1263 Timbershore LaneCITY OF EAGAN 877F
3795 Pilaf Knob Road Eagan, MN 55121
PHONE: 434-8100 ,
i
BUILDING PERMIT
L_ FI'_tE DAMAGE
Receipt ?j
$20,000. fete JANUA2Y 17 19 8 4
Site Address y" Erect ?
Lot Block 3 Sec/Sub TIMBERSHORE 3RD Alter ?
Repair ?C
Parcel #
Enlarge ?
W Name J. *gORROW Move ?
z Address Demolish ?
t ems„-- 894-2881 Grade ?
$? Name 'A""ftl i V c. %oUINO i .
Address 5444 GRAND KVE.
t- Cit iTLS . 55419 ph,,
G°C Name
W
I= Address
Council
Ft.
Permit tvu. u
Surcharge 10.00
Plan check
SAC
Water Conn.
Water Meter
Road Unit
1 hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable 150.50
State of Minnesota Statutes and City of Eagan Ordinances. APC Total -
Signature of Pertnittee
A Building Permit is issued to* CREATIVT: C(1\iS co- on the express condition that
all work shall be done in ac dance with all !Plieable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official L \ r
Occupancy
Zoning
Fire Zone -
Type of Const.
* Stories _
Length
Assessment
818 Water & Sew.
Police
Fire
Eng.
Planner
Permit No. Permit Holder Miae. Permit No. Holder
Plumbing / f).?.SO
H.V.A.C.
Well
Wstar
DisP.
Sewer
ENctric j O
Inspection Dots Insp. Other
Footings
Foundation
Framing
Rough Pibg. )? C
Rough HV
A
Insulation
Final Plbg.
HVAC
J
Describe Location:
Receipt PLUMBING PERMIT Permit No H?
CITY OF EAGAN L"
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address 6 7 ! ''dot _Blk. Tract' ' / < <
4. Owner
5. Contractor
t
6. Address'
7. City / G
zip -7 2
8. Building Type: Residential b- Commercial ? Institutional ?
` 9. Work Description: New ? Add ? Alter ? Repair
f 1-1
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
Bath tubs p
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 wrthl:atI orM*and codes governing this type of work.
Signed : 1,,- for
Bough F inal
Inspections: Date 1_<_ Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
A c
Phone 7
CITY OF EAGAN
3795 P" Knob Rood Eagan, MH 55121
PHONE: 454-8100 .?
BUILDING PERMIT Receipt
FIRE DAMAGE $15,000 JA1,11-, `Y 17 84
Site Address
Lot 3 Block 3 Sec/Sub. TINBERSHORE 3RD
Parcel # 10-76502-030-03
Ji11\4/14[1 W1Y/Ll\1'iCll\
ac Name
Address 1265 TUMERSHORE
_ Far_eu _
$r Name
u Address 2223 E. 35MI T
u
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.
Erect ?
Alter
Repair
Enlarge ?
Mow ?
Demolish ?
Grade ?
Assessment -
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
Permit
Surcharge .
Plan check _
SAC
Water Conn.
Water Meter
Road Unit _
Total 0
Signature of Permittee
A Building Permit is issued to: on the express condition thn+
all work shall be done in accordance with all ooolicoble State of Minnesota Statutes and City of Eooon Ordinances.
Building Official
Fire Zone
Type of Const.
* Stories
Length
Depth Sa. Ft.
i)
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing z, Z VJ $S ?- al -r
H.V.A.C.
Well
Water
Disp.
Sewer
Electric G A e
?' 2S
Inspection Dab Insp. Other
Footings
Foundation
Framing
Roush Pft
Roush HVA
Insulation
Final Plbs.
Final HVAC
Final
Water Describe Location:
Well
Pr. Dltp.
Receipt Z PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C C?
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address 1. 65 Gr?a?E LotBIk. Tract S F D
4. Owner SsiwtQ 5;, - L t +J8cl er i CU c?
5. Contractor y OSS P Im 19 Phone Q 3 ? ! 3w
6. Address 11 3 4 a' k--fie I- 0?
7. City "NT K, State MN N YJ Zip _
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
? Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and cod governing this type of work.
Signed :
`y""cti+4or
Rough Final
Inspections: Date Insp. Date Insp.
This is your per it quhen num ere and approved.
Approved - CITY OF EAGAN 454-6100
31?
CITY OF EAGAN Remarks
Addition TTMRFRAHORF. 3rd Lot 4 Bilk 3 Parcel In 76509 040 01
Owner S;6 wik,,,- L- ek14mA Street 1263 Timbershore Lane State Fagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F. 1974 321.03 64.20 5 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1971 72.25. 3.61 20 Paid
* SEWER LATERAL 1973 432.19 28.21 15 Paid
SW LATS, ST SEW 1974 452.93 90.58 5 Paid
WATERMAIN
* WATER LATERAL 1973 15
WATER AREA 1972 71.46 3.57 20 Paid
* STORM SEW TRK 1973 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 120.00 7522 3-3-73
BUILDING PER.
SAC 260.00 7522 3-3-71
PARK
CITY OF EAGAN Remarks
Addition TIMBERSHORE 3rd Lot 3 Bilk 3 Parcel 10 76502 030 03
Ovvner-"rjt1AVA ?jp?APh?tn I) Street 1265 Timbershore Lane State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1974 333,07 66.61 5 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1971 72.25 3.61 20 Paid
•SEWER LATERAL 1973 432.19 28.21 15 Paid
SW LATS, ST SEW 1974 452.93 90.58 5 Paid
WATERMAIN
• WATER LATERAL 1973 15
WATER AREA 1972 71.46 3.57 20 Paid
* STORM SEW TRK 1973 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 120.00 7522 3-3-73
BUILDING PER.
SAC 260.00 7522 3-3-73
PARK
CITY OF EAGAN Remarks
Addition TIMBERSHORE 3rd Lot 2 Blk 3 Parcel 10 76502 020 03
OwnerTh -A `-'?qnne,44fv. PJ ( uyNA) Street 1267 Timbershore Lane state Eagan, MN 55123
G12 {k,ne., hr. ii?ll??D s`?337
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1974 321.03 64.20 5 P
STREET RESTOR.
GRADING
SAN SEW TRUNK 1971 72.25 3.61 20 Paid
ft SEWER LATERAL 1973 432.19 28.21 5 Paid
SW TS ST SEW 1974 452.93 90.58 5 Paid
WATERMAIN
It WATER LATERAL 1973 5
WATER AREA 1972 71.46 3.57 20 Paid
* STORM SEW TRK 1973 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 120.00 7522 3-3-73
BUILDING PER.
SAC 260- Qn 7t;22 _ _
PARK
CITY OF EAGAN Remarks
Addition TTMRRRRRnRR '3rA Lot 1 RIlk 3 Parcel 70 76502 DID Di
Ownerbayna(brp b Pwlhh street 1269 Timbersbore Lane State Eagan, MN 55123
Dpflmn , W ` I)YABV)
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1974 321.03' 64.20 5 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1971 72.25 3.61 20 Paid
,e SEWER LATERAL 1973 432.19 28.21 15 Paid
SW TS ST SEW 1974 452.93 90.58 5 Paid
WATERMAIN
* WATER LATERAL 1973 15
WATER AREA 1972 71.46 3.57 20 Paid
• STORM SEW TRK 1973 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 120,00 7522 3-3-73
BUILDING PER.
SAC 260.00 7522 3-3-73
PARK
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ?rR.h,!-xC1 .^-!r Y.. a--='- ---- ----- !--........
Address (presenf)??G 'LO...
St . PO?.aQr , 55 ? a-?
Builder ........
Address ......
DESCRIPTION
N° 2811
Eagan Township
Town Hall
Dale ..0. .C .................
Stories To Be Used For Front Depth Heigh! Est. Cost permit Fee Remarks
b100
+???Orc+e?
_-
?a e-r
LOCATION 1114%ZO
Road or other Description of Location Lot Block J
,. ..?•? gabs ?? 3 ?.
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST ??BsE,KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, thar..t--r.sY permission to erect a.. ... .. .... .._ Pon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955. (?
...... ..............a......... Per ..... V_Q+?....... Buildin Ins actor..
Chairman of Tnwn Board J ... ..............................
5795 CITY OF EAGAN Np 8776
Pitt Knob Rood Eagan, MN 55122
A.
PHOHEt 454-8100
BUILDING PERMIT Receipt #
To be used for FIRE DAMAGE Volue $20,000. D
Est JANUARY 17
84
.
ote 19
Site Address 1267 TIMBERSHORE LANE E
rect ? Occu
Occupancy
2 3
Lot Block Sec/Sub. TIMBERSHORE 3RD
Alter ? Zoning
Parcel # Repair ?X Fire Zone
Enlarge ? Type of Const.
W Name J. MORROW M
ove ? # Stories
z Address Demolish ? Length_
city Phone 894-2881 Grode ? Depth Sq. Ft._
Name CREATIVE CONST. CO. Approvals Fees
0
Address 5444 GRAND AVE. S0.
r ri... MPT.3_ SS41q g9f1-1R1R
Name _
Address
I hereby acknowledge that I have read this application and state that
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee _
A Building Permit is issued to:
all work sholl be done in acca
Assessment Permit $ 140.50
Water 8 Sew. Surcharge 10.00
Police Plan check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC Total $ 150.50
?"N-I ' " on the express condition thin
State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
oe.f - g-776
CITY OF EAGAN
BUILDING PERMIT APPLICATION
To Be Used For
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
/- /7 - ? Y
Valuation ?Z'O/ a a O Date
Site Address: / Z %in?J(-i1Sr?0Ae. ?AN?
Lot Block -3 Sec./SubJim helS)-0"- 3v-rect
Alter
Parcel #: ?(?? SO L - 6 LO -03 Repair
J- ?OrL2D w Enlarge
Owner: Move
Address: Demolish _
Grade
OFFICE USE ONLY
Occupancy
Zoning
Fire Zone
Type of Const.
# Stories
Front ft.
Depth ft.
City/Zip Code:
Phone #: APPROVALS FEES
Contractor:
Address: ?k 4-?
City/Zip Code:
Phone #:
Arch./Eng.:
Address:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit 6-0
Surcharge / O U t)
Plan Check
SAC
Water Conn.
Water Meter
Road Unit
TOTAL / 5 O S a
CITY OF
3795 Pil
t K
b R
d EAGAN N? $775
o
no
oa Eagan, MN 55122
PHONE: 434-8100
BUILDING PERMIT Receipt # ! f?
To be used for FIRE DAMAGE Est
Value $15,000 D JANUARY 17
84
. ate 19
Site Address 1265 TIMBERSHORE LANE
Erect ? Occupancy
Lot 3 Block 3 Sec/Sub. TIMBERSHORE 3RD Alter ? Zoning
Parcel # 10-76502-030-03 Repair IN Fire Zone
rr
Name SANDRA GOLDENMAN Enlarge ? Type of Const.
Move ? # Stories
z Address 1265 TIMBERSHORE LANE Demolish ? Len
th
z g
_
Ci RAGAN Phone Grade ? Depth Sq
Ft
.
._
z Name SAMPSON LINDGREN Approvals Fees
0
OU Address 2228 E. 35TH ST.
r r:... MPLS. 55407 721-5546
Name _
Address
1 hereby acknowledge that I hove read this application and state that
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit Is issued to: SAMPSON
all work shall be done in accordance Ith all o
Building Official
Assessment _
Water 8 Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
Permit
Surcharge .
Plan check _
SAC
Water Conn.
Water Meter
Rood Unit-
Total $ 124.50
on the express condition that
e of Minnesota Statutes and City of Eagan Ordinances.
1
CITY OF EAGAN
BUILDING PERMIT APPLICATION
G £ Valuation
Te .ne Used For. 124- p P-M to
Site Address: _
Lot 3 Block 3 sec./Sub. a? s? A44,
Parcel #: f a'-7 (o 59a.-639-93
Owner:
Address-
City/zip Code:
Phone #:
Contractor:
Address:
City/Zip Code:
Phone #:
Arch./Eng. -
Address:
City/Zip Code:
Phone #:
e. P V T?
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date
OFFICE USE ONLY
Erect Occupancy
Alter Zoning
Repair Fire Zone
Enlarge - Type of Const.
Move # Stories _
_
Demolish Front
Grade _
Depth
APPROVALS FEES
Assessments Permit
Water/Seer Surcharge £- 0
Police Plan Check _
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL
?S
VILLAGE Ob' EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122'
PERMIIT NO.,i4?475' Irt?
.. T?l? .
it"
The'Village of Eagan hereby grants to Q?p, BbIYLOk'H0at10t 4 ?0`
of 1001 Xenia Ave So, Mpls 55416
a HEATING Permit for: (Owner) New Horizon Homes
1255-57-59-61 &
at 1263Z5-67-=69- `Nmhwrchore *le, pursuant
to application dated 10/25/72
Fee Paid: 160.00 dated this 7th day of November 19 72
.00 a c
Building Inspector
Mechanical Permits:
i3id Total:
VILLAGE 01' EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
a HEATING Permit for: (Owner) New Horizon Homes
1255-57-59-61 &
at 19E;_65_A7_69 'NmhArchnre ,iv, pursuant to application dated 10/25/72
Fee Paid: 160.00 dated this 7th day of November 19 72
008 c
Building Inspector
Mechanical Permits:
PERMIT N0. Ij <
The Village of Eagan hereby grants to 9?devlAlt"$fattw 4 VO
of 1001 Xenia Ave So. Mpis 55416
Bid Total:
3s ?i
VILLAGE OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122-
PEW4IT NO. e2779 t ?
The'Village of Eagan hereby grants to GAO: 8?dlldok $aatu O v1
of 1001 Xenia Ave 9o. Mple 16-
a HEAPING Permit for: (Owner) New Horizon Homee
1255-57-59-61 &
at 126T-6?`7i9 `f imhwrchere 1e, Pursuant to application dated 10/2K/72
Fee Paid: 160.00 dated this 7th day of November , 19 72
.00 a c
Building Inspector
Mechanical Permits:
13id Total:
7
6 J
'TILLAGE Or' EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO. 475 `
The Village of Eagan hereby grants to Qw# Bedgdaig H?aAlt12 A/0
of 1001 Xenia Ave So, Mpla 551116
a HEAPING Permit for: (Owner) New Horizon Homes
1255-57-59761 &
at 1263-65-67=69 Timherchare pursuant to application dated 10/25/72
Fee Paid: ,160.00 dated this 7th day of November , 19 72
.00 s o
Building Inspector
iiechanical Permits:
did Total:
This request void /?
16 months from Z, ? 3,7
-?
sP a o a-a
Request Date Fire No. Nrq ph e('?Inspertion ?Rcady Now ? Will Notlty, Inspec-
?Yes ?No for When Ready
? Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed et'
Street A?dd/ress. Box or Route No. f City
ectlon NO. Township Name or No. Range No. County
Occupant (PRINT) Phone No.
Powe upplier Address
Electrical Contractor (Company Name)
Ot,)i Q'A (1 c,y?LT
I C Contractor -s License No.
l !
Mailing Address (Contractor o Owner Making Instailah 1
1?1C)
l') L ' .5?-
Auth ned S ature (Cunt ctpr/Owner akmy Installation)
S?. Pho a Number
?-3S? 1 ? so
MINNESOTA STATE BOARD OF ELECTRIC 1 THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 University Ave., St. Paul, MN 55104
Phone 16121 297-2111 ENCLOSED.
0001-04
REQUEST FOR ELECTRICAL INSPECTION EB-0/ /O
I• See instructions for completing this form on back of yellow cope
n ""X" Be/ow Work Covered by This Request r O
A,dd A- Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt Building Dryer Electric Heaton
Commercial Bldg Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other pacify Other (Spcnily)
l her (Specify Other 01hpr
Compute Inspection Fee Below
b Fee Service Entrance Size b Fee Feeders/Subfaoders b Fee cocuits
0 to 200 Amps 0 to 30 Amps 0 to 30 Awns
Above 200 Amps 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100-Amps Above 100-Amps
Transformers Irrigation Booms Partlal.'Olher Fee
Signs Special Inspection
TOT
Remarks .? _ w
a- AL FEE
4 the Electrical
Inspector, hereby
certify that the above
inspection has been
request road 18 moot om c=?
e ms , tz-
Tttis regnesl void
18 months Iron
-3e-,?' y
Z,O.O U
L3, B 3. 1,AABf-eslfav 320
Y/0I
Renaest Date
V
/_
r ire No.
[F R. uflh-m Ins Ver:uon
Rcgmred?
?NeadY Now /III Norty In YRed-
?" h
Wh
IO
/l0 ?NO rt
en Rood
§PL, lensed Electrical Contract., I hereby request inspection I above
0 Owner electrical work installed at:
Street Address, Box or Route No. City
ecuon o. Township Name or No. Hoge No. Covmy _
Do U ant(PRINT)
,gnPso,c? ? C,.cJdG,C«J ?o.??R.9G?7D,e? Phoned Nn
Power Supplier Address
E
I I c. I ot.,ICo aov Name) C.ntraotor's License No.
l D3 3-
Madinq Address (C tratlor or Owner Maku)p Ins' Ilonl
Author, I'd Slgaature (Contract. er Mak ru Installation) Mono Number
11 ?? X67
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
BOARD
Grrppa-Midway Bldg. - Room N-191
RE UNACLESS PROCEPTEDPER BY INSTHEPECTISTAOTEN FEE IS
11121 University Ave., St. Paul, MN 55104
..1___ 1.-m o.,. ENCLOSED.
?? 3a EKtI REQUEST FOR ELECTRICAL INSPECTION f?
1 ' See instructions for completing this form on back of yellow copy.
„X., j9ef-6kfork Covered by This Request
EB-00001 -03
S// 6 )4?
Now Add Sep. Type of Building Amm m aces 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 I Bulk Milk Tank
Farm Other peaty Oth.ri (Soo ni fyl
t ner (Sppcify Other Other
Compute Inspection Fee Below
n Fee Service Entrance Size 4 Fee FeedersrS.MePders a Feo circwts
0 to 100 Amps 0 to 30 Amps 0 to 30 Anl s
101 to 200 Amps 31 to 100 Amps' 31 to 100 Am
Above 200 Amos Above 100Amps Above 100_A mps
Transtorrners Remote Control Circ. Partial:Other Fee
Signs Special Inspection
Remar? / , ``'.iRIONN7
TOTAL FEE
JCLGJ!.(i?st_ J A//l'lO ?f?i lf-' /v / r 9l1_ ,- U
Rough-,,r I. the Electrical
Inspect.,. hereby
til
th
t
h
F anal
4-4)o % n S (?2 c .
t
3 -ar
y
a
t
e nboy.
inspection has been
made.
This request Maid
18 months from
COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
/ 651-681-4675
Foundation Only New Construction Interior Improvement
• Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets
• Civil Plans (2) • Structural Plans (2) • Code Analysis (1) "
• Certificate of Survey (1) • Civil Plans (2) • Project Specs (1)
• Code Analysis (1) • Landscaping Plans (2) • Key Plan (1)
• Project Specs (1) • Code Analysis (1) • Master Exit Plan (1)
• Spec. Insp.& Testing Schedule" • Certificate of Survey (1) • Energy Calculations (1) not always"
• Soils Report (1) • Spec. Insp. & Testing Schedule (1) •' . Elec. Power & Lighting Form (1) not always-
• Meter size must be established Meter size must be established • Meter size must be established - if applicable
Project Specs (1)
1 Energy Calculations (1) 1
1 Electric Power & Lighting Form (1) 1
1 • Master Exit Plan (1) 1
1 • Emergency Response Site Plan (1) "• 1
1 • Soils Report (1) 1
• MC/ES SAC determination letter . MC/ES SAC determination letter MC/ES SAC determination letter
all 651-602-1000 call 651-602-1000 call 651-602-1000
rooo a beverage or iooging raciintes - suDmlt plan to MN Uepartment of Health. Uall (iti1-115-U7UU for details.
" Contact Building Inspections for sample.
Permitfor new buildings or additions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements.
DATE: D rr--2 -WORK TYPE: _ NEW _K REMODEL CONSTRUCTION COST. C1
SITE ADDRESS: ir' fJ
TENANT NAME: SUITE #:
FORMER TENANT NAME, IF APPLICA
BL
E:
J
,,
DESCRIPTION OF WORK ??iSLIAX
?/ p l
?l
/
D'n
qL ( hIUIY)*N i)Qlc ,• ?
?i v,t
Name: ? I ? ?l S
PV p
'
L
-
j
11? / L Ph(
PROPERTY Last First
OWNER
Street Addre
ss:
City: State: rJ Zip: 5, 1 LA
Company: GR-e-ftT Ji K4 F, W I tf yl p.W d S I O' Ph ne #: (?f Sul ) ?$ I ' 3 `f 0
CONTRACTOR
Street Address: )41,o'30
6 it,'Ewej"loC V)Cl-•
City State: )"1 Zip:
ARCHITECT/
ENGINEER Company:
Phone #:,( ) u11
1
at 1
1
Name: t
Registration t#:
?'I 11'
1 `` I L
1
l
Street Address:
i
l
?\
`
{1
City: State: V Zip:
Licensed plumber installing new sewer/water servi
Phone #:
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. ^ ?f
Signature of Applicant: / fV
Updated 7102
OFFICE USE ONLY
SUBTYPE
1 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg.
1 14 Apartments ? 27 Commercial/Industri al ? 32 Ext Alt - Apts.
15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm.
25 Miscellaneo us ? 29 Antennae ? 35 Ext Alt - PF
? 37 Nail Salon
WORK TYPE
31 New ? 35 Tenant Impr ? 42 Demolish (Foundation) ? 46 Windows/Doors
1 32 Addition ? 36 Move Bldg ? 43 Reroof ? 47 Repair
7 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization
7 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION
Census Code Zoning
SAC Code # of Stories
No. of Units Length
No. of Bldgs. Width
Const. (Actual) Basement sq. ft.
(Allowable) First Floor sq. ft.
UBC Occupancy sq. ft.
MISCELLANEOUS INSPECTIONS
Gas Service Test ? Heating
4PPROVALS
Planning
Building
E Insulation
Engineering
sq. ft.
sq. ft.
sq. ft.
sq. ft.
MC/ES System
City Water
Fire Sprinklered
T1 Plumbing C Stucco/Stone
Variance
'ermit Fee
Surcharge
'Ian Review
MC/ES SAC
amity SAC
Nater Supply & Storage
S/W Permit
S/W Surcharge
Treatment Plant
'ark Dedication
Trails Dedication
Nater Quality
Dther
copies
VALUATION $
% SAC
SAC Units
Meter Size
rota)
TIMBERSHORE 3RD 76502
PERMIT
DATE &
TYPE LOT BL ADDRESS
8/72 4-PLEX 010 01 3634/ DENMARK AVE
020 01 3636
030 01 1281/ TIIvIBERSHORE LN
040 01 1279
8/72 4-PLEX 010 02 1277/ TIMBERSHORE LN
020 02 1275/
030 02 1273/
040 02 1271
8/72- 4-PL XE 0 10 03 1269/ TIMBERSHORE LN
020 03 1267/
030 03 1265/
040 03 1263
8n2 4-PLEX 010 04 1261/ TIMBERSHORE LN
020 04 1259/
030 04 1257/
040 04 1255
8/72 4-PLEX 010 05 1253 TIMBERSHORE LN
020 05 1251 TIMBERSHORE LN
030 05 1249 TIMBERSHORE LN
040 05 1247 TIMBERSHORE LN
8n2 4-PLEX 010 06 1243 TIMBERSHORE LN
020 06 1241 TIMBERSHORE LN
030 06 1239 TIMBERSHORE LN
040 06 1245 TIMBERSHORE LN
8/72 4-PLEX 010 07 1260 TIMBERSHORE LN
020 07 1262 TIMBERSHORE LN
030 07 1238 TIMBERSHORE LN
040 07 1240 TIMBERSHORE LN
PAGE 1 OF 2
5
MASTER CARD
LOCATION
STRUCTURE AND
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK Z 4p
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING AV 7 2e- TILE FIELD FT.
FINAL
ELECTRICAL o -
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL -.2)f
SANITARY SEWE
R 7 1/
-
-
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require.
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
COMMENTS:
DATE
CITY USE ONLY
LOT 111. RECEIPT #:
SUBD. RECEIPT DATE: IO-I 15 t I1
MECHANICAL PERMIT #
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY of E.AGm
3830 PILOT KNOB RD
EA6AN MN 55122
(651) 681-4675
Date:
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occupied.
• HVAC: 0-100 .M 6 T TT
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
$ 30.00
6.00
State Surcharge .50
Total $
Complete this section only if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration _ Repair _ Other
A Reminder: Call 681-4675 for inspections.
? Furnace Air conditioning
Air exchanger U7/ Other
S 30.00
State Surcharge 50
Minimum Total Due $ 30.50
SITE ADDRESS: N63 ?/nbjn/`
OWNER NAME: PHONE #: `7`?1 - 46 ef 4S
(AREA CODE)
INSTALLER NAME: -EDGiIV?- ,L,.A, - ?.:,... PHONE #:
W1 U W6ntWOfM AVal1Ua $Otj; (AREA CODE)
STREET ADDRESS: Mhwxb 1Em
CITY: STATE: ZIP:
?l?l<l
SIGNATURE E O OF PERM I
?4)-d
L
SUBD.
BL
CITY USE ONLY .
RECEIPT #:
APPROVED BY:
INSPECTOR
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY of EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 6$1-4675
Please complete for: all commercial/industrial buildings
multi-family bu;ld;ns ?AjhPn geoarate Dermits are not required for each dwelling unit
DATE:
CONTRACT PIRJ(.E:
RECEIPT DATE:
MECHANICAL PERMIT M
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank (Minimum Fee)
Processed Piping (Minimum Fee)
"NOTE: When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
CONTRACT PRICE x 1%
PERMIT FEE
STATE SURCHARGE (S.50 per $1,000 of Dermit fee due on all permits.)
TOTAL
-------------------------------------------------------------------------------------------------------------------------
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
PHONE #:
(AREA CODE)
STATE:
PHONE #:
(AREA CODE)
ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY
LOT BL
q? Z RECEIPT #: ?O I g
SUBD. 1 f/.lC LL J?? RECEIPT DATE:
MECHANICAL PERMIT # o I
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF SAHAF
3830 PILOT KNOB RD
EAGAN MN 55122
(651) 6814675
Date:
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occupied.
• HVAC: 0-100MBTU
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
.50
Complete this section only if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration _ Repair
Reminder: Call 681-4675 for inspections.
Furnace
Air exchanger
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
Other
Air conditioning
Other
$ 30.00 -
State Surcharge .50
Minimum Total Due $ 30.50
PHONE #: _L? (J?
(AREA CODE)
PHONE #: acl a -01QA
(
STATE: cAdAAM ZIP: 56101
SIGNATURE OF PERMITTEE
L BL
SUBD.
APPROVED BY:
CITY USE ONLY
INSPECTOR
RECEIPT #:
RECEIPT DATE:
MECHANICAL PERMIT #:
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGM
3630 PILOT KNOB RD
EAGAN, MN 55122
(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: CONTRACT PRICE:
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank (Minimum Fee)
- Processed Piping (Minimum Fee)
"NOTE: When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: 1% of contract price QR $30.00 minimum fee, whichever is greater.
CONTRACT PRICE x 1%
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (124PROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
($.50 per $1,000 of permit fee due on all permits.)
PHONE #:
(AREA CODE)
PHONE #:
(AREA CODE)
STATE:
ZIP:
SIGNATURE OF PERMITTEE
' EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: January 3, 1973 NUMBER 1269
?? 3 3 i. 3
OWNER: New Horizon Homes Address 26 65-69-$7 Timbershore Lane
PLUMBERThompson Plumbing Co. TYPE OF PIPE heavy cast iron
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling I No, of units
Location of Connections:
Connection
Permit Fee 10.00 pd 12/28/72
.!)U pd 12/20/(2
Street Repairs
Total
Inspected by:
Date
Remarks
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By
Thompson Plumbing Co.
Please notify when ready for.inspection and connection and before any portion
of the work is covered.
fled 1/1,
EAGAN TOWNSHIP ? Ivey-,
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PEMUT FOR WATER SERVICE CONNECTION
January 3 1973
Date: -Deeemiber 'off Number: 4Q9& 1102
Billing Name:New Horizon Homes Site Address: a65-69-67 Timbershore Lane
Owner: same
Plumber: Thompson Plumbing Co.
tion
1263 - 22491884 - 5325872
1265 - 22491885 - 5325873
1267 - 22491886 - S325874
1269 - 22491887 3 5325875
Assn - 22491889 - S325877
Building is a:
Residence
Multiple x No
Commercial
Industrial
Other
Billing Address
Meter Size
Meter No. (Permit Fee 10.00 pd 12/28/72
Meter Reading I{Meter Dep. •50 pd 12/28/72
Meter Sealed: Yes_ I Add'1 Chg. '100-no p(3 1/19/73
NO [Total Chg.
Inspected by
Date
Remarks:
townhouses
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By: 41L? n/S??? ??i
7i '-
Thompson Plumbing Co.
1119
Please notify the above office when ready for inspection and connection.
EAGAN T014NSHIP
.795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: January 3, 1973 NUMBER 1269
S
OWNER: New Horizon Homes Address 1263 69--§7 Timbershore Lane
PLUMBERThompson Plumbing Co. TYPE OF PIPE heavy cast iron
DESCRIPTION OF BUILDING
Industrial Commercial Residential I Multiple Dwelling ` No. of units
Location of Connections:
i'
Connection Charge...d
,e,
1/1
Permit Fee 10.00 pd 12/28/72
Pd 12120112
Street Repairs
Total
Inspected by
Date
Remarks:
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
Thompson Plumbing Co.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
-.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PEM41T FOR WATER SERVICE CONNECTION
January 3 1973
Date: -Pk-, 1-3 Number 4890 1102
Billing Name:New Horizon Homes Site Address: 1263 65 69-67 Timbershore Lane
Owner: same Billing Address
Plumber: Thompson Plumbing Co.
:ation of Connection Meter Size Connection Chg. ' b lle 1/19
a'
Meter No. Permit Fee 10.00 1pd 12/28/72
1263 - 22491884 - 5325872
.50 pd 12/28/72
1265 - 22491885 - 5325873 Meter Reading Meter Dep.
1267 -
1269 - 22491886 -
22491887 } 5325874
5325875 Meter Sealed: Yes
- Add'l Chg. ?Cp_? nA 1/19/73
Assn - 22491889 - 5325877 NO Total Chg.
Inspected by
Date
Building is a: I Remarks:
Residence
'pF-!PlSPECTION FEE FOR
Multiple x No. Units townW
Commercial IMPROPERLY W ALLEO METERS.
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Thompson Plumbing Co.
Please notify the above office when ready for inspection and connection.
/a
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: January 3, 1973
OWNER: New Horizon Homes
PLUMBERThompson Plumbing Co.
n
NUMBER 1269
b r
U.7
Address 1263-65-69? Timbershore Lane
TYPE OF PIPE heavy cast iron
OF BUILDING
Industrial) Commercial
Location of Connections:
Connection
No. of units
Permit Fee 10.00 pd 12/28/72
.5U pd 121201(2
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
BY
Thompson Plumbing Co.
e
Please notify when ready for inspection and connection and before any portion
of the work is covered.
Residential Multiple Dwelling
1 /1
`1
2'33
EAGPN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
January 3 1973
Date• -Deer 4. 192 Number: 4.99 1102
Billing Name:New Horizon Homes Site Address: 1263-65-69: Ti bershore Lane
Owner: same
Plumber: Thompson Plumbing Co.
Billing Address
1263 - 22491884 - 5325872
1265 - 22491885 - S325873
1267 - 22491886 - 5325874
1269 - 22491887 1 5325875
Assn - 22491889 - S325877
Building is a:
Residence
Multiple x No.
Commercial
Industrial
Other
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Thompson Plumbing Co.
Please notify the above office when ready for inspection and connection.
Meter Size (Connection
Meter No. Permit Fee 10.00 nd 12/28/72
Meter Reading Meter Dep. •50 pd 12/28/72
Meter Sealed: Yea_ I Add' 1 Chg. 300.00 nd 1 /1 9/73
NO Total Chg.
Inspected by
Date
Remarks:
units town" egtp.n R -WPECTION FEE FOR
I IN,P[iOFER' Y iNSiALLEO METERS.
1/19
.a,
3
}
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111 I'
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: January 3, 1973 NUMBER 1269
-77
LA
OWNER: New Horizon Homes Address 1263-65r6 ?7 Timbershore Lane
PLUMBERThompson Plumbing Co. TYPE OF PIPE heavy cast iron
DESCRIPTION OF BUILDING
Industriall Commerciall Residential Multiple Dwelling No. of units
Location of Connections:
Connection Chareea
Permit Fee 10.00 pd 12/28/72
.5U pd 12128112
Street Repairs
Tot
Inspected by:
Date
Remarks
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By
Thompson Plumbing Co.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
,e.
billed
1/1
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111 I _
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
January 3 1973
Date- -A 'off Number 4890 1102
Billing Name:New Horizon Homes
Owner: same
Plumber: Thompson Plumbing Co.
1263 - 22491884
1265 - 22491885
1267 - 22491886
1269 - 22491887
Assn - 22491889
er
Meter No. Permit Fee 10.00 od 12/28/72
- 5325872
- 5325873 Meter Reading Meter Dep. .50 pd 12/28/72
- 5325874 Meter Sealed: Yes Add'1 Chg. 300.00 ;d 1/19/73
5325875 -
- 5325877 NO Total Chg.
Inspected by
Building is a:
Residence
Multiple x No. Units
Commercial
Industrial
Other
Date
Remarks:
towns 500 RE-INSPECTION FEE FOR
IMPROPERLY INSTALLED METERS.
By:
Chief Inspector
..y„z
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
Thompson Plumbing Co.
Please notify the above office when ready for inspection and connection.
Site Address: 1263-65}67 Timbershore Lane
Billing Address
1/19
LEO MURPHY
MAYOR
THOMAS EGAN
MARK PARRANTO
JAMES A SMITH
THEODORE WACHTER
COUNCIL MEMBERS
July 12, 1978
TO: Donna Kenny
Burnet Realty
3996 Beau D' Rue Drive
Eagan, MN 55122
tµ ;'?
f
CITY OF;"EAGAN
3785 PILOT` K_NOS-ROAD;
EAGAN. _,M I N N ESOTA.'
55122F ..PHONE ABi.Di004'4y
an 't
FROM: Dale Peterson, Building Inspector
RE: 1267 Timbershore Lane - foundations
THOMAS HEDGED
CITY ADMINISTRATOR
ALYCE SOLKE
CITY CLDRK
On July 11, 19789 at your request, I inspected the above dwelling for foundation
failures. I could find no indications of such failures, and upon checking
city files, I could not find a record of any complaints from that entire
four-unit building.
Dale Peterson, Building Inspector
DP/da
THE LONE OAK TREE ... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY.
r?)13 ?,
73 ?
2007 RESIDENTIAL BUILDING PElevaAPPUcAnoN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements
3 registered site surveys showing sq. ff. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
1 Soils Report if proposed building is to be placed on disturbed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail options selection sheet (buildings with 3 or less units)
Minnegasw mechanical ventilation form
Remodel/Repair Requirements Office Use Onlv
2 copies of plan showing footings, beams, joists Cart of Survey Reod - _Y _ N
1 set of Energy Calculations for heated additions Soils Report - ' _Y _ N
I site survey for additions & decks Tree Pres Plan Recd _ Y _ N
Addition -indicate if on-afte septic system Tree Pres Required - _ Y _ N
On-site Septic System _Y _ N
Plans are considered nublic information unless you state they are trade secret and the reason.
Date l O Construction Cost r T (?z
Site Address
u I z (o S
1 z 4? I "L (o rrr•g Unit/Ste #
Lug lT1 -
Description of Work
Multi-Family Bldg +! Y _ N Firep ace(s) 0 _ 1 - 2
Property OwnerM'16'?c..tiJtu7t? th?r?GMI+Jtd?f ?1"sC Telephone #
r
Contractor ?'-
Address l/ 7/?$ n 1 X
State PllN -A A4 5T -1-? Yon -3S 1 City 1 -p Si nj f,--V
Zip'&-5Y `67 Telephone # (l (Z) Z
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 - Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Cade Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
- Y - N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
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 v/f ti h requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA154743
Date Issued:04/09/2019
Permit Category:ePermit
Site Address: 1263 Timbershore Lane
Lot:4 Block: 03 Addition: Timbershore 3rd
PID:10-76502-03-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Sandra L Beltran
1263 Timbershore Ln
Eagan MN 55123
(651) 454-6895
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA179132
Date Issued:09/20/2022
Permit Category:ePermit
Site Address: 1263 Timbershore Lane
Lot:4 Block: 03 Addition: Timbershore 3rd
PID:10-76502-03-040
Use:
Description:
Sub Type:Water Softener
Work Type:Replace
Description:
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Sandra L Beltran
1263 Timbershore Ln
Saint Paul MN 55123--102
(651) 454-6895
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature