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
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BRIAN THORSON HOMES
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N 110 to
y mow,
0 \ I a`
N 670 DENOTES LOWEST
FOOTING ELEV.
?V S
go 111
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- C871D1, ?
18.50 1 INCH = 30 FEET
N 0° 20'20" W
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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
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Jaynes R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
SUR' tE o 'S CERTIFICATE
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wlLp?ENT
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-?7
870 DENOTES LOWEST I
FOOTING ELEV. 1
871 01. I /
165
N T 13 11 W I INCH = 30 FEET
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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