3955 Clippers Rd??-?- -
INSPECTIaN RECORD COntrol No. 1298
CITY OF EAGAN PERMIT TYPE: p?? ? k C? I t?a
3830 Pilot Knob Road Permit Number: s?l .t 7 7?
Eagan, Minnesota 55123 Date Issued: i. i/ 12/ 92
(612) 681-4675
SITE AQDRESS: I.nT 1 17 At ock?.? APPLICANT:
a9F1r, i' l IPpFRS RQ M1 E lER NAMES JOSERN
%HF'RUOOn pOWN3 (Gk?) 464-4663
PERMIT SUBTYPE:
.1 Iilii;
rvPE oF woRK:
?
-. _ ... . . . ?
REMARF9o S b W CQMI"RACf(1R -• tiEM7-•RYAM PI.F19
PKmI! No. Pwmlt Hold9f Dab 7iirphonf f
S/VH
PLUMBING
HVAC
ELECTRIC
.
ELECTRIG
U?tPOCUGII aft kfEQ. C0 111111 9 11b
Footings I % ?
Foundation
Fram"g 's'943 .S f/.1? T?D GK iir?
Rooflng •
R-g" Pb°
P"jo ?+tg- ' /
WW. ?? ?3 lL?? L/ t s-?? 1- 7• .?l???
Flmpime -S•4 dS
Fimi Hig.
ormtrOW
3-e3;3 ,
Finel Pibg. 11 ?
cv Plbg. I?pedor - NoHty Plumber
COnst. Meter
EngrJPlan 3
Bldg. FinW 3- y-pi as
Do(* Fta.
Deck Final
VYetl
Pr. Disp.
a-t-r 9 3 _
Use BLUE or BLACK Ink
-----------,
� For Office Use i
I
" I Permit#: � ��`-� I �
"� '`. ' t`".�' � u� �
Clt� of �� a� �
� � Permit Fee: � I
3830 Pilot Knob Road ��r� � � ���� i �
Eagan MN 55122 I Date Received: �
Phone: (651) 675-5675 � staff: j
Fax: (651) 675-5694 L________________�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: G" ��-- /J`� Site Address: J 7 S� l.� �! (,�P�t`S `\� •
Tenant: Suite#:
� �
� r
S � Name: �1 4t ��k OD R��S Phone:C65I� ��� - 4 93„2
�'�����nsr
�"a � �.;�� �� Address/City/Zip: 3�.5� C..� ` /�� �dl. prt � �.5/�.L
�� ��
flx� t �' / ,�^
L" �' Name: �{�✓t vr S (/!vM p•n a �c �icense#: OO S',3�3�/' 1
� � � � � ���
� F�� �J ��(�/ �– ,�j�
�a' ' - Address: �.�7.2 �f1SA��� /7✓Q /Y� � �/i // �!c��u¢. �
:� �,��i'��" ��##��' �� ��
City:
°� l�c iv �6/�,� 57�—,�,�3� � C�-
� .� �� ,� :�� State: Zip: ��3 7G Phone:
, tsTM p� ! . � ,
` � '� Contact: /�A� 2 �fi�Email: i+ s lv.n�J� y.Z �G�A•^��'.�4.�`
N��.w
~ ^ � ���"
�`� ` New �Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
�, ,���
�����?��+4�C —
�� ~. �: ��� �hivl a01
�` z .�"�° ��: Description of work: ` � �?�,l) l�e�- J\ S �
3:��� RESIDENTIAL �ot�tJo�� rv�pV �� -tz�i le�'
;� {�
t� �g �# Water Heater
:'� Water Softener
� �x�� Lawn Irrigation�RPZ/_PVB)
" � #�i"�11#'� ,��'` � �
; � � Add Plumbing Fixtures�Main/_Lower Level)
,��� ` : Septic System
�c � � �k� �
� a� «
'� � �w� ,������ � � ���q�� NeW Water Turnaround
�� —
�
�.���`����.��,���d� r ' � Abandonment �
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes$5.00 State Surcharge)
"`Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
� ,�,�� ` � �,
X n , - � �s�z X —
Applicant' rinted Name A p icant' ignature
?1�; �.� g� '� � _i'W . 4 _ . R 4 �1 ._ : il�.F q, 4 t�Y Yry4 _
��yy �, �a ��� ��' r� �
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^4: �� 1.F�: y�!. ��� t � ��k . :-w�` �"i.u!? ' �_ �� �7 x �� s;n�h1�4�'� u�i�� �`r �,'+ f�z �+f '^y'�����
h ti d!e �. � � +� ,a � t�"r� � <
W � �,t4`" i r ro 2 .3 as �r�
`F�eq���ln�'�+ctic�ns� � �k�nd���rcwr��.�,��t��h=� � A�-�`est ��' ����� :r 4�����! ��x;f� i .
'�• ;-,r Q', � �� � �� � ��+` 5 h y.�° h P a � 7'-��'�E�a�.�''��'q�S�"�I�Jt_ ,: ��§9'I� k+ �..�.�v , �""R'�;h:^c'� �_r �-
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I�let�:r�etatetl lt�is Il����r��ze ' . �,G ' . Lf�ad�R�1}�"'��� f�ar���' �-�"� „� � .j��,��
P �. .. �—._�'�.0 . ...., ,. ,. ��� �.�.. ,.�.,;-�. ��'
h
(gtr#'tftratt of Orrupanry
Citp of Cagari
iow#utrnz nf imuniag 3wertinn
77us Certificate rmed pursuaru to Me requimnents ojSection 306 of tlre Uniform Building
Code cerafying that at the time of issuance this structure was in compliance with the variorrs
ordinances of the City regulating building consmxtioa or use, For the following.
t7.e aua7ioh'oo SF DW, Bldg. Anmit tvo. 1776
0-w.-7 Tf? ?? ? Zmiog nkb;a R I Tya r..?? VN
owm of Duafiq .TOE MffLJIM WES Add= 18133 fM4kR AVE RA FAMMar: [rrr
MolftAddmu 3q55 tMIPPE?'S PM L-aft L 17, B2, SEEfbd00D DfJWNS
ti„c 03/04/q3
POST IN A CONSPICUOUS PLACE
Zip 5512 2
L'ot' ' l? Blk 2 Sub siom Dowlvs
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
SodJSeeded grass ?
Ttailkurb damage
Porch
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing undergcound sprinkler system. ?
White - City Copy Yellow - Resideat Copy P'snlc - Contractor C4py
INSPECTIUN RECORD
CITY 4F EAGAN PERMIT TYPE:
3830 Pilot Knob Road
Permit Nurnber:
Eagan, Minnesota 55122-1897 Date Issued: ' (612) 681-4875
SfTE ADDRESS: APPLICANT:
PERMIT SUBTYPE:
;If
! I ",IMiNr,
i I r wpt.frb
TYPE 4F WORK:
I N';tti A T[ rrN
f IMA1
at rf'RAE ?i,r,
i HO f=t- i1a:14„W, ?
I 1AFeYi2 A -,i'F'A17A rF' F'F"R1yfF .X'; 17R'Qtl.tRt:(? icile ANY ElE+°TR 3'CAL tlft F'iI1MHIN', 1.1+1kC
.
` '??1?iUt
Permit No. Permit Holder Oate Telophone S
ELECTRIC 161(?0O I 9? 4/0
PLUMBING
HVAC
inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING r,
ROOFING
ROUGH
PLUMBIfVG « 7 ? C
PLBG
AIR TEST
ROUGH
HEA NG P
,/?-4Y--97
1 44
'
GAS SVC
TEST
INSUL
!
GYP BOARD
FIREPLACE
v
FIREPLACE
AIR TEST ,
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
OPFlCE USE ONLY This requey void 18 monihs Fom wlidation date `rinted m Ihis 6.
" Cr? VU ,
?'LC/?Wwcc P?" +?'L
/°?
:
IIIIIIIIIIIIII?II?I?IIIIII?IIIIIIIIIIIIIIIIIIIIII
/
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I
* 0 4 1 6 1 6 0 0 s Li
J
y? °?
PLEAS OR TYPE
Reqoe t D.
i a
qI Rough in inspeceon reqmredP Yes ? N.
Y
ll M Inspenion Oiher iMn BoughJm ? Reody Now I?Nill Call
. ou mvst ca
(
e mspecror wfi¢n reod yl Reody:
? licensed confractor q&owner hereby request inspection of the above elechicol work ot:
Job Address t54rer, Bo:/, a« Ro1ote No ) Ciy ZiP Code
Se7ion No. Township Nome or No. Ronge N. Fire M. Caunry
`
-L)&
7S "k C3?osc, `;5 Mone N.
?ag-a3i?
Power Supplier Pddress
k= ?, iec -°
ElMrical Canhatlw (Compony Narcre) Conrtoct« Lmnse N. Nwekr Le N. (Plonl Elec! Onlyl
hbiling Address 1Conhacror or Owne. Per'ormiig Inspllanonl
5a-fY-) l
AuthO^zed SiqegN. (Comracbr or er Per(orming Installolion) Phone No.
E ILI? fl/oe
SiAiE BOApO COPY - SEE INSTHUCTIONS ON BACK OF VELLOW COPY
1?2-19 7 REOUES7 FOR ELECTRICAL INSPECTION 6' o 416° 16O ? 8'21 Un vessiry AB earRm. 5-128,'St. Paul, MN 55104
Phone (672) 642-0800 zo
G3 7 510
??a -J
?
--
Repuest Date Fire No Fougn-in Inspetlmn
? FeeOy Now 1?."iiMll Nouty Inspector
Repwred9
77
12110192 «Yes ? No When fleatly>
I?',v?tfcensed conVador ? owner hereby request inspechon of above electrical work at:
Job Atltlress (Sheet Box or Route No I C?N
3955 C??p?e?e /2d. Fayan
Sechon N. TownsNO Name or No Range No County
/7¢kot¢
OccupantlPRINTI Phone No
aoe (7iLee2 Xomeh 454-4663
Pawer Suppher Atltlress St. .
t7¢ko.ta Ekect2?c fa2m?nyton,?fN. 55024
ElecIncal Connai (COmOany Namel Coni License No
Plidiarzd £Qel 041690
MaiLng AOOress (Convactor or Owner Making Inslallation,
17854-13 auU?'ee GI¢y LakeuiQQe,(2N 55044
S gn t e (COn er Meking Installation)
ANM1 PM1One NumDer
:7 892-9444
--?
MINNESOTA STATE 8 ECTRICITY
Gdggs-Mltlwey Bld m 5?93
1821 Universily Ave., SI Paul. MN 55100
Phane (611) 6C2-0800
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTEO BY THE SiPTE 00ARD
UNLESS PROPER INSPECTION FEE IS
ENCIOSED
REQUEST FOR ELECTRICAL INSPECTION 10°"ks
/£qR oypppy]?oe?7
? 72510 ? See mstmclmns for complebng thrs lorm on back ol yellow copy : ? / V C?+ /?/
? Q(-
'X" Below Work Covered by This Request 7J ??•?? `?
ew Atltl Rep TypeofBmttling AppliancesWved EqmpmentWVed
Home Range Temporary Service
6uplex Water Heater Elecinc Heating
ApL Bwldmg Dryer Other (Specdy)
Comm./Industnal urnace
Farm ir Conditioner
Other(spealy) ConVecmr§ Remarks
Compute Inspechon Fee Below
# Other Fee # ServiceEntranceSrze Fee # Circuns/Faedars Fee
Swimming Pool I O to 200 Amps ( O to 100 Amps (o
Transformers Above 200 _ Amps Above 100 _ Amps
Slgns Inspectors usa Only 707AL
Irriqation Booms X0'pJ??3 ? , 5Q
Special Inspection (JP!
Alarm/Communication TFIIS INSTALLATION MAY 8E O OI(NECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO
I, ihe Electrical Inspector, hereby
certify that the above inspection has
6een made Rou9h-10
Finai ? ate
oaie
OFFICE OSE ONLV
Tpis repuest void 18 monihs Irom
RESIDENTIAL
SS ?3 p BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MPI 55122
651-681-4675
New Construdlon Reauirements
. 3 registered sHe surveys showing sq. il of lot, sq. R. of fwuse; and all roofed areas
(20% marimum lot coverege allowed)
• 2 copies of plan showing 6eam & window saes; poured found design, elc.)
. 1 set of Energy Calculations
• 3 coDiN of Tree Preservation Plan if lol platted aRer 711193
• Rim Joist Detail Opljons sdection sheet (bldgs wAh 3 or less uni4s)
DATE ? 13O O -2-
SITE ADDRESS
TYPE OP WOR
APPLICANT
RemodellReoairReauiremenls '118 7 O-?;
. 2 copies of plan
. 1 set o(Energy Calculations for heated additions
. 1 site survey for exterbr additions & decks
• Indicate if home served 6y septic system for add'N"ons
VALUATION'of000
STREET ADDRESS z 77S LP/SP ,VIP,4 CITY.
ATE /?'1?iVZIP SrIO
TELEPHONE # d.sl 77a S"S"7D CELL PHONE #63"1-47.71- S 3lG FAX #o?s"/- 770 - 0 Y9S
PROPERTYOWNER A,'G? o65'?'6 TELEPHONE#dS/-C86-[i$32
-----------------------------------------------------------------------------------------------
COMPIETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submisslon Type) • Residential Ventilation Calegory 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calwlations Submitted
Plumbing Conhactor: __
Plumbing systcm includes:
Mechanical Contractor:
Mechanical syslem includcs:
Sewer/Water Contractor.
iUlTl-FAMILY BLDG _Y i/N
FIREPLACE(S) _ 0 _ 1 _ 2
Phone #
Phone #
_?11- r ii uI I i_ i.,, ,
Fcc: $90.061
,
SEP 3 0 2002
Fec: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or nces.
Signafure of Applicant ?`'?---
OFFICE USE ONLY
Phone #
Water Softcner lawn Sprinkler
Watcr Hcaler _ No. of R.I. Baths
No. of Balhs
_ Air Condilioning
_ Heat Rccovery System
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4/02
.
, RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
New Conatructlon Reauiremeab
. 3 registered stte surveys showirg sq. ft. of lot, sq. ft. of house; arid J roofed areas
(20% mazimum lat coverage allowed)
• 2 wpies of plan shovnng beam 8 windaw sizes; poured found desgn, etc.)
• 1 set of Eriargy Calculations
• 3 wpies of Tree Preservation Plan M lat plaHed afler 7/1193
• Rim Joist DefaH Optians seledion sheet (Wdgs wNh 3 or lesa uniLS) '
DATE ? IS /O2
,-
SITE ADDRESS c
TYPE OF WORK
APPLICANTJ?
STREET ADDRESS
TELEPHONE #(e
PROPERTY OWNI
Energy Code Category
(J submission type)
Plumbing Coniractor:
Plumbing system ini
CELL PHONE
FIREPLACE(S) _ 0 _ 1 _ 2
ZIP?-Z '?
l TELEPHONE#C/L°51 &6-0532
COMPLETE F R"NEW" R I IAL BUILDIyGS?LY
- MIN OTA RLJLF_S 6 TL:GORY I ? v^ MP-I?N?E-SH?I'A RUI.CS 7672
• R sidential Ventila6on Cate 1 Worksheet Submi? ?t?ed1' Energy Code Worksheet Submitted
. nergy Env ope Ca latl ns Submitted
I Vv
,
/
Meehanical Conhactor:
Mechanical system includes:
Sewer/Water Confractor:
_ Water SoEtencr _
_ Water Heater _
No. of Baths
Air Condidoning
Heat Recovery System
LTI-FAMILY BLDG _ Y _ N
FAX #
h ne #
Lawn pruikler
No. of R.I. Baths
Phone #
I hereby acknowledge that i have read this application, state that
with all applicable State of Minnesota Statutes and City of Eagan
Signature of Applicanf
Phone
information
OFFICE USE ONLY
Fee: $90.00
V1L
SEP 19 2002
comply
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updaled 4102
RemadellReoair Reaulremenb
• 2 copies af plan
• 1 set of F.neyy Calculations for heated aEditions
• 1 site survey for evterior additions 8 decks
. Indicate if home served by sepfic system for addiGons
VALUATION -4 I5 C-,O
PERMIT Control No. 1298
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: Bu zLo z N r
Eagan, Minnesota 55123 Permit Number: 001776
(612) 681-4675 Date Issued: 11 J 12 ! 9 2
SITE ADDRESS:
3955 l:L1PPER5 FD
i_UT: 17 8LOC1:: 2
Sti,°_RWOUD t101.JN`?
DESCRIPTION:
Buildi.riq PerniiL Type SF UWt;
Bui].ding ??Work TyPe NEW
, UBC Occuparic.y R-3 M-1
' ConstrucLion -I;ype V--N
Zon.inq R--7.
BuildLng Length 62
Building WidCh 42
?
`
??;??='?•-`?`'?'? " ? t? ?,????
\??t.
REMARKS: C G'?_ I
S& W CDPI7"RAC1"Of`2 - GENZ-R`lAIV F'LBG
FEE SUMMARY:
VALUATION
Base Fee
Plan Raview
5urcharne
SAC
SAC %
SAC UniT.c;
Subtotal
$SI4.+D0
$558.10
$83.50
$708,00
100
$2,225.60
$167,000
MISI:ELLANE0U5 $1z618.50
Total Fee $3,835.18
CONTRACTOR: - Applirant - ^T. LcpWNER:
hITLLER HOMES JOSFPH 19544663 00+D2431 JOE MTLLER HOME5
18133 CEDAH AVE S 7.8133 CEOFlR AVE S
FARMING70N MN 55024 FARMINGTON MN 55024
(612) 454-4563 (612)454-4663
?
I 17ereby acknowladge that I have read this applicati.on and sCate that the
Fnformation is co3°r•ect and agree T.a camp).y wi.th all applicable Stats of Mn.
Statutes and City of Eagan Ordinances.
t.
AP ICANT/PERMITEE SIGNATURE
il?? ft???d
- ED YIG NAT? m ?1
RE?
I'
DERMIT x . CITY OF EAGAN
REACT I YA YIE' _ '
A lit
1992 BUILDING PERMIT
681-4675
APPLICATION ?OV 5
RECO.
Cn ?'-1, j'f\
?, L r
SINGLE MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural p}ans, 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 uested once ermit is issued.
Date
U'
17
Valuation of work J.
, IOo
Site Address:
STREEi SUITE M
Tenant Name: (commercial only)
IAT -k_q BIACR ? SUBD. P.I.D. N
Descri tion of work:
The applicant is: ? Owner Contractor ? Other coes«ice>
Name Phone
Property LAST FIRST
Owner
Address
_ STREET STE /
City State Zip
Company _ ?pE mt61ER HQmES- Phone -5/,-5y
Contractor 16133 CEDAR AVE S0.
Address _ FAtiMINGT9N,MN55(171 License # Exp.3-?y
City #0002431 State Z9p
Company Phone
ArchltecU
Engineer Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber ? . Processing time for
sewer 3 water permits is two days once ea ha been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
S 02 SF Dwg.
? 03 SF Addition
O 04 SF Porch
? 05 SF Misc.
WORK TYPE
J261 New
? 32 Addition
0 06 Duplex
O 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1.
O 33 Alterations
O 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging
O 12 Multi. Misc.
? 13 6arage/Accessory
? 14 Flreplace
? 15 Deck
? 35 Tenant Finish
O 36 Move
Const. (Actual) V-N Basement sq. ft.
(Allowable) v-N lst F1. sq. ft.
UBC Occupancy R-3 M-1 2nd F1. sq. ft.
Zoning R-1 Sq. Ft. total
N of Stories Footprin t Sq. ft.
Length ? On-site well
_
Depth ?z On-site sewage
APPROVALS
Planning Building
Engineering Yariance
REQUIRED INSPECTIONS
? Site ? Footing ? Framing
? Mallboard ? final O. Draintile -
? Insulation
? Fireplace
Fermit fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
snc x L
SAC Units
.g
vetuacia,: S
I ? 1? .- a
?flt7
.
_
GAR
A6E; 32 K ?4 =
Z X 12=
y x 6 =
" ?bg
LZy?
(2y )
SSMt
, 72
11
2
0)4 l?=
5
0
.16?48= t?64
2 x r?= (za)
1%2xh= fl
x ?z= aoy
'
x25
_ oo
--
13 xz8 = 364
2No
? y2
6 Jc JS= I 8690
,
Isr ??eri 2Xir - C??
?,yn,; /2c( 6
?264, 7`
5-3? (p6,
147K zg= /oZ
Iy?3= ac
2X7' ?--
?
?. O 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
O 20 Public Facility
0 21 Miscellaneous
0 37 Demolish
MWCC System "(aS
City Water ?
PRY Required
Booster Pump '
Fire Sprinkler
Census Code ?
SAC Code ?
Assessments
$)2
/6G,'G ?-
. . UIUUFSQTl?AT1,TR?l1?ti.?iY?S2RB?AI4:11I.t,TI?U? ':
, . BA96D OII CIIAPTEp B OF TIIB Z::2
k142I2El?.FJl?tlSiY,?QIl??12B ?ERLTI41t
Adoptlon 6ffaotlve
81te Addreee 'LoT )rl, SLock 2, ShsRWOoa bawN<
Contraotor
ne pate
eullding elaealfloatlont Typa A1 (Bingle Fsmlly i Dtihlex):?K
Type A] (Aealdelltlal1 ] ekoKlea oC leae) (OVer 7 etorlee) (Otlier)
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Type o[ Conelruok on PerlmaEer tt.
Ilanutooturer
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? •
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TYP6 8I86 AREA (Bq,FE.) I li1I110ER OF TOTAI.
l7r,6? II L9 rl?) ? A EACII UIII'f9 8q fEET
t N' ?
9. Total eq.[t. Ulaee
10, Flreplaoe areal Wldth 8 Ilelght ?. X a eh.Et.
11. Exposed [oundahlonl Ilelght X'PetlNeker.?X
COIIp4ETION OF TIIIB PORFI 10 RBpUI1lEp rOR A[.I, IIE{1 COIIBTRUCTI011, IIAJOR
REIIOpELI11Q Allp 8UI4DIIIQB BBI114 F10Y6D WIILRO EIIEIiDY, OTIIER TIIAII TIIE IIIIIYIIAI.
COpB ALGOUAlIC6I I9 U9ED. ' .
-1- . .
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rraAe ? . . .
PEIZMIT
A CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
c?0i? 70
PERMITTYPE: auzLozNG
PermitNumber 029369
Date Issued: 01 / 0 2/ 9 7
SITE ADDRESS:
3955 CLIPPERS ftD
LOT: 17 BLOCKa 2
SHERWOOD DQWNS
p.I.N.: 10-67670-170-02
DESCRIPTION:
Catl;e ?u
?
-- -
t`;}y
Yy '
(NO BEDROOMS)
Permit Type BASEMENT FINISH
??rk 7ype ALTERATION
434 ALTa RESIOENTIAL
3 {y(; +a,a p
#+x tr q?}
4_c,z?' 1
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRTCAL OR PLUMBING WORK
FEE SUMMARY:
Base Fee
Surcharge
7ota1 Fee
CONTRACTOR:
$50.00
.50
$50.50
I I Mer,shp ackhp w].e,dg'?0 t#?atr"?, ti.
_ xnfp-rinat?srns?? ?nr,?"eet ??.d?ag
statut,as':ar,d C3.ty
L 5 - cs. x .
114??
APPLI ANT/PERMITEE SIGNATURE
OWNER: - ApPricant -
BOOSflLIS NICK
3955 CLIPPERS RO
EAGAN MN
(612)229-2317
ci s,E a,pP2'aa?t?can that. Cthe .
agp??,?44s S't?t'?c M'n?
a ?.
?.' '? S'• P- a ? ? ? 1 z X- !
ax.._r_ L.:....._' ?.a . . a 4n.L am?f_ .. .... ...:._.?',.??.... . ..s . = c..... .. ..?ra
ISSUED B : SIGNATURE
CITY OF EAGAN $??. ffO
3830 PILOT KNOB RD - 55122
1q30 1996 BUILDING PEAMIT APPLICATION (RESiDENTIAL)
681-d675
New -enft c+lon Rea uirement? RemedeLReeair Recuiroment.
? 3 mqisterod sile aurvsys ? 2 copiea W pian
? 2 mpiee of plans (tndude Deam d vnndow sizes; powsd fid. Oesign; ete.) ? 2 ake aurveys (exterier addlGona d Oecks)
• 1 energy dlculatfene ? 1 energy platationa for heWeE addipona
? 3 npies of tree preservatlon plan H lol platled atler 7/1/93
ieqWmd: _ Yas _ No
DATE: De-cevnj-,,,Cr' a7 19R? CONSTRUCTION COST:
DESCRIPTION OF WORK: - ?1ntSh ?asern?ri?
STREET ADDRESS: - 3 9 SS Cl i Pger-r 40-c1
LOT ? BLOCK ? SUBD./P.I.D. #: Un??01a%
PROPERTY
OWNER
CONTRACTOR
Name: 50oScz11S ? `44 Phone #: 6 glir-O93,k
'^" (a7-9_ 2317 work)
Strest Address• 14QW'e
City:
State: Zip:
Company: -`e_ I f Phone #:
Street Address:
License #•
City: State: ? Zip•
ARCHITECT! Company:
ENGINEER
Name:
Phone #•
Registration #•
Street Address•
City: State: Zip:
Sewer 8 water licensed piumber.
change are roquested once permit is issued.
Penalty applies when address change and Ic;
I hereby aeknowledge ihet I have read this appliqdon and 8fate that tl1e intortnation is cortect and agree to comply witfi all
applipble State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applieant: 4-6c ???
OFFiCE USE ONLY RECEIVED
Certifieates ot Survey ReceNed _ Yes _ No DEC 2 7 1996
Tree Preservation Pian Received - Yes _ No By.?_
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
i0. FIXTURES EACH TOTAL
SHOWER 3•00
WATER CLOSET 3•00
BATH TiTB 3.00
LAVATORY 3•00
KITCHEN SINK 3•00
LAiINDRY TRAY 3.00
HOT TUB/SPA 3•00
WATER HEATER 3•00
FLOOR DRAIN 3•00
GAS PIPING OUTLET • minimum - 1 3.00
ROUGH OPENINGS 1.50
? WATER SOFTENER 5•00 ?
PRIVATE DISP. • Dak.Cty.lic. 15.00
U.G. SPRINKI,ER • eome under const. 3•00
ALTERATIONS ' to adsting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL:
?
S3
?
:
.
SITE ADDRE
OWNER NAME•
JaItf
INSTALLER:
31
S
D ? 1
/
:
•
ADDRES
CITY: nvds STATE: ZIP CODE:
PHONE #: (1(j12.) '?
,-?
1993 PLUMBING PERNIIT (RESIDElVT7AL)
CITY OF EAGAPI
3830 PII.OT KNOB RD
FAGAN MN 55122
(612) 6814675
l? sL 1-2_ CITY OF FAGAN
PLUMBING PIItHIT
SUSD. (612) 681-4675
AESIDSNTIAL
PLEASB COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH DNIT.
AORK
NEW CONST X
ADD ON _
REPAIR _
pwNER Np,ME: JOE MILLER CONSTRUCTION C0. INC.
SITE ADDRES5:39S..s-
INSTALLER: GIIVZ-RYAN PLUMBING
ADDRESS: 14745 South Robert Trail
CITY: Rosemount Zip; 55068
CITY IISE ONLY
RECEIPT # ?UB
DATE 4?-'-
AISO, FOR TOWNHOMES AND CONDOS
COMPLETE THE FOLIAWING:
N0. . FIXTIIRES EA. TOTAL
REPAIR/ADD ON 15.00
? SHOWER 3.00 75
? WATER CIASET 3.00 ?
BATH TIJB 3.00 G+ "?
? IAVATORY 3.00
KITCHEN SINK 3.00 3 °'a
? IAUNDRY TRAY 3.00 5
HOT TUB/SPA 3.00
I WATER HEATER 3.00 :3 aD
i F7AatZ DRAZIv 3.00 ?
GAS PIPING OUT.
? (MINIMOtt - 1) 3.00
?
AL ROUGH OPENINGS 1.50 . SU
_ OTHER
WATER SDFTENER 5.00
PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
W. T[7RNAROUND 15.00
S,TATE SURCHARGE .50
J?
TOTAL: S J 0
PLEASE COMPI,ETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK
QWNER bL4ME
SITE ADDRESS:
TENANT NAME;
SUITE 1: _
INSTALLER:
ADDRESS
CITY: Zip;
PHONE $:
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
PHONE #: 423-1144
L/ 7 B CITI' OF EAGAN
MECHArTICAL PERMIT RECEIPT # /D8 90?
(612) 681-4675 DATE // /4- 9g;2?
RESIDENT7AL
PLEASE COMPLETE iJppER ppRTION ONLY FOR SINGLE FAMII Y DWELI,INGS. AISO, COMPLETE FOR
TOWNHOMES(CONDOS WHF,N SEPARATE PERAIII'S pgE gEQQIgEp FOR EACH DWF,LLING iJNIT.
aWNER. JOE NffLLER HOMFS ' ?
STlE ADDRFSS:
? SS ADD ON/REMODEL (IIffSTIIVG
CONSTRUC170N ONLI) $ 15.00
INSTALLER: GENZ-RY HEATING HVAC: 0.100 M BTU 24,pp
pHO? ? 423-1144 ADDITlONAL 50 M BTU 6.00
RESS: 14745 South Robert Trail gpg pU?-? _ ?M 1@?? ?? ?}
: Rosemount
E
E Zip; 55068 S??RGE $ ,?p
S
GNATURE. TOTAL: $?! 3 0
.
COMMERCIAL
v
?
PLEASE COMPLETE 'PHIS PORTION FOR ALL COMMERCIALQNDUSTR7AI, BL1II,pINGS. ALSO COMPLETE FOR
APAR7'MENT BUILDINGS OR OTHER MULTI•FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWEI.IdNG UNTf.
WORK DESCRIPTION: CONTRACf PR[CE
196 OF CONTRAGT FEE,
STATE SU FEES
RCHARGE IS $.50 FOR EACIi
$1,000 OF PERMTi' FEE,
$
PROCESSED PIPING - $25.00
11QNAiUM FEE - S25.00
$
ORNER: TOTAL: g
STfE ADDRFSS:
TENANT:
SUI7'E #:
_ .
.
INSTAI.I.ER: ._
. . . , . . :. -.., ..:_ . .
? .-
ADDRESS:
ZIp;
ff CI1Y S
IGNATURE;
F.ai
M 2422 Eoierprise OflV6
* Mendvtv Helghts, MN 65120
•'+` PIDNEEP LAND SURVEVORS - G'nL ENGINEERS (612) 681-1914-Fax 681-8488
* eng n,eer?ng UND FLANNERS • l/?NPSCAPE ARCH11EC19 gys tt;yhwoy to NortnEOSt
* Bloine, MN S5434
* * * (612) 783-1880•Fox 783-1883
Certificate of Survey for: JOSeprI M Miller Constructiortst- -I1"1C.
House Address: 3955 Clippers Road, Eagan. MN
1,. Model Name: Vanderbilt 2
? CLIPPERS ROAD
- -- ? ??,?-?a- -- - - - ---- - - - --- - ---
S 00'33'08" W
Y--?5 00?-
TTyY 83.?.? LDPIVEWAY
.x I
X.o ti 210 20.0o I g9°•4?
841-Q? 11.e7 o N ?wnoo wacn ? ?
0
N cMAce 8e8.,,1
0 12.77
`1 14.0 vANGEF941 2
vROPOSED HWSE
N I
N I m 12 COURgE 9ASE61ENT ? ??
!n d?? 30? " N saa7 ! gg1•q -
? O o __ ?zsa o _ zo.oo p N
nt ?j s 00•33'0e• w
{as?.?•
cv ao
, !? ? D 1 883. -7 ? j
ge?.3 4DP? ?49.9 )
L
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S JO By
?
s? i7-
{? -Zf
d::A?S • iR 5u? ?,^',t_aa l
?
7"j ¢,` -1-:?,
N aee.o
x 900.0 Denotes Existing Elevation PROP05ED HOUSE EL.EVATION
.?o?j Denotes Proposed Eievation Lowest F'loor Elevation: $83.So
-- Denotes brainage & Utility Easement Top of Biock Elevation:$?ri•91
- Denotes Drainage Flow Direction Gavage Slab Elevation:09b.8`8
?- Denotes Monument
-9-Denotes Offset Hub Bearings shown are assumed
LOT 17, BLOCK 2 SHERWOOD DOWNS
DA4(9TA COUNIY, MINNESOTA
I hErapy Certity that thi5 SUNeY, PIen or reporr wes preperad 6y me or undar my direct supervision end [het I em duty RegistkrBd Land SUrvCyOY
under th6laws 01 the Stele of MlnnPsota, Datxd thiskLday tll ??C V' A.O. 19?_
«J.I 114197- ?or.?<ixd Gna. sxRi3 //:--'' f
SCaIP: 11nch=30feet
NO. 1<891
l27 ,' 90206.44
.. ,.
? * ?
?
y* PIONEER ?AND SURVEY01
T -? LANO PLANNERS •
? engineer?ng
*,? ?.*
7_A72 Enterprise Drive
Mendota Heighls, MN 55120
612) 681-1914•Fax 681_9h86
625 Highw?y 70 Northeost
Blaine, MN 55434
612) 783-1880•Fax 783-1883
Certificate of Survey for JOS2p?'1 M Miller Construction, ?r1C.
House Address: 3955 Cii?pers Road. Eagan. MN
Modei Name: Vanderbilt 2
•? C?fPP=LRS ROAD
?. ?o
o? 'b ?C ?, L??M ? r s o0•33 oa" w
ry Pn?e?2.1_-_,-__- -- '
-?- ?- x g g ?. S?o
. /A? 5.00
- - - J=- - --v . ?__?------- -- -- ---
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??c, ? ?? ?
?? / ? t??
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.?a?, ?? ??a?
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899.9
o?
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? 8?3.
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i
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i
3 S 0035'OB" W ??e.f.5??
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-,
,.
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o,,.
,y
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" \
\I ?680
a
, nao.o Denotes Fxisting Flevation PROPOSED HOUSE El_EVATION
.?sqo.o? Denotes Proposed Flevation . Lowest r(oo?
_- Denotes Drainage & Utility Easement Elevation:88 Ilo
' - Denotes Drainage Flow Direction Top of Block Elevatio ??9?.z
-o- Denotes Monument Garoge Slab Elevation? 8? 9D.?.4
--$- Denotes Oftset Fiub 6earings showr are assumed
LOT 17 , BLOCK 2 Sf-iERW00D D?WNS
DAKOTA COUNTY. MINNESOTA ? -? ?
1 hereby certily ihal d?is survey, plon ar reporl w1ns prCpared by me r unJer my diiecl sutp+?r?rvis?ion and that I a?n Auly ftegislerrd land Surveyor
w?der the laws ol ihe Sta?e of Minnesota. DaleA Ihis `bju Jny ol ??? ` A,D. 791_?.
?
?,???",t?- _ _ ? -
,_ ? ?:
? f??v
?????1' ?If1Cf1_??1CCf ? ?R09ERT ,$IKIC????y.?EG.NO.lA891
?7 90206.44
? SERJ? ?<.o
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10 _ _ ? VAI1DFRf31L1 2 y
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C-J/T PROPOSED ? OVSE ? ? a
J ?
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°?' wni?co?r,., to.67 ?J83.] I
37.J3 _ ?? _ JOAO _?
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA108665
Date Issued:12/28/2012
Permit Category:ePermit
Site Address: 3955 Clippers Rd
Lot:17 Block: 2 Addition: Sherwood Downs
PID:10-67670-02-170
Use:
Description:
Sub Type:e - Water Heater
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Renae Freinwald
2200 Hwy 13 W
Burnsville, MN 55337
952-767-1870
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nick J Boosalis
3955 Clippers Rd
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
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C�ESCRIPTICIN ��`
V�ivatian Y Z 300. �c pccup�r��y C—� MC��� s#+�m
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132429
Date Issued:08/13/2015
Permit Category:ePermit
Site Address: 3955 Clippers Rd
Lot:17 Block: 2 Addition: Sherwood Downs
PID:10-67670-02-170
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Nick J Boosalis
3955 Clippers Rd
Eagan MN 55122
(651) 686-0932
Trinity Exteriors Inc
4204 Park Glen Rd
Minneapolis MN 55416
(952) 920-9520
Applicant/Permitee: Signature Issued By: Signature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA136203
Date Issued:04/29/2016
Permit Category:ePermit
Site Address: 3955 Clippers Rd
Lot:17 Block: 2 Addition: Sherwood Downs
PID:10-67670-02-170
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nick J Boosalis
3955 Clippers Rd
Eagan MN 55122
Window Outfitters Inc
12605 Creek View Avenue
Savage MN 55378
(952) 746-6661
Applicant/Permitee: Signature Issued By: Signature