1014 Ticonderoga Tr ' ' CITY OF EAGAN `s ~ 2~
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value ~ Date ~ ~ ,19
Site Addr~B~ " OFFICE USE ONLY
' t.r;;t I~~uTO~i SQL'Ak On Site Sewage _ Occupancy
Lot ~"Block Sec/Sub. j MWCC System _ Zoning
ParCel No. On Site Well Type of Const ;
Ciry Water (Actual)
m Name V ' ` II~C ~anowabie?
u+ ik ol Storles
3 Address Length
~ City Phone ~ Depth •
S.F. Total
, p Neme • • Footprint S.F.
~ ~ Address APPROVALS FEES
~ City PhOne Assessments Permit
F Q Water/Sewer _ Surcharge S
yVj W Name Police _ Pian Review
W
i~ Address Fire _ SAC, City
Engc _ SAC, MWCC
<W City PhOne Planner _ WaterConn.
Council _ Water Meter
I hereby acknowledge that I have read this application and stete Bldg. Off. _ Road Unit
thattheinfarmationiscorrectandagreetocomplywithallapplicable A~ - TreatmentPl
State of Minnesota Statutes and City of Eagan Ordinances. variance _ Parks
Copies
Signature of Permittee TOTAL
, . . ~~L,. >
A Building Permit is issued to: on the expreas condition that
all work shall be done in accordance wlth all applicable State ot Minnesota Statutes and City of Eagan Ordlnances.
Building Officlal
~ Pormlt No. Permit Hold~r Data Talephon~ X
Plumbing ~ , ~ ii:~ ~/~ti ~
H.V.AC. ~1G ~ ~ , ~ ~
Electric c~'~~,?~~~ i:_ . r ' ~ . . :s.,-~
Softener
Inspection Date Insp. Comms~ts
Footings I ~ ~
Footings II
Foundation
Framing ~,p.~L 2
Roofing
Rough Plbg. ~
ROUgh Htg.
Isul.
Fireplace
Final Htg. ? L :
Final Plbg. _ ~ ' '
Bldg. Final .~7 ~ r- • ' b „c ~ -4 7
Cert. Oca ~r ~8 x
. ~i - G . ~4'.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
•.~rn~~+',~c_. r: _ - _ . . • .
, ~ .
, y '
. , PEAMIT # ~7~= ~
~ ' ' ~ PLUMBING PERMIT ~ ~ ~3~
CITY OF EAGAN RECEIPT t~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: "7 ~ 7
CONTRACT PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot Bi'ock Sec/Sub Res. New
Mult. Add-on
~ Name - Comm. Repair
m ~
~ Address Other ~
c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: '
NO. FIXTURES TOTAL
~-Water Closet - $3.00 ~ ~
~ Name ~gath Tubs - $3.00
3 Address ~ ~_Lavatory - $3.04
p City ~ Phone Shower - $3.00
-~Kitchen Sfnk - $3.00 '
FEES Urin21/Bidet - ~3.00
COMM/IND FEE - 1°~6 OF CONTRACT FEE ~-Laundry Tray -~3.00 '
APT. BLDGS - COMM RATE APPLIES _~_Floor Drains -$1.50 .
TOWNHOUSE 8 CONDO - RES. RATE APPLIES ~-Water Heater 50
MINIMUM - RESIDENTIAL FEE - $12.00 Wh~rlpool - $3.00
MINIMUM - COMM/IND FEE - $20.00 ~-Gas Piping Outlets - $1.50 • ~ :
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - 510.00
Private Disp. - $10.00
~_Rough Openings - $1.50
SIGNATURE O
EF
P RMITTEE r FEE:
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
- . ~ ~ PERMIT ~ ' ~ C'c],;2y '-`'k
GG ~1 ~7 . MECHANICAL PERMIT _ ~ r RECEIPT # ~ J ~
` CITY OF EAGAN d
~ 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ~ ~ rf 7
CONTRACT PRICE ;,1 PHONE: 454-8100
Site Add ~ BLDG. TYFE WORK DESCRlPTION
Lot - s ~ Block ~ -2 Sec/Su
, ~ ~ ~ Res. ~ New ?
~ SEDGtNICK HTG, & AIR CON Mult Add-on
Name~~ gg~0 WENTb'VORTH AVE. S0. ~omm. Repair
m Address Other
c City EAFO~~p' S54~0
1-900Q
FEES
~ Name RES. HVAC 0-100 M BTU -$24.0~
c Address ADDITIONAL 50 M BTU - 6.00
p City Phone {RES. HVAC INCLUDES A/C ON NEW
C~NSTRUCTIDN)
GAS OUTLETS (MIMIMUM - 1 PER PERMIn - 1.50 EA.
TYPE OF WORK qp MBLDGSFE COMM. RA E APPLIES EE
Forced Air ~5 M BTU T,OWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RE5IDEMTIAL FEE - ALL ADD-ON &
Unit Heater M 8TU REMOO~LS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # / ~ s BEYOND $1,000)
Other
FEE ~ ~ - ~
; ~Yr ~~t~~~ ~ " ~ ~~'~s.
S/C: I SIGNATURE OF PERMITTEE ~
TOTAI: ~ T ~
FOR: CITY OF EAGAN
. x,~:. . Y...~. . : . .
~ ~~G ~J
e
SEDGWICK HEATING & AIR~CONDITI I G CO. 1 ~1
, HOUSE HEATING TEST RECORD _
ADDRESS ~ ^ ~f ~ CITY ~ n u ~
OCCUPANT_ ~ ~ Lr~~~` ~d >1 S oWNER
HEAT LOSS DATE HTG. iNST.
SOLD BY INSTALLED BY ~ ~ ~S
Electrical Work By 1~ ~ f Gas Line By _ ' y:.C.:
TYPE OF HEAT GA_ FA ~ HW_ STEAM SPACE HTR. UNIT HTR. OTHER
~ GqS DESIGN _ CONVERSION
MAKE i h+L ~ ~ MAKE OF BURNER
Model ~ 3`~ ` f t. n u 7`:, Model
Serial ~ ~ ~S'L>f~~ ~3C~ Max. BTU Rating
INPUT ]_5 . O U ~ MAKE OF FURNACE
Model ~
CONTROLS J
THERMOSTAT~_ Heat Plug Vent Size ~ vj
Valve ~='Y 3~1 2~-==x. ~ - KINOOF LINER V . SiZE NONE
Limit S~'n%'c~ ~ Draft Hood ~Q u da Regulator ~/~'-S
Limit Setting ~ G~~~~ Filters Size Number
Fan Setting Chimney Location Inside " Outside
Pilot Type ~ r ~ u~ Chimney Construction ~ i J
Pilot 11Aake > ` ~ ~ ~
Pifot Model q`~~ ~ SI~ Smoke Bomb " Wiring _
Pilot Timing °~+f/s r~?~ Draft Test Tag
L.W. Cut Off ~oor Pressure " Lighting Inst.
Pressure 3• Percent Co ~ Date Tested Z- fCJ , ~
Input CFH 7 S~ Percent 02 q~ ~6 Company Testing r-'f \.c- ./i ~
S t a c k T e m p-~S~~~~ ~ e r c e n t C O l.~~ N a m e o f T e s t e r ?~~~~~c r
Form 235
Th~s request wid s~ -
18 months from ?/~.c 7/~ ~ - ? S~, ~
a ~
D 2 9 ~ 7 2 - ; ~ / ~-s~~
Request Date ~
~~~e • ouph-in Insp ction
~ ~ ired~ ~ReadY Now~Will Noufv InsPec-
Y~s ? No tor When ReOdy
Licensed Electrical Contractor
I hereby request inspaction of above
Owner
electrical work installed et:
Street Address, 8ox or Route No. Citv
1o r~N F/~d<s/~ (
ection o. Township Name or No.
ange No. Counly
~ ,~GOC~.k L LE.~~N ~t4uA,r~~ !S r7~
Occupant IPRINTI
Phone No,
~-v~N GEo E c~ p 3 3~. -
Power SupDlier
Addre55
Ku Gc.Ec- G
Electncal Contractor (Company N~mel
`An~ ~ Contractor"s License No.
ri~• ,L ~c-E c. PX ~ 4 Yo 7
Mailme Address IContractor or Owner Making Instailation)
l~ ~L S,~ S~~
Authorized Si nature IContractor/Ow r Ma fng Installationi
Phone NumbFr
~90 ' 3~S" ~
MINN pTA STATE BOARD O LECTRICITY THIS INSPECTION REQUEST WI~L NOT
G~~o9s-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STqTE BOARD
~821 Universitv Ave.. St. Pflul, MN 55104 UNLESS PRpPER INSPECTION FEE IS
Phone t6121 642-D800 ENCLOSEO.
s s
t~~r#ifir~#r u~ (~rr~~~tnr~
~
~ ~Citp of ~agari
,
~p~~ ~ ~~am~ ,~~P~rt~
This Certificate issued pursuant to the requiremenu of Section 306 of the Uniform Buitding
Code certifying that at the time of issuance this structure was in compliance with the various
ordrnances af the City regulating building construction or use. Fo~ the following.•
LJse Qaasifintion Dkh~' i' ~dg. Fbrmit No. -
pc~up~~y'f~pe ~ Zoning District Type Co~rst ~1
Owner af Building N1Ai~1T~ "'S •'i " _ ; r~ p~~y Y( ~ i ;
,1 ~ ~ r r,°r,
e„aa;,~ 1_: ~,x:. _1: i«~;cy I.:i 1 a T_~~i.1~+; ~~'L~P a
n~w: tIA~1ST j,',~.
s~aa~~ o~ _ .
~OST IN A CONSPICUOUS PLACE
CiTY OF EAG~!~1 Permit Na - Date; 1 '
3830 Pilot Knob Road Meter No:~ Za 6 F~a Size: .~lfl
P.O. Rc Z1199 Reader No:~~ ~n 3 8,J g' Date: 7-,a]~7
Eagan, AAN 55121
Owner. '~~"'rt'in ';e~>r:•e ~;1~'r:.
Site Address: icor.. ero ~7a Ti i~_, P:_ Lex ~ ton Sc ~.T~
Plumber ~z eY L•^•i ' -
Conn. Chg: 525. OOpii ~,1
Acct. Dep: ~ ~ E~ of~t~
Permit Fee: • ~ EL
Surcharge: I~~le~~~y w~th the City ot Eagan
,.t w
Tr. Plant - ~dinances.
Meter. r . ~1_ d
Misc.: By
WATER SERVICE PERMI
. . ~.~_w~-~~• . _
CITY OF E,qdi,AN Permit No: °Q91 Dat~ 7~-I7-Fs7
3830 Pilot K~ob Road Meter No:
P.O. 9ox 2y199 Size:
Reader No: Dat~
Eagan, MN 55121
Owner. ~~rge Bldrs.
Site Address: ~a QroQa Tr~i1 L~ I fi? ' ~~i.-~~toa S. ~'T
Plumber. a ~ p um ing
Conn. Chg: ~ n J'~~ Zoning: ~
Acct Dep: No. of Units:
Permit Fee: ~
Surcharge: ' p I agree to comply with the City ot Eagan
Tr. Plant ` F Ordinances.
Meter. ~ ~ . ~'11p~
Misc.: BY
WATER SERVICE PERMIT
~-~---t
: ~
cmr oF~c,;.;,~nN SEWER SERVICE PERMIT
3830 Pilot K~ob Road
P~'~~Y~~g9 PERMITNO.: ;t~~~45
Eagan, MN 55121 DATE: ~-~7-~7 '
2oning: ~I ~
No. of Units: 1 1
Owner: George F31drs.
Address: ~
Site Address: _.V
1014 Tic naero a Trai1. L32 E2 Lerin~ton 'VI ~
Plumber: ~~11~Y ~~umhing
- 6? 6 z? 7 75t~44 lOC. 0~~pd
I agree to comply with the City of Eagan Connectlon Charge: 52 S_{~(t~_ +
Ordinances. Account Deposit: 1 5 j
Permit Fee: ~ i~ r~~~~t '
Surcharge: S ~~nc~
By Misc. Charges: ~
Date of Insp.: TotaL• ~
Insp.: Date Paid: !
;
~~~7~7 REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
See instroctiens lor como~e~ine ihis form on baCk ot Vellow copR
" 755/ 7
~`G J87 2 '"X"' Below Work Covered by lhrs Request
l.Ad ReO~ TyOa ol 8uiltling Appliancea Wired Equipment WireA
Home Range Temporary Service
Duplex Wate~ Heater Lighting Fixtures
Apt. BUilAinc~ Dry¢r EleCtrie Heatin
Commerciai Bidg. Fumace Silo Unloader
Indus[rial Bldg. Air Conditioner Bulk Milk Tank
Farm om~. oec~ v inE„ tsno~~fv1
~ e. Suc~~ y o~h~, om~„ -
ompute Inspectron fee Below
p Fee ServiceEntrence5ixe M Fae Feeders~Subieeders # Fxe Circuits
y U to 200 Am s 0 to 30 Am 5 2^ 0 tn 30 Am s
Above 200 qmps 31 to 100 qinps ~j ~ 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Amps
Transiormers Irrigation Booms ~SO Partial.~Other Fee
Signs Special Inspection S
riemarks 3~ TOTAL F
3.00
Rough-in e~ I the Elec -
• Inspector, ~erebv
certity that Me above
Fina~ ' e . [ inspeciion hes been
C B made.
Th1e repues~ voiC 18 montne from
CITYOFEAGAN N~ ~3822
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 rJ~^Q ,
BUILDING PERMIT Receiptir /el `t
To be used tor SF DWG/GAR Est. Value Z~ 000 Date JUNE 26 i 9 87
Site Addr~ss . 1014 TICONDEROGA TRAIL OFFICE USE ONLY
Lot 31 Block 2 Sec/Sub. LEXINGTON SQUAR On Site Sewage Occupancy R3
~ MWCCSystem ~ Zoning Rl
Parcel No. On Site Well Type W Const V
Giry Wetef (Aquaq
MARVIN GEORGE BLDRS INC (Allowable)
a Name
w 7t of Stories
= Address P•0. BOX 428 Length
o ~ity PRINCETON phone 389-3201 Deotn 46
S.F. Total
, o Name SAME 332-3034 Footprin[S.F.
Address APPROVALS FEES
~ City Phone qssessments _ Permit ~ 405.50
Water/Sewer Surcharga ~b.~0
Police Plan Review 202 . 75
W W Name -
~Z Fire _ SAC,City 100.00
Address Engr. _ SAC,MWCC 525.00
aw City Phone Planner _ WaterConn. 575_f10
CounCil _ WaterMeter b~~np
I here6y acknowledge thet I have read this applicetion and state Btdg. Off. _ Roed Unit ~~5.,_pp
thattheinformationiscanectandag~ toco plywithall licable A~ - TreatmentPi 1R(1_[lp
State of Minnesata Statutes an i y E an O in Varience _ Parks
Copies
5ignature of Permittee 707AL ~ 5
A Building Permit is issue ~ IN EOR L 5 INC on the express conditlon that
all work shell be done in accordance with all app ble State of 'nneso Statutes and Ciry of Eagan Ordinancea
Building Official
. ~
~ ' ~ ~ ~
1987 BQILDING PEfiI~S dPPLICATION - CITY OF EAGAN •
SINGLE FAMILY DWELLINGS
IBCLODE 2 SEfS OF PLANS~ 3 CERTIFICAiES OF SQRVEY, 1 SET OF ENERGY CALCOLATIOHS
HOTEi ADDRESSES FOR CORNES LOTS - CONTRACTOR/HOMEOKNEB !lDST DESIGHAiE WHICH ADDRESS
IS DFSIRED. NO CHANGES AILL BE ALLOWED ONCE BDILDING PERMIT IS ISSOED.
MUL2IPLE D{tELLINGS - RESIDE~TI9L RENTAL OAITS FOR SALE OHIYS
INCLUDE 2 SETS OF PLANS~ CERTIFICATE OF SQEiVEY - CHECB YITH HLDG. DEPT.~
1 SET OF ENERGY CALCULATIONS
COl44iRCIAL ~
INCLUDE 2 SETS OF 9RCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS~
a2,000 LANDSCAPE BOND
7z,~
To Be Used For: Sinqle Famil~ Valuation: ^^~-~6u Date:
Site Address 1014 Ticonderoqa lrai OFFICE OSE ONLY
Lot 31 Bloek 2 On Site Sewage Oecupancy ~ 3
MWCC System ~ 2oning ~ ~
Parcel/Sub Lex. Sq. 6th Add. On Site Well Type of Const
City Water ? (Actual) ~
Owner Marvin Georqe Builders. Inc. <Allowable)
~ of Stories
Addressp,0. Bux 428 . Length 43
Depth ¢(o
City/Zip Codeprinceton. MN:. 55371 S.F. Total
Phone 389-32 Footprint S.F.
O1/~32-3034 APPROVALS FEFS
Contractor Marvin Georpe Builders Assessments 'Permit ~tvs ~
Water/Sewer Surcharge 3co.
Address P, G. B ox 428 Police Plan Revieca 2b 2.75
Fire SAC, City 1G~.
City/Zip Code Pr~nceton MN 55371 Engr SAC, MWCC SZS
Planner Water Conn .5Z5.
Phone 3A9-3201 %332-3034 Council Water Meter Co7,
Bldg Off Road Unit oS~
Arch./Engr. APC Treatment P1 E~.
Variance Parks
Address Copies
City/Zip Code T~T~ a 3 p~ ~
Phone S
~~v .
t
Ci'.LE'T~""[/~11~~r7I1ICS 597511ighmny65NC. RO.Iio+32308 Aflnneopo~is.MNS$932 f6121.i7L(+~(b
5[ADi1RITlIN E/VGIMEER/tVG. llsl+C_ ~zm.~rn..~~~~~n~~~ so. m~,,,,~m~.n,nass.3~ r~iri.voa.osio
(:Inll. Adrtl~:lp•rl ~ F,nvin.nrr~o~lnl ~'r~qL~n.:rlnp • l~~.A n,. ,.vr..g . ln~d f9~~,a~a • Sou i sii,~g
Cmrtl~Licato of f3uz-voy for ~1!'V/A ~e~l'qE ~~(//dtYS
Dearl~gs Sho~n hre Assumed ~
o Oenotes Iron Honument ~ ~
o Denotes Fovndetion Corner Offset Stnke. pROPOSLU £LEVA'CZONS
- - -__a Uenotes F.xisting ElevaC}on
Q Deno[es Froposed Elevation . . To0 ef B16ck 96.7 .
Denotes Directton af Surface Drainnge Lovest Floor 3 y
- Denotes Drainage and UC113ty Eosemen[ Carege Floor .f~ ~
~ T
a11
~condero a _
Sca~c: 1 ~uch -j° ,~ect
h e°~'~ a 1 8q ~
s~J~n¢/31~l ~ ~ 4
~f,VO Oq~O _ -
~3, y . .
o Q ~-9
~ 5 r- . - ~ 5 `
e
M ~ .1 0
~ I a \ ~
q~
a6 20.D - 32.33 ~ !2'~ ~-6.0~
1-T- - ~ ~ 8~.^
~
~ . I ~ ~4.33 ° . ~ _ ~
m f~, ~ 6.33 y~ m
- . -Y _ . ~ ~ . 5.0 ~ a~ .
a' ~ v
q I u Q°'` ~ e i I ~`n
~~n~ m~~+a i YIo~`y~ N I y .
~ 9S~ ~ ~
~ T ~ Xo.o_ a~5 3s.o y iz.4 B96
$qk ~
I ~ I 47
, - I x
, _
~
_ ~
I -
~°9 Dr~ina9e ancl UEi~~~y
s Eastmenf _ f ~c~s•g
~ h
_ ~ 7f,0lJ m -
,~'89~343~~ a~'h
Lot 3~ . f3lock ~2
LEXIIV~TC)(~ SC~~..~~?.F~~ 6th AD~ITLOtV
Subject to easemen(s of record Dalcota County, Minnesota
I hercLy r.erllfy that Cids .^,urvey, plnn or report uos pre~~ored by me or anJer my direcL
super•isiun aud [ha[ I nm .duly 13.censed laand Surveqor under thc lavs of the State of
HinneSaW. ~i p7
$i.gneJ Chis ~ d~y of ~.n., 19of•
~ ~Lvmpanlcs
SUI/U1iDAAI EN6INEE G. !NC_
[ 5~~.~.
No[ Cu611shcd: All rl~ht?.recervr.d R Inc. 4
~~pprlght 17li! SE Crtm antes, S~~Uvrl;m t~~ i~~~*i~a, /~o/ierf E Stransk . Minn..~Ci[euse No. / 965 l
~ . ' .
ss~s~8 i7o3
bR LN- HA~Rv~ R d
a~lu
r 1
MINNESOTA STATE BUILDING CODE DIVISION
_ , EXTERZOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER M~-RVyr.1 ~ PpR(',,~- gV p~~j
SITE ADDRESS
CONTRACTOR M~RViN (~~Q f~ j I cI,P1R-j DATE PHONE
Determine workin~ square footarte of each:
1. Total exposed wall area...., ~~'~j~'f sq. ft. x, 1 ~ __1~/3. y 7
2. Total roof/ceiling area..... 9~5 sq, ft. x Ad~
Total exposed wall area above floor = '
a. Total wall window area . . . . . . . . . . . . . . ~-7 ~
b. Total door area. , , , , , , , , , , ~
c. To[al sliding glass door area. . . . . . . . . . .
d. Total fireplace wall area . . . . . . . . . . . . .
e. Total wall framing area (average lOX). . . . . . . ~ p -
f. Total net wall area above floor. . . . . . . . . . : ~
g. Total rim ~oist area . . . . . . . . . . . . . . .
Total exposed foundation area = 9/
h. Total foundation window area . . . . . . . . . . . -
i. Total net foundation area above grade.
Determine "U" value of each wall segment:
a. ~y`7 g ~Jy rjO,~D~O
b. tia X ~,U„ ~a3 = 9~~~
~-la X„U„ ,~la I 6~!
d. - X - _ -
e. g nU~~ O i = I I• I~
f. ~ I (no1 X .nt.l = ~~.y8
8 - ~9 X oy~ y,p
y . { " X 11~~11 a
~l Y
l ~ X IIUII ,Vln • ~ ~3 .
3. TOTAI . . . . . . . . . . . . . . , a~
If item $3 is the,same as, or less than item U1, you have met the intent of SBC 6006(c)2.
To[al exposed roof/ceiling area = ~ O 7 0
j. Total skylight area . . . . . . . . . . . . . . . . ~
k. Total roof/ceiling framing area (Average 10%)
1. Total net insulated roof/ceiling area
Determine "U" value for each roof/ceiling segment:
1 X 11~111 J a I. 3
U
k. 99 X „U~~ .oa~ _ ~.s`~
q9 5 X„U„ ,oa~ a a~~~`7 .
4. TOTAl . . . . . . . . . . . . . = as ~
If total of item 1/4 is the same as, or less than item 1i2, you have met the intent of •
SSC 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum of items
li3 and ll4 shall not be grea[er than the sum of items !!1 and U2. ~
~g 3, yg + z. a~.ss = aaa.oy
3. ~sv.a~ +4. .~~5.7~ = a~~.a5
****#**#*#****~W****t#*f**f**k*****#
• C I TY O F E A G A N PAYMFNr OF FEE AT TIl~ pF *
. * ~isc~oN ooFS r~r oorsrrrc~ *
~ * APPROVAL OF PII2NIIT. *
- /~PPLICATION FOR PERMIT *
~ u~ncrzoiv oF s~ arro/ox v~~nt *
*t r.ramr0~ WIId, NOrP BE S~ *
SEWE AND/OR WATER CONNECTION * ~ ~T ~ ~ ;
• ~ . ~ APPROVID. ~
~ * :
r *
r
. * **+r* *,e,rt,r** *:**x**,rt t«***r*
, P ease Print)
~ 1) PROPERTY ADDRES : ~pl'-I T:c~._~1ce~,~ .}g \
LEGAL DESCRIpTI , N: 3~ « S, t
. Lot Block Subdivisi n or Tax Parcel ID „
g E~QSTING STRCCIL , ~ATE OF ORIGINAL BL~ILDING PF~IIT ISSL'ANCE: :
- (Nbn ear}
PRESENT 7ANING/pR0 SID L~SE:
? C~C~'~T /O~I~ ~y] R-1 SING7,E FAMILY .
Q IDIDL'STRIAL Q R-2 DL~PLEX (1DO C~nits)
~ INSTIZT~TIONAL/ ~ R-3 7l~WNEiOUSE (Three + f)nits) ( Onits)
. ~ R-4 APARTMEN'p/CObIDOMINiLT1 ( Units )
2, ~
W~'lE:
ADDRE55: U CFtcc~ L.
CITY, STATE, ZIP: ~p J~,~ 535~
PHONE: ~`i~-ala~
3) • i:~• N~. For City Use
Plumbers License:
ADDRFSg ; Active
C FStpired
CITY. STATE, ZIP: JG~t ' Not recorded
PHONE: MASTER LICENSE# r1- 1~ ~ ~ gty~{~~tlal
4) • ~ ~..~u~eT~
!~'1~.~~;- ~ 3~d~G,
_ ~woxFSS: 1-~;~ ti a ~ ' :
CITY, STATE, ZIP: ~1 R., t.. /1 _
PHONE: .
5) a: • : ~ • ~r •
~ CONPIDCTION 1U CITY SEWER ~ CONNE~PION ZU CITY WATII2 ~ pZ'E~
6) ' Q PLEASE HOLD APPROVfD PERMIT FC)R PICK-UP BY ONE OF ABOVE
PLFIISE MAIL APPROVID PERMIT ~ 1.~ 3. pgp~g
. ~ ~ (Circle one) ~
7 ) r r
~
- e-r•~.r r ~ ~ ~ • i • ~ n r ~ ~ ~ ~ a~
• r s• ~ ..s ~.t ,n~~ i ~ ~ ~ • ~ ' .
~ a~. :
.~~OR CITY USE ONLY ~
PERMIT # ISSUED
,
Pd w/Bldg. Permit FEES:
$ $ ' S SEWER PERMIT ( INCLUDE SL~RCHARGE )
$ S "S Z7 WATER PERMIT (INCLLDE SL'RCHARGE)
$ L^ ~'U C~ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLODE CORPORATION STOP)
S $ SEWER TAP
$ $ /~S ~0 C% ACCOUNT DEPOSIT - SEWER
$ $ b C~ ACCOC'NT DEPOSIT - WATER
S ~1 Z S. E~ C'l $ WAC
S ,S_'C7 O $ SAC
$ S TRLNK WATER ASSESSMENT
S ' $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRL~NX WATER `
$ C' ' C'~ C~ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
S ~ =5 $ ~ / ` TOTAL
_ s:- a -~S ~ / 3 ,
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLZRE EXCAVRTION IN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MDST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SC~BJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: ,,/,',~~r,~„ f~ 'b , ~ , y~-~
TITLE:
DATE: ~ J
..3 ~ =2~ , ~,z!vyu c~-` ,~~c~~,z~
~ l
, 'Y"~ _ / LC.rrz~~c~~R; ~
" C~ea• ~idgu~~ ~v; y
NeAr~ossca~cu~anoris 1 1-oEATING8AIR CONDITIONING CO. MiNri~nrot.is.rr.irr~
' ~ M'eethsrst~ips A.S.H.V.E. . - Conetruc~lon No. InaulatVon
W~rxlawe Doors Guide Oul. Wall Inl. Wall Cslilnp Rool Floor Kind How applied
Aafarancs
Yea-No Yes-No ~g~_ ~ ~ , '
'F1." ~,~/~-Room Lenplh 3~ Wldth - He~phl FI.G/~ poan Lenplh WWth Haip61
Ylindows end poas-Crackape ead Area Wfndows and Ooors-Crackage and Area
Ne. a~~d~n af~~in~ NI ~hl~ l'n~d I~. ~ nll. . . ' No. vl ~ i~n ple1ahe 1~1 hu Om~n, li. sYr~4.
/G, L -
Coal 6 W ~ ~ Coel B lu
i~r,ia~su~ l05~ ~f~ oo t~nn,suo~ ~l7
Glase ~ ~U ~ Q Glesa - ~ Jr'~
Exp, well ~ ~ ~ ~ EHp. well
Nel eKp. well ~ ~ ~ S Net e~p. well ~3 6
Inl. well - ~ Inl, well - ~ I/
Celliny Celllnp ~ ' Y
F~oo. . . . / S c~/ F~oo. ' . . 5
to~al 9:u. ~ ~ ~ Total stu. ~ ~ //O
FleQulred 5V. It. E.D.R. or sq. Ina. W.A. LeeJer area ~ Requfred 6q. It~ E.D.R, o~ aq. Ins. WA. Leader eree
FI. ~v~,~/ Ropn lenpth ~ Width / Halphl FI./}?. E qoan Lenglh / Witlth /~Z Haiyhl
Ylindows end doors-Crackape nd Area Wfndows end Doors-Creckape end Area
W~~~h { elphl No. ol l~n~nl 11. A~~~ WiNh N~~~pM Nn. ol Unanl h. Aien
No. ol ane o1 ana li hl~ ol u. 1~. . ' . No• ol ene nl nn~ b M~ ol ~ 4 ~9. l~.
~ c, ~ i3 a ~ ~
, i~ / i3
coai ei~ cooi oi~
In1Ulr6lion 'J J Inllllrelion ' 070~ ~ ~O
Glase ~ Gless ~ $O 550
Exp. well ~ Ewp, well ~ ~ _
Ne/ exp. well - ~ Nel eHp. wall S ~a~
e
~nt. wel l ~ Inl. wall .
Ceilinp ' ~ Cefllnp v
Floor ~ S Floa ~ ~
To~nl B~u. ~p Totcl B~u.
Requl~ed aq. It. E.D.R. or sq. i~s. W.A. Leader eren Pequirad sq. 1t. E.D.i1. or sq. fns. W./+. Lcedor aroa
fl. Ropn lenplh Widlh He(pht . / F~. ~FiT/f ~~°f^ ~e^A~n Q Width 14oig6t
YJindows and Ooors-Crackage n Area Wfndows and Doors-Crockapa and Area T
No. Of ~ina • Of~~en~ NI hl/ OI tte 1~• i 1ell. . ' No• ul ~~er~ Ul~~~e~~x ~h10 OI c eck i~~II.
~ 3 /L ~ . - _
~
^
- c~,.;~~ ~ ~ ;
coei ow
I~Jiltration ~ ~f Infiltrntfa+ I - ~1~ '
Glese ll D 5S0 Glese ~ ' So
E~p, wall EMp. wnll _ .
t+e~ eHu. weu ` ~ Nel ahp. well ~
Int. well Int. w~il ' -
~O w..-; ,
Ceiling . ~ ~ _Ceiling , .
Flooi S f-ItMx ~
~ lotol Utu. ~ L~
taal 8tu. ~ ~
~cau~rod sp. IL E.D.R, o~ Sq~ Io3..N',A. LuuJei.a~un ~ ~•=q'.ii~:~l ~L C.D.C. u~ s4. in:, W.l~. lo.Jw o~ua
~~13~~ .
2006 RESIDENTIAL MECHANICAL r~xmi~r arrLiCa~['iorr
City Qf Esgaa
3830 Pilut Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Ptease complote for. singlc tamily dweltings & townhomcsleonckos when permits are reqvired for each unit ~
Date / /
Site Address ~
"L_~~~~~ ` ~ Unlt # _
f n_ ^,Jj
Property Owner Telephone t~ ( ~l ) ~V~
` 1p `i j~/~ c.
Contractor rl_r__~~~) l~ y (
Street Address " t 1. •~Ol C~~Y
State Zip Telephone # ( ~ j ~
Bond L'+xpires: ~
The Applicant ls ~ Owner ~ontractor Other
Add-on or alteratfoa to existing dwelliog unit $ 3Q.00
furnace ,,,__AddiYional ,~eplacement New
air exchanger
~ air canditioner
heat pump
other f
~
State Surcharge ~--°""'(7 ~ $ .50
fj
.
~
~ _ ~ ~ f~,
i 0 ~l`]iib 1~
Tatal , r~L ~ ~ .
~ 1
~ _ -
S~,y
I hereby appty far a Residential Mechenical Perinat snd ackqowtedge that tRe information is completu and sccura[e; tr~ai the wprk will
be in canformazxe with the ordinances and codes of the City of Eagan and with the Mechenical Codes; tltet I undcrscand this is not a
permit, but only an application for a permit, ~nd work is uot to start without a e it; th t the w ik will in accc~rdance with the
approv ian in e cas f work which requires a review and approv~l of pl
~ a~ a
A~plicanYs rinted Nazne ~ Appli ~'s Signature
CASH RECEIPT
.
~ ~ ~~~`J CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
? DATE F 1g ' ~
R6C6IV6D , ~
FRIXN . . . _ ~ ~ ?
AMOUNT 1 $ I
& DOLLARS
~oo
? CASH ~ CHECK
f " ~
FOR ' ~ f f; . ~ C l ~ ~ / ~
_
i ~ ~ % ' ~ ' " ~ _ t ~ ~ yY' :.,4/ ~ .
~
FUND CODE AMOUHT
Thank You
BY ' ' -
+
, . ,y e ~
' White-PaVers CoPY
Yellow-Posting Copy
Pink-File Copy
BLDG. PERMIT NQ. ~38a~
01-3210 Bldg. Permit ` o f ~ ~
01-3422 Plan Check ~
~1-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge ~ S`~
17-3860 Road Unit ~'a ~
F o0
2o-zz~s sAC S~ ~ 9 :
~
ZO-38b5 Water Conn. S cc
20-3868 Water Trmt. ~~~,0 0 0
20-3716 Water Meter ~ c<~
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn. 'C ~
11-3855 Park Ded.
TOTAL ~ a ~ ~
CASH RECEIPT ~
. ;
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
~ ~ Q~A7E ~ 19 - ` ,
~
RECEIVED ~
FROM
f .
AMOUNT $ I
Ce DOLLARS
too
? CASH ~ CHECK
POR
r
FUND ' COOE AMOUNT
G Z L .ri^ ~ i.:
~ J i p C~ U
~ ~ ~ ~
/ ~ „
~
~ ~ J
~'1S~ ~ ~
~
Thank You
BY
- .r
: White-PaVen CoPV
Yellow-Posting Copy
Pink-File Copy
For Office Use
m, a , {0 ::::e:'
/--* *r . e,. E AG A N
,,......
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections a(7citvofeagan.corn L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: —I D 1 t I I t1 f Q\YO\NI; t MIS Unit#:
Name: y0� iIABalm Phone: IX�� �I� ` I���
Resident/ r
Owner Address/City/Zip: Its\ 4 Tt(O�'1 :V9G1 \Yak( A E-PctIMNIA MN 5laJ
Applicant is: Owner X Contractor
Type of Work
Description of work: (q-'oaf
VD
Construction Cost: Cl 1-161,- Multi-Family Building: (Yes /No 3( )
Company: TYIf k-D . irut. . I_-.(. Contact:AkkiVeUJ 4-1(.t"1li
Contractor
Address: III � �C Q City:
State:DAN.' Zip: r51512_2_ Phone: 2 47 U 1't Email: n1t.n. t;L1it,:' E Gi°V0J,A •cinv
License#: � �, -b 1
,„,... ,„ii,_ Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression 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-.ublic if ou•ro�ride •ecrfic reasons that would.ermit the Cit to conclude that the are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeadan.com/subscribe.
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.
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 onform9nce with the ordi .nces .'d code of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and . is no to star withou permi hat t work will be in
accordance with the approved plan in the case of work which requires a review and appro . ,f plan
xNI OAIl x /
Applicant's Printed Name •ppli ant's Signature r