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1092 Tiffany DrCITY OF EAGAN W R VI P IT "- ATE SER CE ERM 3830 at K nob Road P. O, Lax 21 199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: - No. of Units: Owner: Address: Silo Address: i `J2 ^i t• ?,,n Plumber. - v^!:?n # c ??E --, Meter No.:, 6 T 1 Of Connection Charge: ; i U . 0 0 ?:f Size: Account Deposit: 15.00yd Reader No.: IPA Permit" Fee: 10.00vd 1 asm to emaply Walt tie City of Ewtiew Surcharge: . 50pu By AL- Date of I nsp.: Misc. Charges: 2.00 TP Total: Date Paid: Insp.: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box' 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: '- Address: Site /Address: 1.' 92 1 ;`i drit/ Plumber ; -, v ri i :m r. ^ ? {1 R Meter No.: Connection Charge: Size: Account Deposit: Raeder No.: Permit Fee: ' " - opd 1 gsee to 0 pop Walt the Cay of Eeoew Surcharge: 500 i onow nee . Misc. Charges: Total: By Dote Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SER 3830 Pilot Knob Road VICE PERMIT P. O. Rost 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: T I No, of Units: c Owner: Address: Site Address: 1.092 Tif --any Plumber. - nid F. Pumt,c :_ 1 syne to empty Walt tie Cay of Eelew Connection Charge: 42'. G`yp erasweJoe" Account Depcek: 13.00n- Permit Fee: li i !, '•:? Surcharge: By y Misc. Charges: Dote of Insp.: Total: Insp.: Dote Paid: 1082 Payne Ave. St. Paul, MN 55101 6511772-2449 LAST e.I FIRST J oa n CITY i- ec? An 1-4: ZIP -GS 43 HM PH b5? qS2? ?5?1? WK PH TECH J? r+? iC DATE 3 1)-I n22 TYPE MAKE MODEL 5 ,a,Jd d 0"6 SERIAL 5001 A 7(/ INPUT ? C) .DO ORSAT TEST R ECORD C02 % METERED INPUT 00 Cfh / CHIMNEY TYPE U 02 % LIMIT SETTING ( o FLUE SIZE in. CO % PILOT OUTAGE sec CONNECTOR SIZE in. NET STACK TEMP 92' 0 TOTAL CHIMNEY INPUT btuh GAS WORK ORDER STANDARD 6HEATING09 410 W. Lake St. Minneapolis, MN 55408 6121824-2656 & AIR CONDITIONING A Blue Dot' Service Co. EQUIPMENT INFORMATION City of Eag,au 3830 Pilot Knob Road Eagan MN 55122 Phone: (651)675-5675 Fax: (651) 675-5694 RECEIVED AUG292016 r Use BLUE or BLACK Ink For Office Use Permit #: tY3 " ;Z Permit Fee: fDa ts-1 Date Received: . ?9" /& Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: 1092 Tiffany Drive Date: 8/26/2016 Unit #: J Resident/ OWner Name: Mark & Joan Frey' Phone: 651-452-2947 Address / City / Zip: 1092 Tiffany Drive Eagan, MN 55123 Applicant is: Owner ✓ !Contractor ft> Type of Work Description of work: Replace existing deck while using existing frame Construction Cost: $6,000.00. Multi -Family Building: (Yes / No ✓ ) Contractor Company: Lindus Construction Contact: Danny Kehren Address: 879 Highway 63 City: Baldwin State: WI Zip: 54002 Phone: 800-873-1451 Email: Danny.Kehren@LindusCo.com BC007644 NAT -58924-2 License #: Lead Certificate #: If the project is exempt Not disturbing 1 from lead certification, please explain why: any painted surface In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public informa rt. Portions the information maybe classified as non-publ c if you provide spe�� reasons that mould pe ►it City toof 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. aoaherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which regriirei a review and approval of plans. Exterior work authorized by a building days of permit issuance. xJessica Olson Applicant's Printed Name cant's, Signatu (21 -61A) Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of _ Plex WORK TYPES New Addition Alteration x Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% Census Code #of Units # of Buildings Type of Construction DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level /DI'z fir, Porch (3 -Season) -Dr Porch (4 -Season) Porch (Screen/Gazebo/Pergola Pool Interior Improvement Move Building Fire Repair Repair UB REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: _Ice & Water _Final Framing 30 Minutes Fireplace: _Rough In _ Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Occupancy Code Edition Zoning Stories Square Feet Length Width 1 Hour Air Test Final Reviewed By: / O AY) /%%.'k % V61 RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies f , TOTAL, Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant m� 2O Lff / 3 MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required e\O Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Pool: _Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath Stone Lath Brick Windows Retaining Wall: _ Footings Backfill _ Final Radon Control Fire Suppression: _Rough In Final Erosion Control Other: , Building Inspector )2ee I n c e -Dec tL i c R-fiD q re7 RIA; )/7; I1 m ✓ r"- Cin4: \ eve fzeD , )c &F73 Page 2 of 3 ' CITY OF EAGAN ? 3830 Not Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH ON E : 4548100 6UILQING PERMIT TA fir red fea 000 Receipt 85 Site Address '.'711,',Y DF: Erect ® Occupancy CAI%"'F N1311FtY F' Gi' Remodel ? Zoning Lot Block Sec/Sub. Repair ? Type of Const. Parcel No. Addition ? No. Stories Name ,L+1i``.;.I ;? CTllli' 11 Move El ? Length Address 126 ;#12 Demolish Int I ? Depth City Ph i?? 646 - 3 :_ J <`• Phone mps Install ? Sq. Ft. Name l fir- /Y /? ..,.?........ .w. v'j Address Assessment Permit i I City Phone Water 3 Sew. Surcharge cc Police Plan Review u, Name Fin SAC 13 Address Eng. Water Conn. iW City Phone Planner Water Meter Council Council Road Unit d 1 hereby acknowledge that I have read this application and state that Off. f /8 5 Bldg. Tr. Pl. the information is correct and agree to comply with all applicable APC k P State of Minnesota Statutes and City of Eagan Ordinances ar a Var. Date Copies Sign . im of Perrnittee Total A Bui,...np Permit is issued -to: an the express condition that 0535 all work shall be done In accordance with all applicable State of Minrtesoto Statutes and City al Eagan Ordinances. Building Official g J J h' i ?Cl ? ? v O .l 'PIZ N J G Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN - T Fee L Fill in numbered apaa?er =/C Type or Print IVspfb/y Tot. 1. Date L` h VA - 2. Installation Cost r 3. Job Address f ' Lot Blk. Tract 4. Owner r ; a 5. Contractor Phone 6. Address i; 7. City y State Zip & Building Type: Residential Commercial ? Institutional O 9. Work Description: New ,p Add ? Alter O Repair O 10. Describe 11 No. Fixtures Water Closet No. Fixtures C l/D fi i ld Bath tubs esspoo ra e n Se ti T k Lavatory p c an f S Shower , tner o ll W Kitchen Sink e Urinal/Bidet O h Laundry Tray t er 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 46"100 t Ts (gertifiratt of (Orruvaury Cttp of eagan Mrvartmmt of WuiW" Pruan This Certificate 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 Ck"if"fion Bldg. Fbwdt No. l?4'i•/. Occupancy Type Zoning District Type Coast. Owner of Bmlding - - ?r ; Address Bmlding Addren Locality Bmlding Official '0. IN3? Dal!: ';?1 a POST IN A CONSPICUOUS PLACE CASH RECEIPT CITY OF EAGAN? P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 Fmcm Ito FROM r AMOUNT $ Iv' & _DOLLARS 100 CASH [] CHECK FOR / Y f 2, t--Y _ FUND CODE AMOUNT l Thank You 53155 BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN ' Fee Fill in numbered spaces SIC Type or Print legibly Tot. 1. Data 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Pho ne 6. Address 7. City State Zip 8. Building Type: Residential ? Work Description: New Q Commercial ? Institutional ? Add ? Alter ? Repair ? Describe Fuel Type 11. No. Epujpmani BTU . M. Ea. Forced Air No. Equipment CFM Air H dli Mfg. 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 : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 i Receipt PLUMBING PERMIT CITY OF EAGAN Permit No. ? ` Fee I I"J Fill in numbered spaces S/C L Type or Print legibly Tot. ' 1. Date s? 2. Installation Cost 3. Job Address Lot , S Bilk. Tract 4. Owner - APE` 5. Contractor Phone i % lam' 6. Address 5""- 7. City ?-t State f ;Jl4?' ' Zip S S /U -3 8. Building Type: Residential P Commercial ? Institutional ? 9. Work Description: New Jd Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield t 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 / This request void 56 ^8 months Irom lP C U- r 8 - b .....?....?. .,a.? .,c ..,,..u.. .....N .. Reqa ned7 Ready Now Will Notify Inspec- ` 10?11/85 ?Ves ?No fur When Ready n Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Street Address, Boz or Route No. 1tv 1092 Tiffany Drive Eagan action No. Township Name or No. Range No, nty' I Dakota Occupant (PRINT) Phone No. Power Supplier Address N.S.P. 3000 Maxwell Road, Newport Electrical Contractor (Company Name) Contractor's License No. SOUTH SIDE ELECTRIC, INC. 40359 7 Mailing Address (Contractor or Owner Making Instailation) 4219 Bloomington Av. South Authoriz gnature 1 ntractca Owner Making InstallatioN Phone Number 722-6695 THIS INSPECTION REQUEST WILL NOT MINNESOTA STATE BOARD OF ELECTRICITY Griggs-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (812) 297_2111 ENCLOSED. ?j REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 See instructions for completirg this form on back of yellow copy. g _ 90 073756? X" Below Work Covered by this Request ? ?? Ss New tidJ 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 O:har pacify ther ISpecityl t er Specify Other 01her Compute Inspection Fee-Below W Fee Servic .Entrance Sine b Fee Feeders/SUbfeeders fl Fee Circuits 0 to 20 Amps q 0 to 30 Amps 0 to 30 Amps Above 200 Amps 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100 Amps Above 100_Amps Transformers Irrigation Booms Partial/Other Fee Signs Special Inspection S TOTAL FEE TOTAL F Remarks OD rOD Ef Install 200 am sexvi r. Rough-in , ante L,{r? /b ?7r/!& ?the Eleewica Y Inspector- here :ertify that the above Final t'y yam( ruction has been hade. This request veld 18 months from CITY OF EAGAN N°- 10 6 8 6 3830 Pilot Knob Road P O Box 21.199 Eagan MN 55121 PHONE: 4548100 Q BUILDING PERMIT Receipt # ---------=??o - SF DWG/GAR Est.Value_ $113.000 Data AUGUST 1 19 85 Site Address 1092 TIFFANY DR Erect E Occupancy R3 Lot 25 Block 2 sec/Sub. CANTERBURY FOR Remodel ? Zoning R1 Parcel No. W Name ADAMI CONSTRUCTION Address 1726 ASHLAND #12 City ST PAUL Phone 646-3598 o Name SAME ZZ u Address City Phone Name _ Address Phone Repair ? Type of Const. V Addition ? No. Stories Move ? Length 52 Demolish ? Depth 55 Int Imps ? Sq. Ft. Install ? Approvals Fees Assessment _ Water E Sew. Police Fire Eng. Planner - Council I hereby acknowledge that 1 have read this application and state that Bldg. Off. 8/1/85 the information is correct gnd")ogree to comply with oil applicable APC State of Minnesota Statutais /d City cff9gon rdi s. Ver. Date Signature of Permittea A Building Permit is iss d to: ADAMI CONSTRUCTION all work shall be done in accordance with yllaWlicgbte State of Mlnrevi s.'. Copies Total $2,254.75 an the express condition tha+ f_of Eagan Ordinances. Permit $ 465.50 Surcharge 56.50 Plan Review 232.75 SAC 525.00 Water Conn. 500-00 Water Meter 63-00 Road Unit 280.00 5 Tr. PI, 132.00 Parks Building Official CITY OF EAGAN Remarks UI_'. ?'- Addition CANTERBURY FOREST 25 2 ? Lot Blk Parcel Owne r7i '7 ?/ - Street 1092 TIFFANY DRIVE State EAGAN MN 55123 t Improvement , Date Amount Annual Years Payment Receipt Date STREET SUR F. 1979 Paid unde original pa rcel STREET RESTOR. GRADING 1981 106.78 5.34 20 85.46 A013446 1-12-84 SEW TRUNK Ll 1973 Paid unde original pa rcel SEWER LATERAL { :,- WATERMAIN WATER LATERAL WATER AREA 1979 Pal unde original pa rcel STORM SEW TRK ' lgg7 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT RjQaLq Unit "An An ';A1 Q1 A /I /Qq WATER CONN. BUILDING PER. 10686 SAC 525-00 PARK 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET,2F ENERGY CALCULATIONS oc?o- '- 155, To Be Used For: { SF Valuation: Date: 01-2q-85 Site Address: ?d wrvA13Vey Lot: Block C Sect/Sub Rxcs7 Parcel # /D - / (o 3-,?O-dCO0 L owner MAP K z-, Qvj Address 590e I I lb Ayc So City/Zip Cade Mk?qS242pl:4 PlQ ZV17 OFFICE USE ONLY Erect x Remodel Repair _ Addition Move Demolish _ Int.Impr, _ Install Phone ??Orl'(off 1 APPROVALS ContractorJLA1224?(lyiS??rJl(' !©1] Address City/Zip Code 5 t ,P2/ LL :2Z0 4 Phone _ (pq- p ?7j5q g Arch./Engr, Address City/Zip Code Occupancy Zoning Type of Const 0 of Stories Length Depth Sq Ft FEES -T S2- 515 Assessments Permit 4(D5.5o Water/Sewer Surcharge Police Plan Review 73-T. It Fire SAC 525, °° Engr Water Conn Planner Water Meter Council Road Unit L$p. °? Bldg Off Treatment Pl 132.% APC Parks Variance Copies TOTAL X51 7s Phone p ? (x 4'Z ° ? So z x 5 a- a '? o3?v 24-I 3O .?-.'Zo x ll 1`12 ggo x4l 34440 tox 4Z- I i r ( 1 2 (P & 9 CITY OF A A BUILDING DEPARTMENT EXTERIOR ENVELOPE AVERAGE "Ulf COMPUTATION (To be submitted with building permit application) One or Two Family Dwelling Owner MA94 * IaW Tity All Other Site Address 109.2- 7x-&A? PVC ,cp-r.2,f aio?a z CkN762nua? ?'vtE.r? Contractor Date Phone LINEAL FEET OF EXPOSED WALL -'?eE NU-?6P-X- yJ66T" ft. above grade = 2)57-8,00 TOTAL EXPOSED WALL AREA SQ. FT. OPAQUE WALL CONSTRUCTION: 'Pull Value x Area {'PAm_ Detail Pluto -o34 x sQ. FT. 1&90,94- ?(U)(A) A?sP? reference nun .04.5 x S. Q FT- - JD1.$?- (U) (A) from "?:T fluff- •04.0 x SQ. FT. ZSA,oZ- U)(A) attached fluff x SQ. FT. = U) 0%) sheets fluff x SQ. FT. _ (U) (A) fluff x SQ. FT. - (U)(A) WINDOWS: 'PUP' Value x Area Make & Type &,peutr &MIT, fluff , 41 x SQ- rr FT. 13Z-Zo= 570-/tP (U) (A) if 'furl x SQ- FT- _ (U)(A) fl if fluff x SQ. FT. = (U)(A) it of fluff x SQ. FT. = (U)(A) DOORS: "Ulf Value x Area Make & Type L, k7 t?Lr it 'PUP' .?4 x SQ. FT. 0.0 = O (U)(A) It >'ATio t 11u,r -47 x SQ. FT. ?OS.o? Z (u)ta) i If SQ ffufr - (U) (A) n rf _ nun x Q. - F . _ (u)(a) TOTALS MV-00 SQ. FT. I9S,49 (U) (A) AVERAGE 11U'P TOTAL (U)(A) VALUES 175;o47 = DIVIDED BY TOTAL WALL AREA ZSZ$•Op X077 AVERAGE "U" ,115 r less for 1&2 family dwellings ROOF/CEILING- 6 TOTAL AREA: 13 00 6 Detail reference fluff . of q x SQ. FT. 13 ot? Zlv-z9 (U)(A) from attached sheets. "U" x SQ. fluff x SQ. FT. (U)(A) FT. _ (U)(A) Describe openings 11111 x SQ. FT. _ (U)(A) in roof. rrurr x SQ. FT. _ (U)(A) TOTAL (U)(A) VALUES DIVIDED .7 13 84, NT Zk.z9 Cu \ BY Z?O,Z9 = TThV 1 TOTAL ROOF/CEI G AREA I?$j4,pp ?Q? Q AVERAGE "U .025 r ventilated roofs. ?? ? ll wOR? elkeT it ('9Ross. t? IO.oo X (4Z+4Z+ 34+34, _ ?j Eo eb Awc?F •ro7X (4Z+4Z+•34+34 = 1•;3 x (84+ms+4i) WjObows z4x4z = 7. o 24x¢8 = 6.0 zpx¢$ = &.7 Zox 54 = 7-5- 'M(369= &0 3&x(4 = /6•n p 3' Srm. Z$.oo Ze 5IL, 5E2e•2 = ¢z.oo (P- ?ATto = 42.o0 9e ?7R?urs1 = (v?? ns.oo? deT ?x_ s w, clc. 6aS AwwF rTzm ?? Tens ?i w?n??0w5 a b?.s lS20.00 1008.00 ZSLg,oo -k 101. A?? zs8.oz ? X z= -1400 x 5= 40.00 y? 1 = b•7o x s = 37.so X 3 = 18.00 x 1 = /(v, o0 E6t vqLS ,25z8.oo 1OI•? zss.oz. 1.3Z.zv (oK o(a 17s.oa J; g (po q4 00 3z)<¢z = 1344 00 ZX? oo 138 0?- --WALL SECTION-- Determining fluff values at Roof, Wall, Rim, and Conc. Block ROOF/CEILING 1.) Interior Air Film 2.) 5/81, Gyp. Bd. 3.) Insulation 4.) . 5.) Exterior Air Film (STILL) R VALUE 0.61 .56 SO.oo .61 "U'' = 1/R= . O 147 TOTAL (R)= 51.76 WALL R VALUE 6.) Interior Air Film 0.68 7.) ill Gyp. Bd. .45 8.) Insulation 11.00 9.) Z'49 10.) aconite Siding .67 11.) Exterior Air Film .17 J'' 9TVAP 6,00 nun = 1/R=. TOTAL (R)= Zq.Oj RIM 12.) Interior Air Film 13.) Insulation 14.) 2" Fir Rim Joist 15.) $vfL"T- P-?TE 160 Masonite Siding 170) Exterior Air Film (R) VALUE 1% oa 1.0888 .6 .17 fluff = 1/R= TOTAL (R)=Z4'4f FOUNDATION 18.) Interior Air Film 19.) 20.) '?1r1ftpe &Ljwp 21.) 220 ?L?I00? 23.) Exterior it Film R VALUE o.68 Jq.oO .1 / a? ffufl = 1/R= r O? TOTAL (R) = P t- f OP CITY USE ONLY PERMIT #: RECEIPT DATE: 8008 PtESIDENTIAL MECELkNICALPERMIT APPLICATION crrYw 6kam 3850 PELOT KNOB RD EAGAN MN 551 EY 651-681-4675 Please complete for: ? single family dwellings D rr townhomes and condos when permits are required for each unit III MAR 2 9 2002 iii Date: yb? ??, - ` SITE ADDRESS: I l"[ COY! o Ac By J OWNER NAI INSTALLER SMJt4NEAPOL? tv„ ? %&2998 STREET ADDRES : A" - - CITY: STATE: Place a check mark next to the permit work type TELEPHONE 47 31 TELEPHONE #: ZIP: ^`1 Add-on, modification or alteration to existing dwelling unit $ 30.00 a furnace replacement • air exchanger • air conditioner • other Nature of work: GLc / ! yqCC State Surcharge $ .50 Total $ 30 J V SIGNA ERNI TTEE 1102 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: 8008 COMMMCIAL MECHANICAL PUMIT APPLICATION CITY OF PA&AN 3830 PILOT KNOB RD $AHAN, INN 55188 651-6$1,4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: TELEPHONE #: STATE: ZIP: WORK TYPE: New construction Install U.G. Tank - Interior Improvement Remove U.G. Tank - Processed Piping Specify Nature of Work When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1% of contract price OR $50.00 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 $ SIGNATURE OF PERMITTEE Updated 1102 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPER? ! ADDRESS: -. /1 r ??+?.?T C?T!yrll.?T: LJ/ML Dir.`= (Iot/Elcclc/S?.ivisicn or TAY Parcel I_D_ Nt?,ber1 17 z Iy '=i:, S-?i ^?TE, DATE 05' CRIG-AL `UTIDIM. Lam'=ST ISS \C _.; PFLrS= 0?R-1 Si?:GL FP"42LY - ? R-2 DUP1-- -X (7%%o LTTI':S) ? R-3 TC:.zCUSE (TI-a^ i UNITES) UVI^S) ? R-4 AP r LT]T/CC:S?Ci•)T I?rlI ( UNITS) E3 CCLH%= %L/R -AIL/OFFIC ? MMUSiRIAL ? L%STITGTIONAI,/GCv'ER jE?.T 2) tL•'rLiC=.T PRINT AD_^.RESS: C?/6 ??5'Li ??z?•i? sfq ? v - C=, S y, zip: 3) PLL:-TL-LE (PLEASE PRINT) CITY, STATE, ZIP: BhdO--?` _ rn h Sti y ZT7 PHCNE: SAD- 77 V PLUMBER LICENSE #?s- yy „ 4) OCCG'PA.NT/Ct::ER NAME: (PLEASE PRINT) ADDRESS: CITY, STATE, ZIP: PI:'6NE: FOR CITY USE ONLY PLUMBERS LICENSE: of x"UIL-1°iL•E WHICH PM-11T IS BEING REQUESTED: - ? CONNECTION TO CITY Sam ? 074NF=TION TO CITY WATER ? On MR (PLZA-SE DESCRIBE) 6) LNDIEI= C:.c 7) SIG;ATL'RE: ? PL SSE HOLD APPROVED PERXIT FOR PICT:-UP BY ONE OF ABOVE ? PLEASE %7LIL APPROVED PM%1IT TO 1,d? 3, 4 ABOVE (Circle one) DATE: ?! ?! A:taw,r?1s i? r Q lr:asa s r A ri aR?. a ?? a s sr r?a:r a s l! syl:?Yl?j? a a rs ? sssar F O R C I T Y U S E O N L PERMIT °- ISSUED F FEES: $ 9?.SU SE:•IER PERMIT (INCLUDE SURCHARGE) $ WAT= PERttT_T (INCLUDE SURCHARGE) s S 5 63dd WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SE:l:ER TAP $ /S^cy =CCCC::_ 0?GSI: - o-..ER S /S-&? . 'ACCOUNT DEPOSIT - WATER $ 61 1-d WAC $ S S -moo SAC $ TRUNK WATER ASSESSMENT $ TRUNK SERER ASSESS2iE?iT $ LATERAL BENEFIT/TRUNK SEi:ER $ LATERAL BENEFIT/TRUNK WATER $ ?' ' WATER TREAT1,1ENT PLANT SURCHARGE $ OTHER: $ TOTAL $ r ?/ JU AMOUNT PAID/RECEIPT R 5Z/Sr- DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE Q NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: / DATE: t iw wks rrl BRAN sr an sw am== wrm lmj%64 W*M DIUM /fIM:00 W94 RS N%M" Wi* RS¦ MOM fA 11r .. era;-?:?ri-: -r-z.g_.. •? ._. .. _.. . TV 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL?p,? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Requirements Remodel/Repair Requirements ? 3 registered site surveys showing sq. R of 1o4 sq. h of house ands roofed areas (20% maximum 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 if lot platted after 7/1/93 DATE: I©" 5 9 DESCRIPTION OF WORK: 7-0 STREET ADDRESS: ? 2 copies of plan ? 1 set of energy calculations for heated additions ? 1 site survey for exterior additions & decks CONSTRUCTION COST: j0 r r) 1?1 LOT: _ BLOCK: ? SUBD./P.I.D. #: l l?un v?O lA r/ t'0 rf Name: ?L r' l Phone #: yS? ?02?/ y 7 PROPERTY OWNER Street Address: City State: /! r Zip: CONTRACTOR ARCHITECT/ ENGINEER Company. gC/?J q? (?- ?/ Phone #:?? ' 3c;,.:;-)o Street Address: D / `6 S License #r'v1 ,2Z$3-rFxn. ? City mp/ (s State: _ M n Zip: 5'-5 yI 7 Street City Phone #: Registration #: State: Zip: Sewer 8 water licensed plumber (required for new construction onlvl: Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Stat4 of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ONLY Certificates of Survey Received _ Yes No OCT 7.0 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 PorctVAddn. (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 [7 38 Camolish ;lnterix) ? 42 Reroof GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered 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 PI. Park Ded. Trails Ded. Other - Copies Total: SAC Units Valuation: % SAC SURVEYOR'S CERTIFICATE x919.7 _ x911.1 _ x917.0 TIFFANY DRIVE M )` 91Q•6 p } 917.5 M -N 83°32'44" E 100.00 ?1 a N` o S o / f (9I?gV Z sr----- ' ---?5 z I o 1 l?_rI*tA 9A. io911A.8---1? I /1'r ?-30 P9.00 JOL.\/ N GI ; 24 `I s^ w C? N8556 .40_,, u X QIQ•7 I ij I° I ? i I ; °+ a LOT _ 25 m / 1 a 1 '; w r ti / O 511 I? 1 I 1z 4 . N_ 1 N 1 N 1 = 1 3 ;N is I ? 1 = 30 rq .1 ytl .'1 = UO. S Rey, pQ.oPobtLD Eel's ?-Z=85 REVISED 6-24-85 TOSHOW PROPOSED ELEVATIONS PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 8 214 318 56 5/6 X11 ?g 1 Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenue South: FOLDER Bloomington. Mn. 86431 612-884-3028 1:- • r SURVEYOR'S; CERTIFICATE *SIENNA CORPORATION O DENOTES IRON MONUMENT SET • DENOTES IRON MONUMENT.FOUND PROPOSED GARAGE FLOOR = 922.4. FEET ? DENOTES WOOD HUB PROPOSED LOWEST FLOOR - 918.1 FEET (000.0) DENOTES EXISTING ELEVATION PROPOSED TOP OF BLOCK = - FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 25, 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 :22ND; DAY OF MARCH , 1983 SIGNED: JAMES R., HILL, INC. BY: l?JliL- HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NO. 12294 APPROVED FOR SIENNA CORPORATION BY: DATED THIS OF DAY 19 REvlseu PIZOPOSto L-T'l.4VIa7100% 7-3-$g SHEET 1 OF 2 SHEETS PROJECT NO. 821431BS6j/6 FILE NO. FALDER REVISED 5-31-85 TO SHOW PROPOSED HOUSE FOR MARK FREY REVISED 6-24-85 TO SHOW PROPOSED ELEVATIONS BOOK / PAGE m/61 JAMES R. HILL, INC. Planners / Engineers / Surveyors 8200 Humboldt Av*nue South Bloomington, Mn. 55431 612-884-3029 S 18 to RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 A(96a5 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cart of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pros Not Reqd l set of Energy Calculations Addition - indicate if on-she septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after VV93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date 1 / L! Site Address 10 /07 g7- 'r: /IA. or. Construction Cost Zz,670 Unit/Ste # Description of Work Ald ?A S -io,? Aslat', iev - rekert. Multi-Family Bldg _ Y X N Fireplace(s) _ 0 _( 1 _ 2 Property Owner M4,k 1 fd~ k-- - Telephone # ( 6J l ) y$-Z- 2`1'417 Contractor laKeL„? (4 v3G (a C CA-6, ,1Nr . Address 3/Z State Ito r1J 6 6 P ti J4. e city !-"4f&- 0 w Zip rJV76 Telephone # (C ( L ) CPS- 3.5-6 I COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet (J submission type) Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING _ Minnesota Rules 7672 • New Energy Code Worksheet Submitted Telephone y)y % I I hereby apply for a Residential Building Permit and acknowledge that the information is complete 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. f? /1h J(A?Ct!?r r% Applicant's Printed Name App it cant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of_ plex ? 09 07-plex ? 17 Garage )X 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New !`t 32 Addition ? 33 Alteration ? 34 Replacement Valuation D 6W Census Code ?f 3(1 SAC Units Nbr. of Units _ Nbr. of Bldgs - Type of Const w ?- REQUIRED INSPECTIONS _ Final/C.O. y Final/No C.O. _ Plumbing HVAC Other Pool _ Figs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone Windows (new/replacement) Retaining Wall - Footings (new bldg) - Footings (deck) - Footings (addition) Foundation _ Drain Tile Roof Ice & Water _4t Final ?l Framing Fireplace j` R.I. Air Test y Final Insulation Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy __/Z-73 MC/ES System ` Zoning 2) City Water Stories - Booster Pump Sq. Ft. PRV Length /3 Fire Sprinklered r Width / --------------------- Approved By ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Building Inspector ? /3X/3 ® 3y `/y ??? SURVEYOR'S CERTIFICATE _. • '_ x 919.? r 9tA.l _ x gli•69 ', TIFFANY DRIVE 91V•5 f vrs M (q -N 8303244" E 100.00 gr rs ti` o o 1(9nT s $ ---- /--05 Z o I? / el O i /?_r \ 30.0 - 28.00 -?B.IOI_ a) # + GAR\b c+ I o I ? L ?) lu 10.0 quo, :' of o s^ I 221.j 4% POSED HO w • ttI o "- C z 9b$ ( I 42 t 29D0 ? WO) ?I5l00 92 b `tj=-----1-5 19.3 51 IqI 1 30 I -r N 1 .. O t_\1 i -A to LOT 4! of ` N rq If 25 ti „ 'A w 1 0 w a) <? 51 561 5.00-1 N85o 3 I / P r) 4808 / 1MV, p?oPobtA EI.?'S l-Z-SS REVISED 6-24-86 TO SHOW PROPOSED ELEVATIONS SHEET 2 OF 2 SHEETS PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 8 2143/856y6 III A; Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenue South: FOLDER Bloomington, Ma 55431 612-884-3029 SURVEYOR'S: CERTIFICATE SIENNA CORPORATION O DENOTES IRON MONUMENT SET DENOTES IRON MONUMENT FOUND O DENOTES WOOD HUB (000.0) DENOTES EXISTING ELEVATION PROPOSED GARAGE FLOOR = 922-4 FEET PROPOSED LOWEST FLOOR = 918.1 FEET PROPOSED TOP OF BLOCK = ---- FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: . Lot'25, Block 4, 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 :22ND; DAY OF MARCH , 1983 .. SIGNED: JAMES R., HILL, INC. 2 / , ,./ o HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NO. 12294 APPROVED FOR SIENNA CORPORATION BY: .DATED THIS DAY OF 19 ReVls'. PP-OPowwo t -LAVIaTInn1S 9-D-8s REVISED 5.31-85 TO SHOW PROPOSED HOUSE FOR MARK FREY SHEET 1 OF 2 SHEETS REVISED 6.24.85 TO SHOW PROPOSED ELEVATIONS PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 821431BS6 y6 it1 /51 Planners / Engineers / surveyors FILE NO. . 8200 Humboldt Avenue South FjOLDER Bloomington, Mn. 56431 612-884-3029 MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 1-20-2003 DATE OF PLANS: 1-15-03 TITLE: Frey addition PROJECT INFORMATION: Sitting Room COMPANY INFORMATION: Beauclair Construction OMPLIANCE: SSES Required UA = 52 Your Home = 37 28.58 Better Than Code --------------------------- CEILINGS WALLS: Wood Frame, 16" O.C. DOORS Permit # Checked by/Date Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ----------------------------------------------- 169 44,.: 0.0 5 312 21. 2.0 17 42 0.350 15 HVAC EQUIPMENT: Furnace, 90.0 AFUE HVAC EQUIPMENT: Air Conditioner, 13.0 SEER -------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. Builder/Designer Date /-70-0L_ 2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit C Date O 7 - ?« - Site Address /Q p / Z ,/ / y-? Unit # 67 Property Owner ,/ /c•? Telephone # ((9 S/ ) c1 41 3- L - Z 9 Y7 Contractor ANGE I AIDC WO -- . TfrR nnt , rr 12253 Nicollet Avenue South Street Address -?IlfnsvlA9 10155357 ' city , Telephone: 952-746 5200 State ( ) e. nY2 2?e a'n? Zip Telephone # „2I Bond #:_ 0,1 0 8 0 73 Expires: Z.A0o v The Applicant is _ Owner Contractor Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 _ furnace -Additional Replacement _ New air exchanger _ air conditioner heat pump other State Surcharge $ .50 Total $ 5-o..)0 I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and 9e W be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; i perm t, but only an application for a permit, and work is not to start without a permit; that the work wi 7t1tA?dIdC?b6fth approved plan in the ca e of work which requires a review and approval of plans. s 14- ?7?'Ire-'C-a'7an-r i4- BY Applicant's Printed Name Applicant's Signature City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1092 Tiffany Dr Lot: 25 Block: 2 Addition: Canterbury Forest PID:10- 16350- 250 -02 Use: Description: Sub Type: e- Fireplace Construction Type: Work Type: Free- standing Stove (new) Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Fireside Hearth & Home 20802 Kensington Blvd Lakeville MN 55044 (952) 985 -6675 Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Andrew Hoffman BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: $90.00 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. Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Mark J Frey 1092 Tiffany Dr Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 Issued By: Signature Building EA078012 05/30/2007 ePermit ðü ð ÿ þýý ðûûü úýýüþ ò üý úî àñ þýö þýüûúùõ éò ýûúù ûúùõù ùóý ò ý òñíýùú ð þïý î éë ù ùù éÿë ôý ôë ù ø÷ éü ê ý ý ùüýé ù ê ò üôè ïý üúø éôúëô ê îæñåæêê õú þý ë çýæñåæêäêä çýñÿê ôó öòñ ùù ý ò ýã âî ú äóøúàñäûééú ø ãöñ áßàà ë üúø ë ëì ë ùù ëëé ô ôùúøëùùüþ éã þý òúé í ê ùù÷ ôþ ý ýúþ ý Use BLUE or BLACK Ink For Office Use I City I ~J of Ea R Permit#: UX O1 n I I 1 I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ((p 7-0tf 3 Site Address:/017 N tr ' `J Unit Name: tin `l Phone: 15Z 173b. 5,07b Resident/ .~J Owner Address/ City/Zip: G iT/F~ifiN Vfl Xft,4Nt RA) !~~3 Applicant is: Owner V' 1 Contractor Type Of Work Description of work: myt 1~G 1 mg Construction Cost: /0 U d Q Multi-Family Building: (Yes / No ) Company: 6I1f_Da-fP/t5S Ry/t-njg~xs Contact: Address: V • City: 1N Contractor State: MTV zip: .15131 _ Phone: k 7•;?A rl License #:L Lead Certificate 10 7-1 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 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.ciopherstateonecall.ora 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. y~ x O!T)lw I,frv[ x "J6 _d_4 6~s Applicant's Printed Name Applicant's S gnature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA124033 Date Issued:06/19/2014 Permit Category:ePermit Site Address: 1092 Tiffany Dr Lot:25 Block: 2 Addition: Canterbury Forest PID:10-16350-02-250 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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. Fixtures:1-water closet, 2-lavatories, 1-shower Lavern Veit 6636 Penn Ave So. Fee Summary:PL - Permit Fee (miscellaneous)$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 - Mark J Frey 1092 Tiffany Dr Eagan MN 55123 Southtown Plumbing 6636 Penn Ave S Richfield MN 55423 (612) 866-3057 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA150031 Date Issued:06/18/2018 Permit Category:ePermit Site Address: 1092 Tiffany Dr Lot:25 Block: 2 Addition: Canterbury Forest PID:10-16350-02-250 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Mark J Frey 1092 Tiffany Dr Eagan MN 55123 (651) 452-2947 Otogawa Anschel Design Build 3212 Hennepin Ave S Minneapolis MN 55408 (612) 789-7070 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA155384 Date Issued:05/14/2019 Permit Category:ePermit Site Address: 1092 Tiffany Dr Lot:25 Block: 2 Addition: Canterbury Forest PID:10-16350-02-250 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Mark J Frey 1092 Tiffany Dr Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature