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4067 Camberwell Dr N IN P I R CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: 0 1410 l Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: APPLICANT: s:io~tEltt.rt 1 I ltpd HJ 3 ; ~ ±s! ;r~~ rig r rt! II PERMIT SUBTYPE: TYPE OF WORK: INSPECTION DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit Holder Date Telephone # SEWER/ li 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 17 29 ~f AIR TEST FIREPLACE FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL itp of o9agan This Certifuate issued pursuant to the requirements of Section 306 of the Unifornn Building Cade w fymg that at the time of issuance this structure was in compliance with the various ordinanm of the City regukzdng building conshuciion or use For the following: - Use CLOSMc ian Ss! Ac" Mk Pc mk No. f f O-P-YTRC R3411 roaim Div; M4 Typ, ? o.%adll4-. H=S Ad&- B.uingAddnu 4067 t'JM"..T DRDX MFM4&., ' 1. 14, R3, HRm (w 11` Dac 6a6/91 `I POST IN A C.ONSPMOUS PLACE A I TIV " FAR DECK 07`18/91 e , 116f l 4 I'~I HORi5Q1 454-752.4 CITY; OF EAGAN 16857 ,830 Pilot Knob Road, P'.0. Box 21-199, Eagan, MN 55121 at PHONE: 454-8100 BUILDING PERMIT 4 Receipt # G/GAR 5; ` '.~o4` Date APR S is 91 To be used for SF DW Est. Value 4120t,0015 Site Address 4067 CAMERWELL DR N Lot z Block Sec/Sub. HILLS OF OFFICE USE ONLY Occupancy FEES Parcel No. R-3, M-1 Zoning 710.Q0 W Name CLt~% HOMES (Actual) ConSt ' Bidg Permit Address 5929 BAKER RD (Allowable) ~P 60.00 Surcharge city IBS Phone 936-7833 # of stories ,461.00 Length* Plan Review *0: SAMB 8~ ? 7 3W . 100.00 to Name Depth SAC, City 650.00 ~a Address S.F.Total SAC, MCWCC City Phone S.F. Footprints 660.00 On Site Sewage Water Conn L 5 95.00 Ew Name On Site Well water Meter Address MWCC System 30.00 ~ Acct. Deposit a W City Phone City Water 30,00 PRV Required SNV Permit I hereby acknowlege that I have read this applicatipn and state that the Booster Pump Slw Surcharge *50 information is correct and agree) Gomply with 11 applicable- State of 276.E Minnesota Statutes and,O of Eagat Ordinances. Treatment PI Signature of Permitee._~, 1't 1( "e r, APPROVALS Road Unit 370.00 CENTEX/ Rows Planner Park Ded. A Building Permit is issued to: on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off, Copies 9. $4 .50 Building Official Variance TOTAL J Permit No. Permit Holder j ct3V/ Date Telephone # WATER PLUMBING J_ $ 11/91 91 S&fl $;Olf - H.V.A.C. /Cp 9~ 3 $09/5-6947 ELECTFIIC /.P O LF •y Inspection Date Insp. Comments Foolings I Foundation b g hOf 6 a c ! Framing S fJ kJl~ tD L C e~ ~2 92 u f, t Roofing Rough Plbg. Rough Rig. Isul. Fireplace 5 - (a D Final Htg. Final Plbg. Const Meier Plbg. Inspector - Notify Plumber EngrJPlan Bldg. Final l - (Q .CG Deck Fig. ~Iz3, y LU ry Deck Final S ~.v G- Y G e Well 1 Q/ .Z Pr. Disp. SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN r METER # 6/ 4 7/ el PERMIT DATE 04/ 1 L / 3830 Pilot Knob 2Rd. -1897 CHIP # 612/6 1Y-?1 PERMIT # 1.1912 Eagan, MN 55122-1 METER SI B_P. RECEIPT # C 12813 DATE APR 5. 1991 ISSUE DAT 2 B.P. RECEIPT DATE 04/08/ 1 - PRV - BOOSTER PUMP SITE ADDRESS 4067 CAMERRWELL DR N PERMIT REQUESTED LOT 1!'- BLOCK 3 SEC/SUB HILLS OF STONEBRIDGE dJ,'D SEWER X WATER _ TAPS APPLICANT: ~Ir r ADDRESS: COMMAND -L- RESIDENTIAL CITY, STATE ZIP NEW _ EXISTING PHONE: % - ' PLUMBER: Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. ADDRESS: t7045 S ROBERT TR Credit- W}LL NOT be gi en for Deduct Meters. CITY, STATE Ark' , ZIP 55068 ff PHONE: 423-1144 ~T-~- I AGREE TOrEOMI WITH CITY OF OWNER: rAENTEX '"OM 3S EAGAN ORPS S ADDRESS: 5929 BAKER RD CITY, STATE MINNETONKA MN ZIP 55'45 PHONE: 936- 7Z:33 SI ATURE WHEN METER ISSUED Pl-i4 E ALLDW ilk VYOI~KING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEVVE*R & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN V~ METER # PERMIT DATE J 4 / I0;' ' i 3830 Pilot Knob Rd. Eagan, MN 5~fi22-1$97 CHIP # PERMIT # i t912 METER SIZE B.P. RECEIPT # C 12813 DATE Ate a , 199 t ISSUE DATE B.P. RECEIPT DATE 24108/'91 PRV -BOOSTER PUMP SITE ADDRESS 1,067 C,"-', EEC "%TEL "4 PERMIT REQUESTED LOT 1,. BLOCK 3 SEC/SUB NILU Of_`: SEWER WATER - TAPS APPLICANT: ADDRESS: COMM/IND ;i RESIDENTIAL 114 CITY, STATE% tJZ ZIP '`J ti NEW EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: Ahead of Domestic Meters on Water Line. ADDRESS: 1-4745 S ROBERT Tai CreditWlLL NOT be given for Deduct Meters. CITY, STATE A;~ ZIP _5510611r!' PHONE: 423--1144 I AGREE TO COMPLY WITH CITY OF OWNER: CENTEX EO'.~.;:.S EAGAN ORDINANCES ADDRESS: 5929 BAYER RD CITY, STATE MlNNETONKA VET ZIP 55345 PHONE: 936-7`; i3 SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454,5220 FOR INSPECTIONS. FOR STORM ' SEWER PERMITS, CONTACT ENGINEERING DEPT. CITY OF EAGAN NO 18857 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # f.~ ~ I3 To be used for SF DWG/GAR Est. Value $120,000 Date APR 5 tg41- Site Address 4067 CAMBERWELL DR N OFFICE USE ONLY Lot 14 Block 3 See/Sub. HILLS OF Parcel No. Occupancy R-3 M1 FEES Zoning PD RR=1 x Name CENTEX HOMES (Actual) Const V-N Bldg. Permit 710.00 u, Address 5929 BAKER RD (Allowable) V=N Surcharge 60.00 0 City MINNETONKA Phone 936-7833 #of stories Length 521 Plan Review 461 _ 00 R Name SAME Depth 36 SAC, City 100.00 o~ Address S.F. Total 650.00 0a SAC. MCWCC a City Phone S.F. Footprints - On Site Sewage Water Conn .660-00 ow W Name on site well Water Meter 95.00 Address MWCC System X 6 Acct. Deposit 30.00 gm City Phone City Water PRV Required SM Permit 30.00 1 hereby acknowlege that I have read this applicat' n and state that the Booster Pump SAW Surcharge .50 information is correct and omply with II applicable State of 276.00 Minnesota Statutes a -0f Eaga Ordin odes Treatment PI Signature of Permitee ___--APPROVALS Road Unit 370.00 A Building Permit is issued to: CE E1 HOMES Planner Park Ded. on the express condition that all work sh I be one in accordance with all Council applicable State of Minnesota Statutes andCity of Eagan Ordinances. Bldg. ON. Copies Building Official n TA I Vanance TOTAL 3,442.50 "o~ill, `(err#tftr #~`„of;;( rr~t nr , J ~L j rt p% lt, pagan / ~~`~P}[Pll~ Uf Q1Q rttcat~ ~-!./l mar/ Ji 1 ~o r- u ;I \ 7Ris\Cerltjkate lsiued pw=,w ro the nVu&ww=of Swaoa'306 ofthe Unlloim BaiWrng . ,"Code ceirifyzng dial at Ae bare ofiswasm d i&jtrwwe'mw i+7compfianae witk Bie"Naiiour j " N. _ . /o~duuracer of Me 00 regukftbulldiag ooasduc_t on or ase For fie folfowir _ p br v ri Us ~mn- r g Tu'x'/Gf1R &dL Po met, Nw 7* , R3/M I ~ ohma PD/RI n: d (m]..`,a" _ i. q c =Owoex8ml~ey ,dp,m 5929BAKER°tm_.: MrNNR'IY1TIIZA `-moo\.`=: ti faa~;imam%4067!'ArC'RiaFr1.DRIVE„NJR~y L14.,-B3:~ HITd:S~ORSirx~itRTnc~\~ ~ g ~i J r~ec 6/26/91 JO) &e N 06 ➢ VGA ~o 'V~;,~ biJ ii (POST MACONBRICWUS P1ACEll VA.1~~ ~~b 11 k b Address: 4067 CAMBERWELL DR N Lot 14 Blk 3 Sec/Sub HILLS OF STONEBRIDGE 2ND These items were/were not complete at the time of the final inspection. Date: JUN-25 1991 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry /y Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage I Porch L/ Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of vater supply to the outside lawn faucet before freeze potential exists. •cmEO r.wx White - City copy Yellow - Resident copy Pink - Contractor copy s DATE APR 10' 1991 RE: 4867 CAMBERWELL DR N (CENTEX HONES) X Your Sewer & Water Permit for the above property 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 ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. - CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. /008.? (0 H 66833 .W.,- ~~omo Repuest Data Flre No. h-in Inspection rayo p Ready Now Will Notify Inspector Yes ❑ No When Ready? I licensed contractor ❑ owner hereby request inspection of above electrical work at: oD Address (Street, Bar or Route No Qry d~rcL swim No Township Name or No. Range No County Occupant (PR Phore No Power Supplier Address Electrical Contra (C pany Name) ConlractorS Ucense No. T77 41 Mailing dd( s C mor or iein~g Installation) ~j SSf~3 z Authorized Sign (Cont ctor/Owner along slallatwn) Phone Number Q ti _C1 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Gllg I&MI"ay Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 5610, UNLESS PROPER INSPECTION FEE IS Phone (612) 612-0660 ENCLOSED. REOUFST FOR ELECTRICAL INSPECTION lkn• % EB-00001-0e ► .`See instruNions for gomplating this ton on book d yellow copy /OQ D 0/1 66833 "X" Below Work Covered by This Request New Add Rep. Typed Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial 'Furnace Farm Alr Conditioner Other (specity) Contractor§ Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circmts/Feeciers Fee Swimming Pool 0 to 200 Amps 0 to 700 Amps Transformers Above 200 _ Amps Above 100 _ Amps TOTAL S-~ Signs Inspectors Use Only Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY 8E ORDERED SCONNECTED IF NOT Other Fee COMPLETED WITHIN 16 MONTHS. I, the Electrical Inspector, hereby Rough-in Data certify that the above inspection has Final Date U been made. r L OFFICE USE ONLY This request wia IS months from 66$68 ~~o Regusst Date Fire No. 5"i? Inspection ❑ Ready Now Wtll Notity Inspector ❑ No When Ready? licensed contractor ❑ owner hereby request inspection of above electrical work at: Address (Sweet. Box or Route o CM 17 cz s1J Sectmn No Townslnp Name or No. Range No. Cony Occupant (P ) Phone No. Power Supplrer Address Electncal Contr (Company Name Contractor§ Uoi nre No Mailmg A ress tractor or Owner Making Installation) ~~/y AV SF z Auttpnaed Si I Con for/ r g Ilawon) Phone Number JJ YZ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Gdggs•MWwey Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 Univereity Ave., St. Paul, MN 55114 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0888 ENCLOSED, / REQUEST FOR ELECTRICAL INSPECTION t EB-a 7 - ► See mslmFeS For wmpleang thss form on bock of yellow rnpy /O 70 H 6 6 8 6 8 X" Below Work Covered by This Request 7 _0*4- 1 New Add Rep TypeofSuddmg ApphancesWired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (speaty) Contractors Remarks Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps o to 100 Amps Transformers Above 200 _ Amps Amps Signs Inspectors Use Onry TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION Mft BE EDI DIS NECTED IF NOT Other Fee COMPLETED WIT O I, the Electrical Inspector, hereby rnn,i oats, v-4 Cp certify that the above inspection has D K L been made. - 3-~ OFFICE USE ONLY This request vod to months from r yr 0 3 4 r~~13 07' ~~O Request Dare Fre No ugh-in Inspection ~y had, XReatly Now ❑ Will Nearly Inspector ' - [ 1 Yes C No When Ready' I licensed contractor owner hereby request inspection of above electrical work at. To Address (street. Boa or Route No) City i/ 5a art County Section No TownsNp Name or No Range No D~Ilo`ta Occupant( PRINT) Phone No H: iilm-4-76-at{ v;$K1-35~i1 Power Suppler ~y Address Ca") m erg Elettncal Contractor (Company Name) Contractors License No Mailing Address (Contractor or Owner Making Installation) ken Esc im67 C-ei erwellIII, Nr ~ W ti5 ! Authorized Sig Lure C itract / er Makin In Callao 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 Pl one (612) 6424800 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION - ; qqq EB-OD001-08 ► See instructions for completing this lorm on back of yellow copy 14-34-13 ' `"X" Below Work Covered by This Request. v V New Add Rep Type of Building AppllancesWired EquipmenlWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm /Industrial Furnace Farm Air Conditioner Other(speafyl Contractors Remarks a room in 6456mag7; Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Sp TOTAL i Signs Inspectors Use Only '~!RD ~./JJ I =O gaGOn Booms - (RDSpecial inspection AlarmlCommunlcahon THIS INSTALLATION MAY BE O DISCONNECTED IF NOT Other Fee COMPLETED WITHIN NT h the Electrical Inspector, hereby Rough-'n y Date -7 _ c/ certify that the above inspection has Final ~~le been made OFFICE USE ONLY Tins request void 18 months Irom 64~ 69~14/33_ a y°" Request DeceFire No oglIn section ReOuir Inspection Other Tha~n oo gM1-In pV m II i~pector when ready) El Ready Nov,4; dl Nobly Inspector Yes ❑ No Data Ready I licensed contractor downer hereby request inspection of above electrical work at: Job Atlpress IBtreet B r RaNe a) City .n0e► w 1 rr Section No Township Name or No Range No County Occupant (PRINT' Phone No orh5r- Power Supplier Adtlress Elegncal o raclor (Company Name) Contractors License No vre.e0UMe-r- Mailing/A rere/gs Connector or Owner Making Installation) AuIDOnze alure ICOnir ner abn Ratio PM1One Nu~i r MINNESOTA STATE BOARD ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave, St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 6424)600 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION eaooom-oa Sae instructions for completing this form on beck of yellow copy 'SL5 N 4669 'W" Beforv Work Covered by This Request . ew Add' Re Type of Bullding AppliancesWlred EqulpmenlWlred Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contracti Remark' ^ 1$ D!"'1 i n $M r 6.N fG Compute Inspection Fee Below pie~lcct5 IF,.^ed o 3T •3 # Other Fee # Service Entrenc Sze Fee # Ircuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Abov 100 Amps Signs Inspectors Use Only TOTAL ~0 Irrigation Booms Lc~ Special Inspection Alarm/Communication THIS INSTALLATION MAY BE SCONNECiED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rpugn-m Date certify that the above inspection has Final c, •7 been made ♦ O s~ OFFICE USE ONLY This request wid 18 months from 7 , PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: H U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 4 51 7 (651) 681-4675 Date Issued: 0 2 /12 / 9 9 SITE ADDRESS: 4067 GAM8FRWEI.I nR N LOT: 14 BLOCK: 3 HILLS OF S.iTONFBR'FOOE' PLAT 2 LO-32991-140-03 DESCRIPTION: GAS INSERT/GAS LINE 7 B 2'1. rlL Perm,i.t:: T v u e FIREPLACE puildino (~Ork Type NEW r'Census Code 434 AI-T. RESIDENTIAL 1 i ` REMARKS: CHII*INEY/FLUE MUST BE INSPECTFO BEFORP CONCEALING FEE SUMMARY: Base Fee $60.00 Surcharqe _,--~,.5"9 Total Fee $60.50 CONTRACTOR: - Applicant - 3T. LIC. OWNER: FIRESIDE CORNER INC 16331042 20090911 HORTSCH KEN #2700 N FAIRVIEW AVE 4067 CAMBERWELL OR N ' ROSEVILLE MN 55113 EAGAN MN 55123 (612) 633-1042 (651)454-7524 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with a.lt applicable State of Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE IWED BY: SIGNATORE ~Co 0,-50 a-ia 9~1999 FIREPLACE PERMIT APPLICATION CITY OF EAGAN J4~ 1`7 3830 PILOT KNOB RD - 55122 (651) 681-4675 Date: Description of Work: T Construct new fireplace Alterations to existing - Install gas insert only Install pas line only c~ Other Job address: gQ 6o / ca m b er ty e40 /.~r /`y e, Lot: '-A Block: - Subdivision/P.I.D. l lS S Applicant (circle one only): Owner ontractor Permit Fee: $60.50 Name: (l1~S 1 h Phone #:&v PROPERTY Last First OWNER Street Address: `a ~2 ea m bee /via , d~ City /,/T r] an A ~fStat"e:~ V41, Zip: is Company: I 1 Vr PS % ( Q L cl,4 Ar I"~SY' e- Phone FIREPLACE INSTALLER Street Address: City U W Cil~f rIIP State: Zip: Company: Phone GAS LINE /y /qA INSTALLER Street Address: IiL 6 r l City State: Zip: 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. LFEB IVED signature FEB I z 1999 2 1999 - 1991 BU ING PERMIT APPLICA ION, CITY OF EAGAN £ C SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL'PcIANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF-SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS' .'1 SET OF-'ENERGY CALCS OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST-`'WORKING"DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE' WHICH:,ADDI{E§S'IS DESIRED. NO CHANCES WILL BE ALLOWED ONCE 'BUILDING PERMIT "IS.ISSUED.` PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE 'A PERMIT HASBEENsCOMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. sxJ To Be Used For: Valuation: .r^ Date: Site Address OFFICE USE"ONLY sr; Lot Block FEES', Occupancy ,Bldg. Perini( Zoning Surcharge Parcel/Sub f1i`~S Si:o ra p Actual Const Plan Review,.,.,-;.. 71- Allowable 'SAC, City Owner Kdn-t?e0tb r"), art-,e--4 # of stories SAC, MWGC. ; Length 30 Water Conn -dr, 1✓m. Depth ~ ;Water'Meter:~,;.a _ Address 11067 L'ga62Pmya ~ . S.F. Total Acct. Dep'os rt' ge 4 City/Zip Code ~d_a~i'/ Footprint S. F. S%w Permit.Y?.' m4 S` ^ Sitrc Phone 12 Cr site sewage- Treatment On site well Road Unit Contractor stone MWCC System Park De City- water - Trail De Address PRV Copies. Booster Pump _ City/Zip Code SUBTOTAL' APPROVALS Penalty Phone Planner Loot Change ~ Council TOTAL` F=- Arch./Engr. Bldg. Off. ~S-rJy{ Variance Address City/Zip Code Phone # agrees that all work ,shall :be done in -accordance with (Signature of Contractor) V all applicable State of Minnesota Statutes and City of Eagan Ordinances. * * I 2422 Enterprise Drive * PIONEER LAND SURVEYORS •CIVILENGINEERS J Mendota Heights, MN 55120 engineering, LANGPLANNERS •LANDSCAPE ARCr11TECTS f6~^1 y • I~ V L 1 681.1914 Certificate of Survey for:. F- 6 0 C~Mf3~IZ►Ne~~ po9',' Q, a 3 VZ~- L ~ y i CI 61 e7n 1 . . 40 o r 1tv, CeA2. -0 1 .d 1 PC,eo ' 2y 4 t 1 1 w 6pRIosSE s \12 /•ab\- ° o t c 1 a° \ \ 1~A1 ~ 51.5 ~ 1 rap \ t ~ \ 1 ` 1 1 \ \ y 1 \ N_ s \ It e L 1 1 ~ n 1 \ N 1 c ' w N 1. \ h 1 \ 1 \ t \ 1 ` 1 ` 1 \ 1 \ \ 1 `5 pp,,Alr.Lnc,C t UTrUTY G-ASC--race i ~.8°05 iro~•W. J t-13 .Z I soo.o Denotes exisfin Elevation ` sEl~~~uf ELEVAT'ION r 9fio.o Denotes prop 'ed Flevahbrt Lowestfloor Eleva ion 88z•s7 l pates Drainage(UfiliU Fasemenf lop o,nBlock Elevation eiazo Denotes Drain ~e Flow Arrows Gara eSlob Elevation 890•oa Denof-es monumen-f o Deno es Ott. set Nub Bearings Shown are assumed Su~ecl to E-asernerlfs 01 11'RPcord LOT 14 9 BLOU 3 -14I LLS OF STONEBRIOGE PLAT 2 DAKOTA COUNTY I hereby certify that this survey, plan or report was prep/jya(red by me r under I direct supervision and drat I nm duly neglstemd Land Surveyor under the laws of the State of Minnesota. Dated this ~iKyay of A,D. 19 Ire V: g/0) DIFP Hxmse /{E✓ 4l3191 y1D I I Tb FrA2- '2 5c~le ` I H- 4' 'i '30117•lr n C1FRrR,SnurI11.5 pE..rK1.tnA7l 1991 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY•IAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH~ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED'.- PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: PaiNy'„ mGn~ Valuation: wmwm~ Date: Site Address uD~ y ~gmkorwe))dt OFFICE USE ONLY id L Lot Block 3 $ Occupancy Bldg. Permit )Zoning Surcharge Parcel/Sub Wb'- e4 Actual Const Plan Review y Allowable SAC, City Owner ✓1 77 Z7 4 6A*4 # of stories SAC, MWCC 1I / Length Water Conn. Address Al, Depth Water Meter S.F. Total Acct. Deposit. City/Zip Code F_,ta&O, ~K7ot Footprint S.F. S/w Permit S/W Surcharge Phone y; ])7i~ Qri~ On site sewage- Treatment Pl. On site well Road Unit Contractor MWCC System Park Ded. City water Trail Ded. Address PRV Copies Booster Pump City/Zip Code - SUBTOTAL APPROVALS Penalty Phone - Planner Lot .Change Council TOTAL Arch./Engr. - Bldg. Off. Variance Address City/Zip Code Phone # Sewer/Water Licensed Contr. agrees that all work shall be done in accordance with jliyyl, p aCovntEractorl (Signatu e o all applicable State of Minnesota Statutes and City of Eagan Ordinances. 2., CITY USE ONLY L ~ BL ✓ 1/~ e I _ RECEIPT I f5 SUBD. plot a RECEIPT DATE: -01 PERMIT # `I - q-7 1999 PLUM$INex PERmrr (RESIDENTIAL) CITY OF £AGAN 3630 PILOT KNOB RD EAGAN, fAN 55122 (651) 681-4675 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backflow preventer for underground sprinkler system FIXTURES j~-4-"EACtti it TOTAL Bath tub $ 3.00 x = $ 0 Vol Floor drain 3.00 x = $ Gas piping outlet ' minimum -1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund ra 3.00 x = $ vator • 3.00 x = Minimum fee alterations to existing dwelling 30.00 x = $ Private Di al System new/refurbished *requires MPC tic. 75.00 x = $ e Dis osal System abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground srinkler if dwelling is under construction 3.00 x = $ Underground srinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x = $ State Surcharge .50 > > $ 50 Total > S Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. - I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: IC~wt~e~~ 11 eQSi4r~ ttiLt^ S5ta3 MM ~ OWNER NAME:: 7'~v~Y~ Noc~}k TELEPHONE #:5/45 y` 7Say (AREA CODE) L INSTALLER NAME: ~~YL^LCr l L) N i TELEPHONE (AREA 6/;) -D-/3a- ' ~e STREETADDRESS: I3[o)~ ` ~Y1 17 ~r CITY: C Y~ UI IrEj r,, rn r, STA E: ZIP: SS3 37 AUG 2 41999 I'~ 3 A I SIGN URE OF PERMITT E 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 C➢ (651) 681-4676 b() . S New Construction Requirements Remodei/Reoair Requirements • 3 registered site surveys • 2 copies of plan ♦ 2 copies of plans (include beam & window saes; poured fnd design; etc.) ♦ 1 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for treated additions ♦ 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No DATE: g I/0h CONSTRUCTION COST: DESCRIPTION OF WORK: 1"Tn?sh Aocemenf STREET ADDRESS: d 6 -7 C (Id-MhCV-Wej1 O r, `N I'lol c n LOT: I 1 BLOCK: SUBD./P.I. D. Yri C S \ V ~L/~ c3> 1 / 17 1 Name: #0r1s(~1 /Gnrle-t1i Phone PROPERTY Last First OWNER ~ r Street Address:-640b 7 /n~ f d,,h b e, .re /l D r. /y . City State: &19-- Zip: .3 Company: Nlf} L5Q1t -Anr, Ror Phone CONTRACTOR Street Address: License # Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address ctvgrige 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 Stath of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: 61. >~'12Z-" ~ ~7 OFFICE USE ONLY Certificates of Survey Received Yes No AM 2 ~ III IJ11111_ _ Tree Preservation Plan Received Yes No Not Required I OFFICE USE ONLY BUILDING PERMIT TYPE t 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 = plex ❑ 15 Deck WORK TYPE ❑ 31, New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) 5 Basement sq. ft. Census Code A./ (Allowable) - Main level sq. ft. SAC Code ` / UBC Occupancy iz 3 sq. ft. Census Units / Zoning sq. ft. Census Bldg d # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV APPROVALS Fire Sprinklered Planning Building ~/?n l_., A2 s Engineering Variance Permit Fee ~Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. R Other Copies Total: % SAC SAC Units CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # a 9 PHONE: (612) 454-8100 RECEIPT # ~O m WA DATE: 9O $TA`SATr; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00° GAS OUTLETS - MINIMUM 3.00' OWNER NAME: OF 1 PER PERMIT fo'` G/ SUBTOTAL: $ SITE ADDRESS:- 7 r ~r/L'lc STATE SURCHARGE: .50 LOT: BLOCK SUBD./~[ a `v TOTAL: S 3' INSTALLER: RAY N. WELTER WREAATING CO- ADDRESS: 4837 Chicago AVG. SO. SIGNATURE OF PERMITq^`E CITY: ZIP: PHONE US Z ' 4#LI4EICTFfITbt~511AY PLEASE 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: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # D 3 p(Bti((j } DATE: SN'S/%y PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL dEW C ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 O U REPAIR WATER CLOSET 3.00 410 U BATH TUB 3.00 LAVATORY 3.00 ~7rCJ OWNER NAME: KITCHEN SINK 3.00-DEC ~P LAUNDRY TRAY 3.00 J U v SITE ADDRESS: 17 HOT TUB/SPA 3.00 / WATER HEATER 3.00 LOT: BLOCK,.-'-'SUBD. FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: GGENZ-RYAN PLUMBING & HEATING COMPANY (MINIMUM - 1) 3.00 3~0 ROUGH OPENINGS 1.500 ADDRESS: 14745 South Robert Trail OTHER _ _ WATER SOFTENER 5.00 CITY: Rosemount ZIP: 55068 PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 PHONE 423-1144 SUBTOTAL $ 56 ST. SURCHARGE .50 SIGNATUR F PERMITTEE $ TOTAL: QMME$GIA£fINDiiSTRIW PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN RESIDENTIAL BUILDING PERMIT APPLICATION I CITY OF EAGAN I L{ ~j , r f 3830 PILOT KNOB RD, EAGA AGAN MN 55122 651-681.4675 CQ n New Construction Reaulremems RemodelfRemir Reoulmeents ik_X_A-eJ • 3 registered site surveys slowing sq. ft. of let, sq, ft. of house; and IQ roofed areas • 2 copies of plan ~n - (20% maximum lot coverage allowed) • 1 set of Energy Cab dons for healed additions • 2 copies of plan showing beam & wndow saes: poured found desgn, etc.) • 1 site survey for exterior add'it'ion & decks 1 set of Energy Calculations . Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detetad options selection sheet (bldgs with 3 or lass unds) DATE VALUATION 7 4 d- SITE ADDRESS L~ U G t=Q O r' y(_ ULTI-FAMILY BLDG _ Y / N TYPE OF WORK A 00,-i f an (h4eQ. 1 FIREPLACQS),:S~0 _ 1 _ 2 APPLICANT STREET ADDRESS:~Z 9 ( 0 AL Z-\,T "Li IN ky CITY T- Cr- N STAWE ZIP S S 6-7 TELEPHONE #GS9l it CELL PHONE#6'3I-L/(j).- 9 y 6 {1 FAX# 617 'mil I ~l 1 PROPERTYOWNER A Mn,- c4- V-f ~ ~4 u r S c- P\, TELEPHONE# 6S I s`1-7r-1- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MIN 1;E~7fii92: _ ~~°~t (J submission type) • Residential ventilation Category 1 Worksheet Submitted • Ne bvdFl sheet Submilted ti. • Energy Envelope Calculations Submitted ` MAY 244zuu,Z jj: Plumbing Contractor: LIl Plumbing system includes: - Water Softener _ Lawn Sprinkler Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinance . Signature of Applicant ..06 OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ updated 4102 OFFICE USE ONLY o~ . ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) X31 EA. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage x 22 Porch/Addn. (4-sea.) ❑ 33 EM. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg-y or _ N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding J`t 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)' ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation ile 15'y, Occupancy R -3 MC/ES System Census Code h 3y Zoning City Water SAC Units Stories Booster Pump Nbr. of Units - Sq. Ft. PRV Nbr. of Bldgs - Length ~G Fire Sprinklered Type of Const 1//// Width 3 S REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) Final/No C.O. Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof X Ice & Water Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco _ Stone _ Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) Insulation - Retaining Wall Approved By Building Inspector cc Base Fee - 3 ---37-------- V -T/ Surcharge 3 i • ~ FI AU T/,;v 5 yr5142~ 9 9 48 r Plan Review L+_1 1 . ~ v~l , v,S,tRV q CJA~IRf%~J~~~-~,r168 MC/ES SAC lbeplZ City SAC 6 q 7F,2 Water Supply & Storage 0` S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 2-t I . ZO'd -biol r' I _ MNcheck COMPLIANCE REPORT Minnesota Energy Code I -Permit # - MNcheck Software Version 3.0 I Checked by/Date I COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 5-23-2002 PROJECT INFORMATION: ANN AND KEN HORTCH COMPANY INFORMATION: TUTEWOHL HOMES COMPLIANCE: PASSES Required UA = 472 Your Home = 344 27.1% Better Than Code Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U--Value CEILINGS: Raised Truss 2138 44.0 36.0 WALLS: Wood Frame, 16" O.C. 2952 19.0 2.0 1 BSMT: Cont. 8.0' ht/7.0' bg/8.0' insul 992 11.0 2.0 GLAZING: Windows or Doors, Above Grade 235 0.350 DOORS 52 0.350 I COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. Builder/Designer G4U~raLD Date - ZO/ZO'd ST:9S ZOOZ-£Z-Abw * p~~Ep 2422 Enterprise Drive LANB eURVEYORB•CI VIL ENGINEERS Mendota Heigh ts, MN 55120 eng*eerng.• LANOPLgNNERS•LANOECgPEgRCHITECT3 * 1612) 681.1914 Certificate of Survey~Jfor:.__LENre s d• 16•y~ e m yll° I i 6M ~ ~ ` 'r+ nh ` yr I v rt° b 4~ tt &AK a `11 d p Ia'seo y 4 I 3+ t 9• P PR1,~O,~.S6 ~1 1,01:1 w 1 e $ 1 C 1 ;o ~ ~ 1 t `ge9• 1 1 ` 1 , I , 1 ~ 1 ~ L ~ '1 11`, ~ $s l ,1 CO % $ r{'• + \ 1 > i 1 I ` 1 .1 1 1 , DP.41MAGG U11LITy LgseMCNT 1.73.21 - . §00.0 Denoles exislin j Elevt tion PE vsE s EvAr rQ 9170. Dendles pro ed Flevahbrt _ P. Lower Foor eva on b~nolps Ora►na e { Ufili~ Easement . Top of elock Elevation e.gw Denotes Oraincle Flow Orrows Car* Slab Elevation Bo.o; Venter monument d DenoTees OtTsel Nub &vrir jW shown are assumed Sued to Easemerlfs ol'Recaird LOT 14, SLOCIe 3 , HILLS ote STONEBRIDCE PLA-r 2 041407-A COUNrV I hereby certify that this survey, plan or report was prep ad by me r under under the laws of the State of Minnesota. Dated this2 direct sups lsion and that I em duly Registered Land Surveyor l~✓ glib OIFP y"Z ayof~n.0.19 . Rs✓ 41.3/9/ AP 4'T-0 6AR. ~ 46 a I ~~i7 • ~0 R BERT B. SIHI H L. . RE . NO. 14691 1991 BUI! I PERM T 1ALICATION ~~C CITY Of EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS OF RENTAL UNITS OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING RMIT I I SUE PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE P b. PERMIT MUST SHOW A LICENSED PLUMBER. 3 To Be Used For: S;rz) AWL Valuation: Da Site Address (22D OFFICE ' Lot Block J FEES H 4 Occupancy 3 M_1 Bldg. Permit iC) ILK'S O F ?"~j Zoning R- Surcharge AD Parcel/SuVL Actual Const Plan Review 4 1. Allowable V- IJ SAC, City 100,00 Owner # of stories SAC, MWCC (o $O,0 Length Water Conn. 6 100 Address Depth- Water Meter 95)0G~ / S.F. Total Acct. Deposit 30,CO City/Zip Code G N Footprint S.F. S/w Permit 30,C)o S/W Surcharge 15D Phone / - 7 833 On site sewage- Treatment Pl. 2 (o,OC7 On site well Road Unit 3~ D.DO Contractor MWCC System :2-7 Park Ded. City water ✓ Trail Ded. Address PRV Copies Booster Pump City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner Lot Change Council TOTAL S Arch./Engr. /4.c1t~/-® tt 6 Bldg. Off. pS Variance Address ~Q/f City/Zip Code //ale. vj El Phone # ,zz agrees that all work shall be done in accordance with -~-~7 (Signat of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. AT 1% vi GARA61E ' 2'Z L e 4%4 X IS= 72-iv0 BSMT', 3o~c30 =900 ! 2 ~ (a Z ~i72 X 14 = 13 608 - Isr SSMT= cj7- '710.00+ $'u2= 1}(0 I% 60.00+ 461-00+ 9~8 K 03 523(0/-1 2211.50+ 3,442.50* Ztio F~~~ 5 2s,6~ x 30 ~ K12~ 2- $1c,;3 4 ~l ~Z4 q z I I'185~ 0 2 1 I r7 Oaa Li C;~,a A bD, 0 -1 13 I IGt 17~ vK Ec~ a o COMM. NO. Planning Design Inc.. 1611 Highway 10 N.E. 11i nneapol i s, NN 55432 612-780-1920 Minnesota Slate Energy Code Calculations Dascd on Chapter 5 of the Model Energy Code 1983 Edition Adapted 1/1/84 Owner: MOREL #740 COMM. NO, Site Address. P _ Contractor: Phone: Bldg. Class: Al Al for Single Family/Duplex. A2, residential < 3 stories Over 3 stories Other 'vENERAL INFORMATION Note: The section designations ("Section A", "Section B" etc.) are for convenience in calculations only, and are not related from one SeL of calculations below to the next. 1. Bldg. Walls Perimeter x. Wall heights, = Area ground to eave Section A i52 18.58 = 2452.56 Section L{ O U = 0 Section C O 0 = 0 Section D O 0 = O Gross Wall Area - 2452.56 2. Building dimensions Floor or Ceiling Length x Width = Area Section A : 12 6 = 72 Section B : 30 4 = 120 Section C : 30 26 = 780 Section D : 0 0 0 Total floor or ceiling area 972 3. Rim Joist'Perimeter = 132 Floor, joist 2 by (8", 10", 12" or 16")): 10 Rim Joist Area = 110 4. Doors Area. 43.8 Thickness (inches): 0 Perimeter (feet): 0 ?ype of construction: 5. Total door', perimeter: 0 h. Wi f11ln4!5 Marjui:acturor- : WEATHERSHIELD U far.tor: 0.47 State approved: YES" Type Height x Length x Number = Total. (inches) (Inches) 6f glass SgFt uni is BSNT. UNIT 14 27 3 7.88 DBL. HUNG 28 20 4 15.56 20 24 2 6.67 28 28 34 185.11• ROUNDTOP 15 15 1 1.56 0 0 0 0 0 0 O 0 O O O O 0 0 0 0 0 0 0 O 0 0 0 0 0 0 0 0 0 0 0 0 7. Window glass area (SgFt) = 216.78 Type Height x Length x Number = Total (feet) (feet) units SgFt S. Patio Door: O 0 0 0 Atrium: 6.85 2.6 1 17.61 10. Fireplace area 'Width: ' 0 Height: 0 Total Sq Ft = 0 11. Exposed Foundation Height area A: 0.67 Perimeter area A: 132 Sq Ft area A 88.44 Exposed Foundation Height area 8: 0 Perimeter area B: 0 Sq Ft area P = 0 12. SgFt U factor U x A Gross wall area 2452.56 minus Window area 216.78 0.47 101.39 Patio door area 0 0 0 Atrium area 17.61 0.47 8.37 Rim'joist area 110 0.035 3.85 Door area 43.8 0.14 6.13 Fireplace area 0 0 0 Exposed Found. 88.44 0.14 12.33 Framing area 245.253 0.069 16.92 equal Totals for not wall: 1730.4-4 0.037 64.17, 7 Totals for gross wall area: 213.57 Framing area is lei; of gross wall area 10. Gross wall area x factor below = U x A per code Factor is .11 for A-1 single family & duplex .23 for A-2 and other residential .23 for other buildings .23 for over Z stories Factor is 0,11 BTUI = 2:6'.'•.7316 MUST BE > O _ 213.5,17 (calculated above) 14. Gross coiling area = 972 15. Ceiling framing area (10% of ceiling area) = 97,2 16. Joist Area (10% of ceiling area) = 97,2 17. Net ceiling area (Gross veil. area - Joist area) = 874.8 18. U ceiling; 0.021 x Net ceil, area = 18.3708 19. U framing: 0.024 x Joist area = 2.3326 20. Total of item 18 x item 19 = 20,70.?6 21, Gross ceiling area factor below = U r• A per code Factor is .026 for A-1 single family & duplex .0333 for A-2 and other residential .06 for other buildings Factor is: 0.026 BTUH = 25.272 MUST BE > OR = 20.7036 (calculated above) U VALUE CALCULATIONS X 6 / HIGH "R' SHEATHING R VALUE U YAt.Uf•; Inside air film .68 WALL Interior wall .45 (Wall) U = 1 = SECTION Insulation 19.00 R Sheathing 6.0 x037 Siding .67 Outside air film .17 J~ R TOM 26.97 tit Inside air film .68 STUD Interior wall .45 SECTION Stud - G ' 6.50. (Fraoung) U = 1 = Sheathing 6.0 R Siding .67 .069 Outside air film .17 R TOTAL 1447 Interior air film .68 RIM Insulation 19.00 JOIST 1 h inch soft wood 1.84 (Rim Joist) U = 1. _ Sheathing 6.0 .R Exterior wall-covering .67 .035, Exterior air film .17 R TOTAL 28.4 _ Interior air film .68 Insulation 5.00 PDN. Foundation (12 " Block) 1.28 (Foundation) U = 1 = Exterior air film .17 R R TOTAL 7.13 .14 v ti' CEILING WITH VENIEQ ATTIC SPACE ABOVE R VALUE R VALUE FRAMING CEILING 0.61 Air Film 0.61 36.00 Insulation 44.00 4.38 Joist / .56 Ceiling .56 i 0.61 Air Film 0.61 41.55 Total R 45.78 .024 U = R .021 CATO MAL CEILING R VALUE R VALUE FRAMING CEILING 0.61 Inside air film 0.61- . _56 Ceiling .56 14375 Joist(Spacer Insulation 33.85 Air Space .50 .67 Roof decking .67 .06 Felt .06 .44 Shingle .44 0.17 Outside air film 0.17 16.88 Total R 36.86 .059 R = U .027 Window infiltration .5 cfmAllineal foot of crack Residential door infiltration 0.5 cfm/aquare foot or door and minimum code requirement Non-residential door infiltration 11_0 cWlineal foot of crack Ub 12• concrete block no insulation = .781 R 1.28 double glass = .52 triple 91ass = 31 All exterior walls and Ceilings must have a vapor barrier (0.10) perm max.). Vapor barrier must be on the inside (heated side) of wall. Vapor bariers of the PolYethelene thin film have no R value. ° 2422 Enterprise Drive PIC~NEEf=f LANDSYpVEYOp6•CIVILENGrNEXERS Mendota Heights , MN 55120 *enC~*eering.. LgNDPLANNERB•LgND9(:APEARCHITEcTs # 16121681-1914 Certificate of Survey for% t 'EN / C,>e ~~JC a CAMWMI-LL P \ N A ` V1 \ P~ Of b ° nN 1 y ~a~,eo at yty4 't 3' 1 O p ~,yE a.t,.ol.\ 1 qa. 515 t 14 t \ i \ I 1 I + 1 + I 1 1 it W i \ m o .p 1 \ 1d 1 ` is ~ ;rte VA ~ 'a ~ ~'~a Ls:.t V pRJU9Ac.t- t VIILJ rY r•r~uT ~f.b°o5 fb°W. 1 . . 960.0 Denotes exiAq Elevalion Ppoposm ~E r L 'A r 9i7o.o Denotes ProPdged Flevabbin l ~'I~TL tdN ~owe~ Fooreve Denotes Draind e '(Jfilr~ Easement Top Of dock Bova fion oao - -Denotes Drain C~NOW Arrows Cara l Jrhh Elevation 090.0p D denotes monument 1] OenoTef OtI sel Nub trin 9 shown are assumed Su Jed to Easements of Retard LOT 14, SLOCk 3 ,HILLS OF' STONEBRIDCE PLAT' 2 DAKOTA C6VNTY I hereby certify that this survey, plan or report was pre ad by me r under A.D. direct sup isio , n and that I am duly Registered Land Surveyor under the levee of the State of Minnesota. Dated thisay of rr PV' fIllyl .l 0-4t sa 78 Rs✓ 091 AD 4 t rW 64R. g0117. 00 R BERT S. SIKI H L. , RE . NO.14891 . 922865 HILLS OF STONEBRIDGE PLAT 2 INGRESS AND EGRESS EASEMENT IN CONNECTION WITH PRIVATE PROJECT 489-FF This easement, made this /~;7#day of a'cTo O'=/< 1989, between UNITED MORTGAGE CORPORATION, a Minnesota corporation, herein referred to as "Landowner" and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota, hereinafter referred to as the "CITY". W I T N E S S E T H: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its employees, agents or contractors, permanent easements for ingress and egress purposes, over, across and under the following described premises, situated within Dakota County, Minnesota, to-wit: Permanent easements for maintenance, inspection and operation purposes over, under and across Lots 14 and 15, block 3, HILLS OF STONEBRIDGE PLAT 2, according to the recorded plat thereof, said easements described as follows: A 20.00 foot wide easement for access purposes over the southerly 10.00 feet of Lot 15 and the northerly 10.00 feet of Lot 14, Block 3, Hills of Stonebridge Plat 2 as platted and of record in the office of the County Recorder, Dakota County, Minnesota. See also Exhibit "A" attached hereto and incorporated herein. This permanent easement for ingress and egress purposes is to permit City personnel and equipment to use this easement for the purpose of utility maintenance, inspection and operation. No obstructions such as trees, shrubs, fences, buildings, gardens, etc. will be permitted to occupy this easement. Any costs incurred for removal of any obstructions for access usage by the City will be the financial responsibility of the individual lot owner. The Landowner, its heirs and assigns, does covenant with the City, its successors and assigns, that it is the owner of the premises aforesaid and has good right to grant and convey the easement herein to the City. IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as of the day and year first above written. UNITED MORTGAGE CORPORATION B . Its: a~ By_: Its STATE OF MINNESOTA ) &4-rA ) ss. COUNTY OF On this It-Al day of (~CTl~t3t~ 1989, before me a No ary Public wixxhin and for said County, personally appeared L CA 100 C.. kW2 64---4 -ftnd to me persotjallynown, who being y me my sworn, etiaek did say that - "-a °^t ° the ! C t ~Sll1t1~1 i and of the Corporation named in the foregoing instrument, - ZZ-47-h-E. t9 instrumen i the eerperate of said ee eratic., and that said instrument was signed ftnd seele on behalf of said co~ oration by authority of its Board of Directors and said vie-e- 1 I4l AIr aak- acknowledged said instrument to be the free act and deed of the corporation. DENISE J KOENCK W, e°~bw. 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W L~'biT APPROVED AS TO CONTENT: Public'Works Department Date: (Q- 19 -g~ THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, WILCOX & SHELDON, P.A. 7300 West 147th Street P.O. Box 24329 Apple Valley, MN 55124 MGDJkp 32-3136 PERMIT#~- RECEIPT DATE: 8008 RESIDENTIAL PLUMBING PERMIT APPLICATION cPPY OF EAG" 3$30 PII.OT KNOB RD gASAN, MN 65128 651-661,4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEADDRESS: 4062 fo _j C eymbe Itile V )1/ OWNER NAME:: kJpi" /SGGj TELEPHONE 651 ~I S ' 75 (AREA CODE) INSTALLER NAME: TELEPHONE M (AREA CODE) STREET ADDRESS: CITY: STATE: ZIP: _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODDIIF~ICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: V "Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 Abandonment of septic system. Water turnaround - existing dwelling ~unit 5/8" meter if needed - $118) Other: a~ c n ~c~ .gin YVyU,c~ Y6(M RPZ: new installation/repair/rebuild $ 30.00 lawn irrigation system Replacementladditional: _ water softener _ water heater $ 15.00 State Surcharge ^n $ .50 Total AUG 0 9 2002 $ S. I hereby acknowledge that I have read this application, state that the information is correct, and agr~gg com I of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liabik*V. or n d gesraus the Cityduring its normal n operational and maintenance activities to the facilities constructed under this permit within i prpgt-of a yfeas nt. SIG ~ATURREE OF PERMITTEE 1102 RESIDENTIAL C,1o BUILDING PERMIT APPLICATION 1 CITY OF EAGAN / I. 7 r 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Owstnntion Requirements RemodeliRmir Requirements • 3 registered site surveys showing sq. It of lot sq. ft of house; and pll roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, eta) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) yry DATE I - ~ 1 - 0 2- VALUATION a 40 `I V J SITE ADDRESS C/ U 6 -7 C r .v MULTI-FAMILY BLDG _Y _N TYPE OF WORK (k- e- 5 r~-c OL 0 0,1 ,1 f2- Ro k i e y FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT /`A i cL . ` 2 vl~l H e, r t L STREET ADDRESS '"rte t `4ct CITY STATEMN ZIP S_SUD TELEPHONE # 91 J CELL PHONE # o` FAX # L S f' 6e 7-- 711/ 65 (-6~~-glHt 651-Lto)L-9766 PROPERTY OWNER Ice- I-} o r TELEPHONE # 1` y - 7 1 l c/ COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener - Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: Air Conditioning fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan O in ces. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 r•S PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date ~ l J Site Address A109 7 L/~key er we dr g ND, Unit # Property Owner &6,sjP~-A 6r 11,Ae,~ Telephone # (651) ys~/ -7 ~a~ Contractor Address City State Zip Telephone # ( ) The Applicant is Owner Contractor Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes Countyfee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 - Adding fixtures to lower levels or room additions, excluding water softener and water heater - Abandonment of septic system _ Water tumaround 5/8" meter if n eded - $121.00) Other: /7fOVi~✓~/I1 RPZ _ new installation _ repair _ rebuild $ 30.00 Lawn irrigation system Water softener _ Water heater $ 15.00 replacement _ additional State Surcharge $ .50 Total $ 5 0 - Sz I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance With the approved plan in the case' Iof work which requires a review and approval of plans. I~a/1h e/ h 6, ~Oi'SG/ Applicant's Printed Name Applicant's Signature RESIDENTIAL BUILDING 7Y 5 ✓f gO~' Permit Application City Of Eagan Ir /03 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 NewConstruction Reauirements Remodel/Repair Reauirements Office Use Only 3 registered she surveys shomng sq. R of lot sq. it of house; and gll roofed areas 2 copies of plan -Carl of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing bum & window size",; poured found design, etc. 1 site surrey for addiilons & dedcs _ Tree Pres Not Reqd 1 set of Energy Calculations Addition -indreatelawitesq*system - On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711!93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date , i A/0, Construction Cost Site Address 4er~ (Lill pr e/l d, Unit/Ste # Description of Work L n <4 `/CXJY2 qn'"fe~ze 2 ka'rCyi ; Multi-Family Bldg -Y Y N / ~Fireplace(s) 0 _ 1 - 2 (651) ~~y -~~a~ Property Owner kern Telephone # Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 - Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone ) Mechanical Contractor Telephone ) Sewer/Water Contractor Telephone # n - I' FEB 0 5 20 I hereby apply for a Residential Building Permit and acknowledge that the infonn is complete and urate; that the work will be in conformance with the ordinances and codes of the City Eagan and the State f MN Statutes; I understand this is not a permit, but only an application for a permit, and out 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. - Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex 31- 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 EM. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or- N .iaCi 25 Miscellaneous Work Types ❑ 31 New 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)' ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy A-3 MC/ES System Census Code _ Lf 3'Y Zoning 100 City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. 7r (O PRV Nbr. of Bldgs Length Fire Sprinklered D Type of Const V/t/ Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. - Footings (deck) Final/No C.O. Footings (addition) Plumbing _ Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final Pool _ Figs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco _ Stone Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement) Insulation _ Retaining Wall Approved By Building Inspector Base Fee -d-L 5-/O e (9 /O Surcharge S7 fr ~l 00 Plan Review (Diiyl- 1311Tw"ll ra MC/ES SAC ¢ viv r jv SJSVZ~ City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Use BLUE or BLACK Ink r----- For Office Use j non - z Permit City of Ea I - I d R I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff. I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: A 7-~ 1- 0 Site Address: LI C0.^,, b 2r Or . M`j ri- \ Tenant: Suite M RESIDENT/ OWNER Name: ~C Cti rt, Phone: i,'/ S Ll J ~>r L 0 f Address / City / Zip. Ll b► 6' C u- l3 All I-- e L L or Applicant is: Owner Contractor TYPE OF WORK Description of work: 0-e P,---L- ti" ^•~v `~'S s ~i J+-7 ct.`(- '7-e Construction Cost: J ,j Multi-Family Building: (Yes / No CONTRACTOR License Address: 9 L, v- 0. r JL j C-r City: d^ r~ y 1 Stater A- v- Zip: 5'12- Phone:(-., S Lt 0 9 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? i~ _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plain in the case of work which requires a review and approval of plans. X x L)6z~ Applicants Printed Name Ap cant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA169567 Date Issued:06/01/2021 Permit Category:ePermit Site Address: 4067 Camberwell Dr N Lot:14 Block: 3 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-03-140 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. We encourage you to retain an electronic copy of photos until the project passes a final inspection. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any 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 - Kenneth G & Ann C Hortsch 4067 Camberwell Dr N Saint Paul MN 55123--392 (651) 236-7064 Hail Pro Llc 211 River Ridge Circle, Suite 105 Burnsville MN 55337 (952) 567-0676 Applicant/Permitee: Signature Issued By: Signature