3259 Evergreen Drox 21199 PERMIT NO.:
MN 55121 DATE:
uxtit;;ar o No. of Units:
/lddress:
No..
No.:
IO OOM* WIHI IM CIty Of EYvOA
of I nsp.:
'OFEAGAN
Pilot Knob Rosd
Box 21199
% MN 55121
Address:
0 "r- 0.) a 0k.E)4
to eanpfr wieh the Gry of Eetar
of 1 nsp.:
Connection Charge:
Attount Deposit: _
Permit Fee:
5urcharge:
Misc. Chorges: _
Totol:
Date Paid:
SEVUER SERVICE PERMIT
PERMIT NO.: 6039
DATE:
No. of Units:
Cor?nection Charge:
Account Deppsih _
Permtt Fae:
Surchorpe:
Mtsc. Charpes:
Total:
Qats Paid:
CITY OF EAGAN
3E:3 Pilot linob Road WATER SERVICE PERMIT
4951
P. O. Box 21199 PERMIT NO.: _
? Eagan, MN 55121 DATE:
Zoning: No. of Units:
?r_ IIrutger o
Address:
Si? ???: 3259 ergreen r I. 2 B oac an ixg an s
a es on rgc o
? Plumbor: rs
? Mater No.:
?
Connection Charge: ?(] ?lr
.? .
51xe: Acoount Deposit:
? Reader No.: Permit Fee: 1000 • F
1 agme to eomplp whh Iw Cilp of Eogan Surcharge: .50 pci
Ordinenert. Misc. Chorpes: _ 6•0_ p rilatBT
Totol:
By Data Paid:
pnte of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3a30 Pilot Knob Road 6035
P. O. Box 27799 PERMIT NO.:
Eagan, MN 55121 DATE:
Zonlnp: No. of Units:
pr,,,,,r: Brut er Co
Ibddress:
Site /lddi
? Piumber
.
33 37652
3
2
-
-
l
' 1 04M te eemplY wit4 NN Cth of Eataw
Cannedton Charge: 425.00 Rd
; OrdIMRCli. ACWUI1t DCpOSit:
? Permit Fae: 10.00 p
Surcharpe: 50 10.
gy Mtsc. Che?oes:
Dote of Insp.: Totoi:
Insp.: Dots Paid:
CITY OP EAGAN Remarks
Addition COACHMAN HIGHLANDS Lot 12 Rlk
Owner Street 3259 EVERGREEN DRIVE
Improvement Date Amount Annual Years Paymenz Receipt Date
STREE75URF. 1975 Paid UT! r arcel 10 2750 -d10-03
STREE7 RESTOR. a-S 1974 n ri ii
GRADING 1007 1986 354. 14 35.41 la 354, y? - a /a
SAN SEW TRUNK 41
a
1968
Paid UTl
r arcel 10
275Q
-d10-03
SEWER L-ATERAL 1984 ii i+ +r
*WATERMAIN 17
1972
Paid un
r parcel 10
2750
-010-03
WATER LATERAL ?- 1975 it it it
* WATER AREA 1972 o+ te '
' WATER LATERAL 1975 " " "
STORM SEW TRK 1975
STORM SEW LAT
CURB & GUTTER '
SfDEWAL.K
STREET LIGHT
250.00 37652 8-2-83
WATER CONN, 450. pQ rt n
BUILDING PER.
SAC 25.00
n
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 ?'-- PLUMBING PERMIT Parmit No. ?(0-]
CITY OF EAGAN
? Fee
Fill in numbered spaces S/C
Type or Print legibly , , .
Tot. ? ?.
q
??
1. Date 2. Installation Cost %? lC
?Ve?y?e.? Dr,it
3. Job Address 3z Sq l LotBlk. r lI ,t.,; ( ._ ?
l Tract. '?+l'
4. Owner
5. Contractor Phone
i
-
T
6. Address / ?U?J ? f?? ;.;? • L?C ???`, ??
'V-
<-/
7. City State 4'
Zip
8. Buiiding Type: Residential R
I 9. Work Description: New ;H.
1 10. Describe
11
Commercial ?
Add O Alter ?
Institutional ?
Repair O
No.
Z Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Z Bath tubs Septic Tank
7- 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 cor?ect, and I agree to
comply with all or inan?es ar? codes overning this type of work.
Signed : .?>'%, for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved ?_ - , CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fse '
Frll in numbered spaces S/C
Type or Print Jegibly Tot.
1. Date ' ? - 2. Installation Cost ?
, ? •
3. Job Address Lot Blk. r Tract
4. Owner
5. Contractorr(.? ? ')'? Phone - ? '- C • ?
6. Address rJ
7. City /?: /c, r 1 State f'1'> 1/ Zip
8. Building Type: Residential ? Commercial O Institutianal ?
9. Work Description: New [3 Add ? Alter ? Repair ?
10. Describe ' r ?` %l •_ i Fuel TYPe
11.
No,
? Equinment BTU - M. Ea.
Forced Air No. EQUipment CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
? Air Cond.
Mfg.
? Gas, Piping Outlets ?
12. I hereby certify that the above information is true and correct, and 1 agree to
comply with all ord(nances 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$100
Bldg. A-6
BUILDING PERMIT
Ta 6e rS&A fer 1 of 6 PLE% Fd Vnl- $69f00o
CITY OF EAGAN
3795 Pilaf Knob Roed Eegon, MM 55122
P1fGNEt 454-8100
SitB AddflSS .. ........ g?....:.. ..a ?.?. a
Lot 1•` Block 1 ?/SubCoachran Rip;hlands
Parcel # /D ' /tD 75 - 4/.Za' O /
d NOmE ua ua.?r.,cL
? Addrcss One Su
,.___ S t . Cloud
r
252-6252
? $ Name _
v? Nddress
Nome
I hove read this cpplicotion ond stute that
ond ogree to camply with all opplicoble
s and City of Eagan Ordinonces.
Siqncture of Permittee
? •
A Buiiding Pem+it is issued to:
oll work sholl be done in accordonce with oll applicoble Stote of MIi
Buildirkp Oificiai ?
i 78?44
Receipt
_ Auszust 1 ._S
Erect }a Occupancy A.-'
111ter ? Zoniny R-3
Repoir ? Fire Zone NA
Enlargs ? Type of Const. v
Move
?
# Storie5 ?
`
Demolish ? Length
Grade ? Depth Sq. Ft.
Assessment
Woter & $ew.
PoHce Permit ?.
Surchorpe
Plan check.
Firo SAC `
Enp. Woter Conn. 073T
Plonner Water Meter
_
_
5
()
T7T-
Councll Rood Unit
Bldg
4ff
.
.
APC
Totol • S?
on the express condition 1hn+
and Ciry of Eopon Ordinances.
Permit No. Permit Holdsr MitG Permit No. Holder
Plumbinp ?p -'3
H.v.a.c. lq43
w.n Water
Disp.
Sawsr
?
Elect.ic ,4-I osco S ;,?'s El?c, io-17?8?3
Inapection Date Insp. Other
Footinys
Foundetion
Framinp
Rauqh Pibq. ?
Rouph HVAC ? ? y3
Insuletion
Final Plbg. 1.13 g ?u .
f
Final HVAC ?
Final
Wa"r Dacribe Location: .
1Nell '
Sewsr
Pr. Dirp.
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
B1dg..A-6
CITY OF EAGAN
3795 Pllat Kneb RaadEagan, MN 55742
PHONE= 454-8100
BUILDING PERMIT
ro A! YbA FOf 1 of 6 PLEX En.voim $69,000
Sire Address 3259 Evergreen Drive
Lot 12 el«k 1 See/SubCoachman HiQhlands
Portel #
w lName BrutQer Comnanies, Inc.
? Address One Sunwood Dr. , P.O. Box 399
_ Cr 11 _, _ nC, C?L't
a Ncme
f
0? Addre.
Nome _
Address
1 hereby ockrwwledge that I have read rhis npplication ond state that
the in(ormation is correct und ogree to comply with all opplicoble
Stote of Minnewta Stntutea and City of Eagan Ordirwnces.
N° 8344
Receipt #
AuQUSt 1 o83
Erect ? Occuponcy R-3
Alter ? Zoning R-3
Repair ? Fire Zone NA
Enlarge ? Type of Const. V
Move ? # Stories 2
Demolish ? Length_
Grode ? Depth Sq. Ft.-
Aonrorals Feet
Assessmenf _
Woter 8 Sew.
Polite -
Fire
Eng.
Plonner _
Council _
BId9• Off. _
APC -
Permit ??v.v..
SUrchorge 34.50
Plun check 170•00
SqC 525.00
Woter Conn. 450.00
Water Meter 60.00
Road Unir 250.00
Total $1829 . 50
Sipnoture of Pertnittea I
ru r ompan es, nc.
A Building Permit Is istued to: on the ezDress cordition ihnt
all work shall be done in acwrdance wit all appliyc,a?b?l??Sfy of Minnewfa Statutes and City of Eogan Ordinances.
BuHding Officiol Q Q L(/ e?-
FAGAN , Include 2 sets of plans,
„ 1 site plan w/elevations &
' BUILDING PERMIT APPLICATION 1 set of energy calculations.
Zb Be Used For ?f ti pjpx Valuation $36-,669 l//?m,17 Date July 13, 1983
Slte PddY'ESS Z2Sq Evergreen Drive
IAt 12 B1oCk 1 Sec./Sub. Coachman
-Parcel #:
Highlands
Qaner: Brutqer Companies, Inc.
Address: One Sunwood Drive, P.O. Box 399
City/Zip Cod2: St.. Cloud, hIN 56302
PhOn2 #: (612) 252-6262
COIItrdCtor: Brutger Companies, Inc.
Pddt'ess: One Sunwood Drive, P.O. Box 399
City/Zi.p COC12: St. Cloud, MN 56302
Phon2 #: (612) 252-6262
AL'Cl'1./Eng.: Blumentals Architec
Address: 6100 Summit Drive North
Clty/Zlp Code: Brooklyn Center, MN 55430
Phone #: (612) 571-5550
OFFICE USE ONLY
Erect Occ.?upancy
Alter Zoning ^3$
Repair Fire Zone
Ehlarge _ Type of Const.
A'bve # Stories
DeTnolish Front ft.
Grade Deptn ft.
APPROVAI., FEE'S
Assessnieits Penait 34D'
?Vater/seaer ?v
Surcharge 3.
Police • 9
Plan Check
Fire SPG
Eng. Water Conn. QSp '?
Planner Water Meter L.? pO
Council Road Unit 2-Sp J
Bldg. Off.
AFC
TOTAL
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
41!LI••
For Office Use
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Permit 8: / /6b D
city Of E0ti I mo.
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 • Date Received:
Phone:(851)675.5675
buildinaInspectionstiicitvofeaaan.coo Staff:
Sti' 192017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: Phone: 9 s 3=S"),),,,
Resident!
OAddrsC1ip:3 D-S
'Dr,. /e �, t � .wne1 11
Applicant is: Owner X Contractor
Description of work 'R � =-�
Type of Work (
�
Construction Cost Multi-Family Building:(Yes ) /No )
Company: -s flu_ =n=,$r.w4 c t, ,c Contact
Cantractor�.
Address: 2 t �✓ r City: la-3z: 51. v-
State:i`it Zip: 5 SPhone:Li t - 3-X31.3 Email: 5-4\11en 4- i Q„ 1 krr a:,, r "+n
License#: ?-)(1_l3?3` 1 c4 Lead Certificate#: IN
if the project is exempt from lead certification,please explain why:
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 mid supporting documents that yousubmit gue considered to be pribiluMfomution. ions ofthe:....
information may be classitedas non-public if you provide specific reasons thatwould-permit the chyle conclude t tet they
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.citvofeaaan.conlsubscribe.
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 DIG. Call Gopher State One Call at(851)4540002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www,conherstateonecall.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 will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
51,-‘_ "4_.
'C.v.rY., 'mss
Applicant's Printed Name Applicant's Slgnatu
Page 1 of 3
hg-
. • 5.,25- , k-,....' l DON T WRITE BELOW THIS LINE /7 eS G/
SUB TYPES
— Foundation _ Fireplace —
Porch(3-Season) _ Exterior Alteration(Single Family)
— Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi SDeck _ 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 1').1kOccupancy ac., 3 MCES System
Plan Review Code Edition f ; , 1.1:''' 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 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
/4 Base Fee 1) /
4 .4°"
ro-
Surcharge y
. ` ;VA,
Plan Review
MCES SAC
City SAC
Utility Connection Charge �/�
S&W Permit&Surcharge V -1 Thi
Treatment Plant a 21 62 (92
0-144,
Copies x
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA153363
Date Issued:12/13/2018
Permit Category:ePermit
Site Address: 3259 Evergreen Dr
Lot:12 Block: 01 Addition: Coachman Highlands
PID:10-18075-01-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Brian B Coatney
3259 Evergreen Dr
Eagan MN 55121
(651) 325-7731
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature