4709 Covington Cir
Use BLUE or BLACK Ink
For Office Use I
1
Permit#: 1" -7 q_5 I
I
non
City of EaV I Permit Fee:
Z~5;
3830 Pilot Knob Road I I
I Date Received: 1
Eagan MN 55122
I
Phone: 675-5675 1 I
(651) 1 Staff:
Fax: (651) 675-5694
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Z2,: f& Site Address: J
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
CONTRACTOR Name: License
Address: City:
aP~t
State: k Zip: Phone: g v-
Contact: Email:
TYPE OF WORK - New Replacement - Repair Rebuild dify Space rk in R.O.W.
Description of work: r
PERMIT TYPE RESIDENTIAL
Water Softener
Water Heater
Lawn Irrigation RPZ / - PVB) Add Plumbing Fixtures Main / - 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 Surchar9e
( )
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (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 $5--~
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 to receive locates of www. r teone ll.or
y dig a orates o underground utilities. aophe sta ca a
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 --'1""mw L r^'~ x
Applicant's Printed Name Appricant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
F-----------------
I For Offic eUs`e I
j Permit Zt5 j
-7 l
City of EaEdIl I
I Permit Fee: __i
3830 Pilot Knob Road I
r I Date Receiv 42
I I
Eagan MN 55122 t C; F,-- I V E D
Phone: (651) 675-5675 r(/ I I
/ me -
Fax: (651) 675-5694 012010 Staff: T\A
2010 RESIDENTIAL BUILDING PERMIT APPLICATION ~ --A0
Date: Site Address: Q 1 66yi N Gt (L__ W G r, (2-2
Tenant: Suite
RESIDENT/OWNER Name: T I" 12N 1f\j Y--- Phone:
Address / City / Zip410 1 OV.~ N61DNI 4,,~ 5e> 22,2 "
Applicant is: OwneY Contractor r
TYPE OF WORK Description of wor : r1 7~1 A K.c.~~' C)P EU
Construction Col 1124600 Multi-Family Building: (Yes / No~ )
CONTRACTOR Name: ®~iS t.)Lb~ License
Address: City:
State: Zip: 652-k Phone: ~-_61 - 271 4 -IS k
~v(~~~
Contact: Zq4-~ Email:
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:
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.aopherstateonecall.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.
xx 6
Applicant's Printed Name Applic is Signature
Page 1 of 2
I CL
I Z,1-7&c~ CI ? - 7
DO NOT WRITE BELOW THIS LINE I
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 W v l GG~ (r
- 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 iAr~ t~ 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) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation TIC HVAC
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
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant l
Copies
TOTAL
Page 2 of 2
BUILDtNG PERMIT
CITY OF EAGAN #-/OaBS/
3793 Pllst Kno6 Raed fegan, MN 55122
PHONEs 454-8100
SF DWG/GAR
$50,000
$ite Address y1v7 wvinKLvn "rcie
Lot 19 BI«k 6 Sec/Sub. Beacon Hiil
vorcel .# 10 13500 190 06
W Name Joseph M. Miller Const., Inc.
z Aadress 18133 Cedar Ave. So:
A Name _
?? Addreu
1- rit.,
Noma _
Address
1 here6y ockwwledge ihat I haw read rhis applicotion ond stote thnt
the intormotion is torrect ond a9ree to wmply with all applicable
Stafe of Minnewto Statutes ard Ciry of Eagon Ordirances.
Recelpt #
2
Erect C[ Occuponcy x-3
Alter p Zoning R-1
Repoir ? Fire Zone NA
Enlnrga ? Type of Const. V
Move p # Stories
Demolish ? Length 45
6mde p Depth 46 Sq. Ft.-
Apvrovak Faes
Assessment -
Woter 8 Sew.
Police _
Fire
Eng.
Plonner -
CounNl _
Bldg. Off. _
APC
Permit &oa.uv
SurcFarge 25.00
Plan check '147 _ SO
snc 525.00
Water Conr420.00
Warer Merer 60.00
Rood Unit 240.00
Total $1694.50
-
Sipnoture ot Pertnittee I
A Building Permit Is issued to: J080 h M. M11 eL CO St. on the express condition thm
oll work sholl be done in acmrdanca with all applim tote of tot• ' of Eapan Ordinances.
Bulidirg Offtciol y?,?? ?
677
3?GiJ
CITY OF EA"N
, 1795 PIMf Kne? Raaa Eeqaw, MN 5512=
• PHONE: 454-8100
BUILDING PERMIT
Ts 6S rwd i" .
?50. 000
Recelpr # -
DntP
Site /Wdress ('irele
Lot Blxk Sec/Sub. '
Porcel #
ac Nome
W
? Addross
? Name lo ?ti lt LAA
Address L'pI R-Sy. (1L SO
3
j?37 Phons _5_i0 - Zc
W
G°C Nome
I hereby acknowledge that I haw ?ead this applfcotion ond state that
the informotion Is torrect and ogree to wmply with oll opplicable
Stute of Minrxsota Stotutes ond City of Eoyon Ordinonces.
Erect ? Occuponty
Alter ? Zoninq
Repoir ? Firo Zone
Enlarpe ? Type of Const.
Move p # Stories
Demotieh p Length
Grnde p Depth Sq. Ft.
APpemrals Fees
Assessment -
Water $ Sew.
Polite
Firo
Eny.
Plannsr
Council
Bldp. Off. _
APC
Surchorpe
Plon check
S^C
Water Conn.
Wofer Meter
Rood Unit
Tocol
Sipnoture of Pertnittee ?
/1 Building Pertnit fs issued to: on the express tonditlon thar
oll work sholl be done in accordonce with oll opplicable State of Minnesoto Stotutes ond Cify of Engon Ordinonces.
Buildinp OffiNol
Pwmit Na Pwmh Holder Mise. Parmit No. Holdar
Piumbing
H.V.A.Q i.L VL
Ylfeil
Disp.
Soor
EW.Vi,
W z7sq b
Dw&L t-
Iropection Date Insp. Other
Footinqt
FoundBtion
Fnminp F
Rouyh PIb4 -,?
u?
Rouqh HVA
Inwlation
Final Plbp. 4e-
j
Finel HVAC ,
Final
W? Wseribe Lotetion: L
/t
, r/-,. L
NNII
Souwr ?
Pr. Dhp.
CITY OF EAGAN Remarks
Addition BEACQN HILL ADDITION Lot 19 elk 6 Parce l 10 13500 190 06
Owner Street 4749 Couington Circle state F.agan_ MN 55I22
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. (?C6' 1982 1848.67 205.41 9 8 -8
STREET RESTOR.
GRADING 1982 537.84 59.76 9 418.32 A012236 J5-23-83
SAN SEW TRUNK 63.49 A012236 5-23_83
SEWERLATERAL " 19$2 3182.$3 353.65 9 2475.55 " "
watERnnaIrv
* WATER LATERAL I9$2 J
WATEFiAREA ? 1982 202.00 22,44 9 1.12 A012236.. 2-S
* Stuhs 1982 9
STORM SEW TRK (pg?. 1982 367.77 4086 9 286.05 A012236 5-23-83
* STORM SEW LAT 19$2 J
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 240.00 33200 11-2 -82
WATER CONN. 420.00
BUILDING PER. 7 77
SAC 525.00
PARK
Receipt MECHANICAL PERMIT Permit No. ---
' ' CITY OF EAGAN .:
Fee
fill in numbered spaces S/C
Type or Print /egib/y _
Tot. -
1, Date ,1-' 2. Installation Cost
E> - " 1
3. Job Address ??- ?G•.. ? •??- ? ? Lot Bik. Tract
4. Owner </c
5. Contractor Phone -? 7-
6. Address % 5 J/ 3 L?' ? F? X t-? ??E -" ?^•
7. City i//L L C State 1111,; ,1. Zip
8. Building Type: Residential N Commercial ? Institutional ?
9. Work Description: New,b Add O Alter ? Repair ?
10. Describe Fuel Type ?m 17 i
11.
No.
v? Eauopnent STU - M. Ea.
Forced Air 6C=
, No. EQUiament CFM
Ai
H
dli
Mfg. an
ng:
r
Boifers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with sU_ordinances and-codes governing this type of wark.
Signed:
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt
. PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print legib/y
Permit No.r ,
Fee
S/C
Tot.
1. Date r! ' 2. Installation Cost
3. Job Address '^• Lot ? 81k. Tract --: `
4. Owner .?- .: i Ler Consiructinl-:
5. Contractor c;;uirs ;;PChanieaLaa.ra. Phone 'i iZ
6. Address-'n1 . !?vc•
7. City 1! ,- State Zip -Jy!
8. Building Type: Residential E3 Commercial ? Institutional ?
9. Work Description: New Q
10. Describe
11.
Add ? Atter 11 Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
•• Lavatory Softner
Shower Well
; Kitchen Sink -
Urinal/Bidet Otheir`'.t ;r
Laundry Tray . ?
1 Floor Drains
Drinking Ftn.
Slop Sink
; Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : - `' 1 ` 1??\
k +''- - for
Rough Final
Inspections: Date , Insp. Date Insp.
This is your permit when numhered and approved.
Approved CITY OF EAGAN 454-8100
'?-?_
0
r CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: l„,
I ???1?w???t?N i 1
1 41 14 i ,?C ll?
PERMIT TYPE:
Permit Number:
Date Issued:
. APPLICANT:
? n ?.' 1 .'.' c 4 1 t
TYPE OF WORK:
ii: ',i I i 1 f IItiJ
tiii, L 11 r Nc,
A rl;l ii 1
N7/1C4 /4F..
' PERMIT SUBTYPE:
I FtqM I Nii
F
?L-L-
I i NA!
'k
Iffi
RFE'A 1 R
ttk l' I A f F GJ1 N9014`+
?
PermR No. Psrmit Holder Date TNephone R
ELECTRIC
PLUMBING
HVAC
Inspection Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
?
BSMT R I. I
'BSMT FINAL
DECK FfG
DECK FINAL
cInr oF - IE?W?H WATER SERVICE PERMIT
3795 Pilot Keob Rood PERMIT NO.:
Eogan, MN $5122 DNTE:
Zoning: No. of Un(ts:
`?,: ?'i.'.tc?r ''??-• -
Owner:
Address:
Stte /lddrcss: iv, . -,.
Plumber:
aa; Meter No.: Connection Charye: .
Size:
Reader No.:
1 o9rse to eoniplp with tM Cih of legaa
Ordinanas.
Acoount Depos(t:
Pemtit Fee:
Surcharge:
Mist. CFwrges: ` (.r e
Total:
BY DoLe Pcid:
Date of I nsp.: I ^sp"
CIT1f OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Kno` Rsei PERMIT NO.:
Eagan, MN 55I22 DATE:
Zoning; No. of Units: Owner: .
Address: -
Site Address:
acon
Plumber:
.2.,.
i
1egm M eenplp wilb !M Cihr of Eagoe Connection Chorpe: ?
prdianne", Acwunt Deposit:
Permk Fee:
Surchorpe:
gy Misc. Chorpes:
Dote of Insp.: Tatol:
Insp.: Dots Pa1d:
RESIDENTIAL
?/?/?D??l BUILDING PERMIT APPLICATION ,y
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construclion ReauiremeMS RemodellRewir Reauimments
• 3 registerad site surveys showirg sq. fl of lot, sq. fl. of house; aM ?II roo(ed amas • 2 apies at pian
(20% maximum lol coverage allowed) • 1 set at Energy Calculxdwrs tor heated add'dions
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.) • 1 sde survey 1m e#erior additions 8 decks
• 7 set of Energy Calculations . Indicale'rf lame served by septic system for additions
• 3 copies of Tree Presenation Plan H bt piatted after 711193
• Rim Jaist DeWR Optiore selecUon aheet (ddgs wilh 3 or less unils)
DATE lOi 2001 VAWATION ? $400
JOB SITE ADDRESS ?1001 C6U1N(.7ON CtRGCd j 61A1bAnli 5SI 7 2,
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER ?lET-F26Y jyo+n 5 rI n,K
TYPE OF WORK Nr?w Su+roFr?FS ON Qao'F FIREPLACE(S) X 0_ 1_ 2
APPLICANT `T6FF F-lnK PHONE#
ADDRESS q'40`I COViN6-frW CI Rzt5 ZIP CODE 5S l7-z'
PAGER # CELL PHONE # I2q S FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category MINNESOTA RUIES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope CalculaGons Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Piumbing Contractor. Phone #:
Plumbing System Includes: _ Wacer Softener _ Lawn Sprinkler
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Confractor: _
Mechanical System Includes:
_ Air Condi[ioning
_ Heat Recovery System
Phone #
Sewer/Water Contractor.
Phone #
Fee: $90.00
Fee: $70.00
All above infarmation must be submitted prior to processing of application.
I hereby acknowledge ihat I have read this application, state that The information is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Ordin nces. ?
i
Slgnafure of ApplicanT 1, ? - 64 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ updated 11r011
(?rr#if'trtt#e nf (Orru,pttnry
Citp uf Cagan
Erpttrlmenf nf Builaing Jnsprdiun
Tbir Certi/icate istutd purmant to tbc reqrdrrmrnu of Sation 306 of the UnTforot Building
Codc cMifying that ct tix timr a f irtuaate tbit Jtrtirtare war in com plianre witb the variout -
ordinanat of the City rtgrdating brrildieg tonnruttion or ulr. For the f ollowing:
w csmfr.om SF DWG/GAR Bld&PemutNo. 7677
ac.wrwy 'hP R3 TYac?eW V FU.> NA ZaN?own« Rl
O?.fwfta Soseph M. Miller A". 18133 Cedar Ave. So., Farm
B„ad,qAdd? 4709 Covin&ton Cir.LwiV Lot 19 Block 6,Beacon Hill
?'1P ICDYU.(,L10r]/\_ By February 25, 1983
- ewaWaoikW ? o.r:
SEDGWICK HEATING & AIR CONDITIONING CO. HEATiNC JOB NO l9 L^
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECORD
'
ADDRESS?"' .6 ! D'?I?.?Qo'?^ ???/.'?
OCCUPANT
< ^
SOLD BY ` ?'? '-? c C
?
MAKE +6=hWlsL
SERIAL NO. S? U'?(5
CITV
OWNER - Ev, T-,
INSTALLED BY '-e 1v cC
MODEL 7
INPUT 1
THEFiMOSTAT , - "?"
VALVE !l?'
LIMIT t 1 ?y
?-I(}?-.-.
LIMIT SETTING 1
FAN SETTING ` i I'""
PILOT TVPE
IGNITION MODEL
PILOT TIMWG ? C eCo
f- `? J + ?% D
PRESSURE 7 PERCENT C0,
INPUT CFH? PEFiCENT O,
STACK TEMP. V PERCENT CO ?
FOPM 235 (REV 11/89)
VENT SIZE
TYPE OF LINER ?
LINER SIZE
FILTERS: SIZE z
NUMBER ?
`? ?
WIRING
TEST TAG
LIGHTING INST.
/ W
DATE TESTED .?I I 4 COMPANY TESTING
NAME OF TESTER
i
FORM DISTRIBUTI WHITE CDPY J08 PILE YELLOW COPV - CRY
.
.,
1b He Uned Fbr
Site Aadress:
&JIIDING PF.td+aT l1PPI.IC1°?7'IQ?1 . .? !?at of wm'9Y
CM'Y aF' F11GADi ` Include 2ssls;o! Plens.'
1 sits PLM w/1levqtiastiam' ?
valaation DE? ,
4709 Covington Cir.
yjt 19 $1pClC 6 $W./$Ub. Beaton Hi11
Parcel ii: I o ('? ?c)- ?-----
OWW= Joseph M. MilLer Const. Inc.
AddrOSSp 18133 Cedar Ave. S.
City,/Zip Coft; I Farmington MN. 55024
p1CM #; 454-4753
OonkracEOr'a S me,
?BC.w " - .
City/ZiP cocie:
Phone 1:
Asch./@x7• _
Addness:
City/ZiP Oode:
Phate A:
CrFICE t7SE QM
, •• ? .
Ecect K_ O=VwwY
Alter zmtu?J ?
?r Firs Saie
Enlati'9e TI?'?db?!!M
?
?l+al! ? ? ?
? ? D@Pth
APPPWAIS ?' ? '?
nssasonenes Ac+nst
WdtBf/39MRt
Polioe Pim Check
? W3bmL C01C1.
11nber *bter ?
Planner - Aosd Z?h+it ?
Oauncil ? ' .
Hlay. of
APC ,
TOM{s'
; ,
Amah-
City af Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(651) 675-5694
- - - - - - - - - - - - - - - - -
I For Offce Use ?
? r^, I
? Permit#: ?
I permit Fee.
I
? Date Received? I
i ?
I ?
? Staff. I
i I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress:
Tenant:
?i
e: ?r
? Ph
RESIDENTIOWNER ?
on
Name:
Address! City Zip: 1??'+
Applicant is: ? Owner _ Contractor
TYPE OF WORK Description of work:
Construction Cost Multi-Family Buildng'. (Yes _ f No ?
,?O?-O 7??5?L
J?
License #:
? l
?
?'?^?" C
CONTRACTOR .
-
,
o,,,
Name. (/
T
Address: 01
?
City: GStpaie: Zip:
Phone: ? l - Contact Person: Li?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Cdtegonl Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit 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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the informafion may be classified as non-public if you provide specific reasons ihaf would permii the City fo
conclude that the are trade secrets.
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 appr ns. ?
x z?
ApplicanYs Printed Name < ApplicanYs Signature t
Page 1 of 3
Suite #:
41b? City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone:(651)675-5675
Fax: (651) 675-5694
?----------------i
I For Office Use ?
I ?
I ?
? Permit #. ?
I Permit Fee: ?
? Date Received:
i ?
I Staff.
I
------------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / 9 Oc? Site Address: L1701 Clde
Tenant:
Suite #:
RESIDENT / OWNER Name: ? e 1-)-4 `i , Phone: G?l'11 ? 1 6 0 8
`7
L/76
Address/City/Zip
.
Applicant is: _ Owner ? Contracror
TYPE OF WORK Description ofwork: we ?/'?0/. `'?/ 7"e° rr
Construction Cost: & e-?) U Multi-Family Building: (Yes _ I No ?
CONTRACTOR Name: vc OC,License#: Z U) 0 Z3`/?
Address: ft
state: l'7/L/ zip: S?D 4 5
City: _
Phone: 1 60 8 Contad Person: ?a L-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 CateporV 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 su6mission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a simiiar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Controctor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public informafion. Portions of
ihe information may be classified as non-public ii you provide speciftc reasons that would permit fhe Cify to
conc/ude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be inconformance with the ordinances and codes of the City of
Eagan; that I understand Ihis is not a permit, but only an application for a permit, and work is not to s[aA 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 l i G f l 4J4 V ?" x/
ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
? a 3 y 1 RESIDE?IAL BUr.DING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reouirements RemodeVRenair RenuiremenGs Office Use Onlv
3 registered site surveys showing sq. R of bt, sq. R of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20°k manimum bt cove2ge allowed) 1 set of Energy Calculations for heated addNOns Tree Pres Plan Recd _ Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Reqd Y_ N
1 set of Energy Calculatlons Addifion - indicafe if onsrte septic system Oo-site Septic System _ Y_ N
3 copies of Tree Pieservatbn Plan if lot platted afler 711193
Rim Joist Detail Options selec6on sheet (bldgs witli 3 or less units
Date?/ U 1 63 ConstructianCost 41 "70 %- Q2
?
Site Address I r? UnidSte #
DescripHon ot Work'A4Q pa
Multi-Family Bldg _ Y Y N Fireplace(s) k 0 _ 1 2
Property Owner ' / Y ?
-? Telephone # 451) ?Sb •
Contractor RMp` HOME SERVICES INC.
Home Deopt Installed Sales
Address 3200 Cobb Galleria Pkwy., Ste. #200 City
State Atlanta, GA 30339 ZiP Telephone #( )
- 763-542-8826
BG20268257 '
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Venlilation Category t Workshe • New Energy Code Worksheet
(Jsubmissiontype) Submitted (1? Submitted
• Energy Envelope Cal „yons y?rr?e? ?J ? n
Have you previously constructed a building in Ea?? ?j?i N''1p
fee applies. ?
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
#(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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 wark will be in accordance with the approved plan in the case of work which requires a review and
app val of plans.
??.t G,?e,??
'ApplicanYs Printed Name Applicant's Signature
Installed
Siding and Windows
LIMITED POWER OF ATTORNEY
CviJNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Serviccs, Inc., DBA Home
Depot Installed Sa1es located at 660 Mendelssohn Avenue North, Go!den Va!ley, MN
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Etder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, piace and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power uf .Attorney are
limited solely to the express powers delineated herein and apPi_y solely to the Work.
This LimiYed Power of Attorney shall expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
ally time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WI_'NFSS WHEREOF this Limited Povfer of Atto?ne.y is execurted this
21 st day of May, 2003
.,
David N. Katz
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003.
Notary PfiDic in for the State of eorgia
b4y Commission Expires: January 21, 2006
396816.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
? b ciTV use oNLr
? ? ? g? RECEIPTp: I 3ZF (1- 1
SUBD. CtE,LIC?Vi i"?' RECEIPTDATE: -Z)q-oo
PERMIT#
8000 PLUM$IN6 PEiiMTl' (RESID£N'fIAL)
crrYog ensm
3830 Pa= xxos $n
L'lkfiAF, MP 5518E
651-681-4675
Please complete for: D single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FnrN
TOTAL
I'IAIVRGJ
Aiterations to existing dwelling - minimum fee
Describe:
$ 30.00
Bath tub $ 3.00 x = $
Floor drain 3•00 X
- $
$
GeS i in OutlBt ' minimum • t 3.00 X = $
Hot tub/s a 3.00 x = $
Kitchen sink 100 x $
Laund tra 3_00 X = $
Lavato 3.00 x = $ I
Se tic S stem newlrafurbished ' requlres MPC Ilc. 75.00 x = $
Se tiC S StBfTt ahandonment 30.00 x ' $
RPZ new insWllatioNrepaidre6ulld 30.00 X $
Rou h o enin 1•50 x $
Shower 3.Q0 X = $
Under round s rinkler if dwellin is under cons?n,ceon 3.00 x = $ '
Under rounds rinkler ifexistlngdwellin 30.00 x $
W ater closet 3.00 X I = 0-0
$ 0
Water heater 3.00 x = •
$
Water softener If dwelling undercronslructlon 5.00 x = $
W ater softener if Bxistln dwellin 30.00 X - _ $
Watertumaround 30.00 x -
? > 50
$
State Surchar e .50 -?
? ---
? °--
---> .
3 O Sv
Total --? -- ---
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
---•--------••-----
----------------•-----...•----------• •--------------•-----------• -----------...---------
- catlo-n,-state that llie infortna6on is correct, and agree to comply with aN applicable Gry of Eagan ordinances
1 hereby acknowledge tl?at i have read - this appli -
It is the applipnCs responsibility to notlly the properly owner that the City ot Eagan assumes no liability for any damages caused hy the Ciry during its rwrmal
operehonal and maintenaora.ac4mties.to.the_facilitiesmns¢vcted-'^d°Lr^i° aermit witliin City propertyinghl-of-wayleasement.
SITE ADDRESS: I FINK, JEFFREY
4709 COVINGTON CIRGLE
OWNER NAME: : I EAGAN, MN 55122
(651) 686-9268
INSTALLER NAME.
STREET ADORESS: D? ?I...?uAN:
TELEPHONE #:
(AREA CODE)
TEIEPHONE #:
(AREA CODE)
CITY:
STATE: ZIP -
SIG RE OF PERMITTEE
, PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: eui LoiNG
Eagan, M innesota 55122-1897 Permit Number: 0 2 8 2 81
Date Issued: 0 7/ 19 / 9 6
(612) 681-4675
SITE ADDRESS:
4709 COVINGTON CT
LOT: 19 BLQCK: 6
BEACON HILL
DESCRIPTION:
? REPLACE
8sJ i1?d , l'n?o- Permit Type
rBuilding'Work Type
bnsu`s Eoeik
i
i r
h, ?v
WINDOWS
SF (MISC.)
REPAIR
434 AL7. RESIDENTIAL
?:,ix? . ? 3 gF: ? 1 e'^,. ,?t&.?, ;" '"`-'a-° ?{ ( ? Z;' i s?` -».m; ^:'!?; i'" °• z
REMARKS:
FEESUMMARY: vALuarzon $5,ee0
Base Fee $99.75
Surcharge $2.50
Total Fee $102.25
CONTRACTOR:
OWNER: - Hppllcanz -
FSNK JEFF
4709 COVINGTON CT
EflGAN MN
(612)223-4139 '
I heretiy acknQwledge= Lhat' T have ,?^eail this -applic'ation gnd sta'Ge that the
infiormation is correct and agree to comply with all applicable S•tate of Mn.
Statiute°s and City of, Eagan°0rdinances.
APPLICANTlPERMITEE SIGNATURE
ISSUE : SIGNATURE
CITY OF EAGAN
p/ 3830 PILOT KNOB RD - 55122
1896 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
Remodel/Reoair Reauiremenls
? 3 registered sRe eurvays ? 2 copies of plan
? 2 oopies of plana (Mdude baam 5 window sizes; poured fid. design; ete.) ? 2 slte eurveys (exterior addRions & decks)
? 1 energy ealculat(oM ? 7 energy calculetions for healed additions
? 3 eopka ot tree prenerveHon ptan H fot plstted aflar 711/83
mquired: _ Yea _ No
DATE: Sbcv jg. i99b CONSTRUCTIONCOST:
DESCRIPTION OF WORK: PEPrA( JN[s w,Njows lN nN NL)vse 1 Frta>r L,?Wd -fa VA) Y&)
N
STREET ADORESS: `1 y`UI W0k)(Y-10
LOT BLOCK ? SUBD./P.I.D. #:
PROPERTY Name: vur?- 6NK J5-FF Phone #:
OWNER """ (wnek 2Z3 -`I139)
Street Address- N201 LviNGloti C4;2ctF
City: JE?6(qN State: ?.L? Zip• s5-1 ZZ _
coNrw?CTOR Company: N JA ' Phone #:
Street Address: License #-
City: State: Zip'
ARCHiTECTI Company: NI g Phone #-
ENGINEER
Name: Registration #•
Street Address-
City: State: Zip:
Sewer & water licensed plumber: NIl1 . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this applicaUon 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 Applicank
OFFICE USE ONIY HEE Co ENG"
Certificates of Survey Received _ Yes No 9996
Tree Preservetion Plan Received _ Yes _ No -'-'""
CITY USE ONLY
LOT ? BL PERMIT #: O
SUBD. _ok 11 RECEIPT #:
RECEIPT DATE:
2000 MECHANICAL PERMIT (RESIDENTIAL)
Date• 3 -ln
Complete this section on if you are installing HVAC in a single faznily dwelling, townhome or condo under
construction and not owner/occupied.
. HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surcharge .50
Total $
Complete this section onlv if you are remodeline, addina to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New Alteration
? Furnace,?'Y? 6?? J,7S
_ Air exchanger
_ Repair _ Other
V*'? Air conditioning4'gq, 114wf
Other
Fee $ 30.00
State Surcharge .50
Tatal $ 30.50
Reminder: Call jor inspections
SITE ADDRESS:
OWNER NAME: ? PHONE #: ?_- lod lv 'uGr1
( A CODE) (
INSTALLERNAME: n-- .._ ..?. . ... ??. PHONE#:- dS?' CIDYIJ
L ?,. . ,_ ,,,,,,l (AREACODE)
STREET ADDRESS: 1Ce. ?L tJ'.i?i 55420
CI7'Y:
STATE: ZIP:
RECEIVED ?
n
3 2000 sicNA?oFr$xr?irrE -
BY:-_
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN MIlI 55122
651-681-4675
CertiPicate for:
Centex Homes Midweat Inc.
8601.Darne11 Road
Eden Prairie, Mn. 55344
Joe Miller Conat.
18133 Cedar Ave. so. DELMAR H. SCHWANZ
Farmington, Mn. Lnr+oaunvavona,/N6
55024 qNISiMW UMM 6w'l 01 TM StN" 01 MlnnMON
7M - 146T14 3TRfiET W. - WX M RONMOUMT. WbM?YOTA!!ON
SURVBYOR'8 CENTIFICATE
N89-43s9 - 4? E
l4.
SCALE: 1 inch s 30 feet A-,Ajtig;
?
?j
? i
Top laoa ?
0?,0
?
tbp leos.l
92b.8
PL.w-*l 89 044
wHoNe at 423-170
9 22.0 . Gaww$ FL4oe
4 '9U.•+?,_ ToP o$ 8w(-•c
9? gv??cci.??F-Ar Fwoe
LUT l 9
?- Drainage & utilit? ?
? e emen ?Jl•
/ \ 'i i.1'?(?i
?
i
? s
??
xz-:
.. ?qiPebta
0
?•
`
?
' \ , •, `
,..
?
3
qyy. Denotee proposed
elevation
?
o?
w- Dertotes direction oP
drainage
Top 40b
&+&1.+ 911.6
M
?
` 1-7 Top ?O9L5
D.
a??
a Rl I o? 'roP Coeb
q1, :91,.8
?• Top4?a.'6 " ? ?/ /JGI.?i
I hereby certify that thie is a true and correet Peproeentation of
Lot 19, Block 6, Beacon Hill, according to tho remoi'ded plat thereoP,
Dakota County, Minnesota.
Dated: June 21, 1979
Revised to ahow propoeed house Oetober 14, 1982
R?.?.sE+? ? s?+ow N-u?s¢ As S?w.cao TH?'.e?.o?J
?A1%ID : OC,T DPuFe ?? ?98z. /?
`LEJ,SeQ FuR V?006E Q?AU MINNBSOTA 61STR TION N0.8826
?r.?. '" OCiTOBEIZ 2 /, o87.
±`
? j
? C^d44
??_,«.?:?;
..,,??,•
???:
? . ?
., :T, ?_???.._?,_?r,,? ?T_.
^
.
E::T6R[OR
B= -y
--
?
• u:?.r? ? _
,- -
OMNERs
1' 454-4753
1 :
P'1nN
' iITE ADDRIiSS:
?r
CDNTRAMR: .
Detcrmirr a,orki•-g squaie Loowg,: of each '
?
ea
.. ?--•
....
.
9bta1 cxPosed wall ar -
Ala
"d
d •--
.
Z, 'ibal roof/ce113ny area .....
Total ¢xposed wa12 ,rsa ab:,"O floar
.... ?
.. ............ .. .
...... ...........
a. TotL]. wall window r:-c,*l ...... ....
........
. ?
4 ••.,.t•el . ???r ;?r•,d ........... ......
. ........ .
• .. ? .l,.c i c .. . . . . . . . .
- _ l :
C. TO::. "•
..........
. . . • .
...
. ? -
?
.
'rUilll 11L'??j;Z.1Cf wal_ arcA ....
' .....
C?
?
•
'
'? ........ .
.
..
? .....
Totul ?:all f.t.uni;:7 area (aver
.
.
........
.
?
.
..
e.
....
f. T?tul. r;,.i jjiste rc n ;
Llc....................
' ........
.
.
r.
ar.a '?
.. ........ .
...............
4• I? .?.
W:t71 are? &aeve r?
........ -i.
. ?._.-
.............
h. ?.
.____- ?.tall azea above flo??r... .
. ...
...... .
_
1. .....
aall ai'ca alwvc ilc??r. • . . . . ....
j
?
?
:?r? a
? 'fOtal Cv,??O5C?: (,:n ;d,it iOn
=
•
. ^
..
? ......
i
'.blal fcvrdation window ar.ea........ ...
k
?
•
l t'i° .. • .......
. ,
,
?
,
tl
i
1, ??1 nec fnundation :+rca at??l?
?
,
I
Determinc "U• \'?Sl3L o[ cac'? wi1S :,t.yTent
W(e,g. wlndcw. ?!o'?r, ene:t separ,?t.e all sec`..inn?
x
?. ? X
C. ?_.. x
1.1j"
.. U..
?? Y +
wUn . ?,. . 04, _ ?--
.--
??U.?
? l?.
e. IMS 9 X
9• I P2 P"--Y
-'-_._ . _ ? •-?_???
1. _r ?.._ _. ..._ a "Ul • „....
? - tM.
-.
7• ____?---- -- -' ?
? Y ??' • ? -' - - - --
}.•
Yf itcm P3 ic thc ^•"'m': :
or less than itcn iI:• •
haua mct Y.hn inh.rnC ,.?
:?1!? 6G0r> (c) 2.
, "¦-. :. . ....... ... ...M..,,::. --•..., . . ?yr .. ••y.l?a y or a
1? EmelORe! ?V . eraqa "0" Computation
Total er.posed roof/cei21r.3 area '?,T•Y y,.
?
.. ?
?Jptsl slSyjf9hC area .................. •010%)...
Tolal FOg?Ceiling fx+min9 area (avorag .. ?
'Ybbi.l hit?jtienlated soo!/eCilicq area.••••?•••
.. petermine "U" valuc for osch roof/coilinq se9ment
a
ib X, wVa
•
x "u"
x
o.
TIo Lr'- -
q .....................
40
_
If t.otal c.f i14 is the s-me us, or luse: L'is:1 Yt"? have met the intent of
? gBC 6005 (c) 1.
? Alternato,? ai..y F•nvcloQe De,i:n _
?k J a stdn mettod, the vnlucs establiahed by the s'? of
Sb utilize tha total emoloDe Y
items Y3 and 44 shall not bo 4reatez than Yhe su:i, uf items Al and 112•
i: ,? 1• .???. + a. ?-
"`S 3.
C?bA'i ?! ? N r_+rYd, '
.:i51?4 . •
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- ---a?°.?s????aM4rr!'°? ! : ViVT3'M?1°""??.-. a. .. ? ? •
, ,.
L.iuFAt. FTs EXPoSED
ruor Sfi zg =128
PLAu -* 8"
WALI.
?. 4 I ??,
r _
?F L?, ; 3rvtz4+?r?tz4
. U I
. FVI.I.Z..:.?
R.IM= 126
?k?o5ED64 ALI. AQ.EA
F?I..ocK. ; I Z? }L I? y,
x S ? IS61
, x$ -
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03644 Vui+S
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W1lLL B'BC''IcRiS
?M IS• ot qpaquo Mall area for
! r?ms cwtyctlon
?.
? R-Vaiuu
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6. 8xtori1°' ToeaL? s ?,L L•?
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07
• . t7„ A
? ?? • •?'.wA e? • ? •
, 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New CoiuWClion Reauiremenh RemadeVReoair Reauiremen4s
3 registered site surveys showing sq. ft of lot sq. %. o( house; and all roofed areas 2 copies of plan
(20°/a maximum lol coverage allowed) 7 set o( Energy Calculafions for heated additions
2 copies of plan showing beam & window s'aes; poured found desgn, etc. 1 site survey for addNons & decks
1 set af Energy Calculations Add'dlon - indicate ifon-s@e septic sysfem
3 coples of Tree Presarvation Plan if lot plaried after 711/93
Rim Joist Defail Options selection sheet (bldgs with 3 or less unhs
S ``70 U U
? ?
???oni 1g
f&presPlahReai':`:
TreaPresRecruued. Y, ?.N
Date 0.. //0/ Oo y Construction Cost ?
Site Address y]?? ?n V/nJ9 ?GQ ??,n. UniUSte #
Description of Work Re ?/lla.CO ?riS 4?O /? r
,? 4
Multi-Family Bldg _ Y N 0
Fireplace(s) _ 0 _ 1 _ 2
Property Owner 72? iclr K Telephone # vov) QZIv 8
Contractor 4AID SC G J& 2 S
Address /S 4, ' City
State Wn/ Zip -13 Telephone #( 95-2 4A,?g_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Su6mitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar planZ
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone
Telephone
N If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the inforifton is complete and ?ccurate;
that the work will be in conformance with the ordinances and codes of the Cit}ol E'dgaPi mld"TPf€'SLM of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pernvt; that the work will be in accordance with the approved plan in the case of wor$ which requires a review and
approval of plans. ,
?ApplicanYs Printed Name Applicant's Signature
aaze i UL' :
.x Homea Midwest Inc.
F3tiuy Darnell Road
Eder. Prairie, Mn. 55344
1
Joe Milier Conat.
18133 Cedar Ave, so. DELMAR H. SCHWANZ
Farmington, Mn. I,qNDfURVEVORJ, /NG
55024 qMlstM?A UnOw L+ws M TM StOb ef M{nnnol*
1M _ 746TM STREET W. - HO% M ROl9SOUMT. MINNlfOTA 060M
SCALE: 1 inch a 30 feet
SURVEYOit'8 CERTtfICATE
N97-45-- 47 E
/4 ?-7
PL^-,N e9044
PHowe s+s 423-17a
Pr-OPOS*?n CLV'Ld' o?"'
op leoa ?, rt /?F-' air a
?
? - ?
?o .
/ ? d(3' `•
ys •. ,? ?
o_
00? *bp ?taa
= 9'w.6
/LF I ?
ZFL?oe
? 9 ? ToP A. ., ' ' •. '
. ?. ?
? h'+C io
y ? Denotes proposed
o? elevation
M
Denotee direction of
drainage
Top ?4ve
fu.R.J.= 9ZI.fo
*oa
` c)1p•`1
o` ?N ToP c ee)
L
?`?°??` 910,3 l l
.= 920.1
I hereby certify that thia is a tru ax?de?ot?c?6O??epiatithereof,
Lot 19, Block 6, Beacon Hill, aaeording t
Dakota County, M1nr?esota.
Dated: June 21, 1979
Reviaed to show propoeed houne October 14, 1982
R??.sF c? ? s?+ow N-v?sr As Srn?cca ?-?o?
?jArcip : Oc.TOgFe 20, 087-
`ZFJtSr-p 'Fv4 4"SE KAU 89o4q MINNESOTA R GISTR TION N0.88?6 ?
Dar-rEp ". Oc,-roa£?- 29, 198L
PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd Permit Number: EA080542
Eagan, MN 55122 . Date Issued: 10/18/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4709 Covington Cir
Lot: 19 Block: 6 Addition: Beacon Hill
PID 10-13500-190-06
Use
Description:
Sub Type: e - Fixtures
Work Type: Replacement
Description: Second Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Jason LaBelle
700 Prior Ave N
St Paul, Mn 55104
Fee Summary: PL - Permit Fee (miscellaneous) $50.00 0801.4087
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: - Applicant - Owner:
Home Depot Home Services Jeffrey T Fink
40805 Forest Blvd. 4709 Covington Cir
North Branch MN 55056 Eagan MN 55122
(651) 645-5040
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
t7 L4/ Lbll ii: by Jnzby15lu ( --WWUUtW1TE MUUUS I-Aur- Uz
Use BLUE or BLACK Ink
For Offtcv use - - - I
of EaE: an C 0 Permlt #
Cit '
I C• I
I Permit Fee; I
3830 Pilot Knob Road
Eagan MN 55122 / i p j Date Received:
Phone: (661) 6755675 Gj Q l I t
Fax: (651) 675-5694 1 Staff: 1
I
2011 RESIDENTIAL BUILDING PERMIT APPLICATION LC-~-ESS
Date: Site Address: Unit 0:
Name: Phone:01 - Z
srl rr l -709 CpVI NCa i oN G PC
OMER Address / City / Zip:
LF-
Applicant is: Owner x Contractor
ijy.
0P.: Description of work: ,V I T-C-t(C~l t7CZ
E WORK
Construction Cost0 2!7 J566 Multi-Family Suflding: (Yes No )
I lCl~ I l4C Contact:
~rC Company: 1 I DZ L. cx ~I ~r City: A t E )2N~- r
CO'N7'IAICTOR cc ~7
State: I zip: J 2 Phone: Co 5I Cry 4 /
License m 7 J Lead Certificate k N PkT' " 3 1' 1 Y(
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
`Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone;
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
lVItyTE:. Plans jand srsppordr g dbeuments, that you submit arts considerigd.to. be.pubild InhOwtion.. Polti hs of .
lrrfomadan, P*y►:be classified as nonpubfilb Ifyok proVfde sped lessons thar,mnmld:peM. i* the i tb:
-coneludi that they ae lmd6 sar:r mks.
CALL BEFORE OU DIG. Call Gopher State One Call at (651) 464-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities, www.aonheretateopeeall.era
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.
Exterlor work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x~
x
Applicant's Printed Name Appiicar ' Sign ure
i
Page 1 of 3
U'J/ L4I LF711 11 : Icy inzb'di n I U ! ---MU F.UULRl TE NUUGS rAUL Uj
L
aviA/401A (2-.(
-70 e? 1 1
DO NOT WRITE BELOW THIS LINE V qX
TYPES
_ Foundation _ Fireplace _ Porch (3-Season) Storm Damage
I 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 anhra building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy e ZZ MCES System
Plan Review Code Edition SAC Units
(25%_ 100% Zoning _ RQ City Water
Census Code /Y 3Lf 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
4- Framing Siding: ----Stucco Lath -Stone Lath ,-Brick
Fireplace: _Rough In Air Test -Final Windows
insulation Retaining Wall; _ Footings _ Backflll _„y, Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: Building Inspector
R I:N_T_IAL FE p~~~ aJr ~ 7®~
Base Fee 7.3 ? 0 Off/
Surcharge
Plan Review
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:EA147686
Date Issued:01/25/2018
Permit Category:ePermit
Site Address: 4709 Covington Cir
Lot:19 Block: 6 Addition: Beacon Hill
PID:10-13500-06-190
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 -
Jeffrey T Fink
4709 Covington Cir
Eagan MN 55122
(651) 686-9268
Norblom Plumbing
1465 Selby Ave
St Paul MN 55104
(612) 827-4033
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA164188
Date Issued:09/22/2020
Permit Category:ePermit
Site Address: 4709 Covington Cir
Lot:19 Block: 6 Addition: Beacon Hill
PID:10-13500-06-190
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Jeffrey T Fink
4709 Covington Cir
Eagan MN 55122
(651) 665-4139
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature