4497 Ches Mar Dr
PERMIT
City of Eagan Permit Type: Mechanical
Eaaan. Permit Number: EA092552
Date Issued: 01/12/2010
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 4497 Ches Mar Dr
Lot: 005 Block: 001 Addition: Wilderness Ponds
PID:10-84275-050-01
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
Ashley Orman
130 Plymouth Ave N
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: - Applicant - Owner:
Standard Heating & Air Conditioning Patricia A Smith
130 PIN-mouth Ave. N 4497 Ches lolar Dr
Minneapolis NIN 55411 Eagan NIN 55123
(612) 824-266
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
CITY OF EAGAN SEWER SERVICE PERMIT
3830 PIW.Knob Road
P.b. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE-
Zoning: ~i No. of Units: 1
Owner. ~,arry S is,'_,,v
Addres.4:
Site Address: 15 Cliff '02''
Plumber .arson- a t 11
I agree to comply with the City of Eagan Connection Charge: c op e
Ordinances. Account Deposit: '
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total: -
Insp.: Date Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:. No. of Units.
Owner: ti.x i
Addreek
Site Address: 14LI 4ll Coh TAr~r
Plumber: _
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 yree to osrroltr wkb ow City of Eeyew Surcharge:
oramenees. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: o +
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675 (Spo
SITE ADDRESS: t I APPLICANT:
a ~ tlt hilt; 1 I { r'ifa
+1. 1 k,I t t,l t „Nik•, ~ , ~ yr, 1 ~
PERMIT SUBTYPE: TYPE OF WORK:
11
INSPECTION TYPE OATE INSPTR. INSPECTION TYPE DATE INSPTR.
1 1 ra,i t
I Miif~r t+1 1. l Pt+~ ~+i ..I: I rJ I { ,•.k l ~,1, l 11
7
Permit No. Permit Holder Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing 3
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Fig.
Deck Final
Well
Pr. Disp.
B•QOtx)1 07i~
/6 Cl REOUEST FOR ELECTRICAL INSPECTION G(_1 ?E
~ See instructions for completing this form on back of yeNOw copy 00~
E 9. - 98 "X° Below Work Covered 47'%i9 Request
ew Add- TypeofBuilding Appliances Wired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer er (Specify)
Comm./Industrial Fu ace
Farm Air onditioner
Other (specify) tract 0t__ I ~c Ll / G v
Compute on Fee Below.
# Othe Fee Service tr ize Fee # Circuits/Feeders Fee
§okimming Poo 0 to 209 A 0 to 100 Amps
ransformers I bove ps Above 100 Amps
Signs inspect rs TOTAL
Irrigation Boo `•J
Special lnsp n t
Ala m ica ton 1
her Fee
I, th I cal Inspector, ereby Rough -in Data ti..
certify that the above inspection has Final Date
been made.
OFFICE USE ONLY
This request void 18 months from
E 9 5 9 9 8,_,:i- a>,
Request Date Fire No. Rough-in inspection
Required? TO Ready Now III Notity Inspector
6 Q D Yes Ready?
I El licensed contractor owner hereby r uest i pection of above electrical work at:
Job Address ( Strept, Box or Ro No.) City
q~e D
Section No. Township Name No. ge No. County Pq L- O
Occupant rRINT) Phone No.
5 ~ ysy ~3 i ~
er Su liar
Electrical Can ctor ICompa Name) Contfactor$ License No.
Mating Address (Contractor or Owner Making Inatallaflon)
n) Phone Number
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 (812) 642-0800 ENCLOSED.
CITY OF EAGAN 61 f Qt f °ct WATER SERVICE POW
3830 Pilot Knob Road L.-6,
P. O. Box .41199 PERMIT NO.:
Eaban, MN 55121 ! ~''4', 'DATE-
Zoning: - No. of Units. 1
Owner: - marry ; i!, lez
Address:
Site Address: i 7 Q 5 5 2
Plumber. tli w L'a.
Meter .3 G S 67-1 S niti - C.? r 50,'). 040
Stu: ,f Ck ?40) ' 15.00pd
Rea No.: O 'UPetiNO Fee: Z , nnpc
1 oft to amply wll6 the Citj t r,• Surcharge: . 50pd
Or/Mmom Misc. Charges: 132• 0pd 7.T
Total: 63,00Rd meter.
By Dote Paid:
Insp.:
Date of Insp.: (O /r Q ` '
REQUEST FOR ELECTRICAL INSPECTION - E"0001-07
See instructions for completing this farm on back of yellow copy
A 9 5 9 9 8 X° Below Work Covered by This Request ~~}U
ew Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer her (Specify)
Comm./industrial Fu ace
Farm Air nditioner
Mer(speafy) ram a a:
Compute tion Fee Below: r~. L I
# Othe Fee service mr c ize Fee # Circuits/Feeders Fee
imming Po4 V_ 0 to A 5 L to 100 Amps
ransformers bove mps Above 100_Amps
Signs Inspe yv L
Irrigation Boo 5
Special Insp Ion
Alarm/. m nica ton
Other Fee
I, th EI ical Inspector, ereby Rough-In Date
certify that the above inspection has Final Date
been made.
OFFICE USE ONLY
This request void 16 months from
95998~~
Request Date Fire No. Rough in Inspection
Required' ❑ Ready Now / Will Notify Inspects
6 u / ❑ Yes No en Ready?
10 licensed contractor owner hereby quest i spection of above electrical work at:
Jab Address Box or (7o e N o.1
- ^ ^ \t'I Qty
17
Section No. Township No or No. nge No. County
Occupant PRINT) Phone No.
P er SU list
Elewical Ca odor (Cam Name) j \j Contmmorb Ulcerate No.
Melling Address (Contractor or Owner Making Installation)
Contra ation Phone Number
MINNESOTA STATE BOARD OF ELECTRICTTY THIS INSPECTION REQUEST WILL NOT
Gdgg►66dway Bldg. - Room 5473 BE ACCEPTED BY THE STATE BOARD
1621 University Ave., SL Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-CM ENCLOSED.
8 24338
z5Q~
Reque Dole' Fire No. Rough-in Inspection ' L
Required' ! ]Heady Now ❑ Wi l Notify Inspector
v ❑ Yes o When Ready?
I licensed contractor O owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Rout No.) City
7 CS - L/ v ~f~ ~C! G/✓L
Section No. Township Name or No. Range No. Coup il~
4
Occupant PRINTI Phone No.
S; z L %y+ ~ sY
~ Address
Power Supplier
Electncal Contractor 'Company Name) Conbactor5 License No.
/ / ,i, ~r <<r l~/ cs K C iln-4O- ,?o3 7
c ~
Mailing Address (Contractor or Owner Making Installation,
ti`SS5
Aut Slgnawr vac ner Insta ion Phone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT ^ !(L~~
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 Univuilly Ave.. St. Paul. MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (612) 602-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ee.00oo1 oe
~ee instructions for completing this form on back of yellow copy. ~y ~ , 1, ~7~/
243-38
K + X" Below Work Covered by This Request V/
New Add Rep. Type of Building Appliances Wired Equipment Wired
x Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial rnace
Farm Air Conditioner
Other (specify) Contractors Remarks:
Compute Inspection Fee Below: e W Il Vvt R Cl
# Other Fee # Service Entrance Size Fee # ircuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 1C00 Amps op
Transformers Above 200 Amps Above 100 Amps
Signs hapeaars Use Only: L TOTA _
Irrigation Booms /J ~GV ~.y7G
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has Final Data
been made.
OFFICE USE ONLY
This request void to months from
Janta request om id ;b ~ lQ /7 )fT~' 1`.SI Ql~ GUi /d. c~S 7 G. G . S /
C_ 95116 /./s, a 7v iL
Far
Rs s Da 1q ' Fire No. Heq rte'?Inspection ❑R,atly Now ❑ Will Notify In
❑Yas -fly/o for When Ready
setl Electrical Contractor I hereby request inspection of above
❑ Owner electrical work lasts l led at:
Suet tldrss~BOx or ut o. Cit
Section No. Township Name ange o. Co my
Otcupan 2-197;eV ! J j '`J`^1 Phon No. -
Pow r Suppl .er 100 Adtlr ss S
"fa- Sl /(T- I
ElKp,fj jyf& ff NV 111jC Coat 046,Mo,
Malinngg'Adtlt'BSA/Eo¢ygt}plTpF~BrpyrglY►la~rrip{1 tlationl
Aut t rP+Lr11Yl (R+jt j,hjr r
i la\ion! Pho umber
AL4vilipl
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Reom N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 Universitv Ave.. St. Paul. MN 66104
Phone 161216420800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ES---00001-05
Iii See instructions for completirq this form on back of yellow copy.
"X" Below Work Covered by This Request
NawfAddj Pep. Type of Butidi.9 Appliances WirW Equipment Wired
Horne Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatm
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm then peci V Iher ISpeufyl
t r peci y her Other
ompute nspection Fee Below
g Fee Service Entrance Size a tie FeedersrSubfeedera p Fee Circuits
0 to 200 Amps 0 to 30 Amps 0 to 30 Am
Above 200 Amps 31 to 100 Amps 31 to 100 Amps
Swinxning Poot Above 100_Amps. Above 100-Amps
Transformers Irrigation Booms Partial-'Other Fee
Signs Special Inspection 5
emarks TOTAL F - O 0
f
Rough-in its 1, the Elec '
Inspector. hereby
lily thet the above
Final Dat~
petition has been
r de.
This request void 16 months from 4E ""D
CITY OF. E A G A I~ * NOTE: PAYMENT OF FEE AT TIME OF
APPLICATION DOES NOT CONSTITUTE
rt APPROVAL OF PERMIT.
*
APPLICATION FOR PERMIT
* INSPECTION OF SEWER AND/OR W- ER
* rnl yaiATioNS WILL NOT BE Sam)-
SEWER AND/OR WATER CONNECTION ULED UNTIL PERMIT HAS BEEN
y* APPROVED.
* *
*
*
P ease/ Print) fPSS co~pe~{ 1b
1) PROPERTY ADDRESS: C• ,S ( ~li~r ~~-zs -~J LAG ( c~h l1Pr IIr
LEGAL DESCRIPTION:
/ l C,~-~-E c~z-r.•.-ems
Lot Block Subdivision or Tax Parcel ID
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
PRESENT ZONING/PROPOSED USE: (Mon Year)
COMMERCIAL/RETAIL/OFFICE fij R-1 SINGLE FAMILY lu %1 f~
L~
Q INDUSTRIAL F-1 R-2 DUPLEX (To-n Units)
INSTITUTIONAL/GOVERNMENT R-3 TOWNHOUSE (Three + Units) ( Units)
R-4 APARTMENT/CONDOMINIUM ( Units)
2) 1i.
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) For City Use
NAME: -Q 2 @~J~1 SZ Plumbers License:
ADDRESS: "-Arelig Active
Expired
CITY, STATE, ZIP: Lr- S Not recorded
PHONE: MASTER LICENSE#
Sta~tial
4) •t • 17
NAME: 7( 2 h/}~ _~i
ADDRESS: ( ~r
CITY, STATE, ZIP: /
PHONE:
5) • u v 1 v• • a• - p1
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER Q OTHER
6) I • 1 P APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE -
E -PROVED PERMIT TU 1 2; , 4, ABOVE
(Ciele one)
7) r. r.
Y: • Y' C • • • 1' N • a 101• II Y~• . . • . D•
A
.FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ 16? SU $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLUDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ •U V $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ $ WAC
$ Z i [9 $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
• 1 WE a VAN • in M 1 • 15660) 201 • • I• P a• •71
• • ~1' • • 8• • 1 1 • • ' a • 1 1 i 11 • •
• 1 1 •
woomma CITY OF EAGAN
APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION
(Pleas, grant )
1) PROPERTY ADDRESS: 130~~ ~L/Ff GN
LEGAL DESCRIPTION: /0 d 7 G O /i/ ~4
(Lot Block Subdivision or Tax Parcel I.D. Number)
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
(Non Year)
PRESENT ZONING/PROPOSED USE: R-1 SINGLE FAMILY
R-2 DUPLEX (T; Units)
R-3 TOWNHOUSE (Three + Units) ( Units)
R-4 APARTMENT/CONDOMINIUM ( Units)
COMMERCIAL/RETAIL/OFFICE
INDUSTRIAL
INSTITUTIONAL/GOVERNMENT
NAME:
ADDRESS: J~ 1CGI
CITY, STATE, ZIP:
PHONE: e2
3) 1:7 For City Use
NAME. ' ernn A000 Plumbers License
ADDRESS: 6'>fr1~
d
CITY, STATE, ZIP: (4-pu, WRecorc
PHONE: yZ-3 - ~~0 MASTER LICENSE # Staff I ial
4) 0 •
NAME: ~7GY1n e O9~
ADDRESS:
CITY, STATE, ZIP:
PHONE:
.5) n a 1 a• :1
Q CONNECTION TO CITY SEWER CONNECTION TO CITY WATER
Q OTHER (Please Describe)
6) u • I
PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
P E MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
F O R C I T Y U S E ON L Y
PERMIT ° ISSUED
FEES: $ SETTER PERMIT (INCLUDE SURCHARGE)
$ CG'S U WATER PEPblIT (INCLUDE SURCHARGE)
$ 3 ~c~ WATER METER/COPPERHORN/OUTSIDE READER
U WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
$ y ACCOUNT DEPOSIT - WATER
$ ~UG.« WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SE`--
$ LATERAL BENEFIT/TRUNK WATER
$ /
WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TOTAL
$ 7~~uc AMOUNT PAID/RECEIPT
lo.sc -5
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
C~ YES IF YES, THEN A "PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
yy ,-'i PERMIT
Jl CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N
Eagan, Minnesota 55123 Permit Number: 0 2 4 3 7 3
(612) 681-4675 Date Issued: 08/19/94
SITE ADDRESS:
4497 CHES MAR DR
LOT: 5 BLOCK: 1
WILDERNESS PONDS
P.I.N.: 10-84275-050-01
DESCRIPTION:
BLilding---Kermit Type SF PORCH
Building W'o.rk Type NEW
ti
IY t/~/ y"Jy_.
L~1 i1 _
REMARKS: u
DECKING ALREADY IN PLACE FOR PORCH
A SFPARATF PFRMTT TS RFQIITRFn FnR ANY Fl FrTkTrAl WORK
FEE SUMMARY:
VALUATION $4,000
Base Fee $63.00
Surcharge $2.00
Total Fee $65.00
CONTRACTOR: OWNER: - Applicant -
SMITH STAN
4497 CHES MAR OR
EAGAN MN 55123
(612)727-0221
I hereby acknowledge that T 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
ISSWD APPLICANT/PERMITEE SIGNATURE ~A1NA'E
INSPECTION RECORD
CITY OFEAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 0 2 4 3 7 3
Eagan, Minnesota 55123 Date Issued: 08/19/94
(612) 681-4675
SITE ADDRESS: LOT: 5 BLOCK: 1 APPLICANT:
4497 CHES MAR DR SMITH STAN
WILDERNESS PONDS (612) 727-0221
PERMIT SUBTYPE: TYPE OF WORK:
SF PORCH NEW
INSPECTION TYPE DDATE INSPTR. INSPECTION DATE INSPTR.
FOOTINGS FRAMING
FINAL
REMARKS: DECKING ALREADY IN PLACE FOR PORCH
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
CITY OF EAGAN r
1994 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY /2 sets of plans, registered site surveys -eseagy
~calcs. - - _ _
COMMERCIAL 2 sets of'architectural & structural plans, 1 ~se o~f~~~~
specifications, 1 copy of energy calcs. AUG 1 1 1944
Penalty applies: 1) when permit is typed, but not picked up by last J 444r'
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date r - / / Valuatipn of work r~
Site Address: CX9 ! fF-~'D~
STREET SUITE #
Tenant Name: (commercial only) l
LOT _ BLOCK SUBD.
Description of work: ~h r YS U~
The applicant is: Owner ❑ Contractor ❑ Other (Describe)
Name ih-,- i- ~ tc~~ Phone ,
Property LAST FIRST l J 7~') l U 22/
Owner Address
STREET 1 STE #
City State Zip -l
Company Phone
Contractor Address License # Exp.
City State Zip
Architect/ Company Phone
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 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
V
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind.
P 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
Er 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 F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code Y3 V
Depth On-site sewage SAC Code o/
Census Bldg
APPROVALS Census Unit o
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
❑ Site ,T Footing ® Framing LT Insulation
❑ Wallboard Final ❑ Draintile ❑ Fireplace
Permit Fee VaLmtim:
Surcharge
Plan Review
License 1_2X -2 y 2 (,ac
MWCC SAC
City SAC
Water Conn. rc~. y ~~Yra9y fare {or~or~~
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
i3
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1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 1 .'t lJ
1 651-681.4675 ~n S 3
New Construction Reaulremerds Remodel/Repair Requirements
> 3 registered site surveys showing sq. ft. of lot, sq. ft. of house 2 copies of plan
and all rooted areas (207, maximum lot coverage allowed) 1 set of energy calculations for heated additions
> 2 copies of plans (show beam & window sizes; poured fnd. design: etc.) 1 site survey for exterior additions & decks
> 1 set of energy calculations
> 3 copies of tree preservation plan R lot platted after 7/1/93
DATE: /CONSTRUCTION COST:,
DESCRIPTION OF WORK:
STREET ADDRESS: 7y / 7 r!,~ESr~~2- ~~L 6 n n
LOT: BLOCK: C SUED./P.I.D. ,1- &1 -t 1 Cti LL)
Name: Phone
PROPERTY Last// First
OWNER Street Address: 7y/ / L~/cSi~rfJ2 A12-
City -4C- 4 c V`
State: Zip: - s /2-3
Company: LJrti. f Phone
(area code)
CONTRACTOR
Street Address: License # Exp.
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip;
Sewer & water licensed plumber (required for new construction antv):
Penalty applies when address change and lot change Is requested once permit Is Issued.
I hereby acknowledge that I have read this application, state that the information Is correct, and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicc _
OFFICE USE ONLY
Certificates of Survey Received Yes No
I / ~ ~ 19y~
Tree Preservation Plan Received Yes No Not Required ~L/L--~
~
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.)
❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex Z 17 Garage ❑ 22 Porch/Addn. (4-sea.)
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened)
❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous
WORKTYPE A1't`Ath-C--0
❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia
15{( 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors
❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair
❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) 5 Basement sq. ft. Census Code8
(Allowable) Main level sq. ft. SAC Code a/
UBC Occupancy sq. ft. No. of Units
Zoning R • I sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. 3q~_ Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ ~3 Oct ire
Surcharge t
Plan Review
License Sy2X lt. (a?-7 2-
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies .~3
Total:
SAC Units
% SAC
WOO
t /a.
• ~ 12
a
N id
6
i ` e?
e.
N ~ ~ f
34
36 '
3 -
• t f
b
60.E K
41r *qr
s.
ej 4w
• A
00 N b .
_ _ 1~ = f
i15.50
CITY OF EAGAN
L - B MECHANICAL, PERMIT RECEIPT # O S
SUBD. fie as (612) 681-4675 DATE- I/ CY
X
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:
SITE ADDRESS: /1 ADD ON/REMODEL (EXISTING S 15.00
l K fs M f CONSTRUCTION ONLY)
INSTALLER: V6 C k L HVAC: 0.100 M BTU 24.00
PHONE 5 4 07-z ADDITIONAL 50 M BTU 6.00
ADDRESS: r'- t v wd a ) r_[ Y GAS OUTLETS - MINIMUM 1 @ $3 EA.
CITY: - /
L L IV ZIPJ '2
SURCHARGE F SO
SIGNATURE
TOTAL: Is 1'5 ,
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL INDUSTRIAL 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 $30 FOR EACH
$1,000 OF PERMIT FEE. $
PROCESSED PIPING - $25.00
MINIMUM FEE _ $25.01
OWNER: TOTAL: $
SITE ADDRESS:
TENANT:
SUITE
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE CITY SIGNATURE:
SIGNATURE.
~ r
DA'1'P, 7 At1DRF,S~
T0:
FROM:
FILE NUMBER: lyn7 _
FILE NA14F,: DTs: 10 PT.AT02700 PARCEL O752
COUNTY: CHECK ENCLOSED FOR $
ABSTRACT: TORRENS,: PLEASE CHECK TO SEE TF THFRE ARE
ANY LEVIED / PFNDTNG ASSESSMENTS
LEGAL DESCRIPTION:
//v lI D QQ Q.c.IiCL.~C
PLEASE FURNISH THE FOLLOWING LEVIF.n ASSESSMENT TNFORMATTON ON TI1F ABOVE DF.SCRTBHD PROPERTY:
TYPE OF TMPROVF.MF.NT BAT,ANCE DUE ORTCTNAT, AMOUNT
SAN SEW TRUNK 2746.70 3662.30
2430.48 2804.40
WATER AREA
PLEASE. FURNISH THE FOLLOWING PENDING ASSESSMENTS THAT ARE ESTIMATED AT THTS TIME:
NONE _
ALSO REQUESTING ANY ASSF.SSMFNTS CERTTFTED TO THE: AUDTTORS AT THTS•TIMF. AND TNTEREST:
DATE.: NOVEMBER 4, 1977
SIGNED:
AMOUNT OF UNPAID WATER BILL, TF ANY: $ none
i
i
i
t
Abstract of Title
i
to
The following described tracts,pieces or parcels of land situate,
i
Lying and being in the County of Dakota and State of Minnesota,to-wit:
F
That part of theSouth Half (S1) of the Northeast Quarter (NE4) !
of the Southwest Quarter (SW '4) of Section Twenty Eeven (27),
To,:nship Twenty Seven (?_7)-, Ran-,e Twenty Three (23),Dakota
County,Iinnesda, described as follows: Commencing at the Southwest
corner of said South Half (Sz) of the Northeast Quarter ('NE,;)
of the Southwest Quarter (S•,,); thence north along the west
line thereof a distance of 30.0 feet to the point of beginning;
thence east Darallel v,ith the South line thereof a distance
of 300.00 feet; thence north parallel with the west line thereof
a distance of 300.00 feet;thence east parallel with the south
line thereof a distance of 756.00 feet;thence north parallel
with said west line thereof 328.82 feet more or less to its
intersection with the north line of said South Half (S1) of
the Northeast Quarter (NE4) of the Southwest Quarter (S4,'I,);
thence West along said north line a distance of 1056.0 feet
to the Northwest corner of said South Half (S1) of the Northeast
Quarter (NE4) of tle Southwest Quarter (SW-41); thence south along
said west line to the point of beginning,containing 10 acres
more or less,
AND ALSO
A non-exclusive easement for the purpose of ingress to and egress from-
the above described premises over and across the West 25 feet of-the
Southeast Quarter (SE4) of th=Southwest Quarter (SW4) and also
over the West 25 feet of the South 30 feet of the South Half (S12')
of the Northeast Quarter (NE4) of the Southwest Quarter (SW
all in said Section Twenty Seven (27),Tovmship Twenty Seven (27),
RangeTwenty Three (23).
excepting therefrom that part of the South Half (Sj) of the
North Half (N1) of the Southwest Quarter (SW4) of Section Twenty
Seven (27),Township Twenty Seven (27),Range Twenty Three (23)
lying between lines described as follows: Commencing at the South-
west corner of Lot Three (3), Block One (1), Wilderness Run First
Addition,thence running southerly along the extended west line of
said Lot Three (3), 20 feet to a point; and commencing at the South-
east corner of said Lot Three (3), Block One (1) Wilderness Run
First Addition,thence running southerly along the extended east
line of said Lot, 23 feet to a point.
according to the Government Survey thereof.
NO. 00108
WAIVER OF HEARING
Special Assessment Authorization
I/We hereby request and authorize the City of Eagan, MN (Dakota Co.) to
assess the following described property owned by me/us:
PLAT AND PARCEL NO 10_02700-015_52 L11Q_In_ 8h ~Ii_fn~GC~s
for the benefit reoeioed from the following improvements:-- -
ITEM QUANTITY RATE AMOUNT PROJECT
Water Lateral 100 Lin.Ft. $11.88 $1,188.00 234
TOTAL $1,188.00
to be spread over 10 years at an annual interest rate of 9 % against
any remaining...unpaid balances.
The undersigned, for themselves, their heirs, executors, administrators
successors and assigns, hereby consent to the levy of these assessments, and
further, hereby waive notice of any and all hearings necessary, and waive
objections to any technical defects in any proceedings related to these assessments,
and further waive the right to object to or appeal from these assessments-made,
pursuant to this agreement.
Dated:' LARRY AND RGA SIBLEY
_'t 10A
'-tom
By:
Its:
STATE OF
)
SS
COUNTY OF~~
_b_1__ -k-
on this1/ day of e2 7~~ before me a Notary Public within and
for said County, personal
ly appcared_Z;_e/, r ?GrZ a'~4 Q to me
personally known to be the person + d in a who exe
ll6 the foregoing
instrument and acknowledged that8k executed the same as Nt2i= free act and deed.
This Document Drafted By:
Hauge, Smith, Eide E Keller, P.A. )otary APPROVED: Public
3908 Sibley Memorial Highway
Eagan, Minnesota SS122 .s~
u 11~~Le
(612) 454-4224 agan Pu lic IYOrks 4.retor
Revised: 8-3
00
ALNnoo vloava
VJA93NN111 -'JI10ndAWlON ti'
vul"AO •a annr
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
CLAIMANT STAN SMITH
ADDRESS 4497 CHESMAR DRIVE
EAGAN. MN 55123
Location 4497 CHESMAR DRIVE
T.5, Rl, WTT.DF.RNESS PONDS
Receipt No./Date rsnns/17-A-saa
Reason for Refund PER HOMEOWNERS REQUEST
Type of Refund Electrical Permit 01-3211 $ 15.00
Plumbing Permit 01-3212 $
Mechanical Permit 01-3213 $
Surcharge 01-2155 $
Water Connection Permit 20-3713 $
Sewer Connection Permit 20-3743 $
Account Deposit 20-2252 $
Utility Account Over-Payment 20-2250 $
Other: $
TOTAL 15.00
I declare under the penalties of law that this account, claim or demand is just and
that no part of it has been paid.
DECEMBER 20. 1989
Signature Date
December 14, 1969
City Of Egan
3630 Pilot Knob Road
Eagan MN 55122
On December 6, 1969 a electrical permit was applied for.
At this time we do not need the permit and would like to
apply for a refund. Enclosed are copies of receipts that
were received on December 6 with all the necessary
information.
If you, have any further questions please contact me at
454-2319.
Tha yoU~;~/ q
Pat{.y F, '_tan Smith
4497 Chesmar Drive=
Eagan MN J-,1X
N
CITY of EAGAN N-2 3356
BUILDING PERMIT
3795 Pilot Knob Road
Owner ......................./.j......- Eagan, Minnesota 55122
Address (present) .......y,F...t... l~ . y..(%i-.,,........ 954-8100
Builder .............cf' .VY
Address
DESCRIPTION
Stories /j To Be Used For Front Depth c~ Heigh! EJst. Co/sit ermit Fee Remarks
LOCATION
Street, Road or other Description of Location I Lo! Block Addition or Tract
chap ed b LJ , p 1
loe2s cc 4/ i l~'~r ~mLMS .Apnr"^
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or hle agent
the right to create any situation which is a nuisance of which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BS KEPT O T REMISE WHILE THE WORK IS IN PRO S.
This is to certify, thatb7a4u, ~j! ...............:........has permission to erect a_... .Ut ......................................._upoa
the above described remises ject to the rovisions of all applicable Ordinances for the n Eagan.
. . . Per .......t.L...................._.................
- Mayor Building Inspector
i
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4Vq O- e1 g iljar,Dr MASTER CARD
LOCATION &JI~Il S tk~! r LSO
OWNER O/i
STRUCTURE AND
LAND USED AS ore
add h d- le-
Permit No. Issued Contractor Issued To I Owner
BUILDING sQW1!
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items (Initial) Date Remarks Distance From Well 100 FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
1. (d'nTN1N 01 Wi( STATL Oi MONOW)TA UEVANTMENTOI HEALTH MNNESOTI UNIQUE YELL N0.
I1wN. naM . WATER WELL RECORD
N Kw TNIW
WxleuN SNnNa IJnAlll-.IM
T~xYa Nano r-a N.Y.. .-INN.. y...nx Nn. Ixq J. VNOIENIY OWHEESM 4
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sxew AEn MgYN ar w.XbaelNWNxx -x.- - vNeN gyMw•u MMN. NELLO MNHWANl as aCNYMYN
A&M. MM 11 .
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11-3IaKMM AOr.MM 91p1Y 1~InAlY1rP
P--1 N uL TD i.n•.IN IOYIIMIM.I EOCAagr•w
1. iDNYATNIN LOU COLOR XwxIN DE yYDM TO
iMYAT10N 43T. Wp AClAY(nl'b1UNN .Q
7. CARING "RIGHT: A4PPNI, a HOLE DI.W
IDYaA AQINI. *w
Z3.,.. fOWWtl S'HrM' R.
JQ %HUC a~ O•MSW, V.- K-
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a. ro O. w.yxl tea. MAR
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cl aN sa.wb rt. W h.
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s. STATIC WATER LEV EL
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10. PUMPING LLYEL IMbaaW a k
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11. WELL XEAU COMPLETION
I~PNIN.•.NN. a.ael•.nene meY
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❑Yn ON.
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h LT. NGARiBT EOYRCEe O/PYMWBIi CONTAWYATR)N
ry / ) M dYSIW YP(/ l/ WGEWIMb ow-.-MN.! Y.0 N.m
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fI~RP•a'NO •IKLIY N.NIM IL. WATER WELL CONTRACTORICERTI%CATION
M REYARPOL ELEVATION. OpURCL OP DATA K } W WAI WM prM aY••gy r•1YY11M W IY NpN Y b> a
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA110590
Date Issued:05/17/2013
Permit Category:ePermit
Site Address: 4497 Ches Mar Dr
Lot:005 Block: 001 Addition: Wilderness Ponds
PID:10-84275-01-050
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 by law in ALL single family homes .
Tim Shimek
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 -
Patricia A Smith
4497 Ches Mar Dr
Eagan MN 55123
(952) 292-7228
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:Building
Permit Number:EA118786
Date Issued:11/07/2013
Permit Category:ePermit
Site Address: 4497 Ches Mar Dr
Lot:005 Block: 001 Addition: Wilderness Ponds
PID:10-84275-01-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Matt Czech
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Patricia A Smith
4497 Ches Mar Dr
Eagan MN 55123
Pineview Builders Inc
2201 Lexington Avenue N, Suite 100
Roseville MN 55113
(651) 489-3696
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA147809
Date Issued:02/06/2018
Permit Category:ePermit
Site Address: 4497 Ches Mar Dr
Lot:005 Block: 001 Addition: Wilderness Ponds
PID:10-84275-01-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Patricia A Smith
4497 Ches Mar Dr
Eagan MN 55123
(651) 454-2319
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA176082
Date Issued:04/29/2022
Permit Category:ePermit
Site Address: 4497 Ches Mar Dr
Lot:005 Block: 001 Addition: Wilderness Ponds
PID:10-84275-01-050
Use:
Description:
Sub Type:Air Exchanger
Work Type:Replace
Description:
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 -
Patricia Ann Smith
4497 Ches Mar Dr
Eagan MN 55123
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature