3661 Kolstad Rd• CASH RECEIPT •
VCITY OF EAGAN
3830 PILOT KNOB ROAD
..
EAGAN, MINNESOTA 55122
•• DATE tg _
RlCEIVED
AMOUNT $ I
& OOLLAR$
ioo
E] CASH CHECK
BY -1
YVhite-Payers Copy
Yellow-Posting Copy
Pink-File CopY
Thank You
r ,. .
CITY OF EAGAN 3830 Pilot Knob Raad, P.Q. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT (`a.r. !
To be used for 6 F 'tA{;/(;Ak Est. Value $69•OOC
Receipt
Date
OGTUBBa 14
19 2- , 7
Site Address 3661 iUOY.bTAU itOA-0
Lot I Block t Sec/Sub. PINE RIDGa ADU
Parcel No.
oc Name CaNSiiLIFORl1 HtklES LT[3
z Address ( `I RR Ayg '
3
0 Ciry iii:: •,?`?? Phone - ?
, o Name •5AME 825-292:1
? Q Address
r¢- City Phone
Name
Address ;,
City Phone
I hereby acknowtedgethat I have read this application and state that the
informfition is correct and agree to comply with all applicable 5tate of
Minnesota Statutes and City of Eagan Ordinances.
?
Signa2ureofPermittee
A Building Permit is issued to: CUNSCLFOR4 WMY;S L'tD
on the express condition that all work shall be done in accordance with all
applicabte State of Minnesota Statutes and City of Eagan Ordinances.
Building Official -j ?• t
OFFICE USE ONLY
On Ske Sewage Occupancy K 3
MWCC System x Zoning k1
On Site Well (Actual) Const Vn
City Water x (Allowable) Jn
PRV Required * of Stories
Booster Pump Length
gU.3
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES I
EngrJAssess. Permit ? 395•0o?
Planner Surcharge 94• 50;
Council Plan Review 197.50
BIdg.OH. SAC,City 100.00
Variance SAC, MWCC 525.0011
.
WaterConn. 525,00
Water Meter 67.00
Road Unit 305.()0
160'00
Treatment P1
Parks
TOTAL 42,329•00,
BLDG. PERMIT N0.
s01-3210 Bldg. Permit ?-
01-3422 Plan Check 1i' r
01-3445 Surch./Adm. (r' ?
01-3446 SAC/Adm.
01-2155 Surcharge '.? (
17-3860 Road Unit
20-2275 sAC
20-3665 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3$66 Sewer Conn.
11-3855 Park Ded.
TOTAL -=-? J
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CASH RECEIPT ?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MII#VF-90T?4 55122
DATE
19 _T
wacP:Iveo
FROM
AMOUNT $ I
?
& UOLLARS
?oo
? CASH ? CHECK
I .._
BY -
White-Pavers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
.
• ? ? CITY OF EAGAN ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454•8100
i BUILDING PERMIT ; w. ?.: ReCeipt 4k
To be used for Est Value Date
Site Address O FFICE USE ONLY
Lot Block Sec/Sub On SRe Sewage Occupancy
. MWCC System Zoning
Parcel Na On Site well (Actual) Const
LT ij City Water (Allowabla)
c Name
`A PRV Required ? of Stories
z Addfess
Booster Pump Length
? City Phone
Depth
p Name ` S.F. Total
,
? ? Address Footprint S.F.
? City Phone APPROVALS FEES
? a Engr./Assess. Permit
W
W Name
?
Planner
Surcharge
_ Address
? Council Plan Review
¢=
Q u, Cit Phone
Y
Bldg. Off.
SAG City
I hereby acknowledge that 1 have read this application and state that the Variance SAC, M WCC
information is conect and agree to comply with all appiicable State of
Ordinancas
d Cit
f E
a
t
Mi
t
St
t Water Conn.
ag
n
.
nneso
a
u
es an
y o
a Water Meter
Signature of Permittee ---- Road Unit
'
A Building Permit is issued to: Treatment P1
on the express condition Ihat all work shall be done in accordance with all Parks
applica6le State of Minnesota Statutes and City of Eagan Ordinances.
TOTAL
. Permlt No. Parmit Molder Dete Talsphone
Plumbin9 ? ? ,:? ' ?? •?;, ??;?"7
H.V.A.C.
??
2-2 (?^
f ??i??
•???5 ? ?-2
Electric -79'
_ ?.t?.? {'.
/ 9
'•-??/ °z7
Softener
Inspectlon Date Insp. Comments
Footings I
Footings II
Foundation AO/k
?
Framing ?
Roofing
Rough Plbg. % U--)
Rough Htg. `l
Isul.
Fireplace
Final Htg. ?'
Final Plbg. _ _ ? • ??
Bidg. Final ?
Cert.Occ. %8 ? ' •
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Site Address
? Name
A Addre s ' -
c City
Phone
? Name
3 Address h W i?
p City ?J.'o bM - Phone
I FEES
? COMMIIND FEE - 1% OF CONTRACT FEE
? APT. BLDGS - COMM FiATE APPLIES
i TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
OF
PERMIT #
RECEIPT #
DATE: ''
I FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. _X, New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
_J___Water Closet - $3.00 $
I_Bath Tubs - $3.00
__1__Lavatory - $3.00 "
Shower - $3.00.
--l_Ki?chen Sink - $3.00
Urinal/Bidet - $100
--L-Laundry Tray - $3.00
_.I-Floor Drains - $1.50 1 ?
Water Heater - $1 50
Whlrlpool - $100
:::VGas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
_3-Rough Openings - $1.5U
FEE: -- ? ` `
STATE S/C:
GRAND TOTAL• ?
Pr PERMIT # = -
MECHANICAL PERMIT
CITY OF EAGAN RECEIPT #
/
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 7
TRACT PRICE: PHONE: 454-8100
' Site Address ,>'' ?' ? K 0 L 'I-, TA ?
[ Lot Block Sec/Sub
BLDG.TYPE
Res.
Mult
Comm.
Other
WORK DESCRIPTION
New i`
Add-on
Repair
Name
City
? Name
3 Addrp
p City?
TYPE OF WORK ;• - .v ." r ?' ? ? ti.
Forced Air M BTU
Boiler M BTU
Unit Heater M 6TU
Air Cond. M BTU
Vent. CFM
Gas Piping Outlets #
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
_ GAS OUTLETS (MINIMUM - 1 PER PERiYIIT) - 1.50 EA.
COMM/IND FEE - 19'o OF CONTRACT FEE
.?r APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
FEE
S/C:
TOTAL:
FOR: CITY OF EAGAN
?
? w . ..
(ger#ifira#t nf COrrupanry
Citp of (Cagan
ioF}tal`ftPttY Af lltdbfmg jwPCtiMt
This Certificate issaed pursuant to the requirernents of Section 306 of the Unifonn Building
Code certifyrng that at the time of issuance this structare was !n camplrance with the various
ordinances of the City regulating building construction or use. For the following:
!
ux c7as"w6oo / GP.'? Bldg. Rrmit No. !430
Oocupaoi.y Type R3 7Jomne Oistrip RJ TyPe Comt. Vn
o,w orMaing-'')1SULECFM131f'?S :.:?? Am,,. 8516 {7U1207 AVE K-tC:IV
BuadW AM,m ;F 51 ?DUS?'Ai_' IOCal;ty L!,B1, PTlv'E
o.m: - ?
&W&nS officw
POST IN A CONSPICUOUS PLACE
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PRICE: r - PHONE:454-8100
Site Address
? Name
? Addre
c City r
? Name
c Addre
o Ciry _
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
. MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
{ADD $.50 S/C IF PERfiT PRICE GOFS
SIGNATURE
PERMIT #
RECEIPT #
DATE: &,&,5- ') a
r ' r. ' BLOG. TYPE
Sec/Sub Res.
WORK DESCRIPTION
New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $100 $
Bath Tubs - $3.00
Lavatory - $100
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - S3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1 50
Whirlpool - $3 00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT) _
? Softener - $5,00 well - $10.00
Private Disp. - $10.00
Rough apenings - $1.50
Phone
FEE: -
STATE S/C: "
FOR: CITY OF EAGAN GRAND TOTAL: '
,
INSPECTION RECORD ?
? CiTY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
` Eagan, Minnesota 55122-1897 Date Issued:
? (612) 681-4675
St7E ADDRESS: APPLICANT•
, ?i ? . • r ?bl ?fr r , •
Nrd t rli r,1HF •I I' I NE' k 1(l14f_ 1? fs f. i'', ) E?3E:+?•}, :S$3
PERMIT SUBTYPE:
; 1: t 1
TYPE OF WORK:
Ni w
r
r 4 1 r11 iN ': . f l 4 1 1 14 ai
IL
Permit No. Permit Holqer Date Telephone N
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp, Comments
FOOTINGS .?
FOUND
FflAMING
RODFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIFiEPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLPG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
a-ZZ-? C>
DECiC FINAL
7b
ro•o
1- T -7
CITY dF EAGAN
3830 kot Knob Road
_ P.O..Bax 21198
Eagan, MN 55121
Owr
Site
Plun
Permit No' Date: ; i t-' .i-97
B/P No: Date:
MWCC: 5 -5.000
Zoning-
CityChg: ijo-o?'Pd No. of Units: ?
Acct Dep; =5. c'opd
Permit Fee: i ?. ?'t-,c' I agree to comply with the City of Eayan
Surcharge: Ordinances.
SEWER SERVICE PERMIT
CITY OF EAGAN 0- it N• ? 167
3830 Pilot Kr?ob Road
P.O. $ox 21199
Eagan, MN 55121
Site Address:
.? ? - .
HOfttei
Date:
Siz?
Date:
Conn. Chg: 525.00pd Zoning: Rl
Acct Dep: 15, OM No. of Units: Z
? Permit Fee: 10.0O?d
3 Surcharge: • 50pd I agree to comply wifh the Citr of Eagan
Tr. Plant 130• Q?d Ordinances.
Meter. ? ?-.-?
? Misc.: By
WATER SERVICE PERI4AIT
c_
CITY OF ElkGs1M Permit Na Dat? 1??-2 ^'-•"7
3830 F:lot Knob Road Meter No: 3 s Size: ?
P.O. Box 21199 Reader No: Dat? L- 7- 2-p' 7
Eagan, MN 55121
Owner. ?4isulf??- s
Site Address: ' r'' Z?'??' ''??? ?? Ll P.1, n1-; e i' i^ c?
& K P
Conn. Chg: ?=' 7.1? Ll
Acct Dep: ^ o(WOfe i$'bi?tC.
Permit Fee: lcl. OC7?fc?EPHaM -
Surcharge: " 1 ?*e ?J?? l y wfth tM City ot Eagan
Tr. Plant i aO-?? Ordinances.
„
Meter. 44.
Misc.: By
WATER SERVICE PERMIT
rm o._
Merer No: _
Reader Noa.
• CASH RECEIPT •
° CITY OF EAGAN
3830 PILOT KNOB ROAD
, EAGAN, MINNESOTA 55122
y{' ? D?l/.. a?--? 9 ?7
weeeIvEO .?--- ? ,
AMOUNT
DOLLARS
? CASH CHECK ?oo
"
t 21
POP ?
PUND COOE AMOUNT
r-4U 7 /V G
l ° `'v
v / •- "?,
; y
Thank You
B Y YF?
N° 78445,
White-Payere Copy
Vellow-Posting Copy
Pink-File Capv
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199
PHON E: 454-8100
BUILDINGPERMIT (W.F.)
To 6e used for S" OWG/GAR Est Value $69,000
Site Address 3661 KOLSTAD ROAD
lot 1 Block 1 Sec/Sub. PINE RIDGE AD?
Parcel No
? Name CONSULFORM HOMES LTD
z Address 8516 QUINN AVE SO
° City BLMGTN phone 831-6019
olName SAME 825-2922
?a Address
1- City Phone
?
Ww Name_
Fw
i z. Address
aw CitY_
I hereby acknowledge that I have read this application and slate that the
information is correct and agree to comply with,
,Pll applicable Sfate of
Minnesote Statutes and Cit fEagan'O/rdinandes.
Signature of Permittee
A Budding Permn is issued to: C NSUL' OMES LTD
on the express contlition that all work shall be tlone in accordance with all
applicable State oi Mmnesot tatutes and Cit ofy? Eagan Ordinances.
v_ n
BwldingOHicial ?-?- ?-?-??
N_ 14301
Eagan, MN 55121
Receipt 4
Date OCTOBER 14 19 87
OFFICE USE ONLY
Onsitesewage _ occupancy R3
MWCC System X Zoning Rl
On Site Well (ACtuaq Const Vn
City Water X (Allowable) vn
PRV ReqUifed - # of Stofies
48
Booster Pump _ Length
50.3
Depth
S.F. Total
Footprint S F.
APPROVALS FEES
Engr./Assess. Permit $ 395.OC
Planner Surcharge 34. SC
Council Plan Review 197. 5C
Bldg OH. SAQCrty 100.0C
Vanance SAC,MWCC 525.OC
WaterConn 525.OC
water Meter 67 _ OC
Road Unit 305.0C
180.0C
Treatment P1
Parks
TOTAL $?,324.oC
;EQUEST FOR ELECTRICAL INSPECTION L, EB-00001-06
,
See instructions lor completirg this form on beck ol yellow co0v. ?
?? 4 '"X" Below Waik Covered by Thrs Request
FAd Nep. Type ol BmiAmg Aoaliancee Wired Eqmoment Wired
Home Range Temporaiy Service
Duplex Water Heater LiyhUny Fixtures
Apt. BwlAmg Dryer Electnc Heabn
Commeraal Bldy. Fumace Siio Unloader
Industnal BIAg. Air Conditioner Bulk Milk Tank
F3lm Other Ue?i y .iher (Snci.ify)
t ar Succi(y Othcr Othor
ComOUte lnspecbon Fee Below
p Fee ServitaEntranceSize tl Fee Fexdars/Subfeeders N Foe Crtcuits
0 0 to 200 qmps 0 to 30 Am s Z' O 0 tn 30 Am
Above 200 qm ?s 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100-Am s Above 100_Amps
Transiormers IrngaLOn &oorcis s Part?al.'Other Fee
Signs Special InspecLOn S
?Q
T
Ae,rv?,ks .?... ? OTAL F
z
flough-in D,ne
? I, tha Electncal
• ?O-3o I^soector, herebv
certify that the abova
Final ? D 1te spechon hes been
da.
.
fhie reauesl voltl 18 monlhe Irom
?
?
2
62 3
r
Requesl ?ate Fire No Rough- Insp ion
Re,muredl NOTICE: You Must Call Eledncal Inspecror
II A R
h
I
I
l
? Ves No oug
-
n
nspec
mn
Is Required
IEIP&nsed conhactor ? owner hereby request inspedion oi above electrical work at:
Job Atldress (Sheet, Box or Route No.) Qty
.? l`) l
Sechon No Townstlip Name or No Range' No County
X /
OccuRant(PRINT) •' Phone No
a'
Power SupPlier AdGress ?
0- (::?
Electncal Con[roctor (Company Ni ,'?I? ?
A4E FRANd EI.EC Contractor's Lice
af:
D ?:
Mailin Address Conhactor or Owpbl?a in lahon
APPLEVAlLEYMN55124
9
tW
??? ??w? ?j
_,
?__.
AuthonzedSignat -(GbntreotoAOwner-Making Installalion)
L., ?7 Phone Numba ti"det??
w11 f
MINNESOTA STA OAflD OF ELEC`T C TY THIS INSPECTION REQUEST WILL NOT
Griggs-Mltlway Bltlg. - Faom S-173 BE ACCEPTEO BYTHE STATE 80ARD
1821 University Ave., SL Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone(812) 6,12-0800 ENCLOSED
???/?? REQUEST FOR ELECTRICAL INSPECTION
? See ins1mc1ions ftr completing Ihis brm on back ol yellow cppy
M 21623 'X° Below Work Covered by This Request
.? EB-00 1-OB
` ay??o
ew Add Rep. TypeofBuiltling AppliancesWired EqwpmentWiretl
Home Range Temporary Service
? Duplex Water Heater Elearic Hea6ng
Apt Building Dryer Load Management
Comm.Andusinal Furnace Other (Speci(y)
Farm Air Conditioner
Other (spacly) ConVaMOrS Remarks
Compute Inspechon Fee Below: - ? `
# Other Fee # ServiceEntranceSrze Fee # Crtwits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps A4Qve 100 _ Amps
SIgf1S Inspecror5 Use Onty 7'pTAL
Irrigation eooms
`l
00-
Special Inspec[ion ?
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fea COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in oWe
certify that the above inspection has
been made. F,nai o ?e
OFFICE USE ONLY
Thig request void 18 months iram
rnis request voia
18 months (rom
D 285841 / r?/K.J
Request Uate
/
/ Fire No. flouph=5n Insper.t?nn
Peqme d?
?Feady Nuw ill NoGfy Insper
lor Wh?m R
d
??
/?
9 7 ?NO ea
Y
ETlicensed Eleclncal ConVac[ot 1 hereby reques< insDectwn of ebove
? Owner elec[ricel work mstelled aY
Street Address. Boz or Route Na. Cav
ecuon o.
I Townsmp Name or No. RanBe No. County
Oceupam IPRINTI Phane Na.
(2i ?Q
Power SupPher AAtlress,i
y??^/n?rx fC?,
Elec cal C,ponVacj? (Company Namel n
? ?°?2c,cJ ?i. Conlrar.to,'s Licens?No. „
d U ?5S
Mailme ?+ddress ICOntractor or Owner akvip Ins[a' aUOnl
g InstallaLOn)
Aut?orrzed Si ture ctor/Owne P??one Nwn
Oer
e7 /
? J ?;g
MINNESOTA STATE BOOF ELECTpICITV THIS INSPECTION NEQUEST WILL NOT
Grig9s-Midwey Bltlg. ?Room N-191 BE ACCEPTED BV THE STATE eOARD
1821 UniversAV Ave.. SL Peul. MN 55104 UNLE$$ PflOPEH INSPECTION fEE IS
Phone(612)642-0800 ENCLOSED.
];,-0 2007RESIDENTIAL BUILDING rExNUT arrLicaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauirements
3 registe2d site surveys showiig sq, k. of IoL sq. R of house; antl all roofed areas
(20% maximum lot cover.ge allaved)
1 Soils Report if proposed building is to be placed on disturbed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree P2servation Plan N lot plailed aMer 711193
Rim Joist Detail Oplions selecUon sheet (huildings with 3 or less uniLS)
Minnegasco mechaniol veniilation form
RemodeUReoair Reauiremenls
2 copies of plan showing footirgs, beams, jois4s
1 set of Energy Calculations Por heated addiEons
t sde survey for addNOns & decks
Add'rtion - indicate ifonsde sep6c system
Telephone #(
Plans are considered oublic information unless vou state thev are trade secret and the reason.
Date ConstructionCost ?JZ`GG?
Site Address /?
I)U • UniUSte #
Description of Work 2rr='WGw. d- J2G/got cL s'Q rti G
Multi-Famity Bldg _ Y _ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner J ? M ( ? ? hN? ?? ??'^?? •"'G Telephone # (65 -53 G !
Contractor --r.-LjiF"So-.? 6'?l?ds. A/G .
Address J!'?rQ1 / 6i2MRN641f 131 vp -4-1 /G ? City
State A"A-1? Zip ?s u 3 ?J Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
-, Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, daTe and address of master plan:
Licensed Plumber
Mechanical Coniractor
Sewer/Water Contractor
I herebv apply for a Residential Building
Telephone # (
Telephone #(
q
'0-ob
Office Use Onlv
Cert ofSurveyRecd _Y _N
Soils Report _ Y _ N
Tree Pres Plan Recd _ Y_ N,
TreeP2sRequired _Y _N
On-site5epficSystem _Y _N
that the information is complete and accurat
e;
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 will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
? /o LC Gisa?
Applicant's Printed Name
Applicant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvoes
? 31 New ? 35 Int Improvement O 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" O 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolition (EMire Bidg) - Give PCA handout to applicant
DBSCrIqtl011: WaterDamage _ Yes
Valuation Occupancy MCES System
Plan Review _ 100% or _ 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Sheetrock
_ Footings (deck) FinaUC.O.
_ Footings (addition) FinaUNo C.O.
_ Foundakon - HVpC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding
Stucco Lath Stone Lath Brick
_ Fireplace _ R.I. _ Air Test _ Final _
Windows
_ Insulation _ Re[aining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
F?ri SIDENTIAL
BUIL ER MIT APPLICATION
ITY Y OF EAGAN
? U 3830 PILOT KNOB RD, EAGAN MN 55122
851-881-4675
New Consvuction BeaulremeMe
• 3 registered sHe wrveys showing sq. fl. ol bt, sq. ft. of house; and @II roated areas
(20% maximum bt coverege albwed)
• 2 copies of plan shaxing besm 8 wind(yw sizes; poured faund design, etc.)
. 1 set M Energy Cakuletans
• 3 copies of Tree Preservatbn Plan M bt platled afler 711 /93
• Rim.bist Detail Options selaAbn sheet (bMgs wtlh 3 or less untls)
DATE 13) 6 Z
SITE ADC
NPE OF
APPLiCANT
. SReJ-wv?? ?
BemotleNleoeir HeauiremeMs
• 2 copies of plan
?. 1-S
. 1 set ot Energy Cakulatbns for heated addttbns I12
• 7 sitesurveyforexlerbradddbns&Cecks
• IndicateHhomeservedDysepticsyslemforadditlons
VALUATION * Lfcl9 -7 cl-
-S,
4ULTI-FAMILY BLDG _Y )CN
FIREPLACE(5) _ 0 _ 1 _ 2
STREETADDRESS 2Z 32 HC&Icevc, -Dr. CITYVr,?W,-k?STATE?!? ZIP?
TELEPHONE #Itt CELL PHONE #te, z- aar -?r5 FAX #q,?y z- 3s z-% 61
PROPERTYOWNER ?c- ?? !- -,-- Pr-w-^ ?, TELEPHONE# LoS-r -4SZo-5Z"o 1
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIiNNESOTA RULES 7670 CATEGORY 1 r
(J submission type) • Residential VenElaBon Category 1 Worksheet Submitted •
• Energy Envelope Calculations Submltted
Plumbing Confractor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Contracfor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
42R
Fee: $90.00
Fee: $70.00
---------------------------------------------------------------
I hereby acknowledge ihat I have read this application, state that the information is corzect, and agree to comply
with all applicable State of Minnesota Statutes ond City of Eagan Ordlnances.
Signature of Applicanf
OFFICE USE ONLY
_ Water Softener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4ID2
?
.?
1987 BQILDING PERMIT 9PPLICATION - CITY OF E9G9N
SINGLE FAMILY DWELLINGS
INCLUDE 2 SEIS OF PLANS, 3 CERTIFICATES OF SQftVEY, 1 SST OF ENERGY CALCOLATIOHS
NOTE: ADDRESSES FOH CORNEE LOTS - COHTRACTOR/HOMEOTdNBR MDST DESIGAATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCB BQILDING PERMIT IS ISSQTiD.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL DPdTTS FOR SALE IIAYITS
INCLUDE 2 SETS'OF PLANS, CEBTIFICATE OF SDIiVEY - CHECK F1ITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CONIMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS$
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: AODEZ 141wc Valuation: Oc2i bnr1'
Site Address 7? (B I 4S'-'It6 ',?
Lot / B2oek /
Parcel/Sub va ,?c ? vCE A>v'-7'70.1
Owner
Address
City/Zip Code
Phone
Contractor '/";e.
Address Qu;iJ
City/Zip Code?cwnr?,?6r?,?, 1-4,„/r? Ss?37
Phone 6o1,5 /,f?12 5-
-.?522-
Arch./Engr.
Address
City/Zip Code
Phone !!
Date:
6-fl000 0FF
On Site Sewage_
MWCC System ?
On Site Well
City Siater ?
Vt.el I' .ti,?
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Couneil
Bldg Off
APC
Variance
USE
Occupancy
Zoning
Type of Const
(Actual)
(Allowable)
ll of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit
Sureharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
pl-3
tL- I
V-N
V-N
/f8. ?"'
SO. 33
95, o0
OI
Road Unit 3057.0
Treatment Pl J O. oo .
Parks I
Copies
TOTAL ;2-z3 2y?
?A12A6F' ; - -. -. - A
r•_ i)
^
24xzS??X?z,
,
?SMT!
a6 X -99=
1si Fi.oo.i
zG }c 38-4`6q
$ x t o ? ?60
I X ?n= i ?
qh432
?
68 19
_- ??•a -
I
,,?,•???: ?
I?;V •
F?s•uu+
iJU+
' UU-?.
.`U7•'?lll
u?uj?
, ?. •u,.?,
,
U R V E Y 0 R' S C E R T I F 1 C A T E CONSULFORPI HQMES I_TD.
NOTE: THE LEGAL DESCRIPTION USED ON TNIS
SURVEY WILL BECOME VALID UPOPJ FILING
THE PLAT OF PINE RIRGE AppITIQN,
. ?,:. . . .
:' .
?-. DENUTES PROPOSED SURFACE DAAINAGE
O UENU'IES IRON MUPIt1MENT 5ET SCALE: ,1 iMCll n 30 FEET
0 UENOTES IfiON MONUMENT FOUND hROPOSED G/1RAGE fLUUR - 87(0,o FEET
X000.O UENOTES E%l5TIN6 ELEVA710N PflOPOSEU LOWfST FLOUR ¦ 815, 2 FEET
(UUO.U) UENUTES PROP05EU ELEYI1T10N PROPDSEU TOP OF l3LOCK ¦ 674o,4- FEET.
I IIEREDY CERTIFY TU CONSULFORM HOMES LTD. TIIlIT TIIIS15 A TRUE IINU COfiRECT
REPRESENTATIUN UF /1 SURVEY OF THE IiOUNDARIES -0F: '. •. .
Lot 1, Block 1, PINE RIDGE ADDITIOPJ, accordin9 to.the recorded .
plat thereof, Dakota County, P1innesota. -
/IIIU OF TIIE LOCIITIUN OF A PROPDSEb BUILUING. 1T DOES NUT PURPORT TO 5110Id 1h1PfiDVE14EWT5
O!t EtICROACIIMENTS, 1F ANY, THEREUN. A5 SURVEYEU pY ME, UR UWUER htY IJIRECT SUPERV15101J,
TI115 157I4 DAY Uf SEp-T, , 198•7.
SIGIr'EU: 7 R PIILL, 3NC.
OY: ?
ilAAOLU C. PETERSOH; LA11U SUISVEYOR
SNEET 1 Of 2 SHEETS , h11NIlESOTA L1CEtJ5E 110. 12294
PROJECT N0. eooK i PAae ,JAMES ,.R. MlLL, INC.
87436 207/26 planners:/:Engineers / Surveyors
RILfi H0. I • ,
• 8200 Humbofdt Avenue South
F O L D E R Bloamington, Mn. `86431 812-884-3029
S U R V E Y O R' S C E R T I F I C A T E cONSULFORP1 HOMES LTD.
KOLSTAD . ROAD
v i L.V
1 O
M ? M •
872.8 •• 5. 0 SOIiTH ~ a.?.a
- eas. y ?-
' I? O Q r 1?
O ?' .
;
?_.? 1 C
O f'
KI 8
e'm.aE H7ss6?__"_
2?'.33
( ma/GAR.
r
? o. i ? PROPOSED,
NOUS
f-- , .\, (n,
CA Y__ .• "2a00 - - W -..,_._. ,
Q ? ? ?BTQ.f ' ¦8f9.6 ? ¦ .
W m ??7?.,? C?•'?? , m .. ? ? .. .
. , ? ., , . , -' I• ? . .
.I LOT
o ?
° '
? . . . , . , i. ? . .
I . -
,
, -?
.
_878.4 ,•., 85.00 NORTH 'a?&,-
^, ? ?? ?•• r. r? ?- :: ' i_ /?? ?? ?? n•? n A?
?? i ? ,V ?? ??? ?? i.? •?? i ?v? 1 . ' . .L_.?'1 ?: .?. V _
SHEET 2 OF 2 SHEETS
PROJECT NO. BOOK / PAGE
87436 207/26
FILE NO,
FOLDER
I
? ?.
. JAMES R. HIL.L, tNC.
Pianners / Engineers / Surveyors
8200 Numboldt Avenua 8outh
" 81o0m1ngt9n, Mn. 65431 812-884-3029
;
CITY OF EAGAN
E%TERIOR ENVELOPE AVERAGE 'U' COHPUT6TION
OWNER: `L}c`'?tr"'NivI ? G
SITE ADDRESS: XX Kx t..mL57,9-D ?oft-D ?o'r ???ci?Cl 71^?0 Aoc.? flDaoJ
?j
CONTRACTOR: ?SUtFC??'vt? Y-?trm?Ln?DATE: PHONEC f3/-601
82=-ZS 22
Determine vorking square footage of each:
1. Total exposed wall area .. / 93/ sq, ft. x.11 =
?/3 --,
2. Total roof/ceilfng area ., /076 sq. ft, x.026 = ?18 --?
Total exposed wall area above floor = //SZ
a. Total wall window area ............................ ,0Z
b. Total door area ................................... 410
c. Total sliding glass area .......................... 4 O
d. Total fireplace wall area ......................... -
e. Total wall framing area (average 10%) .............
f. Total net wall area above floor ................... 87s
g. Total rim joist area .............................. 1414
Total exposed foundation area = 65f0
h. Total foundation window area ........ ............. 7 z
i. Total net foundation area above grade ............. S/v3
Determine 'U' value of each wall segment:
a. ?Z x
- b. ?o x
c . 46 X
d, x
e, x
f. B7s x
g. ivv x
h. 77 x
' i x
IU? . 3 08 - e215, zS?-
IU' .2S - iG, o-U?
tol .305 = 12,32-
' U' - -
'U' .097-
TUI .036- - 33.25
' U' . Ou/ = 5, 4o'f
'U! • ?£z = ?3.-/1 G
gU' 3C1,f
3 . ................................................... Total :
If item !l3 is the same as or less than item U1, you have met the intent of SBC
6006(c) 2. Total exposed roof/ceiling area a 1076
3. Total skylight area .:....:........................ /?o"e-
k, Total roof/ceiling framing area (average 10$) ..... / 08
1. Total net insulated roof/ceiling area .............. r'7 70
OVER
Determine 'U' value for each roof/ceiling segoent:
i . - x 'U' =
k. / 0 8 x' U' , 0 Z? - ?. 7
1. '??O xlU' . 0 22- 3`f
t
T
l
4 . ............ ............... ............. .... o
a
..........
If total of fly is the same as or less than 112, you have met the intent of SBC
6006(c)7.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum
of Items 113 and 114 shall not be greater than the sum of Items tl1 and t12.
1. + 2.
3. + 4.
2
SINGLE & DOUBLE FAMILY HOMES
1984 ENERGY CODE REQUIREMENTS
On or about March 1, 1984, the following energy code requirements
should be calculated and included with a building permit application.
1. Roof - ceiling assemblies - R-38 U= 0.025 Average
2. Exterior walls & rim joists - R-20 U= 0.11 Average
3. Floors over unheated spaces - R-20 U= 0.05 Average
4. Exterior overhangs will be considered as exterior wall.
5. Foundations (all exterior walls) - Minimum of R-5 insulation.
6. All insulated areas must be separated from the heated space
by a well-lapped or sealed vapor barrier with a minimum perm
rating of 0.1. A 4 mil. polyethlene sheet or equivalent meets
this requirement.
A Kraft face R-19 type insulation will be accepted in the rim joist
areas. Air chute baffles are to be placed in every rafter space.
Interior Air Film (l/alls)
Fzterlor Air fllm (ualls)
In[crlor Air Film (Vcnced
Extc•rig.r Air Fllm (Vcnled
Intcrlor Air Filn (Ilcn Yc
Eateriar Air Fllm (11on ve
sieina
Al.minum .,ith Backer
Aluminum.iith Backcr E Fo
1/1 w B lco 5idina (llooa)
7/16 x 12 IlardboarA Sidin
l.sLcstas Sitlinns I/L LapD
S[ucco (Ora..m and Iinlsh
3;4" Vood Subfloor or Sne
1/2" Ply..oad hca[hinq
1/2" Par¢icle tlu..rd
YOODS:
iir. pinc L sim(tar soft lloods 1 1/2" 1.89
2 1/2" 3.12
) 1/2" 6.35
5 1/2" 6.81
(R)
r baard 3/8" 0.32
r boar0 I/2" 0.45
r board 5/4" 0.56
0.47
0.62
0.93
density 1/2" 1.72
eensity 25/32" 2.a6
inq 1/2" 1.14
0.)7
sninnl,s 0.21
fing 0.15
0.44
7/4" Fiberplass 7.00
2" Fiber9lass 1F.00
Fiberglass 19.00
BLOtIIIIG 1JOOLS Appmx. 3" • 9.00
Approx. 4 I/2" 13-00
Apvrox. 6 I/4" 19.00
ApDrox. 7 I/4" 24.00
..N? .. -
AI1 other inzula[ion materials mus[ be
Fllled verifieE (R iacmr)
(R) Vermiculitc
B'• [oncrc[e Block (5 L G 0.eq.) 1.11 1.93 '
12" Cancre[e 21o<k (5 L G Re9.) 1.18 ;.IS . 8^ Lishc uciqnc 2.18 5.03 ,
12" Light 1:eight 2.48 5.82
dl:?ii_RS?R^f.??Gl?AA?S?:R?dR
NOTE: (U) x Area Squaro Fect
All Vindws . ' - . -. . . . .'
(W/Srorns I" to 4" Spacc) .SL Removal Double Lluzing (0.0G) .55 ,
Thermo or wclded 3/16" air spacc .69 -
1/4" air :pace .65 1/2" alr soace .58 . , '
(O[Aer wlnCO.s specifically tested wn use be[ter ratin9s)
1 3/4 Solid <ore door .46
w/i[orm, wood .31
w/smrm, me[al .16 - Pease StcelOoor Insi/e/tL 7.45n .13 . Sltding Llass Door, Vood .65 XC[dI .715 '
LUIDCLIIIE TO (R) /'ALTURS fROR lSIIPt.C ENfIWL
Of T11P1[RLLY USCD PRODUCTS
(R)
0.68 Gypsum or plaste
0.17 Cypium or plaste
[eilinn) 0.61 Gypswn or nl+stc
Ccilinq) 0.61 Plywood 3/8"
nteA) 0.61 P1Ywood 1/3"
nted) 0.17 PIY?rod 3/4"
Sheathinq, reg.
0.61 SAeathinq, req.
1.62 Nbil-Aase sh<:.ch
ilea 3.96
. 0.81 Built-up Roofs
q 0.67 Asbes[os-cement
ed 0.31 Asph.lp roli roo
Coat) - ASpahIl Shingles
athin9 0.94 Insulation: 2-2
0.62 Insula[ion: 7 I/
0.66 Insulation: 6"
CITY OF FAGAN TfINIPNi1 "i1" VALUE AND R-FACTOR AT ROOF, IdALL, RIPI eV\D CO\`CRETE BLOCf;
lr _
?
?
? RooF j CcIL?NC,
(Y) VAL
1? It1TE?ID? ? A1R F??M . 6 j
O S?s" GYP
? lNSULAtI?N ,,4y
O EX?E.(?!?(? A1R Fl?r1 ? 6l
' (5-[ILL)
ToTAL (R)= -
1 ?
? . ? .
WAtL ? ? ?`
(7-) VALC
QQ iC? tEt=l?f= Alfl ?[lF1 . ?
BD.' ?ZS
ir'sUL.A"[IoN Siz,t?z, ?-
.
Q Z,??it $?1?7 ?JTc • _ .2. o
G
a C'lrt?oNl7c ?tD??C? ,?7
.1'7
. 2,1,. q3
-roTAL (K)_ ?. 03
?
?t It?T?.1'?lot? A?R Fl?t? ,. G e?
? 2' Ftf- Rltj ?plS`(
105
u•
? O . t:xTEO»V- AiF_ F«M '?-
11 Ui, =
. -?--
t?fR=.._.1? ToTPr (R)=ay•?7
? .
foJ??AT?oN ? . ? .
?
? Ctz) Vr?w?
0 tN jEl?l?? Auc F??.t1 ?
? . -
• C ,, .
9•5 - 0.10
EXjc-_mo;c AIR FtLM •
u?,? _ ?/(Z= •j?, To?[A? (C<?= .
Floors ove; unhez[ed spaces must have mininum R-factor'of R-20 (tuck-undeY Karaoes).
Floors ovcr outdoor air (ovcrhangs) nust liave a r.iininum P.-factor of R-33. ,
I/'J ..
CITY 0F FAGAN
f;ASFi:[I'=Rs 8 T'E.lii`tSidE1L N0: 39
tiATE:a 08/20/96 77HEa 15:59r.25
ID a
NFlt1Ec rAMES I. CIC F'1=NNINr,
3'r'10 9001 3661 I:(71..STFaLi fiT1 45.00
205 9001 36E:1 t(01._ST'FaD fiD 0.50
Yol::i:l kecFaipt, Amnunt: 45.50
Ckf7li:315'3
US[::1; ID: NANrY
CIT1F OF-EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMITTYPE: BuzLozNs
Permit Number. 028601
Date Issued: 0 g/20/g6
3661 KOL5TA0 RO
L07: 1 BLOCK: 1
PINE RIDGE
P.I.N.: 10-57675-010-01
DESCRIPTION:
rmit Type
rk Type
pECK
NEW
434 ALT. RESIDENTIAL
`?a= ?rz€ &aw?' p5Pq
??'?m#FlW W: ? ?'?' ," ? `??Si;'40?are
s?
REMARKS:
FEE SUMMARY:
Base Fee $45.00
Surcharge $.50
Total Fee $45.50
CONTRACTOR:
X.harsby a,?kcn?cr?i?d.?e ?i?=a??r? i
, znfb'rrnatian=;: is £trz+ri.*ect `A-v?l
L Statwte??
APPLICANT/PERMITEE SIfG'N3AT
?
OWNER: - Applicant -
pEPENNING JAMES
3661 KOLSTAD RD
EAGAN MN 55123-1016
(612)635-5383
? ? ?_ 4 r Pu 13 ' g F?t I ?j 4 ??i ? I
e` Ccr etfmpAJy,- ?ft3H, afi app]:Y.5ab2e f MM "
R'??CIL`@S'?;
y
?
ISb'ED B : IG URE
CITY OF EAGAN n
3830 PILOI" KNOB RD - 55122
r? „
D J 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
it% n??
681-4675 (?'.t1?EGti n ?-0?
New Construdion Reauirements
RemodeVReoair Reauirements
? 3 registered site surveys ? 2 eopies oi plan
? 2 copies of plans (include beam 8 window sizes; poured ind. design; etc ) ? 2 ske surveys (ezterior addRions & decks)
? 1 energy wlculations ? 1 energy calculations tor heated additions
? 3 copies of tree preservation pla if lol pladed aRer 7I1/93
required: _ Yes Na
tx`
DATE: 13-A5oies0' ' 1P'96 CONSTRUCTION COST:,/?s? ?
DESCRIPTION OF WORK: 1-5 u/ <<? / 1;r- a-f-
STREET ADDRESS:
LOT /0 BLOCK O ?
SUBD./P.I.D. #:
63,5 =5?3?3
PROPERTY
OWNER
CONTRACTOR
W-)
Name: 00,VeS Phone #: '??6'47G? C#2
Street Address: 3 ??l fl? ??
City: 4?0 9mid') _ State:/??
Company: _
Street Address:
City:
ARCHITECT/ Company:
ENGINEER
Name:
Phone #:
Registration
Street Address:
City:
Sewer 8 water iicensed plumber:
change are requested once permit is issued.
zip:5?,%e.3 /o/C<
Phone #: -
License #:-
State: Zip:
State:
Zip:
Penalty applies when address change and Bnt
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with al
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. ?
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
??CIEW 0
No
r?U ? 5 4996
_ No --?------?
/ea
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 5F Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
X' 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Atlowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Waier Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
OFFICE USE ONLY
? 11 Apt.lLodging ?
0 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
ET" 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 AZ Engineering
Valuation: $
? •? ?, ,?- n?
'?w ??,. ? ?,u???;
? w.
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System ?
City Water ?
Fire Sprinklered
PRV
Booster Pump
Census Code. 43
SAC Code
Census Bldg 1
Census Unit v
00 ?
Variance
% SAC
5AC Units
D.?sT = ? ?j n?-.9 T ?
ArY
T
JG 7'
CGG!/' f;?-
r
---?
?
?
/ Lio
?
G 7'
S;fe ?l?//
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
SINGI.E FAMILY •
? R-2 DL'PLEX (Twp Units) ? R-3 'IIOWNi005E (Three + Units) ( tJnits)
R-4 APAR'INENN'T/COAIDOMINIDM ( Units)
'(Please Print-?) / 1) PROPERTY ADDRESS: 3 CQ CQ ? K.Q-Q S`CG cl /C Oe?( •_
LEGAL DESCRIPTION: •-
_ Lot Block Subdivision or Tax Parce ID
I'F EXQSTII`7G 512L'C![JRE. DATE OF ORIGINAL BPZLDING PF72I•]IT ISSL'ANCE: '
PRFSEUP ZONING/PROPOSID L'SE: tbn Year
?
? CO1''Y`MCIAI./RSTAIL/OFFICE
Q IbIDL'STRIAL
n INSTIZt,*PIONAL/GpVF.RN?'p
2?
NAME:
ADDRESS:
CITY. SrATE. ZIP:
PFIONE:
3) i: ?•
NAME:
ADDRESS;
CITY. STp,TE, ZIP:
i PHONE:
MASTER LICEN5E#
4)
i3A'ric :
_ ADDRESS:
CITY. STATE, 2IP:
PHONE:
Plwnbers License:
P,ctive
Exp1Yed
Not Zecarded
St Iilltldl
'5? " ?? ' ?+• : a oa • a?.
',0-CONNEGTI0N 7O CITY SEWER p?'CONNFX.TION 'N CITY WATER 0 p?m '.- .•
, ?.
6) WIN111 • • i- a PLEASE HOLD ApPROVID PEE214IT EC)R PICK-UP BY ONE OF ABOyE ----- -- i
PLEASE MAIL APPROVID PERMIT 1V 1; 6) 3. 4, AHOVE .
(Circle one)
71
?
e
_ --
: NOT13: PAYMKATI' OF FEE AT TIIM Oi'
: APPLICATION DOES NCIr CONSTrrJTE
; APPROVAL OF PERNIIT,
xxsPDCriotv oF sEWEtt AND/10t WA=
ruSrnr.ramrpNS y1rrT• NCYT gg SCHED--
ULS•D ONTII, PERMiT HAS BEIN
APPF2(3VID.
, iSi9C.
FOR CITY USE ONLY
PERMIT # ISSLED
Pd w/Bldg. Permit
c
$ l??,a`v
$
$
$
$
$ JrZ7'?
$ ?oZS`0--b
e
$
C
$
$ $
FEES:
$ /d • ??
s
c
.t :
SEWER PERMIT (INCLUDE SCiRCHARGE)
WATER PERMIT ( INCLL'DE SURCHARGE.)
WATER METER/COPPERHORN/OCTSIDE READER
WATER TAP (INCLC'DE CORPORATION STOP)
$ SEWER TAP
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$ ? ACCOL?NT DEPOSIT - WATER
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$ WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TR[!NK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER ?
$ F7ATER TREATMENT PLANT SURCHARGE
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$ OTHER:
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' DOES DTILITY CONNECTION REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK SQITHIN PF?b-i?E:?+?`ItI-Gf-&Ie?y
'. ? R9?rB6d?iY" MUST BE ISSLED BY THE ENGI[VEERING /
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
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APPROVED BY:
TITLE: DATE : 16 /q 3 Id 7
_ --1
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142380
Date Issued:05/01/2017
Permit Category:ePermit
Site Address: 3661 Kolstad Rd
Lot:1 Block: 1 Addition: Pine Ridge
PID:10-57675-01-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
James L Depenning
3661 Kolstad Rd
Eagan MN 55122
All Season Remodeling & Exteriors Llc
17344 Puma Street NW
Anoka MN 55303
(763) 444-1373
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145555
Date Issued:09/14/2017
Permit Category:ePermit
Site Address: 3661 Kolstad Rd
Lot:1 Block: 1 Addition: Pine Ridge
PID:10-57675-01-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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: 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 -
James L Depenning
3661 Kolstad Rd
Eagan MN 55122
(651) 592-4813
Apex Energy Solutions
9655 Newton Ave S
Bloomington MN 55431
(651) 688-2739
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166536
Date Issued:01/19/2021
Permit Category:ePermit
Site Address: 3661 Kolstad Rd
Lot:1 Block: 1 Addition: Pine Ridge
PID:10-57675-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
James L & Dianne J Depenning
3661 Kolstad Rd
Eagan MN 55123
(651) 592-2561
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178414
Date Issued:08/16/2022
Permit Category:ePermit
Site Address: 3661 Kolstad Rd
Lot:1 Block: 1 Addition: Pine Ridge
PID:10-57675-01-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James L & Dianne J Depenning
3661 Kolstad Rd
Eagan MN 55123
(651) 592-4813
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA178595
Date Issued:08/25/2022
Permit Category:ePermit
Site Address: 3661 Kolstad Rd
Lot:1 Block: 1 Addition: Pine Ridge
PID:10-57675-01-010
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
James L & Dianne J Depenning
3661 Kolstad Rd
Eagan MN 55123
(651) 592-2561
Apple Lake Heating & Air Conditioning
207 150th Street West
Apple Valley MN 55124
(952) 431-4328
Applicant/Permitee: Signature Issued By: Signature