4284 Gadwall CtCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4284 Gadwall Ct
Lot: 19 Block: 1 Addition: Mallard Park 4th
PID:10- 47253- 190 -01
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Cynthia J Swan
4284 Gadwall Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Building
EA083062
05/15/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
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? t`CITY OF EAGAN
- 3830'Pilot Knob Road
• . Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
? lI111 1 tlitl, IlAkk A I 11
PERMIT SUBTYPE: ? , , , 1, ?
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PERMIT TYPE: I I
Permit Number: ''.'r{F?•'»
Date Issued: /96
i0 v1 1
APPLICANT:
(r.l.'1 6t,:? 1//1
? TYPE OF WORK:
INSPECTION
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ELECTRIC
PLUMBING
HVAC
Inspection Dete Insp. Comments
FOOTINGS
evi 7 4L n ?`7' Sv; I J? 9lc.?;s? (<aoe..?.?4?
FOUND y? Q 44e
FRAMING
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ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING D
GAS SVC
TEST
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INSUL 4E /?
C3YP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FtNAI. PLBG `/ yJ
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FINAL HTG
ORSAT
TEST 71
BLDG FINAL , ?M??. ?? ?f??alr.?? ?t ?.'M?..?
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BSMT R.I.
BSMT FINAL
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C?;e?tificate af cccupanc?
Wit4 of wagatt
?artweMt of 13robcg 3aocction
Thrs Certificate issued pursuant to the requirements of !he Uniform Building Code
ctrtifying that at the time of issuarcce this structurie was in cornpliarece with the various
onlinances ojthe City reguluting building constructioR or use. For the following:
??ficatiorL SF DWG/GAR Bldg. Pe,m;t Na. 28820
O-vp-y Type R-3 U-1 Zoning pWjict 8-1 Tya Const. Vn ,
Ovim of 8,,;k;,,g Ml?TELSTAEDT BROS Am.m 2425 96TH ST E.. INVER GROVE HTS.,
B? Ad&m 4284 GADVELL CT Lmalky L19, Bl, MALLARD PARK 4TH mn ?
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Address 4284 GADWELL
I.ot 19 Blk 1
SUb MALLARD PARK 4TH
Zip 5512_
THFSE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF "E3E FINAL INSPECI'ION.
Date: Yes No Inspector:
Final grade (6" from siding) ?
Permanent steps (gazage)
Permanent steps (main entry)
Petmanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing sys[em and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 6814645 before working in righhof-way or installing underground sprinkler system. ?
White - Ciry Copy Yellow - Residcnt Copy Pink - Contractor Copy
PLITMBING (RESIDENTIAL)
Permit Application
City Of Eagan
c) °l 3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete far: Single Famity Dwellings
Townhomes and Condos when pemuts are required for each unit
Date 6?p / Z3 /03
q
2 ? q ?,, 4
Site Address U nit #
Property Owner ?ohs,.4?: 6??&
I Telephone # (jy-N'j j ) ?O ?3 -025::?2
Contractor
Address
State Z-? Zip 6-5 o2'/ Telephone #(r$7 ) `?G 0- t'V L L
The Applicant is _ Owner l/Conuactor Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC l icense $ 100.00
Includes County fee. Additional consultant fees may apply.
Alteratiy?? To Eaistlng Dwelling Unit, Including
?
00
$ 50
Adding fiMures to lower levels or room additions, excluding water soRener and water heater .
_ Abandonment of septic system
_ Water tumaround (+ 5/8" meter if needed -$121.00)
_ Other: n 1?- ?--71 ?
tn'
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacement additional
? ?. ?? ii Yi ?? i
State Surcharge
P ??,
JUN 2 3?._ 03
? $ .50
u?
Total $
Sy J
.
I herehy apply for a Residential Plumbing Permit and aclmowledge tUat the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
pernut, but only an applicafion for a pernut, and wark is not to start wiffiout a ernut; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plan .
? CM.[.S ?'^-?PSGh ?
Applicant's Printed ame Ap cant's Signature
L CITY USE ONLY RECEIPT #: 5a
t.*j BL L_
SUlY'CULrG DATE: 16'11 9&
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? New construction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ??lPin6P.P_ 3? ?QQL
W441
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 4.00
Additional 50 M BTU 6.
? Gas Outlets (minimum of 1 required @$3.00 each) _ -?
? State Surcharge .50
TOTAL _: 50
SITE ADDRESS: '512IF"5/ 4Qlaule-`1 ef
OWNER NAME: N,Cr` 1ye/sfaedf ?v s PHONE #: L-'r /
INSTALLER NAME: Lu,fCasLir 1re ftLrt? f h-?c=
?/>?t S/'¢?
STREET ADDRESS: 1-2yAI
CITY: -1?I//qL1t STATE: ?i9 ZIP: S-'`?78
PHONE #:
CITY USE ONLY
L `I BL I RECEIPT
SUB . aX?qK,d?? DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Ptease complete for: ? single family dwellings
? townhomes and condos whEbn permits are required for each unit
FIXTURES EACH ? TOTAL
Shower 3.00 x
:"latel, CI:,Set 3.00 x 3 = a-
Bath Tub 3.00 ;<
Lavatory 3.00 x y -
Kitchen Sink 3.00 x I = -?> -
Laundry Tray 3.00 x '5 -
Hot Tub/Spa 3.00 ;c =
Water Heater 3.00 "?-
Floor Drain 3.00 ?-
Gas Piping Outlet ' minimum - 1 3.00 :t 3'
Rough Openings 1.50 x `4
Water Softener 5.00 :c =
Private Disposal • Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinkler' home under const. 3.00 =
Alterations ' lo exlsting 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS: q -d g? G ac1 w c<< C-c
OWNER NAME:- Vi ,- f w a? 1<<I z ?•?
INSTALLER NAME: v+? ??•?• RI ?? C?> 2-
STREET ADDRESS: o.- ,
CIN: -7<( ,.. STATE: h ZIP: -1-, 9 3 f-,-)
PHONE #: ( )_ `I ? z-,? I -D.,
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9*!TTY car- i_nc:AN
casHIr:::R,; 8 rF:Rrs:r.NAt.. NO: 35cl
DArr::; 09i0i96 TIMf:a 005W.
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CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 8 2 0
(612) 681-4675 Date Issued: g g /1 z/g6
SITE ADDRESS:
4284 GADWALL CT
LOT: 19 BLOCK: 1
MALLARD PARK 4TH
P.I.N.: 10-47253-190-01
DESCRIPTION:
Buildin§-.Permit Type
f Build3ng W'Qr,k Type
U6C'Ocawpanc?,?_
Construction Type
Zatrlng
Building Length ?
Building Width ;
B?u11 ding .s'?
49ries ?;r =
S q"?3 a r e Fe e, t 7k
Ge?s'u;s ^Gode =
SF DWG
NEW
R-3 U-1
V-N
R-1
68
36
2
2,144
101 1 - FAM. DETACH
?r
REMARKS:
PRV S& W PLBR - VALLEY PLBG
FEE SUMIIAARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Lic. Search Fee
3ubtotal
$1,262.25
$631.13
$87.50
$906.00
100
1
$5.00
'V29VVS.VV
$175,000
MISCEILANEOUS $1.923.50
Tatal Fee $4,809.38
CONTRACTOR: - Applicant - 57. LIC.OWNER:
MITTELS7AEDT BROS CpN57 15521771 0003443 MTTTELSTAEDT BROS
2425 96TH ST E 2425 96TH ST E
INVER GROVE HTS MN 55075 INVER GROVE HT5 MN 55077
(612) 552-1771 (612)552-1771
I herehy acknowledge tH'at I have`read this applicatinn and sta:te that tkre
information is correct and agree to comply with all,applacable State of Mn.
L Statutes and„City;of Ea9an,0rdin,ances. ?
APPLIC NT/PER T NATURE ISSUED :SI NATU -
CITY OF EAGAN ,'? ?? O? J?
3830 PILOT KNOB RD - 55722
160420. 996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
RemodeVReoair Reauirements
? 3 regislered site surveys ? 2 eopies of plan
? 2 cropies of plans (include beam 8 window sizes; poured fnd. design: etc.) ? 2 site surveys (exterior additions & decks)
? 1 energy calculations ? 1 energy calculations tor heated addilions
? 3 copies of tree preservalion plan H lot platted eRer 7/7/93
requlred: _ Yes _ No
DATE: CONSTRUCTION COST:
.I
DESCRIPTION OF WORY
STREET ADDRESS:
LOT -,ey BLOCK / SUBD./P.I.D. #:
PROPERTY Name: Phone #:
OWNER
Street Address-
City: State: Zip:
CONTRACTOR Company;,??'"?D?ss1"?r?l`?dS • Phone #:
Street Address: Ricense #:
State: ? Zip:
ARCHITECT! Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City:
Sewer 8 water licensed plumber:
change are requested once permit is issued
State:
Penalty applies when address change and lot
Zip:
I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicank
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
s No
Yes No
E G?L?C?'[??MC?D
SEP 0 9 Y996
OFFICE USE ONLY
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BUILDING PERMIT TYPE
D 01 Foundation ? 06 Duplex o 11 Apt./Lodging o 16 Basement Finish
R( 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. 0 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex ? 14 Firepiace ? 21 Miscelianeous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
p( 31 New ? 33 Alterations a 36 Move
? 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuat)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
\hj Basement sq. ft.
\IN_ Main level sq. ft.
R-3, J-! 2? e) sq. ft.
12-1 r7a,.,ae sq. ft.
2 ? sq. ft.
? sq. ft.
Footprint sq. ft.
i SC> MCJWS System ?
I sv City Water ?
11 1-7 Fire Sprinklered
/?krv PRV {>
Booster Pump
Census Code. f U I
SAC Code
Census Bidg I
Census Unit I
APPROVALS
Planning
Building Engineering Variance
Permit Fee Vaiuation: $ 1 '7 S, 060. ?-
Surcharge
Plan Review
License I I LI"
MCANS
AC /4+! 2G. 3?"'?
1sb?r x?i?=
? 2
sr
o
City SAC ,
e
Water Conn. ? s?
Water Meter 2- 1
Acct. Deposit
S/W Permit Z ?
S/W Surcharge ------
Treatment PI. 3s ?3v ? ? ??o
Road Unit qu 1, 7S ' s• ?s
Park Ded. iz . sx z,s '3?•?s
Trails Ded. - -7 k,p - ?o
Other
Copies
Totdl:
?--
% SAC _
?X ?? cov
SAC Units ?K 20
y °
6
?
=
/U
b z(40
1 7y 3 3</.
Eetnbliehed in 1982 .
LOT SURVEYS COMPANY, 1NC.
LAND SURVEYORS
REGI3TERED UNDER THE LAW3 OF STATE OF MINNE30TA
7601 79rd Avanue NortA 612-6E0-9099
Faz No. 660-9522
Yianeapolin, 1lfnaesote 66128
burvrgars Trrtifirtttr
MITTELSTAEDT BROS. HOliES
Property located in Section
29, Township 27, Range 23,
DakoW County, Minnesota
Sanitary sewer service invert elevatioq,= ?ld g? proposed
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INVOICE N0. 44677
F.B.NQ- 745-28,29
SCALE: ' 1 " = 30'
o penotes tron Noaanant
? Denotu Wood FNib Set
iw exewatian oNy
x000.0 Danotss Exintfnq Ekvation
0000 ponatss Propossd Ekvotton
Daatas Surfxs Orainage
&iProposecl Pr,p„ea Top or ewc?c
caroqs Floor
S 4' 0 Propoeed Lowest Flow
Typs o( Buildtng ?
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Sou Wi? ws?p,
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lot 19, Block 1, MNLLARD PARK 4TH ADOITION
Oll
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Proposed building information must be checked with approved Cuilding
plon before excavotion ontl constructian.
The only easements 9hown are from pldts o} reCOrd or informotion
provided 6y client:
We hereby certify that this is a true and correct representation of
a survey of the boundaries of the above described land and the
locotion of all buildings and visible encroachments, if ony, from or on
soi0 lond.
Surveyed by us.tnis 7th daY pf September 19 96
5lqned
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PROPERTY LEGAL:
DATE OF SURVEY: Z4 4 ( zfe "
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legaldescription
• Address
• North arcow and scale
• House type (rambler, walkout, split wlo, split entry, lookout, etc.)
•. Directianal drainage arcows with slope/gradient %
• Proposed/ebsHng sewer and water services & invert elevation
• Streetname
• Driveway
ELEVATIONS
Ew'stlna
? ? • Sewer service (or Proposed)
Flr'C3 ? • Property comers
Er ", 13 0 • Top of curb at the driveway
,P?-10 C3 • Elevations of any exdsting adjacent homes
Pra s
• Garage floor
ir' ? ? • First floor
e?p O • Lowest exposed elevation (walkout/window)
e? ? ? • Properly comers
2--'o ? • Front and rear af home at the foundation
PONDING AREA Crf anolicable
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e-' ? ?
ff- ? ?
• Easement line
• NWl
• HWL
• Pond # designatlon
• Emergency Overtlow Elevation
.
0, ? ? •
U-' ? ?. 0
? C]? ? .
Lot lines/Bearings & dimensions
Right-of-way and street widih (to back of cufi)
Proposed home dimensions Inciud(ng any proposed decks, overhangs greater than 2',
porches, etc. (.e, all structures requiring permanent footings)
Show all easements of record and any City utiiitles within those easements
Setbacks of proposed structure and sideyard setback of adJacent ebsting sVuctures
Retaining wall
Reviewed:
Januery 7986
CMpiBGNBLWPftMT.FM
LOT SURVEY CHECKLIST FOR RESIDENTIAL
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CITY DF ERGRN PROJEC? N0. 95-M
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MZNNESOTA FNERGY COD A TERNATTVF CntKnr 7prrCp
,a;.,
'1E'This form is only applicable to detached one-and-two family dwellinqs. The
requirements herein are based on amended Section 502.2.1.7 in lieu of the
" criteria specified in Sections 502.2.1.1, .2 and .3.
=-BUildinq Address:
?'?Contractor or Owner:
Buildinv Element
Ceilings
Walls• (exterior)
Floors*
(overheated spaces)
Windows*+ LOL..7 C
` Foundation Walls
"R" Values
Design'? Required 38
Design.?2aRequired 2-9
Design=Required 20
$rea fsq ftl I of Ext.Wa11s
gZ
(without foundation)
DesignItORequired 2 _V?? .7 1 L? ? ?j
Design_L2?Required 5 L.0?7 Zr
(when insulating full depth of foundation wall) (,(, 2,5
Design_Required 10
(when insulating only to frost depth & footings
extend below)
Slab-on-grade Design_Required 8.83
floors
•;Doors Desi
gnl'2>_Required 3
F'ootnotes ?. * Fo]r the insulated cavit of opaque ** Maximum window area must not exceedW121percentrof the area]ofsts.
exterior walls, not including foundation walls.
CERTIFICATION
? T..hereby certify that I have completed the above information and that it
,complies with t innesota State Energy Code.
Signature
? Date: q
-
uao ,C/ 9?
EW sECEiPT rl ?67td /
:C.'•.IPT DATE /-?,/J/nQ
zx TE l/-zz, --5e.
m
JaH
ou xM
?T..c.15G 3E ADVIEe^,D :':iA; ^rWE IS A M SiiGRTAGE dH THE AHOVE
r..e."C:RICAL 2NSTALI.?:'IQN IN i'!E A2IQUHT OF $ 2n cc
SHORTAGs^. lILST 3E ?AID WHIT!iIN i4 ?AYS.
REYARXS
) '_'O ?? 31IID. C_:CU'_C5? („?
31 co ?OQ amo. circuicsa
0 eo 100 amo service=
? :01 to 200 amo. se-vice= Zc
PEBMIIit hC,
OBIG. BE??IPT;t ? c???a7 _-
RECEIPT DATE
BETU?tN A COPY OF TI3I5 FORM WITH REMITTANCE.
_ TOT.tL "E' DUE- j ?L
RESIDENTIAL BUII.DING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
STo.oo
(yl ID3-
New ConsWCtion Reauirements RemodellRaoair Reoui2menls Office Use OnN
3 registered site surveys showing sq. ft cf lot, sq. tl. of house; and all roofed areas 2 wpies of plan _ Cert of Survey Recd
(20% maximum bt ooverage allaved) 1 set of Energy Calculatbns for healed addilions Tree Pres Plan Recd
2 copies o( plan showing beam 8 windovr sizes; poured fouM design, etc. 1 site survey for addi6ons 8 decks Trae Pres Not Reqd
1 set of Enargy Calculations Addmon - irMkate if onsite sepBc system _ On-site Seplic Syslem
3 cooies of Tree Pmsenatbn Plan if lot plafled after 7/1/93
Rim Joist Detail OpUons selecUon sheet (61dgs wAh 3 orless units
Date
Site Address y z?r Cqj[)tih(( L 1 Construction Cos J
UnitlSte #
Description of Work M??6,{/tCN I
Mu1G-Family Bldg _ Y?- N Nireplace(s) _ 0 '4 1 _ 2
ProperTyOwner ?\/r.(`*V?l? ?-JAf`? `?
? DJC2? G/9'GE Telephone#(oS?) 6??
Contractor
Address ?5??1 ? b!1lQC'r(=t,.?f}l"EK
State {/12{U • '?•
Zip5'533'?V City
Telephone#(75Z
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventllatlon Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope CalculationS.S i
Licensed Plumber Telephone #( ?
:
Mechanical Contractor Telephone #( )
Sewer/WaterContractor Telephone#( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a
permit; that the work will be in accardance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Narne ? kpp4i6nVs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 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 ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
X 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const 1//U
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Fommdation
Drain Tile
Roof Ice & Water Final
I Framing
Fireplace ?/ R.I. f?Au Test \?Final
Insulation?-
?` T
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
42 3-Y4
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinallC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
OWer
_ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
?-- ,
Approved By
------------------
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
`Demolition (Entire Bldg) - Give PCA handout to appliwnt
Building Inspector
2, a vv
/70
?
REQUEST FOR ELECTRICAL INSPECTION Lea-/oo/o?aiq-os?
? See nstruEtions for =ompleting ihis form on back of yellow mpy. ?l?V 6?o d?
"X" Below JNork Covered by This Request ?,.
Ne Add Rep. Type of Builtling Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./lndustrial Furnace Other (S ecify)
Farm Air Conditioner
Olher (specily) Conlraclor's Pemarks' xzl-
L!
1
Compute fnspection Fee Below: .
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 ro 200 Amps - O / to 100 Amps 7
Transformers Above 200-Am ve 700 _Am s
SI nS inspecmrs Use Only: TOTAL
-
Irrigation Booms ? •? 9„s, 5
z)
S ecial Ins ection
Alarm/Communication TNIS I TAL E ORDERED DI5CONNECTED IF NOT
Other Fee COMPL MONTHS.
I, the Electrical Inspector, hereby
if
h
h Rouqhin oate
cert
y t
al t
e above inspection has
been made. Final Dale?
OPFICE USE ONLY -
This reyuest voitl 18 monlhs Irom
0-10?-
3 ?7v?nI?'
?
?
G / d_n 0- Jc o
fiBq est Dal
Z
? Fira No. Rough-In Ins Requiretl
(YOU u t ceil inspector hen reatly) Ins ection Olher Than Rougn-In
Reetly Now D Will No&gspeclor
^ ves N. Oate Read
I?licensed contractor ? owner hereby request ins ec ion oab e electric w ?
Job Address (Slrrel, Box or Route No.) City
? W f_4L COWTIT ?
Sedion No. Township Name or No. Renge No. Coun -
Occupan?(PRINT)
`7?-,H? ?sr??? s 4?NST, Phone No.
ssa-
PowerSupplier Address
ElecMcal ConVador (Company Name) ConVaclor's License No.
U vlv SO
Mailing Atl
tl
re
ss
(COnVa
c
ior or Owner M king Installa?ion) ?
?
-
-(
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v
Aulhonaetl Siapalure Ut/O Meking Inatallalion) Phon i
? ? ?O'T OIJ?J
ICRV
er 99UNVersayy AOe, bY oP m?MNe 5104 II (I I I II I I II I I I I I I III EUNLESS NClOSEp. aul, OP ER NSP CrTIONFOEE 6
Phone (612) 602-0800 u
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119001
Date Issued:11/13/2013
Permit Category:ePermit
Site Address: 4284 Gadwall Ct
Lot:19 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Cynthia J Swan
4284 Gadwall Ct
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146991
Date Issued:11/29/2017
Permit Category:ePermit
Site Address: 4284 Gadwall Ct
Lot:19 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-190
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Cynthia J Swan
4284 Gadwall Ct
Eagan MN 55122
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(952) 985-6675
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159033
Date Issued:11/18/2019
Permit Category:ePermit
Site Address: 4284 Gadwall Ct
Lot:19 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-190
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Cynthia J Swan
4284 Gadwall Ct
Eagan MN 55122
(651) 206-9775
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 745-1400
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159884
Date Issued:01/27/2020
Permit Category:ePermit
Site Address: 4284 Gadwall Ct
Lot:19 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-190
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Cynthia J Swan
4284 Gadwall Ct
Eagan MN 55122
(651) 206-9775
Brigley Roofing Inc
13585 Gardenia Path
Apple Valley MN 55124
(651) 458-5760
Applicant/Permitee: Signature Issued By: Signature