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4021 Deerwood Tr Use BLUE or BLACK Ink For Office Use I 9~a Permit City of Eajan I l Permit Fee: C / 1 3830 Pilot Knob Road I I Date Received: Eagan MN 55122 E C { 1 Phone: (651) 675-5675 1 Fax: (651) 675-5694 JUN 2 7 2011 i 2011 MECHANICAL PERMIT APPLICATION Date: Al L;7~Z( Site Address: ~ c)a, ~ Luood -Fv-- Tenant: Suite RESIDENT I OWNER Name: C~\1e~ h Phone: 1 Address /City /Zip: "Da i Dda-~ufiDCd r ✓Y1 VAS/ a CONTRACTOR Name: -AI-i !LSS C_cO License Address: \C.J 5 ~ lr~a2 ~'V City: PCLILAt j j State: MY---N Zip: Gs I C2 t Phone: ( :nLj lj 1 L4 I Contact: -TC1fY) tom: r /1°'ti''7 Email: New Replacement Additional Alteration Demolition TYPE OF WORK Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical trapector for itlformation on permitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE New Construction interior Improvement Furnace, - Air CoHditiwer Install Piping Processed,. _ Air Exchanger - Gas _ Exterior HVAC Unit Heat Pump _ Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ X1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge (i.e. a $10,010$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.om 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 !popxed plan in the ca of work which requires a review and approval of plans. Q Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By. Date: Required Inspections: --Under Ground _ Rough In Air Test _Gas Service Test , jn4loor Neat -Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink - - - - - - - Foi uffice use I Permit I_ I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I Date Received: ' Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: l Site Address: Unit Name: 1 n Phone' i'' fwff RESIDENT / )t - - OWNER Address / City / Zip: t' J J C" 3 1 i Applicant is: Owner .,-t " Contractor TYPE OF WORK Description of work: !I .a c4 Construction Cost: Multi-Family Building: (Yes / No,,._,~' ) Company: 1 r~ f~ Contact: I L>> a CONTRACTOR Address City: State: ? Zip: t Phone: IL Y License y Lead Certificate r " - If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes;of the City of Eagan; that ! understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that', he w6rk will be in accordance with the approved plan in the case of work which requires a review and ap{yroval of plans. f r' X t l t T 1 t its k- 4 x. Applicant's Printed Name Applicant's Signature r Page 1 of 3 ' DO NOT WRITE BELOW THIS LINE SUB TYPES F0 ndation Fireplace _ Porch (3-Season) _ Storm Damage Single Family Garage - Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) 01 of _ Plex _ Lower Level Pool Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement - Siding _ Demolish Building* Addition _ Move Building _ Reroof Demolish Interior Alteration _ Fire Repair _ indows Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 5GD Occupancy IRC -2 MCES System Plan Review Code Edition o07 SAC Units (25%_ 100% Zoning City Water Census Code 17 3y Stories Booster Pump # of Units Square Feet - PRV _ # of Buildings Length Fire Sprinklers Type of ConstructionWidth REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final 1 C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test ^Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL FE VS Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Pace 2 of 3 NOV-04-2010 THU 0823 AM JRDELDERS FAX No. 6516462634 P-001 Use BLUE or BLACK Ink f t j Permil lI, C. b y of Eap I Permit pee; o 3830 Pilot Knob Read i I Date Received: I Eagan MN 55122 I I Phone. (661) 676-6675 1 Staff: I Fax: (651) 675-5684 ! W^__-___--.___ 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Cry JAIC)UCI f t - Z~1/lite Address' f U 2-1 g `Gi I, / Date: .S Suite Tenant: RESIDENT I OWNER Name;. 1 W ~~r ~7 Phone: Address i City / Zip: Applicant is: ^ owner Contractor 3 )QV CI ca ~ TYPE OF WORK Description of work: ^I(, ~ ~`y Construction Cost; r "p Mult;-Family Building: (Yes 1 Na} CONTRACTOR Name. V License / city: Address; State: J212- Zip Phone: Contact,~,d'~'' t.ji~ ~vt Email:,_,11'>' ~ i ~"~l ~~/~9"~~)►7G•C~~. COMPLETE THIS ARI=A ONLY IF CONSTRUCTING A NEW BUILDING in the last 12 months, has the city of Eagan issued a permit for at similar plan based on a master plan? Yes ___No if yes, date and address of master plan: Licensed Plumber: Phone: Meehanicat Contractor: Phone: Sewer & Water Contractor: Phone: tha u'suti It aret)side►d t`O; b.,prXtr)/c info'ilntatf6n::''!?artiorls of 7ttS: r3 n► sir orfJng :claUri~ M?..._ s. „ hid Gi a. `ty~f fry . '"bon°1i'1gI ,be blassrfred:~es:=no~~pub!1 rf; you.~pro spec •the rnformal Y CALL BEFORE YOU DIG. Call Gopher State One cap at (651) 464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates df underground utilities. www.aophers teoneeall.or~ 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 will be In accordance with the approved plan In the case of work which requires a review and app val of plans. Applicant's Printed Name ppilo signature Page 1 of 2. PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA090232 Eagan, MN 55122 . Date Issued: 07/16/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4021 Deerwood Tr Lot: 6 Block: 1 Addition: Engstroms Deerwood PID 10-23900-060-01 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: huprovements 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. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Renewal Andersen Michael E Collison 1920 County Road C West 4021 Deerwood Tr Roseville MN 55113 Eagan MN 55122 (651) 264-4777 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature J. BUILDING PERMIT To be used for SF DWIGAR 1 049 Receipt # Date SEP 11 t g_ Block 1 Sec/Sub. W Name MITTELSTAEDT BROTHERS 3 Address 785 SUNSET €1'R City FAGAN Phone 458-9125 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 of Eagan Ordinances. ? r Signature of Permitee A Building Permit is issued to: MITTEL,STAEDT 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. Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199,1 PHONE: 454-8100 OFFICE USE ONLY Occupancy R'-3 M-1 FEES Zoning R-1 (Actual) Const VAN Bldg. Permit 808.00 (Allowable) V-N Surcharge 74 00 . # of Stories f Plan Review 4•? Length Depth SAC, City 100.00 S.F. Total SAC, MCWCC 575.00 S.F. Footprints S?.OQ On Site Sewage Water Conn On Site Well XX Water Meter 90.00 MWCC System - Acct. Deposit 3©•00 City Water i S P 20.00 PRV Required /W erm t Booster Pump S1W Surcharge 1.00 Treatment PI 228.00 APPROVALS Road Unit 340.00 Planner Park Ded. Council Bldg. Ott. Copies V 3,250.010 ariance TOTAL Permit No. Permit Holder Date Telephone # WATER / t? S€WER PLUMBING H.V.A.C. I7 I? -? / }- ?G1 d ELECTRIC Inspection Date Insp. Comments Footings I Foundation Ole- 9-73-?i?o Framing Roofing Rough Pibg. Rough Htg. ?? 3 S .?! 19 Isul. /Sl /Cl 4- Fireplace Final Htg. Final Pibg. Const. Meter Plbg. Inspector - Notity Plumber Engr./Plan Bldg. Final e Deck Fig. Deck Final Well Pr. Disp. . r PRICE: PHONE: 454-6100 For Office Use PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3630 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: Site Address - Lot m Name - Address _ c City Name - 3 Address _ 0 City TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent. Gas Piping Outlets # Other If) BLDG. TYPE WORK DESCRIPTION - Sec/Sub Res. New Mutt Add-on • ^ _ Comm. Repair R94-00071 Other Phone Phone M BTU M BTU M BTU M BTU CFM FEE: S/C: TOTAL: FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 . 1, (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) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN CONTRACT PRICE Site Address Lot C. Name- Address c City Name_ Address City PLUMBING PERMIT For CITY OF EAGAN PERMIT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT; PHONE 454-8100 DATE: , BLDG. TYPE WORK Block T Sec/Sub Res. New _ Mult. Add-on Comm. Repair Other FEES COMMAND. FEE -1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ a -4 Bath Tubs - $3.00 If 2 -4,L._ Lavatory - 00 Shower - $3.00 Kitchen Sink - $3.00 UrinaVBidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater $1.50 Whirlpool - $3.00 Z Gas Piping Outlets - $1.50_ (MINIMUM -1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. -$10.00 Rough Openings - $1.50 _ PERMIT FEE: STATES SIC- Y S?SQ 2 GRAND TOT L: /L" SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE SITE A2DRESS _ LOT BLOCK APPLICANT: ADDRESS:- CITY, STATE PHONE: ! METER YQa3J-3 3V PERMITDATE 9/11/39 CHIP #E G Ocl (p t'o q s ? PERMIT a 10888 METER SIZE ?S. nOc/l hemp RECEIPT #E C 3799 ISSUE DATE g s-?5 B.P. RECEIPT DATE 9/11/8q PRV _ BOOSTER PUMP PERMIT REQUESTED Ir .-4, WATER _ TAPS es :Z?SEWER Zoe, ,l • - COMM/IND ? RESIDENTIAL ZIP h 6J-2 Z5?-,LNEW _ EXISTING PLUMBER: Gyr/? ?? Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. ADDRESS: k w T Credit WILL NOT be given for Deduct Meters. CITY, STATE A?' :/ cam, /`1 ZIP . S - r - PHONE: 44 OWNERL I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANC ADDRESS: CITY, STATE ZIP PHONE: IGNATURE ?-HIENMETEW ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. CITY OF EAGAN NO 17 0 4 9 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' PHONE: 454-8100 BUILDING PERMIT Receipt # 3 To be used for SF DWG/GAR Est. Value $148.000 natp SEP 11 ,a R9 Site Address 4021 DEERWOOD TR Lot 6 Block 1 Sec/Sub. ENGSTROM' S Parcel No. W Name _ MITTELSTAEDT BROTHER 3 Address 785 SUNSET DR City EAGAN Phone 456-9125 a Name SAME 0 R09 Address Phone r W w Name Address a W 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 of Eagan Ordinances. Signature of Permitee A Building Permit is issued to: M .S A -D BROTHERS on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes an?dCity 1 of Eagan Ordinances. Building Official in QLI In IIt 11 a T.ertifirai,e al Cap of OFFICE USE ONLY Occupancy R-3 MM1 FE ES Zoning RR1 (Actual) Consl VVN Bldg. Permit 808.00 (Allowable) vN Surcharge 74.00 * of Stories 55' Plan Review 404.00 Length Depth 45' SAC, City 100.00 S.F. Total SAC, MCWCC 575.00 S.F. Footprints On Site Sewage Water Conn 580.00 On Site Well Water Meter 90.00 MWCC System ? ?? Deposit 30.00 City Water PRV Required S/W Permit 20.00 Booster Pump S/W Surcharge 1-0 0 Treatment PI 228.00 APPROVALS Road Unit 340.00 Planner Council Park Ded. Bldg. Off. Copies Variance TOTAL 3,250.00 mr r of "bing rrfion This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure fw as in compliance with the various i ordinances of the City regulating building construction or use. For the following.. Use r]>tsritrca0on SF M/GAIL awl. Pbrmit No. 17049 Oeroer of Madioa Address f 1 ddms Locality DEO§?M 14, M9 Due: SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCS. 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN 110tiq MULTIPLE DWELLINGS 2 SETS OF PLANS REGISTERED SITE SURVEYS - (CHECK WITH BLDG DIY.) 1 SET OF ENERGY CALCS. COMMERCIAL 2 SETS OF ARCHITECTURAL A STRUCTURAL PLANS 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CkLCS. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS i OF UNITS NOTES ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT 13 ISSUED.. SEWER 8 WATER PERMIT FEES AND ACCOUNT DEPOSIT FM WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. To Be Used For: C34S/_ ^Attsr Valuation: Date: Site Address i/p a / [JF?lLi.agy A 7/Ii_ Lot & Block I Ma 15 loss 24,./r? 144- vu J.OFFICE USF Occupancy R-3 M-1 Zoning 2- I Actual Const y-N Allowable V - N R of stories Length Depth Parcel/Sub ,??iyTylm t 5 EF ?: Owner Address City/Zip Code Phone Contractor /?1 rTTFc_ ?7Xl?dTi, Address ^j?<; Carry??tn City/Zip Code„ /ft, Jr5/? Phone 4e 5& ?VaA 5 Arch./Engr. Address City/Zip Code S.F. Total Footprint S.F. On site sewage On site well MWCC System te City water PRV required Booster Pump _ APPROVALS Planner Council Bldg. Off. ?ZI Variance FEES Bldg. Permit W,oo Surcharge uo Plan Review 404,00 SACO City 100.0? SAC, MWCC 5'75.oo Water Conn oD Water Meter 47c), 00 Acct. Deposit 34,01D S/W Permit 20100 S/W Surcharge I,oa Treatment P1. 220,co Road Unit 3 goon Park Ded. Copies SUBTOTAL Penalty TOTAL ' Phone 9 VALUATION Gq0 Zo xl? - ZZo h IL ?? xz2= y ?B X38 x 15= 9s?o Btm-r, 14K44r 61(o it xiq = 4y 9X42-37g ???( 16. Zo9 6u9= 5LI 13 oo x I LI ? x? '?? 3 ? 0 1?(Zl?lo? 13?? to 13zN' 647-00 Zr. p ?or? Iyxy2 - S5? ?? K a? = LrSq IoGI )c?? LI?D? DATE EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION 1 THC G.f-rrA"y OWNER LF?w>T ? °{- Ti l???sfQ.J a9? ? Sao y SITE ADDRESS yip a ,c ry?? r2 Aic CONTRACTOR iA L LL l <??-7- Oj i? IY- . ('o.US7` 101 _ '. ADDRESS_'j 5 Cv, .?? < I v PHONE __j 5L ---I a DETERMINE WORKING SQUARE FOOTAGE OF EACH 1. Total exposed wall area ... U go( sq. ft. x .11 -? 2. Total roof/ceiling area .... / y73 sq. ft. x •026 . L Total exposed wall area above floor ° 2_,7q,7 a. Total wall window area ......................... q 3 p b. Total door area ................................ 3 q c. Total sliding glass door crea .................. y 3 d. Total fireplace wall area' ...................... y e. Total wall framing area (average 10$) .......... 2 15 f. Total net wall area above floor ................ y Z g. Total rim joist area ........................... 7 yo Total exposed foundation area ° C6 y h. Total foundation window area ................... - i. Total net foundation area above.grade .......... y Determine "U" value of each wall segment. a• 3 3n X 'fUff =-951 - I IL.2- b. _ 39 X fluff .07 ° .7 C. '13 X flull L/ 2- d._ '16 X fluff .0Y-3 ° 2,f e._ 255 x ,full z5.o f 19,92- X fluff , O`1'3Y '718 g• 2 qv X fluff , o'N ° / o, & h. - X fluff s i._ I q X ,full . 0'71 L, q 3 . ...............................Total I L?e? If item #3 is the same as, or less than item 1l1, you have met the intent of SBC 6006 (c)2. -1- Page 2 of 2 . . . Total exposed roof/ceiling area J. -Tot-al-sky}ight---area ..'rN. A'Vo F ............... 2 9 ? . k. Total roof/ceiling framing area (average 107.).. '7 y 1. Total net insulated roof/ceiling area ......... /o 3.!i Y??• F/lAM'1V6 10 2RIY CIEUNfs 20 Determine "U" value for each roof/ceiling segment. /Y1 20 .Ores /, 3 J. X fluff .(12 5q n 17.5 k. 7 2 R fluff ,0258 ?. 9 I ._ /( 91? .X Ilull /jL 18' a 23,7 4 ..........................................Total If total of 04 is the same as, or less than 62, you have met the intent of SBC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items 03 and 114 shall not be greater than the sum of items Al and 112. 1. + 2.. '. a 3. + 4. -2- 066E 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) III? a Lt !;;C`7:77R fi =jj i j CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681.4675 a. i-,,r, `?)"\ RemortUReocdr Reaulremis t ?/?),-75 > 3 registered site surveys stowing sq. ft of lot, sq lt. of house d -C ,)D 2 copies of plan and 9Q roofed areas 420% mrnamum lot coverage allowed) o ?3 1 set of energy calculaRons for heated odditlons > 2 copies of plans (show beam 3 window sizes: loured find. design: etc.) 1 site survey for exterior additions & decks > 1 set of energy calculations > 3 copies of hee preservation pion It lot platted after 7/1/93 DATE: Y _ f - c X0 CONSTRUCTION COST: 9 ?- CJ CD DESCRIPTION OF WORK: f-f-- "f- ( P sjw STREET ADDRESS: qd3 ( ff LOT. --4- BLOCK: 1 c??voc32 I r' SUED./P.I.D. #: PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: ` W 1 s o?. -yk,?k-Q- Phone Lost?f First Street Address: ) 0,9- f ?P?w° City state: ZIP: Company, +,- S `1 (1 x 5 O?fi Phone #: 5 4 g ( y , (area code) Street Adpdress:"i "I City )J oy 1 i?r r s F Ole State: Company: y ! ? - _ Name: Telephone #: ( Street Address Registration C City State: Sewertwater licensed plumber (if Installing sewertwater): Phone #: ZIP: SS4fa-O Zip: I hereby acknowledge that I have read this applicotlon, state that the Information Is correct, and a imply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received Tree Preservation Plan Received OFFICE USE ONLY Yes No Yes No Not Required License # S 60 Exp. 3 -,31'-0/ B?w?93- CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT # DATE: 3 o20 .9 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------- WORK DESCRIPTION NEW CONST ADD ON REPAIR OWNER NAME: SITE ADDRESS; L& &,?o/ WaLa4l A LOT: BLOCK _L SUBD. INSTALLER: B?f/L!r/?G+!' ADDRESS: 97:0 `loop /Crp /J? CITY: /? PsJ ZIP: 5 / Z PHONE #: ",? - ?c5 /? ? SIGNATURE OF PERMITTER DWELLINGS & ------------------------------- COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 _ KITCHEN SINK 3.00 _ LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 _ WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING "OUT. (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 OTHER _ _ WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL S / 5. Ov ST. SURCHARGE .50 TOTAL: S I . 6 0 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 18 STATE SURCHARGE TOTAL: (SIGNATURE) CITY OF EAGAN CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN CLAIMANT LIGHT ELECTRIC ADDRESS 1130 WEST 51H STREET Location An91 nEERwnnD TRAIT. L6. B1. ENGSTROM'S DEERWOOn Receipt No./Date -C017888/03-20-92 Reason for Refund REFUND OVERPAYMENT PER CONTRACTOR'S RF.ONFST_ Type of Refund Electrical Permit 01-3211 $ 3.00 Plumbing Permit 01-3212 $ Mechanical Permit 01-3213 $ Surcharge 01-2155 $ Water Connection Permit 20-3713 $ Sewer Connection Permit 20-3743 $ Account Deposit 20-2252 $ a Utility Account Over-Payment 20-2250 $ Other, $ TOTAL S, 3.00 I declare under the penalties of law that this account, claim or demand is just and that no part of items been Daid. 04/02/92 Date w /. .{ n 9!1/-/VAX °-° 463 p 43 /& 4 equest Date ft tion 1pre reb4 ...???!!!''''''''' ?Reatly NowNoector es NO When Reatlyl I icensed contractor -D owner hereby request inspection of above electrical work at: Job AcOress Street Box or Peelle No I City ZI 02 C Secuen No. Township Name or No. Range No. Oou CCClpant(PRINTT,, Phone No. PO Wer $Ilppli2r Address 0ak-G S l er E'edncal Conv ctor IC oany Name Curl License No. ????? Mae,. , c e Com acnr or Owner Making Instellaze n) v ?u AWhunrze gl , ,, iCunlraC(or'Ownae Making Inslallahpm Phone Numb. 5... ?1C6 , I(L? 4.1-3 IF- 31 ESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. S t. Paul. MN 55106 UNLESS PROPER INSPECTION "I IS Phone(612)642-0800 ENCLOSED. 3/?0/g? INSPECTIION .'z ES-0000108 EQUEST ELECTRI CA L R FOR g e h ? ' Do See v c 0 43463 "X" Below Work Covered by This Request fs ew, AddI Rep `f 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 Ispeceyl Compute Inspection Fee Below : Cont,actors Remarks "?^""?` # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 tc 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Ino,roors Use Only: TOTA Irrigation Booms Q" v Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. 1. the Electrical Inspector, hereby Rough in Date certify that the above inspection has been made. F,nal 7' Fee ate , L /. '7 7 OFFICE USE ONLY This reques: voic 18 months from MINNESOTA STATE BOARD OF ELECTRICITY Griggs-Midway Bldg. - Room S-/T3 1821 University A., St. Paul, MN 55104 P110ne(612)642-0800 REQUEST FOR ELECTRICAL INSPECTION 1? See instructions for comr'?ling this form on back of yellow copy. 7 4 7 4 5 3 X" Below Work Covered by This Request Heater Compute Inspection Fee Below. # Other Fee Pool Other Fee -F- f. the Electrical Inspector, hereby certify that the above inspection has been made. IFFICE USE ONLY his request void 18 months 1mm Service Entrance Size Fee 0 ?^ E9-00001-07 y Fee I lul L THIS INSPECTION REQUEST WILL NOT BE ACCEPTED By THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. SURVEYOR'S CERTIFICATE i a w [tom-- /12a 1,0E o¢?SO v?? I ?1aS? I ` w s,?`,w"?o?•1103 g S 6 LIT / Oil T \••, r? DR iAGI r F-E,R PLA f ?9 5\ 505M58 /! lS/ '^101 V~ S a r "1 O ? 6- 1 Fs v 6 esl7o q a? a? (S y"pto- of s P'\ P` 1 yid`6 SEA ?o MIT eLSTAEDT 13¢03. COAST. N 1 r ti m, 1 N B S s I I ? w % 8 ./ l ,- e 1 5 a D/ o 0 a ,e7 5' Yo SenX'". c Rply oee 9-70. EL 63 1 i o i ?? PAL 41 - DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH m 3o FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - SSZ Li FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 8-7*4 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK m 88Z,8 FEET WE HEREBY CERTIFY TO MITTELSTAEOT ¢QOS, C09sr. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot (o , Block 1, ENGSTROMS DEERWOOD ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 7TH DAY OF AL)GLIsT• 1984. PROPOSED GRADES SHOWN WERE TAKEN FROM THE DEVELOPMENT PLAN FOR DEERWOOD, PREPARED BY BRW, LAST DATED 4-4-88. r. SIGNED: JAMES R. HILL, INC. BY: 01"'l, C-? k?'n? JOHN C. LARSON,.LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 2 r C DO W 0 it N ' 7J ? ? O L a r m W n Q u T En o > O M O ? Z 00 0 ( IA U m m A .0 m y ) j James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 ??57 f 6i8w r For OffIce US 1 I C/ Permit Cito En y 1 Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2009 RESIDENTIAL BUILDING PE,,RMIT APPLICATION Date: Site Address: L%%d ? f✓!~ Tenant: Suite RESIDENT/OWNER Name: - 6-5 071 Phone: ~ 1 ~ ~ Address/ City/Zip: Applicant is: 1,K, Owner Contractor TYPE OF WORK Description of work tic liJ 1 9. a Construction Cost:' Multi-Family Building: (Yes / No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted 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 non-public if you provide specific reasons that would permit the City to conclude that the are trade 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 jtL ern x 1 / Applicant's Printed Name A ' an s Signature Page 1 of 3 PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA096159 Date Issued: 09/28/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 4021 Deerwood Tr Lot: 6 Block: I Addition: Engstroms Deenvood PID:10-23900-060-01 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, 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 S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Renewal Andersen Michael E Collison 1920 County Road C West 4021 Deenvood Tr Roseville MN 55113 Eagan MN 55122 (61)264-4777 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Use BLUE or BLACK Ink For Office Use 40' I Ea Permits. 1 ~(QQ~ Clt of Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Z R ived: 3- Phone: (651) 675-5675 I J Fax: (651) 675-5694 i - 2011 MECHANICAL PERMIT APPLICATION Date: Site Address: D t Vt.`JC t TF `I Tenant: Suite RESIDENT I OWNER Name: IY1 \ kE CCU t V) Phone: 3CXn ' S t c l C J rt t, ' .1 - c ~c~e~ i~i7 6'1 i Address/ City/Zip: CONTRACTOR Name: License#: Address. t City: State: YY1ir1 Zip: I Phone: ~S t Wit' y-t Ll 1 Contact: Email: TYPE OF WORK New ~eplaoement Additional Alteration Demolition Description of work: =Q .2 NOTE: Roof mounted and ground mounted mechanical equipment Is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace New Construction - Interior Improvement _ Air Conditioner _ Instali Piping T Processed _ Air Exchanger _ Gas _ Exterior HVAC Unit _ Heat Pump _ Under /Above ground Tank Install / _ Remove) " when insta8ing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, eta) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ X1% $55.00 Minimum (includes State Surcharge) $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE 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.gooherstateonecall.om 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 awed plan in thhee case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By. Date: Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test _ _tn-ttoor Heat Final Exterior WAC Screening Inspection yi7�q4�' n6 r�`F r' � . .� 6 � �.`�� �.ar�,.�i,;a � 7 �� ��, � � � ��� � � �� . .r . . . . . ��. , � .��� i�. . , .. ••'� R.��.,/ _ ' . . . � � � . . . , . . . � .. . . . . . ' . . �� ' Use BI.UE�r BLACK Ink : : ---------------- . 4 � For Of�ce Use � '� • 1 � I �, ^. ! V�1►� Ol 1J���l1 i Permit#: i ' � Perr�`d Fee: ��� i 3830 Pilot Knob Road ' Eagan MN 55722 � Date Received: � . . Phone:(651)675-5675 I I Fax:(657)675-5694 I Staff: I I I �����������������J . . 2014 RESIDENTIAL BUILDING PERMIT APPLICATION � Date: ' 4�� L Site Address: --�� '�U` �'� � ° 1 k.t�Ll ►'L unit#: . � Name;_ 1 �G.� 3- , lwSCr� Phone: `� 3D �rv� C�sL� e C��� � �531 , •� Residentl '/ .,�•.�. Owner Address/City i Zip: �s'�oZ 1 t�,� �h,�,� TrL- 6,�„�,,� rv.�,, �S 1� ' . �; • , � Applicar�is: Owner �Contractor Typ@ Of WO�k Description of work: L.[�> '"'�-(� � '- Construction Cost: �o�:�� Multi-Family Building: (Yes /No� 'f � CompanY� � ����- �B' 11n,S Contact: ! L�� ��5�. � � ` . /����( �tJ g� �e�1� G�tGe �d� c��: 1�,,�� �,�.� (� �� � Contractor Address� State:jp ^.Zip: �( Phone: ,�—�I91'�r��,a�i: �� <r�-��'�Svr,, (�6�,��, �,�„_ • License#:� � '�J 1 �� 7 Lead Certificate#: N+�'� `T���� —"( �', If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) , , �- P� �'�v�( e��'�r ��'''� I �?8 . ' � . COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING , In the last 72 mc�nths,has the City of Eagan issued a permit for a similar plan based on a master plan? .. _Yes"��fo If yes,date and address of master plan: _ ' • Licensed Plurr�ber: Phone: • ' Mechanical Contractor: Phone: , Sewer&Water Contractor: Phone: , �,,..,�, ,. ,. .� . • NOTE:Plans and supporting documents that you submit a►�e considered to be public information. Portians of ;� . the information may be classified as non-public if you provide specific reasons that wou/d permit the City to � � - conclude that they are trade secrets. ' � •` � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. (;all 48 hours . • before you intend to dig to receive locates of underground utilities. wwur c�o herstat�onecaEl.orr� I hereby acknowle�': a� ``s information is complete and accurate;thatthe work will be in conformance with the ordinances and codes of the Cityof • Eagan; that I unde�..:,^��' .us is no4 a permit; bu# only an application for a permit, and work is not to start without a permiQ; that the work will be in • � Pp P � � RP p accordance with the a roved: Ian in the case af work which r uires a rev�ew and a roval of lans. E�Sterior wo authorizsd by a building pertnif issued�in accordance with the Minnesota State 8uilding Cod�must be " mpleteaf within 180.` . . days bf pe�iss,�ance. , .: , � ' , . , ..� ��ls � X � , . X �. Appl�canYs Prir.,ted Name Applicant's g . urs� � � . : • Page 1pf 3� �; . # . r PERMIT City of Eagan Permit Type:Building Permit Number:EA137733 Date Issued:07/19/2016 Permit Category:ePermit Site Address: 4021 Deerwood Tr Lot:6 Block: 1 Addition: Engstroms Deerwood PID:10-23900-01-060 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 - Michael E Collison 4021 Deerwood Tr Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature ty of Eaaa 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 7(0 Permit Fee: l Date Received: Staff: J 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9/14/2016 Site Address: 4021 Deerwood Trail Unit#: Name: Mike Collinson & Leslie Carr Address /city /zip: 4021 Deerwood Trail Applicant is: Owner 1 Contractor Phone: 612-306-4531 ;//,,ory,/,/, ////, / Description of work: Replace siding. Construction Cost: $37565.04 Multi -Family Building: (Yes / No ✓ ) Company: Kreuser & Sons Contact: Rod Kreuser Address: 1469 N. Birch Lake Blvd City: White Bear state: MN zip: 55110 License#: BC131197 Phone: 651-429-9446Email: rodkreuser@comcast.net Lead Certificate #: NAT -43507-1 If the project is exempt from lead certification, please explain why: House was built after 1978 and was re -sided in 2011. COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor: Phone: 0/tea ayiio• //1> 3 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.gooherstateonecall.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 of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. )(Rodney Kreuser Applicant's Printed Name Appli ''s Signature Page 1 of 3