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4040 Deerwood PlCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4040 Deerwood P1 Lot: 30 Block: 3 Addition: Engstroms Deerwood PID:10- 23900 - 300 -03 Use: Description: Sub Type: Work Type: Description: e - Water Heater New Water Heater Meter Size Meter Type Manufacturer Comments: Permit closed without required inspection(s). Letter sent to applicant on 9/25/09. (pf) Fee Summary: Nicole Whirley Contractor: Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767 -1000 PL - Permit Fee (WS & /or WH) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: Serial Number Remote Number Owner: Thomas G Morrison 4040 Deerwood P1 Eagan MN 55123 $50.00 0801.4087 $0.50 9001.2195 $50.50 Plumbing EA088760 04/16/2009 ePermit Line Size I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4040 Deerwood P1 Lot: 30 Block: 3 Addition: Engstroms Deerwood PID:10- 23900 - 300 -03 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Permit closed without required inspection(s). Letter sent to applicant on 9/25/09. (pf) Fee Summary: Contractor: Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767 -1000 Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Elec 445 -2840 ME - Permit Fee (Replacements) Surcharge -Fixed Total: I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: Thomas G Morrison 4040 Deerwood P1 Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 Issued By: Signature Mechanical EA088761 04/16/2009 ePermit cal Inspector, (952) ÿ þ ý þýý üûÿû ú ùýýüüþò þô ôö ÿ þý÷ üûúùø ñôûùø ÷ôùø ÷öõôó öõò ø û ñ ûñ ððìûø ù ï üîû ô í øôë ô îûô ô ú ô êé ôööø ý éôéô ý ø êñ éôé ø é ô ê ñ ôú è ô ô ô îûô úù ö é ù ê í æääêäêðä öù üûô ô æê ê ç û ýê õô ÷óò øø ô ù Ûãôô ÷ ðð ôö ã þ ãó ÝßÜð ô úù ö ë ô øø éô ôô ô øùö øø ú ü éã ü û ñùéþ ìô ê øø õ ô ü ûô û ùü ûô BUILDING P To be used for Site Address _ Lot 3?0 B Parcel No. - W Name _ o Address WMAL HOUSE PLAN 2/91 CITY OF EAGAN `J 18687 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt # DWC;/C" Gcr vat„. $152,000 nntp M 4 199, o Name u< Address City Phone this application and state that the imply with all applicable State of )rdinances. -- - A Building Permit is issued to: YITTELSTAEDT BROTHERS on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. OFFICE USE ONLY R-3 H--1 Occupancy I?-1 FEE S Zoning 822'00 (Actual) Const Bldg. Permit (Allowable) 76.00 Surcharge # of Stories Plan Review 534.00 Length h 100 • 00 Dept SAC, City S.F.Total SAC, MCWCC 650.00 S.F. Footprints - 660.00 On Site Sewage Water Conn On Site Well Water Meter 90'00 MWCC System -? Acct. Deposit 30.00 City Water 30'00 PRV Required S/W Permit Booster Pump S/W Surcharge .50 276'00 Treatment PI APPROVALS Road Unit 370'00 Planner Park Ded. Council Bldg. Off. Copies 3,638.50 Variance TOTAL Date WATER SEWER PLUMBING Kv.A.C. SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. agan, MN 55122-1897 FATE FEB 4. 1991 OFFICE USE ONLY METER # !VV4 .2,2 PERMIT DATE 02/11191 CHIP # 7 ?74? ?S PERMIT # 18105 METER SIZE ?- B.P. RECEIPT # t 1?? ISSUE DATE - y " ?I- B.P. RECEIPT DATE 02 04 ? 1 PRV -BOOSTER PUMP SITE ADDRESS 4040 DEERWOOD PL LOT 30 BLOCK 3 SEC/SUB ENGSTROMS DEERWOOD APPLICANT: ADDRESS: CITY, STATE ZIP PHONE: PLUMBER: CITY,STATE l-<?J11LLF i/???ZIP PHONE: Y 5' 3 3 y , STATE t' ALAN HN ZIP PERMIT REQUESTED X SEWER X WATER - TAPS COMM/IND X RESIDENTIAL X NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahea of Domestic Meters on Water Line. Cr it ILL NOT be given for Deduct Meters. II I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANC S 4J?1 r NO' NATURE I EN R ISSUE j CALL 454-5220 FOR INSPECTIONS. FOR STORM CITY OF EAGAN NO 1 8687 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 (:!? 4tqiiq BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $152,000 Date FRS 4 , 1g21- Site Address 4040 DEERWOOD PL Lot 30 Block 3 Sec/Sub. ENGSTROMS DEERWO Parcel No. W Name MITTELSTAEDT BROTHERS Address 785 SUNSET DR o City EAGAN Phone 456-9125 tF Name SAME o0 Address UQ City Phone Name - Address acknowlege that I have read 3n is correct and agree to c Phone application and state that the y with all applicable State of ances. .r- OFFICE USE ONLY Occupancy R-3 -R--1 FEES Zoning JL--1 (Actual) Const V-N Bldg. Permit ---B-2-2 .00 (Allowable) V-N S har a 76.00 M of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS MITTELSTAEDT BROTHERS Planner A Building Permit is issued lo: on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and iCity of ?E?agan Ordinances. Bldg. Off. Building Official _ T?n ??L I 1 Variance urc g 54' n Plan Review 534-0 SAC, City 100.00 - SAC, MCWCC 650.00 _ Water Conn 660.00 Water Meter 90.00 00 30 ?X - Acct. Deposit _ S/WPermit 30-00 - 0 S/W Surcharge -5 Treatment PI 2 7 6 - nn n Road Unit 370-0 - Park Ded. Copies - TOTAL 3,638.50 citp of Itagan ?r?rtmrtct of ?iuildmg IL--- tM This Certffrcate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. v?ecla&Wfiation SF DWG/GAR I*. Permit No. 18687 R3/MI R1 T vn cam. ?of T? MITTELSTAEDT BROS. A?785 SUNSET DR.,AEAGAN Na: 4/24/91 POST IN A CONSPICUOUS PLACE ,4. . (Urtif iratt of (Orrupaury a i 91 3/ 3 3 5 y v Request Dale f Fire o. Rough-in Inspection Required' C] Ready Now Will Nobly Inspector Wh n R d ? / y a ea Yes ? No I licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) City Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No. 2 7- Power Supp?lier Address Eledrkal Contractor (Company Name) Contractors License No. Mailing Address (Contracor or Owner Making Installation) Authorized Si nature (ContraclodOwner Making Installation( Phone Number I MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midedi Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB.aoo01-08 ? See instructions for completing this form on back of yellow ropy ?OD/ a0 3 3 5.3 2 X' Below Work Covered bV This Request ?O3/ fJ e Add R Typeof ilding Appliances Wired Equipment Wired Range Temporary Ser vice Water Heater Electric Heating R Dryer Other (Specify) ial Furnace Air Conditioner Contractor's Remarks: Compute Inspection Fee Below.' # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps -?: 0 to 100 Amps // Transformers Above 200 _ Amps Amps Signs nspectors Usa Only, ..9 TOTAL Irrigation Booms ? ll// S ecial Ins ti p pec on Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in / Final Date Date 4 OFFICE USE ONLY This request void 18 months from (O)?6??- 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 1 Soils Report if proposed building is to be placed on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 7/153 Rim Joist Detail Options selection sheet {buildings with 3 or less units) Minnegasco mechanical ventilation form Remodel/Repair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on-see septic system 0.00 Office Use Only Cart of Survey Recd Y _N Soils Report _ Y _ N Tree Pres Plan Recd _ Y _ N Tree Pres Required -Y _N On-site Septic System _Y _N Date /Z-/ I / 0 T Site Address 70-q? 611 0 Construction Cost 35DQ, dace Unit/Ste # Description of Work wis c l., wmdoPvS' -I Multi-Family Bldg - Y _X N Fireplace(s) _ 0 - I - 2 ?? Property Owner 7-U RorAl JecC/h ??""? /_?" r1 p Telephone # 451) Contractor[ Address Z / . 7,e 7-e rrw e State M / V ,o f . zip City 111116 Telephone At ( )(095.3100 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 (J submission type) • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Submitted Submitted . 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: _ Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( 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 approval of plans. Applicant's Printed Name Applicant's Signature S os ae New construction Requirements • 3 registered she surveys showing sq. R. of lot, sq. ft. of house; and f3!I roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) I set of Energy Calculations • 3 copies of Tree Preservation Plan If lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE `j' zo _ O Z SITE ADDRESS C/O TYPE OF MULTI-FAMILY BLDG Y N FIREPLACE(S) _ 0 _ I _ 2 SELA ROOFING & REMODELING, INC. APPLICANT 4100 EXCELSIOR BLVD. ST. LOUIS PAHK, MN b541fj STREET ADDRESS In #naoioso CITY STATE ZIP TELEPHONE # Gt Z-'WZ 3-r6CELL PHONE # FAX # PROPERTY TELEPHONE # - ( S?, COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (+l submission type) . Residential Ventilation Category 1 Worksheet Submitted . New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor. Mechanical system includes: Sewer/Water Contractor: RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Water Softener Water Heater No. of Baths Air Conditioning Heat Recovery System RemodeVReoalr Reoulrements 2copies of plan 1 set of Energy Calculations for heated additions 1 site survey for exterior additions & decks • Indicate t home served by septic system for additions _ Phone # Lawn Sprinkler No. of R.I. Baths Phone # Phone # Fee: $70.00 ------------------------------------------------------------------------------ - ----------- --------------- I hereby acknowledge that I have read this application, state that the information is car , and agree to with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applica ------------- - --- --- - ----- - ----------- OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ VALUATION t :?7 22?6 . " IS7 a? Fee: $90.00 Updated 4/02 ICATION 1991 BUKGU q APPL CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS / • % COMMERCIAL 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS _# OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: SreL Fiu,L-k-/ Valuation Site Address go 4o Neg,.q Lot '?g Block 3 Parcel/Sub 4Bzfa,-Ae','5 bF` 7iuAVA Owner Address City/Zip Code Phone Contractor f+'1,,-?y-Ec.4??.?Y1T II??II!5/l1J?i Address 7$S (7ct ??i e?> AI/G. City/Zip Code r'a"/hJ Phone 4" l& `t/ a S Arch./Engr. Address City/Zip Code y..s.?}-C*cr- Date: laI i OFFICE USE ONLY f'J 21 v?r FEES Occupancy 3 M -? Bldg. Permit 27400 Zoning R- I Surcharge 0 , 0 Actual Const V- N Plan Review 5 34,o J Allowable V-N SAC, City 100In # of stories SAC, MWCC L 50,00 Length 53'/z: Water Conn. &6A o0 Depth S2' Water Meter Q0,00 S.F. Total Acct. Deposit 30,o O Footprint S.F. S/w Permit 30,00 S/W Surcharge S'O On site sewage- Treatment Pl. L oG On site well _ Road Unit 70 00 MWCC System Park Ded. City water JC Trail Ded. PRV Copies Booster Pump _ APPROVALS Planner Council Bldg. Off. Variance SUBTOTAL Penalty Lot Change TOTAL Phone # f Xy_ agrees that all work shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. ---al GAr%A&C mwi? ?Oxz.z yyo IoK7,o? Zap loWoXlS=R(o00 Fps.- 2 -14 n? L Z ?g ZG. ? ?'3yL ; C®l l I`I x l?S m 25z Ir u z ? ??.,.) l??g x ly?l5ko? 13hw?? ? rF?? ?2 Kiy ? 1 (o B IX? q 1310 x 51 = GbKro Z No F.uwv4 412k 24 . I OL'a 14 X ly. I?(o ?y 10 = 10 151 X 5?= sa?d??I o yL 1 SZ? vov 0-70 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION DATE / OWNER I-14P OA nPC 1Wlfir SITE ADDRESS y? ?{p -// uk? f /?cr CONTRACTOR_ ! ! l I TT E ! T R ?FiT ?l? f Fn C? A) ST l i ADDRESS rJg S ?u a Sr r' 1) rlC- ?! .t 1 PHONE ll 5 L - i 2 5 DETERMINE WORKING SQUARE FOOTAGE OF EACH. 1. Total exposed wall area ... 2 711' sq: ft. x .11 - 9 q, 2. Total roof/ceiling area ... / -314 sq. ft. x •026 s Total exposed wall area above floor - (o NO a. Total wall window area ........................ 311 b. Total door area ................................ q c. Total sliding glass door area .................. d. Total fireplace wall area ...................... 0 e. Total wall framing area (average 10%) .......... ;.&q f. Total net wall area above floor ................ 175o g. Total rim joist area ........................... 2 3 3 Total exposed foundation area ° h. Total foundation window area ..... .......... 7-5 1. Total net foundation area above grade .......... 10 IF, 5 Determine "U" value of each wall segment. a. 311 X Intl ? /, ?7 7`) - F'7 7. / b. ?9 X $fu" C)7 12.. 7 C. y3 X "Ulf r 1/Z - b r;' / d. 0 X flu" - 211 y X fluff 1 ! - 2J 9 .0 f. 1 / r X ll ell , Oq3 L/ Wo. 6 g. /33 X Ifull o?ay - lc?, 3 h. 75 5 X ffull L. L g. 5 X fluff ,. 0 8 "1_ 'J. 6- 3 . ...............................Total ° L If item 113 is the same as, or less than item 111, you have met the intent of SBC 6006 (c)2. -I- Page 2 of 2 Total exposed roof/ceiling area f.? 3 L/ j. Total etcgti-ght area .(?:3.$..Oltf.A.fi4-A- ?./? k. Total roof/ceiling framing area (average 107.).. 95.9 1. Total net insulated roof/ceiling area ......... /r/_!, / Determine "U" value for each roof/ceiling segment. j- 3 7 7 X flu" 02 r? q, Y/ k. 95,g x 11U11 a2?g 2. 5 i• r?la 1. ! x "D" 02 r 3 23, f 4 ..........................................Total ' If total of 44 is the same as, or less than A2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items A3 and A4 shall not be greater than the sum of items 01 and 112. 1. + 2. 3. _ + 4. -2- CITY OF EAGAN 3?c 3 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 S?DE57T?AI, FOR CITY USE ONLY PERMIT # Xa&0_5 RECEIPT # /o S DATE: o?O 9 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ADD ON REPAIR T OWNER NAME: SITE ADDRESS: OqC) ?JE _?2.! p pL?c LOT: BLOCK SUBD. ?S e??F1 INSTALLER: ADDRESS: Burnsville Heating & A/C Inc. o e Island Ave. So. CITY: Savage, MN 55"$1122 894-0005 PHONE #: FEES ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24.00(jq{_ ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $ 3c'- STATE SURCHARGE: .50 TOTAL: n / $ 3O IA? 0,--,r pkt sL6ENv- SIGNATURE OF PERMITT %OMMER cAxJ ruGaa&[dL; PLEASE COHELETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, . .....:........:........ APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ------------- CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BLOCK SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH 51,000 OF PERMIm cro. PROCESSED PIPING - $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: (SIGNATURE) CITY OF EAGAN CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # AA/?9. - RECEIPT DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ADD ON REPAIR OWNER NAME: _ SITE ADDRESS: LOT: ;W BI INSTALLER: ADDRESS: A COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 SHOWER 3.00 ?- WATER CLOSET 3.00 BATH TUB 3.00 3 LAVATORY 3.00 KITCHEN SINK 3.00 L LAUNDRY TRAY 3.00 3- HOT TUB/SPA 3.00 3 - WATER HEATER 3.00 3 - FLOOR DRAIN 3.00 3 GAS PIPING OUT. ,p, (MINIMUM - 1) 3.00 3 01D ROUGH OPENINGS 1.50 OTHER _ _ WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL S ST. SURCHARGE .5Q TOTAL: $ ?(J PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BLOCK - SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL: (SIGNATURE) CITY OF EAGAN CITY: L7rr1/Gpj, ZIP: -----------------, I ForOffi_ce'l)s'e I Permit#: I Permit Fee: ? Date Received: A--?PR ? g nno I I Staff: ? I ------------------ 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: l% Site Address: y()46 deel-iuond A,?/Cc Tenant: /))? Alvrrl_s6r1 Suite 9: RESIDENT / OWNER Name: Phone: Address/ City /Zip: UUy U /fee rr uvorl Place- Applicant is: _ OwnerContractor TYPE OF WORK Description of work: aaac-L LL tt-,i nd o" Construction Cost: ?)?) Multi-Family Building: (Yes-/ No X CONTRACTOR Namel ( KY?12er License - Address:/ /J7? ei-yaee_ ??G1 V City: /)?LL/%? State: ?7N Zip: ? rr`` / Phone: ?6Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 _ Minnesota Rules 7670 Category 1 _ Energy Code • Residential Ventilation Category I Worksheet New Energy Code Worksheet Category Submitted Submitted (J submission type) • 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? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and `supporting documents that you submit are considered to be public information. Portions of -( the information may be classified as nonpublic if you provide specific reasons` that would permitthe City to , conclude`tha fthe .are'2rade"secrets. 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. x e a c ? App rcant's Printed Name _ r Applicant's Signature Pale 1 of 3 SURVEYOR'S CERTIFICATE MITTELSTAEDT BROS CONST. 1 / W / e775?? I? a S 3 W.0774 % errs P BENCH MARX EXiSTf. rv TOP OF PIPE Eue • ns.O i \ Brae HOUSE are. E 26 143 N89-2457"E } . - e 1re 0 tJ 0 J M 1 sr9.s I f ? .o =?r W 1 ' O a' a 1 - I --i,ere L) O 0 0 i ''6 n j \ J ' 6I&A ,. eras 4 fj ?g I-Q ? as f-- 1W ((? _ Jss ` 614.1 f 10 7.4 1 on.7 n ? ?- n \ 3013 -- 32.34 7s.4 37.53 r "01 S85°47'33"E FX7571 .ere.i LO i HOUSEGi \9EMCH MAMf , TOP OP IT9 E LEV. • 960.41 N. a. lIF f-'.I.V? L3kL ?: .. v.. ?I l'l ? ( L 3 ?--- DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 661,4 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 573.'7 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- 651,9 FEET WE HEREBY CERTIFY TO MITTELSTAEDT BROS. CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 30, Block 3, ENGSTROMS DEERWOOD ADDITION, according to the recorded plot thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SUP,VE?t-D BY ME OR UNDER. MY DIRECT SUPERVISION THIS '%T'-I DAY OF JANUARY '199L PROPOSED GRADES SHONN WERE SIG TAKEN FROM THE DEVELOPMENT PLAN FOR ENGSTROMS DEERWOOD ADDITION, PREPARED BY BRW LAST DATED 6-28-88. rn x rn r 'o in p W w O ?m A v v n n z v z N -j p T m f o M o -z ?cni Z a ??, O M - R. HILL, INC. JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 a 812.884-3029 City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 L Use BL For Office Use. Permit #: Permit Fee: Date Received: Staff: INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Nati Site Address: ""t -J D'xl/tA a1) Tenant: Goy6,4A or BLACK Ink 3-71-13 Suite #: RESIDENT/ OWNER Name: LO1I. 3 (ti(,t71'- Phone: 6S(- 4°7' �j - cE20 Address / City / Zip: .beetate,) Ft' �cic+n. , /40 CS t?z_ CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact: Email: TYPE OFWORK PLUMBING (Within the building envelope) Sump Pump Repair SEWER & WATER (Outside the building envelope) X Repair Other: Other: DESCRIPTION. w, .. Description of work: S-)I"tit NI, ine Ss ko 44. &),C414) SLLKsr Sllbw. 6+aJ c6 aA uk t re. fi, FEES $60.00 I Each (includes $5.00 State Surcharge) TOTAL FEE $ * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground util ty damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qooherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with he 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 rot 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. x UO L. TjG.Gc Applican ' Printed Name � Applicant's gn t� Required inspections: Under Ground Rough -In Final `. PERMIT City of Eagan Permit Type:Building Permit Number:EA124955 Date Issued:07/15/2014 Permit Category:ePermit Site Address: 4040 Deerwood Pl Lot:30 Block: 3 Addition: Engstroms Deerwood PID:10-23900-03-300 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 . Tia Lindroth 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 - Logan S Jacot 4040 Deerwood Pl Eagan MN 55122 Weatherguard Construction 10860 60th St N Stillwater MN 55082 (651) 439-4320 Applicant/Permitee: Signature Issued By: Signature M ___ �. � Use BLUE or BLACK Ink ---------------, � For Offlce Use � � 1, I `��•f' I �^f+ ; Permit#:� �. Clt� ��d��Il � . . o. oo � � Permit Fee. � � 3830 Pilot Knob Road R E C E I V E D , � Ea gan MN 55122 I Date Received:�' 'a 9� � � Phon4: ;651)675-5675 SEP 2 g 1015 I Staff� � Fax: (651)67a-5694 I __________ � ��J 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: �� ►V�� --- �l Ol.Gei Tenant: Suite#: ��.� ��'� ,� ��"� � � � s�� .:,. ►vame: ��c,� �m��G"C-�l � ��t�� r�none: b I Z�8��' E�3 s Residentl0 a ne� � �� ' �` � � � �� ,��, �_�� Address/City/Zip: � � � � " :5t a s.,�4�.. ..,:�:'' . ' - ' . . . ``� �,; P` ' Milbert Co�pany Inc dba Culli a:�Water . WC641376 , � °� �. ' Name: . . g License#: � � � � � a� � � Ada�ess; �1801 50`� St East ��: Inver Grove Hgts. I� � ontracto� �� `"A� �� ' state: � Zi 55077 phone: 651-451-2��'1' �� P� .. �p ��' William R Milbert � � ��,� �, " ; Contact: � EmaiL• �'� _.: � �� _ � �� T��pe of�O[ �� —New eplacement _Repair _Rebuild _Modify Space _Work in R.O.W. f ��'. � �„ ��' � � ��'�,u, �. .� �,�.�,� �� Description ofwork: �� 'f RESIDENTIAL � ` � � ' �� '� � Water Heater �� Water Softener Lawn Irrigation(_RPZ/_PVB) Perm`it Typ ,� �� `� �_�� `� Septic System Add Plurr:oing Fixtures�Main/_Lower Level) .� � _ , �� m��,.�`� � _..�Nevs+ � vvat4.Tu^:�vr�.u�sd � � � �� { ��.� �" �v Abandonment � RESI��NTIAl.,F�ES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turna[ound*(includes$5.00 State Sur�.,harge) *Water Turnaround(add$200.00 if a 5/8"meter is required) � � $115.00 Septic Svstem New($10.00 per as buiit)(includes County fee and$5.00 State Surcharge) TOTAL FEES� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against undergroun�utility damage. : Call 48 hours before you intend to dig Co receiVe IocaCes of underground utilities: www.Qopherstateonecall.ora 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 t Eagan;that 1 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 wiU be in accorda�ce with the approved plan,in the case of work which requires a review and approval of plans. , X � ��C��`�n � ti"��,� ��,�.`�`_. � �x � � ��c��'�'�-�"�� ApplicanYs Prin ed Name Applicant's Signature . a �,��. . ,.. . a,. �. ._ � , . ., , . , , `�FO QFFI�� "� � s> e_ k� ' aS o � equirred Ins�e.c i, a s �r�..�e � �n. �, ir a t, „ .� . �� . y: �. .� ��Meter Related° �� ete 5iz "�" o� ,� �� ,:?tn 4,`t. �'✓:.*"cs.�s"�Jk.'a � ^ t `.ua'�af,�vt . � -.,_... .,- , � ` .—.-.. �� re,.-,.....,,.m.m.. _ .. .._.,�.. w �_. PERMIT City of Eagan Permit Type:Building Permit Number:EA133493 Date Issued:10/16/2015 Permit Category:ePermit Site Address: 4040 Deerwood Pl Lot:30 Block: 3 Addition: Engstroms Deerwood PID:10-23900-03-300 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Logan S Jacot 4040 Deerwood Pl Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature