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4059 Camberwell Dr N Use BLUE or BLACK Ink For Office Use I I 7 qzl City of Ea I Permit o 41 nn b I Permit Fee: I 3830 Pilot Knob Road i 1 Eagan MN 55122 I Date Received: Phone: (651) 675-5675 1 E C Iv 1 V ED 1 Staff: Fax: (651) 675-5694 I I JAN 0 6 2011 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site ~fAddress: WOSci r0,Mbet•u1e•N Tenant: (!l. A In ~ I*,~-dl /C-- Suite RESIDENT/ OWNER Name: 2n~ear11.. }bone- -'Sery;ces - &w: l~er~ Phone: Address / City Zip: CONTRACTOR Name: Jo k Stdc ko,64 License A{acsnIft ply, Address: 1111(o9 P Ara. kuug- City: $c,/n4o State: Mrs Zip: SS31Q Phone: S~• (000 Jl Contact: ZUauL Email: TYPE OF WORK - New Replacement _Repair -Rebuild - Modify Space - Work in R.'O/.Wi. Description of work: uM6 i G. CeJ I: 5eAJ M 7fJ~t. PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation RPZ / PVB) Add Plumbing Fixtures Lc5?~ Main / Lower Level) Septic System Water Turnaround New swcc)-O~ Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add lumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) " ater Turnaround (add $166.00 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) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $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. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of Tans. x ~Owf_ "e.41 x - Applicant's Printed Name App ' nt's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In -Air Test Gas Test Final Use BLUE or BLACK Ink I or Office Use / nil j Permit -;7& City of EaRdfl I o~ I Permit Fee: ~v 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION j_ Ste Address: CAM-r~~rw~G! 'Or. Date: zoIii 3 Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: A). Applicant is: Owner c<~ Contractor TYPE OF WORK Description of work: ) Construction Cost: ` Multi-Family Building: (Yes /No ) Z CONTRACTOR Name: c ► ii-Ae n s e 6 Address: O v 1 G City: 0-0-1 State: Zip: 5 ~~7 Phone: 4P 5- 2 Z"t? J` 3 Contact: A s Email: - ^X C, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public ►f you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orci 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 fora 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 ans. X Applicant's Printed Name icant's Signatu Page 1 of 3 I DO NOT WRITE BELOW THIS LINE ~v SUB TYPES undation _ 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* Qctdition _ Move Building _ Reroof _ Demolish Interior /Alteration Fire Repair _ Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall Vemolition of entire building - give PCA handout to applicant DESCRIPTION pv Valuation Occupancy MCES System Plan Review kLO 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) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows I/ Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock 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 6 ~ ~M Ifi Tntiftro.tr of (Orrupanry Citp of (Eagan lltprb nd of Wid(bi>tto 3tmsvl?r#imt nu Certifrcate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City reguk ng building construction or use_ For the following. use cw Tvwoe SF DWG/GAR 18787 eldg. ttrmic xa. Ocaq~ Type R3/M I 7ooios mirict PD/R 1 Type C.. VN 10--o(&uldmg rcm vrYr-rrY= M IM` Add= 59,() 1 R. RTOR'.R M., BUDI Y > a;~AddressS~[159 r t1iFRt~T.r. pRTyF: No.L,,Ey L16. B3, HILLS OF RUMOR= ZND I4=_hf I~L/At WM POST IN A CONSPICUOUS PLACE SEWER & WATER PERMIT c1~j OFFICE USE ONLY CITY OF EAGAN METER # PERMIT DATE 03120/91 3830 Pilot Knob Rd. Eagan, MN 55122.1897 CHIP # 1 (f PERMIT # 11370 METER SIZE B.P. RECEIPT # C 12545 DATE ~-12-91 ISSUE DATE (o B.P. RECEIPT DATE 03/18/91 - PRV - BOOSTER PUMP SITE ADDRESS 405' PERMIT REQUESTED LOT 1&-BLOCK 2 SEC/SUB ui 13 Is of 1-nn~?~ri.arrn SEWER X WATER TAPS APPLICANT: The Rnt 1 i ine, On. i'nr _ ADDRESS: 5201 Riour Rc)ad COMM/IND R RESIDENTIAL CITY, STATE Frid1gy, Mn. ZIP 15421 NEW - EXISTING PHONE: 571-0344 Lawn Sprinkler Meters are to be Installed PLUMBER: VA11eP11»tg Ahead of Domestic Meters on Water Line. ADDRESS: 610 C';P.P!C Lang Credi WILL NOT be given for Deduct Meters. CITY, STATE Jorcdan, Mn ZIP PHONE: 492-2121 I AGREE TO COMPLY WITH CITY OF OWNER: Th- Rot tlund Co 1no. EAGAN ORDINANCES ADDRESS: 5?~1 tai yB r' ka~~ CITY, STATE Fridley, Mn - ZIP X21 PHONE: 571--0364 _ GNATURE WHEN METER ISSUED PLEASE,ALLOW TWO WORKING DAYS F6R PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. r SEWEE`R ITER PQRMIT OFFICE USE ONLY CITY OF EAGAN b METER # PERMIT DATE y3 Fj l 3830 Pilot Knob Rj Eagan, MN 5512~-'1897 CHIP # PERMIT # 11874 METER SIZE B,P. RECEIPT # t. 12545 DATE ?^~4Z ISSUE DATE B.P. RECEIPT DATE 03 118 1 P1 _ PRV - BOOSTER PUMP SITE ADDRESS 059 C89terVell Dr. N. PERMIT REQUESTED LOT 16 _BLOCK 3 SEC/SUB ui "I s of cr4._,.sbVj4 gG a Y SEWER X WATER _ TAPS APPLICANT: 'NIP Rnttlttnr'A Co. Tne" ADDRESS: 5201 S. Riagr Road CITY, STATE Fridley, Mn. ZIP 5542.1 NEW EXISTING PHONE: 571"0304 Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. PLUMBER: Valley plumbinc, ADDRESS: 6110 Cmek T.am Credit.WILL NOT be given for Deduct Meters. CITY, STATE JorWant Pin ZIP 5k X52 ; ! ~ ~1 i PHONE: z)92--2121 1 AGREE TO COMPLY WITH CITY OF OWNER: rl~ R(A:!;i47~ 6 -n !?3G. EAGAN ORDINANCES ADDRESS: ` 2CI r ♦ ~i y- C-)Aa CITY, STATE Pridlr4,,', Mu- ZIP 1;1-1--114 PHONE: `,,I SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. CITY OF 18787 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 • ° ' BUILDING PERMIT Receipt # To be used for SIP DWC/GAR Est. Value $152,W0 Date MAR 15 1 s X31 RVELL DR Site Acjdless 404 CA#I$I~ N Lot iibb Block Sec/Sub. OFFICE USE ONLY Parcel No. Occupancy R-31 H-1 FEES Zoning PD _4 w Name THE ROTTLUND -CO INC (Actual) Const -Vii;N Bldg. Permit 822 X00 RIVER RD (Allowable) Surcharge Moo Address o City FRIDLEY Phone 571-0304 # of Stories t 534.00 Length Plan Review ~A Depth, SAC, City 1n0'~ ~ Name o 0a Address S.F. Total SAC, MCWCC 650.00 City Phone S.F. Footprints 660900 On Site Sewage Water Conn ww Name On Site Well - Water Meter MWCC ~Vp~'s W 00 Xz Address System- Acct. Deposit d' ccw city Phone City water 30.00 PRV Required S1W Permit I hereby acknowlege that I havd read this application and state that the Booster Pump - S1W Surcharge ''o information is correct and agree to 7r-,H!W VI-with pficable State of 276.00 Minnesota Statutes and Cityp};EagTreatment PI APPROVALS 970.00 Signature of Permitee Road Unit WE ROMIM11 CO INC Planner - Park Ded, A Building Permit is issued to: on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off, Copies Variance TOTAL 3,638.3.0 Building Official i • Permit No. Permit Holder Date Telephone # WATER ,l SEWER PLUMBING C9 91 00 H.V.At. ELECTRIC p'rC/ p Gl 7` 9~ Inspection Date Insp. 9 Comments Footings 1 4 Foundation 9,/ OS Framing C [U,~ Roofing Rough Plbg. Rough mg• S g/ S Qom/ Y~ 9/ Isul. s " fc~ . ` Fireplace 7 a Final Htg. Final Plbg. Consl. Meter Plbg_ Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pr. Disp. DATE: MAR 20, 1991 RE: 4059'CAHBERWELL DR N (THE ROTTLUND CO INC) _0 x Your Sewer & Water Permit for the above property has been completed- It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. i_ CITY OF EAGAN ~0 18787 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PHONE: 454-8100 PERMIT Receipt # J To be used for SF DWG/GAR Est Value $152,000 Date MAR 15 7991 Site Address 4059 CAMBERWELL DR N Lot 16 Block 3 Sec/Sub. HILLS OF OFFICE USE ONLY Occupancy R-3 M-1 FEES Parcel No. Zoning PD R-1 W Name THE ROTTLUND CO INC (Actual) Carter V-N Bldg. Permit 822.00 3 Address 5201 E RIVER RD (Allowable) V=N Surcharge 76-00 ° FRIDLEY 571-0304 # of Stories City Phone , 534.00 Length 621 Plan Review S Name SAME Depth 61 SAC. City 100.00 u< Address S.F.Total SAC, MCWCC 650.00 City Phone S F. Footprints - On Site Sewage Water Conn 660.00 ow W Name On Site Well Water Meter 90.00 w I Address Mwcc System Acci. Deposit 30.00 aW City Phone arywater 30.00 PRV Required 3/W Permit 0 I hereby acknowlege that I he re this application and state that the Booster Pump SrW Surcharge .5 information is correct and rea ffl co I ,in all applicable State of Minnesota Statutes and Cit r antes. Treatment PI 276.00 Signature of Permitee APPROVALS Road Unit 370.00 A Building Permit is issued to: THE ROTTLUND CO INC Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances Bldg, Off, Copies "O nrrn Q' Building Official Variance TOTAL 3,638.50 aaey--Lp Address: 4059 CXdERWIIi, DRIVE NO. Lot 16 Blk 3 Sec/Sub HILLS OF SIONEBRIDCE 2ND These items were/were not complete at the time of the final inspection. Date; 6/14/91 Yes No 33 Final grade (V from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish l/ Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. ,.pa White - City copy Yellow - Resident copy Pink - Contractor copy s/ y/yi -W416. /ads 35 67161. 5°° Request Date Poe No. Rough Inspection q Regw ? J eady Now ❑ Will Not ty Inspector -l ❑Yes ,2INo When Ready? 12r licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, or Rcum No.) CRY D S ~I a 2Q ZIA Section No Township Name or No Ramp No. Co my Occup !(PRINT) Phone No. Power pli4er/^/Address Elecmcal ntr or (Compact me) Contractors License No gaq,a -3 McAm Address ICOnveclor or Owner Makeg Inmellebon) Authorized Signature (C ra downer Makm InstellaM1On) Phone Numher 163- 3~lo MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Odggs-MWwsy Bldg. - Room S•173 BE ACCEPTED BY THE STATE BOARD 1321 University Ave. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED j kt/9~ REOUEST FOPjLECTRICAL INSPECTION ` EB-0000108 fi~ See inslruiLOns for completing this farm on back of yellow copy `y 10133 5 H 6 7161 X" Below Work Covered by This Request k e Add Rep. Type of Building Appliances Weed Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Olher(specify) contractors Remarks Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Clrcuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 _ Amps Signs ~nspeciors use Only ~ TOTAL Irrigation Booms ) Special Inspection Alarm/Communication THIS INSTALLATION MAY I ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. 1, the Electrical Inspector, hereby Rough'" t Date certify that the above inspection has Final 9' been made. OFFICE USE ONLY This request void 18 months from 3' - ~„d 'loo? so ~6 (15 5 Request Data ¢ Fire No. ugh+n Inspection q redo ❑ Ready Now f,~'rAtll Notify Inspector 3 - l Yes ❑ No When Ready licensed Contractor Downer hereby request inspection of above electrical work at: Jab Address (Steel. Box Rene No ) Cry 4051 2JA4. a )2a. Section No. Township Name or No Range No. County occupy t (PRINT) Phone No Power Skjqklier Address L)aA- - lJri1. Elecm Contractor (Company Name) Contradort License No 40. 3 Mailing Address (Contractor onOwner Making Installation) Authored Signature (COntracto n M king Installat _ PYwne Number -3vo MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT ONggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-OSOO ENCLOSED ts, REQUEST FOR ELECTRICAL INSPECTION ^ At ES-00001 .08 jl~ See '2'I uctions Ter compiehng this loan on track of yellow cagy. /d (9 Y~7 X" Below Work Covered by This Request + 67155 New Md yp. Typeof Building AppllancesWued EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm /Industrial 'Furnace Farm Air Conditioner Other (spacity) Conlractorb Remarks: Compute Inspection Fee Below: # Other Fee # ServlceEntranceSize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps ( 0 to 100 Amps 144 Transformers Above 20O Amps 100 Amps Signs Inspectors Use Only' TOTAL SQ Irrigation Booms a Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO I, the Electrical Inspector, hereby Rough-in ° certify that the above inspection has t, Finel t Date been made. J' OFFICE USE ONLY This request wW 18 months from RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 r r 651-681-4675 New Construction Requirements RemodelfReoair Requirements . 3 registered site surveys showing sq. ft. of-lot. sq. R. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions . 2 copies of plan showing beam 3 window sizes, poured found design, etc.) . 1 site survey for exterior additions & decks 1 set of Energy Calculations . Indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan if lot platted after 7/1193 . Rim Joist Detail options selection sheet (bldgs with 3 or less units) DATE 7~19~0„2 VALUATION IZ> V v SITE ADDRESS 410 ,9"? (cr wi eru,6 hY, MULTI-FAMILY BLDG _ Y LIN TYPE OF WORK rL_'eolOCy FIREPLACE(S) _ 0 21 _ 2 APPLICANT dme.--IcRo STREET ADDRESS 1 ?,lN7 /I/yr^o/% f % ✓t•r Sp, CITYl3rrr~SV/ Ile STATEMN. ZI,P~S~S i3~37 TELEPHONE #k2-707-G'Y5V CELL PHONE #t r FAX#-.90 - 9_02 J~ PROPERTY OWNER hsche,- A Ach 1,ni TELEPHONE #6 5 Y-52 -1577 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNES(TI A RILLS 7672 (J submission type) . Residential ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted Energy Envelope Calculations Submitted Plumbing Contractor: _ Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths O LI No. of Baths C Mechanical Contractor: Phone # D AUG 2 2 2002 Mechanical sySLCm includes: Air Conditioning Fee: $70.( HeaL Recovery System By Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances Signature of Applicant ~S~• OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 _ RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF OB RD,EEAGAN MN 55122 S4 73 Y 3830 PILOT KN 651-681-4675 New Construction Requirements Remodel/Repair Requirements I • 3 registered site surveys showing sq. ft. of lot, sq ft of house: and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculations for heated additions . 2 copies of plan showing beam & window sizes poured found design, etc.) . 1 site survey for extenor additions & decks • f set of Energy Calculations . indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE VALUATION SITE ADDRESS '1059 Ogwie,-WC I/ A/ MULTI-FAMILY BLDG -Y ZN TYPE OF WORK awlace KOOK ttCQYaZ! FIREPLACE(S) e0 ✓l - 2 APPLICANT Anrez/cch Q/.r G;7_6140o~>-s STREETADDRESS 192H7 /Vim//ei&. So, CITYSy y7/l' STATE MN ZICP545337 TELEPHONE #W ''/!07-69' CELL PHONE # RSL 2A2 -567/ FAX #IV_ (3 PROPERTY OWNER 61SrhBrsl S oh./z -ny - TELEPHONE#6 S/-252-057? COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNL•'SOTA RULES 7670 CA'l'EUORY I _ MINNESOTA RULES -672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted . Energy Envelope Calculations Submitted Plumbing Contractor: Phone Plumbing system includes: Water Softener _ I awn Sprinkler FOG- Zu 06 Water Heater _ No. of R.I. Baths D el ~ ~ nn ~l ~ D No. of Baths AUG 2 2 2002 Mechanical Contractor: Phone # Mechanical system includes: Air Conditioning By Fee: 570.00 Heat Recovery System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi Signature of Applicant UW3L~: OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 RESIDENTIAL z.. BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ARD, EAGAN MN 55122 T~ o New Construction Reauiremems RemodeilReoair Riau' romen l - 3 registered site surveys shoeing sq. ft of lot sq. ft. of house; and 0 roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Enegy calculations for healed additions - 2 copies of plan showing beam & window saes; poured found design, etc,) • 1 site survey for exterior additions & decks - 1 set of Energy Calculations . Indicate if home served by septic system for additions . 3 copies of Tree Preservation Plan d rat platted after 711/93 • Rim Joist DeleA Options selection sheet (bldgs with 3 or less units) DATE _ SIZ 3/0 VALUATION SITE ADDRESS 4/,0a e if ff iC2wa// 'f • A4 MULTI-FAMILY BLDG _Y _N TYPE OF WORK Deck FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT /-MI Add-4 STREET ADDRESS 04S9 ~irrl c4,c~re// Z,e• Al, CITY Eri STATE^f, ZIP TELEPHONE its/- to s6 -7y-3 CELL PHONE # FAX # PROPERTY OWNER Rs/r Sf,4111.v ~SstNNe .~--1,61n, TELEPHONE# COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY I _ MIN (yry(7~p (J submission type) - Residential ventilation Category 1 Worksheet Submitted • N eeP fshS fitted • Energy Envelope Calculations Submitted MAY 2 3 2002 Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener Lawn Sprinkler ee: 0.00 Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Contractor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor. Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordin es. Signature of Applicant - zii[L y} zri - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-piex ❑ 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 ❑ 10 08-plex X 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Pibg_Y or _ N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (interior) ❑ 44 Siding Q( 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)" ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement `Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 2d Occupancy R-3 MC/ES System Census Code <f-9 Zoning P,0 City Water SAC Units _ Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const ,1L/y Width Y-6 REQUIRED INSPECTIONS At Footings (new bldg) _ Final/C.O. ,Y, 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 Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacetnent) Insulation _ Retaining Wall Approved By Building Inspector Base Fee --W-- Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total jot PIONEER 2422 Enterprise Drive UND eurtVEY0R9• CIVIL EN(.INEERS Mendota Heights, MN 55120 engine@ring,. LAM PLANNER9•LANDeCAPEAR~NITECT$ i * * *~r {612} 681.1914 I Certificate of Survey for: TIDE ROT~p C,-) NORTH l6'tt ti r ~ _ X00 ~ s r ~ , ~ y s7.. gC. Q I IN ~ 'to ~ Qa \ F ~0 \ 0 4 ~ , IS' ?a ~9f ~S~a Z X96 \ a1~9 y v tiro rxi3~ ` a l \ Deeic ~ 4 \ a ~ yt) ar d~ ca `r6A~a~4 gG,q.fl 9oo.o Deno%s { ~o.o exstn SeValion -PROPOSED lJOUSE EV4Loi penote5 propMed Elevation COWES Foor E eva ion a-iz.sk• - Denotes Drarnaje f Gltifi fy Easemenf Top of Block 6evalion sso.-: , ---+--Denotes Drainc~ e Gow Arrows Gara0e5/ab flevoflon s79,93 Denofes monumeof o Dena es Otllef flub Bearinjs shown are assumed Sub cf to Easements of Record LOT 16, BLOCU 3 ,14ILLS OF STONEBRIXE PLAT 2 04 t<OTA CIOVNTY I hareby certify that this is a true and correct repr e;enwaon of a survey of the boundaries of the above de rtbed lend, and of a :o<a:io'•o' all buiidinq;, thereon, and all visiola encroach manta, if any, from or on 59W land. As 'V "eyed by ma th;SdeV of A.D. 19-g4. AT Scale :1 rnth, ~D, PPl R,e. 1KIC L-5 REG. NO.1x831 891 , 2t CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # /a2 C/ e2 PHONE: (612) 454-8100 RECEIPT # U O I€$Cj DATE: gLSAsa PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6 TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC . 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 \U \ OWNER NAME: Cc. OF 1 PER PERMIT nn Y~Q I~ SITE ADDRESS: '±//5S `a ry^ ojzZ` SUBTOTAL: `1Sj~Yi STATE SURCHARGE: I~~J.50 50 LOT: / _ BLOCK d SUBD, p~ TOTAL: !SO INSTALLER: . , ADDRESS: 9303 Plymouth rOo ono SIGNATURE OF PERMITTEE Iden'Valley, MN. 55427 CITY: f' n I _ ZIP: PHONE O~'W o(.0 t7HlIE1tL'tiITTI$TRTA; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x IS $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT PHONE: (612) 454-8100 RECEIPT # /6O DATE: a!r WAR ZP~y; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON I SHOWER 3.00 3_ REPAIR WATER CLOSET 3.00 cl 2 BATH TUB 3.00 f._ 4 LAVATORY 3.00 Q_ OWNER NAME: ~o ~v ! KITCHEN SINK 3.00 3 i LAUNDRY TRAY 3.00 3 SITE ADDRESS: y05q CAvw&t l kk HOT TUB/SPA 3.00 HEATER WATER 3.00 LOT: I~v BLOCK SUBD. /09 a n' FLOOR DRAIN 3.00 3 GAS PIPING OUT. INSTALLER: \jA k ez. Y100 D (MINIMUM - 1) 3.00 3 ROUGH OPENINGS 1.50 Ll.Su ADDRESS: L 1 fJ G 2RZY L j OTHER _ _ WATER SOFTENER 5.00 CITY: ,)o rya 7 ✓ ZIP: S~5 3 ~-D PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 PHONE 4CAD -a4a 1 n SUBTOTAL Li 9.su !L- ST. SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: $ Ct~MMERxA`fiN!)STIfiL's PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. mm m-m CONTRACT PRICE: FEES OWNER NAME: 18 OF CONIRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN 1991 BUILDIFG APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) .1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNAT ER%M[E DESIRED. NO CHANGES WILL B ALLOWED CE BUILD G PERMIT S I LL11 Vv PROCESSING TIME FOR SEWER S WATER PERMITS IS TWO DAYS ONCE A PE HASnBE%C3CI PLE PERMIT MUST SHOW A LICENSED PLUMBER. ~~~wIIHHKR To Be Used For: -tm ~aL6 ~amiuY. Valuation: ~ Date: Site Address [ ~ C v nuFt N. '~Z100J~OFFICE USE ONLY Lot V,, Block FEES Occupancy R-3 M-1 Bldg. Permit 82Z , OO ?s,R Zoning V 11-1 Surcharge 7(2 00 Parcel/Sub µ1LLs OF c~/o P 2iCr sy _ Actual Const V-d_ Plan Review S34 i 0--.) Allowable IV-t4 SAC, City 100100 Owner P-v7Tw11r) yam, # of stories SAC, MWCC (714PJ-0-0 Length Z' Water Conn. (6Go,v0 Address S2o/ E. 72)L)" &ygo, Depth 36 Water Meter '70,0 0 S.F. Total Acct. Deposit .00 City/Zip Code Fjpirx,e-y, 9-5 cgz.l Footprint S.F. S/w Permit 30,00 S/W Surcharge 1-5,0 Phone S11 -biK4 On site sewage- Treatment P1..2?4p, On site well Road Unit 3D0, of Contractor ralE, MWCC System Park Ded. City water Trail Ded. Address PRV Copies Booster Pump City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner Lot Change Council TOTAL Arch./Engr. Bldg. Off. 3-/y-il bs Variance Address City/Zip Code Phone # agrees that all work shall be done in accordance with Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. 32~ x a;z 704 6 HD X IS 1 D, Z Do [3S1y► t, 2e X z8-= 78q 0•* ZZX 1~I_ 30 g 822•oo+ / 76.00+ 1 ~~1Z X IL}= ISZ88 534.00+ 2-,206-50+ 3)638.50* 822.00+ Iy Xl2- 168 ~e 4c) 6r? ZO 76.0()1- 534.00+ 2'206.50+ uu 3,638.50* H 0~ i 1% 6sM7 . 1 C5 '2- °ZX'~KI= zI ( 12l to6 ~I SS Z` * PIONEER 2422 Enterprise Drive UND SUrrvEytsrfs. CI VIL ENGINEERS Mendota Heights, MN 5512D engir„eeringa. LwNpPLANNERS•UNC$SgPEwRCNITECTe r f612) 681-1914 Certificate of Survey for: NORTH Da e\ , Ada w ~ 9 ' `tie 39 . /L C •ejti \ r lj B \ t1 ~ ~ / r?,a Fqe a ~ \6 f \ \ y 6 S B rS1eaE~ +s ~r\ Z )r o n na M~ ~ ~ y\\^ ~ 5l / 9/ ~ ib P~°"~etigA r ~ ~ a ~ yo 4 d~p~ gym' i/~, ~ a 0 a EAGA14 &M z: MIrIjrG DEPT ~q,fl . goo.o Denotes evAq Eevalion SE 1 / EYAT ON ♦ ,~Denotes propaed Elevation Lowes f-oor eva pon _ 8-Iz.s~ Denotes Oraina& Uti(iy Fasemenl Top of Block Elevation sso.7c,, Denotes DraincciYSe Flow , Irrows GargWe Slob Elevation s7*93, Denotes monumenf o Deno es 0Pl sef Nub 8earinjs r&wn are assumed Su~kc~ to Easements of Record LoT L(o , BLOC! 3 , 1l1 Ll S OF STONEBRIIaG'E PtAT 2 DAKOTA COUNTY I hereby cartify that this is a true and correct representation of a survey of the boundaries of the above de Abed land, and of a love: or of all bVildings, thereon, and all visible encroachments, if any, from or on sold land. As surveyed by ma th; o y of A.D. 19-97/- web scale :1 , 401 eef 5tvol /~sEG. NO. 14891 a r zi EXTERIOR h vKLOPE AVERAGE "U" CORPUTATION OWNER Tj*k )%tL J(f6 W►~G,3 PL SITE ADDRESS L UT ~4L G I LL`s ~'u'.' iDL4 ~4L ~t CONTRACTOR dA ME DATE _ PHONE 57 Determine working square footaa/g--e of each. 1. Total exposed wall area 2- ZS ~ sq. ft. x •Il9 = ss- 2. Total roof/ceiling area / ,1&7 sq. ft, x (02 = t7. Total exposed wall area above floor =21f 9 (a a. Total wall window area -3 b. Total door area ` c. Total sliding glass door area d. Total fireplace wall area e. Total wall framing area (average 10%) ~ f. Total net wall area above floor 0 g. Total rim joist area 31 Z- Total exposed foundation area = -7 ffi h. Total foundation window area '7 i. Total net foundation area above grade 7 Determine "U" value of 'each wall segment. a. 253 X "U" 7 _ / b. 3 It X nun. l40 7 = 2-66 C. 40 X nun . ~6 = 2.7-/60 e. 2/3- X nUn "407, _ /D.71 ' f. 193o X "v" .oZfZ = S1006 ry g. 312 X nun _ 12,4 h. -7 ! X "U" r S~ J 6~"a i. 7/ X „Dll 3 ......................................Total 2 0.7 If item # 3 is the same as, or less than item #1, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area Total gross roof/ceiling area j. Total skylight area Total roof/ceiling framing area 1. Total net insulated roof/ceiling area Determine "U" value for each roof/ceiling segment. j. tl-~ X fluff 1. 14 0 9 X „U„ s92~ z7.73 4 Total = If total of 114 is the same as, or less than 112, you have met the intent of SBC 6006(c)l. To utilize the total envelope system method, the values established by the sum of items 113 and 114 shall not be greater than the sum of items 111 and 112. 1. 32 0.3 S + 2. 3a• 6 g = 3S7.c3 -,em 3. 290.79 + 4. L '.Eis = 320.'V u Wtpi.J, Slil;'1'IV~,.~ 1'uye J of 4 NTE:' Use 10% of opaque wall area for frame construction Construction R-Value -~J 1. Interior air' film 0.68 - °J .2. C3'T 1139- C o4S 3 3. lx(, s-rriaS (0088 4. , 4. 2 5/3 2 5 H 7-e, . 2 OCR ASIC 14ALL 5. $/U!tie. UtJE/e FEGr / e ? ro 6: Exterior air film 0.17 Total S' FIG. 111 TOPVIEtP OF OB- FRAHE WALL 1. Interior air film 0.68 2. ~17:P EQZ D oyS ~I 3. f7/4 L -Grlj e . 2532 5/1TCr 2 O[~ FIG. $2 4 IL.. Q 5. //.YAiGr OV05Fe ELT / e2 6 6. Exterior air film 0.17 Total 2 3: 6 Z lI~ I~ Ug~ 1, Interior air film 0.G8' )5eral ~L 1j--`_'__-(J ^ 2. /ir/vL /~vUO + r•,;r~~ I~ "2 X~ nI rA .150 f i I' i• F• 4. 25 Z S H TG~ ..r;~+ u p z doh 5. S/d/+vv PJV~/z FE2T, / e 2 (c •1 r,5 P 6. Exterior air film 0.17 i11Th i• t " 5 Total 2 6.0 g- 10 I::J=~ ♦1: ;1 p ! J~,...,~.-J 1. Interior air film 0.68 /1 / UO 3. 2 l FU2Rtrtc~ 4. 12'~cO.wc, (e- 5. 6. Exterior air film 0.17 Total 13.13 113 FIG. If4 = k ♦ r Lee o _ ' w (Cl Y, X ~ROOF/CEILING Construction R-Valtte 33 (t 1. Interior air film 0.61. I 2. 5/~," COY P 'f3 ~O o S~, n ~N FIL~,f3. 4. Exterior air film (still o.61 MIT /•I l 1 {'ir Total 3~l Jenced Seac flow up FIG. $5 1. Interior air film 0.61 •f.o.~l_•.•:-:1,'1s1~+1 _ti %i.?-~t/Lft n\F..19~G:t oS O ove-2 --izUSS ate' Ej 4.. Exterior ai.r film stiTL) 0. bi ~~KV, Total ? !t I ✓~r7 f IIiII Il~MEIN II .D27 I `61 2 3 1 Heat floss up. -vented FIG. #6....1 . 3 U 1. Inside air film 0.G1 • ~ 1 2. L t•• 4. S. Outside air film 0.17 Total i . 1 ~ Z _ HOt7-p"iEp Note: Use additional sheets if more space is needed for details and calculations. . Henc flow up FT.G_ A7 Use BLUE or BLACK Ink For Office Use r I I I Permit F AQn City of Ealld -'$60-50 1 67 1 Permit Fee: I 3830 Pilot Knob Road 1 Eagan MN 55122 1 Date Received: C) Phone: (651) 675-5675 j I Fax: (651) 675-5694 Staff_ 2009RESIDENTIAL PLUMBING PERMIT APPLICATION Date: V 2~~ 1 Site Address: 46- J/1 ~MJ3~We cc Al /V Tenant: Suite RESIDENT/OWNER Namej2L-4 / 5T/j0./G//V6 3Ue Phone: (oS ~~D-77 3 Address / City / Zip: 1710-5 f L /~/Z . N CONTRACTOR Name: ANfJe-(Z License#: P/Y\ (o-3 !5~77 Address: City: State: Zip: Phone: Contact Person: f TYPE OF WORK _ New 4Replacement _Repair -Rebuild - Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures 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 $165.00 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 $ ~ ? 6 • 0 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.gor)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approyed pla in the case of work which requires a review and approval of plans. x~A~-o N x Applicant's Printed Name Ap licant's Signature FOR OFFICE USE Reviewed By Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA111312 Date Issued:06/18/2013 Permit Category:ePermit Site Address: 4059 Camberwell Dr N Lot:16 Block: 3 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-03-160 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Andrea Preusse 4145 Sibley Memorial Hwy Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Susanne J Fischer 4059 Camberwell Dr N Eagan MN 55123 (651) 206-4949 Wenzel Heating & Air Conditioning 4145 Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA156827 Date Issued:07/19/2019 Permit Category:ePermit Site Address: 4059 Camberwell Dr N Lot:16 Block: 3 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-03-160 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Susanne J Fischer 4059 Camberwell Dr N Eagan MN 55123 (651) 206-4949 Estate Claim Services Llc 6701 Penn Ave S, Suite 201B Richfield MN 55423 (651) 309-1114 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA157411 Date Issued:08/19/2019 Permit Category:ePermit Site Address: 4059 Camberwell Dr N Lot:16 Block: 3 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-03-160 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Susanne J Fischer 4059 Camberwell Dr N Eagan MN 55123 (612) 206-4949 Estate Claim Services Llc 6701 Penn Ave S, Suite 201B Richfield MN 55423 (651) 309-1114 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA167482 Date Issued:03/17/2021 Permit Category:ePermit Site Address: 4059 Camberwell Dr N Lot:16 Block: 3 Addition: Hills Of Stonebridge Plat 2 PID:10-32991-03-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Susanne J Fischer 4059 Camberwell Dr W Saint Paul MN 55123 (651) 206-4939 Apex Energy Solutions 9655 Newton Ave S Bloomington MN 55431 (651) 688-2739 Applicant/Permitee: Signature Issued By: Signature