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4667 Cambridge Dr PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA085140 Eagan, MN 55122 . Date Issued: 08/08/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4667 Cambridge Dr Lot: 19 Block: 4 Addition: Beacon Hill PID 10-13500-190-04 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not acceptable in lieu of inspections. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Signature Home Services Christian P Faste 758 Reaney Ave. 4667 Cambridge Dr St. Paul MN 55106 Eagan MN 55122 (651) 731-1147 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 PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA087329 Eagan, MN 55122 . Date Issued: 11/06/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4667 Cambridge Dr Lot: 19 Block: 4 Addition: Beacon Hill PID 10-13500-190-04 Use Description: Sub Type: e-Siding Construction Type: Work Type: Siding Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and take steps to ensure maximum ventilation into attic space. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Signature Home Services Christian P Faste 758 Reaney Ave. 4667 Cambridge Dr St. Paul MN 55106 Eagan MN 55122 (651) 731-1147 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 $.795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 1 DATE: Zoning: - No. of Units: Owner: Address: Site Address L 1 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 EAGAN SEWER SERVICE PERMIT 3799 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: - Zoning: No. of Units: Owner: Address: Site Address: Plumber: 1 agree to comply i ; 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 EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value Date 19 Site Address Erect ❑ Occupancy Lot 81-le 15e 15 Alter ❑ Zoning Parcel # Repair Q Fl re Zone Enlarge ❑ Type of Const. W Name Move Q # Stories z Address Demolish ❑ Length city one Grade ❑ Depth Sq. Ft. Name , , Approvals Fees 0 su Address Assessment Permit city ho Water & Sew. Surcharge Police Plan check ~w Name E w Fire SAC J'K Address Eng. Water Conn. <"z' CI Phone Planner Water Meter Council Road Unit 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 shat oil work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit Holder Misc. Permit No. Holder pElectric'19 Z'S57(o6 lb-f 1s( C~Fy 7srJ~ ,~r~a~,'c~c Inspection Date Insp. Other Footings Foundation Framing Rough Plbg..r: Rough HVAC Insulation Final Plbg. Final HVAC i i f Final Water Describe Location: 3 Well Sewer " ! Pr. Disp. To Tt) T#l 1 ! 7 f / r Date `a Time f c C~ WHILE 914 WERE OUT M -TTAO 50 ~ of Ph6ne2 Area Code Number Extension TELEPHONED PLEASE CALL CALLED M SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message J 4C A Cc (J~ i YwC7 Operator ANIPAD 23-M 50 SHT. PAD EMCIE[RCYp 23-WI 250 SW. DISPENSER BOX Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Jab Address 4r- rr) Lot Tract 4. Owner---]/, i - E } 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ❑ Commercial ❑ Institutional ❑ 9. Work Description: New - Add ❑ Alter ❑ Repair ❑ 10. Describe Fuel Type . 11. No. Equipment BTU - M. Ea. No. Equipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 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 464-8100 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Tract 1 4. Owner 5. Contractor Phone _ 77; e_=~ 6. Address i 7. City State 1; J~ Zip f-, 8. Building Type: Residential.lb Commercial ❑ Institutional ❑ 9. Work Description: New k3 Add ❑ Alter ❑ Repair ❑ j 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other ~r Laundry Tray 1 Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 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. r ' Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarks Addition. BEACON HILL ADDITION Lot 19 Blk 4 Parcel 10 13500 190 04 Owner A),kyk '5,^;}t,,;x.'l~7 Y. Street 4667 Cambridge Drive State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. " 1982 1848.67 205.41 9 1643.2 A010 66 3-9-82 STREET RESTOR. GRADING (015 1982 537.84 59.76 9 478.08 A010966 3-9-82 SAN SEW TRUNK 197 135.97 9.06 15 72.55 A010966 3-9-82 *SEWER LATERAL 1982 3182.83 353.65 9 2829.19 A010 66 3-9-82 WATERMAIN *WATER LATERAL 1982 9 WATER AREA 1982 202.00 22.44 9 179.56 A01 66 3-9-82 * Stubs 1982 9 STORM SEW TRK~ 1982 367.77 40.86 9 326,91 A010966 3-9-82 *STORM SEW LAT 1582 9 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 1981 185.00 26829 9-16-81 WATER CONN. 1981 335.00 26829 9-16-81 BUILDING PER. 6580 SAC 1981 525.00 26829 9-16-81 PARK CITY OF EAGAN Ng 6880 3793 Filet Knob Rood Bogen, MN !51'11 PHONEt 454-8100 BUILDING PERMIT Receipt * To J° To be used for SF DWG/GAR Est. Value $51,000 Date September 16 i q 81 Site Address 4667 Cambridge Drive Erect U Occupancy R-3 Lot 19 Block 4 Sec/Sub. Beacon Hills Alter ❑ Zoning R-1 Parcel # x.10-13500_ 180 04 Repair Q Fire Zone Enlarge ❑ Type of Const. Vn c Name Feature Builders Move ❑ # Stories z Address 15513 Logarto Lane Demolish ❑ Length 50 c; Burnsville Phone 435-8443 Grade ❑ Depth-28-Sq. Ft.. Name Owner Approvals Fees o~ Address Assessment Permit 2815.00 ttF City Phone Water & Sew. Surcharge 25.50 Police Plan check 143.00 W Name Fire SAC 525.00 Address Eng. Water Conn. 335.00 i CI Phone Planner Water Meter 60.00 Council Rood Unit 185.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. the iniormotion is correct and agree to comply with all applicable APC Total $1559.50 State of Minnesota Stat es d City of Ea Ord' .'ances. Signature of Permittee A Building Permit is issued to: FeatuM ` on the express condition that all work shall be done in accordance with appli bl to of Minnesota Statutes and City of Eagan Ordinances. Building Official P r GiLlO (grrfifirutr of (~rru rttnr t 'Citp of Cagan Ervartn nd of Nuttibmg AmpttYlo n This Certificate iuned pursuant to the rrgniremaus of Section 306 of the Uniform Building l y Code "M fying that at tlx time Of issuance this ureuturr was in compliance with the variant ordinadtca of for City nguladng huildixg construction or un. For the fellmving: w SF DUGIGAR 6830 x _ Wdr. P..9 Na / G-, Tm R3 ci.c--mo w.ra.. Rk RI a'n< .Cbddb. Fpan Ad1dPrs Au. 1t5513 jggarto Zd &riTSVll, bdftgAddIRm 7 ~jle ,lr Jot 19. Block 4. Beacon Fail ~r Bwwftomda _ w wn: bm= 21, 198^ / By: 18 ,aquest yo.d ~/d ti p/ ~,.PFaee>1 'l l S CAD 1 o e~ months hdm T 81259 roo u/~ r;st ate Fire No. Rough-ut Inspection Requiydl ❑ I OReatlv Now &Kill Non for or When hen InsPec- rte,( YrGILes No Ready IbLiceased Electrical Contractor 1 hereby request inspection of above ❑ Owner electrical work installed at Street A dress, Box m Route No. Cr action o. TOWnshiD Name or No. nge No, Cmrmy Occup n )PRINTI Phone No%"o-/L~'_j i ~J 4/,5 01V ~Y1 c l7 aJ~L Power Sry'pller I Atldress '~/~`SiKa y~q l4y Name) Con tor'a License No. Electrical LffJ~~ xw Ili Ir~l.r cTmfb 11V 22C)7,1 I Marling AddressY jt7 o dri wne4Makmg.Anstgilahonl~"' A Authorized Stpnature.(S:ommctm Owner Making Ins'ta`4 Lrdq Phone Number MINNESOTA STATE BOARD OF ELECTRICITY y; THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Ph... (612) 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-03 See instructions for completing this form on bock of yellow copy. Q~ T ~812~9 ► . "X" Below Work Covered by This Request D-7 -7 O Now dd Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater / ightin Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. ornate Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other peer y iher l5 tie r.ify) t or I peu y Other Other Compute Inspection Fee Below d Fee Service Entrance Size N Fee Feeders/Subfoeders N Fee Circuits 0 to 100 Amps 1 to 30 Amps b -b 0 to 30 Am s 101 to 200 AUgi. 31 to 100 Amps / , p 31 to 100 Amps Above Above 100Amps Above 100-Amps Tr or Remote Control Circ. Partial 'Olh-r P-- Special Inspection TOTAL FEE Rem rks Rough-in ( DahI the Electrical 41-141 Inspector, hereby certify that the abuve F nal nate inspection has been ( ' ~6Q ade. This requext void 18 nronths from ~ Thisreoveirvoid' [/y L-17 131r BED-ni ri- LT71(I 1 E'm 1`4hs fFom L r ~-"5760 z~~sa Reque to Fire No. Rough-in Inspect ion ec- flegwredr ❑Ready Now ❑ WWII No"y lose • / ❑Yes ❑No or When Ready _Up"Licensed Electrical Contractor _ I hereby request inspection of,above ❑ Owner electrical work installed at: Street A dress, Box Route No. City 4 7 ecuon o. I wn trip Name or No. angp No. Count G upa t IPRI 1 Pon No 144; 3 SO A) Q6 VAIL 0 -1/ a - Ppwe Supplier Address„ I Electrical ctor (Company Name) Can ernes Licr nse.No. - ~Dy~~Reai Melling Address 4T4'6 ' 2I t ,t1el3897 J`t J 1 Ey~r*T-Q ' vCj 4 "Authorized 5 n t n a in I N 1 Phone'Number r- ARY a= _-jT_95124 'MINNESOTA STATE BOARD OF ELECTeI 2.5p THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N•191' - V , . BE ACCEPTED BY THE STATE BOARD 1821 University Ave.: St..Paal,'MN 55104'. - A - UNLESS, PROPER INSPECTION FEE IS ENCLOSED. ow...._ 1.11, 15471111 ~r v REQUEST FOR ELECTRICAL INSPECTION r« EB-00001.03 ~ _5 / C 0 See instructions for completing this form on back of yellow copy. T 5, xBelow Work Covered by This Request -702 - Add Rep. Type of Building Appliances Wned Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other (Specify) Othor ISpnaiNi t ier ISpen fy Other Other Compute Inspection Fee Below a Fee Service Entrance Sae # Fee Feeders/Subioedem b Fee Circuits 0 to 100 Am s 0 to 30 Amps 0 to 30 Amps 101 to 200 Amps 31 to 100 Amps 31 to 100 Am Above 200-Amps Above 100_Amps Above, 100_Amps Transformers Remote Control Ci re. Partial/Other Fee Signs Special Inspection 9 'Cx Remarks TOTAL FEE !b, .7CJ Rough-in oate 1, the Electrical Inspector, hereby certify that the above Final ( to inspection has been made. This request void 18 months Loin -CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PER UT P IscATIM 1 set of energy calculations. To Be Used For Valua on Date 91/ 8 / Site ePPAdress7. (Q~( ~4ry~ p 6 L ~ r OFFICE USE ONLY Lot ~f~_ Bloc] Sec:/Sub` Erect Occupancy --Alter Zo Parcel ply I350 U (c!'O-G -re Zone Owner Enlarge _ Type of Const. Move # Stories Address: Demolish _ Front ft. City/Zip Code: Grade Depth ft. Phone APPROVALS FEES Contractor: 11.t.Y (~n Q . 2,f!(Pqg Wa Assessrents ter/Sewer Su charg~ C O Address: [ 5 S/S"~ - 7 ~ nJx ti~tAA o Police Plan Check ? O SAC S 2S O O City/Zip Code: 11 0 'l~,Uir-N _ t s-?3? Fire i Eng. Water Conn. Phone # : ~ss5 = S LF +f 3 Planner Water Meter B a Arch./Eng.: Council Road Unit Bldg. Off. Address: APC City/Zip Code: Phone TOTAL 5a RESIDENTIAL MECHANICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122' Telephone # 651-675-5675 Please complete for; Single Family Dwellings & Townhomes and Condos when permits are required for each unit Date 7 / 03 Site Address q667 <f Am $(LI D (.,~-z ;012,4 oc Unit # Property Owner CA\O kS r o-S~ z!O Telephone # ((.S) G 6 l Z , ~ ~:,1:. Contractor a+r^ 3'= Street Address City State Zip Telephone # ( ) - Bond Expires: The Applicant IS Owner Contractor Other Add-on, modification or alteration to existing dwelling unit $ 30.00 furnace replacement - : ' air exchanger _ air conditioner _ New (Replacement other /N ~~2A n~ 1~ ~UD State Surcharge $ .50 Total OCT 0 7 2003 r$ ~C31S0 -171 I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understand this i's'not a permit, but only an application for a permit, and work is not to start without a permit; that the wo will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Ch~,S+~~~ ~asl~ Applicant's Printed Name Applicant's Signature CERTIFICATE OF SURVEY 41 S >?452'97,. u. W 5~~ E - 199.62' i io o ~ ry`° LOT 19 2 ~ 9 p ~ ~ ~ `3p' ~ 6 PROPOSED 22 ~NS" BLOCK 4 LOCATION 9g9 GAR, a !rr I O (P ~NA6f PRO I f1ji ASM` NO JE ED o m ~ 9 38, ~ ~ m _Q S >po n m CZ) 90128""E 30,"1 2pQ 7 s ! lO 87. g 30 V 2 se All elevations shown are existing. grades and / are assumed datum. / Garage floor to be not less than 1.5 feet above street. ` I hereby, certify that this is a correct representation of a survey oft loot 19, Block,4. BEACON H1118, Dakota County, Minnesota, according to the plat thereof on file and of record. and that I am a duly registered land surveyor under the laws of the State of Minnesota, Gene L. Jaoobsoa inn. Reg. No. 7734 Dated this 14th day of September, 1981 DR. BY GRJ SCALE - I°= 40' 1 O DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM Prepared for i Johnson-MoDonald Constr, JACOBSON SURVEYORS 15513 Logarto Lane LAKEVILLE, MINN. 55044 Burnsville. Minn. 55337 PHONE 469-4328 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN I tf 3830 PILOT KNOB RD, EAGAN MN 55122 OO l 1 1 851-681-4675 New construction Recruitments RemodelfReoah Reaulnmems e- • 3 registered site surveys showing sq. ft of lot, sq, fl, of house; and gq rooted areas • 2 copies of plan , Itl _6 (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated addillons • 2 copies of plan showing beam & window sizes; poured found design, etc.) 1 site surveyfor enter or additions & decks • 1 set of Energy Calculations • Indicate 9 home served by septic system for additions • 3 copies of Tree Preservation Plan r lot platted after 711193 • Rim Joist Detail Options selection sheet (burgs with 3 or less units) / DATE 4o -/0 - ~ 2 VALUATION ( O 1~,. DoO+ 00 SITEADDRESS +90 if_Pcrvl199AQ(.C MULTI-FAMILY BLDG _Y fl/N TYPE OF WORK N ~A% IT)O" TD ~~x~ C~HP» lot FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT G~I ~t5~ ItW\i % F STREET ADDRESS ,~r ~o6__? C g~+/) ~CITY~STATE.U ZIP SS/z Z TELEPHONE # ~Sl -(6 )d6 CELL PHONE # G/2 - 2t -13/ I FAX # PROPERTY OWNER ✓Arv-`1 15L TELEPHONE # COMPLETE THIS SECTION FOR °NEWm RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted e Energy Envelope calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone If Mechanical system includes: _ Air Conditioning D Heat Recovery System JUN 1 2002 Sewer/Water Contractor: Phone # y 1 hereby acknowledge that I have read this application, state that the information is correc nd agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ord' es, Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Aft- Multi ❑ 03 01 of _ plex ❑ 09 07-plex I~ 17 Garage 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Aft - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-piex ❑ 11 10-plex ❑ 19 lower Level ❑ 24 Storrs Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Yor-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 -70,cvD Occupancy tZ ; - U1, MC/ES System Census Code y.3y Zoning /J City Water SAC Units Stories Booster Pump Nbr, of Units Sq. Ft. PRV Nbr. of Bldgs Length 7. 0 Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. _ Footings (deck) ~G Final/No C.O. Footings (addition) 1= Plumbing Foundation I-IVAC 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 Z Building Inspector - Base Fee Surcharge Plan Review '1• 4 MC/ES SAC City SAC 1~~s~ 1s7J►v f 7 Water Supply & Storage / Yd S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit , 1L License Search e~ 04 Copies Other lYL QQ Total a-~ N S i L-L CERTIFICATE OF SURF Y, ) Z 12.1 . 8-7 r I Y ~9 '11 4- 9 913•` _ S 7705Z'3T"F _!89.62• I~ ~ LOT 19 ~d 9 ZZ :a' ~ ' V ~g' l BLOCK 4 f0 Irl carp, N / ,cl~ ® y `r` ~R4rN ~e4g f x4f Q ` aaf rL _asf=M` Ho E 8 C U S n ^ fAc 90' 2s••f Q` _ g3r~ 30 a 03 101 8>•.9 30 V 2 g0 All elevations shown are existing grades and eq are assumed datum. Garage floor to be not lose than 1.5 feet / above street. I hereby certify that this is a oorreot representation of a survey ofi Lot 19. Block 4, BACON HILLS. Dakota County, Minnesota, according to the plat thereof on file and of record* and that I an a duly registered land surveyor under the laws of the State of Minnesota. %ne L. Jacobson . Reg. No. 7734 Dated this 14th day of September, 1981 DR. BY GRJ SCALE - Ir a 40' 0 DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM Prepared fore Johnson-NoDonald Conatr. JACOBSON SURVEYORS 15513 Logarto Lane LAKEVILLE, MINN. 55044 P.ornaville, Minlr. 56337 PHONE 469-4328 -r MINNESOTA ENERGY CODE 1-2 Family Residential Building EXTERIOR ENVELOPE U-VALUES WORKSHEET Applicant Naive: Phone Date Statement of Compliance: ~tif• ~ i~ e c -b 6 7bb -1641. Applicant Address: The proposed building design represented in these documents is consistent with the building plans. specifications. and other J calculations submitted %ith the permit Building Address: application. The proposed building has been S designed to meet the requiremenu of the Mi'~-a~ J licant/Engineer Assembly - Ceiling/Roof Area (Sq Ft) U-Value U-Value x Area Ceiling/Roof (Total Framing and Insulation Area) (?32 , O a Ceiling/Roof (Total Framing and Insulation Area) Skylights Other Totals O q 33 m 21 , Average U-Value: ® 2-1 -Z - + p ® D~~ m x O = Required U-Value from Energy Code: ® 0.026 al { , 25 - - Assembly-Exposed Wall------ - Area (Sq Ft) U=Value UNA= x Area Wall (Stud and Insulated Cavity)' )pq o Wall (Stud and Insulated Cavity) Fireplace Wall Rim Joist q OS Z Q Windows- 3 ~5 Doors Q Above Grade Foundation Wall z- b Foundation Windows Other Totals ®'/'7 3C , 7 Average U-Value: ®b 8, S, - ® 7 ® q ®x ® _ Required U-Value from Energy Code: ®0 110 113,D ,3E TRADE-OFF PROCEDURE: If m is greater than 0, or ® is greater than G, revise the design as necessary to meet envelope criteria of the Energy Code. If the total of ® is less than or equal to the total of ® + , then the design meets Energy Code. I Wood frame, MOW frame, masonry U-Values are found on the Wall U-Valises Tables. Calculation equations are on pp.I I.15 of the code. 2 U-Value for skylight and window mast be determined by the National Fenestration Rating Council Standard 10091 or ASHRAE 1993 Handbook of Fundamentals, Chapter 27, Table 5. This is a summary only. Other requirements may apply. See the Minnesota energy Code. 215/% Questions? Call Department of Public Service Information Center at 612296-5175 or 1-800/657-3710. "Mason MINNESOTA ENERGY CODE 1-2 Family Residential Building RESIDENTIAL "COOKBOOK" WORKSHEET Applicant Name Phone Date Statement of Compliance: Building Official Use Applicant Address The proposed building design represented in these documents is consistent with the building plans, speciacations, and other calculations submitted Building Address; with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. ' Applicant/Engineer MINIMUM REQUIREMENTS for "Cookbook" Option: Entry Doors 1-3/4" solid wood w/ storm Ceiling with energy truss R-38°° Rim joist R-19 door tir equivalent (Min. 7Y2' top plate to sheathing) Foundation Windows- Insulated Glass w/1/2" gap in Ceiling with low heel truss R-44•• Floor over R-24 wood 'or vinyl frame unconditioned space *Include square 1500(age in calculation of Window/Door Area Ceiling--no attic R-38 w/ R-5 sheathing to determine above grade Window U•Value. "Insulation Performance at Winter Design Conditions Window and Door Area f 100 It WINDOW U-VALUE : As % of Exposed Wall Area ' Above Grade Window and Gross Wall Area Window/Door Area Source: NFRC or ASIIRAE 1"3 Handbook FedudstionWindow/Door Area MAXIMUM WINDOW U-VALUES Check Will WALLTYPE MAXIMUM WINDOW AND DOOR AREA OF EXPOSED WALL AREA Type 04d 12% 14% 16% 186A 20% 22% 24% 26% 28% 30•/a 32"/a 34% PE A 2x4 framing, R-13 insulation, sheathing R-7 or greater. ;0.55 0.47 0.41 0.36 0.33 0.30 0.27 0.25 0.23 0.22 0.20 0.19 TYPE B 2x4 framing R-I S insulation, sheathing R-5 or greater. 0.52 0.45 0.39 0.35 0.31 0.28 0.26 0.24 0.22 0.21 0.20 0.18 PE C 2x6 framing, R-19 insulation, sheathing less than R-5. 0.48 0.41 0.36 0.32 0.29 .0.26 0.24. 0.22 0.21 0.19 0.19 0.17 PE D 2x6 framing, R-19 insulation, sheathing R-5 or greater. 0.56 OAS 0.42 0.37 0.34 0.31 0.28 0.26 0.24 0.22 0.21 0.20 PE E 2x6 framing, R-21 insulation, sheathing less than R-5. 0.51 0.43 0.38 0.34 0.30 0.28 0.25 0.23 0.22 0.20 0.19 0.18 PE F 2x6 framing, R•21 insulation, sheathing R-5 or greater. 0.59 0.50 0.44 0.39 0.35 0.32 0.29 0.27 0.25 0.23 0.22 0.21 This table contains interpolations of the values in the Energy Code, Part 7670.14757Suhp. 2. "Y This is a summary only. Other requirements may apply. See the Minnesota Energy Code. z/srie Questions? Call Department of Public Service Information Center at 612/296-5175 or I-9001657-3710. QD P9 .1 - i p 1k Permit # l ` + d q r7 Receipt Date: 3 CITY OF EAGAN SEWER/WATER REPAIR OR DISCONNECT PERMIT 2002 Date Sewer V, Water Fee: $50.50 Address/area to be repaired ~lv % G~ . r 6. , e p oe . Description S'FL(/ E2 iL QED S To .e C ~f l.2 C D . Owner: CN,P /S f~ S'T EC Telephone: Street Address: y4 G 7 SAN/ B~/Oli E O AO- Zip Code: S S 2 Installer: G ~9 10je f/ 'S t4 T L- S, x v'~ - Telephone: 6 si 7 6 a a So o (area code) Address: ;7_3Sa- CET! 6- E e- 57 r. City 41/N/7'E 1? C/I2 L/IKC /'~ti Zip Code: S S /~o Signature of Per n ^ MAY 0 3 I'll J By • 6RMIT City of Eagan Permit Type: Sewer / Water 3830 PILOT KNOB RD Permit Number: EA049918 EAGAN, MN 55122 Date Issued: 05/03/2002 (651) 681-4675 w. Site Address: 4667 Cambridge Dr Lot: 19 Block: 4 Addition: Beacon Hill PID: 10-13500-190-04 Use: Description: Sub Type: Existing Work Type: Sewer Only Description: Remarks: Permit Fee - Sewer 50.00 9220.4532 Fee Summary: Surcharge - Fixed 0.50 9001.2195 $50.50 Contractor: Applicant - Owner: Capra's Utilities Inc. St. Lic : 3395 Christian Faste 4120 Isle Avenue North 4667 Cambridge Drive Lake Elmo, MN 550420000 6517622500 Eagan, MN 551222710 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. Applicant/Permitee: Signature Issued By Signature EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER SITE ADDRESS CONTRACTOR £Atvit4!5 e- Gff( DATE %l/Y PHONE $Q4 74i0 Determine working square footage of each. 1. Total exposed wa11 area t97 _70 sq. ft, x 2. Total roof/ceili arcti Z-®O sq. ft. x ~,05' ■ G© Total exposed gall area above floor _LL W a. Total wail window area 12,7?- b. Total door area 37--0/ c. Total sliding glass door area a o.o d. Total fireplace wall area....... e. Total wall framing area (average 10'X)............ g f. Total net wall area above floor ILN.47 g. Total rim joist area !2/,(Z Total c.xposed foundation aiea = -'1 -C- - h. Total foundation window area i. Toal net foundation area above gre.ue Determine "U" value of each .,1 segment. a. --L1 3.72 _ X nun ~J 2.5V b. 37 61 X "U" ` /3 4.4/ C. C(o.OZ X nun ` 7J a ~2. r7/ d. X "U" e. 197. Z7 X "U" fZ 1747 f, 1'566q Z X ,.U" . o7 . !4! 1W g q I- rL T X nun . 06 t.46 h. r X nun J.- ~7tl.,96 x nun .47 3 . ............I q7 . 2 . > d ..Total ` . . If item 13 is the same as, or less than item fl, you have met the intent of SBC 6006(c)2. /3SOD-X90-~f CITY USE ONLY L RECEIPT Jr SUBD. DATE: Z 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add'-on air exchanger, i.e. Vanee system, etc. 0*t R g€}NLru6 I4r,ir EIS J0 r96CA-G t Date: ~7-11-yS EEM Minimum Fee: Add-on/Remodel (existing residence only) $20.00 ► HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 • Gas Outlets (minimum of 1 required @ $3.00 each) State Surcharge .50 TOTAL 2~ r~U SITE ADDRESS: L110(7-7 LIFm3a iD6Z Dp OWNER NAME: C V✓ 7~-tAsi PHONE ~S('414 INSTALLER NAME: L-~ J';b STREET ADDRESS: q( 67 CITY: 4GFJe✓ STATEN ZIP: SS>zZ PHONE ( ) (~/ry 7L~6 SIGNATURE OF PERMITTEE I' 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) `f 1431 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 851-881-4875 New Construction Reaulrements Remodel/Repair Reaulrements 3 registered site surreys dxyMng sq. R of lot, sq. ft. of house 2 copies of plan and g)( roofed areas (20% mmdmum lot coverage atlowem I set of energy calculations for heated addition 2 copies of plans (show beam d window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks > 1 set of energy calculations > 3 copies of tree preservation plan If lot plaited after 7/1/93 6J DATE:` CONSTRUCTION COST: 2.I ~d DESCRIPTION OF WORK: - ROO I:- STREET ADDRESS: 4eZ 7 CAwtbp-i~f Dp, LOT: BLOCK: _ SUED./P.I.D. E: e sQ Q- Y', tom' Name: E- (Vt~ S`f fcvJ Phone (t: f~ s l - X 86 ~ PROPERTY Last First OWNER Sheet Address: L~Lis-) City F,A& 2J State: r" ' Zip: Company: Phone (area code) CONTRACTOR Street Address License It Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone ft: ( ) Street Address: Registration It: City State: Zip: Sewer/water licensed plumber (N Installing sewertwater): Phone 1 hereby acknowledge that 1 have read this application, state ttat the IMomtolion is correct, and a ply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Apptica OFFICE USE ONLY Certificates of Survey Received Yes No RECEDED Tree Preservation Plan Received _ Yes s No _ Not Required AUG 2 2 2000 BY:___ &433/ os~ 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date S l /3 p, / Oq Site Address ij lb ~v~ VJ~t ~Lf K \-)r Unit # Property Owner C Vt64 I v.K + ~jGy L Telephone # (t^S ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace ~JCGJ -Additional XReplacement 4th _ air exchanger _ air conditioner1kC'JX New Replacement other State Surcharge $ .50 Total $ 30 SO I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 ' I be ' accordance with the ap7 ed plan in the case of work which requires a review and approval of plans. )qVlicanfs Printed Name pplicanfs Signature (o q 330 SZ 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ~ ! ~ 3 ! ~ Site Street Address Unit # Property Owner C6'Az-&4baiL ~ i Telephone#(~~-F) 6S(. ?6G4_~ Contractor > Telephone # ( ) Address City State Zip The Applicant is: Owner _ Contractor -Other Alterations to existing dwelling $ 50.00 1'4, Add fixtures to rooms, excluding water softener and water heater -Septic System Abandonment -Water Turnaround (add $121.00 if a 5/8" meter is required) -Other: f~1 f-img B }?-T•h4 _ Water Softener i Water Heater $ 15.00 - replacement 'ZL- additional Lawn Irrigation System RPZ_ new _ repair -rebuild $ 30.00 State Surcharge $ 50 Total $ ~S- 1 hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordan4wh the approved plan in the event a` plan is required to be reviewed and approved. ~G►rrh~lccrl ~~-.g~'-e ~ Applicant's Printed Name A Ii nt's Signature r t. Use BLUE or BLACK Ink For Office Use lo Permit #:v ty of Ea 1 Ci Ed0Permit Fee: 3830 Pilot Knob Road -ZZ-6 /Zi Eagan MN 55122'^ Date Received: Phodb: (651) 675-5675 Fax: (651) 675-5694 APR 2p1~ i Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION S 3`I Date: Site 'A'ddress: Unit Name: l_. ~V' Phon ~J ~n Cis -r 3 RESIDENT q ~A OWNER Address/City/Zip: ~1~1~ ` ~~NhVjrIC:L~~ ,~$✓~~1 a~~~~ Applicant is: Owner Contractor TYPE OF WORK Description ofwork: LC-(Jo-/%Q D A-TP-020 7~ ~1J 57-'Jl Construction Cost: 410 2 C Multi-Family Building: (Yes No 0~ ) Company: A ~ CoLff e-OA Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certifjcation , please explain why: (see Page 3 for additional information) .Xe COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the 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.gopherstateoneGall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a p it; 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 to Bui Ing Co st be completed within 180 days of permit issue r x a \ Applicant's ineed Nam Ap !cant's Signa ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE D° SUBTYPES X67 04•'" 6,,-A,e Foundation Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement Siding _ Demolish Building* Addition Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation V Occupancy MCES System Plan Review Code Edition SAC Units (25% 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: j Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill - Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By:~ Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge / S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 14W CERTIFICATE OF SUR• EP`s y -7 g'~ 9 S 7703Z-37,,,r / ~ LOT 19 30 OS a xx r,; , ~ ~ ~rltrrgLQCK 4 ,ht Oil, 1 Q CASCAQ rNr co 3 r00 l t ~O 30'/ a o 2 9 S3i~ cr lo- r 3a V OTZ $t All elevations shown are existing. grades and / ~ gt•~ are assumed datum, Garage floor to be not less than l.8 feet above street ✓r/ / I hereby certify that this is a correct representation of a survey oft Lot 19, Block 44, B=ON HILLS, Dakota County, Minnesota, aaccrdi ng to the plat thereof on file and of record. and tbkt I = a duly registered land surveyor under the laws of the State of Inunesota. gene L. Jacobson 4&=. Reg. No. 7734 Dated this pith d~yy of September, 1981 DR. BY GRJ SCALE - i" = 40~ O DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM ]Prepared for s Johnson-ftDonald Constr. JACOBSON SURVEYORS 15513 Logarto Lane LAKEVIL.LE, MINN. 55044 Rurn,aville, Minn. 55337 PHONE 469-4328 � '� � Use BLUE or BLACK Ink �-----------------, ��'^+�,����� � ForOfficeo�733 � �,� , 7 � lt�� r ^ I Permit#: Of ���al� SEP 2 9 2Qt4 � � Permit Fee: � • I 3830 Pilot Knob Road i ��g � � Eagan MN 55122 ���------�-- ------_--- I Date Received: � Phone: (651)675-5675 j I Fax: (651)675-5694 � Staff: �����������������J 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: `�a 3r�/ Site Address: Y�b7 C0.�w��"�O`g�- �/� Tenant: Suite#: r �°Res�dentlOwne����'� Name: �r► iA.n cc.,s�e Fhone: �S!' 3 �3� 0?0 <.3 ` ���� ���'�� � '�� �{�6 7 G.,,.w..�r-i �e �r �. ` � _ ,,���"` ���� Address/City/Zip: . � �� �����Y�� Milbert Company Inc dba Cullign Water �f �' ��� �����`�����'�'"���� Name: �i�ense#: WC643176 ���,�� ��� ��� � � � � �� � ia���,� �,� ,�a ������� Aadress: 180150t� Street East� c;t Inver Grove Hgts. � ` �Con�ractor��;���� � y� � � ' � �� �-��� state: >M N � zi 55077 Pho�e: 651-451-2241 �, � � � �� ,� • - �, m t y� ti.��r,r�., � � . ��, `� �� ° £��` .,����� conta�: William R Milbert Email: � �� � � � � ' � �� y ������r`� _New Replacement _Repair _Rebuild _Modify Space _Work inR.O.W. T'ype of d�Norl��� � �� �� ������ �� �'°°� x � Descri tion of work: � �� r�'� . �"" x`� p ��: � � ,�����'d���� � RESIDENTIAL� � � � k � f �d��� � � ���� � � t������� Water Heater � � ����� �,��� �Water Softener Lawn Irrigation(_RPZ l_PVB) � `Permit F�r�e� ��� kg 3��� Septic System Add Plumbing Fixtures�Main/_Lower Level) �' � �'� j � � "��'��`���-��� New � � WaterTurnaround � �� ���`���a �`��—.: — 4 g�„: � ��r �� � ,,s� �� �� a�� r���� Abandonment � RE�IDENTIALFEES: $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 Svstem Abandonment,Water Turnaround'(includes$5.00 State Surcharge) *Water Turnaround(add$200.00 if a 5/8"meter is required) $115.00 Septic Svstem New($10.00 per as'built)(includes County fee and$5.00 State Surcharge) � TOTAL FEES$_ 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. vwvw.gophers#ateonecall.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; thaY 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 pl s. X � l� �,�� - �lpplican Printed Name Applicant's Signature �o-���, � � � �, � � � �� _� �r r r .��� ��� � � � '2 �t*'�'x-�' .�,. -�,,;. . r,�� S 't$ �'�..a°i& ,� } ? �"� 7 '� � � s a����} �.'�' y�a �. -�� n �. ,�,�}. t*r 'k � ��������r ���� a '_.. S�i� d Y ' v ��� a�.� � �Y����' '�'��� °'2���t�.$"������E��'�'�id�}�� � �?�'r.`�;'i t $ . i �� J� P t"A � � S I � ���q4�ired In���+�cti �� - � � �� F * � ' ° � ������ ,�, ` � „` u�, � � '� � �y����, � � a :'�'^n,�.+x!s a.�s I k nw ���, �� �' ' � � � ,� �*� . �� ,� � `������ �������� � �' "� "� °��:- '��,i a ..� � ` �„�„^�,���i! 4�m,..r="' � ��'�ny e �R�at }�tte e e� rz �d�� �, ,�� ��� ���;�� '�'� `�. ,9 ��,�.���� n. �- _ s� .�'���-��.� � � � � � � �. � _ _. I-For Office Use E ; AG NPermit#: / , g�y Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsecitvofeagan.com 2019 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 7.--?-a0( l gSite Address: Li 61 C_cxyv \ ,e i U e_ Tenant: Suite#: • « ;rG Chi . ' �o- V Sl-3S3 - 2.o7 Retideri .s ,arm Name: S�t cc v� Phone: Address/City/Zip: 5 �, Name: License#: contractor Address: City: State: Zip: Phone: Contact: Email: New Replacement —Repair —Rebuild —Modify Space Work in R.O.W. Type of Work — — " Description of work: Water Heater Lawn Irrigation( RPZ/—PVB) Water Softener Description Septic Plumbing Fixtures ( Main/—Lower Level) Septic System Description: New Abandonment Connection to City Water from Well RESIDENTIAL FEES $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+ $290 for Meter and $190 for Radio Read = $540 *Sewer&Water Permit also required for connection charges TOTAL FEES $ 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 You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the or' nces 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 withou . •ermit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. C- c-Si e x Applicant's Printed Name Ap i icant's Signature Page 1of2 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA173575 Date Issued:11/17/2021 Permit Category:ePermit Site Address: 4667 Cambridge Dr Lot:19 Block: 4 Addition: Beacon Hill PID:10-13500-04-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Garage Heater Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Christian P & Gail A Faste 4667 Cambridge Dr Saint Paul MN 55122--271 Applicant/Permitee: Signature Issued By: Signature