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4137 Countryview DrCITY OF EAGAN 3830 Pilvt Knob Road Eagan, Minnesota 55 1 22-1 897 (612) 681-4675 SITE ADDRESS• ? " ? " ` • Ia: t.a nr. fi PERMIT SUBTYPE: , . , PERMIT TYPE: t 1 11 1 ru ii Permit Number. ?' ? ?' + `' •' Date Issued: i? <. I ca ?, i?>s , APPLICANT: , -r'!. ! , . 1, 1 1 •1,, i t•.t,' r 4 ;:, _s4 4 k TYPE OF WORK: INSPECTION D. . .. . ? _ - ---??------- Permit Holder Date Telephone # PLUMBING v HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PtlSMB1NG PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL 711 jIQ p ? V GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG AECK FINAL ? ' CiTY 4F EAGAN 3830 Pilat Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS • INSPECTION RECORD PERAAIT TYPE: Permit Number: Date Issued: , II MlN Y`'r111A C+12 9 I {{ PERMIT SUBTYPE: TYPE OF WORK: ril 41 11 1 a . .? 's t ai i{i/r•tl/?a? INSPECTION . . . .• • , , . . ., . „i .• I'i I fJ ? i r l I 1?! ', ?? ?„ ,,; ?,?? ! t i•i I i.?.i ? I I.. . t 1 rAA1 1 IFt M1lFtK `a : `;hk-l ( 1) N f t'A i { iil,' '.'ql 1!'; P l Illryti t NI i N; APPLICANT: I N, . I lii t?? 1 ? ', . 1 W t{1?f 111111111 I I. PermR No. PermR Holder Dste Telcphone I! S/VH PLUMBING CF7/4w,7 HVAC / ,3 - /40 ELECT "9 • ELECTdgj? " ? , l ? ?? Inspsction Date Insp. Comments Footings1 Foundation Framfng ` Roofing ROUgh Plbg. ? Rough Htg. tsul. 44?/?? l Fireplace Rnal Ht9. Orsat Test Final Plbg. ??? !/191I Plbg. Inspector - Nartify Plumber ConsL Meter Engr./Plan Bldg. Final WB_ Deck Ftg. Deck Final Well Pr. Disp. ? RESIDENTIAL '55 Ja0 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PiLOT KNOB RD, EAGAN MN 55122 651-681-4675 New CansW ctlon ReauiremeMs • 3 registered site surveys showing sq. R. of lot, sq. N. of hause; and all roofed areas (20°h mazimum lot coverage allowed) • 2 copies of plan showing beam & wiiMax sizes; poured found desgn, etc.) • 1 set of Eneyy CaICWaGons • 3 copies af Tree Preservalion Plan N lot platted afler 711193 • Rim Joist DeWO OpUons sefectbn sheet (bldgs with 3 or less units) DATE 7 RemodeUReoairReauiremanb , {U • 2apiesofplan N • 1 set of Energy Calcula6ons tor heated addAions • 7 stte survey Mr extenor additbns & decks • Indicffie iF home served by sepfic syslem for additions CA ?? ? ? VALUATION , f, SITE ADDRESS 1(3q ?; LU TYPE OF WORK Rt%f 11kAY D;? DliJ&15 rt)(G APPLICANT MULTI-FAMILY BLDG _Y XN FIREPLACE(S) _ 0 _ 1 _ 2 STREET ADDRESS 2)YJ-'I LPiIItP,Y U(' 11Y'Y? CIl'1(" Lk, T"l TELEPHONE #?63'?85" `?a CELL PHONE # Glla ql9"2?7?-' FAX # PROPERTYOWNERU "?l ?'b?l6sbn TELEPHONE#?I' COMPLETE fOR °NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINAF'S'OTi L 17692 J submission . Il ? I S I I? ? ? I G ? ( type) Residential Ventllatlon Category 1 Worksheet Submitted • New?EnergyLo orksheet S btqittec i '?' • Energy Envelope Calculations Su6mitted 'll il? S Ep 2 5 2002 I II 11 J Plumbing Contractor. ?J Plumbing system includes: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor. _ Water Softener _ _ Water Heater ? No. of Baths Air Conditioning Heat Recovery System Phone # Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordin Signature of Applicant OFFICE USE ONLY Phone # 1_ Iawn Sprinkler -?Y------Fee: 90.00 No. of R.I. Baths Phone # Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN ?`( O. U? 3830 PILOT KNOB RD - 55122 41q -tz-r C 651-681-4675 ? New Canatruction ReauiremaMs . 3 2gistered site surveys showirg sq. ft of lot, sq. fl. M house; aM all mofed a2as (20% maximum lat caverage allw.ad) . 2 copies o( plan showing beam 8 window s¢m poured fourxl design, etc.) . 1 set af Energy Caladadons • 3 copies W Tree Preservatlon Plan if lot platled after 7M/93 . Rim Jast DeFail Optiore selectlon sheet (Wdgs wilh 3 or less umfs) DATE 14 JOB SITE IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY TYPE OF WORK vavak FIREPLACE(S) _ 0 _ 1 _ APPLICANT 1-?2ac'z / o/%-yCe'i._-- PHONE# ADDRESS y/ ?-7 Coec.,?o?d?ec,J Q/'ea ° ZIPCODE 'S 37Z3 PAGER # CELL PHONE # G ?a- -5-906 FAX # rEw RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ NIDNNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submiqed - Energy Envelope Calculafions Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Confractor. Phone #: Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: _ Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Contractor. _ Mechanical3ystem Includes: Sewer/Water Conhactor. _ Air Conditioning _ Heat Recovery System All above infortnation must be submitted priar to processing of application. $90.00 Phone # Fee: $70.00 "ampiy I hereby acknowledge that i have read this application, state that the informatiori"?,?orr" with all applicable State of Minnesota Statutes and City of Eagan Or in ces. L Slgnature of ApplleaM Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 v RemodeVRaoafrRwulremen'-ID-110 r U . 2 capies at plan ? . 7 set of Energy Calculations for heated additlare4 • ts@esurveytorexterioradditions&decks . Irdiple H home served by septic syslem for addilbns VALUATION OFFICE USE ONLY •• - ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? OS 03plex ? 06 04plex ? 07 OSplex ? 13 16-plex ? 08 OGplex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 OS-plex ?{ 18 Deck / ` ? 11 10-plex O 19 LowerLevel ? 12 12-plex Plbg_Y or _ N ? 31 New X 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code ? SAC Units ? Nbr. of Units Nbr. of Bldgs I Type of Const 11 [\j X ? Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Smcco Stone _ Windows (new/replacement) Approved By I'Z, , Building Inspector 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 Occupancy a? re MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width REQUIRED INSPECTIONS Footings(new bldg) Footings (deck) FinaUNo C.O ' . Footings (addition) Plumbing Foundation Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. __ Air Test _ Final Insulation ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Axessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors `Demolition (Entire Bldg onty) - Give PCA handout to applicant FinaUC.O. ? HVAC ? ?q?-1 G RESIDENTIAL BUILDING PERMIT APPLICATI CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? 651-881•4675 New Cooatructlon ReauiremenM . 3 reg'stered sile surveys showing sq. ft of lot, aq. ft. oi house; and all mofed a2as (20% m2zimum lot coverage allowed) . 2 copies of plan shaxing beam & window saes; poured Mwd design, etc.) . 1 set of Eriergy Calculatlons • 3 copies of Tree Praservation Plan'rf bt plaHed after 711193 • Rim Joal Detaa Optiore selecUon slceet (Mdge wBh 3 or less units) DATE 3' 11"6?? I '7 6 _ C) o c-claU0 RemodellRenairReoulremenb • 2 copies of pWn . • 1 set oF Energy Calculations fir heated additions . 1 sde survey for exterior additbre & decks • Indicate il home served by sepfic syslem lor additions VALUATION JOB SITE ADDRESS J IF MUITI-fAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER Aau-l _7_011642? Z,! TYPE OF WORK LotJer? Geae-/ FIREPWCE(S) _ 0Z 1_ 2 APPLICANT Pau-/ Ti/elio.?-//??s?h?„? V ADDRESS 7 ('oc?.? 74-y ???.LJ /'reve_ PHONE# IIPCODE ?z3 PAGER # CELL PHONE # S-9 06 FAX # rtEw RESIDENTIAL BUILDING ONLY - FILL OUT CGMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORYID ? (check one) - Residential Ventilafion Category 1 Worksheet Sutti - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted Plumbfng Confractor. Plumbing System Includes: _ Water Softener _ Water Heater _ No. of Baths OdR 1 12002 Phone #: Lawn Sprinkler Fee: $90.00 No. of R.I. Baths Mechanical Conhactor. Mechanical System Includes: _ Air Conditioning _ Heat Recovery System Sewer/Water Contraetor. Phone # Phone # Fee: $70.00 All above information must be submitted prior to processing of application. I hereby aCknowledge ihat I have read this application, state that the information is conect, and agree to comply with all applicabie State of Minnesota Statutes and City of Eagan Or inances. / Signature of Applieant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling 13 03 01 of _ plex ? 04 02-plex ? 05 03-plex 0 OB 04plex ? 31 New ? 32 Addition l? ., 33 Alteration ? ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const ? ? ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screenecp ? 24 Storm Damage ? 25 Miscellaneous ? 30 Axessory Bldg ? 31 Ext. Alt - Mufti ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair O 37 Demolish (Bidg)• ? 43 Reroof ? 46 Windows/DOOrs •Demolidon (Entire Bldg only) - Give PCA handout W applicant Other _ Pool Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) i Approved By / , Building Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other ? 07 05-plex ? 13 16-plex ? 08 OB-plex O 16 Fireplace ? 09 07-pleu ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex q? 19 /' LowerLevel ? 12 12-plex Plbg_Y or_ N ``-I--o 50 -`--?-f; 0_ L _V`z Occupancy K :3 - 14- MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) FinaVNo C.O ' . Footings (addition) Plumbing Foundation ? Drain Tile Roof Ice & Water Final Framing Fireplace ?R.I. ?/AirTest VFinal Insulation 1` ?` 1 L1r..k/?14 ?' 20-.._. ?/ ?? . Final/C.O. ? HVAC Total ? CITY tiSE ONLY PERMIT #: S ,;? IS RECEIPT DATE: 5-1527 1 RESID£NTIAL MECHMICAL PEfiMIT APPLICATION crrYoF easM 3980 PILOT KNOB RD $A6RAMN 551E2 i ; 651-6$1-4675 ?.', Please complete for: > single family dwellings townhomes and condos when permits are required for each unit Date: DS f D-71 D f SITE ADDRESS: f//37 COCtn l'YU 1ll eW DViV&, OWNER NAME: PGtLi l TG l/r>-FSOr-? TELEPHONE #: ?a l a ?l7 -?'`?O(,? ? - -- _ (AREA CODE) INSTALLER NAME: _WOhlers Southside Htg & A/C, Inc. 6950 West 146th Street, Suite 106 STREET ADDRESS: _ Apple Va11ey, MN 55124 CITY: - - - sra-rt: Place a check mark next to the oermit work tvoe TELEPHONE #: 95a N31-7091? (AREA CODE) ZIP: New residential dwelling unit under constructionand not owner/occupied $ 70.00 ? Add-on, modification or alteration to existinq dwelling unit $ 50.00 • furnace replacement • air exchanger , • air conditioner • other Natureofwork: I"QPIaCe- Gti'r cahdi`tiohe%" _ State Surchar e $ 50 Total O $ S0 ? Remi»der: Caf[ for inspections. oca"'v .u0 R - wd-i'?- SIG\ATURE OF PERYIITTEE Updated Ir01 FERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P_I.N.: 10-18403-050-05 DESCRIPTION: PERMIT TYPE Permit Number: Date Issued: 4137 COUNTRYVIEW DR LOT: 5 BLOCKc 5 COVENTRY PASS 4TH , -, Buildilig,Permit Type =`suiltling- W,ork Type -f?G'ensur Code '- i? ?. ? ? d? STORM DNMAGE REPAIR 434 ALT. RESIOENTIAL 3E i ? .. i' _ ;? i ? • BUTLDING 032192 06/09/98 REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - sT. LIC.OWNER: RONEL RESTORATION3 14351932 0002158 TQLLEF50N PAUL P 0 BOX 240744 4137 COUNTRYVIEW DR APPLE VALLEY MN 55124 EAGAN MN (612) 432-3444 (612)454-6301 ? I hereby acknowledge that Z infiormatian is correct and 5tatutes and C3ty of E'agan ? have read this application and state that the agree to comply with all appliceble Stat.e qf Mn, Ordinance5. APPLICAN7/PERMITEE SIGNATURE ISSUED BY: SIGNATU E ? Z1012 9 98 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN / 3830 PII.OT KNOS RD - 65122 681-4676 New Construdion Reauirements ? 3 registered ske surveys ? 2 wpies of plans (inGude beam 8 window saes; poured fid. design; eto.) ? 1 energy celalatians ? 3 copies of tree preservation plan H lot plattad after 7/1/93 required: _ Yes _ No DATE: G' 1 3 li- DESCRIPTION OF WORK: STREET ADDRESS: L Ur4 .?T: ?_ BLOCK: SUBD./P.I.D. #: RemodellReoeir Reauirements ? 2 copies af plan ? 2 aite surveys (exterior addRions 3 decks) ? t energy calculatlons for heated adddions CONSTRUCTION COST; J f??? u Name: -/) P/-}+/C Phonetl: LI.YY' 6301 PROPERTY Lwt First OWNER , 1. Street s?oe- W - CONTRACTOR ARCHITECT/ ENGINEER Phone #: Registration k: ? . Ciry State:Zip: y.JZ? 63d/ Company: /?, ?Uz,,dy Phone #: Street Address: pd;C- G License # 15 City ?aCQ 1/ ? State: Ar zip: Street City State: Sewer & water licensed plumber (new construction only): and lot change is requested once pertnit is issued. I hereby acknowledge that I have read this application and state that the State of Minnesota Statutes and City of Eagan Ordinances. tt/ Signatu2 of Applicant OFFICE USE ONLY Certificates of Survey Received _ Yes _. No Zip: Penalty applies when address chang and agree to compty with all applicabl A QW Tree Preservation Plan Received Yes No Not PERMIT CITY OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55123 Permit Number: 022338 (612) 681-4675 Date Issued: 10/28/93 SITE ADDRESS: 4137 COUNTRYVIEW DR LOT: 5 BLOCK: 5 COVENTRY PASS 4TH P.I.N.: 10-18403-050-05 DESCRIPTION: B,ta3ldin'g?_ Permit Type 8uilding Work Type /UBC Occupancy, ? Construction T`ype Zoning ? ; Building Length 1 Building W'idth ? r _- ?.?.,?. ._ ? , _. , REMARKS: S&W CONTRACTOR - VALLEY PLUM6ING 62 38 oG? SF DWG NEW R-3 M-1 VN R-1 PRV FEE SUMMARY: VAIUATZON $178,000 Base Fee Plan Review Surcharge SAC 5AC % SAC Units Subtotal $912.50 $593.13 $89.00 $750.00 100 $2,344.63 MISC FEES $1,744.50 Total Fee $4,089.13 CUNDT???INC, THE- APP i T2bT7 15710304 0001335 TqE--Rr? qYLUND CO INC 5201 E RIVER RD 5201 E RIVER RD 301 FRIDLEY MN 55421 FRIDLEY MN 55421 (612) 571-0304 (612)571-0304 I hereby acknnwledge 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 Ordinances. L 11?1 APPLICANT/PERMITEESIGNATURE ISSUED :S NATUR k ?L drRL`tt?iCQte df CCCItvQItC? ?ittj of ?agan ? "attwept of 8ai[bittg 3adpection r 77eis Certificate issued pursuant to the requirements ojthe Uniform Building Code certifyirtg thai at the time of issaance thrs structure was in compliance with the various ordinances of the City regulating building construction or use. Far the fodlowirsg: Use Qassifiwion: SF DWG Bidg. Pormit No. 22338 Oc-p-YTYP. RUM] 7?ingUistri?.i RI TypeConst. VN OwierofBuilding INE %T? Qp r(,' Admeas '?I E RTVF.R RTI FR'(ftifJ;y su,mNenm,A137 ?R?I?tplQd ?It?E ,m,;yLS B5 ODVErrlav Pa.c.s 41it , Butlkl?g POST IN A CANSPICUOUS PLACE ? t.ur Address 4137 %;oUNr-TZvlEW D?uvE Zip 55123 Lo'= . •5 Blk 5 Sub !;OVENCRY paSS 4IH THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: Yes No Inspector: L(, Final grade (6" from siding) ? Permanent steps (gazage) ? Permanent steps (main entry) ? Permanent driveway ? ? Permanent gas ? Sod/Seeded grass ? TraiUcurb damage r/ Porch ? Basement finish l/ Deck A I , " r.,, ? - nease venry wim the builder the removal of roof test caps from the plumbing system and the shuboff of water supply ro the outside lawn fauce[ before freeze potential exisls. ' ContaM engineering division at 6814645 bcfore working in rightof-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink • Contractor Copy REacTrvAtE ? CITY OF EAGAN PERMII' N ? ?t+w,??•n??r?„?,, 1993 BUILDING PERMIT APPLICATION? 1 L ca,p- . . .. , _ .,:> .: ., 681-4675 -? ? G? i i?o ea.P,ld 10•4L, SINGLE & MULT - ? of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. ENCEMEMEW 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 l O Valuation of work ite Address: '-A131 Co???'v IV?tcj_? pr ;VW- STREET ? SU1TE M Tenant Name: (commercial only) P66I-N"d CO, ?nC • I,pT S BI,OCK GJ SUSD. P.I.D. M GoVeh?v Descri tion of work: •n (c ' The applicant is: Owner Contractor ? Other (Deaerihe) Name 2 +-?l Kr4 ?c?-:r:-V\L. Phone '571'03n? Property LAST FIRST Owner Address ??i €• 2??er 2rJ*?-? a I STREET STE 1' City Fv'?'dle? State M? Zip SS421 Company Phone COt1t'?BCtOf Address License # i?3.?- Exp City State Zip Company Phone Architect/ Engineer Name Registration d Address City State Zip Sewerr& water licensed plumber L? te? e1uwt?,'ytc, . Processing time far sewer'& water permits is two days once area has been ap ved. 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: L . OFFICE USE ONLY BUILDING PERMIT TYP E . . r O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 02 SF Dwg. 0 07 4-Plex ? 12 Multi. Misc. O 17 Swim Pool 03 SF Addition O 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc. 0 05 SF Misc. O 10 Mu1ti..Add'1. ? 15 Deck ? 20 Public Facility 0 21 Miscellaneous WORK TYPE 31 New ? 33 Atterations ? 35 Tenant Finish ? 37 Demolish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actuat) V_ u Basement sq. ft. MWCC System Y6 (Allowable) v-?.f lst Fl. sq. ft. City ilater Y? UBC Occupancy ? 2-3M-1 2nd Fl. sq. ft. PRV Required Y-, Zoning ?T! Sq. Ft. total Booster Pum p #? of Stories Footprin t Sq. ft. Fire Sprink ler Length ? On-site well Census Code !oi Depth 3b, On-site sewage SAC Code ot APPROVALS ? i Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS ? Site ? Footing O Framing [3 Insulatian ? Wallboard ? Final ? Draintile ? Fireplac? 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 Othe,r Total: SAC % (OO SAC Units = v.tuac;a,: $ 11O4,(D Z? z ^ GAnaaE; ,2yX22=5L8 x 16 = gyy? 38}c30 =oyb ? ??2 X ?( = J N IsrFwo,2; ?3N6X?5= Zolqo .---?°- 7x?fi= ?o ,?,9Y1Tc 134 (. ?r fi? ""`r- 7 3 6Sb 13Gd K 54= ? ZNn ?o? 36 N/ 30 -__Ily0 piZ,? i y , 21 ??/zx 8 = ?2 13Yz K 16 = ?S?p?V ? ?_ - oa «. ? 1 ?o„ --v - J °w m a w a m c F ?0 ? • Br 0 ? • ?' o a • D? ? ? • 8" Ror 0 • 0 . 0 o LOT SIIRVEY CHECRI,IST FOR RESIDENTIAL SIII PROPERTY LEGAL Date of Survey: DOCIIMENT STANDARDS Registered Land Surveyor signature and company Building Permit Applicant Legal description Address North arrow and bar scale House type (rambler, walkout, split w/o, split lookout, etc.) Directional drainage arrows with slope/gradient ?. Proposed/existing sewer and water services Street name Driveway Existina ? Cd?O • Sewer service 0 ? • Lot corners ?@' ? • Top of curb at the driveway ? C3? ? • Elevations of any existing adjacent homes Propose9 II?? ? • Garage floor C3?0 0 • First floor 0'?0 ? • Lowest exposed elevation (walkout/window) 3-'0 ? • Property corners ck?0 ? • Front and rear of home at the foundation PONDING AREAS (if anDlicable) ? 0? ? • Easement line 0 EK ? • NWL ? 9? ? • HWL 0 11' 11 • Pond # designation ? 0? 0 • Emergency Overflow Elevation ? entry, ? ? : Lot lines 0 Right-of-way and street width (to back of curb) ? 0 • Proposed home dimensions including any progosed 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 ? 13 ? • Setbacks of proposed structure and setback of adjacent existing homes ? J3,4 • Retaii??I,;,,rjq6irements, if any _ / Name October 1992 l /a/i3173 a /(-1/7(7 M 0209 S g f yi- Requesl Dale Fire . Rough-in Inspe NOTICE: Vou Must Gall Elecvical Inspector Feqyv€d? Ii A Raugh-In Inspection 1^ - V? Ves ? No Is Repuiretl. I Llk censed contractor ? owner hereby requesi inspection ot above electrical work at: Job Atltlress (Sheet, Box or City 4! 3? ? ? Section No. Township Name or No. Renge No. Counry c3? Occu (PRINT) oty,l Phone Na. Power Supplier ? ?LI?CT'•v?? Atltlress Elec?tl Con[ra or (Com eny Neme Contractor5 Llcense No. Mailing A tlress (COnVacbr or Owner Making Installation) Authorizetl SignaWre (Contractor/Owner Making Inslsllation) Phone Number MINNESOTA STNTE BOARD OF ELECTHICRY THIS INSPECTIDN REOUEST WILL NOT Griggs-Midway BIAg. - poom 5-173 BE ACCEPTED BV THE STATE BOAFD 1821 Univereity Ave., St. Peul, MN SSiUO UNLE55 PROPER INSPECTION FEE I$ Phone (612) 6424800 ENCIOSED. - ?f REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 ? , p,? ? See inshuc0one for compleGng Nls lorm on beck oi yellow copy. / IM D? S nr? / 1n I Q d Ralnw Wnrk Covered bv This Request ??? ? 1•1 v ew Adtl u_ Rep. vv I TypeofBUilding AppliancesWired EquipmentWired Home Ranqe emporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Managemem Comm./Industrial Fumace Other (Specity) Farm Air Condi[ioner Other(spacily) ConVaotork Remarks' Compute Inspecfion Fee Belaw: # Other Fee # ServiceEntrance Size Fee # Circuits/Feedere Fee Swimming Pool 0 to 200 Amps o to 100 Amps Transformers Above 200 _ Amps A6ove 100 Amps $I9f15 Inspecior5 Use Only: I OTAL r? Irrigation Booms J ' Special Inspection CTED IF NOT Alarm/Communication THIS INSTALLATION MAY BE ORD DISCONNE O[her Fee I, the Electrical Inspector, hereby COMPLETED WITHIN 18 MONTHS. oate Roughin certify that the above inspection has been made. F;nai oa OFFICE USE ONLV This request voitl 18 monihs from F':C7'F.:;iOR r•:t+vr•.t,rnPti: nvi:',nr,r: "u" Ct)MTirCr,Tlr)rr 171E os.rNL:? - ? SITE ADDSESS LiS? cc'K? Pn6`j A -,l?Ar? - c CONTFL1CT05 D.ATF, Dete-min vorkint; square footai;e of cuch. 1. Tatal exposed vall area ,, ?•O? ?+ 2- sq. ft. x 0.11 - 2. Total roof/ceiling area sq. ft. x e.026 _-32 et • Totzl exposed vail arc3 nbovc fZocir = 22:l q.<, 2- a. Total vall vindov area ............................ 3V 7, b. Totel door area ................................... ?o?D.¢ ? c. Tota1 sliding glrss door area ..................... d. Total Pireplace vall area ......................... ---` e. Tota1 vall frazning area (average lop) ............. ZZCr, P. Total net vcll area above floor ................... Z p?(p . g. Total rim Joist area .............................. 2fe ?J'? Z. Totsl eaoosed frn;ndation area h- Total foundetion vindov y:ee ....................... /-0 i. Total net foundation area above grsde ............. Z?• - Deterzine "U" ti•a1Le o; each vall sFF;cnent. 8. 3 0 l, 5& Y..U„ o. ¢Z = /Z q. b. <08. PE{QNE = 8,33 _ ---- Z x„U„ o. / 3 a - ?. - X „U„ d . e.. 2 2?0. -?" x A,u,l - f. Zo 3l (o X .,U„ g. 2C? 3, 2- X,.t,,, h. X 'lUll x ,PUt. .? .._? .. 0.043 = 87r6sI . 3. . .................:'. ...... r Zf item'q3 is the same as, or less or SBC 6oo6(c)2. 4-0- dFI = !D. 7 f - D?? ? _ ?lP .8S ---- ? _. . _ ? .. ??OU13 ? 2 77. ( ---c?K- :.h:,n item N1, you nave met the intent /?-rll8 €` ?7ais ? 2 0 7??v ? ? RequesY Oafe Flra Na. Rouqh-in Inspecflon Pe ' tl? NOTICE: Vou Must Call Elecfncal(q?c Nr H A R i ough-In I on Ves ? N. Is Requifed . I licensed contractor ? owner hereby request inspection of above el irical work Job Adtlre7ss?SVeel, Box orROUte Na.) , Ciry ? Section No. Township Name ot No. qanqe Na Cou? Occu t(PRINT) Phone No. Power Supplier • Adtlress Electric I Contractor (COmpany Name) CoMracror5 License No. Malling Address (COn[raclor or Owner MaWng Instella[ion) CITIES ELECTRIC, INC. CA003q1 Authwized 51 alure nha i e akln 'on 483-38?11 Phone Number l MINNESOTA STATE BOApO OF ELECGSICITY THIS INSPECTION REQUEST WILL NOT GriggsMidway 81tlg. - qoom S473 BE ACCEPTED BY THE STATE 90AFD 1821 University Ave., St Paul, MN 55106 UNLESS PFOPEF INSPEGTION FEE IS Phone (812) 642.01 ENCLOSED. REOUEST FOR ELECTRICAL INSPECTION ee-ooooi-oe ? See Instmctlons tor oomple6ng ihis form on back of yellow oopy. ?7015 ? 2097 X" Below Work Covered by This Request ?? l Cl !(?/ ew Add Rep. TypeoBUilding AppliancesWired EquipmentWired Home Range Temporary Service Ouplex Water Heater Elecinc Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specity) Farm Air Conditioner ` Other (spedly) Confireotor3 Remarks'. Compute lnspection Fez 8elow: # Other Fee # ServiceEntrance Size Fee # CircuitslFeetlers Fee Swimming Pool 0 to 20o Amps 1 1 o to ioa Amps Transformers Above 200 _ Amps Above 100 _ Amps Signs inspec[av§ uss oniy. TOTAL IM Irrigation Booms ? - ? Special Inspection rO / TAk /i? (?,. ?.o I Alarm/Communication TED IF NOT TNIS INSTALLATION M RED DISCONN?C Other Fee COMPLETED WITHIN 18 MONTHS. I, the Elecirical Inspector, hereby Rou9n-m oal? ? /? / certify that the above inspection has been made. oatt OFPICE USE ONLV This requesl voitl 18 months from , Total exposed roof/ceilinG nrel 'l . . . . . Total g:oss roo}'/ceiling are:; _ . ' ,?- ,j. Total skylight area .......................... k. Total roof/ceiling frarning area • • - - • • • • • • • • • • 1. Total net insulated roof/ceiling area ........ 4 d+ 62 CI _ • Dete:eiine "U" value for ench ruaf/cci I in(; seF,?nent. - -+? X j, u U n ?- . . - ? x: „u„ D.pz7 = 3.?Z ? 1, l1 7? U<i X"U„ O. p 22?- 4 . ............ .............._.:. Total IS total oP H4 is the same as, or less than N2, you have met the intent of ssC 6oo6(c)i. To utilize the total envelope system method, the values establiahed by the sum of items 113 e--id 14 shall not be greater. thnn the surn of itert:s Nl and A2- 1. + 2. ? - g•. + , . . 1', r. o ? . _ . ... o • .=?C? .?UPcI.U? GAl-GI?-ATIDN? ?GoNT?. -?FAML WAU. L? I Nhl-1 LA?I?N LaMPohi P,? N-F-g ?-? ;u ?. ? aITJI?iDE AIF- f9t.M -hp ,g?;1PH(i. . - - -?Iz lNSUI.ATIcr1• av. - F? -vAW 5 (?.o • o, 45 - -_----d.Co'O - ?r,= Z3.o? = ? -FFAMV WRl.1. (& /vTi.?D - pUhN• vif.W. C "? C Cf C C LaMPON?N jg hH?A?I?Nr. U 1?IC15 MP AL-M. . : - F--VALU5: - - -- o ,1 "i . ---- - _ 2 ,oCr - .--- - -7 -- -_ 0;45 ----_ - ?-- -?=?a.--- - U ^ r ? o, a89 . ?L ? O, 0 ¢ =G??tP?. ??U = ?0.lZ X o.ot?9? t?o,8b x o.043? _ _? - ?- 0 0 ? ? NU-- - -?J•Z?G I•?? . ;. a _.?.- ?-f 2q ;? ? 11 O !? _ 4:7?. O tz"coti?::h??, C ! ?-_ ? f I ? ?fZ,)!? I _??.? ? ?• ?? O.O&: r12 ?3 --? -?- i-??-?-?--?-- ; (D C C C C ?x?C - Ia'--?.-/4? l f?-FI GM ? - ?- - -D, `?-- -_Z? - -- F,p -- - - - _---o- ?-- -- -- _ 1, 1 = o, 027 u ? 5.83 ? ??_?u: i???,?, -- O ? L LZ:7i.??????_: _- ? ?,u 3 o.oZ2 i>q-0=-qp 3.1 DEFAILED REF'OFT FOR ETdTIRE HOUSE F'rEparcd Fr,r: F'r-epnred Py: M.W. Guerre Flare Heating , Mn ,7ob tJame: Custam HGLtSe **?:?':*****?W+?.X:*?*'F** ****??C?*?*???%K?C* **?.?A.********?****MC?C*A:?:%r-n?: .nT*?**+?r*Tmm"'r. EXF'OSUFE BLASS NOn7H ------------ SOLE'H EAST 61EST NE/iJW SE:SW 1-IQRZ, TOTAL - - ------ ARcr=1 67 I ---------------- 27 ; 200t ------------------ - ----- 114! 22 I 291 ------------- 0 I 46=r 1 COOLING 1,0?9; os;: 9,2sa! 5,2s0; a79; i,io.-; 0; ia,._in; HEATIPaG 2,964; ------------------- 1,I941 S,9461 ---------------- 570421 1, 1^ot 1,210; ----------'---------------- 01 20024? -------------- rc:c LQW 41ALL5 P•tORFH ------------------- SCUTH EAST WEaT Nc/i•1G7 SE/SbJ Gii n = - = nDE TOTAL --- --------- AF:EA I 815: ---------------- ^0I81 760; ----------- ------- ---- 8431 201 ^<t?; -- 01 296( CGf__iidG I 748; 770; 6qri il=r: ioi Sci . _ ; ,ii27i HEATIhiG : 3,076; ------------------- ,le'•: ,86o^I ---------- ---- .Sc^27 751 751 ----------------------- 77422: 19,2621 " -------------- DG}ORS TdC1F;TH ------------------- -- SDUTH EAST --- --- - --- 'vlcST NE/NW SE/^aW - ----- ^-------- TCITAL -------------- ??,?? r+n?rl , :>t ----- - --- Io! 20; ------ --- -- 181 t>; 0: So: COOLING , o; 2s1; 278, 251; o, o; , 760; HEATiric , 01 ------------------- i>o,>>; 131451 - - l,c>>o; o; i>; -- -- ? _. os, ------------ - FLCCR --- ----------- ARcFi ---- ------------------ COOLING HEATIf•;G - ----------s--------- ---------------- ------------------------ - ------------- ------------------- '439 -- - i 3-, ??,^? ? -------- -------------- CcILING ------------------- --- ---------- AiiEA ---------------- ------------------ COOLING HEnTING ----------------------- -------------- ------------------- '4-9 I ---°----------- --- 1.10: 1 .60c^ ------------------------- -------------- MISCELLAPJcO US COOLING LOADS PE'a?'i1C jCr157.rJIF LGct ----------- rJ 11::5 ---------------- Lrtent Loctd . 7008 Li4hts R. Appi. Lonu 1,195 Latent Safety c^tuh =75 'Jentiiation Lord 1,265 vuct Heat 6nin i; In+iltrntion; Load G1i? SCns1U1C Scl'fCt'y Bt11 11 1, 39c) TOTAL SEiJS I PLE LOf+P 29,192 TOTAL LATEPJT LOAD :,, ^a^c' Summcr ACH 0.07 TemG. Swinq Mult. 1.00 Tc,tal Co o?ing Load 7:5032 PTUH Or =.09 Ton= ,.*T MiSCcLLA^JEClUS HEi=yTIPJ6 LOADS Infiltration Load ---------- 7,673 ----`_----- --- lcntilation Load 5•'5 Dttct HEat Les> p Safety Rtuh Z, i_= Winter r^,CH 0.13 #?r Totnl Heatina Lcnd 65,59Z PTUFi T*T II4-03-9:1 '.1 suMrtaRY REFQRT F'repar-Ed Fc,r: F'reprred Hy: M.W. Guerre . Flare Heatinq , Mn ' Job Name: Custom Ha_i=e $-%rTn**i.m*T%nm?*.r.n*$%?**+Tn.?:?:%n?C*.iY*.w.n?CK:??*"?%r*%r%r"?%F??$'w."?:?"d%n.r?M%nm.r***nn%nT?"+.:K.n%r.*M"* DESIGN COPJ DITIOh15 for OUTDrJGR IhdD00R' SUh1"icR b1IPJTc^: SUMMcR iviPJTcn Dry Puib 95 -25 72 72 bJet PuZb 75 67 naiiy Ranqe 20 Daily Swing 7._) Latittide 4= Elevatiort 622 5Rfety Factor (%) 5 Latent Factor (%:) 27 S21tSlt1= F;??wf-,, Hcating Heatina Cooling _:oolir.g PJame „ ---- BTUH CFM PTUH CFI`1 -- BcISCITIE'flt ------- 19,O4O ------- 2/ C ------- 1,C64 ----- CY ^v'reat F:uom '?55 47 .274 145 Dinette 6,120 ^a6 0,491 176 K.itchen 6,79^0 45 1,144 1Y9 Dining Room 10=5 40 1.99f; 101 Foyer ° =,6 75 ,404 172 Office DCr1 4,422 62 2,335 110 Pedraum 1 4,660 65 .717 1=7 Bcttitroolii 4,4b(''. 62 .E`!=' 135 MC.StE'I^ BCdrQOITI 4,021 JO 2t401 121 Pedroom ? 71 5665 ------- 51 ------- 2.302 ------- 116 ------- 65.540 ?ii 29.17o 1,475 HEATIPJr DELTFi T 65.0 CCCLIfJG DELTA T 13.0 NOTE: *k'k. Calculated Airflow is ba=_ed upcn ioad req!!iremcnts. Vcrify that cir-rlow crlcule.ted is CGi7ipatible with selected equipm_nt requiremen±5. *f* 1993 MECHANICAL PERMTf (RESIDIIVTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMI'TS ARE REQUIF2ED FOR EACH UNTf. ? NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE DATE HVAC: 0.100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-OIv'/REMODEL (ExISTING CoN57'RUCTION) STATE 3URCHARGE TOTAL SITE FEES $ 24.00 ? 6.00 $ 15.00 .50 OWNER NAME: `k?? ` TELEPHONE INST. ADDRESS: v STATE:? ZIP COD : ? 1 TELEPHONE #; PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND CONDOS WHEN PERMTfS ARE REQUIRED FOR EACH UNTT. --- - ---------- - ---------- NO. FIXTQRES EACH TOT? I SHOWER 3,00 3l 3 WATER CLOSET 3•00 ?`- BATH TUB 3.00 LAVATORY 3•00 KITCHEN SINK J 3.00 3- _ ? LAUNDRY TRAY 3.00 z _ HOT TUB/SPA 3.00 I WATER HEATER 3•00 ? FLOOR DRAIN 3.00 1 GAS PIPING OUTLET • minimum • 1 3•00 ?- ROUGH OPENWGS 1.50 `? cu WATER SOFTENER 5•00 PRIVATE DISP. • oex.ay. iic. 15.00 U.G. SPRINKI,ER • eme une? comt. 3•00 ALTERATIONS ' to costing 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE .50 TOTAL: SITE -)Ar.r V , t?j L ?R OWNER NAME: So ?A, I - ' ' v ADDRESS: ? o I U 2«< L' CITY: oc c? A,? STATE: vn ZIP CODE: ? PHONE #: ( ) L(?t2- d ?a I SIGNATURE OF PERMITTEE 1993 PLUMBING PERMIT (RESIDENIZAI.) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PERMIT# 3 c) ? -\!5a-Yh 2. E008 itUIDENTIAL i'LiJM$INfi PEgM1T APPLICATION crrY oF K?sM S$SO PILOT KAOB RD i:ABilP. DuY 551 SS n? 651-667-4675 I?? MAR 2 0 2002 Please complete for: single family dwellings, townhomes and condos when permits are required r each unit, backflow preventer for irrigation system By SITEADDRESS: 4137 UriU-PE, OWNER NAME: : o/lQ7C-r- TELEPHONE #: ?5?? 7Sz/-?O 34 J (AREA CODE) INSTALLER NAME: STREET ADDRESS: CITY: STATE: ZIP: _ 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 • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: X Adding fictures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water tumaround - existing dwelling unit (+ 5!8" meter'rf needed -$118) Other: _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system ReplacemenUadditional: _ water softener _ water heater $ 15.00 State Surcharge $ .50 Total $ So. o I herebyacknowledge that I have read this application, st2te that the information is wrreG, and agree W complywith all applicable City of Eagan ordinances. Il is ihe applicant's responsibillty to notify the property owner that the CiTy of Eagan assumes no liability for any damages caused by the City during its normal operatlonal and maintenance activitles b the facilities consWcted under this permit wiNin ro erty/right-of- y/easement. RECEIPT DATE: TELEPHONE #: (AREA CODE) / ' 1102 SIGNATURE OF'PERMITTEE v 't PIONEER * engineeri * * * * LAND SURVEYORS • 9 LAND PLANNERS 2422 Enterprise Drive Mendota Heights, MN 55120 612) 681-1914•Fax 681-9488 necnirecrs I 625 Highway 70 Northeost Blaine, MN 55434 I(612) 783-1880•Fax 783-1883 Certificate of Survey for: Th2 RottIUnCJ Company, If1C. House Address: Country View Drive Eagan, MN Model Name: Madison v? ° - - J--- ; ,!- , GD /- p-?° e J??--- r? ? 130 .? ? ? ? / ORNEWPY I? N _, : 0J }58 ? . /CB523? N1 ?;B5=:? Z,?g9 N Customer: Tollefson 1 . g ? G1??'?E I w ?g87 1 ?l 53 m .? 1 ?2 ? ro;:ou ? N ? pftOPos, gpSEMENt ? ' 1-?62 y? =1 u "` ? 0 0° I I 1` N 53516• w ak59 1 ? N313 1 ? ` I N V c! W yl, ? 5 W J 4 ? i 4E, ? •0 ? CD: , N p7.3_=yp' W 67.66 a $ ? - - - C ORAINACE EAS ?G ENG?ERING F3EPT- ? ??¢ 50.00 ? • o ?/ ?<?-. ?_ S 03'44'1g" yy . 900.0 Denotes Existing Elevation PROP_OSED_HOUSE_ELEVA_T_ION x (9oa:n-) Denotes Proposed Elevation Lowest Floor Elevation:845.65 - Denotes Drainage & Utility Easement ---=Denotes Drainage Flow Direction Top of Block Elevation:854.46 ---o- Denotes Monument Garage Slab Elevation:854.13 -s-- Denotes Offset Hub Bearings shown are assumed LOT 5, BLOCK 5 COVENTRY PASS DAKOTA COUNTY, MINNESOTA 4TH A D D I TI 0 N I hereby certify that chis survey, plan or report was pre ared hy mur my direct sup?ervZision an at I am duty Re9istered Land Surveyor under ohe laws of the State of Minnesota. Dated this z day of ,A.D. 191? ? Sli /'?ul'1le. 1 If1Cf1=3 Of8@t ROBERT8.51 ICHL.S?REG. .14891 h151 '99596.111 L 1 lU(IC'C? Gtl7 1 flCC• . . ri ** -• * i?tO1dEER * Ei1 1-`I Certifica{e . ? . .. ? ? of survey for The Rottlund Company, Inc. House Address: Country vaw Drive. Eagan, MN Model Nama: Madis?on _.--- ? r?- 5 o^,9??4 \ y??? ? D ,5j? • M `LJ+ 1 .? 85-6 * LSZ•z%; J I iJ?' s?•n? ? .- / S? r? r??.4a 1 1 1 . $ b 0 M ' } 1, I ? L WOO 5 8s1.t6 CUStOm@C: f I? 17 B+?.S2 I I ' .i 'jQ I . N i N W cs? 11 * N a ?yp? w .r 61:66 ? Tollefson Iq X ;z 5' 6 40.00 s oY4a't s• w x ooao Denotas Faclsting Elevation pRpppGEp Hp USE ELEVATION i %4EO Denotes Proposed Elevation Lowest Floor Elevatfon:845.65; --- Denotes Dreinage 8c Utility Easemerat ' ` ? Denotas Droinoge Flaw Direction jop of Biodc , Elevation' • 854.48 ? -o- {3enote3 Manument Garage Slab E(avafton:854,13 --ia-? Dcnvtes OfF9et Hub Beerings shown ara assumed , LOT 5, BLOCK 5 C4VENTRY PASS aAxorn couKn: MW?esorA 4TH A D D 1 TI 4 N 1 hMabY ClrtltY tAat Mis nnrMl. WM ot nCOrt wq Orapand bY rtr W VtdH my direct W!wbioo xd that 1 am duly RepisnrW Lard Surveyw unRNrda Inq ot Me StHr W Mtnnaota. oeted Mb.13ZFL dry ofQcf?6ai _ A.D. 1D't-A_. Nw.>f ?sA ?g?? i, lert 5;d. e? A.ar - VPO? 9Bo-Sri?l ' `. 11_1•43 Aldtd VeM IleY j '" 1 ' ' A ? _L 7 I1 a__a . . ( .L?ACMlC1 ?. ?? , ?cr i 1 • Z l 4 a t D 2422 Enterprise priJe Mandoto Heigh{a, 1AN 58120 ;612) 681-1914•Fax 881-9488 625 Htghway 10 Nwthenat 8folne, MN 55434 ; ;672) 783-1880-F6x 783-1883 PERMIT City of Eagan Permit Type:Building Permit Number:EA125639 Date Issued:07/29/2014 Permit Category:ePermit Site Address: 4137 Countryview Dr Lot:5 Block: 5 Addition: Coventry Pass 4th PID:10-18403-05-050 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Paul S Tollefson 4137 Countryview Dr Eagan MN 55123 Condor Fireplace & Stone 8282 Arthur St NE Spring Lake Park MN 55432 (763) 786-2341 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink � For Offlce Use ^� � I `, Clt of Ea a� ; Pa�„t#:��C ��. � � � � � � 3B30 Pilot Knob Road � pe��t Fee: ° �� Eagan MN 55122 � � Phone_{$51)675-5675 I oate Received: � Fax:{651)675-569a � I I Staff: � �------------------� 2015 MECHANICla1l. PERMIT APPLICATION ❑ Plea e su mit two(2)sets of plans w,I'th all comm�rcial applications. Date: � �`�!" SiteAddress: t �� ( �.(J(_,(��(�-�� L� �� Tenant� _ �,,r , ..� ...� Sulte�F• ._, Resident/Owner Na`"e: L� �G� Phone:CU�� ,��01 --✓ /��O Address I City/Zip:_�� V UN r�� v��/� b� ��ft'J� Name:� /�.L� J'yU�G 5��,��icense#: .�{ ,_ Contractor �ddress:C��5� Gf�jy�/�y��'n�" 57'' city: L State: Zip:s�� Phone: �/�p1�-`7�-�—�� J @ -- � .,_ Contact_ �� Ema'. p ,New Replacem nt Additi nal �AI ration Demolition Type of Work Descrlption of work: � �(1�-��' . ,., . NOTE'Roof mounted and ground mounted meChanical equipment is requlretl to be screened by City Code:..Please contact the Mechanical lnspector for information on pemiitted�screening methods: R�SIDENTIA� COMMERCIAL _Furnace New ConstruCtion �Interior Improvement Pern71t Type —A�r Conditioner i Install Piping _ProCessed _Air Exchanger Gas ,EMerior HVAC Unit Heat Pum � • — _UndedAbove ground Tank �Install I_Remove) Other RESIDENTIAL FEES $60.00 Mlnlmum Add or alteration to an existing unit((ndudes$5.00 State Surcharge) � $100.00 ResldeMial New(includes$5.00 State Surcharge) =g �� TOTAL FEE COMMERCIAL FE�S Contract Value$ x.01 $65.00 Pe1'mit Fee Minlmum $70.00 Undorground tank installativn/removal =$ Permit Fee 'If contract value is LESS than$10,010,Surcharge=$5.00 -$ Surcharge"` *'If contract value is GRE'ATER than$10,010,Surcharge=Contract Value x$0.0�05 ""If tfie pro)ect valuatian is over$1 million,please call for Surcharge �$ TOTAL FEE I herehy acknov�Aedge that thie infortnatlon is complete and aeeurate;that Ihe work will be in c�fortnance with ths ordinances and codes of the Clty of Eagan;that I understend Mls Is not a permit,but only an applicatlon Eor a permit,and wor � ot to start out a pertnit;that the work will be In accordance with approved an i 1 se,pf�lNOrk��"�r uUes a`J�,v;ew sr�Q,�of plans � � �� /�l1 x x Appllcant's P�inted Name Applican nature FOR OFFICE USE. . ..:... . : . . .. ,.;,.. . Requl(ed Inspectio�s::.: .. _ . Revlewed By:. . �. Date: � Underground _Rough In �AIr.Test Gas Se�vice.7est In-floor Heat . _„�Final HVAC Screening J 08-03-2016 10:09 Date: Fax Services -, 16516755694 City of Eaall 3830 Pilot Knob Road"' O, Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ID 2 Use BLUE or BLACK Ink For Office Use Permit #: 15 �o (0 Permit Fee: < ®✓ ` —7 5 Date Received: ._ Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Resident/ Owner Site Address: .... L, ,, . L. ( a i ..w` -v IJ 1 1!' . Unit #: Name: _ "' :., v - `K" \ Phone: KO L 1;1 S Address / City / Zip: '" i Atka) Applicant is: Owner Type of Work Description of work: (%r% ;�/ bi-ic f. F 1 11'k7C(z�i v6. n!:i► ivdi3 J 7�'�l�l .• /.e Contractor Contractor Construction Cost: Company: 1" 1 4) 4.6..4' 1 Address: • 't A/v.. .r Multi -Family Building: (Yes / No ) aoret: City; State: itit ' 2 i ,50 -13 -1^ -Phone: l�f! if.e), 6 & ,, License #: 44/14,1 Pet.44.7_..,. ,ail: fy v f C1i'i. dor- ri r -.t? /`s c'. k7 Lead Certificate #: If the project is exempt from lead certification, please explain why: 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: Phone: Sewer & Water Contractor: Fire Suppression Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.000herstateonecaltore I hereby acknowledge that this information is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of Eagan: that I understand this is not a permit, but only an application for a permit, and work Is not to start without a permit: that the work will be In accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. Vim` Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA154951 Date Issued:04/19/2019 Permit Category:ePermit Site Address: 4137 Countryview Dr Lot:5 Block: 5 Addition: Coventry Pass 4th PID:10-18403-05-050 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 - Paul S Tollefson 4137 Countryview Dr Eagan MN 55123 (612) 812-5906 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA159584 Date Issued:01/02/2020 Permit Category:ePermit Site Address: 4137 Countryview Dr Lot:5 Block: 5 Addition: Coventry Pass 4th PID:10-18403-05-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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 (miscellaneous)$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 - Paul S Tollefson 4137 Countryview Dr Eagan MN 55123 Bruckmueller Plumbing Inc 3992 Pennsylvania Ave Eagan MN 55123 (651) 686-6696 Applicant/Permitee: Signature Issued By: Signature r For Office Use• . \ 6 8 I Pem,it#: I /�, EAGAN \�• wry Permit Fee: -_TT Date Received: / 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 i TDD:(651)454-8535 I FAX:(651)675-5694 Staff: /41/1/ build inginspectionsacitvofeaoan.com 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1/27/2020 Site Address: 4137 Countryview Drive unit#: Paul and Kathy Tollefson 612-812-5906 j s Name: Phone: Res 4137 Countryview Drive owner Address/City/Zip: Applicant is: Owner Contractor Type of Work Description : Replace one master bath window/same style and size of Construction Cost: 1'500.00 Multi-Family Building: (Yes I No 1 ) Hoaglund Woodworking_Inc. Mark Hoaglund. Company: Contact: Address: 6901 Vincent Ave S C.' '' Richfield Contractor State:MN Zip: 55423 phone: 612-816-2401 Email: rnarkhoagIund sn.corn License# BC758474Lead # NAT-106626-2 If the project is exempt from lead certification,please explain why: x Z COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 6 In the last 12-months,-has the-City-of-Eagan issued a permit-fora-similar-plan based on-a master plan? Yes No If yes,date and address of master plan: Licensed Plrnnber: Phone: Mechanical Contractor: Phone: _Sewer&Water Contractor: Phone: Fire Suppression Contractor. Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade You may subscribeto receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of-permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at 1651)454-0002 for proteon against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. floww.lootstztearil I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances rid codes of the City of Eagan;that t understand this is not a permit, but only an application for a permit, and work is not to start.without a that the work wilt be in accordance with the approved plan in the case of work which requires a review and approval of pi . x ark Hoaglund x-77/i77 - Applicant's Printed Name Applicant's Signature