674 Brentwood Lane
? 10 6 6 3 /3-
Req st e fire No. Bough-in Inspeclion
1 Reqwretl?
? Reetly Now &NhX'l1oM1ry Inspector
•
? ?a ? N. When Heatlyl
I L9lICensed contractor ? owner hereby request inspection of above electrical work at:
Jo tltlrese Stre , Bo r ute No )) Qy
Seciion No TOwnship ame or No ilange No County
Occup (PRI T) ? S ? Phone N
S
Paver SupPLer Adtlress
? ?
Eleqnc I ConVact (COrepa y ame) e
MaiL re ont r o? er Making Ins II io
rlnlror? etl Signalu onV ne kmg InslalWtion
00 P r
MINNE50 S ATE BOAflD OF ELECTAICITY -' THIS INSPECTION REOUEST WILL NOT
Grlpgs-MlEwey BWp. - Room S113 BE ACCEPTED BV THE STNTE BOARD
1811 Univertlty Avv., St. P.W. MN 55104 UNLESS PROPER INSPECTION FEE IS
PMne (612) 642-0800 ENCLOSEU
leIll /?0 REQUEST FOR ELECTRICAL INSPECTION
? See ingjrictions IorWmpleLng Ihis brm on back ol yellaw Copy
H 10663 "X" Below Work Covered by This Request
¢???" EB-00001-08
99n5p?
ew Add Rep TypeofBUilding AppllancesWired EquipmemWved
a Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Butlding Oryer Olher (Speafy)
Comm./Industrial urnace
Farm Air Contlihoner
Olhar (specity) CaMractor9 RemaB3
Compute Mspection Fee Below:
# Other Fee M SernceEnirenceSize e S Circuits/Feeders Fee
Swimming Pool D t0 200 Amps 0 ta 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
SigpS Inspector§USeOnly. T L C'J'4
Irrigatwn Booms
Special Inspec6on
Alarm/Communicacion THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONT S.
I, the Electrical Inspector, hereby Rough-m
(
certifythattheaboveinspectionhas
been made. Fnal
. L?
OFFICE USE ONLV
This requesi voi0 18 monihs irom
y?rJ 9 v
? 10 15 --- Y ??r ?.S
Req ate
- M
?` Fre No RougM1-in Inspecbon
Reqmretl?
? Ves ? N.
? Reatly Now
? Will Notity Inspector
N1hen Reatly?
I ensed contractor O owner hereby request inspection of above electrical work at:
Job ress ? r e1, or No l
?
Ciry
Section No T nslnp Neme or No Farge No Counry
Oc PRI
?? 5-7
Power SuOPlier Address
EI r al Conbact (COryp y me) Co c 's /"?
7
M tltlr s( to wner Making ns I tion) ?
AN? Contacto n a ng InsiallaLo
MINNESbTA iTATE BOAqD OF ELECTRICI THIS INSPECTION REOUEST WILL NOT
6rigge-Mldwey BIEg - Room 5-113 BE ACCEPTED BVTHE STATE 80ARD
1841 UnWarsky Are., SL Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Vraone (812) 642O800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
? See Insimdions for completin9 ihis lorm on back of yellow copy
? 10 715 X" Below Work Covered by This Aequest
EB.00001-08
98G?s
?.?,.
ew Add Rep TypealBuiltling AppliancesWired EquipmentWired
? Home Range Temporary Service
Duplex Water Heater leciric Hea6ng
Apt. Building Dryer her (Specdy)
Comm./Industrial ' Fumace
Farm Air Conditioner
Other(spenfy) ConVador§ Remerks
Campute fnspechon Fee Below:
# Other Fee # ServiceEnvanceSrze Fee # Circuns/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above-100 _ Amps
Signs inspectas use only TOT L?
Irrigation Booms
Special Inspection
AlarmiCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 16 MONTHS.
I, the Electrical Inspector, hereby R0u9ft-in oate
certdy that the above inspection has
been made. Final oa?e
OFFlCE U5E ONLY
Tnis repuest votl iB monihs fmm
Address: 674 BRINikOOD I,ANE Lot 13 Blk 1 Sec/SubWIBIDTR'..E?' 7IH
These items were/were not complete at the time of the final inspection.
?ATE: NDVFFME_R 27, 1990 Yes No INSPEr-TOR:
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry L.?
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
Basement finish
Deck v-
Please varify with the buildar the removal of roof test caps from the plumbing
system and the ahut-off of water supply to the outside lawn faucet before
freeze potential exists.
White - City copy Ye11ow - Resident copy Pink - Contractor copy
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
? City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
, j D
CA,
//3aGG
New ConsiNdion Reouiremenis RemodeVReoair Reaviremenis O(?Cet7'set3nA'
3 regisfered site surveys showing sq H of lot, sq fl. of house; and all roofed areas
(20%maximumlolcoveregealbwed) 2 copies of plan
isetofEnergyCalculationsforheatedadcritions CaNd of S+bYeYRectl:'?`.:
TtegPres:Afag„RWtf-::.. ??•Y>">»N
2 capies of plan showing beam & windwr sizes; poured found design, etc. . 1 site survey for additions & decks
.., .. .. . ?N .
'
isetofEnergyCalculations
PddMion-indicateifon-sdeseplicsystem
DTf=?iteBegticSy5leiiis?s:?` _ -
?"N
.:;_Y:
3 copies of Tree Preservation Plan if lol platled afler 7l1/93
Rim Joisl Detail Options selection sheet (bldgs with 3 or less units
Date
Z?l /
d I ConstructionCost
Jj
?
--
SiteAddress II¢iUSte #
% N
Description of Work JNS?/"Iw iiK T15
Mutri-Family Bldg _ Y_ N Fireplace(s) _ 0-/ 1 _ 2
t
O
P Telephone # (
wner
roper
y
(? zPV
Contractor
Address City 7
?7 )71 Li
State M? Zip Telephone #(?j
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 _ MlImesota Rules 7672
Energy Code Category . Residential Ventllat(on Category t Worksheet • New Energy Code Worksheet
(J submission type) Submitted submitted
. Energy Envelope Calculatlons Submitted
Have you previously constructed a building in Eagan with a similar pian? _ Y _ N If so, 259ro plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Confractor
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 approve plan ' the case f work which requires a review and
approval of plan
Applicant's Pried ame Ap41c t 's ASignature?
CITY OF EAGAN
3830 Pi{oS Knob Road, P.O. 6ox 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for SF DWG/GAR
Est. value $123,000
Receipt #
N°_ 18306
c1Lc
1990
Site Address 674 BRENTWOOD LN
LOt 13 BIoCk 1 SeGSub. WINDTREE 7TH
Parcel No. ,
W Name DAHLSTROM DESI('NER HOMES
3 Address 4151 KNOB DR SUITE 100
° City EACAN PhOne 454-8737
}o I Name S?
ga Address
? City Phone
?w Name
-= Address
ew City Phone
I hereby acknowlege thaf I have read Ihis apphcation and state that Ihe
mforma[ion is correcl and agree lo comply wrth all apphcable tate of
Minnesota Slatules and C??ilyp f Eagan Or/din'a?nce,,s.?/ ?
Signature of Permrtee ?M!^-'1 7.`-°""?'r-?`i, ,
A Building Permn is issued to: DAHLSTROM DESIGNER HOME
on the express conditwn that all work shall be done in accadance wiih alt
applicable State of Minnesota StaWtes and City ot Eagan Ordinances.
Buildinq Otficial
OFFICE USE ONLY
Occupancy R-3 M-1
Zomng R-1
(Adual) Const V--N_
(Allowable) V=N
k olStones
Length 152'
Depth ?gt
S.F. Tolal -
S F. Footprints -
On Stle Sewa9e -
On Sne Well -
MWCC System x
Qty Water _x_
PRV Reqmred
Booster Pump
APPROVALS
FEFS
Bldg Permrt 720•00
Surcharge 61 . 50
PlanRewew 4no-UIL)
SAC, City 100.00
SAC,MCWCC 600.00
WalerConn 625.00
WaterMeter 90-nn
Acct. DePOSit 30.00
ShV Permit 30.00
5/W Surcharga .5
?
Treatment PI 759_ nn
Road Llnil 3 55-0n
Planner -
CouncA
BIdg.Ofi. -
Vanance -
Park Ded
Copies 1.00
TOTAL 3,333.00
1990 SUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
UU6 1 7 1gJ0
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALGS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: $%J/(j-,4¢ b4,f-j&4 Valuation:7/Date
L?
v'
Site Address 67Y BiQ?im??G70!'? ?iv'
Lot /,3 Block ?
Parcel/Sub ?J%/,?TR?? 7? ?/='/?,0''
Owner QAblLsTieO/t'1 40's/11-14101.' lj4e?/,+7-91.5
Address y/rZ 2'ryZe Q,P Shc7? Af,%,r/'
City/Zip Code !?04qi4' /41,y° ,53/
Phone 7
Contractor 64,112.?
Address
City/Zip Code
Phone
Arch./Engr. S?11;114?- _
Address
City/Zip Code
Phone #
g--) 7-- 90
OFFZCE USE ONLY
?23,oon"
FEES
occupancy R-3 M-1
Zoning R-1
D0
720
Actual ConsL V-N Bldg. Permit ,
Allowable V ? N Surcharge (ol'Sa
# of stories Plan Review y(,B.D p
Length SAC, City 100,00
Depth 28 '/2- SAC, MWCC OD'DO
S.F. Total Water Conn 6 2$o Oo
Footprint S.F. Water Meter D?Od
Acct, Deposit 301 fjp
On site sewage_ S/W Permit
On site well S/W Surcharge .$O
MWCC System V Treatment P1. 252.00
City water ? Road llnit 3 SS, v o
PRV Park Ded.
BoosteY Pump _ Copies r, ob
SUBTOTAL
APPROVALS Penalty
Planner TOTAL
Council
Bldg. Off. ????
????
Variance
CP/k R.,4 GE
19'/2 k Z?,
0 5)
4324 X 15= (.ygc
Q?
? X ?6 = ?3G
? k 13'?, ? 8 I
1o 1r1 X 14? ?4238
I sr FLooR,
ol 7
I '/z x7'/z ' I l
lozl? x si= 5z42s
2ND 'F'L.,aoa
Z'7x 36 -9')2x51 = yq?r,72
12.2`l18
Va,UnA-noN
RUG-23-'90 THU 09:02 ID:JRMES R HILL INC
TEL NO:612 884-9518 p389 P03
SURVEYOR'S CERTIFICATE
DAHLSTROM
BRENTWOOD LANE .flso.=
%St.. -
?
?
0 m .93I B q0.0. N/
91.62 N 88° 23 18"£
r8341101 a o o, ti(9,3,3):
? g ?F - - - ; ? g
' ?aorosFo
DRIVEWAY
BENCN M/
SEWN
TOP Oi RONN mr a irta
28 cLcv.ass
E?av•a?s.zz ? .0
l
/ ??
0 0 to
'g ?p GAR, PROPOSED N
N
3 N 4I N N r J HC?USE A.t
n n i
N ?' - --25.5 -= ? 3 . _r ?;?
? ? ? l93So) ?93'?J? W?
0 N 1 +
z
L_ I I ? ?
CJ I ?
_J N
I ?
I LOT 13 1x?
8 ?
Z
A/NAG£ 8 Ufl(tTY
-' ,ASEM£NT PER PLAT ?
91.62
WESCOTT F-AGA X
r
Vh
lJ
- J
;R Ha
Re bENOTES PROPOSED SURFACE DRAINAGE '
O DENOTES IRON MONUMENT SEf SCALE: 1 INCH - 30 , FEEf
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 9SS. fEEf
X000.0 DENOTES EXtSTINCi ELEVATION PROPOSED LOWEST FLOOA - qZ7 FEET
(000.0) DEN07ES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - q;,g', FEET
WE HEREBY CERTIFY TO DAHLSTROM DE3IGNER HOMES THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 13, Bbck I, WINDTREE 7TH ADDiTION, accorQing to the reoorded plot there
Dakota Couniy, Mlnnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENGROACHMENTS, EXCEPT AS SHOWN. ?
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 21ST DAY OF AUGUST , 1
e
NOTE: PROF09ED GRADES SHOWN WERE
TAKEN FAOM THE GRAqNG FLAN
FOR NANDIREE 77H 9 BTH ACOfTIONS
PqER4RE0 BY RON KRUEGER 9
0.490C., INC, LAST DA7ED 4-7-87
m
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R. HILL, 1NC.
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12284
?
James R. Hil{, inc.
PLANNERS / ENGINEERS / SURV 'OR;
9441 JAMES AVE. S. • BLOOMINGTON, MM, 56431 •
i4-3Q2!
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;TOTBL ARI 55.26= 40RAL 1f:3.9471
Page 3
?
2006 RESIDENTIAL BUILDING rERvnT nrrLicnTTON
Ctity Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone tF 651-675-5675 FAX 9 651-675-5694
? ?
?? v;- ?
New Construdion Rewiremems RemodeVReoav Reouiremenis Offce Use Onlv
3 registered stle surveys showng sq fl M lot, sq fl of house, and all roofed areas V2 wpes of plan shovnng foohngs, beams, joists CM of Survey Recd ? Y N
(20°hmaximumlot mveraqeallowed) isetofEnergyCalculatiom forhealedadddions TreePresPlanRecd _Y _N.
2oapiesofplanshowingbeam&windowsrzes,pouredfounddesign,etc isitesurveyforaddAionsBdedcs Tree Pres Required _Y _N
1 setofEnergyCalculatans Adddmn - moYcafe'rfonsdeseptlcsystem O rvsAeSephcSysten _ _Y _N
3 copies of Tree PreservaM1On Plan if lot platled after 711193
Rim Joist Detatl Ophons selechon sheet (bmldingswith 3 or less uniGS)
Mmnegasco mechaucal vcntilation form
Date ?/
Site Address ?ff z Gi.?p ?0 / Constraction Coat
/ / `Itl Unit/Ste #
Description of Work !1 v?
Multi-Family Bldg _ Y N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner /j/iS.r1 ZA CJle TelephoneN(65/ ) ?f-7^ 9!112 y
Contracfor ?7-
/
Address ? (11
State ///l/y
7ip ff512- V
Cify CI
Telephone N( 9 y) $''?1/' 30
?
L) 1 h- -YC7(v -/9!A
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateaorv 1
(J submission type) Residential Ventdation Category 1 Worksheet
Submitted
• Energy Envelope Calwlations Su6mitted
I6 A NEW BUILDING
_ Minnesota Rul 6
. New Energy e r il tSubmitted ? 0 ?
In the last 12 months, has the City of Eagan issued a permit for a similor plan based on a master plan?
_ Y _ N If yes, date and address of masier plpn:
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 pernvt, but only an application for a pemut, 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 reqpires a review and
7 approvalof lans.
U
App icant's Printed Name
Ocr
-,A/ 4 zoos
DO NOT WRITE BELOW THIS LINE
11
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-p1ex ? 17 Garage ? 22 Porch/Addn. (4sea ) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Pordi (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish IMerior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
?33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demalition(EntireBldg)-G ivePCAhandouttoapplicant
DesCnptlon: WaterDamage_Yes
Valuation 14 o Occupancy MCES System
Plan Review 100°/a or 25%
Census Code U??
' r Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIItED INSPECTIONS
_ Footings(new bldg) Sheetrock
_ Footings (deck) _ FinallC.O.
_ Foo[ings (addition) ?C FinaUNo C.O.
Foundation HVAC
Dram Tile ? Other
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
? Framing _
_ Siding _ Stuceo Lath
Stone Lath
Brick
Fireplace R.I. Air Test Final _
_
Windows
? Insulation _ Retauilng Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connecfion Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
TptaJ
?(,,- rn? !/
c2
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? ? ..,.?
City of Eaian
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
--
_---------'I
? -_
? ,Ft?is,.??:4lf??/ ?
I Permit
? Permit Fee: `7v ?l`7? I
? Date Received: ?
I ?
? Staff: _ _
--j
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: SiteAddress: 7 JI?64(kbOd L{1 -
Tenant:
Suife #:
RESIDENTlOWNER Name: (ILSI],V? ?-}t.u1AP1/ Phone:? J?? ?- 9yd?
Address / Ciry / 2ip: J ssfa 3
CONTRACTOR Name: License #: ?(0? 1?(?'??Vl
Address: 651-365-1340
3&7U Do d . .
City: I=agan 1%41\1 5S I'?4-33:3P State: Zip:
?
Phone: Contact Person:
TYPE OF WORK _ New _ Replacement _ Repair Rebuild Modify Space _ Work in R.O.W.
Descri tion of work:
PERMIT TYPE RESID?NTIAL
?Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
(__ RPZ /_ PVB) (_ Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
'W ater Turnaround (add $136.00 if a 5!8" meter is required)
$100.50 SeptiC System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES
I hereby acknowledge that this mformation is complete and accurate; that the work will be in conformance with ihe ordinances and codes of the Gity ot
Eagan; that I understand Ihis is not a permit, but only an applica6on for a permit, and work is not to start without a permit; ihat the xrork will be in
accordance with ihe approved plan in ihe case oi work which requires a review and approval of plans. x c ? LlAM1R.5
Applicant'S Printed Name `
FOR OFFICE USE. Reviewed
Required Inspections: ^ _Under Ground,:
t?ate:
\ir Test Gas Test ., _Ftnal
.. . . .. . ,. ?. _ ,.. _ ' .,'n.
35'7?
? •
. ?
4 ;
w
Q.-wrtF?????? ?? ????????ry
Cltp Of Cagart
EppmttinYf' Uf Wltnilv 31tVFtttD2t
This Certifuate issued pursuant to the requirements of Section 306 of the Uniform Buiiding
Code cerrifYinS that ar the time of issuarrce lhis struclure was in compliance wrth 1he varivus
ordinances of the Ci1y regulaling building corrslnrction or us,-- Far the following.
the a.sakR&M SF ]]WG/GAR Bid&. B=k rra. 18306
pm"D.y Typo R3M I Zoaing Diurid RI Type c'nint VN
o?,,,« ot s?a;? DMLw,?M DESIaER Efl+IS ,y&Ic,, 4151 IO]l]B DR., STE 100.
BQ&v ,dd= 674 KPENiwocD LANE L-IU
i
p,?
--? 1
e,Aeing officw 70 y L 13, B 1, WIlVI= 7TEI
1?
OVDM 27, 1990
POST IN A CONSPiCUOUS PiACE
??:; ..?.-,,. . .., .
SE1 r?R-& iNATER PERMIT
.- C1TY OMMA
3830 Pilot Knob Rd.
I Eagan, MN 55122-1897
DATE 17, •'C
OFFICE USE ONLY
METER # PERMIT DATE
CHIP # PERMIT # i ?.641
METER SIZE B.P. RECEIPT # '' 464f
ISSUE DATE B.P. RECEIPT DATE '?8/ ??1 " ';
_ PRV - BOOSTER PUMP
SITE ADDRESS = 7f?
LOT BLOCK t SEC/SUB '> `?`?'•'r`'•?;F. 7"-'::
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: _
PLUMBER: . ? C'GNS _ P JCTION
ADDRESS: ? "? ? ?•i S'i'??.?,1' ?`I'
CITY, STATE ZIP 5`: i":: `.
PHONE: 432-907';'
OWNER: DAitib.a'Tk;)E•i DESIGiN1.,
ADDRESS: ?'! 5l iC140B W., f J4.,
CITY, STATE ',1?:'''.,'. *, z•! ZIP 5?• = t. :.
PHONE: '
ZIP
PERMIT REQUESTED
? SEWER '- WATER - TAPS
_ COMM/IND %? RESIDENTIAL
? NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WiTH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORfCING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTAGT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAIV
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
OFFICE USE ONLY
METER #?Lf PERMIT DATE .S;' i i./' ct
CHIP #p PERMIT # 6Z, 1
METER SIZE c4t B.P. RECEIPT # (1 C, Ei`?
ISSUE DATE 7 al- B.P. RECEIPT DATE
_ PRV - BOOSTER PUMP
SITE ADdRESS
LOT ' - BLOCK I SEC/SU8
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
X NEUV - EXISTING
Lawn Sprinkier Meters are to be Installed
PLUMBER: k,??"'I; 'i:";'''i' Ahead of Domestic Meters on Water Line.
ADDRESS; i31S"' "Tn.'?:=`' Credit WILL NOT be given for Deduct Meters.
CITY, STATE ZIP `
PHONE: ?- =• '--???,. ; : ? - _
OWNER: - : i ,STRtiI;? DE5 '-[Cr - -
ADDRESS: i;R, Sr!- ,
I AGREE TO COMPLY WITH CITY OF
CITY, STATE RArAN _ t?X1 ZIP -14
PHONE: ' ?-'- '73 7 SIGNAI
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220
SEWER PERMITS, CONTACT ENGIMEERING DEPT.
ZIP
PERMIT REQUESTED
- SEWER `?- WATER - TAPS
- COMM/IND S? RESIDENTIAL
ED
FOR STORM
CASH RECEIPT ??. r
CITY OF EAGAN
3830 PILOT KNOB ROAD
,
EAGAN, MINNESOTA 55122
OATE
19
RECp? ?-f-
AMOUNT
&
? CASH VCHECK OOLLARS
,oo
FM •--? ?-,' ? I .??.i L.= --- ?. ?? 1' ?
-f
FUND OBJECT AMOUNT
Thank You .
BY
C ;w: .-. ?,
White-Payers CopY
?, ? ? Velbvr-Posting Copy
Pink-Fi1e Copy
° CITY rF EAGAN
R_. _ .. ; 18306
? 3830 Pilot Knob Road, P.O. Box 21-1 99, Eagan, MN 55121 `
P H O N E: 454-8100
BUIL7ING PERMIT Receipt # `
To be used for SF WiG1GAR Est. Value $123,000 Date AUG 28 19 '90
Site Address ??? BRENT?D LN
Lot 13 Block t SeclSub. WINDME 7TIt OFFICE USE ONLY
Parcel No. OccuPancY ??3 t'x FEF S
R`1
Zoning
W Name D???TR? DESiGNER H?'S (Aclual) Const V'N Bldg. Permit 720'?
o Address 4151 K?$ DR• $UtTE 1(}?; (Allowable) v?
h
S ?1.5?
Cit ?'G'`? Phone 454"8737
y
# orScories
62@ urc
arge
Plan Review
468'00
Lengih
o Name SA14E Depth 29' City
SAC 100.00
,
ZU
?a
Address
S.F. Total
- ,
?'?
? City PhOn2 S.F. Footprints _ SAC, MCWCC
Water Conn 625•00
On Site Sewage _
r
W w
Name
On Site Well
Water Meter
0"00
z?
3 Addr@SS MwCC System x 30.00
u
¢W
Clty PhOn2
CityWater
? AccL Deposit
S/W Permit
?Q??
PRV Required
I hereby acknowlege that I have read this application and state ihat the Booster Pump - S/W Surcharge .50
intormation is correct and agree to compiy with all applicable State of a?J2
?7
Minneso[a Statutes and City of Eagan Ordinances. Treatment PI .
f '
Signature of Permitee
`
APPROVALS
Road Unit
355,00
BA?'IsZI3C3P4 I2?:SIG4?E€? IiOI S Planner
-
A 9uilding Permii is issued to: Park Ded.
on the express condition that all work shall 6e done in accordance with all Councd 1600
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Bidg. Off. _ Copies
3,333.0{?
Building OttiCial
._.?..:._._.._.,W.:.,...:...".._Y.. Variance -
-.. TOTAL
. .
_
Permit No. Permit Holder Date Telephone #
WATER
.
SEWER ?
?
PLUMBING ? ? ? J /? ?•is,.? ?.. - ' ??^. . »??v
H.V.A.C.
ELECTRIG 0160915 ti
Inspection Date Insp. Comments
Footings I ?j? " (rt?, y
Foundation
Framing
Roofing
Rough Plbg. ?•-,5 ? IG - ? ' 6 C?( ?' -?i ?/'SU,{-?
RoughHtg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Canst. Meter Plbg. Inspector - Notify Plumber
Engr.IPlan
Bldg. Final
Deck Ftg.
DeCk Final
Well
Pr. Disp.
CITY OF EAGAN
CONTRACT
PRICE
For Office_Use Only
?----
PERMIT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 1 RECEIPT#
Site Address ?' ` `'
Lot 1-4? Blocl
?
Name
m
? Address
? City
? I Add
? City
PHONE 4548100
, s?
Sec/Sub
Phone
FEES
COMM./IND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH?.S 000 OF PERMIT FEE)
FOR: CITY OF EAGAN
DATE:
BLDG. TYPE WORK
Res. New _
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING: +
NO. FIXTURES T4TAL
Water Closet - $3.00 $
' Bath Tubs - $3.00 ?
`i Lavatory - $3.00
l Shower - $3.00
Kitchen Sink - $3.00
Urinai/Bidet - $3.00
+ Laundry Tray - $3.00
I_ Floor Drains - $1.50
? Water Heater - $1.50 l 4 ? ?
( Whiripool - $3.00
I Gas Piping Outlets -$1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
7 Rough Openings - $1.50 L
-
U. G. Sprinkler System - $12.00 '
PERMIT FEE:
STATES S/C:
GRAND TOTAL: Y 5 • ? ?
?
CONTRACT
Site Addres:
4, Name _
? Address
c City _
Name
3 Addre
p CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
MECHANICAL PERMIT° PERMIT #
CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAQ, EAGAN, MN 55122
PHONE: 454-8100 DATE:
BLDG. TYPE WORK DESCRIPTION
Sec f Su b Res. New
#
M ult Add-on
Comm. Repair
- Other
ion'e -. Phone
M BTU
M BTU
M BTU
M BTU
CFM
PERMIT FEE:
S/C:
TOTAL:
FEES
4 6, RES, HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES AJC ON NEW
CONSTRUCTION)
• GAS OUTLETS (MINIMUM -1 PER PERMIT) -
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - CaMM. RATE APPUES 1.50 EA.
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAL FEE -
STATE SURCHARGE PER PERMIT 20.00
50
-
(ADD $.50 S/C PER EACH $1000.00 OF PERMIT FEE) .
SIGNATURE OF PEFiMITTEE . y?.?
FOR: CITY OF EAGAN
SEDGWICK HEATING & AIR CONDITIONING CO.
1408 NORTHLAND DRIVER SUITE 310 • MENDOTA HEIGHTS,E_MN 55120 • (952) 881-9000
ADDRESS 6C C h k U v� (-C.- Nq CITY
OCCUPANT S.1. --t ve iv lei OWNER
;;��
SOLD BY Id-+.�L.G-%._L J INSTALLE
MAKE
SERIAL NO
THERMOSTAT
VALVE
LIMIT
611zK2 g`12
T5 ay 0 0
G.�H TZ Qo D4 C 2 S
LIMIT SETTING
FAN SETTING
PILOT TYPE
SdAp i) rSC
ifQ
G
IGNITION MODEL
PILOT TIMING
T lr
PRESSURE 3. W PERCENT CO2 7-7
'� ,
INPUT CFH g(
ig K PERCENT 02 - r
STACK TEMP. "" �" PERCENT CO O pf0
FORM 235 (REV. 10/10)
MODEL
INPUT
HEATING
TEST RECORD
JOB NO 35754/
sr
$606r,/i(1)//71j/0,,0,1
D BY
5LZ5bugvo?o 31013
VENT SIZE
TYPE OF LINER
LINER SIZE
FILTERS. SIZE
WIRING
TEST TAG ,
LIGHTING INST. v
Vir
V`ivT
�r!
•' I A 4. / 0 NUMBER
E/,CVo o7
ZC7
DATE TESTED
COMPANY TESTING
/3c 7/iz
5 6: b. (9, (
NAME OF TESTER 1/40 `v V -
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108274
Date Issued:11/28/2012
Permit Category:ePermit
Site Address: 674 Brentwood Lane
Lot:013 Block: 001 Addition: Windtree 7th
PID:10-84476-01-130
Use:
Description:
Sub Type:e - Furnace
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector,
952-445-2840
Joy Post
1408 NORTHLAND DRIVE
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Steve M Hawley
674 Brentwood Lane
Eagan MN 55123
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK lr
For Off ice Use
Permit #: I I L( D
/c):__
V
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PE
RICI APPLACATIO
Site Address: /, A 47"toct J364 /14/5T
c23
Date:
Tenant:
Sute
RCSiDEN T / OWNER
Name: Shemi #/,41L6}/ '_ % Phone: 61022 °7 —5;2617
.
Address / City / Zip: 67q i.Q�/U/7-4)0XG Com✓) „0-74, .SS 23
Applicant is: Owner X Contractor
TYPE OF WORM
Description of work: h/ t %UO®6-3 47619CEefOstr(lb) 6Cr31% 4/12C -'l il--6
Multi -Family Building: (Yes _./ No )
Construction Cost: !3 c t 7 a�
CONTRACTOR
Name:AiLizt.i i, cJ �r .�^ , r rj License #: C1'e64124/41%
Address:37Y ti64exeu E -t) City: S % if6a/S
State: Zip: SS1-%Phone: &fa33"6 oc
Contact: fi'cy bo'Et6Ci Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
!n the last 12 months, has the City of Eagan issued a permit fora 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 per the City to
conclude that they ar '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.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 car -e of work which reyui es a review arid approval of .lens
Applicant's Printed Name laplics it n
Page 1 of 2
r � t
Use BLUE or BLACK Ink
i For Otfice U�� ----� -- i
• � PeRnit#_ ��7� � �
Gity of�a�a� A�� � � - . �� , 3� ;
1 1�1� � Permd Fee. � �
38g Pilot Knob Road i � � �. : i
�a an MN 55122 Date Recewed:
Phone: (651)675-5675 � I
FaX: (651�B75-5694 � Staf�: I
2012 RESIDENTIAL BUILDING PERIIAIT APPLICATION ��l
�
Date.• 1/ 1�/ Site Add�ess• (��y �en�uf�d C n Unit#:
� h 1� '
� w M
;� '�� �' .,, �,�, Name: S tG V e I-f a w(e� Phone:
r��
�$' � y��,'� Address/City/ZIP= 7 DO �a Q,/� /Zr�t/ ,.Sy��2.3
', '�;�, �� ,
�e(! � � �
ar;�o y
,;����, Applicant is; Owner �ontractor
n� � 'Ir
� �� bescription of work: �7'��' t7r"a,�� �r �� / Sk n.�o�ui+t�
' ' '^�
.. i � i�.�ei c � o :
. u;�� . p , ri 1, Construction Cost:� ,3� � �3. �.S Multi-Family Building:(Yes /No�
�� � ; /� :
.�', `° � � Company: i ccc Q rwoi S Contact: �hc��"" �t/e�/rC�� i
� � ud � ���eA'� /� ,
� ■ Address:�a9 ICO��i�tq Y'.,.✓ ln s.� City_ _�nP �S1�i��
� -
� m�
��.� � . :, state: /L1/1/ z�P:_ �"S'9�3 phone: `�DO--�95�/�a y
;�
' � ��,a;,� '.,�' ��
�' � �i,. ; ,�.,�� �, ��cense#: 7.39 S Lead Certiflcate iF: �1 Q.'�" -- 1 O 70 (0 3�—(
If the project is exempt from lead certlfiCation, please explain why: (see Page 3 for additional information)
COMPL�TE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING '
In the last 92 mor�ths,has the City of Eagan issued a permit for a slmilar pla�based on a master plan?
_Yes �No If yes,date and address of master plarr
Licensed Plumber: Phone:
Machanlcal Contractor: Phone:
Sewer 8�Water Contractor: Phone:
y$L1 � ' 'i �,5
1f �I � ''' , . I�in .1 ��{ � ¶
�' ��� , ,,,I� ° �ni � � � u
�R�_ �.� .��i ��.K �cy�� P � ,,�,;
I C .9
CALL BEFORE YOU DIG. Call Oophar State Ono Call at(661)45a-o002 for protect�on egainst underground utlllty damege_ Cau a8 hours
before you inCend to dlg t0 receive locatea of underground utilitles. www.aooh�rsrateQnecall orq �
I hereby acknowledge that Chis infortnatlon�s complete and accurate;that the work will be in confOrmance with the o�nances and codes of the City of
Eagan; that I understand thls ie not a permit, but only an applicatlon for a pertnlf, and work is not to sta�t wlthout e pertnit; that the work wAll�be in
aCCOrdance wltn the approvetl plan in the case of work which requlres a review and approval of plans. �
Extarior Work authorized by a building parmit issued In dccordanco r�th the Mlnne6ota Stafe Building Code mu9t be compie�ed Wlthln 1�0
days of permlt Issuance.
x 7 / /�I�� , X �cu- � �
ApplicanYs Printed Name Appl cant's Signature i
Page i1 of 3
I
�
50/Z0 3J�d H8 MMW� TZ099S�L05 6b�St bl9�/tt/80
t � � �� ��'�� �( �� � ; -
l� / � � y5
DO NO'T WRITE BELOW THIS LINE
SUB TYPES �
_ Foundation _ Fireplace _ Porch(3-Seaeon) Storm Demage
� Single Family _ Garage _ Porch(4-Season) _ ExteriorAlteration(Single Famity)
� nnultl _ Deck Porch(Screen/Gazebo/Pergo(a) ^ ExterlorAlteration(Multi)
� 01 of_Plex Lower Level pool
— _ Miscelianeous
� Accessory Bullding
WORK 1'YPES
,,._ N� _ Interior�mprovement _ Siding _ Demollsh Buiiding'� �
Addition � Move Building Reroof Demolish Interior �
� Alteratlon � FIre Repair _ Wlndows _ Demolish Foundation
� Replace _ Repair _ Egress Wlndow _ Water Damage
,_ Retdining Wdll 'Domolition of antire building-give PCA handout to appllcant ;
D�SCRIPTION � �
ValuaEion Occupancy .��-, MCES System
Plan Review Code Edition �1� SAC Units �
(25%�100%�) Zoning � City Water ;
Census Code Stories Booster Pump '
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction _�/'��_ Width
REQUIRED INSPECTIONS
�ootfngs (New F3uilding) Meter Slze:
Footings(beck) Final!C.O. Required
Footings(Addltlonj Final/No C.O. Requlred
Foundation HVAC_Gas Serv►ce Test Gas Line Air Test
Drain Tile Other:
Roof:,Ice&Water _Final Poot:`Footings Air/Gas Tests ,_Final �
Framing Siding:_Stucco l.ath ,_Stone Lath Brick �
Fireplace:�Rough In Air Test ,Final Windows �
Insulation Retaining Wall:`Footings„Backfill Final
Sheathing Radon Control �
Sheetrock � Z Erosiott Controi
Reviewed sy: , Building Inspector , �
,
RE IDENTIAL FEES ;
Base Fee ��1 ���°�
! �
Surcharge �
Plan RevleW ��+(
MCES SAC
City SAC �
Utility Connectlon Charge _ � �
S&W Permit&Surcharge
Treatment Plant
Copies �
TOTAL
Page'2 of S
50/�0 3Jvd Sg MMWC TZ0995�L05 6b�5t btOZ/TZ/80
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA131082
Date Issued:06/01/2015
Permit Category:ePermit
Site Address: 674 Brentwood Lane
Lot:013 Block: 001 Addition: Windtree 7th
PID:10-84476-01-130
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)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Steve M Hawley
674 Brentwood Lane
Eagan MN 55123
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143202
Date Issued:06/07/2017
Permit Category:ePermit
Site Address: 674 Brentwood Lane
Lot:013 Block: 001 Addition: Windtree 7th
PID:10-84476-01-130
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Steve M Hawley
674 Brentwood Lane
Eagan MN 55123
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature