4266 Svensk Lane
cIrY oF EA"N
, 8795 P'let Knob Raad Ee9ea, MN 55122 N2 4899
. PMONE: 454-8100
BUILDING PERMIT Receipt
Te be uaed for Est. Value Dote t 9=
Site Add?ess =12 t~G Erect Occuponq 7
l.ot 91oCk ~ Sec/Sub. Alter ? Zoning
, . . ~
Parcel Repoir ? Fire Zone _
Enlarge p Type of Const.
W Nome Move ? Stories ~
Z Addr Demolish ? Front ff.
~O Ci L[1Phone ~ 84- 7 Grode ? Depth ft.
& Name ApProrab Fees
Z~ Assessment i 7`.` Permit
Addmss
~ Ci Phone Water 8 Sew. Surcharge
Police Plan check
G W Namo Firc SAC o n•00
u~ Addrcss Eng. Water Conn.
<W Ci • phone Plonner Water Meter
Countil ''c>::Cl T' I i. ? . I hereby acknowledge thct I have reod this opplication and state that gldg. Off.
the information is corred ond ogree to wmply with all applicable APC Totcl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
/1 Building Permit is issued to: on the express condition that
all work shull be done in accordonce with all applicable 5tate of Minnesota Statutes ond City of Eagan Ordinonces.
Building Officiul
.
r.mM # o.ft b.we p...m..
Plumbin9 i / (o 6 7 u2 ) " 26 C'--
_Mechanicol 78'
INSPECTIONS DATE INSP• Rouph-In Finol
Footings Date Inap. Dote Inap.
Foundation Plumbin9
Frame/irts. Mechonital
Finol
RemQrks:
i`
~ F q . ~ `~L
~ r . c - - ~ . .:`z ~r - _ .4 - ' - - - _ . c ~ ~ D e~~ ,
Mk~e~ftftr~t~~e
~GC[tp Of ~agatt
}
3\ A ;
This Certi ficatc ilsued psrrsuant to tbt requinmcnts u f Section 306 o f tbe Uni f orm Building
• °
Code eerti fying that at the tr-ne o f i.rsuame this structure wus rn eam pliance with the various
L~! ordinuaee.c o f tbrCity rrgulatr»g building construttion ar use. Far tbe followtng: 3a 4:~
r~' ! Single Family• 4899
'UxClmifiratim I v BIdg.Permi~No.
C?_
; Qeapaney Type Conalructkai Firc 2one 3 Zoaing Dietrict
McAppe~ Inc• Addrcn10800 Lyndale So., Blmgtn.
'
2 6 vens ane Wi . un
bth
cocality I'Sd , ? I
BY'
~
'
Date:
1 \
'"T IN ? CpN,M"GUOUf ?LAC[ G~ ~
. . $ R
ara._.--°
~
, ~ -r.~+. l ~ _ ~uno t~,~ tta~.. u ~ ~ ,wt~, s z ~ ~
tso~ ' - ^ z~. ~ ~ , ~ ~ .A"
°
~ , , _ s - . • . ~ _ ' . . ~ _ ' ; v~..5.n. . .
G~acS aM
. CITY OF EAGAN
9795 Pilot Knob Read
, Ea9ee. MinnasoM 55122
, Phona: 454-8100
r
_ PERMIT No.
61,28;,- -0;. ,
Date: Receipt No.:
4266 .,vcr,11: Sin91e I
Site /lddress: Residentiol
MuIH Res., Comm./Ind.
Lot J Block ~ Sub/Sec.
12
Name . . _ _ _ : ; . .
New/Alter./Repoir. . 3 Address Cost of Instnllotion
~ :~IOOf?1111t3tG1~ t364-,:
City Phone: Permit Fee
tcay toel ter • -
` Name Surcha?pe
~ Address
e
V . .
City Phone: Tota I
This Permit is issued on the express condition thot all work shall be done in occordance with oll opplicable Stote of
Minnesota Startutes ond City of Eogan Ordinances.
Building Officiol
CITY OF EAGAN
3796 Wlot Knab Read
. . Eoyen, Minnesofo 55122
• ' Phene: 454-8100
!'L ~+:til trli pERMIT No. 11
Dote: Receipt No.:
I
4266 Svensk Single
Residential
Site /Mdreu:
~ otji(i. dL171 ~D'f'!1 I
Lot Block Sub/Sec. Multi Res., Camm./Ind.
Con~,t,_. cticn new
Name New /Alter. / Repoi r
- ]~;BOG Lynda] e „ve. :~o.
~ Address Cost of installotion
i3loominntcn 8 8 4-"%'22!:
City Phone: Pertnit Fee
Nome Thompson Nlumbing Surcharge vp
.
~ 12241 j'Aka. iilvd.
P Address
e
City Phone: Tota I
This Permit is issued on the express condition that all work shall be done in accordence with all appliwble State of
Minnesota Statutes and City of Eagon Ordinonces.
Building Officiul
CITY OF EAGAN Remarks
Additi Wilderness Run 5~h Addition Lot 19 Rik 1 Parcel 10 84354 190 Ol
Owner~,I:i},,,} ''h4yt1p1 G. at414~~treet~l266 r18 Svens3c Lar\--6 state Faqan , MN 55i23
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK C-OQ4 1973 $132.60 6. 63 20 92. A006696 9-15-78
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM 5EW TRK 1981 245.00 16.33 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 250.00 10948 7-21-78
BUILDING PER. #4899
sAC 500.00 10948 7-21-78
PARK
V;
.
CITY OF EAGAN 7319
=745 POW Kw6 Roed Eoyoe, MN 55122
PHONEs 454.8100
BUILDING PERMIT Recelpt #
To 6o uad for Est. Value Date 19
Site Addreu Erect Q Octuponcy
Lot Black Sec/Sub. Alter p Zonirq
Parcel # Repair p Fire Zone
Enlorye p Type of Const.
W Nome Move ? $fories
; llddreu Demolish p Length
b Ci phone Grade p Depth Sq. Ft.
, o Name Approvals Fees
Zu Assessment Permit
Address
F Water 8 Sew. Surchorpe
Cit Phone
Police Plon check
~W NO^1° Ffro SAC
/lddress Enp. Water Conn.
i W Ci Phone Planner Woter Meter
Countil Rood Unit
1 hereby acknowledpe thot I hove read this opplicotion ond state thot Bldp. Off,
the intormotion is correct ond o9ree to comply with oll appiicable
Stote of Minnewto Statutes and Ciry of Eoyan Ordinances. APC Totol
Siqnoture of Fermittea
A Building Permit Is issued to: an tha express conditlon thai
oll work shall be done in occordance with oll applicable Stote of Minnesoto $tatutes and City of Eopon Ordinonces.
8uitdnp Offlciol
Permit No. Permit Holder Misc. Permit No. Holder
Plum6ing
H.V.A.C.
Weli
Weter
Disp.
Sewer
E lectric
Inapection Date Insp. Other
Footingt .~2
Foundation
Framinp
Rough Plbp.
Rouyh HVAC
Inwlation
Final Plbg. .
Final HVAC
F1nsl • ~ ~
Water Dewibe l.ocation:
YYsll
Sewsr
Pr. DisP. ~
~.l~ . INSPECTI4N RECORD
` CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. N{~~ ~
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION . .A
F
L
~
Permit No. Permit Holder Date Telephone M
ELECTRIC
PLUMBING
HVAC
Inapactlon Dete Insp. Commenta
FOOTINGS
O
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVG
TEST
INSUL
GYPBOARD
FIREPLACE
FIHEPLACE
AIR TEST
FINAL PLBG
FlNAL HTG
ORSAT
TEST
BLDC3 FlNAL
BSMT R.I.
BSMT FINAL
DECK FfG
- - -I -
i
DECK FINAI
Z-~-~-~- ~ ~ ~ - -
- ,
'TY OF EAGAN WATER SERVICE PERMIT
F rilot Knob RoaA PERMIT IVO.: -
agon, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address: Plumber.
Meter No.: Connection Char9e:
Size: Acrnunt Deposit:
Reader No.: Permit Fee: .
1 agree to comply wffh Mhe City of Eagan Surcharge:
Oedinanees. Misc. Charges:
Totol:
By Date Paid:
Dote of Insp.: Insp.:
TY OF EAGAN SEWER SERVICE PERMIT
_S Pilof Knob Road PERMIT NO.: -
Eogan, MN 55122 DATE: '
Zoning: _ No. of Units: ~
Owner: -
Address: _
Site Address:• ? Cf IvOt'-_-` LI1 L' V7P 5 tY; _
Plumber:
Z~~~.QD pC1
1 agree ta eomply wilh the City of Eogon Connection Charge: f'~ n ;
Ordinanees. Account Deposit:
~ . r , ~
Permit Fee: -
Surcharge: - '
By - Misc. Chorges:
Dote of Insp.: Total:
Insp.:__ Date Poid:
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITYOFEAGAN
3830 PILOT KNOB RD - 55122 ~
657-687-4675
New ConsW ction Raouirements RemodeVReoair Reauiremants
• 3 registered site surveys showing sq. ft. of lot, sq. fi. of house; and all roofed areas • 2 copies af plan
(2)% maximum lat rmverage allowed) . 1 set of Energy Calculations for healed additions
• 2 copies of plan showing beam & window s¢es; poured found design, etc.) . 7 site survey for exledor additions & decks
• iselofEnergyCalcNations • Indicate'rfhomeservedbysepticsystemforadditions
• 3 copW of Tree Preservation Plan if lol plaHed aRer 711193
. Rim Joist Detail Options seledion sheet (61dgs wiN 3 or less unils)
DATE l ~ VALUATION 30,C'rX)'
JOB SITE ADDRESS ~ 2~~P ~ SU ENSIG Ldy,i~
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER ~J(VA C'g-ICG4C)
TYPE OF WORK s1 bIl'f Wl N~vu1'S FIREPLACE(S) _ 0_ 1_ 2
APPLICANT PHONE#
ADDRESS ZIPCODE
PAGER# CELLPHONE# FAX# q Ez
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelopa Calculations Submitted
~ ~\n
MINNESOTA RULES 7672 ~
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone
Plumbing System Includes: Water Softener _ Lawn Sprinkler . $90.00
Water Heater No. of R:I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical Systcm Includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor. Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is c rrect, ind agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordin
Slgnature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1l01
OFFICE USE ONLY
? Oy Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
,~a 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
0 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plax ? 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
Vatuation 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 W idth
REQUIRED INSPECTIONS
_ Foorings(new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
_ Foundation HVpC
Drain Tile
Roof _ Ice & Water _ Final pdier
_ F28min8 _ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ InsulaHon _ Windows (new/replacement)
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
TBi lY
mon[Y ~(romd ' ~ L l`~ ul' ~~~Jq l
-,WN57 30, oo
t8
fieqaest Uate Fire No. Roun Inspeceion
fleqwreA? []Ready Now IAWiII Nolily Inspec-
• ?1'ns ?NO ~tor When FeadY
koticenseci Elecvii:pl Contrac[or P hereby requnst inspection ol ebove
C,~Owner electrical work installed at '
Straet Address, Boz or Roate No. City
2 ~I. SuPns/~ ~a..N 2 ~'a ctn
ectmn o. TownshiU Name or No. Range No. Couniy
~
Ocr.upaN (PflINT) . Ph Nn.
~ S C7r c y5a-3s(f 7
Power Supplier AAdress ~ ~
CL ~e d~ ic, r~ ,
Electrical nn[ractor ICompany Namel oniructo,"s License Nn.
V~~.UA- --1-t) Cl- LA- WN 4A~
MailinB AdJress (Contractor or Owner MakinH Instailatio
4 ? ' SfVe-at-'5k E-, 1
Authori ed Si nature (Contractor/ n kiny Insta aYOnl Phone Number
Z - y(~pSO
MINNESOTp STATE e0Afl0 OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway.Bldg. - Noom N-197 BE ACCEPTED BV THE STATE BOAHD
1821 University Ava., SL Pnul. MN 65104 UNLESS PROPER INSPECTION FEE IS
P6....e Ifit91 ]4]9111 ENCLOSED.
qqw f ~yREQUEST FOR ELECTRICAL WSPECTION EB-00001.03
T 47V'p~ q/. See inshuc[ions for completiny this lorm on back of yollow copy.
"XBelow~Work Cavered by This Request ` 3d3 T 7
Ne AdA pep. Type of Building AoPliences Wire.tl Eqvipment Wiretl
Home flange Temporary Service
DuPlex Water Heater Liyhtiny Fixtures
Apt. Building Dryer Electric Heatin
Commerclal Bldg. Furoace Silo Unloader
InAustrial Bldg. Air Conditioner Bulk Milk Tank
Farm Dther soeclfv otnEr(SUerifv)
ther Sue"f ther Oinsr
Compule lnspectron Fee elow N Pee Service Entrance Size k Fee Feeders/5ubfeatlar5 fl Fee Circuits
~ to 100 Ain s 0 to 30 Am s D tn 30 Am>s
~ 101 to 200 Amps 31 to 100 qmps 31 to 100 Am )s
Above 200 qmps Abave 700_Amps Above 100_Amps
Transformers Remote Control Cira Tfd. ~ P rtial; Other Fee
Signs Special Inspection ~ $O
R F3Q.
e~wrks $ ~ TOTAL E
RouHh-in the Elnctrical
Inspec[or, heraby
ce 'ly that the above
~z
Final r D~ile nsUaction hes been
~
This request voitl made.
'
18 monNS hom
~ This request oid~ 18 months from
P ~
87881
Date of this Request Fi-29_1 ~8
I, as 19 Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
i
Street Address or Route No. 4266 North S*snok City leEM
Section Township Range County Dakota
Which is occupied by hfaroll ConAt~.^uction
(Name of Occupant)
Is a roughin inspection required on this job? No ? YesZ Ready Now ? Will Call Iff
Power Supplier Dekota Ct,y. Address F'arrtington
Electrical Contractor 0 B. Thonpaon Elcctric Co. Contractoi s License Noa=X3'
(COmpany Name) MailingAddress 12201 Iftk3 Blvd. IrItsa. 55343 (Electrlcal Contractor orowr'1er~ akln9 This Installatlon)
AuthorizedSignature /~vL:-?~:~C/,i~''. PhoneNo. 6
(Electr{cal Contr*to1 or Owner Making This Initallatlon)
~ This impection request will not he accepted by the
State Board unless proper inspection fee is enclosad.
Minnesota State 8oard of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 d
REQU ST FOR ELECTRICAL INSPECTION q
CHEC~Ii 6ELOWOAK COVERED BY THIS REQUEST P 87881
Type of Building New Add. Rep. Check Appliances Wired Fot Check Fquipment Wired For
Home 19 ? ? Range Tempoiary Wiring ?
Duplex ? ? ? Water Heatex ? Lighting Fixtuces ~
Apt.9ldg. ? ? ? Dryer ? Elec[ric Hea[ing ?
Commercial Bldg. Fumace 30 Silo Unloader ?
IndustrialBldg. ? ? ? AaConditionex El ButkMilkTank ?
FJt, ? Lisi _ n; oh _ XXXX List
ehrs~
Other ? ? ? rs} Oe
Heie
1 A 1
COMPUTE INSPECTION FEE BELOW
Selvice Entrance Size: # Fee Feeders@Subfeeders: u Fee Circuits: # Fee
0 tu 100 Am s. 0 ro . Me 0 to 30 Am exe s
101 to 200 Amps. 31 t 0 31 to 100 Am eres
Above 200 AmpsAbod Above 100 Amps7ransformers Rem - C~ Partialorotherfee
Signs Special Inspection Minimum fee 55.00
Remazks TOTAL FEE 20.5
'~iOri ' 1 17 08
I, the Electrical Inspector, hereby ce ,iat t~ enspecIion has been made. O•~G
(Rough-in) ~ i ~ ~ Date
(Final) Date
This request void 18 months from
cinr oF encnN
~ 9795 Pilof Koob Road Eagan, MN 35122 N2 4899
~ PHONF: 454-8100
BUILDING PERMIT APPLICATION Receipt #
ro ea una fa. SF Dwlg. & GarEsr. vai,e 45, 000 oate 7221 is-72-
Site Address 4266 NO_ c,vanak Ered )rL] Occupancy T
Lot 19 Block 1 Sec/Sub.Idy3 aQ,P.~~+i^ 94-j1 Alter ? Zoning Rl
parcel 10 84354 190 O1 Repoir ? FireZone 3
Enlorge ? Type of Const. 17
m Name McApAel Inc Move ? # Stories 1--
Z Address 10800 Lyndale Ave. Demolish ? F.onr FF K.
~ ci BloomingtonPhom 884-7225 Groda ? oevxh 'IR rr.
Name Agprovola Fees
U Address Same Assessment7 2 1 7~ Permit 128_Otl_
Phone Water & Sew. Surchorge Z2, S.Q_
Police Plan check
~dw Nome Fire SAC 5f10_O(1
~
x~ Address Eng. Wa[er Conn. 7 F n_ n n
<W C phone Planner Wuter Meter
Councii Road tini t 75_ Q(
I hereby acknowledge that I have read this applicotion and state that gldg. Off.
the information is corred and agree ro comply with ali appliwble
SMte of MinnewM SMtutea und Ciry of Eagan Ordinances. APC Total
Signcture of Permittee
A Building Permit is i/,n on the express wndition that
oll work shall be done rda w'I applicabie State of Minnesota Statutes and City of Eagan Ordirwnces.
Building Official /
cirr oF EaacnN N° 7319
_ 7793 Pilof Knob Raed Eogan, MN 55112
t ' PHONE: 434-8100
BUILDING PERMIT Recefpt # `3o37 7
To 6s wed /o. SWZM. POOL & FENCHt. Value $7.350 pate Juife 4 _ 1 q 82
Site Address 4266 SVensk Idne Erecr gk Occuponq R-3
Lot 19 Bi«k 1 See/s,b. Wilderness Run StYi Alter p zanin9 R-1
parcel # 10 84354 190 Ol Repolr ? Fire Zone NA
Enlarge ? TYpe of Const. V
c Name J8m8 & DOnrt3 OriCChiO Move ? # Stories
W
~ qddreyt 4266 SVensk IBne Demolish ? Length_32
ci E8q8II 55122 phone 452-3587 6rode ? Depth_IA-Sq. Ft.-
~ Name V811eY POO18 ADProvals Feea
0
s~ Addreu 651 C11ff RoBd Azsessmenr Permit 68.50
Ci Burnaville phone 894-1480 Water & Sew. . Surcharge 4.00
Police Plon check
~w Na~ne . Fire SAC
Address Erp. Woter Conn.
~ W Ci phone Pionner Water Meter
Council Rood Unit
I hereby ockrwwladge thot I hava read rhis applicotion ond state that Bldg. Oft.
tha inlormofion is correct and ogree to comply with all cpplicoble
Srote of Minnesoto Statutes and Ciry of Eagan OQrdirances. APC TMOI $72-50
$ipnoture of Permittee a"ga~" M ~L'~4-0&
A Building Permif is issued to: Va1 on the expren conditlon ihnr
oll work shall be done in occordonce with all apDlic~o/bS~to~te,.p_f Y1v"~1g~ epa-o~to Statu~tes ond Ciry of Eopan Ordinonces.
Buildinp Offieial
• , CITY OF EAC',AN Include 2 sets of plans.
~ 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of enerqy calculations.
m o valuatiOn 7350 -T--
Tb Be used For ~te
Site Pddress: `t2(o(e~SVE6 L NE /JUn s'r~- OFFICE USE OI~II.Y
5S°
Lot l R Block t Sec. /Sub. W' ~E) r~6Erect ~P~cY
Parcel d 1 geAlter pa'yr FirenZor~e ~l
Enlan~e Type of Const
Tnn„re , BovA)F~ OR1CC 10 MjVe # Stories
Qaner: ~
Pddress: 9 2 (R ( a 5 V Es.15K L!~ N E Demolish Front 3~ ft.
Grade DePth /6 ft.
city/zig coae: E RG A rU 5 i ~ z z
Phorie LI Sa - 3aR 7 APPRC7VAIB FEES
Contractor: J i1l.LICV Qo oLS F+ssessrents
Water/Sewer
Pddress: (o S l. G ~.1~~ R1~ Police ~l
City/Zip Code: 13 r. P 1 1~ 1111. r F_ M Al. Fire SAC
c - Water Conn.
Phome/#: I - , P1 Water Meter
9 ounc Road Unit
f ldg. Jf~.
es
~/Zip Code: -3-~Z
Phone
; PERMIT
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: g u r Lo z rv s
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 3 9 4
(612) 681-4675 Date Issued: 08 /05 /96
SITE ADDRESS:
4266 SVENSK LANE
LOT: 19 BLOCK: 1
' WILDERNES5 RUN 5TH
P.I.N.: 10-84354-190-01 '
DESCRIPTION:
{-->u_._ (REPI.ACEMENT)
Baildi Rermit Type DECK
,tB:uilding Work Type REPAIR
Census Code434 ALT. RESIDENTIAL
i
~ . . . _ . ~r'n
F ~
i~
~
i
r
" _
REMARKS:
FEE SUMMARY: '
Base Fee $45.00 COPIES $1.00
Surcharge $.50 Total Fee $51.50
Lic. Search Fee $5.00
Subtotal $50_50
CONTRACTOR: - Applicant - sT. Lzc.OWNER:
OLSON CON3T, CHAD 13223651 2006634 ORICCHIO JIM
15516 CORNER TR . 4266 SVEN$K LN
ROSEMOUNT MN 55068 EAGAN MN 55122
(612) 322-3651 (612)452-3587
T Irereby ackrrowledge 'Chat'I haVe read this ap{slication and state thet the
3nformatian is eorrect and agree to comply with all applicable State of Mn.
Statutes and City oF.Eagan Ordinances.
L
I~ot,f-~ ~
APPLICANT/PERMITEE SIGNATURE ISSUED BY: SI NATJJRE r
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ~
T94 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
"
681-4675
New ConsWdfon Reouirements RemodeVReoalr Reauirements
? 3 repiatered sHe surveys ? 2 copies of plan
? 2 aopiea of plans (Mdude beam 8 window alzes; poured Ind. design; eto.) ? 2 sile surveys (ezterior adtlitions & decks)
? t anergy Calculatiom ? 7 energy celculations for heated additions
? 3 eopks of kee qeservation plan N b! pktted after 711/93
requhed: _ Yes _ No
DATE: 7- CONSTRUCTION COST: ZSUU°o
DESCRIPTION OF WORK:
STREET ADDRESS: ~ 2G(O
LOT BLOCK SUBD./P.I.D. ~1 i i n~rsa&sc iZ,.,, STH .4~d .
PROPERTY Name: Phone 0 `l !SZ" 3S8-1
OWNER
Street Address• tq ZL ( S"`'``s t'
City: c~w State: Zip- 55I z z
coN7RAcTOR Company: Cuw X^ Phone 3ZZ"
D
Street Address: License #•~~~03`~~
City: State: Zip:
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address•
City: State: Zip:
Sewer & water licensed plumber: . Penaily appiies when address change and lot
change are requested once pertnit is issued.
I hereby acknowledge that I have read this application and state that the informaHon is corcect and agree to comply with all
applicable State oi Minnesota Statutes and Clty oi Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECENED
Certifiqtes of Survey Received v--~Yes No
Tree Preservation Pian Received Yes '~~No
OFFICE USE ONLY = s.
.
BUILDING PERMIT TYPE
a 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
a 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
a 03 SF Addition o OS 8-plex o 13 Garage/Accessory ? 20 Public Facility
o 04 SF Porch o 09 12-plex a 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. 0 10 = plex wl 5 Deck
WORK TYPE
* 13~1 N e w o 33 Alterations o 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) VA) Basement sq. ft. MC/WS System
(Allowable) = Main level sq. ft. City Water
UBC Occupancy '2-& sq. ft. Fire Sprinklered
2oning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. u 34
Oepth Footprint sq. ft. SAC Code r
Census Bidg _L
Census Unit D
APPROVALS
Planning Building Engineering Variance
Permft Fee Valuation: $
Surcharge
Plan Review
Lioense
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Pertnit
SNV Surcharge
Treatment PL
Road Unit
Park Ded.
Treils Ded.
Other
Copies 1•oo
Total:
% SAC
SAC Units
r . ~ , . ' ' ' . . 1.Y,,,~~ ~ • s .
V~
C~I'..
DELMAR H. SCHWANZ
LANO SLJRVEVOR
RpiR.,.a Unaar UwS of The Sbd oI M.nnofoU
7978- 745TH STAEET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 61242}7769
SURVEYOF'S CERTIFICATE
1 N75°~3 ~4.£
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~ 120.0~
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~
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MINNESOTA REGISTRATION NO.8675
R~
nama
SUlLDING PBRMIT APPLICATION
include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be used for ~.e Y, d z rj ~ ~,.p 41 &VWaluation
Site Addrest: L~a Up S11 Zs~-S ~C
Lot 17 Block ~ Sec. Sub. Parcel Number 1919 O/
~.t1 r ~~PrN t5' j' ~ ~ ~y_r4 7,p~
Okmer tV c l N ~ Te2ephone
Adclress /p p /1 Aly -
, n ~rlN. i r~I r ~ r~` • .
contractor d Telephone
Address
Arch./Eng. Telephone
Address
OFFZCE USE
Ereat F~ Occupancy / r
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
Move $ of Stories /
flemolish Front ~6
Grade Depth jg'
OFPICE USEi)ate of Approval & Initial FF.ES
Assessment Permit ~2r!l----
Water/Sewer Surcharge -9 Y
Police Plan Check
Fire SAC lr-fi 47
Eng. N?ater Conn. 9 d'D
Planner W ee
Council wil
Rldg. Off.
A.P.C. TOTAI, ~
7"ica`.r fOT: yg99
•E i.''' 1ynd3le Ave. So.
F.1 Dc:rninE-ton, hh, 5:5432 Cert Ne. 64
DELMAR H. SCHWANZ
LANOSUFVEVOA
. Reqiitantl Vnaer LaWS Of The $late of.MmnesOt,m
2978- lA5TH STNEET W. - BOX M ROSEMOUNT, MINNESOTA 65068 VHONE 872 423-1769
SURVEYOR'S CEfiTIfICATE
. Nr5o%3OQNE
, 520.00 , ~ .
0
30
0 1 D°
L O T C~ ~ 19
-N z ,01 4
Po
$
~ NN o SCALE': 1 i,7ch ~ 40 Peet
/
; ,20 0~
, Drainage , utility eacement
30
J hereby certi.^y that thSs is a triae and corrcc,t represe7Lati.en of'
L,-)t 19, nlock IyZLDr'.F.Nt,,_,S R?iN FZi7'N AT)DI':I^.•N, 3ccoro:ng tJ t'ie
recorded plat thereof, liakota County, Ninneaota.
I)sted: *?arch 8, 197,''1.
~i,i
. ' MINNESOTA REGISTRATION NO. 8625
Va&epf Pdv6 Avc.
( 651 CLIFF ROAD
BURNSVILLE, MINNESOTA 55337
(612) 894-1480
June 4, 1982
To whom it may concern:
Valley Pools~ while constructing the swimming pool at l,266
North Svensk Lane, will erect a temporary barrier to prevent
excessive dirt from encroaching on neighbors yards. Upon
completion of the pool, a permanent retaining wall will be
erected.
Sincerely,
Ualley Pools, Inc.
44"_ f "I , srto
Harlan Bricker
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? 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3 3830 PII.OT KNOB RD - 55122
(651) 681-4675
New Construction Reauirements RemodeUReoair Reauirements
? 3 registered site surveys ? 2 wpies of plan
? 2 copies oi pians (inGude beam & wirWow sizes; poured fnd. design; etc.) ? 1 sRe surveys (eMedor addRions 8 decks)
? 1 energy calculations ? 1 energy wlculatians for heated additions ? 3 copies of tree preservation ptan'rf lot pla@ed after 717193
required: _ Yes _ No DATE: CONSTRUCTION COST: D O
DESCRIPTION OF WORK: h~
STREET ADDRESS:
LOT: lq Pf BLOCK: ( SUBD./P.I.D. LLU 1X1112i143 2~ s~
Name: &Ut(u Phone w,
PROPERT'Y Last -~st
OWNER ~ fP Y~ I~Y ~JV ~ •
Street Address: L41 ~
City 0 State: ln n • Zip: ~i) GJ
0
Company: --l Phone
CONTRACTOR Horizon Exteriors
7333 Larc Industrial BNd.
Street Address; Burnsville, MN 55337 I License M Exp.
I (612) 890-3900 ~
City ~ State: Zip:
ARCHITECT/
ENGiNEER Company: Phone
Name: Kegistration
Saeet Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address
change and lot change is requested once pertnit is issued.
r
I hereby acknowledge that I have read this application, state that the information is corcect, and agree to comply with all applicable
Sfate of Minnesota Statutes and City of Eagan Ordinances.
~ r (J
Signature of Applicant:
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 ? 11 Apt./Lodging ? 16 Basement Finish
W02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex 0 13 Garage/Accessory ? 20 Public Facility
O 04 SF Porch C] 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition -R 34 Repair ? 37 Demolition
GENEi2AL !NFt3FiflffA3'iaPJ
Const. (Actual) Basement sq. ft. Census Code
(Aflowable) Main levei sq. ft. SAC Code
UBC Occupancy sq. ft. Census Units
Zoning sq. ft. Census Bldg
# of Stories sq. ft. MC/ES 5ystem
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering . Variance
Permit Fee Valuation: $ C)a
Surcharge
Plan Review
License
MC/k.:S SAC
City SAC ~
Waier Conn.
Water Meter ~
Acct. Deposit
SIW Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other ~
Copies .
Total: •
% SAC
SAC Units
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan ~
Q(o C~ ~ 3830 Pilot Knob Road, Eagan Mn 55122 ~3O
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when pernrits are required for each unit
Date 7 03 ORRICCHIO, JIM
Site Address 4266 SVENSK LANEJW9K4T4- Unit #
EAGAN, MN 55123
(651) 452-3587
Property Owuer elephone # ( )
Contractor NORgLVM Ta.~ING Wg
(612) 827-4033
Address City
State ip - Telephone # ( )
•
The Applicant is _ Owner ~ ConVactor _ Other
Septic System New Refurbished Submit 2 sefs of plans and MPC license $ 100.00
InGudes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair rebuild y, 30.00
LC+ Lawn irrigation system b0.L.4(ciw PV ?1 C"n`
_ Water softener _ Water heater $ 15.00
_ replacement _ additional
S[ate Surcharge ~ D $ .50
I
Tote, ~ AUG 0 6 2003 ~ 30.~ .
I hereby apply for a Residential Plumbing Permit and aclaowledge that the in tion is complete and ac~urate; that the work will
be in conformance with the ocdinances and cedes of the City of Eagan and wi -thlum6mg=~odes understand this is not a
pemrit, but only an application for a pennit, 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 requi*es a review and approval of plans.
Je~ No~-Wuyn
ApplicanYs Printed Name Ys Si~gnatur~~
I '
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan 1 ~
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date 3/ / 0-,? ORICCHO, JIM
4266 N9RMR SVENSK LANE
Site Address EAGAN, MN 55123 Unit #
(651) 4523587
Property Owner Telephone # ( )
Contr•actor NVRBLVM P.VM13I^V Wr
(612) 827-4033
Address City
•
State MINNEAPOUS, ip Telephone # ( )
The Applicant is _ Owner 111- Contractor _ Other
Septic System New Refurbished submit 2 sets of plans and MPC license $ 100.00
Includes County tee. Additional consultant fees may apply. .
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fxtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild ~ 30.00
_ Lswn irrigation system
_ Water sottener X Water heater $ 15.00
x replacement _ additional
State Surcharge i Tn~ (P, $ .50
u LS
AUG 0 6 2003 15, 50
Total
N - I
I hereby apply for a Residential Plumbing Permit and aclmowledge that the ~(prmation is complete anccurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and i~h-tfie PlumbingC-ad~_ t I understand this is not a
permit, but only an applicarion for a pemvt, and work is not to start without a pernur, that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
je-~
Applicant's Printed Name A i igna e
CASH RECEIPT
CITY QF EAGAN
.
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
weceiveo
FROM
AMOUNT Is I
Ee DOLLAR3
~oo
? GASH ? CHECK
FOR
FUND CODE AMOUNT
Thank You
~ - BY
Q' I VYhite-Payers Copy
Yellow-Posting Copy
Pink-File Copy
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4266 Svensk Lane
Lot: 19 Block: 1 Addition: Wildemess Run 5th
PID:10- 84354- 190 -01
Use:
Description:
Sub Type: e- Fireplace
Work Type: Gas Insert
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Fireside Hearth & Home
20802 Kensington Blvd
Lakeville MN 55044
(952) 985 -6675
PERMIT
City of Eaan
4/30/08 Notification letter sent regarding expired perm
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
pf
$90.00
Owner:
James S Oricchio
4266 Svensk Lane
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Issued By: Signature
Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
$88.50 0801.4085
$1.50 9001.2195
Building
EA080284
10/05/2007
ePermit
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA109909
Date Issued:04/15/2013
Permit Category:ePermit
Site Address: 4266 Svensk Lane
Lot:019 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-190
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Stephanie Vought
3451 W Burnsville Parkway Suite 120
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
James S Oricchio
4266 Svensk Lane
Eagan MN 55123
(612) 801-6238
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA110861
Date Issued:05/31/2013
Permit Category:ePermit
Site Address: 4266 Svensk Lane
Lot:019 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-190
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Stephanie Vought
3451 W Burnsville Parkway Suite 120
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
James S Oricchio
4266 Svensk Lane
Eagan MN 55123
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118694
Date Issued:11/06/2013
Permit Category:ePermit
Site Address: 4266 Svensk Lane
Lot:019 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Matt Czech
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 -
James S Oricchio
4266 Svensk Lane
Eagan MN 55123
Pineview Builders Inc
2201 Lexington Avenue N, Suite 100
Roseville MN 55113
(651) 489-3696
Applicant/Permitee: Signature Issued By: Signature
Gity al Eaiall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6764675
Fax (661) 6754694
Date:
RECEIVED
Oji 262016
Use BLUE or BLACK nk
For Office Use
Permit #: / 3‘ ‘ 0 0
Permit Fee: / 7,.7• _g47 1
Date ReceCived: S-- - ? L "ice
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
t
Site Address: 41(44.9 5iiert5 K Ls) 1 SS 1.3> EiNt. otrwl- Unit #:
Resid
Owner
Name: '3 " syI 0 taAre).. 0 KC...ON:0
Address / City / Zip: 9)406 IS Let
Applicant is: Owner Contractor
Description of work: rc, v
rk
ecK
Phone; 49 ) 801 Ltt
mkt cs 113
Construction Cost: - 00 Mufti -Family Building(Yes / No
Company: '.:re re or. +W( ccos t-, Lim Contact
City
Address 5151 '16 TIN /VW,
State: PAO zIP '`; 5 11 Phone 763 ),),71 -Ts trnail
License # 6C (sora I05- Lead Certificate #
If the project is exempt from lead certification, please explain why:
01: ?Afro'?
tei<rftd.::a
eAtrtrj . art" I, - statrs, Oi
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:
err -% sArk, 46i
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer 84 Water Contractor: Phone:
Fire Suppression Contractor: Phone:
ivcifEPlans andsupponing dcun,ei
you -Suborn are consideredtc bepibIIcInformation. Porti�ns of
their:forma f� classifiedes,nerii)tiblic if you provide specific reeiOnS that would perndithe ohy to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. wyor qopnerstateonecall
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 ,757tretifY1 1:tar
Applicant's Printed Name
ApplicatWs Signature
Page 1 at 3
_Cue -.1.4
n -
DO NOT WRITE BELOW THIS LINE
00 0
SUB TYPES
Foundation
Single Family
Multi
81 of Flex
WORK TYPES
New
Addition
Alteration
Replace
Retaining VVall
DESCRIPTION
Valuation
Plan Review
(25% 100% V)
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior improvement
Move Building
Fire Repair
Repair
1-i 3 Li
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof. Ice & Water Final
Framing 30 Minutes 1 Hour
Fireplace: Rough In Air Test Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteratiori (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
-1
/5
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
ff•maegi•
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Pool: _Footings Air/Gas Tests Final
Drain Tile
Siding: Stucco Lath Stone Lath Brick
Windows
Retaining Wall: Footings Backfill Final
Radon Control
Fire Suppression: Rough In Fin I
Erosion Control
Other:
Building Inspector
RESIDENTIAL F ES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
10 3 tr
6-)
11_0.
TOTAL
16 4' 04444 /fAtJ
0
Page 2 et 3
U 053 , 1
3 '-4
2g 4-
c
c?'= .3/1#
3r: '1.'
t ire
i%
i.6,J
Ny'= 'kb
: 74
ry'%
^ ,`
1'1" 3%.