4045 Deerwood TrS d- ?S-
? CITY QF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE? 454-8100
BUILDING PERMIT
To be used for • . Est. Value
Lot
Receipt
` OFFIC
1? S On Site 3ewage
?- MWCC System
On Site Well
?
City Water
PRV Required
Booster Pump
. • -+- ? . ,
Name
Address
City Phone
I hereby aCknowledge that I have read this application and state that the
information is conect and agree to comply with all applicable State oi
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable Stafe of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Zoning _
(Actual) Const _
(Allowable) _
* of Stories
Length -
Depth -
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr.lAssess. Permit
Planner Surcharge
Council Plan Review
Bldg. ON. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1 _ ??? • ?
Parks
TOTAI - '
Permit No. Permit Holdsr Dats Telephona ?
Plumbing
H.V.AC.
Electric °''
Softener
Inspectian Data Insp. Comments
Footings I
Footings II
Foundation
Framing
/?? "
C ? ?s -.1•,?. ry f.
Roofing L-11
Rough Plbg.
Roug
h Htg.
Azz
Isul. k
Fireplace ,f i-e/? ev'f
Final Htg.
Final Plbg.
Bldg. Final lz,?
i
cert. oco.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
BUILDING PERMIT
To be used for ; r pWG/W, Est. Value ;
154 10
Receipt
134, QCjs Date ALFCUST
Site Address '?045 DEERFaO()ll 5'kAIL
Lot I f Block ? Sec/Sub. ?'
Parcel No. DW00O ADD.
a Name J?ONTG()ME1tY DESIvN
z Address ''•ISY ?CNOB DRIVF
d City ..AGAN Phone 681-4260
Address
City _
?rz
?W
W W Name_
i ? Address
v
Q W City -
1 hereby acknowledge that I have read this application and state that the
inlormation is correct and agree to comply with all applicable State of
Minnesota Statutes 6d City of Eagan Ordinances.
SignatLlre of Permittee
A Building Permit is issued to: 'Cr'Ti,.7P;:.T;Y Li:S?.f: Pj
on 2he express condition that all work shal I be done in aCCOrdance with all
applicablq State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
On Site 5ewage Occupancy li-a 71--1
MWCC 5ystem `e Zoning R-1
On Site Well (Actuaq Const V-h
City Water X (Alloweble) V-h
PRV Requlred # of Storfes
Booater Pump Length 62
Depth 42
S.F. Total
Footprint S.F.
CITY OF EAGAN
3830 Pilat Knob 14oad, P.O. 8ax 21-199, Eagan, MN 55421
PH ON E: 454-8100
APPROVALS FEES
Engr.lAssess. Permit t ??+00
Planner Surcharge 69•50
Council Pian Review 350•M
BIdg.Off. SAC,City 100•(X)
Variance SAC. MWCC 550•00
Water Conn.
0
.550.0
WaterMeter ?. 67,?
Road Unit 325.Ot3
Treatment P1 "• jO
Parks
TOTAL 5! 50
19 t&
?-,•?.-?•?.?....?..?...?...
? .?
a• ?y y
$ite
Lot.
m Name
? Addre
? Ciry _
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: -
? Name • '
c Address >
O City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
MBTU
M BTU
M BTU
M BTU
CFM
FEE:
SlC:
TOTAL:
BLDG. TYPE WORK DESCRIPTION
Res. ? New
Mult Add-on
Comm. Repair
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 PERiIAIn 50 EA
- 1
.
.
COMMlIND FEE - 1% OF CONTRACT FEE
^ APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON S
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
- STATE SURCHARGE PER PERMIT - .50
- (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
, c.. ,
' ? SIGNATURE OF PERMITTEE
?
FOR: CITY OF EAGAN
.- ?... .
• - PERMIT 1t _
PLUMBING PERMIT ?Y
CITY OF EAGAN RECEIPT # -
' 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
iACT PRICE: PHONE: 451-8100
Address
City Phone
rvame
Address
Ciiy - Phone
FEES
IM/IND FEE - 1% OF CONTRACT FEE
BLDGS - COMM RATE APPLIES
'NHOUSE 8 CONDO - RES. RATE APPLIES
MUM - RESIDENTIAL FEE - $12.00
VIUM - COMM/IND FEE - $20.00
'E SURCHARGE PER PERMIT - .50
?$30 S/C IF PERMIT PRICE GOES
CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. ? New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES
= Water Closet - $3.00 : TOTAL
$ ?
+ Bath Tubs - $3.00
Lavatory - $3.00 °
t Shower =$3.00 -
?-Kitchen 5ink - $3.00
Urinal/Bidet - 53.00
1 Laundry Tray - $3
00
.
_J Floor Orains - $1.50 ?
_?Water Heater - $1.50 ?
Whirlpool - $3.00
?
=Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $1 0.04
Private Disp. - $10.00
?Ro
h O
enin
s - $1
50
.
p
g
ug
FEE: j
]
STATE S/C:
GRAND TOTAL•
(gtrtifiratit uf (Orrupanry
titp of eagan
appulmmt ? lidiaing .?ertim
This Certificate issued pursuant to the requiremenu of Section 306 of the Uniforrn Building
Code certifying that at the ume of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the foUowing:
ux clanirintion SF DWGV.;A?? sldg. lt?mu No. 15410
OctuprcY'f)'Da R3M 3 ZoniigDiftria ' TypeCOmt. ??<
Owxtof Bw7diug Add= ?i 1_`} I'??i..'-? !?:; ?il!'•:
audding nadrzas 4{J'=5 T!??r,iCW [.aaliry LI2,
Date: ? - -
Buildwg OBdd
POST IN A CONSPICUOUS PLACE
"Opri -pr .
CITY OF EAGAN Permit No: Data ??' '? '
3830 Pilo1 Knob Road Meter Na -410 74/6 a/ giZe:
P.O. Box 21199 Reader No: OL[C .35-a 32 Date: J6 -aej -9k
Eagait, MN 55121
Owner.
Site AOdress:
Plumber
Conn. Chg: , ? 1-' 1? Zoning: ^
Acct Dep: No. of Units:
Permlt Fee: r
S
Ftl
urcharge, I agree to comply with Ihe City of Eayan
Tr. Plant Ordinances.
Meter.
Misc.: ey
WATER SERVIC PERMIT
Pllot Knob Road
Rox 21199
in, MN 55121
Address:
Permit No: 14i 9 9 r
e/P Na 6334
I'Jon t
?J\J. `. _/lJ . '../Opd
Chg: 1. . Dopd
. Dep: --
nit Fee: '
Date: 8 -16-88
Date: 3-$ -8 g
Zoning, -
No. of Units: L
t agree to comply with the City of Eaqan
Ordinances.
sy
RESIDENTIAL
BUILDING PERMIT APPLICATION t-,
CITY OF EAGAN U ?
' T 3830 PILOT KNOB RD - 55122
657-687-4675 ?i a?
NewConstruction ReauiremeMs RemodeVReoairReauirements CJ t
. 3 registered site surveys showing sq. ft. of lot, sq N of house; and all roofed areas • 2 cropies o( plan
(20%mazimum lol coverage allowed) • 1 set of Energy CalculaGons for heated additbns
• 2 capies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for eadenor additions & decks
• 1 set of Energy Calculations . Iridicate if hane served by septic system tor additiore
• 3 copies of Tree Preservation Plan'rf lot platted after 711193
• Rim Jaist DeNail Op6ons selection sheet (bidgs with 3 or less units)
DATE )Zl /' y0/ VALUATION
JOB SITE ADDRESS j1OV5-- &eeD^uJ d m CP 7-?-a-r C_
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER ?IrD 11/l.) ZE t1^
TYPE OF WORK [3a-57(2vw2aU7_
FIREPLACE(3) _ 0>C 1_ 2
APPLICANT 7-6Li /l-) PHONE# fo, S?I_ySd
ADDRESS ?'0-117 0e'PYW00CQ JYCc_!G._ ZIPCODE JS?LZ
PAGER #
CELL PHONE #
FAX #
NIEV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category
(check one)
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
Phone #
All above information must be su6mitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is coil ect, an _tY"g"r o
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ?
_.-
Signature of
_ MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventilation Category 1 Worksheet Submftted
- Energy Envebpe Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Phone #:
_ Water Softener Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths No. of Baths
Phone #
Air Conditioning Fee: $70.00
_ Heat Rccovery SysCcm
Certificates of Survey Received , Tree Preservation Plan Reeeived _ Not Required _
Updated 1/01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 OS-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex y 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
?[ 33 Alteration
/ ' ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Jf? Occupancy 44- MC/ES System
Census Code Zoning City Water
SAC Units ? Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs r Length Fire Sprinklered
Type of Const I/P W idth
?v
-P
Other
_ Pool Ftgs A'u/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By 11-2- , Building Inspector
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addition) Plumbing
Foundation HVAC
y
Drain Tile ?
Roof Ice & Water Final
Framing
Fireplace 4 R.I. )(Air Test y Final
Insularion
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
FinaUC.O.
?( FinallNo C.O.
?
?L ?.h7,s/? ' ,17D ?
CITY OF EAGAN N2 15 410
3830 Pilot Knob Road, P.O. Box 21-199, Eagan,•MN 55121
PHONE: 454•8100
BUILDING PERMIT
To be used (or SF DWG/GAR Est. Value $13
Site Address 4045 DEERWOOD TRAIL
Lot 12 Block l Sec/Sub. ENGSTROM' S
Parcel No DEERWOOD ADD.
.
QlName MONTGOMERY DESIGN I
Address 4151 IINOB DRIVE
City EAGAN Phone 681-9260
°C Nan
0
oQ Add
? Clty
r?
U?y
WW
x?
aw
Name_
Address
CrtY-
I hereby acknowledge that I have read this apphcahon and sta[e that the
mformation is correct and agree to comply wdh all apphcable State of
Mmneso[a Statutes and C/itfyof Eagao Ordmances
Signature of Permittee (NLn.(? 'J71?iq?r
?
A Building Permit is issued to: MONTGOMERY DESIGN
on the express condition that al I work shall be done in accordance wdh al I
applicable State ol Mrnnes Statutes and y of Eagan Ordinances.
ewidmg OHiCial
l
Receipt # 2
Date AUGUST 1((` ?J3u
3 -
1g $$
OFFICE USE ONLV
On Sita Sewage - Occupancy R-3 M-1
MWGCSystem X Zoning R-1
On Site Well (AC[uap Const V-N
City Water X (Allowable) Y-N
PpV Required _ # of Stories
8ooster Pump _ Length 67
Depth 49
S.F. Total
Footpnnt S.P.
APPROVALS FEES
EngrJASSess. Permit 70 0
Planner Surcharge 69,50
Counal Plan Review 350.00
eldg Off SAC, City _1.OQ,QO
Vanance SAC,MWCC 550_00
WaterConn. _350.10_0
WaterMeter 67_[l0
Road Unit -32$. QD
TreatmentPl ?_44-00
Parks
TOTAL $2915.5
O
Z)
Euiid.r:r 5areiu G_,arimen*.
C"itu - E?GA!t ?zTC ?5-5en_-6ii
Joo Address - 4054 DEE+kOGD
4?ai ir:a Centracter - '?erit HVAC, =nc. ;hane 434-0926
vuii dins Contrartor ce r,wner - Ma?K EKLp HOMc= Phone 431-6430
<+ T ha oasir informatior below 1?ust be dSrEp?a;qed irom '.ire enereu _aicuiatians and olan=_
apor aved b+a the Buiidna Deozrimen* fr,r the =_tuccu;e te be buil*..
nmcun*. Delta T r"actor Fartor
1. Souare feer of exoosed wa11 ;rea a6ove crade. 21<+2 0.05 9M
Sauar= Teet oT P-,aosed wiriu?iy ar=a. 336 oS5 93
3. 5ouern t2et of reiiina area. 1125 ,1•.02 >u
4. Sat!3 rc feei oT 4asement iioar aree a.na ='^awi space 1126 5110 .
5. 5ouar- f?et oP eall area beiuw arade. 901 0.'u9 °o
6. Linea^ feet o" i^f?ltratior rer window=: 352 427 0.1E 11085
7. Linear feet of :rfiitration ror doors. Q 915' 1.25 1.0851
5. Lia=e:• `eet or i:fi1{;atiar, for ;lidin, dor,rs. 6E 9a 0.75 1.065
t,iiewance for 4:it.r?hen anu bath fans.
iiic, ea :ar.= @ 600 BT-jH aach. 1 500
hath fan=_ n:100 SiUH each. 3 200
10. ni1err=rces for rt;ture fireaiaw=.
34' to 4_" a?30@ BT',i'r. eacn. 1 13?0
11. Te±ai B-TUH loss far aii a?o:e items.
12 rlui for comhu=t=on air 7722l -(,001) >; net 4'993.55 e
.. r. (.E??) ri 90.
13. ALD
14. i•i;e.ln,am incrFaae allowztle hu SRC 500? - answer ?tov? x 115%.
"u±;ur nf furnece shali fail beiweer ii'•: & 14.
(7'ris ts the size turnaw deu =_houle -.se in this s*racture. Tr= code ooes a11ow uou
to us tne ne:.+ size availn?lle providine tha` aperepriate eqs.:arent is nori
'B3GItq dVdileFF..'
T'Iz undersioned, as a.ppiicact far a heatinq perrtr.'. herebu af`irma the aeave infor-
R,aiimn has 6ee,* preared h!ir andior fer -.mself. o; urder hi_ c;rec±ion; herebu
Inou;edoes the iniormation !o be corr•=c+ anc accurate: anh nereou preserrs ;1his
uirep clarss in supoert of t1e ' aLing Fer,,,i± Appticntinn.
w,.i
re
ti
i
-
`
:
q
orma
en
,
,
Barp; vignarure:
?
B?UH Lass
t-1116.8
ib%3i.F1
3
22523
3378. 0
t:?Z 7
51=2.0
4da"2.5
48?-7.7
xev. e
hri¢. a
iaa0. m
59?c3.7
7051.1
65044. 8
748'"i.5
?/?/sv
C? 3 3579,l
/0?"?/
uo°0
S
Requesl Date f N
! J I /? Rough-in Inspection
Reqwretl'+
' .
?_.Afleatly Now ? Will Nobty Mspecror
Yes ? No
?? When Ready?
I O licensed con2ractor _Lt0owner hereby request mspechon ot above elecirical work at:
Joh Atltlress (Sireet, Bax or Route No ?
D v wo
v?-? '? C'ry
? ?,v
Section o Towns ip Name or No Range No County
Oocupant (PR T)
- Phone N
?
Pawer Supplier
J% Atltlress
Elacincal onlreqtor (COmpany Name) Contreotor5 Lsense No
Matling /tldress iGOnVamor or Owner Mekinq InstallaLOn) ?
?e
Authorrzetl Si na re[Convactorl0 Making Inslgi tion? Ph
"ber
d ? s
MINNF,¢OW1 STATE BOARD OF ELECTRICITY THIS MSPECTION REQUEST WILL NOT
Griggewrtlway 81tlg - qoom 5-113 6E ACGEPTED BV THE STATE BOqqp
1821 Univereity Ave., St Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Vhone1812J6G2_p8pp ENGLOSED
REQUEST FOR ELECTRICAL INSPECTION ee-oooai-m ?
0- See insn mtions (or complelinq Nis brm on paok ol yellow copy ?
5 C? y4?4?2_
C?js 33579 "X" Below Work Covered by This Request -Aal ew 7Apt. TypeofBwldmg ApphancesWired EquipmentWired
ome Fange Temporary Service
uplex Wa[er Heater Electric Heatmg
Bwiding Dryer Other(Specify)
omm /Industnal Fumace
rm Air Conditioner
har(spaoiry) Conkaotor5 Remarks
Compute Inspectron Fee 8elow.
# Other Fee # Sernce Enirance5rze Fee # CuCwts/Feeders Fee
Swimmi Pool 0 to 200) mps 0 to WO Amps
Transtormers Above 200 _ Amps Abol Amps
S190S Inspecmr's Use Onty TOTAL , 7j'
Irngation Booms ? ?
SpeCial Inspecllon
Alarm/CommumcaLOn THIS INSTALLATION MAY BE ORDERED DISCONNECTEE) IF NOT
Other Fee COMPLETED WITHIN 18 MON
I, the Electncal Inspector. hereby
td
ih
t th
6
t
h Rou9n-m oaie
cer
y
a
e a
ove inspec
ion
as
been made. F,,,ai ?
!/ ' v
D.I.
OFFICE USE ONLV
Thl6 fBqll2biV0id 18 010n1h51101Ii
This request void V ry
18 nwn[hs fmm
C? 49798 ?
Pequest Da?e re No. qeuyhe??lnsuecuon DReadY Now Will NoUfy Insvec'
Ves ? No ??or When Ready
I? licensetl Elec[ncal ConVactor I hereby requast inspection oi ebova
a -i ,.,..m mslalted at.
U Uwner
Sveet Address, Box or Po e No.
shiName No.
To
t
????
Cou?
Occuu.rntIPRINTI fJl ?r n1
'r Phone No.
Power upoloer
?
/?
Add,ess
?C
Eler.tncal Convector ICOmpany Namel_ Con<ractm'S L?cense No.
Mailing Add ess ICOnVactor or Owner Mabng Instaliabonl
? Cf l ? - Scru?
? °P !?/?1?1.
?L7?
Author?ed S?B??T?ure IContractor O?+ne? , ine ????talla??on? Phon• Number /
Twc uasccennN RfQUEST WILL NOT
MINNESaTA STATE BOAND OF ELECTflIGITY
GnAps-Midway Bldg. - Aoom N•191
1821 lJmvarsitv A,ox.. SL Paul. MN 55704
Phone (612) 642-0800
BE ACCEPTEO BY THE STATE BOARD
UNLE55 PXOPEft INSPECTION fEE IS
ENCLOSED.
EB-00001-0
REQUEST fOR ELECTRICAL INSPECTION „ '
' See msvocLOns tor completinu this farm on beck ol Vellow caOV'
Q7 (??( "'X" Below Work Covered 6y This Req+?es1
/A'
? T v 1- V WveA
Aoolmncxs Wrted
Hdd ReD Tvpe ot 6w1d:'^e TBRI(lOY2ry SENICB
H e Range -------
Fixttne?
?, ..a«1-.gt.- y.:
Commercial 81dy rumace
Bulk Milk T&nk
Industnal Bldg. Air Conditioner p
i??, isn„uivi
On Sa?iN r
Parm
I I I ? i
1 om?? '
rte lnspect'on Fee Below
Feeders/5ubieeders a Fae c,,,;=??s
Fee ServiceEntrence5ixe tt Fee
0 to 30 Am?s ? 0 tn 30 !1n`D5
U ro 200 Amps
31 to 100 Ainps 31 to 100 An
Above 200 Amps
Ahove 100-Amps Above 1 00-
Swimminy Pool
Irngebon RoomS ?Z p?rual, Othe?
<
TranStormer5
ns
S SVeciallnspecLOn TOTAL FE
ig ?
ks f-7 /y
Final
rnia r
I, the Electnwi
Inspactor, her06y
001111y <hat tM1e above
?nle inspection has been
y ?/ - ,,,,ae.
RESIDENTIAL
BUILDING PERMIT APPLICATION
, CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122 l
851-681-4675 q? • a
New Conetructkn Neaulremenh RemoaeVNeoalr Neaulrements
• 3 registered she surveys shaxing sq. fl. af bt, sq.8. of house; and all roofetl areas • 2 copies of plan
(20%maximum bt coverage allowed) • 1 set of Energy CalwLationsfor heated atltlitions
• 2 coplas of plen showing beam & winGOw sizes; poured found design, etc.) • 1 stte survey tor enterar addAbns & decks
• lsetofEnergyCakulalbns . Indaate'rfhomeservedbysepticsystemforaddttions
• 3 copies of Tree Preservalbn Ppn M bt platleG atter 711193
• Rim Joist Detail Options seledbn sheat (hltlgs with 3 or less unMS)
DATE cl(a 6 Lo2 VALUATION
SITE-(-ApD(?D?R-? ?D ?/ ?oeP/'wos? ? MULTi-FAMILY BLDG _Y N
TYPE ?5?'VVORK k 0e rocd FIREPLACE(S)-e'?S0 _ 1_ 2
APPLICANT AK^ce• c,,... Q ?• I?? ?. eo.--F?.. cfa? s
SiREETADDRESS fZZY? N.'collef' Av• S• CITY 9,-vhsu,Ik STATE ± ZIP 5-?°I3
TELEPHONE #`i Sr 7o7•G'Is9 CELL PHONE # --- FAX # rR5-?) $08 - 88W-
PROPERN OWNER TELEPHONE #???
---------------------------- ----^--------------------------------------- °--°---------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ bIINNFSOTA RiJLES 7670 CATEGORY 1 MINNFSOTA Ri1LES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted E --Cq?? e!!!???{{{yyy rkah etISubmitted
• Energy Envelope Calculations Su6mitted I D? 1?I
? OCT 0 1 2002
Plumbing Contractor: Phone #
Plumbing system includes: Water Softener Y? Iawn Sprinkle?iBy FPP:_$9200
Water Heater No. of R.I. Baths
No. of Saths
Mechanical Confracfor:
Mechanical system includes:
SewedWater Conhactor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $70.00
I hereby acknowledge ihat I have read this applicatlon, state thaT the Information is correct, and agree to comply
wiih atl applicoble State of Minnesota Stafutes and Ciiy of Eagan Ordinances. %
Signature ofApplicant ? WV?'?L?(?L????-e'/?ti -- -
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received - Not Required _ Updated 4/02
_ _ _. _ _ ,
?...i_...:'??1It ?:.?,.I?'I_I._CII''I:°: r!'=ii_„t=i?._?i. "l..l" i._fii`..I'I'i.}I.i
h+i:t;v.'i1:{:il°il::l=('Y Di, 1',:I (=,N . ,"r,ii_Il.l.l.r !:.'?:)
4151 i';Ni-)B oR
El:71;iF1N,. NN ;°J:`.l.,.:i'
6ia y .`J',j3f 1
if.Yi.il=.l... Fo`_:lf_.FZ i-)i:Fiii ii il i•: i-d,01
I;F.4;?i..ll. ;H.%
. -
,
I. I?i.+IFd1. 4:?(-il.l_. f?iYiL:h.., ....::1:}:7 ..LI 277
' ..,-..,...,. - ,
_ .>.-
:.. : , t'? ?...., i .. ? ? .., i ??, it=c-i 1205 : .'...
..il.f I :.Ir.'.ij..ii
H 6UifHd)I.iIFl F?rw:CFW 1i')3 .,:_75 10.1.
i:; Drit_)R A1':.¢t:i .±li .I3 :'i
f; ALE7JINB IiLnji:{try At^:R(-1 ..._ ?C+ri .'..G
P, F1:PF-;.ni.fitf.ll;- a:,Rii::(-1 5A .^ 11
f'. i,.pr}I, ;._ I':.p,f:iT°it. f=tRC!1 2510 .095 24
?" ,I::i IAI "t
???::... ??7L._ (=7?:?:.h 1957.0
1032
71
ra it;ri ..,u:rGr Aitt.n ;.,•c; .04.::;6 -r
H F-lJi.;i•d1J i.;i;.l`.!1)i)I:! f1RE{:y S'? ,._ '1")
GR(:l!},)i_'. 6
.i„ T['i"i't-,i., W(ll...l.. AF;i_rtt 251
3 :.iVYL. ??.::..
?
l?
t,; Pi'rr7F... rRral°ii:. 120„5 ,U:.:.s. 4
I.... NPr`i ii(:.tE:J'r- AkI:pa i:I.`:js..a.'; 1022; :::'!..,
i t.11 f;l._ i;OOl= HRF=A >t?
t3llf°I t.=1t= :i .:+;;.. ;':I.'I.
Ai_I?I Up? .1-1. 2L l. i/
...
1988 BUILDING PERMIT APPLIC9TION'- CITY OF EAGAN
SINGLE FAMILY DWELLINGS
/5 ?/l b
INCLUDE 2 SETS OF PLANS, 3 CERTIEICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
A
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESZRED, NO CHANGES WILL SE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS
On site sewage_
MWCC system v
On site well
City water ?
PBV required _
Booster Pump _
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COhA7ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For:
Site Address
g,F. Valuation: Oou-
410 H SL, y.P/uqJnd ?/tQa. OFFI
Lot 1.2 Bloek I
Parcel/Sub
Owner .? F?'?
Address
City/Zip Code
Phone
Contractor ' , 4? Qe??m
Address GJ 15 f lL?4
City/Zip Code
Phone / q1 -
Areh./Engr.
Address
City/Zip Code
Phone ll
APPROVALS
# OF UNIT3
nate: eu ,U1- 2 81988
Oecupancy R-3 M -?
Zoning R-1
Actual Const V-AI
Allowable t/- N_ _
# of stories
Length ?
Depth ?
S.F. Total
Footprint S.F.
FEES
Permit 1?00,00
Engr/Assess
Planner
Council
Bldg. Of f ARM7-Z`I
Variance
Surcharge ,50
Plan Review 3$0,0?
SAC, City I00,00,
SAC, MWCC S>'^> 01?1
Water Conn 5t,-V. ou
Water Meter ?,r] • J,
Road Unit 0a
Treatment Pl tt . o?
Parks
Copies
TOTAL ? lS,5 O
.
VALUA-1 1oN
. .
?A ".. 19,E-
a6uAY _ -72Y
_---
?sZ X ,q: ,oyye
13 AS??'?1 E?-?T
3?,X 93L
`I y (.- - S ? I
11 X `? ' i i Lt
g?/?
i,
t3? I X l3 : 1695Z
,
I ss
z ND R ou12
3(? >C Z(? = 513? q .-
61-1S8 z
L)sS6 Y
34
`
??
APFLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTIQN
: .
i N3PE: PAYMENf OF EEE AT TIME OF *x*
; n2eLiCnTTau ooFS Nar cON- ;
? 51'INl'L' APPRGVAI. OF PET7MPf. y
e t
R INSPDCPION OP SEZdIt 1@ID/IX2 WA1EH
,*k IraSmatsaT10NS WIIM NOT BE ci^cnn.cn
? ONPIL Pf7tFIIT HAS BEES] APPRWID. ?
ll?W •xnr++rf w??tfst» wxwx?tt?r»s?:tttr?+++
ity OF eC9gan
IPLEASE PRINT
1) PROPERTY ADDRFSS: 4?0CF S OterwanJ Trai I
T,FY;AT, DESCRIPTION;
IF EXISTINGG STRL'CTURE, DATE OF ORIGINAL BUILDING PERMIT ISSLANCE:
PRESENT ZONING/PROPOSID USE:
Q COhIIMERCIAL/RETAIL/OFFICE
Q INDUSTRIAL
a INSTITUTIONAL/GOVERNMENT
Mon Year
?J R-1 SINGLE FAMILY
? R-2 DLPLEX (3WO Lnits)
? R-3 TOWNfi0U5E (Three + Uiaits) ( Lnits)
Q R-4 APARTMENT/CONDOMINILM ( C'nits)
2) NAME: Cvw; rA CQ.,,n,?t
ADDRESS : L{ 151 j<n o d n r.
CITY, STATE, 2IP: 6? 9_¢ h ? 1 Z 7.-
PHONE: („ SI - R?lLoio
3) • NAME: 7YlURR PLum b;,i a
?DREss: I kd 3 AI flv fkI0.hrj O Y. 5,u:f?. L403
crTr, STATE, zzP: M+ndota F+al.-rs
PHONE: G R A- G S 7q MASTER LICENSE #Q 03 5 -70 M 3
4) m " • ?'
NAME: ?at+ tv'
ADDRESS:
CITY, STATE, ZIP:
PHONE:
I? •Active
Expired
Not recorded
Sta Initia
5) w•v R • o I ra e
fET'CONNECTION TO CITY SEWER F,--rCONNECTIO[V Tb CSTY WATEEt a OTHII2
61
*?*,?*?****?**??***?*?*,:****????**?***************+**+?*******???*??*****?***********?********+*+*???
*
* THE GOLD COPY OF 7M PERMIT WILL BE SENP DIREC'1'LY TO PUBLIC WORKS 70 FACILITATE ME:1'ER PICK-OP. *
,,*k PLEASE ALIAW ZWO WURKING DAYS FOR PROCESSING. SOHIDONE F'ROM TfM CITY WILL CONPACT YOU IF TFIERE *
* P12E ANY PROBLEMS. ?
?****??x*****:??**+e??*t**?*??*****x*?**?**********?****t****,t*x,r,r*******??******,r??,t?*+++*+,r****?*:?
FOR CITY USE ONLY
PERMIT # ISSUED
.??
Pd w/Bldg. Permit FEES:
$ $ /b ' 5-D
$ $
$ -7'!f d $
$ $
$ $
$ $
$ $ lT-D
s ,5-ra -0-v $
$ e???•?d $
$ S
$ $
$ $
$ $
$ $
$ $
$ `y.V, ?o s
RECEIPT RECEIPT
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SDRCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCL[!DE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRLNK SEWER ASSESSMENT
LATERAL BENEFIT/TRUNK SEWER ,
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGILVEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO TAE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: el1(?- ld4-,a
Install gas insert onlv
<1 G o .?
?-a-9 ?
Alterafions to existing
Install 2as litae onlv
,2L Other o&,4CTD9W ,Q?j(T F/oPrRncr
Job address: qS b ??--?wrcb TR.
Lot: Block: Subdivision/P.I.D.#: ?CVLaSNy () VvA S V?'?(lJ?,?B?Q
3?0?3
Date:
, ?2 -Yy,
1999 FIREPLACE PERMIT APPLICATION
CtTY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
Description of Work: _ Construct new fireplace XGas _Masonry _
Applicant (circle one only): Owner Contracto
Pernrit Fee: $60.50
PROPERTY
OWNER
City &-A (-N/,? State: im ? Zip: S'S') ZZ
FIREPLACE
INSTALLER
GASLINE
INSTALLER
Name: ?"o57?7E' J-d N'J Phone #:
Last First
Street Address: Sv4??S- bi--veL..r? 7r-
Company: A?,n,g7t ?AXA6r? b064? E? Phone #: d12- 3?1 = 7 s`??
(area code)
c-Hr'o?i?? /g ?r'
Street Address: 9110
City State: J41,?J Zip: .57S?d--J--
Company:
Street
City
Phone #:
(area code)
State: Zip: _
I hereby acknowledge that I have read this application and state that the information is correct and agree to
? comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature
I ( ' AW L SJJ
PERMIT# tff5/ ?; RECEIPTDATE:
Please complete for:
SITE ADDRESS:
OWNER NAME:
US1DFNTLAL PLUM$IAH PFAMiT APPLICATION
CI7'Y OF EAfiakN
s$so Pu.or xxoa itn
EP1fiRA,1HP 55122
651-691-4678 ?
S
single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
e if- v?-Uj L7 Q a? `? re
y„l
Jo
v\- 'ru .5
TELEPHONE #:
(AREA CODE)
INSTALLER NAME: TELEPHONE #: k S j(fl` Ci' QD
STREET,4DDRESS: 70-0 ?L(AREACODE)
CITY: iv&0L (f/f -a l`'GC5 wb S STATE: (/4ttL ZIP: ,/ r
Place a check mark neut to the oermit work tvoe
Modifications that alter living areas, such as adding new fixtures to lower level $ 50.00
areas or additions
Modification/alteration to existina dwelling unit, inciuding: $ 30.00
• new installation/repairlrebuild of RPZ
• lawn irrigation system
• water softener, water heater, air conditioner
Nature of work:
Septic System, newlrefurbished - $ 225.00
• includes County & Consulting Inspector fees
. requires two sets of plans
• requires MPC license
Abandonment of septic system $ 50.00
Water turnaround - existing dwelling unit $ 50.00
• 5/8" meter (if required) 118.00
State Surcharge
$ .50
Total ?o
$ rj Q ?
I hereby acknowledge that I have read this application, state thatthe information is cortect, and agree to complywith all applicable Cityof Eagan ordinances. It
is the applicanPs responsibility to notify the property owner fhat the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance ac6vilies W the facilities wnsW cted under this pertnit within Ciry propertylrightof-way/easemenj. .
SIGNA U E OF RMITTEE 1/02
tiz7;)o?
3830 Pilot Knob Road
Eagan MN 55122
Phone:(651) 675,5675
Fax:(651)675-5694
?-----------------
?
? Permit#: j
Pertnit Fee V
i ?
? /.rtl!/ 1
? Date Received: C I
? I
? Stafl I
i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Ll _?- J ?() 8 Site Address: _( Q HS 1) e-er L,,,*O o 1 r"l I ` L
Tenant:
Suite #:
6 51- C,Sa` Lf 0o
_10 hA IF65-t'e/?
RESIDENT / OWNER Phone:
Name:
Address / City / Zip: L?O / 7 b-2erwOQ 17 79`ol,tt
Applicant is: _ Owner 15( Contractor
TYPE OF WORK Description ofwork: kqr--rQC5-
Construdion Cost: 33 5o• 1 Multi-Family Building: (Yes _/ No /K-)
CONTRACTOR Name ??'Yl'2r I C(? ?ui/? (? tpyi`?aC Sy ? j b9383
l /'1 ? License #
Address: _D1,76o CAe:(_ * lbO
i?Wn 5V,'(1 °U State:'i/"i Zip: Ss 341-7
Cit
y:
Phone: CI r7)L -707-6 I5g' Contact Persorr. 6V ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission typeJ • Energy Envelope Calculations Submittetl
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planT
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
==:NOTEi Plans and s'appoRing document§ thaf you submit;are consideied to be,public.ittformation., Portions?of
_-the informatron may be classifred as.non putilia.tf you provide speafic reasons fha?twould permit the Crty, to ,
that the „are trade:secrets,
I hereby acknowledge that this infortnation is complete and accurate; that the work will be in confonnance with the ordinances and codes of the City of
Eagan, that I undersfand Ihis 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 antl approval of plans.
X???`7 l6l_ 1??(dv
ApplicanYs Printed Name
X 0w/l?4 9
ApplicanYs Signature
Page 1 of 3
. •
- -- ?c+ i"lu#v 1u+YO IumJH19eD R PIILi.. 1MG
. . ._ _...__....?
SU"RVEYOR'S CEnn1'1F9CA1'E 'w+oavooiNltv aE*IQa a aviLo co.
-- ?Wooo T???--
. o
M
° . ' 'EAGAN
' 430.00 "1„"? REdIEWED
I.Y4nS'.:G?i'Y?1?YYY`*G i
.l ryi
' y 88A 'n ? 1 ,+
?
m ? • Q? m
__ M N 0 AR4GE?
24.0 .
PRO OU$E` . .,.
W ? N .
Z' ,$OJb
p0. .
J C?99•g7 . r w
• tc ?'?-...` Q11ry3.?'?
as
i" M
C 7 (.?
_ J
5 ? ? ?AINACE A U71LlTf g
?'ASEM6N1' AER ALAP
1 R (r D
C9os. ° $ s
?107.20 N 0°29'20" W'L`a
rAG?iN E?' Gliti;,,;;t-?ING DEPT
nENOTES PROPOSED SURFACE DRAINAGE
,Q DENO'TES IRON MONUMENT SET SCAIE: 1 iNCH - $Q FEEf
0 DENOTES IRON MONUMENT FC')UNO PROPOSED GARAGE FLODR - 874-3 FEET
X000.0 DENOTES EXI571NG ELEVAl1QN PROPOSED LOWEST FLpOR -$04-d, FEET
(000.0) bENOTFS PROPOSED ELEVATION PROPOSED TOP OF BLOCK •- f14• y FEEI'
WE HEREBY CERTIFY TO MONT60MERY oESicN a euiLo co.THAT THIS 15 A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNOARIES OF:
).ot 12, 91ock 1, ENGSTROMS DEERWOOD ADDITTON, according to the recorded
plat thereof, Dakota County, M9nnesota: (TH%5 LEGAL DESCRIP7T010 YIILL 6ECOME
VALIp UPON FILING THE PLAT OF-ENGS1'ROM5 DEERWOOD AbDITIQN.)
I7 DOES NQT PUFPpR7 74 SHOW IMPROVEMENTS OA ENCRQACHMENTS, EXCEP7 A5 SHOWN. AS
SURVEYED BY ME OR UhaEfl MY DiRECT SUPERVISION TW1521PE DAY OF ;r"•L, x ,18"
TAKHNgRROM7HE6EVEL PMEN7E SIGNED: JA L,{NC.
aLawtpoosr EpNpGSTR DEERwO0D
LA?7?DA?BDEP?R?OMS ?B BRW, .
BY: 4.
HAROLp C. PE7F.R50N, LAND SURVErOR
MINNESO7A LICENSE NUMBER 12294
Jarnes R. Hiil, tnc. PlANNERS / ENtalNEEF$S / SURVEYORS
9401 JAMES AVE. S. 9 BLOOMINf3YAld. MN. 66431 r 812-884-3029
'TEL M71Ei12 CPd4-`J?nltS A?J.Sb Yl'Jl
f5) [ G [ M [
For Office Use-
JUN 2 2 2009 , Permit
City of Ea au
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Fax; (551) 675-5694 start:
2009 MECHANICAL PERMIT APPLICATION
Date: o _ Site Address: M-5 W,r
Tenant: Suite
RESIDENT / OWNER Name: . n FOS Phone: qs
L T
Address / City / Zip: [ .i
CONTRACTOR Name: y;~J - License
Address:
City: State: Zip: o
Phone: _ f L1l Contact Person: d~ kY' -j r
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: i ' !A- bY\ r i r , (ti'' r1i; k f
NOTE: Both roof mounted and ground mounted mechanical equipment Is required to
be screened by city Code. Please contact the Mechanical Inspector or one of the
Planners for Information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE New Construction Interior Improvement
_-Fumace
'Air Conditioner Install Piping , Processed
Gas Exterior HVAC Unit
Air Exchanger
Heat Pump Under / Above ground Tank Install / _ Remove)
When installingtremoving tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ J TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In _Air Test _Gas Service Test _.,In-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA106880
Date Issued:09/14/2012
Permit Category:ePermit
Site Address: 4045 Deerwood Tr
Lot:12 Block: 1 Addition: Engstroms Deerwood
PID:10-23900-01-120
Use:
Description:
Sub Type:e-Reroof
Work Type:Replace
Description:House & Garage
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
John E Foster
4045 Deerwood Tr
Eagan MN 55122
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122642
Date Issued:05/14/2014
Permit Category:ePermit
Site Address: 4045 Deerwood Tr
Lot:12 Block: 1 Addition: Engstroms Deerwood
PID:10-23900-01-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Scott Rise
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 -
John E Foster
4045 Deerwood Tr
Eagan MN 55122
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179297
Date Issued:09/27/2022
Permit Category:ePermit
Site Address: 4045 Deerwood Tr
Lot:12 Block: 1 Addition: Engstroms Deerwood
PID:10-23900-01-120
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 -
John E & Joyce M Foster
4045 Deerwood Trl
Eagan MN 55122--188
(651) 707-7378
Solaris Roofing Llc
1324 Forest Cir
Burnsville MN 55306
(651) 675-8486
Applicant/Permitee: Signature Issued By: Signature