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4165 Countryview Dr
SEWER & WATER PERMIT CITY OF fAGAN 3830 Pilot Knob Rd. Eagan, MN 55 1 22-1 897' DATE _ • OFFICE USE ONLY METER # Q PERMIT DATE 12/09j91 « « CHIP # d L2 VT a 7 PERMIT # 12434 METER SIZE "? S'? sK S B.P. RECEIPT # C 016450 ISSUE DATE ? 'B.P. RECEIPT DATE 121091 91 PRV - BOOSTER PUMP SITE ADDRESS .4 = 6 5 C a •• mV i Q.xa I1r ' LOT c BLOCK 2 SECISUB ?,,.o:,.ntr T 1T g 1 1 our 7 n d APPLICANT: Jospph . , Mil1er _ ADD??:33--Gtd-a-r Av g . ? H CITY.STATE Aiia ZIP-?'"`? PHOhIE: 4.3 3_? nn 1 PLUMBER: enz-R an ADDRESS: 4745 S. Robert CITY,STATE R°8etnount, Mn ZIp 55068 PHONE: 423=1J.1,.4 OWNER: ADDRESS: CITY, STATE PHONE: PLE/1Sg ALLCIW TWO WdM SEWER PERMITS, CONTAGT ZIP _ PERMIT REQUESTED x SEWER x WATER -TAPS _ COMMIIND X RESIDENTIAL -x NEW - EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be givep for Ded uct Meters. /r ? / ? ? [ nr .tna' , !Y;:A1 'r?/i}iil ???' ? • TO GOMaY WI`}'H CITY OF ? WHEN METER ISSUED CL(LLf4 4-5220 FOR INSPECTIOIVS. FOR STORM ?' ? CITY OF EAGAN ?? ,? 9944 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:681-4675 Receipt # ?• ?1 t) /t',`f/--o To be used tor 9F DWG/GAR Est. value $127,01 Site Address 4165 COiTNTRYVIEW DR Lot 9 Block 2 Sec/Sub. COUNTRY HOLLOW Parcel No. ND Napg JOSEPA M MILLER CONST I w Address 18133 CEDAR AVE S O Clty FARMINGTON MN ZP Q Name SAME ? Address ? mY ZP Phone 8 I iranca !! I hereby acknowlege information is correct Minnesota Statutes an Signature of Permitel A Building Permit is is: on the express conditi have read this application and state that the agree to complY with all applicable State of OFFICE USE ONLY FEES Occupancy R-3_IL-1 734.00 Zoning R-_1 Bldg' Permrt (nctuaq Const -L-N Sucharge 63.50 (Allowable) -Y--N Plan RWiew . 477.00 # af Stories - Length _261 Lbyw --- Depth _70' SAC, City 100.00 S.F. Total - SAC, MCWCC 65O. 00 S.F. Footprints _ On Site Sewage _ Water Conn 660.00 On Site Well - Water Meter 95:. 00 MWCC System x Acct. oeposic 30.00 Water Ciry ? Required PRV x_ SNY Permit ?n _ nn Booster Pump - S/W Surcharge - 50 Treatment PI 2 7 6- 0C1 APPROYALS 370 00 Road Unit . Planner il C - Park Ded. ounc BIdg.Off. _ Copies Variance - TOTAL 3,486.00 MM WALLIN BW R4'-RVMFS-$`)4-9034 CITY OF EAGAN ?y !, ` 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ??199?{s} ' PHONE:681-4675 , BUILDING PERWT Receipt # Tobeusedfor ???/GAR Est. Vaiue $127,000 Date QEC 6 . 1991 Site Address 41 Lot Q Block Parcel No. Name JO W Adaress ta 0 ?y PA Name ? Address - city Zp Zp read this application and state Ihat the lo camply with all applicable State of A euilding Perrnit is issued to: JOSEPEI ti MI LLER COtiST on the express condition Ihat all work shall be done in accordance with all applicable Sfate of Minnesota Stalutes and City of Eagan Ordinances. Building Offittial Sec/Sub. OFFICE USE ONLY OccuPancy R-3 M-1 FEES 734?00 Zoning ?l ?. ?R (Actuaq Const -L--X Surcharge 63.50 (Allowable) -Y=p 4T? 8 01 Stories Plan Review Length 26' Ltense Depth ?a• SAC, City 190•00 S.F. Total - SAC, MCWCC ? 630•? S.F. Footprinis On Site Sewage _ Water Conn On Site Well ? Water Meter ? MWCC System x ' qcct. Deposit 30•00 Ciry Water PRV Required x S/W Permit 3o• oo Booster Pump - S/W Surcharge • 50 Treatment PI 276,00 APPROVALS Road Unit 370'00 Planrier il - Park Ded. Counc Bldg. Dff. - _ Copies ? 3 ,4? .00 ? Variance - TO7AL Pem?ft No. Permit Holde? Tekphone # S/W ? 49 PLLiMBING ? g ?a3- r WAC . /o D- ELFCTR{C ELECTRIC Inspsetion Date lnsp. Comments Footings I ?1?p f G? Foundalion Framing Roofing Rough PIb9• wj/, Rough Htg. Xq, l5ul. - 3 yz Firepiace Final Hlg. orsat Test Final Plbg. Plbg. InspecYa - Notiy Plumber Const. Meter EngrJPlan Bldg. Final Dedc Ftg. oedc Flnal T weli Pr. Disp. a. .. 9 a +? ?, f, (grx#ifira#t uf (??rupattry Citp of (eagan igPpwtmnd 11f N1tljwm itiTPtttDli M Cutifu:ate icsued pursuaw 10 Me reqrarementr of Section 306 of the Uniform Building Code caiifying that a! (he time of iuuarxe tlris strucsure wrrs in compliance wilh tfie vcrious ordiruixars of rhe City regulating building rnnsvudion or use For the folloWng: vx abmMme" SEIIc,w eae. nam& rb. i cq6A oawv.a.7 Tppe R3N1 -xo,iSo,,ia R 1 Tya crn... VN pwoerctp,old;oaJrlqEP4 M MffIF.R rY'NST Ady= IR14l !'F71AR AVF: S, FAR?(TTY:iT?I POST IN A CONSPIWOUS PLACE REQUEST FOR ELECTRICAL INSPECTION ? Sae msimc+om for comoleting th,s form on back ol yellon mpy. 0`j ?_ "X Below Work Covered by rhis Request T- E600 0 - B ?New Add Pe,:. TypeolBuilding AppliancesWired EqmpmeniWired I 107' Home Range Temporary Service ? I Duplex Water Heater Eleciric Heating ?Apt.Buildin g oryer Other (Specify) : ?Comm.rlndusirial umace ?Farm Air Conditioner I IQIIIE116p2Cily1 COnt2LcOf5 RBmdfkS'. Compute Inspectron Fee Below: ? Other ? Fee # ServiceEnlranceSize Fee # Circuits/Feeders Fee Swimming Pool D to 200 Amps (s. 0 to 1D0 Amps Transformers ?Above200_Amps 0_Amps $19n5 Inspedors lJSe Only: TOT L Irrlqation eooms o ? 47- ?? ?Q Special Inspection Alarm/Communication THIS INSTALLATION MAV BE ORDE D D O h ISCONNECTED IF NOT _ t er Fee COMPLETED WITHIN 18 HS. I, the Electrical Inspector, hereby i Ro°5n-'" oat ? 3 q Gr cert fy that the above inspection has 6 been made. F,?ai ? Dd1ea OFFICE USE DNLV This request vo10 i8 months from -1 //` a. d ? / ' 9 n 52 219 Fedues: Dale Pve No. Roug ' Inspeclipr. Req Te ? ? Reetly Now u;AYM Notity Inspector DCCQIR? 02 20 1991 ' . !s = No When Reatly? L{ IC,liCensetl coniractor ? owner hereby request inspection of above electrical work at: Job qtltlress (SheeL eox or Route NoJ CLIY 4965 Counf2 View t?/ziue Euyurl SecLOn NO TOwnst Namp or N0. Range No. COUnTy I Dako ta OccopantiPRINT aoe /'liQQe/z Komea Phone No. 439-2009 Po-e' socoie, Aeoless 4300 220 tiz S.f. 5.G/. D¢kof¢ EPecfiu:c r Elecm<al Gont:acbr ICOrnpany Name, ContreclorS l¢ense No- Oid?aad £Qectztic 041610 Madinq Adtlress ?COarcacior or pwnee Mehiny Instanaliom 7803 172nd S£. Gl, LakeviPee,(7.V 55044 Nutnpnzec & a? e ICOnl.ac aMing Inslallalioni Phone Numper 432 MINNESOTA STATE BOAA? CTRICITY THIS INSPECTION AEOUEST WILL NOT Griggg-MiEway BICg. 54]0 BE AGGEPiED BY THE STATE BOARD 1821 University Ave., SL Paul. MN 55104 UNLE55 PPOPER INSPEGTION FEE IS Phone (612) 662-0800 ENQOSW. Address: 4165 OajNfRYVIEW DRIVE Lot 9 Blk 2 Sec/Sub Cp[Nr _y Hp?,p? 2ND These items were/were not complete at the time of the final inspection. - at . ` Yes No Finalgrade (6" from siding) Permanent steps - garage Permanent steps - main entry ? Permanent driveway ? Permanent gas Sod/seeded grass ,/ Trail/curb damage L/ Porch Basement finish Deck L"l Please verify with the buildar the removal of roof test caps from the plumbing system and the shut-off of vater supply to the outside lawn faucet befora freeze potential exists. ? ?rtcaeowu White - City copy Yellow - Resident copy Pink - Contractor copy "'rT Ur E9G6jd 3830 PIIAT $NOB HOAD EAGAN. 2III 55122 PHONE: (612) 454-8100 .... ...... ?? . ? ?<. ?:,.,? ma .. . ...............:..? P; WORK DESCRIPTION NEW CONST k'Z ADD ON REPAIR OWNER NAME: __JOE MILLER CONSTRUCTION C0. INC. SITE ADDRESS:_'1/loS " LOT: g BLOCK ? SUSD. INSTALLER: GENZ-RYAN PLUMBING & HEATING C0. nDDRESS: 14745 South Robert Trail CI'rY: Rosemount, MN ZIp; 55068 F;:ONE #: (612 OF DWELLINGS 5 COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 / sxowm 3.00 3f J WATER CLOSET 3.00 777- _L BATH TUB 3.00 3°x IAVATORY 3.00 / KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 Z) HOT TUB/SPA 3.00 L WATER HEATER 3.00 ? ? FLOOR DRAIN 3.00 y? w1S FiPING aUT. ? (MINIMUM - 1) 3.00 ROUGA OPENINGS 1.50 _ oxHEx _ WATER SOFfENER 5.00 _ PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 SUBTOTAL S A/6„S O ST. SURCHARGE .50 - TOTAL: s ??° dO COMMEFt4zA3s?(?#??g??I,ra pr.FegE COMPLETE THIS PORTZON FOR ALL CO?lMERCIAL/INDUSTRIAL BIIILDINGS AND M[TLTI-FAMILY BDILDINGS 4THEN SEPARATE pERMITS ARE NOT REqIIIRED FOR EACH DWELLING UNIT, CONTRACT PRICE: GwivF.t2 NnAfE- SZTE ADDRESS: LOT: BLOCR __ SUBD. INSTALLER: ADDRESS: CITY: PHONE #: FOR: PLEASE COMPLETE IIPPER PO&TION ONLY FOR SINGLE ' FAMILY TOWNHOMES/CONDOS VBEN PERMITS ARE REQIIIRED FOR EACH IINIT. 2IY: FOR CITY IISE ONLY PERMIT tk RECEIPT # / O DAxs: 10219191 FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SUACHARGE TOTAL: (SIGNATURE) $ $ CITY OF EAGAN lqqqq ? 1991 BUILDING PERMIT APPLZCATION CITY OF EAGAN SINGLE FAMILY DWELLINGS M[TLTZPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATZONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGN ??•, H??. ? DESIRED. NO CHANGES WILL BE ALLAWED ONCE SUILDING PERMIT IS ?€D.`=? r'?1- PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A? IT(JMS BFEN-COMPLE PERMIT MUST SHOW A LICENSED PLUMBER. 'Jy1 L Ii J To Be Used For: New Home Valuation: ? Date Site Address 41(5 r 17 • n ?J Lot _9 Block 9_ Parcel/Sub Owner Address City/Zip Code Phone ContractorJo=o?h M M;iler ra? Address _18133 City/Zip Code Fnrmin?tprif 55024 Phone 431-2001 Arch./Engr. Address City/Zip Code Phone # OFFICE USE ONLY R 3 nn-1 R-I V" N V-N 12 IFVW_. Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. ?2 (o 90 On site sewage_ On site well MWCC System f/ City water ?j, PRV Booster Pump _ APPROVALS Planner _ Council Bldg. Off. Variance FEES Bldg. Permit 73???aJ Surcharge 63,50 Plan Review 1417?, pp SAC, City /DO• o J SAC, MWCC 65-0,00 Water Conn. bbO,0 o Watex Meter `5,1? Acct. Deposit 0,00 S/w Permit 30,00 S/W Surcharge . 50 Treatment P1. a ,oo Road Unit ?0,00 Park Ded. Trail Ded. Copies SUBTOTAL Penalty Lot Change TOTAL /16 z5L ? i agrees that all work shall be done in accordance with (Signature of tractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? i Y ?A Ud? ? ? GaIPqbE IIXZo= 22a 6,3? ?c rg?.? 957? 6S MT ?--- ;zc k?y= gey l0 iy= 14,oS 6 isT 'f3r-?'!,nT= IUO?I 2?x2X5=?? `O 3 a?t s'3 = J V.Sc( p 3uxa? = 9?Sxs3= y8,5S?i ,, m,a ! a 7, o00 - iu iiti[suuA s ini [ tiitiicr cuut OhLOuL"l i u ol -/( cU "ansEO o?i ciinPTEn S or TiiE • Ae-1'131 HODEL ENERGY COUE -.19(13 EDITION !_.:-• , _ ndopttot, EPfectlve I./I/?3?I ' Owner l Site Address Con[ractor . Dullding Classll'Ica[ion: Type A1 (Single Fatnlly E Duplex). NOTE: Complete pages 3 and 4 ffrst. (Other) GENERAI I NFORIIl1T I ON ne Date phone ' - Type A2(Resldentlal) - (3 sto'rl.es or less ' (Over 3 storles) I. 6ullding Perlmeter?Jli?ry??C??? GJ?-YI ft. t• ? ft. 2. 4fa11 helght (ground Co eave) 2 ? . 3, I, x Z. (above) gross wall area Zft. h. Ou.ilding dlmenslons (L) - X(W) Ft.Z roof 6 floor area 5• Square (oot area oF rlm Joist - Floor Jolst slze (2 x / 2 Q X Perlmeter ° Rlm7o st area = `I nZC? ft 12 I `lQ 6. Doors - A'rea Thlckness Type of Construction Manufacturer in. U factor 4-1 Perimeter ft. ' 7.. Total door's perlmeter ft• I 0. Wlndows: Hanufacturer IIj6q1i• State appi'oved U factor . TYPE SIZE AREA (Ft.2) NUIIUER OF. TOTALIEET ? EACH i UNITS . ; . -« ? Il?lc.?(<•I?.. -?.v? . , , i , ? . ?J 9. 7otal (t.Z Glass???1 f ' 10. Fireplace area: Wldth X helght = x = F[.2 2 . 11. Exposed foundatlon: Height X Perlmeter Rf.n ??Lx?o Ft. COhIPlETION OF TIIIS FORM IS 0.EQUIRED fOR nLL A€w coNSTRUC710N, 11AJOR REMODEIING ANU BUILDINGS BEII FIOVED WHERE EIJERGY, OTHER TIIAN THE FfINIHAL CODE ALLOWANCE, .IS USEO. ' ? ? :t t IL. 13 14 }raminy area = iUie u i yiuss riaii aiee. 'r..A?e wal l araa `? I ???, ? ? . _ 2 Windo•rr area A ft. R1m joist area A ?(0? ft.2 2 Dvor area A• it. ?e'11t7 012 ? p 2 . FAr,epl'ace area A Z f t. ? Z Exposed foundation n ft. Framing area A Z i ?7??073'? •7s 1 ft.2 Plet wall area A ?Iq&? 1-7 ft. (138) ? Gross wall area x 0.11 (11-1 single family S duplex (13. above) • x 0.23 (A-2,other resldential) x .23 (Other buildings) • x .28 (Over 3 stot•ies) . = allowable U x A/Code ' BTUN be% larger than ?O`F. 13i3 above or Ette; same .a's) , . 2 q x U Code , 15. Ceiling framing area (Af) equals 10% of ceiling area ' r x(yj? --- e ?j v ft. 15A. Gross ceiling at-ea = (L) Z 154 Joist areA (Af) = 10;6 ceilinq area = O;2' ft. 15C. Ilet ceiling area (Ac) (15A - 158) ° ft.2 U ceil ing x A c= i OZ3 x? -• vz U framing x A f= oZ Z x (J .150. TOTAI*U x A ................................. .:.... h?? .. I , 16. Ceiling area (15A) x.0.026 (A-1 single familyl& duplex - code allowable U x'A • x 0.033 (A-2 other residential)• ? x 0.06 (other) ? . pZ(p DaUH 14ust be larger than•150 (above) A(15A) ??>Z x U(codel= F (or the sa'me.as) NOTE: Use U and A values ob[alned from pages I,•3 and 4.' CERTIFICATION: I hereby certffy'that I have calculated the "U" factors and "R" values ' hereln and tha[ the bullding here descrlbed meets or exceeds the StaEe oF Mlnneso[a Energy Conservat(on Act. ' te STgrature !. 'k i v ft.2 U wi ndows U,x A° U rim Jo1sC = L0? U x A' U door area = r U x A= U I--fi$`ff?rk'aEe U x A = ? ?r U foundation = ?O-j (0 U x A° ?'L I U framing area r ?L.5 U x n° :?q U wall = o?'3 U x J1 °.?Z?? ? TOTAL . . . . . . . .. U x A 0 .. . , •• Uotarmining iitlit valuse at Rooto YVall; Riros and Coba. Bloolt AUOF/OEILI114 1 . ) Interior Aic I'ilm 2.) 518" (IYP. Bd. 3.) Ineulalivn 5.) Exterior Air Film (aTi1,t, ) A YALU ? 0.61 .56 44. cv .61 nUn e 1/Ry ?OZ? 'iOTAL (A)d -K.70 , ?. WALL R VALU 6.) Interior Air Filro o,68 7.) i" (lYt). Bd. .?E5 8.) Inaulatiott 19.vd 5. ) P?o,cr-RirF z.ol- 10.) Maeonite 8lding .57 11.) Exterior Air Film ,17 IIpn TOTAL Mti 23.ol . -?- ? 12.) Interior Air Y'i1m 130 Ineulation 111•) 2" Fir Aim Joiet • 15. ) K? ILT- ?1Tc 16,) Naoardte eiding 17:) Exterior Air Film li V1lL U 0,68 19.00 1.88 Z0oQ- .67 .17 upn e I/Ra #pefp TOTAL (R)dT.?.?T. _? . .?- FOUllDATIOti 189) Interior Air Film 19.) . 20.) J?-?J s 7RrPi1eD 21.) 12" Oonorete Blook 22.) 23.) Exberior Air Film npn e 1/Rd -07(9 E? li VALU 0.68 . Il.cio 1.28 •.17 T9TAI, (R) ° 13.1Zi ?LlLllu? Illll ??i?.?? : ??., ? ,?•? ' -R -,inCuE? li-'vf?iuE ? • rnn141 ric cEtu,iic• , - . , ' • 0.61 A1r Film 0.61 Insulation 4`T' ? c?> • . . j ?..• 3g , ,lotst , Ceiling •?J?p , • + ? • / . .? ? ? . ? ti 'l ia<1? 0.61 0.61 . , Air F11m , ' "L.• `'CQ TOtdl n 70 . ,? . z3 u = I . ozz- , FLAT ROOF OR CATHEURAL CEIL[NG " R 4a ue R 9111UE FRAMI hIG CE1L RJG 0.61 0.17 Inside air film 0.61 Ceilfna Joist (stud)' lnsulation Air space Roof decking ' Insulation Uuilt-up roof Outside air f11m 0.11 Total R 1 u , a R , JinJow inflltration .5 cim/lineal foot of crack tesidential door 1nfilCra[ion 0.5 cfm/square foot or door and minlntum code requirement . ion-r-e5ldential Joor infiltration 11.0 cfm/lineal foot of crack ')b 12" concrete block no 1n'sulation =.47 R 2.1, . !b 12" cviicrete block insulateJ cores _ .26 R 3.8 ly 12" lightweight block =.32 R 3.1, , 1b 12" lightrieight block insulated'cores =.12 R 8.3. ) sinyle glass = 1.13; rrith storm talndow .54 I ' J double ylass = .55 F?. J triple glass = .41 , i . A11 exterior walls and ceilings nuist have a vapor barrier (0.10 perm max.). ' :auor barrier must be on the Inside (heateJ slde) of orall. ' iapor barriers of the polyethelene thin film have no R value. , a. r.. , PERMIT III / REACTIYATE' 0 &. 50 cu? CITY OF EAGAN lzh, 1992 BUILDING PERMIT APPLICATION t' 681-4675 r t? M ? C SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typinq of permit is requested, but not picked up by last working day of month .in which re uest is made or lat chan e is re uested once ermit is issued. Date TLd V ?/ ,9r?c? Valuation of work ?.?.?JCI Site Address: /-W/a 5 ?'ri??,-r?,r,r,?,'•ui ?/, STREET SUITE M Tenant Name: (commercial only) 1.OT C BIACK SUBD. ? ? P.I.D. k Oescri tion of work: Gk The applicant is: O Owner e-ErContractor ? Other (Describe) Property Name ?'rroe.. Phone 6??ti/ uST ? FIRST Owner Address 4/e?5__ l- STREET STE 1 City?'? 2n State 12Jn Zip2_ Company Phorye g9,4,-%O,3L/ C011tr8Ct0r r? Address 4/Jriri License #nab1A6.5-_ Exp, 5/47 .3 City State Zip ?s"3,37 ArChItECt/ Company Phone Englneer Name Registration # Address CitY State Zip Sewer 3 water licensed plumber . Processing time for sewer 6 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: ?. ? ' CZTY OF EAGAN FOR CITY USE ONLY ' 3830 PILOT KNOB ROAD EAGAN MN 55122 PERMIT # PHONE: (612) 454 8100 RECEIPT ?GNdI?ICB?T-.P?R2?? DATE: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 5 TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. -------------------- WORK DESCRIPTION NEW CONST ? ADD ON _ REPAIR _ OWNER NAME: SITE ADDRESS: "?C'? ?•? ??-`m?C`I \7`?P_v.? ? C' \ U LOT:2, BIACK ? SUBD. C_e?-. INSTALLER: ADDRESS: '1 acC1 C?J N C,? ti CITY: ZIP: PHONE #: ??CC? - COO o"? ?)_ FEES ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL : $a3. CZ) STATE SURCHARGE: .50 TOTAL: $ ??•?? /SIGNATURE OF PERMITTEE ? PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDUS TRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE OWNER NAME: SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE a $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING = $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: $ (SIGNATURE) CITY OF EAGAN 954870 , COIINTRY HOLLOW SSCOND ADDITION PRB88IIRS REDUCINO VALVE AGREEMSr i This agreement, made and entered into the day of 1990, by and. between the CITY OF EAGAN, a i municipa?ity of the State of Minnesota, (hereinafter called the City), and the Owner and Developer identified herein. The terms "Developer" and "Owner" as used herein refer to: PROGRESS LAND COMPANY, INC. whose address is 14300 Nicollet Court, Suite 235, Burnsville, Minnesota 55337. WHEREAS, the Developer has applied to the city for approval of the plat or subdivision known as COUNTRY HOLLOW SECOND ADDITION, located within the City; and WHEREAS, the Owner and Developer agree to notify the proposed potential- buyers of all lots within COUNTRY HOLLOW SECOND ADDITION that* Lots 1-4, Blbck 1, Lots 1-17, Block 2 and Lots 1-10, Block 3 are in a high water pressure zone and a pressure reducing valve shall be installed in each home below the elevation of 875 feet. All costs shall be the responsibility of the Buyer and shall be installed to prevent damage due to high water pressure. NOW, THEREFORE, the City, Owner and Developer agree as follows: 1. Recordina. This agreement shall be recorded with the Dakota County Recorder so as to provide notice to the owners of Lots 1-4, Block 1, Lots 1-17, Block 2, and Lots 1-10, Block 3. The Owner shall provide and execute any and all documents necessary to implement the recording of this.agreement. ? i _ .? \?7AAhClj?_ Attest: . J. VanOverbeke Bv: Its: erk Its? 2. Notice. The recording of this document shall constitute notice to all owners and future owners of property in the COUNTRY HOLLOW SECOND ADDITION subdivision that Lots 1-4, Block l, Lots 1-17, Block 2, and Lots 1-10, Block 3 are in a high water pressure zone and that a pressure reducing valve shall be installed in each home below the elevation of 875 feet. All costs shall be the responsibility of the Buyer and shall be installed to prevent the damage due to high water pressure. 3. Validitv. If any portion, section, subsection, sentence, clause, paragraph or phrase of this agreement is for any reason held to be invalid, such decision shall not affect the validity of the remaining portion of this Contract. 4. Binding Aareement. The parties mutually recognize and agree that all terms and conditions of this recordable aqreement shall run with the land herein described and shall be binding upon the heirs, successors, -administrators and assigns of the owners and developers referenced in this Contract. IN WITNESS WHEREOF, we have hereunto set our hands. CITY OF E e OWNER AND DEVELOPi:R: (Date: PROGRESS LAND COMPANY, INC. t? . T m a s A. By: O i:N% J Its: Mayor Its: Poc't/ v6.vr STATE OF MINNESOTA ) ) ss. COUNTY OF DAKOTA ) On this 622 s% day of 1990, before me a Notary Public within and for said County personally appeared THOMAS A. EGAN and E. J. VanOVERBEKE to me p(arsonally known, who being each by me duly sworn, each did say that .they are respectively the Mayor and Clerk of the City of Eagan, the municipality named in the foregoing instrument, and that the seal affixed on behalf of said municipalitp by authcrity of its City Council and said Mayor and Clerk acknowledged said instrument to be the free act and deed of said municipality. q. •M?!Nt!)NrN?Na1111ffSN L :NN ; . ? _Ir.•, E:'a , ., ....... .,,, STATE OF MINNESOTA ) ) ss. COUNTY OF 0,1 7 Notlary ?Public ,. . . . ? J` on this ?'??? day of St , 1990, before me a Notary Public within _ and fo'r said County, personally appeared t .t; ; , : r --:? to me persona?ly? own, `who being -0ar.h-by me duly staorn, easli did say that they e?+ reapeetl?? the 1I( ,; )?i and of the corporation named in the foregoing instrument, ___ _____ ____ ____ ___:..__ __ __:_ _..____..._.._ i_ ' ', and that said instrument was signed arrd-xa}eT1 on behaTf of said corpora ion, kn, autho:ity of its Board of Directors and said rrS;GCc_?zfi' ?- acknowledged said instrument to be the free act and deed of the corporation. . . -? ...-... t 1 . C tn L'!^) 'n " ' ? ` Notary Pub• ic APPROVED AS TO FORM: Public Wo s Department Dated: ?F?y yo THZS INSTRUMENT WAS DRAFTED BY: SEVERSON, WILCOX & SHELDON, P.A. 600 Midway National Bank Bldg. 7300 West 147th Street Apple Valley, MN 55124 (612) 432-3136 MGD '*oL '5,9S l/r^? APPROVED AS TO CONTENT: ? RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Conatruetion Reauiremenb • 3 registered site surveys showing sq. N. of lot sq. ft ot house; and all roofed areas (20% maximum lot coverage allaxed) • 2 wpies of plan showing beam & window sizes; poured found design, elc.) • 7 set ol Energy Calalatlons • 3 copies M Tree Preservation Plan if lol platted after 717193 • Rim Joist Detail Options selepion sheet (bidgs with 3 or less unAS) DATE _2C?: hoG" SITE ADDRESS ?(6? TYPE OP WORK 70 -57??Y. ? APPLICANT 'Y? _/? • C-Ovv MULTI-FAMILY BLDG _Y _N _ FIREPLACE(S) _ 0 _ 1 _ 2 STREET ADDRESS 1/ 97 ?' C1;'7q1 R?'Yv CITY ??"°`?? STATEA' ZIP TELEPHONE #93? ?d'90o3 CELL PHONE # PAX # T,5`2-?a ` qa PROPERTYOWNER_ 6e0 TELEPHONE# -----------------------------------------------------°-------------...------------------------ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ y(IVNESOTA RUL,ES 7670 CATEGORY 1 MINNE:SOTA RULL•,S 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Conhactor. Mechanical systcm includes: Sewer/Water Coniractor: Phone # Phone # Fcc: $90.00 ['ee: $70.00 ---°------------------------------------°--------------°°---°---------------°---°-----------------------... I hereby acknowledge that I have read this application, state ihat the information is ? with all applicable State of Minnesota Statutes and City of Eagan Ordinances,?f-. ?IK ?? IC Signature of Applicanf OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ _ Water Softener _ _ Watcr Heater _ No. of Baths _ Phone # I.awn Sprinkler No. oF R.I. Badis Air Conditioning Hea[ Recovery Syslem RemodallReoair Reouirements • 2 copies of plan • 1 sel of Energy Calculations for heated additions • 1 site survey for exterior additlons & decks . Indiwte if home served by septic system for addAions VALUATION Updated 4l02 2007 RESIDENTIAL MECHANICAL rExMiT nrrLicaTiorr City Of Eagan _ 3530 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when permics are required for each unit Date Sf / (/ '7 S o Or" U Sit Add `7 ? e ress nit # 1 P Property Owner Telephone #(?s-/ ) ?S7 -??? 7 • ??43 = Con[ractor _ aC"Wr .. StreetAddress NFaIM&A1P CiTy 1904 Vermillion Street `? State Telephone #(( S/ ) 7 c37?717 7 a Hastings, MN 55033 Bond #:_ p-Z- % S Expires: 140 -7 The Applicant is _ Owner i/Contractor _ O[her Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration [o existing dwelling unit $ 50.00 ? furnace _Additional ZR eplacement _ New air exchanger air conditioner heat pump other `? ; Dl ?? C?? L, ?' ?;?1 ? StateSurcharge $ so u u MAY U Total $ [ hereby appty for a Residential Mechanical Petmi[ and acknowledge that the infortnation is complete and accurate; [hat [he work will be in conformance with the ordinances and wdes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pemti[, but only an application for a pertnit, and work is not to start withou[ 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 plan;, ? ?? LCuqYutC'.2? Applicant's Printed Name Ap cant's gnature * pl??NEEF * engrneerii Certificate F i onrar- Ene i naer i ns 6819488 LwNOfiUHVlYUR9•GVRCNpINEEPS _ 1N0 RNNNEICI - L-N69CHPE 6HCH1t[C75 S 89°23'41" E I 142.00' w c I cn ¢ G ? O M a z / 26.33' --......? M N I I {g 10.b «,?.o ? ? M 2.0 i- ?,-?- 83 ? b i o ?I .._ ... ., n of Survey for JOSeph M. Milis.r_Construction CO. House Address: A165_Coup_tr iew._D.rive;_ Eg..ggr??. MN Model Name: Aspen 2 2? S ?>y, ? \ y L I ? + O 7 I N ? J ? ` I r \ ? ?ZZ.b?c _J `fog of /I 89° 105.00' gofE N I7o 0 ? • 900.D benotes -aoo. Denotes benotes Denotes -o-- Denotes f; Existing Elevation Proposed Elevation Drainage de Utility Easement Drainage Flow Directivn Monument 8 =, W 4? . r.._- oF,??:. ... F.ez 2422 Enlorprise DrHe Mendota Ileights, MN 55120 (612) 681-1914 7r I Q ?I Q ?p ?..? { cnI I ? 43^' ?,?? I Lii ? ? W / ? V ..?.....so .., . . , .. l 30- _ _. .I../.. . ??A j.... ... ?,?_... ir.RmV. REOU?R-M-! PROPOSED HOUSE ELEVATIQN Lowest Floor Elevation: 525:18 Top of Block Elevation: 833, 28 Garage Slab Elevation: 832.95, -B Denotes Offset hlub gearings shawn are assumed LOT_.9 BLOCK 2 COUNTRY HOLLOW DAKOTA COl1NiY. MINNESOTA S E C O N D A D D I TI ON I here6y cunlly ihal thilsu..ey, plan or repGn was pte(+ared Gy me or urdyr my diwct supervision and thet 1 am duly Repltiued Land Surveyor under J?e lawe o/ ihe $tare ol Minnesuae, Deted IbisZNti dey ai UCCe"<r qp. 1g_'(jV , Z ? Sc, a I?.': 13 0feec . 1700FRT 8.511(ICM L.S. A6G. NO. 14891 fd5q 91253 01 Pianaer EnsineErine 68194$8 P•02 ? * * * 2422 EnterprisC Qrive "t PIONEER uN0 CUnv[rowg•CIVILENa1NEER5 Mendota klaights, MN 55120 ?engineering.. L^ND M^NNEM •LAN?wPewacNMCY9 (612)681-1914 Certificate of Survey for: JOSeph M. Miiler C.onstruction CO. . House Address: 41?C5_Countrv?ew.,Driv? Eaggn?. MN Model Name: Aspen 2 , -. Ify ? ? I I ? ? I I ? ? I I ? S 89°23'41" E I I I ? 142.001 bti9?s 85°?? tl31.71g31??' q,,i,3i ? W I - 3200' ?n 2e.33' 30.D0' ? > ? W l i------??--MrBt?b---? 83?o-_i zs.as ---.? ?,o• I ? I p.t I I ( N s'?? ?q + I ? I I ? ? ? Q? I ? ? -- - - - ? i `' °p °° a.o•?;BSn.b ^3.0 ? ? a M ? ?, 2.0 6jo --.,-r...-... .- I ? ..._.? < ? 4^ a fn n; > 3 z , I a iO a 2?s? °?•, ?? I s ? ?I ? I I :? I ? G I,, ? ? z.o ? ; I I- I 9gs `?i- 1 M( e ?,?„?s ....,--- ??s ? r? at2•b ? 20.33' d t?+ , ? ?- - - - -- - - - ek ? ?_ ? v ? .o?_, n 26.33 r+ :00• ! g'r? ?.. . . ......? .. .__. ? ? ? 105.00 6s ? E ?, N 89°23'?at" w ?' _ 'l,_ ,o• 3 o' op i..?_i.'._. I, + ? ° ?OUMs._--_OI) • 900,0 Denotes Existing Elevation pROPOSED HOUSE ELEVA QN • 900. Denotes Praposed Elevation Lowest Floor Elevation: $25;l8 Denotes Drainaga & Uttlity Easement Denotes Drainage Flow Direction Top of Block Elevotion: ?33,?g -o-- Denotes Monument Garage Slab Elevation: 832.95, -9 Denotes Offset Hub B.earings shawn are assumed LOT 9, BLOCK 2 COIJNTRY H(7LLOW OAKOTA COUN7Y, MiNNESOTA S E C O N D A D D 1 TI O N I hereby certlfy Ihat this w.•ey, plbA or repp.t was prepared by me or undpr my dirrct supervision and thet 1 em duly Re0>>a*red Land Suweyor under tho lawt ol the Si9ee ol Minnewee, Dated this2No dey ol Decew.bfir q,p. 1y-TM, ? Sc?Ia. "? Inch-30feei , ROBERT 0. SIKICH L.S. AEG. NO. 14891 1... , (dK 91253.01 Use BLUE or BLACK Ink -For--- Office-- Use----------I ~ I I I Permit#: ~ © City of Eap I Permit Fee: L176 i q i 3830 Pilot Knob Road I Eagan MN 55122 L~ C~ j E S i Date Received: Phone: (651) 675-5675 e' I Staff:_ I Fax: (651) 675-5694 1 2011 RESIDENTIAL BUILDING PERMIT APPLICATION 1{ ~ Date: 11 7 I r Site Address: Or 5T " `'_Unit r ter Name: e -c- V ESL Phone: 6-Y Lfs `7r l l 2 2 ~ % ] 1 RESIDENT / OWNER Address / City / Zip: Z//6s Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: y~ V Multi-Family Building: (Yes / No ) Company: (4-, 7_11`e 6L= 14"f C A;6 Contact: Al LE'4te{- Address: 90.7 J14 City: r~t4,~/k1 CONTRACTOR State: mltl) Zip: Phone: 6 S 1 2-SS- 7Z.. License 2 0CI 66 C,3 V' Lead Certificate V If the project is exempt from lead certification, please explain why: (see Page 3 for additional i orma io) p, 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: pp y ation. Portions of provide ss eificreas a ublit f oul N- f are ere to b the information may be classified as nton~ ubl cyif you it y p y p ons 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. r( X_ x Applicant's Printed Name Applicant's Sig ture 7T Page 1 of 3 H u DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of - Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES - New _ Interior Improvement _ Siding _ Demolish Building" _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall "Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition 0,1 SAC Units (25%_ 100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS` Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES j Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant l / Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink For Office Use I I Permit k u2 2 Co I City of Eap ~ permit Fee: 65 3830 Pilot Knob Road Eagan MN 55122 j Date Received: ~tQ I Phone: (651) 675-5675 f Fax: (651) 675-5694 Staff: I 2011 MECHANICAL PERMIT APPLICATION ti l 65 C_ 11 - a 14 . De Date: Site Address: Tenant: Ca +y~ V I lw Suite RESIDENT / OWNER Name: / Phone: ~j CI ' t, cQz~'i~ Address /City/Zip: CONTRACTOR Name: _ 1 "k-zi r License M Address: its ~y: State: I~'l Zip: Phone: L61 ~ oZ j o9 q O "G741 ~ Contact: TYPE OF WORK New Replacement Additional Alteration Demolition 1 ~5 G~ ?th~0®arr Description of work: °301il2 SL412 NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x A t2 ~ t~i~ vl / x Applicant's Printed Name Applicant's Sign ure FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground - Rough In -Air Test -Gas Service Test -In-floor Heat -Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink r s f For Office Use i I Permit o City of Ealln Permit Fee:SUb j 3830 Pilot Knob Road I I Date Received: I) - f t Eagan MN 55122 I I Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: {f-- - C_ 2411 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 7° fl), 0/ / Site Address: _ / o,"5- Lt A, {x r Tenant: Suite RESIDENT/OWNER Name: Phone: Address / City / Zip: \,,//4 CONTRACTOR Name: YE R C_ E Y VZ License 6 7 Address: 10 6 O L~ City: L ax-_ e y 11-e State: Zip: Phone: Contact: Email: TYPE OF WORK -New _ Replacement/ _ Repair -Rebuild Modify Space _ Work in R.O.W. Description of work: ^ S Q / bvL2 r~ ' -P piGe LGt v dwe S,/w po- PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ PVB)- Add Plumbing Fixtures Main / _X Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnarounds (includes $5.00 State Surcharge) `Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x sEp c- eY VA y d 1. x - v.._ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough-In Air Test Gas Test Final PERMIT City of Eagan Permit Type: Building Permit Number: EA104860 ~it~ of Date Issued: 06/14/2012 OR Permit Category: ePermit Site Address: 4165 Countryview Dr Lot: 9 Block: 2 Addition: Country Hollow 2nd PID: 10-18276-02-090 Use: Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Replace Description: Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: Perry Firkus 2650 Minnehaha Avenue Minneapolis, MN 55406 612-276-1680 Fee Summary: BL - Base Fee $500 $40.00 0801.4085 Valuation: 500.00 Surcharge - Based on Valuation $500 $0.50 9001.2195 Total: $40.50 Contractor: - Applicant - Owner: Crew2 Inc Dennis A George 2650 Minnehaha Ave 4165 Countryview Dr Suite 100 Eagan MN 55123 Minneapolis MN 55406 612 276-1680 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 Use BLUE or BLACK Ink l for Office Use I ~-_s;;rTsm; - of U~ Se j Pcrnii=: y City f Eagan FzF_cova) 1 I Permit Fee: 3830 Pilot Knob Road 1 9 2~1b ~ 1 1 Eagan N 55122 FEB rate =-,eceived: Phone: (651) 673-5675 1 Fax: (651) 675-5634 1 state: 1 1 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date oyz Site address: 4i (4 " 01 L'S )l' Unit Sine: 0-r,- nn I `J !L Phone: 011 Residenti 4( Owner Address/ City..` Zp: ~O 5 `,jt)l 2 Applicantis: C;:.n,erContractor lescripfion wr' C C~c Cn C3- ~-Y ~S Cu s'0- v3 1 adL~LDS Type of Work V1 Z.:Y- Ii":~ Construction Cost: fauIt-FamflyBuilding: (Yes No Camparty:~~~ri~c`~° intact Contractor nddresstq city. ~UAAsnd- 5tatea 1 ) • Zp: rJ~J 1 l Phone (0~ License Lead Certificate If the pro d is exempt from lead certification, please expra_n why. see Pale 3 for additional n#arniation) COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? I _Yes _-No If yes, date and address of master plan: Licensed Plumber: Prone: Mechanical Contractor: Phone:. Sewer & Water Clntraetor: Pnune: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classifiedas non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOJ DIG. ,opherState OneCall (651)454-00421 , N agar t , . a, +v:,rs Lefore you rte-_ -o rec -,tes _f rri?deigi ound l :^nreby ackla: edge nat ih?s information is corrp?%te and accurate; that ine ..orl ,,PI be o r _g1ormance t`,e ordinances and codes of the City of _a .a" t"at I _„rders a r 9^is is nat a pert it. ? y an app icatior for a permit, and ,<ork is 3,at to start v,1 ,W a permit, that the work will to in acc, ida,?ce .rt .re approvedplan in thece_e _i k ;<.rh~c;r requires a rQVie;, a-~d appraa~af of i,1a=5. Exterior work authorized by a building pennit issued in accordance with the Minnesota State Building Code must be co ed uvlfhin 1138 days of permit issuance. Applicants Printed Name Applicant's Signature Page 1 of 3 V.~1 )lw ~a L"Er~ l~ OCR NOT WRITE BELOW THIS LINE I ZC>! W SUB TYPES Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family) em~ Single Family Garage Porch (4-Season) Exterior Alteration (Multi) Multi Dock Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of_ Plex Lower Level Pool Accessory Building WORK TYPES New ~ interior Improvement ~ Siting Demolish Building* Addition w... Move Building Reroof Demolish Interior _ Alteration Fire Repair _ Windows - Demolish Foundation Replace Repair Egress Window Water Damage Retaining Ball `Demolition of entire building - give PISA handout to applicant DESCRIPTION Valuation ' Occupancy ,.7 ICES System Plan Review Code Edition SAC Units (25°!ay 1000 zoning R" City Water Census Code mmm. ~3Y Stories. Booster Pump of knits Square Feet PRV # of Buildings / Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings {Deck} Final / C.O. Required Footings (Addition) Final / NoC.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof: -Ice & 1J4ater -Final Pool; Footings -Air/Gas Tests -Final Framing Drain Tile Fireplace: -Rough In -Air Test -Final Siding: Stucco Lath --Stone Lath Brick Insulation Windows Sheathing Retaining Wall: _ Foot ngs _ BackfllFinal Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other:. Reviewed By: , Building Inspector RESIDENTIAL Base Fee ly? ! 0 Surcharge "v Plan Review 410 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA120623 Date Issued:02/25/2014 Permit Category:ePermit Site Address: 4165 Countryview Dr Lot:9 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-090 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. Fixtures:1-tub valve,1-shower valve,two toilets,3-lavs. 2nd. floor Alex Barna Po Box 188 Fee Summary:PL - Permit Fee (miscellaneous)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Dennis A George 4165 Countryview Dr Eagan MN 55123 (763) 486-0816 Sowada And Barna Plumbing PO Box 188 Cedar MN 55011 (763) 444-0292 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA147893 Date Issued:02/14/2018 Permit Category:ePermit Site Address: 4165 Countryview Dr Lot:9 Block: 2 Addition: Country Hollow 2nd PID:10-18276-02-090 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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: 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 - Dennis A George 4165 Countryview Dr Eagan MN 55123 Craftmasters Remodeling Inc 2495 Maplewood Dr, Suite 314 Maplewood MN 55109 (651) 757-4100 Applicant/Permitee: Signature Issued By: Signature