3921 Donegal WayAddress 3921 Donegal Way Zip 5512 2
Lot 8 Blk 2 Sub Murphy Farm
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: g 0:2, Yes No Inspector: t llG Zence,
Final grade (6" from siding) f
Permanent steps (garage) V
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF FAGAN
l4 r 3830 PILO1 KNOB -RD - 4673 55122 C?
c
65-681
10 " -o 9-1U
New Construction Reauhemenh I Re
D 3 registered site surveys showing sq. It. of lot, sq. ft. of house
and oil roofed areas (20% maximum lot coverage allowed)
D 2 copies of plans (show beam R window sizes; poured Md. design; (etc.)
? 1 set of energy calculations
? 3 copies of tree preservation plan B lot platted after 7/1/93
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: BLOCK: - SUBD./P.I.D. #:
2 copies of plan
1 set of energy calculations for heated additions
1 site survey for exterior additions s decks
COST:
PROPERTY Last
OWNER
Street Address:
Phone #:
City State: Zip:
Comp Phone#: -?(o7T
(area code)
CONTRACTOR
Street A ess y License # Exp.
City State:? / • Zip:.
U
ARCHITECT/
ENGINEER Compan???_ )t???!p_?l?]s Naam .
Telephone C area code
Street
City
Sewer S water licensed plumber (required for new construction onh
Penot'ry applies when address change and lot change Is requested
I hereby acknowledge that I have read this application, state that the
State of Minnesota Statutes and City of Eagan Ordinances.
Certificates of Survey Received Yes
Tree Preservation Plan Received Yes
Registration #:
State: Zip:
2L
permit is Issued. s' (? 3
nformation Is correct, and agree-to,compty with all appllcabl
Signature of (Applicant
OFFICE U ONLY
No I
No Not Required
J Li-
f
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
0 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Stone Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
Ip 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
5=A/ Main level sq. ft.
sq. ft.
p•/] . sq. ft.
.2 sq. ft.
7d- sq. ft.
Footprint sq. ft.
Building 114?
?v
4a
Q?/e8
Engineering
!D
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNIT Surcharge
Treatment Pl.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation:
33X`/
Yx18'=
Ax IV =
a L"I V
/,6
65l1Y /,/61/0
72,
12IT
5'f 84,
? fG = l5?8
t irk Y = ? ?'
/?XaE : 38
34x3.3.' llal
Variance
F
YX'(8 s<< 7.z.
SAC Units
%SAC
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
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LEON GROTHEFrom: LEON GROTHE TO: KATHY TRIMBLE Pate: 819M Time: 11:15:46
1U8 14;50 PAS 512 450 2502
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL.
DATE OF SURVEY: / /!I>
LATEST REVISION: Z!I -
DOCUMENT STANDARDS
? ? Registered Land Surveyor signature and company
? ? Building Permit Applicant
i
L
l d
i
?
f ? escr
pt
ega
on
t
? ? Address
V/ ? ? North arrow and scale
a/ ? ? House type (rambler, walkout, split w/o, split entry, lookout, etc.)
4K ? ? Directional drainage arrows with slope/gradient %
? ? Proposed/existing sewer and water services & invert elevation
x? ? ? Street name
? ? Driveway
o ? Lot Square Footage
d? ? ? Lot Coverage
ELEVATIONS
Existing
??
/ ? Sewer service (or Proposed)
?
Z ? Property comers
3/0 ? Top of curb at the driveway
a? ? Elevations of any existing adjacent homes
a? ? Adequate footing depth of structures due to adjacent uti ily trenches
Propos
ed
/
? ? Garage floor
?
? ? Firstfloor
m
? ? Lowest exposed elevation (walkout/window)
a? ? ? Property corners
k?? ? Front and rear of home at the foundation
PONDING AREA (if aodicable)
? df ? Easement line
? m/ ? NWL
? CP/ ? HWL
? a/' ? Pond # designation
? a-/? Emergency Overflow Elevation
V1? ?
ru/ ? ?
V? ?
?/ ?
? ?J ?
DIMENSIONS
Lot lines/Beanngs & dimensions
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
Show all easements of record and any City utilities within those easements
Setbacks of proposed structure and sideyard back oyadjacent existing structures
Retaining wall requirements, if any
Reviewed:
9- 9-'
/ Date
March 19M
CRAIGRLDGPRMT.GM
Ca Cm
L V BL
SUED.
CITY USE ONLY
RECEIPT #:
RECEIPT DATE:
PERMIT # &F7
1999 PLumBiNe'PERmrr (f swENTIAL)
CITY OF EAflAN
S$SO PILOT KNOB RD
EAGAN, MN 55122
(651) 6$1-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Bath tub 3.00 _x _e2_ I = I $ G.oO
Floor drain 3.00 x $ 3.o0
Gas piping outlet ` minimum -1 3.00 x $ 3. DD
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x $ .3zo
Laundry tray 3.00 x ?. _ $ -O
Lavatory 3.00 x = $
Minimum fee alterations to existing dwelling 30.00 x = $
Private Disposal System new/refurbished ' requires MPC iic. 75.00 x = $
Private Disposal System abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rough opening 1.50 x 3 = $
Shower 3.00 x $ \3 06
Underground srinkler if dwelling is under construction 3.00 x = $
Underground srinkler if existing dwelling 30-00 x = $
Water closet 3.00 x 0 _ $ 9 o6
Water heater 3.00 x = $ o
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 --> > > --> $ - LK1
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--- ------------ -------------- ---------- ------ ----- --------- ------------ ----------------- ----- -------- ---------------------- ---------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances-
It is the applicant'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:
U JJ ? '
OWNER NAME:: .l_? /?i ?( i o e rYl
INSTALLER NAME: 714
0 G iJ, It i S? ?,.
STREET ADDRESS: /5a3U l /t f 4_A.tl tv Q, -via,
TELEPHONE #: /2?o- G1o75`
(AREA C DE) /
TELEPHONE* ?
(AREA CODE)
CITY: STATE: wlc? ZIP:
?5T6 01,
SIGNATURE OF PERMrrTEE U
CITY USE ONLY
LOT `B,L, ??-
SUBD. ??G Y Vy?
_ Alteration _ Repair _ Other
Reminder: Call 681-4675 for inspections.
1999 MECHANICAL PERMIT' (RESIDENTIAL)
crrY OF Emm
3630 PILOT KNOB RD
EAGAN MN 55122
n arc• (651) 6$1-4675
Complete this section only if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occupied.
• HVA(.: n-'.•nnMRTLr
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @ $3.00 ea)
State Surcharge
Total
n 'v.vv
6.00
9?
.50
$ 41 50
Complete this section only if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New
Furnace
Air exchanger
SITE ADDRESS:
CITY: [J c.-11-1RECEIPT#: 1 ` 9
OWNER NAME: 4
INSTALLER NAME:
STREET"p'{??'n?RESS:
RECEIPT DATE:
MECHANICAL PERMIT # Jg? i
- Air conditioning
Other
$ 30.00
State Surcharge .50
Minimum Total Due $ 30.50
a
(AREA OpE)
PHON
1 61 J0.
STA
OF
ZIP: J` J 3
CITY USE ONLY
L BL
SUBD.
APPROVED BY: INSPECTOR
RECEIPT #:
RECEIPT DATE:
MECHANICAL PERMIT M
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3630 PILOT KNOB RD
H JL0 P., IT ilq CC'I OQ
Yti Vi1! 1liai .V.l .
(651) 661-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
D/! G:
WORK TYPE: New construction Install U.G. Tank
Interior Improvement Remove U.G. Tank (Minimum Fee)
Processed Piping (Minimum Fee)
t?TilITE: \lri,on =nctalhna/removing underground tank, call 651-6814675 for inspection by fire marshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
CONTRACT PRICE x 1%
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
PHONEM
(AREA CODE)
STATE: ZIP:
SIGNATURE OF PERMITTEE
($.50 per $1,000 of pemut fee due on all permits.)
PHONE #: A
(AREA CODE)
I
/'
* PIONEER
* eng neer ng ?xo
Certificate of Survey for
LOT AREA =14,500 SQ. FT.
HOUSE AREA=2,607
COVERAGE=18%
HOUSE TYPE- -7 5't'dlvy
NOTE:
n q)? (Y
ji
?a .
?-a
BENCH MARK
TOP OF PIPE
ELEV.=907.51
i?
Z905.4
o l?
ff N
2422 Enterprise Drive
Mendota Heights, MIN 55120
(651) 881-19WFAX:681-948!
I °Blaine, MN 55434
,(612) 783-1880 FAX 783-1883
''E-moil: PIONEER2®PRESSENTER.COM
ATHY TRIMBLE CUSTOM HOMES
DONEGAL WAY
DONEGAL WAY
S?
901.9
N
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SERV. 02.8
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NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY: BRW
NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION
OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND
FOUNDATION DIMENSIONS.
NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE
SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE
PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR.
I'
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x17.72
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TOP OF PIPE
ELEV.=905.70
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81.22 C00,e?
PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVATION:
TOP OF BLOCK CLEVATION:?
GARAGE SLAB ELEVATION: ;IO
TOB @ LOOKOUT ELEVATIO/N: s
NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN X 000.00 DENOTES EXISTING ELEVATION
THOSE SHOWN ON THE RECORDED PLAT. ( 000.00 ) DENOTES PROPOSED, ELEVATION
- - - DENOTES DRAINAGE AND UTILITY EASEMENT
NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN.
-r DENOTES DRAINAGE FLOW DIRECTION'S
NOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMED DATUM DENOTES MONUMENT
B DENOTES OFFSET HUB
WE HEREBY CERTIFY TO KATHY TRIMBLE CUSTOM HOMES THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SUR VEY OF THE BOUNDARIES OF:
LOT 8, BLOCK 2, MURPHY FARM
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMEN TS OR ENCHROACHMENTS, EXCEPT AS OWN, AS SUWVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 25 DAY OF JUNE, 1999.
REVISED 7-13-99 NEW HSE SIG ED: PIONEER EN EERI , P.A.
SCALE 1 INCH = 30 FEET REVISED 8-13-99 MOVED HOUSE
REVISED 8-20-99 RESTAKED BY:
!? 98050.05 JJS John C. Larson, LS: Reg. No. 19828
---- BQZL--
910.1' ??0
PERMIT
Permit Type: Mechanical
City of Eagan
Permit Number: EA106013
Date Issued: 08/07/2012
Permit Category: ePermit
Site Address: 3921 Donegal Way
Lot: 8 Block: 2 Addition: Murphy Farm
PID: 10-49500-02-080
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
Comments:
445-2840
Ashley Orman
130 Plymouth Ave N
ME - Permit Fee (Replacements) $55.00 0801.4088
Fee Summary:
Surcharge-Fixed $5.00 9001.2195
Total:
$60.00
Contractor: Owner:
- Applicant -
Standard Heating & Air Conditioning Scott A Gray
130 Plymouth Ave. N 3921 Donegal Way
Minneapolis MN 55411 Eagan MN 55122
(612) 824-2656
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114590
Date Issued:09/17/2013
Permit Category:ePermit
Site Address: 3921 Donegal Way
Lot:8 Block: 2 Addition: Murphy Farm
PID:10-49500-02-080
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 .
Matt Kral
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 -
Scott A Gray
3921 Donegal Way
Eagan MN 55122
(612) 802-6932
Midwest Exteriors Plus Inc
6451 Sycamore Ct N
Maple Grove MN 55369
(763) 427-9696
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA130628
Date Issued:05/05/2015
Permit Category:ePermit
Site Address: 3921 Donegal Way
Lot:8 Block: 2 Addition: Murphy Farm
PID:10-49500-02-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Scott A Gray
3921 Donegal Way
Eagan MN 55122
(651) 454-5394
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137939
Date Issued:07/29/2016
Permit Category:ePermit
Site Address: 3921 Donegal Way
Lot:8 Block: 2 Addition: Murphy Farm
PID:10-49500-02-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Scott A Gray
3921 Donegal Way
Eagan MN 55122
(612) 802-6932
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
1
For Office Use
111* Permit#: /�/ 3 (3
City
of Eaan Permit Fee: lP - (9 tp
3830 Pilot Knob Road
Eagan MN 55122 RL TI, ,ED Date Received: (p d( , /7
Phone: (651) 675-5675 Staff:
Fax: (651 - 94 JUN 1 5 20167 -,
2017 SIDENTIAL PLUMBING PERMIT APPLICATION
Date: G– (G — Site Address: Z, • 'J�—'`` L'-
Tenant: Suite#:
1.6:-.:,-. .;;,:, 1 '
,? Name: �, . fit- f G ` ' Phone:61 Z g—z o 3 Z
F °@ 0 f
'` k� ,, Address/City/Zip:
gr Name: t U ��ti ���1� Atil License#: L 1
:' i..:(,--7
4 , 33}}ac 4 t�D1 �n / ' , errs-� y n ( 2(Uf
{ i E W 4 x
w� � � Address: Cit
x6r 'ntract° �E,
`". *t State: 4\t tO Zip: `� l Phone: L ` L--f \--D-*CJ'Lf (
6 � r #0;:ct; Contact:UR P. YY\ \ 3..&te7T( Email: kA. .. . a CLl t� `11 / ��Qy�
=, . ' . "o''''"i,'1', _New _Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
Description of work:
s 'w � RESIDENTIAL j
tit /
" ` '4 p Water Heater <
{ Water Softener
4 1�jx : Lawn Irrigation( RPZ/_PVB)
•
Add Plumbing Fixtures( Main/_Lower Level)
Septic System
�� ��� i _New Water Turnaround
1 < ; '
4 _Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60,00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$
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.gopherstateonecali.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 aPPpe Ian in t e case of wor which requires a review and approval of pl ns.
kU x /lI
�, t 114-g---tE-27----'
Applicant's Printed Name Applicant's Signature
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