741 Windmill Ct11!Pa
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #: ! 5 -7 `; 7
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: a.- - 0 Site Address:
Tenant: Suite #:
RESIDENT / OWNER
Name: —me te SA. OF 5a k I Phone: 65/' 4 /L Z 8
Address / City / Zip: 9L& ().104c1 04; 1( C
CONTRACTOR
Name:App/icon ce IAs!a ((ets' DF%nt+ - wC License #: PPP S9614*-6-rhA
Address:I 4% 05- kc t o s .St it) G City: f t ioi /'t, t ,-
State:
State: M n Zip: 6753 7 2. Phone: QS' Z' LI 6"1 - gS K 1
Contact: 'I'VE i Clekt. c Email:
TYPE OF WORK
_ New )\-- Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
'Sic -Water Softener
Add Plumbing Fixtures ( Main / — Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 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)
$95.00 Fire Repair (replace bumed out appliances, ductwork, etc.) (includes $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 and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x V & 'St W.orr'1'tvti.,
Applicant
rinted Name
Applicants Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: __ Under Ground Rough -In Air Test Gas Test Final
CITY OF, EIIGAN Permit No: % pate: 1?_ _CO)7
3830 PNot Knoh 6ad Meter No: S-3 Size: Ulf 1(044
P.O. Box 21199 Reader No: Date ~•Z-
Eaqan, MN S5121
Owner. Coroqrate Cvnet.
SiteAddress: 741 Titincmill Court L6 1317 ::ricile Rid e
Plumber R I g
Conn. Chg: 525 . t70 d ~ tiliIBS P1
Acct Dep: 15 . o e~g¢in ,
Permlt Fea 1Q. Ouq~l EP.BO.NE_ ~1~•~~Ftc. 1
Surcharge; qrl" Wily wlih the City of Eagen
Tr.Plant_ ls~•~~ 9rdl
Meter r-7 . agtr,-g ,
Misc.: gy
' WATER SERVICE PERMIT
r , • • . ~~.~~.•'T w
_ • T -
C~ OF ~DAN ~ Permit No: ~ 7 {
3830 PNotKnoti Road DaW Meter No: _ 15_g7
P.O. Box 2119! Slze: ,
Eagan, MN 55121 R~der No: Date: I
~ Owner. Cor rate Const.
Site Address: 74I iJf.tidmill Court L6 R t 7 n~ '
; Plumber
, Conn. Chg: _ 525. 4ppd Zonin~ Rl
Acct. Dep: 15.0
Permit Fee: _ 10, r,}ppd No. of Unlts: 2
: Surcharge: _ SODd I
! Tr. Plant 180 . QO d I agres to comply wlth the City of Eapan
Meter. DrdjMnCp.
Misc.. I
er
WATER SERYICE PERMIT I
~ . 1
A
CIT"FXAGAN Permit No: 3 b !
' 383R Pllot Krwb'.#oed B/ P No: i771 Date: 1 S-q-;
PIO. Box21189 Date: 11- IO-87
Eagan, MN 55121 r
I ~
I Owner. Cor ~Ce ~nst ^
k Site Address: 74. . W dmil.l Court 1.6 P 17 F-i.c?;.F.. ~ f Plumber: T~e z ~i~~.~
Plumbin
~ nnwcc; `^5. '
~ Ciry Chg: ~ Zoning~ 1
Acct D No. of Units; j
` ep• 1J ~I~
Permit Fee: i)~1P~ I agrae to comply with tM
Ordinances. ~Y ot Eagan
Surcharge:
r Misc.:
( By i
j SEINER SERVICE PERMIT .
_
- -
, 0 CASH RECEIPT
~
CITY OF ~GAN
3830 PILCr KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 ~
, wccKrvco
IROM
AMOUNT $ I _
~
ac ooLLwws
,oo
? CASH D-CHEGK
roR / c l ~_t rti S ~
r"
FUNC COOE AMOUNT
Thank You
BY ~
. 9731 wnice_Psysn coav
Vsllow-Potting Copy
Pink-File CopY
' BLDG. PERMIT N0. i C(~&,~;-
01-3210 Bldg. Permit
01-3422 Plan Check i2
01-3445 Surch./Adm.
' 01-3446 SAC/Adm.
01-2155 Surcharge 2 -
17-3860 Road Unit
20-2275 SAC , - -
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 kater Meter
20-2252 Acct. Dep. ~ti d U
20-3713 Water Permit
20-3743 5ewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt
To be used for 5~ ~/(;AK Est Value 165,000 Date DECE`a'`~R 10 19 87
' Site Address 741 WINAMLLL CT OFFICE USE ONLY
Lot 6 Biock 17 Sec/SubSIt I DLB On 5ke Sewaqe Occupancy xa
.
MWCCSystem x Zoning ~l
Parcel No. On Stte Well (Actual) Const vA
oc Name COxPORATE CONST IN(: City water 3.- (Allowable) Vr
W PRV Requlred of Stories
Z Addr ss 4466. HEDGWWU IIR
° City . "GAN Phone 454-4664 BoosterPump Length 4tk•6 7
Depth 52.33
°C Name ~ sME S.F. Total
.o
~ ~ Address Footprint S.F.
~ City Phone APPROVALS FEES
yVj W Name Engr./Assess. Permlt ~ 451.00
~ Z Address Planner Surcharge 42 .
~ zzs.w
~ W City Phone Council Plan Review
Bldg. Off. SAC, City 100•00
1 hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 525.00
information ie conecf and agree to comply with all applicable 5tate of waterConn. 525•00
Minnesota Statutes and City oiilaganArdinances.
Waier Meter 47 •QO
$yigneture of Permittee Raad Unit ~OS•~
A Building Permit is issued to: ~RPORATS CONST INC Treatment P1 180•(X)
on the express condition that all work shall be done in accordance with all
applicable State of Minnesote Statutes and City of Eagan Ordinances. Parks
BufldingOHICi91_ ~ TQTAL ~2~4~i.~
. . ~ • CASH RECEIPT 0 'I
CITY OF EAGAN I
3830 PILOT KNOB ROAD I~
EAGAN, MINNESOTA 55122
DATE 18
AMOUNT $
4~
& ooLLwRs
~es
? CASH E~'CHECK
raw
/ T I v (~?--i..-, .J= E,.
~.11 J
rTO coo¢ ~ AMOUNT
14--~
=f G Q
J
Thank You
B Y
t3793 White-Payert CoPY
Yellow-Postiog Copy I
Pink-File Copy
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CITY OF EAGAN I'I
OFtICE INFORMATION MEMO
TO DATE TIME
8 ! w. $ . ,S_ 1_1
fROM OF
aE N`
PHONE NO. RECEIVEO 8V
H was hers to sse you wi 11 ull ayaln
Rease call HReturnod your ull
ACTION REMARKS/MESSAGES
Revlew and sse me
Reviaw and commant Prspare reply far my sig.
Reply and send me eopy
For your approval
For your Informstlon
For signaturs
As vw discussed
As you fequested
ake approprlata sttlon
Notity staif
FILE ? DISPOSE D OVER
PHOTOCOPY:
ONE SIDE ONLY COLLATE
NO.OF COPIES HEAD TO HEAO STAPLE
TE NEEDEO H AD TO F OT Other
TVPING:
ROUGH DHAFT RUSH
DATE NEEDED SINGLE SPACE FINAL COVY
DOUBIESPACE CAR80NS
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454•8100
BUILDING PERMIT Receipt ~
To be used for ' ' ~ " Est. Value J Date ,19
SiteAddre 741 ~~1NIk~! C'I' OFFICE USE ONLY
,
h
Lot _ Block l~ Sec/Sub. On Site Sewage Occupancy '
MWCC System Zoninq 1 I
Parcel No.
On Slte Well (Actuaq Conat Vn
a NemB CityWeter K (Allowable) VT?
W PRV Required N of Stories
= Address >
0 City PhOnB 454-•~+firG BooaterPump Lenpth 48•ti7
Depth 5t•~;
, o Name 'A~tF S.F.Totel
v i Address Footprint S.F.
~ City POpne APPROVALS FEES
v W Nem@ Engr./Assess. Permit ~ 1. i?G
Address Planner Suroherge 44• k'
o~ 2?5,
I = City PhOne Council Plan Review
W Bldg. Off. SAC, City
I hereby acknowledee that I have read this applfcatfon and state that the Variance SAC, MWCC
information is correct and agree to comply with all applicable State oi Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter 07
+ ~•.Signature of Permltlee Road Unit 3o5•, ;
'.~A Building 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
Building OMicial_ TOTAL ~ ` ` '
Psrmft No. Prrmit Holder Wb Tehphone s
Plymbfng • ~ jx/c,;/~. ~
~
H.*IkC.
N
Electric
Softener
InspeMbn Dste Insp. COmnl*nb
Footings I
Footinga II
Foundation
Framing
Roofing
Rough Plbg f _
Rouyh Hty. ~
I sul.
FirepisCe
Final Hty. . ~ -
Final Plbg. ~
Bldg. Final
Cert Oca
Temp. LP
Deck Ftg.
Deck Finel Well
Pr. Disp.
~ ' . , . L . . . . . .
4. . • ~ PERMIT If
~ . , PLUMBINQ PERMIT
CiTY OF EAGAN RECEIPT N 7 y7 y_ ~
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 4""
CONTRACT PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot ~49 Block Sec/Sub " Res. X. New ~
- Mull. Add-on
m Name li,, Comm. Repair
~ Address Other
c City t' j 1`l Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES , TOTAL
Name, _2,Water Closet - $3.00 s +a '
3 Address r -1-Bath Tubs -$3.00
" r 1._lavatory - $3.00
O City Phone ~ --L_Shower - $3.00
-4-_Kitchen Sink - $3.00 j ~
FEES Urinal/eidet - 53.00 COMM/IND FEE - 1% OF CONTRACT FEE laundry Tray -$3.00 '
APT. BLDGS - COMM RATE APPLIES -1-Floor Drains -$1.50 IyU
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$1.50 S(>
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool -$3.00
MINIMUM - CQMM/IND FEE - $2p.pQ _LGas Piping Outlets - $1.50
I • '~D
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES Soitener -$5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
.3_Rough Openings - $1.50
SIGN TURE F PERMITTEE
FEE:
STATE S/C:
FOR-CITY OF EAGAN ` GRAND TOTAL• 33' ~
. . . _ '
PERMIT # ~
I
' • • MECHANICtAL PERMIT RECEIPT # ' ' . C1fiT6F EAGAN 4
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
'i CONTRACT PRICE: PHONE: 454-8100
Site Address 741 Windnill Court ~LDG, nPE WORK DESCRIPTION ~
~ Lot ~ 61o13075 ck Sec/Sub Res. New Name i~ - !i •z n & A x Cond Z n c Mult Add-on Address P• ,er T•a Comm. Repair
c City Eien Prairie Phone 941--4211 Other
5347 FEES
Name Cor rate Constnaction RES. HVAC 0-100 M BTU ~24,00
c Address 4466 F;edaewoocl Drive AQDITIONAL 50 M BTU 6:04
~ e~y Eagan, 55113 Phone 45~4-0644 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS DUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
~ T1fPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE
Forced Air LF'nnox G16k'3-75M BTU APT. BLDGS. - COMM. RATE APPLIES
! Boiler ~ 0~~ ~Z'~7 M BTU TOWNHaUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIQENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODEIS - 12.00
' Air Cond. 3'Pon-ft@1b-411 M gTU MINIMUM COMMERCIAL FEE - 20.00
Vent - CFM- - STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # j $ r' . BEYOND $1,000)
Other ~
FEE:
S/C: ' SIGNATURE OF PERMITTEE ~
~ TOTAL: ~
FOR: CITY OF EAGAN
r ~ t~?
~ (~~rtif ~r~te ~?f (~rru~rttnr~
.
4Cttp of eagari
lop#rartmrnt uf wudbtng 3wertian
This Certiftcate issueod pursaant to the reqairements of Secdon 306 af rhe Uniforrn Building
Code certijying that a1 the lime of issuance rhrs struclure wns ln compliance witJi the varlou.s
ordinances of the City regulaung buiJding construcdon or use. For lhe following.•
l!n Clnifradoa ",-F 34CiGr"tR- Hldt Rrmit No. i 44 oa„p.-r ryW R3 Zonins nWr;u R! 7ya coan vr
o.m oreWum 03MURAIE 0MMJCT'ICXti' Ad&c„ a4-466 tJEDGWOOD i]RiVE. EAG.AN
DW&,g Addrm 7u 1 VJINOMT'L 0".i Lombry L6. B!$, BRID[.E RIDGE ~
' Daw POVEtAR125. 1988
Buidinw Offkw -
POST IN A CONSPICUOUS PLACE
, . . . r. . . . , _ .
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB N
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECORD
ADDRESS 7"1 I L~ 2mdIrYI ,d) l 1. CITY
OCCUPANT l • OWNER ~
SOLD BY INSTALLED BY
MAKE ' MaDEL
SERIAL NO. 10,2 L1 I~ INPUT O. l M /1 ? 1 Vd
V ~1
THERMOSTAT VENT SIZE I , "I
d..
VALVE TYPE OF LINER
LIMIT ~(l LINEF SIZE ~ •
H,r
LIMIT SETTING I-)O FILTERS: SIZ 2n x 25 l,c6llll( NUMBER
FAN SETTING ~rY1~.Q.d WIRING •
PILOT TYPE =)~v m&ff± TEST TAG
IGNITION MOOEL ~ LIGHTING INST.
PILOT TIMING r ~ 1 I IVIJ ~
~ ~ DATE TESTED
PRESSURE PERCENT COZ ~ •
INPUT CFH ~ I PERCENT OZ COMPANY TESTING
O
STACK T'EMFCft PERCENT CO NAME OF 7ESTER
FOfiM 235 (HEV. 11/89) ~b FORM DISTRIBIJTION: WHITE CAPV - JOB FILE YELLOW COPY CITY
~This reques~ void / /p~
1B pnths from
D lL~ I~ 249 ,C((~ I/ i / ~ GT7.J
Feaue DatB Fr. No. Rnu h-in InsVC~l n
Re u e ' / oPeady Now 2~.WffrNolity Inspec-
~ J ?NO to. When Readv
d;~dficensetl Electricai Convactor
I heroby re0uest inspaction ol above
? Ow^er electncal work 1nstolled et:
Street Addre s. on o/r ,R., CitV
k.;.fNclY~_ _1___ 4_
ect on o. ownshlp Nzmc or No. ftonge Nn. Cnunty
cc uant 1/(P@INTI ~ ~ Phon N
~
Powe i pher Address
Ete<tiwal Connactor (Comuany Namel Contractor's Licenye No.
~y ,.,~,rs r. r c~rmRTr` d
^~q~~6/1Ld9.~1.1~i[7a~tL«wnefAl, kini Fl Ins~,iila~ionl
0 PEIVNOCK LANE
j tion) Phon. Number
L'
MINNESOTA STATE BOAHD OF ELECTqICITY THIS INSPECTION REQUES7 WILL NOT
GriBBa-Midwey BIEe. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 Universilv Ave.. St. Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS
hFhone1619 6420A00 ENCLOSED. ~
REQUEST FOR ELECiRICAL INSPECTION dM ee-ooooi-os
~ See mstrvctions lor completing tnis form on Ceck of yellow coCV.
.~y 82249
D_ "N" Below Work Covered by 7his Request
Romp,te TYPe ol Bwlemg Aooliances WrteE Equiumem Wired
Home Range Te ra Duple.x Water Heater iqhtiny Apt. Buildm~j Electric Heatin
Commraal Bldymace Silo UnbaAer
InAustrial Bldg. Air Conditioner Bulk Milk Tnnk
Farm Otnni Peei v ihe~~ t ci ONi:r
pecnon Fee Below
p Fee ServiceEnlrencaSae h Fee Fexders/Subieeders N Fm Circwts
;WAbove 00 qmps 0 to 30 qmps 0 tn 30 Nn
200 p100 qmps 31to 100 Am ing Pool Above 700_Amps Above 100Amps
ormers Irngation Boort~s Partial"Other Fee
SpeciallnspecLOn
Remarks TOTAL
?
Rou6h-in 1-1)th. Elec
~ soector, herobv
yerlity Ihat the abova
Final insVection has bean /17 , ~ e~ mede.
TNerepuoslvoltllBmonlnalrom ' 4 ~
CITY OF EAGAN N°_ 14 4 8 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt p 7L? 7,3 I
To be used for SF DWG/GAR Est. Value $85, 000 Date DECEMBER 10 19 87
Site Address ` 741 WINDMILL CT OFFICE USE ONLY
R3
Lot 6,_Block 17 SeGSub. BRIDLE OnSiteSewage - Occupancy
MWCCSystem X Zomng Rl
Parcel No.
OnSiteWell _ (ACtuapConst Vn
a Name CORPORATE CONST INC Cirywater x (quowable) Vn
W Address 4466 WEDGWOOD DR PRV Required # of Stories
° City EACAN Phone 454-0644 BoosterPump _ Length 48.67
Depth 52.33
, o Name SAME S F. Total
o a Address Footprint S.F.
U
i- City Phone qppROVALS FEES
' En r./Assess. Permit ~ 451.00
w W Name 9
tz Planner Surcharge 42.50
Address 225.50
Q W City PhOnO CounCil Plan Review
BIdg.Off SAC,City 100•00
I hereby acknowledge ihat I have read this applicahon and state that Ihe Variance SAC. M WCC 525.00
informa[ion is correct antl agree to comply wnh all apphcable State of Water Conn. 525.00
Minnesota Statutes and City,~t~age9.Q/dinances.
//l ~i~/ WaterMeter 67.00
Signature of Permitlee 1/ ?~i' 30$.00
Road Unit
A Building Permrt is issued ro: CORPORATE CONST INC Treatment P1 180.00
on ihe express cond ition that al I work shal I be tlone in accordance with all
applicable State of Minno aNtes and C~f9 of~ ~ rtlmances Parks
Building OFficial l ~ TOTAL $2,421.00
-
SEDGWICK HEATING & AIR CONDITIONING CO. HEATiNG JOB N~py~2
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS. MN 55420 •(612)•881-9000 TEST RECORD
ADDRESS 7y f Gocmdm~,d (~i: CITY l J.IViW l l
OCCUPANT OWNER
SOLD BY A.U.V INSTALLED BY
MAKEI~,h,Q~fAMODEL n~OA VD-l~-1JCJlJ
SERIALNO. '`I / lQZqI4 INPUT l7l/rlAil/ 1,)I V11
THEFMOSTAT LUX VENT SIZE q 1' 1
VALVE ~AJI I ~ TVPEOFLINER .IJ~~~/!IA
LIMIT 1 VXXI/ LINER SIZE
LIMIT SETTING FO FILTERS' SIZ 2, NUMBER
~~yy~~ l1U/ {
FAN SETTING I~/I WIRING LA-Frtolrtij PILOT TYPE TEST TAG ~ 0,M
I ~ ~
IGNITION MODEL LIGHTING INST. II
~7~ IIII ~ ~
PILOT TIMING ,1~~.1 , ~ J DATE TESTED Z / 1 VlJ u
PRESSURE . . PERCENT COs ~/C~
BY
INPUT CFH ~ I PERCENT O, 8,~ 0 COMPANV TESTING ~do,;(
STACK TEM PERCENT CO NAME OF TESTER CC~~ l L.KA// I
PoRM 235 (FEl' 111e8~ 2~ FORM DISiRIBOiIOW WHRE COPT - JOB FRE vELLOW COPY - CITY
' RESIDENTIAL a'S
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConaW ction Reauirements RemodellReuair Reauirementa
• 3 registered site surveys showirg sq. ft. of lot, sq. fl. of house; and all roofed areas • 2 wpies ot plan
(20°b maximum lot coverage allowed) . 1 set of Energy Calalatians for heated additions
• 2 copies ot plan showing beam & window sizes; poured found design, etc ) . 1 site survey for ezlenor additions 8 decks
• 1 set ot Energy Calculations . Indirate H home served by septic system for additions
• 3 cnpies of Tree Preservatron Plan H bt plaHed afler 711193
• Rim Joist DeWil Op6ons seledion sheet (hldgs wiN 3 or less units)
DATE 2- !J ~ VALUATION ~J/ ~Dy yO
SITE ADDRESS I / cX 6 1~ k. ' MULTI-FAMILY B~LDG ~_Y
TYPE OF WORK C0 I2- FIREPLACE(SJ OJ_ 1_ 2
~y
APPLICANT ' rSTREET ADDRES7-0/121 2 C, C,~TY u V TATE 1h ZIP~
r
TELEPHONE # 152 -ff9,5" CELL PHONE #
PROPERTYOWNER (26 S S z TELEPHOliS
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNrSOTA RULES 7670 CATLGORY I MINNL,SO"I'A RULPS 7672
(V submission type) • ResidenUal Ventilatlon Calegory 1 Worksheet Submitted • New Energy Code Worksheet Submittetl
• Energy Envelopa Calculations Submitted
Plumbfng Conhactor: Phonc #
Plumbing syslcm includcs: _ Watcr Softcncr L•uvn Spiinklcr rcc:~-~5~o:00
_ ~'l':,tcr Hca.c: _ I`'o. of R.I. 13ath~~~ `Z~
No. of Batlis
Mechanical Contractor: Phone
Mechsmical system includes: Air Condiuoning Uu Pee:`S70.00
Hcat Recovcry Systcm gy ~
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinan es
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY '
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level 11 24 Storm Damage
? 06 04-plex 0 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Inl Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Atteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg anly) - 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.
_ Foorings (addition) _ Plumbing
Foundation HVAC
Drain Tile • Other
Roof _ Ice & Water _ Fina] _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemen[)
_ Insula[ion _ Retaining Wall
Approved By , Building Inspector
6ase Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Water Suppiy & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
b~ -SO 4/17 1 CI7'Y USE ONLY
LOT (a BL I ~I PERMIT
SUBD. f2451\,JU D RECEIPT
RECEIPT DATE: C) o
2000 MECFIANICAL PERMIT (RESIDENTIAI,)
CITY OF EAGAN
3830 PZLOT IRIOB RD
EAGAN AIIi 55122
651-681-4675
Date: /('C"j-DD
Complete this section on! if you are installing HVAC in a single family dweliing, townhome or condo under
construction and noi ownedoccupied.
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BN 6.00
• Gas outlets (minimum of one required Q$3.00 ea.)
State Surcharge .50
Total $
Complete this section onlv if you are remodeline, addin¢ to, or reairin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration _ Repair _ Other
t~ Fumace AV/~JjyLt ~30 RAUD 4o0s0 _ Air conditioning
_ Air exchanger ~ _ Other
Fee $ 30.00
State Surchazge .5u
Total $ 30.50
Reminder.• Cal! for inspections
SITE ADDRESS: 74/
OWNERNAME: &SS L PHONE#:
INSTALLER'NAME: y"'A A'R'~~ ~ PHONE C/T/G~
(AREA CODE)
STREET ADDRESS:
C[TY: STATE: ZIP:
~
SIGNATUR PERMIT"CE •'JU
ey
, . i
CIT1' USE ONLY
L _ gL _ PERMIT#
SUBD. RECEIPT#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
. " 2000.NECHANICAL PERMIT (CO2+RYERCIAL) ~
CITY OF EAGAN
3830 PILOT 1Qi08 RD
EAGAN, IYN 55122
651-681-4675
Please complete for all commerciaUndustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
.^,ATE: -
WORK 7'YPE: New construction _ Install U.G. Tank
_ Interior Improvement _ Remove U.G. 'fank
_ Processed Piping
R'hen inslal/Ing/removing underground tank, ca11 651-681-4675 jor inspection by fue marshal and
p[umbirtg inspector.
Descripdon of work:
gPPq; !^L, nf cnntract price OR $30.00 minimum fee, whichever is greater. - - - -
• Underground tank removallinstatlazion = minimum fee
Contract price: S x 1%= S (Base Fee)
State surcharge calculate at 5.50 for each $1,000 Base Fee
TOTAL S
SIT'E ADDRESS:
OWNER NAME: PHONE -
(AREA CODE)
TENANT NAME (IIviPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER:
ADDRESS: PHONE -
(AREA CODE) -
CITY: STATE: ZIP:
SIGNANRE OF PERMITTEE
'
o•a
p .
451•OU+
42- 5U+
215- 5u+
627'Oll'r
527•u L) F
6'7•UU+
S07•Uur
180•OU+
2,421•0 U:-
/
• 7987 BOILD G PEEirffT 9PPLICATION - CITY OF EAG9N
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQItVEY, 1 SET OF ENERGY CALCOLATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER MDST DESIGBATE AHICH ADDRESS
ZS DFSIRED. NO CHANGES IiILL BE ALLOWED ONCE BOILDING PEAMIT IS ISSIIED.
MULTIPLE DWELLINGS - RESIDENTI9L RENTAL [JNITS FOR S9LE UHITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SQRVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 7 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
To Be Used For: ~ 4? Valuation: 85,000 Date: I Z d-.r~
Site Address OFFICE USE ONLY
Lot ~ Block ~ On Site Sewage_ Occupancy 9-3
MWCC System Z~Ping ~
Parcel/Sub fl (Y ~~k C On Site Well T e of Const
City Water ~ (Actual) V-N
Owner dr O ~ Q (Allowable) V-N
e~ / fl / .0 / /-y li of Stories
Address [!n/ jr+~,, I/ Length VB. h7
/ Depth 52, 33
City/Zip Code E-252l ZY S.F. Total
/ Footprint S.F.
Phone 9PPROVALS FEFS
Contractor f;-?1n Assessments Permit ~lSI,QD
Water/Sewer Surcharge 42•50
Address Police Plan Review Z25,50
Fire SAC, City 100. 00
City/Zip Code Engr SAC, MWCC 525,00
Planner Water Conn 525.
~
Phone Council Water Meter (017.00
Bldg Off Road Unit 30S' D0
Arch./Engr. APC Treatment P1 1 A,O, L9
Variance Parks
Address Copies
TOT9L ~
City/Zip Code
Phone 41
:,-VqLua-rroN
~
~ .
. . .
GA_ ~ • . .
600 xJ2= '~2.00
y2 X3o = / 260
~JX X= ~2 '7
/33z x58=_--~
$UyS6
SURVEYOR'S CERTIFICATE SIENNA CORPORATION
C 1 /
J `
'
0 lb ~
FQ
• ; ~ ~ea~ 0Q
co
A~ry~ , 2710% tD~
•~~p~ m~' ~ s
~o e Q~,P O o a'13 ati. y~
oQOy
/Q Q~ v ` ,1 Q?.~ BS L0 `~Y,, 3g .
: ' ~ y y~-J~,.,•~`. `~3 ~4p. : \ , .
/ .r ~ 2y p LP. . qOp ~4j•~ ~L /
. ~ ` / Pe 1 . 'o
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/ 3 y 'o
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REVISED II-25-87 TO SHOW
PROPOSED HOUSE BY
/ CORPORATE CONST.
' / ?1
DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 887.8 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 885. o FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 888• Z FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
, Lot.6, Block 17, BRIDLE RlDGE IST AODITION, according to fhe recorded
plat thereof, Dakofa County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERV N HIS 2S?H DAY OF NOVEMBER, 1987.
APPROVEO FOR SIENNA SIGNED: J E . HILL, INC.
CORPORATION ~
BY:
BY :
HAROLD C. PETERSON, LAND SURVEYOR
DlITEfI, MINNESOTA LICENSE NUMBER 12294
m T ~ A A James R. Hil I, inc.
- ~m~o ~ ~ Dr*
o m. o~ Z ~ N m~ m PLANNERS / ENGINEERS / SURVEYORS
O m
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431.9 612-884-3029
' a
e
e
OF Txg . . ~
:1ky~_[~•./ _^"_--E SF.D 0
7
•ber 7 I.' l h~
MO C009 - iveli
12tGIf.
1104.
;}!~>~'_~;f ry'^ L~Io "'~opClua ~cclv~ • ~ . ,
Phone ^at.~is'4d
clta AdCreis ~OT ~glOG6f 3)e1DCE P1DGE /ST
:ontractor _,~?+one
• lu11E1ng Clatsifitatlon: Typa A1 (5ingle Fa-nily 8 Duplex) V~ Type A2 (Residential
~ - (3 stories or ess
•(Other) (Over 1 stories) 'aENERAI iNFORM11TI0N '
I. Buitding PeHmeter ft.
Wall hei9ht (ground W eave) s ft.
~ 2
.
3. 1. x 2. .(above) gross r+all arga Z?,O ft. C+9A.5
i. 8uildtng dimenslons (L) 4p x(M) 3~ • ~~~t4.5 ft.2 roof 5 ftoor area
'i
S. SQuare fcot •rea of rim joist - Floor joist stze (2 z lo ?
'k x Perime[er = Rim o st area -\aO ft2
'
° 6.Doors - Ara
i'. Thic ness n. actor 3
TYpe ot Construct on S ~FerleNter 1G~.32~t-\5.9 a ft: r:
Manutacturer p s ~ c '
~ 1. Total door's perimeter 3 Z. Z $ ft P S. Mlndows: 14iw1acturer ~ o c~ c o State spproved ~(~3
U factor 5 O
TYDE SIZE AR:A (F:.2) !VUMBER OF TOTAL fEET Z
' EACH UNITS
. ~ ~ ~ . (e pO ,
4,'i ~b 4
.SoCo ~4. ~4 ~ ~,~~Q
x; . .
ic ' ~o3C~ \-Z.~a9 l _ \_Z.S9
q. 0 3 O S. 5q `~a . S9
,
ig; ~ _ .
g. Total ft.2 Glass a4Z Z .i,
106 Fireplatt arN: Nidth x hciaht ¦ ~-x Ft:
Z
11 . Expostd foundatlOn: Natght x Perimeter , ra x Ft.
')MPlEtIOM.Of THIS FORM IS REQIIIRED fOR ALl NE11 CONSTRUCTION, MAJOR REMOOELING ANO'BUILOIIGS SEII
f3VED NHERE Et1ER6C. OTHER THAB THE MINIMAI LODE ALLONANCE, IS USED.
t,~ 1
. . . _
A:r
, . ' , . . . ,
~3
~';'s7'si
- ' ' ~ ' • - ,'"1;,, :i . ~xf,
L~ 2Z~~
„ •vr• '+'''4,.
alndow aroa A ft.2 I: Mil1EOMf • ~ `
. So .txa• iQ5.~1
Rtm Joist area A \30 , o ft.Z u rim jolst • .04 .
uxa
Door area A `t.~ J door area ¦ U x A ~ r
~Fireplace area A ~ f;.2 U rireplsce a ~g- U xA• .
Exposed foundation A ft,- 0 foundation U y p. 6:1.3g
Framing area A it.` J franing area Og U x A~ l~ ?
Nef wall area A p\ °t. J wall = U x~• Co~
~r;. .
P?°; -.l . . . . . . . . . . U x a O 4G
,":4. Gross wall area x 0.11 (A-1 single family S du;.;=x ~ allowable U.t A/CoQe (13. above)
. .
x 0.23 (a-Z other resiEentia'.;
x .23 (Other building:`
A .2E (Over 3 storie,-)
UH Must be larger than
a Z Z n S x l' Ccde 138 abave
`,~5. Ceiling framing area (Af) aquals 10= nf c_ilinn area - or the same a5)
44.5 0-9,s ,
~:5A.. Gross ceiling area •(L) ~O x(s+} 3p ft.2
t. ''38 Joist erea (Af) - 10" ceiling area ~q.qs ft.Z
;5C. Net ceilina area (.4C) (15A - 15B) ft.2 '
s;a , • ,
U ceiling x A c¦ _ o z,k 16 x
U framin9 x A f~ . o Z~4 x_
:i4. TQTAI U x A
i<'6. Ceiling area (15A) x 0.026 (A-1 sinyle `amily S Cuplex - code allowable U x A .
T ~
x 0:033 (A-2 other reside^'ial) `
:"r
x 0.06 (other)
BTUH Must be larger than 150 (abo,
A(15,~) x Z lconel" _ n~C,.. °F (or the same as)
fi {0,P
NOTE: Use U and a values oDLdined f^om nps 3 and 4.
,jY' , ' '
.
,
~
_ . _ ._...._..-_.....,._,_n-
- - -
' 4 Rq,r:Lr°t!$(j' ~'f{~i'y~" ~ybr 4;t°~ii
` w. ~ p,~,:~:f,h?:, "i.r, t° •'~Cs ~ .
..i~- 1n }'y,~ ~ {'avv~ ~ yYr,~• , ~~i'; Iy:ILa.. r 1:~ .i s,. e' '
.~~u.:X,::. v~' . r.~ r.14~~;!~.. ~ 7°.~3 . ~P.3~;)n.'., . ~,..r:. ' ~ I: `'•1'r~i' i~<~?,
i i .yl l. , A;5 T.j.` ^ . ' ~ ~ . . ~ ~_~:'u"~~di~~Sa . r' .f - , . i ~ .>'t
.:Is;~ib~'~e:~l• .1":r~;re~..~~C I'r'~I'Ci ily': , ~ ~;1':, , ,
~
. , 0.6.1 ~A4~.,~"I1~ 0.61 .
~ •
, 3\ 5 rn~uaatton 44 . o
.
~ . - 4 . 3 b ,iotst .
5 Q, ce~t~nq ` 5 3
: ~ j~, `
.
•
J O.E1 Air Film 0.61
. 3'i . 9 3 To W i R 'q 41C~
t, ' 1 " ~
.Oz~4 U a A O~ 1~
_ ' .
F!.47 ROJf OR CATHE~I CEILI~~G
~ ~-Oa uT-"e R VAItJE ~ ~
, I I FR;.MIN6 CEiLING ~
~ i ,
~ 0.61 Inslde air fi~m 0.61
~ /
F ~ I Cei i i ng -_-T
I Joist (SLuC ~'.i'
:
.f I
• i ~ Alrusdtcen .
P~
, Roof ~kinq
:u. ~
~ Insul~tion
Bu11t•YP r0of
~ ~ 0. 7 Outsldf •1r H1s~1~ ~
~ . . . ~ ,
rot~t a ~ }
,
R ~ . ;.f.:,,
~ , .
3,',itndow infittrotic~ .5 cfm/1lneai foot of crack
;~,tRSlQential door infiltration 0.5 cfm/square foot or dcor and mininuc c9de re~uiren~ent
; IOn-resld~ntial door intiltration 11.0 cfr/lineal foct of crack "
s Ip 12" concr•ete block rw insu9ation ~.47 R 2.1 '
.12" concr~te plock insulated cores =.26 a 3.8 ~ 4
~~1~ 12" li~hto+~iQAt plotk •.32 R 3.1
;p 12" ligntw~igirt Dloek tdsulated cores =.12 Q S.] ,
~:.J. slayle glass ¦ 1.13: with stori, windosr .54 ~
doublt ql~ss • .SS . r;`,;
~;'J triplt qlass • .41 ' .
- . , ~
~~.ill sxterior wa11t and ceilings must have a vepor barrie~ (C.10 perm i^~x.). •
";~por O~~ri~r awit 0~ on tq~ inside (heate~ side) of wall. ~
, ,
~:,t~por b~rrfers of tfi~ pol~yath~len4 thin film have no R value.
y;
• ,
.':i
r,.
. r~:
• f.;
lfi,.. . ' 4.
k ` ,
l~ ~~*r', ~ ~
, . _ . _`.5;.~ ~ _ - ~ . ~ - . . . ~ . . , , c~;; j
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
~JS CITY OF EAGAN
3~.., 3830 PILOT KNOB RD - 55122
651-681-4675
New Corotrucfion Reaulremenis Remotlel/Reoalr Reauiremenh
? 3 regisfered sRe surveys showing sq. fl. of lof, sq. H. of house 2 copies of plan
and all roofed areas (207, maximum lof coveraae allowed) 1 set of energy calculaflonf for heafed addMlons
? 2 coples of plans (show beam d wlndow shes; poured fnd. deslgn; etc.) 1 sRe suney for exterior addHions 3 dec W
? 1 set of energy calculations
D 3 coples of hee preservWion plan B lot plaHed aNer 7/1/93
DATE: lD L5-:!?2 , CONSTRUCTION COST:
DESCRIPTION OF WORK: NN ~ Ollh~J
STREET ADDRESS: 14I Cc)LKrL-~/
LOT: ~ BLOCK: SUBD./P.I.D. k:
Name: Phone }k: L9~ l ~co ~b 'cp
PROPERTY Last F~rst
OWNER l l~l l/~~~ I l I L~
Street Address:
City State: r''_ Zip:
Company: 6-1c- ~I Phone M:
(area eode)
CONTRACTOR
Sheet Address: License N Exp.
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone Ik: area code ( )
Sireefi Address: ReglstraHon
City State: Z(p:
Sewer S water Iicensed plumber (reaulred tor new conshuctton onlv
Penalty applles when address change and lot change Is requested once permff Is issued.
I hereby acknowledge that I have read this appllcaHon, state that the informaHon Is c ct, and agree to comply with all p ca
State of Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applic
OFFICE USE ONL
5--
Certificates of Survey Received _ Yes _ No L
1999
Tree Preservation Plan Received _ Yes _ No _ Not Required ~
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration 0 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bidgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI. •
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
L& gL 19 CITY USE ONLY RECEIPT O/ 6-o2
SUBD. . ~ RECEIPT DATE:
1998 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required 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 =
Hot Tub/Spa 3.00 x =
Water Heater - hqia4tms-^~ 3.00 x I =
Floor Drain 3.00 x =
Gas Piping Outlet " minimum - 1 3.00 x =
Rough Openings 1.50 x =
Water Softener 'tor dwellings under construetion 5.00 X =
Water Softener ' for existing dwelling 20.00 X =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Spfinklef `forexistingdwelling 20.00 =
AltBfetlofl5 `toexistingresidence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' MPC iic 75.00 =
(new and refurbished systems)
Private Disposal Systems ` Abandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE 50
TOTAL 2A•5z)
-------------------------have -------read--this---- application------------------ - the ----info °rm-ation----- is co-rtect----,----and ----agree----to----comply-- --with---all------applicabl---eC-- i -ryo--f-Eagan----- ordin-----ances----
I hereby acknowledge that I , state that
It is the applicanYs responsibiliry to notiry the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructetl under this pertnit wRhm City property/right-of-way/easement.
SITE ADDRESS: WLt I I ~ Ul,(J~i
OWNER NAME: ~ • V~~c~CL~'l t
INSTALLER NAME: A-Q.D ~Il'7< ,7~F~, TELEPHONE 8l~LG -&C9 Z
STREET ADDRESS: Z (P " ?~N ~D .
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
CD/PERMIT FORMSlRPLBG PERMIT (RES) - 1998
,
. APFLr~ATION FOR PERMIT ~NpTE: PA1MNP OF FEE AT TIME OF
nerLIcaTTau ooes Ncm coN- ;
y 9fITS1PE APPRGVAL OF PIItPffT. ~
SEWER AND/OR WATER CONNECTION : INsesmav oF mqER nNn/oR ca+M :
IKSfALI.ATIOPIS WII,L NpT gE SCED[RkD t
~'pt • ~ UNCIL PIItMIT H1lS HFTId ApPROVm. ~
~f`~nC' •~er*«»»~~~Wre~s~~~+aa~~~:~~~e~~f~~
~ . C@t OF
y GCIcjaP1
(PLEPSE PRINT
1) PROPERTY ADDRESS:
T FY;AT DESCRIPTION•' . A--. t-,. 3-- ,V
(Lot B oc S ivision or Tax P el ID )
IF EXISTING STRL'CTURE, DATE OF ORIGINAL BI)ILDING PII2MIT ISSUANCE:
Mont Year
PRESENT ZONING/PROPOSID USE:
Q CONA'E2CIAL/RETAIL/OFFICE ~ R-1 SINGLE FAMILY
Q INDT-ISTRIAL ~ R-2 DUPLEX (3tw Units)
Q INSTITUTIONAL/GOVII2NNENP ~ R-3 TbWNHO0SE (Three + Units) ( Units)
Q R-4 APARTMENT/COAIDOMINIUM ( Units)
2) ~ NA''E: % ADDREss: 744 ~ -O,-c0/sBf, S0.
ciTx, STATE, ziP:
PHOrrE: -k Q("ca-(oaaa-
,n~.I ~ For City Use
3) A1
' F~ME: _vF-H "zm Pl reums I,icense:
ADDRESS: W , ^ Active
Expired
CITY, STATE, 2IP: Ct4-kr~'~'~, KAjJ Not recordeC
PxoNe: -26 MASTII2 LICENSE # b4 (4I Sta rnitl =a
4) ION
NAME: 0 DRPa2~
ADDRESS : 4"(,o- l.i (o1,o[TD(1
CITY, STATE, ZIP: A--t,) ,
PHONE: JL~ iU(o~ ~
5) ~ ~ • a •a~• • n .i a~
CONI~GTION TO CITY SE[^IER CONNECTION 'Ib CITY WATER O OTfER
6)
~ T[IE GOLD COPY OF 'IM PERNIIT WIIS, BE SENP DIREK'lY,Y TO PUBL,IC WORKS 70 FACILITATE METII2 PICK-UP. i'
PLEASE ALIAW 'IW FARKING DAYS FOR PROCESSING. SOMEONE FROM ZYIS CITY WILL COTdPACr YW IF 7nKRE ~
* ARE ANY PROSLEMS • ,*f
~***~r+**w**r**,t***~***+***+****~***,t,r**+~~*r**+*~*+***r+,r«**+***+*****,t**t*+t+,r****,tr*+~**~rt,t****y
.fOR CITY USE ONLY PERMIT # ZSSUED ,
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLUDE SC'RCHARGE)
$ 67 • D O $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOONT DEPOSIT - WATER
$ -Z S ' O?~ $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ ~q C• L' $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ~y',? 7.L'7lJ $ oZ (J'TJ TOTAL
R CEIPT ~ / RECEI T/ 3
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN P[7BLIC RIGHT OF WAY?
~ YES 'IF YES, THEN A"PERMIT FOR WORK WITHIN PC~BLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGZNEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
~
~
RECORD OF'COMPLAINT
DATE:
COMPLAINT TAKEN BY:
NsME: UiCkI F-- rioLL- fNi3Ack~
ADDRESS: I~ I wi1-ID1tilIl.L GT,
PHONE NO.:_~~'v~ ~3S- 70 3S 9-svg
COMPL9ZNT:NEG.1GQpLK Im Hoos~ 1S Z N~tAgS OcA,
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COMMENTS:
TYPE OF BUILDING. - „
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LEGAL DESCHIPTION
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SIGNED:
1 . . . ,
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA120670
Date Issued:02/26/2014
Permit Category:ePermit
Site Address: 741 Windmill Ct
Lot:6 Block: 17 Addition: Bridle Ridge 1st
PID:10-14996-17-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Josh Mcguire
1424 3rd St N
Minneapolis, MN 55411
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Ross M Opsahl
741 Windmill Ct
Eagan MN 55123
Benjamin Franklin Plumbing
1424 N 3rd St.
Minneapolis MN 55411
(612) 604-4285 X61
Applicant/Permitee: Signature Issued By: Signature