4284 Dartmouth CtINSPEC
CITY QF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: ;,r
. :??? +. r
ilhi?l lra?i;ptp t_f;???t, , _•t#ft
PERMIT SUBTYPE:
i?tif#T 1 f?r,•. ''.
f I P> ' •
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
? f.: l A l
TYPE OF WORK:
• , .. , ;'
t I<FlM t Nt?
Allft l 1 XON .
:S-,:-t:A':AN I'f?!}i.1i
ItEiqAltk'Sc `A F`ANA1i" Pf"kMx7'-, +bFtt 0 l:411.1:IF:f !:i F'OR F t 1 ( ET; tt.lti UI? I't 1;;; IIf)Ftk
Psrmit No. Permft Holder uete Telephone At
ELECTRIC i
pLUMBING
HVAC
Inspection Date Insp. Commants
F OTINGS /?
FOUND
F MING
o?cc
L t? ??
r
I
ROaFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GA5 SVC
TEST
INSUL
GYP BOARD
FIREPLACE
a
FIREPLACE
AlR TEST
FINAL PLBG
FINAL HTG
OFSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
...C(Tl( OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
I "r.?' i 1'9?s1 I k! l T
IkEtitllitli:htl 1!!il?I1', ,'t?l?
PERMIT SUBTYPE:
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
};„ I t a, j N c.
r,,f0 ta
4s `+ I 1 '? / ?? t.
INSPECTION DA . D.
• ?ti?? t Pt?. ;;iiiil I f!:,
i, A3 1 i1P? 'r 1 1 1.I'1 :j 4 f
;?,? , ? tt j•! .;r. l:?iil?,ii : ?! i? ! ??
I , s R t: '„ N' it'Y S& 1„I I' ( E+ F+ E? Vk' ST p k i' I. It (o
Permit No. Pe?mit Holder Dete Telephcne ri
ELECTRIC
"PLUMBING 17d
HVAC
Inspection Date Insp. Comments
FOOTINGS A?Z? 7D
oL
FOUND
FRAMING
?
?
/??
r,rq
ROOFING
ROUGH
PLUMBING fJ
PLBG
AIR TEST
ROUGH
HEATING
Q
GAS SVC
TEST
INSUL
GYP BOARD
FfREPLACE /0 '?/?, AX
FIREPLACE
AIR TEST .
0-?
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDGFINAL
BSMT R.I.
BSMT FINAL
DECK Ff(3
DECK FINAL
, • iJ ?
i ?
... . ..M1._ . -__?.
??t? o? ?agan
?c?rtec?ct v? ??i? ?*?ectivK -
T7ais Certificatc issued pursuant to tlu rcqairements of the Uniform Buiidin8 Code
ceriifying that at tht tune of issuance this structurr was in co?nQliance with the various
vndiieances of tlu City rtgulatin8 buildmg CO1st'TMction or use. For the foilowing:
ux aasswiamo.: SF DNG sag. eenit No. -26939-_
Rl 7Ype coost. ?
oo«?r Tra _-8.?1 I zaning piatr1i e?r F V[?iIESL
7601 145Ili ? ?1..
o.? or s?? A?
,
Buildiog Addr 4284 .n,.r*rn1rYYtRT l.ocality
e?s
4D._
guildisg plficial I
"•• pp3T IN A CONSPMIWS PLACE '
s
?
1
? e
' . • . . .?q'b - ' { ? '1 ` ,?, ?.ji
' r•.. •- , i *?41.i'?x ,?', a
- '? , ? a' . ' ?`' •' ,?c?., , . •y??s ???
. W ' LOT SURVEY CHECKLlST FOR RESIDE
W W BVl G PERMIT APPL1CATi0
y
-+
¢
N
PROPERTY LEGAL;
- ` \
a ? W
m DAT OF SURVEY:
4 0 = LATEST RE1/ISlON:
? : :.
?? DOCUMENT STANDaRns
' o • Registered Land Surveyor signature and company
D"
O
- O • Buildinfl Pennit AppUcant
13-?
(3 C3 • Legal description •
? C3 • Address
? o • Norih arrow and scale
• House type (ramblor, yvaUcc4 splK yv/o. split entry
looko4 etc
)
?O a • ,
.
Directicnal drainaps artows with slo
e/
adl
M 9G
?O O
0 •
• . p
pr
e
pro????a seweir and water services a invert elevatlon
Street namo
o ? • Driveway
D-?- C O .
9--' C O
&-' • Property comers
O O
' • Tcp ot curb at the dtiveway
W"
O o • Etevatlons of any exostlng adJacent homes
? ? 0
• Prosed
Garage floor
CL-0 0 ' Frsi floor
[Y O O
- • Lovyest exppged eleVetlOn (walkOUNwirldOw)
tT
o O a Properiy comers
?0 C3 • Front and rear of home at the loundation
O IY O
• PONDING ARFa (if-a.,..u..able)
EasemeM qna
O It" D ? njWL
o e,*- a.
o (tr' ? HWL
o • Pond S desipnaUon
o B-' o • Emerpency Overflow qovatbn
L3/O 0
Cr'a a
8-- 0 O
C!-- o O
Q--G 0
O Q/S
.luy 1995
?
DIMENSIONS
• Lot Iines/Bearings d? dimansions
• Ri9ht-ot-way and str"t width (to badc ot curb) .
• Proposed home dimensions tncfudins any proposed decJcs, overtarps groater than 2',
porches, etc. (t.e. aq structures requiring pertnanent foctlnps)
• Show atl easements of record and any City utllities withln thoss essaments
0 Setbacks of proposed strycture and sideyerd setbsck of adJaceM exdstlna structuras
• Retaining wall
RESIDENTIAI
BUILDING PERMIT APPLICATION
?' ???lJ? 3830 PIL10T KN B RDN 55122 ? 70, ??-
651-681-4675
C
New Constructian Reouirements RemodellReoair Reouirements ?? l D
• 3 registered site surveys showing sq f1. of lot, sq. ft. of house, and all roofed areas • 2 copies of plan
(20% mazimum lot coverage allowed) . 1 set of Energy Calculations for heated adtlifions
. 2 copies of plan showing beam d windax sizes; poured found design, etc.) . 1 sile survey for extenor addiUOns 8 decks f q
. 1 set of Energy Calaia6ons
• 3 copies oi Tree Preservation Plan if lot platted afler 7i1193
• Rim Joist Defail OpGOns selection sheet (bldgs wiU 3 or less unils)
DATE VALUATION (EXCLUDING LAND)
!OB SITE ADDRESS ?yB/
IF MULTI-fAMILY BUILDING, HOW MANY UNITS? ?
PROPERTYOWNER
TYPE OF WORK FIREPLACE(S) YES NO
APPLICANT %/??-???-? ??? ?'? • PHONE #
PAGER #41L - 06S 3 CELL PHONE #60S1 ' 3X7 '01yO FAX #
61T_1 -6T6 -d 9/t
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNESOTA RUL,ES 7670 CATEGORY 1 ?
(check one) - Residential Ventilation Category 1 Worksheet Submitted Jr/?
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing Systein Includes:
Mechanical Contractor:
Vlcclianical SvsLem Licludcs:
Sewer/Water Contractor.
Water Softener
_ YVater Heater
No. oF Baths
Air Conditioning
_ HeaL ftecovery 5ysteru
?
IUI
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
aiV appficable State of Minnesota Statutes and Clty oi Eagan Ord'inances.
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Z. Required _
Phone #:
I.awn Sprinkler Pee: S9 .00
No. of R.I. Barhs
Phone #
Tee: 570.00
_ Phone #
Updated 1101
OFFICE USE ONLY
. ?
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace p 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) Q 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ?_ 37 Demolish (81dg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
bl9
Valuation
Occupancy
2- 3 MC/ES System
Census Code ?f34 Zoning ? L Ci4y Water
SAC Units Stories Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of Bldgs ? Length Fire Sprinklered
I
Type of Const \j ' t-J Width
Footings (new bldg)
? Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Tes[ _ Final
_ Insulation
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Au/Gas Tests _
_ Siding Stuceo Stone
_ Windows (new/replacement)
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Piumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
?.o?4j9s ., S 3o?ar? 8D & pp.o
0
0
r859
S
9?
A,Bo2
?
IRequastj7?le Fve No floug speclion Reqwred Inspechon OtherTh R gh-In
(YO u I cell inspeoior wryen reatly) ? Reatly Now Will Nobi ' pnr
Ves ? No pate Fead `r
I censed contractor ?owner here6y request mspection of above el trical w
Job Atldress (Slr¢et. 9ox or Rome Nu ) CitY " -
l
A V ? ?al tJ 7"5/\ 1 - t- • "?
SecGan o Tovonship Name or N. Ranqe No Gounl
I A?+?r?ue s rtid A
ocq.Pa (PRIN, ld? ?S u ??-? a N Pho e?a "t1(o? I
Powe c.6uppli Atltlres /
?
? J '? n nM 1 Tf`M 1
Elednc ConVacior(G mpany Name) C. actor's Lmense N.
Mailin df-A
tltlress onimotor ner Making Inslella[ion •
Author¢etl SignaWre (COnvacmr/Ownar Making Inslallation) P e Numbe
l N .,i?
MINNE O A STATE BOARO OF EL TPICITY
I
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III
I
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II THIS INSPECTION REOLIEST WILL NOT
Griggs-Mitlway 6149. - Hoom 5-128 II I
I ?
? I I I BE ACGEPTED BV THE STATE 80AF0
1821 Onrversily Ave., St Paul, MN 55109
? ? ?? ???
? UNLE55 PROPER INSPECTION FEE IS
Phone 16121 642-0800 m m n ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION -?` ee-ooooi-os
7 go ? 4
y ?
I V ?? See inslmdions br compleling Ihis lorm on back ol yellow copy
,) ,Z 3
? 91~ ? "X" 8elow Work CovPred by This Request ("M' 376
Ne Add Rer. TV'e of Building Appliances Wired Equipment Wired
Compute Inspecnon Fee 8e7ow:
ie Other Fei
Booms
IOther Fee I
I, the Electrical Inspector, hereby
certify that the a6ove mspectvon has
been made.
Water Heater
Dryer
Furnace
ir Contlihoner
:oniRemarks,
7 Service EntranCe Srze Fe
0 to 200 Amps
Above 200_Amps
isPec[ofs Usa Onty ?
;?W /
3,/ -J ?
i
THIS INSTALLATION MAY BE I
COMPLETED WITHIN 78 MONI
lou9n-in
'inal /
Load
Other
Fee
7 ?4,ccJ L o
)ERED DISCONNECTEQ I
i t
v-fs'
OFFICE IISE ONLY
This requeat voitl 18 months Irom
i
.
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STATAIMl,
Ills'f; la Slt 1f6?
{a700Inq Itolignlgil, in sIt 2.4r1
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OFFIGE 11SE ONLY This reqaeA void 18 monihs trom volidohon aare prinrea in mi., w=.
75?-
?
I•
ry?k 04 3 6 9 2 0 3* PLEASE PHINT OR TYPE
Raugti?? i?xpeclion reqmred2 ?, ? No Inspeceon Other Thon RoogMn 1-1 Ready Now WilI Call
Req esl Dote
y?
(Yoo most wll the inspecror when ready) Do1a Rendy
licensed coNmcror [I owner hereby reqoest mspe<tion of the above electrical work al:
G o
lob Addrese [Sneet, Box, a Rou1a Na ) ?- `fi ? ? `? `I"vw.A. Zip Cde
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Seceon No. Township N.me or N. Ronae No- fire N. Counry
p;-? ? L?:-?"Q ,
Phone No-
Ocwpam
Power Supplia Address
Elxl.iml Connocbr (Compav Namej Conlmr,ior Gcense N. Master Gc No. (Plan! Elecr OnN)
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EB4000IA-11 8/96 STATE 60AF0 COPY - SEE INSIAUCT10N5 ON BACK OF YELLOW COPY _
? REQUEST FOR ELECTRICAL INSPECTION
4 3 6- 9 2 0 Minnesota 5tate Board o( Eleariciry
1621 University Ave., Rm. S-728, St. Paul, MN 55704
- ` Phone (612) 642-0800
4 H
ome
Duplex
Apt. Bldg.
Olher
New
Addn
1 Commercial 1 1 Indusfriol Farm Remod Re air
Air Cond Htg. Equip. Wofer Htr Lood MgmL Ofher:
D er Range Elec. Heat Temp. Service
"X" obove Nte work covered b lhis request ENer remorks in this spate and on the bock of the whife mpy only
r?^`^.,` ,,
Calculafe Inspeclion Fee - This Inspection Requesf will nof be accepted wrthoui the rorrecf fee:
Other Fee # Service Entrance Size Fee Circuits/Feeders Fee
Mobile Home Park Sfall 0 fo 200 Amps 0 fo 100 Amps
Streel Lfg./Tmffic Sig. Abave 200_Am s Above 100_Amps
Transformer/Generotor INSPECTUR'SUSEONLY TO AG
$ign/Oudine Ltg. XFmr.
Alorm/Remate Conirol wQ 67 o
Swimming Poal }
em fhar I ?ed hco msm llanon dOscri6d herein on fhe dare::iomd
Irrigahon Boom
Il t
Imestigafive Fee i - Dote
` 7/.
THIS INSTALLATION MAY BE ORDEREO DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
- ENERGY CObE WORKSgEET T'pR 1& 2 FAZiILY DWELLINGS
AhpRESS GNNgr-
..m.... .... aAnn.,,... n A _...., CITY
. ? ?a
MINZMUM CRITSRIA
Foundation Ineu2ation-R10
Slab on Grade Ineulation-R10
Floor over ujiheated epaces-R24
Foundation 6lindowe 1/2"
ineulated Glaes.
-Wood oT V1ny1 FYame
1 (e
atagory 3 (muat inaluda vantilatio
Walle F Windowo
(See ta61e on Yeveree eide
for allowable percentagea)
STBP 1 WS¢daw & Door Area
A. Total Window ( Ooor Aiea in Sq. Peet
WINOOWS (Including Foundatioii Windowe):
WINDOW MAiNFACT[/RE NAMBs
WINDOW MAINPACT[7R6'TyPB: '
P7IPIDOW MA270FACTf]R8 U FACTOR:
R. O. Quanticy r,q,fC.Area
Dimensions
X
X 1
Lro"- XY,a" )1
Z ?!p" x
X
X
!?, Plx 1
X
'['utal Area of
Witidown k poore
B. Total Wall Area in Sq. Ft.
Wall Total Fleight
Z
V
ft.
Rrea
Roo£ Attic Inoulatiati,
R44-Witlt Attic No Ileel
R38-WiCh Attic Raised ifeel
R38 fi R5-Solid RafteYs
STHP 2 Calculata area ae a percant o£ wall
c. From Step 1 divide box A(471ndaw k Door
Area) by box II(Cotal wall azea) timeo 100
equala [!lo window and door area ae a
peraent oE wall area (box C).
B0X A X 100 -
? I ?
Box [i_9__r] ?
7f/7
STEP 3 Deelgn Featureu
A.SSEHBLY
PRAMING TYPE:
STANDARD FRAh1ING __?/_etuds 16-- o.c.
ADVANC6D PRIIItINa atude 24" o.c.
CAVITY INSULATION 1;I,1
9tIHATHItiG TYPB;
LESS THAIJ a R-5 ?
R-5 > OR hIORE
U-pRCTOR p
From the table, (reverse side) determine the
maximum percenh window & door area for the
deaign optionu selecCed and enter the k value
in Box D helow Uaoed on the window mfg. U-
factor:
[r' p
The } vulue Erom the Cahle in Dox D shall Ue
equal to or greater than the } in Dox C
4q5--4o4v
'fotal AYea of Wal]s _ I D=7u,/./oq,E[
va0t?7
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ?5 I C? l Os Site Street Address ?q )a-r "T 1' v?? ? I l?"t- Unit #
PropertyOwner `??0-C Telephone# g~Qq`%'
Contractor
Address @0 Telephone#
State m -f
Zip ?
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwefling
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other: $ 50.00
Water Softener ? Water Heater
_ new ?replacement $ 15.00
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $?
I hereby apply for a Residential Plumbing Permit 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 the plumbing codes; that I understand this is not a permit, but only an applica ' n o
permit, work is not to start without a permit and work will be in ;ilRcordance with the appro ed plan i
t e event a plan is ired to be revievued an ed.
_ i ???
ApplicanYs Prinb d Name Applicant's Signatu ??-
i ? ? 41AY `- 2005
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN ?
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construetlon Reauiremenfs RemodeVRaoair Reauiremants
• 3 registered site surreys showing sq. fl. of lot, sq. R. of house; and all rooted areas • 2 copies of plan
(20%maximum lot coverage allowed) • 1 set af Eneryy CalcWatians tor heated addihons
. 2 copies of qan showing beam 8 vnndow saes; poured found desgn, etc.) • 1 site suNey tor ezterior additions & decks
• 1 set of Energy Calculalions . Indicffie if hame served by septic system for addilions
. 3 copies of Tree Preservation Plan if bt plafled after 711l93
• Run Joist Detal Optlons selection sheet (bldgs with 3 or less unhs)
DATE 16 VALUATION ?? LlBCJ
SITE ADDRESS nAV` IVY) Q t MULTI-FAMILY BLDG _Y _ N
TYPE OF WORKTea,2 ?" Pevot;'E GinnS22? jic r(nc;6 GGY4LR FIREPLACE(S) _ 0_ 1_ 2
APPLICANT BELA ROOFLNG & REMOnFr nvr rnTr
STREET ADDRESS 4100 EXCELSIOR HLVD. CITy STATE_ZIP
TELEPHONE 68 PHONE # FAX #
PROPERTYOWNER Lo \r-\-?_I g CI/1 V1 -e ?C TELEPHONE# CeSf -CokFS`d 4?
Energy Code Category
(J submission rype)
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
_ MINNESO'I':1 12UI,1:S 7670 CA"I'EGORY l MINNES01'A RULES 7672
Plumbing Contractor:
Plumbing system includcs:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Conhactor:
_ \Vater Softener
4Vater Hcatcr _
No. of Balhs
Air Condi[ioning
Hcat Rccovcry Systcm
Phone #
Phone #
? Fee:a $90:Q6:
_ ' ?ec:: -?70flOJ
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan OrdinanGes?
! ?^-
Signature of Applfcant
OFFICE USE ONLY
Phone #
. New Energy Code Worksheet Submitted
• Residential Ven4lation Category 1 Worksheel Submilled
. Energy Envelope Calculations Submitted
I.awn 5prinkler
No. of R.I. Baths
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4/02
? CiTY'OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 7 2 4
(612) 681-4675 Date Issued: 0 4 J 2 2 J 9 7
SITE ADDRESS:
4284 DAftTMOUTH CT
LOT: 21 BLOCK: 2
HAWTHORNE WOODS 2ND
P.I<N.; 10-32151-210-02
DESCRIPTION:
r y 3-SEASON
Buil:d;}'t?6,Parmit Type
Jbuilding Gtprk Type
C@fi545 COdG , ?.
PORCIi
SF PORCH
ADDITION
434 ALT. RESIDENTIAL
> u?.Y,..-?n \•i fd
a _ -•
?
?.......? _ yh• . ""--; ;'
Ii1..o- -
`I
? =1
REMARKS:
SEPARATE PERMTTS ARE REQUIHEO FOR cLECTRICflL OR PLBG WORK
FEE SUMIIAARY:
VALUfll'ION
Base Fee
Plan Review
Surcharga
Subtotal
$174.75
$113.59
5 0
$293.84
$11,000
COPZES $.25
7ota1 Fee $294•09
CONTRACTOR: - Applicanc - sr. I,xc OWNER:
HOME ENHANCERS INC 18846106 0001949 LOCHNEft GARY
86,09 LYNDALE AVE S 201 4284 DARTMOUTM CT
BLOOMINGTON MN 55420 EAGAN MN 55123
(612) 884-6106 (612)658-0469
I hereby acknowledge that I have read thi.s applicatiort and state that the
information is-,corre.ct And :a gree to oomfrly witt7,_011 ap,plicabie SCate of M.n,
5tatu6e& and C`ity of=Eagan'ordinarices.
?
APPLICANT/PERMITEE ST iNATURE D : S SNAT E t
?'g lJd1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
687-4676
113tNCtIOI1
lta?ydF
? 3 registered sRe surveys • 2 copies M plan
? 2 copiea of plans (indude beam & window saes; poured fnd. tlesign; atc.) ? 2 si[e aurveys (exterior addkbns & tledcs)
? 1 energy calcuiations ? 1 energy calwietions ior heatetl additiona
? 3 copies of tree presarvation plan R Wt platted after 7l1/93
requlred: _ Yes _ Na '
DATE: CONSTRUCTION COST: dMin
DESCRIPTIONOFWORK: ?S 54`S+r+
STREET ADDRESS:
LOT Ji BLOCK A SUBD./P.I.D. #:
6e
PRQPERTY Name: ([h L? aC. fC2 C,-A<-U Phone#: ??'LA - 64161
OWNER .., .?.
Street Add ress:
CONTRACTOR
ARCHRECT/
ENGINEER
City: PAG State: 'VV\ LJ Zip:
Company: +'IOrn V Phone #:
Street Address: ??Dy ?vv?r..lr ,Av= So l.icense #:
City: State: Zip: 5?`/Z Lt
Company:
Name:
Phone #:
Registration #:
Street Address:
City:
Sewer & water licensed plumber (new construction onty):
and bt change are requested once permit is issued.
Penalty applies when address change
I hereby acknovNedge that I have read this application and state that the infortnation is correct and agree to compty with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservatlon Plan Received , Yes _ No
_ Yes
_ No
- Not Required
State: Zip:
qpR 0 4 1997
OFFICE USE ONLY
BUILDlNG PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt.lLodging o
0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ?
? 03 SF Addftion ? 08 8-plex 13 13 Garage/Accessory o
P, 04 SF Porch ? 09 12-plex o 14 Firepiace 'n
0 05 SF Misc. ? 10 _-plex o 15 Deck ?
WORK TYPE
a 31 New
? 32 Addition
3 - 5c--ri svy.
'0 33 Alterations o 36 Move
o` 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft,
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
A;W-
.; -.
r'.f.. .
16 Basement Finish
17 5wim Pool
20 Pubiic Facility
21 Misceflaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unif
Engineering Variance
?
?L
/
Permit Fee
7J`
ZZY-l
Surcharge / .
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies o .`?Total: a94 0 9
Valuation:
$ it, voo.-?
18 X'y = 2 S2- {? d qU -. 10? o$a.-°-
% SAC
SAC Units
\- r 1 ERMIT - &zo O/ /
CITY OF EAGAN 9?`?0/95
3830 Pilot Knob Road PERMITTYPE: euzLozNG
Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 4 m 9
(612) 681-4675 Date Issued: 0 9/ 19 / 9 5
SITE ADDRESS:
4284 DARTMOUTM CT
LQT: 21 BLpCK: 2
HAWTHORNE WOOD5 2ND
P.Z.N.: 10-32151-210-02
DESCRIPTION:
8d31d.1 n c,'',ttp ' ermiC Type
0`t?iidkwrg..4??rlh, Type
O?c'Wpatto y:»,N
Cpnstria-eti'arn Ty'ple ?isaldirigp
?8 ??14 1 n'qF?sSbtf? r
,o Sklk??i l?g? ?Pr 1@S
Fe
SF DWG
NEW
R-3 U-1
V-N
R-1
64
52
2
2,360
4 '
„F
.7
U
REMARKS:
PRV S& W PLBR - FZVE STAR PLBG
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Suroharge
SAC
SAC %
SAC llnits
Subtotal
$1,202.25
$920.79
$81.50
$860.00
100
$2,554.54
$163,000
MISCELLANEOUS $1,892.50
Total Fee $4,447.04
CONTRACTOR: -
MCDONAL[7 CONST INC
7601 145TH ST W
APPLE VALLEY MN
(612) 432-7601
?".
appiicant - sr, LIc. OWNER:
14327601 0002376 MCDONALD CONST INC
7601 145TH ST W
55124 flPPLE VALLEY MN 55124
(612)432-7601
. . _ ?
I.herefay a-ck:ftnuledge, that,-I ha;v'e' reao th'3s-'a'pgalic`at°iqn' an;d stte, 6-a:f
3nform?ti64T is 00,rrect-and?''ag?,ee, t-d: c0 fi?lyw1 th;.k I?aAPI,i•6'a b??? ?tklq 'p'?? mrt -
$tatLFte`s- ffi-stit Cit`y .4f ??ag?f?rY
--
APPLICANT/PEFMI7EE SIGN?ATURE ISSUED SIG ATUR k
CITY OF EAGAN ? ? 3830 PILOT KNOB RD - 55122
1895 BUILDING PERMIT APPUCATION (RESIDENTIAL)
681 at675 L?r l r•, .! ,!? ?
? 3 regMered site wrveys ? 2 oopies of plan
? 2 copiea of plens (induCe beam 8 window saes; poured fid. design; etc.) ? 2 sRe surveys (exterior addkiona 8 dedcs)
? t energy calalatiwre ? t energy calwletiona for heated atldkions
? S mpbe of hee pmervaGon pla iF lot pleHetl aRer 7N/93
requlred: _ Yss No
DATE: - 1
DESCRIPTION OF WORK: ' `?e Lz
STREET ADDRESS: ?+TLL
LOT ? _ BLOCK ?
k V\-
SUBD./P.I.D. #:
cosT:
PROPERTY
OWNER
CONTRACTOR
Name: ? oc-ktJeP, Phone #:
w* Fws*
Street Address*
City: State: Zip:
Company: ?CNrvQ ld Cb w c? Z ?c_ Phone #: ??? -7
Street Address: ) 4Z L I`-I 5 T? S t. I.J- License #• 000a 3> C?
City: 14DJP 1C VA-v State: /J1? Zip• s?
ARCHITECT/ Company:
ENGINEER
Name:
Phone #-
Registration #•
Street Address•
Ciry:
State:
Zip:
Sewer & water lioensed plumber: RU b J 1 a e, 3 7 U Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is corra and agree to comply with all
applicable State M Minnesota Statutes and City of Eagan Ordinances. ,??=e? (? _
` ?
Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received Yes
Tree Preservation Plan Received _ Yes
RECEWED
° 5EP 1 1 1995
No
OFFICE USE ONLY
BUILDING PERMIT TYPE
1+'T ? ' ? • ?0?.
r'
a 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
z?'02 SF Dwelling o 07 4plex a 12 Muki RepaiNRem. 0 17 Swim Pool
0 03 SF Addition o 08 &plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch a 09 12-plex ? 14 Fireplace o 21 Miscellaneous
0 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
A' 31 New ? 33 Alterations o 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) 4=N Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. /.dqvo City Water o?
UBC Occupancy 7-3 a-i ,.7 !?D_ sq. ft. 1077 Fire Sprinklered
-
Zoning Q_/ sq. ft. PRV 7r
,r
# of Stories zfj armr. sq. ft. Booster Pump
Length &Y_ sq, ft. Census Code. /O/
Depth f2 Footprint sq. ft. y,16,0 SAC Code
Census Bldg
Census Unit
APPROVALS fK ?
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
Valuation: $ 1631o 0 0 %-
? -
9x 9 = 3?
.sxYxY = 8
2 r
2?s9.zr ? -79
,syzrz - L
7xi = 8
zz xSZ ' qs'
a,.,i l. sx 8 = 1 L
d'x 33.t = Zb?
2f 13.5 ` Z7
2f
io
D zs'Y= 6/9 9? _
Cj'0, 70 ?O yox Jz
ZAn Z
zzx2z NEY ?z
felr9r ' sr •)lx
?zsu.s = ?}?_ (r-?xs)
677XSy,?-' SY? ?(fx ??
8s-
? Ss = l G& o .
<e.07.? = <v>
?lSr2? - <!z> .
<Z, )
(.srzr?-? ' ?Zl
LrG : /z
Zxb
/, y y 9 0
_ ?{o
, H
: y
• <?z )
= (is >
?F?--?` ; ?p?c7(o
?
14.92 S96ylt65
,
?w.54'' ` s42' `, SaW0+90 ..
3, g?5 5/ ? s43;w5/? S&WOt15
. ?, . ., . ..,?:,.. .
904.2 •. a 42 ,w Sp' SEE SHEET Np-?
899.0 ? 2411U SdW 3+23
140' f M.H 20 16 . 17 ?r20 18 esaisg?
as.o, M.H.19--7 J M.H.18 /
ioo.o' 7r
A
D ?.
" . ,, . ',.s-? • + ?
• 6
-I/16
BEN
DS
/32,., ... ^
&1
?:
91.3
-GATE VA ST.O'
Y
4/.0
24 ' 23
" ?SSW1+95
?s
' Sa' :
?1%ifoo ? 22
? .s40liW30,', ,.' SBWO-1-/9
??A°2'i;X, y
CS4.9
s41, ,w3/'
89
9.2
35.00
?
,
/
21
S&W Of//
s /06',W 7/'
ass,o'
; 2.5'
2s. '
H YDRqp
C.O.
_20
SaWO
s/OT;ti
B94.9 .
L 9/
7`' gL ?
/I CITY USE ONLY
?d
RECEIPT #: D
U
SUBD. 1F ? '/
RECEIPT DATE: ?` OP/ 9/
PERMIT #
Y 999 PLUM$INfi PEft14tIT (RE.SIDENTIAL)
??eVywi 1" " 3C?4 °I(o crrYoeE,asax
3$30 PILOT KN09 RD
EA6kN, b1N 55122
(651)681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTU RES
EACH #
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
G2S i in outlet ` minimum - 1 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $ ?u ?
Private Dis osal S stem new/refurbished `re uires MPCrc. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ- new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 X = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e 50 --> ----> ----> $
Total --? --? ----> ---->
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
------------------------------------- ---------------------------------- --- ----------- -- -- ----- -----------
I hereby acknowled9e that I have read this application, state that the information is cortect, and agree to compry with all applicable City of Eagan ordinances.
I[ is the applicanCs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its
nortnal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: : TELEPHONE #:
(AREA CODE)
INSTALLERNAME: TELEPHONE#: ?Z,-a>
. c/ (AREA CODE)
STREET ADDRESS: ti ?e U n L- v, "?
CITY: 70CO,-- STATE: ZIP: S53: -
SIGNATURE OF PERMITTEE
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
?S.? 3 ? 3830 P (651) II.OTKNOB? - 55122 ? (,,0 . ?--?
New Construdion Reauirements RemodeVReoair Reauirements LakkSly
? 3 registered sRe surveys
? 2 copies af plans (inciude beam & window sizes; poured ind. design: etc.)
? 1 energy calculations
? 3 copies of tree preserva6on plan ff lot platted after 711193
required _ Yes _ No
DATE: S- g- /411?1
8 ? ?i¢.??fa u7
DESCRIPTION OF WORK: _e/-064/F1t
STREET ADDRESS:
LOT: a' k
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
BLOCK: ,-;L_ SUBD./P.I.D. #: wbT1A.n
Name:_ ?OG}?i?? 6~ /?7JY Phone #: G? .5-/- 6 Gi?Jf
Lazt First
StreetAddress: ?ZB4 f?i¢>??hoc?? d7r'
Ciry State: Zip:
Company: T//yGL,p?,?0/l1GS 1-540el =„P? . Phone #: 6Sl- ?j?e5 -?l?
Street Address: Q?A %26.?_/LS 4,9&F- 'Ae?o License # 352- Exp. Z? ?n
City ?6W.-i State:
• 2 copies ot plan
• 7 site surveys (exRerior addkions & decks)
• 7 energy calculations for heated additions
2'=
CONSTRUCTION COST: i:5:?
Phone #:
Name: Registration #:
Zip: 6S?Z3
Street Address:
City Sta[e: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address
change and lot change is requested once permit is issued.
I qereby acknowledge that I have read this application, 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: - - ? i
'
OFFICEUSE'ONLY
Certificates of Survey Received _
Tree Preservation Plan Received
Yes No
Yes _ No
- Not Required
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging X 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 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Misceilaneous
O 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New W33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) 5,4 Basement sq. ft. Census Code 43?
(Allowable) 5- nf Main level sq. ft. SAC Code ol
UBC Occupancy _2 • 3 sq. ft. Census Units _L
Zoning 21 l sq. ft. Census Bldg
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS N - -? " --' - -
Planning
Building
Eng
I 7
Permit Fee Vaiuation:
Surcharge
Plan Review
License
MC/ESSAC
CitySAC 0'?,ii;'?;?`,
Water Conn. -
Water Meter
Acct. Deposit ?
S/WPermit ? :11010;_ 44ANI ;'rRIi-u:?uri-i c,0.00
S!W Surcharge
r,r,i??tr•t+?!.r;i!
'r.l:.; •:a??ri:t ?1t>04
sl.,";t?
Treatment PI. ?
Park Ded. ?
Trails Ded. i
Other ,
Copies
Total: `
%5AC 'i;?n:t [r?._•'i.i-,I: +',nin?;.t„ r,fi.;`7Ci
SAC Units C!'z;tiir,?;r
rnr%`?lT'r.•;;:?.1rYr'i=?,;il:? ;i.
I
LoT ?-/ BLOCK ? sUBO.
RECEIPT #S2`?5 DATE
1996 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAI INSTALLATIONS: FORM MU5T BE COMPLETED BY LICENSED PLUMBER
Date:
Area/address to be irrigated:
Instal ler: C--C-- r e-el
Street address: 6s-Z-D
7 7)q Y'
?f 27
U U?-? c,
I
IA N Owner ?
r? Q v.',1 4 v -,-
Commercial
Residential (boulevards)
Existing residential
GPM
GPM
Plumber 0
Ciry, state & zip code: 2-G K -k, v i Phone #:
Owner Name-
5treet add ress: 7 2Vy `)aY-Ty-?)d l"
City, state & zip code: Phone #:
irrigatian eoritractur, if difiefeiiC [lidfi iniiaiier:
Telephone #:
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 propercy
owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City
p roperty/right-of-way/easem ent.
ApplicanYs signature
Approve? by:
PRV ? Yes ? No
Meter Size & Cost
SB
Fees due: ?
Title
Date:
New service ? Yes
Calculated
? No
,...?, . ?
PROCEDURE FOR IRRIGATION SYSTEMS - 1996
An irrigation permit js required - please contact Protective Inspections at 681-4675.
Fees
Commercial project: $25.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee only if new service is installed.
$300.00 per tap if installed by City.
Residential project: $20.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee if new service is installed.
$760.00 per connection - WAC.
$396.00 per connection - water treatment facility.
Existing residence: $20.50 irrigation permit to cover installation of backflow preventer -(not
required if backflow preventer previously installed).
Meter charge: If gallons per minute are less than 25, a 1" meter will be required at a cost of
$182.00. If gallons per minute are more than 25, a 2" turbo with strainer will
be required at a cost of $822.00. This information is to be supplied by the
designer 9f the sustem.
---- --- - ------- - -- ------ - ----------
No meter will be sold before all sewer and water inspections are complete on a new service. If new
servic-e lines are not req?i? red, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk.
The installer is to contact Protective Inspections at 6814675 for inspection of the inside water line and
backflow preventer. The Public Works Department may be reached at 681-4300 for water tum-on and set
and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for
A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
cirr use oNLv
L o?? BL ? RECEIPT #: 9
??) ..?.p ?v
SUBD. L ?G.ur{.lt6nnt.[ DATE: l0 /$S
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Piease complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
_ Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date:
FEES
? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00
? HVAC: 0-1 DO M BTU
Additional 50 M BTU 6A0
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL .36 $°
SITE AODRESS• 72k? ?1"'t'ZIIW
OWNER NAME: A106419/?4" C ?
INSTALLER NAME:
O
PHONE #: / 32 `760l
?
STREET ADDRESS: 2???e 15??lv Iltle
CITY: FVA/1/67641 STATE: 10, ZIP:
PHONE 4f66 -??22 -
cirr use oNLv
L BL
SUBD.
RECEIPT #:
DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: ?$25.00 minimum fee QL 1% of contract price, whichever is greater.
? Processed piping - $25.00
• State surcharge of $.50 per $1,000 of ppmiit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TELEPHONE #:
TENANT IVAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:.
CITY:
PHONE #:
STATE:
ZIP:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
LcV gL ot CITY USE ONLY RECEIPT #:1r90'Z
SUB . r.. •Ytix o ? ? DATE: /D ??
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease complete for: ? single family dweilings
? townhomes and condos when permits are required for each unit
FIXTURES -- EACH
Shower "s.OG x
Water Closet 3.00 x
Bath Tub 3.00 x
Lavatory 3.00 x
Kitchen Sink 3.00 x
Laundry Tray 3.00 x
Hot Tub/Spa 3.00 x
Water Heater 3.00 x
Floor Drain 3.00 x
Gas Piping Outlet ' minimum -1 3.00 x
Rough Openings 1.50 x
Water Softener 5.00 x
Private Disposal * Dakota Cty. license 20.00
U.G. Sprinkler ` home under const. 3.00
Alterations ' to existing 20.00
Water Turn Around 20.00
STATE SURCHARGE
TOTAL
= 00
_ 2.06
_ )@. 00
= 3,00
= 3.00
= G?•OD
= 3,60
- ,o
= S' 60
50
.??
SITE
OWNER
INSTALLI
STREET
CITY: Ve
PHONE #: ( ) O
NO. TOTAL
STATE: / //? , ZIP: 11?_SOIel
L a/ B o2
SUBD ? . ?IQt-a?
NEW RECEIPT
BECEIPT DATE /?
TIO
JOB
OW N
A27? a?
D?Tt
rLrASG bE ADVISED T}iAT THEHE IS A FEE SHORTAGE ON TFE ABOVE
cl.l
' ELECTRICAL ItSTALLA2'ION IH THE AlSOllHT OF $
SHORTACE RiST BE PAID WHITHIN 14 ?AYS.
RMR[6 ?
0 to 30 amv. circuits= ?
? 31 to 100 amn. circuits=
0 to 100 amn service=
? 101 to 200 amD. service= ?
TOTAL FEE DUE=
<d
LESS FEE RECIEVED 7 7
TOTAL FF.F. SHf1RTAGF.' DUE _ S / , ?
PERMITIf ?J" ??jf ?!
ORIG. RECEIPTlI
?tECEIPT DATE
RETURN A COPY OF THIS FORM WITH REMITTANCE.
J_)_O g1 2006 RESIDENTIAL BUILDING rExMiT arrLicnTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cons[mction Reauirements
3 registered site surveys showing sq R of lot, sq. fl. of house; and all roofed areas
(20% maeimum lot coverage allowed)
2 copies of plan showing 6eam & windowsizes; poured found design, etc.
1 set ot Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selectwn sheel (buildmgs with 3 or less units)
Minnegasco mechanical ventilation form
RemodellRenair Reouiremenis
2 copies of plan showing footings, beams, joists
7 set of Eneigy Calculations for hea[ed addilions
1 site survey (or additions 8 decks
Addfi'on - indicate 8on-site septic system
35/. ZG
ONce Use Onlv
CeA of Survey Recd _ Y_ N
Tree Pres Plan Recd _ Y_ N.
TreePresRequired _Y _N
On-sHe Septic System _ Y_ N
Date dv
Construction Cost / 21
?y- ?/?I?T7LJ0(i7
SiteAddress s/
Z ?7t ? UnitlSte #
w
-1
T?/1??
Description of Work ?Ww!l/GS Sv)?-
Multi-Family Bldg _ Y_6) Fireplace(s)
Property Owner GWtAF? Telephone # ( &u /) AA79- '09'61Z
Contractor ? /?`'?3r'?r.?co?c?S ? ??u?Yi7o'vS ?L
Address CitY
State J'?/i?• Zip _5t5 /Z3 Telep6one # ( 61TY __3d7 -O6</d
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CateQOrv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • NewEnergy'Code Worksheet'
(J submission type) Submitted Submitted i. Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Y _ N If yes, date and address of master plan: i
?--? - -J
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Tetephone # (
Telephone # (
I hereby apply for a Residential Building Permit 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 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 of plans.
?
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 78 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Wo rkTVUes
?
31 New / /
? 35
Int Improvement ?
38 Demolish Interior ? 44
Siding
? 32 Addition j ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
)9t 33 Alteration/ ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire BIdg) - Give PCA handout to applicant
D65CIiption: WaterDamage_Yes
Valuation ? t-f-4) Occupancy MCES System
Plan Review 100% or 25%
Census Code (. ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinkiered
Type of Const 416? Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
YX Insulation
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
_ Sheetrock
FinaUC.O.
? FinaUNo C.O.
x HVAC
T Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
_ Retaining Wall
Building Inspectar
r?c
/2? ??
`A9 zoos RESIDENTIAL PLUMBING PERnnirAPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
t G'?
Date / 1 ?G' I 0?%
Site Street Address Unit #
Property Owner Telephone # ( )
i Contractorilejl-
rc
• Telephone# (?
?
,,I
Address q'C?-C ?'iXc?C.?%? 14.-E - City State Zip ?S3Sj?
The Applicant is: _ Owner XContractor _Other
w _ Refurbished Submit 2 sets of plans and MPC license
Se
m _ Ne
Sys'e
Includes County fee
7 $ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. If you are installing onlv a water sofiener and/or water
heafer, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
uired)
Water Turna
round (a
dd $1
30.00 if a 5/8" meter is req
?J
J
/
?J
X Other. i'????f hLrci. ?l?tat;cOf 5/cc?er-
Water Softener _ Water Heater $ 15.00
_ new _ replacement
t
Lawn Irrigation _RPZ _PVB _new _repair _rebuiid $ 30.00
State Surcharge $ .50
Total $ JrQ•?
I hereby apply for a Residential Plumbing Permit 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 the plum6ing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start withouf-a_permit and work will be in
accordance with the approved pian in the event a plan is requiredJo be reuae e pproved.
?? -
Applicant's Printed Name Applic n' Signature -
r
2422 Enterprlse Driva
;.n Mendota Heights, MN 55120
* PIONEEA ?J0 ? (612) 681-1914 FAX:set-9488
- taND SuR?EypRS • dM? (T?GNEERS
* en?neerTna IMID PLnNNERS• ??WDSGCE MCryp[Q$ 625 Hfghway ?0 N.E.
? .* Jr * Blaine, MN 55434
(G12) 783-1880 FAX:783-1883
Certificate of Survey for: MCDQNALD CONSTRUCTION
k! "-,' 4284 DARTMOUTH COURT
?F,..?- '
? REi ?
?`f ? ?
9 f/ 3 5? n,, ?A7E Dy
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DENCH MARK ??? ? ?' TOP OF PIPE ?? EAGAN ENG , ERING DEPT
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TOP OF PIPE / 5
EIEV.=908.62-- l? ru ° ' ,? J
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908.8
JOiE: PROPD"f, D CaADES SHOYM PER GRADItiG PUN BY: mFR CN (?M?
IOTE: BVILOINC DIMENSIONS SHONN ARE fOR HOftfZONTAL ANO VER((CAL LOCAT?pry ? HOU E ?.J
OG STRUCNRES ONLY. $EE ARCHIIECtVAL PlANS FpR BUILDING nN0 '?Z
Fouanr,noN pIMEnsIoNS. LOWES7 fL00R ELEVATION: Q ?
'OTE: NO SPECYFIC 50145 INYESTICATION MAS BEEN COMp?ETEO ON T111S l0T BY THE TOP OF BLOCK ELEVATION: 1L/•G
SURVEYpR, THE SVITABIIItt OF 501(.S TO SUpppR7 THE ypEqPIC HWSE
PROPOSEO IS NOT THE R[SPpry51811ITT pf THE SVRVEYOR. GARAGE SLAB EI.EVATION: T_,._ ?70 ?, 9
OTE: inlS [EFnFlCATE DOES NaT PVqPORT 7o SwpW EASEMENiS DiNER TNAN
TNOSE $NOWry pN THE RECOROfO PUT. X 000 00 DENOTES E%ISnNC ELEVnTIqr
DTEi CONTRAC7pR MUST VERIfY (0? ) OfNOTES PROPOSEO ELEVAl10N
ORI?EWAY DESIGrv, ?-- _. DENO7E5 DRAINACE µD UOIITY EASEMENT
JTE: BFaRINGS SNOWn ARE BASEO ON AN nSSUMEO DANM -T DENOTES DRAINAGE FIOw DIRECnpry
- oENOTES MONUMENT
'E HEREBY CERnFY TO MCDONALD CONSTRUCiION 7HAT THIS IS a TRUE AND CORRECT EP ESENTA710N OF A
URVEY OF THE eOUNOnRiES OF
.OT 21, BLOCK 2, HAWTHORNE WOODS 2ND ADDITION
AK07A CDUNTY, MINNESOTA
DOES NOT PURPOR7 TO SHOW IMPROVEMEN7S OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
NDER MY DIRECT SUPERVISION 7HI5 29TH DAY OF qUGUST, 1995.
^
CALE ; 1 INCH = 30 FEET IGNED: ' IONEER ENGI EE/Rlryg p,q
P.A.
S1VK ? `.....--...-.
- John C. Lorson, 1.,5. R-eg, N"`o, ?y?2g
* PIONEEEi
? engtnaml
1C * ?, *
LN1D PLNNNEf15• UtiD5C0.GE MCHIYECTS 625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate of Survey for: MCDONALD CONSTRUCTION
? M1 4264 DARTMOUTH COURT
IL f'! 6Y 1\
REVI rEG
3Y,
"A \
J? •905.4
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1 906.7 ?
907.7, %
(90-7.0)
2422 Enterprise Oriva
Mendota Heights, MN 55120
(612) 681-1814 FAX:681-9488
907.6
2 0 GAv
1 45.47
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El E V,=908.62-''
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NOTE: PROPOS£0 GxADES SHOKN PER GRADING PLAN BY: NFR PROPOSF D HOUSE fl FVA77QN
NOTE:
I
SHOW A
?
A
An?
OF
S7RUCTVRES ON?
RCHffQCTUAL
nNO
p ANS FOR BUILDING LOWEST FLOOR ELEVATION: 3
rouNOnnou oiMEnsIoNS. -
1l?•G
rrOTf: NO SPEtlFIC SOtLS INVE57ICAlION MAS BEEN COMPLETEO On TFIIS l0T 8Y THE 7pp OF BLOCK E?EVATION:
SURVEYOR. n1E SUITABILITY OF SOILS TO SUPPORT TME ypEpPIC HWSE GARAGE SLaB ELEVATION: QG
PROPOSEO IS NOT 'fHE RESPONSIBIUTY Of TryE SVRYEYDR.
NOTE: THIS CFRTIflCATE OOES NOT PURPORT TO SHOW EASEMENTS 01HER 7HAN % 000.00 DENOTES EXISTINC ELEVATOta
TF105E SnoWN ON THE RECOROEO PLAT. ( 00000 ) DENOTES PROPOSEO EIEYAl10N
NOTEi CONTRACTDR MUST V['RIFY ORIVEWAY DESIGN. ---- DENOTES DRAINAGE iWD UTILIT' EASEMQNT
-? DENOTES ORAINAGE FLOW OiRECTION
NOTE: BEnqINGS SHOYm ARC BASED ON aN n55UME0 OANM OENOTES MONUMENT
-9-- DENOTE5 OFFSET HU8
WE HEREBY CERTIFY TO MCOpNAI.p CONSTRUCTION 7HnT THIS IS A TRUE AND CORRECT REPftESENTA710N OF A
SURVEY Of THE eOUNOnRIES OF:
LOT 21, BLOCK 2, HAWTHORNE WQODS 2ND ADDITION
DAKO7A COUNTY, MINNESOTA
IT DOES MOT PURPOR7 TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION 7HIS 29TH DAY OF AUGUST, 1995. /"'?
IGNEO: ' IONEER ENCI EE RING1 P.A.
SCALE ; 1 INCH = 30 FEET ti../
` e I?__ ?'.w......
John C. lurson, L.
2422 Enterprlse Drive
Mendota Heights, MN 55720
* PIONEEA L.NO w?YOA5 • pNL QIGNC[FS (612) 681-1814 FAX:691--9488
* engZneer nA 4W0 PUfINERS• IANOSCaPE AftCtdTECfS 625 Hlghwoy 10 N.E.
* Blaine, MN 55434
* ? 'f 1(612) 783-1880 FAX:783-1883
Certificate of Survey for: MCDONALD CONSTRUCTIQN
E!'i,` ?-s Aq' 4284 DARTMOUTH COURT
l I \
REVI EL?
? a?1.,L.?..?,._
elyyr
20 GAN
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907 7
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TOP OF PIPE
EIEV.=908.62-
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NOTE: PROPOSEO GRADES $HOWN PER GRADING PLAN BY: Mf'R PPOPOSFD HOUSE N
NOTE: BNLDING OIUEN510N5 SHONN ARE foR HORRqJTAL ANO VERTICAL IOCAMIN
'
OF STRVCfLRES ONIY, SEE ARLFp
(QCTUAL PUNS FOR B111L01NG ANO LOWEST FLOOR ELEVATION:
FIX;NDATON DIMENSIpyS. ?`? ?
No`E NG SPECffIC Sd{.j iryYtSTICA7IJN NAS dEEN COMpLETEO ON 11{I$ LOT BY THE 70P OF BLOCK EIEVATION;
SURVEYOR, TryE SUITABIIITY OF SOiLS 1p SUPPORT THE $pfqPlC HWSE GARAGE SLAB ELEVATION: 90
3 r
vROPO5E0 IS a0T fHE RFSPONSIBILITr Of 7ME SURVEYOR.
NOTE: 7MIS CFRTIFlCATE OoES No7 pU(1PORT To SHOW EASEMENTS oIHER THAN
iHOSE SNOWN ON THE RECORDEO PIaT % 000.00 DENOTES E%ISnNG ELEVA710N
. ( 00000 ) OFNOTES PROPOSEO EIEVAl10N
NOTEt CONTRACTOR MUST VERIfY ORIVEWAY DESGN• ---? DEN07ES ORAINAGE AryD UiR1iY EASEMENT
NOTE: BEMINGS SHOWrv nRE BASED ON nN nS5UME0 OAIUM -3 DENOTES ORAINAGE FIOw OiRECiION
-?-._ aENOTES MONUMENT
$ DENOiES OFFSET HUB
wE HEREBV CERnFY TO MCOONALD CONSTRUCTION 7HnT THIS IS a 7RUE ANO CORRECT REPRESENTATiON OF A
SURVEY Of THE eOUNDARIES OP;
LOT 21, BLOCK 2, HAWTHORNE WOODS 2ND ADD1710N
OAKOTA COUNTY, MINNESOTA
IT DOES NO7 PURPOR7 TO SHOW iMPROVEMEN7S OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION 7HIS 29TH DAY OF AUGUST, 1995. °
IGNEp: IONEER ENG? EE RiNG P.A.
SCALE ; 1 INCH = 30 FEET ,
_ B ?..__ ,'' ?? ....?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA108167
Date Issued:11/20/2012
Permit Category:ePermit
Site Address: 4284 Dartmouth Ct
Lot:21 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-210
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:House
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, 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 -
Gary R Lochner
4284 Dartmouth Ct
Eagan MN 55123
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:EA122553
Date Issued:05/12/2014
Permit Category:ePermit
Site Address: 4284 Dartmouth Ct
Lot:21 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-210
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 .
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 -
Gary R Lochner
4284 Dartmouth Ct
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136948
Date Issued:06/08/2016
Permit Category:ePermit
Site Address: 4284 Dartmouth Ct
Lot:21 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-210
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Gary R Lochner
4284 Dartmouth Ct
Eagan MN 55123
(651) 335-8545
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature