4584 Lake Park DrCITY OF EAGAN Remarks
Addition T.AKF PARKrAD,? DITIOM Shn7_rps Lot-.l _ Blk_ 2 Parcel #10 44200 O10 02 _
? Owner 5treet 4584 Lake Park Drive State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. C 2529.52 505.90 5
STREET RESTOR. -
GRADING ?
SAN SEW TRUNK
1976
s
* SEWER LATERAL /
WATERMAIN
* WATER LATERAL
WATER AREA
STORM SEW TRK ?
* STORM SEW LAT 1991
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, rion-no
n
n
BUILDING PER. 11443
SAC
PARK
t
Bl71LDllM PERMIT
SF
4.000
Receipt #
114 ? 3
86
SiteAddress 4584 T..riKi: PAiZK DRIVE Erect ?k Occupancy it3
Lot 1 B LAICE PARK SHnRH&model
lock 2- Sec/Sub ? Zoning R.1
Parcel No . Repair LJ Type of Const.?
. Additton ? No. Sto?ies
W
Name CUi,LEGI: CITY CONSTRUCTIOf1 Move ? Length 45
3 BO?I 309, F1WY 3 SO
A Demolish ? Depth
° ddres s
NUR`I':IF
"?'D 507/645-ti6?4$
? Int. lmpr. ?
?
. Ft
Sq
City ?
P Install
o Name MAE
Z
0 u
-c
Address
~ City Phone
F W Name
Address
< W Citv Phone
I hereby acknowledge that I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee •%
A Building Permit is issued to: CGLLEGE CJ'I'Y CO.NS^l:
all work shall be done in accordance with all applicable State oi Minnesc
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Approvals Fees ?
Assessment Permit 355.00
Water & Sew. Surcharge 37. G O
Police Plan Review 177 • 50
Fire SAC 575.00
Eng. Water Conn. 500• Q0
Planner Water Meter 63.50
Council Road Unit 280.00
Bidg. Off. Y 9 86
,
Tr. PI. 132.00
APC Parks ?
Var. Oate Copies
, . 0 U ?
Total
iCT?ON
on
the express condition that ?
Statutes and Cify of Eagan Ord+narrcas. ,
PermR No. Permli Noldsr Date Tslephone N
Plumbin9 I ; ?! 9
_
H.V.1 C. `
t?
Elec,.ic
8oftener
InspacHon Date Insp. C ommenb
Footlngs 1
Footings II
FoundatWn
Framing a
G
RooNny
Rouyh Plby. . _J ^/O^l ? 1/ /SLG 6100e41/O
Rough Htg. J/ ' $
Insul.
Flreplace
Final Htg.
Flnal Plbg. fm2LL1-
Bidy. Final
CeA. Oec. ?
3
Deek Ftg.
Deck Frmg. ?
Well
Cho
Pr. Dbp.
Reaipt
MECHANICAL PERMIT
CITY OF EAGAN
FI/l in numbered apeces
Type or Prinr /egib/y
Permit No.
F»
S/C
Tot
1. Dm 2. Installation Cost
3. Job Addrest Lot Bik. Trsct
4. Owner
5. Cont?actor Phone , .
8. Addnss ?
7. City State 2ip
8. Building Type: Residential ? Commercial O Institutional ?
9. Work Desrxiption: New ? Add ? Alter ? Repair ?
10. Dascribe Fuel Type
11.
No. Equwnment BTU • M. Ea.
Forced Air No. Eauipment CFM
Air Handlin
:
Mfg. y
Boilers
Mf9. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond. -
Mfy.
Gas, Piping Outle#s
12. 1 hereby certify that the above information is true and correct, and I a9ree to
comply with all ordinances and codes governing this type of work.
Signed : for
' Rough Final
' Inspectians: Date Insp. Date Insp.
This is yout permit when numbered and approved.
. Approved CITY OF EAGAN 454$100
i
?
I
1
Receipt PI.UMBING PERMIT Permit No.
CITY OF EAGAN ?
Fee
fill in numbered spaces
S/C
?
Type or rrinr legibly
? Tot.
1. Date 2. Installatian Cost
3. Joh Address Lot Blk. Tract
4, awner
5. Contractor Phone
6. Address
7. CitY State Zip
8. Building Type: Residential 0 Commercial O Institutional ?
9. Work Description: New ? Add ? Alter O Repair 0
10. Describe
11.
No, Fixtures
Water Closet No. Fixiures
Cesspool/Drainfield
Bath tubs : Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet pther
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 governing this type of work.
Signed
Rough
Inspections: Oate Insp.
for
Final
Date lnsp.
This is your permit when numbered and approved.
Approved CITY QF EAGAN 454-8100
' INSPECTIUN RECUIZD ?
CITY OF EAGAN PERMIT TYPE:
3$30 Pilot Knob Raad Permit Number: ?? s•?:'
?Eagan, Minnesota 55122-1897 Date Issued:
i (651)681-4675 !
i
SiTE ADDRESS: APPLICANT:
?? ? ?,!?h I)I; ? , . i r. i ,?? + ? , rr? ? „r , i ,il~r •.???iir! '. ? ?, i : ) :? ? , i l??a .• I
PERMIT SUBTYPE:
I.I , - Ii - 1 N
TYPE OF WORK:
!lf"tif FtiV,l.l.iI M
i h! N1 I
f, .itK.`i° (1?1IMN?Yffl?ii Mtl'iT tIF (M".iF'1'fl[It HI'F()F?F 170I4fitilTNii
F-
iL
?
J
CITY OF EAGAN WATER SERVICE PERHIR
3830 Pilot K:rob Road
P. O. Box 21199 PERMIT NQ.:
Eegan, iiAN 55121 DATE:
ZaninD: - - No. of Unin:
01Mf1lf: ?-' 1 - t 'J Co`1.:. i
Addnfi:
Sit! AAd1m: ,.]- ' . .?? . •.'72'E-R
Plurnber. "
Meter No.: ConnectFon Chorfls:
Size: /kcouM peposit;
Reoder No.: Permit Fee:
1asw Io eewiplp NMh iV Cihr eF Ee"w Surcharge:
OdYMaa. Misc. Chorgs: .`,
Totat: " ,d t.iet r
By
Dote Peid:
Date of Insp.:
CITY OF EAGAN
3830 Pilot K.nob Road SWER sum pEmIT
P. O. Box 21199 PERINIT NO.:
Eagan, MN 55721 DATE;
Zorii
^0' No. of Unih:
-,?
A
??o/:
AU01rSS:
SiM Address: ? ? "' ? ? , :' A.. . ? • 3 P' • ; ?,` - S. `, ? -
Plumber.
I .sm eo ea.oy .rNU fh. cih, oi as.. ccnrnenon aho,pe: -'+
ol a...o... Aoco,,,,r c.posr:
Permk Fee: ? ,:-
&ffcharge:
B
Y
Dote of (nsp.;
MFsc. Charpss:
Totol:
CITY OF EAGAN
3850 Pilot Knob Road
P. O. Boz 21199
Eagan, MN 55121
Zonlnp: _ i
Daft Pold:
WATER SERVICE PERMIt
PfRMIT NO.: 7
D/\TE:
No. of Units:
Ownwr, oi lege ('1 y Conat-
Add.e
sx
Sits /lddross; 4534 Tak' ^ark Dr. .7 R? .q Patk Sho es
Plumber. 'fur.r Pl,.imhin£-APPZe li'allev, ?nc. _
Mete. No.: Charpe, 5o,,D
size: ? NpoWt: 1 ' • n li
Reodor No.: /0 07 n,;
jflg-C8{?;0CM?' '
;C,?
i .o?.e to.??'a'T?? ?'
o.om..e... Nusc. ross: 7 32 _ nnad TP
?-' ? 1RFQ BYFoie w 63 . S?lpd meter
BY Dots Poid:
DoM of I rup.:
y- Zy- 86
CASH RECEIPT
. ? CITY OF EAGAN •
P X 21-199
E AN, MINN SOTA 55121 ?
?oa t s
aecc?vco .?
PPOM .
AMOUNT $ ?[?I/,„
FVNO COCE 41AOUNT
?-
?
G
?V
Thank You
BY
N_ 59162
White-Payers Copy
Vellow-POSting Copy
Pink-File Copy
& , DOLLARS
[]CASH a-C ECK 10a
3830 Pilot Knob Ro di P.O. Box 2G-A1 9, Eagan, MN 55121 N2 11443
PHONE:454-8700 ? q
BUILDIWG PERMIT Receiptri ?yU ?
7obgusedlor SF DWG/GAR EstValue $74.000 Date JANUARY 13 19 86
Snenddress 4584 LAKE PARK DRIVE Erect CF Occupancy R3
Lot 1 Block 2 Sec/Sub. LAKE PARK SHORE Semodel ? Zoning Rl
Repair ? 7ype o1 Const AL
Parcel No. Addition ? No. Staries
COLLEGE CITY CONSTRUCTION Move ? Length d5
i Name gOX 309, HWY 3 SO Demolish ? Depth-?
o Address
c
NORTHF;Fb?p 507 645-6648 Int.lmpr.
u ?
? Sq Ft.
iry msta
o SAME
Name
i
i Address
$
m
?
Ciry
Phone
F W Name
? Z5 Address
< w City Phone
I hereby acknowledge that I have read this application and state that ihe
information is correct and a'e to compJ?vfkkell applicable State of
Minnesota Statutes and Ci f Eagan fQ na ces.
Siqnatwe of Permittee ? t/ ' ?- •^-?
LLEGE CITY CONSTX
A Building Permit is issued to:
all work shall be done in accordance with all applicaW& State of Minpeso
Assessment
Water & Sew.
Police
Fire _
Eng.
Planner
Council
eidg. on.l/9/86
APC
Var.
Permit $ 355.00
Surcharge 37.00
Plan Review 177 . 50
SAC 575.00
water Con n. 500.00
Water Meter 63. 50
RoadUnit 280.00
Tr. PI. 132.00
Copies?? O
Total
' on the expresa condition that
and Ciry of Eagan Ordinances.
Building
RfQUEST POR ELECTROPRUIECTION ' ' ee-ouom.na
? Sae insvuc[ions lor completi" this form on Wck of vellow copy.
` _-37 904 "-'X"' Below Work Covered by This Request ?
Add Reo. Tvoe nl8wleina l . AooLancee Wiretl Equ?umenl WireA
Bulk Milk
p Fee ServmeEntraneeSue B Fea Feetlers/Subfeeders Fee Grceits
0 to 200 Am s 0 to 30 qm s 0 tn 30 Am s
A6ove 200 qm ? 31 to 100 Arnps 37 [0 100 A rnps
Swimming Pooi
L Above 100_Am s Above 100_Am s
Transtormers Irn tionl3oorc's A1 Pertial-"OtherFee
Signs Speciallnspection
Hema?ks SaG J CJ TOT FEE
?"
( I, the EMetiral
Inspattoq horoby
cert ity that tha abo"
e S.? insoection hes bee.
This rxquest wid ?tC1 t0
18 mo s from
37904-.0?
Heque t Date Fire No. pough-'n InsVection
pe urted? ?eatly Now Q WtII Notify Inspec-
-? 3- g? Yas ?No -? [or When ReadY
Licensed ElecVical Contractor 1 hereby request insoeetion ol above
Owner alectrical work installed at
Stree Adtlr ss, Bou or floute o.
0
? CrtV
S
.r. l
i?
eciion o. Township Neme or NO. Range No. Coun
e
OccuOa}K]IPfV?
?? ? Phone No.
Power Suppliar Address
Electnca Contracmr ICOm an
P Y
?
7? Con mor's Lw ns No
'?J
e n nen,
?c .v
Mailmg Addr s ICOnVa r or Owner Makiny Instailavon)
s-?-
Authonzed Srgn ture onttacmr O,w r Maki Installation) Phone Numbxr
MINNESOTp STATE BOARD OF ELECTRILITY TMIS INSPECTION NEQUEST WILL NOT
Griggs•Midway Blde• - Aoom N-191 BE ACCEPTED BY TME STATE BOANO
UNLESS PflOPEN INSPECTION PEE IS
1821 University Ave.. St. Peul. MN 56104
P6... 16121297.2111 E NC LOSED.
REQUEST FOR ELECTRICAL INSPECTION . ee-oouot.oa
See instruetions lor completinq this form on beek o} yellow copy. ..5s723
g.- 7 '-X" Below Work Coveied by 7his Request
Ad Type ol BuilE, ne APPlr.nce! Wirld EquiVment Wired
Home Range Temporary Servroe
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric He2tin
Commercial Bldg. Furnace Silo Unloader
Industrial BIAy. Air Conditioner Bulk Milk Tank
Farm Othei Suecify lhe? lSneufyl
t er $PCCity ffier Othei
Comoute lnsoecbon fee Below
p ServwaEntrameSixe M Fea Feeders/Subleeders N Fee Clrcurts
UD 0 to 200 Am s 0 to 30 Am s OC 0 m 30 Am
Above 200 qm>s 31 to 100 Amps 31 to 100 Ai s
Swiniming Poal Above 100_Amps A6ove 700_Am s
Transformers rngation Booms Partia6'Other Fee
Signs Speciallnspection
TOTAL F
NemSrk5 ? , 10
1, the EleZfrew?
Insoeclor, herehy
certdy thet the nbove
inspeetron has been
n[h Q s (rom'tl a
° O O? 417 Reques[ Oate Fn¢ No. RouPh-n Inspec
/ ?? Re urtee? mn ?ReaAV Now Nobfy Inspec
? es ?No tor When Ready
C!rLicen?A Electj/cal ConGactor ,
I hereby request inspecbon ot ebove
? Owner elactrical work installed at'
Svee[ AdAres/sy, Boa or
?s V me o. f
? ?? Grt?
eaion o. Tow io ame or No. qan0e No. Cow
6" ?
OccuOa (PflINT Phone No.
T
LI,
Power I, er - Address -
Electn
ontractor ICOmpany Na el
*0
,.. ?
Maihn Address ( ontracmr or woer Ma km,
? nstailation)
?
1 '
? O U
Au[honzed ? ature (C V ctor Owner akiny I IlaLOn) Phone Nvmber
MIN A STAT OAPO OF kIfTRICITY iHIS INSPECTION qEQUEST WILL NOT
Grrgg •Midwev 9. - Aoom Nd91?,. BE ACCEPTED BWTHE STATE BOAXO
1821 Universitv Ave., St. Paul, MN 55104 UNLESS PROPEfl INSPECTION FEE IS
Phone (612) 297.2117 ENCIOSED.
PLUMBIlVG (RESIDENTIAL)
Permit Application Sl??
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone 4 651-675-5675 FAX # 651-675-5674
Please compiete for: Single Family Dwellings
Townhomes and Condos when pemrits are required for each unit
E
??
I
/
-
/
/
?
Date
i
-- -- -- -
KLINKNER, PETER 1
Site Address ' 4584 LAKE PARK DRNE I Unit #
I EAGAN, MN 55122
j (651) 681-1376
Praperiy Owner I Telephone # ( )
Contractor NORBtOM P.UMBQ? ??
(612)827"4033
Address City
•
State
ip Telephone # ( )
The Applicant is _ Owner Y- Contractor _ Other
Septic System N0w _ Refurbished Su6mit 2 sefs of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may appfy.
Alterations To Exlsting Dwelling Unit, Indudiog $ 50
00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater .
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigatian system
_ Water softener X Water heater $ 15.00
X
rePtacement additional
- -
t
'`
? $ 50
State Surcharge .
Total «.E0
I hereby apply for a Residantial Plumbing Permit and aclmowledge titat the information is complete and accurate; tliat the work will
be m conformance with the ordinances and codes of the CiTy of Eagan and with the Plumbing Codes; that I understand this is not a
peimit, but only an application for a pernut, and work is not to start without a pernut; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
Je-? l1)0rblwv\
Applicant's Printed Name Ap c nfs Signature
RESIDENTIAL
30 BUILDING PERMITAPPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACaAN MN 55122
651-681-4675
NewConstructlon BeauhemeMa
• 3 regislered site survays showtrig sq, n. of bt, sq. tt. ol house; antl gl rooted areas
(200k maximum lot coverage elbwed)
• 2 copies of plen ftwing beam & window saes; poured taund design, etc.)
• 1 set of Eneigy Cakulations
• 3 copies ol Tree Preservafbn Plan X lot platletl atter 711/93
. R'un Jolst Detall Optbns seiecfion sheet (6Wgs wRh 3 or less units)
_ Water Softener
_ Water Heater
_ No. of Baths
VALUATION 19 Jf ( C?- • ?
qULTI-FAMILY BLDG _ Y 'YN
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT ?MEkiCiqlj ?v(LDP?UG- ((b.)Tj&`FC7ZI0;.
STREET ADDRESS l? 2 y?1vtco lle f 44,6 -? • CIPI STATE N ZIP SS 33 -7
TELEPHONE # 9s'Z 51 64S'g CELL PHONE # FAX 4?
PROPERTYOWNER L"J&VE.2 TELEPHONE# 4lS/
---------------------------------- -°----------- ---- --------------------°----°--------° °--
COMPLETE THIS SECTION FOR uNEW,, RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA
(d submission type) • Residential Ventilation Category 1 Worksheet Submittad • Ne Jy(0?tl??e?
l°1
• Energy Envelope Calculations Suhmitted
II JUI_ 15 2002
Plumbing Confractor:
Plumbing system includes:
Mechankal Contractor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovery System
---------------------------------------------------------------------------
I hereby acknowledge that I have read this applicatlon, state that the
with all applicable State of Mlnnesota Stqtutes ond City of Eagan Ord
Signafure of
OFFICE USE ONLY
Phone #
NamodeVNeceir Heaulremema
• 2 copies of plan
. i set W Energy Cakulatans for heatetl atltlNOns
• 1 site survey tar ex[eiior add'Abns & decks
• In0'iCate'd Fwme served by septk system ior atldiibns
Phone #
Lawn Sprixikler
No. of R.I. Baths
Phone fi
1d g- °? S
Fee: $70.00
--------°-----------°------------------
?n is corr , and agree to comply
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
uPdecea 4102
DATE Q f-1 I? ? z •
+nt?'r?°n .73F
K L -r RESIDENTIAL
?,?,?? BUILDING PERMIT APPLICATION
?? CITY OF EACAN
y ? 3830 PILOT KNOB RD, EAGAN MN 55722
i 1 T ? ? / --? 651-681-4675
' b
New Constructlon Reauirements
• 3 regisfered site surveys showing sq. ft. of lot, sq. fl, of house; aM all roofed areas
(20% maximum lot coverage allowed)
. 2 copies of plan shovring beam & window sizes; poured found design, etc.)
• 7 set W Enargy Calculations
• 3 cop'ies of Tree Preservation Plan if lot plafled after 711193
• Rim Joist DeWil Options selection shee[ (bidgs wBh 3 or less units)
DATE 'V?o?Z4l?`Z
fIREPLACE(S) _ 0 _ 1 _ 2
SITE ADDRESS MULTI-FAMILY BLDG _ Y }cNl
TYPE OF WC
APPLICANT
STREET ADD
TELEPHON6
l
PROPERTY C
e
---------------------------------------------------------------------------------°------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEC,ORY 1 MINNESOTA Ri7LES 7672
(+1 submissioo type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envetope Calculations Submitted
Plumbing Contractor:
Plumbing system includcs:
Mechanical Contractor:
Mcchanical system includes:
Sewer/Water Contractor:
_ Air Conclitioning
_ Hcat Recovery System
TELEPHONE #
Phone #
r-Nozzw
? ? L4 ?-- -? ?
ATE 1774 ZIP;??
Fee: $90.00
Fee: $70.00
Phone #
------- -------------- -------- ------------- -------------- ------------ ----- --------------------
I hereby acknowledge that I have read this application, state that the information is c
with all applicable State of Minnesota Statutes and City of Eagan Ordi nces.
?
Signature of Applicant
------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Watcr Soflener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
RemodellReoair Reaulremants
• 2 copies of plan
. 1 set of Energy Caleulations for heated addNons
• 1 sitesurveyforexterioradditions8decks
. Indicate if home served by septic system for additions
VALUATION-t 4300 Updated 4102
CITY OF EAGAN
CAtiHSEf:e S Tf-:'(1MINAL N0: 947
pATFe 03/09/99 TIMf: f.i'_:53c4.5
IDe
NAME; ALI..IED FIf;EST17E7 T.NC.
321.0 9001 4584 l AKE FARt: 60.00
21. y5 3001 4•584 LAhF F'Flfil: 0.50
;
Tnt;l fieceip+. Amol1nM: 60.50
Cfi 1037?7
USEh' I0; NANCY
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT
PERMITTYPE: °k J T i otN s
Permit Num6er: 0 3 116 4 %-'
Date Issued: 0 % / 0 9
31TE ADDRESS:
iaRt PMiJK n;?
I_O7? 1 tilpCY,? 'L
LAKE: P!ifi#, SHGf?E`3
DESCRtPT10N:
0 A S TN sE aT
t2I-k-'1dJn?`i`-,HPerinJ I. 7vne
E?,L i! d L no l.J`my: k T,; w a
X?f'YIOUS Ci.i:.IN•?_?'
t ?
/
i
. ,?
?,. ???
f?-?.. -\,? 1.f ......
``?' z ?, -.._
REMARK?,; rIr i_u,= e?u's r f'r s , ?;,
n:F r rrr r, ; E H ?? i: cu iu, ?n iTra
,c,
FEE SUMMARY:
F£% ? o n0. 0?
'-'UYr,PI'_i'Gb $' .:]L)
foCat F, ee 6 69.`k;
CQNTRACTOR: _ - ?? p p ? i r.a ri t- s i e L ? c. OWNER:
FCF,CSJDE Crl ;+,i??!Eft LNC 76331v+42 2Vi?5?D911 KL1?4KEfii PETI_
?; ?45 AI PPSItVIGW fivF 4584 I.taF:E PFlFV: OR
RUSFVILLE. MN n5113 L flL;APd MN 55122
r L.i e 1 E33-1FhA. 7 ( 6'it 1(SE31--137b
i hrrebv acknawJ,2dye tr+P, Y. S k3mve read thi.s aPP7.ication and SCare t'Mr,t Lh'a
5n4'orrrietaart i> correr,t a•nd ayree T.o cnma.tY wii.n iIl apo tir.ablw St-a r,sz ol 14n,
Stntutes :and C.ttY of Ea4ar t?rdinancee.
IL
APPLICANT/PERMITEE SIGNATURE
FJ;REPLIdr,E
AL7Ek^lT0Pd
td'?=1 ALT. RN-S] oCNuAi_
?
?, e.-,?- /--c
-CJISSUED BYSIGN TUR
., 'k
's (a0.S0
3_q _9 1.
1999 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
1
Date:&I?qq
Description of Work: Construct uew fireplace _ Aheratimes to existing
K Install gas insert onlv _ Install eas line oxlv
Other `
Job address: k Q- k y/ Jr ? 1 V'?
Lot: 't Block: ?- Subdivision/P.I.D. #:
Applicant (circle one only): Owner actor Pernrit Fee: 560.50
Name: A Phone #:yZCJ?/-l,
PROPERTY Last First
OWNER
Street Address.
City ? Stare: ///? • Zip: ??02
FIREPLACE
PISTALLER
Gt?%//' ?y/?7
Company: phone #: _??y??l/
StreetAddress:
/??,?(??(`/? t ?'-????
City
! v? i/?lJ U? ll-r- [= ?_ S[ate: Zip: __??
19
GAS LINE
IPISTALLER Sueet
City
State:
Phone #:
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 Eagan
Ordinances. n W-
Signature
I . ,, . n
1 I i'•: .R r - •
:
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED HITH THE CITY OF EAGAN
C0141ERCIAL SINGLE FAMILY DilELLINGS
site Address Lk P L .? /?
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND ' 14-,Dpd Q
To Be Used For: 40pt-i Valuation: 7--7--?p- Date:
-_T-----
Lot I Block _?.-
Parcel/Sub W(; AwA< Sup2csb
Owner ,0Jld1.?L-a?d c1S?ca?;Rz-mvc, a.?
Address&??(3q F HWY ?I cSbkr(H
City/Zip Code
Phone .yLQ`7" (,? La- L('LIF
Contractor ?/??(v?t="?" (?60V6
Address
City/Zip Code
Phone
Arch./Engr. rQL1jft.6 Srv.`L 1.S?N ucru,
Address
OFFICE USE ONLY
Ereet X Occupancy
Remodel Zoning
Repair ? Type of Const
Addition
? # of Stories
Move Length
Demolish 1 Depth 48
Int.Impr. ? Sq Ft
Install
APPROVALS FEES
Assessments Permit
'
Water/Sewer Surcharge
Police ? Plan Review 50
Fire SAC l5,
Engr Water Conn SGYJ.
Planner Water Meter (? 3,s°
Council,_, Road Unit
Bldg Off _?reatment Pl 3Z.
APC Parks
Variance Copies
TOT9I. D
City/Zip Code
Phone 0
? (A.a ck-4 ° 6 L `
2?3x qo? 112v K s? _694q?o
?? 4-5 ? 4 4 215 Co
1X?
ZZIc20? ??i'C? ?c (Z " SZBo
f2xr? - ?2° x 8 ` ?
.
?7 33S7-?
,
6 .
,
, EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
'rI h.J
-r 2ve
t TY • 00
QWNER .
?
' SITE ADDRESS • ?
C DATE PHONE 507-(,q S- (C?qS
-
1
(1
Q-
• CON7RA CTOR ,
2
__
h,r
tY
petermine working square footage of each.
1. Total ex pased wall area ...... Z188 sq. ft. x-J/ ? 2A-o•'1
? •2. Total roof/ceiling area ...... IZ IA- sq. ft. xo7t
• Total exposed wall area above floor = 2 I S
.
a. Total wall window area ........................... 148 T
b. 7ota1 door area .................................
-Ll
c. Total sliding glassdoor area ................... •
d. Total fireplace wall area ........ .. ............ --
?
• e. Total Wall framing area (averagelOX)...:........ 2
-
?
f. Total 5
net wall area above floor ................. 1 '
g. Total rim 3oist area ............................ t57
. Total ekposed foundation area = fOA-
h. Total
.........
foundation window area .............
T
i. 7oa1 net foundat9on area above grade ........:... I? 4 n
.. Oetermine "U" value of each wall segment.
1
u' • ?
X"u"
a. ? L4-8 '
. _ ?
b. 38? g,iuil
.
n,
c: A-o •X $ou„ ? GI I_ a 3. .
?
--
-?-? '
' d• n X
-?--,
?
.
' X pVll
e. 4IU
?yR'
f. Ir7$ / X °u° 93_ - -..L2S2..f?-
l57 ? X „u,. `?-
?
h. O X "U"
i. 10 g Nu'l
.079_° 'ZZ
3 .....................................Tota1 = EE=
If item #3 is the same as, or less than item #1t you have met the intent
of SBC 6006(c)2. ,
.,
Total..exposed roof/ceiling area = 17-I 4
J. 7ota1 skylight area:...........
k. 7ota1 roof/ceiling framing area.(average 10?).. iZ 1
1. Total net insulated roof/ceiling area..:........ I o 9 3
Detennine °U" value for each roof/ceiling segment.
' .. ? _ X oVu s -
.
i
k. 17-1 p X"nun • 17
,• ??
1: 109 3 x„u,s . n Z 2 OS
4...•.•.••••.•.•................... TOCdl ° Lx.1lJ`? J
If total of 14 is the same as, or less than :2, you have met the intent of
SBC 6006(c)l.
Alternate Building Envelope Oesign
To utilize the total envelope system method, the values established by the'
sum af 9tems #3 and #4 shal,l not be greater than the sum of items #1 and #2.
1. + 2. _
3. + 4. °
? • ----._._.,_._..
11R,lWD U VALI.IE ANA?.Y515 OF DocR.S AND Cj,LA2ED ARA,qS
WINDoW AREA :
TyPg- pF 1n/1N.Vow:
7Ne \,a/INDOKJ Vu'rS /./A+t BcC14 TiofeP Fog "R'=VA"µi, tNAY AKC Aa Lis1tG
ABoJC qNO may Qt rssiyy8o A OCa14N [sArr.l V,rL,La.c oF "Ji-s 2-.
I4cLwDfy4 AiR flLMS,
Foa7s?4L -4- FOeTAG•
i-ouNtaAT Idn1 yr1NDo w ARZA :
TyPE cr W,'voow :
rNF- vv,NOOw uwr5ia4rL gti.N TEST[D FoR'R^ VAL++CttHtYaRt ns ?. I .Tr.o aeoVIL wein
moY er ASfiyNa.u A C?csiy,,/Csr.pc} VAL++It oc •Xr,r z.?39 ?uc?wolNsy
A1R RlL-MS , o
LIq2c 1/'S? • ?? 2.89 sr?S??1 Foor.?44 + KppTn4C + 3;, ?
SLJD)Wfj (:?La5s LAOR ARfp% TYpj.p' DooR:
51-101IG CjL.459 oOOCLS NNVc Ott•/ TL3TLG FoR"R=TNi.YAi[ &.i waTao ?
AtvVe paJo rnAy B# nssoyN?ct w v?s?c,NGs??U \IALKL or-•W.^A 7.R9 ,?...MJW.4
AI0 FiLrtS ??
1.??.3 ¦ 1.? K9i w ???_ z? FvaT> 4[. -= ?0?
DooR ARF-A: TrP e oF Deorz :
QQOQ UNIYS H-AYL ?.1 BECN TLsTCO ??h!D RouVG To NAVit AN
6??-VALLdN dr 7._1,1-_ JNU..NO0N4 A#a R11,.M3,
Udi :'/Rd? FmrA!Q L -Ir-. 32 0
5Pec,qL5. ; I TrpE :
rbaM E-1 T?4f- ' 514 N6a
--------- - --- - - -
- ------ - - ,
V N n
'R ANO•U VALUC Ani.aLysis pF Wti\LL SiGTIOW$
R, Hr l0, 5 -r- ,qrce:^:
"R' - VA LuE
_ ,(oI _i NrEltIo2 AIP- PIl. M
19,0 -(? IUSULnT)oN CR-19)
2s'/ sHEAr?Nti?111?T-?2??rE,
? ,.
I • ? ? ?I2" SOFYWOOp
.=,,,?4FXTfrz.i0R H1PL 1`14-n
2q, 3 9 Tor A t-'tj..?• yA(-u.G
'4"? • ? ?`?a • I?? ?
roM "r.,C,f._- IS-_
FOUt-i D AT ION I1lIALL- AREA CAHovri, (:IRAoR.,)
„R,. vAL u.E
fNTERIOR, AIlZ Ht-?1
. a S _„?? c! oN ca r?'s L'3?. oc iG
? Z?`l InisiDC? F??2?I rw
1k QO 2-11 GA4.fa OQ [nl.?u.4.1f?; wl ?R' ?
_IZExTF.Kio2 A,2 RILM
i
? 4da3 TOTAL ,Qwq JALuE
"??- ?/a-?. . I / ? Z. ? m ?2?
ro,AL "rArL
I p`f
IbAn s•i iMY*fE Dktc; 91WtD
" rF?rAND"U~ VALUL ANALYSlS OF WALL SE,GT IOIJS
SrLL .o / FRAM IN4q ? ARL xk :
. R. _ vA L ue
•??INTeK??R A?R Fi??'1
GVv.srtM wAC?aoneo
?12
r .
Sof T M/om0 '
?1 SH&41NiN4
_,jAP_ S IDsi.ICi ?ZI
VAKoQ BAaRrt.¢.
•17 ErrsAiok nf2
o. S orAL' R.,.?;
'4ti : t/'-t s I iJ.4,.$?5' •-??
To fA l 1mTAG t 2-IR
I N 5 l.i. {.. AT g- o AR EA G7 rTW ce ?v S T L? OS
"R" vALu. [.
Iure¢ioa ^ja r+g.M
)/ M
?yS_4YPSUM yJnL460.,eo
11JSULAT ION (R-O /9)
? 15 Z SHl.+TM 1044 8011,T Ql-fE
?6 st aj uq L AP
vl+ooK. ?o,?..R.?ct
. L7 GLriltltjX /110. IryLM
2-2-?9(o OT A L PJAw?. VwtuAir
?y,•w.. 1 L..?wz,6Ls•
TcTAL roorA4s, 1?-$2
MLi o"L?M,rt, vArc: 51w,..o--
.,
• , 'R„AND OU' ?ALUE qMALY.5tS OF THt ;?,QOF,/CEILIeIG SfiCTlOqS
JOiST/ FRAM iNiG flRc ^
•Ro- vq Lu E
--,(,21_INTERIOR AIfZ FILM
q.3 i ?
).5 50F1'woop
S "
e 5±1 GrYPSw.M WALLApAIIO
i- _-- yA1:)oR, 154K41clit
s?l NTER 10R. AIR FiLM
TOTAL 'Rw, ?ALLI.E
4iwl n I /Kol a, 1-,4 ??7- 3. Yl = L?1?J
T'oT A l. FoorA.G 19
-tWtCN TNE J0I5'rS
?NSuLqT&' qRLA 15E
"F{" .. VALtA.G
- .0 IIIJTERIOR AiR FILM
41,00. ?NSkLATIoN CR•W )
WC? yPS u M WALLDo+n&0
YAPaR, 15ARQIie-
.1? INTERlOlZ A1R fILM
y5.3 ?ToTWR.-ti:' VALU.E.
U,.y_I /Ks =
j/. 41, (?. 3 6--=?-?
7bTA6 FoorAae. ,[Qg--a I
"r-f I e/y7f,ftr pntq g14MlD
? ? ? ?•? ? • i •• • i?? • u r. ?. .?.
•?• ? •a? •?? • • ?• • ?? • ? ?? ? • • ;
CITY OF EAGAN
APPLICATION FOR PERNLiT SE.'WER ADID/OR WATEE2 CONPID..^PION
1) PROPII2TY ADDRESS:
kL00t/1310cx/5uoa1vislon or 'i'ax rarcei l.v. ivuauer)
IF EXISTING STRCCZ'[.RE, DATE OF ORIGINAL Bi:ILDZNG PERMIT ISSL'FIPICE:
(Nbnth Year)
PRESETTP ZONING/PROPOSID CSE:
F -1 SINGLE FAMILY
R-2 DCPLEX ('I4ao L'nits )
R-3 'II?WNEIOt'SE (Three + Lnits)
R-4 APAI2TMENT/CODIDOMINIL'M
COMMERCIAL/RETAIL/OFFICE
IAIDi:STRIAL
INSTI'I['TIONAL/GOVIItNN1ENT
( Lnits)
( L?nits )
2)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) . i;?•
NAN1E:
FURR PLUi:?81iVG - APPLE VALLEY N1G' For City L?se
Plumbers Licens(
ADDRESS: O
n,esaa r. vALLEY MP! 65124
?t?ive
CITY, STATE, ZIP: Q Expired
PHONE: 31- 717 r MASTER LICENSE # O No ecor,
037??M7 St J niti
4) ?wK •_.r N..ni?;
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5)
Q CO.INE]CTION 7n CITY SEWEF{ C7 CONNECTION TO CITY VATER
Q 0'I'HER (Please Describe)
6) u • i
? PLEASE HOLD APPROVID PERMZT FOR PICK-L'P BY ONE OF AHOVE
i,RASE MAIL APPROVF9 PERMiT TO 1, 2 3 4, AHDVE
(Circone)
>> Ci rOLT,
??? ?
F O R C I T Y U S E O N L Y
PE?ZMIT °- ISSUED
??'}Z7
FEZS: $
S ,E? • So
?3?? •
$
S
S
$
$
$
rG ?
? UQJO
.? '/ S-r? U
$
$
S
$
T i ??Z - CJ CJ
$
$
S
, 741
SS:':LP. n.r_.RMTy (I`ICLrLL. JURCt:A?'.?.JG)
WATER PER4IT (IiICL'JDE SIIRCHAc2Gr,)
WATER METER/COPPERHORN/OUTSID: READER
WATE.°. TAP (INCLCDE CORPORRTION STOP)
SE:vEF TAP
>C:Oi;:YP .,?4SI= - ac. ?3
ACCOUNT DF.POSIT - SdAT°_R
wkiC
SP C
TRUNK SJAT°R ASSESS:lE::T
TRuiIK SEWER ASSESS::°AiT
Le,:E?,lL BE:IEFIT/TRU`IK SE!cLR
LATcRrIL BEVEFIT/TRU.IK WpmE;2
WATER TREATMENT PLAi1TT SURCAARGE
OTHER:
TOTAL
AI•IOL`NT P.aID/REC°I?T n
DOES UTILITY CONNECTION REQUZRE EXCAVATZON IN PUSLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR :40RK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
Q NO ENGINEERING DZVISIO[V. LIST AS A CONDI-
TZON.
SUBJECT TO THE FOI•L0WING CONDITIONS:
APPROVED BY:
TITLE:
DATP : ? 7/??
?
? For,;0#fice;4se -----LC'? ?
? Pertnit
? Pertnit Fee' 7 J I
Date Received:
I Staff. _
I _
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Tenant:
RESIDENT I OWNER Name: F-LIGi Phone:
Address/City/Zip:?y oc
Applicant is: _ Owner ? Contractor
TYPE OF WORK Description of work: ? 1`c-S 1k
Construction Cost: l/i?4 T bf .S? e? Multi-Family Building: (Yes _ I No ?
CONTRACTOR Name aian[ License#:
Address:
City: (-VYiV?T State: zip:
PhoneG0•,)`LQ_4lyi3 Contact Person: ab t.zt
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Cet¢90n/ Submitted Submitted
(4 Subrtlisslon type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical ConVactor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are.considered to be public information. Portions oi'
the information may 6e classifred as non-public N you provide specific reasons that would permit the City to
= conclude that the are trade secrets °
Date:
Site Address:
Suite #:
I hereby acknowledge that this information is complete and accurate; that the work will be in wnfortnance 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 ?0.rtieA dIJ?
icant s Printed Name x
Page 1 of 3
TRI-LAiVD C0.
' SURVEYING
SERVICES
4655 NICu'?S ROAD
EAGAN, h:,NNESOTA 55122
,
SCALE'. 1 " ='J'??
PROPERTY DE5CRIPTION
SITE PLAN FOR:
COLLEGE CITY CONSTRUCTION
?06.v
?
h
V'
N
?
:i
LOT I , BLOCK_2.,
I ALF PAAK S6A0RES
occordinq to the recorded plat ihereof
12o4cnTA CauMy, Minnesota
LcGEND
o DENOTES iRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
?- DENOTE : DRAINAGE DIRECTION
I hereby cemry inut tAis wrvey,plan or
teport was preparnd by me or under my
ditect supervisicn and that I am a duly
Repistered Lana Surveyor under ths
Laws of tha Statr of Minnesoto.
'.N64°52'p4"E
13.95
PROPOSED GARA6E FLOOR ELEVATION= ?o n
PROPOSED FIRST FLOOR ELEVATION = 10z.5o
PROPOSED BASEMENT FLOOR =
ELEVATION
NOTE' VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Brodley Jl/0enson, Mn. Rep. No. 15235
D01! : 77 T) EM43ER ?c) 8,?1
Date:
City of Eaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: 1D9 9) L8 y
Permit Fee:
Date Received: 01-11-13
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: Unit #:
Resident/
Owner
Name: - v14 QAk l S + \ e-" Phone:
Address / City / Zip: C "► Let ke Pct v k r L t
Applicant is: /Owner Contractor
Type of Work
Description of work:
5 -La-- If x5-3 - 3r
4eto l,‘ t'orc k+ 41 C1�
Construction Cost: $ 1.2_1(C00. 00 Multi -Family Building: (Yes / Nov )
Contractor
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for ad
rmation)
1121%,
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW • NG
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:
Phone:
Phone:
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 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.gopherstateonecall.orq
1 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 Builg Code must be completed within 180
days of permit issuance.
�� ue kt I .5,94-C.110/
Applicant' Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _Fireplace
— Porch (3 -Season) Storm Damage
Garage _ Porch (4 -Season) _ Exterior Alteration (Single Family)
Deck _ Porch (Screen/Gazebo/Pergola)_ Exterior Alteration (Multi)
Lower Level Pool Miscellaneous
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New Interior Improvement
Addition Move Building
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation ! ((c`e Occupancy
Plan Review Code Edition
(25%_ 100% >) Zoning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water Final
Framing
Fireplace: Rough In Air Test Final
xInsulation
Sheathing
Sheetrock
Reviewed By:
Siding
Reroof
Demolish Building*
Demolish Interior
Windows Demolish Foundation
Egress Window Water Damage
*Demolition of entire building — give PCA handout to applicant
pJ.
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests _Final
Siding: Stucco Lath Stone Lath _Brick
Windows
Retaining Wall: _ Footings Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
3 )2-, 1)(l3' y/_Fo
�
I jos'
Page 2 of 3
TRI~LAND CO.
SURVEYING
SERVICES
4655 NIC`S ROAD
EA GAN, M, N NE SOTA 55122
SITE PLAN FOR: (0(f67
5 c'1 t )90,141 �)►�
COLLEGE CITY CONSTRUCTION
5CALE: 1"= 3�
949
PROPERTY DESCRIPTION
LOT I ,
LAkE PARK_ SHORFS
according to the recorded plat thereof
D.a <r TA County, Minnesota
LEGEND
o DENOTES IRON MONUMENT
a DENOTES WOOD HUB SET
DENOTES EXISTING
SPOT
DENOTES PROPOSED SPOT
ELEVATION
DENOTE DRAINAGE DIRECTION
PROPOSED GARAGE FLOOR ELEVATION= lo? r�o
PROPOSED FIRST FLOOR ELEVATION = 102,5°
PROPOSED BASEMENT FLOOR
ELEVATION
NOTE'. VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
l hereby certii y mut this survey, plan or
report was prepared by me or under my
direct supervision and that I am a duly
Registered Lana Surveyor under the
Laws of the Stale of Minnesota.
atandj
Bradley %le/
enson, Mn. Reg. No. 15235
Date 27 n ECEN RACK, 1485
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use . /1
Permit #: 1 v
Tc°1"
Permit Fee: e.)5
Date Received:
-13
Staff: k-(7
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Resident/
Owner
Type of Work
Contractor
Name: tti(i,te(At jLChe
Address / City / Zip: ` Cell Lek Pc -V ii
Applicant is: V Owner Contractor
Description of work: Ke 11.00
Phone: CC -1- ‘4 S-14
G/
5.‘1/Z2...
Construction Cost: 000, 0 0 Multi -Family Building: (Yes / No p`
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber:
Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
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 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.gopherstateonecall.orq
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 C.'de must be completed within 180
days of permit issuance.
x
Applicant' Tinted -lame
Applicant's Signatui
Page 1 of 3
_ Use BLUE or BLACKInk
For Otflce Uae' - - - - t,
1.
cI2,.
of Ea" aIl , Perrrtit:
ity .
3830 Pilot Knob Road Permit Fee: I
Eagan MN 65122 i Dale Received:
Phone: (651) 675-6676
1
Fax: (651) 676.5694 t Staff: ,
1 ~
2011 RESIDENTIAL 6UIWING'PERMIT APPLICATION
Date: l7 Site Address:'19 124'_ Z?R(OE Unit
Name: '6146' VE/V fi'r(-ik(- Phone: 5 6 Z`1253 316RESIDENT / . r „
OWNER Address/ City/ Zlp: YY65 6AXE rig R pk E1i-&-,4N
Applicant is: Owner .Contractor
TYPE OF WORK Description of work:
Construction Cost: I 7®~ Multi-Family B tlding: (Yes _ I No _[lJ
Company: '~i'`/%~'C~f / 4 1 -PbK Co Contact:.5yeve •700RqAyEa_
CONTRACTOR Address: _5*8> / B40A*_,A116' 6-14, City: AR Le,
,
State: A). Zip: - Phone s ~ ~R Y -~~4 8
Ucenaa _ Lg D „3Lead Cert4ficat@ M 41,4 T 7,;L. 3 7 3
If the project is exempt.from lead cerdficadon, please a laln whjr (she Pa9 .e 3lor additional information
~•y )
COMPLETE THIS AREA 4X IF'CONSTIR CTING A NEW BUILDING
In the last 12 months, has the Clty of Eagan issued a permit fora similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
t,7censed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents at. 'submit are cprtsl Bred to-be public /nformadon. Portions of
the Information maybe c/asslf/o,4sn017•~ ublJe,lfypq p~,gt%1 9~40 reasons that would permit the City to
Y
F ctlricludA'.Ir`al.ttie . ard.tradb,secrets.
CALL BEFORE YOU DIO. Call Gopher State env Cats at (461) 4f"002 rot protection agalmt underground utility damage. C81148 hours
before.you intend to dig to receive locates of undorgnOwxf utlutlei. VAAW
oooFlenlaleonecairora
I hereby acknowledge that this Information Is Complete and accurate,
4
Eagan; that I understand this b not a Permit, but only an application for a pee tit 4r4 wp(k la not l start withoutralnpermit; that theeworx will be of
accordance with the approved plan In the'case of work which requires a re4w tied approval of plans. • '
Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building
days of permit Issuance Code must be completed within 180
.
Applicant's Printed Name Ap Pcant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA155027
Date Issued:04/24/2019
Permit Category:ePermit
Site Address: 4584 Lake Park Dr
Lot:1 Block: 2 Addition: Lake Park Shores
PID:10-44200-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Evgueni Sytchev
4584 Lake Park Dr
Eagan MN 55122--253
Air Express Inc
1010 - 118th Ave NE
Blaine MN 55434
(763) 291-8519
Applicant/Permitee: Signature Issued By: Signature
r For Office Use/.
�` i i%O../
, ::::
/ S �: 6 D
^1 .r��ry
Date Received: cJ A2� -/
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECEIVED
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspectionsgcityofeagan.com MAY 2 2 2019 7 -'
2019 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: OC/221101 Site Address: I5 R L{ L e_.e PCC' D r
Tenant: Suite#: crf
R@SIdent/Own@I` Name: �1.t.. IA—k-� Phone: 5 G Z — ZS3— ?eb £
Address/City/Zip: 5 Q"'"""c..
Name: l&T l; l)'" 0 "k J 6 License#: / b`Z l J
Contractor Address: (01_l 2,
4 (J Ke vt- GL 'e /" City: (3�µ a �L
State: 1Zip: 937-114> Phone: 6S"--( -3 "S_ ' C '/6' (
Contact: J`,/`- Email: LA-r 0 K 16 e -T)tk{-e v (6)C-0,---c-&-57,N'eq—
Type of Work —New Replacement —Repair —Rebuild —Modify Space —Work in R.O.W.
Description of work:
/ Water Heater
Lawn Irrigation( RPZ/ PVB)
Water Softener
Add Plumbing Fixtures( Main/—Lower Level)
Description Septic System
Description:
_New
Abandonment Connection to City Water from Well
RESIDENTIAL FEES
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 New fixtures, adding or removing piping (includes State Surcharge) .
$60.00 Septic System Abandonment
$100.00 New Residential (fee collected with Building Permit)
$115.00 New Septic System (includes County fee and State Surcharge)
$60.00 Connecting to City Water from Well*+ $290 for Meter and $190 for Radio Read = $540
*Sewer&Water Permit also required for connection charges
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeacian.com/subscribe.
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 i not to start without a permit; that the work will be in
accrd nce with
the approved an{—in the case of work which requires a review and appro al of p ilio
x Lc
C- y r-tiek/
Appli nts Print Name l
Applican 'gnat re
Page 1 of 2
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA171414
Date Issued:08/16/2021
Permit Category:ePermit
Site Address: 4584 Lake Park Dr
Lot:1 Block: 2 Addition: Lake Park Shores
PID:10-44200-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Evgueni Sytchev
4584 Lake Park Dr
Eagan MN 55122--253
(612) 254-5111
Great Quality Plumbing
10212 Xenia Ave N
Brooklyn Park MN 55443
(651) 335-4101
Applicant/Permitee: Signature Issued By: Signature