868 Sudberry Lane
C1TY OF EAGAN WATER SERViCE PERMiT
3830_' ' t Knob Road pE{tMIT ND.: .
P..O. Box 21199 - `3 -"T
DATE: 1
Ea9an, MN 55721 No. of Units:
Z°"i"g' h ~~li l ler
Owner .i o
Add`e'r. ~66 Sudberr Lan~ L14 B2 She ie ld
Sift Address: `ScC~uire i•lecl,,
4SU .00 pd
P1wr+ber• ~ a nectfon G?c?pec
~
n~r.r r,o.: ~ ~ ? ; ~unt ~po~f: lo . o o p
~Size: ° y Pertnit Fee:
da~ ho.: 63 . D!1 ptl :ae4 'x
ro T°~ ^e?~~ _ v ENMBC.
Charpr -
e Pald:
I By I np,:
~ pote of Insp•:
CITY OF EAGAN WATER SERVICE PERMlT
38' Y, Pilat Knob Road PERMIT NO.: _ I.>
P. U. Box 21199
Eagan, MN 55121 DATE: ~
~
Zoninp: Ri No. of Units:
Ownsr:
/lddross:
Site Addren: 6,1 Sadberrv L~^=c l.14 BZ Shef f ie Id
' :cGuire ?~4eCh
4 SJ . `JO ~:~u
Meter No.: Connection Charye:
stu: Account Deposir: IO . UQ pd
Raoder No.: Pertnit Fee: . 50 p.1
~!M Ciry oi la4ve Surdhwroe. ~!l T. T,
1 NrM !e oo~Plf d~,s t, t;!'
Misc. Charoes:
Totol:
BY Date Paid:
Data of Insp.: 1nsp.:
CITY QF EAGAN SEWER SERVICE PERMIT
3830 i'ilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: - - ~ - - =
Zoninp: ~ 1 No. of Units: 1
Owner. J osci> h 'i11 er
Address:
Site Address: 11 $68 Sudberry i,a^e :.13 D2 S.icFfiel.'.
Plumber LSCGUire MCCh
7 -1 c , 1 - 0n~ ^,1
. . 3- ~ ? ' i l t J . ~ ? c1 eorN M ossoly wIlh fbw Ciyr of Eetiem Connedian ChOrpe: ~•00
O~dieshen. /kcount Deposit:
PaRnit Fee:
Surcfwrpe: • i':=
, gy Misc. CFw.pes:
Date of Insp.: Total:
I nsp.: Dote Pold:
Receipt MECHANICAL PERMIT Parmit No.
CITY OF EAGAN
Fee
Fill rn numbered spaces S/C
Type or Print legibly
Tot.
1. Date 2. Installation Cost 3. Job Address Lot Bik. : Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add 0 Alter ? Repair ?
10. Describe Fuel Type
11. No. Equ;pment 8 TU - 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.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464,8700
CITY OF EAGAN No 88~i
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .
PHON E: 4548100
BUILDING PERMIT Receipt
Slr~c FAM d GAkG $7c),000. ~
Te b~ wed for Est. Value Date Feb. 23 , 19 84
Site Address 868 SUDBERRRY Ercct ? X Occuponcy R 3
Lot 14 Block 2 Sec/Sub. StfEFFIE:.D Alter ? Zoninfl ki
Parcel No. 10•67600-140-02 Repair ? Fire Zone
EnlarQe ? Type of Const. }i
W Name 3051~PH MILLER ~ve p # Stories
~ Address 18133 CEDAIZ AVE. Demoiish p Length 36
City F'MG'tN Phone L154-475"1 Grode ? Depth 48 Sq. Ft.
Approvals Fee•
,o Name
Z~ Address Assessment Permit 34.'1.0V
~ City Phone Water b Sew. Surchorge 35•00
Police Plon check 171.50
~Z Nsme Firo SAC - 525.00
Address Enp. Woter Conn. 450, .40
~ZW City Phone 63. aQ
Pianner Woter Meter
Councll Road Unit 260.04
I hereby ncknowledge thot I have reod this oppiication ond state that Bldq. Off.
fhe in}ormation is correcf and agree fo Comply with oll applicoble ^PC Total Z847. SQ
Stota of Minnesoto Statutes ond City of Eogon Ordinonus.
Sipnature of Permittes
/1 Buildi?+Permit Is issued M: QSP ,H M 1..E ex
g preu condition thnt
oll work sholl be done in accordonce with oll applicobls Stote, of Minnesoto Statutea and City of Eoflon Ordinonces.
~ -
Buildirg Officiol , f:
m` •
~
0
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d
Z
i ~
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~ Ita ^1 ` o
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i a ~ ~ $ V
c 0 u ~ o a >
a i4 e d
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6 ~ 1 W ~ IL U. 1=L Q ~ ~ IL IL {L ~ S f~ p`,
Receipt " PLUMBING PERMIT Permit No.
CITY OF EAGAN
~ Fee
fill in numbered spaces S/C '
Type or Prini legibly Tot.
1. Date 2. Installation Cost -
~
3. Job Address Lot Blk. Tract
i
4. Owner • ~ . i
5. Contractor /a Phone
6. Address
7. City State . Zip `
8. Building Type: Residential i'-4K Commercial ? Institutional ?
9. Work Description: New ? Add ? Alter ? Repair ?
10. Describe
11. No, Fixtures No. Fixtures
~ Water Closet Cesspool/Drainfield
~ Bath tubs Septic Tank
_ Lavatory Softner
' Shower Well
-T 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 Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-5100
•
CASH RECEIPT
CITY OF EAGAN
P. 0. BOX 21-199
EAGAN, MINNESOTA 55121
OwTE _ , J. 19-
i
R¢CL~IVED
RROM AMOUNT $
~
i
a ooLLwRs
~oo
? CASH ? CHECK
KO~,~' ~f~, ~ ' / f •
~
FUND CODE AfAOUNT
7
Thank ou ~
~1,. J . .
+BY
VYhite-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addition SHEFFIELD ADDN Lot 14 Blk 2 Parcel 10-67600-140-02
Owner Street 868 SUDBERRY LANE 5tate EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Data
STREETSURF. 1981 28.68 1.43 20 22.96 14111 6-22-84
STREET RESTOR. 19.1 178.09 17.81 10 178.09 008524 -19-83
GRADING $1 191 91.10 .07 15 66.82 A014111 6-22-84
Sewer Lateral 577 1961 152.9 10.20 1 112.22 it 1+
SAN SEW TRUNK 1981 3. 30 • 22 15 46 . 42 it to
SEWERLATERAL 5-93 1981 9•50 6.43 1 77.22 to
5ewer Lateral 1982 5•0 •3 15 2.07
WATERMAIN 19]. 128.08 .5 143.96
WATER LATERAL 19 48.16 38
3.21
.53
AREA 19 1 3.30 22 15 46.42
~ Powerline 19E27 15
STORM SEW TRK ~q 1985 456.09 91.22 5 S6 , o e'O O ~:3-! - zo
$ STORMSEWLATDrSiAB e 1984 91.75 9.18 10 91.75 C008524 9-19-83
~(00 •m.3 t~O6' ,3 ~~Lv ~
CURB & GUT ER
SIDEWALK
STREET LIGHT
S t 1985 1941.64 388.33 5 / 4 (o C'C4 3 - yo
WATER CONN. 450.00 of to
BUILDING PER. 9841
SAC 575.00 91 it
PARK
CITY OF EAGAN AO 8841
, 1 3830 Pilot Kno6 Road, P.O. Boz 27-199, Eagan, MN 55121 lr
PHONE: 454-8100
BUILDING PERMIT FAM d. GARG Receivt # 'S/ SING To ba uwd fer Est. Value $70,000. pate Feb. 23 iy 84
SiteAddress 868 SUDBERRRY Eree ? X Occupancy ~3
Lot 14 Block Z Sec/Sub. SHEFFIELD Alter
10-67600-140-02 0 Zoni~ g}
Percel No. Repoir ? Fire Zone
Enlorge ? TvPe of Const. V
rc Name JOSEPH MILLER Mova ? # Stories
z nddress 18133 CEDAR AVE. DemoNsh ? Length 36
City F'1GTN Phane 454-475"1 Grode ? Depth 48 Sq. Ft.-
rc ADV•o.ala Feas
Name
p
o~ Address Assessment Permit 343.00
u~ City Phone Wuter & Sew. SurcFwrge 35.00
Police Plon check 171.50
FW Name Fire SAC 525.00 .
Address Eng, Water Conn..~~ 0
<W City Phone plcnner WoterMefer_63,90
Coundl Road Unit 260_00
I here6y acknowledge tlwf I have read fhis applicotion and state that gldg. Of4.
Ihe informafion Is correct and ogree to comply with oll oppiicoble APC Totol 1A4~_5~
Stote of Minnewto Stotutes and City of Eagon Ordirwnces.
Signafure of Permittee
JOSPE MILLER
A Building Permit is iuued to: on the express condition thnt
all work sholl be dorw in actordarxe with all o ble Staf f Minnesota Sfatutes ond City af Eopan Ordinances.
Building Official ~
This raquesl wid I I,t j~ ~y
1~r;lh~fro35532 m u4j B Z gAe.44c l~ V~S6C
Henllest Date Fire No. Rough-in InsPer.lion
ReqmreA? ~Aeady Now~Will NotifY Ins0ec-
Yes ?No tor When fleady
Lice nsed Elec[rical CanVactar I hereby reques[ inspection af above
? Owner electrical work instelled a[:
Street Address, Boa or Route No. City
ecUOn o. Township N2me or N. Range No. County
Oc upant IPRINT) Phune No.
Pa $upplier Address
L+C/(fMkA "
Elecvical Controctor ICOmpany Namel Contractor's License No.
74/6AQ -a
MailinB p.ddress (COntractor or O ner ing Inst tio
J~ ~ia3
Author' ed SiBna nt acmdOwne akinD Instaliationl Phnne Number
~ S~ S~~a
MINNESOTA STqTE BOAflD OF ELECT ICITV THIS INSPECTION PEQUEST WILL NOT
Griggn-Midwey Bidg. - floom N•191 BE ACGEPTED 9Y THE STqTE BOAHD
1821 University Ave., SL Pau1, MN 55704 UNLESS PNOPER INSPECTION FEE IS
Pnnnw 1612129].2171 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
w
:
' See insiruclions tor comolating this rorm on back of yellow cooV.
.
A' ~ 5~32 ""X" Be/ow Work Covered by This Request ~,r~~
AAtl flep.' Type ol Builtling Apoliancea WireA Equipment WireA
me ange Temporary Service
Duplex Water Heater ightinp Fixtures
Apt. Building Oryer Electric Heatin
Commercial 81dy. Furnace Silo Unloader
Industrial 81dg. Air Conditioner Buik Milk Tenk
Farm Oflha, pea y therlSpecifyl
t er Suecify Other Other
Compute lnspection Fee Below
A Fee SarvicaEntranea5ite p Fxe Featlers/Subfeeders # Fee Gircuils
0 to 200 qmps 0 to 30 Am s .Z. 0 to 30 Am s
Above 200 qmps31 to 100 qmps / Q 31 to 100 Anvs
Swimmin Pool A6ove 100_Amps Above 100_Am s
Transiormers Irrigation Booms ."f Partial'O r Fee
Signs Specialinspection S
Pemarks T FEE ~p
- " 3 7 ~'O
flough-in ~ . . D-rt¢
sthe ecviwl
ectoq heraby
above
Final Eyt ~iv Ihet tha
rk spection nas baen
made.
ThIC reyueet voitl 18 montln irom
1
. •
.
„
~
~
'
~to
°j
S 3 3 J a-; RESIDENTIAL -
BUILDING PERMIT APPLICATION iz
CITY OF EACAN
3830 PILOT KNOB RD, EACAN MN 55122 C
651-681-4675
New Canatruetion Reauirementi RemodeUReoair Reauirements
• 3 registered sAe surveys showing sq. fl. of lot, sq. IL of house; and all roofed areas • 2 copies ot plan
(20% mazimum lot covemge allowed) . 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window s¢es; poured found desyn, etc.) - • 1 site swvey kr extenor additions & decks
• i set of Energy Calculations . • Ind'icate if home served by septic sysfem for addiUons
. 3 copies of Tree Preservetion Poan if lot platted after 7/1193
• Rim Joisl Detad OpUons selectlon shcet (Mdgs with 3 or less units)
I oa
DATE ~GLNL~ VALUATION ( rl'"UJ!/
SITE ADDRESS - MULTI-FAMILY BLDG _ Y a N
TYPE OF WORK 2Yn~ FIREPLACE(S) _ 0)(1 _ 2
APPLICANT ~I I,
STREET ADDRESS CITY STATE M ZIP
TELEPHONE #7S-1.11Xj-- CELL P ONE # - LiS FAX #
PROPERTYOWNER c LY'JlJ ~~7~/~ TELEPHONE# DS~d-
COMPlEiE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RliLES 7670 CATF.GORY 1 MINNESOTA RUI.ES 7672
(V su6mission type) • Residentlal VenGlation Category 1 Worksheet Su6mitted . Naw Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor. Phone # ~
Plumbing system includes: _ Water Softener _ Lawn Sprinkl ~;l{ ~Fee: 00
_ Water Heater _ No. oE R.I. B
No. of Baths
Mechanical Contractor: Phone '
Mechanical system includes: _ Air Conditioning y Fec: $70.00
_ Heat Recovery Sys[cm
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have reatl this application, state that the information is correct, and a ree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or itta c.
Signature of Applicant
- - - -
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory 81dg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 E#. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move 81dg. ? 42 Demolish (Foundation) 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *DemoliUon (Entire Bldg only) - Give PCA handout to applfcant
_ i
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr, of Units Sq. Ft. PRV
Nbr. of Bldgs Length ~ Fire Sprinklered
Type of Const Width
REQUIRED INSPEC7'IONS Foorings (new bldg) FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addition) _ plumying
_ Foundation gVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insuladon _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Certificate For:
Joe M,iller Construction -
DELMAR H. SCHWANZ
Ln.nosurtvevoac
Re9isteratl Untla laws a/ !he Stata of Minnnota .
2978 - 146TH BTREET W. - 90X M NOSFMQUNT. MINMEBOTA 95088 VMONE 817 429-1788 .
SURVEYOR`S CERTIFICATE
~
}Un~i rv ~-^EMENT
o o ~U
I fn
N GRR . ~ laG~ i ~
k /Joust I ~J
~ 41
Io y 3¢ '
o "1141
;a
~
a~ a
~
00 Z
~
; C _ ~
C~o. oo 'E~~ffi°44 35"U/
I hereby certify that this is a true and correct representation oP
Lot 14, Block 2, SHEFFIELD, according to the recorded plat thereoP,
Dakota County, Minneeota.
Also ahowing the location oP a proposed house not ataked thereon.
Dated: February 13, 1984
As V, I ,
MINNESOTA REGISTRATION N0.8625
CITT OR BUI~IIC DiPA R'l1~N?
QTEiZOA~~TV4Gt "~~pP1lcaMion?
cro e. :ua.scc.a d ce s~slesng n•
One or tro taa11y duwlliug Ovner
All other 91te addnss
Contractor T03~EA~ mILLF.~ Cei1~ST Dat• ona .z
LIMBAL FT. OF t~-r~
EZP09ED YALL iG~ "-A1oPA0dECr tt. •bove srade -
TOTAL EXPOSF.D wALL A
OPAQUE 11ALL COpSTdUCTION: "lJ" value x ar+sa
^U" .D x s~~. ft.~79 ,0~1 iUjj
~Uw CL. 7oiP"r ° 4Ae fa(o t U)(
w
• ~ •
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, z sq. rc.
--w tU;(
Detail reterence "U"~_.x eq. ft. 1)i
t-oa "U" x sa. !c. ~~}r
attached aheets _ "U" x iq. ft. ~ 1
~Vw X 9 (Ull
. . . wUw""~...~~X gq. L'C.. . ~ (U) t
MU"~X !q. fC. ~-tl)j!
wpw~~.'x sq. ft. ~ y(U)(
dINDOWS: "U" value z~aru~r~
Make ! L~rpe 1~N.Str ~T~_ O+.sr--z eq. f t.~-~~ t U!i
w w ~i
w w •V~-X !q. fL. ru m
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~U«~-x aq, ft. ~ ~ i
w w ~Vw,~% aq. ft. ~ (U1(
n w •V~X SQ. rL.. . . . . . DOORS: "U" value x area „UR x sq. ft. .00 i
Maka t t~rps ~
~ -U• • % 3q. L'L. i ~ 1994 GL~1 !
wvw x 9q. ft.
w - wUwx !tq. 1'L. =~.(U ) i
e
e 'fOTALS l,g~Sq. ft.Z/4.' iU!
i'OTA L( U)( A) YA LUES Z~T~_M A JG .•-U4
)IVIDED B7 TOTAL YALL AREA $Z(p,5&, • 117
~VERAGE "U" .~$5 or less for all otheriDuyildingsngs
00F/CEILING: y
'OTAL ARF.A: 111260(a-!q• I~U~ ~O x sq. fc. ~~O~O~O ~ Z~s•~ot t v,' i
ieLail refenRes X 9q. tC.
f r~s m.
.ttaeh*d sheets. x •Q• ft. ~ ~ ~
'*seribe openings ,w,v,-------x sq. ft. ~ (1194
1
la roof.
,-t q. f t. ..i L ,
TALS 5
co~
OTA LM(A) YA LIJES
IVIDED 87 TOTAL ROOP/ 4 O& (o .025
CEILIMG ARFr?
`r
VERAGE 'U" , . o rentilatod roofs
~ , or all otlur constrvetion
_ .
.
• ' ~ - WL
'DE[EI~MiNINL, U" VALUEe.,
~ ~
~ ~ ( ~,,~s,,_~,,;•
~ ic, tiWTEKIDR A1f t-jLM S/Sw GYF. L~D,
~ ~ ~NS~~AT~oN .50,00
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S i i lIL~
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(77
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2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) pgppgw p,ppgESS: 868 Sudberry
LEGAL D~MCN: i.nm 1 d ur.Or. x 2 J~J'1 P~
(Lot/Block Subdivision or Tax Parcel I.D. Ntmiber)
IF EXISTM~G Smic1SJRE. DF_TE OF ORIGINAL EUILDING PE.T.~ffT ISSJA.NcE:
(~'or.r.h/Year)
PRESE.'~1T 201VI1kY;/PR0PUSEp L'SE: .<R-1 SINGLE FAMTLY
? R-2 DUPL,EX (RW0 UNITS)
E3 R-3 TMNHOUSE (T= + UbIITS) ( iJNITS)
, p R-4 APAFZIP4EVT/Caa)ON1IIVIUM i iIAIITS)
? CCKMERCIAL/RETAII,/OFFICE
O IMUSTaTar•
p ztvvs•rrzv2'zONAi./covERNMENr
2) APPLICANr (PLEASE PRINT)
.Tna Millar Cnnstruction ADDRESS: 18133 Cedar Ave So.
• CI'1'Y, $'j'f{`j'$, ZIP: Fa'uungtQny Minn_ SSh9d ` .
pf~; 454-4753
3) PLL14BER PLEASE PRINT) FOR CITY IISE ONIY
rgq.E; McGuire Mechanical Services. Inc.
. PLUMB S LICENSE: "ADDRESS: 208'i0 Holt n..o P_O_ BOX 219 ~Active
CITY, STATE, ZIP: Lakeville, Minn. ~ Expired ,
MA4UH Not of Recard
PHOI`1EhG9-aq88 PLUMBER LICENSE N 002751M7
a ni ia -
4) OCC.•UP71N•z•/a*III2 (P~PRINT) ~ -
ivtru.~i/~ ~ e2~
ADDRESS:
CZTY, STATE, ZIP:
PfKxIE:
5) INDICATE WHICH PERAIT IS BEING RBQLTESTID:
~~AII~iEC.TION ZO CITY SEWER
CONSII~X.TIIXN TO CITY MTER
? OT'fMFt (PIEASE DFS(1tIBE)
6) IIdDICATE ONE:
~ PLEASE HOID APPR(7VID PERMIT FC)R PICK-UP BY ONE OF ABOVE
~ PLEASE MAIL APPR(7VID PERNLIT TO 1, 2,03 4 AHOdE
(Circle one)
7) SIQA1[JRE: DATE: ~
F O R C I T Y U S E O N L Y •
_ PERMIT # ISSUED
FEES: $ ia S a SEWER ?ERAIIT (INCLliDE SURCHARGE)
$ WATER PERMIT (INCLUDE SURCHARGE)
$ G3. m--O WATER METER/COPPERHORN/OUTSIDE READEk
~ $ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
~ $ ACCOUNT GEPOSIT - SEWER '
$ ACCOUNT DEPOSIT - WATER
' $ WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
S • OTHER
TOTAL
AMOUNT PAID/RECEIPT #
' DOES UTZLITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK WITHIN
, PUBLIC ROADWAY" MUST BE ISSUED SY THE
C~ NO ENGINEERING DIVISION. LIST AS A CONDI-
TIUN.
SUB.TECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: TITLE:
DATE:
•a w~ wa ~a~~ ~w ~~~e w~ ~t+~s~w??~!I ~ !~r!1!!'~~'rk1!~'~ ~ ~ ~kTf"k!~'~ !'M! ~!F~~!k!r":r! ~
CTTY UF EAGAN
CASHTEFt: 15 TEFM?NAL N0: 768
DFl7E:: 07/P.3/99 'iTMF: 12;40„53
IDo
NfaMl"~ C;RQSS RF'F'Ltl(:EMf_'NT WINDOWS
:3'c'10 9(]01 868 SUI]RCIiRY LN 237.25
2155 9001 868 SUDNERIiY LN 'r'.QD
int,a:L Rc;>ceipF Amaun+,a 244.25
CR1. i.4;.02
USE:F ID: tAN
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122 yk4 -~S
9 851-681-4675
New ConshuMlon ReauiremeMs Remodel/Reonlr ReaWrdmenh~~
? 3 registered sHe aurveys showing sq. R. of 101, sq. H. ot houae 2 coples of plan
and all rooted areas (20% maxlmum lot coveraoe allowed) 1 set of energy colculafiOns for heated addNbna
? 2 coples ot ptans (show beam 5 wlndow sizes; poured ind. des(gn; etc.) 1 sile suney tor exterior addihons a decks
? 1 set W energy ealculotions
? 3 copks Wfree pr servatlon plan H bt platted alter 7/1/93
DATE: ^ 19/ CONSTRUCTION COST: ~ 0 V j
DESCRIPTION OF WORK: C-- j
STREETADD ESS:
LOT: BLOCK: ~ SUBD./P.I.D.
l \
l~~l
Name: p f l2 ~Q, Phone
PROPERTY Last First
OWNER k p
Street Address: U <vu~ b Q4'~'~
Ci1y ff= < <cV, State: Zip:
Company: L vz) Phone {7 / a a y~~ / U
(area code)
CONTRACTOR
T
Street Address: ,ra u z.l Ucense #&ff ~r 8s Exp. L(4L
City ~U v~~n.SU~~ I c State: V 2tp:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
SfreeT Address: Registrahon
City State: Zip:
Sewer & waler iicensetl plum6er (reauired for new conshucflon onivl:
°enaHy applies when address change and lot change Is requesFed onee permH is issued.
j .
! hereby acknowledge fhat 1 have read this applicatlon, sfate that the Informafiqn is eortect, and agree to comply wRh all applicabl
4tWe of Minnesotc Stafutes and Ciry of Eagan Ordinanees.
Signafure of Applicant- OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE U5E ONLY
BLJILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dweliing ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PwchlAddn. (4-sea.
? 03 1 of _ piex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex O 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg." ? 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) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bidgs
# of Stories sq. ft. MC/E5 System
Length sq. ft. City Water
Wid1h Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee ~_j~-' Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PL ~
Park Ded.
Trails Ded. %
Other
Copies
TotaL ~ (4 ~4.
SAC Units
% SAC
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145280
Date Issued:08/31/2017
Permit Category:ePermit
Site Address: 868 Sudberry Lane
Lot:14 Block: 2 Addition: Sheffield
PID:10-67600-02-140
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Scott Armitage
868 Sudberry Lane
Eagan MN 55123
Polar Builders Inc
1103 West Burnsville Parkway
Suite 110
Burnsville MN 55337
(612) 432-1597
Applicant/Permitee: Signature Issued By: Signature