1600 Wexford CirPERMIT
City of Eagan Permit Type:Building
Permit Number:EA169862
Date Issued:06/11/2021
Permit Category:ePermit
Site Address: 1600 Wexford Cir
Lot:032 Block: 001 Addition: Wexford 2nd
PID:10-83851-01-320
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Linda Do & Luam V Pham
1600 Wexford Cir
Eagan MN 55122--256
(651) 621-9727
Exteriors Plus Llc
12481 Rhode Island Avenue
Savage MN 55378
(952) 345-3408
Applicant/Permitee: Signature Issued By: Signature
_ a .
~~t~tCQ~~ D~ ~CCli~Q1tC~
~it~j o~ ~agan ~ ~
This Certificate issued pursuant ro t/re requirements of the Uniform Building Code
cenifying that at the time of issuance this structure was in compliance wrth the various
ordinances of !he City rrgulating buildirtg const?uction or use. For the following:
uu SE' UJG sidg. Pe,n,R Ho. 26 I 14
O-P-.r iYr- R3113 1 Zoning okm« R 1 Type ca,5t. VN
o..,,of ew~~ liL W'IIZUFRS IlVC Ad6,2,, 14495 fl0[JlJLRY ItD, ROCE[i.S
Ek,,~ Add,, 1600 MCM CI= i,.W;,,, I.32, B 1, MMM 2ND
/
~ -
BaikEng_dsic,d A-~
POST IN A CONSP1ClJOUS PLACE
. INSPECTION RECURIJ
• CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: v
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT: .
14; , I ,I r IF; fi*i
t tt ~ i~.. i~ p,i~ ~ , • ~
PERMIT SUBTYPE: - TYPE OF WORK:
INSPECTION .
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Permit No. Permit Holder Date Telephone 1k
. ELECTRIC
• PLUMBIN
HVAC fe//
Inipection Date Ins + Comments
FOOTINGS
FOUND
FRAMING f Df' pl Cv Y ~ a
I
ROOFING oaj F
ROUGH
PLUMBiNG
PIBG
AIR TEST
ROUGH
HEATING ~
GAS SVC
TEST
INSUL
GYP BOARD
C
t
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG 5 e 6/ '07,
FINAL HTCa J19
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
/
DECK FTG 4/
DECK FlNAL 9 , ~ ~r ~
Address v,m wwnrm rTRrrF Zip 55123_
Lot 32 Blk 1 Sub wEEXEE'oRD 2NID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: ~7L-.n a Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply ro
the outside Iawn faucet before freeze potential exists.
Coatac[ engineering division at 681•4645 before working in rightof-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
PERMIT ~ko /V/, & 15~
CITY OF EAGAN
3830' Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 026114
(612) 681-4675 Date Issued: 0 7/ 2 7/ 9 5
SITE ADDRESS:
1600 WEXFORD CIR
LOT: 32 BLOCK: 1
WEXFORD 2ND
DESCRIPTION:
Bttildiny.Permit Type SF DWG
Building Work Type NEW
ft16C Dccupancy'., R-3 U-1
~ Construct:Lon 7ipe V-N
! Zoning R-1
Building Length 56
Building Width 50
~ Bliilding stories - 4
~Sq'uare Feet, - 2,236
t ,
.E~
REMARKS:
PRV S& W PLBR - PARK PLB6
FEE SUMMARY:
VALUATION $158,000
Base Fee $1,177.25 MISCELLANEOUS $1,892.50
Plan Review $412.04 7ota1 Fee $4,415.79
Surcharge $79.00
SAC $85@.00
SAC % 100
SAC Units 1
Lic. Search Fee $5.00
5ubtotal $2,523.29
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
B M L BLDRS INC 15601878 0001301 B M L BLDRS INC
14995 COUNTRY RD 14995 COUNTRY RD
ROGERS MN 55374 ROGERS MN 55374
(612) 560-1878 (612)428-2070
T hereby acknowledge that I have read this applicatibn and state that the
information is correct antl' agree to comply with all applicable State of Mn.
L Statutes and City of Eagan Ordinances. ~
Au'~t,(.1 m.1y
~APPLIC jER I ATU ISSUEDBY:IGN RETT-
CITY OF EAGAN
~ 3830 PILOT KNOB RD - 55122
7995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Constnue3ion ReaWrements RemodellReoair ReauiremeMs
? S regfatered eile survsya ? 2 copfes ot plen
? 2 eopiea of plans (fndude beam 8 window s¢es: poured fid. desfgn: etc.) ? 2 sile surveys (exterbr addkions 8 decks)
? 1 energy cekulations ? 1 errergy plculstions for heated add'Rions
? 3 topiss oT tree proservation plan M bt plattad afler 711/93
taqufred: _ Yes -2rNo
DATE: 71,z - 9f- CONSTRUCTION COST: _
DESCRIPTION OF WORK: sir`m?U ~dn,'~ DG.aI~
STREET ADDRESS: &rO fo ~ G/'~ I~-
LOT 3,7, BLOCK SUBD./P.I.D. 6'le
PROPERTY Name:- ~L Phone % 6° /~7~' y7~=1va
OWNER . u.. ~.a.
Street Address, ~1qq'`~ ~O~^ R~.?
City: State: ~ Zip: ~~37y
CoNrw?CTOR Company: .T+,. Phone#:
Street Address: License 130/
City: &2c.s State: /%X/ Zip•
ARCHITECT/ Company: At ",rx Phone
ENGINEER
Name: Registration M
7
Street Address
City: State: ~ Zip:
Sewer 8 water licensed plumber: Penalty applies when address change and lot
change are requested once pertnit is issued.
I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all
applipble State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ~
OFFICE USE ONLY /Yes =E9 Certifiptes of Survey Received - r~% Tree Preservation Plan Recei
ved Yes
OFFICE USE ONLY
~
.
y d .a
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging o 16 Basement Finish
,ja-~'-02 SF Dwelling o 07 4-plex o 12 Mutti RepaidRem. 0 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Poroh ? 09 12-plex ? 14 Fireplace o 21 Miscellaneous
a 05 SF Misc. a 10 _-plex a 15 Deck
WORK TYPE
~~31 New o. 33 Alterations o 36 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. 0"74:~ MCNVS System cx--
(Allowable) jF- ,V Main level sq. ft. _7777- City Water T
UBC Occupancy 12 -T u-~ 1~ozg- sq. ft. 5~(3 Fire Sprinklered
Zoning (L ~ 1 sq. ft. PRV Vf.S
# of Stories yt=K~ SP . sq. ft. Booster Pump
Length s~ sq. ft. Gensus Code. GD/
Depth sa Footprint sq. ft. ~1G SAC Code oi
e Census Bldg I
Census Unit I
APPROVALS W( y 17,
"
Planning Building Engineering Variance
Perrnft Fee Valuation: $ o00 -
Surcharge
Plan Review ~j~lqi~ ~ruO`s
/3s m r-
License
MC/WS SAC ~ zK i Z = zf
City SAC Z K~L = Z y . s x L x z = 2
lniater cc,nn. . s,. Z x Z = Z = 7bo
Water Meter ~ Sa x'y
y =z
Acct. Deposit Z /
S/W PertnR zy,r sa zPO
S/W Surcharge &7,~ 7> ia ~
9Treatment PI. ZG _ ~Y fj9G X - - -
Road Unk 6< ~Y - /3, y5'~
Park Ded. C7~
Trails Ded. l s Y9 xs% -
Other ,o r.e GY6 zc~ 7l1.1~7
Copies ~~t Zr r9.m~ _ 3P
4fF iy S
~ ~3 •79 x ~ ~ -
Total: ! F a 3
=
2yX3G.~ ° 1~~._ ~39.4r6p
% sac ; ~ o y
SAC Units S" 0 8/z~° lo~ zZy ~
o~
Z~
9i~ X 5~' y~ 3oz~ TdT~~ = ls 71
I
HY-LAND SURVEYING' fINVICE .BONO.N~iFnSq'
LAND SURVEYORS SCALE 1" s 2n I
9 6~~ Proposed Top of Block o Denotes Iron Monument -
q penotes Wood Hub Sat
g 6 2.2 Propoaed Garaqe Floor 7845 Brooklyn Blvd. Brooklyn Park, Minnesota 55445 For Exeavatioe Only
Propoaed Lowest Floor 560-1984 r000.0 Denofes ExistMq Elevatian
Type ot Building - O Osnofes Propoeed Ekvotioa
te~ Denofeb Surfoce Oroinaqe
BML BUILDERS ADDRESS: 1600 WEXFORO CIRCLE
SANITARY SEWER SERVICE INVERT: 949.91
9~
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~96d•¢g°v 't~ f~.~o 'h~~Qr
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6I p \ \ / ~ ~ ~o
U~~62 UUSi~~
~k 61,9 q
rf~,~6 MN ~ a
M.vo REQUMEDE,
Lot 32, Block 1, WEXFORD 2 ADDITIDN ~
B9 _ . . _ _ ~ ~
LOT SURVEY CHECKUST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL:
~
DATE OF SURVEY:
a m
W 1~
LATEST REVISION:
O ~
C 2 S
DOCUMENT STANDARDS
~ • Registered Land Surveyor signature and company
2'~ 0 ? • Building Permit Applicant
? • Legal descriptlon
? • Address
ar'0 c3 • North arrow and scale
4Yd 13 • Nouse type (rambler, walkout, split w/o, split entry, lookout, etc.)
~12 ? • Directional drainage arrows with slope/gradient %
e~-O ? • Proposed/epsting sewer and water services & invert elevation
2'~ 11 13 • . SUeet name
ffl~-0 ? • Driveway -
ELEVATIONS
xistin
11""0 ? • Sewer service
M"'~ ? • Properiy comers
? • Top of curb at the driveway
13 0 • Elevations of any existing adjacent homes
Proaosed
? • Garage floor
m--'o ? • First floor
M-~'o ? • lowest exposed elevation (walkouVwindow)
,P-~ ? ? • Properiy corners
&~'M ? • Front and rear of home at the foundation
PONDING AREA Cf aoolicablel
El M-'o • Easement line
? gr' 0 • NWL
? B-' ? • H1NL
cl ~?g • Pond # designatlon
~ ~~o • Emergency Overtiow Elevation
DIMENSIONS
M--'O O • Lot IinesBearings & dimensions
e--'o o • Right-of-way and sVeet width (to back of curb)
@"~1'3 E3 • Proposed home dimensions incfuding any proposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
~ El • Show all easemenLs of record and any City utiifies within those easements
? o/ • Setbacks of proposed structure and sideyard setback af adjacent ebstlng structures
? m~~ • Retaining wall requirements, if any
Reviewed: 2a
Na ! Date
Juty 1995
~ - - ~ ~.::r - .
' ~C 1+ 96 , .
V MH STA
~ S=1+16 14 5 RT. - „ • -
~ INV=959.40`i ' S=0+38 24 -
CS=970.6 ' INV=955.64 6CS=965.8 S=1+62
~ WEXFO w t~1CIRCINV-952.71 ~ 22 ~
~E CS=961.7
823 ~ i ~u 55.6'
7/4' BEND 23
3OL7~% 8°-22. 1/2' BEND \
0*05
.s ~ S-
Ne,
- i s~
} • INV=945.55 i
CS=956.9 i ~
y ~
~ j
379 ' 45~_,
~ ' S=1+64
INV=952.77 132-3~; ~ ~ ~U~
.
CS=961.7
COPPER SERVICE y MH ~ STA. 15+17
~ w/ CUPB STOP TO ISl_AND
12 SEE SHEET
; CLEAN OUT a 6.V.
PROPERTY LINE ' 5=0+70
3&g,
~ iNV=949.91
Jp ,
.3 CS=959.0 6
32 I
MH r0+010~ = <14:+ 36:28 : I
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WATER MA[N : : ;
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7.5' MIN. COVER . . . . . . . . . : : :
. . . . . . . : . . . . . . . . . . . . . . . . . 1211 STORM SE'NEt~ :
. : I CROSSrNG . . . . . . . . . . . . . . . . . . . . . . .
: 4 32 ° : . : :
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: : ~ . ?g~'8 1/`'l~ it~CG~710;qS
: . . . . . . . . . . . . . . . . . SDR 35 YHE; ACC 6riiA 15 F0R
AND ~ . . . .
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TERIOEi ENVELOPE ENERGY CODE COMPUTATION'WORKSHEET
~ti~ 502 of `~the State Amended 83 Model Ener~gy Code)
Y a r T y
~~o]eCt Title~~a~~ r ,
~ ~ ?r~ v~sp~ ~ ~
tr,~ ,EXPOSED WAL'L CALCULATIONS`. ~
~
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t's
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~
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F~. f~~ h,F TOc[ y atirn Wall jAbove Grade)
x
x
s~ 3" Frame 47a1.7.
j4-,Insu3ated ALea 16SF! x . 6S' S'
~-,~,Franung Area '(Ave'~ 158 "at 16" oc)
c~`Fram~.ng Area ~Aye: 108 at 24" oc)
4~`~^8eripheia1 Floor Edge/Rim Joist
X •0C12 ~ c'.j,,~~d+~~~,~.'• r 4
• ~"fa7P, i . ' b X O ~
,B• ~ 9 ~ c„ r , .~'c'
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7
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fyl
Solid , . , r • . o X
door ~ t~ ~
~F1ith storm x
tal{ 3g x
X
Other ` o x
~ : , . . .
V= ARFA, sq. f t . . . . . . . . . . . . . . . . . . . . . 23
~ ' . E. TO'l~AL of ARFP. x "U.................................................... Z,o 1:7
~s~
II.,t;~ ROOF/CEILING CALCULATIONS
A. Roof /Cei7ir9:Insulated ,Area
13 x . 02 2
22
x Roof/Ceilirig,.Framirig (Ave 3158 at 16" oc) °z
Ceiliricj Frariung (Ave. 10% at 24" oc)
M~4
SkyTight ; a $ ~ O k ~T y Yi . + . . .
yt4 ' ~ . . . . . . .
h • *v . . : . . 4 . .
~ra~:.RooFit~ir.M"p.xEA, sq: ft /y7 2
i g
. . . . .
C&':. AFtFA X "tT"
R~ ~l . ,
~ c1 4
aa
~ BUILDIN(3~EN~ 1LOPE•REQUIREMENT3, . . . : ~ ;
'TOTAj.,AREA ~t7~:'nUn ,ALLOWABLE
- ~,:.s~.} s;~: . ,~,.>r•~- (Fxrm I.D & II.E) (Ficm V.) (P.tea x
~4 x
~j3t
.`~d Wall Z3l `~6 x . I 1 = z5y>~r&~ t;: ~e
2~ 34':2
X
r.? 1 ',.r y~•~
4.t , o}
~
~
A- ~5l+r,e}. ~ . . . ~ . _ .
C BUILDIIQG IIVVFSAPE (Total of A& B above)
` ' ` 2l7PAL`P.LI,OG7ABI.~E + .I
. . . . .
atY.S ~
rsa'C, ~ 77777
cs t~ .
wr2ACf~L BUIL])ING=~ENVELOPB:';<,
r y r r t i ,
K x uF. . ~ . ~ .
~~~'e r:. asJA s ~ ACTUAL
(AL&'i" X "U")
r~~K Y
~ Exposed Wall (Fro~A ~I •E ^ . ~
. '
i1.'inq ~(~'roan IIy F 32 .4 ~S
• ~ 4~v:
«F,~~ . . . . -)rt
NJ
~Ci'IJAL BLIILDING II9VIIAPE (Total. of A & B) . r .
M~eet~code i~equi`r~emenf-x i ess Lhan III.C)
R
Y ' REG~D "U" YALUES , • ` J ~
. . . _
"r"~-,3
, u .026
otle arc7 two familYt~u~Js , •
X :238 .033:
ly,~Residential: 8uildings
~3~s£oties or less~ in •height)
~ ~ 1 ~ i Y~~ d~ : ~ t v
P,11~Other::~nstruction Types (3 stories
3 or less) stories) .238 .O6
.28
p,]th~r`Constructirn Types (More than
'`,,,.,.~'.•,w^9i',.F+.., ~ ~.L..~: _ ~ _ . _ . . . .
s ~ •^Based on 8007 heattng degree'days (Mpls/St. Paul) . .
~ r ~Adfust 'U° aralues accordingly for other locations.
. _ ri- .
~ ~ ~ _ ~ ~ .
; . . . _ ~ . . . .
CERTIFICATION
x~ _ "'1 ; ' ; ° ~
her,by~,certify,,that I have ca~leted the above information ancl. that it crnplies with~t~:
~ C.
' z- 1K~.lviesota Stabe ,Energy Code
;
/
Date
at ~
Si~}~pture~~~j
7~', . n , . > , . i
L...'
} x
w .
~T `,BCSD 3-89 •
` .;>z:CC/S114/6574 ;
CITY USE ONLY
L 3~.. BL RECEIPT#:14//39
SUBD. DATE:
1995 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 NO. TOTAL
Shower 3.00 x
Water Closet 3.00 x _Cl
Bath Tub 3.00 x
Lavatory 3.00 x 3 = ~
Kitchen Sink 3.00 x 1
Laundry Tray 3.00 x I
Hot Tub/Spa 3.00 x L
Water Heater 3.00 x ~ = 3
Floor Drain 3.00 x i =3
Gas Piping Outlet * minimum -1 3.00 x ~ = 3
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal ` Dakota Cty. license 20.00 =
U.G. Sprinkler * home under const. 3.00 =
Alterations ` to existing 20.00 =
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS: ~&C)O we-YSOrA -i r a-C•
OWNER NAME: ~1)M L- &n-~ ~A-e-IrS,
INSTALLER NAME: Par ~ ~ `~~~~?ncA ZU~ C-~
STREET ADDRESS: = Zo X o`L I LI
CITY: ~(,~~Ic YI0.i v\. STATE: MAtA ZIP: 5~•
PHONE 'I7It -fo1{3
F~PEKMITTEE
;M41
OFFICE USE ONLY
L BL RECEIPT
SUBD. DATE'
7995 PLUMBING PERMIT (COMMERCIAL)~
CIN OF EAGAN /
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)681-4675
Please complete for: all commerciaUindustrial buildings.
~ multi-family buildings when separate rmits are pQt required for each dwelling
unit.
DATE: CONT T PRICE:
WORK TYPE: ~ NEW C NSTRUCTION ADD ON _ REPAIR
DESCRIPTION OF WORK: o k VA.1 I'^ .
IS WATER METER REQUIRED? X ES O. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. R FLUSHOMETERS TO BE INSTALLED? _ YES XIVO.
FAILURE TO PROVIDE THIS INFOR ON WILL RESULT IN A DELAY OF hlETER ISSUANCE.
WILL YOU BE INSTALLING A M ER FOR FUTURE U.G. SPRINKLER SYSTEM? _ YES XNO.
IF SO, YOU MUST APPLY FO A SEPARATE G. SPRINKLER PERMIT.
FEE: $25.00 minimum f or 1% of contract pri whichever is greater. State surcharge of $.50 per
$1,000 of permit e due on all permits.
CONTRACT PRICE x %
STATE SURCHA E
TOTAL
SITE ADD SS:
TENAN NAME: TE. #
O R NAME:
I TALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: DATE: INSPECTOR:
CITY USE ONLY
L BL RECEIPT
d S
SUBD. ~ DATE: 8
1995 MECHANICAL PERMIT (RE.SIDENTIAL)
CITY OF EAGAN +
3830 PILOT KNOB RD
EAGAN, MN 55722
• (612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required foreach unit
New construction Add-on furnace
AJJ.++ AJJ ~ _ •.v. oySac.....n~..a~.
~uu'vi~aicnG$i~yci.uncc.,.:w.
Date: y Q_`i
FFFS
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL JA5U
SITE ADDRESS: ~lO O~ ~X•~c:,rc~ cV V:,P
OWNER NAME: PHONE a002_
INSTALLER NAME:
STREET ADDRESS:
CITY: STATE: //U ZIP:c}o
PHONE
~ , ~
CITY USE ONLY
L _ BL _ RECEIPT
SUBD. DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commerciai/industrial buildings.
? multi-family buildings when separate permits are n43 required
for each dweiling unit.
UAi G. I.VIV I i(Hti T
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ~$25.00 minimum fee pL 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of pff= fee due on all pertnits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
51TE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (iMPROVeMeNTS oNLv)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP•
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
INVOICE `
/
3830 ~ Pilot ~ Knob_.~~~
~5./~/ RoafiZ/
1n 916 Eagan, Minnesota 55122-1897
cityoFaagan . 681-4600
Equal Opportuniry/AHirmative Action Employer ~
To: 6793
r ~
COLLEGE CITY CONST D2t8: 04/15/94
6970 1515T ST
APPLE VALLEY ~iN 55124 ~
L - J xEcramxArex
PLATlLOCATION: LOT 32, BLK 1, WEXFORD 2ND AMOUNT
~ DESCRIPTION
ONE-HALF 0 PL N REV . 268.13
/
n,
~ . .
i
~
~ • TOTAL tg2 68,13 j
001-0121-07
Invoice Prepared By: r?ARLYNN GREENWOOD, BLDG INSPZCTIONSI
name department
WHITE - Customer YELLOW - Remittanc§ PINK - Department GOLD - Finance
TOTAL DUE UPON RECEIPT -
CU
For Office User
a?~ Permit C
City of h in I
R I Permit Fee: 9 -
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I C _
Fax: (651) 675-5694 Staff:
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
f
r
Tenant: Suite
RESIDENT /OWNER Name: / / p i + 7/7,)4 Phone: (~1,~ L C. Cra(~; ;
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: 7 / l) Multi-Family Building: (Yes / No
CONTRACTOR Name: 411 License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 L) VA" '444Pa X Applicant's Printed Name Applicant's Signature
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