4465 Woodgate Ct
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee ~ 5=
fill in numbered spaces S/C
Type or Prini /egib/y Tot S s o
1. Date 3 y 2. Installation Cost
3. Job AddressVV6 9 Gt&!g~),,4780t Bllp 3 Tra t
4. Owner
5. Contractor Phone
6. Address 4P-1' T c.'r~~
7. City a s,~i'hDU.U T State /WA?. Zip S 5 a 6k
8. Building Type: ResidentialX Commercial ? Institutional ?
9. Work Description: New ? Add ? AlierV Repair ?
10. Describe Fuel Type 9~3
11. No. E.quinment STU - M. Ea. No. Equiament CFM
1-1 Forced Air yOi o o 0 Air Handling:
Mfg. L r NN a X
Boilers
Mech. Exhaust
Mfg.
Unit Heater ~
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Fi
Inspections: Date Insp. Date D, Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt MECHANICAL PERMIT Permit Na L/ ~~n U
CITY OF EAGAN
F
Fill in numbered spaces S/C
Type or Prini /egib/y
1. Date 2. Instailation Cost
~ ~JUrlv~
3. Job Address5-1V7/ GClOOd~~~ Lot~ ~ BIkU ~ Tract
e o uR T
4. Owner
5. Contractorel;f -v2 - ~.4q 041 Phone 4,"fz3 -iiV y
6. Address/S~~
7. City State -WA/. Z i p 3J o 6~
8. Building Type: Residential;K Commercial 13 Institutional ?
9. Work Description: New ? Add ? AlterX Repair ?
10. Describe FuelType 9w
11. No. Eauioment 8TU - M. Ea. No. Equipment CFM
` Forced Air Air Handling:
Mfg. - L x
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mf9• Othert/4 .-J~i'! ~
Air Cond. 9A5 Gc~AT = ?
Mfg.
V" Gas, Piping Outlets
12. I hereby certi that the above information is true and correct, and I agree to
comply wi din nce 7ancb6des governing this type of work.
Signed : for
Rough Fingl
Inspections: Date Insp. Date nsP•
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition woodgate 3rd Addition Lot 19 eik 3 Parcel ' 84602 1
Owner Street 4469 Woodgate Ct. State Eaqan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR. '
RADING 1974 37.67 7.53 5 PAID
I a SAN SEW TRUNK 1974 $65.31 $4. 35 15 PAID
* SEWER LATERAL 1976 3
WATERMAIN
li * WATERLATERAL 1976 3
* WATER AREA 1976 3
* TORMSEW TRK 1976 $1628.80 $542.93 3 PAID
* TORM SEW LAT 1976 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, $160.00 804 7-28-75
BUIIDING PER. 7-28-75 43734 saC 7-28-75
PARK
CITY OF EAGAN Remarks
Additio Wood ate 3rd Addition Lot 20 Rik 3 Parcel 160 03,
Owner L Street 4471 Woodgate Ct. state Eagan, MN 55122
Improvement Date r$65.31 Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
RADING 1974 $7.53 5 PAID
: f~1 SAN SEW TRUNK 1974 $4. 35 15 PAID
* SEWERLATERAL 1976 3
WATERMAIN
* WATERLATERAL 1976 3
* WATER AREA 1976 3
%STORMSEWTRK 1976 $1628.80 $542. 93 3 PAID
* STORM SEW LAT 1976 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $160.00 804 7-28-75
BUILDING PER. #3734 7-28-75
sAC 425.00 804 7-28-75
PARK
CITY OF EAGAN Remarks
Addition Wc,odgate 3rd Addition Lot 18 eik 3 Parceltl0 84602 1
OWnerwl1,(-}r.~. Street 4465 Woodgate Ct. state_- Eaqan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING 1974 37.67 7.53 5 PAID
SAN SEW TRUNK 1974 65.31 4. 35 15 PAID
* SEWERLATERAL 1976 3
WATERMAIN
* WATER LATERAL 1976 3
* WATER AREA 1976 3
`TORM SEW TRK 1976 $1628.80 $542. 93 3 PAID
* STORM SEW LAT 1976 3
CURB & GUTTER
SIDEWALK
STREET UGHT
WATER CONN. $160. 00 804 7-28-75
BUILDING PER. #3734 7-28-75
s,ac 804 7-28-75
PARK
CITY OF EAGAN Remarks
Addition~0I44S~.ffAt-P 3ra AddltlOri Lot 17 Blk 3 Parcel~-10 84602 llb' 0~I``
Owner~,Wlf~`~l !,tlC~L Street 4467 woodqate Ct. state Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET3URF. 3 p 1977 476.67 158.89 3 476.67 C003326 10-9-76
STREET RESTOR.
GRADING 1974 $37.67 $7.53 5 PAID
pZ SAN SEW TRUNK 1974 $65. 31 $4. 35 15 PAID
* SEWER LATERAL 1976 3
WATERMAIN
* WATER LATERAL 1976 3
* WATER AREA 1976 3
iSTORM SEW TRK 1976 $1628.80 $542. 93 3 PAID
*ASTORM SEW LAT 1976 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $160.00 804 - -
BUILDING PER. 7_28-75
sac -28-75
PARK
viLLAUe oF EAOAN SEWER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.: 2554
$/5/75
Eogon, MN $5122 DATE: 4
7oning: RII No. of Units:
pwner: New Horizon Woodgate III
Address:
Site Addres4465=67-69-71 Woodgate Court
Plumber: ThOmpson Plunbing
1700.00 pd
I ogne to eomp{r with ti~e Villoge of Eagan Connection Charge:
3rdinances, Account Deposit: 10.00 pd
Permit Fee: . p pd
Surcharge:
3y; Misa Chazges:
:)ate of Insp.: Total:
Date Paid:
:nsp.:
VILLAOE OF EAGAN WATER SERVICE PERMIT =
3795 Pilot Knob Road ~ . PERMIT NO.: 1793
Eagan.MN 55122 . , DATE: SI5/75 ~
Zoning: RII 4
New HOrizon - Woodgate ~IIiUnics: ~ •
Owner:
Address: " ~ f ~
Site Addreds~ d'GS ~f ~n r1 wooagate COUZ't Q
Plumber: Th°mpson Plumbing
-
Meter No.: Connection Charge: 6QQ_ n(1_____._Tnrl
Size: Account lleposit:
Reader No.: Permit Fee:
1 og?ee to complr with the Viliage of Eagon Surcharge: ~
Ordinonces. Misc. Charges:
Total:
By
Date Paid:
Date of Insp.:
Insp.:
3--3
CITY OF EAGAN ~
3795 Pilot Knob Road
Eagan, NIinnesota 55122 ~
. PERqvaT NO. : 739
The City of Eagan hereby grarit's to Goacw4ck Hen*ing& Azc Co
of ,1003, Xenia Ave So
a Permit for: (Owner),U.,w1icisizor3 Fir~mes.-Wr~ndgate ZZI
at Ae~~e Ct__, purauant to application dated $.475 •
Fee Paid: $40 09 _ dated this ~7._day of Aucjust , 19 u
.
1.00 s/c
Building Inspector
Mechanical Permits:
Bid Total:
I
~
CITY OF F.i-;GAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERNlIT NO.: 589
The City of Eagan hereby grants to Thompsan PLumbing Co.
of MInnetonka
a 7?r.rrnrtBiNG Permit for: (Owner) New HOrizon - HToodgate III
44657-69-71, 4457-59-61-63, 4449-51-53-55, 4441-43-45-47, 4446-44-48-50, 4452-54-56-58,
t , pursuant to application dated NLY
4460-62-64-66, & 4473-75-77-79 Woodgate Ct., 1736-38 Woodgate Ln & 4437-39 Woodgate Ct.
Fee Paid: 800:_00 dated this 5th day of Aug. , 19 75 .
1744-46 Woodgate Ln.22'2R4542 Woodgate Court
Building Inspector
Mechanical Permits:
Bid Total:
=w
r C~ •
CITY OF EAG:AN ~
3795 Pilot Knob iioad
Eagan, P+Iinnesota 55122
PER= NO.
The City of Ea.oan hereby grants to
of 1001 vo., xxe c-
a ryT ~ Permit for: (Ov,mer)14 ,,,.,.;.,,,„r~~ v„r,os d~~a TTT
iY~ r • r
at pursuant to application dated 8475 .
Fee Paid: $40 00_ da.ted this _2,L___da.y of nugust ~ 19 ?S •
1.00 s/c
Building Inspector
Mechanical Permits:
Bid Total:
~
/70
G~
czTY oF ~=,GArr
3795 pilot Knob Road
Eagan, Minnesota 55122
PEfiMIT NO.: 58~
The City of Eagan hereby grants to Thoinpson Pi,umbing Co.
of MInnetonka
a LUMBING Permit for: (Owner) New HOrizon - t+looclgate III
4465 67 69-71, 4457-59-61-63, 4449-51-53-55, 4491-43-45-47, 4446-44-48-501 4452-54-56-58,
at ~ pursuant to applica,tion dated JIILY
4460-62-64-66, & 4473-75-77-79 Woodgate Ct., 1736-38 Woodaate Ln s- 4437-39 Woodgate Ct.
Fee Paid: 800_00 dated this Sth day of Auq. , 19 75 .
1744-46 Woodgate Ln.22'V4642 Woodgate Court
Building Inspector
D'Iechanical Permits:
Bid Total:
A/1o
~ czTY oF EP~GAra
3795 pilot Knob Road
Eagan, Minnesota 55122
PERNlIT NO.: 589
The City of Eagan hereby grants to Thompson P7,umhing Co.
of MInnetonka
a Permit for: (Owner) New HOrizon -T+Toodgate 111
4465=67 69~ 71, 4457-59-61-63, 4449-51-53-5-, 4441-43-45-47, 4446-44-48-50, 4452-54-56-58,
at , pursuant to application dated JLTLY
4460-62-64-66, & 4473-75-77-79 Woodgate Ct., 1736-38 Woodgate Ln & 4437-39 Woodgate Ct.
Fee Paid: f3D0.00 dated this Sth day of Aug. , 19 75 .
1744-46 Woodgate Ln.22'44642 Woodgate Court
Building Inspector
Mechanical Permits:
Aid Tota]_ :
CITY OF EAG~IAN GJ ~ ~
3795 Pi_lot Knob Road
Eas,-w., NI_nnesota 55122
FLRMZ i NO.55
The City of Eagan hereby grants to Qommrs Sogt Wat-,sr cD.
af 3801 California St N E
a WatpX r Permit 3f'or: (Owner) M$chene and s_ nmu
446 Woodgate Ct. and ,
~t ~8n F._ Rg1R m , pursuant to application dated ~ 4-7&
Fee Paid; sin_nn dated this __2B__day of 7n1~ , 19~6 ?
1.00 s/c
Building IrlspTctol, ~
Mechanical Per-mits:
Bid Total:
I
';)GO °J'
czTY o~ ~~~GArt
3795 pilot Knob Road
Eagan, Minnesota 55122
PERAZIT N0. : 589
The City of iagan hereby grants to Thompson Pl,umbinq co.
of MInnetonka
a Pr.LlMRTN, Permit for: (Owner) New HOrizon - 14oodgate III
4465=67-69-71, 4457-59-61-63, 4499-51-53-55, 4441-43-45-47, 4446-44-48-50, 4452-54-56-58,
at , pursuant to application dated JLTLY •
4460-62-64-66, & 4473-75-77-79 Woodgate Ct., 1736-38 Woodaate Ln s- 4437-39 Woodgate Ct.
Fee Paid: e00.0() dated this 5th day of Aug. , 19 75 .
1744-46 Woodgate Ln.22'44642 Woodgate Court
Building Inspector
T•lecha.r.ical Permite:
Bid Total:
. ~s
~ !1 CcdCd
~
` I for Otfioa Use - - - - - - - - ~
f Pennit#:
City of Eagn 23 } ~
C~ ; Perrnn Fee: 9b
3830 P(tot Knob Road ~ i
Eagan MN 55122 ~ Date Received: ~
Phone: (651) 675-5675 i i
Fax: (651) 875-5694
_____________--J.-J
2008 CQMMERCIAL BUILDtNG PERMIT APPLICATION
aete• 69 sne MareW: (42 i-t lrI t C~ - C 11s~'
TAnant Nema: (T9rsent 18: New / Existing) Suite :
PRQPERTY OWNER Name: - Phone:
Address / City / Zip:
~
Applicant is: OT er Contractnr
TYPE OF WORK D85Cription pf work:
construcfion Cost= ~C~COC7
CONTRACTOR Name: License
7YrHERCOMMA
Address:
BROOlCLYN PARK. MM
C;ty: State: Zip~
Phone: t !;~erson:
ARCHITECt / Name: Registration
ENGINEER •
Address:
city: \ate: Z'f p:
Phone: Gontact Person:
Lieensed pfum6er installing new sewedwater service: pho
NOTE: P/ans and suppoitingi dacumen!'s that you ubmlt aro conaPdered Co be pub!!c Irrformatlon. Portlons of
the !lf/OrnutiDn may be alassfRed as tlon-publlc you p+'oride specifFa masons tlst would permit fhe Ct(y to
concluds that fhe ar+e hade seCrets.
I hereby adcrrovAodgo ma: mis iriformstion Is cemplete and accurace; that the worlc will be in conformanCe with thg prdinartces and codes of the Ciry of
Eaqan; that 1 undetstand this is not a pefmtt, bu4 only an apptication far a petmit, artd worlc is nRt to start wimout a permit; thai th6 w4rk wfll be In
aooordanCe wiih the approved pian in the case of work whiCh IequireS 2 review and approval of plarss.
r--~.
MN(A X X
~
S[gnature
pfMan s Printed Name Appflce
ivs
Ap
Page 1 of 3
9E/ZZ 3J17d 0-10-U dNNd LCbCC0569L 80 :ZT 800Z/bZ/60
l~
,
~ } wro~u~---- ~i
C~ of Ea p ; Pg~n , t
~ Permit Fee. .
3830 Pllqt Knob Hoad ~ i
Eagan MN 55122 ~ nate Rece;ved:
Phone: (651) 675-5675
Fex: (651) $75-5694 ~ stan: ~
L --r-~w-.~-_____~......-J
2008 CQNlMERCIAL BUILDING PERMfT APPLlCAYION
Date: s;~ naa~- l.oS ~-I l ~
Tensnt NaEne: {TenaM IS: (Yew / Exisdng} Sulte :
PROPERTY 01NNER Name_ Phone:
nddress / city / zp:
Applicant is: Owner Contractor
TYPE OF WpRK Descriptien of work:
Construction Cosr
CONTRACTOR (Vame; L"icense 12.--
TYTHP..R CONTiiAt'TtMQ
Addte33: _ 3141 PEEMON PKWY
C~ty_ ~~lU.YN PAIiK, Mtd 56443 ANNA Staie: Zip=
Phene- , Contact Person-
ARCHtTECT / Name: Regisiration
ENGINEIER
Address:
CftY: state: Zip:
Pfione: Coniact Person:
Lfcensed Plumber instalfing 0CM sewedwater service: Phvrre
NOTE: P/sns and suppprling doctmtents that you subm/t are consldered to be puWic inlormatfnn. fbrtlons of
tIe lnlbtmatien may be cJasslRed as non pub/ic !f you proride specMic reasons thai would permlt ths CICy to
conclude that they a,e fiade secWs.
I hereby admowl9dge that this infprmation Is Compleie and axurate; that the work wllt ba in conformance wiih the ondinartces and tOdes af ttte Clty 01
Eagan; ftt 1 undersidfld this is not 8 petmit, but onty an applica(4on fpr d permit, dnd work is rtot to start wfihout a permlt; thaE the worlc will be in
acCOrtlance with the approvgd dan in the cfte of work which requiras a review and apprnval of plans.
X
AppliCan s prirtted Nsme ~
Appfica Signature
Page 1 af 3
TT/Z0 30tid 010-1A r1NNrl LEbCE0SE9L C£ :ZZ 800Z/EZ/60
09/26/2008 16:28 952--431-2016 FEDEX KINKO'S 0705 PAGE 02
~
,
~ A"• ' 177.7 ~ i c c
CIty of Eaecin y , Permn Feo:
3830 Pilqt Knab Raad
EagAR MN 56122 Date Reoeived: ~
Phone: (651) 675-5675
Fax: (651) $75»5694 I StaK: ~
I ~
2008 COMMERCIAL BUILDING PERMIT APPLICATION
III!! p AA
441,440
Dste:~ f~ Slte Addres's:~ `
Tenant Neme: ~ (i'anani le: New / Existing) Suite
Pq4PERT1f OwNER Name: _ Phono:
Address / Gty I Zip:
Applicant is: Owner ~ Contractor
rn+E oF woRtc DescripWn ofwork:
Construorion Cost:
GQNTRACtOR Name: &,JA
Address:
CifY: State= Zip:
ontact aerson: .+Q'tA 4L GeA 'r~
Phone C
6;ik Al A ho - oc
ARCHITECT / Name: Registrat4o X:
ENGIN~ER
Address• . -
City: State: .,,_2iP=
phone: Contact Person: .
Licensed plumber instaNing new sawer/watcr scrvice: Phone
NOTE: P&11S` .*r1d -*uppVl'!`in# CIoCt?MO»rs lhat yOtrtubHllt co?tsldeMd'ttl !3eptlblJc Plff!'!1'JnatIDh. lsortlans of
the fhi°oMMll+Wt Mby tiie cfasslflbd as nwf-ptlblk K,yDU.p?+vVldps~~`~asnn~ ih*t +d?ould p@rmlt the Cfty to
cdnclbde : thai" tJ&y A1'e:thAtfL+ #OOWB:
I heroby acknowlodgo that this tniortnation is complete and acxurate; that the work wili be in conformance wftkJve%qrdlnances and codes of the Cily of
Eagan; that I understand this Is not a pormit, but oniy, an appAcation far a peTmit, and ric not to
accordancv with thc 2pprovrd plan in thQ case of wodc ch requiros a review and r+~p?vv of lans.
x ~n.~ Aw
Applicant's Prlntad Name Applicarn's Slgnatnre
Page 1 of 3
RESIDENTIAL BUILDING
Permit Application
City Of Eagan ~
9 l~ 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodellReoair Requirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan CeR of Survey Recd _ Y_ N
(20°/a maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks . Tree Pres Not Reqd _ Y_ N
1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _ Y_ N
3 copies of Tree Preservation Ptan if lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date Zl 6. l / / 1.2q03 Construction Cost
Site Address ~y(o 7 tg p~~ ec) u, r~ Unit/Ste #
DescriptionofWork~ska// I exIArT q~,ck ~ r~.r~lf~-CQ dIhi~lin huomwlhJOw Wlsli~~~y 4~Oh'
Multi-Family Bldg ~ Y_ N Fireplace(s) _ 0X 1 _ 2
Property Owner dp yl I(n. R. so r e, n 5 0 h Telephone #((,,S( ) 365-,e 017
Contractor /Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate,gorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
0 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Ea -~~a similar plan? _ Y _ N If so, 25% plan review
fee applies.
~
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor 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 plan in the case of work which requires a review and
approval of plans.
2~j
JOrC n5c~ /n
~
Applicant's Pnnted Name Applicant's Signature
OFFICE USE ONLY
Sub Types ' •
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
x 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex 0 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-piex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types ~ ~ O~
~
~
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
/k 33 Alteration ? 37 Demolish (Bldg)* 0 43 Reroof 0 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 069 Z> 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.
t
_ Footings (addition) Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
-0~c Framing _ Siding _ Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By Building Inspector
Base Fee
Surcharge 69 ~
Plan Review / V
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge ~
Treatment Plant
License Search
Copies
Other
Total
laakota c:ounty xeat Estate lnquiry Page 1 of I
~
G
• PLEASE CLiCK HERE TO G1VE US YC7UR PEEDBACK
Dakota County Real Estate Inquiry
Date Updated 8/7/03.
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2003_ Est_,Value_(Payable 2004)_ $133,100
PINy~t,~r.
: 10-84602-170-03 2002 Taxable_Value(Pa abie 20d3y $101,200
Address,;_ 4467 WOODGATE CT Payabie_2003_Tax:. $875.20
Ci _ EAGAN, MN 55122 Totai_,Acrea e_ 0.14
~l(.=
Year Built: 1976
This application we5 developed by the Dakota Courrty C~ffce af G IS
in cooperation with Assessing_Services, Treasurer - Auditor and Property Records Departments
~
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MECHANICAL (RESIDENTIAL)
~ Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date
Site Address Cl- Unit #
~ ~5 Vl~oo~q
Property Owner Telephone # 036 7~_
. p
Contractor l~ o il r-o
Street Address R6/ City
State A' Zip ~ Telephone # (~51 ) ~ ~ ~
1?V~~ I
The Applicant is Owner 4- Contractor Other
Add-on, modification or alteration to existing dwelling unit $ 30.00
~ furnace replacement
_ air exchanger
air conditioner
other
State Surcharge $ .50
7 f-e ~ Fa
PI iLn ,Total JUN 21~03 ~ I hereby apply for a Residential Mechanical Pernut and acknowledge that the informatio csin pleti~=and_acEUrate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pernut, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the
approved plan in the case of work wh' h requires a review and approval of plans.
~
Applicant's Printed Name ~ Applicant's Signature ~
MECHANICAL (COMMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Address Unit #
Tenant Name (if applicable) Previous Tenant Name
d'raY2; t;y Owr.:.r Telephone # ( ) Contractor "
Street Address City
State Zip Telephone # ( ) •
The Applicant is Owner Contractor Other
Work Type
New construction Underground Tank _ Install _ Remove
_ Interior Improvement Call for inspection during installation/removal of tank
_ Processed Piping
Nature of Work:
Permit Fee $50.50 Mininuinr Fee (includes State Surcharge)
Contract Value $ x .01% Pernut Fee
• If pernut fee is $1,000 or less, add $.50 $ State Surcharge
If pernut fee is over $1,000, add $.50 per
$1,000 Pemut Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Pernut 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 with the Mechanical Codes; that I understand this is
not a pernut, but only an application for a permit, and work is not to start without a pernut; 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 Applicant's Signature
Approved By: , Inspector Date:
CITY USE ONLY
PERN4IT RECEIPT DATE: La~~ oj
MII}ENTIAL MECHANICAL PMMIT APPLICATION
CTfY Of EAfiAN
3$30 PILOT KNOB "
EAfiAN MN 55188
651-6$1-4675
Please complete for: ~ single family dwellings
townhomes and condos when permits are required for each unit
Date:
SITE ADDRESS: y~ 7 v(
OWNER NAME: v r en5dn TELEPHONE Q~
(AREA CODE)
INSTALLER NAME: TELEPHONE
(AREA CODE)
STREET ADDRESS: 56t, jm c-
CITY: ,S[A i-v\ L STATE: - ZIP: -
Place a check mark next to the ermit work t e
_ New residential dwelling unit under constructionand not owner/occupied $ 70.00
~ Add-on, modification or alteration to existinq dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner • other
Nature of work: _I-0(r'Y1 GL Ce_ ~ Gi. C C MC vt
State Surchar e $ .50
Tota I $
Reminder: Call for inspectioizs.
I
I NATURE OF PERMITTEE
Updated 1~01
CITY USE ONLY
PERMIT RECEIPT DATE:
APPROVED BY: , INSPECTOR
COMMEtCUI. MECHi4NICi4L PERMIT APPLICATION
CTTY OF EAfiAN
S$SO PILOT KNOB fi.D
£.AfiAlv, MN 55188
651-681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE -
(AREA CODE)
TENANT NAME (IMPROVEME\jTS O\'LY):
VVAS THERE A PREVIOUS TENANT 1N THIS SPACE? Y N. NAME:
1NSTALLER:
ADDRESS: PHONE -
(AREA CODE)
CITY: STATE: ZIP:
Vl'OW: TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tanl:
Processed Piping
Specify \'ature of VVork:
Wheir l/1SLQIIIl1glYC)710V1/!g uiiderground tank, call 651-681-4675 for ii:spectioir b}, Fire Marshal anrl
Plumbrng Iinspector.
Fees: 1% of contract price OR S50.00 minimum fee, whichever is greater.
Underground tanl: removaUinstallation = minimum fee
Contract price: S x 1% _S (Base Fee)
State surcharge calculate at S.50 for each S 1,000 Base Fee
TOTAL ~
SIG\ATURE OF PERVIITTEE
Updated 1/O1
4
C!ty of Eaaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use l'
Permit #:
Permit Fee: ` "W113
Date Receei
Staff: t t15ived:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: • 05 "2013 Site Address: titt(05 I� (Ate CA` Unit #:
Name:%
Resident/
Owner Address / City / Zip:
Type of Work
Contractor
Applicant is:
146x» o1,)r)rs /159",c.
.3
4/1/6251iiia fiz=_ Ck.
Owner 2 Contractor
Phone: l Z59 25
Description of work: Re.pk C2 e,xi fins deck ci- p 1 a y ,,t tJ
•
•
Construction Cost: t 3 5-0n,
Multi -Family Building: (Yes X / No )
Company: -b PgtgRSoAl e".51-Ructo" ZContact: L/14247 Pe/4ISDA/
Address: W6:05 LLydil bJ .
City: 'pe %s4
State: AV/ Zip: ,553-7 Phone: t¢ i 2 - Woo - 3204
License #: be, 2. 105 401 Lead Certificate #: NAT -1/3513-1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
PD V1i(,
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the 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. Call 48 hours
before you intend to dig to receive locates of underground utilities.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x I- PIG R IJ
Applicant'#Printed Name
Applint's Si gr(a lire
Page 1 of 3
4(4 5 wooa�o &1-e
DO NOT WRI BELOW THIS LINE
1 4c'1
SUB TYPES
Foundation _ Fireplace _ Porch (3 -Season) _ Storm Damage
Single Family _ Garage _ Porch (4 -Season) _ Exterior Alteration (Single Family)
Multi eck _Porch (Screen/Gazebo/Pergola) _Exterior Alteration (Multi)
01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New
X - Addition
I Alteration
Replace
_ Retaining Wall
pESCRIPTION
Valuation
Plan Review
(25%_100% y)
Census Code
#of Units
# of Buildings
Type of Construction
Interior Improvement Siding Demolish Building*
- Reroof - Demolish Interior
- Windows - Demolish Foundation
Egress Window Water Damage
*Demolition of entire building — give PCA handout to applicant
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
y Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
1207
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
?c Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: Footings `Air/Gas Tests Final
_Framing Siding: Stucco Lath Stone Lath _Brick
Fireplace: Rough In Air Test _Final Windows
_Insulation Retaining Wall: Footings Backfill Final
_Sheathing Radon Control
_Sheetrock Erosion Control
Reviewed By: • , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Oak-
rn�
C
Page 2 of 3
1-11-1-66- liticcd att. cf.
Lot rs4 -5(r 3
076r v.,:
11.a `+8�
rift
Use BUS or BLACK Ink
s---- ------7--1
rwomm um '
5~ 0 ,
~1 ~L' ~ P~n1i<Fae~
3M Pilot KAOD ~a 1
I St*
2013 RESIDENTIAL BU'LD'NG PERUff APPUCATION
Daw
Phone, .
77777-
Owner
Dammipbon of wow Type oflor<< Multi-Facn~r Bum (yes
1 No._-? z
cones coat
SEPOpla
x c«ftraCbor ,sib 5.5bb~ Phonw 6571- 2--7 0-7~~
39,6sd8 M57-396.~ E
ff the p vjed is eiaelrppt ftm Ow d ceroftaBom p (S" Pqp 3 for add* MW ifdXmatbn)
Y
} f
2
9
COMPLETE IM AREA ONLY IF CONSTRUCi1NG A MW OLNLEM
x a
in Ow feet 12 monthI6 has 16e City of BOOM kmwd a I P' a sing based on a maatar p ~
p1m
z
# Yes Ib if yes, dab and addvem of nWXW pion:
i
t Phony
phone:
g Medal{ COWAntors
4 Phaas:
86lAwT & t#Ihier Conwaei0r Ask.
t1 trYoit suc met w aJb►P
the_ fvm Bits f ~sno
'
d6f~gm for p~ udearound dw dsmags CaY 48 howl
6r
sisf f RARE YOU DIM COY Qopk*rSbb Ow COY st p
betone you iiafd b db b moewe ioosias d wdeWOund uifss. COY of
1 heradY age fist fiis iitoetaBoe is aa~npiaa and aoourads; ~d alolk is notio start wirlal a p fiat ft wo* YA be in
EmM eat 1 nndendn - tlts is not a pwrat but ariV an epp -F lorm fore POWAL acconknoe wish to appimed fun into case ofvwakwld . jjQuk s a mdaw and app owd of plans.
Bxls fo rwerkaapwasa8pabuYdioO Paaa isessd to acooWWowvd& to OOO MWMg *Oft ant b w 0080fded walls we
r
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Pfiffied tie l 16AQW R Page 1 of 3