3437 Ivy LaneSITE ADORESS3'S'l3 4 Q?e Unit #
Perrnit #
L ? B - 4:21 sect./sub. 1"Jrscok
? e?ia91197 01VI ?,?'ZJ (1/$45 )t 9 OD
INSPECTION INSPECTOR ATE COMMENTS
A. c. v1.,-..vG
.,? Ad
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/9/?/ (;,? REQUEST FOR ELECTRICAL INSPECTION "-?Y; Eg oo??.Oy
(Q/e7?// J , ? See ins(mctions tor complelmg [his lorm on back ot yellow copy .? /
0-r1(?3 2 "X" Be/ow Work Covered by This Fequest ?i?
Nev Add Nep. Type of Building . Appliarxes Wved . Equipment Wired .
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer • Coad Management
Comm./Industrial Fumace Other (Specify)
Farm Air Conditioner
D speci ) Comractor's Remarks
Compute lnspection Fee Below.
# Other Fee # Service Entrance Size Fee # Cvcuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps Above 700 _Am s (
SI OS Inspedors Use Only TOTAL .
?
Irngation Booms n
?? d ?
6
Special Ins ection
Alarm/Communication THIS INSTAlLAT10N MAY RDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 THS.
I, the Electrical Inspector, hereby
if
h
h R°°9n-m oate
y t
at t
e above mspection has
cert
been made. Final Date
OFFICE USE ONLY
This raquest voitl 18 montps irom
43 7
0?
? 9
S
.
Reques? Oa?e
6'
l ? Fre o, Rough-In Inspection Required
(Ypu m?st caWnspedoen reatly) Inspectmn Olher Than Roughln
? fleatly Now ? Will Nohy Inspeclor
pt Q ? Yes ?J No Dale Reetl
I;Ccensed contractor ? owner hereby request inspection of above electrical work at:
Job Atldrees (Sheet, Box ar Foute No )
`t`3I Gry
Seclion No Township Name or o- Rangc No Coun??o 74?t
Occupant
NT) O
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P?
c
Phone?
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Power Suppli
G lec
O
k Atltlress
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Elecirical ont2clor (Company Neme)
/ e. CIeC-7'1- /C di (fi-
iii4i Comradors License No
ez9 c) s3
i
Mailing Atltlress (COnVector or OwOar Meeng Ins)
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AuthorizeG SignaNre onireclor/Ow aking Insl on) Phone Number
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MINNESOTA STAT OAPD OF ELECTRICRY
Gtlggs-MlUwey B g. - Room S-lYB I'I
11 II I I I I I
I I? I? I I I I I ?I I II I I I THIS INSPECTION REQl1EST WILL NOT
BE ACCEPTED BY THE STATE BOAFD
1821 Unlversiry Ava., St. Peul, MN 55109
Phone(612)642-0800
?
? UNLESS PROPER INSPECTION FEE IS
ENCLOSED
Address 3435, 3437, 3439 itn LAM Zip 55122
I.ot 1 Bl& z Sub wESarrr rm.T.s RmsFn 2rm
THESE TfEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: ? Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Peimanent steps (main entry)
Permanent driveway ?
Permanent gas V/
Sod/Seeded grass y ? L
TraiUcurb damage
Porch v
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of waler supply ro
the outside lawn faucet before freeze potential exis4s.
Conqct engineering division at 681-4645 before working in rightof-way or installing underground sprinklet system.
Whitc - City Copy Yellow - Resident Copy Pink - Contractor Copy w
CITY OF EAGAN
3830 PILOT KN08 RD - 55922
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
ime
681-4675
? 3 registered ake survays ? 2 copies of plan
? 2 copies of plens (inGude 6eam 8 window aizes; poured fnd. design; etc.) ? 2 site surveys (exterior eddlUons Q decks)
? 1 energy celculations ? 1 energy calcuiatlons for M1eatod additions
? 3 copiea of tree prosarvation plan IF lot platted aRer 717l93
requfred: _ Yes _ No
DATE: V3 /SS CONSTRUCTION COST: 2Da, 000
DESCRIPTION OF WORI
STREET ADDRE5S: '
LOT / BLOCK Z SUBD./P.I.D. #: WE5C07r i/"-cs /?EViacn Z"'D 4n212/64
PROPERTY
OWNER
CONTRACTOR
Name: W*45H Bo8 Phone#: 65?5--6866
wr nnst
Street Address•
City:
State:
Zip:
Company: P?ei,vciPcL "20,vs7-,euc714.1 Cv, phone #: 7s5-23z/
Street Address: A& -eoX 723 License #• 2°631261
Ciry: C,,,egO?7- L,4t-f- State: N1N Zip- ssoZs
ARCHITECTI Company:
ENGINEER
Name: a-/e 4le-L c iN
Phone #-
Registration #,
f?E?Do w ?.c% ??,e.
Street Address- 1632
Ciry: 57/L 4 WR7-e-9 State: MN Zip; 52?-osZ
Sewer & water licensed plumber: ?RRSon1 ?uh9?wC? Penalty applies when address change and lot
change are requested once permR is issued.
1 here6y acknowledge that I have read this application and state that the information is corcect and agree to comply with ali
applicable State of Minnesote Statutes and City of Eagan Ordinances.
Sfgnature of Appiicant v??, ??" ? ??l/??•w`O"?
OFFICE USE ONI,lI? /
/
Certificates of Survey Received ,- Yes '-No
0VED
APR 0 3 1995
Tree Preservation Plan Received Yes No
BUILDING PERMIT TYPE
OFFICE USE ONLY
M
`'? ? •?° ? ''4s.
.;? .,
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
o 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. CoC 10 L-plex o 15 Deck
WORK TYPE
?31 New a 33 Aiterations o 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? Basement sq. ft. N A MC/WS System -C2?-
Main level sq. ft. 1,373 City Water _p1
sq. f?. Fire Sprinklered
sq. ft. PRV
s sq. ft.
ft Booster Pump
Code
C
?
79, z sq. . .
ensus
4?r- Footprint sq. ft. Y4 4& SAC Code o3
Census Bldg
Census Unit ?-3
Building Engineering Variance
?J /7 r
Valuation: $
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV 5urcharge
Treatment PI.
Road Unk
Park Ded.
Trails Ded.
Dther
Copies
Totai:
% sac
SAC Units
1 SfGt?-
ys,? 9s. ?? = y y??
? 2,0,17 y S(o.zc->°
` ? R?sF415
/?Zo,17 X 1?.53? `? 3?OZ/ I
-----?
3/37)
?
C?l-
2-a.17,?3?.2s = 73/
2o,?7x17, f3
y?b
171
,
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1AMty NlLYUN MLKtLIIN III • Altlfll I LCT
.
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dilt8 o ?q-5
WaRCY CALULATIONS FORI
r-A(OU?1.r ? ,r'
??. ? ?? ?? ;`? n ?l9M ?'t?(?
address,T?l?9-alQ t20 d V'( AvE i .
uA"# ' -
ppepsred byt? U/1=71.??.1 •
CEILIN6/ROOF I? g ,026 Z?'..
Code requirsd nU" values Croee S ' F. I o !3
Buildirg, Ineulstsd arsat x •oza ' ....gp, j
X•p24 ` ? ??-p
Preming 5.F. ?-
x__ -
Otheri
? ZZl?fS
fl...,r »11N value -
WALLS/WINLIOWS/DOORS ?° g- x,11 ¦ ?J' 16Q
Cods required "U" valuei aroee S.F.
Hulldin6s Waile - net S.P. T ? X.047 ?
Waile - ineul - S•F? X .111 •
Framin8 g•F•? " '?'??? x .230 •
Windowe
X •091 '
Doors S.F.i---------- ? .?--
?
Otheri . x
Total wall "tl" valus
.
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.
143jMEAppWkARKORIVE, STIIIWATER,MINNE501A 55082 612•751•7667
LOT? BLOCK? SUBD.?^????
RECEIFT # ? DATE
1895 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: ?C?S,, I s-°IS Commercial -,GPM
Residential (boulevards) GPM
Existing residential
Area/address to be
.?
} v
Installer: _RLa? Owner ? Plumber L'
AifG@l - ( )
Ci state & zi code:
tY? P Phone #:
r
Owner Name'
Street address•
City, state 8 zip code:? _ Phone #:
Irrigation contractor, if different than installer: "-C 2 c-_ 2 L2CJ) \\ '
Telephone #: LI `LI -`T?'7 5t`1
1 hereby acknowledge that I have read this application, state that the Information is correct, and agree
wi+iF aii _np!:c,yle Ci:y of Eaaan prdinances_ It is ths annl!canYB fP,Snn_rigihilifv tp 1ntifv
the property owner that the City of Eagan assumeu no Ilability for any damages caused by the City
during its normal operational and maintenance activities to the facilitfes constructed under this
permit within City property/right-of-wayleasement.
ApplicanYs signature
,
Title
Approved by: Date:
PRV ? Yes ? No New service ? Yes 4No
Meter Size & Cost
Fees due: ? ?
v
-S -9?S ) L
Calculated byy f ,
7 '? a-/,;?L
?