4320 Amber DrCITY OP EAGAN
3795 PIlot Knob Rood Eagon, MN 55122
?HONEt 454-8100
BUILDING PERMIT
$1,000
Site Addrcss ??-- --•--- -----
Lor 20 Block 5 Sec/Sub. eedar Grove 2nd
Parcel # 10-16791-1200-05
oc Name
? I?ddross 4320 Amber 'Jrive
Eaoan 551?_2
°C Name cauii?.v ,
i°
Addran P.O. Box 183
? r;h, noamount M_ 423-1413
Nome _
Address
1 hereby acknowledge thot I hove read this applicotion ond stote that
the inlormotion is correct und ogree to comply with oll opplicable
Stote of Minnesoto Statufes ared City of Eqgor) O di nces.
Siyncture of Permittee ° .
/ Am-tco, riC.
Receipt #
„__ September 1;
83
Erect ? Ottuponty '•
Alter 1ff Zonirq -
Repoir p Firc Zone
Enlorpe Q Type of Const.
Move ? # Stories
Demolish ? Length
Grode ? Depth ''A Sq. Ft.
Approvols Feea
Assessment
Woter 8 Sew.
Police
Firo
Eny.
Planner
Cauncil
Bidy. Off.
APC
N ' g? 6 9
Permit
SurcFwrge
Plan check
SAC
Water Conn.
Woter Meter
Road Unit
Totol ' po
A Buildfng Pertnit is issued to: on the express condition thnt
all work sholl be done in acoordonce with oll applicoble Sfate gf.AO(innesota Stututes nnd City of Eopon Ordinonces.
Buildinp Officiol ? '
Permit No. Permit Holder Mitc. Permit No. Holder
Plum6ing
H.V.A.C.
w.n
Water
Disp.
S?wor
E lectric
Irspsction Date Insp. Other
Footings ?
Foundation
Freminp
Rouph Pibq. .
Rouph HVAC
Inwlation ?
Final Plba
Finsl HVAC
Final
Dasaibe Locrtion:
?
L
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
I . , i r?1•7??t ! ??9d
?MIT SUBTYPE:
; ; 1;
/t!1 :'90 b)?
.' A t7 3 ii+ P? r
PERMIT TYPE:
Permit Number:
Date Issued:
I?tlf 1 1 f1 ! ?1Ii
APPLICANT:
TYPE OF 1N4RK:
Iif?f11 1 f t11V
1 Ni' ( I.IUf ?? Ilkf.J
Iit ,i Fr11'7 iflM
t" 0 {t l I W 4i"
F .f H A !.
U;2A 111 111 1
, :MnRt ', •A VnHAy F Vf;taM I 1S h F i)1i7w va rOf,r ANY (•; I f: 1 f N f( ql. OP Pt 11MR t Nr3 WORK
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Dete Inep. Comments
FOOTINGS
FOUND
FRAMING
wt,
RQOFING
ROUGH
PLUM8ING .
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TE5T
INSUL ? ?? 4,(- .44 ?
GYP BOARD
FIREPIACE ?
FIREPLACE
AIR TEST
FINAI PLBG
FINAL HTG
pRSAT
TEST
BLDG FINAL .
BSMT R.I.
BSMT FINAL
DECK FfG
A
/t i l/ ?
CITY OF EAGAN
Addition Cedar Grove
LN L.C
Lot 20 eik 5 Parcel 10 16701 200 05
Antber Dr. 5tate- Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ?85 1985 12 84.46 1
STREET R,ESTOR.
GRADI NG
SAN SEW TRUNK
# SEWER LATERAL 1972 ? ?OO 2.16 Z I
WATERMAIN '
WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC `.. '?
PARK
273-^^ O m
L ? OPPI USE QNL? is requesf vmd 18 monihs lrom voLdohon date prm?n Mi
'/
?--
? ?
a
PLEASE PRINT OR TYPE 0
Reqmst Oate Roogh-in inspMion m ved2 ` Yes ? No Inspenion Oiher Than Raugh-In ? Ready Now Will Call
g -Z Q- ??j (You most mll fhe mspedorwhe r eady) Date Ready:
I, ? licensed roNmdor owner hereby reques} mspedion of fhe above eleclri<al work af:
Jab Pddres, (Street, Bw, or kovfe N. )
3?i AmlBea- ?. Gry ?? - 1
??%? L? e
?? ZZ
Senion Na Township Noma or N. Roige No. Fira N. CouN Ko -rA
O¢uPa f
?
WE- Phone No `
• I,
BPtAL-D
wer5vpp6er Addresz
ElecMwl Conhacror (ComponY Nome) Contmdon cceme No Maxkn ci, Na. [Plont Elect Only)
Mailing Addm Contmcror or Owner Performing InslollaHOn)
lwih ed ig t ? dormi nslollaM1On? Pho No
EB-OWOlA-10 6195 STATEBOARUCOVY-SEEINS7RUCTIONSONBACKOFYE OWCOW
IIIII III II II IIIIIIIIIIII I I?ullll II
* 0 2 7 3 2 9 0 7*
REOUEST FOR ELECTRICAL INSPECTION v 3
?
3
Minnesota State Board M Etectricity
1821 Universi Ave., Rm. S?1?$ic?ul, MN 55704 ?
Phsns-{S?tq 642-0800 ?? /?
Home Duple. Apt Bldg. Other: New Addn
Commerciol Industrial Farm Remod Re air
Air Cond. Hfg. Equip. Wafer Hfr. Load Mgmf. Other. I-
D er Ron e Elec. Heat Tem . Service ? ?
"k' above rhe work covered by thrs request. Enfer remarks in thu spoce vnd on ihe ba<k o the whife mpy only.
Calculate Inspedion Fee - This Inspection Request wdl nof be accepied without Ihe comecf fee:
Olfier Fee $ Service EMrance $ae Fee # Ciraiils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 fo 100 Amps
Sfreet Ltg./fraNic Sig. A6ove 200 Amps Above 100 Amps
Tronsformer/Generator INSPECTOF'SUSE ONLY ? TOTA
?
Sign/Outline Lig. Xfmr.
' L
O
Alarm/Remofe Control ? ?
$wilnming Pool I hereb cem Ihaf I ins ckd Ih<elecrnca insla11a1ion described herem an lhe daks amtad
Irrigation Baom Rmgh-In Dak
ecial Ins
$
edion
p
p
Investigative Fee
Tn.1 /
D.1
THIS INSTALLATION MAY BE ORDERED DISCONNECTEO IF NOT COMPLETED WITHI 18 NTHS.
EAGAN TOWNSHIP
? BI„IIUUNG PERMIT
Address
Suilder ..__....'....
Address _._ ...__.
DE5CRIPTION
N°
Eagan Township
Town Hall
680
Siories To Be Used For Froni Depih Heigh! Esi. Cosf Permif Fee Aemarks
j? , -'-------^---
_. _. ---- . ---............. ....... --...... -----..
Chairman ot Town Boerd.
This permii does noi auihoriae the use of sSreets, roads, alleys or sidewalks nor does ii give the owner or his ageni
the righlio creaSe aay sifuafion which is a nuisance or which presenis a hazard !o the heallh, safefy, convenience and
general welfare foanyone in the community. THIS PERMIT MUST? PTp TH EMI E THE WORK IS' IN PAOGRE . /
This is 'fo certify, ihail .?.?'.j_.,..._e??as permission to erecf t..._ .._.._..._.. ..?_............_..... upon
!he above described premise subjecf to the pravisions of !he Building rdinance fo a i opied April 11.
1955.. _ _ _ ?
1-74
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex ......r`f
. ....- '------...........-----•--'----'
Addxess (Pxeseni) _'. . ?i -----.----U.._..Y??_'': _-`-.?..?.'".1:-'--------
Builder ---- L?.;yn:4: ...... j'!!.:` -'
. '- _....------.................
:----?'.--'----
Address
DESCRIPTION
N° 1006
Eagan Township
Town Hall
Dafe _?'-- :--._-'.
Siories To Be Used Far Froni Depih Heigh! Esi. Cosk Permii Fee Aemarks
?l 7 6
Sireei, Road or oiher Descripnon ox i.oeenon Lox ntocK naauioa or zxac:
-1 ;2-0 r_, ,f? . j=1 i y
This pexmit does not aufhorise the use of slreefs, roads, alleps or sidewalks
the righf to ezeate anq siSuaYion which is a nuisance or which presenis a hazard
general weltare !o anyone in the community.
THIS PEAMIT MUST BE PT ON?TAE PREMISE WIi2LE THE WORK IS IN
This is !o cerlify. Shaf.....?`:.:":'........_ ?9:c:........__.-.---.has permission !o erec
the above deseribed premise subjecY !o the provisions of the Suilding Ordinanee
1955. --, ,
nor does it give the owaer or his agent
to the healih, safely, aonveaienee ead
PROGR£SS.
! a.... .................
.----- ... l" ... upon
. :.- . ..... . ............ for Ea an Tow' hip adopled April 11,
1 i
64 /
. ... ?/..
. . ................ ... .':. . ' ' _ _ __.t........."' __'_'
? L (1 ........... ..°-°--.........----- Per .----------.---.----°---??- ----N.` :--8 -t ?--
Chairman -
-of Tnwn Board Suildin InsPecios
/., tp'c
CITY OF EAGAN ND g469
3795 Pilot Knob Rmd Esgon, MN 55172
PHONE: /54-8100
BIWLDING PERMIT 3? Receipt #
To M wed forINSTALLySLfiSS-?Vajue $1,000 Date September 12 _ 19 83
Site Addreu 4320 Amber Drive
Lor 20 Bi«k_5 Sec/Sub. Cedar Grove 2nd
Parcel # 10-16701-200-05
W Nome "u.i a.uuc
? Address 4320 Amber Drive
,;,,, Eagan 55122 0,,,,
o JN.nn. ?iCO, Inc.
?U Address P.O. Box 183
r- ?:... Rosmount ol___ 423-1413
Name _
Addreu
Erect ? Occuponty - - R-3
Alter ;g Zoning R-1
Repoir ? Fire Zone NA
Enlarpe ? Type of Canst. V
Move ? # Stories
Demolish ? Length NA
Gmde ? Depth NA Sq. Ft.-
Aoorovolf Faes
Assessment _
Water 8 $ew.
Police _
Fire
Eng.
vlonner -
CounNl -
I hereby acknowledga tFwf 1 have read this applicotion and stote that Bldg. Off.
ihe inlormation i5 corrett on gree to comply with all aDPlicable APC
Stote of Minnewta Stotutes cn Ci f E?a jn Ord`iyyyppp nces.
Signature of Pertnittee ? "'???Y-
Amico InC
Permrt 1/.7U
Surchorge .50
Plan check
SAG
Woter Conn.
Woter Meter
Road Unit
Totol $18.00
A Buiiding Permit is issued to: ' ? on tha ezpren condition thni
oll work sholl be done in accordonce with oll upPlitbp/1fe? State of n esota Statutes and City of Eagan Ordinances.
? Vdt.,
Building Official ?-t-?f?/
?
Zb Be Us
9
4? VY
C?oF??
? BUILDING PERMIT APPLICATION
m
Si? ?ss y 3 Z a ,7M
rAt )C) slorac sec./s,?b. CE.?IarC??oU_EI,Erect
Parcel #: `((J Z O 1" 2b C? -C ? c> -251'?lt2r X_
Repair
Owner: DD /y 1U E EYnlarge
Acklress: ?1Zo /? f'i 13c rZ ,(?r? Move
City/Zip Code: !-,?Q,qi? Geish _
Phone #:
Contractor: /4/vlf Cv ?,+- N C--
Addressc ZQ ,f?x If? -'S
City/Zip Code: ?ot'E d2ou N 1^ s??? 6<Q
Phone # : 4 ? S - J y? !?'
Arch./E,hg. .
Pddrnss:
APPROVAL.S
? For_, ` ` ° ? Valuation f?i7(9 r9 Date
Include 2 sets of plans,
1 site plan w/elevations &
1 set c£ enerqy calcul.ations.
zlz
7
T
OFFICE USE ONLY
Occupancy
Zoning
Fire Zane
Type of Const.
# stories
Front A/ £t.
Depth ft.
Assessznents Permi.t
?4ater/Seaer Surcharge
Police Plan Check
Fire SAC
ESng. water Conn.
Planner Water Meter
Council Rflad Unit
Bldg. Off.
P,PC
City/Zip Code:
Phone # : RbTpS, ? ? C? ?
, - ` PERMIT
CITY OF EAGAN PERMIT TYPE:
3830 Pdot Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 028511
(612) 681-4675 Date Issued: 0 8/ 12 / 9 6
SITE ADDRESS:
, 4320 AMBER OR
LOT: 20 BLOCK: 5
CEDAR GROVE 2ND
P.I.N.: 19-16701-200-05
DESCRIPTION:
8ase Fee
Plan Review
Surcharge
7ota1 Fee
; , INCLUDES DECK
A'uilding--PermiC Type
;.,Buildin,gWg,rk Type
Census Code" ?1 434
}
A'
ni, .
:-aE
"-_;g.°-..I ir:`EW
?,
?-?'h.-.??.w.?-e'• ??,r`?_t?. ?.:?_:Ad?t???71?1???£ . ??
v '
REMARKS:
SEPARATE PERMITS REQUIRED FOR ANY ELECTRICflL OR PLUMBING WORK
FEE SUMMARY:
VALUATION
$187.25
$93.63
$6.00
$286.88
SF PORCH
ADOITION
ALT. RESIDENTIAL
$12,000
CONTRACTOR: - Applicant - sT. LIC.OWNER: ,
VON RUDEN CtlNST, STEVE 14695721 0007022 LANE DON
23625 JERSEY CT 4320 AMBER DR
LAKEVILLE MN 55044 EAGAN MN
(612) 469-5721 (612)454-4539
?
Z hareby ackrr'pwledge that I have re'ad this .app4ics'ti?on and state that the
intormatian is cQrrect end,agree to corrEply„with all applicable State of Mn.
Statutesa'nd City of Eagan'6riiinances. ' _. . _ ._ . ... _
???, rn?-
RMITEESIGNATURE 'ISSUEDBY IG 7UR .
PPLICANT/PE
CITY OF ["AGAN
CASH7:1=R: S 'iF.Rt9INAL nU.- 32
IiA"iF'. 08/:L:3/96 r:r.Me:. i.a:49:Q
SD;,
NFlME+: STG"F'tIEN J VONRIJDEN
3210 3001 4320 AMLtEh' DF' iBi.?`,i
9A22 9001 432I:1 AMPE:R Iil~ 9:3.69
205 9001 4320 AMREh DF 6„00
'int:a:l. fi43ceipt Ama.eni:: 2Eir,',.88
rk062886
tJSl=.h ID: NANCY
J
CITY OF EAGAN
14/ 3830 PILOT l4NOB RD - 65122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
RemadeVReoair Reouiremenh
0'/ 9
? 3 regislered sNe aurveys ? 2 cropies oi plan
? 2 apiea ot plane (indude beam 8 whMow shea; poured tnd, desipn; etc.) ? Y sRe surveya (exterior addRions S decks)
?/ energy eelcutattona ? 1 energy calculationa for heated addkions
? 3 copiee M tree preservation pbn N bt plaMed aRer 7/1/93
mquhed: _ Yea _ No
DATE: CON5TRUCTIDN COST: ?6 So o. o0
DESCRIPTION OF WORK: SCasaH novc? //
STREET ADDRESS: 1'1e? D 14"16 -e Y D y'
LOT a L? BLOCK ? SUBD./P.I.D. #: 2
Phone #:
PROPER71r Name:
OWNER `"°' `"`T
?3zo 11n7l9er Dr,
StreetAddress•
City: ia
3a,= State: ?? ?• Zip• SSi? z
CONTRACTOR v
Company: -?57fQVP (/o? rc-d=.- C--?phone#: 972-1
StreetAddress:2??2 5 `fi?se C - License#- 70 Z7---
Ciry: lr'fcu"`//e- state: !W w-- Zjp• ?soif?{
ARCHITECT! Company: Phone #
ENGINEER
Name: Registration #-
Street Address-
City; State: Zip'
Sewer & water licensed piumber:
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowiedge that 1 have read this applicaUon and state that the informaHon is cortect and agree to comply with all
applicabte State oi Minnesota Statutes and City of Eagan Ordfnances.
/
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
No
No
AUG d i' 3Sg4
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation a 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
e'04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. ? 10 _ plex o 15 Deck
WORKTYPE
0 31 New o 33 Aiterations ? 36 Move
e"52 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const (Actual) _v tq Basement sq. ft. MC/WS System
-
(Allowable) vq Main level sq. ft. City Water
7
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. y3q
Depth Footprint sq. ft. SAC Code o i
Census Bldg 1
Census Unit ?
APPROVALS
Planning Building
Permit Fee
Surcharge
Pian Review
License
MCNVS SAC
City SAC
Waler Conn.
Water Meter
Acct. Deposit
SIW Pertnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
1479- Engineering Variance
Vaiuation: $ tz, o00 • -
i OKL-
1Lv1 (o = zsl. aj@?yr? v, zclo, --
i?' 1 1 zQ J' ?
q
?-------
?cl
% SAC
SAC Units
. Cedit r Grwe Const. Co. ? 130-53
F. C. JACKSON ?J
LAND SURVEYOR
.
REGIBTEREO UND[R LAW6 OF STATE OF MINNf6pTA
LICLH6ED BY ORDINAHCE OF CITY OF' MINN[APOLIB
3818 EAST SSrH S7REE7
*UCb[pOT?A Certiticatt
.-.7 ,'7.
V y,
.?
- /ZO o'
?
pA. 4-4691 N
,i
?
1 HEREBY CERTIFY THAT THE ABOVE IB A TRl1E ANp CORRlGT PLAT OR A SURV[Y OF
lot 20,31ock 5 Cedar Grove No. 2
hagan Toanship, Uakota County, h!inn.
Ai 6l1RVEVEO BY ME THIS-???th -OAY OF_ `Yov • N o- yobo-- ? ? I I
.y-__:-__?-_' - ' .
?----J----
F. C JACKSON. MINN€SyiA REGIBTRATION. NO. 3800
(
2005 RESIDENTLAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
rv "?Ir
<.
5.
P
Please complete for: single family dwellings & townhomes/wndos when pennits are rcquired foc each unit
53v S'
Date
Site Address Unit #
Property Owner .L?)Jnr7 Ir-, Telephone # ((pJ° ) ) L45L4- L453 C7
Contractor CC_Y_)_?701\E7j?, nlr'
Street Address (E) ? ?? ? E a?7) n f-) Lx Suif H City T-n
State Zip Telephone# ylp0-(00(S a.
Bond #: Expires:
The Applicant is _ Owner ? Contrector _ Other
Add-on or alteration to existing dwelling unit $ 30.00
Addi
? t
l ?R
l
ti
furnace _ acemen
ona
ep
air exchanger
diti
N
i ?
?R
l
t
oner _
ew
a
rcon acemen
ep
other
State Surcharge $ 50
Total $ _zda5
f _v
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is comple[e 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 applica6on for a pemut, and work is not to staR without a permit; that the work will be in accordance with thc
approved plan in the case of work which requires a review and approval of p
f ? eS ?
Applicant's ri ted Name Arp ' nt's i atur
° 7 200`
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/industrial buildings
mulfi-family buildings when sepazate peimits are not required for esch dwclling unit
Date 4 / C?fD_
Site Strcet Addres '-Y r' Unit #
Tenant Name (if apptic le) Do n a 1c) L Q n Previous T ant Name
Property Owner 'c'->on D ?... Te phone # (lD5) 14539
Contractor p4r 6 ) r r
StreM Address 611 ) ?- UE + City ?C r m , nG iDn
State N Zip Telephone #((051 > y to o-I?o a a
Bond #: Eapires:
The Applicant is _ Owner _Z
Contrac _ OtLer
;
Work Typc
_ New Construction Underground Ta Install _ Remove ""see below
_ Interior Improvement Install Piping _ ocessed _Gas
Nature of Work: 1 Fv?r- LE ?- 1?
*"When insta!ling/removing undergrou d tank, call for inspection by Fire arsha/ and Plumbing I»spector
PQI'IiiiSF2C': $70a6undergroundlanicin laliutvramoval
$50.50 Muwmem (includ Slate Surcharge)
or
Contract Value $ x 1% _ $ Permi[Fee
• ICpern ut fee is $1,000 or ess, add $.50 ? $ State Surcharge
If nermit fee is over $l 00, add $.50 for
every $1,000 permit e $ Total Fee
i nereoy appiy ior a co erclw 1vlecharucal Yennit and acknowledge that the information is complete a accurate; that the work
will be in conformanc with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a permit, Uut o an applicatron for a permit, and work is not to start without a pernrit; that ihe work wil be in accordance with
the approved plan i the case of work which requires a review and approval of plans.
? i
tvame
Applicant's Signature
Approved By: Inspeaor
?-----------------
,... , ?
I Fo},Off""?e_Usi?
I I
? Pertnit
I ?
? PermitFee: 0 ?
I
? Date Received: ?
I I
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S' (4'60 SiteAddress: 43x) J`Fkbe"' Ofk
Tenant: l?Jo? c y L-'GL Vl?,? Suite #:
RESIDENT / OWNER Name: ?•t °E V?Cc?f ?E' l-Ct t/i.e Phone: (0,5 (-
AddresslCitylZip: &w? 43k6 J?4wIOPr LNC'
Applicant is: _ Owner -)dContractor
TYPE OF WORK Description ofwork: ?k' - Qznrd `
Construction Cost: Multi-Family Building: (Yes_! Noev_)
CONTRACTOR
?
Name: JIW&S i-t ?^' exl k4 License #: ?8 e 3
Address r,F ?07 5=?J-Vn gLrtC
City: State: Zip: J?3
Phone: C?C? '"'131 -bZT? Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventila6on Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submissiOn type) • Energy Envelope Calculations Submitted
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 8 Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are'considered to be public information. Portions of .
fhe information may be classified as non-public if you provide specific reasons that would permit the City to' +"
- condude.that the are trade secrets:;:`' .
I hereby acknowledge that this information is complete and accurate; that the work will be in con
Eagan' at I u er tand this is not a permit, but only an application for a permit, and work is
accordan wif, th approved plan in the case of work which requires a review and approval of pl;
X \' i i u W.P S?i P/1 Q lcf x
App a s P inted Name Applic 's
with the ordinances and codes of the Ciry of
alf without a permd; that the work will be in
Page 1 of 3
------------------
i
? Pertnit #: ?LF t?CO? I
i Pertnit Fee:
? Date Received:
I StaH:
I
Date: "f ^
Tenant:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: q 3 20 A'h 6 e r-
Suite #:
y5 q "'9S?
Q Ph
'
RESIDENT / OWNER one:
r"-
Name:
F
Address / CiN ! Zip 41 Zv W? ?
Applicant is: _ Owner _ Con[racror
TYPE OF WORK Description of work: KC -Riw_(
ConstructionCost: Multi-FamityBuilding:(YesNo?
CONTRACTOR Name: Lc'L• r License #: 7d I? c3 g 3?
Address: \ Ci {L Dr,
????? C ?
Zi
:
??
v
S
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Phone: '-SI "Z?d'-IUS6 ContactPerson: ?lovv?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet
Category Submined Submitted
(4 SubmiSSion type) • Energy Envelope Calculations Submitted
In the last 72 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 Controctor: Phone:
NOTE: Plans and supporting documen;s that you submit are, considered.to be public information. Portions of
the information may be alassified as non-pu6lic if you provide sp'ecific reasons that would perinit the Cify !o -
condude that the are trade secrets.
I here6y acknowledge that this iMOrmation is complete and accurare; that the work will be in
Eagan; that I understand this is not a permil, but only an application for a permit, and woi
accordance with the appmved plan in the case of work which reqwres a review and approval i
xI1'?pS L??Gfl1? [s x
ApplicanYs Printed Name APPri
with [he ordinances and codes of the City ot
3A without a permit; that the work will be in
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113833
Date Issued:09/09/2013
Permit Category:ePermit
Site Address: 4320 Amber Dr
Lot:20 Block: 5 Addition: Cedar Grove 2nd
PID:10-16701-05-200
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Ian Jacobsen
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 -
Donald E Lane
4320 Amber Dr
Eagan MN 55122
Amek Construction
9555 James Ave S
#228
Bloomington MN 55431
(952) 888-1200
Applicant/Permitee: Signature Issued By: Signature