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4677 Kingsbury Dr. . . ,_ CONTRACT PRICE: Site Address Lot Block . ?_ ? Name i--- a - ,?- e m Address c City Phone ? Name ; Address ~ p Ciry Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CON00 - RES. RATE APPLIES MINIMUM - RESiDENTIAL FEE - $12,00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATUR&f,F PERA4E •.!?'.: f /rx ?? fr? % PERMIT H ? f ? 1 PLUMBING PERMIT RECEIPT k CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE: 054-8100 ? FF BLDG. TYPE WORK DESCRIPTION Sec/Sub? Res. New ? Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLE7E THE FOLLOWING: NO. FIXTURES TOTAL _Water Goset - $3.00 $ _Bath Tubs - $3.00 _Lavatory - $3.00 -Shower - $3.00 -Kitchen Sink - $3.00 _Urinal/Bidet - $3.00 -Laundry Tray - $3.00 -Floor Drains - $1.50 -Water Heater - $1.50 -Whirlpool - $3.00 -Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) -Softener - $5.00 -well - $10.00 -Private Disp. - $10.00 -Rough Openings - $1.50 FEE: STATE 5/C: FOR: CITY OF E N GRAND TOTAL: <<-? -? ?7 Receipt MECHANICAL PERMIT CITY OF EAGAN Permit No.= L ; j Fee ,. FiII in numbered spaces S/C ? Type or Print /egibly Tot. ° 1. Date 2. Installation Cost : -. { • ? 3. Job Address ?"` fl.ot ?? Blk. ? Tract f 4. Owner 5. Contractor Lv???`L Phone 6. Address ,:%j " `E- 7. City ' State Zip 8. Building Type: Residential ?fl Commercial ? Institutional ? 9. Work Descripiion: New ? Add ?O Alter ? Repair ? 10. Describe' ? :%'•,?" /i`: 7 '? Fuel Type 17. No, F.Guioment BTU - M. Ea. Forced Air No. EauiPment CFM Ai H dli Mfg. r an ng: Boilers _ Mfg. _ Mech. Exhaust Unit Heater _ Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : ? ' - for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN Remarks Addition BEACON HILL ADDITION Lot 19 Blk 3 Parcel 10 13500 190 03 oWnerThra,.7, ', iGAaf y) streec 4677 Kin¢sbury Drive State Eajzan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1982 1806.93 200.77 9 1806.93 C007560 10-1-81 STREET RESTOR. GRADING ? 1982 526.46 58.50 9 526.46 C007560 10-1-81 SAN SEW TRUNK . ?; * SEWERLATERAL 3 1982 3116.46 346.27 9 3116.46 C007560 10-1-81 WATERMAIN * WATER LATERAL S98 2 9 WATER AREA (p$ ' 1982 198.02 22.00 9 198.01 C007560 10-1-81 * Stubs 1982 g STORMSEW TRK 1982 359.82 39.98 9 359.82 C007560 10-1-81 I* STORMSEW LAT 19$2 9 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 185.00 22049 11 25 80 WATER CONN. 30$.00 22049 11 2$ $0 BUILDING PER. 63 9 1 SAC PARK • ' CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 ' PHONE: 454-8100 BUILDING PERMIT re be owa fo. ":AT? Site Address Lot Block Parcel * W Nome _ 3 Addreu o _ ? Sec/Sub. - ?p Name ? ?U Address Nome _ Address 3F_7[IP. 1 hereby acknowledge that I have read this opplication and state that the information is correct and agree to comply with oll opplicoble State of Minnesota Statutes and City of Eogan Ordinances. Receipt # N4 6391 Erect ? Occupancy Alter ? Zoning Repair ? Fire Zone _ Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grode ? Depth h. Approvals Fees Assessment Permit Water & Sew. Surcharge Police Plan check Fire SAC Eng. Water Conn. Plcnner Water Meter Council Road Unit Bldg Off. . APC Totat $ignature of Permittee I A Building Permit is issued M: on the express wndition that aIl work shcll be done in accordance with all cpplicoble State of Minnesotc Statutes ond City of Eagon Ordinences. Building Officioi Fwmk # YoM Mwd ixmkMs Plumbing 4t7/ C?'D /,?- // . ?p Mechanical _ /,L! ?1L INSPECTIONS DATE INSP. Rough-In Finol Footings //.??1' '? DMe Insp. Date Inso. Foundotion Plumbing ,SW Frame/ins. ? Mechoniml Final Remarks: v? /-/3-?/ ,3-/6 -flri? No. CiTY OF EAGAN 3795 Pilot Kno6 Read Eagan, MinnesMe 55122 Phone: 454-8100 ? PERMIT Date: Site Address: „E'.:7CA? Lot Block Sub/Sec. _..? !+...? Name . . _ , ;,,7.;..-. . . . g Address ? •-.?-: i raixie, . ? . City Phone: ';?V FJ21GC'?' 1;-L-+Pit? . Name ' . ? llddress ? City . -.j . ? ... Phone: This Permit is issued on the express condition that oll work shall be Minnesota Statutes and City of Eogon Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single I Residentioi Multi Res., Comm./Ind. I New /Alter. / Repair Cost of Installotion Permit Fee SurcFwrge Tota I done in accordance with oll applicoble State of Building Officiol No. Dote: Site /lddreu: Lot Biock Sub/Sec. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residential Multi Res., Comm./Ind. I Name N /Alt /R i ew er. epo r . Address t f I ll ti C t ? os ns on o a a ' City Phone: P it F erm ee Nome Sur h r e ` L g c a g Address e ? City Phone: I Totol This Permit is issued on the express condition that Minnewta Stotutes and City of Eagan Ordinonces. all work shall be done in accordance with all applicable State of Building Officiol cin oF E?c,AN 3795 Pitof Knob Road Eogan, MinnesMe 55122 Pbone: 454-8100 PERMIT - - • . CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for QEGiC Est Value $1, 000 qate Site Address 4677 KtNGSBURY DR Lot Iq Block 3 Sec/Sub. AFAC,ON LiIL[eS Parcel No. I w I Name 7'HtkIAS 8 LIlSTAFSON I o Address _ ?77 i?IAiGS1fiIRY Dtt City CA6AN Phone o Name SAII[E I g¢ Address ,- City Phone Name _ Address Clfy - Phone I hereby acknowlege 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. Signature ot Permitee A Building Permit is issued to: THCk",AS E GUS'Y' PSON on ihe express condition that all work shall be done in•accordance with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Building Official 16574 i OFFICE USE ONLY Occupancy - Zoning - (Actual) Const _ (Allowable) - # ol srories - Length Depth ? S.F. Total - S.F. Footprints - On Site Sewage - On Site Well _ MWCC System - City Watei - PRV Required - Booster Pump _ APPROVALS Planner Council Bidg. M. Variance Bldg. Permit Surcharge Plan Review SAC, City SAC,MCWCC Water Conn Water Meter Acct. Deposit S%W Permit S,'W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL FEES 26.50 I . PermH No. PermR Fiolder Date Telephone # WATER StWER PLUMBING H.V.A.C. ELECTRIC lnspection Date lnsp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Pibg. Inspector - Notity Plumber Engr./Plan Bldg. Final Deck Ft9. Deck Final / 16 Well Pr. Disp. CITY OF EAGAN . 3795 PNef Knob RoeJ Eeyaa, MN 5512I ?HONEt 154-8100 BUILDING PE RM?T??? Te M w?d forM Est. Vafue Site Address Lot Block $ec/Sub. Parcel # aWC Name ; Addross u a p Name Z- o" Address u? Nome _ Address 1 hereby atknowledge thot I have reod this application and stote that the intormation is correct end agree to comply with all opplicable Stote of Minnesota Starutes ond City of Eagan Ordinonces. Sipnoture of Permiftee - A Building Pertnit is issued M: all work sholl be done in xco Buildinq Officiol 1. Gustafson wfth oll oppliwbla Stote of J Reteipt # Date 19 Erod ? Occupancy Alter ? Zoning Repalr ? Fire Zone Enlorpe ? Type of Const. Move ? # Stories Demolish ? Length Grode ? Depth Sq. Ft.- AoV?orols Fees Assessment _ Woter 8 Sew. Police Fire Eng• Plonner _ Council _ Bidg. Off. _ APC Permit Surcharge Plun check SAC Water Conn, Water Meter Road Unit Totol on tha express condition Ihns y of Eogan Ordinances. 5kc11 a07k VE I - 19-83 Psrmit No. Permit Holder Miu. Permit No. Holdar Plumbing H.V.A.C. (3 Dw nE r? - $? WMer Disp. Sewer Ebctric O 7S0 8 LQ' ? Inspection Drte Insp. Other Footinqt Foundation Framinp Rouyh P16p. Rouph HVAC . ? Q? Inwlation r Final Plbp. Finsl HVAC Final Waor Dacribs Loeation: YYell . Sewar Pr. Disp. OF EAGAN Piloe Knob Road . MN 55122 PERMIT NO.: DATE: No. of Units: agree fo wmply with the Cify of Eagun Connection Charge: ,rdinanees. Account Deposit: Permit Fee: Surcharge: y Misc. Charges: late of Insp.: Totol: nsp.: Date Paid: CITY OF EAGAN 3795 pilot Knob Road Eagan, MN 55122 Zoning: Owner: Address: - Site Address: Plumber: - Meter No.: Size: Reader No.: I agree ro eomplr vrith the City oF Eagan Ordinanees. By Date of Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: , _ Connection Charge: _ Acwunt Deposit: _ Permit Fee: Surcharge: Mix. Charges: Total: _ Date Poid: - Insp.: CITY OF EAc;AIN Tnclude 2 sets of pLu:s, ? - ? ,?j 4 % _ 3 I 1 site plan w/elevations & <<? BUILDING PERMIT APPLICATION 1 set of ener n?,? gy calculations. To se User3 For valuation ??J ? fCJC? Date ? Site Address: n. Dr Lot ? Block ? Sec./Sub. Erect Parcel #: Alter Repair Owner: ?(. Enlarge ? rl ?X c)h'JE'S /V/ -jt5t NkoVe Address: Deirolish City/Zip Code: ?? • ? Grade e°n `j'iri ? ?? Occupancy Zoning Fire Zone i? Type of Const. t/ # Stories Front ft. Depth ft. --T- Phone #: '721 'ak 71 APPROUAI,S FEFS Contractor: Address: City/Zip Code: Phone #: Arch. /En9• • Address: City/Zip Code: Phone # : ? Assessments 7/&I Water/Sewer Polioe Fire En9 • Planner Council Bldg. Off, APC Permi.t Surcharge .? y •? Plan Check _ SAC 6 a ,s water coru,. Water Meter /_ o Road Unit 'POTAL OFFICE USE ONLY ,/? I QTy pF ??7 Include 2 sets of plans, ? ? U 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. ? Zb Be Used Fbr? Valuation f?' D O r- Date 9- /2 -9 L site Address L/6? ? /C%"ysdu? .?i-. Lot ? Biocx 3 sec./sUv.rP,Fak&-? t t ? Parcei #: 3 s oa [q o c, -z' Owner: i /lesv, ?fs z- Gus ra-40m Address : ?/'?'? 7 ? µ y S?u ?Z? City/Zip Code: Phone #: 5',Sd2- ?O ' Contsactor: O W Vv?-- l? Address: City/Zip Code: Phorbe # : Arch. /Eng. . Adctress: City/Zip Code: Pharie # : OFFICE USE.ONLY Erect Occupancy Alter ? Zoning - Repair Fire Zone Enlarge 7.ype of Const. Nbve # Stories ,t/YJl Denolish Front -' 44A. ft. Grade Depth d/? ft. APPROVAIS FEES Assessnents PeYmi.t ?- ?4ater/Sewer Surcharge ? Police Plan Check Fire SAC gng, Water Conn. Planner Water Meter Council Road Unit Bldg. Off. APC TOTAL ? mavaa uww wavu ul cIen:Encicy . Griggs Midway Bldg. - Room N191 1821 University Ave., St. Paul, Minn. 55704 - Phone 297-2117 ? `''JTEQUEST FOR ELECTRICAL INSPECTION ?CHECK $ELOW WORK COVERED BY THIS REQUEST Type of Building New Add: Rep. Check Aooliances Wired.For 11 ['heek I Home ? ? Duplex ? ? lk- Bldg. ? ? ? mercial Bldg. D ? ? Industrial Bldg. ? ? ? Fazm ? ? ? Other ? ?- ? Range Watei Heater Dryec Fumace Air Conditioner ? ?Y EB-00001-02 T 16650`/ Temporary Witing ? Lighting Fixtures Electric Heating ? Silo Unloader ? Bulk Milk Tank ? COMPUTE INSPECTION FEE BELOW Service Entiance Size: # Fee Eeeders&Subfeedecs: # Fee Cucuits: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres J, 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres Above 200 Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee J Signs Special lnspection Minimum fee $5.0 Remazks n r 17 ? TOTAL FEE o0 Z? ? (, the?Elec)rical Ins?e?tor??feb?.f& t?fir'G?c?abov ? fsI "? 'o D en rrY de.- olo' ,6 ??d Rou -in (Final) This request void 18 months from This request void 18 months from ? Date o his Request IL Fire No. T 16650 I, aLicensed Electrical Contractor 0 Owner, do hereby request inspection of the above electri- cal wirirZg installed at: ?t Address or Route No. ion Township _ Which is occupied by 107 K-ti4b5Bqv i Iv& cicY_Emet, Range_ County Is a roughin inspection required on this job? No ? YeiP<` Ready Now ? Will Cai.. l? ? ? Power Supplier V- Address ( 1*"1 V-?W V Electrical Contractor 961't-' (-`-eqx4L Contractor's License (Comoanv Name) Mailing Address Nil 11.+_ Authorized Signature Y? ? 'Phone No. ??`6 (• lectri contractor or Owner king This Installatlon) This inspection request will not 6e accepted by the tj (? ? ? State Board unless Proper inspection fee is enclosed. C?ertificttte vf (Orrupttnrg Citp of ceagan Eepttrtmrnt nf +uilbmg ilnfivertiim Thi.r Cntificate iajutd pursuunt to the sequirementt of 5ectron 306 of the Unifnrm BuiWing Codc catif ying thot at the timc o f istuanct thit ttracture wus in compliancc with the :lariou.r ordinantca o f the City rrgulating building conltruttion or ute. For the f olloudng: B1dg Pe,,,,?,,,o. SF DWG/GAR 6391 u? c?w;? O=ryocy Type R3 'ryp Cmtuuctioa V Firt Zoo 3 Zonin6 Distnct Pl Orror of Buadin6 Centex Hcsnes Midwe?m 8601 Darnel Rd Eden Pra By 3-13-81 'osr iw w caw?r?cuou+ ru« ur?oivus.n. CITY OF EAGAN 3795 Pilot Kno6 Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT APPLICATION To be used For SF DWG GAR Est. Value $ 0I SiM AdAracc 4677 Kingsbur,y Dr. ? 751? Lot 19 Block 3 sec/s.b. Beacon Hill Parcel # a IN.m, Centex Homes Midwest 3 Address $601 Darnel Rd. ? -- - - - o Nome ? ?? Address S2Ine 1- .-:... ??--- Nome _ Address same I hereby ackrrowledge that I hove read this application and state that the informatian is correct and agree to comply with all applicable State ot Minnesota Stotutes and City of Eagan Ordinances. N4 6391 Receipt # Dnte 19_fin_ Erect ?(3 Occuponcy n3 Alter ? Zoning Rl Repair ? Fire Zone 3 Enlarge ? Type of Const. V Move ? # Stories Demolish ? Front 53 ft. Grode ? Depth 1+4 ft. Approvols Fees Assessment -- Water 8 Sew. Police Fire Eng. . Plonner Council Bldg. Off. APC Permit 157.7u Surchurge 24 -nn Plan check 67.75 SAC 525 _ 0(l . Water Con6305 _ 0C) Water Meter60_ nn Road Unit 185.nn Total 1,302.25 SignGture of Permittee I A Building Permit is issued to: C2rit2X Homes M1dW@St on the express condition tFwt all work sholl be done in accordance with cll opplicable State of Minnesota Stotutes ond City of Eagan Ordinances. Building Offictal • • CITY OF EAGAN N? 16574 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # ? 'D 3 e Tobeusedfor DECK Est.Value $1,000 Date JUNE 5 , 1989 Site Address 4677 KINGSBURY DR Lot 19 Block 3 Sec/5ub. BEACON HILLS OFFICE USE ONLY P8fC21 NO. Occupancy - FEES Zoning - w Name THOMAS E GUSTAFSON (ACluaq Const _ Bldg. Permit 26.00 ; AddreSS 4677 KINGSBURY DR (Allowable) - 50 S h ? ar9e . urc Cit EAGAN PhOnB 733-5716 y # ot Stories _ 23 ' Plan Review Length o Name SAME oePm 1' snGary z ?Q Address S.F. Totai - snc, MCwcc F City Phone S.F. Footprints - Water Conn On Site Sewage _ U¢ W Name On Site Well - Water Meter W _? Addr2SS MWCC System _ ¢= a W City PhOne Ciry Water Acct. Deposit - mit S/W P PRV Required er I hereby acknowlege that I have read this t af and stat th t the Booster Pump - S/W Surcharge information is correct and o ly wi applicable ate of Minnesota Statutes and ' y an Or ' nce . Treatment PI Signature of Permite APPROVALS Road Unit A Building Permit is issued lo E ? $ON Planner - Park Ded. on the express condition that all work shall be dVin accordance with all Council applicable State oi Minnesota Statutes and City ZYf Eagan Ordinances. Bldg. Off. _ Copies BuildingOfficial Variance - TOTAL L6.50 CITY OF EAGAN _ 9795 Pilet Knob Rwd Eagan, MN 55122 N? 7451 PHONE: 454-8700 - BUILDING PERMIT Receipt To be used 4or FINISH BASEMENT Est. Value $2p 500 Dote AuguSt 17 lq 82 Site Address 4677 Kingsbry DriVe Erect ? Occupancy R-3 Lot 19 Beacon Hill Blxk 3 Sec/s„b qlter IP Zoning R-1 . A p l # 10 13500 190 03 Repoir p Fire Zone NA arce Enlarge ? Type of Const. Vn W Name ThOih'?8 E. Gustafson Move O srories # z ? Address 4677 Kingsbnry Drive Demollsh ? LengthMA_ Ci phone 452-4490 Grade ? Depth N8_Sq. Ft.- N ?neY' Approrala Faes ? p ome f ?? Address Name _ Address 1 hereby acknowledge that I have read this applicotion the informotion is torrect and og?rey to comply w4w $tate of Minnesota Stotutes aryl?'sfty of ?qp rdii stote that Assessment - Water & $ew. Police Fire Eng. Plonner - Council _ Bldg. Off. _ APC Pem,ir 38.50 Surchorge 1.50 Plan check SAC Water Conn. Water Meter Rood Unit Totol $an nO Sipnature of PermifTee I A Building Permit {s issue to: E. Gustafson pn the expre53 Condition thm oll work shall ba done in occordonce with cll opplicabl ate o ' e totutes ogon Ordinancea. Buiiding Officfat a.?ef c REQUEST FOR ELECTRICAL INSPEC710N ee-ooooi_oa -9 " r '$ee instructions for completing this form on back oi YellOw copy. ? ? ? ? Pjq "X': 8e1ow Work Covered by This Request ? Add Nep. Type of 9uildin9 ApPlianCas Wired Equipmenc Wired _ Ncine Range Temporary Service Duplex Water Heater Lightin,y Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg Fumace Silo Unloader Industrial BIAg. Air Conditioner Bulk Milk Tenk Fafm OIhPf $PeC.(y OLF12f ($VP.CIfy) 1 er pecify Other Other Compute Inspection Fee Selow N Fee Service Entrance5ize t! Fee Feeders/Subfeeders N fee Grcuits 0 to 200 Amps 0 to 30 Am s 0 to 30 Am s Above 200 Ampsl 31 to 100 Amps 31 to 100 q 5 Swimming Pool Above 100-Amps . Above 100_Amps TransTOrmers Irrigation Booms Partial-'Other Fee Signs Special Inspection S ,,r TO Remarks TAL?j Final This request void 18 mantha Iro L?J f? / ?`1 .? ? • .._.. r?V 4__ the Ele?ctsi G? ?lspector, hereby ertify that the above D:?tespection has been ":2, Q - ?? C) This request void U? ?r ? ri 18 months from ? ? d An7r;nq 1_ , $3, yz? Sy Request Date I Fire No. Rough-in Inspection e ired? CReady NnwxWill Notify Inspeo- yes ?Nu [or When Ready n Licensed Electrical Contractor I here6y request inspection of above ?;ZOwner electrical work installed at: Streep ?gre , Box r Route No. ? ' City t ecUOn o. Township Name or No. Range No. Cnu ` / t!/? /?d4 Occupant (PRWT) Phonr. No. Power Supulier / ? ?, ?l !G- ?'?CL = Address Elecvic?al Contra,cmr (Company Name) 4r Contractor's License No. l!W ? C Mailfi 1 a?ddress (Co itractor or Owner Making Instailationl 2 4 / i0 %r: '\?'V, 5 !^- Authgr Signature tract er ki Installali n) Phone Number ? ? g .IGIINNESOTA STATE BOAND OF ELECTwI.eITV THIS INSPECTION REQUES7 WILL NOT Griggs-MidwaV gldg. - Room N-191 BE ACCEPTED BY THE STATE BOAHD 1821 University Ave., St. Paul. MN 65104 UNLESS PROPER INSPECTION FEE IS Phone 16121 297-2117 ENCLOSED. Clty af Eakan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 I ? Permit #: ? I I Permit Fee: ? ? ? ? I ? I ? Date Received: "l ' U I ? j ? Staff: ? L ----------------- 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date; 5? v6 SiteAddress: Tenant: Suite #: RESIDENT! OWNER i T"t?1 ?r 6/?J Phone: ! Name: /'IYY 1 5l ;,) -a ? Address / City / Zip: CONTRACTOR °?? Name: License #: Ll 77c) Address (`hamrir)n 651-365-1340 City: 36370 n,,dd State: Zip: Phone: Eagan, MN 55123-1338ontact Person: TYPE OF WORK _ New ? Replacement _ Repair Re6uild Modify Space _ Work in R.O.W. Descripfion of work: p? PERMIT TYPE RESIDEN7IAL Water Heater V?Water Softener Lawn Irrigation Add Piumbing Fixtures ? RPZ PVB) ? Main _ Lower Level) Septic System _ Water Tumaround New Abandonment RESIDENTIAL FEES: $50,50 Minimum Water Heafer, Wafer Soffener, or Water Heater and Softener (inciudes $.50 State Surcharge) $30.50 Lawn Irrigation (inGudes $.50 State Surcharge) Y i $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State 5urcharge) *Water Turnaround (add $136.00 if a 5/8" meter is required) $900.50 Septic System New ($10.00 per as buiit) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 5tate Surcharge) C `=? j TOTAL FEES $ ? ? ? I here6y acknowledge that this information is complete and accurate; that the work will be In conformance wkh the ordinances and cotles of the Gity ot 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 [he approved plan in the case of work which requires a review and approval of plans. ? • x x Applicant's P? rinted Name AppiicanYs Si ure . , ?J?... . ...... C.''_. ?:qi'1 ?s •_ . . . .'i ..1ti- ?. ?G : r•r '?9?L?F vi7 . - `? :: ^-n_•;-? -T • - -' ?--:--? ?? , 1?... ?...._._ . 71: 59 t..?.-L,r?.,1$ . . ? ?..: .: . .?.. . , li_: „ ?.. .? . ?., CITY OF EAGAN CASH.T.ER> JS TFRMINAL N0: 99$ DFtTE: 12121133 TIME: iC1::33:55 IU: NFlMEe SCOTT FiTSE 3210 3001 4677 F.INGST3UhY 111.25 21.55 3001. 4677 F:INGfiBUftY 2.50 Tota7. Receip+, Amauni:. 113075 CF1.21429 USE.R IDo :IAN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55722 651-681-4675 0l lLew Construction Reauiremenis D 3 repistered srie surveys showing cq. R ot bt, aq. R of house and all roofed areas (20X maximum bt covereae albwed) ? 2 copies of plans (show 6eam 8 window sizes; poured fnd. design; etc.) ? lsetofanergyeakulations D 3 copies of tree preservation plan Il lot pladed after 711193 DATE: [?t, 1'?, I I Gq DESCRIP710N OF WORK: I sZwt STREET ADDRESS: `Name: JO? n Phone #: V ? Last fiwt dd ? L) LOT: ?q BLOCK: ? SUBDJP.I.D.#:U ?aCC/V? PROPERTY OWNER Street Address: `"I o RemodeVReoair ReauiremeMs 1 C?-- 2- l - `j 2 copies of plan 1 set of anergy calculatlons fo? heated addkions 1 ske eurvey tor exferior addidons & decks CONSTRUCTION C05T: `LIaS •UO 6A City State,Zip: SS? Company: GQ Lne CoCI- Phone#: ??Z ?3a-g9q? (area code) CONTRACTOR StreetAddress: S" S?• S License# 24lpoy7 Exp, 3/ 60 City Q?j(ao w? ? n?o v? state: ?N 2ip: SS?? ARCHITECT! ENGINEER Company: Name: Telephone #: ( Street Address: Registration #: City State: Zip: Sewer & water licensed plumbw (new eonstruction onlv): Telephone PenaRy applies when address change and lot change is requested once permit is issued. I herepy acknowledge that I have read this application, state thffi the informatlon is corteet, and gree to ly all appl{cable 5tate of Minnesota Statutes and Cit ot Eaqan ONinances. , ? Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4sea. 0 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee ? ? ? • 2-? 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: 1?j? Valuation: $ SAC Units % SAC Certificate for: Csntex Rome/ Plan 534 8601 Darnell Road Eden Prairie, Mn. 55344 DELMAR H. SCHWANZ LRNDSURVEVOR Rpiriare0 Untlsr Uwf o1 Tha State of Minnesota 29" - 746Tl1 STREET W. - BOX M NOSEMOUNT, MINNESOTA 56088 PMONE 812 423-1789 SURVEYOR'S CERTIFICATE Garage Floor 939.7 ft. Top of Block . Basement Floor O Denotes proposed finished grade p Denotes set wood hub a~'? ? S 6 B.M. Top hydrant between lota ? ?vohv 6 3, 16 8a 170 Blk. 1, Elev. 944.01 ? LoT 19 \ 5 9 ? ?G?4LE 3o? ? I gLocK 3 ?w N \ St? /S-? / 23 °6 I v? 00 W 5 ?N I DraingBe & o ?? ry ?,ejGE ry? a ,h utility M easement n?' ? ? / vc 67 ? ? ?o at - ?`? • ° ? ??? ? v, . . tn--? } I p ? q3!°a o' \?-' I 392-70 I a ' 97 ? ????J I ? hereby eertiPy that ttti.s is a true and corr4ct repres tation of Lot 19, Bloek 3, BEACON HILL, according to the V"ord plat hereof, Dalcota Countq, Minneeota. ' Dated: August 9, 1979 Revtsed-tofmhoit a.p3moposed riouge 'Hcvember 6, 3969. . . ? ? ? ', • ... _.. ?. ... ._ . ' MINNESOTA REGISTRATION N0.8825 0 1989 BITILDING PERMTT APPLICA?ION CITY OF EAGAN SINGLE FAMILY DfELLIAGS 2 SETS OF PLANS 3 REGISTERED 3ITE SURVEYS 1 SET OF ENERGY CAL.CS. IG6tf4 MIDLTIPLE Di1ELLINGS 2 3ST5 OF PLANS 8£GISTBRED SITB SDRVETS - (CEECK iiliH BLDG DIY.) 1 3EP OF ENERGY CALCS. Date: 6 - 6- -10 MULTIPLE D1aELLINGS AENT9L IINITS FOR SgLE ONTTS # OF DNITS 110TEt ADDRESSES FOR CDRNEA LOTS - CONTRACTOA/EOlEOiiNER MQST DESIGNATE TiHICH ADDRESS IS DFSIRED. HO CAAtiGES WILL BE ALLOWED OACE BIIILDING PEAHIT I3 I3SIIED.. 5EWER b i1ATER PERM3T FEES AAD AGC40AT DEP03IT F!'sFS SdILL BE INCLUDED iTITH THE BUILDINQ PERHTT FEE. PROCFS3ING TIME FOR SEWER AND WATER PER'[ITS IS TWO DIYS ONCE A PERMIT HAS BEEN CDMPLETED INDICATIAG A LICENSED PLt1M8ER. PENALTY APPLIFS kiHENs PERMIT YS IdOT PAYD FOR YA1 SAME MONTH YT YS REQUESTED. LOT CHANGE IS REGOESTED ONCE PERMIT IS ISStJED. To Be Used For: DCG k Valuation: I v?r Site Address y(077 K.?nil,?,$uft Dyt, Lot Iq Black 3 ^cellSub . P.0-CON Hil'a uWner - T? 0bM0-S l:,. ?TU,S+x756t?j 9aareas q6 77. Ki'hA s huvA, Or. City/Zip Code ?"?'-/a Z Aw% Ph ne `45? -;??/90 u0°k 9 33'S9 ? L Contra Addres City/Z Phone Areh.) Addre: City/i Phone Occupancy Zoning Actual Const Allowable • of stories Length 12 Depth )ILI S.F. Total Footprint S.F. On site aeorage On site vell _ M1iCC System _ City eater _ PRV required _ Booster Pump _ COI+@ERCIAL 2 5ETS OF ARCHITECTURAL & STHOCTIIR9L PLANS 1 SET E!F 5PECIFIC9TIONS 1 SET OF E19EaGY CALCS. FF:RS Bldg. Permit 0?&•0a Surcharge , S D Plan Aeview SAC, City SAC, MWCC Water Conn Water Meter Acet. Deposit S/W Permit S/A 5urcharge Treatment P1. ? Road Unit Park Ded. Copies 3UBTOTAI. Penalty ? TOTAL APPROOALS Planner Couneil Bldg. Off. Yar3anee ' Ad-built for: _- Centex Iiomes Midr+est Inc. 8601 Darnell Road Eden Prairie, Mn. 55344 DECTviAK H. SCi-iW?"iNZ LANOSURVEYOR „ RepistvoC Untlu Lawi o1 The State 01 Minnesota 297e- 1+6TH 57REET W. - BOX M ROSEMOUNT, MINNESOTA 55068 SURVEYOR'S CERTIFICATE PHONE 612 423-1789 SCALE: 1 inch - 30 feet I .. ?^ . ? ti Drainage & ,p 0?' ? / v p nN, .A? utility ; ;`? • v r?. V 'c easnment ? ?? NW .Zi ? M? • Q? I .? /'f; ? ?T • ?? ry . h? ? . ? ,39 9 Z;? Q ?1 7 I j° ± I hereby certiPy that this is a true arid correct representation of a survey of the boundariea of: Lot 19, Bloek 3, BEACON I4ILL, Dakota County, Minnesota. and of the location of all buildings thereon, and all visible encroachmenta, if any, from or on said land. As survey -by me this 23rd day of January, 1981. N S TRA 5 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4677 Kingsbury Dr Lot: 19 Block: 3 Addition: Beacon Hill PID:10- 13500- 190 -03 Use: Description: Sub Type: e- Windows/Doors Work Type: Windows/Doors - New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Crew2 Inc 2650 Minnehaha Ave Minneapolis MN 55406 (612) 276 -1680 Applicant/Permitee: Signature PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: $90.00 - Applicant - Construction Type: Occupancy: Owner: Thomas H Zinc III 4677 Kingsbury Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. $88.50 0801.4085 $1.50 9001.2195 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. Issued By: Signature Building EA082276 03/19/2008 ePermit City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4677 Kingsbury Dr Lot: 19 Block: 3 Addition: Beacon Hill PID:10- 13500- 190 -03 Use: Description: Sub Type: e- Reroof Work Type: Replace Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: Capstone Bros. Contracting 216 North River Ridge Cirle Burnsville MN 55337 (952) 882 -8888 BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Hermitee: Signature PERMIT City of Eaan - Applicant - Construction Type: Occupancy: on prior to final, you must meet inspector with ladder and flat bar. Pictures are not Owner: Thomas H Zinc III 4677 Kingsbury Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 $90.00 Issued By: Signature Building EA084503 07/21/2008 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4677 Kingsbury Dr Lot: 19 Block: 3 Addition: Beacon Hill PID:10- 13500- 190 -03 Use: Description: Sub Type: e - Furnace Work Type: Replacement Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector, 952- 445- 2840Ashley Orman 410 W Lak e St Minneapolis, MN 55408 612 - 824 -2656 ashley @standardheating.com Fee Summary: Contractor: Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824 -2656 Surcharge -Fixed ME - Permit Fee (Replacements) Total: 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 Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $0.50 $50.00 $50.50 Owner: Thomas H Zinc III 4677 Kingsbury Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: 9001 0801 Issued By: Signature Mechanical EA076873 03/06/2007 ePermit PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA163966 Date Issued:09/16/2020 Permit Category:ePermit Site Address: 4677 Kingsbury Dr Lot:19 Block: 3 Addition: Beacon Hill PID:10-13500-03-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Molly E Frost 4677 Kingsbury Dr Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature