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4715 Beacon Hill Rd Use BLUE or BLACK Ink For Office Use q, City of nam P6A ~ Permit ~ 7nj j Permit Fee f ij 1 3830 Pilot Knob Road I I an MN 55122 S I Date Received: Eag Phone: (651) 675-5675 1 Staff: j Fax: (651) 675-5694o ! - - - - - - - - - - - - - - - - J I INFLOW & I ILTRATION PERMIT APPLICATION Plumbing I Sewer & Water .1 Date: Site Address: Tenant: 1AQ Name: 4114 1 Phone: RESIDENT / OWNER Address/ City/ Zip: Name: T3, License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email PLUMBING Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK /Sump Pump Repair Repair V Other: Other: u, A J1 a cnpVon o ` DESCRIPTIOt i V 0714 1 - )I-rj ) Wi it ar v $55.00 /Each (includes $5.00 State Surcharge) (Rev. 6-30-10) y l TOTAL FEE $ ."Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for MCA V reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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 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 f 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 wh' equires a Z r w and approval of plans. A4 A. /1 x x Applicant's Printed Name Appli eat's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground -Rough-In Final PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA076882 Eagan, MN 55122 . Date Issued: 03/06/2007 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4715 Beacon Hill Rd Lot: 3 Block: 7 Addition: Beacon Hill PID 10-13500-030-07 Use Description: Sub Type: e - Furnace Work Type: Replacement Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector, 952-445-2840Ashley Orman 410 W Lak e St Minneapolis, MN 55408 612-824-2656 ashley@standardheating.com Fee Summary: Surcharge-Fixed $0.50 9001.2195 ME - Permit Fee (Replacements) $50.00 0801.4088 Total: $50.50 Contractor: -Applicant - Owner: Standard Heating & Air Conditioning Joann I Simser 130 Plymouth Ave. N 4715 Beacon Hill Rd Minneapolis MN 55411 Eagan MN 55122-2707 (612) 824-2656 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature CITY OF EAGAN WATER SERVICE PERMIT 3745 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY OF FAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55123 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF UGAN 3795 Pilot Knob Road Eagan, MN 66122 N~ 5 614 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value Date 19 Site Address Erect ❑ Occupancy Lot Block Sec/Sub. Alter ❑ Zoning Parcel # Repair ❑ Fire Zone Enlarge ❑ Type of Const. W Name Move ❑ # Stories 3 Address Demolish ❑ Front ft. Grade ❑ Depth ft. city ~ 'Phone Name Approvals Fees o of Address Assessment Permit city Phone Water & Sew. Surcharge Police Plan check F Nome Fire SAC Z u~ Address Eng. Water Conn. aW City Phone Planner Water Meter Council - I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit # Date lased Paalttes Plumbing. Mechonical Z (j .3 f7p 162 INSPECTIONS DATE INSP. Rough-In Final Footings Date Insp. Date Insp. Foundation Plumbing a%-s'r Frame/ins. Mechonicol`q_ ga Final - Remorks: r J f ` CITY OF EAGAN 3795 Pilot Knob Rood Eagan, Minnesota 55122 Phone: 454-8100 Plumbing PERMIT No. .1 Date: x!21/Stl TIM- Receipt No.: Single 711 , Peacon `lilt Site Address: Residential Lot Block r Sub/Sec. _ ?emcon Lill! _ Multi Res., Comm./Ind. 'e, tlex Name New/Alter./Repair V Address Cost of Installation 11 O City Phone: Permit Fee Nome ^~?i;^. ` Surcharge 4- 2 Address b e 0 V City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN CJNUSTION AIR RFQi a,L, , 3795 Pilot Knob Road Bogen, Minnesota 55122 Phone: 454-8100 HUTINC, PERMIT No. 17 20 Z 9 313180, Dote: Receipt No.: 1.'F 0"1 `J 1'8CC'i Hi Single Site Address: Residential Lot Block Sub/Sec. _ Multi Res., Comm./Ind. Cnntey :?asps r%, Nome New/Alter./Repair • 86,oi Da-neil -'d. Address Cost of Installation O City Phone: Permit Fee Nome Surcharge 46"V 3.enrro Ave. g Address c City Phone: Total This Permit is issued on the express condition that all work sholl be done in accordance with all applicable State of .Minnesota Statutes and City of Eagan Ordinances. Building Official INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS• APPLICANT: ' i 1 ~ tfi ttr PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DDATE INSPTR. INSPECTION TYPE DATE INSPTR. I~ Permit No. Permit Holder Data Telephone M ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: i Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: tV I11' f l (It I PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. i i 1 I ~ ~I Permit Holder Date Telephone # SEWER/ WATER PLUMBING HVAC Inspection Date Insp. ' Camments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL All H ra Tft ifiratf of (lorruvaury Citp of pagan ~ ErVartment of Builbing Ini pprtion This Certificate issued pursuant to the ruquirtmentt of Section W of trUni firm Bxt :ng Code certifying that at the time of issuance this structure was in compliance with the variout ordinances of the City regulating building construction or use. For the following: $ v.. Cidfil SF Dwlg/Garage 8iee- Permit No. 5614 r 0--p y TyP. R3 Type Cmmalon Fin Zone ITT Zaun* wtrict RI Ir Owmall'badmiq Centex Hgn)I ,x,,.4715 Beacon Hill Ct. LE an, Y. ~ 71 Beacon . ~ •tr--I+3 B7 Beacon Hill a Dale S Peterson By: VDate. June 16, 1980 1 SAWI MST N 4 [ GMCUUIIa ► C. =r~ , 4qr !~~"gtrwl'.r"~1~'Mwdl~y.~'~►rr.►l+LY~~►al~~~`~1~'+~__1"~.L~ ~ ~ ~'.+J11'N~ CITY OF EAGAN Remarks Addition BFACON HILL ADDITION Lot 3 Blk 7 ParJel 10 13500 030 07 Owner LV i-v ~LneVi 't, Street 4715 Beacon Hill Road State Fagan, MN SS122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 10 1982 1806.93 1806.93 0007602 10-1-81 STREET RESTOR. GRADING 771- 1982 526.46 58.50 g 526.46 0007602 10-1-81 SAN SEW TRUNK 1976 7 9.06 is 99-73 008107 9127179 * SEWER LATERAL 3 1982 3116.46 346.27 3116.46 0007602 10-1-81 WATERMAIN * WATER LATERAL 1982 9 WATER AREA 5 1982 198.01 22.00 9 198.01 0007602 10-1-81 * Stubs 1982 9 STORM SEW TRK &7q-i 1982 359.82 39.98 9 359.82 0007602 10-1-81 * STORM SEW LAT 1982 9 CURB & GUTTER SIDEWALK STREET LIGHT Rnnij finit- 17893 2/14/80 WATER CONN. ii It r 13UILDING PER. 5614 SAC 525.00 PARK Owst void 18 months from 0 g, _-3 1 1 Date of is Request C { i ' 17938 I, Licensed Electrical Contractor D Owner, do reby request inspection of the above electri- cal wirin 'stalled at:'~~ Street Address or Route No. ~ U City M o Section. Township Range County WA Which is occupied by COV (Name of occupant) Is a roughin inspection required on this job? NOD { Ready Nqpl~ Will Call 11 Power Supplier. 1Address I1C1k'IZt j Electrical Contractor ~ Contractor's License NOW r (Company e) Mailing Address I~ E' CLNam r ~ iVwviw WIMIrical tetra or or owner Making This Installation) _ Authorized Signature Phone No. (Electrical contractor or owner Making This Installation) O !O1 D D 00H This inspection request will not accepted cl ffie C/ ll L' LS V L~ State Board unless pro raper inspection fee is is a lrcJosed. r Minnesota State Board of Electricity University Ave., St. Paul, Minn. 55104-Phone 645.7703 REQUEST FOR ELECTRICAL INSPECTION C CHECK BELOW WORK COVERED BY THIS REQUEST J 17938 Type of Budding New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ ❑ Range ❑ Temporary Wiring t Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ List List ) Othe p 0 Others Others} F1ere 111111 _ Here 1 .5 COMPUTE INSPECTION FEE BELOW VAL S o:, Entrance Size: # Fee Faders bP R:. Fee Circuits: # Fee 0 to 100 Amps. 0 30 - es ; 0 to 30 Amperes 101 to 200 Amps. to- OW ' s 31 to 100 Amperes Above 200 Amps. A 10 Amps. Above 100 Amps, Transformers Re eControl Circ. Partial or other fee Signs Special Ins lion Minimum fe Remarks IE P (-Z, TOTAL EX- ~.S+0 I, the Electrical Inspector, hereby certify that the above inspection has been Wrade'. (Rough-in) Date (Final) bte _ This request void 18 months from ' WZ from Ile Datrt I~ !'3 4 9 7 0 4 1, ast94icensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: °7 Illl may) i/] St Address or Route No. -5 Bo" iz}li, aw it, Q6AH Se on Township Range County Which is occupied by C_JDC J*tt1 (Name of Occupant) Is a roughin inspection required on this job? No ❑ Yel;K_ Ready Now ❑ will Ca49 Power Supplier N'S p Address W114 A Electrical Contractor Ems' ELFG _e\C Contractor's License Nt?,7.51q (company Name) Mailing Address [ F D. W 51~~~C ~(El trl Contra or or owner making This Installation) ¢q Authorized Signature Phone No. J l -SSZ~S (Electricai contractor or owner Making This Installation) ss will not accepted the NAVE BOARD C®~ This inspection request ~j ~D} State Board unless proper inspection fee is enclosed. State Board of Electricity St. Paul, Minn. 55104-Phone 645.7703 7 1' FOR ELECTRICAL INSPECTION s 349 ~1 0 CHE( _O WORK COVERED BY THIS REQUEST Type of Budding New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ Range Temporary Wiring ❑ flex ❑ ❑ Water Heater Lighting Fixtures Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating mercial Bldg. ❑ ❑ ❑ Furnace Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑ Farm E] List 1 List ❑ pO } p Other ❑ ❑ ❑ Herersl Here s~ COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes 1 1 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes 1 2- 9,00 Above 200 Amps. Above 100 Amps. Above 100Am s. Transformers 11 Remote Control Circ. Partial or other fee Signs Special Ins ection Minimum f Remarks TOTAL EQ?~ J a I, the Electrical Inspector, hereby c that ~insp lion has been ma . (Rough-in) ill Date (Final) Date ,/f -'k This request void 18 months from CITY OF EAGAN 3794 Pilot Knob Read Eagan, MN 55122 NO 5614 PHONE: 4544100 BUILDING PERMIT APPLICATION Receipt To be used for 5F Dovlg/Garage Est value 40,000 Dote 2/14/ , 198 Site Address 4715 Beacon Hill Rd. Erect gl Occupancy R3 Lot 3 Block 7 Sec/Sub. Beacon Hill Alter ❑ Zoning Rl Parcel # Repair ❑ Fire Zone III Centex Homes Enlarge ❑ Type of Const V B Nome Move ❑ # Stories 4715 Beacon Hill Ct. Address Demolish ❑ Front 44 ff. Ci one 454-5236 Grade ❑ Depth 48 fr. Name ame Approvals Fees 0 o~ Address Assessment Permit115.57- 8 City Phone Water & Sew. Surcharge 20.00 Police Plan check 57.75 Z Name Fire SAC 525.00 05.00 Address Eng. Water Con <w CI Phone Planner Water Mete,150.00 Council Rd.Unitl85.00 I hereby acknowledge that 1 have read this application and state that Bldg. Off. 2/5/40 the information is correct and agree to comply with all applicable APC Total 1268.25 State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: Centex Homs Midwest on the express condition that all work shall be done in accord a with-all-applicable State of /Minnesota Statutes and City of Eagan Ordinances. Building Official i'~"` ~•*uC~S_`--'C My Ea p I For OfficeSl --y~-------- ~ ~4y of f ~jU(~(]n I Permit#: L"~T`f`1'~ j 3830 Pilot Knob Road Permit Fee: / Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I /J I Fax: (651) 675-5694 t Stan: L I I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 i 1 D Site Address: 4- 15 ~Regco-A Wit 90 Tenant: 7D0.r1r1 S+rYlSe✓r Suite RESIDENT / OWNER Name: "J00-r1Vl S i M 5p- Phone: (Ds-1- 170- 3 *26~ Address/ City/Zip: 47 1 S I ectcovt ii-fi I ~ le r7 Applicant is: Owner /Y Contractor TYPE OF WORK Description of work: ear OPF 1=e - 4" Construction CostA ~53-8(. r -0 Multi-Family Building: (Yes / No X CONTRACTOR Name:-Az-4f c K GkC~ruc~ License ),L) X10 Address: N)OS ?)V*' AVE t3 City: _P31_0_0LIAA Pa.o1L State: 0111 IIZip: SSLf'f 3 Phone: 716 3-31 S`-C~`3 30 Contact Person: G.n`S P) I COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaorv 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (J 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 t 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 I of p x -k 0.2 ro l ~t 1 ~C t rtQS x Applican s Printed Name Applicant's ignature Page 1 of 3 PERMIT# y RECEIPT DATE: 8008 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preveenteer for irrigation system p SITE ADDRESS: 47 / &-46-&6 8, RD 1 r OWNER NAME:: ~ ~yy1l~'l a Sy r vG TELEPHONE #:V-> 994 f 852 (AREA CODE) INSTALLER NAME: H, P. P_) /P-Y wn r" TELEPHONE#. L34 In STREETP.DDRESS: J~ (o,-70 DDbr) (AR CODE) CITY: 6000 n STATE: YVt ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: - Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 Abandonment of septic system. Water turnaround - existing dwelling unit 5/8" meter if needed - $118) Other: - RPZ: new installation/repair/rebuild $ 30.00 - lawn irrigation system Replacementladditional: _ water softener water heater $ 15.00 State Surcharge $ .50 Total $n_ I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Cityof Eagan ordinances. It is the applicants responsibility to notify the property owner that the City of Eagan assumes. noI'ility for any d mages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit wifhi Ci opertylrighl- f- ay/ ement. SI UR OF PERMITTEE 1/02 - CITY OF EAGAN PERMIT 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 5 8 4 (612) 681-4675 Date Issued: 08/08/97 SITE ADDRESS: 4715 BEACON HILL RD LOT: 3 BLOCK: 7 BEACON HILL P.I.N.: 10-13500-030-07 DESCRIPTION: i'ldznc hermit Type SF (MISC. ) Lt#ld~x~glr~~ Type REPAIR GensUs Cbd 434 A`LT. RESIDENTIAL 5 a t6~cr re t k _ q a ,x r6~ m LL V Lr '~y A- ' C& g P - E 9 ' k' x ° ~ rs - is ~,pa s rram». ems" r ~ k U IL BW M1 _ 4t?z sv-~ ry ~ iflbu wpm ~wk~r~ Fp t5x Ca Ya ~ mi ,"&4" a#'+9~r Aa ° R mt; Arm. Vim; =5 Sw ~ffi,a REMARKS: SIDING SOFFIT FASCIA WINDOWS FEE SUMMARY. VALUATION $.13,000 Base Fee $199.75 Surcharge $6.50 Total Fee $206.25 CONTRACTOR: - Applicant - ST. LIC OWNER: MINNESOTA EXTERIORS INC 13915514 0002877 BENNER WERNER 8600 JEFFERSON HWY 4715 BEACON HILL RD 6SSEO MN 55369 EAGAN MN 55122 (612) 391-5514 (612)452-7737 r t~e ac e a g ~ np'p Er ~ ~ e5 ss x~` ~ a, ~ ~ + ~ & ndKnhPn x<s'ctse,rct5aM11 ~r~ ska~ ors =~rplr,PPb5 Ir ~ p N~ E ~ A.y ti ,y ~~S, ek n. ~ :r i i st rei veb w ie p +naP s t ~ r' tat ar[d '_(r1L Af YdGICLi.W"C S.9 4't LC 3 G t & urz :atAi^itk '4 i'M1~ " 8 1O ~ 6tf Y 5 id i tj R✓I ~ l %C 2 155 11f ~~~b M ll s~`ya 3E Rrs @LA@ `ni - iY ~ 4"2 1 I ~ L y !dt to i I9 & ~'IA L9 k, 4 S R "tT9 I R'Ifl t 6'`~i APPLICANT/PERMITEE SIGNATURE ISSUED B : SIGNATURE ~ CITY OF EAGAN 5066f1995 3830 PILOT KNOB RD - 55122 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Requirements Remodel/Repair 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 & docks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preserve on plan if IM platted after 711/93 required: ss DATE: CONSTRUCTION COST: DESCRIPTION OF ORK: STREET ADDRESS: LOT BLOCK SUBD./P.I.D. I Mn la PROPERTY Name: Phone ZZI 7 OWNER VST FRET Street Address- City: State: Zip: CONTRACTOR Company: Phone Street Address: Lk se # ILI' City: _l r~ State: Zip: 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 ' . correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 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 ❑ 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. 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. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BU I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 7 8 5 (651) 681-4675 Date Issued: 10/26/98 SITE ADDRESS: 4715 BEACON HILL. RD LOT- 3 BLOCK: 7 BEACON HILL P.I.N.- 10-13500-030-07 DESCRIPTION: REROOF Bu'Idin'-",,permit Type STORM DAMAGE Building 4J6'nk Type REPAIR ;Census Code` 434 ALT. RESIDENTIAL tt i h 'v %rf rf F\ I { ) r 6 t'Y REMARKS: FEE SUMMARY- CONTRACTOR: - Applicant - ST. LIC. OWNER: AZTEC ROOFING 18950040 20139140 BENNER WERNER 11583 RUPP RD 4715 BEACON HILL RD BURNSVILLE MN 55337 EAGAN MN 55122 (612) 895-0040 (651)452-7737 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 City of Eagan Ordinances. J APPLICANT/PERMITEE SIGNATURE 149SUED eY: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PELOT KNOB RD - 55122 7 681-4675 1 L New Construction Requirements Remodel/Repair Requirements • 3 registered site surveys • 2 copies of plan 2 copies of plans (include beam & window saes; 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 lot platted after 711193 required: _Yes _ No DATE: q - 2Z~; - Q CONSTRUCTION COST; DESCRIPTION OF WORK: STREET ADDRESS. - 1) ~ N L(iaL 1ji / &L LOT: BLOCK: SUBD./P.I.D. C t C ) y m ( 1 Name: O p' n l Lp~y u Phone 7 7 ,31 PROPERTY Last First A-11 OWNER Street Addr I F R~a D/ 1 l"'• //eyss://~~,, City lA t ~1Q 14 State: Zip: y~a/ 2 Company: Phone CONTRACTOR Obn P= License# 2n I /1 Street Address: J f ^ ,5,?0 7 City L State: MtV Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address chan and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the information correct and agree to mpl~ with all applicat State of Minnesota Statutes and City of Eagan Ordinances. Uri'c` Signature of Applicant: Gil OFFICE USE ONLY Certificates of Survey Received Yes No I U Tree Preservation Plan Received Yes - No Not Requ MOM; /0 DATE BUILDING PERMIT APPLICATION ' Include 2 sets of plans, 1 site plan a/elevations and 1 set of energy calculations. To be used for~W ~LC>i ~u Valuation A-COic3d O Site Address: 3 -7 C~jEACON~~L Lot Block See./Sub, Parcel Number Owner Telephone Address ((~'p ~e^ ContractoJCL4TE X t 1pP•{ f S 1-11~Ky~51 Telephone 54 - d5 a 3 C"o Address vw-Asn Arch./Eng. Telephone Address v OFFICE USE Erect ^ Occupancy Alter Zoning Repair Fire Zone 3 Enlarge Type of Const. Y Move I of Stories Demolish Front Grade Depth y~ OFFICE USE Date of Approval 6 Initial FEES + C Assessment Permit ~~LS2,rJ~ !Pater/Sever Surcharge-- f .2Q,OC) Police t14n Check SZ_3 Fire SAC X15. DO Eng. Vater Conn. Planner Plater Meter ~iO Oa council ROAD L~.LT / Bldg. Of 1. A.P.C. TOTAL. Cortiiicate for: Centex Homes Mid:)est Inc. Plan X31 8601 Darnell Road Eden Prairie, Mn. 55344, DELMAR H. SCHWANZ LANOSURVEYOR R"isteref, Unoer Laws of The State of Minnesota 2978- 145TH STREET W. - 80X M ROSEMOUNT, MINNESOTA 55888 PHONE 812 4231785 SURVEYOR'S CERTIFICATE et, "'C-VT JkA N' L 46 i V a} M n ~ SCALE: 1 inch 30 feet 933 Denotes proposed finished grade BENCHMARK: Top of hydrant between lot: 4 and 5, Block 1, 939.72 ft. Top of Block Garage floor 93`f P _ Basement Floor I hereby certify that this is a true and correct roprc3(2n::at',)n of Lot 3, Block 7, BEACON HILL, acccrding to the rccoracu plat to r.~f, Dakota County, Minnesotti. Dated: may 37, 1974 Revised to 3hr,,'r7 proposer) ht:use anc? st~:k,,d J:n. f ; MINNESOTA NEGISTRATION NO. 8625 CITY ~0F-EAGAN Include 2 sets of plans, /4" 1 site plan w/elevations & BUILDING PERMIT APPLICATION I set of energy calculations. To Be Used For ozao~ Valuation Date C6// /'Po Site Address: -11 7M' C/fC'ci✓ N//,/, lfQ OFFICE USE ONLY Lot ~3 Block Sec./Sub.E/~Cc✓///{{Erect Occupancy A132 Alter, Zoning / Repair Fire Zone Owner: W'LxwC/i F aElyllt / Enlarge _ Type of Const. Move # Stories Address: ~~/_j %3C/J['G ✓ f//~j 7Y~A~' Demolish _ Front ft. City/Zip Code: /jCA~, /17/✓ huh ~i Grade Depth _ft. Phone "74, ~2 - 77,' ~7 APPROVALS FEES Contractor: Sf//U/c '4.5 /~~G✓v' Assessments Permit Address: Water/Sewer Surcharge Police Plan Check City/Zip Code: Fire SAC Phone Eng. Water Conn. Planner Water Meter Arch./Eng.: Council Road Unit Bldg. Off. Address: APC City/Zip Code: Phone TOTAL r, ,..a~„R yaxpk+r..;w+atia'i~n,:~.,;~~~rrar.~+wd~~ccw*a'- .s;w`~-hhaca~s~;e~..,w~-s~.-wz., -~F Mew ~ ~ . {p• - ~ - R i nit 4' r t s i f { :,,-is+ri.ake~•<titiF~AtYk?xSWia.r+a'.~..L'. M' a$~tGwsmxY!,r.sn<&+.MS~..;..s. :.,.Q:}.~n~i;.ra. rn. x. s. ....a --:w..,.~1~> •s x- .i.,i I I J I II i i t +I ( x f d• . I • 6 ~ I 3 E / CITY USE ONLY PERMIT I RECEIPT DATE: 2002 RESIDENTIAL MECHANICAL PERMIT APPLICATION CITY OF EAGAN 3630 PILOT KNOB RD EAGAN MN 55122 651-6$1-4695 Please complete for: D single family dwellings townhomes and condos when permits are required for each unit Date: 4 r, / SITE ADDRESS: OWNER NAME: ~~I Q►7 ] Y,;, TELEPHON44 INSTALLER NAME!!{{{ , ,,r.z e prrnnT051ti;C0. TELEPHONE {~IKSYVNI'i 410 WEST LAKE -TREET MINNEAPOLIS: NIN 5WB-2996 STREET ADDRESS: 612.6242656 CITY: STATE: ZIP: Place a check mark next to the permit work type Add-on, modification or alteration to existing dwelling unit $ 30.00 • furnace replacement • air exchanger • air conditioner D M • other U Nature of work: I,° Pte/ GI J UN 2002 ey State Surcharge $ .50 Total $ •S~ SIGNA OF PERMITTEE v0z • -7060 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 0 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft of lot, sq. fl. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Can of Survey Recd _ Y _ N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report _Y _ N 1 Soils Report if proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pres Plan Recd _ Y _ N. 2 copies of plan showing beam & window sizes; poured found design, etc. Addition -indicate if on-site septic system Tree Pros Required, . _Y _ N 1 set of Energy Calculations On-site Septic System _Y _ N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date Construction Cost 3 O 6 v Site Address &acot\, 'F-'ls- Urit/Ste # Description of Work aAt,1`o-e\,4t(;P_vv~G-fi Multi-Family Bldg _ Y ~N Fireplace(s) - 0 - 1 _ 2 Property Owner J t` Slh'Y.S~ c Telephone#( 6S1) ci~ (_1 - 3-7 K Contractor ww //csl~ AT Address ~lNJ e(Azi l r C__~_ City F State Zip 5%1 R_ Telephone # ((-,S t) CA - ~d 6 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeory 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone ) Sewer/Water Contractor Telephone I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review 5d approval of plans. E ~ v D Our Applicant's Printed Name Applicant's Ignature 7 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Reguirements Office Use OnN 3 registered site surveys showing sq. IL of lot; sq. R of house; and all roofed areas 2 copies of plan showing footings, beams, pats Cert of Survey Reed ' _Y N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report _Y N 1 Soils Report d proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pres Plan Reod _~Y _ N. 2 copies of plan showing beam & window sizes; poured found design, etc. Addition - indicate if on-site septic system Tree Pros Required _Y _ N 1 set of Energy Calculations Onsnte Septic System _Y. _ N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Plans are considered public information unless you state the are trade secret and the reason. Date r~ / ~ / G Construction Cost /-/566- Site Address -7 5 0e (D ^ 7 J' Y UnitlSte # Description or Work Ke /;,le /✓1 N S0 ✓I Y T `^C~ ~A t e, c ~ 4h h e u Multi-Family Bldg _ Y ✓ N Fireplace(s) _ 0 - 1 f-~2 Property Owner -5-D 6f 11 N 'e? Telephone # S t) y 1 7 3 7 (y)- Contractor ra 01 V SA S-fo Ye / A,t"in f Address SS a S~- City Zinc L4 k2°s State Zip S50 / Telephone # ( 6 5 1) 78 S 7 -7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Mumesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - y - N If yes, date and address of master plan: Licensed Plumber Telephone ) Mechanical Contractor Telephone ) Sewer/Water Contractor Telephone I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. /~Aou 1 44141 erS Applicant's Printed Name . Applicant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA138738 Date Issued:09/19/2016 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - 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 - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 (952) 388-4496 Glowing Hearth and Home LLC 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA149879 Date Issued:06/13/2018 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA160442 Date Issued:03/10/2020 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater 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. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 (952) 388-4496 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA160443 Date Issued:03/10/2020 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 (952) 388-4496 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA177102 Date Issued:06/15/2022 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 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. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 (952) 388-3197 All Sons Exteriors Inc P.O. Box 146 Lakeville MN 55044 (952) 469-5221 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA177942 Date Issued:07/26/2022 Permit Category:ePermit Site Address: 4715 Beacon Hill Rd Lot:3 Block: 7 Addition: Beacon Hill PID:10-13500-07-030 Use: Description: Sub Type:Air Conditioner Work Type:Replace Description: Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. 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 - Joann I Simser 4715 Beacon Hill Rd Eagan MN 55122--270 Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 Applicant/Permitee: Signature Issued By: Signature