4299 Sunrise RdOity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
cc,
r
Use BLUE or BLACK Ink
For Office Use
Permit #: I 000
Permit Fee: cS, v O
Date Rec-ived: /r(,� !/
Staff:
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 7 - - ! ( Site Address: 171,;i9 T5 2 2 -
Tenant:
To66tt \i(' 'Lc - e/Mge.. %(sat
Suite #:
Name:
1(71 gie(s ,/ 5xke
Address / City / Zip: £ tf7 _Siiii/2C,
Name:
Address: City:
State:
Contact:
cen Phone: 66-7- %Y 4/634)
714A moi. N/
Se& License #:
Zip: Phone:
Email:
PLUMBING (Within the building envelope)
V mp Pump Repair
()there ? i2e?
t
9id
SEWER & WATER (Outside the building envelope)
Repair
Other:
Description of work:
FEES
$55.00 / Each (includes $5.00 State Surcharge)
TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
x/��►P tr96P/1
Applicant's Printed Name
x
Ap
s Signature
Required Inspections:
CITY OF EAGAN 9361
, 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100 1-7-
BUILDING PERMIT Receipt # ~Iv
To 6e wftd fer SF Dt9G/GAR Est value $ 6 2,0 0 0 Date AUGUST 1 19 8 4
SiteAddr 4299 SUNRISE RD Erect R3
~ Occupsncy
Lot OP Block Sec/Sub. SUN CLIFF ST Remodel ? 2oning RJL
Parcel No. Repair ? Type of Const. V
Enlarge ? No. Stwies
~ Name I-i}:RITAGE ENERGY HOMES INC Move Cl Length
Z 4655 T11 OI.S RU Demolish ? Depth
~ Address
City G Phone - 5 950 Grade ? Sq. Ft.
S ILNjE Approvols Fees
Z~ Name
Ou Addreas Assessffw^t Permit -519.00
31.00
u~ City Phone Woter d. Sew. Surchorps 159.50
Police Plan check
r'W Name Fin y,C 525.00
~4ddress Erq, Woter Conn. 4 7 0. 00
u=
tW City Phone Ptonne? WcterMeter 63.00
Council Road Unit 260.00
I hereby ocknowledqe that I hove, read this opplicotion and stnte thot gldg, pff. Parks
rhe informofion Is corcect and ogree to comply with oll applitable APC Total ~ ~
Stote of Minnesoto Statutes and City of Eaqon Ordinonces.
Var. Date
Slpnaturc of Permittee
A Buflding Permlt is Issued to• iiERITAGE ._.;,;;;i~`1 S ItlWn the express eonditla? Ihol
oll work sholl be done in oaordonce with all,ropplicable State of Mlnnesoto Stotutes ond City of Enpon Ordinances.
Buildinp OfftNal
Psrmit No. Permit HoMler Date
Plumbinq
H.VA.C. I g"j g ~ 1'~i ~ f ~5
Electric
Softensr
Inspsction Date Insp. Other
Footinyt
Foundation
Fnming
Rouyh Pibp. 3/-
Rouqh HVAC
Inwlation
Final Plbq, p
Final HVAC
Final O•~5•~ ~ Cw't/Occ.
Waar DosC?ibe LocMion:
Wsll •
Sower
Pr. Dhp. '
Receipt
MECNANICAL PERMIT Parmit No. CITY OF EAGAN Fee
Fill rn numbered speces S/C '
Type or Prin[ legibly Tot.
1. Date 2. Installation Cost '
3. Job Addresso?w $u.d~PjSE Lot ~ Bik.,:,)- Trac~ ~
4. Owner`~E.P/Ti`1C~ EiVC~C~l~ ~~G~I C~s ~ (
93
5. Contractori,)f?UAJcit/ ~S t/; 4 Phone y-~~ S 9
6. Address lO ~Q (..e (~S-r~~060O T C/~
7. Cit~~C~ ~~'`~•~r~ State AW 2iPS
8. Building Type: Residential tg" Commercial O Institutionai ?
9. Work Description: New B" Add ? Alter 0 Repair ?
10. Describe Fuel Type CQ~~
11. No. Eauinment BTU - M. Ea. No. Equipment CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and 1 agree to
comply wit4 all ordinan and codes governing this type of work.
~
Signed : 1 w for
Rough F inal
Inspections: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-5700
Receipt~ PLUMBING PERMIT Permit Na LI
CITY OF EAGAN Fee
Fill in numbered spacea S/C
Type or Prin[ legibly
Tot.
1. Date 2. Installation Cost
Ci
3. Job Address ~T 5lk Blk. ~ Tr ct
4. Owner T-A F L
5. Contractor U,A uc Fi'1 Phone 1),31) ILI ;
6. Address 41(, 7. City i'~ State Zip
8. Building Type: Residential 0 Commercial ? Institutional ~
9. Work Description: New~El Add ? Alter ? Repair O
10. Describe ?J~-'~ I- i ( I . I >
11. No. Fixtures No. Fixtures
i Water Closet Cesspool/Drainfield
~ Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : f l J+l,-i s for
- Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks ' ' /'f'i`
Addition SIN CLIFF 1ST Lot 7 elk 2 Parcel 10-72975-070-02
owner/2.41 streec 4299 : srnvxrsE Raan State EAGAI+i MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. C009838 10-1 -8
STREET RESTOR.
GRADING
SAN SEW TRUNK 197 76.54 3.06 ZS
SEWEFi LATERAL 54 x ? an
WATERMAIN
WATER LATERAL jC X nr.n 7 C009938 10-19-84
WATER AREA 4 15 12.56 C009839 10-19-84
STORM SEW TRK 05' 1971 322.29 16.11 20 80.64 C009839 10-19-84
STORM SEW LAT - ~ K1985 789.70 4 789.70 C009838 10-19-84
-e K1985 776-63 155.33 5 776.63 C009838 10-1 -84
CURB & GUTTER '
SIDEWALK
STREET LIGHT
Road Unit 260.00 #45127 8-1-84
WATER CONN. 470.00 BUILDING PER. #9361 i~ 11
rr
SAC 595 - 100
PARK
CITY OF EAGAN WATER SERVICE PERMIT
8830 Pilot Knob Ftoad :
P. 0. Box 27199 PERM(T NO.:
Eagan, MN 55121 D^TE:
Zonirtp: ~ No. of Units:
. • r a ~ tiOIIl28
QWf1ef:
re4090 XNARMI"O
, ~ B2 Sun C i yt
- ir0 ~dd~8 , _ S Etc.
' Plumber. ` L. + r .
P
Meter ' ~dion Char9e:
~ No •
Stu: A~ocour,t Depostr: 10.00 pd
Reader No.: PeRnit Fce: .50 pil
1 prM to oa+Pl1? wMb !iw Ciep of Eoge¦ Surchnrfle: 63.00 pd me teT
Ordiw~~s. Mlsc. Chorges:
Total:
By ote Poid:
Date of I
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob iioad Se37
P. O. Box 21199 PERMIT NO.:
Eagan, MN 5~~~1 D/ITE: V 7 i
Zonirg: of Units:
r e.r ng,e .nerh orah
Owner;
Addroas:
Si~ unr se oa un
Plumber. ° n co a lllb;,r
470.00
No.: Connection Charye:
15•
Siu: Acooumt Deposit:
Reader No.: Permit Fee: • P~
1 prw w" Pllr wiN~ t~ Cihr af E~¦ Surcharge: ~
. r
Ordi+anem Misc. Chorgees:
Totol:
By Date Paid:
Dote of Insp.: Intp.:
CITY OF EAGAN SEWER SERVICE PERNIR
3830 Pilot Knob Road P. r- •
P. O. Box 21199 PERMIT NO.: 1- -'3
Eagan, MN 55121 DA?TE:
Zonirq: P.1 No. of Units: 1
Fietitage Ener~;y }io;aes
Address:
Site Address: 42 9 Sunrioe Road L7 82 Sun Gliff l~s[
Plumber, Dstota PlbR
3•-1-84 45127 100.0U p
I.y.ee ro eompiy wih cr. ptr ef Eels¦ Conneccion Charoe. 41-5. CO pd
Ordinanas. Account Deposit: 15.00 nd
Permk Fee: 10.00 pu
SurcFwroe: . 5) 1)d
gy Misc. Choroes:
Dote of Insp.: Total:
Insp.: Dcift Paid:
This request voiA ~U~ '~~17j1O j
78 rtqnths /mm -
q 41770 v'D Si.-,. W
Re t Date Fire No. flouBh-in Insvection ITLI
]N v flea ~etl? eaAy Nowll Notify Inspec-
~ Yes ?No Wr lqhen Ready
icensed Elec[rical Conuactor I M1ereby request insoaction of abave
Owner elechicel work instelletl at
Stree[ AAdress Box or Nowe No. CitY ~ ~
~ r' .
ecUOn Towns ip Name or No. fl nge No. Co,W~tiL
I\
~7~~ n
Occupent INT) i Phone No.
~ i~SZ-S`!td
Power plier /Address
I A1'0 712.f~ GI(~lM~/V -+j16rV^0%
Eleclric 1 ont acw[or ~Company Namel 1 Conlrac'tor* License No.
1 A~ 1.P'-~\G OL/L
Mailing AdJress (Contrac[or or wner Mak' g Instailation)
t - 3 `yL . m ~ ~
ized Signacure (C Va or wner MakinH Installa[ion) Phone Nu e=
a~
THIS INSPECTION pEQUEST WILL NOT
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs-Midway Bldg. - poom N•191 BE ACCEPTED BY THE STqTE BOARO
1821 Univeraity Ave., St. Paul, MN 56104 - UNLESS PROPER INSPECTION FEE IS
NCLOSE~.
Phone 16121 297.27'11 E
c(-~oa3 REQUEST FOH ELECTRICAL INSCTION EB-00001-04./
See instructions for completiriguhis fo.m on back of rallow copv
ra,t~~ T
A 4 Pf ~Q X" 8elow Work Covered by This Request
Adtl Rap. TYPe of BuiltlinB APOliancea Wi~NI Equipment WireJ
Home Range Temporary Service
Duple,x Water Heater Lightinp Fixtures
Apt. Building Dryer Electric He2tin
Commercial Bldg. furnace Silo Unloader
Industrial Bldg. Air Conditioner Butk Milk Tdnk
Farm Otnrr oe=i y tn,,. (spe,fv)
c v~ ut*ci v oiner oro~.
ompute /nspection Fee Below
p Fee ServiceEntranceSize H Fee Feaders/Subfeeders d Fee Circuits
U to 200 qm s 0 to 30 qm ps 0 to 30 Am s
Above 200 Amps 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100_A'mps
Transrormers Irrigation &ioms m Partial-'Othei
Signs Special Inspection S~ ~1 TO7 F 'l
Remarks d
flough-in Date .
, the cal
InsOector, hereby Final p. 1e rt ify that the above inspectian hes bean
IZU
tMS request voitl 18 montlia from
' CITY OF EAGAN N? 9361
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
BUILDING PERMIT PHONE:4548100 2eceiPt # ~ c-
% Te M used fer. SF DWG/GAR Est. Volue $62,000 Date AUGUST 1 1 y 84
'SiteAddress 4299 SUNRISE RD Erect rD Occupancy R3
Lot 7 Block 2 Sec/Sub. $UN CLIFF IST . Remodel ? Zoning Rl-
Parcel No. Repair ? Type of Coast. V
Enlar9e ? No.Stories
~ Name HERITAGE ENERGY HOMES ;INC Move ? length
z 4655 NICOLS RD Oemolish ? Depth
Address ?
City EAGAN phone 452-5950 Grade Sq. Ft.
SAME Approrala Faet
o Name
Address Asseument ' Permit • 00
City Phone Water&Sew. SurcFwrga 1.00
V~ 3
Police Plan check 159.50
Name Fire SAC 525.00
Fw
~z ,4ddress Eng. WarerConn. 470.00
mW Cify Phone Plonner WaterMeter 63.00
<
Council Rood Unit?60..0
I hereby acknowledge thot I have read this application ond stote tFwf gldg. Off. Parks
the informafidn iscorrecf and agree to comply with all opplicoble APC Total $1 r 82~. SO
irote of Minriesofo Stafutes and City of Eoyon Ordinances.
. . . Var. Date ::Sipncture of Permittee-
A Building, Permit is~issued to: HERITAGE EIVERGY HOMES INrm iho exDress conditlon tha+
till Hvork shall tie done in accordarxe with oll plicoble n e Minnewto Stotufes and City of Eogon Ordinantts.
Buildinp:Offldol ; ~1r \vl~(~,~?
CIT}t OF EAGAN Include 2 sets of plans,
1 Gertificate of Survey=&
IILDING PERNIIT APPLICATION 1 set of_ energy calculations.
Zb Be Used For ~ Valuationllj (,2,0!~:O • ~ Date 7(
Site Address 4;~- T S' 3,w21 Y L (N_ OFFICE USE ONLY
Lot ~ slock ~ sec./sub.StiuCLi+=r-
--Erect X occuAancY IZ-3
Paroel I (D s" - 0 `1 0- aAlter Zoning 2- 1
~ Repair Fire Zone
Owner:~M.~t Enlarge _ Type of Const. SZ-
Nbve # Stories
Address: DEKplish Fxnnt ¢3 ft.
City/Zip Code: Grade Depth 4C~ ft.
nhone
APPROVAIS FEES
Contractor: d G-/t-I '("11-Q c C ozt:, y l.I rm Fs Assessaents pesndt 3 I 9
34 Address: 44S~' r!J)COLS 1<14?. [4ater/Sewer Surcharge
Police Plan Check I G q..o
City/Zip Code: SS'/ 2-"}' Fire SAC 525,
Phom L/S ~s o II1g. water Conn. 4~CJ. Q°
Planner Water Meter
Council Road Unit
Arch•/En9• : Bldg. Off.
Address: APC
City/Zip Code:
Phone TOTAL
~ ` ~ w •~a~.
N p
N -
1, p
pC ~
^ Ul
~
, n n
Ui
c,e
12726
;
~ ~~~c~~,6
City of Ea~aIl ; Pe"it# ;
~ Pertnit Fee: ~
3830 Pilot Knob Road
Eagan MN 55122 j Date Receioed: j
Phone: (651) 675-5675
Fax: (651) 675-5694 1 staff: j
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Oate: ~ Site Address: `7 Z-~ ~ ~~?i'~ t" i~ d
Tenant: Suite
RESIDENT/OWNER Name: rJCJh j VbU! S Phone:
Address / City / Zip:
Applicant is: , Owner 4 Contractor
TYPE OF WORK Description oi wow D(V- /ce',P,o 0~c
Construciion Cost: Multi-Family Building: (Yes _ I NoJ( )
/-T-
~
CONTRACTOR Name: 14,&_ License
Address: -tt- iOD
city: state: RA~, 11 ziP: s3 3 3~
Phonel~5~ Contact Person: ps Ve, !`t'S
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 7 Worksheet ~ • New Energy Code Worksheet
Category Submitted Submitled
submis5ion type) • Energy Envelope Calculations Su6mitted
In the last 72 months, has the City of Eagan issued a permit for a similar plan based on a mastar plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
5ewer & Water Coniractor: Phone:
NOTE: Plans and supporting documenfs that yousubmit ace eonsideXed xo be pubAC7nformation. Portinn'ro€
the information may be olassified as non-public if you provide specific.reasons;'that wauld permit the CiCy to
conclude that fhe •are trade secrets:
i hereby acknowledge that this information is complete and accurate; that the work will be in contormance with the ordinances and codes of Ihe City of
Eagan; that I understand this is not a permit, but oniy 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 ihe case of work which requires a review and approval of plans.
X T)iG,hi~ SS&A,~I ~-~r X 4~~ f`
ApplicanYs Printed Name ApplicanYs Signature 1.3
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation ? 05-plex ? 16-plrac ? Accessory Building ? Pool
? Single Family ? 06-plex ? Pireplace ? Porch (3-season) ? Ext. Alt. - Multi ? 07 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? OS-plex ? Deck ? Porch (screen/gazebo/per9ola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04•Plex ? 12-plex . ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building'
? Addition 0 Move Building Q Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
' Demolition (entire building) - give PCA handout [o applicant
DESCRIPTION:
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100°/ Zoning City Water
Census Code Stories 6ooster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers ,
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: Footings Air/Gas Tests Final
- Praming Siding' Stucco Lath -Stone Lath Brick
-
Fireplace:_R.I. _AirTest _Final Windows
_ Insulation Retaining Wall
Reviewed By: , 8uilding Inspector
-
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2 of 3
U-kdt r
N~~ HEI~ITAGE Energy Homes, Inc.
4655 Nicols Road - Eagan, Minn. 55122
"We Build the
Amencan Dream" OCt. 21, 1984
City of Eagan
Aiien: Building Inspection
Re: New Home at~k~2,,q9.s~rise Road"
Gentleman:
This is to confirm that I am aware of the code requirements
for a hand rail on my 3 risers to the bedroom area. This
railing will be installed prior to iqy selling the property
to another party, if not sooner.
Respectfully yours,
Paul HafstadA Homeowner
,
Tei. 452-5950 / 454-4559
G. R. WINOEN 3 ASSOCIATES, INC.
IAND SURVErORS Tat 445-3i4•
1381 EUSTIS iL, ST. MUI, MINN. Sd10t
dOi:
AERITAGE ENERGY HOMES
N
~
,
~
~Q9F Scale: 1" = 30'
iQ r~h e O Denotes Iron
Monument
h Q
> Sl'FQT~pI.
, • i..
0 o-, . OQ J5 h / w~'
~ Qt ~o ~ e
~ \ 2s3~ \q l~~rQC~ ij 3a Y i
_rj
NOTE: ~~59.. ~P~^PC
c Denotes Wooden Stake
Proposed Garage Floor El. $ 95.13 ~
(894.8)..Denotes Proposed
Finished Ground E1.
1-- Denotes Direction
Of Surface Drainage ~
Vertical Datum - N.G.V.D. 1929
Lot 7, Block 2, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
WE NEREIY CERTIFY TMAT TNiS IS A TRUE •ND CORRECT tE?RESENTAt10N Of A SURVEI' OF TME
IOUNDARIES OF THE IAND A10VE DESCRISEO ANO OF TNE IOCATION Of AlL SUIIDINGS, If ANY,
TMEREON, AND All VISIOIE ENCROACMMENTS. If ANY, fROM OR ON SA10 lANO.
Doted #Ai.~dar oi Ju A.D. 1984 CR. IDEN & ASSOCIATES, INC.
SYrr"pr, MipaoN/O Rpulrotion Mo772e,
M111 n
C
~
' EXTERIOR ENVELOPE AVERAGE "U" COMPUTATZON E L
Obi1NER:
SITE ADDRESS:
CONTRACTOR:
DATE :
I. Design Consideration: SBC 6006(c)2 .'I
Total exposed wall area: I-A^jI)
AREAS SQ. FT. X "U" = CALC. "U°
Windows
Doors ~ ~~,y 2 ~ L(p
Sliding Glass Door 40 ,414
Wall Framing'Area (avg) jp2 #0405 Net Wall Area ,p-~6 3L•
Rim Joist Area ~ v .OS 5.
5
Total Net Foundation (y ,v
Total Calculated "U" is:
Since the total calculated "U" is less than the design
qualification required, we have met the intent of SBC 6006(c)2.
II. Design Consideration: SBC 6006(c)1
Total roof and ceiling area: ~UZ~j x~p+5 'ZV ~~/5?
,
AREAS SQ. FT. X "U" = CALC. "U"
Framing Area (avg) (b2 ,p~q(o ~~q
Net Insulation Areas ~p~ 11,~
Total calculated "U" is" ~~,5z~ 2~/•~iFj.'. D(4
Since the total calculated "U" is less than the design
qualification required, cve have met the intent of SBC 6006(c)1
, • .
, .
,
' '
.
- IWT• alg.:.:1U5 ItJT AEp- ~C.CPJ
S.R. & Siding R.
Stud V' 82 Ins.
. 1h/51 PA(1-Shtg. Shtg,
. IIj, INT~Ny ' S•0
Sidinp, `Siding 1 ~rr, iuS, ri`•d:' .
. ~ Exb. Air 11 Ext. Air
T:)tBl nRn T-)tbl "R't a
. l/g ifUn 1/R = ^(Tn
.
, . THRU CETLIN~ Int. Air •~08 THRIJ CEIT,ING Int. Aia Ci$
MEhIDER S. R. INSUI,ATICIIV S. R.
C1p,. Member Ins, - 50~0
. Ins. ~~(o Still Air •Cvl
Still Air To tal ,IH"
Tntal rtRn l/g = "IJ^ =
i/x = ,tUtt ~ vlqlo ~
;
1~.
DiR'fJ CONC. BLTC. Int. Air , l08 TKRU RIM JOIST • Int. Ai* r(06
C,B. (12") Ins. 1',!x'0
Ins. (OPt. ) ~ • ~ 14" Wood
Ext. Air Shtg. 2.0(0
g.R. (OPt•) ~ SidinF
_ Sidin€ (Opt,) ' Ext. Air
• , :i
Tot61 nRn Totel nRn
~ .4-t 1/R ~ nUa, _ ,~S I If l/R : aUn = OKj
• - r ~ . i '
I
,
.
~
2/84
CITY OF EAGAN
APPLICATZON FOR PERtiIIT
SEWER AND/OR WATER CONNECTIO.T
(PLEASE PftINT)
1) PROPERTY ADDRESS: `7c~
t.Frar• DESGRIP'SICV:
(Lrot/Block/Subclivision or Tax Parcel .D_ Ntmber)
u~{I~~' ST.°.ti'C17^:2E, DaT° 0° ORIGi dAL .=;ui2LL`L`IG P=Sm _TCSLL:~%C^:
~ Pti_Sr`~_^ z'^„`7I`Y:/F.-.wC,1DCSED U5E: S'~uIGLE r^P?ALILY
? R-2 DUPIEX (TA'p LNTTS)
? R-3 TCAT7HGYJ5E (TfffLE"' + UNITS) ( UNZT5)
? R-4 FLpAR'2^.ENT/CJ,TDCYS°LIILnl ( (NITSi
? CONffIERCIAL/RESAII,/OFFICE
? LIMUSTRIPL
? INSTITUTICNAL/GGVEEL Ziv'P
2) ApPLIG'\NT (PLEASE PRINT)
N*IE: _D-4 i.t o TA P1--(0
ADDRESS: yC) -3 (l D j /LiJ )7-
CITY, STA'!':.', ZIP: ~LN~ ire~ I"~ X-)
PHONLE: LJ ~ ~l ' Ln ~ Ll ~
3) PiumBER PLEASE PRIHT) FOR CITY USE ONLY
NF4ME: C}2.7 J-2 /-1 CC-
, ~ ~ O PLt1N ERS LICENSE:
ADDRESS: f /jL~V ~ , f~,~L;T Attive
CITY, STATE, ZIP: E"~}.~ J.,t ~ Q Expired
PHOiVE: 'L '~~tR Q No~ of Record
PLUMBEFl LICENSE Nd6p--,)0q
arr nitia
pCCUPpNT/a~ZTER (PLEASE-PNINT)
NPME:
AwDREss:
CITY, STATE, ZIP:
PHODIE :
5) INDICFII'G W[IICH PEP.NLiT IS BEI[QG REQUESTEO:
Q--Gffiv7VFX.T20N TO CITY SEr]ER
~*.~"VECi'ION 'RO CITY SJATER
0'I'IEEt (PLE'I1SE DESCF2IBE)
6) L°IpIG`,T::' O.y'E:
E] P?,EASE FiOID APPROVID PERtitIT FOR PICi:-UP BY O:IE OF ABaJE
~°LEASE MAIL APPRaVM PEP-%LLT TO 12 3, 4 P.EIJVE
(Circle one)
7) SZ .G~IT TL.'RE: &'L DATE:
' -
_ r •
F O R C I T Y U S E O N L Y PERMIT ° ISSUED
F~rs' $ ° SET^iE~ nro~tT; (?`1C=.:;DE Sli.°,C??2i<GE)
$ i a• d WATER PERb4IT (INCLUDE SURCHARGE )
$ WATER METER/COPPERHORN/OUTSIDE REAuER
$ WATER TAP (INCLiiDE CCRPORATICV STCP)
$ SE:QER '.`nn $ ACCOUNT DEPOSIT - SETr:ER
$ ACCOUVT DEPOSIT - WATER
$ WAC
$ SAC
$ TBUNK ?QATER ASSESSAIE:IT
$ TRliVK SEWER ASSESSME:IT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ TOTAL
$ AAIOUNT PAID/RECEIPT $
DOES UTILITY CONNEC;ION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
E= YES IF YES, THEN A"PERMIT FOR WORK WITHIN
~ PUSLIC ROADWAY" MUST BE ISSUED BY THE
NU ENGINEERING DIVISIOIV_ LIST AS A CONDI-
TZON.
SUBJBCT TO TFIE FOLLO?4ING CONDITIONS:
APPROVED BY:
T I T L E : -G/-Zf--~
~
DATE: y - ~o- 7
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" CASH RECEIPT
CITY QF EAGAN
. .
P. O. BOX 21-199
' EAGAN, MINNESOTA 55121
DATE 19
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FROM '
AMOUNT $
Q DOLLARS
+oo
? CASH Q'G`HECK
FOR
FUND CODE AIAOUN'
Thank Yau
BY
4
White-PaVers CopY
Yellow-Posting Copy
Pink-File Copy
CASH RECEIPT ~
~ CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19
.01
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FROM ~
AMOUNT $ 7 I ~ V~
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~ CASH [)~CHECK
FOR
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FUND CODE AMOUNT 17 V
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White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
411)
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Staff:
Fax: (651) 675-5694
RECEIVED
Q12
Use BLUE or BLACK Ink
For Office Use
Permit #: / 8�/�y7� L(o
Permit Fee: C/
— f .:6
Date Received:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 2(� , Site Address: Li 2. q 5u/11v/se lam- • Unit #:
Name: J3O ne e. X"/ iv i1011 s 0)---1
Address / City / Zip: `T/t"///7 / _,9/
Applicant is: Owner V Contractor
Phone: I" 'i 4- `7' Jsf)
Description of work: 14 (/v /} wv
11)1( 4
Construction Cost: '4I 461 it 'OD Multi -Family Budding: (Yes
Compar Beet Exteriors
8017 Nicollet Ave S.
Address Bloomington, MN 55420
PH: (952) 887-1613
State: _ F: (/952) 887-16359
License* lC00te()t'.e lt
/No )
Contact:
City:
Lead Certificate #: I i /T' ?? 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
i V VveA ,qgi
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:
I Licensed Plumber: Phone:
Mechanical Contractor. Phone:
1
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents; that you submit are cons r+ed to be public information. Portions of
the information may be classified as non-public if you providespl iRc raelaalons that would permit the City to
conclude that the are trade secrtets
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.00pherstateonecall.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 Building Code must be completed within 180
days of permit issuance.
x Sk th fih/ %//Y�i
Applicant's Printed Name /
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113762
Date Issued:09/09/2013
Permit Category:ePermit
Site Address: 4299 Sunrise Rd
Lot:7 Block: 2 Addition: Sun Cliff 1st
PID:10-72975-02-070
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Robert J Nichols
4299 Sunrise Rd
Eagan MN 55122
(651) 994-4550
Reroof America
10740 Lyndale Ave S
Suite 10W
Bloomington MN 55420
(952) 888-8440
Applicant/Permitee: Signature Issued By: Signature