1005 Trillium Ct
- ~ INSPECTION RECORD
~ C1T`P' OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued: 0 45 1 i,+ 4
(612) 681-4675 ~
SITE ADDRESS: APPLICANT:
. 1 ir I( I 1110 ! .It PIl, ! l; Ut b't 1 1 I110'
qR , fib44
PERMIT SUBTYPE: TYPE OF WORK:
I I'l I,. Ni L4
INSPECTION .
rit11 Mit l hJi.
~M',lI l Al lilfJ 1 I1+1 F'i N~ f
, llt. fl { Pd # 1 1: Wl1ill I f~ 11 { l~
f iF4 ril t'I i;1 lPiAl
• ~ ~~n~ ? , L1 r t [;it t nr. i i ili t-, t".
~
PsrmR No. Permk HoMN Dets TiNphoee ?
SI1N
PLUMBING
HVAC
ELECTR
ELECTRIC
Inapoction Dab kup. Commsnts
Footings I ~l
FourWa«, 7
F~~ ~
~
RooroiV
P"o P"- ~ -q
Ra,gl,ft 7- ZC 9Y S
'Z.Sq
isui. f 3 #J~ Je la.c't-N -7••
Firepfece
Final Htg. ~
Orsat Test
Finel Plbg. PIb9- Inepecta? - NotifY Plumber
Canst. Meter ~
EngrJPlan
sldg. F".' 3
oock Fig.
oeak FwW
weli
Pr. DiBp. '
7 ~Zs f ,~'~f
. *
~ ~--a
~
' C3'Cemficate vf cccuvanc~
Witv ofi cFagan
Wcoartncat ef sn[iwg andpcctiau
This Certicate issutd pursuanl ro tht nequinements of the Unijorm Building Code
certifying that at tlte tinte ojissuance lhis strrrctur+e was ia compliance with the various
ondinancts of tht City ?rgulating building construction or use. For the following:
U. cj..W..6.: SF DW abg. t~i No. =5
- Ckxupwwy TyP~ R3/141 7.aotng Dutria PD TYpe Const. VN
Owea' of BuildMP~SH HM & Mm Add,,,= 7~ EW.M
Buildoa Address 1OD5 ]MIILIIM Q~T i,ocdity L 11. B 1, UN1U1ON P(~~II~'' lOth
Date:
Buaft
P06T IN A OONSPK:l10US PLACE
USE'C?NLY
T: BC. ;:;.....;;,,w~.<;..,.,;
l 1 I R1~~vm#r,~.~.~
.
ym ....=..w.:. .4 nA't'E..
1994 PLUMBING PERMTT (RESIDENTIAL)
CTTY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMII'S ARE REQUIRED FOR EACH UNTI'.
NO. FIXTURES EACH TOTAL
~ SHOWER 3.00
WAlEFC I,LVSr,I 3.00 / BATH TUB 3.00 d v~
02 LAVATORY 3.00
/ KITCHEN SINK 3.00 3_ w
/ LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
/ WATER HEATER 3.00 3.~N
FLOOR DRAIN 3.00
~ GAS PIPING OUTLET • minimum -1 3.00 3. ";p
ROUGH OPENINGS 1.50 -y.3ro
WATER SOFTENER 5.00
PRIVATE DISP. • Dak.Cty. lic. 20.00
U.G. SPRINKLER • home under consi. 3.00
ALTERATIONS ' to o:isung 20.00
WATER TURN AROUND 20.00
STATE SURCHARGE .50
TOTAL: 3 5'.e'-v
SITE ADDRESS: %On.S ~
OWNER NAME: ~i9k'iSw /~~~~X~~? 6
,
INSTALLER: ~~s1o r
ADDRESS: % i~ ~/i?•`~.?~9 dG s'J
CITY:_ ST,ATE: /~r? ZIP CODE: _A53-2e
PHONE
SIGN URE OF PERM EE
lylaVy ,,Y°okso
K69 35 r
RepueslDate Fne o Rouph-lnlnpsectan RepuveE InsOeclion OtM1er~ROUphln
fVOU mu II ins0eclor when reaEy~ ~ ReaCy Naw Will No1Qy Inspe[tor
Yes ? No pd18 PBBtl
I licensed contracror ] owner hereby requesi inspection of above electrical work at:
loE AQOress (Stme Bor or Row~tI~~~E~a~ ~ Qry
S
Seaion No Townsmp Nama or No Range No Count
O[cupdn~ARINT~ ~ PhOnB N0,
l/
Power Sa lier Atltlress
Ei ;ne ai C r c;or iG mpany Namel A5AI Comractor5 Li se No
Maning naar i nvacmr or Ownar Mexing siai' ioni
/
Conuaci ~Owner Makmg Insta a Phona NumDer
j i
d ~
t
MINNESOTA STATE BO/RD OF ELECTRIQTY THIS INSPECTION REOUEST WILL NOT
Griggs-Mitlway BICg. - Room S-173 BE nCCEPTED BV THE STATE BOARD
1821 Unlversity Ave. St Peul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Vhona (611) 642-0600 ENCLOSED
REI:UEST FOR ELECTRICAL INSPECTION ;°;=`y9tj~'~v eeooom-0s
j5ee msbyctons lor wmplaling lnis form on back o1 yellow copy
~p c C,~r~ ~0/57
.R F, 3 5 "X" Be/ow Work Covered by rhis Request
CU
ew Add Rep.Y TypeofBuilding AOPlianceSWired EquipmentWiretl
Home Range Temporary Service
Duple. Waler Heater Electric Heating
Apt. 8uilding Dryer loa0 Menagement
Comm./InduStrial Fumace Other (Specily)
Farm An Conditioner
Otner(syecdy) ConVatmr's Remarks'
Compute Inspecaon Fee Below: '
# Other Fee fi ServicaEniranceSize Fee -CvcwlsiFeetler5 Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transtormers Above 200 _ Amps Above 100 _ Amps
Sgn5 . mspecior§ Use Only. ~.~7~ ~ TOTA L S~
' Irri9ation Booms ~ j
0 ~
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18,M01i I, the Electncal Inspectoc hereby Rouqn-in
certity that the above inspection has oa
been made. o dFld
OFFICE USE ONLY
Thpi wia 18 ni irom
Address 1005 Trznrnna rrxmr Zip 5512 3
Lbt - .11 Blk I Sub LEXINGICJN POINIE IoIH
THESE ITEMS WERE / WGRE NOT COMPLETE AT THG TIME OF THE FINAL INSPECTION.
Date: 6151~ Yes No Inspector:
Final grade (6" from siding) 111-~
Permanent steps (garage) V/-
Permanent steps (main entry) vl~
Permanent driveway vl~
Permanent gas
SodlSeeded grass
TraiUwrb damage
Porch
Basement finish (l
Deck
Plcase verify with the builder the removal of roof test caps from the plumbing system and ihe shuboff of water supply to
the outside lawn fauce[ before freeze potential exists.
Contact engincering division at 681-4645 before working in rightof-way or insta0ing undergmund sprinkler system. ~
White - Ciry Copy Yellow - ResideN Copy Pink • Contractor Copy
PERMIT 7
,<CITY OF EAGAN PERMIT TYPE: ~`1e u LI I N G
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 0 2 4 0 2 5
(612) 681-4675 Date Issued: 0 7/ 01 / 9 4
SITE ADDRESS:
1005 TRILLIUM CT
LOT: 11 BLOCK: 1
LEXINGTON POINTE 10TH
P.I.N.: 10-45094-110-01
DESCRIPTION:
Building Permit Type SF DWG
Building Work Type NEW
j UBC Occupancy\ R-3 M-1
Construction Type V-N
i~ Zoning ~ PD
Building Length 63
Building Width ~ 50
~ Building stories ~ 2
.
~ j
REMARKS:
S 6 W PLBR - LAKESIDE PLBG
FEE SUMMARY:
VALUATION $104,000
Base Fee $653.50 MISCELLANEOUS $1,828.50
Plan Review $424.78 Total Fee $3,758.78
Surcharge $52.00
SAC $800.00
SAC % 100
SAC Units 1
Subtotal $1,930.28
CONTRACTOR: - Flpplicant - sT. LIc. OWNER:
PARISH MKTG & DEVEL CORP 14526644 0001054 PARISH MKTG & DEV CORP
3799 BRIARWOOD LN 3799 BRIARW000 LN
EAGAN MN 55123 EAGAN MN 55123
(612) 452-6644 (612)452-6644
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 Mn.
Statutes and City of Eagan Ordinances.
~M .o: rr APPLICANTi ERMITEE SIGNATURE I'SUED SI ATUR '
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euzLozNG
3830 Pilot Knob Road Permit Number: 024025
Eagan, Minnesota 55123 Date Issued: 0 7/ 01 / 9 4
(612) 681-4675
SITEADDRESS: Lor: ii BLOCK: 1 APPLICANT:
1005 TRILLIUM CT PARISH MKTG & DEVEL CORP
LEXINGTON POINTE 10TH (612) 452-6644
PERMIT SUBTYPE: TYPE OF WORK:
SF OWG NEW
INSPECTION .
FOOTINGS FOUNDATION
FRAMING ROOFING
INSUI.HTION FIREPLACE
ROUGH IN PLB6 ROUGH IN HTG
FINAL PLBG FINAL
REMARKS: S& W PLBR - LAKESIDE PLBG
I ~
J
L
• CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION ~ ~~J.~q,
14016 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
speclfications, 1 copy of energy calcs.
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 6 ~ 27 ~ 1994 Valuation of work
Site Address: 1005 Trilliim Court
STREET SUITE p
Tenant Name: (commercial only)
LOT 11 BLOCK 1 SUBD. LlbthnAdditionnte P.I.D. #
Descri tion of work: Si le Fautil Home
The applicant is: ? Owner E3 Contractor ? Other (Deseribe)
Name Parish Marketin,Q & Development Corp. Phone 452-6644
Property LasT FIRST
Owner qddress 3799 Briarwood Lane
STREET STE #
City Eagan State Minn. Zip 55123
Company same as above Phone
Co ntractor Address License # 1054 EXP_3-31-95
City State Zip
Architect/ Company Phone
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber T.AICPAI(jP Pli"hine - 894-7600 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 Stat f Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
- OFFICE USE ONLY M- '
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
~ 02 SF Dwg. 0 01 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
G} 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair 11 36 Move
GENERAL INFORMATION
Const. (Actual) V~ Basement sq. ft. /03 o MWCC System k
(Allowable) I- lst F1. sq. ft. !3 s ~ City Water X
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning P~ Sq. Ft. total Booster Pump
# of Stories -s Footprint Sq. ft. Fire Sprinkler
Length G2,s On-site well Census Code
Depth On-site sewage SAC Code ~ i
Census Bldg _L
APPROVALS Census unit
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
?.Site El Footing 0-Framing O Insulation
El Wallboard [B Final ? Draintile ? Fireplace
Permit Fee veimcrm: $ /0c/ C"idB
Surcharge
Plan Review ~9~ k~2 = 57Z
License
MWCC SAC
C i ty SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge 1 0.4'/5 = /0200 ~ ~C
Treatment Pl. '7 Z 2
Road Unit
Park Ded.
Trails Ded. 21 Copies
other ; 9 - J~ /D J2 6/z/
Total: SAC % 3C,zv= ~2dy : 3~'~'Ao'
SAC Units '
A
P. 01
- - -
I * ~C 2422 Enterprise prive .
I Mendoto Heighte, AdN 55120
PIONleA (612) 881-1914 FAX:681-9486
* i,~ ~~ND SVRVE't~RS ~ GYNL EI:CrNF,~RS
* ee+g near ne Lerm KnNaeRS. Lnuosc.>t nncnnecis 625 Highway 10 N.E
* * * 7t 6loine, MN 55434
(812) 783-1880 FAX:783-1883
Certificate/of Survey for: PARISH MARKETING
1005 7RILLIUM COURT
rW~;~.il
aS z 101.67 589006'23"W
~
o - ~ \
' ,,DRAINAGE 9 UTILITY~ ~ I5
~ EASEMENT PFF? PLAT 984.0
983.6 x 1 I (,_984.Ox W
N 18. It - 982.9r
942.93Q0 - ~983.50
984.4 c7~ ~ ~ 4S0
O~/bROPOSED M Q (n
H 0 U S E ~p
I r r
12
EAG~~~ ( 90p0~~.~P, I 981.9 06.83of II m
er5 1 0
y0 9e i. i g aENCr+ MAtiK
tn. ~ I~ 'TOP OF HUB
I
~tP, 9.67~ R 2G~o ~9L1~ Z 1 A` ; ELEV: 981.84
3 ' ~ ~ 981.8 (yg2.5) 981.3 ~ ~
N
SERVCE
SENCH MARK _~`qr~,~J•t~ W` O M rIN=969.3
TOF OF HU8 'v
9B0.2 o
ELEV.:982.10
980.0 979.9 -sg O \ I
~ 5
. R°5500
ELec. a TELE.
` ~PEos.
s7a.5
s7a.s
B ~ a=5~5°09 N
E 14~4 - R~= _-ILLIUM COURT
E~iGAN ENGIN~ERII`~ G DEPT' 5B
7FGPGSEJ CRADES SN'viNJ FER GFAJING FLAN
NOTE: OUILGING GIMENSION^i St1UtNN APE FOR HORIZONipL AND YERTICAL
LGC4TUN GF STFUCPIRES GILY. SEE ARp11TECTUAL PLAN$ FGft 9UILDI40
pND FGUNJATON OIMCNSIONS.
NaTE! [GUMnC7p0. uUST vERiF~ CRiVEWAV qESICu. ~ TMIS CER7IFICATE UOPS N0T pURPURi TU SNUN [ASEMENiS
NiRE: NO SPECyGIC SOILC IN'vESTIGATION HAS BEEN COMPLETrO ON THIS ~ 01HER THAN THOSE SH01N4 ON THE RECORDEO FLAT. '
L07 BY THE SUR'JE'fGR. TME SUITP,PILITY GF SCY'.5 7u SUPPGR7 TME BEARINCS 5HOWN ARE ASSUMED
SPEUrIC HWSC PaGP"viEO i5 NOi THE PESPON$1BILITY OF TH: SURbEYOR.
~ PROPOSEO HOUSE ELEVATION
x oooco Uenotes Exlstiny Elevotir,n
( 000.00 ) Danotes Prupossd Elevotion lowest Floor Eiavation~
Denotes arainaga & Utility Eatement ~
------t Denotes Drainage Flow DirecUOn 7cp vf Block ElovaUon:
t Denotes Monument
-t3-- Denotes Cffset l9ub Garaga Slub Elevntion:
L OT ii , B LO C K I (-EXINGTON POINTE TENTH AqDITION
~
DAKOTA COUNTY, MINNESOTa
v;r ~•.svy ,e•Wy inlf :n:= pl;n nr rsoort .ns prepo.nd by me or under mq Elrect supervlslon.ona.tno1 i om dob rsgislsld t,o :ioi~ cr rmm,escio DcfaC mi, 215T or_--,_JUNE rt.o./
r_ytfga . I ~ '
+ Irkicn, CI/1KICCA CUCW:FY7INC P 6 i
LOT BIIRVEY C$ECRLIST FOR RE6IDENTIAL
~ Pu SIIILDING PERMIT APPLICATION
m
j U PROPERTX LEGAL: ~
W< m Date o! Survey: ~
~
~ Z ~ DOCIIMENT STANDARDS
~D ? • Registered Land SUrveyor signature and company
8~0 0 • Buildinq Permit Applicant
Er-O p : Legal description
? 0 Address
p~ ? ? • North arrow and 1ar- scale
~ p 0 • House type (rambler, walkout, split w/o, split entry,
lookout, etc.) 0~'0 0 • Directional drainage arrows with slope/gradient t.
Q'~?? • Proposed/existing sewer and water services
('~~1 ? • Street name
L~ o 0 • Driveway
ELEVATZONB
Exiatina
T110 0 • Sewer service
C'1~? 0 • Lot corners
t] ? • Top of curb at the driveway
9;01 0 • Elevations of any existing adjacent homes
Pronosed
? 0 • Garage floor
p 0 • First floor
? • Lowest exposed elevation (walkout/window)
Fp • Property corners
0/0 0 • Front and rear of home at the foundation
pONDING AREAS (if applicable)
0 C1*~ ? • Easement line
0 [l- ? • NwL
? CT' 0 • HwL
0 0' ? • Pond # designation
0 8~ 0 • Emergency Overflow Elevation
AIMENSIONS
Q~0 0 • Lot lines
P 0 : Right-of-way and street width (to back of curb)
0 Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
~ 0 0 • Show all easements of record and any City utilities within
those easements
~D ? • Setbacks of proposed structure and setback of adjacent
existing homes
~ 0 • Retaining w qu'rements, if any
Reviewed: ~
Na e / Date
October 1992
i: ~L'- SERVICES ARE -XTcNDE,- 15 FrcT.INT_;
i pT TO.BE SERVICED.
2..QLL WATfr Sc.RVICES:4RE. 0E.7.. TYPE ..P:.. '.tR.
. .
E..~F.. Z! ,
DIAM-TER PL'C SDR-26. .
4 "S.. !NDICATcS SaNITARY SEWER SrnVICE_ iNVEKT... . ~
- Ei-EVATION FiT °ROPERTI' LINE.
5."N,.. lNDICATES ELEVATION Oi,; TGP OF CURB STE° csOX.
7i~2 Cl3'Y CF EAGAN DOES NO7 GUARAfU fEE ~
THF.:..Ar .r.,lJRACd: QF....UT!! !TV L^CAT!0"'~ .
, . . . .
ANDf'JR ELEVATtONS. 7HIS :DATA IS FCR :
:-j1fATtON PURPOSES : ONILY APiD
PERSOidS USlNG IT SHOULD VL•^:; Y TFiE
INrOBMATIODd ON THE SITE.
MH 16
STA 4f9@- 4.89.7C "AH 15
TC "-,:7=r,;-,vr 97Q.73 STA 2,24
, . -
~
. . TC ~09T
;
; I1P
540± LF 6" D.I.P. CL 52
. .
2
65:70. . .
LF g., PVC SDR .~y..o 66%
; INV J36-5;~e 96e.54 .
224 LF 8" PVC SDR 3;
5TA 5ti6 (L)
iNV P66 ~d-
TA 2-50 (L:)
• , ~T. C/loiz Z~'
. .
~ E:CTB(tIUlt F.NVL•'Ipt'li AVIiItAG6 ••U•• C014I'U7'ATIO11
(k1NGR ~ • ~ . .
srre ADDItISS
coNTrcncrort pC`U•
DATE ~ 11IION6
Detecmine vocAing square footoqe of each.
1. Total expo5ed •.+all area .......~,~(JgO sq. f[: x •il~'~;~~~= e?,53•y
2. Total coof.ceiling arca /3YG • O sy. ft. x •025
i
Total exposed wall area above floo[
• a. Total wall window area /jO.J~
b. Total door area S/Z. 8
c. Total slidinq glass door arca .38•ff
d. Total fireplace wall area Q -C'LlZGy.
e. Tota1 vall Eraming area (average lOt) Z3 O•S~
f. Total net Wa11 area above floor...........................
g. Total rim joist area 3.3
Total exposed foundation arca
h. Total foundation window area O
i. Tota1 net foundation area above grade /D G•l.
Determine "U" value of each wall segment. '
a. X..U.. , 3'S = 8~• Cj . .
b. yz.~T x•.u•• . o7G 33
c . 38.B x.•u-
a. O x°u. O = b
. e. 30•Y X ..v.. , /y ~77 d
r. K ..U,. , oyy_ _ _ `l7•.3_
~ 93..3---- • ~f!7-- ~ - -G • 3
~ - . -
o , o
I~. D 1111.1
: /oG.G • , a83 S• &
CRo/)c T~'T .
w
" J ............._...Total
IC item ql is tltc samC ?s, oc lesn than item ql, you havu ot r.hc i.ntcut
ot suc 600() ccl2. llO.y,.~ ~-3 ZZ7. 5/~ - d~s"•.'~~53.Y~
d"~
. ~ st4} eS/.i C G o o L~f) L
ToGal exposed roof/ccilin arca = ~ 3 yG• O_
O
j. T4ta1 skylighC area
Y,.' Total root/ceilinq framiny arua (avcra(jc L6'a)..•........
1. Total net insula[ed roof/ccilinq arca /J' ' •
Detcrminc "U" valuc for cach coof/ccilin(j scynenr..
j. d X,.U., o = o
k. /35~ 6 x..u"
" 1. /Z//• 3' x"U.• , D Z/7 = aG. 3
4............................. ......Total = ~9 S~
If total of H4 is the same as, or less than 42, you liave mct t}ic intent of
SeC 6006 (c)1. (1/,,i, )L ~y z 63•
a
Alternate Building Envelope Design To utilize tlie total envelope system methal, tlic valiies establish•:d by tlie
sum of items 43 and 04 shall not be greater than tlie sum o: item, kl and K2.
i. zs3.y + z.
3, Z177 f~ «4. 7-4,v = zS6~B
~t ~L~/ •t.,a,~,~ Q 9l0 ~9'~"`.~ ,~y0~"Q ' .
~87
~S4 • 8~ ~ Q~2ea"d~ ~Z-
,
OW UsE uNLY
L BL. ~~EEK4,~~~r:
.
, .
;
SITBD . ~ . . ~f~ . . ~AT~~ ;
1994 MECHANICAL PERMIT (RESIDENT'IAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
~ NEW CONSTRUCI'ION
ADD-ON AJC
ABD-ON FURNACE
FIREPLACE INSERT
DATE
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) /n, ~
ADD-ON/REMODEL (ExIS'riNG CoNS'TRUCI'ION) $ 20.00
STATE SURCHARGE .50
TOTAL f~). w
SIT'E ADDRESS: 1005 OWNER NAME: TELEPHONE ~"U/U/ ~-/Y
INSTALLER: 1 G ~ 1 C-
ADDRESS: aa 4011LA41
CITY: c~W)1 STAT'E: A /L ~ ZIP CODE: C`)03J /
TELEPNONE #:_S"/ 4 - O005
)'w'
SI A URE O'P
RMITTEE
7
r-.\.
,f'~l.*,~! Or UI'ILI,'i ~_VVYv~'~~IV~ •
...".I~~~J. ~I'M c'oH
PUR?0SL3 .ai.D
JC1i/qC li Sil~GjUL,. Hc
..'I~_v,1'~~rli~l'~.
' i
i ~ STA 4+45 I
STA 4+77 ~ ''N -'"7?.~: ~
W-.7°./
~ S-969.7 55.60 11 ~ ~ 2
~ 56.70 I~ SI,F ~o i k I
I17.80
*
STA 3
~ ~ N-y/7.
STA 4,87 i~ zo\ " ~ ~ - = ~ ' ~ `S- 968
C_l ~Y-379.2Q 4"9"~~ ~ TNH ELEV.98203 \
S-9%t7.0 47.30
c~ 1 9 6/ 30NH I ~ - ----s,
` CL-52 STA S.n
,
44.90
STA .
STA 4.82 s~e-~ye,
-j79.dC 57.8C
' <I S-970.0 / 7izo
50.4C STA 4+55 I
ll~ ^
S-96U.y1 ' -°6
- I STA 4+72 3710
' W 979.6
' - I S-969.6 O
~ :