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3973 Beryl RdThfs requ*t void 78 m" iths from • T ` 80068 tD?oc? Reque'st Date ?y C Q ? - L- I Fire No. I Rough-in Inspection Requlred? o n -- - eady Now QN?'ill Notifv. Inspec- tor Wh R d , +? ti% Yes ?l en ea y ')!9:Licensed Electrical Contractor ? Owner I hereby request inspection of above electrical work installed at: Street Address, Box or Route No. CitY f -j __ 5 ection No. Township Name or No. Ran No. Coun p. • Occupant (PRINT) ie No. ` PoUPlier Add ress =^ Ele - rical Contractor (Company Name) ._. ? -?...., J ? Contractor-s License No. A Mailing Address-IContractor or Owner Making Insi-4ilation) Authorized Sign ture ( tract /Owner Makg nstallationl Phone Number !. l", 7 r^? C 577 ? ? ELECTRICITY THIS INSPECTION REQUEST WILL NOT MINNESqT E OF S BOARD Griggs-Mid Bldg. - Room N-197 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE tS. Phone (612) 297_2111 ENCLOSED. - ""` Ee- ooooi -oa REQUEST FOR ELECTRICAL INSPECTtON ?':? ,?^a p^? i*7: 6^a ?4 '.See instructions for compieting this form on back of yeliow copy. X` " Belows V V ?l q) Work Covered by This Request ? New Add Rep. Type of Buiiding Appliances Wired Equipment Wired Home Range Temporary Service Dupiex Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercia) Bidg. Fumace Silo Unioader industrial Bidy. Air Gonditioner Bulk Milk Tanic Farm other specrfv other (specifv) Other iSpecify Other Other Comoute lnsnectrnn Fee Relnw # Fee Service Entrance Size # fee Feeders,`Subfeeders St Fee Circuits 0 to100Am s Oto 30Am s 0 to30Am s 101 to 200 Amps 31 to 100 Amps 31 to 100 Am s Above 200 Amps Above 100_Amps Above 100_Amps Transformers Remote Control Circ. ? Partiai `Other Fee Signs Special inspection $ T Remarks ? OT Ef d Rouyh-in - - Date 1, the Efectrical Inspector, hereby tif th t th b Final Date cer a e a ove V ion has been ? ?. 4 de. Ihis request void 18 months from CITY OF EAGAN Remarks * Ced2tx Grove Acauisition Addition CEDAR GWVE #5 Lot 5 Blk 3 Parcei 10 16704 O5O 03 owner Street 3973 BBryl Raad state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, STREE7 RESTOR. GRADING SAN SEW TRUNK Z 1967 100.00 5.00 20 Paid SEWERLATERAL 31 196$ 490.00 24.50 20 Paid WATERMAIN ? WATER LATERAL ((Q 1972 607w00 24.2$ ?„?'j Paic7 WATER AREA STORM SEW TRK 1970 70.00 3.50 20 Pdid STORM SEW LAT CUR6 & GUTTER , SIDEWALK STREET LIGHT WATER CONN. gU(LDING PER. SAC a 10-30-67 PARK ? EAGAN TOWN S H I P BUILDING PERMIT Owner .__.?r? _._........T• _`?? ..---? , --••-•-•-• --•---•-- z--?•--•.-••---••---•-- Address (Presen2) •-'Je-..... d,?------.?? ..... ........................... Builder _..--•-•-•,??:-vr??.............................. ---------------- __._------ --• Address ........................................................... -------- ------ ............... DESCRIPTION N° 16'74 Eagan Township Town Hall Date ?%. SYories To Be Used For Froni Depih Height Bs#. Cos! Permii Fee Remarks //' J ? L G r d'YZ LOCATION Streef, Road or other DescripYion of Location I Lo! I E:ock I Addition or Traci ..?? ? ? 'J' This permit does not suthorize the use of sireets, roads, alleys or sidewalks nor does if give the owner or his agent the righ3 !o create any situation which is a nuisance or which presenis a hazard to the heaith, safeip, convenience and general welfare !o anyone in the community. THIS P£RMIT MUST BE KEPT ON E PREMISE WHILE THE WORK IS IN PROGRESS. This is !o certify, that..... t?:?`':ti_.,i!?_'.:`?: f ___._..haspermission to erect ............ . . . ...--•-=-•-- !he above dESCribed premise subject to the provisions of the Building Ordinance for Eagan T nship adod April 11, 1955. / /, ? ?, ? ?-K c .... °-•------•••------°--••°--- - -•=-•----•---•----, - ---•--•---•?•--•°----------•---• Per ---•---.---- --- :?- _.4:?-•-•••-•-•-?--••---••--r--...----•••-•-•--•-•--••-•-••------••---•-•--•-- Chairman wbf Tnwn Boar el, Building Inspecfor M , ? PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUIL nING Eagan, Minnesota 55122-1897 Permit Number: 025662 (612) 681-4675 Date Issued: ? 5/24/95 SITE ADDRESS: 3973 BERYL RD LOT: 6 BLqCK: 3 CEpAFt GROVE 5TH P. I e N.: 10-16704-050-03 DESCRIPTION: B (sxaING) rmit Type r,k: T Y P e SF (MISC.) REPaxR REMARKS: FEE SUMMARY: - VALVA1-L V I\ $5g000 L7a?'aE' Fee $) 2• C1YJ 5urcharge 2,5iA Total Fee $74.50 f r' 'ISS ED 1111 SIG TUR INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 S(TEADDRESS:P°I.N. = 10-16704`050-03 APPLICANT: LQT: 5 BLQCKe 3 3973 BERYL Rp SANqAU CONST CO ZNC CEpAFt GROVE 57H (612) 447mm8001 PERMIT SUBTYPE: SF (MISC.) TYPE OF WORK: euxLDING 025662 05/24J95 REPAIR DESCF2IP7IQN (SIQING) INSPECTION DA . D• FRAMINC F2QUGH TN Fi.B6 (IUGW TN HTG FINaL I? ? . r VfTY O? EAGAN - 3830 P1LQT KN{)B RQ - 55122 . 1895 BUfL.D1NG PERMIT APPLICATlt)N (RESIf}ENfTIAL) 681-4675 DESCRtPTIt31V t)F WORK: ge "- 5;Je- $'i'REE'!" AD[3RESS: ..??..+. r.? ?...,..r.... LOT i3LC3CfC jSUBD.IR.l.Q. m4r?V 1+RQPLRTY Id8111f3: `?a.,P c? ; ?- r g ? ??' = y ?iC?1't? i?. ?a''? ?` ?.????,.?.....?.. CWNER StroO Addt"ess' Cit3r Sta#e: ?.ia, ? CON"CkAC?'Pt>R Company: ' a cc.." u..t ?.-?? P?te#: q ?1 -7 ? ?. ? ? S#reet f?tid?s:?'V13^ L?t1se #. `'?' .? 1 Cjty• r t o r" Lc.-kC zip.,.?..`?'..?.,?. AR+CHlTEMt Company: Pfifore EX"EER . . Name: Registcation S#reet Addms• ` Gity: State: .,..??.?.?.?.,... 7W ftnaftre of AppOwnt: t}fFlGE USE ONLY Corgflcfts af Survey Reo*nd Yn Nty 'Trn Pieserv"on Plan Receivsd Yes No oFFicE usE aNLY HtI1L.DfNG P£RM1T TYPE o 01 Foundation o 06 Quplejc a 02 SF DwsHing o a? 4•ptex ca 03 5F Addidort o 08 8-p1ex O 04 SF Potch p 09 12-pIeX * 05 SF Misc. A 't 0 --pleac WORK T'YPE 0 31 Now 0 33 Aterations B 32 Adftm ct 34 Repair MNERAL IMFCRMA'tION Const. (AcWat) (Ailow") ? IJBC Cwupancy zonft ._.?._ #tf Stolies - ? Length Depth ? J4APROVALS 0 11 Apt.iLvdgaV M ca 12 Multi RepairiRem. a 0 13 GarageiAcoessory ca • a 14 Fireptace 0 a 15 Ceack 0 36 Mave ct 37 pemol#ian Basement sq. ft. ? MC/V1tS 3ystem ? Main tevet sq. ft. ? Ct'ty Wmet ? sq. }t. Fire Spriokered ?.?..._._. sq. ft. PRV ? ? sci. ft. soosw PumP .?.,_,.., sq. ft. ,,.?.. .?.M.._... Certsus C4da. ? Footprirrt sq. ft. ? SAC Gode comus swo ? Cerous Unft ? Plannirg ? Building Engineering ?., Vaderne Permi# Fee Va#usbon: $ Surchirge Plan R+eview t.icense MC11fllS 5AC Ci#y SAC 1Mater Conn. Water AdeW Ac#. Dpmi# SAN Permit SNV Sundwge Tteahmttt P1. Raad Unit Parit Ded. Tcaiis Dod. Other . Copies Tabf: °ib $AC SAC Unb CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesata 55122-1897 ? (612) 681-4675 SITE ADDRESS: P. I. N a: 19-16704--050-03 DESCRIPTION: B PERMIT 3973 BERYL FtD LOT: 5 BLQGKr 3 CEDAR GROUE 5TH (wzNnows) ermit Type a r;k, T.Y P e PERMIT TYPE: Permit Number: Date Issued: 5F (MISCe) NEW ?K. 413 I? BUTLDIIVG 025602 05f18/95 I REMARKS: I FEE SUMMARY: VAI.UAI"IC11V Base Fee Surcharge Tota1 Fee CONTRACTOR: $1,500 OWNER: - Applicant - DARaxrIs GREG 3973 BERYL RD EAGAN P1N 55122 (612)687-0913 cql CaA / nl'?' I ISSUED Y: S NATU E $36.00 .75 $35.r5 INSPECTICIN RECCIRD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 suxLpxr?G 025602 05/1s/95 SITEADDRESS:p.I.N° ° 10-16704`050-03 Lor: 5 sLacrc: 3973 BERYL RD CEQAR GRqUE 57H PERMIT SUBTYPE: sF (MIsc4 ) 3 APPLICANT: DARA1"(`IS GF2EG (612) 687-0913 TYPE OF W4RK: NEW pESCRIP1'IO(V (WINqOWS) =INAI. r , .a CtTY C?F EA?3AN 3830: P1LC?T KNOB RD? - ?55122 0 1996 BUILDtNC PERMlT APPI.tCA7'IC?N {REstt?E?i't'IA?l.} f,???,? " ? 881-€TS UQ???`? ? ;. ? aroaMwed sft swvep . ? 2 cop" 0 plan ?? 2 +cOP" of ibm WducFe !?eam & uhtcbw sim; Pewrwd ind. deggn; atc.) ? 2 oiEe swrep (oxkvW oddYAme & tledCS) ?? 3 oopiss of? naUan plsn if bt piat?ed siter 7h/93 #"? sner?y c?e? ? t?ed ? ? MP*W? ..._ Yes r.,.. No tATE: corvsTRUCtIoN cOsT; A i it DESCRlP`fl{?N OF WC}RK: -) W,--.-cLowS /rHe..v+-cov l--,q Q! c? -E't' Rt?DRESS: ' .-5 v' 1 LOT ? BL.f?K SUBQ./P.t.D. ? ? a6mv P'tt3P'Ei?rtY Name: ?"0.• ?- ? ?, Phttre # ` ? " ? ??.? OW14ER Street Address? CiiY: Laacxf) .?...... . Y112...,, •??• '??` ? t?? -:: . CoNTRAGtoR Campany: , Phone#: Street Address: t.ficerse GitY: Zip• ARcwrr'ECTt Campany: P'1ore ?EAIGlAtGlR t Name: Regfn #{ Stree# Address• . City: -state. Zip' 01=FIGE USE ONI.Y C*rMmtes of Suney Recoived Yes - Aic Tree P"rvaficm Ptan Rewived ? Yes . No QFFtCE USE ONLY BU1LQtNG PEitMIT TYRE c 07 Foundstion ca 06 Dupiex o 11 Apt.flodging t) 'tB &osement Finish a 02 Sf DwoWng o 07 4plex Q 12 Mufti Repair/Rem. 0 17 Swim Rooi a 03 SF Additian El 06 8•ptex ta 13 GaragelAcoe$sc3ry o 2Q Public Facilitt n 04 SF Ronch d 09 12-plex ? 14 Fireptace o 21 Miscelianeous 0 05 SF Mis+c. 0 10 ,,,,,_-plex o! 5 Dedc 1NORK TYPE Q 31 Now ca 33 Altera#ions a 36 Mawe 0 32 Addftion o 34 Repair o 37 Dem4iiitian GENERAL iNFt3RMATtCiN CCcat7st. (ActuaQ ? Basement sq. ft. ? ANC1tlU"S System (Aiivwabfe) Main lavel sq. ft ? City Wsftr ? 1JSC Occt,tpencY sq. ft. Fire Sprinkler" ? Z.c>r?ing ?... .?,._ sq. ft. PRV # t9f S#aries sq, ft. ? Boasttsr Pump ? Length sq: ft. Cet'sus Ctude. tepth Footprin# sq. ft. SAC Gode ? Gensus 8ldg Cersus Unit APPRE?VALS F'tanning Building Engirteering ? V$riance ? Permk Fee Valuation: $ Surcharge Pian Review . l.tenso MCNVS SAC City SAC Water Conn. Water AAe!€er ArKct. Deposit SAW Ponnit . 5NU Surdtarge Treaftmnt P1. Road Unit F'ark Ded. T'taits Ded. C?thw Copies 7atat: °!a SAC SAC Uni#s EAGAN T4WNSHIP 3795 Pi1ot Knob F.oad St. Paul, Minnevota 55111 Telephone 454-5242 PERMST FOR SEWER SERVICE COIVNECTiON DATE: December 4 , 1967 01,TNEP: Cedar Grove Const. Co. PLUMBER Stei,ris Inc. DESCRIPZ'ION OF BUILDING Industriall Commercialj Residential I Plultiple Dwelli.ng I No. of units x Location of Corenections: Connection Charge $200.04 Pa. Permit Fee $7,,50 Pd+? 5treet Repairs Tota 1 Inspected by: Datie Remarks• By_ Chief Tnspector In consideration of the issue and delivery to me of the above pemit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By. NUMBER 84 Address Lot 5 Blk 3 C.G. 5 TYPE OF PIPE Cast Iron P1Aa,.,ze r,otify cahen ready for inspection and connect:ion ar<d befoxe any parti=:n of the wcrk is covered. ?I NmI! p,?? ,I ?'?' 1 MEMO ? city of eagan TO: DIANE DOWNS, UTILITY BILIING 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 g Block 13, Lots 1-15 15 208 The City is currentiy being billed by Dakota Electric for streetlighting in the above listed subdivision. z 4 1 -4- Z/"'Q - ?E ? Z/ Z, I Edward J. irsc t Sr. Engineering Technician cc: Mike Foertsch EJK/je City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 - For. W111 ;?s?s --------- - ? Permit #: i Permit Fee: ? Date Received: I ?? I I Staff: I 1 ? ---------- ----J 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ?0) Site Address: BE' &car, Tenant: Suite #: ? /?, - `S)C) S (fie t I RESIDENT / OWNER Name: Phone: L? l . t T Cl ? Address / City / Zip: r?-? ?1 /rl Applicant is: Owner Contractor TYPE OF WORK Description of work: il Buildin : (Yes Constr t??( a000 ti do M lti-F C g y uc on os ? u am CONTRACTOR Name: License #: s Address: City: A-l"L ?~L t!?i,y ?-S State: IIIA) Zip: ? lac Phone: (pla Contact Person: `csK ?'t COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheei Category Submitted Submitted (4 Submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: IVOTE. Plans and supportirtg documents tlrat yau suhmit are cansidered ta `be public information: Partivns of ' the infnrmation may be classified as rion pub/ic if yvu provide specific reasons that arvriu/d permit the City #o' ' conclude #hat the are traale secrets. 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 ermit; that the work will be in accordance with the approved plan in the case of work which requires a review and approvgklq plans. x ApplicanYs Printed Name A ant's Signature Page 1 of 3 R DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? 05-plex ? 16-plex El Accessory Building ? Pool ? Single Family ? 06-plex El Fireplace ? Porch (3-season) ? Ext. Alt. - Multi ? 01 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 08-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 03-Plex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 12-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building" ? Addition ? Move Building ? Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows 0 Demolish Foundation ? Replacement ? Egress Window ? Water Damage DESCRIPTION: ' Demolition (entire building) - give PCA handout to applicant Valuation Occupancy MCES System Ptan Review Code Edition SAC Units (25% 100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:,R.l. _Air Test _Final Insulation Reviewed By: RES/DENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Sheetrock Final/C.O. Final/No C.O. HVAC Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall Building Inspector --------------------------- j Page 2 of 3 RESIDENTIAL BUILDING PERMIT APPLICATION REQUtREMENTS: New Construction Requirements ? 3 registered site surveys showing sq. ft. of Iot, sq. ft. of house; and all roofed areas ? 1 Soils Report if proposed building is to be placed on disturbed soil ? 2 copies of plan showing beam & window sizes; poured found design, etc. ? 1 set of Energy Calculations ? 3 copies of Tree Preservation Plan if lot platted after 7/1f93 ? 20% maximum lot coverage allowed ? Rim Joist Detail Options selection sheet (buildings with 3 or less units) ? Minnegasco mechanical ventilation form Remodel / Repair Reauirements ? 2 copies of plan showing footings, beams, joists ? 1 set of Energy Calculations for heated additions ? 1 site survey for additions & decks ? Addition - indicate if on-site septic system ; _ ? I N ? LC 7 ? gff C'1F EAGAN f PERW 7"YPE: i ???? I C V1 14 G 0 Pila# Knob Raad Parrr?ft Nurrber: fo ?2 41; 6 Minnesota 55122-1897 pate is . f9 6 ° (612) 681-4675 ? ADCIRES.?' : 1 , N _ t 0 . 1 4 t? ?" o . 0 's APP"l.tCAN'T: . ; 3 1) i :1 13 x p If t ri lo I r I fAf fi e L SUBTY'FE: 'tl(RE,OF iNORK: - ?` . ' . 0 E r'E t, R tP I I ON I iM ft! ; P?.:- r ? ADt?RESS:?x.. exc.A c t." Y Sam SUB"CYPE: ? § AP'P#:ICANT: y ';AlVI)At? t:,OW;# t"!i IN( 7YPE OF WORK. ? I ;;" 14 c ki C,t 1:() N a a ? .. , .?.. b ? t N Pt ot?> : . 6'?Gtf t 14 14 ?!' c, !-? 1 h# At t FotxgD ' ? ? ? rwou NOUL aW BOAFU) FWASUCE FIFINIMACE AIRTM TK4L riBG FKAL HTG OASAT i'ES'f BL,Ot3 FifM BSWIT R.I. E18AAi' EMi. pEqC FTC3 OEf.YC RNJkt. kh f ,A ,. ;???? Use BLUE or BLACK Ink ! For office Use I ! fEd (~d _ 3 j Permit#. -0's t l i Pemut Fee: ! 3830 Pilot Knob Road 1©" I S I Eagan MN 55122 ! Date Received: I Phone: (651) 675-5675 i I Fax: (651) 675-5694 1 star '-----------------J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 3173 )~,~a~~? S~s/Z2 Date: / Site Address: ~ Unit 4, 1 C Name: V'i ~t~CI t Phone: 9<0_ - 00 91S_ ' oye'd Resident! ?_3 ~ I ~ ~ Owner Address / City / Zip: K- \J U Applicant is: 0mer Contractor Type of work Description of work: Construction Cost: vD Multi-Family Building: (Yes / No Company: IL[JA C.0 OS 7Y1dno Wl Contact: W r ~ ~ 1 C .~-SGl1~ Contractor Address: 5,5-+" S1. AlrCity: AhVL.otO c,~ - ~O 333 State:. r. % ~I_ Zip: 5J 30 Z Phone: 3 _ fl ~00Q y License * 1 c G 35/ 75 Lead certificate * 104- If the project is exem t 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: MOTE: Plans and supporting documents that you submit we considered to be pub#c hilbrnm on. 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 secrete. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4544=2 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.org 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 twilling permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x x of Z&f) l%' •_S Applicant's f1rinted Name Applicant's rgna Page 1 of 3 � � r----------------� I For Office Use � � � Permit#: ��I i � � I , � Clt� 0� ����Il ; . . � ,s� ;�-� Perm�t Fee. 3830 Pilot Knob Road � ---� . � � Eagan MN 55122 �"� � �,�i', ��� �� � Date Received: ,�"'����'/ �' � Phone:(651)675-5675 � �� � Fax:(651)675-5694 ��� " 'u ���� � Staff: �- � I ' I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name:�iG,✓� 4 �J��f�- ,�L�/ Phone:l� 3i9-�,I b� ResidenU � Owner ` address i c�ry i z�p: '�91`3 ��rti I �� ����„ S S I�z Applicant is: Owner �Contractor - T e of Work Description of work: C� t,,�1-bl r��� YP d. Construction Cost: '�'I �o� Multi-Family Building: (Yes /No�, Company���n-.�✓�-C2 ,�-en•�c�2 lln Contact: J os1��AS�f.✓h�R✓� C011#1'aCtOt' Address: I�"ZZ ��2�n�r,r�r-�J�. City: S-�. 7A..�\ State:�Zip: S�!o� Phone: (z Zt�!-S g�'/ Email: I OS� �7��'''�1�2VQ.iYioo�P�,y�r, ,L n.� ucense#: �L'SS�S 9�� �eaa certiticate#: N�T- 1�I S 10 b-I If the project is exempt from lead certification, please explain why: 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: �icensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and suppvrting documents tha#you suhmit are co�tsial�red`to be public ir�formation. Portions of the informatfon may be classified as non pubtic if you provide specific reasons thaf woufd permit the City ta conclude#hat fhe are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utiliry damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the orclinances 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. F�cterior work authorized by a building permit issued in accordance with the Minnesota State Building C de must be completed within t80 days of permit issuance. X �.{ oS1� �L��-�'-f.,/�vl A,r� x Applicant's Printed Name Appli nYs Sig ture Page 1 of 3 l � �' �--- ��i �-� ����' . �'c�., ,..,, ,.....� ���..,. ....� �.,.� %� c. SUB TYPES Foundatlon _ Fireplace _ Porch(3-Season) _ Euterior Alteration(Single Family) � Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi _ Deck _ Porch(ScreeNGazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Buiiding WORK TYPES ),�� ��,,;� ,�-���'� _ New l Interior Improvement _ Siding _ Demolish Buiiding* _ Addition � _ Move Building _ Reroaf _ Demolish Interior � Alteration"��� _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wali 'Demo�ition of entire building-give PCA handout to applicant DESCRIPTION � Vatuation � Occupancy � �,, MCES Sysfem Pian Review ; Code Edition ���V'�, SAC Units (25%_ 100% ) Zoning City Water Census Cod 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) Finat/C.O. Required Footings(Addition) � Finai I 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 Fire Suppression:_Rough In_Final Braced Wafls Erosion Control OtMer: Reviewed By: ` t�' , Building Inspector RESIDENTIAL FEES ,��,� �' ,� � Base Fee ���,. ��r`�c; � `" „.��,�,��`�,. ,�`�'�,''`�l�� Surcharge , - ,,��,� .� �F � �� �� Plan Review �,� MCES SAC �`� , .. � � � City SAC Utiliiy Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA146035 Date Issued:10/05/2017 Permit Category:ePermit Site Address: 3973 Beryl Rd Lot:5 Block: 3 Addition: Cedar Grove 5th PID:10-16704-03-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Brian W Walker 3973 Beryl Rd Eagan MN 55122 (513) 319-5696 Pronto Heating & Air Conditioning 7415 Cahill Rd Edina MN 55439 (952) 835-7777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA146922 Date Issued:11/22/2017 Permit Category:ePermit Site Address: 3973 Beryl Rd Lot:5 Block: 3 Addition: Cedar Grove 5th PID:10-16704-03-050 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 - Brian W Walker 3973 Beryl Rd Eagan MN 55122 Pronto Heating & Air Conditioning 7415 Cahill Rd Edina MN 55439 (952) 835-7777 Applicant/Permitee: Signature Issued By: Signature