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1061 Tiffany DrCITY OF EAGAN Permit No: Date. 9-29-87 3830 Pilot Knob Road Meter No. 3 2.g- .S -7 3 Size: If "CA P. 0. Box 21199 Reader No: 6 Date: '/a ' ?7 Eagan, MN 55121 Owner. Celcr is , Inc. Site Address: 1061 liffany Drive 1,2 ?) 1 Canterbury Forest Plumber D R :'?CDermott AJd1mWmai?l3",cnn ^xrfl,sflri, Conn. Chg: `'5.000 rv?¦Zo¦¦.v F1 Acct Dep: L5.00 d Be ore iggI I at v ititir- i Permit Fee: 10 . ?02d TELEPHONE • EL CIAT %AS7-' Surcharge: • 50 r With the Cl Tr. Plant loin. 00nd W§r* an Meter. O7 o(i„l WATER SERVICE PERMIT CITY' OF lAG`AN - a., _,. - : <-•r.,;,,n,?,?_ _?, 3830 Pilot Knob Road Permit No: 9098 9-29--87 Date Meter No: ' P.O. Box 21199 Size: Eagan, 11011N,55'121 Reader Na Date: i Owner. i;elcris Inc , . Site Address: 1 --3r I T an Plumber. _, ?; r?ntt P e i2 EI terbu ?sorest tab Conn. Chg: 525. UQpd JohnsAn `'xcavatin Acct. Dep: OQ*?d Zoning: I'1 11110, - Permit Fee: 4? No. of Units: Surcharge: .50 d Tr. Plant 180. (}U d I agree to comply with the City of Ea Meter. gan Ordinances. ?r _ WATER SERVICE PERMIT -""w -110T Anob Road P.O. Box 21199 ?, Eagan, M4f 56121 Permit No: % sr i3/P No:2b I agree to comply with the City of Eagan Ordinances. By SEWER SERVICE PERMIT CASH RECEIPT 6TY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RecEivea_,-? FROM AMOUNT $; 6 DOLLARS Leo ? CASH 0 CHECK BY ` White-Payers Copy ' Yellow-Posting Copy Pink-File Copy Thank You BLDGti PERMIT NO. - F-Y 01-3210 Bldg-Permit 01-3422 Plan Check 01-3445 Surch./Adm. r(? 01-3446 SAC/Adm. 01-2155 Surcharge 1 17-3860 Road Unit CO-2275 SAC -7 20-3865 Water Conn. no k-3868 Water Trmt. uU 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. I L` C C%U 11-3855 Park Ded. TOTAL CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 ReC6IvQD FROM AMOUNT $ & DOLLARS Sao E] CASH n''CHECK FOR 1` I Fes' 1 J ? r FUND CODE AMOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy If I CITY OF EAGAN 1 4 0 4 4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Recei t# , f? To be used for - , ` , Est. Value " L,, 7 , 000 Site 1 r FANY DRIVE Lot Block Sec/Sub. Parcel No. Name city o Name . 0 a Address 1- city CC W W W Name F z Addre a z City _ P - Date r. Cal I 19 OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning I On Site Well T Type of Const _ City Water (Actual) (Allowable) * of Stories , Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review ": Fire _ SAC, City Engr. SAC, MWCC Planner _ Water Conn. Council Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. Road UnIt that the information is correct and agree to comply with all applicable APC Treatment P1 State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks Copies Signature of Permittee TOTAL A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Molder Date Telephone # Plumbing HN.A.C. Electric Softener Inspection Date Insp. Comments Footings I 'F?" J Footings II Foundation f 11 _p c . ,' Framing Roofing Rough Plbg. j,n_ Rough Htg. Isul. 9) ?? Fireplace Final Htg. 1? ??Q Final Plbg. Bldg. Final Cert.Occ. 3 Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. . . • 'r..Ap (gPrtif irafr of (Orruvaury titp of (Eagan 1hparbuM of Builbing Amp-PrUm This Certifu;aie issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. Use Cbsn6catkm SF D C/GAR Bldg. Paz it No. 14(?W+ OaUw-r Type F3 Zone Damn R1 rya COM V Own" of 8i,4d;,,g ISIS (D. Ate, 100 E. 146TH ST, B' VIII F SuMm AW,,. 1061 TIFFANY DRIVE locality 1-28, B1, CANIM RY FMS1. Dam: fn !987 Bwlftg Offcw POST IN A CONSPICUOUS PLACE . PERMIT # S / PLUMBING PERMIT RECEIPT # LL CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE - PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub ` Res. New d Name `-? Mult Add-on _ Address - ' ?` ^ E Comm. Repair n' ti LLL / c , . . Phone City Other FIXTURES TOTAL 5 ? Name _ 00 $ Water Closet - $3 c Address . Bath Tubs - $3.00 p City Phone , Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE / Laundry Tray - $3.00 MINIMUM - RESIDENTIAL FEE -$10.00 / Floor Drains - $1.50 ° MINIMUM - COMMAND FEE - 20.00 A&tw+4eater - $1.50 STATE SURCHARGE PER PERMIT - .50 Whirlpool - $3.00 (ADD $.50 S/C IF PERMIT PRICE GOES / Gas Piping Outlets - $1.50 BEYOND $1,000.00) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 - Rough Openings - $1.50 T SIGNATURE OF PERMITTEE FEE , STATE S/C: - U FOR CITY OF EAGAN GRAND TOTAL PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN -r 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 28Z _ NTRACT PRICE: '</1 l) PWnNF• ese_alnn Site Address Name _ Address c City Phone 8l1,DG. TYPE Res. Mutt Comm. Other FEES RES. HVAC 0-100 M BTU ADDITIONAL 50 M BTU (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION). GAS OUTLETS (MINIMUM - 1 PER PERMIT) .s3 COMMAND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS WORK DESCRIPTION New Add-on Repair Name - Address TVP9 OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other 7w ... BTU M BTU M BTU M BTU CFM FEE: S/C: TOTAL $24.00 6.00 1.50 EA. 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) SIGNATU E OF PERMITTEE FOR: CITY OF EAGAN NA) CITY OF EAGAN Remarks Addltio CANTERBURY FOREST Lot 28 Blk 1 Parcel Owne , - ?'-` r ' Street 1061 TIFFANY DRIVE State EAGAN MN 55123 001 01- Nin I,t. AA1 1 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1979 Paid unde original pa rcel STREET RESTOR, GRADING S 198 106.78 5.34 20 85,46 A0134" 1-12-U SAN SEW TRUNK ZZI 1973 Paid unde original p rcel SEWER LATERAL 1981 439.42 21.97 20 XCI-54 AD] 3"6 1-12-RA WATERMAIN WATER LATERAL 20 WATER AREA pg 1979 Paid unde r original pa rcel STORM SEW TRK ff STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK This request void This months from i U ® 300.45 ?7 ?7 ?;, / my39 & ' 1-4 Request Date Fire No. R u h-in -inspection • iretl? W ? Ready Nuw Will Notify Inspec- es ? No for When Heady Licensed Electrical Contractor 1 hereby request inspection of above nor electrical work installed at: Street ddres , pe or Route I. CO 01 f/Q act.. I. Towns ip Name or o. Range No. Co ty Occupy t (P ANT) Phone No. / Power Sup Address a u ? h Elecbica Conirac9miICompan Ne ) Contractor's License No. Mailing A Or s (Contractor or Owner Maki g I ai atio n) ? Authnriz ed 5-gnatwa ntractor/Owner Making Instnllatipnl Pho 7tuberr /y/J(??} MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1921 University Ava.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0600 ENCLOSED- 04.) ?'rf REQUEST FOR ELECTRICAL INSPECTION E13-QVVo,-__ It See instructions for completing this form on back of yellow copy. n A `j -V Below Work Covered by This Request P4&4Addl Red.l 'Type of Building I Appliances Wired I Equipment Wired I F l Commercial Bldg. n('? Furnace Silo llnloader l Industrial Bldq. Air Conditioner Bulk Milk Tank Fe Service Entrance Size a Fee Fee.delerSUbfaeders N Circuits L 11W - 1 0 to 200 AMPS 0 to 30 An s 0 to 30 Amos I Above 200 Amps 31 to 100 An!ps 31 to 100 A Swinxni ng Pool Above 100_ Amps Above 100_Amps Transformers Irrigation Booms Partial Other F nal the EI trice Insp. Cher. hereby certify that the above q inspection has been This request Vold 18 months from 247-542 OFFI UBE NLY This request void IB months from volidatlon date pnmed in this bo . 6? PLEASE PRINT OR TYPE Reques Qste Rough-in inzpetlion required2 ? Yes Inspection Other Than Rough-In: [ff Ready Naw WIII Coll 'a 3-?? (You must mll dre inspector when ready) Doh Ready: I, (P( licensed contractor ? owner hereby request inspection of the above electrical work of: Job Address (5t,W, Boz, ar Ro N.4 - i r City Zip Code 5 ?a Sacnon No. T.1hip Name ar No. Range No. Fin Na. Cognty it?" ?n ?`((rr J?JJ Occvpont Tkoo-s ?, x p hon e No. V N Power Supplier Address ElecMml Contracbr or, Nome( r r• sV i I ?L.+Y? Cgpfto o' Ucense No. /L.i Moshr Uc. No. (Plant Elea. Only) Ming Addren (COmratl9lor Owner erla ?nstgRa?? ? y / j J / f / s? e 5?3?? I . V r [ 1 / / I J , LJ ? Authorized Sign onhatlor or Owney <d "iig Insmll,.n) Pane No.. ? ' -CUSS ?/ _ / 6-00 1A-10 6/95 ST EBO COPY•SEEIN UCTIONSONBACKOFYELLOWCOPY IIIIIIIII ?IIII II REQUEST FOR ELECTRICAL INSPECTION 5?°5 Minnesota State Board of Electricity 1821 x 0 2 4 7 54 2 4* Phone (61642 YoeooS-728, I. Paul, 6 10 Home Duplex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Repair Air Cond. Htg. Equip. Water Hfr. Load Mgmt. Other: Dryer Range Elec. Heat Temp. Serv ice "k' above the work covered by this request. Enter remarks in this space and on the back of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other Fee # Service Entrance Size Fee # Cmcuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Tmffic Sig. Above 200 Amps Ab a 100_Amps Transformer/Generator INSPECTOR'S USE ONLY 12 Sign/Outline Ltg. Xfmr. C 660 Alarm/Remote Control o Swimming Pool I hem .6 that 1 in: ed the elecldml inskllafion dezaibed herein on the date, scored Irrigation oom B Rough-In D.I. S ecial In s edion p p Investigative Fee Firwl / ?J g j? X00 v Dak ! 7 THIS INSTALLATION MAY BE OFIDE1115115 DISCONNECT IF NOT COMPLETED WITHIN 18 MONTHS. CITY OF EAGAN N°_ 14 0 4 4 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 PHONE: 454.8100 H/ ?a BUILDING PERMIT Receipts /(o To be used for SF DWG/GAR Est.Value $97,000 Date AUGUST 12 tg 87 Site 1061 TIFFANY DRIVE OFFICE USE ONLY R3 On Site Sewage Occupancy MWCC System X Zoning R1 On Site Well _ Type of Const V City Water X (Actual) ._ ? (Allowable) s of Stories Length Depth 30 S.F. Total Footprint S.F. Lot 28 Block 1 Sec/Sub Parcel No. a Name KELCRIS INC : Address 1000 E 146TH ST City B' MLLE Phone 432-3447 0alName SAME 0 Address i- City Phone a W m Name sz5 Address aW City-Phone APPROVALS FEES Assessments Permit 493.00 Water/Sewer Surcharge 8.50 Police _ Plan Review 50 Fire SAC, City 100.00 --- - - Engr. SAC, MWCC 523 . 00 Planner Water Conn. X15.00 Council Water Meter 67 n0 I hereby acknowledge that I rea is application and state Bldg. Off. Road Unit An S _ 0 that the information is correct omplywit Ilapplicable APC Treatment P1 7Rn_0 State of Minnesota Statutes aga O nance Variance Parks * Copies Signature of Permittee TOTAL 0 A Building Permit is issued to: I INC on the express condition that all work shall be done in accordance with all applicabl tats of Minn es a Statutea and City of Eagan Ordinances. Building Official - k JI/b Vp 19$7 BUILDING PERMIT APPLICARION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 OF SURVEY, 1 SET OF ENERGY CALCULATIONS ?N. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: $1 Co us/r?c? Valuation: _?s Date:-5-$7 Site Address /pig/ Lot Pe Block Parcel/Sub -r Owner g-0 C12ic ,'VC-Address /OOd F. /YG City/Zip Code ?'Jr?/? SS337 Phone Y 32 3 YY7 Contractor Address City/Zip Code Phone Arch./Engr•\ ?d?O Q Address /do a City/Zip Code ' 0// Ss3? 7 On Site Sewage_ Occupancy 3 MWCC System ? Zoning 2 •l On Site Well Type of Const City Water ? (Actual) -E (Allowable) # of Stories Length Depth 30 S.F. Total Footprint S.F. APPHOVALS FEES Assessments Permit 493, Water/Sewer Surcharge Police Plan Review Z44, 50 Fire SAC, City IDO. Engr SAC, MWCC 5 Z.S• Planner Water Conn SZ Council Water Meter . L7 Bldg Off Road Unit 305 APC Treatment P1 I go. Variance Parks Copies TOTAL OD Phone It Y3a Sao J EXTERIOR ENVELOPE AVERAGE "U" C01411UTATI0N ?'r• iR SITE ADDRESS (l3gl 1 rti: ANY V'14 - CONTRACTOR CONTRACTOR `?AkfWE DATE ;97-144 Determine working square•footage of each. 1. Total exposed wall area ..... Iq `so esq. ft. X .i1 Z 11•ZO .2. Total roof/ceiling area ......j sq. ft. X A. Total wall window area ..................... _ .. A. Total door area .................................. c.' Total sliding glass door area ................... D. Total fireplace wall area ....................... E. Total wall framing area (average 10%)........... Y. Total Rim joist area...... •••••••••••••••• G'. Total Net wall area above floor.... Total exposed foundation area - 60 g, m.,tal foundation window area ................... 1. Tutal rct fou;4- tion area above grade.......... '50. 7-7- Determine "U" value of each wall segment. a. X "U" -& _ b. 77 ]. i X „U., XUb = 7-5-7 C. 34-77& X „U.. g. iGZ8 7k;l x .,U,. _ C .71 h.9 --7 ?P_ X „U„ i. - - ZL X .,u., , 077 = a7. f& 3 ...................................Total I) If item 93 is the same as, or less ti -in item ill, you have met the intent of SUC 6006(c)2. Total exposed roof/ceiling area P-3-1_L2 J. Total skylight area ................................ --1L4- k. Total roof/ceiling framing area (average 101)...... IYA. 47 1. Total net insulated roof/ceiling area .............. Determine "U" value for each roof/ceiling segment. k. V 1. Co X ..U.l u d _ -Z. 15 . 1. ?dDly. , X "U" •o-Z I = lb-°13 4 .............. .... .............Total If total of n4 is the same as, or less than.$2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design T6 utilize the total envelope system method, the values established by the sum of items #3 and #% shall not be greater than the sum of items 81 and $2. i. 7-1 1. Z.o + 2. 234- 3. I7 l a5 + 4. It 0?t4 r" ' .,? vMLL SPrMONS T5: Use 152 of opaque wall area for frame construction construction R-value Y, I t rior it figlp 0 6 2 r 3, in.hes soft wood 5. 4 1 " 7 6. Exterior air film r 0.17 ' Total ?Q.13 l = . 099 interior air film 0.68 ?. 2. lh? um OP 3. . 4. 5. 0.17 6. Lxrerior air film Total ZZ• Z? u= .VT,7 1. Interior air film 0.68 ? - WA IiaGr Cliff ' 3 ' . 4. ys 91#Ear?I? Ib0 r 5 ?1r. t. ?Z _ • W . b. Exterior air film 0. 3.7 Total Z3•75 U _ 04rL 1. Interior air film 0.68 O. z. iv 3 M" In V ?j??? -- • left 4 5. 6. Exterior air film 0.17 Total 12AS Y -L . 077 •1 GRADE • 6 rrr = • /r(F " r ilf o k FIG. #4 I(l a, rl(~ Y, X NOTE: Indicate type, value, death and n(- in anln-ion. •IG. A 3 -DROOP'/CEILING Construction (Use for Item L) H-Value 1. interior air film 0.61 .ate 3. &nr??? fJ UL -?Q- Od 4. Exterior air film (still) 0. L Total VENT 4 0 _ u= :oZt Vented Heat flow A up FIG. #5 CLG. FRAMING(Use for Item K) 1. Interior Air film, 0.61 2. ?.. ? SATZL .156P 3. Inches soft wood +4I / 4. Inches insul above framinglOZZ 5. Air Film 0.61 '?0?1 • D V = . Q- 1. Interior air film 0.61 2- 3. 4. Exterior air film (still) 0.61_ Total 1 Heat flow up vented FIG. #6 1. Inside air film 0.61 2. s. 4. 5. Outside air film 0.17 Total Note: Use additional shccts if morv- si,ace AS needed for details and calculations. FT.fi. 47 Hcat? L.! flow up MINIMUM "U" VALUE AND R-FACTOR AT 12000, WALL, RIM AND CONCRETE BLOCK ROOF f CEILING. (R) VALL IQ 111_fEVID?' PIR FILM ,bf O 5/8:' U-?P FD, , sg 1h5ULRIION yy,oo ® EXISIZID( AIF FILM STILL) I'U"° I IIZ = '_ -z5- TbTAL CR)=yJ• g(? WALL. (R) VAL(k QQ IN IEfzlo(' AIR FILM 6. O 112' GYP.' BD.' 8 1f?SULAlIoN ?/Z/'.= 15.?? © ZS?3zR pul?T-jJTc ?. p? so 'C'IAoNI'jc SIDING ,67 u eX1e^IDr AIR nul /I itUf I/R = .0?3 AIM IL 13 55 G O TOTAL w P 3w03 IIIrEI?IoR NV- FIL1-1 611,° INswNTI0r-4 2 Fitz- R111 FIST f ?h?r?lTE slolrC, "TE1Zmz' AIR FILM (R) VALUE ? 9.00 3•?z. u ?n = I ?[Z = .o?I ToTP.L. (?z? _ ?.S'7d foJN?ATIOIa OQ VALUE 1? INTel7l?i? Alrc FIU? ? .68' ) 11 I'_)u CbJIC" SLY, / a (9 ;C Er. 00 E'XIE[f Ofz. AIR FILM •17 11 u.. _ l CZ = 1> TOIAL- (V4 /0.13 ?r Floors over unheated spaces must have minimum R-factor of R-20 (tuck-under garages) Floors over outdoor air (overhangs) must have a minimum R-factor of R-38. Cities Digital Quality Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. • . . •Iy CITY OF••E&AN:, [ AS3IER: JS TERCfINAi. NO, y,761 DATE; IOM5/99 • TSME: f i -.47, 57 ; t NAMEv CENTURY, ROOFING I 3210 900i 1061 *J,TANY'DR" r •i?5:25k E155 90M. Mi TIFFANY DR 3.'00' , MiO •9001 3683 SjRCjiPND''R . ., i3x3.y25 ?155 90x71 3685 $IRCHPND' R 8.50 ' ' ": ' Taal Receipt Amoillt- k 27 .00' mi167i1 .. tlSER IDs JAN' ;• .I.,TT?.NR•Y•TTT•M•?I??TTTI.M.TT •' tm•?T•?TT 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB B RD RD - 55122 651-681-4675 New Construction Requirements Remodel/Repair Reauhemenh > 3 registered site surveys showing sq. k. of lot, sq. ft. of house and all roofed areas (2maximum lot coverage allowed) > 2 copies of plans (show beam & window sizes: poured Md. design; etc.) > 1 set of energy calculations > 3 copies of tree preservation pion R lot plafted after 7/1/93 DATE: ? ' I { ' i 'Ram 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions b decks CONSTRUCTION COST: DESCRIPTION OF WORK: v 1. ILYARR VVAW op-6 ESS: STREET ADDR (, ? ? 0 LOT: BLOCK: U Name: Phone #: PROPERTY st n OWNER Street Address: City State: AW- Zip: Company \?I%I?A - Phone #:^l (area code) CONTRACTOR A 1 Ucense #Fxp. ?D I &A A Street Address: w2- City State: Zip: y ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Street Address: Registration #: City State: ZIP: Sewer & water licensed plumber (required for new construction only): Penalty applies when address change and lot change Is requested once permit Is Issued. thereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicabl Slate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: -)?' . L - OFFICE USE ONLY 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 Only ? 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 handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning _ Basement sq. ft. Census Code _ Main level sq. ft. SAC Code _ sq. ft. No. of Units _ sq. ft. No, of Bldgq _ sq. ft. MC/ES System _ sq. ft. City Water _ Footprint sq. ft. Booster Pump PRV Fire Sprinklered Building Engineering Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Park Ded. Trails Ded. Other Copies Total: Valuation: $ SAC Units % SAC CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTR: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. (Please Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Nbn Year) PRESENT ZONING/PROPOSED USE: CONmMIAL/RETAIL/OFFICE P?_R-1 SINGLE FAMILY INDUSTRIAL R-2 DUPLEX (Two Units) INSTITUTIONAL/GOVII2NIINENT R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) 0 ADDRESS: CITY, STATE, ZIP: PHONE: L I j / d'y 3) ? is w• NAME: .LAC, LP /1')'1c .9/e!-?, a???kis?ri?s ADDRESS: 1:2 Uo l eiJtire LoE n CITY, STATE, zip:- PHONE: y''/?c? ?1.+. S'S 3 a 7 _ X-f O- oSS6 MASTER LICENSE# eO.Z9 - 7 L M' 4e' rluwers t,icense: Active Expired Not recorded rt-aTf-l' tial 4) ••r • is / NAME: ADDRESS:_ / 02 a 1 X67`/ S T CITY, STATE, ZIP: S7 PHONE: CONNECTION TO CITY SEWER Cff CONNECTION TO CITY WATER OTHER ' 6) • • [3 PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2,0 4, ABOVE 7, r ,. o . D R ?cCircl?e? one, 4 INSPECTION OF SEWM AND/CR W TER IN grAL ATIONS wI LL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. FOR CITY USE ONLY PERMIT # ISSUED jrC> ?7 Pd w/Bldg. Permit c S 6-7,0 $ 7? 7 •? ' 0'(? $_ IDz?'rs $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $-- //Ifs-0-0 $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $_ /3 7 'a -e $ ?1 /fin TOTAL 7776, RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: FEES: $ to-S SEWER PERMIT (INCLUDE SURCHARGE) $ l0 S a WATER PERMIT (INCLUDE SURCHARGE) $ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP $ / e7 Z) ACCOUNT DEPOSIT - SEWER $ 15,e- D ACCOUNT DEPOSIT - WATER $ WAC TITLE: DATE: 7 7?Z/ 4 /0,7,P a r/ CITY USE ONLY L o? ?` BL ? RECEIPT SUBD. 044:Z? M iJ DATE: `: ? 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: P?-O? 9Lo F;ff *1 ? Minimum Fee: Add-on/Remodel (existing residence only) $20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @ $3.00 each) ? State Surcharge .50 TOTAL oZU W SITE AD[ OWNER INSTALL STREET PHONE #: CITY: 6a CUPp?^,r STATE: ZIP: ???5 7& PHONE #: c6102 )Sq4'oco 5 CITY USE ONLY L BL SUBD. RECEIPT #: DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercialfindustrial buildings. ? multi-family buildings when separate permits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: .- NEW CONSTRUCTION DESCRIPTION OF WORK: INTERIOR IMPROVEMENT FEES: , $25.00 minimum fee grr 1% of contract price, whichever is greater. ? Processed piping - $25.00 State surcharge of $.50 per $1.000 of ermit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS:_ CITY: PHONE #: TELEPHONE #: STATE: ZIP: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR CITY OF EAGAN SEWER & WATER CONNECTION CHARGES - 1989 EXISTING PROPERTIES SEWER CONNECTION CHARGES WATER CONNECTION CHARGES SAC $ 675.00 WATER CONNECTION $ 580.00 Previously Pd. Previously Pd. Receipt 11 Receipt 0 ACCOUNT DEPOSIT 15.00 WATER METER 90.00 SEWER PERMIT 10.50 TREATMENT SURCHARGE 228.00 TOTAL: $ 700.50 ACCOUNT DEPOSIT 15.00 be-5 X00 WATER PERMIT 10.50 PLUMBING PERMIT 12.50 TOTAL: $ 936.00 ?' ?`P /03G. oD TOTAL FOR SEWER & WATER HOOK-UP: $t,?36:5& OFFICE USE ONLY PROPERTY OWNER: r6wr l?? ADDRESS: L: ? B: ADD: ham. T ?l l r;io,?c (", / 6?l,,o1t,wl / ,:3,p /. /,r 4 / F 1011 (7 lr1 L U 6 I G /I ) / ,A) (rJTA',6 f'IOJJ If?atd l??Fw???y JPr,'rr/?nale GS?S o0 -F?- (1n/ +?-.- Id 4 OVAI j & S-S; 0 0 G/ov. ao dO.V0 0q, 00 ?? Co / d'y? o v / 0 L /3, 7f/JG? If0. 0 6n ?f)i ??!`/,7P/? .I?n ??s e+ -?/JJ-v/?/? ??/ I',?.1 ? O,. b? 1",9• a :v. x I 6~'~ i `ti t~ , f V I \ .6 r~ r~ / v u.` ,_u ~ ~ ~ ~ r ~ ~ ~ ~ 'x ~ ~ i ~ ~ ' i I - ~ / ~ , _ j .f C _ ,Y .r ~ ur.. ~ ^ ~ ~ ~ , +r ~ / x' ' ~ i E v =y: r X / _ ;9 , x k _ _ f,. ~ t' a /I f y\ F' ~ \ j i / ~ l 30~ ~ ~ - ~ i` F- v p: , p o ~ , ~ / ~ F °40 ~ ~R >r~~~ f v ~ f ~ l . i , a , ~ ` _ C ~ ~i~ . ~ ~ - ~ I ~ i I r l/ I - _ - , 1. V ~ ~ ~ ; ~ ~ / ~ - E ~ / ~ , 0 _ , , ~ 1 ~j '7 i O ~ V DESIGNED CHECNEO I HEREBY CERTIFY THAT THIS PLAN WAS CONSUI,TIN~ ENCsINEEAS, PREPARED BY ME OR UNDER MY DIRECT PR LIED FOR EPA PIANNEA3 ®(IfJ LAND SUAVE4®AS SUPERVISION AND, THpT I~~M _ OVL _ ~ DRAWN OATS RED FOR REGISTERED 6-'4"!J Sc'-40~ J. 1 F)/2$/$~ 3 UNDER THE LAWS OF THE STATE ^ OF MINN TA. SCALE 1 ao EL RIS IS i JOB N0. ® N0. DATE BY REMARKS 563.01 S DATES ~REGNO!L""~. ' TUCI T UCTI ì ý ú þýüýû ÿþþ ýüûùûúù øýýþþù ùÿ åáý ùøì å ÿ ÿþõ úù ø÷ úüêöó é á ùø÷ öø÷ úüêöó é õù êÝýýü á ù íù÷ýø Üü úÞùý ì ö ýüâ ý ððý ýû â ä üý ýëæ æ ýù â èýý ÷ þ ù ýäùâ ýýæáýððý ÷ ýð ýýæ ÷â Þù ý æðý üóó÷ ü ûýððýü ý çæ åæå ôø úù ýü ý çæãæã Ûýùýûæ óùüòü õñð ÷÷ý ú ýïðüï ü ý Ú ý þä ððýø úæù þýüýòô ëèåå øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA107186 Date Issued:09/28/2012 Permit Category:ePermit Site Address: 1061 Tiffany Dr Lot:28 Block: 1 Addition: Canterbury Forest PID:10-16350-01-280 Use: Description: Sub Type:e - Water Heater Work Type:New Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Kris Oien 3670 Dodd Rd Eagan, mn 55123 651-365-1340 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 - 0Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA113438 Date Issued:09/04/2013 Permit Category:ePermit Site Address: 1061 Tiffany Dr Lot:28 Block: 1 Addition: Canterbury Forest PID:10-16350-01-280 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. 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. Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature !" #$%&'()'*+*, -./$%'"&0-1 -23*,$2*4 -./$%'56/7-.189:;<D< ?*%-'!@@6-A1>9B=>B=>9D -./$%'#*%-+(.&1--./$% E$%-'8AA.-@@1''9>D9''"$))*,&'?.'' 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