1418 Kings Wood Rd.., . .. . ?.
Cfer#ificate vf Ccrupanc?
Wit4 of Cfagan .
Teoaxtment ot Vuilbing 3adpcctim
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in contpliance with the various
ordinances of the Ciry regulaiing building corutruction or use. For the following:
use classiecafion: SF DWBG awB. Pema No. 2005
occupancr rype zoning nisa;M Tnx E 1 GAIAXI AVConsL
E, APPIE Vi4ilEY
Owoer ofBuilding Address ' B ' KMM `OW 2M
Bui pg Address Lacality
nate:
Bu;Iding Oft'icial
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830 f'ilot Knob Road
Eagan, Minnesota 55123
, (612) 681-4675
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
SITE ADDRESS:
? • ? r? ,
1 r' 1 e1 Bt ni h
11ririll rt1;r
? APPLICANT:
1 19 19 0, :i 1 !, id bY il
PERMIT SUBTYPE:
TYPE OF WORK:
INSPECTION .. . ..
? !?i Il i 1 i?pJ t?i
. . . . , .., i .
W ar.Elk .. -aF: cmr PieiEi
Permit No. Permit Holder DaUe Tekphone #
S/1N
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectiqn aate Insp. Camments
Footings I (& &
?rc
Foundatiwi //oZbky
Framing ?
Roofing
C
Rough Plbg. ?_
Rough Fltg_
5???
l?l. a) ?
Fireplace
Final Hng. . a l3 ?
o?sac resc
Rnal Plbg. Plbg. InspeCtor - Noti(y Plumber
const, nnete?
Engr./Plan
81dg. Final 9..10 93 be,
Deck Ftg.
Deck Fnal
Well
Pr. Disp.
Adqress 1418 [uxcs wooD RpAD Zip 5512 2
I.ot 4 Blk 1 Sub xm wooD 2rID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Pecmanent steps (main entry) ?
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage ?
Porch ?
Basement finish
Deck 2 CY¢.ckS
Please verify with the builder the removal of roof test caps from the plumbing system and the shuboff of water supply ro
the outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
Pequest Dete Frte iVO
Z Rougn-in Inspection
Reqw
retl?
? Ready Naw /Nill Noniy Inspector
y_
7_ 9?
s No
e
?
When Reatly'
15( hcensed contrector D owner hereby request inspection of above elechical work at:
Job AQtlress (Slreet Box or Route Na I A
h
l?l! P
?
'
C' QyC
5;4-64--41
•
s w
a a d
? G.
SecLOn No Township Neme or No Range No County
Occupant(PRINT)
O B Z Phone o
?31-5? ? o
Poi $upPlrer
A.4 tCe 7?'+ AV A ot.t?`c- Adtlress
.?i++sa ?a 4
Electncal Gonvacror ICompany Name,
,? ??d ?'lcafiCsL G o• ConVacbr's L¢ense No
CA-a o!?`'?
Metling Aaa ess 1conVactor or Owner MaNiyn InstallaLOnl
`z S/.zs D??c/,h ?-•r.Y ?.r.v ? ,ea-? ?r..«,.?f- ,s-a?'b.p
Hub etl Si ture IComracl Owner Mam nstallation)
L Phone Number
?
- W
Z
? '
- S
?
Y
MINNESOTA STpTE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Grlggn-Mitlway Bltlg - Paom 5473 BE ACCEPTEO 6Y THE STATE BOARD
1821 University Ave., St Paul. MN 55104 UNLES$ PROPEF INSPECTION FEE IS
Vhane(61Y)84Y-0800 ENCLOSED,
REQUEST FOR ELECTRICAL INSPECTION ee-oooo'oq
p ?$ee inskuclions for compleUng this form on back of yellow copy S`?g as?l
2 H83 5 "X" BeJOVS'WOrk Covered by This Request
ew Atld Rep Typeof8uilding AppliancesWved EquipmeniWiretl
Home Range Temporary Sernce
Duplex Water Heater Eledric Heating
ApL Buildmg Dryer Otheo (Speafy)
Comm./Industrial Fumace
Farm Air Conditioner
Olher (spealy) Contracror5 Remarks
Compute lnspection Fee Below:
# Other Fee # ServiceEntrenceSize Fee # CircmtslFeeders Fee
VSwimming Pool f 0 to 200 Amps /fi6L ! 0 to 100 Amps (vOp
Transformers Above 200 _ Amps 100 _ Amps
51
n5 Inspecror5 Use Only. TOTAL
9
Irri ation Booms
Speciai Inspection
AlarmlCommunication THIS INSTALlAT10N MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONT
I, the Electrical Inspector, hereby R°uyni oate L J_ jG 7?
certify that the ahove inspaction has
been made. FInai i Date
OFFICE USE DNLY
This requesl voitl 1B monihs irom
S'pS oZa-- RESIDENTIAL
/ BUILDINC PERMIT APPLICATION
q?5 CITY OF EAGAN
I0? 3830 PILOT KNOB RD, EAGAN MN 55122 ?
651-681•4675
New CanstrueUon Reauirements
• 3 registered site surveys showing sq. R. af lat, sq. ft. of hause; and all rooted areas
(20%maximum lot cove2ge allowed)
• 2 copies of plan showing beam & window sizes; poured tound design, etc.)
• 1 set of Eneyy Calwlations
• 3 copies of Tree Preservation Plan if lat platled after 111193
• Rim Joist Delail Option,s selecdon sheet (Wdgs with 3 or less unils)
DATE
SITE ADE
TYPE OF
B?
// 00? ?
iULTI-FAMILY BLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT /9z'?t-°C 5;??
??" ?
STREETADDRESS?fa?O /CtdG.C»i[?.Q.sS! _X1'? CITY?d.P.dS?////PSTATE/LZIP??7
TELEPHONE # 24&?-89--r-0DYdCELL PHONE # FAX #Ts2• ??r' 9ME'A
PROPERTYOWNERTSD.B S/erJ.VGe.eo TELEPHONE# GS/- 99Y- 90 gA
------------------------------------------------------------- ----------------- --------- --------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATCGORY 1 MINNESOTA RUI.ES 7672
(4 submission type) • Residendal Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calcuiations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor.
Mechanical system includes:
Sewer/Water Contractor:
Air Condirioning
_ Heat Recovery System
Phone #
Phone #
Tec: $70.00
------------°-----------------------------------------------------------°------------------°--------°----------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. p
_ C'nl?.C rJ? ???i,l.cA
Signature of Applicant ?
OFFICE USE ONLY
_ Water Softener
_ Water Heater
_ No. of Baths
RemadellRenair Reauirements
• 2 copies of plan
• 1 set o( Energy Calculatlons for heated additions
• 1 sile survey for eztenoradd'Aions & decks
. Indicate it home served by septic system for additlons
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
VALUATION
o???'?S
Fee: $90.00
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
' Llpdated 4/02
OFFICE USE ONLY
? 01 Foundadon ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 9 ? 31 EM. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 77 Garage ? 22 Poroh/Addn. (4-sea.) ? 33 E#. Alt- SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 ,03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 , 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement •Demolition (Entire Bldg only) - Giva PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code 2oning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs • Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Final/C.O.
_ Footings(deck) FinaUNo C.O.
_ Footings(addition) _ plunibing
_ Foundation HVAC
_ Drain Tile pther
Roof _ Ice & W ater _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framin8 _ Siding Stucco Stone
_ Fueplace _ RL _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOIvIES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNTT.
? NEW CONSTRUCTION
_ ADD-ON A/C
ADD-ON FURNACE
DATE
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExisTING coNSTxucrtoN)
STATE SURCHARGE
TOTAL
SITE ADDRESS: r
OWNER
,
.,
FEES
$ 24.00
-6:0@-
.??
$
.50
SD.50
TELEPHONE #:
CIT'Y:
ST
ZIP CODE:
TELEPHONE #: Zt 5 2- G/ ?^l ),
`
SIGNATURE OF PERMITTEE
1993 MECHAHICAL PER114IT (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
1993 MECHANICAL PERMIT (COMIIMRCIAL)
CTTY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIALAINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTI-ER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTT.
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF P(3NI'RAC.'.?' FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF ?'?MT'1' FEE.
TOTAL $
STTE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONL1)
INSTALLER:
ADDRESS:
CITY:
STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CITY INSPECTOR
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNTT.
NO. F 'IXTURES -ACH TOTAL
? SHOWER ' 3.00 • e'zr
WATER CLOSET 3•00 'a-o
? BATH TUB 3.00 z, v-0
?s
? LAVATORY
KITCHEN SINK 3.00
3.00 4e-V
zt a-o
LAUNDRY TRAY 3.00 2, cr-a
HOT TUB/SPA 3•00
-? WATER HEATER 3•01 ?
?
? FLOOR DRAIN
GAS PIPING OUTLET • mso;mum • i 3•00
3•00
o
ROUGH OPENINGS 1.50 U
WATER SOFTENER 5•00
PRIVATE DISP. • Dei.c,y. iio.
U.G. SPRINKLER • home under oonsi.
ALTERATIONS • to aosting
WATER TURN AROUND 15.00
3•00
15.00
15.00
STATE SURCHARGE .50
TOTAL: 00
SITE
OWNER
CIT'Y: STATE:ZIP CODE: ? S~C' r"' f-
PHONE #: (
SIGNATURE OF PERMITTEE
1993 PLUMBING PIItMIT (RESIDENI7AL)
ClTY OF EAGAN
3830 PIIAT KNOB RD
FAGAN MN 55122
(612) 6814675
1993 PLUMBING PIItMIT (COMIVIERCIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL COMAffiRCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMII.Y BUP_DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH
DWELLING U:::T.
_ NEW CONSTRUCTION
ADD ON
REPAIR
WORK DESCRIPTION:
CONTRACf PRICE: $
FEE: 1% OF CONTRACf FEE.
STATE SURCHARGE s.50 FOR EACH $1,000 OF p?RM?'t FEE
MINIMUM FEE: $ 25.00
CONTRACf PRICE X 1%
STATESURCHARGE
TOTAL
SITE ADDRESS:
$
$
$
TENANT NAR'fE: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
ities Di ital ualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
I
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knoh Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: I ,j C ;, . i APPLICANT:
Iei18 KlNGS NOOD RU ()2i'1UN 13LL1R5 INC
I iW.'; WOOn :'I`ID (612) 4j1-So oo
PERMIT SUBTYPE:
^r esJr
TYPE OF WORK:
NetJ
INSPECTION
r007 T ?'f, .. .
FRnt'i TP!G ..
TNSULI1T10td FlI4AL
I I P ' , P, (' r
RFMARI<: ! .>, W Pt BR _- PETPJI= {) $ B G
?
ities Di2ital Oualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
PERMIT
CITY OF EAGAN
13830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE: ???
Permit Number: C,'
Date Issued: '". 7/:. 9 / 9 3
SITE ADDRESS:
1418 KIR, ; Wtl(,D
LDf: I CiLUCK: "I
I':SN(,:; I.JUCO t'I'!D
;n
DESCRIPTION:
Wk..'citnk.--Prrrnif: (Yp r
U31?rtr.?T ?4,r i<, f `IPe
1
UFc O(.cup.jno; ?
.
?
1 ?
w y'
t1I- OWr
I'd 1, 4J
k-3 f7-1
li-1
?n
i3
IcE t V 0 P -ol, .
REMARKS:
1. k w ;11 ;tr ? , cT11!i_ !, i R c
FEE SUMMARY:
iia'
Plnii h:r,?i0 w
iUf' i-',j•
SAi:
Jlit „
;/1(' Uii i ts
i i,r_
V FlL urar:i:0 N
a?i?'.F94Y
$554.?15
't 13'? S U
$/SO?.?DGI
I !d'A
1
mv ;+,62.95
$ i r,, 000
14rsr.P1 I ANr0 U3,
C(JPe'
IoLul c%
CONTRACTOR: Ap p l. i c., n t- s r. 1. T c e OWNER:
LIiMIIP! l!l CIPti 1NC - 14315000 00010414 Oel+lllir! RLDRS
?9?36 ?NLR,t1( flVE 1 5136 (i^.' ^.X1"' 11v
P.PPLL VnLI.`l 11 N 5 S12? APPLE `JALLEY 114: ."LF`
(G9') 4:ti-a0 iil0 (bl?)437-5000
T harsb?,r ?=c kiiow l,) dy„ .:h,7?, I -h, rvY eci 'L'hi?:> a ppceeL'on arid
inioI, nia: .nrr i, cu;-r,7 nd? A i;re t.c? ??<3'ntp!y w £?h ?I rW't?
,.,.*<<L: . .nra i.y , ?( r,^q.,n Ti -, I; ,._ ri,? ,.
APPLICANT/PERMITEE SIGi 7URE
i°
IS ED : IGNAT RE
PERMIT # CITY OF EAGAN
REACTIYAT?? ' RECE
???? ?1=gg2-gUILDING PERMITAPPLICATION ?`????????
RPR 0 9 1993 I`( i;3 681-4675
---------------
SINGLE 3 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuati n of work
1--
?"(/? ? ?.
Site Address: ?X'K
( STREEI SUITE /
Tenant Name: (commercial only)
IAT _ BIACR SUBD6 P. .D. #
Descri tion of work:
The appl icant i s: Owner O?Contra tor O Other (oe$«;be) '
Name ? I Phori2 -'?c-c-Li
Property LASi FIRST
Owner Address 64 (?t,X14?
SiREET STE N
City ???'[?I?U ?U ?? State ZiP ?
T?
Company Phone
Coi1tf8CtOf Address Li en{e #(?'r'1109?' Exp. ' ? ry
City
/'C- J ? 5tate ?? Z;P 551?5
4
Company Phone
ArchitecU
Engineer Name Registration #
Address
City State Zip
Sewer 6 Nater licensed plumber ??(? ??Il?? ! lU• . Processing time for
sewer 6 water permits is two days once area ha en approved.
I hereby acknowledge that I have ead i applica ion and state that the information is
correct and agree to comply wit all p icabl tate af Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
I
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
W02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex . ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex 0 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. O 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
Jg 31 NeN - - 033 Alterations O 35 Tenant Finish ? 37 Demolish
? 32 Addition ',O' 34, Ftepair ' J"O 36 Move
GENERAL INFORMATION
Const. (Actual) 1J-H Basement sq. ft. MWCC 5ystem
{Allowable)
" V- N lst Fl. sq. ft. , • City Water /?
UBC bccupancy )L-3 i 2nd F1. sq. ft. PRV Repuired
Zoning 9-1 Sq.
Ft. total Booster Pump
d of Stories ,
,
Footprin t Sq. ft. fi're Sp'rinkl er
Length, On-site well " Census Code iol
Depth On-site sewage SAC Code o r
APPROVALS
P1anMng Building, X33ps•°•- • Assessments
Engineering Yariance
REQUIRED INSPECTIONS -.?
? Site ? Footing p Framing ? Insulation
? Nallboard O Final ? Draintile ? Fireplace
Permit Fee
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 % Joo
SAC Units _L
veluc;on: g /611 000'
aX't? nzv= Sov
= ?-r?
GA RAfrC: I x 20
8xsx'?= 32
?Yax3'/z %i/Z , f ?
)(16 x '/a -?
$X!G - izg 90o 93_ iy,Hoo
_
3T XZg= ! 06 y
zx/$,?
I z2+3X/0=
ig, 41 2 0
I 157 Fi,ooi¢;
• Sv R.,??'r0'1?= 1228 x Sy =
2Nt??F'i?oR°
1xz5y9 x'/x = l?`f
.18%?tr.?8= 1a77
&
3sxA'y" I 61
722
z
j
?
. ' ? 74-. ,. 54 % Ii r, a cu
»
FAE 0 POY
* * ** .
'k PION@EF1 LAND VAWVGRs •
* " na' Gr ng
4K * * *
orm
MN 85120
.Fax 881-9499
B29 Highwar 10 Narlheest
91dne, 1AN 55434
(812) 783-18806FOx 783-1883
Certificate of Survey for: OZMUN BUILDERSo IN CA
Housa Address:
?
?
?
m
c
?
m
. aW.o nenotes Exiating Elevation PROPO.SED FLSJ ELEVAII.QN
,o. Denotes Proposed Elewtlon l.owest Floor E]evation:Sm'E9
?- Denotes Drainage & Utility Easement 7op of Blodc Elerotion:lQA&lia
Denotes Dralnoge F1ow Dtrection Gorage Slah Elevotion:_qqW
-o.- Denotes Monument
?$- penotes Offset Hub Beorings ahown are ossumed
LOT?, BLOCK 1 KINGS W4?? 2ND ADD.
DAxOTA COUNTI; MINN6DTA
i he.bv e.rnev ens? mu wrwv, p? a rw.• •,w oKw? ev ?• •• uMd.. mv cna ekW on ?nd tMt I wn d?V RpiftHb LMd
ou. OOted 1hhiisa- ?.dry af APRI L ._ MD.10 5 .
?ndn 1M 4w? M tM Sum ol Mir?a
r, .! SF(JS::i1 vrn..i.eS'-'`?? ! L.i •/Ai:Jn/j ?/ ???, f _? ?w _
F [: •1 : . .
T- naeewr e.
kch-30,04
? S 8910'59" W 5 I
NO7E: CONTRACTOR MU5T VERIFY ALL OIMENSIONS I
LCT SIIRPZY CaLCLLi/T tOR U/2DL1QR'I71L
? »TLDI11 ?IT uP IC?TIb ?
ZRODLRTY
?
!o ei wusroye
i
? 0
0 •
• Reqistoro0 =ar?d aurveyoz signatute u?d oampany
' Duildinq Permit ]lpplieant
D 0
6?
? • Leqnl descsiption '
D" 8 0 • llddress
E?0
VD 0
D •
• North arrow and bar scala •
tiouse type (zamblaz, ralkout, split v/o, split sntry,
lookout, etc.) '
8'D 0 • Direetionsl drainaqe arrorrs vitA slep*/qradisat !.
D 0 0 • Proposed/exiatinq sewes and vatez servieos
0 D • btr*et name
D • Dzivavay
=LtvaTioxa
D 8'
0
• TxSstinc
Sever service
V D
Dr D 0
0 •
• Lot eozners
Top oi curb at the dziveway
• Elevations of any axisting aCjacent bomar.
L? D
D
• Proeesed
Garaqe tloer
? D
0
d 0
? • First floor
111 • Lowest •xposed •levation (walkoat/virfdov)
"""
?0 ? • Property cornero
0 0 • Ftont and reez of Aomt •t th• toundation
pOltDitiG KRiaB tif a?olieablat
Easement line
D ? p ; .
xWL
? .
D {f'
D 0
0 •
• Hii L
Pond # desiqnation
A D • L'merqeney ovesilov Zlevation
'
t?'n 0 • n=x?xsioxs
Lot lsnes .
? D
V 0 • Riqht-oi-vay ana stroet vidth (to baek ot eusb)
D G • Pzoposed Aome dimensions includiaq any proponed docks,
overhnngs Qzester tAan 21, porehes, Otc. (i.e. all
struetures requirinq permanent lootinqo)
D^ 0 0 • Shov all easements of sscord ana any City ytilitiss vithin
9?0 thosc •ssements
d
d
t
0 • Setbacka of proposed structuze an
aeL jacen
back of a
existing hom
D? 0 • R:taini all *ments, Sf sny
- Rev i&ved: tr ?
.t
OZMUN BUILDERS, INC.
DESIGNERSAND BUILDERS MN LiC. 0001044
15136 GALAXIEAUENUE, APPLE VALLEY, MN 55124 (612)431-5000
_ ,. Average "W,C bm
Job Site Addres
Legal Description: ? .
LotBlockAddition_ Date
AVERAGE LINEAL FEET OF •
EXPOSED WALL AREA ABOVE GRADE
Main Level ` ' y
Lineal'Et of framed wall above grade?x height of wall I
Second leveY
Lineal ft of'framed wall above grade tplx height of wallL =
Vaulted Area
Lineal ft of £ramed wall above grad _? height of wall_?_=?
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Use BLUE or BLACK Ink
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For Office Use I
I I
Permit
City of Ea1 105.9 _'7 1
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 I Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: (e ry t~ y~~ JGMeSo Phone: SOS • a 3 ~g~g
Resident/
Owner Address/ City /Zip: (Q K~~ts l . ~aSR SSa
Applicant is: Owner Contractor
~w r
Type of Work Description of work: yece.tC
9 Construction Cost: 700 Multi-Family Building: (Yes / No
Company: (jfe4 9►ook r~ Contact: 3e,~a✓1
Address: S6DC AID "c.r, 1~~• W jly City: ~ae ~W11
Contractor
i 1 State: M N Zip: Phone: 29V, 1235-
License aC G 3 { S 1 Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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?
i
j _Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
f NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
i the information may be classified as non-public if you provide specific reasons that would permit the City to I
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.goaherstateonecall.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 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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
day of permit issuanc .
r N
X n
Applicant' Printed Name 7s is Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177844
Date Issued:07/21/2022
Permit Category:ePermit
Site Address: 1418 Kings Wood Rd
Lot:4 Block: 1 Addition: Kings Wood 2nd
PID:10-42001-01-040
Use:
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.cityofeagan.com
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.
Please describe the work, including any skylights that will be repaired or replaced:complete tear off and reroof with asphalt
shingles.
Applicant: Sam Karau
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 -
Mary Beth Ruthford
1418 Kings Wood Rd
Eagan MN 55122
Ashton McGee Restoration Group LLC
5555 W 78th St, Suite J
Minneapolis MN 55439
(952) 426-3736
Applicant/Permitee: Signature Issued By: Signature