1571 Four Oaks Rd73''?
2006 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauirements
3 registered site surveys showing sq tt of l06 sq. ft. of house; and ali roofed areas
(20% maximum lot coverege allowed)
2 oopies of plan showing beam 8 windax sizes; poured found design, efc.
1 set of Enefgy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Minnegasco mechaniplvenlila[ionfortn
RemodeUReoair Reauirements
2 copies of plan stwwing fooUngs, beams, jomts
1 sel of Energy Calculabons for heated additions
1 site survey for addilions & decks
AddRion - ind'icafe'rfar-site septic system
?as
OHice Use OnN
CeRofSurveyRecd - " =_- _Y _N
TreePresPlanRecd " _Y-_N.
TreaP2sRequired - -- _Y =N
OnslteSepticSystem ' _Y_N
Date Construction Cost 10 C--)
5iteAaaress 3/S--3 31 j573 /s-7/ /'a.,_ 67c%r :? .....-f Unit/Ste }i
Description of Work GCoc4., - l?•?.- vLf C? f ?""??e'-- ??' ?o ci e
Multi-Family Bldg N Fireplace(s) _ 0 _ 1 _ 2?-`'?
Property Owner Telephone # ( )
Contractor ` ?='? ? /?ao i? : ? ?5 <- •
Address / 3
J` ??-?c - 5 ?.
?!v? "?/
CitY `
State Zip `$" o Telephone #( 7t3) 7??-OO ? C?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculalions Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, dafe and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Teiephone #(
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 ofplans.
? ApplicanYs Printed Name
ApplicanYs Signature
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address: —_
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: _ • 2)-. 'Z Insp.:
CITY OF°EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagdn, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber: — —
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
B Surcharge:
Y Misc. Charges:
Date of Insp.:
Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA111546
Date Issued:06/28/2013
Permit Category:ePermit
Site Address: 1571 Four Oaks Rd
Lot:3 Block: 03 Addition: Coachman Land Co 1st
PID:10-18150-03-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ed Pelto
1099 Pelto Path
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Holly M Carlson
801 Western Ave
Holmen WI 54636
(651) 503-5475
Ed's Heating And Air
1099 Pelto Path
Woodbury MN 55129
(651) 775-7490
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA124444
Date Issued:07/02/2014
Permit Category:ePermit
Site Address: 1571 Four Oaks Rd
Lot:3 Block: 03 Addition: Coachman Land Co 1st
PID:10-18150-03-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Diane Moyer
Home Energy Center
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Holly M Carlson
801 Western Ave
Holmen WI 54636
(651) 587-4203
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(651) 766-6763
Applicant/Permitee: Signature Issued By: Signature
Use BLUE ar BLACK Ink
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Eagan MN 55122 ► Date Received: �
Phone: (651) 675-5675 � staff: �
Fax: (651)675-5694 `_________________�
20�4 RESIDENTIAL PLUMBING PERnniT APP�icaTioN
Date: `� . � " Site Address:__.___/-r�✓ �fd�.!' G�a �� /`� �
Tenant: Suite#:
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`'��',�t� � ��' Name: / `' k� �� Phone: ��S I ,�� �� ���'�
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� Contact: �'–L�� Email:
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� ��,�� _New �Replacement _Repair _Rebuild ^Modify Space _Work in R.O,W.
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Descriptian of work: � � �G � j � * �% f`/'�: �'I��/ '��
� ` � ; RESIDENTIAL
� ,
�� � ' � �` �Vater Heater
x ' � ��
s � Lawn Irri ation Water Softener
�����,�,� F g �RPZ/_PVB)
� �� 5eptic System Add Plumbing Fixtures(_Main(_Lower Level)
�� � � � New Water Turnaround
=, : � ���: —
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` s�� � Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater ater Softener, or Water Heater and Softener(includes$5.0o State Surcharge)
�. ,
. awn (rrigation (includes$5.00 minimum State Surcharge�
$60.00 Add Plumbing Fi�ctures, Septic System Abandonment,Water Turnaround*(includes$5.00 State Surcharge)
*1Nater Turnaround(add$200.00 if a 5/8"meter is required)
$115.00 Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge)
TOTAL FEES�
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Caii 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
i hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but oniy 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{�ans.
,,� ��—�.
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Applicant's Printed Name Ap an Signature
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Date:
QtnfE
3530 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fac (651) 675-5694
Tenant
RECEIVED
JAN 1 1 2016
Use BLUE or BLACK Ink
For Offte use
Pentilk 13 LI p
Penn Fee:( . () C
Ewe t d:1-1t.—tU)
Staff
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
(/ 1 r 1 l Le site Address: 15-i 1 Solut Oak, kof
Stale 8:
Adcrs I c Izip: ► 571 t34.4 -q-. Oaf, ice( f vti M N 5 slat
Name: v r w- C\L CJLL�- f-40license #- (4 q c1 '7 uW C-
3L4oy
I.QSt - 58'7 - o3
V1) Zip 5LQ41,
115. 3C'rs- 2'Lb77
Phone:
Contact ) ICU SCA -10 i`3.0' Emit CXR -O t rilk 0, a R ►7 EA -
New
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RESIDENTIAL FEES:
560.00 Water Heater, Water Softener, or Water Heater and Softener (indudes State Surcharge)
560.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Pluming Fixtures. Septic System Abandonment, Water Turnaround* (includes State Surcharge)
'Water Turnaround (add 5210.00 ft a 518' meter is required)
5115.00 Septic System New (includes County fee and State Surcharge)
New x Replacement _._ Repair Rebuild T Modify Space
S- c W P)Pe
Water Heater
Lawn Irrigation ( RPZ I PVB)
Septic System
New
Abandonment
)(Water Softener
Softener
/add Plinnbing Fixtures ( Main ILower Level)
Water Turnaround
TOTAL FEES $
CALL BEFORE YOU 016. C4 Gopher St One Celt at (651) 454-0002 for protectiorn against undue utlty
Call 48 hours before you intend tD dig to receive locales of unde www.QopherstateonecaO.orq
I hereby acknowledge that flan ktormatixt is conatete and accurate; that the work wit be in conformance will the ores and codes of the Cky of
Eagan; that i understand this is not a parent, but only an application for a penal, and work is not to shut 'Abort a
accordance with the approved plan kr the case of auk With rte a review and & � P ththat the wank *IN beaukkt
T( SCk40 130- 2
Applicants Printed Name
x
Appticanrs
Etha
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142228
Date Issued:04/20/2017
Permit Category:ePermit
Site Address: 1571 Four Oaks Rd
Lot:3 Block: 03 Addition: Coachman Land Co 1st
PID:10-18150-03-030
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Paul F Geng
1571 Four Oaks Rd
Eagan MN 55121
(651) 587-4203
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143977
Date Issued:07/06/2017
Permit Category:ePermit
Site Address: 1571 Four Oaks Rd
Lot:3 Block: 03 Addition: Coachman Land Co 1st
PID:10-18150-03-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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 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 -
Paul F Geng
1571 Four Oaks Rd
Eagan MN 55121
(651) 587-4203
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature