4277 Trenton Tr
CITY QF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE:454-8100 BUILDIMd PERMIT Receipt #
Tobe.usedfor PORCfI Est.Value $4•000 Date MAY E , lgay
Site Address 4277 TkF'h']'f.1N TR j
- LOt ZA BIoCk 4 SeGSub. NORT"i~~EW HF" OFFICE USE ONLY
Parcel No. occuPancy - Fees
Zoning - ,
¢ Name YBTER NAKRRH (Actuap Const Bldg. Permit 64•0()
o AddreSS 42 Oii TY2 (Allowable) - Surcharge 2•00 1
City EACAN Phone a or scodes - ,
Pla^ Review
Length _
p Name W'AnNE DR$KKEh Depth - SAC, City
ou Address 3836 lU1RRIL+T AVB S S.F. Tolal -
U~ City i~?I~l.'TEAPOLIS phone 923-912E S.F. Footprints _ SAC, MCWCC
On SHe Sewage _ Water Conn
~Q
ci W Name On Site Well - Water Meter
x= AddfBSS MWCC System -
02 Acct. Deposit
a W City PhOn2 Ciry water -
PRV Required _ S!W Permit
I hereby acknowlege that I have read Ihis application and state that the Booster Pump - SnN Surcharge
information is correct and agree to comply with all applicaWe State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI
Signature of Permitee ' APPROVALS Road Unk
A Building Permit is issued to: WA~~ BRLFYI 'r` Planner - park Ded. on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. gldg, pry. _ Copies
Variance - TOTAL ~ r ' eQ
Building Otficial
' PermB No. PermR Holder Drte Telaphone #
WATER j
SEINER
PLUMBING
H.V.A.C.
ELECTRIC v
J"`Ll.•TU'Y,lii /rf
Lffdzll
IntpeClion DMe Insp. Commenb
Footings I s1 W
Foundedon
Framing ~ - -
Fi00fing
Rou9h PIb9.
Flough Htg.
Isul.
Freplace
Final Hlg.
Fnal Plbg. Canst. Meter Plbg. Inspector - Notity Plumber
EngrJPlan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
~Ill Aer"_
~ CASH RECEIPT ~
' CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
. ~ . ~
DATE
wseuve~ ' ~
PROM
AMOUNT $
8.~ DOLLARS
/ +oa
? CASH EICHECK
rO*/~%
~ .
FUND CdDE AIAOUNT
L,
' . ? 7 =
i~•'~.'l
Thank You : . ,
B.1
. Y/_i ;.-t .
~
~ White-Payers Copy
Vellow-Posting CqPY
Pink-Fila Copy
' CITY OF EAGAN I G0 C, s`.
3830 Pilot Knob Road, P.O. Box 21-199, Eapn, MN 55127
PHONE:4648100
tU1La1NG PERMIT R.uiat
u lU J
To le w~ hr Est. Volw ' Octe . 19 •
sIn n" T I<AI L - 6ect oca,psmv
Lot Black ' ~Sub. N(lk.'rt7V iV`.:' :_r`ADc Remodsl ? Zoning
Rapeir ? TypaofComt. ,i
PrcN No.
Enlarps ? No. Staia
f'C)F;;TR(ICTIC)t^? Move ? l.enyth
~ Nrne
- Dsmoli~ ? Dopeh
Addrotl Gnde ? Sq. Ft.
Gty Phona Instetl O
Nema A#prewk FNs
/lsusuneM Parmit ~ . ~ n
~ Addrou U l,
City Phone WaMr 3 Saw. Surchorpt
Poliu Plm Rsview " • ' ~
G~ Nwns Fin SAC . .0 v
~3 Addmt Erp. Watar Conn. 1; J - 0 U
City Phone Plawrr Water AAeNr b.i_~ ri
Couull Road Unit l 8ti . U C
1 herebY akrowbdpe that 1 have road this opplicotion and stote thot eldp. Off. 4/ H!b 5 " 131. U 0
Nr inlormofion ia eorrect and oprae to comply with oll applicobb APC Toql - 1, 3`J~
Srote of Minrrsoto Stotuts and Gry of Eaqan Ordimnus.
Ver. Dab
Sipnotun of PamdMN
A Bull~ny Perenit b isswd ta •:i;Star.Y k~. 'r~~~ r nt,
On fhe utpMY eonditlon IFWl
dl wak shall be dorr in ocoordonee with qH opplimbb Stob of AAlnnewta Stotutas and Gty of Eopan Ordinonas.
swan,o okwni -
- Pwmit No. Pwmk Holda Wp TN Iwne !
Plumbhp ~ U -ol S - V 7 - 1
H.V A.C. . S S 'S /p~- L L~.3 / D
electr+c A rb _y-t c.i-
so+c«»?
Imveeion oro lnw. an..
Footin¢ /S f~ll/
Foundetbn
FnmMp _
Rooflnp
Rouyh Vlby.
Rouqh MVA
Inwubtiw~
FinN Pibo.
Final HVAC `
Fiml
CMt/Ox. ~ ~ ~ (p / g '
Waa. Daerib LoeaNon:
Mwll
Sftwr
Pr. Dip.
Reaipt MECHANICAL PERMIT Permft No.._: •
CITY OF EAGAN
F.. 2-f)"....
Fil! in numbensd apaces 5/C
Typs or Prin[ legidy Tot
;
1. Dab L 2. Installation Cost ~/C' ? ~
/ . ~
3. Job Addrest 4 Lll 4 i NI"'Lot Bik. 'fTract
~
4. Owner S i E Y ( vn n/5 i
5. Contnctor ~ GSoN41- C ~ `1
niuT I'v-Phone
.
6. Addrcss 7L ~ 0 '~?a t [ ~i:# ~
T
7. GtyStaM~A-/ 2ipc'-:V7 ~
8. Building Type: Residential Commercial ? Institutional ?
9. Work Dascription: New C~ Add ? Alter O Rspair ?
, -
10. Describe YFueI Type
17. No• FQu*^me-^+ 8TU • M. Ea. No. Eouioment CFM
Forced Air
_ Air Handling:
Mfg.
Boilero
Meeh. Exhaust
Mfg. / 6? _e'W5~
Unit Heater
Mfg. : Other
Air Cond.
INfg.
Gas, Rping Outlets
12. I hereby certify that the abova information is true and correct, and I agree to
comply wilh all ordinances aAd codes governing this type of work.
5i9ned : ! . : ~ fo?
RouYh Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Rawipt i PWMBING PERMIT Permit No. CCITY OF EAGAN '
~ Fo! I
fi!l in numbered spacsa S/C _T
't Type or Print leyibly Toe.
1. Date 2. Installation Cost
~
3. Job Address Lot • Blk. Trect
4. Owner
b. Contractor •"/1,11si vs',"', Phone
~
6. Address ( , 7 ' • '
7. City State Zip
8. Building Type: Residential D` Commercial ? Institutional O
' 9, Work Description: New I& Add ? Alter O Hepair ?
' 10. Desaibe
17. No. fixtures No. Fixtures
Water Closet Cesspool/Drainfield
_ Bath tubs $eptic Tank
_ Lavatory $oftner
Shower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
~ Slop Sink
% Gas Piping Outlets
12. i hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rouqh Finsl
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
, PERMIT #
MECHANICAL PERMIT RECEIPT # ~ (L
~ CITY OF EAGAM 4
3830 MLOT KNbB ROAD, EAFAN, IYIN~55122 DATE
CONTRACT PRICE: PHONE: 454-8100
~ Site Address 77
„ ~ BLDG. TYPE WORK DESCRIPTION
Lot?"_Block Sec/Su Res. New
~ Name(~ Mult Add-on ,
Comm. Repair
Address
~ City Phonevsa-i~.. Other
FEES ;
Name RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00 T
p City 'Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERM1n - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 146 OF CONTFiACT FEE
Forced Air M BTU Ilz APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
, Unit Heater. M BTU REMODELS - 12.00
Air Cond M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM R (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping OuUets # BEYOND $1,000)
Other
FEE:
S/C: SIG/NAT E M
TOTAL,/! //J14
FOR: GTY OF EAGAN
~ r OF EAGAN Remarks
Addition NORTHVIEW MEADOWS Lot 23 eik 4 Parcel
Owner Street 4277 State EAGAN MN 55123
Improvement Date Amount Annual Vears Payment Receipt Date
STREETSURF. V 7467 LO 53 7 0 16 Io1o s -
STREET RESTOR.
GRADING
R 1981 15.89 79 zo O/6 63 /-~x s
SAN SEW TRUNK 5-7`'j 1981 138.48 6.92 20 ~o• 9(o R-o 16 (oG-3 l.~r'•Z%-dS
SEWER LATERAL TWIN 1994 275.22 1981 22.28 16.31- 18-35 15 571 08 2B ~S ~3 D A-o /66G 3 i:z Z~ -f~'
WATERMAIN y 1984 ']0.6] 4.71 1$ (p. s p/GG65 -.v -e ~
WATER LATERAL 18.65 1.24 iS /~m /(o GG 3 Z- iP jf'
WATERAFEA 1981 138.48 6.92 2
29.52 1.41 1-#6 20 .20-70 a163
STORM SEW TRK 150 1984 392.32 76.'K 39r46s /(o • i40/ LG 5-STORM SEW LAT ~
DRAINAGE S 1984 33.97 73 4-3c46- 10 8o f~0/666 -
CURB & GUTTER
SIDEWALK
STREET LIGHT
280.0n
WATER CONN, n n 500-00 6UILDING PER. n IT
SAC n if 521500 PARK
r-
CITY %cAru WATER SERVICE PERMIT
383Q Mflot Knob Rosd
P. O. Box 21199 PERMIT NO.:
Eageo, MN 55121 DATE:
q Zonirg: 1~1 .+?~pp.,o{ Unih: 1
\OWMr: . wBev (;i`t•-" ,
~1lddross; ue~Ofn r!. . i
Site Add.en: 42 t i1 t iewP4e wa ~
~ flumber: I;ruchmuel
`11*ater No.: ~ Connection Chorpe: _ 500.0() nd
Slze: Acoount Deposir:' 15.00vd
~ Reoder Permit Fee: _ 10.00pd ~
I ~me tO °m* y'kh the City of GYen Surcharps: 50rd I
Ora"e"0Y' Misc. Charass: - 132.90 n 1
Torol: 63.00 pj n,Prer
' By Dote Potd:
Date of Insp.: I
TI 8 ,5 ^4.:
~ CITY OF EAGAN SE1R?ER SERVICE PERMR
3830 Pilot Knob Road 7307
I P. O. Box 21199 PERMIT NO.-
! Eagan, MN 5512] pA~: 4 -
~ Zonl : Rl
I Owner: es eq oIISt No. of Units: 1
I
i /lddrol3:
~ S+ro Addross; renton Taai2 L23 B4 Northview Meadowa
; Plumber. Bruchmuellnr Plumbin
- -
I.o.« to a..* wt1U Ib CIly .i g.p¦ Con,,.eNa, p,c„yu 425.00 pd
o.ai..aa.. Acoouxx Dapoeir: I5.00 d
i PamiM FN: • P
I BY Surcha?pr. Pd
Misc. Cihorpp;
i Dets of Imp.: Total:
~ Insp" DnN Pald:
5/8- y
E 9 5 9 2 7
Requesl D t e ire No. Rough-in Inspeclion
S' 5 p'q Re uirad? ? Ready Now~Nill Notity Inspector
d~ es ? No When Ready?
I? licensed contractor ~owner hereby request inspection of above electrical work at:
Job Atldress (Street, Box or Roule No.) Ciry
-t E TDnI T12, 514 (51. A/
Seclion No. Township Name or No. Range No. County
Ocwpanl (PFINT) Phone No.
5 e E
Power Supplier Adtlress
Electrical Contractor (Company Name) Conhactw§ License No.
Maihng Address (Comractor or Owner Making Installation)
Z Aulhori Sig Wre (COntra onOwner Making Instalialion) Phone Number
S - b1.2,
MINNESOTA STATE BOARD OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
Grigga•Midway Bltlg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
57/e'Cy REQUEST FOR ELECTRICAL INSPECTION r- ~e~ p' ~ J
N
? Sae instmctions for completing this fortn on back of yellow copy. ~r
5927 X" Below Work Covered by This Request
e Add Rep. Type of Building AppliancesWired EquipmentWired
Home Range [fElectric mporary Service
Duplex Water Heater Heating
Apt. Building Dryer ther (Specify)
Comm./Industrial Furnace
Farm ' Air Conditioner
Other (specily) Contrector§ Remarks:
~~w 3
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps o to 100 Amps
Transformers Above 200 _ Amps Above_7Q0 - Amps
Signs insPeccort use onty: TOTAL ~
Irrigation Booms , C-'C
Special Inspection
AIarMCommunication
Other Fee
I, the Electrical Inspector, hereby Rough-in •
certify that the above inspection has Fnal at \
been made. M__e
OFFICE USE ONLY
This request void 18 months from
This re9uest void rj U(~ ~ `~y
18 mon[hs (rom -J l o 'C, rl S !
0~~ V), o o
A -093 616 a-3 ~y ii] o +1
Request Date Fire No. Rough-in Insuection eVU eA7 C]Ready Nuw ~II Notity_ Inspec-
- Yes ?No or When Ready 11
Licensed Eleclrical Contractor I hereby request insDection ot ebove
? Owner elecirical work instal led at:
Street~dress Boxor.Aoute No. Ciry
7
ec ion o. Township Name or No. Range No. 71,
OccuGant (PRINT ~ Phm N .
~7a~L
Supp ier ~ I AAdrOSs
\ ~
Electr Co ract-r (C-pewany Na e) Contractor's License No.
3~..~
Maili Address (CoMr •tor or Owner Makine nstaila[ion) p
3 ~o ~ .5~3~3 3
Author ed S~ namre~LContractor/0 r Mak g stallatonlt Phpne Number '
S-
~ p CJ
MINNES'OTA STATE BOARD OF ELECTqICITV THIS INSPECTION HEQUES7 WILL NO7
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOAHD
1821 University Ave., St. Paul, MN 55106 UNLESS PNOPER INSPEC710N FEE IS
v~,...e la171 997-2711 ENCLOSED.
yo~ 8 E
3 REQUEST FOR ELECTRICAL INSPECTION a-ooooi_on
' See instrucTions tor completing [his form on baCk Of yellow copy.
,~S
0 9 3-61 6 ""X"" Below Work Cavered by This Request
NeV ladd Rep. Type of Building Apptiances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt Bwlding Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Condrtioner Bulk Milk Tank
Falm Othet peci y Olher [SUerify)
I er SVecify Other Other
Compute lnspection Fee Below
p Fee Service EntranceSize q Fae Feaders/Subteeders p Fee Circuits
O to 200 Am s 0 to 30 Am s ~ 0 tn 30 Am s
Above 200 qmps~ 31 to 100 qmps 31 to 100 qrr~
Swimming Pool Above 100_Am s Above 100_Am~s
Transiormers Irrigation Booms Partial-'Other Fee
Signs Special Inspection $ 7
Hertx~rks OTAL F.EE -1\
Rough-in ~ Date s /
I(the Electrical
InspectOr, her06y
ertHy-thet'ttie above
Final D=1ep 2 f. inspection has heen
I l mada.
e
This reQuest voiE 18 months from
CITY OF E'AGAN NQ 16395
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING'PERMIT PHONE: 454-8100 Receipt #
To beaised for PORCH Est. value $4, 000 Date MAY Z , 19 89
Site Address 4277 TRENTON TR
Lot 23 Block 4 Sec/Sub. NORTHVIEW MEADOW OFFICE uSE ONLY
P8fC01 N0. Occupancy - FEES
Zoning _
s Name PETER WARREN (ACtual) Const - Bldg. Permtl 64.00
o Address 4277 TRENTON TR (Allowable) -
Cit EAGAN PhOf1B ra ol Stones _ Surcharge 2. 00
Y Lenglh _ Plan Review
, o Name WAYNE BREKKEN Depth - SAC, Cily
oQ AddreSS 3836 }IARRIET AVE S S F. Total - SAC. MCwCC
¢ City MINNEAPOLIS Phone 823-9128 S.F. Footpnnls -
On Site Sewage _ Water Conn
F W Name On Site Well - Water Meter
Address MWCCSystem - qccl Deposil
a W Cily Ph011B City Water _
PRV Required _ S/W Permit
I hereby acknowlege that I have r ad this application and state ihat the Booster Pump - SiW Surcharge
inbrmation is correcl and agree comply with all ayp licable Stale of
Mmnesota Statutes and Cit of E an Ordinances. Treatment PI
Signature of Permitee APPROVALS Road Unit
W YNE BREKKEN Planner - park Ded.
A Building Permd is issued to:
on the express condition that all work shall be done in accordance with all Counctl
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Olf. _ Copies
Building Official A ~..Qa~ / 111.~ Variance - TOTAL 66.00
CITY OF EAGAN N o 10O 6 O
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDlNG PERMIT Receipt #
Te be medler SF DWG/GAR Est, Vclue $60, 000 pate APRIL 10 _,1y 85
`
Site Addreas 4277 TRENTON TRAIL Erect ~ occupancy R3
Lot 23 elock 4 ~ec/Sub. NORTHVIEW MEADSRemodel ? Zoning R1
Repeir ? Type af Conet.
Parcel No.
Enlarge ? No. Stories
WESLEY CONSTRUCTION Move 13 Length
= Name 9401 XYLON AVE SO Demolish ? Depth 44
Address Grede ? Sq. Ft.
~ City BLMTN Phone 944-7092 Instaii ?
Name SAME Apvrovob he8
~
Z~ Assessment Permit .~Q
o~ Addresa 0 0
u~ Cit Phone Water 3 Sew. $urchorge 3 0 .
Y 156 • 5C
Police Plan Review
~'°C Name Fire SAC 5 2 5. OC
gww 4~ Address Erq. Woter Conn. ~0(
~W City Phone Planner WoterAAeter6-3-0(
Council Road Unit 7 R(1 _ 0(
1 heroby acknowtedge that 1 have read ihis epplicotion ond stote that gldg. Off. 4 5 T. P. 132.0(
the inlormation is correct and ogree to wmply with oll appliccble APC Total $l 999 .5~
Stote of Minnesoto Statute a ity f Eaqan Ordinonces. ' ~
Ver. Date
SiQnafuro of PermiMee
4~ESLEY CONSTRUCTION on the e
A Buildiny Pertnit Is issued fo: xpross tonditlon Ihot
all work sholl be done in xcordonca with all limbla State of innesota Statutes ond City of Eapan Ordinonces.
Buildinq Official
' ' .
~
2/84
j CITY Or EAGAN
VW APPLICATIGN FOR PERMIT
SEWER AND/OR WATER CONNECTIODT
- (PLEASE PRINi)
~
1) Fr-.opERT^% r~DRESs: z~? 7 /d^ <fi~s 7~vrf /vcri ~
/ ~
rFr;L DE..~CtI?TIC~J: ~ 23 - R ' t~ /v"~,%,4 d! Pvv f`1P~vui
(Lot/Blocic/SL:divisicn or la:t rarcel I.D. IN~U:.-+er)
~ Lr _..iIE:G S=L=.M~E, DAT~.' OF O?.T_Gl.~,rriL =iJL`:G ?I"'
RKR-1 SL`:GLc ""ti~1L~'
r.
? R-2 DUP=: ('IYCO LT?ITS)
. ? P-3 ZCf.,.-L~I-?CrJSE (mc-_c= - 1^S) ( r~',II^'~)
? L:-4 GNITJ1
? CCS"?y~Ll~~cuZ?~r: Tl.~
? ~'Tii.S1~.L=~.? L`d$Ti7.TIO,%r'1L/GCiJ=E=.T
Z) APpLI=47 (PLEASE rnIiii)
NAt•LF: I///l?~21~ ~i/~'f
AcDRESS: /'L
CIT'_', Su-'TE, ZIP:
5~1/35e
PxoLNE: 9 y"t/ - `~7oy ?
3) pE17,IEEP, / (Py. cdSE PR T fOR CITY USE ONLY
rArE: ~'iorcl~~ v e
P.DDi2L.5S- PLU!!~ERS LICE~45E:
~ / ~ Active
CITY, STATE, ZIP: ~jP,.~~,~/~4 /-//f' ~ Expired
' " - " Not of Record
PHODIE: ) 7-/~ pLU,46ER LICENSE 3 2 '3 6
arr 5t;ta
4) O('r„•pk,,rr/Cr.ZTER NAhIE (PLEASE PRI!IT)
:
ADDRESS:
CITY, STA'IE, ZZP:
PHONE :
S) INDIG'1TE WHICH PER11IT IS BEIr:C REQUESTID:
~CO.RJEC_TIO-I TO CITY SEWER
~ CON,%=IC:V 'Ib CITY NATE?~
? OT1M2 (PLL'}15E DESCRZBE)
6) I,'DIG~~.. C.:r.: .
? PLv-aSE f?OID APPP.OVID PER.ti1IT FOR PICfi-t,'P BY O:IE OF A6CVE
~ P=,SE :•T'.~IL APP?UIE~ PEF'-LLT T'J 1, 2, Q 4 AB(7VE
(Circle one)
7) SZC~,TL:vF: ~tq~
Dazr: 2~ Zff
S-
a" R OI+Li0.1lJO i ea ! s 1!+t W-'=s~i as aMot s fn Imam l.c= vmmmw~ FOR C I T Y U SE O[VLY
P`'^-%?IT u ISSUED
F7- --1
rr.rS: $ /o.." -e S::',~LR P~R:.1TT (I`_ICL,vD: SURC~?.RGc.)
WATE? PERPIIT ( Ii:CLl.1DL SuRCi?APGE)
$ l0-3• WATER b1ETER/COPPERHORN/OUTSI'JE READER
$ WATE.°, TAP (INCLUDE CORPORATIQN STOP)
$SE`.•iER TAP
$
$ AC^OliVT DFPOSIT - i'1P.mrR
Y c!l /-4, t"'~J wr,C
$ ~-as--B--d sFc
$ TRli'c]K NAT°R ASSESS;-:E:iT
$ T.°.u:1K S`.::ER ASSESS:L'riT
$ L;TERAL SE:•IEFIT/TRU`IK
$ LATER;L BENEFIT/TRUNK TNAT°R
$ i~3d OT :ER '
$ TOTaL
$ `J/. ".d A^-IOli.`:T PAI'J/'RECL'I?T
DOES UTILZTY CONNECTZON REQUIRE EXC;-:VATION IN PUBLIC RIGHT OF WAY?
~ YES ZF YES, THEN H"PERh]IT FOR :dORK SJITHIN
PUBLIC ROr1DWAY" MUST BE ISSGED BY THE
NO E[VGINEERZr]G DIVISION. LIST AS A CONDZ-
TION_
SGBJECT TO TIiE FOLLOWING CONDITIONS: '
.
APPROVED BY:
T I : LE :
DAT°:
N.cM w
7,6,r1~
t r z"
~ 'N t ,i ~~due7~tl'6r ~ C r•1'~9~ p aF rx'~ € ~ y ' ~'4 3A ' , `R . ' f^~, a~~
'M ~ ~k l (tfk r~:i., ti aG! fi~, ~J L ~1t,lM14sid? ~1 t, ~ i
~ S'~ ff ~ ti . 111 J~ ~"i i f 1 l9 4u ~ Y Y AS> t 'C. ~v 7 ~ ~IIYS~~1~ ¦ ' 1 i, ,
~r ~ 1,~ + ? X't ~~#,yyft a "k~#t n~ ~ ~.J :ts p o ;~I e t Y, ~r i•~ ,t w. Y
i , ~
U/4N~ °`Yl i,~ h:,
vl0ltlcs=57
f'Mf~f~If
S'~ d '~"r ~~~QI ry~'~' i ~ ~~r ai v K W ~i d „A ` ~l9~llo
My NA, f1j t i ~
! F T ~ J_~Y ~ ~ ~ S hc lyI i
~ C9,
~
South 0lffce
( wet Mdnit Hwf d' l rai;nnanl6l knR+ru~rnn8 „ r ~ • 89G-t•. , u ~
ry • ` ' f~'.l ,~T` i-m~dSuiorrfnx a~ lonJ I4uiinrn , • , 12J50 F,Yer R;ug• la ~ .
LJ ` ' , Xd Suel~TrsunR , . mviMe' Mmnesota 1, ~
r~, a~t ~y • . ~ , ~ ` E 1~'i . ~ . ' ' .
gki V
-6V~''; QSSDC" ~
-r
R ~ ,.Q 14 1 y' ~ L
~ rl: ~ l ~ . ~ _ • . .
77~ S, ,It:
' A
. 1 Sy y ' ' I \ ,
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• • RESIDENTIAL
50, ` ~ ! BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauirements RemodellReoair Reauirements
• 3 regislered site surveys showing sq. ft. o( lot, sq. ft. of house; and all roofed areas • 2 copies of plan ' ~
(20°~ manimum lol coverage allowed) . 1 set o( Energy Calculations for heated additions ~
• 2 copies of plan showing beam 8 window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations . Indicate it home served by septic system for additions
. 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Delail Options seledion sheet (bldgs with 3 or less units)
DATE I~I rIQ VALUATION 'I-MV .01D
SITE ADDRESS Z-Ia -7 77t^P,n-fnn~Tf a l I MULTI-FAMILY BLDG _ Y N
TYPE OF WORK"CX7~ +IfQk_C L`(-V A*~Ol["P_ FIREPLACE(S) _ 0_ 1_ 2
L16Gl~Se~ ~~D/lcF~3
APPLICANT A'(1(`e-c 1Cdif1 ~T~1 1l l l Yl/-,, nI(4rn~',i('](:`~
STREETADD ESS a Iv~CUIIe+ CITYBLrns?iIIP,STATEMA(ZIP_ 55-33'7
TELEPHONE9Sot ~959 CELL PHONE q5R) d9a-awo'1FAX # A,S.Q -?07-QgaS
. ~
PROPERTY OWNER~~(' i ~ICP~ Warf P/'1 TELEPHONE# '-I 1 621
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'CA RULES 7670 CATLGORY 1 MINNESOTA RULLS 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing systcm includcs: Watcr Softcner Lawn Sprinl:lcr Pec $90.00
Waler Hcater No. oF R.I. 13aths
No. of 13aths
Mechanical Contractor: Phone #
Mechanicil syslem includes: Air Conditioning Fee: $70.00
HeaC Recovery System
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eaga rdinance
Slgnature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
1
OFFICE USE ONLY • • .
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex 0 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bidg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _[ce & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply.& Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search •
Copies
Other
Total
,
- I
6v
/
1985 BUILDING PERNIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS l9llST 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: S•FF)W(1.Aa4P, Valuation: (00,000•'10 Date:
NioNTt2
Site Address: 4 2^]7 OFFICE USE ONLY
Lot:ZL Block ~ Sect/Sub Erect X Occupancy P,-3
Remodel Zoning (L-~
Parcel /I Repair Type of Const ~
C~ Enlarge ~F of Stories
Owner O~ Move _ Length 3 e,
Demolish Depth 4+
Address Grade Sq Ft
City/Zip Code J .j`/.?y
Phone APPROVALS
Contractor Assessments Permit 13 00
Water/Sewer Surcharge 30 .9!-
Address Police Plan Review 15(.•S~
Fire SAC 5Z5.
City/Zip Code Engr Water Conn 500."°
Planner Water Meter Co3.
Phone Council Road Unit 2gD
Bldg Off1-Ljf5- Parks
Arch./Engr. APC Treatment Pl 132.
Uariance
Address TOTAL 5
City/Zip Code
Phone
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,EX;TERY+OkENVELDPE AVE'RAGE.UCOMPUTATION " .
041NER ; , •
. ~ . . N, . - . . . . , . ~ .
, SITE ADORESS ~
CON'fRACTOR DATE '1PFIONE 7YZ ,
t
Determine working square'footage of each.
.
1. Total exposed wall area sq• ft. x = i9 ~v
,
2. Totai roof/cei1i ng, area : : . ~ -
, ~''clf~2 sq. ft. x _026
Total exposed wall. area above floor
i~ a. Total wall window ar.ea...... . . .
. b. Total door area ' , . _
, c. Total._ sl iding glass door~area
d. Total fireplace wall area.........................
- -
e. Total wall framing area (average 10%)...:........
' f. Total''net wall area above floor
g. Total rim joist area
~
i' ~ " • Total exposed foundation,area
h:~ Tota.l foundation window arca...
"
i.-Toal net foundatioti area abevegrade.
Determine. "U" velue cf each wall segment. " ~
~ . a. X "U"
, b. X Ifu„
~
c. yd 'X fouli
d. X uto
„
. ~
, . e. x liuli
X U., :
. .
, 9, X i,u„
, h. x ,fu„
, X fou,i
3 . ...............................:...Total
If item #3 i,s the same as, or less than,item #1, you have met the intent
of,SBC 6006(c)2.
•
. . ,
,
ry...~, . . . . . . _ .
._~it:i , ~ . .i . ~ . f ,
'A: . . . f
wl?LL •sE[rrlciN3
*1,;S~~Nm'Ey os~ 15% of :;opequo wail area, !or
~ I
lramo constsuction , ~ • . • . . tbti~truction ~ R-value
l. tw 0.68
~ ! ,3',2 i.s soft wooct ~ ' T2 ~ ? • '
S. _ C
HASIC 6. Exterior air film = 0.17
'
WALL 7bta1 74,
~ . • ' ~ ' ~ . . . ~ ~ l/ ` , QF~~~
, FIG. 81 TOPVIE[9 OF
ppAMg.-WAIy, 1.• Interior air film 0:68
2.
' • , 3. ?F~t'61tV 13, 420
1 ob
fi. Exterior air film 0.17
F.IG. #2 , Totdl V//
. .
1: Interior air Pilm 0.68
2. 2~6' .Sf~GGPII c?J
,r~ ...r. ..._.e..r I
3. / /J' ' Sci~`rlas~l
Y..,..~Q .
4.
: Si t L l Sr R C.FA
-----Q 5. ~ 1' DiNC 5. ~D
6. Exteriar air film 0.17
Total
r~~.:~.... . .
,
• `r . ' ' ' ' ~ 1. interior air film 0.68
1 ~ . A a 2. 37.~~'fr: ' CAl'~c' .?F
:
FO0t7D~T7CN ~ I `.i S
y.. WP. I.I.
~ ~0. . • 4.
~ , tl • 4L)C 5 .
~
c •r ' ~ ~ : .
. G. Exterior nir film 0.17
h , .
Total 7..3Q
~ SLAB-ON GRADE
a-: . .
Y • , ' • ' ~ . ~
: a
• ~~A~~ ~l . . ' ` ~
I(I . .
- • • ~ ~
~kF, ° ~ . ' . (f I ' ' ~
u r
~ e+ FIG. N4
_ r~~ X d ~ r _
. . ~
FIG. #3 "
' ~ • << ~ /x x
NOTE: Indicate,tyoe, "T_:" value, denth and
I • •
placeMent of insulation.,
r. v . . . , ~ ' • - , •
, ,
~ p#gQ ~Y.f.e~
~
RWP' /,CgI,LIlmti
=_k~
{'.S f1 _ , . . . . . . , . . ~ ; : . . .
~Co»alruction R-Valuo
. J~ .
1. Intorior air film 0.61
3. ~ A?J ~
2
. 12~: LLLl~O.f£
4. Extorior ait film (still 0.61
's: ~ VEtiT Total tlc' V/
,
N
02.~
. .
- -Vented ~ ~lieat flov. t r ~ ~
.ky,,, " • up ~ .
.
ift~ . ; . . . . ' . i . . .
. • , ~ . ' ' . ,
[
.
. , ~ ~ • ~ ,
~i~-~R , . ~ ~ 'I~ ~ . . ' • • . .
,r`. . . . ' .
1. Interioz al,r film 0.61
Z•
n.~.
3• . ~'e.\.
4. Er.terior air; ilm s _
r. , Ti3tdl
S;l • . ,
_
,
,r. . .
1 2 3 ~.4- . •
}:eat flow up . vented
~ FIG. N6 . . .
, . - - - - - ~
u 1. Insi.de ai.r film i~ 0.61
Z.
' w .1` 10 ~.l'• ~ ~ . 3.
'
• r :1~; ~f
e. .~~,=1'a.~,~~: ~ ' Y.
S. Outside air lm 0.17
Tota"L...
1 .
, , • . .
NO.I-VENTF.D ~ NoCas Use ndditional shects if more space L.
needed for deta~ils and calculations.
. .
Heac ~ ' , ~ ~ ~ • ~ , - ~ ~
Eloa up . . . .
. .
°Fr.a,~ .07
~
-o ' r., . ' - . . , r : ; ~ . .
, ~ . ' 4 • '.Y'' . u.~,~~ : < 1~,. .
4,
. , .
dd~}~ • . ' . ~ ' . . ~ ' 'il 9 s.r~r ~ . , , . - ~ . . ~ ,
t~i _ . . . . , : . . , ~ ' ' . ~ ' .
Total exposed roof/ceiling area
J. Total skylight area.............................
~ k,, Tota1 roof/ceiling framing ar.ea (average
1. Total net insulafed roof/ceilin area........... . . 9 .3-7, Fs
~
~ ~'Determtne "U:' value for eacli roof/ceiling segment.
' ~ X „Oil _
.
,
, k• X ;,ull
z ,;u„ o2z
. 4 ...:...................Tota1..
. If total of..Kis the same as, or less than #2, you.have met the intent of
SBC 6006 (c )1;
~ Alternate Building Envelope Design
~
To utilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not be greater than the sum af items #1 and #2.
~ ~ • . 1~ + 2.
~ 3. +
,
'1>% f'~.f'
I r
c.%,.
~
~P~ •
~ . • .
.t
i;
C;
~ ~ ' • , '
:4• ~Y'~ 1 ' 1•'~
4i}t:f~~ . . . ~ _...4'?j~i~.~^'unna.t`~A[~~:'L`e'.~T(J ~Th4v!.Kii¢: ~~.-~sn•.r.-'e... _ 'i,........._._... . _ . . ' . .
~ r v
. 1989 BIIILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS NM6
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRF.SSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MOST DFSIGNATE WHICH ADDRFSS
IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BQILDING PERMIT IS ISSQED.
M[JLTIPLE DWELLINGS RENTAL DNITS FOR SALE ONITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECg WITH BLDG. DEPT.9 1 SET OF ENERGY
CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS PUy 0 1 19$9
, ~dDP
/
To He Used For: P
!0 / 4/" Waluation: Date: Sc
Site Address y~ ~~e~?TG/V OFFICE OSE ONLY
Lot o73 Bloek ~ Occupaney FEE3
Zoning
Pareel/Sub ~r~U9fv~-~-~ r,t1 Actual Const Bldg. Permit
~ Allowable Surcharge 2.
Owner # of stories Plan Review
Length SAC, City
Address 7) Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code 9 3 Footprint S.F. Water Meter
Acet. Deposit
Phone On site sewage_ S/W Permit
Qn site well S/W Sureharge
Contraetor N/c ~Q'e~ffoF MWCC System _ Treatment P1.
' City water Road Unit
Address 4%~/ /7~t2/e PRV required _ Park Ded.
Booster Pump _ Copies
CitylZip Code /v~v~ LS TOTAI.
APPROVALS
Phone Planner
Couneil
Areh./Engr. ~Bldg. Off.
Varianee
Address ~
City/Zip Code
Phone 4
NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building
permit fee. Processing time for sewer and water permits is tvo days once a licensed
plumber has applied for a permit at City Hall.
. :.~~,:,,~~r~f~r", ~
' wt. i r;~ ~ f' ':n.'!F .?.ri~ t,~~:t i ~".27 i'Nl} ,t I, ,r
47
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RESIDENTIAL BUILDING
Permit Application At f)3 1, ~
l!/ ~ City Of Eagan
3830 Pilot Knob Road, Eagao Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction ReauiremenLs RemodelfRepair Requirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% mazimum lot coverage allowed) 1 set of Energy Calculations for heated addiGons Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured lound design, etc 1 site survey for addi6ons & decks Tree Pres Nol Reqd
1 set o( Energy Calculations AddRion - indicate i/on-s'rfe septic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Detail Options seledion sheet (bldgs with 3 or less unils
Date O 7 / Z`f- / U 3 I Construction Cost 2-Z -7. ~ o
Site Address ~Z 77 T/',, ~ Unit/Ste #
Description of Work ~-~o ~n L" S
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner / e 7 e/t ~j(~ ~ c/? Telephone 6s 2.
9ELA RQOFING & REMODELING, INC.
Contractor 4100 EXCELSIOR BLVD.
Address In 40001050 City
~ /
Te iephone~~ #(iZ ) '?Z3-
State Zip ~
M
~
COMPLETE THIS AREA ONLY IF~CONSTRUCTING A NEW BUILDING
gy . .
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Fiumber ?elephone #
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.
L/ 2 MG fi711 i N N t- ' ~ ~
Applicant's Printed Name Applicant's Si ature
' OFFICE USE ONLY
Sub Types
O 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 O 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.
? 05 03-plex ? 11 10-plex ? 19 lower Level ? 24 Storm Damage
0 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` O 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MClES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/Gas Tests _ Final .
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
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 Plant
License Search
Copies -
Other
Total
~ ~ z~ RES[DENT[AL BUILDING
15 J Permit Application 6p
City Of Eagan ~
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauiremenls RemodeVRepair Requirements Office Use Onlv
3 registered site surveys showing sq. R of lot, sq. ft of house; and all roofed areas 2 copies ol plan Cert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy CalculaGons for heated additions Tree Pres Plan Recd
2 copies o( plan showing 6eam & window sizes; poured found design, etc. 1 sile survey for additions 8 decks Tree Pres Not Reqd
1 set of Energy Calcula6ons Addition - indicate ilon-sde septic system _ On-site SepGc System
3 copies of Tree Preserva6on Plan il lot platted afler 711/93
Rim Joist Dehail OpGons seleclion sheet (bldgs with 3 or less units
Date Construction Cost ~ 200
Site Address ~-Z 77 % l~ -T/ac.,' ~ Unit/Ste #
Description of Work cc
-T
Multi-Family Bldg _ Y~ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner `e 42 tNk_ Telephone # ( (>S Z
Contractor
• Address. 4100 EXCELSIOR BLVD City
' ST. LOUIS PARK, MN '~~41'6
State • Telephone # (6/2 ) a-? 3~
-
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
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber Teiephone #
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone j#;(--)---_-,~
~
II ~l i, '
J0'
I hereby apply for a Residential Building Permit and acknowledge that ttie 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 IvIN
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 eview and
approval of plans.
Applicant's Printed Name ApplicanPs Signatu e
' OFFICE USE ONLY
Sub Types
O 01 Foundation O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
0 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
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 R2pIaC2ment 'Demolition (Entire Bldg) • Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W"ater _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Fina]
_ Framing _ Siding Srucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Buiiding 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
2007RESIDENTIAL PLUMBING PERnniT,aPPLicarioN
, 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 ~ ! oL / 0
! Site Street Address ~~1 ler) fon ral Unit # I
.
I Property Owner ~ Telephone #(IpSi
i
Contractor ChamplOn Telephone # ( )
I g~I_~ 1__„
Address 3670 Elodd Rd. City State Zip
The Applicant is: _ Owner & Occupant _c-cicensed Plumbing Contractor
5eptic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-buiit $ 10.00
Fire Repair (replace burr.ed out fixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. If you are
insialling onlv a water soitener and/or water heatei, 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 $136.00 if a 5/8" meter is required)
Other:
Water Softener L/ Water Heater $ 15.00
_ new ?eplacement
_ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $ /55()
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.
AMY-
~,Ur-~<Sto /2 _
Applicant's Printed Name u- ApplicanYs Signature
~