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1135 Tiffany DrCITY OF EAGAN 38s0 Pilot Knob Road P. O. Box 21199 Eagar,,Qh $5121 Zoning: -.I Owner: Tess: ita Address: t 9 umber. 1.. ter No. B is • =? T WATER SERVICE PERMIT PERMIT NO.: -, ' DATE: - No, of Units: } „'9 5,.__? ?r-?Ei - - 4e§onnection Charge: 470.00 pd - f?mount Deposit: 15.00-Pd Reader N1 P rmit Fee: 10.00 Vd agree to 'w?t=Cil gs rcharge: .50 pd OrdinancaL Misc. Charges: 53.00 horn ` Total: meter pd BY Dote Paid: Date of Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Read WATER SERVICE PERMIT P. O. Box 21199 PERMIT NO.: r _ , '' ? Eagan, MN 55121 DATE: -?` Zoning: RI No. of Units: 1 Owner: Joseph Miller C onst Address: Site Address: 1135 Mr For Plumber: ymout R Meter No.: Connection Charge: P Size: Account Deposit: P Reader No.: Permit Fee: 10 p I agree to comply w" the City of Eagan Surcharge: p Ordinances. Misc. Charges: orn - Total: Fe ter p By Date Paid: Date of Insp.: : Iru p CITY OF E'AGAN SEWER SERVICE PERMIT 3830 Pilot Knob Raol )i44 P. 0. Box 21199 PERMIT NO.: Eagan, MN 55121PT DATE: ' "- Zoning: No, of Units: Owner: Joseph Mi er Const Address: Tiffan ss: 13 Dr L14 BI Cantebury ror Site Add, Plumber: 1 agree to eeayrly with the C*y of Eagan Ordineaees. By Dote of Insp.: Connection Charge: 425.00 pd Account Deposit: P Permit Fee: 10.00 p Surcharge: .50 r Misc. Charges: Total: CITY OF EAGAN l.? 9421 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 ,S BUILDING PERMIT Receipt Value $74r000 Date AUGUST 14_,- ly 84 To be used for SF DWG/GAR Est. Site Address 1135 TIFFANY DR Erect 12? Occupancy R3 Lot 14 Block 1 teclSub. CANTERBURY FOR Remodel ? Zoning R Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories cc Name JOS MILLER CONST Move El Length 4 ? 18133 CEDAR AVE SO Demolish ? Depth 50 Address Grade ? Sq. Ft. City FARMINGTON Phone 454-4753 SAME Name wyprovals OE of Address Assessment 01 City Phone Water 8 Sew. Police Cn W W Name Fire !? Address Eng. `Z City Phone Planner Council Permit +' 47J • uu Surcharge 37.00 Plan check 177.50 SAC 525.00 Water Conn. 470- 0 Water Meter G 3 .0 0 Road Unit 2(: O --1? 0 I hereby acknowledge that I have read this application and state that Bldg. Off. Parks the information is correct and agree to comply with all applicable APC Total $1.887.50 State of Minnesota Statutes and City of Eagan Ordinances. Var. Date Signature of Permittee . S MILLER CONST A Building Permit is issued to: on the express condition thar all work shall be done in accordance with all applicable State of PAnnesoto Statutes and City of Eagan Ordinances. Building Official 'ds!O '-Id AMADS IleM :uo!leool eq!Jn*(3 .64vM wo"o Q leu! j i ?r r, 11£1. -Ggld IOWA '00s' u01telnsul OVAH 40noa E/ "Us 'agld 46noa ??- Bu!wej j uogepunoj i j • j ?? ?, c? /irr _ ? 16u1400:1 JOWO dsul Sled uopaodeul x"94" ?` $ aulael3 jl - % L (? q f, '3'V'A'H 7, 7 I - - - 6u!gwn? oleo JeploF{ 1!wJed nN liuued MECHANI PERMIT # CAL PERMIT CITY O 3830 PILOT KNOB R RECEIPT # F EAGAN .?? OAD, EAGAN, MN 55122 DATE: ,???? B`? CONTRACT PRICE: Site Address yf d •Oo / PHONE : 454-6100 BLDG TYPE WORK DESCRIPTION . Lot Qlock l r ?? Sec/Sub Res. k"', New ?•- : ?l t: t-?-i t - r vl?._.-, 7a Mult Add-on Name f C . •= Comm. Repair m Address f fl& Other c city A? Phone 2- ES 71?1 Name e^"6444 - FE RES. HVAC 0-100 M BTU -$24.00 3 Address Z/ r If ADDITIONAL 50 M BTU - 6.00 p City Phone y r+s - (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.0 - Air Cond. M BTU Z. DD 26 MINIMUM COMMERCIAL FEE - STATE C I Vent CFM $ C F PERMITT PRICE GOES ADD $.50 S/ Gas Piping Outlets # BEYOND $1,000) Other FEE ^' S/C: rJ P Pi?A EE GN TOTAL Z' d C r, FOR: CITY OF EAGAN MECHANICAL y i CITY OF EP Fill in number Type or Print 1. Date i \ 2. Installation 3. Job Addre4l ! Lot_ 4. Owner 5. Contractor C P 6. Address 7. City State / 8. Building Type: Residential L3 Commercial ? 9. Work Description: New tO Add ? Alter ? 10. Describe 11. Permit No. Fee S/C Tot. r i Tract ie Zip Institutional ? Repair ? Type c No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Air Handlin : Mfg. g 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 CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 RCC EI V ED FROM ' AMOUNT $ on ? CASH ? DOLLARS FUND CODE AIAOU NT 7 > o 2,1 y4 Thank -7 G`U White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: t 11 1 1 1 I I I AN 'l ON c ,04 11 "hill. 'i 1 Iiti 1 ', 1 PERMIT SUBTYPE: 14 HI UI t.: APPLICANT: t?• 1 ..') ,3 .S a '.I s q i TYPE OF WORK: III ',1 N 1 i' 1 1 11N Hill I11iMh 0.'41 11 11114N N1 W ( lot 1 t 1 No 1 111+F 1I ) Kf`.MAI2K'.: A Sil.VARATV Pr R141 T IS, RFIJUIRED IOR ANY I Lti-T1r1f At 1.40Rli. INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: Permit No. Permit Holder Date Telephone 8 Sm PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I 7/iff/Icly Foundation Framing /f/4 Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Pibg. Inspector - Notify Plumber Consl. Meter EngrJPlan Bldg. Final 1 d G? ! MAP Deck Ftg. ` 9S Deck Final Well Pr. Disp. CITY OF EAGAN Remarks L-) Addition CANTERBURY FOREST L Owner Street 1135 ga(lo I)ILl ": 11) )1, 1-b . A) Al 4e,(Jhy State EAGAN MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 016 1979 Paid unde 7 original pa rcel STREET RESTOR. GRADING 5 i>? 1981 106.78 5.34 20 85.46 A013446 1-12.84 SAN SEW TRUNK Z 1973 Paid unde r original pa rcel * SEWER LATERAL 1981 439.42 21.97 20 351 5 A013446 1-12-84 WATERMAIN * WATER LATERAL 1981 20 WATER AREA p 1979 Paid unde original R, rcij, - STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 #455,09 9-1A-AA WATER CONN. 470.00 rr n aUILDING PER. #9421 r rr SAC 525.00 IT rr PARK TIFFANY DRIVE 0•A 355.00+ 37.0C+ 1 7 7 5 C+ 525.00+. 470.00+ 63.Cn 2 6 0. 0 0+ 1 c B 7 5 0 e This request void lej///9- 7 18 months from C 97235 756 -?- Sao 17° Request Dale Fire No. Hough; Inspection Requrred? Dfleady Now ? Will Notilq Inspeo- '' Dyes ?NO lot When Ready D Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Street Address, Box.or Route No. P 113 5- '-7 ' f 4? Y City E - , r a h V a ectlon o. Township Name or N q 77 County Lea ka?ct. Occupant (PRINT) Al ar Q? t ?'Forel Phone N 4fsa - ??7? Power Suppli A a kofa. El eU Address Ele at Contractor (Company Name) Midlood Flee4r« Corrtrectm s License No. r?rloro Mailing Address (Contractor or owner Making Instailationl ?soo W OPd 8urvcsVi 1l? Authorized Signature (Contractor Owner Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Gri"s-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. &j/r'jF?;, -. Q7?4F "X" Below Work Covered by This Request Add Rep. Type of Suildino Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Hearin Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Cher peci y Cher (Spemtyl _M777 pecU y ter Other Compute Inspection Fee Below 11 Fee service Entrance Size o Fee Feeders?Subfeeders s Fee Circuits U to 200 Am s 0 to 30 Am s 0 to 30 Amps Above 200 Am 1s 31 to 100 Amps 31 to 100 Amps swimming Pool Above 100-Amps Above 100_Am ' Transformers Irn -lion Booms Partial-"Other Fee Signs Special Inspection Is_jn jrl) I TOTAL FEEL, _,e bg -1- root r^(..-- l MAL-V" Rough-in /?t= tj ,tel. the Electrical 1+1 5 certify that hereby certify that the above ?ate G Final inspection has been a {rf??/ ? /?' . V? made. // This request Vold 18 months from - ` REQUEST FOR ELECTRICAL INSPECTION Ee-00001-05 See instructions for completirp this form on back of yellow copy. ??SG 3 This request void 2 A 1' )a. th. from _\ U A. 0L82 5 9 8 L(q r°?' C-ems -? b•. ?, ?.% 5a .? o Request Dare Fire No. Rough-in Inca "unt red? []Reatly Now Will Notify Inspec- -a? as No for When Ready u Licensed Electrical Contractor fl barebv request inspection of above IrJh Owner electrical wark inatallrM at. Street Address. Box or Route No. CiI e ion o. o Name ar o. Range No. C ty Occupant (PRINT) . Phone No. I Y OUer Addr A ^?? ? ,?„f ?/lylail`ri Electrical contra [or IOOmaa Na ) - C n r tot's L' -erase o. Maili g A dress Contractor or r Makin, Irsb ti Hon/ - A th d ignatu C tra or r inp ns i atim) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS 1NSPECTIdN REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER-WSPECTION FEE IS Phone 1612) 297-2111 ENCLOSED. "?_ ?1t^? 00 REOUEST FOR MECTRICM..)NSPECTION EB-OOMI-04 , See instructions for. rnigpleting this f... beck nt Vallee, copy. A- n Q 9 r:Q Q "X" Below Work Covered by This Request I'1e4AddrBep-r TVee of Building I Alrpliances Wired I Equipment Wired Bulk # Fee Service Entrance Size, It Fee Feeders?SuMeedars g Fee' Circuits / to 200 A s 0 D to 30 A 3e,' to 30 Am . bove 200 Amps 31 to 100 Amps j p 31 to 700 A Swimmi Pool Above 100- Above 100-Ang1s Transtorneirs Irrigation Boobs ,y Partial'Other Fee Signs Special Inspection 5 f? TOTAIL--F1-IE' Remarks ( I . Rough-in Da in n ?/ 1 ¢ patter. Y certify tha J . Final Date pettion has I = r /YJi This request Void '18 months tron - - '- 2tl7_ r 0 s CITY OF EAGAN M 9421 ^ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 /?? PHONE: 4548100 t7L BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $74r 000 Date AUGUST 14 19 84 Site Address 1135 TIFFANY DR Erect IN Occupancy R3 Lot 14 Block 1 Sec/Sub. CANTERBURY FOR Remodel ? Zoning R I-- Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories - Name JOS MILLER CONST Move ? 9 Length 4 z Address 18133 CEDAR AVE SO Demolish ? Depth 50 9 City FARMINGTON Phone 454-4753 Grade ? Sq. Ft. F Name SAME E Address City Phone Gp k,W Name Address W City Phone Approvals Fees Assessment _ Water & Sew. Police Fire Eno. Planner _ Council I hereby acknowledge that I have read this application and state that Bldg. Off. the inlormotion is correct and agree to comply with all applicable APC State of Minnesota Statutes and City of Eagan Ordinances. Var. Date Signature of Permittee A Building Permit is issued to: JOS MI all work shall be done in accordant with all ppl Permit S 355.00 Surcharge 37.00 Plan check 177.50 SAC 525.00 Water Conn. 470- 0 0 Water Meter 63.00 Road Unit 960- n0 Parks Total $1.887.50 on the express condition that and City of Eagan Ordinances. Building Official ALAI/, CONTRACCY.QR/S MUST BE LICENSED WITH THE CITY OF EAGAN 1l? ? INCLUDE © SETS OF PLANS. fib L ( / © CERTIFICATES OF SURVEY SET OF ENERGY CALCULAT To Be Used For: Valuation Date: Site Address: 4??• • • Lot: Block: LSect/ u Erect: Occupancy: - Parcel #: Remodel: Zoning: Repair: Type Of Const: Owner: Enlarge: # Stories: Move: Length: gyp, Address: Demolish: Depth: 5D ;t /Z' C A C Grade:' Sq. Ft.: i y ip o e. Phone #: Contractor: { ®• Address: jr) Assessments: Permit: ?j Water „??{;may(/yti jx ,?1IJ1 Sewer: Surcharge: City/Zip Code: Police /? --?? Police: Plan Rev.: Phone 4-s- - w??3J Fire: SAC: 525.° Engr.: Water Conn: 4-ID.°- Arch./Eng: Planner: Water Meter (,-5t Address: Council: Road Unit: 2(00.°-` Bldg. Off.: T7 Parks: City/Zip Code: APC: phnno*- Variance: /I kk7. 5 0 (7w, , t N I? 'N I I 4 r? ?Np O ^n V ? /ROBE ENGINEERING COMPANY, ?1000 CAST 14161h CONSULTING tNG NttAS PLANNlAS and AND iURV(VORS INC. 130,1- ra P46E &7- STREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000 LA-ast ?`??'r?Pa'>r0 • L0T /¢, BLOCK /, CANTE?f'B//RY FOREST, oAeor4 COUNTY, 141/1111YES,07, ,,, [_C is /G 57 E N 79,59 a . s I Z07- 1-f NORTH 1 ?1 SCALE: 30 t ??? °'; DENOTES EX/ST/iYG ?; r ?? bey ? ?- C?3zxo, ELE!/AT/ON Ow o) DENOTES RPOPOSED %.) ELEli,9TiON ? ? X933-0J / PRO g6.p0 X /ND/G'ATES 1?/?QECT/ON OF SURFACE / ? ? ? DRAINAGE\2,? ° sy r°r v I 9 ERR Qo 3,9? N 5 M F/N/SHED GARAGE FLOOR d26Px7lowx 92.&,o Or- $J r ?o ?o e v J o' F,eoA/r B!/li.,Pl G SETBACK L/NE II hereby certify that this is a true and correct representation of a tract of land as shwa' And described hereon. A. prepared by me on this 3Rj> day of A? ??sr 19 9A-, ` ""'?_ Minn. let. No. /z-095 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: Ole- BUILIIN 024131 07/15/94 SITE ADDRESS: 1135 TIFFANY DR LOT: 14 BLOCK: 1 CANTERBURY FOREST P.I.N.: 10-16350-140-01 DESCRIPTION: ^1. (DECK INCLUDED) Building-Permit Type SF PORCH Building Work Type NEW REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY- VALUATION Base Fee Surcharge Total Fee $6,000 $81.00 $3.00 $84.00 CONTRACTOR: I? OWNER: - Applicant - VASUTA JOHN 1135 TIFFANY DR EAGAN MN 55123 (612)337-9343 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 Ordinances. APPLICANT/PERMITEE SIGNATURE -flaa RJdj ISSUED e : SI ATUR I CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION l? 681-4675 b SINGLE & MULTI-FAMILY ednsile' urve , 1 copy of e nergy 2 sets of plans, 3 registe L calcs. 1 1994 COMMERCIAL plans, set of 2 sets of architectural & _ specifications, 1 copy of - Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 7 Valuation of work IB?OI Site Address: 1135 Tr?FAW DRIVE STREET SUITE # Tenant Name: (commercial only) LOT ' l BLOCK ' SUBD. CRP[&fiP P.I.D. # ad &d Description of work: en01050C Of &cdc screened ? seasen arch and oew did ad&d The applicant is: ® Owner ? Contractor ? Other (Describe) Name MUTA JOHN Phone (hams) 686 5891 Property LAST FIRST work 557-73Y3 Owner Address 1135 VIFFRA(Y DRIVE STREET STE # 55)x3 MN Zip City State Company Phone Contractor Address License # Exp.- city State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Alp, Processing time for sewer & water permits is two days once area has been approved. 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 Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ; 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck WORK TYPE PCB rc,4 , ?• ?v?es Ack 13'31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATIO N Const. (Actual) Basement sq. ft. (Allowable) 1st F1. sq. ft. UBC Occupancy 2nd F1. sq. ft. Zoning Sq. Ft. total # of Stories Footprint Sq. ft. Length On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REQUIRED INSPECTIONS ? .Site ? Footing ? Wallboard ? Final J2 Framing ? Draintile / V o/ i ?- Insul ation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Copies Other Total: veltmtim: $ C?(9C5 1 y? jo - t /d k V ?F ? ?6 Bas'AnirFinish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRY Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments J SAC % SAC Units >k?Y,tYxx`?t%kXtXtYXMMYFM)n?'aKh",$UY?tY, RtRt>%8S>$?%?X?'tY6wktXtY,S%?)F$t?( CITY OF EAGAN CASHLER: S C'ERMTNAL NO: 768 DATE. 08/1.9/99 TIME -.1 09:26;150 IDS NAMETHERESA F., MOLNAR 300 001 1135 TIFFANY UR 631.80 205 9001 WS TIFFANY DR 0.90 Total Receipt Amounti 64.70 MEMO USER ID; NANCY riS.",tYFBt?k ?X:X>;S?FY6>X?K7XYFkYF?kYF?kMYFHcM>k?t'm"',k?X'X o1<.M?'CXt?X1Y1k?k?X r r ,:. o _ .' ,, emirs d 1 J --.....:.,,.,;.......,,.......,...ti. n.vv 41..51 inas_ ;Il!*alr C c`.-: !:.I E.a -1 ;4 --f -:.,.x'. a _ ' c $tAk. T } +.'•, f ? F c? t_ ;LOT f? B/tJ l3C/- ?r4NT?,"?'Bffi?'y Faf{ET f ffAkdrfl ' . :. ... .. .. ... ._ cvmNT.Y,- ly//YNESC?f. ? L07-12 ? '; ,y cgs'?Z?57"E a p 79, 59 t`•. 3a.o ?_ ? ?q'Qss S k L,07- /4 ' scAC?T 3 .4i / oar 20 M1 1 d k 1 ec jrpvch 31, MyRA N o??EO ? 3 ? ` Q t!?e\ ad "o ZZ, s .:,\ 309 ,?o' , J X 30' MOAlr BUkDJN4 3 yl J '« /•il• f! t /-li?e? 1. F.f n . C.C-.:Y.T ??!C{ . '?:i4i 72(?.a .4,+? A+?5j?{y: ?' 1 1 C'N 4~1 w. ?r b?t'?S \i1?S 4F.1? {- .y (i`:.a?. ij AQ IlM 4:? ?? ae P t Yxb ? ?. .ylV Re 1??t Yi• .ii. fj LA?Ct?L L'h Ci hereon.. ti. `i pr 4, Dt' F,a Gfl thtk C' ?n (y 1 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)' P?- 70 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681.4675 New Construction Requirements Remodel/Reoak Reautremenh Y 3 registered site surveys showing sq. ff. of lot, sq. ft. of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions 2 copies of plans (show beam b window sizes; poured fnd. design: etc.) 1 site survey for exterior additions b decks D 1 set of energy calculations 3 copies of free preservation plan ti lot platted after 7/1/93 DATE: I -6'19 CONSTRUCTION COST: ? 1800.0° DESCRIPTION OF WORK: rejoe-i r bcca 'la of ro0P 4 SAtsasc STREET ADDRESS: IL3S- TrtWbg s Or L LOT: -VL BLOCK: SUBD./P.I.D. #: / cr(LTf S-1 PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: MOViar TnecGSC, Phone #:(W) 6S L-3 0-?-tco- Lost First Street Address: t t 35 - PFas\.( Or City Frarstl State: mlLl Zip: SSL- 3 Company, Phone #: ` (area code) Street Address: License # Exp. City Telephone #: area code Street Address: State: - Zip: Company: Name: City Sewer (L water licensed plumber (reaulred for new constructlon only): Registration #: State: - Zip: Penalty applies when address change and lot change Is requested once permit is Issued. 1 hereby acknowledge that I have read this application, state that the Information is correct, and agree to comply with all applicabi State of Minnesota Statutes and City of Eagan Ordinances. Si gnature of Applicant: AL 'ad; OFFICE USE ONLY ' 0% r l 71 e Certificates of Survey Received Yes No j ! AM 1 81999 lil Tree Preservation Plan Received - Yes - No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof • Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft, sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Valuation: $ 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: Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance SAC Units % SAC . C II 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: _ 1 1.3,0- / %??A ?v P,' J/?Ya dk a / '? ves f LEGAL DESCRIPTION: Zp f /y (3/ / (Int/Block/Subdivision or Tax Parcel I.D. Nusrber) ! IF Z?IE•i:::G STRUCIIjRE , DATE OF ORIG IAL EUILDIIG PE_m:IT ISS,:A% : PRES= ::nNINt;/PROPOSED USE: E (R-1 SINGLE FAIMILY ? R-2 CUPL M0 EMITS) ? R-3 TC6v-LqFCUSE (Tf Rte. + UNITS) ( WITS) ? R-4 APART!MIT /CC'i '' Zj M- IJU ,T ( WITS ) T/ T ? CaMIE.CLAL/f?C.i I,/0FFICE ? L%DUST. I.AL ? INSTITUTIONAL/GOVE.R114a%7 2) APPLIG Nr (PLEASE PRINT) NAME: 70-- C°a,vsf ADDRESS: 18133 C'.edw, /9 nC CITY, STATE, ZIP: A"w:•+t ?v ,J 4-6o S PHONE: 3) PLU•IBER NAME: PLEASE PRINT) /1 "'/ 2 FOR CITY USE ONLY ?-> ~0':1 / re.W ; j, g, ZAr- ADDRESS: /g128 23.j .Que. .J PLUp CENSE; LI Act ive ? CITY, STATE, ZIP: ssydj 426 AN Expired PHONE: -AASiEO 3 7( PLUMBER LICENSE a J&Q Vy3 Q Npt? f Record a n:tta 4) OCCUPANT/C7,,7I•TER NAME (PLEASE PRINT) : ADDRESS. CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH PERMIT IS BEING REQUESTED: jg-CONNECTION TO CITY SEWER ® CONNECTION TO CITY WATER ? OTHER (PLEASE DESCRIBE) 6) INDICATE ONE: ® PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE ? PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4 ABOVE tG) (Circle one) ? 7) SICZ ATURB: ? /.y DATE: 0, 4 6 f3Y feeeaae??ssuieafaEOa:fefefs'+sfss ... . ... aFiifl>A s E ?i?i t? a at fie fei?yely?js fe fft ? S?saa? ? F O R C I T Y U S E O N L Y PERMIT i ISSUED FEES: $ Od ...s d SETAER PERMIT (I`ICLUDE SURCHARGE) $ / D. 5 WATER PERMIT (INCLUDE SURCHARGE) $ 9- WATER METER/COPPERHORN/OUTSIDE READER $ WATER TAP (INCLUDE CORPORATION STOP) $ SEVER TAP $ ACCOUNT DEPOSIT - WATER $ c?7? o-a WAC $ SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SE[•IER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL $ AMOUNT PAID/RECEIPT # A,,? u l DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR 'AORK.WITHIN / PUBLIC ROADWAY" MUST BE ISSUED BY THE © NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: L/ ,El J?? DATE: / - S - pj City of EaRtu 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 I I Permit #: I Permit Fee: I Date Received: I __ St _aff 22008 RESIDENTIAL PLUMBING PERMIT APP Date: $ (?O Site Address: I I??J T4?0,4/\Q Tenant: 1 2 2008 RESIDENT / OWNER Name: l Q?? 1 1 Y LQ` YA m- Phone: lost (?? 9 ?1 -1 Address /City / Zip: 0 A'Yl 0 as Q-b V:c , CONTRACTOR `n Name: JO 1 t,? Y lp /1C2 License #: C)10 I &;)_-R ? 9 ( A S 2 L v ' j , c? l Address: r l S 25Y1 a (D ?1 ?? City: State: AJ Zip: 5535 v? () Yl / I 1 11 9'10K Ph P a ? k I ? C C" one: , ontact erson: , TYPE OF WORK -- New _ Replacement _ Repair Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater -Water Softener Lawn Irrigat' Add Plumbing Fixtures L RPZ PVB) Main _ Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in Eagan; that I understand this is not a permit, but only an application for a permit, and wo accordance with the approved plan in the case of work which requires a review and appro I x Jet G G/16t x Applicant's Printed Name licg ance Nth the ordinances and Codes Of me c:lly Of to st9rr without a permit; that the work will be in Reviewed By: Date:- :,Rough-In;: „AlrTest Gas Test Final f;e X309