4251 Sunrise Rd
CITY OF EAGAN
3830 Pilol Knob Road, P.O. Box 21-199, Eagan, MN 55121 114-74
• PHONE: 454-8100
BUILDING PERMIT p.) Receipt N
To be used for :;'r' MG/GAR Est Value $69,000 Date :%Aid UAxY 8 ,19 36
Site Address 4251 SUNR I SF IRD Erect ~ Occupancy
Lot slock 1 secisub. Stlta CLIFF 15T Remodel O zonin9 R1
Parcel No. Repair ? Type of Const-v
Addition ? No. Stories
W Name ~VANCE DGVELOt"'f:RS II•1C Move ? Lengtt? 46
Z 3209 W 7 6TH ST # 20 5 Demolisn ? Depth ab
o Address Int Impr. ? Sq. Ft
City rUINI}Phone 835=5405 Install ?
o Name A PLUS REALTY Approvals Fess
~ i Address 7216 PAULSEN DR Assessment Permit $ 340. 0 0
cc
c;ry ~:ncta RIE 937-2617 Water 8 Sew. Surcharge 34 . 50
~ Police Plan Review 170.00
~ W Name j~IN23ETOPiY.A DESIGN Fire SAC 575.00
Address Eng. Water Conn. 500.00
~ W c;ty F.JCCI:L$~&W 474-0644 Planner Water Meter 63 . 50
Council Road Unit 280.00
Iherebyacknowledgethailhavereadthisapplicationandstatethatthe BIdg.Off. 1r3~86 Tf.PI. 132.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of,Eagan Ordinances~ APC Parks
Var. Date Copie .
Signature oi Permittee Total U U
A Building Permit is issued to: A PI'US RF,ALTY on the express condition that
all work shall be done in accordance with all applieable 5tate of Minnesota Statutes and City of Eagan Ordinances.
Building Official
r ParmN No. Po?mN Hddor Oate TsisphoM #
S r ~p
Plumbiny W,5)
H.Y.A.C.
:
Elaetric
8ohsner
Inspectlon Datt Insp. Commuris
Footlnya I
Foodnys II
Foundatwn d 6
Framiny ,A
noof" trJ
Rouyh Plbp. ~ ~6 • ~ 3 ~ ~
Fkoplacs
Fleal Htq. •~/-rG ~
FMN Plby.
&dy. FinM
Cart. Occ.
9 9
~ rb
Dsck Ftp.
Deck Frmp.
Well
Pr. Disp.
PERMIT # ~ CITY OF EAGAN FEE
~ PLUMBING PERMIT
RECEIPT # 454-8100 S/C ~
p MINIMUM RESIDENTIAL FEE - $10.00 +$.50 TOTAL f~
DATE ~ D MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res X Comm Inst 2. New Add Altej Repair
e
S/OD • '
3. Total Bid Price ~ 4. Job Address as L"~ ~x
71-
Lot~ Block Se 't)C", c~ 5. Owner L-G ~Li A,Je?S6y\-
G ri v^e '-2 ~'c~ Jou t~ " 36`~
U,L6. Contractor :ts cr (Neme) (Streel) (city) (Zip)
7. Contractor Phone #
NO. FIXTURES NO. FIXTURES NO. FIXTURES
IWater Closet - $3.00 1 Laundry Tray - $3.00 -Well - $10.00
Bath Tubs - $3.00 -LFloor Drains - $1.50 -Private Disp Syst - $10.00
Lavatory - $3.00 ~Water Heater - $1.50 -Rough Openings w/o
IShower - $3.00 Whirlpool - $3.00 Fixtures - $1.50
1 Kitchen Sink -$3.00 :LGas Piping Outlets -$1.50 ic,~:_ C i7'/ 04uCo `42 a?74 puT[ETS
-Urinall Bidet - $3.00 -SoRener - $5.00 4, q. -Q 3 , n O
COMM./IN ATE OF TOSA BID PRICE PLUS $•50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
_
Signed: for
61
Approved Inspections: Date Rough Insp. Date Final Insp.
~ ' ~ ~~i'( , oL -f'~+~vaf~wK+il r'3r ~ V
. ~
' ko PERMIT # ~ CITY OF EAGAN FEE
> MECHANICAL PERMIT ~
RECEIPT # 454-8100 S/C
MINIMUM RESIDENTIAL FEE - $10.00 + $•50 TOTAL
DATE MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bidg. Type: Res VComm Inst 2. New Add Aiter Repair
3. Total Bid Price ~ a4. Job Address yas ~ .Su n r.s C.
Lot Block Sec U ~I FF j,~ T 5. Owner e r
6. Contractor 'r"lU~~1 ~ gCo (Name) '`r (Sheet) (City) (Zip)
7. Contractor Phone #
RESIDENTIAL NEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
~ HEATING VENTIIATING HOT WATER STEAM --"AIR COND.
_AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. HeFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./I A~1TE OF TOT/~. D PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
~
Approved Inspections: Date Rough Insp. Date Final Insp.
CITY OF EAGAN Remarks
Addition SUN CLTFF 1ST L 8 _Blk 1 Parcel 10-72975-080-01
~251 RI R EAGAN I~W 55122
Owner= ; Street 5tate
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
7
9775-79 995-16 9
STAEET RESTOR.
GRADING
SAN SEW TRUNK 1970 76,54 n6
• SEWER LATERAL c 1985 7.q4 ; ,09,59 , 02 (,2 X - '7 eo II5e 7
WATERMAIN
* WATER LATERAL 1985 -
WATER AREA 7
STORM SEW TRK 105 1971 327.29 16.11 20
,.53 ~ ~7 3 a
* STORM SEW LAT 85 CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 290.00 58947 9 86
WATER CONN. 500.00
BUILDING PER.
sac 575.00
PARK
CITY OF EAGAN WATER SERVICE PEWX
: 3830 Pilot Knob,Rwd 7088
pERMIT NO.: 1-15-
-Tr
' P. O. Box 211 J9 DATE:
; Eagen, MN 551?~1 ~ ~ Vnits:
;
' ZO"~"o' ' tc.~.
p us Rea ty
~
; pwrwr.
Road L B Sun C iff lst
: Sit' Addrompeine Plumbin
CMWWCNW owwv: 500.00 d
: Plumber.
~
, Aftr No.: 15 OOpd u~ peposit:
- ~
pem,it Fee: lo oopa
~-50~_
~ Readtr Na: N Surcfia?9e~
1.wM ~ M"'1 eM Cihr ~ ~ µi,a Ctwro" 1 32.00 d
~°M' Total:
Doa Paid:
BY ~rop,•
Dar. of . 1nsv.
CITY OF EAGAN VIIATER SERVICE PERMIz
3830 Pilot Knab Road pERMIT NO•c
P. O. Box 21199 D/~TE: i..
Esgan, SIIN 551?~1 ~ Uni~
Zoniny: _ . 1 u s ea ~ y
pwrwr:
/lddress:
Jl3Ar
Sft /1ddrow. ,s~. j ^ • ~ r, ~
PILKr+ber. C,or,nectfan Charoe: ;
Mehr No.: Deposit: -
Slu: peRnit Fee:
Raoder No.: urcFwro~~
~
I N~ to a~f IM Gh ~ ~vM S ? 3 2. 00 d TP
Misc. ChoroM
63.5" ' me ,
"MoOM' Total: i
pats Potd:
BY Irop.: .
pote of Insp.: 1
CITY OF EAGAN ~O SUvICE PERMT ry
3830 Pilot Knoh Road PERMIT NO.: .
P. O. Bux 21199 DokTE: '
Eagan, MN 551 Z1
No. of Unitst
Zaninp: .
. i 7
OwMr.
Addresz
$ /1Ridross: r s ~
•
P1urr+ber
Cornw:Hon aOrgo'
I M~ fe 'Mi 1h+ Ci1f ot LM'o
Accound Oepoft: '
O~iMwas. Pe?mk Fee:
Surchome_ `
Misc. Charo"
: BY 7otol:
4 Dote of Insp.: DoW paid;
i Intp-: i
_ .
CITY OF EAGAN nf 0 11424
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT (W.F.) PHONE:454-8100 Receipt# ~
70 6e used tor SF DWG/GAR Est. value $ 69 ,000 Date JANUARY 8 , 19 86
SiteAddress 4251 SUNRISE RD Erect Occupancy R3
8 1 SUN CLIFF 1ST Remodel ? Zoning Rl
Lot Block Sec/Sub. Repair ? Type of Const. V
Parcel No.
Addition ? No. Staries 4 6
W Name ~VANCE DEVELOPERS INC Move ? Length
Demolish ? Depth 48
o Address 3209 W TH ST. ~ Int.lmpr. ? Sq.Ft
City EDINAphone 835-5405 Install ?
a Name A PLUS REALTY Approvals Fees
$a address 7216 PAULSEN DR Assessment Permit $ 340.00
~ ciry EDEN PRAIE 937-2617 Water&Sew. Surcharge 34.50
Potice PlartReview 170.00
~W Name MINNETONKA DESIGN Fire SAC 575.00
ia Address Eng. WaterConn. 500.00
W ~;~y EXCELSNa 474-0844 planner water Meter 63. SO
Council Road Unit 280.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 1/3/86 Tr.PI. 132.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City Eagan Ordinan APC Parks
Si9nature of Permi Var. Date Copies
e TQ~1 00
A Buildinq Permit is issued to: A PLUS REALTY on the express condition ihat
all work shall be done in accordance with all a~p icaJbI/~State of Minn sota St~tutg~ an~d City of Eagan prdinances.
8uilding Official Q
~
~ For~ffice,115Q ~
Clty Of Ea~~Il j Permit#:
I Permi[ Fee:
3830 Pilot Knob Road
Eagan MN 55122 I oate Received: j
Phone: (651) 675-5675 Fax: (651) 675-5694 ~ starf: ~
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ` 2 dt Site Address:
Tenant: o % Suite
RESIDENT / OWNER Name: Phone:
Address / City 1 Zip: SIP~6/11?; .S~TF"qy
Applicant is: _ Owner ~ Contractor
TYPE OF WORK Description of work: /`F ~e c F f (~/J /VOG~ ? /~-~/~6''1 ~ ~SIO
Construction Cost: d / ~ ldd`~ Multi-Family Building: (Yes No
CONTRACTOR Name;~Y1/,~/~L1?°G? ~ License#: C 770 ~
Address:
ciry:.~~G Ls U~Z ~ 6~' State: ?'2 ~ ziP: A/ 2</
Phone: o - 7 2c ontact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 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 fssued 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 thai you submit are considered to 6e public information. Portions of
the rnforrttation may be classified as non publfc if you provide specific reasons that would permit the City to
' condudeihaf the are hade secrets: I hereby acknowledge that this infortnation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; ihat I understand this is not a permR, but only an appiication for a permit, and work is not to start without a permil; th e work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x_~! L x ~
Applicant's Printed Name ApplicanYs Signature
Page 1 of 3
`
7985 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED YITH THE CITY OF EAGAN
COlOiERCIAL SZNCLE FAHILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1'SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND ~ (r>q,000
n J
To Be Used For: r`CS rQ2~ rJ GValuation: :3Q~an-.- Date:
Site Address~-~a~g ~ jVIU~J~~ ~G OFFICE USE ONLY
Lot ~ Block Erect Sc Occupancy ~•3
r i, Remodel ~ Zoning I
Parcel/Sub SUr~ CZ1F~ /5 RDOIno~- Repair ^ Type of Const ]Z
n Addition 0 of Stories
Owner fi0 VdCNG~ k-416 • Move ' Length to
Demolish ~ Depth
Address 3~,09 (,V 1~'~Z 00~4S Int.Impr. ~ Sq Ft
~ Install
City/Zip Code
Phone ~ S! Uv- APPROVALS FEES
Contractor ~i PC U,~, -~NC . Assessments Permit 3~{0.
i Water/Sewer ~ Sureharge 2i¢•5-°
Address 7a/Co J)y'V,56" (lJfi1VL Police ~ Plan Review 4-10.
~ Fire SAC S7-5
City/Zip Code Engr Water Conn r .
Planner Water Meter (~3
Phone Council Road Unit ZgU.
~1 Bldg Off Treatment P1 132,
Arch./Engr. ~j~N/?.~T~'CY,1 ,~.{,.$l61'J APC Parks
' Variance Copies
Address TOTAL ~c yS
City/Zip Code
l/~/
Phone Il '7 77'l
-i-
o~
(
ip~
24x 44'-, I°~ x sv =~~Z48 •
i z , .
l C~ x( C~ - I no x 8= c~c~
cPg~c~o
4251 S^riie Q-owd
Ce& di/~ C. R. WINDEN 3 ASSOCIATES, INC.
LAND SURVEYORS Td 648-3646
; 1301 EUSTIS ST. fT. PAUIO MINN. 66100
~ FOR: A PLilS RBALTY •
N
% Scale: 1" = 30'
O Denotes Iron
$j Monument
n a~0~ ,O' \
6a
? / ~ so
~2s•~F•
2
Op 9.,
1 9D~~~~~~/ ~1 ~4
"Ob~/ y~~ 0 J ys~ \
4~ \ < o o0~y~. ` ~ ~ q1
~
90°
t-J ~s~ ?y 2A ~ Q
S y ~3 ,~o ~ O OQ
NOTE:
o Denotes Wooden Stake ~v
Proposed Garage Floor EIi90593
(9Q5-" Denotes Proposed
Finished Ground E1.
Iq- Denotes Direction ~v
Of Surface Drainage ~
Vertical Datum - N.G.V.D. 1929
Lot 8, Block 1, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
WE MERElY CERTIFI' TMAT TMIS IS A TRUE AND CORRECT RE?RESENTATION Of A SURVEY Of THE
BOUNDARIES Of THE IAND ASOVE DESCRIIED AND OF THE LOCATION Of All WIIDINGS, IF AN1;
TNEREON, AND All VISIIIE ENCROACMMENTS, li ANY, ?ROM OR ON SAID lANO.
Doted 1Ais ey 4_4lar of Nover"ber A.D. IVJS C. R• WIKDEN i ASSOUATES, INC.
~ -
5wr.qrsr, Minnwwh RpiNroti" 1'N. 9'726
,
Narin
` Naye 1"ot 4
EXTERIOR ENVELOPE hUERAfE "U" COMPUTATiON cI S 3'a,
. ~
OWNER; ~ nnrr I 0- q- 5~
SITE ADDRESS: P}IOPJE:
CONTRACTOR:_ ,~~~.QVSo?~
Determine working square footage of each
1. Total exposed wall area...,. =I sy. ft. x.11 = Z C_ z. 2'1
2. 7ota1 roof/ceiting area..... 1 C7) `I'~ sq. ft. x.026 = Z v;. G;!s
Total exposed wall area above floor=__-.; ~ _
a. Total wall window area
b. Total door area.................................................. c. Total sliding glass door area
d. Total fireplace waTl area........................................
e. Total wall framing area (average 10%)
f. Total rim joist area g. net wall area a6ove floor /
h. wall area above floor
i. wall area a6ove floor
j. frame watl area at foundation
Total exposed foundation area=
k. Total foundation window area
1. Total net foundation area above grade
Determine "u" value of each wall segment.
(e.g. window, door, eacfi separate wall section)
B. X uUu .14 rl
b. ' X 1.U11
,
C. N,iJ X liUu
d. X lluii _
e. X ,luil
p. X loul.
y, X ,~U" • _ ,_'/~r'_
n, x 4'u11 ~
t. x liui, _
,i. x „U„ = s .
If item N3 is the:s
k, X"U" = as, or less than it
ql, you have met:,th
1. X"U" = intent of SBC:600§
3 . . . . . . . . . . . . . . . . . . . . . . . . . _ _ ~•~;a ~4
.........Total
. . .r~.a~r+>.er.~......._,j.,.,. ..............r~__..'...l~. . .
EX 4•rior linvclopo Avcrtigc "U" ComputaCion Pagc 2 of A
•y. .
ToLal expo:;ed roof/ceiliug area = I L? `f
m. 7b1n1 ckyliyht aren -
n. TotaJ, rooF/ceiling ftaming area (.ivcr.agc 10%)...
o. Total net insulated roof/ceiling +xrea........... G y,7
. Determine "U" value for each roof/ceiling segment
M. % "U"
n. 1 C'. x IlUll
o. X.,U„ z_= Ii/ 78 .
9 4bta1 = Z Z ~
If total oP ;k4 is L•he same as, or less 1:han 02, you have met the intent oP
SHC 60U5 (c) 1.
Alternate Building Envel.ope Design
4b uY.ilize the total envelope'system method, the values established by the snm of
itenis N3 and #4 shall not be greater than the sum of items Ikl and I12.
l. 2 <<'G,'i~~ + 2.
3. + 4.
PLAQ *tr
~ Lr mF.~4 L FT. ,FXposE0 WALL
$LOGK. ;
iC,u~E ~ r7 l.
FULL I
tz.f~t~LAGE ~ ~
F~T, SK,P05ED wA LL AZEA
t3Loc~C'~ K , S =
kN E.F. x S"
w.o. ; I JC 8 =
Pu C, L I ; iLi~ I X
~:u LL 2 % ~c. S =
F. P, , , . - - -
To-rA l.. Lr
~SQ.~t. ~KaaSE.ll GEI LIUC~
~ w DwrS th ~ D ooszs 0,42
r~...~,
l Z
, Ii4T1 O DR.S,~i
, I
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F.a Uan.l'~y ~f cpaliun uall nrca Lor
frorsv: c<,n::lructiun
I i ~0 _"!c'3
' - - "O
L
5 . .7. t D.! ?.:o 4O ..(YZ.
31C G. F:r.lcrivr slr f iliii t).17
~ .
FIC. ql 7'Gl'VIF1J OF
• F1W1E WALL . 1. 1nCrc(nc aiv :11c~ _~U:GiI
_.6AL~ . .................__.__~.1~~J
• 3• _4'.'_.'Ir~Sul~....._......---------•--~°_l..o.
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_.._._...__o
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ric. 42
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tl
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Intecior air £ilm ~ 0.61
3, s,
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r~lll? ~ 111~_~ - ToraLl 4s8
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Heat floct ~ 1• Intnrior air Pilm ' 0.61
:.nted .S(`
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~ • - ~----r ' . • 3. .
5. Outside air film
4•
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v
2.
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keec llov up - i' . . 4. ~
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. 2.
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2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CIT, oF EAGAN
3830 PILOT KNOB RD - 55122
851-881-4875
New Conafiuclion Reaulrementa - (.A4- 1~ I I C`~ RemoaevReoar Reciuiremems
> 3 replaleretl slte wrveys showlny aq. K of lot, eq. 8. ol housa 2 caplea of plan
antl gj roofed areaa (2076 mmdmum bf eovemae allowed7 1 set ol anergy calculaHOns for heated additlau
D 2 coplea of plana (show beam d wlndow sizea; poured hM. design; elc.) 1 sile survey for axtedor additlons & deaks
> 1 set ol energy calculaflons
> 3 coplAS of tree PreaervaXOn plan i( lot plaHed cdter 7/1 /93
DATE: l0 - Zco CONSTRUCTION C05f: J-(~'062, CG~
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: 1~6 BLOCK: ~ SUBDJP.I.D.#: S~.+?J -t~h I S~
Name:~~F~~-°so Phone r/ o9OSfo<~c'n~
PROPERTY lasl /Flrat
OWNER
Sheet Addresa:
ci}y State: LP:
PhOn6i:
. Company: (area code) q
CONTRACTOR q/Q59O/
sheet naaress: Z2 Spucense 0 " ExP•
Clty Stpte:
ARCHITECT/
ENGINEER Company: Name:
' Telephone A: ( )
Street Address: Reglshalfon Y:
city State: 21p:
Sewedwater licensed plumber (If Installina sewer/water): Pho^a
I herebY acknowledye thaf I have read this applicatlon, siafe thaf ihe iMortnalbn is ca?ecf, and agree to comPIY wNh atl app6cable StatE
of Minnesota Statutes and Ciy ol Eagan Ordirwnces. i ~
Signature o( ApptlcanY.~
OFFICE USE ONIY
Certificates of Survey Received _ Yes _ No '
Tree PreservaGon Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundatlon ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ext. AR - SF
? 03 07 of _ plex ? 09 07-piex ? 18 Deck ? 23 Poroh (screened) ? 36 Mutti
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 5torm Damage
? 05 03-plex ? 71 10-plex Plbg _Y w_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bklg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
0 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories s4• ft•
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actuai) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS IN3PECTIONS
? Stucco/Stone
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
Treatment PI.
Park Ded.
Trails Ded.
Other
Capies
Total:
SAC Units
% SAC
2/84
CITY Ot EAGAN
APPLICATZ0N FOR PEI2A4IT
llpi
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) PReP='n?^! ACDRESS: e fS r.P
T.F^~%L nESC=Pr?cv: ,'i A' / C~ -~~(Lot/Block/Su::,aivisicn or Tax Parcel I.D. NLzrner)
~-CI::'~:G SM =TcE, DAT' 0F OiZTGi7i, uiILUI.`:G
L'•S: M R-1 Si;GL;. FP?ffLY .
? R-2 ~UPL..`"{ (T•~O UTMITS)
? r2-3 'IC'J.t~`:rvTCr (?~?n4, + D:TI':5) ( Wi ITS)
? R-4 tir:~::!"F'^:T/CG_3Ji,i•tr~1l~1i ~ U.iI_S)
? CCin1~CL?L,/RE"",.-.IL?Or 'I~
Q :NCliSiZZAL
? LNSTITUTICNAI,/Gv^V~,.`:~,E~'T
Z) AP?r,ZL_yT (PLFAJE Pft1;i1J
1`~i•~: ~L/li'/.l~' l S-i'(CUVl~//Jti
On
AL`DRE55: /r1~Cf C /z l/ /It~ G'~vY
CIT"_', SirT'P, ZI?: livdP r- C~r..• -r /~l`J' C~J rl.~ ,S-S'v 7S-
PHO-NE:
j) PLj,:.?n~ tPLEdSE PRItiTJ
~y~, ~ n L / FOR CITY USE O4LY
'
M)RESS: ~ ~ r-'--,e- P ERS LI+M'B L~, SF:
, L'k N/-~ rrryi ~J~ / I/r-• Ac 've
CI'. ST.aTE, ZIP: ~trrn r.~ ~e~,1
PAOVE: ~u~icr.
C,(6 3- PLUNBER LICE4SE N tc
' arr iTET nici~T
~ 0.'C.?.;?n,~r /Cr,;m ~ SPLEASE PRltli)
NP~: 4 / TJN
ADDRESS:
CI?"I, STA'I'E, ZIP:
i_ ri • rl ^LllY~
PIiO`IE: - A617
5} INDIC<,TE :•7HICH PER-SIT IS BEZtG REQUESTLID:
O'CGNNFCi'IOV TO CITY SETrIER
~CO^R`IECTICN 'IO CITY TqATER
? diI'ER (PLSASE D.SCI2IBE) 6)
• ? PI.°~SE F?OID APPP.C7VED PER%1IT FOR PICFC-U''t BY CNE OF AHOVE
? PLEASc :•*l+'SL APP?dJVED PU.•LtT TJ 1. 2. 3. VABOVE
(Circle one)
7) SZC.~,'IL:v.• .fi/~;~.~. ` DATE:
F 0 R C I T Y U S E O N L Y pr-R`^.IT " ISSUED
F°ES
$ S:.'::LD Py'J`\1T'i
$ U WATE? PE?utTi• ~ . {T~..>•C?.UDE Si:..C:ARGL1
$ WATv-R METER/COPFERHORN/CC;TS_'JE RE<',Dc2
$ Wpmro TAP ( INC:.CDE COR?OB.~^~TION STOP )
$ SE:vER TAP
$
$ AC:.OuNT D.^P0SIT - tiaT~3
$ ~~n~
$ SAC
$ TRliVK WATER AS5:55::=:iT
$ T3i::1K S: 'NER ySS=S-S:'ENT
$ L:.,c?,AL BE:vEr^ZT/TRli`dK' SE': %TE-
~ I.ci.LR.a.L BL.NLr1T/TCU~:1( ;':Hmr~
$ WATER TREATPIEn*T PL.A:\'T SLBCHARGE '
$ OTHER:
$ TOT:,L
AIMOCi.:T °AID/R:...:.I_ _ ,1,
DCES UTI:.ZTY CO.:NECTION REQUIP.E EXCaVATION IN PUELIC RIGHT OF WAY?
~ YES IF Y£S, THE:: N"PERMIT FOR '.dOBi: WITHIN
PllBLIC ROADSVAY" MUST BE ISSliED BY TF?E
~ NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.' '
SliBJECT TO TFiE FOLLOSVI:IG CONDITIONS: •
APPROVEp By: -
TI:LE: .
DAT°_:
Use BLUE or BLACK Ink
r-----------------,
I For Office Use I
I
Permit _
,Ilk MIR
City Of Ea I Permit Fee: U~
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
2 3 /f
Date: Site Address: 42`7 S / uN I S F 0114 Unit
Name: h ce-/10/x/! S Phone: ~S l " 2 T 17 Z
Resident! X16' Rte/ SS'` 2 z
Owner Address / City I Zip: /
Applicant is: Owner _ Contractor
aO
Type of Work Description of work: AE 'D
Construction Cost: ov d, = Multi-Family Building: (Yes / No
Company: /,91 ~yOap~ Contact: Z)I/~-c L
Contractor Address: -2 9 y 3 City: r rv P
Stater Zip:/27 Phone: 41,12-
License
~~D 8 Lead Certificate
I
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
i
i---
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:
c Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.oopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ~lG7I/I L 2-Afr/ga-) x
Applicant's Printed Name Applicant's Signature
Page 1 of 3