4182 Amberleaf Tr? 11
v---'CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
SITE ADDRESS: .i,wFRI FAf 11
ItJf 1'
f PERMIT SUBTYPE:
•. i?
PERMIT TYPE:
Permit Number:
Date Issued:
""qv I ' '"' " ' - APPLICANT:
13 Rtrtirk': ,
I i Wlt,'
( r: t. ? r; t; _• _ 5? ,:' f, ?i
TYPE OF WORK:
iifsrr
II ! 1 U i Nfi
:oa+! 'c;
INSPECTION .. . .,
14 12F V i C W1= D Ry (:IiA t Is N?)t?ill: i 1'K .
1-11 A (F {,F: RMr T R1 01.ITFe f li F iki' HNY F•I lllq!< i 1`41, 6J(tiklS .
. , :. • • ? r,?
?
?
J
?
PemiR Holdsr Date Tekphone 11
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. CommeMs
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARO
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
MEfER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154063
Date Issued:02/15/2019
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Daniel T Osborn
4182 Amberleaf Tr
Eagan MN 55123
(651) 452-5614
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
CITY'OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PECTIO
WORD
PERMIT TYPE:
Permit Number:
Date Issued:
frrl ri urrtil
H? l :;OGi
H4/t-)I?al;
SITE ADDRESS: ? ? ? " •` I " r? y'y r? H • ! N ?w - ?
! p i: y c rc ??1?•K
,hql+F F?1 F"AF' 1K
PERMIT SUBTYPE:
, APPLICANT:
t FI I;S ?t' 1 ii{4 . ?
1r•1.'1 N/:i 1.?'?1
TYPE OF WORK:
r,i Ij
INSPECTION D . D
1 1? ioMl rji,
t pJ',Ili 1+ L f
1•,?1???11 I rJ { 1., ? .???? I? I;! i i'
? I??f4) 1 I I+f? ! 1 t?r?.l
I r4 A V M
L
A W f' 1!; Ir • 0 l1 ! I M IJA 'o' F kI l1VA II Pil,
?
?
Pe?mk No. Pemtit Hoider Date Telephone S
ELECTRIC ;
?oy3 s9G ?7S
PLUMBING
2 R ll?On-
HVAC
1(?
4
?
Inspection Oate Insp. Com ments
FOOTINGS
FOUND
FRAMING
-? v
ROOFING
ROUGH
PLUMBING
PLBG
Alfl TEST
ROUGH
HEATING r 9)Jb`
/'•j"ud ?
GASSVC
TEST /? -nrJ ? • n
?. f ?S ?+?
INSUL
GYPBOARD
FiREPIACE g ? O? tv
FIREPLACE
AIR TEST Z'"??'? ?' ? LJ ? 1 [? ?
FINAI PLBG
7h --
FINAL HTG i1 N
ORSAT
TEST
BLDG FINAL
BSMT R.I. Qa ?
BSMT FINAL
DECK Ff0
DEC4C FlNAL
2? O??? 7 ?
? OFFICE USE ONLY This request void 18 momhs Imm voldohon dale pnmed in this??? J
?/?iJs? s s
PLEASE PRINT OR TYPE
Request Dak
i
p.pugh-in mspecfmn reqo?red2 ? No Inspecbon CinherThon Roogh-In Eji Now [j Will Coll
(You muzt mll the inspeciar w Dme Reody.
I, P(icensed <on}mctor ? owner hereby request inspedion of iVie above electriml work at
Job Pddress (Slreel, Box, or RoWe N. I
Gry Z
ip Cade
?I
Sadion N. Townehip Name or No. Range No. Fve N. Counry
U
Occupant
c Phone N.
Pats.1ph Jdress
K?
Etednml Cammclo, lCompony Named
Conhador Licenze N.
Mosmr bc N. (PIaM Elea Only)
I
C) Amo1s
Mailing Mldresx ?Conxocror or Ovmer Pedorming Installobon?
' i?
AmhonzdSignaNm (Conhacmr or O+.ner PeAormilg Insmlknon? P?ho/ne? N.
?
& ' (?
co
?1'ICUYYI fX?
.
TlIP
;?p
? EB-OOOOlA-10 6/95 STATEBOARUCOPY-SEEINSTRUCTIONSON6ACKOFYELLOWCOPY
REOUEST FOR ELECTRICAL INSPECTION IIII I II ?I (?I I I? Minnesota State eoard of Electricity
1821 University Ave., Rm. 5-128, St. Paul, MN 55104
17111Y
* 02 6 0 7 7 8* Phone (612L642-0800?????? Home Duplex ApL Bldg. Other. New Addn
Commercial Industrial Form Remod Re air
Air Cond. Hig. Equip. Water Htr. Other.
Dryer Range Elec He Tem . Service
"X" above fhe work covered by this request En e ace and on the back of fhe whde copy only.
Cal<ulate Inspe<hon Fee - This Inspec6on Request will nof be occepfed withouf fhe mrtecf fee:
Olher Fee # Service Erdmnce Sae Fee # Circuits/Feeders Fee
Mobile Home Pork Stall 0 to 200 Amps ? 00 Amps -
Sheet Lig./(raffic Sig. Above 200 Amps Above 10 Amps
Transfortner/Generator INSPECTOq'SUSEONLV OTAL ?
Sign/Oufline Ltg. Xfmr ?
Alorm/Remofe CoNrol
Swimming Paol
I hereb can. thot cted Iha de ml tnsall hercin on Ihe dmes Mat
Irfigailon Boom Rough.ln OoN
S
ecial Ins
eciion
TH p
p
Investigative Fee
IS INSTALLATION MAY
BE OR F'"Ol oa?e
DE DISCONNE ED IF WOTWMIPLETED WITHIN 8 ONTHS.
2 V a- 7 3 4 91
,
PLEASE PRINT OR TYPE OFFlC US ONLY This mquesfvoid 18 monlhs (mm validanon darc pnnted in this 6ox
?s?9?
Req.est Dok Rough-In mspernon reqwredd U1 ? N.
(You musl mll tha inspeAor whm reo y Inspecbon Olher Than Rough-In: 0 Reody Now WiH Coll
Daie Ready:
I, 2licensed confrador ? owner hereby request mspection oi the above elecfriwl work at:
Job Addresz (SM1eet, Bm, ar Rouk Nat LY 1 IC^ Gp Zip Coda
Sa tion No Township Name or No Range N. Fire No Counry
Occupant PMre N.
Powar Svpplier Addrezs
ElMnml Connactor (COmpany Name)
ri ;h; Convacror License N.
Crao??so Masfer lic N. (Plonl EletlAnly)
Amo?59a
Mailing /ddrzsa (Conhacioror Owner P<rformmp InslolloM1On)
- r'd PiJZ tJ0 'b-Oo
n ? IYIII)
Aolhodzed Signavre (CanM1OCrorar Ovmer Pedormiig InsMllaM1On)
T f 1LL'n1.Lo.
_ Phone No.
5 - 0
EB-00007A-10 6/95 ' STA7EBOAflDCOPV-SEEINSTRUCTIONSONBACKOFYELLDWCOPY
?IJII! II III?I? I?? REQUEST FOR ELECTRICAL INSPECTION as ?.
Minnesota State Board of Electricity
:y
1921 UniversiTy Ave., Hm.??B, S?Paul, MN 55104 `.?
? 6 0 7 3 9*- Phone (612) 842-OB00 lg y
Home Duplez Apt Bldg. Other. ew Addn
Commercial Indusfrial Fortn Remod Re air
Air Cond. Hfg. Equip. Wafer Htr Lood Mgmt. Other.
D er Ran e Elec. Heat Temp. Service
"X" above ihe work covered by }his request Enter remarks m Niis space and on fhe 6ack of the whrte copy only.
Colculate lnspedion Fee - This Inspedian RequesT wdl rrot be occepfed withou} }he torrect fee:
OlFier Fee # Service Enhance S¢e Fee # Circvih/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Lfg./lroffic Sig. Above 200 Amps ve 100 Amps
Tmnsformer/Generator INSPECTON'SUSEONLY T?T Fjb
$ign/Oufline Ltg. Xfmr. /
Alorm/Remote Con}rol y
$wimming Pool
d herem on ?he darez sm?
cled elecmml
I h
b
m fh I
Irrigafion Boom ere
ce
ms e
Ro?gh-i oat / p/
S
ecial I
ns
e
dion
p
rvp
at
F
Investige ee Fmol ? e
THIS INSTALLATION MAY BE ORDERE DISCONNECTED IF NOT COMPLETED WITHIN 18 MO THS.
? ?CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-64560-130-01
DESCRIPTION:
PERMIT
PERMIT TYPE
Permit Number:
Date Issued:
4182 AMBERLEAF TR
LOT: 13 BLOCK: 1
ROONEY
Building-,Permit Typa
sBuilding 1'4ork Type
UBG Oceapancyf;
Canstructiorf +y.pe
Zoning Building ten9th`. '
"'
Bu.zlcling Width
8u=i lding sto,r3es
S`9tj7are Fe
C`? n`s)is -•Co d e'°
SF DWG
NEW
R-3 U-1
V-N
R-1
82
40
2
2,532
101 1 - FAM. DETACH
,C i i t:t? t,,t' ? Y rv;,i `?.?•`. 4:. `j '`A
_ U `.J ,.;.
&eosS,51 8'
BUILDIN6
027300
04J19/96
REMARKS:
S& W PLBR - QUICKWAY EXCAVATING
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
3AC Units
Subtotal
$1,572.25
$786.13
$118.50
$900.00
100
$3,376.88
$237,000
MISCELLANEOUS
Total Fee
$ 1.923.50
$5,300.38
CONTRACTOR: - Applicant - S7. I.IC.OWNER:
LUNDGREN BROS CONST 14731231 0001413 LUNDGREN BRtlS CONS7
935 E WAYZATA BLVD 935 E WAYZATA BLVO
WAYZATA MN 55391 WAYZATA MN 55341
(612) 473-1231 (612)473-1231
?
I hereby acknowledgethati I ha+re,:read this-applieatioro and state that the
infiormation,is correct`and egree.to comply wsth all.applicable State of Mn..
Statutes and Cityof Eagan Ordinances, .
f ?•-±
APPLICAN /P RMI7EE SIGNATURE ? ISSUED BSIGN E
_ ?._ ..
CITY OF EAGAN
4
?4
t ?
B
1995 BUILDING PERMIT APP
CATION (RESIDENTIAL) .;
681-4675
?
New Gon=truction Reaulrements ' RemodeUReoair Reauiremenh J"I
v
t ,
_
? 3 registered sRe surveys ? 2 co ies of lan
? 2 copiea of plans (indude beam 8 window sizes; poured fid. deaign; atc.) ? 2 site surveys (exterior additions & dedce)
? t energy ealculationa ? i energy caialations tor heated edditiona
? 3 coples of tree proservetion plan If bt platted after 7/7/93
requlred: _ Yes No
-
DATE: CONSTRUCTION COST: ? - ;, `.
,-
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT ! 3 BLOCK ?
PROPERTY
OWNER
CONTRACTOR
ARCHITECTI
ENGINEER
SUBD.IP.I.D. #:
Name _ •c^.,1 P
y3?' .,..?
Street dress*
#:
City. ? State: Zip:
;
Company: Phone #:
Street Addr . License #:
City: 5tate: Zip: "
Company: Phone #•
Name: Registration #•
?,., ..
Street Address•
4. :[ .
City: State: Zip:
/ .. ? yh.A . ..
5ewer & 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 ttiat t information is wrre d agree to comply?with, all,
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
.
OFFICE USE ONLY
Certificates of Survey Received ? es _ No pqp,R 2 7 1996
Tree Preserva!ion Plan Received Yes No ---
BUILDING PERMIT TYPE
'n 01 Foundation ? 06
?02 SF Dwelling ? 07
? 03 SF Addition ? 08
0 04 SF Porch o 09
0 05 SF Misc. 0 10
?,.. .
WORK TYPE
;, • ?
? 31 New o 33
`o '32 Addition ? 34
GENERAL INFORMATION
Const. (Actual) -4l
(Allowable) - ?v
;UBC Occupancy -3 ?•/
'Zoning
# of Stories 2 43sMr
Length Sy
Depth 4/O
OFFICE USE ONLY
Duplex ? 11 Apt./Lodging ?
4-plex o 12 Multi RepaidRem. ?
8-plex ? 13 Garage/Accessory o
12-plex ? 14 Fireplace ?
= plex ? 15 Deck
Alterations ? 36 Move
Repair ? 37 Demolition
Basement sq. ft.
Main level sq. ft.
7- sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
APPROVALS
?.:. :.
Planning
Building
e
Engineering
Permit Fee Valuation:
Surcharge
Plan Review lM
License -
MCNVS SAC 7 y$
3?X y?O
> = City SAC
'Water Conn
.
Water Meter /7
Acct
De
osit .
p
S/W,Permit
SNV Surcharge
? Treatment PI.
Road Unit
Park Ded
.
Trails Ded.
?;,z Other
Copies
Total:
f"
?: .
c.. : %SAC
SAC Units
?
a? ., .
Variance
g 03 7, oc) o
17x v ? 3 y
ZK
gs 9s?
Z yx y = v??
3g x Y 7 '- /, /06
z x 22 ` yy
1 K
?, +• ? .
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
/,77Io
Z N' FGoaa
?oNUS 'u•v`/iyl7/It?j
//x zz = zvZ
?rr 733 ` L6
z 6, 792
/r?/Lh •
22yc3`?=?Y
(e ri-e? = Uz)
7r(ox/6 = Iz?O?(o
?-.
?
o/
-?
/
?
7 -7
ii
2us T? ;
' i 2422 Entsrpdv 'e
•• • } * ?' ' Mendolc HeigM 1 S5120
? PIONIIEA (Oil) ORI-1ti:+ FAICOM-94M
u.n m.w,m . ek ero.Qe
* enp naer np ua n.wun. wwwo .?arzea BZS Highway 10 N.E.
Blalne, MN 55434
* *'r (017) 703-1eE0 fA1C70-1ee3
Certificate of survey for: LUNDGREN BROS. CONST. INC.
4182 AMBERLEAF TRAII I
?
STORM SEWER IINE -Qc--;-- ? MH.
EP4 L3 A N 9l 0.6fo)
Rf V I E W F D
-•-_- 6-y
?,r Y ?6 T 12 Nib"• -?' - 1- t o
901.5 ?
anTF__ 0
to
BENCH MARK 105?,?` ?903.4 4' ?` =W ? O
TOP OF PIPE aM1JO i? Q? df a Q
ELEV.=902,05 1-11, 90 . Oz ? N I
o ?? z? I
4)903y4 ¢''' I
?'p`vr ? 38• d . ?
10
?
jp
tO ?.? ,4;v/ Q' m SO O?
fTj Ln '
'-.'n/ °co
N
MH. aa'/ ?m/ S I ^
? o
905.7 ?i
906.1 `?? ???0 \ ??oog0 ,- ` boo+ ? ?
?? ? 15NV??B 6.9
00 916J7
(?. m? \ oA ?
0 917.8 ?
10 ? ?.co ?? J W 2.5 .33 o? ?
918.2 °x ? ??
9j 9 ('9v ?? ?` oo ?" N 92061 'q' fA
?(yt7,5)? Qf O
N72o? , - ? ` c4
?
' w 10 y
fl ?? f 1ti d? J
? Bope++ Mnmc 923.9 EAAR G`? G?E?G D? sza. NOTE PROPOSEO GRAUES SHOWN PER GRFOMC PIRN BY: PIONEER ? PROPOSED HOUSE ELFVATION
NOIE: 6UROINC DIMENSIONS SHOWN ARE FOR ROH120N1AL AND VERi1CAL lOCA710N
OF STRUCNRES ONLY. SEE ARCHIiECNAL GLANS FOR BUIIDINC ANO LOwEST FLOOR ELEVATION: 70 5 .7
rovr,oeuw+ oiueNSIor+s. TOP OF BLOCK ELEVATIaN: ?NOTE: NO SPECIFlC SO25 INVESTIGATON Nn5 6EEN COMPlE7ED On TMIS LOT BY THE 9 I3?
SVRVfYOR, iHE SUITnBiLITY OF SqLS TO SUPPORT THE SPECIPIC HWSE GARAGE SLAB ELEVA710N: ?
DROPOSEO IS N0T 1HE RESPON5I91Utt OF 7HE SURVEYOR. NOTE: 1H15 CERT61CA1E UOES n0i VURPORT iD SHOW EASEMENiS OTMCR 7HAN k 000.00 OENOTES EXISTINC EIEVaT10N
THOSE SHOWN ON THE RECORUEO PuT, ( 000.00 ) DEN07E5 PROPOSED ElEVA710N
N01E: CONiRnC70R MU51 VERffY ORivEwar DESICN. --- DENOtES DRAINACE AND UnuiV EASEMENT
- DENOTES ORAINpCf FLOW OIftECTiON
NOIE: BEARiNCS SHOWN AqE BASEO ON AN A55VNE0 DANM -r- OENOTFS MONUMENT
--$- OENOTES OfFSET nuB
WE HEREBY CERTIFY TO LUNDGREN BROS. CONST., INC. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF R
SURVEY Of THE BOUNDARIES OF:
LO7 13, BIOCK 1, ROONEY ADDITION
D/1KOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHRDACHMENTS, ExCEP7 AS SHOWN, AS SURVEYED BY ME OR
UNDER A1Y DIRECT SUPERVISION THIS JRD DAY OF ALCUST, 1995.
REIASEO HQUSE 12-21-25 SIGNED: ONEER ENGI?dE ING, P.A
SCALE : 1 INCH = 30 fEE7 REVISEO 1-12-?15 PROP,ELEVS. ?? ?.,?„J
REVISED HOUSE laC. 2-6-96 ?
Mo.
I9'd
• ' l0T SURVEY CHECKUST FOR RESIDENTW.
BUILDiNG PERMIT APPLICATION
PROPERTY LEGAL: 3
DATE OF S VEY:
LATEST REVISION:
DOCUMENTSTANDARDS
W o ? • Registered Land Surveyor signature arul company
?0 ? • Building Permit Appl(cant
? ? • Lepaldescriptlon
? • Address
? ? • Nortli arrow and scale
_ / ? • House type (rambler, walkout, split wlo, split entry, lookout, etc.)
? ? • Directional drainage arrows witlt slope/gradient %
W!o ? • Proposed/exisdng sewer and water services & invert elevadon
ml? ? o • Streetname
Cy'0 ? • Driveway
ELEVATIONS
3?0 ? • Sewer service (or Proposed) '
a- o ? • Property comeis
P-'O ? • Top of curb at the driveway
Ca" ? ? • Elevatlons of any erisdng adJacent hames
Prooosed
Q-' 0 0 • Garage floor
[?? ? • Flrst floor
d lCl ? • Lowest exposed elevation (walkout/window)
? ? • Property comers
E7" ? ? • Front and rear of home at the foundatlon
PONDING AREA fif aooltcable)
13 Er"'O • Easement line '
? [3-O • NWL
? ?O • HWL
o 0 O • Pond # designation
? C[a?? • Emergency Overtlow Elevation
41MENSIONS
,0'13 O • Lot Iines/Beadngs 8 dimensbns
;2-- ? ? • Right-of-way aod street width (to back of cufi)
Or-- ? ? • Proposed home dimensions incltiding any proposed decks, overhangs greater than 2',
porches, etc. p.e. ail structures requiring pertnanent fooBngs)
e?'a ? • Show alt easements of record and arry City udlitles within those easementa
6---,? • Setbacks of proposed structure and sideyard setback of adjacervt exdstlng struclures
? eT O • Rataining wail requiremenb,'rf any
Reviewea:
14ame Dat
Jantwy 19G8
tnA10199Moowwr.FM
CITY OF EAGAN PERMIT
383Gritot Knob Road PERMIT TYPE: Ca u I I. i; L i! r,
;
Eagan, Minnesota 55122-1897 Permit Number. ()3G 43
(651) 681-4675 Date Issued: 0 1 / 2 ? ( 9 q
SITE ADDRESS:
41821 aol? PE R L ea+ rr'
L 0 r: 1- 8 L cr.K: ?
kuCiN hy
?.?:-iC?e.
DESCRIPTION:
r
E; 11-11 ct i n c,f "...F' cr iri i T, ?I vr e
?
FA:.+ildinq Wtv.rI: 'flt?,
o, ne Lfs Code
,
? .
,
-•
,
--
.??
lFNl fIPII,?Fi
rt?srr) F n -rrr) {_
,, • , _ .
?I _7 ? _.. .._ .
REMARKS:
PI_(thI
51=I'E1'?' '>i: (:f4T f`nEQUI.WEp }=0i> rip"r Ft_UMR?Ci'di:i I,?JI.;I:,: <
rA: I '-I , nrcRU!ii . af? A tr) dn i e'r -i' 'r 1 t '+hi1 ra ?- l';nAl?.
FEE SUMMARY:
Fr,S:-? ;ec `;G01.F1i5
lOCa 1 i'ce,
CONTRACTOR: - L;.c:F'nr. - sr. Ls;. OWNER:
i^OE(G COId.`3( I"Itl(JDI'? J.85I9"C>rs n1G?4"?3A713 D'i?l'Ii;PJ L71?1?!
11 1 H A'JE S 'I 11D10EftL 1'.AP 'I"ft
C;i_k90hi.lNU1"ClN iTIiV 56420 i;dLA iJ MN 55123
(rnl?1 852-575Ti , 4 5G' I0.
I h'er•eby acknpw3ejae that: Z SZoue reack tha?,, i.iopl:ie?tion and .tats that Y.he
inTormation is ao[,rpcr an;1 ac1reo ta caniGltt wi.t'h aki a¢¢11cab.te 9tate a't Mn.
Stecutes and Cz 4y nT Eaqan Card.inanCes.
?
APPLICANT/PERMITEE SIGNANIRA
? ? ? v IC,4?
?C , )ISSUED BY SIGNA URE
I
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
, .• CITY OF EAGAN
3830 ?ru.or?xxo xD - 55122 NewConstructionReauirements RemodeUReoairReauirements
?
• 3 registered s@e surveys
? 2 copies of plans (includa beam & window sizes; poured fnd. design; etc.)
• 1 energy calculations
? 8 wpies of tree preservatwn plaa if tot platted after 711143
required: _ Yes _ No
DATE: ?9
DESCRIPTION OF Wi
STREET ADDRESS:
? 2 capies of plan
? 7 ske surveys (eMerior adddions & decks)
? 1 energy calculaUons for heatetl adddions
CONSTRUCTION COST: SDOCJ
LOT: BLOCK: I SUBD./P.I.D. #: oY\-L?
Name: (,) $?20 QX) r)F}&} Phone Q/A/
PROPER71' Lact First
OWNER o
Street Address: Al/ J?'Z
ciry ?'A
_64VI.J state: I'wt/. zsP: SS/13
Company: 9 i'z Phone (? tZ ) 9-57- F2.tA
CONTRACTOR 7CL
Street Address: ?'fC? ?r'? / / /IU s So _ License # _?34/_ 7gExp.
CiTy A 7 elG? L?? State: bFtJ. Zip: 0
ARCHITECT/
ENGINEER Company:
Name:
Street
City
Sewer 8 water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
Penalty applies when address
I hereby acknowledge that I have read this application, state that the infarmation is correct, and agree to comply with all appiicable
State of Minnesota Statutes and City of Eagan Ortlinances. _
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes
_ No
Phone #:
Registration #: _
State: Zip:
D J -- ,
?< < 5
Il ii
Tree Preservation Plan Received - Yes - No - Not Required
OFFICE USE ONLY
+-
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging K 16 Basement Finish
a 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addilion ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New x 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFOR MATION
nst
(Actuai)
C B
t ft C
d
C 44
.
o ? asemen
sq. . ensus
o
e
(Allowable) Main level sq. ft. SAC Code 6 f_
UBC Occupancy V - 'Pi sq. ft. Census Units ?_
Zoning (L-? l sq. ft. Census Bidg 6
# of 5tories - sq. ft. MC1ES System
Length - sq. ft. City Water
Width - Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building A. Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W 5urcharge
Treatment PI.
Park Ded.
'Frails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
P _ 0 4
zazz ?.+co.p.tse o?wa
C Mentlota Heiqhle. MN 53720 ?I
1•
" IF?l?J11A??i;A=b i. a.,. aewev?? ;(872) Oa1-1914 FAX: 8W-948$ i
........
? .. ...... ._ .... . .. . . _ . .. . ...--- _-" -..... '------- .._ .....- ...... ....... . _._..---"- ......
- - ---- .,- _ .. ..
. . .--- -- - -----
wn?ey-4r,.aC-er°ie?y,'! 825 HighwaY 10 N.E. i
Bloine. MN 55434
ON?3???' ?. (612) 783-1880 FAX:783-1883 f
TREE C TIFtCATtON ;
Ce? ot r: GR BROS. CONST_, IIVC. ; j
?rt + MH. i
vip,?0 K , R Y ODITiON (AMBERLEAF)
M6 , EAG M NESOTA (DAKOTA COUNT!) 9f'O.6
901.5
SCALE : t ?30' ?89 '?ef8$Y
i y
RENSED: 1-15 96
ree 1-m % Ca?S8
? Z_?z_ 1 tolo ? r ? ???? •?898 ?W ? ?
z Tree Protection #893e , `. ? ?, ? ?. 1, '„? Y`. `'•?? +'? ? '?--'?_? ---gO`
FanolTg
` R6l. Wall
? O TYP-
#sas'???.je 0jr2`'% 89'?• .?, oaY ?' -' '::? ? ?
?a
MM. dL..?yo
p 905 7 ? ' ?'y / „pe' .o • ?" ? ? ? ? ^ soa
906
#S06 ?,.. ? d `•-'- -__-?I i
m J SE E . - ,'T `. ? ,,
INV. 96.9 Y. I "y??
? ?A`91? :
3?;..,'?
$ic-x92Q,5--F--?
•#f820 _' ??.?co*??;4'.°? ... -??o i
• .7$ . ?°3p -? ? s?: '?-. 1o ?IGNIFICANT TREES SI1G39 -Sb?yEY
&o zs' wwTE wX (SAVE) 1 4
?si za s' wH? w ?ic (s?i?vEi RENI ?y OF3 7FiEE
si ; ? r?o o,°a K ?s?i??> 'fIOPd
19a zr aeo OAK (REMOVED PRIOR To 1/5/9e)7 C?At?? Pd?'? QPd?.'f
t99 15` WHI7E OAK (SAVE) I
100 10" RED OAX (REAIONED PRIOR TO 1 /5/g6)] /813 ta`? WHRE OAK (SAVE) i01 14 WMITE OAK (REMpVE-MpuSE P1D) i(914 8" WHITE OAK (SAVE)
102 tt' WHRE OAK (REMOV£-MOUSE PAp> #916 - Ap yAyE ?
103 13" WFi1T£ OAK (REA10VE-HOUSE PAD) #j17 9' RED OAK- Bl - '
104 15' WNITE OAIC (REMOVE-HpJSE PAD) y{955 11' NT1RE OAK (SAVE)
I
005 ia' wHrrE wx (rxoaovE-w/IN is• oF Nousc) #956 »- aeo owx (SAVE)
I
los zo` rsEo onx (SAVE) A te VfFiRE OAK (SAVE)
ro7 ,d- W,+rrE OAK (REMOYC-3' EL CHANGE) 9 ,. w.,ITE OAK c5,,vEj TREE SUMMARY
109 15 WHITE ONC REMp?fE-pRNEWAl7 C 14 WH?7'E OPK (SAVE) I
109 tY WF7ffE OAK REMOVE-ORNEWAIf) D tY RED OAK (SAVE) ?
110 78"'RW OAK CRE??-DRIVEWA`? [ /B' 1tE0 OAK (SAVE) a??r 7R?S S?VFD' 10 (OlR) •
Il t 20' WNRE OAK (REMOVE-DRNEWAl) F 8AId. EW (SAVE) spuNricoff TFAMS AF]/wD' 12 (39i
112 15' wHRE W.K (REMOVE-HOUSE PAD) " C 15' RED OAK (SAVE) rorK SOMMrICANT TPIEEft 31 IOOX)
raby cartlfy thnt th4* plan wos pfeparad by ma or under my dirset ?
arHNOn and that i pn a duly reqhts.a0 landscape Nchttect under I
Iwn of tfio State of Mtnnaaoto i
NED: PiQNEER ENdNEEPoNG. P.A.
DwTE: 2tZ?4
51 A RE OVMER/tYATt
_ , .. R?V_?? SEb zrz.T-?.
n r. r +
1a
?.^
V
TREE C
C?ficate for: ?
LOT 13 CK 1,
2 AMBERLE Il. EA ?
SCAIE : ???30'
REVISEO:
RENSS?Wp?:
REHSED:
? Trea Protection #893o
Feneing ?
I Ret. Wall
1 O jrQ- sin
4 MH.
_t
0+ \
90.rS 7
?
9061 ?
?
6
? 906.2
?
?
9
P.94
1 2422 Enterpr{se Drive r
h nnendoto Meighta. MN 55720
'; (872) 6fl1-1914 FAX:881-948$
- - ----- .._::. ---- _ ---- .._.._.......... ...._........
625 HighwGy 10 N.E. "
i; Blaina, MN 55434
(612) 783-tSM Fnx 7e3-tisea
TIFICATiON
;N BR05. CONST., IIVC.
' ADDiT10N (AM9Ef2LEAF)
MiNNE50TA (DAKOTA COUNTY)
9/ •?,.?g l g " "`"
•#920
IGNIFICANT TREES
190 zS wHfre o.vc (swvE)
19t 75 WHITE OAK ($qyE)
392 2C' WHITE ?K SAVE)
!SB tV WMI7E- OAK 9AVE)
S97 SS'_ RED O_NS (SAVE) !
\`'i7'?`? "___.soF
?895 ? , sar ? ?3 i
?
'
=i??r1?
---
4?,. ?Uik?S:• ::_?
03 -C , -
?
. ?
?
7
i92
14
924.7
)04 14" WHITE OAK
' REMOVE-HqISE PAp ,
' ?,914 8'_VjRlITE_OAK
i02 17
WHITE OAIC REMOVE-NOUSE PAD 8
1I?? 2V RE??OAK.-1
303 tS WHITE OAK (REMOVE-F10USE PAD) _
_
#
17
9 -
RED OAK-1
9-
)04 15r-WF4[TE OAK
" (REMOVE-FIOUSE PAD) q
? _
ii`,NRiRE OAK
105, 15
*WHfTE.OMC .(REMdJE-W/I!V 75' OF MOUSE) ?856 7? RED_qAK
308_ 20?_RED OMC (SAVE) ? \
',?L 14 WFIRE?OAIC.
i07 18"?WM1TE OAIC REMOVE-3' El. 'GHANGE) _
1?' WH(TE pN
i? 15• WHfTE-OAiC REMOVE-DRNEWAl7, ? OAK
?
i09 12" WHRE DAK RfMOYE-ORNEM'AY). O ED
t?' R OAK=
il0 18"?RED O.VC (RENOVE-DRIVEWAl7 E 7L•Y RED OAK
?11 2?aWHITE DAK (REMOVE-DRNE1YAl), F S Nd. EUA
i12 15' whlfTE OAK (REMOVE-HqUSE PAO) " G 15' RED CAK_
araby eerttiy that lhis plan was Drepwed Dy me or undar my dlroet
ierv{sipn and thot 1 pm o dury roq(sterstl Landstope Archlteet undar
. lows of ths Stota of Mirnsaoto
NEO: PIQNEEi2 ENGNEERING. P.A.
DATE:
._ ?
6#- 7_.
?
?
MH.
?•9pg
?
R, y?Q
9j*
9)@
`? I ..
- ozo
°Tp
?lsn??4 ?e?l ° 6
Tm "eeca ?- - - 6
; TREE SUMMARY
' gdlFRlA?ff 1qEES SAVFm 19 (e1x)
SlplIrlCAW 7REE;5 RF]MdJEDt 12 (391C)
?
I OTAL SICNFK' dNf 7RFES: 71 (1ODx)
9tl to" vad -- 1 L'V
qeo eY" 0.6? i-L? 4
Z ?01 - lY" :
Oak ? ' t ' M
y qor - Is" 0? . _ ? - t- Y
f? 9Dk-IP?? W(a _' I'r?M
LIIPIDGRffI
BROS' EXTERIOR ENVELOPE AV[RA6E U COMPUTATION
CONSTRUCiION
INC
935 [ Wayiala FIvd
Wayrtl?i
h4innr.;nla 55391
(612)473-1231
Site Address Lott3Block/
R& U Factors R U
Opaque Walls .043
Wall Framing Areas
Ceiling Insluation Area
Ceiling Framing Area
Rim Joist
Masonry Wall
Windows
Doars
Skylights
.09
.023
.027
.04
469
35
.31
.55
i) Lower Level (6asement)
Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Rim Joist
Exposed Block
Window Area
Sliding Glass Door
Door Area
7 lo
a 3 X (u)
? X (U)
-- x (u)
X (U)
.2? x (u)
? x (u)
?O x (u)
Total
.043 =
.09 = a. ?3
.04 = -
.132 = /SY'
.35 =
si
.??
1.Uf1DGREI1
BRO5'
2) First Or Main Floor
CONSTRUC110N
Total Exposed Wall Area
INC
Opaque Wall Area
lJood Frame Area
Rim Joist
Window Area
935 E Wayzala Blvd.
WaY711a Sliding Glass Door
Minnesola55391 Door Area
(f 12)473-1231
3) Second Floor If Two Story
Total Exposed Idall Area
Opaque Wall Area
Wood Frame Area
Window Area
Sliding Glass Door
Door Area
4) Total Ceiling Area
Wood Frame Area
Opaque Ceiling Area
Skylight
/70
? X (U) .043
x (u) .09
/7b x (u) .04 = ?/,D
4L ? X (U) .35 = f 7?/
'-' X (U) .35
x (U) .31 - 3S9?o
Total
A" ?
4o 7& X (U) .043 /
= /?.of0
/e X (U) .09 =
X (U) .35 = Soi
X (U) .35 =
X (U) .31 =
Total
AO42r
AOI'X (U) .027 = J/J
x (u) .ozs = ?. 32
X (U) .55 =
Total
-.' =.
Lu"raGREn
BRO5.
CONSTRUCiION
wC MINNESOTA U FACTORS Total Exposed Wall Area 4Z-3?pX .11
MINNESOTA U FACTORS Total Exposed Ceiling ?,J?
Area K X .026 ?/ 7
cn, -rota, = s? 9,
9,35 E. Wayrata [?Ivd
waYMla Item 1+ Item 2 0 7/ 2-r-Item 3/A 2-1 Item 447, G?? 429, (p/7
Minnesota 55391
(612)473-1231
If Total Of Items 1-4 Is Less Than Item (A), Buildiny Complies With
SBC 6006 (C)s
CITY USE ONLY RECEIPT #:
SUBD. DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH tL.Q. TOTAL
Shower 3.00 x
Water Closet 3.00 x 3_ = 9?
Bath Tub 3.00 x 2 = b. w
Lavatory 3.00 x
Kitchen Sink 3.00 x I = 3, c-o
Laundry Tray 3.00 x I = 3.?
Hot Tub/Spa 3.00 x
Water Heater 3.00 x z = 6. ?o
Floor Drain 3.00 x 6. vz?
Gas Piping Outlet ' minimum -1 3.00 x 3- ?
Rough Openings 1.50 x 3 ?
Water Softener 5.00 x =
Private Oispo5al " Dakota Cty. license 50.00 =
(new and refurbished systems)
U.G. Sprinkler " home under const. 3.00 =
Alterations ' to existin9 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL
,S 9. un .
SITE
OWN'
C lRn G?n /'1 c L ? /?n • ?-fi/ .L %-G .
INSTALLER NAME:
STREET ADDRESS: Cr?'F}]?ior-?('; ?-L .
CITY: S l'? ?} ? STATE: M? zi P: ?3 7 9-
y? 9 Z
PHONE #: vyS°-
. _?
L BL
SUBD.
OFFICE USE ONLY
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
: .
Please comrlele for. > all rr.mrrerc:,:lii ;dustrfal buiidings.
P multi-family buildings when separate pertnits are pg1 required for each dweiling
unit
DATE:
CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION _ ADD ON _ REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of conVact price, whichever is greater. State surcharge of $.50 per
$1,000 of ermit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER: _
ADDRESS: _
crrv:
PHONE #: SIGNATURE:
OFFICE USE ONLY
METER SIZE: DATE:
RECEIPT #:
SfiE. #
STATE: ZIP:
APPLICANT
_ INSPECTOR:
4?_1a, 53&
CITY USE ONLY
L ? BL ? RECEIPT #: A-5?7 /
DATE: -
h??.9?9(v
1996 MECHANICAL PERMIT (RESIDENTIAL) /
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? New construction Add-on fumace
Add-on air conditionirg Add-cn airexchsnger, i.e. Vanee system, etc.
Date: q "jry" 7 U/
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) 6, vc
? State Surcharge .50
TOTAL 150
SITE ADDRESS: 41605 &P°-?erI ea /' w/
OWNER
INSTALLER NAM
STREET
CITY: ?JQVQq e?
u
I
PHONE #: 73-f 3?
STATE: n,,A ZIP: -5?;,378
PHONE #: ( ?y/A) cs
1F PERIVII I IL?U
CITY USE ONLY
L BL
SUBD.
RECEIPT #:
DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? mufti-family buildings when separate permits are = required
for each dwelling unit.
DATc:
CGiJ"i'rwCT i `iii;c:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: o $25.00 minimum fee QC 1% of conUact price, whichever is greater.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 of pgm)2 fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:_
cinr:
PHONE #:
TELEPHONE #:
STATE: ZIP:
SIGNATURE:
SIGNATURE OF PERMITTEE
CITY INSPECTOR
C.T.TY pF F:ACAN
CA?;4!:CER ; r Tf::'RNSLNpI._ N0.^, flE,6
DA"fE„ !1:1./25/99 TT.P11::: 09:0:55
II?.
NFltfF r, T'H(7MAS I_ G{7E.Y7
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20e 9.f.1f1l 402 AI^SREF'tLElIF- 0.50
P'ntaT. feec:FZipd; Amc,s..nt-, 60.50
GR:L Oc? i.5c?
USE=fi :I (l r. NANrY
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MFI i-SIA.r31'q'1 83.0' MH C cr?^„-?,?,TC?c•?
5=0+50 ?
uav=so,.ao 5
C5=911.90 MH STA. 4+2 \
'. "'rAQ `
. . ,. MH ? °z-?T.,.-- {
' S=1+00
INV=904.61
58.9'
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. INV=904-A+3 905.10 ---- -- - --Q,-??
, CS=D?1.4.80.915.10 z9_2'?? ;
1 s=0+82 ''. `
INV=901..36
CS-91 t.36
{ :. ? .
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'__'____'__'____1
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27.5' 137.2' 37'-6'DIP, CL 52 ?
42.4' S=0r80 , GND. EL. 906.3
17 ' ;as.x' 6.8
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INV=900.04; 1T1H. EL. 908.52
et.2' CS=950.04; I C.O. 907.0
? 1-B"-45' BEND 1 ? 6 ? INV=896.53 ? i
i
'HYpRAN --.,.__ 5=1+21 95.0, 1 4 ?
8"x 6' 7EE '--..._ INV=896.9 S S} o I?
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IGND. EL. 914.2
TNH. EL. 916.4 5=0a27 1 -'- ., - C5=906.3 ' I I I
INV=905.23'.
37.0' 18 C5=915.23 . '. '-. ? .?
?1-8.._45' BEND 917.3'-.
5318' .. : ... i ._ - ""' "" .0.
STA. 0+39 INV=904.0 ''• :\_,? )RI
kL?"' ' MH
.75.0 ' , z.3? RT 15
5=0+26 1
INV=898420? 1'1+76
CS=908.20', 1 S--i+B&
,,,,'/• ,,,. INV=904.0 0 END
1_8?._?T?°L? CS=907.0
45' BEND
1-8' C.V.
'acunvc ai i ir rnuucrY,
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I
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TO EXIST. 8` DIP W.M.
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NOTES:
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STAT10NE0 FROM DOYMSTREAM MANHOLES.
2. AlL SANITARY SEWER SERVICES SHALL I
BE 4" P.V.C. (SDR 26).
3. WATEk SERVICES ARE 3' UP57REAM FROM
SANITARY SERVICE.
4. ALL WATfR SERVICES SHALL BE t'
(TYPE "K') COPPER.
5. ALl D.I.P. WATERMAIN SHALL 0E CLASS
52 UNLESS OTHERWISE NOTED.
6. EXTEND SERVICES 15' PAST PROPERTY LINE.
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2 0 1 2 R.P. 2479 11
For Office Use
C ItV of Ea a~ Permit
Permit Fee'N 0 2 ,2009 _~b
J
3830 Pilot Knob Road
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 01
Fax: (651) 675-5694 Staff: I
- - - - - - - - - - - - - - - J
2009 MECHANICAL PERMIT APPLICATION
Dater-2c -cc, Site Address-
Tenant: Suite
RESIDENT / OWNER Name: _SLA JI JL'llYl Phone:( Address / City / Zip: Ti,
CONTRACTOR Name: License
Address: 3451 W. Burnsville Parkway
Suite 120
City:
State: Zip:
Burnsvi'le, MN 55337
Phone:g - tL.( Y t Contact Person: L Yi.
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work:
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install / _ Remove)
When installing/removing tank(s), call for inspection by Fire
C+ther 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)
$ CC TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$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 = $ State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ 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 approved
plan in the case of work which requires a review and approval of plans.
x E r a::i x
N
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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117174
Date Issued:10/16/2013
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
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 -
Daniel T Osborn
4182 Amberleaf Tr
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119608
Date Issued:12/09/2013
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Daniel T Osborn
4182 Amberleaf Tr
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA127197
Date Issued:09/23/2014
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Gas Grill
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ben Radant
2075 67th Street E.
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Daniel T Osborn
4182 Amberleaf Tr
Eagan MN 55123
Mid State Plumbing & Heating
2075 67th St E
Inver Grove Heights MN 55077
(651) 480-1195
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA141127
Date Issued:02/21/2017
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Daniel T Osborn
4182 Amberleaf Tr
Eagan MN 55123
(612) 247-9154
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA172978
Date Issued:10/25/2021
Permit Category:ePermit
Site Address: 4182 Amberleaf Tr
Lot:13 Block: 1 Addition: Rooney
PID:10-64560-01-130
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Daniel T & Cheryl B Osborn
4182 Amberleaf
Eagan MN 55123--149
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature