4359 Metcalf Dr, CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for ???' ADDjT'ONEst
Site Addiess 4JZy METrCALF WI
Lot Block Sec/Sub. '
Parcel No.
W Name CERALD A liEl.30N
? Address
? CiN LAGM Phone -
Name _
Address
Phone
FjW
W Name
?W
; Address
i W City Phone
I hereby acknowlege that I have read this application and state that the
inlormation is correct and agree to comply with all applicable State of
Minnesota Statutes and Gitypf Eagan Ordinan s. !
Signalure of Permitee ' ? ? ?
CERAI,A A !lELSON
A Building Permit is issued to: g
on the express contlitfon that all work shall be done in accordance with all
applicable State of Minnesot? Statutes and City of Eagan Ordinances.
Building Official ?
Receipt # ? t -'
;4' 000 Date MAY 18
Occupancy
Zoning
(Acfual) Const
N oi Stories
Length
Depth
S.F. Total
S.F. Footprints
On Site Sewage
on sae weu
MWCC System
Gty water
PRV Required
8oosler Pump
APPROVALS
Planner
Countil
Bkfg. Ofi.
Variance
QFFICE USE ONLY
M-1
1?M
.9 _ . . .
17893
FEES
63.00
2.oo
V=N Bidg. Permit
-2W
--W
surcharge
Plan Review
SAC. City
SAC, MCWCC
Water Conn
Water Meter
ACCI. Oep0.Sit
S/VY Permit
S/W Surcharge
Treatment PI
Road Unil
Park Ded.
Copies
TOTAL
b8.00
permit No, Permit Holder Oate Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
EIECTRIC .30 9,ZQ (.1?? ,S/ 9 9? $`/X GO
?
Inspection Date Insp. Comments
Footings I ?O pZ
Faundation
Framing
Roof"
qpugh Plbg.
Rou9h Htg.
W.
Freplace
Fin31 Htg.
Final Plbg.
Const. Meter Pibg. Inspector - Notily Plumber
Engr.IPlan
eldg. Fnai 9
Deck Ftg.
Dedc Final
Well
Pr. Disp.
? IC-ITY INSPECTION RECORD
OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. •:;'' ",'
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
t,i;
NiVFft ltIt.L S 97N ' (61?) Et€,H -!`Iwt>
PERNIIT SUBTYPE: TYPE OF WORK:
?
?
E
.
?-
FtPMARk°f;: F[3[?1'1??t? 4 .. ?F FOR ilkc'!5 001.V' ' ?
.-0:, ? ;,i
+?
Permit No. Permlt Holder aate Telephone N
ELECTRIC
il
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
FiOOFf(VG
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
I
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TES7
FINAL PLBG
FINAL H7G
ORSAT
TEST
BLDG FINAL
BSMT R.I.
6SMT FINAL
DECK FTG -5-t77 M.S
DECK FINAL -"
, c uF EAGAN Remarks
Addition River Aills 9th Loc 1 sik 4 Parce? ?00 MUM%
Owner ' Street 4359 Metcalf nr_ State Ea9an,11 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK
? SEWER LATEFAL ?
WATERMAIN
? WATER LATERAL 1976
WATER AREA
STORM SEW TRK
? STORM SEW LAT 1976
CURB & GUTTER
SIDEWALK
STREET LIGHT 1980
13.56
5
WATER CONN. _76
13UILDING PER. 4013
5ac 450.00 3403 7-9-76
PARK
Sewer trtmk ftr.,QOi i e i nn nn 3403 7-9-76
?
K 74$68
,r
ReOuest Date Fire . Rough-ln Inpeeclion Repulre0
(Yau must WI inspeelor when reatly)
en Roug??ln
i?s0ection Olhx Th
? qeatly Now ? Will NogHy In50ector
? Yea ? No Date ReeG
I'Alicensed contracror O owner hereby request inspection of above electrical work at:
Job tltlress ISlrael eox or Route No.)
i Ciry
??.
SeMion No. Township Neme or No. Range No. County
Occu am ?PRINTI
LT Phon No.
Power Supplier
K. i? Aatlress
'FMC-?likZ.
EI Vi al Conlracny N mal Co ect 8 Llcense
Mai- tlCre I o clm wnerMaking nstallaC n? .
num izetl - amre IC v cmrOwner?ileaol, I
? o e?umber-
?
MINNESOTA STATE BOARD OF ELECTflICITY ? THIS INSPECTION fiEOUEST WILL NOT
Griggs-MlOwey Bltlg. - Poom St]J ? BE ACCEPTED 9V THE STATE BOARD
1821 Universily pve., St. Paul. MN 55100 UNLESS PFOPER INSPECTION FEE IS
Phone(61Y)fi61-0800 ENCLOSED
.
g'// Cj I C REOUEST FOR ELECTRICAL INSPECTION
? ?$,¢e instmctims for complelin9 rois torm on back ol yellow copy.
m 7486 "X" 8elaw Work Covered by This Request
it`¢M ?4,.. EB-00001pe
ew ep. lypeoleuiiding AppliancesWiretl EquipmeniWiretl
Home Range Temporary Service
Ouplez Water Heater Eiectric HeaNng
ApL Builtling Dryer Loetl Managemenl
V CommJlndustrial Furnace Olher (Specity)
Farm Air Condilioner
Ol?er (sV?i1Y1 Contracror§ emarks'.
Compute Inspechbn Fee Below: g q'
# Other Fee Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 100 Amps
TranstOrmers Above 200 _ Amps Dve 700 Amps
SignS InspacWrS Usa Only: J TOT L
trrigation Booms
Speciallnspection
Alarm/Communication THIS INSTALLATION MAY BE ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
tif
th
t th
i
b
i RO°9"-f" Date
y
cer
a
ove
e a
nspect
on has
been made. F;,,at
OFFICE USE ONLY
This reQUest wia 18 momM1S Imm
?
? 8?
4 2 0
3 8 ,?.?, q?
Request Oata Fire No. RouBh-in Inepedion
Ra uiretl?
I
?fleatlY ?' ? Will NotHy Inspeclor
? C ?
When Ready?
10 licensed contractor `6(owner hereby request inspection ot above electrical work at: .
Jot AaOreu (Street. Box or Rou1e No.) Ciry
3 marcfry-4p- 0 ILUo e ?Ais 4N
Secfion No. TownshP Name or No. Range No. Counry
OT+
Occupiml
2/}? .
? ?.? Phom a
Power Supplier Ftltlress
ElecVical ConVecbr (Canpeny Nama) Conlracla5 Liunse No.
Mailing AOOress (Conhxlor or Qxner Makin9 Inalalletim) '
Putlqnzetl Sgnat re ICOMreaor r M T. Instella?i ,),n-
Y . .Y?r-?- - - PhMe Nu ber I,,r -. 633-I I
-.238F
-T---- I
MINNESOTA STATE BWPO Oi ELECTPICIiY . ' THIS INSPECTION REOUEST WIL4 NOT .
GrqWdlEway BWg. - Room S173 BE ACCEPTED BYtHE STATE BOARO
/811 UNVeniry Rw., St. PauI.MN 55106 - IINLESS PROPER INSPECTION FEE IS Plqne (87]) !42-0900 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-08
M O?/ ? See instructions for completing ihis form on Oeck ol yellow copy.
?o°-
w 38420 - "X" Selow Work Covered by Thfs Request
ew A d Fiep. TypeofBUilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Speci(y)
Comm./Industrial Fumace
Farm Air Conditioner
Other (sOBCity) Contractor} Ramarks:L,,.Z ((_.LN(, 5'2`Q f(h-C
. k 9SA
!sc Nr - I -o(,rc.cr - c-l.t-oon. LT.- S'cLzlcoa}
Compute lnspection Fee Be/ow: ?' L+ r4Q t,,,tT
# Other Fee # ServiceEnranceSize Fae # Cirouits/Feetlers Fee
Swimming Pool 0 t0 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs inspector§ Use Oniy: 70TAL
lrdgation sooms ?J _ 0 ??•50
Special Inspection
Alarm/Communication THIS INSTALLATION MAV BE OR ED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspedor, hereby flO1gh"" oete
certify that the above inspection has
been made. F;,,st
oete
- /
OFFICE USEDNLY
Tnis request voi0 18 mmRis hmm
CITY OF EAGAN ?0 ? ?$93
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt s
To be used for STORAGE ADDITION Est. value $4, 000 Date MA1 18 , 1990
Sile Address 43$9 METCALF -DR Lot 1 Block 4 SeGSub. RIVER HILLS 9T
Parcel No.
I? I Cd?ress EA 9NMETCAPho eR 633-1133 I
Name _
Address
CIty -
Name _
Address
Phone
Phone
I hereby acknowlege thatl have read this applicalion and state thatthe
inbrmation is correct and agree to comply with all applicable State of
Minnesota StaWteS and City ol Eagan Ordinances.
?
Signawre of Permitee 'e? G `
A euilding Permit is issued ro: GERALD A N LSON
on Ihe ezpress condition that all work shall be done in accordance with all
applicable State of Minnesota Slatutes and City of Eagan Ordinances.
Building Olficial 1 - ?
Occupancy
Zoning
(Ac1uap Const
(Allowable)
Y of Stories
Lerglh
Oepth
S.F. 7olal
S.F. Footprints
On Sita Sewage
on siie wen
MWCC System
City Water
PRV Required
Baoster Pump
APPROVALS
Planner
Council
Bldg. Ofl
Veriance
OFFICE USE ONLY
M-1 FEFS
V-N
0
gldq. Permit 63.0
V
N
- Surcharge 2-o?
200 Plan Review
13' snc, ciry
- SAC,MCWCC
Water Conn
- WatarMeler
Acct. Deposit
SM' Permil
- S!W Surcharge
Treatmenl PI
fioatl Unil
- Park Ded.
Copies 3.00
- TOTAL 68.00
?
CITY of EAGAN
7ILDING PERMIT
f .._..... .. ..,.
F6r ?/ .?.i . .....
owee: ..
Addseu (Pxesant) -°P?., ??-?...........
Buildes ..............
..... .. .
.. ..... .. ....... ........ .. .......................
Addrase .... ..? .... .. ....?°---............ ....
.,.
N4 4013
3795 Pila! Knob Road
Eagan, Minnesola 55122
454-6300
Dale ? ...G/?...??•?v......
?
6foriso To,Ba, Used For Froni Depih Heigh! Eal. Cos! erm!! Ramasks
6Z
' S!!eel. Roed oC o2her DBBCiip!{Oirof lyocaIfon I LOi 1I1510Ck I ACQtriop Ol TraCt
Tdis pe:mit does no2 Pfie use of sireels, roada, allaps or eidewalks aor doea it give '!he owasr' or LU ageat
the riqhlto creale enp situa!?on ich is a nuisanee or whfeh presenls a hasard !0 the health, safelp, eoavsaienes ead
gsnaral welfare 2o anyone Sn the co ily.
THIS PERMIT MUST BE T N AESE WHILE THE WOAK IS IN PAOG .
1'his is !o certifp, lhai. l..c?j.1 .. ..?111..:- ?---_--.has permissioa 2o erec! s.?. . ....??Cji}.:_upoe
the above described premise i io !he prov' " ns of all applicabl ' ces fos ! gan,
.---•----°--------.----.?... ....................... Per ... . ..... - ---.. . . . -- -.. ..............----..........................
Mavor Buildiag Inapsef?
VILLAuE 9F. E4GAN WATER SERVICE PERMIT
3795 Vilot Knob Rood PERMIT NO.: 2012
Eagan, MN 54122 DATE: 9 6
Zoning: R= . No, of Units: 1
owner. Win@sor Dev. Coi'P.
Addresa:
Site Address 4359 Metcalf Dr. L1B4
Plum6er: 'I'hompsnn Plumbin4 Co.
Merer Connection Charge: ZOS. 00 pd
Size: ? Account Deposit:
ReAd"o.:79Si< / Permit Fee: 10.00 blll¢d
I agrea camply wifh ihe Villaga of Eagan Surcharge: .50 N879
Ordina ca°s?. I
Misc Charges: Pd
60.00
Total:
By Date Paid:
Date of Insp.: Insp.:
n«aPE oF eaaaN SEWER SERVICE PERMIT
2764
3795 Pilot Knob Rood PERMIT NO.:
7 9 76
Eogan, MN 55122 DATE:
'I.oning: RI No. of Units: 1
Owner: Windsor Dev. Carp.
Address:
:;ite nddress: 4359 Metcalf Dr. L1B4 RH 9
Plumber: Thompson Plumbing Co.
7/9/76 #3403 • P
350.00 pd
s of Eagan Connection CNazge:
rea ro com
l
wifh tha Villu
I o
p
y
g
y
Drd{nancn. Account Deposft:
10.00
Permit Fee:
.
li
; Chugea:
Misc
y .
Itate of Insp.: Total:
Insp.: Date Paid:
. , PERMIT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDIN6
030557
08/01/97
SITE ADDRESS:
4359 METCALF DR
LOT: 1 BLOCK: 4
RIVER HILLS 9TH
P.I.N.: 10-64400-010-04
DESCRIPTION:
?vilding;-P,ermit 7ype DECK
?a6u3ldihg W?IMkType NEW
Census° Gode ..,..._ 434 ALT.
?
3
`
y
RESIDENTIAL
,
r??c I iet
REMARKS:
FOOTING 5I2ES ARE FQR DECK ONLY
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: OWNER: _ Applicant -
GUNDERSON BARRY
? 4359 METCALF DR
EAGAN MN 55122
? (612)860-7396
? here€iey ackniawledge,.°that ? Fiave raipd thit: a,PP1;tpa,t10n, 4rfd staCs: that.;the
informat3on 3s correaL and agree to eomply wi:th l appliceble atatQ of Mn. '
L Statutes and City of Eagan Ordinanees.
'notI012?,?i,(,I r1?11
APP ICAN ERMIT E SIGNATURE - ISSUED BY: IGNATUR
7 BUILDING PERMIT APPUCATION (RESIDENTIAL)
3mq CITY OF EAGAN
8630 PILOT KNOB RD - 55122
681-411675
hew Conatruetion Reauirements
RemodeURenair Reauirements
? 3 registered ske surveys ? 2 copies of plan
? 2 coDles of plans (Indude beam 8 wirMow saes: pouretl fid. design; ete) ? 2 aite suneys (exterior additiona 8 decks)
• t energy calculatlons • 1 energy calculations for heated additiona
? 3 oopiea of tree preservation plan H bt plalted after 711/93
requ(2d: _ Yes _ No -
""'?/? . ? ?S fJ
DATE: 7"- `?i ?.J CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT -1- BLOCK
PROPERTY N8111e: P?A PhOn#: r-
OWNER
u..
Street Address:-"."s``?
?.. , . ?tc? 60 '73
?r,
?.
City: ? ? 'r b'1 State: Zip:
CoNrttACTOtt Company: Phone #:
Street Address: License #:
City: 5tate: Zip:
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer & water licer•aed plumber (new conshvction only): . Penatty applies when address change
and lot change arc , equested once permft is issued.
I hereby acknowledge that 1 have read this applicatlon and shate that the infortnaGon is oorrect and agree to comply with ali applipble
State of Minnesota Statutes and City of Eagan Ordinancea ?
Signature of Applicant
RECEIVED
OFFICE USE ONLY ?UL 31 1997
Certificates of Survey Received _ Yes No
HY: 7141 ---
Tree Preservation Plan Received _ Yes _ No _ Not Required
=J_ SUBD./P.I.D. #.
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
0 03 SF Addition o 08 8-plex
n 04 SF Porch ? 09 12-plex
0 05 SF Misc. 0 10 = plex
WORK TYPE
x 31 New ? 33 Afterations
0 32 Addition o 34 Repair
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. a
? 13 Garage/Accessory o
? 14 Fireplace 0
? 15 Deck
? 36 Move
0 37 Demolition
. ??
I
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
GENERAL INFORMATION IOT-E?, Fbvnp1(l 54X5 A-:- f"'W, P?t.V- CP1L-Y,
Const. (Actuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
PermR Fee
Surcharge
Plan Review
License
MCMIS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building ),?A_ Engineering
Vaiuation: $
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
:ZEL
_L
0
J
°k SAC
SAC Units
,
CERTIFICATE OF SURVEY
FOR: BARRY GUNDER50N
?
N S I°?,$,?,! 3"E I 50• o 0
?
o 04 31.
8 a 3 p'
?O r-
? +
?_
io Ill
N 35 2 y
?
1
w ? 7 ?
? o
o
? 5 ? nl I
.?ti
o ? . o
? cr
C]
?
/
? ? ti ? 4A
I
1
I
--
-
rx
L
3
6
? ?
?
? ?
?
M
?
tl J
v I
I , o Z w
_._
o
_ o ?
14 81038'13"E 30,
• Denotes Found lron Monument
o Denotes Set Iron Monument
LEGAL DESCRIPTION:
Lot i, Block 4, RIVER HILLS 9"' ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
I hereby cerNfr thaf IAts survey, plan a reDaf was SCALE " = 30
preparcd b
me or under m
dirtcl su
ervislon
nd
y
r
p
a HOSFIELD ? ASSOCIATES
tnot 1 om o duir RlpitfereA Land Surveror under URAWN 8Y W
'
tne lors of the state r M
??eaota. 415 W. NORTH STREET /
-n
J oaTE $
20
)0
- OWATONNA
MINNESOTA 55060
Q , REVISED
oa+e 5?20J l 7 Req. No. TEIEPHONE = 507 - 451- 4598
JOB N 0.
PROFESSIONAL LAND SURVEYORS
s.. 111q5
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
1 ?
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE 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
i# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS HADE.
IAT G'riHh7GE IS kEQUESiED ONCL FERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: ??Tp2AfC ADp'TV luation: Date: S-tG`--9C7
Site Address ?35q MF-TC-AtF 47.KU
Lot I Block 4
p:tV WZ (I-zLC, S Qi4 4b0zjJ"3:4t3
Parcel/Sub
Owner grzRfYL-D 1't-. IVCLSctJ
Address q3s9 6Ylrz7ClkLF i)(u'k
City/Zip Code F- Ac. A Pu SS12Z
t,? oRr
Phone g?f ?-.23 ?'? ie 33 - I I 3 3
Contractor cS IgLF
Address
City/Zip Code
Phone
Arch./Engr. SFLF
Address
City/Zip Code
Phone #
OFFICE USE ONLY
FEES
Occupancy AA- I
Zoning
Actual Const ? Bldg. Permit vo
Allowable V-N Surcharge 'Rluo
# of stories Plan Review
Length -2"' SAC, City
Depth IZ%i' SAC, MWCC
S.F. Toia1 Wster Ccrn
Footprint S.F. Water Meter
Acct. Deposit
On site sewage_ S/W Permit
On site well _ S/W Surcharge
MWCC System _ Treatment P1.
City water _ Road Unit
PRV Park Ded.
_
Booster Pump _ Copies 3.00
SUBTOTAL
APYROVALS Penalty
Planner TOTAL $,oJ
Council ,
Bldg. Off. `
41:?'?:,? ?
_
Variance
f r
2'12-?.
-& *r, 0
,
MASTER CARD
LOCATION i?%???_di???? 40 /^ 4 Y ? ?/
STRUCTURE AND
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUM8ING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING $ 7?. g-ao-,??
GAS INSTAILING
SANITARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING 2-1-74 $EPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PWMBING
WELL
SANITARY SEWER
Violations Nofed
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOIAilONS
PERMIT NO.
DATE OF INSPECTION
CONDITIONS OF GONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
7 REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the a6ove in which I have no interes[ present or prospective, and that 1 have reported herein
all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, aDproved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENT$ ACCEPTABLY COMPLETED
. BUILDING INSPECTOR
CONJv1ENTS:
DATE
?? ?3
• 2004 RESIDENT'IAL BUILDING PERNIIT APPLICATION
City Of Eagan
? ? o C) Z7??- 3830 Pilot Knob Road, Eagan MN 55122 -Dc)
Telephoue # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeVReoair Reauirements c€ Use C?n'?`4
3 regislered site surveys showing sq. N of bt, sq. N. of house; and all roo(ed areas 2 copies of plan CeRof Sn`rs%e'y.?Real, ???Y =`N
(20% marimum lot coverage allouved) 1 sel of Eneyy Calculations for heated additions Tree PfE5 P?n Recd Y
2 copies of plan showing 6eam & window sizes; pouretl found design, etc. 1 site survey for addNon.a & decks ?r„ae P HeqGVed,
1 setoF Energy Calculations Additiom fndlcafe ifon-sife sepficsystem
3 mpies of Tree Pmservation Plan if lot platted after 7/7193
Rim Joist Detail Options seledion sheet (bldgs with 3 w less unifs
`-stAx JQx.I ? w?- W
/ '?, / n&/
Date
?t( onstruction Cost 5, ocv
C
-
- ?
(
Site Address UniUSte #
Description of Work p xy-? \ V` ?w::?"-` t" V ? ?? S??''?n^ ? "t (71'
Mul6-Family Bldg _ Y?C N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ?
?
v\ c 2U sga:' V--) q b
Telephone # ((pa gp)
Contractor
Address City V-\ ?
State )yl? ? Zip -'?? ?Z Telephone # (?? -C?
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ventllation Category 1 Worksheet
(J su6mission type) Submitted
• Energy Envelope Calculations Submitted
Have you previousiy constructed a building in Eagan with a similar pianE
fee applies.
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Y_ N If so, 25% plan review
pf?
Licensed Plumber Telephone
APR 0 2 2004
Mechanical Contractor Telephone # (
Sewer/Water Contractor IBv " ---J _ Telephone #(
I hereby apply for a Residential Building Pemut and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, 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.
ippl cant's Printed Name
, AS4 aignature
OFFICE USE ONLY ?
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 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 (screen/gaze6o) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy R? 3 MCES System ?
Census Code :3' Zoning City Water
SAC Units Stories - Booster Pump "-
# of Units - Sq. Ft. PRV ?
# of Bidgs - Length Fire Sprinklered -
Type of Const - Width ?{G
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings(addirion) _ Pluxnbing
Foundarion IfVAC
Drain Tile Other
Ice & W
Roof ater Final Pool ? Ftgs * Air/Gas Tests Final
_
_ Framing _ _ Siding _ SNCCO _ Stone _ Brick
Fireplace _ R.I. Air Test _ Final _ Windows
_
_
_ Insulation _ Retaining Wall
Approved By:
- - -
- - - - , Building Inspectar
-- -- ---- - - - - ---- - ------- ---- - ---------- - ----- - ---- - -------------------------------
--- - - - ---------- - -----------
Base Fee "
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
?
?
? GENERAL INFORMATION
U
o z ¢
X ?? Applicant - nazue, address, phone & fax numbers, signature
9 ? ? Properiy owner name
?? 411a I,xaal descrintion and address of property
??40 North arrow, scale (1" = 30' or 40') and date
Jif ?? Location and name of all streets adjacent to properry /?
???" Site Plan drawn to scale showing location of house, pool and other exis'm. ,or proposed -h?.%et ?
structures I'D 'kAek" w/??•^?ewsie+?a, shew sAea( ? w?e(;.... i•. Nw Co•.re.1
;K ?W- Directional drainage arrows (e)dsting and proposed)
ELEVATIONS
Existina
? ? House corners
? ? Pmperty corners
g. ?40- On pmperty lines at point of ineasured dimension to pool (see below)
?Id ? If applicable, ground elevation at each end of retaining waUs and at wall's greatest height
Prooosed
0 ? -W Finished pooi deck corners
?X 406 Top of retaining walls (if any) and at esch different elevation (if it changes)
X% ? A*. Pool bottom (or max depth)
Exfstina
19 ? ? All property/lot lines
Proaosed
? ? Pool shew &n dwg.
? ? GW Pool plus integrated deck/patio ?
?*b Shortest distance from outside edge of pool deck to lot lines and house
?Qx4eqaQ . ..
Reviewed:
Name
G:lCECkVJR 2002lPool Permii Checklist
( -l2
Date
zl_Z1-oe?
ql
. ? REjVil,v,,??LIPL ?
?y
??.?e?r E:?rGrza?Er??rG nEr?r.
3j?4
/*'lAI ;5-S/a-a-
40 la S`?O 739lo r
f
?3. tS
? ? falrS?i'?
30
.`???e('S ?flo
S` EXi`nhN
m l?? ?e ?tsPaSM
0
"' 7 EXiSt'%?G
7120Pr
y -? Z -(? y-
?( - ? ? -o 4
3:9 AAasdrtoum Slopes
oF Re4eLining Wsll Will
Be Required
BY
BURf_D!NG ONSPEGT?ONb . ,
"zr 47'•w yo.oo
- -
-
oMETCALF DRtivE o
!
2004 RESIDENTIAL BLTII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
aL V--? c?.a?
NewConstructlonReauiremenls RenodeVReoairReauirements ; sa
3 regfslered sile surveys showing sq. ft of lot, sq. ft of house; and all roofed areas 2 copies of plan
(20% maximum bt coveroge allaved) 1 set of Energy CalalatiaGS for heated addNons P 0?
2 copies of plan showiig beam & window srzes; poured found design, etc. 7 sife survey for additiore & deda ?Pres?eqiiirc?rl ?'Y ?'N
lsetofEnergyCalculations Addifron-indlcateiion•sitesepficsysfem ?feSep ?:;Y" ? ?
3 copies of Tree Preservation Phn i( lot platted after 711/93
Rim Joist Detail Options selection sheet (bldgs with 3 w less uniLs
Date --6--
Site Address
Y "4C
?CQ ( ( r?
L./ ? ? Construction Cost
??q!j a Y,, UniGSte #
Description of Work -??( Ml + I aCk (/L)fi V' -GV 4oY e QdO? ??? Lin'P
Multi-Family Bldg
_ YZN 0161 X Z
Fireplace(s) _ 0 _ 1 _ 2
Property Owner f,-
J )Ci6j l, vn C ? {'S'Cfn Telephone #(&S I)%6Z--QVSS
Contractor 5Ql1- 071/y
Address
State
Zip City
Telep6one # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesob Rules 7670 Cateorv 1 Minnesob Rules 7672
Energy CAde Category . Residentlal Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) SubmiHed Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar pian2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Conti
SewedWater Con
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Pemut and aclmowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, but only an application for a permit, and work is not to start without a
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
eGtf rci j C2C1 Vl?OSth_
ApplicanYs Printed Name A' plicant' i ature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage X 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stonn Damage
? 06 04-plex ? 12 72-plex Plbg_Y or_ N ? 25 Miscellaneous
WorkTypes r?v l'pV6
? 31 New ? ? 35 Int Improvement ? 38 Demolish Interior ? 44
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46
? 34 ReplaCement 'Demolition (Entlre Bldg) - Give PCA handout to appliwnt
Valuation ? Occupancy MCES System _
Census Code Zoning City Water _
SAC Units Stories Booster Pump _
# of Units Sq. Ft. PRV _
# of Bldgs Length Fire 5prinklered _
Type of Const Width
_ Footings (new bldg)
Footings (deck)
? Footings (addition)
Foundation
Drein Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Eut. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
WindowslDoors
REQUIRED INSPECTIONS
FinaUC.O.
FinaVNo C.O.
_ Plumbing
_ HVAC
Other
_ Pool Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
Windows
_ Retaining Wall
Approved By: n , Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
?l/?h/1jN I ??
?OLY-0
CERTIFICATE OF SURVEY
FOR: BARRY GUNDERSON
t
NSI°_? '8 ?3"E 150.00
o .._.?......._..?,._.___._._.__ _?----sR'o
N N ?
10
io
?
4a'
LL0-
M?
3 N ? + ` va
h I \ ?
:t ?Drau4?2 ? llQl+ ? I M
o EaserneKF ??, ,?? 26.
,
0
?' ? -- --_.... _ _ - -- -- --- - - - 10
Zi o
0
I`?81°38'13"E ISO.oe •???
• Denotes Found Iron Monument
U Denotes Set Iron Monument
0
Q
?
?
h
?
z
3 0'
7
?
Q
J
v
o'
LEGAL DESCRIPTION:
Lot l, Block 4, RIVER HILLS 9T`j ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
I I hereby terfffr fhat tMs survlr, plan a report vras
? pre0ared by me w under my dirfef superrfslon ond
fhol 1 om o duly ReQlstered Land Surveyor under
the laws of Ihe Stale Minnesolo.
Date Req. No.LSZ32
HOSFIELD A ASSOCIATES
415 W. NORTH STREET
OWATONNA, MINNESOTA 55060
TELEPHONEj 507-451-4598
SCAIE " 30,
DRAWN BY
oATE 5/zo/9
REVISED
JOB N0.
4s*
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r,
7� / 50 Ccp�eS
r
Use BLUE or BLACK Ink
=9/7 1
Permit Fee: A9qu ?yr
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PE IT APPLICATION
- 7 j - i•
Date: �'" / / �� Site Address: L4 35-q ` / 4 � CQ 1--(1[_2' Unit #:
RESIDENT /
Name: &roil - 6 u 11 Cte I j Y\ Phone: 6 (2' V O'-- -7 Q1)
, a C 9 I f�-Q / c Dr,OWNER Address /City /Zip: `-(
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: 00611'9 cja/ k if r) e -Q/' P
%�
Construction Cost: Multi -Family Building: (Yes / No )
CONTRACTOR
Company: C LF Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
bSNo If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. x ...
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.gooherstateonecall.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 plans.
x �%T 6urd{erre
Applicant'srinted Name
Applicant's
gn
Page 1 of 3
1-4359 ►v10-tW Ori
DO NOT WRITE BELOW THIS LINE
9\977/
SUB TYPES
Foundation Fireplace
NiSingle Family Garage
` Multi Deck
01 of _ Plex Lower Level
Accessory Building
WORK TYPES
New Interior Improvement
S., Addition Move Building
Alteration
Replace Repair
Retaining Wall
Fire Repair
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
\/ Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: Rough In Air Test _Final
Insulation
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Sheathing
Sheetrock
Reviewed By:
TZ
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
VH+,110J?
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests _Final
Stone Lath Brick
Siding: _Stucco Lath
Windows
Retaining Wall: Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
5-62y 90,23 2241
/,yds
6(c -f71,1
Page 2 of 3
CERTIFICATE OF SURVEY
FOR: BARRY GUNDERSON
• Denotes Found Iron Monument
v Denotes Set Iron Monument
LEGAL DESCRIPTION:
Lot 1, Block 4, RIVER HILLS 9Th ADDITION,
plat thereof, Dakota County, Minnesota.
;D (Cril3/1
�n�
according o the recorded
572-4
T2
I hereby certify that this survey, plan or report was
prepared by me or under my direct supervision and
that I am a duly Registered Land Surveyor under
the laws of the State f Minnesota.
Date
5rny / Reg. No I S 23z
HOSFIELD & ASSOCIATES
415 W. NORTH STREET
OWATONNA, MINNESOTA 55060
TELEPHONE: 507 - 451- 4598
SCALE f" 3o
DRAWN BY 1fliaP
DATE 5/20/9'7
REVISED
JOB NO.
PROFESSIONAL LAND SURVEYORS
3,6- /friiv7cAt.i: it
pit;i14ir i”/7/
RFT,7.-1;p7:0
DEC 0 4 71.P3
1 VILLALIM 12,1641
1:15am
I oil
9Atati9649394
lautsamets9e4.9991
iliftriNkthial..1279
Member Data .
Description: Member Type: Beam Apphcation: Roof
Top Lateral Bracing: Continuous Slope: 0.00112
Bottom Lateral Bracing: None
Standard Load: Moisture Cortriltion: Dry Building Code: IBC ARC
Snow Load: 35 PLF Deck Connection: Deflection Criteria: 1.1200 live,1.1160 total Member Weight laConnection: NailedDead Load: 17 PLF
8 Fix
Filename: KYB1
Other Loads ,
Type Trih. Dead Other
(Description) Begin End Width Start ' • End Start End Category
Replacement Uniform (PLF) 3' 8130" 19' 3.00- 204 304 Snow
• -
— , it_ ,' --c - - --A -..- '
. ,'. - --,.,,,•
A(
19 3 0
7
1930
Bearings and Reactions
Location Type krputLength hiln Required Gravity Reaction Gravity Uplift
1 0 0.000" Wail 3.500" 1.500" 35148 –
2 18' 9.76Z Wall 3.50Cr 1.596" 4749# --
Maximum Load Case Reactions
maw wwwwommorpwwwwwwwwwwv
Dead Snow
1 14804 2054$
2 1807% 27535
Design spans
IC 9 759*
Product 1414" x 11-7/8" x 2.09 INS-tAkt LVL 2 ply
Component Member Design has Passed Design Chectur."`
Design assumes continuos"; lateral bracing along the top chord. +-A
Design assumes no lateral bracing along the bottom chord.
Allowable Stress Design
Actual Allowable Capacity Location Leading
PosNive Moment 21724.W 24189.'8 88% 9.41' Teta; load DsS
Shear 4238# 9081.# 46% 17.87' Total load D+S
Max. Reaction 4749.# 10412.8 45% 18.81' Total load 0+8
TL Deflection 1.1121- 1.4109" Lt202 9.41' Total iced ascws
IL Detection 0.8215" 1.1287" L/274 9.41' Total load S
comic Positive monger
00tc UveolOOS Snow --115% 11190=125% Vand-480%
nvierkea 9940409 91:1311,4UST be consulted for WO,* connection detals end aNemallves
,
Situation; LVL was trimmed to match the existing roof line causing sheer violation. Solution; add 4.0x 11-
7/8 LVL using 16 1/4x4-1/2" Simpson SOW screws equally spaced, not closer than 1-1/4" to edge of board.
, Atpoldsmtnorrentraferrallisotilteirmspao *sewn
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„00 0,
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Use BLUE or BLACK Ink
For Office Use 48.1' 641
::::
City of EaaIl //. 61
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3830 Pilot Knob Road20�
Eagan MN 55122 Ilk 3 Date Received: -3( -
Phone: (651)675-5675 /}
Fax:(651)675-5694 Staff: " '��
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 3 i Site Address: -l3561Unit#:
) `E✓'- 1� "� C'v-i�'<
!-) w_� d 6:3LA. 1d v Sc� _- 1 Phone: Lo1 Z — C/? Z-4 172-
Name:
#Own a Address/City/Zip: r IrJc1 IJti U �� r� ,7 7/( 5 57 Z Z
Applicant is: )(Owner Contractor
0,9
*Ix-
- Description of work: Anjd j �-i t
7 Wor's
..4 R: Construction Cost: Multi-Family Building:(Yes /No )O
Company: Contact:
ti' ctor
Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NO E nd supporting'tlocu <' that y bmlt ere � denial tQ `rr e' . a
the informs len be classified = n-,pu a .u provide sp a a !t ;t
zconclud ey are trade
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.qopherstateonecall.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 plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x .J I�L`.� GIA.11 d r t x
Applicant's Printed Name Appli is Si ature
Page 1 of 3
Li SS i Nietreq-I <.V/k DO NOT WRITE BELOW THIS LINE '/ Q't /
SUB TYPES
Foundation Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
`X) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
__ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation Or Hey 3/D.00 Occupancy )-_(2't / MCES System
Plan Review Code Edition /n/770/5 SAC Units
(25% 100%4) Zoning 12-I City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V13 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
_ Footings (Addition) Final/No C.O. Required
Foundation n -.0 HVAC_Gas Service Test Gas Line Air Test
Roof: V Ice &Water 1"Final Pool: _Footings Air/Gas Tests _Final
Framing Drain Tile
Fireplace:_Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: / 0 U11 11,H 'n , Building Inspector
RESIDENTIAL FEES /&'?‹.? Z5 ' 6" W./9//'( 0--)2-- 9,rr .x 4 c,7 3
Base Fee ,, ` S ,e ""4,./7 /eke) 4/l Sy - f7 X ?5,, 7,3
Surcharge
V - C Hev' ►2et.71 Pa / e/&Q 3, , F?' y Z 0.17D s,%. f7
Plan Review
MCES SAC De CK �- 7># } /D e 57.re-r- X rs- oa
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant 7 B ' 6 4)D ,i)' DD.!--4-#'o �,
-41 o, 00&.45)-- fl)—pe 1
Copies
TOTAL ..14. ? . ') Pe;'P Jc/ w;R L,..)4-`�
Page 2 of 3
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LA -r... 4-z.I tu
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Use BLUE or BLACK Ink
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For Office Use
4(04 )
City of Eaaall Permit#: 0o7
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Staff:
buildinginspectionsacitvofeagan.com
2017 RESIDENTIAL PLUMBING PERMIT 'APPLICATION
Date: Site Address: 413 S ' S
l 4 `-� '. !� I
Tenant: Suite#:
Resldent/Cnfner
Name:C 'rl.J'r vi t^�� r Se'\ Phone:G( Z - C.,2 L-16-761
Address/City/Zip: 43 5-() (N- 0..4-Cc‘( F.- c i
Name: u (\ ( ,u (1O,%.0 Sits /)i ./.,,.5 License#:
ntractor `.. Address:-70 �-i p Q0ec,-1-," f �. City: C'O�Gtn 3 2r
State: ! • IQ Zip: S'S 3/7 Phone: ( ,.T/ 2 1 - 4/3 7
Contact: I(Q u ),/\ Email: 0 di r\I O ff. 2. `L Z• .co"—
New Replacement —Repair _Rebuild _Modify Space Work in R.O.W.
Type of —1Nor[c ..
�R. „ Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation( RPZ/—PVB) Water Softener
Permit Typed
Septic System Add Plumbing Fixtures( Main/—Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge)
*Water Turnaround (add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $
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.qopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeaean.com/subscribe.
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 theapproved plan in the case of work which requires a review and approval of plans. `sem
x tc J I n 1/d x �✓
Applicant's Printed Name A plicant-Wer -
FOR OFFICE USE Reviewed By Date
"'Required Inspections Under GroundRough In - Air est Gas Test Flrial
''Meter Rela ed Items Meter' ize Radio ReadA; Manometer . -Staff