4267 Augusta LaneCITY OF.EAAAN WATER SERVICE PERMR
3830 ?ilot Knob Road
P. O. Box 21199 ' PERMIT NO.:
Eagan, MN 55121 pA7E; - - '
Za+inO: -1 No. of Units:
Qwner. t•iiller ?;ons t.
Addresx
Sita 11ddren: ,'" r
Plum6er: -
Meter No.. ConnecNon CFwrge:
Size: 11coount Deposlt:
Reoder' No.: Q z.?.?
? ?? :?
1 yni !o a?ol?rr!?rpl? f?! Cify of E898+6,
Ordiweeor.
w ? • ?? V
gy ' 1I L VIfZ.??Pf C;v " v
Dote of IrKp.: ?
Fee:
SurrF+arge:
Mlac. Choroas: I32.00pd S!C
Yotal; 63.00pd mete_r
Date Paid:
CITY OF EAGAN VIIATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: - ' ''-
Zoninp: No. of Units: -
Ownsr• •-i<??`???° '::?i'lar ::an?t.
Sice Addreas• r,-?r,7 Austista ?L L5 u l v,jnset ?
PlYrtlber. .
Meftr No.: Cannection CFwrpe:
Size: Acaount Deposit:
Reodsr No.: Permit Fee:
1 pm h aowyly MNb !ie Citi of lp"o Surdwrye: •'J".'
Orilwgoas. lNlsc. Charges:
Totol: • , -L£ r
By Doe. Pow:
Dote af IrKp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Kpo6 Roao ? -
P. O. Box 21199 PERMIT NO.: .
Eagan, MN 55721 DATE: ' .
Zaninp: `i No. oF Units: 1
Ownwr Josepii
Addreas:
Sita Address. 4267 :'.?tr;??•?aer.... L? R: "?.uk::Lt 1
'
1 peM io esowh wNb Ib G!T of Rww*
Ordl"eoa.
By
Date of Insp.:
?ion Charge: 42 5 . 9Opd
Aecaue+t Deposit: ? -
Permit Fes:
Surcharpe:
Misc. Charpas:
Totol: _
Do» Paid:
yi.? INSPECTION RECORD
? ?TY OF EAGAN PERIIAIT TYPE: 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 . Date Issued: (612) 681-4675
SITE ADDRESS: APPLICANT:
„ I ANf . ?
PERMIT SUBTYPE: TYPE OF WORK: ?
INSPECTION D, . .A
,,.. ,-
-1
.-
w.
? PermR No. Permit Holdsr Date Telephone #
Stw
PLUMBING
HVAC
ELECTFiIC
ELECTRIC
Inspection bate insp. Commertts
Footings I
"y
3 ac
Foundation
/ v s
Framing
f?i?'/L a 4r
Roofing 2 p
Rough Plbg.
Rough Hig. ?
oi7?? /Uo% '3 PE
ISUI.
Fireplace e2
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Noti(y Plumber
Const. Meter
EngrJPlan
Bldg. Flnal
Deck Ftg. s L Q
Deck Final
Well
Pr. Disp.
CITY OF EAGAN CT F 4
?
.
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for AP+38?tEN T Est. Value ': t, S00 Date APit 26
Site Address 4267 A UGIJSTA I.N
OFFICE USE ONLY
Lot S Block 1 Sec/Sub. 5L,'t SET ] S'?
Parcel No. occupancy - Fees
W Mflf11@ a?rw? nc a??n
; Address 4267 A4TGLSTA U;
° Cit EAre4;d
y Phone 541-2l66
o Name 4A'`1
Phone
6W Name
wW
Address
a W City Phone
I hereby acknowlege that 1 have re?
intormation is correct and agree ro
Minnesota Statutes and City of Eaga
Signature o( Permitee f /
application and state that the
y with all applicable State of
A Building Permit is issued to: 1'
on the express condition that all worl
Building Official
shall be done in accordance with all
s and City of Eagan Ordinances.
Zoning -
16
0C
(Actual) Const - Bldg. Permit 1
(Allow3ble) - Surcharge ; • ?
8 oi Stories -
Length _ Plan Review
DePth - SAC. City
S.F. Total - SAC. MCWCC
S.F. Footprints -
On Site Sewage Water Conn
On Site Well - Water Meter
MWCC System -
City Water Acct. Deposit
PRV Required _ S.NV Permit
Booster Pump - S,'W Surcharge
Treaiment PI
APPROVALS Road Unit
Planner - park Ded.
Councfl
e? Off. _ Copies
37'00
Variance - TOTAL
PermR No. Permit Molder Date Telephone #
WATER
SEWER
PLUMBING 6 ? ?/
H.V.A.C.
EIECTRIC
Inspection Date Inep. Comments
Foo6ngsl
S7-14c. c?a,t.K,.?.? cA-•zd--
Foundation Ge Z,., 4F/ -
Framin9 / ? !JS
Roofing
Rou0 PIb9.
Rough Htg.
Isul.
Flreplace
Ffnal Htg.
Flnal Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Dedc Ftg.
Dedc Fnal
Well
Pr. Disp.
AA??TI1 ? /?T ?1I\?Al?.
Site
3830 PILOT KNOB
PERMIT
4G PERMIT RECEIPl
F EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NQFIXTURES TOTAL
? Water Closet - $3.00 $
Bath Tubs - $3.00
_14avatory - $3.00
4 Shawer - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Neater - $1.50
Whirlpool - S3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - S10A0
Private Disp. - $10.00
Rough apenings - $1.50
FEE:
?'yy; ,
? Name ? / ,
?s Addresc r--
? City.??-?? Phone
? Name
c Addre
: p CitY -
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHQUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.40
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 SfC IF PERMIT PRICE GOES
BEYOND $1,000.00)
l
I FOR: CITY OF EAGAN
STATE S/C: ?'' ' ``GRAND TOTAL: S ?
CITY OF EAGAN
.; 3830 Pilot Knob Road, P.O. Box 21•199, Eagsn. MN 55121
. ' PMONE:4548100
eU1LDING 'ERMIT Rece+p+ #
e- t1,1- ., •+1 a 11Uo n..?. [.-.i „1?-
S1t@ Addea - - - - - - - - --
Lot ? Block -Q-ISu6. :? ?? <. ' •• 1 ' '
Parcel No.
? Name -
Addreas -
?t Nama
u? Addrea
Cltv Phone
Name
Addrea
Ciiv Phone
I hove reod
OfId OgfQA
Sipnoture of PermittN •
h Buildinq Pannit Is lssued to:
dl work sholl be daw in ocoordonct with r
Buildinq Officid
ond stots tF,ot
Oll OpplICGDIe
,, t"v.-r .y
Erect CU Occupancy
Remodel ? 2oning 1
Ropair ? Typa of Const. ?
Enlarge ? No. Storias
Move ? Length
Demotish ? Depth
Grode ? Sq. Ft.
Assessment
Woter a Sew.
PaUct
Fin
E+0•
Plonner
Council
BIdg.Off. ??
APC
Vsr. Date
Pe?mit
Surchorge . ,
Pian Review -
_..?'
SAC .. . it U
Woter Com. _?.._
.:..
Water l+Aeter
Rood Unit
11'r_ , i .+.:. . t? (?
Total ' `
an th@ gxpresS CondiHon Ihot
o Stotutes and City of Eopan Ordinonces.
(;
Pwmit No. Pomit Holda DaN Te1jhon? ?
Plumbinq
H.VA.C. 5? LI L r-fvt) lL+ ? ? 1 ?c O?0 U^) O
ENctrie d
Soitener
Impsction pate Insp. Othw
Footinot
Foundation
Framin9 6
Rooflng
Rouyh Pibp.
Rough HVAC ri
Inwl.eron s a
Finsl Ptbp.
5
Finsl HVAC 7 .
&)A
Final
Grt/Oec.
waMr Oeseri6e LoCation:
ft11
Stvwr
Pr. D'np.
ities Diaital Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
Raceipt -
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prin[ legibly
Permit No.
Fa y
1
s/c .?
: i
Tot j
. ?
1. Date ° 2. Installation Cost - ?
?
3. Job Address f"' R Lot ? Blk. 1 Tract
,
4. Owner - ?
5. Contractor Phone ?
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional O
8. Work Oescription: New ? Add ? Alter ? Repair ?
10. Descrihe
11.
No. Fixtures
Water Closet ND. F1XtUT8S
Cess
aol/Drainfield I
Bath tubs p
Se
tic T
k
Lavatory p
an
Soft
e
5hower n
r
Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
floor Drains
Drinking Ftn.
5top Sink
Gas Piping Outlets
12. I 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
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
Raoeipt NIECHANICAL PERMIT Parmit No.
CITY OF EAGAN
Fee
ff!l i» numbened spaces S/C
Type w Prinr legibly 7ot. '
1. Date 2. Installation Cast
3. Job Addreas Lot , Blk. ' Tract
,
4. Owner -
5. Contrsctor ' • Phcm
6. Address . ?
_ .?
. ?
7. City State ?. Zip ?
8. Building Type: Residentiai O Commercial ? Institutional ?
9. Work Description: New 0 Add ? Altsr 0 Repair O
10. Describe Fuel Type
11.
No.
' Equi ment 8TU - M. Ea.
Foroed Air ? No. Eauiamen CFM
Ai
H
dl
Mfg. r
an
ing:
Boilers
Mfg.
Unit Neater Mech. Exheust
Mfg. : Othe
Air Cond. r
Mfg.
Gas, Piping Outtets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
Signed for
Rouph Final
Inapeetions: Date Insp. Date Insp.
This is Your permit when numbered and approved.
Approved CITY OF EAGAN 454-8700
CITY UF EAGAN Remarks
Addition SUNSET FIRST ADDITION Lot
Owner
10 72985 050 01
Street 4267 Augusta Lane State Eagan, MN 55123
Improvement pate Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAOING
SAN 5EW TRUNK 1981 168.57 8.43 20 /oT y7 01S90 7
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA S• 1981 168.57 8.43 24 , y D l5 0 7 -49-JO-5
STORM SEW TRK 1985 547.79 36.52 15 a? p J 59G7 co- -FS
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
280.00 51778 3117/85
WATER CONN. 500.00 it
BUILDING PER. 10240
SAC 25.00
PARK
I
IREQUEST FOR ELECTRICAL INSPECTION EB'00001104
' Seo i.vuctions Tor tomoleling this torm on beek of vellow coOY. J +?
0 2 88 32 "'X"" Be/ow Wnrk Covered by This Request
Qdd pep. Typa of 8ui1ling Apoliancea MireO EquiDment Wired
Home Range Temporary Service
Ouplex Water Heater Lighting Fixtures
Apt. Buildmg Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
IrKhmtrial Bldg. Air Corditioner Bulk Mi Ik Tank
fam Other peUfy Other (SPCrify)
t r Sueu y t er Other
Compute lnspection Fee Below
• Fae se.vi. e.i.a.oesiza a Fea Faeaar:is.eiseaem a Fee ci.cues
O to 200 qm s 0 to 30 Am s to 30 An!
A6ove 200 qmps 31 to 100 Amps 31 to 100 q fnl?
Swinming Pool Above 100-Amps Above 100_Am s
Transiormers Irngation &mrcs r Partial.'Othe[.F.ee
(Signs ? I ISpecial Inspections
TOTAI FE
i?? JZ/
5 p'?J I sp c ar-keieby
ca.1Ay tha[ the abov
? e inspection has be¢n
/ -F? ?da.
o., .oa
-?//B 7Ky'
E 9 5 916
Requeat Date ?• Fre o
?/ Q
Y/
7/ RougMn Inspection
Requiretl'+
?7 Reatly Now ?'Will Notiry Inspectw
Wh
R
?
`
D es ? No en
eady
I p licensed contractor )V owner hereby request inspection oi above electrical work at:
Jo0 AdErese (Street, Bax or Raute No )
y267 f}c, usfel /-Clne Ciry
? 9n
Saction No. Township lighe arNO. Renge No. Couny .
- ?- Del t
OowpaM (PRINn
sw /J. ge,6er Phone No. •
y52 -65 87
PowerSUpplier AdErpsy
Electncal Contrac[or (COmpeny Name) ContrectorB Lcense No
Matling Fdtlress (ConVaclor or Owner Meking Instellabon)
41 &7 /-9ne ,%ojA /nnJ 3"sl Z3
Aulhor¢eE SignaNre (COMra mer M" I Ilabon) PMne Number
, ,sz. - ' rs?
MINNESOTA SfATE BOAFD OF ELECTpICRV THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bltlg. - poom Sl]3 BE ACCEPTEO BYTHE STATE BOARD
1827 Unlvereity Ave., 51. Peul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Plwire (612) 602-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION ee-oaomo?
jli? See insirupions tor compleTng iMS form on back oi yellow mpy
? 95916 _ X°'Below Work Covered by This Request
e Add Rep TypeofBuilding AppliancesWired EquipmeniWred
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer 6ther (Specify)
Comm.Andustrial Fumace
Farm ' Air Condihoner
Olher (specily) ContracMrY Remarks Q?
1?'Ni?j"/7 ?J61SC/hf/l7~
Compute lnspectron Fee Below: g
# Other Fee # ServiceEMranceS¢e Fee # Cireuits/Feytlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps A 1 _ Amps
Signs lnspector5 U. ony? 7p7p?
?
Irrigation Booms O
CL
Special Inspection
Alarm/Communication ? ,rs f
Other Fea
?
I, the Electrical Inspecror, hareby
certity that the above inspection has
beenmade. R°u9n-?n +.' •-? ' w'7
? ??
F,nai . t oe ?/?_
?
OFFICE USE ONLY
This request void 10 monihs Irom
rn,s .ev.est wie 5 (P ?, (? 1 . ! 6 ? ?' (7 5
78 .nths frpn
A 079685
Repues[ Dafle ryy? n Fire No. tugh= n le?spection
4CJI YJ: /V??J ?'esd' (7NO ?1@aMNOw1 ?lor'When,h?Y _
? Licensed Eiecvica1 Canbaclor I hmebtiY requast inGGpBC m ot ebove
?Owner eleetrieel wuk innlelMtl at: ,
St,eet Addrass. Box a Route Na
`12
(
l Ciry
-
v 0r 7i
zrn e
cuan
• 7owrehip a Na liange No.
?
?{
CaunC, /"?'
o?c."-t ??? ?
c?
b
T ? H yPhone 5 o
z
o
.
c?r
Power Supplier AAdre ?s
ElectriUi Contractp (COmpaM Name) Gon4actoi 5 ALir.ens¢ No.
Mailing Address (CoM ctor a Owner Yakim listallation)
Sc V'L
AuMonzed Si na[ure (C ra?arf Wkinp Irtlallatim) Phone Nuber
THIS IMSPECTION BEQUFST WILL p07
IAINNESOTA$TpTE 116?I10 ElE17IlICfi11
Grigps-Midwer Bide. - 9om M-191 BE ACCEPIED 9T iHE STAIE BOpBD
1821 Univereity Ave_, SL Vau/. YM 5706 UNLES4 PIIOPEB INSPEC710M Fff 1$
Phone (812) 2872717 ENCLOSED.
xEnuESr Fox ELEcMcaL InSPEcrioN E840001-04
' See i¢vct"uva lor?ompletinp thig.`orm m baek oi wllor cavY• I?I Q? 4[
A ""X" BeJow Work Covered by This Requesf u o J
Add Rev- TYPe o1 BuiWing Awolianees Kired E4.iP.t rired
Home ? Range Tentporary Service
Duplex Water Heater Lighti FiMUres
Apt Building Dryer Electric Heati
Cortmercial Bidg. Fumace Silo Unloader
I?xhtistrial Bldg_ Air Canditioner Bulk Milk Tank
Fartn Other oeciy tMr l5peci(yl
? M r pecifY Other , O,her
FPP BCIOW
H Fee SarvieeEnnsncaSaa A fee Faede,a/Sublewdeo ? Fee Grcuits
Om200 Anvs 0 to30A 0 tn30
Above 200 31 to 100 Amps 31 to 100 Asms
Swimmirg Pool A6ove 100_ Above 100_A?S
Transfarmers Irtigation Booms Panial,-'Otl? Fee
$igns Specialinspection S
C -------?
10TA1F? -
xmerks ? Q ?
/?i+
p, v - /
floupMin Date E
y
I i
JN ,???.. ?.
•a' tl0? the ahOVe
Final Datp psetim has Oean
r ?
f
TN6m0uaAvaidlBmd?lisimm (,/r-/I '-'01/
Tnis reauest wea
.mntfis-(m.u ? -
RedUbft te
a Frte No. ftough-in InsPerbon
fle w ed?
?ReatlV Now ill Notity InsOec-
Wh
1
N
5 es ?NO or
en
eady
'RLicemed Elecltical ConVactor I heoeby requesl insOection oi above
Owrner elech¢al work mstallad aY
Street Address, Box or Route No. Qt
Sectriin No. Townshup e or No. Han9. No. Co
Occv IRi1NT1 Phone N
(
. ?
GCJCJ
?voi?e. ? n ss
<
EI l Cqntractm (C Panv Name) Cnntr ctor's Lmense No.
EIaf1onB Addre.s ICom acmr or Owner 1king Instailali n)
7
4 1/
A izetl S[ur (Conhact wner Ma g Insta lationl Pho Num er
?J?-S4VO
tlINNESOTA $TpTE BpqRD OF ELECi111CITY
GriggsalidneY Bld9. - Room N•791
7827 Uviversiq Ava.. 5c. Peul, MN 55104
Pivne 16121 2972111
THIS INSPECTION NEQUEST WILL N07
BE ACCEPTED BY THE STA7E BOAND
UNLESS PPDPER INSPECTION FEE IS
ENCLOSED.
a PERMIT
,
CiTY OF EAGAN ?
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55723 Permit Number: 020820
(612) 681-4675 Date Issued: 0 4( 3 0/ 9 3
SITE ADDRESS:
4267 AUGUS7A LANE
LOT: 5 BLOCK: 1
5UN5ET 15T
P.I.N.: 10-72985-050-61
DESCRIPTION:
Buildinj-.Permit 7ype DECK
Buildinq Work Type NEW
Building Length
Building Width
,.,
.j
16
14
i ai, u
c_.
REMARKS:
FEE SUMMARY:
Base Fee $25.98
Surcharge $.50
Total Fee $25.50
CONTRACTOR: OWNER: - Flppl icant -
REBER CARRIE
4267 AUGUSTA LANE
EAGAN MN
(612)452-6587
I hereby acknowledge that I have read this a•pplication and state that the
information is narrect and agree to aamply with ell appliqable State of Mn.
Statutes and City nfi Esgan brdinances:
?
? APPLICANT/PERMITEE SIGNATURE
-Alv.rn 6r,l I lY,lS
ISSUEO 6% SI NATU E'
?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 5 BLOCK: 1
4267 AU6USTA LANE REBER CARRIE
SUNSET 1ST (612) 452-6587
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
NEW
1-
BUILDING
020820
@4f30/93
REACTIVATE ""-- - 7?4_v
PE?RMI? d? '
? 11V 7 cCITY OF EAGAN
1993 BUILDING PERMIT
681-4675
APPLICATION
'Y
r v- z-..,nU .?";? .,
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy af energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last rorking day of month.
in which request is made, 2) address is thanged or 3) lot change is requested once permit
is issued.
Date Y Yaluation of work
Site Address:
SiREEt SUITE M
Tenant Name: (commercial only)
IAT ? BLOCK SOBD.
P? P.I.D. N
Descri tion of work:
The applicant is: Owner ? Contractor ? Other (oeeorix)
Name ?? L.V?r(NL Phone 4?;? - ? S X'?
Property LAST FIRST
Owner Address `TaLol ?,',tS`f'?- La-??
STREE STE #
?-7??D-3
M?" Zi
?
p
State
City
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration N
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been appraved.
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.
5ignature of Applicant:
5-0
?
o3S ? Cc11 !? 30
OFFICE USE ONLY
BUILDING PERMIT TYPE
D 01 Foundatian ? 06 Duplex
? 02 SF Dwg. ? 07 4-P1ex
0 03 SF Addition O 08 8-Plex
? 04 SF Porch O 09 12-Plex
E3 05 SF Misc. ? 10 Multi. Add'1.
WORK TYPE
0 31 New ? 33 Alterations
? 32 Addfition El 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging
? 12 Multi. Misc.
0 13 Garage/Accessory
? 14 Fireplace
,?L 15 Deck
? 35 Tenant Finish
p 36 Move
? 16 Basement F-inish'
? 17 Swim Pool
O 18 Comm./Ind.
O 19 Comm./Ind. Misc.
? 20 Public facility
? 21 Miscellaneous
? 37 Oemolish
Const. (Actual) Basement sq. ft. MWCG System
(Altowable) lst F1. sq. ft. City Water
UBC Occupancy ? 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
length ? On-site well Census Code
Depth On-site sewage 5AC Code
?
APPROVALS ??
? d
Planning Building ssessments
Engineering Variance
REOUIRED INSPECTIONS
? Site
? Wallboard
?L footing
PL final
? Framing
? Draintile
0 Insulation
0 Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Lopies
Other
Total:
. U a I wluetion: S
so
SAC %
SAC Units
.• -d-AND INC. Certificote of Survey far :
6URVEYING
SERVICES
Eagan , Min nesota 55121 JpE MILLER CQNST.
N
I
SCALE 1"=30'
LEGAL DESCRIPTION: LOT 5, BIACK 1
SUNSET FIRST ADDITION, DAKOTA COUNTY,
ACCORDING TO THE RECORDED PLAT
N89°46' 05 t
140.94
s? ------------- -- - -- -.o
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,
25
3
v
v
0
b
0
z
25
N89°46'OS" E
Garage floor shall be set 18 inches'
above top of curb.
,,-- Denotes drainage patterns
I hereby certify Thot fhis survey, plon
or report was propared by me or under
my direct supervlsion and thot I am a
duly Raqistered Land Surveyor under the
Laws oi the State of Minnesoto.
B rod J. S wenson Mn. Rey No. 15235
Date: Y;/gs'
-- - -? io
1
. ?
i
,
, CITY OF EAGAN N 0 10 2 4 0
' 3830 Pilot Knob Road, P.O. Box 21•198, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT Receia+ #
Te M wnd fa SF DWG/GAR Est. Value $57, 040 Dare MAY 17 , 19$5_
SiteAddrest 4267 AUGUSTA LN erea EI occupancy R3
SUNSET LST
Lot 5 Block 1 Sec/Sub Remodel ? Zoning R7
. Fapeir ? Type of Conct. ?7
Vercel No. Enlarge ? No. Stories
Move ? Length 50
JOE MILLER CONST
W Name Demolish ? Depth 35
£ q?mg 18133 CEDAR AVE Grede ? Sq. Ft.
b city FARMINGTONpheme 431-2001 inscau O
SAME
S` N Avvrovala Fws
eme
?
Asseument
Permit OI
Address Water 3 Sew. Surchorps 28.5(
City Phone Police Plan Review. 152s0(
GW Nema Fira SAC 525.0(
z? qddreu Erp. Water Gonn. 500.0(
?W Citv Phone Ptanner WoterMeter 63.0(
Council Road Unit 280 _ OI
1 hero6y ackrowledge fMt I hava read ihis application and stote that Bldg. Off. 4 I Z $ S T. P_ 132.0(
ths Inlormotion is correct and a9ree ro comvlY with oll opplicable APC Total $1,984,
5(
Ciry
of Eo9on Ordironcas.
a
n
d
Stata of Minnesota Stotufes
@
?
i
?i
- Var. Dete
SWnoturo of Perminae
A euildin4 Permie is issued fo: JOE MTT.T FR CONST on eM exproas eondirwn thot
oll work shull ba done in accordonee with upplimbl t f Minroaota Sfmutes and Ciry of Eapon Ordimncac
?
???
Buiidhq Otflciol
? e?-'
?
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/ ') a Vo
1985 BUZLDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CON?RACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For Valuation: Date: ??? fa-
a>
Site Address: ?0 FICE USE aNLY
Lot: Block J Sect/Sub Erect ? Occupancy -3
Remodel
O?
Zoning _
Q-I
Parcel # l'
Repair Type of Const ?
_
Enlarge # of Stories
Owner Move _ Length ?p
Demolish Depth ?S
Address Grade ? Sq Ft
City/Zip Code
Phone APPROYALS
C
t
t °
°
on
rac
or Assessments Permit 3n4
-
? Water/Sewer Surcharge 2 3'
?2 -
Address ? Police Plan Review 157-?°
Fire SAC
City/Zip Code\??Q.??p{i /'? ?5S4z? Engr Water Conn
Planner Water Meter
Phone Council Road Unit
Bldg Off y Parks
Arch./Engr. APC Treatment Pl 13z-
Address Variance
TpqAL (; r?
qN- s v
City/Zip Code
Phone 0
TRI-•LAND INC. Certjficate of Survey for :
M ` SURVEYING
SERVICES JpE MILLER CONST.
Eagan, Minnesota55121
N
I
SCALE I"=30'
N89°461 05° E
Garage floor shall be set 18 inches'
above top of curb,
..,- Denotes drainage patterns
I hereby cerTify tFat ihis survey, plon
or report was prepared Dy me or undar
my direct supervision and fhat I om a
duly Reqistered Land Surveyor under ihe
Laws of the State of Minnesota.
? ?-i.se,...?.?
B rodlepJ. Swenson Mn. Req No. 15235
Date: Y??/8f
LEGAL DESCRIPTION: LOT 5, BIACK 1
SUNSET FIRST ADDITION, DAKOTA COUNTY,
ACCORDING TO THE RECORDED PLAT
N89°46' 05?'E
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140.94-- - -?-- ?
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CITY OF EAGAN N? 16364
-- 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8700 Receipt # C ` `7
Tobeusedfor BASEMENT Est.Value $1,500 Date APR 26 , 1g-89--
Site Address 4267 AUGUSTA LN
Lol 5 Block 1 Sec/Sub. SUNSET 1ST OFFICE uSE ONLY
P0fC2I ND. Occupancy - FEES
Zoning -
w Name TODD REBER (Adual) Const - eldg. Permit 36.00
Address 4267 AUGUSTA LN JAllowable) - S
1.00
h
o City EAGAN Phone 541-2266 doismries urc
arge
-
Plan Review
Length _
p N2R1C -$AME Depth - SAC
City
?? Address S F. Total ,
_
sac, Mcwcc
? City Phone S.F. Faotprincs _
Water Conn
On S[a Sewage _
?
F w
Name
On Sne well
- Water Meter
?? AddfBSS MWCCSystem -
aw
Clfy PhOnO
Cdywater qcct De st
- ?
SNY Pertnit
PRV Required _
I hereby acknowlege that I have read ihis application and state that the Booster Pump - S!W Surcharge
mformation is correct and agree to comply wilh all applicable State of
Minnesota Slatules and Cry o
t E
a9an Ordmanc Treatmem PI
?
/
Signalure of Permilee /??/ ?L? /Hi*/" APPROVALS Road Unit
A Bwlding Permit is is5ued to: TODD REBER Planner - park Ded
on ihe express condition that all work shall be done m accordance wrth all Council
applicable State of Minnesota Stacutes and Qty
f Eagan Ordinances.
o eldg Off _ Copies
J
?
BmldingOflicial LDIL???w.'?1 ,11
l Variance - 70TAL 37.00
' 1989 BQILDING PfitMT APPLICATION - CITY OF EAG6N
SINGLE FAMILY DWELLINGS 1 4 3??
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
--4 .: -.
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/SOMEOWNER MOST DESIGNATE WHICH ADDRFSS
ZS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BOILDING PERMIT I3 ISSDED.
FNLTIPLE DWELLINGS EENTAL ONITS FOR SALE ONITS
# OF UNIT3
INCLUDE 2 SETS OF PLANSp CERTIFICATE OF SURVEY - CHECB WITH BLDG. DEPT.v 1 SET OF ENERGY
CALCULATIONS
COMASERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANSt
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS APR 2 91989
WVt, !??jv `f"
To Be Used For: Valuation: I 5?? Date:
Site Address Q(91 mlqlAs'?l L"C,
Lot Block ?
Parcel/Sub JUAI'P At
Owner 10M ?.IJC.r
Address -W(,(jr?' La(/)?
City/Zip Code eQAC-v\ 55123
Phone u.)OfL 54l -a.alola kr'Y..L ?51-Or7
Contractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Oceupancy FEES
Zoning
Actual Const Bldg. Permit 36.00
Allowable Surcharge I•?
# of stories Plan Review
Length SAC$ City
Depth SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acet. Deposit
On site sewage_ S/W Permit
On site well _ S/W Surcharge
MWCC System _ Treatment P1.
City water _ Road Unit
PRV required _ Park Ded.
Booster Pump _ Copies
TOTAL a n
APPROVALS
Planner _
Couneil
Bldg. Off. =/24
Varianee
NOTE: Sever & Water Permit fees and aecount depoait fees will be ineluded in the building
permit fee. Processing time Por sewer and water permits is tvo days once a licenaed
plumber has applied for a permit at City Hall.
i 2/84
CITY OF EAGAN
APPLICATION FOR PERh1IT
SEWER AND/OR WATER CONNECTIODi
(PLEASE PRINT)
1) PROPErlI"I ADDRESS: 4,?2G .4 t NAIc.
1
9 -
TFrar. DE.SG4IPTIC:1:
7
(LOt/Block/Subdivisicn o Tati Parcel I.D. Nisti7er)
:G 5`I"?CC^':'?E . DAT' O" CRIG:IIAL 'ttiIiDI::G °?-,-:IT ISSU?-NG.:
P?EGLT :^:]i.rv"PT?OPGSm C'S'r.': 0 R-1 SD;=- P,?tiffLY .
? R-2 GUPL...z"{ ('IG? UNITS)
13 R-3 'iC'f.Q?THCrJSE t L"1ZTS} f WI'^S)
? R-4 AF?,R1^?-"P/CG_MG'LT_`IILt?,l ( iJP:ITS)
Q CCMIMERCL'-iL/RE-?AIL,/OFFICP.
? .i'DL'STRL:?,L
? ?tSTI:LTIO.']AL/Gv^=N--. A.&'^P
2) Appj,TCy;j` (PIEASE PR1iii)
N7V•L: V6¢ ?1{Ich
aDn:zEss:
cIT^:, sraT--, zIP:
PHONE: y31- a ee/
3) pj,L^.tp,Eo
NPl: (PLEASE PRIHi)
Ply meaH, Pltir.r/,: ?c FOF CI USE 04LY
ADDRES5: ?
!'fa128 ,23? A? .tJ PLUHBE LILE4SE:
Active
CITY, STATE, 2IP_ - Expi
PHOidE:
? ' 3(n7J PIUMBER IICENSE lt apbS tecord
ia
'?I u..l.l,Y:91Y1/VVC:tt{
NAME1rLCHac rrc1nj)
:
,4DDRESS: Sa?? _ as Ca ?
CITY, STA'I'L, ZIP: -
PHONE:
5) INDICi+TE W[IZCH PERti1IT IS BEINC, REQLTESTID:
0 QONNECPION TO CITY SD7ER
'?' CONNECrION 'Ib CITY WTATLR
? 0'i[iF'R (PL,PIaSE DE.SCRZHE)
6) I11DI= C:ir.: .
PI,a?%SE I10I1) APPROVID PER.'?LLT FOR PICIC-L`P BYi ONB OF AE('VE 1
? PI.FASE '.-71IL APPR= PERMIT TJ 1, 2, 3, 4 AFOVE
(Circle one)
7) SIG.;'IL"R7.: /.l/? ?'/e?-?.e+-/ DATE:
?/t O??'fR?JY ? i!a !l:gft?! ?{ 1'Y is i?.? ?I/ ? i?.iii :i a!?! ikJ!'J?[lyf? f!71 I?}[ tSOK?? i
F 0 R C I
PE2MZT " ISSUED
F°Es: $ p.So
$ /0.50
S
$
$
$ ? 5 ?-o
S S? o. ?ro
$ S--k S.u-?
$
$
$
$
U 5 E ON;,Y
S.F.'.'iG.n. n??:1Ty^ (INCLJDL JUP.CHARG'L)
WATER PER221T (INCiuDL .-.liRCHAc2Gc.)
WATER METER/COPPEBHORN/QUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SE'dER TA?
ACCOUNT DFPOSIT - P7AT°R
WAC
SAC
TRliVK WATER ASSESS2IE:IT
TRliNK SEI•iER ?SSESSME:iT
LATERAL BENEFIT/TRUNK SE:dER
LATE?2RL BENEFIT/TRUNK SQATER
OTHER '
$ TOTAL
$ S?D ?KP.I,SOUNT PAID/RECEI?T n
DOES UTILITY CONNECTION REQUIRE EXCaVAT20N IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN n"PERp1IT FOR WORK WITHIN
-- - PUBLIC ROADWAY" MUST BE ISSUED BY THE
ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOSJING CONDITZONS: '
APPROVED BY;
TZ;LE: DAT°_ :
aft W-wspwwcMMI IWstW wM wsrawM R+OEM wOw-M Wtsww.a?M M M?M Ras*M wsJ'G M
?
r•zTV oF Enc,AN
!;ASHTEIi: 1S 1'FFP4TNAL NUa 698
AATE° 07/?U/99 I'It1E'u 10:36°47
ID:
NtlA1Er MT(~FIFiEL. BRL)MMl.1Nii
3210 9001 4267 f-1L1C;LI5'TA LN :Lii.?5
27. ;;i 9001. 4267 AUGUSTA I...N 2.50
'ins:al Feceip?k Amoun+,:
CF. i i.3'?64
USf:fi .T.Ar. JAN
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conshuctlon Reaulrements , Remodel/Reoair Reauirements
? 3regisfered sMe surveys showtng sq. R. of lot, sq. R. of house 2 cop(es of plan
and ell rooted arens L20maximum lof coverage allowed) 1 sef of energy calculatlons for healed addXions
? 2 copies of plans (show beam 3 window sizes; poured fnd. design; efc.) 1 sBe survey for exterlor addkions d decks
? 7 set of energy calculaBons
? 3 coples ot hee preservallon plan H l01 platted aFter 7/1/93
DATE: CONSTRUCTION COST: 4.5 ?c(ZEl
DESCRIPTION OF WORK: Cfv'
STREETADDRESS:
LOT: BLOCK: SUBD./P.I.D. #: ? l w in A i? 1 S?
Name: Phone #: ?Oaz y?- 3 q1M
PROPERTY Last First
OWNER rJ Street Address: 7? 4 G c? ?-?l
City &,QIiC. State: 1-41G1 Zip:
("- 8V '26s-T-
(area code)
CONTRACTOR ?? ? 44 ? ?icense#?Exp.
Sheet Address:
City ??Kg State:h7t. Zip: -?Y)o
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area eode ( )
Street
Cffy
Sewer & water Ilcensed plumber (reciulred for new construcflon onlvl:
State:
Peno?y applies when address change and lot change Is requested once permit is issued.
Zip:
I her4by acknowtedge that 1 have read this application, sfate that the Information ?co e n ee fo comp ` u aPPlicabl
State of Minnesota Statutes and Cify of Eagan Ordinances. )
Signature oi ApplicaM: '
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Registratlon ld:
Tree Preservation Plan Received - Yes - No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
C;IX-02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage O 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Oniy ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 - Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
60_34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Building
Engineering
Variance
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Permit Fee
Surcharge
Plan Review
License
MC/E5 SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
11l .2-S
?
Valuation: $
Total:
113.-1:?-
SAC Units
% SAC
r7aaiS a00 (o
?1A6SRESIDENTfAL BUII.DING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
70,,9D
New Conshuction Reauirements $emodeVReoair Reauiremenfs OKice Use OnN
3 registered sBe surveys showing sq. K of lot, sq, ft. of house; and all roofed areas
im
m lot co
era
ll
d
20% 2 co ies o,i'pi'?M
l
C
l
ti
t
h
t
d
dditi
t E CeR oi Survey Recd
?' T
P
Pl
R _ Y_ N
Y
max
v
ge a
owe
)
(
u nergy
cu
a
ons
or
ea
e
a
ons
o
a ree
en
res
ecd _ N,
_
2 copies of plan showing 6eam & wiMovr sizes; poured found design, etc. sBe sbrvey for addltlons 8 de`Cks? Tree Pres Required _ Y_ N
7setofEnergyCalculations Ad n-mQiCetelFonsifeaeptk On-sileSepticSystem _Y_N
3 copies of Tree Preservation Plan'rf bt platted after 711193
Run Joist Defail Options seledion sheel (bu8d'mgs wdh 3 or less un'ds)
DateQ?/ C)
1 ConstructiooCost
' r
SiteA¢dress °?2 0 PV?? kkr'y;r y (,,,ranC, Unit/Ste #
Ea jLwN 1 m m 5
Description of Work kl°yY) Ov ?E,,: t? D PC k d4n.D 03 v;??
Multi-Family Bldg _ Y _ N Fireplace(s) ? 0_ 1 _ 2
Property Owoer __N o^cL t-u (-}C+Y, Telephone # ( E5 1
Contractor
Address 42 City
State ? Zip Telephone # ( )
COMPLETE TIi13 AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code CategOry . Resfdential VenGlalion Category 7 Worksheet • New Energy Code Worksheet
(4 submissionType) Submitted Submilted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the 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.
ra?
?
?Irc.r1C,t ? +'1
Applicant's Printed Name
Applicant's Signature
cv
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex P 18 Deck ? 23 Porch (screen/gazebo)
O 05 03-plex ? 11 10-plex ? 79 lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46
? 34 ReplaCement 'Demolition (Entlre Bldg) - Give PCA handout to applicant
Valuation 2)800 .- Occupancy (L "3 MCES System _
Census Code y 3 f Zoning City Water _
SAC Units Stories Booster Pump _
# of Units Sq. Ft. PRV _
# of Bldgs Length Z y? Fire Sprinklered _
Type of Const Y? Width I q?
Footings (new bidg)
Aj Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ AidGas Tesu Final
_ Siding _ Stucco _ Stone _ Brick
Windows
_ 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
LAND INC. Certificote of Survey for :
?URVEYtNG
SERVICES JOE MILLER C4NST.
Fnnnn LIinnnentn 5512?
', ) cl,.7
N LEGAL DESCRIPTION: IAT 5, BIACK 1
SUNSET FIRST ADDITION, DAKOTA COUNTY,
ACCORDING TO THE RECORDED PLAT
N89°46j 05°E
140.94 -- - -- - -? t0 25
s? ------------- - 'o i
SCALE 1'1=30' i ?
o -7
(M O
Z) p
9
Z Z
N -y
9e ?
"? p?typGE 8 VT, CJ?O 9 ? i
- - _ - -?- -i_- - - - - --- ? - -- ? 10 25
N89°46I 05N E
O?''
Garage floor shall be set 18 inches'
above top of curb.
e- Denotes d.rainage patterns
I herehy certify fhot ihis survey, plan
or report wos prepared by ma or under
my direcf suparvision and that I am a
duly Rey?stered Land Surveyor under ihe
Laws of the StoTe of Minnesota.
?
w
?
J
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?
Q
,
a e0 p ? ?-,?
B rad ._„ •!. S WensOn Mn. Rep No, 15235
Date' y?;?Bf
For Office Use
City of Iat!,aI1 Permit 1L
IE
c7
3830 PilotKnob Road I Permit Fee: vl Eagan MN 55122 Date Received: APR 1 7 2009
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
- - - - - - - - - - - - - -
008 RESIDENTIAL BUILDING PERMIT APPLICATION '
Date: O Site Address:
Tenant: Suite
RESIDENT /OWNER Name
`C1 Phone:
Address / City / Zip:
Applicant is: Owner . Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes i No
CONTRACTOR Name: g2~1_~~cense _ 0`2 cC C o~
Address: Q E'2, 4:-
City: ~ ~
State Zip: =I C-
Phone: --(Cj~~,24d)S-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 he classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this infprmation 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 w crk w' be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X
Applicant's Printed, Name cant's Signature
Page 1:of 3
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4267 Augusta Lane
Lot: 5 Block: 1 Addition: Sunset 01st
PID:10- 72985- 050 -01
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Window Concepts MN
990 Lone Oak Rd #114
Eagan MN 55121
(651) 905-0105
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Diana M Fulton
4267 Augusta Lane
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
Building
EA092213
12/03/2009
ePermit
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121371
Date Issued:03/27/2014
Permit Category:ePermit
Site Address: 4267 Augusta Lane
Lot:5 Block: 1 Addition: Sunset 1st
PID:10-72985-01-050
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 by law in ALL single family homes .
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 -
Diana M Fulton
4267 Augusta Lane
Eagan MN 55123
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126695
Date Issued:09/08/2014
Permit Category:ePermit
Site Address: 4267 Augusta Lane
Lot:5 Block: 1 Addition: Sunset 1st
PID:10-72985-01-050
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 .
Joanne Burr
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 -
Diana M Fulton
4267 Augusta Lane
Eagan MN 55123
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature