4279 Dartmouth Ct--t 7'
ClTI( OF EAGAIV
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMITsSUBTYPE:
ON RECO1W
PERMIT TYPE:
Permit Number:
Date Issued:
H1 APPLICANT: -ro.ti y
TYPE OF WdRK:
?-----
-'2
INSPECTION .. ..
sh U r;i s414 ol rt) ?',ril co W';r
Permit No. Permit Holder Oate Telephone #
SNV
451
PLUMBING
HVAC
ELECT ov
ELECTRIC
Hrspeci'wn Date lnsp. CommerKs
Footings I 2
Foundation ,
Framing
Z, -rA d o(-)t-
Roofing c-
T
Rough Plbg.
Rougn Hc9.
Isul.
Freplace
Finat Ntg.
cGOS
Orsai Test ?G'P? /. ?"? Go'?"'??' l/? ryl9 ?-?
Final Plbg. ? Pibg. Inspector- Notity Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Weli
Pr. Disp.
--
?w
Ol I
i
OIl'
?
INSPECTION RECQRI)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
FlAt1 ? i;?•? rti 1)UtiUS : Nli - ; ?? ? .' i ??, , 1 ?+ ? 1
PERMIT SUBTYPE:
TYPE OF WORK:
?to t I w67-.
i i Ntii
I ,I i r i ii I
N; .i ;,•??
04 Ji t;!<?4
-1
Permit No. Permit Holder Date Talaphone N
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
InspecUon Date Insp. Commer?ts
Footings I
I
Foundation
Framing
Roofing
Rough Plbg.
Hough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Fnal Plbg. Plbg. Inspector - NoUfy Plumber
Const. Meter
Engr./Plan
Bldg. Final ,
Deck Ftg. ? .i
Deck Final
Well
Pr. Disp.
U LOT BIIRVEY CHECRLIST FOR RESIDENTIAL
? m BIIILDIN PERMIT APPLICATI
m
<
m J ? PROPERTY LEGAL:
W<IM
Date of Burvey:
? z ? DOCIIMENT STANDARDS
? • Registered Land Surveyor signature and company
VM? • Building Permit Applicant
0 ? • Legal description
0 EK ? • Address
2-#000 ? • North arrow and bar scale
G-` 0 ? • House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
?? • Directional drainage arrows with slope/gradient t.
D CY ? • Proposed/existing sewer and water services
tr 0 0 • Street name
?r? 0 • Driveway
Existina
•?-/ Boo"? • Sewer service
[??? ? • Lot corners
13' ? ? • Top of curb at the driveway
?@oo"C • Elevations of any existing adjacent homes
Proposed
? ? ? • Garage floor
? ? ? • First floor
Q? ? ? • Lowest exposed elevation (walkout/windaw)
??/? ? • Property corners
[? ?? • Frant and rear of home at the foundation
PONDING AREAS (if avvlicable)
? ?0 • Easement line .
? D? ? • NWL
? ?0 • HwL
0 ? • Pond # designation
? ? ? • Emergency Overflow Elevation
DIMENSIONS
p ? ? • Lat lines
? 0 3 • Right-of-way and street width (to back of curb)
? 0 • Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
? structures requiring permanent footings)
Q
? 0 • Show all easements of record and any City utilities within
those easements
? ?? • Setbacks of proposed structure and setback of adjacent
- existing homes
09-10
• Retaining jvAart:?.*p-n; re,ents, if any
October 1992
• -
---- ---?------, -- ?-. -- - - -? , . _ _ .2_. - - - -- - - : . -- -- .
C'e'tiftCQte Of cCC1tpQ1iC?
Wit4 of ?agan
ze0arbutut of 13xifthas
This Certificate issued pursuant to the requirements of the URiform Building Code
i
certifying ihat at the time of issuance this structur+e was in compliance with the various I
oridinances of the City negulating buiCding constncction or use. For the following:
ux c,ass;rcat;orc SF nWG eleg. Pernut Wo. 22.g30
Oc-p-Y 1)'P? W-1.41 I Zoning District JR- I Type Const. ?
oWwr of euaaing AR.r.Tt,r:rrrt wtW wmress 14551 r F
b, Buiwing nmm, 4279 I]ARM??IRap, tocAityj
/ naze: ???
Building Official,?
POST IN A COIdSPICUOUS PLACE ?b
45--n / , -7 RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
? qQ. 8?
flt
J?1?
5Iro(03
New Construdian Reouiremenl5 RemodellReoair Reuuiremems Oifice Use Oniv
3 registered site surveys showing sq. ft. of l06 sq, ft. W house; and all roofed areas 2 copies of plan CeA of Survey Recd
(20°k maximum lotcoverege allowed) 1 set of Energy CaiculaGons for heated addifions Tree Pres Plan Recd
2 copies of plan showing beam & window srzes; poured found desgn, etc. 1 site suNey for addNOns & decks _ Tree Pres Not Reqd
isetofEnergyCalculations Addi6on-indirataifon-sitesepNcsysfem _On-sBeSepticSystem
3 copies oi Tree PreservaGon Plan if lot plaHed after 7H193
Rim Joist Detail OpGons selecGon shcet (bldgs wiN 3 or less untls
Date S / 2?j / (D -3
Site Address Construction Cost 50 V-
Unit(Ste #
Description of Work ? Ux",f e Lrv,- L finrrSty
Multi-Family Bldg _ Y'N Fireplace(s) _ 0 -?r _ 2
Property Owner 1-LVuF- ?- , F'4'-) ??55'V ? LL Telephone # ((S ?
Contractor C7fS7- 1-4!91t92 S Z-A-)<:?-
Address ?(j. -1,? d?< ? 3 Co
State
Zip3-$3??2 City r6lz ?C?
Telephone#((0I:4
ILI
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber l-l, ,=, r, n nn r; '?Telephone #( )
11 CIiI' 'IIIJt?fI
Mechanical Contractor J ',,,,, I Il?elephone #( )
I
Sewer/Water Contractor ILJI! '-' Telephone #(
I hereby apply for a Residenfial Building Pennit and aclnowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the Cit of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an applicati o a pe ?, d wor ' not to start without a
permit; that the work will be in accordance with the approved an in e c e wo whi requires a review and
approval of plans.
C-4?1S I -Y.4A,1GU< <"
ApplicanYs Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ?'^, 19 Lower Level
v ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_vor _N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? '38 Demolish (Interior) ? 44
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45
X 33 Alteration ? 37 Demolish (Bldg) ? 43 Reroof ? 46
? 34 Replacement *Demolition (Entire Bidg) - G ive PCA handout to applicant
Valuation j& 62 6fl'O Occupancy LPe MC/ES System _
Census Code 4ff 5y Zoning City Water _
SAC Units Stories Booster Pump _
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const yj?) Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
Drain Tile
Roof Ice & Water Final
? Framing
? Fueplace I( R.I. -X Air Test X Final
Insulation
O 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
Plumbing
HVAC
Other
_ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
5--'7 ? gy
PLU111BING (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 Dwellmgs
Townhomes and Condos when pernuts are required for each unit
Date W / 4- / r) --?
Site Address u? Unit #
N? I ?GrrSf HO^?tS
Property Owner [)(
A b h; /) Il Telep6one lt ( )
-
Contractor LAKQSI'GPE' ICrn
Address 64 G/Y1 /`C[n 6-rl C City S/}/c ?-e
State ?'J1 N Zipj-537j Telephone #(
The Applicant is _ Owner Contractor Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Altera ions To Existing Dwelli uding
Adding fxtures to er levels o'r oom additions, excluding water softener and water heater $ 50.00
_ A6andonment of septic sys em
(+ 5
`
_ Water turnaround
/8" meter ff needed -$121.00)
`
-
?-C?-?" L"-L-Q
Other.
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
?
_ Water softener _ Water hea[er `l
I $ 15
00
r
l
t
dditi
n
l
.
_
ep
acemen
_ a
ona
u? .
State Surc6arge
$
.50
Total ?
$ S(??
I hereby apply for a Residential Plumbing Pemut and acknowledge that the information is wmplete and accurate; that the work will
be in conformauce wiffi the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understaud this is not a
pemnt, but only an applicarion for a pernut, and work is not to start without a pernut; that the work will be in accoidance with the
approved plan in the case of woxk which cequues a ieview and approval of pJans.
L AC.t ( , -c S vi /?'1 eS
Applicant's Printed Name ApplicanYs Signature
PERMIT
CITY'OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-32151-190-02
DESCRIPTION:
PERMIT TYPE:
Permit Number:
Date Issued:
4279 OHRTMOUTH -G+ft-C"r
LOT: 19 BIQCK: 2
HAWTHORNE WOODS 2N?
B,tr! ltiinrmit 7ype SF DW6
qu3ldIng t?rk 7ype NEW
p
UBC OCCU{sancp\ R-9 M-1
\
ConstructAan Type v-N
Zortin.g R-1
$uildin9 Length r' 68
Rui].ding Wid"r,h 40
_
, • ?
t .,
r,4-- /%d-"f-
e?-L,J?
022030
09J23J93
?-
????? ? rm
REMARKS:
PRV
FEE SUMMARY:
5& W PLBR - OLBERG CONST
Base Fee
Plan Review
Surcharge
SAC
SAC &
SAC Units
Subtotal
VALUATION
$1e 007. 0 8
$654.55
$102.58
$750.00
100
$2s514.05
$205,000
MISCELLANEOUS $1.744.50
Total Fee $4,258.55
CONTRACTOR: - applicant - 57. I.IC. pWNER:
ARLSNGTON HOMES 14329725 0003200 ARLINGTON MQMES
13774 PRINCE7QN CT 14551 COUNTY RpAD 11
SAVAGE MN 55378 BURNSVILLE MN 55337
(612) 432-9725 (612)432-9725
L
I hereby arknowledga that I kaave read fihis,syxpli,catzvn iand stato that tFce
information is, cflrraat and agres t? camply with aYl apPl:tcalale StaCe o'f Mrr.
SCaCutes and Citp af Eagart Ordsna,rfaes.; ,
" APPLICAN PEFiMITEE SIGNATURE
IuiA Ai.i.r,? 1 ?
?ISSUEfI B : SI NATUR \
?
REMCTcYA`TE.- ( RIE(?EWED CITY OF EAGAN sI' n 11 i'l
PERMiT r 1993 BUILDING PERMIT APPLICATION
S 1 5 1993 681-4675
?? ' -------- f'?i
SINGLE & MULTI-FMIILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural E structural plans, I set of
specifications, 1 copy of energy celcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot thange is requested once permit
is issued.
DatQ y //"J- Yaluation of work
1a ?5p
: ? - 1
7
Site Address
STREEi iU1TE 0
Tenant Name: (commercial only)
IAT 1? SLOCK SUBD.?'??'x?101 P.I.D. M
Descri tion of work:
The applicant is: ? Owner gContractor 0 Other coe.«lbe>
Phone??'??y?7_s?
Name
Property LAsT FIRST
Owner pddress
STREET fTE M
City State /At) Zip .S-fy7
Company Phone
Contractor Address ?-? License # Exp.
City State ZiP
Company 4_/? Phone fl/YL/?49?93
AfChitECt/
Name Registration #
Engineer
Address ?lo/v?
C;ty State I-1zX J Zi
?
Sewer 6 water licensed plumber Processing time for
sewer 8 water permits is two days once edfea has been approved.
I hereby acknowledge that I have read this application and state that the lnformation is
with all applicable State of Minnesota Statutes and City of
l
ree to com
t and a
p
y
g
correc
Eagan Ordinances.
?
Signature of Applicant:
OFFICE USE ONLY
. . .??,.
BUILDING PERMIT TYPE
? 01
Foundation
?
06
Duplex
0
11
Apt./Lodging
' b?' %
Ba5tmen'? ?ini sh
0 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. •`0 1I=Sw4m'Po$1
[1 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch 13 09 12-Plex ? 14 Fireplace O 19 Comn./Ind. Misc.
? 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
A 31 New 0 33 Alterations ? 35 Tenant Finish ? 37 Demolish
O 32 Addition O 34 Repair E3 _36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWCC System `/ES
(Allowable) v-m Ist F1, sq. ft. City blater YG5
UBC Occupancy R_3 M_I 2nd F1. sq. ft. PRV Required 22L:
Zoning R-i Sq. Ft. total Booster Pump
i' of Stories Footprint Sq. ft. Fire Sprinkler
Length ? On-site well Census Code /0/
Depth uo, On-site sewage SAC Code ?
APPROVALS ?
1
Planning Building Assessments
Engineering Yariance
REDUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
0 Framing
? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
license
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC X I b o
SAC Units I
r.iu.t;on: s?a 5 f 00 D 3
GAfLAC?F; z x?z ? (24) /11n i2; /6$
--- ? y X?y ?. B ? lo ,/Ut ft h Y-(3 z
u x! 2= 4 g _.-?--
3 X 3 X,fL = (y) 136 ,c45 =?-1-2-?
836 x f ? = 3,_3?1 ??
3 y X,3.u =
>'?xZyZ? I 1 Sf?
I a
Z? q?t?ac?+..
---- ? .--N
1U?2 KSy 564,'
3X3x'?2 =
y ? ?_
:22nrz =
% 21? 1 -
146bK?5
IST FL0a0- .
B3rn7c14b6
aYzr.x. za
Z7?L1 = 42
.._.,.. . rti e
g Z S`?
OWNER:
SI'CE A
?
C:()N'CRAC:'C()R:ffI•IIVIL'{UN, DA'CE: ?2-93 Pil()NE:
DL•"CERM7Nr WQRKING SOUARG P'p(YrAcr (lF t'AC'H:
i. ToTAr, r•,xroseD waLa, naEA sp. r-'r. x(p_
z. -rO'CAI, ROOP'/CTII,ING Aar•.n ??$U :;Q. r,r. x 1'0Z6,
.
3. '.Cq'.CAI', GXPOSED WA1.,1., AREA CAT,C'UI,A'CIONS:
'.Cotal exposed wall
area above floor
a) :Cota1 wall wi.ndow area lSJ/?
b) 'Cotal door ar.ea SQ.F'C. X"U" (L)l =?L&
c)
:Cotal
sli.di.ng qlass door !
area 1(0i?
SQ.F'C. n
X"U" c? -7
d) '.CoL-a1 fi.i:eplace tiaall ai-ea ? >Q.P'C. X"U"
e) `.Cotal "all fr.ami.ng airea SQ.F'C. X"U" 101 = % tZ-?
( averacfe 10/)
f) :Cotal net wall area above ?riZ, SQ.F'C. X"U° ??l
f .leor (i.nsulateC)
c;) '.:ccal ri.m joi.st ai-ea SQ.C'C. X"U"r 0+= 1243
;COtal foundaL-i.on area 4,D >Q.F`C.
(exposed)
h) 'Cotal foundati.on wi.ndow area ? SQ.F'C. X"U" "- - 0
i) 'Cotal net Eoundati.on ai:ea SQ.F'.C. X"U" lt?
above grade
. 'CO'CAI., a ) through i. )
If i.tem Yr3 i.s the same as, oi: less than i.tem ;kl, you have met
the i.ntent of 2 MCAR 1.16008 A and O.
PAGE 1
r
3 0 9
?2
/
?
Fequest Date
/?' a,-C9? Rr No Rough-in Inspechon
Feqwr ? NOTICE: Vou Mus[ Gall ElecMCal Inspector
If A Hough-In Inspechon
m
? ? No O
Is Requned
IL?4rcensed contractor ? owner hereby request inspection bove elecirical wor
Job Ad esa (Siree; Box or oule No J
G City
? •
?
?
Sechon No Township Name or No Range No Coun
OccupaN (PRINn
L+L/ /?[-L?{Z C I?/ f N/W4./ Phone No
Pawer Sup?lier
?l?
?C1G Atldress
YG? GZ/
Elecln al Conirec?or (COmpany N me) ?
Contrector's Lcense No
?
MaAu?q Atltlrass (ConVact or Ownar Making Inafallabon)
073902 e??-C?.t..e.
Author¢etl Signat ntrac[ dOwnerMakm stallallon) Phone Number
minncsviw sFqTF 60AqD OF ELECTqICRV
GriggaMitlway 61tlg. - qoom S4]3
1821 Onrversky Ave., SL Paul, MN 55104
Phone (612) 642-0600
THIS INSPECTION REOUEST WILI NOT
8E ACCEPTED BV THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED
I ?OG95'/?'?, REQUEST FOR ELECTRICAC INSPECTION
?.r?_.
, See msVUdions for complellng Ihis toriry on back of yellow mpy
M,.2 3 09 4 _'X" Be")w Work Covered by This Request
NewA q¢p TypeoBUtlding qpplianwsWiretl
Home Range
Ouplex Tempai
A ^ Water Heater Electnc
Farm
other (spgoiy)
Compute lnspection Fee Below.# Other Fee
eooms
I, the Electrical Inspector, hereby
certify that the above inspection has
been made.
1FFICE USE ONLY
his request void 18 months hom
?
ee-00001-08
13,erpgs.7-
t?.,me•
ConUactorg Remarks
/S?cf '
s /? 0 to 100 Amps ?
r,NSSsTALLAT,ON irance5ize Fee # CircUits/Feeders Fee
Amps 6ave 700 _ qmps
TOTAt
?rYr.r? -3 ?
qTION MAV B ERED DISCONNECTf?F NOT
COMPLETED WITHIN 18 MONTHS. _ 0
3
4. 'PO'CA1, TXPOSP,D R00F/(7F11 TNG CAI CUT A'CI(NS:
'f'otal exposed rooL/ I iOiQ. P'C.
ceili.ng area
j ) '['oLal skyliqht acca
!c) 'CoCal irooL/cei,li.ng
Peami.ng area
(average 10%)
1) 'CoL•a1 neL i.nsulated
rooP/ceilincJ ai:ea
-D ;q. c•r. x „U., --- _ ?
iL1-C'C. X "U„ t?Z
1046 SQ.F'C. X "W IDZZ _ ?J??
9. 'CO'CAI:, j) thr.ough 1) ;:;;;)?
IL total of #4 is the same as, or less than #2, you have met
the :.ntent of 2 MCAR 1.16008 A and (). O
?1 J? G- 44
.D
A1;'.i`ERNA'CE BUII.,DING ENVELOPE DEiIGN
'Co uti.li.ze l;he total envelope system method, the values
establi.shed by the sum of ; 3 and #k9 shall not be qreatei-
than the sum of items #kl and #2.
1.
3.
+2.
+S.
CERTI FIC'A'CION
I her.eby certi,fy that I have calcuJ.ated the "U" factoi:s and
"R" values herei,n and that the bui.ldi.nq her.e descri.bed meets
oc exceeds the State oP Mi.nnesota Enetigy Conservati.on Act.
9-a-9,3
cDate) ?
PAGC 2
1) v 6 $Cud8
kISTR11f.TI0H
AMING S£CTIDN:
lnterlor air fllw
rio
MALL SECTION (INSULATED)
-{1
A
m
R YALUE
?
.?_.0.:"/
U,? 1/It di
111M J015T SECTI011:
--{I Interlor alr fllm It.611
?
WOML
?
4
_---in Ex!crlor air ?Ilm 0.17
•
FOUHDATION IHSULATION REQU1RED: •
Min. R-5 on entire Nall OR t/it ?_04
pp•;•,pMin. R-10 doxn to frost Uepth FOUHDATION SECTION:
, p A 1 Interior alr filro I D.ISA
j,Wood S 33 Insul ti.on 1:00
I
-A r 4 Exter or a r film
- E'a. • G
a4.4 J.4
T07AL R ? 12.96
SLAR ON GMDE
:'4 a.
?•?.pr.v,. ;,?„ ?
A ,.:
??,,; „ '
a•
Heeted 51abs:
Minimun R • 85
, :?••Q; Urheated Slabs:
?•? •'. Mlnimum R = 6,2
.
4 ?•4 ,. ? . ?Q i'?? ? 4? ?
, ?..•o' ?' '?p
• •.
M°xxWSii"m?vo. p
. . ' .
?,?.•..?c{?? :'a?.?`F•••4'a(?
?. 4
;.¢ ? ? ??Q ?.' • '' '•?
? •.4•,•...4•, ?,....
, . •. .., ' . q?
.. .,• .
?,? ?; .. . ? i .• ? ? ' '
•;Qi ?,? .??.• •?;?i
, , ? . .
• ? ? . , :
% q,?.?,Q,.. _
4
. . : . ,o
Pase 9
U a 1/R - .Q43
U[
?
cEiLit,n secrHnN (iri;uia'Qh)j - • . `,
1 In[erlor alr fllm
2 i/A
- -
i
.56
3 ;
4 Exterlor slr 1 m stilt n.Fl
TOTAL k +4?.78
U '..1/R ¦ • ??r ^2 .
?
VENTED
CEILIHG FRAlIING SECTIfNI:
1
2
3 TnRulation.
b
5
CEILING SEf.T10N (INSULATED): -
1' Intcrlor atr f11m n.(+)
T
9
Exter ar a r fllm (stlll) 0,
Uw 1/R ?
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? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
cR 225qz
q-I?-G4
BUILDING
@23325
04/18J94
SITE ADDRESS:
P.I.N.: 10-32151-190-02
DESCRIPTION:
4279 DARTMOUTH CT
LOT: 19 BLQCK: 2
HAW7HORNE WOODS 2ND
B,uilding Permi t Type DECK
Building Wo,rk Type NEW
f 't
?
?
'
REMARKS:
FEE SUMMARY:
8ase Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant -
JUBBINK DOUG
4279 DAR7MOUTH CT
EAGAN MN 55123
(612)683-1091
I hereby acknowledge that I have read this appl3cation and state that the
information is correct end agree to comply with all appl3cable State afi Mn.
Statutes and City of Eagan Ordinances.
L
, w
APPLICANT/PERIGIITEE SIGNATURE
IS ED BY. IGNAT?
I
?.. -
?.33
?
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
4.j'o • ?? o
,?.
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, 6ut not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work llf'(°K
Site Address: qZ1q L.ynf' +YYl.4f1tivl lt'Wlt . GodlQh f l' M Ss12-3
STREET SUITE #
Tenant Name: (commercial only)
LOT ? BLOCK SUBD. ? P.I.D. #
Descri tion of work: 1?^
The applicant is: )1 Owner 0 Contractor ? Other (Descri6e)
Name dd? ?_ Yl Phone
Property LAST F
Owner cb
N?
?
vt
Address I
w
Su
n
STREET STE #
City G ?V\ State M Zip
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFICE USE ONLY
BU(LDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? il Apt./Lodging
? 02 SF Dwg. ? 01 4-Plex ? 12 Multi. Misc.
? 03 SF Addition 11 08 8-Plex ? 13 Garage/Accessory
13 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. 10 15 Deck
WORK TYPE
[,U 31 New 13 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint 5q. ft.
On-site we71
On-site sewage
Building
Variance
Pd Footing
P Final
? Framing
? Draintile
213
Y
?
/
-?
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
valtmtim: $
?,;,??,?• ?.,?.. `'?.,..,??
? 16 Basement Finish
O 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Census Bldg
Census Unit
Assessments
SAC %
SAC Units
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
851-681-4675
•New Canfhuctlon Rewirementa Rertwtlet/Reoair Reaulremnls
> S repldered site wrvays ahowinp tq. R of bl, fq. B. of house 2 eopfes of Plan
and garooleC areas (2Q6 rtwWmtmn lot coveraae albwedl 1 fet M en6rpy ocACUlaMOns Iw healetl addlMOns
D 4 coplea of piau (slww beam & wlntlow alzes; paued Ind. defipn; efc.) 1 tite wrvey for e77 R decks
D 1set d enerfly colalatlona
? 3 ooples of hae preaervallan plan H bt plalletl aHer 7/1/93 ? rv DATE: t-:l `o?, ` (`/ V CONSTRUCTION COST:
DESCRIPTION Of WORK:
SiREET ADDRESS:
ar? C?
LOT: ? I BLOCK: ? SUBD./P.I.D. M:
Name: ' r d Pnone t: 3;XV ' 0?
PROPERTY taa flM
OWNER ?
Sheet Address:
dy
Sfate:
Zlp:
Company: Phone M: ?L/2 - ? l ?D?
(area code)
CONfRACTOR Sheet Address: r?? UV N LJcense • Exp.
City /' C 1/ V vr Stafe:/ "/v Lp:
ARCHRECT/ Name:
ENGINEER Compuny:
Telephone M: (
Sheet Address: Regishction !t:
citY
State:
Sewerlwater licensed plumber pf instailina sewer/watar): Phone #:
21p:
I hereby racknowledpe that I hava read this apPlk:albn, date thaF Ihe InfortrwHon is cort and agree e mPH wNh oA apPOooble State
of Minnlaia Stalutes and Clly of Eagan Ordinances.
Signolure of Appl'icanY. f'?
OFFICE USE ONLY
Certificates of Survey Received _
Tree Preservation Plan Received _
Yes _ No
Yes _ No
- Not Required
FS - 2
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation O 07 05-plex
? 02 SF Dweiling p pg 06-plex
0 03 01 of _ plex ? 09 07-plex
0 04 02-Plex ? 10 08-piex
? 05 03-piex O 11 10-plex
O 06 04-plex p 12 12-plex
WORK TYPE
0 31 New
O 32 Addition
O 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.) ?
? 17 Garage ? 22 Porch/Addn. (4-sea.) ?
? 18 Deck p 23 Porch (screened) ?
13 19 Lower Level O 24 Stortn Damage
Plbp _Y or _ N ? 25 MiSC6118n60uS
? 20 Pool ? 30 Accessory Bldg.
O 36 Move Bldg. O 43 Reroof
? 37 Demolish (Bidg)• ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair iv
13 42 Demolish (Foundation) ? 46 WindowslDoors
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main tevel sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
O Stucco/Stone
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building ?
r_ITV IlF EFI",AP!
(:;A3HTEI+:: 1S 7E:RMINpI_ NO: 676
PermitFee V81U °firE- 02i02i00 TT.ME: 14332a55
Suroharge
Plan Review IL"
License 4AhiFg HIESTURN CE:DFlFi SUF'PLY I...I..LF'
MC/ES SAC
CitySAC 32i.o ?0oi ¢279 z??,F,Trsrw cr 223.25
WaterConn. 21.3: 9001. a2?°3 DAFT?iThl CT r?.s0
Water Meter
Acct. Deposit •
S/W Permit .
S/W Surcharge ,
Treatment PI.
Park Ded.
Trails Ded.
Other TOk.].I. Rk?OBlpt amour,t a 229.75
Copies Cfi:1.23015
t!OI:::R ID: .?Ak
Total:
yJ yyy
/M1I?ryTTTTM(TTITTMT)f /??yl/?MMMM TTMmTT TTMMMTT,Y
SAC Units
% SAC
31 Ext. Alt - Mutti
33 Ext AR - SF
36 Mufti
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN FERMITS ARE REQUIRED FOR EACH UNTT.
? NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE
NVAC: 0.100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1@ $3.00 EACH) ?
ADD-ON(REMODEL (ExISTING CoNSTRUCifoN)
STATE SURCHARGE
TOTAL
SITE ADDRESS:?
OWNER NAME:_?
INSTALLER: 0-ta
ADDRESS:C) -
CITY: rC?
?
FEES
$ 24.00
6.00
? co
$ 15.00
.50
TELBPHONE #: q-'? q " CI-7 O S-
STATE: M ', n n ZIP CODE: SSO •
TELEPHONE #: ? ? o " (c? o '-_?) ?
1993 MECHANICAL PERMTT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
. ?
7/;?C
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...... - ? ?_ . .... ..:... ..........[ <.:.. ..
:::... <::'n ..:<.<. ??.,35'W i:t8,'.. iY".?'k5" ....b,_•,?05.4:x??.
,At?,? , .. .. ....? ...:<.n::...::.e.S.:':3gA:::':,.., t?9•..
. . ...:...? .:•».::. >?rx:,,;;N,r;:e°c'
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PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AL50, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UN1T.
FIX'fURES EACH TOT!?
? SHOWER 3.00
1?3 WATER CLOSET 3,00
Q. BATH TUB 3.00
? LAVATORY 3.00 I 2 <)
I KITCHEN SINK 3.00
,a LAtJNDRY TRAY 3.00 1•. - c1?7
_ I-iOT TCJB/SPA 3.00
-'? WATER HEATER 3•00
1 FLOOR DRAIN 3•00
GAS PIPING OUTLET • minimum • t 3.00
? ROUGH OPENINGS 1.50 C-1 ? S fl
--? WATER 50FTENER 5•00
PRIVATE DISP. - pek.ay. i,c. 15.00
U.G. SPRINKLER • nome uno« camt. 3.00
ALTERATIONS • to atisting 1$•00
WATER TURN AROUND 15.00
,
75
51 _?3
STATE SURCHARGE .50
TOTAL: S t? - () l
STTE ADDRESS: H 2-?1 Z_A? -
OWIs
II3ST
ADDRESS: `? \ 01 l n L? C?? ?`l-j 0 `-) -
s? nn n-v4 STATE: YM `(? ZIP CODE:
CITY:C? ?
PHONE #: ( ) 14 ??i - c) l A
1493 PLUMBING PERMIT (RESIDIIVT7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN $5122
(612) 681-4675
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S`f 9 (o ?k RESIDENTIAL ? ? acJ
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PlLQ7 KNOB RQ, EAGAN MN 55122
651-681-4675
New Canstruction Reouirements RemodellReoair Reauiremants
• J registered stte surveys snowmg sq. ft. of'o[, sq, ft of house, and all roofe0 areas • 2 copies of plan
(20%maxunum lot coveraqe allowetl) • i set of Eneyy Calculabons (or neated adaitions
. 2 copies of plan showirg beam & wmCOw;izes: pouree fowe design, elc.) • 1 srte survey for extenor additrons 8 decks
. 1 set of Energy Calculations . Indicate d home served by se06c system `or adtlihons
• 3 copies of Tree Preservation Plan if lot DlaYed aNer 7l1193
. Rim Jmst DetaA OOtions selec[ron sheetl,hltlgs wdh J or less units)
DATE 31 aa - Cj?k VALUATION ? f?7 ?
SITE ADDRESS L/ a7? CJa?,? d"? MULTI-FAMIL7 6LDG _Y v N
TYPE OF WORK AQ?opP- fIREPIACE(5) _ 0_ 1_ 2
APPLICANT
STREET ADDRE55 "( / C/( J 1.5 /"lLA['
TELEPHONE # 76 3 *_5/1'030(ICELL PHONE #
Phone #
PROPERTYOWNER C/?'?-IGdM-`? D'4OlN TELEPHONE# ?5?-C?3-lOFf/
COMPLETE fOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ ?(1?;\LSO"L'.\ R[ L1:S 7670 CiVI'EGURY f NIINNtiS0'1':1 RIiLI;S 7672
(d submission type) • Residential VenhlaGon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _____
Plumbing system includcs:
Mechanical Contractor:
Mcch<mic.il svslcm induclcs:
Sewer/Water Conhactor.
_ Air Condiuoning
_ I Icat Rccovcry Scslcm
I hereby acknowledge that I have read this application, state that the
with all applicable State of Minnesota Statuies and City of Eagan Orc
Signature of Applicanf
OFFICE L3SE 0NLY
NVatcr SoC[encr
?Vatcr Heatcr
No, of 13aths
PllO11L' 4
_ L1wn Sprinl:lcr
No. oF R.I. Baths
FAX #
Pcc: :570.00
AUG 2 8 2002 ,
h is correctiand ogneib to comply
?y? ziP SSW
Fee: $90.00
Certificates of Survey Received - Tree Preservation Plan Received - Not Required _
Updated Ji02
. 'M„
cansvLtifio 00
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122331
Date Issued:05/05/2014
Permit Category:ePermit
Site Address: 4279 Dartmouth Ct
Lot:19 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
John Miller
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 -
Douglas A Dubbink
4279 Dartmouth Ct
Eagan MN 55123
James Barton Design Build Inc.
5920 - 148th St W #100
Apple Valley MN 55124
(952) 431-1670
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
k ,
For Office Use
441,1111
Cityof Eaali Permit#: (430 ?--
Permit Fee: Ago?..&y UV/ I
3830 Pilot Knob Road 3 _I
Eagan MN 55122 Date Received: b
Phone:(651)675-5675°
Fax:(651)675-5694 Staff: ��7 114
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: Dcyu) 4- jinn (�u ,7�(; Phone:�o�� ��> - 1���
Resident/ 112-7 P kr 1-'N "' Nl C/
Owner„ Address I City!Zip: 'N "' o�
Applicant is: Owner 7` Contractor
Description of work: C d€4 AAd ck,,
Type of Work
Construction Cost: /51,c") Multi-Family Building:(Yes /No )(; )
Company: /4 4 d L /3✓t'l tC oVtr, Contact: 6A(1 'Opts'ks
ContractorAddress: 3)-((/ ".e/ 14k Pr' City:
Stater Al Zip: 0121 Phone: -3�7 �— Email: j f r r' `�4-41 '`et
License#: a- Zl? Lead Certificate#: 4)4
If the project is exempt from lead certification, please explain why:
05 ". // 7F 3o/67- /A 9 3 Ff
-"1
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 may classified as non.public if you provide specific reasons that would permit the City to
conclude that they are trade;s+ rets
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.stopherstateonecall.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.
x 6'40"9 fro 5 x /21Applicant's Printed Name Applicdnt's Signature
Page 1 of 3
'd 1 g ,aa.rtvno-J 0, Ck j 3C� �-
DO NOT WRITE BELOW THIS LINE
SUB TYPES
•
Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family)
Single Family Garage Porch (4-Season) Exterior Alteration (Multi)
Multi it Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace O" Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION 2-.
Valuation 0.ii Occupancy ^,A6.•/ MCES System
Plan Review / Code Edition ,2O,( SAC Units _
(25%_ 100% 4/') Zoning ?--4 City Water —
Census Code 17 Pt Stories Booster Pump —
#of Units I Square Feet PRV
#of Buildings 1 Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final /C.O. Required
Footings (Addition) Aft Final / 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 PanOther:
Reviewed By: , Building Inspector
RESIDENTIAL F S
Base Fee 73 i
Surcharge
Plan Review y 7 (141-
MCES
-%MCES SAC
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies G Q .Z.a'¢{
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA148826
Date Issued:04/24/2018
Permit Category:ePermit
Site Address: 4279 Dartmouth Ct
Lot:19 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Douglas A Dubbink
4279 Dartmouth Ct
Eagan MN 55123
James Barton Design/Build Inc.
5920 - 148th St W #100
Apple Valley MN 55124
(952) 431-1670
Applicant/Permitee: Signature Issued By: Signature