1097 Tiffany DrCI'f . sr L _..-a
3830 Pllet Knob Road Y AA&K SEkVl(.t PERMIT
P. O. Box 21199 PERMIT NO.:
Eagan, MIN 555121 DATE:
Zoning: 1 No. of
Units:
Owner: "'T
Address:
N-Site Address: 10 ° ' t i r f au , j ; i Lila
Plumber.
r No.: - 3 Y 9 a_5-.S o /
' Connection Charge: :i' Lj Qq ad
-.L?
Size: 3/ 8 A
Account Deposit:
1').00 pd
KReoder No.: O ?? o Permit Fee: 0 P
1 9 IN to 4Nerrt7l/ wkb the City of bgse Surcharge:
Ordloancee. J Misc. Charges: 132,0i Pd
By
n.... .,s 1_._
17- Date Paid:
CH r OF EAGAN WATER SERVICE PER_ MIT
383ii Pilot Knob Road
P. O. Box 21195 PERMIT NO.: I31'
Eagan, MN 55121 DATE: 4 - 3
Zoning' No. of Units:
Sit Address: fan„ n,
Plumber: i om rr s o: , F 1., p
Meter No.:
Size:
Reader No..
I ogee to oesrolq with the City of Eagles
Orisaseee,
By
Dote of Insp..
Connection Charge: 500.00 pd
Account Deposit: 15.00 pd
-
Permit Fee: 0P d
10.0
Surcharge: • 5' Pd
Mica. Charges: 132.00 Ud
Total: 63-nn na W,41-ter
Date Paid:
y SEWER SERVICE PERMIT
Road
PERMIT NO.: 7223
438.5
- -
1 DATE:
No. of Units: I
mul Walentinn
Address:
I •- - 6 to eosrpfir w" an City of Eys¦ Connection Charge:
Ordisoseea. Account Deposit:
Permit Fee:
B Surcharge:
Y Misc. Charges: _
Dote of Insp.: 7-6-1.
Reoeipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Pill in numbered spaces S/C
Type or Print legibly Tot.
,
1. Date i 2. Installation Cost
3. Job Address I Lot_Blk. Tract
r
!-A
4. Owner j `
5. Contractor Phone > >
6. Address
7. City State Zip- i
8. Building Type: Residential-0 Commercial ? Institutional ?
9. Work Description: New fl Add ? Alter ? Repair ?
10. Describe
11.
No.
L Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
i Bath tubs p
Se
tic T
k
Lavatory p
an
Softner
' Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby cert ify 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 4544100
Receipt ' MECHANICAL PERMIT
CITY OF EAGAN
'LA Permit No.
Fill in numbered spaces
Type or Print legibly
Fee
S/C
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City
State Zip
8. Building Type: Residential ?
9. Work Description: New •?
10. Describe
11.
Commercial ? Institutional ?
Add ? Alter ? Repair ?
Fuel Type
No. FQuioment BTU - M. Ea.
Forced Air No. Equipment CFM
Ai
ndli
H
Mfg. r
a
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 464-8100
, - , +
BUILDING PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 4548100
Receipt
Erect ? Occupancy 't - '
Site Address
z 1. Lot B
t
lock Sec/Sub
.r91+' ?:tii " Remodel
? Zoning 1
ii-
. Repair ? Type of Const.
Parcel No.
Enlarge
?
No. Stories
Move ? Length t .'
at
N 1;L fs N'T I N Y
h
?
h S
-
ame
r+ ' Demolis Dept
;
',PIN'
Ad
Address r-t1-4_`.T
Grade
?
Sq. Ft.
Z
? Name ; F - ---
Assessment
Permit
? Address
Water a Sew.
Surcharge
City Phone
Police }
Plan Review. -? ? - -
W Name Fin SAC ' ` '
xt3 Address Eng. Water Conn..
<'z City Phone Planner Water Meter - -
Council Rood Unit
I hereby acknowledge that 1 have read this application and state that Bldg. Off, 5 ! 7, Parla ,
the information Is correct and agree to comply with all applicable APC
n Ordinances
a
f E
t
t
d Cit
f Mi
St
S Total
.
y o
es
n
aga
nnesota
a
u
tate o
Var. Date
Signature of Permittee
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
09991
E
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a
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TC
V lV O
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3 ? - v
?' $
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
CAN?EHURY' FOREST (612) 63:3--104?.
PERMIT SUBTYPE: TYPE OF WORK:
t
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
. . ? • , ? is • . , ,
??
---------------------------
Permit No. ParmR Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD I
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
This request void 6(/5(, K ! \ I bS, \
6 75nn? . Lae P , e?.?x ern 1111 CY?.O?v
I Request Date
ly Fire No. ReqRough-in ? Inspection
ui []Ready Now 1J}?wnr ?,???'N
nlity Inspec-
?Ot '
UX
A P es ?NO for When Heady
[Licensed Electrical Contractor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No.
11- City
-0
7
on o.
Secv Township Name or No Range No. County
Occup'nt (PRINT) 1 Phone No.
Power Supplier Address ,
7Rr?l
Electric Contractor (Company Name) T Contract.,'. License No.
Mailing Adddrress IC ntractor or owner Makin /I nvstall Lion)
4L., V
Authorize ign (Cqn ctnr/O r Making stallationl Phone Number ????
MINNESOTA STAT OARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N.191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Ph- 16121 297-2111 ENCLOSED.
5 + 1 56 REQUEST FOR ELECTRICAL INSPECTION
' See instructions for gomPletint; this form on back of Yellow copy.
E 2 9 0 0 3 "X"- Below & pyered by This Request
EB-OOM- 4
(r - IizS
A Rep. TvPe 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 Other pe.dy Other (SPecityl
[her Succi y ter Other
Compute Inspection Fee Below
R Fee Service Entrance Size a Fee FPeders/Subfeeders a Fee Circuits
0 to 200 AMPS 010 30A m S 1 17 ZA 601 O to 30 Amos;
Above 200 Amps 31 to 100 Amps 31 to 100 AMPS
Swimming Pool Above 100_Amps Above 100-Amps
Transformers Irrigation Booms Partial: Other Fee
IRCrI I Signs - I Special Inspection ?S u - /QJ,?TAL FEE /
.%T` it i_
Rough-in _ /? Date 1 the Elactriwl
Inspector- hereby
fl certify that the above
Final Date inspection hes been
7 oode.
Thla request mid 18 months from
(9rdifirate of Orrupaury
Citp of Cagan
Orpartmmt of luilding 3mprrtiou
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.
me cl...isatio ec -011AT7 Bide. Permit No. 9991
Decup.n Type R3 Zoning Diuriet R1 Type Comt v
D.mee.r Budding PAUL Vd1IiII?PPINY CC)q§T,r '' 7030 ALPINE TR-FAIN
Bwlding Add-u 1097 TIFFANY DR Locality L 22 B 1 CADTPERBURY F0]
D.te: MAY 31 1985
Building ORdd I
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN NO- 0 9 9 91
P.O. Box 21.199, Eagan, MN 55121
3630 Pilot Knob Road
,
PHONE: 4548100 ,n
(to
V
BUILDING PERMIT Receipt #
To be aced for SF DWG/GAR Est.value 111.000 Date M ARCH 22 19_415
Site Address 1097 TIFFANY DRIVE Erect K1 Occupancy R-3
CANTERBURY FORESfiemodel ?
Lot 22 Black 1 Sec/Sub Zoning R-1
.
Repair ? Type of Const. V
Parcel No. Enlarge ? No. Stories
Move ? Length 62
W Name PAUL WALENTINY CONST. INC. Demolish ? Depth12_
Address 7030 ALPINE TRAIL Grade ? Sq.Ft.
CityEDEN PRAIRIFhone 937-2994 Install O
Name _
Address
f City -
Assessment _
Water 8 Sew.
Police
Fire
Erg.
Planner _
tees
Name _
Address
City _
Phone
Permit 4hI) - ',I)
Surcharge SS 5n
Plan Review 3n _ 9 S
SAC 525.00
Water Conn.Snn nn
n
Woter Meter 61_0
0
Council Road Unit 2R()-()
I hereby acknowledge that I have read this application and state that Bldg. Off. 1/1 SIRS ftKs TP 1 "37 no
the information is correct a e to compl with all applicable APC Total 2.246.25
State of Minnesota Statut and dy of a§o i rdi ances. ,Date
Signature of PenniMee
A Building Permit Is issued to: PAUL WALENT t KO" ST INC- on the express condition that
all work shall be done in accordpNe wito all apAcable State of innesoto Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN Remarks ,
CANTERBURY FOREST 22 1
Addition ?
pIk Parc EAGAN MN 55123
[[ 1097 TIFFANY DRIVE State
OwnerPl? Street
Una Ui/,?,• Ot• h,?;.:A,'J ??5:.
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1279 Paid nde original C
STREET RESTOR.
GRADING 1981 106.78 5.34 20 85.46 A013446 1-12-84
SAN SEW TRUNK Z-1 1973 Paid unde Original rcel
• SEWER LATERAL 1981 439.42 21.97 20 351.54 A013446 1-12-84
WATERMAIN
* WATER LATERAL 1981 20
WATER AREA -{.. 1979 Paid unde original p .rcel
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
n
n
BUILDING PER. 09991
SAC
PARK
A
n
b pqq? ?
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 SEY OF ENERGY CALCULATIONS
To Be Used For: Residential Valuation: -GO,------ Date: 3-12-85
Site Address: 1091 I i u r OFFICE USE ONLY
Lot: 22 Block 1 Sect/Sub3anterbury Erect _X Occupancy _lz--6
Forest Remodel Zoning 2 I
Parcel 11 Repair Type of Const
Enlarge 11 of Stories
Owner Paul W'alentiny Construction, IncMove Length (0 IL
Demolish Depth
Address 7030 Alpine Trail Grade Sq Ft
City/Zip Code Eden Prairie 55344
Phone 937-2994 APPROVALS
Contractor Paul Walentiny Construction, ib3'essments Permit L
So
Water/Sewer Surcharge .
ss. ;5
Address 7030 Alpine Trail ER M Police Plan Review 2 ?• zs
Fire SAC 25. oO
City/Zip Code Eden Prairie, 55344 Engr Water Conn 50p, e6
Planner Water Meter °
Phone 937-2994 Council i Road Unit
.L°
Arch./Engr.
Address
Bldg Ofj3/ Parks
APC `'1 Treatment Ply,
Variance a
TOTAL
City/Zip Code
Phone 0
2(? ,? o= l 04c> X s q- = 5co i t? o
12 x to = (2o K ( = 1320
22 x 22
J 1o4o x ?1-1
2?01C 4c)
h
r-•
SUR V E'YOR'S. CERTIFICATE
O DENOTES IRON MONUMENT SET-
* DENOTES IRON MONUMENT FOUND
? DENOTES WOOD HUB
X000.0) DENOTES EXISTING ELEVATION
SIENNA CORPORATION
PROPOSED GARAGE FLOOR = 9 Z`_4 Z - FEET
PROPOSED LOWEST FLOOR = 9'l4e' FEET
PROPOSED TOP OF BLOCK = C? L yi FEET
pn.vE i¢r Coezis g
WE HEREBY CERTIFY OARIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF
Lot 22, Block 1•: 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 29TH DAY OF
!ARCH 1983 .
SIGNED: JAMES R., HILL, INC.
BY:
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NO. 12294
Reviewed without comment
for Sienna Corporation
this 1985
T rpe/e'rad~Yn'g soc Arch{./
SHEET 1 OF 2 SHEETS
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
82143 Planners ./ Engineers / Surveyors
FILE NO, 8200 Humboldt Avenue South
(OLDER BloominUton, lAn. 55431 61'2-084-3029
SUIaVEYOR'S•. CERTIFICATE
SIENNA CORPORATION
WILDERNESS RUN ROAD
A
a p
0
N89°57'28°E 125
/? T-
.-U i
r) I
C_ I
\NSP EASEMENT
PER PLAT •,
8K.62 PG.43T \`
MISC. RECORDS
n m
V W
LOT 2.2
°0 I
.p. \
N -NT4,35 WY ?1NE?
08
DRAINAGE EASEME r
PER AT
-N84.30'42"W 111.55 POND
z
°
I
011
+?l hg dT 09 NE\\??5 `\
EASEMENT PER PLAT N
°
` DRAINAGE U UTILITY
I /?-1-
L_0 1
C-.5
SCALE:
1 -INCH = 50 FEET
m
?us? av I o I
r"
1? 1'?! I?i ? ? 01 1 ?_
?1 I
99, - 58.73244.,E o
/a/ o R=511. 0511
NN-83
y?iN, r n_4 TIFFAY DRIVE
j I
Zoe
SHEET 2 OF 2 SHEETS
PROJECT NO. BOOK / PAGE JAMES, R. HILL, INC.
82143
Planners / Engineers. / Surveyors
FILE NO. 8200 Humboldt Avenue South
FOLDER Bloomington, Mn. 55431 612-884-3020
EXTERICR E XET_,C? E AVERAGE "U' M1?'JTATION
OWNER Pnul R. ?t rrtjy ''nnctrnr+j,.g
SITE ADDRESS
CONTRACTOR Paul l91 entintiT `onst Irr_ DATE PHONE o294i
Determine working square footage of each.
1. Total exposed wall area ... .? 0 63 sq. ft. X .11 = 33G.93
2. Total roof/ceiling area ... //<?? sq. ft. x .026 = -2S;6W
Total exposed wall area above floor =
a. Total wall windcu area ................. L?
b. Total door area ....................... ;Z--
c. Total sliding glass area .............. ;-y
d. Total fireplace wall area ....... c-,/
e. Total wall framing area (average 10%)... a r
f. Total net wall area above floor ........
g. Total rim joist area ?o y
Total exposed foundation area =
h. Total foundation window area .......... o!J
i. Total net foundation area above grade ?o
Determine "U' value of each wall segment.
a. x T'U" = Si. S
b. YZ X TTUt
C. fiV X T U ''
D. y X 11V
e. - X IV' ^ 7.- = iy z L
f. i?y9 X IV; el> _ X5.9 f
h. X "U'
i. 7 X IV, a SS, f
3 ............................................Total = 3/`?? 7
If item .#3 is the same as, or less than item #1, you have met the
intent of SBC 6006(c)2.
..
Total exposed roof/ceiling area
J. Total skylight area ... N
k. Total roof/ceiling framing area (average 10', /i
1. Total net insulated roof/ceiling area .......
Determine IV value for each roof/ceiling segr.;ent.
J N X ,•U. _
X ,:U,.
4 .........................................Total = S,3
If total of P4 is the sane as, or less than f2, you have met the
intent of SBC 6006(e)l.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established
by the sum of items N3 and d4 shall not be Ereater than the sum.of
items P1 and r2.
- 1. + 2. _
3. + 4. _
-?<CtTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE: BUILDING
Permit Number; 029399
Date Issued: 01/10/97
SITE ADDRESS:
1097 TIFFANY DR
LOT: 22 BLOCK: 1
CANTEBURY FOREST
P.I.N.: 10-16350-220-01
DESCRIPTION:
(GAS INSERT)
rmit Type FIREPLACE
1ka Type NEW
m
xy p
434 ALT. RESIDENTIAL
j? ({qyy' ?Ty
'<' o <'§ j ..£ Te#T Try wed °t..'? "?'°yq `4 F? E
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$50.00
$50.50
CPNTRACTOR: - Applicant - ST. LIG OWNER:
F,!IRESIDE CORNER INC 16331042 0001068 LAUBY JAY
700 N FAIRVIEW AVE 1097 TIFFANY OR
OSEVILLE MN 55113 EAGAN MN 55123
(612) 633-1042 (612)452-3384
I hereby ?xtkawledt3 t h
nf6 rmat?'4 i's`" Coro
L Statutes and `clt,y ql.1<4'
APPLICANT/PERMITEE SIGNATURE
`I
d `thle p6?3% ajori-'and. stato Chab the
0,00p,4 < ;tit1. a l a,pplicablq 'S'tate 6 < Mn
?ru.4 U' J (4l -
IS UE B . SIGNATURE
14399
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1997 FIREPLACE PERMIT APPLICATION
681-4675
DATE: I C
DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE
INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTHER:
PERMIT FEE: 50.50
ALTERATIONS TO EXISTING
STREET ADDRESS: /o9-7 ,rA Pj ?2t f
LOT Jj BLOCK SUBD./P.I.D. #: )
APPLICANT: (circle one only) OWNER CONTRACTOR
State: /+1 nl
pJ?
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.
PROPERTY
OWNER
FIREPLACE
INSTALLER
GAS LINE
INSTALLER
Name: L A u >3 ?( Phone #: 45 2 33 E4-
Signature:
l 1` l? a N `( ?L
Street Address: o Q -7
City:-
Company:
Name:
Signature:
Street Address:
City:
Zip: / Z 3
67,00 - 0 7<7'?V
one #:
State:
Zip:
City: 1EACVAJ
State: Zip:
ai
40
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 14 Fireplace
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REMARKS
Chimney/flue must be inspected before concealing.
2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRESS: 1
LEGAL DE." IPTION: r
Dyuu je.
I?L/nlcxx/buDaivlslon or Tax Parcel I.D.-Number)
IF E,{IST=r STR 3=1RE, DATE OF CRT_GINAL BUILDING PERMIT ISSUA.NCE:
' i _c,^. `.z/'Lea-)
PRESENT Z(tMr,/PROPOSED USE:
2) APPLICANT
NAME: ?
ADDRESS: 1Z?
CITY, STATE, ZIP: } C'S-vt?
PHONE: Ct3 - Z
(PLEASE PRINT)
V R-1 SINGLE FAMILY
? R-2 DUPLEX (TWO UNITS)
? R-3 TOWNHOUSE (THREE + UNITS)( UNITS)
? R-4 APARTMENT/CONDaMINIUM ( UNITS)
? CC"4ERCIAL/REYAII,/OFFICE
? INDUSTRIAL
? INSTITUTIONAL/09VERM4ENT
PLEASE PRINT) U
3) PLI)MBER trLM)t YNINI)
NAME: 5 A-M (5- C11Qo S 19 LAS
ADDRESS:
CITY, STATE, ZIP:
PHONE:
4) OCCUPANT/OWNER
NAME:
PLUMBER LICENSE N
ADDRESS : IV-30 AL P,,,,A5 C,,42 C_
CITY, STATE, ZIP: Cl? ?Li L.r
PHONE: Q?? 7 z P y
FOR CITY USE ONLY
PLUMBERS LICENSE:
Active
Q Expired
Not of Record
an1 Ia
5) INDICATE WHICH PERMIT IS BEING REQUESTED:
CONNECTION TO CITY SEWER
CONNECTION TO CITY WATER
OTHER (PLEASE DESCRIBE)
6) INDICATE ONE:
0 PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
® PLEASE MAIL APPROVED PERMIT TO L , 3, 4 ABCNE
(Circle one)
-1
r_j 7) SIGNATURE: V??Co_v DATE:
F O R C I T Y U S E O N L Y
PERMIT # ISSUED
FEES: $ SEWER PERMIT (INCLUDE SURC
$ a tad
? WATER PERMIT (INCLUDE SURC
$ //
(per=d WATER METER/COPPERHORN/OUT.MADER
$ WATER TAP (INCLUDE CORPORAOP)
$ SEWER TAP
ACCOUNT DEPOSIT - SEWER
$ ACCOUNT DEPOSIT - WATER
$ gyp- m .?-? WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
TOTAL
$ AMOUNT PAID/RECEIPT # ?r a G ¢ Jl
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OMW
YES IF YES, THEN A "PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED 37 THE
NO ENG_NEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED °':
TI'S : -4!?9?
w
se +.:.: e..? ?k. at lWm a-S/ R w R fJ! mum w.i swam R qpjq w-_" w:? wt? R ?l?U? R wpm as"
CITY USE ONLY
0
BL ? RECEIPT#: D l 0 1b
SUBD. RECEIPT DATE: 4D
1998 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, NAT 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x
=
Water Heater 3.00 x
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' MPC nc. 75.00 =
(new and refurbished systems)
Private Disposal Systems' Abandonment 20.00 =
STATE SURCHARGE .50
TOTAL •Sb
I ----pp --licable C -----ity of Eagan ordin ----------------ances -----
hereby acknowledge that I+^••_..e;,;?.?:,:'e.:..i?ec...,. ?rsm »,??.eb.?r?,?.?,arlnn.is correct, and agree to compty with all a.
It is the applicant's respol LAUBY, SHELLEY agan assumes no liability for any damages caused by the City during its
normal operational and m{ 1097 TIFFANY DRIVE r this perk within City property/right-of-way/easement.
SITE ADDRESS: _
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
EAGAN, MN 55123
(612) 452-3384
DBA
2905 GARFIELD AVE. SOUTH
CITY: MINNEAPOLIS. MN 55408 STATE:
PERMITTEE
TELEPHONE #:
ZIP:
JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998
Use BLUE or BLACK Ink
I For Office Use I
Permit#:___!~ l
City of Ea
I Permit Fee: 11 In
~ I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff: 7
I I
p~ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ` Site Address: &Z pf 1V y myc Unit
Name: (J/7~-~~' 1 7 Phone: 7(e d • 7Z 'z
Resident/ //,p
Owner Address/ City/ Zip: /o 7/~- D y~/ ~
Applicant is: Owner Contractor
Type of Work Description of work: ~~~T
Construction Cost: lD DUU GO Multi-Family Building: (Yes / No )
Company: f k.(6 I' S JJ~ di~l'~1 Contact:
Contractor Address: City: F-01N 6
State: _ Zip: ! Phone: -L -Z
License tob Lead Certificate
[If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) (
~w- 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?
i _Yes No If yes, date and address of master plan:
Licensed Plumber:
Phone:
I
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone: i
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. i
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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.
x G~!~~s u,~~(L x .
Applicants Printed Name App icant s Signature
Page 1 of 3
For Office Use
•
% . ; : , Permit*
0. ,„,„,,,„, EAGAN
.."
.,C i ?i- c FTVPD
Permit Fee:
Date Received: /6 2—/—/b
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 JCT 0 2 2018
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(cr�cityofeagan.com L 7 ,
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9/29 18site Address: 1097 Tiffany Drive
Unit#:
Name: Jay Laudy Phone: 612-760-7226
Resident) Same as site
Owner Address/City/Zip:
Applicant is: Owner X Contractor
Type of Work
Description of work: install nat gas fireplace insert, gas line & air test
Construction Cost: $3'000.00 Multi-Family Building: (Yes /No X )
Company: Walter Mechanical, Inc. Contact: Rich Walter
Contractor
Address: 517 W Travelers Trail city. Burnsville
Phone: 952-895-1992 Email: waltermechanical@live.com
State: MN Zip: 55337
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaqan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecaii.orq - )
I hereby acknowledge that this information is complete and accurate;that the work will be in cont ance wi 'the ordinan and,,,,.... s of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work of to sta without;a pe , it; •'-)'the work will be in
accordance with the approved plan in the case of work which requires a review and approval pltarls. ' M1`. , >''
x Rich Walter x /` i .0t , -)' �'
Applicant's Printed Name Ap i ant's Signature /' L
i
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA165445
Date Issued:11/02/2020
Permit Category:ePermit
Site Address: 1097 Tiffany Dr
Lot:22 Block: 1 Addition: Canterbury Forest
PID:10-16350-01-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jay & Shelley Lauby
1097 Tiffany Dr
Saint Paul MN 55123--187
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature