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4472 Mallard PlCITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS• INSPECTION i,,{:,l i nkn Fi I nk I 110011`i PERMIT SUBTYPE: , , t. T'? TYPE OF WORK: INSPECTION D• • D• ? r??,rr1 f1 I<<iH ? ? rd?rl I?i f 1 f hA{tKS: S i td F;l Nii II ( Ml•.f.ll :CORD PERMIT TYPE: Permit Number: ? Date Issued: ? 7 H 1 ,,( V APPLICANT: ___I.l Permit No. Permft Holder Date Telephone N S/W PLUMBING HVAC ? • ?1 ELECTRIC pgqg? 7 ? 9 ? ?Q ? ELECTRIC Inepection Date Insp. CommeMs Footin9s I FoundaGon Freming 93 S .? Z LLf' , Rooflng Rough Plbg. Rough Htg. ! lsul. Fireplace Final Htg. Orsat Test Fnal Plbg. O (/ Plbg. Inspector - Notity Plumber Const. Meter Engr,/Plan Bldg. Final Deck Ftg. Dedc Fnal Well Pr. Disp. ?. r ? f W?.?tificate nf Cccuoanc? ??? ? ??? ?? ? ??? ?"ation Tlris Certificate issued pursuant to the nequire?nents of the Uniform Buildiag Code certifying that at tlie rime of issucuice this structur+e was rn compliance with the various orrtinances of the City ngulating building construction or use. For the following: use c? SF DWG sug. Per,dit No. 21295 Occwm-y Type R3/u?I Zoning Disb? PD/Rl _ Tyre cou. VN owoerotsuingP'IEiSM H.DRS Ilm Addmu 4543 BIIiM IN, I.AFMII,IE 7Aftrws 72 MAIiARD Pi,ELE ?? L 17, B I,'{AS I14t? F10i(?S ?. DoW 09/30/43 s?;w? ort? POST IN A CONSPICUOUS PLACE ow ? ---i- INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ?3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 SITE ADDRESS: , , u, APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: . .• 7 I PertnR Holder Qate Telephone # SEWER/ WATER PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING i ROUGH PLUMBING PLf3G A.IR TEST ROUGH HEATING ? GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTCa ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CANDUCTIVITY TEST HYOROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL Address 44'. Lot ' '17 Hlk P.ACE Zip 55122 Sub THMns L?n . Wnons THESE IT'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION. Date: 09 30 93 Yes No Inspector. s Final grade (6" from siding) Perntanent steps (gatage) Petmanent steps (main entry) ? Permanentdriveway ? Permanent gas ? Sod/Seeded grass TraiUcurb damage Porch ? ' Basement finish Deck Please verify with the builder the removal of roof tes[ caps from the plumbing system and the shut-o$' of water supply to the outside lawn faucet before freeze potential exisis. Contact engineering division a[ 681-4645 before working in right-of-way ot installing underground sprinkler system. White - City Copy Yellow • Resident Copy Pink - Contractor Copy ? 7 98 V 49--7-- 11171 Reaues Dale ` Fva o Rough-in Inspe<tlon Reqwretl9 ? ReaGy Now ill Noltly Inspector - ? _ ? ?, N. When Ready? L2<censed contrector ? owner hereby request inspection ot above electrical work at: Jab Ad res (SVeet. Bo oule No I Ciy Seclion No Townsho Name or No Range N. Coun Occup tl RUJTI Phone No, Powe up0??er Z Adtlr s5 ? Elec al C rapor (COmpany Name) ? o Va o?5 4tense No ? or or OwnarMaking stalleDOn) , mra clov ner Making Instal u MI Phon um Ger ? ,?' MINNESOTA STATE BOAND OF ELECTflICITV THIS INSPECTION REOUEST WILL NOT Grlgga-Mitlwey BIEg - Roam S-173 BE ACCEPTED BV THE STATE BOARD 1621 UNVBrsity Ave.. SL Peul, MN 55106 UNLESS PROPER INSPECTION FEE IS Phone(613) 601-DB00 ENCLOSEO 9/7/? ? REQUEST FOR ELECTRICAL INSPECTION ea-0oom oe d? ? See insttuchons Por compleung this krm on back ol yellow copy. ?a?, 70898 ` 'X' Below Work Covered by This Request ?'?•'?`s Add Rep TypeolBuilding ApplianceSWired EtluipmentWired Home Range Temporary Service Duplex Water Heater Electric Heahng Apt. Bmiding Dryer Other-(Specity) Comm.llndustrial Furnace Farm Air Condi6oner Ofier(sUectly) Gonirec!or5 Ramarks Compute Inspection Fee Below # Other Fee 8 Service EMrance Slze Fee CircuitslFeeders # Fee Swimming Pool 0 to 200 Amps 10 100 Amps - hansformers Above 200 _ Amps Above 100 _ Amps $IynS Inspeciwk Use OMy' TOTAI C? a ? Irrigation Booms G ? ?- D Special Inspection AlarmICommunication THIS INSTALlATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MOAkFHS. I, the Electrical Inspector, hereby certify ihat ihe above mspachon has been made. RougO-in F,,,ai oaie OFFIGE USE ONLY This requBSt void 10 months Irom CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITEADDRESS: LoT: 4472 MALLARD Pl THOMAS LAKE WOODS PERMIT SUBTYPE: SF DWG TYPE OF WORK: NEW BUILDINO 021295 07/14/93 INSPECTION FOOTING ., . FRAMING ., INSUlATION FINAL FIREPLACE REMARKS: S& W PLBR - D C MECH INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: 17 BLOCK: 1 APPLICANT: PIETSCH BLORS INC (612) 461-3381 - - - -? PERMIT ITY OF EAGAN PERMIT TYPE: ? ? 3830 Pilot Knob Road Eagan, Minnesota 55123 Permit Number: 021295 (612) 681-4675 Date Issued: 07 /14 /93 SITE ADDRESS: 4472 MALLARD PL LOT: 17 BLOCK: 1 THOMAS LAKE WOODS DESCRIPTION: Bu3lding`Permit Type SF OWG ?uilding Work Type NEW -JUBC Occupancy? R-9 M-1 ! Canstruction Type V-N Zoning , PD R-1 Building length > 72 Build3ng Width 46 ? ? tf ?/'?\? ?1? REMARKS: S& W PLBR - D C MECH FEE SUMMARY: Base Fee Plan Review Surcharge sac sac $ SAC Units Su6total vaLuArroN $891.50 $679.48 $86.00 $750.00 iee $2,306.98 ;i7a,eee MISCELLANEOUS $1.744.50 Total Fee $4,051.48 CONTRACTOR: PIETSCH BLDRS INC 9543 BIRCH LN LAKEVILLE MN (612) 461-3381 - Applicant - ST. LIC 14613381 0002358 55044 OWNER: PIETSCH BLDRS INC 9543 BIRCH LN LAKEVILLE MN (612)461-3981 55044 I herehy acknnwledge that I have resd this applicaticsn and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City ofi Eagan Ordinances. ICA`/P?Rl/ E 1netr 4ud 1,1 D B: SI A I REACTIVATE ???EWED CIIY OF EAGAN aq PFRMIT #JUN 13 ?993 1993 BUILDING PERMIT APPLICATION ' 681-4675 '/? $ f? ? - --- - ---- ? , SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 9,5 /_? Yaluation of work 5- .Q /1? - Site Address: ??{7a? 1?Jal la? PI ?CQ. ? ? STREET SUITE 0 Tenant Name: (cammercial only) ? IAT ? BIACK ? SIIBD.??ryyyc% • N .? ?, ? wLUJ P.I.D. N Descri tion of work: The applicant is: ? Owner Contractor ? Other (Deceribe) Name Phone Property LAST F[R5T Owner Address STREET STE M City State ZiP Company Phone Contractor Address 2fKa e?lrr-A lGt-Gc.Q, License #2358 Exp.3- 1-`?4 mAj Zi Lp k P P State City lC1l p.Ut Company Phone Architect/ Engineer Name Registration # Address City State ZiP c Sewer & water licensed plumber2LCCoxn.Lvx OC."c-llarvc.a?. Processing time for sewer & water permits is two days once area has b en approved: 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. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE I . ? 01 Foundation E3 06 Duplex ? 11 Apt./Lodging 0 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex O 13 Garage/Accessory ? 04 Sf Porch ? 09 12-Plex ? 14 Fireplace 0 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE O 31 New ? 33 Alterations 0 35 Tenant finish 0 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION - ? ??? ? ,"_; ? 1'??ement Finish 13 91 'SIO'i m?ol`? ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous O .37 Demolish Const. (Actual) V- N Basement sq. ft. MWCC System yC3 (Allowable) v-m lst F1. sq. ft. City Water y?{ UBC Occupancy 9,=3 Mr? 2nd fl. sq. ft. PRY Required Zoning PD R_? Sq. Ft. total Booster Pump f of Stories Footprint Sq. ft. Fire Sprinkler Length -TZ7-- On-site well Census Code Depth y6, On-site sewage SAC Code ol APPROVALS 1 i Planning Building Assessments Engineering Yariance REQUIRED INSPECTIONS ? Site ? Footing ? Framing ? Insulation ? Wallboard O Final ? Draintile ? Fireplace Permit Fee vawac;«n: g I 72.0Do Surcharge Plan Review &AR.4foCt 2N ? ,,_ License MWCC SAC Zg 3? = loug k r _ 2 1 4? bIG6 5 K? C9ty $AC Water Lonn. Z`F (2 ? ?2<}) • z ?ZO) LA_rv('I??S7lt^9?A !?P9, b? Water Meter Atct. Deposit ?nr?? ? zg 2Ki2;33? Juy, 17%zk l6 = 2fso S/W Permit S/W Surcharge 9 9 2" x ?? - I? ? Treatment Pl. 363 x?u= 23`/2 Road Unit 3ox32= 960 - Park Ded. Trails Ded. Z? rZ : ay 1 7 = !? ? ?r)? Copjes x `?° l Other 4X1o = Total: Z'`)`4 9 ' SAC % 00 ? ?,?- ?5T_ ?F``"'2 _ !6? o3s SAC Units ? ??7= luv? 13?L'hLS = 3fI $ • I k?`t = (!?? x5'?= 1430 ? 7122,? E16I23L1993 •09:37 6124691899 4JES1"EP,uREN & ASSUCIT PAUE 02 ?e prepared for: //?'prtifj???e o? ?urup,i; ??? PIETSCH B'UILDERS, INC. ? F?'•b d SCALE : 1 " _ i? r ? ? r ` ? H I ? [.a.y I DRAINAGE k UTIIIN EASEMENT PER PLAT O ? I ' ' ? U z I w ? a O I _.. ? ? °rn I o? ? m H c y LoT 17 I O 0 i ? ; , w ? f i 1 a w? + g ------ .- ? ? j" i . -? 3- S?-bACK UNE - - - ? ? {?N qL*0 qv" 7 ? N 83700 u . jr 59. 14 ???R-.D Tfi?A.rL I I : 1, Aestrrgrrn & Assnciatrs, . ---- LANO SURVEYORS ---- LOT 17, HLOCK 1, THOMAS LAKE WOODS according to the recorded plat thereot. DAKOTA COUMI', MINNESOTA LOT 16 s Denotea iron monument Denotes Oif-Set hub Indicates direction of sur(ace drainage 983.5 x Denotea exiating elev. (987,0) Denotea propoaed elev. Top of block elev. ? Top of fin N irpi q?;pp Top of ba ? ? ? ? \ A ? NOT ? ? D ? N ? . ? {Jtt4 FkV : qsq.-rt ? n ?"• ,q a ° *?' ?81? 8? 8 °? :s ' ? .I 'fa? e:1 8 • ? .?' ? --'71 / ` /qSq.Wo / N / C?? r F?vb 6fti "? ?e ? . \ \ 9coo•4Z? Op' _ . . . . . 01?' i D?P?' 9ENCHMARK d.t 9t 6 k 1? f. £Gae4a. 9S?'.69 8500 210TM SiREET WESf UKEVILLE, MIrAIESOTA 550M PHONE : (612) 189-1898 Fax : 189-1889 l hereby certify thot this is o true and correct reprosentotion of o lroct of lond os shown and described hereon. AsIpr?qQared by me Rn fhis Z?D doy o/ J? , 1993. . garage floor ement floor elev. a E YERla7 ELYATIONS dF L4f6'NSIONS PRlOR TO CONSTRUCTfON w_u e__1 osla9 ? LOT BURVEY CHECRLIST FOR RESIDENT=AL ? BUILDING RMST APPLICATION m ? pROPERTY LEQAL: ? c m ? Date of 8urvey: DOCUMENT BTANDARDS C?,CJ 0 • Reqistered Land Surveyor signature and company Q??] ? • Building Permit Applicant Q? p ? • Leqal description Address P North arrow and bar scale O 0 • House type (rambler, walkout, split wyo, split entry, lookout, etc.) [3--0 ? • Directional drainage arrows with slope/gradient $. ? ? • Proposed/existinq sewer and watez services ?0iiL1 ? Street name Cl ? ? D Driveway Er.EVaTioxs Existing 0 6"?0 • Sewer service ? ? ? O ? • 0 • Lot corners Top of curb at the driveway h ?0 ? • omes Elevations of any existinq adjacent prooosed (?'?p ? • Garage floor Cy? 0 0 • First floor 0"?011 • Lowest exposed elevation (walkout/wlndow) Cf ? 0 • Property corners ? 0 ? • Front and rear of home at the foundation PONDINO AREAS (if aDOlicable) 0 EJ"- ? • Easement line ? ? p • NWL 0 Cj? 0 - HWL 0 0 0 • Pond # designation p Ef' ? • Emergency Overflow Elevation pIMENBIONB ? 0 0 • C? 0 0 • p' 0 ? • 0"- 0 ? • ? ??"? • Lot lines Right-of-way and street width (to back of curb) Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e.. all structures requiring permanent footings) Show all easements of record and any City utilities within those easements Setbacks of proposed structure and setback of adjacent existing homJS--] ? y Retaininq?v8,.1??i ments, if an Reviewed: ? te OCtober 1992 , t;x•rrr,IOa i;NVi;nnPe nvr•ancr• -u- coMPuTnTIoN OWNER:_ IVht ? MiS1Y(vfY I.IAIDMA'IUM $I'CE ADDRE,iS: CON'CRAC'COR: q/?34' DL•"CF.RM7NE _k'ORK7NG S OUARG FQO'fAGE OC' FAC'H: 1. 'CO'CAL EXPOSED WAI.,L AREA 3G59;I :;Q• P T• X Jr = _ _ 2• 'PO'CAJ.. ROOF/C:EILING AREA 151 /iD ,Q. r 'C. X rDZ?rj = 39 x ? ] 3. '.Cf7'CA1; EXPQf;ED WA1.J. AREA C:ALC'ULA'CIUNS: '.CoL-al exposed wall 275?0 area abovo ?.loor a) '.Cotal wall wi.ndow area 2?ld gQ,F'.C. X"U" L5, / b) 'Cotal door area SQ.F'l•. x"u" c) 'Cotal sli.ding glass door area ?Q ;Q.F'C. X"U" d) 'COL•al fiteplace wall area ? Sq.P"C. X"U" --? = U e) 'Cotal wall frauni.ng area (aveeaqe 10%) f) '.Cotal net wall area above `leor (i.nsulatc-') 9) '"ocal ri.m joi.st area 'Cotal foundaL-i.on acoa (exposed) h) 'Cotal foundaL•i.on wi.ndoi•r area 275z SQ.FT. x ,.U„ im = 2,6 Z`N?) sa.FT. x „U„ ,t?p = D?,S? so.r•'r. x " u" • 0`r =-79 iQ.F'C. iQ.F'C. X -U" i.) :COtal net Eoundati.on area SQ.P'C. X"U" ri( above qrade 'CU'CAL a ) theough i. ) If item ip3 is the satne as, or less than i.t;em ;kl, you have met the i.ntent oE 2 MC:AR 1.16008 A and f). 2q0,? z---3?,`? ? Pnce I - .1•. TcrrAi, r•.xPosr•.n r_,,;r/c:r1i.?NC c:nt,coi,nriONS: oo[/ osed r 'COCal ex SQ•P'I'- . p cei.liny aeea j) 'lbCal slcyli.qhL airea sO.F'1, X '?I (S? rr s x k) `CoCal rooE/cei.ling ? . o. Ct:ami.nq acea (aveiraqe 10%) ^p,? F'C SQ X "U" _ 7) '['otal net i.nsulated . . iroof/cei.ling area ToTAY, >> througn 1) = 33,?1 q. If total of #4 i.s the same as, or less than #2, yo?ave met )`? ??p,3 the i.ntent of 2 MCAR 1.16008 A and O ? ? AI'./CERNA'CE BUII.,DING ENVEJ:,OPE DESIGN 'Co ul:i.li.ze t;he total envelope system methori, the values establi.shed by the sum of #3 and #4 shall not be (I ceatec than the sum of i.Cems tkl and #k2. 1. +7. - 3. +4. - C:ER'CIFICA'CIUN I heceby ceirti.fy thaC I have calculated the "U" factocs and R" values herei.n and tliat the buildi.nq hece desci:i.bed meets or. exceeds the SLate of Minnesota Ener.c{y C'onsei'vati.on I+ct. Sic;naCUrc Date) PnGE 2 A . 2 ° b Stude TRUCTION ING SECTION: u:• I/R - nn 4A , NAII SECTION (INSULATED) -(1 ?03 3 ti 5 RIM JOIST SECTIMI: ? II__:J 4 S FOUNUATION INSULATION REQUIRED: ' Min. R-5 on entire wall OR 1/R ?•??! o,p.;•,e Min. R-10 down to frost depth , L 7 A.' FOUNDATION SECTION: 1 loterlor atr fllm ? 11.6R 2 a wood & 3's Znsul tj.on 11.00 I-IT ? ?, s • ; U" ` Flock • -::?a• Exter or a r m •4• ?' (5 ; ?:e•:.4 •a,. ?; ? (? a• TOTAL R -12 .96 ? U ? 1/R ? .09 SLAR ON GMDE ..- a .a? . ? . ?1 • .? . • • A . E ?` •' ' - Heated Siabs: ? :•. 'aMinimun R ¦ 8.5 , :a••? Ur.heated 51abs: ?• ? • : M1nlmun R • 6.2 ..4?... ?. a•q•? ,.? b .? ?a . ,, ?; ,?,. , ,..?o:,; ... • •,a , ,.Z, ?? .•?....;a:•. ; 4•:.?.•.4?d,= .. .. ,,. • I ? ? ? ?R •,• ? / ?? ? ? a? :•JI IC, . I ?? ? ? •? 0??,\? •?? 1 ?• ?,?,• . • ? ,+ . ?•, •. • {, ? . ., • ;4. • ?4? {j, f ?1 / • ' "' ? . . ?••' ••• • ? ?t ? . . ,.4..?? Q .•.? ,' t, . . . •. ? . . Q?. ? q.•:.? ,.. ..? ;d.. : Q?S . _•.?. • ? ;? Pase 7 Uo 1/Iln .043 G ".Cys3s?b? - G ? ? 3 4 5 VENTED LiJ wm??v[t.__ ?q? A 1 - UC t¢iti?+n sectInN (tn;utnjth}r ( Interlor aIr /Ilw 11 14 3 ? E terlor a r A st 1 K I TOTAL R o CEILIMG FRANING SECTIOM: 1 13 M S , CEILING SECTION (INSULATED): 1' Interlor atr fllm 11.61 2 M xter or a r film st ? Un 1/R- CEILINR FRaMIMr, SECTION: 1• Interior atrifllm 11.61 t i 3 ' 4 Exter or • r m st S nche so t wooA ; iOTAL R I u - 1/It ? ;.u:. . 1 Ins1Ae •ir.fAlm t l • M S uts Ae a r film ?. TOTAI R ? U? 1/R , li ? Illt ? ?,?,6 X;7?Yiv;YaY:1yi:;. .Y??r i„$;.';t?;qRms;c?:: 1,`;n:t)":ti.it:N'•>" ..;•?Y<:1,':, .. ,.. C;7:rY 0F r:.Ar?r,ta I.: 'Y??.i ? ?,.. IriTRF9L tJLc :;,/J '' I'iQiEa 12/20/98 , INc N !.6a2002 ?JAiSf:.e {?E,l!r!-r? .`i?'Pr?ti:?; YCItItiG 3f'1O ',urr; 447e Mr1LL!aRz, r-L sn.t.o 21:51 `?Ufi•:. 40ii MA!..1.C,Firj F'I.. f).::ifJ Titiu' Rpr7l:Y1.pI: AIYlfi'.:Y1.i. , .{..).:Jn 1_ F:` O .}'i Abi i, ?Ji:?l ?_A?° R?F?1'?'.Y PERMIT ? CITY OF EAGAN 5830'Fifot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMITTYPE: BuzLozNr Permit Number: 0 3 4 24 6 Date Issued: .1 2/ 2 3/ 9 F SITE ADDRESS: 4472 MALLflRO PL 1,0I': 17 t3L"JCKa 1 1'HQMAS LAKE WOODS P.I.N. e 10--751470-1713--01 DESCRIPTION: Bi_i,i?J.dinq l?ermi.t Tvpe 6?11 di no bJO`rjk l'ype y'En?Uus Code \ /' ?-r i ? BASFMENT FINISIi ALTERA'1'ION 434 AIT. RESLDEN7TAL ,t?/+,' ? i _ .% •?, ti. . ,.'i i/ REMARKS: PLAPI REVIGWE,p BY CRAlG IVOVACZYKA SEPERATE PERMLT REqUIftEp FUR flNY PLUMRiNG WOftK. CALL 44G-2840 KECAhOl:NG ELEC1'RICAL PEh3MT1 A!'dtl 1NSWFf'T'i0N`" FEE SUMMARY: BasF Fee $50.88 SLIY'Crlr]YQG A..5 ?J Total Pee $50.50 CONTRACTOR: OWNER: - HDplicant - vouniG vau6 iA n 4472 MFlLLfdftJ NL EAGAN MN 55122 (661)905-1017 S herebv acknowledqe thaY 7 have read this application and ?.Late thr,t the inYOrmation i5 cprrpct and aqree to comply wiT.h cll anollcabLe State oT Mn. Statutes and Gii.v ot Eaqan Urdinance:. I // _ / i. _ PPLICANT/P MI7EE ATURE 04VU ISSUED SI N 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? , . CITY OF EAGAN 3830 PII.OT I{NOH RD - 55122 681-4675 New Construction Requiremenh RemodeVRepair Reouirements O ? 3 registereO site surveys ? 2 copies of Olan • 2 copies of pfans (inGude beam 8 window sizes; poured tnd. desi9n; etc.) ? 2 site surveys (aMeriar adddions 8 decks) ? t energy calculations ? 7 energy wlculations for heated additions ? 3 wpies of tree preservation plan H lat platted after 711193 required: _ Yes _ No DATE: ?Z// -7A-8 CONSTRUCTION COST; DESCRIPTION OF WORK: rl ?-4 A STREETADDRESS: LOT: ? BLOCK: SUBDJP.I.D. #: -t-Vk 6M QC ?? ? ? ? OCL - Name: 91 /U v x V .4 v Phone #: 4?2 S f 7 PROPERTY 1.est First owrrEx 1/y7 ?. Street Address: City A. c'. < State: !<! A-J Zip: S 5- 12 z ComPanY: 4 Phor:° /C /17 CONTRACTOR Street Address: y`> 7 yIW0?/4q ?-F License # City ??'?7 State: ?M n1 Zip: >>/ 2 Z ARCHITEC7'/ ENGINEER Compaciy: Phone #: Name: Registration #: Street Addtess: City State: Zip: Sewer & water licensed plumber (new construction only): and Iot change is requested once permit is issued. Penalty applies when address char I hereby acknowledge that I have read this application and state that the infortnation is cortect and agree to comply with all appiica State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex 0 05 SF Misc. ? 10 _-plex WORK TYPE ? 31 New X33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Pertnit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Pertnit SN11 Surcharge Treatment PI. Park Ded. Treils Ded. Other Copies Total: ? 11 Apt./Lodging W ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory 0 ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition . , ? 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous /5-1 Basement sq. ft. MC/WS System ?-r.l Main level sq. ft. City Water S sq. ft. Fire Sprinklered P-D sq. ft. PRV ^ sq. ft. Booster Pump r° sq. ft. Census Code. ? ?- Footprint sq. ft. SAC Code _JL(_ Census Bldg / Census Unit o Buildi ng ? Engineering Variance Valuation: $ 1 200 % SAC SAC Units PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FIXTURES l q-unwFR 3 WATER CLOSET a BATH TUB LAVATORY ? KITCHEN SINK LAUNDRY TRAY HOT TUB/SPA 1 WATER HEATER 7- FLOOR DRAIN l GAS PIPING OUTLET • minimum -I ROUGH OPENINGS WATER SOFTENER PRIVATE DISP. • Dak.Cry. tic. U.G. SPRINKLER ' hOme under consl. ALTERATIONS • w odsting WATER TURN AROUND STATE SURCHARGE TOTAL: EACH TOTAL 3.00 3 . o n 3.00 °l . 00 3.00 b o 0 3.00 ?5pO 3.00 3 . a a 3.00 3 • ° ° 3.00 3.00 ? - o 0 3.00 3.00 1.50 ?I . Sv 5.00 15.00 3.00 15.00 15.00 .50 53. a6 SITE ADDRESS: 14'A 7D P? l'-C--Q- OWNER NAME: T?c..h ??. L d er-S INSTALLER: ??y. ?n ? ? ? STATE: ?`"`J ZIP CODE: PHONE #: (?1Z) 1")3 1993 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 ?I?:` :.::: : . ................ 1993 PLUMBING PERMIT (CONII?TERCIAL) C1TY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL CObIIvIERCIAL.IINDUSTRIAL BUII.DINGS. ALSO FOR MULTI- FAMILY BUI: DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIItED FOR EACH DWELLING U::.T. ° _ NEW CONSTRUCTION ADD ON RY-prllR WORK DESCRIPTION: CONTItACT PRICE: FEE: L% OF CONTRACT FEE. STATE SURCHARGE $.SO FOR EACH $1,000 OF pEitMTF FEE MINIMUM FEE $ 25.00 " ' ' CONTRACT PRICE X 1% STATESURCHARGE TOTAL SITE ADDRESS: $ $ $ TF:NANT NAMF: S1E, # OWNER NAME: INSTALLER: ADDRESS: CIT'Y: PHONE #: STATE: ZIP CODE: FOR: CITY OF EAGAN APPLICANT PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. w?_'NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE I DATE 9f HVAC: 0-100 M BTU ADDITIONAL 50 M BTU GAS OU'TLETS (MINIMUM 1 C $3.00 EACH) ADD-ON/REMODEL (Ex1sTiNG CoNSrxUCrloN) STATESURCHARGE TOTAL SITE ADDRE55:_ c OWNER NAME:_ 1NSTALLER: C?- ADD •' CITYR?` TELEPHONE #: FEES $ 24.00 6.00 Jp7. DG $ 15.00 .50 , TELEPHONE #: ?L ZIP CODE: ST 1993 MECHANICAL PERMIT (RESmENTIAL) CITY OF FAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 1993 MECHANICAL PERMTf (COMI?EERCIAI,) CTIY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALI. COMIIvIERC1ALJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTf. DATE: C+L'iidTRA'T YRIi.E: NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF CbNTRACI' FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF I!gRMTT FEE. TOTAL $ SITE ADDRESS: OWNER NAME:_ TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE #: SIGNATUP.F OF PERMITTEE '-TT'1' INSPECTOR ------------------ ? For Office Use ? I j Permii Ji: ? ? / I I ? Permit Fee: If I . I I ? Date Received: I ? I ? I StaR: ? I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: O p :Z? o d9 Site Address: 5V 7 L ? 7enant: /?av."°l suite ? RESIDENT ! OWNER Name: Phone: Address / Cfty / Zip: Applicant is: _ Owner _ Contracior TYPE OF WORK tion of work: Descri p Construclion Cost: ? Multi-Family Building: (Yes _/ No `- ?v"',-Y/ ?v lole?S License #: 2 0 a CONTRACTOR Name: Address: 1-7u6O e2Y - City. Al??. °?!?s / ?NU?• State: Zi ?S37y ? P ? Phone: ContactPersorr. !?? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Venliialion Category 1 Worksheet • New Energy Code Worksheel C2t0gOry Submitted Submined N 5ubmission type) • Energy Envelope Calculations Submitted In the last 12 months, has the Ciiy 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 Contrector: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-publlc if you provlde speciflc reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge [hat Ihis infortnation is comple[e and accurate; Ihat tha work will 6e in confortnance with the ordinances antl cotles ot me ciry oi Eagan; that I understand this is nol a permit, Gut only an applicatlon tor a permit, and vrork is not lo start without a permil, that ihe work will be m accordance with ihe approved plan in Ihe case of work which requires a review and approval oi plans. x x Applicant's Printed Name ApplicanYs Signature Page 1 of 3 411j. City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2013 RESIDENTIAL/'BUILDING PERMIT APPLICATION Date: /2.-6—)3 Site Address: �'7 7Z k&24 -//q,1 /- Q/c C Name: Qci✓ t/ t d t L.Q. (.t rre ,( o g e . Address / City / Zip: LI 1] 7 2. I I0 /4 rd PAT e Applicant is: Owner )( Contractor Resident/; Owner Type of Work Contractor Unit #: Phone: Lc) ^ 1152.- 2 ( 7 a5 �� i70 55/2i. Description of work: Lk) i of uj S 2 G 4 /` 4.5- t of O el� S Construction Cost: j &' /t 0 . 00 Multi -Family Building: (Yes / No X ) Company: Gre.QT no.,-/Aetn i eSC(-fete, Contact: CrG fj City: 51. L o Address: 3230 G ©o h 0", State: rnI'7 Zip: 5 5-1/ 2 to Phone: 952 - 39 3 - 919 2. License #: k2 7/ 3/ y 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: Mechanical Contractor: Sewer & Water Contractor: NOTE Plans and supporting documents tha the information may be classified as,norn pu conelu Phone: Phone: Phone: mit are considered to berpublic information. Portions'of ovdespecific reasons thatlwould.permit the City' to rat, 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 plans. 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. x C rG I ' Ecl I Applicant's Primed Name x f Applicant's ' nature Page 1 of 3 Date: City of Eapi 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: RECEIVED FEB 0 3 71116 Use BLUE or BLACK Ink For Office Use Permit #: 1g0 Permit Fee: (S/J - v1.1 Date Received: Q1311, Staff: q12, 2014 RESIDENTIAL PLUMBI G PERMIT APPLICATION Site Address: lc 1)(1 A f lava( 1)1 r\r Resident/Owner Name:J,.t1v Address / City / Zip: Contractor Type of Work Permit Type Name: Address: State: Appliance Connections Iric. 12850 Chestnut Blvd. Shakopee, MN 55379 Zipg5:2-445-4803 Phone: Contac : -I Suite #: Phone:(J S J 5,7 .286°7 License #: 5 1 gol- f l City: Email: New Replacement — Repair Description of work: RESIDENTIAL U Water Heater Rebuild Modify Space Work in R.O.W. Lawn Irrigation (, RPZ / PVB) Septic System New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstern Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) Water Softener Add Plumbing Fixtures ( Main / Lower Level) Water Turnaround TOTAL FEES $ te0' CO 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 c., a„ 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 th -pproved plan in the case of work which requires a review and approval of plans. 1 x CI Appli nt's Printed Name licMnt's - ig FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related fterns: , Meter Size ' Radio Read Staff: 41" City of Eaaall Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651j .5 94 *-a4fl Tenant: `i b"t L 2017 Use BLUE or BLACK Ink 1 For Office Use Permit #: . 65 -Co Permit Fee: wO. 0 Date Received: 5-1)-/7 Staff: 4% SIDENTIAL PLUMBING PERMIT APPLICATION Site Address: Name: rniv 59)a Suite #:. Address / City / Zip: J Name: t U lel! Js" 7\ --ED Aikt a.Alif ) License #: U3 C Or ( q-5 Adress: V` �� c� 5'� City 1/�/ ► L(j+ U State: y ► 10 �/ Zip: Phone: ( S` I; D�`"�, �1• Ir 4 1 Llet, Gds a Contact: �l � � Email: lD New Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. Description of work: RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60,00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge) *Water Turnaround (add $280.00 if a 3/4" meter is required) $115.00 Septic System New (includes County fee and State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Cali Gopher State One CaII 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 wit 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 accordanQe with, the approved plantp the case of wotk which regJires a review and approval of plans. Applicant's Printed Name x Applicant's Signature Agt@ i-R9!Ated-ter City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA143126 Date Issued: 06/02/2017 Permit Category: ePermit Site Address: 4472 Mallard P1 Lot: 17 Block: 1 Addition: Thomas Lake Woods PID: 10-76100-01-170 Use: Description: Sub Type: Windows/Doors Work Type: Replace Description: One Window/Door Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: Valuation: 500.00 BL - Base Fee $500 $40.00 Surcharge - Based on Valuation $500 $0.50 0801.4085 9001.2195 Total: $40.50 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: David Kinney 4472 Mallard P1 Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature „, ‘ roil ,,cd 1 • I— For Office Use -(111r4-4 -,% % , .,, Permit#: \- ,` '/ I! •- 7/. 71 Permit Fee: flEEIJE Date Received: 7''1 ? _, 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 d (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 JUL 1 2 2019 Staff: buildindinspections a(.citvofeagan.com T _, BY. 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: '/. to , M r1 - lin Phone: Resident/ OwnerLi 7Allik7--Z aiir QCe. . Address/City/Zip: lamp Applicant is: Owner Contractor ' 9' ''',/4(C-- T e of Work Description of work: .d. AIN , YP 41., Construction Cost: Air Multi-Family Building: (Yes /No ) Company: 3' ei1AuiJ 6110-(1 .`/hc Contact:Address: ) /l71 n City: u / Contractoreve/ State:frA/Zip: Phone: i� 7764' Email: ( 21 Vol ere---"C d -as / f License#: 13t. Lead Certificate#: If the project is exem from lead certific tion, please explain why: Ye i ?Ott- c 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: Fire Suppression Contractor: Phone: NOTE.Plans and supporting documents that you submit are considered to be public Information. Portions of the information maybe classified as non-public if you provide pecific reasons that would permit the City to conclude that the 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.citvofeagan.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 locates of underground utilities. www.000herstateonecaliorq 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 .ork is not to start without a pe it; that the work will be in accor ance with the approved plan in the case of work which requires a review and appr' - of plans. x ve— .Aiis;l vv Applicant's Printed Name icant s Signature / / IIIftR ( pi . 1 - 7 70 DO NOT WRITE BELOW THIS LINE /y AI SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) — Multi r Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES 1p 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 ' ?.S-pa, - Occupancy 3.712.C b ? MCES System Plan Review Code Edition yyin 42.41.)S SAC Units (25% 100%J Zoning P2 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V3 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Y Footings(Deck) Final/C.O. Required Footings(Addition) 7' Final/No C.O. Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test Hood Roof: Ice&Water Final Pool: Footings Air/Gas Tests Final e Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick EFTS Insulation Windows Sheathing Retaining Wall: Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 170 1N` lNI i Id 14 , Building Inspector RESIDENTIAL FEES 5b a ,,, fT P eek d- sees Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3 06/23/1993 •03:37 6124691899 4ESTEPGREN & ASSUGIT PAGE 02 , prepared for: Ttrtifirate of §1,urtre PIETSCH / s 770 BUILDERS, INC.IVLOT 17, BLOCK 1, 1414 7 11A A 1 oRclPl. THOMAS LAKE WOODS according to the recorded plat thereof. AN�l,b • SCALE .. I" = 30' DAKOTA COUNTY, MINNESOTA I'• I , . M -- 1 N N i Denotes iron monument f I . Denotes Off-Set hub • C� s I ti Indicates direction of surface drainage 1 \ LOT �.6 983.5 x Denotes existing elev. E-4 I \ (487.0} Denotes proposed elev. i & IS ( + lr c7c7(113') m Top of block elev. I DRAINAGEUTILITY PLA ii.----- EASEMENT PER PLAT • `sr. 10-Z.";3S Top of fin. garage floor 0 \ \ irk, q pp Top of basement floor elev. f \ 4 + r CO • I • %31;r•• .9 C 11 ° .../:,0NOTE ` VERI Y ELEVATIONS& + j \ N DIMIJISIONS PRIOR TO f g .... - CONSTRUCTION a ! X N \ ,'"'"' ER+ �, i' ra gs11.rt 4 !+ LOT 17 Q),, ,U��I,,,,� . 000 a �v , c� <c1.7 > I ata 6 !Q ? 6 • / • ca. ! 7 t n� �Y �� W cy /q 5� / �e. ( L v r 4'7 8 :.al / 4 0 "e 1 $ °� °W 0 Caw a� ;e` l r, c►_ n? f .- i ." `�cb pq :C h io 'ti 1 'V 1--- �"3'—S �EK UNE N ' � sv I v 8 —____ j .(0‘s ,..: 0,1,0, .... s4, . \\ ". • 044•? - - ?, 8 r 50 y�00 0 / N 83°00V0„ 5�,1 • � s ti" r� , l0 a;613/ �" -0 4 r flub i c AleizzARD ------ 7:1611:1 j "1 Q 1-38 • i e-----7------ • ,. .. • .,-tn.:- \1 %1�J f r rstrrgren Sc Assnriettrs, in," (_ ' ,0,rfi �; ` ► ---- LAND SURVEYORS ---- X& .°_:;.r+,r,WWI" DEPT BENCHMARK 0500 210TH STREET WEST LAKEVILLE, MINNESOTA 55044 y TG t - PHONE : (612) 469-1899 Fax : 469-1699 La16 & 11:61144 1, awaitior. 957.53 I hereby certify that this is o true and correct representation of a tract of (arid Ias shown and described her-eon. As orad by me n this 22ND day of JUNE , 1993. n__L 06/69 1 /� [ 1/1 1�1►i� PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA174572 Date Issued:02/04/2022 Permit Category:ePermit Site Address: 4472 Mallard Pl Lot:17 Block: 1 Addition: Thomas Lake Woods PID:10-76100-01-170 Use: Description: Sub Type:Fixtures Work Type:Replace Description:Bathroom(s) 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. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$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 - David & Laurie Kinney 4472 Mallard Place Eagan MN 55122 Roelson Plumbing Services Inc 10924 Pioneer Drive Burnsville MN 55337 (952) 288-1486 Applicant/Permitee: Signature Issued By: Signature