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4629 Kingsbury Dr Use BLUE or BLACK Ink I For Office Use I Ed Permit#: Permit Fee: "S''~S My Ol Ea 3830 Pilot Knob Road I Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 Sta 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /0 Site Address: N~~w"01_,y 16"V a, - Tenant: JAAol / A Suite RESIDENT /OWNER Name Phone: ak IS;?- y522Y Address / City / Zip: 71YF~~'7 U,'1 Vim. MAC Applicant is: Owner Contractor TYPE OF WORK Description of work:1,QAlQL1JS - llhui l lld', d7`lll~ Construction CosAgel mn Multi-Family Building: (Yes No CONTRACTOR Name: IJ j(~ ! /pJ21 License 17-73 Address: q01 , NICO~ SY. Ce)' "r City:.~tltJ~'~► `'iiV ¢cp State: !m u Zip: 5'So-L Phone: ! SI ° ° f26 Contact:OA.-j I&Yf(` Email: k*-e. 'larse4wato4ce, Amt- 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 c/assHied as non-public ff 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.Qopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the tApVI e in confonee with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a work is not t st witho x a permit; that the work will be in accordance with the approved plan in the case of work which requires a revieval of plans. tl,8i A sLA me ignature Page 1 of 3 CITY OF EAGAN Remarks Addition BEACON HILL ADDITION Lot 27 Rlk 3 Parcel 10 13500 270 03 Owner CIeau(, ?i ..:.j- Y, 10'. ) s«eet 4629 Kingsbury Drive state Eagan. IMIId 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSUFF. ?j[d 1982 1906 - 23 9,00-77 -9 1$06.93 C007568 10-1-$1 STREET RESTOR. GRADING !p 5 1982 526.46 58.50 9 526.46 C007568 10-1-81 SANSEW TRUNK 197 3.97 .0 15 * SEWERLATERAL ? 1982 3116-46 346-27 9 3116.46 C007568 16-1-81 WATERMAIN * WATER LATERAL 1982 9 WATER AFEA $ 1992 199-01 22-00 9 19$.01 C007568 10-1-$1 ir STORMSEW TRK (0, L 82 359.82 39.98 9 359.82 C007568 10-1-81 * STORM SEW LAT 1982 9 CURB & GUTTER SIDEWAIK STREET LIGHT Rd. UNIT 185.00 21195 1012 80 WATER CONN. 305.00 21195 10/2/80 BUILDING PER. sac 525.00 21195 10 2 80 PARK ? CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVEo FXOM AMOUNT $ I 4 COLLARS 1 oe ? CASH (3 CHECK ROR 27? Thank You BY White-Payers Copy? Yellow-Postinfl CoPY Pink-File CoPY ? . r BUILDING PERMIT Te be used for CITY OF EAGAN 3795 PiIM Knob Road Eagan, MN 55122 PHONE: 454-8100 Receipt # Date _ Site Addreu Lot Block Sec/Sub. Purcel # m Name Z . -! . 3 Address _ o _ -. , .,,, i c 1 .. .. - Erect ? Alter ? Repair ? ? Enlarge ? - Move ? _ Demolish ? Na 6252 i Occupancy _ Zoning Fire Zone Type of Const. # Stories Front ft. Depth ft. cc Nome Approvals Fees ,o 8' Address Assessment Permit ~ Ci Phone Water & Sew. SurcFwrge Police Plan check J<. Name Fire SAC Address Eng. Water Conn. Ci Phone Planner WaterMeter Council Road Unit I hereby ocknowledge thot I have read this application and state that gldg. Off. The information is correct and agree to comply with all applicable APC Total StaYe of Minnesota Statutes and City of Ecgan Ordinances. Signature of Permittee A Building Permit is issued to: on the express condition that oll work shall be done in occordance with all opplicable State of Minnesota Stotutes and City of Eagan Ordinances. Building Official PumM .# Dafe Irmed PwwMtoa Plumbing EYe Mechaniwl Jp ? INSPECTIONS DATE INSP. Rough-In Final Footings Dote Insp. Date Insp. Foundation Plumbing J/ Frame/ins. Mechanical 2y4r Finol Remarks: ' CITY OF EAGAN 3795 Pilof Knob Roed No. " Ee9an, Minnesota 55122 Phone: 454-8100 ',.' ?•'?_ VERMIT Dofe: I-20-80 I Site Mdress: ='"y .12 Lot Block Sub/Sea INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: $ingle I Residential Multi Res., Comm./Ind. Name ("eT'tex 110383 New/Alter./Repoir s Address 4615 Cost of Instolletion O City ? ? ::' ? r?'.• Phone: , Permit Fee ',Velter Name Surchorge . g Address e e V City Phone: Total This Permit is issued on the express condition that all work shall be done in accordante with oll applicable State of Minnesota Starutes and City of Eogon Ordinonces. Building Official : • • crrY oF U"N • , 3795 Pilot Knob Roed No. Eagan, Minnesota 55722 - Ptione: 454.e100 ?'? tUC'? ;:'•' pERMIT Date: 10-15-80 Site Address: 462y,) Kingeb=y ir LM Block , Sub/Set. e° COri Nar,e Centex Hories ` 4015 :?C.^.?O',. -,:il.. g Address " ? n ?- • ? City Phone: ; - . ? , _ . Nume ?iE11;', *[l_'? ? g naares5 . . . City , Phone: ' ' - This Permit is issued on the express condition that all work sholl be Minnewto Statutes ond City of Eogon Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residential Multi Res., Comm./Ind. I New /Alter. / Repair Cost of Installation Permit Fee Surcharge Totol done in accordance with all applicoble State of Building Official BUILDING PERMIT ra ee v..a fo. nECF: CITY OF EAGAN 3795 NIaF Kneb Roed Eogen, MH SSl" PHONEs I54-8100 Recelpt # . r $1,200 Sice Addross 4629 KinRSburq Drive Lot 27 Blxk 3 Sec/Sub. "'Parc,r: ?';' 7 Porcel # 10 135(i -- 114ame GeorRe A. Tako ? Address 4629 Kingabury Drive ,-;,,, Hagan 55122 452-472E 19 Name O'mer ?a ?? Addreu ? Cit GW Name P Z _,-, Address 1 hereby acknowledge that I have read this applicotion ond state that the information is torrect and ogree to comply with all applicoble State of Minnewta Statutes and Ciry of Eogan Ordinances. Siyrroture of Permittee - A 8uilding Permit Is issued to: George A. a-o all work shall be done in otcordance with oll opplicoble $taM of Mir Erect )(3 Occupancy Alter ? Zoning Repoir ? Flre Zone Enlorge ? Type of Const. Move 0 # Stories Demolish ? Length 25 Grode ? Depth 12 Sq. Ft.- Approrob Fees Assessment Woter & Sew. Polica Fire Enp. Plonner Countl I Bldg. Off. APC Permit tU.JU Surcharye 1.00 Plon check SAC Woter Conn. Water Meter Road Unit Toral $21.50 on the exprcss conditlon thnt ond City of Eapon Ordinances. Buildiny Officiol Permit Na. Permit Holder Misc. Permit No. Holder Plumbing H.V.A.C. Well Water Disp. Sswar Electric Inspsetion Date Insp. Other Footings Foundation Framiny Rouyh Plbg. Rouph HVAC Insulation Final PIb4 Finel HVAC Final Webr Deacri6e LocMion: Well ' Sewer Pr. Disp. CITY OF EAGAN ,tWER 5ERV74.c PeRMIT 3795 Pilot Kno6 Road PERMIT NO.: Eagan, MN 55722 DATE: Zoning: . No. of Units: Owner. Address: Site Address: Plumber . 1 agree to eomplr wifh the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: gy Misc. Charges: Date of Insp.: Total: I nsp.: CITY OF EAGAN 3745 Pilot Knob Road PERMIT NO.: Etsgan, MN 55122 DATE: Zoning: No. of Units: Owner: _ Address: Site Address: Plumber: Meter No.: Connedion Charge: Size: Account Deposit: Reoder No.: Permit Fee: I agree M eomply with fhe City of Eagan Surcharge: Ordinanaes. Misc. Charges: R.. Total: - Dote Poid: Date of Insp.: Insp.:- CITY OF EAGAN (? ? Include 2 sets of plans, 1 site plan w/elevations & w ?? BUILDING PERMIT APPLICATION 1 set of energy calculations. Zb Be Used F'or D.?ie valuation Date Site Address !9!q OFFICE USE ONLY Lot 21 Block ? Sec./Sub. &ACOVI Erect X, Oc:cupancy Parcel #: 10 S0 6 027?? D? Alter ? Zoning Repair Fire Zone ?y Oamer: Enlarge TYpe of Const. Address: 1"ove Deblish # Stories Front ZS ft. City/Zip Code: Grade Depth 2L ft. Phone #: ??G?- 417?? ?S Contractor: nwnrc-?-- Address: City/Zip Code: Phone #: Arch./Eng. . Address: City/Zip Code: Phone #: APPROVAIS Assessments Perntit '*_D "5r O Tdater/SEwer Surcharge (,r, a Police Plan Check Fire SAC glg, Water Conn. Planner Water Meter Council Road Unit Bldg. Off. P,FC TOTAL _? a1 1 sD i?-- ? CITY OF EAGAN ?Include 2 sets of plar.s, 1 site plan w/elevations & , - BUILDING PERMIT APPLICATION 1 set of energy calculations. Tb se Usea For valuation O b D Date Site Address: 4(na g j(JCS OFFICE USE ONLY Lot °?..? Block Sec./sub. Erect X._ occupancy Parcel #: V2)???jia lL, , A1ter 2oning r?'! Repair Fire Zone Owner: ? nda T Enlarge Type of Const. Nbve # Stories Address: ( ? 42 7?A, ? ? ?. Derrolish Front 5-3 ft. City/Zip C,ode:IEAj??a 45 S ,'a2 Grade Depth yy ft. Phone # s 4 ' s 2 ?j ?o APPROVAL.S F'E?S Contractor: 5Q1" E Address: City/Zip Code: Phone #: Arch./Fhg.. Address: Gity/Zip Code: Phone #: Assessments a-34? Perntit Water/Sewer Surcharye _14,00 Police Plan Check 6°7,13 Fire $AC ? as •pp Eng. Water Conn. 2)er!s <JO Planner Water Nleter Council Road Unit Bldg. Off. APC `PDTAL mmnesoca state tsoara ot tiectncity Griggs Midway Bldg. - Room N797 EB-40001-02 "Q'1 University Ave., St. Paul, Minn. 55104 - Phone 297-2117 ?EGUESV %E OW WOItKOCO ERED TAYICAL THIS EOUEST ION ?16 y 7 S 99346 Type of Building Ne Add. Rep. Ch¢ck Appliances W'v For Check Equipment Wired For Home ? ? Range Temporary Wiring ? Duplex ? ? Watei Heater Lighting Fixtuies ca t. Bldg. ? ? ? Dcyer ? Electric Heating ? mmercial Bldg. ? ? ? Fumace Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Fm az List List Other ? ? ? pehels? F? p He?ers? COMPUTE INSPECTION FEE BELOW Secvice Entrance Size: # Fee Feeders.@Subfeeders: # Fee Circuits: # Fce 0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres .(}? 101 to 20 to ]00 Amperes 31 to 100 Am eres ,6) Above 200 -r s bove 100 Amps. Above 100 Amps. TransForme Remote Control Circ. Partial oi other Fee v Si ns Special Ins ection mum fe Remazks ? TOTAL F .J7,.? r 3tl I, the Electrical Inspector, hereby ? ins tion has been ma (Rough-in) c t a e _ ? Date 4D (Final) ' ?- Date /' This request vaid 18 months from L,..27 ?6.3' ,?•?c? ? ?` `?= This request void ' ' ?L$J ? 18 months fro? _ Z4 `56 ? Date of this Request 30 60 Fire No. S 99346 1, a censed Electrical Contractor E3 Owner, do hereby request inspection of the above electri- cai nng installed at: ftet Address or Route No. `'f10r? 1 n??iVo? ity ?? ion Township Range County Which is occupied by Is a roughin inspection required on this job? No ? Yes P,, Ready Now ? Will Call,'K Power Supplier (_QQ Address Electrical Contractor. R?' ? Contractor's License ?.? (COmDany Name) ,,"( Mailing Address ? I I ?. L1.i(? cw,, ?l)(v?-?FlL4* Authorized or Ownar Makin9 This Installation) ` Phone No. (eiecvical Contractor or Ov:ner Making This Installation) ?? 0?? °p ?p?3D ?Op? This inspection request will not be accepted by the State Board uniess proper inspectian fee is enclosed. Trr#if irtttr uf (Orrupttnrli ,,_ Citp of (Eagan Urpttrtmrnt; nf +uild'mg Jns.prrtion Thir Ccrti f icau itcucd pursuant to tht requirtmenu o f Section 306 o f the Ur:i form Building Code cnti f ying thut at tlx trmt of itsuarut this strurtura wut in com plianu with tht variour ordinunccr o f the City rrgalruing building conn+rution or use. For the fnllouvng: Us Clamfiution i SF DWGiGAR BIdg.P«miiNo. 6252 Ottupani,y TYDe R'3 Type Cansuuclirn V Firt Zon 3 Zaning Districl Rl Centex Homes 4615 Beacon Hill Ct,Eagan Ow? ofBufldln8 4629 ingsbury Dr Addtta eacon i B ' .? d ?AA T.IIffI11V , , u _`6 BI oa «:- ?v A.YT 1N ? CANilICVW? ?V?G[ 12-18-80 LITM1OIY uS.A. CITY OF EAGAN 3795 Pilot Knob Road Eogan, MN 55122 PHONE: 454-8700 BUILDING PERMIT APPLICATION N? 6252 Receipt # +7?lez To be uaed for SF DWG/GAR Est. Value LF8,000 Dete 10-2 19$O-- Site Address 4629 Kingsbury Dr. E a c O R3 re c upancy _ lot 27 Block 3._ Sec/Sub. Beacon Hill Alter ? Zoning Rl Parcel # Repoir ? Fire Zone 3 Enlorge ? Type of Const. ?T ? Neme Centex Homes Move ? # Stories ; Address 4615 Beacon Hill Ct, pemolish ? Front 53 fr. ° Ea gan Mn 454-5236 Gmde ? DePth 1+1+ ft. C; , . Phone p Name ADProvals Fees 'r ?U Address ? r,r... Name _ Address I hereby acknowledge thct I hove reod this application and stote that the information is torrect ond agree to comply with all applicoble State of Minnesota Statutes ond City ot Eagon Ordinances. Signature of Permittee Assessm@iQ -9--3n-9n Water & Sew. Police Fire - Eng. - Planner _ Council _ Bldg. Off. APC - Permit l 35 . 5(1 _ Surcharge ?-_?0 Plon check h7 _ 75 SAC- 5P 5 nn Water Conn.3()5 - nn Water Meter 60 .,100_ Road Unit 152111 ' Toral 1,302.25 A Buiiding Permit is issued to: C2rit2X H071?eS Midwest on the express condition thot all work shall be done in occorda,n,ge with all ap Aiwb!p State of Minnesoto Statutes and City of Eagan Ordinances. Buildiry Official BUILDING PERMIT N? 8106 Receipt # 6a /S To 6a utsd for DECK Est. Value $1,200 Dote June 6 19 83 Site Address _ 4629 Kingsbury Drive Erect X$ Occuponcy Lot 27 Blxk 3 Sec/Sub. Beaeon Hill Alrer ? Zoning Parcel # 10 13500 270 03 ?c Name GeorQe A. Tako ? Address 4629 Kingsbury Drive r;? Eagan 55122 452-4728 ix Nnme Owner ,o ?? Address ~ Cit Phone Name FW _? Address 1 hereby ocknowledge 4hot I have reod this application and stote that the information is correct ond cgree to tomply with oll applitoble Sfate of Minnesota Statutes n Ciry of Eagan Ordi Otces. Signature of Pertnittee eorge A. Tako A Building Pertnit is issue to: all work shall be done in accordance with all oppliwbls..$tate of Mir CITY OF EAGAN 9795 Pilot Knob Road Eogon, MN 53721 PHONE: 454-8100 Repnir ? Fire Zone Enlurge p Type of Const. Move ? # Stories Demolish ? Length 25 Grode ? Depth 12 Sq. Ft.- Approvals Fees Assessment _ Woter & Sew, Police Fire Eng. Plonner ? Council _ Bldg. Off. _ APC Permit /u.7u Surchorge 1•00 Plan check SAC Water Conn. Woter Meter Rood Unit Totol $21.50 on tha express condition thni and City of Eagan Ordinances. Building Officiol ?. . -- PLA ,4 53,+ p t aE 612 421-17M SURVEYOR'S CERTIFICATE N89 °3e'3a-"W 110 ? ? Ml??j + 10d?' ?1 boo. ? 7 - ? L ?T Z gLOCK?3 ? o - ~ N o?b ?- C?,p 'IOAO?_? ?? _ P 1 IW ? l?? v --'- ? - .? ? °? 5 7,10 " 43.3?"?'? -1-._? ¢/ ?O 1? D ? Q1. I 30, . ? V ? >1 ? ? u ??Uenotes proposed finished grade O Denotes iron pipe C? Denotea wood hub ' Benchmark: Top hydrant betvaeen lots 16 &270 Blk. l, E].e .- 944,01 Garage Floor, 9(0(0.2 Top of Block Basement Floor I hereby cert3fy that thia 3e a true and correet representation oP Lot 27, Block 3, BEACOM HILIS, according to the recvzrled plat thereof, Dakota County, P'[3nneeota. Dated: January 23, 1980 LX*,,nu Revised to ahow the proposed house14 on Sept. 25, 1980. MINNESOTA REGtSTRATION Pf0.8828 CertiYicate 2'or: . Centex Homes Fiic3west Inc. , 8601 Darnell Road 'Eden Prairie, Mn. 55344 F DELMAR H. SCHWANZ LANOSURVEV0R RpVstuetl UnAer Laws of Tns State of Minnosole 2978 - MTH STREET W. - BOX M ROSEMOUNT, MINNEfiOTA 66068 ? ? - H :M I F 'T ( BcocK, ? ? j w 0 5I ? ? _ z? ^Q ^ ? . ? ??• Q ? . s'714 ? i 3! G S '?'' ?- tf? a ? 4a? ^IOAO_? l°, ? w Jy` -?p / ,Z '- 6 ? ?,`• ? -? ' ory. 8+ ' 2 .?. - 31.ZO ID O'o ?,. ? j ? v ? ? Z ?C scAc.E; ) ": ?enotea proposed finiehed grade ? O Denotes iron pipe ? Q Denotes wood hub Benchmark: Top hydrant between lots 16 &17, Blk. l, Ele 944,01 Garage Floor `7?(c?•2 Top of Block Basement Floor I hereby certify that thia is a true and correct representation oP Lot 27, Black 3, BEACON HILIS, according to the recozded plat thereoY, Dakota County, Mi.nnesota. Dated: January 23, 1980 LotATWN , Revised to shosv the proposed houselion 3ept. 25, 1980. k MINNESOTn REGaSTRATION N0.8825 8URVEYOR'S CERTIPICATE P-Ay 53¢ Pt NE 672 423-1789 N89?3B'3z? ?? , / - -------------- ? Foc Office Use - ? ? j Permit#: I ? i Permit Fee: ? ? Date Received: j ? I I Staff: I I `_ _J 2008 RESIDENTIAL BUILDING PERMIT QPPLICATION Tenant: RESIDENT/OWNER ? Name:}a?C? ?n,lLC? Phone: 1'c3?? s3lv Address / City ! Zip: `7 E Z_? ?uvy ,O r. lr4 5e?" N"t/ &42!:/ r? --;L Applicant is: Owner Contractor TYPE OF WORK Description of work: Ic l9,L rJ?°' ?t1/d A? ? uurP d6117- , - PJ Construction Cost: CC -u. $01J Multi-Family Building: (Yes _ I No? ? CONTRACTOR Y I t?yo`Z Name: h a?`S r-RAt[6&!? License #: 2(2>5 Address: Jz n r5.t eGC, S?= City: State: ?''U Zip: Phone: k5t-1?t?" 2c?? ? Contact Person: _3 ??ek COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitled In the fast 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _Plo 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 " vide'specific reasons that would perrnit the City to the information may 6e c(assified as`non-public if you pro conclude'that the are trade secrets: Date: ??v v v"_KSite Address: Iv2 l T?, t?(-s ? Suite #: 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 undersiand this is not a permif, 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 an . X_?L?II,J- T? C.w? ApplicanYs Printed Name li 's Sig t re Page 1 of 3 Use BLUE or BLACK Ink I-----------------~ 1 c+rJtfce Use I t Permit q7002 City R a~a~ j Permit Fee: 11 3830 Pilot Knob Road Eagan MN 55122 RECEIVED I Date Received: ~ Phone: (651) 675-5675 I 1 Staff. Fax: (651) 675-5694 JAN 2 0 2011 1 I INFLOW & INFILTRATION PERMIT APPLICATION _,)r Plumbing I Sewer & Water Date: Site Address: % ~O"Z/ ~/l/~f. yii2y .~12 Tenant: ~igU Suite 7~8 RESIDENT Name: 'j_j*VET .~Ce Phone: lS ~~iZ -Z/ J OWNER Address/ City/ Zip: v"291 ,~i✓ 9 2 Aof. License Name: /7/Cer7/ _3'7 Address: ' A So City: CONTRACTOR State: H~'/V Zip: J3S70,S'_ Phone: l lvYL Z ;7,Z5- Email: /vv.QTfti'_ !G Contact: C~ Contact: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other. Other: DESCRIPTION Description of work: ~~,r✓6/1C / FGcf ioo ,~iD FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or Cd'Y Hall at 3830 Pilot Knob Rd. 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.gooherstateonecall.oro 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 lL. 4!/ /✓~2~f Src- /°GrP6~f7c~i x Applicant's Printed Name Applicant's ign tune FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final Use BLUE or BLACK Ink For Office Ugel 1 I Permit#: City of Eayn 3830 Pilot Knob Road Permit Fee: - j Eagan MN 55122 I { I Phone: (651) 675-5675 I Date Received: b I Fax: (651) 675-5694 ~ Staff: I 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: b d Site Address: Wyl J~t,1~ /fin~9 J'~d16t'J6 (Yr~t~ °Xµ Tenant: Suite M Resident/Owner Name: 1L~ Phone: - OA V1 . Address / City / Zip: 6 /Z ~ Name: License Contractor Address: 14t City: &-rZE State° Zip: Phone: Contact: 'd d" Email: ls~ New Replacement Additional Alteration Demolition Type of Work Description of work: ~?L°1OX/>G)d frunA),qt2.- AtiaLUnn~ ~nlcr NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City i pd Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL 4' Furnace New Construction Interior Improvement Permit Type Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank C_ Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) _ w $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = TOTAL FEE COMMERCIAL FEES: $70.00 Underground tank installation/removal Contract Value $ x1% $55.00 Minimum Permit Fee *If the project valuation is over $1 million, please call for Surcharge 5.00 Surcharge* TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.ora 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 thew rk will be in accordance with the approved plan in the case of work which requires a review and approval of planes... X Applican 's Printed Name Applicant's Signature FOR OFFICE USE 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:Plumbing Permit Number:EA130108 Date Issued:04/06/2015 Permit Category:ePermit Site Address: 4629 Kingsbury Dr Lot:27 Block: 3 Addition: Beacon Hill PID:10-13500-03-270 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Applicant: Jennie Wood 5720 International Pkwy New Hope, MN 55428 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 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 - Janet K Tako 4629 Kingsbury Dr Eagan MN 55122 (651) 452-4728 Benjamin Franklin Plumbing 5720 International Parkway New Hope MN 55428 (612) 604-4285 X61 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK ink r________________1 I For Office Use I • � Permit#: ``-�'� � �t ��_ Cit of �� Permit Fee: �' � C� I Y � , 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Staff: � Fax: (651)675-5694 �_________________ 2015 SEWER AND WATER REPAIR / DISCONNECT PERMIT Date: � � �^ �� Fee: $65.00 S'�� City Sewer City Water � Repair Disconnect Description Of Work: ��L. �� a S/13S y41 �Ou�?�� ' ��od l(Z R�p�� r�;�7�1 Pt P�- #2�'�Q t R av� 1vJ � �L� �,o�� 1�� C.fI�� Street Address for Proposed Work Name: ��"'� ` �� Phone: Address/City/Zip: � �� lC r`'�'�'��U �� Applicant is: Owner `� Contractor Licensed Pipetayer � Master Plumber Property Owner Name: �M��i(�� U�� Phone: � �d ��o��s Address/City/Zip: �� /� J N�'� �� I�. �C�� Pipelayer Training Certification Card#: or Master Plumber License#: I acknowledge that the information is complete and accurate and that the work will be i� conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes. I understand this is not a permit, bu only an application for a permit, and work is not to start without a permit. J�� L'�i��,� Applicant(Print Name) ApplicanYs Si nature 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.goqherstateonecall.org PERMIT City of Eagan Permit Type:Building Permit Number:EA156005 Date Issued:06/12/2019 Permit Category:ePermit Site Address: 4629 Kingsbury Dr 1 Lot:27 Block: 3 Addition: Beacon Hill PID:10-13500-03-270 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Janet K Tako 4629 Kingsbury Dr Eagan MN 55122 (651) 452-4728 Viking Exteriors 901 N Concord St South St. Paul MN 55075 (651) 256-1061 Applicant/Permitee: Signature Issued By: Signature