1942 Berkshire Dr
Use BLUE or BLACK Ink
r-----------------
I For Office Use
` I I
~J,; Permit
City of Eap~
~
la Ea'~..~I ~ e,3 (6'';0~ i Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: t Site Address: C~ ~~~V►l~e ✓"~b~f~-
Tenant: Suite
RESIDENT / OWNER Name: L4ye_, fff~ 7-po M Phone: CV- l bN3 T5-
Address / City / Zip: e-
Applicant is: Owner _ Contractor
TYPE OF WORK Description of work: S Lcl
Construction Cost: rS Multi-Family Building: (Yes / No )
CONTRACTOR Name: [oc t jr _zx5 License 901-TR
Address: CId 5/ eCny-f- t fi -S7 City:
State: Zip: $ Phone: /O-
Contact: I `[CEmail: 1~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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.
x ~t 1~ pe -C Vag-r- x
Applicant's Printed Name Applicant's i atu
Page 1 of 3
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i
i
Receipt f ' 1 PLUMBING PERMIT Permit No.
CITY OF EAGAN {
' Fee
,t
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost , , L,,
3. Job Address Lot_ Blk. Tr~
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ❑ Commercial ❑ Institutional ❑
9. Work Description: New ❑ Add ❑ Alter ❑ Repair ❑
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed
for
Rough Final
Inspections: Date Insp. _ Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner J 1
5. Contractor Phone w
8. Address
7. City State Zip
8. Building Type: Residential ❑ Commercial ❑ Institutional ❑
9. Work Description: New ❑ Add ❑ Alter ❑ Repair ❑
10. Describe Fuel Type
11. No. Equipment BTU - M. Ea. No. Eauioment CFM
Forced Air - Air Handling:
Mfg.
Boilers
Mfg Mech. Exhaust
.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : - for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454.8100
CITY OF EAGAN Remarks
Addition BERKSHIRE PONDS Lot 5 Rik 4 Parcel 10 13750 050 04
Owner Street 1942 Berkshire Drive State
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1 1982 239.09 23.91 10 / oJSR 5 2-13'
STREET RESTOR. q1h 1985 123-80 8-29 is /,!5,r '55 Oj,cJ. 9 5 ~ 2-19-25
GRADING
SAN SEW TRUNK 7 1982 176.04 11.74 F15 o159 5~ - 3 - 8S
SEWER LATERAL JQJ 1982 57.24 3.82 QO 0)5q5.0 s 14 * 427.88 28.53 , 36 R C,1595-9 - 1 -Y5
WATERMAIN j 1982 46.09 3.07 15 3 ,3, ~l o 59 58 - 13-2-5
* WATER LATERAL 1995 -
WATER AREA 1982 176,04 11,74 15 /-2 /s 01595P - 3 -85
STORM SEW TRK qt:Z 1 3 3 01595P -13-85
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
$980 00 51838 5420/8c;
WATER ONN. rr
BUILDING PER,
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
TO be wed for Sp [iWr Est. Value S 5 l Date A)c J 19 h5
site Adc~ls. 1 y 4 F;E~t i _ Erect Occupancy
,Remodel ❑ Zoning
Pat Block /Sub.
Repair ❑ Type of Const. V
Parch No. Enlarge ❑ No. Stories
v , - Move ❑ Length
W Name t7 i~
, Demolish ❑ Depth b
Add _ Grade ❑ Sq. Ft.
City Phone Install ❑
Approvals Fees
Name
ddress Assessment Permit 5a
}ou A
u~ City Phone Water & Sew. Surcharge ~26
0
Police Plan Review- 1
toe W Name Fire SAC ~-0
W ~
r
,j 17. f3 Address Eng. Water Cann. 1:.j_0 Q
W City Phone Planner Water Meter 77 G Council Road_ Unit a
1 hereby acknowledge that I have read this application and state that Bldg. Offer ` 'O 0 G
the information is correct and agree to comply with all applicable APC Total "
State of Minnesota Statutes WW City of Eagan Ordinances. Var. Data
y
Signature of Permittoe
A BuHding Permit Is Issued to. an the expnm condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
I Permit No. II II Permit Holder Dab Telephone H.VA.C. ' -y /U (aG -~pG2
Electric 2 ~0. CCU
Softener
InWection Date Insp. Other
Footings
Foundation
Framing
Roofing
Rough Plbg.
Rough HVAC
Insulation
Final Plbg. ~a
Final HVAC
Final i
Cert/ooc. 3 v , 5
Water Describe Location:
Well
Sewer
Pr. Disp.
a
s CITY OF EAGAN N2 10 2 2 7
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
Te be used tar SF DWG/GAR Est. Value $61,000 Date MAi-1~Y Ises,
Site Address 1941 BERKSHIRE DR Erect M Occupancy R3
Lot 9 Black 2 SAclSub. BERKSHIRE PONDS Remodel ❑ Zoning R1
Repair ❑ Type of Const. V
Parcel No. Enlarge ❑ No. Stories
Move ❑ Length 39
W Name JOSEPH MILLER CONST Demolish ❑ Depth 46
z Address 18133 CEDAR AVE Grade ❑ Sq. Ft.
City FARMINGTON Phone 431-2001 Install ❑
SAME Approvals Fees
Name Assessment Permit 0
u Address 30.50
City Phone Water & Sew. Surcharge
Police Plan Review 158.00
Name Fire SAC 525 _ 00
13 Address Eng. Water Conn. 500- 0
<u
W City Phone Planner Water Meter 63_n0
Council Rood Unit 2813 00
I hereby acknowledge that 1 have read this application and state that BIdg.Off. 5/14/85 T.P. 132.00
the inlorrnation is correct and agree to comply with all applica a APC Total
State of Minnesota Statutes and Ci of E on Ordr orc Var. Date
Signature of PemdMea kze
A Building Permit is issued to. iJ0 EPH MILLER CONST an the express condition thor
Lutes and City of Eagan Ordinances.
all work shall be done in accordance with all appl* blEs~ a State of _ irk to Statutes
Building Official
This request void San 76 04rmnths from
L5b~
R4ques`t Dale Fire No. Itoagh-in I sPar:tion
Req red? ❑ ready Now 11 Notify Inspec-
~ ' Yes ❑No rr When Ready
icensed Iectrmal Contractor 1 hereby request hst tiara at above
Owner electrical work installed at:
Street Address, Box or Rome No. City
09~1~ !z'~Ikx A" A,- q a
ecbon o. Township Name or No. Range No. Cau
Occu rat (PRINT) Pheae No.
Y ~'GY
-7? 1
Po Supplier Address
l
Electrical Contractor (Company 1 Contr for s License Na.
Mai m9 Address 1 ontractor or Owner Making Installation)
7
A on Scg A Co tra r/ vmer rq Installation) Maw Number
Or
CTRICITY THIS INSPECTION REQUEST WILL NOT
MINNESOTA STATE BOARD Of E
Griggs-Midway BId9• - Be.. N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Pl.uv. 1612129].2111 _ ENCLOSED.
/ d REQUEST FOR ELECTRICAL INSPECTION ER-00001-04
l I ,Sea instructions for ..mwbtirm this firm m back of vetteei cepv-
fl
'419.2 ' 8 . ""X"' Be/ow Work Covered by This Request
Add Rep. Type at aw W me Appliames Obed Equipment Aired
Home Range' Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
industrial Bldg. ` Air Conditioner Bulk Milk Tank
Farm O[he, peaty the, Ism6fvl
t .r Spe"OV 01her Omer
ompute Inspection Fee Below
• Fga Service Entrance Size v Fee Feeders/Sebfeaders a Fee, Circuits
U to 200 Amps 0 to 30 q ~y 0 to 30 Arnos
Above 200 Am xs 31 to 100 Arms 31 to 100 Amps
Swinuning Pool Above 100 Anq)s Above 1oO_Anw
Transformers Irrigation Booms .$4 Partial `Other Fee
Signs Special Inspection t
Remarks ~3 TOTAL FEE.
Gfo~O~
RoupN-in D/a~te~ L~//[[ -the EI rcal
r("- / Inspector, hereby
certify tht tM above
F rnal r Da1a fien has been
g_~ t nude.
tt:s reQUeat vdd 18 manthsirom
CITY OF EAGAN N0- 10243
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt #
To he used for SF DWG/GAR Est, Value $57,000 Dote MAY 20 iq 85
Site Address 1942 BERKSHIRE DR Erect kl Occupancy .R3
Lot 5 Block 4 SecISub. BERKSHIRE PONDS Re 13 Zoning R1
Reppair air ❑ Type of Conrt.
Parcel No.
Enlarge ❑ No. Stories
JOSEPH M MILLER CONST Move ❑ Length 43
w Neme Demolish ❑ Depth ¢8
2 Address IbIJJ AR AVE Grade ❑ Sq. Ft.
City FARMINGTONPhone 431-2001 Install ❑
SAME Approvals Fees
Name
i► Assessment Permit . O C
o1 Address
u1- City Phone Water b Sew. Surcharge 28.5(
Police Plan Review 152.0(
W Name Fire SAC 525.0(
2- Address Erg. Water Conn. 500,0C
iW City Phone Planner Water Meter 63.0(
Council Road Unit 220 - o c
I hereby acknowledge that 1 have read this application and state that Bldg. Off. 5/20/8 5 T . P . 132.0(
the information is correct and agree to comply with oil apPlicable APC Total S1 .984.5(
State of Minnesota Statutes and City of Eagan OrdmonceS.
Var. Date
Signature of Permittaa
A Building Permit is issued to: JOSEPH M- MTT.i.F.R CONST an the express condition that
ail work shall be dons in accordance with all appli la Stota of fo Statutes and City of Eagan Ordinances.
Building Official pe m
0
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
'f~3-IOro
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
5l, oou
To Be Used For: Valuation: Date:
Site Address:/ OFFICE USE ONLY
Lot: Block J Sect/Sub ect X Occupancy ~-3
Remodel Zoning Q-i
Parcel # Repair Type of Const
Enlarge # of Stories
Owner Move Length
Demolish Depth
Address Grade Sq Ft
City/Zip Code
Phone APPROVALS
Contracto ssessments Permit 2j( =
Water/Sewer Surcharge Zg.'a
Address Police Plan Review 1 52
Fire SAC ZS
City/Zip Cod 5S0d2~ Engr Water Conn
j.
Planner Water Meter (03-°'
Phone Council Road Unit LSO.°
Bldg Off. yS Parks
Arch./Engr. APC Treatment P1
Variance
Address TOTAL 11 , Y e y, S O
City/Zip Code
Phone #
3DD -00+
28.50+
152°C0+
'25-00+
5-10-00+
53.,)0+
280•,"0+
132.00+
1,984.50
ROBE CONSULTING ENGINEERS
ENGINEERING PIRNNEpS and LAND 1UAYEIf As
COMPRNY, INC*
1000 EAST 1461, STREET, BURNSVILLE. MINNESOTA 55337 PH 4323000
C r~z,~Lf ca~~ Sum-y-e y
LeQest D,,Ycr40eafon- L,,-r 5~ gLoC4 4, BERCs~tit~ FWC>$, M "7A, GovrJTY,
M I tit N ESOTXl.
.1. 1: Jf1~~r1
gvuA ~ b ~ ~ ~y3°.z)
ppot.sl 44A,
Lq.'~~ q~+5~ -sue o M
o ~ s r
10 ty
~ ~ m 5 q,0(~1.a Iv' zq,5~ / / ~29 9i
s~rl - O
to hn-
N
A3o.jJjmje1L3 Exv5mtj& EwA"noo NORTH
DPJMS FRQW!Z-O ELEV471on/ SCALE. 1"=io'
_ INDICATES DIRECTtA~1 CF %,Zgv-E 64"E
FIW64IED OAW-eE R-00M ELEV~a71A 1 = 9~y1~
I hereby certify that this is a true and correct representation of A tra0t,Of
land as shown' and described hereon.. As prepared by me on this /5rW day of
/airy 19 85 .
?Linn. Reg. No. AW5
CITY OF EAGAN SEWER SERVICE PERM
3830 Pilot .:nob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 5.5121 DATE: _ .
Zoning-
No. of Units 1
Owner: n
Address:
Site Address: I_ ;eXkshirr- -Jr. Plumber. "It" 21U.
i.
-5-- •'-8 51-81k . v
1 or" to eon* with as City of Bogen Connection Charge: 4 2 5.00pd
01dineape. Account Deposit.. 1
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Dole Pbid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot K,iob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No, of Units:
Owner: Ynt;ei_ -ii 1 l pr
Address:
Site Address: 1942 ' -
Plumber: 1 - rr.: s
Meter No.: Connection Charge: ',nn - 101sr1
Size: Account Deposit:
Reader No.: Permit Fee:
1 some to so opllr with on City of Bogea Surcharge: ►
Ordinaaa n. Misc. Charges - t'
Total: f ' i; „a ` e T
BY Date Paid:
Date of Insp.: Insp.:
CITY Of EAGAN WATER SERVICE PERMIT
A30 Pildt Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninn: - I2 i No, of Units:
Owner: _ J os ca F ,j r
Address: Site Address: ? RerkRhirc~ A.nrlT r-
4 Per,-shire-Ponds
Plumber. . v. r 1 a L
Meter No.: Connection Charge: 500 -'."101)(
Size: ~g! r u-(,lip i` Account Deposit; L .:"-'PC:
Reader~No.: 0 ~zl 19! Permit Fee. 2J.DO.~r'
I Gem to aear* with the City of Bogen Surcharge: i SOy~u
Or/Iwo 6~~A Misc. Charges: - 1 . OCf~:cl 4 / .
Total: 63 nQ d me er
By Dote Paid:
Dote of Insp.:
Insp.:
_ 2/84
`
` CITY OF EAGAN
/
IEF7
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) PROPERTY ADDRESS : J
LEGAL DESCRIPTICN: S y nc%
(Ipt/Blocc/Subdivision or Tax Parcel I.D. Ni=Der)
u T IST.:G S?".;U L:cE, DATE OF O?SG .AL EUIiDP:G : ~z_-ST ISSU :C.:
P.= 'SEE Z^,`II.,;/P?pPOSED 'SE. ❑ R-1 SL;GLE FAJLY
❑ R-2 DUPL.= (7%'o LTTITS)
❑ R-3 M,-M4C'IJSE (TF_R= + 1:NITS) ( UNITS)
❑ R-4 APAR7_=1T/=.Za..S`;MN1 ( UNITS)
❑ CCi'ME,°CLU/RL"'T L/CFc ICE
❑ MMUST .14,L
❑ 7=TITL'PI0NAL/GGVERN,!,'"P
2) ADPLIC;V"i (PLEASE PRINT)
ADDRESS: 18!33 C• Jot 4. c
CITY, STATE, ZIP: ANW,"rw a'~m.1 IWA~ ,fjma51
PHONE: ~f3!- 2mol
3) PI;7.!B R NPAME: (PLEASE PRINT) FOR CITY USE ONLY
illsuthi p76 iv
PLUMBERS LICENSE:
ADDRESS: / 12 Aw .Qae ve
CITY, STATE, ZIP: ~f ~,~,~µf~ ~JJ(J s1-eyExpire
,~'aar.n Q .N Rec• d
PHONE: ss4-3~o7s PLU.98ER LICENSE N_Q?O6,~ /y3
arr tnttia
4) GCCL'?ANT/aPrIGR NAME (PLEASE PRI!!T)
:
ADDRESS: SAiw« Wx CL
CITY, STATE, ZIP:
PHONE:
5) INDICATE WHICH PER-UT IS BEING REQUESTED:
62, CC:'z=ION TO CITY SEWER
0,CON`ZCTION TO CITY STATER
❑ M= (PLEASE DESCRIBE)
6) INDICAT:. ONE:
R PLEASE HOLD APPROVED PERMIT FOR PICK-Lip BY ONE OF ABOVE
❑ PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4 ABOVE
(Circle one)
7) SICATCRE: DATE: 8S
~ RaalM!lJel:f~ i if li:loftf~! i 17ti~Fii i Ind i [rii9~:ii i flll~F~A-!! fr ! `tsi0iiga/ [
F O R C I T Y U S E O N L Y
PERMIT ISSUED
FEES: $ 7 Q"S U SE:^iER PERMIT (INCL-DE SURC , RGE)
$ /O- S V WATER PERI,4IT (INCLUDE SURCHARGE)
$ 3cc~ WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ ~Slµ~ =CCC .?T L 70 - _..E3
$ ACCOUNT DEPOSIT - WATER
$ jDo c d WAC
$ 5 v SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ TOTAL
$ AMOUNT PAID/RECEIPT 57.x- 7
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
L YES IF YES, THEN A "PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO _ ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: 6
elf~Ilfil Ri MW 0"i A W:915 6"M w"a i W M WiO Ri/!no AM W" w~
City of Ear13n - Conversion
Cash Receipt
Receipt Date 10/2!00
Time Printed 7:48:42
Receipt Number 1001
RUNS MECHANICAL IMC
1942 BERKSHIRE DR
9001.4088 36.50
MP 43054
t
r
Total Receipt Amount 30.50
User HMCGRAM
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
O I ^ 3830 PILOT KNOB RD - 55122
(J 651-681-4675 I13 15
New Construction Reaulrements n r e Ce I V 4 103S 1Remodsl/Reoalr Reaulrements
D J registered site surveys showing sq. ft. of lot, sq. H, of house tea+C k 39 2 copies of plan
and gp roofed areas (20% maximum tot coverage allowed) 1 1 set of energy calculations for heated additions
D 2 copies of plans (show beam Q window sixes; poured fnd. design; etc.) 1 site survey for exterior additions & decks
D 1 set of energy calculations
D ] copies of two preservation plan If lot platted after 7/1/93
DATE: i CONSTRUCTION COST: ZS
DESCRIPTION OF WORK: r ( 1
STREET ADDRESS:
t5P r k S h i rt Po n J,,Q
LOT: 5 BLOCK: _ SUBD./P.I.D. h
Name:_ O 6 CLA,/`u-" Phone O
PROPERTY Lost First
1
OWNER Street Address:- Ll
S S~ ~°L
t State: 'Y" Zip: city
Company. E:2" Phone
(area code)
CONTRACTOR zawa
Sheet Address: 2 100 0 S I License #~'alA Exp.
City State: zip: ~S
ARCHITECT/
ENGINEER Company: Name:
Telephone ( )
Street Address: Registration C
City State: Zip:
Sewedwater licensed plumber (if installing sewer/watte Plane (
I hereby acknowledge that 1 have read this application, state that the information b emect, and agree to comply with an applicable State
of Minnesota Statutes and City of Eagan Ordinances. 2
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 21 Porch (3-sea.) ❑ 31 Ext. Att- Multi
❑ 02 SF Dwelling ❑ 08 136-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Aft - SF
❑ 03 01 of_ plex ❑ 09 07-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Mufti
❑ 04 02-plex ❑ 10 08-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 03-plex ❑ 11 10-plex Pobg _Y or -N ❑ 25 Miscellaneous
❑ 06 04-plex ❑ 12 12-plex ❑ 20 Pool ❑ 30 Accessory Bldg.
WORK TYPE
❑ 31 New ❑ 36 Move Bldg. ❑ 43 Reroof
❑ 32 Addition ❑ 37 Demolish (Bldg)" ❑ 44 Siding
❑ 33 Alteration ❑ 38 Demolish (Interior) ❑ 45 Fire Repair
❑ 34 Repair ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
❑ Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
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:
SAC Units
% SAC
---------I
I 6 Officek07i
~z5~8
Ab~ City of Eap Permit#.
(1 (1 I I
I Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff:
L----
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: q 10 - Site Address: 61bal4sh'rez In
Tenant: ] Suite
RESIDENT I OWNER Name: _I y id ~XC~ -n ki Phone: (a5b9aa - 13
Address / City / Zip: 1
CONTRACTOR Name: License bflio-pm
Address: Champion -
e51-365-1340
City: 3670 Dodd Rd #1gg State: Zip:
Eagan, MN 55123-1339 So 1
Phone: Contact Person:
TYPE OF WORK -New Replacement _Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL V/
Water Heater Water Softener
_ Lawn Irrigation -Add Plumbing Fixtures
L- RPZ / _ PVB) Main _ Lower Level)
_ Septic System -Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 Stat M~l~e~ D
$30.50 Lawn Irrigation (includes $.50 State Surcharge) APR 14 2008
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 S urcharge)
`Water Turnaround (add $136.00 if a 5/8" meter 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 $
1 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
accordai ce with the approved plan in the case of work which requires a review and approval of pl
x 9YW,c, -1vlc.~11'~ x
Applicant's Printed Name Applic , 's Signatu
FOR OFFICE USE' Reviewed By Dater
Required Inspections.: Under Ground Rough In ;-AirTest Gas-,,Test- ~ FIna,
CITY USE ONLY ~L
LOT 5 BL PERMIT I U
SUBD. i, )f Y ~S Yl 1 ~O VAC RECEIPT
RECEIPT DATE:
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAHAN
3830 PILOT KNOB RD
EAGM MN 55122
Date: q n'Zg'ofl 651-681-4695
Complete this section only if you are installing HVAC in a single-family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @ $3.00 ea.)
State Surcharge .50
Total $
4
Complete this section only if you are remodeling, adding to, or replacing an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
- New Replacement _ Other
Furnace Air conditioning
Air exchanger Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call forftnal inspection.
SITE ADDRESS: 1942 BERKSHIRE DR
OWNER NAME: DAVID BERGSTROM PHONE 6 905-1395
(AREA CODE)
INSTALLERNAME: RON'S MECHANICAL ING PHONE#: 952 - 445-8585
(AREA CODE)
STREET ADDRESS: 12010 OLD BRICK YD RD
CITY: RHAKOPEE STATE: MN ZIP: 55379
a EED
r~l -via Co 0j SIGNATURE PE ITTiEE
BY:
CITY USE ONLY
L BL PERMIT#:
SUED. RECEIPT#:
APPROVED BY: INSPECTOR RECEIPT DATE:
2000 MKCfIANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3$30 PILOT KNOB RD
EAGAN, MN 5512E
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank
Processed Piping
When installing/removing underground tank, call 651-681-4675 for inspection by fire marshal and
plumbing inspector.
Description of work:
r
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removal/installation = minimum fee
i
Contract price: S x I% = $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
- - - - - - - - - - -
SITE ADDRESS:
OWNER NAME: PHONE
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS: PHONE
(AREA CODE)
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
530 15 S n
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete f`orj modifications to existing residential dwellings.
Date/ l /0~
Site Street Address Sz ( C~~ ~J 1r 1 Unit #
~ L c-
Property Owner\ \C1a- ~~r 5~ Telephone # ((p51) qos - 139 J
l 1 U L~
Contractor 3GJ~Y 1 f d ~b mb 1 t"1 S~ Telephone # (1-D)
Address 4V 1-\i s\\s- city I L State Y`I J Zip
The Applicant is: _ Owner x Contractor -Other
Lr,-~hejtW Alterations to existing dwelling $ 50.00
-Add fixtures to rooms, excluding water softener and wat 9 [11114
-Septic System Abandonment
-Water Turnaround (add $121.00 if a 518" meter is requir
Other:
_ Water Softener Water Heater $ 15.00
replacement _ additional
Lawn Irrigation System RPZ_ new _ repair -rebuild $ 30.00
State Surcharge $ .50
c5~
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accor ance with the approved plan in
the event a plan is required to be reviewed and approved.
Applicant's Printed Name App icant' Si nature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA147228
Date Issued:12/18/2017
Permit Category:ePermit
Site Address: 1942 Berkshire Dr
Lot:5 Block: 4 Addition: Berkshire Ponds
PID:10-13750-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
David A Bergstrom
1942 Berkshire Dr
Eagan MN 55122
Centraire Heating & Air Conditioning
7402 Washington Ave
Eden Prairie MN 55344
(952) 941-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA147738
Date Issued:01/30/2018
Permit Category:ePermit
Site Address: 1942 Berkshire Dr
Lot:5 Block: 4 Addition: Berkshire Ponds
PID:10-13750-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
David A Bergstrom
1942 Berkshire Dr
Eagan MN 55122
Centraire Heating & Air Conditioning
7402 Washington Ave
Eden Prairie MN 55344
(952) 941-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171346
Date Issued:08/11/2021
Permit Category:ePermit
Site Address: 1942 Berkshire Dr
Lot:5 Block: 4 Addition: Berkshire Ponds
PID:10-13750-04-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
David A Bergstrom
1942 Berkshire Dr
Saint Paul MN 55122--361
(651) 808-0720
Clear Choice Restoration
2722 Hwy. 694, Suite 100
St. Paul MN 55112
(612) 259-7177
Applicant/Permitee: Signature Issued By: Signature