1941 Timber Wolf Ct411*
City of Eaau c l-eE/7
-14
3830 Pilot Knob Road I`
Eagan MN 55122 DECFW D
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: /
MAR 142011
Use BLUE or BLACK Ink
Permit#: 3�
Permit Fee: Z� ,
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION /i0� �l
Unit
(-/-14
�
inn "^, t
r' j/`4c
Site Address: i6, I j - I NI ilk.) (A, F (Jr
RESIDENT /
OWNER
Name: 'PP.1C,E_ S 1 &/lru Phone: L51 Li 1 6 a) ‘"-
Address / City / Zip:// �I1/ new, 3 kit, 4/04,/e C T�
Applicant is: L/ Owner Contractor
TYPE OF WORK
// &O W41 R #'L
Description of work: J '3'ar/A. //II U -
Construction Cosj'3 9& Multi -Family Building: (Yes /\No 'Y
CONTRACTOR
Company: Contact:
Address:
City:
State: Zi :
Ptfbne:
License #: Lead Certificate #:
Does this project require Lead Remediation? 0 Yes 0 No (see Page 3 for additional information)
If no, please explain:
In the last 12 months,
Yes If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit
yes, date and address of master plan:
for a similar plan based on a master plan?
_No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
. , Phone:
NOTE: Plans and supporting documents That you submit are considered to be public information Portions of
the information maybe classified as non-public if you provide specific; reasons that would permit the City 1:o
' conclude that they are trade secrets. ... ,., ;., _., ,..•:
_:
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.ciopherstateonecall.orq
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.
x PAteF ST /ICL
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
/ c/q/ <�7
tD6Ir
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Famit
Multi +I►
01 of_Plex
Accessory Building
WORK TYPES
New
Addition
lit Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation,
Plan Review '
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
IRO
3G
4131
18
REQUIRED INSPECTIONS
Footings (New Building)
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: Rough In Air Test
Insulation
Sheathing
Sheetrock
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Reviewed By:
Siding
Reroof
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Windows Demolish Foundation
Egress Window Water Damage
*Demolition of entire building - give PCA handout to applicant
Peo
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings Air/Gas Tests _Final
Siding: Stucco Lath Stone Lath Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning' No. of Units:
Owner:
Address:
"Site Address:
'Plumber:
eter No.: Connection Charge:
Size' _ Account Deposit:
Reader No.: Permit Fee:
I 09WO to Comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.:
Insp.:
SEWER SERVICE PERMIT
CITY OF EAGAN
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN $5122 DATE:
Zoning: No. of Units:
Owner: -
-
Address:
Tjrihu?
ite Address:
r ,?gt T I h n i£BC?E"?iBl t?
: 7 }
l
b
er
um 'Jl?,?d
t 0?
.
agree to comply with the City of Eagan Connection Charge:
dinances. Account Deposit:
Permit Fee:
Surcharge:
y Misc. Charges:
ate of Insp_: _ Total:
nsp
: Date Paid:
.
r. CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
I
& -DOLLARS
Igo
? CHECK
RCCa1 V ED
FROM
AMOUNT
? CASH
FOR J r:
FUND CODE r AMOUNT
I
r?
f 1 ;
Thank You
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN
37" Pilot Knob Road gages, MN 55122
4.r PHONE: 454-8100
BUILDING PERMIT
Site Address -
Lot Block Sec/Sub.
Parcel $#
at Name
W
Address -
g
a:
z
ot5
01
Name
Name
I hereby acknowledge that I have read this application and state that
the information Is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Receipt *
N2 5364
Erect ? Occupancy
Alter ? Zoning
Repair ? Fire Zone
Enlarge ? Type of Const.
Move Q * Stories
Demolish ? Front ft.
Grade p Depth ft.
Approvals Fees
Assessment -
Water & Sew.
Pol ice
Fire
Eng.
Planner
Counci I
Bldg. Off.
APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Total
Signature of Permittee I
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Penwk # oeb lusted PennNtee
Plumbing X93 - ?7
Mechanical /$b 2 -
R7 9.1 -7 6 -.z'7- 7
INSPECTIONS DATE INSP. Rough-In Final
Footings 5??7 1?
?-F Date Insp. Date imp.
Foundation T _ Plumbing -/ •>
Frame/ins. -/ - ?9 -2-21-2 r/ Mechanical
Final c27
Remarks:
CITY OF EAGAN ? Ia CUILBUSTION REQUIUD
3795 Pilot Knob Road
Bogen, Minnesota 55122
Phone: 454-8100
HLAT'IN ` PERMIT No. 1562
Dote: September 25, 1979
Site Address: 1941 Timber Wolf Court
Lot 16 Block 1
i
Sub/Sec4eadwlwid
. _
Name 7.ACHMM HMS
Address 7760 MitMell Road
City Phone:
Name Rey N. Welter Heatin;_ Cc.
Address 5"i ', hica;.,' A enLe
e
City _ Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagan Ordinances.
161)
Receipt No.:
Single
Residential
Multi Res., Comm./Ind.
New/Alter./Repair NIKW
Cost of Installation
2U' OU
Permit Fee
Surcharge .5-
Total
done in accordance with all applicable State of
Building Official
CITY OF EAGAN
3795 Pilot Knob Road
r
Eagan, Minnesota 55122
Phone: 454-8100
PLUMBING
Date:
SepteWwr 12, 1979
PERMIT
Site Address: 1341 TIT+P-' bvolf Court
Lot _I Block 1 Sub/Sec.MadclyZand
Nome ZaCnMan Rome&
oe Address
City
Phone:
Name Ba et Ploiking
Address 6420 Plv1-nir Cloud
e
0
Na 1493
15868
Receipt No.:
Single I X
Residential
Multi Res., Comm./Ind.
New/Alter./Repair new
Cost of Installation
Permit Fee 20.00
Surcharge
50
N City r { t c' Phone: I Total r
This Permit is issued 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
CITY OF EA"N
3795 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 434-8100
Water softener _ PERMIT
Date: 12
Site Address: 1941 Timberwolf Ct.
Lot n/4 Block ? Sub/Sec..1 ") h? 19?D' -
Name A11an Hommsten
Address `' 41 Timberwol f Ct.
;
City V g,an, MIT Phone: 454 -5--(
Name Commers Soft Water
Addre ss 01 "al.i£orn?a
u City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagan Ordinances.
No. 307
Receipt No.: 1'256
Single
Residential
Multi Res., Comm./Ind.
New/Alter. /Repair
Cost of Installation
Permit Fee 5.00
Surcharge
5Q
Total
done in accordance with all applicable State of
Building Official
CITY OF EAGAN Remarks
Addition M®aaerrlaed Tat Addition 10 48050 016 01
/ Lot 16 Blk 1 Parcel
Owne G L ??? '? z - fStreet 1941 Tinbez lblf Court State Lagan, I?II? 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR. /41 MP. 1 81 1589.99 158.99 10 1589.99 0005569 10/15/80
GRADING
SAN SEW TRUNK 1q7Q 77.95 3.12 25
* SEWER LATERAL j/ 5 - 65 in 3'156.58 CM
WATERMAIN
* WATER LATERAL 10
WATER AREA 1973 95.27 6.35 15 aid 12006920 PAQ/79
p
STORM SEW TRK - 1971 282.92 14.15 20
nq i el
C006570
9410479
* STORM SEW LAT 1981 10 A
• services 1Q81 10
CURB & GUTTER
SIDEWALK
STREET LIGHT
road unit 75.00 15540 8/15/7
9
WATER CONN. 270.00 ii 1?
BUILDING PER.
564
11
SAC Ir if
PARK
1N SFEU ION REU ORII)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? t• 1 is ?I,vi' ?' i? ? e. 411
SITE ADDRESS: APPLICANT:
Io 1 1, (A
hli illll?lal :.ll1 ?' f I 1 t. !, 1 1 1.; t 1 Ii: +
PERMIT SUBTYPE:
TYPE OF WORK:
L
fit "1 1: 111'') 10141 Rf 111M1 "-. F11; h t1Af
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING /
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
This request void 18 months from / G G
:R 79276
Date of this Request Ejeq_ / ? 1 7
1, as)OLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wrong installed at: 4)`6 g t-?-
Street Address or Route No. 2 1 1-100! kJkle CWjtC. y GAvr
Section Township Range County
Which is occupied by
Is a roughin inspection required on this job? No?? YeM Ready Now 4 Will Call ?
Power Supplier DA "M ?J+ gjr5 r C 't11r Address On /At G'WW
Electrical Contractor <3AGNCrt e"&cC /C Contractor'sLicensd o.-
Mailing Address
Authorized Sign
R j f [? ?Ej (? ?j j'?? SCARD CGPV This inspection request will not accepted the
al (?' State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUESr
/tea i ?
R 79276
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? Range Temporary Wiring ?
Duplex ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List ) List
Other ? ? ? }
Herers7 Herers?
COMPUTE INSPECTION FEE BELOW, t
Service Entrance Size: # F eedYii@Stltit ' er # Fee Circuits: # Fee
0 to 100 Am s. v 0 iii, 34:?. re " 0 to 30 Am eres f lo
101 to 200 Amps.. 31 dd 100 mperes 31 to 100 Am res
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers. Remote Control Circ. Partialorotherfee
Si ns Special Inspection Minimum fee $5.00
Remarks R (U? TOT FE
I, the Electrical Inspector, hereby ceryrryyhat } ove ction has been made t.3Z.4%
(Rough-in) VVice?? C Uf Date- S
(Final) Date 6
This request void 18 months from ???
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 5364
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt
To be used for SF Dwlg & Garage Est. Value 43,000. Date 8-15 10
Site Address 1941 Tilrber Wolf Court Erect Xlg Occupancy R3
Lot 16 Block 1 Sec/Sub. Meadowlands Alter ? Zoning Rl
Parcel # 10 48050 016 01 Repair ? Fire Zone 3
Enlarge ? Type of Const. V
Nome Zackmlan Ho lies
e: Move E] # Stories
Mitchell Road 62 f
3 Address Demolish ? t.
Front
o C' k;aen ralrle Phone Grade El Depth 28 ft.
NameSarre Approvals Fees
0
of Address
Assessment
Permit 123.00
u? Water & Sew. Surcharge 21.50
city Phone Police Plan check 61.50
Name Fire SAC 525.00
Address Eng. Water Conn. 270.00
aW City Phone Planner Water Meter 60.00
Council Road Unit 75.00
1 hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total 1,36.00
agan Ordi
State of Minnesota Statutes qrr? ty
/
z?C
Signature of Permittee
A Building Permit is issued to: Za oms on the express condition that
all work shall be done in acco ace kith a)1` op is bl ate of nesoto Statutes and City of Eagan Ordinances.
Building Official L
_y
bq b3
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
/
nL /
tnA,5-
?
Date
l
/
C/
r
/
?y
Site Address Unit #
P
t
O hone # (&S 7 J G tC/O
Tele
wner
roper
y p
Contractor U
Street Address City
State y? I 4 I Iy Zip ?S?YJO Telephone#
Bond #: Expires:
The Applicant is Owner contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace -Additional -Replacement
_ air exchanger
air conditioner -New eplacement
other
.
State Surcharge $ 50
$ S6
Total
I hereby apply for a Residential Mechanical Permit and acknowledge th formation is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan wit the Mechanical Codes; that I understand this is not a
perm' ,but only an application for a permit, and work is not to staFf witho t permit; that the we ill be ' accordance with the
p ved plan in the case ork which res a review and approval of p a s. f t fI z
Applicant's Printed Name (/L Applicant's Signature I ?} 1'1 1'I n
JUL 14 2005 II1!
Li
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is Owner Contractor Other
Work Type
- New Construction - Underground Tank _ Install -Remove "see below
- Interior Improvement - Install Piping - Processed -Gas
Nature of Work:
"When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
Permit Fees: $70.50 Underground tank installation/removal
$50.50 Minimum (includes State Surcharge)
or
Contract Value $ x I% Permit Fee
• If permit fee is $1,000 or less, add $.50 =5 $ State Surcharge
If ermit fee is over $1,000, add $.50 for
every $1,000 nermit fee $ Total Fee
1 hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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.
Applicant's Printed Name
Applicant's Signature
Approved By: Inspector
2000 BUILDING
? / 7 / pece# 10yH
M.._ . _ &+f? 3?
PERMIT APPLICATION (RESIDENTIAL)
CITY of EAGAN ?% 0 3 # DOU 00 v
3830 PILOT KNOB RD - 55122
651.681.4675 1„5 7 air'
Remodel/Reoalr ReaulremeMa
3 registered site surveys showing sq. ft. of lot, sq. lt. of house 2 copies of plan
and gU roofed areas (20% mmdmum lot coverage allowed) 1 set of energy calculations for heated additions
D 2 copies of plans (sfx>w beam rt window sixes; poured Ind. design: etc.) 1 site survey for exledor odditlons # decks
D 1 set of energy Calculations
D 3 copies of bee Preservation plan it lot plaited alter 7/1/93
DATE: 10 CONSTRUCTION COST: 75°2 4
DESCRIPTION OF WORK: -5-1 -/
STREET ADDRESS:
LOT:. I b BLOCK: SUBD./P.I.D. #: MPQLI ?L C
Name: a 9 e- -S/ & - Phone #: L7
PROPERTY /First / n
OWNER Sheet Address: l% 7 I r m (? r WO / l d u r?
City ?Gt Stater zip: J S I e1-
• Company. / Phone #:
(area code)
CONTRACTOR S / Exp. 3/
Sheet Address: 3 Sit e - License # 7
city '2Z4 16 State: A /? zip: SSyv fa
ARCHITECT/
ENGINEER
Company:
Telephone #: (
Name:
Sheet Address: Registration #:
city
State:
Sewertwater licensed plumber (H Installing sewer/water): Phone ft:
Zip:
I hereby acknowledge that I have read this application, date that the Information is coned, and agree to comply with all aPPIcable Stak
of Minnesota Sfahstes and City of Eagan Ordinances. ® /I n
Signature of Applicant..
•
Certificates of Survey Received _
Tree Preservation Plan Received _
6yD k-
OFFICE USE ONLY
Yes No
Yes No - Not Required
OCT 0 2 2000
OFFICE USE.ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation O 07 05-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of_ plex ? 09 07-piex
? 04 02-piex ? 10 08-plex
? 05 03-plax ? 11 10-piex
? 06 04-plex ? 12 12-plex
WORK TYPE
? 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ?
? 17 Garage ?
? 18 Deck ?
? 19 Lower Level ?
Plbg _Y or_N ?
? 20 Pool ?
21 Porch (3-sea.)
22 Poroh/Addn. (4-sea.)
23 Porch (screened)
24 Storm Damage
25 Miscellaneous
30 Accessory Bldg.
? 36 Move Bldg. ? 43 Reroof
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
13 Stucco/Stone
APPROVALS
Planning -
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Aoct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Building Engineering Variance
Valuation: $
? 31 Ext. Aiulu
? 33 Ext. gAl ?F
? 36 Mufti
0
Cl
SAC Units
% SAC
To be used for 7),t/ Site Site Address 19 el
Lot IL- Block -4- Sec./Sub.
Parcel 0 ID ('7t I1,
CITY OF EAGA.V Include 2 sets of plans. i
1 site plan w/elevations 6
BUILDING PERMIT .0 l set of energy calculations.k
Valuation 7 3 ?fl Date
Owner: i? L S
Address: L IL- AN
All
Phone 8:
Contractor: ?? A 6?J1i Q
Address:
Phone Q:
I
Arch/Eng.'
Address:
OF I USE ONLY
/
Erect Occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
Move $ Stories ft.
Demolish _ Front 2
Grade Depth o 8 ft.
Approvals Fees
Assessment Permit
EW
Water/Sewer -
Surcharge
Police a
si
Plan Check o/
Fire S °
SAC
Eng. Water Conn. )O
Planner Water Meter 0
?r
Council Road Unit
Off
Bld
.
g.
PC
A
TOTAL - o-0
Phone A
Form FHA 422.3 t(R.v. 4.17.70) MAP OF PR RTY
See attached for legal
Lot 16 glk. I Addition EAGEN HU5
Address:
I0f4! TIMBER WOLF CpART
.EAGAN, M INN,
City. M
- - - ------------
FIELD NOTES Power ples P Low Areas
Show location of meters Telepone poles T Highest Point
?D '7
Private well Larger Trees NOR
Private septic system
L.P. Gas
Culvert required
Curb cut required
Driveway surface 61TAMfiLT
Front yard setback 30'
Sideyard setback 10'?
Att. Garage YL?
Garage left right
Local Inspector
City of EAGEN
Name PCT ET 50N, PON REID
Phone N-i4-SIX
LOT DETAILS
'size width 106'
Size depth 130'
Approx. S. F. of lot 13,000
High point
Power Poles
Telephone poles
Underground
Larger trees
Street = Elev. 0.001
Lot corners
High point
Low point
Gutter or Ditch
Local Electric Co.
Name N5P
Phone 330- S5YO
Local Gas Co.
Dame PEOPLES NAT/AAL CA f
Phone L163- Tel riser $ 2oa
a) Stoops (I) 2
Decks $ _
b) Sidewalk [ s . f $ 9 moo'
Driveway-5z s.f• $ goo
Parking Paa s.f.$
Curb Cut $ Permits $
lawn steps $
C) Finish Grade $
d) Black Dirt & landscaping _
Sod s.f $
e) Underground Util. $
TOTAL ?-
SAC CHARGE $
Water charge $
Park charge $
DIRECTIONS TO SITE:
.1. A14a
.......... ?# tiOL M 97N
Mw,c.+lrf „... ........... ..........................................
guilder Zachman Homes Inc.
House Name SIRCHMOKTM
House Style RAMBLER
I Sq.Ft.House jM .P sq.ft.Gar.'I8D
F) 9Y• -6--
7'
893J
H? S J °I
i
y2,
- j
89G• 0
I
To.B. SRS ?
I Gnnrx?s7c.
I F(O?R I
'yl 41
I
I I
I I
I ? 893,x,
893
/00.00' J
TIMBER WOLF GT.
100.00' -
Y...• 1 "= 30 =0" I1... ................. 7...... 4.------------------- I4........ 10........ r 4 .......lo....
FC&ihon d
........ 10.... _.% a.......10........
6.0 nwn•
$9s
J
F
LL
J
3
IC
F
r
o wwrr
1 W. r 23%
21)a 771
7 0? 711
Y. l 8~~ Or 4DNAQ411A
?r? aMr 6r?w?r,
FHA 422.3 (Rev. 4.)7.70)
PERMIT
CITY OF EAGAN
3830 Pilo' Knob Road
Eagan Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: BUILDING
Permit Number: 033162
Date Issued: 0 9/ 0 4/ 9 8
SITE ADDRESS:
1941 TIMBER WOLF CT
LOT: 016 BLOCK: 1
MEADOWLANDS 1ST
P.T.N.: 10-48050-016-01
DESCRIPTION:
-, REROOF/STORM
B,ulding°?._Permit Type
Building Work Type
7'Census Code 434
t' s
ti
r
DAMAGE
STORM DAMAGE
REPAIR
ALT. RESIDENTIAL
REMARKS:
FEE SUMMARY:
CONTRACTOR:
OWNER: -,
MATLOCK
1941 TI
EAGAN
(651)681-1883
Applicant -
EUGENE
MEER WOLF CT
MN 55122
I hereby acknowledge that I have read this application and state that the
information=is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
L__ _ _. .,
APPLICANT/PERMITEE SIGNATURE
LLD Ito
UED BY. SIGNATURE
J
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PMOT KNOB IM • 55122 (4 -9 c,
651-4675 I 3
New Construction Requirements
? 3 registered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.)
? 1 energy calculations
? 3 copies of tree preservation plan if lot platted after 711/93
required: ,Yes _ No
DATE: °w B,za 3 ???1l?cY
DES TION Of WORK: /lopes ?eo?feF?
Remodel/Repair Requirements
? 2 copies of plan
? 2 site surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST;0 S
STREET ADDRESS: 17xI cz` •
LOT: I (e BLOCK:
I- SUBD./P.I.D. #: nn
me-o o wl o,
&s
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: Phone#:
Last Fiist
Street Address: ?rl
/ //f?C??°1L?10?? G74
City ?Gt ci,¢ ? State:.? Al' Zip: SS-/ L ?-
city _
Company:,
Phone #:
License #
State: Zip:
Phone #:
Name: Registration #:
Street
City
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this application and 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 Gam/ /r J
OFFICE USE ONLY
Certificates of Survey Received Yes - No
Tree Preservation Plan Received Yes - No Not Required
State:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _ plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Y
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SAN Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
1?B 7
2005 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.
I at I
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Site Street Address -Th1dC'n..lol{P Cour t Unit #
Property Owner Ac ?A Telephone # 7S? ?i??s
Contractor Stead AA?'?`l Telephone # (5t.Q ).213 9 912
Address -7511 1 76 S- - W. City knlll? __ State Mn, Zip SsoS'y
The Applicant is: - Owner Contractor - Other
Alterations to existing dwelling $ 50.00
- Add plumbing fixtures (excludes water softener and/or water heater-complete next
section if installing these appliances).
-Septic System Abandonment
-Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
_ Water Softener X Water Heater $ 15.00
_ new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential 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 start without 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 A licant's Signature I?
115 FEB 0 ? 2005 J
-----------------i
I _Fo_rDffice_t/5"e / ,
?l /? ?' L _b
Permit #: U /y,7 ?Tq0
I Permit Fee: I I
? Date Received: ?
I I
Staff: I
------ I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7" 8-0 eS Site Address:
Tenant:
Suite #:
Ge
RESIDENT/OWNER h
ne: &0us
Name:4?L'Okeh -'1-ac,-e. P
o
/
Address I City/ Zip: 194-11 TinrrGvo(?P t?? c 1 ???L
Applicant is: - Owner - Contractor
TYPE OF WORK Description of work:
j/ 7 1
,`
Construction Cost: 9 ko Multi-Family Building: (Yes No
CONTRACTOR ((??ic
Name: QVC'v-n4- S-T0e Ieo0 P Y?Q License #: 2-0 092D2s
Address: (?2-? "?I u )-ea o C/ ue- S G
0/ 6
City: 4-6no 0C State: 0!7 Zip:
r
Phone: 6 ?I Z /7?5 Contact Person: R, co_- L-?u T ?' t J
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
_ Minnesota Rules 7670 Category 1
_
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you 'submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
-, = conclude that the are trade secrets. ki
I hereby ack edge that t information is complete and accurate; that the work will be in con ance with the ordinances and codes of the City of
Eagan; t I understa is is not a permit, but only an application for a permit, and is not start without a permit; that the work will be in
accord ce with proved plant the a of work which requires a review and ap val of plans.
X / c1 c( a ?v x .? 1
A is Printed Name A ant' ignature
Page 1 of 3
N OCT 3 0 2008
1 For. Use
Permits:.
3'V
I - I
Permit Fee: U
Date Received:
I
I Start: 1
-----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 q ? "60" Site
f'rAddress: 19-11 T rw he-/' ll?? F a
Tenant: Ae phe4 f- Suite A:
RESIDENT/OWNER Name: S7P? /I 442 - Phone: (OS?-?So7-(p??5
Address/City/Zip: bmwa
Applicant is: -Owner )( Contractor
TYPE OF WORK Description of work: EQYP.[d 101"W40 Y ?K T C?iB?2C 6?
Construction Cost: Multi-Famil
Buildin
: (Yes
/ No
y
g
_
CONTRACTOR
fyf ?t icerfse iF o20'f `/b f??
Name: ?GSS?' I YP rI 6rxfide-1'&4'f
?00 /?(e?[q'( N?c GJ
Address:
n ?
City: State: /#/V zip:
Phone: Op9Z9 Contact Person: ri
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
Minnesota Rules 76M Category 1
_
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code wodehaet
Category submitted submitted
(J submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
.Yes _No it yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone'
-NOTE. Plans and supporting documents that you submit are considered to be publlc'lnfonnatlad ?Poitlons of ::
the irrfonitatfommay be clessiiledas;non-pubilc H you ptcvld 0 speckk reasons that wauld pemilt dre,Cftyto,
concludeUW the are bade seerets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with are 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
accotdan/ce with thel alipxov?e"d?plan in Me case of wo* which requires a review and approval of p ans.
x !/15? ?DUYIG6LI St 70 111C? x v i?t?GY
Applicant's Printed Name) -? Appl' 's Signature
Palle 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation ? 03-plea ? 16-plex
? Single Family ? 06-plex ? Fireplace
? 01 of - Flex ? 07-plex ? Garage
? 02-Plea ? 08-piex ? Deck
? 03-Flex ? 10-plex Lower Level
? 04-Flex ? 12-plex
WORK TYPES (AAVV"'? wL? b?
? New ? or Improvement
? Addition ? Move Building
Alteration ? Fire Repair
? Replacement
DESCRIPTION: 1,,'t V
aluation u to
Plan Review
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Corral.
? Accessory Building
? Porch (3-season)
? Porch (4-season)
? Porch (screenlgazebo"rgola)
? Storm Damage
? Miscellaneous
? Pool
? Ext. Aft. - Nutt
? Ext. Aft. - SF
? Nutt Misc.
? Siding ? Demolish Building`
? RerW ? Demolish Interior
? Windows ? Demolish Foundation
? Egress Window ? Water Damage
Demolition (entire building) - give PCA handout to applicant
Occupancy I v V MCES System
Code Edition D-7 SAC Units
Zoning City Water
Stories Booster Pump
Square Feet PRV
Length Fire Sprinklers
Width
REQUIRED INSPECTIONS
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
_ Drain Tile
Roof:-Ice & Water -Final
Framing
_ Fireplace: _R.I. _AirTest -Final
Insulation
Reviewed By:
_ Sheetrock
FIna1/C.O.
Finai/NO C.O.
_ HVAC
_ Other:
_ Pool:-Footings Air/Gas Tests -Final
_ Siding: -Stucco Lath -Stone Lath -Brick
_ Windows
Retaining Walt
I Building Inspector
RESIDENTIAL FEES.
Base Fee
Surcharge
Plan Review
MC/ES SAC \n J
City SAC
Utility Connection Charge 1 (?
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2 of 3
CITY USE ONLY /y' /
L ?R BL RECEIPT#: f'Y l
? p
SUB 0>i i s l n 1/ RECEIPT DATE: `5/1 / 9
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
backflow preventer for underground sprinkler system
FIXTURES EAQH NO. TOTAL
Shower 3.00 x
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 100 x =
Gas Piping Outlet ` minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
Water Softener ` for existing dwelling 20.00 x ®
U.G. Sprinkler "fordwelling under const. 3.00
U.G. Sprinkler "forexisting dwelling 20.00 =
Alterations ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' oak Cty lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems "Abandonment 20.00 =
STATE SURCHARGE .50
TOTAL
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City
of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any
damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this pemdt within
City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: T TELEPHONE #: - -22
STREET ADDRESS: -? / /r??
CITY: d - ?? STATE: / h ZIP: U
PERMITTEE
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Use BLUE or BLACK Ink
r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
I For Office Use
Permit
City of Ea Rd~ .
Permit Fee. I
3830 Pilot Knob Road I ►
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I ►
Fax: (651) 675-5694 I Staff: ►
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone:~,S 2'to~
Resident/
Owner Address / City / Zip: 1 - I 'C ' Tt b P r W- 41v Gt c ( CU c- I,- Applicant is: Owner ontractor
Type of Work Description of work: roc) Ic
Construction Cost: 610 y Multi-Family Building: (Yes /No
)
Company: ~o LIr k__rff19, -To f KCxS l Contact: 1k ILlc_k -
Contractor Address: 9 ( Z... O A a v tQ t_> 4--C,~ s ~ City: G ~o %e uuc
State: Zip: S~• Phone: fp -5~~~ Z- - 3 J
i
License CSC 9tioZ~ Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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 based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota St Building Code must be completed within 180
days of ermit issuance.
x x
Applicant's Printed Name ~Iic is Signature
Page 1 of 3