1516 Thomas LaneAddress
Zip 5512 2
Lot 5 Blk 4 Sub Pinetree Pass 2nd Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: of
19-0 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roo test caps from the plumbing system and the shut-off 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
City of Eap
4?>
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2008 RESIDENTIAL BUILDING
Date: Site Address: q <
Tenant:
r
-----------------
I For Offige Use 1
I Q
j Permit #:
I C (?,
? Permit Fee:
Date Received: j
I I
1 Staff: I
PERMIT APPLICATION
/d/
Suite #:
ur
-
RESIDENT / OWNER 0? 20I J e
Phone: (0IC
Name:
Address / City / Zip:
A-? [//
Applicant is: -Owner K Contractor
C7 / g
1 F
TYPE OF WORK ,
Description of work: Te?q
?y
Construction Cost: (/O Multi-Family Building: (YesqP& 7cr / No
CONTRACTOR Name: a l/1/l0 U License
Address: CQ10, (
State: Zip:
City:
J cf U
/
7 x
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
Minnesota Rules 7670 Category 1
_
_
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
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 the are trade secrets.
hereby ack wledge that this information is complete and accurate; that the work will be ' conforman
Eagan; iha I understand this is nova permit, but only an application for a permit, and rk is not to
accordant v ithgthe approved plan in the case of work which requires a review and appr v ?ofplans. 1
Name
with the ordinances an es of the City of
rrt without-e e , at the work will be in
Page 1 of 3
- RESIDENTIAL BUILDING
Permit Application
City Of Eagan
q 3830 Pilot Knob Road, Eagan MN 55122
l Telephone # 651-675-5675 FAX 9 651-675-5694
New Construction Requirements RemodeiReoair Requirements Office Use OnN
3 registered site surveys shaving sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Can of Survey Recd -Y -N
(20% maximum lot coverage allowed) 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 Not Reqd -Y -N
1 set of Energy Calculations Addition - indicate fl cnsite septic system On-site Septic System -Y -N
3 copies of Tree Preservation Plan If lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date --!Z-- / -,? - / 3
Site Address .
I ( cy Construction Cost 2-0 K
yu Unit/Ste #
Description of Work 100 M 4s?cQ { 1 U?' d-?•-? a r
Multi-Family Bldg _ Y
X N Fireplace(s) _ 0 _ 1 _ 2
I
Property Owner AY1A V ` p
0-rL5?-'c-V ?1y' v' Telephone # ( )
Contractor 0.? rt SUVA l?? $'FY tAC A 1 C",A_
Address
State ` N
Zip City
Telephone # ((p$1) 4 (oO D-q L
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateizorv 1
• Residential ventilation Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone #(
N If so, 25% plan review
p? ?TN P
C 1 1 2C03 I'll
I hereby apply for a Residential Building Permit and acknowledge that the infarmdYton is compcomplete 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.
A- 4 A-A\ )S6 N COtJST-
Applicant's Printed Name
Applic is a re
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace X 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 ? 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_Yor_N ? 25 Miscellaneous
Work Types A?
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
Yg? 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) - Give PCA handout to applicant
Valuation 1 ?? o? 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 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Final/C.O.
_ Footings (deck) Final/No C.O.
Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile _
Other
Roof _ Ice & Water _ Final
Pool
Ftgs
Air/Gas Tests Final
Framing _
_
_
Siding
Stucco
Stone _
_ Fireplace _ R.I. _ Air Test _ _
-
-
Final
Windows (new/replacement)
Insulation _
- Retaining Wall
-- ?y
Approved By I L
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
folt?tp
lq4
r
i rrryw+l ? -s';f '4 T'Y- ilA n,.'zt e-, 4's'Gt ne,.a= ,.yn: n ;,,_ t " 2;?e kYy E7 ?'`.X'?`-•h 1 i vi ngwy %n'Ao a.h t Z''.'^f. ' TL o4.?4 Xun'u3_: ia' 1 :.h2'xgs.- at
' I P.R.Ve REQUIRED
_, -
„ y
rly,
3 - O
3
z
r uv7G DEPT. Roof Area S. F. = 2543 S. F.
` a Lot Area S.F. = 19031 S.F.
Ty?Mgs p `' _ Lot Coverage % 13.4%
LANE m
a4°?'S79LEGEND
R=126 .13 92x9 4a00 X47`
0
S 521 912.5 3?9• QS DENOTES SANITARY MANHOLE
DENOTES HYDRANT EXSIV4 t?
xw= 2Z ? . 9 \ f? DENOTES CATCH BASIN
IPM 'L62. r
(92 n x9229 S DENOTES SANITARY SEWER
92ttx 22. (921.5) FooT 2 N C E?EV• o N rs4z 5 W DENOTES WATERMAN '
L ?21ax uo 'a (925) s%oa Mae LA re 1KTO AMV4.
ST DENOTES STORM SEINER
6 I 'T . '0p" ?9r s;; x N ELEV, or 917.1.07. ® DENOTES STORM MANHOLE
N ,a, 92x3 «j ^ DENOTES STORM APRON
Ga .^ LAW
r 1V
212 0 T KM SETBACKS
%J MW 914M 0
I x ,.9 r y to MIN. FRONT YARD SETBACK = 30
??T FE NCi: 999,9x I „a,l , 42 - No MIN. SIDE YARD SETBACK = 5' GARAGE, 10' DWELLING
p(4c,
,? SuR 2)- I f Proposed Top of Foundation Elevation- 924.83
1100I& ld / di Proposed. Garage Floor Elevation- 924.5
p 5 zy'+ Proposed Lowest Floor Elevation- 915.83
Z J?J C Lowest Allowable Floor Elevation- 907.7
V. 2 0 Denotes Iron Monument
? STORM . +(910 ) Denotes Existing Elevation
Proposed Elevation
EDGE OF PONDS MANHOLE Denotes Direction of Surface
? 910.0 Denotes Sanitary Sewer Service
I sloRM APRON Elevation.
1 hereby certify that this le a true and correct representation
/ VV of a survey the boundaries of.
LOT 5, BLOCK 4, PINETREE PASS. 2ND ADDITION
.6%61 ?e0 DAKOTA COUNTY. MINNESOTA
.0 And the location of all buildings, if any, thereon, and all visible
l? encroachments. N any, from or on said land. As surveyed by
CITY POND. BLP-6 is 21st day, of ben. 1999.
NW4_ a99.0
HAL 905.7 \ _ .
Daniel R. McGibbon `
RECEIVED MAR `.D 3 2DDQ
Licensed Land Surveyor. Minn. Llo. No. 18883 .
}
r?5=0
Co z
LL. ?Bz
F1:1.Z0a
?. a
i?
CITY OF F_AGAN
CASHIER: JS TERMINAL NO: 013
DATE: 03/14/00 Tlhr;
14:49;54
MA. LUNLuGR? BROS CONSTRUCTION INC
2252 9220 1516 THOMAS LAN 30.00
1y 9D01 1516 THOS LAN 1 671.35
' 1p0.OD
79 15i6 THOMAS LAN
3866 93
3422 9001 i516 THOMAS LAN i?086.38
2273' 9220 1516 THOMAS LAN 1'089.00
3446 9001 1516 THOMAS LAN ii.OD
2i$3 9001 1516 THOMAS LAN 0.50
V43. 9220 1516 THOMAS LAN 5p pn
0:50
9001 1516 THOMAS LAN 1±
2155
3868 9220 1516 THOMAS LAN 492.00
CRI245ED: c CONTINUE
LECR ID: JAN: + CONTINUE
s?*?x*&?e*ic*31gc*?k*9?*x?S.Xxic?aYi<A?A:?x*?k
xx *X** * * ***** c**i***** CONTINUE
CITY OF EAGAN
TERMINAL NO: O'13
CASHIER: JS
MITE: "0344/00 TIME: 14:49:56
W
NA14g: LUNDGREN BRO5 CONSTRUCTION ING
37,6 `32go 1516 THOMAS LAN • '114.DD
3713 9220 i5i6 THOMAS: LAN SO,p*
3665 9220 1816 THOMAS LAN 540.00.
5644.'73'
Total Receipt 'Ama?nt•
CRi@4520
USER ID: JAN
Ic**?I tK?%*X**X*#Xi*XX*****kX*XXXX*XXXk*X
_ 11 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF FACM Y 14
q ! 4 3830 PIL
OT KNOB RD - 55122
651.681.0675
New construction Reaulrements Remodellitepair Raoul
> wS mostered sRe surveys staving sq. R or lot, sq. R of house 2 copes of plan
and 911 roofed areas (20% maximum lot coveroas allowedl 1 set of energy calculations for heated additm
> ?2 copies of plans (how bean fr window sixes; poured fnd. design; etcd 1 site surrey for extedw addlRau a decks
> -l set of energy caladatlau
>--4eepla of free preservatlon plan Slot platted after 7/1/93
DATE:-3- (7Z) CONSTRUCTION COST: ?3 S 9/,y
DESCRIPTION OF WORK: 2s F
STREET ADDRESS: E
-77
LOT: S BLOCK
SUBD./P.I.D. is
Name: Phone S:
PROPERTY Last Flrst
OWNER
Street Address:
City
State:
Zip:
Company. ?Uej C.2EAJ CyJ65 Phone S: La/z 413-1z3/ 6L '7'7
(area code)
CONTRACTOR €x
Street Address: 2?? ?/}Y ZAi ft ClG V 0 License #,2 / Exp. 3 -10
city ?Zr¢7A 4A) zip: 55 3 °? /
J
ARCHITECT/
ENGINEER Company: Name:
Telephone *: (
Street Address: Registration t:
city
State:. Zip:
te (a) S'S 4
Sewer/water licensed plumber (H irretallina sewerlrsaler): lL TLLimBZi(7G Phone #:( ({ 1 7 /
I hereby acknowledge that I have read this application, state that the hftm dbn Is correct, and agree to comply with all applicable Stale
of Minnesota Statutes and City of Eagan Ordinances.
Slgrwlure of Applicant
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received _ Yes No Not Required FEB 2
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05•plex
K 02 SF Dwelling ? 08 06-plex
? 03 01 of_piex ? 09 07-plex
? 04 02-plex ? 10 08-plea
? 05 b3-plex ? ,11 10-piex
O 06 04-plex ? 12 12-plex
WORK TYPE
A 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
w 1
? 13 16-piex ? 21 Porch (3-sea.) ? 31 Fact Aft - Murd
? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Fact. Aft - SF
? 18 Deck ? 23 Porch (screened) ? 36 Mufti
? 19 Lower Level ? 24 Storm Damage
Ptbp Y or_ N ? 25 Miscellaneous
? 20 Pool ? 30 Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
I] 37 Demolish (Bldg)* 0 44 Siding
? 38 Demolish (Interior) 0 45 Fire Repair
? 42 Demolish (Foundation) O 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code ?L
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy L tt--
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
gnjQ_ q. ft.
sq. ft.
K M CELLANEOUS INSPECTIONS
Stucco/Stone
ALL sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
!9 o
4z&::
APPROVALS
Planning
Building Engineering
Variance
Permit Fee Valuation: $ o
Surcharge Review
Plan Li
Li
/ 7 it
'7 7S-
cense
cense
MC/ES SAC
City SAC f (? 3 k' ??? Q
I 130-
Water Conn.
Water Meter L?
g
-
5-q 9 ry
Acct. Deposit / j? x
t S
y
S/W Permit
S/W Surcharge
T
t
P
730Y
rea
ment
t.
Park Ded.
Trails Ded.
Other
Copies
Total: S y y 3
SAC Units
% SAC
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: Z, `i ?iL:7°I? F?lNE7REE S -2KC3 .41?y _
h DATE OF SURVEY: Ic?-al- 9?
LATEST REVISION: 2- Z4
W
ty
o DOCUMENT STANDARDS
og O
°
? ? 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.)
q ? ? Directional drainage arrows with slopelgradient %
? ? Proposed/existing sewer and water services & invert elevation
? ? Street name
? ? Driveway
/? ? Lot Square Footage
d ? o Lot Coverage
ELEVATIONS
Existing
? ? Sewer service (or Proposed)
? ? Property corners
? ? Top of curb at the driveway
?? ? Elevations of any existing adjacent homes
? Adequate footing depth of structures due to adjacent utility trenches
Proposed
?? ? Garage floor
ya ? First floor
a? ? ? Lowest exposed elevation (walkou twindow)
e,/? ? Property corners
pro ? Front and rear of home at the foundation
PONDING AREA (d applicable)
C / ? ? Easement line
P/ ? ? NWL
? ? HWL
g? ? Pond # designation
? Emergency Overflow Elevation
/ DIMENSIONS
?/ ? ? Lot lines/Bearings & dimensions
? ? Right-of-way and street width (to back of curb)
? ? Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
?? ? Show all easements of record and any City utilities within those easements
m/ ? Setbacks of proposed structure and sideyard setback of adjacent existing structures
? a' ? Retaining wall requirements, if any
Reviewed:
Date
t
March 1968
CRAMJBLDOPRMr.FM
RE', ?E
fly,
3 -3
-OC7 r
t'..PT
T/y0MAS `- --
\ CANE?M
927.6
N A_
0
912.5
355 T-
I i (924.3)
9?afx f n
SX 13 n 5
^ r
LANE
1182.L n r,N
29 _ -
LEGEND
E MW House
TFM 626.52
U)
ai
0
N
6 BENCHMARK / 11
EEV - 9114.65
S•s e_.r Fe N Cit
3 909.9 x
EDGE OF POND,,
L
QS DENOTES SANITARY MANHOLE
Roof Area S.F. = 2543 S.F.
Lot Area S. F. = 19031 S. F.
Lot Coverage % = 13.4%
110 \
y %8229
92
z. (9v.5)
Fans x r4 C Lc v. oa r&Ax ?
(924) $LO9 RaE.0 re 13e To A MN.
E"Lev, or 917.(07,
I
N /WB HOUM
,PFCN OM52 A
?r
L_ j o
X912s1.7.3
X911.9 ??
132
b2swe 6o6
77 42
.i UNE
J
4Y,a?
STORM .
MANHOLE
SO
/ S3'F
CITY POND BLP-6
NWL 898.0
HWL 905.7
RECEIVED ; 4.A. 0 3 2000
Proposed Top of Foundation Elevation= 924.83
Proposed. Garage Floor Elevation= 924.5
Proposed Lowest Floor Elevation- 915.83
Lowest Allowable Floor Elevation- 907.7
O Denotes Iron Monument
+ 910.0 Denotes Existing Elevation
+(910.0) Denotes Proposed Elevation
Denotes Direction of Surface
Drainage
910.0 Denotes Sanitary Sewer Service
Elevation
I hereby certify that this is a true and correct representation
of a survey of the boundaries of:
LOT 5, BLOCK 4, PINETREE PASS 2ND ADDITION
DAKOTA COUNTY, MINNESOTA
And the location of all buildings, if ar?y, thereon, and all visible
encroachments, if any, from or on said land. As surveyed by
is 21st day of Deco berg 1999.
Daniel R. McGibbon
Licensed Land Surveyor, Minn. Lic. No. 18883
4W
V
z°
APRON
S DENOTES HYDRANT
Wil DENOTES CATCH BASIN
S DENOTES SANITARY SEWER
W DENOTES WATERMAIN
ST DENOTES STORM SEWER
® DENOTES STORM MANHOLE
n MOTES STORM APRON
SETBACKS
MIN. FRONT YARD SETBACK = 30'
MIN. SIDE YARD SETBACK - 5' GARAGE, 10' DWEWNG
Y
s
3
U]
n0M
z1
U?qz
F= 0.
? a
U
DRDO
CHI
DATE
12-21-99
SCALE
1`-40'
JOB N0.
5402-5688
CITY USE ONLY
LOT BL PERMIT #: L/ 0-5 p
SUBD. 1 LPi I ?S? RECEIPT #: ?jo-73S
RECEIPT DATE: ?;- a6- 'V 0
2000 MECHANICAL PERMIT (RESIDENTIAL)
Date: LY ?0
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
cf State Surcharge
Total
$ 30.00'
6.00
D.50
$
Complete this section only if you are remodeling, adding to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration
Furnace
- Air exchanger
- Repair - Other
Air conditioning
Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for inspections
SITE ADDRESS:
OWNER NAME: L?'i rr G (/Gri ?(}/pS?J?LO^ 57 PHONE AREAf-ODE)
)
INSTALLER NAME: PHONE #: ( Yrc ;O- - Yf'r0' /O
STREET ADDRESS: (AREA CODE)
CITY: STATE: ?/ ZIP: S SS?7
SIGNATURE OF PERMITTEE
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN HN 55122
651-681-6675
CITY USE ONLY
L BL PERMIT M
SUBD. RECEIPT#:
APPROVED BY: ,INSPECTOR RECEIPT DATE:
2000 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank
Processed Piping
When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaVinstallation = minimum fee
Contract price: $ x 1%=$ (Base Fee)
State surcharge calculate at $50 for each $1,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
PHONEM -
(AREA CODE)
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
L BL CITY USE ONLY RECEIPT #: ,;Q 13G
n G
SUBD. n1L V 3G, RECEIPT DATE/: r? ?C- OU
PERMIT #
8000 PLUMBING PERMIT (RESIDENTIAL)
CITYOFCA6M
3830 PILOT KNOB RD
EALGALN, MN 55122
651-661-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIYTIIRFS
EACH
TOTAL
Alterations to existing dwelling - minimum fee
Describe:
$ 30.00
Bath tub $ 3.00 x 2- _ $ /o -
Floor drain 3.00 x I = $ 3 °Y
Gas piping outlet 'minimum - 7 3.00 x i = $
Hot tub/spa 3.00 x $
Kitchen sink 3.00 x I = $ 3
Laundry tray
Lavatory 3.00
3.00 x
x 1 =
= $
$ 3
I S °=
Septic System new/refurbished 'requires MPC lic. 75.00 x - _ $
abandonment
Septic System
30.00
X
_
$
RPZ new installationlrepairlrebuild 30.00 x = $
Rough opening 1.50 x = $ 7, V
Shower 3.00 x 'Z. _ $ 00
Underground srinkler if dwelling is under construction 3.00 x $
Underground srinkler if existing dwelling
Water closet 30.00
3.00 x
x
3
= $
$ o-°
Water heater 3.00 x 1 = $ eO
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 --> --> ---> ---> $
Reminder. Call for inspections of alterations, Le. water heaters, water softeners, etc.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I hereby acknowledge that I have read this application, 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: i
OWNER NAME:: LGzr?G[(/U^( ?.5/os Ldi?ST TELEPHONE#: klO
?, / (AREA CODE)
INSTALLER NAME: Z / `4. vL IZ l /1/A _ 4-'^- - ?T? EPHONE #:
(AREA CODE)
STREET ADDRESS: S 9
CITY: Sd/ s?? d7?.e STATE;, ?d zip: S7 J 7/
SIGNATURE OF PERMITTEE
City of Eagan
Cash Receipt
Receipt Gate 10/5700
Time Printed 13:80:46
Receipt dumber 1140
EAKE CONTRACTING INC
9001.2195 .59
BF 43130
9001.4085 68.08
8? 43138
Total Receipt Amount 60.50
User NMCGRA4
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
S CITY OF EAGAN y ?o . 50
?/
13? 3830 PILOT KNOB RD - 55122
Called *4-m
menh
New Construction Reoulremenh Remodel/ReRgr Reaulre
D 3 registered site surveys showing sq. tL of lot, sq. ft. of house 2 copies of plan
and go fooled areas (20% maximum lot coverage allowed 1 set of energy calculations for heated addition $
D 2 copies of plans (show bean & window sizes: poured fnd. design: etc.) 1 alts survey for exterior additions R decks
D 1 set of energy calculations
n 3 copies of tree preservation plan If lot platted Otter 7/1/93
DATE: _(C - Z -Cb
DESCRIPTION OF WORK:
STREET ADDRESS : r ( b r tt o nn {+ 5 4- t J
LOT: S BLOCK: SUBD./P.I.D. #: Pine
CONSTRUCTION COST: 2/ (ZT '66
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: ocn, f) K-Alz Phone 6gr 955
Last First
Street Address: 15 ! 6 i fVO nt 4-.3' G? J
City q,04 ?A- ti State: //LI [ 1 Zip: S E I ,- Z
Phone #: 6 S_/ -
Company:
(area code) _
Street address: 5 5 7 5 Z z 6 ?!? ? .J F_ License # 2 23 S ExP. I - 3i - vs
city ?_ / t,7 /,4 CYC,6( State: M N
Company: Name:
Telephone #: ( )
± Sheet Address: Registration #:
City
State:
Sewertwater licensed plumber (if Installing sewertwaterl: Phone #.
Zip: S?
Zip:
I hereby acknowledge that 1 have read this application, date that the inforrnafion Is correct, and agree to comply with aR applicable State
of Minnesota Statutes and City of Eagan Ordinances.
12
Signature of Applicant.
OFFICE USE ONLY l;??
Certificates of Survey Received Yes No OCT 0 2 2000
Tree Preservation Plan Received Yes No Not Required LIV.
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of_ piex ? 09 07-piex
? 04 02-plex ? 10 08-plex
? 05 03-piex ? 11 10-piex
? 06 04-piex ? 12 12-piex
WORK TYPE
T 31 New
?j 32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.)
? 17 Garage ? 22 Porch/Addn.(4-sea.)
t9 18 Deck ? 23 Porch (screened)
? 19 Lower Level ? 24 Storm Damage
Plbg _Yor_N ? 25 Miscellaneous
? 20 Pool ? 30 Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning _
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Building
4 Engineering
Valuation:
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 6d. Aft - Mufti
? 33 Ext. Aft - SF
? 36 Mufti
SAC Units
% SAC
s
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City of Eagan - Conversion
Cash Receipt
Receipt Date 10/3/00
Tine Printed 12:06:53
Receipt Number 1063
LAKE SIDE PLUMBING 8 HEATING
9001. ?95 .50
PP 43089
9001.4687 30.60
PP 43089 `
Total Receipt Amount 30.50
User HHCGRAU
t L r L C, BL q CITY USE ONLY
f? .f I 0 e)
SUED. I ? 11t'.'I Y 2Q16o?-- -?
RECEIPT #:
RECEIPT DATE: / z?
PERMIT# N30 Q q
C> I
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF KAGAN
3830 PILOT KNOB RD
EAGAN, 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
Alterations to existing dwelling - minimum fee
Describe: ?i ^' i n.t -3/u z L , e(1 Aaj-(-
C4 $ 30.00
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 3.00 x = $
Septic System new/refurbished ` requires MPC Ilc. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installation/repair/rebuild 30.00 x = $ „5 p
Rough opening 1.50 x = $
Shower 3.00 x = $ 3w
Underground sprinkler if dwelling is under construction 3.00 x = $
Underground sprinkler kexisting dwelling 30.00 x = $
Water closet 3.00 x = $ 3b0
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 $ 5
.Q- I
Total -> -> -> -> $
Reminder. # Call for Inspections of alterations, i.e. water heaters, water softeners, etc. 3a_ Sn
- ------ --- ----- - ------ --- -- --------------- ----- --- -----
I futreby acknowledge that I have read this application, state that the irdamurtion 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 perk within City property/right-of-way/easement.
SITE ADDRESS: I I Ito "rltiom a s I_ n A z
OWNER NAME:: ,13 A = IAL?Aj GyNtn TELEPHONE#: e'J? - 2&ii 3
(AREA CODE)
INSTALLER NAME: L0-h11/ a"- PLl-vir?lo [irt4 4- N s TELEPHONE #: 95-2 _x'941-2& O G
(AREA CODE)
STREETADDRESS: 1 D-q&cl 2 f nrcrn cJe
CITY: rrn STATE: m.r1 D ZIP: 5`S 3 7J
SIGNATURE OF PERMITTEE
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 681
DATE: 09/15/00 TIME: 09:43:51
ID:
NAME: BURNSVILLE HEATING & AIR
3213 9001 1516 THOMAS LN ,39.00
2155 9001 1516 THOMAS LN 4 0.50
Total Receipt Amount: 39.50
CR137318
__USER ID: JAN
CITY USE ONLY
LOT, -551- BL PERMIT #:
SUBD. f MJ1-C,2 Paid a n RECEIPT #:
qd? /0
RECEIPT DATE:
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
651-681-4675
Date:
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100MBTU
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
8.dd
.50
$ 0? 0
Complete this section only if you are remodeling, adding to, or repairing an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration
Furnace
Air exchanger
Air conditioning
Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for inspections
SITE ADDRESS: _?LC! Z (J//Yll3 S z 6rL
OWNERNAME: y LGGCC/[°S7` /?YYLILS PHONE#: l00 Rig-/7&
INSTALLER NAME (Y/1S1i1 ?(I (AREA CODE)
PHONE #: o5
(AREA CODE)
STREET ADDRESS: t ?l t (?{ 1,?_ S
CITY:
STATE: 7-w zip: ??37a
CEIVED ZL
SI NATURE OF Pb TTEE
SEP rao?
BY:
_ Repair _ Other
L BL
SUBD.
APPROVED BY.
CITY USE ONLY
INSPECTOR
PERMIT #: _
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for. all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction Install U.G. Tank
- Interior Improvement Remove U.G. Tank
- Processed Piping
When installing/removing underground tank, call 6S1-681-4675 for inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removal/installation = minimum fee
Contract price: $ x 1%=$ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE: ZIP:
SIGNATURE OF PERMITTEE
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
C) 3830 PILOT KNOB RD - 55122 -
651-681-4675
> 3 regbfered site surveys showing sq. ft of lot. sq. ft. of house
ofd 2H roofed areas (2f)% mmdmum lot coverage allowed)
2 copies of plans (show beam & window sizes; poured fnd. design; etc.)
> 1 set of energy calculations
> 3 copies of tree preservation plan H lot plaNed after 7/1/93
DATE: 10. L(. O0
DESCRIPTION OF WORK: L L N S H
STREET ADDRESS:
LOT: ) r
5 1 6 -TL o P A.& (_fljrv e
BLOCK: U SUBD./P.I.D. #:
C ? ?_A_4g I 0 - ?-U
Remodel/Regalr Requirements
2 copies of plan
1 set of energy calculations for heated addiflons
1 site survey for exterior additions d decks
CONSTRUCTION COST: 30 v-
PROPERTY
OWNER
Name: a (+ i" n L Phone #:
Last First
Sheet Address: isti°6r?a' L(1A?
City 1:?A VAN State: Zip:
Company: N Wu-EST (y?J PxS Tnl c Phone #: 952 7L &-3
(area code)
CONTRACTOR, ?. ?cx L?5(o 0 0
3(?S?I`r
Street Address: License # Z Exp.
Cm,? ?(0, ? ?. State: f^? Zip: ?S37z
ARCHITECT/
ENGINEER Company: Name:
Telephone C ( )
Street Address: Registration
City State: Zip:
Sewer/water licensed plumber
I hereby acknowledge that I have read this application. slate that the
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant.
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
an applicable State
0CT Q 4 000
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plea
? 02 SF Dwelling ? 08 06-plex
? 03 01 of_ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
WORK TYPE
31 New
32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.)
? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 18 Deck ? 23 Porch (screened)
19 Lower Level ? 24 Storm Damage
Plbg _Y or _ N ? 25 Miscellaneous
? 20 Pool ? 30 Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Dom
Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code _QL
No. of Units
No. of Buildings
Const. (Actual)
(Allowable) 5-- A)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning _
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Building W4 Engineering Variance
Valuation: $
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
SAC Units
% SAC
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA118753
Date Issued:11/07/2013
Permit Category:ePermit
Site Address: 1516 Thomas Lane
Lot:5 Block: 4 Addition: Pinetree Pass 2nd
PID:10-57661-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Anil N Deodhar
1516 Thomas Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
� r________________�
I For Office Use
I �y� g� �_�
C�� O f �n n n j Permit#: i
y 1 Q�uii � i
I Permit Fee: �` �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 � �
Fax: (651) 675-5694 I Staff: �
�-----------------I
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: l/'' -2� l S Site Address; ���� l l��`ZCi� 6-�c�✓�
Tenant: /�/����af'� � Suite#:
Resid�n#�L�wrter Name:__ �/�(.�l'I�'!/� Phone:
_
Address/City/Zip: j�! �p � �Gr1{° � �l/i� �-Sf��
Name: �� /✓(��'"���, ��� License#: ��������
--�
COi1tt'aC#OP Address: � 7Y 7� �C�'7°/�S'T/f/(•� City: �^!'�l0�`'�'u�
State: �W Zip: ����� Phone: 2��'-2� O '"�`��`>
�
Contact: d� Email: ���/"��S�r�I���L��✓•<O�`(
T�/pe of�l�/+Drk ; —New �I Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:_ _���i' �c��r� �/�'li✓ ��l Gt/E!���+Gr�rl'�` ���l/
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
Q�r�tl11#T�e Add Plumbing Fixtures�Main/ Lower Level)
Septic System —
New Water Tumaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Seqtic Svstem Abandonment,Water Turnaround''(includes State Surcharge)
"Water Tumaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic Svstem New(includes County fee and State Surcharge}
TOTAL FEES$
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.aopherstateonecall.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 with 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 '�N �IN��P�� x `
Applicant's rinted Name ApplicanY Sign ure
�OR OFfIC'E USE: `Reviewed By: Date:
`Requihed lnspections: Under Ground Rough-In Air Tesf Gas Test �inal
°Meter Reiated ltems: Meter Size Radio Read Manome#er Staff:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159635
Date Issued:01/06/2020
Permit Category:ePermit
Site Address: 1516 Thomas Lane
Lot:5 Block: 4 Addition: Pinetree Pass 2nd
PID:10-57661-04-050
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Anil N Deodhar
1516 Thomas Lane
Eagan MN 55122
Twin City Fireplace & Stone Company
6521 Cecilia Cir
Minneapolis MN 55439
(952) 529-5797
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165520
Date Issued:11/04/2020
Permit Category:ePermit
Site Address: 1516 Thomas Lane
Lot:5 Block: 4 Addition: Pinetree Pass 2nd
PID:10-57661-04-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Islam Enver & Fatima Batool Khan
1516 Thomas Ln
Eagan MN 55122
(248) 635-4345
Window Geeks Llc
1200 Center Pointe Curve
Mendota Heights MN 55120
(612) 315-1481
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA168242
Date Issued:04/14/2021
Permit Category:ePermit
Site Address: 1516 Thomas Lane
Lot:5 Block: 4 Addition: Pinetree Pass 2nd
PID:10-57661-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Islam Enver & Fatima Batool Khan
1516 Thomas Ln
Eagan MN 55122
Gv Heating & Air Inc
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature