4184 Amberleaf Tr?1 g 11 ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681•4675
New Construction Reauirements
• 3 regate2d site surveys slwwing sq. iL of lot, sq. ft. of house; an?ll roofed areas
(20% ma)dmum bt coverege albwed)
• 2 mpies of plan showing beam & window sizes; poured found design, etc.)
• lsetofEnergyCalalations
• 3 copies otTree Preservation Plan if lot plaHed after7l1f93
• Rim Joist Detail Options selection sheel (bidgs wiUi 3 or less units)
DATE 0
JOB SITE
IF MULTI-FAMILY BUILDING,
PROPERTY <
TYPE OF W(
APPLICANT
ADDRESS
PAGER #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULI?S 7672
- New Energy Code Worksheet Suhmitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Confractor:
Mechanical System Includes:
Sewer/Water Contractor:
All above informaUon must be submitted prior to processing of application.
Phone #
Phone #
s "?? (D C) 0
I \- i3-a?
Fce: $90.00
Pee: $70.00
xrect, and aaree
I hereby acknowledge that I have read this application, state that the inforrr
with all applicable State of Minnesota Statutes and City of Eag rdin c
Signature of Appllcant
Certificates of Survey Received _ Tree Preservation Plan Received _
_ Water Softener
_ Water Heater _
_ No. of Baths
FIREPLACE(S) _ 0 C.JJ 2
? ONE#
?
r ZIP CODE 2)
RemodeVRenairReauirements
. 2 capies of plan
• 1 set of Eneigy Calalations for heated additions
. 1 site survey for exterioradditions 8 decks
• Indicate'rf home served by septic system for addPoans
VALU,410N
Phone #:
Iawn Sprinkler
No. of R.I. Baths
_ Air Conditioning
_ Hcal Recovery System
Not Required _
Updated 1101
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
O 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 (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq, Ft. PRV
Nhr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addirion)
Foundarion
Drain Tile
Roof Ice & Water Final Other
Framing _ Pool _ Ftgs _ AirlGas Tests _ Final
Fueplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
Insulation _ Windows (newheplacement)
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
FinallC.O.
_ Fina]/No C.O.
_ Plumbing
HVAC
RESIDENTIAL
BUILDING PERMIT APPLICATION
a? CITY OF EAGAN ?`
3830 PILOT KNOB RD - 55122
651-681-4675
NewConsWetlon ReauiremeMS RemodeVReoairReauiremenls
• 3 registered sde surveys showing sq. ft. of lot, sq. ft. of house; anll roofed areas • 2 wpies of plan
(20%meximum lotcoverage albwed) . 7 setof Energy Cakulations for heated additions ?
• 2 copies af plan showing beam & window sizss; poured found design, etc) ,• 7 site survey for ezterior addifions 8 decks
• 7 setof Energy Calculations . Indicate if home served by septicsystem foraddiGons
• 3 copies of Tree Preservation Plan if bt platted aiter 711/93
• Rim Joist Detail Options seleclion sheet (bldgs with 3 or less units)
DATE VALUE[ION
JOB SITE ADDRESS 1411 f y 149',1415 9t G,Sq.F /r'
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER ! S?/1 Y Y,4-tl
TYPE OF WORK FIREPLACE(S) _ 0)( 1_ 2
?
APPLICANT?nn? PHONE#9?z-srs-/-925Yr
ADDRESS 47030 '?.4 4 S?. ZIPCODE .5-S /Z3
PAGER #
CELLPHONE# 9SZ-2oo-?G?S FAX# ?S2-9-JN-9')y^J
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category
(check one)
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Conhactor:
MINNESOTA RULES 7670 CATEGORY 1--? a-
- Residential Ventilation Category 1 Worksheet Sutirip ?l (1-
- Energy Envelope Calculations Submitted
No v
MINNESOTA RUI.LS 7672
- New Energy Code Worksheet Submitted
By
Water Softener _
_ Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
Phone #:
Iawn Sprinkler Fee:
No. of R.I. Ba1hs
_ Phone #
Fee:
Phone #
$90.00
$70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Stafutes and City of Eagan Ordinances.
Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/01
??
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling 0 OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened)
? 05 03-plex ? 11 10-plex ?19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PIbgXY or _ N ? 25 Miscellaneous
? 31 New 9 35
? 32 Additian ? 36
? 33 Alteration ? 37
0 34 Replacement
Valuation /_ `
Census Cod
SAC Units ?
Nbr. of Units -"
Nbr. of Bldgs -
Type of Const v -N
x
-x
Other
_ Pool Ftgs Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 30 Accessory Bldg
O 31 EM. Alt - Multi
? 33 Eut. Alt - SF
? 36 Multi
Int Improvement ? 38 Demolish (Interior) ? 44 Siding
Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
`Demolition (Entire Bldg only) - Give PCA handout to applicant
Occupancy ?- 3 MClES System
Zoning City Water
Stories Booster Pump
Sq. FL PRV
Length ,37 1 Fire Sprinklered
Width 16 '
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck) ?Xx FinaUNo C.O.
Footings (addition) Plumbing
Foundarion HVAC
Drain Tile
Roof Ice & Water Final
Framiug
Fireplace X R.I. X Air Test X Final
Insulation
FinaUC.O.
?, oW SR- Li'ivf. (.. /vI f I f
W Z()06 6J V,4C U4770.?
r
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
IE?? t?? l:??,rr ?
I.; ? r1NftF Fri I A ! 1 iti t)N =; 1 f 14 uP1W,
4?1PJ1°'r' 111.' r,>r,li
PERMIT SUBTYPE: TYPE OF WORK:
,,, ? ;. :,f w
INSPECTION .. , D.
I
?
I
? ?
I
Permit No. Permit Molder Dete Telephane R
ELECTRIC
PLUMBING
HVAC
Inopectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DFCK FlNAL
INSPE
CITY OF EAGAN
3830 Pi4ot Knob Road
Eagan, Minnesota 55122-1897
SITE ADDRESS:
N RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
R?
r i ff,?
}'. 1 , PI • : t+q hrrV1• ! 7er -10.1 -
tf?fe 44 t3?ri f K.
ApIEiF Rt f Af' T'ft
? J.
;, . .
PERMIT SUBTYPE:
PnW 114 ? .;,;4f ! M i'! . ?
, APPLICANT:
TYPE OF WORK:
I i , !,?FhF;k"`;: '3FspkAlf f4. Fr14 j t'-• ftF_Oll'Itil=0 Y014 ANY i l I i: rR Ir'A1 IlhT F'I 1fM131Nf.i 440k1
Permit No. Perml4 Holder Date Telephone N
ELECTRlC -7 97 *t
PLUMBING ? // ? k.,
HVAC
inspection Date Insp. Commenta
FOO71NG5
FOUND
FRAMING
ROOFtPlG
ROUGH
PLUMBING
PLBG
AIF 7EST
ROUGH
HEA7ING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FlNAL ,1/1;y
LJ
DECK FTG
DECK FINAL
CITY OF EAGAN
I N REC4RD
? 3830 Pilot Knob Road
, Eagan, Minnesota 55123
(612) 681-4675
I SITE ADDRESS:
PERMIT SUBTYPE:
PERMIT TYPE:
Permii Number: ?
Date Issued:
14 iq l ,,, P , APPLICANT:
4 i 3 - I ..' ,5 1.
TYPE OF WORK:
INSPECTION ., . .•
i 1 Pi/?) I S f:+? , I?!7 !
? ilxs, •;, b w F' i t,K jf,i" N: RYAr? IA hx,
I?
?
?
?1 ?
Permit No. Permit Holder Date 7elephone ?i
SNV
PLUMBING
HVAC
ELECTR
ELECTR (? , 1 / ry 95 ??D
inspectlon Date Insp. Comments
Footings I r
? 714 tl
Foundation
Framing
Roofing
Rough Pfbg. ? j., rY,S? - Ia ???? 4?7?
Rough Htg.
[ /c
Isui. Z/2L
Firepiace
Final Htg. _ M
Orsat Test
Final Plbg. „9 5 Plbg. Inspector - Notify Plumber
Cottsi. Meter
Engr./Plan
J
Bidg. Final
Deck Ftg.
Deck Final
Wetl
Pr. Disp.
?
? Z r
? L,
'.. ; h J
?
?? -'"
-- - -- -
/lddtes.s 4184 ArmERLEAF T[tAii, Zip 5512 3
I.ot 14 Blk 1 Sub
THBSE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: c23 95 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage) j?
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
Sod/Seeded grass
TraiUcurb damage v
Porch ?
Basement finish q/
Deck
Please verify wi[h the builder the removal of roof test caps from the plumbing system and ihe shu[-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in righlof-way or installing underground sprinkler system.
White - Ciry Copy Yellow • Resident Copy Pink - Conlractor Copy ?
??oia-?
??2 595 0`70°°
?
ReOUest Dete Fre No Fouq Inpsectan RapwreO InsOeclion OMer T a ugn-In
(YOU sl call ?eclw when reatly) [] qeatly Now Will Notlly InsOWor
es ? NO Date ReeC
I censed contractor Downer hereby request inspection of above electrical work at :
Jab Atltlress IStreeL Box or Foule No ? Ci1y /J
?-i
C!G
Section No Township Name or No Renge No Counry
OccuD (PRINT)
do Ppone No
plier
o hl
'
z?-e" AOOress
Elecmcal Conlraclor iCOmpany
I Name) ConvactorS Lirense No
Mailinq AtlttressM ngCALw&hjffiFrj.C r
?t
AOI
- STH ST. W_, FGTN .,
qmhonzetl Si ?Owne akiog nwallation ' Phone Number
` J
MINNESOTA STATE BOAHD OF ELECTPICITY THIS INSPECTION REOUEST WILL NOT
GrlggsMlEwey Bldg - Room S-173 BE ACCEPTED BV TNE STATE BOARD
1821 Umversity Ave. SL Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phane(bt2) 642-0800 ENCLOSEO.
? 7f
REQUEST FOR ELECTRICAL INSPECTION
2 ? ? See instmcLOns lor compleLng this lorm on Dack of yellow copy
? X" Be/ow Work Covered by This Request
E&00001-08
F :? Q
e Atltl Rep. TypeofBwltling ?AppliancesWired EqwpmentWireU
Home Range Temporary Service
Duplex Water Heater EleclriC Heating
Apt Bwlding Dryer Loatl Management
Comm./Industnal Furnace Other (SpeciTy)
Farm Air GondRioner
Oiher(sVenlyl Convactor5 Remarks
Compute /nspecbon Fee Below'
# Other Fee # ServiceENrenceSrze Fee # Qrcuos/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspeclor's Use Only;
/ TOTAL 5 O
Irngation Booms ?
?? ?
Speciallnspection .
-
nlarm/Commumcaoon THISINSTALLATION MAY BE OR PISCONNECTED IF NOT
Other Fee COMPLETED WITHIN ONT
I, the Electrical Inspector, hereby R°°9n-m .., e
? oate
certity that Ihe above inspection has
been made. Final o i
OiFlCE USE DNLY
This reques[ voitl 18 months Irom
s(-
b 2 5? 1jjWg, arv
NZL?po
Fepuest Date Fn N Mln InpsecLan Fepwretl InspeRion Other T FougRln
u r w
n ready)
u 1 c
a
ll
specto ad,
NOw
?
WAI Notify Inspector
11 _? _? ?
?
?
?s
N? 1e Ra
tly
Xlicensed coniractor Ll owner hereby request mspection of above electrical work at:
Job AOtlre1ss ISireel Bor o, Route No ? Pty
Sec?lon N.
TOwnShip Name ol NO
Fky. NO
C.
Oc u t(PRiNT) Phone No
PowerSupplre Atltlrass
?
I
Eleclncal Convactor ICOmpany Name, Contracror§ License No
Mailing Atltlress IConlraclor or Owner Maxin Installalion
CITIES EIECT?ttC, It?C.
CA0038t
3100-225TW Sl", W.. FGTN., KtJ 55M
Autnonzetl Signawre nvacio^Ow Makmg Installa none Number
P
MINNESOTA STkrE BOAPD OF ELECTRICITY ? THIS INSPECTION REOUEST WILL NOT
Grigqa-MlCway Bldg - qoom 5473 ?QjN.p BE ACCEPTED BY THE STATE 90APD
1821 Universiry Ave.. St Paul, MN 55104 (v? UNLESS PFOPEF INSPECTION FEE IS
Phone(813)642-0800 J ENLLOSED
I/7/IS REOUEST FOR ELECTRICAL INSPECTION
lo See mslmctions for compleM1ng Ihis lorm on back o1 yellow mpy
22595 "X" Below Work Covered by This Request
°="•"`'t, 7ee-ooaai-oe
'6???,
??1?.
ew YRi FYep - TypeolBmlding AppliancesWVed EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Builtling Dryer Load Management
Comm llndustnal Fumace Other (Specity)
Farm Air Condrtwner
Other?sVecity) Conbaclor5 Remerks
Compute Mspechon Fee 8elow.
# Olher Fee # ServiceEniranceSize Fee # Circuits/Feeders Fee
Swimming Paol D to 200 Amps
fi> j 0 to 100 Amps 40
Transtormers Above 200 _ Amps oo _ Amps
Slgns Inspecmr§ use only Tp7AL -5*C)
Irriqation Booms
??
Spectal Inspection
AlarmlCommunicauon THIS INSTALLATION MAV B ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18'MONTH6 .
I, the Electncal Inspector, hereby Rougn-in
certify that the above inspection has been made.
OFFICE OSE 9NLV
Tnis request vaitl 18 monihs from
2 1 T? 5 8 9
PLEASE RINT OR TYPE OFFlCE USE ONLY This request wid 18 monMs Imm mlidafion daie pnnted in Mis box x 9 /
?q ;.
Q ?
414 IUij ? D
Reqvesl Rough.in ?- pecnon requ' ? ? N.
(YOV mvsr wll tha inspedar when reodyJ Inspea,on Other Than Ro-gh-In: 0 Reody Naw 0 Will Call
Dare Reedy
I, icensed contracfor ? owner hereby requesf inspecfion of the o6ove elecfrical wark at:
Job Mdrcps (Slrcet, B, or Roab ?
?
lj* &ea- Gry?
rr.,srG Zip Cade
Secnon No Township Name ar No. Ronge No Fre No. Counry
Occupp
Gnt
y`
Pho/ne N/o/ 7
WOVJ !
Power Soppliar Mdress
Fecmml ? (Campany Name) ?
, G Conkacror Lcense Na Maskr bc N. (Plont Eled Onlyl
MaiLn Addrma (Contmcior or Owner Performmg Installobon)
AWho Sigrw Conhacbr or mrP d I mllolionl Phone No
?,t"-306 3
EB-OOOOlA10 6/95 STATEBOAND COW-SEEINSTRUCTIONSONBACKOFVELLOWCOPV
REQUEST FOR ELECTRICAL INSPECTION 1(079innes ?
I?II IIIII IIIII I?? II INI +I I II I I II II M821 U? ersity AvearRmf S 28c5 Paul, MN 55104
* 0 2 7 4 ? t4 9 1 * Phane (612) 842-0800 /? 7?j ?
Home Duple: Apf Bldg. Otner ? New Addn
Commerciol Indusirial Farm Remod Re air
Air Cond. Htg. Equip. Water Hfr. Load Mgmf. ? ? /?!
OI r.
x `
D er Ran e Elec. Heat Tem . Service e
eA`."
"X" abave ihe work covered by this request. Enfer remorks in this space and on the back of the white copy only.
ol FiL wt
tL 'v(,Q? juxyC - Ltt ? Dool2
Calculofe Inspedion Fee - This Inspection Request wdl not be occepled wdhout the mrrect fee:
Olher Fee 3f` Service Enhance Size Fee # Circuih/Feeders Fee
Mobile Home Paik Stall 0 to 200 Amps 0 to Amps
Sfreet L}y,/rraHic $ig. Above 200 Amps A ove 10 Amps
Tfansformer/Generafor INSPEC70P'sUSEONLY TOTAL
$ign/Oufline Ltg. X{mr.
Alarm/Remote Conirol
$wimming Pool
I hareb cati thm 1 ins ened the ea-al im?allanon de:rnbed herein on Ma d6tes ablcd
Inigahon Boom Rough-In U.I.
$
ecial Ins
ecfion
p
p
Invesfignfive Fee Final
w
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
? CITYOF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-64560-140-01
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4184 AMBERLEAF TR
LOT: 14 BLOCK: 1
ROONEY
< Q>???
BUIL
024734
10/18/94
DESCRIPTION:
Bu'ilding',Permit Type SF DWG
guilding Wcs,rk Type NEW
"'UBC Oocupancy,,, R-3 M-1
' Construct3on Typ.e V-N
?Zoning R-1
i Building Length ) 76
?
Building Width 40
? Building stories ' 2
'' - _Square Feet 2,705
C(;ZL u5 J???11L2?
REMARKS:
S& W PLBR - GENZ-RYAN PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
VALUATIDN
$1,059.50
$688.68
$110.00
$8@@.00
100
$2,658.18
$220,009
MISCELLANEOUS
Total Fee
CONTRACTOR: - Applicant - sT. LIC
LUNOGREN BROS CONST 14731231 0001413
935 E WAYZATA BLVD
WAYZATA MN 55391
(612) 473-1231
$1,828.50
$4,466.68
OWNER:
LUNDGREN BROS CONST
935 E WAYZATA BLVD
WAYZATA MN 55391
(612)473-1231
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply,with a11 applicable State of Mn.
Statutes and Gity ot Eagan Ordinances.
L A T E MrrEE SIGNATURE ? ISSU BY.6MATURE
J
1404
1994 BUILDING ERMIT APPLICATION ? I.
??
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 regis e s r , 1 copy of energy
calcs. LL' ' u ,
,
?
,.
..
,
COMMERCIAL 2 sets of architectural structural plans, 1 set of
specifications, 1 copy o --" " ----
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 10 Valuation of work
Site Address:_ TTrM?-r_r 1'5_;z ?lfG?? l
STREET SUITE #
Tenant Name: (commercial only)
IAT ? BIACK SUBD. ?1?
?
F P.I.D. #
0 6 N-4
Descri tion of work: ',,) eKS c-
The applicant is: 9 Owner K Contractor ? Other (Describe)
Name (aVV-w- _&05 . C'ny?5 l Phone 73-1a3
Property LAST FIRST
Owner Address j?.5 ?_.l,J
STREET STE #
City State rv- Zip Gv53 1
Company Phone
Contractor Address ? License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address "
City State Zip
Sewer & water licensed plumber N Z. Processing time for
sewer & water permits is two days once area ias been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances. 9
.
Signature of Applicant:
4?4?
OFFICE USE ONLY
BUILDING PERMIT TYP E
-?-
s
El 01 Foundation ? 06 Duplex ? 11 Apt./Ladging ? 16 Basement Finish
q 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Parch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc.
0 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
A 31 New ? 33 Alterations O 35 Tenant Finish [1 37 Demolish
? 32 Addition O 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable) " /l? Basement sq. ft
l
t F1
f . 1823 MWCC System ?
s
. sq.
t. ? City Water
UBC Occupancy 2 3 -i 2nd F1. sq. ft. ,?zz PRV Required
Zoning R_/ Sq. Ft. total P Booster PumP
# of Stories Footprint 3q. ft. z, xs w15+-Fire Sprinkler
yD
Length On-site well Census Code <o?
N*"'
Depth va On-site sewage ?(7*o.jf'q)SAC Code oi
Census Bldg i
APPROVALS Census Unit
L
_
Planning Building r'N<aAssessments
Engineering Variance
REGIUIRED IN SPECTIONS
? .Site JR Fo oting 0-Framing 0,Jnsulation
? Wallboard CU Fi nal ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pi.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
vaiLiac;oo: g Z ZO, aoo
Z X yv = So
3yxsy = %g7?
!z x z a? = < s? >
> / >
:3x7 Z
4 bes x sYa,l/oi, &
67R4
??.sx zi.s> _ <3z >
?/a x237 =GZ???
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P-01
•- 2422 Enterprisa Drlve
? * * Mendoto Helghta, MN 55120
* ? (612) 681-1914 FAX:681^9488
LhHO SVRW?e • CML ENCMEERS
* lAmo vurw,aes. w/WAvc N+c^TaTS 625 Hlghway 10 N.E.
• Bloine, MN 55434
**4t * * (612) 783-1880 FAX:783-1883
Certificate of Survey for: LUBNDGRRENF BROS. CONST.
?
4 h
? HYQ9 906.4
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TOP Of PIPE
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]EACiARTE SID"E G 'ER GDE?: / REARGAR.SFSET??l15E1DF
PIONEER ENO. DiFFLEY RD. 50FEET
PROpo4D GNADES sioMN POt CRAOWO PLAN BY:
NOIE: BU0.0Na p1E)190N4 9HOw1 NE PWi NORIZQNTK AND YERIICK p p? 1HAM TqBE 910M? dl M TPEOpIOED PU??'TS
?ocAna ov simicivi+?s aax = uiaa'r[ciuK rw+s F'ort auwwo
AlID FOIMDAl10N OWQ190NS
NOTF, amiTRAcxR yUyT VOWy pMVEWAr oESK SCALE : 1 INCH = 40 FEET
rare: ra VEanc saas aVfsnoAnau ws am+ OMKO?n on tws eEAs+as eNO+w w+E esxWFD
LOT BY TE AIMvEYM 1ME 9NRAAUN 43F Os T? ?PPOR7 TNE
8PEQ1C HWSE PROPCg'u IS NOT 7FE RF.W04NiY OF 1ME 9VM1E'N2. -pROPOS.m N 1SC FVAII
x ooo.oo Denotes Extaling Elevotton Lowest fryoor Elswlion:
( ooaoo ) Denotes Propoaed Elevotlon
Denotes Oralnaqe de Utflity Easaneni T?p of B?odc qevatlon: Z ?
Denotes Drolnoge Flow Olrectlon
-?? Denotes Alonumsnt Gorage S1a6 Elewtion:
---R- Denotes Offset Hub
TMAT THIS IS A 1RUE AND CORRECT
LUNOGREN ?ARIES OF:
REPRESENAT10N OF A SURVEY OF TNE BOU
LOT14 , BLOCK I, ROONEY ADD{TION
OAKOTA COUNTY, MINNES07A
I7 DOES N01 PURPOR7 70 SHOW IMPROVEMENTS OR ENCHROACHMENIS. EXCEPT AS SHONM, AS
SURVEI'EO BY ME OR UNDER MY DIRECT SUPERVISION THIS DAY OF OCT. , 1994.
?Jru?7os.? C?.•v IGN
p< ? PIONEER ENq `INC' P.A.
r1 > ?i ?d r/_
GU??J? GAR-
LOT BIIRVEY CHECICLSST FOR ItESIDENTIAL
BDILDINC BERMIT ]1P71Z TION
? 4ROP£RTY LEGAL
? ?
Date of 8u eys /0/ 7 / -?'i
DOCUMENT BTANDA S ?'?"`r
S? 0 • Registered Land Surveyor aignaLUre and eompany
j? 0 • Buildinq pexmit Applicant
• Legal descriptioa
0 0 • Address
D • North arrow and-ba= scale
? 0 • House type (rambler
split w/o, split entry,
walkout
,
,
lookout, etc.)
? D • Directional drainage arrows with alope/qradient t.
? 0 • • Proposed/existiag aewez and water services
? ? • Street name
0 • Drivevay
ELEVATIOHB
Exietina
8`10 D • Sewer service
B' 0 0 • Lot corners
0 • Top of curb at the driveway
D H" O • Elevations of any existing adjacent homes
BrenoaeC
D-113 0 • Garage floor
B?0 0 • First floor
• Lowest exposed alevation (valkout/window)
8
'? 0 • Froperty oorners
-
i? n 0 • Front and rear of home at the foundation
D 2'?-0
• PONDING AREAB (ii ao813eab1e)
Easemerst line
0 0' D • xwL
D 6' D • awI.
D 0
'? • Por?d f designation
?
D D' O • Emergency Overflow Elevatioa
? D
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ac
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D'' D D • Proposed home dimensions including any propoaed decks,
overhanga qreater than 21, porches, etc. (i.e. all
e structures requiring permanent footings)
D D • Show all easements of record an8 any City utilitiec within
? D those easements
d
t
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ruc
ure an
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D • Retaining,aeil,rAuirements, iP any
October 1992
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37'-6"DIP, CL 52
GND. EL. 906.3
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INV=896.53
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INV=$97.13
CS=906.3
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INV=904.0
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INV=904.0 O END
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Dele 5-52-94 $HEET TITtE
Q. We'rM I.A AIN
0
MnDGM
BROS. EXTERIOR ENVELOPE AVERAGE U COMPUTATION
CONSTRUCTION
INC.
HEATHMAN PLM
Site Address#/o'%' Ado tQQfi{'cuI Lot?14 Blockjj4
R & U Factors
935 E. Wayzata Blvd. Opaque Walls
Wayzaia Wa 11 Frami ng Areas
Minnesoia55391 Ceiling Insluation Area
(612)473-1231 Cei 1 i ng Frami ng Area
Rim Joist
Masonry Wall
Windows
Doors
Skylights
1) Lower Level (Qasement)
Total Exposed Wall Area
Opaque Wall Area
Wood Frame Area
Rim Joist
Exposed Block
Window Area
Sliding Glass Door
Door Area
R U
.043
.09
.023
.027
.469
.35
.31
4-S7o
a??a X (U) .043 = y 3?
X (U) .09 = v7/ ?
r X (U) .D4 =
ZZ? X (U) .132 =
3.5, X (U) .35 =
(yO X (U) .35 = c2 ?
X (U) .31 = 'r
Totat ?OD, ??
LunDGM n
BROS.
2) First Or Main Floor
CONSTRUCTION
7ota1 Exposed Wall Area
INC
.
Opaque Wall Area
Wood Frame Area
Rim Joist
Window Area
935 E. Waynla Bivd.
Wayzala Sliding Glass Door
Minnesola55391 Door Area
(612)473-1231
3) Second Floor If Two Story
Total Exposed Wall 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
//- n 2-
X (U) .043 = ?SD(p
? X (U) .09 = ? ??--
X (U) .04 =
3,:?S'x ( U ) .35
CO? X (U) .35
J?(p X (U) .31 = /? ??
Tota 1
141&:?
L14 7 X (U) .043 = 7??p0
/?j X (U) .09
X (U) .35
X (U) .35
X (U) .31 =
roca l /3 3 13
/Scl7
X (U) .027 = 10?13
/70 7 x (u) .023 = 35, 26
X ( U ) .55 = °-j
??1, 3?
Total
` LunDGR(n
BROS.
CONSTRUCTION
iNC. MINNESOTA U FACTORS Total Exposed Wall Area Ll03d,X .11 = L144el/,?
MINNESOTA U FACTORS Total Exposed
Area Ceiling
026
2&2 X
= ?
3 2--
. .
(A) Total = z1%3 fr)
935 E. Wayrata Bivd.
Wayrata Item 14?, Z-1 + Item 2"6,/ + Item 3/33i3+ Item 4??3
Minnesola 55391
(612)473-1231
If Total Of Items 1-4 Is Less Than Item (A), Buildiny Complies With
SBC 6006 (C)s
I?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
mo& P(O5v
/r1113PG
15
BUILDING
027530
05/13/96
SITE ADDRESS:
P.I.N.: 10-64560-149-01
4184 AMBERLEAF TR
LpT: 14 BLOCK: 1
ROONEY
DESCRIPTION:
DECK
NEW
434 ALT. RESIDENTIAL
s? :ga
ry?,ew
?,?: ;;iz '.?-?'?, paY . _ i?s_7
sc. ?;?? a`?i. aH re`??
-m?'.?>' ?3v
?A???_ ,?:????,p_ ?.?at???
gf . ?'?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search Fee
Subtotdl
$45.00 COPY
$.50 Total Fee
$50.50
$.50
$51.@0
CONTRACTOR: - Applicant - ST. LZC.OWNER:
GOETZ CONST TMOMAS 18519258 00@3478 RYAN MIARILYN
9030 11TH AVE S 4184 AMBERLEAF TR
BLOOMIN6TOM MN 55420 EAGRN MN 55123
(612) 852-9258 (612)686-7696
_ F_ , i.ap ? s sn .L ' W' I he r,eby acknr'??es?ge Cft,?? I klar'? d pati0q and ?t??e ?Prdt°'the -_,
3rrfnr-fn4'?la? r°a.? 'a 't? ?qfnply ui?h ?11 aP,Pl?cabla e ?af Ptn St?tut?s' an?lµ t,`?'ty.`?'? ??ac?anfOr?artar?cs?s' H? s ` f`
.,?
-
P n iP p.j,LI 1h.?
ISSUED 8 SI ATUFE
?
CITY OF EAGAN ?
???0 3830 PILOT KNOB RD - 55122
1996 BUILDING PEaMIT APPLICATION (RESIDENTIAL)
681-4675
New ConstrucNon Reaulremenla RemodeURepair Reavirements
? 3 registered aite surveys ? 2 copies of plan
? 2 eopies of plans (include beam 8 window sizes; paured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ?
? 1 enargy plculaUons ? 1 energy calculaUons for healad additions
? 3 capies of tree preservatlan plan if lot platled after 711/93 '
reqWred: _ Yes _ No '
DATE: 1T5Ce CONSTRUCTION COST:
DESCRIPTION OF WORK: c K
STREET ADDRESS:
LOT ? BLOCK q/o ? 4) & 4't`
SUBD./P.I.D. #: 2?n
?
PROPERTY Name: R1'AO &/1 IL i?i) Phone #:
OWNER W•
Y/ r4l rinm
"'16f
4 FR"T A
A
?Tn4?
Street Address ,
e ,
City: 2A4 nAJ State: Zip:
coN7ttac'roR Company: 1y-co?c Phone #:
Street Address: R03 0 License #:
City: State: 6\A) Zip: ?{20
ARCHITECT! Company: Phone #:
ENGINEER
Name: Registration #:
Street Address•
City. State: Zip:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and Ic;
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ? ?
OFFICE USE ONLY -
?
Certificates of Survey Received _ Yes _ No RECEodED
- MAV 3 8 t9S6?--?
Tree Preservation Plan Received Yes. - No
OFFICE USE ONLY
BUILDING PERMIT TYPE
wr. - ar
r ?
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dweiling ? 07 4-piex o 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ? 20 Public Facilify
? 04 SF Porch ? 09 12-plex ? 14 Fireplace o 21 . Miscellaneous
? 05 SF Misc. ? 10 = plex ?15 Deck
WORK TYPE
,,;?1 New o 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
? Building
Engineering
Variance
`7?y
?
?-
?-
Permit Fee
Surcharge
Plan Review
license ?
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
51W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
% SAC
SAC Units
(612) 881-1914
y w?? uno wn?.my • ow? cnw?..... ._
? e? Wq P?,µwxg. uHOw,vc mta^?T= 625 NVghway 10 N.E.
Blaine. MN 55434
** ? ** (612) 783-1880 FAX:783-1883
Cert+ficate of Survey for: LU B NDGR R?IIF BROS. CONST. INAIL
4 ,
? HYQ ?
? 9062
O
htr
Q ?
906.? ?? i
906.5 -,1005A'
\ ?906.4
B --
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1 ?OI?
¢??1
909.3
ENCH MARK x
OP OF PIPE a
LEV.=921I7 b
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/ ?'TOP OF PIPE
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!
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? B IT. PA7H
gtTBACK REQUWEMEN7S
lq? fRONT 28 FEET
.?G? ? (?, ? E?, G DEpT SIDE GAR. 5FEET HOU9f IOFEEI
REAR IS FEET
PIONEER EN(i. DIFFLEY RD. 50FEET
vR0YO5ED aRADES sioMN FEx oRAD" PLM Bv:
MS fER11Fl41E DOES NOT RMiPOt1i ?FASHENTS
NOIE: BU0.DN0 p?EN9W ????IUAL PWiS fOR BIALDIqO OTRA TIAN 7FI09E S110M?
LoCAndi Oi SRNCIURES
/ND f'WNOAl10N OWF1lS10NS
SCAI.E : 1 INCH = 40 FEET
NOiL CWIRACIM YUST VEPIiY DICVEMAY DE9Q1. ??? ?pyN APE AS7lMED
N07E: NO SPEaFlC SQ" QIFESf10A710N HAS KQi OOY%ETm ON 71AS
LOT BY 11E A1NvEVDR, lHE 911fTAEM1H OF SoU roSLIPPMT TME pAnpn m unllr•F l FVAII
$pEQiC NOVS[ PRoPOSEO IS NOT 7}E FZWOMWT? ??"IOL
x 000_00 Danotee Exlating Elevatfon Loreat Floor Elswllon: JI-6•0
( oowm ) Oenoiea ?raposaG Eiavatlon
Oenoteo Orolncgs dc Utillty Easoment Top of Block Elevatlon:
- Danotea Drainogo Flow Dlractlon
---?-? Donotea IAonumant Guroge Slab Elevaiion.
-? Denotea ONaet Hub
REPRESENTATION OF AoSURVEY OFNTNE?BOUNDARI S Of: ?AT 1H?S IS A TRUE AND C?RRECT
LOT 14 , BLOCK I, ROONEY ADDITiON
DAKOTA COUN7Y, MINNESO7A
IT DOES NOT PURPOR7 TO SHOW IMPROVEMENTS OR ENCHROACHMENTS. EXCEPT AS SHO? 94
DAY OF OCT.
SUftVEYED BY ME OR UNDER MY DIREGT SUPERVISION '11?1S
? S
fJFu?IoS? ? C?''v- PIONEER ENGI iNG,?P.A.
Gan- r'/. z<?...s.. ?a+ J.
. D ( ?-_?. =
?:#X<?}ttt:k 4'?.m:'MY,t?kt#?XXtrt, X'?:X<?5h`k:Mi,t?K??!%na'S?s?kc?KiB?k'M'M9F#
r.,:r.rv nr' .r:.Aer,N
r
CASHi?c:Pr $ TI:F.'X-TN!'rL 62
Dc,`rH'„ :i a. /0c::i96 r3:r,i::: 0- i.9.2E
r
r
t.D :
NaK;: riaoMAs L cnErZ
32:I.C1 `anni 404 AMX3L'E,IJr.-A^,r 5C1.00
21 55?_;.ll:i 1 404 F1MI:EIiI._i::A- 0.50
'f'n'k,-..sl ?' crip` Att:luryi;
rt. ::at7.'SO
C: i Q WW. ?
U',3f_:R :I;YYi NAP1CV
A- CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMI'T
BASEMENT FINISH
ALTERATION
434 ALT. RE9IDENTIAL
4184 AMBERLEAF TR
LOT: 14 BLOCK: 1
ROONEY
P.I.N.: 10-64560-140-01
DESCRIPTION:
B1i'ildini} Permit Type
s 'Building Wor,k Type
Gensus Gode?.
r` 1
,`y'?:..rv,«?:°""4:''
?.
i- ?Y?
S ? ?:v ' € ?`mC? ? ?• L ? ) !
?,
??s6s
BUILDING
029179
1f J06/96
REfVIARKS:
SEPARATE PERMITS REQUIRED FOR ANY ELECTRICAL OR PLUMBIN6 WORK
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
?,
$50.00
$.50
$50.50
CONTRACTOR:
GOE7Z CONST THOP1AS
9030 i1TH flVE
BLQOMINGTON MN
(612) 852-9258
- Applicant - ST. LIC
18519258 0003478
S
55420
OWNER:
RYAN CAROLYN
4184 AMBERLEAF TR
kAGAN MN
(612)686-7696
PERMIT TYPE:
Permit Number:
Date Issued:
I hereby acknawledge that Z have read Chis
information.is cQrreat ani1 agr.ee to comply
Statutes and'City of Eagan Ordinances:
? .
APPLICANTlPERMI EE SIGNAT I?c
application and state that Che
-WiCh? a1l- appY,icable SEate,of Mn.
r
ISSUEO B `SIGNf RE
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL, 2?
681-4675
New Construclion Reauirements RemodeVReoair Reauirements
?
?
?
3 registered si[e surveys
2 copies of plans (InWude beam & window sizes; poured fnd. design; etc.)
t energy calculatlons
3 copies of Vee'preservaHon pian if bt platted aRer 7J1/93 required: _ Yee _ No
DATE: UcT .2 9y / ?t SG
? 2 copies aF plan
? 2 sile surveys (exterior additions & dedcs)
? 1 energy calcufations for heatad addkions
so.s0
CONSTRUCTION COST: '4740D
DESCRIPTION OF WORK:
STREETADDRESS: y??/ A-id`Q rv? 7PO-/ L°
?
LOT ? BLOCK ? SUBDJP.I.D. #:
PROPERTY Name: PMMJ CAQ& `r'tl Phone #: 69-6` 76 La
OWNER "'°' `I"°
Street Address- '411 P 'N And P? /rAi`' ?/ L,
Ciry: 9?0- AJ . State: A1-.J Zip: ?123
coNTRACTOR Company: 6)frr 6?sxe.tcnw Phone #:
Street Address: ?030 111??£ .so. License #:
City: 6400.u 10b77,,l State: M/0 Zip: 'r'7`T'"?ci
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #:
Street Address•
City: State: Zip:
Sewer 8 water licensed plumber: ?ESSl? f??4?w& . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to compiy with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
CertiFicates of Survey Received _ Yes _ No pCT 3 0 1996
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Dupiex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? OS 8-plex
? 04 SF Porch o 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New ,a'33 Alterations
? 32 Addition ? 34 Repair
? 11 Apt./Lodging .u' 16 Basement Finish
? 12 Multi Repair/Rem. ? 17 Swim Pool
? 13 Garage/Accessory ? 20 Public Facility
? 14 Fireplace ? 21 Miscellaneous
? 15 Deck
? 36 Move
? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Pianning
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment Pi.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. ?-r 3
SAC Code ° f
Census Bldg ?
Census Unit v
Building inn3 Engineering
Valuation: $
Variance.
Total:
% SAC
SAC Units
CITY USE ONLY 8?
L ? BL _L RECEIPT #:
SUBD. DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAM
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? single family dwellings
? townhomes and condos when pennits are required for each unit
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet " minimum - 1
Rough Openings paT ?
Water Softener
Private Disposal ' Dakota Cty. license
(new and refurbished systems)
U.G. rink=??em er const.
ItefBtio S ' to existing
a er um round
EACH NQ TOTAL
3.00 x ? _
3.00 x
3.00 x =
3.00 x ? _
3.00 ;t =
3.00 ;c =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
1.50
5.00 :c =
65.00 =
=
tOD
STATE SURCHARGE
TOTAL
SITE ADDRESS:
19 y sA Y,., s« le oOc
.50
Q U- S'u
OWNER NAME:- A° "jy^ r1 ? 4"
INSTALLER
HESSIAN PLMG _SERVICES, INC.
Inver Grove Herohts, MN 55077
STREETADDRESS: `°",°'"'°`"`
CITY:
STA'
ZIP:
PHONE #: (
STGRA'TIIFf EOFPERAf f
OFFICE USE ONLY
L _ BL _ RECEIPT #:
SUBD.
DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4575
Please complete for: ? all commerciaVindushial buildings.
? multi-famify buildings when separate permits are M 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 FLU5HOMETER:i TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7' IN A DELAY OF METER ISSUANCE.
VNLL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APFLY FOR A SEPIiRATE U.G. SPRINy(LEf2 PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge oF $.50 per
$1,000 of nermit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS
TENANT NAME:
OWNER NAME:
INSTALLER: _
ADDRESS: _
cirr:
PHONE #:
SIGNATURE:
OFFICE USE ONLY
STE. #
STATE: ZIP:
APPLICANT
METER SIZE: " DATE: - INSPECTOR:
CITY USE ONLY (?9
L BL ? RECEIPT #: ? d
SUBD. RECEIPT DATE:
1998 PLUiMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGP,N, DIIT 55122
(612) 661-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are requir ed for each unit
? backflow preventer for underground sprinkler system
- ----------
FIXTURES ------- ---
EACH -----------------__---------- _
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - t 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construdion 5.00 X =
Water Softener * for existing dwelling 20.00 x =
U.G.Sprinkler 'fordwellingunderconst. 3.00 =
U.G. Sprinkler "forexistingdwelling 20.00
Alterations " to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` MPC iic 75.00 =
(new and refurbished systems)
Private Di5posal Systems ' neandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE 50
TOTAL 62L9
---------------------------------------------------------°------ -----------------------•------------------------------
Ihere6y adcnowledge that 1 have read this application, state that the infonnation is cortect, and agree to comply with all applicable Ciry of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenanca adivities to the facilRies construded under this pertnit within City property/right-of-way/easement.
SITEADDRESS: /, 0 7 rvl? ?? ZeC'LT / o
OWNER NAME:
INSTALLER NAME:
TELEPHONE #: ?z7 7,5)0-0
STREET ADDRESS:
CITY C.C{ 9?-l? STATE: ZIP: 5-S/ Z
OF
3
CDlPERMIT FORMS/RPLBG PERMI7 (RES) - 1998
PERMIT# `f 9 a a
RECEIPT DATE:
2002 MIDENTIAL PLiTM$lAfi P£RMIT APPLICATION
crrY og EAsm
saso PaoT Kxoa ftn
BAHAA, 3iP 5518E
681-6$1-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backFlow preventer for irrigation system
SITE ADDRESS: ? ('R?1! ,? r-? b er ) e? ? !rc i I
OWNERNAME:: /C V TELEPHONE#:
(AREA CODE)
INSTALLER NAME: 14 2.S'.f' TELEPHONE #: Co S/"' (D e? /l g a S a
P
S
' (AREA CODE)
STREET ADDRESS: u y ?
p. t ? /
? ?
CITY: ? a r ? STATE: /'?l /V ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
X Adding fixtures to lower levels or room addRions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 518" meter if ne ed -$118)
_ Other: ?--o W-Z v,- L-2 v-e-- t lt)a-y-
- RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ water softener _ water heater $ 15.00
I
1
State Surcharge VY'Ra
L
1 $ .50
SU - So
Totai $
?.=-..,._.?..?-
I herebyacknowledge that I have read this application, state thatfhe informatlon is correct, and agree to complywith all applicable Ciryof Eagan ordinances. Il
is the applicanYS responsibility to notify the property owner that lhe City of Eagan assumes no Iiability for any damages caused by the Ci du 'ng its normal
operatlonai and maintenance activides to the facllities construded under this permit within City property ' t ayle ment.
SIGNATURE OF PERMITTEE 1102
? F?:o?!,.Office'3t7sz -- --?
?
? Pertnit #:
? I
I Permit Fee:
I ?
? Date Received: I
I ?
I ?
? Shaff: I
L _________________
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: a- da"IJCI SiteAddress:
Tenant:
Suite #:
RESIDENT / OWNER Name: ( t Phone: I(Od IC] 1JOCI?
Address ! City / Zip:
Ct, '-li - 55 ( °L-
4
CONTRACTOR Name: License #: IU I I I O" ???
Address: Champion
65 -
City: 3670 Dodd Rd. #100 State: Zip:
? /f, j s O ` e+-)
Phone: Eagan, MN 55123-133 Contact Person: ??.
TYPE OF WORK _ New ?Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: ? InWtezaS
14
PERMIT TYPE RESIDENTIAL
V-Water Heater _ Water Softener
Lawn Irrigafion Add Plumbing Fixtures
? RPZ /_ PVB) ? Main _ Lower Level)
Septic System _ Water Tumaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
`Water Turnaround (add $136.00 if a 5/8" me[er is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
i nereoy acKnovneage tnat mis inrormation is compiete ana accurate; tnat tne worK van oe in comormance wnn me oroi
Eagan; that I understand this is not a permit, 6ut only an appiication for a permit, and work is not to start without a
accordance with the approved plan in the case of work which requires a review and approval of plans.
7*
X X . . -JO. .
App' nYs Printed Name Applicant' g tu e`.,r.?°-"
FOR OFFICE USE.
Required Inspections: _i
j e{ro? ???e nyuw
d ?Nork willebe in
FEB 2 S 2009
Reviewed By: Date ? ? ?'"
3round Rough In r Test i? Gas°Test ' - Final _
.r
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: t
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ( G c��% Site Address:
Unit #:
Applicant is: Owner X Contractor
Description of work: �� lo hre OiraloGt9 / Vi $ 7T
Construction Cost: Multi -Family Building: (Yes _
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:
Sewer & Water 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.
Uff,
Applicant's printed Name
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127469
Date Issued:10/02/2014
Permit Category:ePermit
Site Address: 4184 Amberleaf Tr
Lot:14 Block: 1 Addition: Rooney
PID:10-64560-01-140
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 .
Luanne Yang
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 -
Lundgren Bros Const Inc
935 Wayzata Blvd E
Wayzata MN 55391
(651) 686-7696
New Life Contracting Inc.
814 Grand Avenue
St. Paul MN 55105
(651) 224-3442
Applicant/Permitee: Signature Issued By: Signature