4009 Deerwood TrCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
JILDING PERMIT Receipt #
be used for ?; Est. Value '122 r 00 Date At'A
Site Address '.. , ( !'1'
Lot Block k Sec/Sub. FNCSI4;'' S
Parcel No.
W Name 01-:" "IT 10 le,
3 Address -XY U
City `'"` LIS Phone 452.0567
I hereby acknowlege 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 Permitee
A Building Permit is issued to: V CT'j1'''
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
S.F. Total SAC, MCWCC U5.00
\?
OFFICE USE ONLY-??--- -
Occupancy R-3FEES
Zoning ° 1
(Actual) Const V_N Bldg. Permit 736.00
(Allowable) V-N 64.00
Surcharge
# of Stories
Length Plan Review
Depth 39 SAC City
S.F. Footprints
On Site Sewage Water Conn aoL: • VV
On Site Well Water Meter alt' • 00
MWCC System
X%
Acct. Deposit .30 00
City Water
PRV Required S/W Permit 20.
Booster Pump S/W Surcharge 1.00
Treatment PI "28.00
APPROVALS Road Unit 340 • `ID
Planner Park Ded.
Council
Bldg. Off. Copies
' a 3 s ' tf{?
Variance TOTAL
Per
it No. Permit Holder Date Telephone #
WATER m /
SEWER
PLUMBING F f
ELECTRIC
Inspection Date Insp. Comments
Footings 1
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. J;LN P/?yn
Isul.
6-647 71
c,
Fireplace L - - ^ 120
?0441-
Final Htg.
Final Pibg.
Const. Meter Plbg. Inspector- Notify Plumber
Engr./Plan
Bldg. Final nS
Deck Ftg.
Deck Final
Well
Pr. Disp.
Site
PERMIT #
• MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN i-- ;
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
'RACT PRICE: PHONE: 454-8100 For Office Use Only:
ddress r' ` 1r BLDG. TYPE WORK DESCRIPTION
Block Sec/Sub Res. E/ New
Name 4L Mult Add-on
Address Comm. Repair
,.._. 1 _/J/•Other
FEES
m
C
3
O
Name
Leo ?' M BTU
M BTU
M BTU
.,.2 . , . BTU
CFM
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
r (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE $ CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
- (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
FEE:
S/C:
TOTAL
FOR: CITY OF EAGAN
WM
Site
MECHANICAL PERMIT PERMIT #
CITY OF EAGAN RECEIPT # 6
3830 PILOT KNOB ROAD, EAGAN, MN 55122 : j
PHONE: 454-8100 DATE:
m Name
Address r rK ?,
c City J'4 - • i (- Phone
Name=7r r'
r'.
3 Address be
o city
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
PERMIT FEE:
SIC:
TOTAL:
BLDG. TYPE WORK DESCRIPT
Res. New
Mult Add-on
Comm.
Other Repair
FEES
RES. HVAC 0-100 M BTU
$24.00
ADDITIONAL 50 M BTU 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMIT) - 1.50 EA. ;
COMM/IND FEE -1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/.C PER EACH $1000.00 OF,PERMIT FEE)
FOR: CITY OF EAGAN
?r
CONTRACT PRICE:
I
PERMIT #
PLUMBING PERMIT
CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-8100
Site Address-
Lot Block
-Sec/Sub
Name
m _
Address -
C City Phone
Name
3 Address
O City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES, RATE APPLIES
MINIMUM - RESIDENTIAL FEE -$12.00
MINIMUM - COMM/IND FEE -$20-00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 S
Bath Tubs - $3.00
_Lavatory - $3.00
/Shower - $3.00 -
Kitchen Sink - $3.00
-Urinal/Bidet - 53.00
Laundry Tray - $3.00
i Floor Drains - $1.50 '
' Water Heater - $1.50
/ Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - S10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE '
STATE S/C:
GRAND TOTAL:
RESIDENTIAL
BUILDING PERMIT APPLICATION
0 q `[ CITY OF EAGAN
U 3830 PILOT KNOB RD, EAG
AGAN MN 55122
651-681.4675
New Construction Reaulrements
• 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas
(20•% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan it lot platted after 7/1/93
• Rim Joist Detail Options selection sheet (biogs with 3 or less units)
DATE
SITE ADDRESS qDD
TYPE OF
APPLICANT
STREET ADDRESS JoZ OU W
TELEPHONE #'(3;1 X35- 01('??ELL PHONE #
PROPERTY
MULTI-FAMILY BLDG -Y _N
_ FIREPLACE(S) _ 0 _ 1 _ 2
i (1 A STATE rA
FAX #
OWNE TELEPHONE #9-4
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _
(J submission type) • Residential ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ____
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor.
Air Conditioning
- Heat Recovery System
Phone #
Phone #
MAY 3 0 2002
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is cur ect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagar?Ardi a
Signature of Applicant
OFFICE USE ONLY
Water Softener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
d---2?
RemodeVRepalr Reaulrements
• 2 copies of plan
• l set of Energy Calculations for heated additions
• 1 she surrey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION"! yaa
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
.1 .,
1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
164 11
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: OFD GARS Valuation: ?Z8?000- Date: ED MAY 3
Site Address u0c, ?oonlil _?.. OFFICE USE ONLY
Lot _ Block / /1
Parcel/Sub C ,v ?®"Ll=z
.ate„
Owner hj-'P t s //s M f --
Address / 401 eG
City/Zip Code
??
Phone S? 0 S r7
Contractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Occupancy R-3 M-1
Zoning fZ_1
Actual Const V -N
Allowable -
# of stories
Length 59,
Depth 1313,
S. F. Total
Footprint S.F.
On site sewage
On site well
MWCC System ?
Ll-
City water
PRV required _
Booster Pump
APPROVALS
Planner
Council
Bldg. Off. 5/4
Variance
191,
FEES
Bldg. Permit 1?39,co
0
Surcharge 6Y.0
Plan Review 369.00
SAC, City OO,oc„
SAC, MWCC 5751
oc?
Water Conn 580.00
Water Meter O,oo
Acct. Deposit 30,oo
S/W Permit Zo,W
S/W Surcharge /,LUG
Treatment P1. Z ZS.C0
Road Unit 3t?J,po
Park Ded.
Copies
TOTAL 4 19 fi _ M
?5?w
NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building
permit fee. Processing time for sewer and water permits is two days once a licensed
plumber has applied for a permit at City Hall.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for SF DWG/GAR Est. Value $128,000
Site Address 4009 DEERWOOD TR
Lot 3 Block 1 Sec'Sub. ENGSTROM' S
Parcel No. DEERWOOD
IslName WESLEY CONSTRUCTION
a Address 9401 XYLON S
City MTN? NFAPOT.TS Phone 452-0587
o Name
U
ga Address
City -
Phone
Receipt #
N4 16421
5 19 89
OFFICE USE ONLY
Occupancy R-3 M--1 FEES
Zoning R-1
(Actual) Const V-N Bldg. Permit 738.00
(Allowable) V-N 64 00
a of Stones
Length 59'
Depth 39
S.F. Total
S.F. Footprints
On Site Sewage
On Site Well
MWCC System XX
City Water XX
PRV Required
Booster Pump
lw Name
Address
aow City Phone
I hereby acknowlege 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 o?Eaga
'' " u /•Z.r''
Signature of Permitee AJ
A Building Permit is issued to WF.91 FY CONSTRTTC TTON
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official 111SU,
+? a
4
APPROVALS
Planner
Council
Bldg. Off, Variance
Tertifirote of rrupunry
Citp of (pagan
Mrvartmmt of INUI o Awertion
Surcharge
Plan Review 369.00
SAC, City 100.00
SAC, MCWCC 575.00
Water Conn 5R0-00
Water Meter 90.00
Acct. Deposit 30.00
S/W Permit 20.00
SM/Surcharge 1.00
Treatment PI 228.00
Road Unit 340.00
Park Ded.
Copies
TOTAL 3,135.00
This Certificate 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:
Use Claesiri auon R F n W 4S /CAR Bldg. Permit No. 16 4 2 1
Occupancy Type P3411 zoning oindrt RI Type CML VN i
Owner of Building W= 0@ISnV-MCN Addrmgtioi SYIfi<I S, MS
Building Address 4009 UPOM TRAM L laity L3, B1, W.SLLMIS EEMM
U, AIIQJ 3, 1989
1
Building. Qina
POST IN A CONSPICUOUS PLACE
P * # J 2422 t
yT? _PIONEER LAND SURVEYORS- CIVIL ENGINEERS Mendota Heights, MN 55120
1f g
r engineering- 1-AND PLANNERS- LANDSCAPE ARCMTECTS ? 11 (612)
TTy II 681-1914
Certificate of Survey for:_ WESLEY CONSTRUCTION
5 lb* 41; 18" 81(4 4
? rvoArH
EAGAN
`?+i,)ymc„? \ REVIEWED
BY
? Z
DATE
\ \ W ?.
\ 1 \ zi 00=
Z K UT
D
ao?
\'o of \S s
a
\ 3a ; - °'
r ?\
g75 09. Do BY L '
R
ate
° EE??poO RAG
900.0 Denotes exislrn Elevation 0 0 - sE N i
Y ,'Xj0-0 Denotes profiled F/evah6rt Lower Foor E eva ion _ 876:6
Uenoles Orpinre( Ufiti? Easement Top o; BfockElevation ee3.46
- Denole-9 DraincYe rlow 4rrows Gar* Slab Elevation 883.33
O Ueriofes morrumeof
Bearins shown are assumed 5u?ec/ to Easetnen1s 01'RPc0rd
LOT 3 , BLor
lwv r EAtamoMs Daewoo Ago.
DAkorR coUNTr , MIN"Le§O--A
1 hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that 1 am duly Registered Land Surveyor
under the laws of the State of Minnesota. Dated this-244- day of -111f- A.D. 19'90
1? cafe :1 me = 40-Mef aid i4?1
?°7 89oi2 ,ol RoRr-.RT R. sll<ICn I_s. nec. No. tnnnt?--
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER
SITE ADDRESS
CONTRACTOR
2
Determine working square footage of each..
Total exposed wall area ..... ZS/C-G? sq. ft. x -11 = =6 7Y,1
Total roof/ceiling area .... .. sq. ft. x _026 =
Total exposed wall area above floor = a2?
a. Total wall window area ...................... ..... /O/,
b. Total door area .. ...................... ..... 7. 7 7
c. Total sliding glass door area ............ .. p
d.
Total
fireplace wall area....... ...... _
.....
e. Total wall framing area (average 10%)........
•?O
..... 2 26
f. Total net wall area above floor ............ ..... %i/y
.33
g. Total rim joist area ....................... -
..... /SG ;
Total exposed foundation area = F4?
h. Total foundation window area..... .............
i. Toal net foundation area above grade ............
Determine "U" value of each wall segment.
a. /0/./? X "U"
b. 37.77 X „u.,
C. ! X „u,f
d. X "U"
e. X "U.6
H?,~ 0
3 X ..If..
g. X olu .
h. - x I.W.
y9 = 52-s?
./z3 = y.GS
5-2 31' LV
y 70
i. ^yr X 1Ull
3.. ................................. .Total G74 C?/'
If item #3 is the same as, or less than item H. you have met the intent
of SBC 6006(c)2.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
OFFICE USE ONLY
PERMIT DATE
WATER PERMIT "4 2 ' SEWER PERMIT #
METER # G B.P. RECEIPT # 1
READER # B.P. RECEIPT DATE
METER SIZE
ISSUE DATE - PRV -BOOSTER PUMP
ADDRESS I ( I? .
BLOCK _I SEC/SUB r Gi. z zz-
Ir..T
S
NEW
RESIDENTIAL
- EXISTING
BER:
ESS: S O /Y 1 z . i 1 AGREE TO COMPLY WITH CITY OF
STATE "? ter. ZIP EAGAN ORDINANCES:
E: L .?'.Y' (n S U
, STATE
PERMIT REQUESTED
SEWER -WATER TAPS
COMM/IND
ZIP
SIGNATURE WHEN METER ISSUED
G? G .GsC
ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT 1
.RING DEPT. ., "? ?:.: ?-,s'? _ r ;?,?• (? _ ?? _ ? ? ?, , r ?j 1 .
WALL SECTIONS
V-.E Use 15% of opaque Wall area for
frame construction
1. r .4, film 6
2 /, a .? . YS
3. . i,nc es soft wood G.?y
s. 1 ra .tlti?5'i t soX ?.O®
6. Exterior air film = 0.17
Total IS.2 t/
11r,07
SILL
e ip
'00I D.1TxON
wall.
FRAME WALL
Construction R-Value
1.
2.
3.
4.
5.
6.
1. Interior air film 0.68
2. G' ?5 f?6CcY/ /9a?
3
.
4. ?I?iz ?ivrat Fa'J "N?f J Obi
5. 1"''11 A?%YJ /fi YJ'llh'? 4X 5, 90
6. Exterior air film 0.17
Total ^9
1. Interior air film 0.68
2.
3.
4. L~ ?o
?. f?c s• 6
_
6. Exterior air film 0.17
Total 7 's/f
SLAB ON GRADE
rrrr-
FIG. $3
• r,
rrr
FIG. 84 Irl 6• of _z '//!
_ '/!/
Y. x
/L! //? lr! .= lR
NOTES Indicate type, "R" value, depth and
placement of insulation.
A.
?/03?ec
03089
Request Bate lw! `. % / Cv
Roe, Rough-in inspegion
s _! Required? ? Ready Now {Will Nobly Inspector
JRLyes ? No ' ten Ready?
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.)
Name or No. Range No.
5
K6 r
(Company
L
Counti
Phone No.
sa -osB
Comractora License No.
41e -7 c/-Op -
or
v- i 3 7V 'rsss I
MINNESOTq STATE BOARD OF ELECTRICITY
Griggs,Jifu y Bid,. - Room S&,, THIS INSPECTION REQUEST WILL NOT
1821 University Ave., St. Paul, MN 55104 BE ACCEPTED BY THE STATE BOARD
Phone (812) 842.0800 UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
jl?3/8q REQUEST FOR ELECTRICAL INSPECTION EB-00oot.07
0- See instructions for completing this farm on back of yellow copy [? 410
0 3 0 8 9 -X" Below Work Covered by This Ranl,anr /
e Add Aep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Conlractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # CircuilsfFeeders Fee
Swimming Pool 0 to 200 Amps 8 0 to 100 Amps f
Transformers Above 200 _ Amps Above
100 Amps 1,
Signs __
inspectors Use only: TOTAL
3-0
Irrigation Booms /? u v .
Special Inspection `? ??• Ste'
Alarm/Communication -
Other Fee
I, the Electrical Inspector, hereby Rough-in
certify that the above inspection has
been made. Final
OFFICE USE ONLY
This request void 10 months tram
owl,
ROOF/CEILING
.
A
VENT
Vented Heat flow
up . .
FIG. N5
Neat flow up
.FIG. #6'...
rayu rill
Construction _ R-Value
1. Interior air film 0.61
2. EGA
3. /O' ?s?QfE AGO
4. Exterior air film (still 0.61
Total 39?
1. Interior air film 0.61
2.
3.
4. Exterior a is st
'Total
1.
2.
3.
4.
5.
Notes' Use additional sheets if more space
needed for details and calculations
vented
' - nUV-vL'N1'ED
Heat
flow up
PM. 07
/33G
Total exposed roof/ceiling area
J. Total skylight area............ e 10%)... / 3s' v
k, Total roof/ceiling framing area (averag ---?-- -
1. Total net insulated roof/ceiling area........ •.• r?-
Determine "U" value for each roof/ceiling segment.
X HURN
X "UCH ----?? -
.............Total ?.?.
If total of N4 is the same as, or less than #2. you have met the intent of
SBc 6006(c)l.
Alternate Building Envelope Design
he val
To utilize the total ?envelope nsystem method,than theusumeofaitems e01 and R.
sum of items #3 a vJ-7`? Q 3/ S7
1. + 2.
335.E ,9,/3
+ 4.
3.
?w" r
L-4 &-r- 4 ; 7?1?
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
-----------------,
?22 I
j Permit#: ? ?J I
ro
Permit Fee:
I
I I
Date Rec
? Staff: _
I
2008 MECHANICAL PERMIT APPLICATION JUL 0 l nub
,2 0`b 1?
Date: Site Address: q0q001, Deeregad ? ? ?? L I j
Tenant: [? "tiger f Jr?rN'71 S?uuitte#:
RESIDENT / OWNER Name: Eger ? C748, Cnn Phon t/-J1ml-1 7356
Address // City /Zip: tfcriq 0? r ROW TOO
CONTRACTOR Name: FC)6'5 M9( h 1101'Mif fliX pd #:
Addresss12-CC) oi 6(((R (_'(?(4 ic N.-d
City: J )i/ f?(,/State, t- Zip:55-3713
Pho eq?l-) C L?r ?5'7 Contact Person:
TYPE OF WORK -New Replacement -Additional -Alteration Demolition
Description of work:
PERMIT TYPE
RESIDENTIAL
Furnace
-7 Air Conditioner
- Air Exchanger
- Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
' HVAC units must be screened
under /Above ground Tank Install / _Remove)
" When installing/removing tank(s), call for Inspection by Fire
Marshal and Plumbina Insoscior
VTIAL FEES:
inimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
re repair (replace burned oul appliances, ductwork, etc.) (includes $.50 State Surcharge)
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value
$50.50 Minimum (includes State Surcharge)
- If P rmit F-g is less than $1,000, surcharge is $.50.
- If Perm! Egg is> $1,000, surcharge increases by $.50 for each =
$1,000 Permit Fee (i.e, a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTALFEE
x1%
Permit Fee
State Surcharge
TOTALFEE
I nereoy acknowledge that this information is complete and accurate; that the work veil be in conformance with the ordinances and codes of the City of Eagan: that
I understand this is not a permit, but only an application for a permit, and work is not to start with Is permit; that the work will be in accordance with the approved
plan in the case of work which requires a review and approval of plans.
x Unda -)ex YlanjeY x I?LU?1f
Applicant's Printed Name
r
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: 3/C/ / 3 Site Address: /2/00 _` Deer1Roeu4 1
Tenant:
Suite #:
.`.
1RESIDENT OW 'ER-
k ) Phone: �p,5--7---A5--q-735-6
Name: > ' c Y}
,1 --f��
Address / City / Zip: 60 - �;QP Y'tcc� ! Y � l Ea jQ
CONTRACTOR
S
Name: .Q I -� License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope)
X Sump Pump Repair
SEWER & WATER (Outside the building envelope)
Repair
Other:
Other:
� x
DESCRIPTION
Description of work: Caal r SUM fail pd$CA(y4t.
j
FEES
$60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.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 utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of 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 ofvyor,Jc which requires a review and approval of plans.
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Ap
Required Inspections: Under Ground Rough -In _Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115510
Date Issued:09/26/2013
Permit Category:ePermit
Site Address: 4009 Deerwood Tr
Lot:031 Block: 1 Addition: Engstroms Deerwood
PID:10-23900-01-031
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Luanne Yang
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 -
Roger W Jenni
4009 Deerwood Tr
Eagan MN 55122
New Life Contracting Inc.
814 Grand Avenue
St. Paul MN 55105
(651) 224-3442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177176
Date Issued:06/20/2022
Permit Category:ePermit
Site Address: 4009 Deerwood Tr
Lot:031 Block: 1 Addition: Engstroms Deerwood
PID:10-23900-01-031
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Sarah Nguyen
4009 Deerwood Trl
Eagan MN 55122
Rooster Exteriors Inc
986 Inwood Ave N
Oakdale MN 55128
(612) 382-4057
Applicant/Permitee: Signature Issued By: Signature