2036 Vienna LanePERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA112280
Date Issued:08/06/2013
Permit Category:ePermit
Site Address: 2036 Vienna Lane
Lot:031 Block: 04 Addition: Rahn Ridge
PID:10-62750-04-031
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Janel Behrends
122 West 3rd S
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Janel F Wahl
2036 Vienna Lane
Eagan MN 55122
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature
PERMIT # ,
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: ",W" - PHONE: 454-8100 7 7~$Y
Site Address Ll!e .1 'L ,t,/ gLpG. TfPE WORK DESCRIPTION Lot Bloc
k Sac/Sub Res. ~ New I
- Mult Add-on X
m Name - - E` Comm. Repair
AddrBSS ; t' !SA Nv.a ft.. S
Other
S City V f''° Phone
° FEES
Name RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
3 z RES. HVAC INCLUDES A/C ON NEW
p Ciry Phone CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEFiilAln - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CON7RACT FEE
Forced Air M BTU APT BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU ~~~~~ELS - 12•00
Air Cond. 2~`~ ~i M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
, Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
. Gas Piping Outlets # BEYOND $1,000)
i Other ~
FEE
4 ~
S/C: " ATU
roraL
FOR: CITY OF EAGAN
v
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3830 Pilot Knob Ro di P.O. B x 2G-A1 9, Eagan, MN 55121 12vy7
PHONE: 454-8100
BUILDING PERMIT Receipt #
A
7o be used1or 1/2 UUP/GAt3 Est. value $ 5 5,0 0 0 Date OCTUBER 28 ,19 8 6
SiteAddress 2438 VZENNA LN Erect 11 Occupancy ~3
Lot 3 elock 4 Sec/Sub. RAHIJ RIDC:E Remodei D Zoning
Parce4 t~o. Repair ? TyQe of Const
Addition ? No. Stories
a Name B. f~I . GRAC;d Move ? Length dn
W 2004 VIEiVNA LN Demolish ? Depth 46
o Address Int Impr. ? Sq. Ft.
city. EAGAN phone 456-9030 Install ?
¢ Approvals Fees
o Name
Address Assessment Permit ~ 298.00
r City Phone Water & Sew. Surcharge 27.50
Police Plan Review 149.00
F W Name Fire SAC 575.40
Address Eng. Water Conn. 500 . 00
c W City Phone PI ner Water Meter 63.50
Co ncil Road Unit 290.00
I hereby acknowledge that I have read this application and state that the BI g. Off. 10/2$/ 6Tr. PI. 156.00
information is correct and agr e Qomply with all appiicable 5tate of
Minnesota Statutes and City o9 6n 0dinances.,/. r C ParkS
`var. Date Copies
Signature of Permittee ' Total ,
' ~ ~
A Building Permit is issued to: B. F3 G
.RACE dORP on the express candition that
all work shall be done in accordance with all applicablerte of Minnesota Statutes and Ciry of Eagan Qrdinances.
Building OHicial ? --`J - -
PormR No. Permlt HoMor Date Telephone
Plumbinp
H.V.A.C. Electric
-V7 e'
G~1NwK , ,t ~2. ~ ~G>,
Inspacdon Dab Inap. Commenis
Footlngf I
Footlngsll
FoundaGon
Frsming % 6
Rooliny
Rouph Plbp.
Rouyh Ntq.
Ineul.
Flreplace
Final Htg. ~ /4 ft
Final Plbq.
Bldy. Final
Cert. Oec. Dack Ftp.
Deck Frmy.
Well
Pr. Dfsp.
PERMIT #i C
PLUMBIN(3 PERMIT
CITY OF EAGAN RECEIPT }i
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRIGE: PHONE: 454-8100
Site Address " BIDG. TYPEl ' WORK DESCRIPTION
lot Block 6!~ Se /S b Res. New
Mult Add-on
~ Name 71 Comm. Repair
~ Address ' Other
c City ~ Phone - ! RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTfL
Name Water Closet - $3 00
Bath Tubs - $3.00
c Address : - ' ~Lavatory - $3.00
p City ~E1t.,~,.~xm.t Phone Shower - $3.00 _
_J
~ Kitchen Sink - $3.00
FEES ,U,in8l/Bidel - 53.00
COMM/IND FEE - 146 OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE - $20.00 -7Gas Piping Outlets - $1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - S10.00
Private Disp. - $10.00
' zRough Openings - $1.50
3Y--
SIGNATURE OF PERMITTEE FEE: or ~sTarE s/c:
So
FOR: CITY OF EAGAN GRAND TOTAL• ~
J`~
sMry.:r•r~.r~.;.,~s,r• . . . , . ~ _ i,.. . _ . . . . . .
PERMIT # ~
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE: TA(,
CONTRACT PRICE PHONE 04-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot Block " Sec/Sub
-Res. New ~
~ Name Mult Add-on
~o Addr Jy~~ ~ ~(6%4V Comm. Repair
c City r l,a._ Phone Other
~ Name FEES
c Address `J RES. HVAC 0-100 M 8TU -$24.00
p City t o tm Phone 03e ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK ~ O ~,J 45 GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Gas Piping Outlets #
Other
FEE ~j
S/C: - ) ~ SIGNATURE OF PERMITTEE
A ~
TOTAI:
FOR: CITY OF EAGAN
. Fl _ . . ' ` 4 . T . . . . . . , . . . : . - r. . . ..r . . .
CITY OF EAGAN N2 t2816
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt#
To be used for 1/2 DUPLEX Est Value $ 55 ,000 Date OC'PO$LrR 28 86
SiteAddress 2036 VIENNA LN Erect B Occupancy R3
Lot 3' Block 4 Sec/Sub. IRAHN RIDGE Remodel ? Zoning Rj
Parcel No. Repair ? Type of Const.V
Addition ? No. Stories
W Name B.H. G~~=F CORP Move ? Length d 0
2004 V I ENZdA LN Demolish ? Depth A G
; Address Int. Impr. ? Sq. Ft
° city EAi,AN Phone 456-9030 Install ?
ac Name SAjlE Approvals Fees
o
nddress Assessment Permit S 298.00
~ City Phone Wiiter 8 Sew. Surcharge 27.50
~ Poice Plan Review 149.00
FW Name Fire SAC 575.00
Address Eng. Water Conn. ~:00
i W City Pnone Planner Water Meter 63 . 50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off. 10/17/$ Tr. PI. 156.00
information is correct and agree to comply with all ap ble State of
ParkS
Minnesota Statutes and City o.f E$gan Ordinances. J - Var. APC Date Copies
Signature of Permittee
Total $ 2j0 S y. 0 0
A Building Permit is issued to: B. H. GR E CORP on the express Condition that
atl work shall be done in accordance with all applicabl State of Minnesota Sta_~_t~~,and City of Eagan Ordinances.
Building Official
a-
_ Prrmil No. PwMt Ho1dN DNa TNephone N
Plum'blny
N.KA;C.
ENen+c hz~ C,
;;.2 / 5 b' C,son.n..
Inapscuon DdS Insp. Commsnb
F°°e^ys l
FooNnpa11
Faundatbn
Framinq
Roofiny
Er~~
FMaI Hty. -7-r 7•
Finai Plby. . .3-
Bldy. Final
r
cs.t. oee. , 7 c=.A C'a,j l -To
a~
o.ck Ftq.
Deek Frmy.
Well
Vr. Dfap.
_ • ~.n.:rie-~1~ . . . . . . .
~ PERMIT #
' a PLUMBING PERMIT
CITY OF EAGAN RECEIPT #
3830 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100 "
Site Address ~ ' BLDG. TYPE WORK DE,SC~RIPT JON
Lot _ Biock Se /S.'b Res. New `r
, F Mult. Add-on
y Name Comm. Repair
m Address ~ '1 ~ Other
c CiryPhone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
' NO. FIXTURES TAL
Name ~ ~Water Closet - $3.00
_/-Bath Tubs - $3.00
3 Address Lavatory - $3.00
p City6Phone Shower -$3.00
::ZKitchen Sink - $3.00 -
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE =Laundry Tray - $3.00
APT. BLDGS - COMM RATE APPLIES -,Z-Floor Drains -$1.50 -4 7!
TOWNHOUSE 8 CONDO - RES. RATE APPLIES -~_/Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $300
MINIMUM - COMM/IND FEE - $20.00 -4Gas Piping Outlets - $1.50 v
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Weil - $10.00
Private Disp. - $10.00
' / y Rough Openings - $1.50
' 6 =
S NATURE OF PERMITTEE FEE: O-V
STATESfC: S
FOR: CITY OF EAGAN GRAND TOTAL•
. r._7~,7~~1F , ~r,n-, x.1:,.--4~t^_ -'.}e. ..r.•. --~w , -r . . _ - .
A PERMIT # ~
MECHANICAL PERMIT RECEIPT #
CIT1f OF EAGAN ;
~ 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: a~ 4 PHONE 454-8100
Site Address -00316 eA' m BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. ~ New x
m Name "Mult Add-on
B Addr~ /~4d/ ti 7e/ , Comm. Repair
c City r? , o r 1-.. Phone pmer
~ Name f r ru-c FEES
(D
Address V L) LN'''"` RES. HVAC 0-100 M BTU -$24.00
p City Phone 7030 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK ~ po GAS OUTLETS - 1.50 EA.
Forced Air 6a M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M gTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Gas Piping Outlets #
Other
FEE
S/C: . "I) SIGNATURE OF PERMITTEE
CO
TOTAL• ~
FOR: CITY OF EAGAN
tl~ INSPECTION RECORD
CITY OF EAGAN PERMITTYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
, , . .
SITEADDRESS: I„~ ~ i <<i t11 t „ APPUCANT:
, ~iNa ( ANf
G
PERMIT SUBTYPE: TYPE OF WORK:
N F !-1
INSPECTION D. • D•
~ ,s J
Permk No. Permk Holder Date Telephone #
ELECTRIC
PLUMBINQ
HVAC
Inspection Data Innp. Comments
FOOTINGS
FOUNO
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIF TEST
ROUGH
HEATING
GAS SVC
TEST
iNSUL
GYPBpARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
1~ " "
4t i } *Y
- ' (gertifirafp uf (Orrupttury
.
tirp of (Eagan
Mrprhnrtci af Swlding jw-rritM
This Certijfcate issued pursuant to the requiremenu oJSection 306 of the Uniform Building
Code certifyrng that at 1he time of issuance rhrs structure w+u in compliance with the various
ordinances of rhe City regulaling building construcaon or use. For the following.•
use cuudnoon eaag. Permit hro. ~ .
Oocupancy Type Zooing District Ri 7ype Comt v
Owneraf&uldin6 Addm
9W7di11gAddfm Lomuty 13. -o+s ltt1?N RU.UC'.
Bw7ding dRicial
POST IN A CONSPICUOUS PLACE
PERMIT# L? I ? J RECEIPTDATE:
EOOE R£SIDENTUL f'LUM$INfi PERMTf APPLICATION
C1TY OF EAHAN
S$SO PILOT KN09 $D
$AHAN, MN 551 EE
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS: Z~ 3(o U I QX1f10. Lcl.Yv2
OWNERNAME:: 1 C~~n!\CV~ ~ T-~Y1) TELEPHONE#: ~vSl 6$$'dg`l~
(AREA CODE)
INSTALLERNAME: N0r610YY) Pl1,1.1MblA.~ TELEPHONE#: ~OIL'S27"' ~'~d3S
STREETADDRESS: 20105 6~604"GIoI SOI041 (AREACODE)
M~ 5540$
CITY: r 'nv,p LS. STATE: Z1P:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply ,
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ watersoftener X waterheater 15.00
state Surcnarge JUN ~ 3 200 .so
Total 8Y g I5.50
I hereby acknowledge that I have read fhis application, stale that the information is correct, and agree to compty with all applicable City of Eagan ordinances. It
is the applicanCs responsibility tonoqfy the property owner that the Ciry of Eagan assumes no Iiabllity for any damages caused by the City during its normal
operational and maintenance activities to the facllities constructed under this permit within City propeA /right-o •way/easement.
-
SIGN E OF PERMITTEE 1102
CITY OF EAGAN p+
3830 PiIW Knob Road, P.O. Box 21-199, Eagan, MN 55121 Np _ 01 ~
PHONE:454-8100
BUILDING PERMIT Receipts
~7obeusedtor 1/2 DUP/GAR EstValue $55,000 Date OCTOBER 28 19 86
SiteAdtlress 2038 VIENNA LN Erect K) Occupancy R3
Lot 3 aiock 4 SeciSub. RAHN RIDGE Remodel ? zonin9 &.I
Parcel No. Repair ? Type of Const.v -
Addition ? No. Stories
a Name B• H. GRACE Move ? Length 40
z 2004 VIENNA LN Demolish ? Depth4 P
o Address Int Impr. ? Sq. Ft
city EAGAN phone 456-9030 Install ?
¢ Approvals Feea
o Name SAME
Address Assessment Permit $ 298•00
¢ City Phone Water & Sew. Surcharge 27.510
Police Plan Review 149.00
~w Name Fire SAC 575.00
~~W nddress Eng. waterConn. 500.00
S
a Ciry Phone P nner Water Meter 63. C
C uncil RoadUnit 290.0C
IherebyacknowledgethatI havereadthisapplicationandstatethatthe dg. Off. 10/28/8 Tr. PI.
156.OC
information is correct and a e t cort~ply with all licable State oi
Minnesota Statutes and Ci an~rdinance APC Parks
~ Var. Date CoPe
~ Signature of Permitt ~~~TOtel 2 r0 59 •0 C
A Building Permi[ is issued to: B• H' . GRACE ORP on the express condition that
all work shall be done in accordance with all applicable tate of Minn sofs utes and City of Eagan Ordinances.
Building Official ~f~1 z ~b-~
A7f
CITY OF EAGAN
N- 12816
3830 Pilot Knob Road, P.O. Box 21-799, Eagan, nnN 55121
PHONE: 454-8100
BUILDING PERMIT Receiptp
Tobeusedior 1/2 DUPLEX Est.value $55,000 Date OCTOBER 28 1g 86
SiteAddress 2036 VIENNA LN Erect 20 Occupancy R3
Lot 3' elock 4 Sec/Sub. RAHN RIDGE Remodel ? Zoning R1
Parcel No. Repair ? Type of Const. V
Atldition ? No. Stories
W Name B• H. GRACE CORP Move ? Length 4 ~
2004 VIENNA LN Demolish ? Depth-4
e Address Int Impr. ? Sq. Ft.
ciy EAGAN phone 456-9030 Install ?
a S~E Approvals Fees
o Name
nddress Assessment Permit S 298.00
' Ciry Phone Water & Sew. Surcharge 27 - 50
Police PlanReview 149.00
_i Name Fire SAC 575.00
o= Address Eng. Water Conn. 500.00
a W City Phone Planner Water Meter63.50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe BIdg.Off. 10/17/8 Tr. PI. 156.00
information is correct and agree to comply with all ap bte St te of
Minnesota Statutes and Ci f Eagan 0'd~ ances. ~ APC Parks
Signamre of Permi Var. Date Copies Total $2,059 . 00
A Building Permit is issued to: B• H. GR CE CORP on the express candition that
all work shall be done in accordance with all applica6 State of Minn ota Sta nd Ciry of Eagan Ordinances.
Building Official
v ~ RESIDENTIAL
D~ BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
657-681-4675
New Conetructlon Heaulremanu pamotleVNeoelr Reaulrementa
• 3 registeretl site surveys showing sq. fl. of lot, sq. ft. of house; vM all roofetl areas • 2 coples of Dlan
(20%meoomumbtcoveragealbwetl) . 1 setofEnergyCakuletionslorneate0atltl'rions
• 2 copies of plan trowing beam & window s¢es; poured lound design, etc.) . 1 stte survey ror exterlor additlons 8 dacks
• 1 set ol Energy Cakuletions . Indicate N home served by septic system for adtlAbns
• 3 copies ol Tree Preservatbn Plan X bt plafled atter 7/1/93 . Rim Joist Detail Opllons seledion sheet (bbgs wNh 3 or less uniGC)
DATE Ul! I~ I l`J s VALUATION lil 030
SITE ADDRESS O lU V m -`e- MULTI-FAMILY BLDG Y ?N
NPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPUCANT l ' rL --7
STREETADDRESS -I~ C STATE Z'yI /P /
TELEPHONE # ' N ELL PHONE # FAX # G ' `'I ' US
.
PROPERT`! OWNER 1-lr , LN TELEPHONE #
COMPLETE THIS SECTION FOR %NEW- RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 M RJ~ERc~e~,s
~
(4 submiasion lype) . Residential Ventilation Category 1 Worksheet Submitted • rJUYN rgCode Workshee ~ mitted
• Energy Envelape Calculadons Submitted 0 4'LUU1 ~
Plumbing Conhactor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Conhactor: Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Conhactor: Phone #
I hereby acknowledge ihaT I have read This application, state that the Information is correct, and agree to comply
with all appllcable State of Minnesota Statutes and CiTy of Eaga,•/,r~-p~r~mances. n f
Signafure of Applican~t 1 J l 4 A.~I,II~X ~ l~-~X
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
O 01 Foundation O 07 05-plex 0 13 16-plex O 20 Pool O 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. Ak - SF
? 04 02-plex 0 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuRi
? OS 03-plex 0 11 10-plex ? 19 Lower Level O 24 Storm Demage
? 06 04plex 0 12 12-plex Plbg_Y or _ N O 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition O 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 fire Repair
? 33 AReration O 37 Demolish (Bldg)" ? 43 Reroof O 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuatlon 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 W idth
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaVC.O.
_ Footings (dcck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
RooF _ Ice & 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 , Buiiding Inspector
-
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppy & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN 1
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConatructionReuuiraments RemodellReoairRenuirements
• 3 registered site surveys showing sq. R. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% mazimum lot coverage allowed) • 1 set of Eneryy CalcWations for healed addi6ons
• 2 copies of plan showing beam & windax sizes; poured found desgn, elc.) • 1 site survey for ezterior additions 8 decks
• 7 set of Energy Calculations • Indicate'rf home served 6y septlc syslem for addiGons
• 3 copies of Tree Preservatlon Plan if lot platted after 711193
• Rim Joist Dettil Optlons selection sheet (bldgs with 3 or less unils)
DATE VALUATION CJl-~V~
SITE ADDRES a MULTI-FAMILY BLDG _Y V N
TYPE OF WORK~ bf ( FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ,,c
STREET ADDRESS V ~1J3 CI STATE ~VIN ZIP
TELEPHONE#61-32 CELL PHONE # FAX 46 "2U OQ"
PROPERTY OWNER .Y l Vk V O~Q TELEPHONE #6I-4'J2' 0f4
. COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
_ N[INNES(YC:\ RULLS 7670 CA"CEGORY t MINNESOTA RULFS 7672
Energy Code Category
(J submission type) • Residentlat Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor: ___________Phone # _
Plumbing sys[em includes: _ Wa[er Sottener _ Lawn Sprinkler Fee: $90.00
Wacer Heater _ No. of R.I. Baths
No. of Baths
Mechanical Confractor: Phone #
blcchanir<tl systecn includes: _ Air Conditioning Pee: $70.00
Hcat Recovcry Sys[em L Sewer/WaterContractor.------°---°---°--------------------------------°--------------------------°---------
I hereby acknowledge ihat I have read this application, state that e infor e to complwith all applicable State of Minnesota Statutes and City of Eaga inanSignafure of Appllcanf
' OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
\ \ Updaled 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 EM. Alt - Multi
? 03 01 of _ plex ? 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
? OS 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 44-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New 0 35 Int Improvement ? 38 Demolish (Interiar) ? 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
N6r, of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addition) _ Plumbing
_ Foundarion HVAC
_ Dtain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding SNCCO Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Re[auting Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
7986 BOZLDIIQG PERIiIT APPLICATIOA - CITY OF EAG9N
HOTE: ALL CAHTRACi08S 14[TS? BE LIC@iSSD {iITH THS CITY OF EAGAN
SINGLE FANIILY DflE[.LffiGS
INCLUDE 2 SETS OF PLANSt 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCOLATIONS
M[JI.TIPLS DWSLLINGS - HffiIDENTIAL RENT6L OBITS FOH SALS ONITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVSY - CHE(K iIITH HLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
COlMCIAL
INCLQDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
I'~Z puP«K
To Be Used For~ Ualuation: Date: ~Q ~S O~O
Site Address Z b 3 6 OFFICS QSE ONLY
Lot _3 Block Ereet ? Oecupaney FZ, 3
'Q Hemodel Zoning R I
Pareel/Sub ~1 ~ y r~ ~S f Repair _ Type of Const SZ
IJr Addition # of Stories
Owner R• ~e r~ C G Move _ Length 40
Demolish Depth
Address ULtM~.-~ 1.~.1 Int.Impr. _ Sq Ft
Install
City/Zip Code ~dC C}, Ss/
Phone T as~o ~ V 3 U APPROVAIS FESS
Contractor Assessments Permit
Water/Sewer Sureharge ~
Address Police Plan Review I•4 9,
Fire SAC 5.
City/Zip Code Engr Water Conn 500.
Planner Water Meter lo3,5O
Phone Council R
Bldg O£fj0•t18h`)fl~reatment P1
Areh./Engr. APC Parks
Varianee Copies
Address TOTAL ~r? y;
City/Zip Code
Phone # ~ l ( d
NOTE: ADDEESSES FOR CORNER LOTS - CONTRACTOR/HOlIEOfiNEB MOST DESIGNAT& WHICH ADDRESS
IS DESIEED. NO CHANGES HILL BE ALLOHED ONCE B[JILDING PERlIIT IS ISSIIED.
.
1986 BOZLDING PEAMIT APPLZCATIOH - CITY OF EAGAA
HOTE: ALL CONTRACIOES HOST BE LICENSSD SiITH T9S CITY OF EAGAN
SINGLE F9FIILY DiiELLIHGS
INCLUDE 2 SETS OF PLANS* 3 CERTIFZCATES OF SIIRVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPI.S DiiELLINGS - RSSIDENTI9L RENTAL ONITS FOR SAL6 OWITS
INCLUDE 2 SETS OF PLANS, CSETIFICAT6 OF SQR9SY - CHEt:g WITH BLDG. DEPT.9
1 SET OF ENERGY CALCULATIONS
CONMCTeT.
INCLUDE 2 SETS OF ARCHITECTURAL & STROCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
~Z DCJPL(r!R /llD DE-t-
To Be Used For:--gME valuation: SS~000 Date: /
Site Address 2N OFFICE IISE ONLY
Lot .3 Bloek 7 Ereet ? Oecupaney R 3
Remodel
Pareel/Sub ~21Pj5r, R pair _ T peof Const -7_
/Addition 11 of Stories
Owner v~f}GE Move _ Length 0
Demolish Depth ~t~
Address ~yr~ Int.Impr. _ Sq Ft
Install
City/Zip Code ~~FGi rl mN ~~f~Z
Phone ~11 APPROVAIS FEES
Contractor ~ • ~-~~~}L~' Assessments Permit Z'i 9).
Water/Sewer Surcharge 7-7.
Address Police Plan Review 149.
Fire SAC 575.
City/Zip Code Engr Water Conn 500.
Planner Water Meter (o 3, so
Phone Council Road Unit 2gc?
Bldg OfF Treatment P1 15Co
Arch./Engr. APC Parks
Varianee Copies
Address TOTAL ~City/Zip Code
Phone ll
NOTE: 9DDHESSES FOR CORNER LOTS - CONTRACTOR/HOMEOIINEB MQST DESZGNATE HHICH ADDRESS
IS DESIRED. HO CH6NGFS iiILL BE ALLOWED ONCE BIIILDING PERMI'f IS ISSDED.
I Hedl~ad Eugineering Services ~Ea1BIoamYqpnf~Nrqr
La~ ~w~n Grll EMIn»n Lond Plonnert Whqq; 004111.02"
WE Su~~ors G~LAute
800K _ PpGE _
_ ' ~ ~,~p, 86•446
M~ F= - B. H. GRACE '
09VJRIM A$. Lot 3, IIlock 4, RAHN RID('rE, City of Eagan, Dakota County,
Minnesota and reserving easements of reco'rd.
~
. .
ti
• _ • .
~VI-ENNA. I.ANE ! .
~13.9~z .3 4q o 94t`'
G :4'pp'pp"
7.68 R•90.00
EAST 90.92
941. 0 94+.0
0
`~---1 0 ~
Sr~ d ~
; ~ ~ p i 6,."_ ? lW
. . t V • a c+ .
24.1 ~y
6aR. ~ 1 a
z-L c~ iu
. ~ Ci PROR76LD .a ~ ~'ir0 ' ' J
d' ~ MIOUG~ 7
N t~: n SC W/O N PR~s '
~
8
~ ~ -----9 , ~d° Q
ti
Vi
i 943.1
W I ' 80 ~
. ~I .
I r ~
:t b . ~
47
~
ko
V
Li~
ti
: ~ ~ ~q`pP OF FOUNDATION =Q
GARAGE FLOOR
I / ~ qa3.z
BASENENT FLOOR ~ ulp
SEWER SERVICE ELEV.
pROPOSED ELEVATION9
ESI3TING £LEVATION9 : -
pRAINAGE DIRECTIONS
DENOTES IAT CORNER3 : 0
DETipTE9 OFPSET 3TAKE: p
1 IprMr qrtlfy Aot M ro~~l ~86 S wra~~d IM proPtAy Oesctlbelf-o0or"d'thof
1M abow pot fsro cantt repnseetotion of 6a10 wrvqr.
- '
• 4SL_5
J tr~j D. Indqnns Llcenist No.14376
1999 BUILDING PERMIT APPLICATIOIN (RESIDENTIAL)
3830 PII.OT KNO RD 55122 ~-~9- t 9
651-681-4676 ~
New Construction Reauirements Remodel/Repair Requirements
• 3 registered site surveys showing aq. ft. oI lot, sq.. k. of house • 2 copies o( plan
and ali roofed areas (20%a mazimum lot coverene allowed) • 1 set of energy calculations for heatetl additions
? 2 copies of plans (show beam & window sizes; poured fntl. design; etc.) • 7 sde survey for exterior additions S decks
? 1 set of energy calculations
? 3 copies of tree preservation plan if lot platted atler 7/1193 ~
DATE: eAt? CONSTRUCTlON COST:
DESCRIPTION OF WORK:
STREET ADDRESS: 2 6 3 G i/ h R
LOT: BLOCK: C y" SUBD.fP.I.D.
T
1Vame:__~~/1 Phone _114 ~y!
PROPERTY Lasi Fim
04N'NER G n
Street Addrets:__ ~ 03 7 ~ ~ U
Cit}-
~-~yg /-I State: 7-iP°
W L~x Co~npan}: GnlC Wd~~C L_ p#a
Con~~~oR _
Street Address:,,~ Irccnse N = Lxp. _
~
Cm State: Zip' Z-~Z_-
ARCHITECT/
ENGINEER Company: Phone
. Ivame:- Registration H:
Street Address
City State: Zip:
Sewer & water licensed plumber (required for new construction only):
Penalty applies when address change and lot change is requested once permit is issued.
1 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 Ciry of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY - -
i{i~
Certificates of Survey Received _ Yes _ No ~f I~v
WVL~ Z 6 IJJJ
~
Tree Preservation Plan Received _ Yes _ No _ Not Requir,
I V ~
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea)
? 03 1of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
13 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New O 35 Tenant Impr O 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas insert 0 44 Windows/Doors
0 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
D 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft . No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/E5 System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES 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
t PERIVIIT CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 030450
(612) 681-4675 Date Issued: 0 7/ 16 / 9 7
SITE ADDRESS:
2036 VIENNA LANE
LOT: 31 BLOCK: 4
RAHN RIDGE
P.I.N.: 10-62750-031-04
DESCRIPTION:
~ ~
B~t~'~~~ Perit Type DECK
Bx31~~F9,rm
k Type NEW
.A en's4 s, Ctids;" ~434 ALT. RESIDENTIAL
~
am8,yy 4 MwPtWF „~8~
"6
Ge
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: OWNER: - Applicant -
WRHL JANEL
r
2036 VIENNA LANE
EAGAN MN
~ (612)686-0816
I he'reb+,r ackn6wlecTg;ethaG `j herte. J°e~`d' ~his :apPAjo`a tii6rt _an ci stdxe; that Cho
.
- irifarmatsoer. i,s` ca'rr~ct a:nd acree' tg ,c.4mp.",*~t1 ~kl appla~ca3~1e StaYe o~ Mn.
Statutes, onsi4C3tg ,af, ta4;09 t#
~ _ . f, _ . x., . . _a _ r.. .
a fiAA
P ICA /PERMITEE SIGNATURE ISSUED BV: SIGNATURE
I
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
? O l~i 5830 PILOT KNOB RD - 55122
V ~ ~ 6814675
New Construction Reouirements RemodeUReoaii Reauirementa .
? 3 registered site surveys ? 2 copies of plan
• 2 copies of plane (fnclude beam & window saes; poured fr+d. dssign; etc.) ? 2 site surveys (exterior addidons 8 tledca)
? 1 energy calculations ? 1 errergy calculatlons for heared additions
? 3 copies of hee preaervation plan H IM plaUed aRer 7/1/93
required: _ Yes No '
~ (;~lSW. ~
DATE: -.a l) CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREETADDRESS: 26,36, `II~AYIQi Law 62". I'I!V S)2,2-.
LOT 0 31 BLOCK ~ SUBD./P.I.D. L~~4~:
PROPERTY Name: Phone
OWNER ~R ~O~Cn O EI G [b~'1CQ)
Street Address: ~3G ulP/li'J(~ (~t/1.¢/
City: rooY1 State: 17'IN zip: 55122 ^
CONTRACTOR Company: P A- Phone#:
Street Address: License
City: State: Zip:
ARCHRECT! Company: tilk Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licer.sed plumber (new construction only): . Penalty applies when address change
and lot change are, equested once permit is issued.
I hereby acknowWge that I have read this application and state that the information is correct and agree to comply with all applicable
5tate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certiflcates of Survey Received _ Yes _ No J U L 15 1997
Tree Preservation Plan Received _ Yes _ No _ Not Required $X; ArNr~
OFFICE USE ONLY ~ .
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex o 11 Apt.lLodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex o 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition o 08 8-plex n 13 Garage/Acxessory o 20 Public Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 = piex o~"15 Deck
WORK TYPE
p' 31 New o 33 Alterations o 36 Move
o 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const (Actual) Basement sq. ft. MC/WS System ~
(Allowable) Main level sq. ft. City Water ~
UBC Occupancy. sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. H 3y
Depth Footprint sq. ft. SAC Code oi
Census Bidg i
Census Unit o
APPROVALS
Planning Building in Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCMIS SAC •
CHy SAC
Water Conn.
Water Meter
Acct. Deposit .
S/W Permit
S/W 5urcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
SAC Units
,
Jund Engineering Services ~Ea1BIoonW~ypnF~NMpy
Bloomington, mkwmm $5420
Md irrvqon Clrll Eaylewn Lond Plonnen Phonc Y8B-OQYY
Srror~~ lcate
_ BOOK _ PAGE _
' jog Np, 84-446
~URYEY /~ON~ B. H. GRACE QLMUM AS. Lot 3, Block 4, RAHN FIDGE, City of Eagan, Dakota County,
Dfinnesotia und re5erving eu5ement,s ot' rvcurd.
P
0
*4 VIENNA I.ANE !
9W.8C~ q9 4,3 yq.4o 9_4t2•4
`A • 4,C70,00"
7, 6a R•,o.oo
EAST 90.92
941.o q~ o
~---I o 0
7
~ iI- 2l.ll 9 .9 61.1.'1 I
I Q 4- .
1Y7~ ll
24.a c4i]) ~ LL
N ~R
6Fe, N
z, .
117 -TI 9 .7 2 rl st~l m
j 1 10 - il-8 - 4n .t.t
t PROLO6E0 0 4 ' 1?re M . • v
N {;.lY~ I N S ~C W(6 N 1 PROWSED d I k11 T
M tbusW '
34 N 5 c wlo ~
I ' 34 12.' p%S g J
in ~ ----56 -----9 6, 1 (14Q ~pj V~ G
I - ~ N J~
I I+ 943. r
W
~ .
I r ~
~ I
<:t 0
--I /
•y ~ r
. ~v
ilf I k~~.~OOa
/
TOP OF FOUNDATION
/
. 946,0
GARAGE FLOOR ~ 443 2
BASEI[ENT FLOOR
SEWER SERVICE ELEV. ~ "jJ14
PROPOSED ELEVATIONB
~ 'b'•h EXISTING ELEVATION3 :
DRAINAGE DIRECTIONB
DENOTES L(Yf CORNERB
DENOTES OFF'SET STAKE: ~
I ApeOy cKtify hot an %S' 186 I wrveyed tM propKty Msttlbed- aDbvi o11d-thOf
the o0ove plot isra corncf npnsentoNon of sald wrvey.
• ~L.S, - JJ' lJ -Y
J f 0. Indqron, Llcani• No. 14376
******##*#************k*******f*#**~
- ~ CITY OF EAGAN * ~•CATT m~F~ ~°F *
. ' * APPROVAL OF PERNffT. *
~
C • APPLlCATION FOR PERMIT
~ : . y. INSPF7CTION OF SEWER ANID/OR M'lER ,*E
* jlg2'AT rATTONS WII.L NM $E $CiIF9- 'F
SEWER AND/OR WATER CONNECTION *~m UNTIL PEEtt'BT HAS BEM ;
. . . . * ArPr.okm. *
* *
~
*****~~*****,.~~~***,..*,~**x*~***,~****
, P ease Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION: 3 ~ .L~I- ~ • '
Lot Block ubdivisio r~Tax Parcel ID
IF EXISTING STitCCIS.'RE, DATE OF ORIGINAL B[JILDING PERMIT ISSC'ANCE: -
;
PRESENf ZONING/pROPOSID L'SE: Mon Year}
COMEI2CIAL/T2E~TAIL/OFFICE -1 SINGLE FAMILY .
1`7 IPIDOSTRIAT, ~ R-2 DCPLEX (Ttoo Units)
n INSTI'iL'TIONAL/GOVERNMENr ~ R-3 TDWNHOTISE (Three + Units) ( Lnits)
. ~ R-4 APARZMENT/CONIDOMINiGRM ( Units )
~
2)
• ADDRESS:
CITY, STATE. ZIP:_ ztF3 C A s
' PHONE: y n~ rJ -30
3) • u i: NAME- , ~ For City Use .
~ C--~S~ Plumbers License:
' A?DRESS:- /o2f E<WCe/ vu67 fJ.~. Active
CITY, STATE, 2IP: ~pired
i __~11/// ~e4F' Nat recorded
PFiONE:__ MASPER LICCEIVVSE#
4) .
Na1e~: •
_ ADDRESS: . .
CITY, STATE, ZIP: '
PHONE: .
-S) v~ d• i • oi • y~ ti~s~
_ p-c5'"rscrzoN zv crrsr sEWER ocrNBcrioN Tv czzx wAZER a oTHER .
6) ~ • r ~ PI,EABE $OLD APPROVID PII2MZT FC)R PICK-C~P $Y ONE OF ABUVE
E MAII, ApPROVID PERMZT TO 1. 2 3~~4, ABOVE
• (Circle one) "
~
7> r,. /l~~~'I/ ~
. `I' y' ~ G' Y.I" M 1 •J1~ ~ 1' N• 9 1~• i~ !Y01'
' • Ja •~IJ~i~Y 1~• ~v 'CTT 1 • • D~ 1' • ~ ~
a b 11~1~ 14 ! l~ .
~_4 e
. FOR CITY USE ONLY . PERMIT # ISSL'ED .
d `
Pd w/Bldg. Permit FEES:
$ $ /0, SEWER PERMIT ( INCLC?DE SORCHARGE )
$ $ ID. JU WATER PERMIT (ZNCLL'DE SL'RCHARGE)
$ IO,~~~U $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
' $ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ ACCOL'NT DEPOSIT - WATER
s $ " wac
$ ~'~)-ooo $ sr.c
$ $ TRUNK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ " LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
$ ~Slr ./7 l) $ WATER TREATMENT PLANT SDRCHARGE
$ $ ' OTHER:
$ 14 $ ~I • O~ TOTAL
RE EIPT RECEIPT
DOES DTILITY CONNECTION REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDTTION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE: II'rJi6 -(T ~ _
. "A ************i4*##*i**#i*******fk##*#
4
CITY OF EAGAi~ * oF~ *
ApPROVAL OF PEEtNIPr. *
*
C • APPLICATION FOR PERMIT *
~ • ~ rtaspFx.'riorr OF sEmm Arm/ct mmt *
,*f rus'mArraTTONS WIIS, NOT $E SCfIID- *
SEWER AND/OR WATER CONNECTION *ULED UNm PEPmT HAS BEm *
. - * APPRC7VID. *
~ •
~ w
r *
r
. * *,t ~ *x*,t ~ x:*****+r:*~****x**w+r**
Please Print
: ~ 1) PRQPERTY ADDRESS:
LEGAL DESCRIPTION: 3 Lot Block Sub ivision or Ta Parcel ID )
g EXISTING STRCtZL'RE, DATE OF pRIGINAL BLILDING PERMZT ISSi'ANCE:
~
PRESENr ZONING/pROPOSID L'SE: - lMn Year -
q CGLtiPIERCIAL/RETAII,/OFFICE M-f--1 SINGLE FAMILY .
Q IDIDL'STRIAL Q R-2 OL'PLEX (7Wa IInits)
INSTITL'TIONAL/GOVERNNg,'NT ~ R-3 MWN30USE (Three + Units) ( Lnits)
. q R-4 APARMMVT/CODIDOMINIUNl ( Units)
2) • ADDRESS:-
CITY, STATE. ZIP:~ S ~f3 /1`!ly~
PHONE:_ 3) c~• r~ , p For City Use .
NAhE:_ ~O /vt C - Plumbers ?,icense:
ADDRFSS: o a c~? ~.P. Active
~
i CITY. STATE. ZIP: Ecpired
Not Z'ecorded
PSO • n rMrsc~sE# _ 370?~~'-t Staff ~tlai
4) ~a• ~ i~+• .
Nl1ME: ' i
ADDRFSS: • , .
CITY. STATE. ZIP: '
PHONE: .
'cj~ • 1 .1 Y• " 1 • ly ' • ~ D~ U0.'YY7i . .
Ej-'C6NPIEGTZON T0 CITY SEWIIt NNECrION TO CITY WP,TER Q OTFIER
6) ~~~r• • r E] PLEASE HOLD APPROVFD PFdtPqT fY)R PICK-L~P BY ONE OF ABOVE _
Utp-MM1.SE MAIL APPROVID PEI2MIT TO 11 2,0) 4, pgpVE .
' (Circre one) ' , ' .
7) r ~ - ' ~ 6
~ -
. :r~: ~ r ~a: ~r ~ . • ~ i. ~ r ~~r ~ ia• ~ r u~- ~u ~ • • • ae r .
a •r• r+. i r : o- •:n •.no. ~ ~ ~ : :n• ~ a•- a- • • •r. .
.FOR CfTY USE ONLY -
. ~
PERMIT # ISSL'ED
6 J~
Pd w/Bldg. Permit FEES:
$ S SEWER PERMIT (INCLODE SURCHARGE)
$ S /n 50 WATER PERMIT ( INCLODE SC'RCHARGE )
$ 42;L56_ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ J, , nJ) ACCOIINT DEPOSIT - WATER
$ WAC
$ sAc
$ $ TRL'NK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRC'NK SEWER
$ $ LATERAL BEN°FIT/TRL'NK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ ' OTHER:
$ I ~9e1) J6 $ 11I1 6D TOTAL
REC IPT RE PT`#
DOES ?TILITY CONNECTSON REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK L9ITHIN PC'BLIC
Q
ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SOBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY: ~
TITLE:
DATE : ~ I`cf 0 U6
Cities Di ig tal Quality Control
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C[TY USE ONLY
LOT QJL BL ~ RECEIPT
SUBD. ftECEIPT DATE: ziII 015
V
......._1997 MECHANICAL PERMIT (RESIDENTIAL)......
CITY OF EAGAN
3830,PIL0T•`KNOB RD....` z 7. . .
EAGAN MN 55122
(612) 6814675 .
Date:
Complete this section only if vou are installing'HVAC in'sinele familv, townhome: or'condos that are
under'construction`and 'are not owner /occupied. " 'r'
• HVAC: 0-100 M B T U. $ 24.00
, ...__.,Y,..._~..~,............ A77DITIONAL50Iv1BTLT `6.00
• t" '°;•a . «i. . ; r 1 r .
Gas outlets ( minimum of one required @$3 00 ea.)
..t
. . .
•°"5tateSurcharge: .50
.
w
• TOTAL:
- • ~ It;; . e i ; i . i i^ 1 -
Complete this section onlv if vou are remodeline, addinE to, or repairing eaisring sin¢le familv
dwellin¢s, townhomes, or condos. ' " " . . -
. .
:
Add-on furnace - ~ _Add on air conditioning
. Add-on air exchanger, i.e. Vanee system, etc.- Other Minunum fee applies to a11 remodel or add-ons of existing residences
. ,
State`5t:zcharge-_._..,.~._., . . . . . . .50
TotaL•::-~020.50
:_.~..~:...,_:..w._..._ . . _ .
SITEADDRESS: 2036 VIENNA LANE ` OWNERNAME: YT TERRY FRENCii - PHONEk: 688-0898.
INSTALLERNAME: RON'S MECHANICAL, INC. PHONE#: 445-8585..
3~ : . _ . . _ _ _ >
STREETADDRESS: 12010 OLD BRICK YARD RD
CITY: SHAKOPEE STATE: MN Zip; 55379
. . . . . . . . . C~'~ n0.~ ~:IL" , n f'a
•,;ry: ' . • , ; ; S[GNATUREOF:PERIvt[TTEE
CITY USE ONLY
BL _ RECEIPT#:
SUBD. RECEfPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
, Please complete for. . all commerciaVindusVial buildings.
~ mWtl-(amily buildings when separate pertnits are io required for each dwelling
unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUC"fION INTERIOR iMPROVEMENT
DESCRIPTION OF WORK:
FEES: . $25.00 minimum fee or 1% of contract price, whichever is greater.
~ Processed piping - $25.00
. State surcharge uf $.50 per $1,000 of rmi fee due on all permits.
' CONTRACT PRICE x 1 % "
~ PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITEADDRESS: ~
OWNER NAME: TELEPHONE
- -T~NANT NAME: (innPaoveMeNTs oNLv) '
INSTALLER:
ADORESS: ,CtT1': STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
5993 1 PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date ~ / 7S / d3
Site Address 203,2 V I {.b~ C& Unit #
Property Owner 4/IyU V0 j'1 L-CA Telephone #(GI2) tB (pb- 4~~
Contractor , P • Pi ~ t.l/~JD f ~L~
Address o City F::-+ ~ GZ/~
State m `v Zip Z3Telephone # (4~`~) 3toS- ~ ~
The Applicant is _ Owner ~ Contractor _ Other
Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additlonal consultant fees may apply.
AlteraNons To Eaisting Dwelling Unit, Including $ 50.00
_ Adding fxtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water tumaround 50' meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener ~ Water heater $ 15.00
X replacement additional
- FEQ 0 4 2003
f111 .
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit and aclmowledge 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 Plum6ing Codes; that I understand tlils is not a
permit, bu[ only an applicarion for a permit, and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name A li ant's Signature
• 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewConsWCtionReauirements RemodeVReoairReouiremenGS
3 registered site surveys showing sq. R. of bL sq. ft. of house; and all roofed areas 2 copies ot plan ia~:^ T,,.~.-~ k~
(20% maximum lot coverage allowed) 7 set of Energy Cakulallons for heafed addNons
Ca
F'sM
2 copies of plan shaxing 6eam 8 window s'u.es; poured found design, etc. 7 site survey for additions & decks iE~~il~
1 set of Energy Calculatlons AddNon - indkate if a~sde sepfic sysfem
3 coples of Tree Preservatbn Plan if lot pWtted after 7l1I93
RimJoistDetailOptionsselectionsheet (bldgs with 3 or less units
Date ~ /~fo Construction Cost
Site Address. iL Q 1') 'r UniUSte #
Description of Work 9~r~ N[aCeN"i-r~ ~~-T w r YlM~ItcJ~ ~ ~p~'t ~ C~
Multi-Family Bldg Fireplace(s) ~-~2
Property Owner G /1 r'L4 L- /U Telephone # (4ALW) ys-2
Con[ractor //le/10,44ri
Address 4yy!! r q~4~~ City ~rlpQn~g ! Y
State Zip ~ Telephone #,f5jS-) 26-1-COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category . Residential Vantilation Calegory 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone # ( )
Mechanical Contractor Telephone # ( )
Sewer/WaterContractor Telephone#~ )
I hereby apply for a Residential Building Pemut 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 th7caseof o rk wrequires a review and
approval ofplans.
Applicant's Printed ame c's a re
OFFICE USE ONLY '
Sub Types
? 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 ? 09 07-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plez ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement 0 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
O 34 Replacement 'Demolition (EnGre Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units ' Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs iength Fire Sprinklered
Type uf Const Wldth
REQiTIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs _ Au/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone ! Brick
_ Fueplace _ R.I. _ Air Test _ 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 & Surcharge
Treatment Plant
License Search
Copies
Other
Total
1
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2036 Vienna Lane
Lot: 31 Block: 4 Addition: Rahn Ridge
PID:10- 62750- 031 -04
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Champion Window Company of Mpls
5100 HWY 169 N, #B
New Hope MN 55428
(763) 574 -2054
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
$90.00
Owner:
Janet F Wahl
2036 Vienna Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA085173
08/11/2008
ePermit
al (i.e. debris that could block vent openings) and
$88.50 0801.4085
$1.50 9001.2195
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
Issued By: Signature
zT
,�`� F •�§ s y � c � ' � � r +.4 : • h t
' 74
� x ,
r PERMIT ,t 9
.1JJ_....v. 8M'y. 1: � Lan e . A l ..
1 " ' sg i
Accou Ir 04pc*
Date of Imo►{,' .r'i: '`
City of Earn
3830 Pitot Knob Road
Eagan MN 55122
Phone: (661) 675-5675
Fax: (651) 675-5694
MAY 202016
r
Use Bilit or BLACK Ink
L
Pem itt: / 52
Permit Fee: (d'/7 -op
Date Received:
Staff:
2016 RESIDENTIAL S PLUMBING/PERMIT APPLICATION
5) Date: r 1 I / t'. 1 V , Site Address: 0.0-LeAvk t)x--
Tenant: Suites:
Resident/Owner Name: � � En v Phone: (4— lQg '- bgq q
Address 1 City 1 Zip: Q 03{.f V 11/114 w Lam— ' IAN 51 a s
Name: 0.r6 1 Ai. License* (21-1(4 c'7
Contractor Address: Z1440O €,4 ' i %i ve City: 141,0-4-02141
state: W1 zip: 5 +C I to Phone: (5- 38 tO -8667
Contact Ti M Emait: exti O C": c , net
Type of Work — New Replacement — Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work: 44/1-WQ. 24 bp -Pk -KW
RESIDENTIAL
Water Heater
I Water Softener
Lawn Irrigation ( RPZ / ` PVB)
Permit Type Add PUmbing Fixtures Main / Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
'Water Turnaround (add $280.00 if a 3/4" meter is required)
5115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Cali Gopher State One Calc at (651) 454.0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utitities.
I hereby admowledge that this information is complete and accurate; that the work wid be In conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a penal; that the work wiB be in
accordance with the approved plan in the case of work which rewires a review and approval of plans.
JIM SCA -‘066R.
Applicant's Printed Name
x
Apptican "Signature
fir_-L0)024l co
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136520
Date Issued:05/18/2016
Permit Category:ePermit
Site Address: 2036 Vienna Lane
Lot:031 Block: 04 Addition: Rahn Ridge
PID:10-62750-04-031
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Janel F Wahl
2036 Vienna Lane
Eagan MN 55122
(651) 688-0898
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143310
Date Issued:06/12/2017
Permit Category:ePermit
Site Address: 2036 Vienna Lane
Lot:031 Block: 04 Addition: Rahn Ridge
PID:10-62750-04-031
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Janel F Wahl
2036 Vienna Lane
Eagan MN 55122
Champion Window Company Of Mpls
5100 HWY 169 N, #B
New Hope MN 55428
(763) 574-2054
Applicant/Permitee: Signature Issued By: Signature
For Office Use
‘ , 0. 0 i , :: e.
Pf
r
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspectionsacityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: tt_ V�� �_ �1� 'fir \ Phone:(„a i , CW O
Resident/
Owner 1 Address/City/Zip: 3 V 1 e��� 1 .,kn�� v - E- '
Applicant is: Owner Contractor
Type of Work
Description of work: ( La'-C� g
j Construction Cost 8000 Multi-Family Building: (Yes /No V )
Company: Contact:
i
Contractor Address: City:
t
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: i
I
r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
s 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: t
Licensed Plumber: Phone: i
s
Mechanical Contractor: Phone:
1
Sewer&Water Contractor: Phone:
I
Fire Suppression 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 ifyou provid ecific reasons that woulaperrnit the city to conclude that thy are trade secrets :
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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.
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. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work w ll 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, \d work is not to !tart without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and ap,',roval of p
Applicants Printed Name Applicant'-)S 1 ature