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3254 Black Oak Dr
FF N%fi... OF EAQM t omim gyp. Oft _ 13Q Not Knob Rid P *"K Pte: EWn, Minrosstft 525123 ire lssu ►g1 ! i., (612) 681-4676, ' "E A DDkESS A CANT: fii.ACK 0Ak Df? MI [TELN-sTAVOT ORt~tulERS, ,E WIN IIA1 1ti! i `.i l , k. PERMIT SUBTYPE: ! TYPE 00 WMK ? DWG # NF w f N °i i! t 9R iCi N V I N A 1, k . u. 7,7 it1" i"1Ar?1' 1~ W fj r NP Po" "ONO am A*oPbom# p TrV :PWIJ 'ter ANPWNN D#h 6"06 p#44taod 9, "'44 3 irl J,l CMML mm . EW~ Deck F~. Deck Final WeA Pc Dep. CF f INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road . Permit Number: Eagan, Minnesota 55122-1897 Date Issued: N!9 (612) 681-4675 SITE ADDRESS: ` ; t ► APPLICANT: I.0FI Fttiicr:~ k; HIC°KV I. C►pF7O~NY 4il.A(tr, t)AR OR tali};k 4}F1k }F I'! l f r: t 464 -1613 PERMIT SUBTYPE: TYPE OF WORK: Flf E't: _ NF'.!„t fAol`rN6 ; i T"At a Permit No. Permit Holder Date Telephone e ELECTRIC PLUMBING HVAC m" o>lim De1e Imp. con"wIft FOOTOM FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPSOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL G ftrtifica#e of C"anev U" of i This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of turn„re this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Use c cafiaw SF DWG BW. Pennit No. 21372 oCcoP-Cy ,rye 7oWng District R1 Type cons[. VN owns of s - N iTIEG. rmT BROS cm Addmn 785 SUNSET DR, EAM , . . Bwldfiii na 3254 OAK DRIVE rL1, B6, BUR OAK HILLS IST r'- j' = Date: POST IN A CONSPICUOUS PLACE Address 3254 BLAM OAK DRIVE Zip 5512 1 Lot • + l Blk 6 Sub BM OAK ffHIS I ST THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: p~p7 y' Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass t/ 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. Contact engineering division at 6814645 before working in right-of-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy 19 9 4 coo-L o s a Other Than Rough-In RequesfDate Fire No. Rough-In Inpsection Required T (You must call inspector w ready) Ready No l i spector ❑ Yes No at e Ready Icensed contractor 11 owner hereby request inspection of above electrical work at. Job Address (Street. Box or Route No ) City '560!r='K n K ",557/5 y,9 Section No Township Name or No. Range No. County I4J~ d~i9. Occupant (PRINT) Phone No. 0gI rGKcL. Power Supplier Address At /Ill . Electrical Contractor (Company Name) /1 Contractor's License No. 7 gQ2,400t _C'__9_-AUA" *191<!~-, ~0.*q 6 Mailing Address (Contractor or ner aRmg Installation) _ Authorize afore (Contra -0w er Making. Instal ti Phone Number ~~a ~J OARD F EL RICITY THIS INSPECTION REQUEST WILL NOT NNESOTA STAT 'fl Griggs-Midway BI . - Room S- A BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul. MN 55104 V UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0600 ENCLOSED. ©ls REQUEST FOR ELECTRICAL INSPECTION ee-oooot-oe 10, See instructions for completing this form on back of yellow copy. y N 9. 4 A"'Velow Work Covered by This Request New Add TypeofBuilding Appliances Wired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Fur ace Other (Specify) Farm it Conditioner I Other ispecifyi Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspectors Use Only: TOTAL Irrigation Booms / L { J.^ Special Inspection Alarm/Communication THIS INSTALLATION MAY BE OFIVEAED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Data certify that the above inspection has Final Dat been made. OFFICE USE ONLY This request void 18 months from This request void i~ 'LL 18 months from ja ~0 D 8577 Request Date Fire No. Rough-in Inspection Required? ]5~,cly Now Q Will Notify Insoec- ` QYes o tot When Ready Licensed Electrical Contractor 1 hereby request inspection of above ❑ Owner electrical work installed at: Streel,;Address, Box or Route No. City A Section No. [TownsMici Name or No. Range No. unty C~ Occupant (PRINT) Phone No. Power Supplier Address 13cno~j 4X W Ave Ne w Electrical Contractor (Company Name) Contractor's License No. 7664 Mailing Address (Contractor or OWnstr Making Instailatio ~ r 2 C? to v c ke . 34 Author zed Signature (Contractor/ ne Makin nstaIlation) Phone Number MINNESOTA ATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WI L NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 561 D4 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-OBOO ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-06 1 See instructions for completing this form on back of yellow copy. D 8577 "X" Below Work Covered by This Request Now Add Rep. ,T!'pe of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other (Specify; Other (Spocify) Other Sped y Other Other ompute Inspection Fee Below # Fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits %1 0 to 200 Amps 0 to 30 Amps 0 to 30 Amps Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100- Amps Above 100_Amps Transformers Irrigation Booms 1,'Qihzr-Fee Signs Special Inspection $ Remarks TOT L FE, L. b J Rough-in Date ) th Electric Inspec ereby certify that the above Final inspection has been -~7 made. This request void 18 months from r5 23-- ~r 1 Q (o , &Aj &e.pt-~l ~T~/ a Request Di Fe No. Rough-in Inspection ` • > )~s ed? D Ready Now ilI Notity Inspector 7 No When Ready? I licensed contractor 11 owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) City AV CA Section No. Township Name or No Range No. County Occupant(PRl T) Phone No. Power Supplier Address Electnca; Contractor (Company Name) Contractors License No. Mailing Address (Cont~~racttortr or Owner Making Installation) uthor o Signaturp iContractdr,Owner Making Installation) Phon Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S•173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 56104 UNLESS PROPER INSPECTION FEE IS Phone (812) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 ► See instructions for completing this form on back of yellow copy. 2 "X" lgelow Work Covered by This Request ,New 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 (Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps c'°* 0 to 100 Amps Transformers Above 200 Amps' I Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms "J Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORD D DI ECTED IF NOT Other Fee COMPLETED WITHIN 18 M HS. I, the Electrical Inspector, hereby Rough-in Rate certify that the above inspection has f 6 Final Date been made. OFFICE USE ONLY This request void 18 months from ' r ii ~5~~3 oo 2004 RESIDENTIAL BUILDING PERMIT APPLICATION /7 o atl City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements Remodel/Repair Reaulrements 3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roofed areas 2 copies of plan f (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions T Pres pta i- ie _ f 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Ares ftused Y 1 set of Energy Calculations Addition - indicate ff on-site septic system 3 copies of Tree Preservation Plan if lot platted after 7/1193 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date / / 15~ Construction Cost 12-t Odc Site Address Unit/Ste # 572- Description of Work ~CI~aG~~ 1 QdL~3'~ "4x VN) Multi-Family Bldg - Y - N Fireplace(s) - 0 - 1 _ 2 Property Owner 1 c~ R r" S Cr-f] w Ci---"-- Telephone #6p 5) 2(6 0 (50 Contractor wJ ~Zl Address f b 7 City t~1p State Zip Telephone # 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 (J 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 # ( ) _j LL, U k:j U-3 Mechanical Contractor at IN 0 1 Telephone # ( ) Sewer/Water Contractor Telephone # ( ) 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 which requires a review and approval of plans. App cant's rented Name pplicant's Signature OFFICE USE ONLY Sub Types ❑ 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 (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 Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # 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 _ Brick Fireplace _ R.I. -Air Test -Final _ Windows Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total RESIDENTIAL , II g BUILDING PERMIT APPLICATION' Q- CITY OF EAQdIH C] - S2;.3Q PILOT KNOR RD - 55122 6B7-081.4878 ~ ~ _ N" Construction Reaulrefflanft • 3 (20% mumn mgis1wW We surveys thawing 4 tt oflot, a0. R of hw W m g roadad arose . 2 caplet ofpWn 1sadoffraWC410011=11ar WNd • 2 copies of plan s w*q born i wk*w slats; pooW lead din, arc.) • I s% swMbr a stior edd amS dada • 1 sat of Energy Catubtlam . In mp h I haste as i by sq* viMua for aftans • 3 Copies of Tree Pruovdan Plan r lot puttied after 711193 Rim Joist Debi oplim seiscim sheet (bidga with 3 or leas anal) DATE VALUAION JOB SITE ADDRESS < IF MULTI-FAMILY BU ING, HOW NY UNITS? PROPERTY OWNER 1,A1297fil TYPE OF WOR F FIREPLACE(S) 0 1 + 2 APPLICANT ..2537 PHONE# 11 ADDRESS b b N rfi z / r ZIP PAGER # CELL PHONE #61 2 FAX* I~fE1V RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELYa Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I (check one) - Residential Ventilation Cohmory i Workstest SL&Mtftd Energy Envelope C wWlons Sid MINNESOTA RULES 7672 New Energy Code Works" Submitied Plumbing Contractor. Phone B: Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 Water- Heater No. of R1. Baths No. of Baths Mechanical Contractor: Ph*ne # Mechanical System Includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phgns Ail above Information must be submiud prior to p=awing of appka Lion. I hereby acknowledge that I have read this application, state that the information i --Pty with all applicable State of Minnesota Statutes and City of Ea in S%pxdm of Appkw* Certificates of Survey Received Tree Pndservet m Plan Reoshed Not Required !y ilpolPltd' 1101 CITY 01~ EAGAN PERMIT -7-4-<13 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 021372 (612) 681-4675 Date Issued: 07/06/93 SITE ADDRESS: 3254 BLACK OAK OR LOT: 1 BLOCK: 6 BUR OAK HILLS 1ST DESCRIPTION: Building Permit Type SF DWG Building f4ork Type NEW ilBC Occupancy R-3 M-1 Construction Type V-N Zoning R-1 Building Length 60 Building Width 52 REMARKS: S & W PLBR - KLUVER MECH FEE SUMMARY: VALUATION $129,000 Base Fee $741.00 MISCELLANEOUS $1,744.50 Plan Review $481.65 Total Fee $3,781.65 Surcharge $64.50 SAC $750.00 SAC % 100 SAC Units 1 Subtotal $2,037.15 CONTRACTOR: - Applicant - ST. LIC. OWNER: MITTELSTAEDT BROTHERS 14569125 0003443 MITTELSTAEDT BROS CONST 785 SUNSET OR 785 SUNSET DR EAGAN MN 55123 EAGAN MN 55123 (612) 456-9125 (612)456-9125 I hereby acknowledge that I have read this applioation and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. ~t APP (CANT/P MI SIGNATURE ISSU Y: IGNA RE . INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 021372 Eagan, Minnesota 55123 Date Issued: 07/06/93 (612) 681-4675 SITE ADDRESS: LOT: 1 BLOCK: 6 APPLICANT: 3254 BLACK OAK DR MITTELSTAEDT BROTHERS BUR OAK HILLS 1ST (612) 456-9125 PERMIT SUBTYPE: TYPE OF WORK: SF DWG NEW INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTING FRAMING INSULATION FINAL FIREPLACE REMARKS: S & W PLBR - KLUVER MECH REACTWA% ~ IEWE® CITY OF EAGAN PERMIT=# 1993 BUILDING PERMIT APPLICATION U N 8 1993 681-4675 SIN GLE & 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, I 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_ ! = / Valuation of work Site Address: STREET SUITE Tenant Name: (commercial only) IAx BLACK SUED p . I . D , Descri tion of work; The• appl icant is: ❑ Owner Contractor ❑ Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE N City State Zip Company 4, &4* Phone Contractor Address e r- , License # Exp. City State Zipi Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber i& Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a lication 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: REACTIVATE CITY OF EAGAN PERMIl # 4 1993 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 Valuation of work Site Address: STREET SUITE / Tenant Name: (commercial only) LOT BLOCK SUBDI44a OAK #^Ay P.I.D. # Description-of work: The applicant is: ❑ Owner ❑ Contractor ❑ Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE S City State Zip Company Phone Contractor Address License # Exp. City State Zip 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: - OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish Gr 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Flex ❑ 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 E 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) V.L _ Basement sq. ft. MWCC System ~S (Allowable) v- Ist Fl. sq. ft. City Water Y GSS UBC Occupancy( -1 2nd Fl. sq. ft. PRV Required Zoning QT Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length o.# On-site well Census Code /o/ Depth On-site sewage SAC Code ~r i APPROVALS i' Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee valustion: g 2~ 060 Surcharge Plan Review a 3z -zy = wu License 13kit r ~ 0 MWCC SAC GARa 1- City SAC Zox22 = x'12 X 15_10090 Water Conn. yyo x f(,± Water Meter Lower ? a~a Acct. Deposit S/W Permit H )c 3 0 = 20 S/W Surcharge 1 = g Treatment Pl. 312 Road Unit '~2Y)C Park Ded. L Trails Ded. /6 %2y 38y Copies 13x+ ~ $ Oter TTotal : 33O 2 rc 20 U ecn l -i Q-S r i SAC 96 100 13SMT= 672 SAC Units L, 726 , ~YzXl= I-ijq~ ti ;2- r qe, . ' r79 ?A ly~yxs4= i~,2`~G .5588466 , SURVEYOR'S CERTIFICATE MITTELSTAEDT BROS. N D II EXISTING W I~1 BENCH MARK HOUSE TOP OF PIPE 8 ELEV. a 898.01 Q O oo ~ s98.7 4 0 64 1-04 166.35 N 89051'48" E _OQ 'v 29.58 - r- ~ ~$~~.6) OD 52.88 898.3 896.6 ao 10 ( I 13.16 8982 - 1--'`8 1 aJ 30 \ Y - - 0898 O7/ O 29.66 8983 I 10 w Q a o I Q f~ r a I W l r ~ ~ ~ 21.0 F O C) 30 899.01 TO C B cr D M 1`. Q N rn i a LOT I ~ w aa wz 0) ow OD 11.67 Z 1 900.2 p n ur r~7 I 1 • ~ lV i 12.66r 901.1 OD o _ W01 10 01 30 10 r r 1 ',1 ~194~.a) I , 905.3 (89~o I r_ D=3°57'2d 901.9 88 5235 i14 n f j 7Y ~D-50.29"A96 2o kra 24 6R=758.32 0=I 106 ~ 1628 N$9°5T19"E e; BENCH MARK a ELEV. 800.15 ST. T~ t0 ' N4 SFlC;; :SOS INVESTIGATION NOTE: BUILDING DIMENSIONS SHOWN ARE HAS BEEN LO~IPLET'ED ON THIS FOR HORIZONTAL S VERTICAL LOC- LOT. BY THE SURVEYOR. THE ATION OF STRUCTURE ONLY. SEE SUITABILITY OF SOILS TO SUPPORT ARCHITECTUAL PLANS FOR BUILDING THE SPECIFIC HOUSE PROPOSED Q FOUNDATION DIMENSIONS. IS NOT THE RESPONSIBILITY OF THE SURVEYOR. 42 DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 7oo,9 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 893.9 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- 902.0 FEET WE HEREBY CERTIFY TO MITTELSTAEDT BROS. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot I , Block 6, BUR OAK HILLS , according to the recorded plot thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 25TH DAY OF JUNE '1993. PROPOSED GRADES SHOWN WERE TAKEN SIGN D. TAR. HILL, INC. FROM THE GRADING PLAN FOR BUR OAK HILLS 2ND ADDITION PREPARED BY MERILA a ASSOC. AND LAST DATED 2-13-92. B LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 z o~(A oo u a James R. H"11,~ inc. M m in F o o °w 0 n om PLANNERS / ENGINEERS / SURVEYORS " zWG) Zw zmC O m 2500 W. CTY. RD. 42 BURNSVlLLE, MN. 55337 612-890-6044 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION { PROPERTY LEGAL: < < Date of Survey: DOCUMENT STANDARDS D'"D 0 Registered Land Surveyor signature and company R- 0 0 Building Permit Applicant Cr ❑ ❑ Legal description D Q'' D Address D~ 0 0 North arrow and bar scale ❑ ❑ House type (rambler, walkout, split w/o, split entry, lookout, etc.) V El Directional drainage arrows with slope/gradient 0 Proposed/existing sewer and water services D' D D Street name 0- D 0 Driveway ELEVATIONS Existing 0 0% Sewer service D D Lot corners D D Top of curb at the driveway ~D ❑ Elevations of any existing adjacent homes Proposed 0 Garage floor 0' 0 D First floor 0 0 Lowest exposed elevation (walkout/window) DAD 0 Property corners [~0 0 Front and rear of home at the foundation JONDING AREAS (if applicable) ❑ 0 Easement line 0 CT 0 NWL 0 D HWL 0 0' 0 Pond # designation 0 L'~0 Emergency Overflow Elevation DIMENSIONS PJ""'D 0 Lot lines t~ D 0 Right-of-way and street width (to back of curb) D 0 Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e., all structures requiring permanent footings) 1~' 0 D Show all easements of record and any City utilities within those easements Qr D D Setbacks of proposed structure and setback of adjacent existing homes 0 ❑V'~ 0 Retaining wa ment if any Reviewed: Nam / ate October 1992 DATE EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER Tics ~~t 1421~+a SITE ADDRESS CbNTRACT0R fit Apmss,7 S 5 Su ~~uT ~n fE fpm PHONE V lk.. 2t21 fi { DETERMINE WORKING SQUARE FOOTAGE OF EACH. 1. Total exposed wall area Z7, 3 sq. ft. x .11 2; Total roof /ceiling area t4:2 $,p sq. ft. x •026 all Total exposed wall area above floor w Ile, i a. Total wall window area 2.5G . 9 b. Total door area c. Total sliding glass door area 3, At d. Total fireplace wail area O e. Total wall framing area (average 10~) .........._20-2.07 f. Total net wall area above floor ! %211& g• Total rim joist area 3G1 . 2 Total exposed foundation area h. Total foundation window area .(I.3 i. Total net foundation area above grade lQ~1, 0 i Determine "U" value of each wall segment. i 3 a. X fluff 1'07. 9 b• 34, y X fluff . f - 2. 4 c. ~i ~h L X fluff F d, X fluff f> O a._ X "Ulf f._ X fluff 6-2. X fluff 0 L4 X ?full 4z h. .21 i • I f~0. D X $fuff .~D L _ to 3 ........................Total $ o If item #3 is the same as, or less than item Ill, you have met the intent of SRC 6006 (c)2. r -i- Page 2 of 2 Total exposed roof/ceiling area = +f -17 ~ I 1 J. Total skylight area k. Total roof /ceiling framing area (average 102).. 1. Total net insulated roof/ceiling area -13g 1,1 Determine "V" value for each roof/ceiling segment. J. X fluir 46 n 1 • ! 4 X 111311 • t 'B = 4.1 .........................................Total if~total of #4 is the same as, or less than 02, you have met the intent of SBC 5006(c)1. 1 Alternate Building Envelope Design To~utilize the total envelope system method, the values established b the sum of items 03 and 04 shall not be by 01`and #2. greater than the sum of items 1 2 { I r" A !j l t 5 i f I PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 7 8 6 (612) 681-4675 Date Issued: 09/09/96 SITE ADDRESS: 3254 BLACK OAK OR LOT. 1 BLOCK: 6 BURY OAK HILLS P . I . N 10-15500-010-06 DESCRIPTION: Building Permit Type DECK .Building Work Type NEW Census Cede 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: Base Fee $45.00 COPY $.50 Surcharge $.50 Total Fee $46.00 Subtotal $45.50 CONTRACTOR: OWNER: - Applicant - MICKEL DOROTHY 3254 BLACK OAK OR EAGAN MN 55121 (612)454-1673 I hereby acknowledge that .1 have read this application and i3tate that the information is correct and 'agree to cofnpl.y with all applicable State of Mn. Statutes and City of Eagan Ordinances, of 'A APPLICANT/PERMITEE SIGNATURE ISSUED SIGNATURE CITY OF EAGAN 3830 PILOT KNOB RD - 55122 161b4996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Reouirements SernodetfRepgir Reauiremenis + 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations 4 1 energy calculations for heated additions 3 copies of tree preservation plan I lot platted after 711193 required: Yes No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK:' STREET ADDRESS: v LOT _ BLOCK SUBD./P.I.D. L&2 PROPERTY Name: Phone OWNER Nn venxr Street Address City: State: f r ► P1 Zip: CONTRACTOR, Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address' - City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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 IRE C F V E D Certificates of Survey Received Yes No "P 5 Tree Preservation Plan Received Yes No - - - - - - - - - - - - - - - OFFICE USE ONLY BUILDING PERMIT TYPE # ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling o 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage /Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plea ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _ plex X15 Deck WORK TYPE 0---'31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code 01 Census Bldg Census Unit 0 APPROVALS Planning Building r' Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit SM Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies . Total: % SAC SAC Units /E YO R' S CERTIFICATE MITTELSTAEDT BROS. o. N rov It EXISTING W It BENCH MARK HOUSE O QW TOP OF PIPE I W N ELEV. - 898.01 UJ -0.0 G~' 898.7 I o o . to 4 166.35 N 89° 51' 4811 E "-826.,6) ^ 29.58 - 52.58 898.3 1 896.6 to _ ~10 ~ 30 0 898.5 .4 898 3 110 I . 22.67/ p , 29.66 N~ ( I~ O. O I O ~a I W Ir 00 ~o 21.0 ,p 16- La I t~ 30 899 0 i 7.0 g D D ~c I ^NMW o LT I o I A/ w z p ~ Zow CID 7 <2 Z I I` W I Z W o I I 11.67 CD ~ Q N I 900.2 p o W I 12.66 901.1 W I k_ 1 LC ) CID O I 1' 01 0) D :g; IW N, - - 10 f I ;K 30 10 I to , I p 71906,0) 905.3 (gg8.8Jp , t-_ 52.35=3°5?11201901.9 u 30.09 6 R=758.32 D= 11°06 14 9o5.T '1028 2o ►6 24 ti46 g W N 89°57'19~~ E •s ~ W BENCH MARK p TOP OF PIPE ELEV. 900.15 ST. r7 TI-1 ~898•Z~' INNO KNd ¢ 0445 INVESTIGATION HAS BEEN CO~IPLE7ED ON THIS , NOTE: BUILDING DIMENSIONS SHOWN ARE LOT, BY THE SURVEYOR. THE FOR HORIZONTAL 6 VERTICAL LOC- SUITABILITY OF SOILS TO SUPPORT ATION OF STRUCTURE ONLY. SEE THE SPECIFIC HOUSE PROPOSED ARCHITECTUAL PLANS FOR BUILDING IS NOT THE RESPONSIBILITY OF 8 FOUNDATION DIMENSIONS. THE SURVEYOR. DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - loo, FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 8919 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 90z_0 FEET WE HEREBY CERTIFY TO MITTELSTAEDT BROS. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot I , Block 6, BUR OAK HILLS , according to the recorded plat thereof, • . Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 25TH DAY OF JUNE 1 1993. PROPOSED GRADES SHOWN WERE TAKEN SIGN PD:AER. HILL, INC. FROM THE GRADING PLAN FOR BUR OAK HILLS 2ND ADDITION PREPARED BY MERILA 9 ASSOC. AND LAST DATED 2-13-92. OHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 m ~ M < nc. James R. Hill, i O r m JW .rn 0W 7 Do MI o W z q> z W MX W PLANNERS / ENGINEERS / SURVEYORS ' 0 m ~ Z 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 a 612-890-6044 w ••+':ahX.- `~'}~iii.: '{im {~i r'v+ x:F'••. h': { "':Oi:'{"J.n"ti4:,v.'::i:~.~•'•..N.{{;::~M::- ..:•:~,••A'- -r{5v{}. ~.Q~{: a Q:Qi ;7+R:vv::, :^~r'r':. ..a';~,.' ;:yS7.k'~i x':: •`\S. A.•,'.6?y3::C: - v:,>:;.>=~4;fY fi:};;;., V:i,`a,: r::.;xii.,,. :xix. ij??x C v..~. i..#' •y~• • ~tt+ 1993 PLUMBING PERMIT (RESIDENITIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN SS122 (612) 681A67S PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NQ FFXTIJRES EACH SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 3 3 LAVATORY 3.00 i?" -7r KITCHEN SINK 3.00 , _ LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET * minimum -1 .3.00 3 ROUGH OPENINGS 1.50 S%' rZ4 WATER SOFTENER 5.00 PRIVATE DISP. ► nasty. iii. 15.00 U.G. SPRINKLER - home under coast. 100 ALTERATIONS • to esistins 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE .50.- TOTAL: SITE ADDRESS: OWNER NAME: I 1 r- G. 0, ii-r,/~~rdx~s~ r INSTALLER:_ L (LA ADDRESS: CITY: STATE:. ZIP CODE: PHONE (mss z)~ SIGNATURE OF PERMI'TTEE f- ;~Jtt•• ~ ::P~:v }:S."..L,'„v'`..+~'K'-•,•.•,+~k_~,~~.-3''><'~6t a'i7"'x^-'.. •2Y'c'{~.., .,.}4;• F.?cC: . > ~ qs::~.: •'t~?i ::4.y •;d`y: :i.:'3 3:~»ti ~'`••s<'`c;:i.. :•.~.:1.: °.c •5~2. .'.g: +'0t '±1a'v..,.At yot'.'r:. •~.:'rte.'•i~i'blS:=~-•.=~RStv}':gitiv:. s- 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-467S PLEASE COMPLETE FOR ALL COMMERCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUPL.DINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UN-71. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF FEE. MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: TENANT NAME: SIT;. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE FOR: CITY OF EAGAN APPLICANT Y i "`.;~?TC:::;-- ,•.;.~.,;ti S, r;+.;x .'.4"::1a.?c~ k,~.k•,3Stan.fi. 1..~:z"~,."t}y.: ,.+i, .,.sxy~q'4;# xcc :..tih.,_.Y.v.. :}:.x;::~.`:>- ':tiv2' 4 ',y33: -,•KnYrrxb;:~,'y~w-: vFk ;;.a.:. ~,jr.;; 3'~' .•:`'g3!i3.'+f}•::-. i rcx~ibb~ }k . min } ~~~.4;:?{y:.S;.'?Y:..a:.~.,v..x:•iw,~.~ ;~Y k ~'.,1.;}S?~i,~,: >T,:.~.2}, • . a ::T.. ::::,F .c„ x3?>., :$-.;t~,• ,.:^i;i'ta°' ~,,yy•~':.•+,'~~;cz.h''.3~,'.';. .w+Ff'✓+.'- •~.`;t.+i:. :c4 4 +3,• yg~4 1993 MECHANICAL PERAUT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD . EAGAN NIN 5S122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH. UNIT. ZNEW CONSTRUCTIO - N ADD-ON A/C ADD-ON FURNACE DATE 1~ 9 FEES HYAC: 0-100 M BTU 24 ADDITIONAL 50 M BTU 00 GAS OUTLETS (MINI 1 @ $3.00 EAC ADD-ON/REMODEL (EXISTING CGNSTRawn N) $ 15.00 STATE SURCHARGE TOTAL SITE ADDRESS: '/Q G~ Ud ] 1-tf VA~-__ OWNER NAME: TELEPHONE INSTALLER: Burnsville Heating A/C. Inc, 12481 Rhode Island Ave, So. ADDRESS: Savage, MN 55378-1122 894.-00 CITY: STATE: ZIP CODE: TELEPHONE FqKATVAE OF PERM=E i q1 r.:jY.''~•h :"i::C.CT;;'`p.;;~i. ' '54.''.»: ^ l N- ':•x•',:n - ':13....:Lt:.:;'4:~':`}:.%.:r .;4{i: ::~.ib:F~vh1' ti~d}Si r.C{}:. ,~V"i.a :.?`ct:~tRr';i:tktr.`:''u.. K:;X 'kty .+f.•'y~:+'i:'{ 't': #r fix- 44 '{Y an~~}pf¢ ~~3Y .tti v}.` ; ` Nny4. ``er'"`~`'r.N,. L]lt, 3` • uT:9GG 1993 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3530 PILOT KNOB RD EAGAN MN 55122 (612) "1-4675 PLEASE COMPLETE FOR ALL COMA MRCIAI41NDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. DATE: CONTRACT PRICE: S NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OFllp0 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: (immovEmENTs ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CORE: TELEPHONE SIGNATURE OF PERMITTEE CITY INSPECTOR - - - - - - - - - - - - - - - - For Office Use i I Akkhk- I f~ ~11 I 4~r my of Eatan I Permit I Permit Fee: v 3830 Pilot Knob Road I Date Received: Eagan MN 55122 JUL G 1011 1 I 1 Staff: Phone: (651) 675-5675 Fax: (651) 675-5694 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 1 i? Site Address: 3259 RIOLk ()ak of, Tenant: CkA Suite Name: Phone: 'a(z o - QQ36 RESIDENT / OWNER Address / City / Zip: 3500 I-U n jj f-a.k ~Y Name: ppll-qncP- Inigtaliftm of MN Inc. License#: Address: 14105 Rutgers St. NE City: 03 12 CONTRACTOR Prior a e, State: Zip: Phone: 011Ea -"L-oq Contact: Email: TYPE OF WORK - New X Replacement _ Repair _Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Water Softener Lawn Irrigation RPZ PVB) PERMIT TYPE Add Plumbing Fixtures Main / _ Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 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) TOTAL FEES $ 111 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 Qooherstateonecall.ora I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x~r !i ()'kL f1 n' x Applic is Printed Name Applicant's att; e FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-in Air Test _Gas Test Final Use BLUE or BLACK Ink For Office Use I ^ I I City of Eapn I Permit 3830 Pilot Knob Road Permit Fee: Eagan MN 55122 t I I Phone: (651) 675-5675 a ;L 0 4, 2 {113 I Date Received: Fax: (651) 675-5694 Staff: I - - - - - - - - - - - - - - 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: ! ~ L(3 Site Address: R (D~zIC .lr'tjC a'✓e Tenant: ~ f Suite Resident/Owner Name: 1~ (~)-a t"1 f +^C S l rte +✓~+Cx Phone: 6 51' 2 6 0 - 003 [ Address/ City/ Zip: lvGJa` a~ 1 .rte' Zr Name: Rons Mechanical Inc License Address: 12010 Old Brick Yard Road City; Shakopee Contractor State: MN Zip; 5 5 3 7 9 Phone: 952-445-8585 Contact: Linda Email: New V Replacement Additional Alteration Demolition Type of Work Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL umace _ New Construction _ Interior Improvement Permit Type - Air Conditioner _ Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank L_ Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) P $ WO, DD TOTAL FEE COMMERCIAL FEES: $70.00 Underground tank installation/removal Contract Value $ x1% $55.00 Minimum = $ Permit Fee If the project valuation is over $1 million, please call for Surcharge = $ 5.00 Surcharge' = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.oru I hereby acknowledge that this information is complete and accurate; that the work will be in formance 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 no to tart withou permit; that1he work will be in accordance with the approved plan in the-.case of work which requires a review and approval of plans. X_ x Applicant's Printed a e Appli is Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough in Air Test Gas Service Test In-floor Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA131194 Date Issued:06/08/2015 Permit Category:ePermit Site Address: 3254 Black Oak Dr Lot:1 Block: 6 Addition: Bur Oak Hills PID:10-15500-06-010 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Calvin-all E Mickel 3254 Black Oak Dr Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA164424 Date Issued:09/28/2020 Permit Category:ePermit Site Address: 3254 Black Oak Dr Lot:1 Block: 6 Addition: Bur Oak Hills PID:10-15500-06-010 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Calvin-all E Mickel 3254 Black Oak Dr Eagan MN 55122 (763) 807-9820 Trusted Builders Llc 20399 Pondview Cir Rogers MN 55374 (763) 807-9820 Applicant/Permitee: Signature Issued By: Signature