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4379 Bent Tree Lane I RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements RemodeffReoair Requirements • 3 registered site surveys showing sq, ft. of lot, sq. ft. of house: and alt 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 (bidgs with 3 or less units) DATE or/ VALUATION 7 1 t ©~d SITE ADDRESS Y.37g b\j, MULTI-FAMILY BLDG -Y N TYPE OF WORK RE7" R©a'~' C (?X-3-770C- FIREPLACE(S) 0 _ 1 2 APPLICANT T-1C1~i o(~- r -Zws STREET ADDRESS/,2-M CITY ~ STATE XAjZIP 5 6 cl TELEPHONE #7`?-~ "r9~d CELL PHONE #~2 `7 `fd FAX # ~~?-G{.Z S- 3 d rte. PROPERTY OWNER TELEPHONE # COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ N1INNESO`fA RULES 7670 CATEGORY I MINNESOTA RULES 7672 (J submission type) • Residential ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # _ Plumbing system includes: r 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: Phone I hereby acknowledge that I have read this application, state that the information 25 v. omply with all applicable State of Minnesota Statutes and City of Eagan Ordina 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-piex ❑ 13 16-piex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-piex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of , piex ❑ 09 07-piex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-piex ❑ 10 08-piex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-piex ❑ 11 10-piex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-piex ❑ 12 12-piex Pibg_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 (Bldgr ❑ 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 bidg) _ Final/C.O. T Footings (deck) Final/No C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool r 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 K N A21 7SS Request D to Fire No. Rough-in Inspe ion r R !'ad? D Ready Now Will Notify Inspector a Yes G No When Ready? 1,1~licensed contractor owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) City dew -tXcc 44A,- ~F'4"w Section No. Township Name or No. Range No. County OccupantlPRINT) Phone No. lei C."tj Power Supplier Address 'n 16 "A - Electrical Contractor (Company Name) Contractor's License No. Mailing ddress (Contractor or Owner Making, I stallation) Authorized Signature (Contractor Owner Maki Inst llation) Phone Number j MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION gy, Ee-oooot-oa e- ~ c K p 0,4 ► S,Se instructions for completing this form on back of yellow copy. X" Below Work Covered by This Request9 ew Add Rep. Type of Building AppiiancesWired Equipment Wired [Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other-(Specify) Comm Andustrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: _ Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps rQt~ 0 to 100 Amps .40 Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms ~ 7 4 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE O ERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M T 1, the Electrical Inspector, hereby Rough-in Rate certify that the above inspection has Final Date , 7 G been made. OFFICE USE ONLY This request void 18 months from f- ' 0 8 3 9 INSPECTION RECORD PEFOW TYPE: 3t33t1 MW XlWb P t d Pe rmit tr Eag, M ` ~ lk3 [aria %Mmd (612) I:1$75 OUT T*4 tom' "$to 10Wk r * swc 'M WORL ~ !Y T~~ 1rR'A~ILl1A ~1~f'~W. SIT ~tl~ . Ix' If t+ly1 R - AIAlItKlif r~ Pam* no. PWWA Haidw puAmoo IJ .71, A -I Jot -.I _4 Y,/Y,/ rv- 7-W . ' . #{1v+A c$A =t 00, 4 PAU*tftg. y f0j"41 94 t d~ 9Z s` FWW F14 o owdTool r~,er,o - NO* Pwkw Cardt Mew EnW~ ek%~ fkW C F _ - - - - Dock r r P(. 0". ..cafe o~ ~cc~u~anc~y • ~ raMC>Kt ~ ~uit~>xg ~t~ctie>K This Cert{~ate 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: ~ r M' Use Classification: SF DWG Bldg. Pavvit No. 1069 J R1 VN Occupancy Type Zoning District Type Cont. Own" of Building BA9IC BUD IM aadress 28 tU 1145TH ST W, R-OSRUM Big nay 4379 IM TREE LANE L «all;ty L1, B1, MMM~T RIDE 2ND 10/29/92 Date: Building Official POST IN A CONSPICUOUS PLACE ~i :1,179 BENT TREE T.ANE Lot I Blk I Sec/Sub AUnM RIDGE 2ND These items were/were not complete at the time of the final inspection. Date: 10 q Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish 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. NEMEDPAPEN White - City copy Yellow - Resident copy Pink.- Contractor copy ` PERMIT " Control No. 0839 X z , ' CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 001069 (612) 681-4675 Date Issued: 07/20/92 SITE ADDRESS: 4379 BENT TREE LANE LOT: 1 BLOCK: 1 AUTUMN RIDGE 2ND DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R-3 M-1 Construction Type VN Zoning R-1 Building Length 68 Building Width 46 REMARKS: C/f RECEIPT 0~ PRV S&W PLBR - GENZ-RYAN FEE SUMMARY VALUATION $141,000 Base Fee $783.00 MISC FEES $1,610.50 Plan Review $508.95 Total Fee $3,672.95 Surcharge $70.50 SAC $700.00 SAC % 100 SAC Units 1 Subtotal $2,062.45 CONTRACTOR: - Applicant - ST. LICOWNER: BASIC BUILDERS INC 14233114 0002097 BASIC BUILDERS INC 2810 145TH ST W 2810 1 145TH ST W ROSEMOUNT MN 55068 ROSEMOUNT MN 55068 (612) 423-3114 (612)423--3114 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. PPLICANT/PE ITEE SIGNATURE ISSUED BY. qIGNATPIE I` PERMIT # j CITY OF EAGAN REACTIVATE _ 1992 BUILDING PERMIT APPLICATION 681-4675 ~UL RECp SINGLE &MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re guest is mad~e__r lot change is re uested once permit is issued. D Valuation of work Site Address: 77 r"z STREET SUITE 0 Tenant Name: (commercial only) LOT BLOCK SUBD. ii-it Yv► ►J P . I . D . 0 9- nP A © t 6~1 Descri tion of work:-5C 6W6 k_z The applicant is: ❑ Owner Contractor ❑ Other (Describe) Name 6t w it C-;r~ Phone Property LAST FIRST n Owner Address '74o ~s+, U/ ~4P✓ ~ C STREET TE R Cit ~ Y State 1114,0 Zip Company s I C- MU 1 L Tf c zz7 . Phone l/ Contractor Address License #4WaU97 Exp._l9 C i tyv~c7u~~.° State Zip Company `PtAl\co /040, Phone V5 ~4;2/ Architect/ Name KQ~T~ Registration # Engineer Address ) Cityi4 State Zip ZZ Sewer & water licensed plumber z Processing time for sewer & water permits is two days once ea has been approved. 9 I hereby acknowledge that I have read this application and state that the information is correct and agree to compl a appl'cable Wto Mi eso tatutes and City of Eagan Ordinances. i Signature of Applicant: i t OFFICE USE ONLY ' BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish P 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 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. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 10 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair L7 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. JS zg MWCC System k (Allowable) 1st F1. sq. ft. i Sz City.Water UBC Occupancy 2nd F1. sq. ft. yZ PRV Required Z7 Zoning - Sq. Ft. total Booster Pump # of Stories z Footprint Sq. ft. Fire Sprinkler Length_ On-site well Census Code Depth On-site sewage SAC Code p APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site Footing JY Framing Ja Insulation ❑ Wallboard ® Final ❑ Draintile ❑ Fireplace Permit Fee vstuatir: g ) V/ 00 Surcharge i3sk.~" Plan Review lok~---= 3~ License 18X5 9az t -7Y,3 = X5 MWCC SAC I ~',r = l b 8 ~.3k z - yy G City SAC -2 6f Water Conn. Water Meter Acct. Deposit ~ S/W Permit S/W Surcharge 3,..5SS, Z-0 Treatment-Pl. Road Unit z Park Ded. _ Trails Ded. Z(91 Co ies Other Total: t- SAC % 2. SAC Units ■■.~■~■~iuuvarLi~xr~~t~i-~~[IFlfCGI LUITI'i LAL~:ULA1'1V(V.7 BASED ON CHAPTER 5 OF THE HOVEL ED GY COUP. 1203 EDITION Adoption Effective . owner_ w. Phone Date Site Address Contractor Phone Building Classification: Type Al (Single Family & Duplex) Type A2 (Residential, 3 stories or less) (Over 3 stories) (Other) NOTE: ComotAte bayg ~7 and 4 first, GENERAL. INFORMATtnN 1. Building Perimeter Q 2. Wall height (ground to save) ft. , 3. 1. X 2. (above) gross wall area 2l rI "der • .A sq. ft. 4. Building dimensions (L) X (W) - r= ` 1.0-sq. ft. roof & floor area 5. Sq. foot area of rim joist - F or joist size t2 X X (Per imeter) sq. f t. 12 6. Doors - Area ~ . Thickness in U. factor Type of Construction Perim ter ft. Manufacturer 7.. Total dooms perimeter ft. , i 8. Windows: Nanufacturer_ (C ~ ~ t '~J State approved U factor TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL EACH UNITS SQ FEET I 9. Total sq. f t. Glass 10. Fireplace areas Width X Height -.,I _X e sq.ft. 11. Exposed foundations Height X ,~eir~Meter X ~ ~ Q ~ s ft. COMPLETION OF THIS FORM zs RE u IRED FOR ALL NEW DON T UC O Q 3 R T1 N, MAJOR REMODELING AND BUILDINGS BEING MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. -l- , irl►ldvw area A ' ---_.acl.E~• U wiltdowa b . UxA a 1 tti~n }01st area A sq • f E • U rim joint- l URA tl , Door area A I gq. f E, U door area_. , UxA a CCU other doors area A_e q.f U otfler door"--d-7 Uxh n Exposed f►1dn A r ~ II! sq•f U foulldablon> >071v Uxh d i 1'raml►1g area Al ~ ~i ~r gq • f t • U framing areaQ10- 7 5 Um d E wall area A', U walls iC~' -'7 + UXA e• d~+ • (130) Tom . . . t UxA _4A ' 4. Gross wall area x 0.11 (A-1 "11109 family 9 duplex) ~ allowable UxA/Code (13. above) X 0.23 (A-2 0th"r re"ldenElal) R •23 ioEi►er buildings) X •29 (over 3 "torten) A?, t, bTUll aunt he larger than or some 41 x U Code_I / Or. as 138 above 5. cellltlg f ranllnq area (At) equals 101 of 09111111 area 5A. Cron" Celllnq area 4 (b) x (N) 50. Joint area (Af) a I0% Cellinq area "q•ft• ' 4C. Ilet Celllnq area (he) '(15A - 15b) n .ft. q U Cell ing x A C I d Q . U f ramie x f x 5D. TOTAL U 6. ceiling area (15A) x 0.o26 (A71 mingle, family 4 duplex) allowable UXA/code x 0.033 (A-9 other re"ldentlal) X 0.06 (outer) A(15A ` d AD, -Or,. aunt bn'iarger than or same ✓ x U codes • 9) _ . an 131) above IOTBI Use U and A values obtained from pages it 3 and 4. 'hU1`l~a~lo~{1 1 herebyy Certifyy kbat I hove Calculated the "U" f"otorn "lid It" valu0F1 1,0170111 and Ei1at Elie bulldlhq here described meets or exceeds Elie :fate of 111►rnesota Energy Cvnnervatlon hot. i to ' ~gnature . _ir r ~ I ZA. ( f- 54. t 55 a~ l P)_ M 6 'T y Df- - = Inside air film HALL Interior wall . ~y (hall) U L a ' sECitoit ' ~ Insulation 11,0 Sheathing 2.Oto Siding ,[off outside alt'flim .l) R TOtAL 2..3 ~ oxj Inside-alt film .68 Stub • Interior wall SECTlOit 4~~ stud R' MIS (0.15 (Framing) U . Sheathing tx.U(o D96 Siding x(07 Outside air film .i~ R TOTAL ~p. 3 Inside alt film R+ .68 tttb UAt L Interior Mali, insulation L Nall) ~--J Sheath Ing Exterior wall tovering Exterior air film' R •oil R TOTAL ' Interior alt film RM .68 Kill Insulation Joist 1% lnth soft wood R•1088 (Rim U ■ • Joist) ' Sheathing Z 0D(O ~ D~•I ~ Exterior wall cover f n ' Exterior air film R TOTAL 4(o Interior sit film R' .68 Insulation ~~00 roundatlon (Fdn. U • R • Exterior Ali film R. .11 •c1(O R TOTAL 3 • Exposed dtotk • ~~rade R VALOR • FIWIIIit1 ' n VALUtI . Ct3ILIlid d Ittgulatlott • ~ _ o.sr Alrlrlltn o.t;t l0 --Total d2-~j 1U T1stlsJ ow" 1n111tratlon q,3 a~ro/lineal foot of crack nintlal door lnflltratiott o.s OEM/equate foot or door attd mlttimum nods reqqulremet~t 11011-reeldetttlal door lttf iltratlott 11.0 otm/litteal took of era Ilb „ aottorete block no ln"ulatlott crack m4l b 12". vvncrete block lttaulated acres " 0 26 n 1.1 ' . 11b 12" llgl,twelght block .26 It 9.1 . Ub 12" lightweight block lttsulated acres - .1a n 9.1 U uingle glean 1.171 With storm window .84 U double glans d .55 U triple glans .41 A11' exterior wall" attd* oblllttc 9 must have a vapor bsrrler (0.10 Veto max.). Vapor barrier must be oil*--the in"lde (heats aid") of wall. vapor barrier" of the polyetltelette title 11 m have Ito n value. Certificate For: Bas-ic Binders Inc. ,j DELMAR H. SCHWANZ LAND SURVEYORS. INC. Replotted Under Lwrt of Me State o11u1fnnaMe 14750 SOUTH R09ERT TRAIL ROSEMOUNT. MINNESOTA 63008 612/423-1769 SURVEYOR'S CERTIFICATE Scale: 1 inch = 30 feet BM: Top nut of hydrant at northeast corner O = Iron pipe monument of Lot 1, Block 1 = 954.73 ❑ = Set wood hub x9~ = Existing spot elevation q 3 7. 3 = Proposed elevation ~l /q~3 a3 1 ~ 949 m~\k 'moo. ~sz,~zs IV N Tor iAS j , ~ / x 9f1, 3 qL' v ~J' i ro M l ~496 0 28 70 sY T- Al V °9, 1) o (1) d! 571 ~ ~~A'~`"', r 153, ~4 0) F _M AF1 K t? F„ Proposed garage floor elev. 9SS.z Q7 i - 8625 - 'Al Proposed top of block elev. 9 55• S3~ Proposed lowest level elev. 7• `3 x lip O p E%L~ Description: Lot 1, Block. 1, AUTUMN RI 2ND ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. I hereby certify that this survey, plan, or report was prepared by me or under my direct supervision and Also showing the location of pro s d house as that I am a duly Registered Land Surveyor under staked thereon. the lawn of the State of Minnesota. Dated 07-10-92 MDelmer H. gch*sn2 t nesoll Reg 9tratfon No. 6829 `e PERMIT -7-eITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road B U 1, L.. D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 7 0 0 (612) 681-4675 Date Issued: 10 ! 19 19 8 SITE ADDRESS: 4379 BFN T' TREE LANE LOT,. I BLOCK. 1 AUTUMN RTDGF 2ND P . I . N 10--12 3 01.-01.0--0 1, DESCRIPTION: Esi.a l_(jino Permit Type BASEMEN'T' FINISH B, R 1-1 :ttdinq I1Aork T v p e ALTERATION i_ 4 nc',us Code 434 ALT. RESIDENTIAL i I REMARKS: PLAN REVIEWED BY WAYNE MILLER. SEPARATE PERMIT REQUIRED FOR ANY PLUMBING WORK. I FEE SUMMARY: Base Fee $50.00 Surcharge Total Fee? $50.50 CONTRACTOR: Applicant ST , L I C . OWNER: RONCOR CONST Co 18885578 0002337 STARR GARY 10740 L..YNDALE AVE S 4373 BENT TREE LANE BLOOMINGTON MN 55420 EAGAN MN 55122 (61,2) 888-•5578 i I hereby acknowIe,dge that L 11av rem J.d I:hi> lal ice,tion and i7~ t o t e t h, t the .nfiorma tion i--~ ;or r ct and i:i gr('-E, to eoinp-1 v with a11, app.licahIe Statel 0t 01n, SCr~r:Late, and C:i.t:.y ) r F<:~gon Clyd ii C APPLICANT/PERMITEE SIGNATURE SUED BY: SIGNATUR CLAM VOUC1tER REFUND REQt1F.ST ! .3 CITY OF EAGAN i i CLAMANT GENZ-RYAN PLUMBING & HEATING, INC. ADDRESS X745 SOUTH ROBERT TRAIL ROSEMOUNT, MN 55068 Location X4';79 RENT TRRF TAME L1, B1, AUTUMN RIDGE_ ND Receipt No./Date 106894 & 106888-7/16/92 Reason for Refund BUILDER HIRED ANOTHER CONTRACTOR - Type of Refund Electrical permit 01-3211 $ Plumbing Permit 01-3212 S 49.50 Mechanical permit 01-3213 S 39.00 Surcharge 01-2155 S 6/Z7/42 Water Connection permit 20-3713 S Sewer Connection Permit 20-3743 $ d Account Deposit 2072252 S Utility Account Over-Payment 20-2250 S Other, S S TOTAL S 88.50 I derinrr under the penalties of law that this account, claim or demand is just and that no part of it has been raid. 8/2'5/92. 4:5~ - S g ature Date ` B CITY OF EAGAN MECHANICAL PERMIT RECEIPT # SUBD. ~w s (612) 681-4675 DATE ~ /~i RESIDENTIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT. OWNER: x FEES SITE ADDRESS: ADD ON/REMODEL OMSTING $ 15.00 7 / CONSTRUCTION ONLY) INSTALLER: GENZ-RYAN BEATING HVAC: 0.100 M BTU 24.00 PHONE 423-1144 ADDITIONAL 50 M BTU 6.00 ADDRESS: 14745 South Robert Trail GAS OUTLETS - MINIMUM 1 @ $3 EA. LEGNATURE: : Rosemount ZIP: 55068 SURCHARGE: $ .50 TOTAL: $j C) C RCIAL PLEASE COMPLETE S PORTIO FOR MMERC USTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDIN OR OTHER LTI-F LY BUI N SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UN WORK DESCRIPT ON: CONTRACT PRICE: FEES / 1'% OF CONTRACT FEE. STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. $ PROCESSED PIPING - $25.00 y OWNER: TOTAL- $ SITE ADDRESS: TENANT: SUITE INSTALLER ADDRESS: CITY: ZIP: PHONE CITY SIGNATURE: SIGNATURE. L 8L CITY OF EAGAN CITY USE ONLY PLUMBING PERMIT SUED. (612) 681-4675 RECEIPT DATE 0 a- RESIDEMIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: Y NO. FIXTURES EA. TOTAL NEW NST REPAIR/ADD ON 15.00 ADD O ONN / SHOWER 3.00 REPAIR WATER CLOSET 3.00 cyZ BATH TUB 3.00 LAVATORY 3.00 OWNER NAME : aC,at~_ I KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS :`3 7c~• / ~tAQ_ Ge., p HOT TUB/SPA 3.00 J WATER HEATER 3.00 3~ FLOOR DRAIN 3.00 INSTALLER: GENZ-RYAN PLUMBING GAS PIPING OUT. (MINIMUM - 1) 3.00 3 V~ ADDRESS: 14745 South Robert Trail ROUGH OPENINGS 1.50 OTHER CITY: Rosemount zip: 55068 WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U. G. SPRINKLER 3.00 PHONE 423-1144 ' W. TURNAROUND 15.00 STATE SURCHARGE .50 SIGNATURE OF P EE TOTAL: COMMERCIAL PLEASE COMPLETE THIS P IL R A ERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY 'BUILDINGS WHEN SEPARATE IT S ARE OT QUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: OWNER NAME: CONTRACT PRICE: 'SITE ADDRESS: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR TENANT NAME: EACH $1,000 OF PERMIT FEE. (SUITE: $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: PHONE TOTAL: $ 'FOR: (SIGNATURE) CITY OF EAGAN CITY OF EAGAN I-_1__ MECHANICAL PERMIT RECEIPT # SUB (612) 681-4675 DATE / P. - RESIDENTIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT. OWNER: FEES SITE ADDRESS: ADD ON/REMODEL (EXISTING $ 15.00 CONSTRUCTION ONLY) INSTALLE ¢ HVAQ 0.100 M BTU 24.00 PHONE ADDITIONAL 50 M BTU 6.00 ADD GAS OUTLETS - NIINIlVIUM 1 @ $3 EA. D Ln Y: Z IPSURCHARGE: .50 NA RE: TOTAL• COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: CONTRACT PRICE: FEES 1% OF CONTRACT FEE. STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. $ PROCESSED PIPING - $25.00 MINIMUM FEE - $25.00 OWNER: TOTAL: $ SITE ADDRESS: TENANT: SUITE INSTALLER: ADDRESS: CITY: ZIP: PHONE CITY SIGNATURE: SIGNATURE. CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # ~~~-yea PHONE: (612) -499 RECEIPT # LC$N>_' DATE : REIDE?2 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 REPAIR 4 WATER CLOSET 3.00 t 00 BATH TUB 3.00 : co LAVATORY 3.00 l OWNER NAME: b~J-, !E't it s KITCHEN SINK 3.00 °Z~ I_, s LAUNDRY TRAY 3.00 '3 - 10 SITE ADDRESS : I'} 1 % k C L Lc-,t c~_ HOT TUB/SPA 3.00 WATER HEATER 3.00 9 LOT : BLOCK l SUBD.~Ct1 t'r'1~it r- FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 ADDRESS: OTHER - WATER SOFTENER 3.00 CITY: ZIP: 53 "2 _ PRIVATE DISP. 15.00 PHONE ~1/~,~ U.G. SPRINKLER 3.00 " ~:d~ y SUBTOTAL ST. SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: $ GOMMERGSALfINDUSTRIAL: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OI.':1E°. ^ ME : 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN REACTIVATE X CITY OF EAGAN PERMIT ` ' 1993 BUILDING PERMIT APPLICATION 0 1993 681-4675 SINGL MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date / / Valuation of work Site Address: STREET SUITE # Te ant Name: (commercial onl LOT BLOCK J- SUBD. L J.D. .Description of work: The applicant is: Owner O Contractor 0 Other (Describe) C Name V© R WER K~ d y Phone of fZa 71319 Property LAST FIRST / Owner Address iQ B E~ T T0~9 Z dAI-L STREET STE #F City State & Zip Company Phone Contractor Address License # Exp. City State Zip Company Nhone act/ ACChit ' Engineer Name Registration # Address City State Zip Sewer & water licensed plumber 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 applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 7L (~j ~z i OFFICE USE ONLY BUILDING PERMIT TYPE ❑ OI Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging O 16 Baseme*. Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim of ❑ 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. I,15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE IX 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length ~c On-site well Census Code y_ Depth 49' On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site IC Footing ❑ Framing ❑ Insulation ❑ Wallboard Final ❑ Draintile ❑ Fireplace Permit Fee IJ 1 L- valuation: $ Surcharge a Review P s s t, SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total. SAC % SAC Units Certificate For: Basic builders Inc. DELMAR H. SCHWANZ • lANO SURVEYOR!. INC. 119919tNed Undo. Laws of tM State of Minnesota 14750 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA 11S06A 612/423-`1769 SURVEYOR'S CERTIFICATE Scale: 1 inch = 30 feet BM: Top nut of hydrant at northeast corner of Lot 1, Block 1 = 954.73 0 =Iron pipe monument ❑ = Set wood hub K9~Z = Existing spot elevation g37.3 O = Proposed elevation A - ►,1 ~ T, "9j,B~.G, xv ` 33 -6, ~ Cb C , ri;j ~J O \ 949 R~\ r O N 4ST•~ XAS ~ ` N a2 q~~ o qsl 9 2 s 3 •o ~ Q / ° , m / J7 < qsl, a V l C 1 9A n ' : / / / 'Vti s01 ~ N 949,ds- 10/' S 7a D S~ 0 r n' l 9 (n yr 9s/.a = \\~.``'V~ Proposed garage floor elev. 9SS, z QJ _ DELMAR H. SCHWANZ Proposed top of block elev. 9SS.53 867.5 ° Proposed lowest level elev. 94 7. 53 ' Description: W Lot 1, Block 1, AUTUMN RI E 2ND ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. I hereby eertlly that this survey, plan. A► report was prepared by me or under my direct supervision and Also showing the location of pra0s house as that I am a duly Registered Land Surveyor under staked thereon. the laws of the State of Minnesota. A ~Wv Dated 07-10-92 MlAnaiwe !leg atratlon No. 662' I 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - SS122 681-4675 - New Construction Requirements Remodel/Repair Requirements=C-' # 3 registered site surveys # 2 copies of plan I `Z # 2 copies of plans (include beam & window sizes; poured fnd. design; etc. # 2 site surveys exterior additions & decks 9. ) ( ) # 1 energy calculations # 1 energy calculations for heated additions # 3 copies of tree preservation plan if lot platted after 7/1/93 required: _Yes _ No . DATE: tn- 13 - CONSTRUCTION COST; 006, I DESCRIPTION OF WORK: S e `e---(- STREET ADDRESS: ~ 3 -7 - - LOT: \ BLOCK: SUBD./P.I.D. V~~~+rvl vti_ ~Q Name: S + a- °2' l rQ y Phone PROPERTY Last First OWNER Street Address: City State: '11- Zip: Company: '1\ C) Y^-) C-- O 1- 14- Phone CONTRACTOR Street Address:-/ w c~ 4 to AC.I-r ~ License # ~'3 3 7 City 13 L-OO k't f r.ra State: i4A Zip: 5- C-) ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address chang and lot change is 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 applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: -~-f' << 1 jI OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required I OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging -12~ 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 X. 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Vim= Basement sq. ft. MCNVS System (Allowable)f Main level sq. ft. City Water UBC Occupancy Z 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 f Census Bldg Census Unite APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units rr c F ~►e INSPECTON .fi t. ~f* G14N PERK ~i d Rat Kra Road P~rrrtit Numb:' Eagan, Mi to 55 1 22-1 897 Date Issued. t (612) 681-4675 • , ADMESS: P 1. 14. APPMANT: 4979 RANT TOFF LANE RAKC+bR Co"ST 'Co 1it17' I11fi!!1 R I t76C k 'If `3, w F mff W B ! ■ i E: iy. TYPE OF WORK* -7 N-977 l~~IiHXH T# SULAT°1fOM DUGH. IN PLO$ ~ FINAL r koomS: PLAm Revirwro fly WAYN IVIL uR. fPARATf PERMIT Fti"pttTAE0 FOR ANY PLU148I#16 WORK . z~ At 1 446 -~R40 RFOAPOTN4 Ftt f'lRTl At P# ttMT'fi ANn INSPE:CTt 49 PermitHokhW Daft T # HVAC inspection 0 hwp. r4xyllowus FOOTNa$ I FOUND FRAMING Zf' ROOFING ROUGH I PLUMBING M PLBG ' AIR TEST ROUGH f HEATING GAS SVC f` TEST INSUL GYP BOARD + FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG i. ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL City of Eagan Cash Receipt Receipt Date 12/2/2009 Receipt Number 155625 DAYCARE INSPECTION 4379 BENT TREE LANE 1221.4216 50.00 4379 BENT TREE LANE Total Receipt Amount 50.00 110249 10:44:21 Use BLUE or BLACK Ink For Office Use I Permit City of Eap r~ T~ I Permit Fee: I 3830 Pilot Knob Road R ~p11 I t ~'Z Eagan MN 55122 MA 1 Date Received: Phone: 675-5675 (651) I Staff: Fax: (651) 675-5694 L----------- 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 5~- Site Address: / Tenant: Suite RESIDENT / OWNER Name:V1 S~-Car Phone: Address / City / Zip: Name: ii,iv License p~ 6 Yy LD CONTRACTOR Address: 112~~ti G"Yt~ S City: f7T 7'CJ State: Zip: Phone: Contact: lam- Email: l TYPE OF WORK - New (Replacement _Repair -Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL ~1Pd'ater Heater Water Softener PERMIT TYPE Lawn Irrigation L- RPZ / _ PVB) Septic System Add Plumbing Fixtures Main Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) "Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) ~~i~ 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.gopherstateonecall.om I hereby acknowledge that this information is complete and accurate; that the work will be in conformance the ordinances and codes of the City of rt with permit; that the work will be in Eagan; that I understand this is not a permit, but only an application for a permit, and work is not tqeff accordance with the approved plan in the case of work which requires a review and approval of Oil- x x Applicant's Printed Name plicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Use BLUE or BLACK Ink For Office Use I b 3, I Permit City ~ RECEIVED ~ Permit Fee: / I 3830 Pilot Knob Road MAR Eagan MN 55122 i Date Received: Phone: (651) 675-5675 I Staff: Fax: (651) 675-5694 ! 2012 MECHANICAL PERMIT APPLICATION Date: l 'Z 5"-lZ Site Address:3 J3~✓V1^'%~' .~,~9.+fi Tenant: Suite RESIDENT lOWNER I Name:,16yJgy-~- Phone: Address / City / Zip: 3 ' r J Name: License I CONTRACTOR Address:.&Z City: Zip: Phone: State: _,,W ~~Z° Contact: Email New Replacement Additional Alteration Demolition TYPE OF WORK Description of work: i NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace _ New Construction = Interior Improvement PERMIT TYPE Air Conditioner Install Piping Processed Air Exchanger _ Gas _ Exterior HVAC Unit b Heat Pump _ Under / Above ground Tank C_ Install Remove) j Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) 4V $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) - TOTAL FEE 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.aor)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x App n s Printed Name Appli- cant's-Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Building Permit Number:EA174059 Date Issued:12/21/2021 Permit Category:ePermit Site Address: 4379 Bent Tree Lane Lot:1 Block: 1 Addition: Autumn Ridge 2nd PID:10-12301-01-010 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 - Gary M Starr 4379 Bent Tree Ln Saint Paul MN 55123--305 (651) 686-5540 Hoffman Weber Construction Inc 2155 Old Hwy 8 NW St. Paul MN 55112 (866) 970-1133 Applicant/Permitee: Signature Issued By: Signature