3861 Gold Pt BCITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot' Knob Road PERMIT NO •
Eagan, MN 55122 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.
B � �1 Total.
Y fj� ttJJ %'�(�pp(� Date Paid
Date of Insp.: 7 " 2 ��,_ 6'4 Insp •
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE•
Zoning: No. of Units'
Owner:
Address'
Site Address'
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee•
Surcharge'
By Misc. Charges'
Date of Insp.: Total:
Insp • Date Paid'
Use BLUE or BLACK Ink
3115 gel PtI3VIA
2013 RESIDENTIAL BUILDING PERMIT APPLICATION) waspz -3$l;o'3
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Date: 1 Site Address: � - 1 e t . 1R r i , I unit # 38T 3 12'33S (pS fr j
P
Name /� 11
Address / City / Zip: 3$ GO d, yoliN+
Applicant is: Owner 4 Contractor
Description of work: Q e,(0 Q-F
Construction Cost: �� 4K 0 0
City of Eapli
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
vilks
For Office Use
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Permit Fee: �J 1 �"7
Permit #:
Date Received:
Staff:
�nP � 1�A J� I'it2s. W till'►$ 4 el Phone:1Q51 a T b Be-b r5 1E3,
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Multi -Family Building: (Yes %Q / No
Company: I lam. `6j1S UCt 6 Contact:
Address: t ' (D Geit
State: ✓ v, N Zip: 5SC71 Phone:
License #: (3 C 03 4-0
Ta_La Err "Si
City: kaSS
Ella 1(JD"i• (ft-ts�
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:
Sewer & Water Contractor:
Phone:
Phone:
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.org
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.
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.
x N� l ILA-;- g ol/eCK,
Applicant's Printed Name
x
lic nt's A
pp Signature
)64,
Page 1 of 3
Use BLUE or BLACK Ink
Date:
CityofEaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use %%��
Permit #: (6/t(J q /
Permit Fee: 5-'
Date Received: fa Aah3
Staff:
2012 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Site Address: . ) )3 6G\i '
V\c.) Lt.) vA
Tenant:
�J
Suite #: '1) C19
Name: (AvV yl ou.J\A Phone: 96AoY `)/94.- j -
Address / City / Zip: ,V3CP / t� ) EC G sY\.
Name: �l�C \`mil �\ \ 'n%.l License #:
Address: l.i 1&41A u City: (<)k
State: Conta %e OC--7 Email:
t 3/1c Phone: 9 • 7 �1(
New x Replacement Additional Alteration Demolition
Description of work:
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
_ Under / Above ground Tank (_ Install / ^ Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add -on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
=
TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1%
$60.00 Minimum, (includes State Surcharge)
- If the Permit Eel is less than $10,010, surcharge is $ 5.00
- If the Permit at is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
= $ Permit Fee
= $ Surcharge
= $ _i_ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against under: round utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.aooheptateonecsll.orq
1 hereby acknowledge that this information is complete and accurate; that the work will be
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work •
with the approv plan i the case of work which requires a review and approval of plan
Applicant's P
ame
the ordinances and codes of the City of
ut a permit that the work will be in accordance
PERMIT
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
ii!Illorpo
Permit Number:
Date Issued:
City
0f Eaftan Permit Category:
Permit Type:
Plumbing
EA132081
07/23/2015
ePermit
Site Address: 3861 Gold Pt B
Lot:
PID:
Use:
115 Block: 01
10-18350-01-115
Addition: Countryside Villa
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater
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 (WS &/or WH)
Surcharge -Fixed
Total:
$59.00
$1.00
$60.00
0801.4087
9001.2195
Contractor:
Benjamin Franklin Plumbing
5720 International Parkway
New Hope MN 55428
(612) 604-4285 X61
- Applicant -
Owner:
TINA M PETERSON
3861Gold PtB
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
PERMIT
City of Eagan
IP1' City of Eaan
Permit Type: Building
Permit Number: EA133366
Date Issued: 10/07/2015
Permit Category: ePermit
Site Address: 3861 Gold Pt B
Lot: 115 Block: 01 Addition: Countryside Villa
PID: 10-18350-01-115
Use:
Description:
Sub Type: Windows/Doors
Work Type: Replace
Description: Two or More Windows/Doors
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
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
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Home Depot At Home Services
6224 Lakeland Avenue N, # 102
Booklyn Park MN 55428
(763) 542-8826
- Applicant -
Owner:
Tina M Peterson
3861 Gold Pt B
Eagan MN 55122
(218) 255-0520
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.
Applicant/Permitee: Signature
Issued By: Signature
PERMIT
City of Eagan
411' CityofEaan
Permit Type: Building
Permit Number: EA134244
Date Issued: 12/04/2015
Permit Category: ePermit
Site Address: 3861 Gold Pt B
Lot: 115 Block: 01 Addition: Countryside Villa
PID: 10-18350-01-115
Use:
Description:
Sub Type: Windows/Doors
Work Type: Replace
Description: Two or More Windows/Doors
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
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
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation S4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Home Depot At Home Services
6224 Lakeland Avenue N, #102
Booklyn Park MN 55428
(763) 542-8826
- Applicant -
Owner:
Tina M Peterson
3861 Gold Pt B
Eagan MN 55122
(218) 255-0520
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.
Applicant/Permitee: Signature
Issued By: Signature
PERMIT
City of Eagan
41' City of Eaan
Permit Type: Mechanical
Permit Number: EA145344
Date Issued: 09/06/2017
Permit Category: ePermit
Site Address: 3861 Gold Pt B
Lot: 115 Block: 01 Addition: Countryside Villa
PID: 10-18350-01-115
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
Surcharge -Fixed $1.00
0801.4088
9001.2195
Total: $60.00
Contractor:
Blue Ox Heating & Air L1c
5720 International Pkwy
New Hope MN 55428
(612) 238-9709
- Applicant -
Owner:
Tina M Peterson
3861 Gold Pt B
Eagan MN 55122
(218) 255-0520
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
Sewer & Water Contractor:
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buildinainsoections@cityofeagan.com
r
RECEIVED
JUL 15 2020
For Office Use
Permit*: 2— SA- I
Permit Fee: ()3 • —c
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7-/- Z, O
Residen
Owner
Site Address: Unit #:
•�! _'►.t�) au2y ` lhc.. ydier Phone: Name: J
Address / City / Zip: 31 Col 8 cDo (.i. , e d, ��. M 84 . SS 1Z2-
Applicant is: Owner i4 Contractor
Type of Work
p.m.gtoc.4-
Description of work:
Construction Cost: 10i 700
4 Dear tri
•
e.xTSIN f%3
Multi -Family Building: (Yes / No )
Company: Bars, C^ 7)c4-c rt.rS Contact: le ho• 2Tit. 1 e P
Address: S f '"; S Z4iIu S+r 4( St.N.ct- S +c 1 City: Ma O lc 'Pf6 ."'^
State: k N Zip: SS3'li Phone:743 •• 2$ t. — Email: J ehnt ED_ {Deues4-ei ers.2e01
3$72
License #: 11C. S24 211 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?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Phone:
Fire Suppression 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.
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.citvofeaoan.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 (651) 454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aopherstateonecaliorq
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.
Applicant's Printed Name A
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166061
Date Issued:12/09/2020
Permit Category:ePermit
Site Address: 3861 Gold Pt B
Lot:115 Block: 01 Addition: Countryside Villa
PID:10-18350-01-115
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Tina Marie Peterson
3861 Gold Pt Unit B
Eagan MN 55122
(218) 850-0544
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature