1895 Sunrise CtCITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21 199
Eagan, MN 55121
Zoning: R1
Owner;
Address:
Site Address: 1895
Plumber
Meter No.: ?? Y 9 -2
WATER SERVICE PERMIT
PERMIT NO.: 6252
DATE: -
No. of Units: -1
Size:., Connection Charge: 500.00pd
Reader No.: Account Deposit: 15. 00 pd
Permit Fee: 10.00 pd
scree to O NP'y H"I the Cift of Esoes Surcharge: 132.0 pd S C
I
on"Re
Misc. charges: 63.00pd mete
BY Total: .50 d
Date of Insp.: Date Paid:
(o ,t S Insp.:
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 2" 199
Eagan, MN 55121
Zoning: R 1
Owner; _Ragsaw 11111ri re Tnr•
Address:
Site Address: 1895 Sunrise Ct,
r
Plumber: t a r
Meter No.:
Size:
Reader No.:
I some to emply wkb tors Ciy, of low,
onandwov"
BY
Dote of Insp.:
F ITY OF EAGAN
3830 Pilot K-Iob Road
P. O. Box 21199
Eagan, MN 55121
Zoning; :I
Owner: "=dssaw Builc
Address:
Site Address: 1895 Sunr
Plun?be _ Star Plb?
WATER SERVICE PERMIT
PERMIT NO.: =
DATE: 5
- No. of Units: 1
L12 R!, Suncliff let
- Connection Charge: 500.00pd
- Account Deposit: 15.00 pd
Permit Fee: 10.00 pd
Surcharge: 132.00 S/8
Misc. Charges: - 6 3 , 00 d meter
Total:
Dote Paid:
I- .
SEWER SERVICE PERMIT
PERMIT NO.: 7.'; zi 1
DATE: ,- r?
-? No. of Units: 1
era Inc.
t
ISam to
°I!'+ Ns City of eg..
ovdlft?
By --_?
Dote of Insp.:
lnsp.:-_
Connection Charge:
Account Deposit: _
Psmrtt Fee:
Surcharge:
Misc. Chargex
Total:
Date Raid:
CASH RECEIPT
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19
wtCEtVED
FROM
AMOUNT $
at-DOLLARS
goo
CASH ? CHECK
row
FUND CODE AMOUNT
l
Thank You `r'
i, -
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CASH RECEIPT
• CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 9
RtCKIVRO _ .,
'retom
AMOUNT $ I-
DOLLARS
+oo
? CASH ? CHECK
s' X'/
FUND CODE AIA OU NT -
l
Thank You
52422
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
• 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
To be stood for Est. Value Dat e 19
Site Address
Erect
1
Remodel
?
?
Occupancy
Zoning
Lot !
Block Se/Sub
. Repair ? Type of Const.
Parcel No.
Enlarge
?
No. Stories
Move ? Length
W None Demolish ? Depth
Address Grade ? Sq. Ft.
City Phone Install ?
Name ' Approvals
0
Address Assessment
1
? City Phone
Water b Sew.
Police
G
W Name
?W Fire
'3 Address Eng.
W City Phone Planner
I hereby acknowledge that 1 have read this application and state that Council
Bldg. Offer
the information is correct and agree to comply with all applicable
f APC
State of Minnesota Statutes and City o
Eagan Ordinancgs.
t
Signature of Permatee Var. Date
Fee*
Permit -?
Surcharge
Plan Review ? , I f
SAC 0
Water Conn. <J
Water Meter
Road Unit ?? LI
" Pbrks .
Total
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesoto Statutes and City of Eagan Ordinances.
Building Official
Permit No. Permit Holder Dab
!
Telephone
Plumbing ;;3 f b
H.VAX. )? ?J ?? ( ( U r? ?? t ,
Elaetric
Softener
Impaction Data Insp. Other
Footings 3
Foundation
Framing
Roofing
Rough Plbg.
Rough HVAC i f
Inwlation
Final Pibg.
Final HVAC
Final
Cart/Ooe.
Water Dow ibe Location:
v%ll
Savor
Pr. Disp.
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fes
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Addresses - ' Lot Blk. Tract
4. Owner
5. Contractor '- ` Phone
6. Address Z ?-
7. City 4r) - 1 State Zip
6. Building Type: Residential d Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe Fuel Type
11.
No, Eauio ant STU • M. Ea.
Forced Air No. Equipment CFM
Air Handling:
Mfg.
Boilers
E
h
Mfg. Mech.
x
aust
Unit Heater
Mfg. Other
_ Air Cond.
Mfg.
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: ,r for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 4648100
3 ? S?
`??ti? ?'E??.
Receipt _2 ? --I
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print legibly
Permit No.
Fee
SIC
Tot. J
1. Date 2. Installation Cost
3. Job Address ??? Sum 'L'o't ?Olk.
4. Owner -70,1752 t.o r%- `-
5. Contractor/ ai Ll F d / Phone --,T ,
6. Address 'L
7. City ; •'? ??'' " State Zip
8. Building Type: Residential 0
9. Work Description: New j&
10. Describe
11.
Commercial ?
Add ? Alter O
Institutional ?
Repair ?
No.
-~7 Fixtures
Water Closet No. Fixtures
Cess
ool/Dr
i
field
Bath tubs p
n
a
Septic Tank
`i 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 wit? all ordinances and codes governing this type of work.
Signed ?_? G,y' ^/?
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
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
"Nk f SI
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
r t.., II II Of r APPLICANT:
TYPE OF WORK:
011 1 1 (11 N;-
H A !F,
Permit No. Permit Holder Date Telephone s
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Dale Insp. Comments
Footings 1
Foundation
Framing
Rooting
Rough Plbg.
Rough Fhg.
[Sul.
Fireplace P fq?n-= ,?-
Final Htg.
Orsat Test
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Dock F1g•
Deck Final
Well
Pr. Disp.
(Irdifiratt of (Orruparcry
4Citp of eagan
Depm ft ind of Indbing 3nsppritnn
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating g building construction or use. For the following.
UW CI&Wrlic tion Si DVC/`AR BMA. Permit Na 10156
R3 -- R1-- V
0. r o[ Building
P-t-
Date: J=28, -19-85---
CONSPICUOUS PLACE
This acniest wed
62.6695 ya1?5
Roque
,?. Fire No. IbuBh-in Inspe
Aequ red? ,?, `..
1
Reatlv Now ['Iw
h1 Notify Inspec-
?
N
Yes ?O or
W
en Ready
K=r Licensed Electrical Contractor 1 hereby request insl+ection of above
TUB Owner electrical work installed at:
Street Addr s, Box or Route NQ.
5? v,v,?is?= C?• City
??
Section Township Name or No. Range NO. County
Occu at (PRINT) Phone No.
r Supplier
-
Address
1
Elec 'cal Contractor (Company N..)
??Y?
?
Co/nt?r/actJyr's License No.
????
?
OU/ C
S Cs
/
t Bttp dress (Contractor or Owner Making Instailatjpg)
E17
;5 Ham.. /
Authoriz Sigreture Cpntrac wnsr Mpkl Installation) P Numher
IN!41: OTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
alidwaY BidB - Room N-191 BE ACCEPTED BY THE STATE BOARD
niversitY Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
219517JVtt ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION E1-00001 04
I DL i
) Y See instructions for completing this form on back of yallow copy-
Ift
526635 "X" Ye/ow Work Covered by This Bequest
Add Rep- Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt Building Dryer Electric Healing
Commercial Bldg.
C Furnace Silo Unloader
l trial Bldg. Air Conditioner Bulk Milk Tank
Farm Othnr pecrfy the, ISperify)
t ,r Speofy Other Other
Compute Inspection Fee Below
tt Fee Service Entrance Size It Fee Feedersr5ubteetlers q fan Circuits
0 to 200 Am 0 to 30 A 0 to 30 Amos
Above 200 Am xs 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100Amps Above 100_Amps
Tramitonners Imgation Booms O Partial,'Other-Fee.
J-0
• •wY "'P++ )rt^1 /-1) 1. the l hmel
inspa t ,.
1._ hereby
rtii that the above
v
Finale inspection hes been
ode.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT
Receipt #
N_ 10150
jr. be aaad for SF DWG/GAR Est, Value $67,000 Date APRIL 26 1985
Site Address 1895 SUNRISE CT Erect Ck Occupancy R3
Lot 12 SUNCLIFF
Black 4 cec/Sub 1ST Remodel ? zoning u1
. Repair ? Type of Const. V
Parcel No.
Enlarge ? No. Stories
BASSAW BLDRS INC Move ? Length 42
Name
Address 19131 ORCHARD TR Demolish C)
? Depth 48
z Grade Sq. Ft.
City LAKEVILLE 435-7472
Phone Install Q
g
Name SAME
Address
City Phone
W Name
11 Address
<F City Phone
1 hereby acknowledge that I have read this application and state that
ta y with all applicab
the inlormation is corre and ogre to m
State of Minnesota St tes an ity of Ef/y??''Q6pQpy?InOrdinon
Signature of Permitta? t ?.
Assessment
Water b Sew.
Police
First
Eng.
Planner
Council
Bldg. on. 4/22/85
APC
Var. Date
permit %, 334. Vl
Surcharge 33.51
Man Review 167, i
SAC- 525.0
Water Conn. 500.0-
Water motor 63.0'
Rood Unit?-4.A
waR.P. 132.0
Total $2,034.5
A Building Permit Is issued to:/ Dt 001an tss.,utca i1)lu - on the express condition that
all work shall be done in accordance with all oppi' la State nesota Statutes and City of Eagan Ordinances,
Building Official
Permit No. Permit Holder Data Telephone C
Plumbing 5 ?.c () 0.e U ' ,e Ja U' 5 y (o ?- 5
H.V.A.C.
El.ctrie 3
Softener
Inspection Date Insp. Other
Footings I
Footings 11
Foundation
Framing 5(Zg f? X16
Roofing
Rough Pibg. t) rAlv+} 11
Rough Htg•
Insul. 51u1g5 JU
Fireplace
Final Ht
g'
d
Final Plbg,
Final
Ce(t/Occ.
Water Describe Location:
Well
Sewer
Pr.-Disp.
CITY OF EAGAN N2 1 0 1 56
t 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN $5121
PHONE: 4548100
BUILDING PERMIT Receipt #
r. " d s.. SF DWG/GAR p.. v.._ $67, 000 r,,,,e APRIL 26 ,q85
Site Address 1895 SUNRISE CT
Lot 12 Black 4 ?eclSub. SUNCLIFF 1ST
Parcel No.
W Name BASSAW BLDRS INC
Address 19131 ORCHARD TR
City LAKEVILLEPhona 435-7472
Name _
?t Add ass
?i City -
W
C Name
?
s0 Address
,tu City Phone
1 hereby acknowledge t t I how mad this application and state that
the information is corre and ag?r ,a to comply with all appiicabJ?
State of Minnesota Sta. tes anx-ty of EgQ?n Ordinancpp.,j /J
Erect EX Occupancy R3
Remodel ? Zoning R1
Repair ? Type of Const. __V
Enlarge ? No. Stories
Move ? Length 4 2
Demolish ? Depth 48
Grade ? Sq. Ft.
Install ?
Appeals Fees
Assessment
Water & Sew.
Police
First
Planner
Council
Bldg.Off. 4/22/85
APC
Var. Date
Permit 334. Vtl
Surcharge 33.510
Plan Review 167. C
SAC 525.OC
Water Conn. 500.0c
Water Meter 63.0C
Rood Unit 280.OC
>pA&Q,p. 132.0(
Total $2,034.5(
I
Signature of Pennittae I :_1
A Building Permit Is issued to: BASSAW BLDRS INC an the express condition that
all work shall be done in accordance with all appl' la Stah wto Statutes and City of Eagan Ordinances.
Building Official LAL A^^^?6 -1
CITY OF EAGAN Remarks
Addition SUN CLIFF 1ST Lot 12 Blk 4 Parcel 10-72975-120-04
Owner; Street 1895..SUNI2ISE-COURT State EAGANMN55122
Improvement Date Amount Annual Years "P5 Payment Receipt Date
STREET SURF. cf Iqg? 9775 79 555 16 5 2220.6 C010549 8-13-85
STREET RESTOR.
GRADING
SAN SEW TRUNK 99 1970 76.54 3.06 25 27.58 001054 8-13-85
ie SEWER LATERAL 1985 3 4 709.59 2838-36 C010549 8-1 -8
WATERMAIN
WATER LATERAL 1985
}
WATER AREA 7-01 1973 93-.SS 6.24 15 12.56 C010 8-13-85
-
STORM SEWTRK 1971 322.29 16.11 20 80.64 C010 8-13-85
STORM SEW LAT
1985 _ -
i r`
?.
* Services 1985
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500-00 t 11
BUILDING PER. 0156 n
SAC 525.00
PARK
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 0-0
(? (" /0. ""i
New Construction Requirements RemodepReoair Requirements Officer Use-0nly
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cart of Survey Rood -Y -N
(20% maximum lot coverage alloyed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _Y -N.
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree.Pres Required _Y _N
1 set of Energy Calculations Addition - indicate ff on-site septic system On4lte Septic System _Y _N
3 copies of Tree Preservation Plan it lot platted after 7/1193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Date _?_/ _6
/ _? Construction Cost Svr/ • (IT7
?J
?? ``
Site Address 7UN/ ? ! A? 'U Unit/Ste #
AN
Description of Work (/llb / Yt1J //Ya uwc
rIvy
/
Multi-Family Bldg - Y la;h eC
Fireplace(s) _.:-'O - 1 - 2 It d --- 4405 Win)
Property Owner //f"fAWIZ 500 I Telephone #(&r 1) Ate'_3?4
LA)n (AI-4,qi-f-9060 ?. 3--
Contractor `?-
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #( )
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
z?A IIIJ
A K A, Sr
Applicant's Printed Name Appli ants Signature APR 0 6 2005
OFFICE USE ONLY
r
Su b Ty pes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex 0, 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
;,11!( 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacements "Demolition (Entire Bldg) - Give PCA handout to applicant
_
Valuation ooy,D Occupancy A -3 MCES System
Census Code -;31f Zoning /P D City Water _
SAC Units - Stories - Booster Pump
# of Units _ Sq. Ft. PRV
# of Bldgs - Length r Fire Sprinklered
Type of Const l04Z Width `
_ Footings (new bldg)
Footings (deck)
Footings (addition)
_ Foundation
_ Drain Tile
Roof _ Ice & Water _ Final
Framing
Fireplace - R.I. -Air Test -Final
Insulation
Approved By: JILJ/DS , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
_ Finat/C.O.
FinaVNo C.O.
Plumbing
_ HVAC
Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Siding _ Stucco - Stone - Brick
Windows
Retaining Wall t ?? e
ca ? P1o 5e 4? w.-
R b
Sd.e lot C a<,pt
'-FOR:
BASSAW.HUILDERS, INC.
C. R. WiNDEN.3.ASSOCIATES, INC.
LAND SURVEYORS Tat $48.8848 " ,
"
1381 EUSTIS ST., ST. PAULO MINN. 88108
W
? 49•a3 _
fl o
5
? I I
a
,
5 `
*J t I t I
? 34
1
t
J S vl N Q`
IB95 ON
!
` N
? t O a
v
a
w
?N
l?_ Q
1 ?
Seale: 1" = 30'
O Denotes Iron
Monument
O, L
Q I ?t0 ??
O ?
28.83 ,N 81° 19' 3f ?
4= l1 ° 15'
R• 14G.t32 r
SU NR1SE GDUR•T '
Lot 12, Block 4, SUN CLIFF FIRST
ADDITION, Dakota Count,, Minnesota.
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY,
THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. -
Dared this 164-L day of I4l2t-, r A.D. 1985 C. R. WINDEN & ASSOCIATES, INC.
House Len coted Mad 16, 1955
Surveyor, Minnesota Registration No. 7
-In
bSwvN AtT'11 /Yg
4
1.15 4;,?w
Pte-/ ?Ae4w1,V?
G, 5 ? -:57
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675.5675
Please complete for modifications to existing residential dwellings.
?. 15-Sb
Date 7 / 23 f Oy 1895 SU RIS MARK
SCHAEFFER,
1895 SUNRISE COURT
Site Street Address
EAGAN, MN 55122
Unit #
-
i (651) 452-3287
Property Owner elephone # ( )
Contractor (612) 827-4033 Telephone # ( )
Address 2905 GARFIELI) AVE. SO. city State Zip
The Applicant is: _ Owner Contractor -Other
Alterations to existing dwelling $ 50.00
-Add fixtures to rooms, excluding water softener and water heater
-Septic System Abandonment
-Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
X replacement _ additional
m
Lawn Irrigation Systee RPZ new _ repair -rebuild $ 30.00
2
o
'
[
State Surcharge Q ` $ .50
Total $
u?
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
Applicant's Printed Name s Slgna ure
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
//JJ 00
;?? Cbo f _ ?
To Be Used For : 7
( W Valuation: -14-1. Date: Z _ F6-
Site Address: /??` ???? OFFICE USE ONLY
Lot: 1,2, Block ?4ect X
f Sect/Sub Yz Lh? Occupancy ?- J
?1 Remodel Zoning (Z-?
Parcel # Repair Type of Const
Enlarge # of Stories
Owner 2?, Move Length 4Z
Address
/
z
qeez 'Demolish
G Depth
, ,
4 rade Sq Ft
City/Zip Co de Q
si-d z-/ -
v --------------- ------------- ------
Phone l 4 13 S- 7zl 7,2, APPROVALS
Contractor
Assessments
Permit 0O
Water/Sewer Surcharge ? -
Address Police Plan Review 1(0'1, -°
Fire SAC V
?
City/Zip Co de Engr Water Conn . V
Planner Water Meter (03, =°
Phone Council Road Unit 280. °°
Bldg Off Y 9 Parks
Arch./Engr. APC Treatment P1 132.°°
Variance
Address TOTAL ?02y, s,l
City/Zip Code
Phone U
2 s4 = 4-7 -? 3?,
4, - <? o Z
,c 54'
Z
(.oCo((0
"*;Da&
w ,r
FOR:.BASSAW BUILDERS, INC.
NOTE:
o Denotes Wooden Stake
Proposed Garage Floor E1. 895.63
(B953) Denotes Proposed
Finished Ground El.
-rt- Denotes Direction
Of Surface Drainage
Vertical Datum - N.G.V.D. 1929
Qr
5
W
;J1
J
.1'
W
N
M
o
N 'n
z
34
Proposed
House
ail
1 3 ?,
4 ?N
-C
?. I Q-"IF /1393.') 24 u1-11 -9
\ n I (A93.28)
b.4
?g92.59? ?-2815- .. ? $\° 181 31?
R= 14r.
SU N RISE COURT
Lot 12, Block 4, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
WE HEREBY CERTIFY THAT THIS 15 A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, OF ANY,
THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND.
Dated thisday of Apt-,) A.D. 19 85 C. R.?W!NDEN 8 ASSOCIATES, INC.
by Surveyor, Minnesota Rogiuration No 7726
C.R. WINDEN-&'ASSOCIATE$, INC.
LAND SURVEYORS Tot 615.3616
1351 EUSTIS ST., ST. PAUL, MINN. 65106
N
S S?°48137" Ig 9383)
1393
.5 ?f9-0I 1 Scale: 1" = 30'
I I O Denotes Iron
Monument
c?
?v
r
m
rI O
N ?
r ti
o ?
WZ 19
AVERAGE LINEAL FEET OF.
EXPOSED WALL AREA ABOVE GRADE
?lain level.
Lineal it. of framed wall above gradel52, x height of wall Z.J I?
Rini joist area ' - 2(P
Lineal ft. of rim ?SZ x height of rim
Lower level 1
Lineal ft. of framed wall above grade?x height of wall 5 34z
_4_
Lineal ft. of masonry wall above grade 11,1,, x height above grade -13
TOTAL wall area above grade including windows and doors
WIEDOW' :
Make .C typ
q•
q•
q•
4•
- sq
" sq.
sq.
sq.
„ sq.
„ sq.
q.
sq.
sq.
-- sq.
„ „ - sq.
„ sq.
!)OORS: Area x "U" vat
a Q II
Make & type ,p
Y/4 C)O oU/J Zsq.
15Li"X ui ' 00JIL', sq.
sq.
sq.
0I1A01.11? WALL CONSTRUCTION; - Area x "U" value
sq.
AMW M)4 -A sq.
Detail. refer
IAWINXr q•
ence f rom V
10 _101-01 d sq.
attached Ow At
GIAA
S ka J5 `r?S sq•
u
l sq.
sq.
ft Z x "U" 5-Z c0. L4' (U)
.
ft
.0x (U)
..U.. ° 9 (tt)
ftx
.
O x
ft (ll)
"
" av (u)
ft x U
ft. x '.un ° (U)
ft. x
ft. x (U)
ft. x "U" ° (It)
ft. x ..un = (U)
x_ LU" - (U)
ft. x " u"--. (U)
ft. x "U" _ (U)
ft. x "U.. (U)
ft. x "U" (IT)
ft. x IOU" ° (U)
ft. x "U" (U)
(o
22?
f t.1 (3 x lull (U)
ft. x .lull ° (U)
ft. x "U" ° (ll)
x
ft "U" d (1')
.
ft. I
ft• x It (U)
?U" v (U) It11 v (U)
ft. ?Lb x
ft. Il )5 x "
U" •0(O (T!)
ft. x U..
.. (p.
s ;
ft. x
TOTAL Wall Area Including
Windows & Doors f??C TOTAL (U)(A) (0lil,
r-=
MlAL (II)(A) Vn[,ltl?S w„ = AVG. "U"
D 1 V 1 DI•:1 6Y TOTAL WALL AREA t`
AVE'RAGF, Minimum ..17 or less for 1 & 2 family dwellings
:Minimum .22 or less for all other buildings
N11TE: !I average "U" values as calculated above do not meet the Energv Code requirements, th.
"Alernate Envelope Design" as indicated on Page 5 may be used.
WALL SECTIONS
NO'I'lyo-_ Use' 10% of opaque wall area
for-framiag members
FRAMING MEMBERS IN WALLS
Top View
Exterior air,_film..___- _
----- Siding
y_ _. -
?. ,L•
Sheathing °1 ?11t?((lilj?'
oft wood -?
dry wall
Interior air film
U - l/R I
ID.q1
_FRAMED WALL
Exterior air film
Siding
Page 2
R-Value
.....17.... _
2•?b
.45
.68
/0.91
U c .Oq
Sheathing ?5L4' [IdLZj?i??
u
batt insulation 1-19
?" dry wall
Interior air film -
.17
Ll
.45
.68
TOTAL R n 2'3 03 --
U= 1/R U m • 0 4
RIM. JOIST -U -
Exterior air film 17
Siding
Sheathing ti???ti'?vdt?t /L?O?
1?" soft wood-- _ 1.88 ---
.68
_
Interior air film
.10. TOTAL R = I?, Alp
U U a ?W
MASONRY WALL
Exterior air film
12" concrete block
Insulation
Interior air film .68
TOTAL R = 1? ?3
U = I,R 5.13 u
ROOF CEILING
Page 3
_ Ntside-air film .61
Insulation
S?
Drywall
Interior air film .61
TOTAL R m 41 &0
---------------
U - 1/R U ° '0Z --
'I'(iPAL AREA: sq. ft.
Detail reference "u" x sq. ft. . (U) (A)
From above. "u" x sq. ft. (U) (A)
Describe openings K "U" x sq. ft. (U) (A)
in roof 'lull x sq. ft. (U) (A)
T - fluff x sq. ft. ^ (n) (A)
"U"-- x sq. ft. (11) (A)
_ nun x sq. ft. (U) (A)
TOTALS 1'75 sq. ft. 23sy (D).
TOTAL (U) (A) VALUES DIVIDED BY TOTAL ROOF/ QZ/ AVG. U
CEILING ARh:A
AVERAGE "U" .05 for ventilated roofs
.10 for all other construction
NOTE: If av"r:iye "I'" values as calculated above do not meet the Engergy Code requirements, tht
"Alternate Envelope Design" as indicated on Page 5 may be used.
--
?r jo PERMIT Cr?6'6;7?-z
CITY OF EAGAN 3 ,3,d -9 ,
3830 Pilot Knob Road PERMIT TYPE: Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS:
1Y'(? SUHH 1,`.; E. CI
5 lJ N (. L. '. I F
^. T.N.. P, 1257; 1. .'?--ri74
DESCRIPTION:
7uiIdL ° rm.iC Type=
i3r!,ldinl? '.7aar': Type
F I I d EPLACl4
I' I I_ W
I:
is
REMARKS:
FEE SUMMARY:
c I '.
_._ rch.Iry?'
total rc•e
j.. J (4
CONTRACTOR: - nup t c:: t r I I I. OWNER:
SESFI-R7 C 0 N S I _NC M H I59Ei:1797 31..1'.1 I7ZCIC ^I^,n?`NC
'11HN1:10NKPNH 55311 =AG E! W
PPLICANT/PERT TEE SIGNATURE
ISSUED IGNATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: 1 o APPLICANT:
1 895 SUNRISE C', St.I I t R I C01'?'?, ..P:C F'
'.111: C1 F1 '151
4bfo:
PERMIT SUBTYPE:
t-TREP1, ACC
TYPE OF WORK:
INSPECTION TYPE
000 7'fgG DDATE INSPTR. INSPECTION TYPE
P,I
F?. 14 DATE INSPTR.
REACTIVATE
PERMIT I
,?0S 7?
CITY OF EAGAN
1993 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Valuation of work
Date_ / /
GG
Site Address: v/'1 <-2
STREET SUITE #
i
Tenant Name: (commercial only)
LOT _LZ- BLOCK SUED. C{, P.I.D.
Descri tion of work:
The applicant is: ? Owner ontractor ? Other (Describe)
Name /a%,/C, Phone ?? y5K?
Property LAST FIRST
Owner Address ?Sfh''-_
STREET STE #
City State Zip
Company Phone 7
Contractor Address ,{.??U-VZQ A., tS/r?0_ License # 3/ f ? Exp.
City ir?.??7`7?l State. /19„/ Zip'. o
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
.I hereby acknowledge that I have read this a pI" tion and state that the information is
p
e State of Minnesota Statutes and City of
correct and agree to comply with all ap li
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYP E
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add11. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
1st F1. sq. ft.
2nd Fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
? Final
? Framing
? Draintile
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
valuation:
SAC %
SAC Units
#? ???X?Xc?C?C?kMXt?C??C%ck??7k%?k?%???X?X?X«C*?X?tXt*M?X?X?7k#
CITY 01 EAGAN
CASHIER% 3S TERMINAL NO: 692
DATE: 08/10/33 TIME: 10:2030
ID:
NAME: IN--EX DESIGNS & ROOFING
3210 9001 035 SUNRISE CT 01.25
W5 9001 1.895 SUNRISE CT 2.50
Total Receipt Am=0 113.75
CR i i °7884
USER ID: JAN
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
-1 a 3830 PILOT KNOB RD - 55122
651-681-4675 I (?\
New Construction Requirements Remodel/Reoalr Reautremen U -
? 3 registered site surveys showing sq. ft. of lot, sq. H. of house
and all roofed areas (20% maximum lot coverage allowed)
D 2 copies of plans (show beam & window sizes; poured fnd. design; etc.)
D 1 set of energy calculations
3 copies of tree preservation plan R lot platted after 711/93
DATE: IS Y/7 ?i
Name: Aalk Phone#:
Last First
DESCRIPTION OF WORK: 7--ea ?' o r4- YL-- o6g!rwc
STREET ADDRESS:
LOT: I BLOCK: q SUBD./P.I.D. #:
PROPERTY
OWNER
Street Address: /6"F/ SJG/OI S,C City E19V e A-" State: ^ U Zip: S_/ Z 2
f l z- S'i'p'-114100
(area code)
CONTRACTOR
ARCHITECT/
ENGINEER
Street Address: VDU ?w/A >L ?4f.(~ S License # 42?,QM s - Exp.
City /7/"t ;ee State: Zip:
Telephone #: area code ( )
2 copies of plan
1 set of energy calculations for heated additions
1 site survey for exterior additions b decks
CONSTRUCTION COST: ?S'C?Y>. ?
Name:
Street Address: Registration #:
City
State:
Sewer & water licensed plumber (required for new construction only):
Penplty applies when address change and lot change is requested once permit is Issued.
Zip:
I hereby acknowledge that I have read this application, state that the Information Is correct, and agree to c
Stave of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No AUG
all applicabl
Tree Preservation Plan Received Yes No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
X 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)
O 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line On ly ? 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),EP-42 Reroof
* Give PCA handout to applicant for demol ition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft,
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Spdnklered
Variance
Permit Fee
Surcharge 3 5 O
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
Copies
Total: i ( -)
Valuation:
SAC Units
% SAC
LOT /, BLOCK -?/ SUBD.
RECEIPT #®?/9?
CITY OF EAGAN
UNDERGROUND SPRINKLER SYSTEM PERMIT
1993
Date:
Commercial project
Residential project
Existing residence
Area/address to be sprinklered: jd l Sitn i-, LouG?
Installer:
Street address:
City, state & zip:
Telephone #: G/ 2- -05-?j%L
Owner name: U?< lC e,y !?? r-- /<---
Street address:
City, state & zip:
f Lj _
Phone #:
Irrigation contractor, if different: f/( D 142 10
Phone #:
I hereby acknowledge that I have read this application and state that the information is correct and agree
to comply with all applicable City of Eagan ordinances.
?C5 F i at a of Permittee
611-
New service required
Fee due: $ J Calculated by: C x
CITY OF EAGAN
UNDERGROUND SPRINKLER SYSTEM PROCEDURE
1993
1. Plans must be submitted to the City's engineering department for approval before
installing a lawn sprinkler system. If digging in the boulevard, a right-of-way permit
may be required.
2. Once plan is approved, it will be presented to the City's plumbing inspector for sizing
of the meter.
3. Jerry Wobschall, Finance Department, will calculate permit fees as follows:
a. Commercial project: $ 25.50 plumbing permit.
$ 50.50 water permit fee only if new service is installed.
$100.00 per tap if installed by City. Please consult with
engineering department regarding feasibility of City
installation (City will only install taps up to 1").
b. Residential project:
$ 15.50 plumbing permit.
$ 50.50 water permit fee
$695.00 per connection -
if new service is installed.
WAC.
$324.00 per connection - water treatment plant.
c. E>ostine residence: $15.50 plumbing permit - (not required if backflow
preventor previously installed) however plan must still be
presented for approval and an application must be filled
out.
4. Once meter size is determined, building inspections clerk typist will contact utility
billing clerk for cost and notify installer of all costs associated with project. If new
service lines are not required, one check may be written for meter and permit costs.
No meter will be sold before all sewer and water inspections are complete on a new
service--(engineering department will advise utility billing clerk when meter can be
sold). Receipt will be coded to 20-3716 (meter portion only) with pink copy
forwarded to utility billing clerk.
5. The installer is to contact building inspections division at 681-4675 for inspection of
the inside water line and backflow preventor. The public works department may be
reached at 681-4300 for water turn-on and set and sea] of meter. Inspection hours are
8:30 AM to 3:30 PM, Monday through Friday. Requests for AM inspections should
be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon that day.
1
,I
2/84
CITY OF EAGAN
Iui APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
C 'r
1) Pro= A.CD,nESS:
=AL DE"RTPTICN: ?F-
(LJtBlock/Subdivisicn or T"' ax ei I.D. NL.?r)
I =E-
..', E .•., STRI:C ME, DATE OF CRIGL17 wl'?^L`.O n== T_S? t\i= :
a _?. ?.. --_,
P=DSO'
S2 :7,z F'%;mlLY
? R-2 DLP_ . (7-.0 L'^'.I IS )
0 R-3 Tr_W,Z-CUSE (T`=.u. - L" _'IS) ( UNI'_S)
( CN1-i
? CCi7=1CZ.L/R _Aiil/CFFT_C
2) APP7T 7 _ -- (PLEASE PR r
y _ -
CT:":', SI;!:TE, ZIP:
PF.ONE:
3) Pam- c"Sc Pte) FOR CITY USE ONLY
NAME:
1 PLUMSERS ,NSE:
ADDRESS: ? (,f
I Active
CITY, _STATE, ZIP: y yy_ ? - ??i - ?t S e/ ? C1 Ex ed
PFOVE. -LU PLUBNREE
LILEfiSE o
f of Record
4) O=,:PA T/C!:??ER (PLEASE PRINT)
NAME: ?. yJgc
e
ADDRESS:
CITY, STATE, ZIP-
PHONE-
5) INDICATE WHICH PEMIT IS BEING REQUESTED:
CC:+TIECTION TO CITY SF i'ER
j' CO,':,% :rICN TO CITY I-TA.TER
O77HER (PLEASE DESCRIBE)
6) L.TUIC:: C: :
Q PLEASE HOLD APPROVED PER`aT FOR PIC:.-L'P BY C` CF E
:I APPROVEID P&? _LLT TJ 1 4 E
'
2
=e one
-
(Ci
7) SIC:ATURE: DATE:
9
s ?! aa?.? ss?s:s +? a ssg? s s r!? o s:aa w s s r:sa? :a a a.e re wtsan+v-?y? a +? is ?e as:saa.
F O R
PERMIT u ISSUED
E:::?
C I T Y U S E O N L Y
FEES: $ /O. o
$ V.. l
/
$
$ ?S•µr>
$
$ UU:?d
S .>oL?v-rJ
$
$
$
$
SEi'lER PE3 uT v * o
WATER PERFlT_T (INCLUDE SURCHARGZ)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SE.1ER TAP
ACCOUNT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSES-c"ENT
TRUNK SE'. ER ASSESSr.EN4m
LATERAL BENEFIT/TRUNK SET
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
AMOUNT PAID/RECEIPT n ?vZ y
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
7-7 YES IF YES, THEN A "PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION-SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: lO -?
A F/?Ml?f?ES l?tM?
?! /? ?-ff w A RA ?k7 /! ?1i+ sA R? ! 1! ?iA ?A R A fA OEM
R- qo.eo
my of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651)675.5675
Fax: (651) 675.5694
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -71 /(,Z(L Site Address:
Tenant: _
RESIDENT I OWNER
Suite
TYPE OF WORK
CONTRACTOR
Name:
Applicant is: _Owner X Contractor
Address I City I Zip:
Description of
Construction i
Name: (1c
------------------
I I
A`f7l ? I
j Permit#: I
Permit Fee:
I
I
? Date Received: ,
I
I Staff:
-----------------
Phone:
Multi-Family Building: (Yes _// N04
L License #: X O69499
City: State: ? Zip; 6608,
Phone: toJ?' ?I 1 ???tJ Contact Person: V0('00
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted submitted
submission type) • Energy Envelope Calculations Submitted
In the lest 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
Licensed Plumber:
Mechanical
Sewer & Water Contractor:
If G e
Applicant's Print N me
Phone.
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 witi be in
accordance with the approved plan In the case of work which requires a review and approval of plans.
X (A ? Ire hl?AgA
Applicant's Slgrtar
Page 1 of 3
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use I
City of Ea~ti I Permit
I Permit Fee: 2~ I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
-
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Q,cI ~y
Date: 10 7-1 13 Site Address: Unit
Name: L -bTj(x F~no( /l-ev Phone: (057-1, 757, 07y
Resident/
Owner Address/ City/ Zip: I 1 ~~t L r` i . ✓4 l`-) ,
Applicant is: Owner Contractor
Type of Work Description of work: I:S)A
e
Construction Cost: -K 2- 0J. Multi-Family Building: (Yes /No
Company: __V6 tJ
eGK C,,, S~/<ca GYlA Contact: ~TJ
Address: 3 d qlr-( Contractor City: e 5t
State: Zip: t7 Phone: t0 'T s ( Z 7 (p tQ '7
I
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
I In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information 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.
ce. Q / e- c 1< 41/
Applicant's Pri ted Name Appl' an s Signature
Page 1 of 3