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1699 Woodgate Lane CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot KROb Road pERMIT NO.: 5511 P. O. 3ox 21199 6-1-84 Eagan, MN 55121 DATE: Zoniny: Rl - No. of Units: 1 Owrwr. Grand Oaks Address: ite Addrcu: 1699 Woodaate Lne L26 Bl Tiberon lst ~~r. McDonald's Plbg a..• Connedion Charye: 470.00 pd te~ No.: 15.00 pd Si e: " Account Deposit: le ~ O.Z. ~ Permit Fee: 10.00 pd Reader No.: 50 pd IsorN to tanPhr !Iw Cihr ef Eeyon Surchorge: . 63.00 Pd ~t2r' Ordi Misc. CF+croes: 7 Total: By Date Paid: Date of I nsp.: I nsp.: I ' CITY OF EAGAN 3830 Pilot Knob Road WATER SERVICE PERMIT P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 'ZOn'ng' P1 No. of Units: Owner: (ran.. ;S _ /lddmss: Site ^ddress: V1'"111--ic cate Plumber: ~c ons E AAeter No.: Connection Charge: • i Slze: Account Deposit: . ~ . , F Reader No.: Permit Fee: p 1agroe to eanPlp witb tIN Citr oi EaOan Surchorge: n Ordinenea. Mlsc. Chcrges: er Totcl: By Date Paid: Date of Insp.: 1nsp.: CITY OF EAGAN 3830 Pilot Knob Road SEVNER SERVICE PERMIT P. O. Box 21199 PERMIT NO.: 6 7 Eagan, MN 55121 pATE: , 74 Zoninp: 11 ~ Owner: G1 Gr3T2d No. of units: E13ss Address: Site Address: a ' G k2'C7ri Plumber: "icDot7~ald's Plb --c _ ~ egne M eanoyr wNh eM CilY of Eagaw Connectlon (horpe: 425.00 d ; Ordiaenpt, llccount Deposit: ~ • P ~ Ps?mit Fee: P Surehorpe; p BY Misc. Chorpex Date of Insp.: Totcl: Date Poid: CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 N 00 9089 . PHONE: 454-8100 BUILDING PERMIT Receipt # Te be wed fer SF DWG/GAR Est. Volue $ 8 0 ,2 7 6 pOfe Ir1AY 21 , 19 8 4 1699 WOODGATE LN ~23 Site Ad~r~ss IBEROIV ;~?r Erect Occuponcy Lot Bloc c/S b Aiter ? Zoning R1 Parcel No. ~ A Repoir Q Fire Zone , Enlorye p Type of Const. V ac Name DAVID PIKOP Z BLOOP~IINGTON ~!,VE Move D # Stories ~ Address Demolish ? Length 5 0 ~ City Phone 2 y04 6rode ? Depth 49 Sq. Ft. ~ • Approvols Fees Zo Name ~ 0 u~ A~resS : _ Assessment Permit • 5 0 ~ City ' one~ Water 8 Sew. Surcharge Police Plan check~' ~ 0 ~W Name Fire SAC ~00 ~ Address 00 Enp. Water Conn. iz Z. City Phone Plonner Water Meter I Council Rood Unit ~ I hereby acknowledge thot I have read this application ond state thct gldg. Off. the informotion is Correct ond ogree to tomply with oll opplicoble ^PC Totol , 922 • 50 ~ Stote of Minnesota Stotutes and City of Eagon Ordinonces. I Siflnoture of Permittee ~ 'QAND 01'?ICS ~/1 Bullding Pe?mit is issued to: on the express condition thm ~ oll work sholi be done in pecQrdance th fl pplicoble State of Minnesota Statutes ond City of Eogon Ordinances. II Buildinp Officiol t~~ Psrmit No. Permit Holder Misc. Permit No. Holder Plumbing y 3 C: Y 1- (ti(-3q H.V.A.C. J 1- 6,s 56y4f W~II Water Disp. S~wsr Ekctric Inopsction Date Insp. Other Foot,ngs r _ aa Dp Foundation Fnminy . Rouyh Pib¢ .9' Rouyh HVA Inwlation ~ Final Plbp. Final HVAC Final Water Dsscribe Location: YVell Sswer Pr. Dbp. Receipt Ll l~ PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prini legibly Tot. 1. Date - 2. Installation Cost - 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor ' Phone 6. Address 7. City State Zip - 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray ~ Floor Drains Drinking Ftn. Slop Sink 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 Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone ' 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional 0 9. Work Description: New ~ Add O Alter ? Repair ? 10. Describe Fuel Type 11. No. Equinment BTU - M. Ea. No. EQUipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mtg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 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 Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CASH RECEIPT ~ . CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE :i ' 19 ( REG6IVED . . ~ FROM ``..-AMOUNT $ ~ & DOLLARS +oo F-1 CASH ? CHECK z ~ ~ % ~ t • [ L - ~ c - FUND i ~ . CODE AM 'p{T . . ~ S, - 5 , f- Tha ou r . BY White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN Remarks ~J ~'J •1'' Addition TIBERON ADDITION Lot 26 81k 1 Parcel 10-76400-260-01 owner Street 1699 iV00DGATE LANE State EAGAN MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, 3-10 1977 3~].21 30.73 10 61.45 STREET RESTOR. q~S 1981 953.23 190.65 S 190.67 " " GRADING SAN SEW TRUNK 1974 128.30 8.56 15 34.34 014245 17 4 *SEWERLATERALStub 1979 1483.09 98.87 15 899-87 it WATERMAIN * WATER LATERAL Stl3U 1979 1S WATER AREA 1977 12$.22 . $.55 15 STORM SEW TRK STORMSEWLAT 1981 15.94 5 15.95 A 014245 7 17 84 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 #43460 -2 -8 WATER CONN. 470.00 BUILDING PER. SAC 525-00 PARK INSPECTION RECORD ~ CITY OF EAGAN PERMIT TYPE: 1:0 3830 Pilot Knob Road Permit Number: 0 Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS' • APPLICANT: 1; r:, fi 1_ (0(k : + j i_)I'1100ATF ! 9Ny" 11:1 PERMIT SUBTYPE: TYPE OF WORK: I s;f . t~ ± 3• i~~~I^~ t i~ ; t4~, r INSPECTION DA • D. 's• ~ L ~ Permit No. Pertnft Holder Date Telephone # I ELECTRIC PLUMBING HVAC Inapecdon DaU Inap. Commenb I FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE I FIREPLACE I AIR TEST I FiNAL PLBG FINAL HTG ORSAT TEST i BLDG FINAL i BSMT R.I. I BSMT FINAL I I DECK FTG I I DECK FINAL ~ I I CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 9089 PHONE:454-8100 BUILDING PERMIT - Receipt # To be used for SF DWG/GAR Est.Value $80?4M Dote MAY 21 19 84 SiteAddress 1699 WOODGATE LN 26 1 TIBERON 1ST Erect {~j Occuponcy R3 Lot Block - Sec/Sub.. Alter ? Zoning R1 Parcel rvo. 10-76400-260-01 Repoir p Fire Zone N/A Enlarge ? Type of Const. V W Name DAVID PIKOP Move p # Stories Z Address 5124 BLOOMINGTON AVE ~ o Demolish ? Length 50 City Phone 824-$904 Grade ? Depth 49 Sq. Ft. o Name GRAND OAKS Approvals Fees Zu Assessment Permit 3 7 6. 0 0 v~ Address 40.50 ~ City LAKEVI7pWW 432-6561 Water & Sew. Surchorge F Police Plan check 188 . 00 FZ Name Fire SAC 525.00 _G Address Eng. Water Conn. 4 7 0• 00 U wW City Phone Planner Woter Meter 63.00 Countil Rood Unit 2 6 0. 00 I hereby ocknowledge that I have reod this applicotion and state that gldg. Off. the informotion is torrect and ogree to comply with oll opplicable ApC Totol 1~ 922 . 50 Stote of Minnesoto Stotutes and City of Eagon Ordinances. Signoture of Permittee A Building Permit is issued to: GRAND OAKS on the express condition thnt all work shcil be done in pccordance with pplicable $tote of Minnesota Statutes ond City of Eogan Ordinonces. Building Officiol TAi~ request void y ~ 18~,~ipnYhs fBDm A 057799 -jl l ~ q 3 6'p / Request D te Fire No. Rouph-in Inspection Required7 [-]Heady Now ill Notify, 4Aj5~j es N. tor When qeady Licensed Electrica Contractor 1 hereby request inspection of above ? Owner ' electrical work installed at: Street Address, Box or Route No. City ~o del 2~. ~ ect on o. Township Name or o. Range No. County Yo n Occupnt (PRINT) Phon No. ra h~(~a~ S 4~3.Z ~ds~ J Power Supplier Address T)a 4 o -t'a- 5le cj~`. Electrical Contractor (C mpany Name)_. Contractor's License No. GG ~o ~~~~3 Mailing Ad ress (Contractor or Owner Making Instailation) 19? 54WI:q Authorized ignature (Contractor O ner Njaking I stallation) Phone umber y MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Ph.,.,.. 16121 297.217 7 E NC LOSED. ~ REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 instructions for completing this form on back oi yellow copy: A "X" BeI`ow Woi',t' 'overed by This Request M"oAddl Rep. Type of Building Applinnces Vlfired Equipment Wired Home Range Temporary Service Duplex Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Buik Milk Tank Farm Ocner peci y Other(sueciry) t er Sueci y Ot er Other ompute lnspection Fee Be/ow q fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits 0 to200Am s 0 to30Am s 0 to 30Am s Above 200 Am ps 31 to 100 Amps ! 31 to 100 A mus Swimming Pool Above 100_Am s Above 1 00_Am • Transformers Irrigation Boorns (.1 Partial,'Other Fee Signs Special Inspection S ~ A; v E Rertarks TOTA ` • ~ ~ Rough-in Date 1, the ai ~f Insvector, hereby - certify that the above Final spection has been de. fMo request vold 18 months from ~ CITY USE ONLY PERMIT C) I~ RECEIPT DATE: 8008 MIDENTIAL bIECHANICAL PEftNIIT ~PPLICATION crrYogEAsAx ~ sgsoP~.oT~~ ~ o , ~si~vMrr-55i2$ MAY Q 6 65t=681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: SITE ADDRESS: I QjC Ln OWNER NAME: TELEPHONE le5/~U INSTALLER NAME: Wotilers Southside,Htg. & Air., Inc. ~ 95Of W..146-:St., #106 STREET ADDRESS:, 1App1e Va11'ey, ;MN ~ 55124 (952) 431-7099 CITY: - ~ ZIP: Place a check mark next to the permit work type ~ Add-on, modification or alteration to existinq dwelling unit $ 30.00 • furnace replacement • air exchanger - • air conditioner • other Nature of work: T'~C'DUC~~ CA~ C Y-,,i ~o State Surchar e $ .50 Total $ ~ ~5b ~ Ce SIGNATURE OF PERMITTEE 1 /02 CITY USE ONLY PERMIT RECEIPT DATE: APPROVED BY: , INSPECTOR 8008 COIHMERCIAL M£CH4NICAI. PERMIT APPLICATION CTTY OF KAf i4N SgSO PILOT KNOB RD EA6M, MN 55188 651-6$1-4675 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 - TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: STREET ADDRESS: CITY: STATE: ZIP: TELEPHONE WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work: When installing/removing undergroui:d tank, call 651-681-4675 jor inspection by Fire Marsl:al and Plun:bing iiispector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. ' • Underground tank removaUinstallarion = minimum fee Contract price: $ x 1% (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/02 RESIDENTIAL BUILDING PERMIT APPLICATION ~ CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements RemodellReuair Requirements . 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions . 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions 8 decks . 1 set of Energy Calculations • Indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan if lot platted after 7/1/93 . Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE - n VALUATION SITE ADDRESS MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK 2~ iZpa ~ FIREPLACE(S) _ 0_ 1_ 2 APPLICANT CQ aS~rMC~ /iovn -I`ervZc es 6 -6 22-iXO l-f STREET ADDRESS 20.J-E rrt°_v'Y~l S' A-l,-,- CITY ao STATEYh2V1, ZIP TELEPHONE # 610=l~L_33-72 CELL PHONE # 65'1- 629 ~3S~s FAX # /__2 - ~S"~l - ~Qg ~ PROPERTYOWNER 12bV TL~ ~1"e, 1" f2 TELEPHONE# COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTr1 RULES 7670 CATLGORY 1 MINNESOTA RiJLES 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted . New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing systecn includes: Water Softener Lawn Sprinkler ree $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechaniril syslem includes: Air Conditioning Fee: $70.00 Hea[ Recovery System Sewer/Water Contractor: Phone # i hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applfcant gil `C ~ IVI ~ I JUN 1 I-20O2 orricr. IJSE oNi.Y 9u Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-pfex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. 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 ? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage 0 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O. _ Footings (deck) _ FinalMo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _[ce & Water _ Final _ Pool _ Ftas _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) (nsulation _ Retaining Wall Approved By , Building Inspector - - - - - - - - - - - - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ' •~GI~F~LK S~~Y~R.p St---Tg4r-11- CITY~OF FAG~~1N . Include 2 sets of p~ans`, ' ` • 1 site plan w/elevations & BUIIDING PrRMIT APPLI:Cd1TION 1 set of enerqy calculations. Zb IIe Used For Valuation Date ° 5-i7 -J-,~---- Site Aciciress J(, 9`~ OT'I'ICE vsi: oNT,Z Lot o1G Block ~ Sec./Sub. _~~Erect Oc;cupancy rZ-3 Parcel # : %j: - 1~ (Uq ~ - oZb ltlter 7oning R - ~ Repair I'ire Zone ~I A Owner: Fnlarge 'Iype of Const. ~ Address: tzeg~ M°ve ~ # Stories Dxrolish Front ~ ft. City/Zip Cocie: S- 5"_V/7_ Gradc _ ncpth 49 f.t. Phone # : ' 11PPIS)VnLS i'IT,S Contractor: G~ ltssessimnts Pernut 37 (o 11ater/Sc~,ier Surcharge qn, ~ ~eSS : 7 ~ ~ _3 71 ~ F'olicc Plan Check ( g8. - City/Zip Code: I'irc SIC 525.~'- T•1x7. water Conn. 4 ~ D. ~o Phor~ # : Planner Water Meter to3 , Arch ./Erig • Cour.c i 1 Road Uni t 2Co0, F31dg. Of f. ° Ac.ct,t.rwT DF-P. 30. °O Address : AI.'C + City/Zip Code: Phone # : ~ TC'I'AI• 1 ~ r , / / . : . . i~ 4-1 X x ~ O G-N (571 -P ~ , c ~ , . ,`.iu:v+'.~....._~ . . .,..~.air'=~':•'.,.. _ ._r... , .,,,_-.~.k':~.i; ,'~`..a~`~i--a':,a~?:ooaef~r:~1Se.:.~~..u~::~:v ~~L::~,.~~;2.1,~:0:.. •y; _ . . , . ~t TY P C: ELIE CARRIER LOAD INFORMATION CENTER Cc.),fl /.kov . j OPTION 1 OPTION Z OPTION : 1. Summer design degrees . . . . . . . . . 9 C # ~ ~ q p ' (90, 95, 100, 105. 110 or 115) (Ii 90, 105, 110 or 115, Item 2 N.A.) ~ 2. Dailyrange(0°-35°) ' 3. Winter design degrees q (Precede a minus number with M) 4. Number of windowpanes p • # (1, 2 or 3. If 2 or 3, Item 5 N.A.) 5. Storm windows? (Y or N) . . . . . . . . . . . ~t 'w• ` : " ` ~ il 6. Windows weatherstripped? (Yor N) . / 7. Four window areas starting with N or NE orientation . . . . . . . . . . . . . (Ex: N#25#30#20#25#q; Max per side: 999 sq. it.) 71 N or NE q p 72 _E or SE 7.~ q 7~ q a. 73 S or SW 74 W or NW ,.3 , y y B. Shadedwindowarea . C q C p a (0 or sq. ft. Enter 0 if not applicable. Max: 999 sq. ft.) 9. Doorarea ~ ,U ~ a (0 or sq. ft. Max: 999 sq. ft. If 0, / Items 10 8 11 N.A.) 10. Doorweatherstripped? (YorN) ° ,q •j~ '~`n~~ y ~ • ~ 11. Storm doors? (Yor N) ~"`~°!._~~,.xa~~a • ~ _ /v 12. First story perimeter . . . . . . . . . . . . . . . . . . . # 13. Second story perimeter . . . . . . . . . . . . . . . . L~ q ~ p # 14. Thicknessoiwallinsulation .....A r q ~ p # (0. 2, 4 or 6" fiberglas. Enter M for masonry; R values, enter R, then value. Ex: R 19) 15. Basementperimeter q ~ y q # (0 or linear ft. Ii 0, Items 16. 17 & 28 N.A.) 771- 16. Basement heated? (Y or N) . . . . . . . . 77 (If N, Item 17 N.A.) 17. Percent above rade 9 (Ex:S%= 5) ,~;r;z:~_ ~~~f°'. • g :~,p~~~~~' ~r, # - - - i'. 18. Area of roof with exposed beams or studioceifing ~ #k ~ #q qq (0 or sq. (t. Ii zero, Items 19, 20 & 21 N.A.) 19. Woodorfiber , # (W for wood, F for fiber. Ii W, Item 20 N.A., _ ~°•~`~~".u~=`~ If F, Item 21 N.A.) 77 20. Thicknessoifiber ;p` , (1.5, 2 or 3" or R values) ~ " ~ 21. Insulatibn (Y, N or R values, Y assumes 1~.5") ' OPTION 1 OPTION Z OPTION 3 ~ 22. Area of ceiling under vented roof or unconditioned sPace . . ~ 7i # (0 or sq. ft. If 0 Item 23 N.A.) 23. Thickness of Insulation . . . . . . . . . . . . . ` ~ ' ti ' ` q - • • • ~ : # (0, 3, 6, 12 or 18" of fiberglas or R values. Ex: R30) 24. Area of floors over unconditioned space N C q # (0 or sq. ft. If 0 Item 25 N.A.) 25. Thickness of insulation . . . . . . . . . . . . . . . . # . q p (0, 3 or 6" fiberglas, or R values) 26. Area of floors over open or vented space, orgarage qq C qq pk (0 or sq. ft. If 0 Item 27 N.A.) 27. Thickness of insulation . . # - # - # (0, 3 or 6" of fiberglas or R values) 28. Basement area . . . . . . . . . . . . . . . . . . . . . . 11,71 # q (0 or sq. ft. If Item 15 fs 0 skip this entry.) 29. 7otal heated area . . . . . . . . . . . . . . . . . . . R3 p . q (sq. ft.) , 30. Perimeterotconcreteslab ~ N # p (0 or linear ft.) (If 0, Item 31 N.A.) 31. Thickness of slab insulation . . . . . . . . . . . . N # q (0, 1 or 2") 32. Desired summer indoor temperature swing ~ Nq ~ k# q# (Value between 1 and 6 inclusive.) 33. Desired winter inside temperature rf ~ N L1 q q 34. Duct location . . . . . . . . . . . . . . . . . . q p (AT = attic, BA = basement, SL = slab, CR = crawl space, CO = conditioned space) (I( BA, SL, or CO, Item 35 N.A.) 35. Thickness of insulation . . . . . . . . . . . . . . . . . q . q q (0, 1 or 2". Use 2 for 1" rigid.) ' REPEAT DATA?........................... qN ~ qq k# Yor N "CORRECTIONS7......................... . If there are no corrections required enter kq. If there are corrections to the data, enter , - question number, N, the new data, and #q. # #a fttt # # E no up thea corrections, enter qq only. # F## 1 COOLING B.T.U.H. EQUAIS~.~R n T..(C0 `l AT ~n °F B.T.U.H.3/ 1~ AT F B.T.U.H. AT °F HEATING B.T.U.H. EQUALS AT 1)(-) °F B.T.U.H. Crl~_AT C*°F B.T.U.H. AT °F "REPEAT THE ANSWERS" (Y or N) . iitf qq gq "SAVE YOUR DATA?" . . qq gp pq Y or N: or YRad will save your data and goes to beginning for new Analysis; or NRqq will not save data but goes back to beginning (or new Analysis. JOB NUMBER . . . . . . . If you want to save your data CLIC assigns Job Number "STRUCTURE CHANGES?................. If there are no changes required enter N4t. If there are changes to the data: enter question number. a. the new data. and aa. k NN a ap p pp Ex: 25NR30ttN If no further changes, enter aq only. aa aa qq nCGGG P PORTUNITY HOME 3-78 Printed in U.S.A. 838-039 ~ SURVEYOR'S' CERTIFICATE GRAND OAKS DEVELOPMENT COMPANY x A o .0 oo ` x9~19 W 5 Z N 690 A lo 6~ N n '31 V Q 3A 1 00 ~ \ •o ~ 937.5 X i` ~ ~ , RopO : C!~ P 8.ao N x9 ~O o x oo p C) X~S~ - R 1 \ w E'PR' W $~N ~GP ~r o) ~ ~ ER ~10 \ `0 N -~Cn w W w pjNPG ENT P 19/;z 2?~:,_:;~'~. ~pR S~M X l i t t E~ P'fj~ , v\ o O w 2 • w T~ ~ ~ / 3 0 ..a 00 O 0 . C F~?X9t c a ^N L / w itG' ~ ~F^ ~ ~(E x93n.e G n 1 `V~~' 0oo r DENOTES PROPOSED SURFACE DRAIPdAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 750 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR =93-7, 4 FEET X000.0 DENOTES EXISTING ELEVATION °ROPOSED LOWEST FLOOR = 9-34,6 FEET (000.0) DENOTES PROPOSED ELEVAT1nN PROPOSED TOP OF BLOCK =937•3 FEET I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0MPANY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 26, Block 1, TIBERON 1ST ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. AND OF THE LOCATIOM OF ALL BUILDINGS, IF APJY TyEREON, AND ALL VISIBLE EROACHMEtvTS, IF ANY, FROM OR 0N SAID LAWD.. AS SURVEYED BY ME THIS iSTti-DAY OF M1984 SIGtdED: JAF?ES R. HILL, INC. v BY: HAROLD C. PETERSON, LAND SURVEYOR PSINNESOTA LICENSE N0. 12294 PROJECT NO. BOOK / PAGE JAMES R. HILL, INC. 84 708 FILE NO 6G 3 Planners / Engineers / Surveyors . 8200 Humboldt Avenue South FOLDER Bbomington. Mn. 55431 812-884-3029 (:;A`:al°I:l:ER:: 38 'f'!":RM:CNOIL NIt:)° 4*i BF,TE„ f.l7/~.'.;3t`Jr' 'T':1:M1':e M48:::37 IL+,: ~AME:: ::}OPHATI"1 Sf_aEUNI L ;r....ll:~ _.~:11]:i. j.(,::..) ..i. ql '~'1~.: x ~ E I(:If..Jr+(;ATf::: L 8trut]c 205 900:!. :I.F`_°)`_•.? HQ(:)Dr:;t1'Y'k:: 2.00 To-Fa:I. Rece:ipt Amour,t;c 89u25 GFt(:l78989 l.lsit:::R :1:De .1AN PERMIT CITY OF EAGAN 3830 Pilot Knob Road ~'PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 4 9 7 (612) 681-4675 Date Issued: 07/ 2 3/ 9 7 SITE ADDRESS: 1699 WOODGATE LANE LOT: 26 BLOCK: 1 TIBERON 1ST P.I.N.: 10-76400-260-01 DESCRIPTION: VT(srnr~vG) ro~ B°uil°ding,,,,Permit Type SF (MTSC. ) ;Bui;].dingw,.W :qrTYPe REPAIR ~ A~"Cens`us ~Cp~de 434 A~LT. F2ESIqENTIAL ~ ~p~ , ~ ~ ~ tl.~ ~ ~ ~ . a ~h 'k,,;,i m REMARKS: FEE SUMMARY: ~ VALUATTON $4,000 Base Fee $87.25 Surcharge $2.00 . Tatal Fee $89.25 r CONTRACTOR: OWNER: - A p p 1 i c a n t - ~ SQEUN SQPHATH 1699 WOQDGATE LN EAGAN MN 55122 (612)687-0162 4 . . 9 H ~ « . . , x . , s . : . . . , y ; , . a ~ . . ? ~ s A 4 . . , o, , ' ' . , o „ , e T~heb "acknowled e,<tliat I~ have~~.r`~ad:.~Ch=is~ a :ta,,c'atii~~n-°and ~st,a~t:e~s ..tlia~t';the~ ~ ~r,FSe.Y,~. a 9 ~ " . . in~format~ip;n .is 'c'nr,r,ectaag,r.ee~.w~C)a<,c.amp~1`9, w~i~th`=a~1: ~appl°icaEi,;l;ez'<Stateaf "I~n` . eq . ' , .R,•i ^3~_ ~•Y ~~...9ti.e a . . .o.. a . ~ Statutes.°a°nd Cit`y of.~Eag.an°,~l`raci,:aria,no3 ce.s A PLICANT/PF.6i{aHfiEE-SIGNATURE ISSUED BY: SIG A4T EJ ~ , 97 BUILDING PERMIT APPLICATION (RESIDENTIAL) cmr oF EAcaN 30' 3830 PILOT KNOB RD - 55122 681 -4675 New Construction Reauirements RemodeVReoair Reauirements . ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (inGude beam 8 window s¢es; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 dedcs) ? 1 energy calculations ? 1 energy calculations br heated additions ? 3 copies of tree preservation plan if lot platted aRer 7/1/93 required: _ Yes _ No ~ DATE: CONSTRUCTION COST: 3$ d DESCRIPTION OF WORK: ~P c~ 0 G~ 0wR S i &-t` wa/ STREET ADDRESS: w ~ oLa~R ~--Av\e ~~~1Q ~ IU ~ ~ S 12. a- LOT L BLOCK SUBD./P.I.D.#: 11yXe worK. PROPERTY Name: 5 0 Z~~U r\~ S ~ Pli Y~- ~ Yk- Phone ~2-- OWNER LM, nRST Street Address: L Lc~ LL L(Ep- (304 "'^-e City: State:~'~ ~ Zip: ~ S 1 2~ CONTRACTOR Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: !v/A- Phone ENGtNEER Name: Registration Street Address: City: State: Zip: Sewer & water licer•,%ed plumber (new construction only): . Penalty applies when address change and lot change are iequested once permit is issued. 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: OFFICE USE ONLY -Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 03 SF Addition o 08 8-plex n 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch o 09 12-plex o 14 Fireplace ? 21 Miscellaneous 0 05 SF Misc. 0 10 _-plex a 15 Deck WORK TYPE 0 31 New o 33 Alterations o 36 Move ? 32 Addition a 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units . i i 2/84 ~ J:• ;y' I CITY OF EAGAN } < APPLICATION FOR PERiMIT '~1 ll ~ SEWER AND/OR WATER CONNECTION (PLEASE P4INT) 1) PF.OPEftTY ADDRESS : C 0 ~ C L a'n e r_Fr3`%L DES=?'TICN: ` D c. 1 1 'o c~ ~ C~ ?n (Lot/Blocic Subciivision or Tax Parcei I.D. NLUnber) IF =537=`:G ST:?L'=_71E, D= G~ CRIG~ jAL, UJE-7. ~ R'-1 SI-INGLEE r ~-M1iV - - _ a R-2 cuPLEX (7_'~;70 wzTS) [3 R-3 'I'GLv1iIHC'LiSE (THRF_" + UNITS) ( TMI'?'S) [3 R_d pppRT.=m/C0'z\IDCi%=IL7m ( Wi ITSi p CON~l`g..'rtCIAL/REI'AIL,/OFFICE p L%MliSTRTAI, p INSTITTi-TIOi'AL/GOV~.~'IF'VT 2) AppI,I= (PLE„SE PRINi) -cCi Y\ c~ n C J) P t r P ADDREss : 71; a`~ (1 a !J e ~ i 6 1 _54 CITY, STA'?'-7, ZIP: L. ~~'e V PHONE: 3) p=TBEIP . PLEASE l~PRINT) ~ FOR CITY USE ONLY NAME- t` ~~Uh cr ,C/ J'/. ts9 ~'J 1/~flr PLUH5.RS lICE4SE: , ADDRESS: 81s''e-) 'ndr/ j ~ Active CITY, STATE, ZIP: 1 A- q~j Expired ~ SitR N~;=~f g~iRe~brd PHOiVE: _:3~~ pLUMBER LICENSE # ~2 y~U arr 1nitla 4) pCC[JPkW/(fy-r_ER NA["I (PLEASE PRINi) E : „ ADDFtESS : CITY, STA'I'E, ZIP: L PHO;VE : 5) INDIG=i= WHICH PEP,h1IT IS BEING REQUESTID: ~ C0~1FfiI'ION -TO CITY SEWER ~ CC..TNECT'ICN Tp CITS.' 6JATER ? G`I'f ER ( PLEASE DESCZI EE ) '6) L,1DIG;-,Z C:E: ' ? PI, :-,SE fiOLD APPROVID PERtitIT FOR PIC.K-UP BY ONE OF ABOVE ?°I.F_n.SE ~t.r'1IL APPROVa) PERMIT 'IIO 1. 2, 3, 4AB0',IE ' (Circle one) 7) SICZ~ZL.'-cE: 1,j~ DATE• . ~ - `5 FOR C I TY U SE OIVLY PERMIT u ISSUED gErs : $ Sr::L.-7 Dz'A\1T^' ~~T y C D $ WATER PERP-tIT (INCLUDE SURCuARGE ) WATER METER/COPPERHORN/OUTSID=- REAGER $ WATER TaP (INCi,UDE CORPGR-'%T=ON STCP) $ - - S.F..:'lEp T.D $ A COUNT DEPOSIT - SE:•:ER $ CCOUNT DEPOS IT -[JATER $ - ~J~ WAC , $ SAC $ T'.2UNK WAT°.°, aSSESSL-IENT $ TRliVK SE:vER ASSESSMENT $ LATE°.AL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNi; WATER $ OTHER $ TOTAL $ AMOU:IT PAID/RECEIPT DOES UTILITY CONNECTION RF:QUIRE EXCAVATION IN PUBLIC RIGi-iT OF tvAY? . YES IF YES, THEN A`PERMIT FOR WORK 6JITHIN ' ~ PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERIDIG DIVISION. LIST AS A CONDI- TION. SUIIJECT TO TfIE FOLLO?IING CONDITIONS : APPROVED BY: TITLE: DATE : Cs~- - ~ ~ •O 01-M w~ ~ ~ ~ ~ W OR s.w M:W w WMs-.M wrG NELa MMM w IM:PI Ws" w.AM Mt Wse wift ok-GW Pkm aa os in w 2004 RESIDENTIAL BUILDING PERMIT APPLICATION \ City Of Eagan c) U 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodeURepair Requirements Offrc~ tlse Cli~rv 3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Ce}l. .Ssiniey Recd:: (20% maximum loi coverage allowed) 1 set of Energy Calculations for heated additions T~ee:Pres P[an 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site suroey for additions & decks 7ree:f?res:f2equd:: N 1 set of Energy Calculations Addition - indicate it on-site septic system Or~site:Sepiic:System:: X::,_ N 3 copies of Tree Preservation Plan if lot plaried after 7/1/93 Rim Joist Detail 0 Idgs with 3 or less units / Construction Cost zor ~Oo Site Address z(a Unit/Ste # w 2 - Description of Work Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner Telephone #441~75/ ~ 4 (1q51 Contractor ABC Seamless s ree 355 Address O....,.+.+ ~ni 55055 City State Zip Telephone # ( 0~ ~v v~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone I CrNf I C I I I~I I herebY apply for a Residential Building Permit and acknowledge that the informateon is complete and acc~ rate; that the work will be in conformance with the ordinances and codes of the City of~agan 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 'n the case of work whi h requires a review and approval of plans. ~ oJ ~ ImAr 1) pplicant's Printed Name A icant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. 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 (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex [3 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge e Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Zoos RESIDENTIAL PLUMBING PERnniT aPPLicATioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date Site Street Address j(Oq VV00~ U'1 • Unit # Property Owner Q')C us 1"61'"'f h Telephone # (651 ) (O8 1 9 c ` Contractor frillo S Telephone #C--~3-I ) 365' [34Q Address • City Q State 11 c Zip The Applicant is: _ Owner Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softener and/or 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 e appliance(s) you are installing. _ Septic System Abandonment AY 3 1 2006 _Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Y?Water Softener Water Heater $ 15.00 _ new N replacement _ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 Total $ A ~U 11 I hereby apply for a Residential Plumbing Permit and acknowledge that toe 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 nof to start without a permit and work will be in accordance ith the approved plan in the event a plan is required to belevie d-arrd-approve. . ApplicanYs rinted Name Applic nYs Signature ~ 4°. Gity of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 OPT 7d2 Use BLUE or BLACK Ink r Fo 14.00 Use Permit#: / 2/G50 Permit Fee: INFLOW liONFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Site Address: Tenant: Suite #: RESIDENT /OWNER Name: 1-y l ( 110 -50-aN6-- Phone: / .571-6)././99 Address / City / Zip: /I q5 t9,9V£ L -N 4 S-5- 2,2 CONTRACTOR Name: _ '' s , ,. TO ; .y- ' ,, License #: 051 5' 5 ft ruv Address: A 0, I •1:.. a s/ 7 a City: E. g se. I State: vvi N Zip: ,',r i r4 a. Phone: S i - % $1- 8 2 5 2 - Contact: Contact: n1'e ti e Sc t, t 1 h Email: PI 1 r he.asst i a ►, "/4 "i i •*, j . e..0,r. TYPE OF WORK PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) A Sump Pump Repair Repair Other. Other. DESCRIPTION Description of work: T\-' j ) 4 t.t. j i ti - 4 r l•( FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ S S - O 0 * *Permit fees will NOT be reimbursed by the City of Eagan. if you plan to submit I/I repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaaan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Cali 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.aopherstateonecalLorq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that i understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires` a review and approval of plans. x t r`►fit.; r Applicant's Printed Name x Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required inspections: Under Ground _,__Rough -In Final Use BLUE or BLACK Ink I For Office Use I j Permit L/ I City of Ea Ed~ 1 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: ! j Phone: (651) 675-5675 I ~I~ I Fax: (651) 675-5694 1 Staff. IGf I 1 I 2013 RESIDENTIAL BUILDING DING PERMIT APPLICATION Date: Site Address: 1400 ooi~a'-e Zw'L Unit Name: Solt' t.4 A (4A Phone: a 7 Resident/ I 1699 r,~ Owner Address/ City / Zip: _ 10.10,0 alf e, w, i I Applicant is: Ownner9 Contractor T e of Work !Description of work: Re~~/~'~Qp4 of lioc c &tj rze4c + I,vx f yp s ~ Construction Cost: ~J Multi-Family Building: (Yes / N~_, Company: 4Contact: qua, Contractor Address: 3V J10a,h / y n, Ave, 0 q City': &Z State: Zip: p Phone.- C152 X4 7 - 79 A,, License U_6393165) Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 S 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 the 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. www.oooherstateonecall.ora 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 worts 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 Minn State Building Code must be completed within 180 days of permit issuance. x r'r\~Q. 1~SS x Applicant's Printed Name Applr S ature y Page 1 of 3 Use BLUE or BLACK Ink r--_-____-- �� I For Office Use ��(�r I / � � � Permit#: ��[O �� I ��../� �lt� 0� ��Il � . - -� ;� ' Permit Fee: �s� 3830 Pilot Knob Road I I Eagan MN 55122 ,��; � � j�� Date Received��-�� Phone: (651)675-5675 ��,�.�, � � Fax: (651)675-5694 �� I Sta�: S�� I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: �� ' `�s �� r�� Y� � �q �. j�� .". Name: � Phone: b�� Y�� 6� � �� ' �, ��` :^ Address/City/Zip: IC�Gl�1 W�1OC��'�'� �.C�h.� CCLCyG�� y�J ��I��C-- ;; Applicant is: Owne Contractor � � Y ` � Description of work: I�(� �'�i`��+t��4�'�C : „ � � � .� �£; Construction Cost: �� Multi-Family Building: (Yes /No� �� " � �� : Company: �� Contact: SI�M s-/�/ � ;' Address: S�''� E City: `—� �� State:` Zip: — Phone: "— EmaiL•,.��trrils.•tt,,.�s.e�1� ��.�wa.Cow� �"' License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: � Phone: ��T�' ��FIu�r�t��Si'�,�}!�''/��E�'�tGi��t�`��,��"B�� l"l��il� �� a��'�r��i��ry��'�'�ct��r��-#�►�±�� ,��cr�+��` � � � _ � � r ; �s,� a :,, �,�._. _ ,,,, . .. ..., ,�; _ � �� : � � N �-�.�. �_ �..�� :. �.�. � ��_.,��„ , ��,�, .: �,��= ,....-� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utilfty damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.poaherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x .-�rs ��Ga✓� e�� ! x�� ApplicanY Printed Name Appli nt's Signature Page 1 of 3 �p� �i(�(,�j C DO NOT WRITE BELOW THIS LINE �� `� SUB TYPES - _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)y" " _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi �C Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES x New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Buitding _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation � � Zfl-a t� Occupancy ,��C_I MCES System Plan Review Code Edition u»�1 2v15� SAC Units (25%_ 100%�) Zoning �� City Water Census Code Stories Booster Pump #of Units Square Feet PRV # fBili � o u d ngs Length Z Fire Suppression Required Type of Construction �/� Width I Z REQUIRED INSPECTIONS Footings (New Buildingj Meter Size: �p Footings (Deck) • rb Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath iStone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: I �� YY1: )C �7 f} , Building Inspector RESIDENTIAL FEES 2„��,,,�,� s��',R y,,,�� Base Fee Surcharge ,Z � 5� � �� Plan Review � X !S• MCES SAC City SAC Utility Connection Charge S8�W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 . �� ,� L� � �i� :� � �U�VEYOR�S� CERTIFIC`ATE � � GRAND OAKS DEVE�,OFMENT COMPANY . . � � . ��' `�i ,� � �� ; �;� / � �- �y,0�j��7 .o�—••" �9��a� 5� � �'� �1 $� W 'L ; � " � � �m � � �� S �, ��" 2 �- 9°y //� �° � �� • N 6 .,,� � ,�'%, u� / .,.�-'",,,.�--' , �� „ � N � ��66� � � � �.. _ , �;,.. � p � �- �.c� / � g� �, V , � `� \ � � '� xg;•� 46� �5� O� . 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C7 � X 93A e �P� • ' ,, oOn � � {_ DENOTES PROPOSED SURFACE DRAIPiACE " O DENOTES IRON h10NUMENT SET SCALE: 1 INCH = �o FEET • DENOTES IRON MONUMEIVT FOUND PROPOSED GARAGE FLOOR = �3Z.4 FEET X000.0 QENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 9�4�� FEET (000.0} DENOTES PROPOSED ELEVAT.1.nN PROPOSED TOP OF BLOCK = �?37• Y� FEE7 I HEREBY CERTIFY TO GRAt�D OAKS DEVELOPMEN3 COMPANY THAT THIS IS A TRUE AND CORRECT REPRESEN7ATION OF A SURVEY OF TNE BOUNOARIES OF: Lot 26, Block 1 , TIBERON 1ST ADDITION, according to the recarded plat thereof, Dakota County; Minnesota: AND OF THE LOCAT�OrI OF ALL BUiLDIhGS, I� ApJ� T�IEREON, AND ALL vISIBLE E OACNMEhTs, IF ANY, FROM OR 0f4 SAID LAWO. AS SURVEYED BY ME THIS �s�t►t-DAY OF M � I98� � SIGt1ED: JAFtES P,. HILL, INC. I' v , BY: � � ,,�A =�G�-tri,.-.� NAR4LD C. PETERSON, LANQ SURVEYOR �SINNESOTA LICENSE N0. 12294 PRC�JECT NO. BOOK / PAGE �AMES R. HlLL !NC• ' s4 708 ' ��- � Planners ! Engineers / Su�rveyors F!!.E NO, ' 8200 Humboldt Avenue Sou#h FOLDER Bbonr�tnetor�, Mn. 55431 812-884-3029