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4640 Dodd RdCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4640 Dodd Rd Lot: 15 Block: 1 Addition: Woodland Place PID:10- 84800 - 150 -01 Use: Description: Sub Type: e- Reroof Work Type: Replace Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: Property Claim Solutions LLC 4655 Nicols Rd, Suite 202 Eagan MN 55122 (651) 994 -2028 Applicant/Permitee: Signature BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: PERMIT City of Eaan - Applicant - Construction Type: Occupancy: $90.00 Owner: David T Forsman 4640 Dodd Rd Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: Building EA086666 10/06/2008 ePermit on prior to final, you must meet inspector with ladder and flat bar. Pictures are not $88.50 0801.4085 $1.50 9001.2195 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature CITY OF EAGAN 3795 Pilot Kn ti,Raad Eagan, MN 55122 N2 5578 - PNEt 454-8100 BUILDING PERMIT APPLICATION Receipt To be used for WOOD HEATER Est. Vnlue 1000.00 Date 12/19L79 . 19_ Site Address 404U DOUG na. Lot Block Sec/Sub. parcel # lo-oi$6oo-o40-25 rc Name David T. Fors Address d. b af7an, o0 f V?y Name Home Place Builders Address Name _ Address 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 Permittee ?!? A Building Permit is issued to: Dayirl T. Forsi all work shall be done In accor a e'w' h all oppl' able State of Building Official - - Erect ? Occupancy Alter EY Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade ? Depth N. Approvals Fees Assessment - Water & Sew. - Police Fire Eng. Planner Council Bldg. Off. 12 APC Permit 7.UU Surcharge .50 Plan check SAC Water Conn. Water Meter Total 5.50 on the express condition that Statutes and City of Eagan Ordinances. CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERdaT APPLICATION 1 set of energy calculations. 1b Be Used For H F-A-r ESz Valuation Date Site Address Lot _ Parcel #: owner: Block __(:S ;/Sub. OFFICE USE ONLY ? ? . -?'- Erect - Occupancy Alter Zoning Rep aik? Fire Zone ?a v , „ 1 r Al A , C Address: City/Zip Code: 4 Phone #: `S 1t - Contractor: ?W4 0Y e S Address: City/Zip code: Phone #: Arch./MW.. Address: City/Zip Code: Phone #: arge _ Type of Cont. Move # Stories Damlish _ Front ft. Grade Depth - ft_ APPRC7t7AI6 FEES Assessments Permit 5-v0 Water/Sewer Surcharge Police Plan Check Fire SAC Ehg • Water Conn. Planner Water Meter Council oad Unit Bldg. Off. - APC EAGAN TOWNSHIP BUILDING PERMIT No Owner --------------------------------- _ Eagan Township Address (precept) .--.7..?r.?------ Town Hall Builder ...._..SClt?t::.!" ..... .... /0/11/ Date ...._.Address .................... .......................................... DESCRIPTION 1877 Stories To Be Used For Front Depth Heigh! Est. Cos! Permit Fee Remarks D LOCATION Street, Road or other Description of Location Lo! 1 Block I Addition or Tract 1_1. a? 1 /A 011,00 O'yo J%5 This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that ..... !9 :.................................................has permission to erect a..................---. - upon -' ......--._ the above described premise subject to the provisions of the Building Ordinance for Eagan Townshi adopted April II, 1955. .......... ...... x.... T -?-.oar....-- d'--......... Chair an of nwnB Per .............................. .1L//?.f? .... ............ !.......... / Building Inspector EAGAN TOWNSHIP BUILDING PERMIT Owner ..... dnt--.-';------- )-a-:-`... ---------------- ------------------ Address (present) ----4L- -10 ..__........................................... - - Builder Address DESCRIPTION N° 2106 Eagan Township Town Hall Date ..../...'............ ...?.?.'....... --........ - Stories To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks This permit does not authorize the use of streets, roads, alleys or sidewalks the right to create any situation which is a nuisance or which presents a hazard general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN This is to certify, that ......... J...:. ?0''-:°i".'.'.'.-•.-.-- .............has permission to erec the above described premise subject to the provisions of the Building Ordinance 1855. / ............................. ....... .... '----1..'..... .....?--............. Per imam of Board nor does it give the owner or his agent to the health, safety, convenience and PROG ES S. t a....................... ..........................upon for agan Yownship adopted April 11, ------------------------- --4...-...... ........................................... ilding Inspector 3OREQUEST FOR ELECTRICAL INSPECTION 1z i'so ins uclions for completing this form an back of yellow copy. "Below Work Covered by This Request M 13573 E&OOpel-W New Adtl p. Type of Building -AppliancesWired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: vlu Iz 6V2 t 0.c i xy-, T rbunCk 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: 'AL C^ Irrigation Booms Special Inspection V Alarm/Communication THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in / t Final Date OFFICE USE ONLY This request void 1a months from 13573 k4, Request QQQaaal??F 2 ^? fi ., a? - - Rough-in Inspetlion Required? NOTICE: You Must Cell Electrical Inspector It A Rough-In Inspection ? yes Is Required, i Oicensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No) 4(046 a, City OCl Section No. Township Name or No. Range No. County Occupant (PRINT) c o ?kK o- rs m an Phone No. 54 -389 5 F( TT ???e Powerer Suppli ?J`?-- ' ? L Atldress r m?r? ?h Electrical Contractor (Company Name) IF Contrzcto nse No. I19? M (a c c? Mailing Addr&s (Contractor or Owner Making Installation) Authorized 5' a (Contractor/Owner Makin ion) Phone Number q0- 3555 MINNESOTA ST E OARD OF ELECTRICITY a,,.,-_ Q, - Q 40 THIS INSPECTION REQUEST WILL NOT Griggs-Mitlwa 81 Room 5.173 ?+"'4vv BE ACCEPTED BY THE STATE BOARD 1821 University Va., SL Paul, MN 55184 ?????? J)? UNLESS PROPER INSPECTION FEE 15 Phone (612) 642-0888 lMrxO.21rt,(,4 ENCLOSED. This request void IS months from ID O$600 Of/O *5 :4 D rc ?" S O 76982 Date of this Request__ 1, as 10 Licensed Electrical Contractor ? Owner, dodo hereby request inspection of the above electri- cal w nng installed at: Street Address or Route No. `Jkb AU N JC:CI.OL F-OL Section Township Olok_631_ Range County Which is occupied by Is a roughin inspection required on this job? No Power Supplier Electrical Contractor Company Name) Mailing Address (ol l ?ettr T ntr ti E or Authorized Signature roi vccupany Yes ? Ready Now Will Call O Contractor's License NOWJS 8 ,mnnesota State Board of Electricity' University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION O 76982 CHECK BELOW WORK COVERED BY THIS REOUEST Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? Range ? Temporary Wiring ? Duplex ? ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? " ? Furnace El Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner IN Bulk Milk Tank ? List List Oth r ? ? ? p Heiers? HeTeer9 COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: or, Circuits: # Fee 0 to 100 Amps. 0 to 30 Am s 0 to 30 Amperes 101 to 200 Amps. 31 to lOD Am'", 31 to 100 Amperes Above 200 Amps. Abok@(1 'A Above 100 Amps. Transformers Remo "- utr" Chc. Partial or other fee Signs Special sec ton Minimum fee $5.00 Remarks TOTAL FEE i 1, the Electrical Inspector, hereby certify that the above inspection has been mad O (Rough-in) Date (Final) Date 7 7 This request void 18 months from ' CITY OF EA"N 3795 Pilot Knob Road Began, MinnesoM 55122 Phone: 454-9100 SFPTZC (ADD. j)RAINFIELD) PERMIT 10=3-78 Date: Site Address: 4640 Dodd Road Lot Block `. -,)3600 040 25 Sub/Sec. _ 132 No. 11441 Receipt No.: Single Residential Multi Res., Comm./Ind. Dave Fors n Name New/Alter. /Repair Address 4640 Dodil 'Rd. Cost of Installation Tai;an City Phone: Permit Fee Weirke Trenchims Surcharge Name " Address s 0 U t City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ??? '? . ?`, + \,\ CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 PHONE: 454-BI OO BUILDING PERMIT Receipt # To be used for Est. Value Date Site Address 0 Lot Block Sec/Sub. Parcel # 3 -`5 e_ I Name l .I. 1 • Vl Jl it ,ll. W n Dodd Rd. z Address 3p :2f 8i1, 1- °C Name _ u10 Address f• r;,., Name _ Address 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. N2 5578 Erect ? Occupancy After 6 Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Approvals Fees Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. - APC Permit Surcharge Plan check SAC Water Conn. Water Meter Total Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official twmit # Deft Iewed Nsllt" Plumbing Mechanical INSPECTIONS DATE INSP. Rough-In Final Footings Date Imp. Dote Imp. Foundation _ Plumbing Frame/ins. Mechanical Final Remarks: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: f.'-10 ti;IzlI.1i t I i,14 PERMIT SUBTYPE: ) I i ibij r M I." MAI INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: A fit I I t APPLICANT: TYPE OF WORK: N 1 1.) I)I i 1= 11 I 1 t1N ( I'ul I Fir DQ ) 11:A14INII I ict MAI,4'? A PAVA 11- I'I I,M I I AI;I VI VIII 11:1.11 r 1)1. ANy I I r I I I 1 1. Al. oll 1'1 IIMit I N1i LlIM R ----------------------------- Permit No. Permit Holder Date Telephone M S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Pibg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pc Disp. CITY OF EAGAN Remarks Addition Section 36 Lot Rik Ownera ,:,, '_C-( ; . I. i I ,'r_, Street 4640 Dodd Rd. Improvement Date Amount Annual Years J`XV Payment Receipt I Date STREET SURF, STREET RESTO GRADING SAN SEW TRUN SEWER LATERf WATERMAIN WATER LATER WATER AREA STORM SEW TR STORM SEW LA CURB & GUTTE SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC J 'S3-1y6 MECHANICAL (RESIDENTIAL) q?, (??? Permit Application 3316 -? City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date --L_ / / r?2 ot J - ? / ?? / ' Sit Add U i e ress n t # Property Owner G(1??? Telephone # ( ) Contractor Sc C'<:^,C4CNFATINGBAI!ICMINT1ONI! Street Address l+unneapo!i , i•.: 420 • City State Zip ( Telephone # ) The Applicant is Owner ;1 Contractor Other Add-on, modification or alteration to existing dwelling unit $ 30.00 furnace replacement _ air exchanger ll// // -D i diti Z l a r con oner o(iy? o ? Y 79 _ other State Surcharge ?1'C: i3 r' $ .50 Tot l PY _ $ a 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 the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. A -)FDGt^oIJK HTG. E ^{R CODID. CO °W4a1r, ,z Applicant's Printed Name Applicant's Signature RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construcdon Requirements Remodel/Repair Reauirements Office Use Only 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Carl of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy calculations for heated additions -Tree Pres Plan Recd 2 copies of plan stowing beam & window sizes; poured found design, etc. 1 site survey for additions & decks -Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate ifonste septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date S / 7/ 0 Construction Cost !/^ n / Site Address L (J J /C1 C U An (Z132 Unit/Ste # -? Description of Work XPL51 t?! a ,y /l el acv Multi-Family Bldg _ Y N q Fireplace(s) _ 0 1Xfrf`kY /h Property Owner (a 1/ 0, V -Cl^ M 2 A Telephone # ( ?) y7 - c3??s d .? Contractor 1 lr ? (/- Address City State {?L Zip ,6. 3? Telephone # ( O O J COMPLETE THIS AREA ONLY IF CONSTRUCTIN NEW BUILDING ?rz Minnesota Rules 7670 Cateeorv 1 inn Energy Code Category r esota Rules 7672 - (J submission type) • Submitted I Ventilatlon gory eC 5 ,l OQJ New Energy Code Worksheet ubmitted • Energy Envelope Calculations Sub fitted MPS Licensed Plumber Mechanical Contractor Telephone #(YL-A) O Lio "0?i Sewer/Water Contractor Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. // at/ ild I- kaSk F A44. Applicant's Printed Name Applicant's Signature PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 eRnW PERMIT TYPE: BUILDING Permit Number: 0 2 4 6 9 7 Date Issued: 10/11/94 SITE ADDRESS: 4640 DODD RD LOT: 4 BLOCK: 25 SECTION 36 P.I.N.: 10-03600-040-25 DESCRIPTION: (POLE BLDG) Bullding'I,,Permit Type Building W3,rk Type GARAGE/ACCESSORY NEW REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK FEE SUMMARY, VALUATION $8,000 Base Fee $99.00 Surcharge _ $4.00 Total Fee $103.00 CONTRACTOR: OWNER: - FORSMAN 4640 DO EAGAN (612)296-8521 Applicant - DAVID OD RD MN 55123 I hereby acknowledge that I have read this information is correct and agree to comply Statute nd City of Eagan Ordinances. L APPLICANT/PER ITEE SIGNATURE application and state that the with all applicable State of Mn. 1?01 AA - MAY ISSUED B : SIGNATURE I INSPECTION RECORD CITY OFEAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 024697 Eagan, Minnesota 55123 Date Issued: 10/11/94 (612) 681-4675 SITE ADDRESS: LOT: 4 B L O C K : 2 5 APPLICANT: 4640 DODD RD FORSMAN DAVID SECTION 36 (612) 296-8521 PERMIT SUBTYPE: TYPE OF WORK: GARAGE/ACCESSORY NEW DESCRIPTION (POLE BLDG) J • J REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK 14L91 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 IfyM Prav,111 1,- I SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy talcs. E ????? COMMERCIAL 2 sets of architectural & structural plans, Ft specifications, 1 copy of energy talcs. 0 4 i F Penalty applies: 1) when permit is typed, but not picked up by last wo R--- --- - in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date o / /7/ Valuation of work ?c?S 9S Site Address:__?_/no STREET SUITE # Tenant Name: (commercial only) LOT_ BLOCK SUBD. J ^-a R I P.I.D. # Description of work: oN rzv,,4 __?>o I_e - D C_ The applicant is: 13-Owner ? Contractor ? Other (Describe) Name ?FOKSM64 RAJ 1n Phone Property LAST FIRST / Owner W 2 J o+,3 D 4'( o. ( - Address _ STREET STE # city F A C,,AN State M N Zip SS123 Company _r-iqrf' S Phone Contractor Address _ V7 (o5 mW I'-+E 1(etlsaYl' License. # 60061Exp. (I City State W\ N Zip SSA/' Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to compl with all appli able State of Minnesota Statutes and City of y Eagan Ordinances. / Signature of Applicant: ?, OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./lodging ? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ?.Site ? Wallboard Basement sq. ft. 1st F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing ? Final ? Framing ? Draintile TZ-7- d/ ? Insulation ? Fireplace Permit Fee Valuation: Surcharge Plan Review License !r i /'n %!?7n MWCC SAC City SAC Water Conn. //0 Water Meter Acct. Deposit S/W Permit S/W Surcharge g Treatment P . Road Unit Park Ded. Trails Ded. Copies Other Total: ?!? '7, 46 +- Z ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments SAC % SAC Units LOT '^w* FARM SURVEYS CONSTRUCTION SURVEYS TOPOGRAMIICAL PLATTING LEO B. SHAW .e1amw saweyes REGISTERED UNDER LAWS OF STATE OF MINNESOTA PHONE TUxcoo 1-8095 HIGHWAY NO. 13 SAVAGE. MINNESOTA SURVEYOR'S CERTIFICATE N L ?r O ss F ?D D m 33 s SCALE 1"=100 ---4ZL.9 ---- N90° E w r z N m m °f z Zz N N¢w °:E ? 26 x i? O,? m cn ?--8o m n -, m ?-- [KIST ING I ? io•a ao' ? W SE CORNER N 1/2 NW 1/4 N89°41'50o1 ---575.0--- •I m n N 1 Ci-OL-encinF at the northeast ceri-r of rai^ '"1%2 of '^e "1' 1/., and ^••rrine thence 1^i r nlr zlonp- the east line the-•enf a aictance of =,I=.'7 feet to the point of be_ irnin ; thence cortin:r_n¢ -1011,1; "' 21onr said Fast line a distance of 32.:.6 feet; agI)OI 1 r r1 m), a distance 5_ of feet to a point on the centerline of Todd road; thence S?5°20155^E along sai' centerline a dis+ .,arce P u.'; of W,,C ; ..ce on a ovr':e to the ri.^tt a distance of ]1°, feet to a -Point whict.. hears 1q9^°?, from the point of bPrinr.ins; thence 7< 'E a d; starce of L? fe•,t to the roint of t,e¢inr.inp. Contair.in[• 7.71. acre-. The above descrihed tract. is s:biect to an easement f;r road r;:roos°s over the westerly ??.C feet thereof. As .,rrveved -,e this 12th d ,: of 'rril, 1?67. SIGNED MINNESOTA REGISTRATION No. SI-C P CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 CEO Row"m FOR CITY USE ONLY PERMIT RECEIPT # # U DATE : REBTDEN IAI PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ ------------------------------ -------------' WORK DESCRIPTION - r FEES NEW CONST ADD ON REPAIR OWNER NAME: SITE ADDRESS:`/ ?(lfT /C? /C?J? LOT: BLOCK 4.5 SUBD. Tg1y ?Y' INSTALLER CEDAR VALLEY HEATING ADDRESS: AND AIR CONDITIONING -6313 ENTER DRIVE CITY: MINNEAPOLIS, MME0432 _ PHONE #: ADD-ON MINIMUM HVAC 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS - MINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE: TOTAL: NATURE OF X& DWELLINGS & $15.00 24.00 6.00 3.00 $ /6-CD .50 cam%??-e'v`e QOMMERCIALf7D?75Ti?1AL;' PLEASE COMPLETE THIS PCRTION 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: 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) CITY OF EAGAN 5 `4? 9 1 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 pll roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 set of Energy calculations • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE et l1 ll 0l o'Z- SITE ADC TYPE OF FIREPLACE(S) _ 0 _ 1 _ 2 Cz 1 -Z5-- APPLICANT STREET ADDRESS n CITY SST?ATE yWp ZIP 5 ?Q TELEPHONE ?" l0 CELL PHONE # 612 -68S Z(LI7 yAX # YS?`DO? O ???L PROPERTYOWNER?F066?lar1/ TELEPHONE# VSq-3Yp !S COMPLETE 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 • Energy Envelope Calculations Submitted Plumbing Contractor: -- Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System Tee: $90.00 Phone # ??F P I P? AUG 2 0 2002 Phone #IIJ I hereby acknowledge that I have read this application, state that the information is-caFfee , mply with all applicable State of Minnesota Statutes and City of Eagan Or ' a e . Signature of Applicant _____.......... ___ -°-- ............. .........--°- ............... --............... .._..___....... _. OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4102 Water Softener Water Heater No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths ULTI-FAMILY BLDG _Y ?CN RemodelfReoair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION Or"/ Soo '11551 • 2005 RESIDENTIAL BUILDING PERMIT APPLICATION 632-7.L" City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Offree usa Onfu 3 registered site surveys showing sq. ft. of lot sq. ft. of house; and all roofed areas ? 2 copies of plan Cad of Survey Recd _ Y N (20% maximum lot coverage allowed) $ 1 set of Energy Calculations for heated additions Tree Pres Pliip Recd - Y _N 2 copies of plan showing beam & window sizes, poured found design, etc. ? 1 site survey for additions & decks Tree pies kuved .T Y _.N 1 set of Energy Calculations Addition - indicate if onsife septic system Onsde:Seph&Syslem . Y -;N: 3 copies of Tree Preservation Plan if lot plalled after 711/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date 11 /3 / as Construction Cost ?f '3, ccc) Site Address '- { COLA0 D30n VLZ) Ef:?) ! (:N r Unit/Ste # Description of Work K Tc_i-lam -Pi--' y 4JC L_ I -OLn 19r00 rT(LY_) Multi-Family Bldg _ Y ? Fireplace(s) ? 0 - 1 _ 2 Property Owner Telephone #((6 1) Contractor SS[F?CL1k? Address 2 1?( RL • 44 Z City U%205Uf l I-e- ?Z) ZgZ 017Z State MC) zip 55 YU Telephone# Q 95Z Z2-/ 3 O COMPLETE THIS AREA ONLY IF CONSTRUCTING A Energy Code Category - Minnesota Rules 7670 Category 1 _ (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on of - Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor telephone #( Telephone #( Telephone #( BUILDING ©r41oDS S I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ij,p-\ art (f Pt? t Applicant's Printed Name plicanfs Signature OFFICE USE ONLY Sub Types . , ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types )A 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) -Give PCA handout to applicant Valuation / 00©• Occupancy -? MCES System Plan Review 100% or 25 % Census Code Zoning - City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length I 'Z Fire Sprinklered Type of Const Width I N REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. _ Footings (deck) so Final/No C.O. ?0 Footings (addition) _ Plumbing 10 Foundation ?o HVAC Drain Tile Other Ice & Water io Roof ?0 Pool _ Ftgs _ Air/Gas Tests Final _ Final . p Framing _ - Siding _ Stucco -Stone - Brick Fireplace _ R.I. -Air Test - Final - Windows Insulation _ Retaining Wall Approved By: Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total !2' X/,/'A54t(00 12' X/y` X &-" NOV 08,2005 13:41 Lindsey Rain 000-000-00000 Page 1 PaanifM it Daft Pe W- REScheck Software Version 3.7 Release I Compliance Certificate Repeat Date: 11111111105 Energy Code: 20001ECC Location: Eagan, Idinnewta Construction Type: Sintgg Family Glazing Area Percentage: 14.8000000060000002% Heating Delimit Days: 1991 Construction Site: ??y0 Dodd/Z?OwnaflAyem: Dost9n0z1CaWartea: Ceiling 1: Flat Coding a Smarm Truso: 1"6 3&0 0.0 3b Wag l: Woad Frame., tai O. o.• 1294 MO 0.0 67 Window 1: Mewl Frame with Thomiai BraAe:Tnits, Peres well 114 01150 40 Low-E: Window 1 copy 1: MOWI Fierce with Thermal 111080, Triple Pana 19 n.31n 6 with Low-E: Door 1; Glass: 4 0.350 15 pawl 1 Masonry Block with Eatilly Cells: 36 0.0 13.0 4 l ahlpaa rce Stale ard: Stateunem of COnphnpp: The pmpmw b1 Wwv Mtlgn deSCLUd here is consistent with the building Plana. spedications, and Other Calradallarw aubmdled with Me "I application. The imposed build'mg has been designed to meet the 200D IECC rNpammWR in REScheck Illusion 3.7 Releeae 1 and to WMPIy with the mandatary 10nunements listed in Ihu REScheck Inspection CheW6sl. 9 F4aN A$Dr ..-^? SWOWDesilyly Crwpwry Name, Date Page. 1 M 0 I SURVEYS ,ON SURVEYS LEO B. SHAW .c'a'rd Sauages REGISTERED UNDER LAWS OF STATE OF MINNESOTA PHONE TUx Eoo I-6099 HIGHWAY NO. 13 SAVAGE. MINNESOTA SURVEYOR'S CERTIFICATE ---575.0--- iws??c?scc?s N900 E ?3\ 11, vs I No ? ly ? JEI / BtDlo 26'x 1? ? 33 --- ?s 40 L_ -422.5---- z SCALE 1••=100' TOPOGRAPHICAL PLATTING m a J r ID Z CID m T Z N Z -Z o? o.a m cn m A iI L I [--,(IST ?NL ? yLDCe ' r0'x iD' • i U U a 4 W O1 N v N W SE CORNER N I/2 NW 1/4 i.o!-Iencins at the Sortheast ccrnrr or saiO "1/- of tI•e •'II /, ^II alor.F the east 1'ne the °f - ,; 1. , and r•.:rr.ir-e thence tance of feet to the DDint of be_innin .; thence cortinuing •101::1_ 111r alone Said Last line a distance of 3M6 5I V(}OI, 1 feet; 1 S?II, a distance Of 5':, ft-t to a point on the centerline of Dodd road; there Snt along 3¢i1'1 cer.'erllne a 4istance of ?Ld4 feet, ' th ce our•:e to the rich a c on a 'istance of 71. feet to a ^oint Trhict bears N?^GI•? from th- noint of h,?rinrine; tt•er.ce -^GE a d?starce.of L?^.; fe^t to the mint of beainrinP. Contairinr 1.7;. acres. The above described tract is srblect to an easement f^,r road r,,Toos-s over the "S*erly ,,.0 feet th-reof. AS sarvetired - .,e this 1?th dr: o` 4Dri1, Tp67. S IGNE? MINNESOTA PVMIQTeAvt^. I- r/tD PERMIT City of Eagan Permit Type:Building Permit Number:EA115417 Date Issued:09/25/2013 Permit Category:ePermit Site Address: 4640 Dodd Rd Lot:015 Block: 001 Addition: Woodland Place PID:10-84800-01-150 Use: Description: Sub Type:Reroof Work Type:Replace Description: 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 . Eva Lewis 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 - David T Forsman 4640 Dodd Rd Eagan MN 55123 Purpose Driven Restoration Llc 325 Main St NW Elk River MN 55330 (763) 633-4737 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA125765 Date Issued:08/01/2014 Permit Category:ePermit Site Address: 4640 Dodd Rd Lot:015 Block: 001 Addition: Woodland Place PID:10-84800-01-150 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 . Kevin Corbin Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - David T Forsman 4640 Dodd Rd Eagan MN 55123 (651) 454-3895 Purpose Driven Restoration Llc 325 Main St NW Elk River MN 55330 (763) 633-4737 Applicant/Permitee: Signature Issued By: Signature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`!55:9:5&4((&B( Z,J,*&EH&&00!X7Z,J,*&EH&&00!X7 K90!L&7906!7:5K90!L&:0:67WV0 3&1/./-@&,$%*Q#/(J/&1,&3&1,Y/&./,(&1)<&,AA#)$,)*&,*(&<,/&1,&1/&)*G.I,)*&)<&$../$&,*(&,J.//&&$IA#@&Q)1&,##&,AA#)$,-#/&=,/& G&E)**/<,&=,>/<&,*(&N)@&G&Z,J,*&+.()*,*$/<M 'AA#)$,*T2/.I)// &=)J*,>./3<<>/(&"@ &=)J*,>./ PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA161563 Date Issued:06/03/2020 Permit Category:ePermit Site Address: 4640 Dodd Rd Lot:015 Block: 001 Addition: Woodland Place PID:10-84800-01-150 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. 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 - David T Forsman 4640 Dodd Rd Eagan MN 55123 (651) 454-3895 Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature