645 Witham Lane . . . , . . , M . . . .
S ER WATER PERMIT OFFlCE USE ONLY
CI~F GAN METER # PERMIT DATE / 13 / 92
3830 Pilot Knob Rd. ya
Eagan, MN 55122-1897 CHIP ~ PERMIT ~
METER SIZE B.P. RECEIPT # C 017760
DATE MAR 13, 1492 ISSUE DATE B.P. RECEIPT DATE 03/ 12/92
~ x PRV _ BOOSTER PUMP
SITE ADDOESS 645 WITHAH LN PERMtT REQUESTED
LOT iQ BLOCK 2 SEC/SUB COVENTRY PASS 2ND
X SEWER X WATER _ TAPS
APPIICANT:
ADDRESS: - COMM/IND x RESIDENTIAL
CITY, STATE ZIP X NEW - EXISTING
PHONE:
3TAR PLBG Lawn Sprinkler Meters are to be Installed
PLUMBER: Ahead of Domestic Meters on Water Line.
ADDRESS: 101$ !lOUND SPRINGS TERR Credit WILL NOT be given for Deduct Meters.
CITY, STATE BLA)ONINGI'ON MN Zip 55420
PHONE: 884-4149
I AGREE TO COMPLY WITH CITY OF
OWNER: MCDONALD CONST INC EAGAN ORDINANCES
ADDRESS: 1212 BLUEBILL BAY RD
CITY, STATE BURNSVILLE MN z1P 55337
PHONE: 688-7061 SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
. SEWER & WAT FERMIT OFFICE USE ONLY
- C1lY OF EdQG~ S 3 p 03 / 13 / 92
3830 PilOt KriOb Hd. ME7ER ~ PERMIT DATE
Eagan, MN 55122-1897 .C+iP# a5'j l3 Z0 PERMIT # 40
. ` METER SIZE ~'e.~ B.P, RECEIPT # C 017760
DATE _ MAR 13 1992 ISSUE QATE 5` ' n B.P. RECEiPT DATE 03 f i Z 92
it . -X PRV _ BOOSTER PUMP
SITE ADDRESS 645 WITHAM LN PERMIT REQUESTED
LOT 10 BLOCK 2 SEC/SUB COVEN'i'xY FASS 2ND
I X SEWER ~ WATER - TAPS APPLICANT:
ADORESS: COMM/IND x RESIDENTIAL ~
CITY, STATE ZIP ]L NEW _ EXISTING
PHONE:
STAB PL$G Lawn Sprinkier Meters are to be Installed
; PLUMBER: Ahead of Domestic Meters on Water Line.
' ADDRESS: 1018 M4UAtD SPBINGS TBRR Credit WILL NOT be given for Deduct Meters.
i
CITY, STATE BLWHINMN MN Zip 55420
PHONE: 884"4149
~ 1 AGREE TO COMPLY WITH CITY OF
OWNER: beDONALD COHST II1C EAGAN ORQINANCES
ADDRESS: 1212 BLUSBILL BAY RD
CITY, STATE BURNSVILLE MN Z{P 55337 aAkl.'~
PHO 588-7061 SiG ATURE WHEN M R ISSUED
~0 3-.~3-~a
' PL SE~ALL ~TWO WORKING DAYS FOR PROCES5ING. CALL 454-5220 FOR INSPECTI4NS. FOR STORM
~ SEWER PERMITS, CONTACT ENGINEERING QEPT.
l.. ,
. . .;Controt
i
INSPECTIUN RECORD ~ Na.
CtTY OF EAGAN - - "PERMlT TYPE:
3830 Pilot Knob Road , , Perm+t Number. M~~~?~ ~
Eagan, Minnesota 55123 Date assued:
(612) 681-4675 ~
SITE ADDRESS: Lp T a 11? AL t)c: a i APPLICANT: i
846 i,lI i'NAM l./iME MCDbNAt,D CDMSY iMC ~
Ct1VEiiTRY PASS '1.Nfl (612) 566-7061
PERMlT SUBTYPE: TYPE OF WORK: s p
~
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ELECTRI - ~ ' •
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ReOUest Oale ~ I ~ Fire No, u Rm InsOection
eq Rtl~ O Ready Now Will NoYty Insp
~Yes ?NO wt~tq R 7-
I hcensed contrector O owner hereby request inspection of above electr al wor ~
Job Aaaress ( Street. Box or Rome No ) pry
Sectmn No Township Name or No. Range No fqunly
Occupa t ij~NT Ph ne N
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Power $ypplierG_ lJ~ E A~Oress
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Elecv/cal Conv ctor (COmpany Name) Co rac r's L¢ens No
MaAin Atltlress ICOnVdQOr or p.vnCr Mdaing In idlldli0nl •
Aut~ nzea 55^~~ure ICo{neanorrpwner ~aai~ng s• ilat~ ~ Pbone Number
~
MINNE O q STATE BOpqD OF EL ICITY TMIS INSPECTION qEOUEST WII.L NOT
Griggs-MlCway BIOg. - Room S473 BE ACGEPTEO 9V THE STATE BOARD
1821 Unmerslty pve. St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Vhone(6tE) 643-0800 ENCLOSED
REOUEST FOR ELECTRICAL INSPECTION E9-0000I-OB
klf-o--
J ~?`ea instmclmns tor completing IDis lorm on back oi yellow copy. ` Q
S
'X" Below Work Covered by This Request Ar'
e tltl Rep. TypeolBUdtling AppliancesWued EqmpmenlWired
Home Range Temporery Service
Dupiez Water Heater Electnc Heating
Apt. Bwlding ryer Other(Specity)
Comm /lndu5inal Fumace
Fa~m Air Condrtioner
Otber (syecdy) ('qnlroctor's Remarks.
Compute Inspecnon Fee 8elow:
k Other Fee # ServiceEniranceSize Fee # Qrcui~slFeeders
Fee
Swimming Pool 0 to 200 Amps - ~ 0 to 100 Amps i
Banstormers Above 200 _ AmpS ( Above 100 _ Amps o
Signs Inspector5 Usa Omy: / TOTAL ,Fj(~
Irrigation Booms ~1~ i , 5 .
Special Inspection rUr~~ < 7 J" ~ L
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNOTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspectoc hereby Rougn,n oaie~'~ y Z
cenity ihat the above inspection has ~
been made. ZrLT a~=f'`7fz-
OFFILE USE ONLY 6 /
Tnis repuest vom tB mantns tmm
, v DATE: MAR 16, 1992
RE: 645 WITHAM LN (MCDONALD CONST INC)
X Your Sewer & Water Permit for the above property has been completed. tl will be held at ihe
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
_ Your Sewer & Water Permil tor the above property cannot be completed for the lollo.wing
reasons:
_ Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
- 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.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Cities Di ig tal Qualitv Control
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:`CASH'RECFIPT'`Y~.^
- ~ - ~:Cinr oF EaGAn%
. . _ . .ti...~.,
_ ~ . ' 3830' PILOT KNOB'RO/fD )Y '
' - EAGAN, MINNESOTA 55122 ,
~.OATE.• v " ; -19
~ iEflrvFO fC ~~f 1 ~~l~ I14 lJ(n" '11
~
' f11Gy _ _
~ AMOUNT
. ' . .r. . .
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i 8 DOILARS
I - . ' . . ? CASH CHECK
fT, 03 1c.%6c.:. & i i LL.Q,.-~~.
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T 3~/C'COU ~ %,733 .~'E~~ f'P•%.~/ wa..,~
( ('>N<• G/~ft' I)~ L~/L~ . rG~: tl~~/.~..'G
• Furw oe.iecr per_! 6di: Ti amounr ,
~ Th~ank You
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GW Devam-M-0763
(gtx#ifirafic of (Orrupanry
Citp of (tagatt
~ EP}ibtbltPt[t of lUairig JtIB}1PQIDtt ~
This CeHifica[e issfeed pursuant m the reguiremencr oJSecdort 306 oJthe Unijam Burlding
Code cenijying that atlhe kme ojissunnce this smucture Hns irt rnmpliance with the variour
o,dinartcrs ojthe City regulaling building rnnstructlon or use. For !he jo!lowing:
ue cumrquoe SF/nC sws. ecmn rw. I'i
w+w--Y TYx Rg/M I m~a p~ PD ryp, C. VN
o~amow.s M)QKAtD OCN5P. A&= 1212 ffi7mJi777. BAY RD B'tm?R
B.W~Add1e1 645 WIIflAM I1fNE L..I;y L10. B2, COVMRY PASS 2D1ID
) /e / o„, 5/26/92
- eUw"oeriw /
\
POST M A CANSPICUOUS VUCE
Address: 545 y]jTHAM LANE Lot 10 Blk Z Sec/Sub r„pVENTRy pASg uNp
These items were/were not complete at the time of the final inspection.
Dat : 5 26 92 Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry /
Permanent driveway
Permanent gas ~
Sod/seeded grass ~
Trail/curb damage
Porch
Basement finish ~
Deck
Please verify vith the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
~a
White - City copy Yellow - Resident copy Pink • Contractor copy
PERMIT C°n 0033
CITY OF EAGAN 3830 Pilot Knob Road PERMITTYPE: suiLoxHs
Eagan, Minnesota 55123 Permit Number: . 000013
(612) 681-4675 Date Issued: 0 3/ 12 / 9 2
SITE ADDRESS:
645 WITHAM LANE
LOT: 10 BLOCK: 2
COVENTRY PASS 2ND
DESCRIPTION:
Building Permit Type SF DWG
Building Work Type NEW
UBC Occupancy R-3 M-1
Construction Type VN
2oning R-1
Building Length 68
Building Width 38
REMARKS:
RECEIPT # Q- J-77 PRV REQUIRED
FEE SUMMARY:
VAIUATION $131,000
Base Fee $748.00 MISC FEES $1.610.50
Plan Review $406.20 Total Fee $3,610.20
Surcharge $65.50
SAC $709.00
SAC $ 100
SAC Units 1
Subtotal $1,999.70
CONTRACTOR: - applicant - s7. }.1p.iNNER:
MCDONALD CONST INC 16887061 0002376 MCDONALO CONST INC
1212 BLUEBILL BAY RD 1212 BLUEBILL BAY RD
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 688-7061
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 Mn.
~ Statutes and City of Eagan Ordinances. J
PPLICANT E ITE IGNATUFIE ISSUE V. SIGNATURE
INSPECTION RECORD I ControlNo. 0033
CITYOFEAGAN PERMITTYPE: auzLoiNc
3830 Pilot Knob Road Permit Number: 000013
Eagan, Minnesota 55123 Date Issued: 0 3/ 12 / 9 2
(612) 681-4675
SITEADDRESS: LoT: ie BLOCK: 2 APPLICANT:
645 WITHAM LANE MCDONALD CONST INC
COVENTRY PASS 2N0 (612) 688-7061
PERMIT SUBTYPE: TYPE OF WORK:
SF OWG NEW
INSPECTION . D.
SITE FOOTING
FRAMING INSULATION
WALLBOARD FINAL
REMARKS: RECEIPT # PRV REQUIREO
F
_ ~
L
2 1992 BUILDING PERMIT APPLICATION
J CITY OF EAGAN
REQUIRtMENTS:
SINGLE. FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SEf ENERGY CALCS.
MULTIPLE DWELLINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET OF ENERGY CALCS.
# OF UNITS RENTAL FOR SALE
COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SEf OF
SPECIFICATIONS, 1 SEf OF ENERGY CALCS.
PENALTY APPLIES WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING
DAY OF MONTH IN WHICH REQUEST IS MADE QB LOT 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.
(6xdtid-s lot)
To Be Used For: ; , Valuation: -}Date: 3-5 -q?
V' Site Address t6 5 ; / 6D O
' OFFICE USE ONLY
Lot 10 Biock 2-_ FEE
Occupancy I~-3 M-/ Bldg Permit i?
Parcel/Sub ove„i PASS 2^4 Zoning 'T-/- Surcharge 6SSo
Actual Const V Plan Review
Owner Allowable License Fee
/Oo
# of stories SAC, City
Address Length ~ SAC, MWCC 9oo
Depth 38 Water Conn. 0
City/Zip S.F. Total Water Meter 9S .
Footprint S.F. Acct. Deposit 30
Phone S/W Permit 30
On-site sewage S/W Surcharge , So
Contractor On-site well Treatment PI. 3op
MWCC System Road Unit 3f~o
Address RA, 2 City water ~Y Park Ded. PRV Trail Ded. '
CitY/Zip r ( M Ss 3 Booster Pump Copies ~
SUBTOTAL
Phone b-bg-7061 License pp APPR VAL Penalt~r
lanner Lot Change
Council TOTAL _9.~10.Arch./Engr. Bldg. Off.
Variance
Address
City/Zip Code
Phone #
: ewer/Water Licensed Contr. 61 . Processing time
foi sewe r mits is ays once area een approve .
grees that all work shall be done in accordance with
ignat;ar~~ y~ i ee
all appftc. 64a of esota Statutes anc+ City of Eagan Ordinances. .
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CITY OF EAGAN
' 1992 BUILDING PERMIT APPLICATION
. 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is equested, but not picked up by last working day
of month in which re uest is made or lot r chan e is re uested once ermit is issued.
Date Yaluation of work
Site Lacation:
STREEi STE N
Tenant Name:
LOT BLOCK SUBD. P.I.D. #
Descri tion of work:
The applicant is: ? Owner ? Contractor O Other coeso~ibe>
Name Phone
Property LAST FIRST
Owner Address
STREET STE k
City State Zip
Company Phone
Contractor Address License #
City State 2ip
Architect/ Campany Phone
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days ance area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
. ~
, ' r, . •
OFFICE USE ONLY ,
BUILDING PERMIT TYPE , .
11 01 foundation ? 06 Garage/Accessory O 11 Res. Add./Porch ? 16 Agricultural
? 02 Single Family ? 07 Fireplace ? 12 Cormn./Ind. New ? 17 Building Move
? 03 Two-family ? 08 Deck O 13 Comm./Ind. Add ? 18 Demolition
1:1 04 Multi-fam. T.H. ? 09 Basement Finish O 14 Corton./Ind. Rem. ? 20 Miscellaneous
? 05 Apt. Bldg. ? 10 Swim Pool O 15 Public Fac.
WORK TYPE
? 90 New ? 93 Remodel 0 96 Move
? 91 Addition ? 94 Repair ? 97 Demolish
? 92 Alteratians ? 95 Tenant Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy Basement sq. ft. 1019 MWCC System
Zoning lst F1. sq. ft. O N~ City Water
Const. (Actual) 2nd F1. sq. ft. ~SS PRV Required
(Allowable) Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code 7a-7-
Depth On-site sewage SAC Code ~APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
I
El Site Eb Footing ~ Framing [D Insulation
El Wallboard ID Final O Draintile ? Fireplace
Valstim: S
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Road Unit
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Tatal:
sac %
SAC Units
;
f
MINNESOTA SLT
.AXZ ENEl~GY COUE CA_LCU?.ATtONG
, BASED ON CHAPTER 5 OF T11E
• •M4P~~~XHBRG CODE _ 1,983 EDITION
' . , Adoption Effective ~
Owner!!:~! Phone Date
Site Address
contractor phone;
Building Classification: Type A1 (3ingle Family 6 Duplex) 7f~'
TYPQ AZ (Residential, J storiea or less) (over 3 stories) (Other)
NOTEC Comolofo ..s...s 3 and d fira},
GEN . A. tNFO 1 Amtph
1. Building Perimete
2. taall heiqht (qround to eave) i1 ft.
3. 1. X 2. (above) grose wall area 9~ I _sq.ft.
4. Buildinq dimensions (L) ~ X(W) =1y sq.Et.roof 6 floor area
5. Sq. foot area of rim joiet - F r j~l.~t~siie Z X to
X'L~D~ ( perimeter
6. Doors - Area 12
Thickness in U. factorA~ -7
Type of conetruction Perimeter' ft.
Manufecturer
7. Totel door's perltoeter ft.
8. windows: Fianp facturertNliv 1L , 77 f State approved
U factor_ f
TYPE SIZE RREA (Sq.FE.) NUMBER OF i TOTAL
EACII UNITB 3Q FEET
9. Total sq.ft. Glase 1 I %
lo. Fireplace erea: Width X lieight X =
eq.ft.
11. Exposed foundations Heiqht R Perimeten~Lg~ ~0
6 9ft.
•
COMPLETION OF TIIIB FORM 28 !tE(2UIRED FOR 11LL NEW L-ON3TRVCTION, HAJOR
RBHODELINO 11ND BVILDING9 9EIN0 HOVED tVIIEAE ENERaY, OTtiER TfiAN TIIE NIN2!!AL
CODE ALLOWAHCE, I3 U9ED.
-1-
12. Framing area = lo$ of gross wall area.
,13. Grose'wall area Ot~6ep aq.ft. '
-Window e'rea A 19tr-~? sy,ft. U wlndows UxA e~ O 1~ ~
Rim joist area A[2 ` sq.ft. U rim joist=I~ ~ UxA =
boor area A ~ sq.ft. U door areaUXA e
other doore area A`i0~~~ty,ft. U other doors=~ ( UxA = IiTJI ~
Exposed fndn ~ (42 sq. ft. U foundation= 1'd UxA
Framinq area sq,ft. U framing area=_q2a~ UxA
Net wall area A~~~f'3 IA15?0q,ft. U wa11= ?'D UxA = 0k 5P
(138) ToTAL . . . . . . . . . UxA = r V i I 0
14. Grose wall area x 0.11 (A-1 sinqle family & duplex) = allowable UxA/Code
(1J. above)
x 0.23 (A-2 other tesidential)
x •23 (other buildinqs)
x .28 (over 7 stories)
1 r) TUN muet be lar er than or eame
A=' X U COdO t~ = C. oF. eB 138 above
15. Ceilinq framinq area (AE) equal8 101 of ceiling area
15A. Gross ceiling area =(L) x(W) _Ud6 gy,ft.
158. Joist area (At) = 103 ceilinq erea ='I~le? By,ft.
15C. Net oeilinq erea (A.) 15B) -cag
~ Bq~.
. U ceiling XAC x
U framinq x A E X
15U. TOTAL U x A........
16. Ceilinq area (15A) x 0.026 (A-1 eingle family & duplex)
= allowable UxA/COde
x 0.033 (A-2 other residentiel)
x 0.06 (other)
A( 15A) ~`x U Code 4 oTUll must be• larger than or eame
F• ae 15D above
NoTEt Use U and A valuea obtained from paqes 1, 7 and 4.
CERTJJE=IfTIONt I hereby certify that I heve celculated the "U" factote and
"R" values herein and thet the building here described meete or exceede the
State of Ninnesota Enerqy Consetvation Act.
Date 9lgnatute .
-2- .
7 G
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~.7o
2 ~
2Ok`'~Cp-~?D X1~ ~~ol
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Cities Di itg al Qualitv Control I
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. R VALUE R VALUE
FRAMIN(3 CEILIN(3
_ 0.61 AirFilm 0.61
3 ~,O Insulation ~y' ~
4.38 Joist
0.56 Ceilinq 0.56
- 0.61 AirFilm 0.61
4Z-•Qv motRiR +0,78
~DZ77 V a 1/R
Window infiltration 0.5 efm/liheal #oot of crack
Residentiel door infiltretion
re o.8 ofm/square foot or door end minimum aode
qvirement
Noh-residential door infiltration 11.0 efm/lineal foot of crack
Ub 12" concrete blvck no ihsulatlon =.47 R 2.1 '
Ub 12" concrete block insulated cores =.26 R 3.8
Ub 12" liqlitweiqtit blvck :32 R 9.1
lJb 12" liglitweiqlit block insulated cores =.12 R 8.9
U single glass = 1.131 with storm window .54
ll double qlass = .55
U triple qlasa = .41
All,exterior walls and cellinge must have a vapor barrier (0.10 perm max.).
vepor barrier must be ori-the ineide (heated eide) of well.
vapor barriers of the polyethelene thin film have no R value.
3
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* LwND 9VRVCVO~• COY' G C~GINL[~ Mendotu Heights, MDI 55120
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PIONEER
* eng * neer ng.. nnens.LnNosc.rcnac+uncn (612) 681 1914
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Certificate of Survey for: MG DONALD C0NSTr4%UGTI0N
~ Nouse Address: -O!iLa~NL'ti~~.+~..~^e~
Model Name: -
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sa9° ~a' 3~'~e ERTCIRlEERI%C DEPT
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• 900.0 Uenotes Existing Elevation pRpp05EU HOUSE ELEVATION
• coo.o Denotes Proposed Elevation Lowest Floor Elevatlon: g2~,,~3
- Denotes prainage & Utility Easement
Denotes Drainage Flow Direction Top of Biock Elevatinn:_,,q,'i
=
"O"- Denotes Monument Garage Slab Elevation: 673_q
---a- Denotes Offset Hub gearings shown ore ?ssumed •
LOT_10, BLOCK Z-C~oVEvrRY Pass ZNC ADOrTroN
DAKOTA COUNT', MINNE50TA
I Ne.ebY cen4y thew :hb eurvev, olaP or report wo, vreoerr} by me or undar my di.ocz supervleion nnd thet 1 nm doly ftegieteietl Ltnd'iu.veyo,
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l6L 'oZ CITY OF EAGAN CITY USE ONLY
7 ~ PLUMBING PERMIT
SUBD. ad~Y (612) 681-4675 RECEIPT
DATE
REBIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE TNE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON 15.00
ADD ON ~ SHOWER 3.00 dv
REPAIR _ 3 WATER CIASET 3.00 .00
BATH TUB 3.00
IAVATORY 3.00 77 °o
OWNER NAME: I ! Q A UGii ~}?C„ KITCHEN SINK 3.00 3 00
l/ IAUNDRY TRAY 3.00 .Oa
SITE ADDRESS: ~/~S- 1~~1IC1QVh HOT TUB/SPA 3.00 3.oa
WATER HEATER 3.00 00
FIAOR DRAIN 3.00 L_6a
INSTALLER: I Ve A GAS PIPING OUT.
(MINIMIJM - 1) 3.00 3,OG
ROUGH OPENINGS 1.50 ~O
ADDRESS: / f'.UiE IIE • ~ OTHER
WATER SOFfENER 5.00
CITY:GdffctqQ ro Ue Zlp; pRIVATE DISP. 15.00
~j qn U.G. SPRINKLER 3.00
PHONE ~E• - C~ U v _ W. TURNAROUND 15.00
STATE SURCHARGE .50
SIGNATURE OF PERMITTEE TOTAL: v0
COMMERCIAL
YLEASE COMPLETE THIS PORTION FOR ALL COHMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
CONTRACT PRICE:
SITE ADDRESS: 1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
FOR: (SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN FOR CITY USE ONLY
, - 3830 PILOT KNOB ROAD
~ EAGAN, HN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # /O /U
34EC,HANTCAT: PE[?~?IT DATE: G 9~-
RESIDENI'IAL;' PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELL
„
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ADD-ON MINIMUM $15.00
ADD ON HVAC 0-100 M BTU 24.00
REPAIR ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM,3 3.00
OI. (}~_Q iS~ OF 1 PER PERMIT
TIER NAME`~~, V~^ J k~c~-~~
4 SUBTOTAL: $ aq-00
SITE ADDRESS: STATE SURCHARGE: .50
LOT: Ic) BLOCK ~ SUBD. `(1111fN~T'Sv, 4~S cJ+J~. TOTAL: $ cc''
INSTALLER: \ \ ~P. l ~ ~ f
ADDRESS: I NATURE OF PERMITTEE
CITY: ~C:~(~(`(\ C .-,e ZIP: ~SUJ~~
PHONE
COMMERCIAL/INDIISTRTAL't: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME: 18 OF CONTRACT FEE.
STATE SURCHARGE a $.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: 2IP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
PERM,[T # ; CITY OF EAGAN t!4q; Ifd PI4"S
O 1992 BUILDING PERMIT APPLICATIO ;
I gg 681-4675 R~~~ v~~ ~t g!
t
SIN6LE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs. ~
COMMERCIAL 2 sets of architectural_& structural plans, 1 set of .
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 2 / Jqc77 / Valuation of nork
Site Address: <~4 E; (0tl-1iP-A1~ ~ -4, k I P.
STREET STE 1
Tenant Name: (commercial only)
LOT 1/!? BLOCK ~ SUBD. V.I.D. M
~a-
Descri tion of work: Z
The applicant is: 04 Owner ? Contractor ? Other comor;no>
Name -'s4\Lj~.E AxY'~~ Phone
Property u5T FlR57
Owner Address
STREET STE N
City State Zip
Company S~--UA,t-7-- Phone
Contra ctor Address License N Exp.
City State Zip
ArchitecU Company , Phone
Engineer Name Registration N
Address
City State Zip
Sewer 8 water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply wi h all applicable State of Minnesota tutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
~ B~I~JG PERMIT TYPE
O 01 foundation ? 05 Apt. Bldg ? 09 Basement Finish O 13 Comm/IndiNew
? 02 SF Dwg. O 06 Garage/Accessory ? 10 Swim Pool ? 14 Cortm/Ind Add
? 03 Two family O 07 Fireplace ? 11 Res. Add. O 15 Cortm/Ind Rem
O 04 Multi-fam. T.H. 1;~ 08 Deck ? 12 Res. Porch ? 16 Public Fac.
. 017 Agricultural
WORK TYPE
~ 31 New ? 33 Alterations O 35 Move
32 Addition O 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION '
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Mater
UBC Occupancy ~ 2nd F1. sq. ft. PRV Required
Zonin Sq. Ft. total Booster Pump
t of Stories footprint Sq. ft. Fire SPrinkler
length !4 On-site well Census Code ~
Depth ttL On-site sewage SAC Code
APPROVALS .
Building Assessments
Planning Variance
Engineering
REQUIRED INSPECTIONS
? Site Eg Footing O Framing Q Insulation
? Mallboard ~ Final ? Draintile ? Fireplace
Permit Fee N L v.iuscia+: :
Surcharge
Plan Review
License
MWCC SAC E,4<~TtU
City SAC
Water Conn.
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Lopies
Other
Total:
SAC %
SAL Units
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA120344
Date Issued:02/04/2014
Permit Category:ePermit
Site Address: 649 Witham Lane
Lot:11 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Phil Holmin
3432 Denmark Ave #228
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Jeffrey A Karel
649 Witham Lane
Eagan MN 55123
(651) 366-7798
Holmin Heating & Cooling Llc
900 Park Knoll Drive
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA129557
Date Issued:02/23/2015
Permit Category:ePermit
Site Address: 645 Witham Lane
Lot:10 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-100
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.
Applicant: Troy Good
3670 Dodd Rd
Eagan, MN 55123
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 -
Gary L Smokewood
645 Witham Lane
Eagan MN 55123
(651) 452-6483
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150018
Date Issued:06/18/2018
Permit Category:ePermit
Site Address: 645 Witham Lane
Lot:10 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-100
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: 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 -
Gary L Smokewood
645 Witham Lane
Eagan MN 55123
Schmidt Roofing Inc
3509 West Highway 13
Burnsville MN 55337
(952) 888-4889
Applicant/Permitee: Signature Issued By: Signature