4641 Kingsbury DrCITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 25 Bik 3 Parcel 10 13500 250 03
ow?e? screet _ 4641 Kingsbury Drive State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1982 1806.93 200.77 9 1806.93 C007566 10-1-81
STflEET RESTOR.
GRADING Y? 1982 526.46 58.50 9 • ?- -8
SAN SEW TRUNK 1976 135.97 9.06 15 90.67 A008956 3/18/80
* SEWERLATERAL 1982 3116.46 346.27 9 3116.46 C007566 10-1-81
WATERMAIN
* WATER LATERAL 1982 9
WATER AREA -54 1982 198.01 22.00 9 198.01 C00 566 10-1-8
* Stubs 1982 9
STORMSEW TRK UgZ. 1982 359.82 39.98 9 359.82 C007566 10-1-81
* STORM SEW LAT 1982 9
CURB & GUTTER
SIDEWALK
STAEET LIGHT
Road Unit 240.00 44 10-10-82
WATER CONN. 420.00
BUILDING PER.
SAC rt n
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE Ig
rtEcsrveo
FROM
AMOUNT $
& DOLLARS
10.
? CASH Fl CHECK
FOR
White-Payers Copy
Yellow-Posting CoPV
Pink-File Copy
Thank You
c:?1°a-' BY
MECHANICAL PERMIT
? ?45 L/
;
CITY OF EAGAN RECEIPT #
3830 PIL OT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address IIZIII Z• BLDG. TYPE WORK DESCRIPTION '
' Lot ? Block • ? ec/Sub Res
? New
;. > ° .
Name ,i /-1?er;1?,:_ , ?c:?. Mult Add-on
? Address !, r7 ) 1.t ? Comm. Repair
c City f; ?i%•: "? d Phone ?G '?76i/ Other
3
Name 9u ? `?? < < `j FEES
RES
HVAC 0
100 M BTU
$24
00 '
c Address y? yl le '"-kLJ .
-
-
.
ADDITIONAL 50 M BTU - 6.00
p City Phone y'`?? ? 7 (RES. HVAC INCLUDES A/C ON NEW ,
CONSTRUCTION)
GAS O
M
IM
M
PER PERMi
E
UTLETS (
IN
- 1
n _ 1.50
A.
U
TYPE OF WORK COMM/IND FEE - 1%OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES ?
Boiler M BtU`_
_
TQWNHOUSE R CONDOS - RES. RATE APPUES
MIFIftv1UNI RESIDENTtAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. J y M BTU 20.00
E SUFiCH RGE PER PERMIT - .50
Vent. CFM R (ADD $.50 S/C IF PERMIT PRICE GOES 1
Gas Piping Outlets # R BEYOND $1,000)
Other R
FEE:
?. ?
?
? S/C: SIG F ER E
TOTAL: ?
!
'
y
FOR: CITY OF EAGAN
7% ? o,????? G??,O
Reqeipt 7?? mit
?L? MECHANICAL PERMIT Per No.
' CITY OF EAGAN
II f?i F°a
Fill in numbered spaces S/C
Type or Prini legibly Tot. ?
]., ate 2. Installation Cost
-:::? -•
?
3. Job Address ? Lo Blk? Tra
4. Owner
5. Contractor Phone
6. Address ? 7 I
7. City State Zip
8. Building Type: Residential 'M Commercial ? Institutional ?
9. Work Description: New LEJ Add ? Alter ? Repair ?
10. Describe Fuel Type
11.
No.
I
? Eauipment 8TU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
_ Mfg. `?'h0.Iti5 r
an
ng:
Boilers ?-?? ?
?
_ ?
Mfg. ? Mech. Exhaust
Unit Heater pV 1)
_
_
9
-5 1 B3 1 ?
Mfg. 1 ?^-
Other
_
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work. .
Signed : _ for ? - --
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
Receipt PLUMBING PERMIT PermitNo.
• CITY OF EAGAN „
? Fes
fi!l in numbered speces S/C
Type or Print legibly Tot.
1. Oate-- 7.InstallationCost
3. Job Address :1?.1 Lot ;". Blk. ' Tract i-: , i r
4. Owner
5. Contractor Phone
' 'i•
6. Addressv
7. City Staie . Zip
8. Building Type: Residential E1. Commercial ? Institutional ?
s _
9. Work Description: New Q Add ? Alter O Repair ?
10. Describe
11.
No.
? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
_
T? Lavatory Softner
? Shower Well
? Kitchen Sink
Urinal/Bidet Other ? T :
Laundry Tray
? Floor Drains
Drinking Ftn.
Slop Sink
y Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and,codes governing this type of work.
Signed: -for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
r „
____.. ? ., .? .. _.. .. ? -?.
CITY OF EAGAN
3795 PIIaF Knob Road Engan, MN 55122
PHONE: 454-8100
BUILDING PERMIT
Receipt #
Te M aosd fer Est. Value t , 1+ ! Dat e 19
Site Addreu ' Erect
Q
Occupancy
Lot Block Sec/5ub. Aiter Q Zoning
Parcel # Repair p Fire Zone
Enlorpe ? Type of Const.
W Name Move ? # $rories
z
1%
Addross
Demolish
?
Length
p Nnme _
???
Address
? ?-?...
Name _
Address
Assessment -
Water 8 Sew.
Police
Fire
Enp.
Plonner
Council
Bldg. OtF.
APC
Fees
Permit
Surchorge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
I hereby acknowledge thot 1 have reod this application and state that
the in}ormotion is torrect ond ogree to comply with all nppiicable
Stute of Minnesota Statutes and City of Eagon Ordinances.
Signoture of Permittee
Total
A Building Pertnif Is issued to: on the express condiTion Ihai
all work sholl be done in accordonce with all opplicable State of Minnesota Stotutes ond City of Eagan Ordinances.
Building Officiat
/ .r
Parmit No. Permit Holder Misc. Permit No. Holder
Plumbing Ag6 /-ac-Gl,lcre- t'7'Y J
H.V.A.C. ?ja'Z?dc' ?on `'ro l?
ll-l0-e-z- C??oiNS
1z.-zt- fE
z
wau
w&cer
Disp.
Sawer ?
Eleetrie W o 54 ,6t> A c 0?14 ?
< - 3- 3
Inspection Data Insp. Othar
Footings
Foundation
Praming ? ?? .
Rouph Plbp. ..
Rouph HVAC
InwlMion
Final Plbg.
Final HVAC
Final
Water Dawibe Loeation:
YVell .
Sevuer
Pr. Oisp.
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Raad PERMIT NO.;
Eagan, MN 55122 pqTE;
Zoning: No. of Units:
c.., ,; . :_.r
Owner:
Co^:st:
Address:
Site Address: _ 1 "{•?$9auTV rt
Plumber: ir -2'
?_/10/•;.? ,`? :. .., r..
I oorea ro eanpy wie6 eha Ciry of Eagnn Connection Charge:
Ordinanps. Acwunt Deposit:
Permit Fee:
Surcharpe:
BY Misc. Charges:
Date of Insp.: TMaI:
InsP.: Date Poid:
CITY OF EAGAN
3795 P31ot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
ZO^'^9: No. of Units: '
OWR2f:
Address:
Site Addreu:
. , ? .
Plumber: '
MMer No.: Connection Chorge:
Size: Account Deposit;
Reader No.: Permit Fee:
1 agres M wmply witU tha Ciry of Eagan Surcharge:
Ordinoneas. Misc. Charges: '
Total:
BY Date Paid:
Date of Insp.: InSp,;
?? ?,??.? Include' Z ae?;ot plMs. ;
? sits plan w/olan?dt3ons C:
1 _! ??/r'
I? V1 w?r??j
APPI+IQ?TIH?1 ; , + ? `
HUIIDII?IC; PF*QT
?. i•• ?? `n +-? I ??'? , ?? d'o c? D1?l? ? ' ? ?-/•'' ?O? ` ?.
'lb Be tT9ed Fbr Vblttailon ? - :
Site Add1^ESS: 4641 KinaGburv USE CHLY
Lot 25 Blodc 3 Sec./5ub. B ac- 11 AErOct
l _?. zonim
Parcel #: !D l3 s? C) 21:50 o? _ Fire Zons
pApsir
. ,
Enlasge
-
QwtmL': Tos nh M1:2? C`nnc_t__ Tnr- #??'„?
Lrmrm* ?. '°?¦
?L^ef/S 1 R1 "3? (`crlar Avc ?•?•••?l•?? !SS•
cRrade ? ?
n v,yty/7ilP Cbde: F' r ? n r^rt r?ri 1?nhL ?; ?(17 il
? ?w #: 454-4753
aCbDr:
dL?288
Ad .
CitY/ZiP Code:
Phane #:
Arch./FYq . .
??.
CitY/Zip Docle: .?-? -
^ ^-
Phom w:
AssesMllNSl?
f•.
Wader/saw
Polioe Plan a?ck ' r 9 Y?; ;; :
Fire , g11C
water Qoc??. y ao -`?' ? ; :
Planner ilaber Mat$r ' ?^ '
Oouncil F"sd Unit --?
Bl.dq. Of .
APC
-
?
. ,.
?a
Tom
- --r-- . --
? ?.
?`?7,??y
; ?? ??
,
_ ????o? `?
minnesota btace noara or tiecmacy
Griggs Midway Bldg. - Room N191 EB-00001-02
1821 Llniversity Ave., St. Paul, Minn. 55104 - Phone 297-2711
CHECK BELOW ORK CO EREDTBY' THIS EOUEST'ON ? I S 99394
Type of Building New Add. Rep. Cheok Appliances Wired For Check Equipment Wired or
Home ? ? ? Range ? Tempotary Wiring
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electcic Heating ?
Commercial Bldg. ? ? ? Fumace ? Silo Unloadei ?
Industrial Bldg. ? ? ? Au Conditionec ? Bulk Milk Tank ?
Fazm ? ? ? List List
Other ? ? Rthexs?
eie Others?
Here
COMPUTE 1NSPECTION FEE BELOW
Sesvice Entrance Size: # Fee Feeders&Subfeeders: # Fee Ciccuits: # Fee
0 to 100 Am s. t 0 to 30 Am eres 0 to 30 Am eres
101 to 20 s. 1 to 100 Am res 31 to 100 Am eres
Above 20 a p bove 100 Amps. Above 100 Amps.
Transform - Remote Control Circ. Partial or other fee ?Iz
Signs Special Ins ction Minimum fee $5.00
Remarks
c-z-
TOTAL FEE .Z?
I, the Electricai Inspector, hereby certify that the abuve inspection has been made.
(Rough-in) ? Date
(Final) 'Date to - 7 ? This request void
18 months from
This request void , IB31 ot-co n- 4 k I ? ? 5
18 tnonths Erom;? ? ? 3 $''op ?
Date o this Request ?C) t3 ?? Fire No. S 9913 9.4
I, as I.icensed Electrical Contractor ? Owner, do hereby request inspection of the above etectri-
cal wiring installed at:
Street Address or Route No.
Section Township
Which is occupied by
4q? ?'1?l7SdJ? w City +-ow
Range County Dft-cm
Is a roughin inspection required on this job? N0P9::Z_Yes ? Ready NoV4_ Will Call ?
Power.Supplier ? Address i 1w't ?1NU??
Electrical Contractor FA!?- Contractor's License No?s'?
(COmpany Name)
Mailing Address ?? nw,m
. (E Aca ontract r or Owner Making This Installatfon)
Authorized Signature ? Phone No.
(Electrical C tractor or Owner Making Thls Instailatlon)
2?Q?? 0 00 6n R This impection request will not 6e axepted by the
State Board uniess proper inspection fee is endosed.
REQUEST FOR ELECTRICAL INSPECTION ?.
. ' See instructions for completing this form on back of yellaw copy.
w
'"X " Below Work?Covered by lhis Requesf 3-7;:.-7 ;7, S
N Adtl Rep. Type ot Builtling Appliancxs Wired Equipmen[ Wired
Home Range Tzmporary Service
Duplex Water Heater Lightin,y Fixtures
Api. Building Dryer Electric Heatin
Commercfal Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Oiner veMv O+her(5ucr.ify)
t r.r Specrty Other - Other
Compute inspection Fee Below
# Fee ServiceEntranceSize St Fea Feeders/Subfeeders 4 Fee Circuits
10 . OO 0 to 200 Am s 0 to 30 Am s 0 to 30 Am s
Above 200_qmits, 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 700_Am s Above 100_Amps
Transtormers Rrigation Booms /50 Partial-'Other Fee
Signs Speciallnspection
S ??
?
T
RernTrks AL FEE
?
//aC / 6 ,/- _ ' ( U Q? ti' `"
RDUgh-in . p ? Date
1, ectrical
Inspector, herpby
tif
lh
t
h
Final
Dflte cer
y
e
t
e a6ave
inspection has 6een
? 3 /-y mda.
o
TAIs request void 18 months irom
This request void
1? n(?s?,[ort1 480
O ;P4
L2 s i g 3 1 BEacov, 44i' (? 5:> . a
3aL S, CD
Request Uate
/J
? fire No. Rough-in Inspection
fiequiredl
?Ready Now?Will Notify, Inspeo-
? Q
^
/o^ ? - O? _D J+ ?1<es No ' tor When Ready
? Licensed Electrical Coniractor I here6y request inspection ot above*?
Owner electrical work installetl at:
Street Address, Box or Route yo. ? .
?ive
y6?/ /{`
' City
E'Q Qn
n sbu
?
ecuon o. Township Name or o. Ranfle No. Cou y
?Li M1a?Q
Occu ent (PRINT) .
l/
'/
o
? Phone Ne.
415V -&53
nvf_
i
?
? ? o n s
n
Powe Supplier
(o A P/a ??A ; c Addrets?s
TG1+--/H rA
Ele ontractor ( ompany Name) Contractor's LfVense No.
A t/6
Mailinp AAJress (Contr ctnr or Ownl Making In tailaTion)
? SS3
t
X
3
?
o
/w
,?
f.v „o
4
0390 SQi4
Authori d Signature ( ra or/Owner Makin InstallatioN Phone Number
, ?7?si3a v
7Tq STpTE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Iway Bldg. - Room N-791 gE ACCEPTED BY THE STATE BOARD
??.ity Ave., St. Peul, MN 55104 UNLESS PROPEH INSPECTION FEE IS
ENCLOSED.
C?nttft-ratr of Orrapttnry
Citp of (Eagan
Drpttrtmrnf u# lluildiscg 3nfiprrtimi
Thrr Certifican iuued purJrtaru to the reysdrementr of Scuion 306 of the Uni/orm Building
Codc artifying tbat at thc Jinu of irsuarar thir rtructuse war in com pliana with tbe variour
nrdiaanccl a f tht Ctty regulating bxilding ronttruction or un. For tht f ollowing;
?chadfiwrim SF DWG/GAR 7722
?? 7y? R 3 e?a& r??? r,a.
ryw Cm+uuctbn V Fin Zon. NA Zunina putrict R 1
o.oft,rama;,,Jos. Miller Const,,,,,a, 18133 Cedar Ave. Farmingt
4641 Kingsbury Dr. L?t?Lot 25,Block 3,Beacon Hill
lew_
By
January 27, 1983
na.:
?T IM A '(qMnryCUMt ?G
. LITFOIN V5.4.
CITY OF EAGAN
3795 Pllef Knob Rood Eegan, MN 55122 NO 7722
BUILDING
P
RM PHONH: 454-8100
E
IT Receipt
Te bs used for SF DWG/ GAR Est. Volue $52 ,000 Date 12-10 19$2-
Site Addreu 4641 Kin qsbuYy Dr Erect 0 Occupancy R3
Lor 25 Blxk 3 Sec/Sub. BeaCOn Hlll Alrer ? Zoning RI
Parcel # 1 D-] 3500 -250-03 Repolr ? Fire Zone NA
Enlarge ? Type of Const. V
W Name JOSeT?h M. Miller COriStri1Ct10I1 Move Q # Stories
z Address 18133 Cedar Ave
Demolish ? 44
Length
? Ci one 454-4753 Grade ? Depth 46 Sq. Ft.-
? Name Approrals Feea
?o
o
Address SHR1E
Assessment
?
V
~ Cif Phone Water g Sew.
u? Police
?W Name Fire
?? Address Eng.
<W Ci Phone Plunner
Countil
I hereby ockrwwledge that I have reod this application ond stote that gldg. Off. 12^10-82
the information is correct ond agree to comply with all opplicable
State of Minnesota $tatutes and City of Eogon Ordinances. APC
Signaturc of PermiMee
/1 Building Permit is issued to: _
all work sholl be done in accordonce
ol I
of Minnesota
Permit 289.00
Surchorge 26_00
Plan check 144 _ 50
sac 525_nn
Wafer Conn. 42n - nn
Woter Meter 60. 00
Rood Unit 240.00
roral 1,704.50
on the express condition thai
and City of Eagan Ordinances.
Building Officiol
'V r9/S-9 9?ao i
5 9 71
Request Date ^?
/ Fre No. Rough-in Inspection
Required? ???
L7?Fiaatly Now ? Will Notily Inspedor
? Yes (DJ1d" 'Nhen Ready?
I '
ensed contractor ? owner hereby request inspection ot above electrical work at:
Job Address (SVeet, Boz or Route No.)
76 ' City
Section No. Township Name or No. Range No. County
Ocaipanl (PRI ) Phone No,? / ?
?
Power Supplier Atltlress
Eiecirical Conhactor (C mpany N e) Cont2Mors Li nse No.
Mailing Address (Contrador or Owner Makin tallation)
? o :?7zxzI6'
Au[horized Signa[ure (ConVacto qwner Ma ' g Installationl!
' 1 ti? l? ' Phone Number
MINNESOTA STATE eOARD OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - poom 5173 8E ACCEPTEO BY THE ST.4TE BOARD
7821 UnNersNy AvB., SL Paul, MN $5104 UNLESS PROPER INSPECTION FEE IS
Phom (612) 642-0800 ENCLOSED.
?/i c? /C{?C REQUEST FOR ELECTRICAL INSPECTION
R EB
?? f`' ? See instmctions for completing ihis (orm on back of yellow copy. ? Q5 g 7.1 'X" Below Work Cavered by This Requ st .??-? A!15?
ew Add Rep. Type of Building AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heafer Electric Heating
Apc Building Dryer Other (Specify)
Comm.llndustrial Furnace
Farm r Conditioner
Other (specity) Contraclor's Remarks:
Compute Inspection Fee Be%w:
# Other Fee # ServiceEntrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 700 _ Amps
SIgnS Inspeclm's Use Only: TQ7pL
Irrigation 8ooms 70c- ?
Special Inspection
Alarm/Communication
Other Fee
I, the Electrical Inspector, hereby
tif Rough-in Date
cer
y that the above inspection has
been made. Fnal o.5
OFFICE USE ONLY
This request void 18 months irom
City of Eapn
? _ _ _ _ _ _ _ _ _ _ ' _ _ _ _ _
? Permit #: V ? 6
? Pertnit Fee:
? Date Rece
I ?I
I
I
? Staff: fill
L----- -
2008 RESIDENTIAL PLUMBING PERMIT APPLICAJD,ON
Date: _ ip- 11-C Site Address: _
Tenant:
Suite #:
RESIDENT 1 OWNER Name: so Phone: (?bk 20 ?
Address / City ( Zip: 'Son, L
CONTRACTOR Name: License#:_?_? A/\ ?
Champion
Address:
City: 3670 Dodd Rd. #100 State: Zip:
Phone: Contact Person: L5
TYPE OF WORK _ New v"?Repiacement _ Repai: Rebui!d Modify Spzce _ Work in R.O.W.
Descri fion of work:
PERMIT TYPE RESIDENTIAL
? Water Heater _ Water Softener
_ Lawn Irrigation _ Add Plumbing Fixtures
RPZ PVB) ? Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
;
?
$30.50 Lawn Irrigation (includes $.50 State Suroharge)
i
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
'Water Tumaround (add y136.00 if a 518" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this infortnatlon Is complete and accurate; that the work wfll be in conformance with the ordlnances and codes of the City of
Eagan; that I understand this is not a permit, but only an appiication 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 requfres a review and approval of plans. ,
x r Q x
App s Printed Namew ApplicanYs nature ,
7? 101 0
r::rrY Or- ErGr-,N
(;A`:i;i-I1:L•:"i. ::, IE:F:Ml:NAI_ NI:}c 764
,. ,_C:_. ?:: „• • Dr-?.; t.)..,/i.?1,_)?? r":CM? :?a 07233
.:I.E.
I I+ ;
ivAiiEt, h;`1f•;1:1Ou !-:?',','rL:F::l:t:)RS 1.L_f.
^::.;'_:LO 9001 4641 i.;`dt;S}'tR`{ itR 111o25
20=; 90I71 464i t'N(:;S,titftY 1?.r.t 2.50
. . i[!?:'.??.l. F?i?[i?=1?:?'?; Aftio?.tt'i'I; t; W.05
CR :I. CtSi3 O:.'.';";
USi`i,: 7:i7^ nflNr`v
?Y'. w , o?A ? ?• Vatrp..?f?? a:.r:J? n,d?,?,J..e..? a4•q"f" ?. tr.:
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
?O 659-681-4675
New Conshudion Reauirements Remodei/Reaalr Requlremenh
? 3 registered sRe surveys showing sq. ff. ot lot, sq. ff. of house 2 copies of plan
and all roofed areas (209o maximum lot coveraae allowedl 1 set of energy calculat(ons for heaied oddHions
? 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 sife survey for exterior addHions & decks
: 1 set of energy calculations
> 3 copies of tree preservatton plan if lot plafled atter 7/7/93
DATE: SIA IAQ CONSTRUCTION COST: ?FSSFS ;
DESCRIPTION OF WORK: TP..dir OaG 1'e.1'D* I'10USt' 4/ld TbYnn-e
STREET ADDRESS 4Vfa5bu 1-4 Dr
LOT: BLOCK: 3 SUBD./P.I.D. #:
Name:_ 2ende,N'?,Y?o TbM Phone #: bg6 - ?Qf
PROPERTY Last Firsl
OWNER
StreetAddress: irXnl'S V'u n?'"
City ?,?1 State:
Zip: 551aA
Company: Phone #: (gotA 090 "c3900
? Z(j6l9 ElSTt?:C;?OP,35 (area code)
CONTRACTOR 1333 Larc Industrial Blvd .? I',?,,,'
Street Address:irrS ,?i „ n r.n ? ?
)5337
License # 0q1 1?xp..y_?c,
...jTvnv
City
ARCHITECT/
ENGINEER Company:
Tu^'.!cNiiviic #. 31eY cVYC c
Street
City
Sewer 8, water licensed plumber (reauired for new construction onlv):
State: Zip:
Name:
Registration #:
State:
Zip:
Penalty applies when address change and lot change is requested once permff is issued.
I hereby acknowledge ihat I have read this application, state that ihe Information Is correct, and agree to comply with all appiicable
State of Minnesota Statufes and Cffy of Eagan Ordinances.
• Signature of Applicant:
Certificates of Survey Received
Tree Preservation Plan Received
OFFICE USE ONLY
Yes _ No
Yes _ No _ Not Required
RECEIVEL 1
MAY 13 1999 1
BY: I
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-piex ? 12 12-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE y,
? 31 New ? 35 Tenant Impr ? 39 Gas Line On ly ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (fnterior) ? 42 Reroof
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
nnr./ES S%?C
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation: $
% SAC
Certificate for:
Centex Homes Midwest Inc.
8601 Darnell Road P,?N 9ooa1
' Eden Prairie, M. 55344
Survey for:
Joe`"Miller Const., Ihc.
18133 Cedar Ave, s. QELMAR H. SCHWANZ
Farmington, MT1. LANDSURVEYORB Tt1C.
. . . 55,124 Re9isNud UnOa Laws of Tbe StaN of Minnefob .
2978 - 146TH STREET W. - BOX M ROS@MqUNT, MINNESOTA 86088 PNONE 812433-178Y
SURVEYOR'S CERTIFICAT@
.? DeNOTFv$ T.2oPbS?Q F?u,sN Geao? !
°J43,0 DEuore.s Fa1sr1.3G FLek]Rnor*A
? (?EUOTES D12F-Gx'10?1 o?'?URFacE ??*?J?E
it/ ' n O£NOZiats Wooo Aue (aoo Tncarc
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Scale.-l1 mc=30
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Opp*
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qb3,5 Proposed Garage Floor3s ?
Elevation
,90,)? ?POS!"iQ TPP PJI.oC?'C FiIJEJPT?D??
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Also Showing the propoaed location of a house not staked thereott.
I hereby certify that this is a'true and correct representation of
Lat 25, Block 3, BEACON HILI$, according to the recorded plat thereof,
Dakota County, Minneaota.
Dated': January 23, 1980
Revised to sriow houae November 2, 1482;
Cities Diaital
ity Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
I ..1?
• LXTLRIOR ENVIiI,OPF nV f??G?_'-U" COM('l,'TATION _
! _- ...' "" ? ? • ?{ , y. d/,??/??? .
or?,rL 11%4/82
1} ? ` • . ---
IJoseph A•1 Mi.ller Const. . lnc. • y
454-4753
'??5: 4641 Kings]?.iry ? PII[?iS: .---
?
-?-:-- . '?
{. •I DetermInc worki i,g squarc [ootayc of each
. , sq. ft. x .17
? 1: Total cxposed wall urea:.....
' ?, i.05 a
?
2. Taal roo!/coilitg area ...... sq. ft. x
., Tbtul oxE:osed wall area above floor ' . ......
' k U. 1bt31 w?111 MiJ1QOw RrC?] ........................ .. .
^otal ctoar nraa ....................................... .?,
' i
,.?.'h.
.............
.
c. :btal slidityj ql.:e-s tloos area ............
.. _? ?
d. 7'otil fireple'ce wAli arca .......................... . ;?
•. Total wall lrasing area (averagc 10^.) ............... ..• ? 3?
........
f. 1bta41 rim joist area ....... .............. ..... ? I
above flour. .... . .... '."
.4• ...?- wsl? e?zes .... ".....
wa]. area above floor..........
aall area pbave floor .........: ............
...........
...........•.
' .rall area above floor.. •...... i
^Potxl expoaed fouudaCioli area
..... ?
k. ',btal fv,»:dation vindov brea ......................
..
1. Total net.f.oundation area above gra<!e ...............
petermine "L"' valuc of each watlrecimenti
(Q.g. window, door, ?! ac,? separat,? a?all ection
a. X
.
_ -20-oL-.._
x „u.. -7A?4--
C. a
X
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-
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x
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_
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-------
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-- - - ----- - - -- ----- __
x „u„
k• X ?Su,: ,?---• - _'`'.
e.u„ 41
I
?
I
if itcin 03 i thc same a::.
or less than?itcm +1% Y011
iw%rn, mrt 0141 13.I1L'cnl'
:?1tC GGOri (C) 12.
1
I
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`? • 1. Twt,erior •ir lilA ,
?t t1ov;? - • ? '
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'Inside atY t 1 ? ig.61
,t
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?? y - ? ? ?? ? /. .• ?I?Y?^
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? : . . • ..-?: ,;• tal
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. : ?.r:•?•:•'•?'?? s? Outside air film ,
•"? ?? • ? . I ••. i . ;
• ' , :. . • !? ? I e;
. • • .
. ,
? ' • r ? '. .? • : ?' ? • ' ' ? i.
•' :• •• .' saaitionai sheetf i! nw Paco
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#? tor ? ians.
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. •
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.
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Q
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2
iW.
3, tnches soft, canoA '
9s. SH?AT4?«G Z.?Z
a.
5. SI??NG . o.l?
6, Exterior air film
_ Total 8•33
.V-.12
1.
s.
3.
4.
6.
interior sir film Q•69
? , t. P ?` • ?
L c ____-?2G
p it
ExteriS'oi aiz film
Total ? , °) B
. us'O7
' 0.6R
• 1, Wnterio-r air Eilm 0
2. .q
?- . !.
4
. .
5. 1IQ111G 0.17
6. Exterior air fiin+ ??al '` •42
U.s .a60
0.68
Tnterior air film
2. .
• 4. O L I.CG
.__..
5. 0.17
•. g. Exterior air film Total • 2,13
y
.r •e or, ?a?U??? '
• . ? ?
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n a .. • •fL ?
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NpTE: Indicste ty}?e. value, depth and. _
• placeMent of insulation. ' •
I+lh L' M? (? 19 11
RESIDENTIAL BUII.DING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
3 oaaY
New Canstniction Reauirements RemodeVReoair Reauirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot sq. ft oi house; and all rooTed areas 2 copies of plan Cert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ 7ree Pres Plan Recd
2 capies o( plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - irMicate if on-site septic system - On-site Septic System
3 copies of Tree Preservation Plan if lot platted aker 711193
Rim Joist Defail Options selection sheet (bldgs with 3 or less uniLs
Date Construction Cost
s?te aaaress Y?'n9??bwq-,1 brAv?e? uniusce #
Description of Work
1ViuIG-Family Bidg _ XV N Fireplace(s) 0 _ 1 _ 2
Property Owner?? {}?? Telephone #(?5i ) L4(6.¢
Contractor RENEWAL BY ANDE12SE1V
Address 1920 COUNTY ROAD °`C°° WEST
City
- ?20SEVLLLE, MN 551 Z3
State 551-264-4777 _ Telephone # ( )
LICENSE #20130983
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted
Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
• Energy Envelope Calculatioras•???'Su "'i
C?3 !nflq n ? i Telephone #(
N ? I iTelephone # (
Telephone # (
I hereby apply for a Residential Building Pernut 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 far 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
approyo1 of plans. , I _
pplicant's Printed Name Ap'pricant's Signature
.. ,s
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 76-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-ptex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alterafion ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bl dg) - Give PCA handout to applicant
Valuation Qccupancy MClES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ P}umbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fraxning _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
••••. We. &v114 tuv ta.oV CtSa IOJ D/1 '44d0 RCIVN.ITAL !il°BlVUfSiG7lSlY re .al . ?.?,?. . . .. . .
. . ?:
. Juno'7, 2001 - (laY of Bagan -
3836 Pitcrt gnob Road Egan+ MN 55-122
To Whom It May eonoern: .
Elder 7ones is 11112¢d to puII building permits for Renewal 8y Andezsm Piease xliow
Elder Joncs to pmvide this seriricc for us in Ba&an. 7t,ia WMho?ac;on Ig ?,. ?.,y
date bcyvud 6/6/0Z: untid a?awa1 bY And?rsen m?a= e?p?y „?;a
to the City- revokes it tn wiicing
I request this authoiization be accepted-exped;douely. av to not dela chn '
ovr building Pctmits anY fu?tcr. Plcaac cali mc If thcrc at+c Y• m proacssisig of
contacted at 763-502,4706_ ?Y ?Eona. , I caa bn
, . _ ?Your immqdiatc wention to this inatter is a?ecierg& 9 Sincciely,
ymvnd'I2. Rau
tistallation Manwr
Rcnowal by AndErscn Corporation
('.c.: Karn-Flc}Pr innee
G- ?
aH p
?P eno??-
"M?y
???
,
,
.
WelU7
Received Tiroe Jun. 1. 1:01pM
?j 112, V RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?
?ZIs? zs_
New ConsWcGon Reauirements RemodeVReoair Reauirements ORice Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft o1 house; and ali roofed areas 2 copies of plan Cert of Survey Recd Y_ N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Reqd Y_ N
1 set of Energy Calculafions Add'Rion - indicate if onsffe sepfic system On-site Septic System _ Y_ N
3 copies of Tree Preservation Plan i( lot platted after 711193
Rim Joist Detail Options selection sheet (61dgs with 3 or less unils
0
3
A `
-
Date /
/ Constructio n Cost
Site Address Unit/Ste #
C
Description of Wark -?L
Multi-Family Bldg _ Y_ N ireplace(s) _ 0 _ 1 _ 2
Property Owner ? Telephone # (&/ 4/0, ?
Contractor
Address ? City
State Zip ? Telephone # ( .%.j) rdc?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category e Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously e:onstructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Wpter Contractor
Telephone # (
Telephone # (
Telephone # (
N If so, 25% plan review
?
SP 3
}by-. -_::___-
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 work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
7221
s
Applicant's Printed Name Applicant s Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New • ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy iv1ClES Sysiem
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Foofings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building inspector
611798
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
J5_Sc?
Date?lO
Site Street Address ° lp ZI Unit #
Property Owner b Telephone #(&5? C92S ?'/`t?l
Contractor . - ? S Telephone # ?`?V
Address ? V City StateINn, Zip cSS I?
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other: $ 50.00
_ Water Softener A Water Heater
!-
? replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total $ 15 5c)
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan i % required t? be reviewed and approved. `
T
ApplicanYs Printed Applicant's Signature
I ? JUN 14 2004
, I PorOffeeU/se /; ----I
C1tOf SJURUfi Permit #:
? I Pertiut Fee:
3830 Pilot Knob Road NOV 0 D 3 2008 ' ?
Eagan MN 55122 ? Date Received: i
Phor.e: (651) 675-5675
Fax: (n51; 675-5694 I Staff:
L ---------------°?
2008 RESIDENTiAL PLUMBING PERMIT APPLICATION
e
Sit
Add
: 4'E'`1 ? ?? N`buf? a'
e
r
ss
inant: Suite #:
?
ESIDENT I OWNER Name: T
? homcs 1-4erv?.o
Phone:
?son
Address / City ! Zip:
License #:
CONTRACTOR Name:
ampion
Address: 651-365-1340
3670 DodJ Rd. #100
Ctty: Fqq32,11fiN 55993-1 33Q State: Zip:
Phone: Contact Person:
TYPE OF WORK _ New V Replace ent J Repair Rebuild Modify Space _ Work in R.O.VU.
Description of work:
- -r ---- ---- -
- - -
PEF2MlT TYPE RESIDENTIAL .
` /
V vvater Softener
Water hleater
Lawn lrrigation Add Plumbing Fixtures
_
RPZ PVB) N{ain _ Lotiver Levei)
Septic System
? _ Water Turnaround
New
Abandonment
=SIDEIV7"tAL FcES:
iC.50 Minimum Water Neater, Water Softener, or Water Heater and Softener (includes $.50 State Suroharge)
;?.50 Lawn frriaaiion (includes $.50 Siate Surcharge)
iO.SQ P,cio F'iumbing Fixtures, 5eotic System Abandonmeni, VVater Turnaround` (includes $.50 State Suroharge)
`L'Jate; ?urnaround (add $136.00 if a 5/8" meter is required)
00.50 5eptic System New ($10A0 per as built) (includes County fee and $.50 State Surcharye)
=0.50 Fire Repair (replace burned ou: appliances, ductwork, etc_) (includes $.50 State Surcharge) ?
TOTAL FEES
.•reby ad<rowlea3e that this informalion is complete and accurete; that the work will be in conformance with the ordinances and codes of the Ciry of
-an; tho-:t I ur,dersiand this is not a permit, but only an applicalion for a permif, and work is nol to start without a permit: tha[ the work will be in
,orelance 4^r.t!: +.he upnroved plan in the case of work which requires a review and approval of plans. .
X
;Tdiicani's P;i:,ted Name Applicant`s nature -
iti OF:=iGE USE
?uired ins?ecfians : Urider G
?
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4641 Kingsbury Dr
Lot: 25 Block: 3 Addition: Beacon Hill
PID:10- 13500- 250 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House
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:
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391 -5514
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Thomas D Henderson
4641 Kingsbury Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Issued By: Signature
Building
EA084892
08/04/2008
ePermit
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
,
Use BLUE or BLACK Ink
For Office Use 1i L PI
4* Cit If of Eapll Permit#: /41c= 6 6 I -11
Permit Fee: c90 - 041 Vs'
Pilot Knob Road ')
Eagan MN 55122 Date Received:
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I
Phone:(651)675-5675
Fax:(651)675-5694 Staff: 7
. L
017 RESIDENTIAL BUILDING PERMIT #:
�pAPPLICATION /1;
/
Date: 4 2,11 ` (
Site Address: J 01 I 4K•I N�.� - �/lV51 -
Name: --13/
� lln IZ4`Q .I Phone: 6c1-qQJ 41
10 i
Resident/
I
Owner Address/City/Zip: '16`f g I Nbs Bogy 1Z-ii -
Applicant is: Owner *X Contractor
Type of Work Description of work: 1•16--1)•) ...r). CiK- ] yiOVe- 014 rg
Construction Cost: 2-0 C Multi-Family Building:(Yes /No
Company: • i Tetnt , ^'t
y&4.MO 1L Contact: ?/u...
Address:Z? o ( �� 1A146 City:
V
Contractor
State:Mf3 Zip: i 7 Phone: 615a,.SL41 'rnail: T kt,kd ell l b i ua top'tc
License#: C_tp,'J I Lead Certificate#: ` J
� Zo 0(0'
If the project is exempt from lead certification, please explain why:
f9
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 may be classified as non-public if you provide specific reasons thatwrrurld permit the City to
conclude that they are tirade 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.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance. •
x 031 yam Oiam / 1x J I ---.de
dill.
A6L�
Applicant's Printed Name Applica r `si:"ature
Page 1 of 3
. .
9( ,
jib tit 4/(Istufe.v DO NOT WRITE BELOW THIS LINE
1 a� �o
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi (0 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 • "
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 Jir S1�• — Occupancy SQL–1 MCES System
Plan Review Code Edition WI in 7..42.1c SAC Units
(25%_100% 10) Zoning , P P City Water
Census Code StoriesBooster Pump
#of Units Square Feet PRV
#of Buildings Length. ,Fire Suppression Required
Type of Construction W Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size: . . ,
r. Footings(Deck) Final/C.O.Required
Footings(Addition) )' Final/No C.O. Required
Foundation Foundation Before Backfill 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_EFIS
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: I 0 JvL INV.'-( y# , Building Inspector
RESIDENTIAL FEES 2 ." ' X ge .
Base Fee
Surcharge In e 1✓p e 5 �`7-n; t).4'1
Plan Review
MCES SAC `-QAC, � ' 59 . i
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Certificate for: X/677/P6/2-Se)(1/7 / 7 --;. .°
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Centex Homes Midwest Inc. , e
8f,01 Darnell Road "R.At.i 90o'zA
Eden Prairie, Mn. 55344
Survey for: Apil
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Joe-Miller Const., Ihc.
18133 Cedar Ave. S. DELMAR H. SCHWANZ qt,qiin6). bte-iy ill,
Farmington, Mn. LAND 5uRvEY01121 Inc. •
55024 Registered Under Laws of TM SUM of Minnesota
• 27S-111TH STREET W.-SOX M ROSEMOUNT,MINNESOTA MOSS PROM 112422-17n
OLONSIZ SURVEYOR'S CERTIFICATE
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01(03.1 Proposed Garage Floor
Elevation • . .
. : 963.4 '9er,Pos iffrO, 1-op latt.acoit, E-Losopertor4 .14i
1&al PEoPo4R4> ''' II.Sq witoKa-r Vueoe- /
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Also Showing the proposed location or a house not staked thereon.
I hereby certify that this is a' true and correct representation or
• Lot 25, Block 3, BEACON HILLS., according to the recorded plat thereof,
Dakota. County, Minnesota.
Dated: January 23, 1980 •
Revised to show house November 2, 1982; •.
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MINNESOTA REDISTRATION NO.8625