4349 Medary AveCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eaga
' PHONE: 454-8100
BUILDING PERMIT
Te be wwd ier '•,i)?: Est. Value ` i f' ,: GO
Site Address Erect
Lot Block Sec/Sub. ?' ". `: , i.; • Remod
Repair
Parcel No.
? Name
W
;
Address
b City Phone
o Name
Ou Address - -
1- Ciry ' Phone - -
u=
Kw
Name
i? Address
t?.Zi City Phone
I hereby acknowladge that I hove read this applicarion and stare that
ihe intormotion is correct and ogree to comply with oll opplicable
Stata of Minnewto Statutes and City o( Eagon Ordinances.
SipnMurc of Permittes
A Building Permif Is issued to: oll work shall be done in acoadonce with all onoliwble State of Mir
MN 55121
?
?
11
?
?
#
MOVB I
Int Im
Install
Occupancy _
Zoning _
Type of Const.
No. Stories
Length
Depth
Sq. Ft.
11169
Fess
Woter b $ew.
Police
Fire
Erq.
Plonner _
Council _
Bldg. Off.. v.
APC
Var. Date
Permit " '-' . J U
Surcharge 5 , fi (J
Plan Review
SAC
Water Conn.
Weter Meter
Road Unit _
; LI Tr. PI.
Parks
Copies
Total
on the exprcss condition Ihot
and Ciry of Eopon Ordinonces.
Buildirp Ofilciol
Permit No. Parmit Holder Daes Telsphone ?
Plumblng
H. V A.C;
Electric
Sottamr
Intpeetion Dats Insp. Other
Footings I
Footings II
Foundation
Framinq ,yw
Roofiny
Rouyh Plbg.
Rough Htg.
Insul.
Flroplace
Flnal Htg.
Final Plbp.
Flnal
CwVOcc. ? ?`(JS ?:U
W?or Descri6e Location:
Well
Sewsr
pr. Disp.
CITY OF EAGAN
Addition
OwnerL
Remarks
Improvement Date Amount Annual Years Payment Receipt Date
STR EET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATEFAL '
WATERMAIN
* WATER LATERAL 1976
WATER AREA
STORM SEW TRK
* STORM SEW LAT
?
CURB & Gl1TTER
SIDEWALK
STREET LIGHT 1980 _,' $0 13.56
?
WATER CONN. Brnsvlle 205.00
BUILDING PER. 16
SAC
PARK
? CITY OF EAGAN
k 3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
? PERMIT SUBTYPE:
CTION RECOR]
PERMIT TY
Permit Number:
Date Issued:
f,f APPLICANT:
, M1
TYPE OF WORK:
'I I ,.rI I I Nt, I I I ?41,1
14 11 1 1 11 t nri
0 " 1 z 1 t,
cif. /.Ir, /tv"!
?
?
Permtt No. Permk Holder Date Telephone #
S/MI
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Inap. Commenta
Footings 1
Foundation
Framing
Rooflng
Rough Plbg.
Rough Htg.
Isul.
Fireplece
Final Htg.
Orsat Tes[
Finel Plbg. Pibg. Inspector - Notiy Plumber
Coast. Meter
Engr./Ptan
Bldg. Final
Deck Ftg.
Deck Final l? - r
Wall
Pr. Disp.
io a 26. 02
cz Tt OF Far:-?N
37C? _nj.1:0't I'Y?Oil ia;',F?Ct
i23;;I':,, t`?a jJ?-2
Pi Pw'/LIi NO.: 29
T:,e Ci.ty of La..?an heieLJ gra:zts to ? Lindsay Water Conditioninq Co.
a WATFR SOFTENER F
3' 2 Vallev Ridge
at 434 Medary Ave._
s/c..
4215 Cedar Ave. So?, Eaqan
R. I?nodel ?
e?'Mit for: (Owner) M_ r,eVake
?r.
pt:i°.uant to a.pplication dated 3/16/76 _
"?llis 22 day of March , 1q 76 lruiidir._- Insrector
CITY of EAGAN
BUILDIN[3 PERMIT
own.r ..::?.......?`Q.`..?'.:- .:................................
L /c U ZU _77
Addreas (Presen!) .•T• ................................................................. ......
Builder ....
Addeess ......
DESCRIPTION
I
.., r.
N2 3792
3795 Pilot Knob Road
Eagan, Minnesota 55122
454•8100
Dale S?-. 7,.f
63orias To Be Used For Front Depth Heigh! Est. Cos! Permi! Fee Ramsrlu
l/? I ?- y I '?k? _S ?? /33• e-c? Lc ? .atc
LOCATION /SL- S O
Stree2, Road or oihee Description of Locatiox+ I Lo! Block Additioa os T:ac!
/3 c/
Thia permit does aot suthorise the use of steeels, roads, alleys or sidewalka nor doas it giva the owner or hle agea!
the righ! !o create any situation which is a nuisance or which presents a ha:ard !o tha health, safetp, eoavenieaca and
general welfa:e !o anyoae in the commuaity. '
THIS PERMIT MUST BE KEPT?ON THEaPIREMISE WHILE THE WORK IS IN PROG8ES8.
Thia is io eertifp, ................ has permission !o erect' a.. r..?..... d. ..?`"? upoa
`.`:?.?. ......._
the above described premise subjecf fo 3he provisions of all applicable Ordinances for the Cif? of Eagan.
t I ?7 °
......................... 2! .......... ..... ...--- ?
? :-:. .................................... per ................ ._....-.9=": G`-----.._e..........':_::...... . .........................
Mayor Sufldiag Inapeetor
43
?
CITY , OF EAG:u,?'
3795 Pil.ot Knob Road
Eagr:.n, Niinnesota 55122
7-3 ?, //' %
YL?= NO.: 778
The City oi Eagan hereby grants to Ray P7. Wlelter F.eating ?
;,f bipls
a sF.AmzrrG Permit for: ((h,.n-,er ) windsor
at _4349 Mgdarv ? pursuanc tc opnl-cat_or, dat'Upd y12/22/75--•.--
Fee Paids g?p,ppdated this 23 cs?; or
.50 s/c `
nec ,
Euilding Inepec-L-or
Mechanical Perrr;its:
Bi:? Total;
,
.
CI'?'Y CF EaGa.J
3795 Pilot Knob Road
Eagan, Minnesota 55122
?? /) 03
//i/iS
PERvIIT NO.: r,; r,
The City of Eagan hereby grants to my,o?,Tcnr ;- •r;n?, cn_
Of Minnntnrka
Windsor nev.
a *! Permit for: (Nmer) ca?rAi tr-•cr i nr,
4349 14e3ary Ave,i
at ,. .• r,r,?, ? pursuant to applicaticn dated 1 1/1 c;i7, .
Billed
Fee iffi?y}: <. ;.,-)q dated this 1`; day of r,,v, , 19 7S •
Building Inspector
Mechanical Permits:
Bid Total:
CITY OF EAGAN N° 1 1 16 9
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE: 454-8100
BUILDING PERMIT Receipt #
To 6e wed 1er ADDITION Est. Value $10 PO00 pare OCTOBER 24 19 85
SiteAddress 4349 MEDARY AVE Erect ? Occupancv
Lot 7 Block 3 Sec/Sub. RIVER HILLS 9 Remodel ? Zoning
Percel No. Repair ? Type of Const.
Addition ? No. Stories
MARVIN LEVAKE Move ? Lengtn
W Name Demolish ? Depth
? Address S?E Int Impr. ? Sq. Ft.
City Pnone 890-0790 Install ?
? Approvols Faes
o Neme O CARLSON CONST
?? Address 13621 V N .NT IR Assessment _
? City BLTRNSVTT.T.j?'hone 890-0339 Water & Sew.
? Police
Name
Address
City _
Phone
1 hereby acknowledge that I hove read this opplication and stote thot
fhe in(ormafion is Correct ond ogree to Comply with oll opplicable
State of Minnesota Stotute and City of Ea9an Ordinances.
Signoture of Permittee < </$4,eS,G "e/E,( -?
A Bufiding Permit is issued ro: O. CARLSON CONST '
all work sholl be done in ocwrdance with oll ooAliwble Stotelfof M
Fire
Eng.
Plonner
Council
BIdg.Off.lO 23 85
APC
Var. Date
Permit a o V.Z)v
Surcharge 5.00
Plan Review
SAC
Water Conn
Water Meter
Road Unit
Tc PI.
Parks
Copies
rotal $85.50
on the ezpress condition Ihot
Statutes and Ciry of Eagon Ordinonces.
Building Official
' REQUEST FOR ELECTWCAL IWSPECTION Eg00001 -°°
tsee ;n?t.uct, -?
o?.'?conplaiiqu this form m back of Velloa copy.
A -YY"Be/aw Work Covered by This Request
?°??-
Add Rev. TvPe of BuildiFog /hppliaxes Yved . EquiPruent Ypired
Commercial Bldg. Fumace Silo unloaAer
r?TTrxlustrial Bldg. Air Corditioner Bulk Milk Tank_ mnute insnection tee
N Fee ServiceErRfent9Siie A Fee Faedars/Subfaeders Jt Fee Circuits
omzoo AnWs 0 m30 Antps omsoam
Above 200 Amps 31 tu 760 Amps 31 to I00 ARUM
Swirtonirg Pool Above 100_Am?s Above 1Q0-A?
Tra?sformers Irrigation Bowrs Partial•' ee
Sigis Special Inspection 5
Remarks f S[J TOT ?
e
d••-•^ ? --- 1. lecti 1
r f ???? I?pec e6y
ce?tify tlm; the above
Final ?a? t:on has been .
? .?,??. ?yus
mis revtmW
This request wid ? ? ? ?j ? / ?
18 months from 6 (
A 079697 -- Q A ca A . tn)
Reque t Date
?
' Fire No_ Rouph-in I?specNon Required? []ReadY How?Will Notity. InsPec-
Wh
?Y
1
d ?YCS ?No en ReadY
?
? Licensed Electrical Contrac[or I beweyv feyuest ynspe?VOn of abwe
?Owner electrical sork insblled at:
Street Address, Box or Route No. Ciq.
3 ?{ ?,r ?e, . rfgAii
ecuon o. Towmhip Nanff or Nn. nge No_ - ouory
C
?
A ?
..?)TK0r1+ ' .
Occupant (PRINT)
?
?' Phwre fVa,
'
?
.l
ril-?V? a
ia-a75
4
Power SuPDlier
?A<6fA Address
FA2,o(1MG-TG AJ
Electrical Contracmr (Compa
n
y
Namel Cmtrac:roi s Gccnse No_
y
?
?
QW,1'?. Wl,?p) n, e wj
fc,t +?a
Mailing Address IContractor a Owmer Making InsIDGlation)
Authori ed Signature 1 on[ract fnu
Incmtla[ian) Plwm N?miher
?
a."03 1 n Q- cr7f6
MINNESOTA STpTE BOARD OF ELEC7RICtit ' THIS INSPECTION BEQUEST MILI NOT
Griggs-Midwrav Bldg- - I1oom q-791 BE ACCEP7FD BY 7HE STATE 80ARO
7827 UniversflY Ave., SC Peul, YN 55104 UNIESS PROPER 17dSPEC710N FEE 1S
PMnre 18121 297-2111 ENCLOSED.
VILLAGE YiF EAGAN
3795 Pilot Knob Road
Eagan, MN 55122
Zoning: RII
Owner: WindSOr
Address
Site Add
Plurnber:
Meter N(
a 7i /
Re?er No.:
I agrae to comply with the Villoge of Eogan
Ordiiwn? ?/ Cic 17 6
v... °tr.+-a[V[
By
Date of Insp.
WATER SERVICE PERMIT"?
PERMIT NO.: 1?Bts .-
DATE: 11/19/75
No. of Units: 1
Connection Charge: ?u:)• Uv yu
Account Deposih
Permit Fee: 10 ,.f1p billed
Surcharge: -._ Pd
Misc. Charges60.00
Total: ?
Date Paid:
Insp.: t\'
riKaoE QF eaaaN SEWER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.: 2645
Eogan, MN 55122 DATE: 11/19/75
7.oning: RrT No. of Units: 1
Jwner: Wi ndcnr l1aY 1 f nrp
4ddreas:
iite Address: 4349 MPdarv Ave L7II7 -A Ri 9
?lUmbCi: ThUmpSOri P1UIIlb].Rq CO
ogroa to comply wit6 tM Villaga of Eapon Connection Chazge: 425.00 Pd
3rdinancoc Account Deposit:
Permit Fee: 10.00 billed
SO billed ?
Surcharge:
?
;y. Misa Chazges:
,.
)ace of Inap.: Total:
nep.: Date Paid:
Dty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
?-----------------
? For Office Use I
j Permit
? Pertnit Fee: ?
? Date Received: ?
I I
I Staff: I
I I
? ___J
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 4?4?? ?y I127;.
Tenant: vG 4" `i 12e f
_ZajU Suite
RESIDENT / OWNER Name: ?Wveg' iz 4m Phone: :?"/
Address / City / Zip: _L,-WW6r64 ?[./ Ag-
Applicant is: _ Owner ? CoMractor
TYPE OF WORK Description of work: _??
Construction Cost.'r aJL?? . ? Multi-Family Building: (Yes No
CONTRACTOR Name: License #: Zt7S $? Z??
? '/
.
Address:.$?o. f?leG/?Sf?jrlQ r;,0?l?1
City: Li?CJ??. ?ob1.OL? H?? State: Afl-/ Zip: _???Z41
Phone: IS J 6T'J? !O O Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A PIEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventllation Category 1 Worksheet . New Energy Code WoAcsheet
Category Submitted
Submitled
(4 Submis5ion type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a perm(t 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 8 Water Contractor: Phone:
NOTE: P/ans and supporting documents fhat you submit are considered to be public information. Portlons of
the information may be classlrted as non-public if you provide specffic r+easons that would permit the Ctty to
conc/ude that the are bade secrets_
-o,o?y a?Kilummye mat mis irnormanon fs comptete and accurate; that the work will be in confortnance with the ordinances and codes of lhe City of
Eagan; thal I understand this is not a permit, but only an application for a permit, and work is no to starl 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 pl s
x A7/'??a-.f?
x_
Applicant's Printed Name ApplicanPs Signature
Page 1 of 3
j Yo. C'0
2005 RESIDENTIAL BUILDING PERMIT APPLICATION 'i ??
L (+ City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Constmction Reouirements Remodel/Reoair Requirements Offite Use Ortly
Gert of Survey Reed
Y N
3 registered site surveys showing sq. fl. of bt, sq. R. of house; and all roofed areas
l
li
d 2 copies of plan
1 set of Energy Calculations for healed addilions Yree Pres Plan Recd 'F N;
ot coverage a
owe
)
(20% maximum
2 copies of plan showing beam & window sizes; poured (ound design, etc 1 siie survey for additions & decks Vee Pres:Reqm[ed , ?1
'
t set of Energy Calculations Addition - indicate if on-sife sepfic system Onsite:5epiic Sysiem :; -? N
?
3 copies af Tree Preservation Plan if lot platted afier 7l1193
Rim Joisi Detail Options selection sheet (buildings wiih 3 or less units)
Date ?
O E
Construction Cost2 .4f D(J
Site Address 3`1 1 VIec)a w Ti VP o Unit/Ste #
Description of Work I 1enp'Q IP oIt6 C?dLII_IrL?2
Multi-Family Bldg _ YY_ N Fireplace(s) _ 0 2
r
O
P
t Il I e7kt?l` l{'Y)b'f'1 FAMI\ Telephone #(65' )?"I
wne
roper
y
contractor GreatLai?es Wivia4,w 1- sid?nq
-
Address APPie W . MN 85124 City
State Pk Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CategOrv 1 _ Mumesota Rules 7672
Energy 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% plan review
fee applies. - -
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a 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;requir.es_a-Leview and
approval of plans. l-77
[i , l, "I iI ?
?<? 005 ?
Applicant's Printed Name Applicant's i nat re
i„
OFFICE USE ONLY
5ub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 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 (screen/gazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Muiti Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
•Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
.. ., ..,?,.
,. ? ?..,?•. -;?s: ?? a•???u:?•?-*,??,.;s.ri1; .x_?
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
Plumbing
HVAC
OtYter
Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Approved 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
Pool _ Ftgs _ Au/Gas Tests r,iw
Siding _ Stucco _ Stone _ Brick
Windows
Retaining Wall
Building Inspector
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: LoT :
4349 MEDARY AVE
RIVER HILLS 9
PERMIT SUBTYPE:
DECK
7 sLo c K: 3 APPLICANT:
FITTERER
(612) 890-5048
TYPE OF WORK:
DESCRIPTION
ausLoxNe
021315
06/25/93
MICHAEL
NEW
5 X 19 & 16 X 20
INSPECTION .. • .A
FOOTING FINAL
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
PERMIT ?
CITY OF EAGAN
383dPilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permii Number:
Date Issued:
SITE ADDRESS:
4349 MEDARY AVE
LOT: 7 BLQCK: 3
RIVER HILLS 9
P.I.N.: 10-64400-070-03
DESCRIPTION: . ,
5 x 19 & 16 X 20
8-u'ildirt+g,, Permit Type , DECK
?Buildirsg 4ittrk Type NEW
?.?.?) (?' ?s L.fu U
REMARKS:
FEE SUMMARY
Base Fee $25.00 COPIES $1.00
5urcharge ,50 Total Fee $26.50
Subtotal $25.50
CONTRACTOR:
BUILDING
021315
06J25/93
OWNER: - Applicant -
FI7TERER I MICHAEL
4349 MEDARY AVE
EAGAN MN
(612)890-5048
? I hereby aeknowledge that I have read th3s applicat3an and state that the i
infarmation is cnrrect and agres to compiy with all apRlicable 5tato at Mn.
Statutes and city af Eagan ord3nanees.
7 ?
AP ANT/PERMITEE SIGNATURE ? SSU BY: S ATURE
._ ._ .. .?. _ ..._ . _ . . _ . .
RE;ICTIYATE _
PERMIT #
,
a/13?s
u?si??E?, V E DD
.f J N 16 1993
---------------
CITY OF EAGAN
1993 BUILDING PERMIT PPLICATION S(?
681-4675 QIy SI
NGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Ti.,A2 57 / 1113 Yal uati on of work
Site Address: 4349 Me.a•-rv Av".,.v-,
STREEi SUITE *
Tenant Name: (commercial only)
LOT 0-70 BLOCK 03 SIIBD: P.I.D. v?
q *& c-d, ct.?' i o?n
Descri tion of work: e.c.k
The applicant is: L? Owner 19 Contractor ? Other (oes«;be)
Name F i1'1?zirev- MicLaet A"w.6--r14 Phone 970 ?c,_oyg
Property LAST fIRST
Owner Address 4349 Medavy Ave-
STREE7 STE #
City F?o-ti avN State Mnl Zip SS? ;t-a-
Company L'Phone IMn - 504 8
Contractor Address 14 34 9 Me-X d/y Av-t- License # 1JA Exp.
City ? aVk State ,44 Al Zip 5517. J_
Company - n oA.t- Phone"76$ - 30S0
Architectl
Engineer Name vQ. Registration # IJ, 4.
Address o3
City ?-ei.J P94+4 (-C State fill ?V n+ . Zip S&OZ ?
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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.
j
5ignature of Applicant: ??//t
V
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
0 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
? 31 New
? 32 Addition
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
0 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
? 11 Apt-./Lodging
O 12 Multi. Misc.
? 13 Garage/Accessory
O 14 Fireplace
lew- 15 Deck
O 35 Tenant Finish
? 36 Move
1 •
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Cotmn./Ind. Misc.
? 20 Public Facility
0 21 Misceltaneous
O 37 Demotish
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy R2nd fl. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pum p
# of Stories Footprint Sq. ft. Fire Sprink ler
Length '57? 1g' On-site well Census Code 93 y
Oepth On-site sewage SAC Code
?
APPROVALS
Planning Building Assessments
Engineering Yariance
REGIUIRED IN SPECTIONS
? Site Footing O Framing ? Insulation
? Wallboard ? Oraintile
;Final ? Fireplace
Permit Fee ZS,ov I v.tLoc;«,: $
Surcharge
Plan Review .
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
?i
t0 1n?1(c?i, t???1wd n-1" Lt;??s ?_loL?1/v
_. ._._.._. ??'._?._... ..__._._._._. _?' . _ ....._ .. . "..' .. ". `.'? tIz?
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1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conshud(on Reauirements Remodel/Repair Reau(remenfs
? 3 regisfered sRe surveys showing sq. ff. of lot, sq. H. of house 2 copies of plan
and all roofed areas (20% maxtmum loi eoveraae allowed) 1 set of energy calculafions for heated addifions
D 2 coples of plans (show beam & wlndow aizes; poured Ind. des(gn; efc.) 1 sNe survey tor exterior oddHions 3 decks
? 1 set of energy calculations
A 3 copies of hee preservaNon plan 81ot plafted affer 7/1/93
2//' ? ?
DATE: D? J"!"/ CONSTRUCTION COST: 9
DESCRIPTION OF WORK: _ IW`DD? `? ? VY ??
STREETADDRESS: J? L ?
- c
LOT: ? BLOCK: SUBD./P.I.D. #: VW Name: )""i 4y e/'' /lt-? Phone #: 56 PROPERTY Lost First
OWNER ?? qcg fi-k-b
Street Address:
Ciy State: Zip:
Company: LM 0i4'L W-0 Phone #: &G
CONTRACTOR (area code)
f? / _?,_ ??J S
Street Address: 6) / ?- License #q853 Exp!
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
7elephan2 #: craa coaie (
Streei Address: Registration #:
City
Sewer 8 water licensed plumber (reautred for new eonstructlon onlv):
State:
Penalty applies when address change and lot change is requested once permff is Issued.
Zip:
I hereby acknowledge that I have read this applfcaNon, sFate that the tr?formatlon is cortect, and agree to comply wHh ail applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signafure of Applicanh C7G?? v w1µ' C) -
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
OK02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage 0 22 ' Porch/Addn. (4sea.
? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level --M.24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool /b 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr O 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alte°atian ? 37 Demoli.eh RI^!ca.* rJ 41 Wor,el c+nye !'[ 45 rir;; P:;pair
? 34 Repair ? 38 Demolish (Interior) M?42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
Zoning sq. ft.
# of Stories sq. ft.
Length sq. ft.
Width Footprint sq. ft.
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MClES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/VN Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
valuation: $ ?530
7
SAC Units
°k SAC
,
1985 BUILDIHG PERIiIT APPL ATION - CITY OF EAGAH
NOTE: ALL CONTRACTORS HUST BE LICENSED ifITH THE CITY OF EAGAN
COMMERCIAL SINGLE FA!lILY DWELLINGS
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 : Ac(LQ[ f( r--4'X Valuation : (0,60d- Or-% Date :
?
Site Address 47? (t N
Lot ? Block,3
Parcel/Sub
Owner ! d f/4- lC -e
Address `/ 3 Y w
City/Zip Code t= A- q 2 w
Phone
Contractor
Address neL
?
City/Zip Code ?-? ur ?? r`rC4,
Phone _F! 0-F2U- 6 33i
Arch./Engr.
Address
City/Zip Code
Phone !/
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
(? a .- 2. 3 - ?-I
OFFICE USE ONLY
Erect ?
Remodel ?
Repair
Addition ?
Move
Demolish
Int.Impr. ?
Install ?
APPROVALS
Oecupancy
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
F'EES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr W 'ter Conn
Planner ater Meter
'
Council Road Unit
Bldg Off ia Treatment P1
APC Parks
Variance Copies
TOTAL
,
?
I (?? K ( ? ` 2j () 4- X 2c) ° (an vo
., ,? -•?, . "s.
,.
, ; '46
.'
? . _.
0 lrI ?1?7 V?. ?A?IqAl
obtr M?- Djql.e- PeTT?-saw o
11//2/ 75
Vi G! 0 SIfA4 ?,? i i GL C-? P G rl /?!? t? -2 1g" Yn CJ U t-. ? d?
1026 b???(d,?.? ??P- e s,
30 C j S k/ CD h k PG ?o w19 h dA eTe y- a? <
7 6[OGr1 3 r41 l?s??? eJA?Y ?vee
ko t-,-e, W-(?
)1. "! Ci W l Y 1 "' l' ,, l ?/ Lin> Ir / y Zf, C3 ??J J
w E r?? / l('r? G ? V ?/ ? ?/l d ? ? X? Z S(?' 6 O ?/5 0 w l? ??(rl.? ?i !!? C] "PJ
?
he,6 owL k,-)??6
c v ( o c, L? e. o ? e ?r - e c- e
U 0 c, c O L
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MASTER CARD
LOCATION
OWNER (qA h pI D I DQ Ll
STRUCTURE AND
LAND USED AS mp b 7J - 3 b
Permit
No.
Issued Issued To
ConTractor Owner
BUILDING
PLUMBING j? M_ '7j 0000 r?I,. r?d s?r
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER I
07HER I I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FGOTING ? ?I-/g- 7J'
FOUNDATION CESSPOOL
FRAMING
? TILE FIELD FT.
FINAL
ELECTRICAL
-
HEA71NG
3 - DEPTH
OF WELL
GAS INSTALLATION _
SEPTIC TANK
CESSPOOL
DRAINFIELD 9- /(O
?
PLUMBING a ?
WELL
SANI7ARY SEWER
_.?[A? ••
?
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OP OBSERVED VIOLATIONS
PERMIT NO.
DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
a NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REIIRSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CE RTI FICATION -1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site imprrnements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING I
COMMENTS:
DATE
_4DO 23
-- ? ? n,? RESIDENTIAL BUILDING
?? Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5674
New Construc6on Reauirements RemodeUReoair Reauiremenls Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft, of house; and all roofed areas 2 copies o( plan Cert of Survey Recd
(20°k maximum bt coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan ReW
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey tor additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Additlon - indicate if onsde septic system _ Onsile Septic System
3 copies of Tree Presenation Plan it lot platted afler 711193
Rim Joist Detail Oplions selection sheet (bldgs with 3 or less unifs
Date
Site Add? ConstructionCost
UniUSte #
Description of Work +``PrN. U U?C
f ?} >?4 }• i- )?? ) 1>
I?J?n /) '- f-.lpiS" a' JSle'f
Multi-Family Bldg _ Y-j/N Fireplace(s) _ U _ 1 ? 2
Pro er Owner
P tY '" / ?/ •?-?
??-et
/` ? -J
Tele hone# t?.?f ) ?1 ?.- ? ?
p ' ( v ` ?
Contractor peilcl?ke c) Ft' i 'Lf
Address
State ?y7? 3'1
Zip City ?DO Yl+ n?
JrS I /.ZJ Telephone #1?/„2,) S'AQ oZ?
?
4 liq a?9 (0
(? kt.Lct 66Lt
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
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the informatio4ris`comp ete 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 rk which requires a review and
approval of plans. A19 7 j
4?2G3 1-, ?? I4
ApplicaR 's Printed Name Applicant's i ure
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 i 6-plex ? 20 Pool ? 30 Accessory Bldg
,U 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 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 z)('?35
'A 32 Addition ? 36
? 33 Alteration ? 37
? 34 Replacement
Valuation Sf VQ
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
Int Improvement ? 38 Demolish (Interior) ? 44 Siding
Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) - Give PCA handout to appllcant
Occupancy MClES 5ystem
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
_ Footings (new bldg)
Footings (deck)
V 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
OWer
_ Pool Ftgs Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (newheplacement)
_ 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
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(812) 880-8331
// GARY OTIS
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407 Ensr 78tH SmeeT OFFice 952.888,2225
BLooMwGTON, MN 55420 Fwc 952.888.2259
www.plekkenpol.com Moeae 6723282338
HoMe 612.861.8948
efefax He, MNLic p1797
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?J? F? ' MECHANICAL (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 pernriu are required for each unit
Date C) ?- / ):-? / 6 _?
Sit
Add
alP42
l3q9
AL, Q Unit #
e
ress
/
U GLC?2N
Property Owner Telephone # ( )
Contractor ANW&'C4^j /¢;t c-?/Jly
Street Address ?7? ?-? iU' 4i, City ?l1 v e2
State MZip -S S 3?0 Telephone #((Q4?- )6Wd-" 7Y?U_
The Applicant is Owner 2-4- Contractor _ Other
Add-on, modification or alteration to eaosting dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner
? other
i
?,;; FFf3 2 7 7_00"j
State Surcharge By $ .50
Total $ 32>0 - ?9D
I hereby apply for a Residential Mechanical Permit and aclrnowledge that the information is complete and accurate; that the wark will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes, that I understand this is not a
permit, but only an application for a pemut, and work is not to stazt without a permit; that the work will be in accordance with the
apJed plan in the case work which requires a review and approval of plans.
?P
Applicant's Printed Name App cant's Signature
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: commercial/industrial buildings
multi-family buildings when sepazate pemvts are not required for cach dwelling unit
Date U a / c? '7 / 0 3
Site Address `-t 3 1q N( Pgqo }iV{ Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor b'?m< <6v A? Sc• t
StreetAddress ,qQ7?k A;C City RiU-ed(
State /vAN Zip S1r33o Telephone#
The Applicant is _ Owner ? Contractor Other
Work Type
_ New construction Underground Tank _Install _Remove
? Interior Improvement Call for inspection durin g installation/removal of tank
_ Processed Piping
Nature of Work: QQ -po.ii.ed J /CQ??v j ?v f iv? ?u6 PLnsY%_
,
Permit Fee $50.50 Minimum Fee (indudes State Surcharge)
ContractValue $ x .Ol% PermitFee
• If permit fee is $1,000 or less, add $.50 =:> $ 3tate Surcharge
If pernvt fee is over $1,000, add $.50 per
$1,000 Pemrit Fee
$ Total Fee
1 hereby apply Yor a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will be in conforxnance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a permit, but only an applica6on 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 ans.
?I?V. v ??eauc. ?? ? ??--
ApplicanYs Printed Name Ap4cant's Signature
Approved By: , Inspector Date:
(?I -?w
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
$ --?-o,0
New Construction Reauirements
RemodeVReoair Requirements ..:...:.::.....
f?fFxe Use {?t
3 regisiered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas 2 copies of plan C PA b f?'u?!e!' ¢ X ?
(20%a maximum lot coverage allowed) 1 set of Energy Calculations for healed additions Tree?te5 Pf?rf E?ecd Y.
t?.
2 copies of plan showing beam & window sizes; poured found design, etc. . 1 site survey for additions & decks ?reePres3?ec7Ui{Ed ?'. ?,;N
1 set of Energy CalculaGons Add'dion - indicate Aon-site septic system t?asde SeplrCSystem ::
3 copies of Tree Preservalion Plan if lot platted after 7l1193
Rim Joist Detail Options selection sheel (bldgs wilh 3 or less unih
"Date o?
Construction Cost „7 SaD'
SiteAddress Unit/Ste# ?!;'?; u-u i'
In
Description of Work
II " ? f! J ZUOq
,u
(<c? 1
Multi-Family Bldg _ Y? Ir?y
Fireplace(s) _ 02 ?-
Property Owner Telephone # (lo?l) ?0 -`1Z YcF---
Contractor e lla(G?-s"
Address ?20J--I.S- City Z/w [ -
State mov Zip ?DYyTelephone # (1??) t - ..71?2?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 _ Minnesota Rules 7672
Enefgy 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% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Conhactor
Telephone #(
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a 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 an .
Name
OFFICE USE ONLY
5ub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Firepiace O 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screeNgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
? 30 Accessory Bldg
? 31 Ext.Alt-Multi
? 33 Ext Alt - SF
? 36 Muiti Misc.
? 35 Int Improvement ?- 38 Demolish Interior. ,O,; `44-
? 36 Move Building ? 42 Demolish Foundation ? 45
? 37 . Demolish Building' O 43 Reroof ? 46
•Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MCES System _
C't Wat
Siding
Fire Repair
Windows/Doors
Zoning i y er..
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered -
Width -
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulalion
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utilify Connection Charge
S&W Permit & Suroharge
Treatment Plant
License Search
Copies
other
Total
REQUIItED INSPECTIONS
FinallC.O.
FinaUNo C.O.
_ Plumbing -
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
Windows
_ Retaining Wall
Building inspector