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4234 Beaver Dam Rd Use BLUE or BLACK Ink I I For Office Use I I Permit I City of EaEdfl I ~ 5s o O I Permit Fee: r I 3830 Pilot Knob Road I ~,,1 I Eagan MN 55122j Date Recei ed: _ I Phone: (651) 675-5675 Staff. Fax: (651) 675-5694 L INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water ' l L Date: `A im Site Address: Tenant: V 4)NAJ Suite Name: U / N 17 Phone: 6)67,76 7 RESIDENT / OWNER Address / City/ Zip: ahv lie- Name: S CL License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK i Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: ~/r)a L- C) l~ t~y ?~YLi ~0~ FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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 rmit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the casawwhich re u es a review an approval of plans. IX) V Ll] N ~ ~ x App icant's Printed Name Applicant's Sig ure FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final CITY OF EAGAN N? 9425 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 4548100 Receipt # To be wed for SF DWG/GAR Est. Value $60,000 Date AUGUST 17 i19. 84~- Site Address 4234 BEAVER DAM RD Erect [ Occupancy R3 Lot 22 Block 1 Sec/Sub. SUN CLIFF 1ST Remodel ❑ Zoning R1 Parcel No. Repair ❑ Type of Const. V Enlarge ❑ No. Stories W Name GRAND OAKS Move ❑ Length 4 7623 UPPER 167TH ST W Demolish ❑ Depth 46 Address City LAKEVILLFPhone 432-6561 Grade El Sq. Ft. Approvals Foes ,o Name SAME 313.0 0 O~ Address Assessment Permit 30.00 City Phone Water & Sew. Surcharge Police Plan check 156.50 W Name Fire SAC 525.00 1E Address Eng. Water Conn. 470- 0 0 00 tz, City Phone Planner Water Meter 63, 0 Council Rood Unit 2-6-0,S) 0 1 hereby acknowledge that I have read this application and state that Bldg. Off. 8/17/84 Parks the information is correct and agree to comply with all applicable APC Total 1 r 817 • 0 State of Minnesota Statutes and City of Eagan Ordinances. Var. Date Signature of Permittee A Building Permit is issued to: RAND OAKS on the express condition that all work shall be done in acc rdanc ith all a iw of Minnesoto Statutes and City of Eagan Ordinances. Building Official iAJ~~ ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN INCLUDE © SETS OF PLANS, ` " © CERTIFICATES OF SURVEY /G © SET OF ENERGY CALCULATIONS To Be Used For: Valuation: 0 Date: Site Address: Lot: 0?9% Block:_L_Sect/Sub: ' Erect: Occupancy: Q-? Parcel Remodel: Zoning: Repair: Type Of Const: TG Owner /IJCtR,~-Lm( Enlarge: # Stories: Move: Length:(_ Address: T~y Demolish: Depth: 4& City/Zip Code: Grade: Sq. Ft.: Phone # E-2 aQ 5~ Contractor: QQt4 • a Address: lid l om S, LW Assessments: Permit: 1 3. T- City/Zip Code: 47 t'-- Water/Sewer: Surcharge: 3d,~ L A~zt~-mot., Police: Plan Rev.: Phone Fire: SAC: Engr . • Water Conn: 4-- o Arch./Eng: Planner: Water Meter Address: Council: Road Unit: 2(,0.~ Bldg. Off.: Parks: City/Zip Code: APC: , f~17 Sc~ Phnna~ Variance: C. R. WINDEN 3 ASSOCIATES, INC. LAND SURVEYORS TA 945•3646 1341 EUSTIS ST., ST. PAULO MINN. 85109 For: GRAND OAKS DEVELOPMENT COMPANY N NOTE: o Denotes Wooden Stake Proposed Garage Floor E1 903.03 (902.7) Denotes Proposed Finished Ground E1. -F Denotes Direction Q Of Surface Drainage C) Vertical Datum - N.G.V.D. 1929 2~ N Scale: 1" = 30' `spa 7G 0 P9, O Denotes Iron QQ e'2. 6 029"w Monument Q~ b ??.tom J ~ ~ Q ~a. i*i Oa ti 3 o ,1, ,4U Vvt* BOO QV q a O , b a= Ev ZpX .~0 6.30 ~15%j r~ cr" /9,29 y •r'0 10 Lot 22, Block 1, SUN CLIFF FIRST ADDITION, Dakota County, Minnesota. WE HERESY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ASOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY THEREON, AND ALL VISISLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Doted tbim, 6th day of AT1 -A .D. 1984 C. R. WINDEN it ASSOCIATES, INC. &'M bye, " Surveyor, Minneteto Rpistrotiim No T7 2-& M7iS19 w-: . ELIE CARRIER LOAD INFORMATION CENTER OP'T'ION 1 OPTION Z OP'T'ION 3 1. Summer design degrees 9 # C # # (90, 95, 100, 105, 110 or 115) (If 90, 105, 110 or 115, Item 2 N.A.) 2. Daily range (00-350) # ? a 3. Winter design degrees yr) # # (Precede a minus number with M) 4. Number of window panes . # # # (1, 2 or 3. If 2 or 3, Item 5 N.A.) 5. Storm windows? Y or N C. 6. Windows weatherstripped? (Y or N) 7 # y # # 7. Four window areas starting with or NE orientation # (Ex: N#25#30#20#25##; Max per side: 999 sq. ft.) 71 N or NE # # 72 E or SE ~7a # 7~ # # 73 S or SW ~a # 3 # # 74 W or NW /3 8. Shaded window area Q # C # # (0 or sq. ft. Enter 0 if not applicable. Max: 999 sq. ft.) 9. Doorarea Sl• # y # # (0 or sq. it. Max: 999 sq. ft. If 0, Items 10 & 11 N.A.) 10. Door weatherstripped?(YorN) # \ a 3 11. Storm doors? (Y or N) #ti x c.. 12. First story perimeter # :#1 #1 13. Second story perimeter t 1 # C # # 14. Thickness of wall insulation # R # # (0, 2, 4 or 6" fiberglas. Enter MA for masonry; R values, enter R, then value, Ex: R19) Q c1 15. Basement perimeter g # p ! # # (0 or linear ft. If 0, Items 16, 17 & 28 N.A.) 16. Basement heated? (Y or N) # Y ; a - (If N, Item 17 N.A.) h 17. Percent above grade (Ex: 5%= 5) ......Q, I j # ~1 x 18. Area of roof with exposed beams or studioceiling C-) (0 or sq. ft. If zero, Items 19, 20 & 21 N.A.) 19. Woodorfiber (W forwood, Fforfiber.If W, Item20N.A., if F. Item 21 N.A.) ; Mks 20. Thickness of fiber 7 '74 -7, (1.5, 2 or 3" or R values) 21. Insulation (Y, N or R values, Y assumes 1.5") j-- OPTION 1 OPTION Z OPTION 3 22. Area of ceiling under vented roof or unconditioned space # # # (0 or sq. ft. if 0 Item 23 N.A.) 23. Thickness of Insulation (0, 3, 6, 12 or 18" of fiberglas or R values Ex: R30) 24. Area of floors over unconditioned space 15 # C, # # (0 or sq. ft. If 0 Item 25 N.A.) 25. Thickness of insulation r (0, 3 or 6" fiberglas, or R values) 26. Area of floors over open or vented space, ergarage O (0 or sq. ft. If 0 Item 27 N.A.) 27. Thickness of insulation K~ ~t (0, 3 or 6" of fiberglas or R values) 28. Basement area (0 or sq. ft. If Item 151s 0 skip this entry.) 29. Total heated area # 3 # # (sq. ft.) 30. Perimeter of concrete slab # # (0 or linear ft.) (If 0, Item 31 N.A.) 31. Thickness of slab insulation (0. 1 or 2") 32. Desired summer indoor temperature swing (Value between 1 and 6 inclusive.) 33. Desired winter inside temperature If K~9C # L1 # # 34. AT t location attic, BA = basement, SL = slab, # ~g # # CR = crawl space, CO = conditioned space) (if BA, SL, or CO, Item 35 N.A.) 35. Thickness of insulation (0, 1 or 2". Use 2 for 1" rigid.) "REPEAT DATA?" Y or N "CORRECTIONS?" If there are no corrections required enter If there are corrections to the data, enter question number, the new data, and E : 9#W further corrections, enter## only. # # # COOLING B.T.U.H. EQUALS I AT °F 13.T.U.H.3/ AT_2_0_°F B.T.U.H. AT °F HEATING B.T.U.H. EOUALS AT F B.T.U.H. CCI.-RI 7 AT -^A 0 OF B.T.U.H. AT °F "REPEATTHE ANSWERS" (Y or N) SAVE YOUR DATA?" Y or N; or YR## will save your data and goes to beginning for new Analysis; or NR## will not save data but goes back to beginning for new Analysis. JOB NUMBER It you want to save your data CLIC assigns Job Number "STRUCTURE CHANGES?" If there are no changes required enter If there are changes to the data: enter question number, the new data, and # # # Ex:25#R30## If no further changes, enter only. ee ~~sAsN MINI ERGY OPPORTUNITY HOME 3-78 Printed in U.S.A. 838-039 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 Reouirements RemodeVReaair Requirements Gffi e t{se On!~ 3 registered site surveys showing sq, ft. of lot sq. ft of house; and all rooted areas 2 copies of plan Cert of Surrey R,ecl' Y N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres'Plan Rt of Y N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Prn. Required' r _ N 1 set of Energy Calculations Addition - indicate if on-sPte septic system On .Ste Septic S~ 5-em -'r _ N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet'(bldgs wilh 3 or less units Date Constructs n Cost Site Address -,lc.~ ~l•Lrn~, s Unit/Ste # Description of Worker LC;~ f 1 Multi-Family Bldg _ Y VN Fireplace(s) _ 0 _ 1 s 2 Property Owner Telephone # (16) !1 22 7 Contractor Address City F7r-f State Zip Telephone # ( btc - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Catemy 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( } Mechanical Contractor u Telephone # ( } F, SUN 8 Sewer/Water Contractor Telephone } Y 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. Applicant's Printed Name Applicant ignature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plea ❑ 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 ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex 0 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex iJ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex P1bg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to.-applicant, Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const 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 _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding Stucco _ Stone -Brick Fireplace _ R.I. -Air Test -Final _ Windows Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total CITY OF EAGAN Q 9428 3830 Pilot Knob Road, P.O. Box 21199, Esgan, MN 5512' PHONE: 45481011 BUILDING PIMMIT Receipt # w.d SF DWG/GAR Est. Vole $60i 000 Date AUGUST 17 .1% $4_ ve is for If Site Address 4234 BEAVER DAM RD Erect 13 Occupancy R3 Lot U Block 1 Sec/sub. SUN CLUF 1ST Remodel ❑ zoning R1 Parcel No. Repair. ❑ Type of Const. V Enlarge ❑ No. Stories m GRAND OARS Move ❑ Length. Name 7623 UPPER 167TH ST W OemeAsh ❑ Depth Address LAKE~7ILL 32.,6101 trade ❑ Sq. Ft. City hone A provels hfee Name Addom = Assessment Perini! Water 8 Sew. Surcharge City ; Phone Police Plan check Narrte Fin SAC Addpels Eng. Water Cortrt City Phone Planner Water Meter Road Mill council acknowledge that I have read this application and state that 8/17/84 Y Bldg, Off. Parks ' Al .infarmation is correct and agree to.comply with oil applicable APC Total "J3 of Minnesota Statutes and City of Eagan Ordinances. JAL' T : Var, Date 1:,. Y r s of PermittN ; ra 1r ding 0errrrit is issued to: on'the aitprfdwt ,all work shdi be. done Jm a do wfth'all opOcpb 0tv of Minneeota statutes and:`d iry of Eatn, J3utlding Official ~wmlt No. Parmk Holder Dab Plumbing t KVA4. L) iElaaul~e >l ehwwr Inspection Data Insp. Other Footings Foundation Framing Rough Plbg. Duo HV Insulation Final Plbg. Final HVAC Rina1 to rtloae. water - In koeat:on: 7 YVsll ~d ° L ~j Opt Pr. Dhp. 79- Receipt L~ MECHANICAL PERMIT Permit No. n 1 I ~`r CITY OF EAGAN Fee g d Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost " ya ~ ~ s vy ~ Job Address t3e-.f v, - p'°"• Lot .2 --,2- Blk. Tract 4. Owner a V)f N do ~'s f,~PV ~(U~Ji j~F 5. Contractor Phone 6. Address 7. City State 5 y S7 Zip 8. Building Type: Residential Commercial ❑ Institutional ❑ 9. Work Description: New EY Add ❑ Alter ❑ Repair ❑ .10. Describe Fuel Type e. 11. No. Equipment BTU - M. Ea. No. Equipment CFM P" Forced Air 74 Air Handling: Mfg. rte! t Air Handling: ✓ Boilers Mech. Exhaust 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 : for R Final Inspections: Date Insp. Date Insp. This is your permit when nui`Flbered and approved. i` Approved CITY OF EAGAN 4100 k - C VEAGAN Foe Fill in mmbered spaces sic _ Type or Mini legibly Tot.... ,2.p.~.~ 1. Dater - 2. Installation Cost Tp~ S, Job AdWfa&, ot,2,gj_Blk. 4. Owner 5. Contractor Phone 6. Address (3ty State Zip _ i,. S. Building Type: Residential qT/ Commercial ❑ Institutional ❑ 9. Work Description: New X30 Add ❑ Alter ❑ Repair ❑ 10. Describe 14. --No Fixtures No. Fixtures Water Closet f / / C:esspooiJDrairpld! Bath tubs Septic Tank, Lavatory f Softner Shower well Kitchen Sink Urinal/Bidet Other La aWrv Trey' ' PWO? brat ft, ~rNllrrn9 Ftn. r*~. ai oudow CASH RECEIPT k CITY OF EAGAN P. 0. BOX 21-199 a EAGAN, MINNESOTA 55121 DATE , 19 .611 xeesnrw FROM AMOUNT ~V.7 & DOLL TARS p CASH ❑ CHECK R ND ' COLiE' AM G f fS ,s p.. Than av° BY • 4 0 Ye1P[Mti~•F~opy a Pink COW i ~ ~ r y This request void `„0~1! Q(~ ~V 1~P (,D 18 months from A -17 7 9 Lo r equest Fire No. Rough-in Inspection Required? Ready Now Wl Notify. Inspec- ,J es ❑Na -;I When Ready Licensed Electrical Contractor I herby request inspection of above Owner electrical work installed at: Street Addresss.JBBoox or Ro No. City j` 171 l{ G~~ C !L Do action No. owns ip Name or No. ,4111ange No- County Occupant (PRINT) Phone No. Power Suppli Add , ,-eC TY 0 Ele i Contr for (Company N 1 Contractor's License No. gas' 67 Mailing Address (Contractor or Owner MaTlb-~ allati 1 /a 7 5~1,v4 Au thor' Signature (Contractor Owner Making Installation) Phone Number MINNESOTA STATE 410ARD OF ELECTRICITY THIS INSPECTION REOU WILL NOT Grigga-Midway Bldg. - Room M-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 56104 UNLESS PROPER INSPECTION FEE IS Ph- 19121 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ES-00001-04 V ' See Instructions for conv#s . u this form on beck of vellow capv. y _ -X"' Be/ow Work Covered by This Request d Reo. Type of ouiktinq Appliances Hired 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 Other (SPeCIFVI _?5tr (specify) t r poci y Other Compute ns ection Fee Be/ow # Fee Service Entrance Size b Fee Feeders/Subfeeders fi Fee Circuits 0 to 200 Amps 0 to 30 Amps -0 to 30 Arims Above 20Q _A 31 to 100 Amps 31 to 100 Amps Swimmi Pool Above 100 Abo" 1100___AMVS Transformers irrigation Booms 5D Partial•'Other Fee Remarks Signs Special Inspection TOT - rks ~ ~ ~ / Rough-in Date sT~7 c Elee 1 rispsc ,hereby osrtifv that the above Final ( Date inspection has been weds. This request void 16 mcaft from CITY OF EAGAN Remarks y' J rc Addition SUN CLTPP 1ST Lot 22 Blk 1 Parcel- Owner Street 4234 BEAVER DAM ROAD S,.. N NN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. $ 1970 0---610.05 1 10 - STREET RESTOR. g 1981 2030.40 203.04 10 1218.24 C009830 10-1-84 GRADING SAN SEW TRUNK 1971 76.S4 3.06 ZS 30.64 C009830 10-1-84 SEWER LATERAL Z 1974 44.21 2.95 15 11.87 C009830 10-1-84 * Sever L8 oral 5 1981 4419.74 441.97 10 2651.86 0009830 10-1-84 WATERMAIN * WATER LATERAL 1981 10 WATER AREA 973 3 'SS 6.24 15 18.79 0009830 10-1-84 STORM SEW TRK 1971 322.29 16.11 20 96.75 C009830 10-1-84 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 #45602 8-17-84 WATER CONN. 470.00 11 11 ~o n BUILDING PER. 99498 SAC -52500 PARK MSWNTUL F PermitAppmud" 393ti PUot Knob R Raga MW. phase complett for single Family Min a 8t T xma;a Md C pas ft Date , _ r } t Site Address Vol fit( a ° Property Owner - day '_a T r 1 ~~~f Contractor ifa d~ l ~ ' ' M1 p Street Address A-m state / p JQ(i+ T # ` Bond Eaphm - C ' k The Applicant Is Owner 1--cowactm r 0 7.7 } Add-OII, snodlflcatloa W Warier to exkftg *VNMft `rpnlit ~x 3 furnace':. i'~ T w air exdtart air conditi®r Ides , f tq nent other i 3 a ,e State Surcharge Total' Y Immeby apply for a Rwittentid Mechm*el PlerM ad acknov&* `thgt tom' dtf wampl ~ . I tailz i be in conformance with the mumneft AtAodft of the city or & *m but only an application ft a p f; and work is not to alert wl a E t is tr l bsw t ed plan in the f work 'oh tthes a meview and anal a".. -er y. Applicant's Printed Name c ~ , ~ ri f , OF. 4 `comma& 38 ~.6 dF g ' ¢ri' Pk M M"Phft for. c rc i f SUN, Street Addrew. d UUSM Naue (if appilcubk) F- - Mayer _ , ~ ' ~ ~ ~ ~ ~ ~ l4++~~~Y' '+!f1 raw' Y. ~ \ i. r Cwwadcr - StFW AAkI iai : mt . i} 1 t yMW~ State b w"' ►Ad _ #s T r 7 7, J, Type 3 r + Y~ 4 , r "y Now Construction W 4" I 1 Interior Improvement Y-} h i i+ ro of Wort: PO=k Few mom d ~rfi~a~teyi~j~ s , r. °"r L x ow _ f F _y Comsat Value $'r° is SUO" w k^ was-50 If pmt is atFes"3f sue; ":~►t3 i Q o- . evay $LOW RKMft The it wVby apply for W be in conformume evil tb ro" . iW $per~ VL66~VLly a0pW gww+p~s.!irofs A':: - ,p. 4~ *C` r + -.11 tf `1.: R to awowd plsq in ft caw, of wad fit ~F t t~ s ' i t, t Applicant's Prifod No* Y- A wed By. _ 5 r~ ~1~}GR!"t"'~^""'~• owmr. 6 .ell } - ,~.n - Ly , J+- Lw.'~latl+41#r..~l!itl _ ti ~j CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. 0. Box 2 v PERMIT NO.: 5658 EagW NN 165121 w DATE: - Zoning: " R1 No. of Units: 1 Owner: Grand Oaks Address: Site Address: 4 Road L22 B1 Sun Cliff 1st Plumber: Bete aQ&W&n;M utilities pd- r No (Connection Charge 15.00 Pd ze: Deposit: count P Reader Na~ ermit Fee: 10. UU 5U pd 1 aline to cam* with the City of 94"m Surcharge: ' 0 ,.t L3 a-lee Mise. Charges: _ 3.0 pd meth' Total: By Dote Paid: of Insp.: e3 4.w / =-oc Insp.: 71 //,07 Y £ CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Ro9d 5t. P. O. Box 2T11119 " PERMIT NO.: Eagan, MN 55121 DATE: Zoning: GIZI rand Oaks No. of Units: Owner: Address: Site Address: 42.34 Beaver Liam Road L22 B1 ..n Cli. f i. Plumber: ?LcDonal%, - lb-; Meter No.: Connection Charge: i, . 1 p " Size: Account Deposit: 15.0 pd Reader No.: Permit Fee: )ci 1 some to comply With the City of Eagan Surcharge: u pa Ordmanees. Misc. Charges: 63.4' od mete; Total: BY Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road 6848 P. O. Box 21199 PERMIT NO.: _ Eagan, MN 551 M DATE: Zoning: No. of Units: Owner: Gran a Address: Site Address: 4214-Beaver Dam Road t22 B Sun C i st Plumber. McDonald R 8-17-84 45602 too. 00 Fd I agree to comply wftb the Cana of Eason Connection Charge: 425.00 pd Ordinances. Account Deposit: 13.00 Pd Permit Fee: 10.00 p p Surcharge: .50 BY - Misc. Charges: Date of Insp.: Total: Insp.: Dote Paid: 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: 3 a.~, Q-✓~ _ ~~,(y, a o,,~ LEGAL DESCRIPTION: \-O- i ~ Is o (Lot/Block/Subdivision or 'Pax Parcel I.D. Number) IF EXISTI-N.G S'-IMTCTURE, DATE OF ORIGINAL BUILDING Pa-,%IIT ISS'CPNCE: i Mor.:~`~j Year) PRES 'T 7nNLIr/PROPOSED USE. Tr R-1 SINGLE FAMILY D R-2 DUPLEX (TWO UNITS) Cl R-3 TOWNHOUSE (THREE + UNITS)( UNITS) ❑ R-4 APARTMENT/CONDOMINIUM ( UNITS) ❑ COPM'IERCIAL/RETAII/OFFICE E3 INDUSTRIAL Q INSTITUTIONAL/GOB 2) APPLI ((PLEASE PRINT) NAME: y"a, V1 j ADDRESS : °'I & -54 CITY, STATE, ZIP: El-" ItP D4 t). cjf C► PHONE: y3 ! r ~t, j 3) PLUMBER LEAS PRINT FOR CITY USE ONLY of j~ PLUMBERS LICENSE: ADDRESS: 01- d of Active CITY, STATE, ZIP: L, e 4k e ✓"I ~~g _ q] ji . 04f 'Expired PHONE: MHO Not of , Record PLUMBER LICENSE Staff Initial 4) OCCUPANT/OWNER (PLEASE PRINT) NAME: ADDRESS: M All CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH PERMIT IS BEING REQUESTED: CONNECTION TO CITY SEWER CONNDCPION TO CITY WATER OTHER (PLEASE DESCRIBE) 6) INDICATE ONE: PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO l,dkq, 4 ABOVE (Circle 7) SIGNATURE: DATE: A ' •ir "wtmuwrmir ;pwm ~ ~.~:.ir,.ear ~Yr! l~rf aii ai.ib ~ .Myt'r"!~n!'!'r*!'tr~! iYiit F O R C I T Y U S E O N L Y } PERMIT # ISSUED FEES! $ SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER $ - WATER TAP (INCLUDE CORPORATION STCPI $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER $ r. - WAC $ SAC $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ OTHER $ TOTAL AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE J NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : ~ ~ w~~ ~ sr:~ ~a wow ~ s~~~ ~ w~ w~~~r ~ ~ ~ ~ s~~r~rt wa• ~•r ~~srt war w . r CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 RECEIVZD FROM AMOUNT $ FJ & DOLLARS too CASH ❑ CHECK FOR FUND CODE AMOUNT ti. Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy Ck.~.~zwo8 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date _ 02 28 06 HINNENKAMP, DAVID 4234 BEAVER DAM ROAD Site Street Address EAGAN, MN 55122 Unit # (651) 452-7045 Property Owner Telephone # ( ) Contractor 1 `t o r igl um PLu bl n e Telephone # (to 12-) Address 2-gD5 C-16,r-f *fLd A-V. S7, City MpIS State M M ZipZ640~ The Applicant is: _ Owner V Contractor -Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are installing only a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. -Septic System Abandonment Water Turnaround (add $130.00 if a 5/8" meter is required) Other: _ Water Softener /Water Heater $ 15.00 _ new Z replacement Lawn Irrigation ,RPZ _PVB -,new -repair rebuild $ 30.00 d State Surcharge 6 006 $ .50 Total $ i 5n ! 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 the plumbing codes; that I understand this is not a permit, but only an application for a permitlbe is of o start without a permit and work will be in accordance with the approved plan in the event a plan is required t ev ' an approved. Applicant's Prin d Name Applica r Signature J € - - - - - - - - - - - - - - i or office Use V ity Permit C of Eapn Permit Fee: / 3830 Pilot Knob Road Eagan MN 55122 j Date Received: / j Phone: (651) 675-5675 i Staff: Fax: (651) 675-5694 1 l 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date. Sir~`1 ~,o~ lJ) Site Address: F'.-.&A.1yI/Y\&;S~/4Z2 Tenant: Suite ~~c~ RESIDENT/OWNER Name:_l)~OlvjD ~thl!~`[rJM~ C Phone: Address / City / Zip: y_A D41 ` f C E .M Sam/ x Applicant is: Y_ Owner Contractor TYPE OF WORK Description of work: ~ C L Construction Cost: , t,o c Multi-Family Building: (Yes / No CONTRACTOR Name: A)o2 r14 klmj) -3uy- C. License Address: City: State: Zip: Phone: Contact 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 lans. . x_ D 1 \ Jai 01 `tr~i X Applicant's Printed Name Applicant's Signature D Page 1 of 3 JUL.: 0 6 2009 DO NOT 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 Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%_) 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) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: 1 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 Meter Size: Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 C. R. WINDEN & ASSOCIATES, INC. LAND SURVEYORS T*L 945.3646 1381 EUSTIS ST., ST. PAUL, MINN. 55108 For: GRAND OAKS DEVELOPMENT COMPANY ~V NOTE: o Denotes Wooden Stake Proposed Garage Floor E1(903 3 (902.7) Denotes Proposed _ ' Finished Ground El. Q _qq Denotes Direction Q Of Surface Drainage /O Vertical Datum - N.G.V.D. 1929 N Scale: 1" _ '30' 00 ?G O Denotes Iron Q 6/\ 82 6 02 9" yy Monument (v ~o Nti io ~o 1, Oft 16 0 `V`im Q b O ~9, Lot 22, Block 1, SUN CLIFF FIRST ADDITION, Dakota County, Minnesota. WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF All BUILDINGS, IF ANY, THEREON, AND All VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Doled this Idor of A,gr' I A.D. 1984 C. R. WINDEN 3 ASSOCIATES, INC. Surveyor, Minnesota Registration No.-7-72-j~ 6! 7^d5 )9 , PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA103548 Date Issued: 04/02/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4234 Beaver Dam Rd Lot: 22 Block: I Addition: Sun Cliff Ist PID: 10-72975-01-220 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Home Depot At Home Services David J Hinnenkamp 656 Nlendelssolm Ave. N 4234 Beaver Dam Rd Golden Valley NIN 55427 Eagan MN 55121 (763) 42-8826 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 Citv of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eaaan. Permit Number: EA103676 Date Issued: 04/09/2012 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 4234 Beaver Dam Rd Lot: 22 Block: I Addition: Sun Cliff Ist PID: 10-72975-01-220 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Replace Description: Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Pere Firkus 2650 Minnehaha Avenue Minneapolis. MN 55406 612-276-1680 Fee Summary: BL - Base Fee $500 $40.00 0801.4085 Valuation: 500.00 Surcharge - Based on Valuation $500 $0.50 9001.2195 Total: $40.50 Contractor: - Applicant - Owner: Crew2 Inc David J Hinneiil amp 260 l\Iinnehaha Ave 4234 Beaver Dam Rd Suite 100 Eagan NIN 55121 Minneapolis NIN 55406 612 276-1680 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 Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA104288 Date Issued: 05/14/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4234 Beaver Dam Rd Lot: 22 Block: I Addition: Sun Cliff Ist PID: 10-72975-01-220 Use: Description: Sub Type: e-Siding Construction Type: Work Type: Sidin, Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: When installing ventilated soffit material. remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required bn law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Home Depot At Home Services David J Hinneiil amp 656 Nlendelssolm Ave. N 4234 Beaver Dam Rd Golden Valley NIN 55427 Eagan MN 55121 (763) 42-8826 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 Citv of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA104288 Date Issued: 05/14/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4234 Beaver Dam Rd Lot: 22 Block: I Addition: Sun Cliff Ist PID: 10-72975-01-220 Use: Description: Sub Type: e-Siding Construction Type: Work Type: Sidin, Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: When installing ventilated soffit material. remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required bn law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Home Depot At Home Services David J Hinneiil amp 656 Nlendelssolm Ave. N 4234 Beaver Dam Rd Golden Valley NIN 55427 Eagan MN 55121 (763) 42-8826 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 Citv of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA124396 Date Issued:07/01/2014 Permit Category:ePermit Site Address: 4234 Beaver Dam Rd Lot:22 Block: 1 Addition: Sun Cliff 1st PID:10-72975-01-220 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 . Elizabeth Hess 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 - David J Hinnenkamp 4234 Beaver Dam Rd Eagan MN 55121 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA130424 Date Issued:04/23/2015 Permit Category:ePermit Site Address: 4234 Beaver Dam Rd Lot:22 Block: 1 Addition: Sun Cliff 1st PID:10-72975-01-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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 by law in ALL single family homes . 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 - David J Hinnenkamp 4234 Beaver Dam Rd Eagan MN 55121 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA175771 Date Issued:04/14/2022 Permit Category:ePermit Site Address: 4234 Beaver Dam Rd Lot:22 Block: 1 Addition: Sun Cliff 1st PID:10-72975-01-220 Use: Description: Sub Type:Water Heater 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 - David J Hinnenkamp 4234 Beaver Dam Rd Saint Paul MN 55122--223 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA177402 Date Issued:06/29/2022 Permit Category:ePermit Site Address: 4234 Beaver Dam Rd Lot:22 Block: 1 Addition: Sun Cliff 1st PID:10-72975-01-220 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: 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 - David J Hinnenkamp 4234 Beaver Dam Rd Saint Paul MN 55122--223 K & S Heating, A/c & Plumbing Llc 4205 West Hwy 14 Rochester MN 55901 (507) 282-4328 Applicant/Permitee: Signature Issued By: Signature