4405 Slater Rd
CITY OF EAGAN WATER SERVICE PERNI~T
5 64 23830 P akt Knob Road pERMIT NO.: E. r 13! P_,4
P. pi . $ox 21199 DATE:
Eaga.n, MN 55vi Na, of Unin:
Z0ni"g' xcept ona orp ZArHrtAt~ liQt~S i~C
Owner: ~
c nuasnoa 6e r
Addrcss: &te7c g +
Site Address: C~allat i Excevat i.n ) p
Plumber. Abn~amaon •
Cor,nection Choroe*
15.00 pd -
MO"r No.: Account Deposit: 10.04 d
Size: permk Fee: .50 d
Reoder No.: ~ 11N Cih? of b~p Su?chc?9et p ~leter
I M~ to oauph Misc. Choroes:
"Mnem Tota1:
' pate Paid:
BY Insp•:
po" of Insp.: - - -
...,.t..-=~-
CITY OF EAGAN SlWER SERVICE P~E~R
3830 Pilnt Knob Road pEyMIT NO.: 3
P. O. Box 21199 p^TE;
Eaya1, MN 551% No, of Units:
Zontnp: ER~eptiona E0r1LACHMAr7 Rm'iyS INC
ownsr' I.26
Addross: 4405 ater Road B Cina~n k ge rd
5tte Address: ra moon Ga nt xcavat nfi . P
Plum6er. 425.00 p4
Conradion coour+t 15 . QO aa
I.p~ !o N"'pi~' `rhl' Nn CMf? ~!'f'" ll
~M~ 10.00 d
Prrmft Fes: .50 pd
Surcmme:
Misc. G+vrow
8Y Total:
pote of Inap•: peft Pald:
nsP•• _
I '
_
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot'Cnob Road
P. 0. Box 21199 PERMIT NO.: 5640
Eagao, MN 55121 bATE: 8413/84
Zonin0: R1 Na. of Units:
pw,,er; Exce tional Cor
fe~; 4405 L25
Sit, Add„m; -4407-Slater Road, JAZ- B2 cinnamon Ridge 3rd
umber: AbSdiAmsjan (r.aiLti F,g -ava ing)
ter No.: 3 t/?1 ;L af o 3 ConnectionCharpe: 470.00 pd
ze: 9 " .L - Acaount Deposit: 1 5_0bpti_
Raadsr No.: A ~ 2 S I,6 Prrmit Fee: 1n_ n0 nrl
~
1 yM h amply wllh tIN Ciryr oi Eqypw Surchorpe: '
Ord1w. MiK. CharQef: 63.00 v metc
Totcl:
~ BY Dote Paid:
Dote of Insp.: _ Insp.:
/i
?
~ CASH RECEIPT ~ i
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19 ~
'
wicsiv=a
FROM AMOUNT $ 1~7 4-Z)
/ (J ~ 7~/(i~ ~ ~?'~rJ ~ar- ooLLwRs
, ,1~oo
~ CASH ~ C H E C `l9 ~
.o (9, c~ pf Z.----
~,~s,-r~r~
FUfdD CODE AMOUNT
p Z~v 313
u
z / sV
~ y •yo
z
7- p 3~,? ' y rJ S"
7 ~'GG iu u U p
U
qZQ
'?d 3 G 3 ~ v
ZG ~ ~ J
Than Y
BY
1Mhite-Payers Copy
Yellow-Postiny CopY
Pink-File Copy
, . _ . _ _ _ . .
CITY OF EAGAN ~r
` 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1V ~ a,~is~
PHONE: 454-8100 l
I 1
dU1LDING PERMIT i R~ce~v~ # ~ ~ ~J
T. w...a M. sr~ nwc/~AR Est. va~ue $6A, ooU oa~e ~uL! ~9~4
s~~Adareu -~4pSSL1~TER RD E,~ ~
. Occupancy ~ 3
Lot ~6_Block 2 ~lSub. GTNN RTi7C.F: ~ q~~er ? Zoninp H1 ~
N/A ~
Psrcel No. .c~~ _ Repoir ? Firc Zone
Enlorfls Q Type of Const. V
~ Name ~~'FL~~N HC1 ES INC p ~t Stories :
Addre~s 4620 W 77TH ST.l STE 104 p~r.,o~;~, ~ Length~~
C~ty ED I NA Phone f~ 9 3 0 7 5 S - p Depth ~Sq. Ft. `
i
~ Apprevals hes
Name .,AME S ~ ~ ~ ,
~ Address Assessment Permit $ 313 . G i)
City Phone Woter 3 Sew. 5urchorfle .
Polica Plc~ check 1`~ b. 5 il
C~
W Name Firo SAC ~ ~`i .~~1
w
Address Enp. Water Conn. ' j~'
~
~W CitY Pha^e Plonner Water Meter 4-~.-
Council Rood Unit 1
1 hercby ockrwwledge tFwt I hava road this opplicotion and stote tfiat g~d~. p~f.
the informnfion is torred ond ogree to tomply with oll applicobls A~ Totol $1 b 1
Stote of Minnesoto Stotutes and,L~f~r~ Eo9on D?dinonces. '
:
Sfpnoture of Permitte~ "~~'E-" .,11~ r~
ZACH:~~~'~N HQt~~ES INC
A Building Pe~nif Is issued to: ~ on the expron tondiHon Ihn~
all work sholl be done i~ acaordonce with a~ oppliwble Stote of Minrkwta Statutes ond City of Eoflnn O~Inonces.
Buildinp UffiNol e,}~~ ~ ` _ y ~ _ `
Pwmit No. Permit Holdsr Misc. Psrmit No. HoldK
Plumbfno y 5(~ -3 D 1~ 4S Y ~
H.V.A.C.
W.ll
w.e..
Disp.
S~rwr
EMctric
Impaetion Dm Insp. Othw
Footinyt
Found~tion
Framinq
Rou~h Plbp. / ~ &,CJ4
Rouah HVA
InwlKion
Final PIb4
Final HVAC
Finai
Watrr
MftII -
Sevwr
Pr. DhP. -
Reoeipt PLUMBING PERMIT Permit No.
CITY OF EAGAN Fee .
? Fill in numbered spaces S/C
~ Type or Print legibly
Tot _c~q-
1. Date7--./'7'- 2.Installation Cost
3. Job Address q 4 ~ i r^ r
4j"ot BIk.U ~ Tract '
r t ~
4. OWnerk.t f t-7 f~~~Y!'L
5. Contractorrj, n.yLr ot-ffse.r PL,,v&one t,F 4• S 3A 3
6. Address ~A <f i j~-,r a s' ~
7. City ',o,rw17.9 .r State Zip s s~~~S38. Building Type: Residential An Commercial ? Institutionel ?
9. Work Description: New)0 Add ? Alter O Repair O
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
/ Bath tubs $eptic Tank
/ Lavatory Softner'
Shower Wel I
/ Kitchen Sink
Urinal/Bidet Other
/ Laundry Tray
l- Floor Drains
Drinking Ftn.
Slop Sink
Z 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. ~
5igned: for ~
Rough Find `
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-6100
Roosipt MECHANICAL PERMIT Psrmit No.
CITIf OF EAGAN Fee
Fill in numbered Wacea S/C
Type or Piint /epibly Tot. ~ U ~7J
1. Date " 2. Installation Coat
~
3. Job Address 4~ y.~S~Ar ti rr5 LotBlk. Tract
,
4. Owner r i= ~ r ; .4
Ld~crv i.•I~j ..~G4NLIPF10fl@ VSv Y- 4' 33? 3
5. ContractgP,,D~!/?~,g&
6. Address f~/p H 13cx :l
7. S28L! 'V iv Zip S
8. Building Type: Residential Commercial ? Institutional O
9. Work Qescription: New 16 Add ? Alter ? Repair ?
10. Describe Fuel Type
11. No, Eauioment BTU - M. Ea. No. Eauipment CFM
Forced Air Afr Handliny:
Mfg.(',-e / ~'-fT',.^ .y
dvu r,- sc
Boilers Msch. Exhau:t
Mfg.
Unit Heater
Mfg. Other
Air Condjr,'&i
Mfg.
Gas, riPing Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and co~es governing this type of work.
Signed : for
Rouph Ffnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464,8100
CITY OF EAGAN Remarks
Addition CINNAMON RIDGE 3RD ADDN Lot 26 RIk 2 Parcel 10-17402-260-02
Owner Street 4405 SLATER ROAD State EAGAN MN 55122
Improvement Oate Amount Annual Years Payment Receipt Date
STREETSURF. Gp 1012.20 COO 4Z7 9-10-84.
STREET RESTOR.
GRADING
SAN SEW TRUNK ~ S n n
SEWER LATERAL 1985 724,53. 144-91 5 724.53
WATERMAIN
WATERLATERAL 1985 617.30 123,46 5 617.30
WATER AREA 261 197-9 131 - 44 8-76 - 15 i"
Services X 1985 393.87
78,71- 5 193-87
+r I
STORM SEW TRK 1979 381.69 19.08 20 f 261,21
STORM SEW LAT 1098.83
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDING PER.
SAC
PARK
CITYOF EAGAN No z64
"a. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .
~PHONE: 454-8100
BUILDING PERMIT Receipt # ~yf1
To ba uwd for SF DWG/GAR Est. Volue $60,000 pate JULY 2 1984
SiteAddress 4405SLATER RD Erect Occupancy R3
Lot 26 elock z __gedsut. CINN RIDGE 3 qlrer ? Zaning Rl
Parcel No. Repoir ? Fire Zone N/A
Enlorge ? Type of Const. V
W Name ZACHMAN HOMES INC Move ? # Stories
Z Address 4620 W 77TH ST., STE 104 Demolish ? Length 38
~ City EDINA phone 893-0755 Grade ? Depth 44 Sq. Ft.-
Name $j{ME ADProrals Feet
o
Ou Addre55 Assessment Permit $ 313.00
u~
1- City Phone Water 8 Sew. Surchor9e 30 . 0 0
F Police Plun check 1 56 _ 50
Ww Name Fire SAC 525.00
Fw
Address Eng. Water Conn.
'Z City Phone Plonner Water Meter ___fi3_0 0
Council Road Unit 2F+n n0
1 hereby ocknowledge thot I hove reod this application and state that Bldg. Off.
the inlormotion is correct and agree to comvly with all applicoble APC Totol $1, 81~.5~
$tate o/ Minneioto $tatutes on Ea n inonces. -
Slpnoture of Permiffee
A Building Permir Is issued to: ZACH N HOMES INC on the express condition thni
oll work sholl be done in acwrdance wrth 1 opplim ¢le Sfa e of Miatutes and City of Eagon Ordinances. ewto Building Official
CITY OF EAGAN Include 2 sets of plar;s, ; t
1 Certificate of Survey &
5P'DWG./1A2, BUILDING PER= APPLICATION 1 set of energy ca].culations.
7b He Used For 5. LValuation 60. 6700 Date s~,P
Site Address: OFFICE USE ODLY
Lot 24~ Block Sec./Sub. G'r,~%~ 3~1 Erect X occupancy R-3
Parcel Alter Zoning R- I
Repair Fire Zone
Oaner: '-a'c-~1074"•f 11,~9417Pt Enlarge _ 2ype of Const. Q
Nbve # Stories
nddress: Y6zoW7T{9re- s4.'tei? Derolisn Front 38 ft.
City/2ip Cocle: Eql.7q S~y3~ Grade Depth 44 ft.
Fhone O 75-- s APPRDUALS F'EES
Contractor: llpssyPS /HGASSessments Perntit 313, a-*
Address: SC! a! L Water/Sewer Surcharge 30o'
Police Plan Check I Slo ,w
City/Zip Code: Fire SAC C~ZS.°°
Phone # : En4 • Water Conn. 4 "7p °O
Planner Water .Meter fp3.
Arch./Fng. : Zq CLlfs,'_~sT Pl ./o G Council Road Unit 2Cop.
Bldg. Off. , f
Prldress: SdLA 4- • APC
City/Zip Code:
Phone TOTAL a/ 75 Q
13x 3~= 9~g x 54 = ZSZ~Z
°~''x ° 144 x 5~-= ~7 -7 (,o
;`7 3oco x q I = I25 4(c>
~j ,c 22 ~ 44o x ~ ~ ~ 484b
5o q-34-
g1 3•OC+
3 0 • ~ 0 +
156•SG+
525•00+
4 7 G• G 0+
6 3 • 0 0 +
26D•OC+
~6 1 7 °SO*
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 --N N-7 0 U
Telephone 4 651-675-5675 FAX 4 651-675-5694
New Construclion Reouiremenis RemodellReoair Reauiremenis Offrce Use OnIV
3 registered site sumeys showing sq. fl. of lot, sq fl of house, and all roofed areas 2 copies of plan CeA of Swvey Recd,:::':'':_
(20°6 maeimum lot coverage allowecl) 1 set of Energy Calculations for healed addil'ans iree Pres Plen. Rectl';~.;; .Y::_tJ
2 copies of plan shaxing beam & window sizes, poured found design, eta . 1 sile survey fw addi6ons & decks Tree Pres:Required;
1 set of Energy Caiculations Addrtion - indicate if oo-sde sephc syslem 0r-site 5eptic,Sysiem _ N
3 copies of Tree PreservaGon Plan if lot platted afler 7/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less unils
Date lb._ l~ I Q! a Construction Cost 7 0 'o C)
Site Address 7/ OS UniUSte #
Description of Work / `~~a f P ~ ~r~~ `~c~` ~~ay e-
Multi-Family Bldg _ YrN Fireplace(s) 1 _ 2
Property Owner 4Q1M Cc f~C ' Telephone )
~
Cootractor O
Address / S/CC fC U C City CZC1i. ti/
, v-
State r'/1-1 Zip VS~~;,- Telephone#(~i ) d'0
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet
(Jsu6missiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ~
Mechanical Contractor Telephone # (
Sewer/WaterConhactor Telephone
OCT - anil
I hereby apply for a Residential Building Permit and acknowledge that the informati is complete and accu ate;
- MN
tate.
that the work will be in conformance with the ordinances and codes of the City of ~gan-and=the=S
Statutes; I understand this is not a permit, but only an application for a pemut, 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.
/*~4-4,.7_ ( '
' Applicant's Printed Name Applicant's Signature ~
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 DS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3sea.) ? 31 Ect. Alt- Multi
? 03 01of_plex O 09 07-plex ? 17 Garege ? 22 PorchlAddn.(4-sea.) ? 33 Ect.Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multl Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Add'Rion Q 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteretion ? 37 Demolish Building` ? 43 Reroof ? 46 Wndows/Doors
? 34 Replacement 'Demolition (Entire Bidg) -Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Unfts Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIItED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addi[ion) _ Plumbing
Foundation _ HVE+C
Drain Tile Other
Roof _ Ice& Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Smcco _ Stone _ Brick
_ Fireplace _ RI. _ AirTest _ Final _ Windows
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
CZ'iY OF E:FlGAN
CA:aFIIEFi: :i5 -f1=F{MINAL NOt 695
OA";E~ 09/00/33 "fIMl:i:. 17:06:03
ID,:
NA,MEe MICH61_I._I_ M. 320 9(1U9. 4405 ',il_Ai'E:R FiD 60.00
3430 9001 440; SLATET; ft1) 0.75
2155 9001 4405 SLAT(_Ii I'iU 0a50
~
'foM1;a:l. Itieceaip+ Amnun+.e Q.25
CF' J. i b807
t.1Slc:fi SX). JAN
7k`X•X, .1'IM;Y:n'M ;;~%lX(:XM>'($.)t7~::k7FYd7XM%R'M%F%FY::~S:'`FKKYr'7~onY:M' Y/'MW
~ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD • 55122
3 651-681-4675
ygw Cr.nsfrucfion Reauiremenh Remodel/Reoalr Reauhe~
D reglstered sRe surveys showing sq. M. of bt, sq. tt. of house 2 coples of plan
and gll roofed areas (40% mmcimum lot eoveraae allowed) 1 fet of energy cakulaNonf for heoted addHlons
A 2 copies of plans (show beam L w(ndcw sKer, puwed fnd. design; Nc.) 1 sHc survey iw enteft addlHons a decks
D 1 sM of energy calculaHons
D 3 coples ol hee preservaHon plan X lol plafled a(fer 7/1/93
DATE: (1 J I"' I`, CONSTRUCTION COST: ~ J U~•
DESCRIPTION OF WORK: PC K
STREEf ADDRESS: TA017) l LIC r Q('),-aC~.l a n r'x-~ ~ ~~1
LOT: ~~v BLOCK: ~ SUBD./P.I.D.
4
Name: &Q Q l 1 II a~L -Qq Phone It: 11~-!~
PROPERTY Lar FUst
OWNER i l~
Street Address:
City ErA-dc State: I I ~r-"\ Zip:
Company: Phone
(area eode)
CONTRACTOR
Sheet Address: Lieense # Exp.
C(ty State: Iip:
ARCNITECT/
ENGINEER Company: Name:
Telephone k: area code ( )
SheeY Address: Regishation M:
City State: Zip:
Sewer S wa?er tlcensed plumber (reauired tpr new conshucflon onNl:
.
2enalfy applles when address change and lot change Is requesfed once permN is issued.
I.hereby acknowledge that I hwe read Mis application, state tFiat the Infomwtion ia cortect, and agree to comply wMh ail applicabl
Sfafe of Minnesota Stafutes and CMy of Eagan Ordinances.
Slgnature of Applicant: v,,~f~
OFFICE USE ONLY
Certificates of Survey Received Ll Yes _ No
+~UG 3 ~
Tree Preservation Plan Received Yes _ No _ Not Required
1 / 4
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plez ~ 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments a` 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 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 Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code 2,1~
(Allowable) Main level sq. ft. SAC Code 6~/
UBC Occupancy sq. ft. No. of Units G
Zoning sq. ft. No. of Bldgs ~
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Pianning Building ~ Engineering Variance
Permit Fee Valuation: $ /2G'o
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 Units
% SAC
r/~ N H. H E D L U N D 7726 Morqan Avenue South
Rkhfiald,Minnasoto 55423
,.0 Surveyor Clvll Enqineer Phone : 866-2523
~ surve#ores Certificate .
JOB NO.
SURVEY FOR: Zachm3n iiomes Inc. S F.xcept;onal 'tome.s
DESGRIBED AS: Lot 26, t;t.ork 2, CIP7h11+40N FI[wE 311D .".DDI'i'ION, City of Eagan,
Dakota Coimr,y, 74inne5ota anr7 rer,orvina easments of zeCOrd.
~509° .
` 59.3
9'q3,.
E
~
N NI
h NI ~
Top of F«snJot;o.r. 9179
a BnSSM'isdt' ~~00/"r 9 ~ 7~7 '
~ fQ ~1/ 9/7.~ J
Prvpo seJ El aver;ons
~
lo'~ 5ro,rr<, i•~ EXistiny Elevat;o~s ~
_D
` - r.;n,9e 'Directlons
Denotes LeY C.rnei O
l,/`'
• ~
SLAT£R R o,~a D
ti Rr,y
'30•
CERTIFICATE OF SURVEY
Z hereby certify that on 7/G /8,1- I surveyed ihe property described above ond ihot
the above platis a correcr representation of said survey. ,
~ ~ i
Calvin H. Hedlund, Minn. Reg. No. 5942
, ~ I
I CITY OF EAGAN 2/84
APPLICATION FOR PERMIT
~
- SEWER AND/OR WATER CONNECTIODi
(PLEASE PRINT)
PROPERTY ADDREss: y~ s
r.Frar DESCRZP'PION:
(LOt lock/ ubclivision or Tax Parcel I.D. Nimber)
I IF STRI'CI?,:T-, DAit, Q" ORIGTN?L cLiI~L`:G PEP: S'?' ISSTj?i•:C?.: `
~ PRESENT --:^.`IPr,,/PT?OPOSr'I) U,-c?: ~R-1 SiiGZw FP?-1rLv
'R-? GUPLE:{ ('P.•:0 L'NITS;
? R-3 'IC~,INHOUSE (TFIREE + UNITS) ( UNITS)
? R-4 APAR'IP-fENT/CONDa?INIUM ( UNITS)
? COMI1ERCIAL/RE.TAII,/OFFICE
Q T'DUSTRIAL
Q INSTITUTIQNAL/GOUE[hR,=
z) AppLICANr (PLEASE PRINT)
ADDRESS:
CTTY, STATE, ZIP: , ' A ~ ! c~,~
PHONE: °72 '2 ~~2!~
,
B
3) PILP4BER NAME_ ~ (PLEASE Pf~.t"N~ ~ fOR CITY USE ONLY
.
ADDRESS: PLUM NS LICENSE:
Active
CITY, STATE, ZIP:~J%jl~i Expired
PHONE: p~UMBER LICENSE p~ ~~i~°rd
L~~
a nitia
4) OCC[JppsyT/a+,n,IER (PLEASE PPINT
NArtE: ~ ~L' 3 Jr iZ~
ADORESS: ~
CITY, STATE, ZIP: kfrl/(L.-r
PHONE: - .~7 Sr
5) INpIG'1TE WHICH PERMIT ZS BEING RDQUESTID:
~ CONNECPION TO CITY SETr7ER
~ CO:VNECPION ~ CITY WATGR
? 0`I'fIQt (PlSE DFSCRIIIE)
6) INDIG,`:'E ONE: ~ PLFASE HOLD APPROVID PERhLTT FOR PICY.-UP BY ONE OF ABOVE
? P b'L4IL APPROVID PIIRMIT TO 1, 2, 3,<~4ABWE
(Circle one)
7) SI~A DATE: ~ } g'
. . . .
. . . . . .
. . . s
F 0 R C I T Y U S E 0 N L Y '
PERMIT = ISSUED
F°ES: $ ~ o. S d SEi4ER P°RA1IT (I:ICLGD° SUP.CHARr,E)
$ S v WATER PERP1ZT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER T.'vP
$ ACCOUNT DEPOSIT - SEi•IER
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ .5- o-~ SAC
$ TRtiNK WATER ASSESSMENT
$ TRUVK SE'r7ER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SE?9ER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER a
$ TOTAL
$ P,iMOUNT PAID/RECEIPT
DOES UTILITY 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 ENGINEERING DIVISZON. LIST AS A CONDI-
TION.
SUBJECT TO TIiE FOLLOWING CONDITIONS;
APPROVED BY:
TITLE:
DAT° :
.~T. A L`'' V I N H. H E D L U N D 7726 Morqan avenus sourn
Rlchtield,Mfnnssota 55423
Land Surveyor Clvll Enqineer' Phorte : 866-2623
survelor`s G'ert~ficate • JOB N0.
SURVEY FOR: Zachman 3Iomes Inc. & Exceptional !IOmes
DESGRIBED AS: Lot 26, Block 2, CINNAMON RIDCE 311D ADDI'I'ION, City of Eagan,
Dakota County, tdinnesota and re,erving eas-r_ment3 of reEord.
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CERTIFICATE OF SURVEY I hereby certify that on 7/G /84- I surveyed the property described above and ihot
ihe above plat is a correct representation of said surve
Calvin H. Hedlund, Minn. Reg. No. 5942
1S,4 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan • ;i5
3830 Pilot Kuob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuction Reauirements RemodellRe air R uiremgn~ts Ofice Use Onlv
3 registe2d site surveys showirg sq. fl. of bl, sq. ft. of house; and all roofed areas 2 copies of plan ? CeA of Survey Recd fY _ N
(20°h mazunum lot coverage allowed) 1 set of Energy Calwlations for heated additions N UTree Pres Plan Reoi _ Y _?~W.
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks ? Tree Pres Required _ YLIV
1 sel of Energy Calculations Addition - inMicate il on-sde septic system On-sile Seplic System _Y yIP
3 copies of Tree Preservation Plan if lot pWtted after 711193
Rim Joisl Dehil Options seleclion sheel (buildings with 3 or less unils)
O
Date Construction Cost $00-
Site Address /q % EIZ UniUSte #
Description af Work .SC/y~it/~ ~Oe-/a ez;' I7j0/y
Multi-FamilyBldg _ Y~N Fireplace(s) ? 0 _ 1 _ 2
- Z f~0 f
Property Owner L1Pr`r6 I~ r FNB~',~Z'2 Telephone #(Gfl ) 3 0
Contractor TN~?"' AJ /.S~/LN t J 4 Tc 'V- y oo -7'fzSs
Address !c z B~, x city C_ 9iv Et30,c o
State /'1/X Zip Sj9 yf Telephone #(Sc,?) z~'Z • Z2 70
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
(4 submissiontype) Submitted Submiried
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar pla~~~\Y _ N If so, 25% plan review
fee applies. ~
Licensed Plumber ~teph~o e#( J
Mechanicat Coniractor Tete~ e#( J
~
Sewer/Water Contractor ephone )
v
I hereby apply for a Residential Building Permit and acknowledge that the 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 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.
7_/7'o~fl A1 /j
ApplicanYs Printed Name Applicant's Signature
OFFICE USE ONLY ~yfy A~ P~O/sS~z~ (zD~J
/Y9~~¢
Sub Types !tY~Sr,:~y /37G !Yl
? 01 Foundation ? 07 OS-plex ? 13 16-plex O 20 0q7~L~ ? 30 AccessoryBldg
O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck x 23 Porch (screen/gazebo) ? 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
X 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 Rep18C2m0n1 'DemoliUon (Entlre Bldg) - Give PCA handout to appliwnt
Valuation ~ Occupancy R-3 MCES System
Census Code 2oning City Water
SAC Units Stories Booster Pump
# of Units ~ Sq. Ft. J,~o PRV ~
# of Bldgs Length Fire Sprinklered ~
Type of Const ~ Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
Footings (deck) ~R Final/No C.O.
~ Footings (addition) _ Plumbing
Foundation H V AC
Drain Tile Other
Roof _y Ice & Water ~ Final _ Pool _ Ftgs _ Air/Gas Tests Final
~ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
-
Base Fee ~~•3 ~~p ~ Q.70 3 6~
Surcharge 0
Plan Review d /2
~
U
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
~ . .
~
ll N H. H E D L U N D 7726 Moraan Avanua south
Rlcnfield,Minnssota 53423
,urveyor Clvll Engineer Phona :666-2523
surve~or`s G'ert~ficate
JOB N0.
SURVEY FOR: 'Lachmcn i?omes Znc. ~ F.Y~eption;~l '.Iome :
OESGRIBED AS: Lot 26, L:lnck CIPIN1li•iGN FI[w:: 3RD F,DDI'CION, City of Eagan,
Dakota C~:mn*.y, :4inneaoY.a an.-3 rer:rrving eisoments of reEord.
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Denatrs Lot C.rnei a
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CERTIFICATE OF SURVEY
I hereby certify ihai on 7/G 134 I surveyed ihe property described above and ihat
the obove plat is a correcr representation of said survey. .
~Q
Calvin H. Hedlund, Minn. Reg• No. 5942
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Use BLUE or BLACK Ink
r
For Office Use ~j
Permit 1 "
Ron
City of EaE
d I 5.05
I 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 PER~MMIIT APPLICATION
Date: ( Site Address: 1 ~ J F ' Unit
Name: 1 " ( Ie(J 6ltTT6 t;,T`--' Phone: 6 3^/ -_336-64//-n
Resident/ SCE
Owner Address /City /Zip:
Applicant is: Owner ~e Contractor
Type of Work Description of work: T
Construction Cost: a Multi-Family Building: (Yes I No
Company:"-5-1 P(TC- cod r Contact: ~
Address: 1 S- . rN )_(y4t t L, J City: ffA_FVC PLAV"
I Contractor
State: Zip: -SS 7 Phone:
License Lead Certificate l~~- 27 /
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.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 Minnesot State Buil ing C de m st be completed within 180
days of permit issuance.
x x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
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