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1110 Tiffany CtCITY OF EAGAN WATER SERVICE PERMIT 3&n Pilot Knob Road P. O. Box 21199 PERMIT NO.: 5033 Eagan, MN 55121 DATE: R-31-83 Zoning: Rl No. of Units: Owner: Paul Oxborough Address: ?,Iite Address: 1110 Tiffany CF, L23 B Cante -u----re, ore. umber; Weierke Trench & Exc 450-00 -- , Meter No.• Connection Charge: P ize: V9 " L Account Deposit: Reader No.: F' Permit Fee: . 10.00 Rd I none to =in* with the City of Eegen Surcharge: . 50 pd Ordinances. Misc. Charges: 60. 00 pd meter Total: BY Date Paid: Date of Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Roa P. O. Box 21199 Eagan, MN 55121 Zoning: R1 Owner: Raul OXh Address: Site Address: 1110 Plumber. 51 e 1 k B Meter No.: Size: Reader No.: I agree to comply with the Ordinances, By Date of Insp.: d Oro ugh Tit any french F, City of Eagan CITY OF EAGAN 3850 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoning: Owner: ='aul ?:?. Address: Site Address: = ? Plumber: _ i'c e i rK -i7-- 3 3 5 9 C0 1 agree "ooa * with the City of Fagan ordinences. By Date of Insp.: WATER SERVICE PERMIT PERMIT NO.:. S'I S 1 DATE: R _ 31- tS 3 No. of Units: - Connection Charge: ` Z) V - V V PCl Account Deposit: Permit Fee: Y? I0 00 red Surcharge: SO Ud Misc. Charges:E 0. 00 a d meter Total: Date Paid: SEWER SERVICE PERMIT i PERMIT NO.: DATE: No. of Units: I 100.00 ply Connection Charges 2 5 n r pj Account Deposit: Permit Fee: _ 10-W) nd Surcharge: ;r! -id Misc. Charges: Total: Date Paid: t CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 Raca?vao '" FROM AMOUNT ar DOLLARS loo ? CASH [I CHECK r BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You CITY OF EAGAN 3793 Pillet Knob Reed Eagan, MN 53122 E1 Solt" PHONE: 434-6100 BUILDING PERMIT Receipt ## `3 T To be teed for SF D`WG/Gt,R Est. Value $120,000 Date May 17 19 33 Site Address 1110 Tiffany Court Erect Occupancy R-3 Lot 23 Block 2 Sec/SubCanterbury Forest Alter ? Zoning - R-1 Parcel .#' 10 16350 230 02 Repair ? Fire Zone I:QA Enlarge ? Type of Const. V cc Name Paul Oxborou2h Move ? * Stories LU Address 1230 Wilderness Park Court Demolish ? Length 76 r:.. V0?0" SSt ?? IN ---- GS9-9998 Grade n Depth 38 Sa. Ft. o Name _ ou Address r- rit., Name _ Address I hereby acknowledge that 1 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. Signature of Permittes A Building Permit Is issued to: Paul Oxboroun?1 all work shall be done in accordance with all ooolicabie State of Mir Assessment Permit 400 . V V Water & Sew. Surcharge 60 _ 00 Police Plan check 743 -10 Fire SAC 525.00 Eng. Water Conn450.00 Planner Water Meter 60.00 Council Road Unit 250.70 Bldg Off. . APC Total $2069.50 on the express condition that Statutes and City of Eagan Ordinances. Building Official m 0 d Z m E IL o ? N 0 kb 1? V ? lh o o C z° O O N c ? t 0 V ? 3 d q W C W > IL L Q U C L c a c LL ' - G Receipt !t ?t f MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C ~ tJ Type or Print legibly Tot. 1. Date 3 2. Installation Cost ? .1 ? c, C. 3. Job Address 1110 T ~ `' "'y Lot BI k. Tract 4. Owner I Q Lt 1? /J ! f r ; :? 5. Contractor H c d HQUT,-V Gy - 3 y7 Phone 6. Address q C4 j3),;, 5 j e 1" CI< . 7. City I -c r 1, Qi d State D/ ° Zip 5 ?' f 8. Building Type: Residential fS Commercial ? Institutional ? 9. Work Description: New 29 Add ? Alter ? Repair ? 10. Describe f{ 1?-'O ?• HI ? C6,44 Fuel Type L ci 5 5 G 11. No. Equipment BTU - M. Ea. Forced Air 37, 04'C No. Equipment CFM Ai H dli Mfg. L C , Jn.I;: ,i r an ng: Boilers Mfg. Mech. Exhaust 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 I " for Rough Final Inspections: Date Insp. Date Insp. This is your permit whO numbered and approved. Approvedi4 e CITY OF EAGAN 464-8100 Receipt - PLUMBING PERMIT Permit No. f _1 CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address/l// / i n^ Lot - Blk. Tract 4. Owner t 5. Contractor Phone 6. Address 7. City State Zip i - 8. Building Type: Residential 13 Commercial ? Institutional ? 9. Work Description: NewI Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank 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 with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 PLUMBING PERMIT DATE: 1/29/91 RECEIPT: 101223 SITE ADDRESS 1110 TIFFANY CQT1RT Unit # Permit # 12156 L 23 B 2 Sect./Sub. CANTEBURY FOREST RF.N9.-RYAN MAC - k AT(` A')l-1144 WATFD uFATrD ruAUr_u nrTT INSPECTION INSPECTOR DATE COMMENTS >? •ZZ'Q 6,J . Cie Gt f C/i O rJ r (/ G •T c d' far 3`e ea f .? U ? w? 0 / r 'L1 .?Gfs l G l ?ur.?c• This request void 7- Z-7 La-3 fJOi? ?+-?•(L•?,r ?' 37 ` Q IS months from I W089289 - - 1, Request Date Fire No. Rough-in R qui d? Inspection ?Ready N Will S s Notify. Inspec- No for When n Ready ady Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: , Street Address, Box or Royyc?e NO. t & City 5 uA '7V // / 4 9 Section No. Township Name or o. Range No. Coun 3 INT( "'A" Phone No. o rc . Pow r Su plier ?? .6 fa g-lil Addre r •- Ele t ical Contractor (L-Om any Name) S?Cr r .. Contructn is License No. 6 67f ?"3 Mailing Address (Contractor or Owner Making testa llat ) 1 7 660 z5 Authorize Signa[ur (Con c or caner Making Installation) Phone Nuumbber MINNESOTA STATE OARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midwav Bld¢?' Room N-191 BE ACCEPTED BY THE STATE BOARD 1827 University Ave., St. Paul. MN 05104 UNLESS PROPER INSPECTION FEE IS o?___ retoi lq?ittt ENCLOSED. CITY OF EAGAN P ' ude 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATI N 1 set of energy calculations. To Be Used For ?49Q?ICo0-C? Valuation s/,???, Date S- (0 Site Address IUD ` l l ?? ?? L o u?? OFFICE USE ONLY Lot Block a Sec./Sub.?an?f r?OUr Erect x Occupancy Parcel #: to 1(03So Z30 ca F Alter Zoning 1 Repair Fire Zone Owner: Enlarge _ Type of Const. Address: / ?? ? (?'i 1 e c vlEss Park I Move # Stories Demolish _ Front Jo ft. City/Zip Code: F&*C ,V\ 5SGrade Depth 39" ft. Phone #: q Z - 2 22 c9` Contractor: Q LL) Y1?-. Address: City/Zip Code: Phone #: Arch./Enc Address: City/Zip Code: Phone #: ?9ater/Sewer Surcharge 6 d Police Plan Check JS//sue Fire SAC -eP6 Eng. Water Conn. y6"D Planner Water Meter Council Bldg. Off.;O!O--/7 Road Unit 0S0 APC rO?D`( S'? TOTAL CITY OF EAGAN Additio Lot 2_ Owne I .'?, < ?IQ 'r'.:rT Street 1110 TIFFANY State EAGAN MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, yl-1: 1979 1 e original el STREET R ESTOR. GRADING 1981 106.78 5.34 20 90-T9 A01226o 5-27-83 SAN SEW TRUNK .L 21 1973 Paid unde original cel * SEWER LATERAL -i 1981 439.42 21.97 20 373.51 A0 1226o 5-27-83 WATERMAIN * WATER LATERAL 1981 20 WATER AREA IC4, 1979 Paid unde original cel STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT FQM I 250.00 35900 5-17-83 WATER CONN. 450.00 n n BUILDING PER. SAC c;?V; On rr n PARK Blk COURT CITY OF EAGAN p 7795 Pilot Knob Road Eagan, MH $5122 ?7 lr ? 8047 PHONE: 454-8100 BUILDING PERMIT Receipt # ?S ion. To be need For SF DWG/GAR Est. Volue $120,000 pate May 17 Iq 83 Site Address 1110 Tiffany Court Erect gl{ Occupancy R-3 Lot 23 Block 2 Sec/Sub.Canterbury Forest Alter ? Zoning R-1 Parent # 10 16350 230 02 Repair ? Fire Zone NA E l T f C V n arge ? onst. ype o W Name Paul Oxborough Move ? * Stories Address 1230 Wilderness Park Court Demolish ? Length 76 C; Eagan 55123 phone 452-2228 Gmde ? Depth 38 Sq. Ft.- Name Owner Approvals Fees f Address t- rtw. DM..e Name - Address 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. Signature of Permittee - A Building Permit Is issued to: all work sholl be done in coca Assessment Water & Sew. Police - Fire Eng. Planner Council - Bldg. Off. _ APC Permit 40J.VV Surcharge 60.00 Plan check SAC 525 ' 00 Water Conn450.00 Water Meter 60.00 Road Unit 250.00 Total 2069.50 on the express condition that State of Minnesota Statutes and City of Eagan Ordinances. Building Official REQUEST FOR ELECTRICAL INSPECTION ynnyqq?^' See instructions for completi.lq this form on beck of yellow copy. J( Belfl 'Wr9r7c'fued by This Request `, ER-Onev?-.-., d Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service _ Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Omer peel v the, (Spprify) t ar pacify Other Other omputa Inspection Fee Below P Fee Service Entrance Size a Fea FBeders/Subfeeders p Fee Circuits 0 t 0 s 0 to 30 Amos Above 200 Arms. 31 to 100 31 to 100 Amps Swimming Pool Above 100_Amps E F ? Above 100_Am s Transformers Irrigation Booms Partia L'Other Fee Signs Special inspection s 1(7 OT FE Remarks ? E U . Rough-in inal /? C V v 10, llxxtkt4? Date a1e ??6 -.Z O7 1, the laeeri Inspecto , erebv certify that the above inspection has been made. This reauest void 18 months from RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGA AGAN MN 55122 J d 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) i set of Energy Calculations • 3 copies at Tree Preservation Plan it lot platted after?/1W • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE -I SITE ADDRESS TYPE OF APPLICANT Remodel/Repair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks Indicate if home served by septic system for additions VALUATION 1. c MULTI-FAMILYBLDG - Y _?N - FIREPLACE(S) S[ 0 -1 -2 STREET ADDRESS Aut J . CITYSTATEI ZIP TELEPHONE # K1-qb0- ( Ilkl CELL PHONE # 61.21--Oak-040S F # lo.K/l, y63-( '5095'-n PROPERTYOWNER Q. I ? i l YV1_ TELEPHONE# IPJI q-C54-9-Fv t ------------------------------------------'---------"--.------• COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (J submission type] Residential ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: Phone # $90.00 $70.00 -------------------------------------------------------------------------------- --- -------- --------------------------- ation is orrect, d agree to comply I hereby acknowledge that I have read this application, state thaW.es. with all applicable State of Minnesota Statutes and City of EagaSignature of Applicant OFFICE USE ONLY Water Softener _ Lawn Sp ' Lr l?- Water Heater _ No. of R No. of Baths 01 2002 I Air Conditioning Heat Recovery System Certificates of Survey Received - Tree Preservation Pian Received _ Not Required Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 15-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 EM. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 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 Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. 1. of lot, sq. ft. of house: and Lit roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes: poured found design, etc • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE 7 ICJ o? SITE ADC TYPE OF ULTI-FAMILY BLDG 4T -N FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT I U 1 ? ?p?? STREET ADDRESS ?a rrrr-- a ff C/1I1kA pI?.Q/I(?.fA S. CITY i_br/STATE TELEPHONE #?sl"1U1I1'?l7tl CELL PHONE # ?1-h10-3 FA #l,o??- TU3?c?b?5 PROPERTY OWNER ?St l?1 e 1 ?1 F "W TELEPHONE# COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 C_ -rEGORY I _ (v submission type) • Residential ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mcclimucal system includes: Sewer/Water Contractor: - Air Conditioning Heat Recovery System Phone # Phone # iergy Code V Jul 0 9 Fee: $90.00 Fcc: 570.00 -------------------------------------------------------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordina ccesue. Signature ofApplican 4i1 -, Z OFFICE USE ONLY Water Softener Water Heater No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths RemodelfReoair Reauirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks Indicate if home served by septic system for additions % I gU . 2s VALUATION q (5 • `C9 Certificates of Survey Received - Tree Preservation Plan Received _ Not Required Updated A102 OFFICE USE ONLY ? 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-plea ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-piex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 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) Finai/C.O. - Footings (deck) _ _ FinaUNo C.O. - Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ F inal _ Pool Ftgs Airr'Gas Tests Final - Framing _ _ _ Siding _ Stucco Stone _ Fireplace _ R.I. -Air Test - Final _ _ Windows (new/replacement) - Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector SURVEYO.R'S CERTIFICATE N "E N 08010 r O __ o0 L SIENNA CORPORATION l75•g? r?7PT Z `°° mot N z LOT m y 1 N ?" z 23 ?m m c r 1 T -o .p ? pi- r I r -? a ? 1 ` 5 ?6 f• 8g a _? O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30-00 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = tolL 7 FEET b DENOTES WOOD HUB PROPOSED LOWEST FLOOR = q q 1FEET (ooo.o)DENOTES EXISTING ELEVATION PROPOSED TOP OF FOUNDATION to ?•o FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot23, Block 2 , CANTERBURY FOREST, according to the recorded plat thereof, Dakota County, Minnesota. AND OF THE LOCATION OF ALL BUILDINGS THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. AS SURVEYED BY ME THIS Or" DAY OF 1MAE21k , 19L3_- APPROVED FOR SIENNA CORPORATION BY: ROBERTS ARCHITECTS DATED THIS DAY OF 19- PROJECT NO. 82143 FILE NO. FOLDER SIGNED: JAMES A. HILL, INC. BY: HA OLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NO. 12294 % \\ N85°56'gB18 W ?I - I 10ll I BOOK / PAGE JAMES R. HILL, INC. Planners / Engineers / Surveyors 8200 Humboldt Avenue South Bloomington, Mn. 55431 812-884-3029 \0\1 W 4.? ?/ \\ 41 0 \ 0-A Z 'd O -{ O\ O O \ CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN. MN 55122 PERMIT # 02 Jr PHONE: (612) 454-8100 RECEIPT # O/ "I DATE: //o2 91/ / 9 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED ------------------------ --------- FOR EACH UNIT. ------------------ WORK DESCRIPTION ------------------------------ COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 /__l' ADD ON SHOWER 3.00 REPAIR >e- WATER CLOSET 3.00 _ BATH TUB 3.00 LAVATORY 3.00 OWNER NAME: N' ?x I?Jr3?Lt?c ?vG? KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS: ??? O _ HOT TUB/SPA 3.00 -Q WATER HEATER 3.00 t LOT: 073 BLOCK SUBD. FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: GENZ-RYAN PLUMBING & HEATING CO. _ (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 ADDRESS: 14745 South Robert Trail _ OTHER _ WATER SOFTENER 5.00 CITY: Rosemount, MN ZIP: 55068 _ PRIVATE DISP. 15.00 U SPRINKLER 3.00 3-1144 PHONE 612 423-1144 x / SUBTOTAL S Js - ?• h% ST. SURCHARGE .50 SIGN TUBE OF PERMITTEE 3 0 d, /J _ n ) /? "`? eLe d c Y IS/ X / TOTAL: S PLEASE % COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS ANI MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR FACE DWELLING UNIT. --------------------------------------------------- CONTRACT PRICE: ------------------ FEES ------------ OWNER NAME: SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: PHONE #: FOR: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE $ ZIP: TOTAL: $ (SIGNATURE) CITY OF EAGAN PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA106794 Date Issued:09/11/2012 Permit Category:ePermit Site Address: 1110 Tiffany Ct Lot:23 Block: 2 Addition: Canterbury Forest PID:10-16350-02-230 Use: Description: Sub Type:e - Underground Sprinklers Work Type:New Description:New Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Dan Clough 3880 Willowwood St Prior Lake , MN 55372 952-447-5761 Valuation: 450.00 Fee Summary:PL - RPZ/Lawn Irrigation $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 - Jeffrey H Irrthum 1110 Tiffany Ct Eagan MN 55123 Preferred Plumbing 6400 High Point Trail Prior Lake MN 55372 (952) 447-5761 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use l I Permit t t~ City of Ea a~ Permit Fee: 1 1 3830 Pilot Knob Road Eagan MN 55122 Date Received: j I I Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: I ~.________________J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: IAVPhone: I Resident/ i AJ RAJ Owner Address /City /Zip: Applicant is: Owner Contractor Type of Work Description of work: } Construction Cost: U Multi-Family Building: (Yes / Ncqe_3 } I ;Company: Contact: Contractor ~ Address: City: ~ / State: "/V Zip: Phone: Z-~~' t1~ i r/ ~J License Lead Certificate 14 v 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 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 L 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.aopherstateonecall.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. ,,~g~ x 0&4s 0~ 1 (/f 4- x Applic n s Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA173172 Date Issued:11/01/2021 Permit Category:ePermit Site Address: 1110 Tiffany Ct Lot:23 Block: 2 Addition: Canterbury Forest PID:10-16350-02-230 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. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. 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 - Jeffrey H & Leslie A Irrthum 1110 Tiffany Ct Saint Paul MN 55123--187 (651) 456-9767 Legacy Restoration Llc 15350 25th Ave N, Suite 114 Plymouth MN 55447 (763) 354-7660 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174152 Date Issued:12/30/2021 Permit Category:ePermit Site Address: 1110 Tiffany Ct Lot:23 Block: 2 Addition: Canterbury Forest PID:10-16350-02-230 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or 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 - Jeffrey H & Leslie A Irrthum 1110 Tiffany Ct Saint Paul MN 55123--187 (651) 456-9767 Legacy Restoration Llc 15350 25th Ave N, Suite 114 Plymouth MN 55447 (763) 354-7660 Applicant/Permitee: Signature Issued By: Signature