812 Golden Meadow RdCASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
nare` .,___:??? 19
wecarvetu
FROM
AMOUNT' $ I
OOLLARS
?oo
C] CASH 0
?
?
AMDUNT
hank You
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
BLDG.• PERMIT ti0. ?:_? .`•%;j ?
--- ?; " .
' ' • -=rt ?.
01-3210 Bldg. Permi
01-3422 Plan Check
01-3445 Surch./Adn:.
01-3446 SAC/Adm.
01-2155 Surcharge
I7-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
? ???
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
. EAGAN, MINNESOTA 55122
DATE 19
?D
TM '
,AMOUNT $ I
C] CASH
? GHECK
U D OOE AMOUNT
Thank You
BY
ae DOLLARS
?oo
White-Payera Copy
Yellow-Posting Copy
Pink-File CopY
M59S
CITY OF EAGAN
3830 PIIot Knob A
P.O. 8ox 21 199
Eagan, MN 55121
Zoning: P
Owner: oe :
Address:
Site Addess: a
Plumber. Tom ties9ia?x rlumbi??
?., Meter No.: Connection Charge: ?C?O _ 00 q
Size: Account Deposit:
Reader No.: Permit Fee:
? I agree to comply with the C1ty of Eagan Surcharge: S(h,?i .?
Ordinances. Misa Charges: 1 5fi fltln.? '? t?
By Totai: ?Pter
?
Date of Insp.: Date Paid:
Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Kaob Road ? 5??
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: I"i I-•`7 7
Zoning: P No. of Unlts: 1
awner. JaE riiller ConsC.
Site Addi
Plumber.
I agree to comply with the City M Eagan
Ordinances.
BY
Date of Insp.:
Insp.:
ZOf!. 00nd
Connection Charge: -14 75 - c1tl.,,j
Account Deposit; 1 '?
Permit Fee: 1
Surcharge:
Misc. Charges:
Total:
Date I
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilct Knob Road
Rs'. 36x 21199 PERMIT NO.:
172177-
Eagan, , MN 55121 DATE: ?
Zoning: i`Z No. of Units:
Jac- Yiller Const.
Owner:
lite addess: 312 Colden rieadow Road L4 B1 Sunset 9
Tom Hessian P_ M
No.:
n
to comply wNh the 1MF`bf Eagan u ,,.- rg? •' -
?. ?t?F.. ---- 1
Total:
t c?dv? ??? Date Paid:
of Insp.: Insp.:
?
G SEWER SERVICE PERMIT
nN
cin oF-ea
3830 PIGt Knob-Raad 9 51 b
'f?.+fy: Box 21199 pERM1T NO.,
l e? 1_ F 7
69an, MN 55121 DATE: 1
Zoning: R1 No. of Units:
Owner. Joe Miller Const.
Address:
sl? Golden *
L4 ?il Sun
SiteAddress:
Piumber: `?nm He4sia
! ?-?7-''h t?t!
0bRn?'sMn?rge: i?5 nntia
- _ • .h-n..oLka? a" 10?
Dr-QUIK'-, surcnarge:
• RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reauirements
. 3 regis[ered site surveys showing sq. ft of l04 sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan shaxing beam & window sizes; poured found design, etc.)
• 1 set of Energy CalcuWtions
• 3 copies of Tree Preservation Plan d lot platted after 711l93
• Rim Joist Detail Options seleclion shee! (bldgs with 3 or less units)
Remodel/Repair Reauirement4
• 2 copies of plan
• 1 setof Energy Calculations forheated additions
. 1 sfle survey fa exterior addilions 8 decks
DATE !- /D ' of VALUATION (EXCLUDING LAND)
JOBSITEADDRESS 8i02 Goldth MlCGAat, Rd
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER /im (?.VcbSbGCY!
TYPE OF WORK I-eqr 01"4 /"o0T' FIREPLACE(S) _0 _1 _2 _3
APPLICANT fO12 I+n-r CoHS-?" t ROO+ ! yol PHONE # 452- 98l- 2aSs
0
ADDRESS oZX W15* C/P' " /'4/y ZIPCODE 5-S'4Za
PAGER #
FAX #
NEW RESIDENTIAL BUILDING ONLY - fILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbin.- 5ystem Includes:
Mechanical Contractor:
Mcchanicid Svs[cm Includes:
Sewer/Water Contractor.
CELL PHONE #
Water Softener
Water Heater
No. oF Baths
Air Conditioning
f Ie1t Rccovery Systcm
All above information must be su6mitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the in rrr?
all applicable State of Minnesota Statutes and City of Eagan Ordinanc .
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Pian Received
Phone #:
L.awii Sprinkler Fee: $90.00
No. of R.I. Baths
Phone #
Fec: $70.00
Phone #
and agree to comply with
A
Not Required _
41v,15
Updated 1/01
CITY OF EAGAN ?
12983
N
?
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
-
PHONE: 454-8100 / `
BUILDING PERMIT
Receiptp
_/K
S?
-
7obeusedior SF DWG/GAR Est.Value $66, 000 Date DECEMBER 17 1986
SiteAddress 812 GOLDEN MEADOW RD Erect 1!7 occupancy R3
Lot 4 81oc k 1 Sec/Sub. Sj7NSET 9TH Remodel ? Zoning ED
Parcel No. Repair ? Type ot Const. ?
Addition ? No. Stories
? Name JOSEPH MILLER CONST Move ? Length S2
3 Address 18133 CEDAR AVE SD Demolish ?
? Depth4.?:2
F
S
° piry FAR MIN892-1010 mt Impc
? q.
C
Install
o Name SAME Approvals Fees
?¢ Address ASSeSSment Permit $ 331 . 0 0
" Ciry pnone Water&Sew. Surcharge 33.00
Police PlanReview 165.50
Fw Name Fire SAC 575.00
¢ z Address Eng. Water Conn. 500.00
a W City Phone Planner Water Meter 63 . 50
I hereby acknowledge [hat I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes andity of Eagan QRtl(arcesi
Signature of
Council
Bldg.Off. 12/7/8 6
var. Date 7/16/86
Road Unit 290.00
Tr. PI. 156. 00
Parks
Copies?. 0 p
Total
A Building Permit is issued to: ?JOSEPH MILLER CONST on the express condition that
all work shall be done in accordan e with all applicable Sta of Minneso utes and City of Eagan Ordinances.
Building Official
/
f
7986 BOILDING PERlQT APPLICATION?- CITY OF EAG9N
NOrE: ALL CONTR9CTORS MOST B8 LICENSED HITH THE CITY OF EAGAN
SINGf.E FAMIILY DWELLIBGS
INCLDDE 2 SETS OF PLANS, 3 CERTIFICATES OF SiJRVEY, 7 SET 0F ENERGY.CALCULATIONS
MOLTIPLE DWELLINGS - RSSIDENTIAL RENTAL IIBITS FOR 3ALE @IITS
ZNCLUDE 2 SETS OF PLANS, CERTIFICATI
? SE1f CF ENERGY CALCULATIONS
AnRCI9L
INCLUDE 2 SETS OF ARCHITECTURAL
t SET OF SPECIFICATIONS AND 1
ENERGY C6LCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: I U:.(,V R-On L
Site Address
Lot ? Block /
Parcel/Sub
Owner
Address
City/Zip Code
Phone
Contraetor ?
Address
City/Zip Codea?aArn,r114>16,ti,1?55oay
Phone
Arch./Engr.
Addx-ess
City/Zip Code
Phone S
OF SQRYSY - CH6C% iiITH BLDG. DSPT.,
& STRUCTURAL PLANS,
SET OF
Valuation:
Date:l C9 " "1 -
OFFICE pSS ONLY ` ,
Ereet ?
Oecupancy? 7 ?
Remadel Zoning 742?F-
Repair ?
Type of
Const ?t I
Addi:;ion
? S of Stories
L ?
Move Length F3?
Demolish
Depth ?
4/Z, -
Int.Impr.
- Sq Ft -
Install
APPROVALS FES3
Asseasments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC '$ 7S
Engr ? 'dater Conn
Ylanner ? 1dater Meter 3• 3-6
Council Road iTni4 rlyb
Bldg Off?2-? Treatment P1 ?
@PC Parks
Variance Copies
TOrA[. 2 /
NOTEs ADDEESSES FOR CORNER LOTS - CONTRACTOR/HOPIEOiiNEB MIIST DESIGNATE pHICH ADDRESS
IS DFSIBED. HO CHAAGES SiII,[, BS ALLOiIED ONCE BOILDING PBRMIT I3 ISSIIED.
Vb
Ir 10? (oZ
7 ? 444 = z7 7Z
sv
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,.
- sw.
?
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TRI-LAND C0.
SURVEYING
SERVICES
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
SITE PLAN FOR:
JOSEPH MILLER
CONST.
GOLDEN MEADOW?,??°
ROA? ???
?
?
Sc
PROPOSED
PROP08ED
PRDP08ED
,,. ?.- .
,
ti ? . ?c yl
?
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/ cy N
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Nc;R I HViEVlf 3 I / y
••c? .? C?t;1.. .•
?•.^ ?N I 4 ?
i???.
;,.li 1
Z
N
SCALE:Ia=50'
--
r 3
a L
o? o
tiM
M
PROPERTY DESCRIPTION
LOT `? , BLOCK__,
SUNSET 9th ADDN.
aceordinq to tM roeaftd plol TMnof
DAiGOTA cmey.mnnnota
L 6 N .
o pENOTES IRON MONWrENT
a pgNpTES Mf000 H118 SET
DENOTES EXIS71NCs SPOT
ELEVATION
DENOTE3 PROPOSED SPOT
E yATION
? DENOTES NAQE OIR6CTION
S 56 ??, 2g" W
A
OR ELEVATIOM ??
)OR ELEVATION •
'RLOOR ¦
NOTE ? VERIFY ALL FLOOR HEIGMTS WITH
FINAL MdlSE PLANS
1 Mre* eortitY fAof 1Mi arwy, Plan or
report was prepand pr ens or unda my ae;
Ainet wpwiNm and tAal 1 om u duly grodl SrenSaa, Ma R*y. Na 10235
Roostaea Laad Su?rel?a undW tho
• 9?'M?s7k
Lan of M? $fah of Mimewfa ?e•
? o
? N /
Ov? _
... ?...... ?......v. 'r.1.1 ? '?/?yyVLnllVl\J
BASED OV f.f1APTcR 5 GF THE
, ...
M
nuc ?.-Juc -
un EEfectlvr.
1TLON
085-13?>
)Wner Phone 9'3a'F?
ea rP
;ite Address . :on[ractor
"I',"
ne
Suitding Classification: Type A1 (Singte Family S Dup.lex)__x -Type A2 (Residential
(3 stories or ess ?
(Other) (Over 3 stories)
3ENERAL INFORMATION ,
l. 8uilding Perimeter ft.
?. Wall height (9round to eave) 57 o ft. 2
3. 1, x 2. (above) gross Nall OxEp _ 1,OO2,2
+. 6uiioing dimensions (L)<<fiV. ?r?nek? (u) ¦ ?Z ft.Z roof S flaor area
i. Square fcot area of rim joist - Floar jois: size (2 x/•J?? _) 2
1h? x Perimeter ? Rim joist area • 1? 9 ft
T ? g'3
? • Doors - Area s /'
' 7hic ness 7n.Tl factor 1 1400
7ype of Construct on Rer#meter ft.
- --Hanufatturer
... .. , _. . . _ - .
,.,.,7..? Total door's perimeter ?ft'•
8. Windows: Manufacturer GSIAI'T? State approved
U factor SZ
TYPE SI2E AR:R (F;.2) !lU4EER OF TOiAC FEET 2
EACH UNITS
5FUl- G?iojz)? _ :?ayl' I . -
Totat 4t.2 Glass
Fireplace area: W1dth x heiaht ¦ x ¦ ?? Ft.2
11, Exposed foundation• Height x Perimeter - 71 x 14a • 16 Z Ft.2
:)PiPLETION OF TNIS fORM I5 R:QUIRED fOR All RElI COtISTRUCTIOa. ?LAJOR REI400:lING AAD BUIIDfNGS BEING
q)V:'J 41F!ERE EkERGY, OTHER TH/1Y THE MINIMAI COUE ALlO:lat1CE, [S USED.
_. ; _......, _. _- ,?. ?. yl"i wa i i area.
13., Gross wall erea ZOOf? ft 2
; Wlndow area A ? /$y ft.2 U windows • , 5Z U x A ¦
`PL
i Rim folst area A ft.2 U rim jolst ¦ ?d U x A •?
; Door ?rea A ft.2
' U door area ¦ •)!.? U x A ¦??
D
ft.
? Fireplnre area A -47, Z
U fireplace • .?? U x
A
¦?
: Exposed faundaNon A /OZ ft.2 U foundatloe ¦ a U x A •
Framing area A 2
ft.
U framing area ¦,09 U x
A _
¦?
: Net wall area A ft. U wall DW'!5 U x A ¦44
? (138) T07A1. . . . . . . . . . . U x A ? (n 9?
14. 6ross wall area x 0.11 (A-1 sirngle family 3 du
(13. above) piex ¦ alloxable U x A/Code
x 0.23 A-2 other residenital)
?
x .23
Other buildings)
`
?
x .28
(Over 3 stories)
q ?aaC? x u?Qde_ ?? ? BTUH Must
r?
- ?0. 138- a 6e larger th
bave__.,_,_-__.
' Ceiltng-fr-aining area - -
(Af) eQuais 10Z-of ceiling area -- - 0r tha same as)
ISA. Gross ce111ng are
158 Jaist area ..(Af) _
f5C. Net.,.ceillng aren
U ce111ng x A c•
s - (L) 5U, c#o,6;C s1? (W
10: ceiting aren
(Ac) t15A
.bZZ x 7,4
? . /oz7 . ft.z . ?.
ft.2
- _ ...
.?Z? ?_-?•. ? .2
ft
- Z0,3Z
U frami ng x A p¦ .(?Z'? x ? D? • Z 37
- ' !
15D. TOTAL U x A ................... .... Z.?
16. Ceiling area (15A) x 0.026 (A-1 singTe family 6 duplex - code aT]owable U x A
x 0.033 (A-2 other residential)
x 0.06 (other)
A(i5A1 BaUN Must be larger than 150 (above)
x lLL4s4€L- ZY0.70 F (or the same as)
, OZ co
NOTE: Use U and A values o6iained from nps 1, 3 and 4.
:
C
i
:
a
a
J
Q
Y
Z
3
4
S
{
1
I
iS
IT
2=
12
t?
?e
31
i:
»
n
31
31
46
1 Z f 4 6 0?
111111 ?
35
31
I 1»
. ?GkO WHLC.. - jSUILt KlTI=-
? F . . . SHeATI-H tAU
WALL
SECTION
5117D
SECTION
2ND vALL
SLCTION
u rrLUt IMLWLMI
Inside •!r fllm
ATCarlac wall
[nsulaelon
Sheaching
Siding
Ouulde a[r E11m
R TOTAL
IM)
?UAIUE U VALUE
.68
0919 (u.tt) v . ? .
t1AM
2.OI(n .04-3
G7 ?
Z3.n3
Inside air Eilm .68
ineerior wa1L
Ia? scud (b") R' 16vW/p.50(Framtng) u . I .
Shea[hing 'l.CXo
Siding .?07' •?S
Ou[slde air f31rs .17
R TOTAL I 0, s 3 ,
Ins1da a1r £Llm R° .68
Interlor vall
Insulatlon (Wall ZU . a ?
Shsa ? . . 1
Exterior va?fil=Rng-. Exterior air S T02AL
@I21
JaIST
f'
.
Inteelor air Eilm R? .63
inaulatton 1140 • 1
1? tneh soft waod R=1.88 (R1m _ U¦?¦
Joist)
Sheathing,
?
Exterior wal l eovering ?G7
Exterior air film Ru .17
R TOTAL ?[q', -f-6,
iatertor air film R= .68
InsulaCloa ??•?D
Foundacion
L2g (Fdn.) 1
U • ? ?
Exterior atr film R' •11 ,d7(O
R TOTAL i2im
,£xDOSed 31uck 15d'3
,
CEILI;if, aT?H VE7lT"cs7 mTTIC SPACE ABOVE
R ::?lL'c 'J lUE
? FAAt4ItIG CEILING
0.61
3lDib0
' 39
, O.fil
. 4-z't?o
Air Film 0.61
Insuiatfon ?,40
Joist .
Ceiling .. i?
Air Film . 0.61
Tatai R
1
U = A • ,b-2,z-
F! AT RGOF OR CAT}IEORAL CEILIyG
;-T- Ya ue R 'lALtlE
pR;,tlING CEILING ,
0.61 Inside air film 0.61
Ceiiing -
Jatst (stv
_- - ., - Iasulation
- , Air Space
, Roaf decking --Ensuiatton - '
Built-up roaf
• • _ _
0.•17- -Outsfide-'air film`0:17--
Total R
. I
A 0 U
4indow infiltration 5 cfin/lineal foat of crack '
tesidentlai door infiltraticn 0.5 cfm/square faot or door and minimum code reCuirement
bn-residential daor inf{ltration 11.0 cfm/lineal foot af crack .•-
Jb 12" concrete btock no insulatian ¦:47•R 2.1. .
Jb 12" concrete biaclc insulated cores -.26 R 3.8 .
15 12" light4eiaht block ¦.32 R 3.1
Jb 12" 1lgntweight block insutated cores - .12 R 8.3 .
J sfnqle glass ¦ 1.13: with storm.windaN .54
1 double glass • .55
1 triple qlass - .41 '
1+
311 exteriar Wa115 and ceftings must have a vapar 5arrfer (0.10 pertn max.).
:apar barrier must be on the lnside (heateA side) of aatl. iapar barrfers of the polyethelene thin film have no R value. .
, .c-2.'5
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*IOTF: PAYMFNf OF kF.E AT 1I24E OF
APPLICATION DOES WT CONSTITUTE
APPRC3VAL OF PERMIT.
INSPDC.TION OF SF.SM ADID/Oi 4M'lER
Tnicmar.ramrpNS WIId, NOT HE S(?gD-
UIED tJDTr1I, PII2MIT AAS BEIN
APPRO7FD.
?j P ease PrintI)
1) PROPERTY ADDRESS: 7?? '2 0 I c? E ard 0 W ?ci
LEGAL DESCRIPTZON: L ? /
. Lot Block Subdivision or Tax Parcel ID )
IF EYISTING STRL'CIL`RE. DpTE OF ORIGINAL BL?ILDZNG PERMIT ISSC'ANCE: . ?
i
PRFSIIJP ZANING/pROPOSID LSE: (hbn Year)
[] CONY'E.RCIAL/REPAIL/OFFICE
f-T IDIDC'STR7AI,
n INSTI'IL'TIONAL/GOVERNNIETI'P
? R-1 SINGLE FAMILY
Q R-2 DCPLEX (ltvo Pnits)
? R-3 ZUWNHOOSE (Three + Units) ( Lnits)
? R-4 APARTME:NT/CObIDOMIDIIUM ( Units)
2) ? NA14 E:
aoDxESS: 7D / ?
CITY, STATE, ZIP: c=
pxorE: ,9?'a 7
,'l-{'i? v 2
!C 1-7 t /12~ [_
?z/
• 3) • i: ?-
tsarE:
ADDRESS:
i CITY. STATE, ZIP:
PHONE:
4) ?..y:.? e..uRwgj
NAME: 1q1 t I I e a (!, m ! l --" ^f -- `'
_ ADDRESS: /'5- D 9 y 0 r•? hj .c,'Cl v C' S
CITY. STATE. ZIP: U R d S tJ, lIe 07t>
PHONE: ? -_'? / 0 /?• 0
riiuwers ,icense:
Active
bcpired
Not recorded
Sta7F Inltial
'S) :? Yi i Y: • 71' C 0 • D? " }i --_.
? CONNECYION T0 CITY SEWFR ? CONN!7(,TION TO CITY WATEFt ? OTFff?t '.
6) ?. r
V? PLEASE HOLD ApPROVID PERIaT EY)R PICK-Cm BY ONE OF ABOVE --- ---- --
PLEASE MAIL APPROVID PERMIT ? 1, 2, 3, 4, ABOVE
? ? ?(Circle one)
..
FOR CITY USE ONLY
PERMIT # ISSUED
l0 J
Pd w/Bldg. Permit
s
s
$ (a 3• of0
$
$
S
$
s ?ov?
$ .57 J_s", rY0
S
$
$
$
$
S
6
RECEIPT
FEES:
$ /D-?
$ /D-?
$
S
$
S / S ; ?b
$ /s-• ?
s
s
S
$
$
$
$
$
S .? ?? aD
?? ?- e
SEWER PERMIT (INCLODE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLLDE CORPORATION STOP)
SEWER TAP
ACCOLNT DEPOSIT - SEWER
ACCOL'NT DEPOSIT - WATER
WAC
SAC
TRONK WATER ASSESSMENT
TRL'NK SEWER ASSESSMENT
LATERAL BENEFIT/TRONK SEWER
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SLRCHARGE
OTHER:
TOTAL
DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
S[7BJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE: f 7
T
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os
? l0 9 S'7?{
/ . ? See instructions for comvletinp this form on beck o1 yellow coDV.
c 80805 "X" Below Work Covered by 7his Request
AAd ReV. TyOa of Builtling ' dp0liancea Wirad Equiumenl Wired
Home Range - Temporary Service
Duplex Water Heater Lighting Fiztures
Apt. Building Dryer Electric HeaUn
Commercial 81dg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tdnk
Farm Iher Deu y ?her ISper.ityl
t er Succi y ther 01her
Compu[e lnspection Fee Below
p Fee ServlcaEntrancaSiza p Fae FaxGers/Sabteeders N Fee Circults
? )$,6L 0 to 200 Am s 0 to 30 qm s 0 to 30 Ani s
Above 200A mps 31 to 100 Ainps 31 to 100 Am s
Swimming Pool Above 100-Amps Above 700_Am S
Transformer5 rrigation Booms . D Partial-'OthFee
Signs Special InSpection $
TOTAL
pemarks
g. SO
•
flough-in r Date .
1. ,ha Ela i
??3 Inspectot, hereby
certily thet the nbove
Final 1e inspec[ian hea baen
?
?
p? / (
motla.
TMa Mquesl voiG 18 montln trom
vaia 1112/87
NIIIIP?d mon}hs irom /
C 80805 /?'S?, al,.?1c?c??
# Sg?fO??y
Nequest Date Fire No. Rouph-in Insoection
H
?
a-3
? e wretl ?Ready Nuw [?Will Nntify Inspeo-
.?IOrWh
q
1-s Yas ?No en
eeAy
[19 Licensetl Electrical ConVactor I heraby reQUest insoection of above
? Dwner elocvieal work iretalled et:
Sveet AddreSS, Boz or Houte No.
&
d
l
i') City
E
/
o/
en /
ead tal oac a. a-h
ection o. Townshio Name or No. ange o. Counly I-Ji
d6tlki
OccuOant (PIiINT)
J , 4 ller Phone No.
8?? - /oro
Power Supplier
L3 a-ko4iz Elee, Address
4300 3ao?
Electrical Convactor ICOmoany Nemel
-
d 5r
10010 ContrACtor's License No.
-
n
,?
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umber
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MINNESOTA STATE BOABD OP ELEICITY THIS INSPECTION qEQUEST WILL NOT
Grigpa•Midway Bldv - Aoom N•1 eE ACCEPTED BY THE STATE BOANO
1827 Univeraitv Ava.. St. Peul. MN 55104 UNLESS PPOPEN INSPECTIpN fEE IS
Phone(612)642-0600 ENCLOSED.
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Use BLUE or BLACK Ink
r------------------
I For Office Use I j'
I I
Cit of EaR a~ ; Permit#: ; q:7 1
I I
J I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: +
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: f 'P- Site Address: Unit M
Name: p j Vol `F ~:9'l1~ t~ i✓T` Phone: ( ty~fo V7
' !
RESIDENT /C~ Yu-`zw
OWNER Address /City /Zip:
Applicant is: X_ Owner Contractor
TYPE OF WORK Description of work: Zc0 zz-11- au(X k&un0 Oink ujo
Construction Cost: Multi-Family Building: (Yes / No )
Company: ~2L-,e~ Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate M
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 2~\ 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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name Ap ' nt's nature
Page 1 of 3
w
DO NOT WRITE BELOW THIS LINE
SUB TYPES
-,,Foundation Fireplace Porch (3-Season) _ Storm Damage
V /Single Family _ Garage _ Porch (4-Season) Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool _ Miscellaneous
Accessory Building
WORK TYPES
New Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
i` Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
i✓G~ V1t b L- SIT i
DESCRIPTION Lbw sf- LCt)e5.r--
Valuation , oo t,6 Occupancy ily,i- I MCES System
Plan Review Code Edition 2a67 MSAC Units
(25% 100% V) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings I Length Fire Sprinklers
Type of Construction w ° 1> Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) __/final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test `Final Windows
Insulation Retaining Wall: Footings Backfill Final
Sheathing Radon Control
Sheetrock - Erosion Control
Reviewed By: ( lp , Building Inspector
RESIDENTIAL FEES
Base Fee 4'
Surcharge t 0
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies 14
TOTAL r
Page 2 of 3
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Use BLUE or BLACK In_k
r
For Office Use I~.
1
1 10P-7
a~ 1 Permit 1
City E of Ea 0
j Permit Fee: '
1
3830 Pilot Knob Road I 1
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675 I
Staff: 1
Fax: (651) 675-5694 L -----------------I
2012 MECHANICAL PERMIT APPLICATION
Date: Site Address: L~> b (-,-p irt-j U "VA,00U di.
Tenant: 1C-- Suite
Name: Phone: ~ ~L
RESIDENT / OWNER
Address / City / Zip.
Name: License
CONTRACTOR Address: City:
State: Zip: Phone:
Contact: Email:
New Replacement Additional Alteration Demolition
TYPE OF WORK Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
PERMIT TYPE -Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install J _ Remove)
X Other V~dfG~C
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) _ $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1%
$60.00 Minimum (includes State Surcharge) Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00 Surcharge
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010411,010 Permit Fee requires a$ 5.50 surcharge) TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.clopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit ut onl 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 r requir s a review and appr val of plans.
x -J
x
A l~HM Name Applicant's Signature
FOR OFFICE U E
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA104763
Date Issued: 06/08/2012
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 812 Golden Meadow Rd
Lot: 4 Block: I Addition: Sunset 9th
PID: 10-72994-01-040
Use:
Description:
Sub Type: e-Fireplace Construction Type:
Work Type: Gas Fireplace (new)
Description:
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney flue must be inspected prior to
concealin,.
Carbon monoxide detectors are required bn law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Fireside Heath & Home James W Krebsbach
20802 Kensington Blvd 812 Golden Meadow Rd
Lakeville NIN 55044 Eagan NIN 55123
(952)985-667
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151699
Date Issued:09/07/2018
Permit Category:ePermit
Site Address: 812 Golden Meadow Rd
Lot:4 Block: 1 Addition: Sunset 9th
PID:10-72994-01-040
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
James W Krebsbach
812 Golden Meadow Rd
Eagan MN 55123
Great Northern Resources
3230 Gorham Ave Suite 1
St. Louis Park MN 55426
(952) 848-0984
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA156467
Date Issued:07/01/2019
Permit Category:ePermit
Site Address: 812 Golden Meadow Rd
Lot:4 Block: 1 Addition: Sunset 9th
PID:10-72994-01-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
James W Krebsbach
812 Golden Meadow Rd
Eagan MN 55123
(612) 325-3557
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA167881
Date Issued:04/01/2021
Permit Category:ePermit
Site Address: 812 Golden Meadow Rd
Lot:4 Block: 1 Addition: Sunset 9th
PID:10-72994-01-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
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 -
James W Krebsbach
812 Golden Meadow Rd
Saint Paul MN 55123--196
Applicant/Permitee: Signature Issued By: Signature