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2835 Burnside Ave <f 1 For Office Use j ( Permit City of Ea~dIl RECEIVED I Permit Fee: 06 l 3830 Pilot Knob Road I I Eagan MN 55122 NO 10 2010 l Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 ; Staff: -----------------J 2008 MECHANICAL PERMIT APPLICATION Date: Site Address: . Tenant: Suite RESIDENT / OWNER Name: D"j4 j- -4' Kell lA .~Y) Phone: 661--;14014`7N Address /City /Zip: 5 r~a~ CONTRACTOR Name: ' w-. ?9 License Address: , City: C2~CZ~ Qlri~ State: Zip: 641i2k Phone 0494a l Contact Person: TYPE OF WORK New V/' Replacement Additional Alteration Demolition Description of work: -Rz4laeu~ .LX i NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL 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) 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 $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 1 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. x M Agwy X A P ? Applicant's Printed Name Applican% Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground - Rough In _Air Test -Gas Service Test In-floor Heat Final CITY OF EAGAN Remarks Addition Country Home Heights Lot 10 Rlk 7 Parcel 10 18300 100 07 Owner-&I-',/ } l 4-2 / -o s-o_-' Street 2835 Burnside Ave. State Eagan, MN 55121 Imwovement Date Amount Annual Years Payment Receipt Date REETSURF. 1972 MOO $84.00 10 1 STREET RESTOR. GRADING SEW TRUNK 1968 100.00 $3.33 30 SEWER LATERAL 1970 15 WATERMAIN %o WATER LATERAL 1970 2022.00 134.80 15 WATER AREA * STORM SEW 1970 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $230.00 1530 7-1-69 BUILDING PER. SAC 200.00 1530 7-1- 9 PARK EAGAN TOWNSHIP No 506 ~~~"~~J~T~~ ~ ILDING PERMIT' Owner ,~+_,GfL~S... ....i~^C_<..... r- Eagan Township Address (present) - Town Hall Builder . rQl----- _ 'p - - - Date Address DESCRIPTION Stories To Be Used For Front Depth Heigh! Est. Cost Permit Fee Remarks E9 ~ ~ I LOCATION Street, Road t r Description of Location Lo! Block Addition or Tract This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it v the owner or is agent the right to create any situation which is a nuisance or which presents a hazard to the heal safely, conve fence and general welfare to anyone in the community. THIS PERMIT MUST B E... Q}~ - MISE-WHILE per WORK tISeIN aOG SS. This is to certify, that- - - ..'-------------...........-'---upon the above described premise subject to the provisions of the Building Or finance Eaga hip adopke April 11, 1955. Per Chairman of Town Board Build' g ctor I Cit of Dian j Permit# gS~ I I I Permit Fee: qV . K I C) V I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: - 2008 RESIDENTIAL BUILDING PERMIT APPLICA HUG 1 2 2008 D Date: W I I I OX Site Address: YYl t~ t 1, ey Tenant: 45e11U ~UYt~ Suite : RESIDENT i OWNER Name: y AT-N C11 S' Phone: Address/ City / Zip: a 8gS 5U irvw l2 AUQ lU-k- Applicant is: _Owner Contractor TYPE OF WORK Description of work: Construction Cost: . 0 It roily Building: (Yes No CONTRACTOR Name: ftL eM,' tCE 5" License# aol9aoloa Address: i) a M t Yle AA/J- S. -fa.0 City: M m a~ State: ~ n Zip: SSu Phone: lpia-m, l-Saa Contact Person: bow i-P lidam'% COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category I Worksheet New Energy Code Worksheet Category Submitted Submitted 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 plan? _Yes _No if yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. -Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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. x ]Swal-y Aktm.S x & ,VI /I r 1 Dj~~a App iccant's Printed Name Applicants Signature Page 1 of 3 1006 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 showing footings. beams, joists Cen of Survey Recd _ Y _ N '(213% maximum lot coverage allowed) I set of Energy Calwlations for heated additions Tree Pres Plan Recd Y N 2 copies of plan shoving beam & window sizes; poured found design, etc. - 1 site survey for additions & decks Tree Pres Required _ Y _ N l set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _Y _N 3 copies of Trans Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date /O? / Construction Cost //~Q Site Address 13((y7s&e 4w17u& Unit/Ste # Description of Work Q~eSliife d17LC 61)1Ybt ~l~ / l dlili VIV Multi-Family Bldg - V X N 1 Fireplace(s) _ 0 - 1 - 2 Property Owner D2WIV KE 1(y ! Elm S4,0-tA.) Telephone,#/( (,S/) ~itJ//( GtS S!~/L~//Li b~u/F~6ld1/f~S Ll~GNd i~ 0~3~110~" Contractor Address 4;,(Aq i+lliLd .~BGrO/ SG49/L ~?p City State Zip Telephone # (&51) ~Y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 . Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (,i submission type) Submitted Submitted • 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 plan? Y _ N If yes, date and address of master plan: Licensed Plumber G( L Telephone Mechanical Contractor DEC 1hUIJ J 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 licant Signature U EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: July 1, 1969 Number: 299 C'-,q ~ Billing Name: Paul D. Pahos Site Address: 2535 Burnside Avenue Owner: Paul D. Pahos Billing Addres9835 Burnside Avenue Plumber: All-State Plumbing Location of Connection Meter Size`s,A Connection Chg. 211 Pd- Acct. dep. 15.00 pd. Picked up xnd meter on July , 1969. Meter No ✓d /LsaC 3 Permit Fee 7.50 Pd. Meter Reading 4;:-o Meter Dep. Meter Sealed: Yes Add'l Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence X Multiple No. Units Commercial Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. All-State Plumbing e ar Ave. So. Richfield, Minn Please notify the above office when ready for inspection and connection. E EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: July 1. 1969 NUMBER 429 1 a 7 G.NNOWNER:Paul D. Pahos Address 2835 Burnside Avenue, St. Paul 55118 PLUMBER All-State Plumbing TYPE OF PIPE Heavy cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge 200.00 pd. Acct. dep. 15.50 pfd. Permit Fee 7 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota All-State Plumbing Co. 6539 Cedar Ave. So. Mcf1fielul . Please notify when ready for inspection and connection and before any portion of the work is covered. ~iva/~/ r ordin No. nos WELL AND WATER SUPPLY MANAGEMENT Permit No. WELL PERMIT 94-9025 DAKOTA COUNTY ENVIRONMENTAL MANAGEMENT DEPARTMENT Unique WATER AND LAND MANAGEMENT SECTION H45184 14955 CsI k Mu*, Appk Vdley, NN 55124 Tdephooe (612) 891.7011 0r WHEREAS, the NON-TRANSFERABLE PERMITTEE/DBA: Hartmann Well Company ISSUED TO: 40174 ADDRESS: 308 E. Main St. REVIEWED BY:Luehrs New Prague, MN 56071 has submitted a permit application, has paid the sum of $111.00 dollars to the County of Dakota as required by ordinance Number 114 and has complied with all of the requirements of said Ordinance necessary for obtaining this permit to seal the Well described herein: An abandoned well with a casing diameter of 4 inches, depth of 240 feet, and completed in Unconsolidated Sediments, will be permanently sealed. The well shall be cleaned of equipment and debris, disinfected, neat cement pressure grouted and terminated at least two feet below grade. THE WELL IS LOCATED IN THE MUNICIPALITY OF EAGAN AS FOLLOWS: WELL LOCATION PROPERTY OWNER & ADDRESS WELL OWNER & ADDRESS 2835 Burnside Avenue Paul Pahos Paul Pahos 2835 Burnside Avenue 2835 Burnside Avenue Eagan, MN Eagan, MN NOW, THEREFORE, Hartmann Well Company is hereby permitted and authorized to seal the well described and located above for a period of one year from the date of this permit. Sealing of this well is subject to all provisions of Dakota County Ordinance 114, the Minnesota Wells and Borings Code and any conditions attached on the reverse side of this permit. Given under my hand Tuesday, March 1, 1994 ATTEST ENVTRO ENTAL SUPERVISOR ENVIR ENTA AGEMENT DIRECTOR 03/01 194 14:58 ID:DAMTA CD-WSC FAK:6128917031 PAGE 1 MUNICIPAL NOTICE OF WELL PERMIT APPLICATION DAKOTA COUNTY ENVIRONMENTAL MANAGEMENT DEPARTMENT WATER AND LAND MANAGEMENT SECTION 14955 Galaxie Avenue West, Apple Valley, MN 55124 Tel (612) 691-7011 Fax (612) 891-7031 Tom Colbert/Wayne Schwan8 Fax ♦i (612) 661-4612 FREs Harsh 01, 94 Water and Land Management Well Permit 0: 94-9028 Well Type: Sealing Municipality : Eagan Reviewer : Luehrs ;i NOTICE: The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for havedescribed. ifeyouwell questionsoorrequire concerns review of contact® application or Specialist listed above or our office at (612) 891-7011, If there is no P.1 response from your office within 24 HOURS (excluding weekends and j holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on „i the permit applicant's observance of and compliance with all applicable laws and codes. A copy of the well permit will be forwarded to your office when completed. F WELL CONTRACTOR INFORMATION: Hartmann,Well Company Application Receivedt 02/17/94 Anticipated Drilling/Sealing Date if knownr 02/17/94 Time: 13:00 LOCATION OF WELL: 'i PLS Coordinates L Well Location " NE :s NW SW Sec 3 , Town~a7 , Range 23 Property Owner P2835 aul Pahoslde Avenue Well Owner Paul Pahos .PID Number WELL INFORMATION: Diameter 4 Casing depth 233 Total depth 240 SWL 153 Aquifer Unconsolidated Sediments COMMyBNTS:7Yu6 t.d( x/•11 ~c~-r =O/1 (}O ~(1SrpJ ,~^lvr f'y cyPrp, y%( c.r Yh~.aF P/k.~r. 4LAO } I ~R=95% 6128919031 03-01-94 01!50PM P001 #22 t'r Log gd s 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New Construction Reouirements RemodeVReoair Requirements Ofke' A"'Ise OnN 3 registered site surveys showing sq. fL of lot sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd '',Y -N (20%maximum lot coverage allowed) l set of Energy calculations for heated additions Tree Pras P(artRecd Y _.N'. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Traa`s RegO`odd `°u" YN I set of Energy Calculations Addition- indicate ifonsde septic system OrtsTe'•Sep6c &gsteY 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bidgs with 3 or less units m Date i 04, o4 Construction Cost 2.-7, q D Site Address -2- 15 (tj f 0S, t)t, lC t £a5°.v yk P 55 / 2 ) Unit/Ste # Description of Work r'bl;-5c ~t 1~ ir4~ or) - 5a, ,Jk Co,lra) - MAC twl 150 Multi-Family Bldg - Y X N Fireplace(s) _ 0 "If 1 - 2 Property Owner pa rI ? Kx1 3 IL l`/S~~ U Telephone #(b51) 7q q-(o1b L~ Contractor C ro 5sr e c4 Address ('7 1 3 Oo L` v`c o l N S City 140 Lta k L State M Zip S S 30 Telephone #(y~3)'t3V-6Z ° z COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. - - 1 Licensed Plumber (i Telephone ) JAN " d Mechanical Contractor I Telephone # ( ) Sewer/Water Contractor I - 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 Applicant'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 ~y 1✓%r1De,✓5 d /9~r ('E/l dlcSC /Y7T•'L L~S;Iw^„'ov ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building" ❑ 43 Reroof A 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation 7 -7 Dv Occupancy P, `5 MCES System Census Code L 3 g Zoning (Z- l City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const R 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 -Brick Fireplace _ R.I. - Air Test _ Final ~C Windows .o 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 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date) L / 2-9 l 05- Site op n Street Address ~3S ~~✓nSJf~Y. AV,- Unit # Property Owner )Woo Telephone # ( 65-1) 2,6-F- 7 DD Contractor Telephone # ( ) Address City State Zip The Applicant is: _ Owner _ Contractor -Other Septic System - New Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes putting in a water softener and/or water heater at the same time. If vou are installing only a water softener ana'/or water heater, do not complete this section. Move to the next section and check the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $125.00 if a 5/8" meter is required) Other: Y _ Water Softener / Water Heater $ 15.00 new replacement -Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ 1 hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. pplica s Printed Name Applicant's Siu ature PERMIT City of Eagan Permit Type: Plumbing Permit Number: EA106971 Date Issued: 09/19/2012 of 3 a R Permit Category: ePermit Site Address: 2835 Burnside Ave Lot: 10 Block: 7 Addition: Country Home Heights PID: 10-18300-07-100 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: David Elgstuen 2835 Burnside Ave Eagan, MN 55121 651-269-7400 Fee Summary: PL - Permit Fee (WS &/or WH) $55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: Owner: - Applicant - David R Elgstuen 2835 Burnside Ave Eagan MN 55121 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:Mechanical Permit Number:EA128469 Date Issued:11/14/2014 Permit Category:ePermit Site Address: 2835 Burnside Ave Lot:10 Block: 7 Addition: Country Home Heights PID:10-18300-07-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Holly Flood 1408 Northland Dr #310 Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - David R Elgstuen 2835 Burnside Ave Eagan MN 55121 Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature SEDGWICK HEATING & AIR CONDITIONING CO. HEATING �oe No.�°Z� �` � 1408 NORTHLAND DRIVE,SUITE 310 • MENDOTA HEIGHTS,MN 55120 • (952)881-9000 TEST RECORD ADDRESS��� °'��J������ CITY � OCCUPANT OWNER ��� ��c.-"��La:��`� , ' � ��; �s,'r�X'�"R- SOLD BY � � WSTALLED BY `� �-�;,;� MAKE_ �O�Z/����� MODEL �����'�4����'D ���� SERIAL NO._ S�l 7' [d" ����-� INPUT ��� �-��1��� �" THERMOSTAT VENT SIZE VALVE �"'"` F � �'�'�-� TYPE OF LINER ,Q U"''( LIMIT J�P ��So LINERSIZE � �� LIMIT SETTING ��v FILTERS: SIZE �� ,"�'�� NUMBER FAN SETTING- � `/`�I WIRING I/�-� ��� PILOT TYPE �S� TEST TAG IGNITION MODEL ,�S� LIGHTING INST. �- PI�OT TIMING � � I' � DATE TESTED �� v� � �/� PRESSURE `S PERCENT COZ � ��� r INPUT CFH ���' PERCENT 02 ��� COMPANY TESTING z-�' STACK TEMP. �4'�� PERCENT CO � NAME OF TESTER �� FORM 235(REV.10/10) FORM DISTRIBUTION: WHITE COPY•JOB FILE YELLOW COPY-CITY JY-1 F . For Office Use 7 Permit#: MAR 13 2020 Lb D.�( 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: buildinginsoectionsc cityofeagan.com L 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Dater I 20 Site Address: i 41.fi Aye ' Unit#: Name: Kei 1� C '%r1s Phone:(si) Owner Address/City/Zip:AM UVf es t(;. Ave Edx1, � M W S51 a, I Applicant is: Owner Contractor — Description of work: IN Mtni VJCk,,` xt Type of Work / • Construction Cost: 7_' �4� Multi-Family Building:(Yes /No V ) Company:1'6e .kft06 Contact: (( 5J) 278.q t sq Contractor Address:I�qq �Q /r •,ANN 44e, std City: .1 __ `_ State: Mu Zip: �I'1 Phone:(),t;' ?1 Email: �d1�'WcYt n License#: t Lead Certificate#: ,awn� S �O If the project is exempt from lead certification, please explain why: 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 r classlNed as Hart p :A ublic f you provide specilk reasons that would permit the City to conclude that#hey 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.cltyofeaaan.comisubscribe. 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.gopherstateonecali.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 �j „a wiith ttheapproved plan in the case of work which requires a review and appro of ns. Applicant's Printed Name App n s Signature r .. cg3s eatzegst d6 A s , / o . DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace Porch(3-Season) _ Exterior Alteration(Single Family) >C Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) — Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex — Lower Level — Pool _ Accessory Building WORK TYPES New ^ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building Reroof T Demolish interior Alteration — Fire Repair Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall 'Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 4 71,000 Occupancy MCES System Plan Review Code Edition SAC Units (25%_100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required — Footings(Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing JC Retaining Wall: Footings )X' Backfill tie Final Sheetrock Radon Control Fire Wails Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By:_t ig , Building Inspector RESIDENTIAL FEES Base Fee 0 53 .Z c Surcharge $ 35: 5-D Plan Review O '/5. 5/ MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL # // £,70, Z( Page 2 of 3 LOT SURVEY CHECKLIST FOR RETAINING WALL BUILDING PERMIT APPLICATION ADDRESS: 2835 Burnside Ave. APPLICANT NAME: Kelly Chris DATE OF SURVEY: 3/12/2020 LATEST REVISION: co **Permits required for Retaining Walls 4 feet high or greater. cos (.) z a DOCUMENT STANDARDS E l 0 0 Registered Engineer signature and company 9 0 0 Building Permit Applicant O 0 0 Address ❑ 0 0 Legal description ❑ 0 0 Lot lines/Bearings&dimensions O 0 0 North arrow and scale ❑ 9 0 Street name ❑ 0 0 Show all easements of record and any City utilities within those easements O 0 0 Setbacks of proposed structure and side yard setback of adjacent existing structures ELEVATIONS ❑ 0 0 Property corners ❑ 0 0 Top of curb at the driveway and property line extensions (only if wall is within 30 ft. of curb) ❑ 0 0 Elevations of any existing adjacent homes O 0 0 Adequate footing depth of structures due to adjacent utility trenches ❑ 0 0 Waterways (pond, stream, etc.) ❑ 0 ❑ At the foundation of the building and/or nearest structure PONDING AREA(if applicable) ❑ 0 0 Easement line ❑ 0 ❑ NWL ❑ 0 ❑ HWL O 0 0 Pond#designation ❑ 0 0 Emergency Overflow Elevation ❑ 0 0 Pond/Wetland buffer delineation No Shoreland Zoning Overlay District RC= Conservation Easements RETAINING WALL INFORMATION El 0 0 Location of Retaining Wall on property O 0 0 Top&bottom elevation at each end of wall and any change in elevation in between O 0 0 Type of material (i.e. modular block, boulder, etc.) O 0 0 Directional drainage arrows with slope/gradient% Reviewed By: Dave Westermayer Date 3-31-2020 G:/1 Engineering/Forms/Building Permit Application-Retaining Walls Rev. 10-16-19 3/12/2020 Dakota County-GIS n __ Dakota Conn ,MN // '�'/ �� �p. 1 ,+ t L 'Q+ - r� P � si22 Oy(� r t XY . 49r4-11 A.a Ilona 4 .H1.4QN Wd,Ld { I Lb P Q2335 g714 1 gr 1-ci! ll --, ---1- -----1-; is 1-1 rec•FA. Sov-r i-+ PRicParrY blvC OF: ars It'lb ' .23.66 . T I ; IPro .� I . Disclaimer:Map and parcel data are believed to be accurate,but accuracy is not guaranteed. Map Scale is is not a legal document and should not be substituted fora title search,appraisal,survey,or 1 inch=50 feet 03/12or :sin_ ' ai I. /2020 '` WED ��_..�. Die By : f . D:.:; d0 - � EAGAN ENGINEERING 1'EM,. �4_LAe .. Date:V. r gis.co.dakota.mn.us/DCGIS/ Eagan Building Inspections Division 1 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA166617 Date Issued:01/25/2021 Permit Category:ePermit Site Address: 2835 Burnside Ave Lot:10 Block: 7 Addition: Country Home Heights PID:10-18300-07-100 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David R Elgstuen 2835 Burnside Ave Eagan MN 55121--130 (651) 269-7400 Peterson Plumbing 4209 Diamond Dr Eagan MN 55122 (612) 655-4022 Applicant/Permitee: Signature Issued By: Signature