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1286 Balsam Tr E CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY 3F EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit- Pen-nit Fee: Surcharge: By Misc. Charges. Date of Insp.: Total: Insp.: Date Paid: --r R 1 G '4t s!- PERMIT # - 9 RECEIPT DATE: 2008 RUIDERTIAL PLUMBING PERMIT APPLICATION crrY of f-AHm S$SO PILOT KNOB RD KAGAN, MN 55'182 651-6$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflOw Dreventer for irrinntinn cvctArn ROSENBERG, GAIL SITE ADDRESS: 1286 BALSAM TRAIL EAST EAGAN, MN 55123 OWNER NAME:: _ (651) 452-3383 TELEPHONE (AREA CODE) INSTALLER NAME: JO r-Wo m ? 1 V M1.01 TELEPHONE (G iz " 9 Zl' 14053 STREET ADDRESS: 2-105 C70.~ fit l!dl /itVe 141"e- SO IA-Oq (AREA CODE) CITY: fVl~ ~5, STATE: Mr~1 ZIP: 55L40$ _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • M ODI FICATIONIALTE RATION TO EXISTING DWELLING UNIT, INCLUDING: - Adding fixtures to lower levels or room additions, 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 - lawn irrigation system Rep lacement/additional: water softener /w water heater $ 15.00 State Surcharge $ .50 Total $ 115.540 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liabllity'for any_damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit withi oDert right-of-wayleasoment SIG URE OF PERMITTEE 1102 CITY OF EAGAN 3795 Pilot Knob Road No. Eagan, Minnesota 55122 INSPECTOR NOTIFICATION Phone: 454-0100 REQUIRED BY LAW PERMIT FOR ALL INSPECTIONS Dote: Receipt No.: Single Site Address: Residential Lot Block Sub/Sec. 1 u Multi Res., Comm./Ind. Name New/Alter./Repair. Address Cost of Installation City - Phone: Permit Fee Name .nder . Surcharge Address 1 3 i VQ . City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 1!' 1 rat' o 3830 Pilot Knob Road Permit Number: ; f, Eagan, Minnesota 55122-1897 ' Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: I !iAI ' Ftl''i ! I t fn 1 Nii: 1 11 r 1 f•', 1 c!t PERMIT SUBTYPE: TYPE OF WORK: 1 r 1 1 INSPECTION DATE INSPTR. INSPECTION TYPE DATE INSPTR. 4 . . ELECTRIC Permit No. Permit Holder Date Telephone M PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN 3795 Pilot Knob Read Eagan, Minnesota 55122 INSPECTOR NOTIFICATION No. Plane: 454-8100 REQUIRED BY LAW PERMIT FOR ALL INSPECTIONS Date: - Receipt No.: Single Site Address: Residential Lot Block Sub/Sec. Id °11n 6 Multi Res., Comm./Ind. Nome New/Alter./Repair. Address 627 S. Snellinf- C Cost of Installation F 11 r City Phone: Permit Fee Name F'-n1T h S P1,1 r ` Surcharge Address }900 Keawic'c. ,T City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 N2 6 119 PHONE: 454-8100 BUILDING PERMIT Receipt # To be and for Est. Value Date 19 Site Address Erect 0= Occupancy Lot Block Sec/Sub. Alter ❑ Zoning Parcel # Repair ❑ Fire Zone Enlarge ❑ Type of Const. W Name Move ❑ # Stories Z Address Demolish ❑ Front ft. 0 city Phone Grade ❑ Depth ft. Approvals Fees Name .o u' Address Assessment Permit ~ City Phone Water & Sew. Surcharge Police Plan check W W Name Fire SAC Address Eng. Water Conn. <W city Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit # DOM breed ►enaittee Plumbing P-- p to Mechanical o20(P INSPECTIONS DATE INSP. Rough-in Final Footings Date Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final 42 Remarks: CITY OF EAGAN Remarks Addition Wilderness R 6th Lot 7 Blk 1 Parcel 10 84355 070 01 Owner ~(.6j~ 4{ lal_tu 1V4 Street 1286 Fast Ral Sam Trail State Eagan, M 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 8AQ 1 197.73 161-21 8.04 20 88.67 A009.647 1-13-80 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA ZLI 16914 gb jk::~ 1 -r, 108.14 A009647 11-1-1-80 STORM SEW TRK .3 1978 215.51 14. 3 6 15 158.07 A009647 1 -1 -i-Ro STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 305.00 20634 9/26.180 BUILDING PER. #6119 906M R.49(,4gn SAC 525,00 20634 S 26 8 PARK ,a U 7 This request void , (3 v& / 3~_ as 18 months from Date of this Request 1 QAo Fire No. 8 2074 I, as f iLicensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 1286 East Balsam City Eauan Section Township Range County Dakota Which is occupied by Tilsen Homes (Name of Occupant) Is a roughin inspection required on this job? No ❑ Yesf t Ready Now ❑ Will Call Ek Power Supplier Dakota Oty. Address Farming-hon Electrical Contractor n _ n_ n mi, p--~-gQn E}est id Ce Contractor's License NoU73-662 (CQmpany Name) Mailing Address 12201 Mtka Blvd s Mtka 553¢3 (Electrical Contractor or Owrier,Making This Installation) Authorized Signature / 66 ~ Phone No. 933-2528 (Electrical Contractor or Owner Making This Installation) ~~~~~BOARD ~lT This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. -.,sota State Board of Electricity Griggs Midway Bldg. - Room N191 / EB•00001-02 niversity Ave., St.-Paul,, Minn. 55104 - Phone 297-2111 REQUEST FOR ELECTRICAL INSPECTION 82074 CHECK BELOW WORK COVERED BY THIS REQUEST S Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home 39 ❑ ❑ Range • Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures $ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ®C2.00 Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner But ank ❑ Farm ❑ ❑ Lppist )y)y is Other ❑ ❑ Heiersl e s - grtl COMPUTE INSPECTION FEE BELOW Service Entrance s--.F # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes 8 1 00 l0I to 200 Amps1 11 10900 31 to 100 Amperes _ 31 to 100 Amperes Above 200-Amps. Above 100 Amps. Above 100 Amps. Transformers _ Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee $ 0- Remarks Hall TOTAL FE C,00 36,50 I, the Electrical Inspector, hereby thaf~t bAe ins ction has been rW (Rougb•in) Date (Final) _ Date This request void W 18 months from . PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 3 3 6 (612) 681-4675 Date Issued: 0 6/ 2 6/ 9 7 SITE ADDRESS: 1286) BALSAM TR E LOT: 7 BLOCK 1 WILDERNESS RUN 6TH P.I.N.e 10--04355--070..-01 DESCRIPTION: - SIDING/SOFFIT/FACIA d jjd3.6 -Permit Type SF (MISC.) ui3dar 47 „rk Type ALTERATION ADe;Ct to #4*'0' 434 ALT. RESIDENTIAL h a m 4 0 Ct t R~ n`k'iea to 4 4 LL°:r~.OErwj yw L '.~rv:frn~x~a ~ rs ~ au r _u a $ 2114 r 3~"1 is 4Ea a 3 a sr v~iwri~$' . bid -x it $fr °c REMARKS: FEE SUMMARY. VALUATION $B,ooo Base Fee $137.25 Surcharge 4.kLe Total Fee $141.25 CONTRACTOR: Applicant ST. LIC. OWNER: MINNESOTA EXTERIORS INC 13915514 0002877 ROSENBERG RICHARD 80,041 JEFFERSON HWY 1236 BALSAM T!? E OSSEO MN 55359 EAGAN NN -(q12) 391-5514 (612)452-3383 R 4 b *p - St t _ y nT_ I het^eby aTr-kis64'1e,d4A *,60, 13 4 ,3 ,1~~ £ 33~~i1 ti (t c( 1i 1 tY3 tc aV0 0, 3ntnrrhAtiarr xerorr o, 601 1,09 ee e rnp1 r ap k ~ a` Sri, f ~Atute6 `arid ~ y 3 r 9 Sr l r5ar f ..._-_a.... x.- 2A~^A" APPLICANT/PERMITEE SIGNATURE ISSUE : SIGNATURE ?#?k?%~~'fik~M!kWik~'c?k~F?K~k~~?k~~kk~W~k?k?k?K?K?K?Kk~>~, ~?~~#~C?k~*?X CITY OF ! AGAN CASHIEiRg S TERMINAL.. NO. 39 DATE..,, 06/27/97 TIME s 008:27 IV: NAME:: MN EXT'IERTORS INC 320 9001 086 BALSAM TR L37„2`'} 205 9001 1286 BALSAM TR 4.00 Total Receipt Amount,.; W.Rf CR076396 USER TDn NANCY :k?k%F~F~FyFyr~~~#~FYF~+~:?~A':~~FyF>'F ~r:M%'?X ~~';k %k.l<'M1K:%MYF?k."~.Yf Yti >,l•Jr; 3 ®3 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) aS CITY OF EAGAN 3830 PILOT KNOB RD - 55122 6814676 New Construction Reauiremerts RemodelfReoair Reauirements ♦ 3 registered site surveys ♦ 2 copies of plan • 2 copies of plans (include beam & window sizes; poured intl. daslgn; eta) • 2 site surveys (exterior additions & decks) ♦ 1 energy calculations • 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan If lot platted after 711/93 required: -Yes N DATE: _ CONSTRUCTION COST: - L DESCRIPTION OF WORK: o S STREETADDRESS: OT / BLOCK' SUBD./P.I.D.9: PROPERTY Name: ® Phone OWNER Street Address: City: State: Zip: J~v~o79' ~70,~ CONTRACTOR Company: /Q,Phone M' Street Address: License City: S~ State: zip: 25r ARCHITECT/ Company: Phone ENGINEER . Name: Registration Street Address: City: State: Zip: Sewer & water licerned plumber (new construction only): Penally applies when address change and lot change are r equested once permit is issued. I hereby acknowledge that I have read this application and state that the information is ce and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No JUN2 6 1997 BIC 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 Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6119 PHONE: 454-8100 /ice BUILDING PERMIT APPLICATION Receipt # ~t7 To be used for SF DWG/GAR Est. Value 66,000 Date $-26 _ Iq 80^ Site Address 12$6 F Bbl Sam Erect ga Occupancy R3 Lot 7 Block 1 Sec/Sub. Wild. Run 6 Alter ❑ Zoning Rl Parcel # Repair ❑ Fire Zone 3 Enlarge ❑ Type of Const. V z Name T' l c Homes Inc _ Move ❑ # Stories 3 Address 627 S. Snelling Demolish ❑ Front 6$_ fr. o G St. Paul, Mn Phone 69$-5501 Grade ❑ Depth 3$ _ ft. p Name Approvals Fees o~ Address AssesslWAt 8-12+-80 Permit 163.50 u~ City Phone Water & Sew. Surcharge 33.00 Police Plan check $1.75 ww Name Fire SAC 525.00 Mtz Address Eng. Water Conn. 305,00 z 60.00 a"' City Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total l ,l6$.25 State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: Tilsen Homes, Inc. on the express condition that all work shall be done in acpprdonce wi al_ I applicable Sta a of Minnesota Statutes and City of Eagan Ordinances. Building Official's •.[~iLi I~~ G 1 CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & lJ BUILDING PERMIT.' APPLICATION 1 set of energy calculations. ib Be Used Fors/~ moo, Valuation (n,000 Date ~-~rd'~' Site Address: ! OFFICE USE ONLY Lot Block Sec./Sub. Erect X occupancy 3 Parcel Alter Zoning Repair Fire Zone Owner: T r (Se Aj 40.0" C.9 Enlarge _ Type of Const. Move # Stories_ Andress: L 27 -r S Dermlish Front fo 8 ft. City/Zip Code: .5.5 Fade Depth 3 ft. Phone 6 Q a° - $ S6 APPROVALS FEES Contractor: Assessments Permit J(3 Address: Water/Sewer Surcharge 33 Police Plan check g l City/Zip Code: Fire SAC ~a5 Phone Eng• Water Conn. 3 o6 Planner Water Meter Arch. /Eng.: Council Road Unit Bldg. Off. Address: APC City/Zip Code: Phone /~~!A~O=AL -77 E d?EHR_ OROAaArY Lw4 i LINE SIMR INVERT LINE a TILSEN HOMES INC. , LOT AND BLOCK L - I J ADDITION t ~Z7 ` NAME ! /~Se~/ eS In~ ADDRESS CITY "-"rte 3Stzv IwIT „e~ROi~Ff~LTY .LINE t110 -i LQT -4 LAN TR~"l0~- _ _ ,~„~;~,,;.,u• -EXTERIOR ENVELOPE SPACE .,.U" COMPUTATION _ (To be submitted with building-:permit application) One ox two :family dwelling _X-- - Owner All other -..Site Address; - - - Contractor1f~~e1~C~M~ l1k• Date=_ phone LIKEAt FT: "OF fRt:; 1 p 11 .1 above WALL ? + grade- . I01AL.EXPOSED WALL AREA SQ. FT j rl 59.(o OFAQUE' WALL CONSTRUCTION: "0" Valtie X urea" tl2 'lull X sq - (:al p t U) (A") "kill _~!Q~.-\ ft. „U.. X sq. ft. _ Aetail, reference. ft. %3;3 (Q - (ou2~_.~" (A Sq. c from q. attached sheets _ X sq; ft: WINDOWS ';1. ' VALUE AREA 1411n1oea~S. m cl~CF1ER I~LxJ : 'U @'a~ 2r mod' ` C] 1~ d~sq ft @Y]c~tt 32x~c3 D rl s-~ 9q , t cz. i q @ ~1.. ~7.G- S• at ,uUn'X sq ft.T (A9 Make & type. n pU" __2 -X sq. fk. ~.5 3 - l~?r~c (L){A)'. n n C-m`c'S 1~=!,iU,i X sq. ft. .Q(L) (A, a S,y ~YPKf'; 'uU"_~X sq. £K. - f ~J•4 DOORS: "i]" value. X. area <_J._x••cs-~ e..-• Malce & Type -1L L'- O _ z x'sq ft..•C~5z- t rA a (U)'(A)' ~ - .,,U,. X sq. ft. . it' .Y2?•.:_ -__rjr-,2.szZ: 7 fA'}% U„ X.sq TOTAL(L").(A) VALUES Le-3. = p..~ o~ P TO't'ALS Z'Z©asq. ft. Z~, 2. (L) t:;~ DIVIDED BY TOTAI. WALI. AREA~;YZ-701 0 AVERAGE "U" .17 or less, for l & 2 family dwellings' - ..22-or less for. all- other buildings CONSTRUCTION FRAMING R-Value 2• 4. I,s~SAT1~i`1 ML. s. r \ . oSq 9-7 j~R_7 E. ROOF/ CEL1ING. sq Tt. TOTAL AREA: - (U} . X sq. ft. (A) (~Z i.~?__°_ •~4.Jc~ Detail ref„ X sq. ft. - - - from X-sy. ft. ( (A);:.,. f ti} `attached sheets UJ -nUn Describe openings.---- X sq ft in roof _ - _ 1.7, L 'TOTAL'"(j)) (A) VALUES 4©(n- 'CO'i'A15 sl. ftr.(U) (Af 0 off? DIVIDED BY TOTAL ROOF/ CEILING AREA. AVERAGE "U" ..05 for'vent ialated ruofs .10 for all other construction ROOFICEILENG:R=value 3 S. - - - - 6. NOTE* If average "U "values as;.calc•ulated above do not me et 'tile F,nergy Code Fequirements the "Alternate ;Envelope ,Design"as outlined in'SBC 6006 (g) may be uacd. Additxunal ' sheets'may:be used to show calculations. Use BLUE or BLACK Ink 1 For Off m Use j Permit j V pa 11b i IL o f E a,,,, n 3830 Pilot Knob Roadv Eagan MN 55122 j Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: rZ 9?b 13h L S h 1" 7? -L 6- Unit i Name: ti GA's IcDS~ O ERA' Phone: (Os/- 452 - 3383 Resident/ i Owner Address/City/Zip: I2g& RPLS#7#A 7-RL E AG>d~, ! - SS!Z3 Applicant is: Owner Contractor Description of work: S / A /NG Type of Work Construction Cost: OdU Multi-Family Building: (Yes / No Company: ~~h~laCr~ 17D•~►E rv~p~py~ME~+T Contact: S Tt~'f9~ti L ya.~S' 1 Address: ~lo r/~ UD9~leB~Q~/~E G[/oq~/ City: LEA L~ Contractor 1 i Ctate M/y 7ir. SS / -7- Phone: T/- 45- 2- 9,1,!~11 a a p License /DJ 6 i~ 3 fj I ¢ ~ Lead Certificate /UfIQ-r- ~ 7~ 3 fo - If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _Nc if res, date a^d address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: mNOTE: Plans and supporting documents that you submit are considered to be public information Portions of ~i the information may be classified as non-public if you provide specific reasons that would permit the City to p conclude that they are trade secrets CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities, www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota S B ilt~' a must be plated within 180 days of permit issuance. x 57- Pt4 6-~ A . LY~•~ x Appl icant's Printed Name Applicant's S nature Page 1 of 3 Use BLUE or BLACK Ink r For Office Use Permit#: 14a J City of EaEd~ 105-95 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: ~ (4 13 Phone: (651) 675-5675 I I 11 Fax: (651) 675-5694 i Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: d LI - 0 3 Site Address: l -)2)6 - E -TSA0 S o,,T vt_ Unit Name: (o , ~ ~ a 5 c~ Phone: h 5 I - 4 -3 3 7 Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: ~/o - Yi c v~o orF sE a a Construction Cost: Z 43 S OF Multi-Family Building: (Yes / NoV ) Company: Contact: ~j_, Contractor Address: 3-2 (oS 0 w e-e ey L~ City: l( State: V k'\- Zip: `j S0 4 q Phone: °t -8OS`1 I S a -3(S -64Lt-o License 9J t Lead Certificate M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. fp Applicant's Printed Name Applicant's Signature Page 1 of 3 • 4- r`PAA For Office Use ---���------((( .1 �� � 44 : �► , Permit /5-7-' 9 f I ,:,„, ..,0%,,, EAGA 1 Permit Fee: c';Oc - oy 1 .....44,„,4, .. E C I E t Received: ---7_,_/4Dae 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810JUL 3 0 2019 A/ 1 ( 651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-56 i Staff: 74 I buildinginspections@citvofeagan.com L BYL 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7/30/19site Address: 1286 E. Balsam Trl. Unit#: Name: Gail Rosenberg Phone: Resdent! 1286 E. Balsam TH. Owner Address/City/Zip: Applicant is: Owner X Contractor ' I Type of Work —7‘1/L-- Description of work: New Deck umcL-4416.- s.. (,�/l Construction Cost: 12,575.40 Multi-Family Building: (Yes /No X ) Company: Outdoor Spaces Design and Build Co. Contact: Jon Hassenfritz Contractor Address: 19205 Harappa Ave city_ Lakeville State: MN Zip: 55044 Phone: 952-457-0597 Email: jhass415@gmail.Com License ii BC689582 NAT-F168253-1 Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.comisubscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you I intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq 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 j 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 plans. c` x Jon Hassenfritz x Jon Hassenfritz I201907�3013.23a(3500 Applicant's Printed Name Applicant's Signature DO POT WRITE BELOW THIS LINE 06, j4�� TT T . • /5-73q SUB TYPES Foundation Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family Garage Porch(4-Season) _ Exterior Alteration(Multi) Multi ---y.Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES NewInterior Improvement— _ Siding Demolish Building* lAddition Move Building _ Reroof Demolish Interior Alteration Fire Repair Windows Demolish Foundation — Replace Repair ! Egress Window Water Damage — Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION yOld Valuation Occupancy � � MCES Systemstem Plan Review Code Edition �/z3 7< SAC Units (25% 100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction /� Width REQUIRED INSPECTIONS 'J Footings (New Building) Meter Size: )( Footings (Deck) Final/C.O. Required J Footings (Addition) NiFinal/No C.O. Required Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof: Ice&Water Final Pool: Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick EFIS Insulation Windows Sheathing Retaining Wall: Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 11 , Building Inspector RESIDENTIAL FEES Base Fee '/5f111717 Surcharge (1r(( Plan Review MCES SAC �. / City SAC (9 Utility Connection Charge S&W Permit&Surcharged Ixi-cO 0 Treatment Plant o .......„.......,.............._ Copies TOTAL 7c2 ) / Page 2 of 3 . / -7..gc---7' :-.• , ..r . •:...1".::.:., ", • '''"'"" '''4""'"""'"'ZlilL"n"." ""''."' ""'"'' ei.09e 0000940a TY ..._ `� • _ % �' • • • . • 1 • - - 'J.i • �'Y;.lr• ' • . . E--:‘ • ....- . . . . \tylo i di . __• ...;:_ ...•.. Y � iLf1 a :. IN 100411114 ., .,..,:• • , • ' \ •, v.....': ... ",; . ,i' 1 -�''.!.`tip ,00HINI • ' • i . f--•.. 'i;,". . .... • 0 i• • . . :.1.•• :.:4...> .... .t.:i.::: • • • • . y;z • . • • -• CMOS Sill\NM Nthh,'11 ,14 : .: ....-.....• ...,.s.: 1 • 7 Rj�. • . . .1.. , . NM C. . ' 4. ,h, 44.41__ 4N„ � } API . •r, 7T :• yrs •R • ••f 7") . • . • • , � /ice \ ! ! • rT4 •r• = _ pE 7�`� SEWER INVERT ' c , L iNE TILSENti. . . . L......j. • •. — � -5 LOT. AND $LOCK LA:14:.—I.. ,r.....rft • _ .r • • • ADDITION 'i t....:•••••', • '/• r .. • .. ,•1 •f • .. • ADDRESS CITY .. LOT 4.. '• PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA168917 Date Issued:05/07/2021 Permit Category:ePermit Site Address: 1286 Balsam Tr E Lot:007 Block: 001 Addition: Wilderness Run 6th PID:10-84355-01-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Gail H Rosenberg 1286 Balsam Trl E Saint Paul MN 55123--170 (612) 840-1268 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature