4168 Countryview Dr? •
,V
• .,
WVmficate nf cccu.panc4
Wit4 of Cfagan
Zow-tuext of louilbi»g 3x"ccN"
I •
This Cenificate issued pursuant to the requirements of the Uniform Buildireg Cnde
certifying that at ihe time of issuance this siruciure was in cnmpliance with tire various
• o?dinances of the City regulating building construction or use. For the following:
S1' UaG 20822
Use ClassiFicafion: Bldg. Ptnort No.
Occupancy'lype _ Zoning District T ? qoN Owner of Building Address
Bu&hn 8 naaress 41? UIIVE ?..Mality L2, B3, OWNlW KILOW
07/16/q3
Date:
Buildiog Offici6l
POST IN A CONSPICUOUS PLACE
i
`/ CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS•
INSPECTION RECORD
RF$4CJ'I?JA?D FOR DECK ?3/22/93 PERMIT TYPE:
R D CONST 452-3575 Permit Number:
Date Issued:
• i 1) 1 -
? "M11 NYW f F.14 (?k
` PERMIT SUBTYPE:
i-
TYPE OF WORK:
INSPECTION .• . .A
;
` {':f P1N('i
?
_ .r:__?"?a .r. _ k ?'?"?`i°.??',`°-??'-?-°.•?_'?.?, _ _ _ . 3 ' ' ? ?
, . . . .. . ? . ;? .?.. ;?. , ?.
? ?' . ? . ? • :? -??y ?
APPLICANT:
Permlt No. Permit Holder Date Telephone #
S/1N
PLUMBING
HVAC ,S 6( 7 - z,1
ELECTRIC - , 6;W3v-
ELECTRIC
Inspectfon Date Insp. Commerns
Footings I
Foundation
Framing
Roofing !
Roug, Plbg. ?y
R°ug?' Ht9_ 4 3 ?
lsul.
Fireplace 6'1719j ?
Flnal Htg. 2X
Orsat Test
Fnal Plbg. 7/1 3 ? Plbg. Inspectar - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final 7 4 - 93 ??-
Deck Ftg. lO_ Z'?4 3
/ ?
Deck Final g 3 S
weli
Pc Disp.
?r
?
'?'VZ 7d
REQUEST FOR ELECTRICAL INSPECTION
im. See instructions for completing lhis form on back ot yeitow copy.
"X" Below Work Covered by This Request
EB-00001-08
?4%
? ??.
????•? 1 C ? /7 ;;1;
ew-
w
eof8uilding
AppliancesWired
EquipmentWired
Range Temporary Service
M Water Heater Electric Heating
ilding
Apt. Dr Other (Specify)
/Industrial urnace
Farm Air Conditioner
Other (specity) Contrector's Remarks:
Compute Inspection Fee Below:
# Other Fee
Fee
# Service Entrance Size
# Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Sigf1S Inspector5 Use Only:
???? TO L
4co '
Irrigation Booms ?? rAL
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE 0 ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M ?
I, the Electrical Inspector, hereby Rough•in '. ??
certify that the above inspeciion has F;,,ai r Date
been made. 19
'
OFFICE USE ?NLY
This request voitl 78 monlhs from
L - -
THIS INSPECTION REQUEST WILL NOT
BE RCCEPTEO 8Y THE STATE 80ARD
UNLESS PFiOPER INSPECTION FEE IS
ENCLOSED.
MINNESOTA STATE BOARD C1FE46CT11I
Griggs-Midway Bidg. - Room 5-173
1821 University Ave., St. Paul. MN 55104
Phone (612) 642-0800
C1TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
416$ COUNTRYVIEW DR
LOT: 2 BLOCK: 3
COUN7RY HOLLOW 21V0
P.I.N.: 10-18276-020-03
DESCRIPTION:
rmit Type
rk 7ype
Znning
Building Length
Building Width
ZL I
REMARKS:
S& W PLBR - RAY HAEG PLBG
FEE SUMMARY:
5F DWG
NEW
R-3 M-1
V-N
R-1
65
46
BUILDTNG
020822
04/30/93
tV oF caLju
?
a
vaLuaTaroN
Base Fee
Plan Review
Surcharge
sac
SAC %
SAC Un3.ts
Subtota,l
$630.50
$409.83
$49.00
$750.@0
100
1
$1,839.33
$98,000
MISCELLANEOUS $1,,744.50
Total Fee $3,583.83
CONTRAGTOR: - Applicant - ST. LIC. OVIfNER:
THORSQN NOMES BRIAN L 14540644 0001317 THORSON HOMES INC
4466 WEDGEWOOD DR 4466 WEDGWOOD DR
EAGAN MN 55123 EAGAN MN 55123
(612) 454-0644 (612)454-0644
I hereby acknowledge that I have read this application and state that the
intormation is correct and agree to cnmp.ly with all applicable State of Mn.
L Statutes and C.ity of Eagan Ordinances. ?
APPUCANTIPERMITEE SIGNATURE 155UED f: SI NATURElIV
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L Q I N G
3830 Pilot Knob Road Permit Number: 0 2 0 g 2 2
Eagan, Minnesota 55123 Date Issued: 0 4/ 3 0/ 9 3
(612) 681-4675
SITE ADDRESS: APPLICANT:
I.OT: 2 BLOCK: 3
4168 COUNTRYVIEW DR THORSON HOMES BRIAN L
COUNTRY HOLLOW 2ND (612) 454-0644
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION
FOOTING .A .
FRAMING DA
INSULA7ION FINAL
FIREPLACE
REMARKS: S& W PLBR - RAY HAEG PLBG
- - .t? ;.? ?
Addiess 4168 CqI1N1RYVIEW DRIVE Zip 5512 3
Lot 2 Blk 3 Sub !rnNrRV tirn.Tnw 2Nm
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 0 16 93 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (gazage) r/
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch ?
Basement finis6 f
Deck
Please verify wi[h the builder the removal of roof test caps from the plumbing system and the shuboff of water supply w
the outside lawn faucet before freeze potential exists.
Cont3ct engineering division at 6814645 before working in righFOf-way or installing underground sprinkler system. ?
White - City Copy Xellow - Resident Copy Pink - Contracror Copy
REACTIVATE _ RECEQQ/JED CITY OF EAGAN
PERMIT #, ' 993 BUILDING PERMIT
APR 2 7 1993 681-4675
---------------
APPLICATION -$5??W(0
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, l set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Valuation of work
Site Address: ?1 ? (1ucc") tr V/ e?c? ?O - w17
STREET SU[TE X
Tenant Name: (commercial only)
IAT ? SIACK ? SIIBD. P.I.D. k
?.i."?ccn T' /o
Descri tion of work: Wt5id ,c'ueY/o
The applicant is: ? Owner Contractor 0 Other (Describe)
Name 'T%n..?`sv.r) . /Je . Phone
Property UST FIRST
Owner Address &,,t /az-ooC1 lvxv-c ? Jaa?., rnci
STREET I STE #
City e!??4ae7Ai State X7.) Z/ Zip =6w/..,2?5
Company 7Aceso.? .C/om?s L.r.ec?, Phone
Contractor Address 44ZZ ldt -/6[c,oclc,l 1).ci?e License # "13 16 Exp.
City 4Q fn State ?rl U Z i p -6-/a 3
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Wx? .(fa- e. ? . Processing time for
?
sewer & water permits is two days nce area as been approv
I hereby acknowledge that I have read this aPplication and state that the information is
carrect and agree to comply ith all pplicable State of Minnesota Statutes and City of
Eagan Ordinances.
/
?
i
Signature of Applicant:
,
OFFICE USE ONLY
BUILDING PERMIT TYPE . _„
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? ??Fin9*
0 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex O 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 5F Misc. 0 10 Multi. Add'l. 0 15 Deck 0 20 Public Facility
? 21 Miscellaneous
WORK TYPE
JW 31 New 0 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair O 36 Move
GENERAL INFORMATION
Const. (Actual) V-N Basement sq. ft. MWCC System ImS
(Allowable) V- N lst F1. sq. ft. City Water lE%
UBC Occupancy R-3 M-I 2nd F1. sq. ft. PR4 Required
Zoning R_1 Sq. Ft. total Booster Pump
8 of Stories Footprint Sq. ft. Fire Sprinkler
Length ? On-site well Census Code !o/
Depth On-site sewage SAC Code
APPRQVALS -=?'-
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Oeposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
rotal:
sac % 1040
SAC Units (
? Footing
? Final
? f'rami ng
? Draintile
? Insulation
? Fireplace
vatuetim_ $ cl BjDba-
Gaa,ar '. -x:32-4'76g
? 7e Za : qO
Z I ??2 x y =?-' B94x1(e?
' ?9 xzz_ 63s
18X 26_ y68
tN,3o'i
?FKB = 3Z
I 13$ x ls"= Ir7,°'7°
IST FL?aarL
By?T_ )13Y
?yZxz9= 4y
i'?z x??rz ? ? i 6 s?
lyz xlarL = ?L
0
b
I
LOT SURVEY CHECRLIST FOR RESZDENTIAL
Le
'm N
SUILDIN PERMIT APP ICATI N
<
m ? >
¢
PROPERTY LEGAL: dflKT
a a W
U a m Date of Survey: ?.Q
S U)
a 2 DOCUMENT 3TANDARDS
IY 0 0 • Registered Land Surveyor signature and company
? ? • Building Permit Applicant
GY ?? ? • Legal description
? B'
8
?? ? •
? • Address
North arrow and bar scale
?
CY ? ? - House type (rambler, walkout, split w/o, split
lookout, etc.)
?v?f] ? : Directional drainage arrows with slope/gradient t.
0 ? Proposed/existing sewer and water services
v? y •
?
Street name
Q/? .
0
Driveway
ELEVATIONS
entry,
Existina
? L?l ? • Sewer service
[i??
? ? • Lot corners
? • Top of curb at the driveway
? ? • Elevations of any existing adjacent homes
Prooosed
?0
? • Garage floor
?? ? • First floor
?Q ? : Lowest exposed elevation (walkout/window)
D?Ja ? Property corners
fil? ? •
?
Front and rear of home at the foundation
PONDING AREAS (if aoolicable)
? B' ? • Easement line
0 fj]/ ? • NWL
? CJ?O • HWL
? nY • Pond # designation
? • Emergency Overflow Elevation
DIMEN3ION3
L?7? ? ? •
Q ? ? •
0 ? o •
X? ? 0 •
? ? .
Lot lines
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
Show all easements of record and any City utilities within
those easements
Setbacks of proposed structure and setback of adjacent
exi
Ret
Reviewed;
October 1992
E12-474-O677 L'r'I-1AN EXCELSIOR 'r'raF'eI7 422 F01 JUN 19'92 17:47
, r. ntnnt4u4n ??A?4 n.M•Y• ?Mr YI?Y4Man?4?r
BASE Q?? ? A TLR o( T
HO EBCY COD DL7lON_;... J?'
. Adap:lort bft?etlv? l{1/ 4
1. .
l++ner THE TUCSON
PIWne /
.. b
;ite Address E'?_ ? ?S? K&ae__V ????? ISCAWA &lM?s?? .
:ontracCOr._? i`: er. ?•., ? ? ,>.-,,,,_ ?s?n phCne
;uitding Classiflcatlon: Type A1 (Slnole Fa?i?y s Duplex) ? Type AZ (acsidential
?
(3 xtories nr ess
(Other) (pver ] storles)
ENERAL INfDRl4ATIQN "
. 8uilding Pertmater ft,
SC,,, 9 -? S`a9
, Wail height (ground to eave) vo,reeg ft, 3-'L~L z--4
'
N, 3 3 z
; ?? kr-C _
1. x 2. (abava) gross walt dno \CmO ft.
Building dimensions (L) _-?? x(W)??, ?-;??CQ ft.2 roGf S fToar area
Square fcot area of rfm joist - Ftoor jaist slze (2 x lo ?
1,o7_ a Perimeter - Rim o st area tZ
Doars - Area ?L?3. • '
Thic nescl'? ? n, actor` 04.7
TYPe ot Construct on .?? ?'erimtter tE.
ManufacWrer???
Tatnl door's perlmeter ' ft _
kindows: Nanufacturer?r? \ItK State approved_
u Factor
TTPE
?.0..5 _
5IIE AREA (F:,2)
EACH
CX
- Z? c?0 !C7- d ?
'IUMBER QF TOTAL FEET Z
UNf75
. Tota] ft.z Glass
? FlrepleCe dree: )iidth x heioht ¦??-?X? -. _?, Ft.2
. Exposed faundatton: He19ht x Perimeter _? x(?? ¦ ?t ? p Ft.Z
'LETIOH OF T11I2 FORtt IS 2EqUIRED FOit ALL kEU CON5TRUCTID9, MAJOR RENpDECIVIG ArfO QUllD1NGS DEII
:0 uHERE CHERGY, O7NER TNAY THE MIHIHAI CDOE ALLONANLE. I5 USED.
. .
• 612-474-05'
p• •{?? ??? ( ?, x • . ?
. *., • .
.* uAlt?
. s=to0
1 ,
F"
f ..
S ?.
snro
SECfTpH,.
?.:
? Y'. ?'.?-?•i
.'..] !.
L`i'I°1AFJ EXCELS I OR `r'ARD 422 F03 SUN 19192 1 r: 4F_t
• *3VLjjC T?'?xl ?? ,'y1 '`py{?/???µj.
? \, ??1???`???F ? ?•?'??[, ?;,?,I? {I)'' ?? 'IF?}n!)!T;xA ??
. (We11) V
• .?
•
s?.
w?? I
!:1suiAEtuf1 .
1 ' ? bQ . ,.
.
R i
3khin4.
?..?
L.. `.e+
.
,.
sidLnR
Jutridr air fllm .17
, .a
R TOTAL
? .i inslde atr Etlm
.69 ?
Intr: tot vfl l
uz C?
? •
`
??
?
?
.cud R= ?
?
??
'?'3?g-
tFS+?mcng? U »
? .? , . "-
' P
?h??khtng _oGa
Z !y.
; ?.
?
Stdfni .Gr7 ...' ? .?
quCsld• ait tiln .11 `- ? :
' 1\ • O! AL \ V1' ? ? ? ? ?'IT..I
. ? I .!I' ???I.''.1'.?: ?•:?1
Instde air i:lm
? - .
fneerior xail .4? . .
insuliitlon ' 64
1t )..; . ?..,.;
1`l;or5,
.Sh*+tthtng
?' •. ?.:. '. • -' :.:;;
Exterlor vall .qvvrino , 4'1
Excertoc air ((1ir "n .,li
R 70TAL
?..?.. r+.
'`.
?
1
1 tH
]OI5T
Intereur air (lim
+I
:r.sula:.ton
I? inch su[t xuud R=1,88 (RSm q? fj •?.? i 5t? 2. oG. joist) '-i
3Ip heath?"hg
•...:,
eer'lnr wall cvvertng •?? ::??}
&xter[or air fllm R+ .17
' '... asrorAr. 4(0
In[»rtvr air [!ln R'
? lnaula:lor,
r
?
.
.
Founetaeion {fdn
) U • tT•
I xterlor air [!ln R+ .17 .
;;•.;`z
t C?,"
?` F roTtiL
? Exputed 3lack
?A
r--? ,
•
`S ....? ` ,L:
612-474-0677 LYNAFJ EXCELS I OP, `(ARD 422 P02 JIJN 18' ?2 17 : 48
t
' Framing area ¦ 10X of gross wall area.
Grass wall aree ?.. ? (:?C) f`••z .
z
•wi?orr erea A ft. 1, windowi •_ .. 4'f 1J x A
Rtnm)oise area A rtt.z U Nm foist ¦_..o?- , U x A+
?
Daor area A____ Pc.'J door area *•?,"? V x•A
Fireplace area A? f.,z UfireplaCe > -?-- U xA ¦ -E3-
Exposed foundatton A ? 3.0 t*..? U foundation - .\ U x A• 'F-).03
framinq area A "?. C. ft.2 U franSng area a09 U x A¦ \a _ 44
het kall area A t. 'J wall U x" ¦ O?j
w
(139; -.?,-?L . . . . . . . . . . U x A
Gross Nall area x 0.11 (A-1 singie famiTy S du;,;=x ? a1loNable U.t A/Codp
(IJ. above)
x 0.23 (a-2 other resiCentis';
x .23 (O[her butlding;;
-c .28 (Qver 3 storfes) .
;!ust de larger than
x L' CG?e, ,.. , ?\? • ? ? 136 zbove
C211ing framtng area (Af) equals )0: af c4;ling area vr Lhe same as)
Gross ceil ing area +(l)___ .t?-? x-z- 9_ __,_ ¦
C 16? \ ??O ft.2
Jotst area (pt) ¦ 10; ceiling area ft Z
. •
Ne'_ ceillna area (.4C) (15A • 158) ft.Z
U ceiling ;c A c¦ Z-1
U framing x A t+ x_?? _
?
tetAL u x a . . . . . . .. ....... . .. .... .... . . . .. . .... . . . ? C6 _ 0's Ce111n9 aree (]$A) x 0.026 (A-1 single `amily 5 duplex - code allowable U x A
x 0.033 (A-2 other residz^tfa7) .
x O.C6 (other)
8o H?MUSt be larger [han 150 (above)
A f 1.5'?) x ?f.mqtj,?O?(a F (or the sdme ds)
r----
!IOTE: Use U and A vzlues ob[ained t?-om nps 1, 3 and 4.
.. ?
? 612-4 r 4 06 r r LYI 1AN E}:'CELS I OR YARD 422 F04 SUtJ 18' 92 17: 4q
W ,.?ry ? . ? 1~ ? b : ??? t' r;'rJy'( U•11 / ?Y'\ i ly,'i'?i
1? ?'•l? ? ,?r?, f? (. 1 fi'I?',1., ? .. ;r.'` : t :• ,. • . I .?n ?..??
141 w ' , .1 , . , . ?.
A1t` F1U
.. - -- - . ?.
':. , , ?\ •-i5 tnautation - 44 •2 ':-?
,;o1st
. ,- --- r?
Cattinq
?
LnsidR d{r fil
Cdi]in9
JoisC (stu _
Tnsutatlan
Air spact ?
Rcof dpckinq _
(nsuletlon
8u!)t*uo roo1'
Outside'ai.r fi
---?--?i!
a. unLuE CEIL[tiG
• To ti 1 R,,.?
? u
R• w?
ndoa tnfiltreticn ,5 ctm/linael tpot of crack
istden N A1 door inflltrat9on 0.5 cfm/square foot or deor and mtnimue code requtreirjent.
in-restdential daor infiltration 11.0 cfm/lineai foot of track
, 12" concrete bioCk no tnsulation =.41 R 2.1
, 12" contretig block inxtilated core; _.26 R 3.8
, 11 lightwsiQht block ¦.32 R 3.1
12" lightwoliht b16Ck irfsuTated cares =.12 4 8.3
singl*.glass ¦ }.lat rrlth;stom,rfndox .54
tlouble glass • .$5
tr1p1• qlass ¦ .4T '
1 exterlor xdlls and ceiling5 must have a vapor barrier (C.10 pErm rU.},
por barrler nNst De on ihe 1nOde (heate4 slde) of wali.
por barriers.of tht polyrGholene thin itlm have no R?alue.
I
0.°--..,. ?.- ?.....?.._
.0g4?4
A1r Fttm
Tptdi R
1 ?y
u
F! AT ROOF OR CATHEQlC14h a(?itIG
R'Ve T e .
FR;,Mti1G
;;.
--w?
"--^t
^ti?=k
?-
.
?f
- ?i
?:'?;
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
COND05 WHEN PERMITS ARE REQUIItED FOR EACH UNTT.
? NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE . J - Z -q3
FEES
HVAC: 0.100 M BTU $ 24.00 ?
ADDITIONAL 50 M BTU 6.00
GAS OLJTLETS (MINIMUM 1@$3.00 EACH) 4t 3•00 ?
ADD-ON/REMODEL (ExisrtNG coNSTRucr[oN) $ 15.00
STATE SURCHARGE .50 ?
TOTAL Z `7. 50
SITE
OWNER NAME:h1-(Qhq ?J ho??SON_? TELEPHONE #: Li CV) 1-{-
INSTALLER: K lPi1JP ? . °r tq-f (- I ?ct"Id .
ADDRESS:
CITY: liU.IC7? aYI r f STATE: !, I zip coDE: 553`47
TELEPHONE #: G ?J I - L4 o2I (
1993 MECHANICAL PIItMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
. 07 ?3
AUING PERMIT (RE
CITY OF EAGAN
3830 PII.OT KNOB I
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLIIVGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIltED FOR EACH UNTT.
NO. FIXTURES
SHOWER
WATER CLOSET
? BATH TUB
IL LAVATORY
/ KITCHEN SINK
,21 LAUNDRY TRAY
HOT TUB/SPA
? WATER HEATER
?2 _ FLOOR DRAIN
_i-3 GAS PIPING OUTLET • minimum - t
ROUGH OPENINGS
WATERSOFTENER
PRIVATE DISP. • nek.ay. uc.
U.G. SPRINKLER ' home under coast.
ALTERATIONS • to odsun8
WATER TURN AROUND
SITE
OWNER N
STATESURCHARGE
TOTAL:
,B-(.c.nf u 11,4,
EACH TOTAL
3.00 3.00
3.00 3.00
3.00 3. )tn _
3.00 /n , d 0
3.00 -?3 e) O
3.00 lo . D O
3.00
3.00 .3 , n O
3.00 /?. fs o
3.00 .00
1.50
5.00
15.00
3.00
15.00
15.00
.50
1-/, o0
" ! U fY/ /! A / A/ t l/
CITY
PHONE #: (
3
Alo_ STATE: 172/1I ZIP CODE: S,5?'2
? v 9 6 Ln- 6 07 O--l-
,Ai4vn,h-AZ
SIGNATU OF PERMITTEE
REACTIVATE _ ------
?ERMIT - VL?
? IL8 93
CITY OF EAGAN
1993 BUILDING PERMIT
681-4675
APPLICATION
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, l copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date /90 3_ Valuation of work
SiteAddress: NJ6$ Cm?„c?tz..?
STREET ? SU1TE #
Tenant Name: (commercial only)
IAT ?.. BIAC& ? SUBD. P.I.D. N
Descri tion of work: ol
The applicant is: ? Owner Contractor O Other (Deetribe)
Name (:;?r z 4 P-?? It 7 Phone 6 g/ -? 9T"O
Property LAST F1RST
Owner Address Cm?Lo?yvc-e"-v D?'
STREET STE-f
City State ?-'-?-?- Zip 5 S' z 3
Company Phone H?y- 3 S"75
Contractor R. O. CAN3TRUCTION
Address 980 STONY PoiNT ap. License # H9?? Exp.3 gF_
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 8 water licensed plumber . Processing time for
sewer & water permits is twa 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.
Si
f
gnature o
Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation
O 02 Sf Dwg.
? 03 SF Additian
? 04 4F Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
WORK TYPE
0 31 New
'O 32 Addition
0 33 Alterations
? 34 Repair
GENERAL INFORMATION
0 11 Apt./Lodging Y?? 1 Ba„se?at Finish ?
? 12 Multi. Misc. ` &1Swim Poc.l
? 13 Garage/Accessory O 18 Comn./Ind.
O 14 fireplace ? 19 Comm./Ind. Misc.
pr 15 Deck ? 20 Public facility
? 21 Miscellaneous
? 35 Tenant Finish ? 37 Demolish
p 36 Move
Const. (Actual) s Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2-3 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length ta' On-site well Census Code '43(1_
Depth On-site sewage SAC Code
/
APPROVALS ?
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site ' 0,Footing
? Wal l board ?Fi,nal
? Framing
? Draintile
? Insulation.
? Fireplace
Permi t Fee a 5. 0n
Surcharge gv
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies 1,00
Other
Total:
SAC %
SAC Units
vea.tta,: g
l.a* z., 8 c. 3;
':fpcw,-J.y NellacsJ Ztilz
Or
3830 PILOT KNOB ROAD TtiONAS ECAN
EAGAN, MINNESOTA 5 51 22-1 89 7 tmYa
PHONE: (614) 454-8100 DAVID K. G1157AFSON
FAX: (674) 454-8363 PAMEv' WCREA
TIM PAWIENiY
THEODORE WACHTER
Cancil Members
THQMA$ HEDGES
Cily Administratrn
October 29, 1990 EU6ENEVANOVERBEKE
Cay Clerk
WARREN ISRAELSON
PROGRESS COMPANIES INC
14300 NICOLLET
SUITE 235
BURNSVILLE MN 55337
Re: Hold on Buildinq Permits
Dear Warren:
The City of Eagan has put a temporary hold on building permits for
Lot 4, Block 5, Country Hollow Addition and also Lots 1-10, Block
3, Country Hollow 2nd Addition.
The pond lying east of Lot 4& 5, Block 5, needs excavation work
at the pipe outlet area where sand has accumulated due to upstream
erosion. This work can best be accomplished by access of Lot 4,
Block 5.
Lots 1-10, Block 3, Country Hollow 2nd Addition, are on hold
because of the lack of final restoration work in conjunction with
the retaining wall construction. These lots will remain on hold
till this work gets completed to the satisfaction of the City of
Eagan Engineering Department.
We hope this work will get completed as soon as possible.
If you have any questions pertaining to these items, please call
me at 454-8100. Thank you.
Sincerely, cc: Mike Foertsch, Assistant City
Engineer
Craig Knudsen, Engineering Tech
Steve Hanson, Assistant Building
Official
Stan Lexvold
Senior Engineering Tech/Construction
SL/jj
THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROYJfH IN OUR COMMUNIN
Equal OppoAunity/Attirmative Action Employer
954870
• COIINTRY 80LLOW BECOND ADDITION
PRESSIIAE R$DIICING oALVS AGRBEMBNT
i
This agreement, made and entered into the day
of 1990, by and between the CITY OF EAGAN, a
municipaYity of the State of Minnesota, (hereinafter called the
City), and the Owner and Developer identified herein.
The terss "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, Block 1, Lots 1-17, Slock 2 and Lots 1-10, Block 3 are
in a high water pressure zone and a pressure reducing valve shall be
insta7,led 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 i, Lots 1-17, Block 2, and Lots 1-50, Block 3. The Owner shall
provide and execute any and all documents necessary to implement the
recording of this agreement.
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 1, 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 agreement 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 ? OWNER AND DEVELOPi:R:
(Date: PROGRESS LAND COMPANY, INC.
l-
By:
its: PRed;De? w 7'
BV:
Its
,
Attest: . J. VanOverbeke
Its: erk
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this o2I-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 personally 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 affixad on behalf of said municipality
by authcrity of =ts City Council ar3 said Mayor and Clerk
acknowledged said instrument to be the free act and deed of said
municipality. .
y •Nire.r•in.r???a???u?r.H
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STATE OF MINNESOTA )
) ss.
COUNTY OF 11,? :'-'; )
On this N day of !A St , 1990, before me a Notary
Public within and f r said County, personally
appeared k./, i ;, r y:-A 7i r?`,, , ea?d to me
persona?ly , own, who being each-by me duly r?orn, edid say that
-the•- `r + resg?eet?e? the F? ( °,I d 77t
?and of the corporation named in the
foregoinq instrument, ____ ____..__ __ __:_ :..____..._.._ _..
Wie t ' ', and that said instrument was
signed arrd--aealen on behalf of said corpora ion kiy authority of its
Board of Directors and said rrS ???
"end-- acknowledged.said instrument to be the
free act and deed of the corporation.
i /l(tLl- : r"L "flfi. r'1
Notary Public
APPROVED AS TO FORM:
?
F,?.C-d, '' o C'? ?a
Public Wo s Department
Dated: ft..? l y yo
THIS 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
,A 0 L -575'l ?K.Q
APPROVED AS TO CONTENT:
RESIDENTIAL
-53 g'y y BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•881-4675
New Constructlon Beaulremente
• 3 registered sile wrveys showing sq. ri of lot, sq. fl. of house; antl II roofed areas
(20% meximum bt coverage alhwed)
• 2 copies of plan showtrig Ceam & window s'¢es; poured lound design, etc.)
• 7setolEnergyCalculations
• 3 coples W Tree Preservefan Plan 8 bt pla8ed aHer 711/93
• Rim Joist Detail Opflons seleclbn 5heet (blUgs wAh 3 or less untts)
DATE / /J V
SITE ADDRESS '
NPE OF WORK_
?
APPLICANT
STREET ADDRESS D 10
YIQ?VYA,-V1c
TELEPHONE # (4ta JXFS-U3MCELL PHONE #
I??a ?s
pamotleMeoelr Neaulrementa
. 2 copies of plen
• 1 set of Energy Cakulations lor heatetl addflbns
• 1 sife survey for exterlor addlHOns 8 decks
• Indipte 0 home servetl by septic syslem for addRbns
VALUATION , <O
MULTI-FAMILY BLDG _Y "
_ FIREPLACE(S) X 0 _ 1 _ 2
Kk) ZIP L? ?P
FAX #
PROPERTY OWNER 2^C.cno k uIIk TELEPHONE #`-M-0)-Ift
-- ° ° °-----------------------------------------------------------------------°-------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RUI.FS 7670 CATEGORY 1 MINNFSOTA RULFS 7672
(4 submission type) . Residential Vantilation Category t Worksheet Submitted ` estf
• Energy Envelope Calculations Submitted FR,7 UI_ 3 1 2002 II
Plumbing Conhactor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Conhacfor:
Phone ri
Phone #
Fee:
Fee: $70.00
---------------------------------------°-----------°------------------°------------------------------°----------------
I hereby acknowledge that I have read ihis applicaTion, state that the information is correct, and agree to comply
wiTh all applicable State of Minnesota Statutes and C(Ty of Eagan Ordinances,
Signature
OFFICE USE ONLY
_ Water Softener
_ Water Heater
Vo. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Bad
Air Conditioning
_ Heat Recovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
RPR-29-'93 THU 16:11 1D:SRMES R HILL !NC TEL N0:612 890-6244 #214.P92
SURVEYOR'$ CERTIFICATE
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MO7[: NO BPCFIC SpILS I!Nl9iGATION HAS 9u11 Cq/rLETEp
oN 1Mq LOT BY 7Hg f NOTE: ?RDI??
?l[Vpq. 7FB l?TA?,I?y pp
SOILS 10 8YPlORT 7H[ 4PnflC Mbt1?L Pltllblrt0 18 aYIOA?
' NOr T!E RE'.?ON91B4,lTY OF TM! EUHVttOR ?
? DENa7Ea^ PRpPO3ED SURFACE DRAINAGE a ION oommolm•
O DENOTES IRON MONUMENT SET SCAIE: 1 INCH - 30 FEEi
• DENOTES IRC?N MONUMENT FOUNp pROPO5ED GARApE FLOOR ?Eyly $ FEE7
X00p.0 OEN07E3 E7(ISTINQ ELEVATION PRQPOSED LOYYEST FLOOR - $LG.! pE3ET
(000.0) DENOTES PROPOSED ELEVATION PqOP03ED TOp OF BLOCK=93g,z FEEf
I WE HEREBY CER7IFY TO BRIAN THORSON THAT THIS IS A TAUE AND COqRECT
REPRESBJTATION OF A SURVEY OF THE 80UNDARIES OF:
Lot 2, Blcck 3, COUNTRY HbLLOW 8ECAND ADDITIQN,acoordlnq to thp rewrded plnt TlWo(,
I bokota County, Mhwspto,
IT DOES NpT PURPdRT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYEb BY ME OR UNDEFl MY DIRECT SUPERVISION THI3 20TH DAY OF A PRIL ,1993.
PnorosFo 6RaM *awM yXpE SIGNEDAM R. HILL, INC.
TAMN PRqA TNE ORON4 OiMpl- . ?
noe s Erallow aoNTRa. p.ANpp?•
CDwrpr FqLLOW sEtalo ionMl?lAI?D BY BY: •'?-?. r
oAfi??r• oN?a EKMNQ' W" LAST JOHN C. LAR30N, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
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PLANNERS / ENGINEERS ! SURVEYORS
2600 W. CTY. RD. 4:! • BURNSVILLE, MN. 65397 * 812-890-8044
BRIAN THpRypN
R-95% JAM&S R H[LL [NC 04-29-93 04:15PM P002 #37
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40 fr'93 TFN 16:11 ID:7AMES R H1LL INC
'I SURVEYOR'$ CERTIFICATE
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BRIAN THORSON
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sai.s nb surPortr n1i e?sa?c ? r??ereo ts
• Nff nc REVotoeLirr. of tHe suavrrae
DENOTE3 PROPOSEp gURFACE DRAINAGE
O DENaTES IRON MONUMENT SET
• DENOTES IRQN MONUMENT FpUNp
xooo_o oENOTEs oasnNa a.FVnnoN
(000.0) DEN07E3 PROP03Ed ELEVATION
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NOTE: 9tALDIN6 pA1p/90M5 SM01Y11 All[
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3CAlE:1 INCH - 30 FEET
PROP03ED GARAQE FLOOR -• 3'33 8 FEEY
PRpPOSEp LOWEST FLOOR -&LG. I pEET
PROP03W TOP OF BLOCK=934•Z. FgT
WE HEREBY CERTIFY TO BRILW 7}IpRSpN THAT TNI8 IS A TAUE AND COqRECT
REPRES9JTATION OF A SURVEY OF THE BOUNDAHIES OF: , ,
Loi 2, Brock 3, COUNTRY HOLL.OW SECANO QOPITION.acoordinq to thp recorded plnt ih"eot,
Dokota County, AMrwoola, %
IT DOES NpT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENT3, EXCEPT AS SHOWN. AS
SURVEYEb BY ME OR UNDER MY DIRECT SUPERVISION THt3 20TH DAY OF A PRIL 11993.
PnorosEo eRaqC? 3?awN wtpt SIGNED? M R. HILI, INC.
TA1I71 o11G1A pTNE 91MDIp,, CMM-
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MINNESpTA LICENSE NUMBER 19628
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James R. Hill, inc.
PLANNERS ! ENGINEERS / SURVEYORS
2600 W. CTY. RD. 4S1 o BURN3VILLE, MN. 65397 # 612-690•8044
JAMES R HtLL INC
04-29-93 04:15P![ P002 #37
411'
CityofEaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
/Z6/0 G� �
Permit Fee: /r1 -73-
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
J
Date: Site Address: Unit #:
Resident/
Owner
Name:
Phone:
Address/City/Zip: ctic04 COU►t,I r"ii€k) 1r. 5\1etvt. 41/W 5-5" /A5
Applicant is: Ar Owner Contractor
Type of Work
Description of work: p -- �
Construction Cost: O
vuv Multi -Family Building: (Yes / No) )
Company: /IeNM(" POtx+.e 541,7hoo Contact: 5/'187 MP 4,4
Contractor Address: 1-157 4 (5 }`T . E City: 454175
State: #%N Zip: 5033 Phone: (Si ti6Email: U shite M N.Ct4 Cowed Net—
License #: ,(/L 6 yo Lead Certificate #: ,i 7 —F108e/95--1._
If the project is exempt from lead certification, please explain why:
c 13,A \4- I I S `1
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:
Phone:
Fire Suppression Contractor:
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 the 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.gopherstateorTcalLorq
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 st be completed within 180
days of permit issuance.
x , lo►wtes geoNevtl
Applicant's Printed Name
p icant's Signat
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA148592
Date Issued:04/10/2018
Permit Category:ePermit
Site Address: 4168 Countryview Dr
Lot:2 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Gregory R Nitti
4168 Countryview Dr
Eagan MN 55123
(612) 201-2823
Pronto Heating & Air Conditioning
7415 Cahill Rd
Edina MN 55439
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature