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3234 Black Oak Dr Use BLUE or BLACK Ink, I- G ----------i 15'~l~Oftlce~llse , I ~ I I City of Ea Permit I. I Permit Fee: `c - 3830 Pilot Knob Road I I' Eagan MN 55122 r ~:5 l )dP„ ! i Date Received: Phone: (651) 675-5675 ( I I I Fax: (651) 675-5694 Staff ~s!---------------- i 2010 RESIDENTIAL PLUMBING PEOMIT APPLICATION Date: Site Address: D Tenant: l ~ L'6 Suite RESIDENT / OWNER Name: 0 r r" Phon Address / City / Zipyc 1 _A L CONTRACTOR Narne: v s`U ILL, . 1 tk C -%V-License l 0 I L G ~ ~ 1 ~ Address: City:~1~ 1 State; 1 Zip: Phone Il ~J Q. ~C' 1 I Contact: Email: TYPE OF WORK New L Replacement _ Repair Rebuild _ Modify Space - Work in R.O.W. Description of work: PERMIT.TYPE RESIDENTIAL Water Softener. XWa't2r Heater Add.Plumbing Fixtures Main Lower Level) Lawn Irrigation.( _ RPZ / PVB) 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 Ir I rigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnar und* (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 $5.0 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.0C~ 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.,goi)herstateonecall.org „ I hereby acknowledge that this information is complete and accurate; that the work will be in yionformance 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 wo.r :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 O plan Ap !cant's Printed Name Appl' amt's Signature FOR OFFICE USE Reviewed By Date: Required Ins ections: Under Ground on In Alr. Te t .Gas Test Ftnai I -,INWCTION RECO."~', I CITY OF EAGAN TVM- 3630 Pilot Knob Road P~trtrert 'low Eagan, Minnesota 55123 Ds1a 4 (812) 681-4675 ADDRESS: L QT i obi • t Sc K e *r APPLIrt 32S4 BLACK O&K 0* SUPP OAK HILLS 2#0 ~ k PER ' TYPE: TYPE OF WORK: l~ll1~~'xMS !!I~AININl1 4 YMSUtAlrttiN ~►Ail4~d#il(RI ) fl-IWAL f ti: ~ S permit ft Permit Wift 7bhppone / _ .r s 9e1e twp, cvma~erw Footet 7. Foy ~r '^0'A _ FYitl tt~ FM Plo fto• *w Maribor CNI& mew Oft. FnW Dea FV. D..o&„ Fhal .~1 Dhip. INSPECTION RECORD CITY OF 9AGAN PERMIT TYPE: su x is x "O 3830 Pilot Knob Road Permit Number. *24642 Eagan, Minnesota 55123 Data Iseued:► t # l 4 (612) 681-4675 SITE ADDRESS: o l H t 01 C, APPtJOANT: lit ALJ 1)Ak ttk tTVESILIt t7i~NtFt lN~; tll.ltt ilrli Ii t 1 t .'N!f 461.2) 633 - 104.1 PERMIT SUBTYPE: TYPE OF WORK; F IW, III At I "t,w t.UN (GAS) Cl 11 li 14 t N h i"A I. a rr, ~ fora l t& PWWAt Hotter ow Teiaphom # ,Pl1JLMNO HIMC EL30G'l~IIG E W t1Me ~F ooaAnaate Faottnps t Foundation Framina PMO taooflrg Pft- Rx* loin. Flrspaae t Final ora T" Final Mg. Pb9. Insp odw - Now Plumber cona mew ErVJPlm Bldg. Final Deck Fig. Deck Frvai WON Pc Disp. but rZ'el HOUSE HEATING TEST RECORD ADDRESS ~ APT. FLOOR CITY -IUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY r-'. w_ P Electrical Work By Gas Line By, TYPE OF HEAT GA FA tt- J'HW STEAM SPACE HTR: UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Mode] ' . Model Serial Max. BTU Rating INPUT ` MAKE OF F E Model ~J ~f NTROLS THERM STATHeat Plug Vent Size , ..5 Val". KIND OF LINER SIZE" - NONE Limit hL4ek'k' Draft Hood Regularor ' Limit Setting PC P Filters Size Number ~ Fan Setting m " Chimney Location Inside Outside Pilot Type 0t (r 1 ~(;x Chimney Construction V Pilot Make Pilot Model Smoke Bomb Wiring Pilot Ti min Draft Test Tag L.W. Cut Off Door Pressure V Lighting In t. ~e Pressure 3 k Percent COQ ate Tested 10 - T--23 'e 2_k Input CFH Percent O Vj 2 Company Testing w~ L' J Stack Temp. I` Percent CO Name of Tester Form 235 - Request Dale r Fire No. fou',h-,nInrpecfion ired? ❑ Ready Now WilI Natty InspNe LNo When ady9 1;<1icensed con actor ❑ owne hereby request inspectio o bow electrical work U Job Aar&d e x or Route No.) City r tse/< Q,*lC ~/2[ V~ "rgN Section No. Township Name or No Range No,. County 154 r<~~ OccupantlPRINT) Phone No. Power Supplier - Address Electrical Contractor (Company Name) Contractor's License No. 140ME Ct. C'# oo Mailing Address (Contractor or Owner Making Installation) 4i oo - G ANb '.vim J1Id o~cL N f~ f~N S.S yzg Authorid (Contractor/Owner Zing Ins tion) Phone Number r +-dL , , ,"'7 - o MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul, MN 55184 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-8688 ENCLOSED- REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 Ili- See irstructions for completing this form on back of yellow copy. J ~D?75 22784 X' Pelow Work Covered by This Request e Add Rep. TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner 1Other lspecify) Contractor's Remarks: Compute Inspection Fee Below: 7Af.1 # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 5,64 mps y$~; 06 Transformers Above 200 Amps 0 Amps /4t r` Signs lnspector§ Use Only: TOTAL Irrigation Booms ;t r Special Inspection _ er o _/4/ 0 Alarm/Communication TH INSTALLATION MAY RDERED/DISrCONN TSO Other Fee COMPLETED WITHIN 1 THS t r I, the Electrical Inspector, hereby Rough-in ate ,.+gY certify that the above inspection has Final Date been made. i ~f Q •,,~.z OFFICE USE ONLY This request void 18 months from 'a_' y~ asa& 15-- N 3 5 8 61 ~`ao av Request Date r Fire- d. Rough-in Inpsection Required I sp ion Other Than Rough-In S (You must call inspector When ready) Ready Now ❑ Will Notify Inspector ❑ Yes No Da a Ready licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route N City 3.;1, .3 q 73`)ac k a ~ Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No.~j~ / Power Supplier Address GG/.J Electrical Cont for (Company Name) Contrac r+s License No. Marling Ac tractor or g 0 ner kmggtatlaliOq) Awed Signature (Co ract 0wne king Installation) Phon Number h MINNESOTA STATE BOARD OF ELECTRICrTY [ THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.0800 ENCLOSED 5(3~y REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 Ito See instructions for completing this form on back of yellow copy. P N 86 ork Covered by This Request 1 _5(" Seiow W ew Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractors Remarks. Compute Inspection Fee Below: # Other T- Fee # Service Entrance Size Fee # Circuits/Feeders Fee 'Swimming Pool 0 to 200 Amps 0 to 100 Amps I 14d Transformers Above 200 Amps Above 100 Amps Signs , Inspector's Use Only - TOTW Jv Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDMRED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date r been made. _ OFFICE USE ONLY This request void 18 months from : "Cate CeeuOanev mvad 10101111fes"3" This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Use Cisssifwation: SF DC Bmg. wit No. 1113 O-Pa-y Type Zoning District Type Cons[. Owner of Building ALEXANDER HU441L Adhm 4129 DIM M DR, EAGAN Bn;ldm Adaress 3234 ffiLACKFOAK DRIVELS, , BUR OAK RMS Dow 10/26/Q2 Buildmy offcw POST IN A CONSPICUOUS PLACE rAddrels: 3234 MAX OAK DRIVE Lot 5 Blk g Sec/Sub BUR OAK HILLS 2ND These items were/were not complete at the time of the final inspection. Date: 10/26/92 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. RECUEDPAKR White - City copy Yellow - Resident copy Pink - Contractor copy RESIDENTIAL BUILDING PERMIT APPLICATION ~ CITY OF EAGAN J 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Np New Construction Reoulrereerns RemodeUReoair R2gulremerm • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house: and $t 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 ti home served by septic system for additions • 3 copies of Tree Preservation Plan ti lot platted after 711193 Rim Joist Detail Options selidlon sheet (bldgs with 3 or less units) DATE VALUATION SITE ADDRESS 7 C " 4 MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK ziz~ FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT ~J STREET ADDRESS CITY' S~S'/~ STATE ZIP TELEPHONE # 66f-~'~J/ CELL PHONE # FAX # PROPERTY OWNER TELEPHONE # COMPLETE THIS SECTION FOR -NEW- RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MIN1!!9 sidential Ventilation Category 1 Worksheet Submitted N d (4 submission type) • Re . Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 _ 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 Eagan Ordincices. Signature of Applicant 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 AccessoryBidg ❑ 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 - 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 PERMIT Control No. 0 9 3 E ~ CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 001113 (612) 681-4675 Date Issued: 07/23/92 SITE ADDRESS: 3234 BLACK OAK OR LOT: 050 BLOCK: 08 BURR OAK HILLS 2ND DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R3 M1 Construction Type VN Zoning R1 Building Length 76 Building Width 52 REMARKS: RECEIPT 0 L S&W PLBR FEE SUMMARY: VALUATION $146,008 Base Fee $800.50 MISCELLANEOUS $1.610.50 Plan Review $520.33 Total Fee $3,704.33 Surcharge $73.00 SAC $700.00 SAC % 100 SAC Units 1 Subtotal $2,093.83 CONTRACTOR: - Applicant - ST. LICOWNER: HUMMEL CONST INC A C 14565667 0003116 HUMMEL ALEXANDER 4129 DIAMOND OR 4129 DIAMOND DR EAGAN MN 55122 EAGAN MN 55122 (612) 456-5667 (612)456-5667 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 Mn. Staof Eaga Ordinances. ATURE ISSUED Y .-SIG )NME PERMIT iI CITY OF EAGAN REACTIlAT - 1~ 1992 BUILDING PERMIT APPLI TION 681-4675 n# SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which request is made or lot change is re guested once permit is issued. Date l tL I/ Valuation of work _ Site Address: 3234 3L4-K. De-, STREET . SUITE ! Tenant Name: (commercial only) LOT BLOCK SIIBD. P.I.D. f0 /SSnI OS-0 c~8 gum O~~ H}'1U.S LNa~~ Description of work: The applicant is: ❑ Owner hContractor ❑ Other (Describe) Name 71 V 'r Phone Property -LAST FIRST Owner Address lil'% / i✓~f STREET STE S City State Zips! ~-Z- Company rir Phone Contractor Address y/o29 ~jr~-o►✓~~ License Exp. City C State /1?~✓ Zip ~6-V-2-- Company Phone Architect/ 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 apppplication state that the information is correct and agree to comply 44h all a lic ble Stat of innesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY nw BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE Y3 311 New El 33 Alterations El 35 Tenant Finish [1 37 Demolish 2 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) :f Basement sq. ft. MWCC System r (Allowable); 1st F1. sq. ft. iss9. City Water UBC Occupancy 3 r~ 2nd F1. sq. ft. 95~, PRV Required Zoning- Sq. Ft. total Booster Pump # of Stories z Footprint Sq. ft. - Fire Sprinkler Length- On-site well Census Code io Depth 3-2 On-site sewage SAC Code _L APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site 13 Footing CAL Framing Er Insulation ❑ Wallboard ® Final ❑ Draintile ❑ Fireplace Permit Fee 600, 5D veitation: 000 r, Surcharge -5- *0 s;x r, Plan Review 522.33 z y_ 7s c License iO2 fi MWCC SAC _bn 1-2 City SAC Water Conn. Water Meter Acct. Deposit TS S/W Permit S/W Surcharge 13~_- Treatment Pl.~ V Road Unit Park Ded. ) - S ~ 8s Trails Ded. 1z,3; ~~6,': 1 Cc~rw Copies Other Total : l (o SAC % S' 0 ~J J cam, ~~;r' ° SAC Units..: P _ 0:2 ~ l ----R--- Land Surveying & 1:ngineering. Inc. Certif loo to , ~ NPLAM PARKWAY St~P APOLIgo AUL, INMTAA tG ~ 77~IM4Y of Survey for HUXAML CONoYMUCT-TON r' N 0011'52" If 92.66 ts$ 0 0 T"A I I ~Dralnoge and UtOlty 15 Easement I s~ ~ ~ I 6 DESCRIPTION OF MQP&RTY fi g Lot 5, Brock 8, WR OAK MUS ee.s I~ w 2ND ADD1110N, Dakota Co., Mn P. U) _ Ke zo N Y EO HOUSE, (895.5 n~G)o , V"Clettt 5 ( b age. (895z)x cis acv bn . _ 2aaa o 11.97 897.Qx Denotes proposed elamUon c~ Denotes surface dr4lhage y _ 66.28 ~ L. 801CFIMARK- d TNH Between Lots 314, Block 8, o OUR OAK MLLS 2N() AM HON.. rr F CIAY. r'y.Tf•'M ~~k? '93,00 IN 04'4733` t' +F~J ~ ~ Top of block - 897.,,34(at garage) -BLA GK-----l K- -0 Garage gQ or ai% ' -AM7. 0 Lowest floot-Wev. NOTE - Verify Sanitary Sewer depth prior to excavation. WE HEREBY CERIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF Y D -urimmBm"m Or Tvir LAND OESCR18Ep ABOVE AND THE LOCATION OF All 13UILPINGS IHEREON, ANUMMMY FENCROAMME,NTS, Ir ANY, FROM OR ON SAID ,7HAT TIPS SURVEY ER S THE LAWS OF THE STATV Or MIN N65QTa StX'ERViS10N AND THAT i AM A DULY REGISIERED LAND SURVEYOR UN AS SU YED BY M DAY OF Ig BY MINNESOTA RECISIRATION NO. ~ rL 7.9- Job Na• .----r- Book Pags~~ Sec. T. ~ R.. s~zae EXTERIOR ENVELOPE AVERAGE 111jel CONPUTATIGN ' ~ . ' ,;.~~,1 ~•-232-= 12UAOF- j- OAFA C2[b&s, SITE!AODRESS: • -NOHTRACTO,R% :...3.J~~'.~...C.....~. DATE:. ~0" ~.iZ~ PHONE • pETERMI NE WORKI I46 SQ,OARE f00TAGE OF EACH:. ; , TOTAL EXPOSED, WALL .AREA........ Z10.2 Sq ft 'luli • M `t M ~ TOTAi: MOF/CE I L MSG AREA........ X00 sq f t x •'U" . ©2~a » E TOTAL. E4POSID WAIL AREA CALCULATIONS S Total exposed wall r area above, f i oor... , . • a) Sq ft.- Total wall window area:. • ~G glazer....... 202.., sq'ft x /Lull' 17 . glatad..:... sq ft x I b), Total door area sq f t e) Total sliding giiss dove oraa~ e•, ' I blazed...... sq ft x U • MEMO glazed,..... sq ft x 'lull ~,d) Total fireplace wall area sgoft x • 'o) Total wall framing area • , • (Average 10%) • ' Sq ft x.flull ' D , f) Total net wall area above • floor (Insulated)....... sq ft x 'lull D4 S 9). Total rim Joist area.......;,2.~ . ' sq ft x "W' ISM r 7740- Total foundation area (Exposed , , , 2 sq • f t h) Total foundation ' • Mlndaw area... : ' . • . , sq ' ft x U . .5 • . 1) 't'otal oat foun6tion area above grade' Z• • ' sq ft x .''U'1 .1 » g2 ToTnL, a) cfiru.•!~ 211'.& sane as or 1 • • • ' ~ . „ „ •5: • • , ; • , ' • t If Item-03 Is tho' ass than itan Al/ you' have met the tntane of S•B..C.,Saction GOAF (c) 2. • V r TOTA4 EXPOSED ROG /CEILING CALCULATIONS i.w..r ' Total oxansed • . roof/coi 1 inn area.......: ( C> sq f t • J) ' Total • skyl ich: area....... sq ft x "U.l w ' MEMO Total roof/ceilinq framing 2 area (Averace 1051)...... 6!~• sq ft'x "U.l .02 w 1) Total net Insulated . roof%cai 1 ing area....... 3• ~D $q ft x f'U" •0 • ( TOTAL J) th ru 1) 35.10 I if total of #b is the sare•as, or less than f2'•you have met the Intent of . S.B.C. section 66061c) 10 ` EPWATE BUILDING ENVELOPE DES 1 Gti..: To utilize the total envelope system method.* 't hie values established by the sung of I0M i3 and A shall not be greater than the sum of .items I and 02. 3 i -room PERMIT r fz--3j-6V GITY-0F EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 0 2 4 6 4 2 (612) 681-4675 Date Issued: 09/30/94 SITE ADDRESS: 3234 BLACK OAK DR LOT: 5 BLOCK: 8 BUR OAK HILLS 2ND P.I.N.: 10-15501-050-08 DESCRIPTION: (GAS) Building Permit Type FIREPLACE Building Wank Type NEW REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: FIRESIDE CORNER INC 16331042 0001068 GIBBS DWAYNE 2700 N FAIRVIEW 3234 BLACK OAK DR ROSEVILLE MN 55113 EAGAN MN 55121 (612) 633-1042 (612)681-1632 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 Mn. Statutes and City of Eagan Ordinances. f cql A, L 1 APPLICANT/PERMITEE SIGNATURE ISSUED BY. IGN R CITY OF EAGAN i4(41 1994 BUILDING PERMIT APPLICATION 681-4675 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 qo~ Valuation of work • OD Site Address: b" ct, m~L' zx- STREET SUITE # Tenant Name: (commercial only) LOT _ BLOCK SUBD. U l P . I . D . # ~,a111, ~ Tl Description of work: 1YlS~6t ~ ~ox-~Cn ~ G1S AZ►,,A ~ v- tWeQ The applicant is: 13 Owner bOContractor ❑ Other (Describe) Name & b~ Z~)Vmfnv-- Phone C ►1-1(A Property LAST FIRST Owner Address ~Q7~!ij )OU, CAS z'r STREET STE # State tate YY-% t-~ Zip , 6aaac- Company 00\\F6 - 66 Phone Sco - 0-7 S9 Contractor Address -Qat d v\OL.O License # ~01-18 Exp. City Tt:)%e _->1 State tv- - Zip 1... Company Phone Architect! 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: ©FIRCE USi ONLY x BUILDING PERMIT TYPE ❑ Ol Foundation ❑ 06 Duplex E3 11 Apt./l.efting. 0 14, gas nt Finish ❑ o2 SF Dwg. ❑ 07 4-Plex E3 12 Multi. Misc. ❑ 17 Swim~Pool ❑ 03 SF Addition ❑ os B-Plex ❑ 13 Garage/Accetsery C! 18 Cana,/Ind. ❑ 04 SF Porch ❑ 09 12-rPl*x ❑ .14 Fireplace ❑ 19 Com./Ind. Misc. ❑ 05 SF Misc. C3 10 Multi, Add11. ❑ 15 Heck E3 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New C] 33.Alterations ❑ 35 Tenant Finish;- C] 37 Do*lish 13 32 Addition ❑ 34 Repair- Q 36 Nove GENERAL INFORMA71ON Const. (Actual) Basawent sq. ft. _._~.r.r MWCC Syst". {Allowable) lst fl. sq. ft. City Water UBC cupancy 2nd FI sq. ft. PRY Re ire~d Zoning Sq. Ft. total Boosteru PO pp 0 of Stories Footprint Sq. ft. dIre Sprinkler Length on-site well ous C06 Depth . On-site sewage Code APPROVALS Census Unidt Planning Building Assessments „ Engineering Variance REQUIRED INSPECTIONS C7.Site ❑ Footing E3 Frning E3 insulotion ❑ Wal.lboard ❑ final ❑ Draintilo ❑ F"lace Permit Fee 3 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. Copies Other Total : SAC % SAC Units 'vi{{{::tivi:Y•... +.v Ltii 4i ...n..vn n • `trt v.1994 MECHANICAL PERMff (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (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 FIREPLACE INSERT DATE _S -1 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 CONSTRUMON) $ 20.00 STATE SURCHARGE .50 TOTAL v . SITE ADDRESS: 3 3`1 OWNER NAME:~4_o,~ 4- me:=2~ 4 TELEPHONE 1 6 3D, INSTALLER:- SWORD tIFONG'ANO AIR CONOITNiMO so 410 WEST LAKE STREET ADDRESS: wonwom mm suw~ CITY: STATE: ZIP CODE: TELEPHONE §I'GNATURE OF PERMITTEE - .,:kSJ.$k`{}~:}v?ii~%.;tn•;,?t4n::{:.x. v:.vhJivx: :.~.1 by •;:]0 :M.x.. s~i}:••aha:,v,3~.} v 'v'h'.: 'k :ik~' v::: v..xolk{}{:i}:{{t}~::nw.v •r. 4 - v:.::: x:..x.. :aYy+-0n~', .•v~ ,•v::. Y,?:x::: i2.,...v'ay :?:?•.O?R?•:•%2? hU.{aC•. •~?iki .}i{. ..:::t ,a' •"k-`v : :}i:.aA2.:F:::$7n.?. 4?.•..:. ko:a.2}L,~>v:...,k.;;;;r:.'•••k}::tas}:{ax•:u::•`.kkYC"'a:{c}•h•R?ox`:~,: QQ '^4?„} •xF"~,u+ir ,-..i::,,: ~•:;Y,~ : ...?;~=k:w..x.}:?•~??.:: <:.~c-,.;: sse:r .x~'}::::?.. "S':`::tk;ii::. w}~\, . •nd•:'. .k:. , •.`t: s?4's;.r.:;3.k4 ; ''~d•~'•,;•'• . ~ t . ,fi".t$:sZ`> ~:-~.':J{c:h~+!.. ~o; ..:::,,I:: .nw xa., 3:.,u'tg3: v?2b}~.•.;:?~~2{.,. t.n ~`'Z: . 'F, 'x i'A s.•,.x. ~ ,.?•g::::~~.n}..:axe»Z}::?.µ:}:::c.,;{ ~c ^a~e... c~... ':c .k , '3#: , k. - fro... ::•kec>.s 2•~? as iti:,}W,.{. ia+~Yv i2} ~ a.; .k { v:..:.i{•y: 'i:::~:; v v : h :N:•" {:ia } ;Y•iv, lCs,.t.t.. ':'c:Y'3ks •:hr,;. sb..}..3R ;4•. .g:.'tx}f;.•S,{nk``'';3{„ {f}... £ •'v , ~;1 „~s.,~.:o}}:;:•.':;.a~'t~.,+•. •R?:h,~.~.''-:•,...'.,.~. •"ar •ki,•'~•.:i:•F:"i+Ns:Rs - 2 \s , 'S s~~~~ i y . 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3838 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAL./INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. - - - - - DATE: CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF , FEE $ PROCESSED PIPING: $25.00 MIND" FEE: $25.00 STATE SURCHARGE $30 FOR EACH $1,000 OF FEE. .IPIM TOTAL $ SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IIvIPROVEMENTS ONLY , INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE SIGNATURE OF PERMITTEE CITY INSPECTOR CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # _ PHONE: (612) 454-8100 RECEIPT # /U DATE : "M " PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: 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 LAVATORY 3.00 OWNER NAME : ~ L1 ~ d►~ W KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS : 3,2 y /`~G L{ r~ HOT TUB/SPA 3.00 HEATER -3 WATER 3.00 LOT : BLOCK SUBD. FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: y (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 ADDRESS: 90 ^61N,0 ~ OTHER A 2 WATER SOFTENER 5.00 ~O CITY: 9- I ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE SUBTOTAL $ ST. SURCHARGE .50 SIGNATJJ E 0 PERMITTEE r TOTAL: S t7MMERCSAL I1)tTSTRI.A' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN ` VIII yr Zfty v rVA Vl11 uan uWLI . 3830 PILOT KNOB ROAD EAGAN. MN 55122 PERMIT Ilt PHONE: (612) 454-8100 RECEIPT # 5 LNG ! DATE : ~In '4 •:i0:•%+t•\.::;.:.:ustit;:i»tititiv.4i,P PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON l SHOWER 3.00 REPAIR WATER CLOSET 3.00 BATH TUB 3.00 O LAVATORY 3.00 9, 00' OWNER NAME: ,,1S~l~lll7i~ll~( ~e.4~i?.c? KITCHEN SINK 3.00 ,DD ~ LAUNDRY TRAY 3.00 .3: l1 D SITE ADDRESS: Z~ HOT TUB/SPA 3.00 c~ WATER HEATER 3.00 DD LOT: 5 BLOCK D SUBD. got FLOOR DRAIN 3.00 / GAS PIPING OUT. INSTALLER: LAL41,~ Cif ~1•/,C~~ (MINIMUM - 1) 3.00 3 ROUGH OPENINGS 1.50 ADDRESS : OTHER _ WATER SOFTENER 5.00 CITY: ZIP: PRIVATE DISP. 15.00 PHONE ~jro2'IS~ S U.G. SPRINKLER 3.00 5O SUBTOTAL 919 ST. SURCHARGE .50 Sz E OF PERMITTEE TOTAL : S D d QMMERCIALjiNA17STELAY' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # DATE : R1' PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT OWNER NAME : JjyM tK ~ SUBTOTAL, ADDRESS: -3.)3L/ D/2. $ ~ _ ~ ~f / STATE SURCHARGE: .50 LOT: _ BLOCK 3UBD. d TOTAL. $l?' INSTALLER: ADDRESS: SIGNATURE OF PERMITTEE CITY: ZIP: PHONE y d :l Du L: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUED. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN PERMIT City of Eagan Permit Type:Building Permit Number:EA164466 Date Issued:09/29/2020 Permit Category:ePermit Site Address: 3234 Black Oak Dr Lot:5 Block: 8 Addition: Bur Oak Hills 2nd PID:10-15501-08-050 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. 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 - Duane S Gibbs 3234 Black Oak Dr Eagan MN 55121 (651) 263-5440 Minnesota Exteriors Inc 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA165269 Date Issued:10/26/2020 Permit Category:ePermit Site Address: 3234 Black Oak Dr Lot:5 Block: 8 Addition: Bur Oak Hills 2nd PID:10-15501-08-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Duane S & Mary L Gibbs 3234 Black Oak Dr Saint Paul MN 55121--233 (651) 263-5440 Minnesota Exteriors Inc 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA177052 Date Issued:06/14/2022 Permit Category:ePermit Site Address: 3234 Black Oak Dr Lot:5 Block: 8 Addition: Bur Oak Hills 2nd PID:10-15501-08-050 Use: Description: Sub Type:Air Conditioner Work Type:Replace Description: 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 - Mary L Gibbs 3234 Black Oak Dr Eagan MN 55121 Schwantes Heating 6080 Oren Ave N Stillwater MN 55082 (651) 439-3331 Applicant/Permitee: Signature Issued By: Signature