3280 Donald AveCITY OF EAGAN . N! 1 4 1 2 3
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT . . 1 Receipt#
87
SEPTEMBER 3
ROOFING/REPAIR
$9,000
used f
T
b
or
o
e
t9
Est.Value
Date
Site Address 3280 DONALD AVE OFFICE USE ONLY
Lot -'Block I Sec/Sub. ROBT. KARATZ On Site Sewage Occupancy
MWCC System Zoning
Parcel No. On Site Well Type of Const
City Water (Actual)
a Name MS KAREN FOURNIER (Allowable)
w
z
Address SAME # of stories
Length
City Phone 452-2524 Depth
Total
S
F
.
.
ii Name HEMM CONST CO Footprint S.F.
ca Address 2531 MARSHALL ST NE APPROVALS FEES
w¢ City MPLS Phone 781-0056 86.50
Assessments Permit
?O
Water/Sewer Surcharge
mw Name Police Plan Review
E E
a Address Fire SAC, City
u Engr. SAC, MWCC
aw City Phone Planner Water Conn.
Council Water Meter
1 hereby acknowledge that I have read t 's >3 lication?fld state Bldg. OH. Road Unit
that the information iscorrectand$§QgreeS th applicable APC Treatment P1
State of Minnesota Statutes rrd a elf ances. Variance Parks
Copies
Signature of Perm itt TOTAL $91.00
A Building Permit isAsued to: HEAE.TH CONST CO on the express condition that
all work shall be done in accordance with all 'ca State of M inn to statutes and City of Eagan Ordinances.
Building Official
CITY. of EAGAN
BUILDING PERMIT
Owner ......... eo?.?... L:sFCFfrx ?'......_..../......
/..P...?a
Address (Presentl ........
Builder ................................................................................................
Address ......
DESCRIPTION
N2 __3202
3795 Pilot Knob Road
Eagan, Minnesota 55172
454.8100
Date ...../...s 3 /..: 3......... ........
stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks ,
?'
5
• I' J ?? i ?5 ? a ? a r ..
•
or
/ I/
This permit does not au size the use of streets, roads, alleys or sidewalks nor does it-give the` owndi or his agent
the right to create any situation which is a nuisance or which presents a hasard 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 PE
This is to certify, thel._?'ilar?.4._ .u:zK..? :.:.................has permission to erect a
the above described premis subject to the provisions of all applicable Ordinances for-
... ....__ May
.[; ..! ............. .................... Per ....._........ .............
of
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 453
The City of Eagan hereby grants to Pay N. Welter Heating Co.
Of 4637 Chicaao Aye So Nnis 55407
a BEATING Permit for: (Owner) Harell Construction Co.
at 3280 Donald Ayenve , pursuant to application dated 1/24/74
Fee Paid: S20.00 dated this25th_day of Jamu= , 19 74
.50 s/c
Building Inspector
Mechanical Permits:
Bid Total:
!oqo 61C) C,
CITY OF L ,i:A ]
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERi'9IT NO,: e1,9
The City of Eagan hereby grants to Thnmmenn
of 12201 M -Wnka "MA M+ etonka 95343
a -DIUMBINC Permit for: (Owned) ti•arull ? „ems,,. «t ?,
3350 Heritage Lane, 3365-3310-3280 Donald Avenue and
at 1671 x-PwAn.agm-'t , pursuant to application dated
Fee Paid: n,n, __ dated this ')7,h day of _Wah
2.50 s/c
ng Inspector
Mechanical Permits:
Bid TuCal:
HOUSE HEATING TEST RECORD
ADDRESS ?aZ R ? Jd
? APT. -FLOOR CITY SUBURB
OCCUPANT AA !=
" -?-
OWNER -`?-'-?
HEAT LOSS DATE HTG. INST.
SOLD BY r
2 c
INSTALLED BY a
Electrical Work By r/ - Gas Lin. By
TYPE OF HEAT GA -FA HW -STEAM--SPACE HTIL -UNIT HTR OTHER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
Model
- u Mod l .
a
Serial
7
M Max. BTU Rating
S
INPUT MAKE OF FURNACE
Model
C ONTROLS
7MgRV=AT xw Play ? ? vent Si:. 6
Yew KIND OF LINER MC
f Draft Hood ,
r D Filters Size 764'20
, Chimney Location Inside
Qg}sida?
(t?7yya STig yrw
mt..."-" AN
??
o
Chimney Construction cs iS
P" Modal
Paw TWny Smoke Bomb -
L•W."OH Draft
/-
p Door Pressure-
lesswe. IWfCFM. J.? ?Prtcwt Date Tested _ _4
S" TavJ6 `7-??Pg1,C?Ot s= Company Testing
FIRM= Name of Tester _
Wiring -
Test Tog_
Lighting Inst.
CITY OF EAGAN
ROBERT RARATZ
it n
Remarks
y Lot 1 Blk 1 Parcel 10 41300 010 01
Street 3280 Donald Avenue State Eagan, MN
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. D 1975 928.73 92.87 10 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 44.47 1.48 30 Paid
* SEWER LATERAL 1973 2 080.12 104.00 20 Paid
WATERMAIN
* WATER LATERAL & Stub 1973 20
WATER AREA
* STORM SEW 1973 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 240.00 9789 12-31-73
BUILDING PER,
-
-
SAC 9789 12-31:J
3
PARK
p cu.,, T/, I.,?
CG L? ,? f a f? j p /Z Tv
G-
A "Y ? ??? ? CITY OF EAGAN "12- 31
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Date ,19
Site Address
4.,Jo DONALD AVE
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well Type of Const
City Water (Actuaq
(Allowable)
* of Stories
Length
Depth
S.F. Total
Footprint S.F.
Lot Block Sec/Sub.
Parcel No.
it Name
W
3 Address
C City Phone
, c Name !?1 T
o 6 Address
City Phone
f?
W Name
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.
APPROVALS FEES
Assessments Permit
Water/Sewer _ Surcharge
Police Plan Review
Fire SAC, City
Engr. SAC, MWCC
Planner Water Conn.
Council Water Meter
Bldg. Off. Road Unit
APC Treatment Pt
Variance Parks
Copies
Signature of Permittee TOTAL
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
VILLAGE OF EAGAN WATER SERVICE PERMIT
]79& PiK±. V ,,b Road PERMIT NO.: 1401
Fagan,MN 55122 DATE: 2/27/74
Zoning: R'1 No. of Units: 1 _
Owner: MA ell Con
Address:
Site Add
Plumber; ThOmpgOn Plllm})lnq CO. _
Meter No.: Connection Charge?4.
090-Rd- 12/31
l+tze: Account Deposit: 73
Header No.: _ Permit Fee: -10.0-00d
1 agree to comply with the Village of Eagan Surcharge: .59pd-
Ordinonces. Misc. Charges: ?Q?00__pd
Total:
Hy Date Paid:
Hate of Insp.: Ins
p.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
379. oaV-'eob Road PERMIT NO.:. 2154
Eagan, MN 55122 DATE: _2/27/74
Zoning: R'1. No. of Units:
Owner: Marcell Construrfi4n CO.
Address:
Site Address: - 12R0 nonald Avenue
Plumber: Thompson Pltnnbing Co.
1 agree to comply with the Village of Eagan Connection Charge375. 00 pd 12/31/3
Ordinances. Account Deposit:
Permit Fee: 00 pd
Surcharge: .50 Pd
By: Misc. Charges: -
Date of Insp.: Total:
Insp.; Date Paid:
j'l J 1987 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3
OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation: Date:
r
Site Address OFFICE USE ONLY
Lot Block On Site Sewage Occupancy
MWCC System Zoning
Parcel/Sub /- • ??.-.r-a2 On Site Well Type of Const
te- City Water (Actual)
Owner (Allowable)
of Stories
Address jv_z9 U v47r?a ???C'/ Length
Depth
City/Zip Code S.F. Total
Footprint S.F.
Phone ` SJ L APPROVALS FEES CC''
Contractor Assessments Permit o ° S
Water/Sewer Surcharge
Address PS -Y/ Police Plan Review
Fire SAC, City
City/Zip Codei CO y/Y
Engr SAC, MWCC
Planner Water Conn
Phone G_1 6 Council Water Meter
Bldg Off Road Unit
Arch./Engr. APC Treatment Pl
Variance Parks
Address- Copies
TOTAL q1 -4rt)
City/Zip Code
Phone #
L / BL
CITY USE ONLY
Y
SUBD.
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
RECEIPT* 14
DATE:Y_?
F/1/9s
Please complete for: single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on m
/0
0
_ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: / y
? Minimum Fee: Add-on/Remodel (existing residence only)
? HVAC: 0-100 M BTU
Additional 50 M BTU
Gas Outlets (minimum of 1 required @ $3.00 each)
? State Surcharge
TOTAL
SITE
FEES
$ 20.00
24.00
6.00
.50
S0?
OWNER NAME: ?'??lD PHONE #:
INSTALLER
STREET
f O.
CITY: re?r, STATE: zip: PHONE #: (?`?) ?P,Q? ? yS? ?????2J?
$ FEKMIT-WE
LOCATION
OWNER
STRUCTURE AND
LAND USED AS
MASTER CARD
Permit
No.
Issued Issued To
Contractor Owner
BUILDING 3 R v?--
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING 3
I
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING /)_M/?•i7 ?i ?? SEPTIC
FOUNDATION, CESSPOOL
FRAMING I TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
y
Violations Noted
on Back
COMMENTS:
Use BLUE or BLACK Ink
�-----------------,
� For Office Use I
� ��V� �� I
��� �� n� �� ► Permit#: �
� .1 � j I
�1 � Permit Fee: " � I
3830 Pilot Knob Road i �
Eagan MN 55122 i Date Received: �
Phone: (651) 675-5675 t �
Fax: (651)675-5694 Staff:
�----------------�
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 03/31/2015 Site Address: 3280 Donald Avenue
Tenant: Karen Fournier Suite#:
w�� _,��� _��i w`s � �
�'� - � � ��� , Name: Karen Fournier � Phone: 651-955-6894 �
� r�f��r fi �
�� �� - ��
� �' � �� � Address/City/Zip: 3280 Donald Avenue Eaqan, MN 55121 �
E.� `r
����'� ,�� i„ �pi���� Name: Air Masters Heating &Cooling License#: PC646107
'� �� � �� Address: 112 Concord Exchange South City: � So. St. Paul �
� — �� �,����
' � �"�`�� r ���� State: MN Zip: 55075 Phone: (65�455-6324
_ � � � �-�.>
` � '��' � Contact: Kim Greene Email: kimCc�airmastersmn.net �
- �- �
_ �4w ���
_ � u,� °��h"'i 4�i, _
— ��i�� �
� a � �� �� _New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
- ���� y
��, = Description of work:
��� ` � �a���� . RESIDENTIAL � �
������ ' ���'�� `�� �Water Heater
a, � � � y � � � Water Softener
�� � Lawn Irrigation(_RPZ/_PVB)
� ��� � Add Plumbing Fixtures�Main/_Lower Level) �
� a
�
_��
= "r, �����1 Septic System ��
_ ' k ` �- NeW Water Turnaround I
�i 9d� 4� 4� — I
�,' �- ii�� � �� �o �
��� = Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Seqtic Svstem Abandonment,Water Turnaround"(includes$5.00 State Surcharge)
"`Water Turnaround(add$200.00 if a 5/8"meter is required) .
$115.00 Seqtic SYstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) ,
TOTAL FEES 60.00
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground u i i y amage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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.
' `
x
Kim Greene x '�d.���'�-- �f�2.�`��---
ApplicanYs Printed Name Applicant s Signature
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Citi of Earn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: 1 3 3' 0?4
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 8/10/2016 Site Address: 3280 Donald Avenue
Unit #:
l�es�tle
Owner
Name: Karen Fournier Phone: N/A
3280 Donald Avenue
Address / Cit / Zip:
Applicant is: ✓ Owner Contractor iq_ I
Type of Works
Description of work: Replace deteriorated entry deck @ back of home
Construction Cost: 1000'00 Multi -Family Building: (Yes / No ✓
o tr ctor
Twin Cities Habitat For Humanity Contact: Mike Robertson
Company:
1954 University Avenue W. St. Paul
Address: City:
State: MN Zip: 55104 Phone: 612-328-1668 Email: mike.robertson@tchabitat.org
License #: BC005603 Lead Certificate #: NAT -23745-2
If the project is exempt
from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents tl at you submrt are considered to be public informat n Po ns of _
the information may be classified as non public if y u provide specific reasons that would permt the City to
conclude at they acre trade see refs
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.
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 Mike Robertson
Applicant's Printed Name
x •�
Applicant's Signature
Page 1 of 3
13 0-(e,
DO NOT WRITE BELOW THIS LINE
SUB TYPES 3 &?-r7 0chi-ed "'''
Foundation _ Fireplace Porch (3 -Season) Exterior Alteration (Single Family)
Single Family _ Garage Porch (4 -Season) _ Exterior Alteration (Multi)
Multi 4j( Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of _ Plex Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
le 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
Plan Review
(25%_ 100%_
Census Code / 34/
# of Units /
# of Buildings /
Type of Construction 1
Occupancy 14 G -/ MCES System
Code Edition 2 i5 SAC Units
Zoning %1'/ City Water
Stories -- Booster Pump
Square Feet y/} PRV
Length y' Fire Suppression Required --,-
Width lb
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
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
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 By:
RESIDENTIAL FE
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
, Building Inspector
Lio 'o/ @ X9-1
7fir-
Pageage 2 of 3
Minnesota/Department of Labor and Industry
Construction Codes and Licensing Division
443 Lafayette Road N
Saint Paul, MN 55155
NOTICES
NOT TRANSFERABLE
CHANGE YOUR BUSINESS STRUCTURE
SUBMIT A NEW APPLICATION FOR NEW ENTITY
RENEW OR REPLACE 'INSURANCE POLICY
SUBMIT NEW CERTIFICATE OF INSURANCE
Licensing and Certification Services
Phone: 651.284.5034
• Email: DLI.License@state.mn.us
Website: www.dli.mn.gov/ccld.asp
TWIN CITIES HABITAT FOR HUMANITY INC
1954 UNIVERSITY AVENUE W.
ST PAUL, MN 55104
NOTIFY THE DEPARTMENT OF A CHANGE IN YOUR BUSINESS
Failure to do' so, subjects you to administrative penalties Of up to $1O,Oi
15 -Day Notice Requirement — Forms available nline_at:=www.dlf.mn.stov/CCLD/LicUpdate.asp
• Change in business physical -address, mailingaddress phone number, or email address
• Change in control,•owners, oftrcers, directors, members, partners
• Change in business' legal name and/or assumed name -
Loss of or change in QUALIFYING BUILDER
Change in general liability insurance or workers' compensation insura
Immediate Notice Requirement—Notification to DLI in writing
• Judgment Debtor. A E1ce-nsed _contractor-rtas__15 days to_provide written notice of the finding thatft isfoundto_be a
debtor based upon conduct requiring licensure =;
• Bankruptcy Petition Filed Aaicensedceatraetar has t =days to provide written notice that it filen a petition for bantvu
• Conviction Notice. A icensed contractor leas 10 days to provide written notice that it has been found guilty, of a'felony gross
misdemeanor, misdemeanor or any comparable offense related to the license, including convictions of fraud,
misrepresentation, misuse of funds, theft, criminal sexual conduct, assault, burglary, conversion of funds, or theft of proceeds
in this or any other•state or any other United States jurisdiction.
'.
OUR.DERTIFICATE IS BELOW THE PERFORATION.
SHOW CERTIFICATE WHEN OBTAINING PERMITS.
MINNESOTA DERARTFIEN•i:S}F-
LABOR & INDUSTRY
onstruction Codes and Licensing Division Licensing and Certification' Services `; '143 Lafayette Road N St. Paul, MN 55155
e: www dlI mn.noviccid.aso Emaii.. dli.licehse@state.mn.tia Phone: 651.28.4.5034
,Website:- ,
its is to certify that the certificate holder is licensed as a RESIDENTIAL BUILDING CONTRACTOR in the state of Minnesota and is in
compliance with Minnesota` Statutes 326B.805, and May build residential real estate, contract or ot'fcr to contract with an owner to build
residential real estate, and contractor offer to_ contract= with -an owner to_improve existing residential real estate; providetd-the_
responsible individual is at all times -a QUA7 IFYINGf3UILI)ER aridthecertificate holder maintains compliance wit
liability insurance, and workers compensate to laws
License : RESIDENTIAL BLDG CONTRACTOR
Lie. Number BC005603 ' TWIN CITIES HABITAT FOR. HUMANITY INC
Effective Date 04/01/201'6 1954 UNIVERSITY AVENUE W.
Expiration Date 03/31/2018 ST PAUL, MN 55104
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VERIFY UP-TO-DATE STATUS;
INSURANCEfNWQ=ATwww.dli mn.aov/ccid/LicVerifv.asp:(EN1ER=NU
All EPA Administered States, Tribes, and Territories
This certification is valid from the date of issuance and expires April 20, 2020
Michelle Price, Chief
Lead, Heavy Metals, and Inorganics Branch
NAT -23745-2
Certification #
January 20, 2015
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