4740 Berkshire Way
2011-08-1510:54 » 651975 5694 P 112
U" ULUh or ULAACK Ink
For Office Use
I I
My of Ealan I Permit 8-. I
~ PenrlR Fee;
3830 Pilot Knob Road j f
Eapan MN 55122 C gate R
Phone: (651) 6754675 I Sm1F I
Fax: (651) 675.5694 L---
Q 2011 RESIDENTIAL 1PLUMBING ~ PERMIT' APPLICA ON
Date: O ► a t Site Address (
""I
Tenant: Suite a:
RESIDENT I OWNER Name: Phone: kQ '~I.5~ 1-13-1
t~Ct00 V
Address I City / Zip: " am
CONTRACTOR Name: ^ f ' -License C.0ki so
Address: a 5 S• Su fh~r LA 6 h ud City:
State: tA,M.._Zip: !5S5 Phone: U ta
ContactcasOlr O~~ -I too~
_ Email:
TYPE OF WORK ew _ Replacement _ Repair Rebuild Modify Space _ Work in R.O.W,
Dacri on of work' f
PERMIT TYPE RESIDENTIAL
. Water Softener
Water Heater
Lawn Irrigation RPZ / 11C PVB) Add Plumbing Fixtures Main t _ Lower Level)
Water Turnaround
Septic System
-New
Abandonment
RESIDENTIAL FEES:
$6S.00 Minimum Water Heater, Water Softener, or Water Heater air Softener (IndtKfes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $6.00 State Surcharge)
"Wager Turnaround (add $168.00 if a 5/8" meter is required)
5105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL 13FFQU YOU DIG. Call Gopher State One Call at (661) 4644M2 for protection against underground utility damage.
Cell 48 hours before you intend to dig to receive locates of underground utilities, www.copherstateonecall.ora
I hereby acknowledge that thi6 information is complete and accurate; that the work will be In conformance with the ordinances and codes or the City of
Eagan; that I understand IN$ Is W a permit, but only an application for a penult, and work Is not to start without a permit; that the work will be in
accordance with the eppropi~rin the cage of work which requires a review and approval of plans.
AppllcanCa Printed Name Applicant gnatUr+e
FOR OFFICE USE Reviewed By: Data:
Required Inspections: Under Ground Rough-In Air Test ,,,Gas Test Final
Use BLUE or BLACK Ink
For Office Use 9171
Permit < / I
City of Ea a~ I I
R I Permit Fee.
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I- I
Fax: (651) 675-5694 1 Staff: I
I
2/010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ~S ) ! Site Address: L~
Tenant: I C ~C r ~17-~ I =C' Suite
RESIDENT / OWNER Name: V jo: L) `T Phone: S_/ X1.7 L/ 7
Address / City / Zip: q7 r '7t ll u~ l /Z~~ W,4 l j _ L:I46,4,u J
Applicant is: Owner Contractor
TYPE OF WORK Description of wor 0 LC/
Construction Cost: L-I 0 0 ( / Multi-Family Building: (Yes / No )
License
CONTRACTOR Name:
Address: (o t160jz). L4 ~ P City: 6Mk_1 C-"
State: P4A-1 Zip: 5309!1_ Phone: /~S r3
Contact: rrWLC4 RVA*(-T-)1t Email: ff2w&-C:7y000 A01- 0)NI
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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 without a that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pl,
Applicant's Printed Name plic ignature
Page 1 of 2
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA085316
Eagan, MN 55122 . Date Issued: 08/15/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4740 Berkshire Way
Lot: 2 Block: 5 Addition: Berkshire Ponds
PID 10-13750-020-05
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary- BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Kaufman Sheet Metal Roofing Vicki Lynn Pautz
2521 24th Ave S 4740 Berkshire Way
Minneapolis MN 55406 Eagan MN 55122
(612) 722-0965
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
REQUEST FOR ELECTRICAL INSPECTION Ee-ooool-oa
b
'See instructions for completing this form on back of yellow copy.
X'" Below Wo;~k Coveted by This Request 773
Now Add Rep. Type of Building Appliances Wired Equipment Wired
Duplex Water Heater Lighting Fixtures
Romp,te Home Rang e Temporary Service
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other Specs v Other(Speify)
ther(Specify Other Other
spection Fee Below
# Fee Service Entrance Size t4 Fee Feeders /Subfeeders # Fee circuits
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) Partial,/Other Fee
Signs Special Inspection $ TOTAL FEE
Rema rks
Rough-in t Date
e E w tri c~wr
Inspector, hereby
' certify that the above
Final P;_4161 inspection has been
y made.
This request void 18 months from
9
Oes old 6 t 3` o
~
months from 7 LV ✓
Request D to Fire No. Rough-in Inspection
R red2 ❑ Ready Now Will Notify, Inspec-
i es No for When Ready
icensed Electrical Contractor 1 hereby request inspection of above
Owner electrical work installed at:
z~ _x x i
St4pe1743 AdBox r Route No., Z_
Section No. Township Name or No. Range No. Co ty
pl~1-07?9
Oc u ant (PRINT) Phon No.
Pa r Supplier Address
El c I Contfac or (Company N me) - Contract s License No.
Mailing Address (Contractor or owner Making Installation)
Ail) 551 2
Author er} Si ture i ntr ctor/O ner Making Ins 1 r ) Phone Number
MINNESOTA STATE BOARD OF ELECTRI ITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Plucl nzr
L 5 9 7
Request Date Fire No. Rough-in Inspection
9 Requ'ued? ❑ Ready Now iy~unill Notify Inspector
Ready?
f w es No X VW'
1 licensed contractor E:) owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Route No.) City
Section No. Township Name or No. Range No. County `
Occupant (PRINT) Phone No.
Power Supplier Address
Electrical Contractor (Company Name) Contractor's License No.
Mailing Address {Contractor or Owner Making Installation)
Authorized Si ature JCo rrOu(ner along Installation) Phone Number
MINNESOTA Sfr TE 80ARD OF ELECTRICITY A / 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 ~t ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ~g EaB-00001-08R
°
►e instructions for completing this form on back of yellow copy.
coit
°F
r5 2 9 3-17 "X" Below Work Covered by This Request
New A€f&t- Rep. Type of Building 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: 8 l
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Bove 100 Amps
Signs Inspector's Use Only: TOTAL _
Irrigation Booms
Speciallnspection t
Alarm/Communication THIS INSTALLATION MAY BE RDERED DI.SCONNESijt D IF NOT
Other Fee COMPLETED WITHIN 18 f
I, the Electrical Inspector, hereby Rough-in Date n
certify that the above inspection has Final
been made.
OFFICE USE ONLY
This request void 18 months from
E 9918
Request Date Fire No. ~Yes gh-in Inspection
uired? ❑ Ready Now ill Notify Inspector
❑ No When Ready?
licensed contractor ❑ owner hereby request inspection of above electrical work at:
Job Address Street, Box or Route No.) City
~/4
Section N . Township Name or No. ange No. Cou
Occupant(PRINT) Phone No.
Power up er Address
s Cw
Electrical Contract ( mpany ame) Contractor's License N .
J. t~
Mailing d re (Co ractor or Owner Making stallation)
Authorized S' aturC a r/Owner Making Installation) Phone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642.0800 ENCLOSED.
REOU cECTRICAL INSPECTION EB-00001-07
//,y ► See instructions for completing this form on back of yellow copy.
~ t. 1919,18 fl X" Below Work Covered by This Request
New Adtii Rep. TypeofBuilding Appliances Wired EquipmentWired
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 0 to 100 Amps
Transformers Above 200 Amps Abo _ Amps
Signs Inspectors Use Only: TOTAL
Irrigation Booms
L~
Special Inspection
Alarm/Communication
Other Fee
I, the Electrical Inspector, hereby Rough-in r Date
certify that the above inspection has Final
C
been made. • Dates
OFFICE r
USE ONLY
This request void 18 months from
CITY OF EAGAN16312
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 /14
BUILDING PERMIT Receipt # t_ I L-D
To be used for 3-SEASON PORCH Est. Value $7,000 Date APR 18 , 19 89
Site Address 4740 BERKSHIRE WAY
Lot 2 Block 5 Sec/Sub. BERKSHIRE PONDS OFFICE USE ONLY
Parcel No. Occupancy FEES
Zoning -
W Name VICKI L PAUTZ. (Actual) Const - Bldg. Permit 90.00
o Address 4740 BERKSHIRE WAY (Allowable) Surcharge 3.50
City EAGAN Phone 454-1777 #ofStories
Length 1) 1 Plan Review
Zo Name SHANTZ CONSTRUCTION Depth 10' SAC, City
0a Address 3304 RIVER BLUFF DR S.F. Total - sac, Mcwcc
City EAGAN Phone 456-9230 S.F. Footprints
On Site Sewage Water Conn
F w Name On Site well water Meter
Address MWCC System -
UZ Acct. Deposit
am City Phone City Water -
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Ea an Ordinance`s., Treatment PI
Signature of Permitee1=~ 1 /rte APPROVALS Road Unit
A Building Permit is issued to: SHANTZ CONS UCTION Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council 1.00
applicable State of Minnesota Statutes and City Eagan Ordinances. Bldg. Off. Copies
Building Official I f i 1 Ll Variance - TOTAL 94.50
CITY OF EAGAN ~ry
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for - Est. Value Date t 19 "f
Site Address
Lot Block t Sec/Sub OFFICE USE ONLY
Parcel No. Occupancy FEES
Zoning
ox Name (Actual) Const Bldg. Permit
w
o Address (Allowable) Surcharge
City Phone'~~` ° ' # of Stories
Length Plan Review
o Name Depth r SAC, City
Address S.F. Total
~a SAC, MCWCC
City Phone s.F. Footprints
On Site Sewage Water Conn
w W Name On Site Well Water Meter
xz Address MWCCSystem
v 0 Acct. Deposit
aw City Phone City Water
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI
Signature of Permitee APPROVALS Road Unit
A Building Permit is issued to: Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council ,
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
'tr 2.~;
Building Official Variance TOTAL" °
• Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
f
Inspection Date Insp.' Comments
Footings l Z,~~f
Foundation
FramingZ S y Z- °
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final f ;r
Deck Ftg.
Deck Final
Well
I
Pr. Disp.
CITY OF EAGAN N2 1 12 5 9
r 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receipt # ~1 I
Te be wed for SF DWG/GAR Est. Value $63,000 Date NOVEMBER 8 19_.8 5
Site Address 4740 BERKSHIRE WAY Erect 21 Occupancy R3
Lot 2 Block 5 Sec/Sub. BERKSHIRE PONDS Remodel ❑ zoning R1
Parcel No. Repair ❑ Type of Const. ~j
Addition ❑ No. Stories
JOE MILLER CONSTRUCTION Move ❑ Length 45
09 W Name
W Demolish ❑ Depth 46
z Address 18133 CEDAR AVENUE I„ t. Impr. ❑ Sq. Ft.
City FARMI NGTOKona 431-2001 Install ❑
SAME Approvals Fees
,g Name
oU Address Assessment Permit 0
u~ City Phone Water & Sew. Surcharge 31.50
Police Plan Review 161.00
P Name Fire SAC 525.00
W
11 Address Eng. Water Conn. 500-00
<W City Phone Planner Water Meter 63 • 00
Council Road Unit 280.00
1 hereby acknowledge that i have read this application and state that Bldg. Off. 11/1/8 5 Tr. Pl. 132.00
the information is correct and agree to comply with all applicable APC Parks
State of Minnesota Stotut s and City of Eagan Ordinances.
GiA C.IVar. Date Copies
Signature of Permittee ,~i 1,~1/ Si f\ $2,014.50
CONS TION Total
A Building Permit is issued to. .70E MILLER on the express condition that
all work shalt be done in accordance w' , t icable Sate o Min a tes and City of Eagan Ordinances.
Building Official's
CITY OF EAGAN Remarks
Addition BERKSHIRE PONDS Lot 2 - Blk 5 Parcel 10 13750 020 05
Owner Street 4740 Berhshire Way State
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1982 239.09 23.91 10
STREET RESTOR. 1985 123-80 8-99 19
GRADING
SAN SEW TRUNK • 1982 176.04 11.74 15
SEWER LATERAL I)Ati 1982 57.24 3.82 15
* 427.88 28,53- 15
WATERMAIN 1982 46.09 3.07 15
* WATER LATERAL
WATER AREA % 1982 176.04 11.74 15
STORM SEW TRK 1 qP'% 25-67 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit $280.00 57404 11/12/85
WATER CONN. 500.00
BUILDING PER. 1125
SAC 525.00
PARK
2085 RESIDENTL41 MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MIST 55122,
Telephone # 651-675-5675
Please complete for: single family dwellings & tovwvirnhomes/condos when are required for each unit
Date
Site Address L4:3 ~4 D _ 5n c 6 Ir l~• \I\f O LA U-Ajt #
Property Owner V i c h l 1" Q O ~ 7 . Telephone # {(CN
Contractor
Street Address 2.. l 1 O ).f;i f) Qo k t City S ran c nq .
State _ M N Zip &W2u Tekp e # t(031 ^1 C? too 7--4
Bond Expires.
The Appkant is owner `Contractor Other
,add-on or alteration to existing dwelling unit 30.00
furnace Additional !Replacement
air exchanger
air conditioner New Replacement
other
State Sarcharge 50
Total - $
I her by fly for a Residential Mechanical 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 with theMcchanical.Codes; that I wderstand Ns is not a
permit, but only an application for a permit, and work is not to start without a p ant that the work will be in ac coAane with the
crowed plan in the case of work which requires a review and approval of
Applicant's Pw%ted Name Ap et'~ S mature
By
I
2005 COMMERCIAL MECHANICAL PERMff APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan.MN 551'22
Telephone # 651-675.5675
Please complete for: commercial/industrial buildings
multi family buildings when separate permits are not required for emb dwelling unit
hate
Site Street Address- unit #
Tenant Name of applicable) Previous Tenant Name
Property Owner 1'elepve # {
Contractor
Street Address city
( )
state zip Telephone #
Bond Expires:
The Applicant is Owner Contractor Other
'Work Type
New Construction Underground Tank Install Remove **see below
Interior Improvement Install Piping Processed _Gas
Nature of Work:
**When installingfremoving underground tank, cell for inspection by Fire Marshal and Plumbing I=Pector
Permit Fees: $70.50 Underground tank installation/removal
$50.50 Mrs (includes State Surcharge)
or
Contract Value $ x 1% _ Permit Fee
• If errrli fee is $1,000 or less, add $.50 $ State Surce
If er ` fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a. Commercial Mechanical 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 with the mechanical Codes;,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 m the case of work which requires a review and approval of plans.
Applicant's Printed Name Applicant's Signature
Approved By: Inspector Date:
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF RAGAN
~-7 38M PILOT KNOB RD - 55122 ` "
651.681-4675 t 577
Now Construction R2gj*ements Itemoday low
> 3 registered site surreys showing sq. ft. of lot, sq. ft. of house 2 copies of playa
and gif roofed areas (29Z MgxImUrn lot cgygE2gj wed) 1 set of energy calculations for heated acht
ns
#io
> 2 copies of plans (show boom & window sizes: poured find. design; etc.) 1 site survey for exterior additions decks
>I set of energy calculations
A 3 copies of free preservation plan tf lot platted after 7/1/43
DATE: 7- 9' CONSTRUCTION COST: ::E/L rQ QQ 9n:
DESCRIPTION OF WORK: ZEAL ltd2E SL
G<J
STREET ADDRESS: Y2 ~zb
LOT: BLOCK:_ SUED./P.I.D.:
Name: VTZ- VI C/<7- Phone #R: ?
PROPERTY Last First
OWNER
Street Address' A- 1
City Erd Al, State: A~,( Zip:
Company: 77- -QA15V,- Phone <,o44 42 912 `
.
CONTRACTOR (area code) 691&k
Street Address: 9!?4tE) QY~LS CYT Dense # $ 1~.,~E
City &E L e'k'e State: .~ll/J/s Zip: Q:Z: 1
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip:
Sewer & water licensed plumber (r*auired for new !;on Sit only):
Penalty applies when address change and lot change Is requested once permit Is Issued.
i hereby acknowledge that I have read this application, skate that the Information is correct, and agree to comply with all appkabi
Skate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
{'999
Tree Preservation Plan Received Yes No Not Required JUL 2
'
I
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 4-plea ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.)
❑ 02 SF Dwelling . ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 PordVAddn. (4-sea.
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck Q 23 Porch (screened)
❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level 0 24 Storm Damage
❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous
WORK TYPE
❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia
❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors
❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair
❑ 34 Repair ❑ 38 Demolish (Interior) ❑ ' 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engines
_ i PM I :tr:r 9 7 9+:F T f, i:M rlrt
Permit Fee Valuation:
f
Surcharge
Plan Review License TrI
MC/ESSAY a..3.=,:,
City SAC
Water Conn.
Water Meter :~.+.rr r:t?:_;..:('•
Acct. Deposit 0(1:1 . r •4.0 k. ,
SMI Permit
SMI Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other _
Copies
"li~ir .'Jr»
CRIf J.
I,
Total SAC Units
% SAC
CITY OF EAGAN WAIM S 0 PNWH
38M Pilot Knob Road 5 ;
P. O. Box 23199 PERMIT NO.:.
Ewan, WIN '55121 DATE:
Zoning: _ No. of Units: g
Owner: - -
Address:
Site Address:
Plumber. P,-!
iW
v
Charge:
Meter No.: Connection
Size- Account Deposit- 77- 7
Reader No.: Permit Fee:
1 agme to comply whh the City of Eagan Surcharge: "
Ordiaeaceo. Misc. Charges:
Total: 6 =f . ` )rd r: atc-r
By Date Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEWR $
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address: T
Site Address:
Plumber:
1 agree to comply wish the Cite of Eagan Connection Charge: -
Ordineaee& Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of I nsp.: Total:
Insp.: Date Paid:
.0- ,
P. O. box 21A" PERMIT NO.t
€ " ,1 121 DATE:
Rl
Zonl
g/~~-~v~_~4~`~~.at V.
~ A
t site Areaw- L
'Upa
SiFe:
Reader Q
F
}t ee:
! 1 agree to r whir 0110 City
Misc. fir : I32.COpd
r
Total: _ 63 . QUpdI: er
f
BY Daft Paid:
r Date o I 1
„i
2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINT)
1) PROPER'L'Y ADDRESS : !.u 4
LEGAL DESCRIPTICN:
(Lnt/Block/Subdivisi or Tax ei I.D. Nt3nber)
IF ST-IRUC77 tE, DATE OF ORIGINAL EUI=D'
1
C.:
PRESE`:T Z^`IT.~:/?'ROPOS~ US': ❑ R-1 SZ;= FAMILY
❑ R-2 CUPL ('IZ`'O UNITS)
❑ R-3 TOG-.-,\&CUSE (7-Tm- . + UNITS) f, UNITS )
❑ R-4 APART: EI:T/CC.Ma,?INTUT.1 ( UNITS)
❑ Cal rL-IEPCLU/'Rh AII,/OFFIC::
❑ MmUSTRIAI,
❑ TNSTIM TIONAL/GOV, T-,%!EL%7
2) APPLI= (PLEASE PRINT)
NAidE : ~o i I U t ir-
ADDRESS : 11133 (_g&t4 A u-r-
CTTY, STAT°, ZIP:
~/~/1;r•w~ = d~, ~-e r~ WLt~ ' „~~i 0.2
r--
PI-ONE: ~f 3t -;Lou1
3) P=IBEP (PLEASE PRINT) FOR CITY USE ONLY
NAME: 'PLy IM.a w+YL-a`-,.
ADDRESS: 1 2 ~ j3 it 0 Luc ~.1 PLUMBERS LI ASE:.
Ctive
CITY, STATE, ZIP: w.s u N• N'lF~ 55' qqc~ [Q it Ld
f PHONE: zs°f~- PLUMBER LICENSE # 20 h, 3' /y3
a r 4} OCCUPANT/CuTTM (PLEASE PRINT)
NAME:
ADDRESS:
CITY, STATE, ZIP: S,a4 4 3
PHONE :
5) INDICATE ATHICH PERMIT IS BEING REQUESTED:
NNECTION TO CITY SDIER
[Rol ON
TO CITY 1
STATER
Q OTf1R (PLEASE DESCRIBE)
6) UMICA-Z" CNE:
1ePZ='%SE HOLD APPROVED PERNUT FOR PICK-UP BY ONE OF ABOVE
❑ Ka-~SE '";UL APPROVED PEPS LIT TO 1, 2, 3, 4 ABOVE
(Circle one)
7) SIG:,'Am:RE: DATE: 6//151
■ 0 Ol:ie_ielleat-se # Mon =w al:afscsw mean At p fair # *a s NO ewfi jm:;ju :m a oft soon mwvwm~'
a >
F O R C I T Y U S E O N L Y
PERMIT u ISSUED
FEES : $ Sy SE:vLR PERMIT (I`ICL ;D~ SURC :,A-FGG)
$ WATER PERIU'[IT (INCLUDE SURCHARGE)
$ ~~C= WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ /_Sc;)G '_CCCU:i'T' OSI= - : _:.ER
$ u ACCOUNT DEPOSIT - WATER
$ v.~ v WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SE:"1ER
$ LATERAL BENEFIT/TRUNNK WATER
$ WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TOTAL
$ AMOUNT PAID/RECEIPT
tta e
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A "PERMIT FOR WORK WITHIN t
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
T
APPROVED BY:
TITLE: /
DATE :
M! wm wig-An M w An eeak~m ter m! wee w~ e~ w iv R~ l4 +e ~i~ pF W 94 t#~PN MRa M*M M NWM w
J
r c
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
COMMERCIAL SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, ,j SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS-
$2,000 LANDSCAPE BOND 6, 31000
To Be Used For : Valuation: Date
Site Address / OFFICE USE ONLY
10 rh~
Lot aC Block J' ~ Erect ~ Occupancy .3
Remodel Zoning
Parcel/Sub Repair Type of Const
Addition # of Stories
Owner Move Length
Demolish Depth (o
Address Int.Impr. Sq Ft
Install
City/Zip Code -
Phone APPROVALS FEES
Contractor Assessments Permit
Water/Sewer Surcharge s"
Address / Police Plan Review (9 .
' Fire SAC 2 .
City/Zip Code Engr Water Conn
Planner Water Meter (03.
Phone Council Road Unit Z
Bldg Of ~reatment Pl 2.
Arch./Engr. APC Parks
Variance Copies
Address TOTAL so
City/Zip Code
Phone #
l -
✓ TRI -LAND CO. e1TE PLAN , IF-
oR.
SURVEYING
SERVICES :,,qE MILLER cONBT.
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
a BERKSHIRE WAYN
'-12'1
b SCALE: 1*:W
? i
T
i
G~ I
N
I"
+ I ~
H=AW
I t
I 38 i 3
3 t I .
to I s
I N
I Iz
~ I
o 22A)0
-{O - W %-1 97.9
G ALAX l E AVENUE
PROPERTY DESCRIPTION
LOT-.-2,, BLOCK,.,
P~EG1.cS1-.1tQE PO.,[~S
according to the recorded plot thereof
County, Minnesota
LEGEND
o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION • 102.00
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = lo i-
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR a
ELEVATION ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
DENOTES DRAINAGE DIRECTION NOTE* * VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
rcilrect hereby certify that this survey, plan or
eport was prepared by the or under my
supervision and that I am a duly Bradley J •nson, Mn. Reg. No. 13235
Registered Land Surveyor under the Aj,~(~BEa. t~5
Laws of the State of Minnesota Date
i
1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
COMMERCIAL
I
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS APR 1 2-1989
J s4wso AJ Po2GH
To Be Used For: Valuation: O Date: 'zzl
Site Address +:Z-4-6 8EIZ/C~gX1,t~c "L) r?000 OFFICE USE ONLY
Lot Block Occupancy FEES
Zoning
Parcel/Sub 61U Actual Const Bldg. Permit
Allowable Surcharge
Owner ~;~K~ PQ u t~ # of stories Plan Review
Length I(~, SAC, City
Address 4740 Bey-KS h i re- W z.4 Depth SAC, MWCC ~
S.F. Total Water Conn
City/Zip Code Ea~36LYI' MN 651Q Q Footprint S.F. Water Meter
Acct. Deposit
Phone 4-s-4-1777 On site sewage S/W Permit
On site well S/W Surcharge
Contractor 3#h1J7-Z- L e-,-AJ r, MWCC System Treatment P1.
City water Road Unit
Address ,3301¢ prvc-R PLu44! h2. PRV required Park Ded.
Booster Pump Copies vO
City/Zip Code TOTALS Ca
APPROVALS
Phone 2 6 9a 3 0 4 Fru4 Ztoo Planner
Council
Arch./Engr. Bldg. Off.
Variance
Address Council
City/Zip Code
Phone #
NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building
permit fee. Processing time for sewer and water permits is two days once a licensed
plumber has applied for a permit at City Hall.
TRI-LAND CO. 'eITE PLAN F:pR;
SURVEYING
SERVICES
.)QE MILLER CONS TS
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
a BERKSHIRE WAY
N
b F--
I SCALE : I"'. W
I
C"^ VC
i
i. Hose i
l I
I 3 ~ 3g
3 I ~ ~ 3
2 I ~
l Iz
I
I.
c u.00
N , a
G ALAX l E AVENUE
I,
PROPERTY DESCRIPTION
LOT-2,, BLOCK-..:5-,
according to the recorded plat thereof
County, Minnesota
LEGEN
o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION = 102-00
o DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = ln2-sn
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR
ELEVATION' ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
DENOTES DRAINAC* DIRECTION Nom' VENRIIFFYH LLE P OR HEIGHTS WITH ANS
certify that this survey, ion or
reppoort~was prepared by me at nder my
direct supervision and that I am a duly Bradley J gnson, Mn. Reg. No. 13235
Registered Land Surveyor under the
Date :..~1,,....~=ag.i3~-t-.`
Laws of the State of Minnesota.
•::\:v.,w::•isT.•+,•.ti:;i:::ti'.•'??v;.;::v; + iii'iy%:+.• v:i
.::::.~.;~..::..:.:'%'•:isi?.:i:•.y:.;....4i:•i:•i•iyi`i::::ii:!~%> it~?>:i`:iii: ~~i::::
' :?:i{:iC:isti:::j::2:~i>'r:<'':~:i:;;:y::;':j:'::Y::::': i,2~:;{:f";:v::;i'• i:y: {::;:j::i;:iy •Y: {is'y,:;iiY,.j~i::Y:,?~'<.:::':<:~ i`:i'i'S.~..::;.
:•::i•y ii:..: i:•ii:•i: ri•iiiti:::. i;.i:: •`:::::::..,f:: :'•i•.;
:v.:;y: :::iii:%{:ii??:'%:v;•~:{.}::;iyy''>iiyii:{•}:•ii:~}::•: ::ii:•}i••.. ni;n;
. : v:•vi.:;:: i::~i `iui: ~i:!ii:4ij v: ~:!~i:~ii:•: i.'j;•ii•>:;i;i: ij•;?.: x:.
~~'rii}} iiti:.'•.: ~..~~v..: ••..':.{2i. ~ .;.•:i,:•:.+Y v..,. vi~'i::i`2::ij:+ii::;:;~..,.
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
- - - - - - - - - -
NO. FIXTURES EACH TOTAL
SHOWER 3•'~
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
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 - 3.00
ROUGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVATE DISP. • Dak.Cty. ►ic. 15.00
U.G. SPRINKLER • home under cont. 3.00
ALTERATIONS • to existing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: l5~ 5
SITE ADDRESS: 7,'~
OWNER NAME:
INSTALLER: r✓' G~ t' l~G'~ ~15.
ADDRESS: ~
CITY: STATE: ZIP CODE:l
PHONE ( )r~'~
SIGNATURE OF PERMIT-TEE
i
Mil,
.iti'$:;if::i: S'::;; ;?:;F::;:;:; ~::;r:?::::::::::i.::::;:::::<>:{:i?S:~>:?~''_J:S:' ~;':y::'ii:!•"~':::?:i:~:
fi
;t
1993 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 681-4675
PLEASE COMPLETE FOR ALL COM IERCIAUINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUR DINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING U: " :T.
NEW CONSTRUCTION
ADD ON
I REPAIR
WORK DESCRIPTION:
i
CONTRACT PRICE: $
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE: $.50 FOR EACH $1,000 OF P,ERMPT FEE.
MINIMUM FEE: $ 25.00
CONTRACT PRICE X 1% $
STATE SURCHARGE $
TOTAL $
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CODE:
PHONE
FOR:
CITY OF EAGAN APPLICANT
PERMIT
CITY OF EAGAN PERMIT TYPE: ~
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 021859
(612) 681-4675 Date Issued: 08131/93
SITE ADDRESS:
4740 BERKSHIRE WAY
LOT: 2 BLOCK: 5
BERKSHIRE PONDS
P.I.N.: 10-13750-020-05
DESCRIPTION:
Building Permit Type BASEMENT FINISH
Building Work Type NEW
UBC Occupancy R-3
REMARKS:
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Lic. Search Fee 5.00
Total Fee $40.50
I
CONTRACTOR: - Applicant - ST. LIC. OWNER:
SHANTZ CONST 14692921 0008886 PAUTZ VICKI
9940 ROLLING OAKS CT 4740 BERKSHIRE WAY
PRIOR LAKE MN 55372 EAGAN MN 55122
(612) 469-2921 (612)454-1777
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_
APPLIC / ERMITEE SIGNATU ISSUED B1. SIGNATURE
SPECTION RECORD
CITY OF EAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 021859
Eagan, Minnesota 5 ,123 Date Issued: 08/31/93
(612) 681-4675
SITE ADDRESS: LOT : 2 BLOCK: 5 APPLICANT:
4740 BERKSHIRE WAY SHANTZ CONST
BERKSHIRE PONDS (612) 469-2921
PERMIT SUB YPE: TYPE OF WORK:
BASEMEN FINISH NEW
INSPECTI TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR.
FFI MING FINAL
EPL ACE
I'
F
IL
= - - - -
REACTIVATE CITY OF EAGAN
PERMIT # 1993 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, I copy of energy calcs.
Penalty applies: 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 3 / Valuation of work 166 on
Site Address: R~~y2K_w
STREET SUITE M
Tenant Name: (commercial only)
LOT BLOCK j SUBD. p.I.D. M '
7g '
Descri tion of work: A IS _ w 7- F-my-1-23
The applicant is: ❑ Owner IK Contractor ❑ Other (oeacrilx) -
Name -A4u T7 L =1~ 1 Phone 4 7 7
Property LAST FIRST
Owner Address - ? -ILO J~E;Ae k S'I~ E
STREET STE M
City C/giU Stated Zip
Company 51-11-A&7-2- C2QIV Phone-4-69 c2 611al-
# xp•
Contractor Address 4,f) koLL.T,V' 1i~S e-F lice e
City Y__ILofz. LA K6 State __✓~y' - Zip s~ 7,2,
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 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 D 11 Apt./Cadging jg~'.J~t Finish
❑ 02 SF Dwg. ❑ 07 4-Pl ex O 12 Multi. Misc. , :1Sw#er`"1 l
❑ 03 SF Addition ❑ 08 S-P1ex O 13 Garage/Accessory ❑ I8 Comm./Ind.
O 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc.
E3 05 SF Misc. ❑ 10 Multi. Add'i. ❑ 15 Deck ❑ 20 Public Facility
❑ 21 Miscellaneous.
WORK TYPE
31 New O 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish
D 32 Addition ❑ 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) Ist Fl. sq. ft. City Water
UBC Occupancy 2nd Fl. sq. ft, PRY Required
Zoning 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
APPROVALS C a`
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site ❑ Footing ❑ Framing ❑ Insulation
O Wallboard ❑ Final ❑ Draintiie ❑ Fireplace
Permit Feed v.LU.ti«n: S
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total: SAC 96
SAC Units
PERMIT
GITV OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BUILDING
Eagan, Minnesota 55123 Permit Number: 021817
(612) 681-4675 Date Issued: 08/24/93
SITE ADDRESS:
4740 BERKSHIRE WAY
LOT: 2 BLOCK: 5
BERKSHIRE PONDS
P.I.N.: 10-13750-020-05
DESCRIPTION:
(GAS)
Building Permit Type FIREPLACE
Building Work Type NEW
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge .50
Total Fee $25.50
CONTRACTOR: Applicant - OWNER:
VIERECK FIREPLACE INC 14455620 PAUTZ VICKI
3465 NW 140TH ST 4740 BERKSHIRE WAY
SHAKOPEE MN 55379 EAGAN MN 55122
(612) 445--5620 (612)454-1777
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.
a-a~ 111
APPLICANTIPERMITEE SIGNATURE ISSUED B : SI NATUR
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 021817
Eagan, Minnesota 55123 Date Issued: 08/24/93
(612) 681-4675
SITE ADDRESS: LOT: 2 BLOCK: 5 APPLICANT:
4740 BERKSHIRE WAY VIERECK FIREPLACE INC
BERKSHIRE PONDS (612) 445-5620
I
PERMIT SUBTYPE: TYPE OF WORK.
FIREPLACE NEW
DESCRIPTION (GAS)
INSPECTION DATE INSPTR. INSPECTION DATE INSPTR.
FIREPLACE
F
L-
REACTIVATE _ CITY OF EAGAN
93 BUILDING PERMIT APPLICATION..,]
' 19
681-4675
PERillA,
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, l 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 U Valuation of work OO
Site Address:
STREET SUITE
Tenant Name: (commercial only)
LOT BLOCK SUBD. P . I . D . !F
Description of work: ~~,4eilo
The appl i cant is: O Owner X Contractor 170 Other (Cescribe)
Name Vl;nkl' OL A' PY9 Phone
Property W&r F~
Owner Address 11KY-O Q^~n✓
STREET STE #
Zi
Cityq-/v(1 State
Company VIE r-K FIR -PL r-F SALES Phone
SHAKePEE, 465140TH ST. N.W. License # Exp.
Contractor Address 3
. 55379
City 445-5620 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 has been approved.
I hereby acknowledge that I have read this a plication and state that the information is
correct and agree to comply ith all applic le State of Minnesota Statutes and City of
Eagan Ordinances. •
Signature of Applicant:
I
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 1 IS, ❑ 02 SF Dw9. El 07 4-Piex ❑ 12 Multi. Misc. ❑Ak7 P
❑ 03 SF Addition ❑ 08 8-Piex O 13 Garage/Accessory ❑ 18 Comm./Ind.
❑ 04 SF Porch ❑ 09 12-Piex )x,14 Fireplace ❑ 19 Comm./Ind. Misc..
❑ 05 SF Misc. ❑ 10 Multi. Addl. O 15 Deck ❑ 20 Public Facility
❑ 21 Miscellaneous
WORK TYPE
❑ 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish
❑ 32 Addition ❑ 34 Repair ❑ 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWC_C System
(Allowable) 1st F1. sq. ft. City Water
UBC Occupancy 2nd F1. q. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census. Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
❑ Site ❑ Footing ❑ Framing ❑ Insulation
❑ Wallboard ❑ Final ❑ Draintile %-Fireplace
Permit Fee vaeuation: $ IC5's S Z
Surcharge
Plan Review D '
License Cale -
MCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total
SAC %
SAC Units
I Receipt' PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential Q Commercial ❑ Institutional ❑
9. Work Description: New Q Add ❑ Alter ❑ Repair ❑
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordigancesrand codes governing this type of work.
Signed:
' /
for
Rough Final
Inspections: Date Insp. , Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
I.
f
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fes
Fill in numbered spaces S/C
Type or Print legibly
Tot.
1. Date 2. Installation Cost
3. Job Address` 14 tot Blk. Tract
q'
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential C7 Commercial ❑ Institutional ❑
9. Work Description: New ❑ Add ❑ Alter ❑ Repair ❑
10. Describe Fuel Type
11. No: Equipment BTU - M. Ea. No. Equipment CFM
Forced Air Air Handling:
Mfg
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
' X CITY OF EAGAN;:,_.::~,.~
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454.8100
BUILDING PERMIT Receipt #
Tlt."~ I x Iq;,
To be wed for Est. Value -l ' (A) Data
Site Address « Erect 1~k Occupancy ~3
> Remodel ❑ Zoning
Lot Block Sec/Sub. Et +€L, Parcel No. Repair ❑ Type of Const.
Addition ❑ No. Stories
Move ❑ Length n
ae Name
. c # h Demolish ❑ Depth
Ft.
Address r' } Int Impr. ❑ Sq. City :r
..PHone r,? a pt° .i Install El
-1010 Approvals Fees
o Name
zu Address Assessment Permit
Ou City Phone Water & Sew. Surcharge 31 5'
16 . ~t'=
Police Plan Review
W Name Fire SAC 52..5 0
Address Eng. Water Conn. 500
i i W City Phone Planner Water Meter 63.00
Council Road Unit 2 b 11 , 00
I hereby acknowledge that 1 hove read this application and state that Bldg. Off. 11/1,11,95 Tr. Pl. 132 • G G
the information is correct and agree to comply with all applicable APC
State of Minnesota Statutes and City of Eagan Ordinances. Parks
Var. Date Copies
Signature of Permittee
tr{: ) .`=i`i4 Total
A Building Permit is issued to: on the express condition that
f all work shall be done in accordance with all a licable State of MinngsoteeStatutes and City of Eagan Ordinances.
f
Building Official
i
Permit No. Permit Holder Date TelMphone
Plumbing WMA.C. Electric 0/6 3a Softener
Inspection Date Insp. Other
Footings 1 II lp $ L')
Footings 11
Boundation
Framing j g5 w,,.b4
Roofing
Rough Pibg.
Rough Htg. l'~~~
insul.
Fireplace
Final Htg.
Final Pibg.
Final ry `rj~/LJ _ t~
Cert,occ. 'lb- wi
Water Describe Location.
Well
Sewer
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: g'R I ` i` I tit,
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR.
I d (t Ili Act
I
~1
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC y
ELECTRIC
ELECTRIC
inspection Date Insp. Comments
Footings I
i
Foundation .aj d S%
Framing 3 ~p
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
II' Final Htg.
I
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final 3d
Deck Ftg.
Deck Final
Well
Pr. Disp.
I
I ~
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:'
(612) 681-4675
SITE ADDRESS: y,~, ; APPLICANT: y
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION TYPE f
DATE INSPTR. INSPECTION TYPE DATE INSPTR.
f
I
i
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC
j ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
I
Framing
I
Rooting
Rough Plbg. 91-"3
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
I
Pr. Disp.
Ili
~I
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA151895
Date Issued:09/18/2018
Permit Category:ePermit
Site Address: 4740 Berkshire Way
Lot:2 Block: 5 Addition: Berkshire Ponds
PID:10-13750-05-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Vicki Lynn Pautz
4740 Berkshire Way
Eagan MN 55122
(651) 454-1777
River Valley Rpz Llc
1623 210th St E
Farmington MN 55204
(515) 210-2094
Applicant/Permitee: Signature Issued By: Signature