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1123 Tiffany DrOF EAGAN WATER SERVICE PERMIT "lot Knob Roan ' A 21199 PERMIT NO.: MN 55121 DATE: No. of Units: 1 Feature Bldrs B1 Canterbury Forest lumber. ter N C'Connection Charge: Size: {? o Account Deposit: Reader No.: Permit Fee: 1 agree to comply with tow City of Eagan Surcharge: . 50 pd " Misc. Charges: 63.00 pd meter nr Total: By Date Paid: Date of Insp.: Insp.; 49 WCITYOF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoning: t1 Owner: I'eature B1dT3 Address: Site Address: 1223 T.{f- ¢at,v Dr Plumber: La cevil e p ,, 1 Meter No.: Size: Reader No., I some to comply with 60 City of Eagan Ordinances, By Date of Insp.: Connection Charge: 470, 00 pd Account Deposit: - M-M-57--Permit Fee: p Surcharge: p Misc. Charges: _ 63.00 pd meter Total: Date Paid: CITY OF EAGAN 3830 Pilot Knob Road SEWER SERVICE PERMIT P• O. Box 21199 Eagan, MN 55121 PERMIT NO.: 6640 Zoning: R1 DATE: 5-3-84 Owner; Feature 31drs No. of Units: 1 Address: Site Address: 11 3 Tiffany Dive L17 B1 Canterbu Plumber: - Lakeville ry Forest I agree to oompy with tw City of Eagan 1 . 0 P Ordinengs, Connection Charge: 425.00 Ad Account Deposit: 15 00 pd Permit Fee: - l0 00 od By Surcharge: Dote of Insp.. Misc. Charges: Insp.: Total: Data Paid: WATER SERVICE PERMIT PERMIT NO.. DATE: No, of Units: 1 t 1 • CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 N® 8962 BUILDING PERMIT Receipt * zy d ?? T To be weed fm ^ • F I l ' r C /C Il}: Est. Value I 10.2 , J 0 0 Die APR IL 11 19 S 4 Site Address 1123 T7F1','' Y )7R. Erect pX Occupancy - Lot 17 Block 1 -+c/Sub. CANTFRBURY FOR. Alter p Zoning ? Parcel No. 10-16350-170-01 Repair ? Fire Zone Enlarge C] Type of Const. I% Name FEATURE BLDRS. Move p * Stories Z Address 15 513 LOGARTO LN. Demolish ? Length 7 0 City BTJ R t'} S V T LLFhona 435-8443 Grade ? Depth 6 0 Sq. Ft. $c Name SAMI' Approvals Fees sl? 41.30 0 0 ?i ?? Address Assessment b S Permit 51.00 S h I-- City Phone ew. Water urc arge k ? Polite Plan chec . 00 W Name Fire SAC Address Phone W Ci Eng. Water Conn. ?0 M ty < Planner Water eter 76-07 OC Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total $2,024.50 State of Minnesota Statutes l nd City of Eagan Ordinances. Signature of Permittee A Building Permit Is Issued to,-r- FFT.'rT r}'? ` PL?? . on the express condition that f Minnesota Statutes and City of Eagan Ordinances. all work shall be done in rdanqe wife all applicable StaTIC uilding Offical `? 0 o L? T ? r ` a ao ` O Lr o ti y d `1 J d " c J s on - , 3 3 E ?° 416 , DO `m CL m J 10 D ? A e E fJ a a u o C o $ _ c d V Q = d ; C LL U. at Q ¢0 C LL LL LL d Receipt ?! ?lr PLUMBING PERMIT Permit No. ~ CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly ? Tot. 1. Date 2. Installation Cost 3. Job Address LotBlk. I Tract t 4. Owner 5. Contractor Phone 6. Address 7. City •' '.1 ? ° ,.'- State ,/???,', Zip 8. Building Type: Residential V Commercial ? Institutional ? 9. Work Description: New M Add ? Alter ? Repair ? 10. Describe 11. No. .--7- Fixtures Water Closet No. Fixtures Cesspool /Drainfield / Bath tubs Septic Tank Lavatory Softner ' Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray ,_ {• y O- / Floor Drains X ;? / C • Drinking Ftn. y - ? 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 Receipt MECHANICAL PERMIT Permit No. i_ CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone y `? 9 9 6. Address - 7. City State ' Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New O Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. ng: r an 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 r GSA'SH RECEIPT CITY OF EAGAN s P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 DATE to k CD DM AMOUNT $ & DOLLARS goo ? CASH ? CHECK J _?o FUND CODE AMOUNT Thank You BY L` R White-Payers Copy Yellow-Posting Copy Pink-File Copy CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE /l 119 RtCQ1YED FROM - `-- -?- l-,? ?' AMOUNT $ L ?` DOLLARS +eo ? CASH 41Z. IECK FOR . FUND CODE AMOUNT c1 1 ) U Y \^ •y Jai J? Than u BY J` y Q L= White-Payers Copy Yellow-Posting Copy Pink-File Copy INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: i1 111, I Nr 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: S ` (612) 681-4675 SITE ADDRESS: ` " t c' I • :'' APPLICANT: t i l l , 1, 141,11t) ? PERMIT SUBTYPE: TYPE OF WORK: Al 1I tin 1 DE acRlP rlnN kt It00F INSPECTION TYPE DDATE INSPTR. INSPECTION TYPE DATE INSPTR. T- R 7 Penult No. Permit Holder Date Telephone M ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING 7 ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CERTIFICATE OF SURVEY N41o03'27°W - 160.00 ,, f ;T 5 DRAINAGE aUTILITY EASEMENT N o 10 pl? co 24 1 m W 3 GARAGE a 30 I PROPOSED J LOT 17 12 ?' C I r' 4 A QD W M M W) 9 01 z I m 4'p ? I M BLOCK I 1ti 0, e 4 , z PROPpgEp HOUSE r I 5 LOCATION N cV f? ti? I 36 (0 1 IV Zoo 35,26 W f 10 50 W) ls6.v0 0h Z326 Elevations and Bearings are assumed datum 4e 1'ti W 0 e 0 o? e: 9 Q N t0 A EL P ra I hereby certify that this is a correct rep-- sent,%ti ??• ^.' a survey' ?` : Lot 17, Block 1, CANTERBURY FORE$?.:Da-:')ta Rccir,-",ng to the plat ;hereof on file and of re^or-i. 'rr un: -r }.e lh vs ` the 3tf.tp of :,"_ir_nesota. i. i? Dated this 9th day of Aril, 1934 Ge:1e L. Jacohson, Minn. Reg. No. 77.A DR. BY JC SCALE - I" = 30' O DENOTES IRON MON. J BEARINGS ARE ASSUMED DATUM. Feature Builders JACOBSON SURVEYORS 15513 Logarto Lane Burnsville, tAV ;.5?37 LAKEVILLE, MINN. 55044 PHONE 469 - 4 328 / oc' - 75 CITY OF EAGAN Remarks I ? 2 Z Addition CANTRRBURY FOREST Lot 17 Rik 1 Parcel Owner -? l Street 1123 TIFFANY DRIVE State' MN q,qu.) r 55 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 40(; 1979 Paid unde original E, rct-i STREET RESTOR. GRADING y5? 1981 106.78 5.34 20 85.46 A013446 1-12-84 SAN SEW TRUNK z-) 1973 Paid under ov inal rcel * SEWER LATERAL tip 1981 439.42 20 351.54 A013446 1-12-84 WATERMAIN WATER LATERAL 19 11 20 WATER AREA ?{ g 1979 Paid unde Orl inal rcel STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 260.00 4-11-84 WATER CONN. 470.00 11 It BUILDING PER. $962 of n SAC 575-00 tt tt PARK This request wid Lf 3 16l?p 18 .meth, fm. A 053361 Lk-? Qhf6v I?puired? V?? ? PReady N..X Wii 1. Notify Inspe, Yes nNa for When Ready K,Li.snsed Eleclriral Cmdraclor 1 hereby re9aest inspection of above ? Oemm elec4{.a1 Wor1c installed at: Street Address. Boa a Rm1fe No. City .m. No- I Toarsbip Namu or No. Ra..p¢ No_ County Occetmnt (PRINT) Phone No. payer Supplier A41??T Address EI - ql Contracmr ICpnmaM Name) p ^T ?j Contractor s License No. ^?J _ t ?.J G .G./U4 © S - tdaili Address (Contractor m O.yrrer Making Insbilationl Authorized SiBrmture l 91-. Maklrlp Z7' F?Z Phone Number W 7 - s7s ) NINNESOTA STATE BOARD OF ELECTRICITY TNIS INSPECTION REQUEST WILL NOT OriGIs-MidMaY Bide - Boom U-191 BE ACCEPTED BY THE STATE BOARD IEn UnWersity Ave.. SL Paul. MN $1OS UNLESS PROPER INSPECTION FEE IS Pw- M212972111 ENCLOSED. REQUEST FOR ELECTRICAL I19PECTION ES-000/011-/0; n ry ' Sea instnatiess far cos plalim this foes are b@4-.k of, Ys11ow copy. A I I ?j q ?' J 'T - Be/ow Wn?l a' vered by This Request atBpi Hipp I Appliances Wheel I ErluipMent Wired Silo Unlo Bulk Milk s Fee Seryico Etmanp S¢a p Fee Feedars/SuMseders p Fee Circuits 2._ R Z 3 2- 0 to 30 A 0 to 30 Am M Above 200 A - 31 to 100 Amps 31 to 100 A Swimmi Pool Above 100_ Above 100-AMPS Traltstomlerg Irrigation Barons Partia[,'Other Fee I Signs Special Inspection [,, !V 11ena.ks ' a TOTAL 1, the Electrical Impactor. hereby rsrlily that the above i peclipn has bee. wid 4a-Sl5 Y-3o-At( 18 months from .A 15 0 5 0 7 Ce.-j-fvjr 4,, -?4m. 10.60 Request Data Fire No. Raugh-in Inspect eq to red? ?ROady Now Will Notity. Inspec- h 0 7 ? Yes No or W en Reatly L icensed Electrical Contractor I I hereby request inspection of above Owner electrical work inatalletl at: K Street Address, So. City eq o. Township Name or No., Range No. County Occup WRINT ? Phone No. V., 'CIE ^ Power ppl er Adtlress Ln ee 24 - Electn cal htractor (Comp Nam el/p Conpttractor's License No. i ? Mailing A s ICOOtra for or Owner Making Instailation) af? Author' a Sign ure (Contract r wner Making Installations hone Number > ?/, ?G. MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Qriggs-MidwaY Bldg. - Room N•181 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS pl-- IR11t 992_7111 ENCLOSED. 4?g?5 REQUEST FOR ELECTRICAL INSPECTION d"Ilt ER-00001 Oa { , lee instructions for eomplet this f m on back of yellow copy, ?-? ?.3?.g I 050507 X` Below Work Covered by This Request I ldlir, Odd 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 un l5) t er peci y they (SOeci Fy) t er Specify ter Other Compute Inspection Fee Below # Fee Service Entrance Size # Fee Feadets/Subfeeders # Fee Circuits 0 to 200 Amps - 0 to 30 Amps 0 to 30 Am s Above 200 AlpS 31 to 100 Amps 31 to 100 A Swimming Pool Above 100-Am s Above 100_Amps Transtormers Irrigation Booms Partial%Other Fee Signs Special Inspection $ TOT FEE I ( Remarks n 1A f1 Rough-in Dato 1, the tricot Inspector- hereby p cer ify that the above Final /F / ,.'20 D/ /i Aar dection has been I 171'. This request void to months from / " ?/r 0 9 8 6,Ci Q Raqu? Date q y O'L Fire No. Rough-in Inspoilpin Required? NOTICE: You Must Call Electrical Inspector If A Rough-In Inspection 4 J El Yes 0 No Is Required. I ?.licensed contractor %owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) l t 23 TIFFANY ?RtvE City ? Section No. Township p Name . orr No Range No. County . ( X11 -- I ?AKo Occupant (PRINT) ?{ y',?,? ( 5 R Phone No. pG En o " Power Supplier Aistiif (c imi ELEC. c Co -ce Address 55* ,. 4300 220`1' W. ftVO46Tat? Electrical Co tractor (Company Name) Coniradork License Na. Mailing Address (Contractor or Owner Making Installation) Authorized Signature (Contractor/Owner Making Installation) D. A&>? Phone Number 456-9760 IN NESOTA STATE jOA 0 F ELECTRICITY THIS INSPECTION REQUEST WILL NOT M Griggs-Midway Bldg. - R M. 5-173 Q BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(812)642-0800 r'? ENCLOSED. a REQUEST FOR ELECTRICAL INSPECTION / ? See inslruoticns for compleling this farm on back of yellow copy. M 3 0 9 8 6 -,,x- Below Work Covered by This Request E&00001-08 OVESIF ew Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractors Remarks: I Compute Inspection Fee Below., # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspectors Use Only: _ TOTAt6 10 Irrigation Booms 6 ? O llz/."//?tl - Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORD ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in 11A I Date certify that the above inspection has been made. Final oataf sl d l OFFICE USE ONLY This request void 18 monNs from CITY OF EAGAN t ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT To be used for SF DWG/GAR $ i02,000 Receipt # N° 8962 Erect IK Occupancy -- R3 Alter ? Zoning -? R1 Repair ? Fire Zone N/A Enlarge ? Type of Const. V Move ? # Stories Demolish ? Length 70 Grade ? Depth_ D-Sq. Ft.- Approvals Feet Site Address 1123 TIFFANY DR. Lot 17 Block 1 Sec/Sub. CANTERBURY_ FOR Parcel No. 10-16350-170-01 W Name FEATURE BLDRS Z Address 15513 LOGARTO LN 9 City aURNSVILL$hone 435-8443 Name SAME 0? Address t- City Phone Ww Name L Z Address <W City Phone I hereby acknowledge that 1 hove read this application and state that the information is correct and agree to comply with all applicable State of Minnesota StotuteYd City of Eagan Ordinances n Signature of Permittee _ A Building Permit Is issued all work shall be done in d Assessment _ Water 8 Sew. Police - Fire Eng. Planner - Council Bldg. Off. APC Permit- $ 438.00 Surcharge 51.00 Plan check 217.50 SAC 525.00 Water Conn. 470 . 00 Water Meter 63.00 Road Unit 260.00 Total S2,024, 0 5b. on the express condition that of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN V. To Be Used For Site Address: ii a -:?- Lot _L, Block / Sec./Sub: Parcel #: - /?3sm- Owner: Address: City/Zip Code: Phone #: Contractor: ?)D._Ie4?AA Q ;tSA, ? QO.Qo r Address: / 5- A entice Znn. City/Zip Code: 6,r??. 5-533 7 Phone #: G/ 3 S _ 8 9,q3 Arch./Eng.: Address: valuation Include 2 sets of plans, 1 Certificate of Survey & 1 set of energy calculations. _ Date OFFICE USE NLY Erect ). Occupancy Alter Zoning Repair Fire Zone Enlarge Type of Const. _ Move # Stories Demolish Front 70 ft. _ Grade Depth 4-h ft. APPROVALS FEES Assessrtents Permit c3 &C, Water/Sewer Surcharge r / Police Plan Check U Fire SAC 5_ Water Conn. Eng. Planner Water.Meter Council Road Unit C? d Bldg. Off. q APC City/Zip Code: Phone #: TOTAL U? t/. SO - EXTERIOR EIS I P AVERAGE "U''COPIPUTATIO3 OWNER K?ol3 3f?'?-fc1L /y-4qC SITE ADDRESS 1/ 3 FF- W . ??i'e ,,;. CONTRACTOR F?[? fy12s= FC:DeS DATE ?I--5 84 PHO'NE' 3 Determine working square footage of each. 1. Total exposed wall area ..... 18 I1o.08 sq. ft. x 11 ?7 L 2. Total roof/ceiling area .... 112 a sq. ft. "X •026 Total exposed wall area above floor = 15 0 a. Total wall window area .................:........ 1 5 5.1p b. Total door area .... ........................... c. Total sliding glass door area .............. ....: ---1 d: Total fireplace wall area ........... ........... e. Total wall framing area (average 101.)............ f. Total net wall area above floor ................. 113.0 lc g. Total rim joist area I 0 g Total exposed.foundation area = 1 -.y.06 h. Total foundation window area ..................... i. Toal net foundation area above grade ............ iZ_CC 8 Determine "U" value of each wall seerent. a. 155.1a X lull Z b. to to `. 1lull , i3q = ?I?I C. 6B X "U" qq d. y g X ,.u., . 3l0 i 9,2 e._ 114.104 X "u" Uh to = lg_ f. b11,17 to x "u" yta. g. 18B X 81U41 h. - X nDn _ i. 12V.Og X „u.. .04Z 3 ......................... t $Ilq.:O.$..Total if item n3 is the same as, or less than item .91, you have met the intent of S3C C"K5(c)2. Total exposed roof/ceiling area Total gross roof/ceiling area 7 Z j. Total skylight area ........................ k. Total roof/ceiling framing area .........,.. 1f)? R 1. Total net insulated roof/ceiling area....... 1 5 5 5i2. Determine "U" value ?.. ?_ x k. I?l2?a x 1. I?SS.zx 4 ..................1"?? $.... for each roof/ceiling segment. "U" _ ?- .,u„ o-Ly 4 j 1 y nun .....Total = ( ?R If total of #4 is the same as, or less than #2, you have met the intent of SBC 0006(c)l. To utilized the total envelope system method, the values established by the sum of items #3 and 04 shall not be greater than the sum of items 01 and #2. 1. + 2. 3. + 4. _ MATERIALS Exterior Air Siding Material Sheathing Insulation Sheetrock Interior Air Studs Rim Conc. Bike. Therm. Resistance "R" ,19 .4S _ 7 13 X45 If A8 I.?- ? 2/84 tf CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) ..p 1) PROPERTY ADDRESS: y LECAL DESCRIPTION: (Iot/Block/Subdivision or Tax Parcel I:D. NtmbLr) IF EYIST=`:G STRUCTURE, DATE OF ORIGINAL BUILDING PE°,=T ISSU2UNCE: y - PRESS ::CNlr:/PROPOSED USE: R-1 SINGLE FAMILY ? R-2 DUPLEX (TWO UNITS) ? R-3 TONNHOL'SE (THREE + UNITS) ( WITS) ? R-4 APARTtT2,T/CONDa-,T\iIIL'M ( WITS) ? COMVE RCIAL/RETAII,/OFFICE ? INDUSTRIAL ? INSTITUTIONAL/GOVERNMENT 2) APPLICANT (PLEASE PRINT) ADDRESS: s2z" CITY, STATE, ZIP?3_I / ? ??, PHONE: 3) PLumBER PLEASE -PNT) NAME: ?Q15 uT ? FOR CITY USE ONLY _ t / (? O d l! /I/ ADDRESS: PLUMBERS LICENSE: J A? CITY, STATE, ZIP: ? Lo Ul Active Expired o PHONE: PLUMBER LICENSE # E mfr Q Not of Record aft nltld 41 (JL-UYANT/CIvTTER NAME: ADDRESS CITY, STATE, ZIP PHONE kVLLAar VNINII 5) INDICATE WHICH PERMIT IS BEING REQUESTED: 0 CONNECTION TO CITY SEWER JW CONNEci'ICN TO CITY WATER OTHER (PLEASE DESCRIBE) 6) PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE 21 PLEASE MAIL APPROVED PERMIT TO 1, 2, 6 4 ABOVE ,?2 - O (Circle one) 7) SIaIATURE: DATE: ??j ?j -%Wi1a1:a1Wft."i M!=,W?Wfr WRWiV ?Wiaii?:is:ia? ! ?:,wwwl*:vd man 2*8w-wm-?-m F 0 R C I T Y U S E O N L Y i PERMIT n ISSUED I I FEES: $ i S Er"'ER PER?!T- (,.TL S.UPCHARGE) _,C JDE .., $ WATER PETUIIT (INCLUDE SURCHARGE) $ WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP $ ACCOUNT DEPOSIT - SEidER $ ACCOUNT DEPOSIT - WATER $ 11 a. o-d WAC SAC $ TRUNK WATER ASSESSMENT S TRUNK SEWER ASSESSMENT S LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 0 YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION, SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: 04 ilk !um R W AR vpl?ft BMW a% Waw R# ¦! m m W fm Mpg !N1 !kw R wn Wpm /(-W iF m" ids R# 060m R Mpg w m CITY OF EAGAN 3830 Pilot Knob Road Eagan. Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 1123 TIFFANY OR LOT: 17 BLOCK: 1 CANTEBURY FOREST P.I.N.: 10-16350-170-01 DESCRIPTION: PERMIT TYPE: Permit Number: BUILDING 029615 Date Issued: 03/21/97 ?11...? R E R O O F B ildinjw.Permit Type SF (MISC.) ,Building L"talk Type ALTERATION ?/-Census Code 434 ALT. RESIDENTIAL PERMIT REMARKS FEE SUMMARY- Base Fee Surcharge Total Fee VALUATION $112.25 $3.00 $115.25 $6,000 CQNTRACTOR: - Applicant - ST. LIC OWNER: DEMART CONSTRUCTION 14329148 2008972 JENSEN TOM 14731 CHICAGO AVE S 1 1123 TIFFANY DR BURNSVILLE MN 55306 EAGAN MN 55123 (612) 432-9148 (612)456-9760 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 Mn. Statutes and City of Eagan Ordinance's. APPLI T/PERMITEE SIGNATURE ISSUED SIGN E J 1997 BUILDING tow& New Construction Reouirements PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (Include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No DATE: 13-al _97 CONSTRUCTION COST: 'S DESCRIPTION OF WORK J_'t t STREET ADDRESS: LOT_ BLOCK //a3 T1-r:rcItv 179IVe r -?- SUBD./P.I.D. #: I ? ?- { m 1_3?kt titIf P A , PROPERTY Name: 73k_il/5fA/ %019 Phone M 45`9760 OWNER u.. Street Address: 2123 14(' ?* .JJ TQIve City: E96-ciN State:1 A) zip: 55/x3 CONTRACTOR Company: 7efilaer C.OA?.V'r Phone#: .3(3114 ok Street Address: /4731 C?r ?a? UJVe? License * City: State: P9)v Zip:5S30?) ARCHITECT/ Company: Phone* ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): and lot change are requested once permit is issued. Penalty applies when address change 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. o Signature of Applicant: ??"`O x y"? OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received - Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. o ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New ,if 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. MCNVS System Main level sq. ft. City Water sq. ft. Fire Sprinklered sq. ft. PRV sq. ft. Booster Pump sq. ft. Census Code. Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance Permit Fee Valuation: $ lv&20 Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units PERMIT City of Eagan Permit Type:Building Permit Number:EA115564 Date Issued:09/26/2013 Permit Category:ePermit Site Address: 1123 Tiffany Dr Lot:17 Block: 1 Addition: Canterbury Forest PID:10-16350-01-170 Use: Description: Sub Type:Reroof & Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 12,000.00 Fee Summary:BL - Base Fee $12K $221.25 0801.4085 Surcharge - Based on Valuation $12K $6.00 9001.2195 $227.25 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 - Thomas P Jensen 1123 Tiffany Dr Eagan MN 55123 Meszaros Construction Llc 4386 280th St W Castle Rock MN 55010 (612) 281-6079 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA119542 Date Issued:12/04/2013 Permit Category:ePermit Site Address: 1123 Tiffany Dr Lot:17 Block: 1 Addition: Canterbury Forest PID:10-16350-01-170 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Beth Janohosky 207 150th Street W. Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 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 - Thomas P Jensen 1123 Tiffany Dr Eagan MN 55123 (651) 334-0035 Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431-4328 Applicant/Permitee: Signature Issued By: Signature