1972 Timber Wolf Tr S
, cIrY oF EAGaN
~ y 3795 Pilot Knob Road fegen, MN 55122 N2 5984
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be usad for Est. Value Date , 19
Site Address Erect p Occuponcy ~
~
Lot Block ` Sec/Sub. Alter ? Zoning
Parcel #k Repoir ? Fire Zone _
Enlorge ? Type of Const.
W. Name Move p # Stories
; Address Demolisfi ? Front ft.
b
Ci Phone Grade ? Depth ft.
°C Nnme • I 1 ? s^: . ~ti,tr.er Co~structicr: ~rovals Fees
o -
u~ Addross - - - • - r, Assessment Permit
F, Ci p~~ Water 8~ Sew. Surchorge
F Police Plan check `;r,FW Name Firc SAC
!K Address En9. Water Conn.
iW Ci Phone Piunner Water Meter
Council Rood Unit
I hereby acknowledge that I hove reod this application and state thot gldg. Q{{.
the information is correct and agree to comply with all applicoble APC Total
State of Minnesota Statutes and City of Eagan Ordirwnces.
Signoture of Permittee
A Building Permit is issued to: ~ ' f ' , " •-j ' ~ ~ = ~ - on the express tondition thot
oll work shall be done in accordance with ali applicable Stote of Minnesota Stctutes and City of Eagon Ordinances.
Building Offlcial
. •
r«+.+r # oafe iawa r..enltf..
Plumbing '
Mechonical Y(j
' ' ' 2-
INSPECTIONS DATE INSP. I
Rouph-In Final
Footings / Inw. Dote Insp.
Foundotion Plumbing ~
Frome/ins. Mechanicul
Final
I ~
Remorks:
arr oF EAGAN
3795 Mfot Keob' Roed '
Easaw, MinneaoM 55122 INSPECTOR NOTIFICATION
"o. PboM: 454-8100 REQUIRED BY LAW
r.bi,.,_. PERMIT FOR ALL INSPECTIONS
-
Oote: . 8'2., Receipt No.. ~
$ingle I
Site Address: ii'`heI"nOif Residentiol
lot Block SublSec. '~ad~l~~~ Multi Res., Comm./Ind. I
Nome i;-attner Conetruetion New/Alter./Repair ne~r,
~^ddress 11913 H3Rh18z1d ViAIV CiT. Cost of Instollation
City „~.irnsville, ?fn. Phone: 890--3992 Permit Fee ?n,nr.
Nome ~s t.-nderaon P1u:ib~rg Surcharge '
.
~ Address 2C5.2 BiLr Oe.k DT.
~ Cfty Phone: Totol This Permit is issued on the express condition that oll work shall be done in accordance with all opplicoble Stote of
Minnesoto StotuYes ond City of Eogon Ordinonces.
Buildin9 Offitiol
cirY oF EAG?N
3795 Pflof Kno6" Read '
Eayoe, M1nwesote 55122 INSPECTOR NOTIFICATION
No. - Phom: 454-e100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Date: - Receipt No.:
_ Single I
Site /hddress: TA'~1~~:7:Clf - Residentiol
Lot ' 81xk 1 Sub/Sec. Multi Res., Corr+m./Ind. I
Name 14 t"ler '.,czict:-uetior. New/Alter./Repoir
s Address i: !i ~?{i^hla.1 Vie^r Cir.
Cost of Installation
O
City Phone: 800-3cf:7 Permit Fee
Nome Surcharge
.
~ Address
~ Ciry ~ - Phone: Total
This Pertnit is issued on the express condition that all work sholl be done in attordonce with all opplicAble Stote of
Minnesota 5tatutes ond City of Eagan Ordinances.
Buildinp Official
CITY OF EAGAN
3795 Pilot Keob Reed
No. Eosen. Minnesots 55122 INSPECTOR NOTIFICATION
Phone: 454-8100 R EQU I R ED BY LAW
FOR ALL INSPECTIONS
' PEltMIT
Dote: Receipt No.: .
Single I
Site Address• Residentiol '
Lot ~ Block J Sub/Seu/ 'zGG±)1..)/G'-XUU ~ J Multi Res., Comm./Ind. I
Nome New/Alter./Repair
.
; Address Cost of Installotion
O
City Phone: 1/ Permit Fee
Ncme Surchorge
.
_ ~ ' . .
~ Address 7 _ f'-»•n'
0
0
V _ .
City Phone: ~ - Total
This Permit is issued on the express condition thot all work sholl be done in accordance with all opplicable State of
Minnesoto $tatutes and City of Eagan Ordinantes.
Building Official
CITY OF EAGAN
3795 Pilot Keob Rood
Eayen, Minnesota 55122 INSPECTOR NOTIFICATION
No. Phone: 454.8100 R E Q U I R E D B Y LAW
PERMIT FOR ALL INSPECTIONS
.
Date: Receipt No.:
Single I
t Residential
Site Address:
Lot vLti Block Sub/Sec. Multi Res., Comm./Ind. I
• ~'i". ` ' .
Name New/Alter. /Repof r
. ~ '
~ Address Cost of Installation 7City Phone: Permit Fee
Name Surchorge
.
~ /lddress ^
,
Ciry ~ Phone: Totnl
This Permir is issued on the express condifion that all work shall be done in occordance with all opplicable Sfate of
Minnesota Statufes and City of Eagan Ordinances.
Buildinfl Officiol
CITY OF EAGAN Remarks
Addition MesBnvland lst l~dditinn Lot- 419 Blk 1 Parcel 10 48050 048 01
Owner Cqtby(lf. ~}l `~-ii•'~.~ •;l.,.i Street 1972 S. T1111be]c NO1! Trail state j%aqan, Mli 55122
~
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STR EET R ESTOR. mP ./4 I . 158.99
GRADING
SAN SEW TRUNK ~ 43.74 A009271 7 24 80
* SEWER LATERAL ~ 1981 5 1
WATERMAIN
* WATERLATERAL 1951 IO
WATER AREA / A009271 7 4 O
STORM SEW TRK 1971 28-7.92 14.15 20 141.$2 A009271 7 24 g0
* STORM 5EW LAT 1981 IO
* s s 1981 10
CURB & GUTTER
SIDEWALK
STREET LIGHT
185.00 20106
WATER CONN. 305.00 20106 7/23/80
BUILDING PEFi. 5984 20106 71231 0
s,ac 525.00 2010
PARK
1NSYL(:'1'lUN ilL(:UK1)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: •~3,6 4 ti
Eagan, Minnesota 55122-1897 Date Issued: • ~ ~ ' ' ~
(612) 681-4675 '
SITE ADDRESS: ' 00 APPLICANT:
~i{,Ae
, , ..!ri:i+' .~ii i . . . • . . . . , PERMIT SUBTYPE: TYPE OF WORK:
. . . . , ~
INSPECTION D• . DA
,I1 i1•,
~ . . . . . . _ - , ~ ~ ~
~ J
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUNO
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
corvDucnviTv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN SEVNER SERVICE PERMIT
3795 Pliot Knob Road PERMIT NO.:
Eogan, MN 55122 DATE:
Zoninq: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agroe to eomplr with the Gty of Eagan Connedion Charge:
Ordieeneat. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Dnte of Insp.: Total:
Insp.: Dote Paid:
;rrv oF EaGaN WATER SERVICE PERM{T
3795 Pilot Knob Road PERMIT NO.:
Eogon, MN 55122 DATE: .
Zoning: No. of Units: '
Owner. -
Address:
Site Addresr.
Plumber. .
Meter No.: Connection Chorge: '
Size: Account Deposit:
Rp:.ier No.: Permit Fee:
1 agree to oomply witl+ !be City of Eagan Surcharge:
, Ordieanees. Misc. Charges: ,
Total:
gy Oate Poid:
Date of Insp.: I ??sP•:
j9'lv,5- 7'1d c1Gn.6,e,U Wo_i~
CITY OF EFIGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PERNIIT APPLICATION 1 set of energy calculations.
0-a-0 D
7b Be Used For ~a Ie Valuation $i Date
Site Address /9,7,j OFFICE USE ONLY
Lot ~ Block _L SeC./Sub. Erect X OccvPanc3' ~
Parcel Tm-;5~ e/ Alter Zoning
Repair Fire Zone ~
Owner: Enlarqe Type of Const.
Address: Move # Stories
Denblish Front ft.
City/Zip Code: Grade Depth ft.
Phone
1 APP~VALS FEES
Contractor: k Vtn~i o~S~ Assessments / 4 ermit
I ?4ater/Sewer Surcharge V7 A =
Address: 9/3 Police Plan Check 0/ 7~
City/Zip Code: /5 u r~s u~ 1 G~ Fire SAC 15-
Water Conn.
Pnone S(
Jc ~ T
Planner Water Meter d
Council Ro Unit ~
_ Arch./F.ng.: Bldg. Off. r~JAoir_1~~a
Address: AFC 7~jC
City/Zip Cocle: 10&
Phane # : =AL
~l,\TCX-XJ ~J'\l..•y\p,~-~ ~'I v~J 7/~3~_
This request void ' J 5!
18 months from 77528
~
Date of this Request Fire No.
I, as ? Licensed Electrical Contrac[or OOwy,er,o hereby request inspection otthe above electri-
cal wiring installed at: /y
s
Street Address oz Route No. ~t ~~Jt ~A.o.:. City ` f v
Section Township Range County ~Shcfc%/W
Nhich is uccupied by %J`~w
(Name of Occupant)
Is a roughin inspection required on this job? No ? YeZW Ready Now ? Will Call,r2K
PowerSupplier ~lLK.c~ iF-Address ~li.c.cn.~~ru
Electrical Contractor IG~ gfR Contractor's License No. _
(COmpany Name)
Mail'utg Address 7 ~ .i
'(Electrlcal ContrOCto,~®r Ownef Making T~I Installation)
Authorized Signature + Phone No. 3Yf7
(E rlcal Contr tor or owner Making T111s Installation)
~~1 ~n~~~~ ci0 tt ~D ~Op~ Thisinspectionrequestwillnotbeecceptedhyffie
s . State Board unless proper inspection fee is endosed.
Minnesota State Board of ElecVicity /
Griggs Wdway 61dg. - Room N791 dS EB-,}OU01-O.y
,J9z1 Uriversity Ave., St Paul. Minn. 55104 - PMne 297-2111 go~ 0
REQUESTzFOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY TH15 REQUEST 7 7 5 2 8
Type ot BuAding New Add. ReP• Check Applisnces Wired For Check Equipment Wired For
Home 0 Rnnge ? Temporary Wiring ?
Duplex Water Healer ? Lighting Fixmres ?
Apt. Bidg. Dryer ? Eiectric Heating ?
Commercial Bldg. ? Furn. ~ Silo Unloadei El
Industrial Bidg. A'u no - Bulk Milk Tank ?
Fazm ? ? ? pList pList
Other ? ? ? HererS~ Heheis~
f
COMPUTE INSPECTION FEE BELOW
Se[vice Enhance Size: u Fee FcedersflSubteedeis: n Fee C'ucui[s: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 ta 30 Am ies ~G
101 to 200 Amps. 31 to 100 Ampeies 31 to 100 Am eies L~
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Txansformers RemoteControlCirc, Partialorotheifee "e
Signs S ecial lns ection Minimum fee $5
Remazks TOTAL F E
C. ep
I, the Electrical Inspector, hereby certify th e~ m~~s {ction has bee ma e.
(Rough-in) ~ ~O~
(Final) DateT~ T3_ b= 0
This request void
18 months from
CITY OF EAGAN
3795 Pilet Knob Road Eagan, MN 54122 N2 5984
PHONE: 4548700
BUILDING PERMIT APPLICATION Receipt # "K4
To ba us¢d fer SF DWG. Est. Value 48,000 Date 7-23 , 19_£30__
Site Address' 1972 S. TiIDber WOlf Tr. Erect g}[ Occupancy R3
Lot 4$ Btock 1 SeclSub. MeadOWl&s1dS Aiter ? Zoniny Rl
parcel # 10 48050 048 Ol Repair ? Fire Zone 3
Enlarge ? Type of Const. V
w Name Move ? # Stories
; Address Demolish ? Front - 5g ft.
b
Ci Phone Giade ? Depth 35 fr.
~ Name William Huttner Construction AppfOV°18 Ffts
Zt
Address 11913 Highland VieW Cir. Asseume nf1G 7-l 5 Permit 135.50
~ Cit y 2ur'T1 Vl 'hone 89C1-3.g9.2 Water & Sew. Surcharge 24.00
~W polite Plan checkh7.75
w Nome Fire SAC 525.00
x-u Address Eng. Water Conn. 305.0~
0
<W Ci phom Planner Water Meter 60.0
Council Road Unit 185.0~
I hereby acknowledge thot I have read this application and state that gld9, pff,
the information is correct and agree to mmply with oll applicable APC Totai ~ i.302 _ 25
State of Minnewta Statutes and City of Ea9on Ordinonces.
Signature of Permittee .
A Building Permit is issued to: William Huttner Construction on the express wndition that
cll work shall be done in occor,d(g~/~~ce all jap.ypI"~wrb`lp State of Min1nesota Statutes and City of Eagon Ordinances.
Building Officiol V" " ~ .
4e"~N-1.s.
~-{rl'~'°1 '
i ~"~`1T1'°
....C~rrfiftrttfr of "l"rrupttnrij
Citp of Clgan o
~Br#?urimeut nf ~iuilAiiin ~J~ts}~ertinn ~ ° .
Tbh Ctrtifiratt ittutd Puriuaru 1o tht nquiremrnu of Sntion 306 of tbe Uui f onn BuiGling +
~ i;~ Calr mtifring tAat at the trme of ittHarut thit thurture wat rn complidnrt with tix variout ;
ordinarurtof theCity+rguGuingbuildingronrt+udiortorute. Forthefollounng:
E~ u..cWar.tim SF DWG amg-rondt No. 5981+
ooo~~ iYa R3 *rrcm,uucuW V FM zon 3 uNotsrn,m« Rl y,
ftufts Wm. Huttner ,,,d~ 11913 Highland View Cir,Bu'
1972 S. Timberwolf L48,B1,Meadowlands
BY
aw: 9-3040 ~ -
: ~ . . ,
° ~.l~~~~„ J ~ ^ +m. ~ . ~ "l ~b'• ,
;
~
RESIDENTIAL BUILDING
~ Permit Application
City Of Eagan
3830 Pilot I{nob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Construcfion Reauiremenis RemodeVReoairReauirements OHice Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cert o( Survey Recd
(20% manimum bt coverage allowed) 7 set of Energy Calculadons tor heated addi6ons Tree Pres Plan Rerd
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey for addNOns & decks Tree Pres Not Reqd
isetofEnergyCalalatlons Add'dion-irMicffieifon-sResepticsyste+n _On-siteSepticSystem
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Oefail Options selection sheet (bldgs wilh 3 or less unifs
Date _ Q ~I ~4 / / ~a Construction Cost UI _Ns~~o
Site Address t YY1CcJl l~a lll'' 11 Q~a <,I. UnidSte #
Description of Work 1 ;%n~~ ry,:
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~ Q,` v Telephone #(6S`) q/q~ T64 P
RMA HOME SERVICES INC.
Contractor Home Depot Installed Sales
3200 Cobb Galleria Pkwy., Ste.#200
Address Atlanta, GA 30339 C'ry
State 763-542-8826 _ Telephone # ( )
BG20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Licensed Plumber Telephone )
Mechanical Contractor TelepMoFle- l'~
ll~ l
Sewer/Water Contractor Te p E.e ) it
~ ~ r$19 ~ , . ; I;
ay
I hereby apply for a Residential Building Permit and acknowledge that ttie-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 applicaUon 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
app oval ofplans.
5J 0, ~~(L~
~ ApplicanYs Printed Name %pplicant's Signature
OFPICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-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-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New ~ 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move 41dg. , L] 42, Demolish (Foupdation) ? 45 FFre Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof 46 Windows/DOOrs
? 34 ReplaCement , 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation: Occupancy MC/ES System
Census Code Zoning City Water
SAC Units _ Stories Booster Punap
, . , , .
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIREDINSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addilion) _ Plumbing
_ Foundetion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Afr/Gas Tests Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
-
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Pertnit & Surcharge
Treatment Plant
License Search
Copies
Other
Total - . , , ,
I
, . . . . . . , i
I
~
Installed Siding and Windows !
y. , 4 . .
LIMITED T'QWER OF ATTORNEY
~
,
, i
,
;
COUNTY OF COBB I
STATE OF GEORGIA j
KNOW ALL PEOPLE BY THESE PRESENTS: ~
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania l
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales located at 660 Mendelssohn Avenue North, Golden Valley, MN ~
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said attomey-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such ,
form as may be required by the municipality) a permit application, or any other '
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and i
repair of windows and siding (the "Work"). j
i
The powers conveyed to the Agent by this Limited Power nf Attomey are ~
limited solely to the express powers delineated herein and appiy solely to the Work.
This Limited Power of Attorney shall expire and automatically be revoked on the 21 st i
day of Iv1ay, 2004, which date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence. i
IN WT_"!NFSS WHEREOF this Limited Power ef Altomey is executed this ~
21st day of May, 2003 ;
. i
I
David N. Katz j
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003. i
~
(`(1~ ~c : n
Notary P ic in for the State o eorgia
h4y Commission Expires: January 21, 2006 ~
396816.v3 '
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPO.Y
PERMIT
= CItY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 5 4 S
(612) 681-4675 Date Issued: 10 J 0 2/ 9 8
SITE ADDRESS:
1972 TTMBER WOLF TR S
LOT: 044BLOCK: 1
MEflpOWLANDS 1ST
P.I.N.: 10-48050-048-01
DESCRIPTION:
ftER00F
Bwf1din'§~ ,Permit Type STORM DRMRGE
Building 4:fork Type REPAIR
,~rsnsus Gade 434 ALT. RESTDENTIAL
~
, . ~
. , a
_
r .
4 ( v, ~ . .
d
REMARKS:
FEE SUMMARY:
CONTRACTOR: OWNER: Applicant -
6RUT5KY NIKOLRY
1972 TZMBER WOLF TR S
EAGAN MN 55122
(651)688-2774
T hereby aeknowledge that I have read this applicatian and state that the
in€ormation is cqrrect and agree to comply With all applzcable 5tate of Mn.
Stetutes antl City of Eagan Qrd9,nances.
APPLIGANT/PERMITEE SIGNATURE ~ ISSUED BV: SF ATUR
i
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
~ cixY oF EncAN /
3830 PII.OT KN08 RD - 55122
J -r 681-4675 ~
New Conatrudion Reouirements RamodeVReoair Reauirements
? 3 registerod ske suneys ? 2 copies ot plan
? 2 wpies of plans (inGude beam 8 wirbow sizes; poured (nd. design; ek.) ? 2 site surveys (exterior adddions 8 decks) • -
? 1 energy calalations ? t energy calculations for heatad adddions
? 3 copies of tree preservation plan if IM plaCed after 711193 required: -Yas _ No
DATE: 1Cy _;-q0 CONSTRUCTION COST; 'Ji, q, O 00 . a~
DESCRIPTIO - WORK: _ Cl/lOI t~~) 11~C7 ~O C~ i=
STREE AT DDRESS: 1 B j'2 W p Lt= S C Ir'}G F"I L(
LOT: ~ BLOCK: ~ SUBDJP.I.D.
m n c~ ~ s
xame: ~12(,iT~~LI N~KCJ(-IA~J Phone#: (G61) LPl~K-a3 4q
PROPERTY 1,asi First '-t
OWNER
Street Address. I imbQ2 W o IV S-
City 65-Q c a State: ~l I~{ Zip:
CompanyE_sP.~ P1 N~], (.i..' I ' ~CVr Phone (~g a --7 14 N
CONTRACTOR Ili
Street Address: \ i VY-\ bo.2 VJD I{~ ' . 5' • License k
City r_~C3State: ~N Zip: C]6:5~14 D,.
ARCHITECT/
ENGTNEER Company: Phone
Nazne: Registration
Street Address:
City State: Zip:
Sewer 8 water licensed plumber (new construcbon only): . Penalry applies when address chang
and lot change is requested once permit is issued.
I hereby acknowiedge that I have read this application and state that the infortnation is correct and agree to comply wRh all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
.
Signature of Applicant: Lil~ J
OFFICE USE ONLY Certificates of Survey Received _ Yes _ No
Tree Pceservation Plan Received _ Yes _ No _ Not Require
:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Dup{ex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Mufti Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-piex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscelianeous
? 05 SF Misc. ? 10 _-piex ? 15 Deck
WORK TYPE
? 31 New ? 33 Aiterations ? 36 Move
O 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 Fcotprint sq. ft. SAC Gode
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/W5 SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
SAC Units
M)- s / ~IJ1
2007 RESIDENTIAL MECHANICAL rExMIT arrLrcATiorr
City OfEagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675
Ptease complete foc single family dwellings & townhomes/condos when pemvts aze required for each unit
Date a
Site Address ~ L/ o~ ~m ~(l/lJoW 1c~S Unit #
Property Owner V-c:. d' -<-vJ MoY a.ri Telephone )
Contractor ~s- 6x~
Street Address ~'50s- CrQ-'i pApc~~~ City
State p~J1(V - Zip <~~?>O(6 Telephone #(~So~.
Bond#: Expires: J.2^ aZ~^ z0C1-7 .
The Applicant is _ Owner ~ Contractor _ Other
Fire repair (replace burned out appliances, ductwork, eYc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a buiiding.
Add-on or alteration to existing dwelling unit $ 50.00
~ furnace _Additional ~Replacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ .SO
Total $ _50
I here6y apply for a Residential Mechanical Pemilt and ac}nowledge that the information is complete and accurate; that the work will
be in confozmance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand ttus is not a
permit, but orily 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 appxoval of plans. Applicant's Printed Name Ap icant Si ahue
2007 COMMERCIAL MECHANICAL rERMiT arrLicaTroN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. commerciaVindustrial buildings .
multi-famil buildin s when se arate emiits aze not re uired for each dwellin uni[
Date / /
Site Street Address IInit #
Tenan[ Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond 'Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _Interior Improvement _Install Piping _ Processed _Gas Exterior HVAC Unit**
*kHVAC units must be screened
Under/Above ground Tank Install Remove
When installing/removing tank(s), call for inspecrion by F'ue Mazshal and Plumhing Inspector
Nature of Work:
Permit Fees $70.50 Underground tank installationhemoval
$50.50 Minimum (iocludes 5[ate Surcharge)
or
Con4actValue $ x I% _ $ PemutFee
$ State Surcharge
To catculatesurcharge
If Permit Fee is less than $1,000, surcharge is 50 cents.
If Permit Fee is> $1,000, surcharge increases by $.50
for each $1,000 Pemtit Fee (i.e. a$1,001-$2,OD0 Permit
. Fee requires a $1.00 surchazge).
$ Total Fee
I herehy acknowledge that this infonnation is complete and accurate; that the work will he in confomiance with the ordinances and
codes of the City of Eagan and with the Mechanical Codes; that I understand tlris is not a permit, but only an applicarion for a perxnit,
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.
ApplicanPs Printed Name _ Applicant's Signature
-
Approved By: Inspector Date:
Required Inspecrions: - U.G. _ R.I. _ Au Test _ Gas Service Test - Infloor Heat _ Final -
'
I por Off_ice Use ~
Clty of Eapn ; Permitu ~(n w eg i
I Permit Fe~ '"I Ooo
3830 Pilot Knob Road
Eagan MN 55722 ~ Date Received: ~ OS ~
Phone: (651) 675-5675 i ~ ~
Fax: (651) 675-5694 I Staff: J I
I 1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~SiteAddress: /~fJ~2 Trn~z~r(/o/F /rai l V
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: _ Owner ~ Contractor
TYPE OF WORK Description ofwork: nrf /2evv'i
Construction Cost~ZUvc~ . cjp Multi-Family Building: (Yes_I No
CONTRACTOR Name: li111~11v5 Z'hr _ License ~2Q3/ 9~'i !Z~-
Address: a SC7e/:~-L: iVaSare i A /7Y'.
City: /rU~oinLUJ State: J*MtJ Zip: 5^.S6el`i
Phone:ContactPerson: ,-T~p4Pj2}\ T i9'lorY'[~ I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateq rv 1 Minnesota Rules 7672
Energy Code . Residential Ven6lation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(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 plan?
_Yes _No If yes, date and address of master plan:
Licensed Ptumber: Phone:
Mechanical Contractor: Phone: Sewer & Water ConVactor: Phone:
~NOTE: Plans and supporting;docum$nts that you submit are considered.to bepublie information. ~ Portions oi= -
;the"iniormation'm'ay be" class,i~ed as non'public,if you provide specifrc reasons that would permit Fhe City`fo '
'corfclude fhat the are traiie secrets.
I hereby acknowledge that this information is compleFe 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 permd, but only an application for a permit, and work is not to start without a perm@; that the work will be in
accoidance with the approved plan in the case of work which requires z review and approval of plans.
x.~ P"CCm X
ApplicanPs Printed Name ApplicanYs Signature
Page 1 of 3
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DA E 19
Fp
ncccive ~
AMOUNT $
Ae DOLLARS
7oo
~ CASH ? CHEGK
FUND COD6 AMOUNT
Thank You
BY I
White-PBYms CoPY
Yellow-Postiny Copy
Pink-File Copy
Use BLUE or BLACK Ink
- - - - - - - - - - - - - - - - -
I For Office Use a
}
Permit O I O j
City of EaEd I _as
,Ilk
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: a-
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: Phone:
Resident/
Owner Address / City / Zip:l
Applicant is: Owner Contractor
1~:7
Type of Work Description of work:
O C~
Construction Cost: ulti-Family Building: (Yes /No Company:) Contact:
r Y c,
6 I` Address: (~-1 ~-~1 Y► Y~ City:
Contractor State: ~Z- Phone:
I~L
I License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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 the 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.aopherstateonecall.ora
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 ' out a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv plans.
Exterior work authorized by a building permit issued in accordance with the Minn sota State i n o completed within 180
days of permit issuance.
x C)~Y\
A icant's Printed Name icant's Si nature
Page 1 of 3