1538 Wexford Ct
~ . INSPECTION RECORD
~
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eag3n, Minnesota 55122-1897 Date Issued:
e (612) 681-4675
SITE ADDRESS: ~ ~y APPLICANT:
ItiI= :l y1 fs t i+~ h
„r xf ORft rT rii I; i011.;,
1 I~ ~„f ~i 1'~ , .
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
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r i'na 1 Nis I,
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Permft No. Parmlt MoWer Dato Tetephone #
' ELECTRIC
~
- PLUMBI
HVAC
Inspection Date Insp. Commenta
FOOTINGS
/
FOUND
ffU
FRAMING
L
ROOFING -r/1 7~; 14ok 74
r u~i
ROUGH ~
PLUMBING
' PLBG H K
AIR TEST I
ROUGH
' HEATING
' GAS SVC
, TEST
INSUL •~04 W
GYPBOARD
~ FIREPLACE T• f U~`~ b
w
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLOG FINAL
BSMT R.I j
1
BSMT FiNAL
DECK FTG i
DECK FlNAL
- -
INSPECTION REC4RDT~^TT ~
CITY OF EAGAN PERMIT TYPE: 1111111011.11.
3830 Pilot Knob Road Permit Number: 44 2 0 J•i
Eagan, Minnesota 55122-1897 Date Issued: 4) 7~~1
(612) 681-4675
, it b 217M.3 4 •
SITE ADDRESS: E;, r; 10 tt r APPLICANT:
1~, cti 11y xF1lKn rY
PERMIT SUBTYPE: TYPE OF WORK:
III; r,i ta,.ti.%, I c ~ i A i r
INSPECTION • D•
jaM I Mit I fJ 011 ;i i flit]
i i Nrli
F
L ~
Pertnft No. Pwrtnk Holdw Dab Tdsphons •
ELECTRIC
PIUMBING
HVAC
InspecUon Dab Insp. Commants
FOOTINGS
FOUND
FRAMING
ROOFINO
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
iNSUL
GYPBOARD
F I REPLACE
F(REPLACE .
AIR TEST
FINAL PLBG
FINAL HTG
I , ORSAT
~ TEST
I EiLDf'a FINAL
'iSMT RJ.
I oSMTFINAL
, 0ECK F7'G
CK FIvnL I
~
~•1i [ 2 -~''K? ~ 'ss ~ s G ~k Z ?s Zt -
9-C.~,.,~ • -
INSPECTI4N RECORD
ITY OF EAGAN ~ PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
' I „t I.Sf F I1RO C I
I ~ i~ x( ~t~rl~ r i 1• 1
I~ PERMIT SUBTYPE: TYPE OF WORK:
I
'I INSPECTION .
N A i
!
~ ~
L - - - - - - - - - - - - - - J
PemiN No. Pamnlt HokNr Dets TNaphone i
ELECTRIC
PLUMBING
HVAC
Inspectlon Dab Insp. Commonb
F0071NGS
FOUND
FRAMIN(3
ROOFIN(3
ROU(3H I
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SV'C
TEST
INSUL
I
GYP BOARD I
FIREPLACE I
FIREPLACE I
AIR TEST I
FlNAL PLBG I
I
FlNAL HTG I
ORSAT I
TEST I
BLDG FINAL I
BSMT R.I.
I
I
BSMT FINAL I
DECK FfG 2,Q ~3 I
~
DECK FlNAL I
I
~ ~ .
a
Wertificate nf cccupanc~
(Fitio of t*IM
WIPW of 3x*-4WC&N
Tbis Certificate issued pursuant to the nqvirrments of the Uniform Building Code
certifying tlmt al the tinK of issuanct this structun was uc compliancc with the vareous
ondinancts ojthe City nguJaring building constsuctiort or use. Far the following:
Un Chos;r,p,;m SF DWG/GAR swg_ p,,.i, No. 27322
OCCW-y lhw R-3 U-1 yonims Disma R-1 ~ Com V-N
OwmerofBwlbg NEW HOHE L'OUNSELING Ad&m 1566 1dEXFORD CT., EAGAN, MN 55122
1538 WEXFORD CT t-alky L10, B2, WERFOSD
i = ' pre. ~ • ~y 'l
~s~ r~P06T IN A CONSPICl)0US PLACE
2 5 5-3 7 9~ OF~E U E ONLY This request void IB mon~s Irom .oLdabon dvle pnmad in ihis baa.
~s~s~ s5s
PLEASE PRIN7 OR TYPE / ~aD
Request b Rough in inspection reqeired7 ~ No Impec4an Olher Thvn Rwghln: 0 Ready Now 0 WJI Call
4 16 / 9 6 (Yoo must mll Iha mspedor whm ready) o~b Reaer
i, [g licensed conirador 0 owner hereby requesl inspeciion of the above eledricai work af:
lob Pddress (Streep Box, or RoWV NoJ Gry Lp Code
1538 Wexford Ct. Eagan
Sxnan Na Tawns Name ar No. Range No. iire N. Covnry
77Dakota
Oavpon,
Phane N.
New Home Counselin 456-0674
PowerSuppLer Address
Dakota Electric 4300 2 S bd Farmi
Eiecinccl Conrtaaor (Componr Name) Commcwr Limme No. Mu.ror Lc. No. ~ Ivm Elea.Only)
Joos Electric Co. CA 00961
Moiliig Addnza (Commtlor or p,vner PedorminB Insblionon)
3980 Beau D' Rue Drive, Eagan, MN 55122
Autharized Signowro (Commdor er Ov.ner PMarming Insmllaeon~ Phoro No.
688-6180
EB-OOOOlA-10 6/95 5TAiEBOl1RDCOVY-SE N5TNU NSONBACKOFYELLOWCOVY
I II I II [Pir ~~I I REOUEST FOR ELECTRICAL INSPECTION.S~Minnesota State Board of Electric 1821 UniversiTy Ave., Rm. 128. St. PaulMN 55104 0 5 3 0* Phooe (612) 642-0800 9
Home Dup ex Apt. Bldg. C'ith~: X New Addn
Commercial Industrial Farm Remod Re av
Air Cond. Htg. Equip. Wofer Hlr load Mgmt Other.
D er Ran e Elec. Heat Tem . Service
'k above fhe work covered by fhis request. Enfer remarks in this space and on the back of ihe whife copy only.
Colculofe Inspectron Fea - This Inspection Requesf wdl not be accepted without the covect fee:
Olher Fee S Service Enhance Sae Fee # Circuifs/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
5}reet Lig./Traffic $ig. Above 200 Amps Above 100 Amps
Transformer/Generator INSPECTOH'SUSEONLY 70T$~3. 50
Sign/Outline Lfg. Xfmr. 7 0
Alarm/Remofe CoNrol
Swimming Pool I hereb wm thot I im ened 1h wl tm h<re.n on ihe dme. smied
Irrigafion Boom Rough.ln Dote~"
Speciol Inspeclion
F~~ei ( o .g
Investigotrve Fee
THIS INSTALLATION MAY BE ORDERED DISCONNEC OT IN 18 MONTHS.
AddICSS 1538 WEXFORD CT Zlp 5512 ?
I.ot lo Blk 2 Sub WExeoitu
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Daie: Yes No Inspector:
,
Final grade (6" from siding)
Pecmanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUwrb damage •
Porch
Basement finish '
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shuboff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in righhof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy ~
~ PERMIT ~rR~.,5I5~5$
C30 TYoOF EAGAN PERMITTYPE: edY'L'o9~Nc
Eagan, Minnesota 55122-1897 Permit Number: 027322
(612) 681-4675 Date Issued: 0 4/ 19 / 9 6
SITE ADDRESS:
1538 WEXFORD CT
LOT: 10 BLOCK: 2
WEXFORD
P.I.N.: 10-83850-100-02
DESCRIPTION:
8uilding Permit Type SF OWG
Building Work Type NEW
UBC Occupancy-, R-3 U-1
Construction Type V-N
Zoning R-1
~Building Length 64
Building Width 39
~
~ Building stories 2
- -Square Feet 1,902
Cens,us ,Code' 101 1- FAM. DETACH
~ r.
% . -
REMARKS:
PRV S& W PLBR - MATTHEW DANIELS PLBG
FEE SUMMARY:
VALUATION $152.000
Base Fee $1,147.25 MISCELLANEOUS $1,923.50
Plan Review $573.63 COPY $.50
Surcharge $76.00 Total Fee $4,620.88
SAC $900.00
SAC % 100
5AC Units 1
Subtotal $2,696.88
CONTRACTOR: - Applicant - sT. LIC.OWNER:
NEW HOME COUNSELING INC 14560674 20060440 NEW HOME COUNSELING INC
1566 WEXFORD CT 1566 WEXFORD CT
EAGAN MN 55122 EAGAN MN 55122
(612) 456-0674 (612)456-0674
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State o'f Mn.
Statutes and City of Eagan prdinances.
AP LIC /Pr MITEE SIGNAT E IS ED BY:
1 2
1q522 CITY OF EAGAN 4 ~ o
3830 PILOT KNOB RD - 55722
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
6814675 cc u~ln~ ,/`1°r1O
New Conslruclion Reouiroments RemodeVReoalr Reauirements
? 3 registered site surveys ? 2 eopies of plan
? 2 coplee of plans (inGude beam d window s@es; poured Ind. desgn; elc.) ? 2 site surveys (exterior addRions & decks)
? 7 energy ealculationa ? 1 energy wleulatlone for heated additlons
? 3 copies of troe proservation plen H bl platled aRer 7/1193 .
required: _ Yes _ No
DATE: ~ - ~ L_5zz CONSTRUCTION COST: /,11L :~D06
DESCRIPTION OF WORK:
STREET ADDRESS: 4 ^
LOT ~ BLOCK 14 SUBD./P.I.D.
PROPERTY Name:,~G~GLY~ ~ Phone
OWNER
Street Address-
' City: State: Zip:
CoNTRACroR Company:1I ~l~Ivn.e- l "~~~~ne
Street Address: ~ License
l`J - -
~
City: State:~i ` Zip4
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address•
Ciry: State: Zip:
Sewer 8 water licensed piumber: enalty applies when address change and lot
ehange are requested once permit is ssue .
I hereby acknowledge that I have read this applicafion and state that the information is c:orrect and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. ,
Signature of Applican j
OFFICE USE ONLY ~~~ENED
Certificates of Survey Received 4Yes No APR TPOf
Tree Preservation Plan Received - Yes No
OFFICE USE ONLY ~°~q•'~^»F~~,
~
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
,p~'02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
p~'S1 New ? 33 Alterations o 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) ~ Basement sq. ft. /0O MC/WS System
(Allowable) N Main level sq. ft. //Z City Water
UBC Occupancy y'~- sq. ft. 11179 Fire Sprinklered
Zoning sq. ft. PRV Y~5
# oi Stories v(6,., sq. ft. Booster Pump
Length ~ sq. ft. Census Code.
Depth ?9 Footprint sq. ft. 4 907, SAC Code o/
Census Bldg /
v~ f~r<F o,'~~r Census Unit
APPROVALS WZ } y ~ 5ti
Planning Building Engineering Variance
~
Permit Fee Vaiuation: Z, Ooo
Surcharge f1i/ni.v /Z~~
Plan Review ~
License L
MClWS SAC 17 33r6 City SAC = / z-
Water Conn. ~ Z =
z, i$ 3&
Water Meter e, p_ i
Acct. Deposit
S/W Pertnit ~ XS`/ Of`~
`
S/W Surcharge n
Treatment PI. 2 ~ ~j2 G •
Road Unit 2r~. ?o - 7 5-0 16 '
Park Ded. ~ yo = S°o - -
Trails Ded. 0;0~
Other SB9 ~
Copies . 50 /~33r 3~
Total: So6 ~ I5 r ZC~' I
% SAC
SAC Units -
,~~6%/,G , y ~
_ _
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BU LDING PERMIT APPLICATION ~ .
PROPERTY LEGAL:
1 DATE OF UR
, ~ LATEST REVISION:
DOCUMENTSTANDARDS
~ ? • Registered Land Surveyor signature and company
?o ? • Building PermitApplicarh
~~0 ? • Legal descriptlon
go"" ? ? • Address
20' ? ? • North arrow and scale
o-'? ? • House type (rambler, walkout, splft w/o, split entry, lookout, etc.)
6"' O o • Oirectional dreinage arrows with slope/gradient %
10"'~ ? ? • Proposed/existlng sewer and water services & invert elevation
Wi ? 0 • Street name
a?" ? ? . Driveway
ELEVATIONS
Ebstlna
~ ? ? • Sewer service (or Proposed)
q.--? ? • Property comers
0~0 ? • Top of curb at Me driveway
21'~'o ? • Elevadons of any eristlng edjaceM homes
Prooosed
2-'C3 ? • Garege Boor
Er~ ? ? • Flrst floar
ff' ? ? • Lowest exposed elevatlon (walkouUwindow)
-fT- ? ? • Property comers
? • Front and rear of home at the foundation
PONDING AREA fif aoolicable)
? 0'- O • Easement line
? [l' ? • NWL
? C' ? • HWL
? Er- ? • Pond # designation
o 13--0 • Emergency Overflow Elevation
DIMENSIONS
2r' ? ? • Lot lines/Bearings & dimensions
Z'- ? ? • Right-0f-way and street width (to back of curb)
0,13 ? • Proposed home dimensions including any proposed decks, overhangs greater fhan 2',
porches, etc. (i.e. all structures requiring permanent footings)
15' ? ? • Show all easements of record and any Cily utilities within those easements
e' ? ? • Setbacks ot proposed structure and sideyard setback oi adjacent exassting structures
? m~o • Retaining wall requirements, ' ny
Reviewed: Z
Na e ate
Jemiary 1996
cwAo199aXooareMr FM
~t* M2422 endotatHeights,DMN 55120
* PIONEEFI IqNU SUftYEY0fl5 • C1NL ENCINEERS (612) 681-1914 FAX:681-9488
* eng neer ng LAND PUNNERS. LANDSCAPE AftCHITECIS 625 Highway 10 N.E.
* * ~ * Blaine. MN 55434
(612) 783-188O FAX:783-1883
Certificate ot S rvey for: NE1N HOM.E COUNSELING, INC. ~
~566 WEXFORD COURT
931.1
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NOTE: PROPOSEO GRADES SHOWN PER GRADING PLAN BY: PIDNEER PROPOSED HOUSE ELEVnTiON
NOTE: BUILOINC DIMENSIONS SHONTI ARE FOR HORIZONTAL AND VERTICAL LOCATON Lt4~„~j
OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND IOWEST FLOOR ELEVATION:
vour+onnoN oiMeNSioNS. TOP OF BLOCK EIEVATION: C~ 5 3' S
NOTE: NO SPECIFIC SOILS INVES11CA110N MAS 6EEN COMPLETED ON THIS LOT BY THE p/ 5311
SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE GARACE SLAB ELEVATION:
PROPOSED IS NOT 7HE RESPONSIBILITY OF THE SURVEYOF.
NOTE. THIS CEftTIFlCATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN X 000.00 DENOTES E%ISTNG ELEVATION
THOSE SHOWN ON THE RECORDED PLAT. ( 000.00 ) DENOTES PROPOSED ELEVAl10N
- DENOTES ORAINACE AND UTILITY EASEMENT
NOTE: CONTkACTOR MUST VERIFY ORWEWAY DESIGN.
~ DENOTES ORAMAGE FLOW OIRECTiON
NOTE: BEARINGS SMOWN AflE BASED ON AN ASSUMED DATUM -9 UENOTES MONUMENT
9 OENOTES OFFSET HUB
WE HEREBY CERTIFY TO NEW HOME COUNSELING, INC. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 10, BLOCK 2, WEXFORD
DAKOTA COUNTY, MINNESOTA
IT DOES N0T PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 9TH DAY OF APRIL, 1996.
SIGNED: PIONEER ENGI ERING P.A.
SCALE : 1 INCH = 30 FEET I
672 96107.00 SWK John C. Larson, L5. Reg. No. 19828
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EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER ~S PLAN NO.
SITE ADDRESS adOZ
CONTRACTOR: N W HOME C UN ING DATE 4/8/96 PHONE 456-0674
DETERMIME WORKING SQUARE FOOTAGE
3564.549
1. Total exposed wall area3611.221 sq.ft. x.11 397.2343
2. Total roof/ceiling area 1668 sq.ft x.025 43.368
3. Total floor cant. area 0 sq.ft. x 0.05 0
(over unheated enclosed areas)
4. Total floor cant. area 12 sq.ft. x 0.025 0.3
(over unheated exposed areas)
5. Total exposed wall area above the floor. 3256.549
a. Total wall window area 266.91
b. Total door area 37.8189
c. Total sliding glass door area 80.04
d. Total fireplace area 0
e. Total wall framing area (ave. 10%)........ 325.6549
f. Total net wall area above the floor....... 2546.125
g. Total rim joist area 308
TOTAL EXPOSED FOUNDATION AREA 46.6722
h. Total foundation window area 0
i. Total net foundation area 46.6722
Determine "U" value of each wall segment.
a. 266.91 x"U" 0.41 = 109.4331
b. 37.8189 x"U" 0.06 = 2.269134
c. 80.04 x"U" 0.41 = 32.8164
d• 0 x"U" 0= 0
e. 325.6549 x"U" 0.090334 = 29.41778
f. 2546.125 x"U" 0.043215 = 110.0313
9• 308 x"U" 0.040683 = 12.53051
h• 0 xi'U" 0.41 = 0
i. 46.6722 x"U" 0.076161 = 3.554623
6 .....................................Tota1 300.0529
If item #6 is the same as or less than item 01 you have met the current
energy codes. 2 MCAR 1.16008 A AND 0.
TOTAL EXPOSED ROOF/CEILING AREA 1668
j. Total skylight area 0
k. Total flat roof/ceiling framing area...... 166.8
1. Total net flat roof/ceiling area.......... 1501.2
Determine "U" value for each roof/clg. segment
j• 0 x"U" 0= 0
k. 166.8 x"U" 0.025549 = 4.261625
1. 1501.2 x"U" 0.021801 = 32.72727
1 _ - - -
7 ...................................Tota1 36.9889
If item #7 is the same as or less than item #2 you have met the
energy code. 2 MCAR 1.16008 A AND O.
TOTAL FLOOR CANT. AREA (enclosed). 0
o. Total floor cant. framing area (ave. 100). 0
p. Total net insulated floor/cant. area...... 0
Determine "U" value for each floor/cant. segment.
o. 0 x"U'l 0.064144 = 0
p. 0 x"U" 0.029386 = 0
8 ...................................Tota1 o
If item #8 is the same as or less than item #3 you have met the
energy code. 2 MCAR 1.16008 A AND O.
TOTAL FLOOR/CANT. AREA (exposed) 12
q. Total floor/cant. framing area (ave. 10%). 1.2
r. Total net insulated floor/cant. area...... 10.8
Determine "U" value for each floor/cant. segment.
q. 1.2 x"U" 0.048333 = 0.057999
r. 10.8 x"U" 0.022805 = 0.246294
9 ...................................TOta1 0.304293
If item #9 is the same as or less than item #4 you have met the
energy code. 2 MCAR 1.16008 A AND 0.
I HEREBY CERTIFY THAT I HAVE CALCULATED THE "U" FACTORS AND "R"
VALUES HEREIN AND THAT THE BUILDING I-IERE DESCRIBED MEETS OR EXCEEDS
THE STATE OF MINNESOTA ENERGY CONSERVA ON~ACT.
~ (signature) '
(datic ~
, , . .
THRU CANT. @ INSULATION (enclosed)
Interior Air...... 0.68
Finish Flooring... 1.23
Underlayment...... p
Plywood........... 0.93
Insulation........ 30
Sheet Rock........ 0.58
Still Air......... 0.61
Total "R" Value............ 34.03
l/g - 'lUll ..................0.029386
THRU CANT. @ MEMBER (exposed)
Interior Air...... 0,68
Finish Flooring... 1.23
Underlayment...... p
Plywood........... 0.93
Joist 14.84
Sheathing......... 2.06
Soffit............ 0.78
Exterior Air...... 0.17
Total "R" Value............ 20.69
1/R - 'lUu ..................0.048333
THRU CANT. @ INSULATION (exposed)
Interior Air...... 0.68
Finish Flooring... 1.23
Underlayment...... 0
Plywood........... 0.93
Insulation........ 38
Sheathing......... 2.06
Soffit............ 0.78
Exterior Air...... 0.17
Total "R" Value............ 43.85
l/g = 'lUll ..................0.022805
CITY USE ONLY
L ~ BL RECEIPT -5~
SUBD. ~ DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH ZLQ, TOTAL
Shower 3.00 x .3_00
Water Closet 3.00 x 3 = 9"c~
6ath Tu`u 3.00 ;c ',L- = G.OD
Lavatory 3.00 x 4/ _ Aa.60
Kitchen Sink 3.00 :c 3.00
Laundry Tray 3.00 ;c
Hot Tub/Spa 3.00 :c =
Water Heater 3.00 ;c
Floor Drain 3.00
Gas Piping Outlet ` minimum -1 3.00 x
Rough Openings 1.50 3 = 5~~0
Water SoRener 5.00 x =
Private Disposai ' Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinkler ' home under const. 3.00 =
Alterations • to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL .S'o-cb
SITE ADDRESS: 1538 Wexford Court
OWNER NAME: New Ham counselina
INSTALLER NAME: Matthew Daniels, Inc.
STREET ADDRESS: 15230 cazrousel way
CITY: xosemoimt STATE: MN ZIP: 55068
PHONE ( 612 ) 43- 7 o
3u
OFFICE USE ONLY
L _ BL _ RECEIPT
SUBD. DATE: 1
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for. ~ all commerciaVindushial buildings.
~ multi-family buildings when separate permits are pgj required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REDUIRED7 _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED9 _ YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7 IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINi(LER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$7,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME: _ STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITy; STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: " DATE: INSPECTOR:
~ CITY USE ONLY
L ~ BL RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3630 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please camplete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
X, New construction Add-on fumace
Add-on air conditioning %iOd-Ui i 7ii e3xcnanyei, i.@. V ai162 sy~si6r1'i, BiC.
Date: S -io - 96
FFFR
~ Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00
? hNAC: 0-100 M BTU 4.00
Additionai 50 M BTU _6:A0'
? Gas Outlets (minimum of 1 required @$3.00 each) -3 9.ov
? State Suroharge .50
TOTAL
SITE ADDRESS•
OWNER NAME: ~/et? /~/v.>.e ' ~nsellc PHONE v~- ~ 7Y
INSTALLER NAME' ~'A X-e/%al 4L:-
STREET ADDRESS: 21-210 154le ,
CITY: STATE: ZIP:
PHONE#:(~<,~ 42-
brU~axroN"t- PFRMITTFF-
CITY USE ONLY . A
L BL RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -4675
Please complete for: ? all commerciaUndustrial buildings.
? muRi-family buildings when separate permits are ~ required
for each dwelling unit. nATF: flrlAITDArlT 001vr,:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: •$25.00 minimum fee QL 1% of conVact price, whichever is greater.
~ Processed piping - $25.00
I Sfate surcharge of $.50 per $1,000 oi 2en319 fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
$i i E AuuKESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPttovEMEN7s oNLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP•
~ PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
' . - - PEIZMIT
GITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 028140
(612) 681-4675 Date Issued: 0 7/ 0 2/ 9 6
SITE ADDRESS:
1538 WEXFORD CT
LOT: 10 BLOCK: 2
WEXFORD
P.I.N.: 10-83850-100-02
DESCRIPTION:
Building,Permit Type STORM DAMAGE
Building Work Type REPAIR
" Census Code 934 ALT. RESIDENTIAL
,
7
~
.
REMARKS:
FEE SUMMARY:
~
CONTRACTOR: - Applicant - ST. I.IC.OWNER:
METRO BLOG CO 15360277 0005944 NEW HOME COUNSELING INC
4738 42ND AVE N 1566 WEXFORD CT
MINNEAPOLIS MN 55422 EAGAN MN
(612) 536-0277 (612)456-0674
I heretiy acknowledge that I have read this applicetion and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
L J
APPLICANT/PERMITEE SIGNATURE ISSUED BV: °IGf T9r1,_
14 CITY OF EAGAN
3830 PILOT KNOB RD - 55122
160 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-3675
New Construdion Reauirements Remodel/Reoair Revuirements
? 3 registeied site surveys ? 2 copies of plan
? 2 copies of plane (includa beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? 1 energy calculations ? 1 energy calculations for heated addilions
? 3 copies of tree preservation plan if lot platted aRer 7/1/93
required: _ Yes _ No
DATE: ~P t ~ ~n I R ~ CONSTRUCTION COST: 0 ~a
DESCRIPTION OF WORK: 5Izu4gr;,r kL6 uSc ~ 4-PPL Y PLYc~fov p-{-p a,,J T
o~ ~Sr 00- co 2 rJ E2S Z w..a-6- c- s ~.J n-l 2.- a.e ,
STREETADDRESS: /_5738 otre- x1=adz-o C'ou e- Tr c~A6 Ju-zt-) o 0 Ar'''A-eE
LOT ~ BLOCK SUBD./P.I.D.
Nbu/ I~d ~Y// L GO GC NS &f-/.a/lo -PN L
PROPERTY Name: MA_T-1-4Y 7 2(m gL(5_ Phone
OWNER `I"'T
Street Address: / 5Z 6 `'`1'1r)` Ed a- (~-'-T_
City: ud_a /J"1 State: M Zip:
coNrrtACroR Company: 1VFc-71'Zd z o G' &o Phone S3 6-d z~ 7
Street Address: 4 7 3S-4 Z N o /J,~El-lo License 5_9 C/"
City: M? cS State:/1/1 YkJ Zip: L Z
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address-
Ciry: State: Zip:
Sewer 8 water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the infor ation is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: efz~ r
(3 L D~R- WA g N d~ C..~ C L E!~ ~(L I I~~t'??i t rJ 6
OFFICE USE ONLY A S DF C-7
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY 41 r
. ~ ~ L .
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
rENERAL ltJFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Total:
% SAC
SAC Units
PERIVIIT
~ C9TY OF EAGAN
3830 PilotKnobRoad PERMITTYPE: BurLoxNG
Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 4 3 5
(612) 681-4675 Date Issued: 0 7/ 16 / 9 7
SITE ADDRESS:
1538 WEXFORD CT
LOT: 10 BLOCK: 2
WEXFORD
P.I.N.: 10-83850-100-02
DESCRIPTIOId: .
Building.Permit Type DECK
Building Work Type NEW
Census Code 434 ALT. RESZDENTIAL
;
/
~ _ -
~
REMARKS: .
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
COfVTRACTOR: OWPIER: - Applicant -
J PERALA KEVIN
1538 WEXFORD CT
EAGAN MN
• (612)830-6969
I hereby acknowledge that I have read th3s application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes snd City of Eagan Ordinances.
I_ J
(
APPLI NTlPERMITEE GNATURE ISSUEDBY: IGNATU E
, .
, , .
~ . . ,
CITY OF EAGAN
CASHIER: S TEfiMIkAL N0: 90
CATF: 0706/97 TIMF_: 14:56:59
IU:
NAiSEc KEVLN H F'EFALA
3210 3001 1538 WF_XFORLI CT 50.00
E155 3001 1539 WF_.XFL'RD CT 0.50
Tokal f;eceipt Amnjnta 50..53
CR07P, r 38
USER ?D: NANC`/
~.;;:c::"YY,tY.:Y,;Y,c;;'cY,a't"c",c:' , :Y,~. „'c::;:Y::r,:r: ;:c;:::cY,•:•~
.
. iy'.' .
I' . . , ul~ . i ~ . . . . . . ~ ~ ,
„ . . ' ~
, - 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
30 CITY OF EAGAN ~ y~
3830 PILOT KMOB RD - 55722
681 -4675
New Construction Reauirements RemodeVRacair Reauimmenri ~ .
? 3 repistered site aurveys ? 2 copios of plan ~
? 2 copfes of Dlans (indude beam 8 window saes; poured fitl. tlesipn; etc.) ? 2 ske surveys (exterior additiona 8 decks)
? 7 energy calculations ? 1 energy calaletions for heated additions
• 3 copies of tree preaervation pWn if IM platted after 7/1/93
repuired: _Yes _ No '
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
U~'
LOT k C/ ~y BLOCK SUBD./P.I.D. LJ,QX -t'.-r~~
PROPERTY Name: _ ~B?i'?i Phone#:
OWNER
Street Address:
City: C-i~y~.State: iOW Zip; .tSl~' 2fG~
CONTRACTOR Company: Phone
Street Address: License
City: State: Zip:
ARCHITECT! Company: N119 Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licer.5ed plumber (new construction only): . Penalry applies when address change
and lot change arc, equested once permit is issued.
i hereby acknowledge that I have read this application and state that the information is correct and agree 3tqc6R}ply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No J U L 09 1957
Tree Preservation Plan Received _ Yes _ No _ Not Required LBY_~
OFFICE USE ONLY ' z
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex p' 15 Deck
WORK TYPE
,ef 31 New ? 33 Alterations o 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System ~
(Allowable) Main level sq. ft. City Water ~
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 41341
Depth Footprint sq. ft. SAC Code o ~
Census Bldg ~
Census Unit o
APPROVALS
Planning Building MS Engineering Variance
Pertnit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
M2422 endoto tHeights.DMN 55120
'k PIONEER ~ LANO SYRYET0115 • dNL ENCWEQIS (812) 681-1914 FAX:881-9488
y
" ang naer ng uno runNM. UNDSCAVE N1aIIlECT4 625 Highway 10 N.E.
* * Blaine, MN 55434
-x 4( 'f (612) 783-1880 FAX: 783-1883
Certificate of s rvey for: NEW HOME COUNSELING, INC.
1566 WEXFORD COURT "
931.1
('9 3
S/ \
/ F0,p
4~F
'P
r
~ j Z4r o
y
9 i .
BENCH MARK 945.4
TOP OF PIPE ` )i9\ ~ O
ELEV.=951.72\ O
.
952.3 `Y' ~ 940.4 \
° 946.0 i z \
' / 0 1 ~941.4 , 940.5 \ \ O •Jr'3'Cl.c~;
m C) i
93~0
952.1~ 8~.5 q qC~ Op /t
o ~
hv~ h~~ yRpao 0 `T4~--5,~ ~
~ i
' pQ T, 4`q
IiD (0 J ~ ` • ,0 ~C- 9 O
~ ' pRpp 951. -°0 ~ ~
~k49~L~ L~ ov,yYO
o . Z 1 Ar•
° 950.1 \*'PORCH951
Q ~ \ / ? 9~ ~ a5 9
949.3 ~ N-SERVICE i ~ ~
949.3R VNV.=939.3~~ • 9
C~~On S9~,DO ?Q* ~0\V ~ / .~50 rn C>C7_-BOPCOFMPIPE
95 4 ELEV.=949.73
EXISnNC 948.7
CO11
G~49.2 9~qqg'S) HOUSE
-1>, 10
N07E: PHOPOSEO CRADES SHOWN PER CRI101NC PIAN 8Y: PIIXiEEfi PROPOSED HOUSE ELEVATION
N07E: BUILDINC DIYENSIONS SHOWN ARE FOR HORIZONTAL ANO VER7ICAL IOCATON LOWEST FLOOR ELEVATION: q4'4"~
OF STRUCNRES ONLY. SEE MCHIlECNAL PLANS FOR BUILDINC AND
FWNDA710N DIMENSION4 TOP OF BIOCK ELEVA710N: q 53•S
NOTE: NO SPECIFlC SOILS WVESTICAlION MAS BEEN CONPLETED ON TOS LO7 BY TNE
SURVEVql. 7HE SVITABiLiTV OF SWLS TO SUPPORT ME SPEqFlC HOUSE CARAGE SLAB ELEVATION: ~1 53, I
PROPOSEO IS NOT THE RESPONSIBIUTY OF THE SURVEYOR.
NOTE: TMIS CERTIPICATE DOES NOT PURPORT TO SHOW EA$MENTS OIHEfl iMAN X 000.00 DENOlES E%1571NC ELEVATION
THOSE SHOWN ON 1ME RECOROED PLAT. ( 000.00 ) DENOTES PROPOSED El EVATON
OENOTES ORAINACE AND U11UTY EASEMENT
NOTE: CONRiACiOR MUST VERIiY DRIV[WAY DESIGN.
DENOTES DRAINACE FLOW OIRECTION
NOTE: 9EARINGS 4fOwN ARE 8ASE0 ON AN ASSUMEO DANM ~ DENOTES MONUMplT
$ DENOIES OFFSET MUB
WE HEREBY CERTIFY TO NEW HOME COUNSELINC, INC. THAT THIS IS A TRUE AND CORRECT REPRESENTATION Of A
SURVEY OF THE BOUNDARIES OF:
LOT 10, BLOCK 2, WEXFORD
DAKOTA COUNTY, MINNESOTA IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 9TH DAY OF APRIL, 1996.
SIGNED: PIONEER ENGI f P.A.
SCALE : 1 INCH = 30 FEET ~
672 96107.00 SWK John C. Larson, L.S. Reg. No. 19825
~ RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55922
651-681-4675
NewConstructian Reuuirements RemodellReaair Reouirements
• 3 registered sAe suneys showing sq. ft. of lot, sq fl. of house, and all roofed areas • 2 copies oi plan
(20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated addi[ions
• 2 copies of plan showing Ceam 8window srzes; poured found design, etc.) . 1 site survey forextenor addihons 8 decks
• 1 set of Energy Calcula6ons . Indicate d home served by sep(ic system for additions
• 3 copies of Tree Preservation Plan rf lot platted after 711193
• Rim Jois! Detail Options seledion sheet (61dgs with 3 or less unfts)
DATE 1--p/Ic:)- IO2 VALUATION ~ ~ oo .c)c)
SITE ADDRESS C4- MULTI-FAMILY BLDG _ Y _ N
TYPEOF WORK o0y FIREPLACE(S) _ 0_ 1_ 2
APPLICANT \Q22he(-~ k ~t~c~G-'i nQ
STREETADDRESS AG g 'P,1v-1-) CITY STATE ZIP
TELEPHONE # ,A84 CELL PHONE # FAX #
PROPERTY OWNER ro,1 Q TELEPHONE #45Z bDBc6
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNGSO'1'A RULL•'S 7670 CA'1'LGORY 1 MIVNESOTA RULGS 7672
(d submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor. Phone #
Plaaibing system includes: Water Softener Iawn Sprinkler rcc $90.00
Watcr Heatcr No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Conditioning Pec: $70.00
Hcat Recovcry System
Sewer/Water Contractor. Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applicant
- - -
-
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY r I .
? 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 EM. Alt - Multi
? 03 61 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 70-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 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES SystPm
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 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stuceo Stone
_ Firep(ace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Re[aining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~ ~
~ I
City of EataIl I Pertnit#: t
i ~
I Pertnit Fee: ~
30 Pilot Knob Road i i
38
Esgan MN 55122 ~ Date Received: i
Phone: (651) 675-5675 i s[an: ~
Fax: (651) 675-5694 I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:! Site Address: 67U 2) ~ ~/~'"1 I1 I C/I 1 f)~ CT
Tenant: Suite
~ Phone:~~~~?
RESIDENT / OWNER Name:
Address / Ciry / Zp:
Applicant is: _ Owner ~ Contractor
TYPE OF WORK Description ot work:
Construction Cost: D Multi•Family Building: (Yes No ~
CONTRACTOR Name: CV)ShAnn License#: ryV~~HB~
Address: ~OV
ciry: state: fY1lY zp: S~'J
Phone:G 151 "'1,;1•Li 3-~1.7 ContactPerson: Knml
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential VentilaGon Cate9ory t Worksheet • New Energy Code Worksheet
Category suanmea submined
(J submission rype) • Energy 6nvelope Calcuiations Submined In the last 12 months, has the Ciry ot Eegan issued a permR for a similer plen based on a master plan?
_Yes _No If yes, date ard address of mas[er plan:
Licensed Plumber: Phone:
Mechanleal Contractor: Phone:
Sewer & Water ConVactor: Phone:
=.#iemtiirm~tiorx~ .
.z~`,5~~'-!M-~r~'`~~."x,~`'~`-d'e~~~._ - _-y : . ~:i-,•'~,-4,.-,_ e~L+'iesrrix+xS:~,-.sY4:.~.
t nereby acknowledge that this irrtormabon (s complete and aaurate; that ttia worK WiII De in corMortnance with the ordinancas arM codes of the Ciry of
Eagan; that ! undersland ihis is not a pertnft, but onty an application for a pertnit, antl vrork is not to start wilhout a permit; that the work will be in
accordance with Me epproved plan in the case of work which requires a review and approval of plans. .
x x ~V / l° l~-C/itl
AppiicanYs Prin ed an e ApplicanYs Signat e
Pege 1 of 3
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r~ Use BLUE or BLACK Ink
For Office Use ` I
j Permit
City of EaEd
3830 Pilot Knob Road Permit Fee. I C~
Eagan MN 55122
( Date Received: I
Phone: (651)676-5675 I I
Fax: (651) 675-5694 1 Staff.
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ( J 13 Site Address: I E 3 5 « ',~G`~(f t~- Unit
Name: \or~ ~ct,,kct
Resident/ Phone:
I Owner i Address / City / Zip:
Applicant is: Owner ontractor
Type of Work ;Description of work: c- ~~33
Construction Cost: 5c~ Multi-Family Building: (Yes / No
I Company: 1e Cans CL Tnr~ Contact: I C
s
Contractor Address: q 1 M~1~ '0_l aye
City: S~l k4
State: fb N Zip: s~QaQ Phone: e15I 0,~ `Ll
License R, Lead Certificate #:~r'r
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
W conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.goDherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed. within 180
days of permit issuance.
x_ [ n x
Applicant's Printed Name Applica is Signature
Page 1 of 3