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846 Govern Cir D ----Use BLUE or BLACK ink l For Office Use City of Eajan l Permit I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Nate: Sitx Address. Tenant: Suite M RESIDENT / OWNER Name: ~ CA Sf%A (E~(-tLYC 9614 Phone: Address / City / Zip: k I G G n VE F, N ~ l F -C 0C. Applicant is: Owner Z Contractor TYPE OF WORK Description of work: !E IN Construction Cost: Multi-Family Building: (Yes / No Al) CONTRACTOR Name: F I PI ~ S 11 [ w License 6r(. y q ~ Address: i SU V U (X W O 6 P 43 City: CA6 Af4 t State: Zip: S-T ( T-3 Phone: Contact: ~L 1 Email: 1 w S G COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING L~ 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 speck reasons that would permit the City to conclude that the 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.gopherstateoner-all.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. x Applicant's Printed Name Applicant's Signature Page 1 of 2 ~itG ~C 1A DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of - Plex Lower Level _ Pool _ Miscellaneous _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant j DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition r G SAC Units (25%_ 100%4 Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath `Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: _ Footings _ Backfill ` Final Meter Size: Radon Control Erosion Control Reviewed By:~ Building Inspector RESIDENTIAL FEES J,~_ B ase Fee Surcharge Plan Review° '0~ MCES SAC 000 City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2 INSPECTION RECQRD ? ' CITY QF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1697 Date Issued: ' (612) 681-4675 SITE ADDRESS: APPLICANT: , ,,r r tz ?? ?- t ? „ , ut Nwt?00 il(IMW. :1"n c1t 1.L"*? drH • *?t 0_1 PERMIT SUBTYPE: TYPE OF WORK: ? • 1 Ai4 F4F;IE 6df 11 f3Y Jt"?F Vr?EI.?, Wrl tE eP t AH lhif)lr'A71 `i TN if'Nl' "tO r t F'AF7 '?I'AN A ltVAM k()M r,?IrT?:.I T1F f'ORNF fi F 1(4 i'(? 411t.it 5+ rf) r• f,(jRMi-, p AF3 TF1 t;VAN T•t AI'Vit1) :: i, IRlI5#F 2^1 :'- SnliiNf°kN Yf'IIOW f^iMf Rf'nm Ic, iitniliRFl) i-I/Mir4 . 1 11 iAroi cf; ? ?. ei?. ?t ? ? . . ;'? . ??.?? .?_?? zaa?? . _ .??-R ? . :???: Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGt-i HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TES7 FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS coNOUCTiwrr TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECKFTG r? DECK FINAL 7 ?t"l1 ? Ir ? CItY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 ' SITE ADDRESS: i lrN i. i II. ? ij? Ij{IIltll { JI'I?K47t,1I PERMIT SUBTYPE: TYPE OF WORK: INSPECTION .. . .. ??•. ????t r r? a'coRD PERMIT TYPE: Permit Number. ,. ? ' • Date Issued: ' f ?+.? / ?? 7 01-060 QPPLICANT: ?{rl g}'0r'r •, . •.1•1: i I•Wti „ M;.1! `.j 3!R ; , 41r", i f S; . ` Permit No. Permft Holder Date Telephona # ELECTRIC PLUMBING HVAC '91 G G 7 4 J? Inapection Date Inap. Comments FOOTINGS 3 _?.;,?.? ? FOUND ?-?'q?l /vtS °Y??y v/ ""? ??K•3 ` S1? ? FRAMING ROOFING ROUGH PLUMBING !D? ? l?• L? ? PLBG AIR TEST ? g ROUGH y e -? - a= ?1 HEATING 4 lrb GAS SVC TEST U- 7 r 4 INSUL Id GYP BOARD FIREPLACE 6T' ? FIREPLACE AIR TEST FINALPLBG l1^c? C ? FINAL HTG ORSAT TEST BLOG FINAL BSMT R.I. BSMT FtfdAL DECK FTG DECK FINAL i ?C ? AddICSS , 846 GOVERN CIR LAt 5 B1IC 4 SllU GARDENWOOD PONDS 2ND THESE I1'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: /5 r/- 7 Yes No Inspector: ? Final grade (6" from siding) ? Permanent steps (garage) Permanent steps (main entry) ? Permanent driveway Permanent gas i% Sod/Seeded grass f/ TraiUcurb damage ? Porch Basement finish Deck ? Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to the oufside lawn faucet before freeze potential exists. Contact engineering division at 6814645 Ixfore working in riglttof-way or installing underground sprinkler system. ? White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy Zip 5512 ` 2007 RESIDENTIAL BUILDING rERMiT nrrLicnTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Consiruction Reauirements 3 re9istered sHe surveys shovnng sq. ft oi lot, sq fl of house; and all roofed areas (20%maximum lot covera3e allmved) 1 Soils Report if proposed 6uilding is to be placed on dislur6ed sdl 2 copies of plan showing beam & window sizes, poured found design, efc. 1 set W Energy Cakula6ons 3 copies M Tree Preservatlon Plan if IM platted aRer 711193 Rim Joist Oetail Options selectlan sheet (buildinqs with 3 or less unifs) Mnnegasco mechanical venfilaM1On fortn RemoddfReoair Reauirements Oifice Use Oniv 2 wpes M plan showmg footings, beams, joisis CeR of Survey Recd _Y _ N i set N Energy Calcula6ons for healed addiGons Soils Repat _ Y _ N 1 site survey for additions 8 decks Ttee Pres PWn ReW _ Y _ N_ Addih'on • mdcale rf orr-sde saptic sysfem Tree Pres Requ"veC _ Y _ N Onsite Septic System ' _Y _ N oi?..- ., ...,hli.- infnrmafinn ii.,ipcc vnu state thev are trade secret and the reason. r .A"'J PIG YV, .J. N-. G_ w- - . . . . v. . . .- ..- .. - . . UU O t3 Date v / 26 /07 / ConstrucHon Cost SiteAddress 4vNe .-s6l? ?J '-^a wL Unit/Ste # Description of Work iZE s9z )e Multi-FamilyBldg _ Y>!? N Fireplace(s) -'V0 2 qi Telephone #(%J-? 66 Z- 3 711 9 Property Owner Wl Conhactor Address ALe7 6 M Cih' State W10'/ Zip SS?l7 Telephone #(?,? J 47 ??,? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ven6lation Category t Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculatlons Submitted In the last 12 months, hps the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of masier 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 the wark will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ve 116aw ApplicanYs Printed Name Applic s Signature 4730.-jLJ -7W-70 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please wmple[e for: single family dwellings & townhomesJcondos when permits are required for each unit Date7 /?(_0 SiteAddress_ ?? "ILY ?`/vY n C1.,A ? Unit# Propeity Owner ? (?m r'?? ?,t(JVI ' Telephone # Contractor -43 Street Address G? Y/ K?I.J V ` ?AJ1?1 City 11 ?1?? I JCi State 1?l I? Zip /Telephane# (IN) ?7&-7- I0A' Bond #: Expires: J ? V J The Applicant is _ Owner "I'sntracror _ Other Add-an or alteration to existing dwelling unit $ 30.00 furnace _Additional _Replacement air exchanger airconditioner _New ARepiacement other State 5urcharge $ 50 Total $ zz7V.? I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 771h-) the case of rk which requires a review and approval of plansnUl f k/ Applicant's Printed Name A icant's Signature S AU6 0 l ?OOti I G', ?? ?o?.,?:? 1?;.:{4'X•'?..° k ?k?::?('if,Yi?:`,'(:;cY;tk? ??9,??.?/.??:it7???cy;i;(?k:'+k:?m:M>X?k?;< C7Ta OF !:"f:.r..,.An CFlMlEr „ S' ii:f•:ilIttA!.. Nn:: `fi?:; I;?Y;:^, C.1R/i?b!97 7Ih1!'-m L4::i?044 •D . I,'iYsir D ]:r HI]Pi'ftJN 'I:NC )'Liri, 9001 046 f;?:',V! G:t! G.T.R 5,619.,71 r Tn!:7i Prilc3:iii??, F.ISq1tJ?l?:s `.:i,ie";3.i.l Cftr:?t}n.L44 ' UMiE!; :ltir i;,r1RCY vtnr??k`;'?:?k'S'I.Y,t,w,,W.?tl:'„kok?n'•k'k.rN.>k,y3'Fe<:',itR<l:'>; ?;r,'e.k1,;X$:i??t 4 P, PERMIT CITY OF EAGAN PERMIT TYPE: • 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 030655 (612) 681-4675 Date Issued: g$/Z 6/9 7 SITE ADDRESS: 846 GOVERN CIR LOT: 5 BIOCK: 4 6ARDENWOOD PDNDS 2NO P.I.N.: 10-28801-059-04 DESCRIPTION: ,--, ¢uilding"P-ermit Type $uilding,WO,r.k Type r' UE3C ocaupancy;'-?" ConstructionType Zoning ? B,uild?n-gLenqt'h s± ° Building Width Bu,i,lding;`_sCaries _.S,q?r a4r, e ,- C e?h s?u se 3F OWG NEW R-3 U-1 VN R-1 78 52 ' 2 2>868 101 1 - FAM. DE7ACH ;j ? _", } r cre j (t .? ti? 4e..,. `.:ea?ia y?i:;4 ?s71 REMARKS: S&W PLUMBER - M&W SEWER & WATER FEE SUMMARY: VALUATION $287,000 8ase Fee $1,822.25 MISC FEES $1,539.50 Plan Review $1,184.46 Total Fee • $5,639.71 Surcharge $143.50 SAC $950.00 SAC % 100 SAC Units 1 Subtotal $4,100.21 CONTRACTOR: _ Applicant - 57. Lrc OWNER: HQRTON INC OF MN, D R 14544663 2000565 JOE MILLER HOMES 3459 WASNINGTON DR 204 3459 WASHINGTON DR 208 EAGAN MN 55122 EAGAN MN 55122 (612) 454-4663 (612)454-4663 I h-e:r;e:by aeknow1edge Lktat 1°?have ke.ad th„ts aoplic,a?ion a.rtd' sta+-e tNa:t; tNe ?k. infarmation is correct and agree'io comply witth all appiiaab3e'Statd-'of Mn`:.' L Statutes and City of Eagan Qrdinences. J . , 2Z ` APERMITEE SIGNATURE ISSUED BY: SIG RE 1997 BUILDING PEF:MIT APPLICATION (RESIDENTIAL) ? CITY OF EAGAN ? 3830 PILOT KNOB RD - 65122 681-4675 Naw Construction Reauirements RamodellReoair Reauiroments ? 3 registeretl ske surveys ? 2 copies of plan l • 2 copies of plans (InGude beam & window s¢es; poured fid. Oesi9n; etc•) • 2 site surveya (exterior add'rtions 8 Eeeks) • 1 energy calculations ? 1 energy calculations Mr heated additions ? 3 copies of tree preaeneti0n lan if IM plaked after 711/93 required: _ Yes ? Na - DATE: &? 7 CONSTRUCTION COST: DESCRIPTION OF WORK: Ae?? ??(A-'4?uct? V?j STREET ADDRESS: e`I4o Go Vevr i`v Gfe. LOT 5- BLOCK ? SUBDJP.I.D.#: PROPERTY Name: Phone #: OWNER ,„„ Street Address: CitY: State: Zip: coNrw?cTOR Company: --IZe fV1 r llew- C,L„,es Phone #: V5471-i1.? kli?? Street Address: ,3? 5(,?06cense #: o?0D0SC S7 City: Eac,.g„ State: 0W zip: "SSia„? ARCHITECTI Company: Phone #: ENGINEER Name: Registration #: Street Address: CftY: 5tate: Zip: Sewer & water licensed plumber (new construction only): 52ccl&- d' (c« 1(5y- . Penalty applies when address change and lot change are requested once permit is issued. i hereby acknowledge that I have read this application and state that the iMormation is cortect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signatu2 of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE , ' • R. . ? 01 Foundation o 06 Dupiex o 11 Apt./Lodging ? 16 Basement Finish x 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool 0 03 SF Addition ? 08 8-plex n 13 Garage/Accessory ? 20 Public Facility a 04 SF Porch o 09 12-plex a 14 Fireplace n 21 Miscellaneous 0 05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE X 31 New o 33 Afterations o 36 Move ?0 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) \ t? Basement sq. ft. (Allowable) \JW Main level sq. ft. UBC Occupancy foU I sq. ft. Zoning ? sq. ft. # of Stories sq. ft. Length -19 sq.ft. Depth t?a_ Footprint sq. ft. APPROVALS Planning Buifding ? MC/WS System City Water Fire Sprinkiered PRV Booster Pump Census Code. I i 2- ?trS SAC Code Census Bldg _T Census Unit Engineering Variance Permft Fee Valuation: $ ????, -:?? ? Surcharge Plan Review .pY1G?1'T ?T MCNVSSAC I ? x ? ? ' City SAC Water Conn. J11t?,'VT ? I/N 1=1 N I Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other ?I SE?'??i?l ?c`r ! Copies rotal: - ? ??l C"F,'(?.9?:aE- (,/' r-r '' • %SAC i sAqW4a _ 82-3X??= I?,II?`6oa ?N'? ?-w?2• `°J_.- , ENERGX CODE WORKSHEET FOR 1& 2 PAMILY DWELLINGS r---- - 'SITB ADDRESS Y?,IG 50 N COMPLETED 6ySD,?, BUZLDItiG CLASSIFZCATIONI ? caC HINIHUM CRITERIA Foundation Zneulation-R10 ' Slab on Grade InoulaL'ion-R10 Floor over unlleated opaces-1124 I'oundation Windowe 1/2" ineulated Glac'o. -47ood or Vinyl I'rame atendard) or it ca Flallo 4 Windowo (See Cub7e on reveree side foc ullowable percentagea) STBP 1 Wladow & Ooor Araa A. To[al Window 4 Door Area in 3q. Peet WINDOWS (Including Cou1nd +ation Wir?ndowo): WIt7DOW HASNPACTURE NAM6t VVI?Jb?i'-- WINDDW MADIi7PACT[tRH TYP6S Gr.+U`)GMFN 7 WZt7DOW MAt7IIgACTURE U FACTORt ??JGA R. 0. QuanCiCy oq.(C.A'rea Uimensions z?"X3'o %-C1X _-? -U Zt Is'" X-?!'7J^ _ 3!u'' xS( -0 " ??roN X ??j Dt i r4?at?l ) X 5 bo 6 140 DOORS: 7 r l.rJ Z$ "?g G D x!? l1J 1'utal Area oE A nq,fL. M Wlndows & Doors H- Total 41a11 71rea in Sq. Ft. Wall Total lleight Trca Perjmeter SS , v 4? ?a n Zov 22CO Z3 I,5%l0 7 Z24 _ 1 g, 8 3 `Fb Total Rrea oE Wulls _ ?=50'j[t CITY DATH 1 (muet iaalvde Roof Attia lneulation: R44-With Attic No Ileel R38-141th Attic Rained ifeel R38 & R5-3olid Ra£tere ST6P 3 Calculate area ae a percent of wnll C. From Step 1 d!vlde box A(411ndow & Door Area) by box D(to[al wall area) timea 100 equale tlie window and door aroa ae a percent of wall area (box C). eox n (4 x ioo = Ilox U C l3?5 , STBp 3 Deoign Peatureo P.SSEIdBLY PAAMING TYPE: STANOARD FRAMING /v etttde 16° O.C. ADVANCEO FRNIING etude 2901 o.c. CAVITY INSULATION Ril_ 9FiBATRZHO TYPSf v LES9 TIIAN c R-5 x R-5 > OR MORE U-FACTOR p From the table, (reverse oide) datermine the maximum percent window & door area for thedeeign op[ionu Bolecled and entor Lhe t value in Oox D helow baeed on tlie window mfg. U- factor: ? LL??1D The b value from l'hc table in Box D shall be cyunl to or greater than the t in Dox C ^ i I11;5tULN I lnL 1)(JILb1NC I'itl'sUUI•I IVLI (CVUK-UUOK) nrPkwnci ? ninxiniuni tiv114uotiv nNu L)()()it n niicn itcn ns n rr-iiCL-rr r vr ovt;nnLL wnLt, Lta?u.?lh??L-.Li?a1?RE?til 1,71> >47F ItibDnlL?lip,?,1 . jtxt?rior hen?li?R ••? lueu?ellon S?ic?l?ilna Y4. ?7nw w'qclor 0.'3I? ?U. 5 t sini?iunicu :3;: `ii, _Slnl?l)AIiU 22. 51 nt?ILlAItU~ - ?? ? 5 ° 17.1 ;: 2U.1'Yo - - iil e = i 9 -< _S1%1tJU%?IIIJ !I1-10_19 - 16.U)s ?I8.81e lj, ~in:vn :n81 uvnN?_i:u ii.v°s` -79?taa `iii; _n?JUR1jlU ` _ -19 ?,L Il - 9 ??.5pi `i9.216 22.97e tU+ It•zl? <it-9V -j2.AY. - , _--26 SlnJ _ /UIU_ j1-21 1 l.U7o j9.'?7e IJ, Ui1".?.;..- V NcLU 1?.53: /1 e 2G -`1i-21?? ?-'.••` -` 19.376 22.5Y nUVA ??CGi.ir - <Ilg 13.6?: IB,?'!5 21.27e 1? ?I1-21?? y Il ._4_ ie ?.i; ?-t?---- - ' -- - 9 4slsllllvtae.l[?11cu1ai?tL?lu r u 51 ??lvAllU i ? ` Il•17 --- sln1?U .'_. nUVnNtLI ? - - { ??'9 ie ? 11.436_ i3 ei. -"-» 18 ? ? _ J nU V A1?Cl:u It-IT `i ... _ C It • 5 . ?12.61i , ? ? ?i6.89e 0- R`g tdulee; ? 1Vlttdow aten equals ruugh oR?ciil„g tnb?ue (n?l?ll?llun cleeiencce. {Yhidotv U-(rcinr inttsl be dr.letmined by tliher Ihe ?Jaqoiirl 1'enceballon iinlhig Cuunc11 elntidaid IU0-91, vr AStIIlAl3 1993 llsndbvok o( 1',undstnewaln, Clmpler 27, 'I able 5. ro.l?ll?r?xl?o?. terl ?;•?. I,-?--? Iriem i. 1 R LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL: iq f ? Q o ?'?" I • ? . ? • ? ? . ? ? . ? ? . ? ? . GY' ? ? ? / ? ? . [&? O ? . DATE OF SURVEY: LATEST REVISION: DOCUMENT STANDARDS Registered Land Surveyor signature and company Building Permit Applicant Legaldescriptlon Address North arrow and scale House type (rambler, walkout, split w/o, split entry, lookout, etc.) Directional drainage arrows with slope/gradient % Proposed/ebsting sewer and water services & invert elevation SVeetname Driveway ELEVATIONS ExisUna ?' ? ? • Sewer service (or Proposed) ? ? ? • Property comers [a? ? O x 0 • Top of curb at the driveway Gl o • Eievations of any exristing adjacent homes Prooosed ? ? ? ? • Garage floor 0 0 d 0 • First floor ? • Lowest exposed elevation (walkouUwindow) ? 13 ? ?0 • Property corners 11 • Front and rear of home at the foundation PONDING AREA fif aoolicable) 21? 7? ? • Easement line g 0 • NWL O?' 13 • HWL 2'-'0 ? • Pond # designation 0 G?o e Emergency Overflow Elevation DIMENSIONS • Lot Iines/Bearings & dimensions • Right-of-way and street width (to back of curb) 15' El 0 • Proposed home dimensions including any proposed decks overhangs greater than 2' ?o , , porches, etc. (.e. ail structures requiring permanent footings) ? • Show all easements of record and any City utilities within those easements ?o o o I'? • Setbacks of proposed structure and sideyard setback of adjacent existing structures ' o • Retaining wall requirements ny Reviewed: me / Date January 1996 CRAIG7988IBLDGPRMT. FM )k:P48t%tWYd:i:n3'i**" Y;V: 13'M 0, *:4?,;S,+.Yd*-***kC}'n4; * );:Y,:>;9.n: r.tTV aF i.:ArPr! f;Acm:.r:i;; s Ti.WUnaL Nne Mi nA"r_.e ei,i29i98 r.r.rEa .-fi.,;2 r.s, 511. Izi c R`61ME„ C;l-17:+`if::f1Fl C!3t•iPAh.T.l:-fi 7N;v 3109O0; 946 GOVr!°;O Cl:R W. 90 205 9001 846 GWEL'h! E;7F< f:i.50 t? .r Tb'I,?l Ri?re:pf. rvmoi.,!tt'.`,: T)e:tQ Ch C?94 3::?c'. , UEi:r '.:I:! : KAh!f'Y >'F03'tn'h, M PERMIT ? - CI4Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMITTYPE: surLozHG Permit Number: 032312 Date Issued: p f/2 g/g g SITE ADDRESS: 646 GqVERN CIR LOT: 5 BLOCK: 4 GARDENWOOD PONDS 2ND P.I.N.a 10-28801-050-04 DESCRIPTION: BRI];;d1 h*T *Permit T,YPe I3`qa:fd1ng.S.JQ,r_k Type ii $'L! 8` C, rr?d t-', 9. u DECK NEW 434 AL7. RESZDENTIAL cs; ?ki?'?14 R? g} ;?1P:At pvn ? ?CfK.?k.d:.V3_t _???r2 H:Wi°??tl? ?qI115W ?F? 2„'5 ma 5fm? ? +`r?' ?h'esrl?P `.r ,?F-„? ?p ? ? is v .? ??'t Gs 3ce fii.y? srhtax REMARKS: PLAN REVEWED BY JOE VOELS NOTE: PLflN INDICflTES INTENT TO CLEAR SPAN A BEAM T FROM OUTSIDE CORNER FTG TO OUTSZDE CORNER FTG. AS THIS SPAN IS APPROX. 14', A TRIPLE 2'"12 SOUTWERN YELI.OW FINE BEAM IS REOUIRED W/MIN. 17" DIAMETER BELL FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: - Applicant - sT. LzC. OWNER: CHIMERA CO 14789103 20108824 ERICKSON TOM 23030 HWY 55 W 846 GOVERN CIR LORETTO MN 55357 EAGAN MN (412) 478-9193 (612)681-0960 , -I har??by sck°nauedg,e?, Vat.i:7 hav?' 1nf'ar'ma?aarr i^s ?or_re?t ?raet: agree:,: ???.tpttes and.. fi,. ?sg&n? 0 r8iriz ? ? ...vP... ._ 1 £ . _.. _....... , ? .:.. ( .. . i . r.. APP,L} ANT RMITEESIGNATURE 1/ Y . ' erpd`;;CT#i ; a K?P'3icaC,XZSfl AA'd:.,atd'Ge," tha'Gth,t., .. . tra cirm(aly: arfth ali applS`Gste p.f , gri.;° t ?e`s IS U D BY: INArURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) q5O-` ? CITY OF EAGAN ?+nf 3 Z? Z r'' 3830 PII.OT KNOB RD - 65122 681-4675 New Construction Reauirements ? 3 registered site surveys • 2 copies of plans (inclWe beam S window s¢es; poured (nd. deslgn; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan'rf IM platted aRer 7/1/93 required: _Yes _ No DATE: (?v DESCRIPTIPN'OF WORK: -YTy?,?EI;?e ./// .. , .STREE7'ADDFtESS: 4;;:57VZ?e1V LOT: ' SUBD./P.I.D. #: ? • PROPERTY OWNER CONTRACTOR J? . ::. . ., • une:" Last First RemodaVReoair Reauiremants 4 2 copies of plan • 2 site surveys (exRerior additions & decks) ? 7 energy calculations for heated edditions CONSTRUCTION COST; -TV ? ,.. Phone #: 601- 014?lo4? Street Address: O`f 6, 4?6l/C.?N el?eL°LgC City 67?14iv State: 01e?) 2ip: Company: C?• -Ovve. Phone#: ??IQj StreetAddress: a3030 r??f ?S lt,??? License# ?24116?eaSl ciry Z-0 Q& /77 state: zip: 5535 7 ARCHIT'ECT/ ENGINEER Company: ??f/y/?? ?• LtiL° Name: ?//sJ'! E/2/C,E'So•J Phone #: `7 7,V' 9/,,)s Registration #: So-eet Address: --' 3 aS61(16J,4) SS 4?A?5T ciry Ld,,L77O stace: 6l1 ? Sewer & water licensed piumber (new construction only): and lot change is requested once permit is issued. zip: SS.3S7 Penalty applies when address chang I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl PState of Minnesota Statutes and Ciry of Eagan Ordinances. e Signafure of Applican OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes No Tree Preservation Plan Received _ Yes _ No _ Not Required g: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 ? 02 SF Dwelling ? 07 ? 03 SF Addition ? 08 ? 04 5F Porch ? 09 ? 05 SF Misc. ? 10 `?- WORK TYPE R 31 New ? 33 .,M-32 Addition ? 34 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS ? , `°• u„,• Duplex ? 11 Apt./Lodging ? 16 Basement Finish 4-plex ? 12 Multi RepaiNRem. O 17 Swim Pool 8-plex ? 13 Garage/Accessory ? 20 Public Facility 12-plex ? 14 Fireplace ,? 21 Miscellaneous _-plex - O` 15 Deck ??„w+. <?u7Sr,,.C '-?oRXt.f. ?T?`/?a. T ?eFrSrd? ?elxtrW'_J?tNP t.?s ; us SPA.ci bi s r'JF'?.a?Tr, l°/j,9 7'",??!'CL v ae /Z Snur??F,?n.r ?Ccr.aW Alterations ? 36 Move P?.rc, 13c,;,•• .rJ Repair ? 37 Demolition ( 7"? ? ?? G- IwBME? FTiG+°??"f !• ' Basement sq. ft. MC/WS System Main level sq. ft. CRy Water sq. ft. Fire Sprinklered sq. ft. PRV sq. ft. Booster Pump sq. ft. Census Code. 'r7C/ Footprint sq. ft. SAC Code ? Census Bidg , Census Unit ? Planning Building r" ? Engineering Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit 5/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Vaiuation: $ -- Variance 14, % SAC SAC Units L 6 gL / CITY USE ONLY RECEIPT #. U? u ,r SUBD, yl JI'6VL? RECEIPT DATE: 9 a 9? 1997 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 687-4675 Please complete for. ? single famity dwellings . townhomes and condos when permits are required for each unit . backflow preventer for underground sprinkler system FIXTURES EACH NO. TOTAL Shower 3.00 x 4- _ .? Water Closet 3.00 x = 7Y -, W Bath Tub 3.00 x = . Lavatory 3.00 x Kitchen Sink 3.00 x = 0 Laundry Tray 3.00 x = _Q Hot TubiSpa 3.00 x = Water Heater 3.00 x : Floor Drain 3.D0 x = Gas Piping Outlet " minimum • t 3.00 x = c3?? Rough Openings 1.50 x Water SOftener ' for tlwellings under construdion 5.00 x = Water Softener " for existing dwelling 20.00 x = U.G. Sprinkler ' for dwelling under const. 3.00 = U.G. Sprinkler `forextstingdwelling 20.00 = Altefatlons `to existing residence 20.00 = Water Tum Around 20.00 = Private Disposal System ` Dak Cty lic 75.00 = (new and refur6ished systems) Private Disposal Systems "nbandonment 20.00 = STATE SURCHARGE .50 TOTAL 6!LM- I hereby acknowledge that I heve read Mis applipGon, state that Ne irrfortnation is corred, and agree to wmply witb all applicable City ot Eagan ordinances. k is the applicant's responsi6ilily to notify the property owner that the City of Eagan assumes no Ilabllity for any dameges caused hy the City during its nortnal operational and maintenance ectiv@ies M Me fadikfas constructed under this permR within City propertylright-of-wayleasement. • _ , SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREETAbbkESS: CITY: ROSEMOUNT AN PLUMBING & HEATING TELEPHONE#: 423-1144 14745 SO ROBERT TRL STATE: MN Zip: 55068 SIGNAT RE OF PERMITTE a CITY USE ONLY LOT 'rJ BL RECEIPT #: gv 79/ SUBD._ RECEIPT DATE: 1997 MECHANICAL PERMTT (RESIDENTIAL) GTTY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 Date• C? `C?^ (612) 6814675 ? Complete this section on y if you are instaIlinz HVAC in single familv, townhome, or condos that are under construction and are not owner /occupied. • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BN 6.00 • Gas oudets ( minimum of one required @$3.00 ea.) 3 qCD • State Surcharge: .50 • TOTAL: 'SC.7 Complete this section onlv if vou are remodeling. adding to, or reoairing existine sinele family dwellings, townhomes, or condos. Add-on furnace Add-on air exchanger, i.e. Vanee system, etc. Minimum fee applies to all remodel or add-ons of eacisting residences State Surcharge SITE ADDRESS: L OWNERNAME:?? ( INSTALLER NAMEC STREET ADDRESS: CIT1': Vol`? I{V-\ Add on air conditioning Other $ 20.00 .50 Total: $ 20.50 l??`_?- S-b'a'Yl l" S PHONE #: PHONE #: 'ttoG- (C)C' STATE: ZIP: ? Cc- ? n „ ? ?? ? Lq? ti ? Minnesota Department of Natural Resources DNR Waters, 1200 Warner Road, St. Paul, MN 55106 Telephone: (651) 772-7910 Fax: (651) 772-7977 L5 R GUrdQnwood lo?S Z"d July 24, 2000 Mr. Tom Erickson 846 Govem Circle Eagan, Minnesota 55155 RE: Bald I.ake, DNR #19-61P, Dakota County Dear Mr. Erickson: On July 20, 2000, I and a representauve of the City of Eagan inspected the bank failure that resulted in the sloughing of a portion of your rear yard in to Bald Lake, a DNR-regulated basin. The sloughing was a result of the high intensity rainfall that occurred in Eagan the weekend of July 7-9. Thank you for your prompt establishment of a fiber blanket cover on the exposed soil area, and for calling me Friday morning to discuss the matter. I received your fas of a proposed restoration plan. Portions of the drawing were cropped off of the fax copy, and others were not legible. If it is possible to get equipment down the embankment, eroded material that has been deposited in to Bald I,ake should be removed from the wetland. As we discussed on the phone, [he timber steps depicted on the plan will rot over time. You may want to consider stone, which is more durable, or stairs elevated above grade, which will be easier to replace. Plantings of crees, shrubs, and grasses should be vazieties native to the area. The location of the plantings should attempt to recreate a natural look, versus a landscaped look. The plan I reviewed has more of a landscaped look than a naturallook. Please work with a landscape azchitect to develop a planting plan that will help stabilize the bank, screen the retaining walls, aze distributed in more of a natural configuration, and aze native to the azea. For stabilization purposes, it is advisable to maintain a band of deep-rooted native vegetation along the top of the restored slope. The width of this ban should be not less than 10 feet. The catch basin depicted on the north end of the project may require a DNR permit. Any work of this nature below elevation 852.6, the DNR ordinary high water elevation (OHW), will require further review. It may be necessary to obtain an elevation survey to quantify the azea of impact below the OHW. DNR Information:651-296-6157 • 1-888-646-6367 • TI'Y:651-296-5484 • 1-800-657-3929 An Equal Opportuniry Employer ^ y,? Prmted on Recycled Paper Containing ss Who Values Diversiry ??p' Minimum of 1096 Post-Consumer Waste e ?. Tom Erickson July ?A, 2000 page 2 The rock landing with bench depicted on the drawing should be eliminated, unless it can be demonstrated it has some structural component necessary for the stabilization of the restored bank. The grading and retaining wall work proposed may require approval from the city of Eagan. Please contact staff from the Ciry of Eagan Planning Department at 651-6814600. Thank you for the opportunity to review your proposed restoration plan. I would like to review any final plan that is developed, and would hope it incorporates my input above. Please call me at 651-772-7917 if you have any questions Sincerely, ?4 4/. Patrick J. Lynch III DNR Area Hydrologist c: Ecic MacBeth, City of Eagan / Pam Dudziak, City of Eagan ? Brian Watson, Dakota Soil and Water Conservation District ?? / s- no.consh9lia, aaw:en?? 3 regdsed sle auweYS shawa9 sQ. R d b1, sQ. R afhwx; and $1 ma(eE meas Cl0%mmm?un mt mrgage allo?m) i Sals Repat N Piaposed 6ukn9 6b De Pomdon Uishubed Sad 2 wp?es of Pmn si? bmm 8 ruWOw saes: Gaured biaid desp, et 1 sGdEndgyCalaAeEae 3 aqie•, dTree PmmOm Plan! lot paKtl aftr 711193 Rm.lart DemB Opdms seechon 5ied NAdngs wMi 3 aless wis) hieogasoo m? vanYls9m brm 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Esgao 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 RanoaeRma RenveneMs P wpmof PIm stmnA f9• bems, las6 1 setdEneugyCaladetlans4orhegAdaaddNois I soes,.4eraxldWrsaaKkS Ad66on - mdcse 6 on.?e sep9c sys(em ? 0&mlkeOtk CertdbYsyeyftecd _Y _N Saibfdepd[ _Y _N TteBPMPIwRectl _Y _N Tree Ptes Reyned _ Y _ N OnadeSeqicsyslan _Y _N Plans are considered uubiic information unless vou state thev are teade secret and the reason. Date o-7 , Coostmetioo com /S; 600 ., SiteAddress 6OVfYi 7 C/rG/r? &Z9. SS/22 UoiUSte # Description of Work o?? J Y2P ?dze- Malti-Fami{y Bldg _ YXN Ftireplace(s) X 0 _ 1 _ 2 PropeRY Owoer / oHl Z?e/L kSClI7 Telephone #(6SI ) G?SrI - d?I 6 0 connaMoT h6rr,.e 7" naarm 7308 Aspa.rs_1. nrlt/!o ciry grooba, n State rhtj F Zip Ssy?l.8 Tdephone # (763) t 5'RL 1I0 ajko 1' {r t?1C9)'A' V CONIPLETE TNtS AREA ONLY IF CONSTRUCTING A NEW BUlLD/NG - Minnesota Rules 7670 Cateeorv 1 Minnesote Rules 7672 Cotle vuorkshaet Energy Cade Category . ResidentlW venttletian CaOeg«r I w«IShcet . New Energy (J wbmission fice) Su6mitted Subffwtted • Fsergy Envebpe Calwlations Submitletl In the last 12 months, has ihe City oF Eagan issued a permit for a similar plan based on a moster plan? _ Y , N If yes, doTe and address of master plan: Licensed Plumber Telephone #? ? MechanicatConhacfor 7elephone#( ) Sewer/WaterConTractor Telephone#( ? T?//19u./veli;/J ApplicanYs Printed Name I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work wi11 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 pertnit, and work is not to start without a petmit; that the work will be in accordance with the approved plan in the case of work which requires a teview and approval of plans. . L ApKicanYs ignature ? ? /(b / iI f Uo'/? qry ? 9 y9 v? L ?O _ 7• ?/ / pml,, ,? . r«m , {?• / ? Fu? ? ?` V ? ? IVNt,, \coA??``? ? / i I ? U? \ ? . . ' ?'S?sA c; J ?' 01 ? R U? 0 ? 181•61 N65'31'24"E LO/?, - , ? rA wb ?,? r? J q3•.ia t ? ?. ,b r q? ? Cb 0 ., ? p ^•? + ? ti 7 J ? oo , / D?A 8,00 ^N ?oQh Q ?m ? 1? .?.::-•?. .:;.;.. ? -1 s . . ? .., .. . .. „ . ..... ... . ;t*.. . _ ,._ . . . . . _ ? . . . _ - - - ? . ?' v t Y ? J I J td I?r o? R, ?e \ ?\ ?. J r ? J\?? "r?? Use BLUE or BLACK Ink ~r^^- r--- ( , I For Office i isA Permit 4 -21 I I I City of Ea Rd~ 1 I Permit Fee: C;T5 - 00 1 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 j staff: I Fax: (651) 675-5694 C - - - - - - -I 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: C, ra-e C, Tenant: Suite RESIDENT / OWNER Name: Phone: Cosi - is i t ~t i~~ Address / City / Zip: a14 tv Gc:k,-N C'-.rc:A CONTRACTOR Name: -g v & 'P1~~ c.n ~ License C 0011-1 1f v(A Address: d I t! , E2 r I .c SG- City: State: vtA-- Zip: Phone: Zz- S~~P Contact: -~n-4- Email: Gcf'lVw~a~N~ trUC E{`r{wt~a~r . TYPE OF WORK -New _Replacement _Repair _Rebuild Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main / Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 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 I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x % u~ ~Gcn scy x -1~e Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground -Rough-In NF Test _Gas Test Finial PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA095298 Date Issued: 08/05/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 846 Govern Cir Lot: 5 Block: 4 Addition: Gardemvood Ponds 2nd PID:10-28801-050-04 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: Heath and Home Technologies Thomas J Erickson 2700 N. Fairview Ave 846 Govern Cir Roseville MN 55113 Eagan MN 55123 (61)633-261 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 Citv of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA095400 Date Issued: 08/12/2010 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 846 Govern Cir Lot: 5 Block: 4 Addition: Gardemvood Ponds 2nd PID:10-28801-050-04 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: Automatic Garage Door Fireplaces Thomas J Erickson 8900 109th Ave N =100 846 Govern Cir Champlin NIN 55316 Eagan NIN 55123 (763) 71-2525 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 e Use BLUE or BLACK Ink I For Office tJse I cc~ j Permit lL~~ City of EaRdn 1 PermitFee: 3830 Pilot Knob Road 1 -,1 Eagan MN 55122 j Date Received: Phone: (651) 675-5675 RECEIVED 1 I Fax: (651) 675-5694 1 Staff: I I NOV 121010 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: )-T-~. ~SiiteeAAddress: ~CJ7g CIAOLk~ Tenant: oy ~r (C~xt.4ay r 1UL~011 Suite RESIDENT / OWNER Name: ~CJi~1 e `0 /VW Gi~tC.IC.Soyt~ Phone: Qy O'77 j Address / City / Zip: fo C/lIV-1L ' Applicant is: Owner Contractor TYPE OF WORK Description of work: QL~tk4(~ V, V R k/Gi t IJ q ssk 1`tAGP Construction Cost: c Multi-Family Building: (Yes / No ) CONTRACTOR Name: 1-;y S 6 Cd License Address: 380 {(JUaI 6ao City: ~ 6101/ State: 1► Zip: 55J Phone: bS I'' ~~,q Contact: MXTF C.CICtL Email: PAc4ck-O FhA546&SoA W 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. - zv/~ x / ~/A7r d x -~a:::2_ Applicant's Printed Name Applicant's Signature Page 1 of 2 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of Plex _ Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair Windows, _ Demolish Foundation Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building - giv ePCA`handoutto applicant DESCRIPTION Valuation' dop Occupancy AC, ~ / MCES System Plan Review Code Edit+orl ' '.LG6? < SAC Units (25%_ 100%-4!!~< Zoning R ~t City Water Census Code t~ Stories ---r Booster Pump # of Units -,Square Feet /9G PRV # of Buildings Length /A( Fire Sprinklers Type of Construction v Width REQUIRED INSPECTIONS Footings (New Building) ' Sheetrock Footings (Deck) T Final /,C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain The 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 Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL F WS I' / G AAe k Base Fee Surcharge Plan Review 7 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant I Copies y e~ ~Jr4~~p TOTAL Page 2 of 2 *° CityofEa�ali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 For Office Use Permit #:' Oe -785 Permit Fee: 490 Date Received: / l O ' 1 3 Staff:,/\C1 1 1 J 1 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 12-3 VI L. Site Address: 81-110 GoJ e rn C 1 r' Tenant: 1 ry\ Gri C�C Sa�''1 Suite #: RESIDENT / OWNER TYPE OF WORK Name: I o -try r i CaG.S (1 Phone: 051 - l08 I ' Oq (oQ Address / City / Zip: &Lk() l3 b V2 rrl G .s Name: plf %(InceOrt Yyllrl License #: Address: 11-1105 ►rut�'C,rS - rig City:t,Y10("(�(AU. State: min Zip: % 1 Z Phone: l S2' L (PR- 8 3 ( / Contact: M t del e1 le ice/ 4i h Email: New X Replacement — Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment A Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Tumaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. CaII 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. x lJ reo\ 6(1&11-1 Applicanttd Printed Name Applicant's S ture FOR OFFICE USE Required Inspections: _Under Ground Rough -Ii Final PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA113379 Date Issued:09/04/2013 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Holly Flood 1408 Northland Dr #310 Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Thomas J Erickson 846 Govern Cir Eagan MN 55123 Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature SEDGWICK HEATING & AIR CONDITIONING CO. 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952) 881-7739 ADDRESS '�'��? a y� OCCUPANT OWNER / t— � -ieg- SOLD BY TEST RECORD HEATING OSB No"e"l SEp 0 CITY MAKE Afisitti INSTALLED BY ArraW tc. MODEL S ac(rG`7 ieCtMcb SERIAL NO SC1 13 t4-0(Zo INPUT �� )� THERMOSTAT 1 VENT SIZE `Y VALVE ? S. LIMIT t q 0 a LINER SIZE LIMIT SETTING FILTERS- SIZE 253 c NUMBER FAN SEI IING WIRING GF,rt°/f TYPE OF LINER `, PILOT TYPE Cts TEST TAG rCaw.c� IGNITION MODEL LIGHTING INST. PILOT TIMING DATE TESTED /1 Y PRESSURE 1 47 /) PERCENT CO2 S `� INPUT CFH 13 5 PERCENT 02 t • t COMPANY TESTING "Y t: ck STACK TEMP. 3jael0 PERCENT CO NAME OF TESTER ` Z 11 R FORM 235 (REV. 6/08) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA144788 Date Issued:08/09/2017 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Thomas J Erickson 846 Govern Cir Eagan MN 55123 Sedgwick Heating & Air Conditioning 1408 Northland Drive, Suite 310 Mendota Heights MN 55120 (952) 881-9000 Applicant/Permitee: Signature Issued By: Signature For Office Use ffi 414 EEAGANf ..' �.. JUN 14 2018 rmit Fee: /C20.(J g ^� ate Received: / -/t/ /c- 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 BY.___._(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694Staff: grit � buildinginspections@cityofeagan.com L ��"" 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: till I ( Site Address: D4 (0 ( j.) C,n CI r Unit#: Name: .1—Y lbf'tCL.S'+ Phone:(OS 1—303—Sg S7 Resident/ p Owner Address/City/Zip: D q co Co eve,-Kt Cr' Applicant is: Owner Contractor Type Of Work Description of work: ye-AooktJ"tvtr ;sbn sir ,n i"Sam,. ..cccb> bt.ct we are_ R moviI;f Construction Cost: 11 t S5S- DO Multi-Family Building:(Yes /No ,/ ) Company: (9(\Q(4 I i1)4l-wln Bo,,1(MM LLL Contact: (2 (tJ Contractor Address:r110%;') 33 au Te s'r� . .J Q- City: �_�l State: NA. Zip: SS IL ( Phone:(/s‘'4151-1.151( Email: rils tw®ljnbmn. con, License#:BC 13(V 1 S Lead Certificate#: N41-- 1031 ?- If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.citvofeagan.com/subscribe. Exterior work authorized by building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conform-. - 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 of to start out 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. -ns. x ,JGc�,�(i(. �/ Applicant's Printed Name a Applicant's Signatur' DO NOT WRITE BELOW THIS LINE /5 60 7 ., SUB fYPESOj `r6 V r 0 / Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior 1 Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation _4_9_Cali Occupancy fhtill, MCES System Plan Review Code Edition A , l * lc SAC Units (25%_100% ) Zoning i City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Yit, Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) 1L., Final/No C.O. Required — Foundation HVAC_Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control — Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control — Shower Pan Other: Reviewed By: 'VI , Building Inspector RESIDENTIAL FEES Base Fee Surcharge r ell 1, Plan Review Q �(}� MCES SAC 66 . ' ` (j U✓ City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant 0 Copies r nr1 TOTAL U (/JiJ1V Page2of3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA151036 Date Issued:08/06/2018 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Thomas J Erickson 846 Govern Cir Eagan MN 55123 Silver Tree Plumbing & Heating Llc 3185 Terminal Drive - Suite 200 Eagan MN 55121 (651) 319-4200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA171031 Date Issued:07/28/2021 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations 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: 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: 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 - Thomas J & Karen L Erickson 846 Govern Cir Eagan MN 55123--246 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA172037 Date Issued:09/13/2021 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 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: 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 - Thomas J & Karen L Erickson 846 Govern Cir Eagan MN 55123--246 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA172409 Date Issued:09/28/2021 Permit Category:ePermit Site Address: 846 Govern Cir Lot:5 Block: 4 Addition: Gardenwood Ponds 2nd PID:10-28801-04-050 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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. When a weather barrier is installed or 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: 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 - Thomas J & Karen L Erickson 846 Govern Cir Eagan MN 55123--246 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature