4659 Kingsbury Dr-- - R emarks
Faddition BEACON HILL ADDITION Lot 22 Blk 3 Parcel 10 13500 220 03
owner street_ 4659 Kingsbury Drive State Eagan, MNt 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ^4;: 1982 1806.93 200.77 9 1806.93 C007563 10-1-81
STREET RESTOR.
GRADING ' 1982 526.46 58.50 9 526.46 C007563 10-1-81
SAN SEW TRUNK '?D" 976 135.97 9.06 15 90.67 A008956 18 8
* SEWERLATERAL 1982 3116.46 346.27 9 3116.46 C007563 10-1-81
WATERMAIN
* WATEF LATERAL IJHZ 9
WATER AREA 1982 198.01 22.00 9 198.01 c007563 10-1-81
I * Stubs 1982 g
STORMSEW TRK 1982 359.82 39.98 9 359.82 C007563 10-1-81
? STORM SEW LAT ly$? 9
CURB & GUTTER
SIDEWALK
STREET
LIGHT
ROAD
USIT 25 .00 35150
'
4-6-83
WATER CONN. 450.00
BUILDING PER.
SAC n u
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED
AMOUNT $ I
& DOLLARS
?oo
? CASH r-1 CHECK
FOR •
JWhiYe-Payera Copy
Yeliow-Posting Copy
Pink-File Copy
Thank You
?°? BY
Receipt ? - - MECHANICAL
CITY OF V
I Fill in numbered spaces
TYpe or Print /egibly
1. DatW • ? ? 2. Installation Cost
3. Job Address' Lot , -?'-
i
4. Owner
Permit No.
Fee
S/C
Tot. _
Tract
5. Contractor '- ' Phone
6. Address ?
7. City State Zip
8. 8uilding Type: Residential `Q Commercial ? Institutional ?
9. Work Description: New a Add ?
1 10. Describe
I 71.
Alter ? Repair ?
_Puel Type '
No, Equipment 9TU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
- Boi lers
Mfg. - Mech. Exhaust
Unit Heater
Mfg. 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 454,6100
'z ' ? PLUMBING PERMIT Permit No.
Receipt
CITY OF EAGAN
Fee '
? Fill in numbered spaces 3/C
Type or Print legibly
Tot.
1. Date ?.; 2. Installation Cost '
? C ? C:_,-,• .
3. Job Address ;"- - Lot :'.t: Blk. ? Tract
iIL?
'R OOt•ISTRUCTZ(
O i
.
, .
wner
4.
1
.
5. Contractor'c'i?'TF??; '4RCa.A•":ICAT. Phone !:-i
,
o-j!n
6. Address ''?"• :?.iLT A?l? 7. City Ln`:I-;'Tfi.,- ? State 0.4Lj:7" Zip rt4)!ii,
8. Building Type: ResidentiaF 11`' ComrtS2rcial ? Institutional ?
9. Work Description: New O`- Add ? Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Ctoset No. Fixtures
Cesspool /Drai nf ield
_L Bath tubs Septic Tank
Lavatory Softner
i Shower Well
? Kitchen Sink
Urinal/Bidet Other
Laundry Tray -
Floor Drains
? Drinking Ftn.
; Slop Sink
Gas Piping Outlets
12. I hereby certify that the above inforfnation is true and correct, and I agree to
comply with all ordinances artd caileIi goveming this type of work.
Signed:
for
Rough Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
?
,
BUILDING PERMIT
cirr oF EAGAN
7795 Nlof Knob Road Eegan, MN 55722 iHONE: 454-8100
' Receipt # '..`.
Slte Addrcss `"'-" ^+ugeioury urive
Lot 2 2 Biock 3 See/Sub. Beacon Hill
j
Parcel # 10 13500 220 03
oc Nome Joeeph M. 14iller Con
Z Address 18133 Cedar Ave. 50.
9 Fsrminatnn GS
Erect zi
Alter p
Repoir 13
Enlarpe p
Move p
Demolish ?
Grade 0
Occuponcy ..
2oning ?? `
Fire Zone PIA
Type of Const. V
# Stories
i ,,,,,,,, 41
Nome 'jwuer wpprovals
sp ? Addreu Assessment
~ Cit Phone Woter & Sew.
Police
?W Nome FIro
lu 30 Address Enp,
<W CI phone Plonner
Council
I hereby acknowledge that I hova read this applicotion ond state that gldp. Off.
the intormotion is correct and ogree to comply with all applicoble APC
Stote of Minnesota $tatutes ond City of Eagan Ordinonces.
5q. Ft.-
Fees
Permit LZSb.VU
Surcharqa 25.50
Plon check 14 3. 00
SAC 525.00
Water Conn4
Water Meter ?
Road Unit M=-
Totol
Sipnature of Permittee I
osep 1 . . er onst. Co.
A Building Permit fs fuued ro: on ths expreas conditlon thnt
oll work shall be done in accordonce with oll applicoblQ.StaM of Minnesota Statutes ond City of Eoyan Ordinancea.
8uildinq Offlclal
Permit No. Wrmit Holder Mise. Permit No. Holder
Plumbin9
H.V.A.C. SS t'C" Z7-$3
Wdl
Water
Disp.
Sawer
eklefti° $ 7525 t' aw1 9[.c -l 7-
Inspection Dete Insp. Othar
Footings
i
Foundstion
Freming
Rouqh Plbp. •z 7 8'j yv
Rough HVAC
4PIb
o_
Descrihe Location:
E t
3830 Pil
BUILDING PERMIT ItIA-4-4
riTV n[Z
?0? PHONE:45
F?e tt Sn
Lot 22 Block 3 Sec/Sub. DUCOl1 HI'LL8
Parcel No.
W Name MAR, '$?A, VFTSRRnN
; Address LfiS9 Yi*1G.RAL1pY DR
0 City RkcAu Phone 681,4%S
,o Name SAMH
?Q Address
U¢ City Phone
?
Ww Name
?
_z' Address
I <W I City Phone
1 hereby acknowlege that I have read Ihis application and slate that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
! .
Signature of Permilee
A Building Permit is issued to: PSAfIK A PETERSON
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
8uilding Official ?
I
rit
.M .. .. . P . .Y .
T
iAN
-199, Eagan, MN 55121 ?
IOD
Receipt #
Dafe- APR 16 , ??_
OFFICE USE ONLY
Occupancy _ FEES
Zoning _
(Actual) Const _ Bldg. Permit 3 . oO
(Allowable) - Surcharge 1.?0
# of Stories _
Length _ Plan Review
Depth - ' SAC, City
S.F. Total - SAC, MCWCC
S.F. Footprints _
On Sile Sewage _ Water Conn
On Sile Well - Water Meter
MWCC System _
City Water _ Accl Deposit
PRV Required _ S/W Permit
Booster Pump - SNJ Surcharge
Treatment PI
APPROVALS Road Unil
Planner - park Ded.
Council
BIdg.INf. _ Copies
Variance - TOTnL 98 • 00
Permit No. Permit Holder Date Telephone #
WATER
SEN/ER
PLUMBING
H.V.A.C.
ELECTHIC
Inspeetion Date Insp. Comments
Faotings I
Foundation .
Framing
Rooting
Rough Plbg.
Rough Htg.
Isul.
Fir lace
?'
Final Htg. 10,
Orstat Test
Final Pibg. PI6g. Inspecfor - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoninp: No, of Units:
Owner:
Address:
Site Address:
Plumber:
I ayree ro eompir with Nro Citr of Eagon Connection Charge•
Ordinancat.
By
Dete of Insp.:
I nsp.:
Account Deposit:
Pertnit Fee:
Surcharge:
Miu. Charpes:
Total:
Dote Poid:
ciTr oF e..cnN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
MN 55122
E DATE:
egae,
Zoning: No. of Units:
`osenh ?'iller
Owner
„-.
-*
-
.
Address:
Site Address:
Plumber: 4 _
N
M Connection Charge: '
eter
o.:
Si Aaount Deposit:
ze:
Reader No.: Pertnit Fee:
I aqree te eomply Wftb the City of Eayan Surcharge:
O Charyes:
Misc
rdinanea. .
Totai:
Date Paid:
gy
Date of Insp.: Insp•-.
,.
,
? ? . .?
, CITY r ?!
• ?,'?' (' BITIiDING PENCP AP'PLI(
•. ._ .??F i ?I C'nt .r? „ ?
l)eed
valuat3on
Irycwae s .ets;ot.pla?s.
1 dt?s p?an w/e?l0vaitions i,, ?
I set Or epes+9Y ??1'',culations"
_ - •? ,
naee
Rb
.??• ` ?.,
Site Address e ? C? tw CI?II.Y
?+.? ;
Iat oV Blodc ? ?z
SHC. ?'?iBl" ? ??"''7 a
13 Sr?o?'O c'? ? - gise Za?e
Paroel A : - ?
BraazVe i°?r ---- qwo uf Oon .
aN1rAr: . Mon ?.?. ?
i+.
Addrlqi Glade
City/2ip Oode:
}? ?? a 1
rf?a? *i ,. .._ _ ,
oontracear
Address: J-4:K
CitY/ZiP Code:? .? ?
Ptro[ye t :
Arch. AM . .
AdBress:
City/Zip Qode:
Phcw t:
?
?.
?
;
?
psi
weiber/SeWar
li
Plan G'heck
oe
Fo
Fire sAC
• WDttB?t 00[??• Sp ?
?
Plamr?er ?
C7oundl
?
Aoad [7hit „
s18g. of . ?-5- ?
APC
------------------
,
'1??191L ?? ?"c'?. ±
. .
:?
:, ? '
? ;.
,,.
?
?
/ ?
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? ?'??
????
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
' REQUEST FOR ELECTRICAL INSPECTION
CHEtK BtLOW WORK COVERED BY THIS REn[ iF.ST
?SgS'$
? 7 ? 91,
Type of Building New Add. Rep. Check Applian ces Wired Fox Check Equipment Wited Fot
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryei ? Electiic Heating ?
Commercial Bldg. ? ? ? Fumace ir Silo Unloader ?
lndustrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Fazm List List
Othei ? ? ? pehels#
fl Qereers#
x
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Citcuits: # Fee
0 to 100 Amps. 0 to 30 Am eres 0 to 30 Am etes ,t,Sd
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100_Amps. Above 100 Amps.
Transformets RemoteConuolCirc. Partialorothetfee Sd
Signs Special Ins ection Minimum Fee
Remarks
TOTAL F E,R,f -Jb
3• 4
l, the Electrical Inspector, hereby certify that
hasbeen nrade:1
n.,4s C', 1-81:1-
(Final)
This request void 18 months from
This request void 18 months1f L aa L 33 ? 13F_ato??
_ - b!-?° u
3s?s g
3z Sc?
Date of this Request ? - 02 7 - ?? 5 9 O?' D
I, as ?1 Licensed Electrical ConUactor ? Owner, do hereby request inspection of the above electri-
cal winng installed at:
Street Address or Route No. S tr<? City&4;'3rt
Section Township Range Couniy f3??
Which is occupied by
Is a roughin inspection required on this job? No ? Yes IV
Power Supplier leQ??P Address _
Electrical Contractor
(Company Name)
Mailing Address Q20 3 40
, ? (Elec_U(cal Contractor or Owner Maki
Authorized Signature
Ready Now ? Will Call gr
10420....s?? 4,
Y/eo ia -?
_ Contractor's License No.
dsote-, , 03
ng This Installa on)
Phone No. 753 `13 27
(Electrical Contractoi or Ownef Making Thls InstallatiOn)
This iMpection request will not be accepted 6y the
?_?: ?? ?? U?C??? ( ??? State Board unless proper inspection fee is enclosed.
C?rrtiftrtt#t'nf COrruparcry
; Citp of ?agan
Ervttrtmrnt nf Bitilding 3njWrrtiun
>
This Crrti ficatt issutd purauant to the rcquirementt o f Sat:on 306 of the Uni form Building
...,.,,?, ? ,
Code artifying that at tbc timc of ir;uarue thir strnaurc; wa,-'.
:c:n c:ompliann with the variour
ordinantrs of the City rrgulating burld:ng toiuf+uttion os ute' iFor tbr followrng:
UwCt+mlintim_ .$DWG'/GAR ?adr.mmtNo. 7900
Ocamwuc I r Tra ' R3 'ryw coa.wcnw V"' FiR ?.,.. NA z,n;nq n;.N?t Rl .°, e.. _.
'o,.mw orema„.s Joseoh M. Miller Aad. 18133 Cedar Ave.So:, Farmir
Biie?Addras 4659 Kingsbury Dr. LIMILryLot 22,Block 3,Beacon Hill
euaak8omaw n,«: June 29, 1983
!? - _.. . . . !aT 111 A CONOlCYW. r4 [ \:?:. . . ' .
' -.
BUILDING PERMIT
Te ba wed fer SF
Site Address
Lot 22
Parcel # -
a IName Joseph M. Miller Const. Co.
? 18133 Cede.r Ave. So.
Addreas
,Farmington 454-4753
o Nome _
u? Addreu
? ??...
Name _
Address
Phone
I hereby acknowledge that I have read this opplication and stote thot
the information is correct ond ogree to wmply with all opplicobla
Stote of Minnewto Statutes and City of Eagan Ordinances.
Signature of Pertnittee
A Building Permif is issued to: Jose
olI work sholl be done in accordonce with
Buildiriy Offtciol f
CITY OF EAGAN ?T. ? 7900
9795 Pilot Knob Raed Eogan, MN 55122 l?l
PHONE: 454-8100
Reteipt # ??J 5i?
GAR
Block 3 Sec/Sub
10 13500 220 03
Drive
Beacon
000
Erect gg Occupancy -1 '
Alter ? Zoning R-1
Repoir p Fire Zone NA
Enlarge ? Type of Const. V
Move Q # $tories
Demolish Q Length 41
Grade ? Depth 46 Sq. Ft.-
Approvab Fees
Assessment Permit 286.00
Water & Sew. Surchar9e 25 . 50
Police Plan check 143.00
Fire SaC 525.00
Eng. Water Conn,4?0•
QI
Plonner O
Woter Mete 25? O
Council Rood Unit
Bldg. Off.
APC Totol $1739.50
. Co.
on fhe express condition that
isota Stotutes cnd City of Eogan Ordinances.
, . CITY OF EAGAN Np ' 8 9 O 6
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100
Receipt #
7o be used for BASEMENT FINISH Est. Value $1, 500 Date APR 16 , 1991_
Site Address 4659 KINGSBURY DR
Lot 22 Block 3 Sec/Sub BEACON HILLS
. OFFICE USE ONLY
P8fC01 N0. Occupancy _ FEES
Zoning _
W Name MARK A PF.TF.R40N (ACtual) Const eldg
Permit 35.00
; Address 4659 KTNGRRURY DR _
(Allowable) - .
1
p Surcharge _ n0
City EA(;AN Phone 681-065 # of Siories _
Plan Review
Length _
o Name SAME Depth SAC
Cit
Z AddfBSS -
S.F. Total - ,
y
Clty Phone
S.F. Footprints _ SAC, MCWCC
? On Site Sewage - Water Conn
W W Name on site weu
'w -
Water Meler
? ; AddresS MwCC System -
¢z Acct
Deposit
`W City Phone crywater _ .
. . PRV Required _ S/W Permit
I hereby acknowlege that I have read this apptication and state that the 8ooster Pump - S/W Surcharge
information is corred and agree to comply with all applicable State of
Minnesota Statutes and City ol Eagan Ordinance . TreatmentPl
Siqnature of Permitee ?rd APPROVALS
Road Unit
A Building Permit is issued to: MABK A PETERSON Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable Stale of Minnesota Statutes and City of Eagan Ordinances. Bidg. Otf. _ Copies
??A D,r l fYI.,N
Building Oflicial (11_.r
Variance -
TOTAL
36.
00
4 REQUEST FOR ELECTRICAL INSPECTION Es-ooooi-oe
/ /? j ? See inshuctions for completing Ihis form on back of yellow copy.
H??(?,_? 7 ')C' Below Work Covered by This Request
ew Add Rep. Typeof8uilding AppliancesWired EqulpmeniWired
Home Range Temporary Servica
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Speciiy)
Comm.llndustrial Fumace
Farm Air Conditioner
Other (specity) Conirector's Remarks:
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspector5 Use Only: TOTpL -
Irrigation Booms
?J 30,t sv
Special Inspection
Alarm/Communication THIS INSTALLATfON MAY BE ORDERED DISCONNECTED IF NOT
Othei Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rough-in
Final . oaie
? -
OFFICE USE UNLV ? .- This request voitl 18 monlhs from ' .
a //40/V/
38427
RequeSt ?ale ? - Fire No. Rough-in tnspedion .
R uired?
? Ready Now ?Nill Notily Inspector
When Ready?
4- p
'? 16 - I? Yes ? M.
I p licensed contractor Pi.owner hereby request inspection of above electrical work at:
,bb Adtlress (Street, Boz or Route No.)
4
l? ?
£AG?M1
i
4-65`1 K?•vGS?vRY
Section No. 7ownshiD Name w No. Renge No. ?unty
Occupant (PRIM) Phone No.
PETF?2SON 6
A
.
ARK
Power Supplier Address
.
Electrical Conuaclor (Company Name) Contractor§ License No.
Mailing Atldress (Comractor or Owrrer Makinq Installation) -
¢
l?
'
.
•
g ?N s??ar
??s
r AulOOrized JA ure (Go?+traCt or?Owoer Makjpp allation) . Phone Number /? s?J -o65?'L.
MINNE807A ATE BOARD OF ELECTRICITV THIS INSPECTION REOUEST WILL NOT - -
GHggs-MlOway Bldg. - Room fr173 . BE ACCEP7ED BV THE STATE BOARD UNLESS PROPER INSBEC710N FEE IS
1l21 UnMarsiry Ave., St. Paul, NN 55106
Ptwne (612) 642A800 ENCLOSED.
W --/v 3
2005 RESIDENTIAL BUILDING PERNII'C APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 9 651-675-5675 FAX # 651-675-5694
Telephone #(
New Conshuction Reauirements RemodeVReoair Reauirements Office Use Onlv
3 registered site surveys showing sq. ft. oi lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _Y _ N
(20°k maximum lot coverage ailowed) 1 set oi Energy Calculations for heated additions Tree Pres Plan Recd _Y _ N,
2 copies of plan showing beam & window s¢es; poured found design, etc. 1 site survey for addilions 8 decks Tree Pres Required' '- _Y _ N
t set of Energy Calcuia6ons Add'rtion - indicate i/on•site sepfic system Onsde Septic Sysfem _ Y: _ N
3 copies oi Tree Preservation Pian H lol platted after 711193
Rim Joist Detail Optians seiection sheet (buildings with 3 or less unils)
Date ?7 !
o5- ad
Construction Cost 4S46 0?
Site Address K/ NGS /,3U 2y /,/41 VE- UniUSte #
Description of Work ?flO[?O96E, F rSTin% L!JlN0(7Jr(i S 00025 F41-L £1?Y?Rtdl2 /
Multi-Family Bldg _ Y? N Fireplace(s) _ 0 x 1 _ 2
Property Owner IVR QV, ? r./ ff 3 nE Fc2 S?? Telephone #(( S( ) 6$1 2--
Contractor
Address C'ity
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 • Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Su6mitled
Have you previously constructed a building in Eagan with a similar planZ _ Y _ N if so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
? ?? (ro
Telephone # ( )
Telephone # ( )
1 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.
ZKA,?!< A JOFFf2sd? z???"??j?-
Applicant's Printed Name Applicant's ignature
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.) O 31 Ext. Alt - Multi
O 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) O 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn 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 Reraof ? 46 Windows/Doors
? 34 Replacement •Demolidon (EnNre Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas T ests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ 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
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New ConsGuction Reauirements RemodeURepairReauirements
3 registered site surveys showing sq. ft of tot, sq. ft. of house; and all roofed areas 2 copies of plan
(20°k maximum lot mverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, elc. 1 sile survey for addiGons & decks
1 set of Energy Calculatlons Addition - indwate ifon-sAe septic system
3 copies of Tree Preservabon Plan'rf lot platted after711193
Rim Joist Detail Op6ons selection sheet (bldgs with 3 or less units
L?
?
I D
S -1 1 ??t- c"??C9=
Oflice Use Onfv
Cert ot Survey Recd
Tree Pres Plan Recd
Tree Pres Not Reqd
_ On-site Septic System
cr?
Date Z / Q-3 Construction Cost ? ?UQ
Site Address 4 6, 5 j u,hre st3Lny 0(1- UnitlSte #
Description of Work /)eC I<
Multi-Family Bldg _ Y')< N Fireplace(s) _ 0 X 1 _ 2
PropertyOwner eV
I R211 A I 'FT?ldSc?.? Telephone # (6 s1 ) r- £rI ` C1C, SZ
Contractor S s t ?_
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
-- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code.Worksheet
(Jsubmissiontype) Submitted Submitted
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.
14gg)l- A - PF(-,g2 S o7y)
Applicant's Printed Name App nt's Signature
,.
,
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 0 i of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex A 18 Deck ? 23 Porch (screenlgazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous
Work Types
? 30 Accessory Bidg
? 31 Ext. Ait - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
?T 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish, (Foundafion) ? 45 Fire Repair
? 33 AlteraUon O 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation pC), ° Occupancy l-z ? MClES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const v? Width
Footings (new bldg)
'>O Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. Air Test _ Final
Insulation
Base Fee
Surcharge
Plan Review MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plucnbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By ,iiG" l , Building inspector
.•tificate for : Q?,Rp 140. 89044
,oe Miller Construction
18133 Cedar Avenue South
Farmington, Minnesota ?
55024
DELMAR H. SCHWANZ I
LANOSURVEYORd, IT1C•
ReyiflwW Undor l.sws 01 Tho StAtO 01 Minnocota
2878 - 146TH STREE7 W. - BOX M ROBEMOUNT, MINMESOTA 66M PFONE 012423'170 ?
SURVEYOR'S CERTIFICATE
??3•5 Garage f loor elevatlon ? cQ le ? 1
ti3?g_ Top of block elevation -??•?'
`n8.o T°p I t.ou
I?o•7 Basement floor elevation ? Eua,:qyg,g
V? \
/?\\ s
?
.
Top leoa) •\ .?' _ .?? \ ?366 ,
Top Wo
?io \ ? ' Qt,W?A ? s? F?.w?•?95l.8
o Denotes iron pipe 36 • ? IL I?-0 \?/ ?3O•o ??'
Monument 1jG?
?o
? Denotes setback monument
qSZ.o Denotes exiating elevation
9yLA Denotes proposed elevation
Denotes direction of surPace
? drainage
EAGAN
R V 'E
BY '?? 12*A?
DATF ISI-W• =9*..'t ?•? ?V ?
I he??b?WPt KQRPOAQEffa true and c6rrect representation of a
survey of the boundaries oP Lot 22, Block 3, BEACON HILL, according to
the recorded plat thereof, Dakota County, 1Minnesota.
Also ahowing the proposed location of a houae not ataked thereon.
Dated: March 3, 1983,
MINNESOTA H fiISTRATION N6.8625
1991 BUILDING PERMIT APPLICATION
SINGLE FAMILY DWELLINGS ? MALTIPLE DWEL INGS COM1fERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WQRKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS I5
DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDZNG PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
??°? ?
f
To Be Used For:^?o0q? Valuation: ? Date:
^ Site Address 4,(o57 xiNGSBURy //R OFFICE USE ONLY
Lot 9-? Block _,?_
Parcel/Sub bqqf[m
? Owner
? Address ? SF K?NGS,6(//2'Y iQ
City/Zip Code 4:?4G.qAJ S512Z
? Phone (PSl-a6S2.
Contractor 0-0-%A4 L
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System _
City water _
PRV _
Booster Putnp _
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit a7a ?
5urcharge e.f?ea
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
5/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL . E9s?
t)e'-c?--?-- agrees that all work shall be done in accordance with
(S gnature of Contractor)
all appiicable 5tate of Minnesota Statutes and City of Eagan Ordinances.
• Cartificate for: ?
• Joe Miller Construction '
18133 Cedar Avenue South
Farmington, Minnesota
55024
DELMAR H. SCHWANZ
LANDSURVEVORg, ynC•
RaqiftorW Untlu Uws of Tbe State of MinnefoL
2878 - 116TH STREET W. - 80X M ROSEMOIlNT, MINNESOTA 660ls
PLRN tao. M64+
1Uq,t,t(,polr
PNONE e12 429-178•
I SURVEYOR'SCERTIFICATE
953•5 Garage floor elevation
953'q Top of block elevation 1
?0 , Top IP.o??
9rt0.7 Basement £loor elevation
?
. ToP lpaQ \
EA-61.-95Zro
p Denotes iron pipe
Monument
?io \
36 • \
s? a
?
..----
r ?
??
?
?? GP+a
?
.
q Denotea setback monument
152.D Denotes existing elevation
- 951A Denotes proposed elevation
Denotea direction of surface
? drainage
/
? /io
?
Top 1904
'a.6Y.t9Slm
?
.?
/
o
3 N????, 'N
1b?p l E0'U p,, a?,?f•? ??
?.sd• =9?1+.'I ?
I hereby certify that this is a true and c4brrect representation of a
survey of the boundaries oP Lot 22, Blxk 39 BEACON HILL, according to
trie recorded plat thereof, Dakota County, Minnesota.
plao showing the proposed location oP a house not ataked thereon.
Dated: March 3, 1983.
:MINNESOTA fi ISTRATION N0.8625
11
Cities Di?1ta1
r 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.
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RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
4";C'1ct
---
New Construction Reauirements RemadeUReoai[ Reauiremenls Oifice Use On1v .-
3 registered site surveys showing sq. ft. of bt, sq, ft. o( house; and all roofed areas 2 copies of plan Ced ot Survey Recd '
(20°k maximum bt coverage allowed) 1 set of Energy Calculations for heated addiGons Tree PreS PWn Recd
2 copies ot plan showing heam 8 window sizes; poured found design, etc. 7 site survey for additions 8 decks Tree Pres Not Reqd
1 set of Ener9y CalaWtions Addilion - indicate if an-site sepBc system _ On-site Septic System
3 copies of Tree Preserva6on Plan if lot platted afler 711/93
Rim Joist Defaif Options seleclion sheet (bldgs with 3 or less units
Date -1Z / ? / OS' Construction Cost
Site Address 7'W J?9 (.A.-G' (./ L? Unit/Ste #
Description of Work
-
? ?
Multi-Family Bidg _ YN FYreplace(s) _ 0 _ 1 ^ 2
PropertyOwner I t/? ? ?e k6d ii Telephone # ?J ,1r? p, l -n (Q 5 ?-
Contractor C? 1J` 1x0V(l_+0AS//j V
Address io w ?1!??? v pribG7(.?- S City ld crf7'?//7G
State
U?P
Zip Sh' G ,/
Telephone#(??? r3k7-ZS1Y
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate orv 1 Minnesota Rules 7672
Energy Code Category • Residential Vendlation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculations Su6mitted
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
start without a
it, and work is not to
Statutes; I understand this is not a permit, but only an appFiiz
permit; that the work will be in accordance with the approvase of work which requires a review and
approval of plans.
,i,w JCh tl I n.s
ApplicanYs Printed Name
Signature
' OFFICE USE ONLY
Sub Types
Q 01 FoundaUon O 07 05-plex ? 13 96-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex O 10 08-plex O 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 5torm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46
? 34 ReplaCement •Demolition (Entire Bldg) - G ive PCA handout to applicant
Valuation Occupancy MC/ES 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
_ Footings (new bldg)
_ Footings (deck)
_ Fookings (addition) ,
Foundation
Drain Tile
Roof Ice & Water Final
_ Framingi
_ Fireplace , R.I. _ Air Test _ Final
Insulation
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
WindowslDoors
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit &_Surcharge
Treatmenf Plant
License Search '
Copies
Other
Total
Building Inspector
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4659 Kingsbury Dr
Lot: 22 Block: 3 Addition: Beacon Hill
PID:10- 13500- 220 -03
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Exterior Innovations
9635 Humbolt Ave S
Bloomington MN 55431
(952) 884 -0814
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
When installing ventilated soffit material, remove existing soffit mate
take steps to ensure maximum ventilation into attic space.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
$90.00
Owner:
Mark A Peterson
4659 Kingsbury Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA084447
07/17/2008
ePermit
al (i.e. debris that could block vent openings) and
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
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA153620
Date Issued:01/08/2019
Permit Category:ePermit
Site Address: 4659 Kingsbury Dr
Lot:22 Block: 3 Addition: Beacon Hill
PID:10-13500-03-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater & Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mark A Peterson
4659 Kingsbury Dr
Eagan MN 55122
(651) 681-0652
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA171201
Date Issued:08/04/2021
Permit Category:ePermit
Site Address: 4659 Kingsbury Dr
Lot:22 Block: 3 Addition: Beacon Hill
PID:10-13500-03-220
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mark A Peterson
4659 Kingsbury Dr
Saint Paul MN 55122--271
(651) 681-0652
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature