4724 Bristol Blvd
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INSPECT
? CIT"? OF EAGAN
3830 Piiot Knob Road
Eagan', Minnesota 55123
(612) 681-4675 ,
SITE AQDRESS:
%/
i
• ii; ,' ? ' " ? .'Plli
` PERMIT SUBTYPE:
<<,
ON RECORD; . . .
PERM[T TYPE:
Permit Number:
Date Issued:
TYPE OF WORK:
I "fb,iy,°
I t',! ,kt1
tr'7;?,1 I'i I'1(? ??j;•,i.?;?I
F7
Permit No. Permit Holder Dete Telephone #
S/W
PLUMBING
HVAC
ELEC R t[OI?CI , ?? f?
ELECTFtlC
ingpection Date insp. Camments
Footings I
Foundation
Framing
L
Rqoting
Rough Plhg.
'
2-1 ' -72
Rough Htg.
isUi. 9,- ?
Fireplace
7 l .t?fli!
Final Htg.
Orsat Test
Final Plbg. Pibg. Inspector- Nviify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp,
#l/?- 705;I-(?f5/ '' /40.%"f/t) -- f /I °/r-/ -??
wert[ftCQte of, CCC1tpQnC4 ? ..
? Cft#4 of CfRgRIt .
? Mepartmett# of ls? uilb' aui$Pectinn
This Certffeeare issraed pursuant to the requirements of the Unifarm Suitding Code
certifying that at the time of issuance this stnecture was in campliance with the various
ordinances of tfte City regulating building construction or use. For the following:
Use Classification: S,'' DW Bldg. Permit No. 22656
? 0ecupancy'1}'pe R3A11_ Zeming District RI Type Consi. VN
Uwnerof BuiWing HOWS }Y CHASE Address M W Cy TED 42, 8'VUJP
Sailding Address ?.? Localit?LJ3a B4? ? HI.1,? 2ND
Date: Mf ?AK
8u7ding Official ?
l
POST IN A CONSPICUOUS PLACE
4
?',''N4^'I v
q 1 I
I ?
1,?1 . . . . ? .
I . L
Address 4724 s?uslXL aa,vu Zip 55123
Lot . 13 Blk 4 Sub taESreN tmTS 2rm
THESE TI'EMS WERE / WERE NOT COMPLETE AT TfIE TIME OF THE FINAL INSPECI'ION.
Date: 02/04/94 Yes No Inspector:
Final grade (6" from siding) t"',
Permanent steps (garage) A, A
Permanent steps (main entry) ?
Permanent driveway
Permanent gas
Sod/Seeded gtass V?
Ttail/curb damage ?
Porch ?
Basement finish ?
Deck ?'
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply [o
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contraclor Copy w
?s 8 V s
"°? ?
5
a
?
Re`u et? ?
,
/ Fi No Rough-?n I13pec0on
Re9wred? NOTICE: Vou Must Cell ElecVical Inspeclor
II A Rou9h-In Inspection
Yes ? No ?a Reqwred.
I,P?licensed contractor ? owner hereby request inspection of above electncal work at:
Jab Atldress (SVee4 x or RaNe Na.)
y 7 g Ciry
Sechon No. Township Name or No Ranga No Cou2ly
Se
Occu nt (PRIM) Phom FJO i/?3
4s
Powe'rnSupplier AdEress
?
tlx- Ok? ?a.a
'
Electr cal ConVacror (COmpanC ypm?l Co/nt?actodr's Li/c/e'n?se No.
Mag tlress (C treclor or OWner aking In aileLOn)
?. I
AWhonzetl $igneture (ConVactorlOwner Making InstellaLOn Phone Number- ? J
Y ?Q
MINNESOTA 3TATE BOARD OF ELECTFICITY THIS INSPECTION REQUEST WILL NOT
Griggs-MWway Bldg. - Poom 91]3 BE ACCEPTED BY THE STATE BOARD
1821 Ilniversity Ave., 51 Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone(81Y)6020800 ENCLOSED.
r
? REQUEST FOR ELECTRICAL INSPECTION
? See insimdions for completing ihis krm an back of yellow copy
M 6 7 28 'X" Below Work Coverad by This Request
EB-00001-OB
co ? I CY ? C i ;?,?
ew Ad . ep. TypeoiBUilding AppliancesWired EquipmenlWired
Home ange Temporary Service
Duplex Water Healer Elechic Heatm
Apt. Building ry¢t Load Management
COmm./InduStrial maCe Other (Specity)
Farm Air Conditioner
Olher (specily) ConhactorS RemaNS:
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fea # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ? o to 700 Amps 60
Transformers A6ove 200 _ Amps Above 100 _ Amps
Sigfls Inspector5 Use Only TOTAL ) J
trrigation sooms
lJ ; G D
?Si ,?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ERED DISCONNECTED IF NOT
O[her Fee COMPLETED WITHIN 16 MO
I, ihe Electrical Inspector, hereby Rough-in oa? y
J
certiy that [he above inspechon has
been made. oale Jc/
?
OFFICE USE ONLY
This reduesl wid 18 months from
PERMIT
CITY aF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 0 2 2 6 5 6
(612) 681-4675 Date Issued: 12 / 0 3/ 9 3
SITE ADDRESS:
4724 BRISTOL BLVD V6
LOT: 19 BLOCK: 4 LC?v
?I U
WESTON MTLI.S 2ND
DESCRIPTION:
Biff'R Permit Type
9 ltiLd3.fi8. rk Type
Bc 0cVuPa?r1lit
Corrgt,ruatgbrol.1 e
SF DWG
NEW
R-3 M-1
V-N
R-1
50
53
???? ?? ??C; (a n
REMARKS:
PRV
SUMMARY:
S& W PLBR - VALLEY PI.BG
Base Fee
Plan Review
Surcharge
5AC
SAC %
SAC Units
Subtotal
VALUATIOM $129,000
$741.00 MISCELLANEOUS 1 744.50
$461.65 ToCal Fes $9,7,81.65
$64.50
$750.00
100
1
$2,037.15
AM£S'"SRTQHRSE PP
?I 18955337 0001619 t{b)f* 'BY CHASE
2500 W COUNTY ROAD 42 260 2500 W COUNTY ROAD 42
BURNSVSLLE MN 55337 BURNSVTLLE MN 55937
(612) 895-5337 (612)895-5337
` s liere•by .ttis? I havs road th4a,
i,nfarmativ;n Is. c.orract ans# M:n,
statukoe anid Ci?y- of'?»gart: acxiIrlatiatt_? ? s
L -- ~- -- .. _ _ , ..._ _ . ..: ., . .. . . , ? .._.. _ ?
Am 6 .
APPLICANT/PERMITEESIGNATURE fSSUEDB .SI NATURe
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: g u r Lo r NG
3830 Pilot Knob Road Permit Number: 0 2 2 6 5 6
Eagan, Minnesota 55123 Date Issued: 12 / 9 3/ 9 3
(612) 681-4675
SITE ADDRESS: Lo r: 13 B l 0 C K: 4 APPLICANT:
4724 BRISTOL 6LVD HOMES 8Y CHASE
WESTON HILLS 2ND (612) 895-5337
PE gMITt?GUBTYPE:
TYPE OF WORK:
NEW
INSPECTION
FOOTIIVGS .. •
FOUNDATION ..
'
FRAMING ROOFING
INSULATTON FIREPLACE
RQUGW IN PLBG ROUGM IN HTG
FINAL PLBG FINAL
ftEMflRKS: PRV S& W PLBR - VALLEY pLBG
F...,..
REACTIYATE CITY OF EAGAN .
PEP)IITd t!?I? 1993 BUILDING PERMIT APPLICATION
lil_ 0 1993 681-4675
?
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 6 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not pitked 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 _1? /o- eYaluation of work 2 Pd
Site Address:
T? STREEi SU[TE /
Tenant Name: (commercial only)
IAT ?_ BLOCK SUBD. P.I.D. M '
Descri tion of work:
The applicant 9s:; Own r Contractor ? Other coe.«tbe> _
Ph
ne
o
Name
Property LAST FIRST
??Ic`
Owner 4
Address r?'>?SD(7 T? C 14?u le,4-
STREET STE M
City ? i.0 " ,?.r State Zip
Company Phone
C011tf8Ct0r Address zzeLl? License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration N
Addr ss
City State Zip
Sewer 8 water licensed plumber ? . Processing time for
sewer & water permits is two days once are has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and a9ree to comply with a applicable State of Minnesota Statutes and City of
"
Eagan Ordinances. /
Signature of Applicant: G
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 OI Foundation
V 02 SF Dwg.
O 03 SF Addition
O 04 SF Porch
O 05 SF Misc.
O 06 Duplex
? 01 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
WORK TYPE
IB 31 New
O 32 Addition
? 33 Alterations
O 34 Repair
r o.
? il Apt./todging C3 ,46-hsem9?t-fM sh
? 12 Multi. Misc. O 17 Swim Pool
? 13 Garage/Accessory 0 18 Comm./Ind.
? 14 Fireplace ? 19 Comn./Ind. Misc.
O 15 Deck ? 20 Public Facility
0 21 Miscellaneous
O 35 Tenant Finish ? 37 Demolish
0 36 Move
GENERAL INFORMATION
Const. (Actual) v- n1 Basement sq. ft. MWLL System Yoi:.
SAllowable) v- N lst fl. sq. ft. City Mater ?
UBL ccupancy ? M-4 2nd F1. sq. ft. PRV Required .y ss
Zoning Sq. ft. total Booster PumP
#? of Stories
_
_ Footprint Sq. ft. Fire Sprinkler
Length eo
? On-site we11 Census Code o/
Cepth 5 3' On-site sewage SAC Code ?
APPROVALS .j
?
Planning Building Assessments
Engineering Yariance
REGIUIRED INS PECTiON S '
? 4ite ? Footing ? Framing ? Insulation
El Wallboard ? Final ? Draintile ? Fireplace
Permit Fee v.iuacim: g ? Zq, O3a --
Surcharge
Plan Review GAR?GE! ?2xz^c.%??l?/
License ?6?
MWCC SAC
City SAC
Water Conn.
(3SMT ; ??? X
I6 =?(? 5? ff
Water Meter
Acct. Deposit 22x25% 55-b X!5= 4?2 Sa
S/W Permii 1
5/W Surtharge IST Fi.,oR ;
Treatment Pl. -'------
Road Unit 155m i= y3b
Park Ded. fl
Trails Ded.
ies
Co ax?o. ?o
p
Other .2 yY3*= F7 32
Total : i x 12 = i2.
1
?
31?l
`71
SaC x ?04 .?
,c55
? ,
SAC Units Z ?N ? ?o/L I
31?/z_XaU: 75?
Ix ii_
5N
r
?6 g x
S,UFiVEYOR'S CERTIFICATE
I 3
414
?
.?
I?
o?
941,8
?
??eye 4
EwcHMARc i_C;r I e
Or oF PIPE
Lfiv. - 94398
17,8.64 N61°
I 7 a9 A:i •+rN
N 7 -.
10
1 t4,7
I?
I
u"
>1 l1R
10
• r, n ?
rro.
?
?
7OR ENCH K
f OF PI
ELEV.. 94R.
07' 30" W ?.
94.3
N
84 4, a{
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?
? po
v Q ,
?san,?
I
1
IN I
I
t- 10
963.? p
N4T°oT???? ~
c? w ?-
?
944,9
W
N
z _Cy r i 2
N
N
d?
?
(iL94S,3
li oRa v a nL?- WRED D_
: BULDINO oIr«o+aIor+S 3HU//N MRE WR MIDR(xONTAL NOT C' jUMNEEN CAMPt,ETED
A V6RTICAL' LOCATIO N O P ' 9 T WX' f U Rg ONL Y 9EE, O N T H I B l. fl T B Y J A M E 9 R. H I LL, I N C. T H E S U I T A B I L I T Y O F
.6 FOUNOATiGN
qHpH176CfUAl, PIANS FbH BVIlDIN0 801L8 70 SUPPORT THE 3pECIFIG HOUSE PROPOSED 19
i
DIM6N9tON4, '
?---T-- UtNU'ltS F'F?UI'UStU SUNFACE UHAINAf?t N01' THE ptESPONSIBl1.l1'Y UF JAME6 R. HILL? INC.
O DENOTES IRON MDNUMENT SET SCALE- 1 INCH m 30 FEET
9 CENOTES IRON MONUMENT FOUNb PROPOSED GARAGE FLOOR -3r,f5:. 8 FEET
X000,0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 90 ?•z FEET
BLOCK - 9?`• ? FEET
(000.0) DENpT@5 PROPOSED ELEVATION ,
PROPOSED T?OPR?OFE
WE HEREBY CERTIFY TO HUMES 8Y CIiASE THA7 7HIS IS A TfiUE AND CORRECT
AEPRESENTAT{ON OF A$URVEY OF THE BOUNDARIES UF;
L01 13, Bkx:k A, WESTON NIt,LS 2ND ADDITVON,according Io ihe recortled plat
Ihereot, Uakota Couniy, Mimiesoto.
I7 bOE5 NOT PURPOp7 TO SHOW IMPROVEMENTS OR ENCROACHMENjS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 17TIi bAY OF NUV, , 1993.
PtaoPOSEU GRApE3.SI10WN wERE 51GNED: JAME5 , HILL I C.)
TAKEN RROM TW@ aReotN6 PIAN
FOR WES70N HiLLS PREPAREp BY
LYMAN DEVELOPMHNT, CO, BY;
QARY R. HARRIS, IAND SURVEYOR
• MINNF-SOTA LICEN3E NUMBF-R 10943
-i inc.
James R. Hil l
,
a ?O
? ?? V
?
PL.ANNERS / ENGINEERS / SURVEYORS
?
- o
• m 0 6 ? 2600 W. CTY. HD, 42 9 BURNSVILLE, MN. 66337 & 872•880•8044
0.I
; C a
. ?
? m
4c F
Z ?
LOT BIIRVEY CSECRLIST FOR RESIDENTZAL
SIIIL
pROPERTY LEGAL•
entry,
?? • Registered Land Surveyor signature and company
p
0 • Building Permit Applicant
B?p
?,e? • Leqal description
?
[i" O • Address
6-'0 El • North arrow and bar scale
0`113 13 • House type (rambler, walkout, split w/o, split
ff--b0
• lookout, etc.)
Directional drainage nrrows with slope/gradient $.
0[3? 0 • Proposed/existing sewer and water services
0'0 ? • Street name
8`10 0 • Driveway
ELEVATIONB
Existina
13 0% • Sewer service
@' 0 13 • Lot corners
?
0' ? • Top of curb at the driveway
???
D 0' ? • Elevations of any existing adjacent homes
Prooosed
LF-13 ? • Garage floor
U? ? 0 • First floor
Q-?? ? • Lowest exposed elevation (walkout/window)
0 • Property corners
0 0 • Front and rear of home at the foundation
PONDSNG AREAS (if aDplicable)
0 Cr'13 • Easement line
0 Q' ? • NwL
n g,0 • xwL
p • Pond # designation
D 0 • Emergency overflow Elevation
0'0 0 • Lot lines
C3??] p • Riqht-of-way and street width (to back of curb)
D? 0 0 • Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
/ structures requiring permanent footings)
? D 0 • Show all easements of record and any City utilities within
those easements
p ? • Setbacks of proposed structure and eetback of adjacent
existing homes
0 D • Retainin 4 wa ents, if any
Reviewed: III- 4TO ? 7.L-
OCtober 1992
Date of 8urvey: 44/44 9' t
?------
coniunc11o it1 uniEi j) -=- - ? -_
:
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bEiEnnniE. uoul:Iun su.unnE roorna 6 o F Encii:
1.. IoInL ExPUCEU 1lnll. nllEn........... .Z sq rt x "U".
7.. 1(?lAl Iloo('/CCIIIIIC AIlCA.......... ^sq ft x "U""
f. 1ofAl EXI'USGU IJALL AIIEA CALCUlATI011St ' :.
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sq .ft . , .
h) lotol fnunJatlon
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windoar urea..... 6064066, sq f t x 'lUn "
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If'Iteln r) Is tiit-t smlla as,• or lels thon Itr.m AI, y oo lio ve it+et lhc Intcnt of .
• ."..II.C. Sectlon 60416 (c) 2.
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'lolal expnsr.J , . .. .' .
Iuof/ccillni1 nren??,???„ ---/? sq
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nLlElUlA1E bVIlU1118 EIIVELUP C• I1C 511:11 , . .
tl llzo lhr. tntol c11veloVc System melhod,, Uie vnluCS .eslabllshed by the swn .?
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tc???s pJ ond Fh shall not bc grester thon the smn nF .
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I hereby certiCy?thnt ( I?eve cnlcvluled U?e "U" factore ond '?n??
ucs I?crcin ?md ll,ot ll?a bullcllnrl l,erC descYllied mects nr exccads llle Sl»te
Hirinesota Eticrny f.onsnrvatlon Act. , - ,
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VENTED
LON:,rRUCTION R VAIUC
,CEILIlIf SECTIOI1 (IIISULATED):
• 1 Interior alr f11m (1.F1
2 s
? g-vo
air ftim still) n.r1
TOTAL R - ?,?V
CEILIN6 FRAMING SECTION:
1
2
3
5
CEILI!:r ;ECTI011 (IfISULATEO):
I' Interior eir film n.FI
2
3
b fxterT^r i r i m stl 1 0- 1
? . ..
TOTA R -
U- 1/Ro
U- 1/R
?
CEILiNr, FRAN117r, SECT1011: •
1• Interior air fflm 0.61
z
3
4 F.xtcr or air film still n. 1
5 Inches soft wood
TDTAL R ?
1
2
4
5
Inslde ai? ??1•
U a 1/R -
n.Fi
Outslde nlr (il.. n .17
? TOTAL R ?
.'
U a 1/R - ,?Z
FlSTRUC710f7
AMING SEC?ION:
R VALUE
t.
""" "CTION (INSULATED)
Inter(or alr fitm
m
TOTAL R
U ° 1/R ° ..Uly
ST SECTIqIl:
Interlor alr fllm f1,6R
i PO
fG ..'C. ??
Z?Fn?SV,+. )''c • 4? l
Exterior a r film f1.17
TOTAL R n ?
Um 1/R?tU?f/
ION SECTION:
Interior atr film n,(,R
i ? 'r G oa?, A/oc1? /.?€
Exterior alr film 0.17
TOTAI R n ./
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PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
RTEW CONSTRUC.'TION
ADD-ON A/C
ADD-ON FURNACE
DATE 14:? -8-cl C`13
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@ 53.00 EACH)
ADD-ON/REMODEL (Exis'r'nvG CoNSTRUCTION) $ 15.00
STATE SURCHAf2GE .50
TOTAL S??SD
STTE
OWNER NAME: 5 ?? t . Ca ?LEPNONE #: 49 WSTALLER: ?p-,Y??
ADDRESS:
CTfY: ?Fv,`( W? ? STATE: _ ?\J ZIP CODE: ?
TELEPHONE #: "4??0 -tocl)2:Z
1993 MECHANICAL PERNIIT (RESIDIIVT7AL)
CT1Y OF EAGAN
3830 PILOT KNQB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOIvES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf.
VLO. FIXTURES -ACH TOT?
1 SHOWER 3•00 ?
? WATER CLASET 3•00 9
BAT'H TUB 3.00 3
3 LAVATORY 3.00 9
KI'I'CHEN SINK 3•00 ??-
, LAUNDRY TRAY 3.00 .3
' HOT NB/SPA 3•00
? WATER HEAT'ER 3•00 z
FLOOR DRAIN 3.00 3
GAS PIPING OUTLET • minimum • t 3.00 ?
ROUGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVATE DISP. • neiLay. uG 15.00
U.G. SPRINKLER • eome unaor mnsi. 3•00
ALTERATIONS • to cucting 15.00
WATER TURN AROUND 15.00
STATE.SURCHARGE .50
3
TOTAL: ? . T"
STI'E ADDRESS: U 1 3 q 6 rc z, Ao l a S- cf
OWNER NAME: r i. .?
INST.
C -
ADDRESS: CI? (? (c
CTTY: STATE: G"` - ZIP CODE:
PHONE #: ( ) '-f 4 a - ),- k a ,
C,cLZLL
SIGNAT OF PERMITTEE
1993 PLUMBING PERMTf (RESIDEIVTIAL)
C11Y OF EAGAN
3830 PIIAT KNOB RD
FAGAN MN 55122
(612) 681-4675
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA105417
Date Issued: 07/13/2012
Permit Category: ePermit
Site Address: 4724 Bristol Blvd
Lot: 013 Block: 004 Addition: Weston Hills 2nd
PID: 10-83751-04-130
Use:
Description:
Sub Type: e-Windows/Doors
Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434 -
Occupancy:
Zoning:
Square Feet: 0
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection.
Comments:
Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $4K $103.25 0801.4085
Fee Summary:
Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00
Total:
$105.25
Contractor: Owner:
- Applicant -
Property Claim Solutions LLC Douglas E Kaudy
2005 Pin Oak Dr 4724 Bristol Blvd
Eagan MN 55122 Eagan MN 55123
(651) 994-2028
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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113587
Date Issued:09/05/2013
Permit Category:ePermit
Site Address: 4724 Bristol Blvd
Lot:013 Block: 004 Addition: Weston Hills 2nd
PID:10-83751-04-130
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
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 -
Douglas E Kaudy
4724 Bristol Blvd
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA166434
Date Issued:01/11/2021
Permit Category:ePermit
Site Address: 4724 Bristol Blvd
Lot:013 Block: 004 Addition: Weston Hills 2nd
PID:10-83751-04-130
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 -
Douglas E Kaudy
4724 Bristol Blvd
Saint Paul MN 55123--398
(651) 402-0552
Blue Ox Heating & Air Llc
5720 International Pkwy
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature