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944 Trail Ct INSPECTION RECORD . CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ~ Eagan, Minnesota 55122-1897 Date tssued: (612) 681-4675 t , SITE ADDRESS: APPLICANT: , ~ ~ ~ r t. r ~ , t ~ „ . ~ ~ rd ~ PERMIT SUBTYPE: TYPE OF WORK: r!itJ INSPECTION .A • .A s r t Iv~,•, ~ r~~, ~ ~ Permit No. Permit Holder Oate Telephone M ELECTRIC PLUMBING HVAC Inspactlon Date inap. Comments FOO11NG5 FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP 80ARD FIREPLACE FIREPLACE AIR TEST FINAL PL$G FINAL HTG . ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL t L tv_I~-`~~ INSPECTION RECORD CIV OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: • (612) 681-4675 SITE ADDRESS: APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . i .i~ltii~ii I h~ ~ ~ . •li~il ~ ~ ii . ~ ~ I 14 1A i I I II h~ilf.i . il I~ } 1 i1191'I I-I~ I f) . ~ PsrmR No. ParmR Holder Date Teiephons Il S/W PLUMBING ~q d-SL8'G HVAC ELECTRIC 100,V D r ELECTRIC Inspection Date Inap. Commsnts F~ingsi a Foundation FrBming Roofing Rough Plbg. fi.4 L ~ Rough Hig. e/P Isul. Fireplace N "`y ! Final Htg. orsm resi Fnal Pibg. Plbg. Inspector - Natlty Plumber ~Const. Meter Engc/Plan i 6ldg. Final Deck Ftg. { Dedc Flnal weu Pr. Disp. A~~480 - `i"/a7 Peques~ ~ala ire Na. Rough-ln Inspeclion Requiretl InspecMion Other Than Roug~~ln a (YOU mu t cell Inspecto~,Y,hen ready) ~ qeatly Now ~ Will Notity Inspector ~Q / ~ Yes u No 0a1e Read IN licensed contractor ? owner hereby request inspection of above electrical work at: Job Atltlress (Street, Box or Rome No.) City qy -r6? 1 ~4 aw cau,~~- Seclion No. Township Name or No. Range No. Counly k ~ ~ ~ Occupa ~(PBINi) Phone No.' Atltl~asa ~ Power S lier c' Elecirical Coniractor (COmpany Name) ConVadoYS Lbense No. 9 Mailing Aaaress (COniractor or Owner Making Inalellation) A,' c4 r SI/,`l L' Au[horizetl SignaWra (Conh o n aking InstallaY Phone N.mbs~ MINNE50TA STATE B HD OF ELECTRICITV THIS INSPECTION REOUEST WILL NOT Grlggs-Midway Bldg. - Faam 5-128 BE ACCEPTEO BY THE STATE BOARD 1821 Unlvewlty Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phane (612) 602-0800 ENCLOSED. 'REQUEST FOR ELECTRICAL INSPECTION e-oo i-os 2 4, 8 O, Se'9 inStmc1bns for complating this i1m.on back Of yelbw capy. "X" Below Work Covered by This Request Ne Add Rep.. 7ype of Building- - Appliances Wired Equipment Wired Homa ' Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Mana ment Comm./Industrial Furnace Othar 5 eci ) Farm Air Conditioner Other (speclfy) ConVectors Remarks: Computa lnspec@on Fee Belaw., N Other Fee # Service Entrance Size Fee # CircuiGslFeeders Fee Swimming Pool D ro 200 Amps .'~O~ 0 0 to 0 Am s [pQ Transfortners Above 200-Amps Ahove:90 _Am s Si ns Inspeclors Use Only: ~ TOTAL a Irrigation Booms 7,~J C? a 7 S ecial Ins ection d Alarm/Communication THIS INSTALLATION MAY BE ORD ED DISCONNECTED IF NOT Other Fee COMPLETED WITHIPIMMONYJS. - I I, ihe Elecirical Inspector, hereby Rovgh-in * oat cetliry that the above inspection has been made. OFFICE USE ONLV ~ TMS request voitl 18 monlhs from 0- ~ %794 E e . ~~'l~~ Reque 1 0 ~ Fire No. RouB~-In nspec~ion Requirg-d nsp ion Other Than Rwgb- D ~ (YOU m?usl call inspe en reatly) eady Now ~ Will NoIn~ityInspeqor Ves No Dele Rea I'14censed contractor ?owner hereby request inspection of above electrical work at: JOb AtlOress (5 eel, Box or .RoNe Cily I/V y l~z2i ~Oarf 4~z7 ax-~ Section No. Township Name or No_ I Fange No. Counly Hennepin Ocwpanl(PRIN Phone No c. v ~~ia 2 Power Supplier Atldress Electncal Cont2ctor jCOmpany Name) ConVamors License No. Harrison Electric Inc. CA 00808 Mailing Atltlress (COniraclor or Owner Making Installation) 2 ' vada Ave 301 n all 42 Authorizetl qn anV to wn M' g In tio ) Phone Number (j~Q L 544-3300 MINNESOTA STATE BOAHD O ELECTNICfTY THIS INSPECTION FEOUEST WILL NOT GriggsMitlwey 61Ag. - poom 5428 BE ACCEPTED BY THE STATE BOARD 1821 UnWersity Ave., St. Paul, MN 55104 UNLESS PROPEfl INSPECTION FEE IS Phone (612) 6/2A800 , . i ENCLOSEO. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os / 40A y(~45 ~ See ns:m[ions for comple~ing this larm on back oi yellow capy. I~ ~ 4~~ f " Below-Work !,.overed By This Aequest - r Ne Add Rep. ype o Buii ng Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial furnace Other (Specify) Farm ir Conditioner Other (specli9) Conlachors RemaMS: Campute Inspection Fee 8elow: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 700 _Amps Signs i~~orors use onry: TOTAL Irrigation Booms '7wq Special Inspection . ~v Alarm/Communication THIS INSTALLATION MAY BE OR DISCONNECTEDIF NOT Other Fee COMPLETED WITHIN 18 MONTH5. I, the Eleclrical Inspector, hereby Roughin oare certify that the a6ove inspection has F~nai r oe~ ~,¢r been matle. OFFICE USE ONLY - This requesi voitl 18 mon[hs From ~ yY Jtl ' . . I ~ x WRL'ttf tCRtC 0f CCC1toRItC4 (Fit4 of W-agan zoartmeat oF Vxi[bag -U40ection This Certijecate issued pursuant to the requiremertts of the Uniform Building Code certifying that at the lime of issuance this structure was in compliance with the various ordinances of the City regulating building constnection or use. For the following.• ~ 1 use Classifrcelion: SF SG alag. Peimit Na. 24864 Occupancy Type R3/M1 Zaning Divria RI Type Const. VN . O~ofBwla;,,g HAiIAfAW RI+HZS IINC A,%6~ 14055 GlATID AVE S, *VITdE ewffi,ia naa. %4 'IItAII. MURT imm :2.8. BI, IRAIIS PSID i~~~ Dow - ~.~P0.ST IN A CONSMCUOUS PLACE , Address oQ Tunrr. Crxmr Zip 5512 3 L.o{ ' g•, Blk I Sub T-RAII.s EPID THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 3 a,7 5- Yes No Inspector: ~ Final grade (6" from siding) Permanent steps (gazage) Permanent steps (main entry) Permanent driveway ~ Permanent gas Sod/Seeded grass TraiUcurb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the ouuide lawn faucet before freeze potential exists. Contac[ engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~ White - City Copy Yellow - Resident Copy Pink - Contractor Copy ~ ~~&a, 1,92 ' N W ~ < O agZ N Q ~ < ~ o . o 0 ~o W ~ n C.~3~ w N F o 'a CT Ot~ 3 y V S) Y U ar W~ W 2 7 co W zd x p , Cn t+ f c~ o ~ ~a~~° cY+ ~ W O W V m ? 3 ~ J Q U. C~3 O LL U ~ v CERTIFICATION OF PURPOSE OF SECONDARY KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING I, Jean A. Olsen, duly sworn and under oath, certify that I am the Owner of the one-family detached dwelling as defined in Section 11.03 of the Eagan City Code located at 944 Trail Court and legally described as Lot 8, Block I, Trails End, PID #10-77160-080-01. A building permit application has been submitted on my behalf to the CiTy to enlazge, alter, improve, remodel, and/or finish the above-referenced dwelling, or a portion thereof, to include the installarion oF facilities for a secondary kitchen within the dwelling. The secondary kitchen facilities to be installed under the building permit are for the sole purpose of providing cooking and food service facilities for private entertainment of guests by the properry owner at the dwelling. I acknowledge that the Eagan Zoning Code prohibits the existcnce of a second kitchen facility within a dwelling unit to serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the installation of the secondary kitchen facilities under the building permit is not for the purpose of providing a second complete, independent and separate living and/or housekeeping u~ within the dwelling. Dated: - 5 , 2005 ° ~ . % Owner's Signature Subsc 'bed and sworn to before me this 2~ day of 200d 5 COMNIE RAN Nafty A Notary blic ~ Minrom" 311M I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities Within Single Family Dwclling was recorded at the County Recorder s Office on January 6th, 2005 By, Joel T. Beckman Its: County Recorder THIS INSTRUMENT WAS DRAFTED BY: City of Eagan Community Development Department 3830 Pilot Knob Road Eagan MN 55122 2004 RESIDENTIAL MECHAIVICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 _ Telephone # 651-675-5675 rJAN ~ 1 3 Please complete foc single fantily dwellings & townhomes/condos when petmits aze required for each unit l 1 - Date Site Address q 9+"I Unit # Property Owner ~-01'(\AL O { san1 Telephoue # ~ I ) D)C= Contractor ^l- F f StreetAddress N,J . City State Zip 41~5Q-745- Telephone# (&6~ ) 0 Bond Eapires: The Applicant is _ Owner _ Conhactor _ Other Add-an or alteration to eaisting dwelling unit $ 30.00 furnace _Additional _Replacement air exchanger air conditioner New Replacement other y ~.?n Q np,a,J S2fQn,~~ & ~L C7f~fYl.Ld+h~s State Surcharge $ 50 Total $ s I hereby apply for a Residential Mechanical Permit and aclmowledge that the informarion is complete and accucate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a pemvt, but only an applicarion 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 wluch requires a review and approvat oFplZ.4' I m- ~~;6A ,r 4 ~-.71 Applicant's Printed Name Applicant's Signahue 2004 COMMERCIAL MECAANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate pertnits are not required for each dwelling unit Date / / Site Street Address Unit # Tenant Name (if applica6le) Previous Tenant Name Property Owner Telephone t! ( ) Contractor Street Address Cit3' State Zip Tefephone S{ ( ) Bond Expires: The Applicant is _ Owner _ Contractor _ Other Work Type New Construction _ Underground Tank _ fnstafl _Remove '"'see below Interior Improvement _ Install Piping _Processed _Gas Nature of Work: •*When installing/removing underground tank, call for inspection by Fire Marsha( and Plumbing Inspector PCPmit F¢¢S: $70.50 Undergmund tank installation/remvval . , $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% Permit Fee • If e~rmit fee is $1,000 or ]ess, add $50 =1 $ State Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 en rmit fee $ Total Fee I hereby appty for a Commercial Mechanical Permit and acknowledge [hat 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 [ 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 acwrdance with the approved plan in the case of work which requires a review and approvat of plans. ApplicanYs Printed Name Applicant's Signature Approved By: , Inspector Date: 2004 RESIDENTIAL BUILDING PERNIIT APPLICATION CiT'~ City Of Eagan j~I a 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Conslmction Reauirements RemodellReoair Reauiremenis ~eflseL7ititv 3 registered site surveys shrnvifg s4 ft. of lot, sq. N. of house; and all roofed areas 2 copiw of plan Ced aFStpveY R?Fd Y,' ti (20% mazimum bt coverage allaved) 7 set of Energy Calculalions for heated additions TteBPr29 Plan.l~sxl 2 cxQies of plan showing beam & window sizes; poured found design, elc. . 7 site survry fa add'Aiore 8 decks 2[ee f'res Repiiired Y:N 1setofEnergyCalculations Add'Aion - indicateifon-sifesepficsyslem OtlSde3eplie~yslem 1 3 copies of Tree Preservalron Plan if bt platled afier 111/93 Rim Joist Delail Options selection sheet (bldgs wilh 3 or less units Date l 1~ l!L ol- Construction Cost ~ p 000 Site Address T/-,-41l COvr~ Unit/Ste # Description of Work Multi-Family Bldg _ Y,V N Fireplace(s) X 0_ 1 _ 2 Proper[y Owner ~ e Q Nve- OS,eN Telephone ) Contractor ~ aQ&zi'a gE/i"Ldedf!~/ Address (--'fhw 4-~s Y*'foo City~/V[/?-/"~~Oce State ~A/ Zip S r h[1~0_LC #(6,s~ ) S'S¢- /2 3 4 ` i S If ~ r' 1 DEC 1 7 `~U9 ,ri ~ COMPLETE THIS AREA ONLY IF NSTRUCTI NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Enefgy Code Category . Residentlal Ventilation Category 1 Worksheet • New Energy Code Worksheet (J 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 Conhactor Telephone # ( ~ Sewer/WaterContractor Telephone ] I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. K(~~ Ne nl O,~f ' Applicant's Printed Name Aep~'S nca t's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accesscry Bldg ? 02 SF Dweiling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AIt=Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorcNAddn. (4sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 D&plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ),q 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-pleu PIMg-Yor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move 8uilding ? 42 Demolish Foundation ? 45 Fire Repair x 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation fFt~ Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const ;4 pi Width REQUIItED INSPECTIONS _ Footings(newbldg) FinaUC.O. _ Footings(deck) _7X Fina]/No C.O. _ Footings (addition) Plumbing _ Foundation ~ HVAC Drain Tile Other Roof _ Ice& Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final Frazuing _ Siding _ Stucco _ Stone _ Brick Fireplace _ RI. _ Air Test _ Final _ Windows ~C Insulation _ Retaining Wall Approved By: Building Inspector - Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Ptant License Search Copies Other Total DAKOTA COUNTY PROPERTY RECORDS ~ DAKOTA COUNTY GOVERNMENT CENTER 1590 WEST HIGHWAY 55 HASTINGS, MN 55033 01/06/05 P A I D R E C E I P T RIX139R1 RECEIPT NO: 421358 RE2 PROCESSING DATE: 01/06/05 PAYER NAME: MCDONALD REMODELING/CITY OF EAGAN AMOUNT: $19.50 CHECK: X CASH: CHECK DATE: 01/06/05 CHECK NO: 5992 RECORDING DATE: 01/06/05 FEE CODES: 10 A SECONDARY KITCHEN CUSTOMER COPY ~ 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITYOFEAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date Site Street Address Unit # Property Owner 0l.s&_,7 Telephone # ( ) Contrector bini~r ~ .Q ~ Telephone# (6S/) 773.S7Yv Address f t~//u~T /-d City State14,~j Zip SJ'iL The Applicant is: _ Owner _ Contractor _Other Alterations to existing dwelling $ 50.00 _ Add plum6ing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). _Septic System Abandonment Water Turnaround (add $125.00 if a 5/8" meter is required) Other. ~ 6~irr+a~ r~,ro~ ~us~., #~vf./.r' - in Water Softener Water Heater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 7otal $ 5 S I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. ~ (-_F' -I= ApplicanYs Printed Name ApplicanYs Signature LJAN Q ~2005 I BY ___J cQ~ 'N °a 3 ~ , ac 15 za o 0 v y ¢z W ? Z ? V ~ ~ 'j, (D W LLI7 ' - o-; ° ' 2005 ~ We~?3 a _ ~ JAN2'' Q1~? ~a° 11 U W°o oY W~°, m ? 3~ By v4'~¢ • x ~ ~ a Q N O V 3 p uWjL- U U ~ V CERTIFICATION OF PURPOSE OF SECONDARY HITCHEN FACILITIES WITffiN SINGLE FAMILY DWELLING I, Jean A. Olsen duly swom and under oath, certify that I am the Owner of the one-family detached dwelling as defined in Section 11.03 of the Eagan Ciry Code located at 944 Trail Court and legally described as Lot 8, Block 1, Trails End, PID #10-77160-080-01. A building pernut application has been §ubmitted on my behalf to the City to enlarge, alter, improve, remodel, and/or fuush the above-referenced dwelling, or a portion thereof, to include the iastallation of facilities for a secondary kitchen within the dwelling. The secondary kitchen facilities to be installed under the building pernut aze for the sole purpose of providing cooking and food service facilities for private entertainment of guests by the property owner at the dwelling. I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit to serve a wmplete, independent and secondary living or housekeeping use within the dwelling. I certify that the installation of the secondary kitchen facilities under the building permit is not for the purpose of providing a second complete, independent and sepazate living and/or housekeeping un' within the dwelling. Dated: 1200,415 Owner's Signature 20~ 5ubsc 'bed and swom to before me tlus S day oA!iii ~N Notary blic 3t.PODa I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities Within Single Family Dweliing was recorded at the Counry Recorder's Office on January 6th, 2005 gy_ Joel T. Beckman Its: County Recorder THIS INSTRLTMENT WAS DRAFTED BY: City of Eagan Community Development Depar[ment 3830 Pilot Knob Road Eagan MN 55122 PERMIT CITY OF EAGAN PERMir rvPe: ~i~ 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55123 Permit Number: 024869 (612) 681-4675 Date Issued: 11 / 21 / 9 4 SITE ADDRESS: 944 7RAIL CT LOT: 8 BLOCK: 1 TRAILS END P.I.N.: 10-77160-080-01 DESCRIPTION: Building''Permit Type 3F DWG Building Work Type NEW j UBC Occupancy\„ R-3 M-1 / Construction Typ.e V-N ~ Toning R-1 ~ Building Length 62 Building WidCh 54 ~ Building stories -.S46 are Feet 2,310 ii~ = V'v\ REMARKS: 5& W PLBR - KLAMM MECH FEE SUMMARY: VALUATION $133,000 Base Fee $755.00 MISCELLANEOUS $1,828.50 Plan Review $490.75 Total Fee $3,940.75 Surcharge $66.50 SAC $800.00 SAC ~ 1@0 SAC Units 1 Subtotal $2,112.25 CONTRACTOR: - Applicant - s1'. LIC. OWNER: HALLMARK HOMES OF MPLS INC 18923636 0001179 HALLMARK HOMES INC 14055 GRAND AVE 5 B 14055 GRAND AVE S B BURNSVSLLE MN 55337 BURNSVILLE MN 55372 (612) 892-3636 (612)892-3636 I hereby acknowledge that I have read this applicatinn and state that the information is correct and agree to comply with all applicable State ot Mn. Statutes and City of Eagan Ordinances. APPLICANT/PEFMI EE SIGNATURE IS ED : 51 ATU E , CITY OF EAGAN 4iL9 1994 BUILDING PERMIT APPLICATION i 681-4675 -~r SINGLE & MULTI-FAMILY2 sets of Plans, 3 registeoPY of ener9y calcs. 1 6 1994 COMMERCIAL 2 sets of architectural & plans, 1 et of rer"ay-egk~s specifications, 1 copy of Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lat change is requested once permit is issued. . Date Valuation of work ~/a, oao Site Address: STREET SUITE M Tenant Name: (commercial only) LOT ~ BIACK ~ SUBD._rRAII S END P.I.D. # D-hh o - osa -o Descri tion of work: SI N(y yYl The applicant is: ? Owner & Contractor ? Other (Describe) Name _HAl,1.UPK__NOV11E S TN Phone lziZ -&3(0 Property LAST FIRST Owner pddress ADSr. hkR,u/,Au•So.5uL7L, F3 STREET STE p City [L>UKNSUI.I.i.~- State WN- Zip S581 Company HR IMR Gvns's =NC • Phone 89d,3(o360 Contractor Address /405S ERAND AY, Scs, SUZTE'8- License #6ob 11'7q Exp. 3-31-95 City Ru a,asr.3xzLE State M1J• Zip 553172- Arp.k?it8ct/ Company k QE S76N Phone 4-as -/4-30o- ErigifiiiieC Name Registration # DOFTSmq9 Address ' City State Zip Sewer & water licensed plumber kLAMNI mF.CNA~-rAL . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: M- OFFICE USE ONLY . • ' ~BUILDING PERMIT TYPE . • . . ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish K 02 SF Dwg. ? 07 4-Plex 11 12 Multi. Misc. 0 17 Swim Pool ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. O 04 SF Porch ? 09 12-Plex 13 14 Fireplace ? 19 Comm./Ind. Misc. ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck 13 20 Public Facility ? 21 Miscellaneous WORK TYPE 9 31 New 0 33 Alterations ? 35 Tenant Finish ? 37 Demolish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) 0-1.! Basement sq. ft. 78Y MWCC System oC (Allowable) /v lst F1. sq. ft. ~ City Water o< UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total e Booster PumP # of Stories Footprint Sq. ft. 2,3io W~5*°oP4o~'Fire Sprinkler length Co z On-site well Census Code Depth sf On-site sewage SAC Code oi APPROVALS Census Unit ~ Planning Building Assessments Epgineering Variance REQUIRED INSPECTIONS ? .Site ? Footing ? framing ? Insulation ~ Wallboard ? Final ? Draintile ? Fireplace Permit Fee veimc;on: Surcharge Pl an Revi ew / 3- F~,Z- License MWCC SAC /sx 9~ ~ y Z Z x z z' f~y City SAC Water Conn. yn Z~ ' y Water Meter y„ iz °4,6 yJs6 x. l~' Acct. Deposit S/W Permit zg K rb . ; S/W Surcharge 4 X io = ~y -71 Treatment P1. !K ~o /Road Unit Park Ded. Trails Ded. / - Z1 ~ Copies r~SMS• v Other Total: yXZe - /oy ~l~?1'~ yK r z ' /f3 ${~C % 7yrs c = S6d SAC Units 61y rZ~ 76o J ~,611 ~ 31%ynr's CxVfk" Hallmark Homea Lot S, Hlock i, T81,ILS BND, City of Eagan, Dakota County, Minnesota and reserving easements of record. . Iks1 ~ TR~ C% 4 ev. , eea.a ~ 0~6, r.~ 6eq.o ~ 0~% ^ ! -W G'R ff 00 c a ees,e ~ $ r4A?~~ l3' zz~Q 4 -I " '3' 4r' g88,q ; gqas m. 71 ~ m la ti 3 LO ty I m N y ? I - - - - - - - - - - - - - - - - - - - - -5 • ~J 1 O 2 y l 3.8 84~0 ~ S89' 44' 09' E174.04 ~ G~~N LOT SO. FOOTAGE = 17, 225= I µ pY c d ! . ' ~ pM76 ~ S~ . ~ ER 'G ~ PT. FAGAN ENG PROP05ED ELEVATIONS BENCHMAqK, e.~gc s~~am~ top of FounOit I on • e912 _ 8BSA3 6ereqe Floor •840.8 Besement floor •ass,i AproX. SeM1r Serrice Eler. •s~4.s. Proposeo Elev. • C~ N MIN. SETBACK.pEeIIIpEMENfiB ExIStlnq Ellr. • - - - Dralnage DlPectlons ~ Front -ao Hbube SItlA -lo Denotes nffeet Stake • o , ScALE 1 InaA 30 fnt Rear -ao 8erage Slde -s : JOB N0: a D I HEHEBY CER[IFY iHAT TNIS IS A TIiUE ANO COfIRECi AEPESEMiAT10N F OF THE BOIINDAPIES OF TNE ABOYE DESCRIBED PROPEHiY AS SUAYEYED QQR'S34 ~ 1~~~Ulm BY NE ON IINDEH MY DIFIECT SUPERVISION AND DOES NOT PUPPORT 10 BOOK: PAGE: SHOM IMPROYE11ENiS OH ENCROACHIENiS, E1fCEPT AS SHONN. PfmnlnP fngInnNnO Arrrqfn0 . R01 tel ~I~w~M~ ~1 pwiqUn, dnsMq !LLE oete I ~ P• N, '•~M"" ~ MIIE TA L~1CENSE~AMIMBENMl137~6 CmDD q ZLE: OM6. CHK. • LOT BDRVEY CHECRLIST POR RE6IDENTIAL ~ ~ 80ILDING PERMIT 71PPLICAT ON 4ROPERTY LEQALs p, z}o ~ ~ Dat• of Burvep: ~ ~~T7~ QQCIIMENT BT A 8 ' ~p 0 - Registered Lend Surveyor signature and company ~ ~Y • Bulldinq Pezmit Applicant ~ 0 • I.egal description 8~ 0 D • /lddress B~b 0- • North arrow and bae scale B"ti D • House type (rambler, vnikout, split w/o, split entry, lookout, etc.) 0 • Directional drainage errows with alope/qradient t. >30 0 Froposed/existing sewer and water services 0 • street name 0 • Drivevay ELL'VATIOliB zxistiaa 713 0 • sewer service r D 0 • Lot corners 0~13 • Top of curb et the driveway D B" O • Elevations of any existing adjacent homes Yrooosed 6~] 0 • Garage floor 0 D • Firat floor rn 0 • Lowest exposed elevation (walkout/window) 8''0 0 • Property corners 0 • Front and rear of home at the foundation ' __..PONDING I?RLAe lif aQplieablel 0 H~ D . ~Lement line D ~ 0 • xwL D • pond A desiqnation D B O • Emergency Overflow Elevntlon DIMEN8201iB 0~0 0 • Lot lines D D 0 • Aiqht-of-wey and stzeet width (to back of curb) 9' 0 D • 8ropomed home dimensions including any pzoposed decks, overhangs greater than 21, porches, etc. (i.e. all structuses requiring permanent footings) 9-113 0 • Show all eesements of record end any City utilities within those easements 0'D 13 • Setbacks of proposed structuze and setback of adjacent O ~ • existing homes Retaining w requirements, if any Reviewed: / Nam / a e October 1992 \ 1 S6N=2«8B 3+2 • i I ~ I SNV.w = 877~5 - INV. = 877.5 ! - I I <f I I I _ ` _ ` ~ . HH 2 I ~ I I ~ I S6N= 3+23 ~ INV. - 877.5 e1 To e' REDUCER HYD////~ G. v. 45' S S N= 3+02 BEND INV. = 879.5 ~ I L_ ~ "..`~..(.i~L7'...,. . ~ ---J ' c; i 7C.^,Y OF UTI!_fi'l )RIVE ~ ~~E~'.",710R!~. T!-~•~ ~ ACE TTER PUR?O:..c;~ ' G IT S!:".~ ' ant _N.w. Corner Of wescott TRA I LS END Lane. Elevation - 874. 15 : . . 2.:'~::.~.:::.:~:.::.:':::::'.::::::::::::::: . . . • . i...:.gB9. 34........ ..:...................a..;...a.. .........m. , . . . ..................~n..;.....r. ..T..-.;.HZ6 • ........UD. , @. , , m.. m.. . , , • m, . m . . . ........m .......m..;....m.. . • . • . • : . ..................i::::::::::'.::::'.:::::'.:" . j . ~ . . . . . . : . . , . . . . ; . . . ~ . • ~ • . . ; : ROP09ED::::::::::::::::::::::::::::::;::::::::: : . ; : . : ' . • . : . SDX:::: , : . : . , . . . 6l:::.A:CP.:::::..:' .8..:: !.P••ilki~:Wyil: u................:................... . ...................:...................g~ •Ua•P~~NkTfflkA'....... . . : . . . ' , . , . . . ' . .........:......................3~: ~F....g....PVE:.....................:......::::::::::::::::::::::::::::: , . . . ; .......:.........................:.........................:.................5{~F...~S.................... , . . _ . . . . . . . , . ~ , . _ ~ ~ ~ ~ . ~ , . .........................~.........................~...`.1.14'\~e ~ . ~r~• v~....l~.:l~~.. ~ i . . • ^:;r:... .r,.:;?Ci'R;~' _ _ . . .........y.... . . . _ . . _ ~ . .:.......,;.ttrA~(~~:.::i...;.:.h!:.........::......;,.......:.._:..........._......... . . , . ..........v..,.....r._,_.. . . • . • - : ~ . • if ~ 4 ~ . : . -...1 . - • ~ . ~ 1 . , , :..;1.. C . • , . • .............................................................i:C°.._.;.....1 . ~ . . . • C al!S. , ff... avj...J....................~.........................~... ...................:............................t.:;~..:...................... . . ~ • . . . . . . , . . . . . . . Z.~.. . . ;.--1~....4..-:::.. . . . . . , . . • ~ . • . . . . . . . . , . • • . . ..........1 . . • . ~ . ' . 4.. . . . . : . .....~...........p • ...................1.........................~....0"" . .........;....m.. . ' ' • . . • , , . : • E:::.::::::.:::...........2+~~ 4+00 3+00 mm~ SCALE~ NOR12. TRAILS END ~E~- 1_ r EXTERIOR ENVELOPE ENERGY CODE COMPUTATION WORKSHEET To Determine Cmrpliance with the Minnesota Ehergy Code (Section 502.of the State Amended 1983 Model Energy Code) Project Title ~~~L/°%~l?/G. ~/0•~~ <F35F site Address 94~ ~R14lL COURf En GftN, /yN ~ 1. EXPOSED WALL CALCULATIONS ARFA "U" UALIJE ARF.A x "U" A. Opaque Wall 1. Masonry/Concrete a. G? x = O b. p x = O c. ~ x = d ~ 2. Foundatiai Wall (Above Grade) a. /S'~/.• x .076 = 10•9Y b. U x = b 3. PTocd Fraim Wall a. Insulated Area /q SS Z x . OK 3 = Co3.73 b. Framing Area (Ave. I5$ at 16" oc) 262 x ,pE S =~'~e3Z- c. Framing Area (Ave. 108 at 24" oc) x = O 4. Peripheral Floor Edge/Rim Joist a. 197 x DYD = 7•gg b. G x = B. Glazing 1. Windvws , a. . 21-7 x oCfS = `fi7.CoS' b _ -'-y------..- c) x = U 2. Doors p~7/q PcYrx5 7Z , x ,'f 5= 32 a'F O C. Dcors 1. Wood ' a. Solid O x = G b. With storm door x = G) 2. Metal 3 Ff X ..07 = 2 m~G 3. Overhead o x = a 4. Other G x D. TOPAL WALL F1ItFA, sq. ft . Zy/Z E. ZUML of APEA x"u.................................................... 238 II. . ROOF/CEILING CALCULATIONS A. Roof/Ceiling Insulated Area 1(,2-7 x ,023 = 3?e4Z B. Roof/Ceiling Framing (Ave. 151% at 16" oc) C> x - cr-,) C. Rcof/Ceiling Framing (Ave. 10% at 24" oc) /FS/ x _zf.3 `r D. Skylight p x - 45 E. TOTAL ROOF/CEILIW3 AREF1 Sq. ft F. TOTAZ CF AREA x "U" q/676 III. BUILDING ENVELOPE REQUIREMENTS TUPAL ARFA RDQUIRID "U" ALLOWABLE (Fran I.D & II.E) (From V.) (Area x"U") A. F~sposed wall: x d// = 2CoS~ 32_. B. Roof/Ceiling: x 4/7-0 C. mM rLr,awaBr,E suu,oirrc ENVELAPE (Totai of A& B above) 3 12, 33 IV. ACTUAL BUILDING ENVELOPE ~ ACTUAL (Area x "U") . A. . Exposed Wall (Fran I.E) 2 3&S5- , B. Roof/Ceiling (From II.F) c. TCYrAu. ACrvrw svzIDrM ENVEAPE (Total of A & s) ? 80.3~ '(Meets code requirements if less than III.C) V. REQUIRED "U" VALUES : ~ 4QLL5 100F/CEILING . Detached,•one ard tfamily dwellings .ll .026 _ . _.74 . _ _ • * Multi-Family Residential Buildings .238 .033 (3 staries or less in height) * All Other Construction Types (3 stories or less) .238 .06 . * All Other ConstructYrn Types (MOre than 3 stories) .28 .06 ~ Based on 8007 heating degree days (Mpls/St. Paul) Adjust 'U° values accordingly for other locations CERTIFICATION I hereby certify that I have ccmpleted the abwe information and that it ccnplies with thc ' Minnesota State Energy Cale. Signature ~ o*-- Date , BCSD 3-89 CC/Sl1'[/6574 } - PERMIT ~ CITY OF EQGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 028721 (612) 681-4675 Date Issued: 0 9 J 0 3/ 9 6 SITE ADDRESS: 944 TRAIL CT LOT: 8 BLOCK: 1 TRAILS END P.I.N.: 10-77160-080-01 DESCRIPTION: .t3uild'zni}-„Permit Type OECK ~Buildin,g Wo.rk Type NEW Census Gode -434 ALT. RESIDENTIAL IV r d 1 i ~ .:l"3_... f.~ _ 1f i REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge $.50 Lic. Search Fee $5.00 Total Fee $50.50 CONTRACTOR: - Applicant - ST. LIC.OWNER: POST CONST INC 19417980 0007061 OLSEN JEANNE 8911 YORK CIR 944 TRAIL CT BLOOMINGTON MN 55431 EAGAN MN 55123 (612) 941-7980 (612)454-2992 T hereby acknowled'ge tYtiat I have read Chis appiiaatian antl stat's thet the information is correct and agree to comply with all applicable State of Mn. ~ Statutes and City of Eagan Ordinances. ,VX `-~APPLICANT/PERMITEE SI NATUFE ISSUED BY: IGNAT CIT'Y OF EAi'AN. ci i::'i:„ c ' 1"i.¢PcM.I. vpt^r ' I t•.1,.1 '1F (;!1.., i .f.... t.. r :ul7lii:; 09j03l96 T:[NE;; W4030 (.i L idf~P112.: I'f.)'i37 CCINSi"?RlIl;f7'flN i..;D .f,f+7r; '3,`:L(:1 ."::}!:)i:)i !:kq.q. 7r;AI!._ i.7 45,,00 '?:I.55 9001 944 71'tiAil:l... f;7 0.50 343:7 90(71 944 TP:AI3... CI~ `,.OO i'.7'i;;C.l. I::;nr`F+1~~i; F11YinilYll:;: `~(..~.:i~~ C~;(li,~y.31'Fji~ . ;.1;3ER :[ii e NPitJCY :''~$<?KY:#.7k?I~:,.YYR7KX(lX!K~~:~'F'~~n ~F>k?k~: ~F%~~'#~s~UkYr'~F~~k ~R~~yF%#%C~ ~ CITY OF EAGAN ~,1 3830 PILOT KNOB RD - 55122 o & U ~ 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) -io 681-4675 New ConsUuclion Reouirements Remodel/Reoair Reauirements ? 3 registered site surveys ? 2 copias of plan ' ? 2 copies of plans (include beam & window sizes; poured tnd. design; etc.) ? 2 site surveys (exterior additions 8 decks) ? 1 energy calculations ? 1 energy calculations for heafed addilions ? 3 copiee of tree preservation plan if lol platled aRer 7J1/93 required: _ Yes _ No DATE: B/Zf04' CONSTRUCTION COST: ~ DESCRIPTION OF WORK: epi°47~W'`-T NcW D~.~ WOrDOYiN6'S /l-/ra/Lrjc~ To /ft:'nE STREET ADDRESS: 5-Si2 3 LOT ~ BLOCK ~ SUBD./P.I.D. S AL~D ~p PROPERTY Name: T~A.~w~ o~sta Phone ysy-L9yy OWNER ' ua* rina. Street Address: Clty. 644 4 N State: r'7y Zip: 553 CoNTttAc7oR Company: P,s.- C..~ cr, L'u rrc-; _ Phone 9 Nt -?98a Street Address: A9ii 'n.zi[ License 704-/ City: State: rvlW Zip: ri-y 3/ ARCHITECT! Company: 5 q:Mt +r 5 tPs vv8 - 1 ns ~ Phone ENGINEER Name: Registration Street Address: ~ City: State: Zip: Sewer 8 water Iicensed plumber: Penalty applies when address change and lot change are requested 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 Minnesvta Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of 5urvey Received _ Yes No _ Tree Preservation Plan Received Yes No - - ~21!lUQ~~J~~ OFFICE USE ONLY ~ ~ _-7 ~ ~t < S BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dweiling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Pu61ic Facility ? 04 SF Porch o 09 12-plex o 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 = piex 15 Deck WORK TYPE p431 New ? 33 Alterations ? 36 Move a 32 Addition ? 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. Li Depth Footprint sq. ft. 5AC Code dL Census Bidg 1 Census Unit 0 APPROVALS Planning Building +ye Engineering Variance Permit Fee Valuation: $ 1 Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units Sine s Gxttfkxrte Hailaark Homea Lot 8, Block 1, TBAILS SND, City of Eagan, Dakota County, Minnesota and reserving easements of record. ~ • okS 1 LS ¢ ~.z f/ ggq.2 OV~'T- , J 0~ 'le.y. 8090 ~ ~ 9. r, tf ,Suq 00 g9q. 4:f ~ G~~' / ~ \ BqO~ ~ N b •D~OO ~ ~ le3'~S ~ $ 00 7 1 5~2 ~M „ a ~g~Bdq ~ ~ gqo.s 2q m ?d n ,,~?~i / ~ fs R7 `4 f~ ~v/e 898~" ~ ~ V) / / ygbo f2p0 ~SOp „ I s 0 W ~ I N - - - - - - - - - - - - - - - - - - - r ~ m „ L- ~5 • ~J 1 O O ~38 0 N S89' 44' 09' E! 71. 04 ~ LOT SQ. FOOTAGE = 17, 225= ,r ti ~1 o;,T~ J OP05ED ELEYAT iONS ]EAGAN ENG ~ ~'G ~ PT. `."~::v _,g!L.:... ~~'3.,...zt.!:,w....w.zc`:o:o>::n;•:a'y..~Y';<.,'s;i::r.,e.fi:>:>.<rt`:....s._.y%'as7a,.. .:cr. ~x~;a d.~ .r' o i w. n p cc~5 ea"'~,' ° ~3 ~ c^4< 'c ~,h. . ~.aE.;~~Y: ~~~YY i~ ~ o a 3. Y ` • 2 4~.. . ~,s ~q~ ~ ~zK~Y.~'~` rEk`~r`31~ ~ng~3~~a .yEa~~i€~tib:~ a '<r~k~2~3~~ aoi• ",~,3 ' ~~~~')~...s~~• 1994 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLE'I'E FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIltED FOR EACH UNIT. - - - - - - - - - - - Y_ NEW CONSTRUCTION ADD-ON A/C AI?D-QN FUP.N 4rE FIREPLACE INSERT DATE 12 / 2Z Af . FEES HVAC: 0-100 M BTU $ 24.00 ADDTTIONAL 50 M BTU 6.00 GAS OUTLEI'S (MINIMUM 1@ S3.00 EACH) 3,00 ADD-ON/REMODEL (ExISTTNG coNSTttucrtoN) $ 20.00 STATE SURCHARGE .50 TOTAL Z ,S17 ~L SITE ADDRESS: 0144 4'~ C.+ kPCe ~jPr1 r7L OWNER NAME:_ Ra l l a•k r l< Ro^ts T'EL.EPHONE qa 7, -3 G 3 6 INSTALLER:_ ADDRFSS: "'1 11~ W l 2L, CTl'I': STATE: IV\ N ZIPCODE: 553~R TELEPHONE 5(ci0 4 2 0 l SI N URE OF ERMITTEE e ; ,g.F $~,y2 fe- ~~{"av;;4 §fi~sf~.~fR~ s x~ s°°t '.~s'aAts kE.. 1993 PLUMBING PERMIT (RESIDEWI7AL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SiNGLE FAMILY DWELLINGS. AL50, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FIXTURES EACH ~ SHOWER 3.00 or) ~ WATER CLOSET 3.00 .o 0 BA'TH TUB 3.00 / .o 0 LAVATORY 3•00 4, o 0 I KITCHEN SINK 3.00 3. o 0 LALTNDRY TRAY 3.00 3, a o NOT TUB/SPA 3•00 WATER HEATER 3•00 3 FLOOR DRAIN 3.00 3.o1) i GAS PIPING OUTLET •min;mum - 1 3.00 0 _a'3 ROUGH OPENINGS 1.50 • sZ WATEFL SOFTENER 5.00 PRIVATE DISP. • oek.cry. uc. 15.00 U.G. SPRINKLER • home unacr eonst. 3•00 ALTERATIONS • ta etsung 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE .50 " TOTAL: STTE Ai7DkESS: 9 e.r T AiL rOIfRT OWNER NAME: HALLMARR.HOMES INSTALLER: KLAMM MECHANICAL CONTRACTORS INc. fDDRESS: 12409 COUNTY ROAD Il11 CI•I.Y: BURNSVILLE STATE: MINNESOTA Zjp CODE: 55337 PHONE ( 612) 890-4868 SIGNATURE OF PERIv~Yf'fEE U sO CITY USE ONLY L ~ BL ~ RECEIPT SUBD../~/6" (L /z~ DATE: ~°.~c~• Q¢.~-'~D/G979~ 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN ~x ~/0195 ~q0 3830 PILOT KNOB RD ' EAGAN, MN 55122 (612) 6814675 Please complete for: ? single family dweilings ? townhomes and condos when perr:iits ara required for each unit New construction Add-on fumace Aud-3ii oii CJiidliiuTiiiy' riicpiai:e i:Giivei'siui7 (io eXistiiiy itiepidCe) C~~[ivvr3o•~ir. l6ACp-~!c ((3anT Date: FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ~ ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU ' 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL a~d , SU SITE ADDRESS: OWNER NAME: ~ PHONE INSTALLER NAME: S..E n~Tr K HEATING & AIR CONDITIONING C0. STREET ADDRESS: aain WENTWnaru etc cn MINNEAPOLIS, MN 55420•2853 CI1Y: 88"9WATE: ZIP: PHONE ( ) ~'k/ -~iUUO ~-~t - SIGNA RE UF FERMI] I LIV