2861 Highridge TerCITY OF EAGAN Remarks
Addition Valley View Plat 1 Lot 3 eik Z Parcel 10 81400 030 02
owner,i?•i .LOu:Jc;), Street 2861 Highridge Terrace State Eagan, N,N 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR, pgvlri 1962 r735. 00 $73 .50 10 ?
GRADING
OSAN SEW TRUNK 1968 $100. 00 $3. 33 30 PAID - - S
9c SEWER LATERAL I970 20
WATERMAIN
*16WATER LATERAL 1970 $2510. 00 125. 50 20 PAID
? WATER AREA 1970 20
STORM SEW TRK
S70RM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER. #3508 2684 1-75
SAC 200.00 1418 5-15-159
PARK
T INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
?Eagan, Minnesota 55122-1897 Date Issued: ?
(651) 651-4675
SITE ADDRESS: APPLICANT:
, ? t)FiC I 1 ic
PERMIT SUBTYPE: TYPE OF WORK:
' ql ! 11I.IC 1 ff_Fl i,t Mtlll
INSPECTION .• • D.
I : 4 fi I
F
L
I'' 1A!+i K F V 1 F' Wi- 1) HY ft ! 1! A! 7 A M
at!''Art Alt" F'i N.h11 f I?1:!,tiU1 i-f l? I
CRi 1 44'i :'840 itF, lif1FxI11Mtii t- l
7
I
?..
-3 3y-?) Permlt Holder Date Telephone #
SEWER!
WATER
PLUMBI
HVAC
Inspectlon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING ?4-
PLBG
AIR TEST /.G??N, 9?' ?.
ROUGH
HEATING
GAS SVC
TE5T
INSUL Q•IS•?B ? ? ? ? ,
GYPBOARD .
FIREPLACE
rc Z ?
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLU5H
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
'
BSMT R.I.
BSMT FINAL
DECK FfG
[DECK FINAL
7
?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 08
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
.. r.S .
SITE ADDRESS: APPUCANT:
:, I „ E i,i :, 1 0 14 !!r?; .
Vli11 FY 1.:'1; 41 t'I ?'i1f Alf r I ?>1,'1 4 i.' If
PERMIT SUBTYPE: TYPE OF WORK: ?
, , ; , . r? t t•? .
I ;! ,,,l ,• !.l i NUCI{J/PA i' I O cInOR
FOni iNib', I I I f rrlnl
Permit No. Permit Molder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOl1NGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
- - - '
--
-
QECK FTG / I
DEC!: ? I': ',L i
.8?L?4lo ?i '
l?f?
?
PERMIT N0.
' WORK ORDER
r
ZUea?eP ;vBum&wq 8c q"tiwg. #70rc,
1955 SNAWNEE ROAD 9 Si. PAUI, MINN. 55111
Uate of Work Order Htg. _ Rough-in _
i
Customer's Name Plbg. _ Finish -
. i
Address A- ' e? Repair _
City ? Water _
MATERIALS-
??NV
d 14,/ ;?s9?
?
WORKMAN'S SIGNATURE DATE MOURS OF WOPK
CUSTOMER'S SIGNATt1flE
EAGAN °TOiIVN S H I P
BUILDING PERMIT
Ownex ...... ... ?
?.------------ _..-..
.-/..?.--?--?--'--
Address (Preseni) ......_.`?.rf_..?"..l
, U ._--------..
Builder ._.........-
_.._... - -?? ? .......... ...
Addsess '------'----"------'------'---.....---"-'-'------------'_.'--'-'-°----------
DESCAIPTION
N° 1400
Eagan Township
Town Hall
Date _. . z?... -?S ?-.....b k ....................
-
5fories To Be Used For Fronf Depih Heighi Es1. Cosf Permii Fee Remaxks
LOCATION
Sireef, Aoad os oihex Descriaiion of Locafion I Lo! I 81ock I Addifion or Tzacf
0, v l / •
This permit does not avihorize the use of sfreels, roads, alleps or sidewalks nor does it give the ownar or bis ageni
the rightio create enp siluafion which is a nuisanee or which presenfs a haaard to the health, safety, convenience and
general welfare !o enpone in the communify. ?
THIS PEAMIT MUST BE PT ONT'H?E ?PREMISE WHILE THE WORK IS IN PROGAESS.
Thfs is !o cerlify. Yhal. '_.."_._. ..._.-------------------------- has permission fo ereet a...'•. " ?...upon
the above described premise su jec! 3o the provisions of the Building Ordinance for a?g ?Tow ahAf ip adopfed April ll,
1955. ? ?
..'•---'°-'---'-.•'------°--- " ...............__v.............................. Per . . 4. ---.?.--'-'-"'-"--"...-"_'......_.
hairman of Tnwn Boazd Building Inspeclor
????? ???? ? ? ? ?
oWna:
Address (presen!)
Suilder
Address ..............----.......-°•'---......
Nc 12'7
Eagan Township
Town Hall
Dale,e? V " ---f,?-..???--...
5fories To Se Used For I Fron1 Deplh Heighi Esf. CosS Permi! Fee Remarks
? ,???? I ? ?? ?' rf?DD ? ,?/-?
or
BUILDIii4G PERP?9IT
LOCATION
d? I ?
or
This perm does noi auffiariKe ihe use of sfreeis, xaads, alleps or sidewelks nor does i! qi?/e She owner or his agenl
!he righ!!o reafe anp siluafion whieh is a nuisance or which presents a hasard !o fhe healih, safefy, convenienae and
general welfare fo anyone in !he communify.
THIS PERMIT MUST 8 ??rp? ON PREMISE WIiILE THE WORK IS IN PROGRE?jg?7
This is fo cerlifY. =ha 1???'?s?L?.??L.?.--------.-------has permission !o erec! a.......'<C?`. -- -' --- -----.....---'--------"_upon
!he above dtscribe ;emise sub'ecf ihe provisions of ihe Building Ordinanee for Eagan Tow ip adopled April 11,
1955. ' ? ,
_"'-.......---......-- -?.------ ?.. . .. .----.. Per ............---...-------'------ ................g....-`p-"----.............--.......
Chairman of own???y? Buildin Ins ecios
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Pleasc complete for: single Family dwellings & townhomes/condos when permits aze required for each unit
3D _F9
Date ? / 3 ? / ??l J??
Site Address (3 aJ I f--E) q h Unit #
PropertyOwner
Telephone#(bi Q
US/9
Contractor (J /
Street Address r?(? s City
State Zip ?5S ?p0 Telephone# ( ?2j)
Bond Expires:
The Applicant is _ Owner Contractor _ Other
Add-on ar alteration to existing dwelling uoit $ 30.00
furnace _Additional _Replacement
air exchanger
?? air conditioner
_New q:ze-placement
other
State Surcharge $ .50
Total $ ?? v
[ hereby apply for a Residential Mechanical Permit and acknowledge th
be 'n conformance with the ordinance s and codes of the City of Eagan
permi . but only an application for a permit, and work is not to start
d
ap r ed plan in the cf rk hich rb?es? a review and approval
ApplicanYs Printed Name
the i formation is complete and accurate; that the work wil]
i the Mechanical Codes; that 1 understand this is not a
?o?i t a permit; that theywork will A in accprdanFe with the
Applicant's Signature
f i ftl1
f?i JUL ]: 4 ?pO5 ?
?
'Y-- -- - '
_ _-- -?
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Ptease complete for. commercial/industrial buildings
multi•family buildings when separa[e permits are no[ rcquired for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Cootractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature ofWork:
**When insialling/removing underground tank, ca!l for inspectlon by Fire Marshal and Plumbing Inspector
Permit Fees: $70.50 Underground tank installation/mmoval
S50.50 Minimum (includes State Surcharge)
or
Conhact Value $ x 1% _ $ Peanit Fee
• If ep rmit fee is $1,000 or less, add $50 => $ State Surcharge
If ermit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and acwrate; 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 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.
Applicant's Printed Name
ApplicanYs Signature
Approved By: , Inspector
` C17Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-11897
(612) 681-4675
PERMIT
PERMITTYPE: guzLorNG
Permit Number: 0 2 8 0 2 8
Date Issued: 0 6/ 2 5/ 9 6
SITE ADDRESS:
P.I.N.: 10-81400-030-02
DESCRIPTION:
2861 HI6HRIDGE TER
LOT: 3 BLOCK: 2
VALLEY VIEW PLATEAU
& WINDOW/PATIq DOOR
4uiYdiitq Permit Type DECK
BuzldingWork Type NEW
Census Code';? 434 ALT.
,_..
?
j
RESIDENTTAL
REMARKS:
FEE SUMMARY:
Base Fee $45.00
Surcharge $.50
Total Fee $45.50
CONTRACTOR:
ARLING7pN HOMES
14551 COUNTY
BURNSVILLE
(612) 432-9725
- Applicant - 37. LI
14329725 000320
ROAO 11
MN 55337
OWNER:
PARKER JERRY
2861 HIGHRIDGE TER
EAGAN MN
(612)454-1947
i
I hereby acknowSedge that I have read?'this
information is-correct and agree to comply
Statutes and City nf Eagan Orclinances`.
L
APPLICA /PERMITEE SIGNATURE
applicati.on avrid state ttrat the
with all applicable State ofi Mn,
?
qs-suEbv? siG DT /? I ?,?-
CITY OF EAGAN
3830 PILaT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 regislered site surveys
? 2 copies of plans (include beam & window sizes; poured ind. design; etc.)
? 1 energy calculattons
? 3 topies of tree preservatio plan if lot plaNed aRer 711/93
requlred: Yes No
/
Remodel/Reoa(r Reauirements
? 2 copies o( plan
? 2 site surveys (exterior additions 6 decks)
? 1 energy calculations for heated edditions
P'-7,11 O?
DATE: i- / 9 ? . CONSTRUCTION COST:
DESCRIPTION OF WORK:?
i u
14-
qs - S'a
lo?
STREET ADDRESS:
LOT ? BLOCK
C3l-
?
SUBD.lP.I.D. #:
?° 9 7
PROPERTY Name: ?T Phone #:
OWNER ' usT
Street Ad dress:
City: ?--?- State: 14-y-I Zip:
?
?
coNTRncTOR Company: Phone # :
-
Street Address: ?Fl/ License #: 3 z ? ?
? ?e
City:
ti State:
? Zip:
ARCHITECT! Company: Phone #:
ENGINEER
Name: Registrati on #,
? Street Address-
City: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is Issued.
Penalty applies when address change and lat
I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with ag
applicable State of Minnesota Statutes and City of Eagan Ordinances. b``
Signature of Applicant: ,-Yo
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dweliing o 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ?15 Deck
WORK TYPE
?31 New ? 33 Alterations ? 36 Move
o. 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MClWS System
(Allowa6le) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 3Y
Depth Footprint sq. ft. SAC Code a/
Census Bidg ?
Census Unit °
APPROVALS
Planning
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S1W Surcharge
Treatment PI.
Road Unit
Park Ded.
Treiis Ded.
Other
Copies
Totai:
Valuation: $
% SAC
SAC Units
w ,
o (?
..
?
_ d#b
0
? w
1
`? .
?
_.L.?•'
w
-
,
,
1?2,5 13 2.5' 13Z.5' ?
--Buildin9 yttback l-irte-
04
Ufiilit
.
Id EvJ
/a x/6
po).o 4, 6Y='? ?
I
1tl
?
Ea s ? cn ent ? -
N
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- -4 32.5' - --
`
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00
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op
30-
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MiX:K:"t;'.1:;'tNYFnC??fiW::<i(?kmYF:'?::?:x;"?M;?>(•.F°;4?y:'R?Yf Y:3;: ??nY,C)?:?1(
CITY O;= F::AE_AN
("A.`:ifH:i:er:, :3 ri.r;MsNai._ "!ou 783
DFl'TEa 1.:1./05i98 rIMr:::; 0:45W
zc,-
r!nMr::,! r,:o!..iraN i...! NTH :tNr::
3210 9O?.?:!. 286i H:[L;I-IR:f..i.?rF 224 „i`:i
3422 9001 2f;6:. I-ISG,ifiTD(:;[= iA6,09
;i'.:I.[Sr; 9001 2E361 FI:f.G4•IIC:I:nGLi 7„50
3430 9001 2861 11:[f:;:?R:i.C!i);E 0,.50
T{]I.:a'I. i?r.,i:'ei.pF, Afid]tan'F,:; 370,8q.
CF't:1399.:'3
USF.::fi :I:Ba NF:i*!CV
" CITY OF EAGAN
3830 Pilot Knob Road
Eagan,-Minnesota 55122-1897
?651) 681-4675
SITE ADDRESS:
P.T.N.: 10-81400-030--02
DESCRIPTION:
zNr.LuoES hzrcw kertoo
Building',Permit Type SF ADDTTION
BUilding Wbrk Type NEW
Census Code ? 434 ALT. RESTDENTIAL
?
1.
??? = C r
?
J
i ,..? _. ,. . . . . . .s ... ..
.. . - /: ?.._.
REMARKS:
PLAN REVTEWED BY BTL1 ADAMS.
SEPARATE PERMIT FtEQUIRED FOR ANY PLUMBING WORK.
CALL 445-2_8_40 RkGARD7NG ELF.CTRSCAL PERMTT ANO INSPECTIONS.
FEE SUMMARY:
VALUN7ION $15,000
Base Fee $224.75 Cf7PIF5 .50
.?.?----
P.Lan Rev.iew $146.09 Total Fee $378.84
Surcharge _ _ _t7.50
Subtotal $378.34
CONTRACTOR: - appl.icant - sr. Lzc. OWNER:
STONEWOCID DEVEL(JPMENT 1.8376267 20077437 PflRKER JERRY
4901 WEST 77Th1 STREET 2861 HIGHftIUGE T[R
C,DINA MN 55435 EAGAN i"IN 55123
(612) 837-6267 (551)688-91.91
I hereby acknowledge that I have read this applicatian and state that the
infinrmation is carrect and eqrea to comply with all appli.cable State of Mn.
StatuCes and City o'P Eagan Ordi.nanr,es.
?
" I?t?J / ?
APPLI NT/PER ITEE SIGNATURE I ED BV: SIGNATU
PERMIT
PERMITTYPE: Bu,r.LozNG
PermitNumber: 033931
Date Issued: 11 / 0 5 19 S
2861 HIGMr2ID6E 'TER
LOT: 3 BLOCK: 2
VALLFY VIEW PLA7FAU
J
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
` ' - CI1'Y OF EAGAN
3830 PII.OT KNOB RD - 55122
r?
-36) 3 esi-4e75
New ConstruGion Reauirements I RemodeVReoair Reauirements
? 3 registered sde surveys
• 2 covtes of plans (inGude beam 8 window sizes; poured fid. design; etc.)
? 7 energy wleulations
? 3 copies of tree preservation plan 'rf lot platted after 711193
required: Yes No
DATE: `? ?
? 2 wpies of plan
? 2 sita suneys (aMerior addkions 8 decks)
? 1 eneigy calwiations for heated additiona
CONSTRUCTION COST; ?56 l D° 0 ?
DESCRIPTION OF WORK:
STREET ADDRESS:,-,???6 ! ?5 t.
LOT: -' BLOCK: SUBD./P.I.D. #: ?
Name: 'LE? C R-?? Phone #:
PROPERTY Lazt .h First
OWNER
StreetAddress:
Ciry State: Zip:
Company:??/l ??vd ,(IE?JC(6pM??'l ? 3'hone #:
CONTRACTOR 3/,? ? q`?
Street Address: 7 7?-? d't License # p?L 0 L 7??J' 7
City / i1f.4 State: /rIAt' Zip:
ARCHITECT/
ENGINEER Company: Phone N:
Name: Registration #:
Street Address:
City State: Zip:
Sewer 8 water licensed plumber (new construction ony):
and lot change is requested once permit is issued.
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the iniortnation is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVFiD
Certificates of Survey Received Yes _ No
Tree Preservation Plan Received _ Yes _ No
_ Not Required $Y:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation 0 06 Duplex
D 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
?31 New ? 33 Afterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
0 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 -9-z- Engineering
Variance
Permit Fee "?j
Surcharge
Plan Review Oq
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies .50
rocai: 3-1g•?s`f
Valuation: $ 4.?Ood
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump 7
Census Code.
SAC Code
Census Bldg
Census Unit
• .,,
. , .?
% sa,c
SAC Units
,
B
L,
s q
1; Xf`?1?d4
LL,
30,
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tv ---
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t
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5,jfib4cjG L?ne
04
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ra 7p V9 '
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CITY USE ONLY p
L ? BL ? RECEIPT#: ?OOlp6b
SUBD7 RECEIPTDATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, tMI 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Shower 3.00 x =
Water Closet 3.00 x _
Bath Tub 3.00 x _
Lavatory 3.00 x
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum - i 3.00 x =
Rough Openings 1.50 x =
Water Softener " for dwellings under construdion 5.00 X =
Water Softener ' for existing dwelling 20.00 x =
U.G. Spfinklef ' for dwelling under const. 3.00 =
U.G.Spfinklef `tarexistingdwelling 20.00 = _? a
Altefatlon5 ` to existing residence 20.00
Water Turn Around 20.00 =
Private Disposal System " MPC iic. 75.00 =
(new and refurbished systems)
Private DiSposal System5'Abandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE .500
TOTAL
---- --- -- --- ---------- --- ------------------ --------------------- ---------------------------------- --- -------------- -- --- •- ----- ---------
I hereby acknawledge that I have read this appliwtion, sGte that the informaGon is cortect, and agree M compty with all applicable City of Eagan ordinances.
It is the applicanYs responsibility to notity the property owner that the City of Eagan assumes no liability for any damages wused by the City during its
nortnal operational and maintenance ac[ivkies to the facilRies wnstructed under this permk within City properly/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: IJ-e_ft L? £d„(/ 01-640,60t TELEPHONE #: LI?_/ -?7 V y
?
STREET ADDRESS: ? 6igC €.OSJ- 2 Q O_4 ?
CITY: ll.Gp s*.t i STATE: .ll/A44f ZI P: ? Q
PERMITTEE
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1998
EAGtiN TOIdNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEF7ER SERVICE CONNECTION
DATE• ]v?v 15. 1969
OWNER•_ Gary Ravlin
PLUMBERWenzel Plumbing & Heating
IVIIMBER 399
Address2861 Highridge Terrace 3-pZ J V,T",
TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industrialj Commerciall Residential I Multiple Dwelling I No, of units
%
Location of Connections:
Connection Charge 200.00 pd
Account Deposit
Permit Fee 7•50 Pd•
Street Repairs
Total
Inspected by:
Date
Remarks•
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tot7nship, Dalcota County, Minnesota
By
enze g ea g o,
1 Q55 Shaum oa 17nisr al,?'}_ Pa iil 55111
Please notify when ready for inspection and connection and before any poxtion
of the work is covered.
RESIDENTIAL SUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
C? '?((?(43
New ConstruIXbn Reauirements RemodellReoair Reauirements Office Use Onlv
3 regisiered site surveys shmving sq. ft. of lot, sq. ft. oi house; and all roofed areas 2 copies of plan Ced of Survey Recd
(20% maximum lot coverage allovrey) 1 set of Energy Calcula6ons for heated addPoons Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured fouM desigq etc. 1 site survey for additions & decks Tree Pres Not Reqd
i set of Energy Calculations Addmon - indicete Hon-sife sepfk sysfem _ On-site Septlc System
3 copies of Tree Preservation Plan if IM platted after 7/1193
Rim Joist Detail OpUons selec6on sheet (bldgs with 3 or less uniLs
Date ( / _23L Cons[ruction Cost .5CC
Site Address i
UniUSte #
Description of Work H00_"15 JQDDITI('J/d ?
X/L'+ ?(?CA-
Multi-Family Bldg _ YX N Fireplace(s) _ 0 'i? 1 _ 2
Property Owner /hf FCE A.tv'SG^) Telephone #( 651) 14S9 •8319
Contractor LERN'/ C&VSTk.LC77da
Address .56( AnJp fFv`E SOtITH City 54. ST A911L
State r}91Nn1 Zip ,5667$ Telephone #( Co${) 306• 97Y6
G &51 ZW-9_-dz1
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category
(V submission type)
Licensed Plumber
Mechanical Contractor
Sewer/Woter Contractor
- Minnesota Rules 7670 Cateeorv I _
. Residential Ventilation Category 1 Worksheet
Submitted
. Energy Envelope Calculafions Submitted
il.?ls"` ??VII
? ;? . . Telph
e?
..;„.__. ???
J i
,BY ---
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
#(
#(
#(
I hereby apply for a Residential Building Pernut 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; T derstand is is not a permit, but only an application for a permit, and work is not to start without a
permit; tt?at e worw' 1 be in accordance with the approved plan in the case of work which requires a review azid
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF ?welling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 ot_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gaze6o)
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 0 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 tdew
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation ? ?G ?'
Census Code ?.?? ?1
? SAC Units -
Nbr. of Units -"
Nbr. of Bldgs ?'
Type of Const _ ? ?L
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
O 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Vni Improvement D 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair '
? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors
'Demolition (Entire BIdB) - Give PCA handout to applicant
Occupancy / -3 MC/ESSystem -
2oning / - ! City Water ?
Stories ?. Booster Pump -
Sq. Ft. 3 ?`?' PRV
Length /? FireSprinklered ?
Width ? ?
_ Footings (new bldg)
Footings(deck)
? Footings(addition)
? Foundation
1? Drain Tile
Roof ? Ice & Water ? Final
,? Framing
? Fireplace ?- RI. ?'Air Test ? Final
? Insularion
REQUIRED INSPECTIONS
_ FinaUC.O.
? Fival/No C.O.
Plumbing
,? H VAC
Other
_ Paol _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
Gity SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
----------
/.?" ?'.c?i, 3&?lC?
Building Inspector
?? ?
?<'°"? ?3 s?r 3?`?'? ? l3 a
? ?iLw,?? i? /NG?ni? b?G..
?.c? v
?D ? ??
% ?Go
?-C?+a ?
3?33C ?
.??
. .?a
Jub Si[c Addrcss:
"CATEGORY 1" ALTERNATE FOR
ONE & TWO FAMILY DWELLINGS
41 city
oF eaqc
INSTRC'C"TIONS: This 3Iternarive may be used for ona and two-family dwellings buiit ro maet the Gtegory I requiremenct of
>linnesoca Rules. Chaprer 7670. Compleee Parts A, B. and C. Clesrlv mark plans wi[h: insulatiun R-values; «'indow and skylight [J_
valuas; size and rype ot aquioment aquipment convals; and location oF vapor retarder and wind«'ash barriea. More detailed
inCurtnadon tan oe tound in [ht .Llinnuota Enelqy Codr summary shaets availablt :rom the Nlinnesota Depaiv:ten[ of Commerce.
Part A. BUILDING ENVELOPE _ _ _
Check pmposed rnvelopejoint sealing opdoe 4? Preseap6ve (eaulldng, gsskers, eec.) .. ? Pa:tomwnce (:esc per 7670.0470 wbp. 7.CJ
Check rhermal rnergy caiailadon apHon used 4 , "Caokbaok" (eampte» woekshac befow) O N[nCheck mc;t:od (utuh roport)
. O$` Perforsnance (auazh f1-value dculations) ? Sysmmt Analysis medwd (azraeh analysis)
"=Cookbook's Worksheet
LNs-.-accnous -
S:ep L Check item(s) ;hat desip mtes on Sfirtimum Requirementr lis[
[o ;he ighc Miuc mr_: all icrms :o iue "Cookbook" oprioa
Sc:p =. Indica:e preposed wall tipe an rablr 6e:ow.
S::p i. Lldica;a R'ir.Cow C-calce arid soarc:.
S.ep 4. Ver.^: :oui winCow i inc!uding area oi .ilI `ouadation windows)
and deor area is eqi:al or !ess [han allowabie percentage.
Maximcm Allowabk ToW Window and Door.3icea az
a?:rceao¢eofE.mouCw'aIl
I?%
11°/a
16%
18%
20%
"%
24°/a
26% -
28%
Witl T? a(Scv:dard Fnmin¢): MaCimwa averaae Window U-vatn: (e:cc:ot foundation wiedows):
Z) '_Cl. R-13 ir.>ulation, R•- ;heathin 0.55 0.47 0.41 0.36 0.33 0.30 0.1-7 025 0.23
7 2s1, R-!5 iasclanen. R-: shea[hin 0.52 0.45 039 0.35 1 0.31 1 0?3 0.26 014 022
2z6.Ra9_insulanon, <R-i >head5in 0.48 0.41 0.36 I 0.32 ?9 I 0.?6 01i O.L' 0.21
] Zx6. R-l9 insulaaoa R-i sheachin 0.56 0.48 0.13 0.37 031 031 0.28 0?6 024
J ?z.R-?Iinsulatioa<R•isheatbin 0.51 0.47 0.35 03-1 0.30 0.38 015 0.23 0.22
? 2x5, R-21 'vuulauoa R•5 shnthin 0.58 0.50 0.34 0.39 0.35 032 0.29 027 0.25 -
Wail T Advanced Fraafin¢ : Maximt? Aver"c Window U-value exe t foundatiou windows):
O W. R-19 insularioa <R-5 sAeathin 0.32 0.43 039 OJS 031 038 0.26 024 022
? 2x6, R-19 insulauoa R-S shathio 0.38 0.50 0.4t 0.39 0.35 0.72 0Z9 017 073 :
? 2z6. R-21 insularion, <R-S sheathin 0.55 0.47 0.41 0.36 0.33 030 0.27 015 0.23 .
0 2r6, R•2l iasuladon, R•5 sheathia 0.60 0J2 0.46 0.41 0.76 0.13 030 028 026 '
Window Cf_value .w ) Snutee: O YFR C 0 ASF?tAE I993 Haidbook EO NfIYL?1L1f REQUIItEJfEYi'S
(for "Cookbook" o don Ool ) Insuluion: S[inimum R•33 wi[h 7h" energy heei; ar
m Ra-i wiLh low r.us heel; or
m R-i9 with R•_ sheaehin¢ •?heo no a¢ic.
oors: Mar. Li-value ot 0.:0 oc t':" soGd wood wich stoim
Rim 7ois: [nsulacion: NGnimum R-I9 Zi Floors ovcr mcondicior.ed soar.s: Nfini.acr R-21 Vry
&, Fou:daoon [nscla;icn: >Gnimum R•10
Fa:nCaaon winCows: insula[eG ¢!ass. wood or vinvt tnme
T.ABLE FOR DETERNfI\EiG M1LkX1[ti.Nt WINDOW A.YD DOOR AREA
I-E=Mt=s?
100X?_?= <! •J7%
window & door uea pss aposed wall uci DESIGN /?r ALLOWABLE (Cram rable a6ave)
M/NNESOTA ENERGY CODF - WHICH RULES MAY I USE ?
TYPE OF RESIDE.Y17.aL BUILDING APPLICABLE RULES
Detaehed R-3 oceupaory 1• and 2-f2mlly dwelllnef C}upra 7672; ar ..
Eaun les: sin le funil , nvin homes, du lexa ChiM 7670 "Cate o t" +'ith sp[uW de «ssurizirion 3nd ventilauan requirements
Attaehed R•] xeupancy dwel6n;s Chapttt 7674; or
Esam ia: Qi lex rownhouus and row houus Chapter 7670 with eirher "Cate¢arv I" or "Catc orv ?" rovisions
R•1 xeapaaer bulidloQf of Jstorid or Inf CNaptn 7670; or .
Examples: tondominiums ot uanenn Chapter 7670 with either "Ca[e orv l" or "Cate o 2" rovisions
R-1 xeopaocy buildlnp over 3storla dlQ6 Chapmr 7676 .
E<yn la: hi rix condos or a enn ?.d
. --1 •--- • I • - • - --I
fl E5?-3?-9h
?,_--•--- ,,..._7/n 3 ?_,__ 15! ?93Z
Num 1
Summary of April 15, 2000 Cnergy Code 12cquircmcnts for Dctaclied 1&2 Iiamily Rcsidcntial 1311ildings
I i-uae reqwremem I Upuoa a- cnapier 76711 category I as amended by Laws of MN 2000 Ch. 407 1 Oplion li - Minnesota Rules Ch•rpler 7672
1. eterials
ment
Plans and
s
ecifications s and specificaliona must show design crileria, rxierior envelope
i
i
l
U Same excepl with adJitional required items: location ul' intrrior air baaier
p
7
ponen
maler
a
s.
-values of the envelope systenu, It-vahtes of insulaling
etials
size and rype of apparalus and e
ui
ment
and e
ui
t
d ,
vapor relarder, and wind w•rsh barrier, idenlilicatiou o(air sraling requireJ;
,
q
p
,
q
pmen
an U-values of windows, doors and skylig6ts and oiher inCormation needcd to
systents
conhols. detemiine com liance (such as re uircd vrniilaiion s sirm & makau air).
2. Foundation wa ll
Insulalion Cookbook requircs R-10. Trade off pennitted with MNcheck. Cookbook has options fur R-5, R-I0, or R-19. TiaJt•off pemiitled with
MNcheck but not less ihan R-5
Pra[ection of
Exlerior iiisulation from rop of foundalion wall to 6" beluw graJe must be .
Same.
exterior insulation rotected a ainst UV and h sical abuse.
Protection of inlerior Moisture bartier rcquired behvern insutetion and foimdaliai wall liom Iloor to Same
insulalion
rade. .
3. m/band oist s
R-value Cookbook o tion re uires R-19. Tnde o(f emiiued with MNcheck.
' Cookbook o tion re uires It-10. Trade off emiitted widi MN
h
k
Va r rctarder
Re uired on rim
oists susce tible to condensntion from moismro diffiision c
ec
.
Warm side va or raarder re uired
Interior air baaier
Rim 'oist r uired lo be sealed to revent sir leaka e. .
Same
Exterior wind wash
Not addressed. .
Exterior wind wasli barrier required
bartier .
4. ramin
General Framing options indude 2 x 4 or 2 x 6 walls, and otlier framing options such Same.
as lo walls analized walls insulated masonr walls and others.
Attic ceilin ftamiji
Wall traming: Not addressed. Nole: wind wash roleclion reuired al auic ed ge.
Eaterior wall corners and intersections of intcrior partiiiun walls wiili Minimum 6" heel lruss from uutside ed e of lo i late to rouf sheathiu .
&
i
Exterior and interior
extorior walls are not addressed. Exteriorjoints in ihe 6uilding Illut may Ue xter
or wall comers and imersectiuns of interior paniiion walls wiih
extcriar walls are fremed so Ihat insulation can be installed afler the
sourcu of air leakage must be sealed. exterior sheething is inslallad. W6enever inleriur framing mecls an
insulaud ceiling or exterior wull, a conlinuous interior air barrier must 6e
installed.
Vaulled ceiling Cookbook option requires R-38 between Gaming plus It-5 sheathing. Cwkbook option requires R-38 betwttn Gaming, no insulaced shcathing
re uired.
Anic access panels Not eddrnssed. K-38 for ceiling panels and R-19 for wall panels, and must be weather-
stri d.
Floon over Recommend R-30. Mnximum U-0.033 or minimum R-30 specified (uaJa-off may not be less
unheated s ces strin ent that these valuea .
Window thertnal Rating must be Netionel Fenestration Raling Comtcil (NfRC) or AStIRAIi 2ating must be NFRC or defaull table in ihe code. Windows must be
rfomunce Hendbook of Fundemenlals. No meximum U-value. labeled. Meximum avera e U-value for windows is 037.
Pagt 1 Of 4-- SoUrce of Summary: Mimlesola Department of Conmierce Energy Information Ccnter 65 1-29G-5175 or 800-657-3710, www.commercasmle.mn.us.
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KRECH, O'BRIEN, MUELLER 8c WASS, INC.
6115 Cahill A v e n u e ¦ Inver Grove Heights ¦ M i n n e s o t a 55076
651.451 4605- ¦ fax 651 451.0917 ¦ komwQkomw.com • wwiv.komov.cam
10/29/2003
Roy Cerny
Cemy Construction
501 2"d Avenue South
Soudi St. Paul, MN 55076
Re: Mike and Toni Hanson Residence
Dear Mr. Cerny,
At your request, this office has structurally reviewed the ridge beam for the addition Yo the above
residence. In order to obtain a I,/360 deflection criteria you would need to add 2-1/3/4 x 71/4 LVL's
beneath the existing 12" LVL's. Provide a beam hanger each end and a 2x4 cleat at each rafter or metal
connection plates at 24" o.c. to keep the 71/4 LVL's aligned beneath the 12" LVL's.
The information and opinions contained herein are based upon the limited investigation described at the
beginning of this report. No warranties are expressed or impiied regazding the existence of other
unknown conditions not specifically addressed. Our work is in accordance with generally accepted
engineering standards and is not intended to be relied upon or transferred to individuals other than the
addressee. Should information or conditions become known which differ from the discussion herein,
they may alter the opinions ar conclusions of the undersigned.
If you should have any questions or require further information, please call.
Sincerely:
James H. Krech, P.E.
Krech, O'Brien, Mueller & Wass, Inc.
Enc.
Architecture • Structural Engineering • Interior' D.esign
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits aze required for each unit
($.S-0 _ 5?)
Date 1? / I5 / U-3
Site Address a<K 14 ?h r• )? r ? t?r?t e Unit #
Property Owner Telephone #
Contractor L`?-T'?TH
Address City
State Zip Telephone # ( )
The Applicaot is 4zowner _ Contractor _ Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alter [i ns To Existing Dwelling Unit, Including
? $ 50.00
Adding fixtures to lower levels or room additions, excluding water softener and waler heater
_ Abandonment of septic system
Water turnaround (+ 5/8" meter if needed -$12
1.
00)
1
`
? Other. ?i) fl.?,rcv m t3 C',d?
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
? . \ I S I
1
_ Water sof[eoer _ Water heater Sr'? ? J ':uu^
$ 15
00
i .
i? --I
_ replacement _ addiiional
State Surcharge $ 50
Total $ - ?'Lo s?
I hereby apply for a Residential Plumbing 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 with the Plumbing Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a permit;h work ill be in accordance with the
approved plan in the case of work which requires a review and approval tans.
1/? ? ??2? ?T?nSr?
Applicant's Printed Name pli e
2006 RESIDENTIAL MECHANICAL rExMiT arrLicaTioN $ 30, 60
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. singie family dwellings & townhomes/condos when permits are required for each unit
JaeL
?51 ?39?
Date
Wu?,?,'?e,sr
Site Address ZolQ7 (q Unit #
'? N SS/?-I
` \\ c
Property Owner fY\ ? C?c?3 1 ?ci?V'? S d"hone #( 2J l) (0(00 ?(04-S
Contractor
Street Address 114 r?+~ S-4- vV City
State Zip Telephone# (Uc rj/ ) 32.z-a9Z.F`i
Bond Expires:
The Applicant is _ Owner ? Con[ractor _ Other
Add-on or aiteration ro existing dwelling unit $ 30.00
l
t
? f
Additi
l
R New
acemen
urnace _
ona
_
ep _
air exchanger
air conditioner
heat pump
other
State Surcharge $ 50
T
t
l $ 3a•sd
o
a
I hereby apply for a Residential Mechanical Permit and acknowledge that the informa[ion is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; 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.
1 T?n- Lsc_ M. A-e_S'\ C' S , L? Or?
Applicant's Printed Name App icant's Signature
2006 COMMERCIAL MECHANICAL rExMiT arrLicaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comptete for, commercia]/indus[rial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date
Site Street Address " Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove *`see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When insta!ling/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
P¢I'mlf F¢es: $70.50 Underground tank installatioNremoval
$50.50 Minimum (includes State Surcharge)
or
ContractValue $ x 1% _ $ PermitFee
$ State Surcharge
If pe rmit fee is less than $1,000, add $.50
If eo rmit fee is more than $1,000, surcharge
is $.50 for every $1,000 owed.
$ Total Fee
I hereby apply for a Commercial Mechanica] Permit and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanicat Codes; 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.
ApplicanYs Printed Name ApplicanPs Signamre
Approved By: , Inspector Da[e:
Required Inspections: - U.G. _ R.I. - Air Test - Gas Service Test - Infloor Heat - Fina]
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2861 Highridge Ter
Lot: 3 Block: 2 Addition: Valley View Plateau
PID:10- 81400 - 030 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Michael W Hanson
2861 Highridge Ter
Eagan MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA090933
08/31/2009
ePermit
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122241
Date Issued:05/01/2014
Permit Category:ePermit
Site Address: 2861 Highridge Ter
Lot:3 Block: 2 Addition: Valley View Plateau
PID:10-81400-02-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michael W Hanson
2861 Highridge Ter
Eagan MN 55121
(763) 843-3907
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JUN U 2 1016
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: �� 1 b ' i yyy
(�(� Site .A+dd�ress'. % �, �, ^ ,� I �a�,�� /� 11► �� ,��
Tenant: Svc_ 11 &)A �l. !i'ex Vj
Name: L 1\k\-(
\\-(
Address / City / Zip:
Phone:
Suite #:
Name: Hilbert Company Inc dba Culligan Water-Licen a 14 C6413 76
#:
Address: 1..01 50th St East
Stater Mn Zip: 55077 Phone: 651-451-2241
Contact: William R Milbert
City: Inver Grove Hgts..
Email:
_ New Replacement _ Repair _ Rebuild _ Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
__Abandonment
RESIDENTIAL FEES:
XWater Softener
Add Plumbing Fixttrlres ( Main / Lower Level)
Water Tumaround
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Tumaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and 55.00 State Surcharge) / J�
TOTAL FEES $ t00 , D O
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.aopherstateonecall.orq
1 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 th work will be in
accordance with the approved plan in, the case of work which requires a review and apprcaval of plans.
t/Vt
Applicant's Printed Narhe
ri 474-
6
Applicant's Signature
DEPARTMENT
OF H EA.i a Er
Protecting, Maintaining and Improving the Health of All Minnesotans
August 1, 2018
City of Eagan
Attention: Planning and Zoning
3830 Pilot Knob Rd
Eagan, MN 55122-1810
City of Eagan:
AUG 0 6 2018
The Minnesota Department of Health in consultation with the League of Minnesota Cities and the
Minnesota Association of Townships, has agreed to notify local government officials when a
Housing with Services Establishment subject to Minnesota Statutes 144D has been registered by the
Minnesota Department of Health. This notice is to inform you that the establishment listed below
has been registered at an address located in your community.
SERENDIPITOUS LIVING
2861 HIGHRIDGE TERRACE
EAGAN, MN 55121
Phone # (651)340-8950
This notice does not require any action by your local unit of government, nor does it create a right
of the local unit to intervene in the registration process of the establishment. It is being provided as
a courtesy only. Because the above named establishment may provide services to residents who
would need special assistance in the event of an emergency, you may wish to notify the emergency
service providers for your city or town that this establishment is now located in your community.
A list of currently registered Housing with Services Establishments may be accessed on the
Minnesota Department of Health website, through the following link:
http://www.health.state.m n.us/divs/fpc/di rectory/providerselect.cfm
Additional information about Housing with Services registration may be accessed through the
following link:
http://www.health.state.mn.us/divs/fpc/profinfo/Iic/lichws.htm
If you have any questions about this notice, please contact (651)201-4101. Other questions should
be directed to your local government association or legal advisor. Thank you for your attention to
this matter.
Sincerely,
Shellae Dietrich
Supervisor, Program Assurance Unit
An equal opportunity employer.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170750
Date Issued:07/15/2021
Permit Category:ePermit
Site Address: 2861 Highridge Ter
Lot:3 Block: 2 Addition: Valley View Plateau
PID:10-81400-02-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Michael W & Toni R Hanson
2861 Highridge Terr
Saint Paul MN 55121--110
All Metro Construction Services Inc
PO Box 490579
Blaine MN 55449
(763) 789-4788
Applicant/Permitee: Signature Issued By: Signature