1412 Deerwood Ct
Use BLUE or BLACK Ink
Fa Office Use
City of Eajan ~ Permit al OS t> -k- I
I
'r" Permit Fee: `,S S
3830 Pilot Knob Road ~ L j , 4
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
2010 MECHANICAL PERMIT APPLICATION
Date: ^1-c -10 Site Address: 1 1 DQ3° (-(A QJ
Tenant: ny* a L ry-I Suite Q j .
RESIDENT / OWNER Name \ Phone: L05 ~ " QO `LJ20
Address / City / Zip: 1 QZLA~ J 0 V, E~~" ) a`
Name: BURNSVILLE HEATING & A/C, INC. License
CONTRACTOR
3451 W. Bansville Parkway
Address: Suite 120 City:
Burnsville, MN 55337
State: Zip: Phone:
Contact: F____ Email:
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: (!_AC- i~C A L11 kj
NOTE: Roof mounted and ground mount Q rr5ec , anical equipment is required to,be screenedbytity
ode. Please contact the Mechanical Iri$pector for information on perm Oed s,F.regning methQ( S.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace _ New Construction Interior Improvement
_,Air Conditioner _ Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank L_ Install / _ Remove)
t t " When installing/removing tank(s), call for inspection by Fire
Other + a k / Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $ Q State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.cgopherstateonecall.ora
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 a approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Applicant's Signature
FOR OFFICE.USE Reviewed By: Date:
Required Inspections: Under Ground Rough In -Air Test' Gas Service Test In-floor Heat Final
Exterior HVAC Screening Inspection
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
OFFlCE USE ONLY
METER# ?3 ??O 7a S/pERMITDATE 03/20; 90
CHIP # D I ?/ 6 ? WATER PERMIT # 11277
METER SIZE B.P. RECEIPT # C FAnZL
ISSUE DATE B.P. RECEIPT DATE03 16 9p
PRV - BOOSTER PUMP
SITE ADDRESS ??? I L b F?I`Lf,cL r PERMIT RE(.UESTED
LOT L "BLOCK 7- SEC/SUB L 1
X SEWER Y WATER _ TAPS
APPLICANT:
ADDRESS: 'Z..jl'S ????r-h-7 _COMM/IND ?RESIDENTIAL
CITY, STATE afiA2 rVR%, ZIP ? z
PHONE: ? 5.. X NEW _ EXISTING
PLUMBER: 421/ QT?ic.?????L
AODRESS: I AGREE TO COMPLY WITH CITY OF
CITY,STATE =-g?F1/j,?F r'y1.LJ. Zip --'4 EAQANORDINANCES:
?
PHONE: --
?-
' OWNER:
ADDRESS: SIGNATURE WH N METER ISSUED
CITY, STATE ZIP
PHONE: _Ie6f?
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERiNG DEPT. APPLICANT AND PLUMBER WILL BE NOTIFlED WHEN PERMIT IS PROCESSED.
? --- -- - . __ _ _ -_- - - --- -
? CITY OF EAGAN
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PEM1T + PHONE: 454-8100 Receipt #
To 6e used fnr DNCK G?t v?io n.,.,. SEP
Site Address lftl= DiLKNppD CT
Lot iZ Block Z Sec/Sub. ENWTWM'5
Parcel No.
W Name i'1aN7g J CARNEY
z
3: Address 1412 DEg1tTiO0D G7
° City B/?GAN Phone 687-9607
;i o Name SAM
OU? Address
City Phone
Address
I hereby acknowiege that I have read
information is correct and agr e to a
Minnesota Statutes and? E f
Signature of Permitee? f f"L Phone
r?.
application and state that the
y with all applicable State of
g Permit is issued to: """ `_' `' `''%ML j
cpress condition that all work shall be done in accordance with all
e State ol Minnesota Statutes and City of Eagan Ordinances.
Oificial
0- t: 19738
OFFICE USE ONLY
Occupancy - FEES
2oning _
(Actual) Const
(Albwable) _ Bldg. Permit u•oo
N ol5tories - Surcharge •50
Length 1MS Plan Review
Deplh 21XZI SAC, City
S.F. Total - SAC, MCWCC -------
-
S.F. Footprints j
-
On 5ite 5ewage _ Water Conn
On Site Well - Water Meter
MWCC Syslem _
City Water _ Acc1. Deposit
PFV Required _ S/W Permit
Booster Pump - g/W Surcharge
Trealment PI
APPROVALS Road Unit
Planner - Park Ded.
Council
Bklg.Ofl. _ Copies
Variance - TOTAL 25.50
Permit No. Permit Holder Oate Telephone #
WATER
SEYVEF
PLUMBING ,
H.VAC.
ELECTRIC
kispection Date Insp. Comments
Footings I
Foundation .
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
FireplaCe
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. tiAeter
EngrJPlan
Bldg. Final
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
- -- CITY OF EAGAN 17-605
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
?g''t 'tj ? PHONE: 454-8100
BUILDING PERMIT Receipt # '
To be used for SF puG/GAR Est. value $135,000 Date ZIAR 15 1990
;S 1412 DEERW00D CT
_ Block Z SeclSub. ENGSTROPi' S
DEERWOOD
Phone
City Phone
Name _
Address
Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree io comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee
A eudding Permit is issued to: pItTTELS?AEnT BROTHERS
on the express condition that all work shail be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
Occupancy R-3 M-I
Zoning 4_--l
u-N
FEFS
7??.00 ?
67.50
;
445.04 ?
100•00 y
600.00
3
625.00 j
90.00 'l
30.00 ':
30.00 ?
I
.50
252.00 ?
355.00 3
(Actual) Const ? Bldg. Permit
(Aliowable) v
?
- Surcharge
# af Slories
570
Plan Review
Length 36'
Depth SAC, City
S.F. Totai SAC, MCWCC
S.F. Faoiprints -
On Site Sewage _ Water Conn
On Site Weli
xx Water Meter
MWCC System
City Wafer XK Acd. Deposit
PRV Required - S+V'I Permit
8ooster Pump 51W Surcharge
Treatment PI
APPROVALS Road Unit
Pianner - park Oed.
Council
&dg.Off. _ Copies
Variance - TOTAL
3,407.OU ?
• ? Permit No. Permtt Holder Date Telephone #
WATER
srewEp
PLUMBING
H.V.A.C. Q ? • ?' f d
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing 3'j,? `!C'
Roofing
Rough Pibg.
Rough Htg. 2-3v
isui. -02? - - ?? "
Fireplace
Final Htg. 494 ?
Fnal Plbg. ? z- 9 a
Const. Meter PI6g. Inspector - Notify Plumber
Engc/Plan
81dg. Final S?•Z (aJ? - - ?G? !(J ? G?I-??
Deck Ftg.
Deck Final
Weli
Pr. Disp.
?... _ ,...
, . , ..,
... ,. . .
-
. _-?
, _. .
PERMIT # G? / _J
`
' . MECHANICAL PERMIT RECEIPT # ' -
. CITY OF EAGAN
DATE:
3830 PILOT KNOB ROAD, EAGAN, MN 55122
j CONTRACT PRICE PHONE: 454-8100 For Office Use Only:
' Site Address R BLDG. TYPE WORK DESCRIPTION
! Lot Block Sec/Sub Res - New :i
,1 ` f , 4' Mult Add-on
- Name
ID
? .
Address 'iliOPE T S?,ANn AVE Comm. Repair
c City Phone 92"-000r Other
Name = T r r, '': ''" £ r, DRO r13 ER S FEES
00
HVAC 0-100 M BTU - $24
RES
.
.
c Address ADDITIONAL 50 M BTU - 6.00
p City Phone '? F-'?' (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTIOH)
50 EA
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1
;
.
.
' TYPE OF WORK COMMIIND FEE - 1a/o OF CONTRACT FEE
? Forced Air M BTU APT BLDGS. - COMM. RATE APPUES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU ? MINIMUM COMMERCIAL FEE - 20.00 -
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping OuUets # BEYOND $1,000)
Other
FEE:
' SIGNATURE OF PERMITTEE
S/C: .
TOTAL• FOR: CITY OF EAGAN
rILuMUInu remml I For a
CITY OF EAGAN PERMIT # s
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PRICE PHONE 4546100 DATE:
Phone
FEES
CC7MM./IND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - CQMM. RATE APPLIES
TOWNHOUSE 8, CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND.IFEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 SIC PER EACH $1,000 OF PERMIT FEE)
BLDG. TYPE WORK DESCRIPTII
Res. X New
Mult. Add-on x_
Comm. Repair
Other
I I
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Waber Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM -1 PER PERAAI7)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
? U. G. SprinWer System - $12.00 1 a-ou
PERMIT FEE:
STATES S/C: T J
!, : _ WND TOTAL: ? a • 5 0
PRICE
Site Add?j
Lot . ?`-
?
?
c
Cfty ?'o?-
FEES
COMMJIND. FEE - 1%OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND.lFEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S1C PER EACH $1,000 OF PERMIT FEE)
CITY OF EAGAN
3830 PILQT KNQB ROAD, EAGAN, MN 55122
?/ ?1 _ PHONE 4548100
PERMIT #
DATE:
BLDG. TY WORK DESCOPTIC
Res. New
Mult. Add-0n
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO FIXTURES TOTAI
.? Water Closet - $3.00 $
Bath Tubs - $3.00
?E Lavatory - $3.00
_L Shower - $3.00 ?
? Kitchen Sink - $3.00 a
UnnaVBidet - $3.00
? Laundry Tray - $3.00 3_c??
? Floor Drains - $1.50
? Water Heater - $1.50
? Whirlpool - $3.00 !3,a ?
Gas Piping Outlets - $1.50 J. ru0
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
--3--Rough Openings - $1.50 ?
U. G. Sprinkler System - $12.00
PERMIT FEE: A)5' 00
STATES SJC: ,So
CITY OF EAGAN
454-8100
DEPT. OF BUILDING INSPECTIONS '
Correction Notice
Located at i5?2 r--
,
Date
-?? Inspector City of Eagan
DO NOT REMOVE THIS TAG
I have this day inspected fhis structure and
these premises and have found the following
violations of city codes governing same:
When corrections have been made, please
call 454-8100 for inspection.
e p
? • `
fgtr#i#iratt of (Orrupanry
titp of (tagan
ioPpd11tPIlf of vwbtlt J jttSpPtttDtt
This Certifrcate issued pursuant to the requfremenls af Section 306 of rhe Uniform Buildirtg
Code certifying that at the time of issuance this structure was in compliance )wth the various
ordinances of the City regulating building constructron or use. For the following.• ,
[lse Cltsti6ntion SF DWGICAR BIdB. Rrmit No. I7605
omw.-r Trx F*/M ? Z-Mw ouuia R 1 Tra ConsL VN
own« of eUMMS MITrUMAEUr BFDIHERS Add= 785 SIM DRiVE, F.ACt
.?_.. 1412 LEERWCM ?-OCIURT ,__,:- L12, B2, ENO..i S DFM,lOm
bau: MAY 711, 1990
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
?,?? r t i? f M?i
I SITE ADDRESS:
pERMIT SUBTYPE:
I
1 .I tt 1 [o r I
APPLICANT:
TYPE OF WORK:
M0 11d i 1 .7
ivi. i.t_ 0 n ? 10 N
INSPECTION .. . ..
i
I ,Af;I", ? q4f'AFACf f'l11MRlNti k f1FI.Tftlirll PFF(MII', RFt)IIlk1-f)
?
?
Pennit NO. PermR Holder Dete Telephone i
S/W
PLUMBING -??g7
HVAC
ELECTRI
ELECTRIC
Inspection Date Insp. Commerrte
Footings I
Foundation
Framing
Io-
XL/?/ C3 ? i G I+ L_
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Fnal Htg.
Orsat Test
Flnal Plbg. Plbg. InspeGOr - Notify Plumber
Const. Meter
Engr./Plan
Bidg. Final 31AZI2,
Dedc Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: 0 { p`' II
Eagan, Minnesota 55122-1897 Date Issued: `' r' •'
(651) 681-4675
SITE ADDRESS:
PERMIT SUBTYPE:
I I 'I Mnirr -; :1:?11 rfNr V iI I
I F
IL
• i w .' s•+wn i rw I.,
4 0 , , APPLICANT:
I t t t, I 1 1 l, i i- ( H R.'
TYPE OF WORK:
i N",P t
?
?
PsrtnR Holder date Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inepection Dete Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE , U
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
MEfER
IRRIGATION
METER
FLUSH
MAINS
coNOUCnvirr
TEST
HVDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN No .1 g738
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454- 8100
BUILDING PERMIT Receipt # 0J
To be used for DECK Est. Value Date SEP 26 , 1991
Site Address 1412 DEERWOOD CT
Lot lZ Block 2 Sec/Sub. ENGSTROM' S OFFICE uSE ONLY
Paicel No. occupancy - FEes
Zoning _
w Name MONTE J CARNEY (Actuap Const Permit u-oo
Bidg
o AddfeSS 1412 DEERWOOD CT _
(Allowable) - .
?
SurChar
9e •
Cily EAGAN PhOne 687-9607 # olStories
8
1 Plan Review
W
Length
o Name S'?'?E Daplh 2?1 Ciry
SAC
i
g¢ Address S.P. Tolal - ,
SAC, MCWCC
? City Phone S.F. Footprims _
t
C
W
On Site Sewage a
er
onn
?w
W Name onsaeweii
w - Weter Meter
Addfess MWCCSystem -
iw City Phone Ciry Waler _ Accl. Deposit
`
PRV Required - .?AN Pertnit
I hereby acknowlege thal I have read this application and state that Ihe Booster Pump - SM/5urcharge
information is correc[ and ag e to comply with all applicable State of
Minnesota Statutes and Ci Ee r" nces. Treatmem PI
Siqnature of Permitee r APPROVALS Road Unit
A Building Permd is issued to: MONTE J ARNEY Planner - park Ded.
on the express contlition that all work shall be done in accordance with all Coumil --
applicable Slate of M
(in?nesota Statutes
and City of Eaqan Ordinances. BItlg.Olf. Copies
.
?
BuiidingOfiicial 1 ??1lAil m?q va^a^ce - TOTAL 25.50
CITY OF EAGAN N2 17605
3830 Pflot K.nob Road, P.O. Box 21-199, Eagan, MN 55721
PHONE:454-8700 ? .
BUILDING PERMIT Receipt a
To be used tor SF DWG/GAR Est. value $135, 000 pntp MAR 15 1a90
Site Address 1412 DEERWOOD CT
Lot lZ Block 2_ Sec/Sub. ENGSTROM'S
Parcel No. DEERWOOD
W Name MITTELSTAEDT BROTHERS
o Address 785 SUNSET DR
City EAGAN Phone 456-9125
?F Name SAME
ga Address
? Ciry Phone
.
W W Name
tAddress
aw City Phone
I hereby acknowlege Ihat I have read Ihis applicalion and state ihal the
informafion is correct and agree to comply with all applicable State of
Minnesota StaWtes and ?f Eagan Ordinances.
Signature ol Permitee ?
A Buiiding Permit is issued to: MITTELSTAEDT BROTHERS
on the express condition that all work shall be done in accordance with a11
applicable State of Minnesota StaWtes and City,of Eagan Ordinances.
Building Oflicial
OFFICE USE ONLY
Occupancy R-3 M=1 FEES
Zoning R=1
(ACtual) Cons1 v-N BItlg.Permil 762.00
(Allowable) V=N
Surchargo
h?.5?
# al Stories
57'
Plan Review
495.00
Length
Depth 36' SAC, City 100.00
S.F. Total - SAC, MCWCC 600.00
S.F. Footprints -
625
00
On Site Sewage _ water Conn .
on Site Well Water Mater 90.00
MWCC System xx
`
Acct. DepoSit
?
30.0
City Walar .
{j _
PRV Required _ S/W Permil 30.00
Booster Pump - SIW SurCharge . -5o
Trealmenl PI 252.00
APPfiOVALS RoadUnit 355.00
Planner - park Ded.
Councii
91tlg.Oft _ Copies
Variance - Tp7AL 3,407.0
0
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number: 022350
Eagan, Minnesota 55123 Date Issued: 10 / 2 6/ 9 3
(612) 681-4675
SITEADDRESS: L oT: 12 BLOCK: Z APPLICANT:
1412 DEERW000 CT CARNEY MONTE J
ENGSTROM'S pEERW00D (612) 687-9607
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FZNISH AITERATION
INSPECTION
FRAMING .. .
TNSULATION „
ROUGH IN PLBG FTNAL
REMARKS: SEPARATE PLUMBING & ELECTRICAL PERMITS REQUIRED
F-
?
?/i
00? +.96
REQUEST FOR ELECTRICAL INSPECTION
? See Instmctions lor completing this lorm on back al yellaw aopy.
`X" 8elow Work Covered by This Request
? /Eg/-o8
? ?"
?.?:.
ew Add Rep. Typeoi6uilding AppliancesWired EquipmeniWired
Home Range Temporary Service
Dupiex Water Heater Electric Heating
Apt. Buildinq Dryer Load Menagement
frial
/I
d
C Furnace Olher (SpeCity)
n
us
omm.
Farm Air Conditioner
Olhar(sGecity, ConVeotor's Remarks'
?Srn'f?
Compute lnspecfion Fee Below:
# Oiher Pee # ServiceEntranceSize Fee # CircuitsiFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above-_ Amps
: TOTA ? O
rors Use Onl
I
SignS y
rispeo
O r?
'
Irrigation Booms
Special Inspection
i
i LATION MAY BE ORD RED DI5CONNECTEO !F T10T
on
cat
AlarmrCommun THIS INSTAL
COMPLETED WIT MO ?
Other Fee o
?A
I, the Electrical inspector, hereby Rouqmm
a
^ ?
d•
certify that the above inspection has F,nai
been made. t
OFFICE USE ONLY
This request vaid 18 monihs from
ni
L_
C3 //_ VI
, u
? `?? ?
02496
V?
Aepuest Date ire . RougRln Inpsetlion Require0
ctar
C1' au mu all inspe when reetly) Inspection Otner Tnan ough-In
? peetly Now ?''ill NotiTy Inspeclor
/U ^
9 es ? No
V Date Read
I-?] licensed contractor gowner here6y request inspection ot above electrical work aY.
Job Address (Slreet. Box ome No.) I
?
? C??y
e?wv?c?
?/? •
Section No. Township Name o, No. Range No. Counry
Occupan:;PFINT /? Phone No.
?1 on ?"a rn e
Powee Suppllar AtlOress
Elecincal Com aclor ?GOmpany Namej . GonVeofor4 License No-
aryr£i e t,
Maiiing Atldre Gonuacror or Owner Makmg iostallation)
Aulhoreetl n e 0 Iractor%Owner Making Inslalialion, Phone Number
6
G,
I_ ? -
MINNESOTA STA E BOARD OF E CTRIQTY THIS INSPECTION REOUEST'?'ILL NOT
kk?
G??9gs-MiEwey Blpg, - Room 5- )3 BE ACGEPTED 8V THE STATE BOARD
1821 University Ave_ St. Paul, MN 55100 l1NLES$ PROPEP MSPECTION FEE IS
Phone (614) 642-0600 ENCLOSED.
i ?
? ??19
.
4 (475 - ge ?
.?
Request Date
3.??? _ Fd Fi o. ugh-in Inspection
e uiretl?
? Reatly Now ?Nill Notily Inspector
Ves ? N. When Reaay?
I Xlicensed contractor ? owner hereby request inspection of above electrical work at:
Job AdCresS,? reet, Box or ROU[e No.)
Y Cify
?
Section No. Township Name or No. Pange No. County
Occupan? PFIiNT)
? s Phone No.
- g zs'
Power Supplier Atltlress
" _ /
Eleclrical Conhacror (Company Name)
247v/_'c-/u CoMractoYS License No.
Mailing Atldress
(
COMra
c
to
r or Owner Mak
ing
Installatqn)
?
J
?
p
?
/
`
?+
1 a lCL/(? L iC.. ? L. V !-/l
?
9
5
AuiMrrzetl ndturnlractr/Owner Making Inslallation) Ph
=
.
MINNESbTA STAiE BOARD OF ELECTqICIiY THIS INSPECiION REpUEST WILL NOT
GdggsMitlway BIOg. - Room 5-173 BE ACCEPTED BYTHE STATE BOARD
1821 Vniverelty Ave., $[, pgul, NN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone (812) 642-0800 ENCLOSED.
?'?3?? REQUEST FOR ELECTRICAL INSPECTION Ar% ee-0aom-o? ?
0-See inslrucuwns tor completing this form on back oi yellow copy. ?9?`O
2 47475 7?0 7
lf' X` Below Work Covered bv This Renuecr
ew -Add Rep. TypeofBUilding ApplianCeSWired EquipmentWired
Home Range 7emporary Service
Duplex Water Hea}er Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Fumace
Farm Air Condilioner
Other (speciry) Contracmrk Remarks
Compute lnspection Fee Selow.
# Other Fee # Service Entrance Size Fee # Circuits/Fe¢ders Fee
Swimming Pool 0 to 200 Amps o to 100 Amps
Transformers Above 200 _ qmps A6 Amps
SiynS
I
n
i Inspectora Use Only TAL
O
r
gat
on Booms ?
Q L?^?
?
?
Special Inspection J
Alarm/Communication
O[her Fee
I, the Electrical Inspector, here6y R0O9n'"
certif
th
t th oale ._>
y
a
e above inspection has
. been made. Finai
r
? ?J
8e
OFfICE OSE ONLY ?
This request void 18 months fmm
?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN a?-
? ?1 ? L? 3830 PILOT KNOB RD, EAGAN MN 55122
? 4 651-681-4675
NewConstructlon ReauiremeMs RemodeVRenatr Reauirementa ????
• 3 registered si[e suneys shawing sq. ft. of lot, sq. ft. af house; and all roofed areas • 2 copies of plan S-? a(20% maximum lol coverage allowed) . 1 set of Energy Calculetions for
heated addMions
• 2 copres of plan shovnng 6eam & wiridow saes; poured fouM desgn, etc.) . 1 site survey for ezterior addifions 8 decks
• 1 set of Eneryy Calculalions . Indicate iF home served by septic system for additions
• 3 copies of Tree PreservaNon Plan d lot platted after 7!1193
• Rim Joisl DefaO Options selection sheet (bldgs with 3 or less units)
DATE 'S(9 I ?AG"?? VALUATION
SITE ADDRESS IqI 7 ?)C- 7C/L?OQ (::!-T- MULTI-FAMILY BLDG _Y X N
TYPE OF WORK PclX-rl AOD rTi ot3 FIREPLACE(S) _ 0Y
_?1
_ 2
APPLICANT C_Az2,JE '- I
STREET ADDRESS )41Z ?C clL??? ? (Z:T- CITY EA??1 STATE'L ZIP S5122
TELEPHONE # ?451 (o;9? '?214-o7CELL PHONE # (o(Z 6 FAX #
PROPERTY OWNER
TELEPHONE #
------------------------°----------------------------------------------°------------°-------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CAT'EGORY 1
(J submission lype) • Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calcuiations Submitted
Plumbing Confractor: ____
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor.
_ Air Conditioiung
Heat Recovery System
Phone #
Phone #
MAY 0 9 2002
5
$90.00
Fee: $70.00
-----------------° ----------------- °--- ° ° --- °-------------- ° --------- ° ------- ° -------- °--------------- °---------
I hereby acknowledge that I have read this application, state that the i rmat' ' correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan O' c.
Slgnature of Appllc
OFFICE USE ONLY
Phone #
_ Water SofCcncr _ Lawn Sprinkler
_ Water Heater _ No. of R.I. Ba1hs
No. of Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated M02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace 21T 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 11' 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
K 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation ?7C! O Occupancy 9-y- 4(4 MC/ES System
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const VN W idth
REQUIRED INSPECTION5
_ Footings (new bldg) FinallC.O.
Footings (deck) ? FinaUNo C.O.
x Footings (addition) _ Plumbing
I
Foundation HVAC
Drain TIIe Other
Roof _ Ice & Water Fina] Ftgs _ Air/Gas Tests
Pool _ Final
? Fraxning _ _
_ _
Siding Stucco _ Stone
Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)
Insulation _ Retaining Wall
Approved By 7 z , Building Inspector
Base Fee
Surcharge
Plan Review ?J y?• ? ..
MC/ES SAC ? ? /?? ?? v n ? ? y o
e?wA,
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant ?/ ?
?U
Plumbing Permit Vv
Mechanical Permit
0 '
License Search
Copies ?!i "/?? 1?2
Other
Total
1- . +
s T r , I ? ??
?
1990 SUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADORESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN GOMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
YAR 1 3 Reco
NjL?/ Valuation: I J? ?(J?`? Date:
To Be Used For: ?J?1-r F 2 ? .?i,3 ??/o
Site Address f`//j l)GP?i.>? CJ1 OFFICE USE ONLY
Lot la Block a
y-P
Parcel/Sub 6m,
Owner
Address
City/Zip Code
Phone
Contractor &7-j'l-L,S7-/42`117- di7/?J`a-
Address 17$ 5 ?'-?I „?s-17- '6/7
City/Zip Code /"60, 55'1'?13
Phone Z{ G/ al_S
Arch./Engr.
Address
City/Zip Code
Occupancy 9?3 M_ 1
Zoning fL ^I
Actual Const V-N
Allowable V-N
# of stories
Length 57 ?
Depth 36l
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System t/
City water ?/
PRV _
Sooster Pump _
APPROVALS
Planner
Council
Bldg. Off. 16P?Y((4
Variance
FEES
B1dg. Permit ?6Z'00
Surcharge 67150
Plan Review
0
1495.0
SAC, City LOQ100
SAC, MWCC ?(? D,OO
Water Conn 20
Water Meter 00
Acct. Deposit 3 D,CO
S/W Permit 30.c77
S/W.Surcharge ?5o
Treatment Pl. ZSZ.W
Road Unit 955100
Park Ded.
Copies
SUSTOTAL
Penalty
TOTAL
Phone #
1/?! ?t'?TI O P? ?. ?
C-?A R,?(7E ° . , ?,
r-e
Z2x22: 4K? x i?= ?2,60
I?6 ,, /s; Ca??)
I4 %/ y
?2y 32= 3??1
I 05(--, xI H = 1 u'7f3 q
I sT ?'?? o??,
?sm-r_ lo?
ax? _ ty
I ? X 51 ; s7o15?
ZKID -FL oo?>-
?S??'+T ? l0 5?
?xr1
/o?u xS? = 552??I
? . .
/ 3Nv7 (.
DATE
EXTERIOR ENVELOPE.AVERAGE "U" COMPUTATION
oWNER v-• . 2., .sr,.{ v r E
SITE ADDRESS? y?'1, p E'E fL ??ajd Ceu, 2-r
CONTRACTOR Mi nE` S'Cr1E,j'f ' ?,:1 ?..?5. ? nti ? Sr. ? n7 !_.
ADDAESS_7$ S. >hrr Lyi, EA r1,J PHONE 45L q 12$
DETERMINE WORRIrG SQUARE FOOTAGE OF EACH.
1. Total exposed wall area ... 2 '7 3,3 sq: ft. x .11 s 3o°,L
2. Total roof/ceiling area ,.. 1 0 g ? sq, ft. x •026
Total exposed wall area abnve floor d?^
a. Total wall window axea ......................... 7_R y
b. Total door area ................................ 3 8
c. Total sliding glass door area .................. 37
d. Total fireplace wall area ...................... O
e. Total wall framing azea (average ioZ) .......... 2(05
f. Total net wall azea above floor ................ 1 A.5 5
g. Total rim joist area ........................... 'ry to
Total exposed foundation area ? '7 g
h. Total faundation window area ..... .......... q
i. Total net foundation area above grade .......... 17 y
Determine "U" value of each wall segmeat.
a. 2 Q L/ x_ "u" ,q 5 ft 1'1'7. 8
b. 3 S x„u" . ?7 2.'7
c . 3 7 x"Ult . y2 - 1 5. 5
d. D R "U" O ?
05
e. 2L 5 x"u"
f. ,S5-5 xflv" , aq,3v - 190.5
g. 1 4/a R „v" O'lY - 6f.'l
h. c/ x"U„ , N.5 - !; 8
t. 7y x"vll , bq2 - 5117
3 . ...............................Total - L 9.
If item i13 is the same as, or less than item 111, you have met ehe intent
of SBC 6006 (c)2.
-1-
Page 2 of 2
To[al exposed roof/ceiling area ? I OS'{l
J. Total skylight area ........................... O '
k. Total roof/ceiling framing area (average 107.).. (p'7,(e
1. To[al net insulated roof/ceiling area ......... 10 1 3,y
Determine "U" value for each roof/ceiling segment.
j • D X "U"
R. ?e /. ?.l R ItUI!
RflUll J. O 21 ? ° 27. ?
4 ....................................... .Total ? 2 3. 8'! ..
If toCal of 04 is the same as, or less than #2, you have met the intent
of SBC 6006(c)L.
Alternate Building Envelope Design
To utilize the total envelope system me*_hod, tha eRtablished hy
the sum of items A3 and 114 shall not be greater than the sum of items
B1 and ff2.
,?.
1. + 2. a
. . . . . . . . . a
3 . + 4.
-2-
-?q?ITY OF EAGAN
830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-23900-120-02
DESCRIPTION:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1912 DEERWOOD CT
LDT: 12 6LOCK: 2
ENGSTROM'S DEERWOOD
B.u3lding;_Permit Type
rBuilding ?Wo.rk 7ype
,
?
-?
?
1
,. ?-
,
BASEMENT FINISH
ALTERA7ION
?\?
?,?'?'??,,,??
BUILpZNG
022350
10J26J93
,
?V?,, C?U co- Cs?i
REMARKS:
SEPARATE PLUMBING & ELECTRICAL PERMITS REpUIRED
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
CONTRACTOR:
OWNER: - Rpplican
CARNEY MONTE
1412 DEERW000 CT
EAGAN MN
(612)687-9607
J
55122
I hereby acknowledge that T have read this applieation and state thaCr the
infiarmation is correct and agree to comply with all applicable State ofi Mn.
Statutes and City of Eagan Ordinances.
L
'. APPLI NT/PERMIT SIGNATURE
?
I ED 8Y: SIGNATURE
REAC7IVATE _
????
PERMIT / C?LCE
14 1993
CI iY OF EAGAN
1993 BUILDING PERMIT
681-0675
APPLICATION
._)e.3S S?
SINGLE d MULTI-fAMILY 2 sets of plans, 3 registered site surveys, l copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is chan9ed or 3) lot thange i.s requested once permit
is issued.
Date Zc-ToI??L /_,._(? /c?3 Yaluation of work
Site Address: l yl Z AD C=/L L,-,) ooC) CT
LiREET W1TE /
Tenant Name: (commercial only)
IAT ? BLOCK c+? SUBD. ENfaST2oHS P.I.D. M/p _ Z39oa -/ ZO -OZ '
,?c ? ?,Joo
Descri tion of work: ?
The applicant is: ? Owner ? Contractor ? Other (Describe).
Name CAIWEY Phone (ye7-9607
Property lAST FIRST
OWnef Address l`{l Z in EEil.l'? oo go C7-
SiREFT STE M
City E/fCnAA?) _ State ZiP
Company OLI-W F2 Phone
Co ntractor Address License # Exp.
City State ZiP
Company NoiJ E Phone
Architect/
Engineer Name Registration y
Address
City State ZiP
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
1 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:
urrit,:t uat vnL.T
BUILDING PERMIT TYPE
? 01 Foundation 0 06 Duplex ? 11 Apt./Lodgin9 jd 16 Basement Finish
? 02 5F Dwg. ? 01 4-Plex O 12 Multi. Misc. ? 17 Swim Pool
? 03 Sf Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comn./Ind.
? 04 SF Porch 0 09 12-Plex ? 14 Fireplace ? 19 Coron./Ind. Misc.
p 05 SF Misc. O 10 Mu1ti. Add'1. ? 15 Deck 0 20 Public Facility
? 21 Miscellaneous
WORK TYPE
31 New ? 33 Alterations ? 35 Tenant Flnish ? 37 Oemolish
32 Addition ? 34 Repair ?.36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCL System
(Allowable) lst F1. sq. ft. City Mater
UBC bccupancy ?i 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster PumP
,1' of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Lensus Code
Depth On-site sewage SAC tode
APPROVALS
Planning Building Assessments
En9ineering Variance
REQUIRED INSPECTIONS '
C1 Site
? Wallboard
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permif
S/W Surctiarge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Lopies
Other
Total:
? Footin9
ER`4 inal
, jS, Ut? I wtr:im:
S
PIff rami ng
? ? Draintile
?
I
?
? Insulation
? Fireplace
SAC %
SAC Units
.3LA 5 ?5 S c, o. -?D
1999 FIREPLACE PERMIT APPLICATION
C1TY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
Date:?z C q-,/'
Description of Work: ? Construct new fireplace _ Alterntions to existing
_ Install eas insert oulv _ Install gas line onlv
Other
Job address:
Lot: ??- Block: Subdivision/P.I.D. #: ?C v?a'T-, 0 Vti^ S Gff fVWa?
Applicant (circle one only): Owner ontracto
Permit Fee: $60.50
Ca v ? -? ? YYl 0
Name: ??/? AJ?aJA? Jbe? d? ?=f Phone #:
PROPERTY Last First
OWivER
Street Address:
City S[ate: Zip:
Company: dbiftHO Phone
FIREPLACE Isom
IP ISTALLER Street Address: '2Tm IL ??i111iQ1 Allt
anrile0 5RI1s
City State: Zip:
Company: Phone #:
GASLINE
INSTALLER Street Address:
City State: Zip:
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 Eag an
Ordinances.
Z"
Signature
6661 t 1933
OFFICE USE ONLY
BUILDING PERM1T TYPE
? 14 Fireplace
WORk TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFOR.NiATION
Census Code. 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
opirAl p.itM
1Vt09 *+lni Fo!
ttlDlOOSII e?.?npU am"bW
.sv4 re"ci .N OULS
S! i u MM ,W(vszs*
tazsUMra
t. .? . .
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT
PERMIT TYPE: P, u:[ i n r iv G
Permit Number. ti 3 4 6 11i1
Date Issued: 0?/ 1 1 I 9 9
SITE ADDRESS:
F-I.N.: 10-23900-720-02
DESCRIPTION:
7.4].? U1=Ff.WO OU Cf
LQT: 12 L3LUCK: "G
tNGSTR0M3 DEL.IRWDUO
,
F/51T:ild3nct_Per'mit 7yue
Isuzldin4 W t?rk 'iVpe
,rnL?ue Code
%
?? .
.` /-
:
.., ;.,.,'
1=7'REPLNCL
hIEW
434 {1Ll'. RESIDkNTIAL
? ? -
?? .. . . , _ . . .. . _ .. _
REMARKS:
cNrrNev;F i_uE: riu:;r hF rn!sP Fr,rFn aer oP E coNCr- sairnr,.
e0
L'ITV UF EA(:;FlN
CASHIFF.e S TERMSNAI_ N0. Eii.B
UA'Tr-.^ 0?/li/39 TIME: 1.4:22:1.4
IE':
NAt1Ee FSRESIDE COF:NEk
3210 9001. 1.41.2 DEFk1400D C 60.00
2155 3001 1412 DEFTR1400A C 0.,50
, sr. I.rc. OWNER:
; 42 28090911 CARNEY IhONTE
14:1.2 Df'ERWOtJO CT
? E(dGHN MR! 5 5 :L:1 3
av2 reod ttis ?inoJ.i_cation and sT,aCe that the
'fo+a7. Receapt Arcicn:n+„ 60.50 ?
?roe to r,omnly w,r`th a11 apoiicaMle St:aT.E? oT P4n-
CR:LOci2:L da nances.
USFR IL: NANCY
SUED BY: SIGNATU E
J
FLEASE COMPLETE FOR SIIVGLE FAMII.Y DWELLINGS. ALSO, FOR TOWNFiOMES' AND
CONDOS WI-EN PERMITS ARE REQUIltED FOR EAGH UNIT.
,.
NO. FIXTIJRES EACH TOTAL
SHOWER 3.00 f
WATER CLOSET 3.00 ?
BATH TUB 5.00
LAVATORY 3.00
KTTCHEN SINK 3.00 1
- LAUNDRY TRAY 3:00
HOT TUB/SPA 3.00
WATER HEATER 3.00
'. FLOOR DR:AiN 3:00
GAS PIPING OUTLET •?? - i 3.00
ROUGH OPENINGS 1.50
WATER SOFI'ENER
_
5.00
PRIVATE DISP. • nakay. uc 20.00
U.G. SPRINKLER • nome uuaer oonsc 3.00 ?
• to adsting .
WATER TURN 20.00
STATE SURCHARGE •?
TOTAL: Z L?
srrE ADnxFSS GQ-c-eA-ic-v C-717C
N/ ?
: ,
OWNER NAME: .('`Gt-P?
P ?6 .
IvsTALLER:
.ADi7)RF_4S! O P / 26-
CTTY:I/V ( `
YHONE #: (
s:t
STATE: ZIP CODEi
) K-t2? 7?-5 D-
1994 PLUMBING PERNIIT (RESIDENTIAL)
C1TY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
1991 BIIR D ILICATION
?
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCUTATIONS
ISITLTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITEGTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
(CHECK WITH SLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APYLIES AHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CNANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER Ft[TST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE SUILDING PERMIT IS ISSUED
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAY5 ONCE A PERMIT HAS SEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: OEc1G Valuation:
Site Address I ? ?Z DF.Ep_LoDOz) C'r
Lot 12, Block 2
Occupancy
?
Parcel/Sub
Owner Noc?T'E \T- CA2NCY
Address lq 12- 0 EE(Lwo6 C) C?
City/Zip Code E/4GAn1 HN J'S)2Z
Phone (? 07- `?(, 07
Contractor S c- L
Address SfFh? E
City/2ip Code 5/tA? t
Phone 5f{p-, E
Arch./Engr.
Address
City/Zip Code
Yhone #
Date: 2/Z6/q!
OFFICE USE ONLY
Actual Const
Allowable
# of stories
Length Xi'3
Depth 2 I Xo? I
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off.
Variance
FEES ??. ??
Bldg. Yermit
Surcharge •-R!P
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
Lot Change
TOTAL a5.S0
Sewer MaLicensed Contr.
agrees that all wotk shall be done in accordance with
(Sign ture of Con actor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
3,? ?/ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? - CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New ConslrucHon ReauhemeMs Remodel/Reoah ReauIremeMs
D 3 registered sBe surveys showing sq. H. ol lot, sq. H. of house 2 copies of plan and II roofed areas (20% maximum iof eoveraae ailowed) 1 sef of energy calculaNons for heafed addXlons
D 2 copies of plans (show beam 3 wlndow shes; poured fnd. deslgn; etc.) 1 sHe suney fw exterior addNiom 3 decW
D 1 fet of energy calculaliom
D J copies W hee preservatlon plan 6 lot plaMed affer 7/1 /93
DATE: °I - ce?, -GI `1 CONS?RUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: C-- ?
LOT: BLOCK: .?- SUBD./P.I.D. k:
Name• V V lo.n.te Phone #• b5 ?- 68? - C( bo'?
PROPERTY Lar Hht
OWNER Sfreet Address: ? ? ( ??> ??'n ? ,?,
cHy ?--- Ac. <,---. State: Wl ..? zip: S S
Company: ?? ?6?c? ?c, Phone#: ?'?a
` (area code)
CONTRACTOR
Sheet Address: ?a t> > Fi - I-A- I'q-[ - Q- vt= ticense # 'j 31Exp.
City c Pt ?o-aa ?? lLc-="? llt State: lq.?% ?-. Zip: -1, 5 ()`4 ?
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code (
Streel
City
Sewer & wafer Iieensed plumber (reaulred for new eonslruction onlv
State:
PenalFy applles when address change and lot change is requeafed once permR is Issued.
Zip:
I hereby acknowiedge thaf 1 hwe read ihis applicalion, sfafe that the info s cone , and agree fo comply wMh all applicobl
Siate of Mtnnesota Statutes and City of Eagan Ordinances.
, Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Regisfraflon #:
3=?
Tree Preservation Plan Received - Yes _ No _ Nof Required
MECHAIVICAL (RESIDENTIAL) ?'3p•SZ?
Permit Application
City OfEagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for. Singte Family Dwellings
Townhomes and Condos when perretits are required for each unit
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The Applicant is Owner t_ Contracror Other
Add-on, modification or alteration ta existing dwelling unit $ 30.00
fumace replacement
air exchanger
air conditioner,
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other
State Surc6arge
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I hereby apply for a Residenrial Mechanical Permit and acknowledge that the information is complete and accurate; that tLe work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I undexstand this is not a
pemut, but only an application for a pernat, 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.
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ApplicanYs Printed Name 6ict's 4 Si ature
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2006 RESIDENTIAL PLUMBING PERMIT APPL{CATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 3
1
13 1O? C
_
_
arney Monte
Site Street Address 1412 Deerwood Court Unit #
Eagan, MN 55122
6513357852
Property Owner
Telephone #1 ( )
Contractor,NOr21u'n PL(,(mblnQ Telephone#((pfZ) T27-410?)'3
Address 2qD? Ezar-Fiei,d flv. Isa City r12.DIS Statei? P?) Zipl?-64D9
7he Applicant is: _ Owner V Contractor _Other
Septic System _ New ` Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-buiit $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee inciudes installation of a water softener and/or water
heater at the same time. !f you are Installing onlv a wafer saitener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
Septic System Abandonment
_
2 ?1
_Water Turnaround (add $130.00 if a 518" riieter is required)
-Other U?
I
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Water Softener
Water Heater $ 15.00
V
_ new
replacement
Lawn Irrigation _RPZ ,PVB _new _repair _rebuild $ 30.00
State Suroharge $ 50
Tatal g
I hereby apply for a Residentlal Plumbing Permit and acknowledge that the informatlon is complete and accurate; that the
work wiil be in conformance with the ordinances and codes of the City' of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a p mit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is req 1?j d to be revj4rwed and approved.
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PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. + BLOOMINOTON, MN. 55431 • 812-884•3029
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DENOTES PROPOSED SURFACE DRAINAGE
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PROPOSED LOWEST FLOOR = 880.6 FEET
PROPOSED TOP OF BLOCK = a6g, 7 FEET
WE HEREBY CERTIFY TO MITTELSTAEDT BROS. CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 12, Block 2, ENGSTROMS DEERWOOD ADDITION, according ta tlie recorded
plat thereof, Dakota Couniy. Minnesota
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 9 TH DAY OF MARCH , 1990.
Pk0Ya3EL 4kNLGS 3HOWN WcRG 7AkEN
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SIGNED: ES R. HILL, INC.
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JOHN C. LARSON, LAND SURVEYOR ,
MINNESOTA LICENSE NUMBER 19828
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PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. 9 BLOOMINGTON, MN. 55431 • 612-884-3029
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PLANNERS / ENGINEERS 1 SURVEYORS
9401 JAMES AVE. S. • BLOOMINGSON, MN. 55431 • 612-884-3029
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For Office Use I
I _ I
Permit Z,b I
City of Eapn i
I Permit Fee:
3830 Pilot Knob Road I Q
Eagan MN 55122 Date Received: v ~y
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION ai~zc ( -
Date: C`' er) Ca d q Site Address: / Lf ! Z l7 E_ h < Cv w
Tenant: Suite
RESIDENT / OWNER Name: AA,.- JP~ Gxz Phone: 65-1- ?SS--Z
Address / City / Zip: Z J r Cc> U + * 4 4xrjC(t - fLt .y 51-117z-
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 4 f h 1Z , . dr- i7 -qwC v° G 4-.~- v z ~-C- C4. 1 Construction Cost: z.n ccoc Multi-Family Building: (Yes /
No
CONTRACTOR Name: ,r & 0 Cse-. a 11, 5 c r <<. s T-<kicense e-c -5 ) C1 C v .f
Address: Z, 1>'
City: 4 State: A,' Zip:
Phone:) Z - Z~ G i Contact Person: U t'~ a =y
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) Energy Envelope Calculations Submitted
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.
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 In
Applicant's Printed Name Applicant' Signature
AU G 0 6 2009 Page 1 of 3
Ml,-)
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of Plex Lower Level _ Pool _ Miscellaneous
_ Accessory Building
WORK TYPES
/Q t.U r s tIJ~ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
x Alteratio _ 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
f
Plan Review Code Edition j' 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 HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
~X Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall
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
Copies
TOTAL
Page 2 of 3
Aug 18 09 10:48a Paladin Plumbing 763-515-3818 p.2
For Office Use [
ermit
P
City 0~Eakan
I Permit Fee: 5?)'
3830 Pilot Knob Road
~Eagan IVIN 55122 l Date Received:
Phone: (651) 675.5675 1 I
Fax: (651) 676-5694 Staff: I
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: '6-10-CA Site Address: C' -
Tenant- Suite #
RESIDENT /OWNER Name: _ ct.JJ} .....Phone: ~'St z Z..
Address / City 1 Zip: f'~ r r~s[
CONTRACTOR Name: ! -r t
G ense
T "cif Ct_ C) t iq Vv
J
Address: 3 7f 3 1 x) it v- 7
t _ state: A4yJ zin: 37
City:
Thane: f ? i ICU r. % Contact Person: e- • d
TYPE OF WORK _ New Y Replacement Repair Rebuild _ Nbdify Space -Work in R.0-W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ 1__-_ PVB) (_Y- Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
f~.C`~i^!
RESIDENTIAL FEES: ' ,
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surchargi)
$31.50 Lawn irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Factures, Septic System A ndonment, Water Turnaround' (includes $S0 State Surcharge)
'Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as buiit) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) 5-7)
TOTAL FEES $ S'J ~
t 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
acoordaripe with the approved plan in the case of work which requires a review and appro at of plans.
App cant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Dale:
Required Inspections: Under Ground _Rough-in _Air Test Gas Test Final
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA105020
Date Issued: 0612112012
itj of 0n Permit Category: ePermit
R
Site Address: 1412 Deerwood Ct
Lot: 12 Block: 2 Addition: Engstroms Deerwood
PID: 10-23900-02-120
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Sela Roofing Remodeling Monte J Carney
4100 Excelsior Blvd 1412 Deerwood Ct
St. Louis Park MN 55416 Eagan MN 55122
(612) 823-8046
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
I
For Office l
l Permit Fee:
3830 Pilot Knob Road 67l/i (1'
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 1 Staff:I
I 111 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: V1010 Site Address: 064fWan 004112 t ,E1961A1 Unit
{
C Name:,/~l'(M/76 Q' ®'!Q/ AZV6 Y Phone: 6,5/ 7
Resident/ J~~
Owner Address/ City /Zip: lia 00"-,;7tV000 e0a-( !F/g6AV 1,!Y/f// J 5-5-1d a
Applicant is: Owner X Contractor
Type of Work Description of work: OA (i✓b Ida
i Construction Cost: Multi-Family Building: (Yes No A-)
Company: 44my'll c4H sV,6,C1&4 1 L" (ll~S&ntact: & YAW 6
Contractor Address:2/5 Y /`I -o-ily6s tI4 ~l:dtT/_ /00 City:
E Stater Zip: 6-3-0 P"5f Phone: 65-1 License F/'/ -7 Lead Certificate 0 "Q®t 7Y(03/7
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
_4~0 15,4-1,V95;0 iylrf4e-9r < nit i 136 V/S/n/P7-461
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. Portionsof
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www: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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ~ Y n✓ 6r,AF~ x 6z,//
Applicant's Printed Name Applicant ff ature
Page 1 of 3
Date:
City of Eaan
3830 Pitot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use /
Permit#: 1 / ' 55
Permit Pee; /— S R5
Date Received: laj5 Q
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:. a L M4 1' 6 ' OC1 oz. /
Unit #:
Name: e;1- %'� /� Y
Resident/
Owner
Type of Work
Phone:
2 Hick ivad. ebol r i.. ,9/I//
Applicant is: Owner x Contractor
Description of work: /� �/1.44'!'w g t r- ,+,c
Construction Cost:��%Olj
Multi -Family Building: (Yes / No )
Contact i42 foA6/ t''!� r(GG
Address / City / Zip:
Contractor Address: _
city „a/.fl', 2
State: MAL. Zip: ..J '' O_ Phone: T c
License #: - Lead Certificate # —
If the project is exempt from lead certification, please explain why; (see Page 3 for additional information)
, :f 11 1. '7-./ c'`,Ea /rl_. / r 7,
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:
Mechanical Contractor:
Sewer & Water Contractor:
NOTE: Plans and supporting documents thatPhone:
the Information may be classified as non-public youf you provide specific reasonsred to be that would permit theCiublic information. ty to of
conclude that they are trade secrets.
CALL BEFORE you nIG. Call Gopher Stats 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. vw�w.000herat teonecall ora
hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that codes the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans, of the City of
Exterior work authorized by a building permit issued inung Code mUst be completed
days of permit Issuance, accordance with the Minnesota State Building thin 180
X
&/
Appllca '-' gnature
Applicant's Printed Name
LLL6'°N
Page 1of3
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