Loading...
791 Camberwell DrINSPECTI4N RECORD CITY OF EAGAN PERIUIIT TYPE /3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: lFti11 FR1-dF7r, . v? .. . , ? l SITE ADDRESS: PERMIT SUBTYPE: TYPE OF WORK: INSPECTION D, . .. FtA P K :, : t7I. A N F? t???F W1-c1 FtY CV w t.r; WOVA 1:1 Yt [=; f.!!'* r f," A t' i?. 1' r, F' Nf fi' Nt? 1=' t1 v n 1l'Y 1? rsh 14`f !q i 1m l " A ! . I tF 4!? - , : ' ;s q G) kri, FV #mi IW r f G' 1 F ! CFi : C A I 1- L ? ?;•r ?--- i Permit Holder Date Tetephone # SEWER/ WATER PLUIviBING - 8 HVAC Inspection Date Insp. Camments FOOTI NGS F4UND FRAMING Y! ? ?:C?'% : 1A ? I ROOFING ROUGH PLUMBING ? FLBG A!R TEST ROUGH HEATING ? ?- GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC MEfER IRRIGATION METER FLUSH MAINS GONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ?. ? .? . ? Ter#t?ir?ft ofOrrupaury C, itp of Cagan lo,?partmm uf a?g jn,?p?imu l? ?. ; . : This Cer,[ificate issued pursua»t to the requiremeatr of Seation 306 of the Unijarm Buidding . Code cerxifying lhal a11he time of issucnce tIrisstructum ucrs ix campliauwe with the various ordinaxcer of the City reguWting building oonsh:cr.tion or use For the foUowing. Use ChstiGag6ou rc+ r,r.r. rn n+e H{dg. RYmic No. a O-UPMZY Tra •???_ ymag potnct rmin t 7YPe ?Cnnst *???- ? . BUIL[ To be u Address City _ CITY OF EA i Pilot Knob Road, P.O. Box : PHONE: 454- Est. Value $1k4yq0 I?LL LiR Sub. -,? g???F iD CO I mC R RD Phone 571 -•0306 Phone I - Phane _ ition and state that the all applicable State of Signature of Permitee A Buildinq Permit is is one in accordance with ail of Eagan Ordinances. 383 ERMIT SF DWG/CAR ..... ----_-- ?z t OFFICE USf ONLY ? j OcCUpancy R-3 A.4 . FEES ' Zoning Pb ?? r, y (Actual) Const V? ?Bldg. Permit 794•00 (Allowable) Surcharge 72+00 ? # of Stories !@ Plan Review ? si$+Q0 Length ' Depth 34 SAC, City 100r?Q ? S.F. Total - SA'G, MCWCC 650,? ' S.F. Footprints wate?-CoA ' 660.00 on Site Sewage _ ;y On Site Well Water Meter 95+00 _ MwCC System X ? Acct. Deposit 30•?' City Wa1er : PRV Required _ S/lN Permit 3n-? Booster Pump - S/W Surcharge - ? Treatment PI 176-0? APPRDVALS Road Unit 320-flt] ' Planner - park Ded. Council BIdg.Ofl. _ Copies VarianCe - TOTAL 3* 593• ? ?- Permk No. Permft Holder Date Telephone # WATER ?Q fd l? / ? SEW R: PLUMBING g Nr H.v.n.c. ELECTRIC Inspectfon Date Insp_ Comments Footings I -?3 5 Foundation Framing t? Roofing Rough Plbg. -,,L ?' Rough Htg. - .?L' ! ? , IsuL I- ' • ? ? ? Fireplace Final Htg. Orstat Test Final PI bg. Plbg. Inspector - Noti(y Plumber Consl. Meter EngrJPlan Bldg. Final i ?,?$ Deck Ftg. dedc Final Well Pr. Disp. ?I We^ ,' SEWER & WATER PERMIT CITY OF EAGAhF . METER # 3834 Pilot Knob Rd. Eagan, MN 55122-189?7 CHIP # 0/7.?, . METER SIZE ? OCT lt3-, 1991 ISSUE DATE ? ? oA-rE SITE ADDRESS /y? ????t b LOT 19 BLOCI( 2 SEClSUB APPLICANT: ADDRESS: CITY, STATE PNONE: C1TY, STATE PHONE: ? OWNER; - STATE r ? 1G- 57 roNEsRiDcE i ZIP m ziP a e. n ? v ?,tc ?ct? D??Y MN ZIP _ -a3a4 : / WOF?KtNfn? DAYS FOR ¢ROGE ITACT ENGINEERING DEPT. U3E ONLY ` . PERMITQATE 10?18/91- PERMIT # 12350 B.P.RECEIPT# C 15$72 ? B.P. RECEIPT DATE 1 Q l 7 91 PERMIT REOUESTED X SEN/ER X WAT S _ COMM/IND RESIDENTIAL X NEW - EXISTING Lawn Sprinkler Meters are to be Instalied Ahead of Damestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. ?Lr I AGREE Ta GOMPLY VVJTH CITY OF ?-> --- ? 55421 SI f ReVYHEN METER ISSUED .? . :SII?G. CA?L 54-5220 FOR INSPEGTIQNS. FOR STORM ?? ,r°,,?._,... . . . . , _ I . . I SEY1(ER _&VA7ER PERMIT OFFICE USE ONLY I GITY OF EAGAk METER # PERMIT DATE 3830 -Pilot.Kiiob Rtl. - 12350 Eagan, MN 56122-1$97 CHIP # PERMIT # METER SIZE B P RECEIPT #!? 1 5872 ,i .. ? OCT I8 1991 _ , . ISSUE DATE B.P. RECEIPT DATE 10 17 91 . DATE - PRV _ BOOSTER PUMP SITE ADDRESS ??? CAMBgR WELL DF PERMIT REQUESTED LOT L9 BLOCK ? SEC/SUB HI?? OF ???EBRIDGR R X SEWER __XWATER - TAPS APPLICANT: ADDRESS: _ COMM/1ND __ RESIDENTIAL : CITY, STATE ZIP X NEW - EXISTING PHONE: , I_awn Snrinkler Meters are to he Installed CITY OF EAGAN Np 1980 1 3830 Pilot Knob Road, P.O. Box 21- 199, Eagan, MN 55121 PHONE: 454-8100 BUILDINGPERMIT ?k 7 ? Receipt # i n I -- To be used for SF DWG/GAR Est. Value $144,000 Date OCT 15 , 1991 Site Address 791 CAMBERWELL DR LOt 19 Block Z SeGSUb. HILLS OF OfFICE USE ONLY PefCBl N0. Occupancy R-3 1i-1 FEES PD Zoning R=1 w Name THE ROTTLITND CO INC (Actual) Const V=N eldg Permit 794.00 . AddreSS 5201 E RIVER RD (Allowebla) V=N 72 00 0 Cily FRIDLEY phone 571-0304 t ol stones Surcharge • 64, Plan R i $16.00 Length ev ew F Name SANE Depih 34? snc ci 100 00 ? , ry . g Address s.F.rocai _ ? SAC,MCWCC 65?.0? OIlY Phone S.F.FOOtpnnls _ 660.00 On Sile Sewaga water Conn ?W Name onsitewen 95 00 ?w X water Melar . x? Address MWCC System ? Aect De osit 30.00 a City PhOne Qty Water X p . PRV Requiretl _ S/W Pertnit 30_ 0n I hereby acknowlege Nat I have read this application and state that the Booster Pump - SM! Surcharge . Sn information is correct and agree lo comply wilh all applicable State of Minnesota Stalutes and Cit of Eaga rdinances. 7reatment PI ?7A _ nn SignaWre of Permitee ? AVPpOVALS Road Unit 370 Qg A Buildinq Permit is issued to: THE ROT LIIND CO INC Plannar - park oed. on the express condilion Ihat all work ghall be done in accordance with all Camll -- applicable State of M inn eso ta S tatute?s an d City of Eagan Ordinances. Bldg. Off. CoGies .(? ? ? ( ? -y ? BuildingOHicial ? t?x(?1 I?,PIIx,,,l Lfl? TT Variance - TOTAL 3,593.50 Address:7gl C94BEFUELL D?W Lot ]g Blk Z Sec/Sub HILLS OF STONEBRD)GE 3RD These itams were/were not complete at the time of the final inspection. I 28/92 Yes No Final grade (6" from siding) Pexmanent steps - garage ? Permanent steps - main entry Peimanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Please vaxify with the builder the removal of roof test caps from the plumbing system and tha shut-off of water supply to the outside lawtt faucet before freeze potential exists. ?* ve?onrtn White - City copy Yellow - Resident copy Pink - Contractor copy DATE: OCT 18, 1991 ' RE: 791 CAHBEHWE6L DR (THE ROTTLUND CO INC) . p X Your Sewer_'&'Water Permit for the above property has been completed. It will be held at the Public W*ks Garage (3501 Coachman Road) until ihe 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 Tor the following reasons: Your Sewer & Wa[er Permit for the above property has been completed, but the meter cannot 6e issued or occupancy allowed until further notice. - COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY W1W < CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. I 01224 ?, /03Llo?9 •? ?e 5 °° Request Dale ` ? ? ?? Fire No Rougli InsOecLOn Fequrt ? ?q - Ves o Veatly Now ? Wtll Notity Inspector When Raetly9 r I?-licensed contracror ? owner hereby request inspection of above electrical work at. Jnb HOtlress (Slreel, ox or qouce No ) b Qry Secuon N. Townsnip Name or No Ran9e No Counry ? Occupant PRINTI Phone No Power S??/Q ?lier q L/l.VRi. n `-6i • Atltlress Eleancal nrcactor 4COmpany ame, Gontracmr§ License No 4a4r?-- MaJing Atldress iCOnVactor or Owner Making Installation, Aothorrzetl SignaWre ICOmraao na ing Installauon ? PM14L One Num3?er - 38/0 MINNESOTA STATE BOAFD OF ELECTRICITY THIS MSPECtION FEQUEST WILL NOT Griggs-MlEwey Bltlg. - Poom 5-173 BE ACCEPTED BY THE STATE BOFFD 1821 Univenlty Ave., 51. Paul. MN 55106 UNLESS PROPEF INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED //??/9? :EQUESToFORoE?LECTR1?CnA?L?NSPECTION pn1??Q, "X" Below Work Covered 6y This Request ?°J2 ? 31 ?yq 0 -0? ?gR ew Atld; Rep Type of Bmltling I Applian7tsWiretl EquipmemWved Home Range Temporary Service Duplex Water Heater Electnc Heating Apt Buildmg Dryer Other (Speciy) Commllndusirial Furnace Farm Air Condi4oner Olher(syeaty) ConVactorY FemaBs Campute Inspection Fee Below: # Other Fee # SarviceEntrance5rze Fee # Circwis/Feeders Fee Swimming Pool 01o200 Amps 0 to 100 Amps Transformers Above 200 _ Amps 00 _ Amps SignS Insvector's Use only TOTAL Irrigahon 8ooms l? OlJ JSSD Special Inspeclion Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electncal Inspector, here by Rouyn-io Date certify that the a6ove mspec4on has been made. F,,,,i ? Da[e ? OFFICE USE JNLV This requesl voitl 18 monlhs imm ////8/9/ 1038-P ?; 1 012 2'c- flequest Date Frte No oighin Inspecbon Req u rtetl'+ ? Reatly Now y}9Vill Notdy Inspecbr p Io - ^ a?" 1 ? . / f'°s n No Wnen ReatlY? I,21hcensed contracror ? owner hereby request inspection ot above electrical work aC Job Atltlress (S treet Bov Roure No Qiy ? / "1 I 4/ Section No Townsnip Name or No Range No, ' C Occupanl INT) Phone No Powar Suppye? Atltlress ? Y14 - Elecincal Co ador IGOmpany Namel ConVacror's license No ' 4-? q/2 -3 Mailing Aatlress (GOnnactor or Owner Making Installalion) Au:honzetl Signature IConlracror ne? M, in -- Insta1191i0nd Phone Nomber MINNESOTA STATE BOAPD OF ELp TPIQTV S THI$ INSPEGTION REOUEST WILL NOT Gnggs-Mitlway Bbg - floom 5173 BE ACCEPTED BY THE STATE 80ARD 1011 Ilniversity Ave, SL Vaul MN 55104 UNLE55 PROPER INSPECTION FEE IS VMne (812) 842-0900 ENCLOSED ' // ?8/?/ ;EQUESToFORoEPECTRI?CA?LbINSPECTION / o n.1 ?22 "X" Below, Work Covered by This Request ds ? 4? EB-00001-08 a ? ew dd Rep TypeotBUildmg AppliancesWiretl EqmpmenlWired Home Range Temporary Service Duplex Water Heater Electnc Heating Apt Building Dryer Other (Specity) Comm./Intlustrial Fumace Farm Air Condiuoner ? Olher syealy) Contraqor's Remarks Compute lnspechon Fee Below. #+ Other Fee # SerwceEntrance5ize Fee # Circuits/Feetlers Fee Swimmmg Pool 0 to 200 Amps d 0 to 100 Amps L? Transformers Above 200 _ Amps 700 _ Amps Signs Inspector's use only TOTAL IrngaM1On 8ooms gq= Speaal Inspection Alarm/Commumcauon THIS INSTALLATION MAV BE ORDERED DISCQNNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO S. ?? I, the Electncal Inspector, hereby poogh"n ? f ~ certify that the above inspection has been made. Final ? oare OFFICE USE ONLY ` This repuesc witl 16 montM1S irom -? ??? RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55112 651•681-4675 NawConaWCtlon ReauinmeMa • 3 registered site surveys showing sq. R. ol lot, sq. ft. of house: and all roofed areas (20% maximum lot coverage allowed) . 2 cnpies of plan showing beam 8 vAndow sizes: poured faurM design, etc.) • 1 ut of Energy Calculatiore • 3 copies of Tree Preaervation Plan if lot platted after 717/93 . Rim Jaisl OetaJ OPtions selection sheel (61dgs xith 3 w less wils) DATE ??I -7--QD'? SITE ADDRE55 I qI TYPE OF WORK YP"_ APPLICANT ?-f STREET ADDRESS TELEPHONE # PHONE # ISY11Ies7'ATEMZIPOCZ57 Fax # 9v?-7o7-825 PROPERTYOWNER 1?TELEPHONE# -----^--------- ---°---------------- --------°-°------ --------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOT:1 RULES 7670 CATEGORY 1 MINNESOT9 RULFS 7672 (J submission type) • Residen6al VenUlatlon Category 1 Worksheet Submitted • New En e'N.o 'et Submi • Energy Envelope Calalations Submitted ? ?n ?h?I ? ? SEP 17 2002 Plumbing Conhactor: Plumbing sys[em includes: Mechanlcal Conhactor. Mechaniril system includes: Sewer/Water Contractor. _ Air Conditioning Heat Recovery System Y BLDG _Y V- N FIREPLACE(S) _ 0 _ 1 _ 2 Phone # Phone i Fee: $70.00 -°--------------------------------°-------.....---------------°----°---------------...---°-....°-----------°------- I hereby acknowledge ihat I have read this application, state that the information is cortect, and ag e to comply with all applicable State of Minnesota Statutes and City of Eagan ' ances. Signature of Applicant OFFICE USE ONLY ? Water Softener _ _ Water Heater _ _ No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths / !?- --7•-?? RemodallRemir ReauiremeMs . 2 copies of plan . t set of Ene(9Y Cakulaliais tar heated addiUore . 1 site surrey ta exterior adaitbia 8 decks • Indicate il tame urred by septic system for additiorts 2 7 VALUATION rt/ I ; 8 Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 PERMIT CITYOF-?,AGAN , PERaniT?vPE: 3830 PilotdKno Road Eagan, Minnesota 55122-1897 , Permit Number: (651) 681-4675 Date Issued: SITE ADDRESS: - 791 ' CflhIBERWELL Oft LQTs 19 BLOCK: 2 ' NTLLS QF :iTqNEBRIDGE 3F2D P.I.N.: 10-32992-190-02 ' DESCRIPTION: ermit Type k,Type BASEiHFNT FINISH AI.TEF2ATI0N 434 HIT. RESIDENTTAL BUSLDING 034256 12/23/98 m . „ czagan REMARKS: PLAN REVIEWED BY CRAIG NOVACZYK. SEPERFITE PERmIT NEEpED FOR ANV PLUMBZNG WORK. CALL 445-2840 REGARDING ELECTRICAL PERMIT AiVD INSf'ECT20NS... FEE SUMMARY: 6ase Fee $50,100 Surcharge $.50 ? 7ota1 Fee $50.50 CONTRACTOR: - Applicant - s7. Lzc. OWNER: . PETERSON CONST, CARL 16886664 0004275 PE1"ERSON JEFF 1554 LAKEVIEW CURVE I 791 CAMBERWEII DR ER6AN MN 55122 EAGAN MN 55123 (8j.2) 688-6564 ,- (551)686-0950' N APP CANT/PERMITEE SIpNATURE ISS BY: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) ' CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 681-4675 Ca?? ? a-a? New Construdion Reauirements RemodeVReoair Reauirements ? 3 registered sde surveys ? 2 copiea aT plans (include beam S windaw s¢es; poured fnd. design; etc.) ? 1 energy calwWtions • 3 wpies of tree preseNation plan A IM plalted after 7/1/93 required: _ Yes _ No DATE: 1°2' le- I,r ? 2 copies of plan ? 2 site surveys (exteriar additions 8 decks) ? 1 energy calculations for heated addNOns CONSTRUCTION COST; DESCRIPTION OF WORK: F'» ?s4 ?9Se rveh f STREETADDRESS: 79/ CQ„„(, e, -we/I LOT: BLOCK: a SUBD./P.I.D. #: Name: r-,0--hGrS0., Phone#: (ooooo- ?9s0 PROPERTY Lan First OWNER Street Address: 7e / CrR rn Le,wL c;ty ?R99? State: Zip: -? Company: C? P< f"«so,j Co?S?n.cAy-) Phane#: loe e - (of& y CONTRACTOR . StreetAddress: /S-7y L9??v?co? (??? License# City Ca 9 q I State: A7'/ /? ARCHITECT/ ENGINEER Campany: Phone #: Regisaation #: Street Address: City Sewer & water licensed piumber (new construc6on onty): and lot change is requested once permit is issued. C/a 7 s zip: ST/ Z ?, Zip: Penalry applies when address chan I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicat State of Minnesota Statutes and City of Eagan Ordinances. ?, _/ Signature of ApplicanL ! OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservatron Plan Received _ Yes ^ No Ce ? ? _ Not Required State: ORRICB UGH ONLY BUILDING PERMIT'rYPH 0 01 Foundation G OQ Dupllx O 02 SF Dwallln9 O 07 4-plwt C] 03 SF Additian O 08 8-plex O 04 3F Porch O 09 12-plex O OS SF Misc, G 10 ?-plox VYORK TYPE 0 91 New ? 39 Alhra#lons a 92 Addttion 34 Repafr OBNBRA,L INFORMATfON Conel. (Actuaq (Allowablo) uec accupancy ZoninQ # oi 8torlK lenpth Depth APPROVAL8 G 11 Apt,l6odging ? 16 Bs"nSnt Fkftf4 G 12 Muill Ropeir/Rom. 17 SvtAm Pod G 18 aaropo/Acceesory 0 20 Public Fsdity G 14 Firoplace C3 21 MiscolforAmus; O 18 Dook G 80 Move G 87 Demolltlon 5_ S Basemont tq, R, MCNVB Systsm _ Main Iewl sq. R, C(ty Wetsr iq, R, Firs SpdnkfarW aq, f1. PRV - lq, n, Booeer Pump - eq, R. Gruui Code, ? -" RoolpAnt sq. R. SAC Cads Gniul Bldg Gnsus Unit Planninp Buildinp Enplnudnp Varlsncs , Permit Fao Surcharoe Plan Rwtow Llcenes MCNV8 8AC City SAC WaNr Conn, Wabr MNer Acct. Oepotit SIVN PermR 8M18uroharp TreatmeM PI. Park Qad. Tnila Dsd, Othar Copi" Toal: ValusMon; S ?2-;? o-e 96 SAC SAC Unita 1991 BUILDING T LICATZON CITY OF EAGAN SINGLE FAMILY DWELLINGS M[TLTIPLE DWELLINGS • C02RIER$I°AL , 2 SETS OF PLANS 2 SETS OF PIANS 2.SET5'OF-ARCHITECTURAL ' 3 REGISTERED SITE Si]RVEYS REGISTERED SITE SURVEYS - & STRUCTURAL,P-LANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1'SET OF.SPECLETCATI'ONS 1 SET OF ENERGY CALCUTAT30N5 ' 1 SET;,`OF;'ENERGY CALCS . # OF RENTAL UNITS _# OF FOR SALE UNITS „ PENALTY APPLIES WNEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CNANGE IS REQUESTED ONCE PERMIT IS ISSUED.' NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DE5IGNATE WHICH;ADDRES'S''?,IS DESIRED. NO CHANGES WILL SE ALLOWED ONCE BUILDING PERMIT I'S:I'SSUED. t PROCESSING TIME FOR SEWER & WATER PERMIT& IS TWO DAYS ONCE'A PERMIT HAS?'BSEN CQMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: Valuation: ?? Date: Site Address -191om- T?R, Lot 101 Block 2 Parcel/Sub H/L?5, ?F :::s Owner QrrLVlyn- Lo- Address G?'7D/ F, QjL, _T City/Zip Code FWDLEY? GG4Z! Phone Contractor 44?_ Addres City/2 Phone Arch./ Addres City/2 Phone ,. OFFICE US$ ONLY ' l ?l'-1, Dae7 " F ES ? Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. R-3 M-1 .Bldg.., Po R-1 $urcliarge` ,° V-N Plan ?R6view?;?$7,, ,oo,' _ V-N SAC, City.,;..A7,0.0,a0 SAC, MWGC", ;??Ej.?.S'.D?;O?`? ' ? Water Conn:;-5; (e,(a0„DOv ??. k?; 3'H^? Water' Meter?':p?a:;S pr7'',. . I Acct. Depns'si't1. Or:d'e? S/w,Permit ,. 5/W Sur,cHarge. On site sewage_ Treatment. Pl:.;a;p ,Rb On site well Road Unit; : r$'rI ? ,6i%. - MWCC System ? ParkDed.; ???.: City water ? T'rail Ded:'.:- PRV CoPies Booster Pump _ ` SIIBTOTAL APPROVALS Fenalty. , Planner Lot Change ; . Council TOTAL A Bldg. Off. 10-15',(? Variance agrees that all work shall b'e done'invaccor.8ance:with Signatu e of Contractor) y. all applicable State of Minnesota Statutes and City of Eagan Ordinances. P 114 ,:, ? U,4 A-rr GARAGE xIJ4 = 59??, , S? r7 ? (35,, 541 X 15= $1?5 USMT, ._:, It3XZg-Spy 2YI2X '79 ?.•0 0 + ?$ '/ 2 - ooi- sis•0o+ SX7 -3 t;'- 2) 21 i•tio? s, 5 9 3 •so I23?xIq= ?9 3c)y 7a4•or]?- ?S'(' 72 •00t ? Slo•Up+ ?,SmT? 123? ? 2,211 •so?- GX?- = Iz 35JS•so-; 1'/zx7= /v ? zs? 53 ? G61, 67q ZN0 F:L oovL S52 9 b y? 5 3= y?/ y?,???' •. .,? u yt o-oa J i. y 3, I gs .. * ?C * I ?wnn?? .aaHOxercnx4wliE]Cfs Gertifitate o# SurwY Tor: -IOi1b r ?F qa9 A4 QdzA ? f ?l ? 6 . ? h W l l ' ' 1i ? 843.• . ? \ p'io .a, ? `rr $q7. Lq ,[? ?Q J T! o ajR n r 913,IY arF •°1 903. - - - ? ? 0 1 1 . j ? 1 ? 7 ? ? / f .-^ r ae1,84 x 9ao.?a DElA*S EX15tlt?f flPV17t10r1b ?o ,:?? ?PS ?t0?0,5CC???tVQl?i'vl1S .. __ __ Drnofts ?rai e Ufi/iJ Fase?en{ - Orr?otes Drci?t ?aw ?iraws o Daiofis Mn?ru?f ftrials sfrorm ore au.rrrad F 1?D fkY.+SS ELfY.4T! N$ 1owest rlaar Ehvafioir 897. A^i r'?a oi Nock flevofrnn Gwle 5lm5 Etrvof;on v DeAnles 4{sef llub LaT19 , BLC7Cl<'2 , F/ILLS OF STCIIV[F?3RIDGE 3WD ADD. _ 04koT9 c•air7r, Mrrv,vfsorA 1 hYlvpy Wf[Hy Nai ihis rVl"y, 04p Ur IGparS "e?s pt?a`O?rvd by me f u R QiMlCt SVpeNKipn rnd Mat I am ?7y pqgi9tCfnd LDM SuTVByOr 4ndlr i1r Im.s af Nn StaTe ef MI.,.?Ex?q. Oated thifld? da`r of A.a. 18? }f r?n0' ??4 AQqrf. ?7 106 RT S. SIKICl+ L.. . FR. N.- 1ae91 ?? -1 7f? 7 CO. ? w r+ o? : ? 2422 Enterprise Driv! Mendota Naighn, MN 55120 (672) 681-1914 a N h < . ? , . .?' . EXTERIOR ENVELOPE A'VERAGIE "U" COMPUTATION OWNER Fl-i"4? '' - ?• SITE ADDRESS LU7"" 19 . SLOo{Z , IJIC.C.e_, 6/2- ?NE?21Di.F -ECD A-0Y0 • ?r---? CONTRACTOR RaTTI- UNL> - G? • DATE PHONE Determine working square footaqe of each. 1. Total exoosed vall area . . ez 3, 3(0.4 sq. ft. x Q0 # = 2. Total roof/ceilinR area . . ? 2 2"? sq. ft. x•D oz(0 = 3. Total floor/cant. area . . 6F& sq. ft. x? _ Total exoosed *aall area above floor = Z 7i3 v a. Total wall xindow area . . . . . . . . . Iz 4? 11.6 C/ b. Total door area . . . . . . . . . . . - c. Total sliding glass door area .... . 3 3 d. Total fireplace wall area . . . . -- e. Total wall framing area (averape 10;6). . . 21 f. Total net vall area above floor ... 6,9. 'Z- g. Total rim joist area . . . . . . . . . 20 Total exoosed foundation area = t? ?•? h. Total foundation window area ..... i. Total net foundation area above grade. . ( .24 Determine "U" value of each wall segment a. 24-1 .'SU X loU^ 0.4ro - !ll,aZ b. +2.'1f x "U" t7•?38 = , - c. 3 ? X „Utt U d. --- x "U" -- _ ?? e. lBf, ZI x "U" •?- •12 f. lre3a. ?Z x flvit 0,C7eL?j - ZG.I Z. g. 2a9, 2 x "u" 0.041 - ,?A.4?R h- 4.1 L x StUll O. ¢S. _ • 4! i. I1?F. 24 x "U" O, 14 = 154 q SUSTOTAL 4. V5 7 3t.as ? 1-7? TOTAL = 'Z- 4' 4 AO 2. b /4- If item M4 is the same as, or less than item N1,'you have met the intent of ssc 6006 (c) 2. J , ? . / J. Total skylight area k. Total flat roof/ceiling framing area ...... 9 7-.8 1. Total net insulated flat roof/ceiling area ... D. GS m. Total vault'roof/ceiling framing area ...... 2• 42 n. Total net insulated vault roof/ceiling area ... 2 Z 5, ¢r' Determine "U" value for each roof/ceiling segment . J. - X ?fUll k. 97. fT5 x "U" 0.027 - 2.fo 1. $SO. !is x "U" 0.D2Z - ? 3 m. Z5. o S x ltUtt n. 225.45 x "u" O,aZB = (?, 31 Total exposed roof/ceiling area '/ S-Z I.... 5 . . . . . .Tota1= z q • & I ar- If total of #5 is the same as, or less than N2, yoiY have met the intent of SBC 60o6(c)i. Total exoosed floor/cant. area (o (?' 0. Total floor/cant. framing area (averaqe .10%) .. (X, 4 v. Total net insulated floor/cant.' area ...... 5. Determine "U" value for each floor/cant. segment o. 6.4.0 X .'Un I?,OS? _ ?? ?Jg p. --37T,-4- x"Un 0. OZ Q 6 . . . . . . . . . . . . . . . . . . . . . . . .Tota1= Z '/ a O/L. If total of #6 is the same as, or less than #3, Yau have met the intent of SBC 6oo6(c)3. . ALTERNATE BUILDING FNVELOPE DESIGN To utilize the total enveloue system method, the values established by the sum of items d4, k5, and R6 shall not be greater than the sum of items #1, n2, end fi3. 1. 95'"1 2. 31, gs - 3. 0 z = 02 90,6"7 4 . aL1y,62 s. at6c7 6. z,/o = ?tP?t?- ? C C o_Izir: A -17L?lfz-MA. i .p,AWCR74- - ? ?F-??.-FTLN?• _- ? _-a? `"1--- ='Za ? -? - --- "r-'-' p --- - - OZo1--- R = 36.-g- 3 --- u -- .1 = 0, 027 -% 5.83 - = -0_??1.. ---- - _=-??-4.?4- : D.022 i GAI,GUt-ATIaN?i (GoNT). -tfzkM WPtU. G? INt.II-ATIoH T --FFkMOr Wftu. c. SPPI7 _ pt,?N- viF.W. , LOMF'OM*-N?i (u C3 ?,4 l? L oa.fPDE AIf?- F11,AA -h° hIPNIi - - 5%z ?NSU?A??rt? :?- /2u G'?P, IaD [?5?r?? A?r? ?I?M, LoMPVNLNTg o_UTI!?IIoE Rtp- pl.M. 72 -11hIDINli. hNP'(f-l 1 N b , -zxu htun(r-PAM ?Nhiv? Miz R?-M . C c C , C?' C C -:.. R-vAWV- - -- D, I'1-- - - - 0.(o2 - !q o . 0.45 - ----?.Co'O - I?fb1y?,° 2 3. o I - ? F--VALUL - - --- o .1? • --- - o•t,2:_ -. 2.OLi _ - ? ? , ?-.-- -- - -- F7ot?v.= _I I. I l?-- l? ?L -l?1?t P?. ??U -?0, IZ X o.ob9 (o,Sb X o•04? ) - ?t?= =??o???' ? ? 0 ? ? ? n2Mf n4tMi7r,?,-_- 1?-k??-F??M ?"_FI?? ?IM ??o?ti . 5-N" I N?a . ?T-?r?= 2q 39? ?l??C??dN • - .. 4ZMFb4N?Pi ? - -?•- s?'U-,?? ? O 0 C -? ?'1------ --.rJ---.-o- -- -- - - --- ???---- -?_=?-a ? ? , i 3 (t z,?3 i_ _-?-=?- = o • ? 4 ' ?0.08? CITY OF EAGAN FOR CITY USE ONLY 3830 PIIAT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT #? "":..::....?`??TT $??<: .. ,. .. . .... DATE: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLZNGS 6 TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT. --° ----- ---°-------------- WORK DESCRIPTION ----- ---------°---------------- ---- ----------------- COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL NEW CONST ? ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 i REPAIR WATER CIASET 3.00 9_ 0 BATH TUB 3.00 4 LAVATORY 3.00 5 OWNER NAME: KITCHEN SINK 3.00 } ? LAUNDRY TRAY 3.00 ? SITE ADDRESS: 11 tor S HOT TUB/SPA 3.00 q ? WATER HEATER 3.00 $_ LOT:?L BIACK o? SUBD. FIAOR DRAIN 3.00 3 ` I GAS PIPING OUT. v INSTALLER: 'P1b, C. ??c • ? (MINIMUM - 1) 3.00 s -? 3 ROUGH OPENINGS 1.50 u•?' ADDRESS: ? ?o C 9-c;K OTHER WATER SOFfENER 5.00 CITY: o a.1,3. ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE SUBTOTAL S ''4l. S ? C ? - ? Vr ST. SURCHARGE .50 SIGNATUR OF PERMITTEE TOTAL: 5 ?023MERCI?i?;fTT1IlFISTRIAL : PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDI NGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ____- -___-- ___--- ------------------ CONTRACT PRICE: ---------------°_____--_____°- ---- ____-_____ FEES OWNER 23AetE: SITE ADDRESS: LOT: BIACK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE FOR: CITY OF EAGAN 18 Or CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: (SIGNATURE) ??,5„???E. . ?'?:„ :s,.<... CITY OF EAGAN 3830 PIIAT &NOB ROAD EAGAN, MN 55122 PHyO?N/E?`p: ??(ryy6y1ty2) p454-8/1?00 FC!N?.t'A:FR?lli4t#?r???k.??k . . . .a-..:?.t FOR CITY USE ONLY PERMIT # RECEIPT #'199J Z?Z DATE: / S PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST _ ADD ON _ REPAIR _ OWNER NAME: SITE ADDRESS: n ? LOT:9 BLUCK og SUBD/4, INSTALLER: NC. 9303 Plymouth Ave. Na ADDRESS: WQeii Vall....r uNG5A27 CITY ZIP: PHONE #; i'5470 -IIC0 tiz FEES ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24,00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $0/ OC/ STATE SURCHARGE: .50 TOT_AL: $ 'QJ' J ? SIGNATURE 0r PERMI TEE ??MM?YtCItiY:??IDTlSTit?AT.,; YLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRZAL BUILDINGS, Y"TAPARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING IINIT. - - - - - - - - - - - -- CONTRACT PRICE: OWNER NAME: SiTE fiDDFEuCi• IAT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: PHONE #; FOR: ZIP: FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR rerg $1,000 OF PERMST FBE. PROCESSED PIPING - $25.00 $25.00 MINIM[JM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: $ $ (SIGNATURE) CITY OF EAGAN Ix CITY USE ONLY ,/ L ? BL 1 RECEIPT #: ? `7? ? d SUBD. RECEIPT DATE: l ? OCI" 1998 PLUMBING PLRMIT (RESIDENTIAL) CITY OF EAC+AN 3830 PILOT IINOB RD EAC,AN, LMi 55122 (612) 661-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit Y backflow preveMer for underground sprinkler system FIXTURES EACH TOTAL Shower 3.00 x ? = Water Closet 3.00 x Bath Tub 3.00 x = Lavatory 3.00 x Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ' minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener "for dwellings under constmdion 5.00 X = Water Softener ' for existing dwelling 20.00 x = U.G.Sprinkler 'fordwellingunderconst. 3.00 = U.G.Sprinkler * for existing dwelling 20.00 = Alterati0ns ' ia existing residence 20.00 = DQ Water Turn Around 20.00 = Private Disposal System ' MPC iic 75.00 = (new and refurbished systems) Private Disposal Systems "Abandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE .50 TOTAL a b ,Z?b - - - - - - ---- - - -- - - - I here6y adcnowledge that I havs read this application, atate that the information is correct, and sgree to comply with all applicable City of Eagan ordinances It is the applicanPS responsibility to notify the property owner that the City of Eagan pssumes no liability for any damages caused by the City during its normal operational and maintenance adivfies to the facilities wnstructed under this pertnit within CRy propertylright-of-way/easement. , SITE ADDRESS: 791 L/,q OWNERNAME: J_@f -? ? INSTALLERNAME: P- Q6t ?Gi"PrSo., TELEPHONE#: ?8-?2 ,P 837 STREETADDRESS: HC- -? y R°X -270 CITY: /-/RCI4 enSRC.k STATE: M/1,/ ZIP: _? 6 lvSv2 SIGNATURE OF PERMITfEE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998 PERMIT Permit Type: Mechanical City of Eagan Permit Number: EA105095 Date Issued: 06/26/2012 Permit Category: ePermit Site Address: 791 Camberwell Dr Lot: 19 Block: 2 Addition: Hills of Stonebridge 3rd PID: 10-32992-02-190 Use: Description: Sub Type: e - Air Conditioner Work Type: New Description: Air Conditioner Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) Comments: 445-2840 Renae Freinwald 2200 Hwy 13 W ME - Permit Fee (Replacements) $55.00 0801.4088 Fee Summary: Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: Owner: - Applicant - Genz Ryan Plumbing & Heating Jeffrey L Peterson 2200 West Highway 13 791 Camberwell Dr Burnsville MN 55337 Eagan MN 55123 (952) 767-1000 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 Permit Type:Building Permit Number:EA109878 Date Issued:04/11/2013 Permit Category:ePermit Site Address: 791 Camberwell Dr Lot:19 Block: 2 Addition: Hills Of Stonebridge 3rd PID:10-32992-02-190 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Jeffrey L Peterson 791 Camberwell Dr Eagan MN 55123 (651) 767-2578 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA127459 Date Issued:10/02/2014 Permit Category:ePermit Site Address: 791 Camberwell Dr Lot:19 Block: 2 Addition: Hills Of Stonebridge 3rd PID:10-32992-02-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Wade Sedgwick 7588 Washington Ave S 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 - Jeffrey L Peterson 791 Camberwell Dr Eagan MN 55123 Pronto Heating & Air Conditioning 7588 Washington Avenue South Eden Prairie MN 55344 (952) 835-7777 Applicant/Permitee: Signature Issued By: Signature 3.'1I _,0/I For Office Use ; /5709 -- +► � � � Permit#: E AGA N Permit Fee: /47 ECEIVE Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 ® (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 ZiCr 0 9 2019 Staff: buildinginspectionscityofeagan.com 2019 RESIDENTIAL BUILDIN I#F APPLICATION Date: 9/5/2019 Site Address: 791 Camberwell Dr Unit#: Name: Robertson Bayer Phone: 952-465-4997 Resident/ 791 CamberwellDr Eagan, MN 55123 owner Address/City/Zip: g Applicant is: ✓ Owner Contractor I'D k-L �� n'fA;' [oma y � Type of Work Description of work: Replace deck surface, guardrails, stair stringers Construction Cost: $8374 Mul Family B ildi : (Y s /No ) 11 fotc Company: none / //171.‘" Contact: /C Contractor Address: City: State: Zip: Phone: Email: License#: 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: Sewer&Water Contractor: Phone: • Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to bePublic inforrraat`it►n. Portions of the information may be classified as non-public If you provide specific reasons that would permit the Citi 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.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.nooherstateonecall.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 accordance with the approved plan in the case of work which requires a review and approval of plans. x Robertson Bayer x Applicant's Printed Name Applicant's Signature ---/c / C #bo1/ OW . 7 -7 --• DO NOT WRITE BELOW THIS LINE ' SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi j.i ..Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building 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 --Y aluationOccupancy ,,,- / MCES System 7-- --61--0 Plan Review Code Edition ,iW ,3 11, SAC Units (25% 100%' ) Zoning I'LL City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction \(-6 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) Final/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 EFTS 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: l, , Building Inspector RESIDENTIAL FEES Base Fee �itt,-- ,,tric / 1 '! 9Ci' Surcharge / GaJ Plan Review 0-'44 rMCES SAC 06 {t,61/40,/W, S City SAC r 0 �` c Utility Connection Charge E S&W Permit&Surchargeifrt r Treatment Plant Radio Meter Read /5-C i)--(9 d Copies3 7 4 r, Y TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA168966 Date Issued:05/11/2021 Permit Category:ePermit Site Address: 791 Camberwell Dr 1 Lot:19 Block: 2 Addition: Hills Of Stonebridge 3rd PID:10-32992-02-190 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any 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 - Robertson Bayer 791 Camberwell Dr Eagan MN 55123 (952) 465-4997 Kaufman Sheet Metal Roofing 2521 24th Ave S Minneapolis MN 55406 (612) 722-0965 Applicant/Permitee: Signature Issued By: Signature