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1128 Westbury Path CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knoh Road P. O. 8ox 21199 PERMIT NO.: 'Eagan, MN 55121 DAh: 1_7 Zoninp: u 1 No. of Unlts: own.r: Joe `iiller Const Add?ess: Stre Add.en; 112 Weat ury Pat ~ L~ S eet u Plumber. Pl mouth Flbp ] _ _ 44701 ~ I qrN h eew* wia d» ph oi fo"w CorowHon Owle: 425 . 40 pd 041"neM. 1lowunt pepowf: 15. P Permlt F«: p Surehorpe: • c 8Y Mrsc. Chorpss: Dota of Inup,: Totol: Insp': Dah Paid: CITY OF EAGAN WATER SERYICE PERMIT 3830 Pilot Knob Road P. O, Box 21199 PERMIT NO.: Eagan, MN 55121 : G--1 I- 34 i I R 1 DATE: Zoninp: No. of Units: ~ Owr»r, Joe M~~~1i~ I ( ?ess: ~ L 'r, ~ _ r ~ 3 ii i?~ ~ Addross: `Z ,I tlJtl~#2~ I I , est ury umber: p: . i r No.: on Chorgs: 4/0.00 P ' Read~r No.. Qeposit: r ~ Pertnit Fee: • P -rtj 1o!m to aeapy wMb Nw Cifp of ieven Surcho?ps: • P , 0"~ ~ AAisc. Cho?oes: P me er ~ ~ Total: ey Dats Paid: Date of I?up.: Insp : . . . . 1 . . . CITY OF EAGAN = ~ 830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 r PHONE: 454-8100 BUIL~IG,~ERMIT Receipt # 7o be uS~e~lor Est. Va1ue $l' 5~ Date ~t+Y 11 1 9 91 Site Address 1124 iR8?RURY lAZH Lot 5_ Block 4 SeGSub. MUTDiRY 16? OFFICE USE ONLY P8fC61 NO. Occupancy FEES - Zoning . W Name ~MEY? 8 DaDQRAg I.RiIls (nctueq consc _ sid9. Pem,a 35.00 ~ Address BAHR (AUowable) i~QQ 0 Ciry Phone 432-3323 e ot sto~ S""~`9e Plan Review ~ Name ~ oepn, - snc. Ciry Address S.F. Total - SAC, MCWCC CitY Phone S.F. Footprinfs _ ~ On Site Sewage _ Water Conn VW Name w= On Site Well - Water Meter Address MwcC Syscem _ g W CitY Phone cny water _ AW• DepO$d PRV Required _ S/W Permit I hereby acknowlege that I Aave read this application ar?d state that the Booster Pump c,,/yy Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI 5ignature ot Permitee APPFOVALS Road Unit A Building Pertnit is issued to: Planner - park ped on the express condition thal all work shall be done in accordance with all Council _ applicaWe State of Minnesot ; Statutes and City ot Eagan Ordinances. g~j. pry. _ Copies Building Official Variance - TOTAL PKmit No. Pumit Holder OM T*NphoM 0 WATER • SEMVER , PUTAABIPIG H.VAC. ELEMOC 383 7 0 0 ,,,ap.ctfon u,,. ,,ap. comm.nn Footings I FourWalion Framing Roofing Rough Pibg. Rough Hlg. Q /yr~ a~/i Isul. ~ ~ Fireplace Fnal Ht9• C~ G '-7 "Le orstac rest Final Plbg. Plbcj. Uspecwr - rbciy Plurtibe. Const. Meler EngrJPlan Bk1g. Final Dedc Ftg. Deck Fnal wen Pr. oisp. , . .k . . . . . , CITY OF EAGAN N212468 3830 Pibt Knob Road, P.O. Box 21-199, EaQan, MN 55121 _ PHONE 4548100 BUILDING PERMIT Receipt # To be ussdtor DECK Est Value $2,000 Date AUl"iUST 18 19 $6 SiteAddress 1128 WESTBURY PA'1'fI Erect C~ Occupancy Lot 5 egock ' 4 secisub. WgSTBURY 1ST Remodel ? Zonina Parcel No. Repair ? Type of Const Addition ? No. Stories W Name a RHETT LEWIS psmoliah ? Depth l~ o Address S~~ Int Impr. ? Sq. Ft City Phone 452-3523 Install D g fJar??e sA[-12 Approvab ryes $ i Address Assessment Permit 32.50 ~ Ciry Phone Water & Sew. Surcharge • d Police Plan Review a W W Name Fire SAC = o Address Eng. Water Conn. Ciry Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that the Bldg. Off~~ Tr. PI. information is correct a a ee to comply with all applicable State oi , Minnesota Statutes and CWy of ~agan Ordinances. APC Perks , Var. Date Copies ~ Signature of Permittee '0 itHS2'T LSWIS Totat ~ A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applikrSble State of Minnesota $tatutes and City oi Eagan Ordinances. j 8uilding Official • - i PWmit No. PrmR Holdw DsN TNMphons M PlwnbNlq M.V.A.C. Ebefr{c 8oltww Or.r,.etion aa in.p. coMn"«a. F°°n"W i 7 Footlnqsll Foundstlon Fnmhq R°°Ilnq Ra+Yh Plbp. ~o HOW Imul. Fko. I Final Nq' I FWW Pbo Oeo. Fkw , C«t oee. Dmck FW Dedc Frmp. YIfM P?. Disp. CITYOF EAGAN ij . 9343 ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eaysn, MN 55121 PHONE:45~4-8100 eU1LDING ~ERMIT Rece+vt # • T• M.wd ie. SF DWG/GAR Est yalue $63, 000 pae JULY 27 19 84 SiteA ress 1128 WESTBURY Pr1TH Erect 15 pccupsncy R3 Lot ~ Blcek Sec/Sub. WESTBURY FieMOdel ? Zoning Percel No. Repair ? Type of Const. V Enlarge ? No. Stwies W N~s JOS MILLER CONST Move 0 I..enqth 4 19133 CEDAR AVE Dsmolish 13 Depch 45 ~ Ci~-1 NGTO P~e 54- 753 Grade O Sy. Ft. ~ SAME Appeevek i.es ~ Name 22.00 A~~ Assessment Permit Water E~ Sew. Surchorpe 31. 50 City Phone Poliu Plon check 161 .~0 I ~W Name Fin 5AC 525.00 u~ Address Enp. Water Conn. _40,Q0 I ~ W City Phone Planner Woter Meter 6-1.00 I ~ Councfl Rood Unit 260.00 . ' 1 hercby ocknowl~a that I how road this opplication ond stote thot g~~, pff. Parks I !F,e i- •-nt~on is correct and ogree to comply with oll opplicoble , 032 ' btote or menrwtSOtO StOtutes ond City of Eoflcn Ordinonces. APC Total Var. Date ' Sip+oturo of Permittae A 9uildinp Permit Is lssued to: JOS MILLER CONST ~~expnm c«~~~ that oll Nrork sholl be dont in accordoncs with oll appliooble Stote of Minrxsoto Statute: ond Gty of Eoqon Ordinances. Bulldinp Official ` _ . f--- , Pwmk No. Pwmk Ho1dN Dab r~u..d2i. H.VA.C. Eleade sattwwr Irap.ecia, D.w lnsp. oM.. Footi~yt Founehtioo Fnminq Rouol+ Plbo. Rouqh HVA /!;~s insulation Final Plb¢ Final HVAC rz- a Final Cwt/Oce. Dftcribe Loeation: wow Ylhll Sawor Pr. O6p. Reaipt PLUMBING PERMIT Permit No. ( CITY OF EAGAN Fee Fill rn numbered apacea S/C Type or Print /egib/y Tot. 1. DateZ- c,) k7 2, Installation Cos%Z2,,-V ~ / ~ 3. Job/Addre Lot-!~-_Blk. X T r a 4. Owner 5. Contractor Phone 6. Address 7. City State Zip S. BuildingType: ResidentialGB~ Commercial O Institutional ? 9. Work Description: New ~ Add ? Alter ? Repair O 10. Desrxibe 11. No, Fixtures No. Fixtures Water Closet Cesspool/Drainfield ~ Bath tubs Septic Tank ~ Lavatory Softner Shower ~ Well / Kitchen Sink Urinal/Bidet Other ~ Laundry Tray ~ Fioor Drains Drin.king Ftn. Slop 5ink ~ Gas Piping Outlets I f ' 12. I hereby oenify that the above information is true and correct, and 1 agree to comply w' II ordinanoqs ard codes goveming this type of work. Signed i': foe4l~ Rouph Final ~ Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-6100 _ - - - - Receipt MECHANICAL PERMIt Psnnit No. Lq '4 CITY OF EAGAN ~ Fee , Fill in numbered spe ~J S/C Type or Print legib/y TOL 1. Date ~ 2. Installation Cost 3. Job Address ~ 'Lat Blk. Trac~~'J i i 4. Owner 1 a 1 / 5. Contractdk I, 1\ 1 C L~ f ~i Y` t~ Pfione ! ~ 6. Address 7. Citv stete n ? ~ z;p 6. Building Type: Residential Ll Commercial ? Institutional 0 9. Work Description: New 0- Add ? Alter ? Repair El 10. Describe Fuel 11. No. Equinment BTU - M. Ea. No. Eauiament CFM Forced Air Air Handling: Mfg. Boilen ~ Mech. Exhaust Mfg. Unii Heater Mfg. Other Air Cond. Mfg, Gas, Piping Outlets 11 12. I hereby oertify that the above information is true and correct, and I agree to comply with all qrdinanoes and codes goveming this type of work. ' Signed : for Ro h Finsl Inspections: Date Insp. Date Inap. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 ~ Receipt PLUMBING PERMIT. • Psrmit No. CITY OF EAGAN Fse Fil1 in numbered Waces S/C Type w Prini legib/Y Tot. 1. Dato'~Z 2. Installation Cost . ( ~ J~ I 3. Job Addres~~~7 'vtot Blk. f ' Tract~ _r 4. Owner`-~`"~-~t 5. Contractor'4-/4, !5= 'i J Phone',,' ''j ~ I 6. Address f ? . ~ f i 7. City C. State 2ip 8. Building Type: Residential 13 Commercial ? Institutional ? 9. Work Description: New I}~ Add ? Alter ? Repair ? II 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspoal/Drainfield I Bath tubs Septic Tank I Lavatory Softner I Shower I Well Kitchen Sink I Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. I Slop Sink Gas Piping Outleu I 12. I hereby certify that the above information is true and correct, and I agree to I comply with all ordinances and codes governing this type of work. Sig^ed' for I Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 CITY OF EAGAN • 3830 Pilot Knab Road, P.O. Box 21-199, Eagan, MN 55121 Np ' 12468 ` PHONE: 454-8100 ~ ~ 7d 6 BUILDING PERMIT Receipts To be used lor DECK Est Value $2,000 Date AUGUST 18 1y86 SiteAddress 1128 WESTBURY PATH Erect 1N Occupancy Lot 5 elock 4 Sec/Sub WESTBURY 1ST Remodel ? Zoning Parcel No Repair ? Type of Const. Addihon ? No. Stories a Name RHETT LEWIS nnove ? Length 20 z SAME oemoiisn ? oePin 1 6 o Address Int. Impr. ? Sq. Ft. City Phone 452-3523 Instau ? a SAME Approvals Fees o Name $Q nadress Assessment Permit $ 32.50 ' City Phone Water & Sew. Surcharge 1.00 ~ Q Police Pian Rewew M w Name Fire SAC _z ~Z5 nddress Eng. WaterConn. w a City Phone Planner Water Meter Council Road Unit Iherebyacknowledge hatlhavereadthisapplicationantlstatethatthe Bld Oft $~la~$6 T~. PI. information is correct d ree to comply with all applicable State of g Minnesota Statutes and o Ea9an Ordinances. APC Parks Signature ofPermitte 4~~ Var. Date Copies--, 33.$0 RHETT LEWIS Total A Building Permit is issued to: on the express condition ihat all work shall be done in accordance with all app ble State oi inn ot atutes and City ol Eagan Ordinances 8uilding Official CITY OF EAGAN N2 19407 3830 Pilot Knob Raad, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # 6 V To be uSed for BASEMENT Est value oate JULY 11 19 91 Site Address 1128 WESTBURY PATH Lat S Block 4 Sec/SubWESTBURY 15T OFFICE USE ONLY . Parcel No. oxupancy _ Fees Zaning w Name RHETT & DEBORAH LEWIS (Actual) Const _ Bldg Permit 35.00 3 Address SAME (quowaole) 1.00 0 Cily PhOne 452-3523 p of Stories _ Surcharge Lengih Plan Rewew ~o Name SAME oePm - sac,cny o¢ AddfBSS SF7otal - SAC,MCWCC ~ City Phone S.F. Footpnnts _ On Sile Sewage - Water Conn r ww Name OnSteWell - WaterMeter AddfeSS MWCCSystam _ iw City PhOne Cny Water _ /+cci. Deposit PRV Required _ S/W Permit I hereby acknowlege Ihat I have read this application and state ihat the Booster Pump - SiW Surcharge information is correct and agree to comply with all applicable State of Minnesola Statutes andr ~iry ol Eagan Ordinances Treatmem PI Signatufe of Permrtee a1U~4-RAj hQ APPROVALS qoad Unit A Building Permit is issued to: RHETT & DEBORAH LEWIS Pianner - park Ded on 1he ezpress condition [hat all work shall be done in accortlance with all CouncA applicable State ol Minnesot Statutes and City Eagan Ordinances BIdg.0f1 _ Copies ~36 Buildmg Official Variance _ TO7AL .00 S CITY OF EAGAN Rema,ks ?>~/f f-5;7r~~ LI) Addition Z+TESTBURY FIRST ADDITION Lot 5 elk 4 Parcei l0 93650 O50 (14 owner Street 1128 Idestbury Path state_ Eagan, MN 55123 Improvement Date Amount Annual Vears Payment Receipt Date STREETSURF. l 1986 2850.00 2850.00 C010007 1-21-85 STREET RESTOR. GRADING Water area > 1986 133.7 8.92 15 133.79 C010007 1-21-85 SANSEW TRUNK 1985 436.23 29.08 1 407.15 A014955 12-14-84 SEWERLATERAI (XV 1I86 5008.73 1001.75 5 5008.73 C010007 1-21- S Watermain 1986 65.2 4.35 15 65.29 C010007 1-21-85 WATERMAIN 1984 68.71 4,58 15 59.55 A014955 12-14-84 WATER LATERAL 1986 WATER AREA fj 1984 184.92 12.33 15 160.28 A014955 12-14-84 *Services 1986 STORMSEW TRK ~ 1986 710.24 142.05 5 710.24 C010007 1-21-85 SEW LAT 1986 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 1i44981 7-27-84 WATER CONN. 470.00 11 6UILDINGPER. #9343 1' SAC 52$.00 r' n PARK 1 CITYOFEAGAN N? 9343 , ' 3830 Pilot Knob Road, P.O. Box 27•199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # Te be wad for SF DWG/GAR Et. Volue $63,000 pO1e JULY 27 _ ~y $4 Si[e Address 1128 WESTBURY PATH Erect C~ occupancy R3 Lat 5 Block 4 sec/sub. WESTBURY Remodel ? 2oning RI- Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories W Name JOS MILLER CONST Move ? Lengch 44 Z Address 18133 CEDAR AVE Demolish 0 Depth 45 ~ City FARMINGTONphone 454-4753 Grade ? sq.Ft. c . Name $lME ADVrovab Feet o Address Assessment Permit $ 322.00 1- City Phone Water 8 Sew. Surcharpa 31 . 50 Police Plnn check 161.~0 tw Name Fire $AC 525.00 Address Enp. Wofer Conn. Q ~ W City Phone Plonner Woter Meter F3- n 0 Council Road Unit 26n n0 I hereby acknowledge thaf I hove read this aODlicntion ond state that Bldg. Off. Parks the in(ormofion is correct and ogree to comply with oll opplicable AP~ Total ~~0 Sfate of Minnewfa $tatutes and City of Eogan Ordinances. - Var. Date Signofure of Permiftee A Building Permit Is Issued fo: JOS MILLER CONST on the express tordition thai oll work tholl be dorre in accardance ith II pli bla 5 ate o Mi nesota $tatute ond Gity of Eoqan Ordinances. Buildirp Officiol ~ . ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 0 SETS OF PL~ ig CERTIFICATES OF SURVEY ~U°~U~• 63,bcn.=~ SET OF ENERGY CALCULATIONS To Be Used For: Valuation:~ Date: Site Address: 912:3144: WRIDEeffm Lot: B1ock:~Sect/Sub:~,~~~,~~Jja Erect: X Occupancy: R-3 Parcel 0 Remodel: Zoning: IZ-I Repair: Type Of Const: -s-L Owner: Enlarge: # Stories: Move: Length: 4 4 Address: Demolish: Depth: 45 City/Zip Code: Grade: Sq. Ft.: Phone Contractor: Address: / Assessments: Permit: 3~LZ.w City/Zip Code: ~ater/Sewer: Surcharge: Police: Plan Rev.: 1<01,o0 - Phone Fire: SAC: Engr.: Water Conn: 4'10,°= Arch./Eng: Planner: Water Meter (v3 Address: Council: Road Unit: Bldg. Off.: 7,~ Parks: .jkK City/Zip Code: APC: 7~7T nhnnPy- Variance: Z3 x 44 ~ l0 12 x~4 = 54G 4~ - Co4 K 4 1 - 2CD 2-4- 2- c~(z3 ~ ~ ~4~ 32 ~d 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for single famdy dwelli s& townhomes/condos when permits are required for each uni[ Date _C~ / / I Site Address Unit # Property Owner Telephone # ( ~ ( ) ~ ~J 4:3 Con[ractor O'Connor ' ~ Street Address plumbing, Heating 8E Cooling ~ CitY State ~ 1904 Vermillion St. (es+)437a177 lephone ) Hastings, MN 55033~ Bond The Applicant is _ Owner Contractor _ Ot lUJ ~ a U~ Add{on or alteration to eaisting dwelling unit $ 30.00 X furnace _Additional ~Replacement By air exchanger airconditioner _New ~_Replacement other State Surcharge $ 50 Total $ ~ I hereby apply for a Residential Mechanical Permit and acknowledge that the infortnation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with [he Mechanical Codes; [ t I understand this is no[ a permit, but only an applica[ion for a perrmt, and work is not to start without a pe ~ih, [ha[ the work wy1 e in accordance with the appro od n the case of work which requires a review and approval of plans. ~ ,P~tr~~~cc~~~nS,~~/ Appli t's Printed Name Appli ant's Signature 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Plcasc complcte for. commcrciaUindustrial buildings multi-(amily buildings when scparate permits are not required (or 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 Perm1l Fees: $70.50 Underground Iank installationlremoval $50.50 M1linimum (includes Slate Surcharge) or Contrac[ Value $ x 1% _ $ Permit Fee • If ep rniit fee is $1,000 or less, add $.50 =:1 $ State Surcharge If permit 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; that the work will be in conformance with the ordinances and codes of the City o( Eagan and with the Mechanical Codes; that I understand this is not a perrttit, but only an application for a permit, and work is not ro start wi[hout a permit that [he work will be in accordance wi[h the approved plan in the case of work which requires a review and approval of plans. Applican4s Printed Name ApplicanPs Signature Approved By: , Inspecror Date: ~ 2004 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. Date~/Z; /V / Site Street Address (N-P U v Unit # Property Owner ,H ( S Tele hone #(~p-~ J) 5Z ~~~3 O'Connor Contractor Plumbing, Heating 8L Cooling e#( ) Addr6SS I 1904 Vermillion S4. (ss1)437{m 'tate Zip ' Has6ngs, MN 55033 ~ The Applicant is: _ Owner Contractor _Other Alterations to existing dwelling $ 50.00 _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other. lWater oftener ~ Water Heater $ 15.00 ~ replacement _ additional Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Su:charge $ 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 accorda ce with the approved plan in the event a plan is req ired to be reviewed and appr ~ 1 ~G~6^4 G~6115 n App canYs Printed Name plicanYs Signature • RESIDENTIAL . BUILDING PERMIT APPLICATION CITY OF EAGAN 5 3830 PILOT KNOB RD, EAGAN MN 55122 657-681-4675 C n 0 i-, o,X.J~A lJ NewCanatructionReauiremente RemodeVReoairRauuiremenb q l . 3 registered site surveys showing sq. R. of lol, sq fl, ot house; and all roofed areas • 2 copies ol plan (20% maximum lot cove2ge allowed) . 1 set of Ene(gy Calcula6ons for heated addi6ons • 2 copies of plan showng beam 8 window srzes; poured found design, etc ) . 1 site survey lor eztenor atldiGons 8 decks . 1 se[ of Ener9y Calculations . Indicate it home served by septic system for addrtions • 3 copies of Tree PreservaUOn Plan A lot platted after 711193 . Rim Jaist DeWil Options seleGian sheet (bldgs with 3 or less uniLS) DATE 7~ Iy-OZ VALUATION SITE ADDRESS /IQ W i?E-srivAeK pisTH 4 004F%,,,)3MULTl-FAMILY BLDG _Y ?N TYPE OF WORK Fuu A~~~ir~ian/ t bHmP oLn+ -~or FIREPLACE(S) _ 0 2 ~ ; ; ncti r a o rr. 0 APPLICANT Iq NErr v2 DF8o2Aj4 /_t i i< STREETADDRESS //a~wFS~.B~Rr A&n4 CITY E7C~Ad STATENIAI ZIP551a,3 TELEPHONE #(u 51-Y5.7-35Q3CELL PHONE # 6S/-,261-473 / FAX # V.loYk u5Z-435-8418 PROPERTYOWNER4raerr Ar?J DE8A,,r .c_1=n/1s TELEPHONE# 6S/-ySa- 3S`a3 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ Y[ItiNESOT:t HULFS 7670 CA7'EGORY 1 MI~INESO"C!1 RULLS 7'r~` (J submission type) . Residential Ventlla6on Category 1 Worksheet Submitted . N , gg~o~e ~O,oflZ~h ~eo ~ itted • Energy Envelope Calculatlons Submitted O ~ IJ LJ ~5 1 5 2002 Plumbing Confracfor. Phone # _ Plumhing system includes: _ ~Vater Softener Iawn Sprinkler By~ • Water Hcater No. of R.I. Baths No. of I3atlis Mechanical Contractor: Phone # 1'Iechauiic:il system includes: Air Condiuoning Fee: 570.00 Heat Recovery Syslem Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with aA applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant ~ C;44t1; OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFfCE USE ONLY . . ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ex[. Alt - Multi ? 03 01 of ^ plex ? 09 07-plex O 17 Garage X 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex O 10 08-plex ? 18 Deck ? 23 Porch(screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous 0 31 New ? 35 Int Improvemen[ ? 38 Demolish (Interior) ? 44 Siding ~ 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33Alteration ? 37 Demotish(Bldg}• 6 43 Reroof O 46 WindowslDoors ? 34 Replacement 'Demolition (Entlra Bldg only) - Give PCA handout to applicant Valuation (2 Vv Occupancy I c., 3_ U~ MC/ES System Census Code Zoning City Water SAC Units Stories _L Booster Pump Nbr. of Units Sq. Ft. 7 qr PRV Nbr. of Bldgs Length / (I I_ Fire Sprinklered Type of Const V t) Width ~ ~ REQUIRED INSPECTIONS _ Footings (new bldg) FinaVC.O. Footings (deck) ~ Final/No C.O. _,X Footings (addition) _ Plumbing ,s( Foundarion _ HVAC Drain Tile Other Roof Ice & Water Final Pool Ftgs Air(Gas Tests Final ~ Framing _ Siding _ Stucco Stone Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemen[) ~ Insulation _ Re[aining Wall Approved By T~ , Building Inspector Base Fee Surcharge 1 r1 , O~ r~~ ~~T~ vv,.) plan Review 3 ~ 3 ~ MC/ES SAC City SAC Water Supply & Storage 3q~ N ~y S&W Permit & Surcharge ~ C2 0a Treatment Plant ~av Plumbing Permit poU Mechanical Permit V L 1~1 License Search ~ Wc- Copies ~ - Other 2 , 3'1 ? 3/ .i S I49 Tatal 7-6 1 / Cities Di ital ualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. ~:n i,:_ :.:,:r:,,. ~/cZ8 WcSTBURY PATl-/ .L~7~A/? SSI~3 ~•C ATEGORX' 1" ALTERNATE FOR *,CitV oF eag O-NE & TNN'O FAINMILY Dtiti'ELLI-NGS ~ I~,STRCCT!ONS: This llcarnarive may be used for une- and ~no-t~m:l•~ d~~allin;i builc m m;a: :h: Gce`)r f roquir::nzns o•' }Gnnesou Rulas. Chspter 7670. Cor.,piece ?zrs A. B. and C. Ciza:iy r...i:'s -Les :r„c!~::c, 2.._._:>. .~:c.ic•,~ icc >:o;i-`: .alecs: s:_= ar,d e..e u( e'°~omenr. rqu:;,,.en[ cont:ois: ar.d ictac:ur. ar ','=cr i-c c.. , ?,!ere . . . ~ . :n:cr.-.ar.on _ar .oe mu:d ;n 1`.t ,L(:nnuo:c Enery~ Codr ;,:r„narr ;r,:e5 Part A. BUILDING ENVELOPE C:-c:kprFexCanve!cpejaine;ealiagopuan-) J ?:.unp(1ve(c3ulic:.".3.3:skt's.::c.) :ei:'":7r,':ii'1~OscSc.7C.) Cirk'..`.<rrnal ene:;y cala:lacc¢ ap¢co ;ued ?"CockSoaK' Lca.r.cic:e .cric.,he:: Seia•H) ] (='axi -ocr) O Per.'ormicc: (ar:acS C-vL_e _ialaacns) ] S':S:t.:S5S 7:eCSCC~a: :C' =1i'.-~iS) "Cookbook" Worksheet `~~""~-QL~.`~``S - • (:or'CoalcSouk' aodoo ooiv) . 7 Gilu:g iasclir.cn3-:3 :.{i::FS.• cr.c73;' 4==i: cr L`'S'z~Cr:ovS Stinim:--n 3 V.v 1 Tt.6 OII.Nf/IllII:Ln .Rt991)?Ten4; Ili: NL'^.T.IS:. Z..B 0.1L~ Z-] i: t1 :0 Y..:C. '.LC<:ItT.ki) :!'3f at5 2. C. :o < -~=c ~Itsf .-..tC lii : eTiU fJ "se "CCOkSCCk" ODtiCn. 2, our' r'.:"~''•" ' ~ J.:C .r iolid'.crCCi:C.-~ ' ir.(:ica:a =rcocs:d +iI',ca on ncle Se!cw. R.__l: Q~ 1:J: f.dC'x f'_.Yt 1f:~ >CL.:O ' ~ c.,......_ 0.'1 - _ o,=: ;[s .es' `;e=;; :e_I +hdew i;me!a.~'.~ing area o(ill rour:da:ien ~ainCaas) ,on i:scia:ier.. ).Lr.-- 2- .v^.C !ecr x:ea s ocui :r less 4han allcwaole pt .er.ta3e. 'r.cr. accc u-~.av! -~..-.c T.aBLE FOR DETERMItiTG }Ca.\T[L?I R'LrDOw .a.,-D DOOR .~LR:.a }ficr.:_ Aifc•.vabie Toral'Nir.cow az:d Dcar.uea is I 16. I I I I , ..o0 ~ 130. o I i J'.+ 6, , o]:Ct....az_ o,r ~ xvexd_ ',~'alt 1_/0 11°.0 . 20°.'0 I „ _av o ~ ,~e ]3s. if! T:-e IS'c~.da:C ' =n¢): `v(ax:== Alr.aYe R?: dc•v U-vi'e lesc:o! [cc.u:icn +~~?ca;l: 2. f?~ascia::cr.. R-';:es:.`.ir. ~ 0.:5 ~ 0.41 1 0.4: O:o I 03: I 9,i0 I 9._? j 0.2 : I 0.23 :D 's-. 2-!: :n,cta::cr.. R-i szeaehine I OSZ ' 0.1: ~ 2i9 I 0._~ I 0.31 I 0.33 t 0.3' I ~i-' o- 2<5. R-!9 :nsula:ica < 2-? sneachm 1 0.18 O.SI 1 Q.:o 0.39 I 0.25 I 0_~ I 0.72 i 6.7; rZ) 2x6.3-19 ;nsclaacn. R-: extun 0.:6 ~ 0.13 ~ 0..= ~ u J7 ~ 0.3- ~ 0.3! I 0.23 ~ 026 ~ 0. ZI ?so, R-' I ir.suladoa < R-: ~aac5in OS l 0.13 0.33 I 0.:4 0.70 ! 033 1 0._: ~ 0.23 I 032 ZI '_xb. R-'I irsuiation. R-i shat4in 0.53 0.50 0.41 ~ 0.39 0.3: ~ 03= 1 0.29 027 ~ 035 W'sll T e(Advanced Framin¢ : h(aximumAvera e Windnw (i-valne (ezcYc Fow:da;ica aicCows): O 2x6, R•19 insuladan. < R•5 sheathin 032 0.45 0.39 035 0.31 0.23 0.26 01S 0~ ~ O 2x6, R-19 insulanom R-5 shnEhin 038 0.50 O.u 0.39 035 03? 0.29 017 025 : O 2~6.R•21 insularioa<R-5 sheachin 0.55 0.47 0.11 0.36 0.33 0.J0 0.27 OJS 02i . O?<6, Ft-:1 insutarion, R•5 sheathin 0.60 032 0.46 0.41 0.36 0.33 1 0.30 013 016 ` Window U-vafue: Souic:: ? NFRC C) A3F0.X: 1993 4u:Chcuk 100 X 1 /53 < wiaCow & door area ¢oss uposed wall ara DES[GN' AI.LOW.i3LE (.`.-m ~3bte acu•:e) M/NNESOTA ENERGY CODE - WHIcH RutES Ma y 1 UsE ? TY'PE OF RESiDENTI.aL BUILD[YG APPLICABLE RCLES . D«2ched R•J occupancy I• and'_-bmtly dwelllnQ3 Clup~cr76%?: or E.car.:elcs: sin-!e fynnily.;+in 4ema, du lexa C;uete 7670 "Ca:e erv ;z3^_:arv Cc.;es;i:^=:ien _ r.d at:ia:ien ;ecuir-ares Attxhad R-3 occupancv dwelGnge CFupcc: i6;1; cr Err.olcr mclez ~own}:cuses md row huusee Ctuome i670 w:~h e:ehr. "Q~:rserv I" ur "C~:czer~ 3" ;m~:s:cn; R-l octupancy buildingf of 7smrtee or Iw Chapter 7671; or E.<vnol<s: condcminiumsorao~rmunn Chaotrr7670 cr "Ca:czcrv?.. =roii;ron; R-1 uccupancy buildings over }~~orla hlQh Chapmr 1675 r . EaWTOIce. hieh r.u mr.dct or 3oar'menc+ ~ .ysa- a s~ a -7 NEW CONSTRUCTION ONLY Part B. DEPRF:SSliRIZATION PROTECTION r•xi icmir.., •^:._r..c.^.t (GUfTGIc:: iC:it--lL'ICS :CIU'A) '\;a ^'r!':c:ni::~ rcr.t y'4c:p EXFiACST/ yLaIti:.-C'P A1R SCHEDGLE• ' G:r.._!e:::;e •.:;^:~:~::.:a .ic^r•_'::id'ce!uw Or.P: E.~:,aes:da~.iceso•;c: iCO: ~ ?!ow ' . . . . . . . •.~::4 i 4" i: s~ , _,...._.~ci _r.i ar :c_ Ca:e~ur,. l' ~~;:r..~:e. err.i '.Ll:rStr.rs.iron!`er,gn[iCdirec_or:exc; ~ e'I :°nce•_' er sol:~' .:t! u^oipcer.t v:n: ieact heira, tccion:n: ts I c~ saiee:rd. CO:N BUSTIOY EQGIP.rIEYi SCELEDCLE (caeck ail :v^es eroeosed) Scacc `as;..^.g -ncr.saiiC 4_zi ~:1 Sea:ed :cr..ocs^:en ~ Y .°.e:r_h - nensalid 6:e! ~Q Sn;ed cor..bisr.on ~ Y" 11 IZl Direc or ;cve: ven.ad I? Di:ec: ar .--owe: ver.ced ~ y Y. ~ A-.mosecc^catlv vented ` ~ a, escher'call veae--d R'i.e: hzae:ng - aorsoLd 4--e! I O Scs:ed .omocscon ~ Y' Spac: heatin3 - solid tue! I~ A-:ospnzr.ca!ly veaeed ~ Y. ~Z] Dir_c:or:owe:•rented Y W3terfieatin4-soGdii:el I l7 Aanosci:ericallvven[--d ~ Y A¢r.orhencaIIv vented \ Hearch - solid tue! O A^escher'callv v:; eed ~ Y t: ic:;orhe:ically v= ::e_ selid :uel or dir.cc or power vrnted noasoiid tuei spaco heacng is iasuilzd, then ma;ce-w ai: co tnatco ::uw is :ecuired :er :aca icd:•.:dua'. cchhaur device which excxds 300 cebic teet oer mincte. Part Ci. VENTILATIO'i"N7 i vEN-rnario:r' Qt.kNTrrY (>[ec: a:.;cal venrilsr.on mesi ce provided pr: [he lar3er quaatiry cala:lated'e<!ow) ° cubic (aet i 0.00583 !minuta = I ~ cfm ( i I s IS cfmlbedroom)+ 15 cfm cfm veicce oi haoitable roocrs numoer of oedrr.oQS - 4'ENTIL4TI0:~ FA-N SCHEDCLE i C; e=k .^..au4od(s) r:oeos:d 4 ~I °:3 cs`acs: or.!•, ? Balancad (heat re:ov:n vae.^:?3!or. ir zxciaa^e;. e:c.) F3n dzscr,^t;on or loca,^:on ~ 1 1 1 TOFAi.S VENT(LAT[Oti ~ (nuic_ ~ c5n cim ccn • c6n « AS DES[G`~7D E.ctiaus: ~ cfm c£~ I cfrn cfm ~ Statement of Compllance: The proposcd building design rcprcsented in thue documrnu is consistent wich the bui]diag plafts, specifications, and othar talculations submittcd with the permit application. Tne proposed building has been designed to meet the requir:mencs of the Ntinnesou Energy Code. A2olican[ (prin[ name) Signatuce Date T:lephone number Part C?. VENTILATION (Submit P3R C1 upon completion oCsystem verifica6oat) x !eb Si[e Addrss: Pemi[ Numoer Paa descriotion or locacion TOTAf.S `.t=ASI,RcD [nLue I .im cfn crn c:n e:n ?E3:0RA-kYCEt Exhaus; I ctm c.`m c:m c;m ctm i b'anti!ation nte must be ncasured ar.1 verit~cd when the per.'ormant: oppon s ated in lieu of the prexr.priv: opcen for the sea!ir.u oC'oinLs in :t;e ouilCir,¢ conCir,oned enve!oe< (from Part A). Cnmpllance Statemene: (ns(al!ed •+en:ilation ;ysmm is in compliar.ce w;th Nf:`f Enc;g;i Cude 3nd is sized to proviCe the Cesi3n iir tta•.v. .-~:plica~e (pr.r.[ nar..c) S:g.^.1c:rc Dacc Te(t?hune number 7ertiflcate For: u,)ae,oh',:-Miller Conatructlon ' A133 .^,edar Avenue South Parmint5ton, MN `i5124 Plan 83-1115 Fairfax A DELMAR H. SCHWANZ LANOSURVEYOR S, 'UC. R0pr51016C UnGO Uwf O/ TM Sbb ol Mmn.wU ~ 2978 - 146TH STREET W. - BOx M ROSEMOUNT, MINNESOTA 65088 PHONE 812 42X1768 ~i SURVEVOR'S CERTIPICATE . ~ ~ l ~ 4 n r i~~ 'IIII( Scale: 1 inch = 3~~ feet ~u.• _ _ Q 383 ~ Proposed elevations r l ~ p= Set wood hub I ~ ~,•~i• ~j~/~ o= Property corner Proposed drainage pos age floor elevatlon ~ Ihereby certify that this is a true and correct representation oP the following - ~ ~ deacrlbed tract oP land: i .r Lot 5, Block 4, WESTBURY FIRST ADDITION, according to the recorded plat thereof, Dakota County, Minneaota. Also showing the locatlon of a propoaed y~ huuse not etaked thereon ae of July 15, 1984, • Nouae staked 198_ v .b11NNE50r4 REGISiR 1TION Nf) 8675 TC 13. The petition regarding the installation of special "No Event Parking" signage on New York Ave and Ventnor Ave was received and consideration of this item was scheduled for the September 17, 2002 City Council meeting. TC 14. The final assessment roll for Project 853 (Woodgate ls` Addition - Street Overlay) was received and a public hearing was scheduled for October 1, 2002. TC 15. The final assessment roll for Project 854 (Parkcliff Additions - Street Overlay) was received and a public hearing was scheduled for October 1, 2002. TC 16. The final assessment roll for Project 855 (Oak Chase 6`h/Ches Mar East Additions - Street Overlay) was received and a public hearing was scheduled for October 1, 2002. Ken 17. Change Order #3 to Eagan Well House Number 20/Park Pavilion to Ebert Construction in the amount of $1,518 was approved. Ken 18. The bids for the infrastructure low voltage wiring for the New Community Center were received and the contract was awarded to Parson's Electric for the amount of $44,550 (Base Bid of $38,168, Bid Alternate of $2,332 and 10% contingency of $4,050) and the Mayor and City Clerk were authorized to execute all related documents. PUBLIC HEARINGS TC 19. The vacation ofpublic drainage and utility easements within I,ot 9, Block 1, Lexington Pointe Addition was approved. TC 20. The public hearing for Lot 7, Block 1, Stoney Point 2"d Addition (3626 Lakeview Trail) was closed and action on the vacation was continued until consideration of the required setback variance. Mike 21. A 10 foot variance for Anne Anderson to the 30 foot reaz yard setback requirement (from a public street) for Lot 1, Block 1, Ridgehaven Acres (1579 Stephanie Circle) located in the southwest quarter of Section 04 was approved. Mike 22. A 3 foot variance for Kazen Dozois &om the allowed 20 foot front yard setback for the construction of deck addition to an existing townhome on property located at 1306 Crestridge Lane (Lot 2, Block 13, Timbershore 3`d Addition) in the southwest quarter of Section 15 was approved. Mike 23. A.22% variance for Rhett & Deborah Lewis from the 20% maximum building coverage and a 1 1/2 foot variance on the 10 foot side yard setback standard in residential zoning districts for the construction of a 352 sq ft living space addition and a 14 sq ft wall "bump out" for Lot 5, Block 4, Westbury 151 Addition (1128 Westbury Path) in the northeast quarter of Section 22 was approved. OLD BUSINESS TC 24. The final assessment roll for Project 796 (Cedaz Cliff/Mari Acres - Street Overlay) was received and a public hearing was scheduled for October I, 2002. RESIDENTIAL s4(4 1~ BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reouirements RemodellReuair Reauirements • 3 registered site surveys showirg sq. ft. ol IoL sq. R. of houu; and all mofeE areas • 2 copies of plan (20% maximum bt coverage allowed) . 1 sel of Energy Calculations for heated addrtions . 2 copies of plan showing beam 8 window s¢es; poured found design, etc.) . t site survey for extenaradditions 8 decks • 1 set of Energy CalcNafians . Indirate d hane served 6y septic syslem for addihons • 7 copies of Tree Preservation Plan rf lot platted after 71153 • Rim Joist Detail Options seleIXion sheet (blCgs with 3 orless units) DATE ~.-~I Oa VALUATION 551 Z3 SITE ADDRESS MULTI-FAMILY BLDG Y N TYPE OF WORKtI, ~pb~c_~ aI~ W ows W I rsor, Wir~C.iow3 FIREPLACE(S) _ 0_ 1 2 !'~C.UJ (.EYnCrNV oar4A s~ i~ 5 'S U-) ~ v~A C) v~5 APPLICANT_ & e,T-~ ~p 0 ebbl2r "lS STREET ADDRESS N_rd eS~tt~A ?4k CITY Q ah STATEANZIP SSI Z3 TELEPHONE #_IPSI"4SZ-3S23 CELL PHONE # 65I-W-q_73 I FAX # PROPERTYOWNER 1lY\A 06h~ e~ ~ PW4S TELEPHONE# 65I-y52-352-3 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MlNNLSOTA RliLLS 7670 CA"fEGORY I MINNLSO'P:\ RUI1:S 7672 (J submission type) . Residential Venhlahon Category t Worksheet Submitted . New Energy Code W orksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _ Phonc # _ Plumbing system includes: Water Sottener _ Lawn Sprinkler Fec: $90.00 Water Heater No. of'R.I. Batkis No. of Baths Mechanical Conhactor: Phone # Mcclr.uiical s}'s[cm includes: _ Air Condiuoning C'cc: $70.00 _ Hcat Rccovcry System 2 n r~ Sewer/Water Contractor: Phone # I I'J I~~ I[ 11 ~J 1_q~ zoo I hereby acknowledge that I have read this application, siate that the information is coyrect, and agree to com~y with all applicable State of Minnesota Statutes and City of Eagan Or ' nces. ~ Signature of Appllcanf /1l~;~ - ~'I ~ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 08-plex 0 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Reptacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) Insulation _ Re[aining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC Ciry SAC Water Supply 8 Storage ' S&W Permit 8 Surcharge Treatment Piant Plumbing Permit Mechanical Permit • License Search Copies Other Total l 7~ 1986 HQILDING PERIiIT APPLIC9TIOB - CITY OF EAGAN NOTE: ALL COtTfRAClORS MOST BE LICENSID HITH THE CITY OF EAG9N SIBGLE FA4QLY DiiELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, t SET OF ENERGY CALCOLATIONS MOLTIPLE DAELLIAGS - RFSIDENTIAL RENTAL OeiITS FOR SALE QNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQR9EY - CHECB FiITH HLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 2Gz'~b o To Be Used For: DE(2 K Valuation: V-2;:W? Date: 161 /3f8G Site Address //d B L?e578uPY ~ATF/ OFFICE OS6 ONLY Lot ~ Hlock ~ Erect 2L_ Occupancy Remodel - Zoning Parcel/Sub Repair Type of Const ~ Addition # of Stories Owner yET r.C Ew/S Move _ Length 00 Demolish Depth Address a a wES i~Su,~ Y PAT+-l Int.impr. _ Sq Ft Install City/Zip Code FAC-,AnI M nl SS) a3 Phone ysa -ssa,3 APPROVALS FEES Contractor ,l/amE OuJA/t-ei Assessments Permit Water/Sewer Surcharge Address Police Plan Review Fire SAC City/Zip Code Engr Water Conn Planner Water Meter Phone Council Road Unit Bldg Off~ Treatment P1 Arch./Engr. APC Parks Variance Copies Address TOT9L 3. -So City/Zip Code Phone # NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER MQST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES IIILL BE ALLONED ONCE BDILDING PERNIIY IS ISSQED. / s X 2~-' ~fJ~ ~j ~ Z l-~C~ U , ~ _ ~ Certifl^ate For: J•.) ae; h 'r?•Miller Construction ' A133 Cedar Avenue South Farmington, MN 55024 9- Plan 83-105 Palrfax A DELMAR H. SCHWANZ LANpSVRVEVOR 5, IN(• Rpislve0 UnCor Lawf o/ Th* SbU OI Mmnnoll i 2878 - 146TH STREET W. - BOX M HOSEMOUNT, MINNESOTA 66068 PHONE 612 4211789 SURVEYOR'S CERTIFICA7E i , L1 ~~q i -'t ~ ~:,.•.i c f:eyo' - i- -i Scale: 1 inch = 30 feet 4~.. Proposed elevations I ~ ' ~ ? = Set wood hub 11 ~ o a Property corner Proposed drainage o, I - - ~ ; ^.y ~ ? Pro oaed p garage floor elevation c•. ~ au i~ ; I hereby certLfy that this is a true and correct representation of the following ~ descrlbed tract oP land: T I.ot 5, IIlock 4, WESTBURY PIRST ADDITION. according to the recorded plat thereof, Dakota County. Minnesota. 4k Also showing the location of a proposed y house not ataked thereon ae oP July 25, 1904, ..=.in; • , .'r/ House ataked 198_ L • MINNESOTA REGISTRATION NO 8625 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3830 PROT KNOB RDN 55722 651-681•4675 New Conshucflon ReauiremeMs Remodel/Reoair Reauhemenh 9 D 3 registered sNe suneys showing fq. N, ol lot, sq. R. ol house 2 copies of plan and all roofed areas (20% maximum lof coveraae allowed) 7set of energy calculations for heated addBlonf ? 2 coples of plans (show beam a window sizes; poured fnd. design; etc.) 1 sRe survey for exterior addMions 8 decks ? 1 sef o} energy caleulations ~ ? 3 copies of hee preservation plan fl lot platted afler 7/1/93 DATE: 9. {~-1~ CONSTRUCTION COST: S DO D DESCRIPTION OF WORK: ~ )zO O r- STREETADDRESS: 1I ~ W 1E7STtSKfLY PATH LOT: ~ BLOCK: ~ SUBD./P.I.D. Name: LE W ~ S 1C 1"T E 1 r Phone lk: (651-4SA- 3 5A3 PROPERTY Lan Fkd OWNER Street Address: lla8 WEMK QY T" Cfty C~ PfGITIV State: mIv Zip: SS Ia`3 Company: ~c-,jNew Phone k: ~ ~ ~ ~ -OS9 (area code) CONTRACTOR Street Address: 160%A4 1 fficacEr s o. License jA&j=p. City I~VRh~11u.C State: K Zip: SS33 1 ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Sireei Address: Registration N: CNy State: Zip: Sewer 8 water Ucensed plumber (reaulred for new conshuctlon onlvl: P`naNy applles when address change and lot change Is requesfed once permft is Issued. i I hereby acknowledge Ihaf I have read this applicaflon, state that the Intormation Is cortect, and agree to comply wfth all applicabl State of Mlnnesota Statutez and Cffy ot Eagan Ordinances. Signafure of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation O 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ?~02 SF Dwelling 0 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. 03 1 of _ plex ? 08 6-plax O 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 ApaRments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex ? 10 8-ptex ? 15 Lodging ? 20 Pool 0 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 hando to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Buiiding Engineering Variance Permit Fee Valuation: $ Surcharge 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 l 3~ J~ SAC Units % SAC 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 3-~ ~,3a 651-681-4675 New Conshucfion Reaulrcments Remodel/Reoalr ReauiremerNs D 3 replsfered sRe surveys showing sq. tt. of lot, sq. H. of house 2 coples of plan and gj rooled areas (4046 maximum lof eovercae allowed) 1 fet of energy calculaNOns tor heated addHlonf D 4 coplef of plans (show beam a wlndow sKa; poured Ind. design; etc.) 1 alle suney for extedor addlNOns a decks ? 1 sN of energy calculafions ? 3 coples ol hee presenaHOn plan Y IW plaked aNer 7/1/93 DATE: 'q~~ 416`7 CONSTRUCiION COST: fiPPRoX ~a 700, o 0 DESCRIPTION OF WORK: 00 CK STREEf ADDRESS: / c`t 8LcJEST u ~ LOT: S BLOCK: ~ SUBD./P.I.D. M: Name: ~l/~~ s RF/~IT Phone Ios~" ~.~d - 35.~ 3 PROPERTY Lasr Ftrst OWNER Sfreet Address: Gc/EST j~UQ y PATH Clty EAGA i? State: /l9 N Zip: S sl a3 Company:~tSQb~r'~ ~ enr ~ t!~ (area eode) CONTRACTOR Sheet Address: Ucense 1! Exp. Cffy State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) SheeT Address: Regishation N: City State: Zip: Sewer 3 water Iicensed plumber ([eauired for new conshucflon onNl: Penely applies when address change and lof change is requesfed once permR Is Issued. I1hereby acknowledge that I hwe read this appllcaNon, sfate that fhe Infomwlion Is cortect, and agree to comply wMh all applicabl Sfate of Minnesofa Stotutes and Cily ot Eagan Ordinances. Signature ol Applicard: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No 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.) O 02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex O 08 6-plex ? 13 16-plex le 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 O 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ~ 31 New ? 35 Tenant Impr O 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) Basement sq. ft. Census Code 11311 (Allowable) Main level sq. ft. SAC Code C~ / UBC Occupancy sq. ft. No. of Units D Zoning sq. k. No. of Bldgs 15)1 # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee 60, l~ Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SNU Permit S/W Surcharge , Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC or: . , ° mSller Construction , adar Avenue South _ngton, MN 55`124 Plan 83-105 palrfax A DELMAR H. SCHWANZ , LANOSVRVEVOR S I UC, ~ RpiftvoC UnaOr lawf o/ TM Sbb ol Minnem4 2878 - 7467M STREET W. - BOX M ROSEMOUNT, MINNESOTA 66088 PHONE 812 6231j8B h SURVEYOR'S CERTIFICATE f: '•1 ,~,a I ` - "':!~/.2 .={y~y= ¦ 6r ! ~ - ' ~ = - - :'~r---_-- i-- _ ~ QQ~~~ ~ I ~ : f~)? ( Scale: 1 inch ~ 30 feet ic.! ~ ~ 'n~i ~ i ~Sf ~ Propoeed elevatlone Q= Set wOOd hub o a Property corner Propoaed drainage ~ Proposed garage floor elevation :~7 , I hereby certify that this is a true and correct representation oP the following deacrlbed tract oP land: 5~ / ~ •r Lot 5, Block 4, WESTBURY PIRST ADDITION, - - - according to the recorded plat thereof, _ Dakota County, MSnneaota. Also showlng the location of a proposed houae not staked thereon aa of July 25, 1984. 1 • , • 1 House ataked 198_ A ~~v~ 1.ti"•/` MINNESOfA RFGISiRATiON NO 8l:',5 ~ 1991 BUILDING PERMIT IPPLO FATI01K to 7 CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DS7ELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PI,ANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. T~J//.~ To Be Used For:,~`j~jhtC• Valuation: Date: Site Address Q~s wm nu Pn`th OFFICE USE ONLY Lot S Block ~ FEES ~ Occupancy Bldg. Permit I, i, Zoning Surcharge Parcel/Sub (N Actual Const Plan Review ~hP Allowable SAC, City Owner / 4 # of stories SAC, MWCC ~ Length Water Conn. Address ~ ~ AU ILA Depth Water Meter S.F. Total Acct. Deposit City/Zip Code t-CL~[~~ M N Footprint S.F. S/w Permit S/W Surcharge Phone y On site sewage_ Treatment P1. On site well Road Unit Con ractor ~ MWCC System _ Park Ded. / City water _ Trail Ded. Addres PRV _ Copies Booster Pwnp _ City/Zip ode SUBTOTAL APPROVALS Penalty Phone \ Planner Lot Change Council TOTAL Arch./Eng . ~ Bldg. Off. ~ Variance Addr s City/Zip Code Phone # 4:2 ~O~fDI ~•~O,l,tr~,, agrees that all work shall be done in accordance with (Signature o Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. 1 2/04 f CITY OF EAGAN aa APPLICATION FOR PERDIIT ~I • SEWER AND/OR WATER CONNECTIOri (PLEASE PRIHi) i) PP.OPEF2TY ADDRESS: ~I>B ~cs/_4'Cfy r.FrAr nE.sciuprTc:r: La f s a/ Y (Lot/Block/SuLdivlsion or Ta:{ ?arcel I.D. NunSer) ' I'r' W;IS':'_:G S-mL'CPT<E, DA'IP. 0F ORIGi LAi, u;2?.DL"G ISS~:Ai;C':: P~WSL.'?' _.^,`IIi:~;~°T?OPOS= C'S• GYi;-1 SiiGIE cPMSLY ? R-2 GUPLE{ ('IS,:O i]iVZTS) . ? R-3 TCi•:1II?CUcg (?'FT= = L~-NZTS) ( L-LTITS) 0 R-d APA2T!E~]T/CO~DCtSIILtiS ( [JPiITS) ? CC1ti1'-1E°CLAI,/RETAIL,/OFFICE ? 1l'DCST2I.1L ? NSTI;L'PIO:]AL/GiVETN:=,;T 2) APPI,ICJIT (PLEASE PFlIi11) ADDREss: /D33 C-4.P.s.. .4e- S, cri'L, s=, zzP: '704 4 /8 A.. PxaNE: SOri un/ j) pu,ffiER PLEASE PRINT) FOR CITY USE ONLY • ,~~Ws s..t. PLUyBERS LICENSE: PDDRESS: Active CITY, STATE, ZIP: Afe(S /~/,v S54ty/ Ezpired I L~ Q Hot of Record Pxo~: _6~~7 PLUMBER LICE4SE k.gp(d A73 ~ a nitia 4) OOCUpAN'p/('J,q[ER NAME (PLEASE PRiNT) : ADDRESS: .SQax,~ Aa eZ CITY, STA'I'E, ZZP: PFiO`IE: 5) INpICATE 1,1[IICH PERMIT IS BEING REQ[]ESTI:D: 2 COrINEC.TION TJ CITY SES^1ER Q7NiQE(.,'PZON 'IO CITY S4A'I'E? ' ? dil= (PLCJISE DFSCRIIIE) 6) P..'DIG,':'E C.+E: ~ PLE!\SE IiOLD APPROVID PET2+tIT FOR PICn-UP BY ONE OE ABOVE ? PI.E)'~SE hTAIL APPRQVED PER•tIT TCJ 1, 2, 3, 4 AHOVE (Circle one) 7) SIa.*r1T[JRE: DATE: t7'41ofa .o• Olal_M/IaA s i ea l~:afr.~ !~a nt iss~.i ~f i f~ia'a:a a!!t ~:l.at~y~~ ~ s!! `~satCcr ~ FOR C I T Y U S E OIV:,Y PE?2:HIT ' ISSUED F°ES: $ ~ O- S<51 SE::ER °ER?1rT (I_`ICLi;D° SU°C.°.ARGc) $ WATER PER4ZT (INCiUDc JLRCi:.`~1ZGL) $ WATER METER/COPPE4HORN/OUTSZDE RE:,DER $ WATER TAP (INCLUDE CORPORATIOV STOP) $ 5-v'.~iE4 TAP $ ~-o =C.~C'i.:iP .._.?C•Si- - ?_:.=3 $ ACCOUVT D.F,ppSIT - 47AT°B $ 11 70. s~-o WAC $ SrC $ TRGNK WATER ASSESS2dE:]T $ TRGNK SE:4ER ASSESSME?]T $ LATERAL BENEFIT/TRUiIK SE?•:ER $ LATERIL BENEFIT/TRUNK WAT°R $ OTHER ' $ TOTAL $ AMOLT:IT PAID/RECEIPT DOES UTILZTY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGi-IT OF WAY? 0 YES IF YES, THEN A "PERh7ZT FOR 140RK L9ITHZi] / PUBLIC ROADWAY" MUST BE ISSUED BY THE ~T NO ENGINEERIMG DIVISZON. LIST AS A CONDI- TZON. SUBJECT TO TFiE FOLLOWING CONDITIONS: ' APPROVED BY: c'iZ° c,p TITLE: DATE : MG G-i+ W*s MW~Mdk= McM w wi+ Na.+ w= w W~=ft wft Wea Mt+ wIW~Vl Mcsq Mca w%" s~ W_M@ R40 pcWw am m m . r C!ty of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use r Permit #: / 0 %p 3) Permit Fee: r Date Received: Staff: (Y\L INFLOW & INFILTRATION PERMIT APPLICATION ,/ Plumbing / Sewer &Water Date: ///a '7/07O/A Site Address: // , 11-/E-57'13 vg;' /?9r,-1 Tenant: Suite #: Name: RHE y'j ALU'®S Phone: to SJ- g5R -3 S -a3 Address / City / Zip: //o1 8 A/Es-n? v a y PRT -1 ft6- a Ai S"S/, 3 Name: At/C/IM,f leK PL c'M License #: Address: 6-'75a"i 45NEf2 19r City: //0V6/2. ergaV1 /--/Eivil3 State: d Zip: 5S r) 71 Phone: 6 5 /- 7.5S -- ` Q 7 6 Contact: jOftvL Email: B6A/c/1AtifiRKC. PL01' 4/3/A C €L1 Vefeer f PLUMBING (Within the building envelope) /Sump Pump Repair Other: SEWER & WATER (Outside the building envelope) Repair Other: Description of work: R.eirt - $ ',AP PdMP L/Mt S /JP 72' ADD � 9i/T) /9e"of /1�� N a gEPFq/f FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.qopherstateonecall.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. x RHE -72- Pt Lsai/3 Applicant's Printed Name 4.4 -VE Applicant's Signature 7 Z, S Use BLUE or BLACK Ink I For Office Use 1 j Permit ! /3 Y V non City of Eap Permit Fee: o 5. 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: V 12q 13 Site Address: VS Unit M Name: "ftQ 1T Lewt s Phone: Resident/ Owner Address / City / Zip: lI Z8 W c)TY)V1 u 9:6 an, MN 55123 Applicant is: Owner L Contractor Type of Work Description of work: Y)t- and I "I f VW ' 00 Construction Cost: Multi-Family Building: (Yes / No X Company: yO VJ CnsJmc )rbl'l) Contact: I t Contractor Address: q l0 ~ City: InUwl o Stater Zip: J2Ca)_7(0q_4_I_ead Phone: l s (D9 p( ` [ ( License Certificate #:-'K) PV - S 0 2-Lt " I 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 infonmation may be classified as non-public if you provide specific reasons that would permit the City to conclude that the 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.om 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 State Building Code must be completed within 180 days of permit issuance. xn__ 1qM11(1 l x &a- I kYA Applicant's Print Name Applicant's Si ura" Page 1 of 3 Use BLUE or BLACK Ink r----------------I I For Office Use r City of EaRd I Permit I I Permit Fee: 6nd 3830 Pilot Knob Road j Eagan MN 55122 I Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 L Staff: 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Z2- Date: Z-?,- Tenant: ~/y Site Address: J/v? a' SS/ 3 Suite A . a, ~ x Name: ~.rf L /71 ~W,`1- Phone: Resident/Owner Address / City / Zip: io28` zv~ B~1R ICE-~ SS>~3 Name: /~~N~t1 N/92✓ Q~c~,+.i gi,n/~ 7 n/~. icense ` Contractor ! Address: City: State: Zip: Phone: 65i - 7--S'S - v 7 6 Contact: ~L Email: C3c/JC Nh I/'~ 2r • Pk L"r AiAJG e t l vim- O 'L4 Type of Work - New replacement - Repair - Rebuild - Modify Space - Work in R.O.W. Description of work: RESIDENTIAL _ZWater Heater Water Softener Lawn Irrigation C_ RPZ PVB) Permit Type Septic System Add Plumbing Fixtures Main Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Staff: