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4130 Blueberry Knoll CITY OF EAGAN WATER SERVICE PERMIT 3830.Pi1'ot Knob Road 5316 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 2-24-R4 Rl No. of Units: 1 Zoning: /\owner Developers Const_ i ~""'ress: i site Address: 4130 BlueberrKnoll-L9 B7 Hilltop Estates Plumber- Weierke Trench $ EXC Meter No.: S! C Connection Charge: 450.00 pd Size: r Account Deposit: Rea No.: L (e3 2 .;Z c~ Permit Fee: 10.00 pd 0 4- 1 agree to comply with the City of Eagan Surcharge: -50 pd Ordinances, Misc. Charges. 63.00 pd mete 0 Total: By '''ti Dote Paid: Dote of Insp.:/ insp.: CITY of EAGAN WATER SERVICE PERMIT 3830 ilot Knob Road P. O. Box 21199 PERMIT NO.: 5316 EaVan,:MN 55121 DATE: _ 2-24-84 Zoning: R1 No. of Units: 1 Owner: Deyeltmers Ctnst Address: Site Address: 4130 Blueberry Knoll L9 b7 11111t2p tites Plumber: Weierke Trench & Exc Meter No.: Connection Charge: 450.00 1 Size: Account Deposit: Reader No.: Permit Fee: 10.00 agree to comply with the City of Eagan Surcharge: .50 Pd Ordinances. Misc. Charges: 63.00 IEQL!!r Total: By Date Paid: Date of Insp.:' Insp.: CITY OF PAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road b405 P. O. Box 21199 PERMIT' NO.: Eagan, MN 55121 DATE: 2-24-84 Zoning: KI No. of Units: Owner: Deye1pper8 coast Address: Site Address: 4130 Bluebe+Y'Y'y' Knoll L9 R7 Hilltop.-Estates Plumber. Wkierke "Trench Exc 2-U-84 41529 .130 i agree to comply with the Char of Eagan Connection Charge: 42S.000 Ordinances. Account Deposit: 10.00 -Pd Permit Fee: Surcharge: • S+~ By Misc. Charges: Date of Insp.- Total: Insp.: Date Paid: .AOL CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN MINNESOTA 55121 DATE ~~,i a lg r r / RECEIVED . / / F's AMOUNT -7 DOLLARS [CASH w_... } s / ; FUND CODE AMOUNT ,al't'` t~'_ `r F r ' VA. 71 M1 -7 z,_5 5Z MN ii I I' If I CITY OF EAGAN O tii 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 , j PHONE: 454-8100 ~r 3r~ BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $ 110, OOOD to FEBRUARY 16 Iq 84 4130 BLUEBERRY KNOLL R3 Site Address Erect ~ Occupancy Lot 9 Block 7 Sec/Sub. HILLTOP EST. Alter ❑ Zoning Rl Parcel No. 10°33000-090-07 Repair ❑ Fire Zone A Enlarge ❑ Type of Const. V Name DEVELOPERS CONST. Move D # Stories 3 Address 1101 CLIFF ROAD, Demolish ❑ Length 70 City BURNSVILLE Phone 890-6194 Grade ❑ Depth 35' Sq. Ft. SAIAE Approvals Fees Name Address Assessment Permit 459.00 City Phone Water & Sew. Surcharge 55.00 229.00 Police Plan check X00 PName ~ Fire. SAC H Address Eng. Water Conn. 0 0 W City Phone Planner Water Meter 63~0 Council Road Unit ' I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable r~0 State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to: DE` ELOPERS on the express condition that oll.work sholl be done in accords ace with al gppli0yiq a of Minnesota Statutes and City of Eagan Ordinances. t Building Official }hnnit No. Refflat Holder Misc. Permit No. Holler Plumbing ~P C1 X11, e Electric Ins"etion Deft Iraqi Other Footings Foundation Framing Rough Plbg. Rough HVA Insulation -2 7- Final Plbg. Final HVAC Final Water Describe Ion: well Sewer Pr. DaP. Receipt f ✓ V o t MECHMICAL PERMIT PM M No. CITY OF EAGAA Foe Z fill in numbered aces S/C ' Type or Print legibly Tot. z. a c: 1J 1. Bate l 2. Installation Cast 3. Job Address 'l LotBlk._ Tract 4. Owrwr e- 6c C 4- -a ,7 5. Contractor Phone 6. Address Ir- s 7. City state Zip S. Building Type: Residential ~ Commercial Q Institutional Q 9. Work Description: New tl Add Q Alter Q Repair Q 10. Describe Fuel Type 11. Nq Equil2rrien$ BTU - M. Ea. No, Ectui ent CFM Forced Air Air Handling: Mfg. Boilers Mach. Exhaust Mfg. Unit Heater Mfg. Ether Air Cond. mfg. f Gas, Piping Outlets 12. t hereby casrtify that the above Information is true uWi correct, and l agree to oamply with all-ordinances and codes govern this type of work. 1t . a e"r+ trurr r am d %Vro ! t "1?' PeaAast a% _ CITY Of 9" J Fill in numbered spaces tl'C Type or Pant legibly Tot 1. Date 2. Installation Cc~s 3. Job Address ~~3G ,~T Tact r--A,# 'AM 4. Owrw N j 1 1l ? - 5. Contractor tl e l"F P' r7 Phon* 1 t4 Address t~ hl 7. City y LL (sa State L11 L--6, zip S S 8. Buificling Type: Residential Commercial ❑ Institutional a 9. Work Description: New ~ Add C7~ Alter ❑ Repair 0 10. Describe Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner E shower Well Kitchen Sink q*y Trey jwl!'l I— I I IN S- P, EC T` ION R'E-C, 0'' RD ZiOF EAGA~I PERIL ' t Ey 0 11 i R 4 N lot Knob Road Oarmtt Number 0. 4 ,l t, n, Minnesota 55123 Date issued: (612) 681-4675 U S WE AbORESS: 1, ce 4` 9 fit V. APPLICANT: t .t .~kt to tk. iBs f: taF5 6 Y t Nr t t. ,ts°2HWIW4 f ()N,; f NAWK #4 i.1,7t31' 4 t/ilk.";k (61") V l lR PERMIT SUBTYPE: TYPE OF WORk: Asp:;l I ION X4.31 1.i4t`ix # I*Ait;4tdfa t ~t A 4 z h f M diP k A '~lf P3'aRAIF PUR143_1' 17:: t:kk4k43.W s# t OR ANY I 4 FGljt CCA i WO WK F"" No. owwo "W" as* vakphom# 3fl HVAC eLectm ELLCTRC wn ~utatkxt Daft mw C*OWAgft s ,fie PA"v i F Fireplace Snal H0 F EWAftn e4t 8'rI Deck Flo. ~ Deck Final FA44f wen Pr. Disp. CITY OF EAGAN Remarks Addition HILLTOP ESTATES Lot Q Bik? Parcel- Owner Street 4130 Blueberry Knoll State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 1980 1336.72 133,67 10 668.37 A013549 2-13-84 STREET RESTOR. GRADING SAN SEW TRUNK 1973 172.14 8.61 20 68.74 A013549 2-13-84 * SEWER LATERAL 1980 3178.74 317.87 10 1589.39 it WATERMAIN * WATER LATERAL 1980 * WATER AREA 1980 * Services 1980 * STORM SEW TRK 1980 * STORM SEW LAT 1980 CURB & GUTTER SIDEWALK STREET LIGHT ROAD UNIT 250.00 41529 2-16-84 WATER CONN. 450.00 it it BUILDING PER. 8820 SAC if ti -1 25,00 PARK t~- ~i as ~Y_ - 00 0901 Request Date Fire o. R,~ uire d Inspection Other Than Rough-In ou uinspecior when ready) ❑ Ready Now ❑ Will Notify Inspector ~t✓ ❑ Yes ❑ No Date Read I A licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or oute No.) City 1.' t LEA ~ Y Iv 6 -z 'EfiC: A, Section No. Township Name or No. Range No. cc L Occ ant (PRINT) Phone No. MPower Supplier / Address cI-W L= LEC /C: ~/~1c'fsJ Electrical Contractor (Company Name) Contractor's License No. Mailin Address (Contractor or Owner Making Installation) Authoiz Signature Contractor/Owner Making installation) Phone Number /3120--0 C~ 3v MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-128 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. l REQUEST FOR ELECTRICAL INSPECTION es-oooot-os 0020 See instructions for completing this form on back of yellow co h ? / O ~ 10- PY• "X" Below Work Covered by This Request 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 (Spec i ty) Farm Air Conditioner Other (specify) Contractor's Remarks: / /~O ss`GJ L / 6:, /t r s /N 9, P..9* CL 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: TOTAL Se> Irrigation Booms G e? (1 Special Inspection ~L Alarm/Communication THIS INSTALLATION MAY-BE ORD E DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 1 F TH I, the Electrical Inspector, hereby Rough-in _9 certify that the above inspection has CC been made. Final E- Date r OFFICE USE ONLY This request void 18 months from Th 18 b ) 9 so t r) in tl 7 L14 est Date Fire No. Rough-in Inspection Required? Ready Now F-11 I Notify, Insp ec- es ❑No When Ready 36, ensed Electrical Contractor I hereby request inspection of above Owner electrical work installed at: Street Address, goxpr Route No. / Cityr ecuon o. Township Name or No. Range No. County Occupa t (PRINT) Phone No. X9'0 -,6i 9 Power ppli r Address o. Electric I Contractor (Com an Name Contractors LjWi 4 '3 Mail ing Address (Contractor or ner Making Installation) a ~ ? 4v Authoriz Signatu a (Con actor/ wrier Making Installation) Phone Number Y1 3555 MINNESOTA STATE OARD OF ELECTRICITY 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 Phone (612) 297-2111 ENCLOSED. EB-00001-0A ~H A. REQUEST FOR ELECTRICAL INSPECTION OY1337 See instructions for completing this form on back of yellow copy. A ~.,93 0 R - "X"" Below Work Covered by This Request Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other Specify Other (Specify) Other specify Other Other Compute Inspection Fee Below # Fe Service EntranceSize # Fee Feeders /Subfeeders # Fee Circuits jv~ 0 to 200 Amps 0 to 30 Amps 0 to 30 nips Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool _ Above 100 Amps Above 100_Amps Transformers Irrigation Booms f !J' Partial,'Other Fee Signs Speciallnspection 3 fg Remarks (1 X , e!;: -J--C, Rough-in ~ Daxe 'Inspector. hereby ~ - certify-that the above Final Da~1?' inspection has been t J %L made. This request void 18 months from Le -~-rr ~S RESIDENTIAL BUILDING ' Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Cart of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system - On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date Construction Cost 12,62yR u/ Site Address obC f ^ y ~rv Unit/Ste # Description of Work ; t°C L C 1(0~ `t Multi-Family Bldg _ Y N Fireplace(s) 0 1 2 Property Owner .~4e/1 / , 4,7 Telephone # (IoSJ ) ~5-.2 - a6Zd Contractor ill A S Address 10')4S ~j~ hSGr~ A fj'd City Z64, 0,v State ,o047Wi7 Zip SY3111 Telephone # ( 213 ) k S 4"5/ - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet submission type) Submitted Submitted Energy Envelope Calculations Submitted Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor ; Telephone # I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Ap icant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ `33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final./C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) - Plumbing Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs _ Air/Gas Tests -Final Framing - Siding Stucco _ Stone Fireplace - R.I. -Air Test Final - Windows (new/replacement) Insulation - Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge` Treatment Plant License Search Copies Other Total i t c RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New Construction Reauirernents RemodellReoak Reouirements offx;e Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all rooted areas 2 copies of plan _ Cert of Surrey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Reod 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ on-site Septic System 3 copies of Tree Preservation Plan if lot platted after M/93 Rim Joist Detail Options selection sheet (bidgs with 3 or less unit Date I ~ / fryx(` / 03 Construction Cost X139. ~9 Site Address 14130 '1 lute j mA l-,rp1~ Unit/Ste # Description of Work &D\aU2 a~q IAS.r,&LgS C pgm~ n.90 Multi-Family Bldg i Y _ N Fireplace(s) _ 0 1 2 Property Owner d &ss- ? ; yb -k` Telephone #46k )459 -P(0@0 PELLA WINDOWS & DOORS Contractor 15300-25TH AVE. N. STEe #100 Address PLYMOUTH, MN 55447 City 763-745-1400 -i- State LICENSCE 920165884 _ Telephone # ( M~~ 1 't IJ COMPLETE THIS AREA ONLY IF CONSTRUCTING A 81U1L70iNG Energy Code Category - Minnesota Rules 7670 Category 1 Minnesota Rules 7672 • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( j Mechanical Contractor Telephone # ( } Sewer/Water Contractor Telephone # ( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 0.t'G. -6tr!~>0 fy Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Mufti Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or ^ N ❑ 25 Miscellaneous I Work Types i ❑ 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) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinkiered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. - Footings (deck) Final/No C.O. - Footings (addition) Plumbing - Foundation _ HVAC Drain Tile Other Roof - Ice & Water Final - Pool - Ftgs _ Air/Gas Tests Final Framing - Siding _ Stucco Stone - Fireplace _ R.I. -Air Test Final _ Windows (new/replacement) Insulation Retaining Wall Approved By , Building Inspector - Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total i I MR l '.g 'unr OWIJ POAMa8 Pella Windows Sc Doors - Twin Cities, Inc. 15300 25TH AVE N. STE. #100 PLYMOUTH, MN 55447 763x145-1400 WATS 1-800-462-5359 • FAX 763x145-1401 June 8, 2001 City of Eagan 3836 Pilot Knob Road Eagan, MN 55122 Dear Jan: Elder Jones Corporation is authorized to pull building permits for Pella Windows & Doors - Twin Cities, Inc. Please allow their representative to provide that service for us in Eagan. This authorization shall be valid until such time as the division manager expressly revokes it, in writing to the City. I request that this authorization be accepted expeditiously, so as to not delay the processing of our-building permits any further. !,Please call me if there are any questions, I can-be contacted at 763-745-1432. Your inunediate attention to this matter is appreciated. cerely, W-1 S Bryan. May. Replacement Sales Manager arzom jWOLM Q "-L, cc: Kara -Elder Jones D enna Krafly - Replacement Sales Process Coordinator Windows, Doors, & skylights 7AAR CUTTT'1 ATTUT-1fli.T 1,11,7 Ci,J 7T8 PHI /T.-CT TUJ Tn/O!1/on i NTIAL BUILDING PERMIT APPUCATtON -7D CITY OF FAGAN 3030 P CT KN(W RD, EAGAN NO 5312 651.081-4675 • 3 regidered ob Sys st*wing 4 iL of tot, sq. ~ of to ; and AR areas 2 copies of (20% ma imurn lot oovwW allowed) plan d • Z CDPW M 09n gowmg beam & wjrrdow sizes p owed found design, etc.) 1 sae Ge ad A hr~ e • 1 set of Energy calcutatior+s y for "W or Wor ar Indicate ~ served by eif~ic apeterrr * of Tree Preservation Plan I lot putted after 7/1193 Opgom selection met (brigs Ah 3 or lass ur+tdl) ;j DATE VALUATIO14 i SITE ADDRESS 44 MULTI-FAWLY fir- Y N TYPE OF WORK--j tRi PLACE(S) t} 1 ~ 2 APPLICANT STREET ADDRESS ' r)D { L cmr:~ , , 53TA ZI P U TELEPHONE #%I-` -01 .CELL PHONE # FAX # PROPERTY OWNER TELEPHONE # COMPLETE FOR "NM" RESIDENTIAL BUILDINGS ONLY Energy COft Cat 04011Y FSOTA RULES 7670 CATEGORY I MINNESOTA RUM 7072 (4 submission type) . Residential Vent4stion Category 1 Worksheet Submitted New En*W Cosh Z3tanNad • Energy Envekspe Ca lv ~ rm Submitted Phmtbing Contractor. Phone # Plumbing sYstem includes: Water Softener _ Lawn Sprin ! leg _ Water Heater No. of R.I. S- No. of Baths I NOV 1 2002 v Mechanical -Cont rractor Ph* # Mechanical systern includes: - Air ntalitioning B cc. 70.00 Heat Recovery System S*wor/Water Contractor. Phone # 1 hereby ackriawiedge that i have read this application, stag that the informa i 4Ct, and amply ,With all appiicab16'State`a4 Minnesota Statutes and City`of Eaga dine. Sigpahse of App4ccrnt ONCE USE ON & Cerfifficates of Starve Recetvati Tree Preservation Plan Received Not Roquired w UVds%d 4X2 OPRCE USE ONLY 0J01 Foundation ❑ 07 05-plea Ll 13 16-plex ❑ 20 P004 0 30 Ac spry BWQ ❑ 02 SF Dwelling 0 08 06-plax ❑ 16 Fo r e 0 21 Po" (3-sea.) 0 31 ExL AR - MutU 0 03, 01 of_ plex ❑ 09 07-plex 11 17 €aracge ❑ ` 22 PordVAddn. (4-sea.) 0 33 Ext. Aft - SF E3 04 02-piex Ct' 10 08-pleo~ C3 13 Dock ❑ 23 Porch (s~reerred) ❑ 36 Matti Q °05 03-fix ® 11 10-plex © 19 Low Level ❑ 24 Stanf Damage 46 04-plex 0 '12 12-plex P#t,,,_Y or ~ N ❑ 25 f scli,ane ous ❑ 31 New 0 35 !nt Irnproveinerd ❑ 38 Demol'csh (interior) 0 44 Siding 13 32 Addition 0 36 Move Bldg. ❑ 42 Demolish (Foundatim) ❑ 45 Fire Repok ❑ 33 Alteration 0 37 Demrtlish (Bldg)` ❑ 43 Reroof 0 46 W kkrv Coors ❑ 34 Replacement *Damoggan (Entire Bldg only) - GWe PCA handout to sppftant Valuation Occupancy - MCIES System - Emus Cole Zunhg city water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinktered Type of Const Width REQUIRE INSWECTtONS Foots (new bldg) - Final/C.O. Footings (deck) Final/No C.O. Footings (additim) - Pluming Foundation HVAC Drain Tile Other Roof Ice Water Final Pool Figs A,ir/Gas Tests - Fiwl Framing Siding _ shw-co _ Stone Fireplace _R.I. Air Test Final Wiu&ws (new/replwement) Insulation RetainiN Wail Appmved Sy Suik€ nq inspector Base Fee Surcharge Plan Review MVES SAC. City SAC Water Supply & Storage S&W Permit Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other - Total RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 551122 651-681-4673 NM c ru an ReaW • 3 registered site surveys shmNing sq. ft. of lot, sq. ft. of house; and of row areas • 2 copies of plan (20% maximum lot coverage aged) . t set of Energy Calculations for hued additions • 2 copies of plan showing bearer & window sizes; poked found desilln, etc.) . 1 site surrey for exterfor adMons & decks 1 set of Energy Calculations indicate I tame served by septic system for additions • 3 copies of Tree Preservation Fir N l pig after 7t1/93 • Ran Joist Dotal Options seleadw sheet (tugs with 3 or less units) DATE VALUATION SITE ADDRESS r ' 211 MULTI-FAMILY BLDG - Y 4:f-.~N TYPE OF WORK ' ~ FIREPLACE(S) - 0 1 - 2 APPLICANT G2! t-< ~hl'~l STREET ADDRESSCITY ✓lY. STATE-^' ZlPs~~'~` _ .r TELEPHONE #Z6' ` SY1-6,~jj CELL PHONE # FAX # PROPERTY OWNER r4 TELEPHONE # G5/ -P3;a .......................................s....................... r............ 0....... COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY I MINNESOTA RULES 7672 (d 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 Fee: $90.00 Water Heater Y No. of R.I. Baths No. of Baths \S) 001... Mechanical Contractor: P 4 9 Mechanical system includes: Air Conditioning Fee: $ .00 Heat Recovery System Sewer/Water Contractor. Phon I hereby acknowledge that I have read this application, state that the information is correct, and a with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applic OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received Not Required Updated 4102 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-piex ❑ 13 16-piex ❑ 20 Pool ❑ ' 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ piex ❑ 09 07-piex ❑ 17 Garage 0 22 PorchlAddn. (4-sea.) ❑ 33 Ext. Aft - SF ❑ 04 02-piex ❑ 10 08-piex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-piex ❑ 11 10-piex ❑ 19 Lower level ❑ `24 Storm Damage ❑ 06 04-plex ❑ 12 '12-piex 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 13 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demollt(on (Entire Bldg only) - Give PGA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length' Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.©. Footings (deck) Final/No CO. - Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pooh Ftgs Air/Gas Tests -Final _ Framing - Siding Siding ^ Stucco - Stone _ Fireplace R.I. Air Test Final Windows (new/replacement) Insulation Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total PERMIT CItY'dF EAGAN. 3830 Pilot Knob Road PERMIT TYPE: Permit Number: BU I L D I N G Eagan, Minnesota 55123 0 2 4 6 2 5 (612) 681-4675 Date Issued: 09/29/94 SITE ADDRESS: 4130 BLUEBERRY KNOLL LOT: 9 BLOCK: 7 HILLTOP ESTATES P.I.N.: 10-33000-090-07 DESCRIPTION: Building Permit Type GARAGE/ACCESSORY Building Work Type ADDITION usC occupancy M-1 Construction Typo V--N Square Feet 384 REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY VALUATION $7,000 Base Fee $90.00 Surcharge 3.50 Total Fee $93.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: JOHNSON CONST, MARK 14511676 0003288 KILBY KEN P 0 BOX 21327 4130 BLUEBERRY KNOLL EAGAN MN 55121-0327 EAGAN MN 55123 (612) 451-1676 T hereby acknowledge that. T hauve 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. APPLICANT/ MITEE SIGNATURE ISSUED B SIG TURET r INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 0 2 4 6 2 5 Eagan, Minnesota 55123 Date Issued: 09/29/94 (612) 681-4675 SITE ADDRESS: APPLICANT: LOT: 9 BLOCKS 7 4130 BLUEBERRY KNOLL JOHNSON CONST, MARK HILLTOP ESTATES (612) 451-1676 PERMIT SUBTYPE: TYPE OF WORK: GARAGE/ACCESSORY ADDITION INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTINGS FRAMING FINAL REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK F CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 9 c? / Valuation of work 660ati4 Site Address: 4*1'30_ 8jue_b(Sr,^V Knoll STREET ke, SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. P.I.D. # Description of work: Q_ Ada 1,44 C' V1 The applicant is: ❑ Owner ;KContractor O Other (Describe) Name _ kAsi Ank J_K.ep? Phone Property LAST FIRST Owner Address Z11,30 ! STREET \IJ STE # City r_-OwSS64 State mfU Zip 5 rl.?A Company Moir, s1 oG~~sov~ 62.1s74 Phone S/5/-/6 ?(o Contractor Address P.O. Qcak a / 3 a.7 License # 3Q 88'_ Exp. 3 -9 City a~ State 1"1V Zip SS/a f Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this apppplication 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: l OFFICE USE ONLY.. BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-flex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex IM 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-flex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add11 ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish 5~32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC OccupancyL 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump I of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Z Depth On-site sewage SAC Code _g 1 Census Bldg_ APPROVALS Census Unit _ Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ .Site Of Footing Framing ❑ Insulation ❑ Wallboard M Final ❑ Draintile O Fireplace Permit Fee valuation: g Z 0<4 Surcharge Plan Review License [1rAge r-~?dh Ya`/=~~ 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 % SAC Units Certificate for: Re ifelopers Const. , Inc. 1101 Cliff Rd. Burnsville, Mn. 55337. ?/¢r- DELMAR H. SCHWANZ LANOSURYEYOR 31 JQL. Registered Under Laws of The State of Minnesota 2978 - 145TH'STREET W. - BOX M ROSEMOUNT, MINNESOTA 56068 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE 902.6 SCALE: 1 inch - 30 feet o Denotes set wood hub -r i o Denotes iron pipe 17 Elevations shown are existing f~,•i$ 911.9 Drainage b M utility easement x9i3.I 9I0'1 14Proposed garage floor r 4f~~'y of t elevation Approved ror Dunn & Curry { Real Estate Management, Inc. s2o0 V S r r hereby certify that this is a true and correct representation of lot 9 Block 7, HILLTOP ESTATES, according to the recorded plat thereof, Dakota County, Minnesota. Also showing the location of a proposed 91S•O* house as staked thereon. r 9,4 q s Dated: February 2, 1984 /ZEaif€ - 9- 8 MINNESOTA REGIS RATION NO. 8625 i CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 NO 8820 PH, ONE: 454-8100 BUILDING PERMIT Receipt To be used for SF DWG/GAR Est. Value $ 110 , 0 0 0Date FEBRUARY 16 19-84 Site Address 4130 BLUEBERRY KNOLL Erectj Occupancy R3 Lot 9 Block ---7-Sec/Sub. HILLTOP EST. Alter ❑ Zoning Rl Parcel No. 10-33000-.090-07 Repair ❑ Fire Zone N/A Enlarge ❑ Type of Const V W Name DEVELOPERS CONST. Move p # Stories z Address 1101 CLIFF ROAD Demolish ❑ Length 70 r 9° City BURNSVILLEPhone 890-6194 Grade ❑ Depth 35 L Sq. Ft. SAME Approvals Fees o Name ou Address Assessment Permit $ 458-00 u~ 1`- City Phone Water & Sew. Surcharge 5 5 . 0 0 r Police Plan check 229.00 WW Name Fire SAC 525.00 15 Address Eng. Water Conn. 4 50. 0 0 <W City Phone Planner Water Meter 63.00 Council Road Unit 250.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable $2,030.00 State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to: D on the express condition that all work shall be done in accord a it a appli le of Minnesota Statutes and City of Eagan Ordinances. Building Official III S CITY OF EAGAN' Include 2 sets of plans, gg Z 1 site plan w/elevations?-o, BUDDING PERMIT APPLICATION 1 set of energy calculations._' • To Be Used For valuation Date A/z_ T Site Address OFFICE USE ONLY Lot Block Sec./Sub. ~-ect Occupancy 3 v il Alter Zoning Parcel # J d Repair Fire Zone Alid Owner: Enlarge Type of Const. Move # Stories _ Address: Demolish Front D ft. ft. City/Zip Code:. Grade Depth Phone #:j APPROVALS FEES Contractor: Assessments Permit Address: Water/Sewer Surcharge S6' Police Plan Check oZ City/Zip Code: Fire SAC Phone Eng. Water Conn 7 Planner Water Meter 3=° Arch./Eng.: Council Road Unit gro Bldg. Off. Address: APC City/Zip Code' Phone TOTAL . Q, h J" a/'r y f y t~ - , D 7 y j 7 Certificate for: Developers Const. Inc. 1101 Cliff Rd. 2 Burnsville, Mn. 55337 DElMAR N SCWWANz LAND SURVEYOR S! W L. Registered Under Law$ of The State of Minnesota 2076 - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 55069 PHONE 612 423-1769 SURVEYOR'$ CERTIFICATE , g0? 6 SCALE: 1 inch s 30 feet o Denotes set wood hub ' o Denotes iron pipe ' Elevations shown are existing 911.9 V, v Drainage "try utility easement i / x913.1 910.1 Proposed garage floor i, elevation I M PROPOSED NOUSF g~,4 qla f~ 04R Approved for Dunn & Curry sae, o M t I' Real Estate Management, Inc 14 1 fl I hereby certify that this is a true and correct representation of 9» Lot 9, Block 7, HILLTOP ESTATES, according to the recorded plat thereof, Dakota County, Minnesota, Also showing the location of a proposed 91'" 11 house as staked thereon, 904.9 X Dated: February 2 1984 r. r MINNESOTA REGISTRATION NO. $625 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: SITE ADDRESS: 'al CONTRACTOR: v% p DATE: ~ PHONE :dam DETERMINEWORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA „ , sq ft x 'lUll~'' 2. TOTAL ROOF/CEILING AREA, sq ft x "Ulf • a 3. TOTAL EXPOSED 14ALL AREA CALCULATIONS: Total exposed wall area above floor., sq ft a) Total wall window area. I glazed. , , , , sq ft ^x Ifuii glazed...... sq ft x ilUli a b) Total door area Zp sq ft x "U" c) • Total sl iding glass door area:' glazed.:.... - sq ft x ''Ull glazed...... sq,. ft x ilUn _ d) Total fireplace wall area so ft x "U" e) Total wall framing area / (Average 109;) sq ft x "U'l ZZ f) Total net wall area above floor (Insulated)........ ~ - sq ft x "U" e® g) Total rim Joist.area...... sq ft x "U'' .a Total foundat-ion area (Exposed)......... sq .ft h) Total foundation window area sq ft x "U",~ I) Total net foundation area above .9rade%.... . sq ft x "U" -4 4 TOTAL a) thru I) If'ltem #3 is the same as, or less than item fl, you have met the Intent of S.B.C. Section 6006 (c) 2. 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/cell Ing"area.....,.,, sq ft ) ~ Total 5kylight, area sq ft x '''U" J k) Total-roof/ceilinq framing ti. area (Average : tO9;) SQ ft x 1) Total net insulated~- roof/ceiling area. _14, _ sq ft x (lull TOTAL j) th ru 1)~ If total of is the same as, or less than #2', you have met the intent of S.B.C. Section 6606 (c) 1. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method,,the values established by the sum of Items #3 and #4 shall not be"greater than the sum of items #1 and #2. r i C E R T I F 1 C A T 1 0 N I hereby certify that I have calculated the "U" factors and "R" ,j values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. Signature (Date) . COIISI'RUr,T I ON R VALUE WALL FRAM I PIG SECTION:, • - I Interior 3ir film 0,68 i2 nc s soft wood 0 Exterior air film 0 17 TOTAL` R 1r U R WALL'SECTIOll (INSULATED) --(1 Interior;ai r f I I m f1;FAR" r , , • ---(t; Exter or ai r; f I lm 7 TOTAL R U a 1 / R RI K ;JOI ST SECT I ON Interior air film I a . . • I • .I Exter1oh a r fi lm 0, 1 7 TOTAL R - 1 a,- - A•` FOUNDATION SECT I ON -{1 Interior air film 0,(R 2 11 Exterior ai r'f i lm n,17 0 •..A' TOTAL R S - U -;1/R' SLAB ON GRADE y a X 14 i IV, CCILIHr~'SECT IOII (IIISULATED) l Interior air film (1.~1 .r--~ Z." 3 n 7xterior a r fi m k t f I I n.(1 TOTAL,R,_ U~.1/Rd~ CEILING FRAMING SECTION 2 5 .1 Interior air film O.f~l AIF~. VENTED 3 caz 6 6 FLOC b nterior`ai r fi lm sti l l 5 ~2i nche s soft wood TOTAL R U_ i/R CEILING SECTION (INSUL.ATED): " 0, 1 1' Interior a i r f i I m _ 2, 3. !i' F.xter' r air film stf11 0.61 r TOTAL R = U _,l /R 2 3 q 5 CE 14 I N, FRA14 I NQ SECTION: " 1 Interior air' film 0.61 VENTED 2 io. it film still n.01 i-nches soft wood TOTAL R = U = 1/R = 3 4 n t . ~ ~ - ! C u r ' s : , • ' - - ' ~ _ - 1 Inside a i r f i l m l--" 3 4 > /r, 0miztside air film n,17 I TOTAL. R A Lot Block Subd. L 4• ~ UNDERGROUND SPRINKLER SYSTEM PLUMBING PERMIT Date,-" Receipt Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If adding new service, a water permit will be required, as well. J Existing residential: $15.54 '(Plumbing permit not required if backllow preventor was previously installed) Residential develop: Fee to be determined by building inspections department. May require payment of water permit, plumbing permit, WAC, and water treatment plant fees. 4, 6e" (Address to be sprnklered Honecvnerfl'Ianbr: vX~ C, ty Phone m 'Street Address: 0oj 1-7 Alt, City, State, Zip: - o ~ tr r y, Owner Name: aG j Street Address;d Phone #sa a a Irrigation Contractor: `l OF, Phone I hereby owledge that I have read this application and state that the information is correct greet m ly with all applicable City of Eagan, Ordinances cc: Engineering Department 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN Ym 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauirements Remodel/Repair Reauirements 97 3 registered site surveys showing sq. it. of lot, sq. ff. of house 2 copies of plan and all roofed areas (2079 maximum lot coverage allowed) l ~ set of energy calculations for heated additions 2 copies of plans (show beam & window sizes: poured Ind. design; etc.) 1 site survey for exterior additions & decks ➢ 1 set of energy calculations 3 copies of tree preservation plan tf lot platted after 7/1/93 r7 DATE: `-t~ ZB-gG CONSTRUCTION COST: DESCRIPTION OF WORK: L. x a j ~ ~ay-d rA - r-cp a7- STREET ADDRESS: I_u ~A~?QJ1 J11_~I'lUU LOT: BLOCK: D SUBD./P.I.D. t fl Name: Ki 1W Phone L051- /4 2(0 20 PROPERTY Last T~ First OWNER "t~ Street Address: city State: Mr)- Zip: 55123 Company: M i (L-A.)e:2A' TLY- Nberrf Phone Wg - I Wci (area code) CONTRACTOR Street Address: - I, I ~Ll License #201 43~ Exp. !QM- city n5y~' I le State: Mrs- zip: o53-1 ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer & water licensed plumber (required for new construction onlv): Penalty applies when address change and lot change Is requested once permit Is Issued. I hereby acknowledge that ! 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 Applicant: )fin OFFICE USE ONLY RECEIVED Certificates of Survey Received Yes No MAY 18 1999 Tree Preservation Plan Received Yes No Not Required BY: OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 6 Fireplace ❑ 21 Porch (3-sea.) 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) 0 03 1 of plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened) 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 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 . 0 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 I Length sq. ft. -City Water Width Footprint sq. ft. Booster Pump PR V Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC CITY OF EAGAN Pag 1 of 4 PERMIT WORK WITHIN CITY ROADWAYS 1. Location 2. Nature of Work ' " 3. A construction sketch or plan shall show the location of the proposed work. A copy of the sketch or plan shall be provided with permit application. 4. Method of Installation or Construction 5. Work to start on or after and shall be completed by approximately c D 6. Will detouring of traffic be necessary? If necessary to detour tAraffic, describe suggested route: i DETOURS: The Director of Public Works shall be notified in writing at least 72 hours in advance of any detour being established, changed or discontinued. NAME OF APPLICANT A 4q LL-~~ PHONE a<~j PUML PRINT ADDRES&4 \ NAME OF PARTY OR ORGANIZATION PERFORMING WORK H ADDRESS PHON1 The undersigned herewith accepts the terms and conditions of the regulations by the City of Eagan as herein contained and agree to fully comply therewith to the satisfaction of the Eagan City Council. For: Title: Signed t Date: 1-3 `a IFOR CITY USE ONLY AUTHORIZATION OF PERMIT Fee: $ ~ekd Receipt No. Permit No In consideration of agreement to comply in all respects with the regulations of the City of Eagan covering such operations, and pursuant to authorization duly given by said Eagan City Council; permission is hereby granted for the work to be done as described in the above application, said work to be done in accordance with special provisions as hereby stated: APPROVED BY: DEPT. OF PUBLIC WORKS BY : `dam" DATE K C 'Tf L ALL LEGAL REQUIREMENTS SHOWN ON REVERSE SIDE AND ON "SPECIAL PROVISIONS" TO BE COMPLIED WITH! THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE EAGAN CITY ENGINEER. Page 3 of 4 c. Except for the negligent act's o-f -the City, its agents and its employees, the permittee shall assume all liability for, and save the City, its agents and its employees, harmless :from any and all claims for damages, actions or causes of action arising, out of the work to be done herein and the continuing uses by the permittee, including but not limited to the placing, constructing, and reconstructing, maintaining and using of said utility under this application and permit for construction. 5. Existing Facilities--The utility facility and installations shall not interfere with any existing utility facility on the City's right-of-way. 6. -Private Property--The work permit or permit for construction as issued does not in any way imply an easement on private property. 7. Quality of Work--Finished surface, base and sub-base of road upon completion of work shall be at least equal to or better than specifications of original road in accordance with City Standard Specifications. Surface shall be finished within 48 hours upon completion of backfill. 8. Cutting Trees--The permission herein granted does not confer upon the permittee the right to cut, remove or destroy trees or shrubbery within the legal limits of the roadway or relieve permittee from obtaining any consent otherwise required from the owner of the property adjacent thereto. 9. Drainage--All waterways and lines of drainage shall remain operative. 10. Pole Anchors--No pole anchors, anchors, braces or other construction to be put on roadway shoulder, except by permit authorization. 11. Driving Limitations--No driving onto highway from ditch or driving on shoulders or over curbs where damage will occur. 12. Lugs on Equipment--No lugs shall be used on equipment traversing road which will damage the road surface. 13. Clean-Up--Street surface and roadside shall be cleaned after construction is completed and left in a neat and presentable condition. 14. Trees and Vegetations--Burning or disking operations and/or the use of chemicals to control or kill trees, brush and other vegetation is prohibited without prior approval from the City. 15. Replacement of Sod--Wherever top-soil and sod are disturbed, they shall be replaced and maintained satisfactorily until the turf is established. The undersigned hereby declares he/she has read and will comply with all the PERTINENT REGULATIONS as stated above. DATE: t c~ SIGNED: lei ~dti~ ~~.,~,,.~.~,.:~,~-,:~.~~.~-.p~~~~.~:~.~a.~~,~R~.n~,7.,~~~...,x.,~.~,.-r.~ ,~--~,.~~st,u_~_ : ~,.~.s~~ .~t:..>. , .>A.,.,~~ v~, :z~~~.,,~~r:,,,~,~~., ~,~:~a~~~,.~,-:.~~,,~~..~~n,,...~~~ m .~..~.,~.w~ r~ , , t i i ^"a i Y r y, ren i . e.. ys+m° w., ~ ~l ~ ~ w. f ! ~a.e.».., ~ . ~ _ ~ ,..~w.,.,~. r r 6 ~ „F- , ~ ~ i ~ ~ ~ ~r i { ~ '1 t, t~ E 1 a ~ a.,~,,.~ LL,~..~r~ ~ M r W e .Hfwwww+d '..r...wwr~~p~ ~ ' 1 t { - e;. r.. E~ 111 r I# ~ 3 ~ 44 t 1 ~ i ti ~ ~ ti f } ~ 4 .f ~ , ~ 1 ~ i ~r ~ V' ~ i {1 Ma ~ 1 ( ~ w'~ ~ ~ . i° ~ ~ i t ' ~ ' ~1 ~ j . ~ , j ~ ~ 'k ~.R '~4,* ;,ry. _ - JJ~~~' ' e ~ r `~°oF ~ ~ ~ ~ fd F ~ ~ f P "ar Y l~l p. j~ J f ~ - !if 'Z~ r°t✓ ~ 1 ~ i.~ f A,. ' ~ Y ~J f ~ i ~ ~ i } . d~r ~ ,j~ f ~ P -s_ 1 i' lip i lL~' T i { f. ° i _ ~i" 7. _ p A;  P(I ~ { ~t i z 0 M, d - a~~ ~ ~ 1. ~ - ~ r 3 ~ ~ 1 ~~k,4 ~l ~q~~ u r 1'.. E~7 @} ~ e~~~,~~~ ,w-~- ~ ' ~ > >3 . j , i i f ~ _v.~ _.w W.,w q T ~ ti t ~ f _ ~ r~ s s a,T. ~ I / ~ ~~.r 1 j 1 ~ r"' ~ t .~yH~rv 1 r r p ~ _ a ~ ~ 1: t ~ ` j I f ...r _.p_.- i~ 4: ~ f ! ~ ~ _ ~ ~ 1 ~ ~ ~ ~ ~ ~ } i E 1 r h q1 1 + " ~ i 1i i i 111 4 ~ I', I t ' i r I. i i j ~ ~5 ,«:;r~ i f ~ is _ _ C ~ ~ ¢ ~ ~ f f ~ I r - i ~ _ _ i r ...~,.m.~,a . _ i a E ~ ~ { ~ a r _ _ _ Y ~ ~ ~ ~ y n. S A y1 t I! 1 ,~f - _ . n_ 9 _,w.. kf ~ ~ k f t n/' l` ~ f' t 1 Jnr A+M1V 1 ~ f e ~ ~ ,tt i t~ 'r' . ; , c _ - ~ r., ~ ~ ( /y ~ < f,; { ~Y;~ i '3l'am  i' i E t RAM Rim d PERMIT City of Eagan Permit Type:Building Permit Number:EA122712 Date Issued:05/16/2014 Permit Category:ePermit Site Address: 4130 Blueberry Knoll Lot:9 Block: 7 Addition: Hilltop Estates PID:10-33000-07-090 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Elizabeth Hess Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Kenneth Kilby 4130 Blueberry Knoll Eagan MN 55122 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA168787 Date Issued:05/04/2021 Permit Category:ePermit Site Address: 4130 Blueberry Knoll Lot:9 Block: 7 Addition: Hilltop Estates PID:10-33000-07-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace 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: 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 - Kenneth & Ann Kilby 4130 Blueberry Knoll Saint Paul MN 55123 (651) 328-1706 Sedgwick Heating & Air Conditioning 1240 Trapp Road, Suite A Eagan MN 55121 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA169836 Date Issued:06/10/2021 Permit Category:ePermit Site Address: 4130 Blueberry Knoll Lot:9 Block: 7 Addition: Hilltop Estates PID:10-33000-07-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Kenneth & Ann Kilby 4130 Blueberry Knoll Saint Paul MN 55123 (651) 328-1706 Sedgwick Heating & Air Conditioning 1240 Trapp Road, Suite A Eagan MN 55121 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature