4619 Halden CirCASH RECEIPT
_+
CITY OF EAGAN
3795 PILOT KN09 ROAD
EAGAIV, MfNNESOTA 55122
DATE 19
RECeiveo
AMOUNT $ I
? & DOLLARg
+oo
? CqSH CHECK
FOR ...• ? ? / .
FUNp CODE AMOUNT
. ._ ' f.i
ThankYou
B Y
White-Payers Copy
Yellpw-Posting Copy
Pink-File CopY
cirY oF EA"N
3795 Pllot Knob Roed Eogon, MN 55122
' PHONEs 454-8100
BUILDING PERMIT aeceipr #
Te M wed for Est. Vnlue Dote _, 19
Site Addrcu Erect ? Occuponcy
Lot .
Block Sec/Sub. Alter 0 Zoninp
pamel # Repair ? Fire Zone
Enla?ge O TYpe of Const.
oWC Nome
Z Addres
s Mpve
Demolish Q
p #k 5tories
Length
? ri.,. • o?,,,,.. Grade ? Depth Sq. Ft.
o N? -
?
OU Address
f- r:...
Nome _
Address
I hereby ackrwwledge that I hove read this applicotion and stote thot
the informotion is conect and ogree to comply wirh oll epplicoble
Stute of Minnesoto Stotutes ond Ciry of Eogon Ordinonces.
Sl9noture of Permittea
A Building Pertnit is issued to: all work sholl be done in accordance with oll oppiiooble State of Mir
Buildinq Officiol
on the express condition tFxit
Statutes ond City of Eoqon Ordinances.
Assessment Permit
Water & Sew. Surchorqe '
Police Plon check
Firo SAC
Enp. Water Conn.
Plonner Woter Meter
Council Road Unit
Bldp
Off
.
.
APC
Totol '
Permit No. Parmit Holder Misc. Permit No. Holda
r
1
Electric
InMpectlon DaLe Inip. Other
Footinys ? r
Foundatioo
Framinp
Rouph Pibg,
Rough HVA '??;? - ,? •
0
Inwlation
Final Plbq. ZJ
Final HVAC
Final
Water Describe Location:
Yllall
Ssvwr '
Pr. Ditp.
Fteceipt
?
Permit No.
Fee
Fill in numbered spaces S/C
Type or Print legib/y ,
Tot.
1. Date 2. Installation Cost
3. Job Address 'kot Blk. Tract
4. Owner ' TIN THOMPSOIJ IiOIi
5. Contractor ' Phone - ' ' f
6. Address lr6j7 Ch7.C,::,,;o
7. City State I? Zip ).5 40'T
8. Building Type: Residential 0 Commercial O institutional ?
9. Work Description: New 0 Add ? Alter ? Repair O
? 10. Describe Ira;A J_I FueITYPe
I 7],
No,
? Fquioment BTU - M. Ea.
Forced Air No. Enuiament CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech, Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mtg,
? 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 goveming this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numhered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
PLUMBING PERMIT
CITY OF EAGAN
Permit No.
Fee
S/C
Tot.
Fr/l in numbered spaces
Type or Print legib/y
?
Date A'/ 2. Installation Cost
3. Job Address
4. Owner
,
? -
5. Contractor ( l?F i l;;f {1I Phone 66'? ?
6. Address L " l' A
7. CitY State ' i l rL. Zip
8. Building Type: Residential ? Commerciat ? Institutionel ?
9. Work Description: New Od Add O Alter ? Repair O
10. Describe
11.
No.
?-- Fixtures
Water Closet No. Fixtures
Ce
l/D
i
fi
l
I
Bath tubs sspoo
ra
e
n
d
Se
tic T
k
Lavatory p
an
ft
S
?
'
Shower ner
o
Well
Kitchen Sink
Urinal/Bidet
pthe
_L
Laundry Tray r
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 : ?
for
Rough Final
Inspections: Date Insp. Date Insp. ,
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
an 'f ucaN WATER SERVICE PERMIT
?"•OR Ytl..& V...1. O--J nrn u ?T ??? . Meter No.: Connection Charge: ' . ' . -
Sixe: Accourrt Deposit: .
Render No.: Pertnit Fee: '
1 egrea te oweply whh tlw Citp ef Eeyen Surcharge:
Ordinenas. Mist. Charpes:
By
Dote of Inap.:
CITY ?i EAGAN
3°95 Pllot Knob Rood
Eayon, MN 55122
Zoning:
Owner• ilrzin Thnr,a:.on
Address:
Site Address: 4f : 9 Ci
Plumber:
1 yree !o oen+plr wk6 !hs Gtp ef Eayon
Oedinaeea.
8y
Dote of Irup.:
Totol:
Doft Paid:
Insp.:
SEWER SERVICE PERMtT
PEkMIT NO.: `
DATE:
No. of Units:
. • n?-
Connectlon Charge:
Accourrt Deposit:
Permk Fee:
Surcharpe:
Mlsc. Charpes:
ToMI:
Dote Pbid:
CITY OF EAGAN Remarks
Addition R' ff r6t Add11. Lot 5 Rik 1 Paroel #10 63980 050 Ol
ownar ? • ? _" L.?:?' str?ec 4619 Halden Cixcle State Eagan, MN 55122
;
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
? SAN SEW TRUfdK 184.49 12.30 s. 147 .(2 C007633 2-18--82
SEWER LATERAL 85 120-93
WATERMAIN
? WATER LATERAI ?.,;? ,. ?
WATER AREA 14 .6P coo7633 2-18-52
Storm sewer trunk 1905 17-1?3 "!
STORM SEW TRK 1982 638.24 5 638.24 C007616 12-23-81
STORM SEW LAT 109. 53 _ r
Services 1982 637.75 5 637.75 C007616 12-23-81
CURB & GUTTER
? SIDEWALK
STREET LIGHT
Road Unit 185.00 26390 8-19-81.
WATER CONN. 6830
?t
n
BUILDING PER.
SAC n n
PARK
I
CITY OF EAGAN N? 6830
9795 PiIM Knob Roed,. Eegai, MN 55112 .
VHOH[i 454-8700
BUILDING PERMIT Receipt # a6 3?v
Te bs uad hr SF DWG/GAR Est. Volue $47o000 Date Allg=t 1i9-EL
Site Address 4619 Rslden CiTCle Erxt M Occupancy R-3
Lot 5 Blotk 1 secisun.Ridgecliffe 1.81, Alter ? Zoning pp
Porcel # 10 63980 050 Ol Repair ? Fire zone NA
Orrin Thompson Homes Enlarye ? Type of Const. 4
a Name
M°"e
z Address 1712 HUpklns CTOSSr09d ? # Stories
Demolish ? Length6Q_
c; Mtka. 55343 P,o„e 544-7333 Gmde p Depth-,3l._Sq. Ft.-
a! Name r1k.BCS Aoororols Feas
0
i? Addreu
r:... eL_"
Name _
Address
I hereby otknowledge tFwt I have read this opplication ond state that
the inlormotion is correct and n9ree to comply with all opplicable
Stote of Minnewta Statutes and City of Eagan Ordirwnces.
Slynoture of Permittee
A Building Pertnit is issued to: -
oll work sholl be done in accordonce
Buildinp Offlcial
Assessment Permit 4v7•Ju
Water 8 Sew. Surchorge 23.50
Police Plan check 134975
Fi.e snc 525.00
Enp. Water Conn.335.00
Planner Wnter Meter 60.00
Countll Road Unif 185_nO
orF
sid9
,
.
APC
Total
_ on the express condition thnt
Ciry of Eagan Ordinancea.
CITY OF EAGAD1 Include 2 sets of plans.
. , 1 site plan w/elevations &
?
BUILDING PfRIIT APPI.ICATIOr1 1 set of energy calculations -
? O-d'i7
C?'
a l
-9
'Ib Be Used For O
c,??Valuation Date
?
?
Sit2 Address: 1{(o\q " txLVEN ta9 OFFICE USE ODII,Y
Lot 'S =?slock
s /s t R?oc_F?CJ.LFFlC E? X ?p?z
??"?1'
Parcel
?
v (?
32 `
7 Ft? r ??
i
-'?? zoning /?ClJ
Fire Zone N
?
. Repa
r .
Enlaxge Type of Const.
a^'rier: _
Nbve # Stories
pddresg-
a Division of U. 5. Home Coraciration Dennlish ? b ft.
Front
-
KINS CFOSSROAD GTdcle
D2pt1 7'y ft.
Clty/Zlp COd2.: MINNETONKA. MINN 54341
Phore #: 544 - l 33 3 APPOVALS FEF'S
contractor: ini TunnnornN HOMES _
Address: a Drvision of U, S. Home Corporation
1712 N
City/Zip Code: MINNETONKA, MINN. 55343
Phone #:
Arch. /E.1n4- :
Address:
City/Zip Code:
Phone #:
Assessrents Pesmit
Water/Sewer Surcharge
-_-
Police Plan check
?
Fire SAC
gM. water Conn. 3.35?
Planner Water Meter
Council Road UTLit 'ISS
Bldg. Off.
P.PC
'IUTAL ? ? ?5 ?--z , 7 S
REQUEST FOR ELECTRICAL INSPECTION
..
? 5 6 9 6 q? See instrvetious lor compleLna this torm an b, ek of Yellow copy.
"X" Below Work Covered by This Request
?.« EB-00001-03
N Add Rep. Tpe ol Bmltlin0 APOliancas Wved Equipment Wvetl
Home RanGe Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Bwlding Dryer Elcctric Heatin
Commeraal 81dg.
Industrial Bldg.
Fann Fumace
Air Conditioner
UuhPr oecifyl Silo Unloader
Bulk Nhik Tanlc
001e1 Isueuivl
t er Sper,ify Other Other
Compute lnspecuon fee Beln.w
# Fae SarviceEnVa ? d Fee Fnedmrs/Sobteeders R Fee Ciwaits
0 to 100 0 to 30 Am ps 0 tn 30 Am s
31 to 100 Amps 31 to 100 Am s
Above 100_Amps Abuve 100_Amps
W
HemoteControl Circ.
sZJ
Partial%Oi ee
4
? TOT
Reinarks 3
, AL F E?.
Rough-in T,."?P ,/? I, the Electncal
I ?}
I ? ??V Insppctor, hereby
certify Lhat the above- -
Pmal n^1e ? 1 n pecuon has been
maae.
This reque.st void
18 monihs fiorn
This request .% 6
?8nip56964
LS1 A( i ?cr? : (
v 3o,c>b
.2 Cv 8"3 6
Requt•sl Date
IGN
i v
0? Fire No. RnuPh-in Insper.bon
Req red?
Dfieady Now Will NnUfY Inspe
r-
or Wh
R
??
4 ?
?es No xn
eatlY
Licansed Electncal Con[ractor
Owner
1 hereby requas[ mspacpon of ebove
elechwal wnrk installed at.
S[reet Address, Bo
n{fo I or Foure No..
Rt-Kt11 C%T. Citv -
EA6w
Uon o. Township Name or No. Rane". Nn. Cou}j?yty?? [.'? '
V6`??` N
Or.cuOamt (PRINT) t
?fZP-?nI `?nhPS??' Phane No.
Power Supplier . Atltlres?s ? ?..( ?1?
F {y"'1 '1 V'
Elect(1cal,CnnIIactor (COmpany Namo) •
i
?-?- ?c? Z Conhacmr's Lfcense No. -
?-395Z5
?'
Madmg AdJress ICOnVacmr or Owner Mabnp Ins2ailauoN
l f. Ct-1 ff- PbD
Author¢ed Sign?rector Owner Making Installavonl ' Ph?(nje?.NUmber' i
MINNESOTA STATEtOARD M ELECTIIICITY ' , •• THIS INSPECTION YEQUEST WIlLMOT
Griqgs-Midway EIEg.'- 11oow N-191 BE ACCEPTED BY,THE STATE SOA110
?. - . 1821 UniversityAve..St 'PauL-MN 55104 UNLESS PROPER fNSPECTiON FEE IS
' . au.....e iat71 onz>iI i ENCLOSED.
C?erfifirttfP nf (Orrupttnry
Citp of (Eagan
Drvttrtmettt nf iguilbing 3nspeQim
Thir Ccrtificatc icsued purruant 1o the reyuirementr of Section 306 of the Uniform Building
Coda arti fying thut at the time of iaruarue this nrurture was in compliancr wrth the variour
ordinanrrr of the City rrgulating building ronrtrrution or ure. For the fo!lowing:
L? CbSF DWG/GAR Blds. PomJ[ No 6830
tluum ? .
_" " ._=..- . .__- OcwpmcyTyp IyWCowwcnan v Firc2on ?' ZmtiryD'utrin
a,,mofe„odi?e Orrin 2fonpson ,da. 1712 Hopkins f_Ysrd., Mtka.
BY lst
D„w Decemler 7, 1981
.o., ,. .
USA.
RESIDENTIAL
BUILDING PERMIT APPLICATION
3830 PILOT NOB RDEAGAN MN 55122 ?C) _0 CD
651-681-4675
New Conetruction Reaulremanb
• 3 registeretl site suneys shawiig sq. fl. af lat, sq. ft of housa; and all mofed areas
(20%mazimum lol caverage allowed)
• 2 copies of plan stawing heam 8 window s¢es; poured tomM design, elc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservatlon Plan'rf fot platted afler 111/93
• Rim Jomt Detal Optbns selettbn sheet (bidgs wilh 3 a less wuls)
DATE g` I a - 0 a
RertrodeVReoalr Reouirements
. 2 cropies of plan
• 1 sel o( Energy Calculatans for heated additwrs
. i site survey for exterior additians 8 decks
. Indicete rf home served by septic system for addiLons
VALUATION -
SITE ADDRESS W I? I-?n Ide ?'V' MULTI-FAMILY BLDG _Y
TYPE OF WORK re_ rao? FIREPLACE(S) _ 0?? 1
APPLICANT
%ru(
.,?L-N
_ 2
STREETADDRESS udN ItwlcQen Gc?-' CITY ec;ii_STATEA961 IIPSEi` aa
TELEPHONE #64-G9 ( l CELL PHONE # FAX #
PROPERTY OWNER S'a„ c TELEPHONE#
COMPLETE fOR "NEW^ RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RULES 7670 CATEGORY t MINNESO'I :A RULES 7672
(J submission lype) • ResidenUal Ventilation Category 1 Worksheet Submitted • New Energy Cade Worksheet Submitted
• Energy Envelope Calculations Submilted
Plumbing Conhactor: __
Plumbing system includes:
Mechanical Conhactor.
Mechanical system includes:
Sewer/Water CoMractor:
_ Water Softener _
_ Water Heater _
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Air Conditioning
Heat Recovery Systcm
I hereby acknowledge that I have read this application, state that ihe
with all applicable State of Minnesota Statutes and City of Eagan Orc
Signafure of Applicant
OFFICE USE ONLY
Fee: $90.00
?ne#SCP 1 2 ?L02
is correct,-and agree to comply
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Founda6on
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
O 33 Ext. Alt - SF
? 36 Multl
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteratlon ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bidg only) • Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nhr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ plumbing
_ Foundarion HVAC
_ Drain Tile pther
Roof _ Ice & Water _ Final _ Pool Ftgs A'u/Gas Tests Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
4619
(9 r97
FOR:
U. S. HOME CORPORATION
0
5c
l
1
C. R. WINDEN & A550CIATES, INC.
LAND SURVEYORS ftl 645•3648
1381 EUSTIS ST., ST. PAUI, MINN. 66108
Z245O??
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SGALF I"=30' I
o DENOTES IRON
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Lot 5, Block 1, Ridgecli£fe
First Addition, Dakota County,
Minnesota.
WE MEREBY CERTIFY TMAT TMIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY Oi THE
BOUNDARIES OF THE IAND ABOVE DFSCRIBED AND OF THE IOCATION OF All 6UILDINGS, If ANY,
TMEREON, AND All VISIBIE ENCROACHMENTS, IF ANY, fROM OR ON SAID LAND.
Dolad IAis ?B{? doy o{1lLLli[_A.D. 195/ C. R. WINDEN 6 ASSOCIATES, INC.
bv (?_ '
Survayor, Minnesolo Rapittrofion Ne.77Z6
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