3896 Denmark Ave
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use
I I
City of Ea naIl ; Permit I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 117WED
Fax: (651) 675-5694 I Staff:
SEP 14 2010 `-----------------I
2010 MECHANICAL PERMIT APPLICATION
Date: 2 /C -/D Site Address: ~g`/v ifl IM~V° l~\? t ~'~GVYt
Tenant: Suite
RESIDENT / OWNER Name: L- -yy e- r\ S'r-, V\ Phone: (51 4S ~2-
Address/ City/ Zip: ! to v k J~' c~
CONTRACTOR Name: Uk k4l Z Q) c~T t V,~Ct aC- License
Address: I J J Ev1 tt~' "I City: qF-C- Cc VA
State:( Zip: j5 t) oZ Phone:
Contact:--DGcyl ~r~~lt-c~►ti Email: AAG~I UAlrikA .C-o
TYPE OF WORK New --,X- Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install / _ Remove)
" When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plum bin Inspector
RESIDENTIAL FEES: ~ ~ ~ - - 7o
$50.WMinimum Add-on or alteration to an existing unit (includes $.7WState Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ = TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50. /l
If Permit Fee is > $1,000, surcharge increases by $.50 for each ' V Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
CJ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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`~ rn't-c? ~ 94- ->a ~ I ~ 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
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 11 j ?
' PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $ 80 r O U 0 Date DECEMBER 9 19 85
Site Ad ess 3895 DENMARK AVE Erect If Occupancy R3
Lot Block BIRCH PARK
/S
b
S Remodel C1 Zoning
u
ec
. i
?
R V
t
T
f C
Parcel No r
epa .
ype o
ons
Addition ? No. Stories
SUNSHINE CONSTRUCTION CO Move ? Length 4 H
= Name 5985 125TH ST W Demolish ? Depth 46-
X Address _
AV
4312200 Int. Impr. ? Sq. Ft
City -
.
Phone Install ?
5¢ JAMES R. HILL
F = Name 8 00 HUMBOLDT AVE SO
_ ? Address
Z W City BLNT14 Phone 884-3029
Assessment
Water & Seen
Police
Fire
Eng.
Planner-
Cou
y g application and statethattne Bldg.
f hereby acknowledge a that I have read this l _
Bldg
information is correct and afro to c ply with lLapplicahle Slate of
Minnesota Statutes and CtWjO Eagan 7tnelins. APC_
Var. [
Signature of Permittee
A Building Permit is issued to: SUNSHINE CONSTRUCTION
all work shall be done in accordance with all applicafile State of Minnesota Statut
Permit T .00
Surcharge -?? 50
Plan Revlew--575-. 00
SAC 5UU. 00
Water Conn. 153 00
Water Meter --2-87V. 00
Road Unit ----T37-. 00
Tr. PI.
Parks
Copies 50
on the express condition that
and City of Eagan Ordinances.
Permit No. Permit Holder Date Telephone K
Plumbing
HY.A.C. 13 U / S
Electric
Softener
Inspection Data Insp. Comments
Footings l 1'`6S
Footings II
Foundation
Framing
Roofing /a6 l3
Rough Plbg.
Rough Htg. l.v ??f l fl` L. Irv,
Insul.
Fireplace
Final Htg. /07 Ly1
Final Plbg. 2 /.A/
Bldg. Final (? f
Cert. Occ.
Deck Fig.
Deck Frmg.
WON Describe Location:
P?. DNp.
MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbwvd *rca S/C
Type or Print legibly Tot
1. Date % 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner ?' -
5. Contractor Phone
8. Address
7. City - State if , Zip = 4 y
8. Building Type: Residential 0
Commercial ? Institutional ?
9. Work Description: New Q
Add ? Alter ? Repair ?
10. Describe Fuel Type ! .
11.
No. Equipment BTU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
i Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :.i .. W * . -.. for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
PERMIT #
RECEIPT #?
DATE I L2
CITY OF EAGAN
1 PLUMBING PERMIT
T 454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $-SO
MINIMUM COMMERCIAL FEE - $20.00 + $.50
FEE
S/C
TOTAL
1. Bldg. Type: Res _X_ Comm Inst 2. New X Add Alter Repair
3. Total Bid Price 4. Job Address -"?-( I I < ' , v v
Lot Block "-i Sec's 5. Owner
6. Contractor I ?? ? I 1 L? ? 1 r ?L (1 11 X i lJ1 I?'?t 1 ?? 1 1??? it jE
(Name) i G Z `l (Street) (City) (zip)
7. Contractor Phone # y? -- -?
FIXTURES
Water Closet - $3.00
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
NO. FIXTURES
Laundry Tray - $3.00
Floor Drains - $1.50
- Water Heater - $1.50
Whirlpool - $3.00
=Gas Piping Outlets - $1.50
Softener - $5.00
NO. FIXTURES
-Well - $10.00
Private Disp Syst - $10.00
Rough Openings w/o
Fixtures - $1.50
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: - ! for
Approved Inspections: Date Rough Insp. Date Final Insp.
CITY OF EAGAN Remarks D i v i -,ion # 16252 10/85
AdditionBirch Park _Lot 5 elk 4 Parcel 10 14175-050 04
Owner
Street 3 89-6 Ida-rk Ave State E agar MN 551 73
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 221 1973 162.96.` 5.15 20 Paid pri r to divisi on
SEWER LATERALbn 931 1985 132.70 8.85 15 " " Be of " It " to
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK 1018 1986 750.48 50.03 15 r
STORM SEW LAT 1048 1986 199.66 13.31 15
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road it
WATER CONN. 500.00
BUILDING PER. 11381
SAC C;91; - no
PARK ?:j
AATY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road I, ?[}Y`
S
21199
B ? 7 S 1
PERMIT NO.:
?
ox
P. O. y
MN 55121 C
Eagan DATE:
,
Zoning . `
No. of Units:
Owner. .1 .
-
k ' , '
Addre-s: ; r ,enmar-
irc arr.
te Address: r• lup?b i
umber. c'
r No.:
ze 2
:
eader No Pe F
I
agree to oemply wkh the rge:
W? ,wm
Misc. Charges: l ,,,n , meter
Total:
Dote Paid:
y
ate of Insp.: inep.
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PENT NO.:
P. O. Box 21199
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner.
Address:
Site Address:
Plumber.
1 agree to eerplr with the CAY of Iowa
ordiwenoee.
By
Dote of Insp.:
Connection Char":
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Dote Paid:
This request vo`dL If ?l[I
18 months from j y
quest vom
r
Licensed Electrical Contractor
Owner
.oat Address. Box or Route No.
W9
Contractor
or
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs-Midwav Bldg. - Room N-191
1821 University Ave., St. Paul, MN 55104
Phone (612) 297-2111
Rough-in?lnspection OC] Ready Now ®Will Notify. Inspe, -
Requ red. -`tor When Ready
es C] No
I hereby request inspection of above
electrical work installed at:
City
1-r
- - -- _- - r-i^Al IIUCDG(-TI(IN
1 ,---:): , -- ?) - C) 0
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
A10011h, EB-00001-04
CITY OF EAGAN 0 y
8830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N . 11 a 1
PHONE: 454-8100 ?r[
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $80.000 Date DECEMBER 9 19 85
Site Address 3896 DENMARK AVE ?t
Erect R3
Occupancy
5
Lot Block 4 BIRCH PARK Remodel ?
Sec/Sub. Zoning Rl
Parcel No Repair ? Type of Const V
.
Addition ?
No. Stories
SUNSHINE CONSTRUCTION CO Move ? Length 4R
Name Demolish ? Depth 46
A c
z
o Address _ Int. Impr. ? Sq. Ft
city 'Phone Install ?
a SAME Approvals Fees
i ame
$p Address Assessment
City Phone Water & Bev
w
w Name JAMES R. HILL Police
Fire
Address 8200 HUMBOLDT AVE SO
s W City BLMTN Phone 884-3029 o N
Planner-
I hereby acknowledge that l have read this ppf tion and stat that the
information is correct and a to cc n y with II applica State of
Minnesota Statutes and ity Easfani rdina s. -
Signature of Permiffee -
A Building Permit is issued to: SUNSHINE CONSTRUCTION
all, work shall be done in accordance with
pli =f of innes a
??
Building Official - -?
Council
BIdg.Off. 12 3/85
Permit $ 373.00
Surcharge
Plan R
Plan Review
- 525.00
-
Water Con
n. 5OV
.0 0
Water Meter 63.00
2$0.00
Road Unit
Tr. PI. 132.00
Var. Date I Tota e ? 5 0
Total
on the express condition that
Statutes and City of Eagan Ordinances.
J?
?joto?`f
Y
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651.681-4675
New Construction Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20°h maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
Y 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
• Rim Joist Detail options selection sheet(bldgs with 3 or less units)
DATE
,Ak fh1-e.
APPLICANT
U-m6i Com4-rG-dDrj-
STREET ADDRESS ISla 14 /7 N-1 C a ile+
TELEPHONE # Rya 70V1-coiSS CELL PHONE #
w t )it STATE N) ZIP 55339
FAX#q$a -70'7_c7"7o?S
PROPERTY OWNER Lli /nn f Ter L Yf?le/IS?/l TELEPHONE # (05)- ySa - 55'::15
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted
Y Energy Envelope Calculations Submitted
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor. _
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
MULTI-FAMILY BLDG _Y ?k N
_ FIREPLACE(S) _ 0 _ 1 _ 2
Phone #
Phone #
Fee: $90.00
I ? l?7 ?e? L7 L
p MAY 2 3 2002
----------------------------------------------------------------------------°°--------- -+=W ---
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicantllbt4?.? I Y/l.ClkY?
OFFICE USE ONLY
Water Softener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodelfReoair Requirements
• 2 copies of plan
Y 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
Y Indicate if home served by septic system for additions
VALUATION ?
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
CITY USE ONLY
SUED. Lich Burk-
RECEIPT #:
RECEIPT DATE:
PERMIT # /Y
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backgow preventer for underground sprinkler system
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe:
Q ?l $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet " minimum - f 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newirefurbished * requires MPc lic. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installation/repair/rebuild 30.00 x = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if dwelling is under construction 3.00 x = $
Underground sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water turnaround 30.00 x $
State Surcharge .50 > -> - > $ .50
Total
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-- ----- --- --- -that ----- -----------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply wdh all applicable City of Eagan ordinances.
It is the appticant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: g6 2?cA)AI WK OWNER NAME:: TELEPHONE #: I Z 833 - ?O Zr
(A EA C E)
INSTALLER NAME: %OTaee TELEPHONE 63 S3T-
STREET ADDRESS: ZB60 (AREA CODE)
CITY: STATE: V ZIP:
SIGNATURE OF PERMIT-TEE
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used For: 1/ J1U- Valuation 80(0>O Date:
Site Address 77 n OFFICE USE ONLY
I
Lot U1 B1 y yy
Parcel/Sub //?? Erect X
Remodel
Repair Occupancy R 3
Zoning
?.I
Type of Const TT
O r Addition # of Stories
wner Move Length
Demolish Depth
Address 7 Int.Impr. Sq Ft
d Install
City/Zip Cod ------------ -----------------
Phone 1 APPROVALS FEES
Contractorc
` Assessments Permit
s Water/Sewer Surcharge
Addres y
` Police Plan Review
Fire SAC
City/Zip Code Engr Water Conn
Planner Water Meter
Phone Council Road Unit
Bldg Off jj • Si'reatment P1
Arch./Engr. APC Parks
Variance Copies
Address / S TOTAL ai
)
City/Zip Code /
Phone # ?n - 9q
0
2¢X 3¢ - of (oy ? = 41328
22? Z2 = 4-?4-x i2 = SSc)
q?? x 44 zo°i¢q-
1 ZX to (2co q q = S ZS o
,1l 3(o o
CITY OF BUILDING DEPARTMENT
EXTERIOR ENVELOPE AVERAGE fluff C014PUTATIO14
(To be submitted with building permit application)
One or Two Family Dwelling_ Owner
All Other Site Address
Contractor J12AIA11fi - CO ST
Date Phone
LINEAL FEET OF
EXPOSED WALL ft. above grade = 389. frj
TOTAL EXPOSED WALL AREA SQ. FT.
OPAQUE WALL CONSTRUCTION: 'full Value x Area
Detail: rxsfntL Fluff •443 x SQ.
reference "U" '098 x S@.
from 1P1a1 nun , 04,0 x SQ.
attached fluff x S@.
sheets fluff x S@,
nun
x
S@.
WINDOWS: 'full
Make & Type
if n
n it
n it
DOORS: ffUff
Make & Type
o u
n ff
u ff
TOTAL (U)(A) VALUES ZQ 4),B /
DIVIDED BY TOTAL WALL AREA 33$9.9.8
AVERAGE ffUaf /
= • 087
.115 9r less for 1&2 family dwellings
ROOF/CEILING:
TOTAL AREA:
FT. 49.00 =&(p (U)(A)
FT. f34;o0 =_39. (U) (A)
FT. _ (U)(A)
FT. _ (U)(A)
FT.- , 2q(G• $/ (U) (A)
Detail reference
f fluff 1'9?-
, x sq. FT. //760 = 70 (U) (A)
rom
attached sheets, fluff
nUff x SQ. FT. . (U)(A)
Describe openings
fluff x SQ. FT. _(U) (A)
in roof
.
fluff x SQ. FT. _ (U)(A)
x SQ. FT. = (U)(A)
TOTAL (U)(A) VALUES DIVIDED BY ?,7,,9+ To7AtLS .L7tO N.fT 2`V)ls?
TOTAL ROOF/CEI IG AREA 117(a . OZ- 3?
AVERAGE 'IV" ,p?s f r vOntilated roofs,
Value x Area
FT. 2!;47-/,g. 109• fit f (U) (A)
FT. ZOZ,5Z-= 19•34(U)(A)
FT. 158.%p= /0,35?U)(A)
FT. _ (U) (A)
FT. _ (U) (A)
FT. -= (U) (it)
)A/70t,, de-,/1/tT, nUff . 4S x SQ. FT. Z¢5.90 = O.(o5 (U) (A)
cuff x SQ. FT. _ (U) (A)
nun x SQ. FT. _
nun U) (A)
x SQ. FT. _ (U)(A)
Value X Area
-yTL, IIIStX`. fluff- ./¢ X SQ.
'full 147 x sQ,
faun x sq.
nun x SQ.
TOTALS 338Y• 48 SQ.
AVERAGE fluff
11 woRK. 11
?Ra`?S EXt?.F.D tJ?c,L,
18.33 x ??tsot ?+2s) = 2859.48
9,6'0 X 54 = 43Z,oo
7OO X 0+7, = 98,oa
6*kl
,(v7XC5Dfi5D+-L$t28)
700 x ( 7t7?
fa/ ?1
1, 606P x ( SotSotz$tZg?
Zs8,9G ,.
,RDows
Zox??o = S,O X gj = 9,0,00
20X9'87 = (0.7 X 9 = rod,3o
Z4 x48 = rg• o x (v = 5'S?Ao
Z4X?(o =- 6,0 x Zc- IZ,Oo
Zo x?ao = 8.4 x 4 = 33.100
14,0 X I = 44,00
Z4s,ga
Z
S7Z:, yE2.. z1,oo
f 3??D0 c Gam, Code, Zo2.sZ.
i? P?M Z58.91d
X S
7 '? Doo2'S 133,oa
14 X z.o =
-150
I17?• oo
3 389.9 -?
= 98.00
31874g'
Z59-q' l °?
V!\
Determining "Ulf values at Roof, Wall, Rims and Conc. Block
ROOF/CEILING (R) VALUE
1.) Interior Air Film 0.61
2.) 5/81, Gyp. Bd. .56
3.) Insulation -4v,00
4.)
50 Exterior Air Film .61
(STILL)
fluff = 1/R= OZ3 TOTAL (R)=11-7$
WALL
6.) Interior Air Film
7.) 1" Gyp. Bd.
8.) Insulation
9.) $oiUT- P-ITLr-
100 Masonite Siding
11.) Exterior Air Film
(R VALUE
o.68
.45
19.00
Z•o9-
.67
.17
fluff = 1/R=.. .O¢7? TOTAL (R)= 23.01
RIH
12.) Interior Air Film
13.) Insulation
14.) 211 Fir Rim Joist
15-) FvIL.T- P-lTrE
16.) Masonite Siding
17") Exterior Air Film
R VALUE
0.68
19.00
1.88
Z. 04
.67
.17
null = 1/R= 40 TOTAL (R)= Z¢,¢4
FOUNDATIOR
18.) Interior Air Film
19.)
20.)
21.) 12" Concrete Block
22.) 1&11> ld kL,
23.) Exterior Air Film
fluff = 1/R= •Oq8
JR VALUE
o.68
1.28
g: o
TOTAL (R)= 1o.1?
. CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PIfAU PCTATI
3=_ :C S CP i, DAT OF ORIGi IAL UILD1tTG PER•IJT ISSu?NCZ-
?_ SifiGLE ^PNULY _.. _.. _ _?.
? R-2 DUPLEX. (TWO UNITS) ? R-3 TavNHCVSE (THREE + WITS)( L=
? R-4 APARRMT/CC`IIJaKMILM
? CMI+ CIAL/RETAIL,/OFFICE
? MMUSTRIAL
? INSTITUTIONAL/GOVE.RNMENr
2) i-??TI1-`T c? (PLLAU RINTJ
ADDRESS : C-4 AA
CI':_', STATE, ZIP:
PHONE: J'
3) PL ' 3'R NAME: 73 J
ADDPWSS: /nO /:?' ?119%n ;1
C17y, STATE, ZIP: d.5 , to C
PHONE: ?S Kam- U/ LJ
PLUMBER LICENSE b Z/lav
4) OC- 7/Ct.
NAi•tE:
ADDRESS:
Cin" STATE, ZIP:
PHO T:
5) I:DM7-. ";-HICH PEP:•LIT IS BEING, REQUESTED:
Q CO'ZIEC^ION TO CITY SEWER
?k CC"TNECi'ICN TO CITY WATER
? OTI1R (PLEASE DESCRIBE)
FG= 'SE ONLY
..FERS Li?:.NSE:
C
of Recor
5) .?iC •.. C:
):OtD APPRQVM PM,11T FQR PICF-UP BY QNE QF LIE: ,:.
? PULSE :-YdL APPQ TD PER•LIT TO 1, 2 3 , 4 ABOVE
f? (Cl one)
.7) S_TC? Lr : DATE:
r
! !! Aa?a1 ?:A } i ¦! l?J??:a q I.t r?r:r i:r:? ¦i al s rt.ic?:a 1? A ? als:r li/-fw:i? r a s t? a t?
F O R C I T Y U S E O N L Y
PER'-lIT = ISSUED
I
FEES 411 <, -
S
$
$ / u
$ w>? .
$
$
:::; .__.... $
S
$
S
SE:?Ea nrRUIT (I,ICL:;DE -URCHA (=)
WATER PEMlIT (INCLUDE SURCHARGE)
WATER METER/COPPERHORN/OUTSIDE READER
WATER. TAP (INCLUDE CORPORATION S'TC?1
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATERAL BENEFIT/TRUNK SEWER
LATERAL BENEFIT/TR K WATER
OTHER f?
S TOTAL
AMOUNT PAID/RECEIPT /
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN'PUBLIC' RIGHT OF WAY?
C YES IF YES, THEN A "PERMIT.FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
CEO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SU2j, r7 TO THE FOLLOWING CONDITIONS:
APPROVED BY:
T1^i
DATE: %? (L
04 sm w" r? a? s w ?a sw a a w w r. t wry w++ ?t? ?? Qar R? in ??r+ w + Pc w oa ?. r.
SORVEYOR'S CERTIFICATE
.4_ DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT.SET
® DENOTES IRON MONUMENT FOUND
X000.0 DENOTES EXISTING ELEVATION
(000.0) DENOTES PROPOSED ELEVATION
SIENNA CORPORATION
SCALE: 1 INCH = FEET
PROPOSED GARAGE FLOOR 8 4o•o FEET
PROPOSED LOWEST FLOOR = ao FEET
PROPOSED TOP OF BLOCK = 840,4 FEET
NOTE: THE LEGAL DESCRIPTION SHOWN'HEREON'WILL BECOME VALID
UPON FILING THE PLAT OF BIRCH PARK.
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION
OF A SURVEY OF THE BOUNDARIES-OF:
Lot 5 , Block 4 ,BIRCH PARK, according to the
recorded plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR'ENCROACHMENTS; IF ANY. AS SURVEYED BY ME
OR UNDER MY DIRECT SUPERVISION THIS 2'6QO DAY OF ocTOgV-Q? 1985.
SIGNED: JAMES R. HILL, INC.
BY: `? -
IIAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
APPROVED FOR SIENNA
CORPORATION
BY:
DATED THIS DAY OF
19_.
REVISED I1-14-85 TO SHOW A
PROPOSED HOUSE FOR SUNSHINE
CONSTRUCTION.
SHEET 1 OF 2 SHEETS
PROJECT NO.
84762
FILE NO.
FOLDER
BOOK / PAGE
13 */ SIQ
JAMES R. HILL, INC.
Planners / Engineers / Surveyors
8200 Humboldt Avenue South
Bloomington, Mn. 55431 812-884-3029
SURVEYOR'S CERTIFICATE SIENNA CORPORATION
_ 834.9 _ 839. Z
DENMARK A VENUE
N 40'01 '57" E
IgSI?-
QD
I
1
3 K?
Ix o
?
o ?
o
?o
a N
?--
i1
539,
? N z\ C9'A.7) 10? o
N\ \ 1
1
932.
7j
I
i
2 rl - V
p in?
0
It
m
w
D O rJ
N ?
Q I
W
-J
g LOT 5
I` ? I
O \ Z? G
f?
1411
?70 S ?.g j
<J c
R
r \
SHEET 2 OF 2 SHEETS
PROJECT NO., BOOK /PAGE JAMES R. HILL, INC.
84762
134- Planners / Engineers / Surveyors
FILE NO.
8200 Humboldt Avenue South
FOLDER Bloomington, Mn. 55431 612-884-3020
Date:
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JUN 202016
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
% Site' Address: 3876 4,9 ! / ,e ,1 �
Name: C>
Address / City / Zip: 3 g9t? DE -Aim' 4-vE
Applicant is: Owner Contractor
Unit #:
Phone: 5/'278 -6 77/1
Description of work: /7Y' r� ti" '� n I
p � %'�a0� • d� !tee
Construction Cost: 1525-6D Multi -Family Building: (Yes
/ No
Company: Contact:
Address: City:
State: Zip: Phone: Email:
License #: Lead Certificate #:
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 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.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x 6C --o%%, Jt,wJ x 4 /
Applicant's Printdd Name Applicant's Si
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
N. Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
k Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
k (It/3z-
Porch
Ifs
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
— Siding
Reroof
Windows
Egress Window
137/q
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
Occupancy %l
Code Edition /l Jf
Zoningt.
Stories
Square Feet
Length
Width
Final
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: — Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough In Final
Erosion Control
Other:
Reviewed By: , 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 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142767
Date Issued:05/17/2017
Permit Category:ePermit
Site Address: 3896 Denmark Ave
Lot:5 Block: 4 Addition: Birch Park
PID:10-14175-04-050
Use:
Description:
Sub Type:Reroof & Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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.
Valuation: 12,000.00
Fee Summary:BL - Base Fee $12K $221.25 0801.4085
Surcharge - Based on Valuation $12K $6.00 9001.2195
$227.25 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 -
Geoffrey R Johnson
3896 Denmark Ave
Eagan MN 55123
(651) 278-6771
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA170335
Date Issued:06/28/2021
Permit Category:ePermit
Site Address: 3896 Denmark Ave
Lot:5 Block: 4 Addition: Birch Park
PID:10-14175-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Geoffrey R Johnson
3896 Denmark Ave
Eagan MN 55123
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature