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3221 Evergreen DrCASH RECEIPT C1TY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 . . . ( . DATE 19 RE EI EO OM AMOUNT $ I? OOLLARS J A .I 32 , 00 /? GASH tZCHEGK i . ,? Ly L FOR . . . . . ? . . 1 ..? . . ? . . ? FUND CODE AMOUNT ) J -714 I Thank You'" 4 F `,-,3 t, '7". .5'o ? z7.y? White-Payers Copy Yellow-Posting Copy Pink-File Copy 2006 RESIDENTIAL BUILDING rExMIT arrLrcnTiorr Ck ?. S?-Y3 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCfion RaQuirements RemodeUFieoair Reauiremenls ORceLse'.Ohlv 3 registered site surveys showing sq, h. of IoC sq. ft. of house; and all roofed areas 2 copies of plan shovnng footings, beams, joists Cert of SurJey ReaJ '-_ Y--- N (20% maximum bt coverage allowed) 1 set of Energy Calculafions (or heated additions Tree Pres Plap Recd Y_ N. 2 copies of plan stwwing beam & window sizes; poured found design, efc. 7 site survey for addi6ons & decks Trce Pres Reqwred Y_ N lsetofEnergyCalculations Addifion - indicateif rn-s8esepficsystem On-sifeSepficSystem '_Y _N 3 copies of Tree Pmservation Plan if loi pbtted after 711/93 Rim Jolst Detaii Options selection sheet (buildings with 3 or less uniLS) . Minnegasm mechanical ven6lation foim Date L_ % U? Construction Cost -P Zo ? M Site Address ?i 213 321S 3 Z 17, ;Z 1 y 3 2 Z I 3 Z 2 3 Unitlste # r 'v?2?n_ ?r T ? DescriptionoCWork NC1'w1[r1I ?In ?@+aS Multi-Family Bldg ? y _ N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner ?oAf_HmA? I4hW TP1+dr??omtS Telephone D Ir 0 5 ?006 Contractor Address 7351 ?ifQkilloo cQ tyi ? 13c? ?p / City /?IqnIL 6110vC State Zip 5531-q Telephone {! ( 'Y?3 ) (L3' DS?/y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilatlon Category 1 Worksheet • New Energy Code Worksheet (dsubmissiontype) Submitted Submitted • Energy Envelope CalalaGOns Submitted In the last 12 monihs, has the CiTy of Eagan issued a permit for a similar plon based on a master plan8 _ 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 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. Applicant's Printed Name Applicant's Signature ??lolal_41}ld0?M !!E!:lrzlAf?lR ... . . ..... . :- .•. -.??- • ?m 1R Yl??M .j,.-on="t i':l?j?s?L et F 0 R C I T Y U S E O N L Y PEFLtiiIT " ISSUED L FEES: $ ze.5-0 $ $ $ $ $ S $ S S $ gE ;•;r,? PvA%1Ty (T,ICL;iD: SliRCH?RG77) WATER PERf1IT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATEP. TAP (INCL'JDE CORPORAT:.CN S:OP) SE;VE4 TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER wac SAC TRUVK :JATER ASSFSSf-1ENT TRliNK SEWER ASSESSitE;IT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRIINK WATER OTHER $ TOTAL A:tiIOUNT PAID/RECEIPT # --7? DOES UTILITY CONVECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A"PERMIT FOR WORK WITHIN ? PUSLIC ROADWAY" MUST BE ISSUED BY THE NO ENGZNEERING DIVISZON. LIST AS A CONDI- TION. SUBJECT TO TFIE FOLL0:IING CONDITIONS: APPROVED BY: TZTLE: ? & DATE: i . I C 2/84 , j ? CITY OF EAGAN APPLICATION FOR PERMIT ? SEWER AND/OR WATER CONNECTIODi (PLEASE PRINT) 1) PROPII2TY ApDRE55: t.Frar DESCtziprzcv: (Lot/B1ock/StilbcLivision or T Parcel I.D. Nlsnber) ir ST.4L'CIT-72° , DAT' G_' ORIGii:AI, v,iILL`L`;G DF,:_,IIm ISSU?:iC:: o-- -.-? , .,.^,`7I`X:/P.-?°CS:?, L'Sz. ? R-i S?iGLE rA'?SLY ? ? 2 DLTPLEX (?tif0 LPIITS) ? I?R-3 'IOVv"NHOUSE (THRE;" + UDIITS) ( I7NTT5) ? R-4 FLpAR7Pfla:T/CJNDa,Lti1ILLI ( UNITS) ? CaT,1EE2CIAL/REI'AIL,/0FFICE ? DMUSTR7AL ? SNSTITUTIONAI./GOVEE2?2? E Z) Appj,ICpV'P (PLFASE PRIYT) NAl`1E: ??TUtQ?1`? C ADDRESS: S?.tYJILX? crrY, sTATE, zIP: PHO.IE: 3) pI13i,1BEp PLEASE PRINi) FOR CITY USE ONLY NAME' .r, ADDRESS: ?c)Oh esw' r ? PLUMQERS LICENSE: i - M Active CITY, STATE, ZIP: ?+- ) oA Expired - PHOLNE: lm? iLh pLUMBER LICENSE # Q Not af Record psOIeol att nitia 4) (X,'C,'UYANP/(7,?iIIE.4 DIFIME: kYLCqJGYH1N1f ADDRESS: CITY, STATE, ZIP: PHONE: 5) INDICATG WHICH PEP,h1IT IS SEING gEQUESTEp: CCf'vNc^.CI'ION 'Ib CITY SE.Tr7EK ICJ '?-'ION TO CITY S+TATEf2 ? OTHER (PLF.A5E DESCRIBE) 6) L`dDIG,`IE C:E: ? P.TF.aSE FiOID APPRC1UEp PER"LIT FOR PICiC-UP BY ONE OF ABOVE ?°LFASE ;,41IL APPRCJVID PER%IIT TO 1, 2? 4 11PWE (Circle one) 7) SI=ZS,'RE: ??" '4' /' DATE: 19W 2007 RESIDENTIAL MECHAATICAL PERMIT APPLICATION Ciry Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single famity dwellings & townhomes/condas when pertnits are required for each unit Date- -7U7_ Site Address 3?-a t cL??P A rt l??o O vi ??_?k UnSt # Property Owner Telephone # Contractor S Street Address City e.- SWte Zip J Telephone# N - Bond Eapires: The Applicant is Owner Contractor Other Fire rep6ir (replace 6urned oat appilances, ductwork, etc.) r $ 90 00 This fee applies when extensive mechanidal repairs are made fo a building. . Add-on or alteretlon to exis[ing dwelling unlt Z/"?mace Z ^y 50.00 _ _Additional ' Replacement _ New ir exchanger ? ir condidoner heat pump other State SurcAarge $ .50 Total I hereby apply for a Residential Mechanical 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 Fagan and with the Mech9nical CodOS; t}lat mdeist2?td thi3 iS nOt permit, but only an application for a permit, and work is not to start without that the work will '%?{?er¢af ?n app11?d plan it7 the cI ?ee ofwor?C which requires a review and approval ofplat?? ? 1 i?'ant's_YrintedNxme e.,? _«? • CITY OF EAGAN 3830 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55727 AT 1?1 ? 9155 PHONE: 454-8700 BUIIDING PERMIT RecelDt # To ba usad ier 1 OF 6 PLEX Est.Value +558,000 Dore JUNE 1 19 84 StteAddress 3221 EVERGREEN DR Erect Rl Occupancy Lot 31 slock 1 sec/sub. COACHMAN HIGHLAW§ ? Zoning R3 Percel No. 10-18075-310-01 Repoir ? Fire Zone N/A Enlorga ? Type of Const. V Name BRUTGER COMPANIES INC ,4ddress 1 SUNWOOD DR., P.O. BOX 399 c;ty st. cloud Pnone 252-6262 SAME o Name ? Address ? ? City Phone u,w Name BLUMENTALS ARCHITECTURE INC i7 Address 6100 SUMMIT DR NO 'W City BRKLYN CTRphone 571-5550 I hereby acknowiedga fhat 1 hava read this application ond state thaf the informofion Is correct nnd ogree to comply with ull opplicable Stote of Minnesota Statutes and City of Eogon Ordinunces. SipnMUre of Pertnittee A Building Permir Is issued to: BRUTGER COMPANI oll work sholl be done in accordonce wifh all pplitable fate of Ml? Buildinp OfHcial 4=-" Move ? .{k Stories Derrwlish ? Length ? ? u ? Grade p DepTh?4-_Sq. Ft.- Approrals Feea Assessment Permit $ 307-00 Water & Sew. Surcharge ?9 - 00 Police Plon check 153 _50 Fire SAC -+9 5-00 Enp. WaterConn. 470.00 Planrror WaterMeter 63.00 Council Road Unit 260.00 Bldg. Off. APC Totol $1,807 .50 _ on the express condition ihni ond City of Eagon Ordinancea. pjL11LD?KI (? I dF, (,?, . A 2 9/5rJ , CITY OF EAGAN ??- BUILDING PERMiT APPLICATION Zb Be Used Fbr Townhouse Site Pr3dress 3221 Everqreen nrive Lot 31 Bloc)c 1 Sec./Sub. Coachman ParCel #: _/Z) -/9,0 2 S ` 3 j0., Hoi qhlands L Owne-r: Brutqer Companies Inc Addre55: One Sunwood Drive, P.O. Box 399 City/Zip COde: st. Cloud, MN 56302 PhoIi2 #: (612) 252-6262 COritraCtAT: Brutqer Companies Inc Addr255: One Sunwood Drive, P.O. Box 399 City/Zip Code: st. cloua, caN 56302 Phoile #: (612) 252-6262 ArCh-/ESxJ.: Blumer.tals Architecture, Inc. AddreSS: 6100 Summit Drive North City/Zip Code; Brooklvn Center MN 55430 Phom #: (612) 571-555n Include 2 sets of plans, 1 site plan w/elevations & 1 set of energy calculations. Valuation 63,5,.eea0 ?p °D Date May 24, 1984 OFFICE USE ONLY Erect )( Occupancy Alter Zoning (z-3 Repair Fire Zone N j Enlarge Type of Const. ? _ bbve # Stories Demolish Fxont ft. Grade Depth ft. APPROVNS FEEg Assesszrents Perntit 30 -7 ?2 Water/Sewer Surcharge j_- Police so Plan Check I 5 3 Fire , SAC G2 , E0 E4• Water Conn. °- P1a1ner Water Meter council goad Unyt 260 00 Bldg. Off. AFC 'IOTAL 11 go 7 5 v CITY OF EAGAN Remarks Addition C4ACFII1AN NIGH.AImS Lot 31 eIk 1 Parcel 10-18075-310-01 Owner 5treet 3221 BVBRGREBN DRIYE state FAGAI+1 MN 55121 Improvement Date Amount Annual Years PaVment Receipt Date STREET SURF. 2, p 197S Paid und r arcei 10 2750 -010-03 STREET RESTOR. 1974 N tf GfiADING 1007 1986 354.14 35.41 10 ,y! 0-/0 /0-l5-g- SAN SEW TRUNK 1268 Paid u lO 27 -Ol -O3 SEWER LATERAL 1994 11 • WATERMAIN , 1 WATER LATERAI S'Z 197-5 tl tt u ? WATER AREA 1977 1t 1f rf ?57i tt of It STORM SEW TRK 2-6 1 H H ' STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT ROAD UNIT • 6-12-84 WATER CONN. 470.00 If BUILDINGPER. SAC PARK CITY OF EAGAN 3830 Pilot Knob Road P. ai Bax ?."! 199 Eagan, MN 55121 Zoning: L - Brai ,r \Pwner: reas: ? S e Address• 322 ; . ??lumber: ?'d D'111?h?? ?OC `? yYletar i-- _?;t• , --?i Slze: . ? o Reode No.: IL? I ayrse fo wmYh wif6 Ila Ciryr ef Ee Ordinanam ?? i?-?? CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55721 Zoninp; '•'U;) Owner. Brutk /Wdress: Site Addi Plumber: WATER SERVICE PERMIT CITY OF EAGAN 3830 Pilot Knob Roac1 PERMIT NO.: P. O. Box 21199 DATE: Eagan, MN 55121 - No, of Units: Z?ing: '>i: I? ??£dw?rsction Charye: ±70. 00 od ?t ?eposir: _ 15.00 nd ? 9an !r?t Fes: - 10.0 Surcharge: insp.. 5E1NER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: 0 Dd 50 ?d Mist. Cho rfles: ?- 0 0 p m P t r ? Total: Date Paid. • ?? ? ? ? ? Eegon Ordinenqs By - Date of Insp.; Connection Cha?ye: 4 2 5.00 d Accourn Deposit: 1S. JO pca Pem,it Fee: I'.) . ??!1 ;? d Surcharge: Miac. Chqrpes; Total: eo eomplr wiA Hw Ghr of Eayen Nos. # 15, C'YI or CITY OF EAl3AN 3830 Pilot Kno6 Raad P. O. Bax 21199 Eagan, MIU 551 a- Zonirg: ?Lrl puvrer; rutgt[ IWdress: Sire Address: srgreen Plumber: Ral hi e Plb ? yne to WATER SERVICE PERMIT PERMIT NO.: DATE: No, of Units: -31-84 of b awn Charpe: _ 4/ U. U U p d unt DeposJh I 510 0 r rI Permit Fee: _ 1 •'1 Oo Surcharge: , S(11 n ? Miac. Chorfler. (:? r)p G•' ta3 Totol: Dots Poid: SEWER SERVICE PERMIT PERMIT NO.: • DATE: % -3 - _ No. of Unirs: d --+vy w, Ni. Cih, o! Ro*o¦ O?alMlllM. Connecrion G+orpe: 42 .99 ci ACOOURt DQ posit: Permk Faa: BY Surcharge: • p Date of Insp,; Misc. Chorpes; ?nsp.: Totoi: ----------- ? Dah Pald: ? PLUMBING PERMf7 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 Site Name m Addre c Cj,}y,r BLOG. TYPE WORK DESCRIPTION Block -= ? ec/Sub ?C-,_C,?\, \ N . Ae?i N, New C '0' Muit Add-on - C Comm. Repair _ Phorte ` I Qther 3 Addr ??/ ??• p City ,4(a(;roi0V FEES COMM/IND FEE - 1% OF CONTRACT FEE MINIMiJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ApD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) PERMITTEE FOR: CfTY OF EAGAN PERMIT # `- RECEIPT # DATE: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 LBUndry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whiripool - $3.00 Gas Piping Oudets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE STATE S/C: GRAND 70TAL• Receipt 7 . a u ? `/ PLUMBING PERMIT CITY OF EAGAN Fi11 in numbered spaces Type or Prini legrbly Permit No. Fee . S/C Tot_ ? - - 1. Oate 2. Installation Cost 3. Job Address -._ `'?? +-? •r-4L•ot .j Blk. ? Tract ? 4. Owner ? y 5. Contractor s' i I Ccr Phone 6. Address 4_:'? C ?'. 7. City i_ ,?•,A iln r State t Y] 1.1 Zip ?-. S. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New ,0 Add ? Alter O ReQair ? I 10. Describe I 11. No, Fixtures Water Closet No. Fixtures Cesspool/Orainfield -T Bath tubs Septic Tank r Lavatory Softner Shower Well ? Kitchen Sink Urinal/Bidet Oiher ? Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Ptping Out4e2s 12. 1 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: -4or ? Rough final Inspections: Uate tnsp. Date Insp. This is your permit when numbered and apQroved. Approved CITY OF EAGAN 464-8100 do ?) t kly PERMIT Permit No. Fse ? ? G I S/C S ? I i Tot. 1. Date -4 2. Installation Cost ? 3. Job Address 3 ll.ot Bl k. ?_ 4. Owner n / v 5. Contractor ? ?--- Phone " ' ??i 6. Address 7. City State Zip 8. Building Type: Residential Br" Commercial D Institutional ? 9. Work Description: New L?r'? Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. ? Equinment 8TU - M. Ea. Forced Air 7 ? No. Evuipment CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Ai r Cond. Mfg. ? Gas, Piping Outlets 12. I hereby certify that the above informat'ron is true and correct, and I agree to comply with all ordinances and codes governin this type of work. Signed : _,?.,?,4 ?.? r_ !?J ? Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I CITY OF EAGAN ?-- 3830 Pilot Knob Rnad, P.O. Box 21-199, Eagan, MN 55127 PHONE: 454-8100 BUILDING PERMIT Receipt # Ts b, ?uae ie. 1 OF 6 PL :X FC# v„i,,, $58, 000 Site Address _ Lot 31 e Parcel No. - W Name _ ; Address b City S Name _ Address N° 9155 84 J L L 1 L Y L' illllCriP?17 Lll Erect t QcCUpOf1cy i\ 1 ec/sub. COACHMAN HZG11LA W4 El Z?ing R 310-01 Repalr ? Fire Zone Enlo?gs p Type of Const. v COP1PAN7ES l_NC Move p # Stories D DR., P. O. )30X 399 pen,olish p Length ' Phone 2 52 - 626l 6rode p Depth J7 ? ? Sq. Ft. Appro vals Fees Phone Nar„e BLUf•3ENTALS ARCHITEC2'i3RF. INC Address 6100 SUMMIT DR NO City BRKLYN CTRphone 571-5556 1 hereby ocknowiedge that I hove read this opplication ond stote that fhe informatiop i correct ond ogree to comply with ull opplicoble Stote of Wnnes`o?a $totutes ond Clty of Eogon Ordinar?ces. Siqnoture of Permitiee BRUTGk?R COMPANI A Suilding Permit is issued to: oll work shall be dona in occordarxe with all applicoble State of Mir Buildinp OffiNol Assessmenf Woter & Sew. Police Fire Eny. Plonner Counci I Bldg. Off. APC INC Permit a J u!. V V Surthorpe 29.00 Plon check 153.50 SAC 525.00 470.00 Woter Conn. ?-0 0 Water Meter Road UniF (rG Total ? . 5 0 on ths exprcss condition Ihnt ond City of Eagan Ordinances. Permit No. Permit Ho1tNr Misc. Parmit No. Holder Plumbing l. H.V.A.C. Wsll Water Disp. Sswer Electric Irnpection Dats Insp. Other Foot?ngs Foundation Framiny U Rouph Pl6g. 9-71 p' ,17? -?• ? - Rouqh HVAG Inwlation Final Plbg. C Finsl HVAC Final Water Demibs Location: r YYell • Sewer . Pr. Dbp. . RESIDENT / OWNER Name: -DA -1 t 4t 1161 -1 LA-tub _5 7G/ ° f(/ 1 C:Phone: Address / City / Zip: _ 5 A- L 3 FL4 ( t Dia— Applicant is: Owner Y Contractor TYPE OF WORK Description of work: RF (200 i Construction Cost: // S' Multi - Family Building: (Yes x / No ) CONTRACTOR Name: Rco 3 /-t/ 4J/ 1)4 -ANC. . License #: 02 ° 1 r 7a i 53 Address: S Q (JAM /44 NE City: ST M /C. f,4- - L State: MX Zip: 53 ( Phone: 76 3 - 5- - C y c /CV Contact: R- (Z / Email: )D • /' _ +w L7 r0 0 '- co iii / . Coo\ 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: Sewer & Water Contractor: Phone: 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 Evan Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Applicant's Printed Name 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Applicant's Signature Staff: Use BLUE or BLACK Ink Qr1e -'/ Permit #: /4(0 Permit Fee: 221 2s Date Received: l2 2 /a Date: Co /U Site Address: 32 I 1 El/ (,,BEEN N, go/l_6(A) 6 L 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 VIG.l 1 I? 17 '2-11 3223 Suite #: 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 . - - , �� 3� :3 aI Sj 3:�- 17j � � ►�� -�1 , ��.3 Use BLUE or BLACK Ink ------------------ � For Office Use � ' j Permit#: '1 �W �� j Cit� of ��Il a� � Permit Fee: ��• I 3830Pilot Knob Road Eagan MN 55122 j Date Received: j Phone:(651)675-5675 I Staff: I Fax:(651)675-5694 � � �..�� -�_��J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: cJ �"1, �� t Site Addr�s: ��' �o��" J �U�.�� VF-LIJ� Unit#: �3"3�-3 Name: Phone: Residenti °� ^� ��1 J � �Wtt@1' Address/City/Zip: J��3 ^ �d��3 � � l✓� Applicant is: OHmer 1� Contractor �.�� Description of work: �� Construction Cost: � `� � � Multi-Family Building: (Yes�/No� ' Campany: i�V b'F �- 1�,� • l�� . Corrtact:�t�'�� 1��1�� C011#C'dC��l Address: ��j0� �Ilf�� 1/� • �L.. City: �� I��lG-Nl��.L ' st�te:�� z�p: �537b Phone:�D1.2-"1��"IP13� EmaiL��{�lr.l►'1C.FL��I'n1a1��CD ' License#: �� 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 moMhs,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 Contractor. Phone: NOTE:Plans and supporting docurr�ents that yau submit ar�e cot►sider�tl to be�ubltc�nfomratiart. Por�ns of #he ir�farmation may be ctassified'�s rwrr publtc if yc�u prQV�iale speci�c reasons#ha#wcruld�errre#t fhe Gity�cr cw»cJuc#e ti+at fhe are tr�ate secr�s, 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.c�opherstateonecalf.org I hereby acknowledge that this information is complete and aca�rate;that the work will be in conforrnance with the ordinances and codes of the City of Eagan;that I understand this is not a permit, but onty an application fior a permit, and work is not to start without a pertnit; that the wro�ic will be in accordance with the approved plan in the case of work which requires a review and approval of plaru. Exterior work authorized by a building permit issued in accordance with the tabe Bui in Code must be completed within 180 days of permit issuance. x ^�� x ApplicanY Printed Name Applicant' ign ure Page 1 of 3 Use BLUE or BLACK Ink * ty For Office Use C. of 11a[au Penmtt ) -‘ig'6. Permit Fee: / ' / 3830 Pilot Knob Road Eagan MN 55122 , , ,:x Date Received: Phone:(651)675-5875 buiidinainspectionsibcityofeaclan.com SEP 1 9 2017 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: AA-1T,- i.,t ph� Name: C.,4> 0". ��`n Ems. � .. 3-ic�� '' Phone: 9 s —xv) Resident/ Owner Address/City/Zip:3 t v..Qv-cvez: a D r;Jam) .,n V-i i 5C3 i 1 Applicant is: Owner X Contractor Type of Work Description of work e- �'--i -+F' Construction Cost Multi-Family Building:(Yes /No ) Company:5AD`a tA:.�>�C-7;•'",-5-1"-‘4-4A c-� Contact Vr14.'1�- Contractor Address: 2'-t �� > .7# may: state:iy`,, Zip: 5S� '6 Phone:4 t h-353-.13.3:13 t License#: 6C-1:3 3 CZ Lead Certificate#: ! If the project is exempt from lead certification,please explain why: ?y_}t v j G, 1 i.zzc ��d s 'uhf t t�b 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 supportingdo uments that you Satre,considered to bepublickihemation. PortionsofthePortions information may beciassiffedis flea-public if you provide specific reasons that wouldpermit the cityto conclude that they are tradesecr+ets. 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.cityofeaaan.comisubscribe. 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. CALL BEFORE YOU MG. 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.nopherstateonecall.orc 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 permt;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 2 • Applicant's Printed Name ppiicant's Signature` Page 1 of 3 • ,,,,, ii)(4-, 45 gt2.3 '30 1 .0 7 "DO NOT WRITE BELOW THIS LINE / 7 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 /24_0_49_2 Occupancy 3 MCES System Plan Review Code Edition til A „ 1 ir` SAC Units (25%y. 100% ) Zoning 1 ° City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction ye / Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: X" Footings(Deck) Final/C.O. Required f - Footings (Addition) X 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 1 /Lk Base Feewil.-i Surcharge , ' t" Plan Review MCES SAC City SAC Utility Connection Charge �j� S&W Permit&Surcharge V "1 Thi Treatment Plant (23 Copies ifrh12„ 20 { TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA147560 Date Issued:01/18/2018 Permit Category:ePermit Site Address: 3221 Evergreen Dr Lot:31 Block: 01 Addition: Coachman Highlands PID:10-18075-01-310 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Anne Guelcher 3221 Evergreen Dr Eagan MN 55121 (651) 454-2580 Window Concepts Mn 291 Eva St St Paul MN 55107 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature