4297 Fox Ridge Rd
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CI'
3830 Pilot Knob Road,
BUILDjMG PERMIT PH
vo be used for SF D4??GW1 Fst. Valuw
Eagan, MN 55121
Receipt #
--------------• ?
19
4297 k?OY RIU??E RD R3
Site Address Erect ? Occupancy
Lot 5 Black 3 Sec/Sub. SUM CLIFF 5`Iti Remodel ? Zoning
Parcel No. Repair ? Type of Const V
W Name 4?11?d17H1+1 DlCVb \.V1Y.71' ?,V
3 Address 4620 W 77TH ST., S''E 104
°
City F: DINNhone 893--0755
= o Name S1V•.IE
o? Address
~ City Phone
¢
? W Name
? n Address
< W City Phone
Move ? Length 14 u
Demolish ? Depth 46
Int. Impr. ? Sq. Ft
Instatl ?
Assessment _
Water & Sew.
Police
Fire
I hereby acknowledge that I have read this application and state that the ?d9
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC_
Permit Y ?'''` • "" 1
Surcharge ' 00 ?
Plan ReviewOG SAC
Water Conn. 500.00
Water Meter ??O
Road Unit
*r. P I. -?2 .00
Var Date Copie '
Signature of Permittee -- -
ZACHMAN HROS CONST
R Building Permit is issued to:
all work shall be done in accordance with all
State c
I TOtal , . 5u
on the express condiUon that
Statutes and City of Eagan Ordinances.
II I"Pumn No. I wmn Had.r I oot. I TdepAona N I
I IRouyh Ht?• W_O Zt /?? ?
Ht4•
Plby.
Dbp.
Reaipt MECHANICAL PERMIT Pe?mit No.
CITY OF EAGAN
F» '
fill !n numbered spaces S/C
Type w Frint leglbJy Tot
1. Date 2. Installation Cost
3. Job Address ^ Lot Blk.
4. Owner '° C hman Ho m e s
Tract
? Phone ?
5. Contrsctor (
8. Addreaa ^ ? . . ` " v r .
7. City State Zip
8. Building Type: Residential Commercial O Institutional ?
; .,
9. Work Description: New ? Add ?
10. Describe : ? ? • . c j f ,
11.
Alter ? Repair ?
uel Type `
No• Eqllipment BTU - M. Ea.
Forced Air No. Equiament CFM
Ai
dli
:
H
Mfg. r
an
ng
Boilers
Mfg. Mech. Exhaust
?
Unit Heater
Mfg. Other
Air Cand.
Mfg,
Gas, P'iping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Finel
Inspections: Date Insp. Date Insp.
This is your permlt when numbered and approved.
Approved CITY OF EAGAN 464-8100
- J
PERMIT # CITY OF EAGAN FEE
-?d PLUMBING PERMIT
REcEiF:'r # 454-8100 S/C
Znc- MINIMUM RESIDENTIAL FEE - $10.00 + $•50 TOTAL ?il
DATE
1. Bidg. Type: Res _4Z Comm Inst 2. New --I.-Add Alter Repair
3. Total Bid Price I? U a 4. Job Address T? /7 )IC;je-?
/
Lot Y Block ? Sec 3 v"1 C!i cr?t 5. Owner
6. Contractor ? * A/? OAJ I(A /CO G/k) ir2? / 3
(Name) (Sdeeq (City) (Zip)
7. Contractor Phone #
NO. FIXTURES
? Water Closet - $3.00
4Bath Tubs - $3.00
Lavatory - $3.04
-Urinal/Bidet NO. FIXTURES
Shower - $3.131.00
ZKitchen Sink 3.00
4 Laundry Tray - $3.00
Floor Drains - $1.50
rWater Heater - $1.50
-Whiripool - $3.00
-Gas Piping Outlets - $1.50
-Softener - $5.00
NO. FIXTURES
-Well - $10.00
Private Disp Syst - $10.00
:2zRough Openings w/o
Fixtures - $1.50
COMM./IND. RAT - 1% OF TOTAL BID RI LUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
MINIMUM COMMERCIAL FEE - $20.00 + $.50
Approved Inspections: Date Rough Insp. Date Final Insp.
CITY OF EAGAN WATER SERVICE PERM
3830 Pilot Knob Road
P. O. Box 21199 : PERMIT NO.:
Eagan, MR 55121 DATE:
Connectian Choroe:
AccoLxit Deposit: _
CITY OF EAGAN A
R
P
Vy
TER SE
VICE
ERMIT
3830 Pilot Knob Road
P. O. BoR 21194 • PERMIT NO.:
Eagan, MN 55121 DATE: '
Zoninp: }6l No. of Units: 1-
Olvflfr: ZaChti13i1 uroS.
Addmss:
5it1 Add
Pl1?1'IbOr:
Meftr N
Slu: -TI
Reader f
1 ym fe omplp wkb
"..asm k1:12 NE• CTW*:?Xrges:
By 10-
Dcyte of
Zoninp: _ • t No. of Units: ?-
Ownlf: 7i3Ci1ibi3v '•r:.
/?ddron -
SItA AddMSi:'!-?p'
Plumbsr.
Meter No.: Connection Qarpe: ,. ,,('
Size: Acoount Deposit:
Reoder No.: Psrmit Fee:
1 yrM te eeisptlr rrNb !M Ciryr of Eapm
-09d
Surdharye: 5
OdIMeCN. AAIft. CMrpli: " ? - nQpt4 TP
Totol:
BY DoN Paid:
Dote of I mp.:
? ?' t??A _? 63 . OO?,d mete
?. Potd:
i?sv.: i,,.p,,;
CITY OF EAGAN Remarks
Addition SUN CLIFF FTFTH Lot 5 Blk 3 Parcel IC) ?7Q'19 (15(1 93
Owner Street 4297 Fox Ridge Road State ??, MN 55122 X
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
ZIL/
1985
357•37
23.83
15
3 01. `73
D719.
17z7n-
STREET RESTQR.
109 ??,?, yp ?? 3 ?? ,•r ?r
.
GRADING
Sf-w ? b.? . ? tt
SAN SEW TRUNK 1970 49• ly. 2.00 5 tP . 0 t C-0 // .Z,.3 /-2
SEWERLATERAL ? 1985 257•00 51•40 •?L-o Lio ? -:2 3 ? Z ?(o
/(J.3rv 58 a. y6 !? ? 3' ' ?s'
WATERMAIN 1985 4• 55 4.31 15 . b D 2-.3 /
WATER LATERAL
WATER AREA 1973 68-60 4.58 15 • b?-- ? ? ??
1985 106.94 7•13 15 ?2. ?o -Z3 i ?
STORM SEW TRK 1971 214. 10,73 ?? ?Z 9rZ
S70RM SEW LAT 1985 86-95 5• 0 15 76 • 31
139.56 3. 56 %
CURB & GUTTER '
SIDEWALK
5TREET LIGHT
qpruices 03 2 . $- i ?• 5'
Z
WATER CONN. 500.00
BUILDING PER.
SAC •
PAR K
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N 0
BUILDING PERMIT PHONE: 454-8700
To be used for SF 1XW3
$66,000
fieceipt k
11399
J?9&71
8$
4297 FOX RIDGE RD ? R3
Site Ad
ess Erect Occupancy
Lot s
3 SUN CLIFF STH
Block Sec/SUb Remodel ? Zoning
Parcel No . Repair ? Type o( Const. V
. Addition ? No. Stories
w N,rn, ZACHMAN BROS CONST CO nnove ? Length
46
= I 4620 W 77TH ST_
STE 104 oemolish ? oeptn
o Addres s
EDINA ?
$93-0755 Int. Impc ? Sq. FL
Ciry phone Install ?
?
0
?U
0<
?
Name SAME
Phone
?Q
F W Name
? E5 Address
a WCiN PhOne
Assessment
water 8 Sew.
Police
Fire
Eng.
Planner
Iherebyacknowledgethat averea [fiis pqRlonandsta4 ihatthe 12 20 E
information is correct an agree t c mp 't bl State of Bldg. Off. / /
Minnesota Statutes and ity of E Ar iR APC
Var. Date
r Signature of Permittee
331.00
Permit
?
Surcharg
Plan Review ?' S 0
SAC 525.00
Water Conn. 500 _ 00
Water Meter 63.00
RoadUnit 280•00
irr. PI. 132.00
Parks
Copies__,_z__ O_Z_9? p
ZACHMAN BROS CONST -?
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with ???(ggg/???ppple S e o Minnes ta.Stat_utes and Ciry 01 Eagan Ordinances.
Building Oflicial pp`?E -C-f .?-- ? %
(P/? ?
/ c,? REQUEST FOR ELECTRICAL ONSPECTION
?Saeinslruc!ions lor.completing ihis form on back oi yellow copy.
?'?! ee.oo.ap/' e
^? ?{L Pj !
? 5 A
/? r?,
`+ 4 L
. -•X" Be/ow Work Covered by This Request {
ew Adtl Fep. TypeofBUilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater ElecUic Heating
Apt. Builtling Dryer Load Menegement
Comm./Indusirial Furnace Other (Specity)
Farm Air Conditioner
Other (specily) Conireclor's RemaBS:
Compute lnspection Fee Below:
d Other Fee # Service EntranceSize Fee S Circuils/Feeders Fee
Swimming Poal 0 to 200 Amps 0 to100 Amps
hanstormers Above 200 _ Amps A4oe 0_ Amps
Signs Inspecror5 use only: TOTAL
Irrigalion BoomS ?. ?
Speciat Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
i, the ElecVical Inspecfor, hereby
tif
th
t th
6
i
h Rouqn-in oata
y
cer
a
ove
e a
nspection
as
been made. F;,,ai
OFFICE USE ONLY ? This request void t8 months irom
4?as19 ass?i ? a-o
? 554 2?, 3 ?
_
ReQUesi Date
, ireNO. . - Rougnpsection RequireJ
(YOU us? wll inspe o? w en reaEy) s ction Other Than Paughln
Reatly Now ? WIII Notfty Inspector
? Y. .NO OateFeatl
icensed contracEOr D owner hereby request inspection of above electrical work at: -.
Job Atltlress (SVeet. Bpx or Route No )
7 Fo ?
i
Cry
e- a
Section No. Township Name or No. R 19e No., Co
(1
Ocapant (PRINT) Phon-eJ?o.
?- ?9p?
-s
o y
o
PowerSuppiier Address
Elecuical Co ctar ?Company
? ?' e?
E
lp- ? 1? Con ctors Licanse No.
?-ADl700
Matling qadres omracto? or
? na57 Installation
?5? n/L ?
/
Aumonzetl SlgnaWre ICOnlranor/0 ner xing Inslallalion, ? Phry?e Number -
? ? O ?
MINNESOTA STATE BOARD OF ELECTRICITY ' a THIS INSPECTION REQUEST WILL NOT
Grigge-Mitlwey Bltlg. - Poom S-173 . BE NCCEPTED BV THE $TATE 90AFD
1821 Onlversiry Ave., St Peul. MN 55100 . UNLESS PROPER INSPECTION FEE I$
Phone(613) 602-0800 ENCLOSED.
7?? D? ? REQUEST FOR ELECTRICAL INSPECTION ea-ooom-oa
See instruc[iona for comDdeting this form on back ot vallow coOY.
_J ?
p_ 5 "X" Below Work Cavered by lhis Requesl
AA eo. Tvoe oi Buildinn Aooliences Wi?wi. 7 Equipment Wired
ex
lo
I I I I Industrial Bida. I I Air Conditioner 1 I Buik Milk Tenk I
p fae ServiceEn[ranee5ize 'k Fee Feetlers/Sabfeedars b Poa Circuita-
U to 200 qm s 0 to 30 qm s 7 0 to 30 An?
A6ove 200 qmpy, 37 to 100 Amps O 31 to 100 Am s
Swinunin Pool Above 100_Amps Above 100_Am '
Trenstormers rng0tion &ioms Partial%Other Fee
Si
I, cna'EFetrfrcal
Inspector, hereby
certiiV Ihxt the »bove
ins0ection has been
mede.
Tliie requast vold
This repuesl void (
nthstrom ?(??.? /-(?- ?!?.
?0'?
888 5 LS 3 Sw?C'f F s 'cD )
fleQUest Do?9 ?
? Fire No. Rnuyh-in InsVection '
? C/
O S? fteqwred7 ?Neady Now Will Notity Inspem
lor When q
d
?
es No ea
y
icensed Electrical ConVactoi I herebv requast inspectian of'above Owner elactrical work installed et:
Street Address, Box or Routa No. ?
1 Ciry
a?7 6xIv
ecUOn o. Township Name or No. . flanee o. Co?yrIX:6
Or,eaoant (PRINT)
2 ???? f3v?
st Phnne No.
755
Power Supplr er G /
?
G
I Address
? ,/-
a? L
GLC ?L
G? K,O ?J ^
Elechical ConUa or (COmp y Name) ConVar.tor's License No.
" ? oyo??le-3
MailinB AdJress
IConvactor or Owner Making Instaflabonl
?J
([/ ! S-.
Aut oN tl Sipnatur Conhact r ne aking Installation) Phoelb Number
?lr
Q - 3s-S?
MINNESOTA STAT OApD OF ELECTRICI THIS INSPECTION qEQUEST WtLL NOT
Criggs-Midway BI .- Room N-191 BE ACCEPTED BY THE STATE BOAND
1821 Universilv A.ye., S[. Paul, MN 557 4 UNlESS PROPEH INSPECTION FEE IS
Phone 1612) 297.2117 ENCLOSED.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD - 55122 ? ? n+?
I 1 ? lo ? 651-68'1-4675 ? \S/
NewConaWCiion Reauirements RemodeVRaoairReauirements
• 3 registered site surveys showhg sq. fl. of lat, sq. ft, of house; aM all roofed areas . 2 copies of plan ?-?- 6?.
(20%maximum lotcoverage allowed) . 1 set of Energy Calculations forheated addilions
• Y copies of Man shaxing beam & window sizes; poured found design, etcJ • 1 site survey for ezterior addilions & decks
• 7 set of Energy CalcWations • Intlicate'rf home served by septic system for additions
• 3 copies of Tree Preservation PWn if lot platted after 711 193
• Rim Joisl Detail Options seleUlon sheet (bldgs with 3 or less unils)
DATE '-t I aQl I0 a. VALUATION cro
JOB SITE ADDRESS y aoi?- VDX 17_4 nA tc? .
IF MUL71-FAMILY BUILDING, HOW MANY UNITS? -
?ROF'cRiY t3YJNER N10\ A K1 d\ U. U .QN
TYPE OF WORK I ,?J i'
APPLICANT Caho?j1/lkY_f?? W i N0eW -4- (_??o
ADDRESS (oSD Ca.Sl.li>-Pc D2 • P< V- Ad A
r-?
PAGER # CELL PHONE #
FIREPIACE(5) _ 0 _ 1 _ 2
PHONE# ?S 3 - 59) "
CODE
Fax # 'zS a- y?-?
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category t Worksheet Sut
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor.
Plumbing System Inctudes:
Mechanicol Contractor.
Mechuucal Systetn Includes:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
All above information must 6e submitted prior to processing of application.
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
Certifcates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
Water 5oftener _
Water Heater _
No. of Baths
Phone #:
Lawn Sprinkler
No. of R.I. Baths
LOT: ?J BLOCK: ? SUBD./P.I.D#: SL/,4\'
• " 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN f-
3830 PILOT KNOB RD - 55122
651-681-4675
New ConstrucHon Reauirements
D 3 regisfered sNe suneys showing sq. fl, of lot, sq. N. of house
and Q roofed areas (20% maximum lof coveraoe allowed)
? 2 copies of plans (show beam 8 window sizes; poured fid. deslgn; efc.)
? 1 set of energy calculations
D 3 copies of free preservatlon plan H lot plaMed affer 7/1 /93
D Rim Jolst Detatl Opitons selectlon sheet (bulidinas wRh 3 or less unffsl
DATE:
oJ
. ,?
DESCRIPTION OF WORK: _- ?e
STREETADDRESS: 2 el,
Name:
PROPERTY
OWNER
Street Addre:
City A
Remodel/Reoair Reauirements
2 copies of plan
1 set of energy caiculations for heated additions
1 sRe survey for exterlor additlons 8 decks
CONSTRUCTION GOST:
N muHi-family 61dg., how many units7
Oda, a'2
Phone #:(k?l '/? 73
Lasf Firsf
State: d"` N Zip: `TS12 2
Company: CAS?(" Phone#: U/?2 211`? ?7aJ
(area code)
CONTRACTOR ? ^
Street Address: l///? ^ License # 20 I^r1? xp. 33 ? 2og?
CMy ? ? 14r state: zip: M G! &
ARCHRECT/
ENGINEER Company: Name:
Telephone N: ( )
Sheei Address: Regishatlon
cMY Stafe: Zip:
Sewer/water licensed plumber (if instailina sewerlwater): Phone #:
I hereby acknowledge that I have read this application, state that th formation is correct, and agree to
comply with all applicable State of Minnesota Statutes and City of gan Ordiryances. /J
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes No --,.--,=1-- -?--?
Tree Preservation Plan Received _ Yes _ No _ Not Required Iy
' vov 02 zooo ?
;
OFFICE USE ONLY
O 01 Foundation
O 02 SF Dwelling
? 03 01 of _ piex
? 04 D2-plex
? 05 03-plex
? 06 04-plex
? 31 New
0 32 Addition
? 33 Alteration
? 34 Replacement
VALUATION
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
? 35 Int Improvement ? 42 Demolish (Foundation) ?
? 36 Move Bldg. ? 43 Reroof ?
? 37 Demolish (Bldg)' ? 44 Siding
? 38 Demolish (Interior)
' Demolition (Entire Bldg only) p¢rmit - Give PCA handout to applicant
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
INSPECTIONS REQUIRED
? 07 OS-plex ? 13 16-plex
? OB 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Ga2ge
? 10 OS-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
_ Footings: New Bldg
_ Footings: Deck
_ Footings: Addition
Foundation
_ Framing
APPROVALS
Planning
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Park Dedication
Trails Dedication
License Search
Copies
Other
Total:
_ Insulation
_ FinaUC.O.
_ FinaUNo C.O.
Fireplace: _ r.i.
Pool: _ frgs
Building _
c?
I- ?
air test fmal
_ a'v/gas tests _ fmal
Engineering
.-.. ,
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
45 Fire Repair
46 WindowslDoors
_ Windows - newheplacement
_ Siding
_ Smcco/Stone
Roof: ice & water final
Variance
/
1985 BUILDING PERNIT APPLZCATION - CITY OF EAGAN
NOTE: 9LL CONTHACTORS IiUST BE LICENSED WZTH THE CITY OF EAGAN
COMQIERCIAL SINGLE FAMILY D}IELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1'SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS'
$2,000 LANDSCAPE BDND
?, g J
To Be Used For: S Valuation: oc) C-D ? Date:
r
Site Address 7 11?OFFICE USE ONLY I
Lot S Block .?
Pareel/Sub
Owner7n? hm^.? ?(71? ot?L t"f?,1Sft' Address Ci,. 4: k
City/Zip Code
Phone
Contractor
Address
?_?.? ?--•_?_?_
City/Zip Code f
Phone
Arch./Engr.
Address
City/Zip Code
Erect X Occupancy
Remodel
? Zoning
Repair
" Type of Const
-
Addition
' /k of Stories
Move
'- Length
Demolish Depth
Int.Impr. Sq Ft
Install
APPROVALS FEES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
TOTAL
.C', , rh
Phone #
2(o x Qo ,
2b x 22 =
(04CD x ??b '
x l ? `
440
(?,0320
5280
(0 scnoO
.,
?... . . . . ; _. ., . . ..?--- -..-- , f-_.-...._,..-,--•-.,
,. . - . . . . . ._
i'
, FOR: ZACHMAN HOMES
?f
I? C
fviY ?c?OB ? at? 717.,.
.:l
C. R. WINDEN b AS$OCIATES, INC.
IAND SuRVErORS iat 645•3646
I39I EUSTIS ST., ST. PAUIs MINN, s4109
NOTE:
O Denotes Wooden Stake
Proposed Garage Floor B.= 9/4.1
(919.8) Denotes Proppsed
Finished Ground E1.
--4- Denotes Direction SCd12: 10=30 '
Of Surface Drainage O D@f10tE8 Iron
' Vertical Datum - M.G.V.D. 3929 MOAUmeflt
Bearinqa Are Assumed
'o '1 ?/fit•'1,
? ? ..7? EOS2r}»,h f
T ? p\0
L_`
?
I f?
?V 14?.?69 3.,?,
e•?.x ??J????
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ro
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cr
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, rib v
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30 0
IL) No S Q
?
l.L
Lot 5, Block 30 SUN CLIFF FIFTH ADDITION,
Dakota County, Minnesota.
WE MElEby CERTIFY fliAT TMlS tS A TlUE AND CORRECT REPRESENiAiION OF A SURVEt' OF TME
SpUNDARIES Of TNE lAND ASOVF CESCRIlED AND Of TME IOCATION Of All WIIDINGS, If ANY.
TMEREON, AND Atl VISIStE ENCROACHMENTS. If ANY, fROM DR ON SAIO tAND.
-. , Defd Mi??day 04 Qecern?frA.O. H85 C. R. WINOEN & ASSOCIATES, INC.. . , : . .
6, CL' ?C"'_??&? .
. . . . tv+viryor. Mienewro Rapinratien NN.772&
? -
«mi?
. i 3.1610 . . ? . a. i • . 01.03 0531
,:. •O• . IRS . O .. . .•
. .
CITY OF EAGAN `J ? ?
.
APPLICATION FOR PERMi
SE
ER
DID
OR
ATER CO
IO
/
T
W
A
W
N[QECT
N
` Please Print)
°: i> PRoPEaTY AonREss: L42-97 Fox pi?C,?gl???a? M?
I.EaAI. DESQ2IPZ'ION:
nD
lWt/nlocx/suparvision or Tax Parcel I.D. Nu
IF EXISTING STRL'CTLRE, DATE OF ORIGINAL BLILDING PERNIIT ISS['ANCE:
(Nbnth ear)'
PRESENT ZONING/PROPOSID USE: R-1 SINGLE FANIILY
R-2 DLPLEX (Twv Onits)
R-3 'IOWNEi00SE (Three + L'nits) ( Units)
' R-4 APAR'IT9ENT/CONIDOMINIL'M ( Llnits}
COMMERCIAL/RETAIL/OFFTCE
IDIDL'STR3AL
INSTI'ILiTIONAL/GOVII2NMENT
.?. .
2)
NAME:
. ADDREss:
a., crxY, sTATE, ZIP: MN 5153 `7 3 ?
PHONE: ?'?'1 -
' 3)' • ?:?• For City L'se
, rIArIE: ?L11D1?9 F??IHttiai? Plunbers I.i.cense:
ADDRESS: _(°OC)4 1?7N6 Oy4`? P?Of?? t. e
CITY, STATE, ZIP: ?ired '
t Recorde
PHONE: MASTEFt LICENSE DCt 9 M
St
' 4)
NAME: zRCHMRtJ ???. CD?15???,C.llD9? --
ADDRESS: \AESI' `].?lti S?2E? 1, S('irc- 1p4 ..
CITY, STATE, ZIP: e'6I NN' MN S S113 Sr
' PxONE: 0? S SJ
5) i? ?• ?
.' ,b(COiVNECTION TO CITY SEWEI2 XCONNECTION TD CITY FR1TII2 . .
' O OTHER (Please Describe)
6). i? ' • i
PLEASE HOLD APPROVFD PERMIT FY)R PICK-UP BY ONE OF ABUVE
PLEASE MAIL APPROVID PERMIT TO 1, 2, 3, 4, ASOVE
-` (Circle one)
X
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tfm4 t.L . . ' J . . '1
N
P O R C I T Y U S E O N L Y
' PERMIT .": SSSUEO
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' FEES: $ ggWER nyR?1T'P (I`1C_L'uDE SUP,C!i?RCa) _
'r $ /6 WATEit PERPI2T (INCL'JDE SLiRCHA
RGc)
$ WATER METER/COPPERHORN/OUTSZDE RE
D
A
ER
$
WATER TAP (INCLUDE CORPORATI
ON STOP).
$ SE;dER TAP
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r .. $ J.
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. . $ , . ACCOUNT D.F.POSIT - 41ATER -
,S" ao..uv WAC
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+ $ TRUNK WATER A55£SSi4ENT .-
'?'"',? - $ TRli:TK SE[aER ASSESSbIENT
s ? $ LATERAL BENEFIT/TRUNK SE:•::1R
,
LATERRL BENEFIT/TRUNK WAT°R \^
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.
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WATER TREATMENT PLANT SURCHARGE
0THER:
$ TOTAL ?
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Ah10L'NT P
S?5e?
c
AID/RECES?T #
5
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.
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F r.:DOES
a._... -.. _. UTILZTY CONN ECTION REQUIRE EXCAVATION ZN PUBLIC RIGHT OF WAY?-;,...
....
. ,..
A? YES IF YES, THEN A"PERMIT FOR WORK WITHZN
?
' nrJBLIC P.OA DWAY" MUST BE T_SSUED BY THE
:- ? NO ENGINEERIN G DIVISION_ i.TSm ac n rnnmr_
MECHANICAL PERMIT (RESIDENI7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTI'S ARE REQUIRED FOR EACH UNTT.
NEW CONSTRUCTION
AD -
?
---? u.,........,... T..*ISERT
DATE c, - n -g `1
FEES
HVAC: 0-100 M BTU $ 24,00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (Mnvitvttnv[ i @ $3.00 EacH)
ADD-ON/REMODEL (EXIs-[7uvG CoNSTRUCTION) $ 20.00
STAT'E SURCHARGE .50
TOTAL ?
SITE r1DDRESS:y a. 9-1
OWNER NAME: TELEPHONE #: "J52- 2991,
INSTALLER:
, N l
ADDRFSS' 410 WESTLAKESTflEET
Raueteavnt ie nav c^
c12-e24•2656
CI`ry: STATE: ZIP CODE:
TELEPHONE #:
7?
SIGNA RE OF PERMITTEE
0
H AT LOSS--?C/??LCULATION _
?
.v
° TEMP. DIFF.
Cupomw Nama Typr Conprudion
CiIY - Windowc
Orlw NameFuJJ: , _ - Walh .
Strwl AIR ?i ;N_17v.,Ceilirq
Citv ,2619 C00`J fMPli}. -- -- . Floor
f1.1 /?)? RoomlLength 3$ Width ?? i! Heiaht
W in{bws and Doorc -Crsckspe md A? ea
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..Exp. wall a
Net exp. wall
Int. wall `-
Cailing 92 ? 97
Flow ?
Tow ew. 1112 7 S-? I roui Btu.
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WirWows and Duors-Gsekam and Arr Windows and poors-Gackap ud Arw Me WMm M?ym No.Of ?1nN/If. A/M
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hration -'
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ing
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HEAT LOSS CAICULATION ° TEMP. DIFF.
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*/ w?n J a H.? t 8 FI.I Room ? L n W;?, H,,
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Total Btu.
_ FI.I HoomlLeqth Width INI t -
Windows and Doors-Gadcaye and ArM
Nn. N?M Oh LO.O? AI?1.
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7obl Btu. ?
. ? • li???/UGllliY 11i4 EY,'1'L'1tl()R L'':7'?I:LOi li AVlii2.'%GE °UcOi:!'li'ii,7'1U:7
o:na:R-----Z-p Cl1 !iA-R?.? -T???------
si?•e ADntIa:ss ?2 y? _ FoX _ ,Pi,045 i'oqp -------- -- -
co;a?:>>>c??ox????RpS----- i?r,•rg //-zt-$S PilO?ae_ $y3 _?7SS_
. Detennine woiking squarc footage of each.
], Total cr.Posed r:all zrca ......_l7 sq. ft. X ,?? = 2/?• ???
--
- --- - -- -
7,. Total roof/oeiling arca ...... /6sq. ft. Y, G
--- -- - ----?_
A. Total Wa11 vi.ndow area.......................... 109,/5
B. Total door area................................. ¢O. 00
C. Total sliding glass door ar.ea................... :--o- , 60--
D. 'PoCal fir.eplace wa11 r,rr_a ........................
--= ---
F.. Total wall frami.ng area (average 108) ... • . • . . ... J d , ?y-
----- -
- 9 Y
F. Total Rim joist arca ............................ 17S
G. Total I:ct tva;1 tarea zbove f:toor. • • • • • • • • • • • • - - _ / 3 /.9 •
Total exoo;eo {oundation are3
fi. Total fci<nP.aLion Wi, dow area ............... .... O
1. Total ret fo•,:nr',ation ar.ca above grade........... 5?
Detera,i_ne "U" value o: each wall seg:nent.
a. la y•/S x-u., , o g 7= S/. 3
b. 4a.d X"U" l37
c. `f?•? X "U" ,OSS = Z 2
d. X "U" _
e. x "U., , 6 $. 7
x,,U„ So
y._!3/q. 8S a..u., V o s3 =--G?• yS
h. x „u.. _
-??
3 ................................... Tet.a1 •o9S
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:?1sC C,OOG (c) 3.
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Totzl c::L.oscd rou£/ceiling area = _ / 0_ f/ D ^ _
? j. Total !Avli, 21it area ............................... -
- . -- =---
Y.. Tnt:il roof/eeilirg framing area (iver,yc 10°)......_10
a ----
1. Total net insiilatcd roof/ecilinq area ..............__
Detennine "U" value for each roof/ceilin, srgn?-nt.
?'--------= x „u., --- -- - - -----
: r'-- l??---- a"ul. 2
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4 ............... ...................... Total = _ 2_6_ 72-
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if total of ,°:4 is the same- as, or less than r2, you have mat the intent of
Si3C 6006 (c) 1.
Altc-inate Building F,nvelope Dasign
To :it::i-ze 1.'ne i_otal cnveloiic systeia nethud, Chc -alu,-s ^-t;iblished ?,* ':t_
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Use BLUE or BLACK Ink
-For 0-M-caUse- - l
i
Eatan Permit:
l 1
~~nn Vf i
I Permit Fee: i
3830 Pilot Knob Road i v- f13 l
Eagan MN 55122 i Date Pacelved: ~ i
Phone: (661) 675.5675 ~
Fax: (651) 675.5694 l l
.
2013 RESIDENTIAL BUILDING PERMIT APPUCATION
# _
Date: t o ~3 site Address: 2 Unit
Norris: Plwne:
Residentf
Owner Address i city zip:
Applicant is: Owner Contras
Description of work: ~e - roo-F
Type of Work
Construction Cost: l3 ppo Mufti-Family Building: (Yes I No,.}
Company:57, Gom( ga r sa.UI t contact S44N'6'_PPWqW
15631 b,49L€ PAIR city.
Contractor Address:
State: Zip: c~Ea I~ Phone: a~ J~ f --7 1
License (9 tad Certificate MT 5 / 3 9 6
If the project is exempt from lead certification, please explain why: (see Page 3 fbr additional information)
_ ...~..m-..--~,.,,.,_..F,.,,.,~.....~,~,...~,,.~.. .,w.....v.~~~..,..~..~..~~,..,..~-..,..-,..,.-gym=
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 tf yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor. Piton:
Sewer & Water Contractor: Phone:
NO TE` P(ans.and sppuorting dnsumehts that you submit ar8 considerea to be pull information: Portions of
the 1n&rmafbn may be classitred as non-public if you provide c reasons that would permit the City to
conclude that they are trade secrets-
CALL BEFORE YOU DIG. CaU Gopher state one call attest) 4544= for protsc Ow against urrdargmund u0ty darnage- Cal 48 hurts
before you intend to dig to recem locales of r gmurld u"". www onhhemtatewAKM ono
1 hereby acknowledge ibis Wormadw is comPlefe and ac curaW. that the work will be in tbMbffUMCe wish ire Odnwxgs and codes of the City
Eagan, that 1 understand ttns is not a permit, but ordy an applicallon for a permit, and work is nol to St *Mh" a pernft that the work wB be kv
accordance with the approved plan in the rase of work which mgdm a review and approval Of Plam
Exterior work a%dhor'rzed by a buikOng permit issued in accordant with the Minnesota Sta& Br Mk* Code must be w"bin 18o
days of penult issuaiue. J
L 5od cmrAw- x-
s 51Srrat Page 1 of 3
Applicant's Printed Natnfe~
WPM pplion
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140051
Date Issued:11/21/2016
Permit Category:ePermit
Site Address: 4297 Fox Ridge Rd
Lot:5 Block: 3 Addition: Sun Cliff 5th
PID:10-72979-03-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Jennifer Nicklay
4297 Fox Ridge Rd
Eagan MN 55122
(651) 336-7462
Eagle Siding
1301 East Cliff Road
Suite 117
Burnsville MN 55337
(952) 746-3046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140052
Date Issued:11/21/2016
Permit Category:ePermit
Site Address: 4297 Fox Ridge Rd
Lot:5 Block: 3 Addition: Sun Cliff 5th
PID:10-72979-03-050
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
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: 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 -
Jennifer Nicklay
4297 Fox Ridge Rd
Eagan MN 55122
(651) 336-7462
Eagle Siding
1301 East Cliff Road
Suite 117
Burnsville MN 55337
(952) 746-3046
Applicant/Permitee: Signature Issued By: Signature