3991 Beryl Rd
Use BLUE or BLACK Ink
I For Office Use
~ Permit
City of EaRd~ _
J Permit Fee: 1.
3830 Pilot Knob Road ;
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
d</ I Staff:
Fax: (651) 675-5694 ~.d~ L - - _ _ _ _ _ _ _I
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: l - 1 !a Site Address: z /S e f
Tenant: / / Suite
RESIDENT/OWNER Name: R 4. efc (c ey"/ Phone:
Address / City / Zip:
CONTRACTOR Name: jn~- kl-t C-/e~7 d-,- License
Address: Z
3 City: l®sy~ c
State Zip: 5ra~l Phone: /.2-
Contact: 22 ~C w l / L Email:
TYPE OF WORK - New _Y -Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
eater Water Softener
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
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.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 appr f plans.
X ~QQ L - _(:I> X
Applicants Printed Name pli ant's gnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In _Air Test _Gas Test Final
RESIDENTIAL
S S 43 11 BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD EAGAN MN 55122
651-681-4675
1
New Construction Requirements Remodel/Repair Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate if home served by septic system for additions
3 copies of Tree Preservation Plan if lot platted after 7/1/93
• Rim Joist Detaii Options selection sheet (bidgs with 3 or less units)
DATE VALUATION
III
SITE ADDRESS MULTI-FAMILY BLDG ^Y VN . 311 TYPE OF WORK S~ FIREPLACE(S) 16, 1 2
APPLICANT Catastrophe Restnratinn Seryicrpa InC
STREET ADDRESS 9489 Race Rt Guite 70 CITY Rncr3VWe STATE_MN ZIP REI 13
TELEPHONE # _ CELL PHONE # FAX # a3 n~
PROPERTY OWNER®~ \ TELEPHONE #\EXAiaS' =~l
COMPLETE FOR "NEW" IRE DENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 Z?
{~1 submission type) • Residential Ventilation Category 1 Worksheet Submitted T-k4r6~ ~od V~rcs 6~ bmitted
Energy Envelope Calculations Submitted II
EP 2 7 ZOj
Plumbing Contractor: Phone #
Plumbing system includes: Water Softener Lawn Sprinkler - ~ _F W_ _ Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor: Phone #
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 Statutes and City of E Ordina s
Signature of App
OFFICE USE ONLY
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi
❑ 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
❑ 05 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 Windows/Doors
❑ 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
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) Final/C.O.
Footings (deck) _ Final/No C.O.
- Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water i Final Pool _ Ftgs _ Air/Gas Tests -Final
Framing - Siding _ Stucco _ Stone
- Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement)
Insulation _ Retaining Wall
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
Request Date / 0 T ire No. Ren Inspection
L777y Required? El Ready Now Will Notify Inspector
❑ Yes X 'No When Ready?
wn
er hereby request inspection of above electrical work at:
I ❑ licensed contractAro
Job Addre s (Street, Box or Route No.) Cit
X 3~ I Be r-L4 I (26 ck
Section No. Township Name or No. Range No. County
OMANe_,604:~~_ 1(PRINT) Phone No.
Powe Supplier Address
Electn al ontractor (Company Name) Contractor's License No.
Mailing Address (Contractor or Owner Making Installation)
Au razed Signature (Contractor/Owner Makin I stallati n) Phone Number
c a
L4
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001.07
10- See instructions for completing this form on back of yellow copy. 5//
G 3 60 X" Below Work Covered by This Request
ew Add Fte pyT f{s oeoe Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks: G
Compute Inspection Fee Below: elieq ~ r
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Amps
Signs Inspector's Use Only: / OT L 7 C9
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
Rough-in Date
I, the Electrical Inspector, hereby
certify that the above inspection has Final Dat
been made. 7;-
OFFICE USE ONLY
This request void 18 months from
CITY OF EAGAN Remarks * Cedar Grove Acguisition
Addition CEDAR GROVE #5 Lot 8 Blk 3 Parcel 10 16704 080 03
Owner r° `'Cf,41.i t 1` Street 3991 Beryl Rand State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK IL 1967 100.00 5.00 20 Paid
SEWER LATERAL 19611 515.00 25.70 20 Paid
WATERMAIN
* WATER LATERAL //G 1972 607.00 24.28 25 P
WATER AREA
STORM SEW TRK 71 1970 70.00 3.50 20 Paid
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC 200.00 470 10-30-67
PARK
l
EAGAN TOWNSHIP N? 1674
BUILDING PERMIT
Owner t. C-~~ C.
~',c'.__..,..T- Eagan Township
Address (present) :..f.``` Town Hall
Builder k r.` / f C
Date .
Address i.. l
DESCRIPTION
Stories To Be Used For Front Depth Height EsY. Cost 'Permit Fee Remarks
LOCATION
Street, Road or other Description of Location Lot Block ' Addition or Tract
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right Yo create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE /KE~P,T ON E PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that......C X-~ ~0 "-:°::?-'----has permission to erect a..... upon
r~
the above described premise subject to the provisions of the Building Ordinance for Eagan T nship adopted April 11,
1955. /
. /x B----- Per -----....._.~Z.C.._./Buildin~~ns actor.-••--•----•-------
Chairman f Tnwn oartlj / g p
f
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.f.}:;:c;:i{.;;,;: z~: x•4~•... ..?::?•J. .J3,:.. .rJh .x . •^•.3i .•,r,•:'•`~~~''
~{•:ti : Y4 ~?'fir .h+'/}'&~i"vti
5>'t...,}C, ~}$~a~p~ tt>)})J~~ try" }L••• Zv:
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.v.,....,m5S:2S'n-•n.i.{tit: ~2ivt\,... v.rYJ~vv+t:`i,ti%k~'a~C'%•i:QS ?,''i.+~.M(ri4~ , '}~N~v~Y~ +w~vv. ~4Xn:
1993 MECHANICAL PE kMI i 0MIIIENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN $5122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH),.
ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 13.00
STATE SURCHARGE .50
TOTAL
9 93
3
SITE ADDRESS:_ 2 2 2 A
OWNER NAME: 4 COL-1 Sr TELEPHONE S~
INSTALLER: COPS= 12A±1,04,ttm - ---A-r a,
ADDRESS: ^I a I C 07,Y
CITY: STATE: ZIP CODE.
TELEPHONE #:7
SIGNA OF PERMITTEE
Rim,
1"3 MECHANICAL PERMff (COMMMCIAL)
CrTY OF EAGAN
39M PELOT KNOB RD
EAGAN MN SS122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCLALANDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MUL71-FAMELY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE:. CON7RACT PRICE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OFpll-..0 FEE
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMEMS ONLY)
INSTA1,LER:,
ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERM=E CITY INSPECTOR
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
t C) r CCU
New Constriction Reculrements 7 - 10 -C> V Re /Recdr Requirements
> 3 registered site surveys showing sq. N. of lot, sq. ft. of house 1~ O 2 copies of plan
and gQ rooted areas (20% maximum sot coverage allowecD i set of energy calculations for heated additions
a 2 copies of plus (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additons & decks
> 1 set of energy calculations
> 3 copies of tree preservation plan If lot plaited after 7/1/93- r--
DATE: -I _ CONSTRUCTION COST: /
DESCRIPTION OF WORK: kA-A-D
STREET ADDRESS:
LOT: BLOCK: SUBD./P.I.D. CQ~ C 0 J
Name: agev j Phone
PROPERTY Lost First
OWNER
Street Address:
City ~~9'►) State: Zip:j
Company. Phone
(area code)
CONTRACTOR
Street Address: License # i~ Exp. "
City AV-5 State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone ( )
Street Address: Registration C
City State: Zip:
Sewer/water licensed plumber (if installing sewer/waterPhone* (
I hereby acknowledge that I have read this application, state that the informaWn is correct, and agree to comply with au applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: - ://n_
OFFICE USE ONLY
Certificates of Survey Received Yes No JUL 1 0
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. Alt - Multi
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF
❑ 03 01 of_ plex ❑ 09 07-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi
❑ 04 02-plex ❑ 10 08-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 03-plex ❑ 11 10-plex P1bg 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 Spdnklered
MISCELLANEOUS INSPECTIONS
❑ Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge O
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
l
Total:
SAC Units
% SAC
r w j III~N
s qu; I
w u.~b!u h Cahij+.
Wi
MEMO
city of eagan
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 g
Block 13, Lots 1-15 15
208
The City is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
/11; 11 1
Edward J. irsc t
Sr. Engineering Technician
cc: Mike Foertsch
EJK/je
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: December 1,,,,--1967 NUMBER g,
OWNER:-Cedar Grove Const. Co. Address Lot 8 Blk 3 C.G.
PLUMBER Steins Inc. TYPE OF PIPE Cast J=n ,
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
x
Location of Connections: Connection Charge $200.00 Pd.
Permit Fee $7.50 Pd.
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota
By
Please notify when ready for inspection and connection and before any portion
of tha work is covered.
Use BLUE or BLACK Ink
- -
For C' Mr-, t-- Use
Permit I
City of Eapn
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 RECEIVED I Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 DEC 2 1 2011 I Staff: j
2011 MECHANIC L PERMIT APPLICATION
Dater Site Address:
Tenant: Suite
RESIDENT/OWNER Name: Phone:
Address /City / Zip:
CONTRACTOR Fume: Mle W( Rolf ! rid. r License
Address: 1gQ4 VC Im 11 111 ±rfel 1 City: i I~IJ
State: rnn' Zip: E Oa Phone: uS 4-3 -1- 4 1
Contact: JQ 11 ii 1. Hem 1 Email:A J2
TYPE OF WORK New 4 Replacement Additional Alteration Demolition
-
Description of work:,
NOTE: Roof mounted and grou unounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
*mace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas - Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install / _ Remove)
Other When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
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.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 n io start without a permit; that the work will be in accordance
wit a roved 1 in ty~ec of work which requires a review and approval of plans
x (i Y\ x
Ap I c n 's Print Name AP ica I * bA%
s Signatur
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough In Air Test Gas Service Test In-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type: Mechanical
Eagan. Permit Number: EA103922
Date Issued: 04/24/2012
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 3991 Beryl Rd
Lot: 8 Block: 3 Addition: Cedar Grove 5th
PID: 10-16704-03-080
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector. (952)
445-2840
Ashley Orman
130 Plymouth Ave N
Fee Summary: ME - Permit Fee (Replacements) $55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: - Applicant - Owner:
Standard Heating & Air Conditioning Joann 1\1 Heim
130 PIN-mouth Ave. N 3991 Beri 1 Rd
Minneapolis NIN 55411 Eagan NIN 55122
(612) 824-266
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127232
Date Issued:09/24/2014
Permit Category:ePermit
Site Address: 3991 Beryl Rd
Lot:8 Block: 3 Addition: Cedar Grove 5th
PID:10-16704-03-080
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Joann M Heim
3991 Beryl Rd
Eagan MN 55122
(651) 493-0999
US Catastrophe Inc
3415 48th Ave N
Brooklyn Center MN 55429
(763) 531-8000
Applicant/Permitee: Signature Issued By: Signature
For Office Us"
e e �✓ :, tr Permit#: 1 /fE AGA
eb.. ME 0 2 nie Z1Permit Fee: 141
Date Received: a v
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 �s�
�
(651)675-5675 I TDD: (651)454-8535 FAX:(651)675-5694 Staff: r�l
build ingi nspections(a,citvofeagan.com
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: Toti.An G3-in V i Tom. Phone:tr.cl 7' i'v—054"
�#r Address/City/Zip: 399 1 E Y� Y
Applicant is: A Owner Contractor
Description of work: Lx 12, et-4C.
Construction Cost: , I•# `" Multi-Family Building: (Yes /No /dam)
company c S Ie in 140011.- 51e(44i Contact: Ft.•kc MO r-knsor)
Contractor y Addressb?(i I2 -1-11 City: ROB-eill t;�,��.
State: MA/Zip: 5566 O Phone:"/2(09-4 7/gtnail:
License#: & 1i - Lead Certificate#:
If the project is exempt from lead certification, please explain why:
1 r— J U �. =O ,i a
7''4/ ''� SU i v/i/ - / 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:
Fire Suppression Contractor: Phone:
4 r4
y
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
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.00pherstateonecali.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with th ordinances an, 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 >/o permit; at the work will be in
accordance with the approved plan in the case of work which requires a review and app• -I of plans.
x ,Cln4c� er)Sa� J Lplicant s Printed J -i
melica s Signatur
` p g
- 36N ( g6- Lti vct /. //i - 0
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi I Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
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
Valuation3 w
dG�"'" Occupancy „rPL,- t MCES System ^.„
Plan Review V Code Edition l,9/,j SAC Units
(25% 100% Zoning 14 ..1 City Water
Census Code 41 3 41 Stories ___. Booster Pump
#of Units J Square Feet /414, PRV —"
#of Buildings Length /Z. Fire Suppression Required "'
Type of Construction --- ,�� Width /1..
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
it Footings(Deck) Final/C.O. Required
Footings(Addition) A. Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath Stone Lath _Brick—EFIS
—
Insulation Windows
—
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
—
Shower Pan Other:
Reviewed By: , Building Inspector
sc3;q
RESIDENTIAL FEES �g� /i Phar 6 /5.e/0 PO
Base Fee
Surcharge
Plan Review C7 0_.
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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