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4612 Cambridge Dr Feb 24 2011 11:27RM HP LRSERJET FRXBRUCKMUELL 6516882160 page 3 Use BLUE or BLACK Ink / I 1 I Permit s: ~ Rio 9 Cat of Ea I g I Permit Fee: I 3830 Pilot Knob Road 1 Eagan MN 55122 1 Date Received: I Phone: (651) 876-6875 1 I Fax: (551) 675-5684 L. INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date:_ ;;2-d 1/ siteAwrees: Cftmhrl;!~i( -c klr1.Ue- do J~J~1o~ Tenant: :TD e Glc° Suite RESIDENT /OWNER Name: O@'ainan Phone: &6-/- 11-1ff2.7P 59 Address I City / Zip: m rd tnN 55" Name: L7I^" Wt1C11e r 1014 0'16ho okC License#: GP / /r 17'} CONTRACTOR dress: 13 ["P~1~/~., -~,,/,.ftJa ~e &e, city: ~iPaf,o State: Zip; ~5Z2a Phone: ~a ! tl~ rar LAG ~1 p Contact: 6r,6 pr"` -a' h cam. Email I' PLUMBING Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK ,-VG Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: i f`+ n A 1 m n 0,91Y-14 [,(02 7) Qp~P. FEES 555.00 / Each (includes $5.00 State Surcharge) TOTAL FEE ffii•~. O 'D "Permit feet will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for reimbursement, tvio quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting w=& ofeaaen.comlinfiow. or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG,. Cap Gopher Mate, One Call at (651) 464.0002 for protection against underground udky damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. www.ogI2bersateonecall.gQ I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 accordanoe with the approved plan in the case of work which requires a review and approval of plans. x ~T(.,l.i4r er Gru.clc'mu edf@i^ Applicant's Printed Name AP karWe Signature F*}~ CITY OF EAGAN } WATER SERVICE PERMIT -U30-kot Knob Road J1 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: 10-19-33 Zoning: 1 - No. of Units: 1 Owner: feature dldrs Address: Site Address: "1612 Cambridge Dr L12 B2 Beacoh Hill Plumber: Lakeville i-Tbg iit :z Meter No.: Connection Charge: ~~d• E)Qd Size: Account Deposit: Reader No.: Permit Fee: 10. 01.) Pd agme to comply whh the City of Eagan Surcharge: -111) Jd Ordieaaew Misc. Charges: GO. 00 2~ meter Total: By Date Paid: Date of Insp.: Insp.: CITY K EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road- 6224 P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: I~' 1' 4 a Zoning: R1 No. of Units: Owner: Rature 11drs Address: Site Address: 4612 Cambrid a DIZ L12 D2 Beacon Hill Plumber. Lakeville >'1 n ~'a l tg 8-23-83 8198 1 come to comply with the City of Fagan Connection Charge: 425.00 pd Ordinances. Account Deposit: Permit Fee: 10.00 Pd Surcharge: 3 0 i 1 By Misc. Charges: Date of Insp.: Total: Insp.: Dote Paid: CITY OF EAGAN 8795 Pilot Knob Rood Eagan, MN 55122 f PHONE: 454-8100 BUILDING PERMIT Receipt # SF D14G/GAR 153,000 -23 3 To bo used for Est. Value Date 19 3 Site Address 4612 Cambridge Dr Erect 5X Occupancy R3 12 2 Beacon Hill KiL Lot Block ~~Sec/Sub. Alter ❑ 'Zoning Parcel # 1043500.420.-02 Repair E] Fire Zone 11 - 19 Enlarge ❑ Type of Const. It Name Joe fx Annette Degnan Move Q # Storiet zz Address 3372 Ballaatrae Rd. Demolish ❑ Length - i 24 city ,,ag` u Phone 452_-7258 Grade ❑ Depth Sq. Ft. Feature Builders Approvals Fees Name 009 Addre 5513 Lod arto Lane Assessment Permit U1 city stu sV a Phone 5.5337 Water & Sew. Surcharge 6.50 Police Plan check 146.00 Ww Name Fire SAC 525.00 Address Eng. Water Conn50.00 i W city Phone Planner Water Meter 60.00 Council Road Unit 250.00 1 hereby acknowledge that I have read this application and state that Bldg. Off. 8-22-83 the information is correct and agree to comply with all applicable APC Total 51749.50 State of Minnesota St lutes and City of Eaga Or, nances. Signature of Permit A Building Permit is ued to. on the express condition that all work shall be d iq` ccord wA all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official/'-/ Permit No. Permit Holder Misc. Permit No. Holder Plumbing 1~ 02/ Zq ~2 H.V.A.C.DS3> y~!? ~~j~ rD p~JJ Well O Water Disp. Sewer Electric lU Q 3,vq q €(F C $ 3 C-#£ ls5lato ID-,z S$3 Inspection Date Insp. Other Footings Foundation Framing AllY ough Ibg. Rough HVAC Insulation Final Plbg. Final HVAC Final Water Describe Location: Well Sewer Pr. Disp. Receipt PLUMBING PERMIT Permit No. 13 C / CITY OF EAGAN ~ ~~a 983 Fee ' Fill in numbered spaces S/C . SQ Type or Print legibly Tot. 1. Date 3 2. Installation Cost rp J ~1 r 3. Job Address j LotBlk. _ Tract t 7 UL 4. Owner c°Q~lh re~ Q I^-~ 5. Contractor -4? Phone 6. Address 7S ~-5-f S 7. City state ~i zip 8. Building Type: Residential la Commercial ❑ Institutional ❑ 9. Work Description: NewA Add ❑ Alter ❑ Repair ❑ 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield _ Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray i - Floor Drains Drinking Ftn. Slop Sink _ _ Gas Piping Outlets J . dl 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: .~/~~A_ n i~ for Rough Final Inspections: Date Insp. Date Insp. This is your rlit`hV1-1TA b red and approved. Approved ,fY OF EAGAN 454-8100 7 1 Receipt PLUMBING PERMIT Permit No.,,~ <a f f CITY OF EAGAN / 1~v Fee .~i Fill in numbered spaces S/C Type or Print legibly Tot., 1. Date 2. Installation Cost < 3. Job Address 0' Lot Blk. Tract 1 4. Owner 7 5. Contractor t° Is'w~JT/ Phone 6. Address y j 7. City( State Zip, B. Building Type: Residential, Commercial ❑ Institutional ❑ 9. Work Description: New -P Add ❑ Alter ❑ Repair ❑ l- 10. Describe k' 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet I: Other / Laundry Tray _ Floor Drains Drinking Ftn. Slop Sink I' 74 1 Gas Piping Outlets / v J(; j 12. 1 hereby certify that the above information is true and correct, and I agree to comply with,all ordinances and codes overning this type of work. ' Signed for Rough Final Inspections: Date Insp. Date Insp. This is your pjerm it h!An'ggpnbeered and approved. Approved f.. ~ 1, r - ✓ k i z - - 1`Y OF EAGAN 454-8100 rF Receipt 3 -r~ r' MECHANICAL PERMIT Permit No. CITY OF EAGAN , Fee Fill in numbered spaces S/C Type or Print legibly Tat. I 1. Date % 2. Installation Cost 3. Job Address ~~t i; i jAibk 7-81k. Tract 4. Owner.'4-f rI-lc1/1~ % L-'A 5. Contractor~t~~; f-./~.- f'/I Phone 6. Address 7. Cityr ~ '&I-J zt: ~fW lel c State Zip-' ~%S 8. Building Type: Residential a~ Commercial ❑ Institutional ❑ 9. Work Description: New B' Add ❑ Alter ❑ Repair ❑ 10. Describe Fuel Type 'A1;1-/ 6;;"; ' 11. No. Equipment BTU - M. Ea. No. Equipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust F ' Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed:, < ~<>r for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 3830 Pilot Knob Road' P.O. Box 21-199, Eagan, MN 55121 N2 12166 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for DECK Est. Value ~ Date J UNE 24 '19 86 Site Address 4612 CAMBRIDGE DR Erect 99 Occupancy Lot 12 Block 2 Sec/Sub. BEACON HILL Remodel ❑ Zoning Parcel No. Repair ❑ Type of Const. Addition ❑ No. Stories a Name JOE DAGi~3A14 Move ❑ Length z Demolish 13 Depth a Address 5 Int. Impr. ❑ Sq. Ft City Phone 452-7259 Install ❑ o Name JAMIESON BLURS, Approvals Fees 0< Address 20360 DOFFING AVE: Assessment Permit X38.50 City F ARMIN(J 460-6262 Water & Sew. Surcharge 1 • Police Plan Review Name' Fire SAC Address Eng. Water Conn. t m City Phone Planner Water Meter Council Road Unit I hereby acknowledge that$ have read this application and state that the Bldg. Off. 6/19/8 Tr. Pl. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Var. Date Copies Signature of Permittee Total A Building Permit is issued to: JFu+~,~.SOh1 ai'➢E on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official e'_' Permit No. Permit Holder Dale Telephone # Plumbing H.V.A.Ci Electric Softener Inspection Date Insp. Comments Footings 1 Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Insul. Fireplace Final Htg• i Final Plbg. Bldg. Final Cert. Dec. Deck Fig. Deck Frmg. Describe Location: Well Pr. Disp. _ CITY OF EAGAN 14 IS 8 i~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454.8100 BUILDING PERMIT Receipt # To be us d fore L'Af:st. Value :s 1i i,• Date 19 `t Site Address CA'' ix t •i > .;'R T VL OFFICE USE ONLY Lot Block yY Sec/Sub:I L), ri.i„ On Site Sewage Occupancy MWCC System _ Zoning Parcel No. I On Site Well Type of Const City Water (Actual) s Name (Allowable) W r # of Stories = Address tjh t 4 L Length c City Phone 452 72 1,9 Depth S.F. Total ,,.._rk 331.' I L1.7E R Footprint S.F. Name ' 2 [ 51.1 4t N 4 z~ o 1 Address APPROVALS FEES UP City t I Phone »,>t p Assessments Permit Water/Sewer Surcharge W Name Police Plan Review FW E E Address Fire SAC, City Engr. _ SAC, MWCC a W City Phone Planner _ Water Conn. Council Water Meter I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit that the information is correct and agree to comply with all applicable APC Treatment Pt State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks Copies Signature of Permittee TOTAL 35..':_ik A Building Permit is issued to: on the express condition that . all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official rt Permit No. Permit Holder Date Telephone # Plumbing 9,a• HN.A.C. Electric Softener Inspection Date Insp. Comments Footings I Footings II Foundation Framing Roofing Rough Pibg. Rough Htg. V. 14 - Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert.Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. PERMIT # PLUMBING PERMIT RECEIPT # 'F/ C7A CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: V CONTRACT PRICE: PHONE: 454-8100 Site Address / BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res. New Mult. Add-one Name "o r 4j Comm. Repair Address Other c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TTAL L Name Water Closet - $3.00 Bath Tubs - $3.00 c Address Lavatory - $3.00 O City Phone ug _J-Shower - $3.00 Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains - $1-50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50 MINIMUM - RESIDENTIAL FEE Whirlpool - $3.00 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 4y w C-, 44~&~ SIGNATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: CITY OF EAGAN Remarks Addition BEACON HILL ADDITION Lot 12 Blk 2 Parcel 10 13500 120 02 Owner C i 4'141I[ i,CV4:~ - Street 4612 Cambridge Drive State Eagan, MN 55122 Improvement Date Amount Annual Years Payment . Receipt Date STREET SURF. (D 1982 1848.67 205.41 9 1932-46 rnn88--2 STREET RESTOR. GRADING (OT97;~- 1982 537.84 59.76 9 3 SR. 56 CQ08812 12-6-R3 SAN SEW TRUNK 3D4- 1976 9 • SEWER LATERAL tog 1982 3182.83 353.65 9 WATERMAIN * WATER LATERAL 1982 9 WATER AREA fp 1982 202.00. 22.44 9 * Stubs 1982 9 STORM SEW TRK 1982 367.77 40.86 9 245-19 C008812 * STORM SEW LAT 1982 9 CURB & GUTTER SIDEWALK STREET LIGHT ROAn mn 20,00 38198 WATER CONN. 4SO.0tt tt BUILDING PER. 840 SAC tr tt PARK CITY OF EAGAN ` 9793 Pilot Knob Road Eason, MH 85122 *T l~l? 8409 PHONE: 454-8100 BUILD1NCa PERMIT Receipt To be wed for SF DWG/GAR Est. Value $53,000 Date 8-23 19__83_ Site Address 4612 C mh i dge Dr Erect M[ Occupancy R3 Lot 12 Block 2 Sec/Sub. Beacon Hill Alter ❑ Zoning Rl Parcel # 10-11500-190-02 Repair ❑ Fire Zone NA Enlarge ❑ Type of Const. V W Nome Joe & Annette Degltan Move ❑ # Stories Z z Address 1877 Rallant-raa PA- Demolish ❑ Length 60 city Eagan Phone 452-7259 Grade ❑ Depth 24 Sq. Ft.- Name Feature Rnildarc Approvals Fees 0 Su Address- 15513 Logarto Lane Assessment Permit 292.00 Cit Burnsville Phone 55337 Water & Sew. Surcharge 26.50 _ Police Pion check 146.00 Cw Name Fire SAC 525.00 ~w Address Eng. Water Conn.4 0.00 iW city Phone Planner Water Meter 60.00 Council Road Unit 250.00 I hereby acknowledge that I hove mod this application and state that Bldg. Off. 8-22-83 the information is correct and agree to comply with all applicable APC Total $1749.50 State of Minnesota Stotdf es nd City of Eagan Ord' nces. Signature of Permittee A Building Permit i ued to. V on the express condition that oil work shall bed in cmdoo _ wl I applicable S of Minnesota Statutes and City of Eagan Ordinances. Building Official Ogg ms, gom 4155 N" an atrrfifirttfr of (~rru~rttnry : i Citp of (Cagan Drvartmrnt of Builhing Jns{arruan a This Certificate IJJHed pursuant to Jl1e ferlJHT[mentJ of Section 306 of the Uniform Building F. Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. Forthefolloudng: SF DWG/CAR Y Umcl..Wi . Bldg P.m N.. 8409 O=w=7TYw R3 ),wc..+w.r„. V Fimr~ NA &.in,Dl . Rl Joe Degnan Ae,.3872 Ballantrae Rd.. Eagan IgjdftAd~4612 Cambridge Dr. ,Lot 12.Block 2 -Beacon Hill r A November 23, 1983 BUILDER: FEATURE BUILDERS ~~'a4a~= ~'i ~Z.-c-~ :"c..:ay':i~a.:a• ow_s~5a°.:~cv_..z: _ .,-v, - _ ~ - .mom ~ - _ ~`7 • ~'r- _ _ _ Li -11 U S.A CITY OF EAGAN e e 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N 2 1216 6 BUILDING PERMIT PHONE: 454-8100 Receipt N ~Q 6 G To be used for DECK Est. Value $2,880 Date JUNE 24 19 86 Site Address 4612 CAMBRIDGE DR Erect.? Occupancy Lot 12 Block 2 Sec/Sub. BEACON HILL Remodel ❑ Zoning Parcel No. Repair ❑ Type of Const. Addition ❑ No. Stories $ Name JOE DAGNAN Move ❑ Length Demolish ❑ Depth - z Address SAME Int. Impr. ❑ Sq. Ft City Phone 452-7259 Install ❑ o Name JAMESON BLDRS. Approvals Fees Address 20360 DOFFING AVE Assessment Permit $38.50 City FARMIN460-6262 Water BSew. Surcharge 1.50 x Police Plan Review F W Name Fire SAC s Address F, W Eng. Water Cann. a City Phone Planner Water Meter Council Road Unit I hereby acknowledge that l have read this application and state thatthe Bldg. Off. 6/19/8 Tr. PI. information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Signature of Perminee Var. Date Copies Total A Building Permit is issued to: JAMESON BLDR on the express condition that all Work shall be done in accordance with all applica State of Mi esots tat lea and City of Eagan Ordinances. Building Official sL V CITY OF EAGAN _ 14582 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 No PHONE: 454-8100 ©g Q BUILDING PERMIT Receipt# U Q 8/ To be used for BSMT/FINISIEst.Value $1,500 Date FEBRUARY 2, 1g 88 Site Address 4612 CAMBRIDGE DRIVE OFFICE USE ONLY Lot 12 Block 2 Sec/SUbBEACON HILL ADD. On Site Sewage _ Occupancy MWCC System Zoning Parcel No. On Site Well _ Type of Const Cry Water _ (Actual) ac Name JOE DEGNAN (Allowable) W * of Stories z Address 4612 CAMBRIDGE DRIVE Length City EAGAN Phone 452-7259 Depth S.F. Total o Name JAMESON BUILDERS FootprintS.F. 0~ Address 20360 DOFFING AVE APPROVALS FEES City FARMINGTON Phone 460-6262 Assessments Permit 34.00 F Water/Sewer Surcharge 1.00 uz m Name Police Plan Review t z Fire SAC, City z- Address ue Engr- SAC, MWCC `W City Phone Planner Water Conn. Council Water Meter 1 hereby acknowledge that I have read this application and state Bldg. Off. Road Unit thatthe information iscorrect and agree to complywith all applicable APC Treatment Pi State of Minnesota Statutes and Cit, f Eagan Ordinances. Variance Parks -~1 Copies Signature of Permittee TOTAL 33_ A Building Permit is issued to: JAMESON BLDRS. on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Off lcial & e `~L,T ,4 This request void '0 -ZS C la 1 g2 ~Eaeoti t 345 z Y 18 months from (~Q LZ1~0 Request Date Fire No. Hough-m InspecLOn Inspec- eq nedl Ready Now 9 [lot When n Ready 8" ~ Yes ❑NO or Licensed Electrical Contractor I hereby request Inspection of above Owner electrical work installed at: Street Address, Box or Route No. City / Di CY~C~ ecvon o. Township Name or Nn. Range No. Cowrty " Occupant (PRINT) Phone No. Power Supplier Addrgss n q,101 s Lmense J40. E tItrical Contractor (Company Name) Com Mali Atldress (Contractor or Owner Making Instailation) SS Authorized Signature (CctoA eWking ALL Inst I anon) Phone Number 1a3& V / MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 UwereAve., St. Paul, MN 56104 UNLESS PROPER INSPECTION FEE IS Phone (6612) 297-2111 ENCLOSED. REQ''-ST FOR ELECTRICAL INSPECTION ER-00001.104 ' See i. Aruclions for completing this form on back of Yellow copy. i~ ~r' ""X" Below Work Covered by This Request 315,:2Y T Adtl Rep. Type of Rui Idi no Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank X It ) y Cher Ispeufvl Farm [her specs y Other Compute Inspection Fee Below a Fee S erv i ce Entra nce S iz e k Fee Feedetsrsubteeders g Fee Circuits 0 to 200 Am s 0 to 30 Amps 13 ?J . ST 0 to 30 Antos Above 200 Amps 31 to 100 Amps s.6D 31 [0 100 A s Swimming Pool Above 100_Amps Above l CIO Amps Transformers Irrigation Booms 1 Partia I. Other Fee Signs Special Inspection s Remarks tb TOTA F„- Rough•in 51 i Dnie Y y~ I, the Electrical ♦ 1V ~~Il'♦ Inspecbr, hereby certify that the above Final / D(,0 7 nspaction has been /OC-Y/ de. This request Vold 18 months Iram This request void `-T -(-E3L12` S~1 DG1+t't_U•L IT'S, 7~..+~ 19 non the from 11.. J W093644 l0` nil Requegt D: Fine No. Rough-m Ins pecbon Q Regmred? []Ready Now Wrll Nolify InsPec- r XYes ❑No for When Ready Licensed Electncal Contractor I hereby request inspection of above ❑ Owner electrical work installed et: Street Address, Box or Route No. City r f l l \ \ ecu on o. Tow Range No. County nship Name or No. UC Occup (PRINT) Phone No. Power Supplier Address 10 0-kf-~ Electrical Contractor (Company Name) Contractors License No. ( 6- d l CoO 3 Mailing Address (Contractor or Owner Making Installation) Z' a --7 y S LO Authotized Signature ICoptractor Owne laking,lostallatem) Phone Number Aa2 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WIL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS e.___ rctni ooy ottt ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 r'. w ~ See instructions for completing this form on beck of yellow copy. X" -~eleOVo Covered by This Request 3 0 I Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm thei PeLl v the, ISnerify) t er pocify Other Other Compute Inspection Fee Below H Fee Service Entrence Si:e u Fee Feeders/Sumfeeders If Fee Grcuits 0 to 200 Amps 0 to 30 Amps 0 In 30 Am Above 200 Am is 31 to 100 Amps 31 to 100 Amps Swimming Pool bove 100 -Amps Above 100_4mps Transformers IArrigation Booms ijl? Partial/ Other Fee Signs Special Inspection g/Q .5~ T L FEE Remarks Ov Oe Rough-in Date I t cel inspector" hereby cerLfy that the above Final Dann inspection has been made. This request void la month from 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122y I S Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date cyl Site Address l A cAX >h t Unit # Property Owner y (ate O-E ft m n f Telephone # (C 1) IS a Contractor Street Addr2Y rnsvllle Heating & A/C, LLC City 1 4 Rhode island Ave. So. State Savage, MN 55378-1122 zip Telephone # Bond w~[l Z o~ I c~ C'~- Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional XReplacement _ air exchanger air conditioner -New Replacement other (%,L 1 cQ 9 ZC State Surcharge $ 50 Total ES~J 0V 1 R 20 4 I, I hereby apply for a Residential Mechanical Permit and acknowledge that the informatio is complete and accurate, at the work will be in conformance with the ordinances and codes of the City of Eagan and with the MecliadieakCodes-1- at Fnndeistand 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 Applicant's Printed Name Applicant's Signature 1986 BUILDING PERlQT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL: INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 2&2~0 To Be Used For: D Valuatio Date: ,re , Site Address FA(O\p OFFICE USE ONLY Lot __L2- Block Erect Occupancy Remodel Zoning Parcel/Sub /e Repair Type of Const Addition Y of Stories Owner wro Move Length Demolish Depth Address W(o~~ C Int.Impr. Sq Ft Install /VyAR City/Zip' Code /2'r', Phone r y~~j APPROVALS FEES Contractor_ypzAssessments Permit 36's-0 Water/Sewer Surcharge /170 Address L~ ' ~?-~0~ y Police Plan Review Fire SAC City/Zip Code rnh ~SC72N Engr Water Conn Planner Water Meter Phone Lk- L C-) Council Road Unit Bldg Of 619. Treatment P1 Arch./Engr. APC Parks Variance Copies Address P"A'&,e,v TOTAL City/Zip Code Phone # NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. S. Y i All Y- I C.V '-A G i I 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OE ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: ?~rAe - Valuation: 64cna!"J Date: Site Address Ait, C w~„be( I~~~ o OFFICE USE ONLY - 15ou - Lot Block On site sewage_ Occupancy MWCC system Zoning Parcel /Sub ~r.c On site well Actual Const City water Allowable Owner PRV required # of stories Booster Pump Length Address ~a. wwhn c~ Depth S.F. Total City/Zip Code Footprint S.F. Phone )A5 APPROVALS FEES Contractor Engr/Assess Permit 3U. (gyp ~~c e- Planner Surcharge Address Council Plan Review ~ Bldg. Off. ')=ZS SAC, City City/Zip Code' VrAinc~~ SshZ~I Variance SAC, MWCC Water Conn Phone Water Meter Road Unit Arch./Engr. Treatment P1 Parks Address Copies TOTAL 3 .00 City/Zip Code Phone # i-vy sE~~A-e~ r~,pM~rs ,eFQUraG,7w~~ ~ cuW..b~.:age,~cz.. ~3~aS~-c~~~~A~ FOR F) REPLACE,, E LEtTkICAL~ R- Pl(AK'&IN& MECHANICAL WopK SSd~y q I ~ - ~ - UA~oR BARRIER a Cdi~3 ` 9 F x , ENCLOSED STORAGE SPACGS tA&JD AZ STg161S- PROTrtr.T- W171-1 F/RECDDC - i X EGRESS WINDOW -S/OED Ta Comky l G ~ ti~ WirN rHE REt~u/QEM6MS 0~ u8C i2o y - ~f ~ ad c S .7 NET Cl4 Ae 0,06W AI A i (2o A4/N. MErCj_ -AX oP ~ SK W rOrJ/. l . ZN 141AI. NATctEr4~f oA~Nt - ----=--"s -------mac - -jJ--- r '-t c,,~i~~rnui - yC Agc- life? //~3;K a CITY USE ONLY L ~ BL RECEIPT SUBD. 16&'+ex DATE: QG 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN / 7 ZZ. 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings ► townhomes and condos when permits are required for each unit FIXTURES EACH NO. TOTAL Shower 3.00 x = Water Closet 3.00 x Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = rain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cty. license 20.00 U.G. Sprinkler * home under const. 3.00 = Alterations * to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL Sa SITE ADDRESS: DEORH JOESEPH 4612 CRMBRIDGE DRIVE EAGAN OWNER NAME: N4.2-7,.9 W , 55122 INSTALLER NAME: NORMLOM INIUMMiNG Co. - DBA YENTOWAPPLIANCE INSTALLERS STREET ADDRESS: @90 A= 90IMN MINNEAPOLIS, MN 56" CITY: STATE: ZIP: PHONE ( ) c'" 9 CITY OF EAGAN Include 2 sets o plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To Be Used For -aluation a Date ~~g ? gqbvp~ Site Address _ j - OFFICE USE ONLY Lot 2-a2- Block sec. /sub.gee Erect Occupancy Parcel ?5 S«~ 0 eo Z Alter Zoning ~ Repair Fire Zone Owner: ~ 11. lt~lk n... Enlarge _ Type of Const. Addres . $ a a < < a^w ,aa. E J~!- a move # Stories Demolish _ Front D ft. City/Zip Codte:I S ( Z Z Grade Depth 2t/ ft. # : 5 d 7~ S q Phone ! APPROVALS FEES Contractor: ~i a~ s~ni? n~ p~ Assessments Permit X07 [4ater/Sewer surcharge 2G~ Address: - a-acti/7~ 'OQtiL Police Plan Check City/Zip Code- &A -AI g..rfQXo, C~? ~f Fire SAC ~5 Eng• Phone Water Conn. sy O ~ Planner Water Meter &d ~ Council Road Unit I Arch./Eng.: Bldg. Off. Address: APC City/Zip Code: Phone TOrAL ' 4 CERTIFICATE OF SURVEY ~d S 139° 38' 3Z' E 1164~; 110.41 , v 44.3 27.94 A /0 I3O A 9 22.33 6 DRPINAGE ~5 IL I [ UTILITY n e 9 0N Q H EPSEMENT 9 3 1199 h m W 9 23.3334' O LOT I Z I O N 2. ' N ! 93'7 lJ d W BLACK d M 0 M % ~ Q N 3 9 23.93 h Uom 10~ 93•a H 57.50 u?! qx~ ✓ 140.00 S 09° 36- 32• E Elevations shown are existing grades and are assumed datum. r hereby certify that this is a correct representation of a survey of: Lot L2, Block 2, WCON HILL, Dakota County, Minnesota, according to the plat thereof on file and of record, And that 1 am a duly registered land surveyor.under the laws of the State of Minnesota. Gene L- Jacobson, innesota Reg. No. 7734 Dated this 15th Day of August, 1983, DR. BY GRJ SCALE - I = 30' 0 DENOTES IRON MW BEARINGS ARE ASSUMED DATUM. Prepared for: Feature Builders JACOBSON SURVEYORS 15513 Logarto Lane LAKEVILLE. MINN. 55044 Burnsville, MIN 55337 PHONE 469 - 4 328 rnaa.a.ara ra.nav ~cnv a~.~ LIF%PLAN SERVii.E EXTERIOR ENVELOPE AVERAGE U COMPUTATION OWNERS-IS G SITE ADDRE CONTRACTOR FF bTl~eE J3ur) n~ 5 DATE 3 - I PHONE ?l3 8 4 V3 Determine working square footage of each. 1. Total exposed wall area 19 $2.1 Z sq. ft. x i8 2. Total roof/ceiling area _ 9 I Z sq. ft. x 0 4 Total exposed wall area above floor = 15rlrl D a. Total wall window area ly 4•LD b. Total door area 3£3 ' c. Total sliding glass'door area d: Total fireplace wall area e. Total wall framing area (average 10'.)............ 1 f. Total net wall area above floor g. Total rim joist area 12 Total exposed foundation area = g 6.52. h. Total foundation window area........... i. Toal net foundation area above grade E! Z Determine "U" value of each wall segment. q a. 1~ ,Lp X "U" , S5 ~LL b. 3 i3 X „u„ ,139 525 C. X "u" 5 - ° Z Z- d. X „Ul, e. 135.1 X "U" U'1 = ID,21? f. 1215.9 X „u„ „ 0 15 = ,Zy.`l 9-- X Plult q.9 h. X f.Ull _ i. 8p.5Z x „u„ ~LDq = 3)-7 to 3 .....................~9 8 Z ....Total = Z I If item #3 is the same as, or less than item fl, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area 1'L Total gross roof/ceiling area = i Z 3m :j. Total skylight area k. Total roof/ceiling framing area . 1. Total net insulated roof/ceiling area..-..... Determine "U" value for each roof/ceiling segment. ' 1..... X "U" _ k. ~1.7, X "U" d3"S = I Q x IV, . 03 - Zq. LoZ 4.....................9 )~~7 .........Total If total of #4 is the same as, or less than #2, you"have met the intent of SBC G006(c)i-. h . To utiltzed the total envelope system method; the values. established by the sum of items 03 and #4 shall not be greater than the sum of items #1 and 02. 1. + 2. - 3. + 4. _ MATERIALS Therm. 'Resistance "R" Exterior Air " .Ih Siding Material .45 Sheathing _ .6 Insulation - 11 Sheet-rock .4-S Interiox Air 1.8 Studs 4, 38 Rim 1.98 Conc. Bika. I . Z S i 'J Q( Q, Q1 C) d U 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reoulrements RemodefReoair ReouimmenfS OtliCits'U§e'OriM 3 registered site surveys showing sq. ft of lot sq. ft of house; and all roofed areas 2 copies of plan (20% win= lot coverage allowed) l set of Energy Calculations for heated additions ItsePtes lemRedd "Yr?'r„ 2 copies of plan showing beam 8 window sizes; poured found design, eta 1 site survey for additions & decks I 1 set of Energy Calculations Addition • indicate it "a septic system (}n-_ 9,S~y#CtPan. - „_1 3 copies of Tree preservation Plan if M platled after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date /W! / IN Construction Cost 101 Site Address 4(c -L` & Unit/Ste ~a# Description of Work J~tLIC Q `Z ~ V S w t ' Q IN, S+) ~1 L~J 1 11 ~ Multi-Family Bldg-{ _ Y' 6 Nom, Fireplace(s) _ 0 _ 1 _ 2 G Property Owner .x}~. ~.LfLN ~ Telephone # (ipso t~ 75Z ~ZS 7 RENEWAL BY ANDRSEN Contractor ! 1920 COUNTY ROAD "C" WEST Address ROSEVILLE, MN 55113 City State 651-264-4777 Telephone # ( ) LICENSE #20130983 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 Have you previously constructed a building in Eagan with a similar plan? -Y -N If so, ie 'ew fee applies. ~y 90~ (b /a 0 Licensed Plumber Telephone # ( ) e~ - ` ( ) Oy Mechanical Contractor Telephone # Sewer/Water Contractor Telephone I hereby apply for a Residential Building 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 the State of MN Statutes; 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. „O L& &~~p - Appltcant's Printed Name pplicant's Signature Lau ''c.vv rtia foa oil "g4tl0 ttCPll:ItA41t1°&PlUtlK~tff't CCU: re al Junat 2WI City of Eagan 3836 Pilot Knob Road EftM MN 55122 To Whom It May Concern: Elder Tones is authorized to pun buildbng permits for Renewal by Andmsen_ Please allow Elder Jones to PrwIdo ft aefvic o for us m Eagan. 41tia gti28tbpn le valid for ary date beyond 6/6/01: until a Mnmal by Andersen mmpr wtMWy revokm it In wining to the City_ 1 request this audio&afum be a 4epted-wgxditboUdy. as to out not delay in the p of building Permits any further. Please can me If there arc any qua dona..I can be contacted at 763-502.4706_ a Your intn 9diaft attention t0 S8s matter is a] pmdwje& Sinoetely. onM -Rau uistallation Manager Renewal by And=m CoMration - K,2f109 Received Time Jun. 1. 1:07PM City of Eap ; Permit rr. 8 I I 3830 Pilot Knob Road Permit Fee: O Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff 11 -D 2 2008 RESIDENTIAL PLUMBING PERMIT Arr--P^^PLICAT OCT o 6 2008 Date: 1 o ' 3 01b Site Address: (o l,Q.~~V id e .V r, C(,t 0.(n - 5 { ~2 Tenant: 11lo6CIPLI DequatA ZZZ Suite RESIDENT/OWNER Name: "J 05<421n De°C{inQn Phone: (05) +5 72-5c1 Address /City/Zip: 402- w(o r i c(e~Dr a 55 f 2 2 CONTRACTOR Name: t LA -Pro TI UMb r 1 License M-0 6 0 (o L P AA Address: 8015 201bl-y cst. city: LQ kevi l l e State: ~t11~ zip:~_ ~~T Phone: 5Z I ~0 cj 1o 2"( CtContact Person: ~Jem N TYPE OF WORK _ New Replacement _Repair _Rebuild _ Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater _ Water Softener _ Lawn Irrigation Add Plumbing Fixtures C- RPZ / _ PVB) Main _ Lower Level) _ Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ rJ Q ..rj D 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 rase of work which requires a review and approval of plans. x D810 0 1/00.14 Larsnti Applicant's Printed Name xl~z 1' it's Signatur FOR OFFICE LSE'. `Regirired; InsRectionss%" Use BLUE or BLACK Ink F----------------- I For Office Usey~ I j Permit U ® ! I City of Eajan I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 RECEIVED Date Received: CU-! Phone: (651) 675-5675 I I Fax: (651) 675-5694 FEB U 6 2012 Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Cft f Date: Site Address: Unit Name:~OS~T_¢y /4rtv\~f"ft ~e_.,,n. t Phone: & 5 VT,9 - ZA57 SIDENT I_ WNER Address/ City /Zip: 'yWA SSI ZZ Applicant is: Owner * Contractor eftx_ G/V?we s 445064►'7ZosL r TYPE OF W~3Ri( Description of work: ~ /K Ae w 67bar . 796 4t~po TP Construction Cost: Multi-Family Building: (Yes / No X-) ~JC/~l¢r4/rt~ Company: 5e-T (10 S5 TTAA_CTlarm baiK9st? Contact: Ay x ff 1 g, E G CONTRACTOR ` Address: / 5e ~ V A&Ag- - City: _'97-,404&t tv1 State: AI.A. Zip: 65/7C)f Phone: / _1Z -9`f9v 09 7 License Aer, & 5/01739 Lead Certificate AWr- d,1737Se-1 If the project is exempt from lead cent' Cation, please explain why: (see Page 3 for additional information) 14me 3uzLn' 1483 COMPLET 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: of NOTE. Plans and s4oportIng d6cuments-that you submit om Considdrod to be pSiblic ►nlbrinatlon. PeMdrti'40. the information mey be clan + as non :public if you p ovide speh c, reasons that would permit the'41, ±nelude /'hat 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.oooherstateonecall.oro f 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. Exterior work authorized by ' a building permit issued in accordance with the Minnesota State Building C e must be p d within 180 days of permit issuance. Applicant's Printed Name plica Signature Page 1 of 3 DO NT WRITE 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 4V Occupancy Zfe_- MCES System Plan Review Code Edition 199q SAC Units (25%_ 100% tom) Zoning City Water Census Code Stories Booster Pump # of Units / Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation it HVAC _ Gas Service Test Gas Line Air Test 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 Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector I/ Fgvv RESIDENTIAL FEES J~ Base Fee Surcharge Plan Review 3 - MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink For office Use I My Permit of Eajan I 0 Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 1 Date Received: Phone. (651) 675-5675 ECC.EIVED I I staff: Fax: (651) 675-5694 ! FEB 1 4 2012 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:'. Site Address: Tenant: Suite nn RESIDENT / OWNER Name: Phone: 5 " `-t S Dr 5g r1 Address / City / Zip: C2 C.~ C0, Y" Name: ~ ~R ~ 4L-,~- ` License CONTRACTOR Address fo~'~y~_~ ° Y~ U S City: St e:\-' tiv 1 h t a 1 Zip: ~o Phone: lO at Contact c- Email ~n TYPE OF WORK - New Replacement _Repair -Rebuild - Modify Space - Work in R.O.W. Description of work: RESIDENTIAL Water Heater Water Softener PERMIT TYPE Lawn Irrigation RPZ I - PVB) Add Plumbing Fixtures Main / -Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this iMormation 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 permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval 2 of plans. x R k~ C -f t~ x , Ap is Printed Name Ap icanYs Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground -Rough-In Air Test Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA142183 Date Issued:04/18/2017 Permit Category:ePermit Site Address: 4612 Cambridge Dr Lot:12 Block: 2 Addition: Beacon Hill PID:10-13500-02-120 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Joseph E Degnan 4612 Cambridge Dr Eagan MN 55122 (651) 452-7259 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA153958 Date Issued:02/06/2019 Permit Category:ePermit Site Address: 4612 Cambridge Dr Lot:12 Block: 2 Addition: Beacon Hill PID:10-13500-02-120 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joseph E Degnan 4612 Cambridge Dr Eagan MN 55122 (651) 452-7259 Warner Stellian Co Inc 550 Atwater Circle St Paul MN 55103 (651) 222-0011 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA166233 Date Issued:12/22/2020 Permit Category:ePermit Site Address: 4612 Cambridge Dr Lot:12 Block: 2 Addition: Beacon Hill PID:10-13500-02-120 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joseph E & Annette Degnan 4612 Cambridge Dr Saint Paul MN 55122--270 (651) 341-0222 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA170283 Date Issued:06/25/2021 Permit Category:ePermit Site Address: 4612 Cambridge Dr Lot:12 Block: 2 Addition: Beacon Hill PID:10-13500-02-120 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joseph E & Annette Degnan 4612 Cambridge Dr Saint Paul MN 55122--270 Renewal Andersen 1920 County Road C West Roseville MN 55113 (641) 264-4088 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA179052 Date Issued:09/15/2022 Permit Category:ePermit Site Address: 4612 Cambridge Dr Lot:12 Block: 2 Addition: Beacon Hill PID:10-13500-02-120 Use: Description: Sub Type:Air Conditioner Work Type:Replace Description: Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Joseph E & Annette Degnan 4612 Cambridge Dr Saint Paul MN 55122--270 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature