677 Windtree Knoll08/0312011 11:20 9527070334
MAY/18/2011/WED 11:21 AM City of Eagan
411"' City (1E411
3830 Pilot Knob Road
Eagan MN 55122
Phj58i5 ".
Fa`x: (651 -589 �l
ACE GARAGE DOOR
FAX No. 651-975-5694
1
PAGE 01101
P, 001/001
Use BLUE or BLACK Ink
SWAIM
Permit #:O 7 /=2
Permit Fee: Q •(_/o
Nig Rwcelved&
Staff;_
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 I( Site Address:,(%;,,.rC.: 0 /!
Name:
RESIDENT /
OWNER Address 1 City 1 Zip:
TYPE OF WORK
Applicant ls:^ _ Owner contractor
Description of work:
Construction Cost`
Unit #:
Phone:( r1
CONTRACTOR
Muiti.Femily 13ulidlnp: (Yes
Com an
P Y: er(41:1'Jif4 Contact:
Address:% o 9 e ,d «, City:
State: 414zIp;._.S. . _ Phone: 9. 4 0 10
1 No )
ac
Cleanse #: G Lead Cariiifoate #:
(sae Page 3 for additional information)
Does this project require Lead Remediation? ❑ Yes ❑ No
If no, please explain;
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Cagan Issued a porrtrlt for a similar plan based on i master plan?
_ Yes _No If yes, date and address Of master plan:
Licensed Plumber:
Mechanleat Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Pians and supporting doouments that you submit amconyidsred to be pubilo Information. Portions of
the information may he classified as non-public if you provide specific ressons that would permit the Clty to
Conclude that they pro trade secrets..' •
CALL BEFORE YOU DIG. Cali Oophmr State One Call at (581) 4544002 for protection against underground utility damage.
Call 48 hours before you Intend to dig to receive locales of underground utilities., yay.QpmilgrstateonaCaU.orq
I hereby aoknowledp that this information le complete and accurate: that the work will be In conformance with the orolneheea and codes or the City of
eagan; that t understand this le not a permit, but only an application for a permit, and work is not to start without a permit; that the work will ba In
accordance with the approved plan in the case of work which requires a review and approval of • arta.
•
x !✓tile
Applicant's Printed Name
x
Applicant's Signa
Page 1 of 3
City of kap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 6754694
Use BLUE or BLACK Ink
For.ti
Permit*:
524
Permit Fee;
Date Received:
Staff:
2011 SEWER AND WATER REPAIR t1DISCONNECT PERMIT
J
Date:
4/ City Sewer
City Water C/ Repair
Disconnect
Fee3• ss5.o0
Street Address for Proposed Work
OWNER
Phone;. /
Name: 7, ►7 sr �'� ty, '
k?o2-
!,/,/�
Address / City / Zip: lfV�,i�1----
Applicant Is: Owner Cantracter
Licensed Pipelayer Master Plumber
Name: 1 4 clkk-%..-
Address / City / Zip: 1-1-4.30 (Vag 4' L.
Pipelayer Training Certification Card #: 4072 V
Property Owner
or Master Pim**, r License #
0 i12 61 (6 1,
i acknowledge that the information Is complete and accurate and that the work ivill ba in conformance with the ordinances and codes
of the City of Eagan and the State of MN Statutes. I understand this is not a p4rrnit, but only an application for a permit, and work is
not to start without a permit.
W4 is e_
Applicant (PON Name) APO
oaf- e 4,4 (4 1 -
CALL
CALL BEF • RE Y • U DIG Call Gopher State One CaII at (651) 464-000k for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. 1www.noPherstateonecall.orp
E/e--
411011b
C!ty of Eaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit#: "--1,���
Permit Fee:
Date Received:
Staff: ((At"?
2010 RESIDENTIAL BUILDING/PERMIT APPLICATION
Date: I )/a`i/aom Site Address: &71 W MlCP9i. , CAVA /
Tenant: Suite #:
RESIDENT / OWNER
Name: hL 2/b)PY Phone: Cela—t'ai /OA?
I
Address / City / Zip: 1,211 W )Y!ll * kok.e. E.rV
Applicant is: Owner 1,, --Contractor (t
TYPE OF WORK
Description of work: CIS2/IiPitt toped..1
Construction Cost: / � serc, — Multi -Family Building: (Yes / No i----7---
--'TCONTRACTOR
CONTRACTOR
Name: 1l l)flkL5 l iiiit Ti Oanii, az License #: c2.06 355 -82r
Address: $iYO /9 VT e City: ,rier Ztth•
State: RA Zip: 6-66-- a_ Phone: Nom'"' 0"' O15-4,
Contact: lErdr l�%i dMe Email: 4MC 1/t,eOY1,/4 l/fGGf /.0 2z_
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Port ►ns of
the information may be classified as non-public if you provide specific reasons that would permit lite City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.org
1 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.
Applicant's Printed Name
Ap • ('cant's Signature
Page 1 of 2
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
1. Alteration
Replace
_ Retaining Wall
DESCRIPTION
Valuation
Pian Review
(25% 100% y;
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
1134i
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Roof: _Ice & Water _Final
otir Framing
Fireplace: _Rough In _Air Test _Final
0f. Insulation
Meter Size:
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
iy7
89
— 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
1116- MCES System
2.CO7 SAC Units
R-1 City Water
Booster Pump
' 7 PRV
Fire Sprinklers
.11110
Sheetrock
Final / C.O. Required
jfr Final / No C.O. Required
HVAC
Other:
Pool: _Footings Air/Gas Tests Final
Siding: Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: _ Footings _ Backfill — Final
Radon Control
Erosion Control
, Building Inspector
"'✓ 337 $ M 1161 & - 6 N
Page 2 of 3
pk)- SoLS
City of Etan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit #:
Permit Fee: - �U
Date Received:�-�."
Staff: 6.7
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1 1,9- (tom Site Address: Lein V3 ii [,"-- rI w
Tenant: Cs 10'' v
\
J
Suite #:
RESIDENT RESIDENT /OWNER
•Ji) � tf Phone: ( l �"(0-1P ( OD -
Name: , ltyr
Address / City / Zip: Om Ace, 6A
CONTRACTOR
Name:f --t ---t, COI\ License #: Q1t t
b�"Pv
Address: V\' Vi City: U� V 1l,.L!
State: \A R. Zip: 1Phone: q3h141 ••
Contact:adbiThlekn'1/ mail: C�
�iCili' 1
TYPE OF WORK
New - Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _
(y
Description of work: i 1 S Vvf p
PERMIT TYPE
RESIDENTIAL
Water Softener
Water Heater
Add Plumbing Fixtures ( Main / Level)
_Lower
Lawn Irrigation (_ RPZ / PVB)
_
Water Turnaround
Septic System
�
_New
Abandonment k `CL,jj'` aL � �
_
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
burned 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.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
accor ance with the approved plan in the case of work which requires a review and approval of pla
ti -
eiocti cL.lap
Applicant's Printed Name App ant's Si
v+.
ure
0
~
r~
&rtifirate of (Vrrupanry.
titp of eagan
appl'$tttPitY Df iwbmg inapP['ttDl1
Thrs Certtficate issued pursuant 1o the requinements of Section 306 of !!re Uniform Burlding
Code certifying lhat at dte tinie af issuance lhrs structare ww in compliance with ihe various
ordinances af the City regu/ating building consrruclion or use. For 1Jce followeng:
ti,e chnitnuoo SF M/GAR ews. nan rm. 18699
00-n•-r 1M R3/141 Zoning Db,,;a R1 .n,a Cow VN
owwO(eUMwMPX"W IESZGN 6 BUIID,,,3772 RMZM DRZVE, EACAN
677 Wi~RFE KM Loom;n, L8, B 1, WDIDrlRPE 8Ili
Dam 4/24/91
1-1 . POST IN A CONSWCUOUS PLACE
.
_ ~
FEa 7, 1991 ~
DATE: I
w' 677 WINDTREE KNOLL (!lQNTGOMERY DESIGN & Si1ILD)
• RE:
X
Your Sewer & Water Permit for the above property has been completed. It will be held at the
Pubqs Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CkCL PUBLIC WORKS (4545220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer 8 Water Permit for the above property cannot be coFnpleted for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notlce.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
t o~fE~agan.{ij~rTAf ~ejW R~FPOLICY.
1991 ~ic~eBnsaingWwith~h~e lgi~y
Secretary, Building Inspections Dept.
.
CITY OF EAGAN 18699
4 ~fr
3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
` PHONE: 454-8100
BUILOING PERMIT Receipt #
Tobeusedfor fiF DWG/GAR Est.Value :102,000 Date FBa 7 , 19 91
877 WI~E IMLL
Site Ad t ess
OFFICE
Lot Block Sec/Sub. USE ONLY
Occupancy M ~ i
Parcel No. FEES
Zoning 6~~.~
W
AddreSS Name ~AY D98Iqi 6 DIJILD ~t ~ Bldg. surcharge Permit
~IDCL~ii00D D!~ (a~owable) 51.00
0 -
. City EAGAJI Phone r oi stories ~ 4~.00
Length ~ Plan Review
o Name oev~ - sac, cri 1~'~
~ Address S.F.Total - SAC,MCWCC 650.00
~ City Phone S.F. Footpnnts - "0.~
On 5ite Sewege _ Water Conn
?.~w Name or, sne wen Water Meter
~I Address MWCC System
-r Acd. peposit
City Phone Cicy water - ~ ~
PRV Required - SNV Permit .I hereby acknowlege that I have read this application and state that tha Booster Pump _ ~~rcharge 150
hlormation is correct and agree to Comply with all applicable State of 76.00
- Minnesota Statutes and Gity ol Eagan 9lrdinances. Treatment PI
' Si9nature of Permitee,,4-L / ` : ~ f . ~ ~ } • APPROVALS qoad Unit 370•00
A Buildir?g Permit is issued ta 'MONTGOMERY DSSIqI Planner - Park Ded.
on the express condition that all work shall be done in accordance with all Couricil
applicaple State of Minnesota Statutes and City of Eagan Ordinances. gldg. pn. _ CoPiBS _ 8uifdirlg Official ~ ' Variante - TOTAL 3,324.5b
PWmi! No. Pwmit Holdw DrM ToMphonw JF
WATEA /O Od-
SEWER J
PL?,MBING q as o
HMA.C. a s S~~-~a~s
ELECTRic IJO,5 3 G 51
kap.o+?wi ate lnap. camrtmvts
Foowg$ I
Founda,io, F?a^M^s ! S E ess
Rooke
P-0 Pns. 1(44
aouen ?+tg_ FKeplace
Final H~
FnW Plns.
coosL Me+er Pws. insveaa - raoti+r Pawnbe?
Engr.IPlan
Bldg. Final Z l_ S
Deck Ftg.
Deck Final
WeN
P?. Disp.
SEWER & WATER PERMIT . OFFICEySE ONLY
CITY OF EAGAN METER #~y~za~3S PERMIT DATE 02/07/91
3830 Pilot Knob Rd. Q3 d 5 3a
Eagan, MN 55122-1897 cHiP# PERMIT # 11803
METER SIZES ~C~- hQ-b.p. RECEIPT # C 12031
DATE A$ 7, 1991 ?SSUE DATE~" B.P. RECEIPT DATE 02/07/s1
_ PRV - BOOSTER PUMP
I 677 WINDTRBE IQdOLL
SITE ADDRESS PERMIT REQUESTED
LOT 8 BLOCK 1 SEC/SUB WINDTREE $TH
x SEWER A WATER - TAPS
APPLICANT:
ADDRESS: - COMM/IND X RESIDENTIAL
CITY, STATE ZIP R NEW - EXISTING
PHONE:
NEU PLUMBING Lawn Sprinkler Meters are to be instalied
PtUMBER: Ahead of Domestic Meters on Water Line.
ADDRESS: 1372 W LARPENTEUx Credit WIL OT be giv n for Deduct Meters.
CITY, STATE FALCON HEIGHTS MN Zip 55113 }`J PHONE:
644-9969 k
` AGREE O COMPLY,~ IT OF
OWNER: MONTGOMERY DESIGN & $UILD EAG RDINANCE '
ADDRESS: 3772 RII3GEW00D Ax
ClTY, STATE EAGAN MN ZIP 55123
PHO~IE: 681-1773 SIGNATURE WHEN METER ISSUED
~
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOFi INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. ,,r•
'
SEIA(ER &WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN MEfER # PERMIT DATE 02107191
3830 Pjlot Knob Rd.
Eagan, MN 55122-1897 CHIP # PERMIT # 118A3 {
METER SIZE B.P_ RECEIPT # C 12031
• DATE i~ hl 7. 1991 ISSUE DATE B.P. RECEIPT DATE 021071 91
PRV _ BOOSTER PUMP
y
SITE ADDRESS 677 VINDTIYZ-M1-1- PERMIT REOUESTED
LOT 8BLOCK I_SEC/SUB WIND7RES 8?N
X SEWER X WATER - TAPS
APPLICANT:
ADDRESS: - COMM/IND _X__ RESIDENTIAL
CITY, STATE ZIP Z NEW _ EXISTING
PHONE:
Lawn Sprinkler Meters are to be Installed
PLUMBER: NEU PL1N$IliG Ahead of Domestic Meters on Water Line.
ADDRESS: 1372 Y L4RFEtITS[1R Credit WILL NOT be gi ven for Deduct Meters_
CITY, STATE FALCON REIGII'1'S 191 ZIp 55113
PHONE: 644-9469 \ 4t t. t: L.- ,
'I GR15E 10 COMPLY VITHC1f~ OF
OWNER: MONT00NgY DYSipI 6 D1R1D EAGAN.ORDINANCE9'
ADDRESS: 3773 EIDGVi00D BR
CITY, STATE ILAGSN 1IIi ZIP SS1214
PHONE: 683-1773 SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALI 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
~ r .
~ CASH RECEIPT ' .
.
CITY OF EAGAN
y t
3830 f'IIOT KNOB ROAD
E_AGAN MINNESOTA 55122
A.RN-)UNT
_ ~----------~_~~J
. ;
C_ E J 0_ COl LARS
,m
. ; CASH ~~CNECK
Fw
w • ~ - L~.c---~
-
FUN[, ~ OWECT AAAOUNT
I
_ _ _ ~ _ -
i
Thank You
B•r ~ 7~ /i£ _s.~ , L.. L'
¦ - 12031 1M~iie--PaYe~'s CaPY
~ v rsuow--Paeurg CoPy
PMk-fde Capy
~35~r867 ~ • ~ ~ os~s
,C k'
Repuest Date Fire No Rouqh-in Inspedion ~
_ / ReQmred, ? Reatly Now YJ W~II Notdy Inspector
~es ? No Wben Ready'+
I;2ficensed coniractor O owner hereby request ins ection of above electrical work at
Jo0 Atltlress (Slreel, Box ar Faule No ) Qty
SecOon No Township Name or No Range No Coun
Occ 1(PqINT~ , y P e No
Y'
Power plier Atltlre55 •
E ec omracror ~COmpeny Nama) / Contraator5 Licerts o
S~
Ma~ling Atltlress ICOmracror or Owner Makmg Inslallation) ~j
I / Cx
Aulhoraetl & aWre ~COmracior/Owner Making Inslali Lonl Pbone Number
~i U'1O.3~o
MINNESOTA STATE APD OF ELECTRICRY THIS INSPECTION REOUEST WILL NOT
Grlggn-Mitlway BIEg. - Hoom 5473 8E AGCEPTED BV THE STATE BOARD
I 1821 Univerepy Ave., SL Peul. MN 55106 UNLES$ PROPER INSPECTION FEE IS
Vlw. (61]) 663-0800 ENCLOSEO
3 REQUES~R ELECTRICAL INSPECTION ee-ooom-oe I
~/yl s~ ~
Mp See iirsimaions lor wmpleung this torm on back ot yellow ropy c
?
57067 JYJ
W "X" Below Work Covered by This Request
e Ad5 Rep. " 7ypeofBmlding AppliancesWired EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Electnc Heahng
Apt. Building Dryer Other (Specdy)
Comm /Industnal Furnace
Farm Air Contlrtioner
Other (specrly) Comractor's ilemarks
Compute Inspection Fee Below
# Other Fee # Servme Enirance Srze Fee # Grwns/Feeders Fee
Swimming Pool 0 to 200 Amps ~ 0 to 100 Amps ~
Transformers Above 200 _ Amps Above, 7 0_ Amps
SIgnS InspecrorSUSeOnly' TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED OISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONT .94 41
I, Ihe Electncal Inspector, hereby Ro~9n-~~ oa~ _-p
certif that the above in5 eCtiOn has ~
Y P pinai oate
been made.
OFFICE USE ONLY
TNS request voitl 18 monlhs imm
CITY OF EAGAN No 18699
~ a 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121
PHONE: 459-8100
BUII,pING PERMIT ' Receipt p
7obeusedtor SF DWG/GAR Est.Value $102,000 Date FEB 7 , 79__4j--
SiteAddress 677 WINDTREE KNOLL
Lot $ Block 1 Sec/Sub. WINDTREE 8TH OFFICE USE ONLV
Parcel No. occuPancy R-3-iL-1 FEES
Zoning R-1
a N2me MONTGOMERY DESIGN & RUII.D (ACtuaryConst V=N BIdg.Permil 647.00
w
; Address 3772 RIDGEWOOD DR (Allowable) V-N 51.00
0 Surcharge
City EAGAN Phone 681-1773 xoistones -
Length Plan Review ~+20 _ 00
. o Name SAME oevm 321 snc. ciry 7 no _ no
~a Address SF.TOtal - SAC,MCWCC 650.00
~ City Phone S F. Foolprinl5 - '
On Site Sewage - Water Conn 660_ nn
~
w W N •
ame 90On Sila Well Water Malar
ti MWCCS stem X
Address Y Acct. Deposit 30.00
aw City Phone cirywater X
PRV Required _ S!W Parmil 30.00
I hereby acknowleqe ihat I have reatl this application and slate that the Booster Pump - S/W Surcharge • Sn
information is correcl antl aqree to wmply with all applicabla State of Minnesota StaWtes an City of Eag n dinances. Treatmem PI 276.0
0
SignatureofPefmite / APPROVALS RoadUnil 370.00
A Building Permit is issued Planner - park Ded.
on Ihe express condinon ihat all work shall be done in accordance wRh all Counal
applicaDle Stale ol Min~nesota Statutes and Cny ol Eagan Ordinances. eldg Ofl. _ ~Pies
0
Building ONicial I Ictiq ~ei+ 1 * Variance - TOTAL 3,324.5
Address: 677 WINDTREE Id9pL,L Lot 8 Blk I Sec/Sub WITIDT_REE 8IH
~
These items were/were not complete at the time of the final inspection.
D • 4/24/91 Yes No Tnqpector,
Final grade (6" from siding) Permanent steps - garage ~
Permanent steps - main entry
Permanent driveway
Permanent gas L,~
Sod/seeded grass ?Trail/curb damage
Porch I/
Basement finish ?
Deck ~
Please verify vith the builder the removal of roof test caps from the plumbtng
system and the shut-off of watar supply to the outside lawn faucet before
freeze potential,exists. ~
White - City copy Yellow - Resident copy Pink - Contractor copy
gb-7a0 (0 9-~ gs
2007 RESIDENTIAL BLTILDING PERMIT APPLICATION ClMa ~
City Of Eagan I ~Ff ~7~ES~ ~
3830 Pilot Knob Road, Eagan MN 55122 ~
Telephone # 651-675-5675 FAX # 651-675-5694
New Construclion Reouirements RemodeVReoair Reuuirements Oifce Use OnN
3 regalered ste surveys showuiq sq. tL of lat, sq. N. of house; and all roofed areas 2 copies af plan showing footings, beams, joists CeA of Survey Recd _ Y_ N
(20%maximumlotcoverageallvxeC) lsetolEnergyCalculaUonsfaheatedaddihons SoilsRepoA _Y _N
1 SoJs Report if proposed huilding is to be placed an disWrbed soil 1 site survey for addi6ons 8 decks Tree Pres Plan Recd Y_ N.
2 rqpies d plan showing beam 8 window sizes; poured found design, etc. AddAion - inrAcafe if orrsife sepfic sysiem Tree Pres RequireB Y_ N
1 set of Energy Calculations Oo-site Septic Syslem _ Y_ N
3 copies d Tree Preservation Plan d lot platled aRer 7/7193
Run Jdsl DMail ODtims selection shcet (buBcings wAh 3 a less units)
Mnnegasco merhanical ventilafion form
Plans are considered ublic information unless ou state the are trade secret and the reason.
Da[e /Q / Q 1 Construction Cost (X ~h .5~0 .00
Site Address (n I~ ~.U (Wc~~l7LfLQ /C./UO C C UniUSte # !
~QN1
Description of Work i oyyCTS 3 N 4.e.3 444,"-'
Multi-FamilyBldg _ Y_XN Fireplace(s) x 0 _ 1 _ 2
Property Owner Uc ~ ! Cl'L~ WW-~ r'P 2~ OlA4.v Telephone # ( ~j ( )
Contractor ltwUr(~ ~tA-1 CO.-d
c.~. F,Ii/~ez-L-L'
Address al`~~(p A-lrk City
State Zip~ Telephone # 't'o~i - 3D, D, Z
Q, _ _2046s( 6 _ (a- 1-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Enefgy Code Calegory , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submission type) • Submitted Submitted
. Energy Envelope Calculalions Submitted
In the last 12 months, has The City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber nFg 0 P H Telephone )
Mechanical Coniractor 11 I nr~2 A, " Telephone ~
~
Sewer/WaterContractor Telephone ~
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved pla 'n the case of work which requires a review and
approval of plans.
(kg ~~ApplicanYs Printed Name ~ Applica~ 's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
71 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) O 31 Ext. Alt - Multi
? 03 Otof_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 ExtAlt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (saeenlgazebo/pergola) ? 36 Multi Misc.
? OS 03-plex ? 11 70-plex ? 79 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
19 33 Alteretion ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
~
? 34 ROplacem¢nl 'DOmolitlon (Entire Bldg) -Givu PCA handout lo applicant
DOSCrIDtlOf1: Water Damage _ Yes '
Valuation Z.~a°0 .O c"~ Occupancy S-~.G 1 MCES System
Plan Review 100'% or _ 25%
Census Code y3 / `f Zoning Ciry Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinktered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) FinaUC.O.
_ Footings (addition) ~ FinalMo C.O.
Founda[ion _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool Ftgs Air/Gu Tesu Final
~ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
Fireplace _ R.I. _ AirTest _ Final _ Windows
?0 insulation _ Retaining Wall
Approved By: Building Inspector
- - - - - - - - - - - - - - - - - - - - - - - - - - - -
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
ToWI
^ 2006 RESIDENTIAL MECHANICAL PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellingc & townhomes/condos when permits me required for each wit
Date I / lo_ / Q L9
Site Address b -77 wirjA4j~eL~F1 Unit #
Proper[y Owner G~I~,..( Telephone LS/) 7,S~ I S7
Contracror VYIS i
Street Address v_k-n v City &4,Vns 0'11( i
State M n Zip ,SS.33-7 Telephooe# (qCA) 89~f-6Z~O5
Boad Expires:
The Applicant is _ Owner ~ Contractor _ Other
Add-on or alteratiao to eaistiog dwelling uni[ $ 30.00
~ fumace _Additional V/Replacement _ New
air exchanger
~ air conditioner
_ heat pump
,
other
~~i~, IAN ' ° 2f~e ~
StateSurcharge 1~~ I $ .50
Totai $ 3b . ~D
I hereby apply for a Residential Mechanical Pertnit and acknowledge that the information is complete and accurate; that the work will
be in confocmance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that 1 understand this is not a
pertni[, but only an appliption 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 plens.
gt4_11_~1 I c, k-Ct'561-) &4-h iv i ekeKsal
Applicant's Printed Name ApplicanYs Signature
q 7(~qq RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conetruction Reouirementa Remodel(Reoair Requirements
• 3 registered site surveys showirg sq. k. of IoL sq. ft. of house; and all mofed areas • 2 copies of plan
(20%maximum lot coverage allowed) . 1 set of Energy Calculations (or heated additions
• 2 copies of plan showirg 6eam & wiridow sizes; poured tound desgn, etc.) • 7 sile survey for e#erior additions & decks ~
• 1 sel of Energy Calculations . Indicate if hane served by septic syslem for additions
• 3 copies of Tree Preservation Plan N lot platled after 711193
. Rim Joist Detail Options seledion sheet (bldgs wilh 3 or less unrLs)
C~o
DATE / I t'Z VALUATION g
JOB SITE ADDRESS A4_-~.,;,P -7:~Z
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER
TYPE OF WORK _ FIREPLACE(S) _ 0_ 1_ 2
APPLICANT PHONE# 6 S"7-~a7-c7b'C•F
ADDRESS (4 Cf7. Co4n, ~-!'CGccQ YYL.~ ZIPCODE =Z
PAGER # CELL PHONE # FAX # ~s / -02 ~7 -vXa k
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMP
APR 1 5 2002 D
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Sub itted
- Energy Envelope Calculations Submitted By
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone
PlmnUing Systcin Includes: VVater Soltencr I.awn Spriiikler Pec: $90.00
Watcr Hcater No. of R.I. 13allis
No. ol'Batlis
Mechanical Contractor: Phone #
Mech.mic.il S}'stcm Includcs: Air Conditioning I'cc: $70.00
Hcat Rccovery Systcm
Sewer/Water Contractor: Phone #
All above information must be submitted prior to processing of application.
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 O/rd7inances.
Signature of Applieant l-)-"b"-etn,
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
,9L02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt- Multi
/
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ^0 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MCIES System
Census Code Zonina Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation H V AC
Drain Tile O[her
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco S[one
_ Fireplace _ R.I. _ AirTest _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee 23~
Surcharge 3. ~o
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plan[
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total ~a~ aS
1 ~ ' '
• 1991 BUILDING PERMST PPLICATION
CZTY OF EAGAN
SINGLE FAMILY DWELLINGS M[JLTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLZES WF1EN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TZME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN CDMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For ~ ~ Valua ~
tion: / . Date: -(qF
Site Address ~ QQ ~ LIti ? ) OFFICE USE ONLY
~.i`IC.iG~
i
Lot 9!P Block FEES
Occupancy 1Z 3M-1 Bldg. Permit yr/iaD
Zoning R- I Surcharge 51,00
Parcel/Sub Ew-;P Actual Const V-N Plan Review q20,0o
t Allowable V-N SAC, City /O1~J00
Owner~~$~~ # of stories SAC, MWCC ((J~O(7
Length '7,54o Water Conn. iD0
Address Depth - 3 ZT Water Meter ,DO
S.F. Total Acct. Deposit 30,0V
City/Zip Code Footprint S.F. S/w Permit 3Q Ao
S/W Surcharge ,Sb
Phone On site sewage_ Treatment P1. 2 6,JC~
Dn s'te well Road Unit D'00
Contractor System ~ Park Ded.
City water Trail Ded.
Address ~17Z fRV _ Copies
ooster Pump _
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone ~Planner _ Lot Change
~ ~ Council TOTAL ,o
Arch./Engr. • ` Bldg. Off.
Variance
Address
City/Zip Code
Phone #
agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
T ~ a . i
1/A L U A'~ '
~ AtL4G E
2zK21= 484X ~5; ~~U
~w4, S`
_ /D li o[2 l01 000-
mURYEYOR'S CERTIFIorI4TE MONTGOMERY DESIGN 8 BUILD
+ , eae.s
t
~ 9,.~
0
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m w
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0.0' ;'l g\ ~ ~a~~ ~ ~g ?
o
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a13 / ,
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S ELCV.=90100 ' ~pr9pi,p 8
7HDUS
~ o 'T r
4q 1 A ~ i
u. ` 291D9 _ oi.s
112.00 _-At'-' 10 1 ~ 40 N ~
/ Te o-24 ~ - ~ F; e,~,141?3 ;I ws 3,
~
L.L~ 1 1
-NOTE: NO iftFIC SOILS INVFSTGATION HAS 8@EN COMPLETED
ON Tltt LOT BY THE 9URVEYOR. TtE SUITABILITY OF rg~~~ ~~;GINE~RIP'sG ~l r,t7T
SOILS Tb SUPPORT THE SPECIFIC HOV9E Pqppplg0 IS
HOT THE FtE9POMS184LITY OF THE SURVEYOR. NOTE: BULDINQ DIMENSIONS SHOWN ARE FpR rqqQpN7qL
6k VERTICAL IOCATION OF ST'RMTURE O?dY. WE
° DENOTES PROPOSED SURFACE DRAINAGE oNS~ftg,~ OuiLrnroO !e rDl~lpprlcN
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - qp(.Q FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 8q4-,7 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - q p,3.0 FEET
WE HEREBY CERTIFY TO MONTGOMERY DESIGN 8 BUILD THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 8, Btock I, WINDTREE 87H ADDITION, accordinq to the recorded plat thereof,
Dekoto County, Minnesota.
IT DOES NOT PURPORT TO SHOW iMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 5TH DAY OF FEBRUARY , 1991,
i+ROroseo GRADES sHOwN WERE SIG D: J MES R. HILL, INC.
~ WINOTIEE H TH 9 B MApDfT10N
DATEDN7k~E87R 9ASSOC., B ,
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
m ~1 c~ p W O
ai <N
m ~ J ~
O p~ A JamesR. , YIllI~:J3
~ r°~ o~ Z W~ m~ m PLANNERS / ENGINEERS / So m N - [
9401 J^"'rS AVE. S e BLOOMINGTON, MN. 554----- - - - - -
i ~
EXTERIOR EhJVELOPE AVERAGE "U" COM!'UTATION
MONTCOMERY DESIGN & EUILD CO
3772 RIDGEWOOD DF2IVE
EAGAN, MM 55123
681-9230 NANTUCKET
ZIBLEY AfdEA U U Y. AREA
REBUIRED
1. TOTAL WALL AREA 2083 .11 230
2. ROOF AREA 816 .026 21
ACFiIEVED
A WINDCW AREA 168.32 .33 56
B DOOR AREA 40 .23 5
C SLIDINC GLASS AREA 40 .65 26
D FIf.E^LACE AREA 0 .2 0
E 'rJALL FRAME AREA 208.8 .095 20
F NET WALL AREA 1630.88 .038 62
G RIM JOIST AREA 116 .0436 5
H FOUND WINDOW AREA 0 .5 0
I FOUND ABOVE GRADE 58 .068
3. TOTAL WALL AREA 178
J SKYLITE .5 0
K ROOF FRAME 81.6 .032 3
L NET ROOF AREA 734.4 .0227 17
4. TOTAL ROOF AREA 19
SUM OF 1.+2.
°UM pF 3.+4. ~27~
~
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 698
~ DATE: 05/08/00 TIME: 14:35:43
i
ID:
NAME: M.J. MOSER CONSTRUCTION
C3210 9001 677 WINDTREE KN 97.25
2155 9001 677 WINDTREE KN 2.00
I
I Total Receipt Amount: 99.25
CR129444
USER ID: JAN
**,t~*~+++~+,r+t+i......++++*****~**x*t_t~~*_I
~ I~Q 7~ ~ 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
l / CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-881-4875 ~
New Conshuctlon Reaulremenh RemodeUReoalr Reaulremenh
> J repisteretl sIte wneys flwwlny aq. fl. d bt, sq. H. of house 2 coPies of plan
and Qj roofed areas (20% mmcimum lol coveraae allowe~ 1 set of enerpy cdculatlons for tfeated addlMOns
> 2 coples of plans (show beam d wlnOOw alzes; poured Ind. Oeslqn; etc.) 1 sife wney tor extedor addiNOns d tlecb
+ 1 sel of eneryy calculanona
: 3 coplee of tree preaervaXon plan If lot platted otter 7/1/93 Oi
DATE: S, d 0 CONSiRUCTION COST: q-S
DESCRIPTION Of WORK:
STREETADDRESS: ~ G1/'rOT2~j6 ~i•o~ L
LOT: ~ BLOCK: SUBD./P.I.D.IY: Mhdf7'tt 7JTf~
Name: Z/ 13 Phone Y:
PROPERTY Last Flrg
OWNER
Sfreef Address:
Ciy Stafe: Zip:
Company.A T/vOSf/Z Phone9:
(area code)
CoMrtnCrOR V6 r"
Sheef Addreu: A Llcense #
~~cly stare: !f] r zip:
ARCHITECT/ Name:
ENGINEER Company:
Telephone A: ( ) •
Sheef Address: ReglshaNOn 9:
CNy Sfate: UP:
Sewerfwater licensed piumber (if tnstallina sewer/waterPhone
1 hereby aeknowledqe Ihat 1 have read Ihis applicatbn, afafe fhat the tnfortnatbn is conect, and agree fo comply wNh atl appqeable Sfate
of Minnesota Statutea and City of Eapan Ordinances.
' Siynature of ApplicantG~~,
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No 14Ay - 8
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex 0 13 16-plex ? 21 Porch (3-sea.) ? 31 F_xt. Aft - Multi
O 02 SF Dwelling ? OS 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Att - SF
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Parch (screened) ? 36 Muki
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-piex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bidg. 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
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 'j
S/W Surcharge
Treatment PI. ,
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
CITY OF EAGAN FOR CITY USE ONLY 3U~'S
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT # 1.12rY 5
PHONE: (612) 454-8100 RECEIPT # ~V~
M4`HA~1xL"j~,7, DATE : o~ 8 9
~',S'TDE~1''TAL:. PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WFIEN PERMITS ARE REQUZRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ~C ADD-ON MINIMUM $15.00
ADD ON ` HVAC 0-100 M BTU 24.OOC0~)
REPAIR _ ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
OWNER NAME: _ MO nl ~ C~o r~.~L'I \ U~3 i a rJ d- 4~jU~ ~-Q
~o
(P 77 SUBTOTAL: $ a~
SITE ADDRESS:~ Wlnlf~"2-&L l^CrJoL_'l- STt1ia SUTcCiiAIcGE: .50
LOT:~ BLOCK ~ SUBD. W~ n1J~!INLe~E TOTAL:
INSTALLER: ,/h~~~
f~~ I 1 ( /
aD~xess: Burnsville Heating & A/C, If1C. SIG TURE OF PER2 EE
Rtiode s an ve. o.
cITY: Savage, MN 55378EIJ92
PHONE
~~OMMERCTA~,ITNDASTRIA7.:' PLEASE COMPLETE THIS PORTTON FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE: FEES
OWCIER NAME: 18 OF CONTRACT FEE.
STATE SURCHPF.GF. - $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
LOT: BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 18 $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT # 9.~
PHONE: (612) 454-8100 RECEIPT # C
~'LUkCBI!?G T'~1~XT DATE: o'L
RESTDENTTAL:, PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMZTS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON SHOWER 3.00 3'
REPAIR WATER CLOSET- 3.00 j
~ BATH TUB 3.00 3
LAVATORY 3.00 ~
OWNER NAME: I1~7s,/~ KITCHEN SINK 3.00 ~3
SITE ADDRESS: 6~77 I./L,,Ikee /livoll ~ HOTLAUNTUB/SPADRY
3.00 3 3.00 -3
LOT:~ BLOCK SUBD. Al~ FWATER LOOR DRAINR 3.00 L
GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) 3.00 3
ROUGH OPENING
ADDRESS: 9lc/ oslow OTHER S 1.50 ySD
WATER SOFTENER 5.00
CITY: Ln~s1n! ,//!~y ZIP: 537.23 _ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE aW- !`lC2`F
i
SUBTOTAL $
7l co. ST. SURCHARGE .50
SIGNATUR OF PERMITTEE ,W.0 O
TOTAL:
dOMMERCSALJ,INDIIST&IAI:: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE; FEES
OWNER NAME: lE OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
LOT: BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 18 $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
(SIGNATURE) .
FOR:
CITY OF EAGAN
Zoos RESIDENTIAL PLUMBING PeRnniT APPLicArioN
J CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 0 1 1~J l
Site Street Address (D~~ VI rd ,1 ~-Ce r~Y lJ~ I Unit #
c
Property Owner ?,be Telephone )
Contractor 6 ,`r)Z- R l~r) 'A T'elephone # 0~) 7~[J~- ~ I.IAJ
Address~W Vv E3 City ~VI,~nUVj i I~i Statem/v Zip~
The Applicant is: _ Owner >f,ontractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. If you are installing onlv 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.
_Septic System Abandonment L)
J
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener AWater Heater $ 15.00
A new _ rzptacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
SU
Total $ I
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand 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
acc rda e with the approved plan in the event a plan is required to be reviewed and approved. ~
ApplicanPs Printed Name Appli nY Signature
Peggy Fleck
7 7 ZJI'aii-r/-6-6 21r2e) )/ qe6
From: wayne opheim [wopheim@yahoo.comj
Sent: Wednesday, May 25, 2011 9:32 AM
To: Peggy Fleck
Subject: Fw: permit 98526
Forwarded Message ----
From: wayne opheim <wopheimPyahoo.com>
To: pfleck(citofeagan.com
Sent: Fri, May 20, 2011 3:25:49 PM
Subject: permit 98526
Igive permission to reissue permit to allied exc. for gary zibley 677 windtree knoll sewer
repair jeff jewison po box 171 savage mn phone cell 6129783367.
thanks wayne opheim able exc.shakopee cell 612 232 1484
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA161178
Date Issued:05/11/2020
Permit Category:ePermit
Site Address: 677 Windtree Knoll
Lot:008 Block: 001 Addition: Windtree 8th
PID:10-84477-01-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Gary O Zibley
677 Windtree Knoll
Eagan MN 55123
(612) 618-1028
Thomas Schultz Construction
8480 195th St E
Prior Lake MN 55372
(952) 440-4056
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA164227
Date Issued:09/23/2020
Permit Category:ePermit
Site Address: 677 Windtree Knoll
Lot:008 Block: 001 Addition: Windtree 8th
PID:10-84477-01-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Gary O Zibley
677 Windtree Knoll
Eagan MN 55123
(612) 618-1028
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA168008
Date Issued:04/06/2021
Permit Category:ePermit
Site Address: 677 Windtree Knoll
Lot:008 Block: 001 Addition: Windtree 8th
PID:10-84477-01-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Kathleen & Gary Zibley
677 Windtree Knoll
Saint Paul MN 55123--130
(612) 618-1028
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA175842
Date Issued:04/18/2022
Permit Category:ePermit
Site Address: 677 Windtree Knoll
Lot:008 Block: 001 Addition: Windtree 8th
PID:10-84477-01-080
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Kathleen & Gary Zibley
677 Windtree Knoll
Saint Paul MN 55123--130
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature