4190 Meadowlark Rd CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 - PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: 7i 7 ft Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. 0.130)021199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber: —. 44.17
1 agree to comply with the City of Logan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Dote of Insp.: Total:
Insp.• —_ Date Paid:
Use BLUE or BLACK Ink
I For Office Use t
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~ of Ealan I Permit
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I Permit Fee: gg 25
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3830 Pilot Knob Road I t
Eagan MN 55122 Date Received: I3 113
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff. I
I 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~t Site Address: ~le~ ' I ll.~lGLf L
Name: fld(,t~Y1 i'ttJ(~ f Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Description of work: mfyvf Sidi to jiies
Type of Work I
Construction Cost: t~ Multi-Family Building: (Yes / f )
Company: ! V Ew &-r lo f At- Contact: S
Contractor Address: )0701 q3 LQ . JV . City: /ICU (5 roV L
State: MA) Zip:( c~/3 (o Phone: Ao3 -3 O (Q l1/
License ILL ~-tJ a Lead Certificate N741-' ~ )Il D /
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 & 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 the are trade secrets.
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.aor)herstateonecall.ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and axles 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.
Exterior work authorized by a building permit issued in accordance with the Minnesota St II must be completed within 180
days of permit issuance.
Foss x J Applicant's Printed Name Appli nt's Sign ure
n Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127732
Date Issued:10/14/2014
Permit Category:ePermit
Site Address: 4190 Meadowlark Rd
Lot:3 Block: 1 Addition: Hillandale 2nd
PID:10-32951-01-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Rosalie A Sitzmann
4190 Meadowlark Rd S
Eagan MN 55122
(651) 405-8289
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
•
r For Office Use
Permit#:E AGA N
Permit Fee:
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 ECEIVE
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)67 694 Staff:
buildinginspections(a citvofeagan.com MAR 2 1 2019
2019 RESIDENTIAL LLCIALG P MIT APPLICATION
Date: /it I/l1 Site Address: ?0 _CO/ r ei r!int)/j/k £�r!_ g'U q n Unit#:
Name: Phone:
Resident/
Owner Address I City/Zip:
Applicant is: Owner Contractor
Type of Work Description of work: 71(k
Construction Cost: 910~ Multi-Family Building: (Yes I No )
Company:_ 6 s om /L� t;L 1 Contact: Ard- ,v/&,j
Address:_c9' 7 (V&l�- 6 � • , City: 0(1-9/9 J/7Contractor 6r---t-z/0 / i
Stater, Zip: /,;22--Phone: ^/W (II--l Ili►.I-- //4-) ; 6 (
License#: (05 d 0/49 Lead Certificate#:
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?
Ss-Yes No If yes,date and address of master plan: Senn -7it4G� '�"Z 'i'4- 711-
Licensed Plumber: // Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe
classified as non-public if you provide specific reasons that would permit 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.citvofeauan.com/subscribe.
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(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 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
accord nce with the approved plan in the case of work which requires a review and approv:I qt•la
/f,1-> iiI J %I�
x
Applicant's Printed Name Ap•'icant's Signature
4
bb NOT WRITE BELOW THIS LINE 0 I / 0 Vil CUDl `k- /`"" / �476,/�
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
a;
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
U1SL Occupancy MCES System
Plan Review Code Edition A, 1 1 J SAC Units
(25%)( 100%_) Zoning MI City Water
Census Code Stories _ Booster Pump
#of Units Square Feet PRV
#of Buildings Length 2 Fire Suppression Required
Type of Construction 1/6
6 Width
' <
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings(Addition) r Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
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: 1-7_, , Building Inspector
RESIDENTIAL FEES
Base Fee 006
Surcharge
Plan Review ( .0 O
MCES SAC yji3PTWT)
/ 3J
City SAC
Utility Connection Charge
SSW Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA174827
Date Issued:02/22/2022
Permit Category:ePermit
Site Address: 4190 Meadowlark Rd
Lot:3 Block: 1 Addition: Hillandale 2nd
PID:10-32951-01-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Rosalie A Sitzmann
4190 Meadowlark Rd S
Saint Paul MN 55122--178
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature