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4064 Camberwell Dr N INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: 373 3-6Z PERMIT SUBTYPE: TYPE OF WORK: )NSPECTJON TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. i i i,i1 i` t 1tt1:FI i Pli' i t'l i.t'14i&fdF~ 1 ! l i ~ flail rl~ !,!t ¢k r Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC L,2 Q ELECTRIC Inspection Date Insp. Comments Footings I I-X /,j1 r Foundation AX W s Framing / n ISAV- 151 Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr.IPlan n Bldg. Final _ rY°°~~l Uzi I r+': .:•c ° ~'a.r'f 11.1 i . . G fa.i7 nVoffin'L fem Deck Final Well Pr. Disp. ~i • i cite of ca0an ]9v, j t>r#au,w of Adwi ng 3mvgrttmt This Cerufwate issued pursuant to the requirements of Section 306 of tine Usuform Building Code certifying that at the time of issuance this structure in compliance with the various ordinances of the City reguWng building consmrcuou or use. For the following: vx chliflowm SF D4/J,G~/GAR ~t r~ 1 ` 3 O=T*--y Type R-3/ Ml Zoning Dbtria PD/11 TYPI ,t VN Owner of SU"Wg THE RpTMW CO III' AM. 5201 E RIVER RD, FRIDLEY AIM&L DRIVE ~;ry L27, B1, HILLS OF SI»DGE 2ND 4064 03/16/92 POST IN A CONSPICUOUS PLACE 4 ~`1 CITY OF EAGAN 30 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 X8 r PHONE: 681-4675 c BUILDING PERMIT Receipt # To be used for SF DIX/GAR Est. Value X159, 000 Date DEC 30 19-9 L_ Site Address 4064 CAMiBEKWELL DR N OFFICE USE ONLY Lot 27 Block i Sec/Sub. HILLS OF FEES Parcel No. STON R G ND Occupancy R-3 jl~- 1 846.00 Zoning PO R-•1 Bldg. Permit Name THE ROTTLUND CO INC (Actual) Const V -N Surcharge 79.50 lu Address 5201 E RIVER RD (Allowable) Purr Review 550.00 Citl FRIDLEY MN p 55421 Leng Stories ~ Z 60 License SAC, City 100.00 Phone 571-0304 Depth 16-1 Name SAME S.F. Total 650.00 SAC, MCWCC S.F. Footprints q Address On Site Sewage Water Conn 660.00 A Ci zip On Site Well Water Meter 95.00 MWCC System 30.00 Phone ~ Acct. Deposit City Water 30.00 ` LICeI1S@ # PRV Required SM/ Permit I hereby acknowlege that I have read this application and state that the Booster Pump S!W Surcharge 450 :j information is correct and agree to comply with all applicable State of 276. Q0 Minnesota Statutes and.CAy of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit 370.00 A Building Permit is issued to: THE ROTTL'UND CO IK Planner Park Ded. 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 Building Official Variance TOTAL 3.688.50 _a. Permit No, ermit Holder ``Date Telephone # PLUMBING WAC ~x I ,Yv - ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing //17 Roofing Rough Plbg. Z2- Rough Htg. - Isui. /.z. z aJ Fireplace f Final Htg. Orsat Test s Final Pibg. 7V7 72 Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pr. Disp. r?j„y7 SEWER & wA . , . _ _ _ , TERPERAMT OFFICE USE ONLY CITY OF EAGAN METER # D r ,"D PERMIT DATE 01106192 3830 Pilot Knob Rd. - Eagan, MN 55122-1897 CHIP # C1 ZO~ PERMIT # 12478 METER SIZE RECEIPT # DATE 12-17-91 ISSUE DATE B.P. RECEIPT DATE 12/30/ 91 - PRV BOOSTER PUMP SITE ADDRESS 4064 Carnberwel 7. Drive N- PERMIT REQUESTED LOT 27 BLOCK I SEC/SUB Hi21s C)-Ston&hr~elq~ a y - SEWER X WATER TAPS APPLICANT: Irlho Roti-i rind CO lnrr ADDRESS: 5201 E River Road COMM/IND PRESIDENTIAL CITY, STATE Fri r]l ey, Mn. ZIP 55421 X NEW - EXISTING PHONE: 571-0304 Lawn Sprinkler Meters are to be Installed PLUMBER: Valley Plumbing Ahead of Domestic Meters on Water Line. ADDRESS: 610 Creel Lane Credit WILL NOT be given for Deduct Meters. CITY, STATE Jordan, Mn. ZIP 55&52 T PHONE: 492-2121 I I AGREE TO COMPL ITH CITY OF OWNER: The Rot-tltnd Cld ~ Tnr.- EAGAN ORDINANCES ADDRESS: 5201 E River Read CITY, STATE Fridley, Mn. ZIP 55421 PHQ,NE: 571-0304 GNATURE WHEN M ER ISSUED PLEAS04LO~ff TWO WORKING DAYS FOR PROCESSING. GALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. l SEWER & VYATER' PERMIT OFFICE USE ONLY CITY OF-EAGAN METER # PERMIT DATE 01/06/92 3834 Pilot Knob Rd, Eagan, MN 55122-1897 CHIP # Pt=KNIT # 128 METER SIZE B.P. RECEIPT DATE 12-19-9r1 ISSUE DATE B.P. RECEIPT DATE 12/301 91 PRV _ BOOSTER PUMP SITE ADDRESS 4064 Camberwal 1 r),- ' ye N PERMIT REQUESTED n. LOT.22_BLOCK I SEC/SUB 2-X- SEWER X WATER - TAPS APPLICANT: The Rgt :1U Co. 1=,Es COMM/IND _ RESIDENTIAL ADDRESS: 5201 2- Riixar, a-ad CITY, STATE Fc4d1ey. ZIP 5542" X NEW EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: Va11 eft P1_ shi na Ahead of Domestic Meters on Water Line. ADDRESS: 610 Ciaet `Lane Credit WILL NOT be given for Deduct Meters. CITY, STATE Jordan, Mn. ZIP 55452 PHONE: 493-2121 I! ATA-Iel GREE TO COMPL` ITH CITY OF OWNER: The Rot * 1 unr1 Co !PC EAGAN ORDINANCES ADDRESS: 5201 2- River Road CITY, STATE Fridley, Mn. ZIP 55421 w PHONE: 571-0304 SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. Address:4064 TELL DRIVE NDR1S-otU Blk 1 Sec/SubHILLS OF S1ONEBRIDGE 2ND These items were/were not complete at the time of the final nspection. Date: 03/16/92 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck 404 C O / Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. ~cm[oarte White - City copy Yellow - Resident copy Pink - Contractor copy CITY OF EAGAN 3 8 " 3 0 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Np 19993 PHONE: 681-4675 ! BUILDING PERMIT - Receipt# 0, o t )fa To be used for SF DWG/GAR Est. Value $159,00 0 Date DF.C. 30 Site Address 4064 CAMBERWELL DR N Lot 27 Block 1 Sec/Sub. HILLS OF OFFICE USE ONLY FEES Parcel No. STONEBRIDGE 2ND occupancy R-3 M-1 Zoning PD R1 Bldg. Pemut 846.00 Name THE ROTTLUND CO INC (ActuagConst V-N Surcharge 79-50 LU Address 5201 E RIVER RD (Allowable) V N Pis„ RUN,e,,, 550.00. O City FRIDLEY MN 7,p 55421 Length Stories 60License Phone 571-0304 Depth 3' SAC, City 100.00 Name SAME S.F. Total SAC, MCWCC 650.00 S.F. Footprints - Address On Site Sewage Water Conn 660 _ 00 City Zjp On Site Well Water Meter 95.00 MWCC System ]6 Phone Acct. Deposit 30-00 City Water License # PRV Required S/W Permit 30.00 I hereby acknowlege that I have read this application and state that the Booster Pump SfW Surcharge .50 information is correct and agree to comply with all applicable State of Minnesota Statutes an¢.Qj(y of agan rdi ances. Treatment PI 276.00 Signature of Permitee - APPROVALS Road Unit 370.00 A Building Permit is issued to: THE ROT UND CO INC Planner Park Ded. on the express condition that all work shall be done in accordance with all Council 50 applicable Slate of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official lyti .0111"4 Variance TOTAL 3.688.50 DATE: JAN 6, 1992 _ - w RE: 4064 CAMBERWELL DR N (THE ROTTLUND CO INC) 7 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 co plated for the following reasons: - Your Sewer & Water Permit for the above property has been completepI 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 TUN ON POLICY. Secretary, Building Inspections Dept. 0-~j 043 ® S/, ` 17 Re uest ate Fire No Ro h In Insp on Required Innotion Other Than Bough-In (You a call inspectonwhen ready) Ready Now ❑ Will Notify Inspector O Yes ❑ No Date Reatl . I licensed contractor El owner hereby re uest inspection of above electrical work at: Job Ad r a (Street, o Dote No ) Qty .N 4-ii Sec o tion No I~TTOwnship Na a or No. Range No. C ry ipw Oc nl 1,14W 'Lo 64#L Phon No Sppller 78- P EIe dcal Contractor (Company yam ) Conlr trots Ucense No ti fXF4~l l MaJ Atltlrass onlractor or Owner Making Installation) S 51D AuthOd tl ignat a (Con ractor/Ow Ma In Ration) Phone Number MI ES AT ARD ELECT ailgrr Y I II I III I III I II I I II I I II II THIS INSPECTION REO ES WILL NOr Mltl 5-128 I BE ACCEPTED BY THE STATE BOARD ge-wey g. -Room S21gUnlvers Ave., SI. Peul, Stec UNLESS PROPER INSPECTION FEE IS Phone (612 a2-0800 ENCLOSED O _ _ O If REQUEST FOR ELECTRICAL INSPECTION Xe EB-00001-0e Oil See instructions for completing this form on back of yellow copy. - / "l Al "X" Below Work Covered by This Request New Ad R/e Type of Building Appliances Wired Equipment Waed Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specity) Farm Air Conditioner Omer(specifyf Connaaor's Remarks (/J, ~,Cd- Y !N¢[c~ l~_/ i 6A" (r i FM Compute Inspection Fee Below: t ~ 'J~ 2 # 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 _Am s Signs Inspector's use Only TD AL Irrigation Booms PROBE 1411IS-50 S ecial Ins action Alarm/Communication THIS INSTALLATION MAY B ISCONNECTED IF NOT Other Fee COMPLETED WITH MO ' 1, the Electrical Inspector, hereby Rough-'n / Da[g~ 4 certify that the above inspection has 77 f been made. F'net DateA4 OFFICE USE ONLY F~ This request void 18 months from 0 /7 3 9 61 ~ 4"W 4:;e 199 a i L"- I. ~~4, oo Request Dale ) 1 + Fine No ugh-in Inspection ~e L No Ready Now W ReInspector When en Ready? I ?ricensed contractor D owner hereby request inspection of above electrical work at* Job Address (SVeei BOx or,~OUte NO I / Qty 4ltoy bn, & Sector, No Township Name or No Range No Coun/[s Occupant lP INTt Phone No Power SupPliecA- Address Elecinwl Cont mor I Zany N et contraclor§ License No S, 4a91~ 3 Mailing Address (Contractor or Owner Making Installation, Authorized Signature (Contract iOwn Making Insta Uonl Phone Number 140-3910 MINNESOTA STATE BOARD OF EL CTRICRY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. S1. Paul. MN 55104 UNLESS.PROPER INSPECTION FEE IS Phone(612)642-0800 ENCLOSED /(;4~ REQUEST FOR ELECTRICAL INSPECTION , ee oaool-oa T " ► See instructions for completing this form on rack of yellow copy 4 ,~il /D ~YO C 173961 X" Below Work Covered by This Request 4 J ew Add Rep.. , Type of Building -AppliancegWlred EquipmentWlred Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) F Comm./Industrial Furnace Farm Air Conditioner Other (spec fyi Contractors Remarks Compute Inspection Fee Below: =Transformers Fee is Service Entrance Size Fee # Circuits/Feeders Fee 0 to 200 Amps 0 to 100 Amps Above 200 _ Amps Above 100 Amps Inspectors Use Only. TAL ..5 on Alarm/Communication THIS INSTALLATION MAY BE OR . .CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector. hereby Rough-in oete certify that the above inspection has Final IF 1 Data 4,4 1 been made. OFFICE USE ONLY This request voitl is months from p M5> A0 8 „d Request Date File No ugh-in Inspection 1 ^Ql O .e.,g/dnadl. G Ready Now~Will Notify Inspector , ( F Yes No When Ready' lZlicensed contractor ] owner hereby request inspection of above electrical work at Job Address IStreat x or Route NoI City ab e2 S.0,0h No Township Name or No. Range No County Occupant RINTI Phone No. Power Su er Address Eleclnca Onlr clpr (Company Name) ConVactOr'a Licen-seq`No Mailing Address (Contractor or Ow or Making Inslallatmn Authonxe Signature IContraclorr wne a mg Installau ) Pho a Number .3$t~ MINNESOTA STATE BOARD OF ELE TRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg, - Room 5-113 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(612)642-0800 ENCLOSED /f/9A REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 ► See instructions for completing this form on back of yellow copy ~=14 _l /10 1/ 73958 °x' Below Work Covered by This Request ~0, New Add, R Type of Building Applumce WVed EgmpmentWired Home Range , sy Temporary Service Duplex Water Heater Electric Heating Apt Building Dryer Other (Specify) Comm /Industrial Furnace Farm Air Conditioner Other ispecilyl Contracror§ Remarks 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 WO Amps Signs Inspectors Use only d TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO I, the Electrical Inspector, hereby R°ugn,n o certify that the above inspection has F,nai ate been made OFFICE USE ONLY This request void 18 months from RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, FAGAN MN 55122 651-681-4675 a New Construction ReaulremeMe RemodeVReoelr Reauhemena S a~ • 3 registered site surveys shoeing sq. ft. of lot, sq. ft. of house; and fill roofed areas 2 copies of plan (20q maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations Indicate d home served by septic system foraddllbn$ • 3 copies of Tree Preservation Plan d lot platted after 711193 • Rim Joist Detall Options selectbn sheet (bkfgs with 3 or less units) DATE 5`,) 1-cl'k VALUATION r a°~ 9 SITE ADDRESS ~OG C~ C Gn~wPl/ l7i tits 2 MULTI-FAMILY BLDG _Y _N TYPE OF WORK ~urpF~~~z~oo~ FIREPLACE(S) _ 0 _ I _ 2 APPLICANT STREET ADDRESS 17~ /3n CITY- -STATE~/~ ZIPS~~ TELEPHONE # 763 -5Vt e3(:%/ CELL PHONE # FAX# PROPERTY OWNER~~/l Z"41 TELEPHONE # COMPLETE THIS SECTION FOR -NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (4 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 Ordinances. ' Signature of Applicant OFFICE USE ONLY MAY 2 1 2002 j Certificates of Survey Received _ Tree Preservation Plan Received _ Not squired _ 4102 PERMIT# RECEIPT DATE: 1;,1:5IDENTIAL PLUMBING PERNH APPLICATION CITY OF EACzAN 3930 PILOT KNOB BD EAGM, MN 55122 651.6$1-4675 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backflow preventer for irrigation system LODAHL, DANIEL SITE ADDRESS: _ 4064 CAMERWELL DRIVE NORTH EAGAN, MN 55123 OWNER NAME:: (651) 452-0206 _ TELEPHONE (AREA CODE) INSTALLER NAME: ~/wY TELEPHONE STREET ADDRESS: (612) OUAQ= (AREA CODE) CITY: STATE: ZIP: Place a check mark next to the permit work type New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existing dwelling unit, including: $ 50.00 irX • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround 1 Nature of work: 6?~~CtC2 /,Ja T hp_~ _ Septic System, new/refurbished - $ 225.00 • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ .50 Total $ Sd • Sy Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have read this application, stale that the information is correct, and agree to comply with all applicable Cityof 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-wayleasement. SIGNATURE OF PERMITTEE Updated 1/01 PERMIT CITY OF EAGAN CKIII zJ~~gS 3830 Pilot Knob Road PERMIT TYPE: BU G Eagan, Minnesota 55123 Permit Number: 025078 (612) 681-4675 Date Issued: 02/03/95 SITE ADDRESS: 4064 CAMBERWELL DR N LOT: 27 BLOCK: 1 HILLS OF STONEBRIDGE 2ND P.I.N.: 10-32991-270-01 DESCRIPTION: Bullding`~,Permit Type BASEMENT FINISH Building Ob,rkk Type ALTERATION REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: Base Fee $35.00 Surcharge $.50 Total Fee $35.50 CONTRACTOR: OWNER: - Applicant - LODAHL DANIEL 4064 CAMBERWELL DR N EAGAN MN 55123-3918 (612)975-1105 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan ordinances. APPLICANT/PERMITEE SIGNATURE ISSUED Er. SIGNATURE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 0 2 5 0 7 8 Eagan, Minnesota 55123 Date Issued: 02/03/95 (612) 681-4675 SITE ADDRESS: LOT: 27 BLOCK: 1 APPLICANT- 4064 CAMBERWELL DR N LODAHL DANIEL HILLS OF STONEBRIDGE 2ND (612) 975-1105 PERMIT SUBTYPE: TYPE OF WORK: BASEMENT FINISH ALTERATION INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR. FRAMING INSULATION ROUGH IN PLBG FINAL REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK F- L Y qqgg CITY OF EAGAN BLO(. PST - 19~4'BUILDING PE-RMIT APPLICATION 681-4675 K SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site survey L!I~Ac y of energy calc s. 3 0 1995 COMMERCIAL 2 sets of architectural & structural plan -o£._____ specifications, I copy of energy talcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 1 / 30 / 5 Valuation of work 5 000, Site Address:- CAM$F'RW'~LL UR.. N. STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. A P.I.D. 0 Description of work: US'EMia_N'r F;ZN$S N0 PLVMQilNG S)LL) N_ I The applicant is: AOwner ❑ Contractor ❑ Other (Describe) Name LQDAl41_ DA4n Z-; L G . Phone 452.- OZO (o Property LAST FIRST T~ v q'Cw 1~ b 5 Owner Address CAMVIFKWIIL K, N, STREET STE # City FAGA>j State MN Zip 55)z3-3VF Company Phone Contractor Address License # Exp. City State Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: art I~QO G2` OFFICE USE ONLY r ' BUILDING PERMIT TYPE it a ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging AC16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New 633 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code ~L Census Bldg _L APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee valuatroo: S ! s Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P . Road Unit Park led. Trails Ded. Copies Other Total: SAC % SAC Units CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # /O CNICA'T DATE: SIAENTN PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6 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 ~,I1 OF 1 PER PERMIT OWNER NAME 1 °/;~cl A k ) / ~~7 SUBTOTAL: $Q!v' SITE ADDRESS:`T q (e ICI fR 7)--- A. STATE SURCHARGE: !~.50~ LOT: _ BLOCK / SUBD.`~~l~ TOTAL: $_LLe. 0 INSTALLER: RARE H%. 8i t INC; ADDRESS : 9303 Plymouth Ave. No. S $ OF PER2 TTEE Golden Valley, . l/ CITY: ZIP: PHONE L77C~" lam, "MERCYALJ TfiTTSTCl 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 c $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 # U "W.ir DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON ` SHOWER 3.00 REPAIR WATER CLOSET 3.00 BATH TUB 3.00 y,= 3 LAVATORY 3.00 OWNER NAME: KITCHEN SINK 3.00 -3 - _l _ LAUNDRY TRAY 3.00 -3 SITE ADDRESS: y C> C r.~.r w ll b ~ ^1 HOT TUB/SPA 3.00 WATER HEATER 3.00 3 - LOT: a*7 BLOCK SUBD. `JAL a? za,4r~ae vT FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 3- ROUGH OPENINGS 1.50 ADDRESS: o `h OTHER _ _ WATER SOFTENER 5.00 CITY: .)OIA A l ZIP: S 3 S PRIVATE DISP. 15.00 II,, U.G. SPRINKLER 3.00 PHONE C SUBTOTAL S y ST. SURCHARGE .50 SIG ATURE OFD' PE-RMfTTTEE _ TOTAL: $ OMMERCATj;INIETSTR~T' 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 _ J U46.00+ BUI11N9P LIGATION 79 , 50+ CITY OF EAGAN 550-00+ 1.50+ SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS 2, 2 1 1 • 50+ 3, fit3d•5U* 2 SETS OF PLANS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALLS 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 HANG WILL BE ALLOWED ONCE BUILDING PERMITIES-49SUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE IT HAS BEEN 40 TED. PERMIT MUST SHOW A LICENSED PLUMBER, 9 To Be Used For: Valuation: D Site Address sq, 000OFFICE USE ONLY ' I Lot j-'7 Block I nn FEES Occupancy Bldg. Permit 8W."00 l Zoning ~1 Surcharge Tq1,510 Parcel/Sub A/y/! c~~il~oT~lr e z Actual Const t~ Plan Review- 5`aSD,00 Allowable y- N SAC, City a Owner # of stories SAC, MWCC Q Length T Water Conn. (x01,00 Address Depth 3(e~ Water Meter, 100 S.F. Total Acct. Deposit '3L00 City/Zip Code RW►x E y ~FZI Footprint S.F. S/w Permit 30"00 Surcharged Phone On site sewage- Treatment P1. ~ On site well Road Unit Contractor dil~l7/E MWCC System E/ Park Ded. City water Jef Trail Ded. Address PRV _ Copies y'71S- O Booster Pump City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner Lot Change Council TOTAL Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # agrees that all work shall be done in accordance with \(Signatufe of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. VAR. iv GA'R^6E Z?-xZ2= yBNXiS- IJZ60 lesm-F 28X 38 = Joc,4 f%z.xg= 12 12XlH= ~/6~- _ it 12yy x ly J7,yi~ IST F~uot% Jx$, 8 ~K~Z= f2 I26y,9531 G6,9g2 ZNa F" ort X35-►y~-7. 12 4 c.( 1'~z n <<I:. ~ ~ 12G~ X53 = G~D~/S~ /se Q13 02 J59,000' r Pioneer Ensineerins 6819468 P.62 * 2422 Enterprise Driw * * unoww.c.ows.elwt.ar+radeeaa Mendota Wghts, MN 66120 P10 E *eng*eerng•• """`""°"'~.`""°°`^"•NCHie'° (612) 681-1914 * 4t Certificate of survey for: The Rottlund Com-P-anA Inc- i Model Name: MG-disosL y V 1 1 r 193.9 \ 8i1,,1 Ste' 1 } In \ ~-yqr _ 1 0 676. ~89.L } l0 _ -g J N w ell -4 V Q C) 0. \ \ 21a, 4q4D e V ~Ln \diy.°q BersQ S ~Aa32- 800. \ 679E \ Poo4 4 1E 3V BY 1 V I Date • soo.o Denotes Existing Elevation PROPOSED HOUSE EL-$jNQ Denotes Proposed Elevation Lowest Floor Bevotion:874.56 Denotes Drainage dl Utility Easement Top of Block Elevation: 882.66 Denotes Drainage Flow Direction Garage Slab Elevation: 882.33 --a-- Denotes Monument - Denotes Offset Hub Bearings shown are assumed LOT 27, BLOCK 1 HILLS OF STONEBRIDGE DAKOTA COUNTY. MINNESOTA PLAT 2 1 Mrebr • ititr that this carver, plan or npwt car errpvW by ~r~ dkoct "mkim"phase I em duty 19eehand land Sunvow under the laws of ft state o1 Mlrmwoa. Dated thh av or A.D. 1S~L. / r a I e: 1 hCA . Of = oar 'r . SIKIC L-S. rrlO. h0.1•e9! 096 60104"96 6819488 12-26-91 08:59AM P002 #10 M'F %IOR ENVELOPE AVERAGF: "u" CoKpi TATIOU ~ ~Jjirdsdyj.- OWN ER SITE ADD^,ESS ~jL~O, T Z-J, CONTRACTOR DATF. PHONE Determin working square footage of each. 1. Total exposed wall area 1-91,50, S- sq. ft. x 0.11 = 3(pj 2.' Total roof/ceiling area Zia 7. sq. ft. X 0.026 = Z_. Total exposed wall area above floor = 2 s q J`, Z a. Total wall window area b. Total door area C. Total sliding glass door area d. Total fireplace wall area e. Total wall framing area (average 10%) 22fi. f. Total net wall area above floor Zo 5-7, Cr g. Total rim foist area 2fe~l.Z Total exposed foundation area h. Total foundation window area i. Total net foundation area above grade T~ Determine "U" value of each wall segment. b. x "U" D,/3a = 8,33 c, x „U„ _ d. X ,ult _ e., x -„U„Q.(}8~ = ZO.~4 f. Zo 3~ . G x „U,. 6, o 43 - 8 7• G g. 2C~ 3 , 2 x .,U„ O- 0 41 - /L9,71 X full /40 Nr 3. Tnt.al = 2 77, Q~ If item-13 is the. same as, or.lesr. than item N1, you have met the intent yh ~ Total exposed roof/ceiling wren Total gross roof/ceiling area _ J. Total skylight area _ k. Total roof/ceiling framing area............... l 2 r!• 1. Total net insulated roof/ceiling area ro G Determine "U" value for encli ruuf/ccilinj; sc6mcnt. X Ifu, _ k: /Z(o.71- X „U„ o.DZ7 = 3.~2 ' 1. lI QO, G L X „U., 0-021Z = Z o 4. Total If total of N4 is the same as, or less than 12, you have met the intent of SBc 6oW c)1. To utilize the total envelope system method, the values establi_hed by the sum of items N3 and 14 shall not be greater. than the sum of items 11 and X2. 1. + 2. 3, + L. _ - VkI.U~ GA►GIILA ('tpl 6GONT). -'rFkMl% WALLA- C~ I N,'vt..t LATICN LOMPONfiN'~i . R-~lALUE t"U, o1.pm Alp- FILM _ I - ~5%L INSUt,AT1cN• 19.0 ' 4 u eYP ~ R, 5 L 1~~ 1 = D-a43 -FFAM; WAk L STOP LoMPoN~NTS : F--VALU5 1 QUThIoE AIlz FiLA. 0. 6 3 3 h05A'(AIN(w- 2 •OU _ 4 f X h1Uv (OAM14) - , -I B - - F:i ~'fofat:- -I I. ~ C~ - pl,►~N view. I =G~MP~. IIU~= 0,12 X o.,oI) t(o,8b X o,o43) = o. 04- FIM Zip'; i Ss / r e GaH1Fbf~IGNJ~._-- --~-Ufa.-!I~: 30 j,i? (tz.rl =o.ob: a ii - I i 3 4 5 R ~ 3~-g-3- 027 4' L - - - - - - - - - - - - - - - - - For Office Us ` •+r City aI Permit I C/ C, I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Oy 4c5-09 Site Address: 7 DGy C~ n'7 fjL' >'Gr/E' Ar. Az. Tenant: Suite ~2- /S12 RESIDENT / OWNER Name: ~ji of ze`,4 Phone: e5-5-1- C/ Address/ City /Zip: 1O ,!:O y z% k- O` f/o .s f Applicant is: Owner ,Y-Contractor ~ya G TYPE OF WORK Description of work: S 0! / yv ~l 2 ~ ST 4601 Construction Cost: / 6®O Multi-Family Building: (Yes /No CONTRACTOR Name: -5-%; t/ icense - S75-6 eta Address: S s y~'~ City: Gy co, ` State: Zip: ~ Phone: 7G 3 ~d3 yyContact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _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. 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. y~ X Z~ 4"-1- , :F- . X Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink r_____ .ar I For Office Us4 I I # Permit City of Ea 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: Site Address: (J q CAn, LC.I$,[J JS~C ~ 10 Tenant: Suite M RESIDENT / OWNER Name: + f _ w) F_ 8IAte/ 1 Phone: ~~l '16-5-66 ~ Address / City / Zip: ej Applicant is: Owner X" Contractor TYPE OF WORK Description of work: ya,11~ & ",(,+a cu Construction Cost: iaxz Multi-Family Building: (Yes / Nq CONTRACTOR Name: i'~ License #:f~ Address: City: State: Zip: 5_50~ Phone: Contact Person: EA Q j P. Ji~-v4 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? _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 ' 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 plans. 1 x T`"W t-t.. f 11 J ~ ~~Q x Applicant's Printed Name Applicant's Signature _Page 1 of 3 t DO NOT ~AITE BELOW THIS LINE SUB TYPES Foundation Fireplace Porch (3-Season) _ Storm Damage Single Family Garage Porch (4-Season) - Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) 01 of Plex Lower Level Pool Miscellaneous Accessory Building WORK TYPES New Interior Improvement Siding - Demolish Building* _ Addition _ Move Building _ Reroof Demolish Interior Alteration Fire Repair Windows _ Demolish Foundation _ Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy 2G l MCES System Plan Review , Code Edition P aQ ? SAC Units (25% 100%0--) Zoning City Water - Census Code !-/t-3 Stories Booster Pump - # of Units Square Feet - PRV # of Buildings - Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: Ice & Water Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough in -Air Test -Final Windows Insulation Retaining Wall: ` Footings _ Backfill - Final Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee 7.3 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA123142 Date Issued:05/30/2014 Permit Category:ePermit Site Address: 4064 Camberwell Dr N Lot:27 Block: 1 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-01-270 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Tia Lindroth Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Randy J Blakely 4064 Camberwell Dr N Eagan MN 55123--391 Weatherguard Construction 10860 60th St N Stillwater MN 55082 (651) 439-4320 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167237 Date Issued:03/03/2021 Permit Category:ePermit Site Address: 4064 Camberwell Dr N Lot:27 Block: 1 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-01-270 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Randy J & Carrie A Blakely 4064 Camberwell Dr Saint Paul MN 55123--391 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature