4165 Kingston Ct-?.--
CASH RECEIPT ? .
CITY OF EAGAN '
3830 PILOT KNOB ROAD r
EAGAN, MINNESOTA 55122
r ? ,• ?
DATE ? - ?
? 19
i !
?ECENED
FIIOIA ' ? / ?_?" '.1
1 Y
AMOUNT $
& DOLLARS
im
? CASH . ? CHECK
r- i
-?
er , n`,
C 15446 Whil??ayers CM?Y ?
VelbvF--Pos4rg (',ppy
Pink-File Copy
Thank You
SEWER dr 1NATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 551?21897
t.e' .
DATE ? sIPT$MBI?R 18. 1991
OFFICE USE ONLY
METER# PERMITDATE Oy/23/9I
CHIP # PERMIT # 12308
METER SIZE B.P. RECEIPT # C 1 S44b
ISSUE DATE B.P. RECEIPT DATE 0919 9I
PRV - BOOSTER PUMP
SITEADDRESS 4165 K11i0STON COUR't
LOT 7 BLOCK 4 SEC/SUB H1I.L3 Oi 9TOHSDRID6B 3BD
APPLICANT: CEN'fEX HOMES
ADDRESS: 5929 DAICBR l3D
CITY, STATE M1NNE11POLI3 MN Zip 55345
PHONE:
PLUMBER: PLYMOiRH PLUlIB1NG
ADDRESS: 9290 ZAGHABY LN
CITY, STATE
PHONE: MAPLE GROVE NN ZIP 55369
493-2474
OWNER: SAME Ay APPLICAlIT
ADDRESS:
CITY, STATE ZIP
PHONE:
PERMIT REQUESTED
X SEWER X WATER - TAPS
_ COMM/IND RESIDENTIAL
x NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL ?OT be given Or Deduct Meters.
1 AGREE TO COMPLY,NVITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
,
,.
. _?_..._ - __...._ - _.?..,s?,o._..._....Lm.,:;`?,..:..:_.?.. ?...,...... _ -
?
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 551 2-2-1897
DATE . SEPTEMBER 18, 1991
?
OFFICE USE ONLY
METER#a-7027-3 PERMITDATE J";/ 9 l
CHIP # Oa PERMIT # 12308
s "
METER SI7F
B.P. RECEIPT # (% l`'414'',
ISSUE DATE ,L?- 11-9Z B.P. RECEIPT DATE `i 9 / 19 / 91
SITE ADDRESS =si 6 ` ';tNGSTON COURT
LOT2_BLOCK 4 SEC/SUB H1LLS OF STON'?BR1DGG 3RD
APPLICANT: CENTER HOMES
ADDRESS: BAKER RD
CITY, STATE MINNEAPOLIS MN ZIP 55345
PHONE:
PRV - BOOSTER PUMP
PERMIT REQUESTED
X SEWER X WATER -TAPS
L COMM/IND X RESIDENTIAL
X NEW - EXISTING
PLYM?UTH PLUMBING Lawn Sprinkler Meters are
PLUMBER: Ahead of Domestic Meters
ADDRESS: Z??CHARY LN Credit-WILL ¢JOT be given f
? b
, STATE ROVE MN 5535
CITY 1 ?
493-2474 ZIP
PHONE:
I AGREE TO COM1J LY NVITI
to be Installed
on Water Line.
Deduct Meters.
L?
CITY OF
OWNER: SAME AS APPLICANT EAGAN ORDINJkNCES
ADDRESS:
CITY, STATE ZIP
PHONE: SIG URE WHEN METER ISSUED
:. _ ? .
PLEASEr'ALLOW TWOlWORKING DAYS FOR pROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. ? ??
I , CITYOFEAGAN ?±? j???t
" 3830 Pilot Knob Road, P.D. Box 21-199, Eagan, MN 55121
I . PHONE: 454-8100 , ; .
BUILDING PERMIT Receipt #
To be usetl for -$p jyW(`, GAQ Est Value 122QQQ Date $Ep I L . 1941-
Site Address 4165 KING'STOl1 CT
Lot 7 i_ Block 4 Sec/Sub. ?? OP OFFICE USE ONLY
Parcel No. Occupancy x-3 11-I FEES
Zoni PD 0.1
I W Name CEM7Ri_g=g
o Address 59$9 ??R Rn
City ?Lg Phone 946..7811
=o Name sAM
oQ Address
UQ
? City Phone
F
yVj W Name
?? Address
aw City Phone
I hereby acknowlege that I have read this applicatio and state that the
information is correct and agcQeo comply wrth al applicable State of
Minnesota Statules and 6i?"of Ea an Ordinances. /
Signature of Permitee
A Building Permit is issued to: x
on the express condition that all work e all be one in accordance with all
applicable State of Minnesota Statute and City of Eagan Ordinances.
BuildingOfficial
9
(AcWal) Const
Bldg. Permit 717,
QQ
(Allowable) ?? Surcharge bl•?
# ot Stories
Le^9th
? ?6??
Plan Review
Depih SAG Cily 100.00
S.F. Total - SAC, MCWCC 630•?
S.F. Footprints -
On Site Sewage _ Waler Conn
On Siie Well Water Meler 9s.?
MWCCSystem x ?
City Water
Z_ .M
??? Oeposit
PRV Required - S/W Permit ?aDQ
Booster Pump - S/W Surcharge • 50
Trealmenl PI 276•00
APPROVALS Road Unit 370*?
Planner
C
il - park Ded.
ounc
BIdg.Ofl. _ Copies
Variance - n
TOTAL 3,455•?
- Permit No. PermN Holder Date Telaphons #
WATER
SEINER
PIUMBING
Abi I
H.V.A.C. 91p3l GOJ O ;?
ELECTRIC 9/9 S U ?
Inspection Date Insp. Comments
Footings I Q
Foundation ? 3 .
Framing
Roofing
Rough Plbg.
Rough Htg. ? ? ;?
Isul.
Fireplace
Final Htg.
Orstst Test All
Final Plbg. plbg. Inspector - Notiry Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Dedc Final
Well
Pr. Disp.
40 f ?.
/
(gtrti#irate of (Orrupattry
Citp of (Eagan
EPpwtmPtd uf RdIdltcg ittSpPl'tiDtt
This Car)lQale iaueid pursuantlo the requiremencs ojSection 306 of the urujorm Building
code ceriitring rrurat rhe time ofissuance rhfs.wwcrure was in co,npr;ance wilk rhe Harivus
ordirtanars of the CuY reguladn%building cronsmcdion ar use I'ror the foUowing:
the cuarKatim SF?I,iC;CAF. mec.ttrmicNo. 19691
OCNPMCY ZYa N 7aoiKDietiC pp?°-7YPe CmC--P[r
Owoer of Bm16q GEMM Ham AddRS 9 M3S
eadi.cAaa= 4169 F.aT: Sm 9a= w-lar 3RD
?
Datc W23p,
, ?oec;,?,?aT-
.. . POST IN A CONSPICUOUS PUCE
-? -?' DAFE
e.. -_
RE:
SEP 23, 1991
4163 KIAIGSTON CT (CENTEX HOI9E8)
., ??+ ,
X Your S?wer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
- Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES -,TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Address: 4165 KINGSTON !;OURT Lot 7 Blk 4 Sec/Su}HIIL5 OF STOMEB_RjDCE 3RD
These items were/were not complete at the time of the final inspection.
12 23 91 Yes No
Firial grade (6" from siding)
Permanent steps - garage ?
Permanent steps - main entry V-.*,
Permanent driveway ?
Permanent gas ?
Sod/seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and tha shut-off of water supply to the outside lawn faucet before?
freeze potential exists.
PEMlEOMifR
White - City copy Yellow - Resident copy Pink - Contractor copy
CITY OF EAGAN Np 1969 1
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for SF DWG/GAR Est. value $122 , 000
Site Address 4165 KINGSTON CT
Lot 7 Block 4 Sec/5ub. HILLS OF
Parcel No.
W Name CENTEX HOMES
o Address _ 5929 BAKER RD
City MPLS Phone 936-7833
=o Name SAME
0
0Q Address
? City Phone
?
WW jName
? ; Address
aw City Phone _
I hereby acknowlege thal I have read this
inlormalion is correct and comp
Minnesola Statutes an of Ea an Ordii
Signalure ot Permitee
A Building Permit is issued to: CEJA
on the express condition that all work all
applicable SWte of Minnesota Statutes and
Building Official
and state that the
pplicabl¢ State ol
one in accordance with all
of Eagan Ordinances.
Receipt #
Date
SEP 1 L? L 5'7 Y
7 -V2
,
OFFICE USE ONLY
Occupancy R-3 M-1 FEES
Zoning PD R-1
(Actuaq Const V-N Bldg. Permit 717.00
(Allowable) -Y-N Surcharge 61.00
# ol Stories
?F8 1
Plan Review 466. 00
Length
Deplh 50, SAC, City 100.00
S.F. Total - SAC, MCWCC 650.0
0
S.F. Footprints -
On Site Sewage _ Water Conn
0
660.0
On Sile Well _ Water Meter
0
95.0
MWCC System X
Atcl. Deposit
30.0
0
Water
City _]?
PRV Required _ S/W Permit 30.00
8ooster Pump - Syy Surcharge .50
Treatment PI 276.00
' APPROVALS Road Unit 370.0
0
Planner - park Ded.
Council
81dg.Otf. _ Copies
variance - TO7AL 3,455.50
9'// 1/ F/
p 61403 ? ? la?oo /
"
Request Dale, ? Fire No. fiough-in Inspec[ion r
Re
fred?
? Ye5 L No '??
? Ready Now/?l Will Notily Inspector
? ?When Ready?
I_? licensed contractor ? owner hereby request in ection of above electrical work at
Job Aatlress (Street eox or Route Na) City
J
Section No. Township Name or No. Range No. County
Occupa ( IN Phone No.
PoWer Supplier Addr¢55
?
Eleci or ?Company Name? Contractor5 License No.
ailing ddre ontrector or Ow aking Installetion)
S b7Z-
Authorizetl Signat omractonOwner Ma'tiny Installa
ionj
t Phone Number
ry
?
/?/G)zdXCN? `
MINNESOTA STATE BOARD OF ELECTRICITY - THIS INSPECTION REOUEST WILL NOT
Griggs-Midway BIOg. - Roam 5-173 - BE ACCEPTED BY THE STATE BOAFD
1821 University Ave.. 51. Paul. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
9? 5??•? REQUEST FOR ELECTRICAL lNSPECTION
? See insiructions br compleLng ihis lorm on back ot yellow copy.
"X" Below Work Covered by This Request
ee-ooom-os
ew Add Rep- Type of Building AppliancesWired EquipmentWired
Home Fiange Temporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Dryer Other (Speclfy)
. Comm./Industnal Furnace
Farm Air Condltioner
? Other (specifyi Coniractor's Remarks:
Compute Inspeciion Fee Below:
# . Other Fee # ServiceEntrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Amps
Signs
Inspecior's Use Only.
P \
TdTAL ? e
a?
Irrigation Booms
Speciai Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Elecirical Inspector. hereby Rou9n-in oate
certify that the above inspection has
been made. Final ( Dat
OFFICE USE ONLY
This request voia 1B months irom `
'i;4i?o? ? 10o& ,
°
- S& 0°
o 4 ?
Request Date Fire No - Rough-in Inspection
Required? ? Ready Now ? Will Notily Inspector
9-18-91 }? Ves [ No When Ready?
I$ licensed contractor Downer hereby request inspection of above electrical work at:
Job Adtlress ISireet. Box or Route No,) City
4165 Kin ston Court Ea an
SeCtion No- Township Name or No. Pange No. County
Occupent(PRINT) Phone No.
Centex Homes Co
Power Supplier Atltlress
Dakota Electric
Electrinal Comracror iCompany Nama) Contractors Gcense No.
Lazer Electric, Inc. 041935-8
Mailing Atldre551Con(raclor or Owner Making InStallationJ
8383 Sunset Road N.E., Minneapolis, MN 55432
AuthorizetlS
l
gnature IConVactor/Owner Meklny InstAllation) Phone Number
?
?
/
i ? 1 j??„ 'z' k?1 784-3729
MINNESOTA STATE BOARD OF ELECTRICITY - THIS INSPECTION REOUEST WILL NOT
Griggs-Midway Bldg. - Raom 5-173 ? BE AGCEPTED BY THE STATE BOARD.
7821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
Il See in5tmc[ions for COmpleting thls form on back ot yellow copy.
?.46, PA n A "X" Below Work Covered by This Request
ee-700001 -0e
ew A$tl TypeotBuilding AppliancesWired EquipmeniWired
X Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./lndustrial Furnace
arm Air Conditioner
f__
? Other Isuecity) Contrector5 Ramarks'.
Compute Inspectron Fee Below.
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Abov Amps
Slgns inspector's Use Only: OTAL
Irrigation Booms $6.50
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DI CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MON
I, the Electrical Inspector, hereby Rough-in
?
g oac .-
certif that the above ins ection has
y P
been made. Finai
r oate /? !.?
OFPICE USE ONLV ?
This request void 18 month5 from
PERMIT# k---)
RECEIPT DATE:
8008 UKS1DEPTIJkL PLUM$INCY PEftM1T APPLICATION
C1TY Ol' EAfiAN
3$30 PII.OT KftOB iiD
EA6A1V, Mlv 551 E8
857-6$1-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS: 41 ? gi 1'76
Ct-
OWNER NAME: : I V?l I?? II?Ir I TELEPHONE #: tPs 1 -2-?;°7 r DD 4 2-
(AREA CODE)
INSTALLER NAME: 1"1 P• P? P?D r' V- TELEPHONE #: I2S i -a6? - I3?A'Z)
sTpEET .,DoRESs: .3 (a7 D b 01 N 2b (AREA CODE)
CITY: STATE: m N ZIP: J?
_ SEPTIC SYSTEM, newlrefurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consuitant fees may apply
• MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ W ater turnaround - existing dwelling unit (+ 518" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ water softener ? water heater $ 15.00
State Surcharge $ .50
? ?J •?
Total $
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Cityof Eagan ordinances. It
is the applicant's responsibility to notify the property owner that the City of Eagan assu es pt?iability for any a ages caused by the City during its normal
operalional and maintenance adivities to the facilities constructed under this perrnit wi hin Ci pro{lerty/righi- way/ a ment.
G T RE OF PERMITTEE 2
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
?P (651) 681-4675
?-?4
New C o n s t ru c ti o n Reouiremen t s Remo de U Reoair Reauiremen t s
• 3 registered site surveys
? 2 copies of plans (include beam 8 window sizes; poured fnd. design; etc.)
4 1 energy calculations
? 3 eopies of tree preservation plan 'rf lot piatted after 7/7l93
required: _ Yes _ No
DATE: ???`qa
DESCRIPTION OF WORK:
STREET ADDRESS: L41L
G1- ,
Zip:
6/ i
LOT: ? BLOCK: SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: ??f t a`?''y Phone #:
Lact First
Sueet Address: Ll I i0 J Cl 4
City State: W ? w Zip:
Company:
-`OVAN4? ???OFIIVG
3treet Address: In^
or-LrwB r -otreet
Ciry Bloomirtgton, !UtlV 5542%te,
Company:
Name:
Street
City State:
Sewer & water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
Zip:
,.
Penalty applies when address
I hereby acknowledge that I have read this appiication, state that the information is correct, and agree to comply with all applicabie
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: LAA"t ?01"',-
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No
? 2 copies of plan
? 7 site surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST: ?? I - ?S
_ Not Required '
Phone #:
?1 ?1- ?1l Ll l?
License # (?wl--qq7 Exp.
Phone #:
Registration #:
OFFICE U5E ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
0 31 New ? 33 Aiterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Variance
Permit Fee
Surcharge
Pian Review
License
MClES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Census Code
SAC Code
Census Units
Census Bldg
MCIES System
City Water
Booster Pump
PRV
Fire Sprinklered
% SAC
SAC Units
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
ing/t PHONE: (612) 454-8100
...................................................
C?AN?C!P:x. .,P:E??'?
FOR CITY USE ONLY
PERMIT
RECEIPT #
# O
DATE:
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------- ------------------------------------------
WORK DESCRIPTION FEES
NEW CONST ?
ADD ON
REPAIR
OWNER NAME : ????
SITE ADDRESS:
LOT; / BLOCK ? SUBD.
INSTALLER: L?,?-,'?y?'?? i?.?rf'/yJ?
ADDRES S :
CITY: ZIP: ?-
PHONE ?-Z" - 2,16?
DWELLINGS &
ADD-ON MINIMUM 5.00 '
HVAC 0-100 M BTU 24.
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
TOTAL:
SI?E F PERMITTEE
SO
$ /S J?li
? r
PLEASE COMPLETE THIS PORTION FOR ALL GOMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPAR.ATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LAT: SIACK SUBD.
INSTALLER:
ADDRESS
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EAi.H $1,000 Oi PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
?
CITY OF EAGAN FOR CITY tTSE ONLY
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # O
"Sm5pWam DATE: 9 r'? _
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ --------------------------------------------------------
WORK 7PTION FEES
NEW CONST ADD-ON MINIMUM $15.00
ADD ON HVAC 0-100 M BTU 24.00 `?
REPAIR ADDITIONAL 50 M BTU 6.00
OWNER NAME: ?AJT?'X
SITE ADDRESS: %/(9 J ,[y
LOT:,??BLOC SUBD.
INSTALLER: 'I'v /U. L.
ADDRESS
CITY: CS? ZTP: J
PHONE #: 01'i ??(s1S ?/
GAS OUTLETS - MINIMUM 3.00
GF 1 PiR PE"MIT
?
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
... . :. ,....,...: :
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME:
SITE ADDRESS:
IAT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
1s np rpNTgnCT F$F,
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
FOR:
CITY OF EAGAN
$
(SIGNATURE)
?
SUBTOTAL: $ .7'•
STATE SURCHARGE: .50
r??
: .
1991 BIIILDING PERMIT APPLICATION
? CITY OF EAGAN
SINGLE FAMILY DWELLINGS MOLTIPLE DWELLINGS COMMEERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCIiITECTUR4L
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENfiRGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT TS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A'
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: `??! 6AR ' Valuation: /7-2A Odr? Dat
Site Address _z??IWGSro,d OFFICE US:
Lot 7 Biock ZI H?Lc.s or
occupancy 1Z'3 M-I
X Zoning PD R-1
Parcel/Sub ?/?-,B,Ql,Q«' Rn QppA/
.-5 Actual Const V-N
Allowable V-/4
Owner ? ?,(ff?fC ?ry?r S # of stories
Length yg?
Address Depth ?Ool
S.F. Total
City/Zip Code G Footprint S.F.
Phone On site sewage_
On site well
Contractor MWCC System ?
City water f/
Address PRV _
Booster Pump _
City/Zip Code
APPROVALS
Phone Planner
?-/ Council
Arch./Engr. E? !?!V( Bldg. Off. `I-f69/RS
Variance
Address
City/Zip Code ? yS
Phone #
D.
SEP 1 2 i991
FEES
Bldg. Permit 17, Dp
Surcharge I.Op
Plan Review (0,00
SAC, City 100000
SAC, MWCC 4Ov
Water Conn. (o(np.Ov
Water Meter 95.w
Acct. Deposit 30.00
S/w Permit 30,00
S/W Surcharge 150
Treatment P1. 2 Rb,oo
Road Unit 3170.00
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL g.?Q
that all work shall be done in accordance with
(Signaturelplf Cg?ntractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
?.
VA LUAT l0
?.
i
2422 Enterprise Drive
? PIONEER LANDlURVlYORd•CIVI.ENGfNEERS ` II Mendota Neights, MN 55120
--- ---- ??
?engiyneering.. LANCS't APEIIACHITECB (612) 681-1914
T
Certificate ot Survey tor:??N
?
EAGAN fJORtN
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AAGAN ERTGINEERiNG EMY.<11
x soo.oo Denotes £xisting flevations PaoP195E0 NOUSE ELEI/qT10N5
? oo.oa OPno¢?s Oroposed Elevations Lowes} x/oor E/evotion 9 i1. oO
--- -- Dtno}?5 Orv?n Q ?U/ ?l?'y fasemenf Tp o?'8/ock ElPVOlion 9r9• ??
-- Dena/es Oraino e low ?rrows
o Denofes Monument Gora?e Slaah F_le;/crf?on q1 g. S3
Becrrmls shawn ore assumed o DFnoles N(1b
LoT 7, BLOCU4, ytL L S oF STONEBRID6E Afl AM
DAkOTA CDUN7Y, M11VNE507-A
I hereby certify that this survey, plnn or report wa5 re ared by m?flr under my direct suprtrvISinn and Itmt I nn, duly fli?gislered Land Surveyor
unAer 1he lev?n ol thr State ot Min"esota. Dnted this 429day o1 A p 191)
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Siding .G7
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36.00 Insulation 94.00
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= Air Film 0.61
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R
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FR1,MIIM CEILIIQG
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r
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-
- Insulation 33.85
- Air Space .50
.67 Roof decking .67
.06 Felt .06
_44 Shingle .44
0.17 Outside air film 0.17
16.88 Zbtal R 36.86
• .059 = U .027
Window infiltratian _5 ?/ii*±?i foot of crack R
Residential door infiltration 0.5 c5n/square foot or door and min??mm+ oode requirement
Non-residential daor infiltration 11_0 cfm/lineal foot of crack
[b 12" conctete block no insulation =.781 R 1.28
double glass = .52
triple glass = .31
All eaterior valls and ceilings must have a vapoc barrier (0.10) petm max.)_
Vapor barrier mast be on the inside (heated side) of vall.
Vapor bariers of the polyethelene thin film have no R value.
2004 RESIDEIVTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeURepair Repuirements
3 registered site surveys showing sq. ft of lot, sq. ft. of house: and all roofed areas 2 copies of plan
(200/o mauimum lot coverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addi6ons & decks
1 set of Energy Calculations Add'rfion - indicafe if on-site septic sysfem
3 copies of Tree Preservation Pian it lot platted after 711193
Rim Jo'st Delail OpSons selection sheet (bldgs with 3 or less units
?
g??
??i?(Surv'??y???
Date -+-/ `J / -DL Construction Cos -1'l •'-r, (000
Site Address ?
, ?? ,S
--?J 1 ()C1UniUSte #
Description of Work ???
l?h ??Y? ? ?? ? ?? ? `<' -e- Q
t n ?? f'1?
Multi-Family Bldg ?
_ Y-Y-- N _
Fireplace(s) _ 0? 1 _ 2
Property Owner I- pcj A ?^, C Q-e i ? Telephone # ( (pS1 ) 454 ' Wq
Contractor -V V b ?
Address City Q
State Zip ? Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worlcsheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan 'milar plan? _ Y _
fee applies.
Licensed Plumber Telephone # (
Mechanical Contractor Telephone # ?
Sewer/Water Contractor Telephone # ?
N If so, 25% plan review
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 permit, and work is not to start without a
permit; that the wark wili be in accordance with the approved plan in the case of work which requires a review and
approval of plans. ?
Lo1' i (T vl ?1 M4.J 2i
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation 0 07 OS-plex ? 13 16-plex /N" 20 Pool
? 02 SF Dweliing ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 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-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
1, 31 New
E3 32 Addition
? 33 Alteration
CI 34 Replacement
valuation 6 ? 0
Gensus Code SAC Units
# of Units
# of Bldgs
Type of Const V"N
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
W idth
REQUIRED INSPECTIONS
FinallC.O.
FinallNo C.O.
_ Plumbing
HVAC
Other
? Pool _ Ftgs
_ Siding _ Stucco
_ Windows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 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 Buiiding* ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
P,9 C) L,
Air/Gas Tests Q' Final
_ Stone _ Brick
V, fO t9 o
POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
?
?
GENERAL INFORMATION
o
d
z U
:a
¢
? O ? Applicant - name, address, phone & fax numbers, signature
? ? ? Property owner name
? ? 0 Legal description and address of property
? ? ? North arrow
scale (1" = 30' or 40') and date
;U ? ? ,
Location and name of a11 streets adjacent to property
9- ? ? Site Plan drawn to scale showing location of house, pool and other existing or proposed
structures
? ? ? Directional drainage arrows (existing and proposed)
ELEVATIONS
Existinq
J2S( ? ? House corners
,W ? ? Property comers
?14 ? On property lines at point of ineasured dimension to pool (see below)
?)2f ? If applicable, ground elevation at each end of retaining walls and at wali's greatest height
Proqosed
Of ?? Finished pool deck corners
?A ? Top of retaining walls (if any) and at each different elevation (if it changes)
U ?? Pool bottom (or max. depth)
DIMENSIONS
Existin
0 ? ? All property/lot lines
Proaosed
E, ? ? Pool
Ek ? ? Pool plus integrated deck/patio
?? Shortest distance from outside edge of pool deck to lot lines and house
Reviewed:
Name Date
G:/tECH/JR 2002/Poot Permit Checklis[
I r .
* * *if
? PIONEER LAND lURVEYOR9•CIVI ENWNEER3
----------- 2422 Enterprise Drive
Mendota Heights, MN 55120
---
- -
? engineering,. LAND PLANNER9 ? LAN APE ARCHITECTS
?
--
I
(V C 12) 681 1914
* * *
*
Certificate of Survey for:?C-N T-EN
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'
' EAG A N IJORiN
? ? EWu- ?c, D
R-E R£v}EwEo
? .17711T ?1$'[!?1
? yp 4r /t ` DATE
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72-94b
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements
3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculalions
3 copies of Tree Presenration Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings wRh 3 or less units)
Minnegasco mechanipl ventilation (orm
RemodeVReoair Reouirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calcula6ons for heated additions
1 site survey for addi6ons & decks
Addifion - indicate if on-s8e septic system
Wled ?-Il
7tp) . t?)t)
Office Use Onlv
Cert of Survey Recd _ 1" _ N
Tree Pres Plan Recd Y_ N.
Tree Pres Requiretl Y_ N
On-site Sep6c 5ystem _ Y_ N
Dat / -,/0
Site ddress ?f??_
?it?bJlQyl? onstruction Cost
?? / UniUSte #
Description of Work G rv /?lS
Multi-Family Bldg _ Y? N Fireplace(s) 0 0 2
Property Owner 0 /lzI G I 7 Telephone #(?/ ) -'/ ! V
Contractor
Address
State 6/? City fJOJ 4
Zip Telephone # (?a ) S\J? A?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code CategOry . Residential VenGlation Category 1 Worksheet • New Energy Code Worksheet
(?1 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
in the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master pian?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber 2 lephone #(
I m LF== ?? LEI U \Y/
Mechanical Contractor lephone # ( unu APR 1 0 2006
5ewer/Water Contractor 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 fo a permit, and work is not to start without a
permit; that the work will be in accordance with the approved pl ' the f wor hich requires a review and
approval of plans.
,C?? 1?????h.; ?
Applicant's Printed Name A lic t's Signature
DO NOT N'4'RITE BELOW THIS LINE
Sub Tvpes
? .01 Foundation
? 02 SF Dwelling
? 03 01 of _ piex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Tvpes
? 31 New
O 32 Addition
?!T,, 33 Alteratiom
? 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
?< 19 Lower Level
? 20 Pool
? 21 Porch (3-se2.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
? 25 Miscelianeous
? 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 WindowslDoors
`Demolition (Entire Bldg) • Give PCA handout to appficant
DesCfipti011: WaterDamage_Yes
Valuation (e2 LEO- Occupancy MCES System
P1an Review 100% or 25%
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ? Width
_ Footings (new bldg)
_ Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
4- Framing
Fireplace _ R.I. _ Air Test _ Final
? Insulation
REQUIRED INSPECTIONS
_ Sheetrock
FinallC.O.
? FinaVNo C.O. •
HVAC
Other
Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
_ Retaining Wal]
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 OS-plex
? 08 O6-plex
? 09 D7-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
el"
,.
r'? ?..°"
(??.???
Z1 6..? 0 0
-( 3t C)G 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION $30'ESD
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when peanits arc required for each unit
Date?_/
, .
Site Address Unit #
Property Owner ? T ephone #
BINDER HEATING & AC, INC
Contractor N
927 u
r1?an Avc
.
w
?• ?• ?ul, MN 55075
Street Address
6514571-8781 City
State Zip Telephone # ( )
Sond #• Expires:
The Applicant is _ Owner ? Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
air conditioner
? other W? T New Replacement
W 1?
State Surcharge $ .50
Total $
I hereby apply for a Residential Mechanical Pernut and acimowledge ihat 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 Mcchanical Codes; that I understand this is not a
permit, but only an application for a pernrit, and work is not to start without a permit; that the work will be in acwrdance with the
approved plan in the case of work which requires a review and approval of plans?
Applicant's Printed Name Applicant's Signature
2005 COMMERCIAL MECHANICAL PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciaUindustrial buildutgs
multi-fauuly buildings when separate pernuts are not required for each dwelling unit
Date / / .
Site Street Address Unit # '
Tenant Name (if applicabie) Previous Tenaut Name
Property Owner?
, , Telephoqe,# ( )
,•
ContraCtor -,;.d .•> . -
Street Address A
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner Contractor _ Other
Work Type
_ New Construction _ Underground Tank _ Install _Remove "*see below
_ Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
**When installing/removing underground tank, call for inspecfion 6y Fire Marsha/ and Plumbing lnspector
pEMlllt FCQ9: $70.50 Underground tank installation/removal
$50.50 Miiumum (inclndes State Surcharge)
or
Contract Value $ x 1% _ $ Pernut Fee
• Lf perntit fee is $1,000 or Iess, add $.50 => $ State Surcharge
If uermit fee is over $1,000, add $.50 for
every $1,000 nermit fee $ Total Fee
i nereny appiy ior a e;ommercial Mechazucal Yermit and acknowledge that the information is complete and accurate; that the work
will be in wnformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that 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.
Applicant's Printed Name
ApplicanYs Signature
Approved By: .lnspector
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4165 Kingston Ct
Lot: 7 Block: 4 Addition: Hills of Stonebridge 3rd
PID:10- 32992 - 070 -04
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Crew2 Inc
2650 Minnehaha Ave
Minneapolis MN 55406
(612) 276 -1680
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
$88.50
$1.50
Total: $90.00
Owner:
Lori A Mcneil
4165 Kingston Ct
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Permit closed without required inspection(s). Letter sent to applicant 3/2/2010. (pi)
Building
EA091259
09/23/2009
ePermit
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA110813
Date Issued:05/29/2013
Permit Category:ePermit
Site Address: 4165 Kingston Ct
Lot:7 Block: 4 Addition: Hills Of Stonebridge 3rd
PID:10-32992-04-070
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.
Amanda Rivard
308 Sw 15th St. Ste 25
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Lori A Mcneil
4165 Kingston Ct
Eagan MN 55123
Upland Heating & Cooling DBA Aspenair
308 SW 15th Street, Suite 25
Forest Lake MN 55025
(651) 982-2626
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA156518
Date Issued:07/03/2019
Permit Category:ePermit
Site Address: 4165 Kingston Ct
Lot:7 Block: 4 Addition: Hills Of Stonebridge 3rd
PID:10-32992-04-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Lori A Mcneil
4165 Kingston Ct
Eagan MN 55123
(651) 592-3595
Warner Stellian Co Inc
550 Atwater Circle
St Paul MN 55103
(651) 222-0011
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179240
Date Issued:09/26/2022
Permit Category:ePermit
Site Address: 4165 Kingston Ct
Lot:7 Block: 4 Addition: Hills Of Stonebridge 3rd
PID:10-32992-04-070
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:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Lori A Mcneil
4165 Kingston Ct
Saint Paul MN 55123--394
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature