3041 Woodlark Lane ~
-CITV OF EAGAN Remarks
Addaion Oslund Timberline Loc 6 sik 2 Parcel 10 55300 060 02 ownerJakn+ J-dA MA~'tnh Street 3041 Woodlark Ln. Stace Eagan, MN 55121
Improvement Date Amoum Annual Vears Payment Receipt Date
STREET SURF.
STREET RESTOR.
GFADING
SAN SEW TRUNK O
*SEWER LATERAL ~r
WATERMAIN
WATER LATERAL
WATER AREA
*STORM SEW TflK 1970 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
9UILDING PER.
snc 666 10-27-72
PARK
EAGAN TOW N S H I P No 1.090
BUILDING PERMIT
Ownex Eagan Towns
hip
~ Address (presen!) 1>71, Town Hall
r
E auiiae: - ? 'Z/ 6
~ Dafe
Address
DESCRIPTION
Siories To Be~j Use'd' ~For Front Depih Heigh! Est. Cosi Permif Fee Aemazks
1 L
aO ' oZl~~
L
LOCATION
Sireef, Aoad or oihe: Descripiion of Localion Lo! Elock Addiiion or Traci
This narmit does nof authorize the use of streeis, roeds, alleys or sidewalks nor does it give the owner or his agenf
the righlYo create any situaiion which is a nuisance or which presenls e hazard fo the health, safety, eonvenienee and
. general welfare fo anyone in the communify.
THIS PEAMIT MUST BE K ON THE/ ~PREMISE WHILE THE WORK IS IN PROGRESS.//
This is fo ceriify, ihaf......~.Fp......1'.f-x.e.................. haspermission !o ereei .L7~./...~... . upon
/f
the above described premise subjeci !o the pravisions of the Buildinq Ordinance for E an To~d`nship ad ted April 11,
1955. d~/~~~~ /J?i"__':"~~/~
N:~'."___..... . Per .L.`.......
Chairman of nwn Board l l Building Insp¢cior
A•$.
$30.50
• 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & rownhomes/condos when permics are required for each unit
Date -5
Site Address ~ ~ ~-`-~~~~~C~ Li~ • Unit #
Property Owner ~~q Telephone #
( Wohlers Southside Htg. & Air, Inc. 1
Contractor ~ 6950 W. 14e St., #106 ~
Apple Valley, MN 55124
Street Address (952) 431-7099 C'h'
S[ate Telephone # ( )
Bond#: RL-ZC54 -7GP, -7 Expires: ~ ~51!~
The Applicant is _ Owner ~ Contractor _ Other F__
Add-on or alteration [o existing dwelling unit J3200 30.00
l~lf
furnace _Additional 1>~Replacement L ; J
airexchanger '
airconditioner _New _Replacement
other
State Surcharge $ .50
Total
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that 1 understand this is not a
permit, but only an application for a permit, and work is not to start without a permit that [he work will be in accordance with the
approved plan in the case of work which requires a review and approval o~f? l~ans.
ChG~cl l~`1112rS l;Cccjej~ Uj~
Applicant's Printed Name Applicant's Signature
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complere for. commercial/industrial buildings
multi-family buildings u•hen separate permits are not required Cor each dwelling unit
Date
Site Street .4ddress Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see 6elow
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
"When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
P¢rrtll[ F¢0S: $70.50 Undergmund lank installalion!¢moval
550.50 Minimum (includu Statc Surcharge)
Of
Contrac[ Value $ x 1% = S Permi[ Fee
• If ep rmit fee is $1,000 or Iess, add S.50 S State Surcharge
If Pe rmit fee is over $1,000, add $.50 for
every SI,000 ep rmitfee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that 1 unders[and this is
not a permit, but onty an application for a permit, and work is nol to start without a permir, that the work will be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name ApplicanPs Signature
Approved By: , Inspector Date:
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
VlY /1~ City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
New Consimction Reouiremenis RemodellReoair Reouirements Office'Use OnIJ _
3 regislered site surveys showing sq fl. of IW, sq. M. of house, and all roofed areas 2 copies of plan Cer1 d Survey Recd''j: _YN
(20% maaimum lol coverage allowed) i set of Energy Calculations for healed adddions Tiee Pres Plan Recd Y. N.
2 copies of plan showing 6eam 8 window srzes; poured found design, etc. 7 sde survey for addiUons & decks Tiee PregRequired' Y: °-N
lsetofEnergyCalculations Adddion - indicateif on-sdesepficsystem Oo-sdeSepticSystemY;;_N
3 copies af Tree Preservalron Plan d lol platled afler 711r93
Rim Joi ildings wtlh 3 or less umts)
Date / / / ConstructionCost 14 -il
Site Address UniUSte #
o 0
ji,
"~-Ow~ "
Description of Work w
Multi-Family Bldg _ Y V N Fireplace(s) _ n 2
PropertyOwner ~Qo i Telephon ,b8~ 4661
Lifetime Siding t~ Reodeling, InC. z~3 ~ Seal~2S S ~U ~k~ 90 55os5
Contractor t ,,,rf ~
Address ' City ~ -
State ~ J Zip Telephone #((pJy -
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Enefgy Code Category , Residential Venlilalion Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submilted
. 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 Conhactor 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 wor ~~s'noY,t =st ifiSout a
permit; that the work will be in accordance with the approved plan in t case of work wch~requis ~ r~A'and
approval of plans. II rl R 3 0 2005
I~ ~
~
oY I
1
Applicant's Printed Name ppli nt's Signature
OFFICE USE ONLY
~
Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-piex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex O 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 vibg_V or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Impravement ? 38 Demalish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' 43 Reroot A 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 P.ump "
# of Units Sq. Ft. PRV
# of Bldgs , Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) _ FinaUC.O.
Footings (dcck) _ FinaVNo C.O.
Footings (addition) _ Plumbing ' ' •
FoundaUOn _ HVAC
Drain Tile Otlier
Roof Ice & Water Final _ Pool _ Ftgs _ AidGas Tests Final
Framing _ Siding _ Stucco _ Stone _ Bnck
Fireplace R.I. AirTest Final Windows
InsWation _ Retaining Wall
Approved 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 / ~~7~~-
Other . y.[ ~L.LI."-
Total I u •
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) 19 bn. 50
` CITY OF EACAN
3830 PILOT KNOB RD - 55122 ~
857 •681-4675 CG"
New CoruhucNOn Reaulremenh I-7 a d R ~n I Z I~
/ Y/
D J reyblered Yfe wneys ahowlny W. R ot bi, aq. B. ol house 7'd b 2 coples of plan
and gu rooleC areas (20X maximum lot coveraae allowed) 1 set of enerpy calculaHons for heated addlMOns
> 2 copies ol plcros (ahow beam 8 window slzea; poured fnd. desipn: efc.) 1 We wrvey lor wAedor addiHona d decks
> 1 set of eneryy calculatlons
> 3 coplee of hee preaervaflon plan If Id platletl afler 7/1/93
pqTE; 1-0/ I CONSTRUCiION COST:
DESCRIPTION OF WORK: -D -6- C~'
STREET ADDRESS: ~ o I U3 60 Lor: b eLocK: sueo.iP.I.o.C OSlund Tirn6hhe>
NameT~/YL'~ ~ r'J PhoneM:
PROPERTY ~~i Fi"i
OWNER
SheetAddress: -fP) Z~-ola
Cly State: Lp:
~
~
Company.~//"/- ca Phone 9s'~ F1r0 -.3Q5'
(area code)
CONTRACTOR
Lu/7/7 ~?v~ llcense # _2y,:j__Exp. ~-dl
Sheet Adtlress: /
City State: ZIP: 32 6L--
ARCHITECT/
ENGINEER Compan : Nn Q:
Telephone M: ( ) _
Sfreet Address: Ra9~TMatia^ If:
CI State: Zip:
Sewer/water licensed plumber (if installina sewer/waterl: Pho^e *
I hereby acknowledpe Ihaf I hwe read this applicaHon, dafe thaf ihe informaNon is cortect, an ee to comply w 1 Q appAcable State
of Mlnnesofa Sfatufea and Cify of Eayan Ordlnances.
Signalure of ApplicanY.
OFFICE USE ONLY
Certificates of Survey Received _ Yes No ,fUN ~Tree Preservation Plan Received _ Yes _ No _ Not Required ~
OFFICE USE ONLY ~
BUILDING PERMIT SUBTYPES
? Ot Foundation O 07 05-p4ex ? 13 16-plex ? 21 Porch(3-sea.) ? 31 Ext.Att-Multi
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 33 Ext. Att - SF
D 03 01 of _ plex O 09 07-plex dk 16 Deck ? 23 Porch (screened) ? 36 MutU
? 04 02-piex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex PIDg _Yor_N ? 25 Miscellaneous
? 06 04-plex 0 12 12-plex ? 20 Pool ? 30 Accessory BWg.
WORK TYPE
0 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Aiteration ? 38 Demotish (tnterior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 WindowslDoors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code 6 1_ # of Stories sq. ft.
No. of Units O Length sq. ft.
No. of Buildings Width Footprint sq. ft. ~
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinkiered
M{SCELLANEOUS INSPECTIONS
? Stucco/Stone APPROVALS
Planning Building rAIA,~ Engineering Variance
Ao
Permit Fee Valuation: $ / d o-J
• Surcharge
Plan Review
License
MClES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
\
• ~
~ I _ _ ~ • ~ o~ •
d
~o isoo s _ _ T -iooo - eo-~ ~ • ~ l~~ 4 ~ v d ~
$ o ~ o r g m o ? b} ~
~ o W • ~ I
.eo o i r> o O
I ~`M.am e
g 9 D 4\1 .
~
~ 30 ?o Ieee ~wo ~eeo ~ +f 1 ~ ~o L 5' 'b. rN
8 A g ~ „ o g+• ' w
" ~ae'~ a ab'~o'~ ~ •
5 I ~ ~
' CHERRYW000 WRT 1 _ t e
o ~
C.bp ~4 ~ 1~b w %i sa• ~
a § W '
~ I i sa a W J ~ N
p ~ -rooo -rooo- iaor-F 'w.o
o -iod.o
V I _ - _ - e
ieo o sur
1 ~ S
f I x -4 ° ° A °
e I ao ao
~ I
se eo
ieo.o rooo iaoo ~oo.o im.o 100.0 1 n.le ne sa _
iwc
uoe esro
iocE ' ' ~~4N aa .,d „
A 2f MY
)p s0 I 1Q
a b - p . " y
u g _ w $ + a E ~
a e
~ ,soo g BwcK 2 , ,o
! ns~o - ne n
^1006 -iODO - tfOrt--
Ta
eo ~ ~
W p
O ~ ~ mm $ • ? _ °
I '
. Iq0 1 1 A.O 1000 00.0 10p0 100.0 01.43
~NE
° WOODLARo
~ N .~'e. .e
7--
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: October 27, 1972 NUMBER 1187
OWNER: Matzoll Address 3041 Woodlark Lane (o
PLUMBERAll-State Plumbing Co. TypE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUIlA ING
Industrial Commercial Residential Multiple Dwelling No, of units
xx
Location of Connections: Connection Charge260.00 pd 10/27/72
Permit Fee 10.00 pd 10/27/72
.50 P /72
Street Repairs
Total
Inspected by:
Date
Remarks•
By
Chief Inspector
In consideration of the issue aad delivery to me of the above petmit, I
hereby agree Co do the proposed work in accordance with the rules and
regulations of Eagan Township, Dalcota County, Minneaota
By.
Al].-State Plwnbing Co.
Please notify when ready for.inapection and coanection and before any portion
of the work is covered.
2005 RESIDENTIAL BUILDING PERMIT APPLICATION ~
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Tetephone # 651-675-5675 FAX 4 651-675-5694
New ConstrvUion ReauiremenLS RemodeVReoair Reouirements ORice Use Oniv
3 registered sile surveys showing sq. 0. of lot, sq. h. oi house; and all roofed areas 2 copes o( plan Cerl of Survey Recd _ Y_ N
(20°h maximum lot coverage atiowed) 7 sel of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N.
2 copies ot plan shovnng beam 8 window saes; Doured found design, etc. 1 sHe survey lor additions & decks Tree Pres Required _ Y_ N
7setofEneyyCalculagons Add'N'on - indicateif on-sdesepficsystem On-siteSeptlcSystem _ Y _N
3 copies of Tree P2servation Plan'rf lot platted afler7/1193
Rim Joist Detail Oplions selection sheet (buldings vrith 3 or less uniCs)
Date' ( /016 Constructian Cost J2 000
Site Address 5 / r E/ 1GU Unit/Ste #
Description of Work T1e ~ ' ~ S v~C~?
Muiti-Family Bldg _ Y N Fireplace(s) _ 0 _ 1 _ 2
Property Owner tnn Q hcIJ Telephone N O/) g 9166
Contractor ~L• ' • ~J1~- `
Address1 , Cit X ~J
State ~-'tINMEiYm~ ZipTelephone#(7) "~V
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submided
• Energy Envelope Calculations Submitted ,
In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of masTer plan:
Licensed Plumber Telephonne #
Mechanical Contractor Telephor~~~k
U IJ APR 2 g 7n; LU)
Sewer/Water Contractor Telephone J
i
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 pla in the case of work ich requires a review and,
approval of plans.
DLtv>o
Applicant's Printed Name Appli fit s gnature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
/L•7"~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 PorchlAddn. (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 Pibg_Y or_ N ? 25 Misceilaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior /p' 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
/33 Alteration ? 37 Demotish Building• ? 43 Reroof ? 46 Windows/Doors
/C3 34 Replacement 'Demolitlon (Entlre Bidg) - Give PCA handout to applicant
Valuation I1 Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning Ciry 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) _ Final/C.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Founda[ion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ S[one _ Brick
_ Fireplace _ R.I. _ AirTest _ Final _ Windows
_ Insulation _ Re[aining Wall
Approved 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 r~
Total ~
O-V. z-n
2007 RESIDENTIAL PLUMBING PeRnnir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651 -675-5675
Please complete for modifications to existing residential dwellings. Do not combine inside and outside
lumbin on the same a lication; se arate a lications and ermits are re uired.
Date ld / ~L / O _7
Site Street Address dV,9U O_~Lt4 L 6 UNt #
Property Owner &A IJ S046~ AEL Telephone # b,~) Gv-9al
CoMractor Iq /f P/tia. Telephoneu (6~1 ) F+S3-a?a2/8
Address aL.6/ lenrh CilyhZte 15'e-ae 1,,4, State-ZJIV 2ipSS/iv
The Applicant is: _ Owner & Occupant X Ucensed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-buitt $ 10.00
Fire Repair (replace burned out firtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alterations to exfstlng dwelling $ 50.00
? Add plumbing fix[ures'to ~ main level - lower level. This fee includes
installation of a water softener and/or water heater at the same time. N you are
instal/ing onlv a water softener and/or water heafer, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment
_ Water Turnaround (add $736.00 if a 5!8" meter is required)
Other:
Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
SWte Surcharge $ 50
Total $
I hereby apply for a Residential Plumbing Pertnit and adcnowledge that the infortnation is complete and accurate; that the woilc will be
in confortnance witli the ordinances and codes of tthe City of Eagan and the plumbing codes; that I understand this is not a pertnit, but
only an application for a pertnit, work is not to slart without a pertnil and work will be in aocorclance with the approved plan in the event
a plan is required to be reviewed and approved. •
~ES S ~i/i /~nm1 tiI 6 /,cCy .[Y7vL
ApplipnYs PrirKed Name plipnYs Signature
~
J, 1119,
r 2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauirements RemodellReoair Reauirements Office Use Onlv _
3 registered site surveys showing sq. ft. of IoL sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joisis Cert af Suney Recd _ Y_ N
(20%maximumlolcoverageallowed) SoilsRepat _Y _N
1 Soils Report if proposed buildinq is to be placed on disturbed soil t2e Pres Plan Recd _ Y_ N,
2 copies of plan showing beam 8 window sizes; poured found design, etc. Addifiar -indicate i(on-sife septic sys(em iTree Pres Required _Y _ N
1 set of Energy Calculations 0_n-site Septic System __Y _ N
3 copies of Tree Preservatlon Plan if lot platted after 7/1/93
Rim Joist Delail Options seleclion sheet (buildings wiN 3 or less units)
Minnegasco mechaniwl venLla6on form
Plans are considered ublic information unless ou state the are trade secret and the reason.
Date _1_ / -0__ / W7 Construction Cost
Site Address UnitlSte #
N
Description of Work
Multi-Family Bldg _ YW/N Fireplace(s) _ 0 1"'_ 2r0TW,-;P-
Property Owoer Telephone #
Contractor
Address j~ City
State /~nf Zip S~ZS Telephone #&V ZZ-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(~f submission typej Submitted Submitted
• Energy Envelope Calcula6ons Submitted
In ihe last 12 monihs, has the CiTy of Eagan issued a permit for a similar plan based on a masier plan8
_ Y _ N If yes, date and address of master plan: '
Licensed Plumber Telephone J
Mechanical Contractor Telephone ~
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Pernut and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the 5tate of MN
Statutes; I understand this is not a permit, but only an application for a permit, and t a
permit; that the work will be in accordance with the approved plan in the case of worMir and
approval o
fplans. AppHcant's Printed Name Applic t's Signa re
~ DO NOT WRITE BELOW THIS LINE
~
Sub Tvaes
El 07 Foundation ? 07 OSplex ? 13 16plex ? 20 Pool ? 30 Accessory Bldg
PL 02 SF Dwelling ? OS 06plex O 16 Fireplace ? 21 Porch (3sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebolpergola) ? 36 Multi Misc.
? 05 03plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage
? 06 04plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
~ 33 AReration 13 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entlre Bldg) - Glve PCA handout [o applicant
Description: WaterDamage_Yes
Valuation 5-DJ MD"~ic) Occupancy T12 CI MCES System
Plan Review 100°h or _ 25%
Census Code q3`f 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) _ Sheetrock
_ Footings (deck) _ FinaVC.O.
_ Foo[ings(addition) FinaUNo C.O.
Foundation )4 HVAC
Drain Tile Other
Roof Ice & Water Fiual Pool Ftgs _ Air/Gas Tests Final
1p graming _ Siding _ Stucco Lath _ Stone Lat6 _Brick
Fireplace _ R.I. _ A'v Tes[ _ 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 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3041 Woodlark Lane
Lot: 6 Block: 2 Addition: Oslund Timberline
PID:10- 55300- 060 -02
Use:
Description:
Sub Type: e - Fixtures
Work Type: Replacement
Description: Main Floor
Meter Size Meter Type
Comments:
Fee Summary:
Contractor:
Suburban Air
1290 -B Osborne Rd NE
Fridley MN 55432
(763) 784 -6100
Krisandra French
1290 -B Osbome Rd NE
Fridley, MN 55432
PL - Permit Fee (miscellaneous)
Surcharge -Fixed
Total:
Manufacturer
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Serial Number Remote Number
Owner:
Pao Her
3041 Woodlark Lane
Eagan MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4087
$0.50 9001.2195
$50.50
Issued By: Signature
Plumbing
EA081527
12/20/2007
ePermit
Line Size
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State