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4287 Valley Forge Pl cirr oF EAGAN S 5 3830 Pilot Knob Road, P.O. Box 21•199, Espan, MN 55121 PHONE: 4548100 eUiLDING ~ERMIT R~ipt ~ To M wW fer Ar. Esf. Value Date . 19 Sita l:ddreu Erect 0 Occupsncv I Ramodsl ? Zoning Lot Block Sec/Sub. , ' - . , 1 ~ ' Repsir ? Type of Const. Prcel No. Entarqe ? No. Stories Move ? Lenyth Name r, . psmoHsh ? Depth I Addresa 173R~ Grade ? Sq. Ft. cicY JORD71M Phone 492-6646 in:t.ll ? SAM! 435-3323 App.oveM F«. Name Addreu Assessment Pertnit • ~ City Phone Woter & Sew. Surcho?p 27.50 Polite P1sn Review 149•00 ~W Name Hl?LIoQQIa'P •A8aOC Fin 5/?C 525.00 iz Add-- goo '1'E OFpICE PL11Z11 Em. Water Conn. 500 . 00 " ~ Z. City Phone Plonner Water Mtter 63.00 Council Rood Unit 280.00 1 hereby xknowledp thot 1 how rood this cpplicotion and stote Hwt Bldy. Off. 3/20/85 •P• 132.00 tM informction Is correct ond ogree fo comply wirh oll opplicoble A~ Total ? • State of MinnesoM Statutts end City of Ea9on Ordi?anps. Var. Date Sipnoturo of Pem+itbt , A Bulldinp Permif Is issutd to: KEYLAND 8Q!!ZS ~~expron cpdition thai all work sholt be done In oooordonte with cll, opplicablo State of Mlnnesofa Statutat ond Uty of Eopon O?dinontes. 9uildirq Off{ciol , ~ ir h o ~ ~ ~ r x s ~ ~ ~ Reaeipt PLUMBING PERMIT Permit No. _ CITY OF EAGAN FN ~ fill in numbered 4wcea .S/C Type or Prini /egidy TOIL . 1. Date 5^ Z~` y y 2. Irutallation Cost YL ;-i¢!c ~"Jr e 3. Job Address ~ Lot /~Blk. ~ Tract /t-l -,'l+ e~- ~.r,~ 4. Owner 5. Contrector_ ~ ~%E' L hA/Cp ,L Phone 6. Address ~7C 9".' 7. citv C C state - zip 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New Add ? Alter 0 Repair O 10. Descxibe 11. No, Fixtures No. Fixtures ? Water Closet Cesspool/Drainfield / Bath tubs Septic Tank Lavatory Softner ~ Shower Well ~ 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 1 agree to comply with aU ordinances and codes go)jerning this type of work. i Si gned for Rough F insl Inspections: Date Insp. Oete Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarks nddition _ NORTHVIEW MEADOWS Lot 18 sik 4 Parcel WAR110-180-04 Qwner Street 4287 VALLEY FORGE pIACE State EAGAN NIIV 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSUFiF. 1 76.7$ -T•6-~ ~B ld STREET RESTOR. GRApING 1981 15.89 .79 20 11.94 " SAN SEW TRUNK Wli 1981 138.48 6.92 20 lo ff t SEWERLATERAL RK 1984 275.22 19-r" 15 238.54 11 7 1981 22.28 2'& s 14.88 " " WATERMAIN $ 1984 70.67 4.71 15 61.2 11 "t- WATER LATERAL ~ 19$1 1$.6s 124 .9'~J' MIt 12.45 WATER AREA 19$1 138.48 6.92 20 103.88 1952 29.52 1 .4'i 1-.48 20 22.1 " STORM SEW TRK 1984 392.32 78.44 1$S 2 . 0 it STORM SEW LAT DRAINAGE 1984 33.97 7.39 3-r46 10 2.1 " CURB & GUTTER SIOEWALK STREET LIGHT WATER CONN. 500-00 ii Tr 9UILDING PER. 9985 if If SAC PARK 3830 Pilot Knob IRoad 6007 P. O. 6ox 21199 PERMIT NO.: 3- 2 7- 8 5 Epan, MN 56121 D/ETE: 1 Zoninp: No. of Units: Owrnr: KUlgmd iiagftammik ~ re~ tits llddrou: 110 V Mea~!o~as ixr+ber 1"(' r No.: .3 4 9 Q F C«+nectfon Cho?w: 500.00 pd 15.00 pd Size: I Ee..d.. o.: wrr„ir Fee: i o. oa pa i.,m t. a..,h? wuh O. aUr .f w.. surcharo•: . 5 0pa ~„o„M,, M~sc. Choroesc 63.00 nd mete Totol: 09_pi _ 1-C By ooc. Poid: Date of Insp.: I^sp.' i I€%TY OF EAGAN `qwiw6oKom SEWER SERVICE PERMIT 3830 Pilot Knob Rosd pERMiT NO.: 3 71 n(, P. O. Box 21199 3-27-85 Eagan, MN 55121 DATL Zoning: ~Z Na of Unfts: OwMr. ~'e lsnd Fiomes /lddron: Sin llddrox: 4287 V811 ev Fo r e I.1 F R 4`;oV Mea oW s Plurnber llC mechanical 3J'1/~'S 50295 • 1 .gw h«mrb w11r tb CRy of B.wm Conrneeia, e]aop.: ![~t 425.00 pd 15.00 pd Aooount Depait: - Parnit Fw: 10.00 pd Surchorw: .50 vd gY Mim Chorqm Dalr of Irop.: Total: Deh Poid: CITY OF EACaAN No 9985 3630 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 BUILDINC PERMIT PHONE: 4548100 Receiot # To M aw6 fer SF DWG/GAR Est. Volue $55.000 Dote MARCH 97 , l9_Z5 Site Address 4287 VALLEY FORGE Erect CK Ocapency R3 ? Zoning RI S Remodel ? T "i$ Block 4 sec/Sub. NORTHVTF.W MF.Al1 Lot ype of Const. V ~ Repair Parcel No. Enlerge ? No. Stories KEYLAND HOMES Move ? Langth 41 W Neme Demolish ? Depth 4$ = Address 7 W 173R~ Grade ? Sq. Ft. ~ City JO'_2DAN phane 492-6646 instaii ? rc SF,M3 435-3323 Aov'°v°l+ Fees =F Name Asussment Permit $ 298.00 Addreu u~ CitV Phone Water 8 Sew. $urcfwrpe 27.50 - 149.00 Police Plan Review GW Name HP.LLOUIST & ASSOC Firo SAC 525.00 q~ress 900 SOUTHGATE OFFICE PLAZA Erp, warer Conn. 500 _(l0 ~uZi City BLMTN phone Plonner WoterMetar~--~0 Council Rood Unit 28n n Q I hereby ockrwwledge ihot I have reod lhis opDlicotian ond stote that Bldg. Off. 3 20 85 T. P_ 132 . 00 the inlormation is wrrect ond ogree to comply with all opplicoble Sfate of Minnewm Srorute d Ciryv! Eeqo ~rdirwnc VarC. Date Total $ 7 974 _ 50 Sipnoturo of Permitt A Building Permir Is issued to: KEYLF.D]D I-iOMF on fhs axprem conditlon thal all work sholl be done in accor ance wilh all liwbla St o innewta Statutes and City of Eapun Ordinontes. Buildinp Ofticiol . . . . ~ ALL CONTRA RS MU BE LICENSED WITH THE CITY OF EAGAN ~ INCLUDE Q SETS OF PLANS, Q CERTIFICATES OF SURVEY Q SET OF ENERGY CALCULATIONS G To Be Used For: Valuation: ~ Date: -3 'o S Site A!d/dress: CJ/~qA.~ o C-~ e • Lot:/1( B1ock:~Sect/Sub:/(/a2Tr( vtc'.c3 Erect: ~ Occupancy: R.3 Parcel 1+7e/f000j S Remodel: Zoning: R-I Repair: Type Of Const: Q Enlarge: $ Stories: Move: Length: ~ Address: :3 7.7 Demolish: Depth: ^ 48 City/Zip Code: T~i2 j~R~? /niIv~v Grade: Sq. Ft.: Phone b: S/9d-GNy~ ut v3S-339)3 Contractor: (f ,lo'XiD 141 ' • o/W e-5 ~ Address: sf~- I I Assessments: Permit: 29g.~ Water/Sewer: Surcharge: s-- City/Zip Code: Police: Plan Rev.: 145,= Phone A Fire: SAC: 525.°' " Engr.: Water Conn: Sco.SO Arch./Eng: ' ui ° fi S oC' . Planner: Water Meter (03.- Address: '`~/ea .$-~Ni.- %e oFr;cc- 6/~y~9Council: r iROad Unit: 2&0.~ Bldg. Off.: Par4E-s: 7Pc. 132.- City/2ip Code: /15x an9i~g.o o n~yAPC: / ~ I py~~~p$, Variance: ~ /J ~ $0 ' ~ ~ • - „ X X cn - ~ ~l a . ~ N c~e 0 (7~ ' , _ i : r O~ce~lls ~ Clty Ol EaIIQII j Permit#: ~ i , i 3830 Pilot Knob Road ~ Permit Fee: I Eagan MN 55122 ~ Date Received: Phone: (651) 675-5675 ~ Fax: (651) 675-5694 ~ gtag: `-----------------I 2008 RESIDENTIAL PLUMBING PERMIT.APPLICATION Date: ~ Qo Slte Address: Tenant: Mary Tollefsrud Sutte 4287 Valley Forge Place RESIDENT 1 OWNER Name: _ Eagan, MN 55123 Phone: 6514936738 Address / CONTRACTOR Name: License lJt1/ l 52~ Address: _2205 67 L.1.A TI l1 V J 7S(J CitY: ( State:ryw Zip: ~ D PhoneAW M qT7' TD %13 Contact Person; ~eS S TYPE OF WORK _ New _ Replacement , Repair _ Rebuild _ Modify Space _ Work in R.O.W. Descrfption of work: ' PERMIT TYPE RESlDEN71AL K Water Heater Water Softener Lawn Irrigation Add Plumbing FiMures ~ RPZ PVB) Main _ Lower Level) Septic System Water Turnaround New Abandonment ' RESlDENTlAL FEES: $50.50 Minimum Water Heater, Water Softener, or.Water Heater and Softener (includes $.50 state Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) ° $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter Is re(juired) $100.50 SeptiC System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) . . $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) 50 TOTAL FEES $ SO, I hereby acknowledge ihat thls information is complete and accurafe; that the work will be in confortnance with the ordin Eagan; thaf I understand [his is not a permit, but only an application for a permit, d rk is not to stad without p i; a e r~~illy ~ D . accordance with the approved plan in the case of work whlch require~, a review an ppro I f a s. LI X l~2~Y?.lil LI~OYbl6YYL X p-2QQ$- Applicant s Printed me Appli gnatu Liu ' .ri.~ " h^',FOR- g, ,~~i r,•sa 3~'',:~ '9'~ `M~~~ " a t:~«., OFF GE-l~ E: i'~ ~•'~Si,a,t s ~.F.., ~.ns:~..;~5.,. ~ ?D ~ ,F~ ~~xas,~~ +3.&~~1tz= i~; •n' - . i,.." 9~ ~S~~~.dJlf~(~ Er si S a ~~~~'r ~€•.-F~a "'ftW,e..,;u.q;,'~ ' / ~ SURVEYOR S CERTIFICATE KEYLAND HOMES ~ L C~ssG ~ 3 '~O,q~ SO6~~G'Fc~J- ,1 \60' ~ tia_ o Q 43 ~ 20Z % s~ ~ ti~' ? ~4~ ' ~ M ~ ~ ~ I • / yoq 33 ~ ' l), J 33 titr O / j (9'u 36 0 \ o ~ 4c ~ ~ 97 y 4/4, 4c~ G \ \~~~}F4SF 8 ' ~ sb•/os \\Nl~~ . \ ~ 9 h (J) ` O ROPOSED GRADES WERE TAKEN ' FROM THE DEVELOPP1ENT PLAN FOR PlORTHVIEW MEAD04JS l3Y SUBUP,BAN ENGINEERING, LAST DATED 9-29-83. DENOTES PROPOSED SURFACE DRAIPlAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED 6ARAGE FLOOR = FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED L04JEST FLOOR = cj1 S•I FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 91g.3 FEET I HEREBY CERTIfY TO KEYLAND HOMES THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 18, Block 4, NORTHVIEW MEAD04lS, accordina to the recorded plat thereof, Dakota County, Minnesota. • PND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION, ' THIS 6TH DAY OF MARCH , 1985. APPROVED FOR SIENNA CORPORATION SIGNED: JAM . HILL, INC. ~ n L/ BY: ~ ' BY: DATED THIS • DAY OF AROLD C. PETERSON, LAND SURVEYOR 19 OTA LICENSE N 12294 PROJECT NO. BOOK / PAGE JpMES R. HILL, INC. ' 85472 - Planners / Engineers / Surveyors FILE NO. 8200 Humboldt Avenue South FOLOER Bloominyton, Ma asast ets-eea-soso _ y, . ~ EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION re ~ OWNER:~,~-~-~-.~ DATF : SITE ADDRESS:_ PHONE: CONTRACTOR:~q,~rj Gont`I. Determine Working square footage of each 1. Total exposed wall area..... 1, B2,(o„4(p sq. ft. x .11 =_,?,Op• Bb97 2. Total roof/ceiling area..... 7.11( sq. ft. x .026 = p,2. 611L Total exposed wall area above floor= ii y~ -or)_ a. Total Nall window erea //4, b. Total door area.................................................. .3 7•7'b ' c. Total sliding glass door area.................:.................., .39. 99G d.- Total firepiace wall area 214- e. Total wall framing area (average l0A) ~7 ~„q• i$;y f. Total rim joist area i,Z.p ~ /,otr g. net wall area above floor i7 ~~.d 7 5 h. wa11 area above floor i. wa11_area a6ove floor j. frame wall area at foi:ndaticn Total exposed foundation area= ,r& k. Total foundation window area......... 1. Total net foundation area above grade Determine "u" value of each wall segment (e.g. window, door, each separate wall section) a. X ..U„ . ~9 ,51~•f~4 b 37.7L,_ X U„ c. _39.994, x "Ul. d. /UA. ~ , e. i7&..6 y, ,lull .DB = 1-1o1 44 / f. /.31.03 x ,Pu,l , D 4 9• I2G.5 - L'1 k 'lUll .-O = 1n3.2B h If item #3 is the same as, or less than ttem /1, you have met the 1. 18 X"U"_ 114, ° . B/L intent of SBC 6006 (c)i 3 . .................................Total = (2n, 842. , , ~prioz Envclopc Average "U" CWt.-,;t;:eicn pa9c 2 of 4 • Total exyosed roof/ceiling area = y 7B .~j ¢ m. Tbtal skylight area , n. Tbtal roof/ccilin; franing arca (.i•:cro,,o• lOZ)... 87.89 " o. Total net ins•,:lated roof/cciling azea........... 791.0~ Uetermine "U" valne fo[ cach cvut/cclliny segnicnt M. _ lU ~4 x.1U.. = n. R1.89 x "U" ,OZ¢-- o. 7Si.n~ x ,.U„ .D2. _ /5•f3z~ a . zbui = ~'7,93 ~ If total of 04 is the same as, or less than #2,; you have met the intent of SbC 6006 (c) 1. , Alternste Building Envel.ope D=s3 n 4b utilize the total envelope 'systun IIP.L}lUCI, the values established by tlle s;um of items q3 and #9 shall not be greater than the sum of items #1 and li2. 1. a~oo•ea~'7 + 2. zt.3.7~- s. 17C~.F34~__ + a: i79~ _ lB8.77.2._ '{ias ~~.~~•a: _ -•a. - M PLAU *.P, L i xiEA L FT. Expo5F-p WAL L ~LOGt~ ' ~7.-, , + -t L- a , FU L L I ' ~-1-i~.-E~~ TZIM' ~ zz 7. - ~ Scsi . ~T, rzyPoSED WA L.L. AZEA 3LocrC1, K , S = ~ e 4,,EE : x s = sBa w o IF . x~ = , . ~ PU l. L. I; /3z. cz~ )C S= 4- )L Q - ~ , , x, ~ ToTA L. 24, ~Sq,:t. EKPoSED GEiI.IUq w ovu5 ih . O D oo~.s ~ . 4nx eo ) _ . -:r`f LE / 7. 77i - t ~ r 36 > ' ?5 ?AT1 O DRS . . 6 °6 ° , . ~ Y , - BSM4 Vut+S . _ _ - - - - - - _ r.~_ ~ ~ ~ 2• . Construction . R-Valuc : ~ . Intcrlor air ftlm , .0.61 2 D i`}~~(~ 3. 4 0 Extcr:c:_ ,;i t:.r, (5t'11) I. ~ , ~11 i,i~il4: 2 58 ¢ ~ Y~ , • ' ~ ' ' V= OZ ~ . . . FtiA+" 6; Hea[ flov Inrcrinr r.ir fiim 0.61 mCed 2_ up ~ • . 3• ' • 4. • ~ . . - :,~tat 2 . qo.iS ~ ~ ~ . . v=.oz4. - _ • . _ . Caq.~s~?cri .r,,_ ? ' t=~1.~=' •/{P. =nJ-~~JM1~L~~41 0.61 Inside iir filin ? • - r----r 3: . , . . 4_ . ir, fiLn 0.17 y ~1~5. cstsidc l„~~~~~ Totaz. _ . ~.~n•-. E • ~-'O L@ LO G • ~ ~ 1. Znsldc aiz film 0.61 • . 2. 8eat Ilov up • , ~ ~•vented 3- ~ . . 4. , ' • ' S. Outside aiz film 0.17 • • , .1SG. 16' . _ . . . ? , Total ~ - ' . • 3 4 Inside air film 0.61 ~ . .1..t•.! : . . . ' ,.~•yr----. 3. • a. ; . . ..r.', . / / ~'s~-~?j•..-..,.~.` ~ j' ~ - 5. QuLidc air fil:n 0.17 i Total ~ ' 1 . ~..L-.T. • : trotc: V-;e idditional sheets it morc 'pacn 1: ~ ~ ' • ycede.t for details and ealeulatians. ~ $eat ' . . ~ • ' ilov up . • . , , . ' !I~"s. !7• i r° - - ~ • ' - . _ • - • ~ ~ - • - - - . . - - - ..r.._._..._ ' ~ • _ _ - . . ~'•1qr •;~:n _ ant•~. sr.r.r:~x~a - _ _ - . ~ Ei U:r of cli-0yua wall ercn for ~ - .(inlM: con[71 rvCt 1un - - ~Cc,n[:tr.ncl iMi ~Y ___-1J 1• 11115~':'i'_ 11 1 i~ai l1 <H _____~j ~ • ~ ~ ~r.?~'~~' ' ' ' ~ im.-hi': :.:Af 3~ ~ - - 4 -45) 4. ~~lekG-~tht•..,syc~ Q SIC . 6. t:r.lcrii,r air ti',m U. 17 1LL ° - 9'~.~ia 27 eic. e1 101'viEi4 oe INSut-• . • F1WtE IIALI. - 1. Iutrrinr air '11m.---_------- D:G~I yi--~yn_~p~-----------~~.5 . -~s ~`--!~`-s - -~3.0 , : , . . . ' a . ~orr ~X~f.N ~~mE?~~- .-(,«O ' ._..--'---._a 5• -'tv.~r~?b_._--~----._~._......_...~i.L G. Extcrior air 1iL, 0.17 FI"G. 12 7bt:a1 ZQ,1 _ R 1, )nt_ei ior nir f ilm 0.~~!1 2. IrISt~L - - ------._..J;.o i. 4' --~~~-~~------------G-'-Qt ~ ~ r--~ 6. F:xtrrfor nir IiJm 0.77 ' -..._,1'otnl Z2. l tc=, • • ' A u ~l..iL ci;c,c air fil^+ -.0. C•ti ; ~ . - - ,t 0 2. ~lStt~_._~~`Y~ - \I'IOII ~ ~ c1 • ' 3. ~-_1QN~•--E. - • • . 'p' 4. ~ V • U +!i•rnil~ ' S. - ,r ,n• r' I h G. 1_:<leri~•Y_.~~r lilr!'._ '__'_-U.li .i ; . u= ,r4 SIA11 Ot,_ ,:W,,_ ' ~ _-R'!A~ p~ r ~ • , . • ' • 14' • ir~ v . • . . ' - 1 • ' ~ ~ 1(I 10 ? • ~ . , / % • r-• lri a~ • i~~ ~ . y ~ ~ ~~._v • ~-~.1~_ ~ ' , . ? ~ ;,)T<': Icdlcatc'ty,.~c, ..v~. valuc, denth nnd • o - , , . ~ ' ~~l.icrnc~:t of 1 ~ ~ 2/84 ~4~J 1 CITY OF EAG?N ~ ~~'rC•~ \ / APPLICATION EOR PEP.MIT SEWER AND/OR WATER CONNECTION - (PLEASE PfliHi) i) PRoDERTY ADDR: ss qQ67 lJ?r/k y Fo rc4 e rFr,L DE..Z?TIC.`I: 2?ar~- (LotBlock/S ~~ivisicn or Ta:•; cel I.D. NL;,..-er) I =r ~•:IS~_:G ST?.[:CI? ME, Da' 0° C2T_G^7;+L EuIT. 7r:G :-=_ST P.---~SE.'?' :'::Ti:X:/p?0?CS:I) i'c'• S-:GI.c :;~.+rr•~ ' • ? R-2 l'Jii.7i (T.:'J L^IITS) ? '-3 TCi:-~=vrcr (`1'!__°^. ~ L"1ITS) ~ U:II'_'S1 L] .,-4 r;?: ~~-rz-.^r/CC:~i;r;I~~•l ~ LiiZ?':i Q CCi~"•TF'?Ci-iL/f2~,':T,~I,/GF?'I~.~ ? T" ~ Du s?~ --.7z ? r.sTZ=zo.iAL/ccv=- n=-,r 2) (7LE;.Sc rRiNr) MV.!E: tc f/V+ll,~. I ADoIRESs: _ 17040 S(1nRi"Se 14vt c=z, sr:=, zzP: Prr~or 1 k~ m.~. Ss37~ PFoNE: Yy7- SGo l j) pu.E= ~ly~- - ~~rnC ACASE ~R tiT~ FOR CITY USE 0NLY ALU!!BERS LIC.45E: PDDRF.SS: `I Active CZiL, STATE, ZIP: ~ E:pired Not of Record PHODIE: PLU96ER LICENSE # S~~~ni;lil 4) ~'[J_°?1PT/C['~i]E.i'2 kL ~~11s+/~ (PLF~ASE PRI4I) NAt+1E: ynrrt tS ADDRESS: 3y7/ n I73'`- CI:^!, ST,TE, ZIP: JO/'tXh/i /I , PFiMrE: q G6 w 5} INpiCATE ;;yICEI PER;-LIT IS BEIP:C RECCJESTf:D: [&Ca,NF.C.TION 'Io CITY Saic.~i M CO`INECI'ZC:I 'Ib CZTY S•IATL'!? El Oi[E2 (PISi,SE D°.SC12It3E) 6) P,:DIG,-= C:.%: . ~ PLz'7~-QE E?OID APPP.OVID pER,++ST FOR PZCi:-L'c BY O:v'E OF aFGVE :S `•'.aIL i1PP??Wm PER,'1IT TYJ 1, 2. 3. 4 AE+QJE (Circle cne) 7) SZC.:,T~~^.: W DATE: 3-(3?-'9Y- w e~alra}~.JSS i el~a~ra: ~ r+~sasra a~ s~s~aa:~ ~~e rd~rw~a ~ a s~zacsar . F 0 R C I T Y U S E O N L Y PEPMIT ISSUED ~ .°IIE$: $ C-:i^? nr. a,.1Tm SJLmER ngRMIT (Ii:CiuDc Su C::aRGE) $ W;iT°R METEP,/COPPE4HORN/OUTST_'J° REA= $ WATE.°. TF,P (INCLUDE CORPORATI0:1 STO? ) $ SE;:cR T.,? $ /S i---d =.r..rJl,..'i _.__=C•Ci - $ /s~~--e ACCOli?!T DEPOSIT - SdAT°_R $ s,..,, •-e wrc $ sr c $ T:?ii_dri S•IAT°R ASSLSS:":E:.'T $ TRii:iS SE;iER _:~SSESSi,1--:iT $ L'nT.: R=.L BEciEFIT/T??U"K SEi•i=.-, S L:-.:ERNL BEVEFIT/TRUNiC [•IATz'3 $ ?-~~7. '-e OT3ER - $ TOT?.L .o $ >d -4J - AMOli:•:T PAZ'J; RECEI?T .1 DOES UTILITY CONNECTZON REQUIP.E EXC.,VaTION IN PU6LIC RIGHT OF WAY? ~ YES IF YES, THE:^7 n"PE:2iSIT FOR :dOR?: S4IT'IIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGZNEERZTIG DiVISZ0N. LIST AS A CONDI- TION. SliH3ECT TO TEiE e0LL0:9IiqG COAIDITIOi:S: • APPROVED BY: aeLp TI.LE:`~~,~ DAT°_: ~c m a~f r m a--3co2B ; F_Tdn0.use ; Pe Clty Of Ea~~Il j rmit u: ~ Li 3830 Pilot Knob Road ~ Pertnit Fee:~ Eagan MN 55122 j Date Received: j Phone: (651) 675•5675 i i Fex: (651) 675-5694 I Statt: ~ I - 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Z Br pl Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip Applicant is: _ Owner -xContractor TYPE OF WORK Description of work: U o Construction CostA ?2. oQ Multi-Family Building: (Yes No)L License CONTRACTOR Name: _Co~(1122cd Cxnsha Address:_ 5rO II IY)P60X-I0.1 1TVe N• Ciry: r7,H I ~(1.xX7f er State: _MN Zip: 'r' S0p0 Phone:G61 'L1-,M - q 3oJ ContactPerson: koren COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Categary submined submined (4 submission type) • Energy Envelope Calcvlations Submitted In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan? _Yes _NO If yes, dafe and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: P/ans and supporting docurnebt§:that you submit areconsldered to.be public 1nf6rmati6n. PoKlons ol. _ ;_.fhe iriforinatiommay 6e olassified as=nonpu6lic i/ you, provide specifia, reas`on's that would-permit the Cfty to,r~ - - sonclude f%'aYthe are tra8e secrets. I hereby acknowledge that Ihis information is complete and accurate; thal the work will be in contormance with the ordinances and codes of the Gity ot Eagan; ihat I underetand this is nol a permit, but only an application for a permit, and work is not b starl without a permit; that the work will be in accordance with the approved plan in the case ot work which requires a review and approval of plans. x 1 o /GU k/l x ~ Applican 's Printed ry me ApplicanYs Signature / V Page 1 of 3 Use BLUE or BLACK Ink r----------------- For Office Use Eata n Permit City of l ll IPermit Fee: fill (0 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (661)676-5675 I I Fax: (651) 676-6694 I staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / Site Address: ti,~oZ87 (J®__ /~-0 ( l'cle Unit fl: Name: Mclrt ✓ e _ PV Phone: l~S~"3~/~ Resident/ Owner Address i City / Zip: 107 4 fvrw gzr E-z n iyln / 3 0- 10~ Applicant is. Owner Contractor Type of Work Description of work: A&¢ Ikee Aheltzow-s in Luce- SJIAr, on ~flb euso tl~ o'i7 Gaya .11 - Construction Cost: A - Multi-Family Building: (Yes No Company: Mn 11V Me -Z iv/0/'ouc°N►NnContact: ryt 34t02~ S.3/ r Contractor Address: RaO if,& U »c~ City; S-f State: J- Zip: -S-L 3 7 Phone: -3v?0 - 313 - !V K License g: 14C 3 3 3 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) Bar I / f__ I * r ./2 ZB COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: - Phone: Mechanical Contractor. Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to _ conclude that they are trade secrets. _ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. mm goohemlateonecall.ora hereby acknowledge that this information is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of Eagan: that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit: that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x L~Ifll ?a -Llee /Z-, Appllcant's Printed Name A plicant's Signat Page 1 of 3 6/L d h695 5L6 X59 « 50"£9£OZ£ IHW 5'i:60 £0-60-£LOZ