4083 Camberwell Dr NCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4083 Camberwell Dr N
Lot: 10 Block: 3 Addition: Hills of Stonebridge 2nd
PID:10- 32991 - 100 -03
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
PERMIT
City of Eaan
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460 -6022 X253
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
- Applicant -
Owner:
Michael D Anderson
4083 Camberwell Dr N
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA090871
08/26/2009
ePermit
CITY OF EAGAN PERMIT TYPE: "E' i f r`' t4'
3830 Pilat Knob Road Permit Number; `' °°' +4 "' i{_ g
Eagan, Minnesota 55122-1897 ?,Ag Date Issued:
(612) 681-4675 SITE ADDRESS: 1011; . 10
i; ., . ,, ?:iJE l L i)14 r1
?t11'lf i;{,- 1 oe;! 'h{(l
APPLICANT: _
M r t M1111 r ; P,4,,: ?;-
SUBTYPE:
!;,I . f,
TYPE OF W(7RK:
III I-i` 1 111N
41 I..F
(I°'riI:f:tI IMI.:i.)
INSPECTION ., • DA
! ;trt
. P I MNf#F '• . fi EaE• r'A14 l1'i 4 {>f fP 14 'd l 1:i fiF' f}i+ l k F.0 1''y?i?. 1314 'r' a 1;::1; l R 1t:;A I Q I? f"f.1.lEW141 N lt 140 P i}
? ?
Permit Mo. Rermit Holder Date Telephone N
ELECTRIC g 95q /f (? ??
PLUMBING '
HVAC
Inspectfon Date Inep. Comments
FOOTINGS
FOUND
FRAMING 74)
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
l
GYP BOARD
FIREPLACE :
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL 2 ?
BSMT R.I. Q tI4'avL? ,? y.???
BSMT FINAL
DECK FTG ?
DECK FINAL
?
P--.61
i
ano St1?PS ?s ? ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675 '
SITE ADDRESS:
PERMIT SUBTYPE:
r i ra,i I.,
oN REcoRD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
f I N :, I
4l:.":Sr..,,3!?
0',10,i /??q
1v1 f i F iA I. I
,
? , ?
Permft No. Permit Holder date Telephone #
5Ml
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isui.
Fireplace
Final Htg.
Orsat Test
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Oeck Ftg.
Deck Final
Well
Pr. Disp.
SEWER & WATER PERMIT
CITY O? tAGi?A ??
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
I DATE 9._2•;'._
METEF
CHIP Y.
FNETEf
ISSUE
I SITEADDRESS 'j033 Cambez"wal-? Di_?'ve N, .
LOT '_?LBLOCK 3SEClSUB rij. 13 g sf 2
I APPLICANT: l"ne RntL'3.1-m4,Cc
n nnn?co. r-^.Ill _
{ PHONE:
? `0n?2 _ PERMITDATE 1
?f `????1
77s 0- ' PERMIT # 1233 a
B.P. RECEIPT # (, ?- `B.P. RECEIPT DATE 10/04/ 1
_ PRV - BOOSTER PUMP
PERMIT REQUESTED
?`i_ SEWER X_ WATER - TAPS
- COMM/IND X RESIDENTIAL
? NEW - EXISTING
. Lawn
PLUMBER: .Vg.11w? gi?i?q Ahead
PHONE: 21 Meters are to be Installed
ADDRESS: ?? r?-?? I pnp Credit
CITY, STATE D21 ZIP551='?.?_ ?i
stic Mprers o Water Line.
be,qpGen for Dduct Meters,
Y WITH CITY OF
OWNER: Tne RnttitynrH C'ri. Tnc-_ tP??,rv vrsu1rvArv%,r_a
i•
ADDRESS: 5201 F Rlver Faad ,
CITY, STATE "r1Cl.f.evr L?I'i:?. ZIPd5L'
PHONE: '?71°"0304 _ GWHEN MET ISSUED '
PLEAS?-1?'L?OW fi?IV?WbRKI?G DAYS FOXt PROCESSING. GALL 454-5220 FOR INSPECTIONS. FOR STORM
,
SEWER PERMI7S, CONTACT ENGINEERING DEPT.
? ;,t
To be used fo
Site Addres:
Lot .10
Parcel No.F _
Name
Addre:
i
y
I Building
_ Phone
on and state that the
U-applicable State of
? ?? INC
in accordance with all
agan Ordinances.
99, Eagan, MN 55121 S 7?" ?
o
Receipt #
Date
OCs2. '
, 1491
, 19
s:
• OFFICE USE ONLY ?
Occupancy $r-3 )!L--l {
FEES ?
Zoning PD R'i ?
(Actual) Const V-N Bldg. Permit ?
(Allowabie) ? 57
Surcharge •
# of Stories
i
Length ? # Plan Revisw ?.?
_
D
h 321 100
?
ept SAC. City
*
?
S.F. Total - SAC, MCWCC 650t00
S.F. Fooiprints - ;
"0
?
pn Site Sewage - 0
Water Conn
On Site well - water Meter 45•00
MWCC System X
x 3Q.?
ACCt. Deposit
Gity Water _
PRV Required _. S/W Permit ?Q+?
Booster Pump - S/W Surcharge 150,
Treatment PI 276?0
APPROVALS Road Unit 370•00
Planner --- park Ded.
Councii
BIdg.Off. _ Copies
Variance - TOTAL 3940A'50
? Permit No. Permit Hatder Date Telephane #
WATER
SOWER
PLUMSING, 10a
H.VA.C. ??c? ?f 7"0! • I ?
EIECTRIC
Inspectlon Date Insp. Comments
Footings 1
----?-
Foundation -
Framing
Roofing
Fough Plhg.
Rough Htg.
lsul.
Fireplace j _
Final Htg.
Orstat Test
Final Plbg. cP?f Plbg. Insor Notify Plumber ?
Const. Meter
Engr./Plan
Bldg. Finai ?23f-9 2
DeGc Ftg. ,
n t
Deck Final ...? f
Well
Pr. Disp.
_ . . ?, .
(grr#tftr?tr of CO.rr??aury
Citp of Cagan
arpahmc# o# wedbittg 3t"nu?n
This Certifuate isrued pursuani ta 1he requiremenls of Seclion 306 of 1he Ilniform Building
Code cerlijying [hat at the ti,ne of issuunce lhisstructure x+crs in compliance with the various
ardixances oj[he Ci1y regulatixg bur7ft cortstrucxion or usc For the fotlowing.
crsc clonifi"doo SE L1G?'G1? B+oa-?x?. 107?G
?a-7 ?'Ae R I/Sii 7m*Rstric4 ?{ su Type f'amt IIN
Owaer d BwldM TTW HMMQ1ID mTW Addcua S?ll l'?? NUMEY
H„u;t Addom 4()83 ?'.AT4=L1F.f T, 11RTVR N_ . ,ty. T.III? RZ, iaTT7 S(1E MrNRRR=. 20
- -• .171, f-? Datc?L'2yC3..jy.... t
POST tN A CUHSPICUOUS ?LACE
SEWER & WAjER PERMIT
CITY OFE&AW ? ' OFFICE USE ONLY
10/CJ7f $X
3830 Pilot Knob Rd. METER # PERMIT DA7E
Eagan, MN 55122-1897 cHIP # PERMIT # 12.331
METER SIZE B.P. RECEIPT #?
' ISSUE dATE B.P. RECEIPT DATE _?L?l
#
DATE ?-- 7-+
- PRV - BOOSTER PUMP
SITE ADDRESS 40$-1 C+te*'+a3 I D' i v'p N PERMIT RE(IUESTED
LOT 10_BLOCK '2-SEC/SUB r_ 1? .. .?F ??
T' -? - .-.-.?.?.?.s .?....- ?
-R ` ?-?'' ?' _X__ SEWER X WATER .- TAPS
I_pC_/
APPIICANT: ?e Rr???IGnel Co
,
,
ADDRESS: 5201 E
var R!)ad
R9 _ COMN9lIND RESIDENTIAL
,
,
CITY, STATE ?'id1e}?r Mn.. ZIPr%5a] _X-NEW - EXISTING
PHONE: .571-03Q4
Lawn Sprinkler Meters arqet?o be Installed
PLUMBER: Ahead of Domestic Met6rs o Water Line_
AQDRESS:
6?n ?.??.k ?„? Credit WILL?NOT be.. yven for D?duct Meters.
.
CITY, STATE jor-tJori - ?
? ZIP SF"?
PHONE:
1 AGREE Ta MPLY WITH CITY OF R
OWNER: In^ EAGAN OR INANCES
ADDRESS: 5201 E_ River Ranc3 f ?
CITY, STATE Edc:7.ly, Mii.
PHONE:
_
ZIPS 5A 21
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS F4R PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STURM
SEWER PERMITS, CONTACT ENGINEERING QEPT.
. ... . .. . .... ... _ .. , . ,. .. . . .,... .. . .... _ ... . .... _,_. ._ .. ... .... ,. ??a..,.. ..... .... W _... _"_ ?L.__?_....?-
. ? . f
??-•. ?'!? y. -
\4083 CAMBERWELL DR N
RE:
DATE: IDCT 7+ 1991
(THE BOTTLUND CO INC)
X Your Sewer & Water Permit for the above properry has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS QNLY: Please pay for meter at City Hall. Meter size must be
confirmed by 8ill Adams or Dirk House (Plumbing Inspectors - 454-8100) before.issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- RE4UIRED BY LAW.
CONTACT COMMUMITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspectians Dept. ?
Adai?ess: 4083,GAMEMELL DRM N. 10 Blk 3 Sec/Sub}7I7.T.S pF $IONEBRIDGE 2Np
These iCems were/were not complete at the time of the final inspection.
12 31 91 Yes No S
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 vith the builder tha removal of roof test caps £rom the plumbing
system and tha shut-off of water supply to the outside lawn faucet before
freeze potential exists. ?
RFCKlEUIUfII
White - City copy Yellow - Resident copy Pink - Contractor copy
, CITY OF EAGAN N2 19764
3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
PFIONE: 454-8100
BUILDING PER?IAIT
To be used tor SF DWG/GAR
$114,000
Site Address 4083 CAMBERWELL DR N
Lot 10 Block 3 Sec/Sub. HILLS OF
Parcel No. STONEBRIDGE 2N1
w Name THE ROTTLUND CO INC
? I
Address 5201 E RIVER RD
° city FRIDLEY Phone 571-0304
o Name SAME
R Address
? City Phone
Name
N Address
g
City Phone
I hereby acknowlege ihat 1 have ad this application and state that the
iniortnation is correct and agre o comp wilh dLaoplicable State of
Minnesota StaWtes and Crty o g O an s.
Signature of Permitee ?7
A Builtlmg Perma is issu o: E ROTTLUND CO INC
on the ezpress conditio at all vrork shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Builtling OXicial kln,TR,v_.? I y'P11?
Receipt # C I 5k?
OFFICE USE ONLY
Occupancy R-3 X-1 FEES
zoning PD R-1
(Actual) Const V=N Bldq. Permit 689.00
(Allowable) V=N Surcharge $7.00
Y ol Sbries
Lerigth 54' PlanReviaw 44$.00
DepN 32 ? SAQ City 100.00
S.P. Total - SAC, MCWCC 650.00
S.F. Footprinls -
On Site sewege _ water Cann 660.00
On Sne well Water Meter 95.00
MWCC System X
A??? Deposil 30.00
Ciry Water
PRV Required _ S/W Permit 30.00
Boosier Pump - Syy Surcharge .50
Treatmem PI 276.00
APPROVALS RoadUnit 370-00
Planner - Park Oed.
Council
BIdg.Ofl. _ Copies
Variance - 70TAL 3,405.50
?
$
? 5 9 ?
`? ?
5 ' • ar? ? v ou
Pequ st Dat /
? G/? FrB N. Roughin InspecU Reqmred pection OMer Than ouqh-In
(VOU st call ins cror when re ady) ? qeady Now WAI Nobly Inspector
?
5
s ? Na De?e Reatl
I? licensed contractor Agwner here6y request inspection of above electrical work at:
Jo0 Atltlress (SVaeq Bo Route o)
?d?? ???-W?lI 'UC Na? Qy
Sec4on No Township Name or No RangB No Counly
Occupant(PRIM) Phone No
C
on
k
/ V
e-
Power Supplier Adtlress
Eledrical Conlracbr (Company Name) CoMreclors Llcense No
eo w
Maling ress (COntrador or Owner Makng Installfltbn)
V
Au[honz Signa ure (COn [olowner Mekl Inst IaUOn) Phane Number
(e 86-7a3a
B
'CIry
I
S
B
? I II I I I
I I I ( I III I I I I I III II I NF
R
III
5104
821
?BUly MN
? ry A?.
Un I I I EE
S
UNLESS PRDPER INSPECTIO
?
;
P ? 1 EN
C
?.xy7REQUEST FOR ELECTRICAL INSPECTION ""=x' ee-ooooi-os
bi? See msVUCtions tor compleVng mis form on back oF yellow copy ,4g6 Yy
"X" Be/ow Work Eovared by This Request ??;,. u
Ne% Add Rep. Type of Building Appliances Wiretl Equipment Wired
Home Range Temporary Service
Duplez Water Heater Electnc Heating
Apt. Building Dryer Load Management
Comm /Industrial Furnace Other (Specify
Farm Air Condihoner
Otherpspecily) ContraclorsRemarks' n d . Qn , n
Kr?vi?? l / `Y
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps Above 700-Amps
SIgf15 Inspectors Use Ony. -NI TOTAL 'SQ
Irri9ation Booms L?/ /(/,{ W
Special Ins eqion
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M
I, the Electrical Inspector, hereby
certiry that the above inspection has
been made. Raugh-in ?
Final Y Date
oa?e
OFFICE USE ONLY
This request voitl 18 months trom
bb? a RESIDENTIAL
? BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstruction ReauiremeMs
• 3 registered site surveys showing sq. fi. af lot, sq. ft. of houae; and all rooted areas
(20% maximum lol coverage allowed)
• 2 copies of qan showing hearn & windax sizes; poured found design, elc.)
• 1 set of Energy CalculaUore
• 3 wpies af Tree Preservation Plan if lot plaHed after 711l93
• Rim Jaist Detail Optiom selecUon sheet (bldgs with 3 ar less unrts)
DATE lU' 3 / - D 2
RemodeOReoairReaufremeMS 3-3 l, as-
. 2 capies of plan
. 1 set of Eneqy Calculations lor heated addiGons
• isilesurveyforezterioraddilions&decks
. Indicate if hane served 6y sepUc system for additbns
VALUATION ZO!
SITE ADDRESS 7 U rS?' j ?iL?C?? ?MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK -4- S/Di? s FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ? 7?? r N GCJ,?te/
STREET ADDRESS )7715/2 /j CITY ? a??i STATE_ZIP
TELEPHONE #
CELL PHONE #
FAX #
PROPERTY OWNER / ?6 TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RCJI,ES 7670 CA'1'ECORY l MINNF.SO'CA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor.
Mechanical system includes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heal Recovery Systetn
Fee: $90.00
Phone_#?- -
?, f1 ??. I ; JFcc:? ?701.00
'_ 22;.'
Phone
?
------?-_
I hereby acknowledge that I have read this application, state that the information is correct, and agree t comply
with all applicable State of Minnesota STatutes and City of Eagan 03diqances,._., ?
Signafure of Applicant
OFFICE USE
? Water Softener
_ Water Hea[er ?
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received - Tree Preservation Plan Received - Not Required _
Updated 4102
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
? ? City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-A "'C3 .C) C
New Conslruction ReaulremenGS RemodeVReoair Reaui2men4s
3 regiscered srte surveys shrnving sq. ft of lot, sq. ft of howe; and aU roofed areas 2 copies of plan lmm
(20% r.iaximum bt coverege allowed) 1 set o(Energy Cakulatlons forheated additions
2 oopi_s of plan showing beam & window sizes; poured found design, etc. 1 site survey for addi?ions & dedc5
t set o` Eneryy CalcuWtiOns Add'dron - indicffie i(onsife SEpUc systCm 3 capies c`. i ree Pteservatbn Plan H lot plalled a(ler 7/1193
RimJoistCaailOptionsseleclionsheet (bldgswith3orlessunAs
Datc 7 / ? l ? I ConstrucGon Cost
Sitc:\dJress UnitlSte #
De.crii)iinn nf W ork ?N ?)7
Mulii4amily131dg _ y_ N Fireplace(s) _ 0 01_ 2
PropertyOwner ?(5 Telephone#((DS1) 6A JGJL
Contrador ?Ly?,'?J b?Jl. ``{2
Addres, 3t3? t,J, city lveazl'
Shtc Zip '617 Telephone#il
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesob Rules 7672
Enerry Code Category Residential Ventltation Cate o 1 Worksheet •
(J <uyn,ission rype) ? 9 ry New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculadons Submitted
Have you ;xeviously consiructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applics.
Licensed Plumber
Mechanical Contractor
Sewer/W;:ler Contractor
Telephone # ( )
Telephone
Telephone #II D
I herehN ::pply for a Residential Building Pernut and acknowledge that the info
that thc Nvurlc will be in conformance with the ordinances and codes of the Ci
Statutcs; 1 understand this is not a permit, but only an application for a pernut, and
permit; tliat the work will be in accordance with the approved planin the ase of wo?
apnrova] ofpl s.
ApplicanCs PnntedName ApplicanYs ignature
is complete and
m? of MN
is not to start without a
;h requires a review and
<
PERMIT cR zg4 G 4
?CITY`OF EAGAN
l414q
?
3830 Pilot Ynob Road PERMITTYPE:
B U I L D I N G
EagBn,Minnesota55123 PermitNumber: 023535
(612) 681-4675 Date Issued: g 5/ 0 9/ 9 4
SITE ADDRESS:
4083 CAMBERWELL ?R N
LOT: 10 BLOCK: 3
HILLS OF STONEBRIDGE 2N0
DESCRIPTION:
DECK
NEW
f --?
'\? ?I?
{?
'j
uo ZIt mLl
?"t_:=?.v_"?,?\?\? Lf
REMARKS:
FEE SUMMARY:
Base Fee $30.00 COPIES $1.50
5urcharge $.50 Total Fee $32.00
3ubtotal $30.50
CONTRACTOR: OWNER: - Applicant -
ANDERSON MICHAEL
4083 CAMBERWELL DR N
EAGAN MN 55123
(612)686-7232
I hereby acknowledge that I have read this application and state that the
infiormation is correcC and agres ta comply with all applicabie 5tate of Mn.
L Statutes and City of Eagan Ordinances. ?
APPLICANT/PERMITEE SIGNATURE -5? BTT` : SIG ATUR
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euILozNG
3830 Pilot Knob Road Permit Number: 0 2 3 5 3 5
Eagan, Minnesota 55123 Date Issued: 0 5/ 0 9/ 9 4
(612) 681-4675
SITEADDRESS: Lor: se BLOCK: 3 APPLICANT:
4083 CAMBERWELL DR N ANDER50N MYCHAEL
HILLS OF STONEBRIDGE 2ND (612) 686-7232
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
r-
-1
I
Building'-Permit Type
Building Wb'r \Type
? _1
- ' CITY OF EAGAN
4 . I RECEN(E?
J? 1994 BUILDING PERMIT APPLICATION
3"1 681-4675 1_5z. o0 MAl' 0 2 1994
---------------
SINGLE & 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 ? o a -
Site Address: 316 F3 Caat bww2lI Dv, a
STREET SUITE B
Tenant Name: (commercial only)
IAT ? BLOC& ? SIIBD. 1-?nt77.Q, P.I.D. iF
Pla+ z
Descri tion of work: Qc.L c7C CSv?.
The applicant is: t=Y-Owner ? Contractor 0 Other (Deseribe)
Name _ l-rNoE'2Soa 114104A r"L !?. Phone (o86--7a3D_
Property LasT FIRST
Owner Address ?o,,F?3 Ca,r,¢k 9 wuL_ r n!
STREET STE M
City State M/? ZiP S,fiL3
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Arch itect/
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 applic ble State of Minnesota Statutes and City of
Eagan Ordinances.
0
Signature of Applicant:
* PIONI
* engini
* * **
#466 ; L'n„p0W1A.
I . 111H0 I'111NNCM. 111NIW11I'EAAf.lIllff}S
2477 Fwripricn ptivC
Mrn(Iola I I?ighit, MN 55120
(612) 6R1 1914
Certiiicate o( Survey ior.! "L-kQTJ L V 1 VD_ Ca._Al.._
81 b ? 'V
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e
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. 900.o DQnolPS exisfin IteVp)inr)
P??S _usE? 1EVAtIc7N ?
.?o o pe?toles F_levaf;n,t . Lowe? l7oor ?PVVliot1 987,14
- f?hnr?loa (hvind Ulilr/? C?rse?nel?l 1t?,) o,''E?/oc/, ElPva/ion 99 eL
-- ? Ue?roles t7rv?rr?f? rIAW /?rrdWS G(YrnoP SIabflevafion m 3s;
? 1)errolR5 monumertl n neno&s Ott scf flub
6?arin5 sltvw?1 vf-e 055(Inird fo C"cxSen)pr?1s n/'qpcOXY
,
LoT lo , BLOCI! 3, N?LLS OF? SToNE6a?dGE PLA7? 2
DAUOrA CeuNry
1 hrroby rerllly Ihet Ihl[ {t R Irue rnd fmrn[I rnproennlalinn nl a<wv?y nl Ihr hounrla?ir- nl tl?r nl?nqV^?}d?•-?rih•d li?vl 1 1 Ihn leralinn OI PII
Mdldin0a, thr,nnn, And all visihb rerrnnrhmrnn, il nnV. fmm m on Sni.l laad. Ae wuveyrd I v m ihie _ G'if'{ dav nf j.n n. 1n.g/ .
{?...1. 9 P$ -°II- /1da t?r?yj E?rv
R.,i- -,•fry.
, l
?`?'?r
SI.IA/e _r II1f?1, ?,--
- •f v .n-nri?i;i"n ^n<tr11 -. nfnn. ineol
' ,MY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
PERMIT TYPE:
Permit Number:
Date Issued:
40$3 CAMBERWELL DR N
LOT: 10 BLOCK: 3
HILLS pF S?ONEBRIDGE 2ND
(PORCH INCL)
34d''Sldin-qw Permit 7ype
?ui7.ding [aDrk Type
.
? ?._.
i
e ?e
c;m
I
SF ADDITION
NEW
BUILDING
026436
ia/0s/95
REMARKS:
A 5EPARATE PERMIT IS REQUIRED FOR ANY ELECTRYCHI. OR PLUMBTNG WORK
FEE SUMMARY:
VALUATTON $29,000
Base Fee $385.75
Plan Review $135.01
Surcharge $14.50
Total Fee $535.26
CONTRACTOR:
OWNER: - Appllcanz -
ANOERSON hiICHAEL
4083 CAMBERWELL DR N
EAGAN MN 55123
(612)686-7232
I
Z hereby aclsnawledge Chet I have read this applicatiofi and sCate that the infiormation ie corroCt ani9 agroe` ttr camply w:ith d11a(5piitlable SCaCe o'F ilnG
StaCutes and City of Eagan tlrtiinances-. . t
?.??'.?.?? f?i?•'??
APPLICANT/PERMITEE SIGNATURE? IS D BV IG A7URE
INSPECTION RECORD
CITY OF EAGAN . PERMIT TYPE: BuIL°1"G
3830 Pilot Knob Road Permit Number: 026436
Eagan, Minnesota 55122-1897 Date Issued: 10 / 0 3/ 9 5
(612) 681-4675
?
SITEADDRESS: LoT: se BLUCK:
4083 CAM6ERWELL DR N
HILLS OF STQNEBRIOGE 2ND
PERMIT SUBTYPE:
SF ApDITION
3 APPLICANT:
ANOER50N
(612) 656-7232
TYPE OF WORK:
pESCRIPTION
Mo1001
MSCHAEL
NEW
(PORCH INCL)
INSPECTION
FOOTINGS .. •
FRAMING .•
INSULATION FIREPLRCE
FINflL
REMARKS: Fl SEPARHTE PERMIT IS REQUIREW FOR ANY ELECTRICAL OR PLUMBIN6 WpRK
L
PERMIT
_ r. _..1
X4,mx
cinr oF EaaaN
Nmr ConsWCion ReauNwmenrts
? S iepateiad sile wrveya ? 2 copies of Plan
? 2 eoPies m Pbns ('cidude beam 8 window aaes; pouisd ind. design; etc.) ? 2 site surveys (eztmbr ufditions 8 dedcs)
? 1 enarpY caiailations ? 7 energY celculaGwns for AestM additions
? 3 oopbs ot tree DrossNetion Plan if bt plaketl after 711/93
raquired: _ Yes No
DATE: / /2Z-?r CONSTRUCTION COST: ??? Od0
DESCRIPTION OF WORK:
STREET ADDRESS: rf0 ?'3 C" "? b ev- /\J
LOT r0 BLOCK 3 SUBD./P.I.D. #:
?,: ?%'/?3 0? S'fenP.?7ri•?yC o?nd ?c??i-!i'ow
?
PROPERTY
OWNER
CONTRACTOR
License #,
? Street Address:
? City:
ARCHITECTI Company:
ENGINEER
Name:
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) Wb,d, q- z
681 -4675
Street
Name: ?v?l d?? ? o rt 01 i G),cLQ.(
u., ....
C?a
Phone #: & 96' ?a 3 -?-
1/ D r /V-
City: ?asa it State: MW Zip• S?/ Z 3
Company: S2?t Phone #:
4-Q,6. 1?
Zip.
Phone #-
Registration #•
Street Address•
City:
Sewer 8 water licensed plumber.
ehange are requested once permit is issued.
State:
State:
Zip:
Penalty applies when address change and lot
I hereby acknowledge Mat I have read this applica4on and stste that the inforrnation is conect and agree to comply wfth all
appiicable State of Minnesota Statutes and City of Eagan Ordinances. ? Ji? „? /? ??,? ? ? ??/J ?
? ?? ? ? ? i
i
Signature ot Applicant tLf ???L ? -,
OFFICE USE ONLY R cC L VV E p
Certificates of Survey Received _ Yes _ No g 1995
Tree Preservation Plan Received _ Yes _ No
BUILDING PERMIT TYPE
OFFICE U3E QNLY
..
x.?
? ? .
n 01 Foundation o 06 Duplex o 11 AptJLodging o 16 Basement Finish
0 02 5F Dweliing a 07 4plex o 12 Multi RepaidRem. ? 17 Swim Pool
JO 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Pu61ic Faciliiy
0 04 SF Porch ? 09 12-plex o 14 Fireplace a 21 Miscellaneous
X 05 SF Misc. 0 10 _-plex o 15 Deck
WORK TYPE
,X 31 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuat) Basement sq. ft. MCIWS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. ? Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
LengHi sq.ft. Census Code. ?
Depth Footprint sq. ft. SAC Code
Census Bldg ?
Census Unit D
APPROVALS
Planning
Building
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
ACCt. Deposit
S/W Pertnit
SIW Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% sAc
SAC Units
_ Engineering Variance
Valuation: $
f?fi??ryD ?Dinnnr
(L°,c u = 3l00
Lr ?/ = zZ' --?
1672o s 3(oD ?i?- S,`lv'
_.?----- S-x 30 _ Z 77101
bs' ??
?-_-----?°° .
I(
#4e$
7477 Fntrtpricn Drivr
Mriidota I I?igh1t, MN 55120
' _
* engineer ng.. L„»n.L .,..,c"„Ac.,. ,«,. 16121 681 .1914
* * **
Certiiicate oi Survey tor.! !4L-kO-rTL UN(J ..CO_•.1 lVl._ _?
cqM NoartN
'4E
x??.<j ?ECC
84x.Vr D??v
- e -. g
R °a A1l.??
•? ??`? ? e?y \ ? s,°
S
2,
n:y
? / ? ? i 967 ? /'r??.? •w., ?
? o
3y.t3
r A ?
I q,??' 1 • ? °
?.
spt / / / 1?ti°P? P?
763 ? ? ? ; . , " • .
"o•
Sd . n %
s t5•4. r '•???? /r? Je_
. 900.0 DenolPS W-orl LEVAI7ON
pertoles prY?p .,ed F_/evo(ic?,l wer ee7
-- IJhnr?l va (h-vma e? Ulilil? frt???r?e??l ToJ? n.; E?/vcl? flPValion 89 e`
-- ?- Uenvles L?roincSie ?low /lrrows C;cMn¢p 5/n11 flevnfipn m ?sa
0 Ve?lvtes monv?neil? ry neno,es Ott scf Nub
6ear,n5 5/10w?1 or•e v55unrFci /
!U L-CY,SP.1)1P11/s nf / 'Reoca- d
?
LOT lD , BLOClC 3, 141LLS UF STONEBa1 bGE PtA-r Z
DAKOTA COVNT}'
1 hr?M?y Cnrlily ih?l this it q Mna and fmrnr.t r?(nienqlelino nf n auv?y nl Ihr hnnmlmi,: nf rbr ihnv?A.?Jn.?rq?rd I?o.l an.lT 1 thn I??q11no 01 rll ?
Mdldinqs, Ihn?Pnn, f?nd all vi1ih1n rn?rai?hmrmt, il rnv. Imrn n, nn iaid lervl. M1e u?rvnyrrl I V m, iI,ie _ Z')f{ dov nl ^ A.D. 19 A .Jf _
P..v_ 9 33 °11- /?d4 Er;y? Elrv .
a..?_ ro-?-?? •rn.,.,. ??;. -,•F•r? /?/ '
,
--
,? n-„nPn, n^.wv?? a nf•: ?in leenl
? ENERGY CODE WORKSHEET FOR ]. & 2 FAMTLY DWELLINGS
SITB ADpRESS &P01,5 N
CITY
nuii.nlNa CLASSIgICATION: ? eF
1 (atandard) or ?
DATE
BINIHUt{ CRITSRIA
Foundation Ineulation-Rlo
Slab on Grade Ineulation-R10
Floor over unheated epaces-R24
Foundation Windowe 1/2"
ina4lated Glase,
-Woodor Vinyl Frame
Walla 4 Wiodown
(See tahle on reveree eide
for allowa6le percentages)
1 (must ipcludo ventilati
RooE Attia lnauletion,
R49-With Attic No 1(eel
R3e-With Attic Raised Fleel
R38 6 R5-Solid Rafte're
BTHP 1 Window G Door Araa ST6P 2 Calculate area ae a parcent of wall
A. Total Window 4 Door Area in Sq. Peet " • '
WINDOWS (Including Foundation Windowe):
WINDOW MAIiUFACTt7R8 NAM6: C. Crom Step 1 divide box A(Window & poor
NZNDOW MAN[TFACT[iR6 TYpgy • Area) by box D(total wall area) Limeo l00
equals tlie window and door area as a
WINDOW MANUFACTUR6 U FACTOR: percent of wa11 area (6ox C).
R. O. QuantiCy aq.fl:.Area BOX AX 100 =
Dimenaions Box 13 C
4OZ4 Xd? ) ?L(I ??I STEP 3 Deoign Featureq
x,?? a II/ _.? P.SSGPI6LY
x PRAMIIiG TYPE:
X' STANOARD FRAMING x etude 16° o,c,
X ADVANCED FRN-0ING Dtude 24" o,c.
X CAVITY INSULATION R_Z/
X
9N6ATF;Tifa TYpHt
X LE53 TIfAIJ e R-5 '
I 1 ?
X R-5 > OR h1ORL'
X U-FACTOR ? _
DOORS; From tlie ta61e, (reveree side) determine the
---?_ maximum percent window & door area for the
?o X/ 8 daslgn optione eolected and enter tho t value
?p ? 4 O in Box D below Uaoed on the window mEg. U-
? fac[or:
X ?
II-?r-1 D
9'utal Area of ? ?---? ?
uq.Et.
Windowe 6 Doore ' -
S. Total Wall Area in Sq. Ft, The t value from Che Cable in Uox p shall 6e
eyual to or greater tLan the };n IIox C
Wall Total Ileiglit Area
Perimeter
7bta1 Area of Nalls _ ???f??'uq.f[
I
,.
,
?
. , .,
yi?i..'? ; • ,
i? i ' ' .. . .
.??i:'?.? ? ?? ' ? •' • .
1? :??;?;? .?;, i'nle ?iI?II?II??R p111e? nn? i:xcr.a?? ?Il? ?un>:Imupl win?lnn? ???d ?Inni? ?i?e? ??? ri
pGrcGninisR nf nvpi???l F*p05???.ival? qfC? (I51C?? ??r.inw (or ilu: cnnil?inallnn
,I ?;?,I:? ? nf fra?nln?j Is?l?lllqna, ?t-va?n4 n? ?n???lalln? lvilhln Ihe In:aii+,w?i cuvli%r.
??j? ?? bI1Gp?INIIII I?-V?II??? ??1?? ?Y?fl??nty 1) faclnf. QIhr.Y r.n?1???on?:nls pl??sl n??ai:l
;. , U?a ?•er?u?rcnl??ls nf Ihls snl,l,nrl. . + r1?xlhl?lli ll1'INpn%Ynlin1lnnpAtt r:?
• AS A r1sl1r.1:l l 'I' nF (1aI:u A I I . I?x1171511) l YAl i.
?
? .
.? , ,
Cd1'i I' ,
.? ?
1Ylndmr II .
U
aTnNPnnn I1."I14 17 11 L 2I j1e 1 1
?j1.
OrAI'IPAIIP I?-15 41t•5. 12.g;L 17 M 11l1
;c .
;
: )
•1:?
I,
Pr^IPAi+
I) ,
•11,?!? ??
?,???5 ..
Il.l;c ??1G(1:?
lu1l;c. .
.
•,,q,?
`IPAIIII
SrA
AUVA ICI?(? It-?0
1?-
? ?:R•5
; 5 ,
1.1.5:6 ' 10 1i4:
.,
' 21 2;.
? ?'?;.
.
APVA 'ICI:Il I
Il•Iq •:I
i:IFS I I.1 1Y
I/ I.Y
115 ?? ?9 2?: ,
>II I,..
2•! 5? 21 I;,.
I I II OIL ,.
1?? Ilt 26
: I I
t
S??I•IPnitl?
It•z?
?:I:•5 •
i I n•:? ?'? a•::
?? ?,;:. ?
.
?e, i•;,
nlIvnNc(:p
ur". in 101c
•21i .
rIaVOiC11) 11.21 5 199::
S?ib??. ?. ??erformanac cr?U :?la. 'fhr, cnu d?ln??l Ihcrmal ?rnn:??uiu,? nru (I I
}
(neEnro fQr wall s, Fan(/eullll,iljy, ul %,l flnnts nvr.r nnhr.nled npnci:a wii:,i 1ll: ?,
lu:;:? lluin nr
fqllal lo; .
n. n.?ln piiint ril °i1- r,i, ,,.,in:,;
D. (1 f12b Iliii/It W V frn inn(/rr.ilin?;?; itnll
I r_- nnl nill/ii n2 T r,li- 11„411:,.
ST•1TA1n'IL• plsgu6c.19
IIIST; 111 Slt 1f,;l
(6706111q I?elidnlga, in s« 21rl
., ..
Y
CITY OF EAGAN
3830? P.I,TLOT?K?NO$ ReOAD
p
l:?[iGfil\ , y L'LL? SSLZL
PHONE: (612) 454-8100
AmdN
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE:
,.
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE I
?....r„ . .. .... .... .. ..
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNIT.
--°--------°------
WORK DESCRIPTION
NEW CONST X
ADD ON _
REPAIR _
OWNER NAME: I 'LJ1TIl )i^C ] l?.
SITE ADDRESS:^I??C7? l fnl?l?rl I pr. n,
LOT:? Bf.OCK j SUEu. pr%
INSTALLER: p ARR FITe f•/A A
ADDRES S : .?9=_ftftft AvL NL_
CITY
ZIP:
PHONE tt: .5"70[ - / I eo &
FEES
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
iOTAL:
DWELLINGS &
$15.00
24.00
6.00
3.00
$ill f
.50
$?
?
IGNATURE OF PERM TTEE
PORREpC14 f7?!7?_tISTPLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE A'JDRESS:
IAT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
E.SC!-? $1,000 QF PFR.MIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHP.RGE $
TOTAL:
( S IGNAT[JRE )
CITY OF EAGAN
CITY OF EAGAN
` • 3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
womt,?"M
FOR CITY USE ONLY
PERMIT #
RECEIPT #
DATE : /all 7 /
?$???NT?IIX:?`: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNZT.
WORK DESCRIPTION
NEW CONST x
ADD ON
REPAIR _
OWNER NAME: J
SITE ADDRESS: L10?"' ?j
LOT:1Q BLOCK -4 SUBD/k& !2 cXn!±
INSTALLER: ?/'-?'w`f NO ?a \ u C e> '1?z •
ADDRESS: ? t0 CiZ«?C L ?
CITY: ZIP: S S 3 S' ?
PHONE #; ) I
S
PERMITTEE
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
k SHOWER 3.00 3_
? WATER CIASET 3.00 -i -
? BATH TUB 3.00 l. -
? LAVATORY 3.00 ? -
? KITCHEN SINK 3.00 3_
? LAUNDRY TRAY 3.00 -3 '
HOT TUS/SPA 3.00
? WATER HEATER 3.00
1 FLOOR DRAIN 3.00 3GAS PIPING OUT.
? (MINIMUM - 1) 3.00 ? -
? ROUGH OPENINGS 1.50
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE .50
?
TOTAL: S y 1 ?
?OMMBkGZAj;?f?ipYSTB2AI::; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
M[TLTI-FAMILY SUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-------------
CONTRACT PRICE: _
0"vINER NAME:
SITE ADDRESS:_
LOT: BLOCK ,
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
(SIGNATURE)
SUBD.
18 OF CONTP.ACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
ZIP:
FEES
W'3
. #
1991 BUI P (&CATION
CIT1C OF EACAN
:':
, ,SINGLE FAM?LY?'DAELLING1r- ' MULTIPLE DWELLINGS COMERCIAL
- . _•?,..>
S, _
'..
2-SSTS OFFLAN 2 SETS OF PIANS 2 SETS OF ARCHITECTURP.L
,
?
' 3-•`REGISTERED*Sd _TE .SIJRVSYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PIANS
ENERGY"t-QAL=CUTATI'ONS-:,
OFa
1 SET (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
;
:
?', ?? 'i:; ,; ' " 1', "-:" • ?? ':'t?` ; 1 . SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
`st,
t:; .•. . . # OF FOR SAL.E UNITS
- :? ,
; PENAI:TY*.,I:FES'WHEN: `'TYPING OF
PERMIT IS REQUESTED, BUT NOT
PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
::'ADDRESjSES FOR CORNER IATS -
NO
TE CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
.
,
' DESIREp];: GHANG S ILL E ALW-WED ONC BUILDING
-NO
??l1l12
'"rFR4CES§2eNG TIME FOR'..SEWER & WATER PERMITS IS TWO DAYS ON PERMIT HAS BEEN LETED.
PERMIjTt•aMITST SHOW A LICENSED PLUMSER. SEP 3 O I9?
To Be Usedx
Si'te Addr,e3
Valuation: MWERiw-r?
iock H4LL& a
?? .
.. . Owner
j?Addr-.ess:
QZip?+,Cqde?, ?
:.". 'Phone'
,'Ad'diess .'
,_ tI,.
.:City`r%Zi?p;; C04e4;_
T.
, :Yhorie
-Enei'. ;.'?.;?:. .
? Address•?
a :"...
? 'Ciiy/.ZYp +C,o:de?
x .-?..
Phone. #
F• '?i? ??;
;
ed Contr
OFFICE OSE ONL
1/N)000?
EM
Occupancy k"3 M-1 Bldg. Permit G8 9, oQ
Zoning M -R-1 Surcharge 57.Oa
Actual Const Y-N Plan Review SidO
Allowable Y-N SAC, City 100,60
# of stories SAC, MWCC ,00
Length Water Conn. (Q60r60
Depth 32r Water Meter ',00
S.F. Total Acct. Deposit ibb
Footprint S.F. S/w Permit 30,00
S/W Surcharge 1SD
On site sewage_ Treatment Pl. 206,00
On site well Road Unit 390,00
MWCC System ? Park Ded.
City water V Trail Ded.
PRV _ Copies
Booster Pump _
SIIBTOTAL
APYROVALS Penalty
Planner Lot Change
Council TOTAL
Bldg. Off. /?'!/
Variance
agrees that all wtrk shall be done in accordance with
i
all applicable':Seate of Minnesota Statutes and City of Eagan Ordinances.
?
I F? ? VA?--?irl 9 . ` :. ,
?
G ARAGE
..?-
? ? X 20 (400 X 1 S? GD4)n •-.
i,
--------.-
3y,'x3Z =
/OSa
3y?
8?2K S? ;•. ,.C C?6 , ; g
3,0,,x 114 3'Z,
? `;L
IsT Fc _. .. „. _ . .._ . ??ti
3y x 2y .y sl ? .
L
?l yl62(.
? l13,?y?12,? orz ?Ily?;aao!-
o? d??•~ a.??S ? . i ?
o • ;:
689•OOF
57°00?
44a • oo+
zo zii•5oE
3, 405 •50?
6U9•p0+
yv•oo+
44B•00+
?_,211•50+
31 405 •50:?
SIvw
ElDS 3 nMQNMw.. is
? * * * 7422 Fnlriprise Drive
* PIONEER IANOSVFV[YO/O• CIVIL [NGINEERS ? MrndotT 1lnighi5, MN 55120
*engineering.. L•N°•L•N"E'°.'^~"QC^°E^"°'"II(s12) setts14
* * ** CertificateofSurveyfor:! n1?0_T_Tl..VlVV.._Ca..l_AIC_._ ?
04Mg . oaTN
F N
\A? 842.'?' QiP/V?
81 b 9 N
e ?46
?e' /? ? ? s?y•
R?3, ?.t c? °do'9 ? A1)?eo
°? ? j? •
m F,s t . , Tg
•N ? ? zeA; ? e ,? 1 S o
i7,, ? ' ?av?;r ?3• ,?.?1 ' ?13?' ? S•?
993 ot- ??.o
` o /f, /•^7r,/ r /
3yf?
+?vsr,/
' S•9 ? ' /P / k?,p ` P?
h?
t
1 '?... ?.\
l^
. 900.0
Denof¢s exisfin Eleval?ort .['kvpvs !2`,? u,sF_ :rEvart N:
.?o.o-- Denofes prY?p?ed F_/evalio>> ./.owe? l7oor Eevcrlron ea?
Uhnvlas U??rina.?e( U/ili l? <<?sPme?)/ 8/vcl/ EJevqlivn 9. 6`
-- ? Ueno%eS Drc7iruF7ow'/1 rraws C;arqke SIoG rievafion ?mss
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• -
Total exposed ua!1 area nbovc floor = Z Z8C ?
s. Total v211 cindov erea . ........................
b. Tote1 door aree ................................... - %,-J%
c. Tota2 slidir.g glnss door area .....................
d. Total fireplece vail crea ....,.... .............
e. Total vall framing a-es (average 10%) ............. /d-
f. Total net uell area above floor ................... /fo . ''
. B. Total rim Joist area .:.............. ........... .2 On
Total exposed fm:ndotion arca
h. Total foundet?on vindov.a:ea ......................
i. To:al net foundstion a:ea above grade ............. Ar
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k. Total roof/ceiling framind area.•••-•-••••
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area
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ng
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If total oP N4 is the same es, or less than N2, you have met ttte intent of
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To utilize the total envelope systex method, the values establi:hed by the
f iten,s Bl a-id 12.
sum of items M3 and B4 shall not be 6reater. thrun the sun o
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- ' - 3. + 4.
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Use BLUE or BLACK Ink
r----------------�
I For Office Use �
� /�'�?I� �
C�+ O� nn n n j Permit#: I
I � �
6 1JQ Qll I Permit Fee: �
3830 Pilot Knob Road i , G i
Eagan MN 55122 i Date Received: d �
Phone: (651) 675-5675 � I
Fax: (651) 675-5694 L Staff: _____ ________�
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: � �l�'�G� Site Address: !��� ��� lf��/� ��ll �'� �(/
Tenant: Suite#:
�ReSlc�etl�1QVl►rler , Name: i'�'�f�G'l �`�'Sc� �• Phone:
,�r�; Address/City/Zip:
�ti��� ���. p
�:
Name: />r t./C S p"��.�.�i.b f � License#: Y ��y���n Z
G�'f1tY1C�OC Address: `��T � Z/' S'� d��.. r�vt� city: �����'
': State: �L Zip: ��e�r� Phone: ��' ��-�r ���S �
' Contact: �'S�'Gl� Email:
! Typ�of Wc�rk —New �[Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
' Description ofwork: �L �� ��� 7"�?c
'' RESIDENTIAL
Water Heater
Lawn Irrigation (�RPZ/_PVB) Water Softener �
���������� �Add Plumbing Fixtures(�Main/_Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$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 System Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
`Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System 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. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x �"�t� `.,–�I/ x
Applicant's Printe ame Applicant's ' nature
�C}F��FFICE USE F��viewed��r.; Cl�fe: '
Required Inspections. Under G.ri�ur�d Ft�ugh-lr� Rir Tes� i �� x Gas T�st Final
Meter Related tt�msR ,�Me't�r�iz� � . ��. �tadi�"R�a�i�� : Manc�met�r' :``�#�f�:
� �°�� �..
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163697
Date Issued:09/10/2020
Permit Category:ePermit
Site Address: 4083 Camberwell Dr N
Lot:10 Block: 3 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-03-100
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Michael D Anderson
4083 Camberwell Dr N
Eagan MN 55123
All Craftsmen Exteriors Llc
1020 East 146th St
Ste 226
Burnsville MN 55337
(952) 898-4680
Applicant/Permitee: Signature Issued By: Signature