858 Govern CirCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 858 Govern Cir
Lot: 2 Block: 4 Addition: Gardenwood Ponds 2nd
PID:10- 28801 - 020 -04
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Royalty Remodelers
4411 Slater Rd
Eagan MN 55122
(612) 414 -8199
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
$88.50 0801.4085
$1.50 9001.2195
$90.00
Owner:
John L Madison
858 Govern Cir
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA080873
11/05/2007
ePermit
INSPECTION RECORD
` CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS: APPLtCANT:
t I ,? ?rry ,. I ?• f!?i!r I i?l'.1 ti'=: r11V. 1? 3,
-I1•4 4 6f?:t
PERMIT SUBTYPE:
TYPE OF WORK: N IJ
INSPECTION D. . ..
IRi MARV,'; .",&W PI.YtMNFft - M7vW " I 4tF i+t b I.FA1(?k
.
. °•`? Fr.. _
.. ,. .. >-? ? . , ._,
-
, .:
<,.? _ . . . .. . : .. ..
.. - -
--
_ _
,
,
?
? ?. ?
r?
Permit No. Permk Hoider Date Tetaphone #k
ELECTRIC
PLUMBING
Hvac /O
Inapection Date Mep. Comments
FQOTINGS 7 y
FOUND G uf v- 3-Ij7 449 /e-,
FRAMING / 4-
ROOFING
PLOUMBING -1-2,,q7 448
PLBti
AIR TEST
ROUGH
HEATING
'
GAS SVC
TEST
? a 7
l f
INSUL
GYP BOARD
FIREPLACE AAS
FIREPLACE
AIR TEST
-JO
FINAL PLBG ?/t7
r?
FINAL HTG « < <
ORSAT
TEST
BLDG FINAL V-?Q ?
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
eQ
k-,W- I
fkddres,s ,5 vo vervi U r: Zip 5512'jl
Lot _0? Blk Sub r4 n wo0 oviJS e
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 69t 7 yes No Inspector.
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry) t,/
Permanent driveway
Permanent gas
Sod/Seeded grass ?
TraiUcurb damage ?
Porch ?
Basement finish r/
Deck ?
Please verify wi[h the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn fauce[ before freeze poten4al exists.
Contac[ engineering division at 681-4645 bcfore working in right-of•way or installing underground sprinkler system. ?
White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
guzLnzNG
4130058
05/28(97
SITE ADDRESS:
SSS GOVERN CTR
LOT: 2 BLOCK: A
GAROEN6JOOD PONDS 2ND
P.I.N.: 10-28801-020-04
DESCRIPTION:
?-?
Bu,?f`ldi.ng =q°ermit 7ype
B?Yilditt? Gfoilk Type
;i?6C 9ecezpency
1? Ccrnstruetioat TYp
Z4 I`C i n g
Ruilding Length
+ Suilding. Wiclth ?
Ga;fft S.Lt s?, 4 d:o
4
SF DWG
NFW
R-3 U-1
VN
ft-1
73
43
101 1 - FAM. DETACH
?
REMARKS:
S&W !'1 UMHrf2 = M&W SEWEF2 & WAl'ER
FEE SUMMARY:
Bass Fee
Plan Review
Surcharge
SflC
SFlC ?
SAC Units
Subtotal
VaLuarr.oN
$1,R42.25
$937.46
$105.50
$950.00
1@0
1
$3.435.21
$2il,emra
mzsc FEr_s 4ap539.5@
ToCal FF,e $4,974.71
CONTRACTOR: - Applicant - sT. LIC. OWNER:
HORrTON INC fJF MN, 0 R 14544663 20005657 JOE MILL.FR IiOMES
395.9 WASHTNGTON DR 204 3459 WflSNTNG70N DR
EAGAN MN 55122 EAGRN MN 55122
(612) 454-4663 1(612)454-4663
204
II
S hereby askxtcrwledge tFiat I haWe €'sad tllis
ijrfar,iraefor+?i?o ao,rrect -and agree to ecrmpiy
Statutes ana City of Eagan prdinartces.
? APL???i EQ'E
fi,pplioatzon ond 5tate that the
wjth ak1 applicalola St??e of 14n.
ISSUED \ URE
?, @?,+1997 BUILDING PERMIT APPLICATION (RESIDENTIAL'? q q 7?. 7 j
CITY OF EAGAN
8830 PILOT KNOB RD - 55122 ? ?
887-d6T5 ?
New Construction Reauiremerds RflmodeVRaoafr ReaulremeMS (^ '
? 3 rogistered sfte surveys ? 2 oopies of plan af ? Z.
? 2 eopies of ptans (include Deam & window saes: poured fid. dealgn; etc.) ? 2 ske surveys (exterior addttions S Mcks)
• 1 energy calwlatlons ? 1 eneigy celculations for heated additions
? 3 mpies of tree preservatio lan ff bt platted efter 717l93
required: _ Yes No '
DATE: ri'a1'41 CONSTRUCTION COST:
DESCRIPTION OF WQRK -14C,w C.ON
,-SREETADDRESS: 192 C)cvP/v% P,i?GIC,
LOT BLOCK L]_ SUBD./P.I.D.GbvA¢MV.104 ? 7014?S o ?
PROPERTY
OWNER
Name:
u..
CONTRACTOR
Phone #:
Street Address:
City:
State: Zip-
Company: =Tot, C16v ?CS Phone #: ysy-y6b3 ev/>a9
StreetAddress: 3q5q License#: a'00??57
-??
Ciry:State: 014 Zip:55lad,
ARCHITECTI Company:
ENGINEER
Name:
Street Address:
City:
State:
Phone #:
Registration #:
Zip:
Sewer & water licensed plumber (new oonstruction onty): M4-VJ ?!W ?-Wa fP.r - . Penatty applies when address change
and lot change are requested once permit is issued.
I hereby acknowledge that I have read this appiication and state thet the infortnation is correct and agree to comply with all applicable
State of Minnesota Statutes and Cily of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY }?CFO??ED
Certificates of Survey Fteceived " Yes _ No kl4ff 21 1997
Tree Preservation Plan Received - Yes - No _Not Required B??
OFFICE USE ONLY
;,;... . , _
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex o 11 Apt./Lodging ?
Er 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem, o
? 03 SF Addition ? 08 8-plex o 93 GaragelAccessory ?
n 04 SF Porch a 09 12-plex a 14 Fireplace D
n OS SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
X('31 New o 33 Alterations ? 36 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
VrJ
J r?
?-!
?
73'
V3'
Planning
Permit Fee
Surcharge
Ptan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
Basement sq. ft.
Main level sq. ft.
a"r sq.ft.
? sq. ft.
sq.ft.
sq.ft.
Footprint sq. ft.
Building
rtti+3
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
1Sq`l
- MC/WS System '
?
? City Water r
IS7 Fire Sprinklered
PRV
Booster Pump
Census Code. + o +
2:510 SAC Code o 1
Census Bldg ?
Census Unit f
Engineering
Valuation:
?---
43 st 2
gK x i
3sx , p
z.zsx <.
2?-a
s-y K z,7
r? u 3S
- qK ?c.
Zy. s >c 38.5"
Variance
$ Z ? ? eoto, ?
a c-
$ 6?f
G 30
? •S
? sa 3. srb? r s'--
i 543.5
z3, Fvz.sp
s44, c. r3gg sk =$r?/ 37g. y o
Isrz
zi o
? 8?s ? d s4 ? 2-
.'-
`1 °?• 7S
--
_
3.-75 q.? 1c. •
aLO,sq2,q
. , LOT SURVEY CHECKLlST FOR RESIOENTIAL
' . ' 903ILDING PERMIT APPLJCATION
PROP
U ERTY LEGAL:
-
? ?
DATE OF SURVEY:
?' LATEST REVISiON:
?
F ?
4 DOCUMENTSTANDARDS
3 C3
? • Registered Land Surveyar signature and comparry
? 0 C3 • Buliding Pertnit Appllcant
ag" o o • LegaldescripUon
91-1? 13 • Address
C3 • North arzow and scale
0 0 • House type (rambler, walkout, splR w/o, split entry, lookout, etc.)
2-' 13 13
"? • DiracKional drainage arrows wifh slope/gradient %
lgir
C3 • Proposed/epsting sewer and water services & imrert elevaUon
13 • Street name
? ? • Driveway
ELEVATIONS
Etistina
/
?p ? • Sewer service (or Praposed)
¦
?? ? • Property camers
_
4' C3 ?
""
C3 • Top of curb at the driveway
M
13 • ElevaBons of any eristlng adjacent homes
Prooosed
1V'C3 C3 • Garage flaor
V-` cl 1] • Frst floor
? o cl • Lowesi exposed elevation (walkaudwindow)
2-'13 C3 • Property comers
Q1'153 0 0 Front and rear of home at the foundation
PONDING AREA fif aoolicablel
0 • Easement line
? H
l ? • NWL
?
0 CY/ O
0 •
• HWL
Pond # designatlon
C3 ? • Emergency Overflaw Elevation
OIMENSIONS
Q--'1 C3 • Lat IinesrBearings & dimensions
o/P C3 • Right-of-way and street width (to back of curb)
?0 ? • Proposed home dimensions including any proposed declcs
overhangs greater than 2'
/ ,
,
porches, etc. (.e, all structures requiring pertnanent footings)
• Show all easemenis of record and any City utildies within those easements
? • Setbacks of proposed sLVCture and sideyaM setback of adjacent exdsUng structures
? C3 • Retaining wall requiremenis, if any „
Reviewed: - / r -'7? ? S / Z
Jar,uary 1996
CRAq/DOdBLDGPRMTFM
HIHNESOTA STATE ENERr.v CODg, AL. •Arn mraNS ?
• BASED ON CNAPTFR 5 OF TFIE
MODEt. ENERGY COUE - 1983_& TiTTON
f Aaaption Effeotive
S,ite . Addre
contractar
8ulldinq classiflcatlon: Type A1 (Single Family & buplex)
Type A2 (ResiQential, 3 etories or less) (QVar ] stories) (athar)
gOTFS Comolete paaes 3 and 4 firat.
SF.NE9Ai TNFORMATIDN ybb 4t
1. euilding Perlmeker ?? ft.
N
2. Wall height (ground to eave) ft.
a. 1. X 2. (above) gross caell area aq.ft-
A. auilaing dllmenslons (L) ? X(W) ?1(PS4q.ft.roof e floor aroa .
5. Sq, foot area oF rim Jolst - F}o??or joist ei2e (2 X
?? _ X _j_j&(Perifieter) _ ?s?;•!t.
?Z •
6. pvors - Area + Thiokneus in U. factor r 141.41
Type af conatruction Perimeter ft.
. Manufacturer ----
T. Total dnor's perimeter ft.
e. Windows: Manufacturer?lhUL ?21 [! ? state epproveci_
tl factor I
TYPE SiZE AREA (Sq.Ft.) HUMBER OF TOT7+L
EACH UHI'i'S 5Q FEET
9. Totel sq.ft. Glass ?l?p ?L'
10, Fireplace areae Width x Heiglit = X ? sq.fe.
li. Exposmd fvundation: Height % Perimeter_Lt_X_j_7Z/a_p118_eq.ft.
C014YLSTION OP 'fHI3 FORM I$ REQUIREb FOR AI.T, N&W CONSTRUCTIOZt, MAJOR
REMODELINC3 I.ND aUILDSNGS BLTNG 14OV6D WHERE BNERGY, OTHER THAN THE MINIMAL
COpE ?LLOWANCE, IS USED.
S0iT0'd 5S92 zSb ZT9 S 'JhlI "OJNy-ld 82:Si b66S-T(1-d35
]a. Framing area = lot of grass wdll atea.
il. Gross wall area -3:/21 aq.Et,
Window area A sq. Pt, U windnws
Rim joist area A?sq.Et. U rim joist= .o (I
Door area A -SI sq.ft, u door aYea=
Other doors area A? gq,ft. U okhor doora= L? 7
Exposea fndn n sq,Pt, u founaQtion= 07&
Framing area r ?'! eq.tt. U[raming area=_.?Ar
Net wall area x.ZZ 217 eq.tt. U wall- jo`f%
(13B) TOTAL . . . . . , . . .
-w ?4 - zi?,f
?XA - ?J
uXr. _ .??
UXA = /
UxA
Uxt. ? ?._
UxA 7j
UXA -
uxA 47
m (
14. Gross wall area x 0.11 (2.-1 single famlly G duplex) a allowable Uac.!e/Code
(1J. abqvo)
x 0.23 (A-2 other residential) '
x .23 (Otltec buildinge)
x .28 (over 3 atoriee)
ZC.?' J ?BTCtH muet be larger than ar same
A_`f 1? % U Coda/ °F. ss 13H ahoVe_,,.
15, ceiling Eraming area (a,) equele 104 oP ae111ng area
15A. Grose ceilinq area =(L) `? x({i) ? d+(O
,..
15B. ,Ioist area (Af) A loE ceilinq area eg.Pt.
15c. Net asiling area (A,:) (15A - 15B) ?sq.ft,
U ceiling x Ae = LO?
U framing x A f ??r°?, ,? x•n*17 ??.
15D. TOTAL U x A .................. .........
16. ceiiing area (isr) x 0.026 (A-i singie family EA duplex)
= ellowable UxA/?ode
x 0.033 (A-2 other resldenlial)
x 0.06 (other)
( ?_ -- Z ? ?BTUH must be laxger than ?>r eame
a(151?'l?1?5 x v code F. ea 15b ebuva
f1oTES Uee U aml A values obtalned trom pages 1, 3 and 4.
.QBgM=gT1g,g: I hereby certify that I have aalculated tha nU?? fsatara and
11901 values hereln and that the building hera dasaribed meats or exoecda the
Srate oP Hlnnesute Eiiargy Coneervetion Ack.
tiate
r
9lqnsture
59/EO'd 6S92 ZSb ZS9 T '?NI `07h1t1-1d 62:ST r66T-70-d3S
,
4
_f ???a??l?.??'?, . .. . . ... ..
--
??_
.....--------- ?---
. lo, 62-7 l<_??L??
--------
-- - -
-.... ......._._.._..,.__.. ._...._.?...?3?17.....___. .. . . _..___.-.__. _.._..
----------?--- . . -? ............
--
--. ---
.. -_--.-
-
. . .. --.--------.--------
_
_.1-_._ (aaf?n .= ZSx? ?_'`?.`?..r-?. . - -- -..._..._..._. ._.. ... . _ .. ..._-- ------
----..._. _?-?I---- z,44b ----------... --
. ..
----
3 3 z.
??-S -------.... _ _ _
??.r..??
.._...__-------------
-
?
SOi£0'd ES9£ FSt' ZT9 S '')NI 'ODNF1-Id 6£:SS 1'65L-Tl)-d35
., , .
? uaLL ?
^ SCCTION
6592 2Sh cL9 S
U VALUE
y•... ;. - :
Inilda ?lx fll?u . .68 .'' • ?
i'• . .
f4?,4CLOC MOLL : •45 (HALI) U •0. w
.;
..--
$tains
<• .
Outelde str film
.17 i'
R YOTli4
K?
.
1 °
[nslde.alr film ?
' 63
Ihtetlar well . .47 Y
40'..stud •. . R'..p'd3Slp,!"l (Framing)0' R
she.thlnS ? 2.otv •'
,
siair,g ..
.to1 :
Ou[slde•Rlr film
.f, ,
}'•` ? R TUTAL
., .
nterlor aIt film R• .68 "
nYUlatlon ` ??•4Q '?
(V Ineh eoEt wnaJ W ,88 (Rim '
Joist) .
' : ..
iheathing '; x•? :
?xtertor ua?l eoveting .(D1
• '{.
txttcloc'alr Etlm Ra ,17 •
f ?' 'R- 7'OTAL z-1 46
. j .
lRC9C?otA?S film r,: • ' ? ? :
Inaulotlop :
'FounJaclan ?•?' (Fdn.)
,.
txtertor e{r film R. H TOTAL I ?I S
, . ,
.
Oh:ST
. c95
..---..-?
. 07 (p
50'00'd 'Jh1I 'O')hIN-ld G6Ei-T'1-d35
Si3'd ?t11U1
R VILLUS
FltmING
R VRLUE
CEILING
0 fil AirFilm Q,.gl
?fl?• p Tnsulation `T? ..?
4 ?0 Joist - - -
c?llin9 Q?.?`si_
0.56
o eL T,irFiln?. 2.61
??•?lA motalR?A r,"1g
.a2J u- i/R
Window infiltratlon 0.5 cfm/lineal foat of orack
}tasidential door infiltratlon 0,5 aPm/sqvaxe [oot or doox and minlmum aode
requirement
tton-residential d4or lnfiltretion ll.o ofm/lineal faot of erack
ua 12" concrete hlock no insulation
Ub 12" concrete block lnsulated coras
Ub 12" llghtweight block
Uq 121' lightweight block insulatad cor,
U eingle qlass a 1.13; with storm window
u double g1a88 = .58
u Yriple glass - .ql
-.47 R 2.1
,26 R 3.8
_ ,a2 R 351
?s p .12 R 9.!
.S4
A1l extarior walls and aeilin e must hava a vapor barrier (0.10 pezm max.).
Vapor bartiar muet be on the ?neida (heate5l slde) of wall.
vapor barrierH of the polyethalona thin iilw hava no R valua.
/
93iSO'd 659E ZS6 ZT9 j
ONt 'O-hNi"ld Oh:ST h66T-S"-d3S
CSTY OF EAGAN
t'.A51-IIF_h: S Tf:RMINAL. NOe 40
DA7E: 05/86/97 T7MF_: 15:4•3c:10
m:
NArse: n R HaRroN zNc
2256 9001 858 G!JVE:fiN C7:R 47974.71
,?.
7nta1 r,eceZp+, Amount: 4,974.71.
CFq7434f
U5C-:fi SD: NANt"Y
? , : ? CITY USE ONLY
LOT OL BL ? RECEIPT #: / ??I? ?`
SUBp? ? I U' w;'
RECEIPT DATE:
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
? (612) 681-4675
Dau: 'L
Complete tlus section 9nlv if vou are installine HVAC in sin¢le familv, townhome, or condos that are
under construction and are not owner /occunied.
• HVAC: 0-100 M B T U $ 24.00
liDDITIONAL 50 M BTU 6.00
• Gas oudets (minimum of one required @$3.00 ea) 9,00
• State Surcharge: .50
• TOTAL:
Complete this section only if vou are remodeling, adding to, or repairine eaistine sinele family
dwellin¢s, townhomes, or condos.
Add-on furnace _ Add on air conditioning
_ Add-on sir exchanger, i.e. Vanee system, etc. _ Other
Minunum fee applies to all remodel or add-ons of existing residences $ 20.00
State Surcharge .50
Total: $ 20.50
SITE ADDRESS: OS-e' GG Ue/n C-•11alB
OWNER NAME: --?-v e- /?l•'l?e lTO.-,eS PHONE #: y.5 Y- ?160? 3
INSTALLER NAME: CP n. .71 LlCd '4«- PHONE #: Y/o0 ??od ,?,2
STREETADDRESS: I(.2?d ?4'rat Ae-
CITY:
STATE: /4IU ZIP: SSDL)Y
SIGNATUR
OF PERMITI'EE
?
` ' • L gL /?L CITYUSEeONLY RECEIPT#:
SUBq;o RECEIPT DATE:.
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681-4675
Please complete for: . single family dwellings
• townhomes and condos when permits are required for each unit
• backtlow preventer for underground sprinkier system
FIXTURES EACH N_Q. TO AL
Shower 3A0 x / _
Water Closet 3.00 x
Bath 7ub 100 x = .
Lavatory 3.00 x = j " T
Kitchen Sink 3.00 x
Laundry Tray 3.00 x
HotTub/Spa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - t 3.00 x
Rough Openings 1.50 x
Water Softener 'tor dwellings undar canstruction 5.00 x =
Water Softener ` for existing dwelling 20.00 X =
U.G. Sprinkler ' fordwelling under const. 3.00 =
U.G. Sprinkler ' ror existing dwelling 20.00 =
Altef2tlOn5 ' to racisting residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' Dak Cty lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems * nbandonmenc 20.00 =
STATE SURCHARGE .50
TOTAL
1 hereby acknowladge that i have reed this appliption, state tliat the infonnation is cortect, and egree to compty with all appliwble City
of Eagan ordmances. It is fhe appliranPs responsi6ility to notiry tha property owner that the City of Eagan assumes no liability for any
damages eaused by the City dunng its normal operational and maiMenance adivities W the fadlities construGed under thLS pertnit within
City propertylright-of-way/easement.
SITE ADDRE55:
aWNER NAME:
INSTALLER NAME: GENZ-RYAN PLUMBING TELEPHONE #: 423-1144
STREET ADDRESS: 14745 So Robert Trl
CI7y; Rosemount STATE: MN ZIP: 55068
C2
SIGNAT E OF PERMITTEE
CITY USE ONLY c
L BL I? v
RECEIPT#: ?
SUBD. 7L ? ?/7td? q ? RECEIPT DATE:
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55121
(612) 681-4676
Please complete for. ? single family dweliings
? townhomes and condos when permits are required for each unit
. backflow preventer for undarground sprinkler system
FIXTURES EACEL TOTAL
Shower 3.00 x =
Waber Closet 3.00 x
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sfnk 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x
Water Heater 3.00 x =
Floor Orain 3.00 x =
Gas Piping Outlet " minimum - t • 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwenings under consuuctlon 5.00 x _L = S•?
Water Softener ' Por existlng dwelling " 20.00 x =
U.G.Sprinkler 'wrdwentrgunderconat. 3.00 =
U.G. Sprinkler * for existing dwelling 20.00 =
Alterdtions " ta existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System • Dak cry iic. 75.00 =
(new and returbished systems)
Private Disposal Systems • anandonmem 20.00 =
3TATE SURCHARGE
TOTAL
#:
I heraby adcnowledge that I heve raed this applleaNon, efaM thet the infonnadon b eorted, end agree to eompy with all applieable City
of Eagan ordinanoas. It is the applieaM's msparrei611ity to nMty the property owner thet the Clty of Eegan essumes no liebility for any
damagas caused by Bre City during its nortnal operetional aM maintenance edlvttlea M the fadiifies wnsWGad under thts parmR wtthln
City propertylrightof-wey/ease MRD i SQN JOHN
SITE ADDRESS: $58 GnWERN r I RCLE
EAGHN , 55123
OWNER NAME: H 68t- i856 W
INSTALLER NAME: V
STREETADDRcESS: ZqOS r?ARLL D A
CITY: MP,WI - STATE:
OF PERMITTEE
.50
i
ZIP: S:C7 40 s
;?
' i.
?
i ,
i
4.• 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-881-4875 /
New ConshucMon Reaulremenh 3?777 Remodel/Reoair Reaulremenh o
> 3 regbtered dte wrveya "wlng sq. ft of bt, aq. fl. of hane ^00 2 copies of plan
and gn roofed areaa (4096 rtKolmum lot eovemae atlowedl 1 set of energy cdwiaHons Por heated addiMOns
> 2 coples of plana (show beam 8 wlntlow sizes; poured Ind. design; etc.) 1 aite wrvey ror extedor adUlHons 8 decks
> t set of enetgy cdculaHons
> J coples of hee preeervatlon plan If tol platted alfer 7/1 /93
DATE: ? I-1 I bo CONSTRUCTION COST: ?4, S D0
DESCRiPTION OF WORK:
STREET ADDRESS:
n
LOT: BLOCK: SUBD./P.I.D. C
PROPERTY
OWNER
COMRACTOR
ARCHITECT/
ENGINEER
city ---za z11 . s?ata: im- zip: ?S I Z 3
S}f66f
?
Name:? --?a?u\ Phonetl: (?(lL/
Last Fl"t I. _ Cv I Z, n8 S. 7SD(o
Company: Phone t: _
(area code)
Sfieet Address: License # ExP•
Cfly
State:
Company: Name:
Telephone M: ( )
Sheet Address: ReglsfraHon #:
Ciy
State:
Sewer/water licensed plumber (if installina sewer/waterl: Phone t.
1 hereby acknowledge fhat 1 have read this applkafion, slafe 1haF 1he
of Minnesota Slahutes and CNy of Eagan Ordinances
Signaiure of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Zip:
Zip:
to comply with a0 applicable Sfate
Tree Preservation Plan Received _ Yes - No - Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? OS 06-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex 0 11 10-plex Plbg _YOr_N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
)9,' 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORM T?1 N-
SAC Code o 1
No. of Units
No. of Buildings ?
Const. (Actual) ?
(Allowable)
UBC Occupancy 'fL•3
Zoning JZ?
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning
Building Engineering Variance
,{ bc?
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC
Ciry SAC
W ater Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
a
? 31 Ect. aft - Muni
? 33 Ext. AR - SF
? 36 MuRi
SAC Units
°/a SAC
s
o?
G ?
CERTIFICATE OF SURVEY
for
JOE MILLER 1?0?ulES
C ?
?' 1?
5
M32-1569=97
9
,? -• r
o?.o
?
?
.
9I1
I
?
BY _
DATE _
D
Top curb to G?a13 s3 b=
Top block _
Lowest bsmt flr = 90S4Z
?
\ '0p ?s
\
\
e ? ?en?
Oto`? J \?\i,? e05e
?
?
\ y i
?
73
Nt D
/ •?.,?c?'N.x ?::
? 4oa 858 Govern Circle
Scale: 1" = 30'
DESCRIPTION
I hereby certify that this survey, plan, or Lot 2, Block 4,
report was prepared by me or under my direct
supervision and that I am a duly Registered GARDENWOOD PONDS SECOND
Land Surveyor under the Laws of the State Dakota County, Minnesota
of Minnesota. Plot bearings shown
o Denotes iron monument
Date 16 AftPf (997 Reg. No. 8140 `Existing-l-N Proposed
BF.PT.
BRANDT ENGINEERING & SURVEYING
1600 West 143rd Street, Su ite 206
Burnsville, MN 55306
(612) 435-1966
_ g\ob ?
G?r q12? ? 5e
E'?op q??•?3? ? syd ?,4?-
0\K i QCOQ ? e\
i
S??e C
?•? ? ?
?
? LO \
C \
`
zQ(a 4'? MR 1
? ?
5.? ?,
\
1
\ \ ??
nn7?')_1?Fa_a7
. CERTIFICATE OF SURVEY
G?'
for
JOE MILLE%R 1?0?iAES
/
?
Go?1 07,D
• - ?' 'o F?, • 910rb? ?5%'?' 9??
` J 412, --
??
0o s?ob \
?9' Gp? q?2? e
C 10.83 ??°?,T' ? 6?09 q`3 No
'i
Q?opo e\
?
\ ?g .0
?? ?
,4
?
?t----
`
?
. ;. ?
Top curb to Gar slab
Top block = 913_13
Lowest bsmt flr = 90S,?Z
M32-1569'-97=
3a. ?'1'
O ?.
\
I \
c?5 \
e0 eP*-
I l Oto\? J\\?,? eo5
/
/•/
h '
/
/ 9J
858 Govern Circle ? Scale: 1" = 30
DESCRIPTION
I hereby certify that this survey, plan, or Lot 2, Block 4,
report was prepared by me or under my direct GARDENWOOD PONDS SECOND
supervision and that I am a duly Registered Dakota County, Minnesota
Land Surveyor under the Laws of the State
of Minnesota. Plat bearings shown
o Denotes iron monument
Date 16 /11lY 1997 Reg. No. 8140 ? Existing/ Proposed
.. BRANDT ENGINEEFtING & SURVEYIING
1600 West 143rd Street, Su ite 206
?-
Burnsvilie, MN 55305
(612) 435-1966 M3?-1569'-? i
318 - 713 request vaid 18 monMs Irom validation dale pnnted in Mis bm? ^
? 7
T _ --
nav c? ?
PLEASE PRINT OR TYPE
Request Dole Rough-in nupetlion reqmred4 (?rMs ? N. Inspecnon OtherThan Rough-In ? Ready Now [}MMI Call
6/17/97 (Youmosrmllihe?nspedorwhmreody) DateReady
I, &;-Vensed conhacfor ? owner here6y request inspection of ihe above elech'ical work at:
Jo6 Pddmss (Street, Bor, or Hauro No.) Crry 2p Code
858 Govern Circle Eagan
Seqion No. Townahip Name or No. Ronge N. Fim N. Covnry
Dakota
Occupanf Phone No
Joe Miller Homes 454-4663
PowerSvpplier Address . L{ 300 daC?-f l.?
1?
K
iA "z?t- S W •
Fl
o ,i
?
i'?lan?"`?iec?rVic`l co?no??? r? Mo,
Lic. Na. (Plant Elatl Only)
Moding Addren (Contmdor or Owner Pedorming Insfallanon)
22691 Red Fox Dr Lakeville, MN 55044
Authonxad Si m onhacror e rming W afion) Phane Na
461-1444
EB.OOOO1A.10 6195 -',0'juT OAflDCOrP7-SEEINSTRUCTIONSONBRCKOFYELLOWCOPY
N1' REQUEST FOR ELECTRICAL INSPECTION 8 5???
I?I ( II •• I I II (?I I II II ( I I? I I? I II g121 Unereity AveR ??y E11 BICSt. Paul, MN 55104 ? .=?
7 1 3 5 * Phone (612) 642-0800 (D?,??? 7(o '
Home• Duple: Apt. Bldg. Olher: New Addn
Commercial Indushial farm Remod Re air
Air Cond. Htg. Equip. Water Hfr. Load Mgmt. Ofher.
D er Ran e Elec. Heat Tem . Service
"X" above the work covered 6y this request. Enter remarks in this space and on the back of the white copy only.
Cal<ulafe Inspechon fee - Thu Inspection Request wJl not be occepied without the cortect (ee
Other Fee # Service Entrance $ae Fee 31 Circuih/Feeders Fee
Mobile Home Park Stall 0 t0 200 Amps 0 fo 100 Amps J
Sireet Lig./1'raHic Sig. Above 200 Amps Above 7 00 Amps
Transformer/Generator INSPECTOR'SUSEONLV TOTAL
Sign/Oufline Ug. Xfmr.
Alarm/Remote Confrol
Swimming Pool i he2b am an i m, exd the el«mmi in:mllanon dew1bed he.nn on N,e dores smted
Imigahon Boom Roogh-In Dak 7J.?
Special Inspedion ?
Invesfigative Fee finvl Do
THIS INSTALLATION MAY BE ORUEHED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS.
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166063
Date Issued:12/09/2020
Permit Category:ePermit
Site Address: 858 Govern Cir
Lot:2 Block: 4 Addition: Gardenwood Ponds 2nd
PID:10-28801-04-020
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 -
John L & Roxanne L Madison
858 Govern Cir
Eagan MN 55123--246
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature