4172 Countryview Dr?. - •+
W . . -..
(3';a*ftcate nf Cccupanc4
?it? o? ?agan
This Cenificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this struciure was in complrance witb the various
osdinances of the City regulating building construction or Wse. For the following:
SF DWG 1548
Use Classificaoioo: Bldg. Permit Na
Oavp-Cy'Iype Zoning Distria Coast
Owoer of Building Address ER, _ EN3W
41 /L UXA"3(YY1M a(1VL L1 , tS.S, ti
By? Adiiess L.ocality
jl/r ? O!/IS/93
Date:
- suddM offieW -,
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION REC4RD ? C°ntr°' "°. 1216
PERMIT TYPE:
Permit Number:
Date Issued:
SITE ADDRESS: 1.n7 .I 1511-0ch: ;4 APPLICANT:
41rCOUN71<YVIt'W DR 111Uft50N HONES BftIAN (.
CnIjMiNY Nt)lCOtJ ?Ni1 (Ci?.) 454-0644
PERMIT SUBTYPE:
•. + tMt,
TYPE OF WORK:
MEW
INSPECTION
? Ut? 1! IMI# ., .
F"tiAl1 J Nti .A
.. ?,.?r
1 N5!!t A t I L?N
F IMA! ?••
FIIdf.Pt ACE -'i
MF 014Ah1k 'S: F'f+V
& u cumiaar, ruR
Parmk No. Permk Holdor Date Teiephone •
SNY
PWM9ING
Hvac
ELECTRlC
ELECTRIC
Impwtbn Date hnp. Commamo
Foaings 1
Foundatior?
Framk?p
Rooling I
i
Rough Plbg.
Rough Htg. r? 2 1
?s??. „ Z
Fireplace S k c1AWO.,-,r-
Final Fttg.
d' d1i
Oraet Test 9G /id
I
Final Plbg. Ins - Notify Plumber
Const. Meter
EngrJPlen
BIJg. Final 1
Deck Ftg.
DeCk Finel
weli
Pr. Dlsp-
s
Hs?' I
RE?UEST FOR ELECTRICAL INSPECTION
r? ^ ?? See inslrucbons ior complating Ihis form on baok of yellow copY?
"X" F3elow Vvork Covered by This Request
?_.., en?s ao? TvoeolBuiltling ApplianceSWired
Compute Inspection Fee Befow:
nme. Fee
8oams
IOther Fee I
I, ihe Electrical Inspector, hereby
certify Ihat the above inspection has
been made.
OFFICE USE ONIY
fhls request voitl 18 monIDS imm
?A EB-00001?08
???? 3
Service
Yater Heater `
Oiher (Specify)
-
?
? e
urnace ?
4 r Cand none I
3cloie Remarks:
Service Entrance Size Fee # CircuRSlFeeders Fee
O l0 100 Amps
0 to 200 Amps Above 100 _ Amps
Amps
00
Above 2 _
ctorSUseOnly: ? T ?AL?q
THIS INSTALLATION MAY BE OR O( ISCONNECTED IF NOT
COMPLETED . WITHIN ONT .
/08f423
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BV THE STATE BOARO
UNLE55 PROPEF INSPECTION FEE IS
ENGLOSED.
Griggs-Mitlway BIAg. - Room rv+
1821 Ilnivenity A+e.. St Paul. MN 55106
phone1612)6C2-0BUO
? CIT,Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4172 cnuNTqvvTEw oR
LOT: 1 BLOCK: 3
COUNT'RY MdGLLOW 2Np
r'SUIL[J1NG
801598
10J22/92
DESCRIPTION:
'buildfn9 Permit 7ype SF CIWC ? B:u7,J.dinx'W?)i•k "i'ype NEW
LlBG Occup?ncy R-3 M--]
GonstYUCtion 'Typc V-M
ZtrCtfni} - R-1
BuIld'zrtg Length 62
Buiitl3ng WS.dCh 29
¢ r? a
tz/ 4? 811 . 4J
REMARKS: ? 0, ? 13 70
PRV S & W COiVTftAC'1"f]F2 -
F
FEE SUMMARY:
VALWATIQN
Base Fee
Plan Review
Surcharge
SF1C
SAC ?
SAC Unit:s
5ubtptal
$657 .00
$427<m5
$82.54J
$700.08
100
1
?i,tss6.5s
$105,000
MISCELLflNEOUS $1,6147.50
Tota1 Fee $3,447.05
CONTRACTOR: - Appl:icant - 5T. LI"OWNER:
THORSON HOMES BRIAN L. 14548644 0001.31 THOftSDN HOMES INC
0.466 WEDGEWOOD OR 4456 WEDGWOOQ DR
EAGAN MN 65123 EAGAN I"IN 55123
(512) 454-0644 (61.2)454-0644
T hei•eby ecknowledge that I have reatl this appYicatZon and state that the
information is correct and agree t'q comply with a7,1 appkicabte 5tats a'F Mn.
Stat'utes and City of Eagah Qrdinances.
L
?-
AYPLICA /P RMITEE SIGNA URE
? la ? Cif Ilbl1
r ISSLIE 8 : SIUIE-
Control No. 1216
INSPECTION RECORD control rvo. 1 ;5 16
CITYOFEAGAN PERMITTYPE: B u:r.1uzNG
3830 Pilot Knob Road Permit Number. 001,698
Eagan, Minnesota 55123 Date Issued: 10 / 2 2/ 9 2
(612) 681-4675
SITE ADDRESS: Lo i. : i BLo CK: 3 APPLICANT:
4172 COUNTF2YVIEW DR 'iHOF?SQN HOMES BRSpN L
CUUNTRY Hf7LLQW 2NI1 (612) 454-0644
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION
FOOTSNG .. .
Ff2AMING DA
INSULflI"I(JN FINAL
FIftEPLACC
REMNIRKS: NkV
I
?
S 6 W GONTRAGTOft -
7
J
Address: 4172 OOUNr_RyVIEV DRIVE Lot i Blk 3 Sea/Sub rT_Py HpLLpW 2ND ZIp; 55123
These items ware/were not completa at the tlme of the final inspe t n.
Date: 01 IS/93 Yas No
Final grade (6" from siding)
Permanent ateps • garage
Permanent staps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass i
Trail/curb damage
Porch
Basement finish
Deck
Please verify vith tha builder the ramoval of roof eest caps from the plumbing
system and the shut-off of water supply to the outside lavn faucat bafore
freeze potential exists. m
Vja?
White - City copy Yellow - Resident copy Pink - Contractor copy
PERMIT #
QEACTIYATE _
m9i
CITY OF EAGAN ti.? ;'.
1992 BUILDING PERMIT APPLICATION
681-4675 oC7 C 7 pECO IqSZ
SINGLE 8 MULTI-FAMILY 2 sets 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.
Penalty applies when typing of permit is requested, but not
picked up by last working day
of month in which re uest is made or lot chan e is re ueste once ermit is issued.
d
Date Valuation of work
Site Address:_ ??- ?? 2 r fPI?Yi AxiIlJiPI;Y n n
37REET ?
SUITE A
Tenant Name: (commercial.only)
IAT / BLOCK . 3 SUSD.Cf P.I.D. N
uc[nfY
Descri tion of work:
The applicant is: ErOwner O Contractor ? Other (Deseribe)
Property Name Phone
LAsT ?,
RS,
Owner
qddress
STREET SiE N
City State Zip
Company Phone
Contractor Address 4-&6 License #vcoi3 /G Exp.,3 si 9
City State ?ncJ Z i p .'3
Architect/ Company Phone
Engineer Name Registration N
Address
City State Zip
Sewer 3 Nater licensed plumber . Processing time for
sewer 6 water permits is two days once area has een approved.
I hereby acknowledge that I have read this applicatton 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:
OFFICE USE ONLY
BUILDING PERMIT TYPE
.
0 01 Foundation 0 06 Duplex ? 11 Apt./Lodging ?
?'I'6 (Tasement Finish
0 02 SF Dwg. O 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool
? 03 5F Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
)? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Additton ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWCC System YEs
(Aliowable) V"N lst Fl. sq. ft. City Water Es
UBC Occupancy R-3 M-l 2nd F1. sq. ft. PRV Required YES
Zoning R-1 Sq. Ft. total Booster Pump
N of Stories
- Footprint Sq. ft. Fire Sprinkler
Length To3
'- -0n-site well Census Code !ol
Depth dq, On-site sewage SAC Code ?L
APPROVALS
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
? Site ? Footing ? Framing ? Insulation
? Wallboard 11 fi nal ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
license
MWCC SAC
City SAC
Nater Conn.
Nater Meter
Acct. Deposit
S/N Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SaC ss 100
SAC Units ?
ve?unt;m: s r os. oa 0?
22 K22 =?-1 ?4 X/ 6 ?
6SM?? Q6u22= S`?2 •
?rgg,c 15=
53 3 I "14'1
?uw?=r?sKEUA,,S??'I x = i
29 K Z2, ?3? x33 = 210.5?f
7? U??
Sl§ Zp
Z 2 x ,Z9 : (
o3"?'a
I'/i K II ? /L
6`54 )4 53= 3y,66 -2-
j
512-474-0677 L1'11Ah4 EXCELSIOR 'YArp 422 P01 SLN 13' 92 17: 47
?w' .• y,. HiP1NL,?U1#1 ?tw1r ..+....-.. ..r..
Be5E ON r, A TER D
I10 ERGY 70-0-1-717
` Adap:l?n EfE?<tive ?(
].+ner
TION_.:...??'`
PhOne_ ^ato 6/,-r
?
?1 te AddreSS ?-Cr I ? hc..ock ,3 . ?cctNTl2y _{ ?c.r ??,tiJ ?ic?z? A ?i?'iU , •
. .
:ontrattor
iuitdtng Classlflcatlon: Type AT (51n41e Family 3 Duplex) 1/ Type AZ (Residenttal?
I (3 stortes ar ess
(Othtr) (nver ] StoriCS)
TNERAL INFORMATIOH ,
Bullding Perfmoter \ 44 ft.
1lnit hef ht
9 (9ri?und to eave)
.3o.c.t ,e,_,?ft, 7,? ?? -?33 z
z
1. x Z. (above) gross wall dr?? \Cop ft.
Buitding dimenslons (l) ?? x(k) 2.9 ¦???? ft.? rnof 3 floor area
. Sqvare fcot area aT rfm julst - F7oor jafit sixe (2 x lo ? z
ko,? x Perimecer - Rim o st area n?.?. ??=ft
?. Doors - Area
Thic n?scT" z" ,.. 9,`._?.."?D`??actor pG,
Type of Construc 5 Perimeter 1.??+ S?• ?,? ft•
PAnufacturer
. Total door's periaieter ft -
. Windows: Manufacturer !?: r r??tt\g State apprpved Usn?
U fictor_
TYPE
r?s, -
5IIE AREA (F:,2)
EACH
G
7 7
- 70?? !Q•O?
- c
g.iotai ft.2 Giass `7t,--\
"IUMBER Qf T07AL FEET Z
ilNIT5
7?=, Ct. o
V 4:? 9'z-a
2 M, _z
?cn,
06 Fireplace aree: Wfdth x hetaht ? a- x Ft z
-.?...-...? ?.?..
1. Exposed foundetlon: He19ht x Pertmeter ?, j x Fl.z
HPLETIOH OF TNIS FOithi 15 REQUTAED FOR ALL NEtt COi157RUCTIOY, MAJOR RE?tpOELING AfiO BUILOING5 HEI1
vED HNERE ENERGY. OTNER TNA4 THE FIIHIMAL rnnc aiinuarorc tK usrn_
612-474-O677 L`r'h1RN E:-'.CELSIOR `r'AP.D 422 P02 JUN 1e"92 1^r:48
Fram1n9 area - 10% of gross wall area.
Grass wall area -Z,
z
c
Windrn+ area A -z_-7-1111 .\`t ft. U wtndowS •_ _4'T t1 x A -
Rim`lJoise area A _rtt.Z IJ rim joist 0U x A * 4.V?
Door area A „
`i _ ft.? '
:1
door area + •O,`j
U
x•
A
* -Z? . aO
Firep]ace area A .f -.z U ,
fireplaCe ? -E?3-- U x a
-?-
-
Exposed foundation A 7:4? -O _P*..2 U faundatiark ¦ ., \ t! x A • ?.C73
Framing area A C, _ft,2 J franing drea ?.O U x A ¦?4
M1et xa11 area A qQ.'g-z,f C. J waTl ?C74'a U X %+ ¦ O?
(!?3; ":,;A L . . . . . . . . • . U x a i ` W?El
? Gross xa11 area x 0.11 (A-1 single family gdu;,;=x ? a1ToHable U.c A/CodB
(I3. above)
x 0.23 (A-2 other resiCentia`;
x .27 ;Q[her building.;
,c ,28 (3vei• 3 sto?•*es) ,
?"!ust be larqer than
A x l' Cp o e, ..__ . ?\? • ?'? C? 136 abave
Cziting framing area (Af) equals 10: of cs;l;na area or Lhe same as)
Gross ceflin area • C 16? 2
4 (L)___ x
Joist area .(Af) ¦ 10°, ceiling area cft. 2
Net ceitina area (.4C) (15A » 158) - {t.Z
U ceiling x A cs
U framinq x A f• fi 0-1?- C7,? xr_ ?''
tC1Al U x A ........................................ -Y- C??) . Oz
Ce111ng area (15A) x 0.026 {A-l single `amily S duplex - code a34muab-reU x A
x 0.033 (A-2 other residz^:ial)
x O.C6 (other)
BTUN Mu9t be larger Chan 150 (above)
A f15A) 0___ _x ?(codel= .O 0 F (or the same as)
C NOTE: Use U an9 a values obtained f,•om nps i, 3 and 4.
512-
,:., t ?r x
??•??M 1?y4??? ' .
.. :ti WAlfr
. SP•C7'IDN
i 4'
r?.
?. , ..
F..
.:. . .
i"
?
l.?
eLH
aqt5T
474 0677 LYhiF
. 14x
', .
?._.._.
r +
n r?• ' 1
! 1 . ?
J I
18"92 17:45
'({7*1l) U . '? ,..
5[dlnR
3uxrid? air fllm .17
,a
R 70TAL ZQ •Q ? •:?
lnsldr atr EilM
•¢R ;z
?
intu:lot vf11 •?? ''?'
?
?scud A' 'j=zw-? (Fr+M+[ng) LI . . ? + -
,
L IA•aCh1ng
? Sidfng
k
Uvt*lar ait Elln .17
i; -ornt
?
xnside air f:lnt
R' 68 ::+, i., , . ? ::; •,
Inter Gor uai l
.
. .
•
ina ul4 ttvn .
oC> ..
EWsll .
; ?;«
Sh*Athln8
ExCetrlor vall coverin$ , 4?'7.
.
: '
"i'
3
£xtrrior air (llir, n . .1 % . .
. ,
'': ..: .
. ...
. `' ` `•'`
R TOTAL ZZ
lnteriur air fli:n ?'
.68 _ •',:F?:r3
'. +
-,- .-?.
:esuln?fon 1?1•°0 ? . -
1? inch saft -auud R=1.88 (Rfm U
Jo1st) '
.
I?h aihMg -
:
.:.?,,.
?'
_?''titerlor walL cuvertns =• .?
•
Sxteriar •ir film
RN .17 .<;i
ar rorAr.
lnt"rtor air ftlh R' .6E
? lnsula:lor, y?
FounJae i un
(fdn. ) IJ l. .. :,?..,
b"?x[erlor air tlln a* .17 ""`?•
F TOTAL
.. i
I "fxpofrd 3lvck
.i=
--+ ,
? I• ?-,.. ?fAdP d. _
EXCELSIOP YARD 422 F03
'f ?' .%A?•?y'M/' 17?1?(?
?? . ?.
??_?aY?? ?ACeY?i?!' VMi?? .?•??--v?`? l ?t . taC?
612 474-067 r LYI 1F1N EYCELS I OR YARD 422 P04 JUN 18192 17 49
t' r 4?Af?K? ?? ' ?~ i7u ?t?. .{r; ?j, {?•?ti? ?? , ? r`?, , .{,i',bj't t
1 i 'ft?t 7r ?1 i
i
r,? y I
+. J N . 1.' ii
1 _f??'^ ?.• , ) j. . ' . . Q`?
.. _0,e1 Air rffi ?7
cnsutecion 'a -
. ?. 4.3% JOiSt
.t
Cs911n9 ? 47 •.
0.E1 Air film
?
.:
insidQ dir fi1
Ceiling
Jqist {stu _
Insulation
A1r sp;ce ?
Koot drtckinq _
Insulation
8utlt•uO roof
Outside:alr #i
Toti1 R
R ? U -
? ? .
l.lndow lnftlcraticn .5 cfm/ltneal foot of crack
}qSidentidl door tnfiltration 0.5 cfm/square toot or dcor and mtnimue code requlrertient,
iOn-r*SiCentlal dabr tnflltration 11.0 cfm/ifneal foot of track
fg 12" concrete bioCk no Insulation =.41 R 2.1
1b 12" concreLg 61oek lnsulated cores 2 .26 ; 3.8
4 11" iightwsight blOtk =.32 R 3.1
!b 12" ligntwsfght hlotk irfsulated cores =.12 4 3.3
! sinylv glass ¦ 1.13; w1thscom.
Nlndcs+ .54
f tloubie glasf ,
¦ .55
7 tripl• qless - .4i .
l11 axterlor walls and ceilings must have a vepor barrier (C.10 perm r,.ix.).
.4par barrler Must 4e on the inside (hented side) of wall.
ippOr barrtars pf th! p6lyrGhelane thin t11m have nv R valve.
, ;1
ri
a-I Totai
1
?oz4•.?„ u ° A
R
F!.4i ROOFTp'e R CAtH6D?Al G?II?It1G
?4"a u '
- FR;,HtNG
L_/. BL ? CITY OF EAGAN
SUBD. 75
P(612)N 681-E46
RSSIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST ?
?:DD ON _
REPAIR
CITY USE ONLY
RECEIPT # 8"5 03
DATE
ALSO, FOR TOWNHOMES AND CONDOS
OWNER NAME: .? ?•?? ??a/
SITE ADDRESS': Y?
INSTALLER: a Sr_ c?:P?
ADDRESS:
CITY: ZIP:
COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
REYAIR/ADD ON 15.00
? SHOWER 3.00 3• _
WATER CLASET 3.00
I BATH TUB 3.00
-
3
T LAVATORY 3.00 /o. -
? KITCHEN SINK 3.00 3 -
I LAUNDRY TRAY 3.00 3, >
HOT TUB/SPA 3.00
l WATER HEATER 3.00 3?
I FLOOR DRAIN 3.00
-
30
GAS PIPING OUT.
l (MINIMtTM - 1) 3.00 3• -
,L ROUGH OPENINGS 1.50 4. SD
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
STATE SURCHARGE .50
TOTAL: S329•60
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTIDN:
OWNER NAME:
SI:'E P.DDRES3:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CI11':
PHONE #:
FOR:
CONTRACT PRICE:
1% Or C025YRACT FEE.
STATE SiIRCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MYNIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
ZIP:
TOTAL:
$
$
(SIGNATURE)
CITY OF EAGAN
PHONE jj: TIrilo (oOGJ -1?
CTTY OF EAGAN
L? . 3 ? MECHANICAL PIItMIT
SUBD r (612) 681-4675
- RESIDEIVI7AL
xECEIPr # /0850?F
DATE I / - -- ?
-J7
PLEASE COMPI,EfE UPPER PORTION ONLY FOR SINGLE FAMII Y DWELI.IIdGS. ALSO, COMPLElE FOR
TOWNHOMFS/CONDOS R'HEN SEPARATE PERhIITS ARE REQUIRED FOR FACH DWEiJdNG UNTC.
OR'NE$: Brian Thorson Homes FEES
SITE ADDRESS: 4172 Countryview Drive ADD ON/REMODII. (F.7QSTIIVG
CONSTRUGTION ONM $ 15.00
INSTALLER: Kleve xeating & Air Conditionin HVAC: 0-100 M BTU 24.00
PHONE #: 941-4211 An1117'If(*NAi. cg M BTST 5.00
ADDRESS: 13075 Pio GAS OUTLEfS - hIINIMUM 1@ $3 EA, 3.00
Crl'y; Eden Prai ' ZIP:55347 SURCHARG& $ so
SIGNATURE: TOTAL: $27. 50
COMMERCIAL
PLEASE COMPLETE THLS PORTION FOR ALL COMMERCIAUINDUSfRW. BUII.DINGS. ALSO COMPLEl'E FOR
APARTMENT BUILDINGS OR 01'fir R IVi r;JLT;-; AAZi:,Y -!':jM.DII':GS P/H£N SEPARATE PER;UCS ARE NOT REQUIRID FOR
EACH DWELLING UNTC.
WORK DFSCRIPTION: 11 CONTRACf PRICE: I FEES
1% OF CONTRACf FEE. ?
STATE SURCAARGE IS $.50 FOR EACH
$1,000 OF PIItMTf FEE. a
Y'RUCEJSEii 'Yli'itlir ' 40•00
. I
$
MINIMUM FEE • $25.00
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCfION
? ADD-ON A/C
A7U-vIy F'JRN,4i E
DATE ? ?? ?9 ?
HVAC: 0-100 M BTU
ADDITIONAL SO M BTU
GAS OLtTLETS (MINIMUM 1@ S3.00 EACH)
ADD-ON/REMODEL (EXISTING CONSTRUCTION)
STATE SURCHARGE
TOTAL
SITE
"tve_
FEES
$ 24.00
6.00
$ 15.00 j(.50 jC
15. 50
OWNER NAME: TELEPHONE #: L'Is5 y- a Qt-i "
WST
ADD
CTTY: Eje_.? Qrqk(iSTATE: M? ZIP CODE: 553u `7
TELEPHONE #: qL'Ik-L'I.f??k t. ?fIG V?*? ?6// IF 3 PIZ/
OF
iY» rcacm.l kxcnwrr'% aarw)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
e
. " 4ITY OF EAGAN
PERMIT
TO WORK WITHIN CIT'Y PROPERTY/RIGHT-OF-WAY/EASEMENTS
1. Location LtDl (.OUt??F?rb?iG?J li?j:tUC, LO'f'
r
2. Nature of Work )r?-11UKL-i? ??rSrCuN
Page 1 of 5
l O?
.2NUADD
3. Indicate helow items to be affected and include a sketch or plan of work to be done.
Curb & Gutter Street Surface
Trail/Sidewalk Trees:
Pond/Wetlands Public
Traffic Control Devices/Signs Private
Drainage `Utilities
Structures/Buildings Other nK I2 r sy S?? n
4. Method of Installation or Construction
5. Work to start on or after: 9 Za and shall be completed by: G1 z? unless an
extension granted to: by:
DATE STAFF/DATE
6. Will detouring of traffic be necessary7 If nec essary to detour traffic,
describe suggested route:
DETOURS: The Director of Public Works shall be notified in writin g at least 72
hours in advance of any detour being established, changed or discontinued.
NAME OF APPLICANT I\lC-K G-0 0 0-3 z I I PHONE (5:?3 'ZSS
PLEASE PRINT
nnnREss ur?z Cc.>?,???.?rv?zw 6n,we- E4 C-ati
1171711/
S5iz3
STREET CITY STATE ZIP
NAME OF PARTY OR ORGANI77T??,,TIOL PERFOR7MTi NG WORK f?ICI? ?• C)C,(5t?I1
?
raoDS`?? EMERGENCY (24 HR.) PHO
CONTACT PERSON: )A IiU NE
ADDRESS 'll"1Z 'uu„ i=I'kt(Cw fIK tl?AL44/ iMN SsIZi DAYPHONE (cA3-YZSS
STREET I CITY STATE Z1Y
The undersigned herewith accepts the terms and conditions of this permit by the City of Eagan
as herein contained and agree to fully comply therewith to the satisfaction of the City of
Eagan.
! /
Signed: Title: ?iN.r/+e- L- DATE: z i3
FOR CITY USE ONLY AUTHORIZATION OF PERMIT
FINANCIAL SECURITY: AMOUNT:
Fee: $lYDhe- Receipt No. N IIA
-
TYPE:
(Cash,bond,IAC,etc.)
Permit No.
In consideration of agreement to comply in all respects with the regulations of the City of
Eagan covering such operations, and pursuant to authorization duly given by said City of
Eagan; permission is hereby granted for the work to be done as described in the above
application, said work to be done in accordance with special provisions as hereby stated:
APPROVED BY: DEPT. OF PUBLIC WORKS
sY:? ? & Se?f y9, l?l?3
/DATE
ALL LEGAL REQUIREMENTS SHOWN ON REVERSE SIDE AND ON ALL "SPECIAL PROVISIONS" TO BE COMPLIED
WITH! THE DATE WHEN WORK IS COMPLETED MUST BE REPORTED TO THE EAGAN CITY ENGINEER.
t. ?
Permit No. Page 2 of 5
PERTINENT REGUTATIONS
Safety
1. Traffic shall be allowed to pass and to be protected at all times. If it is not
possible to allow traffic to pass, a suitable detour must be provided and plans
submitted to the Director of Public Works 72 hours in advance.
2. Barricades shall be erected in a manner which will provide suitable visibility in all
directions. All barricades shall be in good condition, and all signs shall be of such
size and legibility to provide adequate warning to oncoming traffic. At least two 7"
flashing amber lights shall be mounted on each end barricade with one on an advance
warning sign.
3. Excavations must be shored or sheeted when necessary to prevent undez-mining of
roadway, trailways, utilities, or for safety reasons.
4. Guys or stays shall not be attached to trees on right-of-way or ptivate property
without written permission.
5. Flagmen shall be furnished by the party or organization performing the work whenever
the work being done creates a hazard either to the traffic using said road or the
personnel engaged in the construction, or when directed to do so by the City.
OPERATIONS
1. Permit on Job--Permits or copies shall be kept on the site of the work while it is in
progress in the custody of the individual in charge, and shall be exhibited upon
request made by any City official.
2. Provisions and Specifications--These general provisions, specifications and Std. Plate
P-1 shall be considered as forming an integral part of each and every permit issued for
operations mithin Eagan. The work authorized by this permit shall be done at such time
and in such manner as shall be consistent with the safety of the public and shall
conform to all requirements and standards of the City. If at any time it shall be
found by the City that the work is not being or has not been properly performed, the
permittee, upon being notified by the City, shall immediately take the necessary steps,
at his own expense, to place the work in condition to conform to said requirements or
standards.
3. Execution--The permittee shall use diligence in the execution of the work authorized
under this permit in order not to endanger or unnecessarily obstruct travel along any
road or trailway. Operations shall be so conducted at all times as to permit safe and
reasonable free travel over the roads and trailways within the limits of the work
herein prescribed. All safety measures for the free movement of traffic shall be
provided by the permittee at his own cost.
4. Conformity to I.aws--The installation shall be made in conformity with all applicable
laws, regulations and codes covering said installations. All installations shall be
made in conformity with regulations of governmental agencies for the protection of the
public.
a. The applicant shall furnish a bond or financial guarantee in the amount to be
determined by the City which is required to ensure adequate & timely completion
of repair. This bond or financial guarantee shall remain in effect for 2 yeazs
subsequent to completion of street repair to protect the City from defects in
material, workmanship or non-compliance with City Standards or specifications.
Permit No. Page 3 of 5
?
b. The applicant shall furnish evidence of public liability insurance of not less
than $100,000/300,000 and property damage of not less than $25,000 issued by an
insurance company authorized to do business in the State of Minnesota on which
the City is named as an additional insured party.
c. Except for the negligent acts of the City, its agents and its employees, the
permittee shall assume all liability for, and save the City, its agents and its
employees, harmless and defend same at its sole cost and expense from any and all
claims for damages, actions or causes of action arising out of the work to be
done herein and the continuing uses by the permittee, including but not limited
to the placing, constructing, and reconstructing, maintaining, protecting and use
of said facility under this application and permit for construction.
5. Existing Facilities--The utility facility and installations shall not interfere with
any existing utility facility on the City's right-of-way or easements. It is the
responsibility of the applicant to call for necessary locations of existing utilities.
(Gopher One 454-0002)
6. Private Property--The work permit or permit for construction as issued does not in any
way imply an easement on private property.
7. Quality of Work--Finished surface, base and sub-base of road or trailway upon
completion of work shall be at least equal to or better than specifications of
originally provided road or trailway in accordance with City Standard Specifications.
Surface shall be finished within 48 hours upon comvletion of backfill
8. Cutting Trees--The permission herein granted does not confer upon the permittee tha
right to cut, remove or destroy trees or shrubbery within the legal limits of the
right-of-way, easements that are not specifically identified on the plan attached to
this permit or relieve permittee from obtaining any consent otherwise required from the
owner of the property adjacent thereto.
9. Drainage--All waterways and lines of drainage shall remain operative.
10. Pole Anchors--Pole anchors, anchors, braces or other construction will be permitted
within right-of-way or easements and will be approved on a case by case basis.
11. Driving Limitations.
a. Dxiving or parking on City trails or sidewalks shall only be permitted for those
operations requiring direct access to the boulevard area.
b. Vehicles operating or parked within the right-of-way area shall utilize their
warning flashers at all times.
c. Vehicles driving on trails or sidewalks shall not operate in excess of 5 miles
per hour. Vehicles shall operate at slower speeds when weather conditions, trail
conditions, poor visibility, obstructed sightlines or other conditions require
special precautions to ensure the safety of trail users and the general public.
d. Driving shall not be permitted within those boulevard areas where damage to turf
trailways or other infrastructure may occur.
e. Vehicles shall not be parked on trails or sidewalks in such a manner as to
unnecessarily impede the safe and efficient use of txailways by the general
public.
Permit No. Page 4 ;tf,5
12. Vehicles or equipment traversing roads or trailway surfaces shall not utilize studded
or chained tires, caterpillar traction, or any other form of traction which will result
in damage to the surface.
13. Clean-Up--Street, trailways and affected right-of-way shall be scraped clean at the end
of each work day and swept clean after construction is completed and left in a neat and
presentable condition.
14. Trees and Vegetation-Burning or disking operations and/or the use of chemicals to
control or destroy trees, brush and other vegetation is prohibited without prior
approval from the City.
15. Replacement of Sod--Wherever top-soil and sod are disturbed, they shall be replaced and
maintained satisfactorily until the turf is established.
The undersigned hereby declares he/she has read and will comply with all the PERTINENT
REGUTATIONS as stated above and relevant City Ordinances.
DATE: / ZL-23 SIGNED:
?
Revised 5/93
LTS#1-PERMIT.FM
. ? ?
PROPERTY LINE ?
PAGE 5 OF 5
SAME AS REMOVED
(3" MINIiiWA)
SAME AS RfiMOVED
(6" MINiMIJM)
1. Curb and Gutter shall be removed only after saw cutting at joints and replaced
according to specifications or Standard Plate.
2. Bituminous pavement area removed shall be saw cut prior to patching.
3. Boulevard sod removed shall be replaced with minimum 4" of topsoil and cultured sod.
4. 2341 bituminous wear course shall be paved between May lst and November 15th for
permanent patch. Temporary cold mix patch should be used November 16th to April 20th
(or as permitted by weather).
5. Class 5, 100% crushed aggregate base.
6. Roadway closures in accordance with Appendix B- Traffic Control for street or highway
work zones - MnDOT/MiJTCD.
7. Bituminous trailway closure requirements same as roadway in #6 above.
8. Backfill shall be thoroughly compacted by the "Specified Density Method" of compaction.
All suitable backfill material placed below a depth of five (5) feet below the final
pavement surface shall be placed in maximum lifts of twelve (12) to eighteen (18)
inches and compacted to a minimum ninety-five (954) percent of ASTM Specification D698-
64T (Standard Proctor Density), method "A". All suitable backfill material placed
within five (5) feet below the final pavement surface shall be placed in lifts not to
exceed twelve (12) inches and compacted to a minimum of one-hundred (100%) percent of
the above ASTM Specification.
il o1 ea $n STREET AND BITUMINOUS TRP,I! WAY a roved : standard
CY 9 pp plate #:
P U B L I C EXCAVATION/PATCH DETAIL
5/93
?
woRKS
DE PARTMEN TRAFFIC CONTROL REQUIREMENTS P-1
TRAiLWAY I
liliplcitV oF eagan
?",-..?-f`'=?'.,. lIC? I ? ? ? , Q P'0 ?.?i...?^'
THOMASEGAN
Mayor
May 24, 1994
RICK & SALLY GOODSELL
4172 COUNTRY VIEW DRIVE
EAGAN MN 55123
Re: May 6, 1994 Correspondence
Country View Drive & Country Side Drive Street Reconstruction
Associated With Ditfley Road Reconstruction
Dear Mr. & Mrs. Goodsell:
PATRICIA AWADA
SHAWN HUNTER
SANDRA A. MASIN
THEODORE WACHTER
Council Members
THOMAS HEDGES
City Adminisfrator
E. J. VAN OVERBEKE
City Clerk
I am in receipt of your May 6, 1994, correspondence identifying concerns which you state have caused you
great frustration and anger.
The Diffley Road reconstruction proJect, which affects the area of Countryside Drive and Country View Drive
directly adjacent to your property, was approved on March 17, 1992. I realize that this date is prior to the
July 23, 1993, date on which you said you purchased your property at 4172 Country View Drive. You stated
in your correspondence that you found it was odd that after contacting the builder, Brian Thorson, and both
real estate agents involved in the sale of your home, that none of them were aware of any of the proposed
changes which Mr. Stan Lexvold had identified to you at your home on April 6, 1994. State Law requires
that all properties that will have a potential assessment must be notified of the proposed improvements. In
reviewing our files, we find that your property was not notified because no assessment is proposed for your
property.
WRh respect to item #1 in your correspondence, the area directly westerly to your property is public street
right-of-way. During the initial development of the Country Hollow 2nd Addition, it was anticipated that
Country View Drive would be extended southerly and connect to Diffley Road with future development. This
development will not occur and this street extension is no longer necessary. It would seem that a private
driveway would have much less impact on your property versus a public street connection to a County road.
Item #2 has been greatly mitigated through the efforts of Stan Lexvold and his conveying your concerns
to the City's Parks Department. The City's Parks Department has agreed to plant shrubbery east of the
bituminous trailway which will result In a barrier between the trailway and the future driveway of the
proposed lot lying south of your residence. If additional landscaping is desired, this would best be worked
out cooperatively between you and your future neighbor.
In Item #3 of your correspondence, you feel the City is responsible for extending your existing sprinkler
system. Privately owned sprinkler systems in City public right-of-way are allowed only by permit by the City.
This permit states that the property owner may install a sprinkler system in public right-of-way with the
understanding that if the City needs to modify the existing public right-of-way in any form, the property
owner is responsible for any modifications to a sprinkler system which the property owner has installed
wi[hin City public right-of-way.
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122-1897
PHONE: (612) 681-4600
FAX: (612) 681-4612
TOD:(612)454-8535
THE LONE OAK TREE
THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY
Equal OpportunityJAfflrmative Actlon Employer
MAINiENANCE FACILITY
3501 COACHMAN POINT
EAGAN, MINNESOiA 55122
PHONE: (612) 601-4300
FAX: (612) 681-4360
TDD:(612) 454-8535
lat
Page 2
Item #4 identifies a guarantee that the driveway will be installed as specified in the sketch. Mr. Stan Lexvold
has talked with you on a number of occasions and has stated that the driveway installation would be
performed in a similar fashion to what is shown in concept on the attached sketch. Mr. Lexvold will do his
best to assure that this construction in fact takes place.
With respect to the construcHon involving the walking path, the area disturbed by the City contractor in
installing the trailway will be sodded. The area which is disturbed as a result of the home construction on
the southerly adjacerrc lot to your property wiil be the responsibility of the builder/property owner of that
particular piece of property.
Your correspondence mentions plans for the construction of a park at Ditfley and Highway 3. The Cfty has
no plans for the constructlon of a park in the Diffley Road/TH 3 area. The properry iocated at the northwest
quadrarrt of Diffley Road and TH 3 is currently zoned Agriculturel with the Land Zone Guide Plan designation
of Neighborhood Businass. The aforementioned parcel is being graded as a part of the development of the
two ponding areas for future sale by the City.
Your correspondence mentions erosion of material which has caused damage to your backyard sod. Mr.
Lexvold is currently working to assist you in resolution of this matter w(th the adjacent property owner.
If you have any additional questions or need additfonal information, I urge you to contact Mr. Lexvold at 681-
4646. Please be assured that the City of Eagan takes your concerns seriously and commits to working with
you to help resolve them.
Sincerely,
Thomas A. Egan
Mayor
TAE/jj
cc: Tom Hedges, Ciry Administrator
Tom Colbert, Director of Pubiic Works
Stan Lexvold, Construction Supervisor
Enclosure: Sketch
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` - - -----. - - / ? ? - - - ?- EX. DRIVEWAY
COUNTRYSIDE I ?-- --
DR. PROP C&G ?
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EX. C&G -?- ---
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C EiG TO BE RCMOVED
E- PROPOSED DRIVEW1IY
OUTLOT A
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AREA TO BE LANDSCAPED BY CITY
city of eagan apnroved; standard
r PUBLIC plate
? WORKS
R-??? DEPARTMEN
? i
May 6, 1994
Mayor Tom Egan
City of Eagan
3330 Piic'. Knob Road
Eagan, MN 55122-1897
!I rII9Y a
i_
°-_
Re: Reconstruction of Streets - Countryview Drive and Countryside Drive
Park,lNildlife Area at DifFiey and Highway 3
Dear Mayor Tom Egan:
We purchased aur home at 4172 Countryview Drive on July 23, 1993. Prior to
doing so we contacted the City of Eagan with our concerns of the dead end street
to the south of our home and also the plans for the construction of the Park.
Relayed to us was that there would be a wildlife park seiting and a walking path
through the middle of the two pond areas. None of these plans included any
mention of reconstruction ofi the iwo drives Countryview and Countryside to
accommodate the park area, only that the road would remain a dead end. This
+roas very appealing to us in the decision of the purchase of the home as it was an
important factor that this would be a safe location for our children to play in.
On approximately April 6, 1994, Stanley Lexvold, Construction Supervisor for the
City of Eagan, came to our home to inform us of the reconstruction plans for the
Park area and the two drives, Countryview and Countryside. Stan stated that
these road reconstruction plans were entered in to the City ofi Eagan's record
books in February 1993, but without rrention of the proposed driveway. We were
quite shocked and concerned to say the least of these plans as it was only 9
months after we purchased the home and these plans were not mentioned to us
when we contacted the City prior to our purchase. What we found to be odd after
contacting the Builder, Brian Thorson and both Real Estate Agents involved in the
sale of the home, none were aware of any of the proposed changes.
We are protesting the issue because we feel the plans for the reconstruction of
the road and the future driveway to the lot to the south of our home will greatly
effect the appearance and safety of our fot. Enclosed you will find a sketch which
Stanley Lexvold has given to us of the proposed plans for the project which is
Page 2
Mayor Tom Egan
already underway. Our concern with this sketch is thai there is no specific details
or guidelines defining widtii and footage of the driveway as weli as a required turn
around on the lot south of our home.
Points that <ve would like to make which greatly concern us are the following:
1. The vacant lot next to our home (which is in the process of being platted) will
have a driveway which will cross through our front yard. This is a strong objection
on our part as it will impose a safety hazard as well as take away the appeal of
our home should we choose to sell in the future.
2. The eight foot black top vvalking path which will be finished soon, 2s Yhe pians
show it tc be, will be right next to the future driveway. Again, ancther safety
hazard in our opinion. Stan Lexvold has mentioned that there will be bushes
planted and a incline implemented between the walking path and the future
driveway. We fPel because this will affiect our front lawn with people walking and
future neighbors driving on the proposed driveway, that tnESe bushes should be
added to our property as well.
3. Our sprinkler system, which we installed last fall, will need to be extended to
the end cf the property line after completion of the project at hand. We already
had to move one head due to the road reconstruction and we don't feel that we
should be liable for any costs incurred to the system due to these new plans.
4. Can we be guaranteed that the driveway will in fact be installed as specified
on the sketch?
5. In the process of the construction of the walking path the plans are to install
sod from our property line up to the walking path, covering the area of the future
driveway. This would mean that when a home is buiit, the sod would be ripped up
to construct the drivevvay. Wili be guaranteed that the driveway and sod
reinstallation will be done to specification as we have been made aware?
In the process of the developing o( the Park at Diffley and Highway 3, drainage
reconstruction began the middle of April which entailed installation of a drain
system behind our home on top of the hill. On April 26, 1994 there was a heavy
downpour of rain which caused erosion of the mounds of dirt which the work
Fage 3
iv1ayor Tom Egan
crews had created in the process of the projeci. Consequently this caused the
water to floNi down to our backyard, leaving our sod with large piles of dirt and
rock covering it. And also for the first time since the construction of our home
there was water seepage into our basement This was confirmed by our builder
that the house, which stood vacant for one year, never had incurred a water
problem prior to the reconstruction of the drainage system project.
We contacted Stanley Lexvold on Aprii 27, 1994 about this incident and he came
out and inspected our yard ard insured us that the damages would be completely
repaired. Stan stated that he would contact the Contractor af the project and
Developer in regards to this issue. On April 27 we aiso contacted the office of
Tom Hedges to report this incident, Holly Duf(y responded on April 28 saying thaY
they were aware of the problem and that Staniey was handling it but to call her
with any future problems. As of today, May 6, 1994, we have not been contacied
with a date when repairs will be tended to.
Our drainage system was installed by the builder/developer and in working order
up to this Spring. It currently is set up to drain to the south of aur home which
incidentally runs right through the vacant lot south ofi us. If the vacant lot has
to be elevated to buiid a home on, will this cause drainage problems for our lot?
We have contacted our insurance Company in regards to claims for water
damage which they do not cover, we want to be sure that this seepage problem
will not happen again due to the drainage system that is being installed currently.
This letter comes to you with great frustration and anger. We feel that our rights
as home owners have been violated and that we have strong reason to protest.
We sincerely hope that our best interest will be part of the completion of the
proJects in the works and that we will be made aware of any further future plans
which will invoive our property. Your expeditious attention to the repairs already
incurred to our lot would be greatly appreciated as the spring/summer outdoor
months are here and we would like to enjoy our yard.
Sincerely,
L ?41'?J
cc: Tom Hedges, City Administrator
Stanlav I axvnlrl r.nnctriirtinn Siinarvicnr
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EX. DRIVEWAY
COUNTRYSIDE ?-- - -
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OUTLOT A
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.....................
...............
AREA TO BE LANDSCAPED BY CITY
City of eagan an?roved: standard
? ??? PUBLIC Plate
WORKS
DEPARTMEN
954870
O
COIINTRY HOLLOW 88COND ADDITION
PRE88IIRE REDDCING VALVE AGRSEMBNT
i
This agreement, made and entered into the day
of ?-?-?L- , 1990, by and between the CITY OF EAGAN, a
municipal?ty 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, Block 2 and Lots 1-50, 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.
I
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.
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, paraqraph 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
r e? OWNER AND DEVELOPi:R:
Y
INC
(Date: ,
.
PROGRESS LAND COMPAN
Bxf- Th mas A. By: la
Its: Mayor its: PW'.r?LY'+r
(Z -
Attest: . J. VanOverbeke
Its: erk
Bv:
Its•
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this v?/s% day of -1C ??i , 1990, before me a Notary
Public within and for said County personally appeared THOMAS A. EGAN
and E. J. VanOVERBEKE to me p(ersonally 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 municipality
by authority of =ts City CounciZ ar.3 said Mayor and Clerk
acknowledged said instrument to be the free act and deed of said
municipality.
y 'HI!f«!l[!!fIIN?IIIfff:N
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STATE OF MINNESOTA )
) ss.
OOUNTY OF i ) t i _ - -1 ')
.,
,7?,?.
Not?ary ?Public ,- ?
; ?;
On this day of 1-Z„?A S'. , 1990, before me a Notary
Public within and for said County, personally
appeared ( ..?: ; ; .. _ y:_a o,? !, ?%r , ?nd--- to me
persona?l own, who being aa.c2?-by me duly sy?orn, eac#s did say that
t?Sej?resgeeti-vely6 the 11 1?:"d; i? 1
snd- of the corporation named in the
foregoing instrument, -___ _. e_ ____ _ ^_ _____.-_ `_ -_" --`""-"'_ _-
, and that said instrument was
signed eitd se&±ed on behalf of said corpora ion tn, authority of its
Board of Directors and said rr 5,
-enel- acknowledged said instrument to be the
free act and deed of the corporation.
}.,.-_ _^ • ..?:+., .?.,..,,,,,,
t
---
Notary Pub• ic
APPROVED AS TO FORM:
F,.ti?
Public Wo s Department
Dated: /+??y ya
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
,Ao l, 'S95 I /fLb
APPROVED AS TO CONTENT:
S.lJRVEYaR'S CERTIFICATE
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M07C: NO SrfCPIC 501L9 INVESTGATION HA9 BEEN COMPLETED
ON 1HIS LOT BY THE 9URVCYOR. TFE SUITABILItY OF •SbILS TO SUPPOItT THE SMtFIG IiOUSE pROPCsEO IS
' NOT THp RE9PONSIBILITY OF THE SURVFYOR
• DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET
• DENOTES IRON MONUMENT FOUNp
X000.0 DENOTES EXISTING ELEVATION
(OOO.D) DENOTES PROPOSED ELEVATIpN
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ponoMo REQMEG E
NOTE: BUILOING qM¢Jg10N5 ${(pWN ApE
FOtt H=2WlrAl, a T
ATIOH OF $?rp?y rE
ANCHIIECTUAL la OUILGMG
8 FOtNDATIOM WM[WtpNS,
SCALE; 1 INCH - 30 FEET
PROPOSED GARAGE FLOOR - 077 I FEET
PROPOSED LOWEST FLOOk = 9z t. Q FEFT
PROPOSED TOP dF BLOCK - 934 / FEET
WE HEREBY GERTIFY TO BRIAN THORSON HOMES 7HAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOIJNDAflIES OF;
LoI 1, Block 3, CDUNTRY HOLLOW SECANb AbpiTION,occording ro thF recorded plat theroot,
Dokola County, Mlnneaala,
IT pQES NOT PURPORT TO SHbW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. A5
SURVEYED BY ME OR UN6ER MY DIREGT SUT-EaVISION THIS 57H DAY OF OC7 .1992.
SIG
HILL,INC.
IP ADb.pAOjqEp 9Y C-0 _.. c??
IM•, L'AST JOHN C. LARSON, LANp URVEYOR
14 MINNESOTA LICENSE NUMBER 19$28
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3URVEYQ.R'S CEI?TIFICATE BRIAN ?7-IORSON HOMES ;
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=
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9303
8285 8272
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_ 8284 couNrRYViF?w DRIVE ?
+? - B2T2
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NOTE; NO 9'ECFIC $qILS INV[STGATIQN HA8 etEH COMPLETEO
ON 1HIS LOT bY TNC S11R1KY0R. TtE SUITAIIIIIIL17Y OF
80iL9 TU SUPPolIT T?IE SffCiFIC Hdl![ /!10/0lEC 15
" NOT 7HF RESPONSIpIl,1TY OF 7HE SUNVEYQR
= DENOTES PROPOSED SURFACE DRAINAGE
D DENOTES IRON MONUMENT SET
• DENOTES IRQN MONUMENT FOUND
X000,4 DENpTES EXISTINCi ELEVATION
(000.0) DENDTES PROPOSED ELEVATIbN
WE HEREBY CER7IFY TO BRIAN THOR90N HOMES THAT THIS IS A TRUE AND C01iftECT
FiEPRESENTATION OF A SURVEY OF THE BUUfJDAR1E5 OF:
Lot I, Block 3, CUUNTRY HOLLOW SECOND ADDITION,according to the recorded plot thereof,
Uakola Counly, Mlnnasola,
IT DOES NOT PURPOR7 TO SHOW IMPROVFMENTS OR ENCFi0AC1iMENTS, EXCEPT AS SFIOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUeEWSION THIS 5TH DAY OF OCT .1992.
PROPOSED ORqpES 9HOwN 14EpE AOE 9 EIIUMON ODN'f1101. ??I,?N ?FOR
COMrRY HOLLOW sECOND ,ipp.?II?y??O BY
?'ROOHESg
DA7ED HNGINEERIN(l, INC.
1-30.90 , lAST
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1DP OF PIPE
ELEV: 829.97
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James R. Hill, inc.
PLANNERS / ENGINEERS ! SURVEYORS
2500 W. CTV. RD. 42 • BUkNSVILLE, MN. 55337 0 612-890-8044
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DRAWAGE B UTILITY J? ? 10
EASEMENT PER PLAT??
? LOT I
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$ 22, o v ?
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^ PROPOSED
CAR. ? HOUSE
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DRIVEWAY
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, 85.00 Nd°36' 19"E -
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NOTE: BUILbING pMFN510N5 SHOWN q/7E
FOR FqRiZOHfAL 9 VEHTCaL LOC-
A710N OF STIIUC7UqE ONLY. SEE
4qCH17ECTUAt. PLA?fS fOi BUILbING
9 FQUFIDATION DIMEN410N5.
SCALE! 1 INCH = 30 FEET
PROPOSED GARAGE FLOOR = 93?Z. 3 FEET
PROPOSED LOWEST FLOOR -£7z L 0 FEET
PROPOSED TOP OF BLOCK = Q34 I FEET
HILL,INC.
?
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126152
Date Issued:08/15/2014
Permit Category:ePermit
Site Address: 4172 Countryview Dr
Lot:1 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Richard E Goodsell
4172 Countryview Dr
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA145311
Date Issued:09/05/2017
Permit Category:ePermit
Site Address: 4172 Countryview Dr
Lot:1 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Richard E Goodsell
4172 Countryview Dr
Eagan MN 55123
Royal Plumbing
23310 Canby Ave
Faribault MN 55021
(507) 202-1969
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169655
Date Issued:06/04/2021
Permit Category:ePermit
Site Address: 4172 Countryview Dr
Lot:1 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-010
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Richard E & Sally T Goodsell
4172 Countryview Dr
Saint Paul MN 55123--394
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171631
Date Issued:08/24/2021
Permit Category:ePermit
Site Address: 4172 Countryview Dr
Lot:1 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-010
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Richard E & Sally T Goodsell
4172 Countryview Dr
Saint Paul MN 55123--394
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature