703 Camberwell Dr? ?INSPECTION RECURD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
• , 14I tf r:i?I t I tI ir
PERMIT SUBTYPE:
APPLICANT:
i
TYPE OF WORK:
I N'.I1! ,'? : I ??1J
A i 1 rrA rI i ?14
I . r7ARK S s A -;f11 AirA l f 1.- t- k N11 f i;#'ik Vtt l#+F"1) F C)if AN i' F I t E f1+ ( I. Ai 11Fi {'! llpH I N(l LJ0 R!
?
?
Pertnit No. Permk Holder Dete Telephone N
ELECTRIC
PLUMBING
HVAC
InspecNon Date Insp. Comments
FOOTINGS
FOUND 12-? -
FRAMING
? ?
hts? t?eY?.a 'SD ?e 'S NG wz?
?- 1 '? ?s?r. Br++asw
ROOFING ?
ROUGH
PLUMBING -?j IIIZE; yJ?
PLBG
AIR TEST "
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOAFiD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTO
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
r-
CITY QF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
,... , ilE I I
' I 1'.. Ili . I ti1J1 lil, 11111
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE:
Perrnit Number:
Date Issued:
? .• ?;? ??? r - APPLICANT:
I I lt „ ri I
1 l.l ") 4,11 •. N: 7si
TYPE OF INORK:
1sM r1 11 rati
0.1 { ! i 4
Ot. Jcs.1 1 9n
INSPECTION .. . .•
Permlt No. Permft Holder Date Telephone #
S/VV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
inspectlon Dete Insp. Comments
FooUngs I
Foundalion
Framing
Rooflng
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Orsal Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Fnal
Deck Ftg.
Deck Fnal
r
.?rr
Well
Pr. Disp.
.,'
(Irx#t#iraft uf (Oxrupanry
(Citp of (Eagart
apmrhnrat u# WU-0ing,3tcwxrfiott
77r#s Ceruf'raate LssuMpursuaxt ta lhe requinementr of Sectiax 306 of tlre Urriform Building
Code oertilyixg 1ha[ at llce tinre ojissuance tlris smuctune mxs In complianoe with the tinrious ,
ondinanars ojthe Cfiy regul2kn8 building cvnsduc.nion or usa For !he foQowing. ?
che aamrK.o•w - SF DWG/CAK ea6. ranu rb. 18473
?? R3/14I zoo* Dis,? PD/Ri rrac?m VN
o,ma d auading (E'TM E'M Add= 5929 BARFR itD, AffiB
d.,,.:_....... 7Y]3 !'.ATFm;&m, 1mw .__.? L 12. B 1. HII.iS OF SZINE&tIDGE ?rID
FEAMM 12, 1991
POS7 W A GONSPlp.lO1JS PLACE
_..:CITY OF EAGAN
? 3830 Pilot Knob Road, P.O. Box 21-199,
PHONE: 454-8100
BUILDING PERMIT
Tobeusedfor SF OidG/GAR Est.Value $118.000
Site Address 703 CAHBERWELL Dfi
Lot 12 SSock 1 SeelSub. H ?
PSfC21 N0. Occupancy ?
W Name CENl'Ex tlO?S
3 Address 5929 ??R RD
° City MM Phone 936-7833
Name
? City Phone
¢
WUW Name
?w
_7, Address
< W City Phone
I hereby acknowlege that I haye ,.?§ ad this applicatio?t and state ihat Ihe
information is correct and agree? comply with all'applicable State of
Minnesota Statutes and Ci[y of Ea n Ordinances. !
Signature of Permitee - ? -
A euilding Permit is issued to: CEN'CEX HOMES
on the sxpress condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Ofticial
?
Zoning
(Actual) Const
fAliowableJ
# of Stones
Length
Oepth
S.F. Tofal
S.F. Footprints
On Site Sewage
On Si1e Well
MWCC SysSem
City Water
PRV Required
Booster Pump
APPROVALS
OFFICE USE ONLY
FEFS
v-? Bldg. Permit ZQ3,L-W
V-N
Surcharge
?&I Plan Review 457 _[10
SAC, City 300=00
- SAC, MCWCC 601-AA
Water Conn 625.00
- WaterMeter ?•?
x x Acct. Deposi[ 3U . 00
SJIN Permit 30.00
Planner
Council
Bldg. O(f.
Variance
Eagan, MN 55121 18473
Fieceipt #
- SrW Surcharge • 50
Treatment PI Z gZ • 00
Road Unit 355,00
- Park Ded.
Copies
- TOTAL 3,301.50
' Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C. ?? /rT' ?I IS ?L7
El.ECTAtC
Inapection Date tnsp. Comments
Footings I 1 .,?
Foundation //. / -CfQ l>s
Framing 2 3 d
Roofing
Rough Plbg. -
Rough Htg.
Isul.
Freplace
Final Wtg.
Fnal Plbg. _
Const. Meter Plbg. Inspector - Notify Plumber
Ergr.JPlan
Bldg. Final Z- Z- p
Deck Ftg.
Deck Final
wen
Pr. Disp.
CONTRACT
PRICE
Site Address ?
Lot -??
Name ?
ri.vnnoinu reesmi I For
CITY OF EAGAN PERMIT #
3830 RILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT
PHONE 454-81 a0 DATE: -/
FEES
COMM./IND. FEE -196 OF CbNTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
Tnwwuni icP: Jt rnn?nn _ acc onTG eci i
?M - COMM.IND.JFEE $20.00
SURCHARGE PER PERMIT .50
50 S/C PEfl EAGH $1,000 OF PERMIT FEE}
CITY OF
Comm.
Other
NO. FIXTURE3
Water Closet - $3.00
Bath Tubs - $3.00
Lavatory - $3.00
snower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3.00
Laundry Tray - $3.00
T_ Floor Drains - $1.50
T Water Heater - $1.50
Whirlaool - $3.00
? Gas Pipirrg Oudets - $1.50 (MINIMUM -1 PER PERMIT) ?
$
7 4l !,
- ?-- v
a
cJ
Well - $10.00
Private Disp. - $10.00
Raugh Openin gs - $1.50
U. G. Sprinkle r System - $12.00
PERMIT FEE: 3 C.= a?
STATES S/C: J?
GRAND TOTAL: L'?
3830
DATE /L/ e5t,
Lot -h
? 64n
Add
? Ciry
- ? (51 C;4Y - : QfioriB -
" TYPE OF WORK
Forced Air &?W M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
CommJlnd. Contract Price x 1°,6
PERMIT FEI
S/C:
TOTAL:.
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLE7S (MINIMUM - 1 PER PERMI-
NEW CONST.)
COMM/IND FEE • 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/G_PER EAGH $1000.00 OF PE
,R:c
L."
&
- $24.00
- 6.00
- 12.00
- 1.50EA..:
;:
.. 20.00
- .50
i
,
?
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE OCT 22, 1490
SITE ADDRESS _
LOT 12 BLOCK
I APPLICANI-:
? CITY, Sl
PHONE:
MBFsRWF.LL DR
OFFICE USE ONLY
METER # qq?( GCQ Y-Z o PERMIT DATE 10/23/90
CHIP # 474/11 7_ 7 PERMIT # ?WW_116 1
METER SIZE 64 B.P. RECEIPT # f<
ISSUE DATE ? d B.P. RECEIPT DATE 10 22 90
_ PRV - BOOSTER PUMP
:/SUB IiILLS OF STONE
• - 1r--rt : % `=1ri ?? r ?" b
' ,?1..1, •.. •-ZIP_
PERMIT REOUESTEO
x SEWER X WATER _ TAPS
COMM/IND
v" X NEW
PLUMBER: GENZ-RYAN PLUM$IAiG
ADDRESS: 14745 S ROBERT TR
CITY, STATE ROSEMOUNT, MN ZiP 55068
PHONE: 423-1144
Lawn Sprinkler Meters
Ahead of Domestic Me
Credit W1LL NOT be qivf
X RESIDENTIAL
EXISTING
re to be Installed
rs on Water Line.
for Deduct Meters.
WITH CITY OF
OWNER: CEDITEX HOMES EAGAN U?NANC?S
ADORESS: SyZg BAKER RD '
CITY, STATE ???OLIS, MIi Zip 55345
PHONE: 1'6""'7833 SI NATURE WHEN METER ISSUED
PLEASE dLLOW TWO WORKING QAYS FOR PRO(:ESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. i
. . .??.? . ? . ?. . ?..., .,., ,. 4 ..P-?.
SEWIM &WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN MErER # PERMIT DATE 10123/90
3830 Pilot Knob Rd. cHiP # PERMIT # 11691
Eagan, MN 55122-1897
METER SIZE B.P. RECEIPT #
DATE QC`l' 22, 1990 ISSUE DATE B.P. RECEIPT DATE .10122190
_ PRV -. BOOSTER PUMP
SITE ADQRESS 703 CAMBB$L1ELL DR PERMIT REOUESTED
LOT 12 BLOCK I SEC/SUB- 'IYLLS 0! S7'ONEB82DGH 211D
3* SEWER X WATER _ TAPS
APPLIC ?: ,, . ,. r ?' ?,•y ' /' ADDRES. COMM/?ND X RESIDENTIAI
CITY, ST4TE ZIP -21341 X NEW - EXISTING
PHONE: ?/ - , : ! pl' s ?_
PLUMBER: GE1AT-RYAN rLU!lbINC
ADDRESS: 14745 S ROEBR? TR
CITY, STATE ROaEMOUN=• 1N ZIP 5306$
PHONE: 423-1144
OWNER: CEN'fEX 8QM8
ADDRESS: 5929 EAKEA AD
CITY, STATE ElTNWAPOLIS. MMP11 ZIP 5S34S
PHONE: 136-7833
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Me rs on Water Line.
C?qdA WILL NOT be givi for Deduct Meters.
,?..,. • ? ?.. . . . ?:?, _.?_.,1i
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTION5. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
Address: 703 !'AMBNRWELT DRIVE Lot 12 Blk 1 Sec/SubHILSS OF SIOfIEiB?2IDGE ZND
These items were/were not complete at the time of the final inspection.
DATE: FE'iBRUARY 12, 1991 Yes No INSPELTOR:
Fina1 grade (6" from siding) C/
Permanent steps - garage ? .?
Permanent steps - main entry I?
Permanent driveway
Permanent gas ?
Sod/seeded grass
Trail/curb damage ?
Porch LZ
Basement finish ?
Deck ?
Please vexify vith the builder the removal of roof test caps from the plumbing
system and the shut-off of watar supply to the outside lawn faucet before
freeze potential exists.
White - City copy Yellow - Resident copy Pink.- Contractor copy
, . ._ -
- - DATE: OCT 23, 1990
RE: 703 CAMBHRWELL DR (CENTEX HOHES)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons: I
Your Sewer 8 Water Permit for the above property has been completed, but the meter cannot
91b issued or occupancy allowed until further notice. '
SOMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspecrors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
.?c J/ y v i? ???/ V I
H'29616A2 1' ?.i ,,, cL ( .? ?'" °°
3? . 7 L4Y?
Repuesl oate
10-24-? Fire No. bugntin Inspection 01
equiretl? ? Ready Now N Will Notify Inapemor
?'Yes G No Wh¢n Reatly?
IIX licensed contractor ? owner hereby request inspection of above eledrical work at:
Job AdOress (StreeC Bax ar Route NOJ City
703 Camberwell Drive Eagan
Section No. Township Nama or No. Range No. County
Ocwpant (PRINT) pryone No.
Centex Homes
PoweF Suppller qpdress
Dakota Electric
E$ecVicai Coniractm(COnpany Name) ConttactOr's Licansa No.
Lazer Electric, Inc. 041935-8
Mailinq Atltlress Conbador or Owner Making Inst311ation)
8383 Sunset Road N.E., Minneapolis, tM7 55432
mmhorizea Signalure Conlraci r/Owner aking Instailal?on)
Phone Number
I ?
1 784-3729
MINNESOTA STATE BOAflD OF ELECiPIGITV TMIS INSPECTION REOUEST WILL NOT
GrIggMMitlway BIOg. - Room S173 BE ACGEPTED BY?HE STATE BOARD
1831 Univeralty Ave., SI. Peul, MN 55104 UNLESS PPOPER INSPECTION FEE IS
Pho^a(61z)64Z-0800 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION
lp See insVUCtions lor cnmpleting fiis (orm on back ol yellow cupR
M r EA
W P9Gl -rj ' X" 8`elow Work Covered by This Request
ew FC8 Rep. Typeoi6uilding AppliancesWired EquipmentWired
Home Range Temporary Service
?uplez Water Heater Electric Heating
Apt Buildinq Dryer Other (Specity)
Comm./Industriai ' FUmace
Farm Air Conditioner
Ot?er (s0eci(o Contractor's Remarks:
Compute Inspection Fee Belaw:
# Other Fee # ServiceEnhanceSize Fee # Circuits/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Ahove 200 _ Amps -Amps
Signs Inspector5 Use Only: ? TAL
Irrigation Booms ??? $86.50
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO S.
I, the Electrical Inspector, here6y
if Rouyn-in 10,
Date ??30'y?
cert
y that the above inspection has
been made. F;nai oare ?^ Q
OFfICE USE ONLV
This request void 18 monlhs imm
?/ v'L 7 G OFFlCE USE ONLY Thiz request roid 18 momhs kom wlidnfion daie prinied in this 6ox.
C'
/o`l/a??/?
III?IIIII IIIIIII?IIIIIIIIIIIIIIIIIIIII III 7,Y/"'?IW?/?^ef- ,-!/o 0
U
I J ?
?
* 0 4 1 6 1 4 2 8 s
? ?
PLEASE PRINT OR TYPE
Reqoeg WIe RaugMn irmpecfion required? ? No
1 Inxpec?ion Olher Thon RougMn: ? Ready Now WIII Call
?Yo? m?s? coll the inspecror wh
z, Doie Ready:
I, ? licensed confracfor 0 owner hereby requesr inspection of Ihe above elecnicol work at:
lob Address (Srceep Box, or Roure No.) ` Ciry Z'ip Coda
10-? cv...?A pa?.??. 4 h?? ss ? a3
Secnon No. iownship Name or No- Range No. Fire No. Cwmy
D ??* °N
occupam
Lqnc-c ? Q??cSor vh. Nro.
(,43,0
Power Supplier Add.ess
COm
Name?
Elecrciwl Conhaclor ' Conhacror licenu No. MosM lic No. (Plant Ek i. O?ly?
C
C\?
?
Maill, Address fCon4ocror or Owner y
erforming Inslollabon)
`
Sq.?-.? qS 0.DOV(, .
Aolhorized Signrnu onhacior o rmiig Insbllorion) Phane No.
" [?
l? A3 .U??D
u/vo qrera wnenn ene??. eoe memurnnuc nu nnrv ne vn ? nw rnev
/? ?7/9<-,
4 6-142
RI REQUEST FOR ELECTRICAL INSPECTION 67*
MinneSola State-Board of Elec[ricity
7821 Universiry Ave., Rm. 5-128, Sf. Paul, MN 55104
Phone1672) 642-0800
Home Duplex A f. Bld . Ollier: New Addn
Commercial Industrial Farm Remad Re ir
Air Cond. Ht . Equi . Water Hh_ Load M mf. Other:
Dryer Range Elea Heat Tem . Service
"X" above the work covered by this request. Enter remarks in fhis spoce and on fhe bock of Nie white copy only.
Cakula(e Inspection Fee - Tbis Inspection Request will nol be accepfed wifhout fhe correct fee:
Other Fee 8 Service Entrance Size Fee tl Circvits/Feeders Fee
Mobile Home Park $tall 0 to 200 Amps 0 ro 100 Amps
Sheet Ltg./Tmffic Sig. Above 200_Am s Above 100_Amps
Transformer/Generaror INSPEGTOP'S USE ONLY TOTAL
Sign/Outline Lfg. Xfmr.
Alarm/Remofe Conirol
Swimming Pooi
I here ce?fi tMi I ine ied the elxvKUl insmllnnon da.nibed herein on ?he dnres sa2d
Irri9afion Boom Rooghln Dote
SpeciallnspecFion
Imesfigotive Fee '/
F? ?(.(J(G?
THIS INSTALLATION MAV 6E OHDERED SCONNECTEn IF NOT C[)MPLEfEn WITHIN 78 MONTHS.
s5 i?'a'l RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
New Conetructlon Reauirements
• 3 regislered site surveys showirg sq. R af lat, sq. ft of house; and all roofed areas
(20% maximum bt coverage albwed)
• 2 copies of plan showirg beam & windaw sizes; poured lound desgn, elc.)
• 7 set of Energy Calculatlans
• 3 copies of Trae Preservation Plan N lol platled after 711/93
• Rim Joist Defad Opdasselection shee) (bldgs with 3 or less unils) DATE ?3 Oo?
SITE ADDRESS
TYPE Of
APPLICANT
RemodeUReoair Reauiremenb
• 2 copies of plan
• 1 set of Eneryy Calculations far healed additbns
. isitesurveyforezterioraddiUansBdecks
• Indicate if home served by septic system far additlons
VALUATION
--
2D/ a oo PIO
MULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS 177a- 12 t- fV?-- N, CITY
TELEPHONE # CELL PHONE #??? lola2 ?I b`5-?/Gy FAX #
PROPERTY
ZIP
TELEPHONE #
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA Ri7LtS 7670 CATEGORY l MINNESOTA RULES 7672
(J submission type) . Residential Ventliatlon Ca[egory 7 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope CalculaGons Submitted
Plumbing Conhactor: _
Plumbing system includes: _ Waker Softener _
_ Water Heater _
_ No. of Baths
_ Phone #
lawn Sprinkler
No. of R.I. Baths
Fee: $90.00
Mechanical Conhactor. Phone #
Mechanical system includes: Air Conditioning Fee: $70.00
_ Heat Recovery System
? ?w
Sewer/Water Controctor. Phone # Ii i')
I
I hereby acknowledge that I have read this application, state that the information is coRect, and agree to co-MPly
with all applicable State of Minnesota Statutes and City of Eagan Or ' an es. ? lBy ---= -?"" "
Signature of Appllcant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
CWW
PERMIT TYPE: B U I L D I N G
Permit Number: 0 2 9 2 6 2
Date Issued: 11 J 2 7 J 9 6
SITE ADDRESS:
P.S.N:: 10-32991-120-01
703 CAMBERWELL
LOT: 12 BLOCK: 1
HILLS OF STONEBRIDGE
DR
PLAT 2
DESCRIPTION:
8u1ldi-n4,,,Permit Type
Buildi"ng 4J'b,rk Type
Census Cod,e "';,?
V,:
,
j,
1\,ra'hP,? , 1 4^ O rv
BASEMENT FINISH
HLTERATION
434 AL7. RESIfJENTIAL
{ b?
S.'.
<... wl
..? e.
REMARKS:
A SEPARATE PERMI7 IS REQUIRED FOR ANY ELECTRSCAI OR PLUMBING WORK
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
PERIVIIT
CONTRACTOR:
?
I hereby acknowledge GhaC I havs read this ap,plicption ar7d state that the
informaCion is correct and agree to comply'with all 6pplica:6le 5tate `of Mn.
Statutes and Ci,ty of Eagan Ordinancgs. ? kpizu
APPLICANT/PE MITEESIGNATUfiE -'ISSUED:SI NATU E
OWNER: - Applicant -
PETERSON LANCE
703 CAMBERWELL OR
EAGAIV MN 55123
(612)936-7735
jq'I? ?
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4575
• 3 reqbterad eRe surveys
? 2 copies of plans (indutle Deam 6 window sizes: pound fnE. desipn: ete.)
? 1 eneryy calculatiens
? 3 copies of trx preserva0on pkn N bt p4Ced aRer 7J1193
rapulred: _ Yas _ Ho
? T copiea of plan
? 2 afte furveys (exterior aOEitions E deeks)
? 1 energy ulalations for Aeated sddilions
DATE: \\I CONSTRUCTION COST:
UESCRIPTION OF WORK: 1?^`
y3 ?o. oT>
c,?.?.?cc(, I(-?I
STREETADDRESS:
i
LOT BLOCK J_ SUBDJP.I.D.
PROPERTY Name: Q?QrSor? ?-C\VNQe Phone#:
OWNER • ?••, ••^ W- °L34- 7,)3.5
Street Address• ? 03 C4M?e.rw??\ Qr;ve
City: State: ? N Zip; S S 1 d3
coN'rRACTOrt Company: Phone
Street Address: License #-
City: State: Zip•
ARCHITECT/
ENGINEER Company: s<L?? Phone #•
Name: Registration #•
Street Address-
City: State: Zip•
Sewer 8 water lieenaed plumber. Nqra. Penaity applies when address ehange and lot
Chenge are roquested once pertnit is issued. •
t hereby scknowiedge that I have read this appfication and atete that fhe InfortnaHon is correct and agree to eompy wfth all
appiicable State oi Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certlfleates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes _ No
?Cz
?!(31/ ? ? ??) 1VM
s'3. Y ?I
PERMIT
?CITY OF'9AGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Co, Natrc? a-
PERMIT TYPE:
Permit Number:
Date Issued:
(o -5-9 q
BUILOING
023774
06/02J94
SITE ADDRESS:
P.I.N.: 10-32991-120-01
703 CAMBERWELL
LOT: 12 BLOCK: 1
HILLS OF STONEBRIpGE
DR
2ND
DESCRIPTION:
86ilding`_Permit Type DECK
Building Wo.rk Type NEW
? `.
j
. ,?
?
?
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant -
PETERSON LANCE
703 CAMBERWELL DR
EAGAN MN 55123
(612)683-0778
L
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all spplicable State of Mn.
Statutes and City of Eagan Ordinances.
_01in A ai'rt
I a--"103=!)n .. APPLICAN /PERMITEE SIGNA R SSUED B: SI NATUR
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euzLozNG
3830 Pilot Knob Road Permit Number: 0 2 3 7 7 4
Eagan, Minnesota 55123 Date Issued: 0 6/ 0 2/ 9 4
(612) 681-4675
SITE ADDRESS:
LOT: 12 BLOCK:
703 CAMBERWELL DR
HTLLS OF STONEBRIDGE 2ND
PERMIT SUBTYPE:
DECK
1
APPLICANT:
PETERSON LANCE
(612) 683-0778
TYPE OF WORK:
NEW
INSPECTION .. . ,•
FOOTINGS FINAL
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CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
f,50 . 't1j r
SINGLE & MULTI-FAMILY 2 sets of pl s, e e s te surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of ar hitectural & struc ural ptans, 1 set of
specificatio "" "'--"" ?-"-" calcs.
'Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date rnp% / X7 / °\A Valuation of work
Site Address: 103 GaAe:Aws`\ %)rl??? H., Mu. ssl a3
STREET SUITE #
Tenant Name: (commercial only)
LOT ?a BLOCK ?
I
SUBD.,f?A,Cld? .,?I, , ??.I,•_.'?
?'1,
#
+ I.D.
Desczi tion of work: ?bQC• C? n f?ck'lor?
The applicant is: IZ Owner ? Contractor ? Other (Describe)
Name Q anSo?1-10 ?e N , Phone
Property LAST FIRST I
Owner pddress ? D s Gy,,.,?Qr. W?.11 N"k
STREET STE #
City State Zip
Company Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with a 1 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
/
Signature of Applicant: -? _
* 2422 Enterprise Drive
* PIONEER Mendota Height:, MN 55120
7Iengne ng..
(s1216811sta
'
Certificate o?f Survev (or: CENTEK NOMES
?
511 \\?? 3? 563. qb? NORt?'N
1 ?1? 4
\ I
o ? ? O Cli
? . :?.?`
?,y Q - i
Y p;e.+,e N ? lt1
? t:l1 ? ° d 1?
- --- -- : `s ? ? ia?
. PQ?P° E ° W o ? 4 W^.
19•61
-?, I.5 00
N ?
Zb
. ? \ ?e t2.33 O
96.Z ? N ?
q.o ^
1
10 ?
a L? ? +
)
-yZ3•46 --_--"-_= h???bc`pp
f- ?n _.__....._ .
,o.
? 97
CAMgE RWELL
. 9ao.o Denofes exisfinc? Elevation P??oSED NOUSE LE`VATION
• to Dertofes propdged E/evatiori Lowes Foor eva iaR 9.36
Denofes Oraina?efUfi1i? Easemenf Top of 8/ock Elevafion a ".a
-?- Denofes Draind?e ?low Arrows Garae S/ab Clevation s9 (?,53
0 Denoles monumenf o Deno es Or ?'sef Nub
&crrins shown are assumed Su§eci fo Easemenl]5 o?'Recard
LOT IZ , BLOC!! 1, I-/IILS OF STONEBRIDGE PLAT 2
OqKOTA COUNTV
I hareby certlly thal thff evrvey, plnn or rnporl waf ptp.cared by me or n r my direct supervision and Ihat I nm Auly (iepistered l.and Surveynr
under the lewe of the Steie ot Mlnnesota. Daled ihli }L _ day ol M q.0, 19?? .•?
? 1,?
?o11?.07 SCale: -?b • L-
__. _,. Q , ? ROAEn T f3. $IKIC1-1 I...S. REO. NO. 14891
CITY OF EAGAN Ng 18473
3830 Pilot Knob Road, P.O. Box 21- 199, Eagan, MN 55121
PHONE: 454-81 00
BUILDING PERMIT ' Receipt # L/ I?S I
Tobeusedfor SF DWG/GAR Est.Value $118,000 Date OCT 22 , 7g9Q_
Site Address 703 CAMBERWELL DR
Lot 12 Block 1 SeGSub. HILLS OF OFFICE uSE oNlv
PefCBI NO. Occupancy R-3 B-1 FE FS
PD ' R
1
=
Zoning
w Name CENTEX HOMES (qctuap Const V-I'1 Bldg
Permit 703.00
; Address 5929 BAKER RD (Aliowe6le) V=N .
59
0
0
? Surcharge .
Cit
y MPLS Phone 936-7833 ?`of stories -
46 PlanReview 457.00
!
Length
F Name SAMF. Depth 5? SAC
Cit 100_0
0
Z
°a
° Addf85S S.P.7otal
- .
y
F SAC,MGWCC 60f1_(1f1
CISY Phone S.F. Foolprinis -
Wat
r C 625
00
On Site Sewage onn
e .
ww Name OnSiteWell W
M 90
00
- ater
eter .
AddfeSS MWCCSystem _x
oeposn
^cct 30. 00
a W City
Phone ny wa?e? ?
c
.
30
0
?
PRV Requiretl - SAN Permit .
1 hereby acknowlege that I h ead this applicati n and s[ate ihat the 8oosier Pump - SNJ Surcharge
0
.5
infortnation is correct agrea to comply with I applicable State ot /
Minnesota Statutes an Ciry of E gan Ominances 7 Treatment PI 252.00
Siqnature ol Permitee /rAl APPROVALS Road Unil 15, .p0
A Building Permit is issued to: F. HO Plenner - Park Oed.
on the ezpress condition that all wo shall done in accordance with all Council
applica618 Slale of Minnesota Sta
tutes and C
i
ry
ofEagan Ordinances. eldg. ON. Copies
Q
-
/
y?
BuildingOffiClal r??in I\pa I III?J Variance _ 7p7qL 3.301.50
/V/odEG J/-?
7
SINGLE FAMILY DWELLINGS
,. : . / ?
.1t 413
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
MULTIPLE DWELLINGS
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 CALCS
_# 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: D6A Valuation: Iig?ooo Date:
Site Address
Lot L?- Block /
HI tLS A4T Z,
Parcel/SuUcJ7`0,/f',&0/AGE
Owner e?!E?tI-7-GY i?4/Y1FS
Address S5-p2V pI¢??/L A
City/Zip Code
Phone 936, -7833
Contractor ("-
Address
City/Zip Code
Phone
Arch./Engr. beIE? Z!?;16 •
Address 7 Z
City/2ip Code
Phone #
ACT f 8 A?r,v^
OFFICE USE ONLY
Occupancy /C c3 M"1
Zoning PD -pl-
Actual Const V-N
Allowable V-N
# of stories
Length y?
Depth 3p,
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System i/
City water ?
PRV
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off. I[Iq
Variance
FEES
Bldg. Permit 103.00
Surcharge 59.00
P1an Review ySq.pD
snc, cicy / op ,pD
snc, rtwcc goD,oa
water Conn (j25i00
Water Meter 90.00
Acct. Deposi t 30.00
S/W Permit 30•00
S/W Surcharg e ? O
Treatment P1 . Z$Z,aa
Road Unit' .OO
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
1s?"/
2422 Enierprise Orive
PIONEER Mendota lieiglits, MN 55120 7*eng*e ing.. I612l681-1914
* ?C # , '1
e?'
Certificate o( CENTEX NOMES
Surve;v for: ?
5` \ \ ? ? ? 563- a?` NoaYN
? /1o '? 0~[
1 ? ? J
o ? ? ? b? 11 Svi•'-Q ? e ?
s ? w 3e.i'i N I ?
? ; ?'z?T ta!? ? '" n
? > i4 > pQoP° E ? w p ? O W
O < <? H°?" I8•bi '" ? ?` ?C
?O
' \N `•5 N 1
m.b
? 1P•? '9b.2 ? N ? Q
? ? p ?_ __ 1 "5•D hN lL
h J >c ?
10
oA r . _ . b .?..?-.
? K9I0 ' .
9?.g gE(ZWELLD_•`
Cp,EAGiAN ENGINBERING L7?PT
. soo.o Dcnofes exisf;n fleva!%on PaoPosE u E L6VATlON
• 5ioo.o Dertofes proped F/evafiori Lowegt Foor eva ion 8g y.3b
Dpno!-es Draina?ef Utr(iy Easemenf Tp of 8/ock E/evafion 894.$6
-?-- Denofes Oraindide f7ow Alrrow.s Carae5/ab E"levafion E9&,s3
0 Denofes monumenf o Dena es Ot f scf f?ub
Bearins shown are ossumed $u Jed fo Easemenfs or'?ecord
L4T 12 , BLOCI! 1,1JI1LS OF ST4NEBRIpCE PLAT 2
DAKOTA CavNrY
I her¢by tertlfy ihat this aurvey, plan or report wxs pr.pured by m?e orp n?? my direct sup/e?rv,i,sian anA thal I nm Auly Repistered Lend Surveyor
under fhe le?+n ol the Stele ol Minnasota. Deted thlf dey ol ._.,(J?_ A.D.
19 7" y??
/ _
? ?
/n( ? l?
Sca(e : I1n -.?y?o L-
90117.07 qpnERl S. SIKICFI L.S. REG. NO. 14991
----- -
;. ,
?,.
Flanniny Design Tnc.
1511 Highway 10 N.E.
MS (lfl"c'r1pC111 =: , I"IN 55432
612-700-1920
t
COMM. N0.
Minnesota State Energy Code Calculations
Pascd on Chapter J o'F 'lF1@ IModel Energy Code
1983 Cdition -- Adapt.ed 1/1/84
Owner:
S:i. te Aciclre==s:
Contrac,tor:
BIdr. Clas=:
CENTEX HOh71=_S
DCL '14:i
C=N1"kY, HC]MFS
A1 A1 for 5ingle Hamily/Duple>:
F-t2, residential . ti+ stori.es
Qver 3 stories
Qiher-
COMM. NO: 890251
Phone^
Gf.:ihJrFiAL_ IIVF=UFih1Al'LUPJ
P:ote: The =ectian desa.gnatic;ns ("SE:ction Fl", "Section Es" etc. )..?re for
canvenience in ca.lci.ilat:inn.s nn1y, ancJ ,are not relatNd from one set uf
calcul.atiens nel.ow t.c the ne;:i.
1. Bldg. Wa11_=. F'erimeter x 6Ja11 heights, - /-lrea
ground to eave
Section A: 54.E3 9.67 - 529.916
Sec:t:i c,n E' : f3°, b 16.56 = 1664.768
Ser_tci nri i: i.l = O
Section A. O ii =
C1
Gross Wal 1Arr_+e, = 2194. bt34
... F.+i..iil.riiny dimen::::ons Flotir or
Ceiliny
L.ength >: widr.n = arEa
Section A: 16.5 20.67 = 341.055
Section E+ : ;_a 27 = 756
SLC'i.lU7'1 C : ?) 0 _ 0
iE'.Ct:! qC1 D : O l.1 _
O
TorP_z::l flonr cn• ceiliny area = 1097.055
w. F;im Jo:ist F'erim:_ter = 144„4
F=1oor .7aiG,t ^ by (F'", iG"ry 12" ?r :lG")): 10
?-?
1"?1(n lTojst f-;rez = 120.3333
<}. .LOOI"3 .
ArE=:: 37.3 TI-iicl,ness (inches): 0
- Fer;rneter Cfeeeti: :-i
Ty',:e o{ c_ons:i,ructior.:
:.. l'ot;il dr.;c,• ,S pr.,r-irn:-ater:
6. 4! i n r.; c:na cs
P1anufact.urer: WEA71iERSHIEI_ll U faetor: 47
0
:31.r:ate ci(?pi^OVE'd: YE S .
Type HeigPit „ I._enqth r: Number = Tateil
tinr_hes) (Inches) of glass SyFt
units
liASLMEI+!'f 5F1SH
UOUBLE HL'NG 14 27 3 7.88
DOULj!_L I-IIiIVO 16 ib
4
7.11
DCILIYLE HLINEi 20 Sh 2 4.44
I)IJUF+LE_ HUNG 22 16 2 6.22
DOUE<l_C HUNG 24 24 6 24
DOi!E3L?: HUNG 28 24 6 26
DCUBLE HUNG 16 28 2 6.22
DUlJL?I.._E HUNG 24 28 18 $a
I)OLJJ'tt_.r HUhlG 29 28 4 21.70
DOiiF3LE HUPlG 32 . 28 n ^4.89
'-
SK'ILI7'C 16 `
?' ,?
`'
?
40 24 2 16
o 0 0 p
7. Windczw glass ai^eet (Sql=t) _ 238
54
.
T'E''' hleic7hi: .. Length „ Numlaer- - Total
FEGt} (feet) units SqFt
S. I"atio Llnor: p
9. fitrium:
i:i
6.( C)
3 t;
, 1 20.55
10. F:i r-o-ap:l „ce a;-r->r_i
i'!lCi.l'fll¢ 6 H@lCffl't: 5
TG't <t l `,q(= t_. ,:: G
17. Expc;:;ed Fcai.indat.ion
Heiyht area A; 0.67 F'e rimeter a rea A: 145
3
5R Ft area H = . 97,351 .
Er.pos>e-:d Foi.tndati on
Heiyht area E+: !] F'e r-imeter a rea Et: G
Sq F t curc? et lit = t:l
i"
5qFt ll ractor U:: A
6ra5s aiall area 2144.684
minus
4J:indow area
F',?tio door a
? ,_'8,=?q
? 0.47 112.11
i
ca 0 0
?
A'tri?tm .;?i-F.a
' 20.55 ?_?.44 9
C14
F
tirn juist area 2w4._,,3`-..?~ `ti`
"
,
O.U?S .
4
?1
;?
lloc,r a'`e 37.8 0.14 .
5
29
F i repl ace area 30 0.17 .
5
1
E>:pasecl Founcl,
= y7-357 0.14 .
13
63
k 1
raming area 21i',4634 0.069 .
15.14
equat s
n:;t,.,l__. .; o,... ne;_ wal:i : ,
;l4..`"O,L:4'l,?bfr7
Ci.l?^"I
52.97
J
Tota1=s for gr-ass air.-i:t i. ;aree. '<'•'iZ.RS
* 1=rami.ng "re„c i:, 10% of yross wall area
13. Gross wa11 area :: fac•tor be.low = U:, A per code
f=ac-trnr is .li for A-1 singlc family 8< duple>:
.23 for A-2 and athrar residential
.23 icr oiher bi.uldinqs
.::"8 fnr over 3 stories
r-=«rur is: 0.11
B"fIJH = 241.41524 I`1UST FJE ? OFt = 217.45
(calculated above)
14. C;rr_+!ss r_ciling area = 1497•055
15. Cf?111fRCj +Y'af111{'1Ci ar ea (10% ?1' ceiling c1Y'E'cl) = 109.7055
SS. Juis't Area i10"/, ol ce;iling arera> = 109.7055
17. Net cei.;irrg area ( Gres=, cei1, area - Joist area) = 987.3495
18. U cceil:ing: 0.023 :: hlet cei.l. area =22.70903
19. U f rami ng: 0.026 x Joi st area = 2.852343
=0• Total af ifem 16 >: item 19 = 25.56138
21. C'P"OsS C:E'7.i.1Rf3 area .; factor belc7w -• U:: Aper cade
f='actor• :is., ,ii26 for A--:l ::ing:e •family & duple::
.03. irr F;--2 nnd cat.her re::>idential
.On frr ather buildings
Factor is: 0,026
RTUH = 28.52343 t'1lJST BE : OR = 25.56138
(calculated above)
1?. ?n .I I
, 6/. _ _ µic?N r SEIE.lYit 1rl.lcn AIUE
W
SF
U VALUE
Inside atr ELlm .68
Idccrior vall .45 (Wall) U • R .
[nsulation 19.00
Shenthing (0•0
Stding .67 •.
Outsldc a[r Eilm .17
R TOTAL • 031
sTLn
sECrioN
2KD WALL
SECTLON
Insidc atr film .68
Interior wall •45
x4m atua - 6" A- 3qmx6.50(Framtng)u- R.
Shea[hing ?•? ,Q(p?
SLding • .67
Outslde air filra .17
& TOTAL
Insidc air film R= .68
IntetLoc vall
InsulaCion
Shna[hiag
Exteriar vall covering
Exteriac air film R ..17
(Nall ? lJ ? a ?
& TOTAL
RIH
.TO IS'
Incerior atr Eilm R? .63
Lnsulation 19.00 . 1
t? (flCtlSOfC WUUd R=1.88 (Rim U aIr a
-. do;st) .035
Sheathing' ?•D
ExterSor wall covering •67
Exteriar air fltm Rz .17 '
R TOTAL :08 .40 •
InCe=ior alr fllm R' .68 '
Insulatlbr, 5 •00
•.'? .
FoundacLan '(FdO.) U a
Exterior'air film R' .17
• - . .14 . .
s roTaL
`£:cpased 31uck . . •
. . I -?
k ':,iL!.'c
FRAMf ttG
x 'li,lUE
CEILIt{G
? O.fii Air Film `0.61
Insulation 9'O
.0 4.38 ,loist
.56 Ceiling
?
:•
I -7- 0.61
I ?-
I I .
?
? •
0.17
I I
.56
0.61 Air Film
?8,1(o7otal
,02f? u = a
0.61.
R -t I .78
• 0'L3
F! AT. RGOF OR CATHEDRAL C:tLING :c va ue R 'lALUE
FR,;MiNG CEILING
Inside air film 0.61
Ceiiing
Joist (stud)
Insu'ation
Air space
Rocf decking
Insulation
Built-up roof
Outside air filn 0.17
Total
1 = U
R
R
iindow infiltration .5 cfm/lineal foot of crack '
tesidential door infiltraticn 0.5 cfm/square foot or door and minimum code requirement
:cn-residential door infiltration 11.0 cfm/linea] `oot of crack
Jp 12" concr•e*_e block no insulation =..47 R 2.1
!b 12" concrete block insulated cores =.26 2 3.8
J5 12" >iShtneiahc block = .32 R 3.1
:b 12" >i9h*-weight block insulated cores =.12 R 8.3
1 single glass = 1.13; with 5torm.tvindow .54
J double glass = .55
1 criple glass = .41
Ail exterior walls and ceilings must have a vapor.barrier (0.10 perm rax.).
:a?or barrier must be on the inside (heated side) of l•1a'1.
ra.Dor barriers of the polyethelene thin film have no R value.
For Office Use f�6_1
e o a e :::::e:
i 1 WO
FEB 2su1a 0- �-t
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 �/
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: ►'l�
buildinginspectionspcityofeagan.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1 — k Site Address: '7 ,,, CN {N,J j r ij(� t° t i I.
r' �O P s-T-(f vl.�1 116,(A--
Tenant' . Suite#:
,; ' Name: K
q I I / C eA.Ct(f RC1--10 it Phone: 6 17- ''.2-q1-2-406 -
' siticinv itfi
4 -. Address/Ci /Zi , /
z � Name: > (� ct G' 60� License#: f-C, (7 Si
Address: R
3) P ��t Y V {� City: SrPce 1 m /,.)
,, ,fin /,,{ 8/'. 1.,,,,„ N n - State: y r �� Zip: � I Phone: Ct' ) ��' 1 1
:::;;;1;';''" Contact: k. i ' Email:
/ S " u
�, ` ''r New Replacement 41 Repair _Rebuild Modify Space •% ork in R.O.W.
* ; Description of work:
l 11 ' j RESIDENTIAL
•.,. Water Heater
Water Softener
''y F ' Lawn Irrigation ( RPZ/—PVB)
� � -, rQ Septic System Add Plumbing Fixtures( Main/ Lower Level)
New Water Turnaround
zz i Abandonment
RESIDENTIAL ..,. .., _ _,. ..
FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ (P
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.gopherstateonecali.orq
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.citvofeagan.com/subscribe.
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
pe
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start with ut 3 rmit; t the work will be in
accordance with the appr ved plan in the case of work which requires a review and approval of pl
r
x b I ZCP 1'1. jx l I /tk
a.
Applicant's printed Name Applicant's Sig 2 ure
"*' c .'ter s , �� .�a �x ..:it i ..-- 7 '
,..4-1,4;14;~.1*„, .i,* 44ti,:,,,,:itR.N i ,r,4,,i.„:.,,,,,...,„p.„.,„
3
� w3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159582
Date Issued:01/02/2020
Permit Category:ePermit
Site Address: 703 Camberwell Dr
Lot:12 Block: 1 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-01-120
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Patrick W Krile
703 Camberwell Dr
Eagan MN 55123
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature