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4197 Knob Cir MAY,/18/2010ED 11:21 Ali City of Eiagan PAX'No, 651--975-5694 P. 001/001 Use BLUE or BLACK Io I Par nit : l ~o I Purrnit Fwa: I City of Ea ` t 3830 Pilot Knob Road 1 bate R vad'. Eagan MN $5122 I Phone: (651) 675.5675 T 1 staff: I V r-- ~J Fax: (651) 675-5694 2011 RESIDENTIAL BUILDING PERMIT APPLIC ION Unit - q -7 - I]ato:' ` / Site Address.t Name; Phone: RESIDENT I OWNER Address l City J ZIP: Applicant is: 4wrrer contractor Description of work: TYPE OF WORK Constructbn Cost: / Mulbl Family puliding; (Yes I No -X-) Company; ' contact: Address: CONTRACTOR state; ZIP: S~aOb phone;! " ~G~ LicenesE Lead Certificate #'Does this project require Lead Remediation7 0 Yes 0 No (sae Page 3 for Additional information) If no, please explain: COMPLETE THIS AREA ONLY IF CONSTRUCT-IN O A NEW BUILDING In the last 12 months, hao the City of Ea6dn Issued a permit for a similar plan baevrt on a master plan?' _,Yes _.No if yes, data and address of master plan; Licensed Plumber; Phone; Mechanical Contractor. - Phone: Sewer & Water Contractor: Phone: NOTE: F+lansi and supporting documents thaf you submit are consldared to be public Information.. Portions of, the infurrnatl~sri may'he classlfSad vv non-publlo if you' provide speagc reasons that would permit the City to conclude that the aie trade secrefsr CALL BEFORE YOU pIG, Call t3alstter Slue One Call at (651) 044002 for proleotlon against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilitles. ynnrw ooohmrstate9neca ore I hereby aoknowledge that this Informodon is complete and socur2te; that ow work will bo In conformance with tho ordinanoos and codes of tha City of Eagan; that l 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 scoordsnoe with the approved plan in tho case of work which requires a review and approval of plans. Applloant's Printed Name Applicants Signature Page t of 3 10/T0 30Vd d00(1 3!DVdV9 30V b6>;0LOLZ96 LT:TT TTOZ/BT/90 6ASH RECE[PT CITY OF EAGAN . . P. O. BOX 21-199 r EAGAN, MINNESOTA 55121 DATE 19 RHCCIVED FROM AMOUNT $ I & DOLLARS 1 00 E]CASH ? CHECK ? ` Y.' . \ ?..., f ?.^o-.?_ .... _ . FUND CODE AMOUNT Thank You BY- White-Payers Copy Yellow-Posting Copy Pink-File COPY CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE I9 RiC61V60 FROM AMOUIYT $ I ?& DOLLARS +oa E] CASI-1 [:] CHECK FOR f ? ?- ? FUNO CODE AfdOUNT - - 7 1 Tha k ?ou BY White-Payers Copy Yellow-Posting Copy Pink-File Copy NOW CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21•199, Eagen, MN 55121 PHONE: 454-8100 BUILDING PERMIT ReceiPt Te M uwd for 1/2 DUY/GAA `Q Est.Value ; 5610()J Dorp JUCvE li3 t0 84 Site Addreaa Lot 1 Percel No. _ c Name ...,•, caia?Li.a? ?.v?Jt Z Address 1 133 CI;DAR avE 9 cie,r rARMIraGTUtPhone 454-475 ? Erect ? - Alter ? - Repolr 0 ? Enlorye ? - Move p - Demolish ? Occuponcy Zoning `? S Fire Zone `II/A Type of Const. Vri # Storie£ 2 ? Length ZF Name ApProrals Address Assessment ? City Phone Water 8 Sew. Police w F W Neme Firc ?? Addreu Eng ?W City PAone planner Councll I hereby acknowledge thot I have read this applicotion and state thct Bldp. Off. the intormotion is correct and ogree to comply with all applicable ? ,)C).=•. ? ??iZLLF.R Ci)iVST Sq. Ft.- Sfote of Minnesoto Statutes ond City of Eo9an Ordinances. ^ $ipnutu2 of Pertnittee Fees Pertnit ° " '. Surchorge 26.00 Pian check 150.50 SAC `?25.00 Water Conn. 470.00 WoterMeter 63.04 Rood Unit 260.00 Taol ''° , u j o A Building Pemmt is is:ued ta ? ' - -? on the express conditlon thnt oll work shall be done in accQ'rdanct wdth dl oppl4ooyld ,?r6te oi Minnesoto Statutes and City of Eoflan Ordinances. PEL' AS PP.IGh TO_ :iITF: Permit No. Permit Holder Misc. Permit No. Holder Plumbing ?v1 rnC&u? V2 H.V.A.C. )- Wall WMer Disp. Sewer Ekctrie /1" In"ction Dsb Insp. Other Footings Foundation Framinp I ? 4 Ro?o? P??. 7 Rouph HVAC Slo t V D,?cI ? Inwlation 7 Final Plbp. .?- FFinal HVAC ?/ F1nal - D v . WaNr ??i? Location: Wel I Sewer Pr. Dirp. CITY OF EAGAN ar ? n , 3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121 ?f ?i .183 ' PHONE: 454-8100 BUILDING PERMIT Receipt .# To M w? d fo. -j; Ui?/Gli,ti Est. Volue $52,000 Dnte JUiVE lts ` 19 Site Addrese 41'_' `) I (',1i CIR 1,02) Erect ? ? Occupancy • Lot ' Block 1 Sec/Sub. 10 - [ l ) - 01 Nlter ? Zoning Parcel No. . l Re ir po ? " Fire Zone , , ?., JC' , COEy" i Enlurge ? Type oF Const. I?` _ Name W Z Add '.;1.;; 11zYE. 1 Move ? # Stories ? U res ? Cit s 4?i4-9753 ';'Ph Demolish ? Length ° ?4 y one Grode ? '- Depth Sq. Ft.- ? Name i? Address ,. 0- City Phone Name _ Address City - Phone Water 8 Sew. Police Fire Eny. Plonner Council Faas Permit ' '? ; ?` • G Surcharqo 26.50 Plan check 146.00 SAC s' 2:i . 00 Water Conn. l G Water Meter ? Road Unit 10 I hereby acknowledge that I hove read this opplication and state that BIdO. Off. the information is correct ond ogree to comply with all opplicoble APC Srate of Minnesota Statutes and City of Eo9on Ordinonces. Sipnoture of Permittee - A Building Pertnit Is (ssued M: oli work shall be done in accordance with all applicable State of Minnesota Building Officiol ?j Total 1 on the ezpress condition ihnt Statutes and City of Eapan Ordinonces. Parmit No. Pormit Holdsr Mise. Permit No. Holder Plumbin9 y CJ ?p fj rn? huti (2 H.V.A.C. q a a- Wl?'" ?r II S Well Water Disp. Sawar EbMric G Inspection Dah Insp. Othar Footinpc Foundetion Fnming Z Rouqh Plba f Rouph HVA InwlMion R Final Plbg. ? -1 _ Final NVAC Final v Water Oeacribe Location: Well . Sswar Pr. Disp. Receipt Y, i?J MECHANICAL PERMIT / CITY OF EAGAN Fill in numbered spaces Type or Print legibly l x 1. Date 2. Installation Cost ,- i 3. Job Address1-''I ? Lot ? Blk. 4. Owner N 5. l ( Phone Permit No. Fee S/C Tot. . Trad _ T-1 ? 6. Address 7. City State Zip ? 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New 0 Add ? Alter ? Repair ? 10. Describe Fuel Type I 11 No. Epuioment BTU - M. Ea. Forced A ir ' No. Equipment CFM Air Handli : Mfg. - ng Boilers - Mfg. - Mech. Exhaust Unit Heater _ Mfg. Air Cond. • ' Other Mfg. Gas, Piping Outlets 12. I hereby certify that the a6ove information is true and correci, and I agree to comply with all ordinances and codes governing this type of work. Signed : ?-- _ - : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8100 Receipt MECHANICAL PERMIT Permit No, CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print /egib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot Blk. Tract 4, Owner 5. Contractor Phone 6. Address II 7. City State Zip I 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add O Alter ? Repair ? 10. Describe 11. No, EQuipment 9TU - M. Ea. Forced Air No. Eouiqment CFM Mfg, Air Handling: Boilers - Mfg. - Mech. Exhaust Unit Heater _ Mfg. Oth Air Cond. er Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and 1 agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 uel Type Recei t ;/ i L, 1. Date 7123/84 PLUMBING PERMIT CITY OF EAGAN I Fill in numbered spaces Type or Prinilegibly Installation Cost Permit No. V/;G ( Fee 20.00 s/c .5171 Tot. ??- / 3. JobAddress 4 19 9 KT?Ob Lot?2Bik. 1 Tractt-' ?II ' J 4. Owner TOe b?iller Construction A- 5. Contractor ?-CC-ll1TC PeChar. i.,41 Phone n 6 9-4 9 6. Address P. O. Eox 219 I,akPVil le, r;,,r. 55 G_ ti 7. City T.,;kF+vi 1 1 aState p,y?y Zip r r? 0 rn 8. Building Type: Residential ? Commercial ? Institutional O 9. Work Oescription: New ? Add ? Alter ? Repair O 1 70. Describe I 11• No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs $eptic Tank Lavatory Softner ? ? Shower Well 1 Kitchen Sink Urinal/Bidet Other Laundry Tray ? Floor Drains Drinking Ftn. ? Slop Sink Gas PiPin9 Outlets 12. I 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 : 21 for ;.hough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 . ; "I `1'/ Receipt i PLUMBING PERMIT CITY OF EAGAN Fil1 in numbered spaces Type or Print legibly ? Permit No. Fee ?S/C Tot. J ?--r. 1. Date JT I:Y 23 j, .,g, Installation Cost ;' ;I ; I\, '. . 3. JobAddress 4198 1,71or Lot]. i_Blk. l Tract ? ^? ? ry II t ?vvLJ a.Owner Joe r"iller Constrl-cticr: 5. Contractor ' c('ii i rr Atnch ir i r,? 1 Phone I ( q-Q q?p 6. Address r. C.--E03. 2 19 -I,akLQVillip-r 1'inn. 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New a,, Add ? Alter ? Repair ? ? 10. Describe I 17. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank Lavatory Softner 'e ? Shower Well Kitchen Sink Urinal/Bidet Other _L Laundry Tray Floor Drains Drinking Ftn. ? Slop Sink Gas Piping Outlets 12. I 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 Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8700 CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: MN 551 Ea an DATE: g , Zoninp: No. of Units: ?r: ,.a9ep.i . er onet Address. 411 49 o' "`1n '`T` Iin(D . Site Address: Plumber t?CGulI'c: .`?eci•. ' 6-18-84 44171 100 . ) P- 1 epree to aomyy wkh !M Ciyr of Eaoaw Connedion Chorpe: 4 2:i . 00 pd D. Ordiwnces Actount Deposih . 10 00 Permit Fee: . p 50 d Surcharoe: . p B CFa?pes: Misc y . Dote of Ira : Total: p. insn.: Dats Paid: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Ea an MN 551 21 DATE: , g - ,. ;: _ _. Zoning: ?lo. of Units: .. OWfIQr: Addre55: ? o Site /?ddress: . n . Plumbea ,•^tt'?_:rs ",2ci: Meter No.: Connedion Chorge: • .?..i p Size: Account Deposit: 10.00 pd Reader No.: Permit Fee: `i!) n3 . 1 aym ro oomOly Wi1M tM Cih of Faysn Surcharge: . ._ n re er p??nceL Misc. Choryes: Totol: g Date Poid: y Dote of Insp : InsP-: . CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Kno6 Road ?5nb. P. O. Box 21199 PERMIT NO.: Eagan, MN 5812] DATE: 'L : ? Zoning: ` ?lo. of Units: Owner• OSeph :'. . - -.eT nri?c Address: - ; ?Sita Addre ?,1C ?' te or, T ,Plumber: . T???6?? Meter No.: } ?l nection Charge: Iayiw te aowylp wuh Ilr Ciry of Leyan Ordiwaeas. ey Date of Insp.: T//_ / t7 r/ M*eounr oevosit: 15.00 pl.' Permit Fee: 10.00 pd Surchar9e: .50 pd . _ p raete: Mist. Charges: Tcml: Date Paid: Irup.: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. d. Box 21199 PERfNIT NO.: Eagan, MN 55121 DA7E: Zoning: No. of Units: -' ? OWrber: _ ..r03pF'll ?.`t.:.i°_i roI13c. AEAR55: Stte Addrcss: 197 `:nob 'I,? ^: ::i?.. 3' PlUR1b2f: - .:-?%U 11lc flC.!] AAeter No.: Connection qwrqe: 4 7 0. 00 pd Size: Actount Oeposit: 15. 00 pCl Reade? No.: Pertnit Fee: 10. r)0 Ud I pme to aowyr wp6 Nie Ciey ef Eagsn Surcharge: . 50 vd Ordieaneu. Misc. Charyes: 63•00 Dd metCl Total: By Date Poid: Dote of Inap.: Inap,; CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road > P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: ? Zoning: No. of Unies: i of '' Owner: .:`ry32ph P.11.1:tt' Cc,;t3t Address: Site Address: ' 197 Kilob Latic: IJ Plumber. "cCuiTe .'(ech . . 7.) 77 1c!m 1e eonNllwNh Na Cify sf Eya¦ CannacHan C}wrpe: Ordinanees. Account Deposit: I S.()(i n:i Permit Fee: a 4 Surcharpe: -r,c? Bv Mix. Choryes: Dote of Insp.: Total: Insp.: Dote pald: CITY OF E OGAN WATER SERVICE PERMIT 3830 Pilo_ ,: wb Road P. O. Boz 199 PERMIT NO.: Esgar., 'W" L-05121 DATE: c!r 2oning: No. of Units: 1 of 2 Owner. ` 1: tanbe I Peadel nIR-EQUIRED .._...... .__. I I yme to aom0ly wbh MM ah OF Ea9en Surcharge: . 50 Pd ?inances. Misc. Charges 53.00 nd metei ? Total: i Bv " Dote Poid: Dote of insp.: Insp,; ? CITV OF EAGKN Remarks rl /c :!?? - Addition KNOnB. HIL?L?r ?OF EAGAN Loc 002A eik 02 Parcel 10 42500 002 02 Ow'n/er Street ??J /?l/IS.? I'.f. • UI11t 102 State Eagan, MN 55122 Improve ent Oate Amount Annual Years ' Payment Receipt Date STR EET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK nn 1973 SEWER LATERAL trk ? 1 226.32 l0 WATERMA IN 19g3 7 l0 WATER LATERAL WATER AREA 1777- ?.1 U21 2 storm sew trk 1$1 6.8 50.97 1 4 71?- STORM SEW TRK 1$3 79-90 77-99 lO STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN, BUILDING PER. SAC PARK CITY O,F EAGi+N Remarks a L /V/? - Addition KNnR NTT,T, OF F,AC,AN Lot C0?1f Bik 02 Parcel 1-n L.2500 001 02 Owner ? ? - Street ???7 ?//? 1" un1-t 101 State ?, M 55122 //,//- ?) VI): ftL v b.e.??? ,-. ,( Improveme t Date Amount Annual Years ? Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK ? 173 UIl O-l*nial p L C2 ? -* SEWER LATERAL 2263.16 226.32 WATERMAIN 1983 1765.80 176. $ 10 ?J.3?•0 a O//o0y? WATER LATERAL WATER AREA 1 77 ?.l Lll7Cl .?09. 6 a iG o y 2 -2s STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK ? f Rvnewal By Andersen RESIDENTIAL 350-73rd Ave. NE ILDING PERMIT APPLICATION Fridley, MN 55432 CITY OF EAGAN 4? 763-502-4777 3830 PILOT KNOB RD - 55122 #MI?'20130983 ??? 651-681-4675 lo -'& -U? New ConsWcGon Reauirements Remodel(Reuair Reauirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies oi plan (20% maximum lot coverage allowed) . 1 set of Energy Calculafions for heated additions • 2 copies of plan showing beam & window s¢es; poured found design, etc.) • 1 site survey for exRerioraddi6ons & decks • 1 set of Energy Calculations • Indicate if hame served 6y septic system for additions • 3 copies of Tree Preservadon Plan 'rf lot platted a8er 711193 • Rim Joist Detail Options selection sheet (bidgs with 3 or less units) DATE VALUATION 15, JOB SITE ADDRESS y,QI? kTV--)O C.%C 6"e IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER ?%t ktW. C"e9011 TYPE OF WORK?k?Clr Cl l.W wy?Oc,_-?S ca 'iMnjn FIREPLACE(S) _ 0_ 1_ 2 APPLICANT ?.co%. E it-5 [7Qo..r?,V' PHONE#55a•34 574.0044 ADDRESS ZIP CODE S54aO PAGER # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category t Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: _ Pluxnbing System Includes: Mechanical Contractor: _ Mechanical System Includes: Sewer/Water Contractor: - Air Conditioning _ Heat Recovery System Phone # Phone # ree: $90.00 Fee: $70.00 Ail above information must be 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 Or inances. Signature of Applicant CELL PHONE # _ Water Softener Watcr Heater _ No. of Baths Phone #: Iawn Sprinkler No, of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 OFFICE USE ONLY , ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ait - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition , ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) = Give' PCA haniiout to applicant Valuation Occupancy . . MC/ES Systern Census Code Zoning City Water SAC Units Stories Booster Pump Nbr.'of Units Sq. Ft. PRV " Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Footings(deck) _ Footings (addirion) Foundation Drain Tile Roof Ice & Water Final Other _ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucw Stone _ Insulation _ Windows (ne?Nlreplacement) Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinaUC.O. FinaUNo C.O. _ Plumbing HVAC Building Inspector ? CITY OF EAGAN A % 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 l?l? 9183 PHONE: 454•8100 1% G,l,7/17/ BUILDING PERMIT ReceiPt # ? ? To ba wed for 1/2 DUP/GAR Est. Vclue $52,000 Date JUNE 18 19 84 • Site Address 4199 KNOB Wo (UNIT 102) Erect ? Occupancy R3 Lot 1 Block 1 Sec/Sub. KNOB HILL Alter ? Zoning R Parcel No. 10-42500-010-01 Repoir ? Fire Zone N A Enlorge ? Type of Const. Vn - ce Name JOS MILLER CONST Move ? 2 # Stories ? 18133 CEDAR AVE Address Demolish ? Length 20 ? City FARMINGTOI*hone 454-4753 Grode ? Depth 24 Sq. Ft.- o Name S?E Approralt Fees ? Address Assessment Permit $ 584.00 ? f- City Phane Woter & Sew. Surcharge 26.50 F Police Plan check 146.00 FW Name Fire SAC 525.00 ?,?-? Address Eng. Water Conn. 4 7 0. 0 0 QW City Phone Plonner WoterMeter63, 0 Council Road Unit 260 _ 00 I hereby acknowledge that I hove read this application and state that gldg. Off. the information is correct ond agree to wmply with oll opplicoble 074.50 $2 Sfote of Minnesota Statutes ond Cify of Eogan Ordinonces. APC r Total Signeture of Permittee A Building Permit Is issued to: JOS MILLER CON ST ' on the express condition thnr nll work sholl be done in atcoroori?"ithaII app c.l? i "?le tute of Minnta Statutes ond City of Eagan Ordinances. 1 ? Building Official DOUBLE 1. :., :,S .._. , i',- I?Fe1nR Tn RTTF. RF.VTF.W 4 BUILDING PERMIT CITY OF EAGAN ? 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 1?I? 9155 PHONE: 454-8100 ?j? Receipt jk / 'f? ? Te ba used /or 1/2 'DUP/GAR Est. Vo1ue $56 j000 Date JUNE 18 1984 SiteAddress 4197 KNOB *W,:.(UNIT 101) Erect 6 Occuponcy R3 Lot 1 OB HILL Block _?o0c?810 O 1 qirer ? Zoning R3 Parcel No. - l R i Fi Z N/A epa r ? re one Vn 1 N JOS MILLER CONST Enlarge ? Type of Const. 2 0 ame Mo?e ? # Stories i 18133 CEDAR .AVE 20 Addres .. s Demolish ? Length City FARMINGTONhone 454-4753 Grad De th Ft S e ? p q. .- o Name SAME ADVrovals Fees ?? Address r- City Phone ?w Name x? Address V <W City Phone Assessment - Water & Sew. Police Fire Eng. Planner _ Council _ Bidg. Off. _ APC I hereby acknowledge that I have read this application and stote ihat the inlormofion is correct and ogree to Comply with all applicoble State of Minnesoto Statutes ond City of Eoqan Ordinances. Sfgnature of Pertnittee A Building Permit is issued to: JOS. MILLER CONST oll work shall be done in otc da ith RII appl w te of Minnc Lt?? Permit +S 602.00 Surchorge 28.00 Plon check 150.50 snC 525.00 Water Conn. 4 7 0. 00 Water Meter 63. Q 0 Rood Unit 260 _ 00 Totoi 2.098.50 on the expreu condifion that Stotutes ond City of Eagon Ordinonces. Building Officiol AOUBLE FEE AS FTGS WER POURED PRIOR TO SITE REV7F.tia1-. e P$ ?iAs :i )?v J'°/ 6'g /? .. 110v r?l Site Ac?ess: . 1,0t Z* BlOdc / SeC./51ub• , Paroel #: /d - ya S " :: It C? ?, ? ? , ?clu? erte of P1aQ». 1 siks p??+i/elwvatiu?s i IG Pl'3*aT APPI? . I Nt at anxW cOtcailatUx'°' . ? -b Q+ner: A8dresas CitY/ZiP Code: R10n9 #: aonlraccor:? c ir??--w • ?"'-• Aadressz ? J CitY/ZiP Code: Plxx,e i: Arch. /F1x7• • Addresa: :-??- Orr= osa oWX / Alter ir Eora pApa RYP Ct . ?-•----= , Denol?"?? ? D@Pth , . . w ?. APFKws ; 09 - l+sa?stsrnb ?_ ?ca?t D ? - -=???2 0 pLef Chark -- ? ? Q,oa ?y ze ? ---?-?d %--?. . NaCaz-Z' '?r?• ??D=o ? 1lstsr Meter Planner? icad QLit Slc`g. Of . APC CYty/Zip Cbde: -' . SV171L 0 . , . ,. ??' Phone #: P -?i?L av??Q f I or? ? ro .r,? 6&P??? -PoU hlP C P % ",i' l`,BUIIDINC+ +QT -- Tb 3,5G 1fi/O?l . s• : Site Addresss 6-71 U)tp:= = 8lock Sec./Sub. parcei r= ? o- Ya s v? -- o i o- o ? Owr?r: lbdremas City/yip Oode: phone t : Addresa: CYtY/ZiP Ooaftcm Ptxxse t : ?&?L- p,rch, /}]n3. . Ihclude a mte o! Plelfi?s,. 1 dbs p? M/t] ?tlts?s t? . I ?ort o? ?tgY oe?1cul,st,La's?. Dsbs CFF= Vm mx ? ?: JEz?ect !? omwwc9 utiac tisr Earr : papair TYR of b?l,asgs • ? _" ? MiocSM t'?' , Cz? ? D?Ptl? : >> • . G. WE ?c 9 a?x 2 . 58?1 ? ? ? ?' f ? ?eeer/9w? .^..-- PLn Q?scic ?= • ° ? Polioe SAC Fi? ? ? . p3ba . 4 '1 D o Pl.an?' ?? ?1°t? ? Oounci1 _ t400d unit ? 60• fl Bldq. Of?- AFC C:ity/ZiP Oocb; _ -- , ' 0 ? pt,«?e r: ad ,? r?? O?S - S ?d?4Ep RIaR ? S? ?f? l y h?YS REQUEST FOR ELECTRICAL INSPECTION _ _ • ?: ? 1\ ' See instructians fbr compleiing this form on back oi Yellow covY. d? 1b f A;? ? 2Uq "X" 8elow Work Covered by This Request d Rep. Type ol Buiiding Applinnces Wired Equipmen[ Wired Home Range Temporary Service Duplex Water Heater ightin,y Fixtures . Apt. Building Dryer Electric Heatin Commercial Bldg. mace Silo Unloader Industrial Bldg. Air Conditioner Bulk Miik Tank Farm tner Peci v iner Isnecitvl f er Veci y Ot er Other Compute lnspection Fee Below M' fee Service EntranceSize q Fea Feeders/5ubfeeders # Fee Circuits 0 to 200 qm s 0 to 30 Am s e .Z 0 to 30 Am s Above 20 _qm 31 to 700 qmps 31 to 100 A s _ Swimminp Pool Above 100_Amps Above 100_?m?s aigns apeciai mspecuon $ Rema rks OTQI,,,FEE Rough-in oata / ? ectrical • ? ? Inspector, hera6y ?rtit that the ab Final y ove inspection has been mede. Thisrequestvoldl8monthsfrom v This reque5t void j8 mcnth5 from A 082576 ext)h 9-1 1 J`( ???,5v Req -t Date Fire No. Rou - in I nspeUion Req red? ?Ready Now Will Notify, Inspec- 1q Yes ?No - 'or When Ready i sed Etrical Convactor ? 1 hereby request inspection of a6ove O er ?J electrical work inslalled at: Street Addiess, Box or R ute No. ? Ci t bction o. To s p Name or No. Hange No. 4 IM D Occu t (PRINT) Phone No. J A ' 3 . Po Su lier Addr ss Elec ptv - al Contrector (Company Na e) Contr?? sLicenso. Ma-I A ress Co traC lor r Owner king Instailation) l / Authoriz ture ( tra tYOwn a i Instal atio . Phone Numb r S 5?.5 ?aU MINNESOTA STATE BOAHD OF ELECTNICITY - THIS 1 SPECTION REQUEST WILL NOT Griggs-MidwaY Bidg. - Room N.191 gE ACCEPTEO BY TME STA7E BOqflp 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 297_2117 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi oa ' Sae instructions for completing this form on backof yellow copy. ??(l N A . X" Below Work &Awgd6y This Request tlle?A d Rep. Typg oi BuilAing Appliances Wired EquipmBnl Wired Home Range Tem?rary Service Duplex Water Heater F ightin,y Fixtures commercial eing. umace ano unioaaer Buik Milk Tank Industrial Bldg. Air Conditioner I L r.,..., t er peu v ther ?SO?cifvl N ee ServicBEnt?anCeSize tt Fee Feeders/Su6feeders # Fee Circuils Uta200qm s 0 to30qm s Otn30Am s Above 200 q?n ? 31 to 100 Ar?s 31 to 100 Arnp 5 Swimming Pool Above 100_Amps Above 100_Am s Transiormers Irrigation Booms 'St artial;"Other Fee 1 ? I Signs 1-.t -1Special Inspection ]$-,? I T ALFF E Remarks 3 T? 0? 'h 400triCe I or, hereby that the a6ove ion hes been fte request vold This repuest void 1f8 monihs from F? / \ 4i /^1 l1 f? - L c? .,?a;n , 6( K,,,c G, I--? I( ,? i) (( ? y .3 a. s--Zi Req e5t Data ? ^? ?? Fire NO. Rough-in Inspection Reqpired? ? ?Ready Now?Will Notify, Inspec- t Wh - ? y ) es No or en Ready Licensed Electrical Contractor ?i I here6y repuest in5pection o1 a6ove Q Owner - electrical work ingtelled ai: [ Street Address, Box or Route N. ? / City e ' / 1oF " U `n ec11011 o. Towns ip Name or No. Ran9e o. Co nty .. / U C1 / (st./ OccupantlPRINT) y Phone No. -?1753 Pow Sup lier 9 Add s - ? Electr'cal Contractor ICompany Na I Co traCtor'sL,cqnse No. Mai in AdJress (Co ractor or wner MakinB Instailation) ' Authorized ignature (Co11trac or Owner Makin nstallation) Phone Number MINNESOTp STATE BOARD OF ELEC{RICITY THIS INSPECTION PEQUEST WILL NOT Gr{ygs-Midway Bidg. - Room N-791 - BE ACCEPTED BY THE STqTE BOABD 1821 1lniversity Ave., St. Peul, MN 56104 UNLESS VNOPER INSPECTION FEE IS Pha. 16121 297-2111 ENCL03ED. ???_? 3 4 7(D - _?z? RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone #.651-675-5675 FAX # 651-675-5674 . New ConsWdion Reauirements RemadeVReuair Reauirements Office Use Onlv 3 registered site surveys showing sq. ft. of lot, sq. fL oi house; and all roofed areas 2 copies of plan Cert ot Survey Recd, (20o ma)imum lat coverage allowed) 1 set of Energy CalculaUons for heated additions Tree Pres Plan Recd 2 wpies o( plan showing beam 8 window sizes; poured found design, etc. t site survey for addi6ons 8 dedks _ Tree Pres Not Reqd . 1 set of Energy Calcula6ons Addition - indicate if on-site sepOc system _ On-site Sep6c System 3 copies of Tree Preservatlon Plan if lot platted after 7l1193 Rim Joist Detail OpGons seleclion sheet (bidgs with 3 or less unib D t o a e Construction Cost Site Address ? . Unit/Ste # Description of Work d/ Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner Telep6one - Contractor , 111 , Address ?? ' ' City State r Zip ? Telephone # . 67,601 COMPLETE THIS AREA ONLY IF Energy Code Category Minnesota Rules 7670 Cateeorv 1 (J submission rype) • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor 5ewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 • New Energy Code Worksheet Submitted Telephone # ( Telephone # ( Telephone # ( ? I hereby apply for a Residential Building Permit and aclrnowledge 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 work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ??? Apphcant's Pnnted Name? App icant's Signature 1111i JUN 0 6 2nn? ? OFFICE USE ONLY Sub Types ? 01 Founda8on O 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 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 ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Replacement Valuation ?L?• d? Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Int Improvement ? 38 Demolish (Interior) 0 44 Siding Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair Demolish (Bldg)' ? 43 Reroof X46 Windows/Doors •Demolitlon (Entlre Bldg) - Gtve PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered W idth _ Footings (new bldg) _ Footings (deck) _ Footings (addirion) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation REQUIRED INSPECTIONS _ FinaUC.O. _ FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining Wall ApYroved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total L Building !nspPCtor 2004 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 RemodeVReoair Reouirements 3 registered site surveys showing sq. fl. of lot, sq. ft. of house; and ali roofed areas 2 copies of plan (20°/a maximum lot coverage allowed) 1 set of Energy Calculations for heated additions 2 copies of plan showing beam & window sizes; poured found design, etc. 7 site survey for additions & decks 1 sei of Energy Calculations Addition - indicate if onsite septic system 3 copies of Tree Preservation Plan if lot platted afler 711/93 Rim Joisl Detail Options selection sheet (bldgs wiih 3 or less units ?3 ?. () V ??? ? a e34 ? C?Efi?e;F7se 0? CerfoFSiuiieyReed 1u Y„ :N ?F2C??C3PI8Il?i'6Cff ?. _?; 7reepresReq?ir2d ?' N pFrsiteSepti??ystem :' ?' N Date __?_/ J o/..o? Construction Cost Site Address qu q7, ql ? Unit/Ste # Description of Work 4? ? Wd I Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Ow e? p 4 Pro ert Telephone #(? )"F QO '-1 S 0 b ke y p l r1 ? rd ?? ?w Contractor o IMeK 1 1 c Address -, G?qt I&Ce- 5- ? City CA (VICi State Zip ?.?Telephone # (C,5'1 ) ?1? b COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Ene?gy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% pian review fee applies. ?, ? ?n ? D ? L 'J ? 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 pemrit, 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. ? ( ? ?L1t_?1 Applicant's Printed Name Applicant's Signature OFFICE USE ONLY 5ub Types ? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg' ? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-pfex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage x 06 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Buiiding ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" M 43 Reroof A/L?,9//L ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) -Give PCA handout to appiicant ? Valuation ? Occupancy , `/ MCES System - Census Code Zoning City Water SAC Units - Stories - Booster Pump " # of Units Sq. Ft. PRV # of Bldgs - Length - Fire Sprinklered - Type of Const ? Width ? REQUIItED INSPECTIONS Footings (new bldg) FinaUC.O. _ Footings (deck) ? FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile ? Other S'A?k7AO--K ?C? /ZGO??>, _ Roof Ice & Water Final _ Pool _ Ftgs Air/Ga Tests Final _ Framing _ Siding _ Stucco _ Sione _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation Retaining Wall Approved By: Buiiding Inspector Base Fee (/ 3C,' ` Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 5 ? 1 t,5 PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 4 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are requued for each unit r JS . Date Site Address ? j 9 ? 1<"v?hl (3,e e Zc 6-A /!, Unit # Property Owner ?q-? ? L2 a) g a /(/ Telephone # !Y 1,2, Contractor Address City t?/ State ZipTelephone# The Applicant is Owner Contractor Other Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50.00 _ Adding fixtures to lower levels or room additions, exciuding water softener and water heater _ Abandonment of septic system _ Water turnaround (+ 5!8" meter if needed -$121.00) Other: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation system ? Water softener _ Water heater $ 15.04 ? replacement _ additional State Surcharge $ '50 Total $ I hereby apply for a Residential Plumbing Permit and aciaiowledge 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 with the Plumbing Codes; that I understand this is not a pemut, but only an application for a permit, and work is not to start without a pernut; 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 pp icant's Si e 5%?qq PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when pernuts are required far each unit Date 3 0`3 LAWSON, MARK Site Address 4197 KNOB CIRCLE Un'tt # EAGAN, MN 55122 (651) 330-3412 Property Owner Telephone # ( ) contractor NORBLQM PW6'UjBlNC C04 (6 12)$27'4033 Address City 2905 . . State Szip Telephone # ( ) The Applicant is _ Owner ? Contractor _ Other Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00 Inciudes County fee. Additional consuitant fees may apply. Alterations To Existing Dwelling Unit, Including _ Adding fxtures to lower levels or room additions, excluding water softener and water heater $ 50.00 _ Abandonment of septic system _ Water turnaround (+ 5/8" meter if needed -$121.00) Other. _ RPZ _ new installation ? repair _ rebuild $ 30A0 _ Lawn irrigation system Water softener x Water heater _ $ 15.00 X replacement additional State Surcharge $ .50 Tara? $ 15. SD . ncrcuy ayp,y ior a icesiaennai rtumbmg Yernut and acknowledge that the informarion is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I ? qs?ai?c? thi?-is not, a-_ pemut, but oiily an application for a pernut, and wark is not to start without a pernut; that the work will be d?ordam?e w approved plan in the case of woik which requires a review and approva] of plans. t MA R 2 o 20o3 Applicant's Printed Name A nt's 5ignature c-lo ` - S1 9 MECHANICAL (RE5IDENTIAL) A? D _S7D Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 4 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date ?'?2 / (I_ / 0,:? Site Address Lejldk c g('(/YJ Unit # Pro ert Owner ? 4* C-16 ?A!! T l h # o ?n p y e ep one RANDAR? RFATING & aiA cowomoNiKG co, Contractor Street Address MINNEAPOLIS, MN 55408-2998 City State Zip Telephone # ( ) The Applicant is _ Owner X Contractor _ Other Add-on, modification or alteration to existing dwelling unit $ 30.00 ? ? furnace replacement . ? ._. air exchanger MAd air conditioner _ _ other_ - - --- v?_? State Surcharge $ .50 Total $ I hereby apply for a Residenfial Mechanical Permit and acknowledge that the informarion is complete and accurate; that the work will be in conformance with che ordinanc and codes of the ity of Eagan and with the Mechanical Codes; that I understand this is not a permit, b nly an applicatio for pe 't, and work is ot to start withniif-a ernut; that t rk ill be in accordance with the approve pl ?thG case ork hich r uires a review d approva p • Applicant's Printed Name Applican' Si ature MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: commerciaUindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Acidress City 5tate Zip Telephone # ( ) The Applicant is _ Owner _ Coniractor Other Work Type New construction Underground Tank _Install _Remove Interior Improvement Call for inspection during installation(removal of tank Processed Piping Nature of Work: Permit Fee $50.50 Minimum Fee (includes State Surcharge) _ Contract Value $ x .01% Permit Fee • Ifpernut fee is $1,040 or less, add $50 => $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ Total Fee I hereby apply for a Commercial Meehanical Pernut and acknowledge that the informarion is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand ttus is not a pernut, but only an application for a permit, and work is not to start without a permit; that the wark will be in accordance with the approved plan in the case of work which requires a review and approval ofplans. ApplicanYs Printed Name Applicant's Signature Approved By: ,Inspector Date: ""• " I , • ? ,s ••+V ?.:. ov rna ioa a i 1 %soa itZ1VZP1'AL t3r?flttlllCtS=1V June 7, 2001 City of Eagan 3836 Pilot Snob Roaci Eagan, MN 53122 To Whom It May Concern: Elder Joncs is authorized ta pull building permits for Renewal by Andezsen_ Please allow Elder Jones to provide this service for us in Eagan. fihis auncorizaticM is vatid for any date beyond 6/6101; untiI a Renewal by Audersen manager expressly revokes it in writing tp the City. I requtst this autliorization be accepted expedidously, as to not delay in the processing of our building pcmuts auy furthcr, plcasc cail mc if thcrc arc any guestions. I can Ue contacted at 763-502-4706. , . Your immcdiate attention to this mattcr is appreeiatesi. Sincerely, yuiond R. Rau nstallation Man.ager Renewal by A.tadersen Corporataan Kara_FTder .Tnnee O nea???L ?pires Jao. a1,2 0os a UU11UU2 Received Time Jun• 7, 1:07PM -? ? r . 2/84 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION ASE PRINT) 1) PROPER'i'Y ADDRESS: 4199 Iinob C ? LEGAL DFSCRIPTIOA]: r,nt 1/2 B1 ock 1 (Lot/Block/Subdivision or Tax Parcel I.D. Ntumber) IF EXIS:L:G S,TRI?C'I[IRE, D=r, O? CRI=7?I, EIJILDING PE.°u%SIT ISS'JAlrE: (ti!or.?'?/`lear) PRESENT Z0*1I1r:/PR0POSED USE: ?R-1 S?IGZE FAI+rtSI,Y ? R-2 DUPLEX (Zydp MTS) 0 R-3 Ta^RQHOUSE (TFfftEE + [JNITS) { UNITS) E3 R-4 APAfM4E'3v'P/COLZCY,1INI'LV, ?. iTiVITSi Q CaAMERCIAL/f2EIIiIL?0FFICE ? II'vDUSTRTAL Q INSTIZUTIONAL/G0I?PI' 2? ??CAW NAM= (PLEASE PRINT) p,DDgESg; .Tna Mi 11 ar OriStrLC iOri 18133 Cedar Ave SO. CTPY, STATE, ZIP: Farmingt_an, Minn. 55024`- . PHONE: 454-4753 3) pIL]MBER PLEASE PRINT) fOR CITY USE ONLY NPI-E: McGuire Mechanical Services, Inc. PLU RS LICENSE: ADDPESS: ; P _ (1 _ Rox 219 Active CITY, STATE, ZIP: T akpVill P Mi nrL 55044 Ex ? Pired ' PHONE: , . 469-4988 PASrE 002751M7 PLUMBER LICENSE # ? N°tf Refrd G? c_1r? a ni ia 4) OCCUp?/aNNER IVAME: (PLEASE PRINT) ADDRESS: CITSC, STATE, ZIP: PHONE: S) INDICATE WFIICH PERMIT IS BEING REQITFSTID: ;s?C01O11X,'t'I0N 'IO CITY SETVIER k-41 CONIIVVDC'PION M CITY TVATER ? CJ PEM (PLEASE DF TRF) 6) II+IDICA'TE ONE: ? PLEASE HOID APPRdVED PERMlT FpR PICK-UP BY ONE OF IaB(JVE ? PLEASE M1IL APPROVID PERMIT To 1. 2, @ 4 ABWE (Circle one) 7> s2GNATURE: DATE: ?y-424 ??R?'4r???+o!!!4r?..??+?r!F+?r?k??ik?.iiis?N?Ftl?h#??!!??!?k.,.,.. ., ,, . „ih'7?MI. , F O R C I T Y U S E O N L Y •- PERMIT # ISSUED F7 FEES : $ ? s sd $ $ a -4,C $ $ $ $ $ ' i_.?,. . ., .._... . .... ,... j , . .: .. .. $ .. . . -._ .. SEWER PERMIT (IFCLUDE SURCHARGE) WATEE. PERA4IT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATE? TAP (INCLUDE CORPORA;ZON STOP) SEWER TAP ACCOUT:T 'DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK-WATER OTHER TOTAL AMOUNT PAID/RECEIPT # e7l- -541 DOES UTILITY CONNECTTON REQUIRE EXCAVATION ZN PUBLZC RIGHT OF WAY? YES IF YES, THEN A"PERMIT FOR WORK WITHIN / PUBLIC ROADWAY" MUST BE ISSUED BY THE IQO ENGINEERZNG DZVISIOLV. LIST AS A CONDI- TION_ SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: oS`l L? TITLE: DATE : , . . ., .. . , .. . wr? , .. . 4 ._, . s= , . 2/84 , CITY OF EAGAN e APPLICATION FOR PERMIT a SEWER AND/OR WATER CONNECTION ( ASE PRINT) 1) pgppgtTy AppRESg: 4197 Knob Ci IBSAL DESCRIPTION: r.ot 112 Bl ock 1 (Lot/Block/Subdivi.sion ar Tax Parcel I.D. Nwnber) IF EXIS'=2QG ST'RITCI[TRE, pF= OF ORSGIDIAL BUILDIIVG P?.?lIT ISSJP.NCE: (:-:or.thj'`lear) PRES= '1r"7I1N:/PR0POSE?J USE: 9 R-1 SRIGLE FAiw.ILY R-2 DUPI,EX (MO UNITS) 0 R-3 TCGINHOUSE (2E42FE +. UNZTS) l i]D7ITS) p R-4 APAEXImaNTjCavt.aiuZTiw, ( O'vIT'Sj ? CC741ERCIAL/FtEI'AII4/OF'E'ICE ? RMUSTRTAL p INSTITUTIONAL/GOVEPNMENFf 2) AppLICAIV`r (PIEASE PRINT) NA.E; Joe Miller Construction ADDRESS: i st i'41 aed a =-Ave-Se CTPY, STATE, ZIP: - . Farmington, Minn. 55024 ; PFi0NE: 454-4753 3) pLUMM PLEASE PRINi) M i FOR CITY USE ONLY NAME; cGu re Mechanical Services Inc, PLUNpERS LICENSE: ADDRESS : ; n E} $Rii 219 Ae t i ve CITY, STATE, ZIP: Lakeville, Minn. 55044 Expired . p?: 5ILR 469-4988 PLUMBER IICENSE N 002751M7 0 NOt?f R?cord a ni ia 4) OCC[JpANT/C7WNER I3E: (PLEASE PRINT) ADDRESS: CITY. STATE, ZIP: PHONE: 5) IT]DICATE WEIICH PERMIT IS BEING PBUJESTM: 0 CONA1fX.TION TO CITY SEF7ER " COMIDC.TION TO CITY WATER FK ? CJP HER (PLEASE DESCRIBE) 6) INDICATE ONE: ? PLEASE HOLD APPRCJVED PERMIT FOR PICK-UP BY ONE OF ABUVE V PIEASE tg1IL APPRCJVID PF12MiT 2p 1, 2, 0 4 ABCIVE (Circle one) 7) SI(NATURE: DATE: 2 , ; ? ?? . . . , . F O R C I T Y U S E ON L Y Y PERMIT # ISSUED : FEES: $_ ?o.__s_ ° - SEWER PERMIT (INCLliDw. SURCHARGE) WATER PERP4IT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER , S WATER TAP (INCLUDE CORPORATION STOP) S SEWER TAP ACCOUNT ;GEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC S ?-?-5 ---? SAC - $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT ' S LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ OTHER . ... .. .. .. . .. .. . , . , . . . . . ? $ , __ . . TOTAL . AMOUNT PAID/RECEIPT # DOES UTILITY CONNECTIOIV REQUIRE EXCAVATION ZN PUBLIC RIGHT OF WAY? C] YES IF YES, TfiEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ? NO ENGINEERING DZVISZON. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE : DATE : ' C;?C _ 8c? •E +? w?r ???•r a? wt?? s? ? ie??a ? ?'! !? ? ? ?a? ? !'? s'!p??r} *';s?! ? ?!P ?'!k?? ?' ?=`. Use BLUE or BLACK Ink r I For Office Use I 1 Permit City of Ea~d~ I 5~ Permit Fee: Q I 3830 Pilot Knob Road Eagan MN 55122 Date Received: - [ ~3 I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 1' ~7 l I ! Unit Name: Al Phone: Resident/ 4 C , "Owner Address /city /zip: 6 Applicant is: Owner \Z Contractor Description of work: fit: - Type of Work , Construction Cost: ) C¢ 60 Multi-Family Building: (Yes V/ / No ) Company: c1 Contact: c~ wo ~ l~ Z;1-3`E3 r3'(_V '~7/_ ,c) ~raCI -tot[ Contractor Address: 'l 3 o City C~_l q -7 State: ' V~Zip: rd- Phone: /~o _5C77- 77 License C q Lead Certificate If the project is a empt from lead certification, pleaseexplain why: (see Page 3 for additional information)) r r , c~ t~ c ~j P4~? ~av " G~ J C ~2e j "✓v~ Lj 7 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 documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. r ~ l x l~ Q ~ t x Applicant's P ' ted Name App 0*can' Sig ature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA139710 Date Issued:11/04/2016 Permit Category:ePermit Site Address: 4197 Knob Cir Lot:001 Block: 02 Addition: Knob Hill Of Eagan PID:10-42500-02-001 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Tyler B Woodworth 4197 Knob Cir Eagan MN 55122 (612) 790-8153 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA157037 Date Issued:07/31/2019 Permit Category:ePermit Site Address: 4197 Knob Cir Lot:001 Block: 02 Addition: Knob Hill Of Eagan PID:10-42500-02-001 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Tyler B Woodworth 4197 Knob Cir Eagan MN 55122 (612) 200-3145 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature