4733 Bristol BlvdCITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE:
I I . ;+;ilba... '1 o
TYPE aF WORK:
f ; N :# i
I
Permit No. Permit Holder Date Telephone #
ELECTRlC
PLUMBING
HVAC
Inspection Qate lnsp. Comments
FOOTI NGS
FaUND
FRAMING
RDOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL ,
GYPBOARD
FIREPLACF
FIREPLACE
AIR TEST
FINAL PLBG
FINAI HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECIC FfG
DECK FINAL
1c1Tlr'0F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
#733
;. PERMIT SUBTYPE:
i
i.
1?CORD
PERMIT TYPE: -
Permit Number: '?7 ? •' ? ? '
Qate Issued:
t:?i?,, r, E APPLICANT: -
TYPE 4F WORK:
INSPECTION .. . ..
i% el it #, `; i' I' 11
Ld t'I hk - F:,lirF; t 1'N F`i_l.to
'VI
,- ? -
.
. ..-. . ?......,a _:: r'.r . _., ..?? - - ` - . .
Permk No. Permit Holder Date Telephone M
S/W
PLUMBING 3 W
HVAC 8 9 9?9-?l?
ELECTRI
ELECTRIC
Inspection Date insp. CommeMs
Foatings I `-9 f r?
f '
Foundation ?74 1/ A,?
Framing
9lQ'Y
?
Roafing
Rough Plbg. -a2?-%Z/
Rough Htg.
I5ul. ux 3/?olq 4??,Q ?Q
Fireplace R
Final Htg.
Orsat Test I?
Fnal Plbg. Pibg. Inspector- Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
i?0[
Deck Ftg. L
Deck Final
Well
Pr. Disp.
a
:`
4
WCL`tif[CQte nf CCCupQnC?
WU4 of Wagan
Teoartmen# of ZKilbarg ;3ai6Vetrian
This Cenificate issued pursuant to the requfrements af the Ureiform Building Code
eertifying that at the time of issuance this structure was in compliance wiih the various
ordinances of the City regulatiag building construction or use. For the following:
Use Classification: .S'R BW Bldg. Permit No. 22893
pocupancY Type R3h1?_ Zoning Distria R I Type Const. VN
Qwner of Buifding TNMAAR FIM C1 Address ?? ? ?Bwy g MGM
BuiWing Addmss ,1a733 ERTS".fYX. RT VD Localiry 1,5- BL, VESI1'N HI7I.S 2ND
[ate: U ???/X ??•/?
offi
POST IN A CONSPICUOUS PL4CE
Address 4733 &tIS10L ffiAD Zip 5512 3
Lot, . 5- Blk 1 Sub wFSrotv = 2rID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 04 18 94 Yes No Inspector:
Final gtade (6" from siding) V/
Permanent steps (gatage) ?
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
Sod/Seeded gtass
TraiUcurb damage ?
rorcn
Basement finish V ??Z
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shuhoff of water supply to
the outside lawn faucet before freeze potential exisis.
Contaa engineering division at 681-4645 before working in right-of•way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
(3?-/y 01Faillf irv
N 24 3 5 , ?
c?n? ?'p 00
Request Oata
?
?
^ Flre No Rou
gh-in InpSecLOn Reqyiretl
('IOU m?.u?syt call im0edor when reaUy)
IrispecUO? Other TM1an Rough-ln
? qeady Now ? ill NotiFj InSpecWr
'
9 10??es ? Na Date Reatly
IAi,iicensed contractor ? owner hereby request mspechon of above electrical work at:
Job Atldress IStreel Box or Rou[e No ? qty
Secoon No Township Name or No Rarge No Counly
OccupantlPRINT7 Phone No
? /'?
? y?/ r4
Powr5oi ? AOtlress ulf
17r ?.?0
"OTA c te? ?5-c Zo - ,?
Elemncal onvactoleCwnpany Namg) ConVactor's License No
Mailing ADOress (GOnirector or Owner Making
-
9 Inslallation)
1
4o i 5
ANhonzetl Siqnatu IGOnire riOwner Making Ingall on? P?orre NumDer
?t&-3y7
MINNESOTA STATE BDARD DF ELECTpICITY THIS INSPEGTION AEQUEST WILL NOT
OriggsMlOway BIOg. - qoom 3-1]3 BE ACCEPTED BV THE STATE BOARD
1821 University Ave, St Paul. MN 55106 UNLESS PFOPER INSPECTION FEE IS
PMne (812) 662-0800 ENCLOSED
3/8/c's y? / REQUESSFOR ELECTRICAL INSPECTION i.?4?'.?'d?'l3l0
?* ' ?
? See insvuni ns 1or completing this form on back ot yellow copy
,443 ? X" 8elow Work Covered by 'fhis Request %MV
ew Add Rep TypeofBuiltling AppliancesWired EquipmenlWired
Home Range Temporary Service
Duplex Water Heaier Electric Heating
Apt BuAding Dryer Load Management
Comm.llndustnal Fomace Other (Specity)
Farm Air Conditioner
Other (syecdy) Conbactork RemaBs
?yGKZ? CC /s rs FAWO 3 .
Campute Inspechon Fee Below
# Other Fee # ServiceEntranceSrze Fe uhs/Feeders
Circ Fee
Swimming Pool 0 to 200 Amp i00 Amps
0 to
Transformers Above 200 _ Amps Above Amps
Signs . Inspeclor§ o TOTpL Sa
' Irngation Booms
Special lnspeaion
Alarm/Communication THIS INSTALI.ATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 THS.
I, the Elecnical Inspector, hereby Rouyn,,n G Y.
Atfaaa?
certity that the above inspection h
been made F,nai oare
,
OFFICE OSE aNLY
This repuest voitl 18 montM1S lrom
0 -
?? 09 F11
0? ($?0 °N
/JA
.?
I
01
Requetl Date
3o C
Q Fre No ough-In Inspedion Reqwretl
(Y°u mustcell mspaclor en reatly) Ins ion Olher Than Rough-In
eatly Now ? Will Natlfy Inspecmr
-
_? ? Ves Na e Read
I ' ensed contractor ? owner hereby request inspection of above electrical work at:
Job tldress (SVael, Box or Route NoJ
4733 Brisiol 'Ovid Ciry
Seclion No. TOwn3hp Nam¢ or No Renge No County
Occupant(P I ) ? r?
?
? cW/?V `(?Y
Phone No. c?(
Povrer Supplier AtlCresa
ElBdncal Con[2clor (COmpany Name) Contradots License No
Harrison Electric, Inc. CA 00808
Mailing Address (COntredor w O.mer MaWng Installation)
Nevada Ave. N., #301, Go den Valley, MN 55427
Authometl ig ature ConlraclodOwn ng st lation) Phone Number
544-3300
MINNESOTA $T BOAHD O ELECiP ITY THIS INSPECTION PEOUEST WILL NOT
I
II BE ACCEPTED BV THE STATE BOARD
Grigga-Midway Bitlg. - Xoom 5128 I
11111
1111111111111
1821 Universiry Ave., SL Paul, MN 55109 ? UNLESS PROPER INSPECTION FEE IS
.
ew....e.a." uv.nnnn
.
? ruri nccn
REQUEST FOR ELECTRICAL INSPECTION EB-ooopo?t-
?, / 10. See mstmc6ons for completing Ihrs form on back of yellow copy
"X" 8elow WnT1c CaAered by This Aequest
Ne Add R. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt. Building Dryer Load Management
Comm./Industnal F ace Other (Specify)
Farm -I Air Conditioner
Olher (specify) ConVacror's1Remarks
Compute Inspection Fee Below: v 0l? ? ?? qll
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 ta 200 Amps 0 to 100 Amps
Transformers Above 200 Amps A ve 100 -Amps
$I IlS InspecYOr's Use Only TOTAL
Irrigation 8ooms j
Special Ins ection
Alarcn/Communication THIS INSTALLATION MAY BE O D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
h
i RougMn Da[e
certify that t
e above
nspection has
been made. Fina? oace
?y
OFFICE USE ONI.Y
This request vatl 18 monNS hom
ia?('? -s
------------------
; ?n ?7 ;
j Permit#:? v?lY`?? j
? Permit Fee•. l v ?
? Date Received: j
? I
I Statt: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: (;?' d-,9---0 `-' Site Address: 4-131BrC?D5 ? vck
Tenant:
Suite #:
RESIDENTlOWNER Name:Jckin 11'aWLisVetS Phone;t4P_C4^0eb"0?k1
Address / City / Zip: J+_?W k"J< <5id a 01 @&YF_`1y._?1C-L3
Applicant is: _ Owner _i, Contractor
TYPE OF WORK P
Description of work: V_ejA
,
Construction Cost t (l , ?0 ?? Multi-Family Building: (Yes _ / Nak
CONTRACTOR Name: (Y1Py^ U1 64, Caxtaous, V/1C- License #: QLW199A%3
Address.aq(pC? au'd(CCLi (r? ? `?(f?
City: Rc.1f V1SL??fz State: MN Zip: _(-?5?-?
6Ctfwl `4L
q5
--?()-?" b`5?-) C
n
dP
Ph
t
a
erso
:
on
one
a
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Calegory t Worksheet • New Energy Code Worksheet
C8t0g01'y Submitted Submitled
(4 submission type) • Energy Envelope Calculations Submitted
In the last 72 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 Contrector: Phone:
Sewer & Water Contractor: Phone:
NOTE:BIansand'suppAYfln?d¢ctrrnedF'sthatqotrsubmftaYecpn?s7d'ere[?tc?be?zFrblrele?r,r?afio1-1111 n1?'ar=hans??f ?
the inlormahorrmay be 6fa5?+fled as hon p?(b/rc;rf you1prourd0 spectli? rea?tS?? if;ia? kt+at?ld,permit #fiB?Cl?y ta ? _:
?,
'
`
'
esecr?ls
?'Yco?ncl
4???ha[wxhe ace,f?ad
u
I hereby acknowledge that this information is complete and accurate; that the work will be in coniormance with the ordinances and codes of the Cily ot
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to slart without a permit; that the work wiil 6e in
accortlance with the approved plan m the case of work which requires a review and approval of plans.
xbC4'LGt iiz?2V- x
Applicant's Printed Name ApplicanYs Signature "
Page 1 of 3
12713
?-----------------
? ;
?
j Permit
? Permil Fee:
I ?
? Date Received: ?
I ?
I ?
I StaH: ?
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant:
Suite #:
SIDENT/OWNER ;Name: o? o Phone:,? ? lr?r?d-??
Address / City / Zip: -1,7??
Applicant is: _ Owner _25? Contractor
TYPE OF WORK Description of work:
Construction Cost: C6 ? Multi-Family 8uilding: (Yes No
CONTRACTOR Name: \ E'Libense#: Zb/(oci'3??
Address:2
Ciry: State: "r h Zip: S S/Z 3
Phone: clS7_ - 7,07-lol"`S? Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Venfilation Calagory 1 Worksheet • New Energy Code Worksheet
Category submtned sutmined
(4 Submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master pian?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Coniractor: Phone:
NOTE: Plans and supporting docurrments thaf.you submitare consideKeB.to be;pu611c In/orr»ation. Portlons of. ,
the information may be classified as non-public,if'you provide,sp'eclfic:xeasoias.that would-permit:fhe City to -;
oonclude thatthe .?ce trade secrets r._
1 hereby acknowledge that this information is complete and accurate; ihat the work will be in conformance with Ihe ordinances and codes of the Cily ot
Eagan; that I understand this is not a permit, but only an applicaiion for a permit, and work is no[ to start without a permit; ihat the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
(.?t w??
X`?(u.VIC, Sd/L(c ep?lr xh
ApplicanYs Printed Name ApplicanYs Signature
Page 1 oi 3
( . I
`l
. `? D CCGC?M?
0 2o08 D
Cl •ty of Eapn JUL 3 D
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
pS - 05 Ctc.ve,e(?
?----- r ------------ I
?-??7
j Pertnii8: v
? Pemiit Fee. ' ? (? , ?
?
? Date Recei
I I
i stan: i
i
-----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -71,7014o eRSite Address: 4?/' _T
Tenant:
Suite tl:
RESIDENT/OWNER Name: /a`iN t- X/IDndy %^ck0?2f Phone: QS2 (V-OdLlfi
Address / City / Zip: V,77-7 /?re f A / !C4
o
Applicant is: _ Owner -/- Contractor
TYPEOFWORK ?k&/i e.4 /Q 1nG?v'4 9 P IV
Descriptionotwork:
_
Construciion CosL• /R 1t?X 21AI-L iM Multi-Family Building: (Yes No 41
CONTRACTOR Name: lan.rE! License #: 2 (Z!Z 6
Address: A0 5!
City: ik^ r' -//0 S[ate: z? Zip:
r ?? P[?
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 7 Worksheet • New Energy Code Workshee[
Category submined subnmea
(4 5ubmiSSion typ9) • Energy Envelope Calculations Submitled
In the last 12 months, has the City of Eagan issued a pertnit far a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contrector: Phone:
Sewer & Water Contractor: Phone:
NO7E: Plans and supporting documents that you submit are considereaf to be publi'c iniormation. Portions of
the Pnformation may be classlfied as h6n-pub7ic 1P you provlde'spect8c reasons tha"{ woufd permlt the City to
conclude that the are trede secrets.
I here6y acknowledge that ihis information is complete and accurate; ihat the work will be in conformance wi[h the ordinances and codes ot the Ciry of
Eagan; that I understand Ihis is not a permit, but only an application for a permit, and work is not to staA withoui a perm@; that the work wlll 6e in
accordance with the approved plan in the case of work which requires a review and approval ot plans.
x dei^-
ApplicanYs Printed Name Ap nt s i atUYe
Page 1 of 3
. SUB TYPES
? Foundation
? Single Family
? 01 of _ Plex
? 02-Plex
O 03-Plex
? 04-Plex
WORK TYPES
? New
? Addition
? Alteration
? Replacement
DO NOT WRITE BELOW THIS LINE
? 05-plex ? 16-plex ? Accessory Building ? Pool
? 06-plex ? Fireplace ? Porch (3-season) 0 Eut. Alt. - Multi
? 07-plex K Garage ? Porch (4season) ? Ext. Alt. - SF
? OS-plex ? Deck ? Porch (screen/gazebo/pargola) ? Multi Misc.
O 10-plex ? Lower Level ? Storm Damage
? 72-plex ? Miscellaneous
? Interiorimprovemen t ? Siding ? Demolish Building*
? Move Building ? Reroof 0 Demolish Interior
? Fire Repair - ? Windows 0 Demolish Foundation
? EgressWindow ? WaterDamage
' Demolilion (entire building) - give PCA handout to applicant
DESCRIPTiON:
Occupancy MCES System
Valuation I&Q-V Z)
Plan Review Code Edition SAC Units
(25%_ 100%- )C.) Zoning City Water
Census Code .;tgq Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. ? Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
? Footings (addition)
? Foundation
Drain Tile
? Roof: _Ice & Water _Final
,(Framing
Fireplace:_R.I. _AirTest _Final
Insulation
Reviewed By:
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Sheetrock Meter Size:
F1naIfC.O.
Final/No C.O.
HVAC
Other:
Pool: ,Footings AidGas Tests Final
Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall
Building Inspector
Page 2 of 3
k41,
# engmaer??y..
Certificate of Survey for:
House Address:
. Mode1 Name:
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. 900.0 penotes Existing Elevatton PROPOSED HOUS vAl10y •
•(JE?D Danotea Proposed Elevntlon Lowest Flool' Elevatl o : R3G.6
Denotes Dralnoge & Utllity Easement Top of 81ock Elevoti :`??.,] .
Denotes Dralnage Flow Direction Garage Slab Elevati q",3 '
:
--o- Denotes Mohurnent i _
-Q- Denotes Offset• Hob gaorings shown are assumed ? • '
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1 huepY C1r1NV that tAb sUnwK Vlan er nporl wn, pr.ppW bY m* a umitr mY tliral aDervlsion snd !Ml Ia dul
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AW
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT CP-612414
PERMITTYPE: suzLoiNG
Permit Number: 026961
Date Issued: 01 / 16 / 9 6
SITE ADDRESS:
P.I.N.: 10-83751-050-01
4733 BRI3TOL BLVD
LOT: 5 BLOCK: 1
WESTON HIILS 2ND
DESCRIPTION:
(GAS LINE ONLY)
B"uilding-Permit Type fIREPLACE
!6ui`lding Wa_r_k Type ALTERATION
?.
?"'Census Code ? 434 ALT. RESIDENTZAL
....?
j
\ t
REMARKS:
FEE SUMMARY:
Base Fee $25.00
5urcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - OWNER:
GAVIC & 50NS PLBG 17556468 MACKOVETS JON
12725 NIGHTENGALE ST NW 4733 BRISTOL BLVD
COON RAPZDS MN 55448 EA6AN MN
(612) 755-6468 (612)688-0864
! L .,
I hereby acknowledge that I have read this application'and state tfiat the
i,nformation is oorrect and ag_res to ooartply;w3th all applicable State af Mr.
Statutes and City of Eagan Ordinances.
L _.. . _...,_. _ . . . .. b .. . . . , . ,. . __ . ,?. _. ,. _ , fl n R,?r fm?
APP ICANT/PERMITEE SIGNATUFE - (TSSUED BY SIG TURET-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number: 026961
Eagan, Minnesota 55122-1897 Date Issued: 01 / 16 / 96
(612) 681-4675
SITEADDRESS: P•I•N.: 1e-83761-e5e-e1 pppLICANT:
LOT: 5 BLOCK: 1
4733 BRISTOL BLVD GAVIC & SONS PLBG
WESTON HILLS 2N0 (612) 755-6468
L
PERMIT SUBTYPE: TYPE OF WORK:
FIREPLACE ALTERATION
DESCRIPTION (GAS LINE ONLY)
? L' CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122
1996 FIREPLACE PERMIT APPLICATION
687-4675
DATE: Z"/fa ? / rv
DESCRIPTION OF WORK: _ INSTALL bpN FIREPLACE: _ WOOD BURNING _ GAS
INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER: z? S ?
AREA TO BE INSTALLED IN: 15??ame11-'" r.
STREET ADDRESS: 51;7?3 ??'5?? J
LOT Z BLOCK SUBD./P.I.D. #:
APPLICANT: (circle one only) OWNER
???y, I._& 2
ONTRAC
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 5tatutes and City of Eagan Ordinances.
PROPERTY
OWNER
FIREPLACE
INSTALLER
GAS LINE
INSTALLER
Name:Z??4u??c Phone
u., ?.,
Signature:
Street Address-
Ciry:
Company:
Signature:
Street Address:
City:
Company .4
City: ? • Zip:
Name`:
Signatur .
Street Addres • ???°
Phone #:
License #:
State: Zip•
? Phone #• ??- 5/4?22
State:
i
State:
Zip: ? Y
CITY USE ONLY
L S BL ? RECEIPT #:
SUBD. ?004t? IJA DATE:
1995 MECHANICAL PERMIT (RESIDENTIAL)
?? ? y? 5?aQ o? CITY OF EAGAN
I? 3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -t675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on fumace
? A,rd-on air conditioning Add-on air excnanger, i.a.'v'anee sysiem, etc.
ll ?-ennoK'?-Sa9--ail /??L
Date: C") / o? ? lc?5
FEES
? Minimum Fee: Add-on/Remodel (existing residence anly) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL aQ5 d
SITE
OWNER
•?a?n?anpsa
INSTALLER NAME: ?????•-
PHONE #:
Si LOUIS ppW , MN 55428
STREET ADDRESS: ????? SMMEMAO, 1
CITY:
STATE: ZIP:
PHONE #:
ST
? ?-Q? ?
? CITY OF EAGAN
3880 Pilot'Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BuILDING
W?2F393
02/69/94
SITE ADDRESS:
4733 BRISTOL BLVD '
LOT: 5 BLOCK: 1 'WES'PON WIL LS 2ND P,I,Nee 10-83751-056-01
DESCRIPTION:
BK1i1CGin?_, ermit 7ype
,„;?t?ixd$rqg "rk Type
??? Y=:4
8•ua,ltf'i,v7V #JidtH'
R(? J
'a?°'t"a-cGl4?U??'• ??e•? lv"?51
v?
n
6 ? kOf?
f
SF DWG
NEW
Rw3 M-1
V-N
R-1
1
48
45
cotV og aagcin
REMARKS:
PRV
FEE SUMAAARY:
S& W PLBR - BJORLIN PLBG
F3ase Fee
Plan Review
Surchargs
SAC
SAC %
sac units
Subtotal
VALUATLON
$702.50
$456.63
$59.0@
9:800<00
100
$2,01$.13
$118.000
MTSCELLANEOUS
7ota1 Fee
_??$1_ ,828.50
$3,845.63
i
CONTRACTOR: -
ROmAft HOMES CO
1801 OLD HWY 8
NEW BRIGHTON MN
(612) 484-4049 Applicant - ST, IIC.
14844044 0081281
116
55112 OWNER: '
ROMAR HOMES CQ
1801 OLD HWY
NEW BRIGHTON
(612)484-4044 '
8 116
MN 55112
I}+ereby ackrt•awje tYrig
dge that T fiaAv?- r-ead
iE1f01'It1at3'9n 15. GT7 ,
Y`7'eUt SJX1d -35;F."eie,-t'd :G4khply? t3l't''i f4l,? :v
5tatUtEiC S77CI CLty Of Es'Mgc'in GF".Bii'a27PlG.`2'w.`.
4
L . __. _ _. _ ..._ . . k _ ._ . ..._ __._. _. .. . .. . ,_t ... ., ? ?.._ _J
_ .<..
? C
APPLI ANT/ ERM
?. SI ATURE ISSUE :
j- S URE
_--
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: RuzLor.Nc
3830 Pilot Knob Road Permit Number: 022893
Eagan, Minnesota 55123 Date Issued: 0 2/ 0 9/ 9 4
(612) 681-4675
SITE ADDRESS: APPLICANT:
Lo r: 5 B L 0 C K: 1
4733 BRISTDL BLVD ROMflR HOMES CO
WE570N HILLS 2ND (617) 484-4044,
PERMIT SUBTYPE: TYPE OF WORK:
5F DWG NEW
INSPECTION
FOOTINGS ., .
FOUNDATION
i
?
FRAMING ROOFING ?
INSULATION 1=IREPLACE ;
ROUGH IN PLBG ROUGIi IN HTG ,
FTNAL PLBG FINAL
REMRRKS: PRV
F-'
I..... . _ _ _ _ ' "
S& W PL6R - BJORLTN PL6G
o.
r . - ,.._
• - -??<< - - - - - -
?.'..
REACTIYATE _
P6RMI'f iqtt
' SIMGLE 8 MULTI-FAMILY
COMMERCIAL
CI7Y OF EAGAN
19WBUILDING PERMIT APPLIrAT10N?
44 681-4675 j
rr. ^P. jQ1 ! JAN271994
2 sets of plans, 3 registered site surveys, 1 copy of-
calcs.
2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested once permit
Date 4A Yaluation of work
Site Address• "k33
STIIEEi fUITE •
Tenant Name: (commercial only)
lAT ?B1AC& ? SUBDy ?Q?(?ON \N--? P.I.D. N
?a+ `C?i7fl\`C\OP?
Descri tion of work: 0z-
The applicant is: 1$(Owner atontractor O Other co..«iee>
Property
Owner
Name S?rc?E. R'? Phone _
LAST FtRST -
Address
City
State
Zip
Lompany , Phone ??k- y.0LL
COMfBCtOr Address License Exp
City State ?V-) Zip
Architect/
Engineer
Company
eiE r
Phone
Name Registration f
Address
City
Sewer 3 water licensed plumber',"?..,?c? ?tv
sewer 8 water permits is two days once area
Zip
Processing time for
I hereby acknowledge that 1 have read this application and state th;at the information is
correct and a9ree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
s1R¢er
State
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
lp 02 SF Dwg.
O 03 SF Addition
O 04 SF Porch
0 05 SF Misc.
0 06 Duplex
? 07 4-Plex
? OS B-Plex
? 09 12-Plex
? 10 Multi. Add'1.
woRK nrae
Ca 31 New
? 32 Addition
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
?* '
? ?a ,
? 11 Apt./Lodging;=? A°0. BasemPnt Finish
? 12 Mult1. Misc: " &17'Vwim Pool
O 13 Garage/Accessory ? 18 Coma./Ind.
? 14 fireplace O 19 Comm./Ind. Misc.
? 15 Deck ? 20 Public facility
O 21 Miscellaneous
? 35 Tenant finish E3 37 Demolish
O 36 Move
Const. (Actual)
? Basement sq. ft. 3 9 Z MWCC System
(Allowable)
? lst Fl. sq. ft. 13 8 ? City Hater
UBC Occupancy / 2nd F1. sq. ft. PRY Required
Ioning ? Sq. Ft. total Booster PumP
1' of Stories Footprint Sq. ft. Fire Sprinkler
Length YP On-site well Census Code
Depth .33 On-site sewage SAC Code
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
O Wallboard
Building
Yariance
M Footing
0 Final
0 Framing
O Draintile
Assessments
Jc-
T_
?
%.
0 Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
CoPies
Other
Total:
SAC %
SAC Units
Wmtim: Ilte- G
3sG1 N F;ti,
z 55. ?
2 ?13 -7
? 3k y = sZ
38y
l Dk z c? =
lod?,6 xls = /?
??y er
-'zx z. y c /Od8
? yx y = 5 a
?rr 2?? 2 23 x/6
.....?---=
117??/l ?G )
r 3 2f%s`2z 14?
** ** .
* PIONEER ?Q p+p
* eng * eer ng.. L'"°'"`""
* ?c *
Certificate of Survey for:
House Address:
. Model Name:
r . ?
?
?
740.e
Yp?
94ac? ?
. r?
q, ? \
?
Y ?
\
% / ?7• -Vo
9'+? n
i ?
x
? / ro
0
N/
,.-
?
c N
o
i J AT a? i
v I ,
,
ti•;
-• •4/.I9• _ ' w ---?--- ------_ 9.9L?? ?/o,
? ^----
c EAGAN
RENIE'WED
B? . ` _
2 ' 72-) y_.,.
?
4a?,9s ` - y9.o?f
` ?8• 48 ---
,?dt't7'ero•00
913.oa '
0
?Z.
? I
1
I
r ?
?
EERINDEP7: i
ZL
?.
wo?ka.?r Eie?
• afto Oenotes Existing Elevatlon PROPQSEQ _FioUS
•Q Denotes Propoaed Elevotlon Lowest Floor EleVattc
_-- Denotes Oroinoge & lltility Easement Top of Block Elevottc
Denotes Drainaye Flow Directlon ?
-o- Denotes Monument Garage Slab Elevatic
-e.- Denotes Offset Hub Beorings shown are assumed ?
LOT 5, BLOCK I,_ WfSW Hit25 P.aAOD
OAKCTA COUNIY. MINNESOTA i
1 MnpY prtlly that thh wrNy. Olan M rport wn pnpered by mm, vr under mY dlrKl wpeMAOrk ond MH 1duly
unda tM lavw of Mo eon of Minnaou. Dsted iMt.EZLN dri ol A.O, i6
. ' . . -? /
Scale: 1hcl- 30 tfti '
aoecrtr D.
.
?
taza e
Ma?da
(6)21
i
i
?
?
!
?
rlse or?y.
ghu, MN 68120
191-
?
7 •
?
? ? .
\ •
\ X?4Z•? T?s???.s
IO +?'?
?8
°u
?y
al?z
3•
. !
941. 5
VAT10N •
i: 93"
1:9A4•3 ?
?pbdrW LeidSurwYw
?
I?f?i I'f?RC., AY
' LOT iIIitVEY C8ECICLZST !OR RLBID "LNTI7IL
? aIIILDIDt pERM2T A? LIGITION
PROBERTY I.Z6AL= ?
?
? ? • Date of iurveys
DOCIIMENT 8TXND B
I-11O D • Asgistered iand surveyor siqnature aad coapany
? D • 8uilding Permit 7lpplicaat , '
0 • Leqal description
F G • Addrass
G • North anow and bar scale •
DID 93 • Houss type (ramblez, vaikout, split .v/o, split entry,
lookout, stc.)
? 0 • Directional draiaage orrowa with slope/qradient t.
D 0 • Proposed/exi:tinq srwer and vatar services
8? D • Street name
? 0 • Driveway
ELLV]?TIONS
fl ?D
• Lxistiae
Sewer ¦ervice
Ci' 0
D? D D
D •
• Lot corners
Top of curb at the driveway
F?D 0 • Elevatfons of any existir,g adjacent homes
D
?
0
• 4ronosed
Garage floor •
PI
D 0 • First floor
Hr0
F D
D •
- Lowest axposed eievation (valkout/wiadow)
Property corners
D • Fzont and raar of home at the loundation
49NDING f1REA8 (if annlicablo
D ? p • ?Lement liae
a B' o ? xwL
D ?_? • pond y desiqnatioa
D L? U • Emerqerfey Overflow Eiovation
DZlSETIiBioHB
0?0 0 • Lot lines
D??0 0 • 8ight-of-way and street widLh (to baek of eurb)
lY D 0 • ProposeG home dimensions ineludiaq any proposed •Qeeks,
overhanqs qreatez than 2', pczchea, etc. (i.e. all
sLruetures sequiriag permanent toctiaqs)
? D 0 • 8how all easements of record and any City utilities within
those sasements
? 0 D • Setbacks of proposed structuze and setback of adjacent
existin
D 0 • Reta??irements, 3f aay
R??e! / / zO"?% Y
October 2992 1
,
E}CTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER D?l1?s- ?F?iE^:'vACrac.?
`` n .l u:•i. w cw
SITE ADDRESS
CONTRACTOR
PHOYE
DATE
Determine working square footage af each.
1. Total exposed wall area .... " 40 ? sq. ft. x ./1? = 2? y
2. Total roof/ceiling area .... `"r sq. ft. x r02(.? = 35.?
Total exposed wall area above floor
a. Total wall window area ............................
b. Tata1 door area ............................... ,. c+ S
c. Total sliding glass door area ..................... TfU
d. Tota1 fireplace wall area ......................... 0
e. Total wall framinS area (average 10Y) ................ l'l 5
f. Total net wall area above•floor ..................... 1 G.
g. Total rim joist area .............................. I --r 2.
Total exposed foundation area = Sf C,
h. Total foundation windaw area ........................ C-:l
i. Total net foundation area above grade ............... SS C.
Determine "U" value of each wall segment.
a. X "U"
b. y S X "U"
c. `:6 U X t,pll
d. C) X "U"
e us ° /U?.Np
G7 = 3?S-
/S? = 3G.O
o m a
e. / 75 x 1-u„ ,G`s7 = /3:57
f. 1611 XllUll ?6u2 67.4?Z
g. l72 X nUil ? U1? a?(O ?G e7
h. c X "U" o ?
i. -:i? (..? g nUn ./J 7c =
3 ......................................Tota1
IF ftem 0 3 is the same as, or less than item #l, you have mee the intent
of SBC 6006(c)2.
.
Total exposed roof/ceiling area = ? 3? Y
Total gross roaf/ceiling area =
j. Total skylight area ....................... -
k. Total rooE/ceiling framing area ............ i
1. Tatal net insulated roof/ceiling area ... 12i`.;'
Determine "U" value for
J. C:> g uUu
k. '?? ? X t'u,e
1. 125s g $lUll
4 ................................
each rooE/ceiling segment.
O a O
2.5e-
? ??? a 3?• 2
..... Total ° 37V-i ?7/
If total of a4 is the same as, or less than 02, you have met the in[enC of
SBC 6006(01.
To utilize [he total envelope system method, the values established by the
sum of items 43 and U4 shall not be greater than the sum of items A1 and 92.
1. 2G6 .5 6, + 2. 3S" Sff = 30.2 .5,4
3. 2. y0, 20 + 4. 3 u.75/ = 27u 'cl ct
' Henr"GOSs
Wnthontripl
N?exp,
Im, wAll
Cedmg
Pla?7
N?
ConurueNon No. ?
? ... ?.
cr.?I
Im W.
N?_ LVxL.
Inl. -ia11
ara
?.eeder area
Lwidih
e.
i
Btu
OI
and
„N.. ,au
•ru.n? .erai
erp..^ ?. e
prp?. u ?n n.
?fnrK ar.?
w 1?.
Ceef. p?u
?nRltr?llon
t p 24
GI??? S
E+P. wdI
Nn esp. wall
Inl. wAll
Ceilie
Vloor
ww um. 1.Y V
_Rcquired sq, ft, f,D.R. or iq, ins, WJ?. LeAder un
wall
?e T h-e-?",?ee,
--.II__ _ ?qW??11011 •.ti.?
0r
/' W7-0
! yse/
tt. E.D.R. or
f
?.c?uurv lq. 1t. G.U.R. or 14, mt. WA. Ladrr sira I
I
2000 BUILDINC PERMIT APPLICATION (RE5IDENTIAL)
cirr oF IE?caN, r?
3830 PILOT KNOB RD ; 55122 o-
851-881-4675?
I - a- C-o a
•New ConshucMOn RaauiremeMa ? RartadeUReoair ReauiremaMs
D 3 roostered fife wrveyS tf Wwlnp tq. fl. of bt, sQ. fl. of houae ? 2 CcPies d plan .
and go rooted areaa (20% mmdmum kt coveraaa aliowem j t set d energY cdctAaMam for heateG atldinorn
D 2 coples of plana (ahow beam d wlntlow sk" Powetl Ind tleaigm eM.) I 1 siro aurvey for exMda addMOns 8 tlecka
? 1 set of aneryy cdcWaMpq D 3 caples of frea presenatbn plan H Id piaHed afler 7/1/93
?
i
? .
DATE: ---," Zlj _ ?Z,000 " CONSTRUCTION COST: J S f ?ivu
DESCRIPTION OF WORK: ?, , r? xhq 7e
STREET ADDRESS: 33
LOT: ? BLOCK:
8UBD./P.I.D. M: l/I 5'f'o Yl L
;
Name: c/??vef.c' Ya? sti ??k??. Phone M:
PROPERTY Last Flrst ,
OWNER
sheer address:__X??
ciN ? sra,e: zip: s.s-i z.3
i
Campanr.( "`u Phone C
i (area'code)
CQNiRACTOR
SheelAddress: If yJ>ff f??/?sf ! LlCense#26o5?YZY7 Exn. Z?Y,r'c Oc
Clly zl.o le State: Zip: ZK
ARCHtiECT/
ENGINEER
Name:
Telephone ?: (
Sfi'eef
RegishaHon Y:
City Statei Lp:
I
!' 1
Sewer/water licensed plumber (if installirw sawar/weter): I Phone M.
I herepy acknowledqe Ihaf I have read this appftcatbn, slate Nwl Me hifomwibn Is conect, and cpree 1c canPlY wNh aA applicable Sfote
of Minnesota StaNFea and City of Eapan Ordirwnces. ; ?
? Sipnature of ApplicanY. ??„?.. d? •/???
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plen Recetved _ Yes _ No ? Not Required
BUILDING PERMIT SUBTYPES
O 01 Founda6on p 07 05-plex
? 02 SF Dweiling O 08 06-plex
? 03 01 of _ plex O 09 07-plex
? 04 02-plex 13 10 08-plex
0 05 03-plex O 11 10-plex
O 06 04-plex ? 12 12-plex
WORK TYPE
O 31 New
0 32 Addition
,?Iff'33 Alteration
O 34 Repair
OFFICE USE ONLY
? 13 16-piex p 21 Poroh (&sea.) O
O 17 Garege O 22 Porch/Addn. (4-sea.) O
0 l8 Dedc p 23 Porch (screened) O
? 19 Lower Level ? 24 Stortn Damage
Plbg ZCYa_N O 25 Miscellaneous
O 20 Poal p 30 Accessory Bldg.
? 36 Move Bldg. 0 43 Reroof
? 37 Demolish (Bldg)' O 44 Siding
? 38 Demolish (Interior) O 45 Fire Repair s
13 42 Demolish (Foundation) O 46 Windows/Doors
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code o ?
No. of Units i
No. of Buildings D
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Engineering
sq. ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
31 Fxt. Alt - MuMi
33 Ext. AR - SF
36 MuRi
Permit Fee fir6,5 0
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
rotal: 51 60.sU
Valuation: $ 12,600,
SAC Units
% SAC
? CITY USE ONLY
L _ 8L L RECEIPT#:
SUBD. yVP,$TOh RECEIPT DATE:
PERMfT#
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT RNOB RD
EAGAN, LIIt 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TATAI
Alterations to existing dweiling - minimum fee
Describe: -3f? 4.7+L
? $ 30.00
Bath tub $ 3.00 x = $
Fioor drain 3.00 x = $
GeS pi in Outlet ' minimum - 7 3.00 x = $
HottuWspa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = g
Lavato 3.00 x = $
Septic System newrrerumished • rAqulrea MPC Ifc. 75.00 x $
Se tic System abandonmem 30.00 x = $
RPZ new installation/repaidrebuild 30.00 X _ $ '
Rough openin 1.50 x = $
Shower 3.00 x = $
Under round sprinkler rf dwelling is under construction 3.00 x = $
Underground s rinkler 'rf existing dwelling 30.00 x = $
1Nater closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under wnatructlon 5.00 x = $_
Water soRener if exisGng dwelling 30.00 x = $
Water tumaround 30.00 x $
State Surchar e .50 -> -> -> $ .50
Total -> _> -> --a $ ?30.'Sip
Reminder. Cali for inspections of alterations, i.e. water heaters, water softeners, etc,
-----°-•-• ••--•-------•--• •-------------------------------•-------°••-•---------•--...----------- -----•-•• •-•----••----------------------
I here6y adcnowledge that I have read this application, state that the iMOrmation is correct, and agree to cortiply xrith ell applicable Ciry of Eagan ordinances.
tt is the applicaM's responsibility to nofdy the property ownar that the Cily of Eagan assumes no liability for any damages caused by the City during ils
nomial operatianal and maintenance ac[ivkies to the fadlities Conatructed under this pertnk within City property/rightof-way/easement.
SITEADDRESS: _ _1/133
OWNER NAME: : TELEPHONE #: 651 688- OP6-1
(AREA CODE)
INSTALLER NAME: e77"G ea TELEPHONE #: ? Ya3- 3'X30
n I- (n?a, cooe)
STREETADDRESS: /Sa30 C'nk/.A-li?1. W .
CITY: STATE: ZIP: ?5d6S
• SIGNAT RE OF PER I EE
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNIT.
j(_ NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DATE 3- 7-94
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD?ON/RE O?DEL (ExI N Co STRUCTION) C? , $ 20•00
STATE SURCHARGE .50
TOTAL 33zb
SI1"E
OWNER NAME: ?b (:FU C()UQ?c`? ?alillGf I FU?QI\ TELEPHONE #:
INSTALLER:
3260 GORHAMAVE. ADDRFSS: cr ' DUlS Rll{iIE, MIP 55428
SALES 929-6767 SERVICE 92?pA1I.E. ZIP CODE:
CITY:
TELEPHONE #:
SIGNATURE OF PERMITT EE
1994 MECHANICAL PERMIT (RESIDEIVTLAL)
CITY OF EAGAN'
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UN1T.
NO. FIXTCTRES EACH TOTAL
i SHOWER 3.00 3. ?
a WATER CLOSET 3.00 (o -?
I_ BATH TUB 3.00
LAVATORY 3.00 . o0
I. KITCHEN SINK 3.00 3- ao
i LAUNDRY TRAY 3.00 3-o0
HOT TUB/SPA 3.00 ao
? WATER HEATER 3.00 ?
FLOOR DRAIN 3.00 3. 6U
GAS PIPING OUTLET • minimum - t 3.00 ?c10
ROUGH OPENINGS 1.50 N-SU
WATER SOFTENER 5.00
PRIVAT'E DISP. - nex.ay. lic. 20.00 ^
U.G. SPRINKLER • nome under const. 3.00 "
ALTERATIONS • io exisung 20.00 -
WATER TURN AROUND 20.00 -r
STATE SURCHARGE .50
TOTAL: LI a aD ?
SITE ADDRESS: ?a?s`1"fiU ? l ?1 ? • ?
OWNER NAME: ?omO.s? Y?O`?Rn
PHONE #: ( ) 533- la3S?
SIGNATURE OF PERMITTEE
1994 PLUM$ING PERMIT (RESIDENTIAL)
CTTY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
CITY: ???? ? p_l1? STATE: ? t? ZIP CODE: S?a
RESIDENTIAL
. BUILDWG PERMI7 APPLICATION
` CITY OF EAGAN
1Q) () 3830 PILOT KNOB RD - 55122 ? 3C) il
651-681-4675
New Canstructian Reauirements RemodeUReoalr Roauirements
• 3 registe2d site surveys showing sq fl. of lot, 5q. ft, of house, and all roofed areas • 2 copies of plan
(20Wo maximum lot coverage allowed) • 1 set of Energy Calculalions for heated additiORs
* 2 copies o( plan showifg Ceam & window sizes; poured found design, etc.) . 1 site suney for ezterior additions 8 decks
• 1 Set o( Energy Calcutations • Indicate if home served 6y septic system for additions
• 3 copes of Tree Preservation Plan if lol platted after 711l93
• Rim Joist Detail Optians selectian sheet (bldgs with 3 or less units)
DATE -O) VALUA?TION (EXCLUDING LAND)AS ?a? ' dd
5?r
JOB SITE ADDRESS Y`733 ?g+SI DL ,?!i"/-V? ?A 9A 0
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? /
PROPERTY OWNER Zv ? dJ Ft 0- k d j j"
TYPE OF WORK
APPLICANT
ADDRESS
PAGER #
??1IPCODE
FAX # 7_5?2 ' 99S "74zI1
NCIV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category
(check one)
MINNESOTA RULES 7672
- New Enargy Code Worksheet Submitted
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor:
Mecbanical System Includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applicant 11.m-?
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventilation Category 1 Worksheet Su
- Energy Envelope Calculations Submitted
Water Softener
Water Heater ?
No. of Baths
Phone #:
Lawn Sprinkler
No. of R.I. Baths
Air Conditioning
_ Heat Recovery 3ystem
FIREPLACE(S)
Fee: $90.00
Updated 7/01
CELL PHONE #
PERMIT
Permit Type: Plumbing
City of Eagan
Permit Number: EA105059
Date Issued: 06/22/2012
Permit Category: ePermit
Site Address: 4733 Bristol Blvd
Lot: 005 Block: 001 Addition: Weston Hills 2nd
PID: 10-83751-01-050
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Don Istel
Comments:
2500 hwy 88 ste 215
minneapolis, mn 55418
612-354-3350
PL - Permit Fee (WS &/or WH) $55.00 0801.4087
Fee Summary:
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: Owner:
- Applicant -
Istels Installation LLC John M Machovets
2500 Hwy. 88, Suite 215 4733 Bristol Blvd
Minneapolis MN 55418 Eagan MN 55123
(612) 354-3350
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:EA118335
Date Issued:10/31/2013
Permit Category:ePermit
Site Address: 4733 Bristol Blvd
Lot:005 Block: 001 Addition: Weston Hills 2nd
PID:10-83751-01-050
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 .
Lisa Nyberg
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 -
John M Machovets
4733 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:Building
Permit Number:EA122762
Date Issued:05/19/2014
Permit Category:ePermit
Site Address: 4733 Bristol Blvd
Lot:005 Block: 001 Addition: Weston Hills 2nd
PID:10-83751-01-050
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
John M Machovets
4733 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:Building
Permit Number:EA164878
Date Issued:10/09/2020
Permit Category:ePermit
Site Address: 4733 Bristol Blvd
Lot:005 Block: 001 Addition: Weston Hills 2nd
PID:10-83751-01-050
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 -
John M & Rhonda J Mackovets
4733 Bristol Blvd
Saint Paul MN 55123--398
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature