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3962 Worchester Dr . - - . Date: 12113/98 ~~T ~ EAGAN Permit No: 3830 Pilot KnobRoad Meter No: 1' Size: P.O. $ox 21189 Readbr No: ~ 6~ q 0 Date: ~ Eagan, MN 55121 Owner. Mt1RVIN GEORGE BLDRS Site Address: 3962 WOR:;HESTER DR., L5, B1, H1LLS OF STONE- Plumber i'LYMQUTH PLBG RR7nr.F- Conn. Chfl: *550 00- PA Zoning: R-1 Acct Qep: i-5. pp p: - No. 01 Units: 1 Permit Feec 10.00 pd SurchBrga . SO yd 1 ayree to compiy with ttse City ot Eayan Tr. Plant 2a4.00 pd Ordinances. Meter. 67.00 vd _ Misc: By ~ WATER SERVICE RMIT ~ 2/1'!!''•~ 1a167 Date: CITY OF EAGAN Permit N&. 3430 Pilot Kn?, Road Meter No: Size: P.O. Box 2119q Readdr Na Date: Eapan, MN 55121 Owner. Wv iH Uoi?L'F. RT.L~R~ .i • • S 'M Site Address: MatT Plumber. 'L`:wUTFl PLX; Conn. Chg: ti K Sb 00 od Zoning: Acct Dep: 155^^ No. ot Units: Permh Fee: 10•!')0 p~ Surcharge: .50 p3 1 agrse io comply with the Clty ol Eaqan Tr. Plant b~~' -04 t'`' Ordlnances. Meter. 67-00 Y)d Misc.: BY WATER SERVICE PERMIT ~ 12113/88 ' CITY OF EAGAN . Permit No: Date: ~q637 Date: ! 1/ 2~3 / 8F: 3880 Pllot Ifnob Road B/P, No: ~ P.O. Box 21199 Eagan, MN 55121 'P!'.V1N Owner. i.5 Bl. RIL1.5 OF STOME- .'a W„ . Kv}~~.;i~~~.:, f Site Address: I1421nGE r• Plumber: $550.00 c?d Zoning. ~-1 MWCC: City Chg: 10O•D01 od No. of Units: 1 ~ Acct Dep: 15.40 pd 1 agree to comply wNh the Ctty of Eaga^ I Permit Fee: 0• 00 Pd i . ~ Ordinances. Surcharge: Misc.: BY SEWER SERVICE PERMIT ~ _ ~ fltrtifira#t nf Mrrupanry titp of (f agan ; luppu1btPYIf Uf gll~lbwg jwPttwtt This Cerrificate issuerl pursuanr w the requireniertts of Section 306 of the Uniforni Building ~ Code cerlrfying that at the time ojissuance lhis structure xws in compliance wlth the various ordinances of the City regularing building construction or use. For dre jollowing.• uae cww6wuon SF DW/GAR Baft. hnma rto. 15893 0-„p-7 7ype R3/14I Zoning DWO PD/R 1 rype Cono- VN o.-W d e~ag MMWIN GniGE ffiIA2S. TI~ Add,.P.O B(X 428, PRIlEE" ~ IN"% naama 3962 Wl'7MWM IIRIVE .,tyLS, B 1, KIIS OF SIUNMR(E , n.a: APRII. ll. 1989 POST IN A CONSPICUOUS PLACE ~ ~ . CASH, RE~CEIPj ~ CITY OF EAGAN ' 3830 PILOT KNOB ROAD EAGAN, MINNFSOTAt5122 DATE 19 n~rvEu FROM i AMOiJNT $ 8 DOLLARS la ? CASH -fl' CHECK ron . _ ' I ~ . ( _ ~ ! +e.C~'~ ~,1 I ' . ~~l , ~ f : ~ . JI~~ ~ FUND OBJECT AMOUMT Thank You . , BY • n -~w i , ~ - WhNe-PrYars CaPY ~ . . Yelb-Postln6 CcOY Pink-Ffle Capy CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 BUILDING PERMIT Receipt To be used for SF L1WG/G11:3 Est. Value ~74,004 Date N-CV 22 ,1988 Site Address 3962 WOR=gTRR DR OFFICE USE ONLY -vim On Site Sewaqe Occupancy ?'-3 r~- Lot ~ BIoCk ~ SeC/Sub. STpNI ~ MWCC System X Zoning . -''i ?"'I Parcel No. On Site well (Actual) Const Y"d a Name MAKYIN GLO= IlUILD8RS, IIiC Ciry Water (Al?owable) V--N W y PRV Required ~ of Stoties ; Address F 0 IJX 47•: 0 City PRI=TON Phone 389-3281 Booster Pump Ler?gth 4 e Depth 4b t Name 3AM S.F. Total ue Address Footprlnt S.F. - c City Phone APPROVAL$ FEES vW Engr./Assess. Permit h74•~ Wd Name ~~p0 U v Address Planner Surcharge DCouncil Plan Review W City Phone ~ Bltlg. OH. _ SAC. City ' 00 I hereby acknowledge that I have read this applicai+an and state that the Variance SAC, MWCC . informetion ia correct and agree to comply wlth al1 applicable State of Water Conn. 550.00 Minnesota Stawtes and City ot EaBen OrdinapEes. Water Meter 67.00 fJ-, Signature of Permittee Road Unft 325•00 A Building Permit is issued to: ?ARVIN G$ORGE BLI-ILDI.'CS Treatment P1 204•00 on the express condition that all work shall be done in accordance with alI applicable State of Minnesota Sfatutes and City of Eagan Ordinances. Parks Building OHicial • _ TQTAL 1; g3 s . ~ ,~r ? CASH RECEIPT ~ . . . ~ CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 , DATE . ~ dunrT a ; 8 DOLLARS ,ao ? CASH CHECK wn ' , / lY( / i 7 t i ~ ` i_ ~ I ~.1.(/L i ~ i FUND QBJECT AMOUNT . C' ( / ? ~ Thank You ; , / BY e: a WfWe--Pryers CoPY YeYOw--Pastinq Copy Pink--fila Cqpy _ . . } • . . . , . ~.Sr~j T'~" - CITY OF EAGAN A 1804 1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-6100 ` J BUILDING PERMIT Receipt # To be used tor DECK Est. Value =i 9000 Date JUICK 22 119 90 site Add.?ss 3462 i0~TEA Dx LOt BIoCk SeC/Sub. OFFICE USE ONLY Parcel No. occupancv - FEes Zoning N~~ & LI8A AiCKBIt R (p~~l) Conat - Bldg. Permit 2 5.00 ~ AdC1reS8- (alowable) - Swcharge • SO • City SAGM Phone 6117--91113 s ot Stories -i~ Length Plan Review ~o Name am oecth = snc, city Address S.F. Total - SAC, MCWCC City PhOne S.F. Pootprints On Site Sewape _ Water Conn ~ W Name On Site well - Water Meler ~-2 Address MWCC syS1°"' - Accl. Desa i W City PhOnA Ciy water _ p0 PRV Required _ S/W Permit I hereby adc??owlege that 1 have read this applic2tion and state that the Booster Fump - g/yy Surcharge information is correct and agree to com with all applicable State of Minnesota Statutes and Ciry of Eag 0 nances. Treatment PI Signature of Permitee APPROVALS Road Unit ~ER A Building Permit is issued lo: ~IA~C LI8/1 A Pl8"ror - Park Ded. on the express condition that alI work shall be done in accordance with all Council - applicable State ol Minnesota Statutes and City of Eagan Ordinances. . gldg. pff. _ Copies 23 . BuiWing OffiCial • 1Varianoe - TOTAL _ 3 ~ PMnAt No. PermN HoWkr OoM TNephoiw M WATER SEIMER PUMING N.VAC. " EI.ECTRIC 1n"octlon Wu traP• C°m^w^ts I Fooen9sI Foundation Fran*g Roo" Fia+9h PIb9• Ra+Dh FM9• bu. Freplace Fnal H1g. Final Plbg. Corut. 6Aeter Pb9. Wdpeclor - NotifY Plumber Enpr.IPlan BWg- Fina1 ~ Detk Ftg. Dock FNW won Pr. oisp. ~ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt To be used for SF IW/rAA Est. value s74*0FX Date POv 2 2 ,1988 Site Address 3962 WORCdBSTM: Dk OFFICE USE ONLY Lot BioCk 1 SBC/Sub. ~T?%N3L~RI On Site Sewaye Occupancy R"3 Mwcc syscem JI Zoninq pL R- ? ParCel No. On Site Well (Actual) Const V K a Name City Water _X (Allowable) Vp W T PRV Required * of Stories z Address , t' aZP o FRI:fCETt ~ Phone ~~~~7~1 ~~ter Pump Length 43, City Depth .O Name SAM S.F. Total a ~ i Address Footprint S.F. ~ City Phone APPROVALS FEES ~c Engr./Assess.Permit ~1~~~~" ~y W Name ~ = Planner Surcharge _ - Address tKy a(5 Cit Phone Council _ Plan Review ~ 1 W Y Bidg. Off. SAC, City I hereby acknowledge that I have read this applicat+on and stale that the VarianCe SAC, MWCC - - information is correct and agree to comply with ail applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordfnar?Ees. 6T. (NI; Water Meter Signature of Permittee Road Unit 335.: ' A euilding Permit is issueA to: _MARViti C$4RGE WIIAERS Treatment P1 204•L'-' on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks TOTAL BuildingOfficial_ ~ Permit No. Prrmlt Holder Dab TNephone ~ Plumbing H.V.A.C. Electric 19 ~ Softener Inspection Dote Insp. Comments Footings I ~ Footings II Foundation Framing 3 1 Roofing Rough Plbg. Rough Htg. X/~ 9Y ISUI. G. L/t'T-iG' Fireplace Final Htg. ~ . Final Pibg. Bldg. Final cerc occ. y r ~ Temp. LP Deck Ftg. Deck Final Well Pr. Disp. PERMIT # MECHANICAL PERMIT 4 RECEIPT # CITY OF EAGAN Q 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE CONTRACT PRICE PFlONE: 454-8100 Site Addr,ess BLDG. TYPE WORK DESCRIPTION Lot Block ' SeclSub Res. " New L--'= F Mult Add-on m Name Comm. Repair w Address . Other c Ciry Phone FEES ' Name RES. HVAC 0-100 M BTU -$24.00 ~ c Address ADDITIONAL 50 M BTU - 6.00 ` p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEkilAln - 1.50 EA. TYPE OF WORK COMM/IND FEE - 196 OF CONTRACT FEE Forced Air M BTU ' APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. 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 # BEYOAID $1,0W) : Other FEE: • - ; S/C: SIGNATURE OF PERMITTEE - ` TOTAL: , ~FOR: CITY OF EAGAN PERMIT # • ~ PLUMBIN(i PERMIT ~ ,~~j CiTY OF EAGAN RECEIPT tl 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRiCE PHONE: 454-8100 Site Address - 1 (c " e- < ~ '-S BLDG. TYP~ WORK DESCRIPTION Lot y, BIOCk; , Sec/Sub Res. New ~ Mult. Add-on Name Comm. Repair m ~ Address Other c Ciy '~'L' L Phone l~ y ~ y RES. PLBG. ONLY - COMPLETE THE FOLLOWING: ~ ~~OV N~ FIXTURE3 TOTAL f f f~~' .V , r c' Water Closet - $3.00 ~ Name ~-Bath Tubs - $3.00 3 AddrJPss i. J ~ -T Lavatory - $3.00 p City i Phone Shower - $3.00 =Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE -T-Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES I Floor Drains -$1.50 TOWNHOUSE 8 CONDO - RES. RATE APPLIES --T-Water Heater -$1.50 •=c MINIMUM - RESIDENTIAL FEE - $12.00 _ t_Whirlpool - $100 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Oudets -$1.50 i STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn (ADD $.50 S/C IF PERMIT PRICE GOES SoRener -$5 00 BEYOMD $4.000.00) -Well - $10.00 Private Oisp. - $10.00 Rough Openings - $1.50 ~ t . SIGNATURE 0F PERMITTEE FEE ~ Y, ~ STATE S/C: FOR CITY OF EAGAN GRAND TOTAL• _ INSPECTIUN RECORD ~ Contro' No. CITY QF EAGAN PERMlT TYPE: Hu ~ 1 01144' 3830 Pilot lCnob Road Permit Number. $*'17 4 9 Eagan, MinneSOta 55123 Date Issued: 11 /09 / 9 E (812) 681-4675 I SiTE ADDRESS: tal: 4a e05 eLOc K, 0e 0PPLICANT: 3962 I+IARCHEs7'tN OR MIfVII.tf CflHfiT, M4i} #itLlS QF St01iEBRI06f (612) 466-426! ~ PERMIT SUBTYPE• TYPE OF WORK: I E~AtiCrIfNF f"INL`aN AL}-~RATIOH INSPECTION i;.IiANl.fsiN F iMAI 4 I I l+Wmlt N0. Pnmit Fbldw DNb TMmp!?am i SJVV • PWM81PlG f~ i'~ i ~ . c,~ H1IAC ElFCTR1C ~ i(,1'i,1 ~ _ f ~ ~Y; l:~ ~ ' ~~'f ?~!"%~j ,i r. r ELECTRIC YNPselbn Deb bap. Caenmft Footkwd ! FOurldetion . Frwft z fioolkV . • . Fiau9h P6p, Roug?HIy. leul. FhePiuO~ Fined FIig. Otsii Test Flnal Pb9, Pba Wq)=or - Nbft PktnW Conef.lArler EnWRm a'°o: Fm oim* Fig. os(* Flhal 4M811 Pr. Dip. BLDG. ERMJIT 01-3210 Bidg. Permit 01-3422 Plan Check • 01-?445 Surch./Adm. 7LI 013446 SAC/Adm. ~ 01~2155 Surcharge ~~A;I ~ 75-3860 Road Unit L~~~ 20-2275 SAC ~`'°/7 20-3865 Water Conn. F?~/ 20-3868 Water Trmt. 20-3716 Water Meter 67 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL ~~J n~ CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N9 15893 ' PH O N E: 454-8100 BUILDING PERMIT Receipt# RqU37 To be used for SF DWG/GAR,-- Est Value $74,000 Date NOV 22 ,1988 Site Address 3962 WORCHESTER DR OFFICE USE ONLY O Lot 5 Block 1 Sec/Sub. STONEBRIDGE nSite Sewage _ Occupancy R-3 M-] nnwcc srscem _X_ Zoning PD R-1 Parcel No. On Site Well _ (ActuaryConst V-N a Name MARVIN GEORGE BUILDERS, INC Cirywater _X_ (Allowehla) V-N z Address P O BOX 428 PRV Requiretl _ x ol Stories o Booster Pump _ Length ~+3 ' City _pBII1CETO12Phone "~89-3201 Depth 46' , p Name SAME S.F.7otal o a Address Footprint S.F. U w~ City Phone pppqOVALS FEES .W Engr./ASSess. Permit 470•00 "w Name 37.00 ~ i Planner Surcharge Address 235.00 aw City PhOnO Council PianReview l00.00 Bldg Off SAC, City I hereby aCknowledge that I have read this appliC 4n and State Ihat the VananCe SAC, MWCC 550.00 inbrmation is correct and agre compty wit apphcable State of Water Conn. 5$0.00 Minnesola Slatutes and City E an Ortlina . Water Meter 67.00 Signature ol Permittee ~ _ Roatl Unit 325.00 A euilding Permn is issu to:_r1ARVIN GEOAGE_BUSLDERS_ 7reatment Pl T244..00 on ihe ezpress condition that all work shall be Aone in accortlance wi[h all applicable State of Minnesota Statutes and City ot Eagan Ordinances Parks Building Oflicial_Q"ATOTAL 2,538.00 ~ ~S'-- , CITY OF EAGAN NO 1$04 1 • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt fe ~Fq 01 -7 Tobeusedfor DECK Est.Vaiue $1,000 Date JUNE 22 1990 Site Address 3962 WORCHESTER DR OFFICE USE ONLY Lot 5 Block 1 SeGSub. HILLS OF PBfCBl N0. SFUNEBRILIGE Occupanty _ FEES Zoning m Name MARK & LISA ACKER (ACtuaqConst - Bldg Permii 25.00 ~'.-4' qiy"gy 3962 WORCHESTER DR (Allowable) _ 0 CitY EAGAN Phone 687-9753 ?ofStorles Sumnarge .50 Length ,15! Plan Reviaw iF Name Sp`~ Depth 11 SAGCity ou¢ Address S.F.TOIaI - SAC,MCWCC " City PhOne S F Foolprints - On Sne Sewage water Conn w w Name 0n sne weu _ w Watar Meter ~5' AddtBSS MWCCSystem _ ~w City PhOne City Waier _ Au~. Deposit PRV Required _ S/W Permit I hereby acknowlege ihat I have read this application and state ihat ihe Booster Pump - SiW Surcharge inlormation is correct and agree to comply with all ap licable State ot Minnesota StatWes and Ciry of Eagan O inances. / Treatment PI SignaWre ot Permrtee APPROVALS Road Unit u A Builtling Permit is issued to: RK OR L SA ACHER Planner - park Ded on the ezpress condtlion that all work shall be tlone in accordance with all Council _ applicable State of Minnesota StaWles and Cpi~ty ol Eagan Ordinances. gld9 pff Copies 6uilding OHicial m q Oif . I rn~l- Vanance - TOTAL 25.50 \ ~ 70143 ~ E~r~-%s 5 A7J,,,J Repiastdaie ' Fre augh-in Inspection q v ? Raatly Now L i Notdy Inspeclor ~ s o H'han Rearl I -,nsed contractor ~ owner hereby request mspection of above elecirical work at. Jab Aearess (Sreet Box o, Rouie N. i Gty 3 9~..2- 6,4) o ~ Secuon No Township Name or No Ranga No County~ G y~ L/~. O ! OccuoantlPqiNT~ Phone Na Power Su00lier Atleress Eiectncol Comrac;or IComp'(ny Namel Cont act~°•5 L¢ense No Q G, I l.rri^~ CI2c, ff~ L C,ri 0~ 6-~ / ptailinq aaoress ICon;ractor or Owner fAaking Installa4on, 5 y9 4e- cJ Autnonzec &gnaWre IC V•orvOwrEr ~V 'emg In 2Qali Pna e Number `-16 l6 MINNESOTA STATE BOARD OF ELEG CITY THIS INSPECTION REOUEST WILL NOT Griggs-MiCway BICq. - Poom 5-173 BE NCCEPTED BV THE StATE BOARD 1821 Unrversty Ave.. SI Paul. MN 55104 , UNLES$ FFOPEfi INSPECTION FEE I$ Phonc (612) 642-0800 ENCLOSEO REQUEST FOR ELECTRICAL INSPECTION z EB-00001-OB p 7 ? See msVUCtions far compleurp this lorm qn back ol yellow copy t"~` 0-143_ X" Below Work Covered by This Request ew Atltl Rep. TyOeoiBwlding AppliancesWiretl EquipmenlWired Home Range Temporary Service Duplex Water Heater Elecinc Heating ~ Apt Buildmg Dryer Other (Specify) Comm./Intlustnal Furnace Farm Air Condihoner Omer usVecdyI GonVactors Re~ Jr ~ Compute Inspeciion Fee Below. n Olher Fee * ServiceEntranceSize Fee # uwrts/Feeders Fee Swimmmg Pool 0 ta 200 AmpS t0 100 Amps ITransformers Above 200 _ Amps _ Amps Signs Inspecmrs Use Onry, ~TOTAl7 _ Irriganon Booms ~ BF Special Inspection AlarmiCOmmunicanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPIETED WITHIN 18 THS. I, [he Electncal Inspector. hereby Rougn-in oaie ~ y~;z- O cerufy that the above inspection has F,,,ai oaie been made. OFFICE USE ONLY ~ This reques; voio 18 months fmm /gIl/9/xy 9 oao,2 ~ 6 2 5 4 6 `6/ L ReQUesl Date Fire No. ough-m InsOecLOn uirCtlP ? RBady Now '~A3NJI NOtlly In5pBt10r I.2 s ? No NTen ReaAy' I licinsed contractor ? owner hereby request inspection of above electrical work at: Job Atldress (Streel, BoH or Route No I Qry 39(02 ~ .Clf£5~2 D.tIUe- ~tFG-An1 Sedion No. Townshi0 Neme or No. Panga No. County A' O Ocaipenl (PPIfJn Phone o. ,4f4111N 6Ead2lrE -732 - jU 3 4-44 Powar Supplier Atltlrass D/fKo r74 f~tE~,-yt c-I ElecUiwl ConVactor (COmpany Nama) Conlraclor§ L¢ense N. k-5TE/L c _ i o Mailing Atlaress (ConNaqor or Owner Making Insmlletion) 1z y6 AulhonzeC Sgnature (Canlydclor/Dxner Meking Inslallali0n) Phone Numper e9G -3 ss MINNESOT STATE BOANU OF ELECTAIC THIS INSPECTION REQUEST WILL NOT GtlggsMlGway BiAg. - Room Sl)l BE ACCEPTED BV THE STATE BOAPD 1821 Unlvareity Ave., SI. Vaul, MN 56104 UNLESS PROPER INSPECTION FEE IS Phona(61])602-0Bp0 ENCLOSED ~~/~9/8~ REOUEST FOR ELECTRICAL INSPECTION ~ ee-ooooi-o~ lo See iVciqns iw completing Ihis lorm an back oi yelbw copy. SD~/ O-7 E 6 2 -5`4 6 "X" Below Work Covered by This Request e Add Rep Typeot8uilding AppliancesWired EquipmeniWiretl Home Range Temporary Service Duplez Water Heater Eledric Heating ApL Building Oryer Other (Specify) Comm/Industrial Furnace Farm Air Conditioner Olher (specity) ConVaclor5 RemarksCompute lnspection Fee Below: # Othar Fee # ServiceEntrance Size Fee # Circuils/Feeaers Fee Swimming Pool 0 t0 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps s lAbove 100 _ Amps Signs inspeaor§ use Onry. TOTAL .'30 Irrigation Booms S~' Special Inspection AIarMCommunication Other Pee P ' / . • • ~ _ I, the Electrical Inspector, hereby Rau9h-in L.: pgtp ~ ~-/-a certitythattheaboveinspectionhas Final i • • oai been made ~ . ~ OFFlCE USE ONLY This request wM 18 montRS tmm Its, ~ 2 L l I q 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION JJ-1 I City Of Eagan .-p 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwcllings & townhomes/condos when permits are required for each umt Date _72- Site Address Unit # Property Owner ~J r S Telephoue #(6,~S/) y,~T Cor.trsctor 6T NING ea- Street Address 410 WEST LAKE STREET city MINNE , „ 55408 290 State 812'e24'28M Zip Telephone # ( ) Bond ti: Expires: The Applicant is _ Owner _ Contractor _ O[her Add-on or al[eration [o existing dwelliug unit $ 30.00 x furnace _Additional )~Replacement air exchanger airconditioner _New _Replacement other State Surcharge S .50 Total ~ O •S I hereby apply for a Residential Mechamcal Permit and acknowledge tha[ [he information is complete and accura[eha[ [he work will be in conformance with the ordinances and des of the City of Eagan and with the Me Codes; [ha[ I d his is not a pemil but only an apphcation or a p , n work is not to s rtwithout a pe t; tha he rk will be cco dan e with the appr ve plan in the case of o whic equ~ es review and appr val of plans. Ap licant Printed Name Applicant's Signature ,1 Nk 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complem for. commercial/industrial buildings multi-family buildings when separare pertnits are not requircd for each dwelling umt Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Praperty Owner Telephone # ( ) Contractar Street Address Citv State Zip Telephone # ( ) Bond Expires: The Applicant is _ Owner _ Contractor _ Other Work Type New Construction _ Underground Tank _ Install _Remove "see be/ow Interior Improvement _ Install Piping _Processed _Gas Nature of Work: "When installing/removing underground tank, call for inspection by Fire Marsha/ and Plumbing lnspector Perml[ F¢¢S: $70.50 Underground mnk mstallation/remaval $SU.SU Alinimum (inciuties SWte SurcLmge) or Contract Value S x 1% = S Permit Fee • If permit fee is $1,000 or less, add $.50 $ S[a[e Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; [ha[ the work wiil be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is no[ a permit, 6ut only an application for a permit, and work is no[ to start without a permit; [hat die work will be in accordance with the approved plan in the case of work which requires a review and approva] of plans. Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: RESIDENTIAL 2~ ~ LI BUILDING PERMIT APPLICATION 5 CITY OP EAGAN 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 New Construclion Reauirements RemodeVReoair Reauiramenh • 3 registered site surveys shovnng sq. ft. of lot, sq fl, ot house, and all roofeA areas • 2 copies ol plan (20% maximum lot coverage allowed) . 1 set of Enertgy Calcula6ons for heated addilions . 2 copies ol plan showing beam 8 vnndow s¢es; poured (ound design, etc.) . 1 site survey for exterior additions 8 decks • 1 set of Energy Calculations . Indicale rf home served 6y sep6c system for adddiore . 3 copies of Tree Preservation Plan if lot Dlatted after 711N3 • Rim Joist Detail Options sHechon sheet (hldgs with 3 or less unrts) DATE ~~-C~Q VALUATION U9~47 SITE ADDRESS RbZ. c~~c MULTI-FAMILY BLDG _ Y '~-N TYPE OF WORK O qVICXO 4 FIREPLACE(S) _&0 _ 1_ 2 U\J APPLICANTeaA nli~in'i $TREET ADDRESS 2-425-9 lt,)\ n~ SL'501C,_ ~ CITY STATE M~_ ZIPn'~ LL-,s TELEPHONE #~0~1-~'~ 94?i~ CELL PHONE # FAX # PROPERTYOWNER Q`t'c9 :Pa" , a" TELEPHONE# l„51-~cs~~-I1 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ yIINNESOTA R[jI.1:S 7670 CA"CP:GORY l MINNESO'CA RL3I.tiS 7673 (Jsubmission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _ Phone # Plmnbing syslem includes: Water Sottener _ I.awn Sprinklcr Fee: $90.00 Water Heater No. of'R.I. Baths No. oI IIa1hs Mechanical Confractor: Phone # Mcchanical syslcm includcs: _ :Air Conditioning Pce: 570.00 _ Hcat Rccovery Systcm Sewer/Water Contractor: Phone # ° ° ° ° I hereby acknowledge That I have read this application, sTate that the information is correct, and agree to comply with afl applicable Siaie of Minnesota Statutes and City of Eagan Ordlnances. Signafure of Applican -(~7-- orF[ci: usi; oNi.Y JUN 1 11111 Certificates of Survey Received _ Tree Preservation Plan Received _ ot Required _ BY U ated al02 OFFICE USE ONLY ? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ext. Alt - SF ? 04 02-plex ? 70 08-plex O 18 Deck ? 23 Parch (screened) O 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding O 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Afteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg oniy) - Give PCA handout to applicant Valuation Occupancy MClES 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 Wfdth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation H V AC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I, _ Air Tes[ _ Final _ Windows (new/replacement) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Piumbing Permit Mechanical Permit License Search Copies Other Total \ ; - . 1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN ' ~ 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.DESIAED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMZT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COP'MERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENEAGY CALCULATIONS yoy i 8 1988_ To Be Used For: S;ng~p Fa=;iT_ Valuation: Date: 11 /174Su Site Address 3962 Worchester Drive 744 OFFICE USE ONLY , Lot 5 Block 1_ On site sewage_ Occupancy R_3 hA_I M47CC system ? Zoning PD R-1 Parcel/Sub uiil f cr On site well Actual Const V- N City water ~ Allowable V-N Owner mArITin r u•,,,,,_.. r__ - PRV required _ # of stories Booster Pump _ Length ~ Address P 0 R x 49st _ Depth 4 S.F. Total City/Zip Code v• nTnr sc~7} Footprint S.F. Phone (612) iu4 17m APPROVALS FEES Contractor q.. Engr/Assess Permit 4r](~,00 Planner Surcharge 3 oo Address Council Plan Review O Bldg. Off. 11~22 SAC, City 100, 00 City/Zip Code Variance SAC, MWCC S50000 Water Conn 5 O-CV Phone Water Meter G~,DO Road Unit 3 251 c7 Arch./Engr. q.. Treatment Pl 2- O 4, Dc7 Parks Address Copies ` TOTAL City/Zip Code i Phone # V,qLuATION GRRAGEEi 1., o?x~ _ 0~~ . z2xz2= ti~ x 14= 6552 135MT, Z4X38= 912 'll k l f - (12!) tsx-7= Cs0 73Sx 13= qsss r+ousF 3~x~4 ~ 912 1 Xiy_ ?y ax'~~ Iy ax 7- ~y x x 7 = 5G I~u1Z = !6a 1 I~F xyy, sr? 7 zz 73gZ9 " , l~,a~ v ~a ~ o ~ ~ - - ~ MINNESOTA STATE BUILDING CODE DIVI5ION , EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER M?~Rv~N C~PO~C~~ VUIIC~e~'S SITE ADDRESS L~ L~~ I~ J~ p~~ ~ d~ ~~N~~~/~Po~ CONTRACTORM~R`ri1U (~~jQ~,~ j ~~y,p~.S DATE PHONE Determine workinQ square footaAe of each: 1. Total exposed wall area..... SG sq. ft, x , i I 3, y~ 2. Total roof/ceiling area..... b sq. ft. x Ad~ ___E~ Total exposed wall area above floor = ~~o ~p'~ " a. Total wall window area . . . . . . . . . . . . . . b. Total door area. . . . . . ~ c. Total sliding glass door area. . . . . . . . . . . . ~J d. Total fireplace wall area . . . . . . . . . . . . . e. Sotal wall framing area (average 10%). (o p f. Total net wall area ahove floor. . . . . . . . . . : (J(~ o~- g. Total rim joist area . . . . . . . . . . . . . . . ~~7i~ -~-L- Total exposed foundation area = ~ / h. Total foundation window area . . . . . . . . . . . . - i. Total net foundation area above grade. Detetmine "U" value of each wall seAment: a. ~/"r X ~~U~~ . 3 y S~. ~OW b. ti a X~~U,~ , a 3 = c~ y a x„U~, a - I d. - X "U" _ e. X~~~~~ ~ U-f = ~ I• 1 1 f. ' 1 lD~ X~~U~~ n(,,~ = y~, y g -_1~L_- l- X.,,U„ , py ~ y.D h. X 11u11 i. g 111ill , Q(n~ ~ (o , ~s 3 3. TOTAL . . . . . . . . . . . . . . . ~ P / If item 03 is the,eame as, or less than item lll, you have met [he inten[ of SBC 6006(c)2. Total exposed roof/ceiling area = 7 b J. Total skylight area . . . . . . . . . . , . . . . . L4 k. To[al roof/ceiling framing area (AveragelOX) 1. Total net insulated roof/ceiling area Determine "U" value for each roof/ceiling segment: J. y X,lUll , 3 3 = 1. 3 a k. 99 X ~,U,, oa~O - o~.s-7 I. q~ 5 X-,U,- ,oaa a 1, Fq . 4. TOTAL . . . . . . . . . . . . . . ° as. -79? If total of item !14 is the same as, or less than ltem If2, you have met the intent of • SBC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the valuea establiahed by the sum of items , ll3 and 114 shall not be greater than the sum of itema I!1 and 92. 1. ~9 3. yg + z. a$,Ss a aa~.oy 3. ~sv.a~7 +4. LOT SURVEYS COMPANY, INCo F B. a~~~~~ I.AND S[JRVEYORS SCALE I" Zo' 0- OENOTES IRON REGISTEftED UNDEB LAWS OF STATE OF MINNE$OTA 7601 - 73rd Avenue North 660•3093 MARVIN GEORGE BUILDERS Minneapolis, Mlnnesota 65428 Job No. .88-129 Q Denotes Wood Hub Set ~ AdLress: 3962 Worchester For Excavation Only Drive Denotes Surface Drainage 1ype.of;Building - Split Level Denotes Proposed Elevation Denotes Existing ,r' q^' Elevation Qi ~ O : G°r ~1471 9ai ^1 ~ i ~ 3U 4 ~n s V QC Ghf ci Q91Q - R C) 4 / y^ ~ $erJc~~ i Q9~.4 ~A 0 g98.3 / i O gys Ra~e ~ 36 R a~ \ /u~a' l ~ I ~ .rE,K Ful.(~ / I ~ tiv ~Q g ~ \ o t. \ .i ~r(• (qg~i'/? , G 46 ~ : Rq k,r° X 4w ~ ~ b ~R O ' e~ . ~ U _ '1. N• _ ~ V . . 0.0 D'y ~-s - sP~,t XF~ b Top of Block ~joo•S 9 \ \ ~ Garage Floor Lowest Most Floor P'Iqa ~0, a ~ F~sAC-AU' L'I ~:'??EEkIllFCa DEZ"T ~ Lot 5, Block 1, HILLS OF STGNEBRIDGE ~ Tha only easements shown are from plats of recorcJ or Infortnatlon provided by cllent. ~ i , We hereby certify that this le a lrue and conect representetlon of a survey of the boundarles ol the above descrlbad land and the locatlon of all bulldings and vls• ible encroechments, if any, from or on seld Iand. ~ Signed Surve ed b us this 1t y y dayot November 19 88 Reymond A. Prasch, Minn. Reg. No. 6743 PERMIT C°"t 1372 ~CIT~ OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: s u r Lo zrvc Permit Number: 0 0 1 7 4 8 Eagan, Minnesota 55123 (612) 681-4675 Date Issued: 12 / 0 9/ 9 2 SITE ADDRESS: 3962 WORCHESTER DR LOT: 8005 BLOCK: 0001 NILLS OF STONEBRIDGE f'.I.N.: 10-32990-050-01 DESCRIPTION: 6uilding Permit Type BASEMEN"I' FINISH Buildinq,Work Type ALTERATION UBC Orcuponey R-3 1 I I , _ ~ , , , . • ~ _ i, ~ 1 REMARKS: FEE SUMMARY: , Base Fee $35.00 COPY Surcharge $.50 Total Fee $41.00 Lic. Search Fee $5.90 Subtotial ~ $40,50 CONTRACTOR: - Applicant - ST. LICOWNER: NEVILLE CONST, ROD 19560260 0005424 ROD NEVILIE CONST 3607 SUNWOOD TR 3607 SUNWOOD TR EA6AN MN 55123 EAGAN MN 55123 (612) 456-0260 (612)687-9753 7 hereby acknowledqc- Lhnt I hove read thiG aoplicition and state that t.he inforrnation i,, correct and aqree to compty wiLh all opplicoblr. 5I-,Lv ~.I rin Statu'C2s and City ot Faqari Qrdinances. ~ APPLICA /P MITEE SIGNA7UR ISSUED BY GNATURE INSPECTION ItECORD Control No. 1372 CITY OF EAGAN PERMIT TYPE: i3 u r L o r ri r 3830 Pilot Knob Road Permit Number: 001 7 4 8 Eagan, Minnesota 55123 Date Issued: J. 0 9/ 9 2 (612) 681-4675 SITEADDRESS: Lor: 08e5 BLOCK: 000~PPLICANT: 3962 WOftCHESTER DR NEVILLE CONST, ROD HILLS OF STOIVEBRSDGE (612) 456-0260 PERMIT SUBTYPE: TYPE OF WORK: EASEMEN7 FINISH ALTERATION INSPECTION D. . FRHMING FIN(dl_ , F L ~ PERMIT # CITY OF EAGAN REACTIVnTE _ 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets af plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot chan e is re uested once ermit is issued. Date _~2- / f Yaluation of work Site Address: 3c/&/ ) ~m p~~o~,'~a STREE7 SUITE R Tenant Name: (commercial only) I~4Q P.I.D. k IAT ~ BIACK I SUBD._ht ,fig jt,'A k~~ Descri tion of work: l , , .41 u The applicant is: ? Owner ? Contractor ? Other (Oescribe) Name Phone.c/o ~ ? 9 25 a Property LAST F,RSt Owner Address 3~/6oZ L:A LdD I1, ST0.EET STE L City &L-r.~ State 9Gt) Zip S S/~ 3 Company Phone a~O Contractor Address _3~G7 ::r4_ License # s~605~/Exp. c; ty state /A1 z i P`~ 51 a3 Architect/ Company Phone Engineer Name Registration M Address City State Z;p Sewer 8 water licensed plumber d Processing time for sewer 8 water permits is two days once area has been approv . 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 Drdinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ~ ~ . ~ ` • ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 'TFl!7, Bese~ent Finish ? 02 SF Dwg. ? 07 4-Plex ~ 12 Multi. Misc. Swim Pool ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc. ? 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck O 20 Public Facility ? 21 Miscellaneous WORK TYPE 1 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demalish 32 Addition ? 34 Repair O 36 Move C,ENERAL INFORMATION tonst. (Actual) Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Nater UBC Occupancy ~ 2nd F1. sq. ft. PRY Required Zoning Sq. Ft. total Booster Pump / of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code y ~ Depth On-site sewage SAC Code APPROVALS -1- ~5w, Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS O Site ? Footing ~Framing ? Insulation O Nellboard ~Final O Draintile ? Fireplace Permit Fee veiuatid,: g Surcharge _150 P view cen ? SAC City SAC Mater Conn. Nater Meter . Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies .b Other Total: sac % SAC Units 90 15 ' . ` ~ ~9$4 BOILDIBG PEA!!TT IPPLICATION CTTS OF EAGAN P ~ It O SII7GLE FAMILY DIiELLIAGS l~LTIPLE DIiELLINGS COMMERCI9L 2 SETS OF PLANS 2 3EfS OF PL?NS 2 SETS OF IRCHI?ECfURAL 3REGISTEAED SITE SDR9EYS BEGISTfiRED SIlE 3QAVE2S - 8 STBDCTOAAL PLANS 1 SET OF EAERGI CALCS. (CHEC[ iiITH HLDG DIV.) 1 3Ef OF SPECIFIC9TION5 1 SET OF EREAG2 CkLCS. 1 SET OF ENEAGS CALCS. MULTIPLE DWELLINGS HENTAL ONITS F08 SALE U6TTS f OF DliTIS NOTEt IDDRFSSE4 TOH COAHEA LOTS - COIPfRAClOA/HOMEOWNEA NOST DF.SIGNASE iiHICH ADDAFSS IS DESIAED. AO CHANCFS iiI1.L BE LLI.ONED ONCE BUILDIRG PERFIIT L4 ISSIIED.. SEHER d NATER PEAMIT FEES lND 1CCOIINT DEPOSIT TEFS IiII.L BE IRCLDDED WITH iHE BIIILDINfi PERKIT FEE. PAOCFSSING TIM POR SEWER ARD METEA PERHIIS IS Til EA P BEEA CO!lPLETED INDICATIAG A LICENSED PLOFIDEB. fLli ~ PENALTY IPPLIES HHEPIs PENHIT IS NOT PdID FOA IN SAME MONTH IT IS H G~ LOT CAANGE IS H EQUESTED ONCE PERMIT IS ISSOE To Be Dsed For: i)¢c.K Valuation: Date: 3Y b% Site Address '~doru~sc5~ e~t "Drz t0 pD OFFICE 0.SB ONLS Lot 5 Block i Occupancy FEFS Zoning Parcel/Sub ,FIYiI, Actual Const Bldg. Permit 2:5,Do n Allowable Surcharge 15-0 Owner /i3A F1CKer 1 of stories Plan Aeview Length 157 SAC, City Address 3Q69 ls~onc~a~ ~r Depth 17 SAC, MWCC S.F. Total ilater Conn City/Zip Code $S/~? Footprint S.F._ Nater Meter Acet. Deposit Phone 9753 On aite aewage S/W Permit On site well S/ii Sureharge Contractor 5~~ MtiCC System ? Treatment Y1. City vater ? Aoad Unit Address PRV required _ Park Ded. Booster Pump _ Copies City/21p Code sUBTOTLL 1PPAOYlLS Penalty Phone Planner TOiAL S- 50 Council ~ Arch./Engr. SaQ~ Bldg. Off. jlt421 Variance Address City/Zip Code Phone t LOT SURVEYS COMPANY, INC. F B. "O. a~2;~; LAND SURVEYORS SCALE I" 20' 0- DENOTES IRON REGI5TERED UNDEA LAWS OF STATE OF MINNESOTA 7601 • 73rd Avenue North 660•3093 MARVIN GEORGE,BUILDERS Minneapolia, Mtnneaota 65428 - ~?11Y11P 11r~ (~Pl`t~~C~t Job No. .88-129 Cl Denotes Wood Hub Set ~ Address: 3962 Worchester Drive For Excavation Only - Denotes Surface Drainage 1ype.af;Building - Split Level oo<.~ Denotes Proposed Elevation 000 o Deilotes ExistiIlg Elevation ~ Go ~ ~Nr~ •~~98i ^ 1 ~ C9 R~ QCGh7( ofr~ri.~~\ 1 ~ 4 ~ . t? \ V \ I ~ $CrY•~~r i 4 ~ g98 x O ~ V , ti~, o F ~ Bqs•3' \ ti' ' a 3 ~ v -e5 / ~ HqR g9R~O ~ 6 0~ \ Q• u ~ U \ L n~ 0,L ~0 I ~ lrtio kq8 . cs J«,~ au1.G I~ p ~ ~ ! \ \o C411 / ~ ~ \ by~.t~~ , , j c. O ~ ~6 ,A~ u ~ qw bq~ x ~ a r • ' ; . X18 1".. ~ ' . ~ 91 1-5 - sPi,r ~Qi 10 lr 3 9 6 & 0\5 Top of Block h\ J*\ i ~DO S qa3 t, ~ Garage Floor ' Lowest Most Floor ~ ' ~ - • \ - ~ O , _ lD:_. V Lot 5, Block 1, HILLS OF STCNEBRIDGE O The only easements shown are Irom plats of record or Infortnation provided by cllent. / We hereby certly that thls la a irue end cortect representatlon of a survey af the boundarles of ihe above descrlbed land and the Iceatton of ell bulldinpa and vls• Ible encroechments, if any, from or on eald land. Surveyed by us thla 1_~h dayof November 19 gg Signed Reymond A. Prasch, Minn. Reg. No. 6743 Y USE ONLY l 5 BL CITY OF EAGAN LRECEIPT PLUMBING PERMIT SUBD. ~ (612) 681-4675 REBIDENTIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. - WORK DESCRIPTION COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL NEW CONST REPAIR/ADD ON 15.00 ~ ADD ON ? SHOWER 3.00 REPAIR _ / WATER CIASET 3.00 ' -T BATH TUB 3.00 5~ IAVATORY 3.00 ~ OWNER NAME: C' KITCHEN SINK 3.00 ~l Cp ~ /~PJ7L~ JJ r _ HOTUB~TRAY 33.00 SITE ADDRESS:_ U r-r .00 T~ _ WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 ROUGH OPENINGS 1 ADDRESS:__ J u~ S- d~/c ~ r OTHER .50 WATER SOFTENER 5.00 CITY: ~/G ~t' ~Q OIGt ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE W. TURNAROUND 15.00 STATE SURCHAR6E .50 SIGNATURE OF PERMITTEE TOTAL: S lS 'SZc COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: OWNER NAME: CONTRACT PRICE: SITE ADDRESS: 1% OF CONTRACT FEE. . STATE SURCHARGE - $.50 FOR TENANT NAME: EACH $1,000 OF PERMIT FEE. SUITE $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PNONE FOR: (SIGNATURE) CITY OF EAGAN APFLICATION FOR PERMIT +NpTE= pA12ENP OF FEE AT TIME OF ; t APPLICAI'ION DOES N7f CON- i STIISJIE APPR(iJAL OF PII26IIT. te SEWER AND/OR WATER CONNECTION : INSrECTION oe sagEn nrm/oR wATea ; irsrazv,Tiors wna. rpr ee scm[rim ; i[TlCIL PFI2MIT NAS B@7 APPAOVm. ; ~ 4, f1R1l1tf1fYi'tf1f11iMf/!4!};yR11YR41t1h~ dtV oF earjon (PLEASE PRINT 1) PROPII2TY ADDRFSS: e'/ 6.'2- G~/v~~.,le s k r- T FY;AT DFSCRIPTION; L -(Lot B ock ivi on or Tax Parc ID IF EXISTING STRC'CTURE, DATE OF ORIGINAL BliILDING PERMIT ISSUANCE: Mont Year PRESENT ZONING/PROPOSID OSE: Q CONIMII2CIAL/RETAIL/OFFICE R-1 SINGLE FAMILY Q INDI-ISTRIAL C] R-2 DL~PLEX (3WO Onits) ~ INSTITUTIONAL/GOVERN117ENT Q R-3 TOWNIIIOLSE (Three + Cnits) ( Units) Q R-4 APARTMENT/CONIDONIINIUM ( Onits) 2) NAME: N7i¢Na f.J ADDRESS: R-O_ 13~y CITY, STATE, ZIP: #'j M+.) PxoNE: 3 3;x- 30 3,/ For City Use 3) ~ NA[yE: padu,r'4 ~(G ~ Plumbers License: -T ij Active ~D~ss: Z.~6,~av~ Expired CITY, STATE, ZIP: /c (5-° `uv~. Not recorded PHONE: CY 3°.a tify)s MASTER LICENSE # 6+9 Sta Initial 4) • A • NAME: So9A-f~ <9S (~;7~ ADDRESS: CITY, STATE, ZIP: PHONE: 5) ~ ~ • ~ ~ STORM SEWER PERMIT - CONTACT ENGINEERING ~CONNECTION 'I17 CITY SEWEE2 [~aCONNECTION 'IC) CITY WATEEt O TAPS 6) *****~******~~~**~**~*******~******~*~*~*****~********~~.************~***********,********~**~~***:y * * THE GOLD COPY OF THE PERMIT WIIS, BE SENP DII2f•X.1ZY TO PUBLIC WORKS 7b FACILITATE METEE2 PIQC-UP. * PLEFI.SE AILOW 'I4J0 WORKING DAYS FOR PROCESSING. SONIDONE FROM 74E CITY WILL CONfA(.T YO[) IF THERE * * ARE ANY PROBI,ENIS. + ~**r+********~~+r******~*.**~****,r***+**********r~********,++w~****,r*****~*~*******~**+**++«***~*****y . FOR CITY USE ONLY ' . PERMIT # ISSC'ED Pd w/Bldg. Permit FEES: $ $ /O ~ SEWER PERMIT (INCLUDE SURCHARGE) $ $ 112 y WATER PERMIT (INCLODE SORCHARGE) $ $ WATER METER/COPPERHORN/0UTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ -S IZ~ $ WAC $ (D~ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRI)[VK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT S[iRCHARGE $ $ OTHER: $ $ 6 / TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ED YES IF YES, THEN A"PERMIT FOR WORK LJITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING ~ NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE•' _ DATE : 1a 71 3Iop0 December 74, 1988 MARVIN GEORGE BLDRS P.O. BOX 428 ~I' ~?~-`-~'rv~ v PRINCETON, MN 55371 U HEs 3958 WORCHESTER DR., L6, B1, HII.LS OF STONEHRIDGE 3962 WORCHESTER DR.9 L5, B1, HII,CS OF STONEBRIDGE WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, G9S, ETC. - REQUIRED BY LAW _XX Your Sewer and Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SORE TO CALL PUBLIC WORKS (454-5220) FOR YOIIR PERMANENT WATER TURN ON. _ Your Sewer and Water Permit for the above property cannot be completed for the following reason: _ Your Sewer and Water Permit for the above property has been completed, however, the meter cannot be issued or occupancy allowed until further notice. Sincerely, Jan Severson Secretary JS PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA122383 Date Issued:05/06/2014 Permit Category:ePermit Site Address: 3962 Worchester Dr Lot:5 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 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 - Tyan Renner 3962 Worchester Dr Eagan MN 55123 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA167999 Date Issued:04/06/2021 Permit Category:ePermit Site Address: 3962 Worchester Dr Lot:5 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. *Roof permits issued between December and March will be inspected in the spring or when weather warms up. 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 - Michael Sherman 3962 Worchester Dr Eagan MN 55123 A To Z Construction Inc 124 County Road 81 Maple Grove MN 55369 (763) 424-1884 Applicant/Permitee: Signature Issued By: Signature