4377 Metcalf DrHQUSE HEATING TEST RECORd
ADDRESS y37 7 /'1e4r,,1f oi. APT. FLOOR CITY F41"+ SUBURB
OCCUPANT OWNER ArvS?; f.+k
HEAT LOSS- DATE HTG. INST. 11-??-qL
SOLD BY 211r1LL6 INSTALLED BY
Eloctrico! Work 9y ki« 'aY Gos Line By -
7YPE OF HEAT GA FA HW STEAM SPACE HTR. .__
UNIT HTR. OTHER
GAS DESIGN CONVERSION
AIAKE s ?' MAKE QF BURNER
Mode I ? Modsl
S..ial ?709 NSll:)3 Max. BTU Rcriny
INPUT 1?!U.490G MAKE OF FURNACE CONTROLS
THERMOSTAT 717 Hoat Pluy
Yalv
Modsl
VeM Size )
KIND OF LINER «ts C SIZE ? NONE
Limit Oraft Hood Reyularor
Limit S.ning Fil1er• Sits jq yd S;( ' Number ?
Fan Satfiny Chfmney Locafion In:ide X Ovfsid•
Pilot Type Chimney Consfruction 7 " P VC
Pilor AAaks
F'ilot Modsl
Pilot Timiny
L.W. Cut Off
Prsssurt 3 S Percent CO2 7
Input CFH I4J0,0017 Percent 0? ?a?
Sfack Temp. Porcenf CO U?
Farm 235
Smoke Bomb Wiriny
Draft T.st Tag
Door Prossur• LiyhHn9 Inst.
Dato Test•d 1'11' 4
Company Testing •-+3 /"izr sf.l fv
Nome of T•sf.r ?aS ,'i
CITY OF EAGAN Remarks
Addition ?ver Hills 9th Lot 6 Blk d Parcel ?? ? 04 ?-
r-,.
Owner' f`i: Street 4377 MetCalf Dr, state F'.aqan,M1 55127
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 2
1976
8
WATERMAIN
it WATER LATERAL
WATER AREA
* STORM 5EW TRK
* STORM SEW I.AT 1976
CURB & GU"fTER
SIDEWALK
STREET LIGHT 1980 67.80 C 646 10-15-79
WATER CONN.
BUILDING PER. 387 141.50 2630 4-9-76
sac _ _76
PA R lC
INSPECTIQN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS:
rr..A 1 r- t) fr
R1Vt Er i1ll i9TN
APPLICANT:
{ r, 1 1) 7i1) A q 9 b ;i
ii n V I
tlil i 4 if I N4;
A<7A+1+•
i16/0.2 !!lfi
PERMIT SUBTYPE: TYPE OF WORK:
., , i , E> A I r
II i:tl ( itOf1F INEi)
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBIN
HVAC
Inspectfon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDGFINAL
t n?l l 01l N+1a t
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
v
CITY of EAGAN
BUILDING PERMIT
own.: ..(?!1..h.??D.../1.?...... Re.Y/.'.e.<.f??W?.°{..C.l.1 _.r..
Addseas (Psesenf)
.... ' --....'--- ...... ...'_'---- -..
Builder ............. .............................................................
Addreae .................. ............................................ ................................
DESCRIPTION
0 Im
N2 3873
3795 Piloi Knob Roed
Eagan, MinnesoYa 55122
954-8100
a.:e G.f.? .r.....?.....C.9.7...........
6tories To Be Uaed For Fronf Daplh Heigh! Eei. Cos! Psrmi! Fse Aemarks
17cJ9 m,d- 2-r-l0 D fz 16
I LOCATION _'-:--
Sireet. Road or oihex Deseripiioa oi Locafion I o Black Addition or Traet
4377 /??1;1a /6 ? ? W, v PY 4/1// 9
This permit doea aot au2horize the use of siseeis, roads, alleya os eidewalks aor does it give the owas= os h[a agent
the xighf !o ereale any sifuation whiah is a nuisanee or whieh precenis a hezard !o the heallh, saielp, eonvanienee and
ganeral welfaze !o anpoae in the aommunily. THIS PERMIT MUST BE PT/ON THE P?R7EMIS£ WHILE THE WORK IS IN PROGRESS.
This ie !o ceslify, tha2..i.LO.S.O.?......,,v....PJ ............... haspermleaion !o ereet a..... .?4!1:PZI.?..jG?....................._upo¢
the above described premise subjecY !o the provisions of all applicable Ordiniftes or lhe?Ce88*+/
. ....""'___ """"'_'....."'_"'......"_""
.".'.__"""............... "........... ....... _ ....""'...... "
f 2 J ?ti- ° ............... Per
MaY . or BuUdinp Inepaclor
?///5 9 (4p ? REQUEST FOR ELECTRICAL INSPECTION Univemi '-F 17 1- 9 51 ? Phone (612) 6ry42-08pp m. 3 1 8c 5t Paul, MN 55104
r
Home Du lex Apt. Bld . Other: New Addn
Commercial Industrial Form Remod Re air
Air Cond. Hfg. Equi . Wafer Hh. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
°X` above fhe work covered by this request Enter remorks in fhis space and on the back of the whife copy only.
Colculote Inspection Fee -This InspecMOn Request will not be occepled wiFliout Ihe correcf fee:
Other Fee # Service Entance Size Fee N Circuih/Feeders Fee
Mo6ile Home Pork Stall 0 to 200 Amps ta 100 Amps
Sheet Ltg./Tmffit Sig. Above 200-A Above 00_Amps
Tronsformer/Generator INSPECTOP'S USE O ? T T l
Sign/Oudine Ltg. Xlmr. ?
Alarm/Remote Conhol
Swimming Pool I her cem ihar col ???nllono? desc?bed haretn on iF dare::rmed
Irrigation Boom RougM„ pare
?
ecial I
S
ns
eclion ??
p
p
ti
Invesligave Fee Finol / Do% P
??
THIS INSTALLATION MAY BE ORDERED DISC C D I OT COMPLETED WITHIN 8 M NTHS.
/?//S' V 6, D...' ? OFFICE USE ONLV This requasl wid 18 months (ran wlidalion dme prinled in ?is 6ox.
•?cf.aS/'.
I IIII II III II III II II? II III I? III II III II I I I) I?) III le Y-? alzf r, /JA [ov! o(
* 0 4 L 7 9 5 1 1 s ?
PLEASE PRINT OR TYPE O
R uesl Dak Rough+n inspMion requfredd ? Yu o InspecNon Other Than RouglNn: eady Now O W II Coll
I' - ??? (You muat mll Iha inspecror when reody) Doie Reodr
I, licensed conhoctor 0 owner hereby request inspection of ihe above electricol work at
Jo6 Arklrrs ?Slrmr, Boz, or Rwle No.? Ciy Zip Code
?? ?t? J-1 c- eLA ' v a Ct 55 1 Q-a
Salion No. TownsMp Name « No. Rmge W. Fire No. Couny
? a
LtiC.e_ ? v Vi??. 7??4-?-I q
awe. Sapplcer Address
l
Cmhacbr lCompanry NameI Conkacro• Gcrnse No. Mnstlic/. ?No. (Phnt Elect Only)
'er'
l
r Cft(
?
?
I?l
d
?Conkatlor or fx Padormin Wmllal
?/`
?-?/ ?\
,
?
?
k
'
?
CL
n l l . t ?. / v • `l'.i
V
?gn re ICo otl r Ownrr Pe?f nslnlhlion?
, %rone No.
^
/
A.11 1 / 96 ________ _____'"
YIlLAOE OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 1944
Eogan,MN 551II DATE: 4/14/76
Z,oning: RI No. of Unite: 1
Owner: W171d80I DBV. COL'p.
Address:
Site Address: 4377 Metcalf I684 RH9
Plumber: _ThOmp90Tl P1t1DIb1nQ O D
?ete O.? / Q
M Connection Charge?05.00 pd
r
, ?y? e; --SI c ?k•
?r Account Deposit: ___
10.00 billed 69?-
Reader No.: Permit Fee:
116d
'
1 ogrea to soy?l p' the Villaga oi Eogan
? ? 6 0
Surchazge:
Ordinance? ? Misc Charges:
Total:
By Dare Paid:
Da[e oF Insp.: Insp.:
viLLppe_OF E40AN SEWER SERVICE PERMIT
3795VilotKnobRoad . PERMITNO.: 2701
Eagon, MN 53142 DATE: 4/14/76
Zoning: RI No. of Units: 1
Owner: Wlndsor DeV Corp
Address:
Site Address: 4377 Metcalf L684 Rh9
Plumber: Thompaon Plumbing Co.
4/9/76 q2630 100.00 pd
1 agrae ro comply wifh tha Villoge af Eagan Connection Charge: 350.00 pd
Ordinwnees. Accaunt Deposit:
Pernut Fee: 10.00 billed 696
Surcharqe: •50 billed 696
BY: Misc. Chazges:
Date of Insp.: Total:
Insp.: Date Paid:
• I
?
?
I
6
i
\
?
9d :
`?•"?" ,^?., /e
K
3
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'???? b?WM.
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9?-
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e cAI'?
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i
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M J- eC 7s' lo
E Lev D _
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i I
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-
r
9
a
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2
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.
?'y' ---s?-- 22 ' u '
?
?a
- - - -- - -
, . ?. :
i,? -
? C47
/ ? v<a , °?o
p .: ? ? ,
CITYUSE ONLY
L L BL ? RECEIPT#: & ? k5 9
SUBD. h?( ? .u2 lp? ?? DATE: 111le94
7996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos whean permits are required for each unit
FIXTURES EACH NQ. TOTAL
Shower 3.00 x =
NVater Closet 3.00 x
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 ;c =
Laundry Tray 3.00 x =
Hot Tub/5pa 3.00 :c =
Water Heater 3.00 :c =
Floor Drain 3.00 x =
Gas Piping Outlet' minimum -1 3.00 .c =
Rough Openings 1.50 :< _
Water Softener 5.00 x =
Private Disposal ' Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. Spfinkler ' home under const. 3.00 =
Altera6ons ' to existing 20.00 = ?-a • r'
Water Turn Around 20.00
STATE SURCHARGE
Tnr,aL ?
SITE ADDRESS• '?`3?7 ??C?1`L ? ? •
OWNER NAME:
INSTALLER NAME:
STREET ADDR S: CITY: STATE: ZIP:
PHONE #:
OFFICE USE ONLY
L BL RECEIPT #:
SUBD.
DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)6814675
Please complete for: ? all commercial/industrial buiidings.
? muiti-family buildings when separate permits are p4t required for each dwelling
unit.
DA7E: C?CONTRACT PRICE: :?=L9 70
WORK TYPE: NEW CdNSTRUC NApD ON ? REPAIR
DESCRIPTION OF WORK: 6j' -A- IS WATER METER REQUIRED9 _ YES ?O. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETER i TO BE INSTALLED7 _ YES ->40.
FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7' IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 _ YES >60,
IF SO, YOU MUST APPLY FOR A 3EPARATE U.G. SPRINt:LER PERMIT.
FEE: $25.00 minimum fee or 1°k of contract price, whicheNvr is greater. State surcharge of $.50 per
$1,000 of permA fee due on all permits.
CONTRACT PRICE x 1% "1` •? 0
STATE SURCHARGE
TOTAL
SITE ADDRESS: _
TENANT NAME:
OWNER NAME: -
INSTALLER:
ADDRESS:
CITY: STATE:
PHONE #: ?S SIGNATURE:
APPLIC NT
OFFICE U5E ONLY
STE. #
METER SIZE: ' DATE: INSPECTOR:
CITY USE ONLY d
L ? BL ? RECEIPT #: ?6 6 0
SUBD.9? DATE?
!1/1s0F&
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction
Add-on air conditioning
Add-on furnace ?fGlfl??/?ZfiuT
Add-on air exchanger, i.e. Vanee system, etc.
Date: T(e
? Minimum Fee: Add-on/Remodel (existing residence only)
? HVAC: 0-100 M BTU
Additional 50 M BTU
? Cas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge
TOTAL
F444?
$ Zo.oo
24.00
6.00 ,6J ??em
_d7a?I-o? rtP
?
50
o?D , 5e
SITE ADDRESS: ??? 7 199F? ,?A Lf_ 021611
OWNER NAME: BP vt'./_--' SU/M,t PHONE
INSTALLER NAME:
STREET ADDRESS: lck/l eZa0 BetGL?/i9y'.o iPtP
CITY: J?/?YC01?f ? STATE: yI"JXJ ZIP: $? ? 75
PHONE #: (?o/A' )}?- q5_' £f5`?? ?
ISfU 'R
CITY USE ONLY
L _ BL _ RECEIPT #:
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercialAndustrial buildings.
? multi-family buildings when separate permits are 112t required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR,IMPROVEMENT
FEES: * $25.00 minimum fee gr 1% of contract price, whichever is greater.
• Processed piping - $25.00
• 5tate surcharge of $.50 per $1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
51 I E HDDRESB: -
OWNER NAME:
TENANT NAME: (iMPROVEMENTS oNLY)
INSTALLER:,
ADDRESS:_
CITY:
PHONE #:
SIGNATURE
TELEPHONE #:
STATE: ZIP:
SIGNATURE OF PERMITTEE CITY INSPECTOR
MASTER CARD
LOCATION
OWNER
STRUC7URE AND LAND USED AS
Permit
No.
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK . '
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial) Date
Remarks
Distance From Well
FOOTING - ? , SEPTIC -
FOUNDATION CESSPOOL
FRAMING TILE PIELD - FT.
FINAL
ELECTRICAI
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD ,
PWMBING ??`
v- ?=-ic - -
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABLE SUBSTITUTIONS OR
DEVIATIOIVS.
? NON{OMPLIANCE. 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.
? REIfJSPECTION REQUIRED
REI NSPECTION
REI NSPECT ION
CERTI FICATION -1 certify that I have carefully inspected the a6ove in which I have no interest presenc or prospective, and that I have reported herein
all significant conditions observed to he at variance with ordinances of the Town of Eagan, approved plans and Specifications, and any specific repuire-
ments for off-site improvements relating to the pmperty inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
B W LOING
DATE
.4giw. ..
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 6$1-4675
PERMIT
SF {MISC.)
REPAIR
434 AIT. RESIDEN7IAL
(?0 658'a a-?
BUILOING
027446
06/02/96
SITE ADDRESS:
P.I.N.: 10-64400-060-04
4377 METCALF DR
Lp7: 6 BLOCK: 4
RTVER HILLS 97W
DESCRIPTION:
(ROOFING)'
ermit 7ype
¢L??k Type
f-
?
Ae? ? ??? ?' ? j? ?,? ;?
? it7 P? ? ???
REMARKS:
FEE SUMMARY:
VALUA7ION
Bese Fee $37.50
Surcharge $.55
Total Fee $38.05
CONTRACTOR:
PERMIT TYPE:
Permit Number:
Date Issued:
$1,100
OWNER: - ppplicant -
SVITAK BARB
4377 METCALF DR
EAGAN MN 55122
(612)894-4963
Awre?? rn?
ISSUI AT li
CITY OF EAGAN
3830 PILOT KNOB RD - 55722
??
?14
?
1996 6UILDING PERMIT APPLICATIaN (RESIDENTIAL)
681-4675
New Construction Ranuirements RemodeVReoair Reauireme nts
? 3 registered site surv0ys ? 2 copies of plan
? 2 copies of plans (include beam 8 window skes; poured fnd. design; etc.) ? 2 site surveys (exterior additfons & decks) '
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservaNon plan it lot pla@ed aRer 7l7J93
required: _ Yes - No
OD
DATE: I
CONSTRUCTION COST: J. .? I OO
DESCRIPTION OF WORK: ? 1?
STREET ADDRESS: j
LOT ? BLOCK ? SUBD./P.I.D. #: ???14h,yblXP? y?
PROPERTY Name: SvN.?-o,1L ??n-?`1Rst u(s3 Phone #: 25W^u`162,
OWNER """
Street Address•
City: State:
, Zip: ? S??-?---
CoN7RAC70R Company: Phone #:
Street Address: License #-
City: State: Zip:
ARCHITECT! Company: Phone #:
ENGINEER
Name: Registration #:
Street Address•
City: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and Ic`
I hereby acknowiedge that I have read this application and state that the informaHon is coRect and agree to comply with all
appiicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
UFFICE USE ONLY
Certificates of Survey Received
_ Yes . No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? OS 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
? 11 Apt./Lodging 0
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
0 37 Demolition
i ,.+ a?n ?.c. ... . .
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft. MClWS System
Main level sq. ft. City Water
sq, ft. Fire Sprinklered
sq. ft. PRV
sq. ft. Booster Pump
sq. ft. Census Code.
Footprint sq. ft. SAC Code
Census Bldg
Census Unit
Planning Building
Engineering
Variance
Permii Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
_'/oSAC...
-. _. ---- •. _.M:_ ... ---? .?,
SAC Units
?3?n g
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KN06 RD, ERGAN MN 55122
651-681-4675
New Constructfon Reaulremente
. 3 registered si[e wrveys showing sq. fL of lol, sq. ft. oF house; and all mn(ed areas
(20% manimum lot croverage allowed)
• 2 copies of plan showing beam & window s¢es; poured found deagn, etc.)
• 1 set o(Energy Calculatlons
3 copies of Tree Preservation Plan if lot platted after 711193 ?
• Rim Joist DeWil Options selection sheet (61dgs vnth 3 orless uniLs)
DATE 7- 25' G Z.
RemodeURenairRaouirements
. 2 wPies of pan
• 7 set of Ertergy Calculations (or heated addRbns
1 s0e surrey for entenor add'N'ons & decks
?. Indicate d hane served by septic system for additions
0-0 `qA ??
? Z 1- ",y
VALUATION ,?y 3 ?I UU ?
SITE ADDRESS 4/3 7 7 /ylCTci91'F A/P/UL MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK /Ct'IfaU F culrH Yt%`/A°Of_f FIREPLACE(S) _ 0_ 1 _ 2
APPLICANT G?UA?/YY CUN S7W1fG770N f oNNS'[.7''/?O.V ,!tiL
STREEiADDRESS NOiPJ'HE?1N A.PE'?9 RUNT£ $ DAM16?ITY AYT,f'/N STATEINAI ZIP 56 y31
TELEPHONE # 218 •9v• 3335 CELi PHONE # 6/2 • 986 • 7aS9 FAX #
PROPERTYOWNER /NE'L/SII SLJA9Afl/1S TELEPHONE# 4952 - (o$lI
------------°----------------------°-----------------°------°----------------------°------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 n
(J submission type) . Residential Ventilation Category 1 Worksheet Su6mitted •
• Energy Envelope Calculations Submitted
Plumbing Contractor: _
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/WCter Contractor:
_ Air Conditioning
_ Heat Recovery System
1111 2 5 2002
Fee:
Phone #
Fee: $70.00
Phone #
-----------°----------°-°----------^-----------------°---°---°-----------------•--°----------° °-----------------
I hereby acknowledge that I have reod this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordin
Signature of Appltcant
---------.... '----_....... _.._....... .______-------- "----------__._..?.----------°-- -----"---
OFFTCE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Water Softener
_ Water Heater
_ No. oE Baths
Phone # '
Iawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eact. Alt • Multi
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext. Alt- SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multl
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors '
? 34 Replacement *Demalition (Entire Bldg only) • Give PCA handaut to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units . Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Foorings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
'
_ Footings (addition) _ plumbing
_ Foundation HVAC '
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool _ F[gs _ Air/Gas Tests Final
_ Franun8 _
_ Siding Stucco Stone _
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insu?ation _ Retaining Wall ;
Approvet! By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
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2006 RESIDENTIAL PLUMBING PeRnmTaPPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date _0131 o JB LEWIS, RICHARD
Site Street Address 4377 METCALF DRIVE Ulllt #
EAGAN, MN 55122
(651) 882-0918
Property Owner ; elephone # ( )
Contractor N.Dr19.1 a)'3'1 Put,m bf nG1 Telephone# ((oI2)-
Address 2qD5 -tar-fie(.d ?I-v. 4o. city 0112 Is StateM M Zip1?94 09
The Applicant is: _ Owner Y Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add piumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are insfafffig onlv a wafer softener and/or water
heafer, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
/
Water Softener
Water Heater $ 15.00
/
_ new V rep!acement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $ j5 5g
i hereby apply for a Residential Plumbing 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 plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is t t?tart wfthout a permit and work will be in
accordance with the approved plan in the event a plan is required to Tvid ?nd a'I proved.
J e-Ff-re? L. Nor-b lo,-rL
Applicant's Prin d Name Applicants? Signature
J
Page 1 of 1
Jenny Hildebrandt
From: Carol Tumini
Sent: Tuesday, February 07, 2006 10:01 AM
To: Jenny Hildebrandt
Subject; RE: Property Owner question
We have Richard and Elaine Lewis. 651-8824918 is their phone #.
From: Jenny Hildebrandt
Sent: Tuesday, February 07, 2006 9:24 AM
To: Carol Tumini
Subject: Property Owner questian
Can you tell me who you have as the owner for 4377 Metcalf Drive? I got an application from a Richard Lewis,
but our records show Mark Pozorski.
Thanks - Jenny
02/07/2006
Use BLUE-ot BLACK Ink
r
For Office Use
Permit #l: 1 Q(050
City of Eava~ 1 (3
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:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: `13 7 M60,?/~ ^ Unit
Name;'a/3 7C• Phone: - 6~~ _
Resident/
Owner Address / City / Zip: V3 -2 2 e (i led-l/' I)W.
Applicant is: Owner Contractor
Type of Work Description of work:
~
Construction Cost: Multi-Family Building: Yes / No4
Few- '94415,
` ~W !~/7 071'1-~~~
ComPany Contact:
Contractor Address: /l %/'CP0- 5~- City:
State: M4 Zip: ? c;2- Phone: ~J 2 -2 3 7 _ -3
License ~A9/ 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:
Mechanical Contractor: Phone:
LSewer & 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 the 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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with th innesota State ding C mu be completed within 180
s of permit issuance.
x x l
Applicant's Printed Name Applica s Signature
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