1500 Thomas LaneCity of Eaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
gygao
CIb• bD
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7- 13 --fa Site Address: 45-012 t2 7 -c s 4 AI' A- 44 -Al .4 1/
Tenant: Suite #:
RESIDENT / OWNER
Name: re1is. M.,.,,,.w Phone: Gil -7- L'®J- '70 Yr.
Address / City / Zip: /Se 0 71w s Lq/ CM- 1414, k}'
Applicant is: Owner )(Contractor
TYPE OF WORK
Description of work: k.t. 40ck
Construction Cost: liezgte► Multi -Family Building: (Yes / No )Q))
CONTRACTOR
Name: e rat" ; 1 A p r s 0.4 MI) 2. JC, License #:
Address: %,5,23 R'ne v/i'e i/ GA/ N City: moip(e._ crOve
State: th N' Zip: 55-3c9 Phone: 72-J7.' -7s-4 7
Contact: Email:
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
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 info Km Poriions of
the information may be classified as non-public if you provide specific reasons that would permit the Crt,1r tc
conclude that they are trade secrets. u
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.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.
x ` ry Fin Pei V Pi
Applicant's Printed Name
x
Applicant' Signature
Page 1 of 2
C.>
girt'kB;M:kik;;;y;;?k>k?r:,yr.;,..1;X::{:Y,t:M.;..".,?i',... , „ ? ,^:o;kc;:>;(cY,•,?.:.,:,,'IC .
CITY OF EAGA
CASHIER: S TERMINAL NOt 7996
BATE 11/20/99 T.T.Mr'C 1.4¢49„?
y ,
Tr'V
NAME- I_UNDGREN BROS CONSTRUCTION rq
ER56 900i :L:`OO THOMAS LAN Sy7e6.46
I
- III
Total. Receipt; Amount.: 5706 , 44,
CR099': 'r'T
USER TD; NANCY {
u: :,ii;?:l yr n4yd k`}; X 9F1 ,( g'<..',. ;>;(MY: Xn;>k$';"7! ;:1,"TO
Address 1500 THCK4S LANE Zip 5512 2
Lot 1 BIk 4 Sub PD ETREE PASS 2nd
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final grade (6" from siding) ?
Permanent steps (garage) ?
Permanent steps (main entry)
Permanent driveway ?
Permanent gas
Sod/Seeded grass t/
Trail/curb damage fj
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
Kertificate of cccupaucv
Witij of (Ragan
department of 13ailbing an4pection
Y This Certificate issued pursuant to the requirements 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 building construction or use. For the following:
fj c a diiauon:.S' M Bldg Ntoo, No. y.n7--:.M
0-runcy Type I3 Zoning titanic: VR I Type Consl. ?j
Manes of Building TTMGM BRDS -- Addocs 91S WAMM BEND -E- WA3MW
Bufldin nadn? 1%0 IRCMAS-IM Locality PTNR9RER PAq-S ypm
r1 :.?? ?e V
Building oBiicial
POST IN A CONSPICUOUS PLACE
i? CITY- OF EAGAN
38:0 Pilotknob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
034078
11/20198
SITE ADDRESS:
P.I.N.: 10-57661-010-04
3.500 THOMAS LANE
LOT: I BLOCK: 4
PINETREE PASS 2ND
DESCRIPTION:
Buildinq Permit Tyne
Buildinq Work Type
'UBC Occupancy
Construction Type
Zoninq
Buildinq Length
Building Width
Buiidinq stories
Csus Code '
SF DWG
NEW
R-3
5N
R-1
70
42
2
101 1 - FAM. DETACH
REMARKS:
PLAN REVIEWED BY CRAIG NOVAC7YK
S & W PLUMBER IS ELANDER PHONE#445-4692.
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
$1.847.25
$1,200.7:1
$146.00
$1.000-00
100
$4.193.96
$292.000
MISC. FEES $1,592.60
Total Fee $5.786.46
CONTRACTOR: - Applicant: - sT. Lir.. OWNER:
LUNDGREN BROS CONST 1473123:1 000:1413 LUNDGREN BROS
93" E WAYZATA BLVD 935 WAYZATA BLVD. E
WA#eZATA MN 55391 WAYZATA MN 55391
(612) 473-1231
I hereby acknowledoe that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
--p 0
LICANT/PERMITEE SIGNATURE SUED 6Y: SIGNATURE
f - 1998 BUILDING
New Construction Requirements
Last
4 3 registered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.)
• 1 energy calculations
4 3 copies of tree preservatiop plan K lot platted after 711!93
required: _Yes X No
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS: /%,? 0 O I/ /r >f7/i
LOT: BLOCK: 41 SUBD./P.I.D.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Street
PERMIT APPLICATION (RESIDENTIAL)
CITY OF RAGAN
3830 PILOT KNOB RD - 55122
681-4675 4
Ca9_Q1t?fl 1°'
Remodel/Repair Requirements
4 2 copies of plan
? 2 site surveys (e)dedor additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST?? Lo,-)
Phone #:
City State: ??f77?a?wZiip:
U o??fo S?
Company: =? S . Phone #:
Street Address: Q ° , ((/?}l?/?Tf }1??• License #
city ?? ?? State: /lJ Zip:
Phone #:
Name: Registration #:
Street
City
State:
Zip:
Sewer & water licensed plumber (new construction only): EC / J X 6 if Penalty applies when address chang
and lot change is requested once permit is issued. q y _ L( (, / )-
I hereby acknowledge that I have read this application and state that the information is correct and,agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. /1 ?1 f
Signature of Applicant: I ! /rA/7 ???/)/I1f p
OFFICE USE ONL Yi Certificates of Survey Received //Yes N 2 771
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
X 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _ plex ? 15 Deck
WORK TYPE
31 New ? 33 Alterations ? 36 Move
32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) S- ? Basement sq. ft. ZS78 MC/WS System
(Allowable) 5-&[ Main level sq. ft. 2(65 Z City Water
UBC Occupancy 73 2`D?J sq. ft. 13 Fire Sprinklered
Zoning Po runt sq. ft. 2-0 f PRV
# of Stories ?Y Esq. ft. /o®P Booster Pump
Length sq, ft. Census Code.
Depth 7L Footprint sq. ft. SAC Code t7l
Census Bldg
Census Unit I
APPROVALS
Planning Building 0-44 Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License n k / Y=
MC1WS SAC x 2
City SAC _
`fib 32 X "S
Water Conn.
r M
W
t
t ! 3
X
a
e
e
er r
Acct. Deposit 2Qy 1c S
S/W Permit /O'erX /L =
S/W Surcharge
-
Treatment PI. 07-A-Z ,-
7
Park Ded.
Trails Ded
Other
Copies
Total:
$ 'ace) 6,,75 D
530Zoa
/q7j /2-0
loll Z3 4
/11 2-N&
/7, 4DO
292/aou`=
% SAC
SAC Units
r
a
m
o
z
0 ?
E?? ?
E3 ?
2--'? ?
ar, ? ?
W, ? ?
ar' ? ?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: ?J 6W41 /<o-
DATE OF SURVEY:
LATEST REVISION:
DOCUMENT STANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and scale
• House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directional drainage arrows with slope/gradient %
• Proposed/existing sewer and water services & invert elevation
• Street name
• Driveway
ELEVATIONS
Existina
M---o ? • Sewer service (or Proposed)
a--'O ? • Property comers
Gr' ? • Top of curb at the driveway
? la' ? • Elevations of any existing adjacent homes
Proposed
//
?' E ? Garage floor
as ? ? • First floor
D ? ? • Lowest exposed elevation (walkout/window)
?/0 ? Property corners
tion
t th
f
d
f h
e O ? • ome a
oun
a
e
Front and rear o
PONDING AREA (if applicable)
O ? ? • Easement line
? ? ? NWL
? ? ? • HWL
?? ? • Pond # designation
/
O ?Y ? • Emergency Overflow Elevation
DIMENSIONS
t7 ? ? • Lot IinesBearings & dimensions
? ? ? • Right-of-way and street width (to back of curb)
da? ? O Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
/
2- O ? • Show all easements of record and any City utilities within those easements
t5?? • Setbacks of proposed structure and sideyard setback of adjacent existing structures
? L'I ? • Retaining wall requirements, if any
Reviewed:
January 1996
CRAIG? •p919LDGPRMT.FM
t?.'A. CA&
U111 DGRGI
0 R OS. EXTERIOR ENVELOPE AVERAGE U COMPUTATION
CONSIRUCIION
INC.
Site Address_ 1*00 4OD'N4 UNAV-- Lot ) Block
R & U Factors
935 E. wayt017 MO. Opaque Walls
w;yril, Wall Framing Areas
Mb"imaM55391 Ceiling Insluation Area
(612013 1231 Ceiling Framing Area
Rim Joist
Masonry Wall
Windows
Doors
Skylights
1) Lower Level (Basement)
Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Rim Joist
Exposed Block
Window Area
Sliding Glass Door
Door Area
R
?j?IL[ X (U)
U X (U)
At%- X (U)
(02' X (U)
(11 -,?, X (U)
t0 x (U)
--, X (U)
Total
U
.043
.09
_,GET • °x
M.r • om
.04
.31
.55
.043 2?
.09 = 6.f,
04 I?3
/
a ?.fr
35 =
.35 a
.31 =
p
K-it-H??? ? U
LunDGR(n
BRCS.
2) First Or Main Floor
CONSI RUC ZION
INC Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Rim Joist
935 [. Way7,ala Blvd. Window Area
w;ryraL, Sliding Glass Door
MII111P.s II855391 Door Area
(G 12)473-1231
14 ??} y
X (U) .043 =
$
X (U) .09 _
=
X (U) .04 147
?y,
'L41 ,74139 X (U) .35 = ?Iq ,to
X (U) .35 = ?j77 •r7
g X (U) .31 = .?
Total
3) Second Floor If Two Story
Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Window Area
Sliding Glass Door
1 h,72Z-
1' 610'gX (U) .043 = 5'?17 9
loo X (U) .35 = -4q
X (U) .35 =
Door Area / X (U) .31
Total 116 .
4) Total Ceiling Area
Wood Frame Area
Opaque Ceiling Area
Skylight
z?7?• X (U) Ge
X (U.) _'m = Sri ?'
16-X (U) .55
Tota l
LUnDGREII
BROS.
CONSTRUCTION
INC. MINNESOTA U FACTORS Total Exposed Wall Area Gj(Q'IX .11
MINNESOTA U FACTORS Total Exposed Ceiling
Area X .026 (A) Total aO?ol (y
9151. Waymb Md.
Kryrda Item 1 1 " + Item 2 Item 3 1 '4+ Item 4
Mlmx:snla 5 r391
(612)473-1231
v
If Total Of Items 1-4 Is Less Than Item (A), Building Complies With
SBC 6006 (C)s
r4
?? 9ry6
/
? i
i J
i
4ec
a Q
^? CZ I
n•
ego 'S/ w
\?2Ao
\ ,moo
/S & W SERV\
' ELEVATION 930.5
9go.a
PROP
r nYO?,N sfttis,
f
GgRgct
(94J.0)
/ \ I
932? `T RS
^?
937.4 1s
'?
\ O 1 ??.5 934.5
\9?S.S \ POW ( x` l
\OO\ k933.1 , 14.
?S
O??/??C ARE
F?S
5610 --*? F???T??/T? sr r
3853 F
D s<,?
C"
?I
rn
?3ry
/I
k
I i
rn
0
N
O
2
rr
a)
OO
Wil
S
W
ST
ANE
LEGEND
DENOTES SANITARY MANHOLE
DENOTES HYDRANT
DENOTES CATCH BASIN
DENOTES SANITARY SEWER
DENOTES WATERMAIN
DENOTES STORM SEWER
DENOTES STORM MANHOLE
DENOTES STORM APRON
SETBACKS
MIN. FRONT YARD SETBACK = 30'
MIN. SIDE YARD SETBACK = 5', 15' BOTH SIDES
MIN. REAR YARD SETBACK = 15'
Proposed Top of Foundation Elevation-943.83
Proposed Garage Floor Elevation= 943.0
Proposed Lowest Hoot Elevation 934.5
0 Denotes Iron Monument
+ 910.0 Denotes Existing Elevation
+(910.0) Denotes Proposed Elevation
Denotes Direction of Surface
Drainage
I hereby certify that this is a true and correct representation
of a survey of the boundaries of:
LOT 1, BLOCK 4, PINETREE PASS 2ND ADDITION
DAKOTA COUNTY, MINNESOTA
And the location of all buildings, If az thereon, and all visible
encroachments, if any, from or on said land. As surveyed by
me this 22nd day of Octgper 1998.
Gary R. Germond
Licensed Land Surveyor, Minn. Lic. No. 24764
I
'c•?? -
h t'
U
W Z
aspp
W p?
a? o
v?
LU
J
16425
°CI EAGAN PERMIT
38 ILOT KNOB RD
EAGAN, MN 55122
651-681-4617
BATT ON
S- -L-E-S Dot A F-I
730M
WNW
kff:
CD TH: MEM
TR rff: FI1T W
INI: 381
DATE: MY 29, 99 13:P.45
TOTAL $60.50
W. WZIII17MI38 Eli: 01/W
AN ?10173
WD IANf BFAILB
C ACg10ItE0tE5 AT3 n 01: BODDS
SERVICES IN THE MW OF TIE
TOTAL go ma 00 Ams TO Pom
THE RIBATIONS SET FORTH BY THE
C / ''SS AAAf/AE W HITH THE ISM
' L?e i'wo /' /
TIP COFI#BCIm BOTipI CO"mum
.x:,UK$C$ Ac hY,..?.$t),CStY,?1.tYF:?,?7..,..(•ti'x.;..$;?:?u>8?k)k$S
(.',I rY O EIAf,AN
CASHIER: ', rE:RMTNAL NOc 60.
DATE_': 05/20/99 TIME: W5038
TL.
NAMEn LANCE BEAULIEU
EA 900:1 000 TOMMAS LN 60.00
POW 9001 000 THOMAS I...N 0.50
Total Receipt Amount- 60.50
USER TO NANCY
y...,,i,},(r'"%fYI:1?:f,Yn?'F.YF?M1?M)?R:?F?.In)?Ch() )?,::TT?I:r':fiYFn`".:i;#S(BiYF
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
rp / CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651.681-4675
Construction Reaulrements
3 registered site surveys showing sq. ff. of M, sq. ff. of house
and all roofed areas (20% maximum lot coverage allowed)
2 copies of plans (show beam i window sizes; poured Md. design; etc.)
1 set of energy calculations
? 3 copies of tree preservation plan R tot platted offer 7/1/93
DATE:
„ • •I?IIST- , Rl[I L3;e3
2 copies of plan
1 set of energy calculations for heated additions
1 site survey for exterior additions a decks
CONSTRUCTION COST:
DESCRIPTION OF WOk: f)e C (1?- (? ZI ?V(g LL O 6e -S (ff
STREET ADDRESS: 15-0 U -r1 e,1R J Z
LOT: BLOCK: _ SUBD./P.I.D. #:"r ° l^-?? C7 d?-O ry
Name:,)"W,o - dell?L ell7la!s/Phone#:6Ytl- 6-0(9-6356
PROPERTY Last / First / ?P 6i?2-1,2
OWNER Street Address: / r ?Q U ?vt6/?1tfl,I N city cl Leh State: /Al /I Zip:
Gg?l
?? S l Phone #: Gl? r 7e
Company
7 (area code)
CONTRACTOR Sheet Add 300 /74t, S D Z 76 Ucense ti 2do 9a o 4 xp. 3 p 4
Address: City C( State; LZ - Zip: SSj (tJ
ARCHITECT/
ENGINEER Company: 4 ? P Name:
Telephone #: area code (
Street
City
Sewer & wafer licensed plumber (required for new construction only):
State:
Penalty 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 Informations correct, an agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Registration #:
Certificates of Survey Received Yes No
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.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 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) ? 42 Reroof
* Give PCA hando ut to applicant for demol ition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning
Building I `- Engineering
Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SAN Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
CITY USE ONLY
L BL SUBD. f?Xf?n i ?TLI-M? n o
RECEIPT #:
RECEIPT DATE: //7
PERMIT # ?UJ L--I I
1999 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAraAN
3980 PILOT KNOB RD
EAEAN, MN 55122
(651) 681-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTURES
EACH
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 100 x - $
Minimum fee alterations to existing dwelling 30.00 x = $
Private Disposal System new/refurbished ' requires MPC tic. 75.00 x = $
Private Disposal System abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $ _
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground srinkler if dwelling is under construction 3.00 x = $
Underground srinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surcharge .50 > > ----> $ 50
Total --> > > ----> $ - S
Reminder. Call for inspections of alterations, Le. water heaters, water softeners, etc.
- -------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this applicatlon, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: _/<` a? D
OWNER NAME:: ??nr GGc TELEPHONE M
(AREA CODE)
INSTALLER NAME: TELEPHONE #: /n J ?Z 7?0 S??
STREETADDRESS: 1/SIJ u) js7d (AREA CODE)
CITY: STATE: ZIP: 5?1
SIG TORE 0 PERMITTEE
VV BIL G2 CITY USE ONLY RECEIPT M 0.3pOCS 3
SUB .L 4, G?43 ?6 RECEIPT DATE:
1999 PLumBiNH PERMIT (RUIDENTuW
CITY OF EAGAN
3$30 PILOT KNOB ND
EAGAN, MN 5518E
(651) 691-9675
Please complete for: ? single family dwellings
D townhomes and condos when perm its are required for each unit
? backflow preventer for underground sprinkler system
------------------------------------------------------
FIXTURES ------
EACH ----- - ------
TOTAL
Shower 3.00 x 2-
=
Water Closet 3.00 x S = °0
Bath Tub 3.00 x
Lavatory 3.00 x 7
Kitchen Sink 3.00 x Z = 6 °-°
Laundry Tray 3.00 x 3 °O
Hot Tub/Spa 3.00 x -8?-
WaterHeater 3.00 x Z = 6"°
Floor Drain 3.00 x I = 3 °°
Gas Piping Outlet ' minimum-1 3.00 x 2 = (o °°
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
Water Softener for existing dwelling 30.00 x =
U.G. Sprinkler for dwelling under oonst. 3.00 =
U.G. Sprinkler for existing dwelling 30.00 =
Alterations to existing residence 30.00 =
Water Turn Around 30.00 =
Private Disposal System MPC lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems Abandonment 30.00 =
RPZ (new installation/repair) 30.00 =
STATE SURCHARGE .50
Reminder: Call 681-4675 for inspections of water heaters,
water softeners, alterations, etc. S-0
7a
TOTAL
-i ------ ------- -------of - E
I hereby acknowledge that I have read this application, state that the information Is coned, and agree to comply with all applicebla City agan ordinances.
It is the applicants responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: /SOO /?!r 4s L s ??
OWNER NAME ?r Gt S/ ?/d S? ST.
INSTALLER NAME: X/-IG dr/Y?/ TELEPHONE#:
STREETADDRREESS:
CITY: STATE: ZIP: -5-3-37Y-
SIGNATURE OF PERMITTEE
CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999
V CITY USE ONLY >> y
LOT _1- BL RECEIPT #:
SUBD.?ts4t e? l COY RECEIPT DATE:
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
L? /9 a (651) 681-4675
Date: r /
Complete this section only if you are installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required a $3.00 ea.)
• State Surcharge: .50
• TOTAL:
Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Please indicate if it is a new item, replacement item, or repair.
New
Furnace
Replacement - Repair _ Other
Air exchanger, i.e. Vanee system, etc.
Reminder: Call 681-4675 for inspections.
Air conditioning
Other
S30.00
State Surcharge: .50
Total: $30.50
SITE ADDRESS: SAD ?2 0 1j Kl- :5
OWNER NAME: L wiz 13/o s Co-' S T PHONE
INSTALLER NAME: 4-l q K We,, 104 6," l PHONE #: ?ys Yb ??
STREETADDRESS:
CITY: STATE: ZIP: j S??79
SIGNATURE OF PERMITTEE
JS/FOILMS BLD/MECH PERMIT (RES)- 1999
L BL
SUED.
APPROVED BY:
INSPECTOR
RECEIPT #:
RECEIPT D,
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY of EAeAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 6$1-4695
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Processed piping - $30.00
CONTRACT PRICE x 1%
PROCESSED PIPING
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
($.50 per 31,000 of hermit fee due on all permits.)
OWNER NAME:
PHONE #:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS: PHONE #:
CITY: STATE:
ZIP:
CITY USE ONLY
SIGNATURE OF PERMITTEE
INSPECTION RECORD
.., - ITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS:' N - 0 +, / hFC -.N 1 N
L(II 7 ! rzL.ni i
rqr,', . hNi
PERMIT SUBTYPE:
APPLICANT:
TYPE OF WORK:
INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR.
(Etl4ARK' VtAN nfVIHALi1 8Y CRA16 NI)VACZYk
3 71 Permit Holder Dete Telephone #
SEWER/
WATER
PLUMBING
pol
/Q 9
S?GQ?.
HVAC 9 y s• S/G9l
Inspection Date Insp. Comments
FOOTINGS t?
a
f
71 `l?
FOUND o
?
? 2 /
FRAMING 1Z
ROOFING
ROUGH
PLUMBING z?
c,,
PLBG
AIR TEST
ROUGH
HEATING /?-
GAS SVC
TEST
INSUL
GYPBOARD 10
FIREPLACE
d 2
Li
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
Y/
DECK FINAL
Date:
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use %� %
Permit #: 1 D S r
Permit Fee: 514 °I° (1°
Date Received:
Staff: 6-6)
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:
Unit #
1 pc\
Resident/
Owner
Type of Work
Contractor
Name:
Address / City / Zip:
Applicant is: Owner Contractor
Description of work:
Phone: ‘67- rO-Y6z7
Construction Cost: cf Z,
Multi -Family Building: (Yes / No )
Company: ;; - 5c� /?Y'94 Fel ontact:
Address:
/, 3/4v £ G ec— bvcC •
City:
State: 1,06_ Zip: 55 JrY- 1 Phone: 67z._ 2/ -.?S 9
License #:
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
CSRW t et
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public informatior. Portions of
the information may be classified as non-public if you provide specific reasons that would perm it 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
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
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; tha
accordance with the approved plan in the case of work which requires a review and approval of plans.
Call 48 hours
codes of the City of
the work will be in
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.
Applicant's Printed Name
.e0/4 -
Applicant' ignature
Page 1 of 3
) S60 J- — S L,/I-&,
DO NOT WRITE BELOW THIS LINE
/6/
SUB TYPES
Foundation Fireplace Porch (3 -Season) Exterior Alteration (Single Family)
Single Family Garage Porch (4 -Season) Exterior Alteration (Multi)
Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of _ Plex Lower Level Pool Accessory Building
WORK TYPES
y New
f Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation ! /' Occupancy
Plan Review Code Edition
(25%_ 100% ) Zoning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Construction 'i) Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Interior Improvement Siding Demolish Building*
Move Building Reroof Demolish Interior
Fire Repair Windows Demolish Foundation
Repair Egress Window Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Roof: _Ice & Water _Final Pool: Footings ‹„Air/Gas Tests ,Final
Framing Siding: _Stucco Lath _Stone Lath Brick
Fireplace: _Rough In _Air Test _Final Windows
Insulation Retaining Wall: _ Footings _ Backfill Final
Sheathing Radon Control
Sheetrock #) Erosion Control
Reviewed By: Li , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
BENCHMARK --
TR SAN MH
ELEV = 940.0
NOTE - DUE TO SNOW COVER
SURFACE STRUCTURES ARE
SHOWN APPROXIMATE
EXISTING
HOUSE
SURVEY IS SUBJECT TO CHANGE PER
TITLE OR EASEMENT INFORMATION
Vi^ e4;40-
f-
14wcfAats
0613
53
co 0
PROPOSEA0'-:
RETAINNG WAL
TWE 934.0
BWEj.-- 931.0
-1-c0
0 20 40 60
-------4
SCALE IN FEET
OP -5 = EXISTWIG SPOT ELEVATION.
x(998.0) = PROPOSED SPOT ELEVATION
-.'* = DIRECTION SURFACE DRAINAGE
GFE = GARAGE FLOOR ELEVATION
LFE = LOWEST FLOOR ELEVATION
EGAL DESCRIPTION:
LOT 1, BLOCK 4, PINETREE PASS
2ND ADDITION, DAKOTA CO., MN.
ADDRESS - 1500 THOMAS LANE, EAGAN, MN. 551:
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City of Eapp
3830 Pilot Knob Road
Eagan MN 85122
Phone: (851) 675-5875
Fax: (651) 675-5684
OCT 1 6 2014
Use BLUE or BLACK Ink
i For Office Use I
7 11'
I permit*, a , 1
1 Permit Fee: /05" e'll5. , lei
i I)
1 Date Received: /41 — i ia° 71174
I
1 I
Staff: I
I
— — — — — ....
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: T t Site Address: C 4\7) \ t:N, Unit #:
R'.61„.0„._6n
' ner
it
Name: , \r, .1.- \ 1---i: r 1\ - Ai, A Phone: 1,1 k-
Address / City / Zip: ‘1 c '1. i -..t,„ - - ‘t iN Vi \ \ - 'I's
Applicant is: Owner Contractor
,..
' ..,
Description of work:
Construction Cost C.C., .Z. t -, Multi -Family Building: (Yes / No
,
, ...
Contractor
.
t
,...: - - C
Company: % , ‘.i.,,. ',',..‹.,, Contact: I 4.,
el,•,... '
Address' i '-''', 4 \IL *,... ,!‹-i.. '-- - i City:
'
.
,,„ ,,„ t ,
States -l' "N. Zip: rbollek
k ' '-e. License #: c.)- Lead Certificate #:
‘..
If the project is exempt
from lead ea cation, please explain why: (see Page 3 for additional information)
n the last 12 months,
Yes if
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_No
L ensed Plumber
Mechanical Contractor:
Sewer & Water Contractor:
Phone;
Phone:
Phone:
NOTEhMerfsehd supporting _d...,,, J.4 ents,that you, submit are consfcfered to be public inforination. POrtiohs of
the fnformationtrtrapbe ciakifficiaai'non-publie ityou provicio,specific reasonelhat would permit the City to
conciude that thoy are hada secrete.
CALL BEFORE YOU DIG. Call Gopher State Ono Cali at (651) 454-0002 for protection against underground utilliY damage. Cali 48 hours
before you intend to dig to twelve locates of uriderground utilities, wwweeoherstateonecallorg
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 1 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 requites a review and approval of plans.
ExterlOr work authorized by a building permit issued in accordance with the Minnesota State Building Code must be oomploted within 180
days of permit Issuance.
Applicants Printed Name
X
Applicant Signature
Page 1 of 3
t