4288 Gadwall Ct?
wemficate ot cccupanc?
cqtv of @*gM
MeorrtueNt of Owttihgg 3ub*ft*oa
Ais Certificate issucd pursuant to tltt nquinrirents of the Uniform Building Code
certifying that at the time of issuance thes srructun was in compliance with the various
ordinances of the City negulating building construction or use. Far the following:
Use Cbssifkaim: SF DWG/GAR B? ?t No 27395
00-m-r TYre R-3 U-1 zm;os niswxc R-1 Tya cow. V-N
0wnerofewWWg REITH'S KUSTOM BLDR4Ad.. 9039 18TH AVE.$., BLOOMINGTON,HN
Bwming 4288 GADWAI,L CT L18, Bl, MALLARD PARK 4TH 55425
19 9 ?
POST IN A CONISPICUOUS PLACE
INSP
CITY OF EAGAN
3830 Pilot Knob Road
' Eagan, Minnesota 55122-1897
? (612) 681-4675
? SITE ADDRESS:
MAt 1 ?ikl? f'Altl: ?1 1N
PERMIT SUBTYPE:
- 1, .
TYPE OF WORK:
INSPECTION D. . D.
. H I Nts ri
ira',111 r. I I?,t? ; i;??;;••??
('If11l1r' I??
1 1 N HI I
? RII'??IRKJ ! j'}?V
F
L_
t.f P I !?h M A I ! iIF lJ liAw t I 1 1, 1•I Hri
TION
;CORD
PERMIT TYPE:
Permit Number:
Date Issued:
f3 i) 1 t(1 1 Mi
c?q f???lwi
f ridf ? t APPLICANT:
fel n( K : ?
cri?_A t ?.+t-r?/n'•
a
Permit No. Permit Holder Date Telephone #
ELECTRIC l
PLUMBI G
HVAC
Inspectlon Date insp. • Comments
FOOTINGS ?v a
7 ai4 l
FOUND
/
oZ+
FRAMING
Z
??•-??
ROOFING
FOUQH
PLUMBING ?? •
PLBG
AIR TEST
ROUGH
HEATING
?l !
(?
GA$ SVC
TEST G/ ? Q
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
!!
FINAL PLBG
FINAL HTG (( q
ORSAT
TEST
BLDG FINAL o ?
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FlNAL
Addtess 4288 GADwPI[.L cT Zip 5512 ?
Lot 18 Blk 1 Sub MALLARD PARK 4TH
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'fON.
Date: ? a Yes No Inspector:
Final grade (6" from siding) t/
Permanent steps (garage) e/
Permanent steps (main entry) LIl
Pertnanent driveway
Permanent gas {/
Sod/Seeded grass v
TraiUcurb damage ?
Porch ?
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of wacer supply to
the outside lawn faucet before freeze potential exists. .
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - ResidOnt Copy Pink - Contrector Copy ?
PERMIT# 49 /(s A RECEIPTDATE:
2002 MIDEPI7lkL PLUbBIAfi PERM1T ALPP11CATlON
crrY og EAsAuv
3830 PI.or xrtos itn
fnehx, Mv 55122
651-6$1-4675
Please complete for: single family dwellings, townhomes and condos when pertnits are required for each unit,
backflow preventer for irrigation system _
SITE ADDRESS
OWNERNAME:: TELEPHONE#: Io,SY la8'/ •000I
(AREA CODE)
INSTALLER NAME: _ TELEPHONE #: (o,S/ •14730
/? (A.°.EA COCE)
STREETADDRESS: /+„r?qp (?kkA."IW1L llnsy,
CITY: ?,t t {^ STATE: 762_ ZIP
_ SEPTIC SYSTEM, new/refurbished (requires lwo sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
? Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter'rf needed -$118)
Other:
_ RPZ: new installation/repaidrebuild $ 30.00
_ 18v4•fi i;;Igafloil SystP.fTi
Replacement/additional: _ water softener _ water heater $ 15.00
State Surcharge ? $ 50
Total .IAN 2 82002 $ Sb.10
I herebyacknowledge that I have read ihis application, state that the informalion is correct, and Lagoge-o-m2ly m ' ity of ?agan ordinances. It
is the applicant's responsibiiity to notify the propeAy owner fhat the City of Eagan assumes no li ages cause y the City during its normal
operational and maintenance activities lo the faciliHes wnstructed under this permil within qty propedy/tght- -yitrqkVAment. ,
SIGNATURE OFPERMITTEE ? ?l/?2
PERMIT W056 ;rj?l
• CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B u x Lo i NG
Eagan,MinnesOta55122-1897 PermitNumber: @Z7395
(612) 681-4675 Date Issued: 0 4/ 2 9/ 9 6
SITE ADDRESS:
4288 GADWALL CT
LOT: 18 BLOCK: 1
MALLARD PARK 4TH
P.I.N.: 10-47253-180-01
DESCRIPTION:
Building?,Permit Type
'Building W'o.r.,k Type
UBC Occupapey'?L
Construction Type
Zoriing
Building Length .?
Building Width
'S'q.tia,re Feet{-\_,J'
SF OWG
NEW
R-3 U-1
V-N
R-1
67
50
2
2,449
191 1 - FAM. pETACH
R
,. _
J
REMARKS:
PRV, 5& W pLBR - MATTHEW DRNIELS PLBG
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SFlC %
SAC Units
Subtotal
$1,267.25
$633.63
$88.00
$900.00
100
1
$2,888.88
$176,000
MISCELLANEOU5 $1.923.50
Tvtal Fee $4,812.38
CONTRACTOR: - Applicant - sT. LIC.OWNER:
KEITH'S KUSTOM BLDRS INC 14236762 2004941 KEI7H'S KU570M BLDRS INC
9039 187H AVE S 9039 18TH AVE S
BLOOMING70N MN 55425 BLtlOMIN6TON MN 55425
(612) 423-6762 (612)854-5782
I hereby acknowledge that Z have read this application and' state"that the
information is correct and a'gres to c'omply with a11 applicable State of Mn..
L SCatutes and City ofi, Ea;gan Ordinances. ?
zo/ _? . I_
APPLI ANT/PERMITEE SIGNATURE : IG U E .
CITY OF EAGAN r? i( ? I r?,4J?
3830 PILOT KNOB RD - 55122 ??11986 BUILDING PERMIT APPLICATION (RESIDENTIAL) t;U•?` "??
-- A p?„? 29
681-4673
New Construdion Reoulrements
? 3 reghtered ske eurveys ? 2 copies of plan
? 2 oopies of plans (inGude beam 8 window eizes; poured fid. design; etc.) ? 2 site surveys (euterior adddions d dedcs)
? t energy calcNalione ? 7 enatgy ealculatlons far heated eddilions
? 3 copies of pee p rvation plan R bt platted after 7l1193 , requlred: ?Yea _ No
DATE: CONSTRUCTION C05T: 200 006 ?
DESCRIPTION OF WORK: S1N4iK
STREET ADDRESS: C7-
LOT ?S BLOCK ? SUBD./P.I.O . #:
PROPERTY Name: 4717k Phone #: BSf -S?Bz--
OW1\G ,1CR .
?
" fqer
?'
?
Street Address- 1?39 /B ?
•
f
_ City: .Q/AaMirartw State: Zip: - S54-z?
CONTRACTOR Company: 47-f#S 43retc ..Ja?phone # : B'sg'S7 2
-
p a4o- ?'?sv
2
'
?
Street Address: 9a3 y!B 5?, License 04q412-
#• ;
,-
city: i3Co?w?r?? State: PN zip• $s`?1 f
ARCHrrECT/ Company: Phone #-
ENGINEER
Name: Registration #•
Street Address•
City: State: Zip:
Sewer & water licensed plumber: ?ATI"JfL? ut"itn-s iy? . Penalty appiies when address change and lot
change are requested once permit is Issued.
I hereby acknowledge that I have read this application and state that the inform?is correct and agree to comply with all
appiicable State of Minnesota Statutes and Cily of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY ? ?-, ? ??? ??/ p ?
Certificates of Survey Received - Yes N APO 2?
Tree Preservation Plan Received Yes _
OFFICE USE ONLY
BUILDING PERMIT TYPE
?, . ,_.r .....?
? 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
?02 SF Dweiling o 07 4-plex , 0 12 Multi RepaidRem. ? 17 Swim Pool
o. 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
? 05 SF Misc. 0 10 _-plex o 15 Deck
WORK TYPE
,Ef"31 New o 33 Alterations ? 36 Move
a 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? Basement sq. ft. IF6? MC/WS System
Main level sq. ft. /?i 39 City Water ?
IZ-3 sq. ft. 902- Fire Sprinklered
Il-/ sq. ft. PRV YES
2 a'r?s?r, sq. ft. Booster Pump
. sa sq. ft. Census Code. lo/
Sb Footprint sq. ft. ?N SAC Code
d
0
P
? Census Bidg
it
U i
/
WI h?
? ?
?? n
Census
tiY
_ Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Valuation:
/YlA/R/
_.?--
$ o? Ih - / 7s
Z =5,1-57
yXi7. zg = !09
zX s ° /6,
ZZy SS=73 ' /, 2-l7
.
?o ?, 7S• 7 J
3s3
<z???
?---
s`/ :
/, (v 91 x
2 ?=
-
?
l?-s?x Y?i
.. 2 27 .
...?-
Total:
% SAC
SAC Units
9oz ?5 ?=
CQ ?'
,?3x ly = y
23x 3 z = 736
/ x Z°
S
. 33 ?c /Y ?--
7( rr `----
Z Z yo
/?- _
,
t? AS?MErI"5'
T,r-, gSs 0-
MPO
4 /?
U44, ?( W
7 Q
J , h?
vt
. ?
?O
?q4C)x? ? i
??G
ViE
r
tY
X
k
' I -
0
?
S ,Q
.?
`
i?
am?:
Q
a \9 ?
0
??- ? 957. 7
EL..? ?49..?c+:
?
? of?
-
17 Ex ?' a?ai
? ?
lrl -?• X -?
5
1410 p -jig
? M V!
M ?
_ D A. N
t?e ? 3
4.0
Ih ?
5 740B: a ?
?40??
4 'n
10
?
? 5 N ?1t
a ? 19,?? 5 ? : v ??.
0
.
aZ ?AC-C '+ +?r G? ?ao ` ? Otn
-Vo
-S-e.-ALr- ?N.= :5p1
At-t. %C1XR1945 . ASSvAAED
obEKnTPEs ?RbN Mo*IUMENT
????.1 !o
4 -rH Aotit??a•??
DAtLC-=A CaU1?1TY?
M1N t?b4? 5M'A
-I
T he.reby certify that this survey was prepared by me or
unde.r my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State of Minnesota.
Date: ?nrTV_ZC7?,[??v ?'?__
T,eRoy ;3! Bohlen
RegYSteced_L3nd Surveyor No. 10795
.. FAGAN
;. ?l4 rZ"?
530 PO1 HFP 21 ' 96 'D: Sci
•` ? ?, -[ ' J 1 U L
. LOT SURVEY CHECKLIST FOR RESIDENTIAL
ILDING PERMIT APPLICATION
PROPERTY LEGAL: ?I
DATE OF SURVEY: ?
/LCI ? q G
?
LATEST REVISION:
a DOCUMENTSTANDARDS
E3
- 0 • Registered Land Surveyor signature and company
@K
0
' 0 • BuiidingPermitApplicant
W"
13 ? • Legaldescription
e--'o 13 • Address
? 0 • North arrow and scale
? C3 • House iype (rambler, walkout, split w/o, split entry, lookout, etc.)
9--' 13
0-?o 13
0 • Directional drainage arrows with slope/gradient %
?
? • Proposed/exissting sewer and water services 8 invert elewation
?
o? ? • Street name
? • Driveway
ELEVATIONS
6dstina
0 0
ff??P 0 • Sewer service (or Proposed)
3?"O o
? • Property comers
• Top of curb at fhe driveway
o ?o • Elevations of any ebsting adjacent homes
ro os
0 • Garage floor
ZI'o 13 • Frst floor
W ", 0 0 • Lowest exposed elevation (waikout/wlndow)
121?'13 0 • Propertycomers
??O 0 • Front and rear of home at the foundation
PONDING AREA fif aoolicable)
13 0 • Easement line
? • NWL
13 C1 ?
0 0 • HWL
0 cr"? E3 • Pond # designation
• Emergency Overflow Elevation
DIMENSIONS
z'o o • Lot IinesBearings & dimensions
C?--o 13
? • Right-of-way and street width (to back of curb)
? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
? porches, etc. (.e. all strudures requiring permanent footings)
• Show all easemenls ot record and any Cfly utilities within those easemenis
?? • Setbacks of proposed structure and sideyard setback of adjacent exdsting structures
0 0 • Retaining wall requins, if n
remer
V(
`--- Rehewed:
)
Jenuary 7996
au1c1eWE.ocanW.FM
j? T C
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?.
f
: EE
> E" P,EDUCER
i?qTE URLVE
is
5?5.6
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6
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? 946 5
. S-l+4B
s-c-so 23 951.0
°:i5.8 5-0+42
943.0 2^l
25 24 1 6"-1i32 BEND ?
r-HYnRRNT
x o" tEE HYDRflNT
S 95035
?
n
MH 7
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s-:+20 s-o+qe 20
937.0 ` 942•5 t 9
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- N. S?DE OF WOOI?GATE LN.
:h,HOUSE N0. 4318
7-94w
fZf/FU./?'D P? 479 AO&M'"'
tar /8 B1X 1
J4WWdf7P,: /6777/ 11*W4`
!??l?`?jax. s 477? J 4s7-PA(
9039 So.
!3?'/?D??/N?a?'^? ? NW ?s
f752- (OPA4,r?)
,
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AO=T AN
SITE
REVIEW'ED
uURi/EY
TREE
r
AGA? FO?G?'J?°? ???3???
?By
QP
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suMMAW
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3 '
ONE AND TWO FAMILY
EN$RGY CALCULATIONB - AVffiRAGE "U" COMPUTATION
OWNERs REITH HANNABCH SITB ADDRESSt EAGAN DATE: 11-24-9iV
C.ONTRACTOR: V.W.P. CALCULATIONS SYsHOFFMANN YHONE: 451-1019
Determine wo[kinq equare footage of each that applies.
1. Total exposed wall area .............3798.6 6q.
2. Total roof/ceiling area .............1593.5 eq.
3, glqors over unheated space.......... 0 sq.
4. Roof/ceiling arca (no attic spaae).. q sq.
5. Unheated slllb oA qrade .............. Q aq.
6. soated elab on grade ................ 0 sq.
ft, x 0.110 -417.85
ft. x 0.026 - 41.43
ft. x 0.050 - 0.00
ft. X 0.026 • 0.00
ft. x 0.160 - 0.00
Ft: x 0.120 - 0.00
TOTAL ATOOD WALL AREA 3001.89
a. Total wall evindow drea........... 128.09
b. Tntal 8oor area.................. 20.00
c. Total glass door srea............ 35.60
a. xptmi fitaplace wall area........ 0.00
e. Total rim joist erea ............. 277.08
€. Total wall framinq area.......... 254.11
g. Total net wall area above floor.. 2287.01
TOTAL E%POSED FOUNDATION AREA 796.75
h. Total foundatfion window area........... 0.00
i_ Total net foundation etee ebove grade.. 746.75
J. Total unheatad slab on grade area...... 0.00
k. Tbtal heeted elab on qrade,area........ 0_04
Determine ^v^ valua of each wall aegraent
a,
128.09
x
"U"
0.360
- ?
46.11
b. 20.00 x. ".u" 0.070 - 1.40
c. 35.60 x "U" 0.360 - 12.82
a. 0.00 x ^u^ - 0.00
¢. 277.08 x "U" 0.043 • 12.03
f. 254.11 x "U" 0.106 - 26.95
9. 2287.01 x °U" 0.046 - 105.93
h. 0.00 x "U" - 0.00
i. 796.75 x "U" 0.062 ? 49.24
J. 0.00 R Mv^ - 0.00
k. 0.00 x "U" - 0.00
7 ............................. .......... TOTAL - 254.48
If item #7. iR the same na, or less than item #1, you have meet the
intent of sSC 6006(c)2.
NOT1Ce FpUNDATION WALLS
Fu11 basement (Rambler) entirc ext*rior wall must he aot less than
R-5.
flalf baseiaent (Sglit goyer) entfre eaterior vall must be not lesa
than R-10.
TOTAL EXpOSED ROOF/CEjLING AREA 1593.57
1• Total skylight area „
m. Total roof/.ceiling framing.area.......,
n. Total net ineulatea roof/ceilinq area..14159-357
34.213-
Determine "U" value for each toof/ceiling teqment.
1. 0 xnUn
M. 159.357 x"p^ ? 0.00
n. 3434.213.x^U^ 00.028 • 4.53
.025 0 36.05
8 . ........ ...................... ? •..,...Total = 40.59
If tha total of #e is the same as;•ot le6s thaa #Z, you have met
the intent of shc 6006(c)I,
To ut311xe the total snvelope sy6Eem Mothod, ths values
establi?hed by tha sum of 3tems #7'and 86 sha12 not be
greater than the sum of items ?1 and #2,
WALL SECxIpNS
nuk. 1/it
WALL FRAMyNC, AREA CONSTRUCTION?
1• 1nY,erior air film
3. 5,1/2i?phes dsoft
4• 7/16" DSS wood
5. Vinyl SidYng
6• Exterior bir film
Total
"U"•Value
NET WALL AREA AgpyLP FLOOA
1• Interior mir film :
3. FJGninsp. ad. `
4. 7/I6" o8s
5- vinpl siair,g
6• ExterioC air film,.
Total
qAlue
RIM JOI&T AREA
1. Interior air film
2. F/G Ins.
4. 7 ?2" g?ftwood..
/1" b
5. Vinyl 8id4ng
s. Exterior nir film
Total
°U" Value
R-Value
0.68
0.45
6.84
0.67
0.62
0.17
9.43
0.106
0.68
0.45
19.06
0.67
0.62
0,17
21.54
0.046
0.68
19.00
1.89
0.67
0.62
0.17
23.03
0.443
FOUNDATION AREA ABOVE GRADE -
1. Snterior air gilm" 0.69
2. F/'G Ineul. 13.00
3. 10" Conc. Blk. 2.33
4.
5. ..
5• Exterior air film 0.17
Total 16.18
"U" Value 0.062
AOOF/CEILIIVG FRAMING AREA
1, InCerior air fi3m 0.62
2. 5/8" Gyp. Bd. 0.56
3. Cord depth 3_1/2- 4.30
4. In;gulatfon 29.00
5. L"xterior azr fflm 0.61
Total 35.16
"u" value 0.028
ItQ$ULATED ROOF/CEILING AREp
1, interior air film 0.61
2. 5/8" Gyp. ed. 0.55
3. 2nsulation 38.00
4• Exterior aic film .: 0.61
Total 39.78
"U", Vdlue 0.025
70TAL P.03
L? gL ? CITY USE ONIY RECEIPT #: 5704-L
DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAM
3830 PILOT KNOB RD
EAGAN, MN 551::2
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH ?Q TOTAL
Shower 3.00 x %3_4v
Water Cioset 3.00 x -? _ 9-00
Ouat` Tub 3.00 r. /1-0110
Lavatory 3.00 x ?? _ .CSDO
Kitchen Sink 3.00 ;c / _ ?3 oD
Laundry Tray 3.00 ;c
Hot Tub/Spa 3.00 ;c =
Water Heater 3.00 ;c 2-zio
Floor Drain 3.00 :c _L = 3.OD
Gas P'iping Outlet' minimum - 1 3.00 :c
Rough Openings 1.50 x
Water SoRener 5.00 .c =
Private Disposal ` Dakota Cty. Iicense 65.00 =
(new and refurbished systems)
U.G. Sprinklet ' home under const. 3.00 =
Afterations ' to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS: 4298 Gad-all Can-t
OWNER NAME: Y991th'5RxkTWffi?s
INSTALLER NAME- -Vauhew Drdels, JIM.
STREET ADDRESS: my
CITY: RsWrxnt STATE: m ZIP;
PHONE #: ( 612
CITY USE ONLY
RECEIPT
SU DATE: ?3 9?°
L "itj?
1996 MECHANICAL PERMIT (REStDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675
Please complete for: . single family dwellings
? ? townhomes and condos when permfts are required for each unit
New construction Add-on furnace
Add-on air conditioning Add-on air exchangerr, i.e. Vanee system, etc.
Date:
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) (0,00
? State Surcharge .50
TOTAL a 62
OWNER
STATE:?_
5Z(A
SITE ADDRESS: -i ? wty `'xadwau rlw?
/ CITY USE ONLY ,y`/6
V L ? BL ? RECEIPT#: /7'7SO
SUBIJ(??? RECEIPTDATE: ee'?` 97
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete fo??single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkier system
FIXTURES EACH N,Q, TALY
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 -1 3.00 x =
Rough Openings 1.50 x =
Water Sottener `Por dwellings under construction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
II.G.Cprinkler `ftrdr_!lingunderxn=_t. 300 =
U.G. Sprinkler 'forezistlngdwelling 20.00 = c?c).a e.7
Altefat10n5 ' to existing residenoe 0.00 =
Water Turn Around 20.00 =
Private Disposal System ` Dak Cty lit. 75.00 =
(new and refurbished systems)
Prixate Disposal Systems * Abandonment 20.00 =
STATE SURCHARGE .50
S-2)
TOTAL
I hereby aGcnowletlge ttiat i have read this application, state that the iMortnation is cortect, and agree to compty wkh all applicable Ciry
of Eegan ordinances. It is Me applicenYs responsibility to notity the property owner thet the City of Eagan assumes no liability for any
damages ceused by the Ciry during ils nortnal operatlonal arW maintenance adivities to the facildies conshueted under this permd within
City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: TELEPHONE #:
STREET ADDRESS:
CITY: ?i? STATE: f1/v ZIP: SS/d-a
.
SIGNATURE OF PERMITTEE
6 ,-30-g 2 be
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
1 ? G 3830 PILOT KNOB RD - 55122
C 651•681-4675
NewConsWCtlonReauiremeMS RemodeVReoalrReauiremen
• 3 regislered sita surveys showiig sq, fl. of lot, sq. @. of house: and a-Ji roofed areas • 2 coples of plan
(20% maxMum lot coverage allowed) • 1 set of Eneyy Calculalians for heated additions
• 2 copies of plan showing beam d window s¢es; pournd tound design, eta) • 1 site survey tor exterior additions & decks
. 1 set M Energy Calculations . IiMicate if home served by septic system for additiore
• 3 copies af Tree Pmservation Plan iFlot platted aRer 711/93
• Rim Joisl Detad OpUons selection sheef (bldgs with 3 or less units)
DATE
VALUATION oc" _
JOB SITE ADDRESS q2_6S L/wW'fw 60K4r
IF MULTI•FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER T11??L
TYPE Of WORK13Av^crpll'f HN?s?
APPUCANT ,/ ? K?I7-#s 4eP`L
J?v
FIREPLACE(S) _ 0 _Z1 _ 2
PHONE#
q5'L- 274 -y516
ADDRESS 2-6`130 k4-)6 ?e- 1?4o?C GAe,?r ZIPCODE 55-372--
PAGER # CELL PHONE # G/L 4?"_OL? FAX # 95z - Z21, - y3i0
rrEw RESIDENTIAI BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventila6on Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULE5 7672
New Energy Code Worksheet Submitted
Plumbing Confractqe _
Plumbing System Tncludes:
_ Water Softener
_ Water Heater
_ No. of Baths
Phone #:
Lawn Sprinkler
No. of R.I. Baths
Mechqnical Contractor:
Mechanical5ystem Includes: _ Air Conditioning
_ Heat Recovery System
Sewer/Water Contractor.
Fee: $90.00
Phone #
Fee: $70.00
Phone #
All above information must be submitted priar to processing of application.
___1<.4_
_2?_
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all opplicable State of Minnesota Statutes and City of Eagan Ordin S.
Signafure of Applicant
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? Ot Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
O 05 03plex
? 06 04-plex
? 07 OSplex ? 13 16-plex
? OH 08-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 1 D-plex 1$? 19
i? Lower Level
? 12 12-plex Plbg Y or _ N
? 20 Pool
? 27 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessary Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - S F
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
'?( 33 Alteretion
i? ? 37 Demolish (Btdg)` ? 43 Reroof ? 46 WindowslDOOrs
? 34 Replacement 'Demolition (Entire Bldg onty) - Give PCA handout to applicant
Valuation 67va 0 Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr, of Bldgs Length Fire Sprinklered
Type of Const VI't/ Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck) FinaUNo C.O.
Footings (addition) Plumbing
?
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
Eraming
Fireplace 4 R.I. CAirTest ?Final
Insulation
_ Pool _ Ftgs _ AidGas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
P,pproved By rZ , Building Inspector
?
Base Fee
Surcharge
Plan Review
(?-R
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Jther
Total
FinaUC.O.
,
JiL coo'p-5
9? REQUEST FOR ELECTRICAL INSPECTION EB-00001-09
Sea inalmMions ror completing this fortn on back of yellow copy. $", y
?O Q V1 ?] 19 3 ???
'"X" Se/ow Work Covered by This Request N,„;•a?
N Add Rep. Type of Building `41111Appnances Wired Equipment Wiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other Specit )
Farm Air Conditioner
Other (speci(y) Conttector's Pemarks'
Compute Inspection Fee Below.,
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool
0 to 200 Amps -40
:
(
0 to 100 Am s
Transformers Above 200_Amps Ab Amps
SignS inspecior's use oniy: OTAL ?
Irrigation Booms ?
(,v
Special Ins ection `
Alarm/Communication THIS INSTALLATION MAY ORD NNECTED IF NOT
Other Fee COMPLETED WITHIN 1 TH
I, the Electrical Inspector, here6y
certify that the above inspection has
been made. R°uyn-m ?
?
. oaie
o?
OFFlCE USE ONLV
This requesl voitl 18 manths trom
)Q
(93 2 ?/05
Request Date IN ?
? ?? ? Fire No. Ro Inspeclion Requlretl
(Youvst cali inspecmr when reatly) Inspection Other Than Rough-In
? qeatly Now U Will Notity Inspecmr
Yes ? No Da[e Featl
IKlicensed coniracfor ?owner hereby request inspection of above electrical work at
Job Atltlr¢ss (Sireet, Box or Rome No) Ciry Elt
"I G?.?w t •
Section No. Township Name or No. Range No. County
Occupant(PRINT),
?'fh s s
,'Id{rS Phone No.
PowerSUOPlier
PaKo <
<< Atldress
4?30o ao?
-} W- ?acm? }?n
Electdcal Conhe or (COmpany Name) ? Conhaciore Llcense No.
'
er ?c lc ??tJc. oala
C
Malling Atltlress (Conlraotoe or Owner Making Install i
133 f8?o2L?' on)
L.4.
(Yl aV -
Authodzetl Signatvre (COnirecim/Owner Makl Installatlon) Phone Number
MINNESOTA r Gr gga-Mldway 8 dg B Room "5-128ECTRIC 7
1821 University Ave., SL Paul, MN 55100
BN ESSEPROP ER INSPECTIONBOE D
Phone (612) 602-0800 FNCI OCF[].
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA106774
Date Issued:09/11/2012
Permit Category:ePermit
Site Address: 4288 Gadwall Ct
Lot:18 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-180
Use:
Description:
Sub Type:e-Reroof
Work Type:Repair
Description:House & Garage
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.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
ARIC JOHNSON
4288 Gadwall Ct
Eagan MN 55122
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125565
Date Issued:07/28/2014
Permit Category:ePermit
Site Address: 4288 Gadwall Ct
Lot:18 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-180
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 .
Derek Holje
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 -
Aric Johnson
4288 Gadwall Ct
Eagan MN 55122
Shingle Creek Construction
333 Washington Ave N
Suite 300
Minneapolis MN 55401
(612) 524-7066
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA149745
Date Issued:06/07/2018
Permit Category:ePermit
Site Address: 4288 Gadwall Ct
Lot:18 Block: 1 Addition: Mallard Park 4th
PID:10-47253-01-180
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 -
Aric Johnson
4288 Gadwall Ct
Eagan MN 55122
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
r-
For Office Use
; i • Permit#:
E AG N
q7 OD
Permit Fee: }�
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 �E'VE
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-56 s Staff:
buildinginsoections@cityofeagan.com p� 9 20
2020 RESIDENTIAL BLit _ ►' IT APPLICATION
Date: Site Address: Unit#:
Name: -✓blC l it� �7��5c , Phone: (0S1-3A4—
L3,
Resident! ( egg • am`t G
Owner Address/City/Zip: t V
Applicant is: Owner , / Contractor /-76/ Y
Type of Work Description of work: reMOVe OtA t C °' I0i t.t 1R h0.1) [1-1-1( l6 w 54a IYS'1-h2,i,CCo 4 '
Construction Cost: Oa I (P541Multi-FamilyBuilding: (Yes /No
Company: 4 t oNQI4 711, Xi CGS- Contact: 1‘444
Address:9 a5((a NQ -5 City: `y t
Contractor (jl01
State>l"rk Zip:5 ` T Phone: C2`G 7& Email:AA 11.11 q,tl i Sf (4.0v `pi—z)
` rNF I -COI
w•` L`
License#: bc. I y Sb Lead Certificate#:
If the project is exempt from lead certification, please explain why:
INAS& b t+- ac tot-7 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:
Fire Suppression 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.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeagan.com/subscribe.
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.
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.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will b- ' forma ce 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, an,, wo' is o/• .tart without a permit; that the work will be in
accor anc wit the ap oved plan in the case of work which requires a review and approval i f pia
x `L !
Appli ant's Pri d Name Apilr's S s to e
DO NOT WRITE BELOW THIS LINE Gf�Bg 61461w 14 1 I � /16j_J 7
SOT1�
B PES
' T Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi -P Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
X Replace _ Repair Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation g S,reo Occupancy _(-L— MCES System
Plan Review Code Edition 201e) "MARC SAC Units
(25%_ 100%X) Zoning A-1 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
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 Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof: _Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In Air Test _Final Siding: Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee P\q ) (� 11'
c�G� 01 `J� . `"' new
Surcharge
Plan Review Te�� + Pew h oi't^ 5s
MCES SAC
City SAC �7
Utility Connection Charge D«L /7K X /t ` 2 7 1
S&W Permit&Surcharge _
Treatment Plant 1.0A ^)� 3 x 5 ` /5
Radio Meter Read '"" ----- It
�7,,/
Copies 2,q7 /S ' 505
TOTAL
Page 2 of 3
, . . /6
/ 1? 7
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srA v
, ., \ GP
1.6* 1 1 ti S 41
, - - -3\404
r
:gist.
Property lines to be verified
.- by contractor/owner.
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I hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State of Minnesota.
LeRoy . Bohlen _ -_- -