4076 Camberwell Dr NCITY 4F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 6$1-4675
N RECORD
PERMIT TYPE:
Perm it Num be r: +J. ` 3!
t Date Issued: f# o /{j A
SITE ADDRESS: 1 0 i : •14
? 1il i?:. r.?i ,? 131?Jf I??i:?[?t:i!• :'NI'?
I PERMIT SUBTYPE:
? k <-I - t 1lJ
l{ t APPLICANT:
- TYPE QF WORK:
f ] hd11!
i ??? ? ?
?
------ ---- -
PermR No. PermR Holder Date Telephone #
S/1N
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Pibg. Inspector-Notify Plumber
Const. Meter
EngrJPlan
eldg. Final
Deck Ftg.
Deck Final
v
well
Pr. Disp.
INSPECTION RECORD
V CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: ' I ' ! 11 /`r `:'
(651) 681-4675
SITE ADDRESS:
?,;'?J I? F S•'!.:ll 4? ? t li p?
PERMIT SUBTYPE:
:'_?d69? ?9 t
: APPLIGANT:
t:: ? (10
. , . ... ? ,?;, .
1?• f.' i r; .' i S! E? +I ?
TYPE OF WORK:
tz ?_ r=rr r. t?
V F:k (if] f
{iF'.I'{.,lf'I tt.lM
INSPECTION .,
a 5 1 i O ..
I, „'?l?r _'-. k, !;Hi'il AI`dli t;flfiAriw` llisl 1s? ?•c('1)??IN fiAhlAi:;l'
Permit Holder Date Telephane #
SEWER/
WATER
PLUMBING
HVAC
Inspectfon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
C
uKJ
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLAGE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATIaN
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
. . . . . ,. .. . ,
? ,. . •? -'i, '?_. i
?
Ttxtif tira#t nf COrrupttnry
`r Citp of (Eagari
?? MrvarwPtt# of iui[dbtg ittwrii.ao ? .,
77ris CernJ'rcate rssued pursuani io the requirements of Seciion 306 af ihe Uniform Burlding r
Code cernfying lhat a1 the tip?re of irsuance thrs souclum wm iM eompliance with 1Jre variour
ordinatrces of the Crty regulating buildirig construcdan ar use. For the follawing.-
sF tWGiGa..R
??? ??t No. :
'R FD/-1 ??7
. ViY ?f
OMUPWY ? ?X ? ? ?
? 5?124 BAKERRD, MIkV??'i1'.t?
;i
?9 4075",WMWELL DRIt? I?10RTEi , B 1, FILTLS (lF SMM= 2AID :
ew'??s aeafm J- "uty
"'/""'I)L . 3
. Bau'ldieg O&W
. ? .;?
POST IN A CONSPICC1dU3 PLACE
b;
-i
_...?..._,. ,;:. r -:u.?. ._..?.... l.Y .-` .....s. .. _ . '.:. .....
, :?...
o?....... . ? 3830 Pilot Knop Ri
Site Address _
Lot 2k,, BI
Parcel No. _
Name _
W Address _
? c4 -
RMIT i" Y
cv rx.rr_ir,-eD - _. .._,..
CENTEX
?929 BAICER
MYrMraNK? ?
?23-2155
3e that I have read t1
act and agree'to c"
and Ciiy o1 Eargan
ee t
. CrE
Zp
Zap
and state that the
pplicable State of
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Otlieial
AN
-199, Eagan, MN 55121 vr
675
Receipt # x
- :-
?
-?
date I+TtJY 22
?
OFFICE USE ONLY (;n
? ? ?
Occu
anc FEES
y
p
Zoning PD R-i
Bldg. PermR 7$7*00
e?
(Actual) Const ViN Sumharye 71.00.
" - i
(Allowabla) V-m Plan Review 311.00
# or stories ? License ?
Length
l?w??
Oepth SAC, City ?
S.F. Totai - SAC, MCWCC 6???? •'?
S.F. Fooiprints - 660+00
On Site Sewage - Water Conn
? g??
?
On Site Well
?- Water Meter ?
MWCC Sysiem
X
Acct. Deposit 30.00
City water 3Q .00 , i
_PRV Required _ S/W Permit ;
?
Booster Pump - 5IW Surcharge .50
276.00 f?
TreatmentPl
APPROVALS Road Unil 370.00
Planner - park Ded. ?
Council
Bldg. Off. _ Copies
3,580.50
Variance - TOTAL '
Permk No. Permit Holder Date Telephone #
SMr
PLIc'MBING
HVAG ? ' I lr r/o2. ?a?'
EL.ECTRIC' /,??rp.? ? ur 9 e9 ?O 00
ELEcTRic
Inspection Date Insp_ Camments
Faotings I
Foundation 4
Framing
41,
Roofing
Fiough Plbg. y? - 2 M
Fiough Htg. J
lsul. U
Fireplace O? 9:?- '
Final Htg. - d k A?l
orsat TW
Final Plbg. ?b Plbg. Inspector- Notity Plumber
Const. Meter
EngrJPlan
Bldg. Fnal
Deck Ftg.
Dedc Final
Well
Pr. Disp.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knab Rd. ?
Eagan, MN 55122;1897
DATE NOV 22. 1991
4FFICE l
METER # ? ?
cH?P ? 61.s 9 C2 f?(P a
??-
METER SIZE ?? su
ISSUE DATE
E ONLY
PERMITDATE 11J29/91
PERMIT # 12405
S.P. RECEIPT # L ' 4
B.P. RECEIPT DATE 11 26 91
_ PRV _ BOOSTER PUMP
51TE ADDRESS 4076 GAMBERWEL.L DR N '
LOT 24 BLOCK 1 SEC/SUB IiILLS OF STQNEBRIDGE 2ND
APPLICANT:
AdDRESS: _
CITY. STATE
PHONE
ZIP
PLUMBER: PLYM(7UTH PLUMBING INC ADDRESS: 9290 ZACHARY LN
CITY, STATE r1APLE GROVE MN ZIP 55369
PHONE:
493-2474
OWNER: _
ADDRESS:
5929 BAKER
PERMIT REQUESTED
X SEWER X WATER - TAPS
- COMM/IND X RESIDENTIAL
X NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of omestic ters on Water Line.
C i f T ? en for Deduct Meters.
r-4. l.t?z_..-
?
I?GREE TO-COMYLY WITH CITY OF
EAGAN QRDINANCES
CITY, STATE MINNETONKA MN ZIP
PHONE: 423-2155 SIGNATUR HEN METER IS?UEd
? ,--
? ir, ?i..,? r / ?(
PL?ASE dLLOV{I 7W03WORKI?G?A(?O? ?ROCESSING. CALL 454-5220 FOR INSPECTIONS.
SEWER PERMITS, CONTACT EMGINEERING DEPT.
FOR STORM
!? ?
'?+?-?a? .. . , ,.,.,?,?. , , . _ :.:. ; -• s??"?": ???r??. ,
SEWER & WATER PERMIT OFFICE USE ONLY
CITY 60 El1C?'QN ,: .
? NfETER # PERMITDATE
3830 Pilot Knob Rd. .-
Eagan; MN 5512;??1897 CHIP # PERMIT # 12445
METER SIZE B.P. RECEIPT #-'?? ? 1?.
ISSUE DATE B.P. RECEIPT DATE 11 Zb 91
DATE NOV 22, 1991
PRV - BOC?STER PUMP
SITE ADDRESS 4016 GF-BERi,IELL DR N PERMIT REQUESTED
LOT _24 BLOCK 1 SEClSUB HILLS C3F aT-ONE$RIDG? 2 ND
X SEWER x WATER - TAPS '
APPLICANT:
CpMM/IND X RESIQENTIAL !
ADQRESS: _
CITY, STATE ZIP X NEW - EXISTING
PHONE:
Lawn Sprinkler Meters are to be Installed
PLUMBER: i'I.YMaUTH PLLtMBIhG TNC Ahead of Domestic eters on Water Line.
AODRESS: 9290 ZAC?RY LN I Tb iven for Deduct Meters.
C
CITY, STATE N1A.PLE GROVE i?F ZIP 553?i9 T
PHONE: 493-2474
1 70 COM LY WiTH CiTY OF
G6REE
OWNER: CENTEX EAGAN ORdINArlCES
ADDRESS: 5929 BAKER
STATE MZNNETaNKA MN
CITY ZIP
, .
PHONE: 423-2155 SIGNATURE WHEN METER ISSUED ;
PLEASE ALLOW TWO WORKING dAYS FOR PROCESSING. CALL 454-5220 FQR INSPECTIQNS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
CITY OF EAGAN
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 , 11o 19908
BUILDING PERMIT j PHONE: 681-4675 Receipt # ?1od a o / ?0 / '?? 3
?L
Est. Value $142
Site Address 4076 CAMBERWELL DR N
Lot 24_ Block 1_ Sec/Sub. HILLS OF
Parcel No. STONEBRIDGE 2ND
Name CENTEX
qddress 5929 BAKER
? Cjh, MINNETONKA MN ZP
? Dhnnc 423-2155
¢ Name SAME
? Address
? C?' ZP
Phone
8 L.IC2f152 #
I hereby acknowlege that I have read this applicaUOn and stata that the
inlormalion is correct and agr co p; wit pplicable State of
Minnesota S[aiutes and City of a d a s.
Signalure of Permitee
A Building Permk is issued to: CENTEX
on the exprass condition that all work shall be tlone in accordance with all
epplicable State of Minnesota Statutes and Cily ol Eaqan Ortlinances.
Building Oflicial
OFFICE USE ONLY
7 9.91-
FEES
occupancy R-3 M-1 7g7
00
2oning PD ?1 ?' ? ,
(ACtuap Const V-N Surcherge 71.00
(Allowable) V-N plan PAvioy
?
511.0
A otStones -
Lenglh 54' License
Oepth 5' SAG City 100.00
S.F.TOtal - SAC,MCWCC 650.00
5 F. footprinls -
On Site Sewaga _ Water Conn 660.00
On Sile Well Water Meter 95.00
rnwCC system X
Accl. Deposit 30.00
City Water -X-
PfiVRequired _ S/WPermil 30•00
Booster Pump - S/W Surcharge - Sn
7reatmenl PI 276.00
APPHOVALS poad Unil 370.00
Planner - park Ded.
Council -
BIdg.Ofl. _ Copies
Variance - TOTAL 3.580.50
Address: 4076 CFMREEZf26]EL DRIVE N. Lot y{ Slk I Sec/SubFIMS OF GICNFRRnrE 2ND
These items were/were not complete at the time of the final inspection.
Date: 0.h Ol 92 Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent staps - main entzy
Permanent driveway
Permanent gas
Sod/seedad grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify vith tha buildar the removal of roof test caps from tha plumbing
system and the shut-off of water supply to tha outside lawn faucet before
freeze potentlal exists. ?
vemwwu
White - City copy Yellow - Resident copy Pink - Contractor copy
DATE: NOV 29, 1991
? .S
RE: 4076 CAMBERWELL DR N(CENTEX)
X Your Sewei8 Water Permit for the above property has 6een 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 (4545220) 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 Cily 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 Inspeciions Dept.
ia- ao 9i /v CI/9,?-
J84 3 : ?a ?
Request Date Pire No.
0
Rougn-in InepecGOn
2
-17I 1
R ?7 ?ReadYNOw WAhNOtR I?n
Speclor
Yes ? No Y
I licensed contractor ? owner hereby request inspection of above electrical rrork at:
Job Atltlress (Slreet Bax or RWte NO / Qty
Seciron No ? Township Name or No. Ranpe No Courity
?
Occupanl(PRINT) Phone No.
G fC
PowerSuppber Atltlress
Elecincai GonVacmr 9 ny NamB) CoMrectw's Lroense No.
Mailing Abd'mss fContrxdg or Own ing Instaglla wn) /` //? /
UJ
G?
N i'/N G?
I
AumonzM SigneNr nVanor/Owner M king Ins?allation? Phone ?er
11c? Z
MINNESOTA STATE BOAHD OF ELECTFICITY THIS INSPECTION qE0UE5T WILL NOT
Grlygs-MiOway BiAg. - Room S-173 BE ACCEPTED BY TME STATE BOARD
1821 Univereity Ave, 51. PeN. MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone(613) 602-0800 ENCLOSED
1??REQUES7 FOR ELECTRICAL INSPECTION
? See mSVUC[mns br compleLng tM15 torm on back W yellow wpy
J" 18 48 Y -t "X" 8elow Work Coverea' by This Request
A??s EB-00001-OB
ew Add Rep Typeofewlding AppliancesWired EquipmentWired
- ? Home Range Temporery Service
Duplez Water Heater Elecnic Heating
Apt. Building Dryer Other (Specity)
Comm./Induslrial Wmace
Farm Air Conditioner
Other (speciy) ConVector5 Femarks
Compute fnspeci"ron Fee Below:
# Other Fee # ServiceEnlrance5ize Fee # Cirouits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transiormers Above 200 _ Amps ?1bo?e 100 _ Amps
SignS Inspector's U. only TOTAL ?O
Irriqation Booms Oo
Speaal Inspeaion
Alarm/Communication THIS INSTALLATION MAY 8E O NNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
I, the Electncal Inspector, hereby Roogh-in oate
certity that the a6ove inspection h25
been made. Final
OFFICE USE ONLV '-This request witl 18 months Fmm
/ "
51
g 2365
'
Raquest Dale Fre No gh-in Inspectwn
' IZ?-JI ? Yesd' _ No G Ready Now X] Will Nobdy Inspector
When Ready?
II licensed contractor ? owner hereby request inspection of above electncal work at.
JoD Ntl0,e55 ISVeet Box or RoWe No ) City
4076 Camberwell Drive Eagan
Secuon No T nship Name or No qange No Counry
Occupant IPRiNT] PhOn¢ N.
Centex Homes
Power suPpiier Atldress
Dakota Electric
Elecincal ConVactor (COmoany Namei ConVacmr§ 4cense No
Laze E ric Inc. 041935-8
Maibng qeoress (COmrector o.Owner Makmg Instailallon)
8383 Sunset Road N.E., Minneapolis, MN 55432
Avlnorrzeo &qnaWre COntractor.Owner Makmq Instaiialion) Phone Number
/n I'L Waa d.Qn 784-3729
MINNESOTA STATE BOARD OF EIECTRICITY THIS INSPEGTION REQUEST WILL NOT
Gnggs-MiCway 81tlg. - Raom 5473 . BE ACCEPTEO BV TNE STATE BOARO
1821 Univeralty Ave., SL Paul MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (614) 642-0800 ENClOSEO
/?S/S/ REQUEST FOR ELECTRICAL INSPECTION
P Se'9;,str.uclians for <ompleUng this lorm on back ol yellow copy
1 72365 72365 'X" Below Work Covered by 7his Request
EB00001-OB y?4i"?h,g
ew 9 Rep I TypeofBwldmg AppliancesWired EquipmenlWned
X Nome Range Temporary Service
Duplex Water Heater Electnc Heating
ApL BuAding Dryer Other (Speary)
Commllndusirial Furnace
Farm Av Condihoner
OlM1er (syecdy) Contrectors Remarks
Compule'lnspection Fee Below:
x ' Olher Fee # ServiceEntranceSize Fee # Circuds/Feeders Fee
Swimming Pool 0 to 200 Amps O to 100 Amp
Trensformers AbOVe 200 _ Amps A Amps
Sgns Inspector's Use onry 70TAL
trri
gauon eooms $86.50
Speaal Inspection
Alarm/COmmunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, the Electrical Inspector. hereby aou9n-in
ceridy that the above inspection has
been made. F,,,ai o ie I
OFFICE USE ONLY This request voitl 18 maMhs trom
r
(t 5-1-1 9'
2004 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.
? ?J
Date S
!
I
/ '
? •,, I`
??
'
'
0 7
? r 1
S?n_T?,1
-t
Site Street Address
i, 1 C?Y}
1 Iv • Unit #
Property Owner?? ? Telephone # (01 ) Cs%g5l 'a?oS?S
Contractor y`CluJh Wo Telephone#
Address State Zip ?
?
?
The Applicant Is: _ Owner
K-Contractor _Other
Alterations to existing dwelling
` $ 50.00
Add fixtures to rooms, excludin water softener and er, ht?'r '
9
;?? '?.
I
_Septic System Abandonment
1 0
"1004 ?
_WaterTurnaround (add $121.00 if a 5/8" meter is re te )
Other:
Imu
Water Softener Water Heater $ 15.00
_ replacement _ additional
Lawn Irrigation System RPZ_ new <repair _rebuild $ 30.00
State Surcharge $ .50
Total $f ?
I 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
permit, work is not to start without a permit and work will be in accordance with the appr v plan in
the event a plan is required to be reviewed and approved.
ApplicanYs P inted Name ApplicanYs Signature
*citV oF eagan
PAT GFAGAY
Mayor
PEGGY CARLSON
CYNDEE FIELDS
MIKE MAGUIRE
MEG TILLEY
Councd Members
THOMAS HEDGES
Ciry Adminis[raror
Municipal Cencer.
3830 Piloc Knob Road
Eagan, MN 55122-1897
Phone: 651.C75 5000
Fax: 651.675.5012
TDD: 651.454.8535
Maincenance Faciliry:
3501 Coachman Point
Eagan. MN 55122
Phone: 651.675.5300
Fax: 651.675.5360
TDD: 651.454.8535
www.cityofeagan.com
THE LONE OAK "CRBE
The ymbol of screng[h
.oud -1cowch m our
cummuniiv
April 15, 2003
MR JAMIE WINGER
TITUS N WINGER
17715 12TH AVE N
PLYMOLI'fH MN 55104
RE: VALUATION ADNSTMENT & REFUND
BUILDING PERMIT #56687
4076 CAMBERWELL DR N
TO WHOM IT MAY CONCERN:
As requested in your letter of April 10, 2003, we have noted a valuarion adjushnent from $21,000
to $6,000 for Buildmg Permit #56687. The Work Type on the pemut was changed from "reroof
and siding" to "reroof' only.
A$160.00 refund calculated below will be mailed to you under sepazate cover:
$335.25 base fee paid minus
$125.25 base fee due for $6,000 valuarion equals
$210.00 minus
$ 50.00 maintenance fee equals
$160.00 refund
The difference in state surcharge collected is non-refundable.
If you have any questions, please fee] free to give me a call at 651-675-5675.
'ncerely,
anice Severson
Office Supervisor
cc: Dale Schoeppner, Chief Building Official
9 . A
CLAIM VOUCHER - REFiTND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: TITUS N WINGER
ADDRESS: 1771512TH AVE N
PLYMOUTH MN 55104
LOCATION: 4076 CAMBERWELL DR N
RECEIPT #/DATE: 36658 I1l4/02
REASON FOR REFUND: $15,000 DECREASE IN VALUATION
VALUATION: $21,000 TO $6,000
TYPE OF REFUND:
Plumbing Pemut
Mechanical Permit
Building Permit Fee
Plan Review Fee
SAC (MC/WS)
SAC (City)
SAC (Admin)
W ater Connecrion
Sewer Permit
Water Pexxnit
Acwunt Deposit
W atei Metei
Water Txeattnent
Water Supply & Storage
Surcharge
Oveipayment
Curb Box Deposit Refund
Construc[ion Meter Dep Refund
9001.4087
9001.4088
9001.4085
9001.4222
92202295
9379.4681
9001.4246
9220.3865
PERMIT #: 56687
$
160.00
9220.4532 $
9220.4507 $
9220.2252 $
9220.4509
9220.4685
9220.4680
9001.2195
9001.2250
9220.2253
9220.2254
$
$
Other $
TOTAL $ 160.00
I decl under the penalties of law that this account, claun, or demand is just and that no part of it has been paid.
4/15/03
SIGNATURE DATE
A
TITUS N. WINGER CONTRACTING, INC.
17715 12TH AVENUE NORTH
PLYMODTH, MN 55447
763-475-3175
GENERAL WNTRACTOR LIC. #: 20270544
April 100', 2003
Jan Severson
City of Fagan
3830 Pilot Knob Road
Eagan, MN 55122
Jamie Winger
Titus N. Winger Contracting, Inc.
17715 12'h Avenue North
Plymouth, MN 55447
Dear 7an,
On Nov 4'", 2002 we pulled a permit for roofing & siding work to be done at the
residence of Paul M Bjorklund at 4076 Camberwell Dr, Eagan. The permit number is:
EA056687. The valuation of the work at that time was $21,000. Due to a number of
disagreements, we have mutually agreed to cancel the remaining work. We have
completed Mr. Bjorklund's roof at a cost of $5,900.00. Mr. Bjorklund has hired another
contractor to side his home and knows that the new conVactor must obtain a pernut for
that work. We wish to get an adjustment for the valuation. The difference would be
$15,100. We paid $345.75 for the original permit and would like to get a refund for the
difference, if possible. Please call me @ 763-475-3175 with any questions. Thank you for
yow help in this matter.
Sincerely,
J A?Winger
Titus N. Winger Contracting, Inc.
S'?. RESIDENTIAL
41 BUILDING PERMIT APPLICATION
CITY OF EAGAN
.. ...r.-.._
! •?•, 3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New ConsW ction ReouiremaMS RamodeVReoair Reaulrements
V __?J'S71S
• 3 registered site wrveys showing sq. ft. of IoL sq. ft, of hause; and all roofed arem • 2[oDies af plan
(20Wo mazimum lot coverage allowed) . 1 set of Energy Cakulations for heated addiAOns
• 2 copies of plan shaxing 6eam 8 window saes; poured found design, elc.) . 7 srte survey for exlerior additions & decks
• 1 set of Energy CalcWations • Indipte'rf home served by septlc system for addNOns
. 3 cropies of Tree Preservation Plan if bt plaUed after 717193
• Rim Joist Delail Optians selechan sheel (61dgs with 3 ar less unils) ?
DATE O 3r QZ ?,?,? o? ??0?
VALUATION .?! ?VV'CT
SITE ADDRESS Ci\IM6-f WfAl MULTI-FAMILY BLDG %Y _N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT . n9ez
f
STREET ADDRESS n7 (2-? Rvq_ N CITY I?vhw?? STATE_ZIP
TELEPHONE # CELL PHONE # PAX #
PROPERTYOWNER TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RULF.S 7670 CATEGORY 1 MINNFSOTA RULES 7672
(J su6mission type) • Residentlai Ventilation Category 1 Worksheet Suhmitted • New Energy Code Worksheet Su6mittetl
• Energy Envelope Calwlations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mcchanical systciu includcs:
Sewer/Water Contractor.
I hereby acknowledge that I have read ihis application, state that the
with all applicable State of Minnesota Statutes and City of Eagan Orc
Signature of Appl(cant
Phone #
Fee: $90.00
Fee: $70.00
? Idl
_
L?
correct, and a ree to c
? _ ? _ -- -
Phone ?L?
--° ........... ......__....._..__-------- __------------ -- ---.---------- __.._..?
OFFICE USE ONLY ,;I ---
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
^ Water Softener
Water Heater _
_ No. of Baths
_ Phone #
I.awn Sprinkler
No. oFR.I. Baths
_ Air Conditioniog
_ Heat Recovery System
, ,.,
?_ CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
023555
05./10/94
SITE ADDRESS:
P.I.N.: 10-32991-240-01
4076 CAMBERWELL DR N
LOT: 24 BLOCK: 1
HILLS OF STONEBRIDGE 2N0
DESCRIPTION:
Buildin?'_Permit Type DECK
Building Wdr_k Type NEW
?
,
i ?
J \?? ! S`?f•
., . '
Qj1?? ULSLi??' i]h ci
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
7ota1 Fee $30.50
CONTRACTOR: - Applicant - sr. Lxc. OWNER:
LUND6REN BROS CONST INC 14739640 0001413 ANpERSON EDWARD
800 E WAYZATA BLVD 5076 CAMBERWELL OR N
WAY2ATA MN 55391 EAGAN MN 55123
(612) 473-9640 (612)681-1310
?
I hereby acknowledge that I have read this application and state that the
i.nformation is correct and agree to comply with all applicable State of Mn.
Statutes d Cit of Eagan Ordinances.
L a . ?
APPLICANT/PE IT IGNATURE ISSUEO BIY. SFGNATUFF=
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euzLorNG
3830 Pilot Knob Road Permit Num6er: 0 2 3 5 5 5
Eagan, Minnesota 55123 Date Issued: 0 5/ 10 / 9 4
(612) 681-4675
SITEADDRESS: Lor: zn BLOCK: 1 APPLICANT:
4976 CAMBERWELL DR N LUNDGREN BRQS,CON3T INC
HILLS OF STONEBRIDGE 2ND (612) 473-9640
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTIONTYPE .. . .A
FOOTINGS FINAL
F_ . ?
L
?
i ?
1 ?!? 994
CITY OF EAGAN
BUILDING PERMIT APPLICATION
681-4675
460
RECEOMED
MAY 0 4 lggq
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets af architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date 3 / 9'"l Yaluation of work D?c70R ?
Site Address: LJ076
STREET SUfTE #
Tenant Name: (commercial only) n ? A
LOT ? BIACK SUBD.1J II 1&
,q. P.I.D. #
Descri tion of work:
The applicant is: ? Owner Contractor ? OtI121' (Describe)
Phone
Name
Property usT FIRST
Owner pddress c?r,,, ; k C'n ,,.\o zn e?l ?-?-?? -
STREET STE #
City r, State v'`'`X-\ Zip
Company ??,??r•ren ? ? ? a?e.1??,u Phone k -73-I`765?
Contractor Address 8f00 ? L-vcuq2a" `3Aj? License # \LiIExp.`/3 I &S-1
City t.tJcu r'Za%VG State tmY? Zip 5-53c1l
Company Phone
Architect/
Engineer Name Registration #
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
f
correct and agree to comply with plicable State of Minnesota Statutes and City o
Eagan Ordinances.
Signature of Applicant:
,
*
Plo
*
angl
?
* ?c ?F
/ ?
/ ?
.. / ?
? r- \
? ?
Certificate oT Survey Tor: ___" ENTIK__
Qp ? 99 - ?1
q Q NottTN
`A.O
O
as ?
.\ \
n?
i
. i 1-t2a- .
?
?b / i,??nT p ?,^ G?
M
?. •? ti?' r je) ?T
? '?? ? ? ??? ??
? s
?p 1 fi ^ fi
N ??.p? ?
A7n'^F
.o ?-
3e
41-
. soo.o OrnvFes exisf;n £(evafion
• soo.o Dertvfes proped Elevalr'ort
- denofes Draina?e f U1il+ly FUSernet)I
---? Denofes Dr4incf?¢e f low Wrraws
0 Denofes monument
Bedrin?s sltowll ore o55umed
. ?
/p ^y
??.5?
242? FiMcpti<v Diive
Mendnta I lcights, MN 55120
(612168 1 1914
.
?
00 '
\Q'
ZROSEQIi uSE gLEVA7IPN
!-owes f'oor EevRion?&.-S.
Tof) o; 8/ock ElQVnfion 89a.f.
GaraOe S/aG flevation 671.r
o DenoYes Ot ?'sef flub
f0 L-asPmen1,S 01"ReCO"d
LOT 24 , BLOCI! 1,1IILLS OF STONEBRIDCE
DAKOTA CauNTy
PLAT 2
1 hnrebV Cerllfy Ihat this SurveY. Plan or rrporl was pnrpnrnl M1Y mC or u? drr my diirrl .tn,ervi.ioo 41111 iI„i i,irl dfiliy nogilmfPd Im,n sIoYPY(,.
under the lawf ol the Slete of Minnesnta, Ontrd Ihis1?? day at _ 4.f1. 19
SCQ'le : 11^? -/?tte, --- I =-' ?? ? - ' --11- -?'to ?I norni na ier.; t+ntynnt --- ---
PERMIT
Cf`i"Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT TYPE: e uJ L o i ra C
Permit Number: 0 3 4 4 2 L
Date Issued: H 1 1 S9 / 9 3
51TE ADDRESS:
P.I.N.: 1.0 -329y1--Z40 -?D1.
40 7 S CAMi:ERWFI.L p^n N
I.fJT? 24 3L0 ?K: 1
FiTI I_9 0 F S`I"UIVEBR SDGF FI.AT 2
DESCRIPTION:
7.0. F: REROpF
1304 ldiPp rmi_t Tyu? STURpI DNMAGr
?uildinq W'6,rk Tyoe REPATt2
?Censu? Co+?e
?
f
t
?
?
y?
?
434 Ai_l". RESltlti4l"3:AL
?J
REMARKS:
taer<noF »G u?r raran r,gf,A r,1_ 1) ui r9 -:rnFrvi o 1amW(,t-.
FEE SUMMARY:
CONTRACTOR: fl p p 1-x c a n t-
51_LA ROOFING & REhIUUFLING 18238046
4100 ExCELSIOR fiLVD
ST 10UI5 PARK MN 55416
(E72) 823-$04b
sT< Llc, OWNER:
mOniesm ANoERsnN ALIsoN
407C i.AM'BERWELI [Ji2 N
E AC;AN MN 551s'3
( 651 ) 681--1310
iI
I Mereby acknowladqe that 1 hiive read Chais applieat.ion anti state thst the
in1-ormaL-iori is carrect and aqrea ta complq; t.tith aJ.l apol3cabla State af Mn.
5tatutes arrd City Qt Ea•qan brdi,'nanc:ev.
APPLICANT/PERMITEE SIGNATURE
-- 1UUED BV: SIGNA Ri1 E -
I
?41999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ? ?I /l D, (?,
3830 PILOT KNOB RD - 55122 ??? 9`?i
(651) 681-4675 I _
New Construclion Reouvements RemodeUReoair Reauiremen?
• 3 re9istered site surveys
? 2 copies of plans (inclutle beam & window sizes; poured fnd. design; etc.)
? 1 energy calculations
? 3 copies of tree preserva[ion plan if lot pla[ted after 7/1193
required: _Yes _ No
DATE: Z_
DESCRIPTION OF WORK: I?f! ? C?? r 1?f U?00 ?
STREET ADDRESS: T U / b L tEv°\ D?? W 2\ 1 \ J?? ?""
LOT: a`'4 BLOCK: SUBD./P.I.D. #: WMS C4 ST('tv9 LC11 p a
C?k
1?5 _ PlioneN: j?21_13-10--------------
Yt20PERTY F"st
c)\VNLx
sti«<Aaare,,:_Ab] 6 ??P'L???we.,?----1?--=--\? ------ ----------------- ----
1 ^ t? ? ^?-----
city ------- -- state: --- ziP:
?
9ELAROOFIN(3 6c REMODELING, INC. g?3 _?6 W?-------------
Comp:mY'.------- 41(f) .RC .j,?s1??±?.---------- Plionc #:
coN'z'izXci'oit ST.LOUI3PARK,MN 56416
S[reet Address: jD #W1060 License # ____Frp• __
Giv
ARCHITECT/
ENGINEER Compaiiy:
Nune:
Strce[ Adc
Ciiq ---
Sewer & water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the information is correct, and
State of Minnesota Statutes and City of Eagan Ordinances. _-?2
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
? 2 copies of plan
? 1 site surveys (exterior addihons & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; R, 6 50
State: ------- --- ZiP'
Phone#: _______
Rcgistrauon #:
S[atr. _ ZiP: _
Penalty applies when address
to comply with all applicable
Tree Preservation Plan Received - Yes - No - Not Required)I?' I JAN 19 1999
1991 BUILIM"SPLICATION ?
CITY OF EAGAN
SINGLE FNiILY DWELLINGS MQLTIPLE DWELLINGS C014TERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULF.TIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLZES WfIEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALtAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER 6 WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER. ,
To Be Used For: ? 16Ak Valual
Site Address & ?? (4xABr?b-zG
Lot 7-4- alock ? }-J i u?S p P
Parcel/Sub S1T%1`«??W?? Pt-AT 0
Owner
Address
City/Zip Code
Yhone
Contractor NTt, x
Address ? ??q 'BAKt'rn
City/2ip Code /•? O/V
Phone 423-2-)J5
Arch. /Engr . PIa /I/Vri?e
Address
City/Zip Code
Yhone #
(S;j(gnature of Cont?actor)
? Date: AV,
/Z/? oo0 •
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
OFFICE USE ONLY
zs !'1'1
PD R-1
Y-h!
v-N
?
On site sewage_
On site well
MWCC System ?
City water J/L
PRV _
Booster Pump _
APPROVAIS
Planner _
Council
Bldg. Off.
Variance
/f"lno;C-7 --zl? r76S?
FEES
Bldg. Pit 797.00
Surcharge 71°DO
Plan Review 1 .00
SAC, City / .
SAC, MWCC fo O,O0
Water Conn. 60.00
Watex Metkr , 5. o?
Acct. Depo'sit 30.0o
S/w Permit 30.00
5/W Surcharge J °
Treatment Pl. o2 9b.00
Road Unit °v?O.QO
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
Lot Change
TOTAL ? ?IQ
k,
,:.
agrees that all wttk shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Otdinances.
?* **
* PIfaNEER
* engi? eering,..
Pioneer Envineerins
? i
10.00
?
.
Certificate of Survey for: C"rNTlx NO/VIE,r ..
1 r'9
s8Sr ? ?
^,P V -
6819488 P.03
2422 Enterprise Drive
Mendota Meights, MN $5120
(512) 681-1914
?
1
A$
? ? ?3•0 ?r? v ?
C` + N? r r,'°o Ygo
/ ?e • /?
1 \ \ 6> ?t„??r'•??a
DrzluE ?"
X
?
?t'6' ? J a•
3ca?v _
. 900.0 Derrofes exisfin¢ Elevafion
r soo.o Denvf@5 propdyed E/evatr'on
Denofes Orainaee(Utr'!ry Easemenf
----+- Dena s
fe Orc?in Flow Llrraws
0 Denoles monumenf
Bearins sftown are asSumed
'! •/"^..,..
"wesr troor tievcxHurr
Top ot Black FJevpfion
Ga S1ab f/evation
o peno es O.,?sef Nub
Su?ecf' fo Easements oj,-Reca'"d
LaT 04 , B?.OCK 1,1-IILI.S OF STONEBRIDC,E PLAT 2
DAKOrA caunirr
1 heraby certlfy thet this survey, plso or raoorS wes prepered by ma or under my dirKt supervison ancl that I em duW Reyfetered lmd Sw"yor
undsr the lem of tne Stete ot Mlnnewta. Daiad tnls day ot A_O. 19_.
?/ `CS •
?
?
/ a
? N4
?
• Q.
?
NoarM
?;-
Scale : 1?? -'4 O ?? R08GRT Q. SIKICN L.S. REO. NO. 14891
A " •
!=??:jnn I ;In r•esiyn ir,c.
l 1 F!i ghlwa f 1 O IV. E.
hililllF_cl('JU113I P{ha 354._T2
Es 12- % ?'JO- I. 92(,3
i-nrir•1. riO. vf?DS7?
hlinnesuta 5t::te Energy Code Calculations
Nased on Chapter 5 of the Nlodel Energy Cude
1183 Edilien -- Adapted 1r1J24
nw:rer :
(honei_ _n765 CFN'fE}; NO!^ES
coMri. ivn: Qv 0?0700S7 9
Phane:
L:1 dg. ?:; ass:
SEhdEFr'1L IP1F(7F.'MATIOIV
A1 AS for Singi:- FamilyiDuNle;:
A2, r•e=i.dentia] 3 stories
t7ver 3 stories
Other
Nnt'.'=: TI:G ^-,tC't1UR designativn=_ ("Sectzon A", "Scction R" etc. )are fur
r_oriwenience in calcuiations enly, and are not ralated from cane set of
e_a l;=u7. ati obs Iael r,w to tlie iiem+ ,
1. Pldg. Wa.tt.s Perimeter .. Wall heights, = Area
ground tn eave
^ect i uri ,1 : 156 19.83 - :',(79 5. 4E3
C;cf- l.i on B Q 0 = l?
5ec't i. en C. t) n = ft
Section A
0
0 , -.-
;
Gross Wall Area
2. Eit.iilding dimension5 Floor or
Ceiling
Lengfh >: Width = Area
Section A: 16 14 = 224
Section E+ : 32 29 = V396
Section C : Cr 0 _ o
3ectiori D : 0 0 - ti
Tatal flc,or or ceilinq area = 1120
3. fiim Joist Pei^imeter = iSn
Floor jai=t < 6y (8", 16^, 12" or ib")J: 10
Rim Joist Area =
4. Doors
Hrea: 43.8 Thi.r.kness (inches):
F'erimeter !feet?: 0
T,pe of construction;
5. Total daor's perimeter: 0
b. Windaais
13t1
U
I.ianufar: i' t.n- Rr :
:=t:atr. -ii,pr-uvt-M
-r;pF,
E'3FfT. UNtT
li0:_ LLF I-I; I{.1G5
r,{p , .
S. Fa{_ie Dooi^:
S. At.rium:
"Y.. Firepl.ac.e a:-r.so,
wi d`h:
To; aI Sq Ft =
11. Expe_=.ed Fpundation
Flei nhi ar ea A:
Sq Ft area ia =
E>;posed Foundati ar.
FleighE area Et:
Sq Ft area $ _
12.
Gre=s wa1.L area
minu=
l+lindow area
F'atio dvor area
Fttrium area
F;im jois'L- area
Dnor arNa
Fireplace area
'c;:posed Faund.
? Framinq area
equals
Tot.al.s ;ni- riec wali:
6•lFf,fH±=.F:=+l-IfEL.i? I.J factor= 0,47
vM_;
;'-':irllik ., l.r:n_tLh ,. NumbE- .= l'utal
5nct',esl :?nr_tia=s7 af :;%ass SyFt
uri i t s
l.} :?7 _ 7.38
28 16 4 12.44
tb 24 4 10.67
16 20 2 6.22
::8 28 12 65. _._
28 ,2 t 12.44
^v M 1.4 '34
_.U ;;h n. ,:'.
0 p n 0
G r) r U
0 0 O fi
r? p 0
U
tl 0 4) Q
t. IrJinclow glass area (SyFt) =
Fi2i ght :: Length :: Numb=r
(fs?Ht.; (feet) units
U l) 0
6.9 ^<.0 2
2:;0. '::3
= Tc+t.al
SqFt.
Ci
38. 08
b Hei.c_,ht: 5
_r;
0.67 F'erimeter arEa A: 156
104.52 `
0 PerimetEr area E+: 0
u
SqFt U factor U:: A
3033.48
2311. 48 0.47 106.56
Ci 0 ti
38.08 0.47 17.9
130 0.035 4.55
43.8 0.14 6. 13,
^0 0.17 5.1
104. 5^< 0.14 . 14.63
309.348 0.069 21.35
220b. ?52
0.037 C31.65
. •.ir
, `i;..-,1_ f?,r ilri.'_'= ain.ll ?:?r'e,?? s_J-',.
, f." LtL'71 i'.J r.37't?El 1 S.. 1.0;•: G"f C{IrU:= VJ311 i:U'Bd
!'. Ciruss v,c:i area „ factor b,slew = U., A Per code
;=actor is .11 ?'or Fr: sirigle iamliy €: i.Iup1E::
.23 for r'1-2 and oiher r-esicl=ntic?
,23 for u'ther buildiny=.
.28 foi- o•rer- _ staries
raci_or 0.11
9-1111i- 31i,_ 2a28 riuSr B@= : OF.
±cal c:u:l r+i.oN _aburvei
14. i;ous.=_ ce.i. i : nn r1ret, = 1120
D.. UpI! lt;s; Fr- a:ninq area !?i,;: u} ce:i.7in(:1 areai = lJ:i
.,_.
;aist rirca
;1?iY? of cei3iriy aren% _-. ,
il<
11. fJut. e.ei.l.in g area cicir-ess ceil. area -:loy.si_ arra) = 10r0E3
13. U reiJinn: 0.021 :, Net_ ce.il. area = 21.168
1?. U +rzaminq: 0.024 ., Joist area = 2.680
20. Total oF ite;ci 18 ,, itern 19 _ 25.1056
i: . Gros=, cei 1 i. ny au• ea .. +actor bel uwa = U r. A G2Bt' CQL{E'
Factor ia .026 for A-1 single (amily u duple::
.C,:" far A-2 and ct_h-r r-ezicic>nc.iol
.06 for ocE'let^ btiildincs
l- oc t or .i =., c 0. 026
L'Tt:H = 29.12 F1UST ijC i OR = 23.80L,
!C2ICLISiitE?C.I a6ove?
el X G / HIGH "R" SEEAT9ING
WALL
SGCIION
S1VD
SGCTION
RIM
JOIST FDN_
u vntuc cnrcur,nitoNs
Inside air Iilm
InCerior wall
Insulal-ion
sheathing
Siding
Outside air tilm
R TUPAL
R VALUC U YAGOI;
.68
.45 (Wall) U = ]. _
Id
19.00
6.0 _037
.G7 -
_17 •
26.97
Inside air film -63 '
Interior vall -45
Stud - 6" 6.50: (traiuin9) U= 1=
lt
Sheathing 6_0
Siding .67 .069
OuGside aic L•iLo .19 .
R 101AG 14`}7
-Eaterior air film -68
-Insulation 19-00
-1 2 inch sott rrood 1.88 (ktim Joisl•) U=]. _
- li
• Sheatlung • 6.0
-GxL•erior wall coverisg -67 ` .035
• Cxl•ecior air L-ilm .17
R TOr14L 28.4
Interior air film _ .68
Tnw'lation . 5.00 . , rounaacion (12 • siorx),l.zu (roundati(mi) u= z=
Exterior ai.r film .17 K
R 1OTAL 7.13 .14
0_61
36.00
4.38
Ait Film 0.61
Insulation 44.00
Joi.st
.56 Ceiluig
0.61
41.55
Air Film
1bta1 R
.024
U _ 1
R
.56
0.61
45.78
.021
CATHEDRAL CEIGING
R YALOE R VALUE
FRAMIM CEILING
0.61 Inside air film 0.61
56
.
Ceiling .56
r
14.375 Joist(Spacer) -
- 7nsulation 33.85
- Air Space .50
.67 Roof decking .67
06
.
Felt .06
.44 Shingle .44
0.17 Outside air film 0.17
16.88 Total R 36.86
.059 R = U .027
WinBor+ infiltration .5 c?/li.neal foot of ccack
Residential dooC infiltrdtion 0.5 cfm/sqtrat'e foot oC dDOC and minimwn Code r equirenent
Noa-residential door infiltrati«i 11.0 cfm/lineal foot of crack
W 12" cancrete block rw insulation =.781 R 1.28
double glass = .52
triple glass = .31
A11 ezterior walls and ceilings must have a vapor bacrier (0.10) perm maz.).
Yapor barrier must be on the inside (heated side) of vall.
Yapor bariers of the polyethelene thin film have no R value.
CEILING WI'1'H YFN1Z'D ATi'IC SPACE ABOVE
R YALpE R VALUE
ERAMIM CEILING
CITY OF EAGAN
1 " 3830 PILOT KNOS ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
?'?BxAT?.';??
FOR CITY USE ONLY
PERMIT #
RECEIPT # 11 O
naTE: a zyz
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WIiEN PERMITS ARE REQUIRED FOR EACH UNIT.
------°-----------°--- --------------------°----------------°---_.
DWELLINGS &
WORK DESCRIPTION COMPLETE THE FOLIAWING:
N0. FIXTURES EA.
NEW CONST ADD-ON MINIMUM 15.00
ADD ON SHOWER 3.00
REPAIR _ Z WATER"ELOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
/
OWNER NAME: S??i7? KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
SITE ADDRESS: /Z 76 HOT TUB/SPA 3.00
LOT:? BIACK I SUBD. FWATER LOOR DRAINR 33.00
.00
GAS PIPZNG OUT.
INSTALLER: (MINIMUM - 1) 3.00
d OPENINGS
ROUGH 1.50
•
Y7Y?? ?l-
AD OTRER
CITY: ?Zjp:
`d
J JU?7 ?
_ WATER SOFfENER
PRIVATE DISP. 5.00
15.00
U.G. SPRINKLER 3.00
TOTAL
UU
DO
D
?
.30 d
Y__5_0
rnuiv
SUBTOTAL S Z ? S?
ST. SURCHARGE .50
TOTAL: $ %
pMMwIIA?.?;?IDtTSTRIAIPLEASE COMPLETE THIS PORTION FOR ALL COMAfERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
ZIP:
FEES
i$ OF CGNTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
CITY OF EAGAN
y? --. 3830 PILOT KNOH ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
FOR CITY USE ONLY
PERMIT #
RECEIPT
DATE: a?C
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE !
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST /
----------------- -------°---
ADD ON
REPAIR `
OWNER NAME;
SITE ADDRESS
IAT:? B
INSTALLER:
ADDRESS: "/i
CITY: /' `/
ZIP: SS /10/
PHONE #: m S'J? g6 /
FEES
DWELLINGS &
ADD-ON MINIMUM $15,00
HVAC 0-100 M BTIT 24,00
ADDITIONAL 50 M BTU 6,00
GAS OUTLETS - MINIMUM (A) 3.00
OF 1 PER PERMIT
%900
SUBTOTAL: $ AD•
STATE SURCHARGE: .SO
0
a-- TOTAL: $?
SIGNATURrOF PERMIT tE
t'k?Tts'T??TI1'(1S'?RT?.Y::? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
:.,..:,. >.r.:. .... .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME;
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EP_CH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SlIRCHARGE
TOTAL:
(SIGNATURE)
$
$
CITY OF EAGAN
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122611
Date Issued:05/13/2014
Permit Category:ePermit
Site Address: 4076 Camberwell Dr N
Lot:24 Block: 1 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-01-240
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 -
Paul M Bjorklund
4076 Camberwell Dr N
Eagan MN 55123
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:EA122611
Date Issued:05/13/2014
Permit Category:ePermit
Site Address: 4076 Camberwell Dr N
Lot:24 Block: 1 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-01-240
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 -
Paul M Bjorklund
4076 Camberwell Dr N
Eagan MN 55123
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:EA171229
Date Issued:08/05/2021
Permit Category:ePermit
Site Address: 4076 Camberwell Dr N
Lot:24 Block: 1 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-01-240
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Paul M & Susan K Bjorklund
4076 Camberwell Dr
Saint Paul MN 55123--391
Advantage Construction Inc
18750 Buchanan St NE
Wyoming MN 55011
(763) 354-8441
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172265
Date Issued:09/22/2021
Permit Category:ePermit
Site Address: 4076 Camberwell Dr N
Lot:24 Block: 1 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-01-240
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. When a weather barrier is installed or
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 -
Paul M & Susan K Bjorklund
4076 Camberwell Dr
Saint Paul MN 55123--391
(651) 338-3633
Advantage Construction Inc
18750 Buchanan St NE
Wyoming MN 55011
(763) 354-8441
Applicant/Permitee: Signature Issued By: Signature