4362 Metcalf DrCITY OF EAGAN
3795 Pilot Knob Road
Eagon, Minnesoto 55124
Phone: 454-8100
Dote:
WATER SOFTE?VER
PERMIT
'51
No.
?,-
Receipt No.: '
Single I
Residential
Multi Res., Comm./Ind. I
Septersber 13, 1977
Site Address: ?1362 h''atCalf nr.
Lot ? Block Sub/Sec.
Name ' '`ancis C. Campbei :
Address 6Z F3etGalf Ilz'.
; ?
O
City -,-'ran Phone:
` Nanw c'ommers Soft Water Uo.
A Address'8,-j1 Califarnia 5t. N.R.
Ci? ''t)? s. 'i ^ 421. Phone;
This Permit is issued on the express condition that all work shall be
Minnesota 5tatutes and City of Eagan Ordinonces.
3Zte1'ation
New/Alter./Repair.
Cost of Installotion
5: • r?C?
Permit Fee
Surcfwrge
.
?>Q
Toto I
done in accordnnce with all applicable Stote of
Building Official
CITY OF EAGAN Remarks
Addition R'ivar Hi l l S nY' Lot 16 Blk 1 Parcel 10 6 i2400 160 01
Owner .i +. street 4362 Metcalf Dri.we state Eagan,MN 5,5122
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
3£,SEWER LATERAL Paid
WATERMAIN
WATER LATERAL
WATER AREA
STORM 5EW TRK pniA
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT 1
WATER CONN. 205.00
13UILDING PER.
SAC
PARK
Rec'd in Street MUNICIPAL
. MINNEGASCO PERMIT N0.
MpfS,O SERVICE INSTALLATION ORDER N0. •'?'??
Sub. E-N0. )3?
Map No. '- Old? New? Bldg. Class 6
Customer's Name ?E'`?L? ?•` " Tel.
Installatian Address
Legal Description: Lot No. Block No.
Addition
Contr's Name
Contr's Address
Owner's Nome
Owner's Address -
pate Ordered ' -?' Max. Demand CF/Hr.
Main Auth. No. Service Location:
Add'I Info. -?i£ ` TA-43?3 5errr L',' • -li Date Completed
Foreman's Name
To the (City Engineer.._.,,: ,
{City Council
(Village Council
(Town Bqard
The Minnesota Gas Company hereby requests permission to perform
the work indicated above.
MINNE50TA GAS COMPANY
(Chlsf Design Enpineer)
To the Minnesota Gas Company
Permission is hereby granted the Minnesota Gas Company to perform
the work indicated above.
of
Date gy
(Authorized Signaturs)
Tel.
Tel
Taken By
Right 0 Left [:] Front ?
FORM 52-9R 6/ 69
i/
CITY of EAGAN
BUILDING PERMIT
. DEV. CORPT
Owne: ........... WIND%IR.
...... ......... ....... ................. ................................"---.....
Addrese (preseat) .............. 141? .......4362..Metcalf
. .. . .. . ...............
auuae: ........... WIN I7.WR..AU..... .r.QRF ...............................:............
Addseu .... kfi60...W.,....7.7..th..S.t.,...Edina., ...Mina ...................
w; ;+
N° 4164
3795 Pilo! Knob Road
Eagan, Minneeola 55122
454-6100
aa:• ..... Dec...-30,...1'lZb...........
Siories To Be Used For Fron! Deplh Heigh! Eet. Cosf Permi! Fsa Asmarks
Sing. Fam Dwlg. S Gar ? 48
. 46 399500. 11????? Sing. Fam Dwlg. d Garg.
S/c
or
4362 Metcaif Dr.
LOCATION
16 1 1 1 River Hills 9th
This permit does not sufhorise the use of sireels, zoeda, alleys ox cidewalks aor doea it give !he oanes or his agen!
the rfgh! !o ereale anp siluation which is a nuisence or whieh p:esenls a hazard !o the healfh, satelp, eonvealsncro aad
general welfare !o anpane ia the eommunily.
THIS PERMIT MUST BE KEPT ON THE PAEMISE WHILE THE WORK IS IN PROGRESS.
This is !o cerfiip. Ihal.... Idindsur--D,ey. ..°-°°----------------------haspermlasion !o ereei a..._S7.1J$...Fam..... Dwlg..,,6_C,ar?x:_ayon
the above descr'bed mise subjeet !o the provisions of atl applieable Ox es for the Cifq'lof Eagan
• ? . /
<
-...... ..- -.-° 20r'=--....°.-.............. .---°-....... Per ..... ..._..... .. . . ...Ci.>..°..?.'................
?Mayor SulldinQ Impeelos
IF, void 18 months from
Date of this Request?,19 n'? P 114 3 3
Which is occupied by a?-?C?Y
I, asLicensed Elec 'cal ntractor OOwner, do hereby request inspection of the above electri-
cal nng installed at:
Street Add ess or R9ute No dX,L.I?!1 Cit
Section / wn? ? Range County
Is a roughin inspection required on this job? No ? YesZr- Ready Now ? Will CallJd
Power Supplier Address
Electrical Contractor" l??-u/t ?.?t? Contractor's License No!? 3,
^ (COmpany Name) A ? .? I
Mailing Address '1141- "-A
( triwi con i
Authorized Signature •
I C a< or O ne MaM
(?
C%?m'Si?? BUD VIol7 Y
6 36 -`??
? Minnesota State Board of Electricity
niversity Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST POR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
p 11433
Type of Buiiding New Add. Rep. Check Appliances W3red Foi Check Fquipment Wtted For
Home . ? ? Range El Temporazy W'uing ? ?
Duplex ? ? ? Water Heater ? Lighting Fixtwes ? I
Apt. Bldg. ? ? ? Dryei K Electric Heating ? i
Commercial Bldg. ? ? ? Fumace ? Silo UNoader 0
Industrial Bldg. ? ? ? A'v Conditionei ? Butk Milk Tank ?
Fazm ? ? ? List List
Other
?
?
? p
Herers?
)
OehersI
R
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fce Eceders&Subfeeders: # C'vcuita: # Fce
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres 00
101 to 200 Amps. 31 to 100 Ampe ?1 C ! 31 to 100 Am eres
Above 200 Amps. Above 1 A" Above 100 Amps.
Trsnsformeis Remote n 1 r. Partialorothecfee ? D
Signs Special ln-`tio ` Minimum fee $5.00
Remazks TOTAL FEE , 50
I, the Electrical Inspectoi, hereby certify that the above inspection has been made. }"• co
(Rough-in)_ f Date
(Final) Date
This request void 18 months from
MAR. -06' 06(MON) 13:51 LINDSTROM
L?NDSTROM
CLFANIMG 6 CONSiRUCnaN, lNC.
? 7 Z ?-f SS i?'?
March 6, 2006
City ofEagan
Building Inspecrions Department
Re: Nicholas Aalerud
4362 Metcalf Drive
Eagan MN 55122
'9Vater Damage RepAir!
To Whom It May Concern:
TEL 7635448166 P.OD1
inAui uiNrn:n01,111
Pf.l'Alrll1lll rtIN i;1a1 ,lNiS
? ?z% [vz
MAR I 3 2006 ?
Lindstrom Cleaning & Consuuction, ync. completed water damage repairs at the
above referenced job site.
lnsulation, though small amoun[s, was replaced. Drywall was supplied 1'k
installed, taped, sanded and painting completed.
There were also interiar doors and a smait amount of base finished & installed.
Everything at the above job site was completed per code and in a professionsl
manner.
Thank you,
Lin Clea ng & Construction,Inc.
Gary Hennen
VP of Operations
GH/ml
M1NN, LICENSE #0001087
1?l?o?iq
2004 RESIDENTIAL MECHANICAL PERNIIT APPLICATION 30 S16
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
TelepLone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date o,'t_V / vy
Site Address qJLO? M1f,+0(y2" ?J? • Unit #
Property Owner 88 QQJ c?1J? Telephone #(LC)S I)?SS' I 6? 9 d
Contractoe
Street Address ?« Heating & A/C Li c City
Q,?,,,,,,_ e s and Ave.2 So.
State ""'Q!!°. MN 55378-1 ? Zip ?
Telephone #
Bond #:? ? t=?...????a' o? Expires: O( O W
The Applicant is _ Owner ?S Contractor _ Other
?
Add-on or alteration to existing dwelling unit ?? v $ 30.00
furnace _Additional Replacement A20044
AUG 3
air exchanger
? airconditioner _New ?Replacement By
other
State Surcharge $ .50
Total ? W?so
I hereby apply for a Residential Mechanical Pemut and acknowledge that the inforntarion is complete and accurate; that the work will
be in conformance with the ordinauces and codes oF the City of Eagan and with the Mechanical Codes; t6at I understand tlus 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 wMch requires a review and approval of pla%. ^
?fyl, ? CvLob Q(ZeJ2
ApplicanPs Printed Name Applicant's Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 II
Telephone # 651-675-5675
Please complete for: commercial/industria] 6uildings
multi-family buildings when separate pemiits are not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applica6te) Previous Tenant Nam
Property Owner Telephone # ( I )
Contractor
Street Address City I
I
State Zip Telephone # ( I 'i )
Bond #: Eapires:
The Applicant is _ Owner _ Contractor _ Other I ?
n
Work Type I I?
New Construction _
-
Underground Tank
_ Install _Re I
ove **see below
Interior Improvement _ Install Piping _ Processed Gas ?
Nature of Work: I
"When installing/removing underground tank, call ior inspection by Fire Marshal andll
I !Plumbing"lnspector
'
Pe1'[Ilit Fees: $70.50 Underground tank installationhemoval „
$50.50 Mincneun (includes State Surcharge)
or
Contract Value $ x 1% _ $ I I Permit Fee
• If nermi[ fee is $1,000 or less, add $.50 77> $ I II State Surcharge
If ermit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply for a Commexcial Mechanical Permit 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 with the Mechanical Codes; that I understand this is
not a pexmit, but only an application for a pernut, 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. II
ApplicanYs Printed Name
Signahue
Approved By: , Inspector Date:
MASTER CARD
LOCATION 4362 Metcalf L 16 Blk 1 River Hills 9th
OWNER
SiRUCTURE AND
LAND USED AS
Permit
No.
Issued I Issued To
Contracfor Owner
eUILDING 4164 12/30/76 Windeor Dev
Cn
rn
PLUMBING
CESSPOOL - SEPTIC TANK ? / -42-7? r
. Ca.
WELL
ELECTRICAL
HEATING ??I7
??r ?
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FGOTING SEPTIC
FOUNDATION CE55POOL
FRAMING TILE PIELD FT.
FINAL
ELECTRICAL
HEATING
7' DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM8ING
? .
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOtATIONS
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
DATE OF INSPECTION ? ACCEPTABLE SU&STITUTIONS. 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:
O REINSPECTION REQl11RED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION -1 cenify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions o6served to be at variance 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 COMPLETED
BIJILOING INSPECTOR
DATE
/ CITY USE ONLY
1
sUBO.-R??sq-
RECEIPT#: l jd
RECEIPT DATE: 7- 3Q o-rq ?
PERMIT# ?)lO?o
1999 PLUM$INC PERNIFT (RESID?'18TIAW
C?o crnY oF fae?v
sgso PaoT ?oa Rn
?sAv, Mr, ssi QQ
(651) 6$1-4675
Please complete for: 9 single famity dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TUTA:l,
Bath tub $ 3.00 x = $ !
Floor drain 3.00 x = $ '
Ga5 i in oUtlet ' minimum - 1 3.00 X = $ '
Hot tub/s a 3.00 x = $ I
Kitchen sink 3.00 x = $ I
Laundr tra 3.00 x = $ '
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished " re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $ r
Water softener if dwelling under construction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x $
State Surchar e 50 --> ----> ----> $ 50
Total --> --> ----> ----> $ o ?
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-----------------------------------------------------------------------?------------------------------------•---------
I hereGy adcnowledge that I have read this appliration, sfate that the information is corred, and agrea b comply with all applica6le Ciry of Eagan ordinances.
It is the applicanCS responsibility to notify the property owner that the City of Eagan assumes no lia6ility for any damages caused by the Ciry tluring its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of•way/easement.
SITE ADDRESS: 73 ?a Z. 1W7`621-1- &Q_
OWNERNAME:: dTELEPHONE#: ?3
(AREA CbDE)
INSTALLER NAME: RG=?/ "x'w TELEPHONE #: CO/L
n?
STREE7 ADDRESS: ? D !7L '2XVU (AREA CODE)
?
CITY. STATE: ZIP:
`-----
SIGNATURE ERMITTEE
L /(P BL ?- CITY USE DNLY RECEIPT#: / 7?Jl- 5?
SUBD. [,a?, RECEIPT DATE:
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 6814675
Please complete for; . single famiiy dwellings
. townhomes and condos when permits-are required for each unit
. backflow preventer for underground sprinkler system
FIXTURES EACH ?Q TOTAL
Shower 3.00 x =
W:.:3r t'.I`SSe: 3.00 X =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink. 3.00 x =
Laundry Tray 3:00 x =
Hot TublSpa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x -
Gas Piping Outlet ' minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener `fordwellings under construction 5.00 X =
Water Softener " far existing dwelling 20:00 X =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler `forexistingdwelling 20:00 =
Alterations ' to exisun9 resiaence 20:00 =
Water Turn Around 20:00 =
Private Disposal System ' Dak IXy lic. 75.00 =
(new and refur6ished systems) .
Private Disposal Systems' Abandonment 20:00 =
STATE SURCHARGE .50
TOTAL 4;V1 --f?-
I hereby adcnowledga that I have raad this:application, sfate that the information is cortect, and agree to wmplywith all applicable.City .
W Eagan ordfnances. It is the appliwM's responeroility tonotify theproperty owner that the City M Eagan assumes no I4bility?for any
damages wused by the CKy during fts nortnal operational arM mairrtenance aGivities.ro thetedlitie5mnshuUedunderthis permA witHin
City property/right of-way/easement.
"w-eel'q GF
SITEAQDRESS:
6'6f //VE
f /72
?/Vmd6
1
-
OWNER NAME:
INSTALLER NAME: 141Z eCOV,?rW- 6-- TELE PHONE#:
STREET ADDRESS: ?y00 L.V7,W7
CITY:
STATE: ZIP;
` --?.
SIGNATURE OF P MITTEE
?.:
nwt ?: /? ??76 __-
?3*J.'.T.:77:iG P3ItPST c;.?PlaTG1T2Q?d
R70CY.
- ? . . .. ADDI'xSOrS--?---???Z'1'?`K-• `? '--'-'-
Y
& SE^'1'ZO?d .iIIi:L'W: -F
;i?:Q,i??`u',?,
?:;Oi:'i•'?._..?__/ , UCCi7F'i?1?CY
r
_.? f??.?A??ila:.v?????L.
COP$T i:;C7'(.7R o50 !9/h
t:ot? Tr.c1»d,? ?; s-.e ;.lan, bui3.J.ing pl ar.s, anfl energy calcula.:: on?o ::i. t1= ti:hzs
aPpii.rci;ioit
Signed ___. _-
pP'FICE UuE
?
eU
5AC
H?a.tM co.,NRc?z013
'WiT,^-.li ?;:GSEi2
PII:iyD][i:;G FP'1.YIM.` P=;Z
Suii:.^,Fm£.GE F_;F,
I'I;e1'ti P"11s•.
PAf21L b
OT[:i:R EDiC:ATIa:3 I'h'E
`O`S'I+i1k
fL?':?RQJALS. ?
.'?SSFSS?'' CLEF BUTLDING DEP7
'.=R & :'LwZR. DFP'i`. FI3L nL'FT._
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iLWINDSOR
December 14, 1976
City of Eagan
3795 Pi1ot Knob Road
Eagan, MN 55123
Attention: Mr. Dale Peterson
Dear Mr. Peterson:
Enclosed find a check in the amount of $1,005.50 for building
permit fees, surcharge, SAC, sewertrunk, water connection and
meter on:
Lot 16 B1ock 1 River Hi11s 9th Addition 4362 Metcalf Drive
• This home wi11 be a Mode1 76-13 Elevation A and will include
a standard fireplace and a deck off the dining room. This
hovse is the same size as a 75-11.
Allocation of funds is on the check stub. Proposed plot plan
is enclosed.
Thank you for your cooperation in this matter.
SincereLy yours,
WINDSOR DEVELOPMENT CORPORATION
?v aww q
Warren R. Anderson
Vice President
WRA:jb
Enclosure
•
SUITE 192, 4660 WEST 77TH STREET, EDINA, MINNESOTA 55435 • PHONE (612) 831-0717
2006 RESIDENTIAL BUILDING rERnzrT arrLicaTioN
? City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
t Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuction Reouirements
3 registered site surveys showing sq. ft. ot lot, sq. ft, oi house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam 8 window s¢es; poured found design, etc.
1 sel of Energy Calculations
3 copies of Tree P2servation Plan'rf lot platted aBer 711193
Rim Joisl Detal Oplions selection sheet (buildirgs with 3 or less units)
Minnegasco mechanical ventilation form
RemodellReoair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calculations forheated addiCrons
1 sile survey for addAions & decks
AddNion - indicate ifon-sde septic system
?crl3)A
ORce Use Onlv
CeROfSurveyRecd _Y _N
Tree Pres Plan Rerd _ Y_ N,
Tree P2s Requi2d _ Y_ N
On-sileSepticSyslem _Y _N
rir,a,iA ala4-,1\?
Date v l Zl I Z2 k Construction Cast 0!;?, 3 32- S 2
Site Address 4 x e; z- Unit/Ste #
Description of Work %T
Multi-Family Bldg _ Y -?'N Fireplace(s) ? 0 _ 1 _ 2
Property Owner Telephone # Q?;Cl ) ?9?? - ?Sr?
Contractor $'? Jf_
Address City ?-
State Zip r?
" Telephone t#
I'1
'-I ???
'!?? I
., r
lil r,??1
? i•r I_; I ?
FEI3
u
COMPLETE THIS AREA ONLY
Energy Code Category - Minnesota Rules 7670 Categorv 1
• Residential Ventilation Category i Worksheet
(Jsubmissiontype) Submitted
. Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the lasf 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit 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 permit, but only an application for/m permit, and work is not to start without a
permit; that the work will b in accordance with the approved pl
approv lans.
Applicant's Printed Name tXpp icant's
case of worlS,which requires a review and
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? Ot Foundation ? 07 OS-plex ? 13 18-plex ? 20 Pool
x 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.)
O 04 02-pfex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? OS 03-plex O 11 10-plex O 79 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex ? 25 Misqellaneous
Work Tvpes
? 31 New O 35 Int Improvement ? 38 Demalish Interior 0. 44
? 32 AddRion ? 36 Move Building ? 42 Demolish FoundaGon ? 45
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46
? 34 ReplBCement 'Demolition (Entire Bldg) - Give PCA handout to applicant
..-
BSC?IpflOfl: WaterDamage? Yes `
Valuation ?a [? Occupancy MCES System _
Plan Review 100% or 25%
Census Code e? Zoning City Water _
SAC Units Stories Booster Pump _
# of Units Sq. Ft. PRV _
# of Bldgs Length Fire Sprinklered _
Type of Const VAZ_ Width '
_ Footings (new bldg)
_ Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
--;K Insulation
REQUIRED INSPECTIONS
? 30 Accessory Bldg
? 31 E#. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
wndows/Doors
_ Sheehock
FinaVC.O.
FinaVNo C.O.
HVAC
Other
Pool Ftgs Air/Gas Tesu Final
_ Siding _ Stucco Lath _ Stone I.ath _Brick
Windows
_ Retaining Wall
Approved By: :M _ , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
Totat
?I
?1&f/lr,?
rl.
Pftmoilc.
/tl
YwYwj
Jr?L.c9tMi.
?
??1
? ?2
CITY OR EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: _ No. of Units:
Owner: — — Address: — Site Address:
Plumber: _ Meter No.: _— Connection Charge: 05: Size: — _ Account Deposit:
Reader No.• Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges: —
i Total:
By • = e Paid:
Date of Insp.: — 1 -� — �� l nsp.:
CITY OF' EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.•
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: — - -
Address: — - — — —
Site Address: — — — - —
Plumber: -- —
�o
agree to comply with the City of Eagan Connection Charge: - - - --
Ordinances. Account Deposit: —
Permit Fee:
Surcarge:
By —_ -- Misc. Charges: -
Date of Insp.• Total:
Insp.: ( aw � A 7 - Date Paid: —
DEC -9-2013 11:55A FROM:
401/` City of hp
3830 Pilot Knob Road
Eagan MN 56122
Phone: (661) 675-5675
Fax: (651) 675-5694
TO:6516755694 P.1
Use BLUE or BLACK Ink
For Office Use
Permit 8:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /Q/ 9// Site Address: /713k0 m.eroa LC OR Unit 8:
J
Resident/
Owner
Name: -171D n R j/ j a i al Phone: 6, /o2 — / 7cid'�-7p
a
Address I City / Zip: /3[oe? 'eT7•aJ 2r e
Applicant is: _ Owner Contractor
Type of Work
Description of work lJeu.l r 0o+
Construction Cost: O GD • 00 Multi -Family Building: (Yes _ / No _)
Contractor::
Company: Rel a 1 nT•er ior f -J,. f i n c Contact: D4 ✓if -7" a6Oer—S
Address: / 31/ il 077ztgoo- C T City: SQ UOq
p
State: /' ') rt Zip: -S—_57.3 7, Phone: iS-Z d/ �rP1 7
License S; A ( SA 7 / f Lead Certificate ii: _ j.�a T / 4y3s- — /
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
- F)Ce ,,,pr — r0o1►i:�
In the last 12 months,
Yes _No If
Licensed Plumber:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a penult for a similar plan based on a master plan?
yes, date and address of master plan:
Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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 the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call al (661) 464-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.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 DAv t 0 i' rio Lerrf
Applicant's Printed Name
x U0^'f'J�-'�-
Applicant's S gnatt' ure
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA156477
Date Issued:07/02/2019
Permit Category:ePermit
Site Address: 4362 Metcalf Dr
Lot:16 Block: 1 Addition: River Hills 9th
PID:10-64400-01-160
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Vieng Vongnalath
4362 Metcalf Dr
Eagan MN 55122--191
(612) 876-6514
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature