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4013 Camberwell Dr N Use BLUE or BLACK Ink I Permit ~ ~ City of Enn y 28o l Permit Fee: I 3830 Pilot Knob Road l Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: j 2010 MECHANICAL PERMIT APPLICATION Date: 2 ~ V~) Site Address: 4QQ> _ rn l~ i'~►1 Vt'-N Tenant: Suite RESIDENT/ OWNER Name: IGt C ~14 Q Phone: (D61 °'q ~~(y Address / City / Zip: 0Q) N 1('1 k- C92- j-i-C CONTRACTOR Name: '1~'S ~Aow~01YZL 11~Y~G"_I`cLA6 : t " Address: 5U5 City: S 1 State:. Mk~ Zip: 56101- Phone: Contact: Email: •CMA _ TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground,mounted mechanical equipment is required to`be screened by City Code. Please.contact the Mechanical Inspector for information on permitted.screening methods,. RESIDENTIAL COMMERCIAL PERMIT TYPE _ Furnace _ New Construction _ Interior Improvement V Air Conditioner _ Install Piping _ Processed _ Air Exchanger Gas _ Exterior HVAC Unit Heat Pump _ Under / Above ground Tank Install I _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ 5D.9c TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Permit fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge $1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge). TOTAL FEE 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.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. xCcP x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By Date: Required Inspections: Under.-Ground Rough In.._Air Test " ='Gas Service.Test' In-floor Heat Final Exterior HVAC Screening Inspection INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: .(612) 681-4675 SITE ADDRESS: i APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: INSPECTfON TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 1 BSMT R.I. BSMT FINAL DECK FTG DECK FINAL I ft 1. I ' i y (9rdifirate of (Orrupaury Citp of (Eagan Rrp nrW Vf Wankto ittoppd roM j i This Certifiarte issued pursuant to the requirements of Section 306 of the uniform &dlding Code certifying that at the time of issuance A& ziructune cows in compliance with the various ! ordinances of the City regulating bw7ding construction or use, For the following. ~ 1 J use SF DWG/GAR 20136 p=V,ef71)" R-3 M-1 yj PD R-1 Type- V-N Ownffor THE ROTTLUND CO Aad. 5201 E RIVER RD A&,,,,4013 CAMBERWELL DR N t uy 121, B2. HILLS OF STMEMIM 3RD j MAY 19, 1992 i POST IN A CONSPICUOUS PLACE I I y r CITY OF EAGAN`,yw ~I 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 681-4675 BUILDING PERMIT " Receipt # t..i To be used for SI• pk'G/GAR Est. Value $161,000 Date FEB 20 1992- Site Address 4013 CAMBERWLL OR N Lot 21 Block 2_ Sec/Sub. FULLS OF OFFICE USE ONLY STON BRIDG$ RIB R-3 114 FEES Parcel No. occupancy 653.00 Zoning PD R 11 Bldg. Permit Name 'F11E RMLMM CO I1iC (Actual) Con4 V _N Surcharge 80.50 LLJ Address 5201 E RIVER RD (Allowable) V =N Plan Review 554.00 o City FRIDLE7 MN Zp 55421 # of Length Stories 74• License 5•~ Phone 371--0304 Depth 3' SAC. City o.-00 $/!r S.F. Total SAC, MCWCC Name S.F. Footprints F_ Address On Site Sewage Water Conn 623,00 City/ Zip On Site Well Water Motor 95.00 F MWCC System 30.00 Phone X Acct. Deposit 8 0001335 CRY Water VCeI'ISe # PRV Required S/W Permit 30,00 ~ I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge • 50 information is correct and agree to comply with all applicable State of ' Minnesota Statutes and City of Eagan, Ordinances. Treatment PI Signature of Permilee APPROVALS Road Unit 380.00 _ A Building Permit is issued to: THE RO"t CILUND CO INC Planner Park Ded. on the express condition that all work shall be done in accordance with all Council J1 applicable State of Minnesota Statutes and City of -Eagan Ordinances. Bldg. Off. Copies Variance TOTAL 3.803.00 Building Official Permit No. ---Permit Holder Date Telephone # PLUMBING oZ WAC ELECTRI EL EC7RI Inspection Date Insp. Comments Footings 1 9.2, ale Foundation 3 Z 6.5 h av r1 r L Framing Roofing Rough Plbg. .-~~j = Z' Rough Htg.3 (cr Isul. <Z = Fireplace Final Htg. S ,2 Orsat Test Final Plbg. Plbg. inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final T Deck Ftg. Deck Final Well, Pr. Disp. I I SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN METER # yS~ 7~!0 3 PERMIT DATE 02/25/92 3830 Pilot Knob Rd. CHIP PERMIT # 12570 Eagan, MN 55122-1897 METER SIZE eA, li B.P. RECEIPT # C 017492 DATE 7-1`7,q~p ISSUEDATEB.P. RECEIPT DATE 02/24/92 PRV -BOOSTER PUMP 4013 SITE ADDRESS AMR r PERMIT REQUESTED LOT 21 BLOCK 2 SEC/SUB Hi 11 s 1bnabri dge_3 "";>,1 t-Er..1,Jq+,Ll ~-SEWER ~LWATER -TAPS APPLICANT: The Rottluno Co. Inc. J ADDRESS: 5201 E. River Road F`~ -COMMIIND RESIDENTIAL - CITY, STATE Fridley, On. X 571--0304>., NEW - EXISTING PHONE: t/V(i VY-61t'" Lawn Sprinkler Meters are to be Installed PLUMBER: Valley Plumbing Ahead of Domestic Meters on Water Line. ADDRESS: 610 Creek Lane - Credit WILL NOT be given for Deduct Meters. CITY, STATE Jordan. Mn. ZIP 55352 PHONE: 492-2121 ' I AGREE TO COMP WITH CITY OF OWNER: The Ro _ ? and . Tnc- EAGAN ORDINANCES ADDRESS: 5201 E,"River Road CITY, STATE Fridley( Mn. ZIP 554.21 P CANE: 41 571-0304 SI ATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER &:•WATER PERMIT OFFICE USE ONLY CITY OF-EACaAN METER # PERMIT DATE --22/25/02 3830 Pilot Knob Rd: 12574 CHIP PERMIT # Eagan, MN 551,2-1897 METER SIZE B.P. RECEIPT # C 017492 ISSUE DATE B.P_ RECEIPT DATE 02/24/92 DATE 2-1 %-C 2 PRV _ BOOSTER PUMP 4013 SITE ADDRESS AR" CaHipt%rwell Drive N. PERMIT REQUESTED LOT 21 BLOCK 2 SEC/SUB Hills' C I "`Lcnebridre 3 ir. r 3 ff i i,; X SEWER X WATER TAPS APPLICANT: The Rottlund Co. Inc' . X RESIDENTIAL ADDRESS: 5'201 E. River Road ? COMM/IND v ;4n. 554~ ''CITY, STATE Fridley, ZIP r X NEW - EXISTING PHONE: 571571030V Lawn Sprinkler Meters are to be Installed i. PLUMBER: Valley )'ltutlbincf Ahead of Domestic Meters on Water Line. ADDRESS: 610 Creek Lane - Credit WILL NOT be given for Deduct Meters. CITY, STATE Jordan, Mn- ZIP 55352 42-2121 % PHONE: I AGREE TO compibi WITH CITY OF r OWNER: The Rottlund cc. Inc. EAGAN ORDINANCES h ADDRESS: 5201 E, River Road ZIP 55421 CITY, STATE Fridley, Mn. PHONE: A 571-0304. SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. DATE: FEB 25, 1992 RE: 4013 CAMBERWELL DR N (THE ROTTLUND CO INC) 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: - Your Sewer & Water Permit for the above property has been completed, but the meter cannot be 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 LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. CITY OF EAGAN ~~2~ 1 36 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 681-4675 Receipt # G, O To be used for S4 DWG/GAR Est. Value $161,000 Date FEB 20 19 2_ Site Address 4013 CAMBERWELL DR N Lot _2.1- Block 2 Sec/Sub. HILLS OF OFFICE USE ONLY FEES STONEBRIDGE 3R Parcel No. Occupancy R-3 M-1 853.00 Zoning PD RR=1 Bldg. Pennrt Name THE ROTTT. ND O NC (Actual) Const V -N Surcharge 80.50 Cr Address 5201 E RIVER RD (Allowable) V-N Plan Review 554.00 (I(y FRIDLEY MN Zip 55421 LengStones 74 5.00 U08 119(i Phone 571-0304 Depth 3$ SAC, city 100.00 n 0 Nafne SAME S.F. Total SAC, MCWCC 700-0 S.F. Footprints n Address on site Sewage Water Conn 679-0 City Ztp On Site Well - Water Meter 95.00 MWCC System_ 30.00 Phone Acct. Deposit City Water Ucense g 0001335 PRV Required S/W Permit 30.00 1 hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge .5o information is correct and agree to comply with all applicable State of n Minnesota Statutes and City of Eag inances. Treatment PI 300.0 Signature of Pemaitee ^ APPROVALS Road Unit 380. on A Building Permit is issued to: THE RO TLUND CO INC Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off, Copies Budding Official 4,01N Variance TOTAL 3,803.00 A8!dress:4013 CAMBERWELL DR N Lot21 Blk 2 Sec/Sub HILLS OF STONEBRIDGE 3RD These items were/were not complete at the time of the final inspection. at : MAY 19, 1992 Yes No Final grade (6" from siding) Permanent steps - garage `e/ Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. x~cm~onwn White - City copy Yellow - Resident copy Pink - Contractor copy ys ~ 3 880 80 ZZ& - Request Date Fire No Rough-in Inspection p RegJred? O Ready Now ul Notify Inspector 3-17,41 7i ~Ves G No When Ready? 12llcensed contractor 0 owner hereby request inspection of above electrical work at: Jo0 "P Tress IS[rest. or Route No) j N City /f o, Section No Township Name or No Range No Co my Occap t(PRINT) Phone No. Powe Supgkp~r Atldress Electrical l(~nlr~dor IGempeny Nam Contractor§ License No 2 Z Mailing !%s (Contractor or Owner Mining Installation) Authorized Signature contractor Ter Maki In tallaeonl Phone NUmOer MINNESOTA STATE BOARD OF ELECTR ITv THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg - Room S-173 BE ACCEPTED By THE STATE BOARD 1621 University Ave, St. Paul, MN $5106 UNLESS PROPER INSPECTION FEE IS Phone(612)6<2-0800 ENCLOSED y~3 REQUEST FOR ELECTRICAL INSPECTION gl'Tn n-, Ee-oooo,-be 5a2 nsl=tians for completing this form on back of yellow copy 1 10,53F ~ J 5 8 8 0 ► "X" Below Work Covered by This Request New Add Rep. Type of Building AppllancesWired EquipmentWlred Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractors Remarks Compute Inspection Fee Below.' # Other Fee # Service Entrance Sae Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps g to 100 Amps 44 Transformers Above 200 _ Amps Abov 0 _ Amps Signs inspectors use Only TOTAL Irrigation Booms Special Inspection G Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 *QVTHS. I, the Electrical Inspector, hereby Rough-.n bare certify that the above inspection has Final 4 .1 a been made. OFFICE USE ONLY - Thls request void is months from 35877j,-21 L Requesl Date Fire NO o -tn Inspechon 3 equ ❑ Ready Now 9011 Nobly Inspector ' 4-q -q A" as No When Ready? 1 Itcensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street. Bo r Route No) City C&40" Sect n No Township Name or No Range No CouA 3 ~Jxat-L Occup t IPRINTI Phone No. Power6u r Address K~%r Electric Co~Vanor ICOmpany Name) Contractors License No. Meiling Address (Contractor or Owner Making Installatwn) Authorized Sgnature ICOnlractor ner k g InstallauoN i Phone Number :Pe MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grgge-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(612)642-0600 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-00aot.08 J 35877 0, See in Xstructions for completing this form on back of yellow copy 6 ~Q G 7 " Below Work Covered by This Request u~ ✓ J / New d Rep, Type of Building AppllancesWired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm /Industrial Furnace Farm Air Conditioner Omer (specify) contractorg Remarks Compute Inspection Fee Below: # Other Fee # service EntranceSize Fee # Circuits/Feeders Fee $wimmmg Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 100 -Amps Signs Inspector~ Use Only. 6 TOTAL 50 Irrigation Booms r r s Special Inspection J Alarm/Communication THIS INSTALLATION MAY BE OR 1 DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 78 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Iowa been made. 114.1 OFFICE USE ONLY r `4 This request mid to months from S ?S RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 ? j 651.681-4675 New construction Requirements Remodellikeoair Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Edgy Calculations for heated additions • 2 copies of plan showing beam & windmv sizes; poured found design, etc.) • 1 site survey for extenor additions & decks • l set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or kiss units) DATE l7 0~~~ VALUATION SITE ADDRESS 13 e"y 0h8r&'t11 Iy N MULTI-FAMILY BLDG _Y _N TYPE OF WORK_ )'ooi 9- 61'd, FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT 3'4i3e2 ,EW, STREET ADDRESS So?16 /S~ IA-" CITY STATE)M/ ZIP 55~ TELEPHONE#Ao3CELL PHONE# ~3'a7~Go`~L30 FAX# PROPERTY OWNER US TELEPHONE# COMPLETE FOR eeNEWee RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MI 7 II5~6 p (d submission type) • Residential Ventilation Category 1 Worksheet Submitted • N y de orksheet ,_llld` Itted • Energy Envelope Calculations Submitted /U G 1 4 2002 i Plumbing Contractor: Phone # B Plumbing system includes: _ Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: Air Conditioning Fee: $70.00 Heal Recovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or ance"s. Signature of Applicant - ....Y....... OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 x PERMIT C jg1V CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: 411II9ff Permit Number: BUILDING Eagan, Minnesota 55122-1897 0 2 5 3 5 3 (612) 681-4675 Date Issued: 04/10/95 SITE ADDRESS: 4013 CAMBERWELL DR N LOT: 21 BLOCK: 2 HILLS OF STONEBRIDGE 3RD P.I.N.: 10-32992-210-02 DESCRIPTION: R'u' llding -Permit Type DECK Building Wo'r1K,TyPe NEW i ti} C°., i~~''(r t._•5'gi tJ^~~~.L-ry 7~'~f(~"~~~~;, FP~T fI~I~ ~.S ..:1e) i `-.-B i,..: f. •"tTC=' t's~ =`Yt ti~'=~ (S ' "°w, i i? 41 REMARKS: FEE SUMMARY' Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: _ Applicant - PETERSON PHIL 4013 CAMBERWELL DR N EAGAN MN 55123 (612)631-7056 I hereby acknowledge that I have 'read this application'and state that the - information is correct and agree to comply wi'th'"all applicable State of Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ISSUED' INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 025353 Eagan, Minnesota 55122-1897 Date Issued: 04/10/95 (612) 681-4675 SITE ADDRESS: APPLICANT: LOT: 21 BLOCK: 2 4013 CAMBERWELL OR N PETERSON PHIL HILLS OF STONEBRIDGE 3RD (612) 631-7056 PERMIT SUBTYPE: TYPE OF WORK: DECK NEW INSPECTION DATE INSPTR. • TYPE DATE INSPTR. FOOTINGS FINAL e CITY OF EAGAN~ j D , J O 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) (G(x~Y-~~ 681-4675 New Construction Reouireme is Remodel/Repair Reouirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of piano (Include beam 8 window sizes; poured fnd, design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calcule6ons for heated additions ♦ 3 copies of tree preservation pland lot platted alter 7/1193 required: _ Yes _ No $ DATE: 4 Jr CONSTRUCTION COST: 3, 5° u DESCRIPTION OF WORK: I?u :mil) .j A A -c STREET ADDRESS: CA yh & L 1~ t-•`-"L`s.- CA 6A IM rJ LOT _J-L- BLOCK SUBO./P.I.D. ~•xd - 63l- -7r>7[: Aa-j PROPERTY Name: t' ~ r~ R ~o j'I jt Phone M 08IL 2z 1 2 OWNER Street Address- 4 d t 3 -1 v1- 2-2 City: A✓ State: YZA Zip: Sy I LS CONTRACTOR Company: Phone Street Address: License # City: State: zip, ARCHITECT/ Company: Phone # ENGINEER Name: Registration M Street Address- City: State: Zip: Sewer 4 water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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. Signature of Applicant: OFFICE USE ONLY R IEC E NE D Certificates of Survey Received _ Yes _ No APR 0 3 1995 Tree Preservation Plan Received Yes No + 2422 Enterprise Drive I LAND 3u"VLYDay• CD'lLEncj.cnRS Mendota Helghcs, MN 55126 en9ine~ring-.""° TeCa 11.(612) 681-1914 Certificate of Survey for: The Rottlund Compan ,_.lnc_ Model Name: Madison I S pgro5't6 14.71 r ~i M I 0 I_-------------- I 3 i ~ - b ra N LO 1 Co P co ( CO gO7o r? ~ 1 1 z I I a l 1 s~ S ~ a 1 tb o _ ~ l OS~7411' E' 5323 60.00 723 .0 " ' I 9 FW&W F"JSE 1 u 1 FULL BASEWFt4T wnsrosT 1 f~ i Cl.RnCE 3~Sa w 23.00 }I . y 7. D 15.991 ~1 I 2b.67 _ - - I to ~RlyE'N4Y ~ ~ I r p r. t 06 IZS35" ~'r¢ = 729.60 \ g CAMBERWELL DRIVE x -9mo Denotes Existing Elevation PR6POSEO kjQ7 SE ELEVATiQN 4DD." Denotes Proposed Elevation Lowest Roar Elevoticn:896.30 Denotes Drainage & Utility Easement Top of Block Elevation: 904.46 Derc Les Drainage Flow Direction Garage Slab Elevation 504.13 - Denotes Monument Denotes Offset Hub Bearings shown are assumed LOT 21 , BLOCK 2 HILLS OF STONEBRIDtr-;':E dukoba COUNTY. MINNESOTA 3RD A D D I T10 1 moetry eart"y that %N% aurvay. P4- a .Wort v.as V.a ad by ma o .Mar ...y 4i.acl .upa.v:a:on and that 1 atn dWy ResA"ered Land Gw ytw _J~.day of A.D. V under Me flaws of the StaG of Hsenesnn. D6196 shif 1 A p fey, ~ 6L;i~~-•~' S c a Ie. 1 3 Q fe RDSERT 9.94K H LS. R G. ND. 14891 90301.29 CITY OF EAGAN FOR CITY USE ONLY ~}t 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # O 610 O F .....e.DATE: / RSD2A1G PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OWNER NAME: OF 1 PER PERMIT ~I( )Y ]C 1 L21 ~y SUBTOTAL: $ SITE ADDRESS: I~ J STATE SURCHARGE: .50 LOT: t BLOCK SUBD. TOTAL: $V INSTALLER: -rFLARE#TG. & AoT INC. ADDRESS : 9303 Plymouth Ava No. SIGNATURE OT~PERMITtEE 55427 CITY: Valley, •ZIP: PHONE ~734METt4AL{ZNAf15TKi PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING a $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT 0 MBINGY; DATE: 3 ISS:AiAS' PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON ( SHOWER 3.00 REPAIR WATER CLOSET 3.00 BATH TUB 3.00 L - (~1LAVATORY 3.00 9 ' OWNER NAME: \\6`~t,.;~ek 1 KITCHEN SINK 3.00 3- LAUNDRY / i LAUNDRY TRAY 3.00 a SITE ADDRESS: L` O C__Am`~r J'-k I p 2 NJ HOT TUB/SPA 3.00 ^fQ/- I WATER HEATER 3.00 S- LOT: BLOCK SUBD. FLOOR DRAIN 3.00 _ GAS PIPING OUT. INSTALLER: `J c' lac (MINIMUM - 1) 3.00 3- 3 ROUGH OPENINGS 1.50 V.s ADDRESS: Co le-3 c- OTHER r WATER SOFTENER 5.00 CITY: J ure~A ZIP: 5 _s PRIVATE DISP. 15.00 q _ U.G. SPRINKLER 3.00 PHONE SUBTOTAL $ LAG. 5c) C 2 ST. SURCHARGE .50 SIGNATURE OF PERMITTEE oo TOTAL: S H I O'OMMER~Xl"DUSTAIAI- PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/ INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 43 fQ 681-4675 ~INGCE-&=MttE~ Y 2 sets of plans, 3 registered site surveys, 1 copy of energy FEB 1 g 1992 calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy talcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or lot change is re guested once permit is issued. Date 1-7 L Valuation of work 4ois Site Location: - x!: T Gc, Az> ~ zyeW A-lce° -91~ STREET STE Tenant Name: 'TAie X&IAnd eo /rte. LOT Zi BLOCK -2- SECT/SUBD. /6, L P.I.D. # 3 . Description of work: S/ /4 "1 The applicant is: q owner Contractor ❑ Other (Describe) Name The /tn. //r. Phone Property LAST FIRST Owner Address C &)e4 ~Q STREET STE M City Fr,,W _ State U11a Zip GS4?.f Company =g /?off/cad a. Phone S7/ Contractor Address 520/ F• yz ATv Y License # ,Oooooo 3r- City,~1 State 111711- Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Jjtvlle"" Processing time for sewer & water permits is two day!~ oncearea has b n approved. 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. A Signature of Applicant: 71>-XI fLu ~w iJ i OFFICE USE ONLY BUILDING PERMIT TYPE X 01 Residential 0 06 Commercial 0 11 Other Structure 0 02 R. Garages 0 07 Industrial 0 12 Demolish. 0 03 Two-family 0 08 Public Works 0 13 Fireplace 0 04 Townhouses 0 09 Utility 0 99 Undefined 0 05 Multi. Dwellings 0 10 School WORK TYPE $ 90 New 0 93 Remodel 0 96 Move 0 91 Addition 0 94 Repair 0 99 Undefined 0 92 Alterations 0 95 Tenant Finish TYPE OF STRUCTURE 101-01/20 1 Family Res. 0 214-30 Other Shelter/Board 0 324-30 Office/Bank n 437 Alt./Add. Non res. 102-03/22 1 Family attached 0 318-30 Amusement/Rec. 0 325-30 Utilities 0 438 Alt./Add. Res. Garage 0 103-02/21 2 Family (duplex) 0 319-30 Place of Worship 0 326-30 Schools/Ed. 0 645-50 Demo 1-Fam. 0 104-10/23 3 & 4 Family 0 320-40 Industrial 0 327-30 Retail/Rest./Whse. 0 646-50 Demo 2-Fam. 0 105-10/23 5 or more Family 0 321-30 Non-Res. Pk. Gar. 0 328-30 Other Nonres./Sheds 0 647-50 Demo 3 & 4 Fam. 0 213-30 Hotel/Motel 0 322-30 Service Station 0 329 Non bldg. Structure 0 648-50 Demo 5 or more 0 323-30 Hasp./Institution 0 434 Alt./Add. Residential 0 649-50 Demo Other GENERAL INFORMATION Length t1`-( MWCC System Occupancy (Z3 M -l Depth 3 r, City Water Zoning f3-i Sq. Ft. PRV Required Const. (Actual-) v-N On-site sewage Boaster Pump (Allowable) v-~I On-site well Sprinklers # of Stories APPROVALS. J mss. i Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace sac calcul"s (/4LViA-101 1 Q D D Description SAC X~, v~)~ Y'Prn,r3: 853.u° `j PCvµo,y~~-Qb...'{i '3 oo,,,a s Swvcha.•~k', 80.5.; ~sk-~ 3ssv, oo % . SAC-C,~''i + lco.au SAC Units 6'75. Do moyi.zr ~ 45.00 1 S/W Perm.`(, 3v, d~ ]F* * 2422 Enterprise Drive PIGIVEER LAWb sutrveYDR3- Clvrt. ENGI Na;R9 Mendota Heights. 61N 55120 *rAr19!*~@rfn~e LANbY ANntM LwNMtw7 ARC?11TCCYa .(612) 68t-1914 4Certificate of Survey for: The Rott{Und CompQny.,-..Inc'. Model Name: Madison. E S 0g'05'T6 114.71 0 M M J r C3 Q I I---_-_ _ -1 3 C) i I C3 mN 1 op ~OD I I DO p I i z I I m LL I k\`` I I 1 I s na'1~'e6• s sa&~ so-oo 7. J u p"WDS,n Horse ~ I V .00 FILL BA9EYFS7? u a y - ~ ' ~ } 1 Wn~1c0UT I n° ~ ) , o I ~ ^ I i ph1tACE s &3'mu u 23-~ ~ u 7. D 15.991 26-67 - J ` to 1 ~p1FMtiWAY =81.41 oza 08.23' 35' r, 2s.sD - - ~v 'd11T~~ DEPT CAMBERWELL DRIVE 2 .9mo Denotes Existing Elevation PR POSED HOUSE ELEVATION .t:CW0 Denotes Proposed Elevation Loiiest Floor Elevotion:896.36 Denotes Drainage & Utility Easement Top of Block Elevation: 904.46 - Derctes Drainage Flow Direction Garage Slob Elevation 504.13 Denotes Monument Derates Offset Hub Bearings shown are assumed LOT 21 , BLOCK 2 HILLS OF STONEB.RIDGE dakoho COUNTY. MINNESOTA 3RD-ADDITION 1 item" eanw? 1twt Vr•/ lurvay, pt- a sport vtas R. d b r ma d., my dbact µrpar4lalon and thu 1 am duly Reatuaad lard Sonic under the laws of the State of Mienb0t41. Dated this day of A.D. { / i Scole: 1=328 ROBERT 6.9lK IS.R O, 040- 144191 ® 90301.29 . L Zl, 82~ HItaS o~ ~au~&+e,a~cs sresFna'n,, - - 114 cun-r1o~ 1 _ - Ga2ny>< - - - - - -a.6 x 2y = _6'z-s X!3"= 936_ _ ~ - _ f 2 1.-I Lt G 8 - - - - - - 12.4 %-4- X 1 'I r7o V )-(o- - - - Sir --INK!/z = ~2~- - - x53= 6wg,5 - - FCTFTiiOTi 1:NVF.i,rn't: nvr:f;nrt: "u" C;)MOTATIOU fi.d,5 OWNER SITE ADDRESS LClT ZI, N1`6~jt 7` 00M 30 CONTRACTOR7TLC>NO Gf7 , DATF. PfiONE AD~a. Determin working square footai;c of each. 1. Total exposed wall area sq. ft. x 0 17 = T12;'.4 2. Total roof/ceiling area I Z~o7r sq. ft. x 6-,026 = 3Z e~ Total exposed vail area above floor = 2 U C/~• Z a. Total 'wall window area . O 7, ~~J b. Total door area C. Total sliding glass door area d. Total fireplace wall area e. Total wall framing area (average lop) 22 40 , f, Total net wall area above floor Zo~~ & g• Total rim foist area 2(a 3.2 Total exposed foundation area h. Total foundation vindow area 0 i. Total net foundation area above grade Determine "U" value of each wall segment. a. 3 a 7.5 x 'lu„ o. ¢Z _ /Z 9.1 b. df-Z x ..U„ 0.135 _ 8,33 C. x ..U.. _ d. e.. -u- 0,C) f. zo 27 . U x „u,. o, 0 43 = 8 -7 G g• ZCo3r 2-- x "u" O-D'FI - /Or 7 h. x 'lull X flu,. 3. 'ins. = 277. If item-#3 is the same as, or less th:.n item NI, you have met the intent of SBc 6oo6(c)2. Total exposed roof/ceiling area Total gross roof/ceilint, area = J. Total skylight area _ k. Total roof/ceiling framing area............... 1. Total net insulated roof/ceiling area Determine "U" value for each roof/eciling. sepment. J X full _ 1. Ili GG X „U,. O.02Z = Zyj,o 4 . Total If total of #4 is the same as, or less than M2, you have met the intent of sac 6oo6(e)l. To utilize the total envelope system method, the values established by the sum of items #3 and N4 shall not be greater.than the sum of items N1 and N2. 1. + 2. + 4. _ o .=UkLU~ GAI.GUI.A'rlo~ ~GaNT~. -~Iz'~M~ W~u. ~ INxILA~IoN LOMPONt;N~i . R-VALUE AIfz f9LA G = Z3.of -FF-A0 WAuL C. STUD LomFc7HrNTs ' . : F--VALL15 3 3 hN~A'(1-1 I N G. 2 .O Cr _ 4 of x~ hP.ID(FRAN1) 1. Co' 15-.--- INS05 PAP FILM.. - p N• View. u ~ r a o.089. ft%L s. ~ =G~1~1P>. ICU"~ ~0,lZ X o.0~9} t(o.Sb X o•043> = 0~7 - 0 ~'_h~ AIM aa~h " _ I • ss i- -J / 30 _#1 0. 0, ob: J/2.~3 1 1 - 2zccur{~- - I 2 0.027 u X5.83 I 2 L;m 0.022 I 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ~l~z l ! D Site Street Address (u s~~t K Q 1 1 Unit # Property Owner U6 Telephone # (A. Contractor p Telephone # 5~ Address O 15 (iD`1 City L State QV Zip The Applicant is: - Owner _ Contractor -Other Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener arpr~`m ~p heater at the same time. ff you are Installing only a water softener a Q V ED heater, do not complete this section; move to the next section and eck the appliance(s) you are installing. JUN 2 3 2006 -Septic System Abandonment -Water Turnaround (add $130.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 - new _ replacement V Lawn Irrigation ';_RPZ PVB new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permi work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is requir to be reviewed approved. i)QLnnu t -('o(S LJA~ Applicant's Printed N@ a App ant's Sign re -9 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 r1 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit NOV 8 92006 Date it / t yy` / Z Site Address L4C'1 Cory, ` tv' k it D%t t\) unit # Property Owner Qi ~ t yx -Vq I tv\,q L C Telephone # (t>S\ ) SUS C$I4 Contractor _ $c~(_.2 t~~= iV\t'~d\C~ ~i-~,nC~ roc t Q-Y aQri:tt" Street Address C~(l- i-CAt'\%2~C\py N,` City S 2c~_J, State1 Zip J510Z Telephone # ( ) Bond 114 1. s~ -1 OLI,L( Expires; ILIA I:t k' The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional Replacement _ New air exchanger air conditioner heat pump other State Surcharge $ .50 Total 1 I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature I ForCgffice Ilse i Permit 4~0 City of Eap o R t m o T I I JAN 55 Permit Fee: 3830 Pilot Knob Road 2~~8 I Eagan MN 55122 I Date Received: Phone: (651) 675-5675 j G Fax: (651) 675-5694 By I Staff: ------I 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: /06 Site Address: 'LO i-b CGM6K W.Q.It Or N Tenant: L Suite RESIDENT/OWNER Name: Phone: (051- QG5`17a(\I Address/City /Zip: L0 I') CCtu~IOQrW£lf tJ CONTRACTOR Name: S cxrW'.QS t~lJti~alf L~.1 t~J C~ Gv~k License ' Address: 505 RCaY`L lAa-\ City: CiTPOLJ\ State: vV\V-'A Zip: ostdy- Phone: \-2L"~~1( Contact Person: Cla1\l~e- G-PISk~G~ U TYPE OF WORK -New V Replacement _Repair _Rebuild _ Modify Space _ Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater _ Water Softener -Lawn Irrigation -Add Plumbing Fixtures tRPZ I _ PVB) Main _ Lower Level) _ Septic System _ Water Tumaround _ New Abandonment RESIDENTIAL FEES: 50.0 Immum 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) 'Water 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 $ JO 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 t ft-r U - t a.Q U..P \f 1 x I =a Q 1l Il QQC_ QVl~ Applicant's Printed Name App- Ircant s Signature FOR OFFICE USE Reviewed By:, Date: Required Inspections: -Under Ground -Rough-In =Air Test Gas Test -Final (C For Office Use ` Q� a an d y Permit#: f $/ 9 8 l,� Permit Fee: NOV ()9 /Jot � Date Received: 1 I !—I O/ f 3830 PILOT KNOB ROAD f EAGAN, MN 55122-1810 I (651)675-56751 TDD:{651)454-8535 I FAX:(651)675-5694 Staff: i buildinoinspections(c�citvofeagan.com 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: \\ Ci r1"DA Site Address: t'"\b\3 Ccv ctW-\ �}c4�y- 1,J. 4\.. SSV):Mf-i Unit#: 7 v 4 Name: Vii`v( 1 R -v k\Cees" Phone: ()\')-.-?--')--5 --1'). 1_... Resident/ '' Owner Address 1 City l Zip: \--\ \'' C Vb tt(,J(.\ f)c\vt Delo , t c�a� t-\\,A , S 5 t 13 1 ' Applicant is: Owner'��Contractor ! Description of work: CU�t'1 �\C. \LLt ot\ c C -c o oC' . \\cL X{t1�n ,t,,cr\v�u-.t.S `i Cc .R - Type of Work p 4Q Construction Cost t\V `1EO d Multi-Family Building:(Yes l No✓ ) Company: rvA\t_( ZotkV‘t, Coni\-c.\1ES QA. Contact: 'Gmnv,rk ct c.vn\.t, { i Address: '-..tk\\ L)Oc��4� Contractor S\ City: Qty \,-;•• -‘,/\(-/ ` State: 1,-\\ Zip: SS t., C Phone: b6t-.1ct%•a4‘6 Email: \2vuc. Q an6,v1/4 .iectCst.\\rtt0 , C6h License#:Ct (-62)S%6I k Lead Certificate#: t`, If the project is exempt from lead certification, please explain why: I i 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: I Sewer&Water Contractor: Phone: IFire Suppression Contractor: Phone: NOTE,Plans and supporting documents that you submit are considered to be,public Information. Portions of the information maybe 1 E.classifiedashen..ublic if ' u>• vide s.: tic reasons that would•:rmitthe Ci to conclude that the are tradee secrets. You may subscribe to receive an electronic ts. , notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeaclan.comisubscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL.BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecatl.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 ' not to start wi ut a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval o fans. x .PV\\N(n J1NC..1‘,\O` x V/044. ,k Applicant's Printed Name Appq ant's Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA177360 Date Issued:06/28/2022 Permit Category:ePermit Site Address: 4013 Camberwell Dr N Lot:21 Block: 2 Addition: Hills Of Stonebridge 3rd PID:10-32992-02-210 Use: Description: Sub Type:Ductwork Work Type:Alteration Description: Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Vicki L Palmateer 4013 Camberwell Dr N Eagan MN 55123 (952) 412-1118 Sabre Plumbing Heating & A/c Inc 15535 Medina Road Plymouth MN 55447 (763) 473-2267 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177593 Date Issued:07/11/2022 Permit Category:ePermit Site Address: 4013 Camberwell Dr N Lot:21 Block: 2 Addition: Hills Of Stonebridge 3rd PID:10-32992-02-210 Use: Description: Sub Type:Fixtures Work Type:Replace Description:Kitchen Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Vicki L Palmateer 4013 Camberwell Dr N Eagan MN 55123 Pattim Llc 400 Lyman Blvd Chanhassen MN 55317 (952) 220-4568 Applicant/Permitee: Signature Issued By: Signature