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4138 Blueberry Knoll
PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA098425 Date Issued: 03/31/2011 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4138 Blueberry Knoll Lot: I I Block: 7 Addition: Hilltop Estates PID: 10-33000-110-07 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 openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BE - 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: American Exteriors of Minnesota LLC Wane B Gj-sland 1169 W Littleton Blvd 4138 Blueberry Knoll Littleton Co 80120 Eagan MN 55123 (303) 86-3328 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 l Oct. 4. 2010 2:07PM No. 6224 P. 1 Use BLUE or BLACK ink 1 I- 1 Permit of E qaIl I permit Fee: 3830 Pilot Knob Road 1 Eagan MN 55122 i Date Received: Phone: (651) 675-5675 Fax: (651) 675-5684 j staff: 201o RESIDENTIAL BUILDING PERMIT APPLICATION Date: 0400 Site Address: H m Q,J&OU, I } F - Tenant- Suite RESIDENT ! OWNER Name: S aj phone: Address /City/ zip: Applicant is; _ owner ✓ Contractor TYPE OF WORK Description of wor; Construction Costal X000 + Multi-Family. Building: (Yes _ / No l } (ACONTRACTOR Name: U + I.e Vt01( License U 1 Q pc 40 -1-1 Address: G ` 0L City: Ilk d ita) i -f r LP ~LP State: 0 Zip: , Phone: O Contact: ~-4'f✓ Email, 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 S Water Contractor: Phone: Bas ..........._..........1`IMntrrc'.:;::::::.::: ir'R.S.........._......,. , _ : :iYRbRR.G 4 CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 0 hours before you intend to dig to receive locates of underground utilities. www.aooherstal pg0U1 Lq 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 not to st ~ thout a permit; that the work will be in actor once with the ap ~ved plan in the case of work which requires a review and approv of p ns. 1 x X Applicant's Printed Nam AppllcirM's Signature Page 1 of 2 WATER SERVICE PEWIT r PFF7 EA6AN 3795 Pilot Knob Road PERMIT NO.: G Eagan, MN 55122 DATE: 11 26/79 Zoning: No. of nits: Owner:'` Op3 Inc. fTY3~3:LtCtCtT1Address: 4138 Site Address Blueberry nos , L11 B7 top a 8te& Plumber: QP-TtZ R An Meter No.: Connection Charge: 270.00 Rd Size: _ Account Deposit: .Reader No.: Permit Fee: 10-00 Rd 1 agree to comply with the City of Eagan Surcharge: .50 Ad. Ordinances. Misc. Charges: 60.00 pd 1net~r Total: By Date Paid: Date of I nsp.: I nsp.: N SEWER SERVICE PERMIT E 375 P"aat Knob Read PERMIT NO.. Eagan, MN 55123 DATE: 11/26/79 Zoning: No. of^Units: 1 e Owner:, Developers Cor4tr ct3mInc. Address: Site Address: 14138 B16pberr Knoll, L11 'B7 11top Estates Plumber. ,eriz F Tan RDJ109l79 1634 100.00 Pd agree to comply with the City of Eagan Connection Charge: 4.25.00 pd Ordir►spEes. Account Deposit Permit Fee: 1"), 00 cad Surcharge: . SUpd By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid IRWI months from red Date of this Request__ S 1 2 6 5 0 I, as ❑ Licensed Electrical Contrac or O Owner, do hereby request ' spection of the above electri- cal wiring installed at:~ Street Address or Route No. ~7` ~ ~ft/ ~ ✓ ~'L ~(~L~, City ~ -mil Section Township Range County 1ld Which is occupied by ~~ia c.•:'1J~©//~ u~/i-~ (Name of Occupant) Is a roughin inspection required on this job? No ❑ YesX Ready Now ❑ Will Call Power Supplier A6~~ Address . X 34010 Electrical Contractor M 4 S2%< !EG'VC C Contractor's License No. (Company Name) Mailing Address 12--Y,~7 A6614 ox Ac1E V ix f r Electric o cto r Owner Making This Installation) Authorized Signature ne-No. "'o ec rical contractor or O er Ing This Installation) This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity y vershy Ave., St. Paul, Minn. 55104-Phone 645-7703 / 10 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST S 12650 Type of Building New Add. Rep. Check Appliances Wired F r Check Equipment Wired For Home 19 ❑ ❑ Range Temporary Wiring Duplex Otl' ❑ ❑ Water Heater Lighting Fixtures Apt. Bldg. ❑ ❑ ❑ Dryer Electric Heating ❑ Commercial Bfdg. ❑ ❑ ❑ Furnace Silo Unloader ❑ Industrial Bldg. ❑ ❑ D Air Conditioner Bulk Milk Tank ❑ Farm , ❑ ❑ ❑ List b D , S P' Lpoist J~W Herehers Other ❑ ❑ ❑ Herers COMPUTE INSPECTION FEE BELOW ' . Service Entrance Size: # Fee F A!rs4, ub'feedars: # Fee Circuits: # Fee 0 to 100 Am s. 6 to 3), es 0 to 30 Amperes 101 to 200 Amps. 31 to peres 31 to 100 Ampere!- 2- S-02 Above 200 Amps. Al tAve 100_Amps. Above 100_Amps. Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fe Remarks S® TOTAL E f I, the Electrical Inspector, hereby certi t~t th has been e. 1 1~? (Rough-in) #,T~?Date (Final) Date ~F-a22 V, This request void 18 months from CASH RECEIPT CITY OF EAGAN , 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE ts 3 RECEIVED A r i , Y FROM AMOUNT $ & DOLLARS too CASH f~J-CHECK -J FOR PST! ~ l • 4,9 4~_ ~^'c..~-i K... ✓'/X~ e 711 FUND CODE _--I--.. AMOUNT ry ~Q de 4.. 9'x`1 a V ` Wf ite-Payees CopY- +J -YjI+ow--Post F,g copy nk-File Copt 16349 -n IMP ; 37#5 Poet xtwh P'0" PLUMBING - POW IT No. ,1559 s . 1, Date: 11/21/79 16774 ^ Site Address: 4138 Blueberry Knoll Singk Residentioi Lot _ 11 dock 7 Sub/Sec. _ Hilltop Estates p -Multi Rem, CiTAM./fnd. Name Developers Constr. IVewlAftar.~Rr ~eW m Address Cast Of 1 Eagan cry - - Phone: Permit Fee 06 Name (3en2 Ryan a - - Surctwrge Address - _ c• Rsmt City x This Permit: is issu-d 0,, the e - - ~ 'tea' ti ~i#~1+Rth cidi k ate. Minnesota Statures and City of Eagan Otd ck Act Off sMr4E slwft be dQ rid 4. yk+f 'dpi y.. r~ "uCK s',iW`~4Y.~~A`;ar.~- : ! ~,:e,Y.#1,~.+vri yr!~r.. ~.W At:s :,:+f?"l`~'~c w f M■ ' WT Lim"ice REQUIRED A' 379" W-t K.Mb Read r favor neseq 58122 'I HEATT Ci PERMrP No. 164 Z s 11/26/76 Dow. - Receipt t4cx: Y i Single 4118 Blueberry Knoll Site Address: _ Residential 11 7 Hilltop Est. Lot Block Sub/Sec. _ Multi Res:, Comm. ttnd: ]V" Developers Constr. Inc. New 'i Ntkne Neav/Air./i► t 4515 Oak Chase Rd. ti a Address cost at tn,sta Eagan - 20 OQ~ ~ 551231 City _ Phone: Permit fee yl Nome Home- Htg. & AC - , 5 0' Surcharge Address 5211 Eden Road Mound. MN city _ 411.4 This Permit_ is issued i+ the ~i E ` # egress G{~tt~#i ioNt thtW, 04 ,Work s # be doh i gin; +~rd * ~K Minnesota Statutes and City ofann C7rctKnores t - 8795 Plot Knloot~d EAGANMH 55122 ~Q 5471 * PHONE: 4548100 $U11.©ING PERMIT Receipt *14 ,l rY 4 ~;x Lrin Est. Value Date 19 To be coed for ~rq Site Address Kroll Erect Y20 Occupancy 11 7 F!T11 tcm F sty f~ Lot Block Sec/Sub.' Alter ❑ Zoning Parcel * % 37111f) 1_lr~ 1'? Repair ❑ Fire Zone Enlarge [I Type of Const. W Name 'RE'V it~4X?1 CkaZ`,at, , T"C• Move ❑ # Stories z A91 7, PST 3 Addre~ys Demolish ❑ front ft. O c3C! lII 55173 City Phone Grade ❑ Depth fi. Name gc"6 K' Approvals ,O Pees 174 ob Address Assessment Pernott U~ city Phone Water & Sew. Surcharge ~ 1.5 Police Plan check WW Name Fire SAC uG Address Eng. Water Conn,. U Planner Water r 6;-)° 1r3 City Phone Council t'oe, r'rd'- 7~7 hereby acknowledge that I have read this applicption and state that Bldg. Off. the information is correct and _agree to complgf with all applicable APC Total State of Minnesota Statutes and City of Eck' Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official A Permit # Dote Issaed Pennittee Plumbing fJ~ q / 7 _ Mechanical >~P ~oZ / i 7 qt_ e4& . S /,A & 5_0 INSPECTIONS DATE INSP. Rough-In Final Footings Date Insp. Date Insp. Foundation Plumbing = ? Frame/ins. Mechanical f/- Final Remarks: CITY OF EAGAN Remarks Addition HILLTOP ESTATES Lot 11 Blk 7 Parcel l© '~3 090 1-1 07 Owner Street 4138 Blueberry Knoll State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1336.72 0006542 9-26-79 1980 13-16,72 133- 67 1 STREET RESTOR. GRADING SAN SEW TRUNK 1973 172.14 8.61 2n 111-94 AQ.083-U- 9/26/79 * SEWER LATERAL 7 3450.87 A008339 9/26/79 WATERMAIN * WATER LATERAL * WATER AREA * STORM SEW TRK * STORM SEW LAT 980 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 75.00 16349 10/19/79 WATER CONN. 270.00 it it BUILDING PER. if 5471 SAC 525.00 16349 " PARK I 1 Permit 3-r)4 41 City ~ F of Eapn I Permit FeorOtlice"Usee: I 3830 Pilot Knob Road I I JIDL T_r_~fta_ Eagan MN 55122 i Da Phone: (651) 675-5675 Fax: (651) 675-5694 st 2008 MECHANICAL PERMIT APPLICCATIO Date: Site Address: ""t ~ Tenant: Suite RESIDENT/OWNER Name: 000, rv~ Phone: Address/ City/ Zip: CONTRACTOR Name: Lice s Address: City: i State: Zip: Phone: VA ~s 1 Contact Person: TYPE OF WORK New NL- Replacement. Additional Alteration Demolition Description of work: NOTE: Both roof mounted and ground mounted mechanicalvquipment 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 PERMIT TYPE Furnace New Construction Interior Improvement - Air Conditioner _ Install Piping Processed Air Exchanger -Gas _ Exterior HVAC Unit ' ' HVAC units must be screened Heat Pump _ Under / Above ground Tank Install Remove) Other " When installing/removing tank(s), call for inspection by Fire 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) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) = $ 00 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 $1,00142,000 Permit Fee requires a $1.00 surcharge). Vr~ $ 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 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 a approval of plans. MM S V X x Applicant's Printed Name App ant's Signature Reviewed By: Date: FOR OFFICE USE Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test -In-floor Heat -Final CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 NO 5471 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # Y To be used for 5F Dwlg & Garage Est. Value 87,000. Date 10-19 , 19 79 4138 Blueberry Knoll R3 Site Address Erect XM Occupancy R1 Lot 11 Block 7 Sec/Sub. Hilltop Estates Alter ❑ Zoning Parcel # 10 3300 110 07 Repair ❑ Fire Zone Enlarge ❑ Type of Const. V Name Developers CAnSt. Inc. Move ❑ # Stories i Address 4515 Oak Chase Road Demolish ❑ Front 81 ft. 18 City Eagan 55123 phone 454-1004 Grade ❑ Depth 28 ft. Name Same Approvals Fees 0 01 Address Assessment Permit 196.0 ut- City Phone Water & Sew. Surcharge 43.50 Police Plan check 98.00 ~WW W Name Fire SAC 525.00 Address Eng. Water Conn. 2 0 00, a W City Phone Planner Water Meter 60.00 Council Road Unit 75.00 1 hereby acknowledge that i have read this opplic tion and state that Bldg. Off. the information is correct a ree to com with oil applicable APC Total 1,267.50 State of Minnesota Statutes an City of E Ordinance Signature of Permittee A Building Permit is issued to Ve OpeYS COI15tY11Ct1 Onr Inc. on the express condition that all work sholl be done in accordance with all a licable State of Mtpnesoto Statutes and City of Eagan Ordinances. Building Official ~n CITY OF EAGAN~ Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. ~J y To Be Used For Valuation ~ Date Site Address: -{/3e? 2L11,4- I ^'OZZ- OFFICE USE ONLY Lot dock sec./sub. ,%f c erect Occupant' J 71 Parcel Icy e) ~A2 C; 7 Alter Zoning j - Repair Fire Zone - Owner; `AI- Enlarge Type of Const. Ll Move # stories Address: 04,< Demolish Front l ft. City/Zip Code: 6,-,Wf V -~f-,3 Grade Depth ~ ft, Phoebe /O 0 -I'S11- APPROVALS C-t Contractor: 'A 9I~v a V,!5-r Assessments Permit Address: Water /Sewer Surcharge 41J Police Plan Check City/Zip Code: Fire SAC Eng , Water Conn. ? o Phone Planner Water Meter Council Road Unit 7S Arch./Eng.: Bldg. Off. Address: APC City/Zip Code: Phone 'DOTAL l ~ ~ . ~ ~ ~ / . ~ .S C% EXTERIOR ENVELOPE THERMAL TRANSMITTANCE PAGE 1 STANDARD WORKSHEET Site Address f 101-L Owner Contractor e!?,,41\/97- Phone Date 0 - - Building Type (check one) One and Two Family Neliing ~ Other Assembly (Describe type from Table ? or Area (A) U-Value U x A show calculations on Paoe S Ft) r~, / s Insulated Area ~3 Framing Area v. Sk lights Tv e o+ _ Other describe Y v Other describe 1 Totals ZE- 2 Average U-Value, UxA / A from Line 1 ****~"k 3 R uired U-Value from text Insulated Area Framing Area. Windows, Type- Doors, Type 77 f -5- 112.,;~ - Rim Joist Area ® 070 oz- . j i Fireplace Wall A a Foundation Wall a5ove rade 67, ai a Foundation Windows, Toe Otter (describe) Other describe Other (describe) 4 Totals -7Y-5z. 5. -717,63 5 Average U-Value, UxA / A from Lire 4 6 Reouired U-Value from text / If Line 2 is greater than Line 3, or Line 5 greater than Line 6, complete the followin to determine alternative U-Value for total exterior envelope. 7 Area (Lire 1) + Area (Line 4), + 8 UxA (Line 1) + UxA(Line 4), + 9 Area (Line 1) x U-Value. (Line 3) x _ 0 ai ~Eiede~feeae Q W 10 Area (Line 4) x U-Value (Line 6) x s (d, , Y 11 "Budget", Line 9 + Line 10 * 0 F' 12 Alternative U-Value, Line ll/Line 7 If line 8 is greater than Line 11, a];-er assemblies as required so Line 8 does not exceed Line 11. Material describe Tic -ess R -Value Material describe Thi knes~- F 77 /-90 CIA" 141 2- 60 Interior f-Value see Table 2 Interior f-Value see Table 2 Exterior f-Value see Table 2 Exterior f-Value see Table 2 Total Assembly Thermal Resistance Total Assembly The „al -Resistance Assembly U-Value see Table 4 Assembly U-Value see Table 4) Enter on Pa e 1-~ Enter on Pace 1 -i - -Assembly ALL , ssemb v Z- Material describe Thickness -R- lue Material describe Thin ess R-1 ue /YZ ~,~~~a✓~ ~~r~= p~~ ~~?~i~l~ ,;rte ~ Interior f-Value see Table 2 Interior f-Value see Table 2 Exterior f-Value see Table 2 Exterior f-Value see Table 2) 1 .77- Total Assembly Thermal Resistance Total Assembly Thermal Resistance Assembly U-Value see Table 4 Assembly U-Value (see Table 4) Enter an Pace 1 K Enter on Pave 1 , Assembly =717: ssembly A i Material describe Thickness R-Value ! Material describe Thickness R-'/al6_ Interior f-Value see Table 2 Interior f-Value see Table 2 Exterior f-Value see Table 2 Exterior f-Value see Table 2) d7l Total Assembly Thermal Resistance L Total Assembly Thermal Resistance 3 Assembly U-Value see Table 4 Assembly U-Value see Table 4) Enter on Pace 1 Enter on Pace 1 9 7 Assembly ssem Material describe Thickness R-Value Material describe Thickness P,-'la1-e Interior f-Value see Table 2 Interior f-Value see Table 2) Exterior f-Value see Table 2) Exterior f-Value see Table 2 I , To-.-al Assembly The <<ai Resistance Total Assembiv Thermal Resistance i Assembly U-Value (see Table 4) Assembly U-Value (see Table 4) Enter on Pace 1 Enter on Pace 1 J Certificate far. 1-Devtelopers Const. Inc. B 3z ~j9 4491 ;yak Milse. lane Eagan, Mn. 55123 DELMAR H. SCH tZZX1' LAND SURVEYOR Registered Under Laws of The State of Minnesota 1978 - 146TH STREET W. - SOX M ROSEMOUNT, MINNESOTA WW8 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE ~ r. V 1~v -j4 Y "'r pi V to c x X`y' N •%1-•~L? I 40 V r Y I t ~ Au W ` '•tk SCa1e4.1 n t ~f /Y r > . l ? FIevatlons shown are exlst;ing .Proposed garage floor oor S ~qs I ~ R \ u" t~ 4a I N Approved for Darin 'k Cu*,ry t s is _ true >nt c.)r-t;t~ \ Peal i e M<ks~.k;era~ j '4 n%,' r f t : i r z_ f !,o t i I r 7 r ?i14: , jtl .,f`t!'ror+s? $ w):.i.~C f _ r `l 5 Ma '~;r ~c far' house s 'A MINNESOTA REGISTRATION NO. 8625 _________________1 J For wee. US I CityOf E*,dl,n i Permit#: 030 1 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: j 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 2 ,2, / I Site Address: ~ ~ J ~ " I" J l (,C_Q h PAY r Q kY1dkL - j Tenant: Suite RESIDENT/OWNER Name: IaA'd Phone4S I - &8(o --75-7 Address / City / Zip: t" -415513 - CONTRACTOR Name: License D S AM P-M4 Address: k 1 4 -City: Stated / 1~ Zip: 6'b42-73 Phone: ) Contact Person: TYPE OF WORK -New _Replacement _Repair -Rebuild _ Modify Space - Work in R.O.W. Description of work: 11~-,IA PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ / _ PVB) Main X- Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES. $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge) "Water Turnaround (add $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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 appa;4061 x 110 x App lica Printed Name Applicar#j Signature FOR OFFICE USE Reviewed Sy: Date: Required Inspections: Under Ground Rough-In _ Air Test Gas Test Final 17131 Use BLUE or BLACK Ink 1 For Office Use 1 ` j Permit j CI ~ sz>j itof Eap 16, , Permit Fee: Y6 1 3830 Pilot Knob Road IRI-- i S"IT~Z 1 Eagan MN 55122 Mp~ I Date Received: 1 Phone: (651) 675-5675 i staff: 11K I Fax: (651) 675-5694 1 1 J/~ / 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~ 1() I2 Site Address: Unit /Z &-elvtlu Z~~/ / Name: Phone: (PSI -4,4 9 Q I e~_7 RESIDENT / . ' J OWNER Address / City / Zip: Applicant is: Owner Contractor r TYPE OF WORK Description of work: J ` Construction Cost: DO `7 Multi-Family Building: (Yes / No Company' _ Contact. IL r CONTRACTOR Address: 1 City: 2"&7IM664 State: Zip: Phone: License 3~L662a~ Lead Certificate #-/UT- z?yZ:~- 6 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: MOTE. 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 speck 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.aooherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. n x x inlr Applicant's Pnnt Name Applicant's gnature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA154946 Date Issued:04/19/2019 Permit Category:ePermit Site Address: 4138 Blueberry Knoll Lot:11 Block: 7 Addition: Hilltop Estates PID:10-33000-07-110 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Wayne Tstes B Gysland 4138 Blueberry Knoll Eagan MN 55123 (612) 309-2862 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature r For Office Use �. ) , f orEAG UV * � r 1-r Permit#: N Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionst cityofeagan.com f_ `/Y �(/ 2019 RESIDENTIAL BUILDING PERMIT APPLICATION 5 Date: Site Address: G ` 38 " 1I4 e 6 terry -k\ t( Unit#: Name: 1/1(°k-7/1 f, 675 1-0,`ti V Phone: Resident! / S(7-14,1 f' owner , Address/City/Zip: Applicant is: Owner Contractor Contractor WDescription of work: '`Qa or'e-a 0l r-e (etc-to Typeof work lD Construction Cost: J QMulti-Family Building: (Yes /No >4 ) Company:60 !"�aK yr £"o 'e 'S (-au f ac4•`� Contact: J�t v- Address: / 7513 F 6o�v C City: far .7Q 1-491.1 Contractor / / rqv ,,J Statel�� Zip: S�'Dol� Phone:6` /. / ` �3 Email: License#: v /700 6(( Lead Certificate#: If the project is exempt from lead certification, please explain why: r(� icl15- 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: Fire Suppression 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 ff you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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.orq 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 • - . x S 1*'t l gorn x 4 Applicants Printed Name Applicants licant's Si natu pp PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA173233 Date Issued:11/04/2021 Permit Category:ePermit Site Address: 4138 Blueberry Knoll Lot:11 Block: 7 Addition: Hilltop Estates PID:10-33000-07-110 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner 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 - Wayne B & Guadalupe B Tstes Gysland 4138 Blueberry Knl Eagan MN 55123 Bonfe's Plumbing & Heating 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature