4059 Amethyst Lane
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CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used for Est. Value Date ,19
Site Address
Lot Block Sec/Sub. `
Parcel No.
a Name
W
; Address
0 City Phone
a Name
.o
? ` Address
? City Phone
Name
Address
City Phone
I hereby acknowledge that I heve read this application and state that the
information is correct and aQree to comply with all applicable State of
Minnesota Statutes and Cityjof Eagan Ordinances.
Signature of Perminee
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFIC E USE ONLY
On Site Sewage OccupanCy
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required # of 5tories
Booster Pump Length
Depth
S.F. Tot81
Footprint S.F.
APPROVALS FEES
Engc/Assess. Permit
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
}` •
Permit No. Psrmit Holder Dato Talsphone #t
Plumbing
H.V.A.C.
E lectric
(
Softener
Inspection Date Inop. COMment8
Footings I
Footings II
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final
Cert Occ.
Temp_ LP
Deck Ftg. z 5F S. f/ ?? /?o ?L
Deck Final
Well
Pr. Disp.
CITY OF EAGAN Remarks ?
d St , 4059 Amethvst Lane
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
' GRADING
SAN SEW TRUNK aL 1967 100.00 5.00 20 Pafd
SEWERLATERAL 196 525.00 26.20 20 Paid
WATERMAIN
* WATERLATERAL 1972 607.00 24.28 25 Pdld
WATER AREA
STORM SEW TRIC 1974 70.00 4.66 15 Paid
STORM SEW LAT '
CURB & GUTTER
SIDEWALK
STREET L4GIiT
WATER CONN.
BUILDING PER.
sa.c 200.00 702 3-25-68
PARK
REQUEST FOR ELECTRICAL INSPECTION ?? 5??
FJ? , See?instroctjons lor compleLng this torm on beck of yellow copy.
E "13a8 5 "% ' Below Work Covered by 7hrs Request
RAJ ReD. Type ol Bwlaing Aoobancea W,red Enuiumem Wired
Home Fonge Tempoiary Servir.e
Duplez Water Heater Liyhtiny Fixtwes
Apt BwlAing Dryei Electnc HeaLn
Commercial 01dg. Fumace Sib Unloader
InAustnal Bldg Au Conditioner Bulk Milk Thnk
Parm otnar svP(Jfv Oihe,lsounfyl
511Cr $UCG y UIBf Othe?
ompute Inspectlan fee Below
M Fee ServiceEntranceStze p Fee Feeders/5v1pleeders k Fee Cvc.rts
0 to 200 qm 5 0 to 30 Amps 0 tn 30 Am s
Above 200 qm;)y, 31 to 100 Amps 31 to 100 Am s
7 73(D Swimming Pool Ahove 100-Amps Above 100_Am 5
Trensformers Irngation &ooms Pdrtfal O
ee
ther
F
Signs Special Inspection s?
1 '
/
'
TOTA
I
P
)
Rerryrks 130
?
?F. Q
/
%?.%)
R I 1 / ? /
he E a,
Inspector, he,eby
If
CBftlf
AS thB Ab
V
Final
Ui11e y
I
B
O
?nsoactmn has bee.
17,L /(J mede.
tMaraQueslvoi419monthsirom
V
This reQUesl void
8 nwnths
1 Imm ?
E 13985L5Q// , ,d),r • ? r??
?'?o °-,
Feauest Date
I Frte No. Fouuh-in InsVecUOn
qo
qvrted?
?flrmtlY Now ILYIM1hII Novfy Insoec-
'"C l
Wh
?
?
Yes No or
en fleady
? Lice:nseA Elec[ncal Contnaor 1 hereby request mspection oi ebove
00wner electncal work installed at
Street AdAress. Box or Rouce No.
os s? ?.,? C,rv
c? aw
ecuo?? o- Township N me or No. Range No. Cnuuly
Occupant IPflINTI
Ga S Phone No.
Power 5 pifer AAdress
Electncal Conlractor (COmpany Nnme) Convac«v's Lfcense No.
MeiM1nB AdJress (ConVactor or Owner Makmg Instailauon)
Au?honied ? nature (Contract r wner anng InstallatioN
_
Fhone Number
MINNESOTA STAT?OAHU OF ELECTqICITV THIS INSVECTION REQUEST WILL NOT
Grigqs-Midwxy BIQg. - Room N-191 0E ACCEPTED 8V THE STATE BOHND
1821 Univars.tv Ave.. St. Peul. MN 55704 UNLE55 PROPEN INSPECTION FEE IS
vhnne 16121 662-0800 ENCLOSED.
CITY OF EAGAN
' N0 15 5 0 5
•
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH ONE: 454-8
1 100
c ? (
'l (
e,
BUILDING PERMIT Receipt # 4
l
To be used for POOL/DECK Est, Va1ue $3, 500 pate AUGUST 22 1988
.3ite Address 4059 AMETHYST LN OFFICE USE ONLY
Lot 5 Block 11 Sec/Sub. CEDAR GROVE STH On Sire Sewage _ OccuDancy
MWCCSystem _ Zoning
Parcel No
OnSiteWell _
(ACtuapCOns}
a Name GARY S SEVERSON Ciry Water _ (Allowable)
W
=
Address 4059 AMETHYST LN PRV Required
- # o/ Stories
-
-
0 City EA6AN PhonC 454-2568 BoosterPUmp Length
Depth
s
0 Name SAME S.F. rotal
?Q Address FootprintS.F.
P City Phone ppPROVALS FEES
t-T
w
Name
Engr./Assess.
Permi[
58.00
W
tz
i-
Address Planner Surcharge --- 2 . QQ
aw City Phone Council PlanReview
Bidg. Off. SAC
City
_ ,
I hereby acknowledge that I ave read this application and state that the Variance SAC, MWCC
informatron is correct and ree to mply with all State of
lica Wa[er Conn.
Minnesota Statutes and, 't of E Ortlinances.
? Water Meter _
Signature o( Permdtee `
Road Umt -
A 8wldmg Permit is issued to._G?1RY _?EVE13$QN- _--- Treatment Pt _
ontheexpresscontldionthatallworkshal bedoneinaccortlancewdhall
applicable State of Minneso[a Statutes antl City ot Eaqan Ordinances. parks
Builtling
1 ' TOTAL 60.00
EAGAN TOWNSHIP
BLJILDING PERMIT N° 1731
Owne= ----- . S;Gi r..!!.:? ...L?'i... . &I-_4 ...... .?.?.....----- Eagen Township
'
Addcess (precent) _?......9Ft...:.............Town Hall
Boildet .._................................. .__................---.......
Addreas .............................................................. ............................... DaSe
DE5CRIPTION
Siories To Be Used For Fronf DepSh Heighi Esi. Cos! Permif Fee Aemarks
A ' ? -_ ?? ? ?a0 ?y - _ . _
•
SiLeef, HoBtl oi oIh?ei UOSe[lpllOn oI LOCBIIOn I LOI 2510CY AtlGlllon oi TIeCt
di-Z' 3 Gak tz/ i Q, t / G? / I tf / d '7 ?o . i.? • XY S1 --
This permit daes aoi aufhorize the use of slreelc, roeds, alleys or sidewalks nor does it give She ownet or hia egent
the righffo ereate any siluation which is a nuisance os whieh presenls a haaard !o the heallh, safely, convenienee end
ganesal walfare So anpone in the communify.
THIS PERMIT MUST B£/? K?E?PT? ?ONq ?THE PREMISE WHILE THE WOAK IS IN PROGA£SS.
This ia 2o eetlify, ihat..VS.r..•'..?::"'/?.'.:....?..''.a."'.'?'?.:...w.....haspermission !o erect a._...?i .. `,?.......... p...?.-.. ??... ........... upon
the above descrihed premise subjaci fo the provisiona of the Building Ordinence for Eagan R'ownship ado ed April 11,
1955.
? /? ? ?
.L . ....--..... ... .._--.. ..... .._._..?/..!'.`...` .:".?.t
..._. ? ...............
--"-----.... _ ...---- .---- . ........".-.'...........--"---. Per at
C airman of Tnwn Board Suilding InapecSOr
A•B
EAGEN TOWNSHIP
3795 Pilot Knob P.oad
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SBRVICE CONNECTION
DATE: Mar. 25, 1968 N[MSER 136
OWNER: Cedar Grove Const. Co. P.ddress 5-11-bfic Cedar Crrove 5
PLUMBER Steins. Inc. TYPB OF PIPE cast iron
DESCRIPTION OF SUIIAING
Industrial Commercial Reaidential Multiple Dwellixig No, of unita
%
Location of Connections:
Connection Charge 200.00 Pd 3/25/68
Permit Fee 7•50 °
Street Repaira
Total 207.50 "
Inspected by:
DaCe
Remarka•
By
Chief Inspector
In consideration of the issue aud delivery to me of the abave pexmit, I
hereby agree to do the proposed work in accordance with the rules and
regulatioas of Eagan Toianship, Dakota County, Minnesota
BJ? 4telna Lnc
Please notify when ready for inspection and connection and before any portion
of the work is covered.
. ? /
.;.v
C1TY of EAGAN N4 4158
BLJILDING PERMIT
3795 Pilot Knob Road
Owaes BRUCE._ANDER$ON ......... ................................................. Eagan, Minaesola 55122
..........
Address (Presenl) .....4059...Ame.thySL ......................................... 454-8100
susides .................. D ...................... & C . Cons....................................................... t.
k
1903 Hi hland View Burnsville Minn Dale ..._.RE.?....1..4? ... .. ............
Addreu ..........................gi.........................:.........---................e...........
Siories To Se Used For Fron! Depth Heigh! Eal. Cw1 asmi! Fea
Aen sk?
P
Fire Lace I
?pCx? 9.00
1,00 or z eetroc c Barr er
s/c
or
4059 Amethyst Ln
5 I 111 CG 5
or
blE
This permit does not aulhorise the use of sfxeefs, roads, alleps or sidawalka nor doet St give the owner or hls agent
the right !o ezeale anq ailuation whieh is a nuisaaee or which presants a hasard !o the heallh, safely, eonveaience aed
geaeral welfare !o anpone in the communilp.
THI$ PERMIT MUST BE KEPT ON THE PAEMISE WHILE THE WORK IS IN PROGAESS. D d C Const, ire e
T6is is !o cerrify. 2hat-----------------------?---......................... ............ has Pasmission !o erect a........ F.-?---?--2.l..ac..........._......................... _ upon
the above describ p mise subjec! !o ihe provisions of all appliaable?'8rdin es f r fh7i'u-'?'ildwing gg' an
?--....""--- e.---?....._...................
Mayor Impxlos
,Z??-4 I/ j-7-
n?t? `-
IIII'!7DI"t?G PSKIIT nPPLSCn- I011
/
?.,r,Fr.ocr. -?? nDniTIe-0
P:I?Y.CEL & Sli^^10?7 i1x7iMisR L: iiiii:',:a'i'`PED ---
.:Js.:i T" GCiT7T'P1:CY USr -_.._-._...
T_'15'C;.ii:'i'.?ll
TELP:°Ib'N0 .
ein.i?,.t?'v:i_ o? ? /7 ? ___ .? __.__
OIF
Fl'+iDaL:'.-.S__??(JJ ---
tl?t.^_' It:CI.IY:?: -mi.te plan, nuilainn plans, and energy calculatiu,s/-' '`1: chis
ai:,,licction
Signed
OFI'ICE UuE
? ? ?G
SAC (r
i'7.:i'};??2 ?" v
(]iaTEFc METER V ?
r'J.tLD"'M FMl-re z?.M ?
STJi:•^.'.^,FG: iTIF°
I?1
M1:I C1=:.:Cit F.?^^?,
PAR:C .7ZJ1C7-'1`i2C:d FtiE 1/
(?% - FyL
/
.'?.?:.?ESS;??.'::< CLSt? RUILDIidG DEPT POLICS Di.^-T?
T.):a::'T.'R F cL•°,TLR DyP3.'. FIRY, DRPT. PARK DEP'P._
.--1 ??- -
' . ?
LOCATION
4059 Amethyst Ln _
STRUCTURE AND Fireplace
LAND USED AS
MASTER CARD
710?
Permit
No
I
Issued I
Contractor Issued To
Owner
BUILDING
4158 1
12/14/76
D d C Const,
PWMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER I
O7HER I I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TIIE FIELD FT.
FINAL
ELECT(iICAL
HE.4TING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
PERMIT NO.
COMPLIANCE INSPECTION REPORTS
TO BE USED OHIY IN EVENT OF OBSERVED VIOIATIONS
CONDITIONS OF CONSTRUCTION AT THIS INSPEGTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
a ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
? NONtOMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED
DATE OF REINSPECTION
REVEALED
CERTI FICATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I hwe reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any speafic require-
ments for off-site imprwements relating to the property inspected.
7 ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR
?-_
DATE
'?? ?3
?.
1988 HUILDING PERMIT APPLICATION - CITY OF EAGdN
SZNGLE FAMILY DWELLINGS
155off
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WFiIC$ ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF DNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COtMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: 1006 / /A'R-64? Valuation: ? Date:
Site Address T OFFICE USE ONLY
Lot Block On site sewage_ Occupancy
MWCC system Zoning
Parcel/Sub On site well _ Actual Const
/? City water Allowable
Owner L7i1rv S -?rok4? r_,snnJ
- PRV required # of stories
?
Address S=?f c/,??r/ Booster Pump _ Length
Depth
7 ?
City/Zip Code -a- S.F. Tota1
Footprint S.F.
Phone '?s5l- APPROVALS FEES
m e
Contractor
- Engr/Assess Permit
Planner Sureharge 27671
Address Council
4 Plan Review
?J2L SAC, City
Bldg. Off.
City/21p Code Variance SAC, MWCC
Water Conn
Phone ' Water Meter
Road Unit
Arch./Engr. Treatment P1
Parks
Address Copies
TOTAL ?
City/Zip Code
Phone 11
,
-ciiy of eagan
MEMO
TO: DIANE DOWNS, UTILITY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN
DATE: AUGUST 23, 1993
SUBJECT: STREETLIGHT ENERGY COSTS-CEDAR GROVE NO. 5(208 LOTS)
This memo is to inform your department to begin to invoice the energy costs at the single
family rate effective August 1,1993 to the property owners in Cedar Grove No. 5 Addition.
BloCk 1, Lots 1-22 22
Block 2, Lots 1-19 19
BloCk 3, Lots 1-11 11
Block 4, Lots 1-16 16
BloCk 5, Lots 1-25 25
Block 6, Lots 1-22 22
Block 7, Lots 1-25 25
Block 8, Lots 1-5 5
Block 9, Lots 1-2 2
Block 10, Lots 1-23 23
BloCk 11, Lots 1-14 14
BloCk 12, Lots 1-9 9
Block 13, Lots 1-15 15
208
The City is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
Edward J.`?'irs?l'ic t
Sr. Engineering Technician
cc: Mike Foertsch
EJK/je
i
,d.'4:?'.?+:`k^.?'t;:'?'f?.i'fim'?h£Yrv:4?;j??• nMmll18:t+n s,
ctVr!rn CaGAN
^as3??r.?-., .i?, ' ;t-?-•?tnr,? i.??• ;n?-r
PF1TF:, 0?14199 'Y'1MC:x , ?.L3aa`;1;,4t?
'•?lth"'s . rE?'?I.. ;;1.'rdRT SY47F,?89 :[NC,.
32ii] 9:701 4059 F?Me=i'l'i'ST I., 03 05
2:C'tSS 9on1 ihl'.l°?J; ml"7ti'YM 1. %. C]C
• ? ?
i
a a
7o1;o'I Rr2r4a::i:r:. orjri.tnt
I.;Si=R 70!' ,lFSW. '!
,
? ' ?
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) 1?7) 5? ?S
3g ??3 cIrr oF EacaN
3830 PILOT KNOB RD - 55122
651•681-4675
New ConsfrucNon Reauiremenh Remodel/Reoair Reauirements
?
D 3 reglstered sRe surveys showing aq. H. of bt, sq. M. of house
and ?II roo}ed areas (20% mmcimum bt eoveraae allowed)
? 2 coplea of plans (ahow beam 6 window sius; poured fnd. design; Mc.)
? 1 set of energy caiculatbns
? 3 copla of hee presenafion plan B lot plailed aHer 7/7/93
DATE: 9 h (D I q aI
DESCRIPTION OF WORK:
STREET ADDRESS: `"-f 0!7p" tjf'1(rVr'1 t
LOT: --5- BLOCK: _ I l SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Mame:??) ? Phone#: (? c)CnSg
Last Fi
street Address: 4bSG ?-?-
City f e"Gc-e-l State: (Y)? . Zip: C-),D^ (C)?
Company::?)Q a\ Gt x"Ca f?)tF -?2 Phone #: (0 ,[4_?
(area code)
Sheet Address?, U(? I F.l_-P ?Ue • ?`+ • license N?up. ???1 00
Cfty V\ l? ?S State: ZiP: !?-
Telephone #: area code (
Name:
StreeT Address: Registrafion #:
City State:
Sewer i water Iicensed plumber {reauired for new conskuction onlvl:
Penallytapplies when address change and lot ehange is requested anee permR Is luued.
Zip:
I hereby acknowledge ihot I have read this applicaFbn, state that Ihe Informaflon Is cortect, and agree fo comply wfth all applicabl
Sfate of Minnesota STatWes and CMy of Ecgan Ordinances. ??? ???/?? A ?
Signafure W Applican}: 1 I I I1 V Iit?
Certificates of Survey Received
Tree Preservation Plan Received
OFFICE USE ONLY
Yes _ No
Yes _ No _ Not Required
2 copfes W plan
1 set of energy caleulallons for heated addRlons
1 sBe survey fw e#erlor addMiont d decks CONSTRUCTION COST: -1 I I -? - ??
-k
RECEIVED
OCT 12 1999
BY:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01
' Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
W 02 SF Dwelling p 07 5-plex L] 12 12-plex 0 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex D 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only .Q?7 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg " ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 ,,Demolish (Interior) ? 42 Reroef
= Uive KJA naf1dout to appucant fur aPrnonuon permic
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. R.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee 1 . af?)
5urcharge nv •?Lo
Plan Review
License
MC/ES SAC ,
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: 15co ? 2 t
Valuation: $
SAC Units
°k SAC
?ly U5?1.1 970
2006 RESIDENTIAL BUILDING PERiVfiT APPLICATION
hdew Cor.s;ructlon Re uirements
3 2gistered site surveys shcwing sa. ft. o! lat, sq. fl. of house; and all roofed amas
(20 o macinurr lot croverage allowetl)
2 cooiss of plan :howing beam 8 window sizes; noured found design, efc.
1 sel a(Energy Calculatbns
' copies of Tree preservafion Plan "rf lot plaffed ;fter 7/1193
P,im Jois[ De:ail Opfions selection sheet (bwldings with 3 or less umts)
Minnegasco mechanical ventilation form '
Date 0 /?? ??j
SiteAddress
RemodeVReoair Requi2ments -
2 copes of plan showin fioti s, beams, 'oists ??ce Use Only
1 set of Energy Calculati ns fir heated addihons Cert of Survey Recd _ Y_ N
7 she survey for addihons 8 decks Tree Pres PWn Recd _ y N
Adddion - indicate ifon-sde se Ik sYStem T?P*Required _ Y_ N
P On=sAe Sepfic System Y_ N
Construction Cost
?S?cY S a
- - Unit/Ste #
Description of Wor W
vlv?awo 54?- K 51-1? U? u'v K 3? u n7r v y y
Sc) t
?
l ?v x1H
'
?
'
K s
i y?rc y?
X
bi K35
1VIulti-Family Bld; Y N
?
Us;
- - ireplace(s) _ p 2
-
/'
Property Owner 1??1.Q,d
5 , ,- -._
.:
?t?
-
-- .-'I
_ y ? , Tel?e phone #((SJ
l -S?/JS`
I l
Contractor
? r r7 L'?O (.?) C'C))7, N P
Address
-
State M rj ` - _- - _. City
ZiP 5S12.1 Telephone # (6,r/ ) (S/ '%OS'-D)oS-
COMPLETE TFi1S AREA ONLY IF CONSTRUCTING A NEW BUILDING
Eneiyy Code Category - Minnesota Rufes 7670 Cate o 1 Minnesot_ a Rules ?6Z
(J subrc.ission type) • Residential Ventilation Category 1 Worksheet
Submitted • New Energy Code Worksheet
• Energy Envelope Calculations Submitted Submitted
In -he lasf 12 months, has the City of Eagan issued a permiT for a similar plen based on a master plon?
- Y _ N if yes, date and address of mcster plan: _
Licenced Piumber
tilechanical Contractor
SeweriWat=r Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby agply for a Residential Building permit and acknowledge that the information is complete and accurate;
that the werk will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit that the work will be in accordance with the approved plan in the case of work which requires a review and
approva1 ofplans.
-2pllCant s Pnnted N e
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
C'
Applicant's Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4059 Amethyst Lane
Lot: 5 Block: 11 Addition: Cedar Grove 5th
PID:10- 16704 - 050 -11
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Seta Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823 -8046
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Charles F Rice
4059 Amethyst Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Building
EA084596
07/23/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
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EAGLE TIOWNSMIP
ti 3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
'
PERMIT FOR SEWER SERVICE CONNECTION
; DATS: Mar 19�
Address 8 - � s
,� Conat. CO• oast iron
OWNER: TYPE OF PIPE
PLUMBER s• DESCRIPTION OF BUILDING
Industrial Commercial Residential
Multiple Dwelling NO. of units
1
28/68
Connection Charge
Location of Connections: Permit gee
Street Repairs
Total
Inspected by:
Date
Remarks • d I�-
Sy Chief Inspector
of the above permit. I
issue and delivery to we the rules and
of the i work in accordance with In hereby agree do the proposed work acCO County,
hereby agree an Township.
regulations of Bag B Y In
when ready for inspection and connection and
the before any portion
of t
Ple wo rk is covered.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114996
Date Issued:09/20/2013
Permit Category:ePermit
Site Address: 4059 Amethyst Lane
Lot:5 Block: 11 Addition: Cedar Grove 5th
PID:10-16704-11-050
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 .
Ashley Otto
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 -
Charles F Rice
4059 Amethyst Lane
Eagan MN 55122
Northland Home Exteriors Inc
308 Southwest 15th St. SW, Suite 100
Forest Lake MN 55025
(651) 464-0234
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112466
Date Issued:08/14/2013
Site Address: 4059 Amethyst Lane
Lot:5 Block: 11 Addition: Cedar Grove 5th
PID:10-16704-11-050
Use:
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of house wrap and leave on site for final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $103.25 0801.4085
Surcharge - Based on Valuation $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 -
Charles F Rice
4059 Amethyst Lane
Eagan MN 55122
Northland Home Exteriors Inc
308 Southwest 15th St. SW, Suite 100
Forest Lake MN 55025
(651) 464-0234
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122106
Date Issued:04/24/2014
Permit Category:ePermit
Site Address: 4059 Amethyst Lane
Lot:5 Block: 11 Addition: Cedar Grove 5th
PID:10-16704-11-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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 or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Charles F Rice
4059 Amethyst Lane
Eagan MN 55122
(651) 686-5495
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
a
Use BLU�or BLACK Ink
�----------------�
� For�ffioe Uo
I � ���I
CitY of�aoaIl � Pe�;��: ,
J S � Pertnit Fee: ����• I
3830 Pllot Knob Road � ���' I
Eagen MN 55122 � Date Received� �
Phons:(B51)675-567�3 I l�� �
Fax:(651)675-5684 � S�N=----_-----------� �
� I
�----------------�
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:,�'� ' ��_Sit�Address:_ �5 _Unit#:
� n� �r
Name:�.L�� '`F' ��_r,�- _____ Phone: �9����b"J'�'���
" :' Address/City/Zlp:_ �S � (�tn��-- �� �✓�'�/��S�%�
��
„ � � Appllcent Is: Owner _�Contractor
Description of work:�'�(`��� , C�_e/►�-�"�� �-�"'�-� � �'e � �-�?���
. --�--
Construction Cost:_�0���� � Multi-Family Building:(Yes`/No�_)
Company_ �l '��Wl4-v1 c,�a�e��o�r�o��COntad: V P�`� �r`�'c'✓� —
II ,� �.� ,,
u Address:�� $ ���`���e"�'�____City: �I�� !-�-�
loS1— 'lbro—
State:rn�Zip; S�i� Phone: D4�"t _ Email: v�`�� ~i{�—�'`�'4'�'�u��4'�eC p �'`�'
,p ,� License#:��� 3V��,Lead Certificate#:!v�����3��I
If the project is exempt from lead certification, please explain why:(see Page 3 for edditional informetion)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the lest 12 months�hes the City of Eagsn issued a permit for a aimilar plan based on a master plan?
_Yes __No If yes,date and eddress of master plan:_,..._,_.__._ _
Licensed Plumbee__ _ Phone: __.._.. . ._.___
Mechanlcal Contractor: _�„W� _ Phone:_ __
Sewsr&water Contractor:_ Phone:
�`o ' a��G m'�, ��,���,,�,�"" -� , . — r��l
�� ��o�� �i ' � hp➢i��•::'" V '�41 yIIW�I�ICll�pldll iM •.i': !�' '„p,y��.� 3 ,� ' .iw^ �a I
t I �� �`►�iiil��� �p�II $ '' I "` '1�Y'�Nal f �t'� t w' i �� � " a� uYR'1 ���
. , .
� .i=.� ,. .f. .. i �C,..i . _.i. � :�.. .�.' .... ... ..�� _,r • ; 4- i�lp �� ::
�.,
CALL BEFORE YOU DIG. C811 Gopher State One Call ffi(6S�)454-�002 for protecGon agalnst undarground utllity damage, Call 48 hours
before you intend to dig to receive locates of underground uliGlia6. www.gooherstateon,�Sell.om
I hereby eeknowledge that this irdortnatlon Is complele and aeeurata:thel the work will ba in eonformAnce with the ordinances and codes of lhe Clty of
Eegen;that I underetand this is not a permlt, but only an appllcatlon tor a permit, and work i6 not to start without a pertnit;that the work wlll be In
accordance wlth the 6pproved plan in the caee of work which requires a revlew and approval of plans_
Exterlor wo�k authorized by a pullding permit iasued in accordance with the Minnesota 6tate 8ulldlny Code must b•completed wlthin 180
dey9 of pe�m�t Issuanco.
X � .�o'��-`- - �- - _-
ApplicanYs printed Name Applicant's Sig�atura
Page 1 of 3
096L lS LO�l l p l OZ/t O/Z l
� . .
�os `� �,�:Q..�+YS�- ��-
DO NOT WRITE BELOW THIS LINE ������"
SUB TYPE8
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Singie Family)
� Single Family _ Garage � Porch(4Season) _ Exterior Alteration(Multl)
_ Multi _ Deck _ Poroh(Screen/Gazebo/Pergola) _ Mlscellaneous
_ 01 oi_Plex _ Lowe�l.avel _ Pool _ Accassory Bullding
WORK TYPES
_ New _ Interlor Improvement _ Slding _ Demollsh Sullding*
Addltlon _ Move Bullding Reroof Damollsh Interior
�,Alteration _ Fire Rapair _ Windows � Demolish Foundetion
� Raplace _ Rapalr _ Epress Wlndow _ Wator Damaee
_ Reteinina Wall •Demolition of'entire building—giva PCA hendout M eppliceM
DESCRIPTION
Valuatlon �'� Occupancy �, MC�S System
Plan Review Code Edition Y v , ' ,. '`� SAC Units
(25°�,.,,__ 100%_�) Zoning Clty Water
Census Code Storles Booste�Pump
#of Units Square Feet PRV
#of Buildings Length Flre Sprinklers
Type of Constructlon Wldth
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:_._._,...,,,,.....___
Footings(Deck) Final/C.O.Requlred
Footings(Addition) Final I No C.O.Requlred
Foundatlon HVAC�Gas Service Test____Gas Line Air Test
Rooi:_ICe&Water �Flnal Pool:_Footings �Air/Gas Tests �Final
Framing � Drain Tile Y�� ,,�• � �
Flreplace:__Rough In _Alr Test __Flnal Siding:_Stucco Lath _Stone Lath _�Brick
Insulatlon Windows
Sheathlhg Retaining Wall:__Footings_Backfill_Final
Sheetrock Radon Control
Flre Walls Erosion Control
Braced Walls Other_�_��--- _ —
Revlewed By:�_�_ __ _ _,Building Inspector
RESIDENTfAL FEES
Base Fee
Surcharge
Plan Revlew
MCES SAC _ .
Clty SAC
Utility Connection Charge � ��,
SB.W Permit&Surcharge �
Treatment Plant
Copies
TO7AL
Page 2 019
000/£00'd SSS09BLlS9(XV� LO�II blOt/101Z1
Use BLUE or BLACK Ink
` r----------------�
I For Office Use �
� � Permit#:_�����
City of ����� ; . � ;
Permit Fee: �� �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 _j '' I Staff: � �
I I
--------------
2015 RESIDENTIAL BUILDING PERMIT APPLICATION -i ��fi ���"
,- I-�-i5�"
Date• � �-�� �`� �
Site Address: U�� ����l'7 . (^.c;1 Unit#• /���
� �� �[�,
� ��� Name ��l (.,.�`�-'�� ������ Phon�� " � � T ��-�
r� c / /�j�
Address/City/Zip: L�' � ` L,. � � ��'/� ��7 jr� �1 -
,
Applicant is: Owner Contractor
:, Description of work: L"��.-�Lc ' �� ``�i�,� �� �/� � .� �Z�
�
Construction Cost: Multi-Family Building: (Yes /No�
Company: C�'=��1,��L ✓� l��'�"'�'-��,i°�/,'�''�Contact:���{��'�- L�-�S� �
�� Address: �(J D �� `°7 t�/�'" L",��_ �� City:Z�Z-- ��'� �
�
�°a State�Zip:�� Phone���°-,�Z���ma��Z°('.�i 1� Y i'�Z��P
' License#:���� ���� Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
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. uwvw.aopherstateonecall.ora
I hereby acknowledge that-this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x X -
ApplicanYs Printed Name Ap i ant's Signatu e
Page 1 of 3
DO NOT WRITE BELOW THIS LINE ��"<� G �''
SUB TYPES ��'� I �l o^u'�1���•�Sy}— ��-e`
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
�( Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
woR�KrYPES `�t �e. w�t,�; I5'` �p �o�. ��Ln�r ,�, 3s� c��� pr�,�.��,�, � ��r�,�� � �
_ New � Interior Improvement _ Siding _ Demolish Building"
Addition _ Move Building _ Reroof _ Demolish Interior
� Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION f
Valuation �(�UO• Occupancy ���_ MCES System
Plan Review Code Edition '�jv7�t.y�BL SAC Units
(25%_100%� Zoning ��� City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction _� Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) � Final/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests �Final
� Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: -#�' � , Building Inspector
RESIDENTIAL FEES ' ,.,1 ,, ,v.
Base Fee �� ��`��`�. �� ��`�
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S8�W Permit�Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3