4615 1_2 Penkwe Way
Use BLUE or BLACK Ink
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Permit Fee: s~' V Q 1
3830 Pilot Knob Road I I
Eagan MN 55122 MY I Date Received: 1
. 70 1
p Phone: (651) 675-5675
Fax: (651) 675-5694 1 staff:
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 114 f 1Pkuol6- ~aZ~.
Tenant: / Suite
RESIDENT/OWNER Name: ,Phone:
Address/ City /Zip: ! ~iJ1 lX/ (QyL
CONTRACTOR Name: A License C2 (,e 3a 3 I 1
Address: (a ~ , a e f--~ City: ~P c 7(J~ a?'/-zS
State: Zip:6S a -72 Phone: t .L X11
Contact: L7> eL<
Email:
TYPE OF WORK New _Replacement _Repair -Rebuild - Modify Space - Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater -4--Water Softener
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures L_ Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $ f/
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.oro
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.
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Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections. Under Ground -Rough-In Air Test Gas Test Final
13161 Cit y of Eap j Permit #i ,
3830 Pilot Knob Road Permit Fee:
j
Eagan MN 56122 j Date Received _
Phone: (651) 675-5675 I t
Fax: (651) 675-5694 1 Staff: 1
t
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:G f ~j `16/✓/~- , ``/Gl~ ~5",f2- J9/ts- - ~Yic
Tenant: 0114 01 le- Suite
RESIDENT / OWNER Name: ~'To 'L r49&vn 1 'hone:
Address / City I Zip:
Applicant is: Owner X Contractor+
TYPE OF WORK Description of work:
Construction Cost; 1s-J7~ Multi-Family Building: (Yes / No
CONTRACTOR Name: 0,* License ✓ I 7 3
Address: R1 I zl r-,jmoo-
City: State: Zip:
r ~
Phone: Gl~-~ cy Contact Person: t) 11- ~ 'J-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Fagan 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 grid su
ppotting do uments-,bat, you. subinit are 664sidered to.be public +nformation. PortJons of
the inforrim on. may b4 classified as non-public if you provide spec ? sons that ~would perr+iitthe City to,
c ~olude that iihe pare tiraiese
I hereby acknowledge that this information is complete and accurate; that the work will be in c0i6mtanc a 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 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 pla
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Applicant's Printed Name Signature
Pagel of 3
ILL
L16
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) Storm Damage
Single Family Garage Porch (4-Season) _ Exterior Alteration (Single Family)
~C3 Multi ; Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of Plex _ Lower Level Pool u Miscellaneous
Accessory Building
WORK TYPES
_ New Interior Improvement Siding Demolish Building
_ Addition Move Building _ Reroof i 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
Valuation l6j Y3~}t . Occupancy :~PC'3 MCES System
Plan Review Code Edition n 2%:oQ`"I SAC Units
(25%100% Zoning r City Water
Census Code q3Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
_ wa Footings (Deck) Final ! C.O. Required
Footings (Addition) Final / No C.A. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water Final Pool: uFootings rAir/Gas Tests ^Final
Framing __t4 Siding: -Stucco Lath -Stone Lath Brick
Fireplace: _Rough In Air Test -Final Windows
Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee to C~ 5
+J~~( 1 LAO iZ
Surcharge , Ua 71 ~OcZ 1>cV 11>1-, y,
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
POW
F r` - or- O-ff-c e-U-se
~ ~
• j Permit j
City of E
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I l
Fax: (651) 675-5694 i Staff: '
I
2009 RESID TIAL BUILDING PERMIT APPLICATION
ate: Site Address:
mant: Suite
tESIDENT 1 OWNER Name: Phone:
Address I City I Zip:
Applicant is: Owner ontractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes ( No
':ONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Pers :
COMPLETE THIS AREA ONLY IF CONSTRUCTI G A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
• Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submitted
City of Eagan issued a permit for a similar plan based on a master plan?
~d address of master plan:
~ Phone:
J ,8~ Phone:
Phone:
nts that you submit are considered to be public information. Portions of
on-public if you provide specific reasons that would permit the City to
^lude that the are trade secrets.
accurate; that the work will be in conformance with the ordinances and codes of the City of
iplication for a permit, and work is not to start without a permit: that the work will be in
quires a review and approval of plans.
20`~
Qa9~ x
Applicant's Signature
Page 1 of 3
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' t C. R. WINDEN & ASSOCIATES, INC.
LAND SURVEYORS Tel. 645-3646
1381 EUSTIS ST., ST. PAUL, MINN. 55108
Far:
U. S. Home Corporation
N
EAGAN
REVIEWED
DATE: 417 L
BUILDING INSPECTIONS DIV1S14N Jt x~d` A"Apec - I r
Scale: 1 - 50
2 2 I
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Lots 1 through 4 inclusive, Block 10,
Johnny Cake Ridge Third Addition,
Dakota County, Minnesota.
WE HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF ANY,
THEREON, AND All VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND.
Doted this-day of Ocy, A. D. 148/ C. R. WINDEN 6 ASSOCIATES, INC.
A d r
by k
Surveyor, Minnesota Registration No.
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA087615
Eagan, MN 55122 . Date Issued: 12/01/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4615 Penkwe Way 1/2
Lot: 3 Block: 10 Addition: Johnny Cake Ridge 3rd
PID 10-39802-030-10
Use
Description:
Sub Type: e-Fireplace Construction Type:
Work Type: Gas Line
Description:
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: Chimney/flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Tim Shimek
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Glowing Hearth and Home Matthew W Hutchinson
100 Eldorado Dr. 4615 1/2 Penkwe Way
Jordan MN 55352 Eagan MN 55122--371
(952) 492-9276
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.
Applicant/Permitee: Signature Issued By: Signature
crr''AAAN WATER SERVICE PERMIT
37 Knob Road PERMIT ` NO.: 40
umen/KiN 65122 DATE: .12L18181
Zug; RIV No. of Units: 1 unit tuhse
Owner: Orrin Thompson Homes
Address:
Site Address 461511 Penkwe Way, L3 B10 J C Ridge III
Plumber: E3~p1 Mnrha i aT
Meter No.: Connection Charge: 335.00 pd
Size: Account Deposit: `
Reader No.: Permit Fee: 10.00 Rd
agree to comply with the City of Eagan Surcharge: _ 50 pd
Ordinances. Misc. Charges: - 60.00 pd meter
Total:
gy Dote Paid:
Dat Insp.. ~ - Insp.:
-77
cl ~;GAN SEWER SERVICE PERMIT
y.. , 5021
37"~F" Knob Road PERMIT NO.:
Eogaq~'`" 55122 DATE:
TcIV r No. of Units: 1 unit tnhse
Owner: Orrin`i vo -
Address:
Site Address: 4615' enkwe Wa L B 10 3 C RlAdge III
Plumber: lRenzel chanicak
10/19/8 27334 00.00 pd
1 Gem to amply with the C*Y' n Con _ 25.00 Pd
Ordinances. Account Deposit:
Permit Fee: 10.00 pd
Surcharge: .50 pd
gy - tr ~ Misc. Charges:
Dote Total:
Ins I - Date Paid:
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'} �t j Permit#: ' l I j
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��� � Permit Fee: � �
383U Pitot Knob Road ;
Eagan MN 55122 1 Date Received: j
Phone:t651)6i5-5675 t Staff: 1
Fax.(651)675-5894 � �
- � .. . . . . . . .. .. .. .. . . . . .. . �. ��.���J .
20'1A� RESIDENTiAL BUlLDING PERMIT APPLICATION
oac�: �-�I�`j`� s�naa�s:�6 l 3 1-!� l`5 �1� ��l��v� tv✓� un�t#:
€ Name: Ll!�/�l?i'a� ��1 �- !e�t,v��1,�^�r2� �Phane: �
Resitlertt/ ,
owner aadress�c�Y��p: ,���"� ��-'
ApPlicant is: Owner � Cont�actor �
Description of work: �'Gv�''� ��� � �� '��o'�'�
Type of Wor�€ <
Constnaction Gost:��'i!�� � Mut�-Family Building:(Yes .� I No„_,_�
� /" f( sy/ 4'
Company:11/G�YZt/�.5 7� �,,�,7.f��r�r�t�'�t��5 '� Contad:��r s� �G�t���
C4t1#t�4'�A!' Address:���j� Z�`6?�/ �7� yr�Y� � City:l�l�'�t" t�tZl��'''�.--
1�
state:�z�p_ `'�.��`� Phone:�f��`"�'Emait:�+m��j.��-r,��:s7"�.c���"�'���"��
ir�R �7 ���_��r.�yl c� }
{_IC@flS@� �� +tA � L@fld�Rf'�I�Ca�#:I�J�L°t""�..�1' j 1 f 6.�.? �!
I�the project is exempt#rom lead ce�tification,please expiain v�►hy: (see Rage 3 for additional inforrnation)
- COMPLETE THIS AREA ONLY IF CONSTRUCTiNG A NEW BUtLDING -
!n the tast 72 miont , the City of Eagan issued a pertnit fcu a similar-planbased on a master ptan? �
,,rYes _No if yes,date and adctr f master plan:
Llcensed Plumber: Phone:
Mechanical Gontractor: , ;
Sewer&Waber Co r. Phone: ``'��„p,
��1t7XE: ° s�r►r#suppc�r�r��s>c�m�rrts��Kaer submrt are�ansi�l�red'#o be publ�c ic�`e�r���r #�ns:�'
� � � �.
,rnfareriatz���ra,��r�class�e�f as r#cc�r�-pubric if you pr�viai�specff�r�asax�s�woul�perm����`ta'
co�cl�de tha�the �re+��i�s�cr��s
GALL B�FORE YOU DIG. CaII GapherState One Calt at(651}454-0002 for protection againsf underground utility d�mage. Caii 48 hours 'i
before you intend to dig to receive locates of underground utili6es. www.gonherstaTeonecali.oro
i hereby acknowledge that this information is c�mp�te and aa�rate;that the work wii4 be in confarmance with ihe ordinanc�s and codes af the City of
E�ar►;#fiat i understar�d this is not a pe�nit,but ortty an applicatian for a permit, and work is not to start wiihout a permlt;that the work-wi[I be in
ac�ordance with the aPProved ptan in ft�case of uaark which requires a=eview ar�d approval of ptans.
Exterior work autMorized by a bulldi�permit isstred in accor�nce wi�the Minnesota State ildir�g Code m�t 6�compieted w�th9rt°!80
days of pernt(t issuance. _
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AAp�iicanf s Printed Name T ` ' arrt's�ignature '
Page 1 of 3
1 -13Z2 -S) tlrru
City
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RE , ED
AUbZbZ016
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
1,5E lig 7
(e0 0 0
Date Received: a d (
Staff:
2016 MECHANICAL PERMIT APPLICATION
0 Please submit \V
two (2) sets of plans with all commercial applications.
Date: d I )9 ) / Site Address: ` .e I J l/2 1' (�c Yl �/_VJe? _ V' CU./
Tenant: J
Suite #:
J
Name: Mot* 1ti--(1 i I Y1Sn Phone: 2 -IS " 709 tDy 1 S
Address / City / Zip: _. G GVY1
55(21_
New )( Replacement
Additional Alteration Demolition
Description of work:
RESIDENTIAL
Furnace
X Air Conditioner
_ Air Exchanger
_ Heat Pump
Other
New Construction
Install Piping
Gas
COMMERCIAL
Interior Improvement
Processed
Exterior HVAC Unit
Under/Above ground Tank ( Install / Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge
TOTAL FEE
COMMERCIAL FEES
$60.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
_ $ Permit Fee
= $ 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 plans.
I?asseu MaKhrd
Applicant's Printed Name
x yritiy\4,4)444014
Applicant's Sign