3649 Widgeon WayGity of Eaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Permit #: c2N,‘04=c'�j
Permit Fee:
Date Received:
Staff:
I 2010 MECHANICAL` PERMIT (APPLICATION
Date: \` - 5'« Site Address: 3(S)'4 W) C� (1 11
Tenant: _ 01)0C, \CQ d JCC -n Suite #:
J
RESIDENT / OWNER
CONTRACTOR
Name: Cj1II �,,��'`� LS -TO�I�
hone: � .
I -(-N
��V;PAIL 'ft -QU`tV
Address / City / Zip: lQ4 ()i / itwcLut' j
in . J D
BURNSVELLE HEAT NG & �— -`
3451 W. Burnsville Parkway
Name:
Address:
Suite 120
Burnsville, MN 5
State: Zip:
Contact: ana
Phone:
Email:
License # l.L Sc >C 4-1 i
City:
Rte,8c44-600
TYPE OF WORK
PERMIT TYPE
New )(Replacement
Additional Alteration Demolition
Description of work:
)(Furnace
RESIDENTIAL COMMERCIAL
xFumace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank ( Install / Remove)
**When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbin. Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal
$50.50 Minimum (includes State Surcharge)
OR
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
_ $ Permit Fee
_ $ Surcharge
$ TOTAL FEE
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.gonherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance
with Jif approved planip the case of work which requires a review and approval of plans.
-Th1 � SIC
Applicant's Printed Name
.qua
App icant's Signature
, ~
~r~~
~ CITY OF EAGAN WATER SERVICE PERMIT
3830 c+iut Knob Road PERMIT NO.:
P. O. Box 21199 DATE:
Eagan, MN 551.21
L No. of Units:
Zoniny: - j o ,,1i1
Qwner;
Addross: ancis j,oo-.'- ~
Site /lddress: .c`_ar.i. a_.. . 81 E~C• ~
Plumber. Q • • ,
MQtQf NO.: 3710 ir ~t:
$izE: 8 / oc
Reader No.: rmit Fee:
,
1 ayne to ooR+Vb wub tM Ci F eyen Surchar9e:
Misc
Ordinenas. . Choryes:
Total:
Date Paid:
By
Dcte of Insp.: Insp.:
.6-- Zo '86
'
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. O. Bo:. 21199
E,agan, MN 55121 DATE:
Z~ing: No. of Units: .
Owr1!r:
.
A~IQSS. '•S:';~~ -•f~?P:l'.o,i . .?`isT.•.ti.:.c~ 6-.iCi~:i ~J~.
S1f! /,ddIYSS:
Plumber.
M ge: -
eter No.: Connedion Char
Size: Account Deposit:
Raoder No.: Pennit Fee:
1 pno to emVh with 11N Ciey of been Surcharge:
Ordinena.. Mtsc. Choroes:
Totai:
By Date Pald:
Dete of Irnp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road pERMIT NO.:
P. O. Bcx 21199
DATE:
Eagan, MN 55121 No. of Units:
Zoninp:
OM/fllr:
Add?CSS: i ~~=F9 ;ti j.4~ PAtl ~~ttl i... - . -
Site Address: , . , • ; . e ~
Plumber.
~y
nection Charpe:
1moro@ to eemVM tlw CN1? Co^
AcaeuM peposit: ,
Oraiuaeas. Pemnk Fes: ,
SUfChGfOO' .
Misc. CFarow.
' By TotoL•
pote of Insp•: pc" Poid:
Insp.:
' CASH RECEIPT
.
,
' CITY OF EAGAN P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19
eeceIveo
FROM
AMOUNT $ I
~ DOLLARS
1 oo
? CASH Q CHECK
FOF ~ .
FUND CODE AMOUNT
Thank You
BY
White-Payers CopY
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN ~
3830 Pilot Knob Road,.P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUlLDING PERMIT (W,F, ) Receipt#
To be used for SF DWG/GAR Est value $92,000 Date NOVE F 2 19 85
Site Address 3649 67 I DGEON LvXiX Erect O'{ Occupancy 113
Lot 4 sloc?c 1 Sec/Sub. ST F'RANCIS WOOqUmodel ? Zoning R 1
Parcel No. 2ND ADDITION Repair ? Type of Const. V
Addition ? No. Stories
W Move ? Length
ic Name JC?Eit3 TACKMAN
Demolish ? Depth 30
o Address Int. Impr. ? Sq. Ft.
~ity EAGAN phone 452-0440 Install ?
CL1RTI S HOME$ 2 9 7- 4 4 2 6 (W) Approvais Fees
o Name
o~ 220~ FLbRIDA AVE SO .OG
Address Assessment Permit ~ 00
lc city '~PI'S Pnone 542--4300 Water & Sew. Surcharge --77475 0
Police Plan Review
" W `'A`~2r' Fire SAC ~ • 00
F Name • 00
¢ a Address Eng. Water Conn.---6-3_00
< Wz City Phone Planner Water Meter~~
Council Road Unit~3~00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe BIdg.Off. 11/26/8 Tr. PI.
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC ParkS
Var. Date Copies
Signature of Permittee Total ~ 1bg ~ ~ ~
A Building Permit is issued to: Ci3h` :IS HOMFS on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
i -
PermN No. Permlt Holder Date Tslephons #
Plumbing J ~~c~~ y5:~ 5
H.V.A.C.
ElecGic V .
~
~7~ • ~ d0 C 4 A
Soltener
Inspec:lon Date Insp. Commenta
Footfn3a I ~D
Footir.gs II
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg. 51 / 4 vo RS ~ rAdi
Insul. % lf
Fireplaee
Final Htg.
Final Plbg. AW
Bldy. Final /
Cert. Oca
Deck Ffg.
Deck Frmg.
Well Describe Locatlon:
Pr. pisp.
Rodipt MECHANICAL PERMIT Psrmit No. ol
CITY OF EAGAN
F~
fill in numbered spaces S/C ~
Type or Prin[ legidy
~ Tot
1. Date 2. Installation Cost '
3. Job Address Lot Blk. Tract
'
4. Owner `
MERI`I' HVAC, INC.
5. Contractor Heating, Ventilating, CoolinEPhone V. U. Hox 4w
' 8. Address 1450 Park Court
. CHAMHASSEN, MN 55'237
(612) 934-)826
7. City State Zip
- 8. Building Type: Residential.E7 Commercial ? Institutional ?
9. Work Description: New 0 Add 13 Alter O Repair ?
10. Describe • Fuel Type 11. No. Eqyinment 8TU - M. Ea. No. EQUiament CFM
Forced Air . Air Handling:
Mfg. Boilers Mech. Exhaust
Mfg. _
Unit Heater
Mfg. Other
Air Cond.
Mfg,
Gas, Piping Outlets
4 12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Hough Final
Inspections: Date (nsp. Date (nsp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit No. ~
CITY OF EAGAN '
Fee i
. <
Fill in numbered spaces S/C y
Type or Print legibly Tot. '
1. Date ~ _2. Installation Cost ~ j
3. Job Address Lot Blk. Tract
<
4. Owner
~
5. Contractor Phone ;
i
6. Address
;
7. City State Zip ~
- ~a
~
8. Building Type: Residential ? Commercial O Institutional ? j
9. Work Description: New Q Add O Alter ? Repair ? ~
~
~
10. Describe
~
~
11. No, Fixtures No. Fixtures ;
- - y
Water Closet Cesspool/Drainfield ~
Bath tubs Septic Tank t
Lavatory Softner ~
Shower Wel I ~
:
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
;
Slop Sink
Gas Piping Outlets '
i
1
12. I hereby certify that the above information is true and correct, and I agree to ~
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition ST. FRANCIS WOOD 2ND ADDITION Lot 4 Blk 1 Parcel 10-65901-040-01
Owner C?0l[A hP,I JVic Street 3649 WIDGEON WAY State
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. i 1981 86.84 17.37 5 17.40 A014775 10-19-84
STREET RESTOR. 153 1983 2675.93 535.19 5 1605.57 " "
GRADING 1983 610.85 122.17 5 366.51 " "
SAN SEW TRUNK 1983 316.84 63-37 5 190.12 A014775 10-19-84
* SEWER LATERAL 1983 5510.68 1102.14 3306.42 if WATERMAIN
* WATERLATERAL 1983 S
WATER AREA 141 1983 316.84 63.37 5 190.12 A014775 10-19-84
*Services 1983 5
STORM SEW TRK r i, 1983 670.74 134.15 5 402.40 A014775 10-19-84
* STORM SEW LAT 1983 5
CURB & GUTTER '
SIDEWALK
STREET LIGHT
n n
WA . 500.00
BUILDING PER. 11362
sAC 525.00
PARK
. ~ CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 No 11362
PHONE: 454-8100
BUILDINGi PERMIT (W,g. ) Receipt#
To be used for SF DWG/GAR Est. Value $ 9 2 r 00 0 Date NOVEMBER 2 7 , 198 ~
Site Address 3649 WIDGEON WAY Erect C~ Occupancy R3
Lot 4 Block 1 Sec/Sub. ST FRANCIS WOODGemodel ? Zoning R1
Parcel No. 2ND ADDITION Repair ? Type of Const. g
Addition ? No. Stories O
W Name JOHN TACKMAN Move ? Length ~ n
= 17 RAHN RD.~ APT Demolish ? Depth
o Address Int. Impr. ? Sq. Ft
City EAGAN phone 452-0440 Install ?
°C CURTIS HOMES 297-4426 (W) Approvals Fees
o Name
Address2201 FLORIDA AVE SO Assessment Permit $ 409.00
~ city MPLS Phone 542-4300 Water & Sew. Surcharge 46 . 00
Police Plan Review 204 . 50
F W Name ' SAME Fire SAC 525.00
Address Eng. Water Conn. 5 0 0. 00
a W City Phone Planner Water Meter 63 . 00
Council Road Unit 280.00
# I hereby acknowledge that I have read this application and state thatthe 11 2,6 /8 132.00
information is correct and agr to comply with all applicable State of Bldg. Off. ~ Tr. PI.
Minnesota Statutes and C' gan dina s. APC Parks
Var. Date Copies
Signature of Permitte - , Total $ 2.159 . 50
A;Building Permit is issued to: CURTIS HOMES on the express condition that
all work shall be done in accordance w~tfi'a I licable Stat of Minn ota Statutes and City of Eagan Ordinances. ^
Building Official
'
~ .
request void ^
18 months from 1 / t YiJ - r~ ~ sy
0770~91 ~ ~ ~
Request Da_te Fire No. Rough- inInspection
Required? :K]Ready Now Q Will Notify, Inspec-
" ?Yes ~No tor When ReadY
~ Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at:
Street Address, Box or Route No. City '
3649 Wid eon Ave Wap Eagan
ection o. Township Name or No. Range No. County
D8kOt8
Occupant (PRINT) Phone No.
John Taclanan 452-0440
Power Supplier Address.
Dakota Farmington
Electrical Contractor (Company Name) Contracior's License No. 40445
Mailing Address (Contractor or Owner Making instailation)
3600 Kennebec Drive Ea an
Autho iz ~gnat e CQn actor/Ow er Making Installation) Phone Number
, ( 452-1565
MINNESOTA STATE BOARD OF ELECTRICI7Y THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N.191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
7821 University Ave., St. Paul, MN 55104
Phorie (612) 297-2111 ENCLOSED.
~
X REQUEST FOR ELECTRICAL INSPECTION 0 Es-00001-0
nR6 See instructions for completing this form on beCk of yellow copy.
. , X"" Bel'i"ow lN~r~C Covered by 7his Requesi ~ ~
Wevy Add ReP. TYPe ot Building -Appliances Wired Equipmen[ Wired
Home Range X Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electric Heatin
Commercial B1dg. Furnace Si!o Unloader
industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other SPecify Other (Specify)
ther SUecify Other Other
LHMpute lnspection Fee Below
M Fee Service Entrance Size N Fee Feeders/Subfeeders # Fee Circuits
0 to200Am s 0 to30Am s 0 t6 30Am s
Above 200 qmps, 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Amps
Transformers Irrigation Boorns .SQ Partial-'Other Fet~k
Signs Speciallnspection
$ Remarks TOTA Ff~
[C/
Rough-in Date 1, the Electrical
Insp tor, hereby
. rtify that the a6ove
Final e~jD, inspection has been
i
~ made.
This request void 18 months from
This request void
78 months from . a
077250 k1-I It
Request Date Fire No. Rough-in Inspection
R R ired? ~Ready Now Will Notify, Inspec- ,
3-27-86 Yes ?No tor When Ready
Licens6d Electrical Contractor I hereby request inspection of above
? Owner electrical work installed at: '
Street Address, Box or Route No. City
3fi49 Wid eon Wa Ea an
ecuon o. Township Name or No. Range No. County
Dakota
Occupant (PRINT) " Phone No.
John Tackman
Power Supplier Address
Dakota Farmin ton Electrical Contractor (Company Name) Contractor's License No.
Ril{* Elertric40445
Mailing AddressF(Contractor or Owner Making Instailation)
3600 Kennebec Drive Eagan, MN 55122
Athorized Si nature (Contractor/Own r Making I`stall tion) Phone Number
y \ - 452-1565
MINNESOTA STATE BOARD OF EL TRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
7$21 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297_2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ea-00001-04
' See instructions for completing this form on back of yellow copy. - 'Z//) ^
""X" Below Work Covered by This Request ~
ov, Eldd Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
' Apt. Building Dryer Electric Heatin
Commercia! Bldy. Fumace Si!o Unloader
industrial Bidg. Air Conditioner Bulk Milk Tank
Farm Other Speci Y Other (Sper,ify)
ther Specify Other Other
ompute lnspeciion Fee Below
# Fee ServiceEntranceSize # Fee Feeders/Subfeeders # Fee Clrcuits
2. 00 0 to 200 Amps 0 to 30 Am s 8 3.00 0 to 30 Am s
Above 200 Amps 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100_Amps Above 100_Amps
Transformers Irr'igation Booms .50 Partial- Other_Fee
Signs Speciai Inspection S
Remarks TOTAL ~FE~~
ac, -
~
Rough-in Date the Electrical
r I-a~ Inspector, hereby
certify that the above
Final inspection has been
b made.
This request void 18 months from
.
`
, a
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS HUST BE LICENSED WITH THE CITY OF EAGAN
COP44ERCIAL SINGLE FAl1ILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1-SET OF 1 SET OF ENERGY CALCULATIONS -
ENERGY CALCULATIONS' ~
$2, 000 LANDSCAPE BOND i
To Be Used For :~./m54G /kuluation : 9 Z104& Date :
Site Address OFFICE USE ONLY
Lot ~ Block ~ Erect K Occupancy ~Z3
~ l) Remodel Zoning (zl
Parcel/Sub S;, is Repair A Type of Const T[
Addition # of Stories
Owner Move ~ Length ~0
7~ ~ Demolish Depth 30
Address 4/ , y.v Lem eT, '0 Int. Impr . Sq Ft
Install
C i t y/ Z i p Cod e~.1.~1~
- Phone APPROVALS FEES
Contractor ~~,~1?i~~y~,~~ Assessments Permit
Water/Sewer Surcharge
Address ~.o~s~~? ~d~ Police ~ Plan Review 5=
Fire SAC 525 .
City/Zip Code Engr ~ Water Conn Do,
Planner Water Meter (173.
Phone S"grt- ¢Sn~ Council Road Unit Z60.
Bldg Off11- • Treatment Pl 32.
; Arch./Engr. APC Parks
Variance Copies
Address ~c;'Q,C TOT9L
City/Zip Code .
Phone 1d
~-IOMEoWh~G~ I S y.IOR.~UNG tli.lp~l2
LC.112T 1 S I~~GS LIC.~fJSG , WE 1-i-A~1C-. ,c~
LGITee F(1or"\ GU/zT t 5 -i-D 01,,_ °n-?p.T,
3-,;2~ x15 a- 19
r. ,
25x~o" 43saa ht
x'i " 1~~ x SS
Z~ x ZZ
2 5~~ SO x Z~ ~ l Sao~
~ 12Z~
B~ 33 P~ ~5 .
aoBE
ENGINEEt~ING C pLANNERS °ndOIAND S~URVEYOAS
' COMPRNY, INC.
1000 EAST 1461A STREET. BUfiNSVII.LE, h11NNESOTA 55337 PH ~132•3000
Cer-~Z~`, z ccxi? u~'`
Zaaal .lae.scrtA2ion_ LoT 4, eLocK 1, sT. FRANCrs wooo 2rvo ADDITION,
. DA KOTA CoUNTY, M I N N ESOTA
~ .
30' FRON7 BUILDIN6
SETBAC K L I NE
po 'o ~ ~o
4j5 ~ R'j ~c7.
°o_
L ~ .
' , h • Q ~
, \ • ~l $~a~
i`I O R T H 8w~
_ ~~a1~~ ye.° •o~ o,\ ~v~` q,~ - ~ ~g?4/
s[.41..E : l11 40,
.
' ~ aSti9 ~ taat ~ n~
01 • 5
~ l
I . ~ ~81b'0
` ~81Ao1 , ( .
, ( .
\ .
~
~ w
wW I ~ 2
m I qu o
\ N
DEMOTES EXIST/NG ELEVATIOIt/ I
. 1
( 875, o) DENOTES PRoPOSBA ELEVi4TfON ` I
. I
I NDI CATES DI RELTION OF ` LOT 4 ,
SURFACE DRAIKIA6E . I
• r-. i\ ~ i 4
I--: I ~ i a f~~ I I
~Z.o = I ~ •1
, FINISHED GARA6E FLoOR 151
ELEVAT/0/ll ,
-j
J
LD 3'~•°~
qo.41
S 88° 3l' 32" W
,
; DRAIIJA6E AWp
UTILITY EqSEMEN'T
I hereby aertify that this ie a true and correct repreeentation of a lract~ot
land as sho+m'and described hereon.. 11e praparad by me on thia z`L day ot
' 4 VFin8r 2- ~ 1 g g 5~ .
Ninn. Asg. No._
. ~
•
November 22, 1985
TO N1HOM IT MAY CONCERN:
John and Maggie Tackman have been authorized to use Curtis Homes
General Contractors License for the purpose of securinq a buildina
permit from the City of Eagen.
License # 0842 General Contractors
Bond # 984F462-8
Sincerely,
Gre lark
Customer Service Coordiantor
cc: File,
D. Benesch
2201 FLORlDA AVEfVUE SOUTH, MIMMEAPOLIS, fVllfVNESOTA 55426 Ph10fVE (612) 542-4300
~
EX?ERIOR ENYEIOPE AYERII6E "U" COMPUTATION
OWMER:
tITE ADDRESS: = CONTMCTOR: DATE' 'HONE'
DETE1tMINE MORKIN6 SQUJIRE FOOTII6E OF EACM: TOTAL EXPOSEO W1L1 AREA..:_,....
. 026 . z8, ~S G
TOTIIL ROOF/CE i l l N6 J1REA........ fq f t x "11"
' 3. TOTAL EXPOSEO VALL AREA CALCtlLJ1TIOIIS:
Total sxpostd xall ' ars~ ~bow f 1 oor.. . 7 ~ sq ft .
t :
a) Total ws11 windaw •na: -
~
- ; gtazed...... Zc ~ sd it x "11'• • ~9 • .~--~^j, -=~5~'
~1az~d...... sq ft x "U" •
b) Total door area sq ft x"U" _=,7___ ~
c) Tota1 slldin9 qiass door area: .
glased...... _ sq ft s "U'• •
qtas~d...... sa ft s "U" •
d) Total fireplace wsit area sq ft x"U"
a) Total wall trantng area
(Awra9e 107t)............ 7-3 sq ft x"U" ~ G q~ ~
f) Total nst r+al i area abov
, ~ '
.
. floor (Insulated)....... a`~G sq ft s "N'• • G, Z
9) Tetal rIw joist ana......,, ~ r sq ft x"Ir' < G~~-
Total foundattoe '
•n. (Expos.e).......... -71 sq ft
h) Total foundation
Wiltdow ~rsa . sq tt • "V" '
. ~ .
Totai Mt fowndatiaw q G5"~ ~G~
•ha abAM~ tradl. ~ ~ ~ ~ ~ ~ • _ eq ft X IV$ i
• . . . .
3. . ToTAt. a) thro t) • 0 9
It itaw 03 is ths sawe as, er lsss than ttr f1. You Mve mt tha tetent ot
2 Mc'.AR 1.16008 ? and 0. •
. ~ .
• . . . _ ~~'~~~,~l~L~~`% !a=e 1
~
r -
4AL ExrosEO off/cti~ING tALcuu?Tia+s: _
Tota1 •xoo"d
reetlal l i~l1 ~~a... .
j~ Tota1 sih/11lI+t •ha....... N tt ~c •'11" .
• k) Total reot/a I 11 M f rM1r4 N f! y'
~f~a ~MItra4~
Tetat• Mt tnsutated tt x'~' , p 2.~ .-2z , 97
• ~ reet/qi l tut •ha.......
. t+oRK )I etm 1)•
1t 'totai • et 84 is tlie sawe as. er l*ss thae I!. Yod how wt the totMt ot
2 M~'.~ 1.16008 ? ast O. . . •
. ,.t
.
~ ALTEp1ATE ellILDINC ENYELOrE OESICN .
Te ntt 1 ias N+s tetat ewwlope sYstam wwtl+odo tAe wiws "tabl isW w tM sus
ot ftews /3 and /k shatl eot begrsster thm t1w sum of ttsws
z ~ , ~ 7 • 2~ ' 3-
1.
.
, • • . . '
• ` , .
~V ~~1 E I tAT 1 01! '
isoreby qrtily tMt 1 Aaw eatwt•tsr tfy taetona u d
rat u e s I ~ s r s i s a nd that t1+s ?uItainq Mn Ass~ri~ iwts K tx,cN~s t~ ftat~
~t Mta~sseta Ewsriw taMwrwttaw Act.
' . . .
, qnatut~ . . .
. . . .
(Oate) -
2
• ' tMTluctIS
wiLL "w+ia sEtTioN: . •.ti1
sot Z~
,
ftt~~ a I • • o;o~i
. , ~~~•~09
. • I • • 1MLL ftCT1011 (IMATU) A.~ .
~ 1 l~ttriet air tth
. ~ j z-~
. i s , .
B•_ R xt ~e •r •
• • 1/t
. :
21N ,01sT uciIoN: e.~
~ 1 t•~te~ at~ til~
. ~ _ •
.
~ . . I . '
I S s B~ ~i_ ~~v
. I ~ tar o~ ~ ~ • ' . i • ~,~c,~ , .
. . ~ FoumTia tNSw?na . ua-
M1.. R-s o. .ntire r.t
•
IH~. R•10, ioM fa trost 6*18
fp1~l0AT10r ~IOMs ' A. • .
~ 1~~ ~~t ~ r• ~I1~
i 2
. ~ .
Nr et ar f A A'
~
. , _ • s.~ • . f •
• ~
~ f~J I •
. r•1/~•.`~r5, ~
~Mi3
j;• ; 44••'oe •„t
.
' ' • . j•0..~•; ' •~:4';;
• ~ . i ~ . ~ ~00 0
•
• .5,~~ • • . • ~l L•r • t
j' . .
• •1 ~ . dk ~ • ~ • 4 ~~0~~. • :
• * ~ ~t~
~ / • • ~ ~ • ~ ~
~ . ~ ~t~ sla~! ` • ~
• ~i.. ~ • .
~
E 0-1 4'4' '
. •,e . ; -
pn..td :t.e:: . . .
tll~.. ~ • . . • ~ .
• ~ : ~ .•10w:,.%
r ~ • •
~
~ ~ W1 • ' . ' .
• ~A ' •s.
~ • . . . . . . . ` .
~ : . ~stid I,v~' ~ '
• ' ~ i
y.~ wl!• ~1~ pt~ .1 • - ~ ~
. . . H
~ . . ~ f . ~ . .
, . . .
. , , . , - .
i~ ~ • . ~ ~ • c
• ' ' '
. ~
~ . .
' • • '
~ ~ •
f ~ •
3 OS . • f
. if 1~1 J • ~ J~~ G31X3A :
y.o ' ~ ~+i~ ~~~i~ " ~ ~ ' ~ ~ {
-
. . ,
• 1/1 • w ~
• • ~ ~
ty'O • lltl~~~ •l1~ ~1~ Jo~~s3Y~ ~ ~
i , .
t~'V •1 tl ~ t• ~1~• ~ .t ' . • _ . •
i~0~1~~~ ~Il~3S l11111~ • ~
. •
Lp'•~/1 ~ . - , , .
.
,'~;..y 7~; •
y•~ Ilj 1~ ~i~~~rl 1 ~i
=pllm tMlMlu lM11133
• .
: zp'•r/1•w ,
~
• Wjti •11! ~ • ~o~~ _ ~ ~ .
~ I ~
. _
~ ~ t ~1 ~
.
t (O)11r11KM1) W1133S 1011133
~ 1 L~ft111~110~ ' . ~ rv '
• 111A • '
.
2/a4
v~
• )CITY OI' EAGAN
APPLICATION FOR PERMIT
- SEWER AND/OR WATER CONNECTIOrT
(PLEASE PRINT)
1) PROPEFZTY ADDRESS :
LiJ.:f1L DESC:RI°TTCit: :71'"d~ .
. (Lot/Block/Subdtvision or Tax Parcel I.D. Ntmber)
STRL'GI?J:2E, DATi: OF ORIGi ZAL ruILDIING PER,?IT ISSu';4itiC°:
~ PP.~S--: USE. E5~R-1 SUiGI.W r^P~.ILY ' C] R-2 DUPLaX (TWO Wi ITS)
0 R-3 TOW1,1HOL?SE (THRE^ + U?VITS) ( LTNITS)
? R-4 ApAR'Il`A1E~+T/COj\IDCA~'~P,i'IU~I ( tNITS)
p COMMERCIAL/RET'AIL,/OFFICE
p I~USTRIAl,
Q INSTITU'I'IONAL/GOVERNMEVT
2) APPLIC-7~NT (PLEASE PRINi)
I~I1\I~SE : 'l, f Qh ~ '~/l7Ci i ~
ADDRESS:
CI'i'Y, STA'I'E, ZIP: -
PHONE:
3) pLUMBER NA~~. Y PLEASE PRINT) FOR Cji
E OHLY
ENZEt DRIYE EAGAFl, MINN! 5^' PLUN S ADDRESS: RF 5122 &,.,e
g~p0~tEG
CITY, STATE, ZIP: 452•1565 MASTR
t cord
PHOiVE: PLU
MBER LICENSE # 001445M2
tia
i 4) pCCUPt~NT/a,,TNJER ~ ~ / ~ (PLEASE PRINi)
NANIE : ~/G~//)-~ ADDRESS:
CITY, STA'I'E, ZIP: PHONE :
5) INDICATE WI-iICH PEPINLIT IS BEII~,'G REQUESTID:
Q CO~,'NECTION TO CITY SE.Tr1ER
~ CO:.Ti~tECTION Tp CITY WATER
? 0'I'HEf2 (PLEASE DESCRIBE)
6) DdDIG;' lz' C`E:
? PLE'ASE F?OLD APPROVID PER~iIT FOR PICi<-UP BY ONE OF ABWE
~ PL.~~SE MAIL APPROVED PERXIT TO 1, 2, Ci; 4 ABCn1E
(Circle one)
7) S IQ~~TL"-cE :
DATE :
l ~
,
~t ~:a~e ~e+~:~ar ~~.e ae:::: ~~nt sd r!+R' ~r:a~asc:a w tisc crr ~r ar;s ascp. iaw ar i~t wat :.AR fmpnt ~ sd am ami~rsmmav m
v
F O R C I T Y U S E O N L Y -
PER:tiiIT = ISSUED
FErS $ SE;.;ERl PEA\iT':.' (T',CL7_7D_" SSliRCuARGE)
$ WATER PERP'[IT (INCLUDE SURCHARGE)
$ WATER METEP./COPPERHORN/OUTSIDE READER
$ WATLR TAP (INCLJDE COF.PORF.TICN STCP)
$ SEWER TAp
$ ACCOUNT DEPOS IT - SEWER
$ ACCOUNT DEPOS IT - WATER
$ _Y3 WAC
$ SAC
$ TRUNK WATER ASSESSi1ENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEttiTER
$ LATERAL BENEFIT/TRU WATER
$ OTHER ~ ~ ~c' /~.Eee $ TOTAL
$ AMOUNT PAID/RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A'"PERMIT FOR WORK WITHIN
" PUBLIC ROADWRY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST RS A CONDI-
TION. SUBJECT TO TIIE FOLLO,,IING CONDITIONS :
RPPROVED BY:
TITLE:
i
DATE : 6
.E s-~ ~eia s,t ~ a•~~e o~ sE ~ rt•~ ~.r rE ~a-.s~ ~r~ ~a.a ~t~ ~•t ~~t w-•~ i.t•~ ~ s~ i.t•~ ~•e s~ ~
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
• -C l 651-681-4675 D-6 6 •-7 5-
New ConstrucHon Reaulrements n~ Remodel/Repai~ Reauiremenls~ -d~
vr~ ~
y 3 reglstered site surveys showing sq. ff. of lot, sq. N. of house 2 coples ot plan
and gII rooted areas (2096 maximum lot coverafle allowe~ 1 set of energy calculafions tor heated addlHons
> 2 copies oi plans (show beam & window sizes; poured ind. design; etc.) 1 site survey for extedor addiflons & decks
~ 1 sef of energy calculafions
> 3 coples of tree presenratlon plan If lot platted afier 7/1/93
DATE: 2'-7"G v ~ ~oa Sf, CONSTRUCTION COST:
DESCRIPTION OF WORK: ~~i+'O~ ~lC YcSD P qqr4qr 14~eelmuiti-famity bldg., how many units?
W t'
STREET ADDRESS: 1-1
LOT: _l BLOCK: l SUBD./P.I.D. r-&• 11- CJ"/o w6-0 CQ' .
Name: ac f'14o1 '~Okli ?1 Phone
PROPERTY Lost First
OWNER
Sheet Address: 36417c wWY7 WCs ~
City ~ 4 94I1 State: V*VA &A Zip:
Company: )eA Aam 1 Phone (76-a 4`~~~ ~qyo
(area code)
CONTRACTOR Street Address: 41160 r-xcei slqi" License #1G 0 Exp)YM~*-4701
ctty sUoC4 ?.ftr K state: ztp:
ARCHITECT/
ENGINEER Company: Name:
Telephone ( )
Shset Address: Registraflon
City State: Zip:
Sewedwater licensed plumber (if installina sewer/waterPhone
I hereby acknowledge that I have read this appliccHon, state that the information is c rrect, an a to compy wilh ali applicable State
of Minnesota Stctutes and City of Eagan Ordinances.-
, •
Signature of Applicanh
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preseroation Plan Received Yes No Not Required AL2V
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext, Alt - Multi
0 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Aft - SF
? 03 01 of _ piex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 04 02-plex ? 10 08-p6x O 19 Lower Level 0 24 Storm Damage
? 05 03-plex ? 11 10-plex Png Y or_ N? 25 Miscellaneous
? 06 04-piex ? 12 12-plex O 20 Pool ? 30 Accessory Bidg.
WORK TYPE -
? 31 New 13 36 Move Bldg. 43 Reroof ,
? 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding
O 33 Aiteration ? 38 Demolish (Inte(or) O: 45 .Fire ReRair ;
? 34 Repair ? 42 Demolish (Foundation) [3 46 Windows/Doors 4
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code , # of Stories sq. ft.
No. of Units 'Length sq.ft.
ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. , Census Code
(Allowable) Main level sq. ft. MC%ES System
UBC Occupancy, sq. ft. City Water
Zoning ° sq. ft. Booster Pump. °
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
0 Stucco/Stone APPROVALS . ' . . ' ' ' Planning 8uilding Engineering ° Variance
, . , f . . ,
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: 2--GO
SAC Units
% SAC