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4253 Amber Dr' CITY OF EAGAN ? 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: t+J,i ,, 1t . ? PERMIT SUBTYPE: I"rI i1T t i4I -o ':c F 1 N A ! ;CORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: t:d0 .1 :i1 TYPE OF WORK: .I .,, ll , i-ra i fcA?11 tl0 or w ( [iE"1RrHFfi) REMIANk '. ;', )(f F'I {iM 1 NOI t'ATk s fNA I I ? ARAAF IN To) Itt; ,1' T EtAf. K'1-FttlN I"Hf- SinE YfttlPt R f Y 1 IFif /MT f"i:AC'TLY 6' Q" Pt pN kE`ViF11fO 13Y MX?F RAkt-'V .• - ? t ? , ? Pertnit No. Permit Holder Oate TNephone M ELECTRIC PLUMBINd HVAC Inepectlon Data Inap. Comments FOOTINGS FWA'riNG S4vr/3 O1c. FOUND FRAMING ROOFING ROUGH PLUMBiNG PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAI HTG ORSAT TEST BLDG FINAL BSMT R.I. ? BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Cedar Grove Acquisition Addition Cedar Grove #2 Lot 6 Rik 7 Parcel 10 16701 060 07 Owner Street 4253 Amber 4euia46- D lr ` state- Eagan.MN ,-?r'S122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. .1989 1266-95 84-46 15 STREET RESTOR. , GRADING SAN SEW TRUNK # SEWER LATERAL , 1972 1 2 WATERMAIN # WATER LATERAL 1972 WATER AREA STQRM 5EW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, i ? BUILOING PER. SAC I PARK I This request void 18 months from (6- 7 ' &A'R39542 Date of this Request ?c _ctFs, \?'1'15 I, as C?Tcensed Electrical Contrao OO eni r, do hereby request inspection of the above electri- cal wmng mstalled at: Street Address or Route No. J`?a.53 City Section Township Range Count n o Which is occupied by Is a roughin inspection required Jthis jo6? 140116? Yes O Ready Now ? Will Call.Jil- Power Supplier _ Electrical Contractor Mailing Address _ Authorized Sienature Name) Contractor's License No. or or owner Makln9 Tnmnstallatlol? L ;?2 ,i/?f. Phone No. leclricel Contractor or Owner MeKin9 Thls IMtallation) 2V /'? ?j ? 6000 ?0?? This inspection requen will not 6a accepted 6y the i,a u State Board unless proper inspection fae is endosed. 40 Minnesota State Board of Electricity .1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 '?40REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST /,:;z l0 9 <:? R39542 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment W¢ed For Home El ? Rangc ? Tempocazy W'ving ? Duplex ? ? ? Water Heater ? Lighting Pixtures ? Apl. Bldg. ? El ? Dryer q Electric Heating ? Commexcial Bldg. ? ? ? Furnace i Silo Unloader ? Industrial Bldg. ? ? ? A'v Conditioner Bulk Milk Tank ? Faim Lis[ ) List l Olher ? ? ? } p Hehe sf p } Heie?s! COMPUTE INSPECTION FEE BELOW ?:k A Secvice Entrance Size: # Fee Feed u . ? Fee Circuits: # Fee 0 to 100 Am s. to 3 s 0[0 30 Am etes 101 to 200 Amps. to Am eres 31 to 100 Am eres Above 200_Amps. bov 00 Amps. Above 100 Amps. 'Iransformers 1 1 emoteControlCirc. Partialorothwfee $' ns Special Inspection Minimum f Remazks TO'IAL F E S ? (j? I, the Elec[rical Inspectot, hereby certify that the above inspection has been ma (Rough-in) Date (Final) ?ate This request void 18 months from . i' EAGAN TOWNSHIP No 405 BUILDING PERMIT ? Eagan Township _ , Ownez ? -- Addsess (Preseni c ?? ,?;?.,?;. -`l..r? .,F? /rCl,?•?-`-`-'J ) ..... '----?^---- ?-,J . . ........ Town Hall Builde: ....----°-------_..........--- ------- ..------- ---° Date . _---?__.._ Address -----------------....._.. , - DESCRIPTION lwoz7ga To Ba Used For Front Depih Heighf Esl. Cos4 IPermif FeeI Remazks ? ?G? rC/'1?lll?? C?`?OCI??`GI 7rr' l:? i? °!i . or LOCATION This permit does not aulhoriae the use of streels, roads, lleys or sidewalks nor does ii give the o?wner or his ageni !he righS !o ereaie any siluafion whieh is a nuisance or which presenls a h=zard io the healfh, safefy, convenience and general welfare !o anyoae ia the community. THIS PEAMIT MUST B K$PT THE f??MI?$E' "W?HrILE THE WORK IS IN FROG/R£SS. This is fo cerlify, Shat?1F..?Cf:.O?_haspermission io erecf ------ 4!?%?F?r_,__.upon the abo e described pre ' e subjec io !he provisions of the Buildang Ordina:?co ior Eagan Townsht?adonied iep:il 11, 1955.. Chairman,?. - ?'- -...??.. Per -"- - --- - -ild_ --in -Q .I.n - p o ow a3?'d ---- Bus ecior EAGAN TOWNSHIP BUILDING PERMIT oWnO: - -----`-,`---. _.... ...._.-"'- ----------- ...----- ...... ...............'-- Address (Pre en!) =?---------??--"'"=?`-=-''"?------=??.----------.. Suilder ---?t-..... ?.......e.°...'_......... '--------------------- __. .......f ................ Address -----.?.-...1L ??- -_ ? -'- ' z.......---'---...... DESCAIPTION N° 2169 Eagan Township Town Hali DB:e ................... Siories To Be Used For Fron! Depih Heighf Esi. Cos! Permit £ee Remarks LOCATION Slxeei, Aoad or oiher Descripllon of Locaiion Lot rilocK Atlaltion or "1"reet I 4 g 7 2 This pexmii does not aulhorize the use of slreefs, roads, alleys or sidewalks nor does if give the owner ox his aganf ffie righ! !o creafe any situation which is a nuisance or which presenls a hazerd fo the heallh, safety, eoaveaience and general welfare !o anyone in the communify. THIS PEAMIT MUST BEPT ON THE PREMISE WHILE THE WOAK IS IN PROGRESS. _ This is 1o eerlifp, 1hai.... ...r.+:?...._4%?....___.___.....__...has permission !o erecY a._.-.?_'.Z:°__.?pon !he above desasibed psemise subjec! !o the provisions of the Building Ordinance for Eagan Township adopfed April 11, 1955. ?l ?? p? ... .?.......(!.?`f.`.T..<. ................ """"""'----"-- r.!c-:c._ .................'----. Per . :c Cha?man of Tnwn Soard Building inspeofor 4 < 0 LbT (,,,. `gulz 46 Ce7op2 G2ovs ?2- ? oc: IZ ?I-nc:*j -1S,o' JOr-11.t ?1«?? 4ZS3 Annr3?Z?. CEp?.2 ?2dvE ?J Q N i(N.(4iA,?i:ii, 'hUX ?n:RUO?Ji:40X:t::YAO!t CT7v OF I'ulrAN C'???:!-ITP ??• c; iPp;M'(Nfa.. N!'c i 79 C'F, 7S.0'S!J`:;/90 'rIPM1f:::? I':??:`?'•i:-';3 t'OI?;G'!1R?;1_f)Id (l 11{1 :Li's-,; .? r':i 2'.'S5 SiDO:I :F,•:i:" fiNib't1=.P{ i7fi 2a'"-0 '?g.;?;] yflt:l:l q.(R?J; fl`f?;L'Pi Ltl?: :::i„OU ? lo1t::i!. h'OraipF, Amn.)lJY1'.:.. 2"51 LJSE"F .[I!? t?.AN(.4 I CITY OF EAGAN ' 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDING 032007 @5J14/98 SITE ADDRESS: P.I.N.: 10-16701-060-07 0.253 AMBER DR LOT: 6 BLOCK: 7 CEDAR GROVE #2 DESCRIPTION: (DETACHED) .= Buildint'}?;,Permit Type Building l,rv,rk Type ` Caneus Cod 'e .. ,' : n GARAGE/ACCE550RY NEW 438 ALT. GARAGE REMARKS: 5T7E PLAN INDICATES THAT GARAGE TS 70 BE SET 6ACK FROM THE SIDE PROPERTY LINE AT EXACTLY 5' 0" PLAN REVTEWED BY MIKE BARCK FEE SUMMARY: VALUATION $7,000 Base Fee $124.75 Surcharge $3.58 Lic. Search Fee $5.00 Total Fee $133.25 CONTRACTOR: - Applicant - sT. LIC.OWNER: 1SUSSEL CORP 16450331 0001934 MICHAEL JOHN f852 COMO AVE 4253 AMBER DR T PAUL MN 55108 EAGAN MN 55122 ?(612) 645-0331 (612)454-3525 , I fier6.by acknawled-9e that T h4v'e art:cl statey°tha'C th? p information is correct an'd ag'ree to aomplywith sll eppli-cable Stete`ofi Mn. .?, ,:and City;cafEagan Ord,ina-taicev. ? SCatu.t'es ' . _ . .._ m . ' _. APPLICANT/PERMITE SIGNATURE ISSUED B: SIG ATURE I ? 008 BUILDING PERMIT APPLICATION (RFSIDENTIAL) -? I? •?.--? CITY OF EAGAN Sloof 3830 PII.OT I{NOB RD - BS 122 r- 681-4b75 New Consiruction Reauiremants RemodeVReoair Reauirements ? 3 registered site surveys • 2 copies of plan ? 2 copies of plana (inGUde beam 8 window saes; poured fnd. dasign; eta) ? 2 site surveys (ex[erior addRions & decks) ? t enerpy calalatlons ? 7 energy calculedons for heated addRions ? 8 copies oi tiee presenation plan N lot platted eRer 711193 required: _ Yes _ No ?? 7 ff DATE: 2-), l CONSTRUCTION COST; 4. DESCRIPTION OF WORK: STREETADDRESS: 9,,5?3 LOT: t BLOCK: ? SUBD./P.I.D.#: (A&, 111tmEL4L Name: <6 ?h,eG ,- U Phone #: PROPERTY 1-ast First OWNER ,I J? Street Address: '7 .2- 5LZ ! Y Pq h-2.1 0,P1 City 4-t- Ci?cc VI State: Zip: -' Company: ? ? -?; S e Phone #: CONTRACTOR //J Street Address: P ?/l ? 7V (J License # ? % T Ciry ?? CC LIC? State: Zip: --5 ? ARCHITECT/ ENGINEER Company: Phone #: Name: Registrarion 1t: Street Ciry V State: Zip: Sewer 8 water licensed plumber (new construction onty): . Penalty applies when address chang and lot change is requested once pertnR is issued. I hereby acknowledge that I have read this application and state that the iniormation is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. 1-11 Signature of Applicant OFFICE USE ONLY Certficates of Survey Received _ Yes _ No Tree Preservation Pian Received - Yes - No - OFFICE USE ONLY BUILDING PERMIT TYPE .?y, « '?P ' ?. ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex Er-13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace r ? 21 Miscellaneous ? 05 SF Misc. ? 10 _-plex ? 15 Deck ? WORK TYPE firc P.1,/v 2?31 N ' 6719"4L 9?S 7b 1 ew ? 33 Aiterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition ?'K 9c r-z 5? S? 69 GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. 4K38 Depth Footprint sq. ft. SAC Code o ? Census Bldg _L Census Unit d APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ li Surcharge ' Plan Review License MCNVS SAC ? City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. ? -? l/ Park Ded. Trails Ded. v Other Copies - Total: L ? I % SAC SAC Unif's""` .---?-? % 1 _ i . , , . . ? .,. , .. - . F. C. JACKSCfN ` .. , . .. . , Mr. John Michaels SUR\'EYOR 4253 Amber Dr. Eagan, MN 55122 ^???=-=r== '-.°==r -?.?= ?. ?-••? ? VIHH[4DTA 4C[RLLO CY ORDIMANCE OF CITY Or MINH[APJLIL 31716 EAST 55rH STREE-F PA. 4"4GB1 ?ff urbrr-,r'?; Ccrtificatt . S Flo* 7 10? ? ? ? ? pvS ? oS qv o i i ? y, N ? Ok N I HEFECY CERTIFY THAT THE AeOVE IB A TFUE ANp WRRECT PtAT OP A SURVEY OF i.ot 6 Blook 7, Cedar Grove P:o. 2 'na-an Po-;rns,iip,liakota `%ount9, M.inn. ? i O \I c1 ? ? ? +I I Scale: / ? = 30? PZRAM 1ca n ?'1 f Af SUPVCYEO 6Y MC THIS SIGAE0.-? F. C JACK50`.. KINHrsC? F[¢IilR/.TIOM, h<. 3E0*! ?h?M?yn:k?%kh,?'C9FmYnf;M7'?ik4l•8(??kh'?SCWht?i %R7R:4??i k?`??KWKL;:XCx CIT'r' 01= F.:Af;iAN CFl;3Fi.f.El;: lS TEF.'W1:Nt•tl.. N0:: 692 DA713:: 02/1.0/959 T:I?1E: 1.0? 1 f3 ^08 IT.i;; P!FlME: FiL.COVI_ Rf]f:IFINt:i ix 9111 i:NW :[NC. ;E':lp 13001 211.4 MAIIBI...E I_N L'r?5.25 2155 9001 i?ii i MFlS;BI_F:: LN 3.00 -;c'10 :JOCI'I. 42.`i3 AMBL-::Ci DF( 11. J-c 5 205 9001 425;3 AMf.3EFt UF 2.50 3210 9001 2066 LiZFf L.EY hii 03„25 205 9501 cQE'iE, Tl'1:FF'I._Fi:V FiD 4.00 Tr]'1;1.L IiL-+CF7.pt F;mnuni:. 399.25 Gf':I.1C'iCi68 l.1Sf:i:R TD: 1FlN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) and all roofed areaa (20% maximum lot coveraae allowed) 1 sel ot energy caleulaHons for heated addttions D 2 coples ot plans (ahow beam 6 wtndow sizes; poured Ind. design; etc.) 1 sRe survey for exlerlor addMlons 3 decks D 1 sef of energy calculaf(ona ? 3 copies of hee preservation plan M loi platted affer 711 /93 DATE: g-T 6e-) CONSTRUCTION COST: DESCRIPTION OP WORK: ? ?-?e oef CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 I IS- New ? 3 Conregidsfiueredc}ion ske suneys Reauiremenfs ahowing sq. R. of lot, sq. R. of house 2 copies ol plan Remodel/Renalr Reauirements STREETADDRESS: Lta-53 /`???ee:?c ,/? LOT: BLOCK: ? SUBD./P.I.D. #: rov Name: I ??I cAE? J ONN Phone #: ??[ o PROPERTY lcs? First OWNER Street Address:qd4U" /" p•M3 &A- ? City 4 State: CONTRACTOR ARCHITECT/ ENGINEER Company: td C CG)l J e /C06AJN"6 Zip: J?? Phone#: cs-l - cl-a ? s?CIO) (area code) Sheet Address: 3aO "VN 6-6EC City E-4 ?4N State: Company: Name: Telephone #: area code ( Zip: ?-?-- Street Address: Registration #: City Sewer 3 water Ilcensed plumber (reouired for new consirucHon onlv): State: Penalty applfes when address change ond lot change Is requested once permN Is izsued. Zip: I hereby acknowledge thaf I have read ihis applieatlon, state that fhe informailon Is cortect, and agree to comply with all applicabl Staie.ot Mlnnesota Statufes and Cify o( Eagan Ordinances. . Signature of Applicant: OFFICE USE ONLY llcense # ao 13 0614p. Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dweiling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 5torm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool O 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Tenant Impr ? 39 Gas Line Only ? 43 Siding/5offits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.* ? 41 Wood Stove 0 45 Fire Repair Demolish (!riterior) ? 42 F2eroof • Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Buitding Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit SNV Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ SAC Units % SAC 2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION City Of Eagan ? 3830 Pilot I{nob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 -S??o.oo Nevr ConsW ction Reaui2ments RemodeUReoair Reauiremenis ro? 3 registered site suneys shaving sq. ft of lot, sq. ft of haise; and aU roofed areas 2 coDles of plan C"?ert?,a??rirvey,`?3eotl' 4°^ eY-,''-'?``N (20% mazimum bt coverage allowed) i set oi Energy Calalatlons for heated additions Tree?P?e`s'Parmecil Y"N, 2 copies of plan showing beem & window sizes; poured found design, etc. 1 ske survey Por additions & decks ? ,'?d N 1 sel of Eneigy CalculaUons Addilion • irMicete if on-stte sepfic system bo- _?0 3 copies of Tree Pieserva0on Plan if lot platted after 7/1193 Rim Joist Detail Options selectlon sheet (bldgs wilh 3 w less unlls Date (D / LC! l O? ConstrucGon Cost SiteAddress u2, S U 194AJO,' C. l n ? U12. Unit/Ste # ? ,-) Description ot Work lN $ %?? Multi-FamilyBldg _ Y 4<N Fireplace(s) _ 0 1 _ 2 Property Owner m /P? ? Telephone # ( ?? ) ? ??' ??? 2" ? Contractor ti f d Address 3?' ? L"?, (7f:j/ '7 / 3 City State ?J Zip ?9,;3 3 ? Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Tviinnesota Rules 7670 Cateeorv 1 Minnesoh Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone # ( I hereby apply for a Residential Building Pemut and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pemut, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved pl in the ase of workAv?#h requires a review and approval of lan ? s. ' o? `,sG?'`? ? Apphcant s Pnnted Name Apphc t s Signature OFFICE USE ONLY Su6 Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIG ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage ? OB 04-plex ? 12 72-plex Pibg_Y ar _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building• O 43 Reroof ? 46 Windows/Doors ? 34 RepleCement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS FinallC.O. FinaVNo C.O. _ Plumbing HVAC Other _ Pool Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Building Inspector 2004 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. Date0!5"_/OS /? T Site Street Address Nag2 QmbQC nQ Unit # Property Owner V44 M•C6LQI Telephone# (bSl) HSH•35a5 Contractor -n K 4rr1e QI,m h:na Telephone #( 95ZI)99y - 7 60e Address laqbl Z:n raA ailp _ City JCO.Jasey State1],? a_ Zip 4C218 The Applicant is: _ Owner LC Contractor _Other Alteretions to existing dwelling _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5l8" meter is required) Other: $ 50.00 Water Softener Water Heater _ replacement _ additional $ 15.00 /Lawn Irrigation System RPZ_ repair _rebuild $ 30.00 State Surcharge $ •50 Total =30_? 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 permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. paJe 9".e1l _ ApplicanYs Printed Name Signature MAY U 6 2004 1 l ajI 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construdion Reauiremenis 3 regislered sile surveys showing sq. R. of lol, sq. ft. of house; and all roofed areas (20No marzimum lot coverage allawed) 2 copies of plan sfwwing beam & window saes; poured found design, e[c. 1 selaf Energy Calculatlons 3 copies of Tree Preservatlon Plan'rf lot platled aRer 711193 Rim Joist DetaJ Options seledian sheat (6uildings with 3 or less units) RemodeVReoairReaui2ments Off?ce Use Onlv 2 copies of plan CeR of Survey Recd _ Y_ N 1 set of Eneqy Calculatbns for heated additions Tree Pres Plan Recd _ Y_ N lsilesurveyforadditbns&decks Tree Pres Required _Y _N Addition - irMkate'rfon-snesepficsysfem bn-siteSepticSystem '_Y _N Date / & Construction Cost 1J Site Address ? ir- ? Unit/Ste # Description of Wo k (. ! I Muiti-Fumily Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 -3 Property Owner 52 S Telephone #(il J Contractor Ao d I IIfM wAnJW _ itix. Address ??O GkfWla Dfto C<<Y State ? ( ?1?1.t100at? N1?tL0 Telephone # ( ) m Lie. N Z00l01111V COMPLETE THIS AREA ONLY IF A NEW BUILDING Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheei • New Energy Code Worksheel (J submission type) Submitted Submitted • Energy Envelope Calculations Su6mitted Have you previously constructed a building in Eagan with a similar plan2 fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Y_ N If so, 25% plan review Telephone # ( Telephone # ( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Shei iq Patp- Applicant' Printed Name Applicant's Si e OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mutti ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4sea.) ? 33 EM.AIt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors ? 34 ReplaCement 'Demolition (Entire Bldg) - G ive PCA handout to appiicant VBlUat1UP1 Census Code SAC Units # of Units # of Bldgs Type of Const _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water _ Framing Final Occupancy MCES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length a : -t,,{rv Lyt...FirAe+Sprinklered Width arItU cL:YaZ; ?le?'Ar i?:D.'C8 7iZYI i' ` v3ac? c? ?sz• , is? xEQuiREMWTiAs Final/C.O. Final/No C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ SNCCO _ Stone _ Brick _ Windows _ Retaining Wall _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved By: Easa Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector 41 Dty Of ?ap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 F----------------- For Office Use ? j PermitM: ? Permit Fee: ? Date Received: ' j I Statt: ?----------------' 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 4253 1'f h\,bv- DC. Tenant: -,TO ? ?Cjka-e- ? Suite #: RESIDENTlOWNER Name: ?O?n (fi iC,ka21 Phone: 4N- 3Jra2$ Address / Ciry / Zip: 4qSJ nYVI bo- D(' Applicant is: _ Owner ? Contractor TYPE OF WORK Description of work: Op-e ? Construction Cost: ??3? • w Multi-Family Buitding: (Yes No CONTRACTOR Name: AZ'TEC 1'1OOp nG l ar sOx License 1t: 20 139 1'F0 Address: 4 I O5 554.1, A/E Ciry: .4ri Pa.fk state: (Ylh1 zip: 55i1?3 Phone: -7 (Q3- 31 S- 053 O Contact Person: A4_2j C?utK-in0.5 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 _ Minnesota Rules 7670 Categorv 1 _ Energy Code • Residemial Venhlation Category 1 Worksheet • New Energy Code Worksheet CatEgOry Su6mitted Submitted (4 Submission typC) • Energy Envebpe Calculations Submitted In the last 12 moMhs, has the City of Eagan issued a permit far a similar pian based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plum6er: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporiing documents that you submit are considered to tre public information. Portions o/ the information may be classiiied as non•public if you provide speclfic reasons thaf would pennit the Clty to conclude that the are trade secaais. I hereby acknowledge that this information is complete and accurate; that the work will 6e in confortnance with the ordinances and cades of the City of Eagan; ihat I understarcl this is not a permit, but only an application for a permit, arM work is oot to staA without a permR; that ihe work will be in accordance xnth ihe approved plan in the case of work which requires a review and approval ol plans. x -? p. 1 E C?.u-k-t naS x iYkPA.f' ? ApplicanYs Printed Name ApplicanY Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA112023 Date Issued:07/24/2013 Permit Category:ePermit Site Address: 4253 Amber Dr Lot:6 Block: 7 Addition: Cedar Grove 2nd PID:10-16701-07-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 60.00Total: 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 - John R Michael 4253 Amber Dr Eagan MN 55122 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 952) 435-2442 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r----------------- I For Office Use I i I Permit City of Ea Ed~ I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: 3 Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: "`t ✓YL Unit Name: Vfl Phone: J/ Resident/ C~ Owner Address / City / Zip: J &C,- Gt 'G'am Applicant is: Owner .Contractor clo_~ Type of Work Description of work: Construction Cost: L` O Multi-Family Building: (Yes / NoD_~ I rWB~ I. Company: 3-U,7CST 4. ~ "i Contact: ' Pt~ Contractor Address: U o t~ ' 6_ City: State: ~M4_) Zip: Phone: Yom" License YJ Lead Certificate y" /U 0~~ `C If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of i the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of ermit isZance. x )-r x /7~ Z~Lf4,/ Applicant's Printed Nm Ap lic t' gnature Page 1 of 3 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: RECEIVED AUG 0 8 2016 r Use BLUE or BLACK Ink For Office Use G / f Permit #: / O b 7 7 Permit Fee: 'It/6"C' Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: C. A C(A:l2 C- 0 C' v e_ Unit #: J esident/ Owner Name: �c\t1 c c\ \Gere Address / City / Zip: k --\a S CC\'C Phone: GS \-�lS�l �t1 n SS Applicant is: Owner Contractor Type of Work Contractor 2Qe CAV& ce Oatwyc\l tet.) Description of work: ex\SS c tc..3..c5V) o&'N Construction Cost: Company: U S CASCD? Multi -Family Building: (Yes Address: 81_)V /No�) Contact: \\ iA_ t`c1c:�C1S(S't'\ City: 'iAeoc"Nc1nU(\ State: \(\ Zip:i<N(.) Phone`tStXS Email: License #` Pc,LOo (09-0-k 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 25 -No If yes, date and address of master plan: Licensed Plumber: Phone: Phone: Phone: Fire Suppression Contractor: Phone: Mechanical Contractor: Sewer & Water Contractor: y07Er..Plans-and supporting documents that;you submit are consitit the information may be classified as non-public if you provide' spec conclude. that the are:,trade ad t be public; information:? Portions of c feaa nerr'that-would permit the Cita to Sts, 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.aooherstateonecall.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 l understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Buildin • Co • e must be completed within 180 days of permit issuance. x \\fin ��1C71C1 Applicant's Printed Name x Applic Page 1 of 3 City of Eaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 a35d,L1, \ DS Use BLUE or BLACK Ink RECEIVED AUG 182016 r I For Office Use Permit #: Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 8 -Ys-\ L Site Address: k a,STS Qm ?c . Unit #: J Resident/ Owner Type of Work Contractor Name: •-\dcyc\ c\�,c-`c e Address / City / Zip: k -%S3 C‘VN\ c- pc Phone: bS\-L►S4- 3�s Eo\ ctc•\ c\ -‘t -N SS \d' Applicant is: Owner Z5- Contractor e mcwe o.c‘C ' e ?\ot.ce Description of work: c cw?cox \S, S sc _Ac .ce Construction Cost: \a, 5'3C O o Multi -Family Building: (Yes Company: 4w �u v cx S / No Contact: c\-, vS\SU Kl Address:80\1 cm cA\\e\ City: 1:Acc>c\-,, -‘cn\uy State. Zip: SS`-id0 Phone:`1S4 S1- \2 Email: \ManSUv _be, cc c�‘k . GcAh License #: (SCCX (OS(. 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 D No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: NOTE:.Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons -that would permit the City to conclude that the are trade -secrets, CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Builds g Code must be completed within 180 days of permit issuance. x MX\SUn x Applicant's Printed Name Applic Page 1 of 3 as k, 5 r /\ \ U S Use BLUE or BLACK Ink ,- I For Office Use ` � { `(_0 Cll of Ea n j Permit#: 1'"1()t Permit Fee: I '-i '05 3830 Pilot Knob Road r Eagan MN 55122 Date Received: 5 -to- i 7 Phone: (651) 675-5675 Fax: (651)675-5694 FEtn. 1 Staff: 2016 RESIDENTIAL BUIMLDING PERMJT APPLICATION Date: 5-9.-\--\ Site Address:L`c�S-)- k-)CliN c o f Unit#: IName: J Q\- � c\ ,ic.\.ae. (5\ Phone: t-ctSit,-- 53,5S- Resident! _ Owner Address/City/Zip:L\�S: i ��* 'c �� • • 1 u r1 S Applicant is: Owner Contractor .:s Type of Work Description of work: ',1c��Raj . Construction Cost: I S1CMulti-Family Building: (Yes Company: (�� t i c ‘c...)(�‘c...)(c S /No ) Contact G, mvVI.SUi7 Contractor Address:.7,T\. C1.i C� Aker\ 9to e S City: \.cx..)ch cNN -UY1 State:t 1C\ Zip:,,,,5Lid0 Phone: 1-- 1-1613 Email:ki�ilO� .KNA 'c t\ .cuM License#: 6LtOL,SfoL1 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 be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the -:are trade secrets, CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. _.. x ll- VOA n x Applicant's Printed Name Appli ,. 's Signate Page 1 of 3 Use BLUE or BLACK Ink r (� Eaaan For Office Use iof r .D Permit#: 141),`"7°70 3830 Pilot Knob Road Permit Fee: (Q 0 Eagan MN 55122 MAY 1 8 2017 Date Received: S"-Ig'--11 Phone:(651)675-5675 Fax:(651)675-5694 Staff: / 2017 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: \\O\NI. Site Address: '"� -�s 4x),--.10.51,-- Vi 1 1--(2-- Tenant: Suite#: - Resident/Owner Name: i b n ' MAC � Phone: Cod l"ck. U-3S2�t Address/City/Zip: Name: P r( ( S \--- --eA- L_C C License#: 11 YO 1 0 2 Contractor Address: `-\Ct(,) �L< [r.1 (- �) J City: C_UC State:rnN Zip: 3---1 2" Phone: CD1'N 2 31 S" t00 2 Contact: )--.172.-ii) Email: /J t® at.r;C 1(`-�� cCo V-N New x Keplacement Additional Alteration Demolition — Type ofWork 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 infomiation on permitted screening methods. �� RESIDENTIAL COMMERCIAL Furnace _New Construction _Interior Improvement Permit Type —Air Conditioner _Install Piping _Processed _Air Exchanger _Gas _Exterior HVAC Unit Heat Pump Under/Above ground Tank ( Install/_Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, indudes State Surcharge $100.00 Residential New, includes State Surcharge =$ ZWO TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee =$ Surcharge Surcharge=Contract Value x$0.0005 �� If the project valuation is over$1 million,please call for Surcharge =$ a TOTAL FEE 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 appr ved plan in the case of work which requires a review and approval of plaps: 41119hbl Xe, SC Lk) ‘ x Applicant's ' ted Name Appli ant's i a, re FOR OFFICE USE �`' Required Inspections: Reviewed By: fats Underground Rough In ' Air Test " Gas Service Test" In-floor Heat Final ~: .HVAC Screening. .. PERMIT City of Eagan Permit Type:Building Permit Number:EA148437 Date Issued:03/29/2018 Permit Category:ePermit Site Address: 4253 Amber Dr Lot:6 Block: 7 Addition: Cedar Grove 2nd PID:10-16701-07-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - John R Michael 4253 Amber Dr Eagan MN 55122 (651) 454-3525 Budget Exteriors 8017 Nicollet Avenue South Bloomington MN 55420 (952) 887-1613 Applicant/Permitee: Signature Issued By: Signature