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3269 Black Oak Dr
PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA081653 Eagan, MN 55122 . Date Issued: 01/10/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 3269 Black Oak Dr Lot: 5 Block: 1 Addition: Bur Oak Hills PID 10-15500-050-01 Use Description: Sub Type: e - Water Heater Work Type: Replace Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: STEVE FRANCE 505 RANDOLPH AVE ST PAUL, MN 55102 Fee Summary: PL - Permit Fee (WS &/or WH) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Bonfe's Plumbing & Heating Nancy G Larson 505 Randolph Ave 3269 Black Oak Dr St Paul MN 55102 Eagan MN 55121-2334 (651) 228-9071 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. Applicant/Permitee: Signature Issued By: Signature INSPE TION RED II CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road `s ~r Ea9 ats I an, Minnesota 55122-1897 Date I Number: : Issued: (612) 681-4675 E SITE ADDRESS: 1.0 1 1. APPLICANT: PEFff kT~ SUBTYPE: TYPE OF WORK: NSPEGTi:)N TYPE V00 1 7014x'•, Vi NA I 3. t a i 9g !`i~ rc r a 1 17 s Permit No. Permit Holder Date Tallephane ELECTFNG PLUMBING HVAC anmee► F3ste Ifww FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLOD 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 FIG DECK FINAL i-li -7-7 • ~Ir s " " r t . RE tC .v ey 1"''Iy a, Y";t x l4 r, OF EA'1AA1 PE r"m pom "ota 55123 Date bukued; r " tea;`'' 691-46' 5 M SITE ADDRESS: r AM IGlII T '69 s 11?- siHF 1411.f" i`a1 (612F 4b6-!%l1?ti'` aJY P IT SUBTYPE: TYPE OF VUK:IRK: ' 11#11 . FRANi'hi mA A 1. PI MAR) `y&W CON I f+AC''I 410 R; L 11Vf h MU CHAN t C:#11 : tet~ -ems IM~ rib e t eAA H r f s pwf t V Wli CJ~ r1~1P~ - Well r y NSP CTIONIRECORD, CITY OF EAGAN P "TM'. 3830 Pilot Knob Road Pwmit Number Ewan, Minnesota 55123 C lul: (612) 681-4675 SITE ADDRESS: 131 11j x APPLICANT: Hlif; 0AU Hi l PERMIT SUBTYPE: TYPE OF WORK: RAMNO 10111611 TN f #ii~!# IN 1.I111 ! 1Nf11 { I R#: #9AV1 1 I't468 f r 11, ItM t I A k I fe 0111 Vi f► ~`11{i AWt f`11.►INH f N 0 91 F1 E U F C 1' 141 A k ,W#7NC d-. _ I l I~ I~~ ry - ' _ - lPerr~"it 1NYt. l~rl! # 4~M ~ ~ ~Pog PLUM PICK. SIG - bumsw ON" low ftdt"rwp i FoundMo leg fl rq OWA7 Flml Plbg. Pft fir- NOW Plumber Ccna.Maer Engr.1Pbn Bldg. Final " Deck Po Deck Final Well Pr. ENSP. Address _ 3269 RAM OW nRTW Zip 5512 1 Lot 5 Blk 1 Sub BUR OAK ILLS 1 ST THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway j/ Permanent gas Sod/Seeded grass TraiVcurb 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 681-4645 before working in right-of-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy K A q599 - / Ylt 51-'5 12tve- /a~ 1' / - Request Da a Fire No. Rough-In Inspection ❑ Re :rail? Ready Now ill Notify Inspector 1-7 Yes L No When Ready? I licensed contractor D owner hereby request inspection of above electrical work at: Job address (Street. Box or Route No.) City zrRi Olf'Oe 474 Section No Township Name or No. Range No. County Occupant PRINT) Phone No. Power Supplie Address Electrical Contractor (Company Namel Contractors License No. ' 4 G '~A Mailing Address (Contractor or Owner Making Installation) Author Sgnature I cntractor,Owner Making Installation) Phone Number fl~ove 8-40 lop 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 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB01 -oe K 69599 See Xinstructions for completing this form on back of yellow copy. $ .SS7° Below Work Covered by This Request` New Ad0_ Rep, _ TypeofBuilding Appliances Wired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other jSpecify) 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 & 0 to 100 Amps Transformers Above 200 Amps Amps Signs Inspector's Use Only: V~ TOTAL Irrigation Booms , Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date - 7 certify that the above inspection has Final oate_ 7 been made. v/vti~ OFFICE USE ONLY This request void 18 months from 0 6 /FIT -;?T8X15Z 64650 i?l Request Date Fft No. ough•In Inppection Required Inspection Other Th n ugh-In is (You call inspector when ready) Ready Now Will Notify Inspector y Ves ❑ No Date Ready IT I 1 ❑ licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Adgress (Street. Box r Route No.) City Section No. Township Name or No. Range No. County Occupant RINTI Phone No. ~r 4o_ )e- SarN Power Supplier Address Electric I4 Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) Au or a ignature ( ntractorOwner Maki Installae Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL OT Griggs-Midway Bldg. - Room 5.173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-08~ ► See instructions for completing this form on back of yellow copy.' 3Sp p N 6 4 6 5 0 'V Below Work Covered by This Request lrf2p New 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 (specrfyl Contractors 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 Inspector's Use Only: TOT' f Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in y n .`.1, = , ~certify that the above inspection has Final been made. OFFICE USE ONLY This request void 18 months from RESIDENTIAL BUILDING PERMIT APPLICATION . ; U CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConstructionReauirements RemodelfRepairReguirements 10 - • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 7/1193 • Rim Joist Detail Options selection sheet (bidgs with 3 or less units) DATE 1 Q, 2 2 VALUATION 3 01 0 O O SITE ADDRESS 3 Z 6 2 ~j 4~~ 6< 0 MULTI-FAMILY BLDG -Y ~CN TYPE OF WORK 2- 0GJeV L-e- FIREPLACE(S) _ 0 91 - 2 APPLICANT u VP LA n C 11-540 e,G STREET ADDRESS i~2 KJu _CITY ak STAT0d 1ZIP S7~:-;j23 TELEPHONE # ~1 6$1 I~S~I CELL PHONE # 6 2-72Q--623 FAX # PROPERTY OWNER C AVd hl'if t- V y jOASOLI) -TELEPHONE # O0~ COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNES(A'A RULES 7670 CATEGORY I _ MINNESOTA RILES 7672 (4 submission type) • Residential Venulafion Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: r 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 Hcat Recovery System: T I ~J Sewer/Water Contractor: Phone Fay - I hereby acknowledge that I have read this application, state that the information is ecf,-and agree to omply with all applicable State of Minnesota Statutes and City of Eagan Or noes. / Signature of Applicant v _----..d--_--...... OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex X19 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 P 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 4-t=--k> Occupancy f qa**, MC/ES System Census Code L4 Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const V ) Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) Final/No C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile 7` Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco _ Stone Fireplace R. 1. Air Test Final _ Windows (new/replacement) Insulation Retaining Wall Approved By . Building Inspector Base Fee Surcharge Plan Review Lr/flf L~ MC/ES SAC City SAC s7 ~ Water Supply & Storage fJ S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total •44V s PERWT# Plealtse complete for, W* ttntly d%**Vo, Umhomes aM owifts whertpomift * h oventer ftW Wqation ay sliem R JACKSON, CAROLINE 3269 BLACK OAK DRIVE v $I M ADDRESS: r; r EAGAN, MN 55121 s CyVIfNER NAME:: (651) 456-9004 TELE INSTALLER NAME: STR 'ADDRESS: WNG Co. ~ E v s 771 • CITY. 2905 A STA'TE- r MINNEAPWS 1 _ SEPTIC SYSTEM, newwh kwbl (regains Wm eats of plops wd- C kolvw ` ~ . in*cles $40.00 Cow* fee Note: Additional oomultlaM fbe6 nut/ uppfy MOMICATIONI'ALTEFtAT" TO OWEL 3 WHIT, = t - Adding fftm to lower Wvefs or mm aekiftm, w oluding Avatar svftsoft._ Abanci0nr mt of septic vj"n. - Water tumwmnd - e ng dwell M unit 5W meter K pbetled - S1E _ Other: . ' 3A'f } RPZ: new insMllatir)WreFtaWh0u9d _ lawn Irrigation $yatem w VV: Repiacemelntladditlctnal: vex au terser vvatel State surcharge Total I heniby 9&jwwledp thas I twee made We apps , Oft that dve liftmu lup as =n4 a" Is the aWficanfe n sponaUlty to notify ft prgmdy omw than the Ck of Ea gn nwam no operational and maintenance alias to the- ee conpkruated under thtsiennit vwk Y' S1C1► ' PERMIT 2" a 1 lil ■/y~yy may j ' ' a E VLUJNM PRIM 3fto Paw =a i t t.. Please complete for: single family dwellings, townharnes and Concha whelt,p o . 110 badclDw oreventer for N1 1 >9yaterrrt { ttv srrEADDRESS: gad 9 44ok n 'Aa OWNER NAME:. TELE INSTALLER NAME: TILEP'. STREET ADMESS: r4f/ ` CITY: ?'~dr6~ STATE; iz a SEPTIC SYSTEM, noWreftstished (requires two sets at. plans and M PC includes $40.04 CourAy fee i n s . r - B Note: Additional oonaukarit lass n (8y* • MaDiFICATIONtALT 'fON TO ,MIAIELL:i UNIT, x€ Adding fixtums to lower levels or mm a"ons, occludin water so"Wim o4 ow **Mt Abandonment of septic system. r, Water turnaround - existing dwelling unit W motor N'rWxbd -'$I 18) _ f eve i by ; R _ Other. i _ RPZ: new imtallatIcWmpairfrobulid :{t lawn irrigation system • - w'0 .v .air. ro 04 ReplacemenUtIditionsA: water seiner water hem Y State Surcharge tiu 5 T'. x Total I fiereby adcnowledpe tltat r hmve read this ep~dicsition, Chet Infrxmatl~.ist~or~ot, ~ •i~~M'~t~ ` 13~ the appilc arllS rosporNlty lQ rfy 1hs S►dparl~t OVIA1erlet tbs Cif3r of Esr+ tu~sulTa tr4_ilifi 6 ' f operaftnal and maintenance aoliv to to foacrw" oo wbu d fender Ws power vot"W mMti• 8IC31ylAT1JF1E CIS :,r• irl~ RESIDENTIAL G7 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 657-681-4675 New Construction Requirements RemodeUReaair Requirements • 3 registered site surveys showing sq. ft. of lot. sq, ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks 1 set of Energy Calculations indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE C(' 0 VALUATION SITE ADDRESS MULTI-FAMILY BLDG Y _ N TYPE OF WORK [rr ct r~+~ ~o l~u._ _~G,s FIREPLACE(S) _ 0 b 1 2 Aftffd R"* APPLICANT dba Bide STREET ADDRESS )7 f# ~ CITY STATE ZIP TELEPHONE # ROM` BR 'CELL PHONE # FAX # PROPERTY OWNER. Ate, ~l~s TELEPHONE # LXV- kz0V COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 tJ submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _ Phone # Plumbing system includes: _ Water Softener Lawn Sprinkler Pee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: P e Mechwiical svstc:n includes: fir Conditioning OT 70.00 Heat Rccovery System L" L Sewer/Water Contractor: 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 Or noes. Signature of Applicant - - - - - - - - - - - - - - - - - - - - - - - - - - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 402 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex C1 13 16-plea ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg); ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Bdwwrf b" Nbr. of Units r Sq. Ft. ,1tr~ we~ erA= Nbr. of Bldgs Length A'Arltlered ICI,', Type of Const Width f" REQUIRED INSPECTIONS Footings (new bldg) FinahC.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 leplacement) 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 Renewal By Andersen RESIDINTIAL i 350-73rd Ave. NE Fridley, MN 55432 DING PERMIT APPLICATION 763-502-4777 CITY OF lAOAN #MN20130983 3830 PILOT K110Q RD - 53122 ds'1-nl."7S 1 0(0 • 3 ngbtend Site surveys showtrg 4 R d bt, s41 of house; and d coded areas (20% msxhrrrurr lot aovsnge Mowed) 2 owia d phn S • 2 conies of plan showing beer" & window sins Pound burW design, eto.) • 1 set d ErAW rpr • 1 set of Energy CabAa> m 1 SIBe survey for eWbrior addtlans deco • 3 copies Of Tree Preservation Plan E bt PlWled dw MA3 • Rim Jaist D" Optbns selection AW (bldgs w1b 3 or lees units) DATE U •O I VALUATION (E=LUDING LAND) ~O JOB SITE ADDRESS ^9 IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER TYPE OF WORK FIREPLACE(S) 0 _:...1 -2 _,.,3 APPLICANT ADDRESS ONE # 4 ZIP CODE PAGER # CELL PHONE # FAX # F=Codee BUILDING ONL- FI LL OUT COMPLETELY MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor. Plumbing System Includes: _ Water Softener Phone Lawn Sprinkler Fee: $90.00 Water Heater No of R.I. Baths No. of Baths Mechanical Contractor. Mechanical System Includes: Phone # Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone AN above Information must be submitted prior to processing of applicatbn. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Apptic Certificates of Survey Received _ Tree Preservation Plan Received Not Requlrieq Updated 1101 O DICE USE ONLY - i r pool ❑ 30 Amory Bldg ❑ 01 Foundation ❑ 07 05-plex O 13 1d-PMec 13 31 Ext. A8 • Multl E) 16 f plr s,. 17 a 1 Pole 3•sea•) ❑ 02 SF Dwelling ❑ 08 06-0" t7 22 PorcWl *M- (4-sea-) 13 33 Ext. Alt SF ❑ 03 01 of - plex ❑ 09 07-plea ❑ 17 Gei'aQs 13 04 01 of 13 10 08-plex ❑ 18 09& 13 23 Poach (weaned) 13 36 ❑ 05 03-plex ❑ 11 looex ❑ 19 Mower twel 13 24 Sbrm Damage ❑ 06 04-plex ❑ 12 12-plex PlL Y or_ N ❑ 25 Miscellaneous ❑ 35 tnt ImProAMM © 38 Demolish (tnteriot) O 44 8idlnp ❑ 31 New bon p 45 Fire RepSr ❑ 32 Additbn - O 36 Mow 8fdg• D 42 Demolish (i+owada • ) 4Vkt611~~` 1 Q46 (aftr Q 43 Reo 0137 ❑ 33 Alteration ❑ 34 Replacement -DwnoRdM i Mdg oMy) -tiiw PCA handnut4o p a+t . - Valuation Zooft wow. Census Code SAC Units. _,St = PRV keed Nbr. of Units Lery Fire SWM Nbr. of Mdgs. . VYkfthType of Const REWIM INSPECTIONS Footings (new bldg) `t"..:`` }•.P Y t a...' t F~.~...~'....._J Footings (deck) P18 Footings (addition) r ; . IENAC - Foundation Drain Tile Roof _ Ice & Water _ Final - Fool F Air/Gas T~s Final Framing - Sides _ gtoccp. -Stone Fireplace _ RI. _ Air Test _ Final WkWk (ivament) Insulation , APPM d SY Bu$&V inspector Base Fee Surcharge - Plan Review ; 3 MC/ES SAC 'Y City SAC 1 Water Supply & Storage_ . SRR PCB I Ifl S. _ l r ! 4 ~1 r }I n Treatment Plant Plumbing Permit Mechanical Permit - License Search - Copies Other Total RESIDENTIAL BUILDING PERMIT APPLICATION y CRY OF EAGAN. Q, 1 -3830 PILOT KNOB RD - 59122 851 • 3 registered $ke VXWO 910MV sq. & at 104 sq- & of house; and it roofed sm8s • 2 copies of plan itx held addi! lone (20% maximum lot owmwe a9a ii d) • 1 set e1 am • 2 copies of plan showkig beam 6 wMdow sizes; powed found doOetc.) • 1 sk swrvelrfereodertor sdd .ti dedrs " • 1 set of Energy Caladst M • kdcets I tto O edrved by 101* sly for 1111011110M, ' • 3 or Tree Preservation Plan d lot pinked after 711193 • Rim joist betel Olin" wWjon shoat (fts wkb 3 or lase unb) DATE VALUATIONa JOB SITE ADDRESS ....52 ~ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER: 't:C+'~'l -^L u TYPE OF WORK a FIREPLACE(4) D 1 APPLICANT N IS Y` PHONE# ADDRESS ZIP CODE PAGER # CELL PHONE # FAX i N RESIDENTIAL BUILDING ONLY ~ FILL OUT COMPLUELY Energy Code Category _ MINNESOTA RUIN'S 7670 CATEGORY 1 (check one) - Residential ventilation Category I Worksheat SU11011tt0d Energy Envelope Cidcu ations WMAW . MINNESOTA RULES 7675 - - New Energy Code Worksheet Submd Plumbing Contractor. Phone Plumbing System Includes: Water Softener lawn Sprinkler Fee: $90.00 Water Heater y No. of R.I. Baths No. of Baths Mechanlcal Contractor. Phony 0 Mechanical System Includes: _ Air Conditioning Heat Recovery. System ^ psi A~t sewer/Water contractor PhOn Y_ Ail above Information must be submitted prior to processing of application- I hereby ocknovoledge that I have read this application, state that the hftmation is orrect, and agree trti comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. sispature Qf.APPItco Certificates of Survey Received Tree Preservation Plan Not Flred` ups !!01 Rett_"'al By Andersen RESIDMTIAL 35 -73rd Ave. NE IILDING PERMIT APP.ICATI Fridley, MN 55432 0 . 763-502-4777 CITY OP ""N #MN20130983 WM PILOT KNOB RD - 33122 - - BR'I-~1-a87s • 3 regMmW slie ardwo *owinp sq It d lK 4 it d housc anrg x dad areas . 2 000ae d On (2016 nwalmum tot cwwage raNlared) i Id d Eftw Ce WOM ter mmbd am= • 2 dies of plan slroMr V beam & r kdm skm Pound Lund dwok dr.) • 1 ab up" tar a rierrwddltm A do* • 1 sd of Erww COmisbre l+a is M Uoaae aereed a fcr • 3 soPbs of Trove Prawwa n Plan d bt pkftd d or 71!193 • Rim Jobt DqW Op#= seiedlon street (bldge w1h3 a lees urdly DATE VALUMO I _ a~ . . JOB SITE ADDRESS 3 a 69 IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER TYPE OF WOR V FIREPLACE(S) 0 1 -2 APPLICANT - 1rl1101NE# ADDRESS PAGER # CELL PHONE # FAX #F N f RESIDENTIAL SUIIMNG ONLY- FILL OUT COMPLE:"TKY Energy Code Cafory _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Vendlaation Category f 111Nartcedteut Subm1W - Energy Envelope Calculation Sulmnitikd MINNESOTA RULES 7672 - New Energy Code Wodutd st Submitted Plumbing Contractor. Phone Plumbing System Includes: Water Softener - Lawn Spri>ra cr Fee: 190.00 Water Heater No. of U. Baths-. No. of Baths Mechanical Contactor: Phone # Mechanical System Includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone AM above information must be submitted prior to processing of appiioation. I hereby acknowledge that I have rend this application, state that the information is correct, and C ijfl coMpiy with all applicable State of Minnesota Statutes and City of Eagan finances. S%pahwe of Appik Certificates of Survey Received Tree Preservation Plan Re mbted Not tVdW*d OFFICE USEI +1LY 0 01 Fourmiallon D 07 05•plex 0 13 *w 0 4~ Pool 0 30 Accessory Bldg D 02 NSF Dwellfn0 Doe M-plax ale FAWN" O'. 21 Porch (3-see.) 0 31 l xL Alt - Mutt D 03 01 of _ Alex D 00 07-plea 0.17 CUMP 13 22PordVA4M. (4wees.) D 33 e& Alt - SF D 04 02-0ex © 10 060" 0114( Deck D 23 Pwahiscrewss 1 D .4 ' 0 05 03131ex .0 11 100" O L 19, 6cwer Levu Cj 24 SIUML Danrage a 06 04W D U : 12i*m P1t4L_Y or t4 0 26 D 31 Nears © 35 0. 2$ Demoi!W P*WkW) a +44 0 32 A Mft D 36 i DW 13 42 twmil0f rtbn) D X45 File Rehr D 33 Alter Wn J3 37 (Eftr ; D 43 RwW 46 )lfkxkAN*0o D 34 Replsaenrent OM*WWY Comm mm IsCo'AN SAC Units L.." f. w° `;,,:Pt a,;..,,,-; of Umo fir. Of MP tavlft Flm SprtnWwed, Type of Const Wid#t PAQMED NSPECTMS . Fad (mw bldg) Fia cio. , Faadaga (ds~ _ 1l+To.~.t). Footings (additWA)S _ Faamdation _ HVAC , _ Drain. Tile Roof ks do Wad 0dw _ FrsMiang Pool Ftgs _ Ai#Qea Tests ]PhW Fireplace R.I. Aix Test Fbaawl Siding CCO ° Std. InsWation Windows O AppmvW ft et sli+ti Ease f=se Srrrdtarge Plan Review MMS SAC City SAC water Supply a swinge Sew Permit & Serge Treatment Plant M nbfng Permit Mechsnicei Pennft ` se Search Copies a . Y " ' . . ofm Toni! sv iuu s:.. uv rArl vv all -44100 iS?.. ZYFAL b1° k1YVBKOW W UU2J UUd 4 re al June 7, 2001 City of Eagan 3836 Pilot Knob Road Eagan, MN 55 122 To Whom it may concern: Elder Jones is authorized to pull building permits for Renewal by Andersen- ]Please allow Elder Jones to provide this service for us in Eagan. This authorization is valid for any date beyond 616101; until a Wenewal by Andersen manager expressly revokes it in writing to the City. I request this authorization be accepted expeditiously, as to not delay in the processing of our building pcrmnits any further, please call me If them are any questions. I can be contacted at 763-502,4706. Your immediate attention to this matter is appreciated. Sincerely, ynaond R. Rau nstallation Manager Renewal by Andersen Corporation C'a: Kara-F.Icipr Jnnec 4 ° awry ~ GA AL Minn 1~ ~n.31, TOGS Received Time Jun. 7. 1:07PM PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 2 3 8 (612) 681-4675 Date Issued: 07/22/96 SITE ADDRESS: 3269 BLACK OAK DR LOT: 5 BLOCK: 1 BUR OAK HILLS P.I.N.: 10-15500-050-01 DESCRIPTION: Building Permit Type DECK Building W>ork Type NEW "Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY- Base Fee $45.00 Surcharge .50 Total Fee $45.50 CONTRACTOR: O W N N Appilcant J E R R Y 3269 BLACK OAK DR EAGAN MN (612)456-9004 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. r(~ C APPLICANT/PERMITE SIGNATURE ISSUED BY I TURE~'T CITY OF EAGAN 3830 PILOT KNOB RD - 55122 S 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 ~ New Construction Requirements Remodel/Repair Rtguirements 7/j Z, i 3 registered site surreys ♦ 2 copies of plan * 2 copies of plans (include beam & window sixes; poured fnd. design; etc.) ♦ 2 site surreys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan H lot platted after 7/1193 required: _Yes _ No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: 670 c3c ' ' " vR~ STREET ADDRESS: 32- ~ 9 L c L LOT BLOCK SUBD./P.I.D. PROPERTY Name:, 4 Phone y0o OWNER Street Address 3 2-~ / ~Cc City: State: Zip.- CONTRACTOR. Company: Phone Street Address: License City: State: Zip ARCHITECT/ Company: Phone ENGINEER Name: Registration M Street Address- - City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. 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 R i E- C L ~ V C D Certificates of Survey Received Yes No Ill 0 9 1996 Tree Preservation Plan Received Yes No - - - - - - - - - - - - - - OFFICE USL iJNLY ' r, BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex o 11 Apt./Lodging o 16 Basement Finish 0 02 SF Dwelling o 07 4-plex a 12 Multi Repair/Rem. o 17 Swim Pool 0 03 SF Addition o 08 8-plex a 13 Garage/Accessory o 20 Public Facility a 04 SF Porch o 09 12-plex a 14 Fireplace o 21 Miscellaneous a 05 SF Misc. a 10 = plex #t 15 Deck WORK TYPE #P 31 New o 33 Alterations a 36 Move o 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System (Allowable) Main level sq. ft. City Water USC Occupancy sq. ft. Fire Sprlnklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. .7 Depth Footprint sq. ft. SAC Code Census Bldg Census Unit 0_ APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units -193 TLE-15:24 ID:JFtES R HILL INC TEL NO:612 890-6244 #178 P01 d V E Y O R' S CERTIFICATE MITT El-STAEDT BROS. CONST., INC. ,OTE: sulLarwa DIMONLiIONS ARE„ s F~OIMi6Ar10M N!. ' xas2.a SEWN MARK eta BLACK OAK DR. s~ lLEW& 893.5 s t-`~ ~ r-- r• 1 ;<v a seal ~r + .1 OIDpos 1 _ ~tyE 7A) ,9 to e 889.2 BtMH MARK 04RA m OF PIPE 11.0 LC 4 P ~O 31 ~ 840.2 ~!,rd Ng w - a I coat ni I ~3 1 X8AT3 40 A UK UTY.~ to RIMaB • o L OR1►tNl~ PIER ~ 9$S 28 g► Q. p RE r\ 2. r 66. r Si3$~I 321E 111T"W B 117 NOTE; NO W=FIC eotf_S INVCSTuATION HAS BMI4 C t^ 4 ON THIS LOT BY THE SURVEYOR. THE SutTA9 L %F 14 IN~IINEERING DEPT SOILS TO SUPPORT THE SPWFIC WJZ PROPOSED IS Ntth~ THE pE1111PONS1aLITY OF THE SURVEYOR DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - q ys.0 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -009.1 FEET (000,0) DENOTES PROPOSER ELEVATION PROPOSED TOP OF BLOCK - 8 9 y 1 FEET WE HEREBY CERTIFY TO MITTELSWUT BROR OONST., INC THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 5, Bbck I, BUR OAK HILLS, according to the recorded plot thereof, Dokoto County, Mlnneaalo. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVE`!ED BY ME OR UNDER MY DIRECT SUPERVISION THIS 14TH DAY OF APRIL , 1993 PROPOSED GRADES SHOWN WERE SIGN ILL, INC. TAKE)i FROM THE QRAp INO, ORAIN- AOE a QROSION CONTROL PLAN FOR BUR OAK HILLS LAST DATED r 2-5-92 ;2L"- JJ OHN C. CARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 % 2 4 06 james R. Hill, inc. % N4 "M (5 `1 a 0 m PLANNERS I ENGINEERS I SURVEYORS 0 0 CA n : z 6) VIZ Z -C 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 66337 • 612-890-6044 R-95% JAMES R lilt i INC 04 -27 93 03:2RPM P00) It49 PE MIT '&6~ Y/u~I'~> CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55123 Permit Number: 0 2 0 7 8 9 (612) 681-4675 Date Issued: 04/28/93 SITE ADDRESS: 3269 BLOCK OAK DR LOT: 5 BLO K: 1 BUR OAK HILL 1ST P.I.N.: 10-15500-050-01 DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R-3 M-1 Construction Type VN Zoning R-1 Building Length 59 Building Width 52 REMARKS: S&W CONTRACTOR - KLUVER MECHANICAL FEE SUMMARY: VALUATION $142,000 Base Fee $786.50 MISC FEES $1,744.50 Plan Review $511.23 Total Fee $3,863.23 Surcharge $71.00 SAC $750.00 SAC % 100 SAC Units 1 Subtotal $2,118.73 CONTRACTOR: - Applicant - ST. LIC. OWNER: MITTELSTAEDT BROTHERS 14569125 000 443 MITTELSTAEDT BROS 785 SUNSET DR 785 SUNSET DR EAGAN MN 55123 EAGAN MN 55123 (612) 456-9125 (612)456-9125 I hereby acknowledge that I have re d this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinanc s. APPLICANTIPERMITEE IGNATURE AllSSSUEEDB . IGNATURE REACTIVATE CITY O EAGAN PERMIT# _ 1993 BUILDING PERMIT APPLICATION / APR 2 1 1993 681-4675 33'6 3 ~ SINGLE & MULTI-FAMILY 2 sets of plans, 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 / ~21 / Va uation of work Site Address: & 1-7 'q6 STREET SUITE 0 Tenant Name: (commercial only) LOT BLOCK SUBD.~k P.I.D. # I Description of work: The applicant is: ❑ Owner ❑ Contractor ❑ Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE it City State Zip Company Phone Contractor Address v=-7- License #3y~ Exp. 9 City State Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber ' Processing time for sewer & water permits is two days once area as been approved.. I-hereby acknowledge that I have read this _a and state that the information is correct and agree to comply w1 applite of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: L'Z OFFICE USE ONLY r BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ji~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. Add11. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE x;31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) V_ H Basement sq. ft. MWCC System (Allowable) V_ tq 1st F1. sq. ft. City Water UBC Occupancy R-3 M_1 2nd F1. sq. ft. _ PRV Required Zoning -I Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length'- On-site well Census Code o/ Depth On-site sewage SAC Code -L APPROVALS` bl Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee vatuotion: g 1 `t 2, yy0 IgT Surcharge 3sm7__ 1309 Plan Review Ga.--- 3~ x z z. X60 ~Y.d License z v p) ► x z_ R z MWCC SAC ~'~zxz ' City SAC X 6 ` _ / 53Z?I- 5Y=17y62~ Water Conn. 3`f X l~= ld /L/L/ Water Meter Acct. Deposit S/W Permit ~Z-0 S/W Surcharge a4 X Ay = ,5'? Treatment P1. Road Unit 3d x/,,-- Park Ded. Trails Ded. Copies x307- r7 2,0 Other I Kt2 12 Total: B 32 X sq , SAC % 100 G~2r-D _ tt SAC Units f~x2y 30N Zo 1 NF LR►~~ F, ~c._D CITY OF LAKEVILLE BUILDING INSP CTION DEPARTMENT 20195 HOLYOKE A ENUE, P.O. BOX 957 LAKEVILLE, MINNESOTA 55044 612-469-4431 MINNESOTA ENERGY COD -,<ERNATIVE COMPLIANCE This form is only applicable to deta hed one-and-two family dwellings. The requirements herein are based on ame ded Section 502.2.1.7 in lieu of the criteria specified in Sections 502.2.1.1, .2 and .3. Building Address: 1 Contractor or Owner: Building Element "R" Values Area (s4 ft) I of Ext.Walls ceilings Desigr(Requir d 38 Walls* (exterior), besig equir d Zg _ 9 ~;'2) 3 (without foundation) Floors* DesiRequir d 20 (overheated spaces) Windows** Design ?.17Requir d 2 21 (o Foundation Walls DesigrfLA,6quir d 5 (whennsulatin full depth of foundation wall) Design Requir d 10 (when insulates only to frost depth & footings extend below) Slab-on-grade Desiq~9equir d 8.•83 floors Doors Desi nequir d 3 footnotes: * For the insulated cavity of op que walls, floors, and rim joists. Maximum window area must not exceed 12 percent of the area of exterior walls, not including foundation walls. I I hereby certify that I have complet the above information and that it complies with e .Minnesota State Ene gy Code. Signature Date: / e RPR-27-193 TLE, 0:24 ID:SAMES R FALL INC TEL N0:612 BM-6244 #i% Pot gA ~7~wis U R V E Y O R' S CERTIFICATE MITT ELSTAEDT BROS. ODNST., INC. NOTE: 9UILm1IlEI Oy1ENdIgI ~Hp> ARE., ~~~~~Ipt %~JI b~t4 IQM e* ro r>9~:.i}~ gs . s 11,AM OAK DR. 9E VCN MARK ~ i i r' g9ar w~ ~ In R WCH MARK a TOP OF P1 L-31.7 4 ICI - a mat Rgg.01 i 1 I T x~,.-cAla1 pA L FN aRa ape u Y rr~ a~,u d. 10 NOTE- No1CFC SOILS IM/ETWmatt Hai aEEH C ON THIS LOT aY THE SWWWOR. THEE SIfIMSI ? w F.F'RI,NG DF T-`:' SOUS 70 SUPMRT THE 9P'E FIC N= PROPOSM IS NOT. THE WSPONSIDLITY *I° THE SURMEMM DENOTES P SM SURFACE DRAINA E O DENOTES IRON MONUMENT SET SCALE:1 INCH 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR =914C.4 FEET X000.0 DENOTES EXISTING ELEVAnor4 PROPOSED LOWEST FLOOR -Ogg, 'S FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSM TOP OF BLOCK - 89 x I FEET WE HEREBY CERTIFY TO MITTELSVWf 1311f7S CONST., NC. THAT THIS IS A TRUE AND CORRECt REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 5, Bbck 1, BUR OA HILLS, according t the recorded plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS R ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 14TH DAY OF AFFIL ,1593 PROPOSED GRAC0 SHOV01 WE RIE SIGN . M FI. HILL, INC. TAKE4 FROM TIN d , ORAIN- ASE E HNOVION C4~ PLAN R _BUR OAK HILLS LAZY DATIM B ~ JOHN C. CARSON, LAND SURVEMR MINNESOTA LICENSE NUMBER 19828 % n ?I lD C p 0 E 0 James R. Hill, C Q 040 PLANNERS I ENGINEERS inc, SURVEYORS /n :9 6 AZ 2600 W. CT Y. RD. 42 i BURNSVILLE, MN. 55337 i 612-1190-6044 R~9596 JAMES R HILL INC 04-27-93 03:28PM F001 #49 w . LOT svRvzy !'nciun "R Rammi aL )QIUMN !iR#IIT PLTCa dR tMa Sate of awmays 0~0 G Registered Land Surveyor signature and oompany V0 Building Permit Applicant D 0 Legal description ` 0 0' 0 Address ~0 0 North arrow and bar scale D~ D Douse type (rambler, walkout, split w/o, split Imtry, 80'D D • Directional drainage arrows with slope/gradient to 0 VD Proposed/existing sewer and water services 8' O D Street name ~0 0 Driveway ZLrVA%20X2 DD sewer service D 0 Lot corners .0' 0 0 Top of curb at the driveway. ~0 D Elevations of any existing adjacent bases D D Garage floor D D First floor tip 0 0 Lowest exposed elevation (walkout/window) V' 0 Property corners D' D D Front and rear of home at the foundation po)%•DSNG f►RLl►B ti! a~fllieaDiel D e D Easement line 0 D- D • 0 0' D Pond 0 designation D 8' D Emergency Overflow Rlevation nil~N620N2 eD 0 Lot lines VD 0 Right-of-way and street width (to back of curb) D D Proposed home dimensions including any proposed decks, overhangs greater than 20, porches, etc. (i.e. all structures requiring permanent footings)- II 0 0 show all easements of record and any City'vtilities within those easements ~D 0 setbacks of proposed structure and setback of adjacent existing homes 0 u Retain wall r irements, it any / .0% dir- • Reviewed:' J , ~ - PERMIT cP'A14 1/1/4/g s CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Eagan, Minnesota 55123 Permit Number: 0 2 5 0 0 7 (612) 681-4675 Date Issued: 01/03/95 SITE ADDRESS: 3269 BLACK OAK DR LOT: 5 BLOCK: 1 BUR OAK HILLS P.I.N.: 10-15500-050-01 DESCRIPTION: 112 BATH/LAUNDRY RM Building, Permit Type SF (MISC.) Building Wfti`rk Type ALTERATION REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION $1,500 Base Fee $35.00 Surcharge $.75 Total Fee $35.75 CONTRACTOR: OWNER: - Applicant - JACKSON JERRY 3269 BLAK OAK OR EAGAN MN 55121 (612)736-9045 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. L_ APPLICANT/PERMITEE SIGNATURE ISSUE13 B . SItNATURIE CITY OF EAGAN JAN 19ft-BUILDING PERMIT APPLICATION ~ . 681-4675 SINGLE &MULTI-FAMILY 2 sets of plans, 3 registered site Li!!#* rgy cal cs . COMMERCIAL 2 set s of architectural & structuraspecifications, lcopy of energy ca Penalty applies: I) 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. Valuation of work 'p <-O , Address: 3261 ~dL OAK- bPUE_ STREET W1 T8 f t Name: (c ommercial only) FT LOT BLOCK SUBD.~~ Q~~ P. I D. ~Ik Description of work: ►vl 'Z 1 7H' Hopy Paua''t f ~ ~ cap The applicant is: Owner ❑ Contractor ❑ Other (oescribe) Name C Phoneme o Property LAST FIRST 73G,- 9~YS w Owner Address 3261 &,4e k- COW— 169-14:L- STREET $TB City J/t4A y State ru- 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 com ly with all a plic t;le State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation C3. ;-Q6 Duplex ❑ 11 Apt. /Lofting 1148asemant Finish ❑ 02 SF Dwg. 13 v 4-Play ❑ 12 .Mufti. *St. ,a 17' Swim .Pool O 03 SF Addition ❑ 08 8-Plex ❑ 13 Garap/`, cessory C3 18 Comm./Ind. ❑ 04 SF t=orch ❑ 0g 1P-Alex 13,14 Fireplace C] 19 Cc'mm./Ind; Misc. 05 SF Misc. ❑ 10,Nulti. Add' 1. ❑ 15 Back ❑ 20 POlic Facility E3 21 liiscellaneous WORK TYPE C] 31 New 3 Alterations ❑ 35 Tenant Finish- ❑ tip 4.sh ❑ 32 Addition ❑ 34 Repair 0".36 Move GENERAL INFORMATION Coast.Actual 848nt sq. ft. 14WCC System (Al owabla) 1st f1« sq. ft. City Water UBC Occupancy 2nd Fl . sq. ft PRY Required Zoning Sq. Ft. total tester # of Stories Footprint Sq. ft. ~ fire Sprinikier- Lenngqth Ortwsite well, Census Code Depth On-tite sewage SAC Cede -.c.- Census BI d APPROVALS Census Unit Assessments Planning Variance Engineering REQUIRED INSPECTIONS ❑ Site ❑ Footing Eraing `nsulatian ❑ Wallboard 'C fianai L'i Draintila ❑ F1replace Permit Fee Surcharge- `',,..._~~...Plan Review License MWCC SAC City SAC . Mater Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pi. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units LOT BLOCK SUBD. RECEIPT # ~G 4°-57 & DATE 1994 CITY OF EAGAN IRRIGATION PERMIT (FOR BACKFLOW PREVENTER) COMMERCIAL INSTALLATIONS - FORM MUST BE COMPLETED BY LICENSED PLUMBER Date: Ca "3'"p Commercial GPM W Residential (boulevards) GPM Existing residential Area/address to be irrigated: 39& 9 13-& ®atlj-, p L Installer: 17i?-41 t-- A k e 2 L U un. 3 t oy~_ Owner ❑ Plumber E- Street address: d 3 ~"o S City, state & zip code: ,P i ~ ' L kP , all .157,,r Phone Owner Name: pep -l _r14 6 A-SG,oiJ Street address: 3212? City, state & zip code: -5~ Phone Irrigation contractor, if different than installer: Telephone i f0 - '?2z-4 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. f =Gl~i Cwt A J-46t~ Signatur Title If construction activity occurs in public easement or City right-of-way, signature of property owner is required. The property owner agrees to hold harmless the City of Eagan for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. Property Owner Date Approved by: Date: PRV ❑ Yes 5~, No New service ❑ Yes D4 No Meter Size & Cost Fees due: Calculated by: ~ (hi GC Aw' It PROCEDURE FOR IRRIGATION SYSTEMS 1. A site plan must be submitted to the Engineering Department for review before installing an irrigation system. A permit to work within City property/public easement/right-of-way may be required. 2. Jerry Wobschall, Finance Department, will calculate permit fees as follows: a. Commercial project: $ 25.50 irrigation system permit to cover installation of backflow preventer. $ 50.50 water permit fee only if new service is installed. $100.00 per tap if installed by City. b. Residential project: $ 20.50 irrigation system sprinkler permit to cover installation of backflow preventer. $ 50.50 water permit fee if new service is installed. $725.00 per connection - WAC. $348.00 per connection - water treatment facility. c. Existing residence: $ 20.50 irrigation system permit to cover installation of backflow preventer - (not required if backflow preventer previously installed), however, plan and application must still be presented for approval. d. Meter charms If gallons per minute are less than 25, a 1" meter will be required at a cost of $165.00. If gallons per minute are more than 25, a 2" turbo with strainer will be required at a cost of $775.00. This information is to be supplied by the designer of the system. 4. No meter will be sold before all sewer and water inspections are complete on a new service. If new service lines are not required, one check may be written for meter and permit costs. Receipt will be coded to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk. 5. The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and backflow preventer. The Public Works Department may be reached at 681-4300 for water turn-on and set and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted until 12:00 noon. r Raindanse SFrinkler Sys. 612 88S 1953 P.02 NDAty:E IRE V, :WED Sprinkler Systems, Inc. K 10541 Nicollet Ave. SO. Dats _ ¢ Bloomington, MN 55420 IAQAN INGINIIAINQ DEPT (612) 888-1953 X~ 'pQIY a. CItY ONLY L SL OttwipT (RES i' I il)+ : ~ 1 PLUM BM P E1111110 CITY Of EAGAN 3830 PILOT f(MM EAGANq'MN 56M (612) M, -w 6F6 Please complete for: sirglefarnilydwollings towns and cand06 wh`e # FIXTURES EACH NO. Shover 3.00 x Water Clot 3.00 x Bath Tub • Q~ 3.00 x Lavatory 3.00 x Kitr hen Sink 3.00 x Laundry Tray 3.00 x Hot Tub/Spa 3,00 x;: Water Heater 3.00 x Floor Drain 3.00 x Gas Piping Outlet * mine -1 3.00 x_ Rough Openings 1.50 'x Water Softener 5.00 x Private Disposal • Sawa ety. liwww 20.00 U.G. Sprinkler * trans tinder cow. 3.00 Alterations * to existing 20.00 Water Turn Around 20.00 STATE SURCHARGE v • TOTAL f. SITE ADDRESS: - OWNER NME' w P0 INSTALLER NAME' STREET ADDRESS. CITY: STATE: PHONE V. ( ) qw MY USE ONLY L BL RECEIP'TSUED. V AIV: I"s PL1 O P 1' ~C'•CI kt~ CITY OF EA"N " MOT KW9 RD MQM9 SM 55122 ~61~ 8i'1~3'fb Please con*gete for ! aIi I buildings. ► f R&ft r r bug*V when npwMe p ft ra fort such :dwW&v unk. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION. ADD ON DESCRIPTION OF WORK: FEE: $25.00 minimum Cie or 1% of comsa prlae, *Wove, "FOWAO.-StMe sardrargoo $.31b pf $1,000 of i fee on an ps n*t CONTRACT PRICE x 1 °i6 STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: w INSTALLER: ADDRESS: w,..y...,, CITY: STATE: zip. PHONE: SIGNATURE: APPU. NT CITY O EALGAN 0 For Office Use City o1 EaRaR Permit I /p~ ,y I JU . ~CJ I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 l Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 i Staff: 2009 MECHANICAL PERMIT APPLICATION Date: ~ Site Address: Tenant: Suite Narne: V[ ,,tA Phone: RESIDENT / OWNER Address/City/Zip: eklVd~''l~~=tGl~~~ C4 r C%Imkic CONTRA TOR a~j tcense C -If Address: 40 City: ` State: LY\~\-Zip: W Phone: Contact Person: Cni~ i TYPE OF WORK New ~_Replacement Additional Alteration Demolition ,Description of work: NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. RESIDENTIAL COMMERCIAL PERMITTYPE Furnace New Construction rInterior Improvement aAir Conditioner - Install Piping Processed Air Exchanger Gas Exterior HVAC Unit _ _ Heat Pump _ Under / Above ground Tank Install / _ Remove) " When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) C TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1% $50.50 Minimum (includes. State Surcharge) _ $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ -State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). TOTAL FEE 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 fora permit, and work is not to start without. a permit; that the work will be in accordance with the approved plan i the case of work which re uires a review and approval f plans. X MOD U 4, ' X Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -..Under Ground Rough In -Air Test __Gas Service Test -in-floor Heat -Final Exterior HVAC Screening Inspection PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA094804 Date Issued: 07/06/2010 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 3269 Black Oak Dr Lot: 5 Block: I Addition: Bur Oak Hills PID:10-15500-050-01 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Renewal Andersen Nand G Larson 1920 County Road C West 3269 Black Oak Dr Roseville NIN 55113 Eagan NIN 55121--233 (61)264-4777 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature too W- ; I Use BLUE or BLACK Ink I For Office Use ¢ I Citt 6 Of l Ea~j~ Uil I Permit ~ I Lf Permit Fee: (0 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 ~ I Fax: (661) 676-5694 I 3 I L Staff: 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 9111115 Site Address: CD a- -Tenant: Suite Resident/Owner Name: ~5 CA-A 1 Y t (XY h k\ Phone: U S)1- Z.LQ_ I - Z,-PSSJ Address / City / Zip: " Zl ? a V-- Name: no Hou w Wa.b"t 4 y- License 8 ZZO Z6 C54 Contractor Address: 19b g V pyw i I 11(, L SA City: 6(61, nn Stater t-A Zip: 55 ~ Phone: La S1-- 43-1 - q 2 AA X 2,2 Contact: Email: Ike I Y .Vi~C ~c ~rSr~v~ Okle 6 U41 CLI r". C OW New - A 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 Furnace New Construction _ Interior Improvement Permit Type -Air Conditioner _ Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit - Heat Pump Under/ Above ground Tank 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) _ $ V TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1% $60.00 Minimum (includes State Surcharge) = $ 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 Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. V" j,p x f v i c-4 y-s 6v-I x Applicant's P nted Name Applicant's ig ature 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:Building Permit Number:EA164254 Date Issued:09/23/2020 Permit Category:ePermit Site Address: 3269 Black Oak Dr Lot:5 Block: 1 Addition: Bur Oak Hills PID:10-15500-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. 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 - Nancy G Larson 3269 Black Oak Dr Eagan MN 55121--233 (651) 261-2351 Elite Restoration Pro 1120 E 80th St, Suite 201 Bloomington MN 55420 (952) 322-7773 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA178770 Date Issued:09/01/2022 Permit Category:ePermit Site Address: 3269 Black Oak Dr Lot:5 Block: 1 Addition: Bur Oak Hills PID:10-15500-01-050 Use: Description: Sub Type:Furnace & Air Conditioner Work Type:Replace Description: Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Tammy M Schumacher 3269 Black Oak Dr Eagan MN 55121 Bonfes Plumbing Heating & Air Service Inc 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature