3231 Black Oak DrINSPECTION RT CORI)
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WACtIVAZE FDR BA'amT F'IIdISld I/27/43 °
ONaoutaE APPEL b"Q tw?452-3648
Cner#i#traft uf Orx?panry
titp of (tagari
BqWtMIt gf WW1MM
Tbis Cemfiaate issudpursuant to the requtre?nents of Secuon 306 of the Unfjonx BuUding
Code ?rafYInB rlrat at the dine of issuance this structure wrrs ne c»nrplianae with the Hwious
„':.y •\K ordhsances of the GY1y regulaQing building consducion or use. For the following:
use Cbsomamiom SF DWG/GAR NO& rwmk Nm 815
O-JPwv-7 TM R-3 M-1 n
JOHNSON ?ON?T ? ..??"' , VALLEY, MN
? ? ? Addmu
3231 ., , ' 511, NB- ? -
HAWint m ? ?oaliry
SEPTEMBER 11, 1992
dAft oeicw ?
POST IN A WNSPICUOUS PLACE
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.A4dijess: 3231 BLACK OAK DR Lot 1 Blk liSec/Sub BUR OAR HILLS 2ND
These items were/were not cornplete at the time of the final inspection.
September il, 1992
Date. yes No
r
Inspector;
Final grade (6" from siding) ?
Permanent steps - garage
Permanent steps - main entry t!
Permanent driveway t?
Permanent gas ?
Sod/seeded grass
Trail/curb darnage y+?
Po rch
Basement finish
Deck ?
Pleasa verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of watar supply to the outside lawn faucet befora
freeze potential exists. ?
RECIM17EDPVER
White - City copy Yellow - Resident copy Pink - Contractor copy
q ?a
?
? 3 yG ?
?
Request Dale 7 re No. Rough-in lnspection
q
? ?/
? Ready N. ytvvill Notify Inspeetor
i
Yes C No ?N?hen Ready7
licensed contractor A owner herehy request inspection of above e(ectricai work at:
Jot Adtlress (StreeT Box or qoute No.)
?
64
1, City
R
-
'?
?
? ?
Sedion No. Township Name or No Range Mo. Gounty
(5ccupanllPRINT)
? 46/. ?L) -?_ Phone No.
Ppwer Su lier
ii,l s
, z- Address
_j
t
Electrical Conlractor IComparty Name? Gonlractor$ License No.
'-f
Qd1LE . !.J ,.
NYaihng Add.ess (ConhacEOr oF Owner Making Installation) .
i24
_
Author¢ea SignaWre (Con actonOysqe+ MaWng ?Installation)
/ !
?? . Phone Number
MI'ICNESOTA STATE BOAR O ELECTR? IC?T( THIS INSPECTION REOl1E5T WILL NOT
Griggs-Midway Bitlg. - Room &173 BE ACCEPTED BYTHE STATE BOARD
1821 University Ave., St. ?aul. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION es-?o7oo/o,- y?y
instrudions for com letin this form on back of ellow w
P 9 Y PK t?,? jO // !J
???: '
"X" Below Work Covered by This Request `?_?_?
ew Add Rep. TypeotBuilding AppliancesWired EquipmentWired
' Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (spec,fy) Conhactor5 Remarks:
Compute lnspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 010 100 Amps
Transformers Above 200 Amps Above 100 Amps
Si9nS Inspector5 Use Only: TOTAL
Irrigation Booms ?? . w 76
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 HS ?
I, the Electrical Inspector, hereby R°ugh-in aW
certify that the above inspection has
been made. Fi„ai a?e
- lJ
OFFICE USE ONLV
This request void 18 months trom
??4 16,1, `?_
K ?
R quest Date
7 Fire No. Rough•in InSpection
Uirgd7
? Ready Now ill Notily Inspedw
Yes C No When Ready?
I?:] licensed contractor )e owner hereby request inspection oT above electrical work at:
Job Address t. B?o?a ck a1? bf-
city
No.
Section Township Name or No. Range No. County
Occu INT) Phone No.
1e
Power Supplier Address
Electric I ntractor ICompany Name) Contractor9 License No.
Di'»tO i'lcf?
Mailing AddrContractor oi Owner Making Installationl
? Of-
Authori nalyrc?,Contractor?Owner Making Installafionl
, - Phone Number
.E- l? ; -
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grigge-Midway Bldg. - Room 5-173 BE ACGEPTED BY THE STATE BOARD
1821 Unfversity Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
;21 REQUEST FOR ELECTRICAL INSPECTION es-oooo, a
? See instructions lor comeleting Ihis form on back ol yellow copy.
K?+-, Below Work Covered by This Request
ew Ad'd R?p. • Type of Building AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer OtheF (Specify)
Comm./Industriai Furnace
Farm Air Conditioner
Other (specity) Contractor! s
Compute lnspection Fee Befow: ),,4' ?'-,
# Other Fee # Service Entrance Size Fee # CirouitslFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
S19nS Inspeclor+s Use Only: U TO
TAL
Irrigation Booms Q ?
e3?
Speciai inspection
AlarmlCommunication THIS INSTALLATIOPI MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M HS.
I, the Electricai Inspector, hereby Rough•in Date
certify that the above inspection has
been made. Final , o `?
OFFICE USE JNLY
This request void 18 months fiom
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstruction Reauirementa
• 3 registered site surveys showing sq. 8. of lot, sq. ft. of house; and aII roofed areas
(20°k maximum lot coverage allowed)
• 2 copies of plan showing beam & window saes; poured found design, etc.)
. 1 set of Energy CalculaUons
• 3 copies of Tree Preservation Plan if lot platted after 7/1l93
• Rim Jofst Detai Options selection sheet (bldgs with 3 or less uniLs)
DATE
_ Water Softener _
? Water Heater ?
No. of Baths
SITE ADDRESS 7,,,2 e?I MULTI-FAMILY BLDG _Y _ N
TYPE OF WO
E(S) _ 0 _ 1 _ 2
APPUCANT
STREET ADDRESS CITY__!7J /- STATE.&ZIP C'J ?
TELEPHONE CELL PHONE # 7FAX #
PROPERTY OWNER ?-S -e TELEPHONE #
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RiJLES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ?__
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
Heat Recovery System
Fee: $90.00
Phone #
P82002
Phone #
--------------------------------------------------------------------------------------------' ?-----
I hereby acknowledge that I have read this application, state that the informatian is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordi ances.
Slgnature of Applicant
OFFICE USE ONLY
' -l I .-1 ??
RewdellReaair Reauirements
• 2 copies of plan
• 1 set of Energy Calculations for heated addiflans
. 1 site survey for exterior additioris & decks
. Indicate if home served by septic sysiem for additions
VALUATION I (5-S 00 _ co
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
0 10 08-plex ? 18 Deck
O 11 10-piex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
O 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
0 30 Accessory Bidg
O 31 Ext. Alt - Multi
O 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
0 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
? 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) FinaUC.O.
_ Footings (deck) FinaUNo 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
Pian Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? GITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
3231 BLACK OAK DR
LAT: 1 BI.OCK: 11
8UR OAK HZLLS 2ND
DESCRIPTION:
REMARKS:
Building Perm3t Type
Bu3lding Work Type
UBC Occupency
Construction Type
Zon.ing
Building R.ength
Building Width
RECErPr # e. U l lql?
S F pWG
NEW
R-3 M-1
V-N
R-1
64
53
S&W PLBR - WENZEL MECH.
Control No. 0 ? ???
v?
eurLozNG
@G0815
f96 J18/92
FEE SUMMARY
VALUATION
Base Fee
Alan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
$695.50
$452.@8
$58.00
$790.00
1@8
1
$1,986.58
$116,05@
MI5CELLAIVEOUS 11.610.50
Total Fee $3.616.08
CONTRACTOR: - Applicant - ST. LICpWNER:
JOHNSON CONSTRUCTION M W 14326838 8082287 M W JONMSON CONST
14251 CEDAR AVE 14251 CEDAR AVE
ApPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(512) 432--6838 (612)432-6838
I
I hsreby aaknowledge that I havs read tMis application and stats that the
information is correct and agrse to camply with all applicable State of Mn.
Statutes and Gity of Eagan nrdinances.
/gy zM'9_1M --.1
APPLI NT/PER IGNATURE
j-,' &?"o
ISSUE : SI NATURE
PE(?9IT i
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
ssi -as75
$_3 ,.xi / ?.c?I
3u w 1 2 RECo
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural_& structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
af month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 06 / 12 / 92 Valuation of work $116.700.00
Site Address: 3231 BLACK OAK DIRVE, EAGAN, NN
STREET STE 8
Tenant Name: (commercial only)
Lor I BLOCK 11 sueD, BUR OAK HILLS 2ND P.I.D. #
Descri tion of work: SINGLE FAMILY NEW HOME CONSTRUCTION
The applicant is: 0 Owner iM Contractor O 4ther cDosertbe)
Name MMI JOHNSON CONSTRUCTION CO Phone 432-6838
Property uST fIRST
Owner Address 14251 CEDAR AVE., APPLE VALLEY. MN 55124 _
STREET STE 0
City APPLE VALLEY, State MN Z;p 55124
Company NW JOHNSON CONSTRUCTION phone 432-E830
Contractor hddress 14251 CEDAR AVE License # 00-02-207EXp,
City APPLE VALLEY, State MN Zip 55124
Company CHARLES PHILLIPS DESIGN 0 Phone 432-4290
Architect/
Engineer Name 14253 CEDAR AVE Registration #
Address APPLE VALLEY, _
55124
City State MN Zip
Sewer & water licensed plumber WENZEL MECHANICAL . Processing time for
sewer & water permits is two days once area has been approved. .
I hereby acknowledge that I have read this application and state that the information is
correct and agree to compl with allapplicable State of Minnesota Statutes and City of
Eagan Ordinances.
.
?
Signature of Applicant: •
OFFICE USE ONLY
?.
BUILDING PERMIT TYPE
p OI Foundation ? 05 Apt. Bldg D 09 8asement fin ish O 13 Comm/Ind New
002 SF Dwg. Q 06 Garage/Accessory O 10 Swim Pool ? 14 Comm/Ind Add
D 03 Two family O 07 Fireplace L7 11 Res. Add. ? 15 ComnJInd Rem
? 04 Multi-fam. T.H. D 08 Deck ? 12 Ttes. Porch D 16 Public Fac.
? 17 Agricultural
WORK TYPE
)9(31 New ? 33 Alterations ? 35 Move
O 32 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. Actual V- N Basement sq. ft. MWCC System
(Allowable? V N lst F1. sq. ft. City Water ?
UBC Occupancy ?73 M'I 2nd F1. sq. ft. PRY Required
Zoning R-1 Sq. Ft. total Booster Pum p
# of Stories Footprint Sq. ft. ' Fire Sprinkl er
Length ? On-site well Census Code lo?
Depth ? On-site sewage SAC Code c?t
APPROVALS _
Planning Building Assessments
Engineering Yariance
REGIUIRED {NSPECTIONS
? Site
? Wallboard
? Footing
? Final
? Framing
O Draintile
13 Insulation
? Fireplace
Permi t Fee .
v.imtron: s 1!
Surcharge
Plan Review ? t- = ;
license
MWCC SAC ° !f3'1-'L x Z ? yd17
Ci ty SAC I!'%z. X z i= a? i
Water Conn.
Water Meter -
? `i 2.
Acct. Deposit SSKV
S/W Permi t
S/W Surcharge f 5 3`? X 15
t?? ?
? 23
Treatment Pl.
Road Unit I St FLoOR;
Park Ded. Trails Ded. 155'? -A 53 ? .
Copies ?
Other
Total : 9 sct
.
t
SAC 96 I fl?
SAC 'Jnits Z
EXTERIOR ENVELOPE AVERAGE "U" COMPifTATIQN
O4tNER
. ? . .?
SITE ADDRESS ?.,??r ? • rl <?_?? ?,`' . ? ??, ? ??y? ?c` ?./? ?? ; ? ,,, y?• ?. ? ? "?..r .
` C4NTRACTOR
bATE . pHONE .
• . . . . ?.
Determine warking square footage af each. .
1. Total exposed wall area ...... Z.3dy?5?- sq. ft. x
2. Total raaf/ceiling area ...... 5q. ft."x •O2l?? '
Total exposed wall area above fZoar = Zal°I a. Total wa'[ 1 wi rtdow a rea . . . . . . . . . . . . . . . . . . : . . . . . . . . 7 y Lq
b. Tatal daar area ................................. 3 '
c. Total sliding gZass doar arza .............•......
'.d: Total fireplace wall area....... ....... ...........
e. Tatal wall framing area (average 10%) .... ........ S`i. ,.
f. Tata1 net wall area above flaar ................. -
g. Tatal rim joist area ..........................?..
Total exposed foundatian area h. Total foundati on wi ndow area.....................
i. Toal net foundation area abpve grade ........,... I I'l,- D'etermine "U" vatue of each wall segment. •
a. ? zN Lv X .,u1, __ , 3 ? 12 . i ? t S
b. 39 x,iu,,. , 139 c. B$ x liu» 65 _ yH
a. yg X,eu,t ?'7sz?
C. x au" r OqlO ? ? 5?3 "r?
x „U„
g, ??72 Xiiuii s 04I = ?, 05
h X "U'° ----- - "'
i. X
_..m?.,.._ .
...? . .. s?.
3 ................... ..Total
If item D is the same as, nr less than item fl, you have met the lntent
of SBC 6006(c)2. , -
Total exposed roofjceiling area
?., . . _ _ ? 5 3 a
Total gross roof/ceiling area = .
, ...... .......•..........
,
? .. j Total skyl i ght area
..
' . k. Total roof/ceiling framing area ..........
1. Totai net insulated roof/ceiling area....... Z . .. Determine "ll" value for each roof/ceiling segment.
:. .. . ? . .. ?.,,_._ X „U,l
k. x „ull
1. I"38y,'Z- X l,Ul,
4.......... . ........ ? ?. . . . . . . . . . Tota7 ° .
If total of #4 is the same as, or 7ess than #2, you'have met the intent of
SBC 6006(c)i.. . To utilized the total envelope system method, the values.established by the
sum of items #3 and #4 shall not be greater than the svm of itens #1 and 02.
' ? . . ... + 2. -
3. + .4. _
IrIA2ERIALS
' Ext eriax AiT
" Sidfng Xaterial
Sheathing -
xnsulation .
Sheetrock
Interioi Air .
Studs
Rim.
cone. Blks.
Therm. 8esistance "R."
,45
? 1Q B .
,
? _. .
?
" - ?
IT
.ad&
X•
?iAt.? M?NT ? L • ?a $?? . Z
??
t-. ??? OgioL.
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Z 30
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Lo:,;.,, ... i r_ML04-k-. I y j
6uK.. Or?rV- 4?IVl.?
? ?O ja.D01"t1°??
?,r?.??To. covraTY?
_. _------? __ ------ -• - •
L he•reby certify that t-his survey was ,prepared by ma os
under my diC?.er supervision ?hetState duly
?,and Surveyor Un
J ?oyev,a te:L?R?Bohlen 1Q79?
ke?,is-?ered .Land Surveyor No.
woommoomm
J CnUSE
ONLY s,
LBL ? I d RECEIPT #: qo? 9?1
? ? ??
SUBD. ? RECEIPT DATE: 61AI
1998 PLUNBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT EQdOB RD
EAGAN, MIN 55122
(612) 661-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
----------- - - --- - ------------ - - - ----------------- - - -
FIXTURES -------------- - - - -
EACH ----------------- - - - - - - - - --------------------------
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot TublSpa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet " minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener `for dwellings under construction 5.00 x =
Water Softener " far exisYirg dwelling 20.00 x =
U.G. Sprinkler * for dwelling under const. 3.00
U.G. Sprinkler " for existirig dwetling o 20.00
Alterations " to existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System * MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems " Abandonment 20.00 =
RPZ (new installafion only) 20.00 =
STATE SURCHARGE .50
?
TOTAL e
------------------
- ----------------------------------------------------------------- ------------------------------------------------
Iherebyacknowledge that I have read - this - application, - state that the - infortnation is corcect, and agree to comply with all applicable City of Eagan ordinances.
It is the applicanYs respansibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:, S?`_,L =-)?> ??ZaIIP TELEPHONE #:
STREET ADDRESS: S?1?m CiS r-_,Job?
CITY: ? STATE: 016 ZIP:
720- 9
P-ilA
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1998
SIGNATURE OF PERMITTEE
REACTIYATE ? CITY OF EAGAN
PERMIT # 1993 BUILDING PERMIT
681-4675
APPLICATION
F.1AN 2 2 R=
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1} when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date I /z /9,)- Yaluation of work
Site Address• (3o"13) Q14-cl?. Qa l? 0-?- t v-P
STREET SU1TE *
Tenant Name: (conanercial only)
IAT BLOCK SUBD .,? P. I. D. # '
Descri tion of work: s M T FlNiS
The applicant is: Owner ? Contractor ? Other (o.s«;be)
Name &WaL1 T p?'?-e Phone
Property LiST FIRST - 36 Vfi
Qwner qddress /4-?/? ?2 /c
STREET STE 0
City State
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architectl
Engineer Name Registration #
Address _
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant
OFFICE USE ONLY
BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
O 02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc.
O 03 SF Addition 0 08 8-Plex 0 13 Garage/Accessory
0 04 SF Porch ? 09 12-Plex O 14 Fireplace
0 05 SF Misc. ? 10 Multi. Add'1. 0 15 Deck
WORK TYPE
[3 31 New ? 33 Alterations O 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
[3 16 Basement Finish
D 17 Swim Poal
O 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
D 21 Miscellaneous
O 37 Demolish
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
t16C Occupancy Znd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site
0 Wallboard
O Footing
? Final
O Framing
O Draintile
? Insulation
0 Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
city sac
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Cop ies
Other
Total:
vatuscian: $
sac %
SAC Units
PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. ALSQ, FOR TOWNH4ME5 AND
CONDO5 WHEN PERMTTS ARE REQUIRED FOR EACH UNTT.
NG. FIX'I`[7RES
SHOWER
WATER CL4SET
BATH TUB
LAVATORY
KITCHEN SINK
LAUNDRY TRAY
HOT TUB/SFA
WATER HEATER
FLOOR DRAIN
GAS PIPING OUTLET • m?nimum - i
ROUGH OPENINGS
WATERSOFTENER
PRIVATE DISP. • Dak.Cty. lic.
U.G. SPRINKI.ER • home under const.
ALTExATIarrs • to ?ting
WATER TURN AROUND
STATE SURCHARGE
ToTAL:
STTE ADDRESS: 9?'-,7)
C
3.0(j
3.00
3.0f1
3.00
3.IX1
3.00
3.00
3.fl(l
3.00
3.00
1.50
5.00
IS.Qti
3.0(}
15.? ???
15.00
? .54
r s :S? OWNER NAME• / fZ P? z9a-C
INSTALLER:
.ADDRESS:
CT'TY: STATE: ZIP CODE:-S?Y7
PHONE #: (?/-;z_
?
SIGNATURE OF PERMITTEE
1993 FLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIL4T KNOB RD
FAGAN MN S5122
(6I2) 6814675
1993 PLUMBING FERMIT (COMMERCIAL)
CTTY UF EAGAN
3834 PIIAT KNUB RD
EAGAN MN 5S122
(612) 681-4675
PLEASE CaMFLETE FC)R ALL COMME1tCIALJINDUSTRIAL BUILDINGS, ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED F4R EACH
DWELI.ING UNI'I'.
NEW CONSTRUCTIUN
ADD QN
REPAIR
W4RK DESCRIPTION:
CONTRACT PRIGE: $
FEE: 1% QF GONTRAC."1' FEE.
STATE SURCHARGE: 5.50 FOR FAGH $1,000 OF < .
?FEE.
MTNIMUM FEE: $ 25.00
CONTRACT PRICE X 1°l0 $
STATE SURCHARGE $
TOTAL $
SITE ADDRESS:
TENANT NAME: S'I'E. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
STATE: ZIP CODE•
PHONE #:
FOR:
CITY OF EAGAN APPLICANT
.
CITY OF EAGAN
? r?CHANICAL PERNIIT RECEIPT
SUBD. ???..???,;, (612) 6814675 DATE
RESIDEN'I7AL
PLF.ASE COMPLElE UPPER PORTION ONLY FUR SINGLE FAIVIILY DWELLINGS. ALSO, COMPI EPE FOR
TOWNHOMFSJCONDOS WHEN 5EPARATE PERMITS ARE REQUIRED FOR FACH DWELLING UNTf. '
OWNER: I "j ? t-. ?, ), - _ FEES
STfE ADDRESSY _?
? . 3, . ADD ON/REMODII. (EI?STING
CONSTRUCTION ONLI? $ 15.00
INSTALLEI?_ HVAC: 0-100 M BT[J 24.00
PHONE ?:
- ADDTTIONAL SO M BTU 6.00
--r ,.
??RES?: GAS UTTT'IETS -11?IIrTIMIJM i @ $3 EA. C'
CITY ZIP:,??: SURCHARGE $ .SO
SIGNATURE: ? 71
----c ---- - TOTAL:
, 1 ? .
COMMERCIAL
PLEASE COMPLEfE THLS PORTION FOR ALL COMNIIItCW,/INDUSTRIAL BUILDINGS. AISO COMPLErE FOR
APARTMENT BUILDINGS OR OTHER MUL1T-FAMII,Y BUII.DINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELIJNG UNTI'.
WORK DFSCRIPITON:
OR'NER:
SITE ADDRESS:
TENANT:
SUITE #:
INS'I'ALLF.R:
ADDRESS:
CITY:
PHONE #:
SIGNATURE:
CONTRACf PRICE: I FEES
1% OF CONTRAGT FEE.
STATE SURCAARGE IS $.50 FOR EACH
$1,000 UF PERMIT FEE. $
PROCESSED PIPING -. S25.00
mINIAii7tvfi F'EE - ?a.?
F
TOTAL:
S
F"m lv _ ? ur --
ZIP:
CITY OF EAGAN FQR CITY USE ONLY
3830 FILOT KNOB ROAD
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIFT #
I}ATE: T 4
?:???', PLEASE CQMPLETE
? IIPPER PORTION UNLY FOR SINGLE FAMILY DWEI.LINGS &
:?.:..:.:.,?.ri-:.,,?.y,,:?.?,
TdWNE30ME5/CONDOS WHEN PERMIT3
ARE REQUIItED FOR
EACH UNIT.
--
------
------------------------
WORK DESCRiPTIQN ------ ---------- --------------- -------------------
C4MPLETE THE FOLI+OWING:
NO, FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON ? SHOWER 3.00
REPAIR WATER CLOSET 3.00
BATH TUB 3.00 la-,
? I.AVATORY 3.00 7--Lu
OWNER NAME : t'R.?S, i?? ???``? 1 KITCHEN SINK 3.00 3,`G
? ? IAUNDRY TRAY 3.00
?
SITE ADDRESS :`,?, k`?Vc e? c'? HOT T[JB/SPA 3.00
?
?
LOT:BLOCK ? SUBD. !
t ???/./??
/,
?R 2? 1 WATER HEATER
FLOOR DRAIN 3.00
3.00 .'-v
INSTALT.ER: GAS PIPING OUT.
(MINIMUNf - 1)
3.00
.?
RQUGH OPENINGS 1.50 {-430
ADDRESS.1?? OTHER
:s WATER SOFTENER 5.00
CITY:
f?? ?. _ ZIP: PRIVATE DISP. 15.00
U.G. SPRZNKLER 3.00
PHONE #:
SUBTOTAL S
Vr_ A ST. SURCHARGE .50
SI E 4F PERMITTEE
rl?Tr TOTAL: $
PLEASE COMPLETE THIS PORTION FOR ALL COMRMERCIAL/INDiISTRTAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLIAIG UNIT,
CONTRACT PRTCE:
QWNER NAME :
SITE ADDRE85:
IAT : SLOCIC SUBD.
INSTALLFR:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY QF EAGAN
ZIP:
FEES
1% QF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.04 MINTMIIM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
( S I GNATLIRE )
$.
$
.
r
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reguiremenls
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
1 Soiis Repod'rf proposed building is to be placed on distur6ed so1
2 copies o( plan showing beam 8 window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan if l01 platted after 711/93
Rim Joist Detaii Options seledion sheet (buidings with 3 or less units)
Minnegasco mechanical vendlation fortn
RemodeUReoair Reauiremsots
1;7`? f -76'
2 copies of pian showing footings, beams, joists Cert of Survey Read _ Y _ N
1 set of Eriergy Calculations for heaUed addiUons Sals Repat _ Y _ N
1 site survey for addition.s & decks Tree Pres PIan Recd Y _ N,
Addition - indreate if on,s'rte s8ptic system Tree Pres Required _ Y _ N
Onsite 5eptic System _ Y _ N
Plans are cansidered public information unless you state they are trade secret and the reason.
Date A -0 7 Construction Cost L4
Site Address „3a 3/ B 14- G/C 0416 i? L-e- Unit/Ste #
Description of Work ]?Q e-Ie- m0'( D-/` OGZ h-w ? f? t??'''L t n-?O 6(
Multi-Family Bldg , Yw N Fireplace(s) _ 0_ 1 _ 2
Property Owner / 04/0 re f1 Telephone#((.Sj ) rG+
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy COde Category * Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Ener+gy Emelope Catculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar p{an based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber 5??? Telephane #( )
Mechanical Contractor MAY 2 5 2007 Telephone #( )
Sewer/Water Contractor (v S-r'v Telephone # ( )
I hereby apply for a Residentia! 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 pertnit, 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.
--_.?
eo c(o r?e ---
Annlinant'c PrintPri NamP Annlinant'e CionatiirP .
i ?
DO NOT WRITE BELOW THIS LINE
. . ..,. .
Sub Tvpes
? 01 Foundation 0 07 05-plex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
0 06 04-plex 0 12 12-plex
Work Tvpes
O 31 New ? 35
? 32 Addition *' ? 36
? 33 Alteration ? 37
? 34 Replacement
DBSCrIqt1011: Water Damage Yes
r,
Valuation
Plan Review `100% or
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
? 13 16-plex X 20 PooI O 30 AccessoryBidg
? 16 Fireplace ? 21 Porch (3-sea.) 0 31 Ext. Alt - Mut6
? 17 Garage ? 22 Porc:hlAddn. (4sea.) ? 33 FJCt. Alt - SF
X- 18 Dedc ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 19 Lower Level O 24 Storm Damage
? 25 Miscellaneous
Int Improvement CI 38 Demolish Interior 0 44 Siding
Move Building ? 42 Demolish Faundation ? 45 Fire Repair
Demolish 8uilding• ? 43 Reroof C] 46 WindowslDoors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MCES System
25%
Zoning Ciry Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
T Footings (new bldg)
? Footings (deck)
, Footings (addition)
Foundation
Drain Tile
Roof Ice & Watex Final
_ Framing -
_ Fireplace _ R.I. _ Air Test - Final
_ Insulation
REQUIRED INSPECTI4NS
_ Sheetrock
FinaUC.O.
? FinaUNo C.O.
HVAC
Other
? Pool Ftgs y Air/Gas Tests ? Final
_ Siding ?tucco Lath _ Stone Lath _Brick
Windows
_ Retaining Wall
Approved By: -)- , Building Inspector
Base Fee
Surcharge
!
Plan Review
MC1E5 SAC
City SAC P L)
Utility Connection Charge
Treatment Plant
License Search
Copies
Pther
S&W Permit & Surcharge
(.!?
?- ' ? !?? ? ?ti??r?. o1°i•1 Wrz
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6!t..A?i.e t" =_: 5to`
ikL.L 3r__?4N14?f Ph4hvMED
a pt?•k,-?i, 1Kc ? i?Ro Nlt M?.t•?7'
I hereb?, certify-that survey was prepared by me or
ander my 3irec t supe?he MLa?s of ?hatStat? duly
Lanfl Surveyor un32r
Ja-e:?r?tQ ?e.•?.s.joy. - -- '
LbRoy H*-,"Bahlen
F?e:gistered Zand Surveyor No. 10795
i
! .? ? .
S. 4
1
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4 M
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.7
1
'S •G ? 1 io
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uei o
EAGr1N E1VGllVEEFtiNG DEPT.
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=rid
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�uv,c,a I a bea
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3+s
Scott Peterson
From: Ted Appel [mn.appel@usfamily.net]
Sent: Monday, June 15, 2009 12:44 PM
To: Scott Peterson
Subject: Extension of Building Permit
Dear Mr. Peterson:
I request that my building permit, EA078332, be kept open for at least another year.
As required I will request the appropriate inspections upon completion of the deck.
Please call or e-mail if you have questions or comments.
Regards,
Ted Appel
3231 Black Oak Drive
Eagan, MN 55121
(651) 683-9669
P.S.
Were the changes to my original plan approved?
--- Get FREE High Speed Internet from USFamily.Net! -- httb://www.usfamilv.net/mkt-
freepromo.html ---
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140725
Date Issued:01/17/2017
Permit Category:ePermit
Site Address: 3231 Black Oak Dr
Lot:1 Block: 11 Addition: Bur Oak Hills 2nd
PID:10-15501-11-010
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.
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 -
Theodore Appel
3231 Black Oak Dr
Eagan MN 55121
(651) 325-2430
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:Plumbing
Permit Number:EA147509
Date Issued:01/16/2018
Permit Category:ePermit
Site Address: 3231 Black Oak Dr
Lot:1 Block: 11 Addition: Bur Oak Hills 2nd
PID:10-15501-11-010
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 -
Theodore Appel
3231 Black Oak Dr
Eagan MN 55121
(651) 324-2430
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA153816
Date Issued:01/24/2019
Permit Category:ePermit
Site Address: 3231 Black Oak Dr
Lot:1 Block: 11 Addition: Bur Oak Hills 2nd
PID:10-15501-11-010
Use:
Description:
Sub Type:Reroof & Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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: 15,000.00
Fee Summary:BL - Base Fee $15K $265.50 0801.4085
Surcharge - Based on Valuation $15K $7.50 9001.2195
$273.00 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 -
Theodore Appel
3231 Black Oak Dr
Eagan MN 55121
(651) 324-2430
Dubois Design & Remodeling Inc
715 St Croix St
Suite 14
River Falls WI 54022
(651) 458-0844
Applicant/Permitee: Signature Issued By: Signature