4333 Lodgepole DrCITY OF EAGAN Remarks
Addition Evergreen Park Lot 25 Blk 1 Parcel 10 24880 250 01
oWner k.e-LC,--) Street 4333 Lodgepole Dr. State Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK .1/
SEWERLATERAL '
WATERMAIN
WATER LATERAL .
WATER AfiEA
STORM SEW TRK 323.00 C005511 8/6/80
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGNT
WATER CONN. 6425
HUILOING PER. 28 8
sac 240,00 11 12- 0- 2
PAR K •
- ::
1072 Payne Ave. St. Paul, MN 55101
651/772-2449
GAS WORK ORDER . '
STANDARD 410 W. Lake St.
b HEATING o Minneapolis, MN 55408
s6HEATIN & AIR CONDITIONING 612/824-2656
A Blue Do0 S i C
? . ervce o. EQUIPMENT INFORMATION
LAST FIRST /r, c?? ?f? TYPE
CITY stJ ZIP
HM PH ?o?? - WK PH
TECH L? ?2,., DATE
? MAKE
? MODEL
SERIAL
INPUT
O AT TEST RECORD ..,,
C02 S d % METERED INPUT CfFI CHIMNEY 1Y,QE
.02 % LIMIT SETTING ° FLUE SIZE ? S ifl.
CO °k PILOT OUTAGE i,/s7,4,<rrsec CONNECTOR SIZE
in.
NET STACK TEMP /// 0 TOTAL CHIMNEY INPUT " btUh
?
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ----...`?..........!---------------- --•----- ...........
Address (Pneseni) &;;':.7-°---.... L .......... d¢ 9 .................
Builder .......?--.......•••••....----°-°
- .....------------------------------
Address .........
DESCRIPTION
xO# 2838
Eagan Township
Town Hall
9-i?- 7Z
Dale ....
-..........................................
5YOrias To Be Used For Fzoni DepYh Iieight Esi. Cos! Permi! Fee Remarka
,A-?-? "_"" ? I I al' 00
S
' 9
°? ?
?
r?
I??
LOCATION 3-& , "
SirBel, Road or oiher DescripYion oI Locafion I Lo2 81ock Addition or Trac!
-?3 3,3 A-ZJ
This permit does not suihorue the use of streels, roads, alleys o: sidewalka aor does it give the owner or his ageat
the righi !o erea3e aay situation which is a nuisaace or whieh presen2s a hazard !o the health, safeip, convenianae and
general welfare !o anpone ia the communifp.
THIS PERMIT MUST BE- EI$, P?TON THE PREMISE WHILE TIiE WORK IS IN PROG ESS.
This is !o terlify. !ha!•-•-•••••....................... ............................. has permission !o erect a-- • -------- _upon
- -- • - •
the above described premise subjec! !o the provisions of the Building Ordinanee for Eag Township dopied April 11,
1955.
.................°-..........:?":.t':"^r':.`.:."_--•-................................. Per ..................... ..A--:..... U...-.a ..... ......
:?.:.......:..._•-..........
Chairman of Tnwn Board Building Inspeclor
? ?
EAA; %c
VILLAGE OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.:_ pZA
The Village of Eagan hereby grants to
NeLl & ibbbas?d iisat'?.o.g.-
of -99 Na Rae3la
a Permit for:
(Owner)- 9,11-6„ r=v+= tinn
at
??'., pursuant to application dated 11 f1
Fee Paid: dated this 6
7
--,,,,gay of
- bIOY °" l f 9._.,7,2__,
1.00 s/c
Building Inspecto.r
Iie;,hanical Permits:
Bid Total.
1
X
--------------,
I Permit #: 3 74 l4
?
I
? Permit Fee:
i ?
? Date Received: ? 2-3
?
? I
? Siaff:
I
J
----------- -----
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: CUq"--'vU Site Address:
Tenant:
Sulte #:
RESIDENT ! OWNER Name: C ? Phone: ?&61?'??
Address / City / Zip:
CONTRACTOR Name: License #:
?
Address: -
City: State: ' Zip: ?
Phone: VZ! Contact Person: ?
TYPE OF WORK _ New ? Replaceme t _ Repair Rebuild _ Modify Spac _ Work in R.O.W.
Descrl tion of work: rl
PERMIT TYPE RESIDENTlAL
? Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
C__ RPZ /_ PVB) (_ Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RES/DENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State 5urcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State 5urcharge)
'Water Turnaround (add $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State 5urcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) ?
?j?
e
TOTAL FEES $ LJ
i nereoy acKnowieage that trns Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Gffy oi
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
accord wi
X th the app?ved p an in the case ot work which requires a review and approval rns.
I , X
Appli anYs Printed Name Applic nY
2004 RESIDENTIAL BUII.,DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 s
Telephone # 651-675-5675 FAX # 651-675-5694
New Construc6on ReauiremenTS RemodeUFteoair Requirements
r?istered site surveys showing sq. iL of bt, sq. ft oi house; and all roofed areas 2 copies of plan
3
(20% maximum lot coverage allowed) 1 set of Energy Cakulatior?s for heated additions
2 copies of pian showing beam b window sizes; poured found design, etc. 1 site survey for additions & decks
t set of Enert?y Cakulatiais Addition - indicate if on-slte sepGc system M-
3 copies of Tree Preservation Plan'rf lot ptatted after 711193
Rim Joist Detail Options selecllon sheet (bldgs with 3 or less unils
Date 9 I a 7 /
?y ` a
Construction Cost
Site Address -M3 L? epOle - Dr UniUSte #
Description of Work /
kQ ?'1'1 O C! e/ /? I? / o s?v
1! C'?'/ 1 e`'1
Multi-Family Bldg _ Y k' N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ? A?" i? G/'c((1 QS Telephone #(esr )YS2^ p/J 6
? 41
h&
?(
d CD
M
1'01
S? uC
a
Contractor /
O
I em
h
/
Address
State ? f es JJ
-1 /v City C /?"16
Zip ?Sey 2 Telephone # (0! ) / OE
Cel/t 6'.?l ?20F-6/7q7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Ivlinnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . ResidenGal Vsntilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar planZ _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # (
64
I hereby apply for a Residential Buildi.ng Permit and aclnowledge 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 pernut, 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.
TC / 6h U 0 119'o?el?
Applicant's inted Name Appl' s' ature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-ptex ? 20 Pool ? 30 Accessory Bidg
-)iC 02 SF Dweliing ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
0 05 03-plex ? 11 10-piex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or_ N? 25 Miscellaneous
Work Types 1CrrX-4-#ll'tiJ fl PVvn 0 c fU4;'- t-1 13 dl
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation 0 45 Fire Repair
X 33 Aiteration ? 37 Demoiish Building• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement `Demolition (Entire Bidg) - Give PCA handout to applicant
Valuation .? C9> Occupancy MCES System
Census Code
?T Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const IIA ) Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Final/C.O.
Footings (deck) ? FinaUNo C.O.
_/V Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Ice & Water _ F
Roof Pool Ftgs _ Air/Gas Tests Final
inal
_
?C Framing _
_ Siding _ Stucco _ Stone _ Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
X Insulation _ Retaining Wall
Approved By: T? , Building Inspector
Base Fee a-("ks ?-?
Surcharge
Plan Fteview
MClES SAC
??
°
City SAC ,?.. f? ?1, ? ?'j 7
.? J( ? ?
0
Utifity Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Totai
RESIDENTIAL
BUILDING PERMiT APPLICATION
3830 PILOT KNOB DEAGAN MN 55122 C),
651-681-4675
New Construction Reauirements RemodellRepair Reauirements
• 3 registered site suneys showing sq. R. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% mazimum lot coverage allowed) • 1 set of Energy CalculaGOns for heated additions
. 2 copies of pian showing beam 8 window sizes; poured found design, elc.) . 1 site survey far exterior additions & decks
• t set of Energy Calculations . Indicate if home served by septic system tor additions
• 3 copies of Tree Preservation Plan it lot platted after 7/1/93
• Rim.loist Oetail Opcioru sefection sheet (bldgs with 3 or less umts)
DATE ?? VALUATION j < < Y
?
51TE ADDRESS ? 3 33 . ?-Qu j? MULTI-FAMILY BLDG _Y
TYPE OF WORK I?a 51 d-J2, FIREPLACE(S) _ 0_ 1
APPLICANT
.
W
XN
2
STREET ADDRESS M I"LLkyr k At212-- CIN STATE m/1 ZIPJS
TELEPHONE #((3I4'Z11 5333 CEII PHONE # FAX #?D???' `M
1??' U73(P
PROPERTY OWNER TELEPHONE# &5 r
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category ?IINNE50"C:1 Rt.'I.L•'S 7670 C;\'1'EGORl' 1 yfI\NE VRL':Lls? 6?72??
(d submission type) • ResidenGal VentilaGOn Category 1 Worksheet Submitted • New Energy Code Worksheet Su¢mitted
• Energy Envelope Calculations Submifled Q u-( 1? 20?2 ? It
i?Jl1 ?
Plumbing Contractor: Phone # 0,1 P1uRibing system includes: ?Water Softener _ Lawn Sprinkler Fee: 590.00
bVater Heater No. oF R.I. Baths
No. of Baths
Mechanical Contractor.
Mcchanic.il sN,sccm includcs:
Sewer/Water Contractor:
A -kir Conditioning
Hcal Rccovcry Syslciti
Phone #
Phone #
Per. 570.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or ?ances.
Signature of Appilcant /(_ 14 - - --- - -- - - - -- - - - -- - --- - ---- - -- - ------ - -- - ---------- -- - - ---- - --------------- - - - ---- - ----- - - ----------------------------
- ------ -- - -
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4102
f 2004 RESIDENTIAL BUILDING PERMIT APPLICATION '3
City Of Eagan w tvll?
3830 Pilot Knob Road, Eagan MN 55122 ?-,_f 1
Telephone # 651-675-5675 FAX # 651-675-5694 ? ?
New Conatruction Repuirements RemodellReoair Reauirements Office Use Oniv
3 registered site surveys showing sq. ft. of bt, sq. ft. o( house; and all rooled areas 2 copies of plan Ged of Sunrey RaCd ' _ Y_ N
(20% maximum lot coverage allowed) 1 set of Enertgy CalcWations for heated additions Tree Pres Plan Recd _Y _ N,
2 copies oi plan showing beam & window s¢es; poured found design, etc. 1 sRe survey (or additions & decks Tree Pfes Required _Y _N
1 sel of Energy Calculations Addition - indicate if on-site septic sysfem Qn-sife Septic System _ Y_ N
3 copies dt Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selecGon sheet (bldgs with 3 or less units
Date i"
L-.;- I Z-'l l OK ?-, ConstructionCost
-
/& G0Q
Site Address 57
2 ZI ?., ? ? p ? 0 ?. ? Unit/Ste #
k-) SS z
Description of Work ' ;?c,%me l/ (l QII? S 100 k'vJ C " ? ? f.,J ?1
"?- rY ry
Multi-Family Bldg _ YX N Fireplace(s) ? 0 _ 1 _ Z
Property Owner hC%`-. K 9 hone # ( o ()
Contractor 0ppn15
[
Address Q(j. bo 222 ?? 13 y City
?
State M ? Zip S S ? LZ Telephone # (65() 'f562 -9S5!??
COMPLETE THIS AREA ONLY IF CONSTRUCTING A'NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category 0 Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submifled
Have you previously constructed a building in Eagan with a similar plan? _ Y J N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
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 permit, but only an application for a pe
ork is not to start without a
?Iw
permit; that the work will be in accordance with the approved plan in t c of ork which requires a review and
approeal of plans.
Applicant's Prin d Name Applicant' e
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
13 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage X 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06. 04-piex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New
? 32` Addition
? 33 Aiteration
? 34; Replacement
Valuation 'L'
jjGY_-ca
Census Code ?i3y
SAC Units -'
# of Units
# of Bldgs ?
Type of Const
_ Footings (new bldg)
Footings (deck)
? Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
? Insulation
Approved By: _
:?,
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
"Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy /3 -:3 MCES System ?
Zoning ;Z- I City Water -?
Stories '-?-?Booster Pump ?
Sq. Ft. 1 `)G PRV -
Length Fire Sprinklered
Width
REQUIRED INSPECTIONS
Final/C.O.
W Final/No C.O.
Plumbing
? HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
Base Fee ?
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
Total
?
/yc
Permit Number
REScheck Compliance Certificate
1995 MEC
REScheckSoftware Version 3.5 Release lb
Data filename: Untitled.rck
TITLE: ADDITION
CITY: Eagan
STATE: Minnesota
HDD: 798]
CONSTRUCTION TYPE: Single Family
DATE: 12/27/04
DATE OF PLANS: 12/I5/04
PROJECT [NFORMATION:
GRAVES RESIDENCE
4333 LODGE POLE DRIVE
EAGAN, MN.55122
COMPANY INFORMATION:
ROOMS TO GROW INC.
P.O. BOX 22207
EAGAN, MN. 55122
COMPLIANCE: Passes
Checked By/Date
Maximum UA = 46
Your Home UA = 34
26.1% Better Than Code (UA)
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Flat Ceiling or Scissor Truss 196 38.0 38.0 3
Wall l: Wood Frame, 16" o.c. 364 19.0 19.0 9
Window 1: Wood Frame:Double Pane with Low-E 70 0260 18
Door 1: Solid , 11'-) 16 0.260 4
COMPLIANCE STATEMENT: The ed b ding design described here is consistent with the building plans, specifications,
and other calculations submitted ' ?.?pe ' njumm, posed building has been designed to meet the 1995 MEC
requirements in REScheckVersi ?1`tel e lb (form Cchec? and to comply with the mandatory requirements listed in
the REScheckInspection Ch
Buitder/Designer / / / // / Date
S4 13 \
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
New Construction Reauirements
• 3 regislered site surveys showing sq. ft. ot lot, sq. fl. of house; and all roofed areas
(20°k maximum lot coverage allowed)
• 2 copies of plan showing beam 8 window sizes; paured iound design, etc.)
• 7 sel of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selectlon sheet (bldgs with 3 or less units)
DATE
-?? -1A
.. ?
RemodellRepair Requirements ?--
. 2 copies of plan ?c5? ?
. 1 set oT Energy Calculations for heated additions
. 1 site survey forexterior additions & decks
• Indicale if home served by septic system for additions
VALUATION
SITE ADDRESS 12 ?33 4, oaPa -0 1 Y' MULTI-FAMILY BLDG _Y X, N
TYPE OF WORK nIc-F FIREPLACE(S) A 0, 1_ 2
APPLICANT -T-h v ? s --, f-
STREET ADDRESS S-7 ??7 ` I l 3 j` e?lJe. ? CITY GLuz?P ? STATE _?"ZIP
TELEPHONE #76 -' CELL PHONE # 61d-- S&g ` ?j fQA> FAX # '-'
PROPERTY OWNER <cifG e-a vu j E r?L?e 5 TELEPHONE #?- 1'S_ a a 73?
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNE50`1'A RUL,ES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Calcula[ions Submitted
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener _ Iawn Sprink ? r? e?? .00
Water Heater No. of R.I. B - ?
_ No. of Bachs ? ? AUG 0 8 2002
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor.
Phone #
00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant 4?
? 4 A=-!.?
. _- . ....._ ...
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
Air Conditioning
Heat Recovery System
CITY USE ONLY
L ?-? BL I RECEIPT #:
SUBD. (J V'P Y C;,/l qoq?,y? RECEIPT DATE: I ci
PERMIT #
20'00 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOH RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
A townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to exi tin dwelling - minimum fee
Describe: -3??? $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $ 10'-0
Gas piping outlet ' minimum - 1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $ a"O
Septic System newlrefurbished " requi?es MPC lic. 75.00 X = $
SeptiC SyStem abandonment 30.00 X = $
RPZ new installation/repaidrebuild 30.00 X = $
Rou h opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler rfdwelling is underconstruction 3.00 x = $
Undergroundsprinkler if existing dwelling 30.00 x = $
Water doset 3.00 x = $ l?2)
Water heater 3.00 x = $
Water softener If dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 X = $
Water turnaround 30.00 x $
State Surcharge .50 --> --->
Total _> --> --> _--.> $ . SD
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, state that the information is corred, and agree to comply with all applicable City of Eagan ordinances
--------------------------------------------------------
It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no lia6ility for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit w"thin City propertylrightof-way/easement.
SITE ADDRESS: `'7 3'3 3
OWNER NAME: : ? CLLJ?-?II TELEPHONE #: ?S l 7X7,4 -
(AREA COOE)
lNSTALLER NAME: 2"ELEPHONE#: ?E6
?i (,? ( REA CODE)
STREET ADQBESS: -7 / 73? - V`'?.. d-?
CITY: ST TE: ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY
LOT 2a BL I
SUBD. LOrleQh Park l
PERMIT #:
RECEIPT #:
?341?
RECEIPT DATE: I OrUI/ QO
8000 MEGHANICAL PERMIT (RESID£NTIAL)
C1TY OF SEk&AN
9$30 P1LOT KNOB gD
f.AfiM biR 35122
Date: 651-6$I-4675
Complete this secrion onlv if you are installing HVAC in a sing:e-faanily dwelling, townhome or condo under
construction and uot owner/accupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
_ Other
State Surcharge .50
Total $
Complete this section ohlv if you are remadelinp, adding to, or replacin? an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
_ New
J? Furnace
_ Air exchanger
Reminder: Call for f:nal
SITE ADDRESS: ?
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY
X I
Replacement
S 30.00
PHONE #: -
(AREA CO E)
PxoxE #: ("7 ( a-- -
(AREA CODE)
$ 30.00
6.00
? Air condirioning
Other
Fee
State Surcharge
Total
S ATE: ZIP:
JwY???-?
SIGNA PERMITTEE
LOT: BLOCK: ? SUBD./P.I.D #: F 1/=C' V??.e
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ?
CITY OF EAGAN <
-R L0 . ? ?
3830 PILOT KNOB RD - 55122
651-681-4675 ?
New Construction Reauirements
? 3 registered sffe surveys showing sq. ff. of lof, sq. ff. of house
and all roofed areas (20% maximum lot coveraae allowed)
? 2 copies of plans (show beam 8 window sizes; poured fnd. design; etc.)
D 1 sef oF energy calculatlons
a 3 copies of hee preservation plan if lot pioHed affer 7/1/93
? Rim Joist Detail OpMons selection sheet (bvildinas with 3 or less units)
?.? ? I - 'i ?J(_
Remodel/Repair Reauirements
2 coptes of plan
1 set of energy calculattons for heated additions
t site survey for exFerior addHions 8 decks
DATE: CONSTRUCTION COST: ?70(DD?
DESCRIPTION OF WORK: ??j YZL1U1"Yl ?'???s LJ If multi-family bidg., how many units?
STREETADDRESS: ? 3 LC DCr-E Nlb LE [) ??_
5-2--C7 3 E?-H
Name; G-u?,lZi5 Phone #: 612 --257I - Q-lDh -w
PROPERTY Last First
OWNER StreetAddress: L"2L-L ?La 1) 1?
City State: MA-,1_ Zip:
Company: q+ Phone #:
(area code)
CONTRACTOR
Street Address: license # Exp.
City State:
ARCHITECT/ qA- ENGI
NEER Company: Name:
Telephone #: ( )
Sheet
Cify
Zip:
Registration #:
State:
Zip:
5ewerJwater licensed plumber (ff installina sewerlwater): Bi-Ati(I.DC lC YLV WB1U(i- PhOne #: ?I( 5 Z)Z6 1"-7-!Y-3 /
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable State of Minnesota Statutes and City of Eagan rdinances.
5lgnature of Appllcant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No v._
Tree Preservation Plan Received _ Yes _ No _ Not Required ? NO1! _d v 2003
?
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 31 New
O 32 Addition
g 33 Alteration
? 34 Replacement
VALUATION
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 30 Accessory Bidg
? 31 6ct. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 42 Demolish (Foundation) ?
? 36 Move Bldg. ? 43 Reroof ?
? 37 Demolish (Bldg)* ? 44 Siding
? 38 Demolish (Interiar)
' Demolition (Entire Bldg only) permit - Give PCA handout to applicant
oJ
O
/
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
INSPECTIONS REQUIRED
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinkiered
45 Fire Repair
46 Windows/Doors
_ Footings: New Bldg X Insulation _ Windows - new/repiacement
_ Footings: Deck _ FinallC.O. _ Siding
_ Footings: Addition ? FinaUNo C.O. _ Stucco/Stone
Foundation Fireplace: _ r.i. _ air test fmal Roof: _ ice & water _ final
?C Framing Pool: _ ftgs _ air/gas tests _ fma]
APPROVALS
Planning
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Park Dedication
Trails Dedication
License Search
Copies
Other
Total:
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace 0 21 Porch (3-sea.)
? 09 07-piex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screened)
El 11 10-plex 1619 Lower Level ?AII-l ? 24 Storm Damage
? 12 12-piex Plbg_Y or _ N 0 25 Miscellaneous
Building /1-0?-_ Engineering
Variance
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTIUN
Date• September 12, 19Y-2
Number: 977
Billing Name: Tilsen Construction Co. Site Address: 4333 Lodgepole Drive
Owner: same Billing Fddress
Plumber:
Location of Connection Meter Siz Connection Chg. •, 9/12/72
? ./ ta.vo eof 1,,131.7 -.
, Meter No. ?,5/7to-2 Pexmit Fee ,.sD If
Meter Reading Meter Dep.
Meter Sealed: Yes lAdd'1 Ghg.
NO . [Totai Chg.
Inspected by
Date
Euilding is a: Remarks:
Residence xx
22ultiple A'o. Units $25.00 RE•iNSPECTION FEE FOR
Commercial WROPERLY 1N$TALLED flIIETERS.
Industrial gy;
Other Chief Inspector
In consideration of the issue and delivery to me ot the above permit, I
hereby agree to do the proposed work in accordance wiCh the rules and
regulations of 8agan Township, Dakota County, P2innesoCa.
sy: -
Please notify the above office when readq for iuspection and connecCion.
EAGAN TOWNSHTP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTiON
DATE: September 12, 1972
OWNEF.: -Tilsen Construction Co.
PLUMBER
NUMBER 1135
Address 4333 Lodgepole Drive
TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUIIA ING
Iudustriall Comanerciall Residential I Multiple Dwelling I No, of units
xx
Location of Connections:
Connection Charge -0-
?p. c o d?':Oe If/13/-1'z-
Permit Fee
Street Repairs
Total
Iaspected by:
DaCe
Remarks•
By
Chief Inspector
In consideration of the issue aiul delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota CounCy innesota
B ?
Please notify when ready for.inspection aud connection aad before any porCion
of the work is covered.
MASTER CARD
LOCATION
OWNER
STRUCTURE AND ? + G A ?
LAND USED AS
Permit
No.
Issued Issued To
ContracTor Owner
BUILDING
?Q+ ?
PLUMBING --
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
? 7 9' AjA
GAS INSTALLING
SANITARY SEWER
OTHER ?/ I
OTHER cr7? i
Ifems Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING ?p_2o - J SEPTIC
FOUNDATION ?? , r? 7 CESSPOOI
FRAMING L/15 ? TILE FIELD FT.
FINAL
ELECTRICAL
HEATING
/T -ZC7' DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
_ I - 7 - 7 ?,?--
?i
ViolaTions Noted
on Back
COMMENTS:
Use BLUE or BLACK Ink
r----------------�
1 For Office Use � 1
� � Permit#: ° �� �
Clty of ����� ; , ,� �
Permit Fee.
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 � �
Fax: (651)675-5694 I Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �� �a j� Site Address: �`�'�3 L`°l�e�°% �r Unit#:
' , = Name: /I ����'C— �J Y'���S� Phone:
°Residentl � �
= Owner �� Address/City/Zip: y33� ��>°C,�� �r �����, 5Y� � �-
°K Applicant is: Owner �Contractor
'. Description ofwork: �"e-�t �'2-
Type of Work;
� � � Construction Cost: �,�, �jG� Multi-Family Building: (Yes /No�)
„�N,
� f r;� �� �"..
�,� :�� Company: /�.eSZ��I'C�' �n�'�r�7� Contact: �/t� �;�'Z�iraf'
Contractor ' Address: L�.3�� ��D '`� S�- �v city: �s� ��v�
` : 6 State: n'//✓Zip: ��G�C� Phone: �l a i��j�ma: /1'LQ.S' �f'con s"'�r���zo��, �.��
17a /iicr!/.co n,
License#: .�L 6 7!'l53 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:
�NOTE:,Plans and supporting do,cuments that you°submit are considered;'to be public information. ;Portions of :
:the�nformatiQn ma�r be classified as non publ�c if.you provide spec�fic"reasons thaf would permit the`City to :
t.,;� conc/ude#hat 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.qopherstateonecall.ora
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_ /V L�-GC� i�,�ZC'��-a,�' X
ApplicanYs Printed Name ApplicanYs Signa
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA160461
Date Issued:03/11/2020
Permit Category:ePermit
Site Address: 4333 Lodgepole Dr
Lot:25 Block: 1 Addition: Evergreen Park
PID:10-24880-01-250
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Ricky A Graves
4333 Lodgepole Dr
Eagan MN 55122
(651) 452-0736
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature