3233 Evergreen Dr-?Zg6S 2006 RESIDENTIAL BUILDING rExnuT arrLrcATioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construcfion Reauirements
3 re9isfered sde surveys showing sq. ft of lot, sq. ft of house; and all roofed areas
(20°k maximum bt wverege allowed)
2 copies of plan showing beam 8 window sizes; poured found desgn, etc.
1 set of Energy Calcuia6ons
3 copies of Tree Presarvation Plan A lot platted atter 711193
Rim Joist Defail Optiws selection sheet (buildings wAh 3 or less units)
Minnegasm mechanini ventilation form
RemodellReoair Reauirements
2 wpies of plan stawing too6ngs, 6eams, joists
1 set of Eneqy CakxAations for heated addNOns
1 site survey for additions & decks
Adddion - indicafe i(an-sRe seAfic sysfem
A 33? zs
Ck. --?- s1-4 3
Office Use'AnN
CeAofSuivey?Recd _Y _N
TreePres'PlaoRecd ?-_Y _N.
TreePres.Requ'ved ._Y _N
OnsiteSepticSystem Y _N
Date ?-J / ? % 0 b Construction Cost 4'Z0 m
SiteAddress 3Z-ZSy3Z-Z?- 32Z.9 13 231? 3233
, 3Z3S i? UniUSte #
1
Description of Work ? Iei Cl' tTy ni ! I hQ '6+6
Multi-Family Bldg ? Y_ N Fireplace(s) _ 0_ 1 _ 2
PropertyOwner _C64c.H mAI) A?A /G4 74?n h omt 5 Telephone #( D?
Contractor -t rA 0
Address ?35) rl ? ?[?lloo? Ly
?
13C? ?p
City /?'Iqnk k'OVt
--
State MIv
Zip 7531?? r
Telephone#(-V3) 1 0` DSL"
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv l Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculafions Submitted
In the last 12 months, has the CiTy of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
SewerlWater 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.
( ?ui ? ?iZU77lh?4<? Z/1'
Applicant's Printed Name Applicant's Signature
/? ^? l b CITY USE ONLY m
PERMI"C #: ? ?/ RECEIPT DATE: / </?
f;£SIDENTIAL MECHANICAL PERMIT APPLICihTION
crrY of EAsm
3830 Pu.o'r KNOS [tD ,
' 'f.A6A1PbfN551YE,
ssi-sgi-?s?s
Please complete for: D single family dwellings
townhomes and condos when permits are required for each unit
Date: Lo
SITE ADDRESS: _?)
OWNER NAME:
TELEPHONE#: ?7S 1 (o J ?S3
(AREA CODE)
INSTALLER NAME: TELEPHONE #:
I AI i l 74 """11 ' (AREA COOE)
410 INE$l l.AKESTREET
STREET ADDRESS: MINNEAPOLiS, fViN 66408•2998
612-824-2656
STATE: ZIP:
--
o??..:?-a..6.,-..L?..;.?.L._ ..o...,i#...n.L+...:o.._._..__. .... ___ ._._...._ . _.__ _. _..
e4i'i- 11:u
New residential dwelling unit under constructionand not owner/oceupied - $ 70.00
i? Add-on, modification or alteration to existina dwelling unit $ 50.00
' • furnace replacement
? • airexchanger
• air conditioner
• other ! ^
Nature of work:
U°
State Surchar e $ 50
? ?
?5?
Total -
Remii:der: Cal! for tnspectians.
upaamu iivi
_ -i
. I
C= I 2/84
' CZTY OF EAGAN
A PPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIODT
(PLEASE PRINT)
1) PROPERT"I ADDRESS : _ 3? 3? t 1' G C` F' P Zv%'. l9 *'
r,FrAr• D S I°TICAI: e l
i
(LOt/Block/SUbClivision or TaX arcei I.D. Ntunber) c
a
2
li ._r'..{I:^_'^_:G S'IRIICPTRE, D;%T' 0_' QRIGii:AL EuIi.DI.`;G F? :Sm IcS,:?NC°:
? PRES: :' Z:^„II`X:/F.-wG1DCSE7.? U5E: ? R-1 SLNGLE r^Pm.I:.Y
? R-2 DUPLEX (2Wp Wi ITS)
Q'R-3 `IC4v"NrIajSE (THRE" + LPUITS) ( UNZTS)
? R-4 APAR`R'AEXT/CJDIDCk?=ILry1 ( I7iPIITS}
? CONfi1ETtCIAL/FtE,TAiI,/OFFICE
? LML'STRIAL
? INSTITUTIONAL/GGVE.4NME[v'T
2) AppI,2G'= (PLEASE PRINT)
NAh?_ C'
ADDRESS: ?- SU (?_
`?
s??R)t?bd? ?
QP
CITY, STATE, ZZP: ?C 1??A mk) _
PH=i:
3) pj,j,^ijggt C PRINT) FOR CITY USE OHLY
NAME_ ? ??bG
, ?
ADDFtESS: ?'[][?
? ? PLUMBERS IICENSE:
Cl 9iC
TQ, Q Active
CITY, STATE. ZIP: Expired
PIE:
PHOq aLY - I
-
?
? Not af Record
_
7 l PLU
MBER LICENSE N
arr nitia
4) (-?C:UYAMl'/O,•zIER NAME lrLLnac-rnirvi)
:
ADDRESS:
CITY, STATE, ZIP:
PHCE^IE:
5) IIVpICATE WHICH PEPMIT IS BEIiv'G REQUESTID:
?Cb.,iVECI'IDN 'ib CITY SET9ER
?CO:?'NECTION Tp CITY WATER
? dPEEt (PLF'-71.SE DESCRIBE)
6) INDIG= C:a:
? PLF;SE HOID APPR(JtIID PERtiLLT FOR PICi:-UP BY ONE OF 11BOVE
?°LEF'SE tiTAIL APPROVED PER11IT Tp 1. 2, 3 4 ABOVE
(Circle one)
7) :-? 2 DATE: ? ?
1
F O R C I T Y U S E O N L Y •
PERMIT °- ISSUED
FEES: $ a
/O •? S.?'..i•.,-L-D nEppirm (r, r.-?-- o
i 1 ?il(7
$ WATER PERf1IT ( I1?,TCLUDE SURCHARGr, )
$ lo J f--l/ WATER METER/COPPERHORN/OUTSI?E REr1DER
$ WATEf'. TAP (INCiODE CORPORATION STOP)
$ SE:4ER TAn
$ ACCOUNT DEPOSIT - SE:4ER
$ /?• °-O ACCOUNT DEPOSIT - WAT°R
$ .,/ 7o. ?--a wac
$ sAc
$ TRUDTK [4ATER ASSFSSAIENT
$ TRliNK SEWER ASSES$MENT
$ LATE°,AL BENEFIT/TRUNK SES4ER
$ LATE:tAL BENE'FIT/TRUNK WATER
$ OTHER
$ TOTAL
to O . a--O ?Q
? ,? ? J O
AM0UNT PAID/RECEIPT # 3 5'
DOES UTILITY CONN ECTION REQUIRE E XCAVATION IN PUSLIC RIGiiT OF WAY?
? YES . IF YES, THEN A"PERMIT FOR WORK WITHIN
PUSLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVISZON. LIST AS A CONDI-
TION.
SUBJECT TO TFIE FOLiO;4ING CONDITIONS:
APPROVED BY:
TITLE:
DATE: _7
1998 BUILDING PERMIT APPLICATION (COMMERCIAL)
3 40 L) ? CITY OF EAGAN
681-4675 s
. .. . . _ ?.- - ------?a-
uom¢ roiwwmy w wwni iIoCwl y N
Foundation Onl ?......
New Construction
. Interior Improvement
structural plans (2 sets) architectural plans (2 sets) architectural plans
i
l (2 sets)
(1) ?
civil plans (2 sets) structural plans (2 sets) s
code ana
ys (1 geU
code analysis (1) " civil plans (2 sets) project specs
soils report (1)
1 landscaping plans
codeanalysis (2 sets)
(1) ° Key Plan
energywlculaGons
(1)notalways"
)
projectspecs (
Special Inspections & Testing Schedule " soils report (1) Electric Power & Lighting Form (1) not always °
SAC determination letter from MC/WS - SAC determination letter from MCM/S - SAC detertnination letter from MCMlS -
ca11 6 02-1 00 0 call 602-1000 call 602-1000
Special Inspections & Testing Schedule (1) "
projed specs (1)
energy calculations (1)
Electric Power & Lighting Fortn (1) "
Contad Builuing inspecuons Tor sampie
Food & Beverage or Lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details.
nnTF?I- ?C??cl ? WORK TYPE: _ NEW REMODEL
DESCRIPTION OF WORK:
CONSTRUCTION COST:
TENANT NAME: C^ ° d // -" ai? / ^f OS f>7" l
SITE ADDRESS: SUITE #:
LOT Dc1 BLOCK SUBD. OC, CJ\-VV\ o< <-s ???•1.D. #
a.9,3?3I???a33
,
Phonc ft:,
PROPERTY last
OWNER
Street
City
State:
Zip:
/ ? /
Company:_ 2 SSe L_W i/?rdQw ?g Phone #:
CONTRACfO ?j?J? ?/
R Street Address: J`^ ? /'?L9 i'7 t?S on/ ?cense k ?P `f 5 -3 -
City -------- ----- State: ZiP: _
ARCHITECT/
ENGINEER Compaziy:_ _____ Phone k:
Name: __ __ Registration N:
Slrcet Address: ___ -----
City --- -- Statc: _ -- - Zip' - -
Sewer & water licensed plumber (only if installing sewer & water):
I hereby acknowledge that I have read this application and state that the informatio r d agree to comply with all applicable State o
Minnesota Statutes and City of Eagan Ordinances.
Signature of Appli ? ? -
OFFICE USE ONL
First
BUILDING PERMIT TYPE
? 01 Foundation
? 18 Comm./Ind.
WORK TYPE
? 31 New
? 32 Addition
GENERAL INFORMATION
Const. (Actual) _
(Allowable)
UBC Occupancy
Zoning
# of 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 Demolitian
MC/WS System
City Water
Fire Sprinklered
Census Cade
SAC Code
Census Bldg.
Census Unit
Variance
Permit Fee
Surcharge '-f0
Plan Review
MCNVS SAC
City SAC
Water Conn.
SIW Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Water Qual.
Other
Copies
Total:
% SAC
5AC Units
Meter Size
Valuation: $
? GIT;f` OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55722-1897
(651) 681-4675
SITE ADDRESS:
PERMIT
PERMITTYPE: Bu1LosNr
Permit Number: 03y 005
Date Issued: 11 l 1 7/9£3
3225 EVG:.ReRt_Uu nit
LOT: 29 Bt.OCKa 1
COACHMAN N1G1-II.ANDS
P,I.N.: 1.8-18075--290-01
DESCRIPTION:
ftEROar-/ 6 F>IEx
REMARKS:
IracLuoEs:
Bui.tdina Perm3Y. Type MULTI, (MISC,)
quz-Sding Woe.k. 7ype REPA]:R
Census Gode - 434 AL.7a W",ES:CDEN't"7AL
?
z
t r
32z7, 3229, 3231, s2:33, nwo 3235.
FEE SUMMARY:
b'RLIJATTfJN
Fiase Fee
Surcharge
7otal Fee
1; 8 .() 0 0
`1137. 25
$1A1.)5
CONTRACTOR: - Applicant -OWNER: '
6EISSEL WTNOOW & STI]tNG 2457.E835 COflGHMfliV H:I.GHLANDa ASSQC.
3213 EVERGP,EEN pR 3:15 EVEIZGlREcN IJR
EA13qN MN 5512:L Ef) GFiN MI'd 55122
(612) 451-6836
a
?
Z hareby aa4cnowledge thati I have reaci This applicataon aricf state that the
in'Farmar_ion is correcr_ and aqree Co camPly with a:ll appli.cahLe 5Cat2 ot' Mn.
SGatutes and City of Eaqan Orclanances>
APPLICANT/PERMITEE SIGNATURE
?,JIsueo er: siGNniuaE C
?
,.
? ?.a.. , A-_I:;r:% 10.r3,.•.:.
[ ....
%n
I...?.?( ?i '.II' i:'?.;..??,?'..?,? . ?, . 1:i ? ...?
1 ....'.f ( . , ?I.;..:?.:_. -.-f::: W::,
I'' IS./.??... M_.. :i..i.r'C..
. _.. .... .._.
.!_.? „ .'!Ti Yi . ... .. ... ._.
P74
..... Tpr '!Ai'.!`.,'.I
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u•,y J;C'a .:?'.:}h1 1.}:.`!) 9.?.', ' kY,;;
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210Mi
... ? :'..... . ? •.'I:',.I I _ :, i I.'"-?i:.'
.25
....:i 9001 _ 1620 II /... ...i ... 2r1
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l.l'n,l..f:? ,.
9M{J
............ . i.D.. NAN%..._.i
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? ? &) /V3? y?l
I OF, C?
Zb Be Used Fbr Townhouse
CITY OF EAGAN
BUILDING PERMIT APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Valuation ?35 ? 900 ?5? ? °O Date
Site PddYess '6235 Ever reen Drive
Int 25 Block 1 Sec./Sub. Coachman
P3L'Cel #: _ /0 - (y0 7S _;,Z -,, Hi3?lands
Oal'Ier: Brutqer Companies Inc
Adds25S: One Sunwood Drive, P.O. Box 399
C.ity/Zlp Cpde: _ St. C1oud, MN 56302
Phone #: (612) 252-6262
COIltr'aCtpT: Brutqer Companies Inc.
Address: One Sunwood Drive, P.O. Box 399
City/Zip (:pde: St. C1oud, MN 56302
Phone #: (612) 252-6262
Azch-/E71q•: Blumer.tals Architecture, Inc.
AdG1TeSS: 6100 Summit Drive North
Clty/Zlp COdO: _ Brooklyn Center MN 55430
Phone #: (612) 571-555o
May 24, 1984
OFFICE USE ONLY
Erect X occupancy (Z-I
Alter 2oning
Repair Fire Zone N ?
Enlaxc3e _ Type of Const. -?
Move # Stories
DeTrolish Front £t.
Grade Depth ft.
APPROVAT.S EEE,g
Assessmcnts PexTut ?-? 00
Water/Sewer Surcharge
Police Plan Check ? r?3
So
Fire ,
SAC _^
E-n4• Water Conn. 4'7p
Planner Water Meter (Q 3. -
council RDad unit 2/,o ?o-
Bldg. Off.
AL?c
ZDTAL / , &G? ?• S C?
• CITY OF EAGAIV N. ? 9isi
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 454-8100 , /!
BUILDING PERMIT Receipt # `7`r00 ?
Te be und for 1 OF 6 PLEX Est.Value $58,000 DO1e JUNE 11 1 y 84
3233 EVERGREEN DR
Site Address Erect ? R1
Occupancy
-
Lot 25 slock 1 sec/sub. COACHMAN HIGHLANA& ? Zoning? R3
ParcelNo. 10-I8075-250-0I Repoir ? ??
FlreZone ??/?
Enlorge ? Type of Const. V
BRUTGER COMPANIES INC
rc Name
Move ? # Storie
SUNWOOD DR., P.O. BOX 399
Z ?? ??
Address
Demolish ? Length
? UD 52-6262
City Phone Grade ? 3 ? ?
Depth Sq. Ft.-
c SAME AvVrovala Faes
o Name
?u Address Assessment Pertnit $ 307 _ QQ
l- City Phone Wufer 8 Sew. Surchorge 29 - 00
Police -50
Plan check 12
Gw Name BLUMENTALS ARCHITECTURE INC
Fire SAC 525 _ 00
tz 6100 SUMMIT DR NO
¢0 Address Enq.
Water Conn. 470 . 00
pW City BRKLYN CTF?ha?e 571-5550
Pl
6-4
00
W
t
M
t
?
anner -
a
er
e
er
Council Road Unit 7rf1 00
I hereby acknowledge that I have read this apDlication and store thot gidg. Off.
the in(ormation Is wrrect and ogree to comply with all opplicable rjQ
AP?
$tate of Minnewta Statutes and City of Eogan Ordinnnces. T?a
Sipnoture of Permittee
A Building Pertnit is issued to: BRUT?'iER COMPANIES INC on the express condition tha+
all work tholl be done in occordonc with ol ppli bl taM
'nnesofo Stotutes ond City of Eapen Ordinonces.
-
Building Officiol
OF EAGAN
PilotKoob i;oad
Box 21199
i, MN 5572i
,!', ..
WATER SERVICE PERMIT
PERMIT NO.:
DATE: - ; l. > , .•,.
No. of Units:
Slze: ..y`.
uM D
it
15.
Reade? No.: 1J /?/? f74 /?i epos
:
Permif Fee: _ 10 . QO pd
1Oaref to eomply wieb the Citr of Eagan Surcharge: • 54 Pd
O.riaawor. Mtsc. Cho rges: `? 3. U 0 p d m e t e r
Total:
BY Date Paid:
Dote of Insp.: Insp,;
?:.?
CITY OF EA¢AN --- _-
S
3830 i'ilot Knob Road ?ER SERVICE PERMR
P. O. Sox 21.99 PERMIT NO.: `' g?` 7
Eagan, MN 551;1 pqTE; 4
Zoninp: No. of Untts: ?" '
O,,,,,?,, r rutp,er
Addi
of Insp.,
Connectlon Charpe: 425.00 pd
Account Deposit: _ 15.00 pd
PeRnit Fae: - I0.00 pd
Surcharpe: ,-
Misc. Chorpes:
Totol:
Dote Patd:
CiTY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 2179$ PERMIT NO.: =-?
Eagan, MN 55121 DATE:
Zoninp: No. of Units: 1 ?
O/w-n.er. ? r-
?Wdress:
tIfB Address: - ornr?an 111^iv.R. 7 ?S _t?-_C[Ta: .Itl:t,,
ter No.: b ;,?'-:• ? "'v - ?: "ldrinktion Chorge: A7(} _ (] 0
T--.
?^ ?lytcodr?i Deposit: l 5_ f3? n i
der o.: ? bermit Fee: l t! -()!? r[Z?
irN to wmolyr wilh 1ho Citr of Eagan Surcharge:
inaneti. Mlsc. Chorpes:
Totol:
C??Lti Date Paid:
Box 21799 PERMIT NO.:
-
i, MI4 557%D DATE: 131-84
D: No. of Units:
Address:
a
to eomply wilh MN Cify ef Eagan
of Insp.:
Connectron Chorpe: 425. 00 2d
/kcount Depastt; 15. 00 pd
Pa?mit Fee:
Surchorpe:
Misc. Charges:
Totnl:
Dato Paid: -
te eanplp wilh t1M Gry of Eagan
.. GAS WORK ORDER
1082 Payne Ave. STAN DARD
St. Paul, MN 55101
651/772-2449 46HEATING09
& AIR CONDITIONING
A Blue of' Service Co. EQUIPN
LAST L vNh??a?? FIRST TYPE
CITY ?a-e-,4,.) ZIP
HM PH ?&?'/ 6A /-?o S3 WK PH
TECH Z'41.r-, r- Y DATE_
410 W. Lake St.
Minneapolis, MN 55408
612/824-2656
ORSAT TEST RECORD
C02 % METERED INPUT Cfh CHIMNEY TYRE
02 % LIMIT SETTING app ° FLUE SIZE
CO % PILOT OUTAGE CONNECTOR?SIZE S?- in.
NET STACK TEMP -e- I4 0 TOTAL CHIMNEY INPUT btuh _
. _' f`/
Receipt PLUMBING PERMIT. • Permit No. ! `? ? ?
CITY OF EAGAN
Fee .
Fill in numbered spaces S/C
Type or Print legib/y Tot -
.
1. Date 2. Installation Cost '
r .
3. .lob Address f; r t r? +Lot Blk. ? Tract I?
IrT
4. Qwner
5. Contractor Phone
6. Address
7. City ! 1 ?? ? t??"C? ? State Zip
8. Building Type: Residential,0' Commercial ? Institutional ?
9. Work Description: New-Ef Add ? Alter ? Repair ?
1 10. Describe
I 11•
No,
; Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
/ Lavatory Softner
Shower Well
? Kitchen Sink
Urinal/Bidet
Laundry Tray Other
? Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and 1 agree to
comply with all ordinances and codes governing this type of work.
Slgned . ' fOt
• Rough ' Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt L'1 MECHANlCAL PERMIt Permit No. ? t,? r}.
CITY OF EAGAN Fee
fill in numbered spaces S/C
Type or Print /egibly Tot.
1. Date 2. Installation Cost
. ,`l't=" ( ( .d C ?1. ? ?. ?
3. Job Addreu 3 Z 3 3 '" Lot?Blk. ? Tract ?
4. Owner
5. Contractor Phone -t
6. Address
7. City
State
Zip
8. Building Type: Residential ET" Commercial ? Institutional ?
9. Work Description: New Cfi Add ? Alter ? Repair ?
10. Descri6e
11.
Type
Na.
' Equinment STU - M. Ea.
Forced Air i L No. Equipment CFM
Ha
Ai
dli
Mfg. . r
n
ng:
Boilers
Mtg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Z Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances andcodes governin this type of work.
?
Signed : 4=--_ for
? Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN ?.? 9is1
, 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 .
PHONE: 454-8100
BUILDING PERMIT Receipt # 5 l
I To be amd /or 1 OF 6 PLEX Et, ya,,, 558, 000 Date JUNE 11 19 34
SiteAddrese 3233 EVERGREEN DR R1
Erect
? Occuponcy
i] c
1 . 7l COACHMFtN l? tGtILAN Rer Zoning
25 Sec/Sub
0
Lot Block DI/A
Percel No. 10-18075-250-01 Repoir ? Ffre Zone
SF;UTGER COMPAN I FS I NC Enlarpe p Type of Const.
oc Name Move Q # Stories
; Address '' • • P.O. OX 95
Demolish p Length i `
b City Phone Grode ? Depth -3y 'erlSa. Ft.
Name Jt?? npprovou
g
?? q?reBS Assessment
?- City Phone Water & Sew.
toc E3LU1ALNTA7.S ARCHI`!'ECTUi2E INC Police
P
,,,W Name
S t?`jIT DR NO Fire
z
?? Addres
' S 5 0 En
0•
W. W City hone Plonrwr
I hereby acknowiedge thaf I hove read fhis opplicotion and stote that Council
gldg. Off.
the inlormntion is correct ond ogree to comply with oll appiicuble
Stute of Minnesote Stotutea ond City of Engon Ordinonces. ^PC
Siprtature of Permittee
/1 Building Pemiit Is Issued to:
oll work shall be done in octo
Buildinq Officiol
Permit $ 307 . 00
su?cha?ge 29.00
Plon check 153.50
sAC 525.G0
Water Conn. 470.00
Water Meter 6 ± • c 0
Road Unit 2 L,-k- U
Totol !f'bO7 . 50
INC on the express Gwdition thnt
Statutes end City of Ewan prdinonces.
Permit No. Permit Holder Misc. Pe?mit No. Holder
Plumbinq L
H.V.A.C. Lq 21
Well
Water
Disp.
S?wer
ehW.ic 3 9517 !?Q onsr '? t? qo . e v
Irnpection Date Insp. Other
Footings 7
Foundetion
Framinq c r
Rouph PIbY.
Rouyh HVA o1
Inwlation
Final Plbg. ?
Final HVAC
Final
Water Dewxibe Location: .
VYell
Sswer `
Pr. Dbp.
CASH RECEIPT
C1TY OF EAGAN
P. 0. BOX 21-199
EAGAN, MINNESOTA 55121
.
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DATE 19
RE EI EO
OM
AMOUNT $ I?
OOLLARS
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/? GASH tZCHEGK
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FOR
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FUND CODE AMOUNT
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-714
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Thank You'"
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White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks biv' 41 1r, < < f-,
Addition COACHW HlGliI.ANDS Lot 25 Blk 1 Parcel I0-18075-250-01
owner Street 3233 fiVERGREEN DRIYE state EACAN MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. Z10 1975 Psid und aTCO1 ZD 2750 Q10-03
STREET RESTOR. ' 1974 11 to of
GRADING 1007 1986 354.14 35.41 10 C'- 16O /4-/S-XS
SAN SEW TRUNK 1968 Paid und r aresl 10 2750 -010-03
SEWER LATERAL 1984
? WATERMAIN 1972 Psid und arcal 10 Z750 010-03
WATER LATERAL 2S?Z 1975 of
* WATER AREA 1972 01
MATEit LATERAL Z- 1975 " " "
STORM SEW TRK ?g 1975
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
ROAD UNIT 260.00 44005 6-12-8
WATER CONN. LF]Q.QQ
BUILDING PER. #915 n of
SAC
PARK
. �, 3 ��`� 3 � �%� 3���, :�c�3S
3�� ��� �3� ��]. �
Use BLUE or BLACK ink
�------------------
� For Office Use �
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a 1
• j Permit#: � 1��°'�� I
Clt� of E���� � � ��,a '
� Permit Fee: �
3830 Pilot Knob Road j �- � �
Eagan MN 55122 � Date Received: l �
Phone:(651)675-5675 I I
Fax:(651)675-5694 ( Staff: �
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date• (� �lJ' Site Address� ��J ��� ��`-�"+�C� �`"''V�-- Unit#: 3�5��3 J�
Name: Phone:
i�esictentt �,��. 3�!�c'J �v��� �i1J�. .
�p�r Address/City/Zip:
Applicant is: Owner � Contractor
Description of work: � ���
Type af Work �,
' Construction Cost:� �a�� Multi-Family Building:(Yes�/No��
Company:��� �. �. F�, l �,• Contac�:~�"t�c�F�� ���f(�
.�51�� C���v�- r��. n!�.. �,ry: �t• �.�c���L
COf1tf�CtOC Address�
' State:�Zip:�Z�� Phone:�4��'b v��� Email:�GK1�GC��lA.L✓�G�- ��►'�� L,C.0
License#: 4 �� 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 lssued 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:
N4TE:Plans ar►tl suppvr�ing dacum�artts t�#you�submet are cunsider�al to:be pubtic ir►#armatic�n. Pur��s r�#
t�re enfQrmaiic�n may be cfass�fieal as nort�aublic if yoet prouide sp++�cific r�easorts tha#w�tttld p�mit the City t+a
concfe�ale#tat tlte are U�de secr�sets.
CALL BEFORE YOU DIG. Call Gopher SYate 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.aopherstateonecall.orQ
I hereby adcnowledge that this information is complete and accurate;that the worlc will be in conformance with the orciinances and codes of the City of
Eagan;that I understand this is not a pertnit, but only an application for a pertnit, ar�virork is not to start without a pertnit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plar�s.
E�ctsrior work authorized by a building permit issued in accordance with the nnesota i�te B 'Iding Code must be completed withln 180
days of permit issuance.
x�� ���� X ��!"�—
Applicant's Printed Name Applicant' ig ure
Page 1 of 3
Use BLUE or BLACK Ink
-4[1101, For Office UseC•tyofEaauPermit
Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(851)875-5875 f 3` °.4.7
buiidinainspectionstlicitvofearian.com Staff:
SEP 191017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Aktr, 1-st , t-kKs-pr,
Name: C.p } �.�. ty Z�Y� . 5=..: . a 3 ��:ti A Phone:
Resident/
Otic mer Address/City/Zip:31'3 3 v-c��r-cxr _,�, rb J J �a,� n ti �)i 1
Applicant is: Owner }C Contractor
Description of work ���=
Type of Work
Construction Cost Multi-Family Building:(Yes i No )
Company: , l.c,
C. Contact W14.ki-7- 43'ab:a
Contractor.
Address: est i} ; -114-
fi�` may_ l:�.a-z,11�a'iiv-
State:1' ;:r Zip: 55c=. Phone: 17" S °33.3 Email: 5-2�-2-cz ,"4''. i -,�t'_ a ` . -,..
License#: _ 1`i Lead Certificate#: t. A
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:Pias mid supporting documents that you submit mu considered to bepiMilcinfommtion. Portions o the r.: -
informal maybe coed as norrpwblicIfyou provide specific reasons that would penult the Citytwconclude 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.citvofeaaan.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 DIG. Call Gopher State One Call at(851)454.0002 for protection against underground unity damage. Call 48 hours before
you intend to dig to receive locates of underground util s. www.aopherstateonecal.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 permk,and work is not to start without a permit;that the work wall be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
P1,2_4",
Applicant's Printed Name Applicants Signatu
Page 1 of 3
Cti
. 3 S WRITE BELOW THIS LINE l `7 /el
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi 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 0 19Occupancy 3 MCES System
Plan Review Code Edition /4 a, „ l SAC Units
(25% 100% ) Zoning A `' City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction7-6--- Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
X" Footings(Deck) Final/C.O. Required
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
Base Fee
11)6/14
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge f/(11 Thi
Treatment Plant (hi! „2/ 0 C2Q'
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161651
Date Issued:06/05/2020
Permit Category:ePermit
Site Address: 3233 Evergreen Dr
Lot:25 Block: 01 Addition: Coachman Highlands
PID:10-18075-01-250
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Lee A Bethune
3233 Evergreen Dr
Eagan MN 55121
Quality Heating & Air Services Inc
12912 Ventura Ct, Suite 21
Shakopee MN 55379
(952) 403-1110
Applicant/Permitee: Signature Issued By: Signature