4010 Hosford Hills RdCASH RECEIPT (D
?
CITY CrF E/4dAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE i ?w ?g ???
RE??
aMOUrn
1(rX? ? ?=
& DOLLARS
tm
p CASH ?I CHECK
? ?
C 4940 W^;l?e? ?
Yego,--4losssng Covr
a:*--Fae covy
Thank You
BY
bATEj 12/6/89
RE: 4010 HOSFORD ROAD, L1. B1, HOSFnRD
xx Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
*ur Sewer & Water Permit for the aboue property can?at be completed for the foilowing
rea?ons:
.? .;?•
" Your Sewer & Water Permit for the above property has been campleted, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for rr?eter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CON7ACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
. . . . _ , . :.,?n••..hTCI,.t..:. .,..,op.. .,?.....,r.w;e: ? F-i..+.r:.? ..?, ..r-e,±rra?. .. - s . , .. _. , . . . .
CITY OF EAGAN p
1?
??357
.
3830 Pilot Knob Road, P.O. Box 21- 199, Ea gan, MN 55121
.
PHONE: 454-8100 ,
BUILDlNG PERMIT Receipt # -'
To be used for SF DSwGJCAR Est. Value $151, 000 Date__ _IlEC 5
Site Address 4010 NO3FORD HILLS RD
Lot 1 Block 1 Sec/Sub. HOSFORD OFFICE USE ONLY
ParCBI NO. Occupancy R-3 M-1 FEFS
R
1
ZoNng -
W Name f'MTt'+*ERY DESIGN (ACtual) Const V-N Bldg
Permit 818•00
? ; Address 37? NIN3)'CREE UR (Allowabie) V'N . 75
?
0 Surcharge ?
Cit EA?K Phone 481-9230
y +? of Siories 681 Plan Review 409.00
f Length
o Name SAME oevtn ? s
ac
c+i 100.00
= ,
,
y
?
O AddreSS S.F. Total - 00
575
U SAC, MCWCC •
? Clty Phone S.F. Footpnnts _
C
W
580.00
? W Name On Site Sewage
On Site Well ater
onn
W
M ?
?
x? AddreSS MWCCSystem -
u- ater
eter •
<W City Phone Ciry Water zx_ Acct. Deposit 30•00
00
20
PRV Required _ S/W Permit •
I hereby acknowlege that I have read this application and state ihat the Booster Pump - SiW Surcharge 1•00
information is correct and agree to comply with all applicable State ot
Minnesota Statutes and City of Eagan Ordinances. Treatment Pi 228•00
Signature of Permitee ? APPRUVALS 34
Road Unit 0.00
A Building Permit is issued to: ?NTGOWRY DESIGN Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutas and City of Eagan Ordinances. gidg, pry. _ Copies
Building Official _ Variance - TOTAL 3,266.50
Permk No. Perm it Holder Uate Telephone #
TER
SEWER
PLUMBING
w
H.V_A.C. ?y ? ?/0?3 O
ELECTRIC z x
Inspection Date Insp. C omments
Footings 1
Foundation !
Framing
Roofing
Rough Plbg. e ?j , O"
Rough Htg. ? ** 0
Isul. - ;,/' e " v ?
Freplace /' p .
Fnal Htg. -/3 J'rJ .?/
Fnal Plbg. /3'QJ ?{ ;Q ? _ •
Const. Meter Ptbg. Inspec lor - NotiFy Plum r
Engr./Plan
Bldg. Final '?? OS CtO OI' C?OSv/"e ?/' .? ?`ti rz •'•, Ef -
Deck Ft9 % H4 ? /?t cY fro 4•-
Deck Final ,
Well
Pr. Disp.
Cities Di2ital Oualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100 For Office Use Onl
Lot Block Sec/Sub
m Name
y Address
c City Phone
L Name
c Address
p City Phone
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other $
FEE:
S1C:
?s. TOTAL•
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MiNIMUM - 1 PER PERI1
COMM/IND FEE - 1% OF CONTRACT FE
APT. BLDGS. - COMM. RATE APPUES
1.50 EA.
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 1
REMODELS - 12.00 {
MINIMUM COMMERCIAL FEE - 20.00
?
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
i ?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT #
RECEIPT # DATE:
r?vmo???w rcnMN ¦ FOr
CITY OF EAGAN PERMIT #
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT a
PRICE pMAmF dr.d.R?AA neTF• ?
Site Address ']'Ul U !
Lot -I/ Block
? Addr s
s City? ?e q (- ?'crVf- Phone
? I Addre 3? $ 6 Wr hd J;'c.? -?
8 City 4 a r1 Phone
FEES
COMM./IND. FEE -1% OF COMTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO- RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
FOR: CITY OF EAGAN
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COIr1PLETE THE FOLLOWING:
NO. FIXTURE3 TOTAL
waeer cioset - $3.00 $ 9- d0
Bath Tubs - $3.00 ?
Lavatory - $3.00
Shower - $3.00 0
T- Kitchen Sink - $3.00
UrinaUBidet - $3.00 ?
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50 " ? ?
Whi?lpool - $3.00
Gas Piping Outlets - $1.50 •1 . S{J
(MINIMUM -1 PER PERMIT) ?
Softener - $5.00
wau - $10.00
Private Disp. - $10.00 ?
7:a- Rough Openings - $1.50
U. G. Sprinkler System - $12.00
PERMIT FEE: • ? ?
STATES S/C:
?
GRAND TOTAL: -? B
?- -
. INSPECTION RECORD
j' CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
? (612) 681-4675
SITE ADDRESS: t 0 1":1 tilo(_ F:? APPLICANT:
Aete? ttosropt) MIA. t, Krt R 0 caNsr
aa,FVkn :t?Fi?ir) aad--?sr?
PEW!T %4?Typjf?H
TYPE OF WORK:
Control No. 0237
a????/
04/1b/yl
NFW
"rf, '?'
Permft No. PermN lio9dsr Dste Telephona N
SNV
PLUMBING
HVAC
ELECtRiC
ELECTRIC
Inspection Date Insp. CommerRa
Foo6ngsl
7
Foundation
Framing _ ? 9Z
Roofing
Rou9h Pl49-
Rough Htg.
Isul.
Rrepiace
Final Htg.
Orsaf Test
Flnal Plbg. Plbg. Inspector - Notify Plumber
Const Meter
EngrJPlan
Bidg. Final `s?Z 7 Cq
Deck Ftg.
Deck Flnal
Well
Pr. d'sp.
?
.
( Irr#ifiratt af Orrupanry
titp of (Eagan
10epttrtmrrit nrf Mtitbmg 3mpPrtinn
This Cenificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of usuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
u? ciusifica6on `'? DW/?'? sWg. eerniit No. I6M 17357
oa„p,ncy TyM R3/M 1 Zomng nWrict Ri Tra ConsL VN
owner or auilaing MMTC,1QrM PIESIIN Add,.3786 WDIDrIm DR., EAGAN
p.AA.. ,AA- 4010 H06FRD HIILS %kD L1, B1, IiDSM-M
D,te: JUNE 4, 1990
POST IN A CONSPICUOUS PU1CE
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
SITE ADDRESS
LOT i BLOCK SEC/SUB R
CIIY,
?
ZIP
PERMIT REOUESTED
A SEWER ?:?WATER - T,
i
- COMM/IND ? RESIDEN'
? NEW - EXISTING
Lawn Sprinkler Meters are to be Inst,
Ahead of Domestic Meters on Water l
Credit WILL NOT be given for Deduct Me
PERMfT DATE
PERMfT # 11135
B.P. RECEIPT # " 494;'
B.P. RECEIPT DATE 12 5"?9
- PRV - BOOSTER PUMP
CITY, STATE . c • ` . • , . '-.._._ ZIP ' -,
PHONE:
OWNER: - - -
ADDRESS:
CITY, STATE ZIP
PHONE:
I AGREE TO COMPLY WiTH CITIf OF
EAGAN ORDINANCES
METERISSUED
;ESSING. CALL 454-5220 FOR INSPECTIONS. FOR
WER A WATER PERMIT OFFICE USE ONLY
Y OF EAGAN METER # ' 3'I??7-3 3 PERMff DATE 12
b Pibt Knob Rd. CHIP # U/.S.S PERMIT #
;an, MN 55122-1897
METER SIZE B.P. RECEIPT #?''•=L
rE ISSUE QATE -9o B.P. RECEIPT DATE - , 39
- PRV - BOOSTER PUMP
ICANT:
IESS:
STATE ZIP i ?
IE: r' `Z 3 C?
SO (En
-'?
, STATE
ZIP
PERMIT RECIUESTED
_.ME_V?ER AWATER _ TAPS
- COMM/IND ? RESIDENTIAL
? NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
1 AGREE TO COMPLY WITF,*V OF
EAGAN Q06INANCES // -
SIGNATURE VlffiEN METER ISSUED
TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
CONTACT ENGINEERING DEPT.
CITY OF EAGAN NO 17357
3830 Pilot Kn2b Roaa, P.O. Box 21-199, Eagan, MN 55121 ???
PHONE:454-8100 I BUILDING PERMIT Receipt p
To be used for SF DWG
Est Value
151,000
Site Address 4010 HOSFORD HILLS RD
Lot 1 Block 1 Sec/Sub. HOSFORD
Parcel No. ..
W Name MONTGOMERY DESIGN
o Address 3786 WINDTREE DR
City EAGAN phone 681-9230
o Name SAME I
ai.
Address
Ciry Phone
?
ww Name
t: ; Address
aw Cfry Phone
I hereby acknowlege that I have read this applicalion and state that the
inlormation is correct and agree to comply with all applicable State ot
Minnesota Statutes antl C?ty, 1 of E?Ordinpnces.
V[
Signature ol Permitee
A Building Permil is issued to:? MONT O.IZYiHE I N
on the ezpress contlition that all work shall be done in accordance with all
applicable State of Minnesota StaWtes and ?City o,`l Eagan Ordinances.
BuildingO(ficial-.?1?I QI? I11 rI
OFFICE USE ONLY
Occupancy R-3 M=1 FEF.S
Zoning R=1
(ACtual) Const V-N Bidg. Permit $18.0?
(Allowable) V=N
Sumharge
75.50
R of Slories
681
Plan Review
409.00
Lengih
Depih 40 ? SAQ Cily 100.00
S.F.TOtal - SAC,MCWCC 575.0
O
S.F. Footprints _
on Sita Sewage _ water Conn 580.00
On Sila Well Water Meter
0
90.0
MWCCSystem Ax- Acct. Deposit 30.00
City Water
PRV Required _ S.M! Permil
O
20.0
Booster Pump - ShV Surcharge 1.00
7reatment PI 228•00
APPHOVALS Road Unit 44n nn
Planner - park Ded.
Council
BIdg.Oif. _ Copies
Variance - TOTAL 3, 266.5(?
1? 0 4 0
FeQUest Dat _e '
?(? _ Cj/) Fire No '
? Rougtrin Inspecfion
Re uiretlP ??i///
? Reatly Now I?Will Nofify Inspedor
? Wh
R
d
?
/ Yes ? No en
ea
y
IX licensed contractor ? owner hereby request inspection of above electrical work at:
JaD Atltlress (SVeet, Box oe Rome o.) /^,? / Glty??
/'"?"
Section . Name or No.
IT.w.sNjr qange No. CounTy
Occopa (PqINT) Phone No.
PowerS .pliar
? Atldress`? D N J
Eleotnc ICOnVettor (Campany Name, Conlra rk Llc
e
nse
N
o
.
(
J
?
y
r
Mailing Atla!ress IConVactor or Owner Making Installation)
Aunhorize Signamra (Coni ner Making Installa[ion) Phone Number
l
MINNESOTA STATE fiOAqD OF ELECTtiICITY THIS INSPEGTION REQUEST WILL NOT
GtlggsMidwey Bldg. - Room 5-113 BE ACCEPTEO eY THE STATE BOaRO
1821 UNVerslty pve., SL Peul, MN 55104 ONLE55 PiiOPER INSPECTION FEE IS
PMmre (612) 642-O8D0 ENCIOSED
.
?/??jp - REQUEST FOR ELECTRICAL INSPECTION
lo See inslmclions for completing this brm on back oi yellow wpy.
@ 1,30 y Q 'X" Below Work Cavered by This Request
??"`'?. 11 ee-aoooi-o?
2 4°
ew Add Rep TypeofBuilding AppliancesWiretl EquipmeniWiretl
Home Range Temporary Service
Duplex Water Heater Eleciric Heating
APt, Builtling Dryer Other (Specity)
Comm./Industrial Fumace
Farm Air Conditioner
Other (speclty) Convaclor's Remarks
Compute Inspection Fee Belaw:
# Other Fee /t ServiceEntrance5ize Fee # Circuit5/Feeders Fee
Swimming Pool 0 ro 200 Amps ? 0 to 700 Amps 5,2
Transformers Above 200 _ Amps Above 700 _ Amps
Signs Insi Use Only_ TOTAL ? C
Irrigation Booms
Speciallnspection ??? pu
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCON
Other Fee .(f COMPLETED WITFIIN 18 5. (
I, the Electrical Inspector, hereby Rougn-m . oate5` ?
e?
certify that the above inspection has
been made. F;nai ? oaie
OFFICE USE ONLY ?
Tllis lequ¢5t vOM 18 month5 flOm
?qll? ?
. ? 2007RESIDENTIAL BUILDING rExMiT nrrLicnTioN
` City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauiremenis
3 registeretl site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20°k macimum lot coverage allowed)
1 Soils Repod if proposed building is m be placed on disturbetl soil
2 copies ot plan showinq beam 8 wintlow sizes; poured found design, etc.
1 se[ ol Energy Calculations
3 copies of Tree PreservaGOn Plan if lot plafled after 711193
Rim Joist De[ail Options seiection sheet (buildings with 3 or less unils)
Minnegasco mechankal ventilation form
RemodeUReoair Reouiremen6
2 copies of plan showing footlngs, beams, joisLs
1 set M EneTgy CalalaGOns for heated addifions
1 site survey foraddifions 8 decks
Addibon -irMicate Aoo-sife sepyc system
/
La2e6ed 4?'6
Plans are considered oublic information unless vou state thev are trade secret and t e reason.
ConstructionCost ?S?r3
Date J' /_2-7/ 6 -/'
/
Site Address Y,6`l d 1:2?US 4rJ N, ?l S Unit/Ste #
Description of Work lra.r c?.C {.
Multi-Family Bldg _ Y -/- N Fireplace(s) _Y- 0 _ 1 _ 2
Property Owner poi rn. ? 0.WA J e? A-NO-V So i? Telephone # ( (, 9 ) 3 YU l 4147 $ 9'
ContrectOr V</A W1dI- L t7rJS?/ (4 G11?^J, ?4--
Address 1 3 o a ,7-3 51-`J ,
;,4.
City
State - iV Zip -570Y Telephone#(6/?) y?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minneso[a Rules 9670 Cateeorv 1 _ Minnesota Rutes 7672
Energy Code Category , Residential Ventilalion Calegory 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitletl Su6mitted
• Energy Envelope Calculations Submitted
In ihe last 12 months, has the City of Eagan issued a permii for a similar plan based on a master plan?
_ Y _ N if yes, date and address of master plan:
Licensed Plumber nD
Mechanical Contractor
Sewer/WaterContractor
appiY
Telephone #(
Telephone #(
Telephone # (
'572i 3?1
Offce?Use Onh
Cert of Survey Recd _ Y _ N
SalsReport : _Y _N
TreePresPlanRectl _Y _N,
Tree Pres Required Y _ N
OnsileSep6cSystem _Yi N
and acknowledge that the information is complete and accurat
e;
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 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,
y lyla/?t `iv Vvvk 2 ciltA
Applicant's Printed Name
ApplicanPs Signature
DO NOT WRITE BELOW THIS LINE
?
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EnT. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteralion ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitfon (Entire Bldg) - Gi ve PCA handout to applicant
DBSCfIptlOf1: Water Damage _ Yes
Valuation /0 <rto Occupancy R-3 MCES System -
Plan Review
Z100% or 25%
-
Census Code ti 3y _
Zoning ?C `! City Water
SAC Units -' Stories ? Booster Pump ?-
# of Units ? Sq. Ft. PRV ?
# of Bldgs ? Length ? Fire Sprinklered
Type of Const Width 2=
REQUII2ED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
Footings (deck) Final/C.O.
# Footings (addition) ? Final/No C.O.
? Foundation HVAC
Drain Tile Other
Roof ice & Water Final Pool Ftgs Air/Gas Tests Final
? Franiing _ Siding _ Stucco Lath _ Stone Lath _Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
_
_ Insula[ion
7 _ Retaining Wall
Approved By:
uilding Inspector
B
-
-------------------'---'-- -----------
BaseFee
-------- --------------
- - --------------
- -------------------------------
-----------------V --------------------
33
surcharge
Plan Review
MCIES SAC
City SAC
Utiliry Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55722
651-681-4675 ? i
New Conatruction Reaulrements
• 3 regisle(ed site suneys showin9 54. ft of ht, sq. it. of house; antl all mofed areas
(20% maximum lot coverage albwed)
. 2 capies ot plan shaxing beam & window sizes; poured foaW design, eta)
• 1 setof Energy Cekulstbns
• 3 copies W Tree Preservatbn Plan B lat platled afler 711/93
• Rim Joist Deteil Opibns seledbn shaet (hltlgs wim 8 or less unt)
DATE 5r?a ?O Z_
1 3?s,7s
RemodeuRepair Heauhements
• 2 copies ol plan
• 1 set of Energy Calculatlons ror heated add'aions
1 sttesurveyforexterbradd8bns&decks
• Ind'rcate 4 home served Dy sepBc system lof atlditions U
VALUATION 0,)_ o l b-D O
SITE ADDRESS 41Wd 40Sd'o 2D 41CL .S MULTI-fAMILY BLDG _ Y XN
iYPE OF WORK leL_° (Z-DO F FIREPLACE(S) _ 0_ l_ 2
APPUCANT
STREET ADDRESS 7'-f (o b GtJ?ti
TELEPHONE# qS__NYI-Y232- CELL
PROPERTY OWNER K r /Z1L
[ S C-A'2 !e-
FAX #
J? 3
TELEPHONE#
COMPLETE THIS SECTION FOR uNEWm RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(J submission lype) • Residential Ventilation Category 1 Worksheet Submitled • New Enargy Cotle WoAcsheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanicpl Contractor:
Mechanical system includes:
5ewer/Water Conhactor:
Air Conditioning
Heat Recovery System
Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone q
Fee: $90.00
D?? 0
MAY p p 2002 ; ?
Phone # i .! '.______'-_'..'__"_'___..__..."_"'.-_._..'.'_'.__"""__'______.__.".."'__'"""""_ i_'r."'
I hereby acknowledge that 1 have read fihis appllcation, staYe that the information is correct, and agre t comply
wiTh all applicable State of Minnesota Statutes and City of Eagan O' ance .
Signalure of Applicant -
. _..---- °-----°............ _.... --...... --.. -..?.?e.? ` ..rd._..._..._.?.._........_._ .............
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Water Softener _
_ Water Heater _
No. of Baths
OFFICE USE ONLY
O 01 Foundation ? 07 05-plex O 13 18-plex ? 20 Pool O 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Poroh/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y ar_ N O 25 Miscellaneous
O 31 New 0 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Aiteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EMire Bldg only) - Give PCA handout to applicant
Valuatlon Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Btdgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new b1dgJ _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water i Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MGES SAC
Ciry SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Piumbing permit
Mechanical Permit
License Search
Capies
Other ,
Building Inspector
Total
r .
SINGLE FAMILY DWELLINGS
2 3EP3 OF PLANS
3 HEGISTERED STTE SIIRVEYS
1 5ET OF ENERGY CdLCS.
1989 BUIl.DZBG YERMTT APPLICATION
CTTY OF EAG9N
I 1'5?fi
MDLTIPLE DWELLINGS
2 3h'f8 OF PLANS
BEGISTfiRED SITE 3IIRYEYS -
(CHECB TiIITH SLDG DIV.)
f SEf OF ENERGY CALCS.
MTLTIPLfi DWELLINGS RENTAL IINTTS FOR S9Lfi IINITS # OF DNITS
HO't&s ADDRES3ES FOE CORNER LOTS - COATRACTOR/SOMEOWNER M[T3T DE4IGNATE WHICH ADDRESS
IS DFSIRED. NO CHANGFS WILL BE ALLOiTED ONCE BIIILDZNG PERMIT IS I33DSD..
SEWER A itATER PERMIT FEES AND ACCOIIAT DEPOSIT FEES 1iILL BE INCLTJDED idITH T8E HUILDING
PEAMTT FEE. PROCESSING TIME FOR SEWER dND iIATER PERMIIS IS TWO D9Y5 ONCE A PEAMIT HAS
BEE9 COFlPLETED INDICATING 9 LICEN3ED PLIJMBER.
PENALTY 9PPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS &EQDESTED.
LOT CBANGE IS REQOESTED ONCS PERMIT IS ISSIIED.
h10Y 3 a 1989
To Be Used For: Valuation: Date: 0. Z ' a
Site Address Io 465?-dl of 41 LL5 V-C-/
Lot I Block (
Parcel/Sub LS ELd (1?dd
?
Owner ?-?
9ddress (?, ?"2uo UJ
City/Zip Code ?
Phone - f-1Z36
Contraetor Incj??
p 3'u
Address ?,c• ,?- -?
City/Zip Code
Phone
Arch.fEngr. _
Address
City/Zip Code
Occupancy R-3 M-I
Zoning R-1
6etual Const V-N
Allowable V-N
0 of stories
Length '
Depth ?
S.F. Total
Footprint S.F.
On site sewage
On site well
MWCC System v'
City water ?
PRV required _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off. ?
Varianee
COI+AfEACIAL
2 SETS OF ARC$ISECTURAL
8 STSOCTiTRAL PLANS
1 SET OF SPECIFICATIONS
1 3ET OF EAERGY C9LCS.
?y?? N
Bldg. Permit 8VB,00
Sureharge 1155o
Plan Review p9 0- 0
SAC, City IbO,oC
SAC, MWCC ,5')S,?
Water Conn 0,07
Water Meter p?Do
Aect. Deposit 30,00
S/W Permit 20,00
S/W Surcharge hoo
Treatment P1. 22,oo
Road IInit 40 100
Park Ded.
Copies
SIIBTOTAL
Penalty
TOTAL
J0 ?j
Phone #
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'Y & EAGAN
?ilot Knob Road
Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
Control No. 02 3 7
BUILDING
000257
04/15/92
SITE ADDRESS:
4010 HOSFORD HILLS RO
LOT: 1 BLOCK: 1
HOSFORD 1ST
DESCRIPTION:
Building Permit Type RES. AOD/PORCH
Building Work Type NEW
.UBC Occupanoy., R-3
' Building Length 18
Building Width 10
_ j
-7
,
?.
JlJ i l
•? _ " _ ??J
REMARKS: e O 1 $3rj (
FEE SUMMARY:
Base Fee
Surcharge
Subtotal
VALUATION
$5,000
$72.00
$2.50
$74.50
LICENSE SEARCH $5.00
CpPY $.58
Tatal Fee $80.00
COI?TF1qbq? _ App1i14523575 0004 88WR %RCONST
980 STONY POIN7 RO 980 STONY POINT RD
EAGAN MN 55123 EAGAN MN 55123
(612) 452-3575 (612)452-3575
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinanees.
?
APPLICANT/PERMITEE SIGNATURE
I
ISSUE : SIGNATURE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
? Control No. ? ? ? (
BUILDINO
000257
04/15/92
SITEADDRESS: Lor: i aLocK: i
4010 HOSFORD HILLS RD
HOSFORD 1ST
PEREST SAD-D/P96 H
FOOTIN6
FINAL
?
?
APPLICANT:
R 0 CON3T
(612) 452-3575
TYPE OF WORK:
FRAMINCa
r
.+ ,
t:u? ?-J i:" ,10 1; 1 rth. 41;('1
?iu,1 1,..tiur1 inn.. i? 1 ?;llii?t,LF?rI{
Nn. F ili:tl I:: I.
I?i I.' ? l; ? ui I? 1
!IPtI f? Ilu. ?.n;-,n It I! i' L?
NEW
f:f; I I 11 1 'nI1
?-- a
PERr?IT # CtTY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-0675
? ge_ o 0
APR g 1 RECO
?V Y) W, ???
SIMGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date q /? z- Yaluation of wor yspd ^
Site Address: yD l ? 1409'fn. "
STREET - 8TE f
R
/o &
t N
T
4
u..r
enan
ame:
LOT 1 BLOCK j- 5Lgp.H05PbRD ST DaJ4 P.I.D. / .
Descri tion of work: SereeK+-Or
The appl icant is: ? Owner . JW Contractor ? Other (Describe)
Name Ra J`er Phooe 6$%7 'Oti g7
Property LASZ FIRST
Owner 14cD10 14ms-Fdrd N"lls
Address
STREET ' STE Y
City State ?-? Zip 4-?' Z- 3
Company 2• ?• 0m.,. RIcK Oc.+Ne Phone'rSZ
Contractor Address 9?? S?Tm ?.?.4 License 9 g xp. ?" 9
City State w. G Zip 5s i z 3
?
Company Phone.
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber N/?+ . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
i
Signature of Applicant: i
urrmoe uat unLY
BUtLDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish ? 13 Public Fac.
? 02 5F Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 14 Agriculturai
? 03 Two family O 07 Fireplace ?11 Res. Ad . orch ? 15 Miscellaneous
0 04 Multi-fam. T.H. ? 08 Deck ? 12 Comn./In
WORK TYPE
%=3INeZ'
32 Addition
O 33 Alterations
? 34 Repair
O 35 Tenant finish
? 36 Move
GENERAL iNFORMATION
? 31 Demolish
? 99 Undefined
Const. (Actual
? Basement sq. ft. MWCC System
(Allowable lst Fl. sq. ft. City Water
UBC Occupancy ?- 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length I8' On-site well, Census Code y 3 y
Depth /°, On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Yariance
REQUIRED IN SPECTIONS
? Site 19 Footing 10 Framing O Insulation
? Wallboard IZ Final ? Draintile ? Fireplace
Permit fee 20 a n,a,.t;o,,: s 5? n o
Surcharge ? . So
P7an Review
License
`u
/9 =? SS U X 2 s: = LI 5 0 v
?
SAC
MWC /
K
City SAC `
Water Conn.
Yater Meter -
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Raad Unit
Park Ded.
Trails Ded.
Copies
Other ?
Total: z
SAC % ?
5AC Units
CITY USE ONLY yq
L ? BL ? RECEIPT#: /o?0 Q/
Sl1BD. RECEIPT DATE: 1Z1? 9 7
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 65122
(612) 687-4675
Please complete for: . single tamily dwellings
. townhomes and condos when permits are requited for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum - i • 3.00 x =
Rough Openings 1.50 x =
Water Softener `for dwellings under construction 5.00 x J_ = Sc)O
Water Softenef ' for existing dwellNg . 20.00 x °.
U.G.Spritlkler 'Pordwellingunderconst. 3.00 =
U.G. Sprinkler ' forexisting dwelling 20.00 =
AlterdtlOnS "roezisting residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` Dak Cty lic. 75.00 =
(new and refurbishad systems)
Private Disposal Systems' Abandonment 20.00 =
STATE SURCHARGE
TOTkL
.50
M-0,
I hereby acknowledge that I have read Nis appliration, stete that the infortnation Is correct, and agree to. ramply withall appliwbleCiryof Eagan ordinences. It is the applicarrt's responsbility
to notify the Droperty avner thet tha City oi Eagan assumes no.liabiliry for any
damages pused by the City durin '?' N dlities constructed under this pertnR wn
Ciry property/rightcf-wey/ease 4010 HOSFORU H I LLS RDflD
SITEADDRESS: EFOM ' 55123
H 434-3328 W
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
ciTV:
NORBLOM PLUNIBINU CU.
DBA VENTCO/APPLIANCE INSTALLEHS
(812) 827-4033
H
290 MSNNEAP'OLISAMN 55408
. ZIP:
SI RE OF PERMITTEE
1??
2006 RESIDENTIAL MECHANICAL rExMiT arrLicaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single (amily dwellings & lownhomes/condos when permits are required for each unit
Date '1. ? / (./ (!/
Site Address Unit #
Pro
ert
Owncr1
)P I j hone#(?
5?
!Srm Tele
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r
7
-t
Contractor ?il1l f' (?lJ)1111
? 90? V
%/ 6
S[reet Address rr?? ,v City J
,
State _ ? UAI Zip ? Telephooe # / '7
Bond #: Expires:
The Applicant is _ Owner Y Contrac[or _ Other
Add-on or alteration to existin g dwelling unit $ 30.00
? furnace _Additional 1/eplacerue-nt_ New
air exchanger - ? --- --
; !`'
?
air conditioner
-.; JUN
heat pump ? S
other ?
State Surcharge $ 50
T
t
l $ ??
s
/)
o
a •
c
I hereby appty for a Residential Mechanical Permit and acknowledge that the infoanation is complete and accurate; that the work will
be in conformance with the ordinances and codes of [he Ciry of Eagan and wi the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start withou permit; that the work wi be in accordance with the
appro d plan in the case of ork which requires a review and approval of p s.
? re- vi
Applicant's Printed Name App icant's Signature
5URVEYOR'S fERTIFICATE
"0 DENOTES f' tOPOSED SURFACE DRAINAGF
O OENOTES IkGN MONUMENT SET
0 DENOTES i' :',N MONUMENT FOUND
XOOQ.O DENOTES f .'STING ELEVATICN
(OOOA) DENOTES F'Rt)POSED ELEVATION
s
SCALE: 1 lNCH - 3c FEET
PRUPGSED GRRACE FLOOR - 8e1.7 FEET
PROPOSED LOWEST FLOOR -- 874?.?,-) FEET
PROPOSEp TOP OF BLOCK - 85::. r FEET
WE HEREBY CERTIFY TC MoNT4onqe&Y Dgsiv N THA7 7HIS IS A TRUF AND CORREC:?
REPRESENTATIQN OF i•'iURYEY OF THE BOUNDARIES OF:
LOT . BLOCK I, HOSFORp tST ADDITION, ACCORDING TO 1"}iE
REC' ;:pEp PLAT THEREOF, DAitOTA GOUNTY, MlNNESO7A.
IT DOES NOT PURPOR' 1 0 SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWIY. ,^:S
SURVEYED BY ME OR ( '!)ER MY DfRECT SUPERVISION THIS 23RDDAYOF htovepnpF ?L , 19F«
SIGN[D: JnNtES ft. HiLL, iNC.
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JOt-1N C. LARSON, LAND SURVEYOR
MINNESQTA LICENSE NUMBER tA828
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PROPERTY DESCAIPTION.•
L01' 1,6LOCK f,NOSFORO 15T ADOZrION,ACCOROING TO THE
RECOFOED PLAT TNEREOF, OAKOTA COUNTY, MINNfSOTA.
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' I hereby cedly lhAt lhls survey, plan, or repod wae prepared by ma ?*? SGH,r,?pplZ t?
or under thy'dlraEt suprarylsloh an8 thel I am a duty Repigtared Lend - • =
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Minneeota Llconjib No. 8625
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A
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114598
Date Issued:09/17/2013
Permit Category:ePermit
Site Address: 4010 Hosford Hills Rd
Lot:1 Block: 1 Addition: Hosford 1st
PID:10-33600-01-010
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Fireplace:1,MAIN FLOOR, ST-CFL-24NG-B
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Paul E Anderson
4010 Hosford Hills Rd
Eagan MN 55123--140
Hearth and Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA141840
Date Issued:04/03/2017
Permit Category:ePermit
Site Address: 4010 Hosford Hills Rd
Lot:1 Block: 1 Addition: Hosford 1st
PID:10-33600-01-010
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Paul E Anderson
4010 Hosford Hills Rd
Eagan MN 55123--140
(651) 338-9871
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature