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3253 Evergreen Dr:ITY OF EAGAN ICE R PERMIT CITY OF EAGAN WATER SERVICE PERMIT ` V WATER SE 3830 Pi:ot Knob Road 4 -) 3 830 Pilot ICnob Road 4 ';,j4 Box 21199 O P PERMIT NO.: 8-3-0 . O. Box 21799 PERMIT NO.: 8_3-83 . . Esgan, MN 55121 DATE: !agan, MN 55121 DATE: Zo+in9: No. of Units: :oni?g: No. of Units: 3TUt&0Y CO Iwner: LYUtKeT CO Owner; Wdress: Addnm: 3255 Evergre?r? t3r i. B1 Coac nfi n lasi(s ite ,,,ddmss. 3253 Ever reen D r L15 Ii1 Coachman !ii a1an41s Sire Address: ayas on rac ors 'iyeS ContxAGtoTS Plumber. .?? , 00 ??d lumber. 00 Ad 450 Meter No.: Connection Charqe: Aeter No.: Connection Char?: . ^ Account Deposit: ize: Account Deposit: 10.00 Y`' Size: Readar No.: 10.U0 ) ? PeRnit Fee: P ,eoder No.: Permit Fee: . SQ _?i, 1 agree to oo?nplp whl? !6w Ciyr of loyae Surcharge: Gi) lOter 00 -? T a4re? to ooa?ol?r with tht Citp ei Eaqen Surthorge: . . Misc. Charfles: ? bdinona:. Misc. C?wrpes: 00.00 ',: ;,?, a i eT Ordinenas. Total: Total: By Date Paid: ?Y )ate of I nsp.: Dote Paid: InsD.: date of Insp.: I^sp.: Pilot Knob Road Box 21199 n. MN 55121 SEVIIER SERVICE PERMIT 6(?12 PERMIT NO.: DATE: 6 No. of Un1ts: Address: 0 -L-V.7 J!\l-I s to aanpiy willi lhe Ciyr of ielon Connection Charpe: 42..7 . t -JI •?li Account Deposit: Permit Fee: 10.0?? P Su?chorpe: . SO Pd Misc. Charpes: Total: --- of Insp.: SEWER SERVICE PERMIT PERMIT NO.: 0940 , DATE: .•-. - 3 No. of Units: ;3rut er Co V- r _..i? .... . " _ 1 eom to eomPy wIh tus Cihr of Lagoe Connection Ct+arpe: 4 2 5. 04 p d Ordinences. Account Depesit: ln, Qf! Pd Parmit Fae: '; n r. d su.c.t?aroe: B Misc. Chorpes: Y Dota of Insp.: Total: Insp ; Doh Poid: CITY OF EAGAN 77- RemarksI )I / Add'+tion COACHN AN HIGHLANDS Loc 15 Bik 1 Parcel 10-18075-150-01 Owner srrPer 3253 EVERGREEN DRIVE ?*a,P EAGAN NIN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1975 Paid L1II r arcel 10 2750 -010-03 STREET RESTOR. 1574 n n of GRADING 1007 1986 354.14 35.41 10 C - d /Q -45267 SEW TRUNK p 1968 Paid lln T' arCel 10 2750 -010-03 SEWER LATERAL 1984 el IF ft * WATERMAIN 17/ 1972 Paid L1II r arcel 10 27$0 -010-03 ? WATER LATERAL 1975 It if * WATER AREA 172 of n n WATER LATERAL 1975 " " " STORM SEW TRK 1975 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 450.00 it of BUILDING PER. 8342 SAC 525.00 t? n PARK INSPECTION RECORD CfTY OF EAGAN PERNlIT TYPE: ? 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: 1V1 I1i±F4E r hl IIF2 ... i • t s: ?,li;??? ?, ??? ? ric, PERMIT SUBTYPE: TYPE OF 1NORK: INSPECTION DA • D• !ii I F pdri -1 ? --- -- ---- ------_?? - Permit Holder Data 7elaphone # SEWER/ WATER PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBINQ PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD F4REPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATIdN METER FLUSH MAINS corvoucriviTv TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FfG DECK FINAL ? -- --- Receipt 6 / L; 1. Date 0 Z 3. Job Address ? 4. Owner PLUMBING PERMIT Permit No. CITY OF EAGAN Fee - Fill in numbered spaces SJC - Type or Print legibly Tot. a 2. Installation Cost . 'E ?P/7'j /;`f?,! L.vi ?-l ?; , : . , > Lot/5,Blk. ? Tracty n ? 1 (? 5. Contractor Phone / Z ?? ??S ~ 6. Address 7. City aTJ,Zz nlC? ??% State i Zip ?--- 8. Building Type: Residential 19 Commercial ? Institutional O 9. Work Description: New E Add O Alter ? Repair ? 1 10. Describe 1 11• No, Z Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic 7ank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with.All ordina ces and codes gryverning 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 464-8100 ? Receipt MECHANICA4 PERMIT Parmit No. CITY OF EAGAN Fes Fill rn numbered apacea S/C Type or Prini legiBly ' Tot 1. Date 2. Installation Cost . 3. Job Address Lot Blk. ? Tract 4. Owner (-14/Z ? 5. Contractor Phone 6. Address 7. City : c 1- State ,': / I _ I Zi P 8. Building Type : Residential Ll Commercial ? Institutional ? 9. Work Description: New CI Add ? Alter ? Repair ? I, 10. Describe` TC Fuel Type 11. No. ? EaJoment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. an ng: r Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other f Air Cond. -,?l 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 lnsp. Tfiis is your permit when numbered and approved. Approved _ CITY OF EAGAN 454-8100 PER+IAIT # - ?, RECEIPT # DATE CITY OF EAGAN MECHANICAL PERMIT 454-8100 MINIMUM RESIDENTIAL FEE - $10.00 + $.50 MINIMUM COMMERCIAL FEE - $20.00 + $.50 7. Bldg. Type: Res X Comm Inst 2. 3. Total Bid Price /? 1 0-'0? 4. Job Address - Lot ? Block r , sec 6. Contractor RESIDENTIAL HEATING - 01-104,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00 RESIDENTIAI COOLING>- 01-24,000 BTU's -$72.00. Each additional 6,000 BTU's or fraction -$6.00 MODIFICATIONS/AL7ERATIQNS -$10.00 minimum fee ' HEATINE', VENTILATING HOT WATER" 3TEAM ? AIR COND. e1R PIPING PROCESSED PIPING AIR HAND. EdUIP. RtFRIG. RES. GAS PlP1NCi OUTLETS -$7.50 TANKS: L.P_ UNDERGROUND OTHER COMM./IND. R E- 1aYo F TOTAL BID PF11CE PLUS $.50 STAT URCHARGE FOR EACH $1,000 O FEE. ? Signed: 7 r •??'?-+?? for ?- FEE /,2 • C9-+d S/C ' Vrd TOTAL J'O New Add /'` Alter Repair Approved Inspections: Date Rough Insp. Date Final Insp. B1dg. A-6 CITY OF EAGAN 3795 Pilot Knob Rood Eogoe, MN 55122 PHONE: 454-8100 BUILDING PERMIT W_ ?_ ____, ,__ 1 of 6 PLER N?v 8341 Receipt # =J7': :E?L ----- Site Address sz» Lvergreen urZVe Erect ? Occuponcy R-3 Lot 15 Block 1_ $ec/Sub. Coacllman High j.a nde Alter ? Zoning R-3 Porcel # / 0 '/pC) 7 5 - !i /s?' D/ Repair 0 Fire Zone NA Enlorge ? 7ype of Const. V oc Nome BrutgeZ Compsn:Les, Inc. Move p # Stories 2 z One Suniaood Dr., P.O. Box 399 p oli h Len th Address (' em s ? g 9 ,... St ?' Cloud .w___ 252-6262 Grade n Depth Sa. Ft. 0: Z0 uu § r Nome Address 1 hereby acknowledge that I have read this appiication ond stote that the informotion is Correct and ugree to comply with pll applicoble State of Minnesoto Stotutes and Ciry of Eagon Ordinnnces. Signcture of Permittee isru A Building Permit is issued to: oll work shall be done in occordance Build'+n9 Officio) Assessment Water & 5ew. Police Fire Eny. Plonner Council Bldg. Off. APC Permit L7c.vv Surchorge 26.50 Plan check 14 h. 00 sAC 525.00 Water Conn.450. 00 Water Meter 60 • QU Road Unit ? 51) - 00 Totol $1749 _ 50 on the express condition thnt and City of Eagen Ordinances. Permit No. Permit Holder Misc. Permit No. Holder Plumbing '56 'l 3 L? H.V.A.C. qD bO U. 1?.a? ?D-I l?OJ weu Water Disp. Sewar Electric A- (D5 Co S 1 nn SVL.Q.. /p -(7 `I153 Inapection Date Insp. Other Footings Foundation Flaminp Rouph Piby. Rough HVAC Inwlation Final Plbg. 3,? L Final HVAC Finai W?? Describe Location: Well m Sewer Pr. Disp. RESIDENT / OWNER Name: eeDA /t(- -0 4I1�N LIAJbj l i(/ SPhone: Address / City / Zip: S7od F L - c P DA— Applicant is: Owner X Contractor TYPE OF WORK Description of work: RE': Rooj Construction Cost: f7/ S Multi - Family Building: (Yes x / No ) CONTRACTOR Name: RCOF 41 /t41- 4A- License #: 020l 70 l 5 Address: 53— IC A44 /4U /W. City: ST: G44/CNfd4- L State: 7A-J Zip: 3 7f Phone: 76 3- S 0- 0 Y Y' Contact: /Z (ZY Email: » • mac -+! +t-A-i J NC° 0 'e - CO OVI n 000\ COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non - public if you provide specific reasons that would permit the City to conclude that they are trade secrets. City of kap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 S Applicant's Printed Name Permit #: Permit Fee: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ( 4 7 - . 2 s /U Site Address: 3 Tel E voi-e N 1 , U Tenant: (rcL 9,S I ( "l � J , 3SSS r S , 1 Use BLUE or BLACK Ink Suite #: c 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.gooherstateonecall.orq Applicant's Signature 9:74614 — QZ7.2 Date Received: (d . I Z-' l 0 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 wit be in accordance with the approved plan in the case of work which requires a review and approval of plans. Page 1 of 2 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3253 Evergreen Dr Lot: 15 Block: 01 Addition: Coachman Highlands PID:10- 18075- 150 -01 Use: Description: Sub Type: e - Fixtures Work Type: Replacement Description: Second Floor Meter Size Meter Type Comments: Fee Summary: Jason LaBelle 700 Prior Ave N St Paul, Mn 55104 Manufacturer PL - Permit Fee (miscellaneous) Surcharge -Fixed Total: Contractor: - Applicant - Home Depot Plumbing Contractor - Jason LaBelle 40805 Forest Blvd. North Branch MN 55056 (651) 645 -5040 Applicant/Bermitee: Signature PERMIT City of Eaan Permit Type: Permit Number: Date Issued: Permit Category: Serial Number Remote Number $50.50 Owner: David D Taylor 3253 Evergreen Dr Eagan MN 55122 $50.00 0801.4087 $0.50 9001.2195 Issued By: Signature Plumbing EA081483 12/17/2007 ePermit Line Size I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State ' Bldg. A-6 CITY OF EAGAN 9795 Pllot Knob Road Eagan, MN 55142 PHONE: 454-8100 BUILDING PERMIT T_ " ....w 9_. 1 of 6 PLEX $53,000 N° 8341 Receipt # :?_??.?,L? p.p August 1 1983 Sire Address JLJ:i Evexgreen llrive Erect MD Occuponcy R-3 Lot 15_ Blxk I._ $ec/Sub. C oarhman Hi nhl ands Alter 0 Zoning R-3 7arcel # Repnir ? Fire Zone NA Enlarge O TYpe of Const. V W Name BrutQer Companies, Inc. Move ? # Srories Z z Address One Sunwood Dr.' P.O. Box 399 Demolish ? Length_ ci St. Cloud phom 252-6262 Grade ? Depth Sq. Ft.- p Nama awner ApOrorals Fees ot Address Assessment Permit ' 00 u? Woter 8 Sew. Surchorge 26.50 Cit Dhone 146 00 Police . Plan check ?W Nume Fira 5qC 52$.00 _a? Addrexs Eng. Wnter Conn.450.00 <'Z" CI Phone Planner _ Council _ 1 hereby ocknowledge that I hove read this applicotion and state that Bldg. Off. _ the informafion is correct nnd ngree to comply with oll opplicable APC $fafe of Minnesoto $tatufes and Ciry of Eogon Ordinunces. Signafure of Permittee BrUtgEr ? A Building Cermit is issued to: oll work shall be done in accordance wifh all Water Meter 60,00 Road Unit 250.00 Totol 57749.50 . _ on Me express condition thni ond City of Eaqon Ordirwnces. Buildirp Official _ if 4 W_o' `l, S CITY OF EAGAN 6 'Ib BE Used FOY 1 of 6 Plex Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. _ 2 6fZ. Valuation S?B0d- ?D D Date July 13, 1983 Site Address 3253 Evergreen Drive Lot 15 Block 1 Sec./Sub. Coachman -Parcel #: Highlands Owner: Brutqer Companies, Inc. AddT255: One Sunwood Drive, P.O. Box 399 Gity/Zip COde: St. Cloud, MN 56302 Phone #: (612) 252-6262 CAntsdCtOY: Brutqer Companies, Inc. PddL'2SS: One Sunwood Drive, P.O. Box 399 City/Zip Code: St. Cloud, MN 56302 PhOR2 #: (612) 252-6262 Psch•/Ehg.: Blumentals Architecture, inc. AddL'2SS_ 6100 Summit Drive North City/Zlp Cocle: Brooklyn Center, MN 55430 PhOne #: (612) 571-5550 OFFICE USE.ONLY Erect Occupan Alter Zoni.ng Repair Fire Zo Enlarge Type of Const. Nbve # Stori Derolish Front . Grade Depth ft. APPROVALS FEES Assessments Peimit [+Tater/SEwer Surcharge ? 6 ? Police Plan Check ? g 6°= Fire SAC En4 • Water Conn. 450? Planner Water Meter Ln Council Road Unit zs'D? Bldg. Off. APC T(7PAi, 5-C) CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651)681-4675 SITE ADDRESS: PERMIT PERMITTYPE: ButLozNr Permit Number: 03yO39 Date Issued: y ?/ y 7/9g 3 2 4 9 t_vErtc,et_r:rd oR i -n -re 17 aL ocK e i rnArriariAn 111rOHi._Aivns P.i.iv.: 10-18075-170-e1 DESCRIPTION: REROOF! ,r,, PI_EX B,uildinq P2i°m:i.c TvoP h1U1..7'1 e (MI:SC<) Bu%ldzng Wofi°k_rYp° REPRIR CettSUS CQde 434 flLl"< RESIDENTTAL n. 71 . il si ^ ,t" r r? REMARKS: INCLUDES FEE SUMMARY: 3251, 3253,. 3S_'5 5 . 325i ,. l3N D 32 59. `dFiLllAlCOtd Base Fee Sur-charge Total Fee i o,0d0 $137, ??? $191.25 CONTRACTOR: - Awpl.tcant: -- OWNER: BETSSEL WINDOW F STI)TiVC 2R516£33F9 COfaCHMAN HICNLANDS ASSOC. 3213 EVEf7GRIiEN pR 3249 t`_4'ERGREEN pR FAGAN MN 55121 EA6AN MN 56122 (61?) 451.-0835 ? I hereby acknawiedge that Z have read this applicatir5ri and state that ttle information is correet and aqree Co camply with a11 applirable StaCe 41` Mri, Statutes and City of Eagan Qrdinances. APPLICANr/PERMtTEE SIGNAiURE pSUED BV: SIGNATURE Cr I k f?. .!-'.-(r.ll I .. , ..., ., _ ?.;.iG,'• ? ::. -. ?. . 9.`?i ?:?.I:':;:': ._..- . ...:, ??. ....: F?1 te ',?..u?? 7.: ..... .:.?....., ...I17:. I..._)... . . I ?. ?-??.,... ...? ? ) .g[i(1 f •`_:li : If4{ ... '.i!::?::. ::'?..] ? r: .u"y). -'37' ? I !..::.'•r.:.l : i. r,c; e _?.. ?. . ?:.. . i. ?'??.. ...?..?.:..? (I:: I i??.?' . ?'. -? ... n... '..? 1 I 1"'I..'?I'.•. ::!,..-y ....:Z'J,u";:. :....,...;.i, ?..?.. ;..;... . ...; . .•,C(-1(d ;... ... ,..., ??? r ? i .? ?.. .r', ? ? .. •:' I i .f. i: !:r;,i .- r i:'.`] , i .f.?'4 :? .-.?i?..r.! 1998 BUII.DING PERMIT APPLICATION (COMMERCIAL) CITY OF EAGAN . 681-4675 s il- l-1-9,F? uunm iuuuwuiy w w.un? uc..w?a?r ?.. Foundation Onl ... 1... New Construction Interior Improvement strudu2i plans (2 sets) architecturel plans (2 sets) architectural plans (2 sets) civil plans (2 sets) structural plans (2 sets) eode anaiysis code analysis (1) •• civil plans (2 sets) prqect specs (1 set) soils report (1) ecs (1) t landscaping plans codeanalysis (2 sets) (1)" Key Plan energycalculations (1)notahxays" projec sp Special Inspections & Testing Schedule " soils repoR (1) Electric Power & Lighting Form (1) not ahxays " SAC determination letter from MC1W5 - SAC determination letter from MC/WS - SAC determination letter trom MCMlS - call 602-1000 call 602-1 D00 call 602-1000 Speciallnspections&Testing5chedule (1) " pmject specs (1) energycalculations (1) Eledric Power 8 Lighting Fortn (1) " DA DESCRIPTION OF WORK: W2 CONSTRUCTION C05T: SITEADDRESS: 3o;H C/' Z( TENANT NAME: A SUITE #: LOT BLOCKSUBD. P.I.D.# Phone #: Name:--- -- ---- - --- -- PROPERTY Iast First OWNF,R Street Address:__ ___ - ------------- '- City _ --------------W- SGqte: ---------- zip' -- Compaz?y???W_Jl?` ?-•r?? ?-_?-=-/?'r f Phone 4t: coNTRAcro R StreetAddress: 1.icense # City _0! State: Zip: ARCHITECT/ ENGINEER Compairy:_ __ __-_-____ Phone #: --- Namc: Registradon #: Street Address:---?---- - ------- - City Slate: --------- Zip' ----- Sewer & waSer licensed plumber (only if installing sewer 8 water): I hereby acknowledge that I have read this application and state that the information ' ect and agree to comply with all applicable State oi Minnesota Statutes and City of Eagan Ordinances. Signature of Applica OFFICE USE ONLY Contad eunamg inspections ror sampie Food & Beverage or Lodging faciliHes: Plan must be submitted to Minnesota DepaRment of Health. Call 215-0700 for details. TG. // /i) -q/ WORK TYPE: _, NEW REMODEL BUILDING PERMIT TYPE ? 01 Foundation ? 18 Comm./Ind. WORK TYPE ? 31 New ? 32 Addition GENERAL INFORMATION Const. (Actual) _ (Allowable) UBC Occupancy Zoning # af Stories Length Depth APPROVALS ? 19 Comm./ind. Misc. ? 20 Public Facility ? 33 Alterations ? 34 Repair Basement sq . ft. First Floor sq . ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Engineering ? 21 Miscellaneous ? 35 Tenant Finish ? 37 Demolition MC/WS 5ystem City Water Fire Sprinklered Census Code SAC Code Census Bldg. Census Unit Variance Permit Fee Surcharge ? Plan Review MC/WS SAC City SAC Water Conn. SIW Permit SIW Surcharge Treatment PI. Park Ded. Trails Ded. Water Qual. Other Copies Total: % SAC SAC Units Meter Size Valuation: $ 2006 RESIDENTIAL BUILDING PERNIIT APPLICATION CIc," City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX 9 651-675-5694 New ConsVUCtion Reauirements 3 registered site surveys showing sq. ft. of bt, sq, fL of house; and ail roofed areas (20Yo mawmum lot coverage allowed) 2 copies of plan showing heam 8 wkvdow sixes; poured Found design, etc. 7 set of Energy Galculations 3 copies of Tree Pmservafion Plan if lot platted after 771193 Rim Joist Defail Options selection sheet (buildings with 3 or less units) Minnegasw mechaniplventilationfortn S7'!3 RemodeVReoair Reaviremenis OfficeUse:Onlv 2 copies of plan showing footings, beams, joists Cert of Surrey Recd Y _N 1 set ot Eneigy Catuiatimr for heated additions Tree Pres Plan Recd _ Y N. lsitesurveyforaddilions&tlec TreePresRequired _Y _N Addition - irMicate if on-SBe se79 f$i? ?? On-site-SepGc System _Y _ N ?? ??i7? V APR 0 Date ?' ! V ? Construction Cast site AaaTess 3 2LI q 3a51 7 Z 5'? f 3 2 5 S 3 2 5-??, 32 S q nfuste # Description of Work -?t IaL@.: n7 W, Iv1 @u1S Multi-Family Btdg _ Y_ N Fireplace(s) _ 0 2 Property Owner lo-flc.HmA? ?iIA14/iw ????OmtS Telephone#( ) Contractor ?hA 1.554 Yf(Q 16 606 Address -7?iSl htekwOO C.Q lVl -4130 ?q City State /h A1 Zip 75?q Telephane #(?3 DSVV COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventllation Category 1 Worksheet . New Energy Code Worksheet (4 su6mission type) Submitted Submitted . Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permif for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone # ( 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 wark 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. [ 14?? At6/T7(fiitx C Applicant's Printed Name Applicant's Signature $?331.zs . � � 3��, �3 � SI, �3�5�3, 3� 5 �; 3�s7 3� 5 � Use BLUE or BLACK Ink �----------------- � For Office Use � ' j Permit#: °� �Y1�`� I C�ty of ��Il � a ��s � � Permit Fee: � 3830 Pilot Knob Road Eagan MN 55122 j Date Received: � I� f I Phone:(651)675-5675 I I Fax:(651)675-5694 I Staff: I i I `��.��J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION �t�: ��, �� Site Address:��- `i�`� E�F�C��r� '�� • u��t#: 3�?'-lc1-3�.�� Name: Phone: �OWt1@t'� Address/City/Zip:�� l �3�� kh� ��1�� Applicant is: Owner �Contractor L��t�� Type of wortc Description of work: �� `w�/� ^1 � ' Construction Cost: '� a o�� Multi-Family Building:(Yes�/No� Company: !`�� • �v . I�� f�• Contact: L�� G\�Y`�1'�-1 ��t� COI��I'aC#Di' Address:��-.7 �UIpV'✓� ►7v� �� c�ty: 5� �'l L G�i A�(_„ state:�z�p: �5�� Phone:(QL2'��'bI� Email:�fJ(��2 11�1 rtiG��r�rao � c c.�v►�. �icense#: T�C- ��(�j � 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 8 Water Contractoe Phone: NorE;Plarrs and supporting d�rcumerri�rhat yr�rr suamit ars conslder+ear ro be p�,8lic i►�form,s#on. Par�bor�s+�# Nte rnforntat�crt may be ct�ss�fte+�f as t:crn�wblic lf you pravitl'�speci�c�asans tt�at would perrrtit#he+�ity� cancl�rcYe#tat th�,� are#rade s�ecrets. 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.popherstateonecali.orq 1 hereby adcnowledge that this infortnation is comp�te and accurate;that the work will be in�nformance writh the ordinar�es and codes of the City of Eagan;that I understand this is not a pertriit, but only an application for a permit, and work is not to start without a permit; that the uvo►k will be in accordance with the approved plan in the case of virork which requires a review and approval of plar�s. Entsrior work authorized by a building permit issued in accordance with the ' tate Bu' ing Code must be completed within 180 days of permit issuance. ��I �� _ . X c� X ApplicanYs rKed Name ApplicanY gna ure Page 1 of 3 • Use BLUE or BLACK Ink For Office Use o City f Permit 8: /(/ 6 c�0 l� �1 Pernik Fee: q • I el 3830 Pitot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5875 buildinginspecfionstficitvoteagan.com SEp 1 92011 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: C r �. l� �, �aY` la.5s,, , a 3 �>> A Phone: `3 3 s Resident! Owner Address 1 City I Zrp:3 v-c�v:o,,n r Applicant is: Owner X Contractor Type of Work Description of work Construction Cost Multi-Family Building:(Yes ) f No__ J Company:5, > `a " :n=�' .�L�� :� "�cam., Contact In`, AA Contractor. ` Address: Z."t � r may_ 1r.:e.13r�~l v- State:i`i'+,) rrp: `�`'`''`'`s Phone:Ce t -3 c3).3 Email: 5"2\1:)-ae-a. %;4" 4i"cY„eib 4 s"a:` • -�t License#: 6C-13 3`1 l`i Lead Certificate#: 1% I A If the project is exempt from lead certification,please explain why: cti�3:= ? l-Ztr t � 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: Fire Suppression Contractor: Phone: NOTE:Plans and sung documents that you submit;am considered to be pubilainitemation, Portions of.the information`may be cidsdifiedaS normPublic.if you provide specifm reasons t at wouldpermit the;City to conclude that they-. are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.comisubscribe. Exterior work authorized by a building permit issued in accordance with the Mimesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48[rows before you intend to dig to receive locates of underground utik'ties. wwwgropherstateonecaii.oro 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 wilt be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicanrs Printed Name pplicant's Signatur( Page 1 of 3 � U �' 0�WRITE BELOW THIS LINE /4-/ - 6 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi X Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building — WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace Repair Egress Window Water Damage — Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 112, s 0 Occupancy 3 MCES System Plan Review Code Edition 0 I SAC Units (25% ( 100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction f Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) )L Final/No C.O. Required Foundation Foundation Before Backfill / HVAC_Gas Service Test Gas Line Air Test Roof: Ice&Water Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test _Final Siding:_Stucco Lath Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Feet_, ` Surcharge ri 1,e2Pa-}4- Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant (1112/ 2 0 (-22 Copies i TOTAL Page 2 of 3