4084 Halite Lane
Use BLUE or BLACK Ink
1"office
(3
I
City of p Ea an I Permit
I Permit Fee. : `-o
I j I I
3830 Pilot Knob Road I Date Received:
i
Eagan MN 55122 I
Phone: (651) 675-5675 I staff:
Fax: (651) 675-5694 i
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing I Sewer & Water
Date: Site Address:
Tenant: ~9A-l Suite
/ Gt Cl(-P L7/l -;7
RESIDENT OWNER Name: Phone: co~~ - b b
Address/ City/Zip: Name: k'4vSOIJ License
Address: Is j r^ahJ L-'q /u Uj _ City: /q7v D d ✓L-r--'
CONTRACTOR
State: /W /V Zip: SS ~U ` Phone: -7& 3 L/ - -7 & &
roh-
Contact: W lvjo~/ / ve L S(J AJ Email: I.JYI -e I cLi l' /gvS6 n V ~IJ'-h
0
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Description of work: I
DESCRIPTION
FEES
TOTAL FEE
$55.001 Each (includes $5.00 State Surcharge) (Rev. 6-30-10)
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.qor)herstateongggli.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 1 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.
x71 I/l U SdYJ X "
Applicanrs rinted Name App Ys Sign
(31=FIC'USE Review Qd
FOR
required Inspections: Under Ground Raugk?-1n " final
CITY OF EAGAN Remarks
Addition Lot- 11 Bik 5 Parcel 116 16600 310 05
Owr,er " screet 4084 Halite Lane State 'Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREE7 SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 58.18 2.08 28 Paid
* SEWER LATERAL 1971 2
WATERMAIN
irWATERLATERAL ( 1971 1,615.00 80.75 20 Paid
WATER AREA
rt STORM SEW TRK I51 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 260.00 3655 6-10-71
SUILDING PER.
sAC 200.00 3655 6-10-71
PARK
INSPECTIQN RECORD??? CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road `^ .' +` ?` `? s
i Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
??:,. ? iE??i ? ? } ? ?ifyi ?i• . . , 4:3?
?
(.LIIAk [1k.U?? 71141
PERIIAIT SUBTYPE: TYPE OF WORK:
1;f' P A yR
pl?ut- y tit;
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Data Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR 7EST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL ? Z
8SM7 R.I.
BSMT FINAL
OECK FTG
DECK FINAL
??.
EAGAN TOWNSHIP
BUILDING PERMIT
Owne: ef?? '
..------------ ........----..__ ..... ....... -----..___------..........._.......
. .... ...................... ....
Address (Preeenf) --.?14..:......-!t-y.1:..........'?"?`?'
Buildet ........................... .._..................--------- .-
Addrasa ..............................................................................................
DESCAIPTION
N° 2480
Eagan Township
Town Hall
Date ._.. ?// ? 7/ .......................
Sfoziaa To Be Uced For Fronf Depfh Helghi Esl. Cos! Permi! Fee Remarlu
" LOCATION
Slrsel. Roed or ofhes Daseripfion of Looafion I Lo! Bloek Addilioa os Trae!
fi ?a y?
.
3?-3
S 7
?•
This pesmlt does aot aulhorisa the use of sirssls, roadg, allapa or aidewelks nor doss it give the owner or hia ayent
the right lo ereale anp ailuation whie6 is e auisenaa or which presente a hasard !0 1he heellh, satefy, coaveaianee and
ganeral welfera !o enpona in the commurtify.
THIS PEAMIT MU5T BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS.
Th3a is !o carliip. 2hel...??---C"•""? ...has permission fo erect a....?j .?.:.,. ..:....°_?°.... ....... upon
.........
the abeve dasexibed premisa aubjeet to the proviaioas of the Building Ordinence for Eagan 7oweship a pled Apri! 11,
1955.
....................... ...... ..J`^./.._-4-:-................. per .........................?-!-e-? .. _... . ?........'..?.--?-:-?.......
......_.irmao. v P .N>
Cha! Tnwn Board ? Buildin Ins ecior
t
EAGAN TOWNSHIP
BUILDING PERMIT
Owne= ._..._.1!-`...".'.."'".:.":?...:???y.?-------'----........_-"-'
Address (Presenf) ......... ,f?..... ..-....
Builde: -----'-- -"--'-----.-'_ .............._......-----
Address .................................. ........................
N° 2573
Eagan 7ownship
Town Hall
De:. .... .'..`'J?:?7i
.... ---------------?-
5toxies F
r
To Be Use Fron2 Depih Fee
l
Heighi Esf. Cosi - ermi Remarka
o
d ? '
?
e ?
LOCATION
$liaei, Roed o} OIriei DBSCi1pS10T Ot LOC8I1on I LDi I 810CY I Aq11I1on Oi 1'SBCI
This permit does aot auihorise the use of sireels, roada, alleys or sidewalks nos doea it give the owner or his agent
the tighL !o cteate any siluation which is a nuisance o: which pxesanfs a heaard !o the heal2h, safeYp, convenienee and
general welfare !o anpoae in the communilp.
THIS PERMIT MUST BE,JfEPT ON THE PR£MISE WHILE THE WORK IS IN PAOGAESS.
This is !o eerrifY. Sha2_?::..... :?............... .....has permisaion !° '-- ' ---J-??Q-
the above deseribed premise cubjecf to the provisions of the Suilding Ordinance fo{ Eagan Tawnship adopied Aysil 11,
1955.
............._.... ...... i'.:?..-".. .. ?...................
Chei?ap of Tnwn BoBrd
B
. . .. .......j,/....:..`..`..............""......
.
Par -------'-------------....-
Suliding Iaspectos vo
_ `.124 - -.__ -._,.- --
CeQar Gxove CoasCruetiea -
Co. 7343 Concard IIlvd. E.t So. St,P aul PL.UM3ING
1946 Jade Lana, 2831 Carnelian#
Cedar Grove Constrnction Co. 1716.Carusl#as-esd -
+1084 Halite 8-59 24-1, 38-5, 31-5 of CG #7 ,,,June 90 1971 - -
$80,00 ilth Jtme 71
f.G•
.
? - T04411 OF G4GAN
979; Pilor P.nob P.oed
SC. PailZy T?'.nn. _.11.1
PGRMIT NQ1
Cedar Grove Constrnctioa----
Co. 7343 Concord 131vd. li. Bouth St. Pau1 f9SAT.ING
? 1-845 Jade Laneg 1831 Carneliang
Cedar ;rove Constnnction Ca. 1796 Carneliau# 40¢? Halite -
C.G. ;; 7 $
8-5t 24-19 38-5, 31-5 June ?p 1q71
Sgp,00 llth June 71
i
.. .
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEF7ER SERVICE CONNECTION
DATE: ,j?}ne 9. 1971 NUM$ER 794
OWNERtCedar_ crove Const. Co. AddYe88 4084 Halite ,31;,5„7
PLUMBERStesn P7umbina omna v TYPS OF PIPE Cast Inon
? DESCRIPTION OF BUILDING
Industrial Commerciall Reaidential MulCiple Dwelliag No. of unita
X 1
Location of Conaections: Connection Charge 200.00 pd 6/11/71
Permit Fee 10.00 pd 6/11/71
Street Repairs
Total
Inspected by:
Date
Remarks:
By.
Chief Inspector
Ia consideration of the issue aad delivery to me of the above pexmit, I
hereby agree to do the proposed work in accordance with the ruies and
regulationa of Eagan Toimship, Dakota County, Minneaota
BY Cadar f,rrnvr> ('otlc ,. ion. Comnanv
Please notify whea ready for inspectian and connection and before any porCion
of the work ie covered.
i . - . Y
EAGF.N TOWNSHIP
3795 PiloC Knob Rosd
St. Paul, Mianesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE COAiNECTION
Date: June 9, 1971
Meter No. 'Permit Fee 10.00 pd 6/11/71
Billing Name: Cedar Grove Construction Site Address: 4084 Halite 31-5-7
Owner: Cedar Grove Construction Company Billing F.ddress 7343 Concord Blvd. E.
Plumber: Stein Blumbing Company
6/L1/71
Meter Reading ( Meter Dep.
Meter Sealed: Yes_ 'Add'1 Chg.
NO i Total Chg.
Suilding is a:
Residence xx
Piultiple Ao, Units
Commercial
Industrial
Other
Inspected by
Date
Remarks:
Nvmber• 637
f ?
9NiPROr'[RLY INSTALLED Mt(ERS.
Sy:
Chief Inspector
In consideration of the issue arni delivery to me of the above permit, I
hereby agree to do the proposed work ia accordance with the rules and
regulations of 8agan Township, DakoCa County, Mianesota.
By: CEDAR GROVE CONSTRUCTION COMPANY
Please notify the above office when ready for inspection and connection.
4
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Constmdion Reowrements RemodeURepair Reqwrements CNfics.li9e.OFit4
3 registered site surveys showing sq fl oi lol, sq, fl. of house, and all roofed areas 2 copies of plan CerErkSurveyRecd . Y_N
(20% maximum lot coverage aibwecl) 1 set of Energy Calculatnins for heated adddions Tree Pres Plan Recd _ Y,... N,
2 copies of plan showing beam & wmdow srzes, poufed tound design, etc 1 site survey for addihons & decks Tree Pres Requited V N
lsetoiEnergyCalculations Adddron - indba[eifon-sifesepticsystem 9?si195EpCiCSyStsrh _Y_N
3 copies of Tree Preservahon Plan if bt platted after 711193
Pom Joist Detad Ophons selection sheef (bldgs with 3 or less unds
Date //9
SiteAddress YlI /0,,/
B',{ Construction Cost `V
UniUSte #
y
Description of Work Se-QS wn
A-A' D, r r0l/ fbeC (
L
Multi-Family Bldg _ Yx N Fireplace(s) X 0 _ 1 _ 2
Property Owner 5 1NO v C li EM Telephone #(( 5O AS j' /Ofa 1
Contractor A-7 K4m f10M6 (CCVAiR d KC-MoDFtING ('D
Address 12-A
State /I9/y ?5 N feoL.tFT i4f/E City fgw P[JK.4?L))Gt?c
Zip SSJJ'? Telephone # ( 6(2 ) o190- Sa ,Y?(_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- esota Rules 7670 Cate o 1 Minnesota Rules
Enefgy Code Cate9ofy , ResT +nti Ventilation Category 1 Worksheet • New E Code Worksheet
(Jsubmissiontype) Submitted itted
• Energy Envelope Calc ' s Submitted
Have you previously constructed a building in Eagan with a
fee applies. I
Licensed Plumber_
a Mechanical Contractor
!?`i, Cv-s °>
I hereby apply for a Residentia?4-t3?idi?P?erm
that the work will be in confo @?ith the
Statutes; I understand this is not a 't, but
permit; that the work will be in accor cil
I
approval of plans. °
62ev S Aavi b
Applicant's Printed Name
_ Y _ N If so, 25% plan review
Telephone #(
Telephone #(
Telephone #(
t cknowledge that the information is complete and accurate;
p?dinances and codes of the City of Eagan and the State of MN
ly an application for a permit, and work is not to start without a
the approved plan in the case of worwhich requires a review and
OFFICE USE ONLY ?r
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea )
? 03 01 af_ plex ? 09 07-plex ? 17 Garage X 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 DS-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New
A 32 Addition
? 33 Alteration
? 34 Replacement
Valuation QQ
Census Code _??t?
SAC Units
# of Units
# of Bidgs
Type of Const 146
? Footings (new bldg)
Footings(deck)
_ Footings(addidon)
_ Foundation
Drain Tile
Roof Ice & Water Final
? Framing -
_ Fireplace _ R.I. _ Air Tes[ _ Final
? Insulation
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinkiered
Width
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
Plumbing
?(. HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
'
Plan Review 1 ry"
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
T
t
t Pl
t
rea
men
an
License Search
Copies
Other
Total
? 30 Accessory Bldg
? 31 Ext. Alt - Mufti
? 33 Ext. Alt - SF
? 36 Multi Misc
? 35 Int Improvement ?1 ,38 bemofish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
'Demoli[ion (Entire 81dg) - Give PCA handout to applicaM
,2 ?f 766)
?2, 0 0J
?S, ???
.
Permit Number
RFScheck Compliance Certificate Checked By/Date
2003 IECC
REScheck Sodwaze Version 3.6 Release la
Data Slename: C:\Pmgram Files\Check\RESchock\job#1214c addition - dedc.cck
PROJECT TITLE: 4084 halite In.
CTI'Y: Eagan
STATE: Minnesota
HDD: 7981
CONSTRUCTION TYPE: Single Fatnily
WINDOW / WALL RATIO: 0.24
DATE: 11/18/04
DATE OF PLANS: I1/12/04
PROJECT DESCRIPTION:
4 season addition / deck
DES IGNER /C ONT RAC T OR:
ateam - corey
COMPLIANCE: Passes
Maximwn UA = 76
Your Home UA = 68
10.5°/a Better Than Code (UA)
Gross Glazing
Area or Cavity Con[. or poor
Pstimetrx B-1'alue R-Yalue -rLFaat 3L?
Ceiling l: Flat Ceiling or Scissor Tmss 440 0.0 40.0 11
Wall 1_ Wood Frame, 16" o.c. 496 19.0 0.0 23
W indow 1: Vinyl Frame:Double Pane with Low-E 64 0.190 12
Door L' Glass 56 0.190 ll
Floor 1: All-Wood JoisUTruss:Over Outside Air 440 38.0 OA 11
Fumace I: Forced Hot Air, 78 AFIIE
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations submitted with the peanit applicatioa The proposed building has beai designed to
mcet the 2003 IECC requirements in REScheck Vwsion 3.6 Release la (8rmedy MECcheck) and to comply with the
mandatory requirements listedjyt11e REScheck Ins"ion Checklist.
Builder/Designer Date // ?` O
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
ct ? 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction ReauiremenFs
3 registered site surveys showiri7 sq. ft of lat, sq. ft of house; and all raofed areas
(20% maximum lol coverage allowed)
2 copies of plan showing beam & wiidow sizes; poured found design, etc.
1 set of Energy Calculations
3 cop reservation PWn r'o tted a tl93
' Jo'st Detail Options selecGon sheet (bl with 3 or nits
RemodeVReoak Renuiremenis
2 copie,s of plan
1 set M Energy Calcufations (or heated additrons
t site survey for additions & decks
Addition - indkate ifon-site sepfic sysfem
STl U 00
?
i m
. ,.. . , .
l
6Q O
Date i
•C/onstruction Cost /
' Unit/Ste #
c- EQ
Site Address /? W
DescriptfonofR'ork
Multi-Family Bidg _ YN Fireplace(s) _ 0 2
O e? /NOy e?e ?? Telephone #
rvner
Property
ABC Seamless Z,,
Contractor 355 21st Street
Address Newport, MN 55055 City
Sta[e Z Telephone # ( ??-
? ?W 61 a
e II
te
J ( 9as ?'6inl F ,Qa v,J(ccs pr, so? uft < ?I
COMPLETE THIS AREA ONLY IF CONSTRUGTING A NEW BUILDING
Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilafion Category 1 Worksheet • New Energy Code Worksheet
(d submission type) Su6mitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #
(? rI,2C i
Telephone
I hereby apply for a Residential Building Permit and acknowledge that the info ation is complete an accurate;
that the work will be in conformance with the ordinances and codes of the Cit e of MN
Statutes; 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 !?e case of work which req?? s a review and
approval of plans.
cJmL'oi/? a4l5
Applicant's Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowsJDoors
? 34 ReplaC@ment "Demolition (Entire Bldg) - Give PCA handout to appliwnt
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Fina] _ Windows
_ Insularion _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC1ES SAC
C+ty SAC
Utility ConneCtion Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
i-"F 04 3'S 3830 PILOT KNOB RD, EAGAN MN 55722 I
651-681-4675
New Conetructbn BeoulremeMe RemodflURenalr Reaulremente
. 3 registeretl sile aurveys shaxing sq. it. of lot, sq. fl. oi nouse; and ao roofed areas • 2 copies ol pYan
(20°h manimum bl coverege albwed) • 1 set of Energy CelculetMns lor haeted addftans
• 2 coples of plan showing beam 8 wintlow sizes; poured found design, etc.) • 1 ske survey for exlerbr adtl0bns & decks
. 1 set of Energy Cekulatbns • IntlMate 0 home served by sepHC system for addttions
. 3 coples of Tree Preservatlon Plan il lot pletted afler 7l1199 „
• Rim ,bisl Detsil Optans selectbn sheet (bMgs wRh 3 or less unfts) DATE Z VALUATION I 12>i576•?
SITEADDRESS 'Vt)S?I f7Qlt'te k-et• MULTI-FAMILYBLDG _Y N
NPE OF WORK USZA na FIREPLACE(S) _ 0_ i? 2
APPLICANT 14''6 C-
STREETADDRESS Ia2 1-IIN?eolle-t /ar? 's • CIT`!$arn5v?1l'.e STATEt^(N LP
TELEPHONE 11aS-I) VQ?-69 !',q CELL PHONE # FAX'11 (9 54 Vb S'- -8 SS `P 1-
PROPERTYOWNER Sa4kLKSihp4/ aEvn TELEPHONE#C6Sl?(,S??-p161
------------------------------------------------------°--°---------------°-°-------°----°
COMPLETE THIS SECTION FOR ?•NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(d su6mission type) - Residential VenUfation Category 1 Workshael5ubmitled •,New Energy Code Workshsel Submitted
• Energy Envelope CalculaNOns Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
5ewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Fee: $90.00
Fee: $70.00
Phone # 2002 ,Lj
I hereby acknowledge that I have read this application, state that the InformaTion is correct, and agreelo comply
with all applicable State of Minnesoto Statutes and City of Eagan Ordinances????? (?
Signature of ApplicaM a??' u?'
OFFICE USE ONLY
Phone #
_ Water Softener
_ Water Heater
No. of Baths
_ Lawn Sprinkler
_ No. of R.I. Batkss
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
uPeaiad aroz
OFFICE USE ONLY
O 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Muld
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? DS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvament ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration 0 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacemant *Demolition (Entire Bldg onty) - Give PCA handout to applicant
Valuatlon Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Boaster Pump
Nbr. of Units Sq. Ft. PRV
Nbr, of Bldgs Length Fire Sprinklered
7ype of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Dram Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement)
_ Insulation _
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Searoh
Copies
Other
Building Inspector
Total
CITY USE ONLY
PERMTT #: RECEII'T DATE: U' U
2002 RE5IDENTIAL 141ECHANICAL PERMIT APPL?. CATION
crrY oF EAswnr
3830 rv.oT icxo$ ttn
£!4&AN MN 55122
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: 6 ' -?-b D--
SITEADDRESS: LlcgLA ?-a' \'1 .1P (01? ?-
OWNER NAME: S I fi('1 i cl'1ci.r+n TELEPHONE #: &?-l_ Cn k'i -016 l
INSTALLERNAME: 'gu`{nSVlllg ?-YlVff"," TELEPHONE#: 95?. 5?
STREET ADDRESS: ??Jrv? P'1J ?L S.
• CITY: STATE: ZIP:
Place a check mar& next to the permit work type
>C Add-0n, modification or alteration to existin dwelling unit $ 30.00
? furnace replacement
• air exchanger
Q air conditioner
• other
Nature of work:
D
Z002
PAAY 0 9
State Surchar e $ .50
TOt81
SIGNAtURE OF PERMITTEE
riaz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
2002 COMMERCIAL M£GHAIVICAL PERP4IPf APPIICATION
C1TY OF EAea4N
S$SO PILOT KNOB RD
EA6AN,14iN 55188
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (IMPROVEMENTS ONLl):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CITY:
TELEPHONE #:
WORK TYPE:
New construction
Interior Improvetnent
Pmcessed Piping
STATE:
7nsta1l U.G. Tank
Remove U.G. Tank
SpecifyNahue of Work:
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing dnspector.
Fees: 1% of contract price OR $50.00 minimum fee, wluchever is greater.
Underground tank removaUinstallation = minimnm fee
Contract pnce: $ x 1%_$ (Base Fee)
State surcharge calculate at $.50 For each $1,000 Base Fee
TOTAL $ _
SIGNATURE OF PERMITTEE
Updated 1/02
? CITY OF EAGAN
3830Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BulLozNG
PermitNumber; 028341
Date Issued: 0 7f 2 2/9 6
SITE ADDRESS:
P.I.N.: 10-16706-310-05
DESCRIPTION:
? _-
,e. .. ,
(ROOFING)
Permit Type
4ork Type
SF (MISC.)
REPAIR
434 ALT. RESIDENTIAL
.,? ?
AM
'?? ??F -!a^av nt 14'3 0 W. REMARKS:
FEE SUMMARY:
VALUATYON $3,000
Base Fee $74.75
Surcharge $1.60
Total Fee $76.25
CONTRACTOR: - Applicent - sT. LIC.OWNER:
MOSER CONST, M J 14555888 0002668 CHEM
847 19TH AVE N 4084
S S7 PAUL MN 55075 EAGAN
(512) 455-5888
I 6 ,
V T
infu_reitat34n ,.is oaer-?C`?:
?, .?_ ._ .._.. _ .....__ .. , _ _ ". ,.,e.
APPLICANT/PERMITEE SIGNATLIRE
4084 HALITE LANE
LOT: 31 BLpCK: 5
CEOAR GROVE 7TH
SIDpHI
HALSTE LN
MN 55122
r??ad Ghis
rg?e ?a. camply, witEr a1JE appStoto???
E 6 : IG URE
li54 ' CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Constructlon Reauhemenls Q;IDodeV$gpair Reauirements
? 3 regislered slle surveys ? 2 coples M plan
? 2 coples ol plana (indude beam 8 window aizea; poured fid. design; etc ) ? 2 site surveys (exterior additiona & decks)
? 1 energy ealculatimf ? i energy ealculadons for heated addRlons
? 3 copiea of tree preservaHon pfan H bt platted aRer 7/7/93 requtred: _ Yes _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: ZA p` A(Ua L
STREET ADDRESS: f QZ? 1 1 L'e?0?I
LOT BLOCK X_ SUBD./P.I.D. #: ?c?11d!
5aii I`
PROPERTY Name: ? C? t/ G fm Phone #:
OWNER
CONTRACTOR
ARCHITECTf
ENGINEER
Street
..&
City: 170"g I/, State: Zip• 5 5?2-Z
Company: rairt g Phone #:
Street Address: '5q7lq??S(l /)vO License #•
City: State: 1,14/N Zip• 5SG7,L
Company:
Name:
Phone #,
Registration #,
Strest Address•
City:
Sewer 8 water licensed piumber:
change are requested once pertnit is issued.
State: Zip:
Penalty applies when address change and lot
I het9by acknowiedge 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 OMinances.
Signature of Applicant: r
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY ?
?.
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex o 11 Apt.lLodging o 16 Basement Finish
0 02 SF Dwelling ? 07 4-piex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 0$ 8-plex o 13 Garage/Accessory ? 20 Public Facility
n 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
n 05 SF Misc. ? 10 _ plex ? 15 Deck
WORK TYPE
0 31 New
0 32 Addition
;
0 33 Alterations ? 36 Move
0 34 Repair o 37 Demolition
GEWERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Pianning
Basement sq. ft.
Main level sq. ft.
sq. ft.
Sq. ft,
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Permit Fee 7//, 7 5
Surcharge 1. S ?
Plan Review
License
MC/WS SAC
City SAC
Waier Conn.
Water Meter
Acct. Deposit
5NV Pertnit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Total: 07 (p o'Z 5
Engineering
Valuation: $
MC/WS System
City Water
Fire Sprinkiered
pRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
% SAC
SAC Units
MASTER CARD
? LOCATION
OWNER
STRUCTURE AND
LAND USED AS
3/- S =
Permit
No. ?
Issued Issued To
Contractor ? Owner
BUILDING
PIUMBING
CESSPOOL - SEPTIC TANK
YVELL
ELECTRICAL
HEAiING
GAS INSTALLING
SANITARY SEWER I
OTHER I
OTHER
•
?
Items Approved
(Initial)
Date
Remarks
Distance From Well
FUOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIEID FT
FINAL
ELECTRICAL
HEATING DEPTH
OF WELI
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBWG
WEIL
SANITARY SEWER
Violations Noted
on 8ack
COMMENTS
/
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO.
CONDITIONS OF CONSTS?UCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
?
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
D COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION
•
DATE OF REINSPECTION
CERTI FICATION - I certify that I have carefully inspected the abwe in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, apprwed plans and specifications, and any specific reryuire-
ments for off-site improvemenu relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR
COMMENTS.
pATE
lv? 23
:
MASTER CARD
• LOCATION
OWNER
STRUCTURE AND ? r
LAND USED AS ?`? _GA n J 6?
Permit
No.
Issued Issued To
Contractor Owner
Bl11LDWG zf? v I
PLUM8ING
-
CESSPOOL - SEPTIC TANK -.Z?
L
WELL
-
ELECTRICAL
HEATWG
GAS INSTALLING
SANITARY SEWER ?
OTHER Ok ?
OTHER
?
.
'
Items 'Appro'ved
(Inrtiap
Date
Remarks
Distance From Well
FOOTING / V • f ? SEPTIC
FOUNDATION ? ?I' L .
?
? CESSPOOL
FRAMWG
FINAI
ELECTFICAL - Pi
-0- --???- TILE FIELD FT
HEATING
n1
Q? 7't ?
^y DEPTH
OF WELL
GAS INSTALLATION Y-
"
SEPTIC TANK - v
CESSPOOL
DRAINFIELD I •
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
r
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
0
PERMIT NO.
CONDITIONS Of CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OP NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITl1T10N5 OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZFD AND DESCRIBED AS FOLlOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE OELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION RE4UIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
?
CERTI FICATION -1 certify that I have carefully inspected the ahwe in which I have no interest present or prospective, and that I hava reported herein
all significant conditions o6served to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
mants for off•site imprwemen2s relating to the property Inspected.
? ALL IMPROVEMENTS ACCEPTABIY COMPLETED
6UILDING INSPECTOR
COMMENTS:
DATE
:?
?
.? ?
4-?
?
PRQPoSED PDDITipN -
v
? EX IS rrN G HousF
REVISED D6cK Pj..W
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!?'?[RIIMMA1r1?R'?ha 41h r8
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116068
Date Issued:10/02/2013
Permit Category:ePermit
Site Address: 4084 Halite Lane
Lot:31 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-310
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Siddhi S Chem
4084 Halite Lane
Eagan MN 55122
Residential And Commercial Exteriors Inc
16040 St Andrew Lane NW
Anoka MN 55303
(763) 443-0830
Applicant/Permitee: Signature Issued By: Signature
Date:
CityofEaan •
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
CM 142016
2015 RESIDENTIAL PLUMBI
Site Address: 1 611
Use BLUE or BLACK Ink
For Office Use
Permit ft: /39?3`
Penult Fee: 0 • (! t7
Date Received:
Staff:
G PERMIT APPLICATION
1
L f l
Name: �i�►W Phone:
Address / City / Zip: if U MEM 5
Suite #:
Name: Milb�rt• Cornpany.Inc 4ba Culligan Water
Address: •18.Q1 50,t St East
State:. Mn Zip;, 55°7'
Contact: William R Miibert
License #: WC641376
City: Inver Grove Hgts. ,
651-451-2241''
Email:
New Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation L RPZ / PVB)
Septic System
New
Abandonment
XWater Softener
Add Plumbing Fixtures (. Main / — Lower Level)
Water Tumaround
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 System 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) / f�
TOTAL FEES $ 100 , 0 0
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.aooherstateonecail,orq
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 thls 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 approvedIan 'n.the case of work vrthIch requires a review and approval of pi
\\3t(1
'.
Applicant's Printed Name
x
Appl cant's Signature