4389 Malmo Cir.
? CASH RECEIPT 0
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RECBIVED
19
AMOUNT $ I
{
$ DOLLARS
t0o
? CASH ? CNECK
NUMERICAL FILE COPY
?4'
H Y
--?
U
?? t 1! ?
CITY OF EAGAN Remarks
Addition Wilderness Run 4th Addition Lot 16 Blk 3 Parcel 10 84353 160 03
O?rner? ??? ?' u!h _,1 S.Vk "}- A n", -tr?t 4389 Malmo Cr. State Eagan, MN 55123
l 1 i; t: L ` 1?.?,#, i?i. s.? ?i(t f, ti?.(t !
Improverrl?nt Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RE570R.
GRADING
SAN SEW TRUNK 163. 6 8.16 20 122.46
SEWER LATERAL
WATERMAIIV
WATER LATERAL
WATER AREA
STpRM 5EW TRK
STpRM SEW LAT
CURB & GUTTER
SIDEWALK
STREET L.IGHT
WATER CONN. :V- 0
BUILDING PER.
sAC 75Oo - ' 7
PARK
f
? • CITY OF EAGAN
3795 Pilot Knob Road Eogun, MN 55122 N2 4407
. PHONE: 454-9100
BUILDING PERMIT Receipt # 6
To be used for Date - ' S 19 ?
Site Address - Erect ? Qccuponcy =
Lot ` Block { Sec/Sub. `' Alter p Zoning
Porcel # _ Repair ? Fire Zone
Enlarge ? Type of Const. 1%
CK Nome -: t t r?;; i?? : i[r:gr; Move p ?# 5tories
Z Address Demolish ? Front 69 it.
0
Grade I-I Depth 44 ff.
? Name 17QIii6SI i.nc.
0
z
o? Addreu, f.7' So, ?-riol.l;nr' Ave,
U< DL..-.. Nome _
Address
I hereby ocknowledge that I have read this applicotion and state thot
the information is correct ond ogree to comply with a!I opplicoble
Stote of Minnesota Statutes and City of Eagan Ordinances.
Assessment -
Water & Sew.
Police
Fire
Eng. -
Planner
Council
Bldg. Off. _
APC
Permit _
Surcharge __=.yr.,6cnG_
P!on check
SAC
Woter Conn. 230, 0
Water Meter 60.0
Totol '- 30. 50
Signature of Permittee - I
S , inc.
A Building Permit is issued to: on the express condition that
oll work sholl be done in accordance with all opplicable Stete of Minnesoto Statutes and City of Eoson Ordinances.
Building Official
r«mir # Date lm.a P«.xt»
Plumbin9 77 ,j? Z?-?-c-t? ??.
Mechanicol -77 ' ,? ?.,,?
INSPECTIONS ? DATE INSP.
Rouph-In
Flewl
Footings ? Date Irap. Dote Imp.
Foundation
- Plumbing
Frome/ins. ? Mechoniwl
Final
Remarks:
. CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-5100
PERMIT
Date:
Lgust 5, 1977
Site Address: 4339 M.altmo Circ'-e
Lot Block - Sub/Sec.
WR 4tP
No.
Receipt No.: '?,053
Single
Residential
Multi Res., Comm./Ind. I
Name ilsen flOZneS I:. New/Aiter./Repoir
m ?-? 7 arEl1 iT{
Address ?
? F.' ?. . . Cost of Instollation
;
O
. 1?aul .; , nn
City ` ` Phone; Permlt Fee -
?,ouis 14. pe?.er
? me ' - Surcharge
541 C7ra!:d Ave.
P Address -
s
0
C+ty " Phone: Total
This Permit is issued on the express condition thot all work shall bs done in occordance with all applicdble State of
Minnesota Statutes and City of Eagon Ordinances.
Building Official
. CITY OF EAGAN
3795 Pilot Knob Rood
Eogan, Minnesotn 55122
P6one: 454-8100
. PERMIT
R
?TUly 3n, 1077
Dute:
Site Address:
Lot Block Sub/Sec. '' 4t
Name .1Sen raMes Inc.
?
? Address" 7 SnelZina Avz. ;'o.
City ' -• Paul Phone:
ame' Binder 5 Son
?
?
? Address ?O E. Butler
e
0
V r
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagon Ordinonces.
No. =a
06757
Receipt No.:
Single
Residential k
Multi Res., Comm./ind. I
New/Alter./Repair. Cost of Instoflotion
Permit Fee zd' 0n
?n
Surcharge ' -
Toto I
done in occordunce with oll applicable State of
Building Officiol
CITY OF EAGAN
7745 rilor Knob Rood Eogon, Mli 55122
PHONE: 454-8100
?C01
BUILDING PERMIT Re«ipr #
Te be w"d f m Est. Vclue Date , 19
5ite Addrcu Erect (3 Occupancy
Lot Block Set/Sub. - Alter p Zoniny
Parcel # Repoir ? Firo 2one
E
l T
f
crfle
n 0 ype o
Const.
19 W No? - Move 0 # Stories
; Addross Demolish p Length
b rw w,.,.,? • . . Grade
?
Depth Sq. Ft.
$? Nnme
tu Address
r:.,, e?...-_
Nome _
Address
Assessment _
Woter 8 Sew.
Police
Firo
Enp.
Planner ?
Countil
Permit
Surcharye '
Plan check
SAC
Water Conn.
Water Meter
Road Unit
I hereby acknowledge that I have read this opplicotion ond stare thct gldg. Off.
the informotion is correct ond ogree to comply with oll applicoble
State of Minnewta Stofutes and City of Eogon Ordinonces. APC Total
Siynaturo of Permittee -
A Building Pertnit is issued to: on the express tondidon thni
oll work shall be done in occordonce with all applicable State of Minmsota Statutes and City of Eopon Ordinonces.
Buildin9 Officiol
Psrmit No. Permit Holder Misc. Permit No. Holder
Plumbiny
H.V.A.C.
Well
Weter
Disp.
Sawer
Electrie
leapaction Date Insp. Other
Footinyt
Foundation
Framinp
Rouph Plbg
Rouph HVA
Inwlation
Final Plbp,
Final HVAC
Finsl
Water Dacribo Loation:
YYell
Sewnr '
Pr. Disp.
CITY OF EAGAIV SEWER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.:
Eogan, MN 55122 DATE: '
Zoning; _ No. of Units:
O+vner.
Address:
Site Address: - - ? '
Plumber: _ ,.
I agree !a comply with the Gfr of Eogan
Ordinances.
R..
Dote of (nsp.:
I nsp.:
CITY OF EAGAN
3795 Pilot Knob Road
Eagon, MN 55122
Zoning: _
Owner:
Address:
Site Address:
Plumber: ' rer
Meter No.: „r
Size:
Render No.: "
1 agree to eomply with the Cilp of Eagan
Ordieanees.
By - .
Dote of I nsp.:
Connection Chorge:
Account Deposit: _
Permit Fee:
Surchdrge:
Misc. Charges: -
Total:
Dote Poid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
_ No. of Units: 4_ -
, . -
_ Connedion Charge: '
_ Account Deposit:
_ Permit Fee:
Surchorge:
Misc. Charges:
Total:
-- Dote Paid:
- I nsp..
100. 00 pd
.,•.r A.. ....
' CITY OF EAGAN
3795 Pilm Knob Road Eogan, MN 55721 N! 4407
4 ' PHONE: 454•8700
BUILDING PERMIT APPLICATION Receipt #` 6739 _
$SOv
D00.
To be uaed fer si ?- Fe... n..,tg t c.,« Dote July 19, 1 q 77
s
Site Address 4389 MalIDO CT_ Erect [?C Occupancy I
Lat 16 Block 3 Sec/Sub. WFL 4th Alter ? Zoning Rl
Pa??l # Repair ? Fire Zone _
Enlarge ? Type of Const. V
w NaR,e Jeffrey D Hoffman Move ? # Srortes
Z Address _
O Demolish ? Front 69 ft.
Cit Phone Grade ? Depth 44 ft.
o Name Tilsen Homes, Inc. Avararels Feea
o? 627 So. Snelling Ave. Assessment - Perrnit 140.50
Addre
?. 8U Water 8 Sew. Surcharge _ 25•00
Phone
k
ww Name - Police
Fire Plan chec
SAC 475.00
?
?-,
Address
Eng.
Water Conn. _?MO
6w Ci Phone Planner Woter Meter 60.00
Council
I hereby ocknowledge that I have read this application ond state that gldg
Off.
the informotion is correct and agree to comply with aIl applicable .
APC Total 930_50
Stote of Minnesota Statutes ond City of Eagan Ordinances.
Signoture of Permittee I
A Building Permit is issued to: Ti1Sen Homes, IIIC. on the express condition thot
all work shall be done in accordance with all appliwble State of Minnesota Statutes and City of Eogan Ordinances.
Building Official
, cirr oF Ee,anN
. ' 3795 illst Kno6 Aosd Eegan, MN 55122 NO 7601
vHONe: 454-e100
-
BUILDING PERMIT Reteipt
Te M wed forMASONRY CHD'M Esr. Value $500.00 pafe OCtober 27 ?q 82
Stro Address 4389 Malm o Circle E,?t 10 p???ncy R-3
Lot 16 Black 3 Set/Sub.WildEL'TleeB R1121 4th Alter p ZoNng R-1
p
l # 10 84353 160 03 Repair ? Fire Zone MA
ame
e
„iaro. ? TyPe of Const.
W Noma 7eT*y Kan rnhwr Move ? # Stories
€ Addross 4389 Alalmo Cirele Demolish ? Length NA
5 c; Eag an 55123 phone 452-3907 Gmde ? Depth n Sq. Ft.-
? (lunnr AOOrorals Faas
o Name _
z)-
Address
r ??...
Name
I hereby ockrowledge thot 1 hove reod this opplicotion and stare that
the inlormation Is wrrect and agree to comply with all opplicable
State oi Minnewto Stotutes and Q* of Eagan Orirwnces.
Assessment _
Woter & Sew.
Police -
Fire
Enp.
Planmr _
Council _
Bldg. Off. _
APC -
Permit -
Surchorge _
Plon check _
SAC -
Woter Conn.
Water Meter
Rood Unit _
7ofoi $11•00
Sipnaturc of Pertnittea/?? I
A Building Permif is issuad to: JE y 1Caeseher on the express condition tha,
oli work sholi be done {n occordance with oll applimble Sta,t?y/pf Minnesota? $tqtute/nd?ry'of Eayan Ordinonces.
Buildirg Oificlal .[?et-?-Q L?'?
?y'
?? ? ? ?
= CF EAGAN
gIIILpING pEgMIT APPLICATION
Inclittle 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculaticns.
/!*A?
Zb Be used For M0.?oh ?` &CW(?uation SOC.D nabe
site Address 47-,.P? 12)p/mn
r,ot I (o Biorx 3 sec./sub. W t 1A k Qu. V1 T--Erect
rarcei #: la v 4 3 ? ? /foo p?- Alter
Repair
Owner: --12YYv '/ 1lck PYC4' Enlarge -
Address: Move
4?X ° ? 1/11 C ? f r G? Leoolish
City/Zip Code: F u tr 5 S I-?L a Grade
Phone #: `? S" 3 3 ?3 07
Contractor: 0 i -U Y1 -F '(
Pddress:
City/Zip Cade:
Phone # :
Arch./IIx3.. _
Address:
City/Zip Code:
Phone #:
CEFICET----USE ?I'Y
occupancy oP ?
Zoning K.1
Fire Zone ArA
Zype of Const.
# Stories
Front ft.
Depth ft.
APPROVALS FEES
Assessments Peimit
[dater/Seorer S?charge ?
po7_yce Plan Check
Fire S?
Eng, Water Conn•
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
T= I /
\
,?
WMDU?TIOH AIR Rk.'QIIIM CITY OF EAGAN
3795 Pilef Knob Road
Eagan, Minnesota 55722
Phare: 434•8100
HE9TIICC} pERM1T
Date:
Sire Addreu:
2/89/80
4389 D"a7.mo Circle
u?n I
Lot // ? Block 2 Sub/Set. -We y _ I
Na. 1708
ReceiDt No.: 17919
Single
Residentiol ?
Multi Res., Comm./Ind. I
Jeff Aoffui
Name New/Alter./Repair
? 9aR8
g Address Cost of Installation
? EflgBn, 11IN 452-3239 ?t 3.1 1!)
City Phone: - Permit Fee
Fredricks? ]it?. y?
Nume Surchorge
g Addreu 40'?l hpait t3 Rnr- t}rivo
?
V City ?-'.AnII27. 'U" 551 ?? Phone:lc,?_?n".rr? Total : 51'
This Permit is issued on the exPress condition that all work shull be done in accordance with all cpplicoble SEvte of
Minrresota Statutes and City of Eagon Ordinances.
Building Officiol
S?F 4u.5o--12yydu
This request void 18 months from
ad?o G 7S
Date of this Request 7-25-77 p10363
I, as a.Licensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street ess or Ro ?.N;o. 8 b<a Circle City ??''?
Secti- on ??wn?p Range County Dakota
Which is occupied by Tilsen Homes
(Name of Occupanq
Is a roughin inspection required on this job? No ? YesfM Ready Now ? Will Call 0-
Power Supplier Dakota CtY. Address Farmington
ElectricalContractor O.B. ThOmpaon
Contractor's License N0?32503
(COmpany Name)
Mailing Address 12201 P.itka. Blvd., AiItka 55343
(Electrical Contrector or Owner Making TNS Instaliatlon) _
Authorized Signature Phone No. - - !'•'?'-
(Electrkal Contractor or Owner Making Tnis Installatlon)
????E BOARD COPY
ElectricCo.
- Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
fi.EbU98T FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
-xf D 6 a-Sd
p 10363
Type o[ Building New Add. Rep. Ch¢ck pppliances WiredFor Check Equipment Wired Fm
Home XED ? ? Range Z$4• Temporazy Wiring ?
?uplex ? ? ? Watei Heate: ? Lighting Fixtures ?-`
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Fumace 00
?2, Silo Unloader ?
Industrial Btdg. ? ? ? A¢ Conditionei ? Bullc Milk Tank ?
Fwm List j List
O he ? ? ? p
}ieie`s) Disro. Diah. [1.0 RehersI
COMPUTE INSPECTION FEE BELOW
Seavice Enhance Size: ft Fce Feeders&Subfeeders: # Fee C'ucuits: if Fee
0 to 100 Am s. 0.30Am e7es 0 to 30 Am eres 8 1.00
101 to 200 Amps. 31 tof 1 Am° j s; 1 J 31 ro 100 Am eres
Above 200 mps. Ab '-
Above 100 Amps.
Transformers Re "eCo olCrc. Partial or other fee
Signs 11 Special Ins ection Minimum fee $5.00
Remazks Ag 1
fJ? /J f ? TOTAL FEE 0.50
I, the Electrical Inspector, hereby ?(j??tha ir???tion tias been ade. cFO-0d '
(Rough•in) i. ^> v o ? Date ?
(Final) Date
This request void 18 months from "
RESIDENTIAL BUILDING
O(
b Y' Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
G60
New ConsWdion Reaui2ments RemodellReoairReauirementa ORce Use 0nN
3 registered sde surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20°k maximum lot coverage altaved) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 si[e survey for additions & decks Tree Pres Not Reqd
1 set of Energy CalcuWtions Add'Aion - indicate if on-sde sepfic system _ On-site SepGc System
3 mpies of Tree Preservation Plan'rf lot platted after 711193
Rim Joisl Dehail Options seleclion sheet (bldgs with 3 or less units
Date /0 / 0 3
Site Address y3 $ 9 Vt'LAA w?o L° fZ Construction Cost
C'za? cu.? vtt-A? UnivSte #
Description of Work Mtw ?.e c..? {,2avA t Uti
Multi-Family Bldg _ Y_?O N Fireplace(s) _W 0 _ 1 _ 2
Property Owner S Telephone #( b Q 3 Z Z
Contractor 5 2 t i-`
Address
State City
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
I hereby apply for a Residential Building Permit and acknowledge that the information
that the work will be in conformance with the ordinances and codes of the City of Ei
Telephone #(
7elephone #(
Telephone #(
complete anZt-acurate;
n and the State of-_MN
Statutes; I understand this is not a pernut, but only an application for a pernut, 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.
??.arles J_ u ?j
ApplicanYs Printed Name
pplicanYs i ature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 04 02-plex ? 10 08-plex -1C 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-p16x Plbg_Y or_ N ? 25 Miscellaneous
Work Types
F 31New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation Ju o
Census Code 4 3 y
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const v_
Footings (new bldg)
X Footings (deck)
r? Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
_ Fueplace _ R.I. _ Air Test Final
Insularion
Zoning City W ater
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
Occupancy Z -3 MC/ES System
REQUIREDINSPECTIONS
FinaUC.O.
X FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retainiug Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 30 Accessory Bldg
? 31 Ext. Alt - Multl
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* 0 43 Reroof ? 46 Windows/DOOrs
'Demolition (Entire Bldg) - Give PCA handout to applicant
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PelRCEL & SEC^sZOT3 2Jt3i4i$R IF U11PLY1TTEll
.fflo"- ?4w7
Date: 2-6` ;'7
ADDimio-:a
ADURESS OE' PARCEL -V3
7,OidL'1G JP ? OCCUPANCY =4 USE^S ?
Es:zMA^,En cosT
OY'!]ER ??yp,u TELEI'IiOIIE i40.
0?-
COLdTPrCiOR .i(1 QA?» 4?J? TELEPHONE :110.
AllDc'2ESS
Tdote: Include site plan; building plans, and energy calculations vaith this
applicatiofz
5iqned
OFFICS USE
vALunmsoci;
SaC N 7 ?. . nli
S•iAiB'3 CO:FNEC'-IO. -?
F?ATLFR METER
BUILDITdG PTP.IiIT F.EE
SURCHARGE FLF
PLr1Ii Ct7EG1t Fr:.E
PAELK DEDIC.'?TIa.:t FEE
OT:"'aR
TOTAL*
?z 4n- nn
O d'
APPROVFILS.
ASSESSi+lE:?T CLERK BUILDIidG DSPT
BUILDI't7G PERMIi P.PPLICA^tIO:Q
POZICE DEPT.
?1AiER 6 SfiTJER DFP'i . FII2G DL•'lPT. P<9RK DEPT.
1
Homes, In
I SNELLING AVENUE
, MINNESOTA 55116
DNE: 69&5501
SubjeCt oate 77
BABSSage a??
a .
PIEASE REPL// Y'TO l l/,4/- 4/ 7.?/V siened y,/ ? ? )???5 ??If?vv .-.
Reply
Signed Date
Form No. QL-3 SEND PARTS I hND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPIV
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• .. 154 -
grlqR NAii. CONSTRUCI'ION: "U" valne E or" '
•'nll : sq, ft. '
P,p.tjC, G2 wME. "sL-1- "U" . ?: sq. ft. f Z3P, _ 1 ?
gouil. nfereoe• "u" : .q. ft. '
!!am i ...vo&t ?? "D" •a-r : sq. ft. i•71? '
ttsObN shNts 'Rl" z sq, ft. '
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s4L. FteQn4 !S "U" . S?ix sq. fc. a,. fS - 1 4. ^7 (11)
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? 6 gpe
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,sr
11l? b c"e 1@ 3= x?? 'v"_„?dc :.q.
xsq*
_ sq.
* $lu° tiC, = tq•
mSAL. (U) (A) VALUES ??- I65
ONIDED SY 1'OTA:. WA1.L nRFA
illlglgItAGE "U" .17 or less Eor 1 6 2 family dvellings
,22 or lesa for ail other buildinpx
NW/CEILING: '
1'OM ARFr?: 94• f' • '
14ta11 reference x eq,
q
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.
aRtse6od shaete sq.
OMftslDe opaninse ?•i.•? x eq.
. ft !Nf .?.,,- _x Fq.
W
(A
(A)
(Al
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ft. '10.O ? _1; .2 (U) U
fc. 11. -L -' l. l? (U) fA
ft. ' (?h (w
ft. 40 2 2 (V) `U
TOTALS1 -1 A_6_eq, ft,2EYQ.9 (!) (
ft.
ft. Y_SR4--_'-s$ . N)
tc.
(?
f t. ' (1n fli
tt. ` (U) YA,
J
70fAL (lT) (A) VALUES TOTALS I?i?Y4 sq. ft. (U)
? omngb s,r TOTw ROOF/ / 5e4
UMIIIG ARRl1 . A
f
t' a . y ° . . • . `?.? , . ?' . ??, ' . et
e !f ?i?f? . ' ' . r 'l1 ' ? ' '1.
'11". .OS for nntialltN eooks .
:10 for all ethet eaastruetion ' •
1. Q?T S? c?E vo2
2. QnC-V- .4_S
3. lA" uu,-r i O?.r 22.00 '
. a. y.,c,vF a.%t2--
s.
6. '
? . .?..
CMTinICTION FRAFIING: R- valuo .
1. A? Q 1`1 •
2. Qtf-r Sa Aa??%"4+. 2. n?
3. `i-i' 1 u?..??bcr ?ew? 1_1- O° '-
4,
6.
14.. R7
MDT&: If +varage "U" ralues as ealculatad above do aot rst the Enatgr Cod• r*quireMnce,
tiu "Alceroace Envelopa Design" •s outlined !n SDC 6006 (S) wr De used. Additional
*hoecs way be used to shw ealeulations.
,
,-. ?
5 a a ? ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conctruction RaouiremaMs
• 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all rooFed a2as
(20% maxinum lot coverage allowed)
. 2 copies of plan shovrirg beam & vnndow sizes; poured found design, etc.)
• i set of Emagy Caladations '
• 3 copies of Tree Preservation Plan if lot platted afler 717/93
• Rim Joist Delail Oplmns selecGon sheet (bidgs wilh 3 or less unlts)
DATE -r-- 1 3-d)-
als I aS
RemodeUReoair Reauirements
. 2 copies oi plan
• i set of Emyy Calculatbns for heated additions
• isitesurveyforexlerlaraddiM1Ons&decks
• IMkxte if home served by septic system for additions
VALUATION I I10 kco
JOB SITE ADDRESS MGj1M 0
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER CAGfCK J- L bR 1 rkq9g
F
TYPE OF WORK PUi9Ce I( G/ iY)t/vwt d- I P9 T i a l?r FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ?? ys ca,? ? e jFK7;!i','15'rS PHONE# 70 - l}9d -e2Oe'd
ADDRESS H" f8 r'IOUhvS" !/ i Pu/ f/hN 4*? ZIPCODE f3'_/12
PAGER #
CELL PHONE #
FAX # ?'I642^7,t0
Nt1V RESIDENTIAL BUILDING ONLY - PILL OUT COMPLETELY
Energy Code Category _ 1bIINNESOTA RiJLES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNFSOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing Syslem Includes:
Mechanical Confractor:
Mechanical System Includes:
Sewer/Water Contractor.
_ Water Softener _
_ Water Hcater _
No. of Baths
Air Conditioning
Heat Recovery System
Fee: $70.00
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
SlgnWureofApplicant o'/ - -??
Phone #:
Lawn Spiinklcr Fee: $90.00
No. of R.I. Baths
Phone #
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 2002
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? CITY OF EAGAN Q n
3830 PILOT KNOB RD - 55122
3GO9
851-881-4675 ?
New ConsMucflon Reauhements Remodel/Reoah Reaulremenfs
? 3 registered sNe surveys ahowing eq. N. of bt, sq. B. of house
and QII roofed areas (20% maximum lot coveraae allowed)
? 2 coples o1 plans (show beam 6 wlndow sizer, pouied ind. design; etc.)
> 1 sef of energy calculaNOns
> 3 copies ol hee preservaHon plan H lot plaMed atfer 7/1/93
DATE: t, l 3 IRS
2 coples G plan
1 se1 W energy calculaHons for healed addNlons
1 eHe survey for exfedor addBlona R deeb
? /? oU
CONSTRUCTION COST: ? ( w
DESCRIPTION OF WORK: ZOA u
STREET ADDRE55: _`Sb9 {MaAmo Cw -
?} n F? . ?
?
LOT: I (O BLOCK: ? SUBD./P.I.D. #: W `i-Q ?-1? -k ll V
PROPERTY
OW N ER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: ? f 0.at ?'k a kAC V- Phone #:
ta P6s1
SheetAddress: ??(Rq fflodm0 G (
City ?icl,cie?V\ State: / IuP: s s1 a 3
Company: ?bOLihP I.ChST I 'n? Phone#P:
(area code)
StreetAddress: ??"?I (,Vt"/V ucense#t Xi °Exp. 3 po
City State: ??Y Zip:
Company: Name:
Telephone #: area code (
Sheet Address: Registration M:
Ci1y
Sewer 8, wafer Iicensed plumber (reaulred fw new conslrucHon onN1:
State:
Zip:
PenaHy applies when address change and lot change is requested once perm s issued.
I hereby acknowledge thaf I have read thia appiicatbn, stafe fhat fhe informa Is ?ec, d agree to comply wiFh all appUcabl
State of Minnesota Sfatutes and CNy of Eagan Ordlnances.
J
Slgnature of Applieant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes - No _ Not Required
City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fvc: (651) 6755694
- - ---------,
; ?or o?e ii_s"e ,
?
j Permit #: yJ ? ? ? I
? Permit Fee: J--D
1
I ?
I
? Date ReceifEQ?Q??_
i -,??. i
i starr:
J I
2009 MECHANICAL PERMIT APPLICATION
Oate:???' d Slte Address: T3 c?f 9 //[ GL-?/?y[ n (%,fF [p
Tenant L?{?ZLtC',tG &:Lv:d5/ Suite#:
RESIDENTI OWNER Name: A64 64- Phone: ?VS -3, a 3 a?
Address / Cdy / Zip:
CONTRACTOR Name: 8 RN VI HEDTING & AIC INC License p:
3451 W. Bumsville Parkway
nddress:
City: Bumsallle MN 55337 State zip:
Phone: ?/S v1 k1W (JOO,?- Contact Person:
TYPEOFWORK -New _.yReplacement _Additional _Alteration Demolition
Description of work:
NOTE: Both roaimounted and'ground mobnt§OI iriechanfcaLdqoipn}ent isrequlred t0 ?
$e "screened hy City Code. 'Please confast the Mechanlcallnspector oc orre of the
Pianners for lnformation on rmltted sCreenlq 'methods. ,.
PERMIT TYPE RESIDENTIAL COMMERCIAL
-4V- Fumace _ New Construcfion _ Interior Improvement
?. Air Condihoner _ Install Piping _ Processed
Air Ezchanger _ Gas _ Exterior HVAC Unit
Heat Pump
- _ Under / Above ground Tank L__ Install /_ Remove)
" When installing/removing tank(s), call for inspectlon by Fre
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Mlnimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fife f2p8if (replace burned out appliances, duc[work, etc.) (includes $.50 State SufCharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1°k
$50.50 Minimum (includes State Surcharge)
- If Permi Fge is less than $1,000, Surcharge is $.50. Permit Fee
- If Permi E,g, is >$1,000, surcharge increases by $.50 tor each =$ StatO SurCh8fge
$1,000 Permit Fee (i.e. a$1,001-$2,000 Permit Fee requires a$1.00 surcharge).
$ TOTALFEE
„e, euy an„vw,cuyv mai mrs nnunnanon is cwnpiete ana acCUrdtO; mat In@ WofK wlll be in COniOrman the ordinances and codes of the City of Eagan; Ihal
I underst is is not a i, ut only an applicalion for a permit, and work is not ro slad v,nthout a ertnit; hal Me xror in accoMance with lhe appmved
plan in t c e of work ich reqwres a review and approval of plans.
X i ??vi YYi-?GL X
ApplicanYs Printed Name AppllcanYS Signature
•--?
FOR OFFlCE USE " ' -
= Revlewed. By: pate:
Required Inspectlons: Under Ground' • Rough In Air Test' .=Gas.Service Test " lo-floor Heat _Final
_ Exterior HVAC Screening Inspectbn,
. ,
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117472
Date Issued:10/18/2013
Permit Category:ePermit
Site Address: 4389 Malmo Cir
Lot:016 Block: 003 Addition: Wilderness Run 4th
PID:10-84353-03-160
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Matt Czech
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Charles J Bragg
4389 Malmo Cir
Eagan MN 55123
Pineview Builders Inc
2201 Lexington Avenue N, Suite 100
Roseville MN 55113
(651) 489-3696
Applicant/Permitee: Signature Issued By: Signature
!"
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P[
ECEIVE
AUN 2 5 2020
Y A►PPLICATION
2020 RESIDENTIAL BUILDLI
Oka
I
Date: 6_®Z mite Address: L� g Oka i LA (-Are* unit#:
Resident!
Owner
Type of Work
Contractor
Name: Sur Yr. / 54.
Address / city l Zip: 1.4 3 `t q irh di river, e lver ie -
Avv
y( 4�fn 411
pcant is: �-Owner Contractor � _1
r k�1
Description of work: 6
Construction Cost ea MA -Family Bing: (Yes / NoK )
Company: Contact
Address: City:
State: Zip: Phone: Email:
Licensee: Lead Certificated:
if the project is exempt from lead certification, please explain why.
er. /7 7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BLIILDIN
In the last 12 months, has the City of Eagan issue 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:
Phone:
Fire Suppression Contractor Phone:
Sewer & Water Contractor.
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
buil4inginsaeetionsCdicih►°fee an.com
rForOflice ���
pemed; � °
Permit Fee: _.L=-�
Date Received: CC
Staff:
NOTE: Plans and supporting documents that you submit are considered to be public lnlbnnallon. Portions of the information may be
classified as non- ublic if , u - Wde Inc reasons that would the CI 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 emaU update on the City's
webslte at wwwr.citvafeaaan.comisubscribe.
Exterior work authorized by a building penult issued i i accordance with the Mlnnosots State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One can at (851) 454-0002 for protection against underground utility damage. Cali 48 hours before you
intend to dig to receive locates of underground utilities. wwwv nopherstateonecall.orq
i hereby acknowledge that this information is compete 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 penult, but only an application for a perm t, and work is not to start without a pemtt% that the work will be inn
accordance with the approved plan in the case of work which requires a review and approval of plans.
`
,Applicant's Printed Name
nt's Signature
0
•
DO flpT WRITE BELOW THIS LINE 3 �� I4 Ini 0
1r�
/
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
_ Fireplace
Garage
Deck
Lower Level
_ Porch (3-Season) _
Porch (4-Season)
Porch (Screen/Gazebo/Pergola) _
Pool
Interior Improvement
_ Move Building
_ Fire Repair
Repair
b
o_
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
_ Footings (Deck)
_ Footings (Addition)
Foundation Foundation Before Backfill
/ Roof: _Ice & Water _Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
Final
_ Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
_ Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
/ ZD 2_0
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Service Test Gas Line Air Test _ Hood
Pool: _Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick _ EFIS
4(Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
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