4658 Beacon Hill RdCITY OF EAGAN WATER SERVICE PERMR
3€30 FiF6t Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: `'-1 2`
Zoninfl: No. of Units: 1
Owner: '-'J11er l;or°t"ucCior,
Addross:
Stte Nddrcss; 4650 . 3eacon Hill Road I.11 r3 F3eacon I?ill
Plumber 'cGuire ?.sec',,
Meter No.: Connection Chorge; 450.00 pd
S1ze:
Reoder No.:
1 sem to eoMpip wNh !w Citp of Eagen
OrdiwenoM.
Accamt Deposlt:
Pem,lr Fee: 10.00 p d
Surchorge: •50 pd
Mlac. Charyes: 60• 00 pd meter
ey
Total: -
Dote Paid:
Dote of I r?sp.:
' CITY OF EAGAN
3830 Pil'ot Knob Rosd
P. O. Box 21199
Eagan, MN 55121
SEWER SERVICE PERMR
PERMIT NO.: ?
DATE: . .
Zoninp: ., No. of Unita: 1
Ownar. Toseah "`iller GonStru rinn
Address:
Site Add
Plumber.
I oprem to oon*ly whh tw Cihr ei [e"s
Oedisanees.
By '
Dote of Irup.:
???lonCharp: 425.00 Ed
Actoixit Depoaif:
Pormit Fae:
Surcharpe: _
Misc. CMrpes:
Totol:
Dote Poid: -
CITY OF EAGAN
? 1795 Pikf Km& Raed Ee9ew, MN 55122
• s a236
PHONE: 454-8100
BUILDING PERMIT Receipt
To be awd Mr,, SF DWG/GAR Est. Value $501 000 Date -ju y 17 , 198.,
Stte Address 4658 Beacon Hill Roaa Erect ? Occupor,cy F-1
Lot 11 Blotk 3 Sec/S„b, BASCOn ilill Alter ? Zoning R-1
parcel #_ 10 13500 110 03 Repcir ? Firc Zax NA
enioMe ?
Nm„e _Joseph 14. Miller Conat., Inc. Move ?
Addross 18133 Cedar Ave. So. peffioiish p
ci*„Farsninittou o?,- 454-SI 4753 6rode C]
o Name Owtlez ? °°?
~ Assessment -
Address
I.- r:.., o?....._ Water & Sew.
Name _
Address
Police
Firo
Eng.
Permit 233 . JO
0
Surchorpe 25.0
Plon check 141 _ 50
SAC S 2 S - (l0
Wuter Conn. I+ +n - (1n
Water Meter
Road Unit
<W LCity Phone Plcnner
Countil
I hereby acknowledge thot I hove recd this opplicotion and state that Bldy. Off. _
the informotion is correct and cgree to tomply with all opplicable APC
Stote of Minnesota Stotutes and City of Eagon Ordinances.
Sipnoturc of Permiftee
11 Bullding Pemnit is issued to: ??-vr--
oll work sholl be done in eccordance with oll
Buildtn4 Officiol
State
Totol $1734.50
.? ZIIC. on the exprcss conditbn thni
nesoto Stotutes onA City of Eoflan Ordinonces.
Type of consr. v
# Stories
Length 41-l,
Psrmit No. Parmit Holder Mise. Permit No. Hotder
Plumbing ? ?'T 3 /?/,?-l9G?L?i? ?'-?`?
H.V.A.C.
g'
l
?` ro
w.u
Water
Disp.
Sswer
elace.ic wo-tS7?? '?l av?.d -IG-? 3
irnpect{cn pete Irtsp. Othar
Footings
Foundatfon
Framinp ?
RoupF+ PI6g.
Rouyh HVAC /,, ; ';
Inwlatfon cs?3
Final Plbp.
Final HVAC Cf
Final
Wa"r Describe Locatfon:
YYell .'
5ewer
Pr. Di?p.
Receipt `PLUMBING PERMIT
, . y CITY OF EAGAN
-? .
L
f Fill in numbered spaces
Type or Print legibly
1. Date ????A ?; 2, Installation Cost
3. Job Adi
-3?? ?
Permit No. ?`?
Fee ;? f _ C? [1 '
S/C ?3L_
To#. 2 C.
?
5. Contractor ?????rg, seekan=c? Phone 469?
6. Address ?071r i:UZf: l.VE:
7. city La?_eville
8. Building Type: Residential ?
9. Work Description: Newr1M
10. Describe
1 11.
State J`irr_ zip 55044
Commercial ? Institutional ?
Add ? Alter ? Repair ?
No.
_ Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
J_ Bath tubs Septic Tank
Lavatory Softner
Shower WeR
r Kitchen Sink
Urinal/Bidet ?
S \\
Q hef `
Laundry Tray ;
_
Floor Drains
Drinking Ftn.
` - -
4_ Slop Sink
Gas Piping Outlets
12. I hereby certify that the ahove information is true and wrrect, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : far
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved • CITY OF EAGAN 464-8100
I - PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: _
Site Address !%Ll?
Lot _lI Block
m Name
?o Addre
c City?='
Name 'h^v.K I
3 Address
p City 1?4 c,A nl
' TYPE OF WORK
- Forced Air
Boiler
Unit Heater
Air Cond.
Vent ,
Gas Piping butlets #
Other
y/A/?le Ar/
M BTU
M BTU
M BTU
? M BTU
CFM
BLDG.TYPE
Res. ?
Muit
Comm.
Other
WORK DESCRIPTION
New
Add-on ?
Repair
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE _ 10,00 '
MINIMUM - COMM/IND FEE - 20.00 '
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00) w I
? I
FEE
?v SIG ATURE OF P RM E
5/C: -
TOTAL• 12 52
FOR: CITY OF EAGAN
Receipt MECHANICAL
CITY OF EA
d Fill in numliere
? Type or Prini /egibl;
1. Date 2. Installation Cost
3. Job Address Lot
Permit No.
Fea - '
S/C
Tot.
_? Tract
4. Owner - J uQ:_ % I 1, 1 1 C_ 6
5. Contractor Phone
6. Address ? y 1
7. City ?• ' State _ , `• , ? 2ip ?
8. Building Type: Residential `D Commercial C] Institutional ?
9. Work Description: New CY Add ? Alter ? Repair ?
i '
10. Describe Fuel Type
11.
No.
! Equipment BTU - M. Ea.
Forced Air ' No. Equiament CFM
Ai
H
dl
Mfg. r
an
ing:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
--- - - I
12. I hereby oertify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : --- foY
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-5100
D-RD -------
CITY OF EAGAN PERMIT TYPE: ,
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: ,
(651)681-4675
SITE ADDRESS: ' • ? . c 10 ?- 1:Jf`Aa--:L 1 0- `' ` APPLICANT:
[0 t: t 2 H1 c?f. r
PERhAIT SUBTYPE: TYPE OF WORK:
??. ? ? i i• ? ? ??r? ? i? .. i ? ??,?
INSPECTION
1. .• • ..
I Nk`:• {?fR00F NnliSi ANIl AAItAAf- I11It it
I1-
?
1 (1R1
?
?
??
Pormk Holder Date Telephone M
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BIDG FINAL
DOMESTIC
METER
IRRIC3ATION
METER
FLUSH
MAINS
coNOUC'rivirv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMf FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 1Z' Blk 3 Parcel IO 13500 110 03
Owner -Street 4658 Beacon Hi 11 Road state Eagan,',,tN SS 122
Improvement Date Amount Annual Years Payment Receipt • Date
STREETSURF. 6";'^. 1982 1806.93 200.77 9 1806.93 C007552 10-1-81
STREET RE3TOR.
GRAOING $ 1982 526.46 58.50 9 526.46 C 07552 10-1-81
5AM SEW TRUNK 1976 135. 97 9.06 15 g
* SEWERLATERAL 1982 3116.46 346.27 9 -1- 1
WATERMAIN
* WATER LATERAL 1982 9
WATER AREA 1982 198.01 22.00 9 198.01 C007552 10-1-81
* Stubs 1928 9
STORMSEW TRK 1982 359.82 39.98 9 359.82 C007552 10-1-81
* STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
RO I 250.00 37026 7-12-83
WATER CONN. 450.00 11 0 1
BUILDING PER. 8736
SAC n n
PARK
At?xtifirttte nf (?rr??ttnr?
Citp of (Eagan
DF}iFtTlritFrit Df W1ttlatlU3 ltISpPLlilrit
Tbit Cnti firate irtued Purtuant to the +equi+emenrt of Sertiom 306 0/ the Unif OYOf Btl1I(I(flg
Cadr mtifring that at the time uf ittrrrtraa tbit xtruttutt wat in torrs pliann +vitb the variowt
ordinasrct of tbeCity rtgulaiing building mnnruction or un. For tlx folloudng:
U. CuWontlm SF DWG/GAR Bldf Pemut Ne 8236
.
?wwr'hw R3 'hwc?? V Fiaz? NA zowrea.uici Rl
a„w,??,., Joseoh M. Miller ?,,,,,18133 Cedar Ave. So., Farm
B„wim?4658 Beacon Hi11 Rd z,hLot 11 Block 3,Beacon Hill
Z6" 6- p °' September 2, 1983
a«:
.e.. ?. . ?...???W. ...?. . ..
REQUEST FOR ELECTRICAL INSPECTION
' Sea inatructions for comDating this form on beck of Vellow coVV.
?IlYOrk Cired by This Request
.EB-00001-04
.3-i 4q O
Atltl Rep. TVPe of 8uiltling Applinnces Wired EqaiUmenLWired
Home ange Temporary Service '
Duplex Water Heater igh[ing Fiztures
Apt. Building 40 Dryer Electric Heatin
Commercial Bidy. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other vaci v ther t5ocr,Itv)
i nr Speci y t er Other
ompufe lnspection Fee Below
t! Fee Service EnbancaSi¢e q Fee Peeders/Subfexdera N Fee Circoits
/OtoO 0 to 200 qm s 0 to 30 qm s Q ?- - o to 30 Am
Above 200 qinjs 31 to 100 Amps O. 31 to 100 Am s
Swimming Pool Above 100_Am s Above 700_Afnps
Transtormers Irrlgation Booms s Partial:"Other Fee
$igns Special Inspection $ LJ 3
Aertu3rks I
? T PEE \
? Y'
r v -
Rough-in D(?me , ihe Ele e
? Y?? nspector, hereby
? ertify thet the above
Final ? ???'el? ? .(. inspection has been
mada.
•
Thle reouest voiE 18 monttia lrom 41
This reques[ void ';L?? ((J
18amont4s tJom
WI 078772
Lll 1 133, b?acon µC l ? 3-[q°1 6
(/'7"so
Renuest Date
'? ??3 Fire No. Rough-in Insuection
RequrteA?
?NOady Nuw ?.M? ntity In-
sOec
«?r WN
h
R
d
? ? No en
ea
y
P_r;'c-Ised ElecMcal Conlractor I hereby requast inspectian of above
? Owner electricel wark installad et
Streeft ?Atldress,Bon or Route No. -1
GS(? D ?-?4 ?
?7
?+ ?..
Clry
G+
ecuon o. Township Namo or No. anee No. Co/v/m??y fir
IV ? R ill
OS et IPRIN;//?h Ph??Y ?40J3
Power SuD0lier r/ (
7?wI
@
?Q ? Address
l .4
A/
s yl
?
L
.L
O h y
o
.
.
Elachicel Co tramor ICompany Name) Contwcmr's Licensa No.
Meilinp AAJress ICOnVactor or Owner MakinB Instailatio )
?oe/ E/?/ .Q& n?tse?r '.S$337
Authori ed ignaNre ICOn[ractWOwner Makine tristallaUOnl Phg?ona Nuymber
MINNESOTA STATE BOARO OF ELECTRICITY THIS INSPECTION PEQUEST WILL?NOT
Grigga-Mitlway BItlQ. - Poom N-191 BE ACCEPTED BV THE STATE BOAHD
7821 University Ave., St. Paul. MN 56104 UNLESS PROPER INSPECTION FEE IS
1e,?1 - -- ENCLOSED.
cirr oF eaG?N -
9795 Pibf Kaob Rond Eagan, MN 55122 ?T lr? 8236
PHONEs 454-8100 -5270 1 .
BUILDING PERMIT Receipt #
To M wad 1er SF DWG/GAR Est. Volue $50,000 pate July 12 1 q 83
Sire Address 4658 Beacon Hill Road
E
R-3
recr gg OccuPonq
11 3
Lot Blak Sec/Sub. Beacon Hill Alter ? Zoning R-1
Parcel # 10 13500 110 03 Repolr ? Fire Zone NA
V
Enlarpe ? Type of Const.
rc Name Joseph M. Miller C onst., Inc.
W Move ? .{k $tories
Z
? Addren 18133 Cedar Ave. So. Demolish ? Length 41-4
G Farmington PhoM 454-$A 4753 Grade ? Depth 45-8 gG, Ft.-
a Name OWLler . . Avo.orab Faes
i
05 ? Hddress
Name _
Address
I hereby ocknpwledge thof 1 have reod this opplication ond stote Ihat
the intormation is correct and ogree to comply with all opplicable
State of Minnesota Statutes and City of Eogan Ordirwnces.
Sipnature of PermiMee
-- osepr'
A Building Permit Is issued to:
oll work sholl be done in eccordance with oll
Auessment -
Water 8 $ew.
Police -
Fire
Eng.
Plonner _
Council _
Bldg. Off. _
APC
Permit GO.]. V V
Surchorge 25.00
Plan check 141.50
SAC 525.00
0
Woter Conn. 450.0
WaterMeter 60.00
Rood Unit 250.00
rorol $1734.50
, Inc.
_ on fha express condition thal
ond Ciry of Eayan Ordirwnces.
Buildinp Offlciol
CITY ? FAGAN ! Include 2 emts of Plans.
l ? 1 eite pIan w/elevations a
% ll scrtIDnJC PF?T t?P'P?.?cTiaa, I set of amecqy cescAatsan4;
--
' oa0.
Z+o be Uaed For
Site Address: Sz&.Sd' ?tLGD
I,ot _Z/ slxx 3 sec./sub.
Paroel A: /0
Owner: (
Aoarese:
City/Zip
Phaaie N:
a
Addresstor.
City/ZiP Gbd2:
Arch./fn9• -
Addtess:
City/Zip qc)de:
Pt+one N:
35ao ((o c)
Aseeemffonti ?e?nit a 83 °?'
WatPr/3ewer ? 2s
Poliae ` Plan Checic
Fire 3AC saer .
;
gly, ,. .
W8t@I CC1tt?. 4/6?p t3• . ,..
Planner Nnter
?
??
APC _
CertiP ate
Gen z H Midoa Inc, 15
?,• 8 l Da ell R t?uaN ?'1'
.clen airie , 5 44
A 1 ei?
;roe Mll;er CKjnstr..ietlon rncbELMAR H. StWWANZ
13131 Cedat• Awrerrxf South
Flrriington, M.tnnesnt:t LANOSVRVEVORB, 2nC.
^.4 RpislnW Unaa laws of TM SHN O/ MlnnnNs
]97{ - 1A6TM STpEEI W. - 80X M R06EMOUpT, MINN660TA 10141110 MiOME $12 471-17q SURVEVOR'S CERTIfICATE
? Uenotes irun plpe monument
53 ? B Denotes setbac:k monument
(IIRjDenoteg propoaed finish elevation
? 9Ic.7Denotes existlng elevatlori
.0
S q -
"? 4 -------- _,. „?_'---- ?? - - - ?:' 4 / 4
o
I ?
r 11 ?.
; ? :? ? tt;u g,yy ' ?
c t3 ?1 ?? ? t, ti, i 1
+ 0 `
CP elp y ? .
\ r? J ? "? oa * ^ ?
elPwbo ?Jl
i7a'1 a
? '? ?v' ?- - t?A M y. • n . . ??' ?' , M
, ? . ? . ...."... ?
`Z n, ? [7 R A? N a[.6 ? o
iT „ITY F/r:??:,? s?
?--
`
Proposed garage f.toor ,eleu':
? ; 9's7. roPotsed top oP biock elgv:
Uenoter dire ?tic}n oF surface dralnage 9'S4?7 Propoeed baeement floOr e1e
? .
? hereny certlfy that thfa is a true and aorreet represent;atian pf
Lot 11;, Block 3, BEACON HILL, aoeording to the Teaorded P1at the'eof, ,
Dakots,County, Minne6ota. '
•
Dated:.J3nuarY 39. 1980
Aleo ahowing the proposed locatlon ciC ? house not staked thereon,
D$Ced: M3r?h 23, 1983:
!
?? .
-
, . . . '. : .-. `, . : .. "FAINNlSOTA R8615TMT11
?k
PERMIT
-CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55122-1897 Permit Number:
(651) 681-4675 Date Issued:
SITE ADDRESS:
4658 BEACON H7LL RO
LOTa 11 BLOCKc 3
E3EACtJN HILL f?
P,S.N „ 10-13500-110-03 t?
DESCRIPTION:
STORM DAMAGE
REpAIR
ALT. RESIbEN7TAL
("?•._:? T . 0 . & R E R O O F
u9ldinq t.P.ermit Type
Gzlcting Wa`k, Type
ensus Gode,...?\ 434
,
i
c r_"
B
BULLpING
0.3.3909
11/03l98
? ? w , •'y ?•_1
i
_ _ ... a
REMARKS:
' RERQOF HOUSE AND GARAGE DUE TO STQRM DAMAGE.
FEE SUMMARY
CONTRACTOR: - Applicant - s?-. '.zc, OWNER:
GOPHER CO., TNC. 13315897 E3617 ANbER5C1N GERRIN
445 MALCQLM AVENUE 5E 4658 BEACON HILL RD
MTI4NEAPOLZS hIN 55414 EAGpN MN 55123
(612) 331-5897 (661)681-1761
1
I hereby acknawledge tMat I have tead this applicatinn anei state tt1zt t:he
in'YarmatSon is :co-rract and aqrae to comply with ali applicabie Stete af Mrti.
Statutes and Gity pf Eagan OrdSnances.
APPLiCANTlPERMITEE SIGNATURE
*SUED BY: SIGNATU
I
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
68i-ae7s y.
New Construction Reauirements
? 3 registered site surveys
• 2 copiea of Dlans (InGude beam & window sizes; poureC fnd. design; atc.)
? 1 energy plalations . .
? 3 wpies of toe preservation plan iF lot platted after 7/7/93
required: _ Yes _ No
DATE:
DESCRIPTION OF WORK: %
RemodeVReoair Reauirements
• 2 eopies of plan
? 2 sRe surveys (exterioi edtlitions & decks)
? 1 energy calculations for heatad addkions
or?
CONSTRUCTION C05T; :Z-?k:t7 -
' S?o r w. c?
v4/ F ? nn.?0.
STREET ADDRESS: / 5-,.t4,"7 i,?'?? J 'd •
LOT: LLOCK: ? SUBD./P.I.D. #: ?i 1 I
Name: ? 4,ji/ SOri Phone #:
PROPERTY 1.ast First
OWNER
SheetAddress:
?.$-5
S ?iC?a?i
???
??
Ciry /??a?1n State: ??? Zip:
'
'33 l
Company:_ ??? ? Phone#:
CONfRACTOR
Street Address:
1/15-
/Y/?'?cfl?rn .QvC ?
.SL'
License # 5;S? 7
City 12?5 State: 00A Zip:
ARCHITECT/
ENGINEER Company:
Name:
Street Address:
City State: _
Sewer & water licensed plumber (new construction onry):
and lot change is requested once permit is issued.
Phone #:
Registration #:
Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree ro comp(y with alf applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
i
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes _ No _ Not
v'
Street
Date: I ? ,2( _v C)
Description of Work: k, Construct new fireplace
_ lnstall eas insert onfy
Other
Job address:
Lot:
Applicant (circle one only): Owner ontractor
PROPERTY
OWNER
FIREPLACE
INSTALLER
2000 F[REPLACE PERMIT APPLICATION
C[TY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
Last
XGas _Masonry _
Alterations to existing
Install im line onlv
J
City U State: //L!V Zip:
Company: Phone #:
Street
City
Permit Fee: $60.50
Phone #:
(azea code)
State: MA) ZiP: 5.S33 7
Phone #:
(azea code)
GAS LINE
INSTALLER Street
City
I hereby acknowledge that I
comply with all applicable S
State:
?read ' 4S,,/ a?d st?e th?the informati
ofMinn tu s anand City\ofi Ea an Ordinae
n_ ?. ll l n l? n
Zip:
and agree to
NOV 2 7 2000
_ Bfock: Subdivision/P.I.D. #: 0 V?-
"? ( ?
? R 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
S?-7d .cb
New ConsWCtion ReouiremenGa RemodeVReoair ReauiremenLS Office Use Onlv
3 registered sAe surveys shawing sq. f4 of lot, sq. fl. of house; and all roofed areas 2 copies of plan CeR of Survey Recd _ Y_ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated addifions Tree Pres Plan Recd Y _N
.
2 copies af plan showing beam 8 window sizes; poured tound design, etc. 7 site surveyfor additbns 8 decks Tree Pres Required Y _N
1 set of Eneyy Calculations Addifron - irMicffie il onsde sep6c system Onsite Seplic System _ Y_ N
3 copies of Tree P2servation Plan if lot platted atter 711193
Rim Joist Detail Options selectbn sheet (bldgs with 3 or less units
Date /,;v / Y
Site Address ?
?j.' ?eaC?v.
f?; Construction Cost 5?74C?
?
Unit/Ste #
Description of Work _
?pLCP 2 V15-L?,s de c k-
//
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone #( 6s "/) S!s f?I? ???
Contractor A .S,--y/v//UT
Address `7(3 J5 Ujr'1Sli
State Al?v 3,/,?
Zip
sj 3[_?
? City
Telephone #(?'S;?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submilted ? Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25%, plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone
Telephone
I hereby apply for a Residential Building Permit and acknowledge that the info ation is co '?plete and ccurate;
that the work will be in conformance with the ordinances and codes of the Cit e of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to s[art 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.
ApplicanYs Printed Name Appli Ys Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 04 02-plex ? 10 08-plex X 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
Work Types
? 31 New
A 32 Addition
? 33 Alteration
X 34 Replacement
Valuation ?21av
Census Code l.3t?
SAC Units ?
# of Units
# of Bldgs ?
Type of Const ?
• IL
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
•Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy R-3 MCES System
Zoning _ 2D City Water ?
Stories ? Booster Pump -
Sq. Ft. PRV '
Length ? Fire Sprinklered ?
Width
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Fina]
Insulation ?
Approved By: _
Base Fee ? U
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIREDINSPECTIONS
Final/C.O.
? FinalMo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Fina]
_ Siding _ Stucco _ Stone _ Brick
W indows
_ Retaining Wall
Building Inspector
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136774
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 4658 Beacon Hill Rd
Lot:11 Block: 3 Addition: Beacon Hill
PID:10-13500-03-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joseph S Sass
4658 Beacon Hill Rd
Eagan MN 55122
(651) 330-0072
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136774
Date Issued:05/31/2016
Permit Category:ePermit
Site Address: 4658 Beacon Hill Rd
Lot:11 Block: 3 Addition: Beacon Hill
PID:10-13500-03-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joseph S Sass
4658 Beacon Hill Rd
Eagan MN 55122
(651) 330-0072
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170865
Date Issued:07/20/2021
Permit Category:ePermit
Site Address: 4658 Beacon Hill Rd
Lot:11 Block: 3 Addition: Beacon Hill
PID:10-13500-03-110
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 -
Willem J & Madeline J Crabbe
4658 Beacon Hill Rd
Eagan MN 55122
(651) 366-9425
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 745-1400
Applicant/Permitee: Signature Issued By: Signature