1136 Tiffany Pt06/1712011 01:36 7637805011
mate:
City of hp
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (051) 675-5694
201, RESIDENTIAL BUILDING PERMIT APPLICATION
o.
INSTALLATION MASTERS
PAGE 01/02
Use BLUE or BLACK Ink
Par Office Use
qq
Permit*:
Permit Fee:
V
Date Received
Staff:
o-sv
Site
Suits a:
Tenant:
RESIDENT / OWNER
TYPE OF WORK
CONTRACTOR
J
iv)
Contractor
Description of work:
Construction Cost J5 ✓ "
Multi -ramify Building: (Yes / No _)
—. 14-0 1. 1 11 k L b.0 -44A4
License* 2-05 7201—if
State: ►ML%1p:
City:
..-�1�)
Phone: J..CfS l ^. r -
Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan bred on a master plan?
Yes _No If yes, date and address of master plan_
L.ioaneed Plumber:
Mechanical Contractor:
Phone:
Phone:
Sewer & Water Contractor: Phone:
NOM Plans and supporting documents that you subml are considered to be public information. Portions of
the Information may be classified as nonpublic it you provide specific reasons that would permit the City
to
conclude that they are trade :secrets.
CA L, BE ORE . Calf Gopher State One CaII at (651) 454-0002 for rotection against uncle , round utility damage.
•• - cali,a
Call 48 hours before you intend to (Ng to recervre locates of underground utilities, , ri
I hereby a
Eagan:
acoo
t this information is complete a
not a Permit. taut a
n in the case
= N to
ccurate; that the work will be in conformance with the ordinances and codes of the DIY of
application for a permit, sad wort i9 not start without a Permit: that the work will be In
Mob requ - a review and approval of
ei
d4im
Page 1 of
WATER SERVICE PERMIT
3795 Pilo. Knob Reed
Eagan, MN 55122
Zoning:
PERMIT NO.:
DATE:
No. of Units:
iress:
Address ll^6 71ffanv n
()
nber: FIT.
er No.: Connection Charge:
Account Deposit:
der No.: Permit Fee:
irea to comply with the City of Eagan Surcharge:
"
inanees.
Misc. Charges: ? I
. 7
Total:
Date Paid:
of I nsp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3755 POW Knob Read PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: T No. of Units: '
Owner: ?y e 1 '
Address:
Site Address:
Plumber:
i agrea to campy w"b tlw City of Eagan
Ordinances.
By
Date of Insp..
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge: '-
Misc. Charges:
Total:
Date Paid:
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED
FROM
AMOUNT
DOLLARS
loo
? CASH ? CHECK
FUND CODE AMOUNT
i
Than You
c> + BY
/ white-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
3795 Phial Knob Rood Eagan, MH 55122
PHOH& 454-8100
BUILDING PERMIT Receipt #
T. t..... j E.. SF DWG/GAR c.. v„i.._ $84.000 r,_._ MAY 16
Site Address 113b 1xirrany ro=c
Lot _ 12 Block 2 Sec/Sub.Qanterbury Forest
Parcel * 10 16350 120 02
W Nome ,. rerersen LonsErucuic,
Z Address 4701 W. 110th St.
ao/. cI
$ Name _
F
uU Address
Nome _
Address
I hereby acknowledge that I have read thi"r
the information is correct and agree tort
State of Minnesota Statutes and of Ea
and state
Erect gY
Alter ?
Repair ?
Enlarge ?
Move ?
Demolish ?
Grade n
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
( I L
141
,s 83
Occupancy R-3
Zoning R-1
Fire Zone NA
Type of Corot. V
* Stories
Length 64
Depth 51 Sg. Ft.
Fees
Permit )t's . vu
Surcharge 42.00
Plan check 192.50
SAC 5~5.00
Water Conn450.00
Water Meter 60.00
Road unit 250.00
Total $1904.50
S. Petersen Construction,-Inc.
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 Misc. Permit No. Holder
Plumbing
H.V.A.C. L /k2- &-2
T 3
Well
Water
Disp.
Sewer t
Electric Wo5YQ3-7 4PL Se (EA 5--11$3 C}f +?
wos4'9Go ?` `? 7-24-?g
Inspection Date Insp. Other
Footings G-(T S Aof
Foundation
Framing - 643
Rough Plbg.
Rough HVA / . "A
Insulation ?X ?r
Final Plbg ->7.
Final HVAC •'J
Final
Water Daaibe Location:
Well
Sewer
Pr. Disp.
fit
Tntifiratr of COrrupaury
Citp of Cagan
Erparhm# of Buiiaing 3myr fine
T'bis Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the tine of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
SF DWG/GAR ma?e?rio 8041
UN Mukhadw
O-P wyType R3 TypeConwctiao V Fire zanA NA Zm%Duukt Rl
rvresL
iii. July 26, 1983
Dsts-
PC= W A CMMPIC OUG PLACR
Receipt PLUMBING PERMIT Permit No. -"
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly
Tot.
1. Date 2. Installation Cost
3. Job Address Lot f ?Z Blk. .Z Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New L1 Add D Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
+Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address Lot L. Blk. -? Tract, ,
4. Owner , .. c
O
5. Contractor r' Phone
6. Address
7. City -- t State Zip -
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New B- Add ? Alter ? Repair ?
10. Describe Fuel Type 29,
11.
No, Equipment STU - M. Ea.
Forced Air No. Equipment CFM
Ai
Ha
dli
:
Mfg. r
n
ng
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
CITY OF EAGAN Remarks
' - '1' Street 1136 TIFFANY POINT State EAGAN MN 55123
?.
Llh - H
5!,5A .5
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ( 1979 Paid undes original qLa rcel
STREET RESTOR.
GRADING 5-$' 1981 106.78 5.34 20 90-79 C008324 R-R-R3
SAN SEW TRUNK 2, z, 1973 Paid unde Ol'i final CeI
* SEWER LATERAL 5-1.6- 1981 439.42 21.97 2 8-8-583
WATERMAIN
* WATER LATERAL 1981 20
WATER AREA 1979 Paid unde original pa
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
RM 11M 2
WATER CONN. 450.00
n
M
BUILDING PER. AnIll
SAC r.05 00
M
p
PARK
This request Void 1
la,r nth. 3r0m
N9058957
35$(10 (
zo, 6 0
Req?. Datte
L) ?? Fire No. qe¢ i?nyl aspect... OReady Npw ill Notif Y. -
fo
Wh
R
?Yes r
en
eatlY
? Licensed Electrical Cogf`actor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. City
,
e on
No. Township 77, N., tiange, mPc. County
D
Occupant IPRl ) Phone No.1 y
?? [
/
?/ r}
Power Supplier A
s
I r r
,t,7 <r3'
Ele triral Co rector (Company amel i Co actor's
License No.
/
Mailing Address (Contractor or Owner Making ta{la on1
c 'D
A [hor'zed Signature (Con ner irrg Ios1a latrue) Phone Number
O/
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
1821 a U-MldWay Bldg.. St. Room Paul. -1 MN N 66104 UNLESS PROPER INSPECTION FEE IS
1821 ity Ave.,
_. ._--- __ ____ cNCt nscn
REQUEST FOR ELECTRICAL INSPECTION
QQ 9' See instructions for completim this form on back of yellow copy.
""X?' Below Work C 5overed by This Request
EB-00001-04
u:
3 5?(01
Now Add Rep. Type of Building Applionees Wired Enuipment 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 [Specify] Other ISperify)
t .r Specify Other Other
Compute Inspection Fee Below
# Fee service Entrance Si[q # Fee FeederSrSubfeeders # Fee Circuits
0-tOG700`Am 0 to 30 Amps 0 to 30 Am 1s
Above 200 Amps 31 to 100 Amps 31 to 100 Amp,
Swimming Pool Above 100 Amps Above I00_Am)s
Transformers Irrigation Booms 1'D Partial.'Other Fee
Signs Special Inspection 6A TOT
Remark -
^'
JG'1 'O
V
00
Rough-m to I th ectri cal
f Inspec lor, hereby
Final '
+
Da to certify that the above
u /i ?Li+'
? inspection has been
made.
This request void 7-?
10 mm the from
W058960
Ll a L S-?> 1 3-73--23
sue. o0
Request pate
/'' b
7
/ Fire No. Rough-in Inspection
R q fired?
?Ready Now Will Notify Inspec-
tar Wh
R
d
^
p Q Ves ?NO en
ea
y
Qy Licensed Electrical Contractor 1 hereby request inspection of above
L/? Owner'y electrical work iestalled at:
Street Address. 'T r )cute o. Cif ryn
Y
Sdf,tria, No. Townsh a or No. Range No. County
bQ
Occ - nt (PRINT) Phone N
P wer Sfipp Address 1
F
top
E lectri al Contracto (Company Name) TT//
? Cootr ctor' ss License No.
p /2 7 7 "- zA v e, V V
Maili g ddress Y Contractor or wner
C Makii ng Insta ll tionl
v S jJ
s?i'
Autho' ed Signature 1 er ng hs Ilation) yp?e r.? yl/?
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
MINNESOTA S -Room N-191 BE ACCEPTED BY THE STATE BOARD
Griws-Midway Bldg. 1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
o.--- rater egy?nt ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
' See instructions for completing this form an back of yellow Copy.
"t' " S-' 0960
X' Beyow Wor Covered by This Request
EB-00001-0C
ill 37 3a B
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg- Furnace Silo Unloader
Industrial Bldg. Air Conditioner.? OA Bulk Milk Tank
Farm Other peci Other (Soecify)
t .r Specify Other Other
Comoute lnsoection Fee Below
# Fee Service Entrancefuze # Fee Feeders/Subteeders # Fes Circuits
r 0 to 200 Amps 0 to 30 q 0 to 30 Amps
Above 2 0 Am s 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100_Amps Above 100-Amps
Transformers Irrigation Boons 6a Partial/Other Fee
Signs Special Inspection $L ,:
OTAL
Rerryrks / r V?? E fr,
Rough-in
4 r
2 `Datey
(,?j f I, the Ele
Inspector, hereby
certify that the above
Final P
?AAk Q+},te
i? inspection has been
made.
CITY OF EAGAN ?T p
5793 Plot Knob Road Eagan, MN SS122 N? 8041
PNONEs 451-8100 ?/
BUILDING PERMIT Receipt # t7
To be wad for SF DWG/GAR Est. Value $84,000 Date may 16 -. 19 83
Site Address 1136 Tiffany Point
Erect gg
Occupancy R-3
Lot 12 Block 2 Sec/Sub.Canterbury Forest Alter ? Zoning R-1
Parcel # 10 16350 120 02 Repair ? Fire Zone NA
Enlarge ? Type of Const. V
r< Name S. Petersen Construction, Inc.
y, Move ? # Stories
zz Address 4701 W. 110th St. Demolish ? Length_ 64
CI pls. 55437 phone 884-5144 Grode ? Depth 51 Sq. Ft.-
p Name Owner Approvals Fees
ou Address
u Assessment Permit 385.00-
42
0
? city Phone Water 8 Sew. .
0
Surcharge
Police Plan check 192.50
W Name Fire SAC 525.00
Address Eng. Water Conn450. 00
iW City Phone Planner Water Meter 60.00
Council Road Unit 250.00
I hereby acknowledge that I have read thi pplic ion and state that Bldg. Off.
the information is correct and agree co wi appl' Is
"
APC
l $1904
50
T
t
State of Minnesota Sto s and y age r
ce .
"
o
a
Signature of Perini
S. Petersen Construe on, nC.
A Building Permit is issued ra: on the express condition that
all work shall be done in accordance with all licobl tat f Minnesota Statutes and City of Eagan Ordinances.
Building Official ?1 %4
S??E ?S ?f376 f/p/Orecrr? /IiifyCITY OF EAGAN (fU-dude 2 sets of plans,
+W 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of e calculations.
ST-, D
To Be Used For ?6 Valuation!!K% 000 Date X& - f3
Site Address: ?( 3lo Ti ?? Apt ?1
Tc?esuP x
Lot Z,:7-_ Block Sec. /Sub. -VRF sr
Parcel #: 10 1(,4 350 X20 d Z
Owner: -S ?L-?r?SF? CeJrrS? /wG
Address: lyI70/ W!/oZ R-?
OFFICE USE ONLY
Erect Occupancy 3
Alter Zoning
Repair Fire Zone
Enlarge _ Type of Const.
Mve # Stories
Demolish Front ft.
_
G ade
r M. p th h^j ft.
Ssrz/37
City/Zip Code: ApGS
Phone #: PY t f APPROVALS FEES
Contractor:
Address: /
City/Zip Code:
Phone #:
Arch./Enng..
Address:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police
Fire
Eng.
Permit 385.2
Surcharge
Plan Check
SAC
Water Conn. yS0 43"
meter Water Council oad Unit
Bldg. Off. -
APC
TOTAL I o
Certificate for:
Svend Peterson
4701 West 110th St.
'Bloomington, Mn. 55437
DELMAR H. SCHWANZ
LAND SURVEYOR SI 1 e3 C..
R egistered Under Laws of The Stale of Minnesota
2976 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 66086
N&30 424'W
r
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co
la
2v
I ?Ati ?P?
F
I
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I ?
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r'^JDrainage & utility
easement
r
r ?
X 624/
612 423-1769
SURVEYOR'S CERTIFICATE
TOP NNB / \
.$d ? .. ?pGuQB
x
L2
_ --- - ..
lo sti
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d,
xq'7. `
3
?s
\
g
Ep zB ?' ?$?
op Nud
r
I / om
I ?
Sv
S Elevations shown are existing
A(!/ O Denotes set wood hub
91 Proposed garage fl66r
elevation /oZ
I hereby certify that this is a true and correct
representation of Lot 12, Block 2, CANTERBURY
43,? FOREST, according to the recorded plat thereof,
N ?o?3g„w Dakota County, Minnesota.
Also showing the location of a proposed house
as staked thereon:
Dated: May 6, 1983
?r
MINNESOTA REGISTRATION NO. 8625
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 771
DATE: 11/30/99 TIME: 14:07:45
ID:
NAME: M.J.-MOSER CONSTRUCTION
3210 9001 1136 TIFFANY FT 1.67.25
2155 9001 1136 TIFFANY FT 4.50
!I
Total Receipt Amount: l7i.75
CR1201'7S
USER ID: JAN
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF
3830 PILOT KNOB RDN 55122
651-681-4675 c?
New Construction Requirements Remodel/Repair Reautremenh l I - J
D 3 registered she surveys showing sq. ff. of lot, sq. ft. of house
and all roofed areas (20% maximum lot coverage allowed)
a 2 copies of plans (show beam & window sizes; poured fnd. design; etc.)
1 set of energy calculations
3 copies of tree preservation plan h lot platted after 7/1/93
DATE: // 36-9 /
DESCRIPTION OF WORK:
STREET ADDRESS:
?rP
Name: 1/.?/??sdv? C ? Phone #:
Lost first
2 copies of plan
1 set of energy calculations for heated additions
1 she survey for exterior additions & decks
LOT: I BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Street
City
IFfoN
ass: ?/3G r,?Fati
G. ?7/
State:
Zip:
Company` `' T Phone #: bS) qff - S?
(area code)
Sheet Address: o-T? /-,d
City -S ? f? Stater
Company: Name:
Telephone #: area code ( )
Street
city
rSewer & water licensed plumber (required for new construction only):
State:
Penalty applies when address change and lot change is requested once permit Is Issued.
Zip: SSG 9 S
Zip:
I hereby acknowledge that I have read this application, state that the Information is correct, and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: dJ%?//1
OFFICE USE ONLY
Certificates of Survey Received - Yes _ No
Y,97d C I
CONSTRUCTION COST:
License # W'?- Exp3 3 )• dO
.
Registration #:
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 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee 3 5
Surcharge ?f- cv
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: I-1 (--7 ?)
Valuation:
04
SAC Units
% SAC
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115191
Date Issued:09/24/2013
Permit Category:ePermit
Site Address: 1136 Tiffany Pt
Lot:12 Block: 2 Addition: Canterbury Forest
PID:10-16350-02-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Chuck Glum
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 -
Richard L Harlson
1136 Tiffany Pt
Eagan MN 55123
Highmark Exteriors
11237 Nicollet Ave S
Burnsville MN 55337
(952) 882-8904
Applicant/Permitee: Signature Issued By: Signature
For Office Use
; Permit#:
E AG N
1533
Permit Fee:
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:
buildinainspections(a�citvofeagan.com L
2019 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date: till /1/ Fee: $65.00
City Sewer City Water Vs. Repair Disconnect
Description Of Work: pA-(Q BEL pJ setAJCZ ANO c,fFSTCT
Qv C.TO CA-Sr- 1'f)tIMF GTt v!J
Street Address for Proposed Work LU, 71CrA ry 'PT EA-a434.1 , �lN Ss 123
Name: (ZtC.Io g-SON PhoneC t) Cps •C 313
Owner Information Address/City/Zip: (l34"TticeN PT: EAGAN 1 MI4 SS 123
Y
Applicant is: Owner X Contractor
Licensed Pipelayer x Master Plumber Property Owner
Name: (LTD (2-0014:12- Phone 2- -3 73 0
Address/City/Zip: 14S-3o 2? Ph 111.( SS ft
r
Pipelayer Training Certification Card#: or Master Plumber License#:
I acknowledge that the information is complete and accurate and 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.
GettAN 00,-.P I a
Applicant(Print Name) Applicant's Signature
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.
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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA175050
Date Issued:03/09/2022
Permit Category:ePermit
Site Address: 1136 Tiffany Pt
Lot:12 Block: 2 Addition: Canterbury Forest
PID:10-16350-02-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Richard L & Nancy Harlson
1136 Tiffany Pt
Saint Paul MN 55123--187
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-7052
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA175368
Date Issued:03/30/2022
Permit Category:ePermit
Site Address: 1136 Tiffany Pt
Lot:12 Block: 2 Addition: Canterbury Forest
PID:10-16350-02-120
Use:
Description:
Sub Type:Water Heater
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 -
Richard L & Nancy Harlson
1136 Tiffany Pt
Saint Paul MN 55123--187
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature