4099 Camberwell Dr NINSPECTI0N RECURD
TY OF EAGAN PERMIT TYPE:
JC38130 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued: `•' ??? 199
(651) 681-4675
, f !, ' - .. .: i ' ? • 7 I -y?i . ':.
SITE ADDRESS:
? 10 - ,, ?
iiE r 1 1. ni •: rr?r?? t?r? ? i???r a-li ?n r
t APPLICANT:
? ???? ? ? ?? ??, ? ? ???? ; ? ? ,-?? t q ,. ? . , tsi, i_ :'s'?:s4?
PERMIT SUBTYPE:
,,. ,. _ I ,1. ,11
TYPE UF WORK:
Al r? RA t I;rN
INSPECTION .. . D.
i t r,N i,VvTJ=i_.if Iz ftY i.:i,AJ(s NOV:?' ?'vI:
?[' fA?f1 1' E' i' F' fi' 141 I k 9' E? f i f{; i? f I {? k 1;' R? ?d 4" f' 6. !d 6? ?R :G R3 f,t 4lf?w ??, ir: ,.
4 11,:, :lrs 1ti;?I 1 V i' 11;1f r1i ," V III "t 1
?
,
?
nriit , eq ,,#;F, I. s 1 0 rir, .
Permit Holder Date Telephone #
SEWER/
WATER
PL.UMBING / "w
HVAC
Inapection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
T r
?J
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TE5T
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER -
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECf{ FINAL
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
,,.
I'E ADDRESS:
fi i{ 4`, i.t? '; i tfF'd( Itfi 8lii'if' ;'i'QCF
PERMtT SUBT1fPE:
;caRD ? .
PERMIT TYPE:
Permit Number.
Date Issued:
APPLIGANT•
•
:ItAP V Ii V Y
( 3'• ?., 1 q;e y': ^??.a?.'Ei
TYPE QF 1NORK:
t-1 %1 i:1
INSPECTION rATE INSPTR. INSPECTION TYPE DA
f
Permit No. Permit Holdar Uate Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
?
FflUNi}
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATIIdG
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSM'f R.1_
65MT FINAL
DECK FTG 1V
DECK FINAL ? ?
(grr#tftra#t of (?rrupartry
Citp of eagari
Brpmtmd uf Builbhcg Jrcptdim
T/tis Ceriificate issued pursuan! to lhe requirernenis of Section 306 ojlhe Uniform Building
Code certijJ'inS that ar 1he time of rssuance thissmwlure ms in rnmpliance wilh the mriaus
ordinancrs of tfte City regulatrng buildirtg construadion or trse- For the foflowing.
usc C122dficKfim SF DWG/GAR W&FwMitN& 18772
oa„p+dCr7hx I*/MI zooing Dkftid FD/Rl 7h,c- VN
- -- --- rTcnrr+cRr r?Wo cr)n oerrcm nnen vr*lKTc'rrr,vA
2m
POST IN A CONSPIpJOl1S PLACE
.•. •? CITY OF EAGAN
?
Jrp ?
18772 .?
3830 Pilot Knob Road, P.O. Box 21-1 99, Eagan, MN 55121
PHONE:454-81U0
BUILDING PERMIT Receipt #
To be used for ?? ?/(;AR Est. Value $1459000 Datb HO ? , 1991
409Site Atliress 9 ?UR??'i' DR N
FFICE USE ?NLY
Lot Block Sec/Sub O
.
Parcel No. occupancy F??? FE ES
C.?? HOMES Zoning
*97 ?? ?
W Name (Actual) Const ? Bldg. Permit :
iml
?
J
Address (AJlowaele) _ Sur
e
h id
72.
a c
arg
Gity H ? ? Phone # of siories gial?
' Plan Review
Name ?A? Length
Depih
SAC, City ?
--
z?
?` Address S.F. Total - MCWCC
SAC 0. (X
cIly f h4118 S.F. Faolprints - , 6,60.
Water Conn ?
? On Site Sewage .
90
00
W? Name On Site we11 W
t
M .
-?. er
eter
a
_?
? Addr9ss MwCC System
-? 3?}.tl(1 .?
o Accl_ Deposit
55 City Ph4ne Ciry Waler - 3(f,?
S!W Permit
PRV Required _ 50
I hereby acknowlege that I have read this applic ?on and state that the
?a Booster Pump - &W Surcharge .
information is correct ancl,agte to comply witt
ll applicable State of 27?}.(0 .,
Minnesata Statutes apd City of?gan Ordinance5.
" ?• ! ?. 4??-?
;r Treatment PI .?
3 7as 0Q
..:
Signature of Permitae APPROVALS Raad Unit
?
? K HME
A Building Permit is issued to;
Planner
-
park Ded.
on the express condition that all work shall be done in accordance with all
f E Councii
Copies
.?
applicable State of Minnesota Statutes and City o
agan Ordinances. Bldg. Otf. _ .
394-00
3
?
Building Oflicial Variance
-
TOTAL ,
?
Permit No. Permit Holder Date Telephone #
wATER
sEwER
PLUMBING
??
H.V.A.C. II J
-
EIECTRiC
Inapection Date Insp. Comments
Foolings I
Foundation
Framing y
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace / ?'j ?
Fnal Htg.
Final Plbg. - Q
Const. Meler Plbg. Inspectar - Notify Plumber
Ergr.lPlan
Bldg. Final
Deck Flg.
Deck Finai
Weli
Pr. Disp.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
aATE MAR 7, 1991
. . . , ., .. . . .. ,
. ?,
. , OFFICE USE ONLY
METER # PERMITDATE
CHIP # 112 3? ?SEE 0 PERMIT # 11847
MCTER SIZE u.CjB.P. RECEIPT #
ISSUE DA`fE `5"`/U B.P. RECEIPT DATE 03 07 91
_ PRV , BOOSTER PUMP
SITE ADDIiESS 4b94 CAMBERWE.LL DR N
' LOT 1 BLOCK 3 SEC/SUB I-IILLS OF STQNF..WiDGE 2ND
- «?
; APPLICANT:
ADDRESS:_
CITY, STATE
{ PHONE:
ZIP
PERMIT REQUES'TED
X SEWER X WATER _ TAPS
- COMM/IND RE5IDENTIAL
X NEW _ EXISTING
'?-? ?y` Lawn Sprinkler Meters are to be Installed
PLUMBER: ? Ahead of Domestic Met s on Water Line.
ADDRESS: -14745 S ROBERT TR Credit.Nit NOT be give for Deduct Meters.
CITY, STATE ZIP 55068
?'`•. ?--`?- ? '. "
PHONE: 423-1144
I AG TO C.• MP WITH GITY OF
OWNER: CENTI:X HDMES EAG N
ADDRESS: 5929 BAkXR Rp 7
CITY, STATE MIi'ZNNETONKA Mij zip 55345 ?
PHONE: 936-7833 51 E WHEN METER 15SUED
;' „ , , . , .:?
PLEA?E ?L'Lb?VU TWO WORKINGD"AYS FORyPROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
°' SEWER PERMITS, COIVTACT ENGINEERING DEPT.
, .. .: .
St"WER.?,.W¢1TER PERMIT . ,
OFFICE USE ONLY
CITYbF EAGAN METER # PERMIT DATE 03/11I91
3830 Pilat Knab Rd.
Eagan, MN 55122-1897 CHiP # PERMIT # 1 T??+7
METER SIZE B.P. RECEIPT # "?
MAR 7
1991
I ISSUE DATE B.P. RECEIPT DATE 0,31071 l
I DATE
,_
_ PRV - BOQSTER PUMP
51TE ADDRESS 4o99 CAmEE RtaELL blt N PERMIT REQUESTED
LOT I BLOCK 3 SEC/SUB HTY•LS QF SrnNEBitIUGE 2ND
X SEWER X WATER - TAPS
' APPLICANT.
` ADDRESS: - CaMM/IND ? RESIDENTIAL
CITY, STATE ZIP X NEW - EXISTING
PHONE:
PLUMBER: Lawn Sprinkler Meters are to be Installed
`? Ahead of Domestic Met
es on Water Line
.
q
ADDRESS: -.14745 3 RO BERT TR Credit WIL• NOT be giveA for Qeduct Meters.
CITY, STATE ZI P 55068
PHONE: 423-1144
I AGREE TO C4(MP WITH CITY OF
OWNER: CErIT1?X MOM E:S EAGAN ORDIP ANg S
ADDRESS: 5929 BAKER
MINNETOIdK RD
r
A
CITY, STATE p4N ZIP 5534
)
PHONE: 936-7833 SIGNATURE WHEN METER ISSUEQ
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 4545220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
Addsess: 4099 rpOM.qT DgIVE N. Lot I Blk 3 Sec/Sub H]IT,g pg SICNEBRIDGE 2ND
These items ware/were not complete at the time of the final inspection.
Date: 6/20/91 Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry ?
Permanent driveway ?
Permanent gas
Sod/seeded grass ?
Trail/curb damage t/
Porch
Basement finish
Deck
Please varify vith the builder the ramoval of roof tast caps from tha plumbing
system and the shut-off of vatar supply to tha outside Lawn faucet before
freeze potential exists. ?
xcwmnwx
White - City copy Yellow - Resident copy Pink - Contractor copy
DATE: MAR 11, 1991
_ - ?
RE: 4099 CAMB6RiiBLU pR N (CENTEX HO!!ES) `
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 PRWkCTS ONLY: Piease pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEPORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, 8uilding Inspections Dept.
?5 ZZ---3
\v
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675 FAX # 651-675-5694
NewConstrucfionReauiremeMs RemodeVReoairReauiremenis ;? ..
3 registered sife surveys showing sq, tt. W lot, sq. ft. of twuse; and all roWed areas 2 copies of plan (20% macimum lot coverage allowed) i set of Energy Ca?ulations for heeted addiGOns OEM
'?
2 copies of plan showing Ceam & window sizes; poured found design, etc. i site survey for additions & decks '?
i set of Energy Calwlations Addifion - irMkate ff ar•srte sepfic system - ? .
3 copies o( Tree Preservation Plan if lot platted after 7l1193
Rim Joist Detall OpGons seledion sheet (bkkgs wBh 3 or less units
Date r /3 Construction Cost D V. ?
/
Site Address ?,(.i /t-?J,Oi1e,.fsG[ ? A) Unit/Ste #
Description of Work Ad?! -
-
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 ?1- _ 2
Property Owner IL l/J&aA, Telephone #(?'? ) ta?l- ?'7 l1
nnrea wovae
Contractor deaFlnumHeao aftro
Address n
2M nFawmr^p&
FONOWMayn
City
State a
es'm+''as°'
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesob Rules 7672
Energy Code Category . Residendal Vendlation Category 1 Worksheet • New Energy Code Worksheet
(q submission type) SubmiUed Submitted
. Energy Envelope Calcula6ons Submilted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber - Telephone #( )
Mechanical Contractor IF) 1, ? ? ? U? Telephone #( J
Sewer/WaterContractor AUG 0 6 2004 Telephone #( )
I hereby apply for a Residential iu mand 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
approv f plans.
1,
A plicant's Printed Name ? App icanYs Signature
C?
2004 RESIDENTIAL BTJIILDING PERMIT APPLICATION
City Of Eagan
' 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
3D-7
&?q /o y
Nev Construction Reouiremenis RemodellReoair Reauirements
3 registe2d sile surveys shavirg sq. fL W IoL sq. 8. ot house; and all roofed areas 2 copies of plan
(20% maximum bt coverege atlowed) 1 set of Energy Calaula6ons tor heated addifions
2 copies of plan slwwing beam 8 window sizes; poured tound design, etc. 1 site survey for addilians & decks
7 set of Eneyy Cakulations Additbn - indkete ifon-sife septic system .
3 copies of Tree Preservation Plan If lot pWHed afler 717193
Rim Joist Oefaa Options selection shcet (bltgs wBh 3 or less unifs
Date 1
SiteAddress ?O Construction Cos?,.? l0 lsaa _ o 0
NUnitlSte #
DescripGon of Work
Multi-Faroily Bldg _ Y J!? N Fireplace(s) _ 0X- 1 _ 2
Property Owner Telephone # ( )
Contractor /1fl!!?G.? 5,.: t <-
Address 6c,3 /9,21 City '00w,?
State Zip 63-2v(ol Telephone ?.5-2?0 a
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Tviinnesota Rules 7670 Cateeoro 1 _ Minnesob Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
Telephone rfi T
Telephone
I hereby apply for a Residential Building Permit and acknowledge that the info?.tion ,?f.,tPr 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 pemrit, 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.
? ?/?'
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types , W ,,,.
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace 0 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex 0 08 07-plex ? 17 Garege ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex 0 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
O 05 03-plex ? 71 10.plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
0 31 New ? 35 Int Improvement O 38 Demolish Interior ? 44 Siding
? 32 AddiGon ? 38 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 AlteraUon ? 37 Demolish Building• O 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demoikion (Entire BIdg) - Give PCA handout to applicant
Valuation j?. oUd Occupancy rZ -?J MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length 100' Fire Sprinktered
Type of Const Width /, St
_ Foatings (new bldg)
Footings (deck)
?j Footings(addition) jl1)[ pnSTS
Foundation
Drain Tile
Roof )? [ce & Water ?D Final
? Framing
? Fireplace O R.I. ?O Air Test ? Final
?= Insulation ^
Approved By:
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wail
Building Inspector
Base Fee
Surcharge
Plan Review
AAC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
I?'Rl S'x vo. on :/O 80o, -
** * v 2422 Ealetprise Oiive
PIONEER ? MenJota Ileighta, MtJ 55120
* ? * ?----__
* engmeering.. ?
* t6121661 i94
--
'
??`?
Certiiieate of Survey for:_CFNTEX NOME_S.____ .&.?-r?
?0\ v. C, NoaYN
, ?p ? `o ?"'
? 6 ?e 9
?QJ
p`? / /` ?• ??y/ ? ??''?V?T/./ /??
i
V `
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\? / / /? ?? ' 6A \ \ yy4
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\ ? ? / ?ay4? ?6`? y Y?? ?/ r-1? ? Eu
F%
`tiy??
n
Pf6?osefil. ,?N\n ??M Q 4bD6MC 6(NISPECi'9?MJS Cy
G?ti Q??G
. sao.o Denofer exisfin¢ Elevafion ?gg sE usF LEVATION
. soo.o Oertofe5 propdYed E/e.vafiort Lowes Flva ?on a11.a6
Denofes Dra,na?e (Utr iiU E a s e m e n f T p of Bl ock Elevpfian 8
--•- Denotes Drainc?e Row ,4rrows GarQe S/ab flevation sq9.33
0 Denofes monumenf o Deno es Ott sef Nub
Bearins shawn are assumed Su Jecf to Easemen1]5 o'R&cord
LOT 1, BLOCK 3,1IItLS OF ST4NEBRIUGE PLAT 2
DAKOTA CdUNTY
I herepy cerfl(y that ihi! SurvBy, pipn Or report Was" p/repereA,by ma undx y dirP.ct eapervisian »ral thnt 1 nm duly RepiStP.rrtA len SurveV?x
unAa the Iaw? of tMa State of Minnesota. Deted fl?isdny ol 1?'y? ., A.D. 19?/ , ?
7?
Sca(e: j,.,ch,? «f ?.y
11 L.S. ftFq. Nf1. 1AR1f -
7A' PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits aze required for each unit
Date /A /
Slte Address Unit #
? ? ? D ?
hone # ( (P[
Tele
P
t
O
p
p
roper
wner
y
Contractor
oioc?nrno?
,
crrvr?
3670 DODD ROAD
Address rnni ?eni ?.? CitY
,
(651)3651340
Zip Telephone# ( )
State
The Applicant is _ Owner X Contractor , Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes Counry fee. Additional wnsultant fees may apply.
Alterations To Eaisting Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water tumaround (+ 518" meter'rf needed -$121.00)
Other.
_ ItP2 _ new installation _ repair $ 30.00
_ Lawn irrigaUon system
Water s
tener ? Water heater
of
_
`
/ $ 15.00
replacement _ additional
?T
$ .50
State Surcharge
15
Tora? s
I hereby apply for a Residential Plumbing Pernilt 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 with the Plumbing Codes; that I understand tlus is not a
pemut, but only an application for a pemvt, and work is not ro start without a pernvt; that the work will be in accordance with the
p
approved plaa in e case of wock which cequues a teview and approval of.Rlans.
Applicant's Pnnted Name ApplicanYs Signature
?:..
PERMIT # ? ` ? 1
RECEIPT DATE:
2002 RSIDENTIAL PLiJMBIAfl PEiMiT AfPLICATION
CrrYoFEAsM
3830 Pu.or xROS Ru
SAHAA, MN $51EE
651-6$1-4675
Please complete for:
SITE ADDRESS:
single family dwellings, townhomes and condos when permits are required for
backflow preventer for irrigation system
kfjE[..L 7>R d
D) ? R !? (J 1
APR 2 7.• 7np7
unit,
OWNERNAME:: >7?i? 106'il TELEPHONE#: P.2 3*71- 0fl? (Dnt?jJMF
(AREA CODE)
INSTALLER NAME:
STREET ADDRESS:
CITY:
TELEPHONE #:
(AREA CODE)
STATE:
ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 Counry fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
i
_ Adding fixtures to lower levels or room addiGons, excluding water softeners and water heaters. •.;$- 50.00
_ Abandonment of septic system. -
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
X lawn irrigation system
Replacementladditional: _ water softener _ water heater $ 15.00
State Surcharge $ .50
Total ' $ ? .?
I hereby acknowledge thal I have read this application, shate thatthe information is Correct, and a re to complywlth II applicable City of Eagan ordinances. It
is the applicanPS responsibility to notiry the property owner that the City of Eagan assumes no I ity for any de s use b C dunng its normal
operational and maintenance activities to the facilities constructed under this permit within Ci roperryldghtof-wa sr? ,.?y
SIGNATURE OF PERMITTEE 1102
" CttY-taF EAGAN PERMIT c24 W"2
3830 Pilot Knob Road PERMIT TYPE: B u I Lo x N G
Eagan, Minnesota 55122-1897 PermitNumber; 026347
(612) 681-4675 Date Issued: g g/07/95
SITE ADDRESS:
9099 CAMBEftWELL DR N
LQT: 1 BLOCK: 3
HILLS OF STONEBRIDGE 2ND
P.I.N.: 10-32991-010-03
DESCRIPTION:
B,,Liilding? Permit 7ype DECK
@ui],ding Wklc Type NEW
/ 6--
si l
f '
i
?
. J
i
tan; ?.. :,r, • ??,;^' ?? ?? :i..:i ??u1 ?_1 `"'?? f f ???m?.a ? , i.
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $,50
Total Fee $30.50
CONTRACTOR: - Applicant - sT. LIC. OWNER:
JAMES CONST, JEFFREY 14860525 0002631 WOLTERS STEVEN
P 0 BOX 17991 4099 CAMBERWELL DR N
LITTLE CANADA MN 55117 EAGAN MN 55123
(612) 486-0525 (512)454-6713
' T herebp ackhowledge Chat °I have head Ch3.s appli`oatf'an'and state that th,6
infonmation is correct and'agree to comply with all applicable State qF Mn.
Statu`ties and CiCy of E2gan' Ordinancas_ • ° ?
L
Aoun QlAl mJ-
APPLICANT/PERMITEE SIGNATURE ?-. ISSUED B SI TUR
IN5PECTION RECORD
CITYOF EAGAN PERMITTYPE: auzLozras
3830 PilOt Knob Road PermitNumber: 026347
Eagan, Minnesota 55122-1897 Date Issued: 0 9 J 0 7/ 9 5
(612) 681-4675
SITEADDRESS:-P' i• N. : 10-32991-01e-03
LOT: 1 BLOCK:
4099 CAMBERWELL DR N
HILLS OF S70NEBRIDGE 2ND
3 APPLICANT:
JAMES CONST, JEFFREY
(612) 486-0525
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
NEW
INSPECTION ., . .•
FOOTINGS FINAL
F __
7
3830 PILOT KNOB RD - 65722
Its4f11996 CITY OF EAGAN
BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 8 iegbterod si[e smveys ? 2 copba of Dlen
? z oopbs a Nens ('vKWde beam 8 window s¢es; Dcuied fnd. design; ata) ? z si0e surveys (exteiior ad0rtions 8 dedcs)
? 1 snerpy ealalations ? t energy calwlations for heaktl add'Rions
? 3 mpiea ot troe prsseivatbn ptan N bt pletted aRer 7/1193
mquired: _ Yes _ No
DATE: k ??1-9E- CONSTRUCTION COST:4,?2700 do
DESCRIPTION OF WORK: ? eeJ?
STREETADDRESS: Camb*-r lvefl lvorrL,
LOT BIOCK SUBD./P.I.D. #: N? ?? s a? STo??e? Gs
PROPERTY Name:bjolrers Phone #: ??,f ? -6713
OYYNER •"•'
Street Address- Li olil CG,46erwc,11
City: State: M,,_ Zip:3Sla3
CoNrRncroR Company: Phone #: L*6-oSz-16-
Street Address: po BnA /?751 License #-R63 I
Ciry: State: Zip. 3SI17
ARCHITECTI Company: Phone #•
ENGINEER
Name: Registration #:
Street Address-
City: State: Zip:
Sewer & water licensed plumber.
change are requested once pertnit is issued.
Penairy applies when address change and lot
I hereby acknowledge that I have read this application and state that the information is cortect and agree to compty with all
applicable Shate of Minnesota StaWtes and Cily of Eagan Ordinances.
Signature of Applicant
?
OFFICE USE ONLY RECGNLSD
Certificetes of Survey Received _ Yes _ No SEP 0 1 1995
Tree Preservation Plan Received _ Yes _ No --------------'
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
a 02 SF Dweliing o 07 4-plex
a 03 5F Addition o 08 8-plex
0 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 _-plex
WORK TYPE
J"1 New o 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Const (Actual)
(Allowable)
UBC Oxupancy
2oning
# of Stories
Length
Depth
APPROVALS
0 11 Apt./Lodging o
0 12 Multi.RepaidRem. o
im 13 Garage/Accessory o
0 14 Fireplace o
,,Ef- 15 Deck
0 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Misoellaneous
MCiWS System
City Water
Fire Sprinkiered
PRV
Booster Pump
Census Code. ?
SAC Code o "',
Census Bldg ?
Census Unit
Engineering
Variance
?
Perrnit Fee Valuation: $ /000
Surcharge
Plan Review
license
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIW Permit
SM/ Surcharge
Treatment PI.
Road UnR
Park Ded.
Trails Ded.
Ofher
Copies
Total:
% SAC
SAC Units
?
? b
?
* PIONEER
* engineering . -----
* * **
(612) 681-1914
' NOMES
Certificate of Survey for:-CENTEX -- - ----- -!I?
?g•Z\ v, ? Nott7H
-S7 ?
o ?
\? / ` ?• -P V 7 ?({{/(??
;'
?.
\? ?/ \ t ?° !'< ?•? P?f`? ?is "?-
/
P ?q?
i R N
\ro .5`^
b15b / ? ?. ? .
Rp
.
41.0
(.??16 d e??? Cij
0
. sao.o Denofes exisfin Elevafr'on Q? o sE N usE LEVATIDN
• soo.o Denofes prop?ed E/evatiori Lowes Floor E eva ron s-I 1,9 6
- L7Lanofes Urainaie (UfrlrU Easemenf Tp of Block Elevafion s-i9.64*p
-•- Denotes Drainc?e Flow Qrrows Garae Slab flevat+on saq.33
0 Dertofes monumenf o Deno es Ott?'sef Nub
Bearin?s shown are assumed Su JeCf fo EasemenfS bnRPCOrd
LOT 1, BLOCU 3,14ItLS OF ST4IVEBRIDGE PLAT 2
DqKOTA COUNT)'
1 hereby certify that Ihh survey, pIAn or r¢pon was. p,r.ry?areA,by me undr/r,m y direct supervi5ion and [hal I am duly RcyistereA Laurveyrn
I under the lawt of the State af Minnesota. Dated t6is.{.? dny of ??•< • A.D. 19 --74-.
??1?3 ?I /? ,, %•
/`(?Ie: 1 1 //?]O ?Ct? ? --
Sl.l.llJn? -?{' t?t)p RI fl 51KIPII t'S. FC N(1. 14877
2422 Entetprise Drive
Mendota Heights, MN 55120
-`10111,0
- PERMIT
?CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651)6814675
f3ase Fee $6uoo
Surcharge $ , 5 e
ror.al t°pe aio 7i 6
SITE ADDRESS:
P.7.PI. a 10--32997-010-103
4099 CAI4I;ERWfil.L DR IV
LO1'; 1 HLOGK: ..
H11L5 [Jf- :3TpNEBRIDGF f%I..A? 2
DESCRIPTION:
, ?_._
8uLt'ldinfn - Pei°mit Tvpe
B?ildintt 4WVk Type
Cinsus Code
-,
?
-.?
f
?
EiASEMEiVT 1=11VtSM
AL.TE(iAT:CORI
434 AiT". RESTDEMiIAL
?i:*Z..,*?t.v il?l °-..?., v i°_L",?•C:k4. - t.li? Ci
REMARKS:
PLRhl RC`JTE6JE0 QY CRAIG NG`JAC7YK.
SEPFfiHft P6Ri+11F REUUIftk=U 1=0R FlN'r' PLUM[31NG WORK.
CNLL (612) q45-2a4GJ HL-GFlROTNG ci_tCTHICAL FL'RNiT AND INSPECTTOIV3.
FEE SUMMARY:
PERMIT TYPE: g kJ I i p r. N i;
Permit Number: 03 '4 6 4 .3
Date Issued: 02I18Y 9 9
CONTRACTOR: - N P n 1 i r, a n L.- 3 7. L. I c. pyyN ER:
TA,'VCOh CONST INL; 1^0612930 00003234 WCILTER ST[VE
60V L- 701H S`i q033 CflMBEI2Wt=LL CR Iq
R'TCNFIELU MN 55423 ERGAN MN 55125
(1]2) 861-293VJ 1651i681-8717.
?
a
I her°Qby acknowlRdye that F have read ttSio auplicatiqn and staCe thar_ Che
intc,i°n&at.ion ie cnrrer,t and aqre, ta comply wir4al'1 laplieable Sr_aCe aY M,1.
Statutes and Ci.ty o'Y Eagan t7r-dir9ances. ;
V a
APPL T! RMITEE SIGNATURE
UED BY: SIGNAT FE
I
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
? (o o .
3 (esl) 681-4675
NewConstructian Reauirements RemodeVReoairReauirements
? 3 registered sde surveys
? 2 copies of plans (inGude beam & window sizes; poured fnd. destgn; etc.)
? 1 energy plculations
? 3 copies of tree preservation plan if lot pla@ed after 717/93
requfred: _ Yes _ No
DATE:
? .
DESCRIPTION OF WORK:
r"K "5 4
? 2 copiee ot plan
? 1 s8e surveys (extedor addRions & decks)
? 1 energy celwlations for heated addidons
CONSTRUCTION COST: e /4, ?YCD
STREET ADDRESS: zk 9 q Cam 4e,'We< ( Dr. ?/O
LOT: ? BLOCK: ? SUBD./P.I.D. #: C51 ??S ? S?? Q r?? ?
Name: Phone tr: 6 5(- 68 /- 8 7/ I
PROPERTY Last Firsc
OWNER n
Street Address: (?.,?4ewluell 0/,
City G A!; T7v
State: m k) Zip: S5- ?2-3
Company: ffi/UCO)C 061US7'RuC7-1?9? -'ZW- Phone #:
CONTRACTOR
StteM Address: (PUI ?°? J ?6 ? ?T License # 36Exp. ?
csry /?i C??' e C? state: xj ziP:
ARCHITECT/
ENGINEER Company:
Street
City
Sewer 8 water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.,
Phone #:
Registration #: _
State: Zip:
Penalty applies when address
I hereby acknowledge that I have read this application, state that the informatypn is correct, and agree to comply with ail applicable
State of Minnesota Statutes and City of Eagan Ordinances. ??
Signature of Applicant: - ?J C1.4v CL!??
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03' SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Pubiic Facility
? 04 SF Porch ? 09 12-plex ? 14 Firepiace 0 21 Miscellaneous
? 05, SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New )9 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
S N
Const. (Actual) Basement sq. ft. Census Code 3
(Allowable) ? Main levei sq. ft. SAC Code o
UBC Occupaney _(Z."-* sq. ft. Census Units I
Zoning sq. ft. Census Bldg 0_
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MClES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Valuation:
TotaL•
% SAC
SAC Units
. .?, CITYOFEAGAN Np. 18772 ,
3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721
PHONE:454-8100 (?f,.?. ?
BUILDING PERMIT
Tobeusedlor SF DWG/GAR Est.Value $145,000
Receipt # (-?- ?
Date MAR 7 , 19_91 Site Address 4099 CAMBERWELL DR N ?
Lot 1 Block 3 Sec/Sub. HILLS OF
Parcel No. N
w IName CENTEX HOMES
o Address 5929 BAKER RD
citv MINNETONKA Phone 936-7833
g Name sAMF.
;ka Address
? City Phone
I Name
Address
City Phone
1 hereby acknowleqe ihatl have read this applic tion and state lhatthe
mformation is correct and to comply wit all applicable State ol
Minnesota Siatutes an i y of agan Ordi nc .
SignaWre of Permitee ?
A emldmg Permit is issued to: TE HOMES
on the ezpress condNOn that a11 wo shall e done in accordance with all
applicable State of Minnesota Statutes anA City of Eagan Ordinances
BuilGing Offiaal n
? r' ixi D/ d.1 rno
OFFICE USE ONLV
Occupancy R-31?L-1 FEES
2omng PD R-1
(AC1ua1) Const V-N Bltlg. Permit 797.00
(Allowable) V-N Surcharge 79- Sn
8 of Stones
?n9th 64' Plan Review Si s_ nn
pepm
0
SA0. Ciry 100.0
S.F.Totel - SAC,MCWCC 650-0
?
S.F. Footpnnls -
OnSileSewage _ WaterConn 660-0
0
On Sle Well Weler Meter 90.00
MWCC System X
0
30
0
Ciry Waler ?. .
Acct Deposn
PRV Hequired - S/W Partnrt 30.00
Booster Pump - SM! Surcharge .5
n
?
0
Treatment PI 276.0
APPNOVALS qoatlUnit 370.00
Planner - Park Ded.
Coumu --
Bldg. ON _ CoPies
Vanance - TOTAL 3 e 594.00
1991 BIII ?ING ?CITY OF EAGAN
$INGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
? tw
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEYT.) 1 SET OF SPECIFICATIONS
1 5ET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UY BY LAST 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 ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For:SFD/GA/2 Valuation: lqs,OOu! Date?D ?
Site Address
Lot ! Block 3
HfLLs or-
Parcel/Sub."6?
Owner
Address
City/Zip Code
Phone 777 ---
Contractor /_ ?i?/Tf=fr (-/ssAS?G
Address
City/Zip Code
Phone
Arch./Engr.
Address
USE ONLY
occupancy R 3 M-(
2oning r?p R.-I
Actual Const V-/q
Allowable V-h/
# of stoYies
Length 6y,
Depth 3 !5'
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System ?
City water ?
PRV
Booster Pump _
APPROVALS
Pianner _
Council
Bldg. Off. 3 -5-9/QS
Variance
FEES
Bldg. Permit
191,D0
Surcharge 72,
Plan Review I $, 0 0
SAC, City IODLQP
SAC, MWCC 6Et7100
Water Conn. 0'
Water Meter D'Oa
Acct. Deposit 0,0
S/w Permit 3D,zv
S/W Surcharge _1!910
Treatment P1. :217(e.
Road Unit -VJO,on
Park Ded.
Trail Ded.
Copies
SUSTOTAL
Penalty
Lot Change
TOTAL
/vtoDa--0f16Sr
agrees that all work shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
4 1991
City/Zip Code /d( / fKM
*** *
PIon
* engir
* **
?
2422 Enteipiise Drive
Mendota f leights, MN 55120
(612) 68I-1914
? NOMES
Certificate of Survey tor:-cE-rEx
N --- ----_---_ ?
87'f'Z\ NoarN
r'? n
p
o ?
G'(4
.
!?.L / \3> ?,'' 3J p? 9 \
?•! ? ? ?
/ ''s• a?'w ? e°A
/ 'S•r`' F9 ? ;/ a' \ 44
`r S.
(13 / 6tt o \ g4
6C '041
,
jk\
(I?
"1°)v %
\
90
OF-
S \ i ? 4ah?? ???
Q ? c? gr??",:.sa .a ?--• .r.
ri,
S9 ? / ? ?? u ? t? ii ' ?`?
?-2-- ?
'?' ...?:_.,
-„?•`T_
? ?`b
. goo.o Denofes exisfin? Elevafion Q o sE? u5E ELE'VATION
Denofes propdYed F(evafiori Lowes Floor E eva T
ion aji.96
- Drnotes Ora,na?e (Utrliy Easemer?f Top o; 8/ack Elevafron 8?t9,6?,
--? Denofes DroincIde law Arrows Garoe S/ob Elevation s99.33
0 Denofes monumenf o Deno es Ott s?f Nub
Bearlnjs shown are assumed Su?'ed to Easemenliq oRecord
LOT 1, BLOCW 3,141 LI.S 0F ST0NEBaI pGE PLAT 2
DAKOTA COUNT}'
I hereby certlfy that this survey, plaa or report was prnparnd by me r undar/^ y direct sunPrvision and that I am duly Repistered Land Surveyor
under the lewe of the State of Minnesota. Dared this?-" /_" day of A.D. 1?3?.
/.'
C??Ir?,O$ Scale: Iirr0 m4() * C? r?ne r??a.siKiriii_s nFC.ru? ine? ZeA
!'lanninn Desiyn Tnc.
!'•.l1 h?iyhway lu N.E.
I`linneapolis, hIN 55432
612-7SjV-19211
cC'm1iW. ran. 080579
Mincvesota StatE Energy L'ode Calculritions
Nased on Ctiapter 5 of the Nlodel Enerny Code
1y83 Edilicn -- Adapted 1!1/34
JwriFr:
Sli.t:' A;Ji!Y-1:3S:
C'urI i." 4.c.f.()°e
!`iOnEL kF 7ci5
CEldTE;C N(];•tE5
CUr;M. IVCi: c.QJ[ivS? /
Phone:
Bldg. t:.i a5s:
=ENERt-'iL INf=OP,FIF1TS0N'
a! A1 +or Siny1N l=ainilyJDuple::
A2, residc•ntial < 3 stories
Over 3 stor-i es
0'tf7er
PJet:e: The sect:ic,n deu'Qnatiuns ("Sectinrt A", "Section F" etc.) are for
r_on+renierice in calculacions nnly, and are noi related fram unra seE oF
calc-ulations he:ow to tl'ie n,>;±,
1, Pldg, Wc.lis Ferimeter 5; Wall heights, = Hrea
greund to eave
Section A: 156 19.83 - 3p43.48
_,euEaun li : 0 G = O
Seutacn G. n p _ ii
S;;rtl.Un 0: ll 0 r =- C?
Gross Wail Area = 3093.43
2. Puildinq dimensiuny Floor or
Ceilinq
Length >: Wi dth = Area
Section A : lu !h = 224
aec t i an P: 32 29 = 896
Section C: 0 p = G
Section LS : 0 0 = 0
Total f 1 oor or cei 2 i nq area = 1120
_.. F.i m Joi st Per i meter = 156
FIDOI' jC11 5L 2 try t8", 10", 12" o r 169>: 14
Rim Joist Area = 130
4. Doors
Hrea: 43.8 Ttii.r_kness (inches): • u
Perimetnr !feetl: O
Type uf cnnsfruction:
5. Total danr's perimeter: n
6. PJincloais
!``.:.int.t t ar. Eun-er :
t_t:ate approvr-d:
T 'j' p o
E1::ihIT. UNIT
L,p!_IL'•i_E= I-IU!•lCE,
r.,Pp
C. PaL'io Daor:
S. At.riiim:
Fireplace arE:,.t
N!id}he
Totai sq F L- -
Y
11. E::par>ed Foundatiun
Fleight area A:
Sq Ft area A _
E::posed Faundaf.i.or.
Height arFa
5q Ft area P =
i:
6ros> wcl.t area
minu=
4!indow area
uatio dvor area
Atrium area
Rim joist area
Ocanr arHa
Fireplace area
Expused Found.
# Framing area
equaJ. s
Tot.als rc,r net wall:
WHA'II-EF:Snlil'EL_D I.I 3aCtnr= '.'•=E;'
Y'rf;
ir,hF.
?? i_t?ntisl_t? ..
, (`Ii?rraEr - Iot?jl
;incYres? (T_nches) of qt,3=:>:s Syf=t
4l1'IS t=`-4
14 27 3 7.88
<6 lb 4 12.44
16 211 4 .67
.l!
?
[
1fJ i.11 L ?
[
Q.2i
;?q 23 12 65.37
23 32 2 12.44
24 ._6 zu 04
~__ ;h n 772
C, ,, p o
c; o 0 a
i? ii 0 ?-}
0 0 Ci
{l ?1 S1 C1
7. 4linclow glas5 are.i t5qFt7 =
!-i2iqht :: Lenyth :: fVumber
(feet) un:ts
0 Q
6.F3 2.0 2
6 Hei.ght:
30
0.67 Perimeter area A:
144.52 '
0 Perimeter Brea R:
0
SqFt U factor
3p93. 48
230.48 0.47
Q 0
38.08 0.47
130 0.035
43.$ 0.14
,;0 0.17
104.52 0.14
309.348 0.069
2206.752
0.037
2'0. `?8
= Tntal
SyFt
O
38. 08
5
156
t]
U „ A
108.56
li
17.4
4.55
6.13
5.1
14.6T
21 . 35
S] 1 . 6.`i
73r._:1 3 F r, i.. ?;
7??O•d'S lJ,.:i.( J.
r.il^-L'a;
- `
, F ranr_r?r? a?-r=a it. 1C1'/. eE gruss tvall
'
cli
k?c3
r-
-?.
:;
`?actor i factur t,?ylew = U r
fl
s .11 ;,
or ,
per c<,cJc>
sinyle f
.
2.-'; for amaiy r; c.4uple::
A-2
•23 fnr• and other r-esiclentiat
uther 6uxldinys
. 28 For
Fac:t nver- storie
- s
or i=_,:
i:c7'Ul f -= 0.11
? •'tG. 2928 NIUST , _
bE : i!P -- - -??
? , -
fc_.:tlct.t.lrt'Fyi1 .ibuvei 1
\ --?
.
-
l;• O::,'l l;ftii 'FI'afi7:lfY4
<ai?;?a r i?.}',`: of c??:i
.
1 i
,7;?i
:
n
t
•
tl'. .r
1'- Y
.s
r-irea ;
.??-, v+
1
I?!ti•r .
.
9 au
r ai -
cei;iny
.yrea; = 1?=
13. _
c.e.tl.?rig area i{jt'pc-.= C_E?A1. ct!^f??-l - i7oisl_
II ?-?x1
:
'trt 11<
1`i'. .
n
lJ frarciriq: area} _
:7.021 x N2t ce
il
ar 1 00f3
-
2?_r, .
.
ea
?1. 42?F :: Jni st - r.
? ?- 1.??3
21
Cir aT ? area
=
?ota_ aF itea? 1e
"d, b8?
- ass cex?iny arc ,
F_ a r: item i4 =
.. factor bela
?..,.85b
aCtor i:, .026 fdr A-i r; A per code
_ r -i 'ingle family « du?+le;;
.:;?- ? ar A ancl othFi• r
I" E.? 1 C1 f.: l i'[ ,{ ?{;
hactnr .t s .{ti? f??r aclter bui.ldings
fll I.1?'{ _ s. ?}. QiL+
29.12 MU3T BE ? pF - ?
lcalculated Nbove? L?,•:3 ?L?
- ---J
.
CITY USE ONLY
• L •?_ BL ? RECEIPT #: I03051
SUBD.Xi?k gg.,jjk??',Q, ?At i?L RECEIPTDATE:
1999 PLUhi$INfi PEftMiT (ft£5ID£N17AL)
crrYoF EAs,ax
S$SU P[LOT KHQB RU
f.1?fiAN, lfN 551 EY
(651) 6$I-467S
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet ' minimum -1
Rough Openings
Water Softener " for dwellings under construction
Water Softener " for ezisting dwelling
U.G. Sprinkl8i ' for dwelling under const.
U.G. Spfiflkler " for existing dwelling
Altef2tiofls ' to existing residence
W t T A d
a er um roun
Private Disposal System ` MPC iic.
(new and refurbished systems)
Private Dlsposal SyStems ' Ahandonment
RPZ (new installation/repair)
Reminder. Call 687 -4875 for inspectlons of water heaters,
water softeners, alteretions, etc.
EACH
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
30.00
3.00
30.00
30.00
30.00
75.00
=
30.00
30.00 =
STATE SURGHARGE
TOTAL
x
x
x
x
x
x
x
x
x
x
x
x
x
# TOTAL
? -
? -
TELEPHONE #: 86 ?` 75&/
30, 0
.50
3?15-D
-----------------------------••-••------------------------........-•---------•°--------------•--°-------------------- ----------------
I here6y acknowledge that I have read this application, state that the infortnaUon is corred, and agree to comply with all appliqble City of Eagan ordinances.
It is the appliranCs responsibility to notiTy the property owner ihat the City of Eagan assumes no liability for any damages caused hy the Ciry during its nortnal
operational and maintenance activities to the facilities constructed under this pertnit within City propertylright-of-way/easement.
SITE ADQRESS: klO q G/ Cyn,6.[iw 7-ty c/,7o .
OWNER NAME:
lNSTALLER NAME:
STREET ADDRESS: / /?3 V,' C-C? wFJ•
CITY: G?STATE:
ZIP: SS-7 d3
CO/PERMIT FORMS/RPLBG PERMIT (RES) - 1999
SIGNATURE OF PERMITTEE
? CLAIM VOUCHER - REFUND REQIIEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: MIDLAND HEATING
ADDRESS: 6442 PENN AVE SO
RICHFIELD MN 55423
LOCATION:
RECEIPT i3/DATE:
REASON FOR REFUND: 4099 CAMBERWELL DR N
103014 - 02/17/99
PERMIT NOT REQUIRED P.I.D./LEGAL: 5I.1, B3, HILLS OE STONt=
CSRIH -?!E:?PS;?A?I'dfF2'*. "`:= '?
VALUATION: ?
PERMIT #:
TYPE OF REFUND:
Electrical Permit 3211-9001 $
Plumbing Permit 3212-9001 $
Mechanical Permit 3213-9001 $30.00
Building Permit Fee 321 D-9001 $
Plan Review Fee 3422-9001 $
SAC (MC/WS) 2275-9220 $
SAC (Ciry) 3866-9379 $
SAC (Admin) 3446-9001 $
Water Connection 3865-9220 $
Sewer Permit 3743-9220 $
Water Permit 3713-9220 $
AccountDeposit 2252-9220 $
Water Meter 3716-9220 $
Water Treaunent 3868-9220 $
Surchazge 2155-9001 $
Utility Acct Overpayment 2250-9220 $
Curb Box Depasit Refuud 2253-9220 $
Construction Meter Dep Refund 2254-9220 $
Water Usage Charge 3711-9220 $
Other $
TOTAL $30.00
[ declaze under ffie penalties of law that this account, claim, or demand is just and that no part of it has been paid.
SI NA URE
Febcuary 18, 1949
DATE
CITY USE ONLY
LOT BL ?7 RECEIPC9: 1O, fU
SUBDA?o ? /},aAjry?& S.y',9q,? o2-- RECEIPT DATE:
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAG.aN
3830 PILOT KNOB RD
EAGAN MN 55122
2-16-99 (612)6814675
Date:
Complete this section onlv if vou are installing HVAC in sinele familv, townhome, or condos that are
under construction and are not owner /occuoied.
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets ( minimum of one required @$3.Op ea)
• State Surcharge: .50
• TOTAL: ? I
? W
Complete this section onlv if you are remodeline. addin¢ to, or reoairina eaisring single Familv
dwellin¢s, townhomes, or condos. . . ., . . .- . . -
Add-on furnace -= -Add on air condidoning
x
Add-on air exclianger, i.e. Vanee system, etc. Other
Add sunplies and returns to baaement,vent fan
Minimum fee applies to afl remodel or add-ons of existing residences _ $ 20.00 ?
- State Surcharge S o
Toiai: $ 20.5
?s
SITE ADDRESS: 4099 Camberwells Ar.N -
-Z 3teve Wolter _ 651-681-8711
OWNERNAME: - ' PHONE#:
INSTALLER NAME: Midland Heating PHONE#: 612-869-3213
6442 Penn Ave So
S'fREET ADDRESS:
Richfield MN- 55423
CITY: STATE: ZIP:
-SIG TURE OF PE EE
?# RESIDENTIAL ? 3? • ?S
BUILDINC PERMlT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAIV MN 55122
851-881-4875
New Conetructlon Reaulremanu RemodeURert91r ReaufremeMa
• 3 registered stle surreys showing sq. tl. M bt, aq. k. ot house; entl all roofetl arees • 2 copias of plan
(20% maximum bt coverage allowed) . 1 set of Energy Calculations iar heated addiCrons
• 2 copies ol plan shaxing 6eam & window sizes; poured fouM deslgn, etc.) . 1 sfte survey for exlerior addYtlons & decks
• 1 set of Enerpy Cakulatbns . Intlicete N home sened by septic syatem for addNbns
• 3 copies af Tree Preservatbn Plan il bt platted afler 711/93 /• Rlm Joist Defail OptiOns selBCiion sheet (bklge wtlh 3 or less unNS) DATE (o 1,?S/a2 VALUATION OOr I14000
SITE ADDRESS Yo 99 r&rnbm w-r,?t &. lLI MULTI-FAMILY BLDG _ Y _ N
NpE OP WORK Reroor? {- &IGCE - FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS
TELEPHONE #
ZIP 6
60-'§4-'19f0 FAX# 912-M-d'yY0
PROPERNOWNER tPQA(A. h10I7P/L TELEPHONE# 65-1 -4fl-V11
COMPLETE THIS SECiION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RLTLFS 7672
(4 submission type) • Residential Ventilation Category 1 Worlcsheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing ConhaCtor.
Plumbing system includes:
Mechanlcal Conhactor:
Mechanical system includes:
Sewer/Water Contractor.
Phone N
Phone #
Fee: $90.00
Fee: $70.00
I hereby acknowledge ihaT I have read thls applicatlon, state that the information Is correct and agree to comply
wiTh all appllcable State of Minnesota Statutes and City of Eagan Ordfn
ll? 1 Vy\L,,.,?
Signature of Applicant
....... _._...... -......... ----...... _._...... ----------............_.?.._..r.........._?...
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
? Water Softener
_ Water Heater
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
_ Air Condiaoning
- Heat Recovery System
/Sep 27 2013 9:27AM HP LASERJET FAX (763) 241-0140 p.l
Use BLUE or BLACK Ink
For Office Use I
fit of E an ;Permit
I
3830 it Knob Road Permit Fee: tad. OO
Eagan MN 55122 I
Phone: (651) 675-5675 i Date Received: 1
Fax: (651)675-569/ I 1
I Staff----
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: J Site Address:
Tenant: Suite M
"o Name: A4L* tors Phone: 02
~derttsi~er .
Address /City /Zip: CaMbcrrv 1 Vr
Name: u p 1 d' License
t? t~>ktc,toT Address:1 O 5~W City: tiC/!i /C I ✓"t°l"
?63 --~fy l•- ~ib'
State: / VN Zip: ~33c) Phone:
Q(1 763-2~'6 - Y
Contact: C `0. Email. is C1i e ' Ca fK-
y New _X Replacement Additional Alteration Demolition
Description of work
SRI
RESIDENTIAL COMMERCIAL
Furnace New Construction _ Interior Improvement
CFI n
,r H f 1,, ~4j;
Air Conditioner _ Install Piping _ Processed
-Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under/Above ground Tank Install I _ Remove)
{r ~
r r' tr Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) of D
$100.00 Residential New (includes $5.00 State Surcharge) _ $_t0 0 TOTAL FEE
COMMERCIAL FEES Contract Value $ X.01
$65.00 Permit Fee Minimum
$70.00 Underground tank Installationlremoval Permit Fee
`If contract value is LESS than $10,010, Surcharge = $5.00 Surcharge"
"If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
'If the project valuation is over $1 million, please call for Surcharge TOTAL FEE
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 X- IZA-f. x I" !@!~
Applic n ' rinted ame AppH 's Si tore
7 1 F' ski SI r ` nR tv
Imp ,ti
itd jEttst~on>s, R~riewed 13y. iatx,
' 00
QS. trhIQdt:yT^i':t ~,~7I11Cr8Qllif
lJlll"Btf1Lt9 f{t
NWIT~
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128951
Date Issued:12/17/2014
Permit Category:ePermit
Site Address: 4099 Camberwell Dr N
Lot:1 Block: 3 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-03-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Matthew D Diers
4099 Camberwell Dr N
Eagan MN 55123
(651) 283-3002
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168272
Date Issued:04/15/2021
Permit Category:ePermit
Site Address: 4099 Camberwell Dr N
Lot:1 Block: 3 Addition: Hills Of Stonebridge Plat 2
PID:10-32991-03-010
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
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 -
Matthew Donald Diers
4099 Camberwell Dr N
Eagan MN 55123
Kremer Brothers Construction Co.
516 Second Street, Suite 202
Hudson WI 54016
(715) 554-2600
Applicant/Permitee: Signature Issued By: Signature