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4665 Kingsbury Dr r1 Use BLUE or BLACK Ink r For Office Use I Permit 100(915ef CC- City of Ea I Permit Fee:%) . I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: ` C I I Phone: (651) 675-5675 f~ F C l V ED Fax: (651) 675-5694 I Staff: I JULL 2 0 2011 I----------- - - (A 2011 RESIDENTIAL BUILDING PERMIT APPLICATION U~-~ i Date: Site Address: Unit Name: C-,'MC'X3.a -14 tip - t Phone: RESIDENT OWNER Address / City / Zip: ~a ~c S ~►Cst~(is.( j~ i; Applicant is: Owner X contractor _..w.._., TYPE OF WORK Description of work: e-.~.►'r`f<' Construction Cost: Multi-Family Building: (Yes / No Company: Ls._'CC~•c_~G Contact: v r Address: City: CONTRACTOR State: Zip: Phone: i License GUZ,1 c'P; A Z-- Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? ,Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting docuirlents that you submit are considered to be public information. Portions of the information may be 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. 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.gopherstateonecall.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 will be in accordance with the approved plan in the case of work which requires a review and approval of pla x i~l rc1r~' x Applicant's Printed Name Ap nt's Signature Page 1 of 3 Pf "JC DO NOT WRITE Q SN SUB TYPES Foundation Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous 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 Cal Valuation lpQ Occupancy J,, C, MCES System Plan Review Code Edition a® SAC Units (25%_ 100% ~ Zoning ~p City Water Census Code Lp' 3y Stories Booster Pump # of Units Square Feet - PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC - Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings - Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector ca RESIDENTIAL F S p 6;0 Base Fee Surcharge Plan Review $ C~ MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - -I r,} ror Office Use Permit /~V® `-I City of Eayn I I Permit Fee: 3830 Pilot Knob Road I I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I INFLOW NFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Site Address: Tenant: Suite Name: l s c=4-{ Phone: RESIDENT / OWNER Address / City / Zip: Name: License Address: ~G ( C'~LCC. e~\~ Z-CiL City: CONTRACTOR IAl State: `v\N Zip: Phone: Contact: J~-~ - Email PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK _&Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: t j FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 review and approval of plans. x x Applicant's Printed Name Appli s Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final CITY OF EAGAN Remarks Addition RFA('ON HTi L ADDTTTON Lot 21 Bik 3 Parcel 10 13500 210 03 Owner h!? t'' 1;', " C i,^ ^ Street 4665 Kingsbu DTive State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1982 1806.93 200.77 9 1806.93 C007562 10-1-81 STREET RESTOR. GRADING ?-' 1982 526.46 58.50 9 • -- SAN SEW TRUNK 1 1976 135.97 9.06 1$ Q * SEWERLATERAL g-. 1982 3116.46 346.27 9 3116.46 C007562 10-1-81 WATERMAIN * WATER LATERAL 1982 9 WATER AREA (47 1982 198.01 22.00 9 198.01 C007562 10-1-81 * Stubs 1982 9 STORMSEW TRK g Z 1982 359.82 39.98 9 359.82 C007562 10-1-81 * STORM SEW LAT 1982 J CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, BUILDING PER. 6303 SAC PARK I CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt # To be usad foe Ect. Value Dntn Site Address Lot Parcel # - Ih'. N4 6393 Erect ? Occupanty Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. 6rade ? Depth ft. Approvols Feea Block Sec/Sub. m Nome W ; Address O Ci Phone ? Name o z OU Address ?--- Nome _ Address I hereby acknowledge that I have reod this application and state thot the informution is correct and agree to cromply with all applicable State of Minnesota Statutes ond City of Eagan Ordinances. Assessment _ Water & Sew Police Fire Eng. Plonner _ Countil _ Bldg. Off. - APC Pertnit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signnture of Permittee ? A Building Permit is issued to: on the axpress condition that oll work shall be done in accordarxe with ail opplicable State of Minnesota Stotutes and City of Eagan Ordinonces. Building Official n PawR Deb Iroad pwsNfr Plumbin9 .?/ v -.?6 Mechanical Tic c INSPECTIONS DATE INSP. Rough-In Firwl Footings Date Insp. DWe Insp. Foundation Plumbing U - ? Frame/ins. --/?? MecFanicol Final Remarks: 114:1141 AqfQ-vs Fy/? No. Date: 1-13-81 cirY oF eac,AN 3795 Pilof Knob Reod Eogan, Mineesota 55122 Phene: 454-8100 PERMIT i Site Address: Lot Block Sub/Sec. -' ,.y Namc ? g Address ' ? City Phone: Nome . ?. ":(?Y g Address ? Y City ' Phone: ' This Permit is issued on the express condition that all work shoil be Minnesoto Stotutes and City of Eagun Ordirances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single I Residential Multi Res., Comm./Ind. New/Alter./Repoir Cost of Installation Permit Fee Surcharge Totol done in acrnrdonce with all applicoble State of Building Official ' .. , . No. 1.49 cIrir oF E?w?N 3795 Pilot Knob Road Ea9an, Minneaofa 55122 Phone: 454-8100 PERMIT Date: l Site Address: 1&UYy ' _. Lot Block Sub/Sec. Be.Fwon FLill Nome ''r, F1CI11eS i 11.ctWest I Address 7arnP,1 ? CitY Phone: - . J 1 Name ' ?r- . ? g Address ? ?ity Phone: . -:. .??..''.-. . INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Sin91e I Residentiol Multi Res., Comm./Ind. I New /Atter. / Repair Cost oi Installation Permit Fee Surthorge Torol This Permit is issued on the express condirion thot olI work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eogon Ordinonces. 20.5I 20 Building Official (e Trr#if'trttt.e of COrrupttriry titp of Cagan Brprtmmf nf Builbing 3nsperiinn Tbir CMifuau i.rsuul purruaru to the Code ccrti fying ihat at the time of irsu ordinancer o f the City rcgulating buildi Uae Claaifiutim ? ??C? ?wttr'?Ya ? Tvr?co.,w« OrvnerofBWld'm6 C.e.n?}? aau1 Vr.. ? requiremcnu o f Section 306 of tix Uniform Buildiag ancc thit structurc war in compliancc with the various ng connruction or ute. For tbe follourng: alde. Pern;t No. 6393 V FireZooa 3 ZaninRDistrict RI. ? /. i? evaame otnaa By: p„e 4-9-81 .A, ?e ? ? ' ?"?..-?-? --?7' 7" "- ? . aTY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owne r; Address: _ Site Address: Plumber: 1 agree eo aomply with tha City of Eagan Connection Cha e• of Insp.: CITY OF EAGAN 3795 Pi1ot Knob Road ?gon, MN 55122 Zoning: r9 • Account Deposit: Permit Fee: Surcharge: Misc. Charges: Totol: Date Paid: WATER SERVICE PERMIT PERMIT NO.: DqTE: Owner; No. of Units: Address: - Site Address: Plumber: Meter No.: $ize: Connection Charge: Reoder No.: Account Deposit: 1 agree to eomPly N,lµ µ@ CitY of Ea an 9 Permit Fee: Ordinonees, Surcharge: Misa Chorges: BY Total: Dote of Ins P ? Date Paid: Insp.: minnesota State lSOartl ot Electricity Griggs Midway 81dg. - Room N791 ? - 1821 llniversity Ave., St. Paul, Minn. 55104 - phone 297•2111 ? } -REQUEST FOR ELECTRICAL INSPECTION ?: ' °° CHECK BELOW WOEtK COVERED BY THIS REOUF.ST EB-00001-02 166494 Type of Building New Add. Rep. Check Applian ces Wired For Check Equipment Wired For Home ? ? Range ? Temporazy Wiring ? Duptex ? ? Water Heate: ? Lighting Fi?ctures (`? t. Bldg. ? ? ? Dryer Electric Heating ? mercial Bldg. ? ? ? Furnace ? Silo Unloadei ? dustrial Bidg. ? ? ? Air Conditioner Bulk Milk Tank ? Farm ? ? ? List List Othe: 0 ? ? p HeierS? ` p Heiers? COMPUTE INSPECTION FEE BELOW Service Entiance Size: # Fee FeedecsBcSubfeeders: # Fee Cucuits: # Fee 0 to ] 00 Am s. 0 to 30 Am eres 0 to 30 Am eres 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformecs RemoteControlCixc. Paztialorothe:fee , c. Signs S ecial Inspection Minimum fee $5 Remarks U/?' I! 11 9? TOTAL FE ? ? 1, the Electrical lnspector,'herft(oifify,t?iat in'_'t e_% °?'?"'v..r has been m?af„??J T_i /? _ \ ?? (Fina]) D? y''+rZ 7 This request void 18 months from 7 This requesi void ? °? ll '' ? ?-'-'°`L ? ?,j ? ? •34 ? 18 months €rom Date o his Request Fire No. T 16649 I, a sicensed Electrical Contractor O Owner, do hereby request inspection of the above electri- cal winng installed at: Street Address or Route No. City ?of-i Oon Township Aange County Which is occupied by (6vd q/( (Name of Occupant) ls a roughin inspection required on this job? No ? YeC9(_ Ready Now ? Will Ca& Power Supplier Address Y wm Electrical Contractor Contractor's License Nbft.?? (COmpany Name) Mailing Address HI Authorized Signature ieieccricai contractor or owne ?IM BOARD COPY or Owner Makln9 This Installation) ?. a Phone No. aking This Installation) This inspection request wiil not be accepted 6y the State Baard unless praper inspectian fee is enclosed. CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55722 N! 6393 PHON 8: 454-8100 BUILDING PERMIT APPUCATION Receipt # To be used for $F DWG/GAR Est. Value 5$4000 Dote 11-24 , 19_$4__ Site Address 4665 Kingsbur.y Dr. ?Ivloael R3 - Erect ? Occuponcy Lor 21 siock _3 sec/sut. Beacon Hlll ? Alter ? zonin9 Rl Parcel # Repair ? Fire Zone 3 Enlarge ? Type of Const. V W Name CP71-FPX Hnmaq Mi wPSt Move ? .# Stories 3 Address 8601 DaT'I781 Rd. Demolish ? Front 50 ft. 0 ?? Eden Prairie,%one 941-6671 Grode ? Depth 36 ft. ? Name Approvals Fees 0 u Address Assessment _ ? ~ Ci Phone Water & Sew. F? Police Nome F ? ire ?? Address Eng. <W Ci Phone Planner - Countil - I hereby ocknowledge that I hove read this application and state that gldg. Off. _ the information is correct ond a9ree to comply with oll applicoble State of Minnesoto Stotutes and City of Eagan Ordinances. APC Signature of Permittee A Building Permit is issued to: _ oIl work shall be done in uccordance Centex Homes Midwest oll app1iwblg State of Permit 17G.7U Surcharge 29.00 Plan theck 76.25 SAC 525.00 Water Conn.305.00 Water Meter 60. 00 Road Unit 185 . 00 Totol 1,332.75 on the express condition thot Stotutes and City of Eagan Ordinances. Building Official ?? -?- ? ? 'lb Be Used For CITY OF EA(y=N BUILDING PERMIT RPPLICATION Include 2 sets of plans, 1 site plan w/elevations & 1 set of energy calculations. _ Valuation _ S? 62/Ie-2 Date ///zi/?`o Site Address: 1445 - 'IZ4 Sb, e. D? OFFICE USE ONLY Lot gj_ Block,?jV_ Sec. jSub. jj Erect` ' Occupancy Parcel #: A1ter Zoning ? Repair Fire Zorie Owner: Enlarge Type of Const. j/ I`9ove # Stories Address: 4 2?he? /Cd . _ Demolish Front c;v ft. City/Zip Code: ?de;j P?a (- Grade Depth ,36 ft. 1 , ? Phone #: gJ1l/-lvk,T / APPAOUALS FEFS Contractor: Assessments >/4 Permit 160?7 14-0 Address: City/Zip Code: Phone #: Arch./Eng• c Address: Water/Sewer Surcharge a 9 Police Plan Check Fire SAC Eng. Water Conn. Planner • Water .Meter ?p Council Road Unit ---o Bldg. Off. APC City/Zip Code: Phone # : Z,02.AL 7`W ?? It01 2007RESIDENTIAL PLUMBING PERnnir aPPLicaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please com lete for modifications to existin residential dwellin s [Date/Q7 te Street Address "qUnit # Property Owner Telephone # 6S711_ ? Contractor Telephone # Address City Stat O Zi ? e,, ? p - The Applicant is: _ Owner & Occupant /ok Licensed Plumbing Contractor Septic System _ New Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built Fire Repair (replace burned out fixtures etc ) $ 10.00 , . This fee applies when extensive lumbing repairs are made to a buildin . $ 90.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures to main level lower level. This fee includes installation of a water softener andfor water heater at the same time. !f you are irtsta/ling onlv a water softener and/or water heater, do not complete this section; move to the next section and piace a checkmark next to the appliance(s) you are installing. _Septic System Abandonment _ Water Turnaround (add $136.00 if a 5/8" meter is required) Other. Wate:Softee:nneerr Water Heater , $ 15.00 repiacement I Lawn Irrigation -RPZ -PVB -new _repair -rebuild I - $ 30.00 State Surcharge $ .50 Total $ - .???' "r -rNIr ,V' aI ""UM Mfl r-1urr10iny rermit ana acKnowiedge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes or 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 accordanc ith th? prove lan in the event a plan is required to be reviewed and approved. App canYs Printed Name A pli nYs Signature /?T 3 7-5 E65 New Construction Reauirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; pou2d found design, etc.) • 1 set of Energy Calculations • 3 copies oi Tree Preservafion Plan'rf lol platted after 7l1193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE JOB SITE AD RemodeVReoair Reauirements • 2 copies of plan . 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions 8 decks . Indicate if home seroed by septic system ior additions VALUATION /! IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER 4eSc,0 TYPE OF WORK FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT 44-!!5fh 1.-7 ? ^l- ?I l S??-a34? Y PHONE# 76 ADDRESS P?%h1 / 0/'? ZIPCODE Ss?? , PAGER # RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD - 55122 651-681-4675 CELL PHONE # FAX # NFN' RESIDENTIAL BUILDING ONLY - FILL OUT COMP Energy Code Category (check one) Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Mechanical Systeln Includes: Sewer/Water Contractor: Phone # Phone # Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant _ MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Sut - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Warksheet Submitted Phone #: Water Softener Lawn Sprinkler Water Heater No. of R.I. Baths No. of Baths Air Conditioning ? Heat Recovery System Y?N_MMAR 2 6 2002 D ? Fee: $90.00 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 OS-plex ? 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 OS-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) 0 24 Storm Damage D 25 Miscellaneous ? 34 Accessory Bldg ? 31 Ext. Ait - Multi ? 33 Ext. Ait - SF ? 36 Multi ? 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 WindowslDoors ? 34 Replacement *Demolition (Entire Bldg only) - Give 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 REQUIRED INSPECTIONS _ Footings (new bldg) ' FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fraining _ Siding Stucw Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MClES 5AC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector Certi£icate for: -Cezetpx Homea Midwest Ia1c. ? " 8601 Darnell Road Eden Prairie, Mn. 55344 DEIMAR H. SCHWANZ 573(c LANOSURVEVOR RpisterW Under Laws ol TNS Stalo of Minmsota 2978 - 1"TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 66088 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE TOp Of B10Ck .. ? Denotes proposed finished grade Q Garage Floor 958.5 . ? Denotes wood hub Basement Floor . p")' / s 5' /' oT ?L I \ ri v I ?? d ?, L ? s /U ?RAI N?G? \ILiTy ¢ o / EqS?Mt N 7-? ry• ? . 0 30, ? °3 ? / tiA• ??tiE \ s ? o? 3 ? ?o i ,/Q f 0 , \,y 9 . ,6-? or'? y p I hereby certify that this. is a true and correct representation of Lot 21, Block 3, BEACON HILL, according to the recnrded plat thereof, Dakota 8ounty, Minnesota. Dated: August 14, 1979 • Revised to show proposed house November 18, 1980. Benchmark: Top hydrant between lots 20 & 21, Blk. 3, kev. 944,06 ft. (? 6 ? ?? ` ? 3C?2 aS? RESIDENTIAL BUILDING Permit Application City Of Eagau 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWdion Reauirements RemodeUReoair Reauirements Offce Use Onlv 3 registered site surveys showing sq, ft of bt, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd (20% maximum lot couerage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 stte survey for additions & decks Tree Pres Not Reqd 1 set of Eneqy Calcula6ons Addition - indicate ifon,s'rfe sepfic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot plalted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date S. / ! / o,3 Construction Cost / _71!,_3 & / I Site Address o-7 0 CiS XIG-05PJ ,CY7 J JY 1!N J J Unit/Ste # Description of Work Multi-Family Sldg Property Owner Contractor RENEWAI, BY ANDEpgSEN . 1920 COUNTY ROAF) °'e° VYC, S'1' Address .[tUSEVILLE, i4IN 55[11 State 651-264-4777 -1=ICENSE #20130983 Telephone # (QJ 1) t 3 - a7" ! ip City. Telephone # ( COMPLETE THIS AREA ONLY IF CONSTRUCTING, A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (q submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( ) Telephone #( Telephone #?1 III; ml,? i 9nn ? Li L ?- I hereby apply for a Residential Building Permit and acknowledge that the info ?tion-is complete-and;accurate; that the wark will be in wnformance 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 accardance with the approved plan in the case of work which requires a review and appr v of plans. ? C 7C- - ) - e Applicant's Printed Name Applicant's Signature C'./ L- _ r n iv eyrepiace(s) /, u _ i _ L OFFICE ]USE aNLY 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 Bidg. ? 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 MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. af Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinallC.O. _ Footings (deck) FinallNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile dther 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 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ,. I . wv.ve.6?rva. tuv LG.JU Ctia /OJ a!1 'g46Q??n'? bin amuMWW re?,j .. ?? . .. . ?: , JUnat 2oa, city Of Eapa . 3836 Piicrt Snob Road Fa$M MN 35122 To Whrnn It May Cancern: Elder Jones is authori'd to pttll btuld3ng pennits for Renewal by Andexs= pIeasa xitow Eldcr Jones to provide this servicc for na in F,nan. 'l?his authariza6cm is validfvrany ctate beyond 6/610,: tunti? a?arova! by Andorsen manag,e?r ?p?+asiy to theCity reyakas it in wtIting - I request this autliozization bc accepted•axpeffidously. av W not deEsy in tke prr?cessi?g of ovr bailding pcunita aay fuzthcr. Elcasc caA mc lf thccc ai+c enp qnESCions.. I can lae c0ntac? at 763-502-4706. Your imm9diatc attcntiott to fhis matter is a?re68rrli_ 9 . . Sinceivly, ymand R Rau nsta[I?tion lv?anagor Renowal by A,nderscn Corporatian ('r.: Kara-F.1dPr Tnhm- .?'?•?..?4 ??? GA? . WVu2 , Received Time Jun. ). 1:01pM i a' ? y~ p, A _ . _ PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA131994 Date Issued:07/20/2015 Permit Category:ePermit Site Address: 4665 Kingsbury Dr Lot:21 Block: 3 Addition: Beacon Hill PID:10-13500-03-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Gordon T Lesch 4665 Kingsbury Dr Eagan MN 55122 (651) 341-8541 Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 Applicant/Permitee: Signature Issued By: Signature tr7 tea ,. ,1 • 0 0 2 2.018 , ir G� For Oftke Use : + , / /' � � " • , Permitil: /���L EAGAN i `� ". Permit Fee: I q i ?O Date Received: t t/y.V 1 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675(TDD:(651)454-8535 I FAX:(651)675-5694 stat buildinoiinspections@citrofeaaan.com L. //� 2018 RESIDENTIAL BUILDING PERMIT APPLICATION�+ (/ Date: ! ✓/-Iff Site Address: 66),.S.--k/y5.1.7/..6/1..J�I_. Unit#:_ ,' Name: `Ad ,r i &EC/) Phone:•• 6/-•3 "J 2cV4 Resident/ 1 -— 03,E- Address 1 city 1 zip: (PID,,/ //n4 S'J 1J " JJT e I Applicant is: Owner )(Contractor C 3 Description of work: !-)4-...1- [A 2 /.' 3 f ' � Type of Work A • Construction Cost 4-3a Multi-Family Building:(Yes ' —I No ) �N Qr i Compan ,...: / /i './ _' _461i J '�� '. ( ontact i J i Contractor Address:/1,633,5- Lf.S j* �� City: A' _ ;_ .% ; ) StaZp: �, , 355Ph0 one; �/Z9Emai1; �1 ' ."6J6{'f�►PC4h7 LiceLicense*:gal/41101/2f? Lead Certificate#,A.47746��'5 oR • If the project is exempt from lead certification, please explain why: k)9 . _ • COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUI • • = In the last 12 • • I.s the City of Eagan issued a permit for a similar plan base. • master plan? Yes _No If yes,date and a•• ---- •-- ter plan: i Licensed Plumber. Phone: { 1 Mechanical Contractor Phone: Sewer&Water Con ec6r. Phone: 1 r Fire pression Contractor: Phone: NOTE'Plans and supporting documents that you submit are considered to be public information. Portion's of the information mayTe.. i classified as non-public If youprovide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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 locales of underground utilities. we vw,000herstateonecall.ora . I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan;that I understand this Is not a permit but only an application for a permit.end 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 r t sh eJ,S))11;4i, x eli,u7•G;.0-/ 1 Applicant's Printed Name Applicant's Signature • 'd 09S6 '0N WdL I V C WIZ 'z '100 DO NOT WRITE BELOW THIS LINE i/ / „yam- /1 -SUB TYPES /-71,65- / r`,'� elthme j9 - 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 _ Windows _ Demolish Foundation _ Replace _ Repair Egress Window _ Water Damage Retaining Wall 'Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation I .4/300. - Occupancy �-_ 1�( -/ MCES System Plan Review Code Edition ., ?I'? 2.6)/c SAC Units (25%_ 100% Y') Zoning ),- j City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V Width REQUIRED INSPECTIONS • Footings (New Building) Meter Size: _ Footings(Deck) Final/C.O. Required Footings(Addition) _ Final/No C.O. Required — Foundation HVAC_Gas Service Test Gas Line Air Test Roof:___Ice&Water _Final Pool: Footings Air/Gas Tests _Final Framing 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 Fire Suppression:_Rough in_Final - Braced Walls Erosion Control Other: ?viewed By: �oal �r f.--(f/" , Building Inspector ESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 sJ2 S7/ . Certificate for: i . ,-' _ -Centex Homes Midwest Inc. r g601 Darnell Road Ara Eden Prairie, Mn. 55344 DELMAR H. SCHWANZ 'Z./V''' 5-3(0 LAND SURVEYOR Rasistafad Under Laws Of TM State Of Mint-mot, 2978*146TH STREET W.— BOX M ROSEMOUNT,MINNESOTA 66068 PHONE 812 423-1719 SURVEYOR'S CERTIFICATE Top of Block . . . (T Denotes proposed finished grade Q Garage Floor 958. 5 0 Denotes wood hubfki /\ Basement Floor . S c, 41 \. ; o J�1-‘1 ‘,' Qp4,`1 c� tht \ %) 1)kAiN 4 64- 44 19 Ns<IL 1Ty EgSIEN � �NC' 1-f � N°- /-7'6 _ = 4' ' / 1�. \''= c:NN ,,,,' j40 \ >c 0/ ''' 5CAL I 30' 30, ' 1 6",), / 47..,• -\-.,*,\ / / P4 r �b© 4 / /1/0 /- �� I �.8 v 435." I hereby certify that this. is a true and correct 4 0 (S representation of Lot 21, Block 3, BEACON HILL, \A according to the recorded plat thereof, Dakota County, Minnesota. / Dated ; August 14, 1979 • Revised to show proposed house November 18, 1980. Benchmark: Top hydrant between lots 20 & 21, Blk. 3, ev. 944. 06 ft. .br, {.-:-'-ctcu--) x •• ! J / ,.. ,-.4., ,-r 1 g, , t ` MINNESOTA REGIStRATION Mo,482Sl f