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1303 Wilderness Lane lrTb:I~ . _ . _ , . . :'TI+r]'.V1.:~~„r. . ~ CASH RECEIPT : r~4. ~ ~ CITY OF EAGAN . ~ - 3830 PILOT I~NOB ROAD • EAGAN, MiNNESOTA 55122 on~ L-L. C, t9 ' ~ C ~ r ~ , r ~ - ~ i.-rL ~ -r~~ ~ uNr $ ~ f- ~ G" ~ d & DOLLARS ,oo ? CASH ~,CHECK ~ ~ w 7'~ ~ I w, . /~C/ i, L /o~' " ~ ` ' ~ j' ~ Lc%r ' ' . , f / u~1~J .~rG~ ~.u, ~ ~c. ~ ~ ~ -(~.Gl.~ i'. ~ 1_ Er-~J / c_ ~--t~ c~L.~ : FUNO OBJECT AMOUNT Thank You _ sv V ~-,L= : / ci:J _ f~ , ' White--PeY~ ~PY , , Yellow-PosHng Capy ~ V Pink-File Copy , BLDG. PERMIT NO. ~ G~ ~ • ~ ~ i./ G~ ''J~/!~. ~ ' L~1 ~ li, ,C7 ~f/ ` , ~ a~.~Kl~ ~ 1~ ~ 01-3210 ~ Bldg. Permit 01-3422 Plan Check ~ f~ r~ r~/ ~ 01-3445 Surch./Adm. " 01-3446 SAC/Adm. ~ ~ ~-2155 Surcharge ~ 75-3860 Road Unit 2~-2275 SAC `r ~ Q 20-3865 Water Conn. ~ ~ ~ 20-3868 Water Trmt. y " ~ 20-3716 Water Meter ~ , 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. i~J ~ 28-3855 Park Ded. TOTAL ~ CITY OF EAGAN } ~ ~ ~ 3830 Pllot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PH O N E: 454-8100 BUILDING PERMIT Receipt ~ f To be used for ~P i?tti€;/GAR Est. Value e~I ~ i,^•L~_~ Date .;liL1' 'Lc± ,~g~_ Site Add?ess 1303 WII. ,~F;t.,,l} L;; OFFICE USE ONLY , t t~ On Site Sewage Occupancy ~ M"'1 Lot Block ~ S@C~SUb. ti' ~~'4- '~FW!.J,~ t'~~`1E1;~ MWCC System Zoning Parcel No. On Site Well (Actual) Const v--~ W Nerr~e L~f1L~~-~i~,i::~'~`i~)~ti, li;C CityWater (Allowable) z Adc~?~ess i 5 i 36 c~l.~x 1~ AV k: PRV Required _~L ~ of Stories 3 » Booster Pum Len th h~~ ~ ~ City =~j ~ LF; VALL~I~hone ~'31-~1)•:t, P 9 Deptn 3 S' , o Name yA~tF S.F. Total ~ ~ Address Footprint S.F. r¢- City Phone APPROVALS FEES ~ s Engr./Assess. Permit ~ ~4 • ~ Name _ = Address Planner Surcharge d~ • ~ ~ Z City~ Phone Council Plan Review 347.00 W ` Bldg. Off. SAG City ; ~U • ~ I hereby acknowledge that I have read this appiication and state that the Variance SAC, MWCC ~S~ infc~rmation is correct and agree to comply,~with all applicable State of WaterConn. 55u.(~ Mii~nesota Statutes and City of Eagan Ordiriances. - • WaterMeter b7•ih~ ~ Signature of Permittee ` Road Unit ~ 2~•~ A$widing Permit is issued to: U~'~~~~--~'~k~~8~'+!'~ s~~L Treatment P1 ~U'~•~ on theexpress condition that all work shal I be done in aCCOrdance with al I appliceble State of Minnesota Statutes and City of Eagan Ordinances_ Parks Building Official TOTAL + ~Og. 5~3 , e CITY OF EAGAN ~ ~ 7~~ l v~ 3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121 ~ ~ PHONE: 454-8100 , , BUILDING PERMIT Receipt # To be used for Est. Value Dafe ,19 Site Address OFFICE USE ONLY ; ; On Site Sewage Occupancy Lot _ Block - Sec/Sub. • ~ ~ . MWCC System Zaning Parcel No. On 5ite Well {Actual) Const Ciry Water } {Allowable) W Name PRVRequfred % #ofStories o Address Booster Pump Length ` City Phone Depth ' , o Name S.F. Total ~ a Address Footprint S.F. ~ City Phone ApPROVAL3 FEES ~ W Engr./Assess. Permit Name ~ Z Planne~ Surcharge _ ~ Address u Council Plan Review ~ W City Phone Bldg. Off. SAC, City I hereby acknowledge that I h8ve read this application and state that the ~ariance SAC, MWCC ' information is corcect and agree to comply with all applicable State of Water Conn. ~ Minnesota Statutes and City of Eagan Ordinance5. Water Meter 5ignature of Permittee Road Unit A Bui(ding Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks Buiiding Official TOTAL ` ' ' ' ' • Permit No. Permit Holder Date Telophone # Plumbing ~8~ . , ` .~~ti . H.v.a.c. Ci `~.e,~, ~'~l 8 Electric ' , ~ ' ~ ~ Softener Inspection Dats Insp. CommBnts Footings I Footings II Foundation ~ ~ Framing rG. ~ ; j~~ Roofing 5~~~~ Rough Plbg. ~ Rough Htg. a~ ~ Isul. Firepiace ~b ~ Final Htg. Final Plbg. Bldg. Final ~ S" Cert Occ. ` ~ 7emp. lP Qeck Ftg. Deck Final Well Pr. Disp. , ~ ~ ^ PERMIT # ~ ' PLUMBING PERMIT RECEIPT # CITY OF E/1GAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE PHONE: 454-8100 Site Address ' ~ ~ ~s - ` BLDG. TYPE WORK DESCRIPTION Lot Block Sec~Sub Res. ` New • Mult. Add-on m Name ` r • Comm. Repair ~e Address ~ ~ ` = - --Other c Ciry Phane ~ RE3. PLBG. ONLY - COMPLETE THE FOLLOWING: - NQ. FIXTURES jOTAI ,y ~t , , , -~Water Closet - $3.00 S ! Name " - ' Bath Tubs - $3.OQ t ~ ~ 'A. ' i( / .J ~ ~ f ~ . c Address f Lavatory - $3.00 , < p Ciry Phone ~ ~ ~'G~' ~ Shower - $3.00 ~y, ~ Kitchen Sink - $3.00 ~ • ~ ~ FEES Urinal/Bidet - ~3.00 1--~+t' COMM/IN~ FEE - 1°~6 OF CONTRACT FEE ~Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPUES Floor Drains -$1.50 ' TOWNHOUSE 8 COND~ - RES. RATE APPLIES Water Heater -$~.50 MINIMUM - RESIDENTIAL FEE - $12.00 Whlrlpool - $3.00 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 SoRener -$5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $t0.00 . ~ ~.~y, ~ L'•,; Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: ` STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: r..~.r-...»...-.-_ r . _ _ ;~cu~: . ' . PERMIT # ~ ~ MECHANICAL PERMIT RECEIPT # ~ 7 CITY OF EAGAN d; 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 1~ CONTRACT PRICE ~ PHONE: 454-8100 For Office Use Only: Site Addr~ss ' ' ~ ' z'-- • g~pG. TyPE WORK DESCRIPTION Lot Block ? ~Sec/Sub Res. ~ New ,-~lw .J Muit Add-on Name ! .c.s.i.J ~ lt~ ~ ~ p~ • Comm. Repair ~ Address Other c City Phone 4~_ ~ ' ' FEES Name '°i', a~ RES. HVAC 0-100 M BTU - 524.00 c Addres9 -g ADDITIONAL 50 M BTU - 6.00 p City Phone L~ (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1~i6 OF CONTRACT FEE Forced Air f~~,~ M BTU ` u~ APT. BLDGS. - COMM. RATE APPLIE5 TOWNHOUSE & CONDOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent T_ CFM (ADD $.50 S/C IF PERMIT PRICE GDES Gas Piping Outlets # ~ • ~ - BEYOND $1,000) Other R • FEE ' ~ i c.v ~//l~l/G` t/ ' 4 J SIGNATURE OF PERMITTEE S/C: TOTAL• ` ~ FOR CITY OF EAGAN ~~rfi#tr~tp uf (~rru~~tnr~ ~Citp of ~agan ~P}t81'bttPitf Af ~ilt~~ .~tt~lPtf~OYt 77ers Certificate issued pursuant to the requirements of Section 306 ojthe Unijorm Building Code cenifying that at the time of issuance lhis structure x~as in compJiance with the various ordinances of the City regulating building construction or use. For the following.• !7,,~";" ~ ~~;£r uae c7at~fiaria~ ; eid~. Rrmh No. R3~: ; i : `L'l': w~r ~Ya~ ~p~~ ~ ~'RJIS ~TA ~nmg„Llitl[iCt 1 ~ 1 1 ~ r': T 1~~ 1 ~~t Oweer ot Bwldin~ Addres~ A~~ I~13 ~TIID~1F.55 I~T1~ ~~y 82, W'II.J~a~.CS PQ~'[1S ~ , ^ - - o.~: •r : . . s~a~ oe~;.~ POST IN A CONSPICUOUS PUCE f CITY QF EAGAN Permit Mo: Date: ~i-j'2-88 ' ' 3830.Plloi Knab Road Meter No: ~~d /~O size: ~ " Q~If P.O. Box 21199 Reader No: Date: ~d~~~' Eagan, MN 55121 Owner. ,_~~d~>son, 1uc. '`s'~' ~`.+'1lderr~ess L2ze L2 B2 WildeXnes3 Pc s Site Address: - ~ Plumber i~~?µ~san ?j~a` ~ i~.~IPe_r~~. "iurnbin~ Conn. Chg: • Zoning: ~ Acct Dep: ~t No. of Units: ~ Permit Fee: r Surcharge: •~Qad 1 agree io comply with the City o1 Eagan Tr_ Plant - f»~d Ordinances. ~ Meter. iu' t;1:~d Misc.: ,r~ gY WATER SERVICE PER IT - . ~ ~ ~ -iz~~aa ~ CITY OF EAGAN Permit Na 984~ Date: t 3830 Pilot Knob Road Meter No: Size: . ~ P.O. Box 21199 Reader No: Date: . ' Eagan, MN 55121 i i f13,r,+..ri1--PQ~iEZB~n, ~C' • Owner. I.2 ~2 Wi1.de~ranss ~ Site Address: 13fl~ ~~d~~~s Plumber. Jo~huaon ~xct~vstti~a Ye3ne Yluabin~ ~ - F.1 ~ Conn. Chg: Q~ Zoning: Acct. Dep: •x` ~ No. of Units: ' Permit Fee: ,.`.t?~>d I agree to comply with the City ot Eagan Surcharge: Tr. Pfant 4~~ t'~Tu'' Ordinances. Meter. " ~ Misc: 'n ay ` WATER SERVICE PERMIT _ - ~~9~~~ aate: R-1Z-$P CITf Of~EAGAN Permit Na Date: 7-2`3-•~~ 3830 F+Idt Knob Road B/P Na P.O. Box 21199 Eagan, MN 55121 , ' Owner. ~`'--`''a e ~a Pnnd~ i3J3 WiZdernese I.~*~~ I'' 82 b1ilRerne Site Address: - Plumber. 3o~~nson Exclpeine Pl.um6~.a~ MWCC: 57`~ ~n"~ Zoning' ~ City Chg: 10~- d No. of Units: Z~' ' n~" 1 agree to comply wRh the City oi Ea9an Acct. Dep: 10.0~p~ Permit Fee: . ~ Ordlnances. Surcharge: By Misc: gEWER SERVICE PERMIT ; _ RESIDENTIAL ~ ySJ~~, BUILDING PERMIT APPLICATION ~ CITY OF EAGAN 3830 PiLOT KNOB RD - 55122 ~,0, 651-681-4675 NawConstrucUonReouiremeMS RemodeVRecairReouiremenb Ca~~ed 6~J7/~OI • 3 registered site surveys showing sq. ft. of l04 sq. IL of house; and all roofed areas • 2 copies of plan ~ (20%maximum lot coverage allowed) • 1 set of Ener9y CalculaGons for healed addilions • 2 copies of plan showing beam 8 window skes; poured (ound design, etc.) • i sile survey for exterior additions 6 decks . 1 set of Energy Calculatians • I~icate if home served by septic system for additio~ • 3 copies of Tree Preservation Plan'rf lol plaHed after 7/1/93 ~ . Rim Joist Deta~ ODtions selection sheel (bldgs wAh 3 w lew uniis) DATE rO/ ~S(O~ VALUATION JOBSITEADDRESS ~~3 ~~t-~~ ESS L{~~ IF MULTI-FAMILY BUILDING, HOW MANY UNnITS? ~ gSZ-3Z'Z~ 3Zy~ PROPERTY OWNER ~Jar~A! ~-~a K~ YtJO ~ S TYPE OF WORK I_-D i~ FIREPLACE(S) ~0 _ 1_ 2 ~ APPLICANT ~~K~! lY~ tS2N'1D.D~1~)G A~(~.~,C PHONE# ~ rJ"' ° ~ ~ ADDRESS I3ZS'~ L7oLJn1t=.-n,~ 1~ ZIPCODE PAGER # CELL PHONE #~,t2 ~ S~J FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Res~~ntial VePtilation Category 1 Worksheet Su - - Ene Envelo e Calculations Submitted D ~ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor. Phone BY Plumbing System Includes: Water Softener _ Lawn Sprinkler Fee: $90.00 _ Water Heater ~ No. of R.I. Baths No. of Baths Mechanical Conhactor: Phone # Mechanical System Includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Conhactor: Phone # All above information must be submitted prior to processing of application. I hereby acknowledge ihat I have read this application, state that the info ion is correct, d agree to comply with all applicable State of Minnesota Statutes and City of Eagan rdin i Slgnature of Applica t Certificates of Survey Received _ Tree Preservation Plan Receive _ Not Required _ Updated V01 OFFICE USE ONLY ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling 0 08 OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ~ 19 Lower Level ? 24 Storm Damage ? O6 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ~ 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ~ 46 Windows/Doors ~ ? 34 Replacement 'Demolition (Entire Bldg only) • Give PCA handout to applicant Valuation o~4~a Occupancy ~~3 , MC/ES System CensusCode Y~~ Zoning ,CityWater SAC Units Stories Booster Pump Nbr. of Units ~ Sq. Ft. ~ PRV~ Nbr. of Bldgs l Length ' ' Fire Sprinklered Type of Const ~ W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) ~ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile ~ Roof _ Ice & Water _ Final = Other - - - pram~ng Pool Ftgs Air/Gas Tesks Final Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone ~ Insulation _ Windows (newheplacement) Approved By , Building Inspectar - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total CITY OF EAG4~N N~ 1 5 3 9 8 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 Q/_ ~ Q~( BUILDING PERMIT Receipt # o / To be used for SF DWG/GAR Est. Value $137,000 Date .7ULY 28 ,19$~ Site Address 1303 WILDERNESS LN OFFICE USE ONLY Lot 2 elock 2 Sec/Sub. WILDERNESS PONDS OnSitesewage - Occupancy R-3 M-1 MWCCSystem Zoning R-1 Parcel No. On Site Well V-N - (Actuep Const a Name OZMUN-PEDERSON INC Cirywater ~ (Allowable) V-N W Address 15136 GALAXIE AVE PRV Required ~ # of Stories z ; Booster Pump _ Length 66' ° City APPLE VALLEYPhane 431-5000 Depth , p Name $A11E S.F.TOtal ~4 Address FootprintS.F ~ City Phone APpROVALS FEES ~rc Engr./ASSess. Permi[ 694.00 Name ~ w Planner Surcharge 68.50 1i~ AddreSS Council PlanReview 347.00 ~w City Phone Bldg. Off. SAC, Ciry 100. 00 reby acknowledge that l have read this application and state that the Variance SAC, MWCC 5$0.00 information is correct and a ee to compl with all applicable State of Wate~ Conn. SQOQ Minnesota Statutes and C~1 E anW r a~s. ~L~,`~ Wa[er Meter ~7.00 Signature of Permittee Road Unii ~25._~Q A Building Permit is issued to:_QZMUN= QNy_INC-_ Treatment P7 Z0~+.00 on the express condition Ihat al I work shal I be done in accortlance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks BuildingOfficial~.~~~.~ _ TOTAL 2 905.50 • • ~ CASH RECEIPT • CI~Y OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 oarE ~ ~ ie~ ~cevEU ~ ' FRbA AMOUM s ~ c ~ & DOLLARS ` ~,w ? CASH O ~CK Fqi .L~ JN /~03 ~~~~.~r p...~ ~ \ FUNO OBJEC7 AMOUNT rJ O v i p uCJ ~U L? r~C~ ~j"'~ c Thank Yo ~ BY N° 86478 Wnil~PayereCOPY Ve11ov~POSHnB ~PY Pink-File Copy s (rom ~d O/P' //O ~ ' ~(.L~7 /J ~5-~2 7,C a ~ C~ ' ~ ~ . ~ Requesi ~ate~-~ Fire No. • Rooph-i i lnspcr,tion ) jI Requrtetl? ~Roady Now ~ill Noti(y, Insoec- [ G~ ~~'J ~M1'es ~NO ~~r When FeatlV ~Licensed Eleclrical ConVactor 1 hereby repues[ inspeclion ol above ? Owner electrical work i~talled e1: Street Atldress, Bak or Floute No. QM~ Ciry ~ /3 a ` C.%~' dt~zi,~sJ e ~4~A eclwn o. Towns~io Name or No. ange No. County ~A'K ° fr9~ Occupnnt IPRIN.Tn) ~ Phone No. / ~ Power Supplier Atldress cc f'~ ~'~~cT~2, ~ ~~~s~~-s, ~ah Elechical Conuacmr IComO~~Y Nam 1 Conlrar.ror's License No. ~o ~ U~I c e~ ~ ls y z-y Mailin~/A Jress (COnvactor ar Owner Makinp InstailatioN 2 5~2~ ' ~h. y~~ Y /c-v, Gf» 6 Uwf s.rn~i' Aut~o ized Signa[ure 1 ntrector ner Mnking Ins~allntion) Vhone Number ~ z3-Yi~~' THIS INSPECTION pEQUEST WILL NOT MINNESOTq STATE BOAPD OF ELECTpICITY GriB9s•Midway Bldg. - Roam N-791 BE ACCEPTED BV THE STATE BOAP~ UNLESS PNOPEN INSPECTION FEE IS 1821 Univarsitv Ave.. St. Paul. MN 55704 ' on....e ~wi~~ aea.nenn ENCLOSEO. .b~~ REQUEST FOR ELECTNICAL INSPECTION es-ooooi-os l~ ~ See instructi~ns lor comD~eting ~his lorm on beck ol vellow couV. ~j 7 "'X" Be/ow Wo~k Cove~ed by 7his Request Add Rep. TVOe of Builaing Apo~~ancea nireA Equiuman[ Wiretl Home Fange Temporary Service Duplex Water Heater Li~htiny Fixtures Apt. Buildinc~ Dryer Electric Heabn Commercial Bld,y. Fumace Silo Unloeder Industrial Bldg. Air Conditioner Bulk Milk Tunk Parm thxr De~:i v C~h~~ ISOCrily) t er Succify Othce O~hi;r ompu[e lnspection Fee Below p Fee ServicaEMrancaSiza tt Fee Fande~s~Subfexde~s N Circuits p 0 to 200 qm s 0 to 30 Am s ..9 0 tn 30 Am s Above 200 qmps 31 to 100 qmps ~U-up 31 to 100 Am Swimming Pool Above 100_Am~s Above 100_~m 5 Transiormers Irngation Booms -,j PdrtiaL~Other Fee Signs Special Inspection S Nema~ks TOTAL FEF~ ~ .sa ~ Nouen-in ~nte I, me Elecvicai R n Q~' Inspectoq he~eby certi~y that t~ bova Final , ~ ~'1~0~~(~ spect' as Oee ~ ~ mede ~ ~is repueat vo1C 18 monihe irom RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN ~22j `f~ 3830 PILOT KNOB RD, EACAN MN 55122 651-68'1-4675 2~ New Construction Reauiremenis RemodellReoair Reauirements ~ - • 3 registered site surveys showirg sq. ft. of lot, sq. N. ol house; and all roofed areas • 2 copies of plan ~ (20°k maximum lot cove2ge allowed) . 1 set of Energy Calculations for heatetl additions • 2 copies of plan showing heam & window sizes; paured found design, etc.) . 1 site survey far extenor addi~ons & decks • 1 set of Energy Calculations . Indicate if home served by septic system for addiUons • 3 copies of Tree Preservation Plan if lot platteE after 7l1I93 ~ • Rim Joist Oetail Options seiedion sheet (bldgs with 3 or less unBs) DATE 2~ ? b Z VALUAiION l~T SITE ADDRESS I? ~3 (/1//LCJ °~/'/i! ~N MUITI-PAMILY BLDG _Y /lN TYPE OF WORK ~~'DO7- FIREPLACE(S) _ 0_ 1_ 2 APPLICANT ~-C J<C `l. ~(~fe 1~i ~ ~'S STREETADDRESS 7~~0~ (.(~~Sltic-v~~~.S CITY P~t TATE ~~ZIP 5~3~~ TELEPHONE # ~'Jr2~~F~ "~Z3ZCELL PHONE # FAX # PROPERTYOWNER ~6n~~~1Qs~l j~i'I./~l~(lS TELEPHONE# ~SI~~O~7'Dln9~J' COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ >[IViVI{S(~"f:\ RULLS 7fi70 CA"1~I:GORF ( ~.'~E~"~ ~L~:~f ~ (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • ew Energy C 1 ~WOO? sh t ubmitted ' • Energy Envelope Calculations Su6mitted JUN 2 L L Piumbing Contractor: Phonc fl BY Plumbii~ systcnt includcs: ~Valcr SoFtcncr _ lawn Sprinkler Fcc $90.00 Walcr Heatcr No. of R.I. Baths ~10. of BaUis Mechanical Contractor: Phone # ~[cchanic:il systcm indudcs: Air Condilionina Fce: $i0.00 I-Icat Rccovcry Systcm Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agr ~fi comply with all applicable State of Minnesota Statutes and City of Eaga inan s. Slgnature of Applica ~ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 73 76-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 O6-plex ? 16 Fireplace O 21 Porch (3-sea.J ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muiti ? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? O6 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES 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) FinaWi o 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 (new/replacement) _ Insulation _ Retaining Wall 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 i/,4t~UAT~o~~ ~ - ~ . G.4RAG~ ~ 11,, ~1 ~ s.. ~ 3~ 1( ~J = ~SL X Jy= IbSBN I ST FinotZ, 4- T3AS~htEN! ~8x ~y = 6~2 ~y X 30= y2o Zx7= 1~ I 10~ x ~z= Ggs~2 Z Nn F~ ~2 30 ~c 3.5'~/z. = f o~S s%~ X rs = ~s3 ~ X ~ = G Z ~ ~ _ _~i I I~~ x y9 = s~~ 3y J 3 6290 , . Cer•tif:Xcete for: Ozmun-Pederson Inc. ~ . 15136 Galaxie Ave. App1e Valley, Mn 55124 DELMAR H. SCHWAN2 uNO sunvcrans, nrc. ~.e u~a. a nn sae. a wn~ra. 1~760 SOUTH ROBERT TRAII ROSEMOUNT, MINNESOTA 560t! 61Z/~2~-17N SURVEYOR'S CERTIFICATE ~1/ 89° 3~' ~ ` /O2. 89 ~ ~ I ~ ~ ~ ~ ~ ~ ~ 1,~I Drainage & I~ ~~v c Pa L. . Q~O Utility I Easements I ~ . .O - - - ~ ~ Q 1~ I ~ m r' 17.21 , ~ f~ ~ iz.s~ • ~v M I I s l~ N ,\„J ' ~1 ~ N ~ y~ - n o~ ~ N° N 1~ I ~ ~ ~ I~1 ZZ.L'7 N L.L~ ~ ~ ~P¢ N gb.33 . j(a~IX7, I ~ - - a 74.L6' / ~ ° G ~ I~ ~ 1 M I - M scale: 1 inc, = 30 feet d ~ M ~ f,,r., ..i,;~;_:; nu ~ y~z3 d = 1'y oo" ~ Rs3o85.08 L= 9 ~a M LANE~ Lot 2, siock 2, WI7DHRNESS PONDs ~ ~R~165S ` *~,~~~~9`~ ~ _ ADDITI~i, according~ to the recorded `,,~":;v;e''~~~+"`•'•'t~~~,,/ .plat thereof, Dakota Coanty, Minnesota~. •4., ~ w.-e' % C~' h~tr~.R H. ~'-f Also showing the proposed locatian - `~`'~'~`r`''~"z = of a house thereon , =b~ -~;.~w- i . '`r•iiir,i,,,~arr:~;n.~ ~ 1 Mroby asrlily t~at IMt wrwy. PNn. a r~poA wq • prop~rM Ey m~ a undsr my direcl wparvlsbn and ~ , thet I~m ~ duly Rpylsrod U~W Sufwyol unAM . tM I~as ol tM Saa of Mirow~au. ~ ~ ZS-~' onm.. H. sen..~u ~ D~bd ~ , Min~ Rp~tlon Ne. ~ 1 • . ~ Ozmun - Pederso . n, Incorporated AveraI'g,e '"U' ComputatIion Job Site Address ~~'~J W~(~~~~~~J I~~~.~ Legal D/eIscription: Lot Block 2' Addition_,VI~i~".-~~~;1~~ ~~~~~JDate AVERAGE LINEAL FEET OF EXPOSED WALL AREA ABOVE GRADE Main Level Lineal ft of framed wall above grade ~~x height of wa11 %'Z= ~272 Second leveT Lineal ft of framed wall above grade ~~x height of wa11~= ~,5 = Vaulted Area Lineal ft of framed wall above grade ~ x height of wa11~= ~2~ Rim Joist Ar~a ~ Lineal ft qf rim ~?jx height of rim ( _~--,f`-~~ Lower 1eve1 Lineal Pt of framed wall above grade xheight of wall = O Lineal ft of framed wall above grade x height of wall Lineal ft of masonry wall above grade_x hgt:.abovergrad~-= Ir,(~ Total iaall ar.ea .above grade including windows and doors =~j,~j~~~ / ~ WINDOWS : Brand and Type_ p~~~ ~L.~b ~I._- L,2~y°~~ 2:- Area U va ue 4- ~~`.iMr ~~;-l-s X ~.s~ sq.ft._ I x , 4~ 4_ ~ 2 x/a'1 sq.ft. 2 X ~~U~~ .41 = x d~ sq. ft. 2~'L x"U" ¢ Git- _ a D~S sq. ft. I~x "U"~= ~ sq.ft.~x ~~U~~~= °I~(D sq.ft.. Zci• A-- x~~U~~~~. 12•0 ' 2 x ,2 sq.ft. --~,2 x~~U~~ .41 = 2.~5 sq.ft. 2•CD x ~iU~~~~_ c,,-i =_L! ; X .I sq.ft. ~ X ,~_--u~~ sq.ft. x "U" _ 'c!O sq.ft. x ~ , sq.ft. X _ sq.ft. x "U" - sq.ft. X _ DOORS: Area x"U" yalu ~.U 4 ~ D'~~ ?~=-'s'rr,~~ 11.1.~U~ sq.ft Zi,,y~ X ,~3 = 2.93 r' ' °f~f7kl%~-,L ~ sq.ft x •31 = ~~14 • ° S ~ sq.ft. ?~O Y~ X ~~U~~ 44 ~ sq.ft. x "U" _ . ~7~~1 - 2~~~2GJ OPAQUE WALL CONSTRUCTION:,.Area x"U" value ~Framinq members ~ sq.ft 'L(o~,'~ x "v" •G~II = 23.Co~j Framed wall sq.ft '7 , 4-I x"U"~= If~'J 70 Rim Joist Area sq.ft p ' x"U" .C~4 = Masonry wall • sq.ft_ ~5(p x"U" • I/~.l,~q . 3UC0~ .OCo ~ `''J3,~1 - Total wall area includinq ' Windows and Doors a. 3~2~ b~.~~ ----f- Total (U) Values , b. ~S~•~ = Avg. "0" • O~ 0 Divided by total wall area a, 3~j2-~ , AVERAGE "U" Minimum .11 or less for 1& 2 family dwellings ~ i - , ~ • I . , , _ ( , , . . ` J '1 , , G . . . ~ ` ' . . D ~ ' . . ~ . . . . ~ ~ i ~ . ~ ~ ~ q~ . , a • . a ` ~ ~ { w_1~ ~ ~ . ,,`n . . t j v~ ' i~- i . b~ o, i( 1 t :~\r 1 ~ / ly, . r ' /-"tiJ~~~t i /r, . . . . ' ~ if J ~ t J~~ rC_ ` ~v., ; ~ ~ ~ . . . i - ~ . - ~ . _ - . I ~ j . . . . ~ . . ' . ~ ~ ~ ~ ! ~ ~ ~ ~ ~ ~ ~ ~ ~ -,-C ~ ~ N ~ II _ ~ ~ ~ ~ ' O ~ ' p ~ p ~ ~ ~ 6 ~ ~ F ~ ~ ~ ~ ~ ~ ~ p -~~v ~ ~ ~ F ~ p - ~~a 'N Z N ~t ~ L : : 1~ I~ ~p -1 Z ~a ~ p L = i~ y 7a p o~~ p Q Y v i C ~ ~ ~ l~i-~ p~~ N ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .n ~ -?I ~ ~ ~ 'tt ~ ~ p "n i ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ; F ~ ~ I i I~ i~ ~ ~ ° ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 N p N , q If ~ . II . . 1~ , ' w ~N ~-N. N ~N_ s ~ . _ , Ow s_ :a~, d~ecm p ~ m w ~ a~"~ d~ ~i cA p ~ ~ g ~ -P ~ m ° ~ ~ ~ ~ ~ ~ ~ ~ ~ 6 - ~ o U'~ - ~ m 1. :S.:e s:,<.,a.~x:. at, "t,l, .a ts:-':' , i*:~A!T ~,.r . ,:.,~:r :T.~~'1. a: 'r r e.:,- r :,-.g, a.q> p'.3,',. L ~ i., r~+"" _ _ , " ~ . . e . , r. ..r r _ , . . . . :tv L'~ I • ~ ' , : . . . _ . - . : : ' : . : , i ~ . b. . . ~ . . ~ ~ ' ! . . . _ . . . . . i ~ . - . ' ~ ~ - • _ jY' ' . ' . ` . " . y - ~ ~ , . . . s."~ = . , - - ' . ' , . _ I ; . _ . _ ~ ~ - _ ~ ~ , - ~ - . . . _ : ~ ~ ~ ~a I ~ ~ . ' ~ t .~I' _ . , ~ . . . _ I~ . . . . . ~ ~ - . i 1 ~ ~ ~ II ~ ~ : +I ~ ~ ~ ~ - ~ , ~ ~ ~ " . , _ ~ ' rx _ _ _ ~ ~ ~ ~ ~ N_ _ ~ ~ n . Z ~ ~ ~ r ; i! . l6 m~ V~ fi ~ ~ C ~ ~ ~ ~ p ~ ~ ~ 1 T, ~ ~ l~ ~ Q ~ ~ ~ ! n ' -v ~ ~ ~ ~ ~ ~ ~ ~ p ~ - f:: -n ~ ~ ~{{~~t ~ ~ i rr r:'~ . r O O ~ ~ r ~ i~. ib% ~ 3. ~ L m ~ ~ z ; ~i ; p p ' ~ ~ ~ ~ ~ ~ ~ ~ Y~; ~I ~ ~ ~ ~ ~ . _ . . _ ~ - ~~~~a~6 0~~~~~ .~J ~ ~ N ~ ~ ; m _ . ~ APFLI~ATION 1=0R PERMIT k ±~'E= PA1R~II~27P OF FEE AT TIME OF • ~ . ; ner~xr~oN ~s c~ar cror~- ; ~ ~ ~ SCI1SIlE APPRQJAL OF PIItFIIT. : + SEWER AND/OR WATER CONNECTION : I~~~ ~ ~ ~i~ ~ + ; irisrn[a~,TioNS wna. r~o~r es sc~rm ; [4/~' ~ LPII'IL PII2GIIT HAS B@] APPROVm. R ? • 1fi(lf~4f}y4kk~F#!ff}f1f#iiktl4Af!lf~3fA ~ ; ~ 1~0,~ OF C~C9C~C'~P1 3 (PLEASE PRINT /J 1) PROPERTY ADDRESS: /~v~~~O2/^/~eJ=S d~C/~~'- i,FY:AT• DESCE2IPTION; . . ~ ~ ~~et./~" 2 . . . . Lot B ock S ivision or Tax Parcel ID IF EXISTING STRL'CTL~RE, DATE OF ORIGINAI, BLILDING PERMIT ISSLANCE: Mont Year PRESENT ZONING/PROPOSID C!SE: Q CONP~RCIAL/RETAIL/OFFICE ~~~R-1 SINGLE FAMILY Q INDOSTRIAL ~ R-2 DLPLEX ('i+no Lnits) a INSTI~;TIONAL/GOVERI~A~NT Q R-3 TCYWrII30('SE (Three + Dnits) ( Lnits) Q R-4 APARTMEPTP/CODIDOMINIL'M ( Lnits) 2) ~ NP,ME: ,~v~j~J'on ~A'c~c,Lr,.1ii/~ ADDRESS: ./~OS ~'c./~ l/a/~ty ~~(iz~ CITY, STATE, ZIP: Sn?tr Gr~~~ /~~S s~~~ PHONE: yS%-~J~~ - ~ For City Use 3) NAME: ~.e/r/~ ~~um~-ir y P1LUnbers I.icense: ADDRESS: ~ 3 (V ~ Active Expired CITY, STATE, ZIP: . ~q ~-„-,.~n n , .77J.r-~ .~`~va `f Not recorded ~ PHONE: ~b 3-;F'~ 3 c7 MAS'PEE2 LICENSE # Do2 _ b d~ i~M£~,, Sta In~'itial 4) e ~ r7AN~: D~.nan r- F'e~enror.. Znc_ AD~RFSS: /S/36 G'a/axi~ A-ve CITY, STATE, ZIP: ~b.y~_ (~Lt.~/Gy ~Y/i.--- cS-~l.:tfl ~O J PHONE: y3/- SDOO 5) ~ d ~ ~I a~ ~ CONNECTION TO CITY SEWEE2 ~ CONNECTION TO CITY WATII2 O OTHII2 5) ~ ~ ~ ~6'' :F4****************rt*********~k~/r* ******Y(****************+F**********W******~r**YeitiFlt***nt****~F*****~k****y * ~ THE GOID COPY OF 14iE PERNIIT WILL BE SENf DIRDCPLY TO PUffi.IC FARKS 7U FACILITATE METER PICK-[JP. r *r PLEASE ALIAW 1W0 WORKING DAYS FOR PROCESSING. SOMEONE FROM Tf~ CITY WILL ODA~PAC.T YOU IF TI~RE * ARE ANY PROBI,ENLS. ~ ~+r*~~*~*+******«~*~**************+*+***********~:r**~****+***********+*~~*~~**~,r**~~******+~******~; . . FOR CITY USE ONLY ~ ~ PERMIT # ISSUED 9~ Pd w/Bldg. Permit FEES: $ $ /O "S~ SEWER PERMIT (INCLODE SURCHARGE) $ $ ~O' j~ WATER PERMIT (INCLODE SL'RCHARGE) $ ~`U U $ WATER METER/COPPERHORN/OOTSIDE READER $ S WATER TAP (INCLODE CORPORATION STOP) $ S SEWER TAP $ $ ACCOONT DEPOSIT - SEWER S $ •!9~ ACCOL~NT DEPOSIT - WATER $ ~Sv $ WAC $ /p 5~ ' ~ S sAc $ $ TRLNK WATER ASSESSMENT $ $ TRL'NK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRC~NK SEWER $ $ LATERAL BENEFIT/TRUNK WATER `7~` 6Z~ S WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: X ~ ~ 0 $ (yD TOTAL ~ ~~7~`~ la -7~ RECEIPT RECEIPT DOES UTILITY CONNECTION REQOIRE EXCAVATION IN POBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: _ a ~l~ PERMIT # ~ 1~ RECEIPT DATE: b- ~ V I R~.SID~NTIiA~L ~LiJM~INC ~EiiMIT ~PLIC~tTION crrY oF ~~x ssso enor xivos ~tu L'A6AA, bfA 551 EE 651-6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system Gre.~ p,~nd~/1~ SITEADDRESS: 3 i~~ n..r n E.PI' G..~ rl OWNER NAME: : TELEPHONE (AREA CODE) INSTALLERNAME: ~~eSS'lon ~I^^,~ S~-ar~~~af TELEPHONE#: ~'4~~8~~Z ~ (AREA CODEJ STREET ADDRESS: P' U- ~S o X a a,~ a CITY: ~ °Sa ~ - STATE: Zlp: ~ S ! Z,~ Place a check mark next to the ermit work t e New residential dwelling unit under construction and not owner/occupied $ 90.00 _ d-on, odification or alteration to existin dwelling unit, including: ~ $ 50.00 abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • waterturnaround Nature of work: i,~ e a~- Z ~ Szptic Sys;em, nEw;refurbished - $ 225.OC • includes County & Consulting Inspector fees • requires MPC license ~ ~ 5 i'~~ 4ti~11ti~. ~ l` I~ ~dl ~ ~',II ~ ~~,j JU 2 7 Z001 • StateSurcharge ~JiJ $ y~.,_ _ _ --~-~=~:'3v Tota I $ Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby adcnowledge that I have read this application, state thatthe information is cortect, and agree to complywith all applicable Cityof Eagan ordinances. It is the applicant's responsi6ility to notiTy the property owner that fhe City of Eagan assumes no liability for any damages caused by the Cily during its normal operational and maintenance actlvitias to the facilities constructed under this permit within Ci pertylright;of-way/easement. /1 ~ ,1 ~a ~ /h/h~ SIGNATURE OF PERMITTEE Updated 1/Ot ~a~~ ~ ~ 2006 RESIDENTIAL PLUMBING PERMITAPPLICATION CITY OF EAGAPJ 3830 PILOT KNOB ROAD, EAGAN MN 55122 551-675-5675 ~ >_ase complete for modifications to existing residential dweliings. ~.te 6 ~ f 0 ~ ~~p ~ :e Street Address / ~p ~ ~ ( ~~~~~-S I Unit # opertyOwner 1/~{7/1 ~~~~/~/~5 Telephone#(/~rj~)1~z~j7"~ >ntractor ' t Telephone # ~ :lpq~~ idress ~ ~ City ~X~ State_~. Zip~ ie Applicant is: _ Owner Contractor _Other :ptic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-buili $ 10.00 Iterations to existing dwelling $ 50.00 Add plumbing fixtures. This iee includes instailation of a water softener and/or water heater at the same time. !f you are insYalling on! a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. " - ~ . ~ ~ il j~' ~ ~ 9 - i Septic System Abandonment Water Turnaround (add $130.00 if a 5/8" meier is required) I,~ ~ SE~ ~ 7_0~ ~ - _OYher: ; -.c~- Water Softener ~Water Heater $ 15.00 new replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild 5 30.00 ~tate Surcharge $ 5~ 'otal ~~v hereby apply for a Residential Piumbing Permit and acknowledge that th2 iniormation is complete and accurate; that the ~ork will be in conformance with ihe ordinances and codes of the City of Eagan and the plumbing codes; that 1 inderstand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in 3ccordance with the approved plan in the event a plan is required to b reviewed and approved. ~(j-~e~~- ~'~}`~D n ~pplicanYs Pnnted Name AppiicanYs ignat e 4411111. C!tyofEa�ali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use �( Permit #: /061 31 90 Date Received: "` i 1- l ) Permit Fee: Staff: 61'1/1. 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Resident/ Owner Type of Wor Name: !JO/UAW" 4 !IAaJa Reynold Address / City / Zip: /3 0 3 W l / dcvn C.a( Lei Applicant is: Owner /Contractor Construction Cost: 3 2 . o 4'2) Description of work: Phone: 61)" 41? V Multi -Family Building: (Yes / No /) Contractor Company: l?.t { cfiet Address: 0-0 2 03 4 12,s-6) Contact: Se0 ?`( �S^I- ti) -1/ Or/) City: State: M/1 Zip: SS 371 Phone: Pa) 7'(7 License #: 4 G 6 3 if o 93 Lead Certificate #: N# -T- S 3 7 / ? - / If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) _ Lii,oLt COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: MOTE: Plans and supporting documents tEtat you submit are considered to be public information. Portions o the information may be classified 'as non-public if you provide specific reasons That would permit the City to conclude that the are trade : _ _ 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.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 review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota days of permit issuance. X Aif RGt) QIlblw Applicant's Prin Name Applicant's S Bui ng Cod must be completed within 180 Page 1 of 3 SUB TYPES Foundation $4 Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Ait Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% Census Code # of Units # of Buildings Type of Construction DO NOT WRITE BELOW THIS LINE vMr (AJ,1aL',,� 5 5 Fireplace Garage Deck Lower Level 13v3 Porch (3 -Season) rch (4 -Season) orch (Screen/Gazebo/Pergola) Pool Interior Improvement Move Building Fire Repair Repair 3 049 /3y REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Insulation Sheathing Sheetrock Reviewed By: Y RESIDENTIAL FE Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Occupancy Code Edition Zoning Stories Square Feet Length Width Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant Adz) 7 /7)— / y' MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required ve Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: Footings Siding: _Stucco Lath _Stone Lath Brick Air Test _Final Windows Retaining Wall: Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector Air/Gas Tests Final TOTAL / /3 k lTc/ 4 RA/P1#1)41--- C'.v~// /7't811 /A -4X /4f Pj t;// 4.0440474, Aas /53 M° W`'""QowJ w► beicv Ai &VP— Page 2 of 3 Cer.tificate for: Ozmun-Pederson Inc. : 15136 Galaxie Ave. Apple Valley, Mn 55124 DELMAR H. SCHWANZ LAMOMMMWOMIUM Moptimod0WWLImotTIMPUMOMWmoits 14750 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA 112/4234 SURVEYOR'S CERTIFICATE 8?° 36' .7" W 102.3? Drainage & Utility Easements ?30 a PeRwV. REQU1 Scale: 1 inc = 30 feet LAWS". Lot 2, Block 2, WILDERNESS PONDS \IP- Og/ZNA's AV.114,21. --4ADDITION, according' to the recorded„,, y.ecg, .plat thereof, Dakota County, Minnesota'. .... '.:'''. ..... 't Ai' --1..t71 gt.' ry rt H. .---- s: Also showing the proposed location SCHWANZa of a house thereon 1 — • ' tT,na .-4-• . ''';' 6::'''''... .... - .. 0.•..;%-4. iii - V',4 BY: I hereby certify that this survey. plan. or report was prepared by me or under my direct suPerviefen and that I am a duly Registered Land Surveyor under the lavas of the of Minnesota. EAGAN REVID ED DATE: 2rIONS DIVISION itCa 1Z-0 /34 km ir /0e SURVEY 1” = 30' Use BLUE or BLACK Ink r----------------- I For Office UseI Permit City of Ea a~ I f I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 j staff: p Fax: (651) 675-5694 L 1 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ,-el-.,2,i1 Site Address: Tenant: /<-e v! a Suite Resident/Owner Name: Phone: Address / City / Zip: Name: s 6;"License#: pC~ ` 72J Contractor Address: ~3r Q/,QAL)rn City: _ 1 DeQ State: N Zip: 55 3 71 Phone: v Contact: Email: SL I-" al) ceo~~)~► .-s . o Type of Work New _ Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation Water Softener Permit Type C_ RPZ I _ PVB) Add Plumbing Fixtures Main / Lower Level) Septic System New Water Turnaround 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) t $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances 4nd codes of the City of Eagan; that I understand this is not a permit, but only an application for a permitfand ork is not art without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and ' a x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-in Air Test Gas Test Fin I PERMIT City of Eagan Permit Type:Building Permit Number:EA115464 Date Issued:09/26/2013 Permit Category:ePermit Site Address: 1303 Wilderness Lane Lot:002 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-020 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 . Elizabeth Hess 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 - Jonathan F Reynolds 1303 Wilderness Lane Eagan MN 55123 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA118679 Date Issued:11/06/2013 Permit Category:ePermit Site Address: 1303 Wilderness Lane Lot:002 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Jonathan F Reynolds 1303 Wilderness Lane Eagan MN 55123 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use y�J mo Gid of Ea an Permit#: (/ o iF/ Permit Fee: v D 3830 Pilot Knob Road 22 Eagan MN 55122 MAR 3 1 2017 Date Received: J'3!- Phone: (651) 675-5675 staff: Fax: (651 - 94 2017 SIDENTIAL PLUMING PERMIT APPLICATION Date:13•a -1 Site Address: t31.I� 1, , 11( &• tv2/YLv1 W`.e, c ih k.)...13, 3 Tenant: AA A IN\ r elX\ Suite#: 4 4' -24\ ( hone: L �/"(3 3C7- .�' ' ®� �e ® Name: / +'3- ',,. , x Address/CityI Zip: (3 &A_,.. c..., y, • hil,. .e ,.„...s*,,„ .„,,, „,,,,..,,,,,,,,,,,„,,,,,,„ *CID dM\hq� License#: W C LI lit? ;, �; Name: " iE ' . ah` qU( �O , 44` 4P� + � (dUi Address: r City:` ntrac M T) [S1` `l�\�� ( �,'� �`� �� 4.� State: Zip: � Phone: � � �� ,%';'''''..",=`''''''''''''4:"::1:0'.!:,,,�a ' Contact:"VI' 1�k•ML\�T�/uv' Email: � i. ,, ♦ Q ad 4(4 5,1-14.1)(4/4-6 ,I,„,,.,,:,,,,., r diV New Replacement _Repair _Rebuild Modify Space Work in R.O.W. - �: Description of work: KY',".:..;;-.. ,;',‘ . ' ,,.:•.,J: RESIDENTIAL �, , � Water Heater- �� .-...--.- ''''' '''''e, � ° '54' Water Softener t ,, _ Lawn Irrigation( RPZ/_PVB) � � ,,# ® - Add PlumbingFixtures Main/ Lower Level) Septic System ( ;11.~' ,Z' V # ;. _New Water Turnaround , , 4,T#'14,t, +, —Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) - *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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.clopherstateonecall.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 ac ordance with the approve plan in the,c se of wor which requires a review and approval of plans. �7x • 07)\ . x 1}/b40-11/e:6.67- Applicant's Printed Name Applicant's Signature C �s t 7-xr- t 7iF.O „O " 'U.. °' i "'' T {:P''�o- • - '�Y, � � �; .a n " 3 .F'a ?r ix aa" :-I'e,i; tip `* a ,'-',,� ' r g x` x x . k k �"� ° . �� '� �r5 .a �� + 7 ' � ..� S gt�I is�F +,r.:; i'equlre® I $•e t •n-x ,`„' Ufa.= Grou '9,,,,14.:•.,',e.: ou® {. V,� �z.''''4"01q311:::::”,p +� �±� #"rEYT'ix. "t` � a.,� � d ��zt roz�,� a :7:::� >:t .i'''.('!': i -. a p'--+t�C ` s '"t �"'�'s� i�za � ��^�' X' a''�`��g � a vas t ,_. °.y� fi, " ^ � �e ,a s'#'3� �" Meter Related tetmms` Mete. +Size d otRe a 4 ' ' e d * ➢ - ,' ar PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA163849 Date Issued:09/14/2020 Permit Category:ePermit Site Address: 1303 Wilderness Lane Lot:002 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Gebi Yabato 1303 Wilderness Lane Eagan MN 55123 (651) 431-8300 General Heating & A/c 11081 Chaparral Avenue Shakopee MN 55379 (952) 445-2820 Applicant/Permitee: Signature Issued By: Signature