4309 Metcalf DrCITY OF EAGAN Remarks
Addition River Hi Lot 9 Bik 3 Pa,cei '. 10 6 1Z,OO 03o na
Owner 22?? Street 43A9_MOtC?-j„?p?'iUE Stare Eagan,MN 55122
Improvement Date Amount Annual Vears Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
..SEWER LATEflAL
WATERMAIN
WATER LATERAL 1970 3
WATER AREA
STORM SEW TRK
*STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET UGHT -1980 67. $0 13.56 $
WATER CONN,
HUILDWGPER, 1 Q ( -21-
snc p 1 0 6
PARK
I
YIII.ACE.OF EA6AN WATER SERVICE PERMIT
?
3795 Pibt Nnob Rood PERMIT NO.: 1738 :
Eogon, MN 55II2 DATE: 5/20I75
Zoning: R-1 No. of Units: 1
Owner: W soz v. Corp.
Address:
Site Address: _ . d309 Mgtnalf
Plum6er: -Zionap6ofl P11a11b1t1 Co.
Meter Nn? Cormection Charge: 205.00 pd
Size: AcCOUn[ Deposit:
Reader No.: permit Fee: 10.00 pd
1 aq.ee eo cemply with tM Villoye of Eayon Surchazge: • SO pd
Ordinoeeos. Misc. Charges 60.00 Pd 5/8 meter
? Total:
gy Date Paid:
Date of lnsp.: Insp.:
YILLA4E OF EAOAN SEWER SERVICE PERMIT
3795 Pibe Knob Road PERMIT NO.: 2500.
Eogan, MN 55122 DATE: 5/20/75
Zoning: R-1 No. of Uni[s: 1
Owner: wi nAanr flnv ( Yf;p
Address:
Si[e Address: _A,?E?{H?l 1?FiYiH?Yt@e 439° AtOtsdlf
Plumber: ¢?pscn--AlwN ?ing Co
I oyree ro eomyly with ihs Villape af Eagan Connection Charge: 425.00 pd.
Ordimnem Account Deposit:
Permit Fee: 10.00 Dd
Surchazge: .50 pd
BY: Miea Charges:
Date of Insp.: Total:
Insp.: Date Paid:
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD • 55122
651•681-4675
New Construetion Reaulremenh
• 3 registered site surveys showirg sq. R of lot sq. R o} house; arW @II roofed areas
(20% mazimum bl wverage allowed)
• 2mpWs of pan showing beam & witWow sizes; poured fowid design, elt.)
• 7 setof Energy Calala6ons
• 3 oopies of Tree Preservation Plan H lol plaked aher 711/93
• Rim Joist Detail Optians seleclion sheet (bldgs wilh 3 a iess units)
DATE '??O V LU TION (EXCLUDING LAND)
.j JB SITE ADDRE:
IF MULTI-fAMILY
PROPERTY OWNI
TYPE OF WORK
APPLICANT ?
ADDRESS 141
PAGER #
0
P_
MW V LlS
vb N0
mdj'cvp" (J/'_
1??d0
loo
MANY UNITS?
FIREPLACE(S) _0
PHONE #
CELL PHONE # 61 ? '3 tL - H99 S FAX #
_1 _2 _3
ZIP CODE
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CA1'EGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RLTLES 7672
- New Energy Code Worksheet Submitted
Piumbing Contractor:
Plumbing System Includes:
Mechanical Contractor:
btechanical S}'stem Iiicludes:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovery• System
Phone #
Phone #
Fee: $90.00
Fee:
$70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read ihis applicotion, state that the information is correct,
all applicable State of Minnesota Statutes and City of Eagan Ordinanceff."k
Slgnature of
Certificates of Survey Received _ Tree Preservation
_ VVater Sohener _
Water Heater _
_ No. of Baths
RemodellReoalr Reauiremeats -
. 2 copies of pWn
. 1 set of Eneagy Calalatiorts fw healed additions
. t sAe survey for exterior additions & decYs
Phone #:
Iamrn Sprinkler
No. of R.I. Baths
Not
Updated 1/01
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N 0 25 Misceilaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) 0 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolltion (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Watei
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) _ FinaUC.O.
_ Footings (deck) _ FinallNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Srone
_ Insulation _ Windows (new/replacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
?
- CITY of EAGAN
BUILDING PERMIT
own.e .49-- •
.........................................................................................
Addreu (presen!) .L.?l.,,,'. w ....... 7....-
........................ ..........._.w.?i
Builder
Addreu
w i+
N2 3533
3785 Piloi Knob Aoad
Eagam Minnesola 55122
454-B100
Dsts ......:?..- 1 /- ?S
Biozies To Se Used Fos Fson! Daplh Helgh! Eef. Cost armi! Fee Remesin
?wnc- ?-? .
? y
.? G ??.3?ro
?9? S?
'7 C_ ?? LOCATlON /,72.,?0
or
`4 3o`I r??c rd"f 'b; - I 3 1 3 I g`/
This permit doas no2 aulhori:e !he use ot slxeels, raada, etleys or sidewalks nos doas it gite the owaes oe hSs agent
the xigh! !o ereele anp siluation which is a nuisanee ox whiah presenls a haserd !o the heelfh, aefelp, eonvenieees and
general welfara !o aapone in the eommunify.
TFIIS PERMIT MUST BE BEPT ON THE PREMISE WHILE THE WORK IS IN PRO RESB.
This is !o ce:lifY. !hal....:1???".'.:-?- .:............has parmieaion !o eree! a.<.....`-^^?.. ?Y...._4aL:: ............. ...... ...._upoa
the a6ove described premise subjecf !o the provisions of all applicable Ordinances foc !he ?Y3 of Eag?`
? .------ {a ? :1......°----......--- -. Per .......... ?°----?:??':._ :?.•-
.....- ........... ...._---.... ...... - ?- -. ..----°-°--...................
Mayor ? ? Huildinp Inspselor
)3
2 - -t? - `-lAii
'4Kv-e1h,11s
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PFIMT NO.: r, 74
The City of Eagan hereby grants to rav 1L We] rer ?*?-stinc rA/C [b.
of 4637 Cliicaao five So D+nls 554n7
14arell Construction
a Permit for: (Owner) Wirdsor nev.
1355rE. SigfriQ
attca? f, r. ? pursuant to applicatian dated 5/r, / 7 5
Fee Paid: 4^.00 dated this -"- daywl'? ? ",?Y ? 19 77
•
. ? .00 6/C
F` .
Buill
• .,[ .
Mechanical Permits:
Bid Total:
Jb 630 6-S
czTr eF E:;GAra
3795 Pilot Knob Road
Eagan, Dlinnesota 55122
S
PERMIT NO.: S64
The City of nagan hereby grants to nv,mpa„n pbmh{ng Co_
of 179m Ma...,er..ng. nivd_
3 nytmmrur_ Permit for: (Owner) w;„AQnr b„_ r,,,.p_
4305 and 4309 Metcalf
at 43ls_MQAnZqr ? pursuant to application dated r}l A#7t
Fee Paid: $ro on dated this ?n day of may , 19 7S •
1.50 s/c
Building Inspector
Mecha.nical Permits:
Bid Total:
SEDGWICK HEATING & AIR CONDITIONING CO. HeariNC JOB NO. fNZO
8970 WENTWORTH AVENUE SOUTH• MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECORD
ADDRESS r-
OCCUPANT
SOLD BY
MAKE
SEFIAL NO. THEF
VAL?
LIMII
LIMI7
FAN
PILOT NPE
IGNITION MODEL
PILOT TIMWG
PRESSy RE M1f?? ' PERCENT CO,
t7?
INPUT CFH x? PERCENT Os
STACK TEMP. 3 PERCENT CO
FORM 235 (REV. 1ll0B)
CITV M? ?.e'1 ..
OWNER INSTALLED BV
MODEL 3 - 7?2A - V "
INPUT
VENT SIZE
TYPE OF LINER - ?'
LINER SIZE I J
FIL7ER5: SIZE NUMBER r- Z5?
WIRING
TEST TAG
LIGHTWG INST. -
i DATE TESTED_. ?7? 1
G' ? t
(?, ? COMPANY TESTING_
?/
V NAME OF TESTER
FORM OISTRIBUTION:
JOB FILE VELLOW COPV - GIN
AYI t Cca l f, -450,
LOCATIONO" 0k&jA 1't'a-re---AII"
OWNER
n
MASTER CAR,D
STRUCTURE AND
LAND USED AS /NO4 AS- 't V
Permi}
No.
Issued Issued To
Contractor Owner
BUILDING ,15.43
PLUMBING . r-6q
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING G 7Gl
7
GAS INSTALLING
SANITARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION ? 7-3 CESSPOOL
FRAMING ? S TIIE PIELD FT.
FINAL
ELECTRICAL
HE.471NG
_
i DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER-4 (/lJ
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPOR.TS
TO BE USED ONLY IN EVENT OF OBSERVEC VIOLATIONS
PERMIT NO.
CONDITIONS Of CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
DATE OF INSPECTION
1:1 ACCEPTABIE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FICATION - I certify that I havP carefully inspected the above in which I have no interes[ present or prospective, and that I have reported herein
all significant conditions otserved to be at varianca with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPIETED
BUILOING INSPECTOR
DATE
c*qjLr' s.
:ity of eagen
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122-1897
PHONE: (612) 681•4600
FAX;(672)681-4612
MAINTENANCE FACIIRY
3501 COACHMAN POINT
EAGAN, MINNESOTA 55122
PHONE: (612) 681-4300
FAX: (612) 681-4360
THOMASEGAN
Mayor
February 6, 1992
CURTIS THOMPSON
4309 METCALF DR
EAGAN MN 55122
RE: P.I.D. #10 64400 030 03
Dear Mr. Thompson:
PATRICIA AWADA
PAMELA McCREA
TIM PAWLENtt
THEODORE WACHTER
Council Members
THOMAS HEDGES
qry Adminlnstwtor
EUGENE VAN OVERBEKE
CNy Clerk
The Community Development Department has received a complaint from a property owner
in your neighborhood regarding the storage of an automobile in front of your garage. A
site inspection reveals that you are storing an unlicensed vehicle which appears to be
inoperable.
I was unable to contact you by telephone on February 5. This is to advise that it is unlawful
to store an unlicensed and/or inoperable vehicle outside of a lawfully erected building.
Please see to the proper storage of this vehicle. I will re-inspect the site on February 12,
1992. Feel free to contact me if you have any questions. Thank-you for your cooperation.
Sincerely,
.
Michael7. 'dley
Project Planner
MJR/js
THE LONE OAK TREE ... 7HE SYMBOL OF STRENGTH AND GROWTH IN 6UR COMMUNITY
Equal Opporfunity/Aff(rmative Actlon Empioyer
CITY USE ONLY
LOT ` O BL I PERMIT #: ( Is?5 D
SUBD. l"11{?i??f AI11:? RECEIPT 1i: I 34-/5 /
RECEIPT DATE: I- ?O" 0cl
2000 MECHAN1CAL i'EfiMTf (RESID£NTIAL)
crrYoF saeax
saso Pu.or xNos sn
snsax auv 55122
6$1-6$1-4675
Date•
Complete this section on[V if you are installing HVAC in a single-family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BN
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surchazge .50
Total $
Complete this section only if you are remodeline, adding to, or renlacinp an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
_ New
?` Fumace
_ Air exchanger
Reminder: Call jor final inspection.
SITE ADDRESS:
_ Replacement
L
? Other
? Air conditioning
Other
Fee
State Surcharge
Total
$ 30.00
30.50
OWNER NAME: ?(Z e C> J T d Y L 2 PHONE #: 6 S I - R I?'?? O?
(AREA CODE)
INSTALLER NAME: PHONE #:
(AREA CODE)
STREET ADDRESS: „?nIner,MeI tteeTUlA_ B. AIA IW _-
ciTY: 181 ?,East 41 St SVeet, Suite A.
(812) 7241889
CITY USE ONLY
L _ BL _ PERMIT#:,
SUBD. RECEIPT#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
Eooo MEcHMtcAL PERMrr (coMMEtcliaL)
crrY oF EAsAN
3$30 PILOT KNOS RD
£AfiAN, MN 55122
651-681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: _ New construction _ Install U.G. Tank
_ InteriorImprovement _ Remove U.G.Tank
_ Processed Piping
When installing/removing underground tank, ca[I 651-681-4675 for inspectiat by fre marshal and
plumbing inspector.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaVinstallation = minimum fee
Contract price: $ x 1% = $
State surchazge
TOTAL
?
SITE ADDRESS:
(Base Fee)
calculate at $.50 for each $1,000 Base Fee
OWNER NAME: PHONE #: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE: ZIP:
SIGNATURE OF PERMITTEE
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cinr oF EAcaN
}A 3830 PILOT KNOB RD • 55122
651-681-4675
Newca,sm,cna,Reamremenrs aemod - - ,,;
? 3 regisferetl aife wneys ahowing sq. fl. of lot, sq. 0. o} houae ¢,. 6p 4 copiea d Plan
and gl( rooled areaa (20% mmcimum lol coveraae allowed) 1 sef of energy cdculatlom lor hepted admMOna
> s coPiea apcns (shoW ceam awindoW aizes; pa,rea ma. deaign; erc.) i ane wNey ia exroeor aamnaa a uecks
? t set ol energy calculatlons
D J coples of hee prefervallon plan H lof plalletl aRer 7/1/93
DAiE: 15 ? ?D CONSTRUCTION COST: ?7 70 ?
DESCRIPfION OF WORK: !(?/? n?? ?(>r ??? If muMl-famity bldg., how many unNs?
SiREEi ADDRESS: 11 KETrALF ?(/P-1VF
LOT: 1 t° BLOCK: i_ SUBD./P.I.D. M,-R t?J -e V I?- ? ? S 01'"--
Name: CLSnN ??O PhoneN:
pRQpE(ny Last Finf
OWNER / 1 7I ? ./_ t P-\ -
Sfreet
City ?ll A /y ?. ' Stafe: MA/ Zip:
?wf?1 E ?t?_.?.?1" ?o ?
company: ? !!l'?DrU pnone a: 5-/ 771-o;?b3a.
(area code)
corrMcroa meetAddress: /OSL l-F YWC-/rl'T1-) A UE uce„$er 6233nE,p.
ary 'ST• GUl I stare: 14 zip: 567 1610
ARCHITECT/
ENGINEER Company:,
Telephone #: (
Name:
Sheet Address: ReglsfraNOn N:
City
Sfafe:
Sewerlwater licensed plumber (H installina sewerlwater): Phone #:
Zip:
I hereby acknowledge fhat I hwe read this applicaNon, state that the informaHon is rrect, and agree to comply wilh all apptlcable Sh
of Minnesota Sfafutea and CMy of Eagan Ordinances.
Stgnalure of ApplicanY.
Certificates of Survey Received
Tree Preservation Plan Received _
OFPICE USE ONLY
Yes _ No
Yes _ No _ Not Required
AUG - 7
?.?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07. 05-piex ? 13 16-plex O 21 PorCh (3-sea.)
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Poroh/Addn. (4-sea.)
? 03 07 of _ plex ? 09 07-plex ? 18 Deck ? 23 Poroh (screened)
? 04 02-plex ? 10 08-plex ? 19 Lower Level O 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
O 32 Addition ? 37 Demoiish (Bldg)" ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLAN EOU5INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Engineering
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
Ciry Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 Ext Alt - Mun
? 33 Ext. AR - SF
? 36 Muw
Permit Fee
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
O c.J
Valuation:
SAC Units
% SAC
CITY USE ONLY
LOT ? BL (5 PERMIT #: ? ; ) J zn
SUBD. K 1 Va I11S vl TVl RECEIPT
RECE[PT DATE: -0p
2000 MECHANICAI, PERMIT (RE3IDENTIAL)
cxrx os €acaN
3830 PIIAT IINOB RD
EAGAN A'II7 55122
651-681-4675
Date:
Compiete this section oniv if you are installing HVAC in a single family dwelling, townhome or condo under
consuuction and not ownerloccupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outtets (minimum of one required @ $3.00 ea)
$ 30.00
6.00
State Surchazge .50
Total $
Complete this section onlv if you are remodeline, addine to. or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration _ Repair _ Other
Y Furnace ('-'?? _ Air conditioning
_ Air exchanger _ Other
Fee $ 30.00
crare Surcharge .50
Total $ 30.50
Reminder: Callfor inspections
SITE ADDRESS:
OWNER NAME:
INSTALLER i•tAME:
STREET ADDRESS: 81"O WWOMUT AINIMIB.901M
. _ _ sw.
CITY:
STATE: ZIP:
? !)E?: I) `? 7(I?Q S[GNATUREOFPERMITI'E ?
CITY USE*DNLY
L _ BL _
SUBD.
- APPROVED BY:
INSPECTOR
PERMIT #: _
RECEIPT#: _
RECEIPT DATE:
_ -' 2000: MECSANICAL '.PERMIT _(CObIdERCIAL) ,
CITY OF EAGAN
3830 PILOT 14NC8 RD
EAGAN, DIld 55122
651-681-4675
Please complete for all commerciaUndusUial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction _ Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When iasta!ling/removing underground tank, call 65I-681-4675 for inspeclion by fere marshal and
plumbing inspector.
Description of work:
Fees: 1% of conhact Drice OR $30.00 mtnimum fee, whichevei is greafec
Underground taak removaVinstallazion = minimum fee .
Conaact price: $ x 1%= S (Base Fee)
State surc6arge calculate at $.50 for each $1,000 Base Fee
TOTAL S
SITE ADDRESS:
OWNER NAME: YHUNr; iF:
(AREA CODE)
TENANT NAIv1E (IMPROVEMENTS ONLl):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER
ADDRESS: PHONE
(AREA COOE)
CIT'Y:
STATE:
ZIP:
SIGNATURE OF PERMITTEE
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - i
I For Office Use
City of ~a Permit I I
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff: _
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 26 r3 Site Address: 7 ~W_F Unit
Name: \I A IV L~~ IBS C7 KJ Phone: 6 1 Z- Z67 S
Resident/
Owner Address /City /Zip:
Applicant is: Contractor
Description of work: c~ l
Type of Work
Construction Cost: Multi-Family Building: (Yes / No
Company:c_~ S ~N11V~ e~~ Ccyt tW-Ar-CK~~ Contact:
Contractor Address: Vic W City:
State: m1 Zip: o Phone:
. License 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?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
i Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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.aopherstateonecall.ora
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 Stat Building Code must be completed wit ' 180
days of permit issuance.
X U') x 1
Applicant's Printed Name App . nt's i a ure
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA147278
Date Issued:12/22/2017
Permit Category:ePermit
Site Address: 4309 Metcalf Dr
Lot:3 Block: 3 Addition: River Hills 9th
PID:10-64400-03-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Brian W Larson
4309 Metcalf Dr
Eagan MN 55122--192
(612) 267-0755
Heating & Cooling Consultants Llc
46001 Hardeggers Ln
Cleveland MN 56017
(952) 461-5100
Applicant/Permitee: Signature Issued By: Signature