H. of house 2 copies ot plnn
and glj roofed areas (20% maximum IoT coveraae allowed) 1 set of energy caleulafbm for heated addlNons
D 2 coplea of plans (show beam 5 window sizes; poured tnd. design; etc.) 1 sRe survey fw exterbr addttions i decks
? t set W energy calculotbns
D 9 coples ol hee preaervafton plan C loT plaMed alier 7/1/93
DATE: / D~2~S l~9 CONSTRUCTION COST: T~1~
DESCRIPTION OF WORK: ~OItJ~ L,EIlEt, L'i+J%Sl--F
STREETADDRE55: ~G~~S ~~~l9 ~P..D (~9~G
LOT: ~ BLOCK: ~ SUBD./P.I.D.#: WESTbn! ~tl(~(.S ~ti'~ ~'~~/6L,
Name: /~~~4~/~ Ctl/2~~ Phone ~5 ~S~ -S35~S
PROPERTY ~a~ F~~
OWNER
Sheet Address: ~f-~J ~ S ~ TJ?--f7-~'~c,~'d~ ~fJ-i~'~
Ci1y C~afY~ State: /~i~ Zip: jS-/?3
Company: Phone
(area code)
CONTRACTOR
Street Address: License iF Exp.
C11y State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Tetephone area code ( )
StreeY Address: Regishation
Ciiy State: Zip:
Sewer 3 water Ilcensed plumber (reauired for new eonslruetion onlvl:
~~enalFy applfes when address chenge ond lot change Is requesfed once permH Ia issued.
i
1 hereby acknowledge that I have read this appllcatlon, stafe ihal the informaNon is cartect, and agree fo comply wRh all applicabl
• 41dfe of MinnesWa 5latutes and City of Eagan Ordinances. ^~a\~~~
Signqture of Appllca~: T~
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
~ Tree Preservation fian Received _ Yes _ Na _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? O6 4-plex ? 11 10-plex 0 16 Fireplace ? 21 Porch (3-sea.)
O 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ~ 19 Lower Level ? 24 Storm Damage
O 05 3-plex ? 10 8-plex ? 15 Lodging 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
~ 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building ~ Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC :
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
4 ~
Treatment PL ~
Park Ded.
Trails Ded. ^
Other
Copies
Total:
SAC Units
% SAC
r
~
i:v : ::i'
::i317F:t)
~
ti.i:.~i~.>:~.a:.:~E;;:...::....
. ..w.1 , ~.o-. .,y.~.. s.~:.i ..:..:.....a:......:.w^.Z:`e::b:9..v r u~~u.n:>: :a:..r.r.n::~ .:R,';E:;R:r,>•i.h<:'e,:N...:...y..:a::a: ~ . ~.ey ~y.rp. . :~o-::<::....e....:..... .
` ° $ E a c . iE '~~£s~`F ?'r ; a34a i~~<~ .cy Mc~ i c z 33 ~3 ~ F£,~~~°~tr~M~`YC~ ~ ~ <s >O¢t~i;
,
~i 2,~~ g 3 st~F F '~O ¢ ~ tL ~'L ~ ~`9~ ~ ~~~<F e ~4x ~ ~ar~ ~',`urroE `~~.«~,.:.a~f ~ ~ f ~t tF ;t~ .
s ta q £ - 3 &i F °3~- ~d,Cn .Sf,~~ R3~ '`s~~e3~~e4°~ a~~s~~3T~v'~~ rr ~o Z+ ~r ~ s ~ ~
c. &~a c `~.m# ~gC,j'f u ''a~' ~
? . h:,e
.w -s 1~
~ ' . ,,.e...a~? ' ~ ;._„Y'fi $ ' ~ ~~yd~`~`.~ 3A~ik
4~- ,y, g . 9
r~,~..Gk~o'~~.+5 ~+~s~,w'
"°ke;, ^ ;
.~~...c... .c.. . . m ~:D4~. . . i 4 :d:uo-:o-.w.w. ....a. xa ew:~xv. ~at.~.
`aM`.,:.ZC~~. : `.4:.~~.'~nw~ ~ ~ . , ,~s..< c.a . . C. nR.C~:.
1994 MECHANICAL PERMTT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTI'.
~ NEW CONSTRUCTION
.SDD-^*1
ADD-ON FURNACE
FIltEPLACE INSERT
DATE ! 5~9 c~
FEES
HVAC: 0-100 M BTU $ 24.00
ADDTfIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@$3.00 EACH) . 00
ADD-ON/REMODEL (Exis~rIIVG CoNSr[tucrtoN) $ 20.00
STATE SURCHARGE .50
TOTAL ~ 33.Sa
srt~ .~Dx~ss: 5~~~ 5 ~trc~`J~~rz..~ !___a.n ~
OWNER NAME: l~.E~-l L~?-r~ ~n1 eS TELEPHONE y~0 - 9 yo a
INSTALLER: ~E
(72 d ~-i
2 ~,-lc •
~DxESS:.~~, 9 ~b (,~J~[~.o,~-e-- l~u ~e ~ S ~ -
CITY: ~2~~Orz STATE: ~Yl~ • ZIP CODF't l S.3 7~~
~LErHOrrE Lf - a~_
SIG ATURE OF PER E
r
.
y' ~
7lY c . a t„ ? s$e~t~' a 3 t f{ ' TFs£ ~r < ~ b .
5
~ ~ : .a «~wa ^k 4 . r fi ~n . t .
~a~y~ ~x ~ ~,#6g 'g ssT¢Y~~ kR~~~~E: ~£°n!a<ea~"a,„,,wv'~^.~z„+.i'"~a a; . ~a~~ay,. .x °s~ }';3~x y~.
r,. ,.a.. s::., ,a,_,.,. ,
~3k!.i~~ £ ~ ...,....,E£rc¢tai4aa.~a~~~~~~9" ,:~iei~~€<;:s~..xK£4~~,a5.<..~„~~~,~`,;~~,,v,.~,s.~x °~.t.>?>p>,~,~..s3si°„'....<..x..
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE'COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDWGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTTS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF #~,`i;~~`~,~^ FEE $
'c:~.~..<..n.:.:.;.:~x.;^.fu;.,;.o};.
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF ~It~T`~' FEE.
F. :
q
. . . . . . . :
.U'.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLI~
INSTALLER:
ADDRESS:
CITI': STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CITY INSPECTOR
' , ~ ~ ~ ~ RESIDENTIAL BUILDING ~ O ~7S
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtian Reauiremen45 RematleVReoair Reaui2men15 Office Use Onlv
3 registered site surveys showing sq. ft of lot, sq. ft. oi hause; and all roo(ed ar~s 2 copies of plan Cert of Survey Recd Y_ N
(20°h maximum bt coverage allawed) 1 setoF Ener9y CalculaGons for heated additions Tree Pres Plan Recd Y N
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 sile survey for additlons & decks Tree Pres Not Reqd Y_ N
lsetofEne~gyCalwhations - AddAion-iiMkateiion-sitesepficsystem Oo-siteSeptlcSystem _Y _N
3 copies of Tree Preservation Plan if lol plaHed after 7/1/93
Rim Joist Detail Opfions selectWn shcet (bldgs witli 3 or less unifs
Date ~ / / ConstructionCost 19PP2aX' ~3c~oo•oa
Site Address S~~O( S ~~f~i~p2.L~ ~~9X~L~ Unit/Ste #
~~rt~J w s~/ 2 3
Description of Work 1~~w
Multi-Famity Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~0
T [v~1.,_S 0~ Telephone # ( (aS( ) '~3~ 6
Contractor /U/,~}
Address City
State Zip Telep6one # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category • ResldenUal Ventilation Category 1 Worksheet • New Energy Code Worksheet
(~1 submissian type) Submitted Submitted
. • Energy Envelope Calculatioos Submitted
Have you previously constructed p building in Eagan with a similar pian? _ Y _ N If so, 25% plan review
fee applies.
i -
Licensed Plumber I I ~ ~ ~I~ ~ Il Telephone )
~ ~ ~n ~ II
Mechanical Contractor ! t~'~'' J Telephone ]
Sewer/WaterContractor In ~ ~Telephone#( )
u)'
I hereby apply for a Residential Building Pertnit and acknowledge that the information is complete and accurate;
that the work will ba in conforntance 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 ptan in the case of work which requires a review and
approval of plans.
~ARy f~EtSa.J
Appiicanc's Printed Name Applicant' S ature
OFFICE USE ONLY
~
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 D6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? D3 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 PIbA_Y or _ N ~ 25_ Miscellaneous
Work Types
31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding
~ 32 Addition ? 36 Move Bldg. ? 42 Oemolish (~oundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 ReplacBmCnt , 'Demolition ~EnQre Bldg) - Give PCA handout to appliwnt
Valuation L/k°.~i.w Occupancy MClESSystem
Census Code L/ Zoning City Water
SAC Units Stories Booster Pump
N6r. of Units Sq. Ft. PRV
Nbr. of 81dgs Length Fire Sprinklered
Type of Const ~ Width
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
~ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbmg
Foundation HVAC
Drain Tile Other
RooF _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Framing _ Siding Stucco Stone
_ Fueplace _ R.I. Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By ~ ~ , Building Inspector
Base Fee
Surcharge ~rl~~~l ~.3
Plan Review . ~
MC/ES SAC
City SAC ~-'j G~ .e--
Utility Connection Charge i'~
S8W Permit & Surcharge
Treatment Plant
License Search
Copies r ~s
Other
ToWI
; ~
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BUM.pl1C DlYEH910NS 9NOMN ARE FOR 1WIq20NtAl ANO KRiiCM. ~a-N~ ~.(~L.f S~-/23
ION OF S1AflCiURES ONtY, SEE ANCl111EC7VAi OIIJ/S FOR BVNAIkO
our~~hON DIMENStON4. ~oS/- ZG j - /3'(~
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City of E~~a~ j Pertnit# D J/~5 j
I ~ I
I Permit Fee: ~
3830 Pilot Knob Road i ~'a-(~ i
Eagan MN 55122 ~ Date Received: ~
Phone: (651) 675-5675 i ~ C~ i
Fax: (651) 675-5694 1 Staff: I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~/~O C~U SiteAddress: %~b.s vrTrc~~~~~ ~"thP
Tenant: Suite
RESIDENT / OWNER Name: l
BW~~v~ Phone: '~~S- ~~a
Address l City I Zip:
Applicant is: _ Owner Contractor
TYPE OF WORK Description ofwork: rl ~'f ~"e~ ~ou~~a.cc~ g S9
Construction Cost:~S~~ Multi-Family Building: (Yes No
CONTRACTOR Name:/"(i~Wls~' KOU~r9.r S'.b~r~5.e oi Wi'~d xhc. License#:2d41~~~7~
Address: , ~ 3 ~T p~~erso., ~~Y
City: C~arDlln state: zip: ,SS316
Phone: 7~7.3 /~O ! b Contact Person: l~veo~a G ud Z jR k
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Venlilation Category 1 Worksheet , • New Energy Code Worksheet
Category Submitted SubmiNed
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 planT
_Yes _No If yes, da[e and address of master plan:
Licensed Plumber: Phone:
MechanicalCantractor: Phone:
Sewer & Water Contractor: Phone:
I` NOTE: Plans and supporting documenfs that you submit aie considered to be pu6lic information. Portions o#
the information may be classified as non-public ii you provide specific reasons ffiat would permit the City to
° conclude lhat ihe are trade secrets.
I here6y acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of
Eagan; that I understand [his is not a permit, but only an application for a permit, and work is no[ to start without a pertnit, that lhe work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans. .
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ApplicanYs Printed Name ApplicanYs Signature ,
Page 1 of 3
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1994 PLUMBING PERNIIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUII2ED FOR EACH UNIT.
NO. FIXTURES ]EA.C:~ TO'g'.~1L
~ SHOWER 3.00 3 . ~
WATER CIASET 3.00 -b-e~ ~ ~U
~ BATH TUB 3.00 3. ~D
LAVATORY 3.00
KITCHEN SINK 3.00 :3• ~
V LAUNDRY TRAY 3.00 3• UtJ
WATER
BI-IEATER 3.00
/ FLOOR DRAIN 3.00 3~-
1 GA5 PIPING OUTLET • m~~~~m - t 3.00 3- ev
~ ROUGH OPENINGS 1.50 S7~
WATER SOFTENER 5.00
PRIVATE DISP. • ne~.ay. u~. 20.00
U.G. SPRINKI.ER • nome anaer oo~t. 3.00
, ALT'ERATIONS • ~o ~~B 20.00
WATER TURN AROUND 20.00
STAT'E SURCHARGE .50
TOTAL: ~
SI'I'E ADBRESS: ~c~ ~~rr~C ~ •
OWNER NAME:
INSTALI.ER: /~~Gh.cvu~
ADDRESS: ~ / / / (~tJ f
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CIT'Y: UZ STATE: m~ ZIP CODE: _;z.1 d
PHONE ( ~ D _ ~
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SIGNATURE OF PER ITTEE
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1994 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL COI~IlI~RCIAUINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWEI.LING UNTI'.
_ NEW CONSTRUCTION
ADD ON
REPAIR
WORK DESCRIPTION:
CONTRACT PRICE: $
FEE: 196 OF CONTRACT FEE.
STATE SURC~IARGE: S.SU FOR EACH $1,000 OF ~ FEE.
MIHIMUM FEE: $ 25.00
CONTRACI' PRICE X 1% $ ,
STATESURCHARGE $
TOTAL $
SITE AllDR~:SS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
C~~ STATE: ZIP CODE:
PHONE
FOR:
CITY OF EAGAN APPLICANT
For Office Use
*City of Eaian Permit it
12-17,0
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone:(661)675-5685
Fax:(661)675-5694
Email: lannin ioci hfear-10-,1 con)
ZONING PERMIT APPLICATION
o Please identify improvements on a scaled site plan drawing that shows lot lines, structures
and existing conditions.
PROPERTY Site Address: -/'b$ 5.7124-7-rd42) 64,Lie
INFORMATION
Owner Name: C401Jl2.,1
Name: _eAke-y, Alta 540N- Phone: 65-1-X5-07-f3YS- Hiove
6.51-247-/ yS
CONTACT Address: _ _615_57-41.7.--ferieb 'JJ City/State/Zip: 0^; 1.
•
4111
Applicant Signature: tat Date: q
Email address: tvSO 0.2_471#0.A. cwl.
0 Retaining Wall<4 feet 0 Driveway 7.1 Other.
TYPE OF 0 Patio 0 Sport Court
WORK 0 Sidewalk 0 Fence
Description of work: , JO c Peer few, Hou,se- 1 LC iCtT' fitahk Carioasee
PLANNING Setbacks,hard surface coverage,shoreland zoning,bluff zone/setbacks,etc,
proved I ied Dale-ef-illoreveti- 44-4t Staff: 01 ill 'I ai
N. The owner applicant is
ProbpiertycnlitnroLt!anba,urivrIfied
ac
11
responsible for compliance with
applicable construction codes.
Revised Plans
Approved: Yes I No Date of Approval: Staff:
- I Grading,drainage,utility easements,wetlands,erosion control,improvements in the Right-of-Way,etc.
Approved/Denied Date of Approval: Staff:
Notes:
Revised Plans
Approved: Yes I No Dine of Approval: Staff:
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground laity damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.norwherstateonecall..
GABtildng InspecticatAPERMIT APPLICATIONS1201112011 Permit Applications
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