4321 Dorchester Ct
Werti f ceate of cccuvancC
Wit4 of Wagan
ze0wi at of a xiibins aci?pecdsx
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use cuwr"ion: SF LAG Bldg. Permit No. 24635
occupancy Type R31MI_ Zoning District RI Type Const. VN
Owner of Building E 113?W Address
Building Address 4321 Locality L8, B3, RAWTHnFM WOOS
Darr
Building6ilk /Y
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
454-8100-DEPT OF BUILDING INSPECTIONS
Correction Notice
Located at
I have this day inspected this structure and
these premises and have found the following
violations of city codes governing same:
/' C C/ ///
When corrections have been made, please
call 45 G-for inspection.
Date
Inspector City of Eagan
DO NOT REMOVE THIS TAG
City of Eaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEVED
SEP 01 2016
Use BLUE or BLACK Ink
For Office Use
Permit #: / 3rK , )/
Permit Fee:
60.0-b
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
w
Date:}1, Site Address: 4 kb:4C r?
Tenant:
Suite #:
Name: ft. L,CL Phone: 1 O.
Address /City !Zip: olvA U _ c\'- -ER Nt D ;3
Name: Croix Crystal Water Treatment License #: 64997
Address: 3440 Yoerg Dr City: Hudson
State: WI Zip: 54016 Phone: 715-386-8667
Contact: Jim
Email: croixcrystal@att.net
_ New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of vCIk: Install Water Softener
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ /_ PVB)
_ Septic System
Add Plumbing Fixtures ( Main /_ Lower Level)
Water Turnaround
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 Tumaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge) )
TOTAL FEES $ C- v
Abandonment
CALL BEFORE YOU DIG. Cali 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.gopherstateonecail_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.
xJim Schober
Applicant's Printed Name
FOR t'FFICE USE
R wired Insp n
M Related It+r ms:
x
Applighnt's Signature
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
L II I I I IIOIt IN I W11111i
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
H 141 a 1, r APPLICANT:
1 ;,, l;
S {1 1 000
TYPE OF WORK:
IV
INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR.
h1 ?rl P, I I rl;f ? 1 ,,?
1 fi.? i t l ?. f il:?l
14 f MANK'3 r PVV
F
7?
. N 1-1 1.1 111 MA f I fit W nri?! I i I `. 1
Permit No. Permit Holder Date Telephone R
S/W
PLUMBING /a lO ?0?3
HVAC ?? /'J ?jl
a3- ESL
ELECTRIC Q???? ?1a5 E
Y? U
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
L? 24.
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace /'t
Final Htg. ! S f'S?- l -/il?i tv Co gy n.-?d•- vu T
Orsat Test Co 44rc/7 a w P -
/ -M1- 'a-aT 12--
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrlPlan
Bldg. Final h7l
Deck Fig"
Deck Final
Well
Pr. Disp.
Z-?o?
0 0 61 6 .. 1 4e as
Request Dale Fire No. Roucjfi to Inspection Required Inspection Other Than oughdn
o IYo call inspector when ready) O Ready New W01 Nolity Inspector
/ Vas ? No Date Ready
I icensed contractor ? owner hereby request inspection of above electrical work at:
Jch Address (Street, Be. or Route No
A'^ City
)
n ?
O-Z
tz?
Section No. Township Name or No. Range No. County
Occupa (PRINT) Phone No.
Power a lie Atltlress
Electric ntractor )Company N me) Contractors License
Y
Melling Address ( ontractor ar Ovrner Making Installation)
r
Authorized t
(COrnractoring Instal
)
Phone Numbar
`?
l
?J\/(ly??? 9`9o- BY THE STATE G699 University Avee.. S oPaul, N 55104 ELECTRICITY IIIN II N Illu IN4 UNLESSEPTED ER INSPECTION PEE DT
Phone (612) 642-OSDO ENCLOSED,
??aJr/cJ? JEST FOR ELECTRICAL INSPECTION EB-00001-09
n cc ons for completing this form on back of yellow Copy.
4i0 AJ 6-1- 'It M "X" Below Work Covered by This Request) T
Ne Add Rep. Type of Building Appliances Wired 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) contractors Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps bqv 100 _Am s
Signs Inspector's Use Only: UO TOTAL O
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD RED DISCONNECTED IF NOT
Other Fee , COMPLETED WITI . MO S
I, the Electrical Inspector, hereby
tif
th
t th
b Rough-In %
?t•is
- Dal If
Jam(
cer
y
a
e a
ove inspection has
been made. ._
Final
oalefr 3ry
OFFICE USE ONLY
Thls request •mid 18 months from
Address 4321 DORQESM COURT Zip 5512 3
Lot R Bik 3 Sub HAwiHmE "ps
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: o & Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway J
Permanent gas
Sod/Seeded grass y
Trail/curb damage i vu l fact SYe_
Porch
Basement finish
Deck
Please verify. with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
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
116V24z2006 14:26 EAWIN ENG+CDM DEU a 922992@1
4
20D6 RESIDED TIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
NO. 481 002
44 ?o. so
Site Street Address
71 On r r
1e?Y?if r C [ Unit 9
Property Owner A a I4
U?+ Telephones (4.51) -Lai ?:Z*x
}
Contractor 5+ r I q' 1 I Telephone'g Ial) 2 c
Address 'old' (i'!'r ?i1 City S p[1,t,._1 StateAAA?_ zip03
The Applicant is; _ Owner C
ontractor -Other
Y
septlc System _ Naw _ Refurbished Submit 2 sets of plans and IMPC license Includes County fee
$ 100.00
Peras-built S 10.00
Alterations to existing dwelling $ 50,00
Add plumbing fixtures. This fee Includes installation of a water softener and/or water
heater at the same time. If you am inatolling gall e water softener and/or water
heeler, do not complete this section; move to the next section and check the
appliance(s) you are installing.
Septic System Abandonment
_'Naier Turnaround (add 5130.00 if a Wil" meter is required)
_Other:
Water Softener -Water Heater S 15.00
t4p)rii- • ?_ csplacement
Lawn Irrigation ,JRPL ___,PV8 ,pew
-repair ?rebuitd $ 30.00
I?
P M:2zo vr
State Sur
ha
c
rge
f 5 50
Total S '?10_So
I hereby anniv for q Raa7r1Qnfl l Ph ,.nr.;.,.. P_ -;f ?...r ow...w,W.a_. .?... .?. i....?_a__ : ..?.,. . ., .?_ .
work will b-2 in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this Is no! a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan Is required?a reviewed and a?f oved.
Applicant's Pnnted Name Ap a 's Ig ure
Z0 39Vd 10Z68ZZ199 G9:US 9002/4Z/0L
?,EDUCED PRESSURE BACK=LO'J'J RREVENTER TEST REPORT AN ID
OG? TESTABLE DOUBLE CHECKS
SAINT PAUL REGIONAL WATER SERVICES
Service Name: Contact Person/ T ele 33j/_ n?yvv
Address: ' .,i?/Dr^?hea?e? City: .` cg State: zfL- zip. _--
Device Location: p, c 3, d 2 /o? AC Serve what system:
o
Account Number:
Type:
Install Date: - :o =w_ ",,s T•=/7
Rebuild Date: d7-Z ?•• 7' z,-, c/ar A.
Check Valve #2 Differential Pressure Relief Valve
Annual Check Valve 1
Report
Pressure
Pressure Opened at psid reduced pressure.
Did not open
Serial Number'
Make: W, ,Y r5 Model: `I7SXL- Size:
Air Gap Installation Date
Test Date: - ??? ?a E lrt2 ` ,
/r,n:JS d-?i•cSC+•i Lln- T c.J?, 1 n,oT '7%>»
Cleaned
Replaced
R. _ Disc
E _ Spring
P Guide
A Pin Retainer
I Hinge Pn
R Seat
S Diaphragm
Other, describe
Cleaned
Replaced
Disc
Spring
Guide
Pin Retainer
1 linge Pin
Seat
Diaphragm
Other, describe
Cleaned
Replaced
Disc. Doper
Disc, Lower
Spring
Diaphragm, Large
_ L ower
_ upper
Diaphragm, Small
_ Lower
Uppe
Sea[:
Lower
Upper
Spacer, Lower
-!it
Other, describe
L] Sign and dale Tag
The above is certified correct. Signed DateTested:- -.__----
Tested by (Print Name) =`%z•ah<? -Ce ification Numbers-•/J.?G%
-e-- -
Cornpany Name. S License Number
Company Telephone Number ___GS /• w,7. 7?v J _____
All sections rt ihis repoii roust be completed.
Relufn lo: Sa,nl Paid Regional Water Services
8 4'h St E Ste AGO
Number of Dew ices _e_per D. -a vice
First S 30
Devices 2-21 a 25
» arrl >, e
f t'^Yt?l r`? ? y
GS
-3
?? l3g
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
$/s sa
Date / .Sr /
/?
Site Street Address <???/ C? ' Unit #
PropertyOwner ? Azlq PGi/ Telephone # Z4 ?-
Contractor //'? ??//r17c1j//V? Telephone# (/a602) 2E! /- I/,O
Address 4L??4rle ?!/ r a Cityt5?'/5' glf? State,,?WL Zip_?
The Applicant is: _ Owner Contractor . -Other
Alterations to existing dwelling $ 50.00
S
Add plumbing fixtures (excludes water softener and/or water heater-complete-
section if installing these appliances).
-Septic System Abandonment d .3 ft
5
-Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
_ Water Softener Water Heater $ 15.00
- new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
Applicant's Printed Name AFj:rp ffffa`rffs gnat
r,I ., tPERM1T# 0 ? RECEIPT DATE:
2008 itI:SIDENTIAL PLUMBING PEWIT APPLICATION
CITY OF EAtGAN
3830 PILOT KNOB BD
EAGAN, MN 55122
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS:
OWNER NAME:
C
TELEPHONE #: q?3
(AREA CODE)
INSTALLER NAME:
STREET ADDRESS:
CITY: It (W 41 - STATE: MK) ZIP: zYT)(14-
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100
00
includes $40.00 County fee .
Note: Additional consultant fees may apply
• MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
- Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
Abandonment of septic system.
- Water turnaround - existing dwelling unit (+ 5/8" meter if needed - $118)
Other:
RPZ: new installation/repair/rebuild $ 30.00
- lawn irrigation system
Replacement/additional: water softener _ water heater $ 15.00
State Surcharge $ .50
Total $ 16:5 D
I hereby acknowledge that I have read this application, state that the information Is correct, and agree to complywith all applicable Cityof 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/ri ht-of-w y/easement.
SIGNATURE OF PERMITTEEE 1102
KGB C, I(?-Y\ TELEPHONE #: (Q_ ? 0(R)
(AREA CODE)
s3 g 2 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. fc of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window saes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan h lot platted after 7/1/93
• Rim Joist Detail options selection sheet (bldgs with 3 or less units)
DATE - zl Y -d Z
Water Softener
Water Heater
No. of Baths
SITE ADDRESS '4_5Z(_ &,fcb_,s? Coz,s-t MULTI-FAMILY BLDG Y N
TYPE OF WORK lAoldb46 M f67A- g>! 2L f- Q FIREPLACE(S) -0 _ 1 -2
SELA ROOFING & REMODELING
APPLICANT 4100 EXCEI RIr1R Ri yn
STREET ADDRESS ST. LOUIS PARK, MN 5541; CITY STATE ZIP
l[3 #0061058
TELEPHONE #GA&j6Z3-0?(L CELL PHONE #
FAX #
PROPERTY OWNER 1 12 u C-7-TO e--V? TELEPHONE* (2S-(4Q - 6q 3_?
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672
(4 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
? d a aJ_
Fee: $90.00
Phone #I 1111.2 9 2002
I hereby acknowledge that I have read this application, state that the information isfteZ , arf?agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. 0
Signature ofApplicant ? A
OFFICE USE ONLY
Phone #
VALUATION $ l1, 390 , lT0
Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodelfRegair Requirements
• 2 copies of plan
I set of Energy Calculations for heated additions
• t she survey for exterior additions & decks
Indicate if home served by septic system for additions
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 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 EM. Alt - Multi
? 03 01 of _ 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 (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
- Footings (addition) _ Plumbing
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
- Framing _ Siding _ Stucco _ Stone
- Fireplace _ R.I. - Air Test - Final _ Windows (new/replacement)
Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
XGITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55123 Permit Number:
(612) 681-4675 Date Issued:
/-9
BUILDING
024635
10/11/94
SITE ADDRESS:
4321 DORCHESTER CT
LOT: 8 BLOCK: 3
HAWTHORNE WOODS
P.I.N.: 10-32150-080-03
DESCRIPTION:
Building`? Permit Type SF DWG
Building Work Type NEW
r-6 BC Occupancy R-3 M-1
Construction Ty'p.e V-N
Zoning R-1
Building Length 57
Building Width 52
Building stories 2
.,Square Feet 2,240
REMARKS
PRV S & W PLBR - MATTHEW DANIELS PLBG
FEE SUMMARY.
VALUATION $160,000
Base Fee
Plan Review
Surcharge
SAC
SAC
SAC Units
Subtotal
$849
$552
$80
$800
50
18
00
00
100
1
MISCELLANEOUS $1,828.50
Total Fee $4,110.18
$2,281.68
CONTRACTOR:
BRENTWOOD HOMES
1322 HELMO
OAKDALE
(612) 730-1000
- Applicant - ST. LIC.
17301000 0001519
AVE N
MN 55128
OWNER:
BRENTWOOD HOMES
1322 HELMO AVE N
OAKDALE MN 55128
(612)730-1000
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan Ordinances.
L_
PPLICANTlPERMIT GNATURE '?G/?n?
application and state that the
with all applicable State of Mn.
ISSU : SIG TUBE -?
INSPECTION RECORD
CITY OFEAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 0 2 4 6 3 5
Eagan, Minnesota 55123 Date Issued: 10/11/94
(612) 681-4675
SITE ADDRESS: LOT: s B L O C K : 3 APPLICANT:
4321 DORCHESTER CT BRENTWOOD HOMES
HAWTHORNE WOODS (612) 730-1000
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
INSPECTION TYPE
FOOTINGS DDATE INSPTR. INSPECTION
FOUNDATION DATE INSPTR.
FRAMING ROOFING
INSULATION FIREPLACE
ROUGH IN PLBG ROUGH IN HTG
FINAL PLBG FINAL
REMARKS: PRV S & W PLBR - MATTHEW DANIELS PLBG
F
z4M
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
4 11-.-R
r,o dtd 9-,3D
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered sit s , Y o energy
calcs.
COMMERCIAL 2 sets of architectural & structur 1 plans, 1 set of
specifications, 1 copy of energy c --------- "
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
slate 9 Valuation of work Z16-0.°.
Site Address:
??3Z!?Gf/?FJ72 CuUQ?
STREET SUITE #
Tenant Name: (commercial only)
LOT :O BLOCK SUBD. ?WT?N?i OJJS
6% P I D. #
l0 X150 - D?0 -D
/
,,,
Description of work:
The applicant is: .9 Owner Contractor ? Other (Describe)
Name >3?E1.1? WoDi7 'I--[Qmtf- Phone
Property LAST FIRST
Owner
Address
STREET STE #
City State Zip
Company ?12?I?iTlnlUdl? ?'rtlvlit!?? Phone 1 30- IDOO
Contra)-tor Address i5Z,---_ 45L_j`-A0 Avg-- l\J. License #15 107 Exp. ;5
City_ OAK' QALIf- State /l/ W zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two day's once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
-a?! S?C?J?7
OFFICE USE ONLY
BUILDING PERMIT TYPE
•w
w .11-t
? 01 Foundation ? 06 Duplex ? 11 Apt./lodging
)8( 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'l. ? 15 Deck
WORK TYPE
® 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual) Basement sq. ft. -7f 7 MWCC System
(Allowable)
UBC Occu
anc v
Q 3 1st F1. sq. ft.
2nd F1
s
ft City Water
PRV Re
uired
p
y , .
q.
. 9Sg q
Zoning ,¢-1 Sq. Ft. total Booster Pump
4 of Stories zs...er Footprint Sq. ft. Tz
-va Fire Sprinkler
Length -7 On-site well r '`,,+s Census Code
Depth 5-2- On-site sewage d4
7 SAC Code
e z1 Census Bldg
APPROVALS ZY Census Unit
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
?.Site
? Wallboard
F3 Footing
Final
0- Framing
? Draintile
0 Insulation
? Fireplace
Permit Fee Vetust;m- g /&0,00.
Surcharge
Plan Review
License
MWCC SAC Zx ' ,y
City SAC zx r s°
Water Conn. /y f yv c vv
Water Meter „ vb - szs
Acct. Deposit y6 "
S/W Permit aK z?•/l z„
S/W Surcharge 6
v
Treatment Pl. °'b7
Road Unit / s7z x fY= uY, 80
s,
Park Ded. 2 t?
Trails Ded.
Copies /C n 33.5- > ?o?
Other -ass
Total: - --
5s$ xs / = S /, 75z
SAC %
SAC Units
1jRr r
X10
/6,7
/Y. 75- )111.3s 757 7,r/S°
l% 9sr r
4,q.,5 4 L
G5Z
tzf3 x 7/ Z2>
[/
\Z F
<.sa,?w> ° L 7 >
660./
JJ/p, Shp
7?iv ? = /S5; /3s
CERTIFICATE OF SURVEY
For BRENTWOOD HOME • DESIGN
PROPERTY DESCRlPT10N: Lot So Block 3, HAWTHORNE WOODS
1ST ADDIT
21
Dakota I
ngyj Minnesota.
We hereby certify that this is a true and correct survey of the above described property and that it was
performed by me or under my direct supervision and that I am a duly Licensed Surveyor under the
laws of the State of Minnesota. This survey does not purport to show all improvements, easements
or encroachments, to the property except as shown thereon.
Signed this ?3.?el day .of {r?+6,.?
B y.
19 ?cf Ja es R. Hill, Inc.,
Gary R. rri , Minnesota LS. No. 10943
Notes: U annWo
1. Building dimensions shown are for
horizontal & vertical location of structure only.
See architectural plans for building &
foundation dimensions.
2. No specific soils investigation has been
completed on this lot by James R. Hill, Inc.
The suitability of soils to support the specific
house proposed is not the responsibility of
James R. Hill, Inc. or the surveyor.
3. Proposed grades shown were taken from
the grading Wor development plan prepared by
MOCOMBS FRANK ROOS ASSOCIATES IN.C.
O Denotes set iron monument
• Denotes found iron monument
x 927.68 Denotes existing elevation
(930.00) Denotes proposed elevation
-4? Denotes proposed drainage
Bench Mark, PAO. rao, rvy i0a ?ssr or
oo:CCNEYT4n2 ../. of
Proposed Garage Floor V4'sV X~O&MIE
Proposed House Top Block= drz/.
Proposed Garage Top Block= B+d'/. ¢
Proposed Lowest Floor- B3 Z, C.P
Bearings are on assumed datum
Scale: V= 3 0 '
r Page 1 of 2
:1v
a 7 h Jame . 1 %0
1, inc.
A D a
L
a 0 ° ° m b` z PLANNERS /ENGINEERS /SURVEYORS
0 m 0 co
2500 W. CTY. PD. 42 • BURNSVILLE. MN, 55337 • 612.890.6044
-i CERTIFICATE OF SURVEY
For BRENTWOOD HOME • DESIGN
d = 90? .. ? ?p.Y 938.4
BENCHMARX
TOPO
ELEV.. 9Q/.8¢ ` A
J( r
?' two
vl?
14 ? i
14j
?.
k2
30
a
DRAMAGE d U -IUTY
EASEMENT PER pLAr
o Q e??
i ?- r
n
a -?
I?
James R. Hill, Inc.
Page 2 of 2
-0 _ _9,393
M
ijeotbsEc
GR/YENAr
r? r
i
b¢ee ?/ "?l i 936 0
9,36. S
?9.LB. 7-J BENCHMARK
?y ? ELEV.. 93G. B7
y ..c
i 3 f/ous?-
i
i
-I GOTB
X4.2. 8G
LOT SURVEY CHECKLIST FOR
entry,
Sj0
C 0
0 Registered Land Surveyor signature and company
i
i
0 Bu
ld
ng Permit Applicant
Legal description
0 Address
Q-'D 0 North arrow and be, cale
0 House type (rambler
split
split w/o
walkout
,
,
,
lookout, etc.)
0 Directional drainage arrows with slope/gradient $.
0 Proposed/existing sewer and water services
0 Street name
0 Driveway
ELEVATIONS
?,0
0 Existing
Sewer service
B 0 Lot corners
a Top of curb at the driveway
0 a Elevations of any existing adjacent homes
Proposed
0'0 a Garage floor
11 0 First floor
.8' 0
- a Lowest exposed elevation (walkout/window)
2?
0 a Property corners
2`13 0 Front and rear of home at the foundation
PONDING AREAS (if applicable)
Basement line
D @- 0
a O - HWL
P
0 Pond # designation
0 Emergency Overflow Elevation
W''a 0 •
Q` 13 13 -
a' 0 a
Lr'0 0
Ef'a 0
a 2' a
Lot lines
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks,
overhangs greater than 21, 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 setback of adjacent
existing homes
Retaining_y*l requirements, if any _
Reviewed
October 1992
Data of surveys//
DOCUMENT STANDARDS
IV E
U
'\ C!
M.H.4
,94.0
8
S a W 0+86
s-42 11.
w-53 1. f.
928.7
SCALE IN F--ti w-321.f. \
20 25 50 10 923.5
SaW2+22 18
19 w -311 1f.
923.4
HOUSE
611-1/16 BENDS
6"-1/32 BENDS
n 50.0' /
35
_ lo' \ 41.5' 80.0' _
EL. 2
C.O
36.0' 49.0 TEL.
29
42.5' 42.0'
THE LOCATIONS NS OF EING TCONTRACTORROSHALLTIDETERMINE SHOWN WN EXACT N LOCATION OF ALI-13E FULLY
BE OCCASIONED SBYOHIS FAILURE TO EXACTLY
EXISTING ANDILALIESDAHAES COMMENHICHCMIGHING WORK. FE
LOCATE AND PRESERvE ANY AND ALL UNDERGROUND UTILITIES.
.... /awl nrv?I nPMENT
•T
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER
c. X "Li
d. X "U"
SITE ADDRESS '?E?j TC2 ( CX/?/
CONTRACTOROD/'7 /Me`?' DATE 9? ZS PHONE 7?0-/DOU
Determine working Ysquare footage of each-
1. Total exposed wall area ...... 3'?17y.G sq. ft. X , IL- - _&{ L4,46
2. Total roof/ceiling area ..... -?9 `- sa. ft. X a U7i?p - 4(,0, 71L
A. Total wall window area .......................... ?41 .di
B. Total door area ................................. 4E.
C. Total sliding glass door area ...................
D- Total fireplace wall area ....................... ?? d
E- Total wall framing area (average 10%)...... .....
er
?_tot.
F. Total Rim joist area ............................ Zbt. .
G. Total Net wall area above floor ----------------- Z
Total exposed foundation area V .
H. Total foundation window area ....................
I. Total net foundation area above grade.--........ 7U gm
Determine "U" value of each wall segment-
a. 2?F1.`10% X ..U.. .34?- = f
b. 4L. X ..U.. . 0(07 = Z . s
e. ?AA 01, X "U...
f- 'Lpfo , X -U.-
g- Z,664.4- X --U..
X "U"
= N A.-
,iZ = 31,3
•? = 8.z4
vsL = 9 ,1
17 6. x
Z2. ? 07, .....Total = ". r9
If item #3 is the same as, or less than item #1, you have :net the intent of
SBC 6006(c)2-
%
yy 1 ?? ?f 1 k ? .y?
Total exposed roof/ceiling area
j. Total skylight area ................................. q? Air
k. Total roof/ceiling framing area (average 10%)._....107A1.
Total net insulated roof/ceiling area -:_.........
Determine "U" value for each roof/c?,ei//ling' segment.
j. X "U" = ILL Fem.
k. 1-79, 7 X ..u" O3 = 3
1. ? (w 17, -3 X "o" 02.E _ ?JZ. ?4
4 ............ ......................... Total = 37.7 :•
If total of 94 is the same as, or less than #2, you have met the intent of
SBC 6006(c)1-
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by.the
sum of items #3 and #4 shall not be greater than the sum of items #1 and #2-
1.?yl?¢.43 + 2. 4(o,7Z = 411,15
3- VIPC- .910- + 4. X7.73 = 3oQ . (MI
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE IN ERT
DATE II
FEES
HVAC: 0-100 M BTU qG /?? sfo $ 24.00
ADDITIONAL 50 M BTU ?/OA) 6.00
GAS OUTLETS (MINIMUM I Q S .00 CH) ?QO
ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 20.00
STATE SURCHARGE .50
TOTAL,
SITE ADDRESS: 1-1
OWNER NAME:_,,bYt
TELEPHONE #: -7, 1) -IX-6
INSTALLER: GEVZ-RYAN pI,I]MBING & DATING COMPANY
ADDRESS: 14745 South Robert Trail
CITY: Rosemount STATE: MN ZIP CODE: 55068
TELEPHONE #:-423-1144
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOW-S ANDr
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES EACH TOTAL
1 SHOWER 3.00 3 , 0 0
WATER CLOSET 3.00 o cz
BATH TUB 3.00 ?- 00-
LAVATORY 3.00 o
KITCHEN SINK 3.00 3 • st
t LAUNDRY TRAY 3.00 3 . a
HOT TUB/SPA 3.00
WATER HEATER 3.00 T
-L FLOOR DRAIN 3.00 3 a
t GAS PIPING OUTLET • minimum - t 3.00
_ ROUGH OPENINGS 1.50 L4 • SU
WATER SOFTENER 5.00
PRIVATE DISP. • Da.ay. tic. 20.00
U.G. SPRINKLER • home under cone 3.00
ALTERATIONS • to =istfog 20.00
WATER TURN AROUND 20.00
STATE SURCHARGE .50
TOTAL: ! } 4 • dJ
SITE ADDRESS: 3a \ ?dirC?v at ° C?
OWNER NAME.
INSTALLER:
ADDRESS: ?S? 3 O C ra >_a- C ?-5 0,
CITY: STATE: t, . ZIP CODE:
PHONE #: (U-) '--f 2:?, - 3 3 0
SIGNATURE PERMITTEE
1994 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-467S
LOT sLnC'.•: j SUBD."o/lite, l
R.-Ce1PT # L g1?Oz DATE 1'QC'?5 ff
1885 CITY OF EAGAN
IRRIGATION PERMIT (FOR EACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: Commercial
_ Residential (boulevards)
_ Existing residential
GPM
GPM
Arealaddress to be irrigated- 1921 L2 l2!'?Ffsim?
i, ef?llnr _ A*T7W W-DAll)1a?j J:VC. - r •.-na? r ^hemhor {?7
Street address- f 5230 CAr?MS61-. WAq '
City, state & zip code: 440"T- MIJ 550bg Phone #:C1/1Z) 423-3730
Owner Name- A_uba W1 Lb
Street address- q32( 70&?WSTF r. et
City, state & zip code: IF-46AN MN Phone #: 01647/91
Irrigation contractor, if different than installer:
Telephone #:
I hereby acknowledge that l have read this application, state that the information is correct, and agree
to compiy with all appilcaDle City of Eagan crd+nances. h is tirra 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. ,
_ '"'"'. c
Applicant's gnatu ?- Title -
Approved by: Date:
PRV ? Yes ? No New service ? Yes ? No
Meter Size & Cost
Fees due: - Calculated by:
/1-l -7
PROCEDURE FOR IRRIGATION SYSTEMS - 1995
An Irrigation permit is required - please contact Protective Inspections at 681-4675.
Fees
Commercial project: $25.50 irrigation permit to cover installation of backflow preventer.
$50.50 water permit fee only if new service is installed.
$300.00 per tap if installed by City.
9'3 iwe.¢i •' a7iGEa: -P.7 5n _ ??-?•;?? ;?ar;nitr !`+ rnvor r•'aila?i;'•? nf.h?'flow nrw'son+?r_
$ 0 water permit fee if new service is installed. .
$750.00 per connection - WAC. ' . `%
$372.00 per connection - water treatment facility.
Existing resilience: $20.50 irrigation permit to cover installation of backflow preventer - (not
required if backflow preventer previously installed)..
Meter charge: If gallons per minute are less than ?5, a 1" meter will be required at a cost of
$170.00. If gallons per minute tire more thbn 25, a 2" turbo with strainer will
be. required at a cost of $800.00. This information is to be supplied by the
de'signer of the system.
No meter will be sold before all sewer and water Inspections are complete on anew service. If new
service lines are not required, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk.
The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and
backflow preventer. The Public Works Department may be reached at 681-4300 for water birn-on and set
and seal of the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. Monday through Friday. Requests for
A. M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
? / 3®4
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
ywi
New Construction Requirements RemodellReoair Requirements Office Use Only
3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cart of Survey Recd _ Y _ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _Y _N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Reqd _ Y _ N
7 set of Energy Calculations Addition- indicate if onsffe septic system On-site Septic System _Y _N
3 copies of Tree Preservation Plan If lot platted after 711193
Rim Joist Detail options selection sheet (bldgs with 3 or less units
Date! / /03 Construction Cost
Site Address 1 3 2) D 0 y- c,dt ?sJe? C-4- Unit/Ste #
? ccn.? lM ? . z
3
,
Description of Work ( ll e l In tnd F f yl (S V1
Multi-Family Bldg _ Y LC N Fireplace(s) x 0 - I - 2
Property Owner Kawe` (I r6e4, v- l r ae //
f zr Mbet,) Telephone # ( 657 ) r' 26 -043 3
Contractor d t c-' ev --
Address W oz) j lavt.A Q I/ City `L"cw_
State E4 6LyL mpx, zip 55 1L3 Telephone # (65!) 6dff-07 SX
(Idl G,12- FMS 3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone
Telephone #(llp? ) SEP 0 9
I hereby apply for a Residential Building Permit and acknowledge that the informati6n_is=cetnp'lg-e--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.
tju I YVI -0u +a1e,.(-
Applicant's Printed Name
Applicant's Signature
N If so, 25% plan review
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 EM. Alt - Multi
? 03 01 of _ 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
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation j0490 Occupancy MC/ES System
Census Code 36 Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
- Footings (new bldg) Final/C.O.
- Footings (deck) Final/No C.O.
- Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof - Ice & Water _ Final _ Pool _ Figs _ Air/Gas Tests _ Final
Framing _ Siding _ Stucco _ Stone
Fireplace - R.I. - Air Test - Final _ Windows (new/replacement)
7K Insulation _ Retaining Wall
Approved By T Z 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
_aS
t r (?I J PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
DateQ,/ 03
Site Address 3 0 f C -N e./ +e Y- Unit #
Property Owner Telephone # ( )
Contractor _ v --c Ae.r ?e r d d e )ef,
HeSslan
Plumbing
ervices, nc.
-
Address P.O. Rnx 99179 city
Eagan, MN 55122-0172
State Zip Telephone # ( )
The Applicant is Owner 11,- Contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPG license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alteration xisting Dwelling Unit, Including $ 50.00
Adding fbdures to lower levels or room additions, excluding water softener and water heater
Abandonment of septic system
- Water turnaroun (+ 5/8" meter if needed - $121.00)
Other:
- RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacement _ additional
$ 50
State Surcharge I
In?l
l? $SQ SG
Total r:
I hereby apply for a Residential Plumbing 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 Plumbing 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. i A A
1" i V I-E. G N i?
Applicant's Printed Name A icant's Signature
1 ?'6 Lo Co-, ?
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
30
a
Date_tQ I ?`
1 V ?
) ( A A 1
22
Site Street Address Ll %?? VC)YGhPS r "i I.: f?fil?l?) N4IV ? ? nit #
P
i
Property Owner Telephone #)3/?"?n/?
Contractor X3
Telephone# ?Qj h /7ik ???)
1 ?C I? ?i1AIIIAIf) IVIG1 t I-Ie ?Ylr?
r?
{
Address Ll) %- IJ ?12 (???i d city s? . A ('41 State[4/Q_ zipC515015
L
The Applicant is: _ Owner Contractor -Other
Septic System - New _ Refurbished Submit 2 sets of plans and MPC license ncludes County fee
S 100.00
Per as-built $ 10.00
Alterations to existing dwelling S 50.00
Add plumbing fixtures. This fee includes installation of a water so ener andior water
heater at the same time. If you are installing onlv a water softener and/or water
heater, do not complete this section, move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
-Water Turnaround (add $130 00 if a 5/8" meter is required)
-Other:
I - - I
Water Softener Water Heater
$ 15.00
_ new _ replacement
_ Lawn Irrigation r RPZ _PVB -new -repair -rebuild 5 30,00
State Surcharge S .50
Total Sa'
I hereby apply for a Residential Plumbing 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 plumbing codes. that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
Applicant's Printed Name Applicant's Signature
JUL 0 3 2007
FMice Use
City of Ealan Permit#:
3830 Pilot Knob Road Permit Fee: Eagan MN 55122 Date Received:
Phone: (651) 675-5675 l I
Fax: (651) 675-5694 staff:
pp 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: L s 7 3 0 f Site Address: 1 e, r C e J° 4t r C
Tenant: Suite
RESIDENT I OWNER Name: Al C`) Ck 1\ 14 h bi e 4 Phone: to y 9 7 2 4-7o
Address / City / Zip: Q a cQ T im, S S / Z '2
CONTRACTOR Name: A2S 3 } ea v~ P I r~ "''Lv e c r C-ei License O S S - _
Address: o a a / 7
City: state: .1/V Zip: SS / 2 3
Phone: (,S) (s g 1~ $ a S Contact Person:
TYPE OF WORK _ New Replacement Repair - Rebuild Modify Space Work in R.O.W.
of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn irrigatio Add Plumbing Fixtures
C__._. RPZ / PVB) Main -Lower Level)
Septa System Water Turnaround
New
Abandonment
/
RESIDENTIAL FEES: V v J r
$50.50 Mg M Water Heater, Water Softener, or Water Heater A(ld Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$5050
Plumbing Fixtures, Septic System ndorrmerrL WOW Turnaround- (ftkKW $50 S" Surcharge)
06
Ater Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System hft ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (Includes $.50 State Surcharge)
TOTAL FEES $
t tweby ack this information is comp* and the work will be in conformance with the ordinances and codes of the City of
that I understand this is not a p it, but only an apOootion for a permit, and work Is not to start without a permit; that the work will be in
acx with the appmW plan in p» Case of work which r a review and i"taval of X
Le . ~ I ) -)Z--. 1 14 - - Ak,4s
Applicanre Printed Nance Appllicant's Signature
FFOR OFFICE USE Reviewed By: Date:
[Required Inspections: Ground ----Rough-in Air Test _Gas Test ---,Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143843
Date Issued:06/28/2017
Permit Category:ePermit
Site Address: 4321 Dorchester Ct
Lot:8 Block: 3 Addition: Hawthorne Woods 1st
PID:10-32150-03-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Randy Luc Le
4321 Dorchester Ct
Eagan MN 55123
Polar Builders Inc
1103 West Burnsville Parkway
Suite 110
Burnsville MN 55337
(612) 432-1597
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA147231
Date Issued:12/18/2017
Permit Category:ePermit
Site Address: 4321 Dorchester Ct
Lot:8 Block: 3 Addition: Hawthorne Woods 1st
PID:10-32150-03-080
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Randy Luc Le
4321 Dorchester Ct
Eagan MN 55123
(651) 413-0487
Assured Comfort Heating & Air Conditioning Llc
PO Box 6
Roberts WI 54023
(612) 221-2663
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA152109
Date Issued:09/28/2018
Permit Category:ePermit
Site Address: 4321 Dorchester Ct
Lot:8 Block: 3 Addition: Hawthorne Woods 1st
PID:10-32150-03-080
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Randy Luc Le
4321 Dorchester Ct
Eagan MN 55123
(651) 431-0487
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature