4653 Kingsbury DrCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
D A T E 19 RECEIVED
FN ?
AMOUNT $ 1
& DOLLAR4
+eo
? CASH ? CHECK
FOR
4452
White-Payera Copy
Vellow-Posting Copy
Pink-File Copy
Thank You
ce?- , ev
CITY OF EAGAN Remarks
AdditionflEArnnr HTT T ADDTTTON Lot 23 Bik 3 Parcel 10 13500 230 03
owne.UYE'c%` k screec 4653 Kingsbury Drive Stace Eagan, hIlV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1982 1806.93 200.77 9 1806.93 C007564 10-1-81
STREET RESTOR.
GRADING 1982 526,46 58.50 9 • 0- -81
SAN SEW TRUNK 90.67 A008956 3 18 80
* SEWERLATERAL g 1982 3116.46 346.27 9 3116.46 C007564 10-1-81
* WATER LATERAL 192$ 9
WATER AREA n`3' 1982 198.01 22.00 9 198.01 C007564 10-1-81
* Stubs 1982 9
STORMSEW TRK 1982 359.82 39.98 9 359.82 C007564 10-1-81
* STORMSEWLAT 1982 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sac 525.00 21196 10/2/80
PARK
? • - CITY OF EAGAN ?
3795 Pflet Koob Roed Eagen, MN 55142
PHONE: 451•8100
BUILDING PERMIT Receipt
Te 6o wed fer 7I:CK EsF_ Velue $700• D0 Dere E1t1(?uSt 9 19 33
Site Address ?UJJ au1&?5avu,.y uLivC
Lot 23 BI«k 3 See/5ub Beacon :iill
Parcel # 10 13500 230 03
s Name .?,f, --. .,Y....,...
? Address 4553 i:ingabury Drive
,,, :.anan 55122 ? 52--4781
c
ZO
Ot
u?
Nome _
Address
Erect Iff Octuponq
Alter ? Zoning
Repoir ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stor'e?s
Demolish ? Length
D
Grode ? epth Sq. Ft.-
Aov?oruls Faes
Assessment
Water 8 Sew.
Polica
Fire
Enp.
Plonner
Council
Permit 1J.JV
Surchorge • S0
Plan check
SAC
Water Conn.
Water Meter
Rood Unit
I hereby ockrrowledge that I have read this opplicotion and state that gldgOff.
Ihe inlormotion is correct ond ogree to comply with all applicable ? a.State of Minnewra Srotutes and City of Eagan Q inances. APC Total
Sipnoturc of Permittee?`
A Building Permit is issued to: on the express condition Ihm
all work sholl be done in occordonce with all opplicable State of Minnesoto Statutes and City oF Ea9an Ordinances.
Buildirq Officiol ^
Permit No. Permit Holder Miu. Parmit No. Holder
Plumbinq
H.V.A.C.
Wall
Weter '
Disp. .
Savuer
Eleetric
Inspection Date Insp. Other
Footinps Jj
Foundation Frsminp
pouph P16p.
Rough HVAC
Inwlation
Final Plbg.
Final HVAC
Final
Weter Dexrihe Location:
YVell ,
Sawer
Pa D'np.
• - CITY OF EAGAN
3795 Pilot Kno6 Road Eagan, MN 55122 N2 6251
PHONE: 454-8100
BUILDING PERMIT Receipt #
To Mwtsd for Est. Value Date 19-
Site Address Erect 0 Occupancy
Lot Blxk Sec/Sub Alter ? Zoning
.
l Repair ? Fire Zone
pafGe1 #
E
l f Const
T
n
arge ? .
ype o
rc
W Nome ° - Move 0 # Srories
Z
3 Address Demolish 0 Front ft.
?
Ci
Phone Grade ? Depth ft.
? Approvals Feea
o Name - : - -
?
?? Address
? riw oti,...e
Name _
Address
I hereby ocknowledge that I have read this application and state that
the iniormotion is correct and ogree to comply with all applicobie
State of MinnesoM Srotutes ond City ot Eogan Ordinances.
AssessmeM - Permit
Water & Sew. Surcharge
Police Plan check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC Total
Signature of Pertnittee I
A Building Permit is issued to: on the express condition thot
oll work sholl be done in accordance with all applicable State of Minnesoto Stotutes ond City of Eagan Ordinonces.
Building Official
iaoM # CaM I?ed P?lefM
Plumbing
Mechanical
INSPECTIONS DATE INSP.
RouQh-In
Finol
Footings Q'.,7, p Date Insp. Dute Insp.
Foundotion Plumbing - I
Frame/ins. /- 7-bt. /A r/U -70 Mechanical yb-JD
Final
Remorks:
I No.
2166
CITY OF EAGAN
3795 Pi1M Knob Read
Eagan, Minnesota 55122
Phorre: 454-8100
PERMIT
Dote:
, ?,
Site Address: r
Lot Block Sub/Sec. ''et1C0T!
Name Centex FTOmea l?u.dlaest
• ; 1ri
`
e Address
? City Phone: Name ''fly "elter rie?.ti:?;r
.
g Address
C
O
v City Phone:
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
?9
Receipt No.:
Single
Residentiol "
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installotion
Permit Fee
Surcharge
Tota i
rLer.
,
This Permit is issued on the express condition thot oll work shall be done in occordance with oll appliaoble Stote of
Minnemta Statutes and City of Eogan Ordinances.
Building Officiol
No.
CITY OF EAGAN
3795 PiIM Knob Raad
Ea9an, Minnewta 55122
Phone: 454-8100
PERMIT
Date:
Site Address:
Lot Block Sub/Sec.
INSPECTOR NOTIFICATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
Single I
Residential
Multi Res., Comm./Ind.
Name r"c-ntE% HOIIl@9
New/Altec/Repoir
0 2A1r
3 Address - Cost of Installation
O
City `l+ Phone: ? ' - . .., Permit Fee ,. ..
Name ,•'•- -
? Surcharge
?, _
? Address ? 7
? ' -` -
e
u
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesoto Stotutes and Cihy of Eogan Ordinances.
Building Official
CETY OF EAGAN
3795 Pilor Knob Road
Eagan, MN 55122
Zoning:
Owner:
Address:
Site Address: -
PI umber:
I agree Yo oomply with the Cify of Eagan
Ordinances.
By
Date of Insp.:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Insp.: Date Paid:
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122
Zoning:
Owner:
Address:
0
Site Address:
Pfumber:
Meter No.:
°'--• -
SE1r+fER SeKV?.:? PcRiv?..
PERMIT NO.:
DATE:
_ No. of Units:
Reader No.:
I agree to eomply wit6 the City oF Eagan
Ordinances.
WATER SERVICE PERMI i -
PERMIT NO.: ?
DATE:
No. of Units:
Connection Charge: ?
i
Account Deposit: - ?
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Dete Paid:
?Y
Date of Insp.:
?oo S?, ? CITY OF EAC?,v lInclude 2 sets of p1.3rs,
`? 1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set of eriergy calculations.
Tb Be vsed For ;Sos- W'??,? (? valuation ?ro, b 00 Date g 2`? /8n
site Aadress: 3 ? iJ ?5 p,v T?2 . oFFzCE vsE oru,Y
Lot ? B1ocJs ?j Sec./Sub. Erect ?_ Occupancy
Parcel #:
awner:
Address:
i
City/Zip Code:
Phone #: -454- ? a -jss
F'
ContractAr: '2
,?N 1A IE
Address:
City/Zip Code:
Phone #:
Arch./Eng..
Address:
City/Zip Code:
Phone #:
Alter Zoning /
- Repair Fire Zone ?
Enlarge 7ype of Const.
Move # Stories
, Demolish Front ?f ft.
Grade Depth y ft.
APPROVALS FEE,g
Assessments . . ? Permit ? v's AST`
Water/Sewer 5urcharqe
Police Plan Check
Fire SAC 11 , fj
Eng. Water Conn. ,Q (
Planner Water.Meter
Council Road Unit d?
Bldg. Off.
APC
TOTAL 1 a,(09,25
CITy pF EAGAN . Include 2 sets of plans,
1 site p1an w/elevations &
BUILDING PERMIT PLICATION 1 set of energy calculations.
Zb Be Used For Valuation -*tk - -t Date
Site Address I1f S-z, ?, n,?t??ru O r? ?? V--
Lot 23 Blocx ? sec.isub. BEa&n. ?l C t I
Parcel #: l C) ( 3 S O (.D A3t) Oa
Owner : G??-caCa '(Yl ? P A w? O?
Address: -A„os c-"')r.+ Qt' .
City/Zip Code:
Phone # : -i-c; ?. - ?t ?? 5? ?
Contractor: ??,? ?1 Q ''(-
Address:
City/Zip Code:
Phone #:
Arch./Fhg..
Address:
City/Zip Code:
Phone #:
OFFICE USE-ONLY
Erect +!\
? Occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
Move # Stories
Demolish Front l ft.
Grade Depth Y? ft.
APPROVALS FEES
Assessments Perrnit ?
[aater/SeHrer Surcharge ,
Police Plan Check
Fire SAC
Enq, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TO'i'AL
BUILDING PERMIT
N° 8366
Reteipt # 'i, 7,9 7?-
To ba uaed ior DECK Est. Volue $700.00 Dote August 9 i9- 81
Site Address 4653 KinQSbury Drive Erect g][ Occuponcy
Lot 23 Blotk 3 $ec/Sub. Beacon Hill Alter ? Zoning
parcei # 10 13500 230 03
W IName Gregg M. Spandl
Z Address 4653 Kingsbury Drive
9 r;, Eagan 55122 0,,,,„e 452-4781
p Nome OWner
?
?? Address
~ Cit Phone
?
Ww Name
?
_? Addreu
1 hereby acknowledge that I have read this opplication and state that
the iniormotion is correct and agree to tompty with all applicoble
State of Minnewto Statutes ond City of Eogan Or 'nances.
Signoture of Permittee
lT?r? rTd- pan
CIT1f OF EAGAN
9795 Pilet Knob Roed Eagon, MN 55122
PHONfl: 454-8100
Repair Q Fire Zone
Enlarge ? Type of Const. .
Move ? # Stories
Demolish ? Lengthl$
6rade ? Depth LO Sq. Ft.-
ADprorals Feet
Assessment
Water & Sew.
Police
Fire
Eng.
Plcnner
Council
Bidg. Off.
APC
Permit 13.UV
Surchorge .50
Plan check
SAC
Water Conn.
Water Meter
Rood Unit
ToTal
A Building Permit is issued to: on the express wndition thai
oIl work sholl be done in accordonce with oll oppli le State of Mi/n9/?soto Stotutes and City of Eagan Ordinances.
Building Officiol
?L?"
mmnesoca scaie noara oT tiaccncicy
Griggs Midway Bldg. - Room N191 EB-00001-02
`; t821 41Diversity Ave., St. Paul, Minn. 55104 - Phone 297-2111 ? 0
' KEQUEST FOR ELECTRICAL INSPECTION
-CHECK BELOW WORK COVERED BY THIS REQUEST s 99348
Type ot Building New Add. Rep. Ch¢ck Appliances Wired Fo[ Check Equipmeni Wired For
Home ? ? Range ? Temporazy Wiring ?
Duplex ? ? ? Water Heatet ? Lighting Fixmtes
t. Bldg. ? ? ? Dryer Electric Heating ?
mmercial Bldg. ? ? ? Furnace ? Silo Unloader ?
Industrial Bldg. ? ? ? Au Conditioner ? Sulk Milk Tank ?
Fazm ? ? ? List List
Other ? ? ? p
Heiers?
) Heers?
COMPUTE INSPECTION FEE BF.LOW
Service Entrance Size: # Fee Feeders.@ Subfeeders: # Fee Cirwits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Ampeies 31 to 100 Am ies
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers ote Control Circ. Partial or other fee
Signs S ciai Inspection Minimum fee.00
Remarks '' TOTAL FE 3 ?
peion has been ma?"e:
1, the Electrical lnspector, hereby certify that th3?-?ove ma
(Rough-in) i Dat,?.
(Final)
This request void
18 months from
This.request void ?
18 months from
Date oflhis Request Fire No. 99348
I, asU;f:Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electd-
cal wiring installed at:
Oet
Address or Route No. q?053 ?SB0I`y Dp- City ' ?
ion Township Range County IJkK64
Which is occupied by ?1v 1? ?S
(Name ot Occupant)
Is a roughin inspection required on this job? No ? YeCR?_ Ready Now ? Will CallO
PowerSupplier PEA Address FroP+vIwA-qv
Electrical Contractor 6,6CI?F -CL, Contractor's License 43-I&E
(COmpany Name)
Mailing Address E. fF Po" DLPV5YIt4!'r
(Elec r cal ontra or or Owner Making This Instaliatlon)
Authorized Signature Phone No. `?AW
(Eleetrica on aetor or Owner Making Thls Installatlon)
r' This inspection request will not be accepted by the
? ???
? ?? ?V ki? State Board unless proper inspection fee is endosed.
r , 4
C?rrtif iratr of Orrupttnry
Citp of (Eagan
De.pttr#menf uf iguilbing 3ns#redirnt
Tbi.c CertitlCUt[ 1lfutd Purtltaftt t0 the ft[(uirnnaiL3 o f Sertion 306 0/ the Uniform Building
Codt certifying that at the time of itsttance this structure wat in canplianre with the variour
ordinancts o f the City regulating bailding wnttrrution ar ttsc. Far the f olloruing:
uN chmsc.hm SF DKr,/GAR elag. eemiit Ho. 6251
Oewpaory Typc R3 Typ CaatUUCtiw V Firz 7 e_ 3 Zo" D"uMtt Rl.
o.W oredams Cente]c Ha'1es Aaama 4615 Be,acon Hill Ct,F,
Badlall M" 4653 Kingsbury Dr. LocaRtY L23,B3, Beacon Hill
By 2-19-81
? pte:
qi IN A Cd11PICYOYM RACI
LIi401M 11 .S.P.
CITY OF EAGAN
3795 Pilot Kno6 Road Eagen, MN 55122
PNONE: 454-8100
BUILDING PERMIT APPLICATION
N? 6251
Receipt # Ali&
To ba uted for SF DWCs/CiAR Est. Value 40,000 Date 1 0-2 , 19_sa_
Site Address 4653 Ki ngGhtiro Dr _ Erect ? Occupancy R3-__
Lot 23 Block 3 sec/sub. $eacon H111 Alter ? Zoning Rl
Parcel # Repoir ? Fire Zone ?. _
E
l n
T
f C
t V
arge ?
n ype o
o
s
.
w Name CPnt,Px HomPG Mi dwPqt, Move p # Stories _
Z
? Address 4615 Beacon Hill Ct. Demolish ? Front ft.
Ea an
Ci g' Mn Phone 454-5236
Grnde Q
Depth
ft.
?
0 Ncme Approvols Feea
AssessrrA?} ?
?8Q Permit 115 _ 50
?? Address _ 00
' 20
k' Cit Phone Water & Sew. .
Surcharge
Police. Plan check 57 _ 75
F
?w Name
?,,,
Fire
SAC 525.00
?zAddress Eng. Water Conn.305.00
aW Ci Phone Planner Water Meter hn _ on
Council Road Unit ???J nn
I hereby ackrwwledge thot I hove reud this applicotion and stote that gldg. Off.
the informotion is correct ond agree to comply with all opplicable APC Total 1 26g.25
State of Minnesota Statutes and City of Eagon Ordinances.
Signoture of Permittee
A Building Permit Is issued to: CPriteX HnI11PS ?JEdAN2 Es' on the express condition that
oll work shall be done in accordance w' all a plicob ate of Minnesota Stctutes and City of Eogan Ordinonces.
Building Officlal .
Certificate for:
Centex Homes Midweat Inc.
8601 Darnell Road ??A-al 531
Eden Prair*e, Mn. 55344
(,,,., DELMAR H. SC?iVVA??Z
LANOSURVEVOR
RpHtPOtl UnAer Lawt of 7ho SIaU of MinMwU
27@ - 145T6i STWH&T W. - 00X RA RO=EMOUPIT, b11kNE80TA 680Y8 MIOddQ 81! 1311,9769
tllAVEYOR'8 CERTIfICATE
Garage F'loor 958.5
o4A
Top of Block
41a ? Baaement FlaDr
°
8 4 .4C 3
q
i N
„
uT o?0
?' ?^?
? s?O b°
? + 4? qb 3p ,
.?
?Denotes proposed finish
L tes Nood hub
Z De?
Benchmar3c: Top of hydrant between 90
lots 16 & 17, Blk. l, Elev.
944.01 I hereby certify that this is a true a.nd co ect repreaentation of
Lot 23, Block 3, BEACON HILIS, according to the reCOrded plat thereof,
Dakota County, MinneBOta.
Dated: January 23, 1980
Revieed to ahow the proposed houde location on Sept. 25, 1980
A,
MINNESOTA REGtSTRATION N0.8826
4155-b
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.
Date G
/
_
Site Street Address WcD 3 j mosbw-w - Unit #
Property Owner • Telephone # (&54 ol-1
Contractor Telephone #(bs? ) f 6 -13 v
Address City StateJ00? Zip
The Applicant is: _ Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_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:
W
ater Softener Water Heater
Y
$ 15.00
replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total F - ? $ I ?
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 pla is requiFed to be reviewed and approved.
ApplicanYs Printed Name
2005 RESIDENTIAL SUILDING PERMIT APPLICATION ?o
City Of Eagan ?
3830 Pilot Knob Road, Eagan MN 55122 ?
Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruction R?ouirements
Remodel/Reoair Reauiremenis _ .......... .... . . .
?3ffrce ?ke C7?Iv
CQri a# SuNey Recd
3 regislered site surveys showing sq. fl of lot, sq. ft. of house, and all roofed areas 2 copies of plan
1 set of Energy Calculations for heated additions Tree Pies Plan Recd Y N
(20°/a maximum l01 coverage allowed)
2 copies of plan showing beam & window sizes, poured found design, etc. 1 site survey for additions & decks
t 7cee PrzsReq,tited
Dn-sile SepticSysiem Y N
Y.,
.N
1 set of Energy Calculations em
Addition - indicate iton-site septic sys .
_
3 copies of Tree Preservation Plan if lot plalted afler 7/1193
Rim Joist Detail Options selection sheet (buildings wiih 3 or less units)
Date 01 / Z /0 ?J
Site Address
Description of Work
Multi-Family Bldg
Property Owner
Contractor
_ Y XN
Construction Cost M
Fireplacc(s) _ 0
_ 1 _ 2
Unit/Ste #
S
??iaJ?o?f
Tclephone # (,? ) IMI- illq?7'
6?
Address .5?7-71 Tk7? 1/Il,G[)?lild/?G K.?. City L){19n-' UC?
State t 2X-I- ...,VA/ Zip aV Telephone #((e)????? •
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Mimiesota Rules 7672
- Minnesota Rules 7670 CateQOrv 1 -
Energy Gode Categofy . Residential Ventilation Category 1 Worksheef . New Energy Code Worksheet
(J sutimission type) Submitted Submitted
. Energy Envelope Calculations Suhmitted
Have you previous{y constructed a building in Eagan with a similar plan? _ Y ^ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
6av1Ax nr ?
D
AppLicant's Printed Name
lf' 1/lkiaf I
Applicant's
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 Ect. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-pleac ? 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 Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 ROplacement `Demolition (Entire Bldg ) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water _
SAC Units Stories Booster Pump
# of Units 5q. Ft. PRV
# af Bidgs Length Fire Sprinklered
Type of Const Width
REQUIItED INSPECTIONS
Footings (new bldg) _ FinaUC.O.
_
FooUngs(deck) _ FinallNo C.O.
_
Footings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests _ Final
Framing _ Siding _ Stucco -Stone _ Brick
_ Fireplace R.I. Ai r Test Final Windows
Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Total Building Inspector
Pian Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
------------------
? For Office Use ?
j Pertnit #:
? Permit Fee: `J I
I ?
? Date Received: ?
I ?
I Staff: ?
I
_ _ _ _ _ _ _ J
20 8 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: t3 12- J_o J-s-i-te Address:
Tenant:
T) 21 L_1? A ja?f ?.
Suite #:
RESIDENT / OWNER Name: TA-i,14 W%L ck v Phone:
Address / City / Zip:
Applicant is: _ Owner _ Contractor
TYPE OF WORK Description of work: T/? /4 UF
Construction Cost: ?s -7 ?o O Multi-Family Building: (Yes No
CONTRACTOfl Name:
Address: \0 YC'Qt cJ CQ v-e- S U
City: State?Vl '? Zip:
Phone: ?S I^C?S' l1 ? s Contact Person: IR I L?G b v?? w
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential VenGlation Category 1 Worksheei • New Energy Gode Worksheet
CatBgOry Submitted Submitled
(q submission type) • Energy Envelope Calculalions Submitted
In the last 12 monfhs, has the City of Eagan issu0d 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 Contrecior: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents tha; you submit are considered to be public lnformafion. Portlons of
the information may be classified as non-pub!!c if you provide specific reasons that would permit the Cfty to
conclude that the are trade secrets.
I hereby ack at this information is complete and accurate; thal the work will be in conformance with the ordinances and codes of the Ciry of
Eagan; t I underst d this is not a permit, bu[ an application for a permit, and work is not to starl without a permih that the work will he in
acco ance with th proved plan in the ase rk which requires a review and approv of plans.
X ? -f- X lAo rd 'vc_)Tc-x--v
Ap ' anYs Printed Name " ApplicanYs Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116118
Date Issued:10/03/2013
Permit Category:ePermit
Site Address: 4653 Kingsbury Dr
Lot:23 Block: 3 Addition: Beacon Hill
PID:10-13500-03-230
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Tamara R Haug
4653 Kingsbury Dr
Eagan MN 55122
(651) 681-1884
Storm Guard Restoration
1355 Geneva Avenue North, Suite 201
Oakdale MN 55128
(651) 738-1698
Applicant/Permitee: Signature Issued By: Signature
r
.,,
Use BLUE or BLACK Ink
�-----------------
� For Office Use �
� j Permit#: � U�� I
Clty of E���Il � Permit Fee: � '� �
3830 Pilot Knob Road RECEIVED I �.- L,--( � I
Eagan MN 55122 � Date Received: �
Phone:(651)675-5675 I I
Fax:(651)675-5694 �UN O 6 ZQ�4 I Staff: I
I I
�__�_____________J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: � 7 � Site Address: �� �r E�W.� ��a Unit#:
� '` Name:�!`�.°��,Yl���� � �
1� Phone:(,��J��-I���
�-� ���EfC!/!��� � ty P: ��c�. ° � � � �t►�. �✓1 ���Z,�
Address/Ci /Zi ,�t►�_ � [!.�
,'�,, , Applicant is: Owner �Contractor
�}k� ,> i� �`�
" � � � �
� Description of work: �i ���x�O��`�.(�; � l�,►,� y�cc� � �}-,
Type���a� `.
��k�� _ Construction Cost: ���°� Multi-Family Building: (Yes /No�)
� Company:�u,L�j�,��`i�1,1 ���i"1 Contact: Cl�iv'� ��,�)�If�
��
� `�"��� a.�`�' d'I�wl1 i_,�� �W City: G�KI�
"�` Address:`
`�'
,�
� /_l
�° �` State:�Zip:�� Phone. G73 ��J�`�7��Email: ���(l�����-��
�,�: �
��
�,�:. -�j�>� I
"�,~ License#: �1..�0�0�E�� Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
���, ��1�,� Iq� �1� I°i�
�
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 72 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 8�Water Contractor: Phone:
�:�"�� rv u s ca��red ���rni'atron s
tJte �� {' r�.,:
i���r►���may�; ctass - ,�!` X . .' �.#�wo�r� CN�r.
�
rv, .,, ,� , ,.:,
,
t. the �t� .•t �
, CALL BEFORE YOU DIG. Call Gopher State One Call at(657)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 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 wi�l 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 buildi.ng permit issued in accordance with the Minnesota State Building must be completed within 180
days of permit issuance.
x f M+�� ���� �
ApplicanYs Printed Name pplicanYs Signature
Page 1 of 3
n' �� L���� �-� f, �,-v
DO N�T WRIT��E O� THI�INE ���C,�E�
�
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) ]�' Exterior Alteration (Single Family)
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
� Alteration Fire Repair ' ' r, + _ :,,Windows' ` Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ' Q�p� Occupancy ,T,�j�- �.. MCES System —
Plan Review Code Edition ,Z�7� SAC Units --
(25%_ 10OD/o _��_ F Zoning , r ' ��Q � �City Water -�
Census Code Lf 9Y Stories " Qooster Pump --
#of Units � Square Feet '� PRV .�
#of Buildings , 1 �ength = �- � - Fire Sprinklers �
Type of Construction � Width `�"
� �
REQUIRED INSPECTIONS
Footings�{New Bui.lding) . � • Meter Si�e: � °
Footings (Deck) Final-/C.O. Requir�d
Footings (Addition) � Final I No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
� Roof: _Ice &Water _Final PooL• _Footings _Air/Gas Tests _Final
� F'raming Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings_ Backfill_ Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: , Building Inspector ��
I
RESIDENTIAL FEES
Base Fee 7 3 �' '!
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S8�W Permit& Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
!"
#$%&'()' *+*,
-./$%'"&0-1O3$2>$,+
-./$%'53/4-.1 6789:KK
<*%-'!==3->1?7@7A@A?7:
-./$%'#*%-+(.&1- -./$%
B$%-'6>>.-==1''9:P8''R$,+=43.&'<.''
7Z#$ %& ''Z())* * + ''#1-% +'D*$$
234 !56!Z85565Z67Z5'
:;1
<-=F.$0%$(,1
<=>'?@A1 B*+) .;S4 C;O +; C=% * +'?@A1
B C&'?@A1 /1A$-%1
41;%C*A * + ?. ' C'E C1'B*+) .;S4 C;
O1+;=;'O )1 VZV'6'Y%%=A-+%@
a +*+0
<Q=-C1',11 5
3IAC W1I1+ ;' ' M1'M I1'C1Q=*C1';I &1')1 1% C;'*+'-$$'>1)C I;N'3G'-$ 1C*+0'.*+) .' A1+*+0;' C'*+; -$$*+0'#-@' C'# .'
#(//-,%=1
.*+) .;\]'%-$$'G C'GC-I*+0'*+;A1% * +N'O-$$'G C'G*+-$'*+;A1% * +'-G 1C'*+; -$$- * +N
O-C> +'I + P*)1')1 1% C;'-C1'C1Q=*C1)'.* M*+'!5'G11 ' G'-$$';$11A*+0'C I' A1+*+0;'*+'C1;*)1+ *-$'M I1;'JE*++1; -'< - 1'
# '6'#-;1',11'TVbT!5ZN78'595!NV598
D--'B3//*.&1
<=C%M-C01'6'#-;1)' +'_-$=- * +'TVbT7N55'U55!N7!U8
_-$=- * + ''V\]555N55
"(%*21G7?PHAP'
#(,%.*F%(.1IE,-.1
6''(AA$*%-+ ''6
(A1P'X+1C0@'< $= * +;OMC*; AM1C'^'/-*;$
!85U'< = M%C ;;'4C*W1'B1; VK8Z'b*+0;>=C@'4C
#=C+;W*$$1'EH''88Z5KX-0-+'EH''88!77
JK8!L'K9967"ZUJV5KL'UZU6!79"
3'M1C1>@'-%&+ .$1)01' M- '3'M-W1'C1-)' M*;'-AA$*%- * +'-+)'; - 1' M- ' M1'*+G CI- * +'*;'% CC1% '-+)'-0C11' '% IA$@'.* M'-$$'-AA$*%->$1'< - 1'
G'E*++1; -'< - = 1;'-+)'O* @' G'X-0-+'YC)*+-+%1;N
(AA$*%-+ S21CI* 11 '<*0+- =C13;;=1)'#@ '<*0+- =C1
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159428
Date Issued:12/17/2019
Permit Category:ePermit
Site Address: 4653 Kingsbury Dr
Lot:23 Block: 3 Addition: Beacon Hill
PID:10-13500-03-230
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael J Sande
4653 Kingsbury Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
i rn t C) I )-�
r_---------------------
For Office Use i I
a i Building Permit #:
SSW Permit #:EAGA N l
1 Permit Fee:
ECE'VE I 1
I I
3830 PILOT KNOB ROAD I EAGAN, IVIN 55122-1810 I Date Received:
'
{851 } 675-5675 i FAX: (851 ) 675-5694 OCT 2 5 2022 1 I
buildinoinspections oityofeagan.cotri I Date Issued: I.
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/25/22
Site Address: 4653 Kingsbury Dr
Applicant is: ❑ Owner 14 Contractor
k �
Name: Mike & Shannon Sande
Address: 4653 Kingsbury Dr
State: MN Zi 55122 Phone: 612-479-
Description of work: Bathroom Remodel
Ty10000
�111ock Construction Cost:
Type of building: Single Family
13 Townhome
Company: Great Lakes Window & Siding
Building Add 14690 Galaxie Ave
Unit #:
PT) I & ("?l C o'VIA 1
s
of units ® Twin Home
Contact: Derek
ress. city: Apple Valley
Contractor state: MN Zip: 55124 Phone: 952-891-34%
Email. derek.glwsco@gmaii.com
I j,.a .a . BC060427
Sewer &
Company:
Water
Contractor
Address:
Required for
State:
new construction
License #:
Date: 03/31 /24
Contact:
City:
Zip: . Phone: Email:
iration
Ill-1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE: Plans and supporting documents that you submit are considered to be public information: Portions of the
Information may classified, as non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
CALL BEFORE YOU DIG, Contact Gopher State One Call at (651) 454-0002 or ww .rto herstateonecalq ora for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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 Derek Brouillet
Applicant's Printed Name Applicant's Signature
SUB C%
JYPES
.!f!:�-S1ngIe*amiIy
01 of Plex
Deck
Site Address: 4653 Kingsbury Dr
P-ermit4:
Fireplace Lower Level
Foundation Porch
Garage Pool
WORK T)LPES
New
Rep air
Siding
Addition
Fire Re pair
Rerodf
Water Damage
Windows
Replace
Egress Window
Solar
DESCRIETION
Calculated Valuation
Plan Review 1125%,a`100%
Census Code
# of Units.
# of Buildings
Type of Construction Yb
Retaining Wall
Mo,ye,Building.
Demolish Sulldipg*
*Deftlitjon of entire building - give PCA
handout to applicant
Occupancy Vkc-
ti — IVICES System
Code Edition 111N It C -.10470 SAC Units
zoning TN' City Water
Stories Booster Pump
Square Feet PRV
Fire Suppression Required
Separate Stormwater Management PermitRequired
REQUIRED INSPECTIONS
Footings:_ NeW —Addition Deck
Foundation: Before Backfil] —Roured Wall
Framing: I Hour ---- Residential Alteration
Braced Wall Fra rn ing/Sloc king
'Braced Wall Sheathing (prior to house wrap)
Interior Braced Wall Ranel(s)
Firewalls
Insulation
F1repI0c&.-._Rough In _Air Test _Final
HVAC: _ Rough In _ Final
Radon Control
Siding: Stucco Lath Stone Lath Brick
Roof: Ice & Water Final
Erosion Control
Pool- —Footings Air/Ga,s Tests —Final
Retaining Wall: —Footings _Bnkfill _Final
Fire Suppression: _Rough In Final
Windows
Other.
Final/No C.O.. Required
Final/C.O. Required
Reviewed Building Inspector
FEES
Calculated Valuation A470%
Awe— 0,L
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply & Storage
lei
TOTAL
TOTAL
5-6 t q.1, V ;V : des