4729 Beacon Hill CirCITY ? EAGAN
3745 Pilor Knob Road
Eagan, MN 55122
Zoning:
Owner:
Address:
Site Address:
Plumber:
reir i?i1
1 agree to eomplr wieh the Ciry oE Eogan
Ordinonces.
By
Date of Insp.:
SEWER SERVICE PERMIT
PERMIT NO.:
DATt:
No, of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surchorge: ,
Misc. CFarges: -
Total:
Dote Poid:
CITY 0& EAGAN '
3795 Pilot Knob Rocd •
Eagan, MN 55122 • ? •
Zoning:
Owner. _
Ar4rlra cc-
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Site Address:
Plumber:
Meter No.:
Size:
Reader No.:
I agree to eomply wit6 !be City of Eagan
Ordinances.
ey
Date of Insp.:
Connection Chorge:
Account Deposit: _
Permit Fee:
Surchorge:
Misc. Chorges: -
Total:
Date Paid:.
CITY OF EAGAN Remarks
Addition Tn,?AKE TeIDGE ArION Lot 16 elk i Parcel 10 39800 160 01
Ownerhci,?;ti-i 1: jJ)" Street 4729 BeBCOfl Hi11 Circle State Fgg,an,, MN 55122
Improvement Oate Amount Annual Years Payment Receipt date
STREET SURF.
57REET RESTOR.
GRADING
SAN SEW TRUNK ,
* SEWER LATERAL -
WATERMAIN
* WATER LATERAL
WATER AREA 7
STORM SEW TRK
,t STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
? WATER CONN.
? BUILOING PER.
SAC
PARK
CITY OP EAGAN
3795 Pilot Knos Rood ??n, MN ss1?.2 N4 6 3 2 3
PHONE: 454-8100
BUILDING PERMIT Receipt # -
To be und for Est. Volue
--- Dote , 19
-
,
Site Address Erett 'p Octupancy
Lot Block Sec/Sub. Alter ? Zaning
Parcel # ' - Repoir ? Fire Zone
E
l f C
t
T
n
nrge ? ype o
ons
.
s
W No e '' o- Move ? # 5tories
3 ]
reSS C", Demolish Front ft.
? Phone Grade ? Depth ft.
o Name
? e
S? Address { Assessment _
1- Ci Phone Water & Sew.
v?
Ncme Police
F
F W ire
?? Address Eng
Q W ci phone .
Plonner
I hereby acknowledge that I have reod this application and state that Council
Bidg. Off. _
the information is correct ond agree to comply with all applicoble
Stnte of Minnesota Statutes ond City of Eagan ardinances. APC
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total
Signature of Permittee ?
A Buiiding Permit is issued to: on the express condition thot
oll work shall be done in accordance with oll appliwble State of Minnesota Statutes ond City of Eagon Ordinonces.
Building Official
Pemdt # Data Iwad Permiffse
Plumbing 4{f
Mechanicul
44-
INSPECTIONS DATE INSP. Rough-In Finol
Footings Date Insp. Dote Inap.
Foundation Plurnbing
Frame/ins. Mechanicol --
Finol y -? r
?
Remarks:
.?
No. '
CITY OF EAGAN
3795 Pilot Knob Roed
Eogon, Minnesota 55122
Phone: 454-8100
PERMIT
Date:
12-D-80
Site Address:
*- t:
Lot "`' Blxk Sub/Sec.
Name ? - - .?0I1 '?CY'.?
Address 2^
City = Phone: .
e
?
y
?
c
0
Name , •?„ .
Address INSPECTOR NOTIFICATION
REQUf RED BY LAW
FOR ALL INSPECTIQNS
Receipt No.:
Singie
Residentiol
Mufti Res., Comm./Ind. I
New/Alter. / Repair
Cost of Instcllation
Permit Fee
Surcharge
?n.^n
r}0)
V
I City Phone: ' I Total
This Permit is issued on The express condition that oll work shall be done in accordonce witfi oll applicoble Stote of
Minnesota Stotures and City of Eagnn Ordinances.
Building Official
. . cirir oF EAGAN
3795 Pilet Knob Rosd
I Eo9en, Minnesote 55122
NO' Phom: 464-8100
PERMIT
5ite Address:
Lot
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
'-_-17-80
Receipt No.:
Single I
' BE9CO1-i I- I? ", r 1 I' . Residentinl
Btock Sub/Sec. Multi Res., Comm./Ind. I
Nome ?107ifP30I1 HOI'e 3 -
New/Alter./Repoir. ? Address - , y._ :iopkins CT6Td.
Cost of Instolletion
' ° tOri}:e?
City , Phone: Pertnit Fee Name .,@Z ' I0C}7g:li (-7
? Surcharge
? Address
?
City ? Phone: '. - Total
This Permit is issued on the express condition that oll work shall be done in accordance with all applicable State of
Minnesota Stotutes and City of Eogon Ordinances.
Building Officiol
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fae
Fill in numbered spaces S/C
Type or Prini /egib/y Tot. 1. Date 2. Installation Cost '
0 ;c, t f
3. Job Address _. ; Cot ??, Blk. `
4. Owner ' lichael ShorTdo'1
Tract SC?
5. Contractor '"c7r''"'..7":3 `'-oft [•?attar Phone 7".11-
6. Address i.ft?7-rLi.;F? r ;r
7. City _ • State Zip '
8. Building Type: Residential;g" Commercial O Institutional ?
9. Work Description: New ? Add fl' Alter O Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cess
ool/Drainfield
Bath tubs p
Se
tic Tank
Lavatory " p
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Othe
Laundry Tray r
Floor Orains
Drinking Ftn.
Slop Sink
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.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
? O
This request void 6, 6/1 ` J
18monthsfrom
Date o this Request ?Z F;re No. ?' 16635
I, aLicensed Electrica( Contractor OOwner, do hereby request inspection of the above electri-
cal a?iring installed at:
Street Address or Route No. -1 / 71 IS??? ffiu,- J?'V City ??A/J
Section Township Range County VNi"'°TA-
Which is occupied by ftMP5,;D/^1
(Name of O?ccfupant) ''+?
Is a roughin inspection required on this job? No ? YesYd` Ready Now ? Will Caaa
Power Supplier 1'iEpt Address I!.l`t'"' ?A1`(??tl'"
Electrical Contractor Rek Contractor's License N'o"??S
(Company ?Nanme)
Mailing Address ' (i`
( rical oMractor or Owner Making Thlz Installatlon)
Authorized Signature YAV Phone No. O "S0-0
(Electrlc Contrac[or or Owner Making TMS Installatlon)
Q? f,?(f??? ????n ?? ,(?? This i?pectian request will not be accepted by ffie
?j CUf ?? State Board unless proper inspection fee is enclosed.
maao waru m nuciricrry
Griggs Midway Bldg. - Room N191
1821 University Ave., St. Paul. Minn. 55104 - Phone 297•2117
__.-REQUEST FQR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUEST
1j EB-00001-02
T 16635
Type oP Building New- Add. Rep. Chftr ppP?ces Wir!S For Check Fquipment Wired For
Home ? U Range -
I-z Tempocary Wiring ?
Duplex
A
B
? ?
? ?
? Water Hea[ec Ligh[ing F'nctures ?
pt.
ldg. Dryex Electxic Heating
Commetcial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List .
Other ? ? ? Q
HeieiS? p
HererS?
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subteeders: # Fee Cucuita: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 ta 30 Am eres
101 to 200 Amps. 31 to 100 Ampeies 31 to 100 Am eres J
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee C • "
S' ns
. -
?? Special Ins ection Minimum fee $5
°?-
Remack
? iOTALFE ?V (xJ
I, the El " tricai? ' Y certify th e ab ectio s been made.
(Rough-i' ate
(Final) J'40C/?41A
This request void
18 months from
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(657)6T5-5694
I - - - - - - - - - - - - - - - - -
I For"OfficeUse
?i/?., //^ I
? Permit#: ?!/
I Permit Fee: ?
t ?
? Date Received: ?
I
i ?
? StaH: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress: \? -7 a9 ?,P4Cc7n ? ? ? I CI y2C-`-P
Tenant• co''? MU\?-N , 1v?f?;)e n S? l? Suite#:
RESIDENT I OWNER Name: Phone: GS I-?9?/-?
Address / Ciry / Zip:
Applicant is: _ Owner ;`Contractor
TYPE OF WORK Description of work: S? ?, V, S
Construdion Cost: cs 7 0 (??2 Multi-Famity Building: (Yes No ?
CONTRACTOR
Qv6,/L--rTFf, _776P IC041.?) License#: Z_C? Z`
Name:
Address: j
(? O l ?
City: /' `O Q GYcr"e ?rr Y/ State: ?1'7 Zip: -?
Phone: ? S? Z3.? -? 7 3S Contact Person:?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
Category Submitted Submitted
(4 su6mission 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 Contrector: Phone:
Sewer & Water Contractor: Phone:
NOTE: PJans and supporting documents that you submit are considered to be pu6lic information. Portions of
the informaf+on may be classified as non-pub/ic if you provide specific reasons that would permit the Clty to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be inconformance with the ordinances and codes of the City of
Eaga ? 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
ac rdance ith the approved plan in the case of work which requires a review and x prov of plans. ?
---
App icanYs Printed Name ApplicanYs Signature
Page 1 of 3
CITY OF EAGAN
•? ? 3795 Pilot Knob Road Fagan, MN 55721 , N2 6323
PHONE: 4546100 /
BUILDING PERMIT APPLICATION - R'eceipt # ? Site Address 4 eBCOri u?i vii .
Lor 16 Block 1 Sec/Sub. Jlu?Y•Cake Ridge
Parcel .# 10 39800 160 Ol
SF DWG/G
729 B
700
Erect X$ OCCUpancy x 3
Alter ? Zoning R1
Repair ? Fire Zone 3
Enlorge ? Type of Const. V
Move ? # Stories
Demolish ? Front 52 ft.
Grade ? Depth 34 ft.
Approvab Faes
W Name Drrin Tho=son Homes
Z Adaress 1712 Hopkins Crsrd.c ^^^^
o Nome _
?r
u Address
f r:...
Name _
Address
n
nssessr?'mt I ()--J 4r8
Water 8 Sew. -
Police
Fire
Eng.
Plcnner
Councii
Permit l 77. nn
Surchorge 37 - 5f1
Plon check 88-50
SAC 595_ M
Woter Conn. 305 nn
Water Meter (?n . nn
Road Unit 195 nn
1 hereby atknowledge ihot I hwe read this opplication and stote that Bldg. Ott.
the informntion is corred ond ogree to mmply with all applicable APC Totol 1.37$.00
State of Minnewta Statutes and City of Eagon Ordinances.
Slgnature of Permittee 3Wx]s.SwQ&>**
A Buiiding Permir Is issued ro: Orrin Thompson HOID@S on the express condition that
oll work sholl be done in acmrdanyq with oll agqlit le Stafe of Mtnnewta Statute5 and City of Eagan Ordinances.
Buildirg Official
CITY CF FAGAN Include 2 sets of plans,
ir %? ?. r 1 site plan w/elevations b
6-0 G f= gUiIDING PII?MIT APPLICATIdN 1 set of enerc3Y calculations.
7b Be Used For ???oENCe valuation 'At70U.do Date l0 "9-b'O _
Site Address: 47ac? ?ercor.F CL.
Lot ) 1,- E1ocx / sec./sub.ao)iNNy cAKe
????? fZto4E
Parcel #: D ?l / iJ /J/
Qaner:
Pddress:
City/Zip Code:
Phone #:
OFFICE [7SE OHI,Y
Erec.'t DC Occupanc7' /<?
Alter Zoning
Repair . Fire Zone 3
Enlarge _ Zype of Const. I/
hbve # StAries
Dennlish Front ?a. ft.
Grade Depth _ 3? ft.
Contractar: (RRIN TNnMPS(1N 1-If1MRC Assessments 4?/
a Division of U. S. Home Corporation W3tEr/SE-'heT
Addr2SS: }}?2 1 -Eg.pM<IP?5-6Fi0SS.?BnB POllce
City/Zip Code: MINNETONKA, MINN. 55343 Flre - Phone #-,` : S yq•'?33 3 ? er
Council
Arch./Eng.' Bldg_ Off.
Pdclress: APC
City/Zip Cocle:
Phone #-
ernut l 77 ?"
Surcharge
Plan Check ?
SAC
WatPS Conn. 3 ? ?5 ZS`
Water Metes
Roaa vnit
n7PAL ??'74- 0C9.
4729
,0 ? ' ' ' r
C. R. WINDEN 3 ASSOCIATES, INC.
IAND SURYEYORS Tel 645'3646
1381 EUSTIS SL, $T. PAULP MINN, 55108
For:
U. S. HOME CORPORATION
SCale: 1" = 50'
O Denotes Iron
?
i,
I
I
J'
?
?
P
- - - 192.14-- -
193. 8 ?
?
?
13t
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4? ^
' ?. e .
5
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b°' '?' SJ
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341.54(
/?Y S? , %
G ???'?? y
0
Lot 16, Block 1, Johnny Cake Ridge
Addition, Dakota County, Minnesota
,
110
`'V
N-?
WE NEREBY CERTIFY THAT iM15 !5 ATRUE AND COqflKT REPRESfNTATION OF A SURVEY OF THE
60UNDARIES OF THE LAND ABOVE DFSCRIBEO AND OF TME LOCATlON Of All 6UIlDINGS, tf ANY,
TMEREON, AND All VISIBLE ENCROACHMENTS, IF ANY, fROM OR ON SAID tAND.
Dotad rhis 74` doy oF OCI' A.D. IV,qp C. R. WINDEN d ASSOCIATES, INC.
bY
?•??
5urvror. Minnswra Rapi.trotien No. ?/_?
L I(v, Bl ,
CITY OF EAGAN
EARLY UTILITY CONNECTION PERMIT
understand that the City has not yet completed, inspected and/or accepted
the sewer and/or water lateral. I agree not to use, test, or connect these
individual services to any interior plumbing and understand the require-
ment to cap the sewer service to prevent any unauthorized use.
,
In accepting this permit, it is agreed that I will hold the City and its
agents harmless fiom any damage that may occur due to this early connection.
It is understood that no Occupancy Permit will be issued or water allowed
to be turned on.until the City utility system has been declared operational
by the City Engineer.
Signed by - Plumber:d
Owner:
Developer:
4
Builder:
Dated:
--T
I hereby request permission from the City of Eagan to connect to the
sanitary sewer and water lateral line in the public right-of-way. I
. BEABLOMOUIST
. MAYIIP
1
THOMASEGAN
MARK PARRANTO
? JAME5A.SMITH
THEODORE WACHTER
COUNCIL MEMBEPS
I
September 9, 1981
.,
n;', • ,?'
;IT??OFr E'AN
? DB
AV,
4t
;' .
9_RO {•
9yO`rIA .
Y'
THOMASMEDGES
dTY RMAINISTMiOfl
EVGENE VAN OVERBEKE
CITY CLEBN
MICAAEi, & PAMELA SHQMffCN `?--
4729 BEd10CN AIIL CII2QE
EAGAN MN 55122
Re: Project 262, Beacon Hill Addition Street an3 Utilitv Assessment Notice
Dear Mx'. & Mrs. Shanion:
Previously, you were foraarded a notice of final assessments associated with Lot I6-?
B1oek-1; =Johnn"y"- Cake::Ridge=Additicn- ?for the installation of streets and utilities.
Please disregard this earlier notioe as our files indicat,ed that these assessments
have been paid imder Project 283 by U. S. Hanes Corporation imder Receipt i7o.C005834.
We apologize far any confusion that this previous notice may have caused and hope
that this letter gives you the prnpe.r assurance that there are no additional assess-
ments associated with your lot for the installation of streets ar utilities.
Sincerely,
ThQnas A. CAlbert. P.E.
Disector of Public Pbrks
TAC/jac
TME LONE OAK TREE ... TME SYMBOL OF STRENGTH AND GROWTN IN OUR COMMUNITY.
Gity af Faq3ri
Cash F.eceipt
Receipt Date 18110,'66
?iIDe F°rinted 8:54e49
Keceipt Nuaber 1247
kfi5'i10NU Pf TORUENSEN
4729 BEAC47N HILL CIk
900i.M5 3.067
BP 43200
9001,4185 125.25
EP 432@@
Saini a:cceio; timuVnt I2e.25
Usar H(4C:iftAii
; 2000 BUILDING PERMIT APPLICATION (RESIDENTiAL)
? cinr oF RacaN
3830 PILOT KNOB RD - 55122
851-681-4875 D b?
o
New Conthuctlm ReaWremgnh Remodel/Reoalr Reauiremenh CQI I{4 Il/n-1-O^
U
> 3 replttared tlte wneYS showlny tq. R W lof. a41f. o( houte 2 coPies of plan
antl gll rooled areas f20X mmUmum lot coveraoe albwedl 1 sef of enerpy eaOCUWMons for Ifeafed adtllXOns
> 4 coPlea of Wam (show beam 3 wintlow tixes; Pcxjred Md. desiprr etc.) 1 dte wrveY lor exfeAOr adtlilions R decks ri r V?
D 1 set of eneryy ccdculaHOns
n J coples ot hae PresenaMOn plcn N lof plalled aBer 7/1/93
DA?? ?0--5-"00 CONSTRUCTIONCOST: C)
p ( ?
DESCRIPTION OF WORK: I'14C( ( 31i? ?TF?. ?I f{7T/iCN ??D C-?rAl21hl L
STREETADDRESS: V72, el l.l Lft COn! XJ C? {QCIF
LOT: /(.0 BLOCK: I SUBD./P.I,D. i:
PROPERTY
OWNER
COMRACTOR
ARCHIiECT/
ENGINEER
Name: `.Jc ftG,ZNsEN ;?A yPhone CoS 1-?t 4 S/- 6 9 9 Z?
Lcet Fust Y?Gca 6S/ -/O --7 0 yS'
Sfreet Address: q 7 a 9 RER con/ h'W 310Q0-It=
Ciy _ LAGA &l Staie: M r NN Zip: SS/ Z Z
Company: c* EC- F Phone o:
(area code)
Sheet Address: Llcense N
Ciiy
Sfate:
Company: . (::?- 0 L F Name:
Ietephone M: (
Sheef
citY
State:
Zip:
Zip:
Sewedwater licensed plumber (ff installina sewer/water): Phone #: L?
1 hereby acknowledpe ttwf I have read Ihis applicaNon, alate ttfat ihe Wortnatton is eortect, and agree b co ply wNh atl apWtcable State
of Mfnnesota Sfahrtes and CNy of Eagan Ordinancea
Sigrwlure ol ApplicanY.
i
?
OFFICE USE ONLY = -
Certificates of Survey Received _ Yes _ No ? OCT 0 5 ZOOO ?
f
Registraflon #:
Tree Preservation Pian Received _ Yes _ No _ Not Required
?
OFFICE USE ONLY r ' *
BUILDING PERMIT SUBTYPES
0 01 Foundation ? 07 OS-plex ? 13 16plex ? 21 Porch (3-sea.) O 31 Ext. Alt - Mutti
? 02 SF Dwelling ? 08 06-piex PV 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
O 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muw
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Y or _ N ? 25 Miscellaneous
? 06 04-Plex O 12 12-plex ? 20 Pool ? 30 ' Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. 0 43 Reroof
32 Addition O 37 Demolish (Bldg)' O 44 Siding
33 Alteration O 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq. ft.
No. of Units L Length sq. ft.
No. of Buildings _ Width Footprint sq. ft.
Const. (Actual) ? Basement sq. ft. Census Code
(Allowable) ? Main level sq. ft. MC/ES System
UBC Occupancy 4.? ar e. sq. ft. ? City Water
Zoning ? sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
O Stucco/Stone
APPROVALS
Planning
Building f?d
Engineering
Variance
Permit Fee Valuation: $_ 4?D??•
Surcharge
Plan Review
License
MC/ES SAC
CitySAC Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
4729
?P ' ' o? ?u??•
?
C. R. WINDEN 3 ASSOCIATES, INC.
IAND SURVEYORS Tel 645•3646
1381 EUSTIS ST., ST, PAULP MINN. 55108
For:
U. S. HOME CORPORATION
Scale: 1" = 50'
O Denotes Iron
JY
P
1938? ? ?
'j37er_ - ?
i
/3' ?Q)
. ?. .. ?
1/7 ,? aa 5
°
i')rp
1 10
--- /g
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/4--- ---' -- --1=?Ac--
341. 5d
Lot 16, Block 1, Johnny Cake Ridge
Addition, Dakota County, Minnesota
r?o? rJ
I
'V ?`J
WE MfRE6Y CERTIFY TMAT TMIS IS A TRUE 4ND CORRECT REPRESENTATION Of A SURVEY OF THE
60UNOARIES OF THE IAND A90VE DESCRI6ED AND OF THE IOCATION OF ALL 6UILDINGS, IF ANY,
THEREON, AND ALl VISI6lE ENCROACMMFNTS. IF ANY, FROM OR ON SAID IAND.
Dofod rAis 7{?j doy ef DC?A.D. 1V?.';^ C. R. WINDEN 8 ASSOUATES, INC.
?
by
Surreyor, Minnewro Ropiurafien Ne f???
2013-05-0612:31 » 651975 5694
41,1 City of Eaaall
Data:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
1 U!a MI II F AP MU /I1 -11[ ICY
P 3/5
For Office Use
Permit x: 3 217
Permit Fee: on6:2-
Dale Received: 0 - 7- 3
Staff:
(7
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
S LP l3 Site Address: 4-1 a -t �� 0.0 511 lfi t Gf
Tenant:
Resident/Owner
Contractor
Type of Work
Permit Type
Suite #:
Name: 3O^^ 241$. 4' Phone. toS1 c1.9-44 (09
96
Address i CitIy / Zip; �JZ Q .S S,}{--,
Name: 3
License #; 01.01 3€2
Address:
Lo1307
Address: 5 S. Su hrn Ltd Blvd. City: Jor-cituA
State: Zip. 5535 Phone: Lo 1 a ' Log ' ) D
Contact Mason
Email:
New Replacement Repair Rebuild Modify Space Work in R.O.W.
Description of work: 2\ irks VOA) 1 C i1 , 6Yi
RESIDENTIAL J
_Water Heater
.1_ Lawn Irrigation ( RPZ / r, PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / — Lower Level)
Water Tumaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic SYStem Abandonment Water Turnaround' (includes $5.00 State Surcharge)
'Water Turnaround (add $200,00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and 55.00 State Surcharge)
TOTAL FEES$ (D.a
CALL BEFORE YQU DIQ. 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. •
I hereby acknowledge that this information is complete end accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan, that 1 understand this is not a permit, but only an application for a pemtit, and work is not to start w$th0U1 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- ,\ate LQ r c5
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Applicant's Printed Name Applicanrs gnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: _Under Ground _Rough -In Air Test _Gas Test _Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151169
Date Issued:08/13/2018
Permit Category:ePermit
Site Address: 4729 Beacon Hill Cir
Lot:16 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-160
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 -
Raymond M Jorgensen
4729 Beacon Hill Cir
Eagan MN 55122
Platinum Builders LLP
20830 Holt Avenue
Lakeville MN 55044
(612) 919-3220
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA157764
Date Issued:09/06/2019
Permit Category:ePermit
Site Address: 4729 Beacon Hill Cir
Lot:16 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-160
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Raymond M Jorgensen
4729 Beacon Hill Cir
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177280
Date Issued:06/23/2022
Permit Category:ePermit
Site Address: 4729 Beacon Hill Cir
Lot:16 Block: 1 Addition: Johnny Cake Ridge
PID:10-39800-01-160
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Raymond M & Karen M Jorgensen
4729 Beacon Hill Cir
Saint Paul MN 55122--270
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature