1671 Mallard Dr?. CASH RECEIPT ?
• CITY QF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECfi1vED ' . ?
FROM
?
AMOUNT
& ooLLwRs
?oo
? CASH ? CHECK
FOR
i .
1 F / / l f L41. ! t - `- d - LJC% L.C/J?L
RUND COD6 AMOUNT
( J `?` L C
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uC
Thank You
7166O
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File CopY
: BLDG. PERMIT N0. , 13?
01-3210 Bldg. Perm2t
01-3422
01-3445
01-3446
01-2155
•17-3860
-20-2275
?20-3865
20-3868
20-3716
20-2252
20-3713
20-3743
79-3866
11-3855
G -_/ j88d
Plan Check
Surch./Adm.
SAC/Adm.
SurCharge
Road Unit
SAC
Water Conn.
Water Trmt.
Water Meter
Acct. Dep.
Water Permit
Sewer Permit
I4
Sewer Conn.
Park Ded. I
z !
i
?
Q
TOTAL
? CASH RECEIPT 0
. CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
, • ? -- ,
,7DAT?? ' 19
1'
wscnvw
RRdN ?
AMOUNT
3 DOLLARS
?se
? CASH ? CNECK
.? r
(,t,
/UHD COD6 AMOUNT
Thank You ,
sv
wnite-asvers copv
Yellow-Posting CopV
Pink-Fils Copy
CITY OF EAGAN
Addition Mallard parls SPrand Addition Lot 21 elk - I Parcel #10 47251 210 01
Owner 5treet 1671 Mallard Drive State Eagan, NW 55122
71 -?tLL
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 100
STREET RESTOR. -376
GRADING
SAN SEW TRUNK ?.j 7
,t6EWER I.ATERAL
WATERMAIN
*iNATER LATERAL 1991
WATER AREA
STORMSEWTRK 1981
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
? . .
• 4..•
• (ter#if ira#it uf (Orrupanry
Citp of (Eagan
Drpartrnrtit of iuilbtng AwpPrHna
This Certificate issued pursuarct to the requiremenu of Section 306 of the Unijornt Building
Code certifying thar at rlre time of issuance this structure was in compliance with the various
ordinances of the City regulaling buiJding coMStruction or use. For the fo!lowing.•
use a.ffi?bm W =,-?GAR Mg. termit wo.
o-„wKy ryP R3 zoming nisuia Ri Type com.
o. d Bu&.i n-''M- U' Gf. aM?-R' nam= (,4`,25 I'E..CjpLLI'1 P,%,','
B? ? . .. r!i':ht'."t'._? '? :• 2 ?.^.?.-.,?rti.:'
I.ocality
Dlkte:
Bulding Official
POST IN A CONSPICUOUS PLACE
A?
(ttrtiftr?te of (Orrupanxy
titp of eagan
lnp#iMl't11tPttf t1# llTllittttJ jwPt#Ltiit
This Cerfificate issued pursuant to the requirements of Section 306 af the Uniform Building
Code certifying that at the time of issuance Phrs structure was in compliance with the various
ordinances af the City regulating bui7ding consirucrion or use. For the fo!lowing:
Use Classifinuon ?, .'?' C? Bldg. Permit No. =
Otcupncy Type R3 Zaoing Distritt Type Crntst. vr
Owner of Etilding ,qddreas MME, P,111,
ew"ng Addrcss Loc,Lty 121, $ 3. WARD Pf: 7I-1l
neu:
Huilding Ofriaal
POST IN A CONSPICUOUS PLACE
.?
'. CITY OF EAGAN
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Date MAY 1 ,19
Site Address OFFICE USE ONLY
LOt Block Sec/Sub. On Site Sewage _ Occupancy
MWCC System _ Zoning
PBrCeI No. On 8ite Well _ Type oi Const
City Water _ (Actuaq
¢ Name (Allowable)
W * of Stories
3 Address Length
? Ciry Phone IV5a- 9803 Depth
S.F. Total
, p Name Footprint S.F.
? 4 Address APPROYALS FEES
? City
Phone Aasessments _ Permit
?.6 Water/Sewer _ Surcharye
yVj W Name Police _ Plan Review
_ z Address Fire _ SAC. City
u Engr. _ SAC, MWCC
? W City Phone Planner _ WaterConn.
Council _ Water Metar
I hereby acknowledge that I have read this application and state Bldg. Off. _ Foad Unit
that the information is co?rect and agree to comply with all applicable APC _ Treatment P1
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee 7oTaL
A Buildino Permit is issued to: __ • on the express condition that
all work shall be done in accordance with all ap! 'icaple State of Minnesota $tatutes and City of Eagan Ordlnances.
Building Official
__ Permi? No. Permit Holder Date Telsphone ?t
Pl ,? / I
H.
7A
E l Sxf ? X/,
Softener
inspection Dats Insp. Commenta
Foatings I ?Kl
Footings II
Foundation 2 A yr''-
Framing 6? ?
Roofing v
;
Rough Plbg. 4e
T
ough Wtg. 4?f??
1.,0 gfs ? ? ? ,
Fireplace
Final Htg. % B
-
Final Plbg. ?
Bldg_ Final ?• ??? ?- , `
Cert.Occ.
?
Temp. lP ?. ?
Deck Ftg.
Deck Frmg. j • ` ?
Well
Pr. bisp.
• PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
CONTRACT PRICE: PHONE: 454-8100
Block
? Name Sa t- 43.dE b_T?
a?
? Address SC,L? f1A G r.
c City ,ftz'
Name Nf r. 6- r.u e. xt
3 Address fL- 'T =?J • Ll.h R P?
O Ciry ,? ?4A - Phone
COMM/IND FEE - 136 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
-^_?J?? ??
SIC'aNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT q EU' '-A/
RECEIPT ri 3 4 ? Z9
DATE C_n - 1 'v • Z1
BLDG. TYPE WORK DESCRIPTION
Res. New X?
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
*4 Water Closet - $3.00 $
?Bath Tubs - $3.00
??Lavatory - $3.00
--4-Shower - $3A0
-LKitchen Sink - $3.00
Urinal/Bidet - $3.00
'
1-Laundry Tray - $3.00
-,2-Floor Drains - $1 50
I_Water Heater - 51.50 ; -50
Whirlpool - $3.00
Z Gas Piping Outlets - $1.50
(MINIMUM - i PER PERMIT) ?o
?SoRener - $5.00 S `
Well - S10.00
Private Disp. - $10.00
_.';_Rough Openings - $1.50 H "
FEE: 3cl • J U
STATE S1C: • J ?
GRAND TOTAL: ?? 0 ' 00
-f-_... _ _ _ . . _. _ ._ :. ..,.
PERMIT # ? C? '.•, MECHANICAL PERMIT RECEIP7 # f f <'
' CITY OF EAGAN
3830 PIL07 KNOB ROAD, EAGAN, MN 55122 DATE:
J
Site Address • ` BLDG. TYPE WORK DESCRIPTION
Lot Block ?- Sec/Sub?, Res. ? New X
- ?
Name Mulk Add-on
?
(E Addre" Comm. Repair
? c City X, ;Ps?i.,. r? f',,,k1, Phone 3- ? Other
?
, L
Name ? .. FEES
RES. HVAC 0-100 M BTU
-$24.00
f 3 Address ADDITIONAL 50 M BTU - 6.00
O City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTtON) ;
GAS OUTIETS
M
IM
M
P
PERMIT '
(
- 1
)
IN
U
ER - 1.50 EA.
I TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLfES
Boile TOWNHOUSE & CONdOS - RES. RATE APPLIES
r M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond, M BTU MINIMUM CaMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT -
50
Vent CFM (ADO $.50 S/C 1F PEAMIT PAICE GOES .
'
Gas Piping Outlets # / • ! ?- $?? BEYOND $1,000)
Other ?, -- . •
FEE: i ? ?
? `} ' ? I ?
`
,
? •.
, , ? ?
- `e
S/C: - SIGNAT E OF PERMITTEE
TOTAL
FOR: CITY OF EAGAN
i
BUILDfNC PERMIT
To be used for DECI
CITY OF EAGAN { A
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 •? +'? ?? a
PHONE: 454-8100
Receipt # ???
Est Value Oate
Site Address 1671 MA[1.ARD Qit
Lot _21_ Block I Sec/Sub. ???.o.: o°a.^. PARK 2NE
Parcel No.
5 Name 10MAERT W C8AKILRS
3 Address 1691 llA1.i.AO UR
° City 1U?W Phone 43I-9a03
Name _
Address
Name _
Address
Cilty _
Phone
Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with all applicable State ol
Minnesota Statutes and Giry of Eagan Ordinances.
Signature of Pertnitee?;'
A Building Permit is issued to: UZMRT WCiAMUM
on ihe express condition that afl work shali be done in accordance with all
applicable State of Minnesota Statutes and City ot Eagan Ordinances.
Building Official '_
I ?
OFFICE USE ONLY
Occupancy - FEES
Zoning -
(ACtual) Const _ B1dg. Permit 25s00
(Ahowable) '- Surcharge _.50_
* of Stones
Le^9th 24 t Plan Review
DePth -
--?? SAC, City
S.F. Total _
SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
City Water _ Acct. Deposit
PRV Required _ SNV Permit
Booster Pump - S/yy Surcharge
TreatmeM PI
APPROYALS
Road Unit
Planner - Park Ded.
Council -
BIdg.OfL _ Copies
23
30
Variance .
- TOTAL
Permit No. Permit Holder Date Telephone k
WATER
SEYYER ,
PIUMBiNG
H.V.A.C.
EIECTRIC
InspecHon Date Insp. Commerits
Footings I
Foundalion .
Freming
Rooting
Rough Plbg.
Rough Htg.
Isul.
Firepiace
Finel Htg.
Orstal Test
Final Plbg• Plbg. Inspectw - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Dedc Ftg. . ? • ? S
Dedc Final ?• 7-1-
weli
Pr. Disp.
CITY OF EAGAN Permit No: " Date ?17 -87
3830 Pllot Knob Road Meter No: 3 Size:
P.0.13ox 21199 Reader No: Date:
Eagan. MN 55121 ;
Site Address: _ 1671 "Tal 1 a 1 Uivp 1.91 nl P al 1pr j P TT
Plumber. StaCe r<echani al
Conn. Chg: S_ ? 5_ Q ?\A/ AQ?IRy?9: •?
Acct Dep: ? N???? i
Permit Fee: ,` B di Iflg call Ifl
9ec ?t--?.6j, ¢BP WF - EL . T?I?r'eGAS Eft
Surchar y with the C?r ol Easan
Tr. Plant n e to co I
Meter.
WATER SERVICE PERMIT
,-.- _ - -- ?-:? .
CITY OF EAGAN Permit No: 3826 Date: E' 17" s7
3830 Pilot Kpob Road Meter Na Size:
P.O. 9ox 21199 Reader No: Date:
Eagan, MN 55121
Owner.
Site Address: 1? 7I ''ailard D ive I21 Y:l '•tat 1 nrd Pk TT
Piumber. ' `a t ? te Mechanical -
Conn. Chg: S 4_ 00; d
Acct Dep: 1 ` - nand
Permit Fee: tlflnd _
Meter. r- 7TQ4Zoning: -
Surcharge: - 9 0}?j
Tr. Plant 1 :n _ na= A
No. of Units:
I agree to comply with the City ol Eagan
Ordinances.
WATER SERVICE PERMIT
-- = i
OF EAGAN SEWER SERVICE PERMIT
r+,
PNot Knob Road
3ox pERM1T NO.;
,21?99
n, MN 5511 DATE
ig: s No. of Units:
. . . ,ontr .
agrse io canPh with the CRy M Ea"n
By .----
Date of Irnsp.: -
Insp.:
- 1uv.
5?5.
Connection Charge: --?-
Account Deposit: --.'T
Permit Fee:
Surcharge:
Misc. Charges:
TotaL• ?
Date Paid:
CITY OF EAGAN rJ° 13 516
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt ?13 d / 9
# / ?
TobeuseCfor SF DWG/GAR Est.Value $105,000 Date_ MAY 1 ,19 $7
SiTeAedress 1671 MALLARD DRIVE
Lot 21 Block 1 Sec/Sub. MALLARD PK 2ND
Parcel No.
x Name HERBERT W CHAMBERS
= Address 16625 FLORIN AVE
? City ROSEMOGNT phone 431-6674
,o Name G.A.P. CONSTRGCTION
?a Address $328 BLOOMINGTON AVE SO
0? City BLMGTN phone 854-4028
¢
w
u
z
w
Name _
Address
City _
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 Sta 1 5 ai d City of E ga ?/'S inanGgs ?
ll.,
Signature of Permitte -?(1'?'
A Building Permit is issued o: G.A.P. CONSTRUCTION
all work shall be done in accordance with all a ic le State of I
Building Official _ ;4
OFFICE USE ONLY
R3
OnSiteSewage Occupancy
-
- -
-
MWCC System y Zoning
- Rr
On Site Well Type W Const
City Water X (qchaq Y
(Allowable) V
# of Sfories _
--
length 69
Dep[h ?R
S.F. Total
Footprint S.F.
APPROVALS FEES
? 518.50
Assessments Permit
WatedSewer _ Surcharge 52.50
Police _ Plan Review 959 _ 95
Fre _ SAC, City ?40
Engr. _ SAC, MWCC 525.00
Planner _ WaterConn. 525.00
Council _ WaterMeter 67.00
BIdg.Off. _ Roetl Unit 305 _ (10
APC _ Treatment P7 180. DO
Variance Parks
' CoPies
??5
TO7AL
on the express condition that
Statutes and City of Eagan Ordinances
"?r
BUILDING PERMIT
To 6e used for DECK
CITY OF EAGAN Np 195 19
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?
PHONE: 454-8700 /1 ' { ? ?/G?'
Receipt # ??? ?7 ?
Est.
Site Address 1671 MALLARD DR
Lot 2 1 Block I_ SeGSub. MALLARD PARK 2ND
Parcel No.
W Name HERBERT W CHAMBERS
; Address 1671 MALLARD DR
° Cit
y EAGAN
Phone 452-9803
o Name SAME
.
o?
Address
City Phone
ww Name
Address
aw City Phone
I hereby acknowlege that I have read this application and state that ihe
information is correct an agree to comply wiM all applicable State of
Minnesota Statutes a ity Eaq n O{{{tltltl ces.
of Permiree ?
Signawre
A Buileing Permit is issued to: HERBERT W CIiAMBERS
on the ezpress contlition that all work shall 6e done in accordance with all
apphcaGe State oi Minnesota ?Sptalutes and Ciry of Eagan Ordmances.
Building Oilicial 4 n 11 Jl {JD?
Oaupancy
Zoning
(Actuap Consi
lA1lowable)
4 ofSiones
Langlh
DeOth
S.F. Total
5 F. Footprints
On Sne Sewaga
On Site Well
MWCC System
Ciry water
PRV Reqmred
Booster Pump
APPROVALS
Planner
Council
Bldg ON.
Vanance
OFFICE USE ONLY
- FEES
- Bldg. PermM1 25.00
- Surohar9e .50
_2A! PlanReview
_202 snc, cny
_ SAC,MCWCC
Water Conn
- Water Meter
Acci. Deposn
5/VJ Permit
- SM! Surcharge
Treatment PI
Road Unit
- Park Ded.
Copies
- TOTAL 'L5.50
-24;?;T REQUEST FOR ELECTRICAL INSPECTION . Es-ooooi-os
% L'
1 See instructions lor comOlating this (orm on back ol Vellow copy.
US ?f--?
l?,l? ' S "X" Below Work Covered by 7his Request
AdJ Rep. Type o1 Bwltlina Aoobancea Wired Equipmenl Wired
Home Range Teinpoiary Service
Duplex Water Heaier Lightmy Fixtures
Ap[ BuilAing Dryer Electne Heatui
Commercial Bldy. Furnace Silo Unlunder
Industnal BIAg. Air Conditioner Bulk Milk Tank
Farm ome, Veai v ome,r &uenNl
t r.i ucu(y Other Oth(.r
Compute lnspection Fee Below
p Fee ServiceEnVanceSize H Fee Feeders/Sublee.ders a Fee Cucwts
',tM 0 ro 2100 qm s 0 to 30 Am s 0 tn 30 Am s
Above 20 qn?ps 31 to 100 Amps X11 37 to 100 A rnp
4
ming Pool Above 100__Amps Above 100 m?s
iormers Irrigation Boon-?s Pur[ial/Other Fee
gns SpeciallnspecLOn S _ ^
Nemarks TOTAL KE`
/ I dfll
\ / W
flooeh-m . ? Date .
s th pee Elac
inctor, heraby
certrty thet Ihe above
Pinal (specLOn hes been
da.
? ??/,!?_.
fhin reaueat voiE 18 months imm
1B'll%1I1[I15 IfOT,d ?/?/?+ ?
D 2$6 05 '?/ .31 ;hGG ? ??.
RenLJest Date "
_ 1 2 Q
? Fre No: Rouph-in InsVe.cUOn
e wredt
?Reatly Now Will Notify Inspec
«?? M1hen Fead
? ,J
Q Yes ?NO y
?Lmensod EleMncal Contractor , I harebV re0uest inspaction ot ebove
Owner electrical work installad at:
SVeet Adtlress, Boz or flou N:
`ll ?
k C.N
L=
J
r
aal t
ecuon o. Township Name or No. angc No. CQUn
.,Te
/T ko-M
Occ.p nt IPRINT) Phone Nn. ,
PowerSuD?uer Address -
? 0 300-. & *w? ? ?
Elac wal CnnUaa or (ComOa Nemel
P?`TQu.?xfi,'?,? Crle` ?B? I I
?S?eR?
Contruror' Lmense No.
,t
n ?I 4 B-2-
Mailinp A{idress ICont[ ctor or Own r Makong Insl
V 1 al aLOnl ,
Authonzed Signature IConhactor wner Making nstallahonI
ly fhone Number
L
. zo-GZ6
MINNESpTA STATE BOAPD OF ELECTqICITY THIS INSPECTION qEQUEST WILL NOT
Gr.gga-Mitlwey Bldg• - Poom N-797 BE ACCEPTED BY THE STATE BOAflD
UNLESS PNOPEP INSPECTION FEE IS
1821 Uniwrsitv Ave.. SL Vnul. MN 56104
Phona(612)642-OB00 ENCLOSED.
elF n o
/6 7/ /1a /? arc? k?' r
V'd ?R r ?? a nc?
•
0
F 1991 BIIILDINGIIILICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
?
%
?
COMMERCIAL ?
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITB SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PIGKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MTJST SHOW A LICENSED PLUMBER.
To Be Used For: -v t k •
Site AddYess 16,11 m2lkrcl L"?-.
Valuation: Date: 1/// 'P/y/
OFFICE USE ONLY
Lot 9-1 Block I
Parcel/Sub MAJ P0.A.I QWqv"
Owner Herbe,rl V CkZmb'e`rS
Address 1671 malIard bV'.
City/2ip Code F-n ? ?? 1,2 ?
Phone 6? 1'2) /IS 2 -qg0 3
Contractor _
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length o??r
Depth
S.F. ToCal
Footprint S.F.
APPROVALS
Planner _
Council
Bldg. Off. S '>iz9/
Variance
Dn site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
FEES
Bldg, Permit ?S.aD
Surcharge 13-0
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Pexmit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL a? O
i?'u ""i agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
TRi° ? ? D 15' o si j t '`t?I"Aa? FOR' '
.
???????????? ?
?? ????? ???? ??A1V,;ERS ?
? 4655 NICOLs R0AD ?
s EAGAN, OvilA1NES0TA 55122
SCALE:
6D
U)
?
I 2-1 .,
@'?? ?
B'L
??52
I?` _ 30 o\
S?o ?2
?? / I .
LOf 21
-? ? ?-
\
0
??N 4 A`.?E
\ \O r
.4N? ?
ri?, `U? ?? „
4503 0
N, O ? g023?? E 170
z
?
0
0
.tq,
m
flKiVt' r
? .?_--•{?'
PR IERTY DESCReP-rIoN
LOT-ZJe, BLOC§4?.._, 3 'T
MALLARD P,A,RK SECOiVL) ADa.
accordinq to tha roc"ded piat 4twreo4
DAKOTA courgr, qp;,,,,esWo
LE
o pF-Ms3fES IROE6 MO+ltJMENT
o O£P30TES VYOOD Hija Si.Y
DEIdOYES EXISI'i9dG SPOT
ELE Vp,TION
DEMOTES PROP(zSED sPOT
ELEVATIOP9
4e,- DENOTES DRAINAGE OIRECTiON
i iwcby cmrEi4Y ths9 Y@aYs saxVeY9 Pton oP
ropnrt woa pregcaG1 by me or vndar my
dSrwst supmrviaion and thaP I qen a duty
RegisPeeod Lond Survegor undmr ftro
Laara o4 tF?o 54aie of Miedeiesota
PROF''OSEI7 G#=;A'E FLOisR ELEVAY10N '?
?O?'?iSED r ii?5s ?'L06m° ELEVATION =
PROPQSED Bi4SEMEP0T FLOORt *
ELE VAT9 ON
NOTE: VERlFY ALL FLOOR HEiGHY'S WIgH
FINAL HOUSE PLq4S
BPa810y J. nw9n, PAf1. Reg. P60. 1M30
fic?4'6? ? $./ZaZ&%d
CITY OF EAGAN
3830 PIIAT RNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
Wl
FOR CITY USE ONLY
PERMIT #
RECEIYT
DATE: W
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6
Y TOWNHOMES/CONDOS WHEN PERMITS ARE REQOIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON ?
REPAIR
OWNER NAME: TTCrbL,?--? ChQpniker?S
SITE ADDRESS: lpG1AlCoh¢ l?J h
IAT: BLOCK ? SUBD.c-?Yl?'-?C
INSTALLER: lJaYll-Qi-S 5UGL?4Sid-e
ADDRESS: 7630 I.?I7S?? S ? ,
CITY: !/Cl,ZIP: S-'-, laW
PHONE Y?3I"7U v/CJ'
FEES
ADD-ON MINIMUM 15.0
HVAC 0-100 M BTU 24.00
ADDITIONAL SO M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $ /S, a a
STATE SURCHARGE: .50
TOTAL: $ S?` d
SIGNATURE OF PERMITTEE
G li ) / y -2. °?}''?'j h)'?'
G94?f?RCYAi.f?1pII$''RTA2:ii PLEASE COMPLETE THZS PORTION FOR ALL COMMERCIAL/INDUSTRIAl BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LVT: BLOCK _ SUBU.
INSTALLER:
ADDRESS:
CITY: ZIP: ,
PHONE #:
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25. "v"v i4iNIi4UM FES.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
( S IGNATIJRE )
CITY OF EAGAN
Cities Di ital uality 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.
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• 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN f l;?S, a,s--
? 3830 PILOT KNOB RD - 55122
651-681-4675 ? G
?--
New Conshuction Reaulrements Remodel/Reoalr Reauireme 5
Ms ?
? 3 regisfered sHe surveys showing sq. tt. of lot, sq. k. oF house 2 copies of plan 1(- a'i ')
and gU roofed areas (20% maximum lot eoveraae allowed) 7 set of energy calculafions for heated addilions
D 2 copies of plans (show beam 3 wlndow sizes; poured ind. design; etc.) 13He suney for exterlor addRions a decW
? 7 set of energy calculatfons
? 3 copies of hee preservaflon plan X lot plalted aHer 7/1/93
DATE: ??`6?q 7 CONSTRUCTION COST: 6-7 SS Q. SiS
DESCRIPTION OF WORK:
4- 022
STREETADDRESS: /4 7/`?'/".?GCa?.? Ay?L
LOT: BLOCK: t SUBD./P.I.D. #:
Name :CL'? N -Vj? Phone #:
PROPERTY Las} Ffrit
OWNER . , _ n
Street
City ? State: X Zip:
Company:?a?-T '`QAJ !.%m??`?a71 Phone #:
(area code)
CONTRACTOR
Sheet Address:/40 a???%?hf -? ? Lieense 00 33 6cp.3 ao
City State.%? Zip: ? 33
ARCHITECT/
ENGINEER
Telephone #: area code (
Street
City
Name:
Registration B: _
State: Zip:
Sewer 8 water Ifcensed plumber freauhed for new conslructlon onlv):
4naMy applies when address change and lot change is requesfed once permR Is Issued.
I hereby acknowledge that I have read fhls applicatlon, atate that the informaflon is eonect, and agree to comply wlth all applicabl
ftate of Mtnnesota Statufes and City of Eagan Ordinances.
Signature of Applicant tlY ??- ??
OFFICE U5E ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
O 34 Repair 0 38 Demolish (Inte(or) ? 42 Reroof
* Give F'CA handout to aaplicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee r?- Sa
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: I a z'i5 a ET
Valuation: $
.
SAC Units
% SAC
APPLICATION FOR PERMIT
CITY OF EAGAN
SEWER AND/OR WATER CONNECTION
e
1) PROPERTY ADDRESS:
2)
LEGAL DESCRIPTION:
*T07E: PA)WTTf OF FFE AT TIME OF
AerracrTIorr DoFS Nom oOsizTUTE
npPxovat oF PERMIT.
rNSrEMoiv oF sENM raro/CR WkM
rnSmar.ramrONS WIIy IVOr EE S(HED-
UI,FD UN'1ZL PERMLT AAS HM
APPROVID. '
Lot B ock Subdivision or Tax Parcel ID )
IF EXISTING 51RCL'iURE, DATE OF ORIGINAL B[,'ILDING PERMIT ISSL'ANCE: .
PRFSENP 7ANING/pROPOSID LSE: (M? Year)
q COMMERCIAI./RETAIL/OFFICE ? R-1 SINGIE FAMILY
? iNDLSTRLAL Q R-2 DLPLEX (Zt.o Lhits)
? ZNSTITUTIONAL/GOVERNMENr CD R-3 70WNHOOSE (Three + Units) ( Units)
. Q R-4 APARThEN'P/COAIDOMINIUM ( Units)
6AME:
r.DDREss: AKL/G / 9e -? 'Af- 5,4412,e A1 hc.
CITY, STATE, ZIP:
PHONE:
For Cit
y L?se
3) • ?: ?• ?_ n"E
? Pltm ibers License:
ADDRFSS: L? r Active
CITY. STATE, zIP: ti,..7jb N?otlrecorded
k PHONE: 'y(t.? '-,?'2a a MASTER LICENSE# t??tyal
4) ?? b..n?a?•
NAM:
ADDRESS:
CITY, SfATE, ZIP:
PHONE:
.5)
CONNLTION RO CITY SEN]ER ? C==ION TO CITY WATIIt rl prPHER
6) '? • ?? [? PI.FASE HOLD APPROVID PERMIT EC)R PICK-UP BY ONE OF ABOVE -- --
? PI.EASE MAIL APPROVID PERMIT ZO 1, a;) 3. Q. p,B(3VE
(Circle one)
7) a n •
FOR CITY USE ONLY .
PERMIT # ISSUED
D?Z?
Pd w/Bldg. Permit FEES:
$ $ h2 •S Z) SEWER PERMIT (INCLUDE SURCHARGE)
$ $ l(`)-S-v WATER PERMIT (INCLUDE SDRCHARGE)
$ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ JS,U Z? ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER '
$ 4 0,•?? ? $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ 0 $ ? /• Q -o TOTAL
7,31e 2? c-S
RECEIPT RECEIPT
DOES LTILITY CONNEC TION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
Q
NO
DIVISION. LIST AS
A CONDITION.
SUBJECT TO THE FOLL OWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ? 4' 0 7
518 •7U'r
52•50+
259•25+
625•OU+
? 527•00r
67•00+
? 305•0U+
180•00+
2 , 532•25*
1987 BIIILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
I37CLIIDE"2 SETS OF PLANS, 3 CERTIFICAiES OF SOAVEY, 1 SfiT OF ENERGY CALCOLATIOHS
NOTE: ADDRESSES FOR CORNEE LOTS - CONTRACTOR/HOMEOANER MIIST DESIGAATS WHICH ADDRESS
IS DFSIRED. NO CH9NGBS WILL BE ALLOWSD ONCE BIIILDING PEAMIT IS ISSOED.
MOLTIPLE DWELLINGS - RFSIDENTIAL RENTAL 0NITS FOR S9LE ONiYS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECK iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
t SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used F
r:N 1 Valuat ion:
-?
Date: 7
?
Site Address - OFFICS USE ONLY
Lot 2? Bloek 1 On Site Sewage Occupancy
??
??
?
??? MWCC System Zoning ? I
???
Parcel/Sub
1?S-0?[!l.e.-..1?J ? IC On Site Well Type of Const
I 1 II
?
??
? City Water ? (Actual) Q
-
-
Owner
yCrber
?f.
,vt2m I?e.rS (Allowable) _v_
li of Stories
Address 1(a(a2.5I-LriN /Lz Length
City/Zip Code ^? ?`0Se,mouJ, MN. 5506$ Depth
S.F. Total 3 B
Footprint S.F .
Phone q31-l?1??4 APPROVALS FEES
Contractor LA.p epNStru cT10 0 Assessments Permit 51,5.
1 Water/Sewer Surcharge ?Z.O
Address 932$ $lottiml? `t" S. Police Plan Review ,ZS?.zS
Fire SAC, City (Gb.
City/Zip Code , oa M . 5$410 Engr SAC, MWCC !5-zS
Planner Water Conn S2S
Phone G 12- 9., Sq -40 2 R Council Water Meter (07 .
Bldg Off Road Unit
Arch./Engr. APC Treatment Pl I alO,
Variance Parks
Address Copies
TOT9L
City/Zip Code
S?
Phone #
?
-706
.?
2 I x'30 ? 3o x
-4-
24-?22 ?? ?Z8 ? ?2-
4-45¢4..
Co33?
(043?G
TRI-LAND C0. SITE
SURVEYING
SERVICES HERB
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
;_?? I i?)
i It*
SCALE
s?
2.c
n
?
U')
PLAN FOR:
CHAMBERS
?,O ?r?-'? 96+I
???? ?
1?? - 30? SZO? ZZZ
/
/ q L0
/
? 10a19
?
\ I
\ oL)
m-A 'oN \o ?,056
z
\ So=
i?
I
f 21 I
?
? .
?l?
` ? `Y
z
N
0
O
?
m
?-
/ -v-
L= 66 26 „ S0?
=17° 43 03 0
i6og0 3„E ?
N'r2°52 2 DRIV
PR??
MP?'L '" ?+ a r 92?
MALLARD PARK SECOND ADD.
accordinq to ihe recaded plat thsreof
DAKOTA camty, Minnesota
LEGEND
o DENOTES IRON MQIiUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
1 hxeby cerfify tAat this swvey,plan or
reporf was preparsd by me or under my
direct supervision ond thaf I am a duly
Repisterad Land Surveyor under the
Laws of the State of Mirmesofa
PROPOSED GARAGE FLOOR ELEVATION= ?Q?J!r3
PROPOSED FIRST FLOOR ELEVATION =! y? S
PROPOSED BASEMENT FLOOR =
ELEVATION
NOTE'• VERIFY ALL FLOOR HEI6HTS WITH
FINAL HOUSE PLANS
Bradley J. 3Wnson, Mn. Rep. No.15235
Date - Zlt7 ZR?
TRI-LAND C4. sITE
SURVEYING
SERVICES HERB
4655 NICOLS ROAD
EAGAN, MINNESOTA 55122
!_Oi iC)
N
SCALE: I" = 30' oo?z' 2
PLAN FOR:
CHAMBERS
3* //
/
/
lDnr9
W
LO ?
?
96•f
LOT , 21 I
Y?'Z3" E
?
z
N
Oa
-
O?
m
q '0?
?J
-
.26 ?? \00b-
p=1? 43' 03 ?
O DRIV
0
PR ERTY DESCRIPTION Mp,LLPR ?N? q7,q
L0T2.L, BLOCKI, S
MALLARD PARK SECOND ADD.
xcordinq to the rscorded plaf tMreof
DAKOTA cawy, Minnssoto
LEGEN
o DENOTES IRON MONUMENT
n DENOTES WOOD HUB SET
DENOTES XI
E
IAT
N?T
E
L
E
IO
V
DENOTES PROPOSED SPOT
ELEVATION
4e,, DENOTES DRAINAGE OIRECTION
I hsnDy eertity that ihis surveY,Plan or
report was prepored by me or undor my
direct suprvuian and that 1 am a duly
Roqistered Land Surveror undW iM
Laws of fAe Stafe of MinnOwta.
PROPOSED GARA6E FLOOR ELEVATION = ZOOK
PROPOSED FIRST FLOOR ELEVATION =
PROPOSED BASEMENT FLOOR ?
ELEVATION
NOTE * VERI,FY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bradley J. %Wnson, Mn. Rey. No.15238
Dafe * 2/27ZR2
Iii
Cities Di ital sualit,y 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.
. ,
d
ftE7ERHINE 1?ORY,IIIG SDUARE FO OTAGE OF EACFl:
--
TDTAL ExrosED uALL AREA,;•„,,,, Z? sq ft x "U"
--
TOTAL ROOF/CEIIING AREA........ 1;)rJ
3f' sq f t x "Un 4M* 6 r
L
1 1
TOTAL EXPOSED 11ALL AREA CALCUlATIONS:
Total exposed wall
area above floor,,,.,,,, _????'?) sq ft,
a) Total wall window area: ,
J„7glazed......
sq
ft
x
??U"
?13 .
--
glazed...... _ sq ft x "U" _ - ? --
b) Total door area
......... _-r-- 59
ft
x -
??U?? -
- - -
- ---
-, ???--
Z---
c) z
Tota) siTding glass door area:
9lazed......
sq
ft
x
??U"
• glazed...... -- sq ft x "U" ---
d) To[al,fireplace wall area .? sq ft x "U"
e) Total wall framing area ?
(Averaoe 10$) .........
sq
ft
x
"U'l
,
rL?--
?•, `?i_
f) Tota) net wall area a6ove
floor (Insulated)....... sq ft x"U"
ZI? % = J? l" 7 1
g} Total rim joist area...... sq ft x"U"
Total foundatlon -
area (Exposed)...._..... sq ft
h) Totat foundatlon .
wlndori.area............. sq ft x "U"
I) Total net foundation
area above grade........ sq ft x"U"
,
TOTAL a) thru 1)
v -
= Z?.G
If ltem #3 is the same as, or less than Itcm P1. you have met the lntr_nt of
S.B.C. seceion 6006 (e) 2.
Total cxpasca ?
roof/,ce11 inp arca........ sq f[ ? •
: . , . . • . ---
J) -'iotal,,,s?yliaht arca....... 9 ft x "Un - ? °
.. •
l:) Tota1 rpof/ccllinq framTng
.ly
fC X fiUll .?lil. /
arca (Avesa9e
. • ?t r
1) 7ota1 net insulatcd ' ?• •??j T`
rooflcelltng area..... 59 ft x"Un ?--?Z-° ?-
. . TOTAI J) thru 1) CI_h0 ]
total of 94 is the same as, or less tfian ??. you ?aJe met the Tntent of
3.C. Section fi6D6 (C) 1. •
_ ? . f.
ALTERtIATE Bllii_UING ENVELOPE DESIGN
o utilize the Yotal envelope system method, the values estab)islied by the sum
.f items JF3 and fh shall not be greater ihan the sum of items'R1 and 02.
. 1. ?-?-_? + 2. ^..------- ---- a -------
3•
: i
. ,
.
+ 4.
?
? . C E R T!'F '1 G A T 1 O N •
1 hereby certefy tfiaC C have caTculated ihe "U" Factors and "FY"
values hereinland thei the building fiere descrit» d ? ? exceeds the State
of Flinnesota Energy Conservation AcCe ?
?[51 nature ?
y-------
(Date)
?
Cities Digital Quality Control
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zoos RESIDENTIAL PLUMBING PeRmir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
srS. so
Date / ?_{Z / Q?
9
Site Street Address 1?I /Ui 4l(?CCI QC• ll? At vv Unit #
Property Owner Telephone # ( 6$'1) 4JI' q 663
Contractor .?-4tiL? Telephone # ( L'SI ) 43 `701 1
Address 5t w. City m?t'CS1 StateAt'f) Zip SS?L?r?
The Applicant is: _ Owner -S Contractor __Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-buiit I $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee, includes installation of a water softener andlor water
heater at the same time. if you are installing onlv a waier softener and/or wafer
? heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
I --
,
_Septic System Abandonment
_WaterTurnaraund (add $730.00 if a 518" meter is required) e?;
'`
? ?II
Other:
Water Softener ? Water Heater '-$ 15.00
_ new X replacement
Lawn Irrigafion _RPZ ,PVB -new _repair _rebuild $ 30.D0
State Surcharge $ .50
T
l $
ota
I hereby apply for a Residential Plumbing Pennit and acknowledge that the intormanon is compie[e ana accurate; aiai ine
work wiN be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand ihis is not a pefmit, but only an application for a permit, work is not to start without a permit and work wili be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
N1 ?v, k ,??;,?+a. /tA
ApplicanYs Printed Name AppficanYs Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA084657
Eagan, MN 55122 . Date Issued: 07/25/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1671 Mallard Dr
Lot: 21 Block: 1 Addition: Mallard Park 2nd
PID 10-47251-210-01
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: Permit closed without required inspection(s). Letter sent to applicant on 4/8/09. (pf)
If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Rybak Brothers Construction LLC Herbert Chambers
2206 East 117th Street 1671 Mallard Er
Burnsville MN 55337 Eagan MN 55122
(952) 405-8871
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.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
' I For office Use Icc
E~ rx=~ I I
Permit
City of Eann I
I Permit Fee:
3830, Pilot Knob Road
Eagan MN 55122 Date Received: j
Phone: (651) 675-5675 j Staff: I
Fax: (651) 675-5694 ___________I
INFLOW INFILTRATION PERMIT APPLICATION
4- Plumbing / Sewer & Water
Date: Site Address: 4 / ~Q G (a ✓ cl lcJi/. ~ri , f ll~/, J 12 2-
t
Tenant: V_ e ~r ~6V. i locV, 1 ~p Zy-S Suite
RESIDENT OWNER Name: 4e-V-N 1 %V. L'y C v>'tbeys Phone: 65-1 - 'I J Z-9 k0 3
I
Address / City / Zip: 16 7 a~~~ r l~r, h4rt 5 12- 2
Name: License
CONTRACTOR Address: I~ City:
State: Zip: Phone:
Contact: Email:
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
DESCRIPTION Description of work: llC - j 7~~_ f 1
FEES
$55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes f 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
p rmit; that the work will be int~\accordance with the approved plan in the case of work which requires a review and approval of plans.
iLA 0,4_-~j Vim-' . ~ic X
Applic nt's Printed Name Her ro e✓ him ~J--er S Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: ^Under Ground -Rough-In -Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA147317
Date Issued:12/28/2017
Permit Category:ePermit
Site Address: 1671 Mallard Dr
Lot:21 Block: 1 Addition: Mallard Park 2nd
PID:10-47251-01-210
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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: 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 -
Peter & Syndal Ortman
1671 Mallard Dr
Eagan MN 55122
Scherer Brothers Lumber Company
9401 73rd Ave. N
Suite 400
Brooklyn Park MN 55428
(952) 277-1600
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA162818
Date Issued:07/30/2020
Permit Category:ePermit
Site Address: 1671 Mallard Dr
Lot:21 Block: 1 Addition: Mallard Park 2nd
PID:10-47251-01-210
Use:
Description:
Sub Type:Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of house wrap and leave on site for final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Peter & Syndal Ortman
1671 Mallard Dr
Eagan MN 55122
(218) 343-8638
Twin Cities Siding Professionals
664 Transfer Road
St. Paul MN 55114
(651) 255-2844
Applicant/Permitee: Signature Issued By: Signature