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4029 Deerwood Tr Use BLUE or BLACK Ink 111100 For Office U j Permit < ~U City of Ea Ed~ I o, oa I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 S- 0 p_ I Date Received: ~ Q ~ I I Phone: (651) 675-5675 C~~ I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: ZL_' / 13:nye~ 6 Phone:/ RESIDENT / OWNER Address / City / Zip: ra J ~ Applicant is: Owner Contractor TYPE OF WORK Description of work: 4a: _ C Construction Cost: Multi-Family Building: (Yes / No ) Company: 41"Pf~ Contact: Address: C-_ A,.'6ty: CONTRACTOR -T State: Zip: Phone: License /Q-- Lead Certificate Does this project require Lead Remediation? ❑ Yes ❑ No (see Page 3 for additional information) If no, please explain: 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 they 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.or-q 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 with accordance the approved plan in the case of work which requires a review and approval of pl ns. X_ x Applicant's Printed Name Applicant`s Signature Page 1 of 3 PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA083754 Eagan, MN 55122 . Date Issued: 06/23/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4029 Deerwood Tr Lot: 8 Block: 1 Addition: Engstroms Deerwood PID 10-23900-080-01 Use Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840. Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Angell Aire Patrick E Appel 12253 Nicollet Ave S 4029 Deerwood Tr Burnsville MN 55337 Eagan MN 55122-1885 (952) 746-5200 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 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 -? 18384 Receipt # 1 T_ Date SEP 18 1 g 90 BUILDING PERMIT To be used for SF DWG/GAR Est. Value $139,000 Site Address 4029 IDBEIRiiOOD TR Lot 8 Block 1 Sec/Sub. ENGSTRQEiS Parcel No. W Name BRIAN L THOIRSON HOMES o Address 4466 WEDGEWOOD DR City EAGAN Phone 454-0644 City Phone Ww Name Address <W City Phone I hereby acknowlege that I have read this application and state that the information is correct and agree tQ comply with all applicable State of Minnesota Statutes and City of Eagan Orrddinanncc s.; Signature of Permitee A Building Permit is issued to: BRIAN L THORSON MMES 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 OFFICE USE ONLY Occupancy R-3 M-1 FEES Zoning i--1 VAR 776.00 (Actual) Const Bldg. Permit (Allowable) V-R 69.50 Surcharge # of Stories ?i Plan Review 4. Length Depth 42' SAC, City 100.00 S.F. Total SAC, MCWCC 6N•0 S.F. Footprints W C 625.00 On Site Sewage ater onn On Site Well Water Meter 90.00 MWCC System x 30.00 City Water $ Acct. Deposit PRV Required SJW Permit 30 oo i Booster Pump SrW Surcharge : 9q 252.00 Treatment PI APPROVALS Road Unit 355.00 i Planner Park Ded. Council Bldg. Off. Copes Variance TOTAL 3,432.00 Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. d, e . f ELECTRIC Inspection Date Ins . Comments Footings 1 , f -10 &?X Foundation t Framing a Roofing Rough Plbg. -Z-? O 3 Rough Hig. / ??/30( f(j Isul. AA2 Fireplace ' Final Htg . Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final 421? Deck Ftg. Deck Final Well Pr. Disp. Site Lot. MECHANICAL PERMIT PERMIT # CITY OF EAGAN RECEIPT # r?'f 3830 PILOT KNOB ROAD, EAGAN, MN 55122 MRICE: PHONE: 454-8100 DATE: Block Sec/Sub o Name Address _ c city Name _ 3 Address p City & Air Phone BLDG. TYPE WORK DESCRIPTION Res. ti New ® - Mutt Add-on Comm. Repair 1 i Other 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. COMMAND FEE -1 % OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 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 SIC PER EACH $1000.00 OF PERMIT FEE) TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. 3 - ° I M BTU Vent CFM Gas Piping Outlets # ' n Other PERMIT FEE: S/C: TOTAL: SIGNATURE FOR: CITY OF EAGAN CONTRACT PRICE Site Address Lot 91 m CD Sec/Sub Res. _ 4 New Const. %Z Mult. Add-on Comm. Repair w ?D Other Phone FEES COMMAND. 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 PER EACH $1,000 OF PERMIT FEE) OF EAGAN LUMBINU PERMIT For City Use Only CITY OF EAGAN PERMIT # O 3830 PILOT KNOB ROAD, EAGAN, MN 55122 I RECEIPT +an.? PHONE 454.8100 DATE: RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL _j - Water Closet - $3.00 $ -1 Bath Tubs - $3.00 Lavatory - $3.00 /t n r? Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 _ Floor Drains - $1.50 Water Heater - $1.50 Whirl ool - $3 00 n p . Gas Piping Outlets - $1.50 , _ -- (MINIMUM -1 PER PERMIT-NEW CONST Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 - U. G. Sprinkler System - $12.00 PERMIT FEE: La. STATES S/C: GRAND TOTAL: INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: I N?.i'. I KuFI'. 1,11 f k61??i?11 PERMIT SUBTYPE: II Ili : :,r4)Ni, II '.I1 1N 1't 1i+, IF F1'Al.:All 1.1 LMI APPLICANT: ?. I .' t 'I') 1., 0" 4 / TYPE OF WORK: I H"111 A I I ,?N 1 INAI Al II VA i,nN qhl It'll U?11;•t l_? 1 ilh ANY III IIMI,INI, Ilk , 1 t+ ltrl? All Iwi i I I Permit No. Permit Holder Date Telephone # S/W PLUMBING FA- I- 3-? HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. taut. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pr. Disp. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: ti! I Ir4filtt(1 i fr tI1. I {11M 111 ! Itlflll)If PERMIT SUBTYPE: 1 1 i,, , i i . ; ! it MI I I N11 Ir INAI F L ON :CORD PERMIT TYPE: Permit Number: Date Issued: APPLICANT- I,, i •1`10 1 #'1 TYPE OF WORK: FI?AM I N11 NI W lilt 11 11 1 Mi M.'1 1 it gr, l 1 Qf /SI; Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC O° ELECTRIC Inspection Date Insp. Comments Footings 1 alot Foundation Framing Roofing Rough Pibg. Rough Htg. [Sul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter EngrJPian Bldg. Final Deck Ftg. GG n y/ 1 4M AAI Deck Final Well Pr. Disp. VI CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE 5EP 18. 1990 METER CHIP # PERMIT DATE ()9/19/90 PERMIT # 11651 METER SIZE OC B.P. RECEIPT # C 10007 ISSUE DATE - B.P. RECEIPT DATE D311 U10 - PRV - BOOSTER PUMP SITE ADDRESS 4029 -c',L 1..'0n I LOT L, LOCK 1 SEC/SUB s ?• :1'.0' : i t. Res 4 i? APPLICANT: ADDRESS:- CITY, STATc PHONE: - ZIP PLUMBER:' i&-7 P"S r ft-h l r ADDRESS: CITY, STATE -! c ' f ' MN ZIP ff WZ3 PHONE: kb! ' 6 F 2 CITY, PERMIT REQUESTED -K SEWER X WATER _ TAPS; COMM/IND - RESIDENTIAL: NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. I AGR E TO COMP Y WITH CITY OF CAD ORDINAN ES SIG URE WHEN METE ISSUED FOR INSPECTIONS. FOR STORM OWNER: BRIAN L ThQRE0?, ADDRESS: 4466 WEED ;i:W00D 1; . BUILDING PERMIT To be used for SF DWG/GAR Site Address 4029 DEERWOOD TR Lot 8 Block 1 Sec/Sub. ENGSTROMS Parcel No. W Name BRIAN L THORSON HOMES 3 Address 4466 WEDGEWOOD DR o City EAGAN Phone 454-0644 Name Address Name _ Address City Phone I hereby acknowlege that I have read this application and state that the information is correct and agree to comply with X11 applicable State of Minnesota Statutes and City of aan Ordinance Signature of Permitee A, ?-b111 A Building Permit is issued to: BRIAN L THORSON HOMES 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 LM4 t.Oi 1411 11 Receipt # Let, I )C-! - I Date SEP 18 , 1990 OFFICE USE ONLY Occupancy R-3 M1 FEES Zoning R1 (Actual) Const 'L--N Bldg. Permit 776.00 (Allowable) VN Surcharge 69.50 # of Stories Length 611 Plan Review 504 - 00 Depth 49' SAC, City 1 00 - 00 S.F. Total n SAC, MCWCC 600-n S.F. Footprints - On Site Sewage - Water Conn 6 9 5 _ no On Site Well Water Meter 90.00 MWCC System X Water City 0 Acct. Deposit 30.0 PRV Required S/W Permit 30.00 Booster Pump SM Surcharge - 50 Treatment PI 252.00 APPROVALS Road Unit 355.00 Planner Council Park Dad. Bldg. Off. Copies Variance 0 TOTAL 3,432.o /(/ POST (N A CONSPICUOUS PLACE CITY OF EAGAN ND 18384 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Phone L 4 3 r7ss N $ / ?i O ov Req est Date Fire N Roughin Inspection Required? D Ready Now $r Wil^ Notify R ??to U (?? D No en eady Lensed contractor ] owner hereby request inspection of above electrical work at: on Address (Sire Box or Route NoJ c. ?.. City Section No. Township Name or No. Range No, cl ty / Occupant (PRINTI C7& cv- Phona Nc. Power Supplier Address El it al Ccniracm: i Compa.ng'NBma) Contractor's License No. ' nt M r dr r aking Installation) % rrr f AContractdro rr.r M g Ins r von ? i Phone N mber -2 -76 M44407A B ATBOARO OB'ELECTRICITY -v"THIS INSPECTION REOUEST WILL NOT Griggs-Midway Bldg. - Roam S-173 p III I ON )?60/ 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 .T° ??, EB-00001-08 I? See instructions for completing this form on back of yellow copy, 0 ?. 9 Q .Q X" Below Work Covered by This Request ew Add Rep. 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 Otherlspeafyj Contractor's Remarks'. Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to IOU AMPS Transformers Above 200 --- Amps Above 100 _ Amps Signs inspectors Use Only'. OTAAjL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M S. I, the Electrical Inspector, hereby Rough-in Y certify that the above inspection has been made. Final -' ; ?- Di OFFICE USE ONLY This request vo-d 18 months from - Grlgge-MlEway Bldg. - Room 5.113 , 1621 University Ave.. St. Paul. MN 55101 phone (612) 602-080o 10670 REQUEST FOR ELECTRICAL INSPECTION ? See insuuclions fur completing this form on back of yellow copy. THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. X" Below Work Covered by This Reouest ?"o-? ??4 EB-Ix10p1 ?p8 ew Add ep. Typeof Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial race Farm Air Conditioner Other(specifp Contractors Remarks. Compute Inspection Fee Below: # Other Swimming Pool Transformers Signs Fee # Service Entrance Size e # Circuits/Feeders Fee 0 to 200 Amps 0 to 100 Amps Above 200 _ Amps Above too _ Amps Inspector's Use Only TOTpL Irrigation Booms O r Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDER Other Fee ED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONJAP. I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in Final Date -?S De '? U OFFICE USE ONLY This request void 18 months from ITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.M.: 10-23900-080-01 PERMIT F " L9 8L[ R-& ?Q PERMIT TYPE: ? BUILDING Permit Number: 021177 Date Issued: 06/10/93 4029 DEERWOOO TR LOT: 8 BLOCK: 1 ENGSTROM'S DEERWOOD DESCRIPTION: Badldieg•v.Permit Type SWIM POOL Building !Pork Type NEW /--` BC Occupanc' j .,' M-2 Building LengterI 36 Building Width 16 3 x rn F" c t3p REMARKS: FEE SUMMARY: Base Fee Plan Review Surcharge Total Fee VALUATION $126.00 $81.90 $5.50 $213.40 $11,000 CONTRACTOR: - RpPii.cant - OWNER: PRESTIGE POOLS 14901399 WORRE ERIC 3 E LITTLE CANADA RD 4029 DEERWOOD TR ST PAUL MN 55117 EAGAN MN 55122 (612) 490-1399 (612)683-9594 4 I hereby acknowledge that I have read this application and state that the information is carract and agree to comply with all applicable State of Mn, Statutes and City of Eagan Ordlnanceo., L_ APPLICANT/PERMITEE SIGNATURE ISSUED By. SSIIGNATU -? REACTIVATE RECRE?VED WIT Vr CAUAN PERMIT # 1993 BUILDING PERMIT APPLICATION $Z 15,• O m 21993 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work ro?? Site Address: 1/&-';0 '77Z - STREET SUITE / Tenant Name: (commercial only) LOT BLOCK SUBD." °'.vzk P.I.D. Description of work:' The applicant is: ? Owner It Contractor ? Other (Describe) Name r.'L' ?__ Phone6,83 r i T7 `/' Property LAST FIRST Owner Address Y??9 ?f?2w0 STREET STE / City ??? ?? State Zip t? 7--L- Company Phone Ygev -/2E2 Contractor Address 7rtF/?Irv?A rr/J License # Exp. City State .4-' Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is tes and Cit of sota Stat f Mi t ll li bl t d l wit St y nne u correc an agree to comp ca y h app e a e o Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Addl. ? 15 Deck WORK TYPE g(31 New ? 32 Addition ? 33 Alterations ? 35 Tenant Finish ? 34 Repair ? 36 Move GENERAL INFORMATION 4? M Bayern Finish 17 Swim Pool 1S Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy hi - a 2nd F1. sq. ft. PRY Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length 3 W On-site well Census Code Depth On-site sewage SAC Code I APPROVALS Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS ? Site EL Footing EIr Framing ? Insulation [I Wallboard ,® Final ? Draintile ? Fireplace Permit Fee 26 , o ° valuation: Surcharge "50 Plan Review Sf,9o License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: $ ]j boa SAC % SAC Units FPM STATE OF MINNESOTA 1t3 FASI' 71h S11MVI' • St. I-Atli., 61N 551111 6121296-6319 CF. OF THE COMMISSIONER OEPARTMEN"P OF COMMF;RCE FAX: 6121296-432A )vwe V if ?? q6-?9 AN EQUAL OPPORTUNITY EMPLOYER UNDERGROUND SPRINKLER SYSTEM PLUMBING PERMIT Date: 5--Iq - Permit # Date Receipt # /V &0 78 Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If adding new service, a water permit will be required, as well. EAstina residential: $15.50 (Plumbing permit not required if backflow preventor was I previously installed). Residential developments: Fee to be determined by building inspections department. May require payment of water permit, plumbing permit, WAC, and water treatment plant fees. yo,Zq oecnw'V'(? /M./ (Address to be sprinklered) Homeowner/Plumber: ?6? ?CVU' -?Junbinq C1? Phone #: ?; 2eZ Street Address: ?/ IA NZ Gees CAL %Ci City, State, Zip: 6,WMe I /. ? Y ? -S3 /6/ Owner Name: w?( Irk E r 1 C- Street Address: ,??'P/ G?d? T?t?l L1023 Phone #: Irrigation Contractor: (OviGCr RA?X4?¢Sj Phone #: - Gf 0 I hyreby acknowledge that-1-have read this application and,state that the information is co ect and agree to /comply with all applicable City of Eagan Ordinances cc: Engineering Department CITY 'OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE Permit Number: Date Issued: ? ,2c )lS-l BUILDING 022949 03/03/94 SITE ADDRESS: P.I.N.: 10-23900-080-01 4029 DEERWOOD TR LOT: 8 BLOCK: 1 ENGSTROMS DEERWOOD DESCRIPTION: ding':Permit Type ding W I_j Type G'- BASEMENT FINISH ALTERATION QRrp p wagon REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY Base Fee $35.80 Surcharge $.50 Total Fee $35.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: NYGREN CONTRACTING, D H 14960247 0003387 ORRE ERIC 14054 RUTGER ST NE 4029 DEERWOOD TR PRIOR LAKE MN 55372 EAGAN MN (612) 496-0247 (612)683-9594 I hereby acknoA41edge that I have read this application and stogie'that-the. information is correct and agree to comply with all appllcal,te State of Mn. Statutes and City of Eagan Ordinances.'' APPLICANT/P MI SIGNATURE ISSUED B : SIGNATURE u449 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 G 9 "S'54 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. alty applies: 1) when permit is typed, but not picked up by last working day of month E request is made, 2) address is changed or 3) lot change is requested once permit which is issued. Date Yaluat'on of work /S?crzK?,dCS Site Address: yL-,2 STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. C1l PX?? P.I.D. # Description of work: The applicant is: ? Owner Contractor ? Other (Describe) Name _Ootft_ t! I`c Phone g' " 2?79/ Property LAST FIRST Owner / o q Address Y d STREET STE # city ig9 +'1 State Zip Company Ha-? n Phone -'17K-GaY7 Contractor Address IV05-V V e.? `ter 6, License #tXXU338)Exp. 3 3: City r+_ (Aii State IYIAJ Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to com 1 with all pplicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck WORK TYPE ? 31 New 33 Alterations ? 35 Tenant Finish ? 32 Addition 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ? .Site ? Wallboard Basement sq. ft. 1st F1. sq. ft. 2nd Fl. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing )] Final f$ Framing ? Draintile r O ,2 Insulation ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: Valuation: $ ??o X .i T A16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments SAC % SAC Units 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALLS _# 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: Site Address Valuation: j n Date: 1 A Lot 9 Block Parcel/Sub ta1?iiAO?fP i Owner f l,?n. 1, ..? ?9. 1 i,. j. . . ILI. Address City/Zip Cs rte ???j Phone 1: de .; Contractor .4 A AIZA p Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # SEP 1 I RECD OFFICE USE ONLY Occupancy R-3 M Zoning R-1 Actual Const V-N Allowable V-N # of stories Length Depth S.F. Total Footprint S.F. On site sewage_ On site well MWCC System y? City water v/ PRV _ Booster Pump _ APPROVALS Planner Council Bldg. Off. Variance FEES Bldg. Permit 1162L-0-0 Surcharge 69, 5? Plan Review .sC544,00 SAC, City 1001 SAC, MWCC 41 00,00 Water Conn 625,00 Water Meter 90,Da Acct. Deposi t 30,00 S/W Permit 30,00 S/W Surcharge $O Treatment P1 . Road Unit 00 Park Ded. Copies SUBTOTAL Penalty TOTAL ryI q .)A„ . ', GA'RA GC- 32kzJ = (VyO L,0 ??'soX /5. ldZoo BSMT 21x 2?, = 7 SH Z ?e ?, = IZ II A /L = 132 ? X ?L4 1J2 lolo xiy:' 14-10 ISIT a rt ?5''`tiT = I of o 2 x2x? ? Z,g 1 K l 5 ° 2938 Z ur,, ?i-oorz 2(,x4= loyo l380?? i y..u..J• •/VJY V/.YVVYAI .V/. .I ntnn??ui^ 1.„.Y BASED ON CHA iER OF T ?.J'...__.._.___-.__...._: NO EPCY CODE •.:. DL?LON_ AdoFclua EEf•ecLvt 111 Phone ^att• ?iq )caner .. - _ : ,, . ' lr ;ite Address ? ??. PhOrte ti cr?? races :ontractor 21\?t- wilding-Classification Type Al (Single Family 3 Ouplex) Type A2 ?3estoriesaar. ess (Over'1 stories) (Other) ;ENERAL INFORMATION 1. Building Perimeter ?? ft. } ? .,-ms's e' ? Wall height (ground to eave) 2 ?i . 3. 1. x 2. (above) gross wall dtt..'zt-? ft. 3. Building dimensions. (L) x (W) \o `t ft - roof S floor area i. Square fcot area of rim joist - Floor joist size (2 x f 2 l x Perimeter • Rim o St area • C ).Oft AS. Doars - Area Thic ness n. actor' ?Z f 3. w eriweLlrl(? 3t ?t \'t RR? t= Type of Construct 0 7. Total door's perimeter 3 Z Z `? ft State approved C??,._ - r o c o 8. Windows: Manufacture U factor w ' 2 2 SIZE AREA (F NUMBER OF.,.TTPE TOTAL FEET EACH 'UNITS W G o i?•...c? '?--- : ? -moo .,??_ ! <i IO_y.3 C?rc1?L y?11$ ? /n Z`-C 1 0..? ---`- 2 ` Glass---L:kZAT r ----- Total ft. 2 • Ft. 10? Fireplace area: Width lit ' ?-`- x ( . O Ft.Z `. Exposed foundation: Height x Perimeter x ?-- 11 ? . :)MPLETION OF THIS FORM IS REQUIRED FOR ALL NEW COIISTAUCTION, MAJOR REMODELING AND BUIIDI!iG5 BEIt I IS USED . WHERE ENERGY. OTHER THA/V THE MINIMAL CODE ALLOWANCE 13VE0 Z _ \ <3 z Q: rig area • lot of gross wall area. y 'Gross wall area -Q ?'j fr 2 window area A ? ft.2 U windows U x A = Rim*Joist area A 7!_,2"C . C ft.2 U rim joist ¦ C4 U x A = Q,.8 poor area A `t , 1 1 ft.? J door area ¦- \Z-.1 _ U x• A ¦ (o Fireplace area A ?-- ft.2 U fireplace = U X A = Ems. Exposed foundation A C?.c^ ft.3 U foundation ? \\ U x A ¦ -l: Z? Framing area A Z'?\ta -`! ft.z J franing area . O <nk U x A = Z?. \\ Net wall area A 1 `T l?\-a-ft. 9 wall = e C'\3 U x + (!19 '; . . . . . . . . . . U x A C ?. Gross wall area x 0.11 (A-1 single family S du;*,=x = allowable U c A/Code (13. above) x 0.23 (A-2 other residenti a'.; r x .23 (Other buildings; x .28 (Over 3 storie.) TUH Must be larger than A L Code. Z-1(D Z 'l 138 shove Ceiling framing ar ea (Af) aquals 10: of cei ling area ?r or the same as) r'3 2 A. Gross ceiling area = (L) 4o x ('a Zj V? ft• 8 Joist area (Af) = 10': cell ing area - _ \O QA1. \ ft.2 C. Net ceiling area (.AC) (15A - 158) _ ft.2 U ceiling x A C= C ? l e-, x R U framing x A f= m C (?,Q x_ 0. TOTAL U x A ....................................... q Ceiling area (15A) x 0.026 (A-1 single family S duplex - code allowable U x A x O.C33 (A-2 other residential) x O.C6 (other) Ba H Must be larger than 150 (above) A (15.41 ?C?\ x ? ?ode)z v (o . F (or the same as) NOTE: Use U and A values obtained f-•om aps 1. 3 and 4. :Q . t.t WILL SEMOlI ; gIM. JOIST e? `{aS lntarlor waiX (il*ll):t . • .' s,4!nsu&At1vt1 .00 l,?`?h?athlnt 5 id I no; . (a,. 7.f P Outside air film .17 R TOTAL Inside air-film . .68 Interior -wail s,i? ? s-ud R?3ft (Fraising) U . F • .k?heathing Siding . ?'/ Outside air filn .11 TOTAL O - Inside air film Re 63, ' Interior wail insulation \?,00 . (Wall.' .' ' Sheathing Z..oa . Exterior rvl I . coverin$ A Exterior air fiitn n ..li' R TOTAL Interior air film ?+ .6.3 :nsula_ton' 1 1? inch soft 'rood Rvl,$5 (Rim U e I ?a SL sYNeiMIng Joist)-. (-7 1-tit erlor veil coveting Exterior air film Re ,17 ' 1( ? 04 R TOTAL r 4? Z4 intoirlor air fit-., R4 CcL?:?.ee., Insulation CD C5 1 1iL Ce.c.a4Foundation tCD (Fdn.) xterior air film; Re .11 r C _\ R TOTAL en _on 5 _ .. l 34 I 'Exposed Mock S^ V `?- _. !,rage s I r.. Y1?.• tl 1 OPO i . I '40000 IT' IF. rdNH4!rtt Er???? 7F i?lf R?V?i ??1 IVI ?,l,?,4a \ l7' i \ 1 y?' i? r \>il r ?. > i } t? Y A a ?1 airtlnr 0.6r Insulation,. ' 4 O Joisc d ? S' Cei,l.ing •.54? _ O.E1 Air Film 0.61. 3'1'.9 3 Total. R i , ." ,, ... . Ir.. :Ceiling Joist (stud) . .Insulation Air space Roof dgWng Insulation ' Built-up roof, _ Outside' air film Total R 1 ='`'U. 111ndow infiltration .5 cfm/lineal foot of crack ;.t?sidential door infiltration 0.5 cfm/square foot or door and minimur-'code.requireMent '.'ibn-residential door infiltration 11.0 cfm/lineal foot of crack - s' 16 12" concrete block no insulation - .47 R 2.1 _a 1b 12" concrete block-.insulated cores .26 d 3.8 lp .12" lightweight block • .32 R 3.1 A/b 12" lightweight block insulated cores - .12 R 8.3 l., single glass i.13: with stom.,window .54 l double glass .36 '!.triple glass .4T r-,'111 exterior walls and ceilings must have a vapor barrier (C.10 perm rsx.). ;;por barrier must be on the inside (heated side) of wall, rifpor`.barriers of the palyethelene thin film have no R value we tM I . ?. R1 ? 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OY EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681.4695 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES - CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FIXTURES EACH TOTAL 1 SHOWER 3.00 3-'? 7 C WATER CLOSET 3.00 . 3, vO 1 BATH TUB 3.00 J LAVATORY 3:00 .3:. KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum - 1 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 ` PRIVATE DISP. • Dptcty. iic. 20.00 U.G. SPRINKLER • home undw wort. 3.00 ALTERATIONS • to cowing 20.00 WATER TURN AROUND 20.00 . STATE SURCHARGE 50 - TOTAL: 91 5 0 - e , Ucta ?.,c? O v a / SITE ADDRESS: 4029 DEERWOOD TRAIL OWNER NAME: ERIC WORRE 07 INSTALLER: STATE MECHANICAL, INC. ADDRESS: 5050 W 220TH ST. CITY: FARMINGTON STATE: MN 5502.`- ZIP CODE: PHONE #:-( ) 463-8220 SIGNAT URE OF PERMITTEE 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 I -lt) on New Construction Requirements Remodel/Repair Reguiremenk Oftim Use Onlv 3 registered site surveys showing sq. N, of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cart of Survey Recd -Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y -N; 2 copies of plan showing beam & window saes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _Y -N I set of Energy Calculations Addition - indicate B on-ste septic system On-she Septic System,. _Y.-N 3 copies of Tree Preservation Plan if lot plated after 7/1193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date 0 . / 09_ / U c?0 Construction Cast 2 J? Jrd '° Site Address L'10' J NN-w-r-"00 ! a T rw" 1 Unit/Ste # 0 S as I Description of Work -E rl i re c y e?7-- &J-3 r r) ? S'R) - J Multi-Family Bldg _ Y `"N ) Fireplace(s) - 0 '! 1 _ 2 /?? Property Owner PaTi I cK A ++ nDC 1 Telephone # (h5 j) 33 D 6 9 S Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) 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. Eclat r ?c.1L - A:wj Applicant's Printed Name Ap cant's - ature SURVEYOR'S CERTIFICATE .1 4 \ SE L'( OMS pFPEL CEµp.B Ej/,ENI PERK J•' y ?1J5 Dt , to /i 10 to BRIAN THORSON HOMES 9 d \O [JO A 0 X90 i3 ?FtysF /`91 ? 00 9 ' i \ t2 NAT \ I I I IDm /y \\f J` m P / 9 ! A 30 vm '?s'" \ I y ? \ Z % 10 Fp a I uo 0 N IAC \ Ol y 9 I N O °9A ? ? r ? N \o \ / G r o / cP?, /pti°' M ia ?M cy) N 110 to y mow, 0 \ I a` N 670 DENOTES LOWEST FOOTING ELEV. ?V S go 111 r_ - C871D1, ? 18.50 1 INCH = 30 FEET N 0° 20'20" W 10 N am M It co 0O m 6 E O < ? p L D p Z M f 71 v p ? m z m 0 m p \) cn z > z cD m N O M O < James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 5 l/ SURVEYORS CERTIFICATE THORSON HOMES L,111 MA `G ` EZ%MG D Ulf ? DENOTES PROPOSED SURFACE DRAINAGE • a O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 8'Ff7. 1 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR s 879,4 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = rf7.5 FEET WE HEREBY CERTIFY TO BR I AN THORSON HOMES THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 8, Block I , 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 IOTH DAY OF SEPTEMBER , 1990. PROPOSED GRADES SIKMdN WERE TAKEN FROM THE DEVELOPMENT PLAN IOR EmGsmoms DEERWOOD AborION PREPARED BY 6RW, LAST DATED 3-25-66. SIGNED. ;JA ES R. HILL, INC. BY: L C N C. LARSON, LAND SURVEYOR NESOTA LICENSE NUMBER 19828 N X m -0 O O T m 0? O M (D I n O z N < O O m > m z M0 cnz G) w 0 { O M O tV Jaynes R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 SUR' tE o 'S CERTIFICATE \4? .1 ?? b236 g?,LV ?INg wlLp?ENT I r' -?7 870 DENOTES LOWEST I FOOTING ELEV. 1 871 01. I / 165 N T 13 11 W I INCH = 30 FEET n z n V J -1 A0 / N0.045y02 ? ? p P- . I A \ 1TA tft I (t? ?f. yy I VKIAN I HUKSUN 11UPA" ^ \o ?.0? A a C7 /a 0 rip r?Fiy`?o ?9i qG F ?1 J \ b?'t F f \ I ? I ? 1 s a? 0 16,0 A r? 'o ka ^0 r W cr, 10 ( 10 100 30 l s .. x 1 o c. l0 O m ni Z P < 10 10 1?. James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 i i Use BLUE or BLACK Ink ----------------i I `7 City of Eajan ; Permit I Permit Fee: ' I 3830 Pilot Knob Road f , * I I i Eagan MN 55122 1 Date Received: I Phone: (651) 675-5675 I Fax: (651) 67565694 1 -J ~I bl~ EP j Statf: ----------------J 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: Z 07J 9S ZL_ Tenant. Suite RESIDENT I OWNER Name: Gt 7L~ 1 L{/E~ Phone: 40Y/ 2 J`l LQ fr Address / City / Zip:%V 1~ l~ SS/ Z2 y. CONTRACTOR Name: MILBERT COMPANY INC.dba CULLIGAN WATER Address: 1801 50THST EAST City: INVER GROVE HGTS. State:' MN Zip: SS077 Phone: 651 '.451..-2241 Contact: BILL.MILBERT.., . Email: TYPE OF WORK VNew _Replacement _Repair _Rebuild _ Modify Space _ Work in,R.O.W. Descri tion of work:, PERMIT TYPE RESIDENTIAL ~ Water Heater -'Yater Softener Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level) Septic System Water Turnaround -New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) 'Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU Did. Call Gopher State One Cali 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.oopherstateonecall.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 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 x Applicant's Printed Name Applicants Signature FOR~OFFICE `-USE Reviewed 6y •ai " Y ~~-",w. t~~ ~ ~a6 F a. i^ t y e~,+,p ~~li~°~'~ ` L Y ±^r.~ ~1 t t.;:~tir1?: Required Inspections Under, Ground Rough In Air, Test GasTest,„'' Flnal,' - - - PERMIT City of Eagan Permit Type:Building Permit Number:EA111799 Date Issued:07/11/2013 Permit Category:ePermit Site Address: 4029 Deerwood Tr Lot:8 Block: 1 Addition: Engstroms Deerwood PID:10-23900-01-080 Use: Description: Sub Type:Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Anurag M Mathur 4029 Deerwood Tr Eagan MN 55122 Minnesota Exteriors 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - I For Office Use 1 lion I -7 f1 I 1 ~ 111 Permit#: I 111. 1 City of Ea I I Permit Fee: J~ 3830 Pilot Knob Road I OJ I 1II`I( Eagan MN 55122 I Date Received: 1 Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 I Staff: -----------------1 INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: J tt 9 / L3 Site Address: 4b2_q Tenant: \ Suite Resident/Owner Name: .Ay\.Lk txt'4-1 `Ot~y1~,r~ Phone: Address / City / Zip: ~D ZQ l~eei► WCI t Name: ~~st,~~~innu~e eru1nnM ~V~o, LIULLicense 3q!92_ f0dn r%JC414 W,121 c 4(,LC City: Contractor Address: State: Ar.) Zip: j S' I23 Phone: J G kt;- ti 6 q L Contact: 6M c, Email: lo clyi-w" .w 6t m 4z cm, PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) Type of Work Sump Pump Repair Repair Other: Other: Description of work: c~ c rec. # &L&e .,o d t a L Aca4ms r. c Description FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ (08,°° *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeacian.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.goi)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x as t y ~ F 2u{ 6L C/' x~.~.. - v Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA136454 Date Issued:05/13/2016 Permit Category:ePermit Site Address: 4029 Deerwood Tr Lot:8 Block: 1 Addition: Engstroms Deerwood PID:10-23900-01-080 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 - Anurag M Mathur 4029 Deerwood Tr Eagan MN 55122 (651) 216-1008 Bruckmueller Plumbing Inc 3992 Pennsylvania Ave Eagan MN 55123 (651) 686-6696 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA179683 Date Issued:10/18/2022 Permit Category:ePermit Site Address: 4029 Deerwood Tr Lot:8 Block: 1 Addition: Engstroms Deerwood PID:10-23900-01-080 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: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Anurag M & Deepa A Mathur 4029 Deerwood Trl Eagan MN 55122 Pudas Construction 864 78th St Victoria MN 55386 (612) 481-3053 Applicant/Permitee: Signature Issued By: Signature