4670 Kingsbury Dr
Use BLUE or BLACK Ink
For Office Use
I I
CiPermit +Iby of Eajan I
RECEIVE? I
I Permit Fee:
I
3830 Pilot Knob Road 3 I 4
Eagan MN 55122 1010 1 Date Received:
Phone: (651) 675-5675 I I
1 Sta:
Fax: (651) 675-5694 I --ff-__
/ 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: / '"v7V- j Site Address: ~1 7G' /S// 2L[.c
Tenant: Suite
I _
RESIDENT I OWNER Name: q,-. Phone: ~is~ 7-5'r Q ~tl
Address / city /Zip:
CONTRACTOR Name: j~ License
Address: r'at'. ty.
State: Zip: Phone:
Contact: r _ Email:
TYPE OF WORK -New V Replacement -Repair Rebuild - Modify Space_ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation C- RPZ / - PVB) Add Plumbing Fixtures C_ Main / Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
'Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
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.oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X vm~n~' G . jjCZ _ X
Applic Ys Printed Name Applicant's ignature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
CITY OF EAGAN Remarks
Addition BEACON HILL ADDITION Lot 12 elk 4 Parcel 10 13500 120 04
Owner street 4670 KinjzsbuTY DTive State FSgan. MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. $O 982 1806.39 200.77 9 1806.93 C007584 10-1-81
STREET RESTOR.
GRADING (p 5 1982 526.46 58.50 9 • -'
SAN SEW TRUNK p' 1976 135.97 9.06 15
* SEWER LATERAL 1982 3116.46 346.27 9 3116.4 --
WATERMAIN
* WATER LATERAL 19$2 9
WATER AREA r? 1982 198.01 22.00 9 198.01 C007584 10-1-81
* Stubs 1982 9
STORMSEW TRK Yj ? 1982 359.82 39.98 9 359.82 C007584 10-1-81
* STORMSEW LAT 19$2 9
CURB & GUTTER
SIDEWALK
STREET LIGHT
250.00 35685
WATER CONN. ' ?450•OO M „
BUILDING PEFi. T
99 5
SAC - n n
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVGD
FROM
AMOUNT $ I
& DOLLAR9
_ ... . .__'_^ 1 oo
? CASH ? CHECK
•OR
FUNO COOE AIAOIINT
Thank You
BY
? White-Payers Copy
Vellow-Posting Copy
Pink-File Copy
Receipt
MECHANICAL PERMIT Permit No.
_ CITY OF EAGAN Fee
fill in numbered spaces S/C
Type or Prin[ leglbly
I Tot.
- i .
1. Date -- / 2. Installation Cost
. - „
3. JobAddress?`b70 /J',.tv?,;ot ?G- Blk. ? Tract ± i
4. Owner-?4%r`:'?:Nii?/c
. ,
5. Phoner
:
.•
6. Address r _
7. City<`L1EiY"ie'4kir State Zip ? J`•''?
8. Building Type: Residential LY' Commercial ? Institutional ?
9. Work Description: New,E] Add ? Alter ? Repair ?
10. Describe
11,
FuelType,?? ?
No. Eauioment BTU - 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 correci, and I agree to
comply with all ordinances and codes governing this type of work.
Signed:
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
1 ?
Receipt ? PLUMBING PERMIT Permit No.?
CITY OF EAGAN _
Fee
l r
fill in numbered spaces S/C
Type or Print/egibly ?
Tot. '
1, Date S ? 2. Installation Cost
a? • ?
r;n
3. Job Address ?yLot /Z Blk: Tract 1-i i}
i /
4. Owner "?Gf..?S/) / ,?* ( oiL.`
5. Contractor L ?T P?t'U l''Phone f-
6. Address
7. City State %1 J-L Zip
8. Building Type: Residentiai lEg
9. Work Description: New'g
70. Describe
11.
Commercial ? Institutional ?
Add ? Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
%
-?- Bath tubs Septic Tank
'"' Lavatory Softner
/ Shower Well
% Kitchen Sink _
Urinal/Bidet
_
_ Laundry Tray c'fr r
Floor Drains ? _
i
Drinking Ftn. __-
/ Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: ? for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
.? /
BUILDING PERMIT
CITY OF EAGAN T,' J
9795 Pilof Kno6 Raad Eayan, MN 55111
PHONE: 451-8100 /
Te be wed 1or SF DWG/GAR Est. Value $61, 000
Siro Addreu 4670 I:inQaburv Drive
Lor_12 BI«k 4 Sec/Sub. Beaccn Nill
Parcel #
W Nome 5une111ne l:onatruction Go.
? Addrcas 1507 Clmmeon Ct.
r;fi, Tiaqan 55122 p,,,,,,_ 454-7485
o Name Oumer
Z?
u? Address
? .-?... .,? -
Nome _
Address
I hereby ocknowledge thot I hove read this opplication ond state that
the information is torrect ond ogree to tomply with oll applicoble
Sfate of Minnewto Statutes and City of Eagan Ordinoncet.
Receipt
Date t'aZ' 19 `3
Erect ? Occupancy P•-3
Alter ? Zoning '-t-1
Repatr ? Fire Zone NA
Enlarqe ? Type of Const. V
Move O # Stories
Demolish ? Length <<s
Grade ? Depth 44 Sq. Ft._
Apyrorals Fses
Assessment
Woter 8 Sew.
Police
Fire
Eng.
Plonner
Countil
Bldg. Off.
APC
Slpnoture of Permittee -
A Buildinq Permir ts issued ro: Sunsiiine Consr_ruction Co.
all work shall be done in xcordonce with all aoolicable State of Minnes(
Permit )iv.vv
Surcharqe 30.50
Plan check 158.70
snc 525.00
Water Conn. 450• 00
Water Meter 60.00
Road Unit 250.00
Torol $1739.50
n the exprcn condiTian Iho+
of Eapan Ordinonces.
Building Officiol
Permit No. Permit Holdar Misc. Permit No. Hoidar
Plumbing
H.V.A.C. ?(.1'II?
Well
Water
D'up.
Sawer
'
Ekctric L707Q0 t? ?? ?(f.C . S"?{ ??f3 L'?E ?
r,moZ 3 4-2 u ` ? ?°z-Sr 3
Inspeetion Date Insp. Othar
Footings $-4-92) (,j)/?- -:le
Foundation
Fromin9 - - 3
Rough Pltq. . • 3 ?
RouOd HVAC i5
Inwlation
Final Plbg ....
Final
VAC 4
Final T
Wate ??ibe Loeation:
VYall .
Sewer
Pr. Diap. . .
CITY OF EAGAN SEVIfER SERVI
3795 Pilot Knob Roed PERMIT NO.:
Engan, MN 55122 DATE: .
Zoning: No. of Units: ?-
Ownee
Address:
Site Addi
Plumber. '
1 agrea to eompy wlfh Fhe Ciry of Eogan Connedion Charge:
Ordinanqa, Account Deposit:
Permit Fee:
Surcharge:
BY Misc. C'harges:
Dote of Insp.: Total;
Insp.: Date Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Rnob Rood PERMIT NO.:
Eogau, MN 55122 DATE:
Zoning: + No, of Units: -
,
QWfl@f:
Address:
Site Address: 7J_KlnKbbuz'+ a;L'l,if K&L-, ,•r?•.,,. ? t ?
No.:
No,:
a9ree W oomply with eha Ciry of Eagon
Connection Charge;
AccouM Deposit:
Permit Fee:
Surcharge:
Misc. Chorges:
Total:
Dote Paid:
1X1'
of Insp.:
?-Iq L? Ty pF EF;;,AN ` Include 2 sets of plans,
{v??v 1 site plan w/elevations &
s?Y-? BUIIDING PERMIT APPLICATION 1 set of energy calculations.
Zb 13e Used For aluation 1101,o(16 Date
Site Address q(0 -1e) " pFFICE USE ONLY
rAt %a- slocx sec./sub. Erect Zl, occupancy .3
Parcel #: O l"v Sn c)6?{ Alter Zoning ?
Repair Fire Zone
Owner: Enlarge 7.'ype of Const.
Move # Stories
Address: Demolish Front ft.
Gity/Zip Code: Grade Depth fr' ft.
pnone # :
APP12pVALS FEES
Contractor: a,? CQ-? AssessmQnts PP-rmit 4-?
Adciress: `' `,
[4ater/Sewer Surcharqe
50
Police ?
Plan Check
--
Fire SAC S a?
Eng, Water Conn. a,/cS1?
Planner Water Meter
????l -
Road Unit ,,c-A
City/Zip Code:
Phone #:
.-
Arch./Eng.. 12.-a
Address : o? 0 3 - ?--
ti-
City/Zip Code: C?...:2?-_ M.Y.
'Phone #:
?u,
Bldg. Off.
APC
TOPAL I131 7:S::C) ^
? .
? ? ? ? ?,.?..r,? I,,,??..? ? -?, ?9
'4?
/
oV V
?./ S Y a
G???a
REQUEST FOR ELECTRICAL INSPECTION ?. E8•00001-04
?:
See instructions for comple[ing this form on 6ack of yellow copy.
.?.? .. ?
" X"' Be/oo ork?? ?ered by 7his Request
:? ? ? / ;;'-
Add Hep. Type oi Building Appliances Wired Enuipment Wired
Home Ranqe Temporary Service
Duplex Water Heater Liyhting Fixtures
Apt. Buiiding Dryer Electric Heatin
Commercial Bldg. Furnace Siio Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm oiner Dec?fy cne? Isuec?tyl
t er pecify Ot er Other
O!lIDU[B /pSDBCIIOn !-P.B
it Fee ServiceEntrenceSize # Fee Fenders/Su6feeders 4 Fee Circuits
U to 200 qm s 0 to 30 Am s U to 30 Amus
Above 200 Amps; 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100_Am s Above 100_Amps
Transformers Irrigation Booms Partial-'Other Fee
Signs Special Inspectfon
$
Re
marks
s
T FEE?
1.. nr
v
I, tAp-Ef?ricAl
7 ector, here6y
ify thet ihe above
inspection has been
made.
Tnis repuest void 18 months from
This requast void j _Ck
18 rttonths fYOm
W074027_
S
?f
,. __- ==y
;3 5-7/ a
/o ,oU
nequest uaie Fire No. Rough-in Inspection
ired? ?ReaAy Now- WiIINBtify, lnspec-
I S L ?Yes ? No or When Ready
? Licensed Electrical Contractor I hereby request inspec<ion of ebove
Owner electrical work installed at:
Street A? d/ye?ss, ?Bo/x or Route N'o./
? ?+ { I ?.A? • .V? ?
ecuon o.
I
Township Name or No. ange o.
C unty
Occu ? IPqiNT) , Phone No.
Power,$4pplier
hl! Address
EI •trical Contractor ICom any 4"sel
_ Contractor's License No.
1
ft-I A ress (Co tractor or Owner Making Instai tion) ?
?
I
Authorized Signatu ntracto wne
akinp Installation)
v I \_. l? ! _? Phone Numbtjj?
MINNESOTA STATE BQAND OF ELECTRICITY THIS INSPECTION REQUEST W LL NOT
Griggs-Midwey Bldg. - Hoom N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 65104 UNLE55 PHOPEH INSPECTION FEE IS
ei._.._ iaill aoi o'll ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
. ' Sae inetructions lor completing this form on back of yellow copv.
Belo?Woifc'Co?eied by This Request
?.' EB•00001-04
?;.
New Add Ra
P? T
Vpe oi Buildfng
AppliancaS Wired --?
Ec1uiPmen[ Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm r ' W o rner isper.jfy)
t er Specify Other
(,'ompute Inspection Fee Below -
# Fee Service EntrenCe5i2e N Fee Feeders/Subfeeder5 K Fee Circuits
.?
i
0 to 200 qm s
0 to 30 Am s
•?
0 to 30 Amps
Above 200 qm??y 31 ta 100 Amps ? 31 to 1D0 qm s
Swimming Pool
F Above 100_Amps Above 100_Flm '
Transformers
4 Irrigation 6ooms , Partial•'Other Fee
Signs Special Inspection
'
$
TO L
Remarks ?, ?FfE o
!w Y
k -t . /
floueh-in • /
' Dace
? I, the irical
Inspector, hereby
certit
thal the above
Final Date y
inspection has been
_ 7.; ^ada.
Thisreauestvoltll8montnarrom {,S
This request void (L -Z ).,I>q ?l,L C ?00"
18 months from
? 073q70 ?4
fiequest Dace No.
7 RouBh-in Inypection
Req ired? ?['
?Ready Now111Wi11 NotifY. «spco-
?
,S?1- 93 yes ? No < <ar When Rcady
?
Licensed Elecirical Contractor I hereby requestinspection of e6ove
Owner electrical work installed at:
Street Address, Box or Route No. Ci1Y
'r
ection o. Township e or No. Range No, Co
Occ pent IPqWT1 Phone No.
Power pplief AAdre55
Ete rical Contractor (Company Name) Contractor's License No
Mailing dress (Con ra tor or Owner Making Instail onl _
Authorized Signat ontractor/Owner aking Install tion) Phone 4Vnber
MINNESOTA STATE BOAflD OF ELECTPICITY THIS INSPECTION REQUEST WILL NOT
Grig9s-Midwey Bldg. - Hoom N-191 BE ACCEPTED BY THE STATE BOARD
1821 Univargity Ave., St. Paul, MN 65104 UNLESS PROPER INSPECTION FEE IS
o,. ___ ?wiel 107.1111 ENCLOSED.
w-rx#iftra#e uf Mrrupttnry
Citp of (eagan
Ervbrtmpnt nf luild'mg Jnsprrfimt
Thu Cati ficate isrued purraunt to the rcqxiremrnts of Seuion 306 ot thc Uniform Building
Codc nrtrfyiag that at the timc of irtrrann this struclure wdr in compliante with ehe vurioru
erdinancu of thc City ngulating building conriruction os ure. For the following:
u..c,,wfic,uou, SF DWG/GAR Bia,.eefftdt No. 7995
oo;uwicr rype R3 ryp con.uictim V Firc Zone NA uting or,Nn Rl
o.,K„rwams Sunshi ne coasc. co Aac.1507 Clemson Ct., Eagan
8???Adduni, 4670 Kingsbury Dr. Lot 12,Block 4,Beacon Hill
1?)dX` RMw;ngSwxwL? ?a June 29, 1983
?r Ow w cawmcuoos ruca
m,s +m un?um u.s.n, .
CITY OF EAGAN ? ?J .9 5
'-- , 9795 Pilot KnoA Roed Eagon, MN 5511' l?l.o PHONE: 454-8100 ? ?
BUILDINCa PERMIT Receipt #
To ba uaed fer SF DWG/GAR Est. Volue $61,000 Date May 5 1 q83
Site Address _ 4670 Kingsbury Drive E
r O R_3
?? ? ctuponcy
Lot 7-2 Block 4 Sec/Sub. Beacon Hill
- Alrer ? Zoninq R-1
Porcel # r--
10 13500 120 04J Repair ? Fire Zone NA
V
Name
Sunshine Construction Co.
Enlor9e
?
Type of Const.
W M°"e ?
# Stories
Z
? Address 1507 Cletnson Ct. Demolish ? Length 48
Ci _Eagan 55122 phone 454-7485 Grade ? Depth 44 Sq. Ft.-
p Name O^7nel ADProrala Fees
?? Address Assessment pe?it 316.00
~ Ci Phane Woter & Sew. Surcharge 30.50
Gw Palice Plan check 158 . 00
Nome
F w
Fire 525.00
SAC
?Address Eng. Wnter Conn. 450. 00
<W Ci phane Plonner WaterMeter 60.00
Cauncil Road Unit 250.00
1 hereby acknowledge that I have reod this application ond state that gldg. Off.
the in(ormation Is correct and agree to wmply with all applicable $1789
50
$tate of Minnesoto Statutes and City of Eogon Ordinances. APC .
Total
Signoture of Permittee
A Buildiny Permir is issued ro: Sunshine Construction Co. an the express condition thar
all work shall be done in accordcnce with all opp) o an ity of Eogan Ordinances.
Building Officiol
- p40?el
q6..Cf0
- - - - - - - - - i
? Pem,a #.
I ? bb I
i Permit Fee:
? Date Received: j
? I
I Staff: I
I
`____ J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant:
Suite #:
%
-
RESIDENT / OWNER I
PhoneA22??? -45
Name: (
Address? City / Zip:
Applicant is: _ Owner ? Contractor
TYPE OF WORK Description of work: ?- ?
r
Construction Cost: Multi-Family 8uilding: (Yes No
#
Li
C?? gL4(aq
CONTRACTOR :
cense
Name:
Address: 5GL41 I t IPIYICinC3li Ave N.
M
Zi
-
I
!
`H
wo
er
p:
City:
c
I
State:
?
J
t
f
Phone: GGI "-1.?I•"I 3JaQ Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 monihs, 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 docum?r?tsitfia?b?ou subm?t ar? cons?tlered 14 ? Pub?? ?r?fatmatron YPa?ons:of
as?s=tltatwoerl,`d?erm?tt??rf?fio y
u#ire?nformat?onmay;be,class?i?ed
E
:?l?d axe't'ra
d?seaieiF?,
I hereby acknowledge that lhis information is complete and accurate; that the work will be in contormance with the ordinances and codes ot the City ot
Eagan; thal 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 l Cle-e X
Applicant's Prin ed Nam Applicant's Signatur
Page 1 of 3
90
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN ,--?-*,
3830 PILOT KNOB RD - 55122 C) ? v
• r? ?? 651-681-4675 C? -?v
New Conshuctlon R?vuiremenh ?? ?3077g Remodel/Reoalr Reaulremenla
? 3 reglslered site wrveys showing sq. lt. of loi, aq. ff. ot house ?--oO 2 copies of plan
and go rooled arecis (20% maximum Iot coveraae allowedl 1 set o( energy calculaNons tor heated pddlflona
D ? coplea of plans (show beam & wlndow sizes; poured Md. desifln; etc.) t sife wrvey for extedor additlons & decka
> 1 sef ol eneryy calculaNons
> 3 coples ot tree preaervalfon plan if lot plalted after 7/11/93
O?
DA7E: n ( I-7I ZDclo CONSTRUCTION COST:
DESCRIP'fION Of WORK:
STREET ADDRESS:
LOT: BLOCK: --A SUBDJP.I.D. #:
Name: B?i=zQ PLl- 1nc, Phone Y: G,51- 451-D23 F
PROPERTY taat Flrot
OWNER
Sheet Address: y?o`1U ?-11v?s(?-`r ?.h
Cify %-Al-? Sfate: zip: 1-2?
Company: S-2L 4?- 15,jl I o' VV I TT
Phone #:
(area code)
conirRAcroe
Stree4 Address: Lkense # Exp.
Ctty State:
ARCHITECT/
Zip:
ENGINEER Company: Name:
Telephone #: ( )
Sheet Address: Regishatlon #:
Ciy State: vP:
Sewerhnrater licensed plumber (if lnstallirka sewedwaterl: Phone #: U
I hereby acknowledge that i have read this applicaHon, state ttwt ihe infortnation is cortect, and agree to comply wNh ap appticable State
of Minnesota Statutes and Cify of Eagan Ordinances. Y?
Signafure of Appticanr
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No MAY 2 5
Tree Preservation Plan Received _ Yes _ No _ Not Required ?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dweiling ? OS 06-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ piex ? 09 07-plex 151?--18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 OS-plex 0 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous
? 06 04-plex O 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
.. ,
.
? 31 Ext. Ait - Multi
? 33 Ext. Alt - SF
? 36 Mufti
WORK TYPE
,W?31 New ? 36 Move Bldg. 0 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish.(Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ?' 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code 0? # of Stories sq. ft.
No. of Units C)_ Length sq. ft.
No. of Buildings i Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code K3k
(Allowable) Main level sq. ft. • MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning
Building ?
Engineering
Variance
Permit Fee 116 0. S 0
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S1W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: 'r6 d ? s d
Valuation: $ 1,2Uu
SAC Units
% SAC
. . • .
G Y O R'S' C E R T 1 F 1 C A T ESUNSH I NE CONSTRUCT I ON COMPANY
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4'g JO S?c ?
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, - S 65 °05'30"E 146. 85 - ?
? h .- 3?00 ^- X94-4.06 942.9X 9308
i 3O - - 48.33 "?-I-s
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1 IR
O (af942 3? 94Z.6 _ ?.N `n- ?
22:6/$ !94 5 ?5 37.9 \?QZ
?
(938 - .6)
M Q? PR4POSED ' ? ?
RJI/EWAY O
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d942.6 O r'n O ? O ?pb(q /
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26•33 !Z (g38,6)
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4
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? N 9357
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_?.____ • DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MOPIUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON M0NUMENT FOUND PROPOSED GARAGE FLOOR = 9?2.0 FEET
X000.0 DENOTES ERISTING ELEVATION PROPOSED LOWEST F100R = FEET
(000.0) OENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = ?1k2,3 FEET
I HEREBY CERTIFY TO SUNSNINE CONSTRUCTIOP! COhSPANY THAT THIS IS A TRUE APID CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot /2 Block 4, BEACOPi HILL, accordina to the.recorded plat thereof,
. Dakota County, Minnesota.
AND OF 7HE LOCATION OF ALL BUILDIhr,S, IF ANY THEREON, AND ALL VISIBLE ENCROACHMENTS,
ua."w.r+.rwcaa?-mca -' ?
-4-
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 _9 ?
? 651-681-4675
New Construclion Reauirements
Remodel/Repatr Reauirements
? 3 registered site surveys showfng sq. ft. of lot, sq. ff. of house 2 copies of plan
cnd alt roofed areas (20% maximum lot coveraae allowedl 1 set of energy calcutationslor heated addBfans
? 2 copies of plans (show beam 8 window sizes; poured (nd. design; etc.) t sMe survey for exterior addifions & decks
? 1 set of energy calculations
> 3 copies o7a ee preservatfon plan if lot platted afler 7/1193
DATE: 7T?'?I ? CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: _7 (P7D ?c ingg?jaR y ??Z . ?? &A P`)
LvT: I')_ BiOCK: ?_ SUBD./P.I.D. #: &-pi- C?Prv?
Name:? R.T fZAL- `1AwtC3- phone #: (p SI' ! 5d? -Ob'?O
PROPERTY Last Firsi
OWNER
Street Address: YV70 N S.2 iz!g 1212.
?
City ?Apf'-j State: loAl Zip:
Company: f't?Tf ?ar1 5?A ftd; o.4' eO- Phone #: I oZ 915 -boqo
(area code)
CONTRACTOR ,?/
StreetAddress: ) l5? 3 k?c?p ?,?2 , License #?Z1., ?fri(? Exp.
City /5 1-02 .0s ?«c- 6 State: A't f4M F}`b jFE Zip; S S 3 3 7
ARCHITECT/
ENGINEER Comaany: Name:
Telephone #: area code ( )
Street Address: Registration #:
City State:
,
Zip: •`
?
Sewer & water licensed plumber (reauired for new construction onlv):
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the intormatlon is correct, and agree to comply with all applicable
Siate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
f i
,
OFFICE USE ONLY Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of_ plex ? QS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
O 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New 0 35 Tenant Impr - ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
C 33 Altora:icn ? 37 pemolish Bldg.* ? 41 Wnod Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
.
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI,
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Basement sq. ft. Census Cotle
Main level sq. ft. SAC Code
sq. ft. No. of Units
sq. ft. ` No. of Bldgs
sq. ft. MC/ES System
sq. ft. City Water
Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
Building Engineering Variance
Valuation: $
°/a SAC
.
SURVEYOR'S?
.? . ,
a
?V
? 30
.
?
o
4
?. p
Z m
Y +?
.a
s?Q X
,-h
? -
'--' -
' SUNSHINE CONSTRUCTION COMPANY
?
/46. 85 -
- a?, - S 65 °05'30"E
.}? 3000 --L,X94¢.OB 942.9X
1f`-- 48.33
- - T - - ?
,o r
? h
I NI:?-5¢I7)-, _ ?a
fr.
94i) s
PROPOSED 25.661 C`?:
' iDRlVEW?iY o.Q / O
V) Q
W
? 2.00 ? 1,1942 6 I ? 'I C941 7)?
? ? $+ i 6 3.3 X I
? X943.3 ?
( 94f.7) I ?
i?
i ? - ---?-
10 -i-9.35
936 ?9 "I r
3o.6 5 760/p?3? r
h
-------?
. ?S .
y f?
n
27
X937.9 `V ?l
Cq
4P??v? o?l i
5 \ ? \
" j
93?
/
105. ?r
? r?
\
1 I i
f_ DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MOPlUMENT SET
• DENOTES I'RON PqONUMENT FDUND
X000.0 DENOTES EXISTIiVG ELEVATION
(000.0) DENOTES PROPOSED ELEVATION
SCALE: 1 INCH = 30 FEET
PROPOSED GARAGE FLOOR = C9A?2.-0 " ; FEET
PROPOSED LOWEST FLOOR = FEET
PROPOSED TOP OF BLOCK = FEET
I HEREBY CERTIFY TO SUfdSHINE CONSTRUCTION COMPANY THAT THIS IS A TRUE APlD CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot /2 Block 4, BEACOP; HILL, according to the.recorded plat thereof,
- Dakota County, Minnesota.
AND Of THE tOCATION OF ALL SUILDIh?',S, IF ANY TNEREON, AhD ALL VISIBLE ENCROaCHMEN7S,
IF ANY, FROP1 OR Oh SAID LAND. IT ALSO SHOWS TNE LOCATION OF THE STAKES AS SET FOR
A PROPOSED BUILDIPlG. AS SURUEYED BY P?E THIS 207-8 DP.Y OF APRJL, 1983.
SIGPIED: JAME H LL, IP;C.
n ?/,1.? ? ?+ '
BY:
HA OLD C. PETERSON, LAND SURVEYOR
MIPlRESOTA LICENSE NUMBER 12294
PROJECT NO. BOOK / PAGE jAMES R. HtLL, INC.
83215
2.9/? Planners / Engineers ! Sucveyors , FILE NO. 8200 Hum6olQt Avenu• 8outh 1 FOLDER , Bbatnington, Mn. 65431 812=884-302 9
i
?
?
. i;? .
.?
, , . Cuide Congtroction No.
\?'indoNZ ? poora ReTference Out. Wall Int. waH Ceiling Roof
Yce--No ? -:[ce--Vo ? 19_
L Fl.I ?•??S)i1 _ Rootn L,!nRth\l,,?pu?Wid1h\U'1O11 iieightg%()u
%kinde•Ne arc Doors-Crarlixo? .d A..- ? T
- µ-?-. i iie.,3h[
No. of;?r.• I-=?ene tip. o:
ii?hte Llneal [0.
ufcrack AFea
p.fl. .
1C
,
- - -
-
?
-1---
?
__?_ -- "--
' -
_- . Cocf. &a
Infiitration (o O
c!as3
Exp. wall z2
1N[I lS7. N'dll
Inl. v:a11
Flnnr
ceii.
i ota! tttu.
Recuired sn ft. E.D.R. or sq. ins. W.A. L.eader area
m I LenRfh tllo' w;athyOd' Heightbwe"
W;ndsti-s and Doors-CrackaQe and Aree
I
No. w'-'^ ^i+!IRht
pnne No.o[
Iiehb i,lneallt.
of eraek AT?I
q. tt
II
----
? t--
? Coef. Bcu
lnGllration
! ?
Glaia
--
E:p. wall
?h'et c :p, wall LA8
Tnt. wall
Floor
Ceil----
(otal Gtu.
Requir d~q. Et. E.D.R. or sq. ins. W.A. l.eader atte
F%kvV AT* Room I Length Width`'j'
?'i?do•,ve ar.? Doors-Craetiax enii Ar.- a-
No. ? ttii7in I i;P?.ght
er pnne ? C yane Ye.ot
119hts Lineil[t.
o! crack Arn'a
eQ. [t. ' -
? I
?
i
Coef. Btu
Infiltra:ion
Glaas
`-
Erp. wal!
?
I,Pt fEp. N'O
-----
]nt. waiJ
Floor
L..
kequir.d s;. (e. E.D.R or sq. ins. W.A. L,eader srcn
Iasnletion
Floor i??? How Applied
FI -? AW Room I l.erg(hyk,V' I'L'icfth
xv,..A„W. n?.Z-_c'.arlaQe and Area
No. ;
paWldt sDt
ot Wa No. o[
lifbb
ot Cratk Arc•
pit.
j
a
4? t, Z.Z.
? Z. dn Lv
Coef. Qtu
[n6.itration , _ Gq ' O
Glss« ? B0 50 L-I o 06
Exp.wnlllNSt"L
Net exP. watl
-
-
? 1
W. wall Ne'r--ExJ Uu
i N tZ,
i C
c..,
Totnl Btu. I NO-.1-tS?K-L-ld_ ??'cL Z? 1
Requircd sq. Et E.D.R. or sq. ins. W.A,_Leader area I
Fl.l ~ Room I L.ength Width Height
I Wi...1.,..,e a-all.nra.-rearirAao and Q,rea WIAC? HelRpt No. o[ I.In.al tL dret
No. of D?oe nf na" 1i[Ot• ot crack eo, fl.
l".cef. Btu
InlilUation
?
??--
Glaes
Exp. wall _
Net ezp. wall
3nt. wail
Floor
Ceil.
Tota1 Btu.
Required aq. ft. E.D.R. or eq. ins. W.A. Leader area I
?
FI., Room I Length Width Hcight
Winclowx and nenr Lratka¢e and Area
Na Wlcltn
oI Dane Na1Qht
of,pane No. of
Ught• LIne.l f[.
of cnck Ares
sQ. it.
Coef. Btu
Infiltration
Glass
Exp. a•a1.
Net exp. wall '
Int. wall '
Floor
Cql.
Total Btu,
ft. E.D.R.,or aq. ins. W.A. Leader area
t,
VV , AS.H.V.f: ,
• ??i Cunstroction No.
Gue
Rekrider.ct Out. R/all Int. WaN Ceiling
-s--?a ?I 19-
\-Fl.i Fc vF ? Room lLcnRth -?'U'Width lAA' HeiahtA%r^I'
u':nG?'.?,•??? ;.. ' Doors- -Gracka ge and Ar ea
: i: :.r
_
',ine
li.ht• Lineai tt.
otcrack 7.rr?
p.[t
??,
k.
Z
Infi?tratioa Coef. &a
G!.,se ? °JC> 2.
F-xp. w,;i b
Net exp. all
Int.
or sq, ina. W.A. L.cadcr area
Roam ? Leng!hZ2. width y'(?•? Neight
--
-i
l. _.? 11
I
I
I }i4_rr,,
L.xp. wa!I
T?ct c ;p.
Tnl. wall
Floor ---
Ceil.
Total Btt:
1\P!lllIRd
• ? ar.;i Dcors---Cracka ge and Area ?-
-.. . 1 ' r.t Fo. oI
" n` ?QAts Llneal ll.
a( craek ATla
q, tt.
Coef. Btu
___.__-------_- _?3 5G \ a
-- -----.. ?.?.
---
30 12 2V
ir. F.,,D.R. or sq. ins. W.A. L.eader aree
? FI j (?j? Room I LenKth 1 ?'U Width IC)tU?? Ne:Bht 1?`Olj ?
arci Uours-Craekave nnd Arra
N. qh[
' pn*:c , -.?ne
\' fi`'_l?" :Jn. of
Ilght•
I LlneLl tL
, otcrack
Zo Arm
sp, f[.
1
L
i coe7`.
??
D piL
Infiltration
-- ----
En C)
('?axe -- J
11Ct tEp. NA.11 1 ` Z
Int. wall
?UO(
0_
_Tota! E:u.
Ftequired ?.;. ic, c:.DR ar sq. ins. WA I.eader orea 11
Intolation
Roof Floor I F:ind HoW Appl;ed
Room ] lrngth Width HeiBht
And Air.l ?
No. Wiate
ot pane Ite16LC
ot Dano No. of
?c6t• 1.?ne+i tc.
of cracl[ wrea
e4. (t.
I
C«f. Bsu
Infiltrafion LA0 ?'bZ
c?ass y a -
Exp. wall 1
Net acp. wall
[nt. wall
F!uor
NL 4 k4LA
T . 1 fl.
l91 A 1 _ ]
\V;.,r1„w? a„d D?r.-Cracl•aae and Area
NO.
-Z A'IAth
o( 9aoe
-iQu IielFht
of P^>+e
?Qi No- of
llp6ts
1 I,!n.ei It.
of erack
1'??Ci?f Area
p[l. ' -
`?ass
`Z CoeE. . Bcu
`JQ aQ
`_
Exp. wall _` `O-}
Net esp. wall Z.
Int. wall _
Floor
CeJ.
To[a1 Btu, ?
Reqnired sq. ft. E.D.R. or eq. ins. W.A. L,tadv aree
FI•1 WZ, ZD Room I Length 1Z;I Width \?1011 Htight? Q
XV;nAnwa enA nnnra_Trer?ae? anrt Qr,
Na WWth
ot pane Hel[bt
oLOan• No. of
Ilshu Linesl ft.
of cnck Area?
•v. ft.
\
Coef. Btu
Infiltration ,• LiD (4 C}
Glass ?
EuP. wali _
Net exp. wall Z,
Int. wall
Fleor
ced: M
Total Btu.
Reqaired sq. ft. E:D.R.,or aq. ina. W.A. Leader area 1 _
-Tc-I-A - +A/L = 50 ,1-I b 2, l?ru O5!`'1 CA'I o O M
S? ? ?too
P of Ealan
3830 Pitot Knob Road
Eagan MN 55122
Phone: (651) 6754675
Fax: (651) 675-W
a?q-?o
?-----------------
? ?
; Pamlit?: ;
i aeana Fee' ?
i
? paDe Received: I
I SaF: ?
? -----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Dae: Il S sfteada.: 41?`?h Kim6S(3 oru
suft r
Ter?ant:
RESIDENT/OWNER nam>31m 9s?-?`f-
addrm r cay I z.O:
wwnis: -owner
TYPE'OF WORK Descripibn of wwk: S EA<t2 01'F ? ??- S I DE ? SQ
? Conatructlon CosC o? 4 Gb, c? Mu1ti-FamiN WMv: (yes-1 N0,XJ
CANTRACTOR Name: L.mm #:
?
Address:
Phone: C'o5i • yS9-q= coWaown: Knc`Pt'1
COMPLETE THIS AFiEA ONLY fF CANSTRUCTtNG ANEW BUILDtNG
NGnnesote Ffules 7870 Cateaorv 1' Minnesata RuW-=
Eltergy COdE !• RoWerAw Vwdadon.Camory 1 Waw;hw • Nar &OW Code Wofthm
Cdepry gudnimed : Subrdw
(d subm 'lsooniype) • E^eW Emretope CdadabOrs &bnibd .
1n tho bast ta moMhs, ims tho Ciey ot Eqgan issusd a pwmit fo? a aGnilar pian based on a masta+ Plan?
_Yes No it yes, date and address of mWer plan:
i.icettsed Plumber: Pmm.
MedwniCal Contraotor: PhOnes
Sewer & water Contractor. Pltolfe:
"CfBDY 4kno? ih81 tl$f WOflffWM IB COfliPiftBlld 804d8I8;VO 11161YDrk YYW dB In CW*I11101= 1'Vhh t0 ddnmum arld COtl4'9 OtU1C C1410f
F.aw; mat I wdmtud ads ie rw a pertNr, ha oroy an ?on tar a p?. arw woAc is noc ao:amrt w%ha+c a pensit nffi the waic wm be m
aocordmroe witfs tlre vroved plmt cf 1h@ me at work: wltieh roquees a tavleW elid ? ot PMre. .
x
Apocarit's Pib?ted Name AppGcanYs Si9rotute PeQe t af 3
PERMIT
City of Eagan Permit Type: Mechanical
Eagan. Permit Number: EA097566
Date Issued: 12/28/2010
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 4670 Kingsbury Dr
Lot: 12 Block: 4 Addition: Beacon Hill
PID:10-13500-120-04
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
JON EAGLE
10625 VESSEY RD.
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $55.00
Contractor: - Applicant - Owner:
Engle Mechanical James 1v1 Ba tizal
1062 Vessel Rd 4670 hingsburv Dr
Bloomington NIN 55437 Eagan NIN 55122
(92)888-771
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
"h~
'
~ ~
~ ~ ~~a
I
i _r
(
~3' 'i -
t ~ ~
r
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA150070
Date Issued:06/20/2018
Permit Category:ePermit
Site Address: 4670 Kingsbury Dr
Lot:12 Block: 4 Addition: Beacon Hill
PID:10-13500-04-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
James M Bartizal
4670 Kingsbury Dr
Eagan MN 55122
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160777
Date Issued:04/13/2020
Permit Category:ePermit
Site Address: 4670 Kingsbury Dr
Lot:12 Block: 4 Addition: Beacon Hill
PID:10-13500-04-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James M Bartizal
4670 Kingsbury Dr
Eagan MN 55122
(651) 231-5577
Legacy Restoration Llc
15350 25th Ave N, Suite 114
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA166243
Date Issued:12/22/2020
Permit Category:ePermit
Site Address: 4670 Kingsbury Dr
Lot:12 Block: 4 Addition: Beacon Hill
PID:10-13500-04-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
James M Bartizal
4670 Kingsbury Dr
Saint Paul MN 55122--271
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature