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1167 Tiffany DrCITY OF EAGAN Permit No: 3640 Pilot Knob Road Meter No: P.O. Box 21199 Reader No: 3? `? P _? ?? Eagan, MN 55121 to Addres lumber onn. Chg: cct Dep:_ ermit Fee: urcharge: r. Plant- Meter. Laubach Const: Data -7- ;7 Sizes " oclf Date: ? ? ` - WATER I,ie#oAc?ly a ity of Eagan e r. Y ICE PERMIT .. ?-aw----FESS?-w- -^-: -i1p•Y , +y.K.,,,?..et?.-. ?.,, -,?,s? -v,r-; - ? .-_??U.-?-+.-.-n. - . -- k CITY OF EAGAN Permit Na Date: 5-7--2.7 3" 30 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner. Site Ad Conn. Chg: 52-5. 00 Zoning: Acct. Dep:? i§ go No. of Units: Permit Fee: jgj,1 Surcharge: I agree to comply with the City of Eagan Tr. Plant ??agTgk? Ordinances, i Meter. (7 00 Misc.: B W y ATER SERVICE PERMIT CITY OF•EAGAIq _ 3830 t°Ilo't Knob Road SEWER SERVICE PERMIT P.O. Box 21199 PERMIT NO.: lOC9:? Eagan, MN 55121 O DATE: Zoning: - 7;1 No. of Units 1 Owner: Laubach Conat Address: Site Address: _ 1167 Tiffany Lr L? 1 (,an e Plumber. Svenz a mp h "Y Fo Pitt BFRV 74378 6-5-87 100.00 I agree to comply with the City of Eagan Connection Charge: c7? 00 Ordinances. Account Deposit: Permit Fee: 6 Surcharge: Y Misc. Charges!- Date of Insp.: Total: Insp.: _ BLDG. PERMIT NO. 01-3210 Bldg. Permi 01-3422 Plan Check 01-344P Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permi 20-3743 Sewer Permi 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL ^'' } CASH RECEIPT;. I CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19'? RECEIVED FROM AMOUNT $ A DOLLARS goo ? CASH CHECK FOR \f BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You ' CITY OF EAGAN 3729 ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value Date ,19 Site Address Lot Block Sec/Sub. NNTE>tBUeY FORS Parcel No s Name W 3 Address o City Phi c0 Name 0 Address IE City Phone U¢ W WW Name g Address z City Phone 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. UPPIGe use L)NLY On Site Sewage Occupancy MWCC System Zoning On Site Well Type of Const City Water (Actual) (Allowable) of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC, City Engr. SAC, MWCC i Planner Water Conn. Council Water Meter Bldg. Off. Road Unit APC Variance Treatment Pt Parks C opies Signature of Permittee TOTAL 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 Permit No. Permit Holder Date Telephone e Plumbing .1 5" Electric (`Vi`a 7 77 /G C??,??$ 7 9?J Softener Inspection Date Insp. Comments Footings I 6 Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace 9 Final Htg. rD3a Final Plbg. Bldg. Final ?U ZZ Cert. Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. 5 a At . 10, Trrtifiratt of Mrrupaury citp of Cagan lorpom if of wwatna jmvjprtwn 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 ivarious ordinances of the City regulating building construction or use. For the following.- Use CUnfimon SF DWG /Cr.a PCRM( No. 13729 oaumv-y Type R3 Zoning District R I Type ra v Oww of Building ;.AUBACH (:C : ? FIt)6 347 MAPLr ST-Afl7 RD. B' VTLLE Building Addmw 157 T I FFA:" LOM14 -2, B1 5 , N : 7"is I : R `' 70RES T D..: -)CTOBER 30. 1987 Building Officud POST IN A CONSPICUOUS PLACE CONTRACT Site Address Lot ? Name Addre c City ? .-fry PERMIT # y-- PLUMBING PERMIT 2 2 CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE f kls PRICE PHONE: 454-8100 / « 7 r, f1 4,Y 1) ; i)&-, 11 BLDG. TYPE WORK DESCRIPTION Name Addre O City-' FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE _$10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) OF FOR: CITY OF EAGAN Res. New Mult Add-on Comm. Repair Other FIXTURES w Closet = $3.00 Tubs - $3.00 tory - $3.00 war - $3.00 en Sink - $3.00 it/Bidet - $3.00 dry Tray - $3.00 Drains - $1.50 r Heater - $1.50 Ipool - $3.00 Piping Outlets - $1.50 ;ner - $5.00 T TAL c' C ',LAC oc^ vveu - a i u.uu Private Disp. - $10.00 =Rough Openings - $1.50 FEE y'L1C STATE SIC: SG 9' J GRAND TOTAL, PERMIT # MECHANICAL PERMIT i ' RECEIPT # CITY OF EAGAN -9-4-87 x ?G 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE b 7 CONTRACT PRICE: PHONE: 454-8100 Site Address any r' BLDG. TYPE WORK DESCRIPTION Lot ?Block /Sub ? ec Res. New Name A C INC Mutt Add-on -°' Address 403 , 0 beau Comm. Repair c City Ewan Phone 452 -277 Name ' CONSTIIUCTION FEES RES. HVAC 0-100 M BTU -$24.00 3 147 Address Maplig Tglaxid Rd. ADDITIONAL 50 M BTU - 6.00 O City mirn myi 1 1 Q Phone ES. HVAC UDES A/C ON NEW C ON STR CTION GAS UTLET INIM M S (M O U - 1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air Rn,nfn M BTU APT. BLDGS. - COMM. RATE APPLIES Boiler M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. +•o M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent CFM STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # $ 1 4n BEYOND $1,000) Other FEE: 25.5 S/C: SIGNATURE OF PERMITTEE TOTAL 26•p FOR: CITY OF EAGAN L INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: t 1 It I N'' 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ? ilhi I i i.?.i1t } i 11:it 51 I ?• I i . :?? ( i J PERMIT SUBTYPE: TYPE OF WORK: ,,? w IN FR7/(W; i rNt ? Permit No. Penult Holder Deft Telephone N ELECTRIC PLUMBING HVAC Inspection Dote Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE AIR TESTCE '( 4A???f FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks- 1?. I U ??I Z L ?/ Addition CANTERBURY FOREST Lot 2 Blk 1 Owner Street 1167 TIFFANY DRIVE q*jo i ,:7 r Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1979 Paid undo original pa rcel STREET RESTOR. GRADING SS.46 A0134" 1-12- SAN SEW TRUNK 1-7,1 1973 Paid und8 origitial pa rcel * SEWER LATERAL r-A;5 19$1 439.42 21.97 20 SSI S4 A0134" 2-84 WATERMAIN * WATER LATERAL 1981 20 WATER AREA 410S 1979 Paid unde Orl inal cel STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK RESIDENTIAL ?r'? BUILDING PERMIT APPLICATION I CITY OF EAGAN 3830 PILOT KNOB RD - 55122 J 5 7 651-681-4675 New Construction Requirements RemodelfReoairReauirements 3 registered site surveys showing sq. ft. of lot, sq. ft of house; anchll roofed areas . 2 copies of plan (20% maximum lot coverage albwed) . 1 set of Energy Calculations for heated additions 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks 1 set of Energy Calculations . Indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan I lot platted after 711193 . Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE P-a5=0i JOB SITE ADDRESS l /l 7 Tr• f-L-, k q IF MULTI-FAMILY BUILDING, HOW MANY PROPERTY OWNER L TYPE OF WORK APPLICANT ADDRESS 165-51 S PAGER # VALUXION #;?1000 . DD FIREPLACE(S) . _ 0 )? 1 - 2 PHONE# y5? By/-,?6 ?o CODE 5'59 4Y ?4 FAX # NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted Plumbing Contractor. Plumbing System Includes: Mechanical Contractor: _ Mechanical System Includes: Sewer/Water Contractor: - Air Conditioning - Heat Recovery System Fee: $90.00 Phone # Fee: $70.00 Phone # All above information must be submitted prior to processing of application. 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 Ordinance . Signature of Applicant ] i --J CELL PHONE # Water Softener Water Heater No. of Baths _ Phone Lawn Sprinkler No. of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received Not Required _ Updated 1101 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or - N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) FinaUNo C.O. Footings (addition) Foundation Drain Tile Roof _ Ice & Water _ Final _ Other Framing _ Pool _ Ftgs _ Air/Gas Tests - Final Fireplace _ R.I. -Air Test -Final _ Siding _ Stucco _ Stone Insulation _ Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Plumbing HVAC This ran a^ /5/?Q 18 month. C -qem 9 0 .? ,Zl °i Now?&Will Notify. Inspec- mr When Ready El Licensed Electrical Contractor 1 hereby request inspection of above jikO--.r electrical work installed et: Street Address, Box or Route No. ;' li i IF F/IA' y DxfV f - City FA'fA .1. Incline No. Township Name or No. Range No. County ^ Occupant (PRINT( 72/tou1.i5 POl'TSyL Phone No. 3VZ- Power Supplier (?? ud r q ?t?cT#+ C Address Electrical Contractor (Company Name) Con trartor's License No. Mailing Address (Contractor or Owner Making Installation) _ !'767- )SLtiES)LL- CllZcl T ?i9CiPu- f ? 7?J22 Authorized Signature (Contractor Owner Making Insta llatlonl Phone} Number D 9 C C H q 5'-2 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1021 Un1 97Ave., St. Paul, MN 66104 Phone (6122) ) 297.2111 ENCLOSED. (p/?j/Sf7 REQUEST FOR ELECTRICAL INSPECTION yEB-000001-04 See instructions for completing this form on back of Yellow copy. /??? / ` "4 49 Q X" Below Work Covered by This Request Ana Rep Type of Building Ablation... 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 pec? v Oih,:r lSper.ifyl t nr Spea y Other Other ompute Inspection Fee Below a Fee Service Entrance Size R Fee Feeders/S.bfeeders b Fee Circuits 0 to 200 Amps 0 to 30 Amps 0 to 30 Am Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swi mini ng Pool Above 100 A Above 100_Amps Transformers Irrigation Booms E Partial 'Other Fee Signs Special Inspectio S F T A N .marks EE , ?7 V jam.! ^?;,/.'ii/.%? Inspector, hereby =? i ?!? r''t ?? 0 1e center that the above Final inspection hes been meas. This request void 1S months from . -4.4 2 9 5 754 8-1W qe? 0-0 request uate 'tire NO. nougn-in !TPecOOn Required? ?fleady Now, Nill Notify lnsoec- '&hyas/I AflNn i _ for When fleedu Licensed Electrical Contractor L' I, ' -? ? I hereby request spec lion of above rI 'Owner electrical work installed et: V Street Address, Boa or Route No. 11,67 TIFPA-r Dolvz City / Fig ?N Section No. Township Name Or No. Range No. County Occupant (PRINT) T'YoriA C. ? ?aTTR12 Phone No. '. $y Power Supplier VAK0r.4 EtrcY/Li( Address Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) 1762 QL-V661L " r- l/e.LCS4 1"1 -,1.N ti 5 f A [we (Contra tor ;O Installation) Phone Number MINNESOTA STATE BOARD 4 ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 Uniyersity Aye., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone 18121 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION yE13.00001 oa /- See instructions for completing this form on back of Yellow copy- "X" Below Work Covered by This Request 295 N.q Addl Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heatm Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other pectv lher ISDecifyl Other (Specify) ter Other oInspection Fee Below p Fee Service Entrance Size it Fee Feedeis/SUbfeeders # Fee Circuits 1 0 to 200 Amps 0 to 30 Amps 0 to 30 Am s Above 200 Amps 31 to 100 Amps 100 q s 41- 0 Swimming Pool Above 100 _Amps Above 100_Am>s Transformers Irrigation f3oorc?s Partia l,'Olher Fee Signs Special Inspection TOT " Remarks Rough-in Final c Date I1' I, the Electrica71 l Inapector, hereby cerlily that the i love /Date inspection has been made. This request Vold 18months lrom _?7/? ( ? • CASH RECEIPT • CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNES TA 551222 DAT T i9 eD 67 aM AMOUNT $ ll(J I ,?(J & DOLLARS CASH ? CHECK 00 7? d FUND CODE AMOUNT c O ?? c 'Z 1/4 qq C/ CI el / C U UG ! Q L / 01( % O c Thank You N_ 76222 - White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN 3$30 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 PHO N E: 454.8100 BUILDING PERMIT To be used for SF DWG/GAR Est. Value $139,000 N_ 13729 Receipt # --7 4 3-70 Date JUNE 5 19 87 Site Address 1167 TIFFANY DR Lot 2 Block 1 Sec/Sub.- Parcel a Name LAUBACH CONSTRUCTION Address 347 MAPLE ISLAND RD City B'VILLE Phone 435-6713 U¢IName SAME o ? Address P CityPhone a w Name- z Address a w City_ I hereby acknowledge that I have read this that the information is comec degree to col State of Minnesota St es City of E Signature of Permit A Building Permit is issued to: LA B all work shall be done in accordance with all Building CANTERBURY OFFICE USE ONLY On Site Sewage Occupancy - MWCC System ? Zoning On Site Well Type of Const City Water X (Actual) (Allowable) * of Stories Length Depth SF. Total Footprint S.F. APPROVALS Assessments Water/Sewer Police Fire Engr. Planner 'ication nd late Id .Off. with a ap l le A actin c riance ONSTRUCTIO dice I tateofMinnesoJg: FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks Copies R3 ---RT-- $ 620.50 679.50 310.95 tnn_n0 525.D0 525.00 67 n0 X305 0 X60 TOTAL $9,-.209 5 on the express condition that and City of Eagan Ordinances. city of eagan PATRICIA E. AWADA Mayor PAULBAKKEN PEGGYCARLSON CYNDEE FIELDS MEG TILLEY Council Members THOMAS HEDGES CiryAdministrator Municipal Center. 3830 Pilot Knob Road Eagan, MN 55122-1897 Phone: 651.681.4600 Fax: 651.681.4612 TDD: 651.454.8535 Maintenance Facility: 3501 Coachman Point Eagan, MN 55122 Phone: 651.681.4300 Fax: 651.681.43150 TDD: 651.454.8535 v ..cityofeagan.cum THE LONE CAKTREE The symbol of strength and growth in ou rommhmiry January 16, 2002 MR. BILL POLLOCK EMMICK CONSTRUCTION INC 15146 DUN BAR BLVD APPLE VALLEY MN 55124 RE: 1167 TIFFANY DRIVE BUILDING PERMIT #47910 ISSUED OCTOBER 25, 2001 Dear Mr. Pollock, On December 5, 2001, you and I met with Owner Thomas Potter to inspect a new roof recently installed by Emmick Construction. Mr. Potter claimed the roof leaked near the chimney. A re-inspection revealed the following items that need to be corrected: • The Building Code requires 4 nails per shingle; numerous shingles had only 3 nails. • Step flashing was not installed correctly. • Shingles above skylights & vents were incorrectly installed. You agreed to make these corrections within two weeks and call for an inspection. On January 11th, Co-Owner of the property, Lynn Renz, called our office and stated that no corrections have been made to date. Attempts to contact you via telephone have been unsuccessful. Please contact me at 651-681-4697 by January 30, 2002 to discuss a resolution to this situation. If you fail to do so, a complaint will be filed with the Minnesota Department of Commerce. Sincerely, e? ?Frevel Building Inspector cc: Ms. Lynn Renz, 1167 Tiffany Drive, Eagan, MN 55123 Mr. Thomas Potter, 1167 Tiffany Drive, Eagan, MN 55123 Dale Schoeppner, Chief Building Official PERMIT #: 7 O ? Z Y/ CITY USE ONLY RECEIPT DATE: 8008 RESIDENTIAL MECHANICAL PERMIT APPLICATION crrY of EAem 3830 PILOT KNOB RD BAGM MN 55188 ! -- 1 9-0 2- J 651-661-4675 Please complete for, ? single family dwellings townhomes and condos when permits are required for each unit Date: -? n n SITE ADDRESS: //b7 / ;7'7or) OWNER NAME: 4 n /I 2 pen z INSTALLER NAME: J?Y)C STREET ADDRESS: TELEPHONE #: TELEPHONE #: ® 5> / • M54. 4'7'Js CITY: L as co STATE: M to ZIP: 6 S/ o? aZ Place a check mark next to the permit work type Add-on, modification or alteration to existing dwelling unit $ 30.00 • furnace replacement • air exchanger • air conditioner • other f I /4n ri I A i r P k ? i A ip wor o : $ Q r Urvti i 4i er State Surcharge $ .50 o Total $ 30 #6 ?2 F1 SIGNATUIV, (V PERMITTEE O T"' t/02 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: 8008 COMMERCIAL MECHANICAL EMIT APPLICATION CITY OF EAGAN 3$30 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: SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: STATE: ZIP TELEPHONE #: WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing inspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removal/installation = minimum fee Contract price: $ xl%=$ (Base Fee) State surcharge calculate at $50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/02 l3 ?a9 - CITY OF KAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 7 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, e $2,000 LANDSCAPE BOND 'Z' I - fo o To Be Used For: ` Valuation: Date: Site Address 16 /9 T A6L Lot 01 Block Parcel/Sub Owner Address City/Zip Code vvy?7 /- '-] Phoney Contractor Address City/Zip C?oJde 2 OLLL Phone Arch./Engr. QI1t//1Glif? Address City/Zip Code OFFICE USE ONLY On Site Sewage MWCC System On Site Well _ City Water ? APPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance Occupancy Zoning Type of Const (Actual) (Allowable) 4 of Stories Length Depth S.F. Total Footprint S.F. FEES R•I G 4dv Permit (O LO. Surcharge Co'I.O Plan Review 10. SAC, City IC)O. SAC, MWCC 525 Water Conn SZS Water Meter p7. Road Unit Treatment Pl 180- Parks Copies TOTAL ?2 : a" R's- Phone # ? X z(` -l 35`- x (2_ 89 za a-?k, x 5LS ?6 I2 t2= (4?tk, = ???? I 'URVEYOR'S; CERTIFICATE \1 S? 1898.9 ` 1 1 I ?? tIDJ ?? L 551 0 006 3 901.3 (i /"? ? N6 0 3v 00,2 1 f Z o 907.0 ? 903.. ?L 900.0 30 \ 9x9.1 ? . O ? ?q99/ c: ?O 'Z \ COs _O? \\ \ ?G 1 \ \ 909 O 0 10 V u!oo ?J . 0 00 Zx913, QZ , ,?`` ,3Q E 1 l? 006 s r1 1 l 1 i N l " J REVISED 5-28-87 TO SHOW FROppppSED HOUSE 8 EXISTING ELEVS. FOR LAUSACH CONST. REVISED 5-29-87 O DENOTES IRON MONUMENT SET * DENOTES IRON MONUMENT FOUND CI DENOTES WOOD HUB f000.010ENOTES EXISTING ELEVATION SIENNA CORPORATION I i r SCALE: 1 INCH = 40 FEET PROPOSED GARAGE FLOOR - 9o s.4 FEET PROPOSED LOWEST FLOOR S9'1. 'I FEET PROPOSED TOP OF FOUNDATION = 9 o 5,K FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 2, Block I, CANTERBURY FOREST, according to the recorded plat thereof, Dakota County, Minnesota. AND OF LOCA FROM ORTON SAIDTLION AND OF-AL ASLSURVEYEDGBYTMERTHIS I6TfALLDAYSIOBLE ENCMAR HMENTS,'I19B3Y. APPROVED FOR SIENNA SIGNED: JAMES R. HILL, INC. CORPORATION BY: BY: DATED THIS DAY 4HAO06CNETERSON, LAND SURVEYOR OF , 19- MINNESOTA LICENSE NO. 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 82143 (8-1 333 z1B3 Z3 Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenue South FOLDER Bloomington, Mn. 65431 812-884-3020 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION 00IER: Lynne Renz and Tom Potter SITE ADDRESS: 1167 Tiffany Drive - CONTRACTOR: Laubach Construction, Inc. DATE: June 6. 1987 PHONE: 671 DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA........ 2444.25 sq ft x "U" .11 312.9 2. TOTAL ROOF/CEILING AREA........ 1749 sq ft x "U" _025 43.7 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor........ 9406 a) Total wall window area: sq ft 9 glazed...... 277.25 sq ft x "U" .46 V 127.5 3 glazed...... n^x^rxx sq ft x ''U" .37 . l d 63 sq ft x "U" .13 tl.2 b) oor area ......... Tota c) . Total sliding glass door area: 2 glazed...... 42 sq ft x "U" .46 19.3 3 glazed...... sq ft it "U" .39 d) Total fireplace wall area 120 sq ft x "U" .03 3.6 e) Total wall framing area (Average 109).......... 191 sq ft x "U" .06 11.5 f) Total net wall area above floor (Igsulated)...:*.. 1714.75 sq ft x ."U" .03 51.4 g) Total rim joist area...... 275 sq ft x "U" .03 •8.3 Total foundation area (Exposed):........ 161.25 sq ft ' h) Total foundation window area............. 43.25 sq ft x "U" .46 19.9 1) Total net foundation l l ;t erea above grade........ 116 sq ft x .06 . 3• TOTAL a) thru 1) 256.u If Item P3 Is the some as, or less than Item /1. you have amt the intent of S.B.C. Section 60D6 (c) 2. A. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/telling )) Total skylight area....... 16 sq ft x "u" .46 • 7.4 k) Total roof/cellinq framing area (Average 10l,)...... 173.3 sq ft x "U" .02 ? 3.5 1) Total net insulated roof/telling area....... 1559.7 sq ft x "U" .01 15.6 4. TOTAL J) thrv i) 26'5 if total of 04 is the same as, or less than F2. you have met the intent of S.B.C. Section 6006 (c) 1: ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items. F3 and F4 shall not be greater than the sum of items F1 and 02. . IN i. 312.9 + 2. 43.7 356.6_ 256.6 + 4. 26.5 - 263.3 3• C E R T i F I C A T I 0 N 1 hereby certify that i have calculated the "U" factors and "k' r values herein and that the buildinn here described meets or exceeds t state, of Minnesota Energy Conservation Act. n ' June 2. 19U7_ (Date) HALL VAAMWC SECTION!- - 41 Interior air flies aterior a "'•• SECTION (INSULATED) TOTAL R - 17637 it - 1/R - .a6 DATION SECTION: -41 interior air film 0.99 11•" at ofoar 12" concrete block 2.27 Exterior air Men ft- 17 1 " styrofoam •? TOTAL R - 18.12 . V ?, 1/R - •06 SLAB ON 6iADE .a..Q Q.•?„ 0 . % . t. / .03 ST SECTION: ... . to 11 - i/R - .03 VENTED . COIISTRUCTION !' R VALUC- CE I LING SECTION (INSULATED):' y Interior air film 0.91 2 " sheetrock .39 3 0" fiber lass 0. A Exterior air film still #)-AT TOTAL R 61.61 Ua 1/Ra .O1 CEILING, FRAMING SECTION: I Interior air film 0.61 2 B" sheetrock .39 3 1 5" fiberglass 43.5o A Interior air film still r). AI 5 " inches soft wood 6,93 TOTAL R x52.0 U - 1/R a .02 CEILING. SECTION (INSULATED): O Al 1' Interior air film 2 " sheetrock 3 1 " fiber lass 60.00 A Exterior air film still O. 1 TOTAL R 1y1 U a 1/R - .01 CEILING FRAMING SECTION: 1 Interior air film O.Fi 2 " sheetrock •39 3 9" fiber lass 30.00 4 Exterior zir film still n• l S 9, " Inches soft wood 11,97 TOTAL R i8 U - 1/R . _ .02 1 Inside air film O.RI 2 3 A S Outside air ilm O•? TOTAL A Ua 1/R-? k t L . CITY-OFf-AGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 i PERMIT TYPE Permit Number: Date Issued: Cg HMS BUILDING 031216 12/03/97 SITE ADDRESS: P.I.N.: 10-16350-020-01 DESCRIPTION: REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: - Applicant - OWNER: GAS LINE PLUS INC 12266220 POTTER THOMAS 4806 RUTLEDGE ST 1167 TIFFANY OR PRIOR LAKE MN 55372 EAGAN MN (612) 226-6220 (612)452-7063 I hereby acknowledge that I .have read this application and state that the - information is correct and agree to eomplit with_all applicable State,gf=Mn, Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE PERMIT 1167 TIFFANY OR LOT: 2 BLOCK: 1 CANTEBURY FOREST .-, (INSERT/GAS LINE) Building-Permit Type FIREPLACE Puilding Wiark Type NEW "Census Code434 ALT. RESIDENTIAL `Z to SIoa ° ISSUED SIGNATURE CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1997 FIREPLACE PERMIT APPLICATION q 681-4675 DATE: Q--I- 11 DESCRIPTION OF WORK: _ CONSTRUCT NEW FIREPLACE _ INSTALL GAS INSERT ONLY _ INSTALL GAS LINE ONLY OTHER: "AA1 1I nas e STREET ADDRESS: LOT I 13LOCK SUBD./P.I.D. #: APPLICANT: (circle one only) OWNER 10,10 PERMIT FEE: $50.50 - ALTERATIONS TO EXISTING Iti? 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. q P (- ) A 5? ' 7oc?3 PROPERTY Name: e o ffmilJ - Phone #: OWNER u+ Ate. Signature: Street Address: City: State: Zip: FIREPLACE Company: (sae TJ"e Plug Inc Phone #: aa?o' (0 as O INSTALLER 4W6 Rutledge Street fl n P Signature: y 4w r alga AIN -658721 c CJA.t 826w L 1 /U?? . Street Address: License #: City: State: Zip: GAS LINE Company: Phone #: INSTALLER Name: Signature: Street Address: City: State: Zip: 2 OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Census Code. 434 SAC Code 01 REMARKS Chimney/flue must be inspected before concealing. CITY OF EAGAN .APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *TJTF : PAYME•I. OF FEE ATa,TI2? :C APPLICATION DOES NDr cazw = APPROVAL OF PERMIT. INSPECTION OF SEWER AND/C1R-,%k7E nzZnr.r. cNS wILL NOT BEy-g= UI,ED UNTIL PERMIT HAS BEEN •'.. APPROVED. .. _ P ease Print 1) PROPERTY ADDRESS: //& ! J LEGAL DESCRIPTION: %?/nlvcK/Ouoalvlslon Or -Tax Parcel !D_ Z +-[aSTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (Mcn`n/Year) f-1 CO:•2-2RCIAL/R.TAIL/OFFICE Cj INDUSTRIAL INSTITUTIONAL/GOVERaNm T 2) NAt•SE : ADDRESS: ®. R-1 - SIDLE FAMILY R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) R-4 APARTma4 T/CONDZ)MINIUM, CITY,, STATE, ZIP: PHONE: .y E S -1p 71 DAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3kC KENNEBEC DRIVE, EAGAN, MINN.557zt 21366 MASTER LICENSE# 001445M2 4) aau• . iy. IVAN"G ADDRESS: CITY, STATE, ZIP: PHONE: CONNECTION T• CITY SEWER CONNECTION TO CITY WATER 6) r ,r r? c ? r 7) f r. r• u• ( Pnits) units) P AC't1Ve``" .... EVired Not "record St 7lutla C?= PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE - - -- PLEASE MAIL APPROVED PERMIT 70 1, 2,Q 4, ABOVE (Circle one) s/s/87 ' FOR CITY USE ONLY ' - .- PEGS : ?U• O SEWER PERMIT ^" ---' - ?_ S c w, JQ WATER PERMIT- (I3;CL_DE WATER METER/CCPP°_R-CR`. =-I= -. C.-._= - S WATER TAP (INCLUDE CORP :.^=C:Z =C_ - $ SEWER TAP U ACCOUNT DEPOSIT - -„__ ACCOUNT DE?OS'_T WAC v SAC $ TRUNK WATER AS= SS:?°:;^ - - - -- TRUNK SEWER AS _,D _..L..= S LATERAL BENEF_^_/=r.,,.... ---- _ - $ LATERAL Q ?OZJ ?, S WATER -TREATMENT - S ?0- OTHER: '5-100 TOTA L 7'/ ..- -......_...GN REQUIRE REQUIRE EXCA VATION IN PUBLIC .._,_=- ,.c ...-._- %?! =S IF YES, THEN A " PERMIT FOR WORK t4_Tr._.•: =_n_._.. _ ,0A 0WAY" MUST BE ISSUED BY THE ENG=_;E-= _ DIV ISION. LIST AS A CONDITION. ----- - -- -.. -- - -_?O'„I VG CoNDITIOns f--7 4`7 .fin i o3 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements RemodeVRe L R remems Office Use only f S d o ? 3 registered site surveys showing sq. ft. of lot, sq, ft. of house; and all roofed areas (20% maximum lot covera e allowed) 2 copies of plan Calculations for heated additions 1 set of Ener d o urvey Rec C N I) Tree Pres Plan Reod _ N Y ?f1 g 2 copies of plan showing beam & window sizes; poured found design, etc. gy 1 she survey for sections S decks ? Tree Pres Required - -Y ?F1 1 set of Energy Calculations Addition - Wicateifonskeseptic system On-sideSeptic System _Y ?N 3 copies of Tree Preservation Plan g lot platted after 7/1193 Rim Joist Detat Options selection sheet (buildings with 3 or less units) Date Construction Cost y y . (0 011 Site Address H (8-1 T t a ., b r t c. Unit/Ste # Description of Work 1yX16 k-d Cons<cu?tar.r 3-YXIS6ir/ Multi-Family Bldg - Y---/ N Fireplace(s) --4 0 _ 1 - 2 Property Owner T kao y,s PoH cr I V ftl R t , 7- Telephone # (4s/ ) 3Y-I - 9S Contractor Pc t?o C r.?`o? bu1on . tr rc1 ? Address ll 8 3 5 Qo v .? ? o? \ c s Q. City w. P State M N Zip SS a )1 Telephone If ( &5-/ TS?r-? a° ie COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateiorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. (? VW ' Licensed Plumber n a 5 g 2005 Mechanical Contractor Il JUL - Sewer/Water Contractor iW F11,-75 (jcx ? ?13 6eL I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 9 GC 1 t V S -l o, c r A ? T.?. ?1`i?1. Applicant's Printed Name Applicant ignature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace X 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 1 D-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New 1'M 32 Addition ? 33 Alteration ? 34 Replacement ?d v Valuation 4 Census Code ?14? SAC Units # of Units # of Slogs Type of Const Footings.(new bldg) _ Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof _ Ice & Water _ Final Framing Fireplace - R.I. -Air Test -Final Insulation Approved Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy RO-3 Zoning P /9 Stories / Sq. Ft. _ clLength Width /y MCES System 'J City Water Booster Pump PRV Fire Sprinklered J REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing _ I-IVAC Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco - Stone - Brick Windows Retaining Wall Building Inspector -zap 40 h'o? ?3 Zo Monaav; Deeember 19; 2005 3:24 PM Joe Pasma 551 -760398 R Z l(G 7 Tir??F?? p2 1 .soa$ „_?p ._ „ .oseph G. Pasma P. E. Cellular 612-309-0857 i r?8 P1111eis, 5098 Cottage Lane Fax, 651-762-0399 Oasly enA^enstmdon Whit- Raar f akE 1"N 55110 E-Mail; joegpCprpoligi-get December 19, 2005 Duane DuBois DuBois Conservatories 11825 Point Douglas Drive South Hastings, VIN 55033 Dear Duane: This letter is in reference to the Thomas Potter 1 Lynne Renz Sunroom addition at 1167 Tiffany Drive, Eagan MN 55123. The sketch on the "Foundation Actual" sheet shows addttrorrai 2-20 bears, that are going to be added beneath the diagonal edges of the structural insulated floor panels. The framing shown on this sketch is adequate to support a 40-psf live bad and a 15-psf dead load. If you have any further questions; do not hesitate to tali. Sincerely, Joseph G. Pasma, P.E. JP/hp 4 ?xu4?rnnlag t ?!? k nnZ {? X2 ? d f 7` I . ?0??2 (fir I f?: a it f;?. u a T 1 l Y) ,,- P 11,1bib City of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: q 07 9-oo 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ") - /(/ Site Address: /1 / / t ✓`7 Tenant: / U w'` re17/;:" r' LAN K / tc.11 Suite #: RESIDENT / OWNER ets.71 Name: :b Ln /2/kr- C Yin el -L Phone: Cs— I -13 t( ' Y57-4" Address / City / Zip: //C 7 it. 51r' �___.- q r.� 1 t Applicant is: Owner / Contractor TYPE OF WORK Description of work: /("lit _ ` 1/ q1 T i Construction Cost: ,1-0D Multi -Family Building: (Yes / No '1y ) CONTRACTOR Name: L-/ De SU4 rat, J License #: q) Address: 3 7--.3 0 6L-0, /,,, . City: ,__S--/- 4r.4 AC A- State: Zip: S. Y Y,..2(:,l Phone: J,) - c00. , ? t 7 Contact: L%"rf5 711 t—( Email: COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you subinit are considered to be public information ;Portions of the information maybe classified as non-publicsif you provide specific reasons that would permit the City to = conclude that they are -"trade secrets. '`,.,.'4;-:',z, CALL BEFORE YOU DIG. Call Gopher State One CaII 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; at t - work will be in accordance with the approved plan in the case of work which requires a review and approv 7:5"-t' Applicant's Printed Name Applicant's Page 1 of 2 i, i • Use BLUE or BLACK Ink - For Office Use G j r 1~ City of Eap I Permit I I G~ I Q~ 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 1 Date Received: c y 113 I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 Staff: 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION N Date: Site Address: ~y Tenant: Suite a P Name: one: 1 Resfden O..wner~ ~ Address Name: Iv1ILBERT COMPANY INC dba CUL IGAN WATER License 063031-WC II ~ ` ~ • Address: 1801 50' STREET EAST City: INVER GROVE HGTS Contractor 2 -State. MN Zip: 55077 Phone: 651-451-2241; it Contact: BILL MILBERT.' Email: e o or -New OReplacement -Repair Rebuild Modify Space Work In R.O,W. Description of work: 1 RESIDENTIAL Water Heater Water Softener Lawn Irrigation RPZ / PVB P r " it .;ype Add Plumbing Fixtures Septic System 9 (-Main / Lower Level) • x, - New Water Turnaround 1 , Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge) $60.001awn Irrigation (Includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $.105.00 Septic System New ($10.00 per as built) (Includes County fee and $5.00 State Surcharge) TOTAL FEES $ 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. 40 x- L1/1 llG)~~22`~ x Applicant s.P,rinted Name Applicant's Signature t vOR O FI US eOwe ,By equt ed I & ec t s e PERMIT City of Eagan Permit Type:Building Permit Number:EA131585 Date Issued:06/25/2015 Permit Category:ePermit Site Address: 1167 Tiffany Dr Lot:2 Block: 1 Addition: Canterbury Forest PID:10-16350-01-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Thomas Potter Lynne Renz 1762 Bluebill Cir Eagan MN 55123 (651) 334-4576 Signature Select Contracting 332 Minnesota Street - W3171 St Paul MN 55101 (651) 248-4994 Applicant/Permitee: Signature Issued By: Signature For Office Use �^ 7 ',I ::::::er E AGA N : 'C Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 ,.' Staff: buildinciinspectionsacitvofeagan.com 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: Tenant: Suite#: Name: J)'0°'`Z. ) �$ ) ✓L Phone: U 5- /-3 3 �- 9�7z Resident/Owner 7 _ r� : Address/City/Zip: )1 �I FFj�j ,Pe_ l� c Au' j� 7 ' t Name: r License#: Contractor Address: City: State: Zip: Phone: Contact: Email: Type of Work ____New —Replacement Repair —Rebuild —Modify Space —Work in R.O.W. Description of work: Jr 12-66 L y1 I L/SChr9�G I �- RESIDENTIAL Water Heater { Water Softener • Lawn Irrigation( RPZ/—PVB) Permit Type Add Plumbing Fixtures( Main/—Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.orq 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.citvofeagan.com/subscribe. 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 per , ,i i work is not to start without p_permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval ' . - / \4 x 11s f(9 F Applicant's Printed Name Applicant's Signat e FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size- Radio Read Manometer Staff: 1 For Office Use 197 --k...1 a e „o E AGA N %%% i ''0° :::e: 105--), Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(a7cityofeagan.com L 2 18 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 7 r Site Address: 11&.7i Unit#: Name: Lr Z w wM �GC(/l Phone: `f —65 i 75-74 Resident/ Owner Address/City/Zip: (1 4 7 -444 ' Applicant is: Owner X Contractor Description of work: C''44/ii Type of Work Construction Cost: .73tX i Multi-Family Building: (Yes /No X)` Company: �f . Contact: uAI.. p �,yh Address: 3?3O 6/ 7ketw. 4f( City: S L1i,.,i /J; Contractor State:(4444 Zip:' (c # Phone:76,3- 1/9.70 Email: License# e 117 y a Lead Certificate#:A)/ft 3A 5'7 ,. ......... ,. If the project is exempt from lead certification, please explain why: I COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 1 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: Mechanical Contractor: Phone: Sewer&Water 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 •ublic if ®u ®rovide s•ecific reasons that would •-rmit the Ci to conclude that the 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.citvofeagan.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.gopherstateonecall.oro 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 wor is not to start without a permit; that the work will be in acc% 5Sc ith the approved Ian in the case of work which requires a review and approve •f plans. / x (( e&* x / Applicant's Printed Name . •plicant's Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA163462 Date Issued:09/02/2020 Permit Category:ePermit Site Address: 1167 Tiffany Dr Lot:2 Block: 1 Addition: Canterbury Forest PID:10-16350-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater 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: 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 Potter Lynne Renz 1762 Bluebill Cir Eagan MN 55123 (651) 334-4576 Weld & Sons Plumbing 3410 Kilmer Lane North Plymouth MN 55441 (763) 475-0296 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA178763 Date Issued:09/01/2022 Permit Category:ePermit Site Address: 1167 Tiffany Dr Lot:2 Block: 1 Addition: Canterbury Forest PID:10-16350-01-020 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Thomas Potter 1167 Tiffany Dr Saint Paul MN 55123--189 Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (651) 633-2561 Applicant/Permitee: Signature Issued By: Signature