4497 Mallard Tr N
Use BLUE or BLACK Ink
I-----------------
For Office Use
I
City Ol Eatan ; Permit
Per mit Fee: ~Sbm- -.'sue
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff: j
2010 MECHANICAL PERMIT APPLICATION
Date: 11 3 la Site Address: VVAt' Vk_AV-X~~ T AXk.,
Tenant: Suite
RESIDENT I OWNER Name: T OVA. t w -1E V3v/9:,Tw4 Phone: 54 n
Address / City / Zip: S1w INK-1 fac,l6_
CONTRACTOR Name: yfL r~C' ti1kT~ ~&it.vl~) t60yV_ License I'S k9'S +kk0
Address: ~"L'~ L v~/$l`'RS 0 ~ City: t~1Pe$ Vwt+~►7CyNG
State: Zip: Phone: (-sX- 'ZLkp
Contact: QAP\1S ~ *a Email:
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: kAt~ 'b A~) aV%' V\AK'j
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace _ New Construction _ Interior Improvement
Air Conditioner _ Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank Install / _ Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge)
= $ TOTAL FEE
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.oooherstateonecall.or
I hereby acknowledge that this information is complete and accurate; that the work will be in conf rma ce with the ord' nces 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 to art thout a permit; t the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Appl cant's gnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In -Air Test -Gas ServiceTest -in-floor Heat ----Final
Exterior HVAC Screening Inspection
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number: ? • ? ? ' ? ? '
Date Issued:
SITE ADDRESS: ,0'1, ,t fi 1 01: 1
,tj ! 1•i;?? i w,l) fR N
I iN?1MAS t NKF 6iU11iD'.
, APPLICANT:
(?;1.?) Jtl aalti
?
J
PERMIT SUBTYPE: TYPE OF WORK:
, I VnI V
I , 1011dt, 1
Permit No. Pertnit Holder Date Telephone t
ELECTRIC
PLUMBING
HVAC
Inspectlon Debe Insp. Comments
FOOTINGS
FOUND
FRAMING y- Z 2' ?S Si i wJ /f o 5 Ai'
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
/
BLDG FINAL ' 1? s,• /
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FlNAL
v
0 CASH RECEIPT
.
CITY OF EAGAN .
3830 PILOT KNOB ROAD , EElGAN, MINNESOTA 55122
DATE 19 I^ ,
HECENEO , - i
FR0?1 ' , \
Qv . 1- j ^ S?J
AMOUNT s
--l ?- ?
a oa.uws
? CASH (p+eHECK
f
I yI t , ! ..? ;
!
FUND OB.IECT AMOUNT
Thank You
BY
C 11062 ?CCopy
OP,,
Pft*-Fpe ca,y
SEWEA & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE Mf 13, 1994
? _.
METER #
OFFICE USE ONLY
CHIP #
METER SIZE
ISSUE DATE
PERMITDATE 11/14/SO
PERMIT # 11715
B.P. RECEIPT # G 11062
B.P. RECEIPT DATE l i J 13 / 9a
X PRV _ BOOSTER PUMP
SITEADDRESS 44`7 ''. :'AI.LpRD TR
LOT '3 BLOCK ' SEC/SUB THOW LAKE WOODs
APPLICANT:.
ADDRESS:_
I GITY, STATE
ZIP
PERMIT REQUESTED
? SEWER WATER TAPS
COMM/IND X RESIDENTIAL
X- NEW
EXISTING
PHON E:
, _, Lawn Sprinkler Meters are to be Installed
PLUMBER: ??'• " Ahead of Qomestic Meters on Water Line.
ADDRESS_ 15185 CAHOIISLL WAY Credit WILL NOT be given.for. Deduct Meters.
CITY, STATE i ;• . .m:;.:,:.._. ZIP ' . •
?
PHONE:
-f AGREE TO COMPLY WITH CITY QF
OWNER: CARROLL CU8TOtl HQMES a', EAGAN ORDINANCES
AQDRESS: 14355 CI?4ARRUN AVE
CfTY, STATE ROs?? MN ZIP `' 50?"
PHONE: 423-61M SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, COMTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITYOF ItAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE NOV,13, 1990
?
SITE ADDRESS 4497 N MALLARD TR
LOT " BLOCK 4 SEC/SUB
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
PLUMBER: y-
ADQRESS: 15185 CAF:UL'S?:I, 51AY
CITY, STATE i C<.>;,;• jX,rir. ,,, ... ',; ? ZfP ? --
/ L1
PHONE:
PERMIT REQUESTED
X SEWER -`WATER TAPS
_ COMM/IND RESIDENTIAL
X NEW - EKISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be,givenfor Qeduct Meters.
Y WITH CITY OF
OWNER: CEiI:RULL CUSTOM UOMt:S f? EAGAN O NANCES
AaDRESS: 14355 CIME4Ri20N AV??:
CITY, STATE =?nSE?fOUPTT I?:Py ZIP ?``06i5 ?
PHONE: 42 3-6 10C SIGNAT RE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
OFFICE USE ONLY
METER #qY4a a9 I9 PERMIT DATE
CHIP #? a? ?-il 7_9 PERMIT # 11715
METER SIZE ?ZoLff? B.P. RECEIPT ? C 11Ub?
ISSUE DATE B.P. RECEIPT DATE
PRV - BOOSTER PUMP
THOlSAS LAiCE WGODS
ZIP
@
• ' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
DATE PHONE 4548100
?
m
?
?
c
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
CommJlnd. Contract Price x
RECElPT #
DATE: __L
BLDG. P WORK DE CON
Res. New Const.
Muit. Add-on
,Comm. Repair
FEES
JAC 0-100 M BTU - $24.00
:)NAL 50 M BTU - 6.00
HVAC INCLUDES A/C ON NEW
TOWNNOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS (INCLUDES GAS PIPING) - 12.00
GAS OUTLETS (MINIMUM - 1 PER PERMIT-
MEW CONST.) _ - 1.50EA_
COMM/IND FEE -1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
E SURCHARGE PER
$.50 S/C PER EACH
PERMIT FEE)
20.00
.50
S/C:
TOTAL:
•--C- .., . . ... ? . , ._ .
CITY OF EAGAN ?.?.? 18540
3830 Pil t K ob R d P O B 21-199 Ea en MN 55121
o n oa , . . ox , g,
1 PHONE: 4548100
BUILDHVG OERMIT Receipt #
To be dsed for ? 5 F ?'/''?R Est. va?ue :I 1 Sl000 Date ? 13 19 90
5ite AI ress
Lot Block SeGSub.
Parcel No.
W Name CARRUL?. CUSTOM i?lES 00
3 Address 14355 CIZtAARON AVE
° City ROSMKKW Phone 423-6100
o Name SAME
OUi.. Address
City Phone
?
W W Name
? ; Address
< W City Phone
I hereby acknowlege Ihal I have read this application and state that the
informalion is carect and agree to comply with all applicable Statef
Minnesota Statutes and City qf Eagan Ordinances.
Signature of Permitee I ` ."' e.lr ;l
?
A Buildin9 Permil is issued to: CARROi.L CilSTO!! NUMLS
on the express Condition that all work shall be done in acCOrdance wilh all
applicable State ol Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
A-3 K-i
Occupancy
PD-ltz1 FEES
zonfng
(Actual) Consf
l ? Bldg. Permit _
{Allowab
e) - Surcharge _
# ot Stories
Plan Review _
Length
?
Depth SAC, Ciry _
S.F. Total - SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well ? Water Meter
MWCC System
?-
ct. Deposit
Ac
City Water
?
PRV Fequired S/1N Pertnit
Booster Pump - S/W Surcharge
Treatment PI
APPROVALS Road Unit
Planner
Council - park Ded.
EUdg. Off. _ Copies
Variance - TOTAL
692.00 1
4S0•C0 :
1?.? '
600.00
• 50 .1
s,282.001
? Permit No. PermH Holder Date Telephons #
WATER `? _? ' ,??.( ' :1LC?t? ???7` ?(J
•
SEWER '
PIUMBING
H.VA.C. /c 11? a?! O
ELECTRIC O --i
InapscHon Date insp. Commenta
Faotings I
Foundalion
Framing ? 0
Roofing
Rough Plbg. -? - - d ? U 1
Rough Hlcj. 1
!re s
Fireplace ??Y' (J • ' ? 4? ? ??? ?Ai ?sf??ii? !?c
Final Filg.
Fnal Plbg.
Const. Meter PI6g. Inspector - Notiy Plumber
Engr./Plan
Bldg. Fi,al
Deck Ftg.
Uedc Fnal
Well
Pr. Disp.
$':- D
•
Ter#ifir?te uf (Or.rupanry
Citp of Cagatt
arprbnptct nf Wuitditug Aprrtinn
Thir CaYyrwate ir.sued pursuant 1o the naquirements of Sertion 306 ojthe ilnijorm Building
Cade ce?ifying that ai the time of issuanre rlris sfruuune ww in compliance with flre wariour
ordinaxcer of the C+h' regulaGiRB buildin8 conrtrucuon or use For the foUowing.
l1le Ch"So110C SP .1 •/n.n Bfd&14amil DI0. 107'?l pSLA
L/?1V/ ?Y1 T?
°°M.°m TNM ?.a?l41 zmm oou;a PpAi Tipe Cow VN lEpm Aea?
BolftAamra lanrql+arB,'-r-amAs i Ag'4-WOMS
POST IN A CONSPICUOUS PU1CE
• • rSvmo54MW rW.nmI ¦ Fol' City U8e Only
CITY OF EAGAN PERMIT#
,?7
CONTRACT 3830 pILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PRICE PHONE 4548100 DATE: /<=':!%? / "' -'
? ...?,
? Add
c CRy
City
Phone
Phone
FEES
COMM./IND. FEE -1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIAdUM - RESB)ENTIAL FEE
MINIMUM - COMM.IND./FEE
STATE SURCHARGE PEA PERMIT
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FI
OF EAGAN
Res.
Mult.
Comm,
Other
New Const. ^
Add-on
Repair
RES. PLBG. ONLY - COIYIPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
?
? Bath Tubs - $3.00
Lavatory - $3.00
5hower - $3.00 _' r»
I lGtchen Sink -$3.00 ?. v;
UrinaVBidet - $3.00
/ Laundry Tray - $100
! Fioor Drains - $1.50 i 5J
/ Water Heater - $1.50 /
j Whirlpod - $3.00 '
.50 Softener - $5.00
Wel) - $10.00
Private Disp. -$10.00
Rough Openings - $1.50 U. G. Sprinkler System - $12.00
PERMIT FEE:
STATES S/C:
GRAND TOTAL: -? 7 ?'J
Address: 4497 NORTH MAT7ARI1 TR,qII, Lot S Blk 4 Sec/Sub TH(MAS I.AKE WODDS
These items were/were not complete at the time of the final inspection.
12/17/91 Yes No
Final grade (6" from siding)
Permanent steps - garage ?
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass ?
Trail/curb damage Show
Porch ?'
Basement finish f
Deck
Please varify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply ta the outside lawn faucet before
Preeze potential exists.
•[CR4FONRR
White - City copy Yellow - Resident copy Pink - Contractor copy
CITY OF EAGAN
3630 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
PMONE: 454-8100
BUILDING P.ERMIT
7o be used for _ SF DWG/GAR Est. Value $115, 000
N°_ 18540
Receipt # C I lo(n (?
Dale NOV 13 , 1990
_
Site Address 4497 N MALLARD TR
Lot $ Block 4 Sec/Sub. THOMAS LAKE WOOC
Parcel No.
w Name CARRO .. CUSTOM HOMF.
a Address 14355 CIMARRON AVE
City ROSEMOilNT phone 423-6100
o I Name S?
?a Address
? City Phone
r
Ww Name
?? Addre55
i W City Phone
I hereby acknowleqe that I have read ihis applicauon and slate that the
inlormation is correct and agree to comply wrth all applicable State I
Minnesota Statules and Ciry pt Eag J dina s. ?
`?.
Si9nature ot Permitee ( v
A Buildmg Permit is iss?d to:
on the espress contlition ihat all work shall be tlone m accord ce wnh all
applicable Slate of Minnesota Stpaw-testand City of Eagan Ordinances.
Buildinq Oflicial
OFFICE USE ONLV
Occupancy R-3 M-1 FEES
2oning PD R-1
(ACWaI) Const V-N Bldg. Permit 692.00
(Allowable) Surcharge 57.50
M olStodes -
60'
Plan Reviaw
450. 00
lenglh
DeOlh SAC, City 1100,00
S.F.7otal - SAC, MCWCC 600.00
S F. Footprinis -
625
00
OnSiteSewage _ WalerConn .
On Sde Well Water Meter 90.00
MWCC System x
Accl. oeposil
30.00
Ciry Waler X
PRV Reqmred x S/W Permil 30.00
Booster Pump - S/yy Surcharge - 54
Treatment PI 2 57 _ OO
APPROVALS Road Unit 3 5 5_ OQ
Planner - park OBd.
CounCil
BIOg.OfI. _ Copies
Vanance - TOTAL I- mg- n0
?
??°
H 4 4 7 2 0 ?r_
,
fle ue 10 Fire No
? Rough-in Inspedron
qgy
p Reatly Now <?II Notrfy InspectOr
'
? s ? No Wlien ReaOY?
I censed contractor ? owner hereby request inspection of above eleclrical work at:
Joo n.ess treat, Box or oute )_
J Ci
5 on No ownship Name or No Range No. Coumy
ant (P INT) s4 41 Phone N
--
PowerSupD?er
• Atltlress
Electncal ractor (COmparry Name)
Allak,
• dOrS Lioense No.
Mailing Atl re ConVaclar or Owner Making InstalWtion)
Aullwn ea Signature IGonirector/ ner /M?aAkmg Installalion) Phon N e
? ?
13.?fi? ? \•VYl ? .. -
MINNESO E BOAPD OF ELECTFIqTY THIS INSPECTION qEQUE$T WILL NOT
Grlggs-MlEway Bltlg. - Hoom &173 BE ACCEPTED BYTHE STATE BOAftD
1827 UnlwnHy Ave, $t Paul, MN 55106 UNLES$ PROPER INSPECTION FEE IS
Plqna(672) M24800 ENCLOSED
/]
?? REQUEST FOR ELECTRICAL INSPECTION °??? e-aom???-oe
T1 fl? Sae insimoUOns 1or compleLpg tNS farm an Oeck of yellow copy ? ?
a 4 4 7 2 0 "X" 8e/ow Work Covered by This Request
ew A Rep Typeof6miding AppliancesWirad EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Eleciric Hea4ng
Apt. Building Dry Other (Specify)
Comm./Industnal ' umace
Farm Air Conditioner
ane, (sPaoiyl CoMractwt Remarks
Campute Inspectian Fee Belaw:
# Othei Fee S ServiceEntrence Size FW6 # Circmis/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
TranSformer5 Above 200 _ Amps Above 100 _ Amps
Signs insoecrora use onty: TO AL ?
Irrigation Booms /
Special Inspection Y?
Alarm/Communicanon THIS INSTALLATION MAY BE OR RED DISCONNECTED IF NOT
Otner Fee COMPLETED WITHIN 18 MONTH5.
I, the Electrical Inspector, hereby R°°9n-'"
certify that the a6ove inspedion has
been made. Tnai
o?
OFFICE USE ONLY
This request voi0 18 monlhs irom
f
&
99??s
r73 ,?
10
?
.4 5
H Date
-m InapecUOn
Fre No Rough
?
1 fleqwted> ? ReaM Naw ? Will NoMy In9pectot
? Ves G No When ReaM?
I icensed coniractor ? owner hereby request inspection of a6ove electrical work at:
Joo 1 x or Route o) Qry
I
Siltation o. wnship me or No Range No. Counry
pant PRMT) Phone N?
?
P er ie AOtlress
Eleclra niraqo (Comeen ame ract r5 ic s
?
Ma?lin d ss ?on r or n Makmg Instellati
L
AutMn Sgnalur nvatto ner a ng InstallaLo Pn
NINNE504A SMTE BOARO OF ELECTIIICrTyj ? •' THIS INSPECTION REOIIEST WILL NOT
Griggs-MbMay Bltlg. - Room S-173 BE ACCEP7ED BV THE STATE 90ARD
18SI UnlvaroHy Ave., St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone(61R)60t-0800 ENCLOSED
10090 REQUEST FOR ELECTRICAL INSPECTION =N%? EB-00001-08
:
? Sre insimcLOns lor compleLng Ihis form on back ol yellow Wpy
a 10773 •'X" Below Work Covered by This Request
ew Aa Rep. TypeolBuilding ApplianceSWired EqwpmentWired
Home Range emporary Service
Duplex Water Heater Electric Heatinq
Apt Building Dryer Other (Specity)
Comm./Industrial ' Furnace
Farm Air Contlitioner
01her(specry) Conhactore Remarks
Compute Inspection Fee Below:
# Other Fee # ServiceEnirenceSrze Fee # Circuds/Feeders Fee
Swimming Pool 0 to 200 Amps o to 100 Amps
Translormers Above 200 _ Amps h oo _ Amps
Signs Inspector5 Use Onty TOTAL
Irrigation Booms ? AeML
Special Inspection .
.
Alarm/Communication T
THIS INSTALLATION MAY BE ORD D DISCONNECTED ?F NO
Other Fee COMPLETED WITHIN 18 MONTHS.
1, the Electrical Inspector, hereby Rough-in oeie
certity that the above inspecti0n has
been made. Flnal
OFFICE USE ONLV
This request voM 10 monihs Gom
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: a u i Lo s rv c
3830 Pilot Knob Road PermitNumber: 025262
Eagan, Minnesota 55122-1897 Date Issued: 0 8/ 21 / 9 5
(612) 681-4675
SITE ADDRESS: Lo r: s eLo c K: 4 APPLICANT:
4497 MALLARD TR N PANELCRAFT OF MN INC
THOMAS LflKE WOODS (612) 721-6628
r-, ?
L ?
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) REPAIR
DESCRIPTION (SIDING)
.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
PERMIT
MOilo
PERMITTYPE:
BurLozNG
Permit Number: 0 2 6 2 6 2
Date Issued: 0 8/ 21 / 9 5
4497 MALLARD TR N
LO7: 8 BLpCK: 4
THOMAS IAKE WOOD5
(SIDING)
13,uildin4?-Permit Type
Eiuiiding.Wor.k, Type
?.
? -
F 1s
I
1
?
SF (MISC.)
REPAIft
i??li??......
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
VALUATION
$137.25
$4.00
$141.25
$8,000
CONTRACTOR: - Applicant - 5T. Lzc. OWNER:
PANELCRAFT OF MN INC 17216628 0002179 BURTON TNOMAS
3118 SNELLING AVE S 4497 MALLARD TR
MINNEAPOLIS hiN 55406 EA6AN MN 55122
(612) 721-6628 (612)452-5417
S hereby aokrsowledge thtrC T Rave read this appd.'ication and state Cha'C the
information is correct end agree to comply with all applieable State of Mn.
L Statutes and C3.ty ofi Eagan Ordinances. ?
A I m.?
APPLIGANT/PERMITEE SIGNATURE ISSUED IG URE
????? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1995 BUlLDING PERIVIIT APPLiGATION (RESIDENTIAL)
6$1-+1675
New Construdian Reauirements
Remodel/Peoair Reauirerrents
? 3 registered site surveys ? 2 copies of plar
O 2 copies of plans (include beam & window sizes; poured fnd design; etc.) ? 2 site surveys (exterior additions & decks)
O t ener9y calculations ? 1 energy wlculations for heated add'Rions
O 1 tree preservation plan 'rf lot platted aRer 711/93
required: Yes No
State:
DATE: CONS7RUCTION COST:
DESCRIPTION OF WORK: ?L
STREET ADDRESS: LOT ? BLOCK ? SUBDJP.I.D. #:
PROPERTY Nam@: ,a.? ,rZk ln / l 1?1 I Il'? > Phone #:
OWNER '"°* "
"s' ?
, (I rr?
Street Address 9
7 State: n_ Zip:
City: (-(
CONTRACTOR Company: P6NF1 PRAeT nr ?11WE'",.- Phone#:
3118 ?NELIING AVE
Street Address: MPI S Mr cs4.n,Q._ License #:
LIC
City: 111111112179 721-6828
ARCHITECT/
ENGINEER
Company:
Phone
Name: - Registration #:
c{.oA{ 4ddress'
City:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
1131
Zip:
Renalty applies when address change and lot
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
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received ` Yes - No
1990 SUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CAI.CULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROGESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
JOY C 6 REgp'
, JO Date:
To Be Used For: S41 : 7A,")'1 Valuation: ? T
-
Site Address yWp /Vm, 1,&11yFq T,e_
Lot S Block _;?
Parcel/Sub 22,0 .cc ? Wdbo P
Owner (Zd,,e.?M41Z 0iis7i-,.. ?DmFs^
Address A?7rx- PLm?aJ 1/E',
City/Zip Code A zlr-2,,,,, ?/'j/(; SSa6,e
Phone jj/A3 - 91d 0
Contractoi ? S:A/13,E' ,
Address
Ci[y/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code ,?jp,Cfn)
OFFICE USE
Occupancy R 3 m - I
Zoning Fb R-I
Actual Const V-N
Allowable V-N
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System ?
City water
PRV Jef
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road IInit'
Park Ded.
Copies
SUBTOTAL
Penalty
Z, c)o
59,5[5
S0,On
r DO,Op
(Qp 0100
26 5,40
U,00
30,00
30,C?D
IS'C?
252,ao
5.5,DO
TOTAL -3
Phone #
. . ?A?u?T?a?J g
so x z z ? ??o
zx?1= (22?
? 3i3 X iSc 95'7 0
6SmT,
3akzs =7so
7 bxiy=la?zy
Isr F',.?p?
LSx3o _ 7S0
! v '
Z-
1058 X 5i = S?f?5$
Z N? T?"L oa(L
3oXZs = ?SO
!X?5`= l?
'7 '63 l? SI = 39 `} 33
?85
hq)
IIfl08? .
ENGINCEflING
CornPA?vY, iNC.
.IUUU EA9i 146Th BiflEET,
C9RROGL Ct/STaM
fC PlRN4
r?E??s n ?aLRf1U sVRVEVUP6 58
dUflN6YIl.LE , MINNE80iA 6633f PIi 432''JUUO
Certificate ofi Survey
Lega! Description : LoT a, aL,016e a, 7Naw-45 ?KE Wcvos,
pq,eorA covnrrY, 441n/NE907-A.
?955,0) DENOTES EXISTING ELEVATION
(?97,0) UENO'fES PCIOPUSEU ELEVAI'ION
? INUICATES Ulll[C'1"IUN OI' SURt"ACE URqINAGE
SCALE t 1' - 30'
pRqIN46E AND
UrIur/ EA66mE,vT ?
i9b? Z's ?
T-
8`
z
v 1
a ?
W ?
N_
(765, 0)
v
?i?o% g
957, 33 = fINISI-16U UAf1AUE fLOUR ELEVAI'ION
999• 6Z ? gASEMENT FLOOR ELEVATION
957.(v/a= TOP OF BLOCK ELEVIAfION
00
FRDA/T 49111[Di.t16
SETEi9CK UNE -? ? ? f'D??'
O ?
l? -73 q9,08 ? g w?
? ? 533 ?r`•^`o
+-'''?`? / r?s•' ? ? ? 6 ? \
?? \ Y k51°??136?a m
? .
.c o
°-P
W
N?? yT9?F 9 9? F^(?
I?? 1. 0 ? T'D R ysT
W ? m Z '?0??"?9S •2. C'a
? ? ? ? ? 3g ? ty?Rs
?„ .N _ U'-
?
D
i?
?
?
-a? ?•$ Zp.3% ? ?5?? ? ?
`N l?5?-?? \
c,• (y5??` a \
\o
?Q.
/
??` 182?i8, 3" E
77' 3?
NKD?
P R.V. ??OURED
A
„c
0
Edv'
-U, -?
4'3'
-- • ?, 9.44
_
DEPx
1 hereby cerllly ihat fhls la a true and aorteal reptesentaUon ol a Irnci of land as ahawn
? ,/_'' O
and desarlbad heroon, As piepateJ by'me on 11ifs day al ?Fm?+'r ,1g? ,
=?Y
.__?
aiz1ia
MINNESOTA STATE ENERGY CODE CAICULATIONS
BASED ON CHAPTER 5 OF THE /
MDDEL ENERGY CODE - 1983 EDITION
Adoption Effective 1/1/84 ,
Owner Phone S/?-,l/DO Date
Site Address_
Con[ractor Phone
?la'??-6i Of!
Building Classification: Type A1 (Single Family 6 Duplex)Type A2(Residential)
0 stories or less
NOTE: Complete pages 3 and 4 first.
(Other) (Over 3 stories)
GENERAL INFORMATION
a N
I. Building Perimeter!!?;:_e
1r0?'.L ft.
2. Wall height (ground to eave) ft.
. ? Z O
3• 1. x 2. (above) gross wall area
?
4. Building dimensions (L) ---- x(W) ft.2 roof E floor area
5• Square foot area of rim joist - Floor joist size (2 x G? )
(Cl X Perimeter = Rim Joist area = Z?? ?V ft2
12
6. Doors - Area 6 /,c '
Thickness In. U factor PY4 *, 41 •
Type of Construction Perimeter ft.
Manufacturer
7. Total door's perimeter
ft.
?
8. Windows: Manufacturer State approved
U factor
TYPE SIZE AREA (Ft.2) NUMBER OF TOTAL FEET Z
? EACH UNITS
9• Total ft.Z Glass ZZ9 • 2'J`
10. Fireplace area; Width X hefght = X =
Ft.2
Il. Exposed foundation: Hei9ht X PerimeterX 7Z, _ '?I• ? Ft.2
COMPLETION OF THIS FORM IS REQUIRED FOR ALL E CONSTRUCTION, MAJOR REMODELING AND BUILDINGS BEIN(
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USEO.
-* q?- se+??
??-"
zg+ 2 aZ4,
asca ?1 .
IWN ?s
12-3,757
PON D'('?j = ld, v X ?2
,2La'
II WX12
I/Ox2 =
I,4r0
1 I ? cox ??c.o = ?, Z J X Z =?O, ?
IIII loX(00 = I I?D X A = 4
4,
,
Z 2? , 25
4D?ts
o
Zl,o
?1, 62
WALL
SECTION
STUD
SECTION
Sheathihg !Z.O(p . ??'
S ld 1 ng , (p1 ?-?-
Oueslde•a1r film ' .17
R 'IOTAL ? ? • / 3
?)
SheaihLng 2,.0(p JoiSt) .
Extettor vall covering ,(p'J
,
E:cGerlor air film R-- ,17
R TOTAL Z4. 4Cp
Intertor alt film R= .68 ,
lnsulatlon 11.0
?
Foundation 1•18 (Fdn.) U = R =
? Erterlor alr film R' .17
F TOTAL I Z7 . I 25 -^
? ?Exposed 8luck
---i
`.??";•'?.?Grade 3.
2ND HALL
SECTiQN.
U VAWE CALCULATIONS n
ALUE U VALUE
Inside air film ,68
Lntetior wall - ? (Nall) U . R i.
Lnsulatlon 19,0
Sheathing '/„OCO
Slding ,(p7
Outetde alr film .11
R TOTAL 23 , 0 ?j-
Inside atr film ? .68
Interiar r+all ,L}:5
411 stud R= 4.38 (Framing) U.? .
Inslde alr film R= .68
Lnterlot wall
Insulatlon
Sheathing
Extertor wall covering
ExGerlor air fLlm R ..17
R 'fOTAL
(Wall zU . R . \. /
/?
.Y ?
lnterlor aic film R= .68
F ?
RL.I Lnsulation 1q•o ?
JOIST ?`-% 'lk inch soEt wood R=1.88 iR?m U=?_
CEILINf WITH VENTED ATiIC SPACE ABOVE
? R 'IALUE V lUE .
FRAMIPIG CEILiN6
? 0.61 Air Film 0.61 '
D Insulation
?
? e7 Joist
Ceiling
.
FIAT ROOF OR CATHEDRAL CEILING
R Va ue R 'lAIUE
FRAFIING CEILING
0.61
. 0.17
Inside air film 0.61
Ceiling
Joist (stu
Insulation
Air space
Roof decking '
Insulation
euilt-up roof
Outside air film 0.17
Total
R=U
R
Jindow infiltration .5 cfm/lineal foot of crack
tesidential door infiltration 0.5 cfm/square foot or door and minimum code requirement
-lon-residential door infiltration 11.0 cfm/11nea1 foot of crack
Jb 12" concrete 61ock no insulation = .47 R 2.1
!b 12" concrete block insulated cores = .26 R 3.8
15 12" 1 igiitweight block = .32 R 3.1
)b 12" lightrieight block insulated'cores = .12 R 8.3
J single glass = 1.13;
J double glass = .55
J triple glass = .41
0.61 Air film 0.61
-'-s--
?Z l(0 Total R 45.70
1
U=R OZZ
with storm iaindow .54
all exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
;apor barrier must be on the inside (heated sid<) of wall,
tapor barriers of the polyethelene thin film have no R.value.
4.
~ 7-/ 6 6-5- 2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenfs
3 registered s'rte surveys showiig sq. ft. of lot, sq. ft of house; and all roofed areas
(20% maximum bt coverage aliowed)
2 wpies of plan showing beam & window sizes; poured found design, etc.
1 sel of Energy Calalations
3 copies of Tree Preservation Plan'rf lot platted after 711193
Rim Joist Oelail Options selection sheet (buddings witlh 3 or less uniLs)
Minnegasco mechanical ventilafun foim
RemodeVReoair Reauiremenls
2 copies of plan showing footings, beams, joisls
1 sel of Eneyy Cakuhafions for heated additions
1 site survey foradditions 8 decks
Adddion - indicefe if on-sde septic system
qa- o(D
6%'?ce Ose On '
Cert OfSUNeyi?ecd;I_ ? --_„'N
'freePieaF??nRz ecG;??;..? =:=_f:-?,N
. „;?;
7.
tee:Pres.Reqi?ired Yv-_ N
On-sife:5eptl6Sy61em "_'.`__ Y=? N
Date Construction Cost
Site Address ? 1 ,
417 ? /? IFx? rt?LU( UniVSte #
c
Description of Work °P
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2
Property Owner Telephone #( 65 o yS ? Sq17
Contractor
Address
St
t /v City
Zip Telephone # (7F73
e
a
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules'7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential Venfilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculatlons Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanicai Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, 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 lan in the case of work which requires a review and
approval ofplans.
k'obiFet .CAKE-
Applicant's Printed Name ApplicanNs Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA086020
Eagan, MN 55122 . Date Issued: 09/12/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4497 Mallard Tr N
Lot: 8 Block: 4 Addition: Thomas Lake Woods
PID 10-76100-080-04
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Sela Roofing Remodeling Thomas H Burton
4100 Excelsior Blvd 4497 Mallard Tr N
St. Louis Park MN 55416 Eagan MN 55122
(612) 823-8046
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
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA093799
Date Issued: 05/05/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 4497 Mallard Tr N
Lot: 8 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-080-04
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Great Lakes Window & Siding Thomas H Bruton
14650 Glenda Dr 4497 Mallard Tr N
Apple Valley MN 55124 Eagan MN 55122
(952) 891-3400
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
ZI r _ _ _ Use BLUE or BLACK ! - I
I For Office Use
• j Permit 1 Y U j
Clty of E a~~Il I Permit Fee: I"
3830 Pilot Knob Road RECEIVEID
Eagan MN 55122 j Date Received: r j
Phone: (651) 675-5675 MAY 12 2013 I I
Fax: (651) 675-5694 1 Staff: I
I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 517114 Site Address: 4497 North Mallard Trail Unit
Name: Tom & Lauren Rtirtnn Phone: 651-452-5417
Resident/
Owner Address / City / zip: Same as site
Applicant is: Owner -x. Contractor
Type of Work Description of work: Remove & Replace one window
Construction Cost: $2,600.00 Multi-Family Building: (Yes / No
Co Budget Exteriors, Inc. Contact: Jaymi Lund
8017 Nicollet Ave. S
Contractor Ad Bloomington, MN 55420 City:
Sti 952-887-1613 Fax: 952-887-1659 e:
License # 60006564 Exp. Date:3/31/16
License Lead Certificate Nat-22128-0
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Home was build in 1990.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classed as non-public if you provide specific reasons that would permit the City to
conclude that the 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.gol)herstateonecall.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 Jaymi Lund x /.Zm
Applicant's Printed Name App is Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA148506
Date Issued:04/03/2018
Permit Category:ePermit
Site Address: 4497 Mallard Tr N
Lot:8 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-04-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Thomas H Burton
4497 Mallard Tr N
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