1410 Kings Wood Rd- s,
r •
• .?
C3';ei.tificate nf Cccuvano
Wit4 o f Cfagan
Toat huttt ?'r SwiIbiMg auoectiAa
Titis Certifieate issaed prersuant to the requirements of the Uniform Building Code
certifying that at tht time of issuance rhis structure was in eornpliance with the various
omfinanees of tire City regularing building coRStruction ar use. For the following:
use ck%jficafiwr SF DWG aw&. p„l, Na. 28774
oo,pmyzy, R-3 U-1 zonmgowrin R-1 TypeConst. Vil
ownerofBuikung MAX iM HLIMF.S iN . nadm- 9671 HAMASH7RF i_Al_ _ FIIRTI pgAIRIE,
e,im4Am.. 1410 K1NGS WdOD RD am- L2 81 K1NGS WOOD 2ND MN J
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nate-
. ey?'?n? o?icut r ? ?POST IN A CONSPICUOUS PLACE ?
I
` INSPECTION REC4RD
?• ,
CITY OF EAGAN PERMiT TYPE; k" +tI? r"i'
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? ? ? e?, ,a ? ?i i? t - •? ; , , ,
SlTE ADDRESS: APPLICANT:
? ! -i I 0 1 Ih1I ,'. {itlst '. I{J? ,
f F" f NW: lai)rt{? .'NL? p`a 4 1.._;; 111 I
PERMIT SUBTYPE:
I io;l.
TYPE OF 1NORK:
ntr 1.1
INSPECTION DA . ..
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aEMaRKS: fi & w) P t Kra - tlkiEV;kwuf I! rR rt t+O
Permit No. Permit Holcler Date Telephone M
ELECTRIC
00
PIUMBING
HVAC
Inspection 'DMY Insp. Comments
FOO7INGS
FOUND
FRAMING
/ d-16
ROOFING
ROUGH
PLUMBING
Nbq
PL6G
AIR TEST yl ?,
ROUGH
HEATING
GAS SVC
TEST
o-1/ .
INSUL
!
GYP BOARD
FIREPLACE
Q'
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG „? O9
!
ORSAT
TEST ??/?7 G , JJ
?Q
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG /%46 (,?Z
OECK FINAL
(
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i
AddPbss 1410 KINGS WOOD RD
L.ot Z Blk
Sub
KINGS WOOD 2ND
Zip 5512_
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: a ? 19 Yes No Inspector: ?
Final grade (6" from siding) I/
Permanent steps (garage) t/
Permanent steps (main entry) ?
Permanent driveway ?
Permanent gas
Sod/Seeded grass
TraiUcurb damage ?
Porch ?
Basement finish ? '??`,,,('/
Deck
Plcase verify witA the builder the removal of roof test caps from the plumbing system and the shuboff of water supply to
the outside lawn faucet before freeze porential exists.
Contact engineering division a[ 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy w
I II I II If1) II 1111111111 11 11111111111111111111 REQUEST FOR ELECTRICAL NSPEZTION ?Or -?
Minnesota State Board of Elec[ricity Vmow
0 3 Z L 0 9 7 0p
1821 hone (612)s?2 v0a? m. 5-126, St. Paul, MN 55104 ome Duplex Apt Bldg. Other.--"
New Addn
Commeraal Industriol Form Remod Re air
Air Cond Htg. Equip. Wafer Hh. Load Mgmt Olher:
I] er Ran e Elec Heat Tem . Service
"k' above the work covered by this request Enter remmks in this space ond on the back of fhe whde mpy only.
'?//,2? 114CQ-.
Calculafe Inspection Pee - This Inspecfion Request wdl not be accepfed wdhovf fhe correct fee. ?
Other Fee S Service EMrance Srze Fre # Ciraits/Feeders Fee
Ma6ile Home Pork Stall j 0 to 200 Amps 1 b -} 0 to 100 Amps
Sireet Lig./Traffic Sig. A6ove 200 A Above 100 Amps
7ransformer/Generaior ixsvECroxsuse_ Lr TOTAL?,c?
--
Sign/OuNine Lig. Xfmr /
I
?
Alarm/Remote Conkal I
?-
Swimming Pool ?
I hereb c m ihm I ins Med 1 ecmcal h n on Me dores smt
Irngahon Boom Raugh-In Date
' ecial Ins
ection
l S
A p
p
Inveshgafive Fee Final ?re
lzm
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLEfED WITHIN 1B MONT S.
?
311 -O J 7 OFFIC USE ONLY Thrs reqoest vaid 18 monlhs from volidaeon doM pnnkd in ihrs 6w
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54Z9
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?Hts D S E P z s-
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PLEASE PRINT OR TYPE r
R I ?ok Rough-in mspeclion reqwred Ye ? No
Inspeclion Olher Thon Rough-Irc ? Rmdy Now Will Call
I
?1'a? must mll the inspedor whert mody) Date Ready
I, licensed conhacfor Q owner hereby request inspedion of }he a6ove elechical work af.
Job Addrosz (Slreet, Bow, ar Rauk Na ) Gry bp Codv
'41
Sec4on No. Township Na r No. Ronge No Fire No ??ty
?
upan! Phone N.
Power pLer Addrese
Elecm I Cantrocror Compon ? ?
Commnor Lcrose No
Masror Lic No ?Planf Eled OnlyI
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G Pt l
M Aing Address (Conhacro Ovmer Pedorming ImbllaHon)
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24 an?
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Autharized SigqoNre(Comracior 0iy Insbllanon)
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EB-OOOOIA-10 6195 STATEBOAIiOCOPY•SEEINSTXUCTIONSONBpCKOFVELLOWCOPY
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NAM4 ` C.Rf"97 :I'NVFfii'T'MCN7 Cf:)piP
2256 ':)OCIi ih:LO I{:[NGS I4f:1[7D 49700.38
Te+,a:L Rer..Ei.pt Flmoi..ni;r 427G!i1.3s3
CRp6hCl1 3
l.l'3L:R IPa NANCY
PERMIT
- CITY Of EaGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
euzL oa?
028774
09/06/96
SITE ADDRESS:
P.I.N.: 10-42001-020-01
DESCRIPTION:
ermit Type
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REMARKS:
S& W PlBF2 - BRUCKMUELLER PLBG
1410 KINGS WOOD RD
LOT: 2 BLOCK: 1
KINGS WOOD 2ND
SF DWG
NEW
R-3 U-1
V-N
R-1
68
34
2
1,921
101 1 - FAM. DETACH
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC ?
SAC Units
Subtatal
VRLUATION
y1.qZ0Zs25
$691.13
$81.5@
$900.60
100
1
pp
Q?2y7VY p/aVV
p
.
$163,000
MTSCELLANEOUS $1,923.50
Total Fee $4,708.38
CONTRACTOR: - ,qpplicant - sT. Lzc.OWNER: .
MAXUM HOMES INC 19416111 0008836 MAXUM HQMES INC
9671 HAMPSHIRE LN 9671 HAMPSHIRE LN
EDEN PRAIRSE MN 55347 EpEN PRAIRIE MN 55347
(612) 941-6111 (612)941-6111
( I hereby ?ab'IKn0+a1`ed'ge th,a;te ? have rk??d" ?hLS. a?s{31$caCicsnah=cY st-Aje that? C#?? .. s; )
informat.iae?°.?s c???r?ot ?nd agP'tt ?o 0t_c?anpk?y,'with al`?:`a?,13?aT??3??Stkt?'`nf pFif--'
an
&teCutes eacrd? C4ty-?o# Ea?arr {1rdie?a,n ce s.` APPLICANTlP SIGNATURE ISSUE IG TURE
?,
CITY OF EAGAN 44, 10
It q 3830 PILOT KNOB RD - 55122
14996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
RemodeVReoalr Reauiremenffi
? 3 regisMred site aurveys ? 2 copies W plan
? 2 copies of plans (InGude beam & window sites; poured tnd. design; elc.) ? 2 site surveys (euterior addftfons & tlecks)
? 1 eftergy eakulations ? 1 energy ealcvlafions for heated addltlons
? 3 copiea M tree preservafion plan H lol plaNed efler 7/1193
iequired: _ Yes X No ?
DATE: 3-30-96 CONSTRUCTION COST: 153,000
DESCRIPTION OF WORK: 2storv single familv with 3 car aaraae
STREET ADDRESS: 1410 Yings vdood Road
LOT Z BLOCK 1 SUBD./P.I.D. #: Kinas Wood IZ
PROPERTY Name: Hoang Tran Ph0n2 #: 681-0755
OWNER '^" `"°`
Street Address• 1899 Deer tiiits Trail
City: Eagan State: Mn. Zip: 55122
CoN7RacTOR Company: Maxum Homes, zric. PF10nB #: 941 -6111
Street Address: 9671 Flampshire La. License #: 8836
Ciry: Fden Prairie State: Mn. Zjp: 55397
ARCHITECT! Company: Rtlsseii nesign Phone #: 335-5970
ENGINEER
Name: Tim Russell Registration #•
Stteet AddrBSS' 4940 Viking Drive
Ciry: lEdina State: Mn. 2ip: 55435
Sewer 8 water licensed piumber: Fsruc;cmueller . Penalty applies when address change and lot
change are requested once permit is issued.
1 hereby acknowiedge 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.
Signaiure of Applicant: ?-
OFFICE USE ONLY
Certificates of Survey Received Yes
Tree Preservation Plan Received _ Yes
No
? No
?
_ ? 1S ?
OFFICE USE ONLY
.? z?
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BUILDING PERMIT TYPE
1 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
02 SF Dwelling o 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 _ plex o 15 Deck
WORK TYPE
0?31 New o 33 Alterations ? 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Adual) \/N Basement sq. ft. MCNVS System ?
(Allowable) dN Main level sq. ft. City Water ?
UBC Occupancy 1z-3. J-1 2 Kj sq. ft. 9 q s/ Fire Sprinklered
Zoning 2- I zk sq. ft. 707 PRV
# of Stories ?'- sq. ft. Booster Pump
Length sq. ft. Census Code. ICD;_
Depth S,11 Footprint sq. ft. 7,1 SAC Code en I
Census Bidg _L
Census Unit i
APPROVALS
Planning Buiiding AA I'S Engineering Variance
Percnit Fee Valuation: $ 000
• `?
Surcharge
Plan Review
- License
MCNVSSAC
City 5AC
.--
i
Water Conn. r an ?
S
x y
Water Meter
ACCt. Deposit
S/W Pertnit
SNV 5urcharge
Treatment PI. y
w d
----?
i z r c(. S, ?l &5 " Sd'3
x
Road Unit s g V z?_
Park Ded. d
Trails Ded. uIt/ = z ?
Other
Copies _
9.9
79 . 2-
Total:
9
t
??
?
93.Cr.
/ 53,ses?(.a/
% SAC
SAC Units t74
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it.x 7C,? ? ?NG
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`? -7 t? P,h Y'?I(e = 1 L2? Uc]4. ?
CERTIFICATE OF SURVEY
LAND SURVEYORS
.c'" R, eoutwrc. ;Dua.
8713 OVPONT AVENUE SOUTH
BLOOMINGTON,MINN. 55420
888-2084
Survey for: MAXUM NOMES, INC.
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, ?70.46 3¢65 ?i
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DESCRIPTION:
corner of
u T a
3a z¢
-
475 *l
ai
lot 2, Block 1,
56.33
vv ?
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1
ai ro
I 3
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CQ14
KINGS WOOD 2ND ADDITION
Proposed Grades:
Top of Blocks 9p?s Garage floor -2? Basement floor B9Z s
NOTE:
Circled elev?d???Flh?e proposed, others are
Arrows dc?o??t??rio f drainage. ?
Bench
We hereby ce
boundaries o g , y,
thereon and all visible encroachments, if any, from or on said land.
Dated this 3rd day of September , 1 9 96 . ? ?
se
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fi
EAGAN E GIIVEERIIVG DEB?].`!
rtif h is is a true and correct representation of a survey of the
f t?and above described and of the location of all buildin s if an
3/? -//
LOT SURVEY CHECKLIST FOR
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PROPERTY LEGAL:
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DATE OF Si7RVEY:
LATEST REVISION:
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legaldescription
• Address
• Narth arrow and scale
• House type (rambler, walkout, split w/o, splft entry, lookout, etc.)
• Directional drainage arrows with slope/gradient °,6
• Proposed/ebsting sewer and water services & invert elevatlon
• Street name
• Driveway
W s7 ? •
G}/p ? .
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? ? .
W ? ? •
? ? .
? ? .
? .
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ELEVATIONS
Eastina
Sewer service (or Praposed)
Property comers
Top of curb at the driveway
Eievations of any ebsting adjacent homes
Prooosed
Garage floor
First floor
Lowest exposed elevatlon (walkouUwindow)
PropeAy comers
Front and rear of home at fhe foundation
PONDING AREA fif aoolicablel
? 0 ?L7 • Easement line
? a/ ? • NWL
? ? ? • HWL
? R?? 7 • Pond # designation
? ? ? • Emergency Overflow Elevation
?0 ? • Lot IinesBearings & dimensions
?o ? • Right-of-way and street width (to back of curb)
QF?C] ? • Proposed home dimensions including any proposed decks, overhangs greater fhan 2',
/ porches, etc. (.e. all structures requiring permanent footings)
? • Show all easements of record and any City utililies within those easements
??/ ? • Setbacks of proposed structure and sideyard setback of adjaceM erisfing structures
? [?" ? • Retaining wall requiremenTs, if any .
Reviewed:
January 7996
cRA1c19We=aRwr. Fra
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La? 'o"'?'°"°" °^°°"° KING S WOOD 2ND8?4TH ADDN
HORNE DEVELOPMENT CORPORATION
S.4NITARY SEWER,
AND WATERMAiN
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EAGAN MINNESOTA
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STRUCTURESjTC
' 20LF-e''P--? <nLL OFF ROAD BE HNED I I CL 52-QBOXsW n/113LF-8'DIP ? ? _
CL52-090K -?a$ !970_ __ _ _"_ WITH POSfS 9 SIGNS.
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? f s.iu eea3 . 870
n
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_ ?? SDR? _ __ -___
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I.
3 3.0 RLCG:tO LAN 2Gi4 J
Ou11ER:
EXTERIOR ENVEIOPE AYERRGE "U" COMPU7ATION
SITE ADDRESS:
CONTRACTOR: DATE: 0 " Zq ' Q(,o PHONE:
DETERHINE NORKING SOUARE FOOTAGE OF EriCH:
l. TOTAL EXPOSED WALL AREA „_,,,,, 3Cq6 sq ft x "U" •iI ? 3? ?•?
2. TOTAL ROOF/CEILING AREA,,,,,,,, sq ft x "U" .OZ,(p
3. TOTAL EXPOSEO WALL AREA CALCULATIONS:
Total exposed
area abave wall .
fioor,,,,,,,, ;2?p7O, sq ft
a) Total wall w indrn+ area:
9lazed...... 338o sq ft x ???" lp 101.1
glazed...... sq ft x "U" _
b)
.
Total door area n
.? . sq ft x"U" --
,,,,,,,
,,
c) Total sllding glass door area:
I.6tU F-- glazed...... ?"{Q sq ft x"U„
glazed......
d) Toial fireplace wall area
sq ft x "U"
m
sqftx"U" .% -
e) Total wall framing area
(Averaoe lOq)........... sq ft x"U"
f) •Totat net walt area above
floor (insulated)....... 2,0:Z 7s.(a sq ft x"U"
g) Total rim Joist area...... sq ft x"U" e0q I ?? f2•i
Total foundation
area (Exposed).......... J ? sq ft
h) Total foundatTon
rrindow area............. ` sq ft x"U"
i) Total net foum;ation
area above grade........ sq ft x"U" r?'A', ? ?-"?r•?
3. TOTAL a) thru t) ? Z?Og'b
If item A3 Is the same as, or less than item 1?1, you have met the intent of
S.A.C. 5ectton 6006 (c) 2.
1 4., TCiAL EXPOSED ROOF/CEILING LALCULATIONS:
Total exposed
roof/celllnq area........ _ sq ft
J) 7ota1 skylioht area....... ?- sq ft x"U"
k) Total roof/cellinq framing
area (Auacaae 1n9.,)...... M?eg, sq ft x"U" •DZ? ? z."a?
1) Total insutatcd
roof/cciling area ... . ? 3?. sq ft x"U" e0 Z Z
y, . TOTAL J) thru 1)
If total of #4 is the same as, or less than 92, you have met the intent of
S.B.C. Section 6006 (c) 1. -
ALTERNATE BUILDINf, ENVELOPE DESIfN
To utilize the total envelope system method, the values established by the sum
of ltems A3 and 94 shal) not be greater than the sum of ttems R1 and 12.
1, + z.
g, + 4.
C E R T 1 F 1 C A T I 0 N
_
a
1 hereby certtfy thai 1 have caleulated the "U" factors and "R"
vslues herein and that the buildinq here described meets or exceeAs the State
of Hinnesota Enercy Conservatiom Act.
wY? ??e?`I -
ZSiqnature
e- 2q--l?
(Date)
t -.
sL ?..
IrP
? g g(o 1993- PLUMBINGIyPEORMIT ? SIDIIVTIAI.)
3830 PILOT KVOB RD
FAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf.
NO. FIXTURES EACH TdT?
? SHOINER 3.00 3.00
-3 WATER CLOSET 3.00 9,00
BATH TUB 3.00 B v
? LAVATORY 3.00 t 7, Dv
Z KITCHEN SINK 3.00 3,00
_
_ LAUNDRY TRAY 3.00 3f Oa
? HOT TUB/SPA
WATER HEATER 3•00
3•00
-?-
/ FLOOR DRAIN 3•00 9v
? GAS PIPING OLTTLET • m;nimum -1 3.00
ROUGH OPENINGS 1.50 5U
? WATER SOF!'ENER 5•00
PRIVATE DISP. • Dek.cry. nc. 15.00 -
U.G. SPRINKLER -eome under consi. 3•00
ALTERATIONS ' to eASting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
TOTAL: 6-7' > 0
SITE
OWNER NAME:
INSTALLER: t"14 vell? ??1- -
ADDRESS:
'/
CITY: STATE: ZIP CODE:
PHONE #: ( ) ? S?IY6c> j ?
e-1,00
SIGNATURE OF PERMITTEE
1493 PLUMBING PERMIT (COMMERCIAL)
C'ITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL CONIIviERCIALIINDUSTRIAL BUII.DINGS. ALSO FOR MULTI-
FAMILY BUI: DiNGS WHEN SEPARATE PERMITS ARE NOT REQUIItED FOR EACH
DWELLING U- T.
_ NEW CONSTRUCI70N
ADp ON
REPAIR
WORK DESCRIPTION:
CONTRACT PRICE:
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE $.50 FOR EACH S1,000 OF PERMt!' FEE
MINIMUM FEE S 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
SITE ADDRESS:
$
$
TENANT 1v'AME: STE. #
OWri'ER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
L BL CITY USE ONLY
SUBD. -
RECEIPT #:
DATE:_ 10--7-9?
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? ? townhomes and condos when permits are required for each unit
New construction
Add-on air conditioning
Add-on furnace
Add-on air exchanger, i.e. Vanee system, etc.
Date: /d ' #1 '4??
.
.
Minimum Fee: Add-on/Remodel (existing residence only)
HVAC: 0-100 M BTU
Additional 50 M BTU
Gas Outlets (minimum of 1 required @$3.00 each)
State Surcharge
TOTAL
SITE
OWNER NAME: f!I!'L L JS d
INSTALLER
STREET ADDRESS: W o' / ?cin: ?f
FEES
$ 20.00
24.00 1_?
6.00
V?
.50
-3 30, - -V
PHONE #: S OOU J
STATE: kO/II. ZIP:
PHONE #: ( } S?S2S?f G?67 ?-?
`?
cirr use oHLr
L BL
SUBD.
RECEIPT #:
DATE:
1996 MECHANICA! PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are nDl required
for each dwelling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee QC 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of Rermit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
51TE ADDRESS:
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:_
CITY:
TELEPHONE #:
STATE: ZIP:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE
INTERIOR IMPROVEMENT
CITY INSPECTOR
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118507
Date Issued:11/01/2013
Permit Category:ePermit
Site Address: 1410 Kings Wood Rd
Lot:2 Block: 1 Addition: Kings Wood 2nd
PID:10-42001-01-020
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, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Hoang K Tran
1410 Kings Wood Rd
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r -+
For Office Use
Permit#:
////c3-2—
City of Eaall
Permit Fee:
e /
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
, -�
Date: -S- a® t Site Address: I,LI 1 0 ki h SU ao P.On E 'N Unit#:
Name (---i OG✓Zr� Phone: .
Resident/
11
Owner Address/City/Zip: + L l 1 0 1( , g J l: r P �-,
t 575i a
l S..�, o,
Applicant is: Owner Contractor a
R
1 Description of work: ��-,- -e i' e e rQ
4 Type of Work
i
Construction Cost: Multi Family Building: (Yes /No I
f Company: L. ce I _CH-, C Contact: "1 Jct .‘,.s. 9
Contractor z Address: c�3 0 1 4 L S- N (A), Z "00 City: 6,(4.. 0(i
1 State:Y^')''•) Zip: S-S))-Y Phone: Cid-.99Y-? O Email: OC Q 0.�.,/1 ceGll7'vo "'1- 1
16 7 07 7
License#: 0 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
4
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
1
Yes No If yes,date and address of master plan: i.
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
I Fire Suppression Contractor: Phone:
I NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. . _
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.00pherstateonecall.orq
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 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 fans.
Exterior wor uthorized by a building permit issued in accordance with the Minnesota t to Building Code must be completed within 180
days of per i issuance.
x �'‘- 7-Q`11INCx
App ' a e ame' Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144708
Date Issued:08/07/2017
Permit Category:ePermit
Site Address: 1410 Kings Wood Rd
Lot:2 Block: 1 Addition: Kings Wood 2nd
PID:10-42001-01-020
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 -
Hoang K Tran
1410 Kings Wood Rd
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature