4360 Bent Tree Lane
r '90 8 8 2 Q 7 g
l t~t
Request Date Fire Vo. Rough-in Inspection NOTICE: You Must Call Electrical Inspector
Required? If A Rough-In Inspection
es Cl No Is Required.
licensed contractor ❑ owner hereby request inspection of above electrical work at:
Jab Address treet, Box or Route Na.) ~ City
Section No. Township Name or No. Range No. County
Occu I(PRINT) Phone No.
r
Power Supp' Address
Electrical ractor (Company Name) Contractor's License No
Mailing Address ( tractor or Owner Making Installation)
Au horbzed Signatur (Contractor/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
1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0600 ENCLOSED.
P 9fp REQUEST FOR ELECTRICAL INSPECTION ES-00001-08
O► See instructions for completing this form on back of yellow copy.
M 48 _ "X" Below Work Covered by This Request
e Add Aep. TypeofBuilding Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
CommAridustrial Furnace Other (Specify)
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
Transformers Above 200 Amps e 100 Amps
Signs Inspectors Use Only: TOTAL
Irrigation Booms
Special Inspection G V
Alarm/Communication THIS INSTALLATION MAY BE D DIS~PNNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, the Electrical Inspector, hereby Rough-in t0
certify that the above inspection has Final Date !
been made.
OFFICE USE ONLY
This request void 18 months from
Werti f irate of cccupanc~
WU4 of Wagan
zepartment of Zambia anotrtion
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: S DWG Bldg. Permit No. 22461
Occupancy Type R3/14I Zoning District R3 Type Const. VN
Owner of BuildingPA~SH WTG & DEVE ' . Addtes,37)4 MIARW M LN, EAGAN
Building Address 4360 SW TREE LAM B2, An" M-= 31-ID
Date:
POST IN A CONSPICUOUS PLACE
Address' 4360 BENT TREE LANE Zip
Lot 9 Blk 2 Sub A nm RIDGE 3RD
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 7 ff l~ Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage) a/
Permanent steps (main entry)
Permanent driveway a%
Permanent gas
Sod/Seeded grass r
Trail/curb damage
porch
Basement finish
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
PERMIT
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Rbad B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 022461
(612) 681-4675 Date Issued: 11/03/93
SITE ADDRESS:
4360 BENT TREE LANE 5630
LOT: 9 BLOCK: 2
AUTUMN RIDGE 3RD v, ,l
P.I.N.: 10-12302-090-02
DESCRIPTION:
Building Permit Type SF DWG
Building Work Type NEW
UBC Occupancy R-3 M-1
Construction Type V-N
Zoning R-3
Building Length 48
Building Width 54
i
REMARKS:
PRV S & W PLBR - LAKESIDE PLBG
FEE SUMMARY:
VALUATION $118,000
Base Fee $702.50 MISCELLANEOUS 1 744.50
Plan Review $456.63 Total Fee $3,712.63
Surcharge $59.00
.SAC $750.00
SAC % 100
SAC Units 1
Subtotal $1,968.13
CONTRACTOR: - Applicant - ST. LIC. OWNER:
PARISH MKTG & DEVEL CORP 14526644 0001054 PARISH MKTG & DEV CORP
3799 BRIARWOOD LN 3799 BRIARWOOD LN
EAGAN MN 55123 EAGAN MN 55123
(61-2))-452-6644 (612)452-6644
I hereby acknowledge that I have read this application and that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
i
APPLICANT/PERMITEE SIGNATURE 'ISSUED (GNAT RE
REACTIVATk CITY OF EAGAN
PERMIT # ` ~ 1993 BUILDING PERMIT APPLICATION
0 Z 1 igg3 -681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy ofdenergy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, I copy of energy calcs.
Penalty applies: 1) when ppemit 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 i.s requested once permit
is issued.
Date 10 26 93 Valuation of work
Site Address: 4360 Bent Tree Lane
STREET SUITE 0
Tenant Name: (commercial only)
LOT 9 BLOCK 2 SUBD. Autumn Ridge 3rd P.I.D. #
Description of work: Single Family Home
,The applicant is: Cl Owner 13Contractor E3 Other (oe*crfbe) -
Name PARISH MARKETING & DEVELOPMENT CORP. Phone 452-6644-
Property LAST FIRST
Owner Address 3799 Briarwood Lane
STREET STE S
City Eagan State Minn. Zip 55123
Company same Phone
Contractor Address License # 00d2as Y1Exp.
City State Zip
Architect/ Company Phone
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Lakeside lumbim - 894-7600 Processing time for
sewer & water permits is two days once area has been approved'.
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,
r~
BUILDING PERMIT TYPE
O 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging nish
02 SF Dwg. ❑ 07 4-flex ❑ 12 Multi. Misc. w ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind.
❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc.
❑ 05 SF Misc. ❑ 10 Multi. Addl. ❑ 15 Deck ❑ 20 Public facility
❑ 21 Miscellaneous
WORK TYPE
0 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish
❑ 32 Addition ❑ 34 Repair ❑ 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWCC System
(Allowable) \/-N 1st Fl. sq. ft. City Water 9;
UBC Occupancy M-t 2nd F1. sq, ft.' FRV Required
toning f~-3 Sq. Ft, total Booster Pum
# of Stories Footprint Sq. ft. Fire SprinNer
Length_ On-site well Census
Depth SN' On-site sewage SAC Code 0
APPROVALS j
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
a
❑ Site ❑ Footing ❑ Framing ❑ Insulation
❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace
Permit Fee Valuation: $ R, 000 "
Surcharge
GA•RAGE
Plan Review 4 x 24 ° S9
-
License ,
aT..: a4 k Y2 - /pt~$
MWCC SAC
City SAC 5 /o - d}
Water Conn.
Water Meter cx 30 = S4 °
Acct. Deposit 34
S/W Permit- f 636 X i = 1~Tj gals
S/W Surcharge
Treatment Pl. IST
-Riemk
Road Unit
Park Ded.
Trails Ded.
Co ies j~
Other
Total: SAC x 10D 15~'?3'~ Sy:. ~~~.""''..,~~'"'a•°
SAC Units 1
10/61/93 16:21 002
„
Y
ss9sa6
SURVEYOR'S CERTI ICAT PARISH MARKETING
9 7_ 'BENT THE LANE _ ~93s.o
X09°' Q9
14-9' 111.51 N~9*05' iiE 935.7
93
( `j~N r7 ~g g / TOPOOFPPJ E
M
PROPOSED EIEV..9$6.64
\ DRIVEWAY
-41
9 D 0 ~38A -I
'S _ s _
\ 49 938.3 24,0 ,
W
o t4,33 N 1 +
GAR,
/ i 8.$7 ii
TO
BSNOH P OF MARK J 938.4 - 7PROPOSED o
ELEV.-
9~t8.64 le Ito
too
OUSE Rt '
2.0
42.0 , 836.6
LW{.~'^I .i 938.5 T rrG 9a.v~ 9383 LOT
N
938' 5
70,00 492*16
/ 940,8
i ~
D
8y
1
1
0're; NO 5PM FIC SOILS .INVESTIGATION HAS aFZN COt, METED
ON THIS LOT 13Y THE SURVEYOR. 71 $UITAJ =ti 't`f. 6F i(! 6 AT 1191~ONPfJA& i~R HORI~ONTA(
SOILS TO SUPPORT THE SPECIFIC HOUSE PROPOSE0 IS NOT'J'_. 1I;"~1MI~
NOT THE RESPONSIBILITY OF THE SURVEYOR. (I VERTICAL LOCATION OF STRUCTURE ONLY. SEE
L PLANS FOR BUILDtN.G a FOUNDATION
DENOTES'PROPOSED SURFACE DRAINAGE DIMENSIONS.
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 9 ¢0-3 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR y3Z .0 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = c'40.7 FEET
WE HEREBY CERTIFY TO PARISH MARKETING THAT THIS IS A TRUE AND C79 RECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
1-01 , Block 2 1 AUTUMN RIDGE, :~Iht) ADDITION, 9.tcordinq to the recorded plat fitt@ 01°, Dakoto
County, Minnesota.
IT DOES NOT PURPORT 1.0 SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 25TM DAY OF SEPT. 1199.31
PROPOSED GRADES SHOWN WERE SIGNED J S R. HILL, INK
TAKEN FROM THE DEVEOPMENT
PLAN FOR AUTUMN RIDGE PRI!
PARED BY PIONEER ENG. LAST
DATED A.- 22-90 $
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
fn ro
03 'K
„ oN~ James R. Hill inc.
,am~~ O ~cpr`n /
R o b r w m" PLANNERS / ENGINEERS /SURVEYORS
p N m VT cn w
2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 • 612-890-6044
" LOT SURVEY CHECKLIST FOR RESIDENTIAL
• W W
BUILDING PERMIT PPLICATIO
M 00,
PROPERTY LEGAL:
<
N Date of Survey:
Z 2 DOCUMENT STANDARDS
CV' -'13 0 Registered Land Surveyor signature and company
M`13 0 Building Permit Applicant
0~ ❑ 0 Legal description
❑ 0"" ❑ Address
0o'*13 0 North arrow and bar scale
D- 13 0 House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
P0'' 0 ❑ Directional drainage arrows with slope/gradient
eo 0 Proposed/existing sewer and water services
0i ❑ 0 Street name
0 ❑ Driveway
ELEVATIONS
Existing
❑ 0~ ❑ Sewer service
0,-13 ❑ Lot corners
21- D 0 Top of curb at the driveway
0 5" "'13 Elevations of any existing adjacent homes
Proposed
0 ❑ Garage floor
PJ~ D 0 First floor
PJ° ❑ ❑ Lowest exposed elevation (walkout/window)
['J1~ 0 0 Property corners
D 0 Front and rear of home at the foundation
PONDING AREAS (if applicable)
❑ D' 0 Easement line
0 [T*-, E)
NWL
❑ 1~1 ❑ HWL
0 u 0 Pond # designation
D O 0 Emergency Overflow Elevation
DIMENSIONS
0% 0 Lot lines
0' 0 ❑ 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)
0~ 0 D Show all easements of record and any City utilities within
those easements
GK D D Setbacks of propo ed structure and setback of adjacent
existing homes
0 D/0 Retain' quirements, if any
Reviewed:
N eW / ate
October 1992
I~
E}(TL'ItIO14 FNVEWI'IS AVERAGE "U" COMPUTATIOCJ
OWNER
sin c
ADDRESS Y1 Zu rc~i-
. CONTRACrorA~2/~Sh~ •q/I~C6'Ti~y` f GO irir~E~%
DATE PHONE
ONE
Determine working square footage of each.
1. Total exposed wall area 1930. D sq. ft. x .11
2. Total roof .coiling area .397• D sq. ft. x •025 8s
z
Total exposed wall area above floor 30. D
a. Total wall window area........ .
b. Total door area yO.B _
c. Total sliding glass door'area .301¢
d.. Total fireplace wall area........ O
e.' Total wall framing area (average 10%) o
f. Total net wall area above floor 06-
9. Total rim joist area.......... ...3r
Total exposed foundation area O
h. Total foundation window area......... O
i. Total net foundation area above grade 7A o
Determine "U" value of each wall segment.
a• X ..u.. .s"S 7G~B
yO. X U.. b. B .Q~~ _ ,►?.89
30. X ..U..
d. Q X ..U.. Q a 4
e. /93► o X ..U.. 2-
$
-0 71e
• 3 .................Total A8.2
it ite►n 43 is the same as, or •wi than item Ml, you h.av • mot the i.ntenf
Of S U C 6006(c)2. ~.3iz.3~ -
fee.
Total exposed roof/ceiling area
J. Total skylight area...... b
k.' Total roof/ceiling framing area (averago r0•L) _l3~• S/
1. Total net insulated roof/ceiling area
Determine "U" value for each roof/ceiling segment.
p X U., _ - p O
k. /39• x ..U.. _ . ors = 3• s'
.4 ......Total - ~!•8
r
If total of A4 is the same as or less than 42, you have t the intent of
SBC 6006 (c) 1. 02ls»1 ~y! ►-z g, ,L. ~QQryv► # ,z .3 y. ~.S„J `~/?4`~!v
~G 3 C. G G o
ATEernate Building Envelope Design
To utilize the total envelope system method, the values establish-,d by t)►e
sum of items 03 and 14 shall not be greater than the sum of items 01 and P2.
2 15-
a4e
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
p, CITY or MGM
3830 PILOT KNOB RD - $5122
551-881-575
Uncondwation
> 3 fegistered site wrorvoys showkV sq. ft. of lot, sq. ft. of house 2 copies of pan r~ w , sw,
and gj rooted areas (M maximum Id covenno g1gMM 1 set of ensW colculollons for
> 2 cops of plans (stow beam i wkwdowr sizes: poured Intl. design: etc.) 1 sir sandy for exteft n s & decks
> I set of energy calculations
> 3 copies of free presemaflon plan N lot platted alter 7/1/" 1 eAL
p~ 10~rn~~`
DACE: CONSTRUCTION~OST:
DESCRIPTION OF WORK: L PQ ~7.d s~ e Z--E&Z
STREET ADDRESS: '(3 6 o e,ti
3Y
LOT: BLOCK: SUBD./P1.D.
Name: ~j tt o l1/1 Q At ~6 / Phone ~2 f 1 ' 72 7 v -7/.
PROPERTY tact Forst
OWNER
Street Address:
E. Q-
city ? State: ~1PJ Zip.
~ :~Yoc~
Company: Phone _
(cues code)
CONTRACTOR
Street Address: q SU N~ Ile , e ..So _ License # ...E>~•
city ZI/F State: 4,7-,,-) Zip: - - 7
ARCHITECT/
ENGINEER Company. Name:
Telephone area code ( )
StreaO Address: Registrafion
City State: Zip:
Swgw i water licensed plumber ftgW ddffor new cam ft asnNt:
Penalty applies when address change and lot change b requested once permit Is issued.
j
I hereby acknowledge that 1 have read this application, state that the information Is correct, and agree to comply with all appkabi
Slide of Minnesota Statutes and City of Eagan Ordinances.
Sign kw* ad AppEcant:
OFFICE USE ONLY
Cerdficates of Survey Received Yes No SEP 2 3 19
. Treo Preservation Plan Received Yes No. . Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.)
❑ 02 SF Dwelling ❑ 07 .5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 PorctVAddn. (4-sea.
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened)
❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous
WORK TYPE
❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia
❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors
❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair
❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee l l • Valuation: $
Surcharge . IS70
Review
License
MC/ES SAC t
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded. y
Trails Ded.
Other
Copies
Total: 5~--
SAC Units
% SAC
l
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO ~4l , Xt ,
ADDRESS 1941 r
FYI Iny0TArA!1,
LOCATION &I J , 1x v, 'I'T o
RECEIPT # / DATE
REASON FOR REFUND1,
TYPE,OF REFUND ELECTRICAL PERMIT 3211-9001 $
PLUMBING PERMIT 3212-9001 $
i
i
MECHANICAL PERMIT 3213-9001 $
SURCHARGE 2155-9001 $
WATER CONNECTION PERMIT 3713-9220 $
SEWER CONNECTION PERMIT 3743-9220 $
ACCOUNT DEPOSIT 2252-9220 $
UTILITY ACCT OVER-PAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTRUCTION METER DEP REFUND 2254-9220 $ - -
WATER USAGE CHARGE 3711-9220 $
OTHER: _A.lulftfna LQtnut CYQ16 L. .~24~-~~0I $
I declare under the penalties of law that this account, claim or demand is just and
that no part of it has been paid.
• Sign ure Date ~a``~~-'c •
CITY OF EAGAN~
3830 PILOT KNOB RD - 55122 ,
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Requirements Rem el/Regair Requirements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if tot platted after 7/1/93
required: -Yes _ No
DATE: 0--Z , _ CONSTRUCTION COST:, triry
DESCRIPTION OF WOR
~~o ~rc~ 1 I~te Cvt
STREET ADDRESS:
LOT BLOCK SUBD./P.I.D.
PROPERTY Name: &-t vvx vv,-~r ea ~i e- Phone W7 - 96_3,1
OWNER . u., .V.,
(35 0
Street Address
City: l~~c State: Zip-
CONTRACTOR. Company: e .Slat. itit.e Phone M-PO(o ~3 y
Street Address: JSVS <:,4e✓f6,rn r2 _ c, i.- License
. .
Cl :kT(cu Sate: Zips-3as
ARCHITECT/ Company: Phone_
ENGINEER
Name: Registration -
Street Address-
City: State: Zip'
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
1 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
161
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. j2,1 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
j a 05 SF Misc. ❑ 10 = plex ❑ 15 Deck
WORK TYPE
31 New ❑ 33 Alterations ❑ 36 Move
32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft.: Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. ^T
Depth Footprint sq. ft. SAC Code d
Census Bldg t
- Census Unit
APPROVALS
Planning Buildin En meerin Variance
Permit Fee Valuation: $ 20cw
Surcharge
Plan Review
License
MC/WS SAC t 3 m,
City SAC
Wafer Conn.
Water Meter
Acct. Deposit
SM Permit
SIW Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other _
Copies fif="
Total:
% SAC
SAC Units
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
4996 BUILDING PERMIT APPLICATION RESIDENTIAL
ss1-as75
New Construction Requirements RemodeURegair ea rerpents
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if tot platted after 711/93
required: Yes _ No
®t UT?
DATE: CO TRUCTION COST:
DESCRIPTION OF WORK:
S7 9T ADDRESS: ' C
LOT BLOCK SUED./P.1.D. J~ &_iAJz3,X1
PROPERTY Name: I vvi vv,,er AC- Phone 9Q.3 j
OWNER • VMS?
Street Address'0~v ~~r Z ~-~e-
City: fa&,Vl State: Zip.
CONTRACTOR Company: LVIA_~l YC_ vvc e Phone #:ca3 y
Street Address: aZVS- c1te„ 1go v :a c License e? /-?3
City: Tl State: Zips~3as
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration #
Street Address-
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
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 1 6
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY ;
BUILDING PERMIT TYPE
o 01 Foundation ❑ 06 Duplex o 11 Apt./Lodging ❑ 16 Basement Finish
V0 2 SF Dwelling ❑ 07 4-plex o 12 Multi Repair/Rem. o 17 Swim Pool
3 SF Addition ❑ 08 8-plex o 13 Garage/Accessory o 20 Public Facility
❑ 04 SF Porch o 09 12-plex o 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck
WORK TYPE Q, * -a- 4-ole-
❑1 New ❑ 33 Alterations o 36 Move
a/32 Addition o 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 41, 14
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit v
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ t 000.--
Surcharge
Plan Review
License z v
MCNVS SAC
City SAC J~
Water Conn.
Water Meter ty )e zo - Zeo
Acct. Deposit
SNV Permit z . s- - z z . s
SNV Surcharge 3 o z • s ~sy -
335,
Treatment Pl.
Road Unit
lam, 5 3s.
Park Ded.
Trails Ded.
Other
Copies Total:
% SAC
SAC Units
RESIDENTIAL(
BUILDING PERMIT APPLICATION
2!~J CITY OF EAGAN
1 3830 PILOT KNOB RD EAGAN MN 55122
651-681-4675
New Construction Requirements RemodelfRepair 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 beam & 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 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE ~~L9 b VALUATION
kS oil fMULTI-FAMILY BLDG _ Y ^ N
SITE ADD
TYPE OF WORK FIREPLACE(S) _ 0 i 1 _ 2
g+ ► e"M
APPLICANT + MN 55433
STREET ADDRESS CITY STATE ZIP
TELEPHONE # - 55' ELL PHONE # FAX #
! L D -TELEPHONE
PROPERTY OWNER 63::U'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted y New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: `_____y_~__~_ Phone #
Plumbing system includes: Y 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
Sewer/Water Contractor: P -
j ,12 2002
n
I hereby acknowledge that I have read this application, state that t inform i in o ct, and a e to comply
with all applicable State of Minnesota Statutes and City of Eagan r inanc Y
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. 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 (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 Bldgs 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
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: 6 1.1 11, 0 ~
3830 Pilot Knob Road Permit Number:'
Eagan, Minnesota 55122-1897 Date Issued:'` `
(612) 681-4675
SITE ADDRESS• APPLICANT:
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4;360 ttFNJ THFt VANE tz t-1()N11t H00f~~ INC
PERMIT SUBTYPE: TYPE OF WORK:
TK)N 'TYPE
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R V X A R W' ti, 1': P A P A I t'.. A N 'Er t't_ i'1 I'. # R( } i? F A.. F [ P .E. C A F. WORK
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Penult No. Permit Mohler Daft T #
ELECTR#C
PLLMNG
HVAC
inspecdon bate insp. Comments
FOOTINGS
r
FOUND
FRAMING
r ROOFING
ROUGH
PLUMING
PLBG
AIR TEST
ROUGH
HEATING
GAS
TESTS
I
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
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INSPECTION RECORD
CITY OF EAGAN ;PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 551,22-1897 Date Issued: t
(612) 681-4675
_$M ADDRESS:. N . 10 ~ ' 0 r-40 0 APPLICANT:
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PERMIT SUBTYPE: TYPE OF WORK:
44 .F ! F~ t"a ! NEW
la .uo
Permit No. Permit Hodder Date Telephone #
ELECTRIC
PLUMBING
HVAC
In Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUL SING
i AI
AIR TEST
ROUGH
p HEATING
TGAS SVC
i
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
t7 J7
1 X41. ,ar INN RECORD
PER K" TYPEr
(too # oaci - Permit Number: 4 61
s el , Minrlsota 55123 gate Issued: r #
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- - - - - - - - - - - - - - - - -
For Office Use
I
~ J I
City of EI Permit#:
I
I 1
3830 Pilot Knob Road Permit Fee:
~a~ 0~ I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant: (9 L
r`~~
Suite
RESIDENT / OWNER Name: phone:
Address / City / Zip:
Applicant is: Owner eCactor
TYPE OF WORK Description of work:
Construction Cost: C...~ Multi-Family Building: (Yes d No
1
CONTRACTOR Name: License Address: C CkX
r C ~F
City: State: YA ip. =_I
Phone: 0Contact Person: - J~aAy 'e
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota? Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(N( 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 approv lans.
t
an 4'01)je(
Applicant's Printed Name p an s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124995
Date Issued:07/16/2014
Permit Category:ePermit
Site Address: 4360 Bent Tree Lane
Lot:9 Block: 2 Addition: Autumn Ridge 3rd
PID:10-12302-02-090
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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 by law in ALL single family homes .
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 -
Robin W Brimmer
4360 Bent Tree Lane
Eagan MN 55123--305
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use
EaaariCity of ::::e:
t-ti-ti , t,
j J�( l�4 D3
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
Fax:(651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7_/11 (
Site Address: ti3°o / 7 nee Lci, Unit#:
Name: 6`'J 19 r1 Phone: 5/- 330-O
Resident] L / --
owner - Address/City/Zip: [<JU �Jl ( -L N`e, G / `7 >' 3
5
Applicant is: Owner X Contractor
Description lep),,,r� coot-le,-,-F-1,--) r r S,G
Type �f work of work: -� � l
Construction Cost: )1/A962-2 Multi-Family Building:(Yes /No X)
Company:Ali 5-41„, Cw,j/P K-cLe 617\ K� r i I I Contact: Z`J te /,/6 6,21
Contractor Address) ! 3t) J r r+i 0(A Or City: t i
State: rill/ Zip: 5-511 J6 Phone:7k6,70"-61v7 EmailZ`'cA`47 )15T )Od ,,(em
License#: EC(„e2103 5 A, Lead Certificate#:
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 he public'nformation ,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.qopherstateonecall.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.
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.
x Zpi.,26\f' x ,/l
Applicant's Printed Name Applicant's Sign
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174498
Date Issued:02/01/2022
Permit Category:ePermit
Site Address: 4360 Bent Tree Lane
Lot:9 Block: 2 Addition: Autumn Ridge 3rd
PID:10-12302-02-090
Use:
Description:
Sub Type:Fixtures
Work Type:Replace
Description:Water softener & pressure relief valve
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.
All tiled shower bases require a water test.
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 -
Robin W Brimmer
4360 Bent Tree Ln
Eagan MN 55123--305
(651) 330-0864
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature