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1014 Wedgwood Lane N Receipt r,- `lI MECHANICAL PERMIT Permit No. EITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prinr legib/y Tot, i. Date " 2. lnstallation Cosi 3. Job Address Lot J Blk. ~ Tract ~ 4. Owner 5. Contractor ~ ! K ; ~ ; ~ ~ ' i r • Phone c 6. Address 7. City , , • State Zip ~ S. Building Type: Residential ~ Commercial El Institutional O 9. Work Qescription: New,)6 Add 0 Alier O Repair ? 10. aescribe Fuei Type 11. No. EQuipment STU - M. Ea. No. EQUiament CFM Forced'Air r Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. pther Air Cond. Mfg, Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8700 Recaipt PLUMBING PERMIT Permit Na CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1 . ~ ~ 1. Date IJ '-2- e' ~ 2. Installation Cost ,1 i( ! I ~I'1 we.), , ; 3. Job Address Lot^ ? Blk. L Tract l.ui- ot t~. 4. Owner i"'N 5. Contractor j)I'' Li Phone Ll ~ 6. Address L/ ~:0!` 7. City State Zip 1 ~ 8. Building Type: Residential Commercial O Institutional ? 9. Work Description: New Add ? Alter ? Repair O 10. Describe 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 I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 IN5PECTIaN RECORD vCITYaF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesata 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: {ti'rtif1f4f1 ! 14Nf' M ~ PERMIT SUBTYPE: TYPE OF WORK: INSPECTIOtJ D, . D. . , ,~z, . , , ~ ; , . , ~ , , { , • . . ;s:. , r 1 , . . , F7- Permit Na. Permit Holder Date Telephone N ELECTRIC P4UMBING ~O ~jb Jr Hvac Inspection Uate Insp. Commen4s FOOTINGS FOUND FRAMING RODFING ROUGH PLUMBING /0 PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYp BOARD FIREPLACE FIREPLACE ~ AIA TEST 27 FINAL PLBG 4: FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK FINAL • CITY OF EAGAN ! , , 9"4 3830 Pilot Knab Rosd, P.O. Bax 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # , ! Te w 0100d fer SF DWG/GAR Est Value $65,000 Date NOVEMBER 30 19 84 1014 WEDGWOOD LN NO R3 Site Add Erect ~ Oocupancy Lot ~ Block 4 Se,./s„b. WEDGWOOD ST Remodel ? Zoning Parcel No. Repair ? Type of Const. Enlerge ? No. Stories W Name DAN SQ(3IRFS Move ? Length 5 ~ Address Demolish ? Depth 40 City Phone Grade ? Sq. Ft. Name IiERITAGF. ENERGY HOMES Apprevala fees o~ Address R Assessment Permit 7 326.00 u~ City t;AGAN Phone 5 Woter & Sew. Surchorge 32.50 Police Plan check 164 . 00 FW Neme Fin S^C 525.00 ~O Address Enp. Water Conn. 470,~ 0 ~ W City Phone Plonner Woter Meter ~,.Q 0 Council-~-~~--7~-7~ Rood Unit 260_ 0 0 I hereby acknowledfls that I have read this opplication and stota thot gldg, pff. 11 Parks the informotion is correct ond ogree to comply with oll upplicable APC Total ' $tote of Minnesota Stotutes and City of Eagon Ordinonces. Var. Date Sipnnfure of Permittee IIEP.7TAGF; ZNE~:C~Y F10M.,S I.JC A BuHdlnp Permit fs issued to: on the express condit(on thao oll work shall be done in occordarxe wlt~ll; o'ppliooble State pf Mlnnesota Stotutes ond Gty of Eagon Ordinanus. 8uildinp Officiol ~l Pa mk No. Permit HoIdN Dato Plumbin9 H.V.A.C. u 3 Electric l a ' Y Y Softerwr Inspection Date Insp. Other Footingt zfef Foundation Framiny RouQh Pfbg. Rough HVAC _&~5 Inwlation Final Plb¢ , x Final HVAC Final Ce?'t/OcC. ~ Water Desc?ibe Location: YYell Sewsr Pr. Disp. CITY OF EAGAN Remarks Addition WEDGWOOD 1st ADDN Lot 3 Rtk 4 Parceti 10-83550-030-04 Owner 5treet 1014 Wedgwood La.r?e North state EAGAN MIlV 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. s 1981 58.69 2.93 20 46.97 A013432 1-11-84 STREET RESTOR. GRADING 54/ 1981 186.48 12.43 15 136.76 A013432 1-11-84 Sewer Lateral 5ZI 1981 313.16 20.88 15 229.68 " " SANSEW TRUNK 1981 198.50 13.23 15 145.58 " " SEWER LATERAL 19$1 197.54 9.87 20 158.06 it Sewer Lateral 1982 133.17 8.83 15 106.56 " " WATERMAIN WATERLATERAL r 192.30 A013432 1-11-84 WATERAREA J;aQ 981 98.50 13.2 5 145.58 " " *VJater Lateral 1982 98.57 6.57 15 78.86 rt STQRM SEW TR4C STORM SEW LAT ower ine e ocatio CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 #48035 11-30-84 WATER CONN. 470.00 IP of 8UILDING PER. 9754 SAC 999-00 PARK CITY OF EAGAN N? 9754 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ` PHONE:4548100 /~~D3 J BUILDING PERMIT Receivt # Te 6a wed Ier SF DWG/GAR Est. Value +565,000 Da1e NOVEMBER 30 Iq 84 Site Address 1014 WEDGWOOD LN NO Erect ~ occupancy R_ Lot 3 Block 4 ~clSub. WEDGWOOD ZST Remodel ? Zoning Percel No. Repair ? Type of Const. V Enlarge ? No. Stoties W Name DAN SQUIRES Move ? Length 55 Z Damolish ? Depth _40 S Addrass Grade ? Sq. Ft. City Phone HERITAGE ENERGY HOMES Approvala Faes o Name us Adcimgg 4655 NICOLS RD Assessment Permit ~ CitY EAGAN phone 452-5950 Water85ew. Surcharge 32.50 0 Police Plan check 164_ 0 Fw Name Flre SAC 59%- 0 4,~-~ Address Erg. Water Conn. .470- 0 u ~W City Phone Plonner WaterMeter 63 n0 Council Road Unit g~+l n0 I hereby acknowledge ihat I hove read thia opplicotion ond stote ihat Bldg. Off. 11 3 0 8 Parks the inlormation is correct and ugree fo wmply with oll opplicoble APC ToWI~-.L, 04Z . 5U State of MinnesoM $tatutes a Ciry of Eu9cn rdi Me Var. Date Sipnature of Permittee A Building Permit Is issued to: HERIT E ENERGY HOMES INC on the expren wnditlon iha+ oll work sholi be done in occordance wit lica! nle 5t~ e to Statutn and City of Eagon Ordinonces. Bulldirq 04ficial oll uxX. , ~ . . - ~ ALL CONTRA TORS MUST SE LICENSED WITH THE CITY OF EAGAN ~ INCLUDE 19 SETS OF PLANS, ! 0 CERTIFICATES OF SURVEY f~ 11 SET OF ENERGY CALCULATZONS To Be Used For: Valuation: ~pS,CYJC~• ~ Date: Site Address: / B r t( I-) 45-0G)WO'O i!) 1-0. 0 Ll ' ~ ' • Lot: 3 Block: y- Sect/Sub: Erect: X Occupancy: R"3 Parcel t 0 -~6' o- Remodel: Zoning: (Z-I , Repair: Type Of Const: 7Z- Owner:DR,~ ~h23 SVlc-S Enlarge: # Stories: Move: Length: 55 Address: ~NL1. AOO-r\e. 2S~ Demolish: Depth: 40 City/Zip Code: PVGi\' ' Grade: Sq. Ft.: Phone # : q ~~4 " f '1 y' Contractor: C-~L-RG~ Address: q-655 1,31CpLS (~D. Assessments: Permit: 3ZFj.~ City/Zip Code: r~tCk)~) S S i'a~ Water/Sewer: Surcharge: 32.5` Police: Plan Rev.: 1(o4.22 Phone Fi•re: SAC: 525.°` Engr_: Water Conn: 4"70." Arch./Eng: Planner: Water Meter (93,_' Address: Council: Road Unit: 2110 Bldg. Off.: Parks: , City/Zip Code: APC: ~ nh~~oR- Variance: ~ ~ A J. o~~ 1 1~C Ob~ = ZZ ~ OZ 2004 RESIDENTIAL BUII,DING PERMIT APPLICATION , • City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ~ "T New Construction Reauiremenh RemodeUReoair Reauirements tyH'ice l~s'e OnN ~ 3 registered sile surveys shaving sq. ft of lot, sq. R. at house; and all roofed areas 2 mpies of plan Gert of Survey R~cd _ Y_ LJ (20%maximum lot coverage albwed) 7 set of Energy Calculations for heated addi6ons 7ree P~'Wn Reetl Y 7 9 2 capies of plan showing b~m & window sizes; poured found desgn, etc. i site survey for additions & decks Tree Pr~Reqwr~`~d t~ isetofEnergyCakailations Add'rtion-irMicatetlonsdesepticsystem OnsiteSeptic:System _Y _N , 3 copies W Tree P2servation Plan If lot platted after 717/93 Rim Jaist Dehail Optlons selection sheet (bldgs with 3 or less unifs ~ Date 17 / 2C7Uq Construction Cost -y~ Gv,QQd - SiteAddress 101 4 \AlEO(; N<r,11i UIJk N UniUSte # Description of Work 'PG Q cH f~' ZI TIG4) Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner ~ Nt~`( 4- gItQ~AQh S~ U1 ~ Telep6one #al ) Q514- 092 Contractor ~ F- 4- GU Address iL32 kQoN ItVE E, City WV6r 6t20q- 1'IEI~FY State M N Zip I~S677 Telephone #(C5) )rQ2'4-E`1r. 9 Ek'r rJ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , Residentiai Ventilation Calegory 1 Worksheet • New Energy Code Worksheet (Jsubmissionrype) Submitted Submined • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% pian review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone ) M- Statutes; Sewer/WaterConiractor Telephone#( I hereby apply for a Residential Building Permit and acknowledge that the informatio that the wark will be in conformance with the ordinances and codes of the City of 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 ofplans. N ikF- IzvD~l Applicant's Printed Name ApplicanYs Signature OFFICE USE ONLY Sub Types ' • , ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck X 23 Porch (screen/gaze6o) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding /114 32 Addifion ? 36 Move Buitding ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Altera6on ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy R'3 MCES System Census Code 1~1 3t/ Zoning City Water SAC Units Stories - Boaster Pump # of Units Sq. Ft. J b-2- PRV J # of Bldgs - Length Fire Sprinklered Type of Const Ir, Width / 1-1 REQUIRED INSPECTIONS Foo6ngs (new bldg) FinaUC.O. ~ Footings (deck) ~ FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ RI. _ Air Test _ Final Windows _ Insulation _ Retaining Wall Approved By: , Building Inspector - - - - Base Fee / 5-3 = ~ SGA.K.'W /7vivti+ ,~O -7)-p Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies ~ Other - Total Picate for: tage Ehergy Homee Inc. ,5 Nichola Rasd . „gah, Minnesota 55122 ,TTTI; Wally Hafatad DELMAR H. StH1MANZ ,.»o Wmvon «c wpnrwea UrWw LM M M9W 0 0~- ' ' . 14150 SOUTH POBERT TRAII ROSEM04lMT• MMMNISOTA !!OM MIONE $12 421'1700 _ SURYEYOR'S com"QATE _ Scale : 1 inch ~ 30 Peet • Denotes iron monument qtl~ 0 Denotea aet wood hub M~ Denotes propoaed elevation 932-9Denotes existing elevation ~ r~,,,,,~.~?,. 3. ~ e~s ~ s l~,~~~ , ~ , ; ~ ,~A• rropodea ~ ~r^a ANf L~ - H01786 4~ . N0 • M Let 3 Bloc p ~ O Y I hereby certify that this ~ I Drainage and M is a true and correct ^eP- ~ IIti11Ly Easement ` resentation of I,ot 3, ~ ~ . Block 4, WEDGWOOD F1RST ADDITION, according to the \ recorded plat thereof, q'~ Dakota County, Minnesota. s' 5 82-S4-0pr.c 7S, M41°I p.Iso showing the location of 32 4 a proposed house not staked thereon. Dated: t3ovember 12, 1484 . House staked Plovember ls, 1984 46ziO. l825 / a k a' RESIDENTIAL S 37~~ BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681•4675 New Construelion Reauirements RemodellReoair Reauirements • 3 registered site surveys showing sq. N. of lot, sq. ft. of house; anE all rooled areas • 2 copies of plan (20% maximum lot wverage allowed) . 1 set of Energy Calculations for heated additions • 2 capies of plan showing beam & window s¢es; poured found design, etc.) • 1 site survey for extenor additions 8 decks • 1 set of Energy Calculations . Indicate if home served 6y septic system for additions • 3 copies ot Tree Preservation Plan if bl platled after 711193 • Rim Joist Detail Oplions seledion sheet (hldgs with 3 or less units) DATE VALUATION I(A. Zir SITE ADDRESS 10 l`f WL` bk%(X(30) L.N Il/ MULTI-FAMILY BIDG Y ~N TYPE OF WORK "KAL~d( 7- K-f zx1-- _ FIREPLACE(S) _ 0_ 1_ 2 APPLICANT T^A l~ 60 STREETADDRES3 3 6t C~NAa AUF S CIflDL\LS STATEN~ZIP(~Yd TELEPHONE #M'6A' 2000 CELL PHONE # FAX #~-,IZ' K~2~ •~l O OD PROPERTYOWNER EI-S ~)A NNTELEPHONE#1291 ']i COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIVVLSO"CA Rli1.I:S 7670 CA'1'LCORI' 1 NIINNLSOTA RUI~,[„'nS.7 (d submission type) . Residential Ventilation Category 7 Worksheet Submitted • Ne E e~y 6ad~V~ks~et~u ~ ed D • Energy Envelope Calculalions Submitted ~ JUI 2 9 2002 Plumbing Contractor: Plione H Plumbing systcm includes: Watcr Softcncr _ Lawn Sprinkler gy Watcr Hcatcr No. oF R.I. Ba[lis No. of 13aths Mechanical Contraetor: Phone # Vlcchrmical systcm includcs: _ Air Conciitiouing ['cr. $70.00 Hcat Rccowry Systcm Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that ihe informaTion is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan ~n ces. Signature of Appllcanf - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4l02 ~ -a~ ~nJ il-ls. ~ v -~vrs~- ~ln~.+» • 1 ~~'~e• ~~r-Ilscrica-1 3s: v • ~ ail~ 5rzworv ?4,1 ~ i~ ~~~a ~ ~a IK, aR f32~ e~e 2.or. ~:?Ir7J t-IG~ .7'7 ~lcac( - I/~~J ,041 IN r • ~O~ O 'f 13 .14-=J, -C~Illl-j~!t A~ X .OZV y ~ AP~t`• X 1l~1~-IE ~P~t'fl~iG ~C~ ~I°O X ,a1~1 = 2~Z I oue z x.v29 = 777 vJal-~ ~v~ u , I ? ~ y,/~F.lr~~.:s I CoG r: ,~1 to2 ~ q" 101 Z'1 2 • ~,.jt_I';-~• ii_-~~ 1'Lq' ._._~1.~..'_'~ ~ i~.~• r Certificate for: . - . Bks Ht/55 • Heritage Ehergy Homea Inc. • . 4655 Nichola Road Eagan, Minnesota 55122 ATTN: Wally Hafetad DELMAR H. SCHWANZ L .NO .,WME.OW .W nw:«.a uww L..s n n. err ai w.wn. . . - 14750 SOUTM R06ERT TRAIL IIOS[MOYMT. ENNINOTA MUN P1101M its 4iqM . . ' .~c . - suRVEraR"{ ClQ.71 ,~1 1E _ _ . . . ; W I' ~ Scale: 1 inch = 30 feet No,~r7.~ ' • Denotes iron monument ~ Denotea aet wood hub 0 Denotea proposed elevation 932.9Denotes existing elevation l/ y • . vi ~..~P I~ C'1 ' . Pmposed House M 1 Lot 3 Biock a o N ~ / 0 ~ O I hereby certify that this ~ M y is a true and correct ^ep- Drainage and ' ~tillty Eseement \ resentation of Lot 3, Block 4, WEDGWOOD FIRST ' - ADDITION, according to the \I ' I~ recorded plat thereof, Dakota County, Minnesota. s'~- 5 82-sa-rs~ ys 32 q"~~'~ Also showing the location of a proposed house not ataked thereon. Dated: November 12, 1984 House ataked November 13, 1984 ~ RE6ISTMTION N MINNESOiA O. l625 L ~ BL i,/ CITY USE ONLY RECEIPT SUBD. W ~F RECEIPT DATE: 9 9 PERMIT# -~o 1999 PLUM$INfi PERMIT (RESIDENTIAL) crrY oF f-asm saso PI.or Kxos gn f.A&AcN, MN 55] EQ (651) 6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit i backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Ra!h4uh a~.vn 1 -1 x Floor drain 3.00 x = $ Gas i in oUtlet " minimum -1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laundr tra 3.00 x = $ Lavato 3.00 x = y Minimum fee alterations to existin dwellin 30.00 x = $ Private Dis osal 5 stem new/refurbished ' re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/repair 30.00 x = $ Rou h c enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water Softener if dwellin under construction 5.00 x = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x _ $ State Surchar e 50 $ j 0 Total g O, oRgmlrrler; Call for incpcEtiqne nf al4praljnne, i c, wafgr he3fors, wafor 5pffcilQfs, 91C. -----------'----------"--"-----------------'------------'----------------------------'--I hereby acknowledge that I have reaa this appliration, sfate that the infortnalion is correct, and agree to mmply with all applicable Ciry of Eagan ordinances. It is the applicant's responsibility to notiry the property owner that the Ciry of Eagan assumes no liabiliry for any damages caused by the City during its normal operational and maintenance ac6vities to the tacilities constructed untler this permit within City property/right-oi-way/easement. SITE ADDRESS: ,/O,/~/ C?~D~c6?o a D L,v i? OWNER NAME: : S/ ~4(11'-r TELEPHONE /29,- (AREA CODE) INSTALLER NAME: IAIX i(OOTt-,e T<c.~~i.?G TELEPHONE 6/1 ,~'S/- p.s s'.5~ (AREA CODE) STREETADDRESS: ~~pa ~'Hr~vuf pz CITY: STATE: ZIP: GNATURE PERMITTEE ' CITY OF EAGAN PERMIT 3830 Pilot Knob Road PERMITTYPE: BuiLozNc Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 9 7 9 (612) 681-4675 Date Issued: 10 / 2 0/ 9 7 SITE ADDRESS: 1014 WEDGWOtlO LANE N LOT: 3 BLOCK: R WEDGW000 iST P.I.N.: 10-63550-030-04 DESCRIPTION: " (N0 BEDROOMS) B~r~ilding~ermit Type BASEMENT FINISH ,~Pu3ldirrg W&rk Type ALTERATION ;/Census Code ~\434 ALT. RESIDENTIAL , r' Ld REMARKS: A SEPARATE PERMIT IS REQUZRED FOR ANY PIUMBING OR ELECTRICAL WORK FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: _ ppplicant - sT. LIC OWNER: VALLEY INVESTMENTS CONST 14545191 0004241 SQUIRES OANNY 2461 LEXINGTON AVE S 1014 WEDGW000 LN N MLNDOTA HTS MN 55120 EAGAN MN 55123 (612) 454-5191 I h_gr~eby acknowledg-e thatI have read~thit applicaxiot+ an-d stiatetha-t- 'the information is correct and agree to comply.with all applicable State af Mn. II~ Statutes and Gity of Eagan Ordinancas. ~ru~.a R~~;~ I rn~- - APPLIGANTlPERMITEE SIGNATURE ISSUED B SIG AT RE \1 3 0419 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681 -4675 New Construction Reouirements RemodeVReoair Reauiremants ? 3 registered sde surveys • 2 copies of plan ? 2 copies of plans (InUude beam & window sizes; poured fid. design; etc.) ? 2 ske surveys (exterior addRions & dedcs) ? 1 energy calculet(ons ? 1 energy calculations tor heated additions ? 3 eopies of tree preservation plan if lot platted aRer 7I1193 required: _ Yes _ No - DATE: I D r"' I'-f ^`~I7 CONSTRUCTION COST: DESCRIPTION OF WORK: ~,e F, Nt ( STREETADDRESS: LOT BLOCK i.~ SUBDJP.I.D. U PROPERTY Name: ~IJ~ ~~y v~(crfe.AS Phone#: _ OWNER StreetAddress:l19L.`f City: E#6At State: ~l rNn~ Zip: CONTRACTOR Company: I )A~ 4J J , Phone Street Address: 137~f0 / L~61-JGta.J ~ License City: AeiJDa7-A 77GTS State: Z1p; SS/~-d ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & water licer.ned plumber (new construction only): . Penalty applies when address change and lot change arc iequested once permit is issued. I hereby acknowledge that I have read this application and state that the info 'on is corcect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. - ~ Signature of Applicant: OFFICE USE ONLY I 110190 ~ Certificates of Survey Received _ Yes _ No ~ 14~( Tree Preservation Plan Received - Yes _ No _ Not Required OFFICE USE ONLY e> r1 iC ~ , BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex ? 11 Apt.lLodging X 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. o17 Swim Pool ? 03 SF Addition ? 08 S-plex ? 13 GaragelAccessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _ plex o 15 Deck WORK TYPE 0 31 New X0 33 Alterations o 36 Move ? 32 Addition 34 Repair ? 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. Depth Footprint sq. ft. SAC Code Census Bidg ~ Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies %:SAC SAC Units "i F ~e~l~laafa~JSi~sr~a~t~:t~al~h~asaaa~osri;ss:a:~ar~~tf.~:rr~~r=~s~.r`~.~~, a F 0 R C I T Y U S E O N L Y ' . , PERn1IT ISSUED FD1us' $ /D S Q Sz'i'iE2 ncoalrT (IlIC:.~D: SliRC[??i:G~) $ /d- S d WATER PERC1IT (INCLUDE SURCHARGE) $ WATER METER/COPPERHORN/OUTSIDI~: REACER $ WATER TAP (INCLUDE CORPORATICN S;02) $ SE:1ER TAP $ ACCOUNT DEPOSIT - SEidER $ ACCOUNT DEPOSIT - WATER $ WAC $ u~-~~ ~rJ SAC $ TRUNF: ?+IATER ASSESSME:IT $ TRliNK SES4ER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL $ ANIOUiVT PAID/RECEIPT # DOES OTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGIIT OF WAY? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO E[VGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO TFIE FOLLO:PING CONDITIONS: APPROVED BY: TITLE: DATE : _/:2 - l D-- ~ ~ MR.MwMw OL.e ws6 w.40 FtM w w iE sIM w.~ &*Msf ~w Ra RM Ma Mr wm 1 ~ i ' z/$<} _ ' ? " ~ ; CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTZO:T (PLEASE P9INT) 1) PROP= ADDRESS: MAX4- J D/ Lf (n)~--~ ,y ~ LcJo 0 1> LEC',.aI, DFSCRIPTICN: 3' (Lot/Block/SubdLVision or Tax Parcel Z.D. Nunber) li E{IS='2:G ST.°.CCP':2E, DaT:.' 0F ORIGi IAL BiILL`L~IG P=T ZSw?iaC:: , P4=Sr.~.: ZC`IPX:11--RC?OSa) i5:_ IR~'R-1 SI-INGL.°. rPmffI.Y ? R-2 DUPLE;.Y ('?T,No Wi ITS) Q R-3 TGSvNHOL'SE (THftF" + LNITS) ( UNITS) p g_4 AnpRT=~;m/CvmC'.~~1L1IIL'm ( Wi ITS) 0 COL`~ME.4CIAL/RETAS7,/OFFICE ? aMUSZRIAL ? INSTIT[JTIONAL/GCVERIMiVT 2) APPLIC~~+T (PLEASE PAINi) 11ar1E: CA c l A,Ccy~-`~t AnDREss: CII1', STATE, ZIP: /oAYi~ PHO.IE: L/ j) pIjJMBER (PLEASE PRINT) FOR CITY USE OHLY NkM E: 11Pf ?O T7~ L PLUXQHiS IICENSE: ADDRESS : u Active CITY, STATE, ZIP: Expired -F4~~ i t ~ Q PHOiVE: LJ5 L/-(~b y.~~ PLIIMB:R LICENSE H'~c~a~, No Record F-~ att nitia 4) O=p,p]'p/(Jp7pIM (PLEASEPRINi) ruuME: 77 )+6 - AnDRESS: CITY, STATE, ZIP: ~}--tof-~-,tJ PHONE: f - .SC1 ti f~ 5) INDICATG FVFIZCH PERNLIT IS BEING Rf•QUESTEED: &'C.'CNT]ECTION TO CITY Sa]ER JR-CO*,iv'ECI'ION TO CITY SVATER ? r1I'f'.ER (PLEASE DESCRIgE) 6) INDIG;.~ O`IE: ? PL,°,;SE F?OLD APPROtJET.J pg2:4IT FOR PICi:-UP gY ONE OF A6WE ~°L.FASE MAIL APPROVFD PII2MiT 'Iq 1, 2, 3, 4 P,BC71E (Circle one) 7) SI='I[,:cE: jy~., DAT'E: 0 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: 096 D Permit Fee: Date Received: J 2 Staff: ( �� 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Q \ \ Tenant: Suite #: RESIDENT / OWNER TYPE OF WORK CONTRACTOR Name: ban Address /City / Zip: Description of work: Construction Cost: :r Phone: V'1 `-t 4 V-1 Applicant is: Owner 4•'D ontractor cP1/2ii* (2eUel S2 Multi -Family Building: (Yes / No ) Name:` p'1Q 04.3 COM License #: / Address: f ,c)c) Ci a O L 4t1/e/ F G ko t l State: /9/A) Zip:, 'S J f Phone: C3S"-7 9 $°'- J' Contact:'C),'- r) ke Email: 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: CALL BEFORE YOU DIG. Call Gopher State One Cali 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 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 wo . will Se in accordance with the approved plan in the case of work which requires a review and apo .f plans. r1 z (S-tc.) Applicant's Printed Name s Signature Page 1 of 2 env' ©r EAGAN WATER SERVICE PERMIT lot K flak Road PERMIT NO.: 5816 P.O B 2'11 9 12- 10 MN 55121 DATE *ago: No of Units Ow Reritape Brierlry Bones Address: Site Address: 1014 Wed od In No 1.3 B4 Wedgwood tot Plumber. Inaglanigit Dakota Plbg Meter No.: Connection Charge: � 47(7t .40 pd 15.00 dd Size: Account Deposit: 10.00 Pd Reader No.: Permit Fee . 50 1 ogres M Comply with the City of Eegen Surcharge: 63.00 Fd Slater Ordinenea. Misc. Charges: Total: and born By Date Paid: Date of Insp.. 17//9 insp.. TY OF EAGAN SEWER SERV��REItN11T 3830 "If aobrRoad 7065 P. O,,ox 21 199 PERMIT NO.: Eagan, MN 55121 r- DATE; 12-10 .84 Zoning: El/ No. of Units: _______ Owner: Her -fi argv_R es Address: Site Address: 1014 W ood In N I3 B4 Wodgrood 1st Plumber: Dakota Plbg 11/30/84 8035 ; 00.00 pd agree to comply with the Wkingan Connection Cho : , 4a5 .0S Opd Ordinances. '. Account De t: A CA' • pd y Permit Fee: 10.00 pd 1 Suo . 50 pd $Y 4 1 Mi • rgess Date of 1 Total: Insp.: / y Date Pdid• Use BLUE or BLACK Ink r For Office Use Permit I C411100 non ity of Ea a~ I bay Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Zt N Unit Name: v 1 /e ✓ Phone/ V IC11 Resident/ ,y L, f J Owner Address / City /Zip:// ryP L~ /J Applicant is: Owner. Contractor Type of Work Description of work: 1 C_ VIA_ Construction Cost: Multi-Family Building: (Yes / Nam ) Company: Le Contact: LY97~=1C Contractor Address: city: t-d State: ' Zip: Phone: 21 2 '~3~ License Y/6 Lead Certificate IJ L° ~y ~ If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I 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. 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 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. Ap licant's Printed Name A plicant's Signature Page 1 of 3