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1737 Woodgate Lane CITY OF EAGAN ^ " 3830 Pilot Knob Road, P.O. Box 21-199, Eagsn, MN 55121 ~ PHONE: 454-8100 BUILDING (PERMIT aeceia To be weA ier 't.;A.id Est. Value L, 0 k: t:; Date Site Address l_ 3 7 :<N Erect ~ Occupancy t•;:.3 Lot 6 Blxk 1 ~ec/Sub. TIFIXR014 ' f"'+ Remodel ? Zoning Parcel No. Repair ? Type of Const. Addition ? No. Stories J'IFTi tR.tD47Lfi°1' H02'lE5 Move ? Len9th 5 ~ ~ Name ` - Demolish ? Depth 46 Address 3908 S~ B M"ti~ ~ #E Int Impr. ? Sq. Ft. City r:AG11A} phone 4 54 - C3 433 Instau O Name f~ty1g E; APOrovals FNs ~ ~ . ~u A~~ Assessment Permit 2 ~1 u City Phone Woter & Sew. Surcharge •0u Police Plan Review 14 0 tW Nsme Rzf'E:.AE{D CdiARLIL;R Fin SAC 5i W Address 1-1 3 Gl9RC1 r: i:v' V I E;'~T UG ` - ~ Enp. Water Conn. • • ~ t Z. City r~ ' J • Phone 4 3 2 - , 4 2 Plonnwr Water Meter • i~ Council Road Unit :%G . t+ , ( hercby ocknowledye that 1 how rood this opplication ond storo that Bldg. Off..1% 18 t' Tr. PI. I1 2. tM informotion is torrect ond ogree tp wmply with aU-.applicable Stah of Minnesob $totutes ond Gt,~,ef ~oyan Or,dinor?c~e; APC Parks , s ,,r'1~ ~r. Var. Date Copies Sipnotum of Pem+ittae " - Total A Buildinq Permit Is issued to: on tM express ca+ditlon that oll work sholl be dorw in accordonce wlth oll oppliooble Stote of Mfnnesoto Statutes ond City of Eaqan Ordironces. Buildlnp Official PKmit No. Permk Holder Dob TNephonis s Plumbkq J /a- Y H.vA.c. EhWde son«w insp.ction D.a Insp. Otha Footlngs I 7 ~ Footlnys 11 Foundation Framin9 Roofln9 Rouyh Plbp. Rough Hto. jl (r Insul. Finplaco Final Htg. Final Plby. D _ - Final CKt/Occ. WatN Wteribe Loeation: WNI Sswer Pr. Olsp. Raceipt MECHANICAL PERMIT Parmit No. CITY OF EAGAN FN ~ ~ fill in numbered apaces S/C ~ Type or Print legibly Tot . 1. Date 2. Installation Cost f • :_rtQ... / . . . 3. Job Addresa/737 u~-~~-~-'' ~-*~~Lot • Blk. I Tract 4. Owner' •~`1~.~--x._~~.2.~~ -r.~g~.~-~u~.a. 5. Contractor ? -^.a--tPhone 6. Address r,~_a._-, . ~ 7. City State Zip 8. Building Type: Residential ~ Commerciai ? Institutional O 9. Work Description: N e w Add ? Alter O Repair ? 10. Descxibe Fuel Type% f f 11. No. Equio,¢leat 8TU - M. Ea. No. Ectuipment CFM X Forced Air Air Handling: Mfg. t Boilers Mech. Exhaust , Mfg. ~ ~ Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outleu 12. 1 hereby certify that the above information is true and correct, and I agree to oomply w1th,a11 ordinances and codes governing this type of work. $Igned : A,:'A LJJ~. fOr Rouyh Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt ~ZPLUMBING PERMIT Permit No. CITY OF EAGAN . Fee fill in numbered spaces S/C Type or Print /egibly Tot. " 1. Date •4 2, Installation Cost , Lot ' Bik. 3. Job AddressJ Tract 4. Owner j,7; .A 7-:4 5. Contractor ~:€=;i,~E-L ;Zi~~:;•H Phone 6. Address ~ r 7. City 4~ ; ; State A,~',.I'i Zip _ i 8. Building Type: Residential ~ Commercial ? Institutional ? ~ 9. Work Description: New Ca Add ? Alter ? Repair ? ` 10. Describe 'i 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner ~ Shower Well Kitchen Sink E UrinaUBidet Other E ' 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 : L •"4x.= for , Rough Final Inspectionf: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarksh.ld #15ng0 7~~53 Addition TIBEM ADDITION Lot 6 Bik 1 Parcel 10-76400-060-01 Owner street 1737 WOODGATE LANE state FAGAN MN 55122 Improvement Date Amount Annual Years ' Payment Receipt Date STREET SURF. O 1977 307.30 30.73 10 STREET RESTOR. 04~i 1981 9953,30 190.66 S GRADING SAN SEW TRUNK Zc/ 97 128.30 8,55 15 7/5 0/~ S 9~ i!-i -~s * SEWER LATERALQ rq R- o /lo S' 95 WATERMAIN ir WATER LATERAL Stub 1979 lrJ WATER AREA .9p/ly5 l'~S STOFM SEW TRK STORM SEW LAT y~q 1981 79.67 15.93 5 ~ CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. n n BUILDING PER. sac 525.00 PARK CITV OF EAGAN WATER SERVICE PERMR ' 3830 Pilot Knob Road F37C P. O. Box 8~ 199 PERMIT NO.: Eagan MN 55121 DATE: E-11-85 Zonirip: ~i No. of Units: I Owner: Addreaa: r.. ? ~ ~ i: 51te /lddross: r Plumber e a{E, ~ 1~LrL Meter No.. / i V t ` nection Charye: 5 0').44 51ze. AkAMO&pwt, 15. 'v' Reader No:4 Permit Fee: - 10. JC?;.~ 1 qn~ to ao~sPlp wilU eM Cirr oi Epwn Surchargs: . SG,'~ oAtwesoM. ~ Mtsc. C?wrpes: 132.00pd S/C Totol: 61.4G'pd r:Y-ter BY l ' Dote Paid: Date of I . Irup.: to~( CITY RJF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road PERMIT NO.: • P. O. Box 21,199 Eagan, Mld 55121 DATE: Zoninp: 1 No. of Units: ~ Vwror. /lW nm: . Site Addrcss: ~.7~v7 Pluxnber. ~ Meter No.: Connedion Charge: ~0~'' ° Stze: Actount Deposit: .i5. dvC~ Reader No.: Permit Fee: 10« Q'CIi.d 1 pm !e aemoly wuh !IN Ciyr ei hyow Surchorys: O~diw~~a~s. Misc. Chorpes: ' Totol: x- gy Dote Paid: Dote of Irnp.: Insp.: ; CITY OF EAGAN SEWER SERVlCE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: _r ; Eagan, MN 55121 DATE: Zoninp: No. of Untts: ' OWrMr: Address: $itO AddroSS: '6 E~l Plumber. P1a''r.r~7 ~ t prN te eewolp wNa !M Gfy ef iM/eO Conrnction Chorge: OrdiMeoM. Acoount Deposit: Permit Fee: D • o!:i.'„ ~ Surchorpe: , gy Misc. Chorpes: ' Dote of Insp.: Totol: Irup.: DaM Poid: ~ . . _ ~ CITY OF EAGAN N 0- 10 5 5 8 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BIJILDING PERMIT PHONE: 454-8100 Receipt * . Te be w~d for SF DWG/GAR Est. Vclue $52,000 Date JULY 11 19 85 SiteAddress 1737 WOODGATE LN Erect M Occupancy R3 Lot 6 Block 1 Sec/Sub. TIBERON 1ST Remodel ? Zoning Rl Parcel No. Repair ? Type of Const. V Addition ? No. Stories FRONTIER MIDWEST HOMES Move ? Length 38 ~ Name Z 3908 S I B MEM HWY # E Demolish ? Depth 4 6 Address Int. Impr. ? Sq. Ft. ~ City EAGAN pnone 454-0433 Install ~ Approvals Fees o Name SAME S~ Address Assessment Permit 289.00 ~ City Phone Water 8$ew. Surcharge 26.00 Police Plan Review 144.50 ~W Name RICHARD CHARLIER Fire SAC 525.00 x~ Address 14103 GARDENVIEW CT Enp. WaterConn. 500.00 GW City A- V• Phone 4 3 2- 5 4 9 2 planner Water Meter 63.00 Council Road Unit 280.00 I hereby ocknowledge thot 1 have reod this applicotion ond state that Bidg. Off. 7/10/85 T, pi, 132 . 00 fhe inlormation is correct ond ogree to comply with oll opp ' le APC State of Minnesoto Stotu nd ag n Or n Parks Var. Date Copies Slpnoture of Permittee ' $1, 9 5 9. 5 0 Total A Building Permit Is issued to: FRONT ER MIDWEST HOMES on the exprcss condifion thot oli work shall be done in accordance with oll ble State Mi esota Stotutea and City oF Eopcn Ordinances. Buildinq Official ~ This request void - 18 mont,hs_from / 0 5 9 ~ 5-7 Request Date Fire No. Rough-i i Inspection ~ / ~ Requi d? ~Ready Now~'fl Notify, Inspec- es ? N. [or When Ready +n, ~icensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Stre /'7 07 A et Address, Box or Route No. City ~Q*~ ~ - V ° ~ ection o. Township Name or No. Range No. • County ~ / OccuGan PRINT) . n Phone No. tL/ a Power upplier Address Electncal Contractor (Companv Name) C mtrac or'"s License No. . . ~ Mailing Address (Contractor or Owner Making Instailation) ~ ENDRICK EI.ECTRIC ~ Authorized Signa~tg4bn l~Q~i~Cf~tq~'n Ir ~ion1 i Phone Number j tl V1.11 MINNESOT R C RI&ITY THIS INSPECTION REQUEST WILL NOT ` Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 7821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ,r-„ es-uuuu, va ~ ' See instructions for completing this form on 6ack of yellow copy. W~-,n X" Below Work Covered by This Request K nqqR 7 ' e4,~r1d Rep. Type of Building Appliances Wired Equipmeti! Wired ~i Home Range Tq~Wporary Service Duplex Water Heater / Liyhtin,y Fixtures Apt. Building D er Electric Heatin Commerciai Bldg. t Fumace Silo Unloader Industrial'Bldg. Air Conditioner Bulk Milk Tanl< Farm otne. Specify Other ISpeciry! ther Speci(y Other Other ompute lnspection Fee Below # Fee Service Entrance Size # Fee Feeders/5u6feeders # Fee Circuits -N 0 to 200 Am s 0 to 30 Am ps ZC «!J 0 tn 30 Am ps (J Above 200 Ampsi 31 to 100 Amps ~ <7C)p 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_Amps TransTOrmers Irrigation Boon-is Partial-'Other Fee Signs Special Inspection TOTAL%FEE Rertmrks Rough-in J . Date _ry-the Electrical Inspector, hereby ' ce 'fy that the above Final Date vspection has been " G/'a-f made. • This request void 18 months from ' '49,~~~ ~ - 2004 RESIDENTIAL BUILDING PERMIT APPLICATION , D~~~ n n~ ' City Of Eagan ~ LJ lJ ~ r 3830 Pilot Knob Road, Eagan MN 55122 JAN A Telephone # 651-675-5675 FAX # 651-675-5694 2005 ~ New Construction Requirements Remodel/Repair Requirements Offte Uss Onlv y . . 3 re9istered site surveYs showin9 s9. fl. of lot, s9 fl. of house; and all roofed areas 2 coPies of Plan C~r !_YN t-of Sury:: eY?ecd--------,.~, (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree_PreS:Plan:Recd--:_" 2 copies of plan showing beam & window sizes; poured found design, e1c. 1 site survey for additions & decks 7ree:Pres:fteqyired:.":: _ Y:>::T N 1 set of Energy Calculations Addition - indicate if on-site septic system On-sife:5epiic Syslam 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 (p /:LN / d~ Construction Cost Site Address Unit/Ste # 31 lA O O dA0.7e L~~'. Description of Work Q, w~ ~ 1~ t 5 1 Multi-Family Bldg YVI N ~ Fireplace(s) _ 0 _ 1 _2 ' Property Owner Telephone # Contractor ~RMA HOME SERVICES INC. ~ Home Depot Installed Sales Address 3200 Cobb Galleria Pkwy., Ste. # 200 City State Atlanta, GA 30339 , Telephone ) BC-20268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (,I 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 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 apval of plans. Printed Name pplicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-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 0 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea. ) ? 33 Ext. Alt - SF ? 04 02-plex 0 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding O 32 Addition ? 36 Move Building ? 42 Demolish Foundation 0 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 Approvsd By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total . , , Installed ~ome seiv.~:-~'~ Siding and Windows I;IMITED POWER_OF ATTORNEY , _ , . : ~ _ . ~ . COUNTY OF COBB STATE OF GEORGIA . KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales loca±ed at 6E0 Mendelssohn Avenue North, Golde ln Va!?ey, r?INT 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary arid appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the."Work").. The powers conveyed to the Agent by this Limited Power of Attcrriey are limited solely to the express powers delineated herein and appl_y solely tu the Work. This Limi*ed Power of Attoi7iey shall expire and automatically be revoked on the 21 st day of Nlay, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. I?~1 WiTNF.SS WHEREOF this Limited Poiver of grro„-ney is e.xecuted this ' 21 st day of May, 2003 . David N. Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. Notary P t ic in for the State of eorgia Nly Commission Expires: January 21, 2006 3968 I b.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT ~¦m~es~ . ' Elder-Jones i~ ¦ Building Permit Service, Inc. o~mo as~ fjr, ' 1 ' C - March 17, 2005 !j C'G:5 City of Eagan 3830 Pilot Knob Road • Eagan, MN 55122 To: Building Department I am requesting a refund for cancelled building permit #EA067622, issued 01111105. The permit was for replacing windows at the residence of: Steven Gallagher 1574 Rustic Hills Drive Eagan, MN 55121-1131 Enclosed is the original permit. Please make the check payable to Elder-Jones Building Permit Service, Inc. If you have any questions or need more information, please call me at 952-345-6047. Thank You, Kara Benson Permit Service .v - 7 U uL~ r ;-4*' 3 0105 ~ Elder-Jones Building Permit Service, Inc. 1120 East 80th Street • Bloomington, Minnesota 55420-1498 952-854-2854 ' FAX: 952-854-4909 PERMIT # ` RECEIPT DATE: 8002 USIDENTIAL PLU1VI$INfi ~EftMIT APPLICATION CITY OF EAfiAN , 3830 PaoT Kxo$ Rn E,QCsAx, Mv 551 EE 651-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEADDRESS: 1131 WOTAU\W-ti LO,ff-, 11-1 OWNER NAME: : P wcaw PQl,ffl TELEPHONE 6'Jl 4O5" (AREA CODE) INSTALLER NAME: PPl jXW0'(1LS TELEPHONE b5I 13LI0 STREETADDRESS: 36I0 VQdA Y.J, (AREACODE) CITY: L~w•1ovi STATE: MN ZIP: E~51213 _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit 5/8" meter if needed -$118) Other: _ RPZ: new installation/repair/rebuild JUN 0 4 7002 $ 30.00 _ lawn irrigation system By - ReplacemenUadditional: _ water softener li, water heater $ 15.00 State Surcharge $ .50 Total $ rDo I hereby acknowledge that I have read this application, state that the information is co4City(, o i a pplicable Cityof Eagan ordinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan asd es cause by the City during its normal operational and maintenance activities to the facilities constructed under this permit r' h of as ent. ERMITTEE 1/02 1 S ~J 1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN NOTE: ALL COAITRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Single Family Valuation• 62-1999' Date• 7-8-85 Site Address: 1737 Woodgate_Lane OFFICE USE ONLY Lot: 6 Block 1 Sect/Sub Erect }C Occupancy t2-3 s~- Remodel _ Zoning (Z-f Parcel Tiberon ~ Repair _ Type of Const ~ Enlarge # of Stories Owner Mary Leonard Move Length 3 g Demolish Depth ~ Address 12025 Cty. Rd. 11 #305 Grade Sq Ft City/Zip Code Burnsville, MN 55337 Phone 894-1092 APPROVALS ContractorFrontier Midwest Homes Corp. Assessments Permit ~ 2gc~. - Water/Sewer Surcharge Address 3908 Sibley Memorial Hwy. ~kE Police Plan Review 144•S=' Fire SAC S25 City/Zip Code Eagan, MN 55122 Engr Water Conn Soca °-tl Planner Water Meter co3. Phone 454-0433 Council Road Unit 280l O° Bldg Off &olVj Parks Arch./Engr. Richard Charlier APC Treatment P1 13 2.= 14103 Gardenview Ct. Variance Address TOTAL City/Zip Code Apple Valley, MN 55124 Phone # 432-5492 ~ S0GMA . . SURVEY0 NG House Certificate For: SERVICES 3908 Sibley Memorial Highway Eagan, Minnesota 55122 ~~~~0~~ ~i~~ Phone: (612) 452-3077 M0aA - N ARTFoRO 3 0 . 9b4.o N x Q N ~0 , ~ v~ S85°52~39"E Ntfl' SA 10 N y 60.51 `935% _~n h x prninape 9 Utilily Ea meM S I,~ %4)1 L . , W) vasc~_ \ O / IHOJSE~O ~ - O f O o Q \ O~ 9/n ~ 9yz.~ So3 °v., d? ~s N - \ -R~ e• Ui;~;~ y'S~s, ~v CO ~7~ \ c ~ ~ • y Ft'~ 4j . i 410 0` 4D~ ~ ~ ~ ~l ~ ~ _ ~ ~ /,,~i ~~,~XN u~ . .`~.,.V% 64 E S n WAYNE D. CORDES ' = t.~. . -.14675 Q Af S PRC?POSED GARAGF fL00R ELEVAIIUN= 9~I,O 0 Denofes Ircxi Mor,,men1 PRUf'USED Top of Eslock ELEVAl10N= _9~•_~_ Llenotes ?Yxd Nut, Set PNOPOSED BASEMFNT FLODR ELEVATION= 941.1 Lc-not_ ~ 1")/0 o, fxistinq .`,F'ot C icv,ir I c,ai NUIE: Veri(y <?11 flnor heights with F~rial Ha.ise Plans. Sh°w^) LZerkoles f'rop,ase;l Spot Eleva t ioy I Dra ina(j D i rec t i crl -SURVEYQRS CERT 1 F 1 CAZ 1 QN _PR)PERI-Y, DESCR,FTION_ 1 hereby cerl ify tlat this survey„ plan or report /q was Ex epared by rte or urrler my d i rec; t s uperv i s r an L~>> .&-(X KarrJ t ha t I am a du I y Req i s tered Lard Surveyor TIr3EROrJ ~ST ~~q111Qrv tir ~e~tl~e lans vf 1he Stafe of Minresota. accvrd irq to 1 6e recordel pl,.if thereof, ~ --------J'=~=0` Dafe: O _Covnty, ,Ginnesota VYayne D. Crndes, Minn. Rey. No. 14675 Page 1 of 4 /h 1MP~ ~ B~ ~ ~ C~ 4~ • ' ` , . ` IOR CNVELOPL /IVfR/1GE ~~1~~~ cohir~IT/17IC)~~l AA1~`t'~'~'~ . . ' w 146 0..-^ tm OWNER; - f1,1TF: S I TE ADDRESS : PHONE : CONTRACTOR: ~rtAi0*MM Determine working square footac~e of each c . 'l, Totalexposed wall ar-ea..... j_ZSsq. ft. x .11 = . 2. Total roof/ceiling area..... ~ sq. ft, x.026 ~~v(B ~ Total exposed wal l area above filoor- .V5 a. 7otal wall window area b. Total door area. c. Total sliding glass door area d. total fireplace wall area.......... . . . . . . . . " e. Total wall framing area (average 10;) " f. Total rim joist area. . , „ " ~ g• net wall area above floor.i1F~ " " - ~ • - h• wall area above floor. --V`a.~~..-- i• ~wall area above floor J frame wall area gt foundation Total exposed foundation area=_ S ; _k., Total foundation window area„ ~ l. Total net foundatioti area above grade ~ Determine "u" value of each wall segment (e.g. window, door, each separate wall section) a. I t 3 _ X n U,, . , , b • X lluii , A c. ~ X "Ull _--dzz•'ss'~_ ' . X iiult d e . AZ_ ~ ~7_ X " ll f . _ ~ z a • `sX u,,_i ~ o.3 9 Co• ~ X U" ' h X "U" _ i X j X u k, I' - I fi i Lem ~13 i s X U the'.sam aS , or less than°;'..i.tem X ~u~, lll, you have"."met x; . ' _ - ..Z ~ • ~ O ~ i n t e n t o . 006 3. - f SBC6, . , ta~ ~~'i.r„,, . . . . . . . I • . . . . . . . . . . . . . . . To "J~~.____~._.._.__ . ' ~ .1~ Tx -~~rjar Enva].al>a nvni-ngo "ll" CompuLnL.i.an " Pttcfo 2 0.e 4 ~ • Tol•.rzl exposed roof/ceilinq arca , m. '1bLa1 skylj.gltt arca 'i' n. Total rooF/ceiling framinq area (average 10%)... o. Total net insulated roof/ccilin g area........... . . lleter.mine °U" value for each roof/ceiling segment ; Itl . _x u uu x nUn o . ~ 7,X „u„ 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . ToLal P 07. If total of '44 is the szune as, or less i:hzn Jf2, you have met the int.ent of ShC 6006 (c) 1. , , Alternate Buildinq Lnve]_ope Desiqn , r `!b ut:ilize the total envelope 'systGn method, Che values esL-ablishecl Uy thc sam of items U and 1N shall not be greater than the stun oL- itcros fkl and 112. + 2. 3. -H 4. df ~ . , . I . • ..,iii~!1:' . a` ,t' . . i*..-,U;•r ~!~1 ~I` t`1'a~ii~r, wn11 f,-)L, 00t% ' • jf~~l11~1 l 1"UC:I iUfl Y~a.-,• ---------~I~ l. I~l~,'1 /~1 ~4y~'i.~ . ~.~l~ '.r' ~ : . . . II, M ~ ~ t~ ~~yl I1, ~II 7. VIC, , ~ ~ . ~_l P~ +4?L~ ~ . . . _ r.f~ ~ 'V5 ~:C • r,..- , t'ii,r n1i (I;iu ~ - - - . . . _ . ~ . c~ ~ ' PIC. tll T011VIFZ9 OF ~ FltNth: IqALL . InCrrli~t~ ~iir ' 1 lin 0,f,ll . 2 . • _ (3.~ ~ ~4.JW i . 3 • _ . ~ a _ ~ 5~.~ . • . ~ ' 4. .~r_~~ , • , ~ , 5 . `_.r._.....{~ • ._t~l~i,_ ~?4.t~4~_._. . . 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ExCcr3.or air film (still) 0 v Total p z . ~ . ~LaW 1. Interior. air film ~ 0.61 `n t e d 2 _ ---~-~-,v-G~ ~ c. ~ ; ~ vp - • ' . . . 3. • ' • 4. F,xtetic~- air tj.ln ,6T, . • , , , . ' To taL ~'IC. ~5 • . . . . . . . . . . . . ~ V - . o2-~.. , . Co.a, s~r~ v c ri ~ y~_. ' • ..~v--~~.v~:'^•'~'-• •%n_~,,,p,-,+~r...~n~~~ T nsi d c a i r. f i 1 in 0.61 2 - ~ . • 3_ . , . 4. . S. Outsidc air Filin 0.17 f I II { ~ ~ 'I ~i ~ . Total . IL - - • . . _ - -Z- , 3 4' ' • Znside air Pilin ~ • • . . ~ a' - . ~ • l _ lolo up j-trentr-d 3. ~ ~?ect F • . - . . 4_ • . , ' ' - ~ . ' S. Outsidc air Lilrn _ 0.17 ~6.. . ~ . . . ' • ' • . Tota1 . . ~ _ F05Insid c aiz film 0.61 Z_ . ' • ,o~ _i1,°_- . • . . 3+ - ~ , . • r..: v~,C~t'~~'~ :,...:•..•-:'-,~~-flj~ 4_ t ~ ~ ~~~_l-, : , . . ~ ~ ~ ~;:~':;~~-j"~•.•-.•.,:.. ,~;~_r~. - ' 5. O'ut!Adc air PiLn 0.17 To ta L . ' ~ ~ . . , . / , Z . - . . ~ . . , . . - . • . . H~7_~;~ ' Ptatcs U;e additional sheets i.f morc -pacQ i: . 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D I(1:;11~.,1 1rJf1 x•~;s~"~y;"~4}i?.~~~~'~Y~':~~p4 n J ~.~~it~i~~~+_'~~~~~.1~t'~~~'t . . . ~ I . . •!r.~;:,>. ' ' ~;2z:~i ~ ' • , d'~ ~ ~ w , PL~Q ii: ~ . I I +ki r ~ Li rjr=-AL_ (1-T, EXPosEC) WALL ~ . aZ,~+ 4c*.4G -7z 4 4~. 5 ;:'uLLI~~ , . , ~ I : ~A { ` ' _ .:I-. S~ PV Seb Wi Y LL AP1+E• O i X 64, ZS BC.N ; 1 ~ ~ ~5 x S° ~ dFr a. s . , . . , . ~ , . 1:: u L L ,t~ ' ~ . , R:. ~ e z~ , ~ ~ t s I ; . : . "T_o rA L IS , F_xo5~D ~ Et Ltuq 98o W Dw5 ~ ~ i , D aO ~.S r~-1 3 14 7w, 45 7,4146~ 4 = 3 ~ ~~-,ri o ti~ go- ~ ' . . . r . 1 ~ . ~ 1~`~~ . • f ti 1 i , ! ~ y 2/84 CITY OF EAGAN APPLICATION FOR PER1%IIT ; . SEWER AND/OR WATER CONNECTIODT , (PLEASE PRINT) 1) PF.OP= ADDRESS: 17-17 InInnrigat_P 12nP - _ ' . . - - - - r.~~I, DESCaSPTICV: 6/1 Tiberon (Lot/Block/St:bciivisicn or Tax Parcel I.D. Nt,.nber) ! I'r' E::I=:'=:u SIpL'CT-.":%, DAT~.' Ot' CrZTG =~L r,vIZ :2':G _:r_=_I: ISJ~.rS.~ pprcL-r t'S': N R-1 SiNGIE FPtit.ILY 0 R-2 L~UP =i ('IT.:U L',\IITS ) 0 rZ-3 ZG:,.-urvTCr (mz= y L-:nTC) r L JNILimc) p F:-4 CCtin1E.:'=/F~.'TAIL/OF'FIC-r- ? 2=S 1. T al, - - - - - - - - - p 1STI 'rIO~L/G~"V~~~n~;T - - 2) A~DT,IC7-y,4T ( PLEAJE PRi;i i) N2V•1E: Frontier Midwest Homes Corporation ADD-RESS= 3908 Sibley Memorial Hwy. Bldg. E CIT`', STnTE, ZIP; Eaqan, MN. 55122 - P~ONE: 454-0433 3) pU71BE-"R N(PLEASE PRINT) FOR CIiY USE O4LY '1`'~= Star Plumbin , ADDRESS: 1018 Mound Springs Ter. PLUHBERS L-i- cEvsE: Active CITY, STATE, ZIP: Bloomington, MN. 55420 Expired No ~f Record PHOVE: 884-4149 PLU"18ER LFCENSE tl 3329 ~ a't"r :nizi3 4) OC'CT„'pp,D]T/Crv'L\;M (PLEASE PRINT) Marv Leonard ADDRESS- 12025 Cty. Rd. 11 #305 CITY, STATE, ZIP: Burnsville. Mn 55337 PHO,E= 894-1092 5) INDIGATE :%1E-iZCH PER-IIT IS BEING REQUESTID: ~ COINN=ION TC CITY Sai'ER Please mail gold copy to ~ CONt=IGV TIO CITY WATE:t Wenzel Mechanical 3600 Kennebec Dr. Q 071ER (PLZI-SE DF_SCP,IBE) Eaqan, MN. 55122 6) INDIG~:: C.:i: . • ? PT..r-~,SE F?OID APPP.aVF.D PERm.IT FOR PICi:-C7r BY ONE OF ABCiVE AT F',SE ApPnOVED PE1-.•1IT T`'J 1. 3, 4 ABOVE (Cir e one) 7) SI^,A~IL,-^rci: DATr': ' • . , : en ss s..a .a s s.~.ss~ :a a.IR .m ..tm.~..muri..: ~.s.s ys e~ara„s F 0 R C I T Y U S E O N L Y P:.DtiIIT ISSUED _ rrZ7 S . $ SE.:GD Pr. DMT'i^ . $ WATE? PER.DSIT (IiICL'JDL :.uRC:iARGc,) $ WATER METER/COPPERHORN/OL'TSZD= REr,uER $ WATER TAP (INCLUDE CORPORATIOy STOP) . $ S :TdER TA? $ _R $ ACCOU`IT DrPOSIT - j•IATEER $ S~u. wac $ SP_C - - S -------TRliNK WATER ASS-ESS::-E.;T-- - S TRli:vK SE;•iER _`SSESSM_NT $ LATEP,AL BEi3EFIT/TRUNK SE:• S LATc?2AL BEVEFIT/.TRU.~K :'7AT°R WATER TREATMENT PLANT SURCHARGE $ OTHER: S TOTAL ' $ °~v~a-SU Ai~?OC`:T PAID;'RECEZ?T ; .~~fZfy DOES UTZT,ZTY CONNECTION REQUIP.E EXCaVATION IN PUBLIC RIGHT OF WrlY? ~ YES IF YES, THEN h"PERIMIT FOR TnIOR?i WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ~ NO__--= ~ ENGINEERZNG DIVISION. LIST AS A CONDI- TION. SUEJECT TO THE FOLLOWING CONDITIONS: , APPROVED BY: • „ ' ~ . , TI:LE: ' DAT°_ : •7~/ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION kV10O'3 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Reauirements Otfrce l7se OFlIu 3 registered site suroeys showing sq. ft. of lot, sq. R. of house; and all roofed areas 2 copies of plan Ga~t.of. Suryey Recd ::N (20°a maximum lot coverage allowed) 1 set of Energy Calculations for heaied additions Tree:Pres:f'lan Recd:::..`: 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree f?res Required i;"Y_ N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic:System:: ;:.:;~>Y:;_; N 3 copies of Tree Preseroation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date d 9 / K)a')n! 57 Construction Cost 3, I'o ~ ~Q. Unit/Ste # Site Address -3-4 U3006CAn:R. Description of Work u" ~~'n ~ S ( Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 C-7 Property Owner ~ Cl n ~I ~ ~ ~ ~ nt Telephone # ~ The Home Depot A.H.S. Inc. ~ Contractor 3200 Cobb Galleria Pkwy. . Address ' Atlanta, GA 30339 City ' 763-542-8826 Telephone # ( ) State \,License #-20268257 - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Categor~ _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) • Submitted Submitted . Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber 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 lan in the case of work which requires a review and ap roval of plans. Applicant's Printed Name pplicant's Signature OUFICF 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 O 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 ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement 0 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair O 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System • Pian Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIItED 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 Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surch&ge Treatment Plant License Search Copies Other Total ~ Installed ld'Itlg and Windows f,NomeSeN S , . ~ • ' LIMITED POWER.OF ATTORNEY E} , • , , , , . . ~ . COUNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Serviccs, Inc., DBA Home Depot Installed Sa!es loca±Pd at 660 Mendelssohn Aver_ue North, GOlui.ii Valley, T~T 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any o.ther instrument(s) which may be necessary arid appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the."Work"). The powers conveyed to the Agent by this Limited Power`of Atterriey are limited solely to the express powers delineated herein and appl_y solely to the Work. This Limi*ed Pow er of Attor7iey shall expire and automati-c ally be revoked on the 21 st day of ?`?Iay, 2004, which date is one year from the executiori hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN Ws"?'NFSS WHEREOF this Limited Poiver of qrrorney is eseci_rted this 21st day of May, 2003 ~ David . Katz SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, 2003. Notary P ic in for the State of eorgia My Commission Expires: January 21, 2006 39681 b.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT R CO.&6 C:~ 2006 RESIDENTIAL BUILDING rExMiT arPLicATioN ~ 0`7 3 7 City Of Eagan fe 3830 Pilot Knob Road, Eagan MN 55122 l-/ Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodeUReoair Reauirements Office.Use:OnN iste2d site surve s showin s. ft. of lot, s. k. of house; and ail roofed areas' 2 coPies of Plan showin9 footin9s, beams, Joists Ceit , . 4 3 re9 Y 9 4 4 (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions 1 Soiis Report if proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pres Plan Recd x~ Y N, 2 copies of plan showing beam 8 window sizes; poured found design, etc. Addition - indicate if on-site septic system Tree.Pres Required • On-ii4e'Septic System~-;~,~?~,'_Y°~•_ N 1 set of Energy Caiculations p~' 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date o7 / d G lz97 Construction Cost 79 ak/), Site Address -LJ7U WC'dG(a, LA UniUSte # Description of Work TQ_~/I'' ~Tt 4 0 ~ ULGXJI- Multi-Family Bldg _ Y~ N. Fireplace(s) _ 0 _ 1 ^ 2 Property Owner Q/Yl ~ 1t- P-raJ ~ CQein Telephone # Qeu Contractor /kQ.'"/~'' GCQd'U G`(i~1:S~GtL/4U,7 • _ ,~y~1 Address City State i'n zip Telephone 67) - COMPLETE THIS AREA ONLY-IF,CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 CateQOrv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type)_ Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber 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. ' 0 f/,k V(%1'15 Applicant' rinted Name Applicant' 'gnature :5- 90.00 RIy00 -71 2006 RESIDENTIAL BUILDING PERMIT APPLICATION ~ City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements • RemodellRepair Reauirements Office.l~se:Oniv v....,, 3 registered site surveys showing sq. R of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Ceit offSurniey;Recd (20% maximum lot coverage aliowed) 1 set of Energy Calculations for heated additions Soils Repor4 N Y a ~r- 1 Soils Report if proposed building is to be piaced on disturbed soil 1 site survey for addiUons & decks Tree Ries Plan Recd y=_Y N 2 copies of plan showing beam & window sizes; poured found design, etc. '~Addition - indicate if on-site septic system Tree. Pres;ReY;,~, _ N :Septic',;°~;";`;'~°'=,Y t set of Energy Calculations . Qn=sife System;; 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form ' Date -7 / ip / u7 Construction Cost (o 5(7 • o C) Site Address UniUSte # Description of Work I leSi C!~ e, Multi-Family Bldg _ Y j~ N. Fireplace(s) _ 0 _ 1 _ 2 Property Owner _RQ~ ~ Y rQdl Gf\J Telephone #(1p5 a. ~C~~~y Contractor Q : : . . Address S ~ 4/7 City State P9 fV Zip_ ~SCb'~ Telephone#(,~z 57) `319, V 3 `~O - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateizory 1 Minnesota Rules 7672 Enetgy Code Category Residential Ventilation Cafegory 1 Worksheet • New Energy Code Worksheet (q submission type): - ~ Submitted : Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber 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. ~ " I~11 (a r%1e. Qf4j~,~ Applicant's Printed Name Applicant's Si re RESIDENT / OWNER Name: I ) L ?r/ f Phone: Address /City l Zip: l , r � 11 ',w • —4 CONTRACTOR Name: oi'/ rise it: 1.1110 - rrr i1��/ Address: / 7-/_ it) . 7Y ' • City: State: Zip: ,a Phone: . ' / - 4.!!< A. Contact ' . / 1 ,lisr i ' TYPE OF WORK New 7 Replacement Additional Alteration Demolition Description of work: -- -lry/ NQ i E : ; led Nttld grot inbuntied Cade s tha Mee " by rrfecha nical a is rsrµilred to be set eened C ity l lltspecfsrrher;l 4i dlon on?pw nt d screening m thuds.' PERMIT TYPE RESIDENTIAL Fumace COMMERCIAL New Construction _ interior Improvement Air Conditioner install Piping Processed Air Exchanger — ,- — Gas Exterior -IVAC Unit _ Heat Pump Under / Above ground Tank ( Install / Remove) — — Other — — "When instalting/removing tank(s), calk for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes burned out apps, ductwork, etc.) (includes $5.00 State Surcharge) $5.00 State Surcharge) $ TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimal (includes - If the Egg is less than T installation/removal OR State Surcharge) $10.010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Pen Fee requires a $ 5.50 surcharge) Contract value $. x 116 = $ Permit Fee nit Fee = $ Surcharge - If the Permit Ea is > $10,010, (Le. a $10,010- $11,010 Permit $ TOTAL FEE 4 , 11 ` City of Esau 3830 Pilot Knob Road Eagan MN 55122 RECEIVED Phone: (651) 675 -5675 Fax: (651) 675 -5694 OCT 2 0 2010 2010 MECHANICAL AL PERMIT APPLICATION Date: 1 C'' 1' L D Site Address:) 6 7 li Y 4 TJ , 1af\o Tenant FOR OFFICE USE Required Inspections: Applies Name ■ Alt Permit #: Permit Fee: Date Received: 1 Staff: Suite 8: Use BLUE or BLACK Ink CALL E F O t Yoy DIG. call/ Gopher State One Cali (651) 454-0002 for protection against underground damage. eau as hours before you intend to dig to before locates of underground utilities. www.booherstateonecalLorci 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a perm! + ; t the work will be in accordance w a�#mp assee of work which requires a review and approval of pier . rated _ Under Ground Rough In _Air T Exterior,FNAC S Test _„ �In -floor Heat _Final Use BLUE or BLACK Ink Again. r--- I For Office Use Permit I I City of Eap Permit Fee: Las 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff: I I 21013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: !1-I Q / / -3 Site Address: J lycJ q / _aUGT a G{//J Unit ~.m Name: flQ✓I1 ~i~ ~Q1✓I U~ACfJvc~li ~tb~Qyl~a►'YPhone: Resident/ Owner Address / City / Zip: / woodQQ /e Gt.yt~_.- Applicant is: Owner Contractor r Type of Work j Description of work: Q~ 0 Vl/O~ eeA✓ i Construction Cost: P,r d0 Multi-Family Building: (Yes / No 26 Company: 2 ya / ReJ'Oii~fa+)6.1 .l v► C• Contact: _ Q 1y? Address: ! 7i C~e1r L1 S City: ) Contractor ~~7103 7Cl~i~ State: Zip: Phone: 3 i ; License#: Lead Certificate t✓' Lp 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 & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of i the information may be classified as non-public if you provide specific reasons that would permit the City, to f 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. www.gor)herstateonecall.oro 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 52-e GI emQ~)., x Applicants Printed Name Applicants Signature Page 1 of 3 i