4625 Beacon Hill RdarY ot EAcinN
3795 PiRlt Kwo6 Roed
Eagaa, MN 55122
,
Zoning:
Owner. ,'. -i?-1Qr Can
Address:
Sita Address: 1{ ?-'21BC8COI1 :ii.
Plumber.
Meter No.: Sixe:
Reader No.:
1 eyras !o winPlp w&h Hw Ciry of Eeyen
Ordinsnass.
By
Dote of Insp.:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
- No. af Units: 1
i:OtiCl
?r^
_ Connection Chorye: !t 50. i.:!
_ Account Deposir:
_ Permit Fee:
Surchorge:
Misc. Cfwryes: -
Totul:
_ Dota Paid:
_ I nsp..
CITY 0F EAGAN SEWER SERViCE PERMIT
9795 Wlc'k Knob Road PERMIT NO.:
Eoilivn, MN 55122 DATE:
Zoninp: No. of Units:
O1NnCr: l.C'lfif;
Addre55:
5ite Address: rPtiCO?', H111 z'.C, L'.': .• _ i:?°?^_oi1 i:ill
Plumber. - ?{c c?' at1l reI
1i T??^
Iagree te eempfy wilh tha Ckp of EaAaa Connection Charpe: -20
Ordinaneas. Acoount Deposit:
Permit Fee:
Surchorge:
BY Misc. Charpes:
Date of Insp.: Total:
Insp.: _ Dote Paid:
Site ?,ddreu 401D rieacon ri111 Koad
Lot 10 BI«k 1 Sec/5ub Beacon Hill
Parul # 10 13500 100 Ol
Nama uvowyu ?a. rai.aica vvuo%..
Addrem 18133 Cedar Ave. 50 .
Erecr 11 Occuponcy R-3
Nlter ? Zoning R-1
Repoir ? Fire Zone NA
Enlorye p Type of Const. Z1
Move 0 # Stories
Demolish ? Length_ 41
Grode Q Depth4fLSq. Ft.
Approrals Feet
Nome _
llddress
I hereby acknowledge that I have read this opplicotion and state that
fhe informotion is correcf ond ogree to wmply with all applicable
5rote of Minnesoto Storutes and City of Eagon Ordinonces.
Sipnaturc of Permittee
osep Z :9
, A Building Pertnit is issued to:
oll work sholl be done in accordorxe with oll
, Buildiny OfHcfal
Assessment _
Water 8 Sew.
Pol ice
Firo
Enp.
Plonner
Counci I
Bldy. Off. _
APC
, Iac.
Pennit Lti:i . UU
Surthar9e 25.00
Plan check 141, 50
5AC 525.00
Woter ConnA So _ nn
Water Meter 60. 00
Rood Unit 250.00
rotol 1734 . 50
on the express conditlon thno
ond City of Ea9on Ordinonces.
f CIT1( OF EAGAN
3795
Pilef Knob Road Eeyon, MN 55122 • ?? ?•.?' ? v
r PHONts 434-8100
BUILDING PERMIT Reuipt
Permit No. Parmit Holder Misc. Permit No. Holder
Plumbinq -? L? ?t tj t1i '$3
H.V.A.C. -- 3,71 con r,c f ? 9,g3
wau
w.?
?
Disp.
S?wer
Electric WOZO`Ir6 ?+1t??4K? EIbC. -/ tS3
Infpection Date Insp. Other
Footingt
Foundation
Framiny / ?c3
Rouyh Plbq.
Rouph HVA
Inwlation 43
Final Plbg.
Final HVAC
Final
Wstsr Dxcribe Locatfon:
Well "
Sewer ?
Pr. Dkp.
n •
.? s
Receipt PLUM6ING PERMIT Permit No. CITY OF EAGAN
Fee ' "• -
.
' Fi1l rn numbered spaces S/C .?.:
Type or Print legib/y
Tot.
1. Date Installation Cost
3. Job Address •,l.ot ;_. - Blk. _I Tract
4. Owner
5. Contractor Lt:f:L Phone °
_.
6. Address`°'' ?.'3') -? 7. City - - State Zip B. Building Type: Residential Q Commercisl ? Institutional ?
9. Work Description: New 0Add ? Alter ? Repair ?
10. Descri6e
1 11.
No. Fixtures
Water Closet No. Fixtures
ool/Drainfield
Cess
Bath tubs p
Septic Tank
Lavatory Softner •
Shower . Well
_ ,
Kitchen Sink .
`
Urinal/Bidet Othsr
Laundry Tray
Floor Drains
Drinking Ftn. -
Stop Sink
Gas Piping Outlets .,
12. I hereby certify that the above information is true and correct, and 1 agree to
comply with all ordinanceS and codes governing this type of work.
Signed : _ . , .. • x • for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt - J - MECHANICAL PERMIT
CITY OF EAGAN
,
?..
Permit No. - - ? rr {
Fea `
j ` Fill in numbered spaces S/C
Type or Print /eg/bly "
Tot. ?
1. Date c?? 2. Installation Cost
ri
?l.?
3. Job Address ? ;\ Lot Blk. ? Tract ' •
4. Owner
5. Contractor -. ` Phone
-?
6. Address ?
7. City ? . .. . - ` State ? Zip --- _ ,
--,-
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New Add ? Alter ? Repair ?
10. Describe Fuel Typ????
11.
No.
-
' Equipment STU • M. Ea.
Forced Air No.
- Equiament CFM
Ai
H
dli
-
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
5igned : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 10 elk 1 Parcal 10 13500 100 01
Qwner-?-? Street 4625 Beacon Hill Road State Fagan, MN 55122
improvement Date Amount Annual Years Payment Receipt Date
5TREETSURF. 1 18o6. 3 200-77 9 1806.93 C007372 10-1-31
STREET RESTOR.
GRADING f? g5- 1982 526,46 5g.5p 9 526.46 c007372 10-1-81
SAN SEW TRUNK 976 135.97 9.06 15 90.67 A008956 188
1FSEWER LATERAL 1 1982 3116. 346.21 9 3116.46 C007372 10-1-81
WATERMAIN
*WATER LATERAL 1982 9
WATER AREA 1982 1 S.O1 22.00 9 198.01 C007372 10-1-81
Stubs 1982 9
STORMSEW TRK Z 1982 359•82 - 39.98 9 359.82 C007372 10-1-81 i
*STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK ?
STREET LIGHT
--RDAD UNIT 250.
Q0 570
5=6-83
%;ONN. -
4 O.OO
BUIIOING PER. 08
sac 525.00
PARK ,
This requesl void
1y8?p??anths trQm
9¦ /?
o! O f8V
Ll o, ZI, N--2Ca/l 4M
3sgs 9
:?52•So
Request Date Fire No. Roueh-in Insuoction
Reuuu tl?
?Ra:?dv Nu ill NotitY Inspec-
?O D s ?NO lor When Reatly
p 5-nsed Eleclrical ConVactor I herebV request inapectlan of above
? Owner elactricel work installed at:
Stre,et` Atldress, Bo/x ?or Roure No. ?? p
??
' C ity
?
L7
¢acen fl
?
4f
ecuon o. Township Name or No. nnyu No. Co ny?
?L4,ol
Or.cupant(PRINT) ? I
?J?ri
/
?
/ Phone N`o.
IS
d
f
!gA l.C
?
Pow r $upplfe?
? ? ?
I
Addrass
raill.,,.-
Elecvical Convactor (COmpany Name)
' lo
eY
fl 2'"
c
*4 Contracinr's License No.
yl c eo - a
,,
«
?
.,
,r,
Mailing Address (Contractor or Owner Making Installauon
0'703 9Q ,Qc3se/f s? W.sil A?I40 S5303
Authorized Signamre ont ctor Owner Makina Inswllationl Phone Number
?? 3 -?3?'7
MINNESOTA STATE BOAflD OF ELECTflICITY THIS INSPECTION pEUUEST WILL NOT
Gria9s-Midway BIdB- - poom N-181 BE ACCEPTED BY THE STATE BOARD
1821 Universitv Ave., St. Paul, MN 56104 UNLESS PXOPEH INSPECTION FEE IS
1.11, ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
See inetructions for comoletine this form on back at yellow copV.
'Xn" SepwWork Covered by This Request
*.,w EB-00001-04
W:
?'jct;'
Ne% A ,ild Nap. Tyoa of Builtling Appliances Wired Equiumenl Wired
woo Home Range Teniporary Service
Duplex Water Heater ? Ifuqlhtinq Fixtures
Apt. Building Dryer ElectNC Heatin
Commercial 81dg. urnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
f2rm tner pecify Dthnr Isoenityl
t er Suco Y Other Oth,r
Compute Inspection Fee Below
N Fee Servica EntrenceSize # Fea Fenders/Subteaders H Fon Circuits
Ad 0 to200qm s 0to30Am s .5 0to30Amn
Above 200 qmps 31 to 100 Ainps 31 to 100 q y
Swimming Pool Above 100_Am s Above 700_Amps
Transiormers Irrigation Boons S'p Partial•Other Fee
Signs Speciallnspection
$
T
Remarks
FEE
0T 7_
.?
Roueh-in t D.rte
t
ha ectricel
? pe
Insctor, hereby
th
tif
t
h
b
Final
???? cer
y
t
e
e a
ove
ingpection hes bean
?? made.
TM1In .onuaal vnitl 1A mnnlM1x Irom
CITY OF EAGAN 8OOS
3795 Pilaf Knob Rmd Eagnn, MN SSI? lr ?T? PHONE: 454-8100
BUILDING PERMIT
$50,000
Site Address 4625 Beacon Hi11 Road
lot 10 BI«k 1 Sec/Sub. Beacon Hill
parcel # 10 13500 100 Ol
? Name .Toseph M. Miller Const.
z pddreu 18133 Cedar Ave. So.
9 i.cr. e1?1
a Nome_
?
?U Address
r ?:...
Nome _
Address
I hereby ocknowledge thot I hove read fhis applicotion und state that
the inlormation is correct ond ogree fo comply wilh oll opplicoble
State of Minne:ota Stoturea and City of Eagon Ordirwnces.
Signofure of PermiMee
-Josep?
A Building Permit Is issued to:
all work sholi be done in acwrdance with all
Building Officiol
Receipf # ?5?/di(7
Mav 6 .,, 83
Erecr U Occupancy R-3
Alter ? Zonirg R-1
Repoir ? Fire Zone NA
Enlarge ? TYce of Const. V
Move ? .# Stories
Demoiish ? Length41
6rade ? Depth-46 Sq. Ft.-
AvYrorab Fee.
Assessment
Woter 8 $ew.
Police
Fire
EnO.
Plonner
Countil
Bldg. Off,
APC
, Inc.
pemit Ga3.VV
Surcharge 25.00
Plun check 141.50
SAC 525.00
Weter Conn 45 0 - n 0
Water Meter 60. 00
Rood Unit 250.00
Tmol 1734.50
_ on fha express condition thno
ond Ciry of Eagon Ordirwnces. ..
This reqvest void
18 months from L - )6 7 - g, y aQ • O b A n7a q R L 1.0) & I S wea caY? ;?'l 1?4j& 41 GqI
Request Dale " Fire No. flo. qh-in Insper.tion
fleyuired?
E]Reatly Now?Will Notily InsOeo-
a Yes ?NO , tur When Neatly
? LicenseA Eleotrical Contractor
Owner
I hareby request insOecHOn of above
electrical wnrk instailed eC
Sveet Atldress, Bax or Route No. City
?
er.LOn o. Township Nam. or No. Renge No. County
OcCUpan? (PflINT) Phonx No.
!f'iw:. l?, SZ-069
Power $upplier + AdGress
Elecvical Contractor (Company Name) C??ntractoe's Licenec No.
0 C.11 h c f?
Mailiny Address (COntractor or Owner Makinu Instalta
i
t
o
n
)
'
y
?
f
'
?
K?.?
Si na[uribIConl c r/Owner Making Installationl Pho
n
eNumber
)
?
L ?+
%fS z
MINNESOTA STATE eOAAD OF EIECTPICITV THIS INSPECTION HEQUEST WILL NOT
Grie9s-Midwev Bldg. - Room N-791 i BE ACGEPTED BY THE STAlE BOABD
1821 Universitv Ava., St. Peul, MN 65104 UNlESS PPOPEN INSPECTION FEE IS
Phone 161 21 2 97-2 7 11 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-oa
' See instructions for comoleting [his form on back of Yellow copV.
? r P ? ?")('" Be?w Work Covered by Thrs Request T
Add Reo. Typ¢ of Builtling AoUliances Wired Equipmenc Wired
Home Range Tem{mrery Service
Duplex Water Heater Ligh[iny Fixtures
Apt. Buildinq Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloader
InAustrial BIAg. Air Conditioner Buik Milk Tank
F2rm Other pea v iher (Specily)
? er Sut?u y Ot er Olher
Compute lnspection Fee Below
q Fae ServiceEntrance5ize b iee Feetlers/Subfeetlers # Fee Circuits
0 to 200 Am s D to 30 Am s 0 to 30 Am
Ahove 200 qrnps 31 to 700 qmps 31 to 100 Amps
Swimmin Pool Above 100_Am s Above 100_Amps
Trensiormers Irrigation Booms .SO Partial; Other Fee
Signs Speciallnspection
S ?
F
L
Remarks
I _ ?
.w.?
Riia roduest ia 18manih;
?W b
n S P--c <-- 44 ay'1 S
,:?L 0
?? ?
. V'? .
., ?
. S?
...'lb He Oled P+m. cz}- -- Vblust3on .
Site Addpess:
Slodc ? 8ec./Sub.
roe'
;
.' Paiti7el ?s b I 3S? o r0o o
.. ,\ ?
Own6ri . - ,?U ,tf
AMrGW:
d
`' Ptrone t: ' 51- ?J
Oont?caclor'i
' a??? ??
Phow ::
Atch./ghg.
A&bmw: .
,
' ?i"ip
, .
?,.. ,
crr?r ae? ?-: s?oi,?a. ..t.af
1 db ??+/?N oer i', r
, AppLiG'1?(" Mt oe Wre9Y ;?rtlaer! ?.
DIIEt 3 -/?9'rp-3
? ;..
, ?!1"LCS q? ? ' ? ?
06rect O:oWn%Y
Alber
?r ,?
?
3? ..
ASSOOmmuntS ?.-- 9lemi!
POliOB ram aa?.• ?
?.--?--?- ac
EV. ? •
?NOW?. ;
Planner - P40d VAit
? ?- ?
?. ?? ? 'sa ? ::'
4
Plaa€e for.:
. , , iZtiex Homes ?+e$t inc.
;,-$6{11 Darne11 Road
' Eden Prairie, Mn. 55344
JOe MiTler Conet.
1e133 ^edar Ave, so. L?ELMAR M. SCHWANZ
FSY'tningtOri,'Mri, 55124 lANOSUPVErOP
' . RNiNVW 4"*1 Uws of TtIM 5104,?4.MinMwta
4RJ? - 14M fT11t[T W. -mQX M N04EMOUNT, MiNNF30TA l6M
VMqN6 617 7176p
/ BURVEYOR;SCERTI?ICATE.
.. ? _ 4 .'/?0-¢/MB.? i ? I/ •,?`3?$ ?R'1.
? ,v P?
----
. ?p •''? 3" _ ?, ?- _-__?,_ -r ---? -?- ._._g? "Af
AA
41
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9?s=r? ? 4g 4
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9 Denotes
?3...? Denotes
.w---Denotes
i
+i
:?.
?
i
,
aet wnod hub
exieting elev3tinn
proposed elevation
propoaed drainaF,e
?? ?t.G1-'??•aa.9
0 ?..-.'.?O.a6?t /
!
-7j '
?
C?
. ?
?
Proposed garage fi loor e2ev, 9ta? S-' . ?Tser,
Proposed ba.aement flnor elev,
I hereby certlfy that Lhis 1o a:rue ?tnci r'e c::
LOt 1^, B1ocK 1. BEAq?)N 14=LIS. ;zec:?rr31•?i;. to the,
Dakota Courtty, MinneBvt.a.
Dated : Jul,y 3, t U%`?
yl?
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.;
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4'
1 i
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yi
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,764,4 ? ?\j ; ?
tnp of
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bl.ocu ??E 9
re?E?r??±nenr,t?t.; >n af
rer.nrdNd )1:.at t:E?et^N1?P,-
Revlsed to ahow propoaed hc>use ,3s stakeci Vi,,rch 21, i 9A,3.
1E ?
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Dutexm
fL. X •?,,_,_ ? ???---'-
r71'@d . . ? ..
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F/ceilinq area . eq. tL. x_.?____ Z?,---
fiotal onyosed•wa11 ar3a14bo?e Elaor ?? I,
??` Pttcx?t: 454-4753
?
11? woikir,g squarc foot?y.: of ieach
'tf iY.ccn 93 is thc sAM. :
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tip4i). area r.tc)cc flcc•?. • '
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;aroa al?e f)dar;
Area abovc flcer, ••.. ...
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ru:slaLipn xindow ares., ..: ..•. • ^ I .?
•t foandation area ahowap xic' ..........:.
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?? (e.g. windc.w, dcx>r., eac.i scparate ??mll aec'.ign)
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ot 4
C?l_?rt1?? 1 .. Y.
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h? " • ?
;?ptal ? At acea ...... .............• .:. ?
.
. R'otal Ceiliag hwing acce (arveraqo 10%)...
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"rlbtl?i ?t???ii?ulated seo[/cei?Iin9 ares........
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psLasaine 'p" vuluc for oach roof/cuiliml ge9mnt
X wUa . ??.--.?.. ? . - .
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II•Wtal ef P4 is the adme as# or l?esr l'i9:? k'd, Y?,?: ha'Ve1?C tM' intent of
SHC 6005 (<r) 1.
Alt<srnate Bulldiml Envclope Desi_ ?y_
TO at,illse Lhe toCal aaY44oy4 'sYetan mf:thod, the valuee established by tha sWm If
,.itOiand i0 sha11 rat :9seatex `thaq tha suiu of, itewa Pl and 02.
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U CIN USE ONLY
? RECEIPT #:
SUBD. BLL'1717 +II RECEIPTDATE:
PERMfT# 713330
2000 PLUNBING PERMIT (RESIDENTIAI+)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTIIRES
FAGH #
TATAI
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet `m'rn;mum- a 100 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System new/refurbished "requfres MPC tIc. 75.00 X = $
Septic System abandonment 30.00 x = $
RPZ new installation/repaidrebuild 30.00 X = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if tlwelling is under construction 3.00 X = $
Underground sprinkler dexisting dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dweiling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Waterturnaround 30.00 x --- _ $
State Suroharge 50 --> ---> ----> $ .50
TOtal --> --? ---? ---> 130.a 0
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
•--------•--------------------- ------------------------------------------•------•-------------------------------?---?--
I hereby acknowledge that I have read this application, state that the i?ormation is correct, and agree to comply wtth all applicabie City af Eagan ordinances.
tt is the applicant's responsibility to notffy the property owner that the City ot Eagan assumes no liability for any damages cauaed by the City during its
normal operetlonal and maintenance activities to the facilities constructed under this pertnit within City propertylright-of-wayleasement.
SITE ADDRESS: soLoMON, RusSOM
OWNER NAME: :? 4625 BEACON HILLL1RWVE?'.c' I TELEPHONE #:
EAGAN, MN 55122 (AREA CODE)
(65'I ) 994-9804
INSTALLER NAM ` TELEPHONE #:
(AREA CODE)
STREET ADDRESS: -'- ???????__
IzeA VEHT?/APPLIAiJCE
CITY: '872i 827-^.0ee STATE: ZIP:
MIHNEAPOLIB, MN 6640b L2/?J?°/!//?IAyi-?
SIG NATUR?.Qy'PE RM ITTEE
5??5 g
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PIlOT KNOB RD, EAGAN MN 55122
651•681-4675
New Construction Reauiramente
• 7 registered site surveys sfwwing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20%maximum lol cove2ge allowed)
• 2 copies of Olan showing beam 8 window s¢es; poured found desgn, atc.)
• 1 set of Energy Calculafians
• J copies of Tree Presenation Plan if lot platted after 7l1193
• Rim Joist Detad 001ions selec6on sheet (Ndgs with 3 or less unJs)
DATE P' ZL U2,
SITE ADC
TYPE OF
APPLICANT Cedar Valley Exteriors, I?1C.
tULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
STREETADDRESS Cnnn Rgp[dg M(?rann??CITY STATE_ZIP
TELEPHONE CELL PHONE # FAX # -M-3?'755,-S39 6
PROPERTYOWNER Q-IIXll1'Yn I 0(Y=:bVVI,CYI TELEPHONEA04" `'1 4L3oO
----------------------------------------------------------...----------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOT:1 Ri;[.f:S 7670 C:\'CECORI' 1 MIVVB50'1'A lttiLLS 7672
(J submission type) . Residenfial Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculatlons Submitted ?
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhactor:
Mcctianical svstem includcs:
Sewer/Water Contractor:
?<<e # ?J
?,&P
R.I. Baths
Phone #
Phone It
Fee: $90.00
Fee: 570.00
------------------------------------------------------------------------------------------°-°------°-------------------
I hereby acknowiedge ihat I have read this application, state ihat t information? rTct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan r in nces.
Signature of Appltcant
OFFICE USE OtiLY
_ Water Softener
Water Heater
\ o. oF Baths
-- lir Conditioning
Hca[ Recoven System
I Z'5.Z5
RemodellRewir Requirements
• 2 copies o( plan
. t set of Energy Calculations for heated addifions
• 1 site survey (or extenor additions 8 decks
• Indirate it home served by septic system for additions
VALUATION 6-7t03 . 1"?)
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
updatea 4102
9- to, co
2008 RESIDENTIAL BUILDING PERMIT
Date: Site Address: 4f 6.5: 1 l( ALv? ` }{'
Tenant:
aqJ&5_
?-----------------
; ?
j Permit N: j
? Permit Fee:
j Date Received:?- ^? r ?
I ? I
I Staff:
-________________?
'LICATION
Suite #:
RESIDENT/OWNER Name: ({/ 1 Phone:y?jZ?2??
Address / City / Zip;
Applicant is: _ Owner ' Contractor
TYPE OF WORK Description of work: --
Construction Cost: Multi-Family Building: (Yes _/ No
CONTpACTOR Name: ,(` Q(1 d License#: .i???9?C?l
i ?
Address: ?,
City: State: miv Zip: Sr'JOM
Phone: GJl' -13I-L4 - ? Contact Person: KQcer)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code • Residential Ven[ilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted
Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City oi 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:,P/ans and supporting?docuFnerrts fhatzyou su6mTt are constdet?d ?o b? pLbfic rr?/ar?af?oi?
i?orlrons at'.
,
the information may be classHfed as ?ron publ/c r1 you piobfde'speciffc reasoYis fhat woultl perm?t tlre ? to ;
?
?.wt?oncfudeil?8t;t?te aie trade'secrefs.. ' ,. ? , ,:; ? ?>
I hereby acknowledge that this information is complete and accurate; ihat Ihe work will be in confortnance wilh ihe ordinances and codes of the City ot
Eagan; ihat I undersland ihis is not a permil, but only an application tor a permit, and work is not ro start without a permit that the work will be in
accordance with Ihe appmvedq?in in the case ot work which requires a review and approval of plans.
x [l l01w Nue'E'" X_ ?UM, k
Applicant's Printe7 Name J ApplicanYS Signalure
3
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA176010
Date Issued:04/27/2022
Permit Category:ePermit
Site Address: 4625 Beacon Hill Rd
Lot:10 Block: 1 Addition: Beacon Hill
PID:10-13500-01-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Russom Solomon
4625 Beacon Hill Rd
Saint Paul MN 55122--270
Pcs Residential
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature