4363 Bent Tree Lane
L 65 19 41~2cz 40"V
qtDat Fire No. Rough-in Inspectio
Required? ady Now 0 Will Notify Inspector
~ Yes G No , ` When Ready?
I licensed contractor D owner hereby request inspection of above electrical work at:
Job Address (Street. Box or RoLAW No. ( City
Section No. Township Name or No. Range No. County
Occupan (PRINTi Phone No.
Power Su tier Address
Etectnc Contractor (Company Name) Contractor's License No.
Mailing ddress (C tractor or Owner Making Installation)
Auth ed Signatur (Co ct r~owner Making Installation) Phone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
0 REQUEST FOR ELECTRICAL INSPECTION 5x4 EB-ooool-oe~
► See instructi~for completing this form on back of yellow copy
L "X" Below Work Covered by This Request
New
'Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other {specify} Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps hj
Transformers Above 200 Amps Above 100 Amps
Signs Inspector's Use Only: TOTAL
Irrigation Booms Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee ;Z~C, COMPLETED WITH S ONT r
I, the Electrical Inspector, hereby Rough-in flat~~~.~~
certify that the above inspection has Final Dal
been made.
OFFICE USE ONLY
This request void 18 months from
6~ertc jicate of cccoanc~
WitV of OR agan
Zee+artnient of 10nitbWS 3n6pecdon
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
.
Use Classification:.' ~ Bldg. Permit No. 21805
Occupancy Type R3//41 Zoning District R1 Type const Vn
owner of Building R A Wr HMS RU Address NO I UPPER. HAiM LT, APPLE VAUM
Boding Add.4363 BENT TR)5E I.AN I.ocalit,+7, B3, MM RIB 3RD
- = Date:
Building Official
POST IN A CONSPICUOUS PLACE
Address 4363 BENT TREE LANE Zip 5512 3
I-Lt 7 Blk 3 Sub AU11 Mty RIDGE 3RD
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes
No Inspector: ~
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish !O
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact 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
*t PERMIT --A)'CITY OF EAGAN'
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 021805
(612) 681-4675 Date Issued: 0 8 / 2 4 / 91
SITE ADDRESS:
4363 BENT TREE LANE
LOT: 7 BLOCK: 3
AUTUMN RIDGE 3RD
DESCRIPTION:
Building Permit Type SF DWG
Building Work Type NEW
UBC Occupancy R--3 M-1
Construction Type VN
Zoning R-1
Building Length 69
Building Width 34
REMARKS:
S&W CONTRACTOR - MATTHEW-DANIELS PRV
FEE SUMMARY:
VALUATION $155,000
Base Fee $832.00 MISC FEES $1,744.50
Plan Review $540.80 Total Fee $3,944.80
Surcharge $77.50
SAC $750.00
SAC % 100
SAC Units 1
Subtotal $2,200.30
CONTRACTOR: - Applicant - ST. LIC. OWNER:
KOT HOMES, R A 16879513 0001506 KOT HOMES INC R A
7901 UPPER HAMLET CT 7901 UPPER HAMLET CT
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 687-9513 (612)687-9513
I
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 Mn.
Statutes and Cit of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE 01-ISSUED Y: SIGNA
L1AU671993 ~VED CITY OF EAGAN
PERM'11 1993 BUILDING PERMIT APPLICATION
S 681-4675
C~
~
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
talcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy talcs.
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
is issued.
Date > Valuation of work ~ a
r
Site Address: ^1
STREET SUITE #f
d
nant Name: (commercial only)
LOT BLOCK SUED.v~U r~►, S~r~~ P . I . D .
raj
Description of work: C~-Q S
The applicant is: O Owner O Contractor O Other Macron) ~
Name -1aM ZLo' P_. AVoz Wc _ PhoneAP:),Z -9 S 1z~
Property LAST FIRST M
Owner Address ti Gr
ST ET STE # 0~
City A:IzState X14.!• Zip ,►Z4
Company ~&ANVO Phone
Contractor Address TT License #CO,91~_-Z'6 Exp,~J,,,-_
City State Zip
Company ,Pf>L_ Phone t8`I -°i S IS
Architect/
Engineer Name V,&"eLA- UAvJ"Rb4._1 Registration #
Address
city State Zip
Sewer & water licensed plumber Y1~EA N«LS 'R_j t4 Processing time for
sewer & water permits is two days once area has been ap roved,.
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.
Signature of Applicant:
OFFICE USE ONLY
is
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt,/Lodging ❑ 16 Basement Finish
C9 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. O 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-Plex O 13 Garage/Accessory ❑ 18 Comm./Ind.
❑ 04 SF Porch ❑ 09 12-Plex O 14 Fireplace ❑ 19 Comm./Ind. Misc.
❑ 05 SF Misc. ❑ 10 Multi.,Addll. ❑ 15 Deck ❑ 20 Public Facility
O 21 Miscellaneous
WORK TYPE
31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish
❑ 32 Addition ❑ 34 Repair ❑ 36 Move
GENERAL INFORMATION
Const. (Actual) V-tq Basement sq. ft. MWCC System YES
(Allowable) Ry. 1st F1. sq. ft. City Water
UBC Occupancy 2nd Fl. sq. ft. PRV Required
Zoning R-i Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length -G TE On-site well Census Code 161
Depth 3y~ On-site sewage SAC Code 01
1
APPROVALS i
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site ❑ Footing ❑ Framing ❑ Insulation
❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace
Permit Fee v.tuati«,: S I R
Surcharge GAR,&&a 2 x 31 '14~{
Plan Review
License
MWCC SAC, r72 o x 1(v H~SZ
City SAC
Water Conn. ~g 39 Water Meter
IN
Acct. Deposit I x )4=
S/W Permit (6 "A I -L Q
S/W Surcharge .000
Treatment P1 . 13 ca KI'T Ins 1
Road.Unit ~~Ta
Park Ded. 204 Q R oo& ;
Trails Ded. 11Sv 2l 38 lp14
Copies AYX $1/.~ 117 Y K W a 9
Other XW K2 !G. Z 221 c►a
Total: ,
JO: z
SAC % Qe ~
SAC Units 3X
SURVEYOR'S CERTIFICATE R, A, KOT HOMES
11 A ',VT;-IC R NE
5 -7- DRA E 11 VTILITY
s i
EASI %4T PER k AT
LOT 7
(~5►35, i x 931.
r ~ ' Rl
1.Q
~
r x 934.8
936.2x 9 46 936.5
%
I
939A
t O
PROPOSSD m, I "S r
L~1. I HOUSE
e~ N~ GARACit: M
~ ,k I a 37,38
SEJCM MARK U► ` Z, 3 4(D ~T
TOP OP PipE U49 9 9y~
ElEV,- 94 1.08 PROPOSED 941.10 + BENCH MARK
W DRIVEWAY TOP OF PIPE
Sr' I ELEV.= 93869
.4 00
48II '1130 -5)
4•2r~
939.6
(UNDER aON$TRUCTION)
'3-
I"io'r6e 6uLoW6 oiMa'•1JSi0NS SHOWN ARE fVR 4 0ffl TA
Bi vERTICAL LOCATION OF STRUCTURE ONLY. $ NOTE! NO SPECIFIC SOILS -INVESTIGATION HAS BEEN COMPLETED,
ARC'HITECTUAL PLANS FOR 9UILOINO Ik FOUNDAtION ON THIS LOT By THE SURVEYOR. THE SUITASILITY OF
DIMENSIONS, SOILS To SUPPORT THE SPECIFIO HOUSI= PROPOSEV tS
-4 _ DENOTES PROPOSED SURFACE DRAINAGE NOT THE ktSPONSIBILITY OF THE SIJRVEYOft
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = C,t ` 4.0 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 754,7 FEET
(000.0) bENUTES I'RUPC7SEb ELEVATION PR O D TOP OF BLOCK - FEET
r
■ ■ • Law
WE HF-RE13Y CERTIFY TO R, A. KOT HOMES THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OP THE 130U iDARIES OF.
Lot ,7 , Olock 3, AUTU~y R++DGE..4,RD A ITIdN, according to the recorded pint thereof, Dakota
County, Minnesota. Vrh,MNOgal dasOlp►lon will ologme valid upon filing
tho plat of AutoMn Rlddo AcfdiflOn).,
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN, AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS IOTH DAY OF AUa, 1993.
SIGN J R. HILL, INC.
OROPoSES upADEs SHOWN WERE
TAKEN FROM THE DEVffi DPMENT C.
PA D AUTUMN AIODOE LAST
DA► b - 52-+330. JOHN G, LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 15828
-O
av v
s.
re n
Q ~~QCn y
~pmW O
PL N~ oy >:E
m.
a O _ O m to (A
2600 W, CTY. RD. 42 * BURNSVILLE, MN. 55337 + 812-890-8044
LOT SURVEY CHECKLIST FOR RESIDENTIAL
~ o
J W BUILDING ERMIT APPLICATION'
m
M PROPERTY LEGAL: "
CL Co
U < Date of Survey:
z
z 2 DOCUMENT STANDARDS
0% ❑ Registered Land Surveyor signature and company
Q-1-0 0 Building Permit Applicant
Q'-❑ 0 Legal description
❑ Cry ❑ Address
❑ ❑ North arrow and bar scale
0 ❑ House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
C3~~❑ ❑ Directional drainage arrows with slope/gradient
0 D~-❑ Proposed/existing sewer and water services
Q--0 ❑ Street name
•0''❑ 0 Driveway
ELEVATIONS
Existing
0 ❑ Sewer service
0 ❑ Lot corners
0~ ❑ 0 Top of curb at the driveway
0 ❑ Elevations of any existing adjacent homes
Proposed
❑ D Garage floor
Q~ ❑ ❑ First floor
C1' ❑ ❑ Lowest exposed elevation (walkout/window)
D'y 0 0 Property corners
❑ 0 Front and rear of home at the foundation
PONDING AREAS (if applicable)
❑ 0' 0 Easement line
❑ 0` 0 NWL
❑ D' ❑ HWL
0 Ct'` Pond # designation
D O~ ❑ Emergency Overflow Elevation
DIMENSIONS
P1" ❑ ❑ Lot lines
2' ❑ ❑ Right-of-way and street width (to back of curb)
0'' 0 ❑ Proposed home dimensions including. any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
C~'~ ❑ ❑ Show all easements of record and any City utilities within
those easements
0"0 0 Setbacks of proposed structure and setback of adjacent
existing homes
❑ 0r0 Retaining qu' ements, if any
Reviewed 462&-ZZ
Na e / bato6f
October 1992
CITY. OF EAGAN PERMIT ORO 11A1 4 i Q
3830 Not Khot Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 9 2 4
(612) 681-4675 Date Issued: 07/05/95
SITE ADDRESS:
4363 BENT TREE LANE
LOT: 7 BLOCK: 3
AUTUMN RIDGE 3RD
P.I.N.: 10-12302-070-03
DESCRIPTION:
(INCL DECK)
Building Permit Type SF PORCH
Building Mork Type NEW
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
FEE SUMMARY:
VALUATION $7,000
Base Fee $124.75
Surcharge $3.50
Lic. Search Fee $5.00
Total Fee $133.25
CONTRACTOR: - Applicant ST. LIC. OWNER:
HENDRICKSON CUSTOM BLDRS 16888507 0000608 CARLSON JOEL
570 PRAIRIE CIR E 4363 BENT TREE LN
EAGAN MN 55123 EAGAN MN 55123
(612) 688-8507 (612)454-9152
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Stat es and City of Eagan Ordinances.
o~
APPLI T/PERMITEE SIGNATURE ISS D BY: ATURE
CITY OF EAGAN 4 az
j1914 3830 PILOT KNOB RD - 55122
1985 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
t 3 regisbend site surveys t 2 copies of plan
t 2 copies of plans (Include beam & window sizes; poured fnd. design; etc.) t 2 oft surwsys (estew additions & decks)
I anew ♦ 3 copies of~ rvation plan if wt platted after 7/1/93 t 1 energy c at s for #
Nom: _ Yes No CPO
DATE: c1 CONSTRUCTION COST:
DESCRIPTION OF WORK: E'GK f?A/ r
Sea
STREET ADDRESS:
4136 LOT BLOCK SUBDJPJ.D. 01111AW
PROPERTY Name: Soe.l fi bt aN c... C04-(50&)_ Phone
OWNER W
Street Address-
City: Err r,.,,~if State: Zip.
CONTRACTOR Company: , r~l/ i 4 J 4 Phone M Z.
Street Address: lY Liirnsle
City:....._._A,.AJ...., . State: Zip`
ARCHITECT/ Company: Phone M
ENGINEER
Name: Registration
Street Address-
City: State: Zip:
Seer R water kWMd plumber. Penalty dies when addrOSS dWge and lot
dwn$e are requested once permit is rued.
1 hereby adcnow a that I have read this application and state tfut the ' affil r con" with aN
applicable State of Minnesota Statutes and City of Erman Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECOQJ/ ED
Certificates of Sunray Received Yes No J U N 2 1 1995
Tree Preserntlori Plan Received Yes No
w~rrr~ ".wr+.r
- r s~ s :4
OFFICE USE ONLY
BUILDING PERMIT TYPE
n 01 Foundation a 06 Duplex o 11 Apt./Lodging a 16 Basement Finish
a 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rern. El 17 Swim Pool
a 03 SF Addition o 08 8-plex a 13 Garage/Accessory o 20 Public Facifty
04 SF Porch a 09 12-plex o 14 Fireplace a 21 Miscellaneous
a 05 SF Misc. a 10 --plex j2,-"15 Deck
WORK TYPE
a 31 New a 33 Alterations o 36 Move
2 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
USC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Cade.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ 7 °O
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Depose
SNV Permit
SNV Surcharge /L q, X To ; o ~
Treatment PI.
Road Unit U44 JZ~
Park Dad.
Trails Ded.
0
Other
Copies
Total:
% SAC
SAC Units
3•~
!,S
/!K ~1l
'H
Q lF z~ At
1(9 ff t
w H
!I
H
SSS 7
pssr 3.0
ssT I • .
SST
5s'f
O LS
NAME: ~rAn~M . o C !2
-13(13 ,3T ' ' 6,4 `A
iONEER s'a
H 11511- 9 /.Sa w PSI GPM ~'f co
DWEST DATE: SCALE 13o DRAWN BY:
I c
TORO MASTER INSTALLER RESIDENTIAL/COMMERCIAL
N/ . LARGEST RETAIL DO IT YOURSELF CENTERS IN THE MIDWEST manptl•
NC.
NORTHWEST SOUTH EAST SPRINKLER SYSTEMS
TORO "CONTRACTOR OF THE YEAR" - 1964,1988 420-8961 934-2554 681-1614 '~`~40
LOT BLOCK 5- SUBD.
RECEll?" # 0~'l & DATE S
1994 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS - FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: Commercial GPM
Residential (boulevards) GPM
Existing residential
Area/address to be irrigated: X03 &n i- Try psi r
Installer: _ LL 1 RA'tG- ~ ak <'0y] Owner ❑ Plumber ❑
`"rte. Lau,
Street address: 1~i11i
City, state & zip code: '-4Afg,vi _
~ ► ~-3 Phone
06 l iautc~ ISO k-1
Owner Name:
Street address: 9162 1310- Tttt' t4a&=
City, state & zip code: E k4(ti✓y 5S ( ~S Phone 14 9 4 " 11 S
07-
Irrigation contractor, if different than installer: Q. _ I
Telephone y 2-0 - 9q 81
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable City of Eagan ordinances.
O {
OOA
Si ture Titl
If construction activity occurs in public easement or City right-of-way, signatlire of property owner is required.
The property owner agrees to hold harmless the City of Eagan for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City
property/right-of-way/easement.
,on
Property Owner Date
Approved b Date:
PRV Yes 2-90-
New service ❑ Yes No Meter Size & Cost
~y v
Fees due: Cl-Q Calculated by: C.~ `
. r r
PROCEDURE FOR IRRIGATION SYSTEMS
1. A site plan must be submitted to the Engineering Department for review before installing an irrigation
system. A permit to work within City property/public easement/right-of-way may be required.
2. Jerry Wobschall, Finance Department, will calculate permit fees as follows:
a. Commercial project: $ 25.50 irrigation system permit to cover installation of backflow preventer.
$ 50.50 water permit fee only if new service is installed.
$100.00 per tap if installed by City.
b. Residential project: $ 20.50 irrigation system sprinkler permit to cover installation of backflow
preventer.
$ 50.50 water permit fee if new service is installed.
$725.00 per connection - WAC,
$348.00 per connection - water treatment facility.
c. Existing residence: $ 20.50 irrigation system permit to cover installation of backflow preventer - (not
required if backflow preventer previously installed), however, plan and
application must still be presented for approval.
d. Meter charge. If gallons per minute are less than 25, a 1" meter will be required at a cost of
$165.00. If gallons per minute are more than 25, a 2" turbo with strainer will be
required at a cost of $775.00. This information is to be supplied by the designer
of the system.
4. No meter will be sold before all sewer and water inspections are complete on a new service. If new
service lines are not required, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk.
5. The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and
backfiow preventer. The Public Works Department may be reached at 681-4300 for water turn-on and set
and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for
A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
• r
S-~
3
~l
y
i ff
Q ~ f
H
/f
i i
4sS 7 N
~
fssr 3.o
SS7
59'i
NAME: 'b,AA)i-
10NEER 43(9,3 96.3T E 6,-J 5/~
H ~s`✓ 9/Sa W PSI GPM 9
1 DWEST DATE: l q SCALE: /So DRAWN BY:
TORO MASTER INSTALLER RESIDENTIAL/COMMERCIAL
N/ . LARGEST RETAIL DO IT YOURSELF CENTERS IN THE MIDWEST spa.
NORTHWEST SOUTH EAST SPRINKLER SYSTEMS
TORO"CONTRACTOR OF THE YEAR" - 1984.1 420-8981 934-2554 681-1614 ~`M~"
v}»• .}:a' "k •ii ~ ~ f' ?`•'it's` v':kij. t : v: ti k' :k: ~,+.}.f' rr,: , .
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tti} :Q.r;;},..,,r.:.•'?ti,'''•,{v `~'~{ry:{i•.p,. v:~. .'fie, •~i.. ~$'~Yti• 71..n?•: n:L:: KCi: v•.
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' }.v r... }r: x: n.•.:v; n •:::•}+:d•'v:::. • • ~ •7ir: 7: • vv v: t?+•~:••?}?•7:•F'vv}:..: :{•iv
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:~7;:~:•i.:.:;2.;.•d.•:;•:•7i}':ar ,.:ds:a~+n£+... }uar wk • :Yt?a:?; ;•:~,w:xry. • r,:•S.•:r,.ro, `.~;.:a,.}';;}.;::+?,:::.::::::
.::t• •.??o: :}.t 7:•7wi}xxd,}?!ir ~ h}..:Y.?•4k n':{.},.v.;v S'•. a :~;i:}.ixs"'}ir: :},:'~a~~-~t~+..°%~~ati~':', .'F+=^..'ro:%d•...
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. 17?r~}, . .:::f:•><:,. :n. :'.ti::h :,.~yvv~ w}?a;F2S}`~:?2•>}?n`,:~.3.~,:. .•47..x? ~5. n. ..r....:::': f+,?~
1993 MECHANICAL PERMIT (RESEDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE , -71 1`3
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.
GAS OUTLETS (MINIMUM 1 @ 53.00 EACH) a.
ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 15.00
.50
STATE SURCHARGE
TOTAL '
SITE ADDRESS: ~eyfr e---
OWNER NAME:• P4- K0 ~es TELEPHONE s
INSTALLER:
Burnsville ritau ADDRESS: 2481 Rhode Island Ave. So 22
Savage,
CITY: 894.0005 STATE: ZIP CODE:
TELEPHONE
rAT LYRE OF PERMITTEE
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1993 MECHANICAL PERMff (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
612 681-4675
PLEASE COMPLETE FOR ALL COMMERCLUJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF 9M77ACI' FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE `'TTY INSPECTOR
::::.~L.:'. • .:....::.:::::::::::.v.::::.v:..:..:?iYJ:•}?:4:i•}}?i:4: }::.:}}:t .?::J?i::v:;??::•::::J:??}}??ii}:J::ti4:::::'.}}}ii
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1993 PLUMBING PERAHT (RESIDENTIAL)
CM OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES EACH TOTAL
_ SHOWER 3.00 3 . 00
WATER CLOSET 3.00 t : • v 2
BATH TUB 3.00 n
(O LAVATORY - 3.00 g '
KITCHEN SINK 3.00 3 0 °
LAUNDRY TRAY 3,00 3 ° v
HOT TUB/SPA 3.00
WATER HEATER 3.00QN
FLOOR DRAIN 3.00
----T GAS PIPING OUTLET • minimum -1 3.00 ell
ROUGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVATE DISP. - Dak.Cty. lic. 15.00
U.G. SPRINKLER - home under oonst. 3.00
ALTERATIONS - to existing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: 3 S
SITE ADDRESS: L A -3
OWNER NAME: A • T
INSTALLER:
ADDRESS: S 18 ~-~r o~ s c l
SSIJ~~
CITY: 7~K)k"5 - STATE: N•~t--S ZIP CODE:
PHONE
SIGNATURE OF RMITTEE
a...
D.
1993 PLUMBING PERMIT (COM MMCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN SS122
(612) 6814675
PLEASE COMPLETE FOR ALL COMNERCLALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUI? :7INGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING U %,T.
NEW CONSTRUCTION
ADD ON
r REPAIR
WORK DESCRIPTION:
CONTRACT PRICE: $
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE: $.50 FOR EACH $1,000 OF I'RMT FEE.
MINIMUM FEE: $ 25.00
CONTRACT PRICE X 1% $
STATE SURCHARGE $
i
TOTAL $
SITE ADDRESS:
TENANT NAME: STh...r
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP CODE:
PHONE
FOR:
CITY OF EAGAN APPLICANT
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER JOEL AND DIANA CARLSON PLAN ~lO, 9 -ry~~a^cr?-~;
SITE ADDRESS i,-~=L u i ;ntru
CONTRACTOR R . A . KOT HOMES, I NC . DATE___.____._____P6130193 PHONE 6S7-9513
DETERM I ME WORKING SQUARE FOOTAGE
:,51.3.67
1. Total exposed wall area 3584.02 sq. f t . x .11 394.242'
2. Total roof/ ceiling area 1318 sq.ft x .025 34.268
3. Total floor cant. area 22 sq.ft. 0.05 1.1
(over unheated enclosed areas)
4. Total floor cant. area 60.67 sq.ft. x 0.025 1.51675
(over unheated exposed areas)
5„ Total exposed wall area above the Vloor.---_3194.67
a. Total wall window area ....................366.4696
b. Total door area 37.8189
c. Total sliding glass door area 77.7722
d. Total fireplace area
e. Total wall framing area (ave. 10%) 319.467
f. Total net wall area above the floor 2393.142
g. Total rim joist area 319
TOTAL. EXPOSED FOUNDATION AREA 70.35
h. Total foundation window area 0
i.. Total net foundation area 70.35
Determine "U" value of each wall segment.
a. 366.4696 "U" 0.39 = 142.9231
b. 37.8189 "U" 0.06 = 2.269134
C. 77.7722 "U" 0.39 = 30.33116
d. 0 Ulf 0 _ 0
e. 319.467 "U" 0.090334 = 28.85881
f. 2393. 14'2 U 0.043215 103.4202
9- 319 X ''U'' 0.040683 _ 12.97803'
h. 0 X U 0.39 = 0
i. 70.35 "U'' 0.076161 = 5.357959
6.................... Total
If item #6 is the same as or less than item #1 you hav _ e current
energ = codes. 2 MCAR 1.16008 A AND O.
TOTAL EXPOSED ROOF=/CEILING AREA 1318
j. Total skylight area 0
F:. Total flat roof/ceiling framing area...... 131.8
1. `("otal net flat roof/ceiling area.......... 1186.2
Determine "U" value for each roof/clg. segment
1. +_J x „U,s 0 0
k:. 131.8 M U" 0.025549 _ 3.367399
1. 1186.2 "U" 0.021B01 - 25.86004
7 ..............................Total ^9.:"_"744
If item #7 is the same as or less than item #2 you have met the
energy code. 2 MCAR 1.16008 A AND 0.
TOTAL FLOOR CANT. AREA (enclosed). 22
o. Total floor cant. framing area (ave. 10%). 2.2
p. Total net insulated floor/cant. area.,.,.. 19.8
Determine "U" value for eachfloor/cant. segment.
0. 2.2 U 0.04 ;819 = 0.096534
P. 19.8 U" 0.024254 0.480233
8... ..............................Total (0.57W6,/
If item #8 is the same as or less than item #3 you have met the
energy code. 2 {VICAR 1.16008 A AND Q.
TOTAL FLOOR/CANT. AREA (exposed) 60.67
q. Total floor/cant. framing area (ave. 10%). 6.067
r> Total net insulated floor/cant. area 54.603
Determine "U" value for each floor/cant. segment.
q_ 6.067 x "U" 0.044346 _ 0.269047
r. 54.603 x U" 0.024396 = 1.332105
9..> ......................„.......Total 1.601152
if it .rn ##9 is the same as or less than item #~~4 you have met the
enell code. 2 MCAR 1.1600e A,....ANa-G,
I HER-BY CERTIFY THAT I HAVE CALCULATED THE FACTORS AND
VALUE HEREIN AND THAT THE WILDING HERE L ill, I EKED MEETS ,W E CEEI a
THE S °ATE: OF MINNESOTA klER Y CCIIVSERVAT I C AC
(s i g na t~kf°e)
r
w
K date)
DETERMINE "U" VALUES''
THRU TUD WITH SIDING & S.R.
Inter or Air...„.. 0.68
Sheet Roc:k:........ 0.45
Therm --Break:.. „ > 0
Stud . 6 , 9:,
Shea t i ng „ , . 2.06
Sidin 0.78
Etter or Air'...... 0.17
Total "R" Value......„..... 11.07
I /R "U" Value 0.090334
THRU l~ISUL_A7'IOhI WITH SIDING & S.R.
Inte for Air...... 0.68
ShIs Rock........ 0.45
Ther o--Fuca k:..... .
Insulation 19
Shea hing......... 2.06
Sid i.rg............ 0.78
Exterior Air...... 0.17
Total "R" Value 23.14
I /R "U" Value 0.04 "215
THRU CEILING MEMBER
Interior Air....... 0.68
Sheet Rock 0.58
Ceiling Member.... 4.35
Insulation 32.92
Still Air......... 0.61
Total "R" Value . . . . . . . . . . . . 39.14
1/R "U" Value 0.025549
THRU EILING INSULATION
Interior Air...... 0.68
Sheet Rock:........ 0.58
Insul Lion........ 44
Still Ai.r......... 0.61
Total "R" Value............ 45.87
I /R - "U" Value 0.021601
THRU ONCRETE BLOCK
Inter or Air...... 0.68
conc. Blk:......... 1.8
Insul Lion........ 11
Sheet Rk. (opt.). o
Exter or Air...... 0.17
Total "R" Value............ 13.13
I/R = "U...................0.076161
THRU IM JOIST
Interior Air...... 0.6B
lnsul tion........ 19
Rim J ist......... 1.89
Shea is i ng 2.06
S3.cii.nc „ 0.78
Exter or Ai 0.17
Total "R" Value............ 24.58
I /R = "l.!" 0.040683
U" value for window........ 0.39
U" value for doors......... 0.06
U" value for Patio Drs..... 0.39
i
'THRU CANT. @ MEMBER (enclosed)
Interior air...... 0.68
Finish Flooring. 1.22',
Sheathi.ng......... 7.2
Plywood 0.93
joist 11.56
Sheet Rock........ 0.58
Still Air......... 0.61
Total "R" Value............ 22.79
I /R = "U. 0 . 043879
THRU CANT. @ INSULATION (enclosed)
Interior Air...... 4.68
Finish Flooring... 1.2
Sheathing......... 7.2
Plywood 0.93
Insulation 30
Sheet Rock:........ 4.58
Still Air......... 0.61
Total "R" Value............ 41.23
I /R _ "U".- 0.024254
THRU CANT. C MEMBER (exposed)
Interior Air...... 0.68
Finish Flooring... 1.23
Underl.ayment...... 0
Plywood 0.93
Joist 11.56
Sheathing......... 7.2
Soffit............ 0.78
Exterior Air...... 4.17
Total "R" Value............ 22.55
1/R "U ..................0.044346
THRU 'ANT. C INSULATION (exposed)
Interior Air.. 0.68
Finish Flooring... 1.23
Underlayment...... o
Plywood 0.93
Insulation 30
Sheathing......... 7.2
Soffit............ 4.78
Exterior Air...... 4.17
Total "R" Y'alue............ 44.99
I /R = „U. ..................0.0243,96
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
' 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 "4
New construction Requirements RemodeURepair Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan
(20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions
2 copies of plan showing bears & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks
1 set of Energy Calculations • Indicate if home served by septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 7/1/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE (D 1 S! VALUATION 3 f 3 3 `t
SITE ADDRESS q 3(-0 3 ► TPete- La Yt-p - MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK D hc8lou_ FIREPLACE(S) - 0 ^ 1 _ 2
i 91~2Q Mils 3tres#
APPLICANT COOn RWWS,, MN 85M
STREET ADDRESS CITY STATE ZIP
TELEPHONE # 1 SS - c~'-gPj CELL PHONE # FAX # 75; s' 5390
PROPERTY OWNER D('G"' A- CQ P' S0 yt TELEPHONE # ((951) L4'54 _ `'11 ~
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone # Plumbing system includes: - Water Softener Lawn Sprinkler _ Fee_ ^ $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: Air Conditioning Fee: $70.00
Heat Recovery System
0
UL9
Sewer/Water Contractor: Phon
-
I hereby acknowledge that I have read this application, state that t i formati is Corr t and a e comply
with all applicable State of Minnesota Statutes and City of Eagan rd a s.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received Not Required _
Updated 4/02
OFFICE USE ONLY
❑ 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. Aft - 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 (screened) ❑ 36 Multi
❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex Plbg Y or _ N ❑ 25 Miscellaneous
❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (interior) ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors
❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const 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
Fireplace _ R.I. - Air Test _ Final _ Windows (new/replacement)
Insulation _ Retaining Wall
Approved By , Building Inspector
- - - - - - - -
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
47
tiC"`'1l t3F EAGAN PER#"i TYPE:s
3830 Pilot Knob Road Pe
Date rmit Number: ~Evart, Minnesota 55122-1397 Issued: a e P
(612) 681-4675
ADDRESS: t rt ° F APPLICANT:
t B(N) f t~ t't t. A #If !4t NOR 1. 11 IS ON t`4)IS't 0fq 01, 0
AWSUBTYPE: TYPE OF WORK:
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1) 5. C R t,. pt T am ( 041A 0 U -C ~r .
31 '1
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1 14 A h A t; f' ft tt~ i 1f' t~ ~ t I I ' V,, f` Q 1) t V V k-) f 0 1~ A ~i' `r U I V("i I ► C3 1 1,40 -
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FWdPLACE
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FINAL HM
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B= F K4L
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A N PERMIT TYPE:
~ t Road , - Permit Plumber:
FAQ, MWwsota 55123 Date ~ssuec + r'
;
(012) 881-4575
,
ADDRESS: APPLICANT.
4163 "UNI Jkltu UAW
Alf foom - xo(ir-. 3Rt) g-flit l rfi i7
ftfttT SUBTYPE: TYPE OF WORK:
f, OW14
i i lif -ft AC,U
c
F _
F *"ON** ow f1 kwok
All
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4
Paugt Plug.
AJAE
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PAUW H'g 3 s „ r®°rr~s
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FkW Pft. Pft. wqxlcw - PkMVy Pk r
COrnt mew
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Pr. Cam.
Use BLUE or BLACK Ink
For Office Use
j Permit I
CRY of Eap )
I Permit Fee. I
3830 Pilot Knob Road
Eagan MN 55122 Date Received: / 3 I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: c Lri~Fcv+. M ff Unit
Name: %_3e__VNtN Phone:
Resident/
Owner Address / City / Zip: 3 A -1c- (VIII) t j
Applicant is: Owner Contractor
Type of Work Description of work: (Zec - ooc- 4- (P..._e 0~ . e af✓ r<91'e
Construction Cost: Le ay Multi-Family Building: (Yes / No
Company: cLC,e_c` LL C- Contact: L7(--!gk 1
T 19®
Address: c~.uU +e `r City: Contractor ~r nor' 2
State: t Zip:S~ Phone: t e I o~~ Qba -,99 30
License ~ LpL~L4 5; Lt Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
y_
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:
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 they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesot State Buil g Code must be completed within 180
days of permit issuance.
x J F~ ~c-c~ s x
Applicant's Printed Name Applica Signa e
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140388
Date Issued:12/15/2016
Permit Category:ePermit
Site Address: 4363 Bent Tree Lane
Lot:7 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Valerie Martin-kuehn
4363 Bent Tree Lane
Eagan MN 55123
St Paul Plumbing & Heating
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145299
Date Issued:09/01/2017
Permit Category:ePermit
Site Address: 4363 Bent Tree Lane
Lot:7 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Valerie Martin-kuehn
4363 Bent Tree Lane
Eagan MN 55123
(952) 451-7019
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
For Office Use
, Permit#: /46) o -4'7'
%soE AG A
`•`s IVSD Permit Fee: DOD .0g
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
MAR 0 9 2018 Date Received: 0- _ /'4
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 • Staff:
buildinginspections(&cityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 t Site Address: '13/3 /4 '7(e€i Unit#:
Name: 11 vja an c 'Jo &i t. K t1 r'i li v'� Phone: (v5 7-3,Pi - ?153
Resident! I l�, j _
Owner' t = ' Address/City/Zip: 3g5 $0.4-t- lice. !^ nL
v I
Applicant is: Owner X Contractor / / �`�``
L41,(' > / / nJl( I-ILS 4ted Ot Oa✓
Type of Work Description of work: rahlr G7�%� rir/. - Re..1 �i Ccc/ 1
Construction Cost: Multi-Family Building: (Yes /No )
Company: f(l4c.N Liiaf5 Contact: -✓, -w,.. $vim
Contractor Address: 5-2(,(4) Lt �/i+e ial W J. c 1• City: / i `
Stat Zip:�5O7 Phone:41,674 2--64,4e 3,$ .5. %.1a56)Email: kJ-etGr CXIPI-;Q dolo
License#:V L 5r 3 t Lead Certificate#: 4/ ` 7 /5 351
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 s rpporting documents iftat,,y4vionit are considered to be public information ;Portions of i `ion maybe
classified as non-public if you provide specific reasons that would permit the City to conclude re trade sect
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.citvofeacian.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x 54A/4 -51°e5 x
Applicant's Printed Name ''cant's Signature
DO NOT WRITE BELOW THIS LINE q,6 "<_/-2/ /:,cam Z-i. /q ;7
o
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration(Single Family)
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 _ 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 We4 '— Occupancy __.)-l2 C-/ MCES System
Plan Review Code Edition SAC Units
(25% 100% A Zoning { '-/ City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of BuildingstiF
Length Fire Suppression Required
Type of Construction J 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 66 HVAC_Gas Service Test Gas Line Air Test
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
yl Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan k I,- / Other:
AReviewed By: / `U01 y1" , Building Inspector
RESIDENTIAL FEES , J ,t 5. , /
Base Fee _
Surcharge ) /.5.-,
5 ,
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA148097
Date Issued:03/06/2018
Permit Category:ePermit
Site Address: 4363 Bent Tree Lane
Lot:7 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-070
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Valerie Martin-kuehn
4363 Bent Tree Lane
Eagan MN 55123
(952) 451-7019
The Fireplace Guys Llc
680 Hale Ave N #110
Oakdale MN 55128
(612) 326-1919
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA149673
Date Issued:06/05/2018
Permit Category:ePermit
Site Address: 4363 Bent Tree Lane
Lot:7 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-070
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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 -
Valerie Martin-kuehn
4363 Bent Tree Lane
Eagan MN 55123
(952) 451-7019
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature