4254 Moonstone DrCITY OF EAGAN Remarks Ced.ar Grove Acqu.isition
Addition L'Ad3'C' Grove #2 Lot 22 Blk 2 Parcel 10 16701 220 07
Owner?(,??l?6 ??1'-L' ? Street 42?l?. Moonstone 1}I'. 5tate Eagan, MN 55122
;r
t i?ti_lldd'1 •
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, p8S 1985 1266.95 84.46 15 1266.95
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL
WATERMAIN
# WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-189
(612) 681-4675
SITE ADDRESS:
PERMIT SUBTYPE:
11?I NY?;?;'1'lUl?l itL(.:UK1)
PERMIT TYPE:
Permit Number:
7 Date Issued:
- . .. . .. . I , .. .
2 ;, tit. 0t F • APPLICANT:
(,R i :.,. r:,:,?; ,
ti ! w 11 00 11 ')
TYPE OF WORK:
{)1- ':. CCt ft'T CfiF1
f<i?tl_f!1N?
Q! :? ;' 7 1 N
07 /?9fkIR
ttf PAIR
ce t Rt1nf
Rf MARK'S+: fiFRll[?F IlIJF Ttt STt,RMt Irflroq61 '.•`??;;?j
Pertnit Holde? Date Telephone #
PLUMBING
HVAC
Inspectfon Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING ?r
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
OFSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAI
DECK FTG
DECK FINAL
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121
4PHON E: 454-8100
e' BUILDING PERMIT Receipt # } To be used for a-SIDr''V Est. Value $4pooo Date ?EPT b ,1988
Site Address 4254 PnONMwI` I)It
Lot 22 Block x Sec/Sub.??? ??? 2ND
Parcel No.
ac Name ??? A OLSON
z Address 4254 momTOim Da
? City W-0 Phone 454"29"
. o N a m e JIM ?:ODi EI.DO 11A1'ESIwL?6 9 I 11C
o ? Address
"-C
City J' A Phone i5G7) "S-$17*
Name
Address
City Phone
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.
Signature of Permittee
A Building Permit is issued to:_-J 114 COLE
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well (Actual) Conat
City Water (Allowable)
PRV Required # of Stories
Boaster Pump ' Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. _ Permit 9?'?
Planner Surcharge ?•?
Council _ Plan Review
eldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
?"?
TOTAL
Permit No. Permit Holder Dats Telephona #
Plumbing
H.V.A.C.
Electric
Softener
Inapection Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.1 1
Rough Htg. 1 1
I su I_
Fireplace
Final Htg.
Final Plbg.
Bld9• Final '
Cert Occ. ??`• ?!j ?,?
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
aa5?r.?.c .... ?.. ,. .. : : -. ' _ :-s'94Fr ? . . •?v'?.: '?c^rl7e
CITY OF EAGAN ?`?'?J = 8 ? ? e
3830 Pflot Knob Raad, P.O. Box 21-199, Eagan, MN 55121?
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for EKK Est. value ;1'000 Date JULY 9 , 19 90
Site AdIrgss 4x? ?? CS
Lot ? Block Sec/Sub.
Parcel No.
W Name ""•'"_ '"""_'.
0 Address
City EAGIIIIN Phone
?o Name $?
;? Address
? City Phone
Name _
Address
Phone
Building Official ! i ' OFFICE USE ONLY
I hereby acknowlege that I have read this application and state that the
information is correCt and agree to comply with all applicable State o(
Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Permitee r 4-' ?- -
?? Q??
A 8uilding Permft is issued to:
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Occupancy - FEES
Zoning - 25.00
(Actual) Const _ Bldg. Permit
(Allowa6le) • 50
- $urcharge
# o1 Stories
Length Plan Review
?
oepm - snc. ciry
S.F. Total - SAC, MCWCC
S.F. Foolprints _
On Site Sewage _ Water Conn
On Site Well - Wlater Meter
MWCC System -
Aoct
• DePosit
City water _
PRV Required _ S/W Permit
Booster Pump - 5NV 5urcharge
Treatment PI
APPROVALS Road Unit
Plenner - park Ded.
Council
BIdg.O(t.
_ Copies 1.00
Variance - TOTAL ?
Permit No. Permit Holder Date Telophorn #
WATER
SEWER
PLUMBING
H.VA_C.
ELECTRIC
Inapection Dafe Insp. Commenls
Footings I
Foundation
Framing
Roofing.
Rough Plbg.
Rou9h?ft9•
W.
Faeplace
Fnal Htg.
Final Plbg.
Const. Meter Plbg. Inspectw - Notify Plumber
Ergr./Plan
Bldg. Final
oeuc Ftj. a
Dacis Final ?- .G O 7-3/ 90 hoi.,44,` ow .Q rq ,
we?i? be- wa k c,
Pr. Uisp.
EAGAN TOWNSHIP
DESCAIPTION
h'° ].013
Eagan Township
Town Hall
Dale ......................
5tosies To Be Usad For Front Dep1h Height £si. Cosf P mif Fee . Aemarks
--
?? - _ i. •
?L.t?-+? yr
0
--
-- ?
iSrc-C
?? _
1o0°= --
LOCATION
Streel, Road or ofher Descripfion of Location Lo! Block Addition or Traei
d'Za ? /- .4- ?l 9 ? t• ie ? .
This permif does noi aufhorize the usa of s!=eels, roads, allepa or sidewalks nar does it give the owner or his agenf
the righ2 !o creafe any aiSUafion which isa auisanee or whieh precenis a hazard io the heallh, safety, convenienceand
general welfare So anyone in lhecommunifp.
THIS PEAMIT MUST BE K?E_PT O?N TNFIl E PAry? EMI3E WHILE THE WORK IS IN PROGAESS.
Thic is So cerlify, lhaf..?! .c'a.rysi..?.i......has permisaion !o erect 4k..4. ---.....`. ? .................... . upon
the above deseribed premise subject fo the pzovisions of the Huilding O:dinance for Eagawnship adopted 11,
1955. /f ?, l / /?
---------------------- ?'!r!i4f!t.vci. ?'?Tis?.J'.........._... Per ......_...__.D. /.Kt....LPs.?."f..^...:1..... _.-'-...-.."=.-:.'..............._.......
Chairman oi Tnwn Board ?/ 8uilding Inspecior
ic I A
EAGAN TOWNSHIP
DESCRIPTION
N° 702 ,
Eagan Township
Town Hall
::-? -_ ?.?
Date ... Z?/ - . -
ilories To Be Used For ?Froni Depih
_ Heighi
- Esl. Cosi Permit Fee
- - Remarks
????f/' (S?o 60 (p p.ao6
? /
LOCATION
SYreei, xoaa nr otner liescrpnon ox LOCaLOn I_i.ox I r•tocx i naainon ox iraci
----- ---? ?-- =-
This pexmif does nof auth ize the use of slreefs, roads, alleys or. sidewalks nor does it give !he owner or his ageni
the righifo cxeale anp situati n which is a nuisar.ce or which presents a hazard io the heallh, safefy, convenience aad
general welfare to anyone in the communify. , - .
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORf{ IS IN PROGRESS. - This is !o aeriify, ihaf..-------------- ------- ------- ------- ------- --------------- has permission !b ereai. a----------- ___._......................... ................. upon the above descrihed premise subjecf-fo the provisior.s of the Building O:dinance foz Eagaz Township adop2ed April 11,
1955. ".
......................... --------- ...... .................. ....... ......... ? Per --....... ............ .....-_.---__..-'-----...........---...._.._....._....__..._...
Chairman of Tnwn Board ? ? Building Inspeeior
EAGAN TOWNSI-IIP
BOJILDING PERMIT
Ownex '---R&'Y'? --'Qr---- --.......--......---'----
?-s'?Y
Address (Presen2) ....-' -------'-'-'----------.....__'---------------- ?<.
Builder ...... .?a .--------- .............--..........?---
Address .---------....;./.l.L::4ett'N.
?l
DESCRIPTION
N° 1482
Eagan Township
Town fiall
Dafe ............. ""-""'-'......
Sfories To He Used For Froni Depln Heighf HsS. Cosf Permi! Fee Aemarks
.Qj,?t_?4.Z? ol 0 .? S-. j.J 7S <''`" ?5 ,?'C-tP C?C.e?.- ?
? U LOCATION
s¢reex, noan ar omes uescrxpuon o: a,ocauon _ i..o: aiocx _ naainan or iracz
I 2J- - C? '12 -it- Z
This permii does not auihorize the use of sireels, roads, alleys or sidewalks nor does it give the ownes or his agent
the righ!!o create any siluafion whiah is a nuisance or which presenls a hazard to the healih, safefy, convenience and
general welfare fo anpone in the communiip.
THIS PERMIT MUST BEEPT ON,nT?HE?. -PREMISE WHILE THE WOAK IS IN PROGRESS.
This is !o rerSify. !hffi_- ... :....Cr-:-_-__---_-.....has permission !o esect a_"'-"' -'---- '-"""'-....'."-'-""..upon
the above described pxemise subjaet fo the provisionsof the Building Ordinance for gan To ship adopied April 11.
1955.
_- Q p p ,,
..""-"-------------------------. ?J a`=!-? Per .--'------. ... ?
.?.C......??!?:•-?-4-.......4-Kd?II.?l..............
Chaixman of Tnwn 8oard Building faspecior
a. ?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 NO 15564
PHONE:454-8100
u
BUILDINGPERMIT Receiptu
'To be used for RE-SIDING Est. Value $4,000 Date SEPT 6 .79.88_
SiteAddress 4254 MOONSTONE DR
Lot 22 Block Z Sec/Sub. CEDAR GROVE 2ND
Parcel No.
w Name RONALD A OLSON I
3 Address 4254 MOONSTONE DR
0 City EAGAN Phone 454-2968
o Name JIM CODE BLDG MATERIALS. INC
,
oa Address
? ???y DUNDAS phone (507) 645-8178
W
i
a
2
w
Name_
Address
Ciry_
I hereby acknowled9e that I have re d this application antl state that lhe
information is correcl antl agre o comply wit 401 a pllcable State ol
Minnesota Statules and Ciry Eagan Ortlin s
Signature of Permi
A Building Permit is i ued ta-_ JIM_CODE
on the express cond'Hion that all work shall be done in accordance with all
applicabie State of'Minnesota Statutes and City oi Eagan Ortlinances.
Building Official__?,?'_-ft
OFFICE USE ONLY
On Site SewaBe _ Occuoancy
MWCC System Zoning
On Site Well _ (ACtuap Const
Ciry Water _ (Allowable)
PRV Required _ # of Stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPHOVALS
Engr./ASSess.
Planner
Gouncil
BIdg.Otl.
Variance _
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
7reatment P1
Parks
TOTAL
58.00
2.00
60.00
' ? CITY OF EAGAN N0 ..; 18 118
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE:454-8100
Receipt p
To be used for OIK Est. Value $1 , 000 Date , JULY 9 1990
Site Address 4254 MOONSTONE DR
Lot 22 Block 2 SeGSub. CEDAR GROVE 2ND
Parcel No.
wlName RONALD OLSON
? Address 4254 MOONSTONE DR
city EAGAN Phone 454-2968
?o Name SAME I
g¢ Address
? City Phone
? W Name
Address
14z City Phone
I hereby acknowlege that I have read this application and state that the
information is correcc and agree to comply with all applicable Stale of
Minnesola Statutes and Cit 1 Eagan Ordinances.
Signature of Permitae ? /q Qza A?
A euilding Permit is issued to: RONALD OLSON
on the express condition that all work shall be done in accordance with all
applicable State ot Minnesota Statutes and City ot Eagan Ortlinances.
8uilding Official
Occupancy
Zoning
(ACWaq Const
(Allowable)
# oi stories
Length
Depth
S.F. To1al
S.F. Footprints
On Site Sewage
on sae wen
MWCC Syslem
City Water
PRV Required
Baoster Pump
APPROVALS
Planner
Council
Bldg. Ofl.
Vanance
OFFICE USE ONLY
14'
14_'
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC,MCWCC
Water Conn
Water Meter
Acct. Deposit
SAN Parmit
5/W Surcharge
Trealmenl PI
Road Unit
Park Ded.
copies
TOTAL
25.00
.50
1.00
26.50
1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
1554qw
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDAESSES FOR CORNEB LOTS - CONTRACTOR/SOMEOWNER MUST DESIGNATE WHIC$ ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS U OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT,,
1 SET OF ENERGY CALCULATIONS
COM4fERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For:
Valuat
ion: /I'
Date: `7- ,-'-ao?
Site Address OFFICE USE ONLY
Lot ?-2-- Hlock '-2- On site sewage _ Oecupancy
Parcel/Sub 6,40- A2Aw M`dCC system
On site well Zoning
Actual Const
O City water Allowable
wner a n1A- PRV required 4k of stories
Address Booster Pump _ Length
Depth
City/Zip Code-ff; ? ,./.? . S.F. Total
Footprint S.F.
Phone Ll APPROVALS FEES
Eontractor r%Assess Permit g,b?
/
Address ?'f //%-el P anner
Council Surcharge 2,Oc?
Plan Review
City/Zip Code Bldg. Off.
Variance SAC, City
SAC, MWCC
Phb
n Water Conn
ne _« ? , Water Meter
- Road Unit
Arch./Engr. = Treatment P1
Parks
Address Copies
I
CitylZip Code
TOTAL 60,00
Phone #
I Cbms
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) LSET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIDNS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
# 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 MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMSER.
To Be Used For: ,o-- U/< Valuat ion: Date : p
/`
gd
Site Address -*7?S OFFICE USE ONLY
Lot B1ock ? FEES
Occupancy
Parcel/Su6 CE.b.A,, ` /??? ????e -Z`vp
A-Pt? ^' Zoning
Actual Const
Bldg. Permit
d
n
) Allowable Surcharge iS?
?1
Owner /TUY?ci/?? N O?.SDIV # of stories Plan Review
Length lq' SAC, City
Address l-?`V {/ppe,c?j0/Vt /l O . Depth /y' SAC, MWCC
S.F. Total Water Conn
City/Zip Code c A G R N f2(yj Footprint S.F. Water Meter
Acct. Deposit
Phone On site sewage_ 5/W Permit
On site well S/W Surcharge
Contractor MWCC System _ Treatment P1.
City water _ Road Unit"
Address PRV Park Ded.
Booster Pump _ Copies
City/Zip Code SUSTOTAL
APPROVALS Penalty
Phone Planner _ TOTAL
Council
Arch./Engr. Bldg. Off.
Variance
Address
City/Zip Code
Phone #
yr ?
o?
IA
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?,
FERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: euzLozNG
Permit Number: 032710
Date Issued: 0 7/ z 9/ 9$
SITE ADDRESS:
4254 MOONSTONE DR
LOT: 22 BIOCK: 2
CEDAR GROVE #2
P.I.N.: 10-16701-220-02
DESCRIPTION:
ti.", REROOF
Buildinq_Permit Type
Srrilding W'ork Type
Ces?sus Cade /
i
%
41 $
4.,.
STORM DAMAGE
REPAIR
434 ALT. RESIDENTIAL
REMARKS:
REROOF DUE 70 STORM DAMAGE.
FEE SUMMARY:
CONTRACTOR: -
RTGHT WAY ROOFIN6
1209 E. 79TH ST
BLOOMINGTON MN
(612) 853-0049
Applicant - ST. LIC OWNER:
18530049 0003999 OLSON RON
4254 MOONSTONE qR
55425 EAGAN MN 55122
(651)454-2968
' . . . . . ". . . . .::..
I hereby acknowledge thet I have read this
, information is correct end agree to camply
Statutes and' City af Eagan Qt^dinenCes.
L -_ APPLICANT/PERMITEE SIGNATURE
applicaCion and stats that Che
with all applicable State of Mn.
J
? SUED BY: SIGNATURE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
?J CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-4675
New Construction Reovirements
? 3 registered site surveys ? 2 wpies of plans (inGude beam 8 window saes; poureC fnd. design; etc.)
? 7 energy wlwlations
• 3 copies of free preservation plan H IM platted after 717193
? IrTvW?l?? I 1 1 U
DAT: .
OF
RemodeVReoair Reauirements
• 2 eopies of plan
? 2 site surveys (erterior adOdions & decks)
? 1 energy calcuWtions for Mated atld'rtions
CONSTRUCTION COST; 00
S?? vV\- ci-a.
STREET ADDRESS: -I? `T j/ lUU 1 l ?7-T/Y ?j±ja?5? u Y.
LOT: BLOCK: ? SUBD./P.I.D. #: C ?ko,-r CVU \J-e
NamrPcX.1 Jm 2V ' ` P6one #: 4
PROPERTY ? First
OWNER c if) n n - n
Street
CONTRACTOR
Zip: 5 5 I a
,e -oo q
License # V l I
1 Zip:
ARCHITECT/
ENGINEER Company: Phone #: _
Name: Registration #:
Street Address:
City State:
Sewer 8 water licensed plumber (new construction ony):
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this applicatlon and state that the info at?correct a
State of Minnesota Statutes and City af Eagan Ordinances.
Signature of Applicant ? OFFiCE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
Zip:
Penalty applies when address chang
agree tQcompy with ail applicabl
-
'-
?_._. ---'-,-
??i Jut- _ 7
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = piex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Firepiace ?
? 15 Deck
? 36 Move
? 37 Demolition
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft.
_ Main level sq. ft.
_ sq. ft.
_ sq. ft.
_ sq. ft.
_ sq. ft.
_ Footprint sq. ft.
Building
MC/WS 5ystem
City Water
Fire Sprinkiered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
°k SAC
SAC Units
?
C?
?
?
- ? - ? .
-- ? _
?Yoll? ?)- I
- kea
?
?
?
?v C2
m
y?is'y /?IbeN?o??E
0
w«
-- - -
?
I
? -
?
,s ?
6$-7((o
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675 Please complete for modifications to existing residential dwellings.
OS OLSO
N, RONALD
Date l (
4254 MOONSTONE DRIVE
Site Street Address EAGAN, MN 55122 I
Vnlt #
(651) 454-2968
Property Owner -lelephone # ( )
NORBLOM PLUMBING CO.
Cvntractor Telephone # ( )
Address City State Zip
MINNEAPOUS, M
N ?5540? '
Oth
?
er
The Applicant is: Owner ontrac or _
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_WaterTurnaround (add $125.00 if a 5/8" meter is required)
_ Ofher:
Water Softener X Water Heater $ 15.00
_ new ? replacement.
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ I S. 50
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 not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
,Je4 NarblU,rn
ApplicanYs Printed Name.
Ape$,dant's Signature
!- - - =- - ?
City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
? ForO_?fige.Use I
j Permit #:
? Cl
Permit Fee:
? Date Received: j
I I
I Staff: I
i
2U08 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7`" -?l? ?06 Site Address: 4oLSV 2.
Tenant:
Suite #:
RESIDENT/OWNER Name: k?"vs?? 0I.-;n?1 Phone??ASl)?ysy'a?`jfog
2?gan md`j .SJr?e7D
Address/City/Zip:ya2.5q
?iY9/1.cfm?p_ 1)r
_
,
cl
Applicant is: _ Owner X- Contractor
TYPE OF WORK Description of work: Cc fC[111-F
Construction Cost?%?o Multi-Family Building: (Yes_! No?4-)
CONTRACTOR Name: `1'r_r le r" 0''' License k: .a?aww ?
Address: 147261 2y
rfl.{uibe arK(.,.Z'tiy
,
City: ?]U.fn.Sj7i 1'P State: eild Zip:.SJr39 60
Phone&A) -?0 ]-/o7.Slv Contact Person: rV 1I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Su6mitted Submined
(4 SUbmISSiOf1 type) • Energy Envelope Calculations Submitted
In the last 72 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:
NOTE: Plans and supportfng documents that you submlt are considered to be public intormation. Portions o/
the information may be classified as non-public if you provide specific reasons that would permit the Ciry to
conclude that the are trade secreis.
I hereby acknowledge ihal ihis iMOrmation is complete and accurate; that ihe work will be in conformance with the ordinances and codes of ihe 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 permif; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans. ,/J
X 6f4 il f-fC I I X
Applicant s Printed Name Ap ' a ' nature
Page 1 of 3
i:Uave l�ite (ProWork Builders LLC) To:Buiding Inspections (C.ity of Eag�n) (16516755694) 14:24 05�14�15;EST Pg 2-8 '
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. ' j Pertnil#: � ' � �1�
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��4 �71:`....� �� � Permii Fee: �7 J • �� ,
�' �' ( �-y [�C `
383Q-Pilot:Knob Road; � Date Received: r '� �✓ �-` �'"
E.agan MN 55122 �
Phone::'(651)675�5675 q y � �
; �
Fax:(651)675-5694 MQY � �F LO i5 j �a�' `� - i �'�
, ���_����������...._�J � I
;
2015 RESID,El�T�AL B�IILDIt�1;G PERMIT APFLICATION j �
Date:;�,:�� -�� . Si#eAddress:�.'�..�� ,�+P/r�a3����,°��"'" U�lE#A
�� � � � �..,�;.�,�,.,, ,�,..-:,�.�;.�,,, �.�..�....�....�„�." `
s.�x r fi� � , Name:�Ga �a ���+ �.�7�- Phone: s
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If the project;is exempt from lead certi��at�o�,:ple�s�.explair�why \
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G.OMPLETE TI�IS.:AREA:;ONL'�(::i�CO.,I�STRU:�TIhf�;A:NEV�I B.UILDING
in the iast 42 mo:nths,has the.:City of Eag.a..n�ssued a p�m�it for a similar.plan base:d.on a masterplan?
, c::
Yes _No If yes,date..and address'pf.masterplan:. ; >
Licensed Plumber: P,hone:
Mecba�ical Contcacfor: >.: Phone:
Sewer&:VYater C.ontracfor: : Phone:
F.ire.Su.p.pre.ssion:C.o�tractor;. ; ` '.' Phone;.
��.��,z.��.l.�k�ll""�e���SZ 1�Tf�.+P����i� ���il�*'.��� �� -ZTT�9„� �� s' l�yr��"y .�- {Ai��nS����/�M' ��rt.. .•"rY����f,y y �k� g�,�",�' .
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s"�����+3�s�����,^e�rxrd��r�����a��►�'�,""��.�'�.v����������"�`''��t�#!a.''����`��f��'�'�'*���� �" ��.H'��� ��`�
'fs.,�e`M.�.� 3�,��i h"x`['c"l if.rh"Ff''{��'t a"`�s ixz p¢*�x'y. � rµ t., r t>�r �,�y n? 5�:d}� >n1 },37".��4. ��t�����, r�'�ss�,�a'.�'�. 1���� K�v�i�.w.:�i t'
..:.�, . .� .� ..,: ..,i....�.y' h�,..,ct:. �....�rr:�:�"^" �.;3Y.: Y'.� �e �.�. �� � .33 �'T�+ K�i.. �.vti-, �.L�3?uc'���''�'..n.�q��tti
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CALL BEFORE YOU DIG. .�ali Gop..hsr.StaCe,;On...e.C.all;at:(657)454,0.0.02:fot ptot�ction.against underground utility damage_ Call 48 hours
before you_intend io:dig io�e1ve 14caies of undergrpund utlUties ;.wwy�qQphersiateonecail oro :
,.
,: . .
I hereby..acknowledge that:this.:infotmation is CamR�e.ke:and.accu(ate:::that:(he..�vock.will be.in conf.ormance with the_ordinances and co�es of the City of
Eagan;that I under�tand this:is not a perrr►it,;but.pnly,;an appii�Eion for a permit,.and.:inrork.is;not lo staR wifhout a permif;that the work will be in
accordance wilh ihe:app.r,oved,plan:in.the case'.oiwoik:Which.teguites.;a:r�vjew.and;appcoval of;pla►�s.
, ,..
,
,... :
Extsr.i.orw.o.tk a.uthorized;by;a buildin..g.permit.issyod in:ascordan.ca wrih.k6e M��nesota$kate;Building Code must be comploted wiEfiin 10Q
days of permii issuance,
�
x..:... ..._....... ..
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App.licant's:Frinted Mame. �1pp�ca�t��s�%gn�kur�:
I.i . ... �.'.. :. ' '. . .: ).' :.,:: '. � .. '. .. .' .
..; ' _.. .'...::.:�.::.
.. .....: ' �:...; . .
, ,;Page;):;Qf;3:...:..::. :.. ..::.
' � �.�� �OQ�1S��'l.��'-DO NOT WRITE BELOW THIS LINE �� � �
St1B TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
� Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(ScreeNGazebo/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 / 7ov� Occupancy �-/ MCES System --
Plan Review Code Edition ,to��"' SAC Units -�
(25%_ 100%� Zoning �,+�/ City Water
Census Code y J►4 Stories J Booster Pump ..-
#of Units � Square Feet ,'�/� PRV _.
#of Buildings � Length �,�� �'�� Fire Suppression Required —
Type of Construction � Width ��
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
� Footings (Addition) � Final/No C.O. Required
Foundation � HVAC Gas Service Test Gas Line Air Test
� Roof:�Ice &Water ,�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
,�r Other:
Reviewed By: G , Building Inspector
RESIDENTIAL FEES .- � �//� �
—� o�./� � /fl��k i l�aW � ��o �/ 7" ��i j19�, �
Base Fee o�,9
Surcharge
Plan Review f Qfl ?
MCES SAC
City SAC
Utility Connection Charge
S8�W Permit& Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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Use BLUE or BLACK Ink
r----------------�
I For Office Use �
I /� �
� � Permit#:�� ��v I
City of ��o�� ; . G� ;
b Permit Fee: �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 � �
Fax: (651) 675-5694 I Staff: �
�-----------------�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: � �� '� Site Address: �� �� V � 1(�b'(1S�e � i ��
Tenant: Suite#:
Residen�O�v�er ' Name: Pnone:
Address/City/Zip:
Name: ��(� ���a��}- �I�}fy�`�ti�Gj License#: ��
CO11tx'aCt01' Address: ���I�) ��JUI�� � U YLQ Vl W City: �"'7"Y1�C�PY
` State:�Zip: ���j b�' Phone:__��-J �l� �Q�O
Contact: /"1 � Y U� EmaiL d rUl�GV ( • (;C3 t'�
T��e Of�+prk —New _Replacement _Repair _Rebuild �Modify Space _Work in R.O.W.
' Description of work: L ��� �,� '
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
�����#T��� Add Plumbing Fixtures�Main/_Lower Level)
Septic System
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 Svstem Abandonment,Water Turnaround*(includes State Surcharge)
"Water Turnaround(add$210.00 if a 5/8"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 reeeive locates of underground utilities. www.gopherstateonecall.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 approv of plans.
X.�Q��Vl�t �-� e r �� �J� d � X �
App ant's Printed Name A pl' anYs Sig ature
FOR�FFICE USE. Reviewsd By: Da#e:
Required Inspections. Under Ground Rough-In Air Test' Gas Test Final
Meter Reiated Items: Meter Size 'Radio Read Manometer �taff:
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j. Roof/ceiling assemblies shall have a minimum 6-inch energy heel.
R402.2.1 Ceilings with attic spaces.
When Section R402.1.1 would require R-38 in the ceiling, R-30 shall be deemed to satisfy the
requirement for R-38 wherever the full height of uncompressed R-30 insulation extends over the wall top
plate at the eaves. Similarly, R-38 shall be deemed to satisfy the requirement for R-49 wherever the full
height of uncompressed R-38 insulation extends over the wall top plate at the eaves. This reduction shall
not apply to the U-factor alternative approach in Section R402.1.3 and the total UA alternative in Section
R402.1.4.
A. Additions, alterations, renovations, or repairs.
Additions, alterations, renovations, or repairs to an existing building, building system, or portion of a
building shall conform to the provisions of this code as they relate to new construction without requiring
the unaltered portion of the existing building or building system to comply with this code.
Additions, alterations, renovations, or repairs shall not create an unsafe or hazardous condition or
overload existing building systems. An addition shall comply with this code if the addition alone complies
or if the existing building and addition comply with this code as a single building. Attic insulation shall not
be installed unless accessible attic bypasses have been sealed.An attic bypass is any air passageway
between a conditioned space and an unconditioned attic.