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3665 Birchpond Rd CITY of EAGAN WATER SERVICE PERMIT 3795,P'flot Knob Road PERMIT NO.: Y Eakin, MN 55122 DATE: Zoning: No. of Units. - Owner: Address: Site Address: Plumber: Meter No., Connection Charge Size: Account Deposit: Reader No.: Permit Fee: II agree to comply with the City of Eagan Surcharge: OrAinances. Misc. Charges: 't Fs3 Total: SY Date Paid: Date of Insp.: Insp.: _ CITY OF EAGAN SEWER SERVICE PERMIT A ,r 3795 Filot Knob Road PERMIT NO.: wpan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: ' ` - Ordinances. Account Deposit: Permit Fee: a R l Surcharge: By Misc. Charges: - Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATC-Z;r. 19 i RECEIVED c..P~,. FROM AMOUNT $ _ 1 & DOLLARS too E)CASH CHECK _.~L t~ qWi per FUND CODE AMOUNT ,r t!i Thank You 2 4 White-Payers COPY Yellow-Posting Copy Pink-File Copy CITY OF EAGAN L- 3745 Pilot Knob Road Eagan, MN 55122 NO- 6684 PHONE: 454-8100 BUILDING PERMIT Receipt # To be and for ~;Ft L'',';G/GAR. Est. Value Date' 14 Site Address Rirchporid ROad Erect] Occupancy R3 Lot Block 1 Sec/Sub. Blackhawk Hills 2 Alter ❑ Zoning Pi Parcel # 1(' 1 381 050 01 Repair ❑ Fire Zone NA Enlarge ❑ Type of Const. y Name=d Ke11ogMove ❑ # Stories ft. z - Address Demolish ❑ Front 69 City Phone Grode ❑ Depth 53 ft. Name Vesta rorstruction, Inc. Approvals Fees U 11 220 Lewis Court Assessment Permit, / u Address 4 - Water & Sew. -73• 5n c; ],ia'nsville phone 89Ow2 ld0 . Surcharge Police Plan chec~ 1.25 Name Phill ins Flan S ervic@ Fire SAC 525.00 335.r~ Address Eng. Water Conn. city Phone 2044 Planner Water Meter £%G•OG Council Road Unit 185.0() I hereby acknowledge that I have read this application and state that Bldg. Off. - the information is correct and agree to comply with all applicable APC Total 1157?• State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: Vesta Construction 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 r I I II PWSrNt~e Permit #k -Drato b m" Plumbing - a ~t (o ! Mechanical :2 to L g' f y~ E y 5d , vi- -Z C= T [ S8~ `a'-t$- 8 t Ll~or~. u- INSPECTIONS DATE INSP. Roth-In Final Footings /d & Date In Date Insp. Foundation Plumbing to -q Frame/ins. Mechanical - -B c~ 4 Final +3s-~ T" Remarks: Re nt PLUMBING PERMIT P it so. 2 ~ S 40; CITY OF EAGAN r; Fee - Fill in nuM1 eyed 81C Type or Print fepibiy T at. 1. Date 2. Installation Cost 3. Job AddressC Lot -1 Blk. Tract 1 , 4. Owner ` 5. Contractor Phone ` 4~ t C i. 6. Address 7. City States zip; 8. Building Type: Residential) Commercial ❑ Institutional ❑ I , 9. Work Description: New Add ❑ Alter ❑ Repair ❑ 10. Describe 11. No. Fixtures f = No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank i Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other - Laundry Tray ~}tc' 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 lpspections: Date Insp. Date Insp. A. This is your pgrmit when numbered and approved. Approved [ CITY OF EAGAN 454.8100 ,_71 Receipt MECHANICAL PERMIT Permit No. ` r CITY OF EAGAN Fee Ca) _ i fill in numbered spaces SIC Type or Print legibly r Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner r 5. Contractor Phone 6. Address E 7. City State l Zip 8. Building Type: Residential CI Commercial ❑ Institutional ❑ 9. Work Description: New Add ❑ Alter ❑ Repair ❑ 10. Describe Fuel Type 11. No. Equipment BTU - M. Ea. No. Equipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets i 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 lospections: Date Insp. Date Insp. t This is your permit when numbered and approved. + Approved r t.t',_t r CITY OF EAGAN 464-8100 RESIDENTIAL BUILDING Permit Application City Of Eagan 6 dl 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 r New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cert of Survey Recd _Y _N (201/6 maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _Y _N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Reqd _Y _N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _Y _N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units 5o a , ©a Date 0_ Construction Cost Site Address Unit/Ste # Description of Work t.~e) ~~c~VL f"ro to c e, xr S~ Multi-Family Bldg - Y N Fireplace(s) _ 0 1 - 2 Property Owner 0~11rn--c._5 Telephone # (6/ 7) 3 2 Contractor Address City State Zip _e~' 0Telephone # ).SJ } N 7-:R - 19 33 12- -_3 6 -ZZZ-? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? ` Y _ N If so, 25% plan review fee applies. Licensed Plumber -telephone ) Mechanical Contractor T l T lephone # ( ) n~T 1 ~ ?nn3 ) Sewer/Water Contractor 1 _ lephone I hereby apply for a Residential Building 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 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 whi h requires a review and approval of plans. Applicant's Printed Name Appli is Signature Sub Types OFFICE USE ONLY i ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBldg ❑ 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 /K 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or_ N ❑ 25 Miscellaneous Work Types ❑ 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) - 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 _ 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 .,..-----762 City SAC ` Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total I CITY OF EAGAN Remarks Addition BLACKHAWK HILLS 2ND ADDTTT(lAT Lot S Blk 1 Parcel 10 14381 050 01 Owner f d< , kY i~ L I Street 3665 Birchpond Road State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1976 1120.65 112.06 10 336.23 STREET RESTOR. 1979 48 248.55 10 1491.29 A01©846 1-1-82 GRADING SAN SEW TRUNK 1970 462.77 18.51 5 222.14 A010846 1-T-82 * SEWER LATERAL 1972 1590.73 79.54 20 715.90 A01 846 1-7-82 WATERMAIN * WATER LATERAL 1972 WATER AREA q 1977 96Q-?d 37-95 41.60 A010846 1-7-82 Sow wat Lats. 3 1978 54M101- 36_5.8.6 15 3658.71 A010846 1-7-82 * STORM SEW TRK stubs 1978 * STORM SEW LAT 1972 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 94876 5-29-81 WATER CONN. -of) 94976 BUILDING PER. 6684 SAC 24276 PARK O - - r Ctv Y 13 MAP ICJ O X35 Ito ~l 1 s~t~ 75' q?•_t 77.s.__ I F41, t ~ o m n J'O r r'9t 72.3 LOT- Ct ST aT LK 1 l~ l.JqC K Naw K ss.~a CITY OF, EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N-0 6684 PHONE: 454-8] 00 BUILDING PERMIT APPLICATION Receipt # '04 ge 7 To be used for SF DYE= Est. Value 147}000 Date WY 29 19 81 Site Address 3665 Birchpond Road Erect ,X3 Occupancy R3 Lot 5 Block 1 Sec/Sub. Blackhawk Hills 2 Alter ❑ Zoning R] Parcel # 10 14381 050 01 Repair ❑ Fire Zone Nd Enlarge ❑ Type of Const. V w Name Ed Kellog Move ❑ # Stories 2 Z Address Demolish ❑ Front 69 ft. 0 City Phone Grade ❑ Depth 53 ft. Name Vesta Construction, Inc. Approvals Fees O it- 262.5 Address 11220 Lewis Court Assessment Permit ~ City AurnsVi le Phone 890-2040 Water & Sew. Surcharge 73.50 Phillips Plan Ser~ric~ Police Plan chec1131.25 rW Name Fire SAC 525.00 u3 Address Eng. Water Conn. 335.00 a W City Phone -2-2 ~ Planner Water Meter 60.00 Council Road Unit 185.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total 72 25 State of Minnesota Stotu~tes and City of Ea n Ordinances. Signature of Permittee'Z4-j--- A Building Permit is issued to: Vesta Construction on the express condition that all work shall be done ' accord a with a,P cable State of Minnesota Statu es and City of Eagan Ordinances. Building Offi CITY OF EAGGANN Include 2 sets of plan::, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For Valuation Date u Y . j Q,~r/ Site Address: 3to& 5 OFFICE USE ONLY Lot Z- Block r Sec. /Sub. Erect Occupancy' 3 J* Jx Parcel [0 f 0 5c1~ j Alter Zoning L Repair Fire Zone NA _ - Enlarge Type of Const. _ )f Owner: e e S~ Move # Stories Address: Denali h Front ft. Grade Depth 3 ft. City/Zip Code: Phone APPROVALS FEES Contractor : Assessments Permit. Address : j ,-.2 o iG G ► .r water/sewer _ Surcharge Police _ Plan Check City/Zip Code: wrns~, Fire SAC 52 S, e D Phone c - ~ 0 Water Conn. a o # : Planner Water Meter a, Aso / Road Unit a d Arch./Eng.: ,1~,~a 9an a~,r,` Bldg. Council Off. Address: APC City/Zip Code: , Phone - .2 o y TOTAL I S~ -7 i TOP P F7S 47.1 77-S wit r t ~ O O O~ h ° ao s NSIO f t 7Q.3 Lor sr C) T- LK `4L ll L S r> -c .TEAR? 99 ICM PYELOo[ T1iMAL T><MWTTMCC PAGE 1 p-q,,,` VANDARG WORKSNm .s , Site Adires: _ Owner Centractur _1~Lr n/ t/t s ff► Phone Date 0^I Building Type (check or,e) Da One and Two Family balling Other Assembly (Describe type from Table ! or Area (A) U-Vaiw U x A show calculations on Pat S Ft Insulated Area Framing Area skylights, Tyac _ g Othet.describel T w r Other describe 1 Totals ~0 t***** 4,2 Avera~t U-Value. (M)/(A) from ire 1 * • OZ - ~ed,a C 3 Re uir•ed U-Value from text)- -insulated Area I ~1(vl• .024 Framing Area - 0 G 3 ' Y Windows T r R LE / w ,Z. 4 S 52 3 "r boors T 1N S 'me+-a1. ~7w I3(0 0 Rim Joist Area 3 V0 - 0 I a6 fireplace Wall Foundation Wall above rade ~ D ' 4~ 9 L Z Foundetior, Windows. Type • S6 S~~ 3 7' Other (describe i o W jo • u 34r) /00,51, Other descriF -5 4-D r Y40R L~ ' 43'3 - Other describe 4 Totals 3141 4 IA ,,,,.tw~z -PU0w 5 Average U-Value UxA A fm tine 4 13 5' C441 6 Re ulred U-Value (from text) If line 2 is greater than Line S• or Line 5 greater than Lint 6# complete tha following to determine alternative U-Value for total exterior envelope, 7 Area (line 1) + Area (Line 4). - + • + B UxA (Line 1) + UxA(Llre 4). 9 Area (Line 1) x U-Value.(Line S) x • *****a 10 Area (Line 4) x U-Value (Line 6) x 11 `budget'. Line 9 + Line 10 t***t* I 12 Alternative U-Valu*. Line 11/1.1ne 7 f Line d is greater than Line 11• alver assemblies as rpuired so Line • does not exceed Lira 11. t , - 4of, - rr!! c 1~.. 1 6b 24-1361/ - o 3 -l, o A4/ 0/1 " /I!I a 9.7 t 3A. ,Z•~/ gyp/ 1- 1 ~ 1 I e. io.o t •~lo • D loo • s ~ c 4-fl. o }~o. o G - 3 9/b 8 - l I C. x,, a t 4o• n / s'FrR 3 4. a. .4 .,o + S-3. o t 7 j x fe : 13 9 Z o Af t 34 • o v+ 39. o 146 x 8 r ~S6o.0 ~~y¢,~%.. ~ W o.lJ2.... C-~Y ow.,,L'„~ r0,f~ lC~to~►r~'~ i;-&.-~--• ~.304~~ ~R mac, S =i]z ~ ~~,a.ott~e.~7'~ 3 ~„~'.1...~ ' • M G?/u.«.. 3 320,0 X 1.0: '33.0.0 44Z4C a 3 4-- o 1 3 4- o o+ 5 .0 : 170. o X, C) 0 3 ,~2 Sv~ 4 kr o e oc 4-. '31 37 G 7 - w vak...t . O A 7 43.78 va d 23 r ten,,. . G 8 " ~ 5'~t JJ-~-.~ ~ w o oc.L ~ • q . CIO Aw Ji.ao +.AAA- z 13 44? I e, Z-( 11 '3f~o%llaj~l~ 1- tits o? 53'/=5-© This request void 18 months from Date of this Request l? ey c, yl Fire No. 15158 ` I, as ❑ Licensed Electrical Contractor J&Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 3 e-6 i kr- i+ PC 1,; City M Section Township Range County DPri~c Which is occupied by C, (Name of Occupant) Is a roughin inspection required on this job? No ❑ Yes 2~ Ready Now O Will Call 9 Power Supplier t~A Ke T A E-LE CTA21cr Address Electrical Contractor ce- Contractor's License No. (company Name) Mailing Address 3t-6,S" i i/c~el { ,i) kZ , F rv' SSr2 Electrical C ntract r o Owner Making This Installation) Authorized Signature _G Phone No. q.% 1" rr• (Electr cal contractor or Owner Makln is Installation) "Opy This inspection request will not be accepted by the " State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity Griggs Midway Bldg. - Room N191 EB-00001-02 1 48210, University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ' REQUEST FOR ELECTRICAL INSPECTION T z& 3 CHECK BELOW WORK COVERED BY THIS REQUEST ` 1 5 1 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ pLList List Other ❑ ❑ ❑ Herers~ Here s COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 0 to 30 Amperes 0 to 30 Amperes '7.R, 101 to 200 Amps. ICJ 31-to 100 Amperes 31 to 100 Amperes Above 200 Amps. Above 100_Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee C ; Signs Special Inspection Minimum fee Remarks TOTAL F E a -7 I, the Ele certify t abo innkecttion has been DAID (Rough ADate /,;2 (Final)°j Date 44 7-,1.2 - J=y d This request void X18 months from ED WICK . s S G HEATING & AIR CONDITIONING CO. HEATING JOB NO 8910 WENTWORTH AVENUE SOUTH MINNEAPOLIS, MN 55420 (62) 881-9000 TEST RECORD ADDRESS C t~ti~ I JU lc9c CITY 0. OCCUPANT J w 2S ! ✓~~I t~ c l OWNER SOLD BY L 4 C INSTALLED BY _ MAKE L n (DMODEL SERIAL NO. INPUT THERMOSTAT VENT SIZE 1 VALVE TYPE OF LINER /3 V a LIMIT vt" LINER SIZE L"- F LIMIT SETTING i FILTERS: SIZE NUMBER o` FAN SETTING WIRING PILOT TYPE L J TEST TAG IGNITION MODEL LIGHTING INST. PILOT TIMING '1 l DATE TESTED PRESSURE PERCENT CO, r INPUT CFH i 00 PERCENT 02 COMPANY TESTING =Z 't2' LlJ t C STACK TEMP. ~ 3 ~ PERCENT CO ~ NAME OF TESTER FORM 235 (REV. 11189) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY ..5' MY USE ONLY Lot [ . BL 471 T : , RIO Rpcmpr R EPr 20041+ r > .,RlD?} cii o.fir 1010 PXWT' >B 10 F M 55122 cotjs if 'Inc . SAC* it singk am ly civrellin& wwwwam,or *Dftoo fir * HVAC: 0-100M T U S 30.08 A 'P MjAL 5e iM BTU 6.00 • :mAlft (minimum of ow required $3.00 w0.) $td Sorg .5a yF . TOW $ 41 Noma* tel. ftedon .'~f am addin or an Dx ►g siugw-&f"4 &Oii~ Mme, or condo. Pl+ Wdic*e if it is a n6w*m, ulUu*m or mpsir. New Upair off . Furauce i+~' `!!`lt►"` Air cmwmIF ...r.. Air aK,*uilw__.. Otber Fen $ 30.00 state smvhwge 50 Taal 30.V qtr: Ctlfor ors - SITI ADDRESS: Owl" NAB: PRONL NA PHcn: - iO Wir~brr~r~t REETAIDDRM; elm, 7-T-7-7 7-7 77~ QTY; sTXrE: ZIP SIGNATURE OF PERMT I$E / C"Y USE ONLY SURD.~C'T E. APPROWD : INSPECTOR P1OA"iE ' 2000 *XCI ZC Z PxmaT o ) 31830, FILM 23100 IlV ma"', Nor 351, 651-6~#iw46T5 _ . ' u4'owvvftr*"u4*W min buWArvs w*m sopw#* poonft ws ' fi r oiw*` wv urn DATE: WORK TYPE: New don. . Iu" U,G,, Toi& h*riw Impmmmnt J.G. TV* rrrQ se to ma 1451-a1-4o5 r t r ax<6yftW 00"kai a^d Dfta#km of work: Pees: 1% of Contract price-QJt $30.00 misiou fm, whiclaft- r is gr eate". Un&qVowd , ft* mmaay b - Uft wd e aft*o,* s0'ft* h $o,i41,&a TOTAL SITS, ADDRESS: OWPM NA C: F> ~ : `t AN"T NAW OV 1T3 omy): WAS11MM A PREVIOUS TEIWNT IN TWS 5PAtW' _ -'Y ,l,N'. NAME: INSTALLER: ZIP. SIONATURE OF PIIM ME PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA146752 Date Issued:11/13/2017 Permit Category:ePermit Site Address: 3665 Birchpond Rd Lot:5 Block: 1 Addition: Blackhawk Hills 2nd PID:10-14381-01-050 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 - Azber Ansar 3665 Birchpond Rd Eagan MN 55122 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA169703 Date Issued:06/07/2021 Permit Category:ePermit Site Address: 3665 Birchpond Rd Lot:5 Block: 1 Addition: Blackhawk Hills 2nd PID:10-14381-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. 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 - Azber Ansar 3665 Birch Pond Rd Eagan MN 55122 Haley Comfort Systems 3708 Broadway Ave N Rochester MN 55906 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA172686 Date Issued:10/12/2021 Permit Category:ePermit Site Address: 3665 Birchpond Rd Lot:5 Block: 1 Addition: Blackhawk Hills 2nd PID:10-14381-01-050 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 - Azber Ansar 3665 Birch Pond Rd Eagan MN 55122 (312) 560-8799 Principles Building & Remodeling Llc 7287 153rd St W P O Box 241477 St Paul MN 55124 (651) 340-5057 Applicant/Permitee: Signature Issued By: Signature