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4772 Galaxie Ave Use BLUE or BLACK Ink r------_-----------I ~ Permit -706-6 City of EaE nd oI ` y" Permit Fee: I 3830 Pilot Knob Road j I Eagan MN 55122 RECEIVED Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 NOV 17 7010 I Staff_ 2010 MECHANICAL PERMIT APPLICATION Date: 0Site Address: -7 Z ~ C_~ Q.-- Tenant: ~ 4 C, Suite RESIDENT / OWNER Name: C_" JtVa- C7 l Phone: Address / City / Zip: C, C, C_ CONTRACTOR Name: License Address: RESIDENTIAL HEATING & AIR, INC City: , 1819 9W 41st feet, Suite A Mtnntl~p01i3, MN 554o State: Zip: 7Fi6e: 1 Contact:/ Email: TYPE OF WORK New h~ Replacement Additional Alteration Demolition Description of work: t cx 8 Lo G U -1' A ' NOT1 Ro>sf riiauttted ar3cl gCouAd;mt urzted e ical equFtpme :lsr ` 001o beset by~City;. 'A S Z-9 7-74n coder Pie ge csi{ tll+ctthe: c anicdt.trts SCCoi #ot in#oris~Atiot~: n p rrtitted scr8er~tn etl tads. PERMIT TYPE RESIDENTIAL COMMERCIAL _ Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed Air txchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank Install / _ Remove) " When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) `a $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ s. TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,01(T$11,010 Permit Fee requires a $ 5.50 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.aopherstateo ecall.or I hereby acknowledge that this information is complete and accurate; that the work will berm conforma with th rdinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work isP of to start ut a r t; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. (J x D C&_ ^ Y. ~[s7 tic C- x Applicant's Printed Name Applija is Sig ature actitre8 Jrtspeirnnsier GC{euY t9 Ire x4,3i~,si Cs~rtiri+ e 7st In ftQOf N>flat )+rnl W xte?#oe}d~} e " ipspeeb PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA083238 Eagan, MN 55122 . Date Issued: 05/28/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4772 Galaxie Ave Lot: 6 Block: 1 Addition: Park Ridge PID 10-56750-060-01 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Home Depot At Home Services Cheryl L Siebold 656 Mendelssohn Ave. N 4772 Galaxie Ave Golden Valley MN 55427 Eagan MN 55122 (763) 542-8826 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 CITY OF EAGAN Remarks - Addition pARK RIDGE 1ST ADDN Lot 6 131k 1 Parcel 10-56750-060-01 owner Street 4772 GALAXIE AVENUE State EAGAN MIIV 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, -- ?, , S lo cZ " S STREETRESTOR. GRADING SAN SEW TRUNK ? (Qf.? 1982 147.21 , / / O'a 4S * SEWER LATERAL 626.16 41.74 - ?Ca, ? ? WATERMAIN * WATER LATERAL WATER AREA \ (Q 9.81 / - STORM SEW TRK ? f, y ? t U' -P * STORM SEW LAT 1985 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit $280.00 54455 8 9 85 WATER CONN. 500.00 " if BUILDING PER. 0768 sAC 525.00 PARK ^^ i INSPECTION REC4RD CITY OF EAGAN PERMIT TYPE: ' 3830 Pilot Knob Road Permit Number: ! Eagan, Minnesota 55122-1897 Date Issued: , I(651) 681-4675 SITE ADDRESS: - APPLICANT: liti 1. i;,. fi, ? , I n1" o F: y tis;t PERMIT SUBTYPE: I A/' F R f 4)M s; 1'ts 11c7 1 m ((.!?) [tti q. `.f,tif't TYPE OF WORK: INSPECTION .. . .• i i i GI i?1 AN i:; 'Jtt lt. 1) tt •o ? I if, 14, ??{ii??ri! ,'Y?•. ? ? J Permit Holder Dete Telephone N SEWER/ WATER PLUMBING FiVAC Inspectfon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PIBG AIR TEST ROUGH HEATING CiAS SVC TEST INSUL GYP BpARD FIREPLAGE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDRO5TATIC TEST BSMT R.I. BSMT FINAL DECK FfG 19, ar y y1? DECK FINAL Receipt _ PLUMBING PER1rA1T Psrmit No. • ' CITY OF EAGAN • Fes fill in numbered spaces S/C Type or Prin[ legib/y Tat, 1. Date - 2. Installation Cost 3. Job Address Lot' Blk. Tract 4. Owner 5. Contractor Phone 6. Address ? 7. City State I ' Zip ' I 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Descriptian: New ? Add ? 10. Describe 11. Alter Repair ? No. Fixtures Water Closet No, Fixtures Cesspool/Drainfield Bath tubs $eptic Tank Lavatory k' Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray 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 9overning this type of work. Signed : Rough for Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT CITY OF EAGAN Psrmit No. Fes I Fill in numbered spaces S/C Type or Print legibly T?. 1. Date 2. Installation Cost --' -->?-' . i r,. 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor Phone ? 6. Address 7. City -1As State Zip 8. Building Type: Residential P' Commercial ? Institutional ? 9. Work Description: New Q Add ? Alter ? Repair 0 I 10. Describe 1 11. No, Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs $eptic Tank r ` UYOLOfy $oftner Shower Well Kitchen 5ink Urinal/Bidet Other l.aundry Tray 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 RouQh Inspections: Date Insp. for Final Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 Roceipt 1. Date 3. Job Address _ 4. OWner '. 5. Contractor _ 6. Address 7. City 8. Building Type; 9. Work Descript 10. Qescribe 1 11. pAECHANICAL PERMIT Permit No. C17Y OF EAGAN ' Fse Fill in nambered spaces S/C Type ar Print IegiWy Tot. . 2. Installation Cost . . ; Lot Blk. Tract _ Phone State ? Zip Q Commercial ? Institutional ? New Cl Add ? Alter ? Repair O Type No. EQyipMent BTU - M. Ea. Forced Air No. Eauipment CFM Air Handling: Mfg. , ?'. Boilers;:' E Mfg. Mech. xhaust Unit 42er Mfg, Other Air COO Mfg Gas, Plong Outlets ?. %?. 12. I hereby certify.?ttat the above information is true and correct, and I agree to comply with alf?ordinances and codes governing this type of work. Signed : far Rough F inal Inspections: D4 Insp. Date Insp. 7his is your perrit when numbered and approved. Approved CITY OF EAGAN 454-8100 . ' eU1LDING PERMIT TA V u?A fw ? -? " . CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan. MN 55121 PHONE: 454-8100 $59,000 SiteAddress 477i ' ++.:`.,A_XIi, AVE Lot Block- 1 ?c/sub. PARK RiDGE 'Ll Parcel No. W N? ;i U SCON ;!i )IMF S I NC ? Addre:a - _ TJ NOCs AV7. City 'V" Phone 4 3?--14 3 3 Name Address Clty Phone Name City 1 Ixrcby ocknowltdye thot 1 have rood this opplicotion ond stote that fhe informorion is correct ar+d ogree to comply wifh cll applicobla Stah of Minnesoto Stotutes awd City of Eoqon qrdinonces. Sipnaturo of Pem?ittss A Building Permit Is issusd to: dl work sFwll be dons in occordonte with all opplicoble Stata of Buildinq OffiCfol 4 10758 Receipt # Erect LPC Occupancy ?.S Remodel ? Zoning Repair ? Type of Const. v AddRion ? No. Stories Move ? Length 4 v Demolish ? Depth 41 Int. Impr. ? Sq. Ft. Install ? Apprevak Fon Asussment Water b Sew. Police Fin Enp. Planner Countil Bldg. Off. APC Var. Date Permit Y ? 1 v. v u surcnarge 29.50 Plen Review 15 5• 00 5,,,C 525.00 Water Conn. 500.00 water Meter 63.00 Road Unit 280.00 Tr. Pl 132.00 Parks Copies on tM express ConditFon Ihor ond City oF Eoqan Ordinonus. Pamk No. Pwmit Holda Dob TeIsphone ? Plumbiny H.VA.C. ekctdc L Soitwwr In?psetinn Date Insp. Othw Footlnys t Footinys II Foundation Framiny Roofiny Rough P16y. Rouyh Hty. Insul. Fireplace Final Hty. ? Flnal Plbq. Final Cort/Occ. Water ??ibo Locstion: Wsll Sawer Pr. Dlsp. }. . • ? ----• CITY OF EAG AN 3830 Pilot Knob Road, P.O. Box 21-199, Esgan, MN 55121 ' PHON E: 454-8100 BUILDING PE?MIT Receipt# To be used for Est. Value i• Date 119 Site Address OFFIC E USE ONLY Lot Block ? Sec/Sub. On Site Sewage Occupancy MWCC System Zoninp Parcel No. On Site Well (Actual) Const ¢ Name City Water (Allowable) W ; Address PRV Required Booster Pum # of Stories Len th 0 City Phone ? i p g Depth °Co , Name S.F. Total ? q Address Footprint S.F. IX City Phone APPROVALS FEES pj W Name Engr./Assess. Permit . ' - sz AddreSS Planner Surcharge ?• L- 6 W City PhOne Council Plan Review Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with ail applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter Signature of Permittee --- - Road Unit A Building Permit is issued to:_ - - Treatment P1 on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official TOTAL - Permit No. Permit Molder Date TeIephone i? Plumbing H V.A.C. 5?8 Electric Softener Inspectlon Oate Insp. Comments Footings I Footings II Foundation Framing Roofing Rough Plbg. - Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bidg. Final Cert Occ. ? Temp. LP Deck Ftg. Deck Final Well Pr. Disp. , , . PERMIT # - ?'- ?-' MECHANICAL PERMIT RECEIPT # ' CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 For Office Use Only: Site Address BLDG. TYPE WORK DESCRIPTION Lot Block ? Sec/Sub Res. K New 'l m Name S ? Mult Add-on u _;. ., Address " _ • r, Comm. Repair c City Phone " ? - Other FEES Name RES. HVAC 0-100 M BTU -$24.00 c Address C ' ADDITIONAL 50 M BTU - 6.00 O Ciry Phone •' ??~ (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) 50 EA GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1 . . TYPE OF WORK COMM/IND FEE - 14b OF CONTRACT FEE FOrCed Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES Boiler M BTU • MINIMUM RESIDENTIAL FEE - ALL ADD-ON & I Unit Heater M BTU REMODELS ? ? Air Cond. - M BTU R : MINIMUM COMMERCIAL FEE _ STATE SURCHARGE PER PERMIT - .50 Vent CFM $ (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE: I SI(3NATlIRE OF PERMITTEE S/C: ? TOTAL• FOR: CITY OF EAGAN PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Site SeciSub ' J S ?'- PERkR1T # RECEIPT # t+ / J' V .vi DATE: BLDG. TYpE. Res. Mult. Comm. Name `:.:,_?1 m ro Address 195y `i1?;.w?ik•? ??u c City 49L Phone Name ?•..,?? ??ac???vsK?, ? 3 Address 4;'7'2 r^,b' O City Phone FEES COMM/IND FEE - 19'o OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) OF PERMITTEE FOR: CITY OF EAGAN WORK DESCRIPTION New Add-on Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: FIXTURES TOTAL ? Water Closet - $3.00 $ Bath Tubs - S3.00 I_Lavatory - $3.00 J?Shower - $3.00 Ki?chen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whiripool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIn Soitener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL• CITY OF EAGAN 3830 Pilot Knoh Rasd WATER SERVICE PERMIT P. O. Bax 21199 PERMIT NO.: Eagan. MN 55121 DATE: - - Z} NO. Vf Uflits. Owner. Addross. Sita /lddross: ,tr,: Plumber: SMeter No.:` ` -C? D ? Connedion ChaFqe: _ . . . ' ; .., ?No.: 1S? / rS _ A"ounr DePOStr: . Permit Fee: ?"? ?"MOh? w?lf? Nw CMp ef Eeyan Surcho?ge: . Z Mtac. Chorpes: 3-2 - Totcl: By ?t"4 ?e Poid: Dcte of I rtsP•: Insp,: Ia -/ s-rS S r ? CITY OF EAGAN ` 3830 Pilot Kriob Road P. O. Box 21199 Esgan, INN 55121 Zoninp: _ Ownwr: /lddre:s: t??2 ^aI aa i ? - Site llddress: Plumber. Meftr No.. Siu: Reoder No.: 1 Mme 1o e- ply wft !IN Ckp of Lapm Onunmar. Corwwdion Chorpe: ? JU _ v P: : Aocamt Depotit: • ? ? Parmit Fee: Surchwye: Misc. Chorpss: TotoL• DaM Paid: Insp,, CITY OF EAGAN SEWN setvia "Mff 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eaganr MN 65121 p^TE: Zoning: No. of Units: Ownwr. /lddross: -- Site Address- Plun-ober: I yne to easplp wMh 11w Clhr ei Ealsw Connoction Chor?ps: :' OnNw?ew. - - - Permlt Fea: By Surchorpe: Dote of Irop.: Misc. Chorper Totol: Doh PofA: WAT'8t SERVICE PERMR PERMIT NO.: DATE: - - No. of Units. CITY OF EAGAN No 10768 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILOING PERM1T Receior # ?7 7DJ Te M wd fa SF DWG/GAR Est. Volue $59,000 pate AUGUST 9 1 y 85 SiteAddreu 4772 GALAXIE AVE Erect IN occupnncv R3 Lot 6 elock 1 SeclSub. PARK RIDGE Remodel ? Zoning Rl Repair ? Type of Conrt. V Percel No . Addition ? No.Storiea RUSCON HOMES INC Move ? Length 40 Narime ? Z pE OCK AVE Demolish Depth 47 ? Addm$ A.V. 432-1433 Int Impr. ? Sq. Ft. City Phone Inatall ? ? Aoo•mek F•es e Name SAME ?? Address ? Clty Phone jrj!W I Neme MARK NAGEL/PROBE ENGR x? Address 1000 E 146TH ST ?W Citv A.V. phone 432_2044 Assessment _ Water 8 Sew. Police _ Firo Eny. Piunner - Cnuncil _ Pymlj ? 31 V. V V Surcharge 29-50 Plan Reviaw 155. 00 SAC 525.00 water conn. 500.00 WaterMeter 63.00 RoadUnit 280.?0 TcPI. 132.00 Perks I ha+eby ackmwlsdge thot I hove reod this opplication and stote thof BIdg.Off. $/S/$S the information Is rnrrect and ogree to wmolY with all applicable APC Stats of Minnewta Stature iry?of Eagog„Ordironces. M? Y> 1! i VBf. DBSB Sipnoturo of Permittee A Buildiny verm+e Is iuue?! !es RU ON HOMES INC all work shall 6e done in occordenee with ol limbls Sfote gf-M., Buildirq Offlciol Copies I Totsi $1,994.50 _ af H1s exOretf COnditlon IMo and City oS Eopan Ordironces. CITY OF EAGAN No 15402 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 r - BUILDING PERMIT Receipt# ??9 I 3?-G/ • To be used for BASEMENT Est. Value $1, 500 Date JULY 29 ,tg 88 SiteAddress 4772 GALAXIE AVE Lot 6 Block 1 Sec/Su6. PARK RIDGE Parcel No. s Name DALE & ,IAYNE MACHOVSKY 3 Address 4772 GALAXIE AVE 0 Ciry EAGAN Phone 452-5057 o Name_ 0 a Address ? City_ w Z a z W Name_ Address City _ I hereby acknowledge that I have read this application and state ihat the information is correct and agree to comply with all applica6le State of Minnesota StaNtes and City of Eagan Ordinance. s. ?? /? /l i?1/I Signature o( Permitteel?/?(?/ / A euildin9 Permii is issuedto: JA-YNF--MACIL9YSICY- on the express condition that all workshall be done in accordance with all applicable State of Minneso[a Statutes and City of Eagan Ordinances. Building OFFICE USE ONLY OnSRe Sewege _ Occupancy MWCCSystem _ Zoning On Site Wall _ (ACtuap Const Ciry Water _ (Allowable) PRV Required _ # of Stories Booster Pump _ Length Depth S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit 34.00 Planner Surchar9e 1.00 Council Plan Review Bldg. OIL SAC, City Variance _ SAC,MWCC Water Conn Water Meter Road Unit Trea[ment Pi lexrxacCopy .51 TOTAL 35.$0 HOME SERVICES To Whom It May Concern: Site address: 4772 Galaxie Ave. Eagan, MN ? ? MAY o 7 Zoo8 U We replaced a window in the bedroom of this home. We removed the frame of the window to increase 1'1Z " to meet egress code. We did not alter the structural opening to instali the egress window. The other 2 windows were installed into the existing frame of the origional window. Thatilc you, gradch Installation Manager The Home Depot At Home Services THD At-Home Services, Inc. 656 Mendelssohn Ave. • Golden Valley, MN 55427 763-542-8826 • Fau 763-542-8227 • Toll Free 866-718-7092 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ID 1 (o ! 6 1/ Q? /y Site Street Address '7 71 ,?. .?F1?0 , ld,?.l?,• Unit # Property Owner Telephone # V,5)) gDS -0 .7 1'S .uJ a-l-t?..p? Telephone l? ((?j J) 3L6 - )? Yd Contractor ? ()0 y e-(? ? ? Address ?3 /Q '?? { ? kso?2+ ?1Pc?t• City ? State Ynn • Zi /,-7 The Applicant is: _ Owner ?Contractor _Other Alterations to existing dwelling $ 50.00 _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Water Softener ? Water Heater $ 15.00 ? l ddi i rep acement _ a t onal Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge $ .SD Total $/-5-50 I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an a?licati a permit, work is not to start without a permit and work will be in accordance r? I in the event a plan is required to be reviewed and approved. I ?? a J? V .616V evti5 Applicant's Pri ted Name ApplicanYs Signature OCT 13 2D04 ??SSa CL1Y f1r, EAr,AN cn;sHIE:;;: S r4:R:*ttr!Ai_ Nn", r°.°F, DA7e:,: 1W3/98 ra:M.r-.e Wa.a.08 TD • NAi11'.r, Lfiil'ir.l?: RR1.0 700i 4772 f„Ai...r-::<:r.E. aV 50.00 205 9001 57 7i.'. G'?I....4X.L@i. AV CJ .5(] Totai. F:'erni.r..rt, Flmo?;r1+,: 5:?:"1,'SO CR[195i:1t:,:t ' Ufi( 4' TLI^, Nr^,i C`d -ACITY OF EAGAN PERMIT 3830 Pilot Knob Road Eagan; Minnesota 55122-1897 ((351) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILOING 033976 11/13/98 SITE ADDRESS: 4772 r.,ni_ax:rF FlvE LUl"c 6 BLOCK: 1 PARK RIDGF P.I.N.: 10-56750-060-81 DESCRIPTION: Puilding P,ermit '1°ype I)ECK Buildinq Wor-k Type NEW ,'Census Code 434 ALT. ? i REMARKS: PLAN REVIEWED 8Y CRA7G NOVACZYK. RESIDENTIAL ? _ -- - FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: - applicant - sT. Lsc. OWNER: LflKER CONSTRUCTION 188A5503 20053900 ALL.EN SCOTT 9.179 W 98TH Si/5TE #213 4772 GALflXIE AVF BLOOhiINGTON MN 55420 EAGRN hIN 55122 (612) 884-5503 (651)905-3785 I hereby acknowledqe that I have read this application and state that the informatinn is correct and agree to r.omp].y with all appli;cable State ofi hln. Sta tes and City of Eaqan Ordinances. J ? AP LICANT/PERMITEE SIGNATURE ISSUED BY: SIGN'UREC- ^ 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) ` CITY OF EAGAN 3830 PII.OT KNOB RD - 55122 681-4675 New Construttion Reouirements ? 3 registerod sRe surveys ? 2 copies ot plans (inGuEe Deam 8 window s¢es; poured fid. Oesign; etc.) ? 7 energy plculations ? 3 copies of tree preservation plan if IM platted after 7I1/93 required: _Yes _ No DATE: _ _OUOJ DESCRIPTION OF WORK: STREET ADDRESS: G C c,.?Ul ? l l RemodeUReoair Requirements ? 2 copies of plan ? 2 site surveys (exlerior adOitions & decks) ? 1 ener9y calculations for heated addilions ?o "tJ CONSTRUCTION COST; -5j-,?20 d LOT: ? BLOCK: 1 SUBD./P.I.D. #: ? Phone #: PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: Phone #: 20 S -3?$ 5 I.ast First StreetAddress:_ 4 -7 7? ?R 64?C' ! ?2 City v7,,- State: Zip: b S ? 2 Z ? Company: Phone t!: ?'??'a 5 v 3 Street Address: / 4 o (,v. 97' f{ ?! 3 License # s;Z a 05- 39 d 6 City 9d u?'?^ •°'S7?cn-? State: Y v?`- Zip: S,S_ `4`2-6 Company: Registation #: Street Address: City State: Sewer 8 water licensed plumber (new construction only): and lot change is requested ance permit is issued. I hereby acknowledge that I have read this appliption and sfate that the State of Minnesota Statutes and Ciry of Eagan Ordinances. Zip: Penalty applies when address chang is cortect and agree to comply wRh all applicabl 1 4 Signature of Applicant: ' c ' D OFFICE USE ONLY Certificates of Survey Received _ Yes _ No 9lj% Tree Preservation Plan Received _ Yes _ No _ Not Requ' ed OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation 0 06 Duplex ? 11 Apt./Lodging ? 02 SF Dweiling ? 07 4-plex ? 12 Multi RepaiNRem. O 03 SF Addition ? OS 8-plex 0 13 Garage/Accessory ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 05 SF Misc. ? 10 = plex A 15 Deck WORK TYPE A 31 New ? 33 Afterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actuaq 5-1 Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy P,-3 sq. ft. Zoning Fl- I sq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS ? Planning Building ? 16 Basement Finish ? 17 Swim Pooi ? 20 Public Facility 0 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bidg Census Unit Engineering Variance p / Permit Fee Surcharge Pian Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: ? Valuation: $ % SAC SAC Units . jkose CONSUlTIHO EHdINEERS ENGINEERING PLpNNEAS ond LAND fUBVEYORS COMPRNY, INC. ? 1000 EAST 1461h STREFT, BURNSVILLE, ?IINNESOTA 55337 PH 432'3000 cer?i}'ica? S'?v-ey j,?oa2 Iaeacr--P2foat: LoT 6,, BLoCK i, PARK RIDGE, bAKOTA COl:ti1Tl, MINMESCT? 6-Y?? CENOTES ExISTlNE ELeVATlom (930.0) pENO1E5 PROpOSEp ELS-?VATION `- 1(UDICATES DIRECTION OF SUKFACE PRAIPLA6E N ORTH _ SCA(.F; /'I =¢p' FINISHED CyARA6E FLOOF2 ELEVA-f10?.1 = 433.3'? ?G=??Ui111 V Bv DATE ? I ? cl ? GlP> BUILDIfVG INSPECTIONS DEPT. 4.0'FRCNT BUILpIF16 pRqU?A6c AIJD 3 SE73r'\C' LINE UTILITY EAScME.!:T N 8 ' 49' /7" W ? --,--- o 4. ze,3 - - ? • _ ti ? . 60 ?-- - -- ? j ?I - - - -??_5?..33 9?3a) '^ •a \ o 4,.u H ? ? 2 ? y .61 LOT 6 t Q ?I K `? a - ? -?.+s , ? - •in ?? Y ? 24-7.75 N 89° 49" 17"W -,-;-?- -?, ? ?? / , ° p N "' I hereby eertify 4hat thia ie a trve and correcL repreeentation of a traot of land as ahown'and deacriDed hereon.. As prepared by me on this lf7;v day ot ,?u?? ? 19 g5 . 1tsR. No. /4a95 1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS L64 0 % INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE HUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF IINIT3 INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONA'lERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS ['j4ScMt-N i FiH'yf - L00tr Level /5" r/ To Be Used For: ,1 W? r? rd J e rn! ?{S Valuation: -E ?-g?_ Date : ?' n +a-F? k-I- - - Site Address a,r ; c Av[ I 0 FICE USE ONLY Lot to Block ? On site sewage_ M41CC system _ Pareel/Sub -p4 r On site well n 1? City water Owner -IJQ ?? t- Jq u n ? a c?'l0 5 K . PRV required _ Booster Pump _ Address ?{1?1 1('?u ?a x r 2 T? City/Zip Code ? q q n Ss ? Z Z Phone y S?' S 0 S"-j APPROVALS Contraetor Apm -c Oh)YI f Y Engr/Assess /? Planner Address `l ? A K; C /'tV f. Council Bldg. Off. City/Zip Code EO O n ?? S I Z-2- Varianee Phone S o.S ? Areh./Engr. Address City/Zip Code Occupaney 2oning Aetual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. F'EES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment Pl Parks Copies TOTAL • ? ?> _, L -' , >o Phone l! ? 1485 BUILDIIIC PEli11iT ftPPLICATI0t1 - CITY OF GAGAN t10TE: ALL COIITRACTOIiS t1UST DE LiCG11SGD WITH TfIE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFTCATES OF SURVEY 1 SE'L OF ENERGY CALCULATIONS = p?- To Be Used For: SinQle I'ami1V Valua?ion :4AX Date: Site Address: ?Je, _?.-- OFFICE USE ONLY Lot: ( - fi Block --L- Sect/Sub 1'ack Ric eT Parcel I! Owner DALe lYkfJ )V-1-Y Address City/Zip Code Phone Contractor RUSCON HUhllS, 1NC. Address 14530 Penuock Avenue City/Zip code AVple Valleyi HN 55124 Phone 432-1433 Mark Nagel Arch./Engr. Probe GnaineerinQ 14530 Pennock Ave Address 1QOQ E. 146Ch St_ Apple Val.ley, hiN 55124 City/2ip Code Burnsville. PiN 55337 Phone 0 432-3QUU Erect ? Occupancy P- -3 Remodel ? Zoning 2-I Repair Type of Const 7- _ Addition # of Stories _ Move _ Length ?p llemolish ? Depth 42_ Int.Lnpr. Sq Ft Install APPRUVILLS PEES nssessments Permit 310.` lJater/Sewer Surcharge ? 2-9 .g Police Plan Review I55• °^ Fire SAC 525.°-0 Engr Water Conn 500. m Planner Water Meter ? 3." Council d Unit 280.°° Bldg Off Treatment Pl 132,= APC Parks Variance Copies TOTAL ? S G ? aoBe : . CONSUITINd ENdiNEEBS PIEiURVCYO NGINIECRING PLpNNEAS ond LAND NS COMPANY, INC. ?1000 EAST 1461R STAEET, BURNSVILLE, YINNESOTA 55337 PH 432'3000 Cer?i?'i ca? ?Su?-y-e y LOQat laGtcrt 2ian • LoT 6, BLOCK I? PARK RIDGE, DAKOTA COl)NT( MINAIESDTA DENOTES ExI5TIN6 ELE-VA710k1 (430.0) DEMOZES PROPOSED ELEVATION ? ? W Q W K J ? Ai ? N oRTH 5cA1.F: /.., *0- .? o N N \ ro, o- ? ? ? ?r m ? a ?? ? 10 -"0 INDICATES DIRECTIUN OF SURFACE pRqtNA6E FINI51-+ED GARA6E FLOOR ELEVATIU^! = 933.3?j Q,pOFRONT F,uIW1N6 5ET6ACK- LINE ? ? L.?._ . 49` 17W 1-1.('0 DRAINA6E AMD UTILITY EAsEMENT -,-- _ 9'?3A? `` 9t9,i? \ -- ?3a_5??4,753 9i°•°? \ 4 -a`,'•?_".?Jj o r Z47.75 N 89° 49' /7"W ????41/ Ll1,o) LOT 6 ? --,-,- --, O N_ I rereby cartify that lhis in a true and carrect repreeentation of a tract of land as shown'and described hereon.. Ae preparad by me on this ? day of .7Lcy • 19 S5 . kE?. S/s/85 Jiinn. 1leS. No. /da'?L ? 1 • • ' ..? . .. ? • ?' = . .,._ ` J . ' . ... . ' .• . . = ' ' ' ^ ' . •- ...... :."_ ? . ? .? . _..,.r- EXTERIOR ENVELOPE AVERA6E "U" CDMPUTATION . . .... .. . . . - ' . OWNER .,: , • . . ? s ' ' . S2TE ADDRE55 ?_ . . :. . :'... 'k.- .i ' .:.._.'y? . .. .. ... i.e :. . . , _. , . _ :. ?..i. . ?: '..n'16 a ' .... ? DATE . u? PHDNE• _-4?Z- CDNTRACTOR ?o tZ , ' .. < < . _ . , : . _ Determine working square footage of each. 1. Total exposed wail area ...... ? S?1 9? g sq. ft• x sl l 2. Total roof/ceiling area .... Jooo sq. ft. "x •OZb °[-_I Total exposed wall area above floor = a. Total wall window area ..................:........ 1, b. Total door area ................................. 3x q c. Total sliding glass door area .................... .... • d: Total fireplace wall area ........ .. .....'.:..... - . e. Total wall framing area (average 10A)...:........ IHZ• O . : f. Total net wall area above floor ................. 1Z-1k_ • y. Total rim joist area ............................. 1"'o Total exposed foundation area = 116 h. Total foundation window area..................... I i. Toal net foundation area above grade, .......... 62%%A Determine "U" value of ea:h wal] seg,r:_nt. a. \ loZ ? "u" • 33 53. A b. -SSf X „U„ _ 1-3 43A_ c. ' Aq x „u's .-53 = ?N?S7i d. -- X ?lull _ s - e. X IIUII f. 12'i g x„u„ ?IL) S 9• ISO gituli .64 h. - g „ull I _ - i . X "u" .01 = Le-_ 3 ........:.................:...........Tota1 = 15 3?2 ' If item 03 is the same as, or less than item r21, you have met the intent of 58C 06005(c)2. .! t T ?r( A v . I " ' . '?.y . '. .. . . .t. , y a"._ ' • ? f _ . I . ? , . . . . . . ... . ... . Total expased roof/ceiling area A `:, ' ` • 'fotal gross raof/ce9ling area Tota1 skylight area ........................ . .. k. Total roof/ceiling framing area .........,,. ]. Total net insulated roof/ceiling area....... Detennine "U" value far each roof/ceiling segment. ,. . . . . _.. . ;... ,.,.. • . ?. . X "uu J- . w '?'? . .. . . . . k. x nUn . ? ?-1 • ? ? ? ?eea?Z.3ZIUSO? ovf.¢. X uUn. ,rzSb 4........ .......................Total If totaT of i4 is the same as, or less than #2, you have met the intent of SBC G006(01. - . ..• To utilfzed the total envelope system method, the values.established by the sum of items #3 and #4 shall not be greater than the sum of itens 11 and $2. + 2. ° 3, + 4. _ MATERIALS Therm. Resistance Ezterior Air " LS 5lding Naterial . (e5 I+: ?Me. Sheathing 2•ai. • Insulation - 11_ s?rL ShefltroCk .95 Mi' Interiox Aix .17 stLLas .._s t? I rtA 1 ° R3m 1.5 Conc. Blks. 1.28 a11.41s-zl . ? .. . a/44 CITY OF EAGAN APPLICATION FOR PERMIT SESVER AND/OR WATER CONNECTIODI (PLEASE PRIHT) 1) PP.OPEFYPY ADDRESS: LEG.aI. DESCc2IP'I'ICN: u EtI-S=:G STRL'CP'RE, DaT G^ ORIGIidAL :ii2LDL`IG P=-,?ST ISSJ?NC_°: .. _ --•• -- • P4:.5E:: Z:.^,?II`!:/P.;r°CS=? U.SE: 13 R-1 SD1GL-v 2PY1LY . ? R-2 DUPLE{ ('IWU Wi ITS ) ? R-3 TGWTIIiIXJSE (THRE'" +[JNITS) ( Wi ITS) O R-4 ApARTr=P/CODIDQ`4LVI[],q ( UNITS) p CCMMEE2CIAL/REi'AIL,/OFFICE ? LMUSTRIIL ? INSTITUTIONAL/GOVERNZENr Z) Apoi,7Ca-Nr (PLEASE PRINi) NAME; Ruscon Homes, Inc. ADDRESS: 14530 Pennock Ave. CITY, STaTE, ZI2: Apple vallev MN 55124 PHOLNE: 432-1433 3) pu;.lgER NALN1E: Star Plumbing PLEASE PH1Nf) FOR CITY USE OHLY ADDRESS: 1018 Mound Springs Ter. PLUnBERS ctiv ENSE: , Q CITY, STATE, ZIP; Bloomington, MN $5+20 Exp' ed 7 PHO??IE: $$1.-1}11?9 PLUMBER LICENSE N 3329M of ?co 4) OCCC7PPIqT/U,Ti1ER NAh1E: ADDRESS: CITY, STATE, ZIP: PH(R7G: 5) INDICA'PE WHICH PEPh1IT IS BEING RDQ(JESTEp: - FLI COtiT1ECrI0N TO CITY SETr1ER ID CO^11=0V 'Ib CITY W1aTER ? dI'f'.II2 (PLEASE DFSCf2IBE) 6) DdDIG;::: C:z: ? PI,E?.SE f?OID APPROVEp PEFhMIT FOR PICFC-UP BY ONE OF P.BOVE PI£aSE :*AIL PRWED pEFi?IIT TO 1, 2,(D 4 AHOVE (Circle one) 7) SIQa'IL'RE: DATE: ??e aK:wa ?.?s s a= E?;?-?a ? s r.? s:ssa:a ? sai ??:ss:? r? ??e n.e ?t?r:r ?r.lE.? s r?1 rry?r.?? w .. . . . . . ..... .. ?? F 0 R C I T Y U S E O N L Y PERMIT °-. IS5UED F°_LS: $ $ $_ ? 3 cc.S S $ g $ $ S S S $ $ $ S (, SEI•7E.°, ncgMrm (I.1C:.:iDE SUP,CHARG^c1 WATER PERf1IT (ZNCLUDE SURCHARGE) WATER METER/COPPERHORN/OiJTSIDE READER WATEP, TAP (I.ICLUDE CORPORATION STOP) SESVER Tpn ACCOUNT DEPOSIT - SES4ER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK SJATE.°, ASSESSMENT TRUNK SESQER ASSESSMENT LATERAL,BENEFIT/TRUNK SEWER LATERAI; BENEFIT/TRUNK WATER OTHER TOTAL A.*IOUNT PAID/RECEIPT # sy?/?-- DOES UTILITY CONNECTION REQUZRE EXCAVATION IN PUBLIC RIGi-IT OF WAY? YES IF YES, THEN A'"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGIN$ERING DIVISZON. LIST RS A CONDI- ? TION. SUBJECT TO TEIE FOLLOS9ING CONDITIONS: APPROVED SY: TITLE: DATE: RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 df l (3.-75 New ConsWcticn ReouiremenLS RemodeVReoair Reauiremenls Office Use Onlv 3 regslered sile surveys showing sq, ft. of lot, sq. fL of house; aiM all roofed areas 2 copies of plan CeA of Survey Recd (20°k maximum lot coverege albwed) 1 set ol Energy Cakulalbns for heated addNOns Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addiUons 8 decks Trce Pres Not Reqd t set of Energy CalculaEons AddtGOn • indicafe Non-sde septic sysfem _ On-site Sepfic System 3 mpies of Tree P2servatbn Plan A bt platled after 711193 ? Rim Joist Dehdil Options saledion sheet (bldgs with 3 or less unils Date <9 / r,? G / -f Construction Cos[ !Y ! / 2 Site Address U V?e UnidSte # Description o( Work J'ecck S-e?? 11?r C ?n R'?? Multi-Family Bldg _ Y ? N Fireplace(s) _ 0_ 1 _ 2 Property Owner GCI Sl L lil ?C ? Telephone # ((a5i Contractor sELA ROOFING 6c REMODELING, INC. Address $T I, ptTISPARI{,MN 155416 City State ID N0001060 Zip Telephone #(('y[ a)$?3 -? 6L-1 ? COMPLETE THIS AREA ONLY IF Energy Code Category Minnesota Rules 9670 Cateeorv 1 • Residentlal Ventilation Category t Worksheet (4 submission type) Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Telephone #( Telephone #( Il kVl L ? AUG u 'r 2J31, I hereby apply for a Residential Building Permit and acknowledge that t that the work will be in conformance with the ordinances and codes of is complete and accurate; ean and-the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval ofplans. ScofT (1`"6INe? S ? Applicant's Printed Name Applicant's Signature 2005 RESIDENTIAL BUILDING PERMIT APPLICATION p?. City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New Construction ReauiremenLs RemodeVReoair Raauirements OAILB U58 Of1IY 3 registered s'rte surveys showing sq. fl, of lot, sq. ft. of house; and ?II mofed areas 2 copies of plan Cert of Survey Recd _ Y_ N (20%mazimum lot coverage elimaed) t set of Energy Calculadons forheated add0ions Tree Pres Plan Recd _Y _ N, 2 copies of plan show?g 6eam 8 windaw s¢es; poured found desgn, e[c. 1 site survey for addNons 8 decks 7ree P2s Requi2d _ Y_ N 1 set of Energy Calalafions AddNOn - indicate il onsde sepfic system On-site Septic SysMm _ Y_ N 3 copies of Tree P2servation Plan if lot platted after 711193 Rim Joist DetaO Options seleUion sheet (buldings vrith 3 or less unfls) Date a -? /0-5: Construction Cost ?. C J&U Site Address L/no "q -A(1k . Unit/5te # Description of Work Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 _ 1 _ 2 I PropertyOwner JIScrT) Telephoneis1 ) 76 5-3 Contractor The Home Depot A.H.S. Inc. Address 3200 Cobb Galleria Pkwy., Ste. 4200 Atianta, GA State 763_ 30339 542-8826 BC-20268257 City Telephone # ( COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet (4 su6missiontype) Submitted Submitted • Energy Envelope Calculations Submiited In The last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan2 _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that ?hiy work will be in accordance with the approved pla ' the case of work which requires areview and approval of s. ( s 10 Applicant's Printed Name A plicant's Signature Installed Siding and Windows LIMITED POWER OF ATTORNEY CuuN ? Y ur c:OBs STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sa!es located at 660 Mendelssohn Avenue Nerth, Gnlden Va!ley AiIN 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-7ones Building Permit Service, Ina ("AgenY') as my true and lawful attorney-in-fact and do authorize and grant said attomey-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "iVork"). The powers conveyed to the Agent by this Limited Powe: of Attern.ey are limited solely to the express powers delineated herein and apply solely tu the Work. This Limited Power of Attoiney"shall ehpire and automatically be revoked on the 21 st day of May, 2004, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetenee. N Wi`INESS WHEREQF this Limited Power ef A±?orney is e.tiecirtcd this 21st day of May, 2003 . David . Katz S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 21 st day of May, <?"Ao NTotary Poic in for the State o eorgia b4y Commission Expires: January 21, 2006 396816.0 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT This reQues? voitl q? C/d 18 nronths trom / ? ? E 13972 trz fi:;?i .._?,. __._ .o .._. ,.?_N.. ... ...,??..?.. /? g `, Re?uireAt E]Ready Nuw Will Notity Inspec- (- yes ?N.o. ?nr When Feady n Licensetl Eleclncal ConVactor 1 heraby request ins0ection of a0ove V Owner electrical work installed et Sveat AAdress, Bon or Roure No. Cify 4 Z, ?L, Crt-a k 6, ? &v c. E a a ectmn o. Townshio Name or No. Raner` No, Counly 1 CL Q 1 ?L Occupant (HiINT) .ba.1 C -V J G. a c ho vs Phone No. s a s 7 Power Supplier y ' ?? P Atltlress C C IY 1C C, O C- ElecLical ConVar.tor (COmpanY Name) Concractor"s l.icense No. Mailin9 AAJress ICOnVactm or Owner Making Instailationl q 7 -) 2 -?l?'? ? c u r• A?Nori ed $igna[ure ICONractodOwner Making Inslallation) Phone Numher 4{s- -' Sbs -7 MINN660TA ITATE eOAPD OF ELECTflICITV p THIS INSPEGTION HEQUEST WILL NOT Griqgs-MiCwey qldg. - Noom N-191 BE ACCEPTEO 9V THE STATE BOARD 1921 Universitv Ave.. St Peul. MN 55104 UNLE55 PPOPEH INSPECTION FEE IS Pnnnn1612)RA2-O80D ENCLOSED. ? d d, ntQUEST FOR ELECTRICAL INSPECTION . es-ooooi-os ? See inshuctions tor complating this torm on back ot yallow copY. J'? SCG/??v E 13972 "X" Be/ow Work Covered by lhrs Request avA Addl Neo. Type o1 Building Apoliancne Wired Enuipmenl WireA Home Range Temporary Service Duplex Water Heater Lightiny Flxtuies Apt. 8uilding Dryer EleMric HeaUn Commercial 81dg. Fumace Si!o Unloader InAustrial BIAg. Air Conditioner Bulk Milk Tank Farm oine, oeci v omc, (sn.,ufvl ther urcity ther Othur Comoute Insoection Fee Below k Fea Service EnVenceSize b Fee Feeders/Subfexders N Fee Circuits U to 200 Am s 0 to 30 Am 5 0 to 30 Am s Ahove 200 Amps 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_P.mP+ Transiortners Irrigation duoms , Partial,Other Fee Si ,Q,/. rt.T I " ^ / ? ? Insoactor, her ?he eby Final 1 ' ce mrGfy thxt above ?) insOeclion hes baen ?`./? ^/(p atle. itiia rapuesl volE 18 montlu hom 18 nwnths Immo;d #-)5 3 0 0545 9ti 3 /gs 3,240 Feques[ ate ` ?5 - I Fire No. RouBh-in Inspar.cion Ne?quj? A7 ' Insoec- ?Roady Now ill No?ifv . tor Wh n R tl D ( ? es ?No e ea Y ?L'5?0419etl E tor I hereby raquest inspection o} above ? Ow r eiecpical work installad aL - reet AAdress, Boz o, Houte No. % I pi? -?19'7a Ga/ax: Citv eclio o Tow ame-or Nn. Range No. County OccupanLIPRINT) - Phnne No. y3?- / 3,3 Power Supplier AdOress Elec[rical Contrector pany Namel Cnnh ,tor's Licnnse No. ? Maili e P.ddress (ConVacmr or Owner Making InstallaGOn1 Authorized " na onva tod0 er MakinBIns lation) , ? Phone NumOer $'i9? 89? MINNESOTA STAT OAND OF ELEC ITY THIS INSPECTION flEQUEST WILL NOT GrigBs-MiEway BI g. - floom N•191 BE ACCEPTED BV TNE STATE BOAND 7821 Unive,sitv Ave., SL Paul, MN SSlOG UNLESS PROPEH INSPECTION FEE IS Phone 16121 297-2117 ENCLOSED. REQUEST FOR ELECTRICAL IIdSPECTION ea-ooooi ' See instructions for camDletinq this form on beck of Yellow copy. ' ^? ? l o??? 3? ""X" Below Wak Covered by This Request ?( f S Ney? FAtl flep. Type oi Builtlin0 APOliancea WireO Equipment Wired Home Range - ` Temporary Service Duplex - Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercial 81dg. Furnace Silo Unloader IndGstrial Bldg. Air Conditioner Bulk Milk Tank Parm Ocner oea v ,her (Snecify) t er SVeci y OtOer Othei Compu[e lnspection Fee Below X Fea ServicaEnhaneeSiza # Fee FeeAers/Subteeders p Fea Circuits 10 00 0 to 200 qm s- 0 to 30 Am s 2Q. 0 0 to 30 Am Ahove 200 qm s 31 to 100 Amps 31 to 700 Am s Swimming Pool Above 100_Am s Above 100_/amps Transformers Irrigation Booms 0 PartiaLOther Fee Signs Special Inspection S ? ?---? TOTAL 7 Aemarks . 33 ?rtt , ?y, Pough-in i, the ElecV?cal Inspector, haraby , certity thet the above I Final Di11e in meaa. s0ection has been Tnls reaueat voitl 18 monihe irom PERMIT City of Eagan Permit Type:Building Permit Number:EA137670 Date Issued:07/14/2016 Permit Category:ePermit Site Address: 4772 Galaxie Ave Lot:6 Block: 1 Addition: Park Ridge PID:10-56750-01-060 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 - Cheryl L Siebold 4772 Galaxie Ave Eagan MN 55122 (952) 891-1248 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA179566 Date Issued:10/11/2022 Permit Category:ePermit Site Address: 4772 Galaxie Ave Lot:6 Block: 1 Addition: Park Ridge PID:10-56750-01-060 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Michael Kinsel 4772 Galaxie Ave Eagan MN 55122 (651) 408-5779 Schmidt Roofing Inc 3509 West Highway 13 Burnsville MN 55337 (952) 888-4889 Applicant/Permitee: Signature Issued By: Signature