1575 Four Oaks Rd??? -7/ 2006 RESIDENTIAL BUILDING rERNnT arrLicaTioN
City OfEagan
3830 Pilot Knob Road, Eagau MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requiremenis
3 registered site surveys showing sq. R of lol, sq. il. of house; and all roofed areas
(20% maximum lot cove2ge allmved)
2 copies of plan showing beam & windax sizes; poured found design, etc.
1 set of Energy Calalations
3 copies of Trce P2servation Plan if lot platled after 711/93
Rim Joist Detail OpGons selection sheet (buildings with 3 or less unib)
Minnegasco mechanical ventilation fortn
RemodellReoair Reauiremenls
2 copies of plan showing footings, beams, joists
1 set of Eneyy Calculations for heated additlons
1 site survey for add'N'ons & decks
AddiVon - irMkate il on-sRe sep6c sysfem
?S "-qz?
Office use onlv
CedofSurveyRerA . = Y _N
TreePresPlanReoi - _Y _N,
Tree Pres Required , . _Y _N
On-site5epficSysiem -- _Y =N
llate I / Construction Cost r$`/a Do cl . o 0
Site Address 31y?I Alt UniVSte #
DescriptionotWork ?oci 2
Multi-Family Bldg ? N Fireplace(s) _ 0 23?`{
Property Owner Telephone # ( )
Con[ractor ?3? ? /?00 ? •? ? r-
Address / 41 ?.3 J` ?c: ?c - S l`'. /7/v? Citv 14- v
State 11V?71 1-1- Zip ' S- 0 Telephone #( 7?3) 7S-7-Ou 6 C/
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy COde Category , Residential Ventilafion Category t Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations 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, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Teiephone #(
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 plans. ,
Applicant's 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 'th the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp --/2. 7i Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By /�" Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119679
Date Issued:12/12/2013
Permit Category:ePermit
Site Address: 1575 Four Oaks Rd
Lot:4 Block: 04 Addition: Coachman Land Co 1st
PID:10-18150-04-040
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Robert L Ewert
1575 Four Oaks Rd
Eagan MN 55121
Hearth And Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA162230
Date Issued:07/06/2020
Permit Category:ePermit
Site Address: 1575 Four Oaks Rd
Lot:4 Block: 04 Addition: Coachman Land Co 1st
PID:10-18150-04-040
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 -
Robert L Ewert
1575 Four Oaks Rd
Eagan MN 55121
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA162230
Date Issued:07/06/2020
Permit Category:ePermit
Site Address: 1575 Four Oaks Rd
Lot:4 Block: 04 Addition: Coachman Land Co 1st
PID:10-18150-04-040
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 -
Robert L Ewert
1575 Four Oaks Rd
Eagan MN 55121
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature