1275 Wilderness Run Rd . . - . . . =~"p . . cirr oF EA"N T`; t~ 6~(~
»sa ruor Kne? Ra.a 16900, MM Sf121
PHONLs I54-0100
BUILDING PERMIT aece+pt T. be w.e fe. n:"c ADpIT1oN Esr. value $6 , OGO nme ~ c?-27 I 9L-3--
Stce Addreu 1275 Wilc?erness !?un Rd Encr d occuaoncy n-3
l.ot 22 Block 3 Sec/Sub. [di I. d. Run 4 th qlter ? Za,tny R-1
Parcei # 10-84353-21-0-03 Repotr ? Fire Zone
Enlanpe ? Type of Const. Vn
W N~e 7'hOTtt3S L. Lay ~e p # Srories
~ Addross 1275 V-i Zderne s s Run Rd Der„ii,h Q Length
Ci Eagan 55123 phmb 452-5395 Grode ? Depth Sq. Ft.
s~r;~e as vwner AyPeorals Foes
t~ Nar,,. 6 . ~ ~
ut /lddretf Assessment Permit 4.00
~ Weter & Sew. Surcharye CI PFwne
Police Plon check
tW
Nome Firo SAC
u~ Addross Ernp. Water Conn.
~W C~ ~oM plonnar Woter Meter
Countll Rood Unif
I hereby acknowledye that I how reod this opplication and stote that Bidp. Off. 22 10 2
fhe informotion is oorrecf and agree to comply with oll opplicable 7~ ` `
Stote of Minnewm Stotutes and City of Eoqan Ordinances. APC ToRol "'0
Sipnature of Permittes
A Buildfny Permit {s tssued w: on the express conditbn t1xat
all work sholl be dona in acw?dante with oll oppliooble Stote of Mlnnesote Statutes ond City of Eepon Ordinonces.
Bulldlnp Officiol
E P~rmit Na PKmit Holdsr Misc. Parmit No. Holder
Plumbiny
H.V.A.C. r 3 - 01~
W~II
Wtbr
Ditp.
S~w~r
ENetrie ~ ~i
IraWetion Data Insp. Other
Footirp ,
FoundaNon
Fnmino
Rouoh Plbp.
Rougohi HV
Inwlation
Firwl Plbq.
Fioal HVAC
Firwl
Wow Dac+ibe Loeation:
M11
Swwr
Pr. DMp.
CITY OF EAGAN
3795 Pllot Kno6 Rood Eagan, MN 55122 N2 4545
PHONE: 454-8100
BUILDING PERMIT $1,475. Receipt #
~i~ tU±;r T Zb~ ~ i y 77
Te ba utad fer F l T P i4 ! ~C P Date
Site Address 1 z 7 S Tr. i 1 dernes s Rutl Rd. Erect Occupcncy ~
Lot " 2 Block 3 Sec/Su4. y~A ,lt.tih.- Alter p Zoning f`~Z
Porcel # ' Repoir ? Fire Zone _
Enlarge ? Type of Const. _
W Name ~'hotn,8s L Lay Move ? # Stories
Z Address i'T 75 S, ~ jdei~QS x'~ Demolish ? Front
3
cit-Y ` - ft.
o
Phone 452- ;-i~•,r Grade ? Depth it.
~ ~',x'tic~ rz [•Ialilie
o Name APProvals Fees
Dr.
.
oi Address Assessment Permit
~ Cit 1'u r'1'w ie Phone 890- b 1 41 Water & Sew. Surcharge iU
F Police Plan check
W W Npme Fire SAC
~W
Address Eng. Water Conn. _
<W Ci Phone Planner Water Meter
Counci I
I hereby acknowledge that I hove read this application and state that gldg. Off.
the information is correct ond agree to comply with all applicable
State of Minnesoto Stotutes and City of Eogon Ordinonces. APC Total
Signature ot Permittee
A Building Permii is issued to: ay- - on the express condition that
all work sholl be dane in accordonce wlth all appliwble State of Minnesota StoTutes and City of Eagon Ordinances.
Building Officiol .
P~k # pofe IuMd rMwIIIM
Plumbing
Mechonicol
INSPECTIONS DATE INSP.
Rouph-In Find
Footinys 10 -R6-7 onr. Iroc. Dor.
Foundation Piumbing
Frcme/ins. 7j Mechanital
Final Tl • j Q_.- 2 '1
Remcrks:
INSPECTI4N REC4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
i. ' I I t!!i?~ IcNt . RIIN RIl ~i~~; I ~:i, ; iii~f ~1'~~i
11I I I~t I:tJI I iiil I I 11 I ~ ~l, ~:~c~
PERMIT SUBTYPE: TYPE OF WORK:
.A
~ ---------------------------------~~J
Psmk No. Pwmk Moldw Dab TNephono M
ELECTRIC
PLUMBING
HVAC I
Iwpwtlon Dab hup. Commwb I
FOOTiNGS I
FOUND I
I
FRAMINO I
ROOFING K' s4 I
ROUGH I
PLUMBING I
PLBG I
AIR TEST
ROUGH I
HEATING I
GAS SYC I
IEST
I
INSUL I
GYP BOARD • I
. I
FiREPlJ1CE I
FlREPLACE I
AIR TEST I
FINAL PLBG
FlNAL HTG
ORSAT I
7EST I
BLOG FINAL I
I
BSMT R.I.
I
BSMT FlNAL I
I
DEp( FfG I
DECK FlNAL I
l ~
. , .~i.
. CITY of EAGAN N° 3644
` BUILDING PERMIT
^ - 3795 Pilof Knob Road
Owner ........_~.!.lSt.N.....Na.M.k.~.......=NS.......................... Eegan, Minnesola 55122
Address (Preeeni) ..ba1....~?.:.....Sl:>E.U.II.I~....~.....~:~......~'.~....J~ 454•8100
Huilder .~`.ft!~kf.............................................................
Dnls
Address
DESCRIPTION
Siorias To Be Vsad Foz Fronf Deplh Hsighl Esl. Coa! Psrm(! Fsel Remasks
5ir~g. dwail. G~ J4 HH //S.SO /J' a'da /ot /.~E
A~IiCh. cibl. SRrug~ ao _,X ~900 .;,p.oo
MOD&i -7 ~J b LOCATION /.iS•.~o
SlreeS, Aoad or olher Deeesipfion of Locnlion I Lo! Sloek Addition or Trec!
ia7s (u+~d~~n~es- 20 ..3 2oad a~ 3 IWiJdrrnfss I'a*~
This permit doea not auihorize the use of slreeis, roeds, alleys or sidewalks nor does it give the ownes os hL agen!
the right !o ereafe eny situaiion which is a nuisanee or which preseMa a ha:ard !o the healih, ea4efp, coevsafenaa aad
general weliare !o enyone in the communiiy.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORIt IS IN PAOGRESS. ~
This ie !o eeriify. !hal.~ .ts~-~..... ..~~%l. GP. poo
.......has permicaion !o ereef a.S!.........................
the above described premise subjetf !o the provisions of all applicable Ordinances tor !he Cilq oi Eagan.
*......~.'ce-.4~.C. par ..............._....----La...l.................................
Mayor r, Bulldlny Impxlor _2~
J~
CITY OP EAGAN N~ $620
9793 PIIM Knob Raad Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be umd for DWG ADDITION Est.Volue $8, 000 Date 10-27 I9_$3-_
sire nddress 1275 Wilderness Run Rd Erect eg occupGncy R-3
Lot ZZ Block 3 Sec/Sub. W11d.Rllri 4th Alter ? Zoning R-1
Parcel # 10-84353-220-03 Repoir ? Fire Zone
Enlarge ? Type of Const. Vri
e Name Thomas L. Lay Move 0 # Stories 1
; Address 1275 Wilderness Run Rd De,„ous, ? Length_
b Ci EacTan 55123 pho, 452-5395 Grade ? Depth Sq. Ft.-
°C Name same d5 owner ApDrorals Feat
0
ou Address Asseument Pertnit 68•
u~ Cit Vtwne Woter &$ew. Surchorge 4• 0 0
GW Police Plon check
Name Fim SAC
~Z
Addren Enp. Water Conn.
~W Ci phaM Plonner WaterMeter
Councll Rood Unit
I hereby acknowledge thot 1 have read this opDlication ond state that Bldg. Off. DP 10 2
the inlormotion is correcf and ogree to wmplY with oll opplicable APC Tofol 72
-5~
State of Minnewta $totutes a Ci of Eagon Or inanc s.
Slpnoture of Pertnittee '
A Building Permit Is iuued to: on the expreu condition thnt
oll work sholl be done in acc ance wit/h/p/1fq)oD liwble State of) Minnewta Statutes and City of Eopon Ordinances.
Building OfFlcial ~~0 0 "-~~-!-Q~N~ -
CITY OF FIAGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set cf energy calculations.
• ~ W~ ~ ` -
1b Be Used ForZN?n !~i€ar AGVJiTioiv Valuation Sf~O ~oo Date /o
Site Fddress iZGipl F'd. OFFICE USE ONLY
rAt ja slocx 2a seo./suv. G7fl~€rkE55 Erect occuPancy
Parcel 10 -$q3 5 3- z~o -0 3 u V~ J-l~ Alter Zoning
Repair Fire Zone
Oaner: -TwD/11/;S G L/~Y Enlarge _ Type of Const.
Adclress • P'bve # Stories
)295" liv/i-OF2ivESS /Zqid A14 Delrolish Front " ft.
City/Zip Caie: Fj{~/~~ ni/f? S S/L 3 Grade Depth ft.
Phone ~S2 - 5395
APPROVALS FEES
Contractor: ~Tyoy,~~j/S 1- G~Y Assessments Pesmit
[~7ater/Sewer Surcharge
Address: Police Plan Check
City/Zip Code: Cfi J 3 Fire SAC
Phone Eng' Water Conn.
Planner--~~rr-- Aater Meter
Council Road Unit
~~•~g•~ Bldg. Off. o-)L-
Address: APC
City/Zip Cocle:
Phone TOTAL
cirr oF EncaN
3793 Pilot Knob Rood Eagon, MN 55122 Ne 4545
PHONE: 454-8700
BUILDING PERMIT APPLICATION $1,475. Receipt # 7883
To be und far F{ranlnra paLe OCtObEr 26, 1 q 77
Site Address 1275 W11dei[IeS3 RUn Ra. Erect ff Occupancy 1
Lot22 Block 3 Sec/Sub. y}p yo}, Alter ? Zoninq Rl
Parce1 # Repair ? Fire Zone _
Enlarge ? Type of Const.
z' Name Thotnas L L8y Move ? # Stories
z Address 1 275 Wttdo+..eae aUn Rd Demolish ? Front ff.
a ?
Cit E9 Phone 459-5'i99 Grade Depth ft.
~ Nome Bruce R Moline ADDrorals Fees
Z~ 13240 H1ghV1eW Di, qssessment Permit 9_00 _
o Address
U~
1- Cit BuTnsv1118 phone 890-6141 Water&Sew. Surcharge 1_00
Polite Plan check
ww Name Fire SAC
rw
Address En9. Water Conn.
<w Ci Phone Planner Water Meter
Council
I hereby acknowledge that I have read this application and state that gldg. Off.
the information is correct and agree to comply with all applicable AP~ Totol 1~.0~
Stote of Minnewta Stotutes and City of Eagan Ordinonces.
Signature of Permittee
A Building Permit is issued to: T110 85 L L8 on the express condition ihat
oll wor9 shall be done in accordonce th ol icable tate of Minnesota Statutes and City of Eogan Ordinances.
o>•~.
Bulldin Official F~Y
- -
VILLAOE OF EAOIIN SEWER SERVICE PERMIT
3751 VlIc::t,obRood PERMIT NO.: 2626
Eagan, MN 55122 DATE: _ 10/21/75
'I.oning: Rl 7 1 No. of Units: 1
Owner: m' i H r ~eji Address:
Site Address: 1275 L' ldnrneaa R~ ~ T-22H3_YIR4
Plumber: ReX~Oc
1 ayree to comDl1 with the Villa9s of Eayan Connec[ion Chazge: 425. 00 Pd
Ordinoncaa. Accounl Deposit
Permit Fee: 10.00 pd
.50 pd
Surcharge:
gY: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
4;. eacaN WATER SERVICE PERMIT
379: rtob Road PERMIT NO.: 1868
Eogan,MN 55122 DATE: 10/21/75
Zoning: -Alll No. of Units: 1
Owner: Ti1~ Ta c Tnr
Address:
Site Address: -1275-Wildern6s^'~-1.22B3-WU4
Plun )er: Y~--~rOc-. - 00 pd
Meter Connecnon Charge: 37p
Size: - / _ Accoun[ Deposit
Reader No.: permit Fee: 10.00 Pd
1 agree to comply rifh fhe Villa e of Eogan Surcharge: 50 Pd
Ordin es. Misc. Charges: 60 90-p°- .
` Total:
BY Date Paid:
Date ot Insp.: Insp.:
f
~ ~ A?E/~1~ OR~OERTY LwE r--~ -
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7114,
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9~0 -5 o
MASTER CARD
, LocarioN
OWNER h
STRUCTURE AND
LAND USED AS
Issued To
Permit No. Issued Contractor Owner
BUILDING
Wr
PIUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING -9,/
GAS INSTAILING
SANITARY SEWER
OTHER 'I~ 1)
a>__.~~qNl v
OTHER
Approved
Ifems (Initial) Dafe Remarks Distance From Well
FOOTING Z SEPTIC
~
FOUNDATION - - J CESSPOOL
FRAMING •7 TILE FIELD FT.
FINAL
ELECTRICAL DEPTH
HEATING ~IC3 - J OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIEID
PLUM8ING
WELI
SANITARY SEWER
go
0001-.~~ ~
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS -
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDI710N5 OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPIIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR ?
DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
17EMIZFD AND DESCRIBED AS FOlLOWS:
? REInSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEAIED
CERTI FICATION - I certify tha[ I have carefully inspecced the abwe in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to ba at variance with ortlinances of the Town of Eagan, approved plans and specifications, and any specific require-
manu for oft-site imprrnements relating to the propeny inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR D11TE
COMMENTS:
»
~ PERMIT 0,rzo y~7yl
CI t'Y OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 6 8 5
(612) 681-4675 Date Issued: 11 / 0 7/ 9 5
SITE ADDRESS:
1275 WILDERNESS RUN RD
LOT: 22 BLUCK: 3
WTLDERNESS RUN 4TH
P.T.N.: 10-84353-220-03
DESCRIPTION:
(ROOFING)
Building Permit Type SF (MISC.)
Building Wdrk Type REPAIR
~
. . ~ . ~
REMARKS:
FEE SUMMARY:
VALUATIUN $5,000
Base Fee $99.75
Surcharge $2.50
Total Fee $102.25
CONTRACTOR: - Applicant - s7. LTC. OWNER:
HORIZON ROOFING 18903900 20012795 LONGMAN MIKE
1333 LARC INDUSTRIAL [3LVD 1275 WILDERNESS RUN RU
BURNSVILLE MN 55337 EAGAN MN 55123
(612) 890-3900 (612)952-2591
I hereby acknowledge that i have road tfiL,, applic.+tinn and st,,te that the
information is correct and aqree to cumply with al] appliceb?2 SI.ote ui Fin.
Statutes and Cit,y oF Eagan Ordinances.
L J
APPLICANT/PERMITEE5IGNATURE ISSUEBY:FIGR~URE k
-
_ CITY OF EAGAN
3830 PILOT KNOB RD - 55122
t41995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
687 -4675
New Construetion Reauirements RemodeVReoair Renuirements
? 3 registered ake surveys ? 2 copies ot pfan
? 2 copies of plana (inGude beam & wirMow eizes; poured fid. design; Mc ) ? 2 ske survays (exterior edd'rtiona 8 dedcs)
? 1 energy calwlations ? 1 energy calcuWtions for heated additions
? 3 coDies ot troe proeervation plan 'rf IW platted efter 7/1l93
requirod: _ Yes _ No
DATE: it 13~115 CONSTRUCTIONCOST:
DESCRIPTION OF WORK: 12Q-`" +ccq-~
STREET ADDRESS: Rtw Pd
LOT ~ BLOCK SUBD./P.I.D.
PROPERTY Name: Phone ~O~-°~SQJ
OWNER
Street Address,
f!/~.aii,.v State: InM ~ zip: 5s~z3
INSPECTION RECORD -T ~
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob fload Permit Number: 0 2 6 6 8 5
Eagan, Minnesota 55122-1897 Date Issued: 11 J 0 7/ 9 5
(612) 681-4675
SITEADDRESS: p'j'N.: 10-84353-220-03 qppLICANT:
LOT: 22 BLOCK: 3
1275 WIIDERNESS RUN RD HURIZON ROOFING
WI4DERNESS RUN 4TH (612) 890-3900
PERMIT SUBTYPE: TYPE OF WORK:
SF (f4ISC.) REPAIR
DESCRIPTION (RDOFING)
~ " .
ROOFING
~I
~
OFFICE USE ONLY
y y
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dwelling o 07 4-plex o 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Misceilaneous
? 05 SF Misc. 0 10 _-plex ? 15 Deck
WORK TYPE
0 31 New ? 33 Alterations ? 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL fNFORMATION
Const. (Actual) Basement sq. ft. MCNVS 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 Bldg
Census Unit
AFPROVALS
Planning Bu+lding Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
VVater Gonn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
SAC Units
Cities Digital Qualit_y Control
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BUILDIc?G PiRKIi P.PPLICATIO!7
LOT BIACK 1DDIT10;7
~
PARCEL & SECT20PI t9UT1DER IF UiIPLATTED
/
ADllRESS OF PARCEL ,
~
tel
ZOiv'I:1G OCCUPANCY 7~ USE
ESTZiNAi'ED COSs f y /,5 -
~ O['117Ei2 %1~nvriaS L La.v TELEPHONE N0. 75~2 -53 ~/S _
ADllRBSS ln.1'ljev~ -eCC /C[ kk Rd' ~EQaatr~ f M"v?~q $--s123
CO?,ITRF:CTOR TELEPFiONE 510.
ADVRESS A-i w ~ v i v e Q ca vvic
.[iote: Include site plan, building plans, and energy calculation3 urith this
application
Siqned
OFFICE USE
V21LU11i IOi1______'__'7~~? ~
SAC
S•L'1YEA COld;JEC^20':T
11ATEFt METER
BUILDIfIG PERLIIT FEE ~
i
SIIRCHARGE PLE ~
PLr1M CFMCK F£E
PAf2LC DED2C:1TIOi1 FEE
OT..nR
~
TOTF;L*
APPROV2iLS:
ASSESS;+IE :'T CLERiC BIIILDING DE POZICE DEPT.
[9ATER & SEP'LR DEPi. FIRn DMPT. PARK DEPT.
LOT ~ BL CITY USE ONLY
~
PERMIT
SUBD. WIII,IPrr1CU, RUh 1V) RECEIPT k:
RECEIPT DATE:
2000 M£CHA1VICAL PERMIT (R£SIDENTIAL)
cm'oF E,nsatr
3$30 PU.OT KNOB iiD
_ EA6ANMP551EE torm Damaqv
q-13 OD e51-661-4675
\i
Da[e•
Complete this section onlv if you are installing HVAC in a single-family dwellmg, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-]00MBTU $ 30.00
ADDITIONAL SO M BTU 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
State Surcharge .50
Total $
Complete this section oi:lv if you are remodelinp, addinp to, or replacing an existing single-family dwelling,
townhome, or condo. Please mdicate if it is a new item, alteration, or replacement.
_ New X Replacement _ Other
T Fumace I Air conditioning
_ Air exchanger _ Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for fina! inspection.
SITE ADDRESS: ~51. Vy i'l der ness P6h KG7
OWNERNAME: Michael LQhmyntlm PI-IONE#:
~t'(,~ (AREA CODE) ~f /INSTALLER NAME: n YeDnI Pl, I 1VQ7 U ra' f9Cll` PHONE IO I - 7L
~i Yl 72~
I (AREA CODE) .
STREET ADDRESS:
CITY: STATE: ZIP:
SIGNATUR.E OF PERMITTEE
CITY USE ONLY
l _ BL _ PERMIT#:
SUBD. RECEIPT#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
2000 M£CHA1Y1CAL P£RLlIT (COMMERCL+kL)
CITY OF £A&."
3$30 PiLOT KN08 RD s~ Y m ~Q m Q ~f
fAfiAN, MN 55122
~
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: h --r o
WORK TYPE: New conshuction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When installing/removing underground tank, ca11 651-681-4675 for inspectEou by fre ntarshal ai:d
plunrbiirg inspector.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater
Underground tank removaVinstalla[ion = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculare at $.50 for each $1,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNER NAME: PHONE
(AREA CODE)
TENANT NAME (IIvfPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS: PHONE#: -
(AREA CODE)
CITY: $TATE: ZIp:
SIGNANRE OF PERMITTEE
~ 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construchon Reawrements RemodeUFteoair ReauiremenLS OHice Use Onlv
3 registered site surveys showing sq. fL of lot, sq. R of house; and ali roofed areas 2 copies of plan CeR of Survey Recd _ Y_ N
(20°h maximum lot wverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y_ N
2 copies of plan showing beam 8 window srzes; poured found design, etc 1 site survey for addilions & decks Tree Pres Required Y N
1 set of Energy Calculahons Addrtion -intlicafe don-sfie septic sysfem On-site Septic System _Y _ N
3 copies of 7ree Preservation Plan if lot platted aker 711/93
Rim Joist Dehaii Options seledian sheet (bidgs with 3 or less units
Date / Z / Z/ l o 7 Construction Cost leJ~ J
Site Address J 1.? ) ~~i? Id Unit/Ste !k
4"'
SA~L
Descriptionof Work /A1 T/
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 -k1 _ 2
i .I / l
Property Owner M 1V(,~
i L Ql"( Y/W7?`~' Telephone #(/p ) Z' LJ ~i /
Contractor
Address -)D W 4~41`1 /j City~/~ ~611('16
State '41 Zip J 3 Telephone # (9 ) L) P'/f,)%) 7•~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Mumesota Rules 7672
Enefgy Code CategOry . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet
(q submission Type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/Water Contractor Telephone J
I hereby apply for a Residential Building 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 State of MN
Statutes; 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 pl in thkaseof work which requires a review and
approval of plans.
,~rb~~lN
ApplicanYs Printed Name Appli anYs Signature
OFFICE USE ONLY
Sub Types
? 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 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Siorm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25. Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof O 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings (addi[ion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice $ Water _ Fina] _ Pool _ Ptgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fueplace _ R.I. ` Air Test _ Final _ Windows
Insula[ion _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC `
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
City of Eaaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
t�l
Use BLUE or BLACK Ink
For Office Use �I
/$2o3
I Permit #:
'-'
Permit Fee: I
-..L - )
I Date Received: ___
Staff:
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:�' Site Address:
'7
Tenant:
lags
(uL[derness ku.Au ge,1
Suite #:
RESIDENT / OWNER
Name: Lt n LGn ], w5�'�,`t, C�3cI ..
1cA___ PhQon�e,: ____ `
Address / City / Zip: t �15 , d f cSS un r•Ci' t rt. ' ,...,-,10(..)
CONTRACTOR
Name: f(if 11rlisJ f Cvnn
C� ICr S 0 License #: / oL0q PM
Address: l t3 OQn t -ct at
to City: .
State: � Zip: _5539 q
Phone: ' _i4 5_
(3 V 3
Contact (T e ?fie. I Finail:
— New Replacement Repair
Description of work: ___
__?Rebuild _ Modify Space _ _ Work in R.O.W.
TYPE OF WORK
PERMIT TYPE
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / PVB)
---- Water Softener
�__ Add Plumbing Fixtures L__ Main / _— Lower Level)
Water Turnaround
_
Y Septic System
New
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water
Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County
fee and $5.00 State Surcharge)
TOTAL FEES $ &O. 00
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 undergrourtd utilities. www.gopherstateonecall.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 the approved plan in the case of work which requires a reviewland approval of plans. -
gaeli
Applicant's Printed `I
l
App ' ant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113838
Date Issued:09/09/2013
Permit Category:ePermit
Site Address: 1275 Wilderness Run Rd
Lot:022 Block: 003 Addition: Wilderness Run 4th
PID:10-84353-03-220
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Melissa Weaver
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael Longman
1275 Wilderness Run Rd
Eagan MN 55122
(641) 442-0342
Nmc Exteriors & Remodeling
15 - 1st Avenue South
Buffalo MN 55313
(763) 684-1662
Applicant/Permitee: Signature Issued By: Signature