1665 Walnut Lane
VILLAOE OF EAOAN WATER SERVICE PERMIT
3795 Pilot.IG eb Rood PERMIT NO.: 147$
Eogon, MN 55I22 DATE: 549/4
Zoning: R 1 - No. of. Units: 1
Owner:
Addreas: .1'4- 5 ' f
Site Address: -_1665--La-Il1L1t-Iiane
Plumber: Thomson P1UinbinR Gb .
' Meter No.: 23496681 Connection Chazge-130.00 pd 3/18
Size: SI$ Account Deposi0.00 b ~q
Reader No.: 532159 Permit Fee:
I oyrN to eornplp wkh NN V111eye of Eooan Surcharge: • 50 b e
Ordi.wnus. Misc. Charge~-a-e--d ,
Total:
Sy ao!t~~c~ ~s%•.--- Date Faid:
Date of Insp.: Inrp.:
YILLAOE OF EAOAM SEWER SERVICE PERMIT
3795 ?ilot.Keob Rood PERMIT NO.: -2 2 3 3
Eoyoe, MN 65122 DATE; _ 5/29/74
7'°ni°g: R-1 No. of Units:
Owner: N s
Addreae:
Site Address: I
Plumber: ThQMpSon Plumbin Co.
1 a9~ ~ c0-0r wit+ th+ Yilloge of Eayan Connectian ChargopT0g =,a j /
O'di^a"coc Account Deposit: _
Permit Fee: 10.00 billed 5/21!
Surrharge: 50 billed 5129
BY: Misc. Charges:
Date of lnsp.: Total:
lnsp.: Date Paid:
. . . ww,•
CITY OF EAGAN Remarks
Addition wood ate lst dition Loc 10 pik 5 Parce~ 10 84600 100 05
Owner ajaL~ti Street 1665 Walnut Ln. State Eagan, MN 55122
Improvement Date Rmount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR. pAVINGZ'~ 1974 $115.45 $23.09 5 PAID
GRADING
ISUIPA-VING 1976 992.92 $330.97 3 PAID
SAN SEW TRUNK ZX41 1974 $93. 54 $6. 24 15 PAID
* SEWERLATERAL 1975 ZS
WATERMAIN
* WATERLATERAL 1975 15
* WATER AREA 1975 15
* STORM SEW TRK 19 7-5,
* STORMSEW LAT 2 1975 $2036.55 $135.77 15 PAID
CURB & GUTTER I
SIDEWALK
STREET LIGHT
WATER CONN. $130. 00 10204 3-18-74
BUILDING PER.
snc 400.00 10204 3-18-74 I
PARK
INSPECTION RECORD
C1TY OF EAGAN PERMIT TYPE: 1' 1r4'"
3830 Pilot Knob ROad Permit Number: NI t{
Eagan, Minnesota 55122-1897 Date Issued: ~ 0,4
(612) 681-4675
SITE ADDRESS: r I „ i~• t 10 111;,, ~ , APPL{CANT:
, , , I ,rl t Ntit rANf
~ r~~~~rr~, : i ~ r~, t ~ , i+,
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION D• ON TYPE DA
~
II ~
~ ~
Parmk Mo. Pormlt Holdsr Oate Tetephona #
~ ELEGTRIC
~
I PLUMBING
HVAC
I Inipsctlon Data Insp. Comments '
I FOOTINGS I
i
II FOUND '
I
I FRAMING J
I ROOFIN(3
2 I
ROUGH I
PLUMBING
~ PLBG
AIR TEST
ROUGH
HEATING
GAS SVC I
TEST I
INSUL
GYP80ARD I
FIAEPLACE +I
I
FIREPLACE I
AIR TEST
FINAL PLBG I
I
F(NAL hITG
I
ORSAT I
TEST I
BLDG FINAL
BSMT R.I. '
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERP2IT N0. ; 473 i
The City of Eagan hereby grants to C,eo 3edcrwick I3eat3ncr t. 11/r co -
of ipQ Xania Pve So.,mr.1s. 55416
•
a s.EaTTU Permit for; (Owner) sm Hori7on "ones
.1685-77-73-69
at VLj,„,} r~.,~,.~ , pureuant to appli.cation dated 311JM,,,~
Fee Pa,id: cinn_nn dated this .IfiY r ~~}~dav of March
• ~.~r~.
2.50 S/C , q•.~.~ . ~ x:
, " i
Building Inspector
Mechanical Pexmits:
Bid Total:
~
~ CITY of EAGAN N° 3223
BUILDING PERMIT °
3795 Pilai Knob Road
.
Ownes . . . ~ Ee9en. Minnesota 55122
Addeau (present) 459-6100
Bulldar
_5,- /fi -7 f
Del~
Addreu
DESCAIPTION
Sto:iss To Bs Ucsd Fos Fron! Deylh Hsighf E~l. Cm! ~rmi! Fee Remarks
/ [4 yr-t- I 3 qi~ / ar/ av /o ~ ,a.4Z-<- -Fo-t
p / Y 9 So ~ a~
LOCATION / ~3 0 ~So
Slrael, Roed ar olher Dssczipflon ot Locelion I Lo! Bloelc I Addilfoa or Trad
/-S G
This permit does not aulhorise !he use ot sireefe, roads, alleys or sidewallu nor does it giTe !6s owaer or Lis ageat
the righilo cre¢te aap aituation whiah h a auisanes or which presentc a hassrd !o !ha health, sefetq, oonveaieacr aad
gsnaral weliara !o anpone ia !he communily.
THIS PEAMIT MVST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAE88.
T6is is !o eerliip, !6el.. :?.~..........hupermieston !o eree! a. _ayoa
!he above described premise subject !o ihe provisions of all appliea6le Ordinances for the Cit~Eagaa
1Q.:......_~'--.... . r... Per AQ~....
Ma r SuSldinq Ina pklur ~
~
~ D o a io v~ S
CITY OF EAGaN
3795 Pilot Knob Road
Eagan, A'finnesota 55122
PCRIZT NO4.2
Phe City of Eagan hereby grants to ThomPaor. Pl,inhin^ Co.
af 72201 Mtnaetonka R1vR.
a PLPMAT*7G Permit for: (Owner) ?]ew Horizon tto*,net - 4!eoc3nate Addn. 1
at _ see atYached list ~ pursuant to application dated 4/19/7P
ree Faid: $1,Q60.00 dated this 24rh day of P.eril ~ 19 74
4Q.0(` s/c
Building Inspector
Mechanical Perr::its: Bifl TotaL•
' EAGAN TOWNSHIP DALE S. PETERSON
Burldrng & UfJity lnspecror
PUBLIC WORKS DEPT. wiLunM H. aRaNCH
3795 PILOT KNOB ROAD SupermtendenrolPuALcWorks
EAGAN, MINNESOTA 55122
PHONE 454-8100
?crrrnt 411? _ e/24%74
Covers follow.in~ units aaci }iomes:
1r,28,1532, 1636, 164), 1F,44, 1F50, 1654, 1558, 1r-62 l~Er., 1C7n; 1574, 1F7R, 1F-82. 169F, 1F~n,
1r^?, 1F,?4, 16ar, 1~°f', 1?~O lJalnut I,ane and ].f35, FS 1«1, CF; 1C5~. 1673, 1F77, ]PR1,
7Ff?5, 16s39, 7693, iF~i, 1701 47a1nut Lane
1C31-?^-27-25 Hicl:orp Hil1, ]r,(-if-68)11ickocy ?i11 & 1667-r5 Hickory Lane, ]565,57-F^-77
:;:r_}:ory Hil1, 1653;r1-59-57 Hickory Elill, 16R7=83=85=87 Y,i.ckorv Hill plus last eleven
(71) townhouse buildinys -do not have carrect house nu[aLiers a5 vet.
HOUSE HEATING TEST RECORD D-21023
ADDRESS 1665 Walnn} 7Rnc APT. - FLOOR CITY SUBURB Faaan
OCCUPANT Tom Sayt.hPr OWNER S'P4
HEAT LOSS HTG. INST. GAS C0. METER BADGE #
SOLD BY WSTALLED BY Sedgwir.k Htg_
Elscfrical Work By Gas Line By 11 ff
TYPE OF HEAT GA _ FA -X HW _STEAM -SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE K`illiamaon MAKEOF BURNER
Mode I 1117-10-5 Model
Smial 7402802 Mox. BTU Roting
INPUT 100,000 Btu Hx', MAKE OF FURNACE
Modal
CONTROLS
THERMOSTAT CID 260 Heat Plu~g Vent Size Sn
VO1Ve M.H. V800C KIND OF LINER Alllnt. SIZE s° NONE
LimiT Robshaw RFI, 750n Draft Hood V¢rt1C81 Regularor
Limit Setting 2QOof Filters Size 16" x 25" Number 1
Fan Setting 90 f & 12001 Chimney Locafion Inside Ye9 Outside
Piior Type Couule Cy,;mn,y C,nzrrucrion Metalbestoe
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing 74 Seconda Draft OK Test Tag Yes
L.W. Cut Off . Door Prcssuro Lighting Inst. YeB
Pressure 4.3"W.C. percentCO 7.5% Data Tested 10/24/74
2
InputCFH 98 0 Percent OZ 7-R~ Company Testing c,
A
$tack Temp. 50f percent CO 0.00 Name of Tester ~
Form 235
f - , PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 030182
(612) 681-4675 Date Issued: 0 6/ 0 9 J 9 7
SITE ADDRESS:
1665 WALNUT IANE
LO7: 10 BLOCK: 5
WOODGATE 1ST •
P.I.N.: 10-84600-100-05
DESCRIPTION:
(ROOFING)
I " k'~. :e,rmit Type SF (MISC.)
T y p e REPAIR
a C~nsur Caci~ 434 flLT. RESIDENTTAL
Jf 4
F
~00 Gk T"" f1QiS T1
REMARKS:
FEE SUMMARY:
VALUATION $2,000
Base Fee $62.25 "
Surcharge g1.00
Tota1 Fee $63.25
CONTRACTOR: OWNER: - Applicant -
~ MILLS BRIAN
, 1665 WALNUT LN
EAGAN MN 55122
' (612)454-3222
I hc:reby aoknowledgV t.hat I havt- read th,ia applics:etiort j~nd stc,tk r.hst the
informatIon is corro*et and aqree to c~tply vrCth iall a-pplicabia Stat.e a€ Pfn.
StaLutns a#id, CiCy a~ ~a-gan Qr43r,ffitre03.
APPLICANT/PERMITEE SIGNATURE &u
'ISSUED B: SIGNATURE I,
r
~X~7IC7k~X~~X7FX~X~X~X~~XX~~X~C~C~X~X~X~XCXCX~~XX~~XX~X~~~XC~XX~~~X~X
CITY OF EAGpN
CASHIEfi: S TERMINAL N0: 32
LATE. 06/03/37 TIMiE: 14:17:33
IG:
NAHE: LISA A M.T.LLS
3210 3001 1665 WALNUT LAN 62,25
2155 3001 1665 WALNUT LAN 1.00
i
To+,al Receip+, Artioijnt: b3.25
CFOi5Oi3
USER IDa NANCY
~
r,
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
30111 CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ,
681 -4675
Nerr Constniction ReauiremeMS RamodeURaoeir ReauiremeMs
? 3 regiatered site surveys • 2 copies of Dlan
? 2 copies of plans (Indude beam & wirMOw saea; pouied fid. deegn; etc.) ? 2 site surveys (extedar additbrm 8 dedca)
? 7 enargy ealwlaGons ? 1 energy calculatlons Mr heated atlCitlons
• 3 copiea of tree preseivation plan H lot platted after 7/1/93
reQuired: _ Yes No
DATE: CONSTRUCTION COST: rDOO'-v O`"""^'""^^""' ~
DESCRIPTION OF WORK r~ -'~U~ ~-OLIS-~
STREETAODRESS:
LOT 10 BLOCK ~ SUBD./P.I.D. ~
PROPERTY Name: hone
OWNER
StreetAddress: I7~ I yLC.,~-t ~.F'1.
City: CA-2 State: /t%/!U Zip:
CONTRACTOR Company: Phone
Street Address: License
City: State: Zip:
ARCHirEC7/ Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address change
and lot change are requested once permR is issued.
I hereby acknowledge that I have read this applicaGon and state that the infortnation is correct and agree to compty with all applicable
State of Minnesota Shatutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
CerU'fiptes of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
. ~ 3830 PILOT KNOB RD - 55922
651•681•4675 „ ~ ~ ~
~5~~ P~~ /
New Cons}ruction Reovirements Remadel/Reoalr Reduiremen}s
? 3 regisfered site surveys showirtg fq. ft, ot lot, sq. k, af house 2 copies of plan
and all roofed areas (20% maxfmum lot coveraae allowed) 1 sef ot energy calcvlations for heoted addkions
> 2 coples ol plans (show beam 8 window sizes; poured tnd. desfgn; etc.) 1 sHe survey tor exferior atldBions 8 decks
> 1 set of energy calculations
> J coples of free preservation plan H lof platted aNer 7/1 /93
DATE: ~ L~. ! / CONSTRUCTION COST:
DESCRIPTION OP WORK: G q ro) m e 41 [ o r,
STREET ADDRESS: 16 6 S w°, 1n ct T L aI G
LOT: 10 BLOCK: i SUBD./P.I.D.
Name: NV ~ ~ rFl r~ dl Phone b s( Y $1{ 3 0 Z 7,
PROPERTY Last First
OWNER
Street Address: 166 li1/ m( h.1~- L a#I e
City mdl State: M l~ Zip: S 5! )L-~
Company: Phone
(area code)
CONTRACTOR
Street Address: License # Exp.
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registratfon
Cih' State: Zip:
Sewer 8 water Ilcensed plumber (requtred tor new constructfon onlv):
1 Penalty applies when address change and lot change Is requezted once permit Is Issued.
I hereby acknowledge that I have read this application, state that ihe informatfon fs conect, and agree to comply wif I applicable
' State of Minnesota Statufes and City of Eagan Ordlnances.
Slgnature of Applicant: '
~.5k~~ LPm~ L
OFFICE USE ONLY D ~r
r '
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received _ Yes - No _ Not Requir d
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-piex ? 12 12-plex "k 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-piex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level O 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool O 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Oniy ? 43 Siding/Soffits/Fascia
32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) l/N Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code e,_
UBC Occupancy 5 -3 sq. ft. 1144 No. of Units Zoning sq. ft. No. of Bldgs
# of Stories ~ sq. ft. MC/ES System
Length 12 q sq.ft. City Water
Width 2v Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning _ Building h/1L- Engineering Variance
Permit Fee 153,2 5 Valuation: $ 9,,,96CJ
Surcharge y,m r
Plan Review 2,Hy2Q- <lgv y16 76$0
License
MCIES SAC CITY Of- EAGAN
City SAC
Water Conn. CASH.LEF: S TEfif17NAl_ N0: 6133
Water Meter DFlTE:: O i/09/39 l' SME: 07 e 7.O c 10
Acct. Deposit In:
S/W Permit
S/W Surcharge NFlMF- BR7AN 5 MILLS
TreatmentPl. 3210 9001 i.665 NIALNUT LN 153.25
Park Ded. 2155 9001. 1665 wAI,.NUT LN 4.00
Trails Ded.
Other ~
Copies
I . ,
Total:
SAC Units '
%SAC Tnta.l F\ecP.1p{. ARIDuTIt: 1.57.25
Cr1 IA. 29f 3
U,:r:.a; r.n~ NANcv
NAlW' . n.OYV[tl', y~ 4~'~ L'b
D>Y! -`.NDy'SS'1l' - : ~ t~i VA` V
7var er•sm. 4
~e.u~a~ o .rertrini.-
%a~
OUTLOT
,8 .
13 ve ^ , , 4, 7 I
8 ;,-~es•ooaaE-~iv~ ~M
hp ~'oooo E ~?sw eeee.,-?vr~.- '~o v , .v°~srv ,ooo.''
~ b ~ 3 /2 e $ 6 tio
~ H~ ~ 8 2 ~ w k~ a'~". ~i ~ ~4 ~~pl~l~~. o o~'Ya y ~i ~ 5? /0 0`^ `~.zs oZ ~ v~•
~ ~Oti~' ~r 9 ~ti ~mb8 i >~i~'ol!~: ~ ~.v___- L/+ N1'•H"E
p,SS.N~\ . HfA~
'aBp ~ \ B :'n /6 ` eld ~ • 'OfM~.. d,`~~' ~8 - ' c
~ e •iL ~ b °I' n• ~.,efo3 w x e
°9' ~'rb'1p rrn ~ n r'~"i e.3~i G,fdOf
a4 N~.`~ S I 0
' W~ . . e~~,~ e.~r,av , ~;vs ,,~r~•rroo• eise.sz
NvT u.ex~z .z9a " ~o ~ .r ~ o
4e ' ' ~'l . E , a , L ~A~ +~`b:y ~
' A7~ p.. rr- o C 1f 1b
. , •isivG
~i °'•4rv[V• ~,P• Il11f ~ . ~.7~1niv'_.. e. ~iri~. SS~ , , ~,~~I~ ~
9 d.1F!d '.a ~,rf1v a-vs7
F1 ` • ~r7N~.MN CF.tliJ%, s,ssV/1n~~ 'f
A c ~t : ~siRr p/ ~ t. o e•It•N72' . = ~ •
~ A
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7~+ p'jIc0~~6 Z
y 1? ~
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p~ h v ~
e ~ Z Z s• ~..-rIro OM yprof
T L 0 r D ~••-nsc ..._~o~ai-._ v.ro- -Jr`, .revsrm~.- ,?vi<aor~ O v r[ 0 7
.YB9'If II'N 70.! K y fd W
~-es as rsvr ixvro
~~vrr ,eo,yo No 32) l20AD
~ •4
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'
,
WOODGATE HOMEOWNERS I & II
1691 Hickory Hill
Eagan MN 55122
February 24, 1999
Brian Mills
1665 Walnut Lane
Eagan MN 55122
RE: Garage Addition
Dear Brian and Lisa Mills;
The Board of Direcrors approves your garage addilion with the folbwing slipulations:
¦ it conforms with the exterior hartnony in the Woodgate community
¦ all neighbors in the azea approve
¦ all city permits and codes are obtained and met
if Uiere is anything else we can help you with let me know.
Sincerely,
~
~ vl1"
Angela Friley, Treasurer
Baard of Directors
~
Woodga[e Homeowners Assoc I& II p
~
1~
~
LO
5 8 9 61 ?4rEw
C4i ~~wy
0
m
~ E 1 Eh15T F~`+E ~ lxc nT
5 5
2ZXZ~~SzY
~ WQ ~~.2= g5~a
I 2o"X 2 y=~~
s _ pkl
~
RESIDENTIAL BUILDING t( 0 `o
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Tclephone # 651-675-5675 FAX # 651-675-5674
NewConsWCtionRepuiremenis RemodeUReoairReouiremenis OfficeUseOnly
3 registered site surveys showing sq R of IoL sq ft of house, and all roofed areas 2 copies of plan Ced of Survey Recd
(20 % maximum lot coverage allowed) i set of Energy CaIwlaUons for heatetl addi4ons Tree Pres Plan Recd
2 wpies of plan showing 6eam 8 wintlow sizes, poured found design, etc. 7 site survey for additions 8 decks Tree Pres Not Reqd
1 set of Energy Calculations Add'Rron - indreate don-sde septic system Onstle Septic System
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail OpUOns seledion sheet (bldgs with 3 or less units
DAtc Construction Cost 5
Sifc Address /~6 S y/o/~y1t4 t G~h ~ Unit/Stc #
~ 9 n SS-/ z- Z
Description of Work 7'`Z;,c- AV $~d' f I~Kri~
Midti-Family Bldg _ Y~ N Fireplacc(s) _ 0 ~ I _ 2
Proper[yOwner ?y Telephoneil~5 3pZ 2
Contractor L2~~j / 7!/-e-
Address z g (N rCity
Statc Zip s.S Jd,rv Tclephonc #(~~?I 73 9 3~ 3
i '
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rides 7670 Cate,orv I Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber Telephone )
Mechanical Contractor Telephone J
Sewer/Water Contractor Telephone )
, r
~[1C1~,;~
I hereby apply for a Residential Building Permit and acknowledge that the infonnatioii is,-y4mpl3te aiid :iuc~yu:uc.
that the work will be in conformauce with the ordinances and codes of the City of~L~agan and tlieatQ,l N4\'
Statutes; I understand this is not a perniit, but only an application for a permit, and ~vork is tw't~ tart viil~owi ?
pcrmit thnt thc work will be in accordance with the approved plan ii c case oF worl 5wl7ich i'e _'_[~i1~VnnJ
approval oFplans.
Applicanr's Printed Name pplicant's Signature
~ For'Offic`e Use ~
City of Eaian ' Pemit#:
~ Permit Fee: / O• v v ~
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675
Fax: (651) 675-5694 i stafl: i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ye-y~.,<._
Tenant: Suite
RESIDENT / OWNER Name: Phone
Address / City / Zip:
Apphcant is: _ Owner ~ Contractor
TYPE OF WORK Descriptian of work: ll~'~ ~ r P-0, 0"B 6
Construclion Cost: b~I~ Multi-Family 8uilding: (Yes No X-)
CONTRACTOR Name: License
Address:
City: S[ate: Zip:
Phone: ContactPerson:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitled Su6mitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan7
_Yes _No If yes, date and address of master plan: Licensed Plumber: Phone:
Mechanical Contrector: Phone:
Sewer & Water Contractor: Phone: NOTE: Pfans and supporting documents that you submit are considered to be public intormation. Portions of
the information may be classified as non-public ii you provide specific reasons that would permit the City to
conclude that the are trade secrets..
I hereby aCknowledge that this information is complete and accurate, that Ihe work will be in confortnance with the ordinances and codes of the Ci[y of
Eagan; ihat I understand this is not a permit, but only an application for a permit, and work is not start without a permit, that the work will be in
accordance with Ihe approved plan in the case of work which requires a review and appro f plan .
x x ~
ApplicanYS Printed Name ApplicanYs Sll;lha ure
Page 1 of 3
Date:
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit#: 9��
Permit Fee: El/
Date Received:
Staff:
2010 MECHANICAL PERMIT APPLICATION
10 l- 10 Site Address: / 6 6 5 1A/01 1 n 0\ sel e
Tenant:
Suite #:
RESIDENT / OWNER
r n^
Name: 6 r- r v. ! V l f l L S Phone: (J 5 (- `tS4-- 3°4
Address / City / Zip: 16 4 5 W'n [ t 4 e
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work: A010( C 6" rA e H6 *ter' I✓6 - lc(19d + r/ e.4 4'
!
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
Furnace
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under / Above ground Tank (_ Install / Remove)
j/ H
k Other N 6 b 4`ta.01C GG1t(r.
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
JJ
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)
$5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
_ $ Permit Fee
- If the Permit Fee is less than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
_ $ TOTAL FEE
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I 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,' -rmit; th t the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
x � t 014\
f"Vtl'
Applicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE
Required Inspections:
Under Ground
Reviewed By:
Rough In Air Test Gas Service Test
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132970
Date Issued:09/15/2015
Permit Category:ePermit
Site Address: 1665 Walnut Lane
Lot:010 Block: 005 Addition: Woodgate 1st
PID:10-84600-05-100
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Brian S Mills
1665 Walnut Lane
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature