862 Sudberry Lane
I
CITY OF EAGAN SEWER SERVICE ~ERMlT
3830 Pilot Knob Road pERµIT NO.:
p. O. Box 21199 D^TE:
Eagan, MN 5512IRI No. of Units:
Zoni"g' Joseph }tiller
pwnsr.
862 Sudber Lane L12 B2 Sheffield
sire ~dd?eu: ,,t~ ,u re e
Plumber. S_9_93 37904 .00 pd
425.d0 nd
1 Nm to oasoh~ ~ tM CN1? ef E096" ~
Oedlw~na~. 10.0 p
P.m,it Foe: .50
Surcharye:
Misc. Choro+c
By Total:
DOtQ °f I^sp•' pote Paid:
Insp.:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road pERMIT NO.:
t`.O. Box 21199 0-~
Esgan, MN 55121 DATE:
Zonirp: F 1 No. of Unhs: 1
pwner:
/lddress:
Sito Addresc 962 Sudberrv Lane I 12 B"' S;Leffi~] c_
450.00 p
Plumber. n Connection Charfle: "
~ Meter Pfo.:
I Size: Aooount Deposit:
Reader No.: Permit Fee: 10.00 i 1
i
w111~ IIM Cih ~ E~e Surcho?ys: j
1 M~w to ao~~lf Misc. Choroes: G`'' 0 0 p d ?reter. Of'JIM110r.
TOYOl:
BY Date Pcid:
Dote of Insp.: Insp.:
` . cinr oF EAw?N ,
' • 3795 PIle1 Kno? Road Eepoe, MN 56122
PHONEi 454-8100
BUILDING PERMIT Receipt ~t
Ta w owd for c' DIX/GAR Est. Vulue $50,000 pQte Aupust 19
~ , u erry ane
Stte "r5ss Erect Occupancy
Lot Blotk 4 Se~/Sub. S 1ef fie A{ter Q Zoninq
Parul # i0~7 1-0 02 Repair p Firt Zone
. osep,. M. er .onst. ; nc. Enlarye p T;pe of Const.
W Nome , Move , ? # Story'es
^
Z oo.ar AVe. So. Demolish p LengtFi,.~
/lddrass
~ - , . Phax 454-4753
Ci Gmde ? Depth ;,q. Ft.
Nome L`-' L' Aporovals Foos
~
u~ ^~r~ Assessment Permit
~ Gt p~M Woter 8 Sew. Surchorqe
P Polica Plon checL.
°C Name
W Fhe SAC
Addrest Eny. Woter Conn.
<W Ci Phone Plonner Woter Meter
Council Rood Unit
I hereby acknowledge tVwt I have read this opplitotion and stote that gldp. Off.
the inlormation is correct and ogree fo comply with all applicoble ^PC Total 91/34 .J
Stute of Minnesoto Stotutes and City of Eogun Ordinonces.
Sipnoturo of Permittee
A Building Permit is issued to: _ on tM express cwdition thar
oll worlc shall be done in occordance with aIl,cQpliwble Stete of MlnKesotEi Sttttntes and Ciry of Eayon Ordlnances.
Buildinp Officio) /
,
rl ,6 - 3 P"3 (0 w y, eR- i ;,-e
Permit No. Permit Holder Misa Permit No. Holder
Plumbinq "70"''Qo Mc Cof.l l, rf- - 3b-Y3
H.V.A.C. ~D ~j- 3 Co:~. v~l
~ 7:533- ownedP- ~-19-7
Disp.
Sewsr
elen.ic o-,g$Is M~ atc~?~d o-Z7-8'3
07y7 9 Pwn1T -Y
Inspertion Date Insp. Other
Footings f~
Foundatlon
Fnminp
Rouyh Plbq.
Rouyh HVA j
Inwlstion ).~t
Final Plbp.
Final HVAC
Final
water Describe} ocation: '
wen ~/~Y .
s.w..
Pr. DisP. ~
-''~~i"'
;,ZZ
'r~-r+~ ? r T
r~' ~.`0' r~ Y.
-
LI a ,
(S~ ~
tr~tf tira#e nf (Orrupttnry
Citp of (Eagatt
iBrptt.r#mpnt of Wuild'mg JmWrrtiom
\ r
1
rarrinrnu o Sutioa of thc Uroifor+a Buildin
T h u C c r t i f s ta t t r s u r c d ~ n r 1 N r i~ 1 t t o i i b e nq f 306 8 ,
Codc artif yixg ti~ at t& titNC o f it.urarcr tbrs rtructecrc war in rom pliana witb tbc varioicr
ordinaruu o f tbt City riguG+timg Wlding to"?ucfivx o? xu. For t f x f o l lowixg:
S,
SF DWG/GAR 8364
Ur CIdBu4m Wda. hrmit No.
OC-aE-r'sM _-83_TyP c- .~nm v Pi.:a.. NA Zoaft DWnd Rl
Joseph 'M. Miller Am.,,18133 Cedar Ave. So . . Farming"
862 Lmmeril_2,,B1ock 2,Sheff{e1d
- -
~=Y by.
awwm rea,, November 4, 1983 ~
nu.: "'3
_ . . . . . ~a
. . : ~ ` • ~ ~ ~ ~ ~ ' ' ~ T
Receipt MECHANICAL PERMIT Permit No~~
CITY OF EAGAN
. Fee
Fill rn numbered spaces S/C
Type or Prinr legibly Tot.
1. Date 2. Installation Cost
3, Job Address ' _ • L(a~;~ j~ Bik. Z Tract - ~ s
;
4. Owner . .
5. Contractor t 1'. j Phone v. ~
6. Address r.
7. City State Zip - •
8. Building Type: Residential Commercial O Institutional ?
9. Work Description: New Q-' Add ? Alter 0 Hepair ?
~
10. Describe Fuel Type
11. No. Eaui_pmenc 8TU - M. Ea. No. EQUipment CFM
Forced Air Air Handling:
Mfg. .
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
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.
I~ 5igned : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
i w .
Receipt PLUMBING PERMIT Pa?mit Na.
CITY OF EAGAN -
, Fae
1
Fill in numbered spaces S/C
Type or Print /egib/y Tot. '
1. Date G2. Installation Cost
3. Job Address.LotBlk. _~4 Tract -
4. Owner , 11,~f ~ ~ • . i,,.~- 2~- _
5. Contractos Phone
6. Address - i ;
7. City State ; Zip
8. Building Type: Residential B Commercial ? Institutional O
9. Work Description: New ~ Add ? Alter ? Repair ?
10. Describe
11. No, Fixtures No. Fixtures
Water Closet Cesspool/Orainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
' Kitchen Sink
~
Urinal/Bidet Oth~
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 Ffnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
p`CEIY6D
FROM
AMOUNT $ (
~
1l & OOLLARS
~oo
? CASH E)CHECK
FOR ~
FUNO CODE AtAOUNT
Than u
BY
J 'White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN ~ 91~0
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
' BUILDING PERMIT Receipt
Te be wnA fer DE:C K Est. Volue $ 10 Q() Dote h1AY 2 4 , 19 $ 4
i362 SUDBERRY X R3
Site Ad e Erect ? Occupancy
~ SFiEFFIELD
Lot Alter 0 Zoninp N7A
Parcel No. T Repalr ? Fire Zone
oc Name RICI4ARD PRATT EE e ? Type of Const.
4, Q # Stories
SM1
z Address Demolish ? Length .17
9 City Pnone 4 5 2- 9 8 3 8 Grode p Depth Sq, Ft.
~ SAME Approrob Fees
o Name
Address 1lssessment Pe?mit .50
1- City Phone Water 8 Sew. Surchorpe
Poliu Plan check
~W Name Firo SAC
Address Enp. Woter Conn.
~ W City Phone Planner Woter Meter
Council Rood Unit
t hereby acknowledge thot I hove reod this opplicotion and state thot gldg. Off.
the intormation is correct cnd cgree to tomply wifh oll opplicoble APC Totol .
State of Minnesoto Statutes ond City of Eugan Ordinonces.
Sipnature of Permittee
A Buildir?y Permif Is issued to: R I f l . ..~J"1 on the expross conditfon thni
all work sholl be done in occq!!ao-r'o wlth oll ppplicoble Stote of Minnesata Statutes and City of Eapon Ordinances.
Buildinq Official
mit No. Holder
VDisp Permit No. Permit Holdar Misc. Per
.
Se~nror
EMctric
In"ction Dats Insp. Other
Footingt -g' LcIG
Foundation
Fnminy
Rouph Plbp.
Rouph HVA
Inwlstion
Final Plbq.
Final HVAC
Final p Wator Doscribe Loeation:
VYell
Sewir
Pr. Disp.
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN ,
Fee
Fi!l in numbered spaces S/C
Type or Prini /egib/y -
Tot.
1. Date 2. Instaliation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
B, Address
7. City State Zip
8. Building 7ype: Residentiai ? Commercial O Institutional ?
9. Work Description: New ? Add 11 Alter C7 Repair ?
10. Describe Fuel Type
11. No. Eouinment 8TU - M. Ea. No. EQUiament CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
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 numhered and approved.
Approved CITY OF EAGAN 464-8100
Receipt PLUMBING PERMIT Permit No. -
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly '
Tot.
1. Date 2. Installation Cost 3. Job Address ..r Lot % Blk. . Tract
4. Owner
5. Contractor Phone
6. Address _ •
- , - -
7. City , . , State Zip
8. Building Type: Residential D Commercial ? Institutional ?
9. Work Description: New O Add Q, Alter ? Repair ?
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
~ Lavatory $oftner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
E 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
CITY OF EAGAN Remarks
Addition SHEFFIELD ADDN Lot 12 Blk 2 Parcel 10-67600-120-02
Owner Street 862 SUDBERRY LANE State EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STR EET SUR F. 5SYL 1981 28.68 .4 20 22.96 A013185 11-16-83
STREETRESTOR. 11 1984 178.09 17.81 10 175.09 C008522 3-19-83
GRADING 1 1981 1.10 6.0 1 66,82 A013185 11-16-83
Sewer Lateral 7 1981 152.98 10.20 1 112.22 A013185 11-16-83
SANSEW TRUNK 1981 6. 0 4.22 1 46.42 A013185 11-16-83
SEWER LATERAL 1981 96.50 6.4 1 77•22 A013185 11-16-83
SewL-r Lateral 6/ 1982 6.06 4.34 1 52.07 A013185 11-16-83
'JVATERMAIN 1981 128.08 8.54 1 93.96 A013185 11-16-83
* WATERLATERAL Z 1, 82 ~4a.16 .21 1 38,53 A013185 11-16-83
WATERAREA 1 81 6. 0 ~+.22 1 46.42 A013185 11-16-83
* POwerline 1 82 1
STORM SEW TRK ~ 1985 456.09 91.22 5 1,/~ •o Coo
g
1~ sroRn~ sew L,aT Draina e IQ84 91.75 9.18 10 91.75 C003522 9-19-83
811 s -7Lo9.19 3 e47 oy3 z P-zo-
CURB & GUTTER
SIDEWALK
STREET LIGHT
1 ei l. G e"mo y3 14-2-
ROAD UNIT 250.00 37904 5-9-83
WATER CONN. 450.00 BUILDING PER. 8364
SAC 1~ ~r
PAR K
CITY OF EAGAN N° 8364
9795 Pibt Rno! Road Eayan, MN S5122 •
PHONE: 454-8100
BINLDING PERMIT Receipt
To ba wed fer SF DWG/GAR Est. Value $50,000 Date August 8 19 83
Sire Address $62 Sudberry Lane R-3
Erect $p pccupanq
Lot 12 Block Z Sec/Sub. Sheffield qlter ? Zoning R-1
parcel # 10 67600 120 02 Repair ? Fire Zone NA
Enlarge ? Type of Const. V
w Name Joseph M. Miller Const., Inc. Move p g Srories
z Addreu 18133 Cedar Ave. So. pemoush ? Lenqth41=4
Ci phom 454-4753 Grode ? Depth 457$ Sq. Ft.-
p Nome Owner ADCrovals Foes
Ou Addrets Assessment Permil ~0
u§ Cit Phone Water 8$ew. Surchorge 25.0~
Police Plan check 141.50
~w Nome Ffre SAC $25.00
Address Enp. Wofer Conn. 450.00
iW CI Phone Plonner WaterMeter 60_00
Council Road Unit 250.00
I hereby ackrawledge that I hore read this opplicotion ond state thot BId9• Off.
the inlormation is correct and agree to comply with oll opplicable APC Totol $1734.50
State of Minnetota Statutes ard City of Eogon Ordinonces.
$ipnature of PertniMee
osep i er t., Inc.
A Bullding Permit Is issued to: on tho express wndifion Ihnr.
oll work sholl be done in accordance with all o ica t es end City of Eopon Ordinoncea.
Buildiny Offidol -
i A.M
• - /~D~~ crrr o~ ~rirwae~. pLn~~q/e~ PlfnD,
PErAm ~ ..t oe wa~+ : ;
~a ~'SV aov ~ r~~ ° M
To se tmea Ua aux
Site Address: /~3 ,,,_^,T
tot ./,2 Hlodc Sec./sub. Alter ftnim ~
Paroel D(0-7 (od 0 t zo O Z j6~= pirs gpm
< T" Cc rwr
Eniet'9e
Qdl1QIi ~ r1:~""T~:. r
DKTh
ciq/zip coft•
rhons 0:
~
oontsactor= AsseSsrortS a,
Waber/BeMer 2 s~°
Plen Chsck F
}1ddt+esa: Polioe
B~IC
Cih+/ZiP C+oden ~ Wstez arm.
.y
rnom r~ ~ u~t a6-0 r,tv~~
n./Ts.: s~s•
adrcw. ~
ff A
C1tY/7'iP Oode: l~7 Rnoe i:
- y C ITY OF EAGAN
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~T
ir ? 9100
PHONE: 454-8100
BUILDING PERMIT Receipt # I
To bs wed for DECK Est. Volue $1000 Date MAY 24 , 1984
862 SUDBERRY Erect ~ pccupancr R3
Site Adc~e~s
1 2 SHEFFIELD R1
Lot Block Sec/Sub. Alfer ~ Zo^i^9
ParceI No. 10-67600-120-02 Repoir ? Fire Zone N/A
Eniarpe ? Type of Gonst. V
a Name RICHARD PRATT Move ? # Stories
; Address SAME -9838 ~"10li'F' ? Lengthi2
b City Phona 452 Grode ? Depth Sq. Ft.-
SAME Approvals Feas
o Name
oU Address Assessment Permit 17.50
u~ City Phone Water & Sew. Surcharge .50
Police Plan check
~w Name Fire SAC
1K Address Eng. Water Conn.
<W City Phone Plonner Waler Meter
Councll Road Unit
I hereby ackrwwledge thot 1 have reod this opplication ond stote ihat gldg. Off.
the inlormotion is cnrrect and agree to comOlY with all applicoble ~
Stafe of Minnesota Stotutes and City of Eogon Ordinances. APC Total .
Signoture of Permittee
A Building Permit is issued to: RICHARD PRATT on the express condition thnt
oll work sholl be done in occ o th oll oppli ble oM osotu Stututes ond City of Eogan Ordinantes.
Buildiny Offidal
~S
CITY OF EAGAN Include 2 sets of plans,
1 Gertificate of Survey
, BUILDING PERMIT APPLICATION 1 set of energy calcu7.ations.
Oa
Th se usea r or ~-'C - / vaiuation Date
Site Address ~G-a S'ct c{(5~A ,w, . OFFICE USE ONLY
Lot j z sloclc z sec./sub. A~,,L Q Erect X occupancy ~-3
Parcel -1Z D- 0 2- Alter Zoning ~G- I
RPpair Fire Zone IJ f~
Owner: ~~ChiircY Enlarge _ 1'ype of Const. 'g
Nbve # Stories
Address: 5F~l~=o v" C`~~.~ Demlish Front ft.
City/ZipCode: Grade Depth IZ ft.
Phone # :
APPROVAIS FEES
Contractor: Assessments Permi.t I T yO
T4ater/Seaer Surcharge .5°
Address: Police Plan Check
City/Zip Code: Fire SAC _
gKj, Water Conn.
Phone Planner WatEr Meter
~j Council Road Unit
~~~/~9• : Bldg. Off. ~
Address: APC
City/Zip Code: _
Phone # : TOTAL
This request void i p' ~ a{~ • Q~
18 months from
An 479 z g a sAexie 11 Yo
Vques[ Date :r Fire No. Rough-in InsOection
Repuiretl? 0fteady NuwkWill Nolity InsPec-
?Yes ?No Wr When Roady
0 Licensetl Eleclrical ConVactor I hereby requast inspection of ebove
xOwner electrical work installed at:
Stree[ Address Boz ar oyte No. Ci
" u.~7
F~ ~~t " ~
ec uon o. Township N2me Range No. nly `
I.
~ CY~ Zz~
Occ m( FINT) ~ Phone No.
-yCs - - .
Power Supplier Adtlress
~l~-~r;~ . ; .-n • N ,ti , ivr nQ
Electrical ConVacmr ICOmpany Namel Comractor's Licanse No.
CTW;J d1t ,
Mailing Atldress (Con ractor or Owner MakinB Instailation)
x~ a.v ?71~
r(.,9 t
Auffi ' e 5' a re C ner aking Inst ation~ Phone Number
~S"~ -9'~'~ .
MINNESOTp STATE BOARD OF ELECTNICITY TMIS INSPECTION PEQUEST WILL NOT
Grie9s-Midwey Bldg. - Room N•791 BE ACCEPTED BY THE STATE BOARD
1821 UniversitV Ava., St. Paul. MN 66104 UNLE55 PFOPEN INSPECTION FEE IS
Ph.nw 1612) 29].2111 ENCLOSEO.
f r-,?y REQUEST FOR ELECTRICAL INSPECTION : EB-00001-04
~ ' See iostNCtions for rompleting this form on beck of vallow capy.
'"x"" Belaw Work Covered by 7his Request
AA,3 'flap. Type ol BuilCine Appliunces WiroO Epoipment Wired
Home Range Temporary Service
Duplez Water Heater Ligh[iny Fixmres
Api. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm omx, oerl y the, ISpe,ry1
t er Suecify Other Othei
ompute Inspection Fee 8elow
# Fae ServiceEntrenceSiza IX Fee Feeders/5ubfeeders N Fee Circuits
0 to 200 Am s0 to 30 Am ps 0 tn 30 Am ~
Above 200 qmps 31 to 100 qmps 31 to 100 Am s
Swimmin Pool A6ove 100_Amps Above 100_Amps
TransformerS Irrigation Booms ,SQ Partial-'Other Fee
Signs Speciallnspection $ pem~rks T AL FE 04))
Bough-in Date ~ •aI
1 spector, har eby
certify that the above
Final 'ns 'ection hes baen
~ de.
Thlereqw~est vo d 18montnalrom ~t O~l O . 6 0
~
This rP~uest void L lv:~~ 3-l ..J -7 (o
.
%i8 mro;ths irom
W0 8815 3x-~
.Request Date ~ Fire No. RouPh 'n InsVection
/ Fe aire ~ReadY Nuw Notily, Inspec-
~ ~ s ?No lor When Reatly
mensed Elec[rical Contractor I herebV request ins0ection of abova
? Owner elecnical work inslalled et:
Street Address, Box or Route No. CHy
- cvon o. 7ownshi0 12a or N Range No. C•~oun~ly L
YfNCO / Q~
Occupent(PfllNT) Phone No.
- y~s3
/-/174
Power Supplier ~ ~A4 )
Elecvical Con ractor IComVany N mel Convacmr's License No.
Wilinp AdJress 1 on actor or Owner akin Instail ionl
C5P
Zb , ~ SS
Autho ized Signatur Co actor Owner M i nstallavonl Phone Number
THIS INSPEGTION HEQUEST WILL NOT
MINNESOTA STATE BOANO OF EL CTRICITY
Griggs-Midway Blde. - Room N•181 BE ACGEPTEO 6Y THE STATE BppHD
UNLESS PROPER INSPECTION FEE IS
1~827 University Ave., SL Paul, MN 55104 ENClOSEO.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
Sae instructions for completing [his torm on back ot yellow coOY.
`
" X" BeAork o e ed by This Request S 7(p
AAd Aep. Type ol 8uildinB APOlinncxs Wired Equipment Wired
Home Range Temporary Service Duplex Water Heater Ligh[iny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
~ Industrial Bldg. Air Condi[ioner Bulk Milk Tank
Farm iher peu y ther(Sper.ity)
tier Succify Other Oth,r
ompute Inspeciion Fee Below
p Fee ServiceEnvanceSiza k Fee Fnxdars/Sabfexders N Fee Cimuits
0 to 200 Am s 0 to 30 Am s 0 to 30 Amus
Above 200 qmps37 to 100 Amps 37 to 100 Am s I
Swimmin Pool Above 700_Am s Above 100-Am s
Tr anstormers Irri ation Booms Partial'Other Fee
Signs Speciallnspection
Remi rks S'~.(~'~ ~ FEE
7J~~~
NouBh-in 7y ~ e ElecVicel ~
Inapectoq herehy
~ certify thet the above I
Final r D^~~ 3 5 napection hes bean
made.
This reeuest vaiE 18 montlq tro.
zoos RESIDENTIAL PLUMBING PeRnniraPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complefe for modifications to existing residential dwellings.
Date o~ 310(6 CURRENT, PHILLIP -
SILB Stf@¢Y Addf85S 862 SUDBERRY LANE Ufllt #
' EAGAN, MN 55123
. (651) 207-6436
Property Owner alephone # ( )
Contractor_Norbi(S)'Yl Raj'Y(jo! 1'2 q Telephone# ([o2) 97-7-y0;5~3
Address 2q05 C-tct,r-fl el.d tt-v. ,4p crty 1'41s State fYI N ziP r-,f+-t D8
The Applicant is: _ Owner V Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
` Per as-buiit $ 10.00
Alterations to ezisting dwelling $ 50.00
_ Add plum6ing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing an! a water softener and/or water
heater, do not compiete this section; move to the next ti ~d ~heek the
appliance(s) you are installing. ~
_Septic System Abandonment APR ~
_ Water Turnaround (add $130.00 if a 518" meter is required)
Other:
_ Water-Softener /Water Heater W 15.00
_ new v replacement
_ Lawn Irrigation _RPZ _PVB _new _repair _re6uiid $ 30.00
State Surcharge g 50
7ota1 $ ~ ~ 50
I hereby apply for a Residential Plumbing Permit and acknowledge that the informatlon is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City' of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is n t o tart 'thout a permit and work will be in
accordance with the approved plan in the event a plan is required to b d Aar/o~ed
J.
e~rev L. Norb1~,-/, -
Applicant's Prin d Name Applicant" ignafure
/ CITY USE O1VLY
PERMIT RECEIPT DATE:
2008 MIDENTIAL MECHANICAL PEiZMIT APPLICATION
crrY oF EAs,aN
3930 PaoT tcNoe xn
£R6AN b1N 55122
651-M1-4675
Please complete for: ? single famity dwellings
townhomes and condos when permits are required for each unit ,
Date: .
- --1
SITE ADDRESS: L) (i{Ca P.l"l-) ( 6-'-()C)
OWNERNAME: ~~A'A,\~p TELEPHONE#:
INSTALLERNAME: ~VC~.I ITQLXJ Ifid . TELEPHONE#:
STREETADDRESS: 395
CITY: STATE: ZIP:
Place a check mark next to ehe permh work type
~ Add-on ' n-ac ration to existina dwelling unit $ 30.00
• furnace mlacemen~
• air exchanger
• air conditioner
. other
Nature of work: LLc'-C'A~
&u~J L(~f~/CD~~~ E"•P ~~5, 000.6~~ G~~
State Surchar e $ 50
~-O
rotal
SIGNATURE O ' E ITTEE
vo2
ciTV use oNLr
PERMIT RECEIPT DATE:
APPROVED BY: INSPECTOR
2002 COMMEftCIAL MECHANICAI. PERMI1' APPI ICATION
Cl1'Y OF EA6AN
S$SO PILOT KNOB RD
EAs", MN 55122
651-681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER:
STREET ADDRESS:
CITY: STATE: ZIP:
TELEPHONE
WORK TYPE: New construction _ Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
Specify Nature of Work:
When installing/removing underground tank, ca[I 651-681-4675 jor inspection by Fire Marshal and
Plumbing iaspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surchazge calculate at $50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/02
Jpe Miller Conatruction
' 18133 Cedar Avenue .outh
. Fa~rmington, rdinnesota PLq^1 ~)9046 (,V-L vIor-')
5592 4
DELMAR H. SCHWANZ
LANDSUAVEVORS W~•
RepiSllrCtl UnEBl Llws Of Th! State Of Minn¢sole
~ 2978 - lA5TH STREET W. - BOX M. HOSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769
SURVEVOR'S CERTIFICATE
9N~ o qN
s 6~ ~ ~ a 19
qs
\F
4
Yroposed garaee floo^ elev.
-h- Proposed top of block elev.
c'tOD o ; l3.bl ob . Proposed basement floor
~Gp.~ 050 ~ 6~ elevation
n ,y
p Uer.ctes lron pioe monizment
O Denotes setback montunent
('n ~ .VG~ N I
ypq,~a , Denotes existing elevation
~ I 3re,o 134.1
z I I~ ~•3'~,~+ ~•3 ~J" i Z Der.otes proposed f'iniahed grade elevation
, Denotes direction of surf3ce d;ainage
~ - - -
13
~ ~I.oo S~°44~ 35" U~1
I hereby certify that this Ss a true and correct representstion oP the
boundaries o£ Lot 12, Blook SHEFFIELD as on fi2e and of record in
the oPfice of the County Recorder, Dakota ;nunty, f•'innesota.
Also showing the proposed location of a house not staked thereon.
As surveyed by me this ? day of hiay, 1.9$3.
Fevised to ahow di£"ererit proposed "nouse not stai:ed thr_reon.
%
MINNESOTA q GISTRATION NO 8625 ~
CITY UF EAGAN
CASH:CEf"t: 1S YER.MINAL ND; 758
PA'T'E: 07/26/93 TIMI_: 10t25e05
SLi:
NAMU A"17EC RO[)F'1'NG & CONS'f'fil1CTi0N
321D '-J001 4842 !il-IEVLTN C7 1.1:1..25
^c9.,r'e5 9001 4842 SNEVLTN CT 2.50
3210 9001 4395 kIpOL1GATE L ihi .i?.°i
215`.i 900:1. 4335 WOpLiGATE: L. 4.150
3210 9001 1362 SLILiFtCRFiY LN i H..LJ
2J. JJ 9001 86?_ ,I.aZiLtFRkY l N r?. JO
,
~
7ota:L Receip+, Amount; 399.25
CF:7.9.4 2r 7
USE:R .T.T): 1AN
i
~ ~Cj 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ~
3830 PII.OT KNOB RD - 66122
(651) 681-4695
New Construction Reauirements RemadeVReoair Reauirements
? 3 registered site surveys • 2 copies of plan
? 2 wpies of plans (include beam S window sizes; poured fnd. design; etc.) ? t ske surveys (extedor additions & decks)
? t energy calculations ? t energy wlculations for heated additions
? 3 copies of tree preservation plan H lot plalted aRer 711193
required: _ Yes No
DATE: J' I `-'I -"I g CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREETADDRESS:
LOT: BLOCK: SUBD./P.I.D. -
Name: 1 Phone
PROPERTY Latt First
OWNER
Street Address: a
City State: mN Zip: ~S~ Z 3
Company: 1~*D '1-' ~ Phone - LO r b
CONTRACTOR p ~
Street Address: 1 f~ g 7 '-~Q License # -tO Exp.
is stace: zip: Ss' 3 37
cicy
ARCHITECT/
ENGINEER Company: Phone
Name: Regishation
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when.address
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to compty with all applicable
Sta,te of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ~
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
I
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging O 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. O 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
0 31 New ? 33 Alterations ? 36 Move
? 32 Addition O 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. Census Units
Zoning sq. ft. Census Bldg
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Widtli 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
SAC Units
2007RESIDENTIAL BUILDING rERMiT arrLIcaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Cons4uction ReauiremenGs RemodeVReoair Reauirements Ofice Use OnN
3 regisiered site surveys shaving sq. R of iot, sq, tt, of house; and all roofed areas 2 copies of pian showing foo6ngs, beams, joisis CeR of Survey Recd _ Y_ N
(200/o maeimum lot coverage allowed) 1 set of Energy Calculations for heated additlons Soils Report _ Y_ N
1 Soils Report if proposed huilding is to 6e placed on distur6ed soil 1 site survey for additions & decks Tree Pres Plan Recd _ Y_ N.
2 copies of plan shaxing beam & window sizes; pouretl found design, etc. Addi6on - indicate if on-Site sepfic system Tree Pres Required _Y _ N
1 setofEnergyCalcula6ons Onaite$eptic5ystem _Y _N
3 copies oiTrea Preservatlon Plan'rf lot platted after7l1193 Rim Joist Detail Options selection sheet (buildings wiN 3 or less unifs)
Minnegasco mechaniplventilafionfortn
Plans are considered ublic information unless ou state the are trade secret and the reason.
bate 1. / Construction Cost
Site Address ~ ef 69- ~ ~IIniUSte #1
a !~'l 02
Description of Work S//hq
Multi-Family Bldg _ YA N Fireplace(s) _ 0_ 1 _ 2
Property Owner I~) r! L4,f rC,4'~ Telephone IvSI ) p,Z Q 7'"(o
ContraMor
Address ~7y~(p ~P~ih(~cJljp~ l.e- City
State ?V! Al. Zip Y.~/oZd- Telephone # ((e5"[ ) oZ
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING .
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Resitlential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submiked
• Energy Envelope Calculations Submitted
In ihe last 12 manths, has the City of Eagan issued a permiT for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master pian:
Licensed Plumber Telephone ~
Mechanical Contractor Telephone )
Sewer/Water Contractor Telephone # ( )
I hereby apply for a Residential Building Permit and acknowledge that the informarion 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 the case of work which requires a review and
approval ofplans.
Applicant's Printed Name ApplicanYs Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvqes
? 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 Eut. Alt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish lnterior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
0 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire 81dg) - Give PCA handout to applicant D85C1'iptiOn: WaterDamage_Yes
Valuation Occupancy MCES System
Plan Review 100% or 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) Sheetrock
_ Footings (deck) FinaUC.O.
_ Footings (addition) FinaUNo C.O.
Foundation HVAC
Diain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insularion _ 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
CityofEaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: 16).
$ cL
Date Received: 7-,01 ' S
Staff:
/c7
2013 RESIDENTIAL BUILDIN9 PERMIT APPLICATION
Date: 01:cl l3 Site Address: 5_'Y'- �Gr J� �� Unit #:
Resident/
Owner
Type of Work
Name:
Address / City / Zip:
re
Phone: 64) --7 Lll -O/ g9�
d
Applicant is: Owner Contractor
Description of work:
Construction Cost: tj 000
Multi -Family Building: (Yes /
0
Contractor
Company: 0 (,19 S �q Cr
^� (Vl� aContact: �d �/ � r' SAddress: //gS f ill `2714(� City: r 6,(7Q-L1-"Xc-
State:
f V Zip: ,S 5—C [ Phone: 6(Q. 'i(:).0 w -(,14.
License #: P R,3 3 70 Lead Certificate #: 4./4 C a dfrz, L
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
¥00� to ce dk- I kt.,
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:
Phone:
Phone:
Mechanical Contractor:
Sewer & Water Contractor:
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.orq
I hereby acknowledge that this information is complete and accurate; that the work wit be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance..
x . C) 5 r./6/---n(czh_
�
App cant's Print ame—_
icant's Signature
Page 1 of 3