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4102 Johnny Cake Ridge Rd Use BLUE or BLACK Ink I For Office Use Permit# a / d t h ~ City of Evan I Permit Fee: I - 1 3830 Pilot Knob Road Eagan MN 55122 ' Date Received: 1 Phone: (651) 675575 ' Staff: Fax: (651) 67"694 / . 2011 RESIDENTIAL PLUMB/IN ERMIT AP, C TION ~j Date: Site Address: C Tenant Suite M. RESIDENT / OWNER Name: Phone: Address / City/-Zip: CONTRACTOR Name: ,~440- K/ G~ License: Address: City: I- rF5.~'"~ State: /CLs2. Zip: Phone: % 5p - Contact 0G' kz 4.1 e°C Email: TYPE OF WORK New _ Replacement _ Repair , Rebuild _ Modify Space _ Worts in R.O.W. ripthm of work PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ I - PVB) Add Plumbing Fixtures Main l _ Lower Level) Septic System Water Turnaround -New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge) "Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($1 o.oo per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burred out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ 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. e .go herstateonecail.orr~ I hereby acknowledge that rius 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 ties 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 s~a~ x S41111K x Appli nt's Prin d Name Applican s ignature FOR OFFICE USE Reviewed By. Date: Required Inspections: Under Ground -Rough-In -Air Test Gas Test Final f Use BLUE or BLACK Ink r I For Office Use 1 I I City of Ea an Permit#: I LJ 5• I Permit Fee: 1 3830 Pilot Knob Road I I Date Received; Eagan MN 55122 JUL Phone: (651) 675-5675 7 2011 I Staff: I Fax: (651) 675-5694 1 _ I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION ~1, ,~'rp Date: Site Address: Unit Name: y A*_ 151_111Q Phone: RESIDENT / OWNER Address / City / Zip: z<,& kdoo Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: #30, OoD Multi-Family Building: (Yes / No ) I Company: 7rcS7% e- elo's c, Contact: Address: C/~-0/ _s11r. City: CONTRACTOR tate: / //4/ Zip: S^S0 7 Phone: to l~ 3 2~'O Z State:/4//4/ License M -:~t&06 3/ /p Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: i NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of d the information may be classified as non-Public if you provide specific reasons that would permit the City to i ~ 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.aopherstateonecall.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 ans. x ~S'fe~e ~5f z4fic,:2 Applicant's Printed Name Applicant's e:r/ Page 1 of 3 D 4004 WRITE T "1S ~I rQOQ~ SUB TYPES - Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage - Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family) - Multi Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi) 01 of _ Plex Lower Level _ Pool - Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation - Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION ( Valuation G 010 Occupancy MCES System Plan Review Code Edition 04SAC Units (25% 100%4-) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick __~C Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: Footings _ Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: :!no* , Building Inspector RESIDENTIAL FEES Base Fee ~/~>rJ Surcharge Plan Review MCES SAC City SAC Utility Connection Charge 0AJ Y )-0 S-0 S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Address 4109 .T o h n n v Pa k a u; a g P u a Zip 5512_2 L.ot 3 Blk 5 Sub THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector. Final grade (6" from siding) Permanent steps (garage) Permanent steps (main enhy) Permanent driveway Permanent gas Sod/Seeded grass Trail/curb damage Porch Basement finish Deck Please ve ?'ywith the builder ttie removal of roof 4est caps from the plumbing system and the shuhoff of water supply to the outside Iawn faucet before &eeze potential exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinklet system. ? Whitc - City Copy Yellow - Resident Copy Pink - Contractor Copy ?;- t. . ,,_ ' ... •. _. _ _ . VEMTq10 FlREPLAC S LOCATION GAS WOOD MANUFA RER °MQpEI. = BTU'S wnEcr nrwos .. ,. . .. b x ` Site address: tiID2 _J41k. On April 15, 2000 the MlnneSOtd Er tightness, and ventilotipn, iaas adppto submitted prior to issoncd qf a.Cerqry v , _ rnis saucsure: Iiiiimnslnucled ic meet i?This etruqure WIM W' 41"d GD i -- -- ? 6? . t; / £.- ? ? iUon protection, air nring information be MAKE•UPAIB MODEL , TYPE CFM's -? I hereby acknowledge that the 8bova InfortnaUon l& wrrgct and agree to coinply with iha Minnesota Energy Code and City ot Eagan requirements. DO ?.. Company Name 1 3 3 ; ` Thisiormisthe re spon bililY ? Gf Rr sl tl?gQe??alCanlraCd4?. ? ,??? ?'. T ? * * * * * * * CITY OF EAGAN ? l,J -"4" q () `? 1 (d CA IER: JS TERMINAL NO: 775 DATE: 04/20/00 TIME: 09:25:48 ID: NAME: PULTE MASTER BUILDER 2252 9220 3210 9001 3866 9379 3422 9001 2275 9220 3446 9001 2.155 9001 3743 9220 2155 9001 38'68 9220 4102 4102 4102 4102 4102 4102 4102 4102 4102 4102 JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R JHNNY CK R 30.00 1,296.15 100.00 842.50 1,089.00 11.00 0.50 50.00 77.00 492.00 CR127037 USER ID: JAN ** CONTINUEL ** CONTINUEE *?,c***?*?*:*+*+x**t,r??****?**********?* **x****,t+******rr.x**,t,r**,r,r*?*** CONTINUED CITY OF EAGAN CASHIER: JS TERMINAL NO: 775 DATE: 04/20/00 TIME: 09:25:50 ID: NAME: PULTE MASTER BUILDER 3716 9220 4102 JHNNY CK R 114.00 3713 9220 4102 JHNNY CK R 50.00 3865 9220 4102 JHNNY CK R 840.00 Total Receipt Amount: 4,992.15 CR127037 USER ID: JAN 2000 BUILDING PE[tMIT APPLICATION (RESIDENTIAL) crTr or FAcwr ? 3630 PILOT IQN06 RD • 55122 . " 851-681-4675 ??1 Naw ConafnicNOn Reaulrsjnanfs RamOAel/Reoalr Raadrert?enb D 3 reylefered tlie wrvaYs ahowinfl sc41L of W. t9. K of houw Z copiet d Plan and gR rooled arew (20% maximum lof coveraae albwedf 1 tbt d enerpy ealcWaHau fa haalad addiXaq D Z coPies ot Wau (ftw beam b window yx9a: Pared hW. dedyn: atc.) 1st19 suneY for exfeAa IX1dIMaq 3 deCb D 1!ef Of aferyy ctlcWaMOtu . D J coPieIsI d hee Prewrvalbn Plan H loi Wo4ad dlw 7/1/93 DATE: T I l I/?? CONSTRUCTION COST: DESCRIPi10N OF WORK: /( Ls 1 R"17"1 01I 51REET ADDRESS: ?IOa ?S U 71 Y!n ?7 C?l ?? ?1W LOT: ?3 BLOCK: SUBD./P.I.D. #: DA K&R13K1= Name: Phone PROPERTY ?ast qrst OWNER Sheef Addresa: citY State: ZiP: Company:AU I( R- fpNrl?,b Phone #: 4?-l /?2 -SZo"a CONTRACTOR (area code) sfroet ndar? l3s r?x r?,r?vd u?? r???.`?'???2??J cny /Yt.uidoic, l?s srare: MiL/ zip: ?S`l2 b EWGIN ER / Company: sZM ?? i7s A 8OVF- Name: Telephone s: ( Sheet Address: Registralbn 11: CRY State: 3eweMNater Iicenaed plumber (If Insfallino seweAwater): M Il??/ 1Q11/v1fiac^ Phone #: MP. (0)????12) I hereby acknowled9e 1haF 1 have read this opplicafion, alale ttwf 1he fMonrwlbn B correcf, and apree b comply wilh a1 app6cable SFala of Minnesofa Slahifea and Cily of Eapan Ordinances. ? . Sipnature of AppOcant Certiflcates of Survey Received _:?_S"es Tree Preservatlon Plan Received ._ Yes OFFICE USE ONLY q06. O'( IS _ No _ No -]"ot Required ? OFFICE U3E ONLY BUILDING PERMIT SUBTYPES 0 01 Foundation p 07 05-plex X 02 SF DweAing O OB O6-plex O 03 01 of _ plex O 09 07-plax 0 04 02-plex p 10 08-plex 0 05 U&plex E3 .11 10-plex O 06 04-plex O 12 12-plex ORK TYPE ? 31 New O 32 Addition 0 33 Alteration O 34 Repair 0 13 16-piex O 27 Porch (3-sea.) 'L]• 3.1 Ext. Alt - Multi O 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext Alt - SF O 18 Ueck ? 23 Porch (screened) p 38 Muw O 19 Lower Level O 24 Storm Damage aibp _vor_N O 25 Miscelianeous O 20 Pool O 30 Accessory Bldg. O 36 Move Bidg. O 43 Reroof O 37 Demolish (Bldg)' p 44 Siding O 38 Demolish (Interior) O 45 Fire Repair 13 42 Demolish (Foundation) O 46 Windows/Doors * Give PCA handout to applicant for demotition psrtnit GENERAL INFORMATION SAC Code No. of Units No. of Buildings a Const (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. Main level sq. ft. G?AJO sq. ft. sq.ft. MISCELLANEOUS INSPECTIONS X StuccofStone 6 (Lg;r,L APPROVALS Pianning _ Permit Fee Surcharge Plan Review License MClES SAC city sac Water Conn. Water Meter Acct. Deposit siw aem,it S!W Surcharge Treatment Pi. Park Ded. Trails Ded. Other Copies Total: Building ? ?-- a-. sq.ft. sq. ft. Footprint sq. ft. Census Code MCIES System City Water Booster Pump PRV Fire Sprinklered Engineering Variance ? ValuaUon: $ ? ??i? (?l?l? eff5rc A A 45? C.-k3 dZ 6?-dr? /aOK e ? q'-` k" ?- I Iwo 0( 7 kX SAC Units % SAC Surveyor's Certificate SURVEY FQR :PULTE DESCRIBED AS : Lat 3, Black s, oaK reserving easements BA13n?1r EnTGIMERnvG _ ? 2, 225. = 1,819- 15% uT° ?--- , ? ? -- ? Exiome TO6t= 935.2 i ? ? ? ? - IL _?? ` y Jk LOT H SE. LOT SQ. FOOTAGE SQ. FOOTAGE COVERAGE _ Plon # 18052 PROP05ED ELEVATIONS Top of foundation = 934•7 Garage Floor - 93,y.3 Basement Floor -qu,o Aprox. Sewer Service = Gzl.o Proposed Elev. - (Z=) Existing Elev. - - Drainage Directions = - Denotes Offset Stoke = . of Eogon, Dokoto County, Minnsoto ?nd ? SCALE: 1 inch = 30 ieet 4Y BtNCHMARK, 771Vy @ (-o+7 6IKS a4_ Sa-5.94/ MIN. SETBACK REQUIREMENTS Front-25 House Side - Rear -i5 Goroge Slde- JOB N0: HEDL!'!/VD I HEREBY CERTIFY THAT TMI$ IS A TRUE AND CORRECT REPRESENTATION OOR-OBS OF Th7E BOUNDARIES OF TfiE ABOVE OESCRBEO PROPEltTY AS SURVEYED BV IAE OR UNCER MY OIRECT SUPERVISION AND OOES NOT PURPORT TO BOOK: PAGE: PLANN/NC 8NC/N66RlNC SURV6YlNC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT A$ SHOWN. 2005 Pin Oak Orive _3_ Z? CO • Eagon, MN 55122 DATE Cn0 FiLE: Phone: (657) 405-6600 FF 0. IINDGREN, LANp URVEYOR Fax: (651) 405-6606 MIN OTA LICENSE NUMBE 14376 OAKBROOKE PECEIVED APR 1 4 2009 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ? W PROPERTY LEGAL: Lo> 3?GOeK 3 65WRA1-c2{'=' ? DATE OF SURVEY: 3- 21 -GO ' H w .. LATEST REVISION: ? 0K o DOCUMENTSTANDARDS ? Q O ? Q Y ? ? ? • Registered Land Surveyar signature and company i a ? • Bu ldingPermitApplicant a--'o ? • Legal description v'o o • Address W? ? • North arrow and scale o ? ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) Di l d ti i Rh l ¢ ona nage arrows w • rec re s ope/gradient % ar' ? Z/ ? • Proposed/ebsting sewer and water services & invert elevaBon ? ? • Street name 6?0 ? • Driveway Er, ? ? • Lot Square Footage ly? ? ? • Lot Coverege ELEVATIONS Existinq d?/ ? o • Sewer service (or Proposed) q ? , o • Properry corners V a ? • Top of curb at the driveway a' ?/o • Elevations of any ebsting adjacent homes ? Ef ? Adequate footing depth of structures due to adjacent uElity trenches Prooosed / 9" ? ? • Garage floor ;/ ? ? • Firstfloor W/ ? ? • Lowest exposed elevalion (walkouUwindow) e o V ? • Properry corners ? ? • Front and rear of home at the foundaGon PONDING AREA (if aodicaMe) / ? u ? ? ? ? • Easement Gne NWL 4 a d o • • riwL ? ? ? ? • Pond # designation 0 ? • Emergency Overflow Elevation d ? ? ?? ? W? ? a y? a m? ? DIMENSIONS • Lot lineslBearings & dimensions • Right-oi way and street widtli (to back of curb) • Proposed. home dimensions induQng any proposed decks, overhangs greater than 2', parches, etc. (i.e. all structures requiring permanentfoodngs) • Show all easements of record and any Ciry utllitles within those easemenis • Setbacks of proposed structure and sideyard setback of adjacent epsting structures • Retaining wall reauiremenis, if anv Reviewed: March 7998 CRAIOIBIDGPRMf.FM Jr'S INITIATION ORr ER Pulte Homes of Minnesota Corporation 1355 Mendota Heights Road, Suite 300 Mendota Heighi3, MN 55720-7112 Phone: (651) 452-5200 Fax: (651) 452-5727 DO CONTRACTOWSUPPUER: JOBNO.D Z__2_0 /?O GALDESCRIPTION: IAT? BLOCK UNR LE COMuIl1N1TY: ???{)?,7?.?C /:?S??"l-?,?' ? /i'? ADDITION: . eUILDING ADOqESS?7?, n C`_,( U U U 1M UA{:? ? Q . ? MOUEL NAME: ?"I L? h1pDEL NUMBE ? q7y; ELEVATION• STATE: L OARAGE: LEFT RIG (?/ t/6 ? BWER'SNAME(3DER:4 C? CURRENTADDRESS: L - ?y;S7ATE:?ZIP: 2p ?j '? 7BUSINESS c. . HOME PFIONE: S• J O PHONE: c2? d-tl5'? 'BUSINESS OATEPMONE:OFO SALES REPRESENTATIVELJ 9yY-1" ;,6tTY:N? 0.O1PT1 ON 4??s ?r,?? ????:OI:?t?i'.??r.? DES.CRtPE7lOhk?i?'Z ¢i, °??; ? .? `'sPIiICE?'?a; 0000 BASE PRICE L ? ---- LOTPREMIUM ELEVATION # ? o(D , ao ?? ? 5 ? C?C ZD r , 7_,S Q;'Z5 146 2 ? cx"t S6 ? OoC ?; ALQ- 75 1410OU (5? ( Z(? (Yl.i nn,k ? Cc/LQ? I ! n? 0?5 ? ac Cc,ba ? ?5 ? fECt! 7 a5o z0 EE BuildeYS License 90001371 TOTAL APPROVED BY BUYER (S)-? --_-J APPROVED BY SALES: I ? RELEASED TO START CONST.: eouaL l{ousinc oPVanrurnri This constitutes a contract between the Seller and the Purchaser(s) for lhe above items. MAR-16-2020 10:28 P.02i02 MdT4heck COMPLIANCE RE80RT I MirWnsota Snergy Cods ? Perm t k Wcheck Software veraion 3.0 C acke y DaCe COIID7TY: Dakota -- 9TATSt Minsseeptp 20NE; 2 CONBTRUCTSON TYpE: Siagle Family DATE: 3-16-2000 DAT'Z OF PLJW3: 3/16/00 TITLE: FALKIRR W/D EL. #2 COMPLIANCE: PA9$ES Required UA . 508 Your HomE = 407 19.9} Bettar Than Code Arsa or Cavity Cont_ clazing/Door __Perimeter R-Value R-va:.ue U-Value --^---------------------------- _ ----^ -------------------------- CEILING3 1444 44.0 0.0 WALLS: Wood Frame, 161, O.C. 2327 19.0 2.0 ViALIS: Yiaod Frame, 16° O.C. 283 10.0 2.0 BSMT: ConC. 9.0' ht/8.3' bg/9.0, insul 402 11.0 0.0 CT?n?ING: WindoWe or poore, Above arade 485 0_350 1 ?ORS 38 0.350 F'I+aoRS: Over Unconditioned space 352 38.0 0.0 HVAC BQCTIpidENT, Furaace, 92.0 AP'[TE -'-----------'------`-------------- COMPLIANCE gTATEMENT; The propoeed building deeign deacribod here is - consistant with the building p1ane, epacificationa, and other calculatione suhmitted with the.pextqit application. The propo0ed building h>s been de8igned to me ?11 e M?ota Energy Code. Huilder/De Dace 4/??-?? - TOTRL P.02 CITY USE ONLY L _ BL _1; RECEIPT Ii: SUBO. RECEIPTDATE:/ PERMIT# 8000 PLUM$INfi PERMiT (RESID£NTIlkL) U C17y0FE*fiM 3830 PI.OT KNOB ftD SAtHlkN, SIN S51 EE 861-681-4675 //// ,G/l- ' Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH TOTAL Alterations to existing dwelling - minimum fee Describe: $ 3C.00 Bath tub $ 3.00 x - $ Floor drain 3.00 x = $ GeS i in ODUOt ' minimum -1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchert sirtk 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Se tic S stem newtrefurmsned • reqUGes MPC Ifc. 75.00 x = $ Se tiC S Stem abandomment 30.00 x = $ ? RPZ new installatioN2pairlrebuild 30.00 X = $ ? Rou h o enin 1.50 x - $ b, 50 Shower 3.00 x = $ Under rounds rinklet ifdwellin isunderconsWction 3.00 x = $ Under round s rinkler if existing dwellin 30.00 x = $ Watercloset 3.00 x = $ Water heater 3.00 x = $ 73 Water softener If dwelling under eonaVuction 5.00 x = $ W ater softener tf exunn dwewn 30.00 x = $ Waterturnaround 30.00 x $ State Surchar e .50 --> ---> ---> $ .50 Total -> -> ----> .---> $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. I -h--er---eb-y --------•••--•-----have ---•--read••-this----appli-----wtl-on--,- stat---e--that---.the_.. information......•---is-- co--r--rect---, ---and-• •agree-----tq-----comply-••with----all-ap pli----ca-b--leCiry -...--of--Eagan------ord•-----•-inances-- acknowledge Mat I . It is the applicanCs responsibilily to notl(y Me properry owner that the City of Eagan assumes no liabiliry for any damages raused by the Ciryduring iGS nortnal operatlonal and maintenance activities to Ne faciliqes constructed untler Ihis Oermit within City properrylrighl-of-way/easement. SITE ADDRESS: OWNER NAME: : INSTALLER NAME: TELEPHONE #: - (AREA CODE) TELEPHONE #: (aRea. cooe) STREET ADDRESS: CITY: STATE: ZIP: SIGNATURE OF PERMITTEE L 3) BL CITY USE ONLY 'J __,sua:. ???i?roon-e? 8000 PLUMSIN6 P£fiM1T (USIDENTIAL) CflY OF EAGM sgsoPI.OT KNOB RD EAeAv, Mx ssi sg 651-681-4675 RECEIPT#: I J G ?7-3 RECEIPT DATE ? ?".}/7 /' (70 _ PERMIT# ?( ? / 5 51,24100 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: 5 30.00 Bath tub $ 3.00 x Floor drain 3.00 x = $ -- G85 i in outlet ' minimum -1 3.00 X = $ ? Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x $ r' Lavato 3.00 x = $ ? Se tic S stem newlrefurbished 'requlres MPC Ifc. 75.00 x = $ S@ tIC $ stem abandonment 30.00 X = $ RPZ new instaliaUONrepaldrebuild 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ -- l Undef rOUnd S finklef ifdwelling is underconsiruction 3.00 x = $ Under rounds rinkler ifexistin dweuin 30.00 x = $ Watercloset 3.00 x = $ Water heater 3.00 x = $- ? Watef SoftenEf if dwelling underconstruction 5.00 x = $ Watersoftener ifexistin dweilin 30.00 x = $ Waterturnaround 30.00 x ---- _ $ State Surchar e 50 --> ----> ----> $ .50 Total --? _> ----> ----> $ 50" Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. --- ?---------------------------------------------------------•---------------?--------------------•--------------- I hereby acknowledge--Nal I have read--this applicatlon, state tha[ the informatlon is covect, and agree to comply with all applipble City of Eagan ordinances. It is the appliCan['s responsibilily to notl(y the properly owner that the Cily of Eagan assumes no liability for any damages caused by the Ciry during its normal operational and maintenance activities to the facilities constructed under lhis permit within Ciry propertylright-of-way/easement. , , , - , r'i ,1 11 n ; n I SITE OW NER NAME: : INSTALLER NAME: STREET ADDRESS: CITY: TELEPHONE #: (AREA COOE) TELEPHONE #: ??, (AREA COdE) C17'Y USE ONLY LOT ? BL 6 PERMIT #: / II (f b SUBD. ?Yl C/ 1' O o RECEIPT #: I-;i 15 & ? RECEIPTDAI'E: (' '?' UG? 2000 MECHANIC,AL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT KNOH RD EAGAN IIId 55122 651-681-4675 Date: Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under construction and not ownedoccupied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) State Surchazge Total $ 30.00 6.00 3r.0D .50 $ 3R. 15e Complete this section onlv if you are remodelin¢, addine to, or revairine an existing single-famify dweliing, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New _ Alteration _ Repair _ Other _ Fumace _ Air conditioning _ Airexchanger _ Other ? Fee $ 30.00 State Surchazge .50 Total $ 30.50 Reminder: Call for inspections SITE ADDRESS: lil C7 a -Z?bv\Yl nl.A cc1.???W-_J_Q& OWNER NAME: y v 40- q40 fYIQSv v PHONE #: (DSI -Sap p r (AREA CODE) INSTALLERNAME:?$'L1 ?M L(Q. ;t ok? ?'I(' PHONE#: (o/'?- , _ _ (AREA CODE) STREET ADDRESS: CITY: 5 _ ST E: :_SL??CL GNA OF P ITTEE f? -9aw C4 of Ealan 3830 Pifa Knob Roed Eagsn AfN 55122 Phone:(657)675-b675 FeX:(651) 67"694 as140q ?----------------; ; Pairit Fm-?=?- , I I Date Recened' ? i smrr: i ---------------- r ? zoos REStDEN?IA! BUILDING PeRMIT nPPUCAnON oate: 1 l 00 sIM ,aadress: ? I b i a41 r1 n C'aks? ?-? D?- Q?? TenaM: Suil! P. RFSIDENTIOWNER Nmdh(o,e Aea?/ CRY fzW. npprcau is: _ owner Z,C cmMor rrreoFwoRK o?a?TEDr? oFr ?2q SQ Canstr?6on Cost: `?? ??,CO MulG&FamdY Bidlding: (Yes _.1 No ZC J CONTRACTOR INeme: (.Z?_.L?'li'IFT7kZ'1P[`? L.4g?SPt)Ctf?"1_Ckseraet. c?: ? 1Ic?`r?es' _ sta, _ mtY -_?.- Phone: Co51 • yAq-y3X Con= Pawn: KctCPn COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUII.DING _ Minrreaoffi Rules 7870 temrv 1 _ AA'u,.estn Ru(es 7672 F.nBlgj( COd2 . pesiclanyv Vwddedon.Camgcry 7 Wwbhw • New 6mWCode Waksheet : SubldRfld Category (4 submbslm lYPe) ' Enew Fnvabpefaj? &&m'bd . in the mst ts monqhs, hm uio Q+lr oe Eaga, iaswd a pexnn ter a oanlbr plan eaeea on a rtmOmr alan? _Yes No If yes, dafe erd address af inester plan: . Lieensed Piumb9f• PhWIB' L?:_'^1'?^T •, 9efror de Waror COnh2ctD[r. R- qD°-° assoq ; ---------------- ; j Pertnit #: City of EaaaIl ' 40' I 3830 Pllot Kt1ob Roed ? Permit Fee: I Eagan MN 55722 ? Date Received: Phone: (651) 675-5675 ? i Fax: (651) 675-5694 I StaH: ? j L J 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 5 (? Site Address: "? ? 0 c oh n n.., l_R k,F IeiOC E rCd( Tenent• Suite #: RESIDENT/OWNER Name:3bS4 Phone:6'a'SIoS'q?9x . Address ! City / Zip: Applicant is: _ Owner ? Contractor TYPE OF WORK Descriptian of work: TFA2 OFF 5Qle200iF Construc[ion Cost: ?OUnLjCO- Multi-Family Building: (Yes NoN-Ij CONTRACTOR Name: WEl`l1{U_(?oA0 l.Gn S[1,2u Gi'? t?{'1 License #: ? ?qz?q 1?? Address: 5tDq, f IF-H(jj? ( w- A-ve CitY: ul1 ?' WQAec State: n?Zip: 512)211? Phone:(E-43?) ' `tl?(? ContactPerson: t'l COMPLETE THIS AREA ONLY IF CONST_ RUCTIWC, A NEW BUILDING _ Minnesota Rul s 7670 ateaorv 7 Minnesota Rules 7672 EnBfgy COdC • Residential Ventilation Calagory 1 Worksheet • New Energy Coda Worksheet CBtByOty Submltled Submitted (4 Su6miSSiOn type) • Energy Envelope Calculations Submitted in the 1as112 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 Piumber: Phone• Mechanical Contractor: Phane: Sewer & Water Contractor: Phone• . , .__.:. ._... ?"°.YT.., K tF ? I hereby acknowiedge that this informafion is complete antl accurate; that the wnrk wili be in contormanca with theorUinances anA codee uf the City of Eagan; that I understand this is not a pertnit, but only an application for a permit, and work is not to start without a permit; ihat the work will be in accordance with the approved plan in the case ot work which requires a revlew and approval of plans. x k . C.°Rmrnu cn X yYl 011.,-Y, Applicant s Pnnted Name Applicant's S(gnature Page 1 of 3 Use BLUE or BLACK Ink r----------------� I For Office Use I C� � Permit#: I ����� � ��el O� �^�^� I Permit Fee: � �c�-°�� I 3830 Pilot Knob Road I =+'-- �'–T— I Eagan MN 55122 Date Received: Phone: (651)675-5675 I I Fax: (651)675-5694 i Staff:_� i 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: � �" �~ l � Site Address: -/ 1�� �1���1��"� G`"''�� ����- �� Unit#: Name: �o��� �t~L �`�`" Phone: �l� ��� ` �� �RO ner� `� Address I City I Zip: ��� � ������I ��`-{�'2 �' �'� � L�"G't��� ` Applicant is: Owner Contractor Type of Work Description of work: 1�� t" � S�I ���x 6'1�'r�.+�-�t ��'" �`��'`� �N�-�ir( Construction Cost: Multi-Family Building: (Yes /No� �� �� �y� �� � Company: �� ��'�� �ZSL�, h�E Contact: � ( � Contractor Address: (�j�a W� Cc�� ��L�`�9 City: ��idr �"� ' State:�Zip: J J��.� Phone: �����"✓�°�`gmail: ' License#: �� 4 � ���� Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ��-�� `-�' �.�-� �r 1 `� ? g' 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 classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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 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 ���'��'1 ��e.v2��� X , �m., ApplicanYs Pririted Name Applica s$ig ture Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA129385 Date Issued:02/05/2015 Permit Category:ePermit Site Address: 4102 Johnny Cake Ridge Rd Lot:3 Block: 5 Addition: Oakbrooke PID:10-53760-05-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:2/5/15 Per Diane at Home Energy Center the customer canceled the job today. I suggested she call with a replacement address for this permit and she agreed to do that. pf 763-782-7432 Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Jorge S Rodriguez 4102 Johnny Cake Ridge Rd Eagan MN 55122 (651) 994-3988 Home Energy Center 2415 Annapolis Lane N #170 Plymouth MN 55441 (651) 766-6763 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA142124 Date Issued:04/14/2017 Permit Category:ePermit Site Address: 4102 Johnny Cake Ridge Rd Lot:3 Block: 5 Addition: Oakbrooke PID:10-53760-05-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Jorge S Rodriguez 4102 Johnny Cake Ridge Rd Eagan MN 55122 (651) 994-3988 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA157478 Date Issued:08/21/2019 Permit Category:ePermit Site Address: 4102 Johnny Cake Ridge Rd Lot:3 Block: 5 Addition: Oakbrooke PID:10-53760-05-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Jorge S Rodriguez 4102 Johnny Cake Ridge Rd Eagan MN 55122 (612) 865-4898 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature