4101 Deerwood Tr
Use BLUE or BLACK Ink
------------i
For Office Us ,
City of Ea an i Permit
I
Permit Fee: GQ ,
3830 Pilot Knob Road
Eagan MN 55122 I Date fRived
, Phone: (651) 675-5675 StaffFax: (651) 675-5694
2011 RESIDENTIAL PLUMBING PE IT APPLICATION
Date: Site Address: _A.~tii
Tenant: Suite
RESIDENT / OWNER Name: 1 rC~ Phone: uGv ^ I.Ac~sv` •
Address / City / Zip: 7txm 4
CONTRACTOR Name: G' G License
Address: `lam City:
State: -nk~) Zip: Phone: ~✓a' `a3
Contact: Email: OC'~`~ r'
TYPE OF WORK _ New - Replacement _ Repair - Rebuild Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Softener
Water Heater
Lawn Irrigation RPZ / _ PVB) Add Plumbing Fixtures Main Lower Level)
A
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 DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
11 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall'or
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance wit the or ina ces an des of the City of
Eagan; that I understand this is not a rmit, but only an application for a permit, and work is not to star ithout a ermit; t t the work will be in
accordance with the appr ved pl in th case of work which requires a review and appro of ns.
xS~ ~ x
Applicant's Printed Name App icant's ignature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-in Air Test -Gas Test -Final
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
t I For Office Use q
1 Permit / 1
City of Eap I Permit Fee:
C
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: j
R I I
Phone: (651) 675-5675 AY
Fax: (651) 675-5694 Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Lill t d I-) t-~ ,L-,,. t.- ,*-N Unit
Name:, A ~,4 a~~ k~ Phone:
RESIDENT /
OWNER Address / city / Zip: LI-~,()/~ Q L&UX)A SS-rl A-)
Applicant is: Owner V /Contractor
TYPE OF WORK Description of work: a2St d9 - /
Construction Cost: ~ Multi-Family Building: (Yes / No )
Company: L;a Y2, TZ,-, +M,7_4110>~ Contact: JJ
CONTRACTOR Address: ~Lz✓~-,Vr City: 1-
State: MIJ Zip: (O Phone: 612e_-363-:3_-G1'5
License M-2-0 (P3 -q- Lead Certificate i W i.•"~ l
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 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 1 <_E~y - rl~ E\Q 6, LUQ J b x c
Applicant's Printed Name Applicant's Signatu
Page 1 of 3
q10 / -f~D/ I
DO NOT W I BE W TdS LINE
I
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) J Exterior Alteration (Multi)
01 of Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding - Demolish Building*
Addition _ Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION _
Valuation 0 6w0 Occupancy -MCES System
Plan Review Code Edition lc r? SAC Units
(25%_ 100%-e) Zoning City Water
Census Code 3Y Stories Booster Pump
# of Units Square Feet _ PRV
# of Buildings Length /3 Fire Sprinklers
Type of Construction Width ; of ,
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: Ice & Water Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector r,-may`
t9 rl,t Me 3 O fO 64 9
RESIDENTIAL FEES Z 14 l
Base Fee 3 39 y g'PO
v owe 3~
Surcharge
)V
Plan Review Z 0
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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Use BLUE or BLACK Ink
F-Fo-r --ce-U-se
4110~ Offi--'7 I
j Permit ( -7 -3
j
City of Evan I '
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: 1
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: t(110. Phone: RESIDENT /
OWNER Address / City / Zip: ~tj o(
Y? +~JOt ~'io > r' .
Applicant is: Owner i~ Contractor
TYPE OF WORK Description of work: V ft rk>..J
Construction Cost: 4 O~X) Multi-Family Building: (Yes /No
)
Company: at C(-:I: in k i` 'fit,. a s(1J.~ Contact: 11. k°,i/i to n&, l,-=V4
CONTRACTOR Address: }e~5?~~. ~'irf4.- City:
State: A /A Zip:i Phone:
License Lead Certificate
Does this project require Lead Remediation? ❑ Yes 0'No (see Page 3 for additional information)
,
If no, please explain: N to 0-"z , ova Li: r ;u 9
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.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.
Applicant's Printed Na a Applicant's Signatu e
Page 1 of 3
SEWER & WATER PERMIT
CITY OF EAGAN '
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
OFFICE USE ONLY
METER #L a F 16 PERMIT DATE c-6! 19r 91
CHIP 4.17 ' oyV PERMIT # 12076
METER SIZE r e Y S B.P. RECEIPT # C 14040
ISSUE DATE B.P. RECEIPT DATE 06/181 91
PRV -BOOSTER PUMP
SITE ADDRESS .'+101 111
LOT 19 BLOCK ! SEC/SUB 1'.NGSTROM' S DE1;RWCO
APPLICANT:
ADDRESS:-
CITY, STATE
PHONE:
ZIP
PLUMBER: k C PLWBING
ADDRESS: `)910 CHESTER AVE
CITY, STATE 7,l?'-,T13F1ELD Mlv Zip 55057
PHONE: L11-2096
OWNER: SONS CONSTRUCTION
ADDRESS: 4600 FAIRWAY I1 LS Dr
PERMIT REQUESTED
X SEWER X WATER TAPS
COMM/IND RESIDENTIAL
X NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Oomestlc Meters on Water Line.
'Credit WILL NOT b? givgn for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
E7N,ORDINANCES
CITY, STATE EA AN MN ZIP 55123
PHONE: 452-53' IGNATURE WHEN METER ISSUED
PLEASE ALLOW 'flj?O WORKING DAYS FOR PR6&ki §s N&'"CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EA'GAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE JUN 18, 1991
OFFICE USE ONLY
METER# PERMITDATE 06/19/51
CHIP # PERMIT # 12076
METER SIZE B.P. RECEIPT # C 1404E )
ISSUE DATE B.P. RECEIPT DATE l?b / 1 i /' !
- PRV - BOOSTER PUMP
SITE ADDRESS 4 , G 1 uti !.:WLWL TR
LOT -1y BLOCK ? SEC/SUB I' NGSTROM' S DEERWOOD
APPLICANT:
ADDRESS:
CITY, STATE ZIP
PHONE:
PLUMBER: R. C PLUABING
ADDRESS: 5910 CHESTER AVE
CITY, STATE
PHONE: NORT11FIELD 101 ZIP 55057
461-2096
OWNER: SONS CORSTRUCTIOW
ADDRESS:
CITY, STATE
PHONE: 4600 FAIRWAY HILLS DR
EAGAN HN ZIP 55123
452-5355
PERMIT REQUESTED
-K- SEWER X WATER TAPS
COMM/IND RESIDENTIAL
X 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 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
CALL 454-5220 FOR INSPECTIONS. FOR STORM
Iv A. _ IJ?WS (H)454 °5636 CITY OF EAGAN
[/ A66-
6
- ` - WJ •; .? ?.,
.
1830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121
PHONE: 454-8100 '
BUILDING P15AMIT Receipt # : +` - i t
,
To be used for ST DRiiG/GAR Est. Value $149 WO Date MIN 18 1941-
Site Address 4101 DEERWOOD TE
Lot -19 Block 2 Sec/Sub. EIVGSlR04lt 3 S OFFICE USE ONLY
Parcel No. 4 DEERVOW occupancy R-3 M-1 FEES
Zoning
?
JL-
W Name SONS COIdST8UG7IDN (Actual) Const Bldg
Permit 811.00
.
Address "00 FAIRWAY HILLS DR (Allowable) 74
30
Surcharge .
City EAGAIII
Phone 452-5333 * of Stones
3
Plan Review
527.00
Length
$ Name SAME Depth AL3 SAC
Cit 100.00
.
y
q0j Address S.F. Total
SAC, MCWCC 660.00
City Phone S.F. Footprints
t
C
W 660
00
On Site Sewage a
er
onn .
W Name On Site Well W 95
00
ater Meter .
?u Address MWCC System X
_
Acct. Deposit 30.00
W City Phone City Water X 30
00
PRV Required SAV Permit .
I hereby acknowlege that I have read this application and state that the Booster Pump SrW Surcharge • 50
information is corrtb and agree tq Comply with,all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI 276.00
Signature of Permitee APPROVALS Road Unit 370.00
A 'Building Permit is issued to: SMS MISTRUCTION Planner P
D
on the express condition that all work shall be done in accordance with all
Council
-- ark
ed
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
Building Official r , , 4,
, Variance TOTAL 3.624.00
- Permit No. Permit Holder Date Telephone #
WATER ? •J .e, a
SEINER
PLUMBING
H.V.A.C. 9? 'YUfo?' ???
ELECTRIC
Inspection Date Insp. Comments
Footings I 711D f Z f
6// 102
((J?
//
?3l?t
Foundation 71
Framing
Rooting
Rough Plbg.
Rough Htg. St
Isul. SS 9? SZ S/ IG?!/ U
Fireplace
Final Htg. -/ j
Orstat Test .LUt? 9-
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
/,? 9l
/?
Deck Ftg. s 2
Deck Final
Well
Pr. Disp.
NEAT. - - - - ?,
&rttfiratt of (Orruvaury
Citp of Cagan
Marva mu"W of Who inwertwu
nis Cardficale issued pursuant to 11e requirements of Section 306 of the Uniform Building
Code certifying that at the lime of issuance thiss"xWre was in compliance wish the w 1bus
ordinances of the City regulating building conn"x4on or use For the following.
tbeasswmfm SF DWG/GAB BIi6a.?a Nm 19280
0=ws y Type R3 - za,t mwi R 1 Tree'-- Vn
o,..wacs,wm SONS GONST Add= 4600 FAIRWAY HILLS DR., EAGAN
&.mi„sAea,.-4101 DEERWOOD TR L.&y L19. B2. ENGSTROM' S DEERWOOD
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN Np 19280
3830 Pilot Knob Road, P.O. Box 21- 199, Eagan, MN 55121
PHONE: 454-81 00 ?? tt
, l ??
BUILDING PERMIT Receipt #
_ , ??t
? o
`?
To be used for SF DWG/GAR Est. Value $149,000 Date JUN 18 tg91
Site Address 4101 DEERWOOD TR
Lot 19 Block 2 Sec/Sub. ENGSTROM' S OFFICE USE ONLY
Parcel NO. DEERWOOD Occupancy R-3 M-1 FEES
1
R
Zoning -
w Name SONS CONSTRUCTION Actual) Const ?!-N Bldg
Permit 811.00
Address 4600 FAIRWAY HILLS DR (Allowable) V-N . 74
50
o City EAGAN Phone 452-5355 a of Stories Surcharge .
52' Plan Review 527.00
Length
Name SAME Depth 42' SAC
Cit 100
00
u
o< Address SY Total .
y .
City Phone
S.F. Footprints SAC, MCWCC 650.00
t
W
C 660
00
On Site Sewage er
a
onn .
w W Name On Site well
W
95
00
is
=6 Address MWCC System % ater Meter .
6 X Acct Deposit 30.00
a City Phone City Water
30
00
PRV Required S/W Permit .
t hereby acknow'age at I have read thi ppucation and state that the Booster Pump S/W Surcharge .5
0
information is correct n gr t c ply t all applicable State of
Minnesota Statutes an of n in c Treatment PI 276.00
Signatu to of Penn it" APPROVALS Road Unit 370.00
A Building Permit is issued to SON ONSTRUCTION Planner Park Ded.
on the e.piess condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and C
y of Eagan Ordinances.
itt Bldg. Off. Copies
1
??
Building Official nnn Rgrd ( D l Variance TOTAL 3,624.00
Address: 41 01 DEERWOOD TR Lot 19 Blk 2 Sec/Sub ENGSTROM'S DEERWOOD
These Items were/were not complete at the time of the final inspection.
4?--13 - Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry 1.?
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
Basement finish L/
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
PfCKfF?NKR
White - City copy Yellow - Resident copy Pink - Contractor copy
? "i"8 2 3 ? /e>a2 as g?
Roques Date
7 ve Rough-In Inspection
/22/91 Regwred9 AReady New ?WtlINoLty Inspactar
Yes - No When Ready?
I # licensed contractor ] owner hereby request inspection of above electrical work at:
JoD Address IStreat Brx or Route No 1
4101 Deerwood Trail City
Sallie, N. Township Name or No Range No County Eagan
Occupant (PRINT) Dakota
Sons Construction Phone N.
Pewer Supgher - 452-5355
Dakota Electric Co. Address
EleCtncal conladrfDO Name- 4300 W. 220 St
mpany
I . Farmington, MN
BOOS Electric Co, Contractor's License No
Medmg Atloress "d1,rn1tor or Owner Making Inslaliatigni AM01895
2104 Great Oaks Drive, Burnsville
Anhonied s.7dre lCpq(ractq., - MN 55337
Owner Making Instal nl
Phune Number
431-4755
MINNESOTA STATE BOA R. OF ELECTRICITY
Griggs-Midway Bldg - Room 5-173 TH
1801 University IS INSPECTION REQUESTWILL NOT
Phone (610) 64 42-Ave.0800 St said. MN 551114 BE ACCEPTED By THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
- / ENCLOSED
9? REQUEST FOR ELECTRICAL INSPECTION ;•?"" -
?? 77 ? See insrucoons for Completwg this form on back of yellow copy /EB- Dl 08?
11 X` Below :Vdrk Covered by This Request e?
Home
Comm /Industrial
Farm
Other lspealyi
lnspechon Fee 8e1ow
Other
Fee
nng Pool
Irngaaon Booms --
Specaal Inspection
AlarmfCOmmumcatlon
Other Fee
I, the Electrical Inspector, hereby
certify that the above Inspection has
been made
)FFICE USE ONLY
his request I'd 11 months Irom
Service
Furnace
Service Entrance
0 to 200 Amps 7 5
Above 200 _
-ors Use Only
Circuits/Feeders
Fee
to 100 Amps
LbQ
9 Amps
0TAL
- $65.50
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
COMPLETED WITHIN 18 MOATM,S.
augh-In ? .
rat
65912 Lc-,Y- I9
3CK -2 ?3-
Eifl_26_nn
Request Date Fire No
81 (/
G7 Rough-in Inspection
Regmreds ? Ready Now krWIII Notify Inspector
Yes ? No When Ready?
I,? licensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.) City
Section No Township Name or No Range No. County
k IY (???
Occupant (PRINT) Phone No.
Po Supplier
? (ec f? « Address n
?cz ?
? ? l ? ? z
Electrical Condyad tractor (Company Na )
_11
1
I --,
? 1 Contractors LicenseNO.
.
iC
LkIf?,-3
8
Mailing Address (Contractor or Owner Making Installation)
Authorized Signature (1O,ntrac.r1Owner McNln Installation) Phone Numb.,
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-1]a BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612)1142-0900 ENCLOSED
$3' REQUEST FOR ELECTRICAL INSPECTION EB-Doom-07
P. See Instrucuons for completing this form on back of yellow copy ?-
y• Sad
LS 6 5 91 2 'X" Below Work Covered by This Request
ew Add Rep. Typeof Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractors Remarks
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 -Amps Above 100 Amps
Signs Inspectors Use Only, TOTA
L
Irrigation Booms 1
Special Inspection U
Alarm/Communication ?/ 6
Other Fee
I, the Electrical Inspector, hereby
certif
that the abo
i
t
h Rough-,n r Da
y
ve
nspec
ion
as
been made. Flne1 I
ea -o
OFFICE USE ONLY
This ra.--
6
04 s
g ??416.7-- -
4
?, av
Request are /? F,re N
/ Rough-In Inpsecimn Pegwretl
(YOU must call inspector whe atlyl Inspecteo her Than Rough-In
qtly Now ? Will Notify Inspector
? Yes No Date Ready
nsed contra
t
]
c
or
owner hereby r equest inspection of above e lectrical work at:
Job Address Street Bo or Rout o-) City
LIW
Wr ??
Section K. Township eme ar No Range No County
Occupant (PRINT)
Phone No
,..or Supplier Address (/
n
Electnc I,C tee Iompany el
Contractors License No J
Mal- g An ress iCOnrr c
t
or or Ow e ng Instaim,cmt
y
?
Authq tl S
ConlractonOwner Making Ration, Phone Number
??
MINNESOTA STATE BOARD OF ELECTRICITY
Gd THIS INSPECTION REQUEST WILL NOT
1621 Griggs-Mrdway aid, St Room BE ACCEPTED BY THE STATE BOARD
Phone (612) (61P1 64A AYe ve, , 6d4e860 St Paul MN N S 65104 UNLESS PROPER INSPECTION FEE IS
ENCLOSED
?/ QGL REQUEST FOR ELECTRICAL INSPECTION `rT x'qa, EB-oooot.oa
7 ? See fiybtrucliops for completing this form on back of yellow copy
c-- Gil rP
0 6
tlU `' 'X" Below Work Covered by This Request
ew Add P Typeof Buiding Appliances Wired EquipmentWlred
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer Load Management
Comm /Industrial Fu P46e Other (Specify)
Farm it Conditioner
Other(apedry) Contractor Remarks
Compute Inspection Fee Below.
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ( 0 to 100 Amps
Transformers
Signs Above 200 _ Amps Above 100 Amps
Inspectors Use Only TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCO
Other Fee NNECTED IF NOT
COMPLETED WITHIN 18 MONTHS.
1 the Electrical Inspector, hereby Rougn-In Data
certify that the above Inspection has Final
been made to
OFFICE USE ONLY
This request vold IS months Nom
7Iq 7
2007 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651.675-5675
Please complete for modifications to existing residential dwellings.
60.E
Date 8 / 23 I o7
_
Site Street Address `rya l7ce. cJOOCJ ?-r?1? rl Unit #
Property Owner ?ow? Telephone # (Io5!) to88-716f
Contractor I?orbv7{ lu Mn?ot? Telephone # (6tt) ?27- q033
Address z9oS Liar e%? gve. So. City ILRCL State__140J Zip &S-qoeF_
The Applicant is: _ Owner KContractor -Other
New _ Refurbished Submit sets of plans and MPC license
Septic System Includes County fee
_ $ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
Alterations to existing dwelling $ 50.00
Add plumbing fixtures This fee includes installation of a water softener and/or water
_
heater at the same time. if you are installing only a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
5/8" meter is required)
Water Turnaround (add $136.00 if a
-
f
Other: Q,4w+oJe, [ 2"? F /oar (oc-bt row, - &k im"i ll 4 ? Ij
_ Water Softener _ Water Heater $ 15.00
new _ replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
$
Total
and nnnnrate- that the
- • - --• - - - - -
I hereby apply for a Resioentiai Pwmoing Permit anu auKnuwmuyc u- tilu
work will be in conformance with- the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is required to be reviewed and approved,
je-t} OUOdb?
Applicant's Printed Name 's ignature
2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes(condos when permits are required for each unit
?-o0So
Date
/ / ()( 0
'
Site Address Unit #
Property Owner :T Dm l Telephone # ( )
Contractor bf- 1(..
Vl?
1
.
'
??
''
\\
t}}
i
''ll
nr-\
`
11 f
` ,
n
Street Address a%VV V V - L I VVV 1 y
^
'
`J City `a yi L
State Zip Tel
ep
h
o
#
nee
Bond#: ??- 1 l lXl? le
?I
/
??
??
Expires:
?J Il I J
The Applicant is Owner A Contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
_ furnace -Additional -Replacement New
air exchanger
air conditioner
heat pump
other
State Surcharge $ .50
T
t
l $ ?
a
o
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 t/hg ?work will be in accordance with the
approved plan in tj "ale of work which requires a review and approval of plan] 1 1 f
Applicant's Printed Name AVplidant's Signature
71fg3 (a
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
5D 1,5 D
Date S I 2'? f 0(o
Site Street Address 17e?r4ToOCI -7-ra. I Unit#
Property Owner w ?t . Tows Telephone # ( )
Contractor Nprblm-n Plf.(mL-)(n Telephone# ((oly) ?67?1-u0?3
Address 2aD5 C-ar-f i,fw A-V.. so. City mpts Stater ill Zipr.?1?g
/
The Applicant is: Owner V
Contractor Other
Septic System - New
Refurbished Submit 2 sets of plans and MPC license Includes County fee
_ $ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing only a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing. IC;t c1r.?vt 1Zew?odal
-Septic System Abandonment
-Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $ '30. 90
1 h b I f Residential PI mbin Permit and ecknowled a that the Information is comple te and accurate; that the
are y app y or a u g g
work will be in conformance with the ordinances and codes of the City' of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan In the event a plan is required to be reviewed and approved,
jef-fret/ L. morblor>1, /. ?
Applicant's Prin d Name Ap an s Signature
PLUMBING (RESIDENTIAL) '
Permit Application
City Of Eagan
323311 Pilot Knob Road, Eagan Mn 55122
Telephone ? 1,51-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwel;:ngs
Townhomes and Condos when permits are required for each unit
Date /o/ / 03 WHITE, KATHY
4101 DEERWOOD TRAIL
Site Address EAGAN, MN 55122 Unit #
(651) 405-9474
Property Owner - Telephone # ( )
Contractor NMLOM PL1 3ONG CO,
Y
692 "`i' -----
to
Address
e
2905 GARFIELOMM -w
City
State MINNFAMA ip _ Telephone #
( )
The Applicant is Owner Contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ SO
DO
Adding fixtures to lower levels or room additions, excluding water softener and water heater .
_ Abandonment of septic system
Water turnaround (+ 518" meter if needed - $121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
- Water softener Water healer $ 15.00
X replacement _ additional ?n
rn'i.
$
.50
State Surcharge
Total ?`/ -- -""---- "" -"' $ Is-, EO
I hereby apply for a Residential Plumbing Permit and acknowledge that the mformation is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an application for a p, ,At, rnd 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 rcyu.r„s a rcview and approval of plans.
Applicant's Printed Name A_ 's Sig-nature
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
2n ?/ Il 3830 PILOT KNOB RD, EAGAN MN 55122
L 651.681-4675
New Construction equirements
• 3 registered site surveys showing sq. R of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window saes; poured found design, etc.)
1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE
SITE ADDRESS" I I V I LX
TYPE OF WORKI' 10 L
APPLICANT
STREET ADDRESS
TELEPHONE # I'
PROPERTY OWNER 1 y t
ALTI-FAMILY BLDG _Y '`ZN
VALUATION -1000
FIREPLACE(S) _ 0 _ 1 _ 2
tQ STATE W ZIP
FAX#605( aQQ-62C)5
TELEPHONE# fikUV5-9WN
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: --
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
- Air Conditioning
- Heat Recovery System
Phone #
NT `w
Fee: $90.00
Fee: $70.00
Phone #
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and gree to comply
with all applicable State of Minnesota Statutes and City of Eag rdinances.
Signature of Applicant
OFFICE USE ONLY
Water Softener
Water Heater _
No. of Baths
RemodelfRegair Requirements
• 2 copies of plan
1 set of Energy Calculations for heated additions
• l site survey for exterior additions & decks
• Indicate if home served by septic system for additions
Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received - Tree Preservation Plan Received - Not Required
Updated 4102
CITY OF KAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
vogg"M
FOR CITY USE ONLY
PERMIT #
RECEIPT #
DATE: c)PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS b
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST R
ADD ON
REPAIR
OWNER NAME: Sons CoRstruction
SITE ADDRESS: 4101 Deerwoood Trail
LOT: ?L BLOCK _,2- SUBD.Qa Ira?njQ
INSTALLER: R C R C Plumbing (fJ
ADDRESS: 5910 Chester Avenue
CITY: Northfield ZIP: 55057-4743
-------------------------------
COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
SHOWER 3.00 3-
WATER CLOSET 3.00 J.
a. BATH TUB 3.00 /i. -
LAVATORY 3.00 /.2
KITCHEN SINK 3.00
L LAUNDRY TRAY 3.00 3. -
HOT TUB/SPA 3.00
WATER HEATER 3.00 3 -
FLOOR DRAIN 3.00 3 '"'
GAS PIPING OUT.
(MINIMUM - 1) 3.00 3•
ROUGH OPENINGS 1.50 RS D
OTHER _
_ WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL
ST. SURCHARGE .50
TOTAL: $
Ste.
002fMERGTAIj7I1TjSTRZATs PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUED.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
PHONE #: 461-2096
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
MEG?NICAI:' 1'EEtEtI'?
FOR CITY USE ONLY
PERMIT #
RECEIPT # A9
DATE :
PSIDEI;Mf? PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------
WORK DESCRIPTION
NEW CONST
ADD ON _
REPAIR
OWNER NAME: Sons Construction
SITE ADDRESS:4101 Deerwood Trail
LOT: BLOCK oZ SUBD.
INSTALLER: GENZ-RYAN PLUMBING & HEATING CO.
ADDRESS: 14745 So. Robert Trail
CITY: Rosemount ZIP: 55068
PHONE #: 41,2 3 °I/ it y
DWELLINGS &
-------------------
FEES -----'------
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
9
SUBTOTAL: $Q i
STATE SURCHARGE: .50
TOTAL: sv
$? 7
SIONATURE OF PERMITTEE
COMMERCIAL/INDUSTRI`AS.L PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
1991 BUILDI? APOPLICATION
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 CALCS
# 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 AA $-4-EENU60MPLETE
PERMIT MUST SHOW A LICENSED PLUMBER. J
' / 41991 J1
To Be Used For: ?/ 07 'A i t Valuation Da
Site Address {Q{ Npmm-04 J1 OFFICE
Lot y Block L ???? ?a0 FEES'
,?y Occupancy ;?-'3 M-1 Bldg. Permit 811,00
£N GS 1 PUPI Zoning VI-{ Surcharge '7N,50
Parcel/Sub 0 e Nh 4? Y Actual Const V- N Plan Review 5Z17, OLD
Allowable V-N SAC, City /0010
Owner SG 7 s 90 *? # of stories SAC, MWCC 6,5701
[}?
Length .171 /yj_ Water Conn. (y Ad
Address ??G ?/QG?? j?•LE' ?4 Depth r/2.' Water Meter 95, QV
S.F. Total Acct. Deposit 0,00
City/Zip Code _. v Footprint S.F. S/w Permit O,(JJ
/ S/W Surcharge 150
Phone Ll 2-- J ) jS On site sewage- Treatment Pl. 2r)6,0
On site well Road Unit (), po
Contractor MWCC System Park Ded.
/, City water J4 Trail Ded.
Address 146 ?f PRV Copies
Booster Pump _
City/Zip Code yr? SUBTOTAL
APPROVALS Penalty
Phone J?> >_ Planner Lot Change
Council TOTAL
Arch./Engr, r3Y/f1.J I?57/N? Bldg. Off.
Variance
Address
PA
City/Zip Code 2-4 ;2,4/7
Phone-,# L/ 1-5-3-)-j-
agrees ? r•-1? that all work shall be done in accordance with
(Signature f Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances,
. ow-
? A 2AG?
ZIY2uZY. SIb?c15<<1rg0
6sMr,
32x3 _ ?6 0
(0'12x!5 ; 158
((I S x !4= 15652
1ST(.oo
?3Sr?T= 111 ?
2 ?c q,
1136 k 53= Cl
ZNr) ?i. uo92,
3o x3z. ? 96?
a?!?x l2yZ , Z?
bcz? x 5? r ?sog?
f'?n <l V' ??71
EXTERIOR. ENVELOPE ENERGY CODE COMPUTATION WORKSHEET
To Determine Ompliance with the Minnesota Energy Code
(Section 502 of the State Amended 1983 Model Energy Code)
Project Title Rasmuggen Job- Franklin Model
Site Address o 9 lock Deerwood n?P rg d Drive
1. EXPOSED WALL CALCULATIONS
A. Cpaque Wall
1. Masonry/Concrete
a.
be
C.
2. t C Wa
a.
be
3.
Woo Wa
rF
a. Insulated Area
b. Framing Area (Ave. 158 at 16' cc)
c. Framing Area (Ave. 10% at 24" cc)
4. Peripheral Floor Edge/Rim Joist
a*
be
Be Glazing
1. Windows
a.
be
2. Doors
C. Doors
1. Wood
a. Solid
be With storm door
2. Metal
3. Overhead
4. Other
AMR 'U' V= AREA x "U"
x
x
x =
co'-15 x . 0-7 ¦ . 4-01
x
x0+
¦ ?s4 . o
x j Q
x
21A x -0+ ¦ 8. P.
x
x --- = 14(0.1"x=
40 x 47 ¦
x
X .0(0 I•?-
x =
X'
x =
x =
D. TOTAL. WAIL. AREA, sq. ft. e - * * 9 e - ............. ?,lip)
E. TOTAL of AREA X 'U" ................................................... 2c' Z .i0
IL ROOF/CEILING CALCULATIONS
A. Roof/coiling Insulated Area J(014 .(a x OZ Z. Z-9
Be Boof/Ceiling Framing (Ave. 158 at 16" CC) x
C. Roof/ceiling Framing (Ave. 10% at 24" 00) 111.4 X o ? . 'S - 58
D. Skylight
E. TOTAL R(OF/tEILIG AREA sq. ft .............. 1'194
F. TOTAL OF AM X "U' .................................................. J • S 7
III. BUILDING ENVELOPE REQUIREMENTS
"Ua ALLOWABLE
(From I.D & II.E) (From V.)• (Area Y "U")
A. Exposed Wall; 2:7 16 X .11
Z98. 8
B. Roof/Ceiling: I1cl4- X e) 2(o
' .., 1. _, ,,?,?,.?lt ..-: .. •[.. ,,..
C. TOML Ar.r[T. Xz BUILDING 34YEWPE ('total of A & B above) ... s . L -
Z-IV. ACTUAL BUILDING ENVELOPE
A. Exposed Wall (From I.E)
B. Hoof/Ceiling (From II.F)
ACTUAL
(Area X "U")
2(-02. 10
?5. R7
C. TOTAL ACIWL BUILDING ENvE[APE (Total of A & B) ............ 291.91
'(Meets code requileaents if less Use III.C)
V. REQUIRED "U" VALUES
-aal Y I
Detached one and two family dwellings .1.1 .026
* Mlti-Family Residential Buildings .238 .033
(3 stories or less in height)
* A11 Other Construction Types (3 stories or less) .238 .06
• All Other Construction Types (More than 3 stories) .28• .06
• Based on 8007 heating dogma days (Ipls/st. Paul)
Adjust •B' values accordingly for other locations
CERTIFICATION
I hereby certify that I have ocapleted the above information and that it ocaplies with tt.
Minnesota State Energy Code. (\
BCSD 3-89
CC/SAi/6574
PERMIT t (J+? ?/ D CITY OF EAGAN
// Q 1992 BUILDING PERMIT APPLICATION
681-0675
HAY 1 8 RED
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs.
COMMERCIAL 2 sets of architectural.& structural plans, 1 set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re guest is made or lot change is re guested once permit is issued.
Date /S / 492- Valuation of work be. J( 6" /A04K o? .?ou5
Site Address: 9)0) Aer1UPA Tal? 1I67,1d) ?J !E)ZZ.
STREET STE /
Tenant Name: (commercial only)
LOT ?I G .. SLOCK SUBD. cfl?? P.I.D. M
Description of work:
The applicant is: CW Owner ? Contractor ? Other (Deseribe)
Name Rnsmll Alte2 Phone G/5?i'-r6 3l0
Property LAST FIRST 6 - Y6 lO_j
Owner Address L?/Dl A,lw,,,Oj T u i l
STREET STE 0
City 'Ell uah State AM) Zip _!?_)22
v
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect)
Engineer Name Registration _
Address
City State Zip
Sewer & water licensed plumber /1//`? 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 comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: /0 1Aaj 'a_0 4
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish
? 02 SF Dwg. 006 Garage/Accessory ? 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add.
? 04 Multi-fam. T.H. ?8 eck ? 12 Res. Porch
? 13 Comm/Ind New
? 14 Comm/Ind Add
? 15 Comm/Ind Rem
? 16 Public Fac.
? 17 Agricultural
WORK TYPE
19 31 N El 33 Alterations E3 35 Move
2 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) 1st F1. sq. ft. City Water
UBC Occupancy K?3 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
i of Stories Footprint Sq. ft. Fire Sprinkler
Length Igo On-site well Census Code
Depth ?s,??• On-site sewage SAC Code
APPROVALS
Planning Building
Engineering Variance
REQUIRED INSPECTIONS
? Site lp:Footing ? Framing
? Wallboard IS Final ? Draintile
? 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: S
Assessments
SAC %
SAC Units
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.,
- - - - ----------------- ----- - --- - ---------
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DATE a
FEES
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExlsT o coxsTRucriON)
STATE SURCHARGE
TOTAL
SITE
/-LC-
OWNER NAME: ED/ l S,reg /L) TELEPHONE #: VS* 3? ? a-
1 C_
$ 24.00
6.00
$ 20.00
.50
CITY:L STATE: 2WIC-1 it ZIP CODE: ?2
TELEPHONE #: ?? - 76P /`
SIG A E O RMITTEE
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
YLE ASE OMPLETE FOR ALL COMMERCIAUINDUSTRIAL
FOR AP TMENT BUILDINGS OR OTHER MULTI-FAMILY
PERM E NOT REQUIRED FOR EACH DWELLING UN
--------------
DATE• Y CONTRACT PR y
NEW BU G
INTERIOR ROVEMFNT
WORK
FE
1% OF Cp FEE $,
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50
ALSO COMPLETE
WHEN SEPARATE
$ 4190 o
OF :M FEE.
TOTAL
SITE
OWNER NAME: IYn-j
TENANT NAME: (WRO NTS ONLY)
0
#: 337a-
CITY:
CODE: 3
TELEPHONE #: 61j-266-7611'
SIGNA R F PERMPITEE CITY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
3-(G-q9
1999 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
Date:
Description of Work: - Construct new fireplace - Alterations to existing
Install Eras insert only - Install Eras line only
Other
Job address: eec-t_.9p?r? e
Lot: Block: ?- Subdivision/P.I.D. #: V SAYO VUiS (?(V?GZ8
Applicant (circle one only): Owne Contractor Permit Fee: $60.50
Name: Ae' l tlWl Phone #: ?
PROPERTY Last First
OWNER ,p
Street Address: LA -%q e? l t ??Y Y u `
City State: Zip:a
t,0 I-2-
Company ? M 12 Cit ?. l OL Phone #: -N
FIREPLACE ,,J_
INSTALLER Streets Addddress: 1:2 Q'je 't1
City '?[ A State. Zip:
Company J 9 Phone #:
GAS LINE
INSTALLER Street Address:
City 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. -V
Signatur
>x'x?????m??>x?m>?r???>x>K>KZ?>x??>K????z?mm?>xm??>x
CITY OF EAGAN
CASH.f.E.R: S TERMINAL NO: 935
DATE. 03/1.6/99 TIME: 15:39:29
ID",
NAME-. STOVE & FIREPLACE GALLERY
32210 9001 4101 DEERNOOD T 60.00
21.55 9001 4101 DEERWOOD T 0.50
Total Receipt Amount: 60.50
CR1.03994
USER ID: NANCY
>K%-.? ?ckcXc m ?X?X?X??X#?kYC:K?>K??%?X??n?k?X>X>X # %?>x>X?k# ?>K??X?k#
City of Eagan
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 681-4675
Site Address:
4104 Deerwood Tr
Lot: 19 Block: 2
Permit Type: Building
Permit Number: EA034680
Date Issued: 03/16/1999
Addition: ENGSTROMS DEERWOOD ADDITION
Description
Sub Type: Fireplace UBC Occupancy:
Work Type: Alteration = Construction Type:
Description: Gas Insert Zoning:
Census Code: Sq rp Fe_
w{?
,6:uu?na,tt Ate,...,
Remar
Chimnev/flue must be inspected before concealing.
Fee Summary: State Surcharge - Fixed
Permit Fee - Fixed
Contractor: - Applicant -
FIRESIDE CORNER INC St. Lic.:
2700 NFAIRVIEW AVE
ROSEVILLE, MN 551130000
6126331042
I hereby acknowledge that I have read this application and state that t
t applicable State of Minnesota Statutes and City of Eagan Ordinances.
PERMIT
0.50
60.00
$60.50
Owner:
Tom White
4101 Deerwood Tr
Eagan, MN 55122
agree
651-405-9474
Applicant/Permitee: Signature 'Issued By: Signature
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2008 RESIDENTIAL BUILDING PERMIT
Date: -1 '22)'08 Site Address:
Tenant:
RESIDENT / OWNER Phone: 425 `fog
Name: 10 N1-M K?VUA (A) kS C'E
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Address / City / Zip:
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Applicant is. Owner V
Contractor
TYPE OF WORK Description of work: .&SbL MLk* t L ?'I7ti IK7N?i11?' 1
Construction Cost: IS'jbbb` Multi-FamilyBuilding (Yes/Nom
CONTRACTOR Name. 1CVl1J ??D`1L-1AA1? License#:
Address: ?L $(j St. C6titt. AK
MIN ZI
: 1607
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L St
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e:
City
AAA
Phone ?(p)I,) W)-15 11 Contact Person. KF-VI
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Rlans and supporting documents that. yoir stibMit are considered to be public.inforinationt Portions;oi
the information may be `classifi'ed as non-pu&ic ri you providespecffic reasons that iyou!d permft#he City ro;:
°conclude;thatxthe are trade secrets.= -
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit, that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
'` r c??u\?? ?A
X ???11 fJ i'18 LU,iJ 15 J ? D x -NC1 L
Applicant's Printed Na a Applicant's Signat e
SEP 2 3 2008 Page 1 of 3
---
I Fo`Q??5? --y
Permit #:? 3z /
I Permit Fee:
I
Date Received
I /1 I
I Staff lj/ I
I g_
A4 _q
PPLICATIONOT6 "??,1
Suite #:
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation
? Single Family
? 01 of _ Plex
? 02-Plex
? 03-Plex
? 04-Plex
WORK TYPES
? New
? Addition
X Alteration
? Replacement
? 05-plex ? 16-plex
? 06-plex ? Fireplace
? 07-plex ? Garage
? 08-plex ? Deck
? 10-plex Lower Level
? 12-plex
? Accessory Building
? Porch (3-season)
? Porch (4-season)
? Porch (screen/gazebo/pergola)
? Storm Damage
? Miscellaneous
? Pool
? Ext. Alt. - Multi
? Ext. Alt. - SF
? Multi Misc.
? Interior Improvement ? Siding ? Demolish Building*
? Move Building ? Reroof ? Demolish Interior
? Fire Repair ? Windows ? Demolish Foundation
? Egress Window ? Water Damage
* Demolition (entire building) - give PCA handout to applicant
Valuation 3?o Occupancy
Plan Review Code Edition
(25% 100% Zoning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Const e3 Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof: -Ice & Water -Final
Framing
Fireplace:-R.I. _AirTest -Final
Insulation
Reviewed By:
W1 MCES System
,W4? SAC Units
P,t) City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock Meter Size:
Final/C.O.
Final/No C.0
Building Inspector
Base Fee J 3d
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
HVAC
Other:
Pool:
-Fo
Siding otings -Air/Gas Tests -Final
: -Stucco Lath -Stone Lath -Brick
Windows
Retaining W
all
Page 2 of 3
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Ilse
Permit #. `
_(// ? ? ITT
Permit Fee:
Date Received:
Staff:
-------------
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: rte' J I o t /Site \Ad/dress: qI (j l ?eCf V wood Tree,
Tenant: ?U k y, Li vi 14 C Suite
RESIDENT / OWNER Name :TD hn l -0 (A c I Phone:
Address/City/Zip 4110 V?Ctt?ac c( Tr!L'A
CONTRACTOR
VO c?e ns n t LoHt 5 3 3 -sP+?
Name: ? r ? r S Cr H `L( K,,-b
Address: J 3I'/ 7 "h e r L-Sc"
City: (?'s V O c, `K o t c State?h Zip: 5c5 ( Z
Phone' iS4 - -LOS Z Contact Person:
TYPE OF WORK ')( New Replacement -Repair Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMITTYPE RESIDENTIAL
Water Heater Water Softener
- Lawn Irrigation _Add Plumbing Fixtures
C- RPZ / _ PVB) Main C Lower Level)
Septic System Water Turnaround
_ New
~?
X"?Se
?
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
`Water Turnaround (add $136.00 if a 5/6" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate; that the work will be in oontonnance wim the ordinances and codes or the Giry or
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. .T--
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Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By:
Date:
Renuired Insnectiens- Ilndar Ground Rounh-in Air Test Gas Test Final
•.,. Cerfificafe o f Surue for. . IQW§6f I'n
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SONS CONSTRUCTION
LEGAL.. 'DESCRIPTIONs LOT.MjfiL0C9.Ls ENGSTROMSB ERWOOD
ACCORDING_TO -T_NB AECORDED PLAT
THEREOF OAKS COL+NUMMESOTA
PILOT KNOB ROAD (CO. ROAD 31)
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SONS CONSTRUCTION
LEGAL. •DESCRIPTIOW LOTAiSLOCd.2, ENGSTROMS DEERWOOD
ACCORDING?TOT?mEg AEOORDED PLAT
THEREOF .,?A5sZi9.,._ CO?wTr,MMESOTA .
PILOT KNOB ROAD (C0, ROAD 31)
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---------------i
Nam=
City of Eajan REcE\vell Permit
Z z
clp-
3830 Pilot Knob Road ,AN 3 1Q1't Permit Fee:
Eagan MN 55122 1 Date Received: ' 3~ -/Z ;
. Phone: (651) 675-5675
Fax: (951) 6754694 ; StatF. 1
2011 RESIDENTIAL PLUMBING PERMIT PLICATION
Date: I a Sito Address- 4101
Tenant:
suite p:
RESIDENT I OWNER Name: y-4
Phone:
Address / City / Zip: //)A/ -
CONTRACTOR Name: MILBERT COMPANY INC.dba C=GAN WATER
Address: 1801 50TH ST EAST city:_ : INVM GROVE'HGTS
State:-- MN__.Zip: 55.077 phone: 651 .::451-2241
Contact BILL.MILBEkf . Email:
TYPE OF WORK _ New Replacement _ Repair _ Rebuild _ Modify Space _ Work iq.R.O.W.
Descri tlon of 'ork:,
Rd IDENT/AL
PERMIT TYPE
Water Heater Water 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 E4 Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround' (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.) ancludes $5.00 State Surcharge)
TOTAL FEES $
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.oooherstateonecall.om
I hereby acluxWedge that this Intomhation Is complete and accurate; that the work will be in confoananoo with the ordinances and codes or the City of
Eagan; Mat I understand this is riot a permit, but only an application for a permit, and work not to start without a permit; that the work will be In
• accordance with the approved plan in the co" of work whit h requires a .review and app 1 of s.
x ~414111 )1A A.P 194- Ji
x
Appl ant's Printed name a t's,Signa r•
fi0R OFFICE'USE Rev ewea "
13
F2eqij)redspe s' fiy U,d r t,' s
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116142
Date Issued:10/03/2013
Permit Category:ePermit
Site Address: 4101 Deerwood Tr
Lot:19 Block: 2 Addition: Engstroms Deerwood
PID:10-23900-02-190
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 .
Elizabeth Hess
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 -
Thomas White
4101 Deerwood Tr
Eagan MN 55122
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
Sao,
o�a0
a i
Name: J� ,� �(�,�- Phone: SIn ' 01
a d
Owner
E AGA N
For Office Use
jPermit #:
� Permit Fee:
I L
D t R d , Cj -/ t
a e eceive I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 EC E IVE
(651) 675-5675 1 TDD: (651) 454-85351 FAX: (651) 675-5694 1 Staff: 1
buildinginspections a)cityofeagan.com NOV 2 0 2018 L
2018 RESIDENTIAL BUI ING PERMI APPLICATION
Date: \\ Unit #: — T)-ewA6=4 T.\
�\S �` Site Address: �'' 10�
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cltyofeagan.com/subscribe.
Exterior work authorized by a building permit Issued In accordance with the Mlnnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you
Intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this Information is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of
Eagan; that 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 g1a`ns.
x - �f_Z_w �_,_
Applicant's9i3rinted Name Applicant's Si nature
Name: J� ,� �(�,�- Phone: SIn ' 01
Resident/
Owner
_
Address / City / Zip: y1 O� 4_.WZ��?c� �,� , �L t N�� SS \ -2 -2 -
Applicant is: Owner Contractor
Type of Work
Description of work: Wf� ia�y6m C�gaV'I. :S 1'� ter Ql; to �CCa Q_0 ,
Construction Cost: Multi -Family Building: (Yes /No '� )
Company: CIYr11c.� s � U� 12 Contact: (", Yu�K')
Address:UC) ROCity:
Contractor
State: N) Zip: S�cA Phone:�U--_) ,� 3 i mail: (c��iGLxy��r►C(Un- W10—kyV y" -
GUm
License 4:7, 7!3,%"J 1-R� Lead Certificate 2_
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the Information maybe
classified as non-public if you provide speclflc reasons that would aermit the City to conclude that theZ are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cltyofeagan.com/subscribe.
Exterior work authorized by a building permit Issued In accordance with the Mlnnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you
Intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this Information is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of
Eagan; that 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 g1a`ns.
x - �f_Z_w �_,_
Applicant's9i3rinted Name Applicant's Si nature
DO NOT WRITE BELOW THIS LINE
Ci iQ TVDCQ
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
Valuation
Plan Review
(25% 100% )
Census Code
# of Units
# of Buildings
/�2)1-42
Fireplace Porch (3 -Season) Exterior Alteration (Single Family)
Garage _ Porch (4 -Season) _ Exterior Alteration (Multi)
Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
Lower Level Pool Accessory Building
Interior Improvement Siding Demolish Building*
Move Building Reroof Demolish Interior
Fire Repair Windows Demolish Foundation
Repair Egress Window Water Damage
*Demolition of entire building — give PCA handout to applicant
Type of Construction F2
Occupancy -1
Code Edition 4224110/&
Zoning
Stories
Square Feet
Length
Width
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
REQUIRED INSPECTIONS
Footings (New Building)
Meter Size:
Footings (Deck)
Final / C.O. Required
Footings (Addition)
Final / No C.O. Required
Foundation Foundation Before Backfill
HVAC Gas Service Test Gas Line Air Test Hood
Roof: Ice & Water Final
Pool: Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour
Drain Tile
Fireplace: Rough In Air Test Final
Siding: Stucco Lath Stone Lath Brick EFTS
Insulation
Windows
Sheathing
Retaining Wall: Footings Backfill Final
Sheetrock
Radon Control
Fire Walls
Fire Suppression: Rough In Final
Braced Walls
Erosion Control
Shower Pan
Other:
/
Reviewed B y:
,Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2of3