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1318 Wilderness Curve • _„r ~ ~ (gtrfi#iratr o# (Orru~~ury Citp of eagan ~tparbntct n# iWbittg JnsWertion This Certificate issued pursuant to the reqairenvenls of Sectian 306 of the Unijontt Building Code cenijying that at tlie ame of issuance this structure was in compliance with the various orrlinances of the Ciry regulating building construction or use. For the following.• uu c~.ni6c.don L!'1['~'1f{ eldg. Rrmi! rlo. ' OocuWaY'1yP~ R3 Zooin6 Disuict 1 'lype Cdbt. ~'1 O+voer of BwldM OWN'~~? INC• ""I'ireta { b ; ~ ~~~7i , d , ' 1 euiiangnaaress f 318 W!-LDEFNESS CURVE Locali B], WI'~~~;:E'urc:.C~' P~8 a,c: APRII, 8, 1988 BWkUa OfficW POST IN A CONSPICUOUS PLACE I ' , . . , . ~ CASH RECEIPT CITY OF EAGAN • 3830 PItOT ICNOB ROAD EAQAN, MINNESOTA 66122 DATE 10 ~ l AMOUNT $ / c:i rJ • DOLLAR{ o~ ? CA8H CHECK r Ao ~ '/UNO GOO[ AMOUNT 1 ~ ~ Thank You ~ liv ~ Whlie=peVe?! @8 Y ~ . Yelle Ae 4ing ~~Y i~~l~ ~II• ~av • ~ , BLDG. PERMIT N0. ' -J • f J 0I-3210 Bldg. Permit r 4 L10 . 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge %r J 17.t3860 Road Unit CC 20-2275 SAC 20-3865 Water Conn. 00 26-3868 Water Trmt. 20-3716 L:ater Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. Jf-3855 Park Ded. TOTAL CITY OF EAGAN 146 6$ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH ON E: 454-8100 . BUILDING PERMIT Receipt To be used for ;iF -TkJWGNt Est. Value A4 a,QU;: Date ~~~~~~~~I"'i 15. ,19 Site Addrsss ial~: ~illj,)~•.t'di:.iS C7lildYE OFFICE USf ONLY ' 1 'r~'IY.~!"~i:.'•t-~~•'~S Lot ' Block Sec/Sub. CX~). On Site Sewage _ Occupancy MWCC System ~ Zoning Parcel No. On Site Well Type of Const City Water ? (Actual) ~ (Allowable) s Name a~ of Stories z Address 15136 GAL?LYIi"s isVP. Length o City .1nPLE; VALI,d•,'S~hone 43I--5600 Deptn /A2 S.F. Total °C Name Footprint S.F. .o ~ ~ Addrefs APPROYALS FEES ¢ 7Z4 .40 1City Phone Assessments _ Permft Water/Sewer Surcharge ~ W ~ W Name Poiice Plan Review - Address EngFirer. = SAC, City SAC, MWCC - cc = W City Phone Planner _ Water Conn. a~ Council _ Water Meter rj7 j}j I hereby acknowfedge that I have read this application and etate Bldp. Off. _ Road Unit Di: that the information is correct and agree to comply with all applicable APC _ Treatment P1 n_06 ' State of Minnesota Stetutes and City of Eagan Ord)nances Variance _ Parks ! Copies Siqnature ot Permittee TOTAL A Buildi'ng Permit is issued to: ~ ~r`~ on the express condition that all worlc shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinancea A Building Official . CASH RECEIPT ' CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 - ; oarE 19 ncccIveo . AMOUNT $ , I 6 DOLLARf ~es ~ CASH ~ CHECK r J ~'?tGf.1 ~ ~ ,:I ,{t~ FllND CODE AMOUNT .'f?~r' i7'~+' ~.J / ~1 l ~ ! i Thank You BY tL-~~ / White-Payers CoPY ° % Yellow-Poscinp CopY Pink-File CopY CITY OF EAGAN ' 5 ~ $ 3830 Pila~t KnQb Road, P.O. Box 21-199, Esgan, MN 55121 PHO N E: 454-8100 BUILDING PERMIT Receipt ~ To be used for Est. Value Date ,19 Site Address 1 OFFICE USE ONLY Lot Block Sec/S b. On Site Sewaqe _ Occupancy ~ MWCC System _ Zoning Parcel N o. ~ On Site YVell _ 7ype ot Conat City Water = (Actual) (Allowable) W Name s of Stories ; Address Length ~ City Phone Depth SF. Total , p Name Footprint &F. Address APPROVALS FEES 1- City Phone nssessmertts _ Permit WateqSewer Surcharge ~ W Name Police _ Plan Heview _ ~ Address Fire _ SAC. City v Enqc _ SAC, MWCC g W City PhOnB Planner _ WaterConn. Councfl _ Water Meter I hereby acknowledpe ihat I have read thfa application and atate Bldp. Off. _ Road Unit thattheinformationlscorrectendagreetacomplywfthallapplfCSble APC _ TreaimentPl State of Minnesota Statutes a?id City of Eagan Ordinancea Variance _ Parks Copies Signature of Permittee TOTAL A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State af Minnesota Statutes and City of Eagan Ordinances. Building Official PermR No. Permit Nolder Date TNephone Jt Plumbing . H.V.A.C. EleCtric Softener Inspection Date Insp. Comments Footings I Footings II Foundation Framing g~ uA Roofing 3~g g~ W Q Rough Plbg. _ ,A Rough Htg. Isul. ' - - - Fireplace Final Htg. Final Plbg. ( Bldg. Final Cert.Occ. A Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. PERMIT # y,) C -r! • MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot - Blopk ~ Secl8ub - Res. V' New Mult Add-on ~ Name m Address ~ " r' ~c'. r_ _ Comm. Repair V; ~ Other c City Phone - % FEES Name ~ .s - , RES. HVAC 0-100 M BTU -$24.00 c Address ADDITIONAL 50 M BTU - 6.00 p City ' Phon (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEkMI'n - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent. CFM (ADD $50 S/C IF PERMIT PRICE GaES Gas Piping Outlets # BEYOND $1,000) Other $ , SEC: ` SIGNATURE OF PERMITTEE .C~tc~c.CC~ U'~?2 ~`'x~' TOTAL: FOR: CITY OF EAGAN PERMIT # { . ' r PLUMBING PERMIT RECEIPT k CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ~ ` - CONTRACT PRICE PHONE: 454-8100 Site Address ~ ` • ~=G BLDG. TYPE WORK DESCRIPTION Lot Block jT,Sec/Sub Res. ~ New Mult. Add-on ~ Name Comm. Repair -ia Address ' ~ Other c Ciry Phone4e 2'^` RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL ~ Name Water Closet - $300 $ ` Bath Tubs - $3.00 A c Address ~._Lavatory - $3.00 p City Phone~ ~Shower - $3.00 ~Kitchen Sink - 53.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE f_Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains - 51.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater -$i.50 MINIMUM - RESIDENTIAL FEE - $12.00 . Whiripool - S3.00 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: - - STATE S/C: - FOR: CITY OF EAGAN GRAND TOTAL: GG INSPECTIUN RECORD GITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ~ i, i ~ I~; . I~ii•iii . i , , , . . , PERMIT SUBTYPE: TYPE OF WORK: f1~ ~ INSPECTION DA • D• F . . ~ . ~ . . . . ~ . . . . ~ L Permit No. Permit Holder Dete Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments , Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Fnal Htg. Orsat Test Final Plbg. Plbg, Inspector - Notify Plumber Const. Meter Engr./Plan Bidg. Final Deck Ftg. Deck Final 3 ~or~ wigi Pr. Disp. CITY OF LtAGAN Permit No: Datec 3830 PUot Knob Road Meker No: 3 9 70 Size: rr P.O. Bax 21199 Reader No: 3 I~T date: Eagan, MN 55121 Owner. ~;z::rsz~-Pedersr. ,.nc. ' SiteAddresq; 13 18, :+ilderness ~':urve LI S1 ':ilaer.n_ess Podti.s Plumber Tnilnson 1'xc/Peine P mhdn,i, ALY1NWO W g. CORR. Ch ~ n.yirJ r.~ ~q WR ACCt. Dep: i i_ tlt~ rQ~4,,, 4QC . Permit Fee: ~;IIIAAIP J ~-L+(- i i~; t, - ~rr~J ~tC Surcharge: - 5Pf ~ ~-1 agree to compfy with the CRy ot Eagan Tr. Plant -0nREf'_l l I I 1? F[ln$ w . Meter. Misc.: BY WATER SERVICE PERMIT CITY OF EAGM Permit No: 9356 Date: 2iQ=8 g : 3830 PMot Ifnob Road Meter No: Size: P.O. Box 91199 Reader No: Date: Eagan, MN 55121 ~ ~ Owner. - •Fe<iQrsoa, Inc. ! SPte Address: i3'1E. wilderness Cuzve Ll BI "il.'eraess "clis ; Plumber. jolt-son Exe/Peine P2umbLn„~ Conn. Chg: 550,002A Zoning: Acct. Dep: 15• d0pSl No. of Units: Permit Fee: 10 . Cl0Rd ~ Surcharge: - 50pri I agree to comply with the City of Eagan Tr. Plant ?-~A - COpd Ordinances. Meter. 67, ggpd- ~ M1SC.: By WATER SERVIGE PERMIT CITY OF EAG Date: AN Permit No: 3830 pibtknob Road B/P No: - Date: ~ P.O. Box 21199 I Eagaf,; MN 55121 I Owner. ~ , . . ~ Site Address: ~ T~ ilderne s Cu- , Plumber: 0 ~ I r ~ MWCC: ~50.001'`' Zoning. City Chg: 0'1;j" - No. of Units: ~ Acct. Dep: 1 . I agree to comply with the City of Eagan PermitFee: Ordinances. ~ i , Surcharge: Misc.: BY i i SEWER SERYIGE PERMIT 1 ~ RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OP EACAN 3830 PILOT KNOB RD - 55722 651•681•4675 47l//~ 0p . ~ New Construction Reauirements RemodellReoair Requirements • 3 registered site surveys showing sq, ft. of lot, sq. ft of house; and all roofed areas • 2 copies of plan (20°6 maximum lot coverage aliowed) • 1 set af Energy Calculafions for heated additions • 2 copies ot plan showing beam & window sizes; poured (ound design, etc.) • 1 site survey for ccierior additions & tlecks • i set of Energy Calculations • 3 copies o! iree P2servacion Plan if lot plaKed after717193 . Rim Joist Detail Op6ons selection sheet (bldgs with 3 or less uniLS) ' DATE ajO C,,~ Q31A~~ C~ 1 VALUATION (EXCLUDING LAND)~~j(Z~j JOB SITE ADDRESS f~/ tg4~(' (t y'o ..S~5 /.tr 1/d, IF MULTI-FAMILY BUILDING, HOW MANY UNITS? ~ PROPERTY OWNER Aike, p1AA6R / J TYPE OF WORK FIREPLACE(S) _0 ~!'f _2 -3 APPLICANT 'Pz `iv'PC/~PHONE# ez. ZIPCODE.f0 332 ADDRESS eT & PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - PILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calcuiations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone Plumbine System Includes: Watrr Softencr Lawn Sprinkler Fee: $90.00 Wa[er HeatAr No. of R.I. Baths No. of Batlis Mechanical Contractor: P,AL? S/`f~ Phone # qJS7 C1 ?6L"~ 7.7/Y N[eclianiril Sys[em Includes: Air Con iitioning Fee: 170.00 _ Heat Recovery Systern Sewer/Water Contractor: Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, sfafe that the inforrnatian is correct, and agree to comply wifh ali applicable State of Minnesota Statutes and City of Eagan Ordinan C Slgnature of Appiicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updatetl 1101 OFFICE USE ONLY N ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of,_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex 11 10-plex019 Lower Level ? 24 Storm Damage . ? 06 04-plex ? 12 12-plez 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 p 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/0oors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC1ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinkiered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) P.lumbing Foundation HVAC Drain Tile ' Roof Ice & Water Final Other _ Framing Pool _ Ftgs _ AidGas Tests ~ Final _ Ficeplace _ R.I. _ Aic Test _ Final _ Siding Stucco _ Stone _ Insulation _ Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total t r` CITY OF EAGAN (f ° 1455 8 . 3830 Pflot Knob Road, P.O. Box 21•199, Eagan, MN 55121 F PHONE:454•8100 go~ a~ BUILDING PERMIT Receipt# To be used for S:' DTAG/GAR Est. Value $146, 000 Date JAI`II7ARX 15, ,1988 Site Address 1318 WILDII2NESS CURVE OFFICE USE ONLY Lot 1 Block 1 Sec/Su6. WILDERNESS PONDS on Site Sewage _ Occupancy R-3 MWCC System L~ Zoning R-1 PBfCRI NO. On Site Well Type W Const City Wa[er ? (ACtuan Vn c Name OZMLIN-PEDERSON• MC pgp (alioweble) Vn ? # ot Stories ~ Address 15136 GAI.AxIE AVE Length 74' ~ City~PLE VAI-•E'Qhone 431-5000 Depth 491 S.F. Total ,p Name ~ FoolprintS.F. ~Q Address APPROVALS FEES m i- City Phone Assessments _ Permit 724.00 Water/Sewer Surcharge 73 _ OQ Uw Name SAME Police - PlanReview jr?.,.QQ_ ~ nn _ nn Address Fire _ Saq City vtf Engr. _ SAC,MWCC SSO_00 ~W Ciry Phone Planner _ WaterConn 550_00 Council _ watermeter G7 ac) I hereby ecknowled9e that I have read thia ap lication end state BIdg.Off. _ Road llnit 375 nn thattheinformationistortectan tocom withallapplicable APC _ TrealmentPl 704 nn SteteofMinnesota5tatutes it 4tEa In s. Variance _ Parks Caples ~ SignatureofPermittee rOTAL 2,955.00 A Building Permit is issue to: 0ZWN-PID on the express condition that all work shall be done in accordance with all applica6le State of Minnesota Statutes and City of Eagan Ordinances . Building Official Z-12aj G~<~- IAF ° Request Oate , Fire M. Rough -in Inspeclion NOTICE: Vou Must Call ElecVical Inspeclor q Hequir p etl? II A Rough-In Inspectian T3 ?Ye5 No IsRequiretl. y I pI licensed contractor ? owner hereby request inspection of above electrical work at: Job Atltlress (Street, Box or Route No.) City 13iiT w,~os2".«s &'CVF Csf-li Section No. Township Name or No. Rarge No. Coun ~ Occupant(PRINT) 16L Phone No. btTNe4rn,< 57i1oM Powar Supplier G Adtlress hn/17~?C07A ! cE47;vC Elecinca/~l C"ontractar (COmpany Nama) Contracror5 License No. a.~GSTi</C /~GFC?i/!G GA~~~7S~ Mailing Pdtlress (COnVactor or Owner Making Installation) , /V.SV ANFwnzetl SignaWre (CO irac~otlOwr~er Making Installation) Phone Number ~ Ggg (b.Vrr~~ sMitlway B~Ag. OA ROOm F S-173 ~ICm 1_•3' UNILESS Pfl PIER NSPEGTI NIFOEE ST 1821 UnlvereNy Ave., SL Paul. MN 55109 V Phone(612) 662-0B00 ~ ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION eeooooi-oe ? See insimctions for completing ihis form on back oi yellow copy. / p~ ~ 191 07091 'X" Be!ouy Work Cavered by This Request ewAdd Rep. TypeoBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./InduStrial FUrnaCe Other (Specify) Farm Air Contlilioner Other (specity) Cortlractor5 Remarks: ~N ~ ~~Awc~ Li4ca~~ Compute Inspection Fee Below: # Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee Swimming Po01 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 700 _ Amps SignS Inspector5 Use Only: TOTAL Irrigation Booms /J . 60 /,SSp SpeCiallnspection AlarmlCommunication THIS INSTALLATION MAY BE O DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough,in oata certify that [he above inspection has F;nai J- 6een made. ~ OFFICE USE ONLY This reques[ void 18 monlhs irom • This request voiE eTlp~sCJ 18 nwn[hs trom D•6-10 6 9/ Request Dat Fire No. Roup~-in InsVec'ion ~ ReqWred? Ready Nnw~]i'Will Notify Inspec~ ~J [a Yes ? NO tor When Reatly RlicenseC ElecVical ConVactor I herebV requast insOectfon of abova ,Q Own¢r electrieel work inslalleA et: Street Address, eoz or Route No. City 3 Lc/ c ~l2 l~ 4 ~ Ui2?G ' ~q ~SA ection o. Township Name or No. R.anue No. Counly Occuuant (PqWT) Phone No. u V .r Y 31 i- 0 C-` Power SupDIier Adtlress /).9- a ,q4.~h,a ~h Electrical ConVacmr ICom/pany NamJel ~r Conha'r/,lor's License No. ~f'Ff'~`LtL~IIG Ma~ AdJress ICon[ractnr or Owner Makiny Instailationl 1.Z ,z.t- ttlq- ~ .fTo c:oQ Avthori d'gnature ICOnt actod ner Makiny Installation) Phone Number e,y Y~~ MINNESOTA STATE BOAND OF ELECTRICITV TNIS INSPECTIDN XEQUEST WILL NOT Griges•Midway BItlO. - poom N•191 BE ACGEPTED BY THE STATE BOAHD 1821 Univareilv Ava., St. Peul. MN 65104 UNLE55 PROPER INSPECTION FEE IS aeo.nnnn ENCLOSED. ~ aI runF[ECTRICAL INSPECTION instruttions for completing this form on b EB-00001-06 aek of vellow copµ D 6 6 9 "X" Below Work Covered by 7his Request AAtl ReD- TVPB ol Builtling ~ Aovliancea WireE E9uiVment Wired i~ome Range Duplr;x Water H Tempprary ServiCe q eater Liyhtiny Fixtures pt. Buildinc~ Dryer ` Commercial Bldy. Fumace Hectric Heatin Industrial Bld Silo Unloader 9~ Air Conditioner Bulk Mllk Tenk Farm mei pec, y t Nr ueci V the r (SPecifv) Ot er OtM. r - ompute lnspection fee Below p Fee ServiceEntrenca5ize H Fae Feeders/Subfeeders N Fee .~c~o 0 to 200 qmps a,cuits Ampy 0 to 30 Am)s '2 Cu 0 t 31 ta 100 o 30 An >s Above 200 A'01~~ 2/J.C)D 31 to 100'Am s Swimming Pool Above 100_qniS Transiormers ~ anove 100_Am Irrigation &oom,s . b Partial.0 Signg • Rema.ks SUeaal Inspeaion 5 , / -LN TOTqL E flouph-in ~ Y ie I, the Electrica Final r " -/7,~ inspactor, heroby p,,e ecertily that tha above 7 Cry insDection has Eeen ^nde TOia~uestvoiEtBmonihsirom ~Y . RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN L~ 3830 PILOT KNOB RD, EAGAN MN 55122 U 657-681-4675 New Canetructlon Beaulremente flemodeVHeoair Heauirements • 3 regislered sile surveys showing sq. tl. of bt, sq. iL o1 house; and LR rooted areas • 2 copies of plan (20°/<maxYnumbtcoveregeallowed) • lsetofEnergyCalculetbnsforheatedadditbns • 2 ooples of plen showing beam & window s¢as; poured found design, etc.) • 1 slle survey for exterior adtl'A'rons & deCks • 1 Set of Energy Calculetions • Intlicate d twme served by seplic rysiem tor additlons • 3 copies of Tree Preservatbn Plan M bt plaftetl afler 111/93 • Rim ,bisl Detail Optbns selectiai sheet (bldgs with 3 or less uniGS) DATE VALUATION D J ? I ~O SITE ADDRESS to ~,d'e ro 'e s s ~ on- MULTI-FAMILY BLDG _ Y ?<N TYPE OF WORK Pe./'OOF , w r vt C/uwS FIREPLACE(S) _ 0_ 1_ 2 e ~ APPLICANT ~K'J~2~ !Q-rV G n!~ leI D~ STREET ADDRESS S 111 i'i CIN Ctl atYkSTATE ~I P-~~53 T`T TELEPHONE # 5Z- K~19132CELL PHONE # FAX # PROPERTY OWNER rn t C~~Gt ~ ~ PLi;t1'tV yl TELEPHONE # LZ/ COMPLETE THIS SECTION FOR -NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission lype) • Residential VentilaUon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted . Energy Envelope Calculadona Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Conhxtor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 Sewer/Wafer Conhactor. Heat Recovery System Phone I MAY 1 7 2002 I hereby acknowledge that I have read this application, state that the inform t on rrect, and agreete, omply with all applicable State of Minnesota Statutes and City of Eaga nan s, Y. Signalure of Applican ---°°_...-°---------------------°------------------~_._..._..._..._...Y... / ...~.......Y._..._...Y._ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 I OFFICE USE ONLY O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg O 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorohlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screened) ? 36 Multi ? 05 03-plex ? 11 10-plax O 19 LowerLevel O 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. O 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Afteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/DOOrs 0 34 Replacement 'Demolition (EMire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const 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 _ Air/Gas Tests _ Final _ FraminB _ Siding Smcco Swne _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Suppy 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ~ER~'ri ~ T ~ / ~SS~ . . 1988 BUILDING PERMIT APPLICATION - CITY OF E9GAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MQST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BQILDING PERMIT IS ISSIIED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS U OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMA'IERCIAL IVCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET (;F SPECIFICATIONS AND 7 SET OF ENERGY CALCULATIONS To Be Used For: 51~12 Valuation: o00,'° Date: J"1 ~"~8[} Site Address I~I8 tV/LA2Z/yE'sj OFFICE USE ONLY G a1 Lot ~ Block ~ On site sewage Oceupancy !2•3 M47CC system 7 Zoning JC-/ Parcel/Sub f/Ef2JVESj ~d /lr0~ On site well Actual Const I-),/ City water ~ Allowable xAt Owner Jw<f/!/- ~~~(~G.JUy? li'?' C, PRV required ~ il of stories Booster Pump _ Length Address J2-23 6 lh (AX/ EA V' Depth ~ S.F. Total City/Zip Code Footprint S.F. Phone ~ 0() 55/Z APPROVALS FEES Contractor Engr/Assess Permit Planner Surcharge 73.eO Address Couneil Plan Review 3[a•°' Bldg. Off. SAC, City )00, City/Zip Code Variance SAC, MWCC sso Water Conn sse. 'O Phone Water Meter s 9. 'O ~ Road Unit 3AS. sO Arch./Engr. Treatment Pl 2oy, Parks Address Copies j TOTAL City/Zip Code + Phone ak 6asz,;~~ 3013 k I~ ~ y S5e. 9- ,6= #T8' k x o2s:3x3o.s= S6 3 . • ' ~ a0- 3 x~s = -lc7 /v23 x d26•I _.394 x ~ ysyy_ oa ~ x 30 = y!'~ _~=y7~ a~X 3a = 9 ``p X `-/~l _ G 3 J Ss' o o, 9o k Yy - Sa 360~ ~ ~ /yr ad 7 . EXTERIOR ENUELOPE AVERAGE " U" COMPUTATION , Owner: ' pZA,lVrt(-PE: ZD Er~- SDnf_, ~Nc Site Address: ~ Contractor: bZMUt1 - ~'~J~1Zaa~~ IIiC. Date: ~-5b Phone: ~..SODD : Determine working square footage of each. 1. Total exposed wall area Sq. Ft. x.11 = 5 aj 2. Total roof/ceiling area % 134- Sq. Ft. x.026 = 55,57 , Total exposed wall area above floor = a. Total wall window area..... 4 I 2 b. Total door area 4 1 c. Total sliding glass door area ojg . . d. Total fireplace wall.............. . - . e. Total wall framing area (average 10%) ~ f. Total net wall area above floor g. Total rim joist area............................................ 3-7 2 Total exposed foundation area = IA C. h. Total foundation window area.................................... ¢ - - i. TotaT net foundation area a6ove grade 18 2 Determine " U" Value of each wall segment. a. 4 I2 xIt u~~ , ao = I 23, (P b. 4-1 x„u,~ ~1~L5 = 5~1 C. Xu~~ ,41 = 40,2 d. ~ X u - . r_:. . e• 412 Xu~~ f. 2541~ xu 04 5 = 1 ~ `j _ s. 372 xu~~ , 041 = 15, 3 h. 4- Xu.~, , 3U = 1~2 X u 1 4- _Z 5, 5 -3 TOTAL 1r° -.-If'item #3 is the same as, or less than item #1, you have met the intent of Sec. 6006 (c); . • , , . ~ Total exposed.roof / ceiling area j. Total skylight area k. Total roof / ceiling framing area 10% ~ I 3 1. Total net insuTated roof / ceiling area ~51 ZI Oetermine " U" value for each roof / ceiling segment. X u K. 213 X„u„ L. 1°l21 11 x u I, , ol °I = 3Co, 5 4. TOTAL If total of 4 is the same as, or less than #2, you have met the intent of 56C 6006 (c) 1. To utilize the total envelope system method, the values established 6y the sum of lines #3 and #4 shall not be greater than the sum of lines #1 and #2. i. 453 +z. 55 S = Sog,S 3. Cn Q. I +4. 2, = L{'D 28 , PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: 6 U I L D I N 6 Eagan, Minnesota 55123 Permit Number: 021907 (612) 681-4675 Date Issued: 0 9/ 8 7/ 9 3 SITE ADDRESS: 1318 WILDERNESS CURVE LOT: 1 BLOGK: 1 WILDERNESS PONOS P.I.N.: 10-84275-010-01 DESCRIPTION: Bu31di`n'g Permit Type DECK Building GJork 7ype NEW /-UBC Occupancy\, R-3 / Bu3lding Lengtkr, 30 Building Width 28 ~ .:`X,~~ \V Cy „ 0 ta ^ c \~:j~'l~~ REMARKS: FEE SUMMARY: Base Fee $25.00 COPIES $1.00 Surcharge $.50 Total Fee $26.50 Subtotal $25.59 WOTM91ONNST, STEVE PP 114695721 0007022 KTLVSTR-6M CATHY 23625 JERSEY CT 1318 WILDERNESS CURVE LAKEVILLE MN 55044 EAGAN MN (612) 469-5721 (612)688-7701 I hereby acknqwledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. IL . / - I APPLICA /PERMITEE SIGNANRE ISSUED 0T51 NATURE REAC714'A7f _ U-3LFLc ~ C ~p~~~ C{TY OF EAGAN t~~. ~D PEStM1T # 1993 BUILDING PERMIT APPLICATION ~ y ~1 3 4 681-4675 SINGLE 3 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural 6 structural plans, I set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month- in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Yaluation of rork ys0 Site Address: STREET WITE 0 Tenant Name: (commercial only) IAT BLOCK ' SUBD. P. I. D. M Descri tion of work: DNi~~1 1he applicant is: El Owner U Contractor ? Other (Dsscribe) Name ~l .5 o & 1 Phone Property t• i FIRST Owner Address 1,3 SiREET tTE Y City State 2ip Campany ,.i Phone C011t1'BCtOr Address ~3(°z License NC~O2y O~~ Exp `7y City State ~N Zip S SP`fy Company Phone Architect/ Engineer Name Registratian i Address City State Zip Sewer & water licensed plumber . Processing time for sewer 6 water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable St te of Minnesota.St utes and Lity of Eagan Ordinances. u~ 5lgnature of Applicant: ~ OFFICE USE ONLY * -P . • « y BUILDING PERMIT TYPE ? DI Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish O 02 SF Dwg. ? OT 4-Plex 0 12 Multi. Misc. _ ? 17:Swiai° Pool O 03 SF Addition ? 08 B-Plex ? 13 6arage/Accessory ? IB toom./Iad. ? 04 SF Porch ? 09 12-P7ex O 11 Fireplace 0 19 Comm./Ind. Misc. L3 05 Sf Misc. ? 10 Multi. Add'1. 1?115 Deck O 20 Public facility ? 21 Miscellaneous WORK TYPE fl 31 New ? 33 Alterations 0 35 Tenant Finish 13 37 Demolish b 32 Addition ? 34 Repair O 36 Nove GENERAL INFORMATION Lonst. (Actual) Basement sq. ft. MWCC Systera (Allowable) ]st fl. sq. ft. City Water UBC bccupancy ~ 2nd F1. sq. ft. PRV Required 2oning Sq. Ft. total Booster PumP # of Stories Footprlnt Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code APPROVALS 1 D` Planning Bui7ding Assessments Engineering 4ariance REt]UIRED INSPECTIONS ' ? Site 1,1 Footing 0 Framing ? Insulation ? Wallboard C~Kfinal ? Draintile ? fireplace Permit Fee 2S, 00 v.o.cip,: g 5urcharge Plan Review License MWCC SAC City SAC Water Conn. IJater Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Vark Ded. Trails Ded. Copies %(So Other Total: SAC % SAC Units z U d } I 1 . , a.. . ..5~ I . t' . ~ ~ n ~ ~ 34Iq1_.,+ ~ ) _ ' . f, I , . N . , .T- . . ? " . ~jDRA1NA5i . ! , . lHSlnvM~) n I ~ . - r..... QY . . . I J~ . lo oRCN \ T ~ ~ C~• A~ I n y;} ~ [:2A~ No"~'E R a~ + s ~ ~P . -y ~.o ~a ~ ~ ~ . ~ ~ ~ . r=-_- ~ o' ~ _ , , , al•o4 ~.A'1 ~~~a Ax I~n~ f . . ~ ' ~~•s : ry`. CITY USE ONLY ? L ~ BL ~ RECEIPT 914-1 9 SUBD. Ca ag~w~9~ RECEIPTDATE: 1998 PLLJMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings D townhomes and condos when permits are requirad for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = HotTub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet " minimum - t 3.00 x = Rough Openings 1.50 x = Water Softene! * for dweilings under construction 5.00 x = Water Softener ' for existing dwelling 20.00 x = U.G. Spflnklef ' for dwelling under const. 3.00 U.G.Spflnkler "forexistingdwelling 20.00 = Alterations * to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ` MPC iic. 75.00 = (new and refurbished systems) Private Disposal Systems * nbandonmenc 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE .50 O TOTAL oZ B. S I hereby acknowfedge that I have read this appliwtion, state that the infortnation is cortect, and agree to comply with all applicable City of Eagan ordinances. It is the applirant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by tha Ciry during its normal operational and maintenance activities to the facilities construded under this pertnit within City property/nghFOf-way/easement. SITE ADDRESS: 131S ClJi/~i~NESS ilE OWNER NAME: 4/Y Pu59n' lo~i L 905-- /yol INSTALLER NAME: 72AI/9 ///C-Pj9i?lCA~ TELEPHONE STREET ADDRESS: CITY: /JS STATE: ZIP: SS5~0ln . PERM E CDIPERMIT FORMSIRPLBG PERMIT (RES) - 1998 SIGNATURE OF _ ******************i***i*****f#*****# CITY OF EAGAf~ P~"~' °F ~ ~ °F * ~ ArriscATIoN DoFS Nar wrsriTUTE ; lip Aepxovar~ oF P~T. APPLICATION FOR PERMIT . . r INSPDCrION oF SES~R ADID/OR 44~TER *F rNsTprT.amrOflS Wiid. NiYP BE SCfIID- ~ SEWER AND/OR WATER CONNECTION ~uum UNM PEPMT HAS BEEN ~ , . * APPROVID. 4 rt s * ~a+~*~ t* **w **t*s,r*,e* *,t,t ir+e,r* P ease Pr1nt) ~1) PROPERTY ADDRESS: ~3/~ (,,~,'/~pr.h~s Cu,1^?e LEGAL DESCRIPTION: Lo f'/ CSIn~ i LJ,'/~t!-r~csc- ~on ~.r Lot Block Sub ivision or Tax Parcel ZD ) IF E7QSTING SPRLY.'1VRE, DATE OF ORIGINAL BL'ILDING PERMIT ISSCANCE: ' ~ - , PRESETIr ZpNING/PROPQSID USE: {Mon earl CO2ZERCIAL/REI'AIL/OFFICE ~ R-1 SIW.LE FAIqjLY . ~ IPIDOSTRIAL Q R-2 DOPLEX (RSwo Units) ~ INSTI2L'TIONAL/GOVII2NM,NP ~ R-3 TOWNiOUSE (Three + Units) ( L~nits) q R-4 APARTT9ENT/CODIDOMINIIIM ( Uni.ts ) 2) ~ -T NAF'!E0_ J 6417d c JC(~d. Vc`/is/ y - . v ADDRE55:1 Ld'CS^ ~ ~ ~j y , CZTY, STATE. 2IP:_-g~7de r l~ ru ve- PxoNE: ,~4i-djys~o . 3) . y,; NAME. For City Use 43 . eln P1UR1}.7eT5 L].CEIISE: ADDRESS: Active . - 5~a••-EXpisea i CITY, STATE, ZIP:_-~icrm:.~,a~v~ Not recorded tHoNE:_~(& 3- d",?3 a MASTII2 LICQVSE# O G2 -C o_ 5~ M S~tial ~a~y•:.~ ~.,~.i~: ,F~ NAME:-_ . aoDREss:__[,5/3 G 6~ /w J", crrx, srATE, zzP: pxot~:~3 ~ ;s-O J J • • -5) b v i a: • : ~t • o~ - R CONNECrION TO' CITY SEWER gg-COrID7fX.TION TO CITY WATEEt ~ O'i'HER . 6) wv -F i- [3 PLF.ASE HOLD APPROVID PERMIT £OR PICK-UP BY ONE OF ABOVE - ~ PLEASE MAZL APPROVID PERMIT M 1, 2, 3, 4, AHUVE . (Circle one) 7) r ^ u • - ~j`,.~.. '~.Y' c~ - 7• '1: • :1: M ~ ~ ~ • I' ~ 17• i~ 1• Y71" • ' • ' J• • ~ ~ r r. ~ o- ~:r• -,naI -A&MIN411 ;n- ~•r s• ~ u y . . FOR CITY USE ONLY . PERMIT # ISSL'ED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SC'RCHARGE) $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ~J &-6 ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ wAc $ $ sAc $ $ TRLNK WATER ASSESSMENT $ $ TRL'NK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRC!NK SEWER $ S LATERAL BENEFIT/TRC'NK WATER WATER TREATMENT PLANT SURCHARGE $ S OTHER: $ I'q 7 TOTAL fD6 ZL RECEiPT RECE IPT DOES UTILITY CONNECTION REQOIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSL'ED BY THE E[VGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE : RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New ConsWCtion Reouirements RanodeUReoair ReauiremenGs Offce Use OnN 3 registe2d site surveys showing sq. ft. of lot sq. N. of house; and all raofed areas 2 copies of plan Cert of Suney Recd (20% mazimum lot coverege allowed) 1 set of Energy Calculations for heated addNons Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey foradditions & decks _Tree Pres NolReqd lsetofEnergyCalculations Addifion-indicstei(on-sitesepHcsysfem _OnadeSepticSystem 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options seleIXion sheet (bldgs wiN 3 or less units Date __Ck / / V 3 / Constru~MVion Cost ~~Q Site Address d~{r/// P S S' lilK e P . UniUSte # Description of Work If ({y (90 .S' 1r ecl Mid 1 LL~(~V~(~1(~,j^ Gt !i 4CXl f i h -L/ Multi-Family Bidg ~ Y~ N Fireplace(s) _ 0 ~ 1 2 ! 7L- Property Owner '0171K~ ~(~~a~•~ Telephone #(~5 4"5-1/ Contractor P~',f dh Address w( 13 City j"A Z/J:~ Sta[e ~ r'1 r Zip 5~ Telephone # (9r~oZ) ~rl(~' C) ~g COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission rype) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone ) MechanicalContractor flVe S/'LIP /7eUYIA t/y,&jE Telephone#(t?0) 4t1/j-759 5ewer/Water Contractor F,l fs' f6l"phone I( ) ~ i I hereby apply for a Residential Building Permit and ac owledge that the info ation is complete and accurate; -Fif that the work will be in conformance with the ordinanc - of Eagan and the State of MN 5tatutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a pertnit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. , l ~ ~ ~Vfje,, ApplicanYs Pri d Name ApplicanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plhg_Y or_ N? 25 Miscellaneous Work Types ? 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 *Uemolition (Entire Bldg) - Giva PCA hantlout to applleant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const 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 _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total , , , , ; - - , '~;-~'-o": , 150. 3~- L ~,ao ~ ` i ~ ~ - ._w.__ ~ ` y~ ~ ,l _ _ ~ 1 Y , Dr~~sir~A~~ 1 ~',4~~N~LN7S ~ I \ ~ l . ~ P`~'i~''~~ , ~ I n r a ~~~r~ I" ~ ~ ~ t ~ ~ ' ' ~ ~ ~ ~ _ ~ . _T,,,~~ z~, ~ , ~ ~ ~ i-~-o. ~ ~ ~ ~q ~ , ~ Q' ~ 1 t. ' _ ~ ~ ~ 0 ~ 2 ~ ~ , ~ ~ ° s ~ J ~ 4 ~ M~ i y ~ . ; P ~ F ;n 'L ~ t,f°~, ,1'C' . j ~ ` , / ~ , _w ~ ~ i ~ ~ / p ~ ~ : ~ N ~ t .~.~....1~,.._... ~ ~ ` ~ y,. ~ o, 1 ~ _ ~ _ , ~ - , , ~ s. , - ~ ' ' ; _ ~ ~ _ ~ . ~ , ; z~,o4 , . i t-..----- ~ ~c'~~t; ~ ~ ~ . ~ ~ ~ ~ , u R,L f~> ~ 'o_ ~,y . ~ i q 1 q ~ ~ ~ z _ ; v ~ _4,~ _ s 4~; s. ~;A ~ ~ t x, ~ r : r ,'p o~ ~K~i~+ ~I~fc, ~ f~At7~5 f _ ~ ~ . ~ oT i , c~~~ ~ 1 , j~ p~ f'",: d`° r°~ t . ~1..~~~'`, ~ ~ oE~ ~ Ozmun - Pederson : ~ derson, Incorporated Custom Homes and Re 'Iomes and Remodeling Apple Valley, MN 431-5000 FOR: ~ ~ ~ ~ ~ t ~ T~ ~ . ~ ~ O~e L ; SH EET OF ~ ~ ~ ~ SCALE ,r p ~ DATE ~ ~ o"a . t~,. ~ - ~ 8 ~ ~ Date: City of Ea�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: /(3 r L Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: I %'7 CD°. Date Received: Staff: INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Site Address: /3/8 (t)C t_ £-.Ness A -C I -ti( ki Suite #: ESIDENN RT OWERM Name: 2.v \_ N L U \ Z- Phone: 45/-4 A,- S (a1 Address / City / Zip: 73/g ,-),. L➢ A'C SS oe. ✓e'/ Liar% -----v ►4t-a CONT -'• CTOR� Name: License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK PLUMB .NG (Within the building envelope) (/ Sump Pump Repair SEWER & WATER (Outside the building envelope) Repair Other: Other: DESCRIPTION Description of work: FEES $60.00 I Each (includes $5.00 State Surcharge) TOTAL FEE $ * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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 review and approv.I of plans. x t4 CV UT -7 Applicant's Printed Name x Ap • icant's Signature Required Inspections: