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537 Eastwood Ct 05/05/2011 08:40 FAX 16001/003 Use BLUE or BLACK Ink -------s,J------ - , Permit#: • C Of Eat Permit Fee, V 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone_ (651) 675-5675 I I 1 Staff. Fax: (651) 675-5694 l I 2011 RESIDENTIA/L~ BUILDING PERMIT APPLICATION Date: Site Address: -r 3r 4' W cog Unit Name: Ma-ri l 1,1 ig -s(, oo ►'1'r Phone: RESIDENT I ~T OWNER Address I City l zip. 5-3 q /L' As+wyeJ ~O ~rr.OL - Applicant is: _ Owner t/ Contractor TYPE OF WORK DescrIptlon of work: ! Z Lr- O F[ c -III- o o t-i Ala 1 s'b rJ S Construction Cost: / 0 a 0 Multi-Family Building: (Yes No 1+: ) Company:7W;'4 Te9e9# d A!3 • -J7 'a [ Contact: Tt,-'f't' 0r- CONTRACTOR Address' 7-.?- Z J Ave~ ~►t.~e.S-~ - City: T- Pys t State: N ZIP: ~ T Phone: (F 5-1 fy c'~& O license P 3L Co X 09 4 3 Lead Certificate - 1 ?Y-1 4 - to ` oll ro If the project is exempt from lead certification, please explain why, (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone; Sewer & Water Contractor: Phone: =4r-.' ,l Fro'.: w'.'Y 4 r-e':"•f'7.7T: ",:cj'y^' s h ,si-.y+{j~i~fl{+ ,ir~,1 ~1l~•%~1: ,~4w'. •}T~. _ i9•'/,^ Y.:ry ~.'!}`~„.~-n ,z3, JS.*• y. i Y.tJ.r ."$~y~{ • .K" ~•i~' ,.1,;. J.::'~•.' '•r}•t .C. v6w'. r1 "•"'r'Ii 'k,"Jwr.~'av, ~t.rA'Itr`c,.F y;OG,`k:•••,d, ,.K^ s'i: ' . 7•"', .5F r• ;i.Q":• dr"Fi.l •1;~.. r.., ~ y+~ +rA •ll,i".1~~t t. :.'Fl~~i h• , k h' 'u.,51.f h Cr y w~. f~• r~~.:~,,.:'4- i,~~;z:r.1ifY:v.~wt • ~,:U• 1.t5 ~ 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 recelve locates of underground utilities. www-geeherstateonscall.om I hereby acknowledge that this information is complete and accurate; that the work will be In conformance with the ordinances and Godes of the City of Eagan: that I understand this Is not a parmt but only an applicetion fnr a permit, and work is not to start without a pennlt; that the work will be in accordance with the approved plan In the =a of work which requires a review and approval ans. ~1=--- x X 47A - Applicant's Printed Name Appl nature Page t of 3 PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA086735 Eagan, MN 55122 . Date Issued: 10/09/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 537 Eastwood Ct Lot: 2 Block: 2 Addition: Hawthorne Woods 3rd PID 10-32152-020-02 Use Description: Sub Type: e-Siding Construction Type: Work Type: Siding Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and take steps to ensure maximum ventilation into attic space. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Pyramid Enterprises Inc Stuart D Bloom 23231 Logan Way 537 Eastwood Ct Lakeville MN 55044 Eagan MN 55123 (952) 469-6743 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 CIl`Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: tMl1111N11 Ntld 1/<aq ' SITE ADDRESS: I ii t ., s ? ;.11111 1 Intl I I II kWP4I 1'1111111 1'11 PERMIT SUBTYPE: fit 111 t : APPLICANT: . 1?,t.l jls?- ??,Irl TYPE OF WORK: INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. r l'.i111114: ?;Illii I IJ1? 1 N 111 A i I Ito I t I I I 111 1 { I111,11 M I t::, ?+??4,ii I f1 II i I 11+r,i I 1 Iti1 i Ira/11 I i'r51tM : V14V Permit No. Permit Holder Date Telephone # S/W PLUMBING a? y y?g/go HVAC ELECTRI ELECTRIC Inspection Date Insp. Comments Footings I _7?? /Q Foundation Framing ` Roofing Rough Plbg. Rough Htg. Isul. Fireplace n GGU???JJJ < PEA 7-4", Final Mg. /? ?, Orsat Test Final Plbg. 0 Plbg. Inspector- Notity Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. lisp. I a/ 9y ,?? L-'CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) SITE ADDRESS: `t PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. L f,VVTI t. if. 1) NY VVA'f 1; NW-)A(' - Yk INSPECTION RECORD PERMIT TYPE: Permit Number: 7 Date Issued: "' W W ELI APPLICANT: r 3 + 11 Permit Holder Date Telephone # SEW Ri WATER PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING i? ROOFING ROUGH PLUMBING /- PLBG AIR TEST ROUGH HEATING s / . / GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVfTY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ` INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: " r" roc, 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: i (612) 681-4675 SITE ADDRESS: APPLICANT: PERMIT SUBTYPE: !?J • . r 0f) 1 1 Nf,': TYPE OF WORK: 1 IHAI Permit No. Permit Holder Date Telephone k ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL Address 537 EASTWOOD COURT Zip 5512 3 Lot' '2 Blk 2 Sub HAWRIORNE 4WDS 3RD THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: p 9 Yes No Inspector: Final grade (6" from siding) v Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass Trail/curb damage Porch L11 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 Request Dale ?I ` Fire No Roughdn Inpsec8on Required po m cell inspecdor when reatly) Ins echon they Than Rough-In Ready NOw ? Will NOtlbJgs0ectOr ?? 4 ? Yea o Date Read licensed contractor ? owner hereby request inspection of above ectriceI w Job AUtlrgss (Street. C Route No M4 U Cary Seiiction No Township IN e or No 'a gangs No, W cou Occupant (PRINT) C O\11 r s"V ?I?V \- `Phone No _l? O Power Supplier 1?3At U Atloress /^^ Eiecm Contractor (Company Name) Contractors License No CA o©g00-1 Mailing Address 6racmr owner Making Installation) ? Aw rrzed Signature ICOnvactor.Dwner Makin stallauon) C,? c rt_ 551 d.?{ Phone Number TI a0? L1 ,3Z MINNESOTA STATE BOARD OF ELE41CITY THIS INSPECTION REQUEST WILL NOT Goggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 Unnouslty Aye., St Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION a 73 CJ ?rr O 1 see inetrp iXons for completing this lorm on back ol " Below Work Covered by This Request e Add Rep TypeofBwi ing Appliances Wired EgwpmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm.llndusinal Furnace Other (Specify) Farm Air Conditioner Other(specryl 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 Above 100 Amps Signs Inspector's Use Only TOT L Irrigation Booms ?f 71 - ;11 ? f t Special Inspection J 1 ? . ( . Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCON CTED IF NOT Other Fee COMPLETED WITHIN 18 THS. I, the Electrical inspector, hereby Rough-in certify that the above inspection has been made Rinai - oat Q _Cf OFFICE USE ONLY This request void 18 months from (t t f O?/?_ D? REQUEST FOR ELECTRICAL INSPECTION EB-aoool-os See instructions for completing this form on back of yellow copy q 0 d /? 1111 8/93 "X" Below.Work Covered by This Request Lew Add Rep. Type of Building AppliarjuS, ,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 tspecilyj on ctor's 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 Am s 100 -Amps Signs inspectors use only TO AL Irrigation Booms co?? 1 20-51(1) Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 16 MONTHS. I, the Electrical Inspector, hereby h h f Rough-in Data certi y t at t e above inspection has been made. Final D ,7-? OFFICE USE ONLY This request void 18 months from y7a? y Owl 830 J'' 0 Request! Date $ ?/? F'a No. Rough-M IM..pection Required yOV must call inspe for w n ready) Ins than Other ugh-In ffReatl No NoIR Inspector J es No pate Rand I " ensed contractor ?owner hereby request inspection of above electrical work at: Job Address (Street, Box Route No) City Section No Township Name or No Range No Co Occu ant (PRINT) Phone No. ak I- T t A \?,- cQ a Power Suppler Address Electra Contractor (Company Name) Contractor's License No / ? ? v C4 L v Meilmg ddress (Contractor Owner Ma mg Installation) O orized Signature (Contractor/Owner Making Installation) Phon umber U ? RICITV B I I THIS INSPECTION REQUEST WILL NOT Bldg, Griggs-Midway gs Room 5-128 Midw II I I I I II I I II I ? ? II BE v E S II ry UnIver Paul, MN 04 . p UNLESS PROP R INSPECTION E I T Phone (6121 662-0 rn 0 1 1 Y FNr:I l1CFr1 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE Permit Number: Date Issued: 3?4 BUILDING 027668 05/24/96 SITE ADDRESS: P.I.N.: 10-32152-020-02 537 EASTWOOD CT LOT: 2 BLOCK: 2 HAWTHORNE WOODS 3RD DESCRIPTION: DECK NEW 434 ALT. RESIDENTIAL go 4r" REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge .50 Total Fee $45.50 CONTRACTOR: OWNER: - Applicant - GERCZAK TOM 537 EASTWOOD CT EAGAN MN (612)454-6044 .'s ,? rbw. ??ir';s s vi s re i sang. as='' £ B a re ... e KLRIFff 3?k ?? Xr?Iikfi ?? 4 S.g v - E F '_° 15, I here y aopi rts+ V_ at aaxr H e? ac h 61- i i ? n anct s?t s that in fAo rm tia>'r'i,z Pi P lad „ t a xtn Ctrs pLg is tt1. RFi i'z ;Mate ?_Q f rl N rn "zf, e't` °- °? APPLICANT/P MITE IGNATU E ' ISS BY. SIGNATURE OF EAGA 3830 PILIOT KNOB RDN 55122?J • 50 flu 1996 BUILDING PERMI6APPLI5ATION (RESIDENTIAL) nn nn ? _z New Construction Reauirements Remodel/Repair R auir meat U?kX ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ' ? 1 energy calculations ? 1 energy calculations for heated additlons ? 3 copies of tree preservation plan if lot platted after 7/1/93 required: -Yes _ No DATE: Af ct t/ A, - Th CONSTRUCTION COST: y DESCRIPTION OF WORK: oeck STREET ADDRESS: Y 5-2 7 L?aS f .J 0J C7? LOT BLOCK SUBD./P.I.D. #: QW ± n,rNP 00c)ci S 3r4 QQ? PROPERTY Name: 127 `? ?? n e+T? ?? r C Za/Phone #:y ?- OWNER WT / "„r Street Address 7- City: Ea,Oa State: Zip: CONTRACTOR, to pany: Phone #: Street A s: Lice e # City: Sta Zip: ARCHITECT/ Company: ENGINEER Name: Street Sewer & water licensed plumber: change are requested once permit is issued. Phone Registration #* State: Penalty applies when address change and lot 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: 0 61 (-j OFFICE USE ONLY Certificates of Survey Received _ Yes Tree Preservation Plan Received - Yes REC ENEDD _ No MAY 2 100 No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit SAN Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MCNVS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit SAC Units - ?`k Svc ?kkCBCY,: Xc??C?C?C?t9bY,c? ray; ?t? ? ?#?k)k??>Y?*)k???:%k>'65,r K:%;? CITY O EAGAN CASHIER- S TERMINAL N0: 866 DATE:: 1.2!09/98 TIME: 14:27225 ID: NAME: GINNY S GERC7_AK 33210 9001 537 E_.ASrWOOD CT 50„00 21.55 9001 537 E:ASTWOOD CT 0.50 Total Receipt Amount: 50.50 C.,R00500 USER ID: NANCY 2k?)kB:?sFMY,(kM?%*k?x;k•X?X.?XX?A'?a' k?%C'x".Xc?kdr;R?Y,ok#S:)'??).??:$i: PERMIT CITY OF EAGAN 383.0 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT TYPE: B U I -0 I N G Permit Number: 0 3 41 9 4 Date Issued: 12_ / 0 9 / 9 8 SITE ADDRESS: P.I.N.: 10-32152-020-02 537 EASTWOOD CT LOT: 2 BLOCK: 2 HAW1'hiORNE WOODS 3RD DESCRIPTION: Bu,j:- ding 'Permit Type elpildinq WoY?k Type ,L"ensus Code t BASEMENT" FINISH ALTERATION 434 ALT. RESIDENTIAL REMARKS: PLAN REV]EWti) BY CRAIG NOVACZYK. SEPERATF. PERM CT REOUSRED FOR ANY PLUMBING WORK. CALL 445-2840 REGARDING FLFCTRTCAt PFRh1TT AN") TN4PFcrrnNg FEE SUMMARY: Base Fee $50.00 Surchlarge _ __ ___ g_.50 Total Fee $50.50 CONTRACTOR: M OWNER: - Applicant - GF.RCZAK THOMAS 537 EASTWOOD CT FAGAN MN 55123 (651)454-6044 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 Mn. Statutes and City of Eagan Qrdinances. L ` N /PERMITS E UED BY: sIGNATUH 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF FAGAN 3830 PILOT KNOB RD - 55122 681-4675 , New Construction Requirements ? 3 registered site surveys ? 2 copies of plans (include beam 8 window saes; poured fnd. design; etc.) ? 1 energy calculations • 3 copies of Use preservation plan if lot platted after 7/1/93 required: _Yes _ No DATE: /g jqh? Renrodel/Reoair Requirements ?6QQe) ?? . l `?? ? 2 copies of plan ? 2 site surveys (exterior additions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST; DESCRIPTION OF WORK: r-1V1S17 h SL'/ne-/ rl f STREET ADDRESS: ?I ??/SfGr/OOCC LZr c?LLU?fV??i??, l'/ LOT: BLOCK: ?- SUBD./P.I.D. #: ? zk>%o-ne- Name: 7-A4019 ? -. l9/4"1/Y lo? 549' 7" AO ?yrT ? Phone #: 6. PROPERTY Last First C 1 ???l to 9,3 6 a36 OWNER ? 2Z4LGlOGG? Street Address: city ,C-aqd ?4 state: /VV Zip: SSJZ-S Company: Phone #: CONTRACTOR Street Address: License # city State: Zip: ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street Address: City State: Zip: Sewer 8 water licensed plumber (new construction only): and lot change is requested once permit is issued. Penalty applies when address Chang I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received - Yes No Tree Preservation Plan Received Yes - No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE ? 11 Apt./Lodging ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous ? 31 New * 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) S- ? I Basement sq. ft. MCNVS System (Allowable) S-?L Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning fz-I sq. ft. PRV # of Stories - sq. ft. Booster Pump Length - sq. ft. Census Code. Depth - Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS r Planning Building (J Engineering 01± ? Variance Permit Fee Valuation: $ ?2 C9-(i -fix Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: lot 6 % SAC SAC Units CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: BUILDINV 023972 07/13/94 SITE ADDRESS: P.I.N.: 10-32152-020-02 537 EASTWOOD CT LOT: 2 BLOCK: 2 HAWTHORNE WOODS 3RD DESCRIPTION: B"uilding_, ermit Type I SF DWG !Building Work Type NEW UBC Occupancy\ R-3 M-1 f Construction Type V-N j ' Zoning R-1 Building Length 64 Building Width 36 Building stories 2 REMARKS: PRV S & W PLBR - FEE SUMMARY, VALUATION Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal $790.00 $513.50 $71.50 $800.00 100 $2,175.00 $143,000 MISCELLANEOUS $1,828.50 Total Fee $4,003.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: MCDONALD CONST INC 14327601 0002376 MCDONALD CONST INC 7601 145TH ST W 7601 145TH ST W APPLE VALLEY MN 55124 APPLE VALLEY MN 55124 (612) 432-7601 (612)432-7601 I hereby acknowledge that I have read this information is correct and agree to comply L- Statutes and City of Eagan Ordinances. a A SIGNATURE application and state that the with all applicable State of Mn. ISSUE BY: S TUBE CITY OF EAGAN 9ql 1994 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered s' a surveys, 1 copy of energy calcs. J'ufY 1994 COMMERCIAL 2 sets of architectural & struc - ;au_j_jet f specifications, 1 copy of energy calcs. 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. // Date Valuation of work 1 yh , 5?? Site Address: ,S 2E 4GA v?ooa A4 Fi STREET ITE # Tenant Name: (commercial only) LOT BLOCK 1 sUBD. 4W 00.N !? wtw P.I.D. # Description of work: Q 6W S , FA The applicant is: ? Owner l?Contractor ? Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE # City State Zip Company N1 e c Ce?,?j Phone Contractor <JSTti- St ko. License #000,237 Exp. ?(S Address 76901 1 99 City AOP (? J .4 H & Y State 6 A Zip 55 Qq Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber m 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 comply with all applicable State of Minnesota Statutes and City Of Eagan Ordinances. ? ? Signature of Applicant: G ?+- 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'l. ? 15 Deck WORK TYPE 113 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Z2 S. S/? 1- r Const. (Actual) ?A/ Basement sq. ft. 1/ 3/ MWCC System (Allowable) li / 1st Fl. sq. ft. //3/ City Water UBC Occupancy <• ,? / 2nd Fl. sq. ft. P4/ PRV Required Zoning ?• Sq. Ft. total Booster Pump # of Stories z Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code /a Depth On-site sewage SAC Code o i APPROVALS Census unit i Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? .Site C] Footing © Framing t7 Insulation ? Wallboard El Final ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units VaLLat;on: $ 3 D D - ?a y / ?/ ,•r z _• 2? 2 ..lJ z y?. s 2 yzy , ? 16 Basement Finish ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish J /k ?? -- 1070 to (o O l •%?t 2S j- 99/k.??: ? 3S/v d J O ? m z 2 ? 0' 0 D? ? D Q'D 0 e' 0 ? - 0/0 ? LOT SURVEY CHECKLIST FOR RESIDENTIAL BUI; PROPERTY LEGAL: Date , f'purrve/y:: (o / ?04 (? y DOCUMENT STANDARDS ?J/ 7 Registered Land Surveyor signature and company Building Permit Applicant Legal description Address North arrow and-bey-scale House type (rambler, walkout, split w/o, split entry, lookout, etc.) Directional drainage arrows with slope/gradient %. Proposed/existing sewer and water services Street name Driveway ELEVATIONS Existinc H'? ? ? Sewer service M• -0 0 Lot corners 0, ? ? Top of curb at the driveway Ci?0 0 Elevations of any existing adjacent homes - / Proposed C? ? ? Garage floor 9r-0 0 First floor 8' ? 0 Lowest exposed elevation (walkout/window) ?iQ ? Property corners Q?? 0 Front and rear of home at the foundation Pomim AREAS (if applicable) ? ?? Easement line 0 6' 0 HWL 0 0 Pond # designation 0 ? Emergency Overflow Elevation DIMENSIONS 0,-"13 0 Lot lines 0-'? ? Right-of-way and street width (to back of curb) C?- ? 0 Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e. all structures requiring permanent footings) 0/0 ? Show all easements of record and any City utilities within those easements B' ? 0 Setbacks of proposed structure and setback of adjacent existing home D ??0 Retaining re i ents, if any Reviewed- / Na e ate October 1992 saw r`' l ` I I I 6 -I/32 BENDI ES L so' ESMT?\ \ Ll6 W81 END ?- , 7 6 S 6" X 6"TEE 6° GATE VALVE - HYDRANT MH.24 _ _ - -} - - --L1 \ - - -- -1 I- _ C Er 324 ( H. 25 IUt ? I I i I I INSTRUCT EARTHEN DAN 3 2 )WNGRADE FROM C.B. 1.5' ABOVE GRATE - / it \ )D 6 PEG BERN; SOD ?'-EMERG= JCY )NTAINMENN'T AREA AROUND OVER, :-%D \ \\ 4 ' - LATE OUT TO 10'R. OUTLE' J MAX. E-EV.=85 5 \ L-- 6 5 DRAIV:.GE SUTILi=!Y EASE,'AE,NT, ?=`•sWA7E I.."Illy I.0UF'.I(f)P"3 C.B.3'3 -- - / 1.,"',I IUP!S. THIS LUiG', I") FOR I,. - i0F2 PURPOSES ?NLV AND 1 J ? ?ST._M. ss \--'-EXISTING EASTWOOD .•-? v. o. a.' v ,?rre+vnn ++ro tvw cn I A55•Y.. W/CA$'CING.ASS.`Y_ i-3067v TREES \ \\ \ ` C.B. 136 COURT C Q. DEQ4sN Op'w a- 4a?-1 i 8 84 MR 25 ? i R.E.1881.9 ' PROPOSED ? PROFILE', i S{7 R 35. R.E.867.7 LF-8 P ! m ?„ o> SDR 35=8.0% 75'.MIN ii :OVER l i,- ', I-.. I I I I -8°PVC F 160L SDR35-8,Op/° . , ... I.. . , .... °pvc SDR 3514.0% F -8 . .. I. 4 N I VLjf EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: MaDONALD CONSTRUCTION. INC_ SITE ADDRESS Job Number: Base Plan: BW I CONTRACTOR: McDONALD CONSTRUCTION. INC. DATE: 11118193 OVERAGE .110.15 PHONE: 432.7801 DETERMINE WORKING SQUARE FOOTAGE OF EACH 1. EXPOSED WALL AREA : 3099.83 so ft x "U' 2. ROOF/CEILING AREA : 1217.00 eq ft x "U" 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area 3099.83 aq ft a) Total well window area: 3/4' insulating pleas 328.50 aq it x "U" b) Total door area : 37.82 sq ft x "W c) Total sliding glass door area : 3/4' insulating Blau 33.35 sq fl x "U" d) Total fireplace area 4.50 .q ft x "U" e) Total wall framing area (average 10%I: 309.98 eq ft x "U" R Total dm ales: 281.48 eq ft x "U" Total foundation area Exposed: 157.87 sq ft g) Total foundation Window are.: 11.25 sq ft. "U" h) Total net foundation area Exposed: 145.42 aq ft x'U" 0.110 340.98 0.028 31.84 0.45 147.83 0.47 17.78 0.48 15.34 0.04 0.17 0.10 30.09 0.03 7.50 0.48 5.18 0.08 3. TOTAL et THRU h) 1. TOTAL EXPOSED WALL It d31 the same as er less than Item ll you have met it am Is ................ 11.30 a `5. 2317 340.98 The intent of 2 MCAR 1.18008 A and O. ANSWER: YOU PA ........ ........ 4. TOTAL EXPOSED ROOFICEILING CALCULATIONS: Total sxpc..d roof/ceiling area: 1217.00 sq ft 1) Total skylight area: 0.00 sq ft x'U' 0.00 0.00 k) Total new roof/ceiling framing area leverage 10%1 121.70 art It x "U" 0.03 3.37 11 Total net insulated roof/ceiling arse: 1095.30 sq It x "U" 0.02 23.91 Total vaulted ceiling framing and Insulation 0.00 sq ft x "U" 1.28 0.00 4. TOTAL 11 THRU 1) 27.28 2. TOTAL ROOF/CEIUNG 31.84 If Item Y4 Is the Be" as, or less than Item t2, you have met the Intent of 2 MCAR 1.18008 A and O. ANSWER: YOU PASS ................ ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items 13 and 94 shall not be greater than the sum of items /1 and 72. Items 3 + 4 - 235.17 PLUS 27.28 282.45 Items 1 + 2 - 340.98 PLUS 31.84 372.80 ANSWER: ...........s.... PASS ................ CERTIFICATION I hereby certify that 1 have calculated the 'U" factors and the "R" values herein and that the building here described meets or exceeds the Stale of Minnesota Energy Conserve an, c (Blg.m.re) (Date) / CONSTRUCTION WORKSHEET A. WALL FRAMING SECTION R 1. Interior air film 0.68 2. 112" sheetrock 0.45 3.5 112 ' of soft wood 6.87 4. Sheathing 1.32 5. Siding 0.81 6. Exterior air film 0.17 TOTAL n = 10.30 U = 11R = 0.10 B. WALL SECTION (INSULATED) R 1. Interior air film 0.68 2. Int. wall covering 0.45 3. Insulation 19.00 4. Sheathing 1.32 5. Siding 0.61 6. Exterior air film 0.17 TOTAL R = 22.43 U = 1IR = 0.04 C. RIM JOIST SECTION: R 1. Interior air film 0.68 2. Insulation 30.00 3. Rim joist 1.89 4. Exterior sheathing 1.32 5. Siding 0.81 8. Exterior air film 0.17 TOTAL R = 34.87 U=11R= 0.03 D. FOUNDATION SECTION: R 1. Interior air film 0.68 2. Insulation 11.00 3. Concrete/Block 1.11 4. Exterior air film 0.17 5 0.00 8. 0.00 TOTAL R = 12.96 U = 1IR = 0.08 F. CEILING SECTION (INSULATEDI R 1. Interior air film 0.61 2. 5/8" sheetrock 0.58 3. Insulation 44.00 4. Exterior air film Istill) 0.61 = TOTAL R = 45.80 U=1IR= 0.02 F. CEILING FRAMING SECTION: R 1. Interior air film 0.61 2. 518' sheetrock 0.58 3. Insulation depth - framing 30.00 4. Interior air film Istill) 0.61 5. 0.00 'of soft wood 4.35 TOTAL R = 36.15 U=1/R= 0.03 G. CEILING SECTION (INSULATEDI R 1. Interior air film 0.61 2. Interim ceiling 0.00 3. Insulation 0.00 4. Exterior air film (still) 0.81 = TOTAL R = 1.22 U =1IR= 0.82 0. CEILING FRAMING SECTION: R 1. Interior air film 0.61 2. Interior ceiling 0.00 3. Insulation depth • framing 0.00 4. Interior air film Willi 0.61 5. 'of soft wood 0.00 TOTAL R = 1.22 U=1IR= 0.82 H. VAULTED CEILING: R 1. Interior air film 0.61 2. Interior ceiling 0.00 3. Insulation depth • framing 0.00 4 0.00 5. Outside air film 0.17 TOTAL R = 0.76 U=1IR= 1.28 ?eaYX<Xi ;(?v:XC:i?,?MX?X(kd::cY,<;(`;:T,:Xc:?>?Y, ;:R(s:ckstrc:k;?X'?X?:r?X:>;aXZ, CACHIER: IS TERMINAL NO; 893 DATE: 08/:31/99 TIME i.i'00H 'I( - NAME: SLLA ROOFING & REMODELING 3RiQ 9001 537 EAEiINOOD CT 03.85 2'.15 9001 5x37 E'ASTWOOD CT 4.00 S Total Receipt Awuunt? 07.0 CRA16209 USER 1Dz .3AN ?:(:; %Y?.'.?s'<n"F7Y.;%st:'T:ncMY,?n:::r?(??.i!:r..X%'FXfi{?C)r?'<X(R: ?c1:M:`:•k?.Y,:`? a,5- 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) 5 -7 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681.4675 New Construction Reaulrements Remodel/Repair Reauhements ? 3 registered site surveys showing sq. ff. of lot, sq. ft. of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions 2 copies of plans (show beam tL window sizes; poured fnd. design; etc.) 1 she survey for exterior additions b decks ? 1 set of energy calculations 3 copies of tree preservation plan it lot platted after 7/1/93 DATE: CONSTRUCTION COST: 76LD DESCRIPTION OF WORK: feaA' f STREET ADDRESS: ?3? Cu St??y9{(f G I?( }' 1 I LOT: BLOCK:_ SUBD./P.I.D.#: 1IGY?y?OYV1Q WOLYIIS ??y Name: G f C 2P ?? -rig wt 65 % _ Phone #: ¢S Cfl ?? PROPERTY Last First OWNER Street Address: S City State: Zip: SELA ROOFING & REMODELING, INC. Company: 4101) E(CFL4TOR BLVD. ST. LOUIS PARK, MN 55416 CONTRACTOR In 00001000 Street City r State: ARCHITECT/ ENGINEER Company: Name: ) Telephone #: area code It Street City Sewer 3 water licensed plumber (required for new construction only): State: Pnnaity applies when address change and lot change is requested once permit is Issued. Zip: Zip: !,,hereby acknowledge that I have read this application, state that the Information Is correct, and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: U?1 OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required 2 Phone #: 4i 1 (area code) Registration #: License# )05'o Exp. 3/5//&'? L o2 qq CITY USE ONLY BL oC.. RECEIPT#: uYICiHR? ?iJ4/L 3/a RECEIPT DATE: 1999 nummH PERMIT (RESIDENT A W CITY OF $AHAN 3$30 PILOT KNOB RD £AGM, MN 5512E (651) 651-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES Shower Water Closet Bath Tub Lavatory Kitchen Sink Laundry Tray Hot Tub/Spa W I H t a er er Floor Drain haw 5u? Gas Piping Outlet ' minimum -1 Rough Openings Water Softener for dwellings under construction Water Softener for existing dwelling U.G. Sprinkler for dwelling under inst. U.G. Sprinkler ' for existing dwelling Alterations ' to existing residence Water Turn Around Private Disposal System MPC lic. (new and refurbished systems) Private Disposal Systems Abandonment RPZ (new installation/repair) EACH 3.00 3.00 3.00 3.00 3.00 3.00 3.00 r? 3.00 3.00 3.00 1.50 5.00 30.00 3.00 30.00 30.00 30.00 75.00 Reminder: Call 681.4675 for inspections of water heaters, water softeners, alterations, etc. x x x x l x x x x X X x x x TOTAL 30.00 = 30.00 = STATE SURCHARGE TOTAL 3 () o .50 ------ --- - ------------------ I hereby acknowledge that I have read this application, state that the information Is correct, and agree to comply with all applicable City of Fagan 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/rightof-of SITE ADDRESS: 53 7 G ASJ Woea Ct OWNER NAME: TOM Ge/rc-zJ4G INSTALLER NAME: SA )L¢r f ll m b W!4 TELEPHONE #: %4 q-' ROaeS .2 q7 STREET ADDRESS: 4!5 q y I "I 7t K .5':t W `f >> 3( CITY: Pr,)r ?KQ STATE: r+4w ZIP: J?J?c3 rya SIGNATURE OF CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 PIONEHIM sn r *IK *it 1J 10 rLAW1E11• ......i"Qui ,Irlynle, MIA 52i12.0 (614 081--1914 rAX:601-9488 625 Hlphwnyy )t) N.E. Ilinllle. MN 55434 (612) 763-1880 FAX1703-1883 C@IIMCUle of SUrvey for: MCDONALD CONST,, INC. 531 FASI WUUD CT. `- 'cow ` OGO,G ?Grrs 7. TEIF. hEU. b° po BENCH MARK 0 9 fj ror or Hun '?$? 071.9 ELEV.•069.42 Iv sf` - 175.0 4 REhVICEE= A7 ??.G F? N INlC?f1G'I,U A ?• \?\ G9.H"S?: -•-870,2 RlLEI rMft tV U tv Yg'"41' N •E . \ L7 h m h / 1/0 1167 9 I1GG.9 ? .?A/©76.8 5? A6d !^k l 17 )C ?a 861.2 f '4 h t 71.27 S01°01'2YE 0693`' r?75 n k a ELEC 8 b . TV. PED. -- ~-OENCII MARK ll)P OF IV 13 ,y ELCV.+87232x• ?G ?f17U.tl6 7/l0 yl C.f/ LT rCf.) ?'G ?(s ? I X 6 ) rnorOSED HADES RIIOWN PEn ORAD1110 PLAN OYt?4. DM?9 ?RAN_ (??IlUV_' n NOTE! DIIILDNO D01I01SION11 5110WH ARE rOR NOMZONIAL ANU VENIICAL [I^y 12"? In, (t1? , u ?`? ' i-OCAUON or smumVnES oNLY. SEE ARCIIIICCTUAL PLANS FM UUILCINO FY'.? IY5+9`F It tb?Wly„',1 l,? Me romnAT1ON INUENSInNS ¦ ¦ WINE! CONTRACICAI NIJST VERIrY ORWEWAY DrSION. MIS CEn ITICAIE ODES NOT rUnrORI ID SNOW EASEMENTS IIOIEI No SPECUIg SWLS IIIVESIIUAIIU14 11AS URN COMPLETED ON MIS OTNEII MAN -HOSE SIJOATI ON 111E RECOROED FLAT. LOl By DIE SURVEYOR WE 8VIIAeN1Y Or SOILS 10 SUrPOnT 111E BEAM1103 SHOWN ARE ASSUMED SPECINC imsE PROVWD 13 1101 111E RF.SPM1SIRII11Y or IIIF minvrYnR. It (500.00 Denotes Existing Flevollon ( ooo.oo ) Denotes rroponed Elevation - -- )P.1lalas DralNago & Utility Easement --- Denoles Drolnago rlow Dlrectlon w-• Denotes Idonument --0 Donoto0 Offaol IIUb OT 2 , BLOCK 2 DAKOTA COUNM MINNESOTA LOW09t Floor Elevation: J? lop of Clock Flevotlon: _S 7(j. I Gurago Slob Elevallonl HAMHORNE WOODS 3RD ADDITION hllehy ea•Iily 11hol 110, eu.v!y, plon Or re-oll *01 Dlepored by m@ or undol my dlrlal rirv?c? l?a?av, duly np1111rd land Svroly" .. . .. -, 1, n,.,- _r,n._... r. . . ... RT11 .11111 n P.02 2422 Enterprise Drive Mendota Heights, MN 55120 PIONEER Mora SUR%VAM a ah& 9NWrtbA5 (612) 681-1914 FAX2681-9486 engineering LWO iLAM1E314e WIDEDAIC ARM111475 825 Highway 10 N,E, * * Blaine, MN 55434 (612) 783-1880 FAX:M -1863 Certificate of Survey for: MCDONALD CONST,, INC 537 EASTWOOD CT. EQ ? O© N BT.6 ? TELE. Pm--- `f86 ,8 4 ?r$ -CO R7. BENCH MARK y o 9[j3' rr 871.9 TOP OF HLB ^ EL EV.=869.42 6 4 rv ?`? ?'? 975.05 .9 SEW M 5 ,y & r In1G=es4.0? 875.3 h .I lap e r o ?? N? TV PED. \W r "?+ o % 3 , N 21,17 ----BENCH MARK OS °4 q4 TOP OF W B 10 cu h a`° phbp I t 1,0,0444 ` N ELETlr875,U 3 ti i - l aB2.5 h $66.9 ?o ? ?a BT4.8 ao A / ??Gc r 1 64,E 8695`.. ? AP ? 870,05 4a?N x 867, 5 Sq?(p??y ?iLoJld G9 rc AGE R 86t.2 `^?\r a Ly ? h ?b --7 > 2 / DEPT (?M-'o) PROPOSED GRADES SHOM PER GRADING PLAN eY: MCCOMRS FRANK ROD NOTE! 6UILDSJG DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL S ?? (? - L R LOCATION OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING Li ? ? Q- I ? ? a ti! o G AND FOUNOATION DIMENSIONS NOTE: CON7RACtOR MUST VERIFY DRIVEWAY DESIGN. IRIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTNER THAN THOSE SHOVM ON THE REOOROED PLAT. NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE SURVEYOR- THE SUIIA81UIY OF SOILS TO SUPPORT THE BEARINGS SHOWN ARE ASSUMED SPECIFIC HOUSE PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR PROPOSED HOUSE ELE AVON x oao.oo Denotes Existing Elevation ( ooo.oo) Denotes Proposed Elevation Lowest Floor Elevation: -9-41A. Denotes Drainage & Utility Easement ?????? - ---? Denotes Drainage Flow Direction Top of Block Elevation: L&j - * Denotes Monument * Denotes Offset Hub Garage Slab Elevation: 87sU LOT 2 , BLOCK 2 HAWTHORNS MODS 3RD ADDITION DAKOTA COUNTY, MINNESOTA We hereby certify that this survey. Plum or reoort ,as ppreepared by me or under m dlreol supsruq14ED' am duly regletwd land Surveyor under the tare at the Slate of Minnfoola. Dated lhia _6TH day of UUNF A.D. 19 R4 ultr.A J 6-? 16-• Qe- 1Il ye"e' d NEER ENGIN RING, P, / ? -J.------ Scale: 1 inch = 3o feet John C. Larson, L.S. Reg. No. 189'4 194168.00 R-96% 06-23-94 12:20PM P002 #38 PERMIT City of Eagan Permit Type:Building Permit Number:EA121995 Date Issued:04/21/2014 Permit Category:ePermit Site Address: 537 Eastwood Ct Lot:2 Block: 2 Addition: Hawthorne Woods 3rd PID:10-32152-02-020 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - 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 by law in ALL single family homes . 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 - Stuart D Bloom 537 Eastwood Ct Eagan MN 55123 (651) 452-9623 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA146739 Date Issued:11/13/2017 Permit Category:ePermit Site Address: 537 Eastwood Ct Lot:2 Block: 2 Addition: Hawthorne Woods 3rd PID:10-32152-02-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations 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 - Stuart D Bloom 537 Eastwood Ct Eagan MN 55123 (651) 452-9623 Capital Construction Llc 406 Gateway Blvd Burnsville MN 55337 (855) 766-3221 Applicant/Permitee: Signature Issued By: Signature