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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 ` . \? ? / \ ?, L??!? *?.? e?? `• ? ?? ? ? i 1;e / f .L a r? '. ja .?S G a ? • ? ?lu? ? / JJ S? ?8 ? 'o ?ti?^ s rt d \? / / /? ?? ' 6A \ \ yy4 '&\iiI \ ? ? / ?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