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1173 Tiffany Dr.CITY OF EAGAN WATER SERVICE PERMIT 3830 Prot Knob Road P. O. Box 21199 PERMIT NO.: ,Eagan, MN 55121 DATE: Zoning: _ No. of Units: 1 Owner: to Address: (,antc.Furv Por ,:* umber: r No: 072 11. 1 ze: s K OCEC , U t der No.: 71.70 p ape to amp k, I kh the Qy of e, R Data Paid: of Insp.: ° Insp.- .2-CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: ZOnino: No. of Units: Owner. Address: Site Address: - - :; fe[3y '?riv. L1. 51 C^liLcr!"Iv rozest Plumber: r ?' Plural I r Meter No.. Connection: Size: A t D 1 ?Oc' ccoun eposit: Reader No.: Permit Fee: I epe to seva* wah the C *y of Iowa Surcharge: OVAaaaeee. Mist. Charges: -_ i`<a Ty Total: 50nd meter By Dote Paid: Date of I nsp.: 1?. 3830 Pilot Knob Road SEWER SERVICE PERMIT P. 0. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner. - a t10:208 Address Site Add, Plumber. 1 o.ew to .em* wwa awe cky of ypa OrAaoaae. By Date of Insp.: Insp.. Convection charge: - 0Q' Account Deposit: l0pd Pen.0 Fee: Oo 1 Sun*Kwgo: Misc. C}aross: - Total: Dots Paid: BUILDING PERMIT To be used for DOCK CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # Est. Value $1,000 Date JUNY 22 Site Address 1173 T1"A" DRIVE Lot I Block 1 Sec/Sub. CANTERBURY Parcel No. FORZST w Name .-" " %~A' 9Vz%A' 3 Address rAk - - - - - - - - - - - - 0 Citv - - - - - - - Phone - - - - - - - o Name SAME OU< Address Cc City Phone Name Address I hereby acknowlege 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 Permitee A Building Permit is issued to: tdARIr L 1120111IRM 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 1989 OFFICE USE ONLY Occupancy Zoning (Actual) Const # of Stories Length 20ZU- Depth Sx22- S.F. Total S.F. Footprints On Site Sewage - On Site Well - MWCC System City Water - PRV Required Booster Pump - APPROVALS Planner Council Bldg. Off. Variance FEES Bldg. Permit Surcharge Plan Review SAC, City SAC. MCWCC Water Conn Water Meter Acct. Deposit S,W Permit S,`W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL $26.00 .50 10 tau =27.30 Permit No. Permit Holder Data Tek"Aone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Rooting Rough Pibg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. . ` CITY OF EAGAN j `'? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, M PHONE: 454-8100 N 55121': C 12065 BUILDING PERMIT Receipt # To be used for ''L DWG/GAR Est. Value $62,000 Date i l J, `?' 19 06 Site Address 1173 TIFFANY DR Erect [J? Occupancy X23 Lot 1 Block 1 Sec/Sub. CAATERBURY POR odel ? Zoning 1Z1 Parcel No. Repair ? Type of Const. VF1 W Name RSM HOMES INC 3 Address 18308 MURPHY LAKE BLVD ° City PRIOR "ne 432-2440 Name SAbJ:' i 8R Address City Phone ?Q F W Name a c= Address i z i 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 Ci of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: Rsm HOMES :VG all work shall be done in accordance with all applicable State of Minnesc Building Official Assessment Water & Sew. Police Fire Permit +' ., L.7 • Surcharge 31. Plan Review 159. Eng. Water Conn. SUU. UU Planner Water Meter 6330 Council Road Unit 290.00 Bldg. Off. 5/29/8 Tr. PI. 156.00 APC Parks Var. Date Copies Total 0 on the express condition that Statutes and City of Eagan Ordinances. Permit No. Permit Holder Date TeN Ohs M 7 7 `t y f HMA.C. 7 ( I? Electric Softener Inspection Date Insp. Comments Footings 1 Footings II F Foundation Framing Rooting Rough Plbg. _ v?? G Rough Htg. Insul. -? Fireplace 8 as /l>8 Final Htg. Final Pibg. -7 -?G &dg. Final Cert.OcC. 2 G!? Deck Flip. Deck Frmg. Describe Location: Well Pr. Olsp. PERMIT # 7 yy 7 PLUMBING PERMIT RECEIPT # S CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: 3 U ? Ce Sec/Sub A BLDG.TYPE Res. WORK DESCRIPTION m ?o y C Name - Address 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 PERMITTEE FOR: CITY OF EAGAN Mult New Add-on Repair FIXTURES TOTAL N. Water Closet - $3.00 $ Bath Tubs - $3.00 =Lavatory - $3.00 / Shower - $3.00 = Kitchen Sink - $3.00 Urinal/Bidet - $3.00 = Laundry Tray - $3.00 Floor Drains - $1.50 =Water Heater - $1.50 Whirlpool - $3.00 -/Gas Piping Outlets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 3 Rough Openings - $1.50 ' FEE STATE S/C: GRAND TOTAL, a ? 17' r b PERMIT # MECHANIC AL PERMIT RECEIPT # CITY OF EAGAN _ c? 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE PHONE: 454-8100 Site Addr _4? 71 BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sufi ? f t Res. x New X N m ame ' 7 Mutt Add-on Address ° 0 : tx ! 1 Comm. Repair C _ City r, Y (? -Oi"O / 1 ` Phon Other Name E f C_-1 FEES c Address - U e r 7 Z24 rf"LAIZ 14 RES. HVAC 0-100 M BTU -$24.00 p city Phon ' LY O ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK ?o GAS OUTLETS - 1.50 EA. Forced Air - ? M BTU - COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond M BTU STATE SURCHARGE PER PERMIT - .50 . (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other FEE- SIGNA URE OF P MITTE S/C: O TOTAL- FOR: CITY OF EAGAN CITY OF EAGAN Arlditinn CANTERBURY FOREST ?Wner Stre ? - 7, State_ EAGAN MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1979 Paid undel original pa rcel STREET RESTOR. GRADING 1981 106.78 5.34 20 85.46 A013446 1-12-84 SAN SEW TRUNK 2, Zj 1973 Paid under original pa rcel * SEWER LATERAL 1981 439.42 21.97 20 3 WATERMAIN * WATER LATERAL 1981 2 WATER AREA o, 1979 Paid undo original Pa rcel STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ( /^ / OiAT ?-LF?b ?i g Q b AMOUNT I$ G DOLLARS loo CASH CHECK FOR / C"???' - -? ,41 FUND CODQ AMOUNT fC) ? d is od Thank You N_ 65548 - _ r White-Payers Copy Yellow-Posting Copy Pink-File Copy t BUILDING PERMIT To be used for DECK Est. Value $1,000 N4 16690 C z 113S JUNE 22 . 1989 Site Address 1173 TIFFANY DRIVE Lot 1 Block 1 Sec/Sub. CANTERBURY Parcel No. FOREST w Name MARK L COLBURN z Address SAME o City Phone 681-0220 Name - Address City - Name - Address City - Phone f hereby acknowlege that I have read this application and state that the information is correct and agree to 2r plh all applicable State of Minnesota Statutes and City of ag n i Signature of Permitee A Building Permit is issuedRo: MARK T 1201 nlrnw on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and Cty of Eagan Ordinances. Building Official Phone CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # OFFICE USE ONLY Occupancy Zoning (Actual) Cons[ (Avowable) # of Stories Length 2046 Depth 5x22- S.F. Total S.F. Footprints On Site Sewage On site Well MWCC System City Water - PRV Required Booster Pump APPROVALS Planner Council Bldg. OH. Variance - Bldg. Permit Surcharge Plan Review SAC, City SAC. MCWCC Water Conn Water Meter Acct. Deposit SW Permit SiW Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL FEES $26.00 .50 1.00 527.50 Z4 I. -? a CITY OF EAGAN BUILDING PERMIT Receipt p 3S(o 12065 SF DWG/GAR $62,000 86 JUNE 5 To be used for Est. Value Date '19 Site Address 1173 TIFFANY DR Erect Li 1r Occupancy R3 Lot 1 Block 1 Sec/Sub. CANTERBURY FORE a'model ? Zoning R1 PD Repair ? Type of Const. 17-14 Parcel No. Addition ? No. Stories RSM HOMES INC Move ? Length 36 w p Name Address 18308 MURPHY LAKE BLVD Demolish 11 11 Depth dF Int. Impr. Sq. FL Clry PRI OR IlAcne 432-2440 Install ? F Name SAME Address City Phone a w w Name r u o Address a W 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 C' of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: RSM HOMES NC all work shall be done in accordance with all appligattle jMte of Minn 4c 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Assessment _ Water & Sew. Police Fire Eng. Planner Council 6 Bldg. Off. 5/29/8 APC N2 Permit 319.00 - Surcharge 317 09, Plan Review 159. 0 SAC 575.00 Water Conn. 500.00 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156.00 Var. Date I Copies 0 Total on the express condition that St to es and City of Eagan Ordinances. Building ? qoq 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. #/S.sa Date I IS / 04 Site Street Address 173 Ti -4GYN, 0,- 11' ? Unit # n ? ' Property Owner J1U?4 Ssy? ?1 Telephone # ( ) Contractor L? i P S IV wJojnfh ? rwi ?Q f'?'c Teleph ne # ( \) Z-1- ctr) Address__. .6L) ZOtO4(\ Akx city S -12 State .?. Zip 5SiWL The Applicant is: _ Owner Contractor - Other Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are installing only a water softener and/or water heater, do not complete this section; move to the next tion and check the appliance(s) you are installing. 0? 9 -Septic System Abandonment e AUG 0 V -Water Turnaround (add $130.00 if a 5/8" meter is required) l ?006 Other: Water Softener Water Heater $ 15.00 _ new - J_ replacement Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ i nereby appiy for a ttesidential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to startwithout a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. _ Applicant's Printed Name Applicant's Signature 4P 70 X67 If :. 2004 RESIDENW ?L, B&Jl7?jG P ERMIT APPLICATION City Of Eagan p3830 Pilot Knob Road, Eagan 1V1N 551_22 _-- :. -`--` -- ---.--- - ===-=?elekoiie?651r675?67S=--FAX'?651 6755694----=-- Nevr Constnicdo merits 3 registered site smveys sWng.sq, ft of lots , Remodel R Dart Reouiremen? (2fl%maxunum lofcoverdge allowed) qit ofhouse; and alt roofed areas 2cropiesofplan I set tofEnengyCakxr? addi5ons oEnerg aingbeam §windowsaes poured founddesign,eta lse ftonsforheated s?f of Energy calculations 1 site survey fof additions & deck 3 Copies of Tree Piesetvaffon Plan ff lot plaffed after711193 Rddrfron -irMicate ifon-s•[a septic system Rim Joist Delail Options selection sheet (bldgs with 3 or less units 3;? Y,w MEN Date-1- /0 tl 6a Site Address =1 - Construe on Cost 5 C1VP? Unit/Ste # Description of work f W Idav Multi-Family Bldg _ Y, N J Fireplace(s) )! 0 2 Property Owner Telephone # ((p51 )`?S fZ - $amll Contractor Address ZU RQcId u Q_ ,'t State IA N aty nn&-AhIke J Zip CJSI '? Telephone # ((mil) COMPLETE TkIS AREA Energy Code Category - lbfinnesotaRules 7670 Cate o 1 (,/submission type) !- f2esfdenut Ventilation Categ9ry,1 Worksheet submitted • Energy Envelope Carwla(iong §bmitted ANIMB _ Minnesota Rules 7672 • New Erjetgy Code Worksheet Submilfed 1 rave you previously constructed a building in Eagan with a ee applies similar plan? - Y _ If . icensed Plumber 1echanical COrltractor =Wer/Wafer Contractor i-g ?7 Telephone # r ( ) ICT 1 ,4 U Telephone # ( Telephone #( iereby apply for a Residential Building permit and acknowledge accurate. totes; it the work will be in conforrauce with the ordinau and odesao ftlie City of Eauvt? gan and the State MN I understand &s is not a permit, but only an application. for a permit, and work-is not fo start with a ) out Mt;that th oatfpltheans. work will be in accordance with the approved plan in the case of work which requires a review and rov ?p7zcantsprmtedName ' App tout's Signature. V OFFICE USE ONLY Sub Types '°.?- 01' Foundation-- ?-07 -o5-pie?-M-. 13-1Epfex P6ol -- - O- 30--Accessory Bldg== ? 02 SF Dwelling Q 08 06-plex El iS Fireplace 13 21 Porch (3 sea.) ?.. 31- Ext. Alt- Multi (7;-;03i. 01 of - `plek- 13 09 07-p(ex Q_ 17 Garage El 22 Porcf (Addn. (4-sea.)' ?" $3 , Ext. Alt= SF []t 0==02=918x.;_. _;.- -::?.10 08-plex ? 18 Deck ? 23 Porch(screen/gazebo) ^? 36 MultiMisc: 13 03:p[ex: D 11 10-plex Q 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex' Ptbg yor_N ? 25 Miscellaneous Work Types ? 31. New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding 32.Addition .El ? 36 Moue Building ? 42 Demolish Foundation ? 45 . Fire Repair ? 33. Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowafDoors ? 34 Replacement 'Demolition (Entire Bldg) = Give PCA handout to applicant Valuation Occupancy MCES System Censu's Code Zoning City Water SAC Uhits Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) FinaUNo C.O. Footings iddrtton) w Plumbilri r?t gK ' "''.;fit #•zY•"' S'. tr'?q* ±i 3'.'` "?,•'?--f..? r$?.. .VCt' - ?' ?.i".±4 Poundatio ' Ii AEG.. Drain Tile Odier .1 1 Roof `. Ice; &. Watea: ` :_.. Final •% Ftgs . : tlir/Gas Tests _ Final Framing: _ Sdidg .; !` Stucco Stone _Bric1 Fireplace _ R.I.: _'Air Test Final Windows Insulation _ Refauiiiig Pfau "App'roved By: Building lbspector Base Fee Surcharge Plan Review MC%ES SAC City SAC Utility connection Charge -, -S&W Permit & Surcharge ' Tfeatment Plant License Search Copies Other Total ??, .,e, c..•s iuv zc. vu tnA (OJ oil Yf46p xruu rrw nr WLIMMIM - re June ?, 200i _ . Cary of Eagan 3836 Pilot Knob Road Eagan, MN 55122 To whoa, It May Concern: Elder Jones is authorized to pUn building permits forRenevtal Bider )ones to Provide tills service far us in E". `Krisauchoriz.g. Andmm Is valid four any snow l date beyond 616101; until a 16nevW by Andersen y revokes it in wilting to th6 City. I request this authodzadon be a . our baiidjug pomoits any fur=??o xpem, rw IfIth snot delay in the prvicesft of contacted at 763-502-4706. any gneadgns.. 1can be Your immgdiate attention to this matter is ftLeeisted, a sinceialy, and R'Rau ostallatV Manager Renewal by Anderson Catpotadou y QH p. ??? i wr won ?La•.ra. n?zaa wuu Received Tihe Jan. 1. 1,07pM- 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COMMERCIAL SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS ONj & STRUCTURAL PLANS; 1 SET OF V 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1-SET OF v/ 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND To Be Used For: S /;r Valuation: :;?&X;0 Date: Site Address , i 3 ?;any ?R. Lot 1 Block ` ?^ y Parcel/Sub ?p@(' pV c?J r pry' $ L Owner RSM HOMES, INC. Address 18308 Murphy Lake Blvd. City/Zip Code Prior Lake, MN 55372 Phone 432-2440 Contractor Same Address City/Zip Code Phone Arch./Engr. A.P.S. Home Design Address City/Zip Code Phone # Erect A Remodel Repair Addition Move Demolish Int.Impr. Install (APPROVALS Occupancy Zoning Type of Const # of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off Ze P Treatment P1 APC Parks Variance Copies ?? TOTAL NFRO B E ce- :9PPA6,E 71bb 140 INOMMS ENGINEERING COHSUlTI PLANNERS IS and LAND LAD RD SURVEYORS COMPANY, INC. 1000 EAST 146M STREET, BURHSVILLE, MINNESOTA 5337 PH 432-3000 C4070ZjE ctZ?`e aS [TY? (? „Q?I_, ? Pc?ZCrt • LG-r / BLO-^K ! CANTERBURY FOREST DAKOTA CCUNTY/ MINNESOTA i A/ 69° 57' 28"E o, W D ? N ?A J yy o o" T 4- ?. O DRAIIUAEE AAiD UTILITY E45EMENT N_5. F. EASEMENT LOT i \ Z0 ,9z 6 VIo2 JDOiDx 9°L )) I ? (9D jc ?'$Yy' 1: .t ' r., y 9P 0 0 9C \ \\ on? t? J ' 6 D N ,c o, SURVEY LINE ? z * ewe J s, 9-7 898= S 898.D? 6X 've- Z" f C / ? gB97 S? \+7.2) 21' 33 i N m m, ? O O O DRAINAGE AND UTILITY EA5EMEjUT IB ' I¢ 0? NC •i-1H ID \ ?• 1a1. 6 3 r ° 0 Li - 30' FRONT BUILDING SETBACK LINE SCALE I" ° 40' ?? ?qo°.4) X900 9j DENOTES EKIST/N6 E16YATr011 0091 e (907.0 j DEA.'OTES PROPOSED ECEYATlOw 1---- IIJNcATE5 DIRECT/av OF SURFACE DRAINAGE 901.33 > FINISHED GAR46E FLOOR ELEVATION I hereby cartify that this is a true and corract representation of a tract of land as shown" and described hereon.- As prepared by me on this 7-7n1 day of /< Minn. leg. No.160Vf 5 OWNER SITE AD CONTRACTOR DAT3 ->'2b`a0PRONE-4-3-5-P869 Determine working square footage of each. 1. Total exposed wall area .... /960.0 sq. ft. x .2a = 2. Total roof/ceiling area .... //O y!o sq. ft. x .'D-4 Total exposed wall area above floor = X50.0 a. Total wall windovi area .9a"y b. Total door area . .. , .:& y c. Total sliding glass area .... d. Total fireplace wall area o e. Total wall framing area (average 10%)... f. Total net wall area above floor ........ 9,9 - = g. Total rim foist area ................... Total exposed foundation area 99.U h. Total foundation window area .. o I. Total net foundation area above grade 8•v Determine "U' value of each wall segment. a. X "U'' yj yG• s b. yo Y. X "U" -,02,(, m 3• / D. o X "U" o w O e. 196.0 X '.Ul i f . /590 - '/ X "U': oyr? G 9.9 Q. X "U'Q o?? a h. o X "U, a a o i.p-- X "Ui' 3 ............................................Total if item #3 is the same as, or less than item N1, you have met the intent of SBC 6006(c)2. a3 64, 3.7?) L Slt» ,. / (a//S, ?1r? fem. ?) -Sac 4(ogqo6rc.) EXTERIOR EINE:C?E AVERAGE "U' C0I41°'JTATI0:1' Total exposed roof/ceiling area = J. Total skylight area .. ... k. Total roof/ceiling framing area (average 10h) 1. Total net insulated roof/ceiling area .i..... _. Determine-11W value for each roof/ceiling segment. J. (J X bUil ? s G k. //o•f X •:Un ofyo : ,3.1 1. ?9 3• L X IV, O 2 P- 4 ....... : ....• • .........Total = ;2 56G GooGCc>l If total of i,'4 is the same as, or less than f2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum.of items #1 and fit. //?? 3. + 4. v? •s?- /Z= ?1 ` i1 ao -e-z, !? ft &-^4a o?U _ v y' - zx V94.,, c0`cc ? y,Bg - a h= X46 -2 t- ,DAR I 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN -1 t (0 L, 170 SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - i STRUCTURAL PLANS 1 SET OF ENERGY CALLS. (CHECF WITH BLDG DIV.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALLS. 1 SET OF ENERGY CALLS. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS f OF UNITS NOTEt ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.. SEVER A WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. PENALTY APPLIES WHENt PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. To Be Used For: Valuation: Site Address 1173 TIFFANY t)Riui5 Lot I Block I Parcel/Sub (? gNT?RauA?l To WEST Owner (%' V'- L Ca t?Of- ) Address I I -) 3 Ti FfAN? n)?-. City/Zip Code r-A (,N?j N nJ . Phone (, ? 1 - 0-a a U Contractor s, q I?-- Address APPROVALS `OOV Date: L-7-1-S'q Occupancy Zoning Actual Const Allowable of stories Length do fvb Depth SX ZZ S.F. Total Footprint S On site On site MWCC Sys City watt PRV requi. Booster PL City/Zip Code Phone Arch./Engr. Address City/Zip Code Planner Council Bldg. Off. Variance FEES Bldg. Permit 26 • a? Surcharge Plan Review SAC, City MWCC Conn Meter Deposit -mit charge it Pl. t ma ..opies ?o SUBTOTAL Penalty TOTAL ,one e , 13E COHSULTIHO EN61HEfA5 ?? ?A ?? .tNGINEE8ING PLAHHEAS and LAND URYEYO!!S COMPRNYI INC. 4 10.00 LAST 146es 57RE=T, BURHEVILLE, YIHHENTA 55337 PH 432'3000 C4SP rZz i ccz?e a?`I,LrYe? . . ,?eQcl IJe?Cr 2iort; LGT /, BLOCK 1, CANTERBVRY FOREST DAKOTA CC)uNTY1 MINNESOTA I r m H D W ? p N 0 T ? L t Nc;-.H Al 05' 57' eO'E DRA/NAE6 AUD UTILITY £A'EMENT 1 1 . _ N_5. F. EA5EMEIJ7 LOT 2 N m m ? O _o SURVEY LINE ?'sc?J / /tB9BQ 9 _ Tg fO +?Yj,2? / s ti ym 33 DRAINAGE AND o ,b 9 ,/ E UTILITY EASEM£/JT a \ Cc.. ?o ? I 01 2 3D 30' CROAIT 80ILDIA16 SETBACK LINE DENOTES EXISTING ELEY.4T14/ o? °9? ?,c ( 901.0 j DENOTES PROPOSED ELEY.gT/ON ?- IN0ICATE5 DIR£CTiov OF SURFACE DRAIAIA(PE 9o1.33 . FINISHED GAR*C FLDOR ELEVATION I hereby certify that this is a t:na and correct representation of a tract of land as ¦hown'and described hereon.. As preparsd by tan on this Zr? day of i i \ Z° fJ brI°Z.9 A; E 001. i1 ? \ C / ` Minn. Res. No. /L_S CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NUTG': PAYmEr OF FEE AT TIME OF APPLICATION DOES NOT CONSTIT= APPROVAL OF PERMIT. INSPECTION OF S&M AND/OR WATER IrSTArr.ATIONS WILL NOT BE SCHEo- ULM UNTIL PERMIT HAS BEEN APPROVED. (Please Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Mon Year) PRESENT ZONING/PROPOSED USE: El COMMERCIAL/RETAIL/OFFICE _,[E1R-1 SINGLE FAMILY Q INDUSTRIAL 0 R-2 DUPLEX (Two Units) n INSTITC;TIONAL/GOVERNbEM R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) NAME:_ I-A-?e-' G d e_ ?A?? . /?Fr1 21 ADDRESS: /_) t4 :? r /;tf/? CITY, STATE, ZIP:,f PHONE: %7( Q O 3) a : NAME: ADDRESS: CITY, STATE, ZIP: ,5e -2 7 PHONE: t? - ) MASTER LICENSE# NAME: __?. S: YYi ADDRESS: CITY, STATE, ZIP: PHONE: ?f4f 7 /? 3 !J • . Active Expired Not recorded S?tial 5) : r• i a •: : o? • a• ?• CONNECTION TO CITY SEWER {j, CONNECTION TO CITY WATER Q OTHER ' 6) • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE 0, PLEASE MAIL APPROVED PERMIT TO 1, 2, 0 4, ABOVE (Circle one) 7) FOR CITY USE ONLY PERMIT # ISSUED 77'1-5; Pd w/Bldg. Permit FEES: $ $ /O1 S -D SEWER PERMIT (INCLUDE SURCHARGE) $ $ 16 - S-6 WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ S mT? ACCOUNT DEPOSIT - SEWER $ $ / ?- -C) ACCOUNT DEPOSIT - WATER $ ? $ WAC $ 7 S / ?' U U $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ // O $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ `` $_ d e.-6 TOTAL 3 3 s'-? ?s z4 RECEIPT R ECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION IS . L T AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : (} A 3 of a ag an 3630 PILOT KNOB ROAD. P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454.8100 DATE: July 3, 1986 1 ASSESSMENT SEARCH Universal Title Insurance Co RE: Canterbury Forest 14031 Burnhaven Drive I 10-16350-010-01_ _ Burnsville mN 55337 1 BEA RLOMOUIST Mayor THOMAS EGAN .KMES A SMITH VIC ELLISON THEODORE WACHTER Coins MaMpf 1HOMA5 HEDGES of, Pdmu 1100 EUGENE VAN OVERBEKE GN cmk Enclosed herein is the search which you requested made on the above described property. Kind of Improvement Years Beginning Original Amount Balance Due SEE ATm= SHEET I further certify that according to the records of said office, the following improvements are contemplated or pending after having been approved and are now in the process of planning or completion. Kind of Improvement Approximate Date of Completion Approximate Cost ANY PEMOINGS WILL BE LISTED ON THE ATTACHED SHEET. WAIVER: Neither the City of Eagan nor its employees guarantees the accuracy of the above information which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form and for all other consideration of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN, 3830 Pilot Knob Road, P.O. Box 21199, Eagan, MN 55121. Very Truly yours, SP CIAL ASSESSMENT DI N THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY TRANSACTION ID: 8768 SPECIAL ASSESSMENTS SPECIAL ASSESSMENTS SEARCH SUMMARY PROPERTY I.D. TODAYS DATE: 07/07186 ---SPECIAL FLAGS---- 10-16350-01 1-2-3-4-5-6-7-8-9-10 -0-01--- ?.?-z?/----------------------------------- ---------------------------------------------- S.A.# ASSESSMENT DESC.R. YR YRS RATE TOTAL ANN.PRIN. PAYQFF COMMENT **jrx SUMMARY OF ACTIVE .00 .00 .00 Comm #* THIS YEAR'S TOT P&I .00 Press ENTER (Comments), F1 or Fi (Header Form) or F7 (Restart R768) PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA109363 Date Issued:02/28/2013 Permit Category:ePermit Site Address: 1173 Tiffany Dr Lot:1 Block: 1 Addition: Canterbury Forest PID:10-16350-01-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, 952-445-2840 Dayna Gardner 505 RANDOLPH AVE 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 - Jeffrey J Smith 1173 Tiffany Dr Eagan MN 55123 Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA131977 Date Issued:07/17/2015 Permit Category:ePermit Site Address: 1173 Tiffany Dr Lot:1 Block: 1 Addition: Canterbury Forest PID:10-16350-01-010 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jeffrey J Smith 1173 Tiffany Dr Eagan MN 55123 (651) 688-8291 Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA178666 Date Issued:08/29/2022 Permit Category:ePermit Site Address: 1173 Tiffany Dr Lot:1 Block: 1 Addition: Canterbury Forest PID:10-16350-01-010 Use: Description: Sub Type:Fixtures Work Type:Alteration Description:Bathroom(s) Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jeffrey J Smith 1173 Tiffany Dr Saint Paul MN 55123--189 Norblom Plumbing Company 1465 Selby Ave St Paul MN 55104 (612) 827-4033 Applicant/Permitee: Signature Issued By: Signature