The URL can be used to link to this page

4271 Moonstone DrLot Parcel No. ? Name YAL S;)GN Address c A iy-!,: CitY Phone ?9 Name ??OUNTRYWr'JC CONMU; i I NC. addrom 3355 :, ,4-1a ',`1A AsaE u? cit, _ '4PL= annnA - - Phone I hereby otknowledge thot I how reod this oR fM inlormation is torrect ond oqree to ton Stote of Minnwtota Stctutes ond City of Eo Sipnoture of PormittM _ • - A Buildinp Permit is isswd to: oll work sholl be dprr in att.ordcntt with oll 8uildinp Offitiol Erect l?l Occvpancy RemodN Zoning Rapair ? Type of Const. Enlarge ? No. Storias Move ? Length Demolish ? Depth . Grsde ? 5q. Ft. Iratall ? Aapeeveb Fees Nssessrrienr Water 3 Sew. Police Fin En0• Plarxw Cowscil Bldg. Off. 4/ ? J i i.} 5 APC Var. Dsts Permit 3u• DO Surchorqe 2 Plan Review SAC Woter Conn. Water AAeter Road Unit Parks Total 1"1(jM . l.NL . on fM exprM condition tha+ of AAfnnesota Stotutes ond City of Eopan Ordinancas. C1TY OF EAGAN 3830 Pilot Knob Rosd, P.O. Box 21-199, Eapn, MN 55121 - PHONE: 4548100 ! ' ,C i SUILDING ?ERMIT Receivt # ? PMmit No. Permk Holdar Dm Tsle hone it Plumbinp H.VA.C. Ehetrle Softwwr Ir"ctfon Data Insp. Other Footinys r Foundation Framinq Rooflnp Rouqh Vibp. i Rough HVA Inwlation Finsl Ptby. Finsl HVAC Final Cwt/Ooe. Watir Dftalbe Loeation: YVsll SsrNr P?. Disp. CITY OF EAGAN Remarks Cedar Grove Acquisition Addition Cedar Grove #2 Lot 9 Rik 3 Parcel 1016701 090 03 owne? 't I L' street 4271 Moonstone Dr, state Eagan,MN 55122 IUrl. tf Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. FES 1985 1266.95 84.46 15 STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL 1972 1 .00 2.1 2 7.o A012252 5-2- 3 WATERMAIN WATER LA7ERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 1 i BUILDING PER. SAC ? PARK RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN a1 / '7 3830 PILOT KNOB RD • 55122 651-681-4675 lew Construcfion Reauirements RemodeUReoair Reauirements 3 registered site surveys showing sq. ft. of lot, sq. k. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set af Energy Calculations for healed additlons 2 copies of plan showing beam 8 wiiMow sizes; poured (ound desgn, etc.) . 1 site survey for ezterior additions & decks 1 set of Energy Calalations . Indicate if home served 6y septic system for additions 3 copies ot Tree Preservation Plan if lat platted afler 711193 Rim Joist Delail Options selection sheet (bldgs with 3 arless units) )ATE o5-a3-o i ?]Q,Do Callcci 5-1-01 "fV' VALUATION ? C) obI o? IOB SITE ADDRESS 42`7 I Mooe? S^ro?? p??v? ?,n?C?_til F MULTI-FAMILY BUILDING, HOW MANY UNITS? ?oRSi?R? 'ROPERTY OWNER SC-4-->77 'YPEOFWORK FIREPLACE(S) XO _7 _2 _3 kPPLICANT PHONE# (-)sZ? 036"28-71 kDDRESS ZIPCODE 5'ge>AA 'AGER# CELLPHONE# 9- 426y FAX# l9sz)890-7070 NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 Plumbing Coniractor: _ Plumbing System Includcs: Mechanical Contractor: Mechanica] 3ystcm Includes: Sewer/Water Contractor: Air Condiaoning Heat Recovery System Fee: $90.00 Phone # Fcc: $70.00 W above information must be submitted prior to processing of application, hereby acknowiedge that I have read this application, state that the infon 311 applicable State of Minnesota Statutes and City of Eagan Ordinances. 3, Dod Signafure of Applican+ :ertificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ New Energy Cade Worksheet Submitted Phone #: Water Softener Lawn Sprinkler Waler Heater No. oFR.I. Baths No. of Baths Updated 1l01 OFFICE USE ONLY I ] 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory 81dg ] 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 7 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ] OS 03-plex ? 11 10-plex `K19 Lower Level ? 24 Storm Damage 7 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ] 31 New ] 32 Addition )( 33 Alteration ] 34 Replacement /aluation 6?-?- :ensus Code 3AC Units Jbr. of Units dbr. of Bldgs -ype of Const ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding D 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof O 46 Windows/Doors *Demolition (Entire Bldg only) • Give PCA handout to applicant Foorings (new bldg) Footings (deck) Footings(addirion) Foundarion Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. _ Air Tes[ _ Final Insularion Occupancy Zoning Stories Sq. Ft. Length W idth REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. Plumbing HVAC MC/ES System City Water Booster Pump PRV Fire Sprinklered Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approved ByBuilding Inspector 3ase Fee iurcharge 'lan Review ,AC/ES SAC -ity SAC Nater Supply & Storage i&W Permit & Surcharge -reatment Plant 'lumbing Permit Aechanical Permit .icense Search ;opies )ther fotal E IEAGAIeI TOV1/N51-IIP BIJIBoDltdG PERMIT Address (preseni) Builder Addreas DESCRIPTION N° 449 Eagan Towxship Town Hail Dafe ------ -------°----°------------------- Siories To Be Used For Froni Depfh Heighf Est. CosY Permik Fee Remazks / ? ?CL1':??? LOCATI02v ? ox This g?e iS does not auihoriae the use of sireels, roads, alleps os sidewalks nos daes it give the owaer os his agenY the ri} ifo ereaie any siluafion which is a nuisance or whieh presenfs a hazard io the heal2h, safely, conveniance and general welfare !o anpone in the communify. THIS PEAMIT MUST EP?vt, ON' T,P £ WHILE THE WORK IS IN PROGAES,S??.), This is io eerfifY• lh???$.?#}BR?-?S.e.Yt<.-_-hes permission !o erect a..!,/i??` ..??---------------------upoa the above described premise subjecl !o the pzovisions of the Building Oxdinaace n¢ p adopfed April 11, 1955. ! i>.9 _..._...'----------------- .__ .............................._...__.'_ _...........__.. .?... _.. . . _....._.'__,........_.... . _..___'...""_..._. Chairman of Towa Board difig Iaspeclor n n S 7y a ? ? R Lu. g8 4lequesl D-te ? 3??n ?? Fire No. fiovgh-I^. Inspsction ReQUiretl (Yrni m?vst c'ell inspecmr wh aatlyj Yes No Inspecti Other Than Rough-1 eady Now g W Notity spef?or Dete Reetl I'iicensed conhactor ? owner hereby request inspection ot above electrical work at: I Jo0 jAtldress (SVOet, 8ox ur Roota No ) ? "'F" , I k- <,?Aa !V !V C?b V?"' E IS=clion No. TownsM1io Name rn No. Range No. Co ?Y OUpcupant lPRINTi p 1 ? Phon?NO_ / 1? (i Porvor Supplter ? Atltlress Ele dcal ConVactor (Company N e? Contractor's License No - ? Mn g Atltlress (Convactor or Ownee tdaking Inst tion) > Authoriia ature (GOn[rac OOw r Making Insfellatlon) ` ona Numrer " DVV 1CITY T OPERINSPECTIONFOE O Phne(fi125 642pDB00 St?PauSMN 8 55 4 EUNLSS NCEOSED CITY OF EAGAN N2 1O 1 4 5 . 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHUNE:4548100 // ? BUILDING PERMIT Recelpf # ? « Te !e uwd lar (:ARA[:F Est. Value 4.100 Dare epBIL ')5 . 19--25_ Siteaddreu 4271 MOONSTONE DRIVE Erect C? Ocwpancy Lot 9 Block 3 SeclSub. CEDAR GROVE 2 Remodel d Zoning Repair ? Type of Const. Pareal No. Enlarge ? No. Stories Mave ? Length 0Neme - - _PAT MOGA ? Damolish ? Depth pddm$ SAMF. Grade ? Sq. Ft. City Phone Install ? S` Neme COUNTRYWOOD CONSTRUCTION,INC. pddreu 3355 HIAWATHA AVE City MPLS phone Name Address City Phona Assessment Woter 6 Sew. Pollce Firo Erq. Plonner Counefl pemit 50_ 50 Surcharge ') s_ Plan Review SAC Water Conn. Woter Metar Road Unit 1 hereby acknowladge that I hova road this opplicotion and stare thae gldg.Off. 4??7?R5 Parks fhe inlormotion is torrect and ogree ro comOlY with all oppli I State of Minnawto Stotutes and Cy¢J Eogon O"ncas. APC Totnl 53 _ 00 Var. Dete Sipnoeurc of Pennittes -? 1"O9"" A Building Parmit it issuad ro: on the exprou ea+dinon thai nll work sFwll 6a dons in rdo wlth all qppliwbl,? e State of Minnmoea Statutes and Cify of Eapon Ordinontes. Buildlrq Of(iclol f?l_a-C/l.o_[??n r ?... ., t...:'$ 1 "....?. ... .. r ? .. , . .... ,?. -. _?tl., . „_. i., .r:. . ?.....o?! ,.:_rLt .,..,. -..tn ? }.r 1 a .• . REQUEST FOR ELECTRICAL INSPECTION ee on0o i.os , See inshvclione lor ComplBlirp ?hi5 fO'm o0 bACk Of VBIIOw mpy. ?', ? b' 23 5 '"X" Below Work Covered by Ihis Request N Fee Service EnNeneBSize H Fea Feaders?Suhteetlare d Fee Circults U to 200 qm s 0 to 30 qm s 0 tn 30 t1n s Above 200 qmps 31 to 100 qmps 31 to 100 Am Swinuning Pool Above 100_Amps Above 100_A.mps Transformers Irrigation Booms PartialOther Fee ??y??. apeciai inspec[ion Nemarks ..{- 5-0 1 TOTAL FEE Rough-in Dat e I 1, the ElecLical Ineoactor, hereby Final Date ?e?i?+v ma? ina aeo?a inspection hes been mede. thla reQuastvaia 18 momhalrom This reauesl voitl ?I//?:/O? 18 h f 0 ?J? j ?• ? / mnnt s mm D 6 3 2 3 5 .?J„ 1 + . Nect uest Date ire o. RouAh-in Insuectim - Heqwretl? ?qeatly Nuw ili NoGfy Inspec- ?yes o Iar When fleady uec?ncai i,om?acior 1 hareby repuest inspection of above Owner elacerical work instelled at: Sb¢et Address, Boa or Pou?e No. _ _ Citv ur Phone No. ?'"? • '? .ut? 'Y w-. Electrical ConVa tor ICompany Name) } a ?.1a?lin0 AdJress IConirac(orbr Owner Makine Instailationl ? y ? O'}L2. .. • . C ' : ? ? . __ ..? ._. . gna i nvac or/Owr%er Makine InstalCatii ? ' ?. -?. - .: ?... .+?- ? . .. .. .... - ? _ MINNESOTA STATEOARD OFELEGTpICITY -..<-_ - - ':Y 's 3i Griq05•Mitlway Bltlq. - floom Nd91 ?. ..... t821 UniJersily Aye.. S1. Paul,'MN 55109 . . . ' . . Phone 16121 642.0900 . . . . .__"". . . r's Licansa'NO, G) !- ) __.. y •_,_. (._7_ Phona Number ,-,7HI$ INSPECTION flEdl{ES?WILLNOT ?'BE ACCEPTED BY THE STP.TE BOARO ' UNLESS PPOPEfl' INSPECFION'FEE' IS '. 'ENCLOSED. ?yJ 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN \ NOTE: ALL CONTRACTORS NUST BE LICENSED HITH THE CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: Gyfyz,?F?, Valuation: L1,,/00•00 Date: Z2,3/?.? -T- Site Address: 1,/2rJ / rI1 du,? S rone 0,& L OFFICE USE ONLY Lot: ? Block ? Sect/Sub W C7ypJ1 1rect Remodel Parcel !1 Repair Enlarge Owner p>YT IVPqq Move 6 Demolish Address mb pw S're,rr-c pi21tle- Grade City/Zip Code f94 e,,,_ -------- ? Phone 4,5--2 -bb'f9 APPROVALS X Occupancy Zoning Type of Const It of Stories Length Depth Sq Ft Contractor Ca unr.cywavc? Cow,iTrlu cf?-,Assessments Permit Water/Sewer Surcharge Address Police Plan Review Fire SAC City/Zip Code /n?/J lyin/ Engr Water Conn Planner Water Meter Phone 'J2/ - fJ?,s2 Council Road Unit Bldg Off 1s Parks Arch./Engr, APC Treatment P1 Variance Address City/Zip Code Phone p TOTAL -- ----------- 4 ?ZJ SD. 5-0 Z. =° I ?? • I f f I i I I ' ? y 4a i % r ? 3' ea ?'ya? N p? ` , ? .i fx tr t i a.y?. . ? . . .., , I 1 i • ' ' ; . . . , ? ; I ' f ? J F k I ? ?i il qI 1 /0 i i ? ? r? i?9 L y gL d, CITY USE ONLY RECEIPT #: J7WA11:F SUBD. OLP?,[t' .IC? ?UC? 051 DATE: 012o77/9J~ D0793a(P 1995 MECHANICAL PERMIT (RESIDENTIAL) 3/j0/95 4?20 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 furnace Add-on air conditioning Fireplace conversion (to existing fireplace) Date: FEES ? Minimum Fee: Add-on/Remodel (existing residence only) 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL .LD• "?JC? SII'E AUDFtESS: 4"27 1 [Yi Uic_) OWNER INSTALLER STREETADDRES5:1 I V1( CITY: PHONE #: /? y_za-9s q- PHONE #:.46q_::&0q"/ STATE:?.?7_ ZIP: CITY USE ONLY L BL REC:EIPT #: SUBD. DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD 'EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commerciaUindustrial buildings. ? multi-family buildings when separate permits are not required for each dwelling unit. DATE: WORK TYPE: CONTRACT PRICE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ?$25.00 minimum fee QC 1% of contract price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of pgpft fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OVtiivER PrAPVIE: TE?EO;-!ONE #: TENANT NAME: (tnnPROVEMENTS oNLY) INSTALLER: ADDRESS:_ CITY: PHONE #: SIGNATURE: STATE: ZIP: SIGNATURE OF PERMITTEE CITY WSPECTOR ? L BL CITY USE ONLY ? SU80. ClAV GV'0oeAA?) RECEIPT #: f J (,?, 73 ? RECEIPTOATE: `I -od PERMIT # G q4q 5000 PLUM$IN6 PERMTI' (MIDENTIRL) crrYoF $wsnx 3830 PaoT Kxos Rn BA6u4N, btN 55 t YY 651-e81-4e75 Please complete for: ? single family dwellings D townhomes and condos when pertnits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH TOTAL Alterations to existing dwelling - minimum fee Describe: _ $ 30.00 ? Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' minimum -1 3.00 X = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ ? Lavato 3.00 x = $ Se tic S tem newrrefurnisned ' requhas MPC Ifc. = $ $e tiC 5 Stem a6andonment = $ ? RPZ new InstallatioNreidrebuild - = $ ? Rou h o enin M = $ ? Shower Under founds rinklef ifdwellin isunderconswction Under round s rinkler iraxistn dwellin W ater closet Waterheater Water softener 1} dwelling under construcBon Watersoftener iiexisnn dwemn Water tumaround State Surchar e 30.OO . 3.00 5.00 30.00 30.00 .50 X x x X x --> - ---? = = = = = ° _ ---> $ ? $ $ ? $ $ $ $ $ .50 Total --> "'"> $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. -------------------------•-•••-----------...._-----------••----------••------ ---•--------•------------•----------••--------•------••---- I hereby adcnowledge that I have read this application, state thal the intormatlon is cortect, and agrae to comply with all applicable City of Eagan ordinances. Ic is the applitan['s responsibility W noti(y the properry owner that the Ciry af Eagan assumes no liahiliry (or any damages caused by the City during its nortnal operetlonal and maintanance activities to the fadlities constructed under this permit within City propertylrightoF-way/easemenl. SITE ADDRESS: zg?-/f 6y49ctr S/O/w 't c rTi--rm'v ro '? - ?- , - ?- OWNER NAME: :??% TELEPHONE #45-1 7U.S Z? 7ZU (AREA CODE) INSTALLER NAME: ??? 0,9' TELEPHONE #: C7G3> (AREA CODE) STREET ADDRESS: CITY: STATE: ZIP: SIGNATURE OF PE ITTEE PERMIT # RECEIPT DATE: U.SIDENIUL PLUM$INfi PE"IT APP1ICATION crrY oF EAsm 3930 eu.ar xxos en EtsAtv, aix 55122 651-681-4675 Please complete for: SITE ADDRESS: OWNER NAME: : INSTALLER NAME: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system TELEPHONE #:CaSI - <(.3 ?- qs?, ? (AREA CODE) ? ? TELEPHONE #: (AREA CODE) STREET ADDRESS: CITY: Place a check mark next to the permit work type STATE: ? 1Z- ZIP: sS_0°1`? New residential dwelling unit under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existin dwelling unit, including: $ 50.00 • abandonment of septic system I • new installation/repair/rebuild of RPZ • lawn irrigation system • water tumaround Nature of work: IN /? + 1 oIN ??){?K ,V ??'C?C, ??/ . 1-AY 15 d I ?u J?... ...._....._....?_ I Septic System, new/refurbished - . • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ 50 Tota I $ Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have read Nis appliration, state lhat the information is correc[, and agree to wmply with all applicable City of Eagan ordinances. It is the applicanCs responsibility ro noti(y the property owner that the City of Ea9an assumes no liability for any damages caused by the City during its nortnal operational and mainlenance activities to the facilifies constructed under this permit within Ciry p` f- e sement. ? SIGNATURE OF PERMITTEE Updaled 1101 7710? 2007 RESIDENTIAL BUILDING PERMIT APPLIC9TION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion Reauirements 3 registered site surveys showing sq. fL of lot, sq. R. of house; and eil roofed areas (20%maximum lot coverage allaved) 1 Sals Repod if proposetl building is to 6e placed on distur6ed soil 2 copies of plan showing bwm & window sizes; poured found desigq etc. 7 set of Energy Calculations 3 copies of Tree Preservation Plan i( lot platted afler 711193 Rim Joist Detail Options selection sheet (builtlings with 3 or less units) Minnflgasco mechanical ventilation form ??,6r-) RemodeUReuair Reouirements Office Use OnH 2 copies of plan shawing footings, 6eams, jois5 Cert of Survey Recd _ Y_ N lsetofEnergyCalculationsiorheatedatlditions SoilsRepoR _Y _N lsitesurveyforatlditions&decks TreePresPlanRecd Y _N, AddRion-indicateifon-sdesep6csystem TrcePresRequired _Y _N OnsiteSeptic.SYstem _ _Y _N Plans are considered public information unless vou state thev are trade secret and the reason. Date tt' / 3 / 07 ConstmctSon Cost ?ock,) -"- Site Address 4/ 2-7l M? Szor-i e ? ?'v-e UniUSte # ? 4 q c? J f ? Z'C- Description of Work f e iuo P Multi-Family Bldg _ Y i( N Fireplace(s) _ 0 ? _ 1 _ 2 PropertyOwoer 0^r..? C4azGr SLOTT rur ber Telephone#((oS( ) yvs- ?7 ZO MOr ?/-7y C t -r 4v ra on , s . Address !`fS*- Sr E City f4,at r_'cA$ State Zip SS 3 7 Z Telephone #(yS2 ) S' ?10 ??/ ?S 6 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet submissian type) • New Energy Code Worksheet Submitted Submitted . Energy Envelope Calculations Submitted ' In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a masTer plan? _ Y _ N If yes, date and address of masfer plan: Licensed Plumber Telephone #( ) Mechanical Contractor Telephone #( ) Sewer/Water Contractor 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 Stawtes; I understand this is not a permit, but only an application for a permit, and woxk 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. App]icanYs Printed Name Applicant's Signature ?- DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SFDwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch(3-sea.) ? 31 Ext.Alt-Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4-sea.) ? 33 Ext.Alt-SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Sidin9 ? 32 Addition ? 36 Move Building ? 42 Demoiish Foundation ? 45 Fire Repair ? 33 ANeration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDOOrs ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA Nandout to applicant DQSCI'IptlOfl: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bidg) _ Sheetrock _ Footings (deck) - Fina]/C.O. _ Footings (addition) _ Final/No C.O. - Foundation HVAC Drain Tile Qther Roof _ Ice & Water _ Final J Pool Ftgs Air/Gas Tests Final _ Framing _ Siding _ S[ucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. Air Test Final Windows _ _ Insulaiion _ _ _ Retaining Wall Approved By: , 8uilding Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Capies Other Total úúî ÿþ þýý üûîûú ùýýÿúì ýþ ãð á ë âãð þýö ýüûúùø÷ö õ üúùø ÷ ÷ö õ ôöõóøò ñü ü ðìüøù ïÿ ýîü òø ëò ò îü ò û ò êé ÿööøÿ þé é òÿ ý øêé é øé ê ûòè îü ûùö ÿéòùò ê íæðåæääêäêä õù ýü æêãêã çüðþê ôó öòñ øø ý í û ÿ â ë ø ôâ ÿ ô àâßââä ûùöÿë øø é ò ÿ òøùöøøûý é ýü ùé ÿì ê øøõ òýÿü üùýÿü PERMIT City of Eagan Permit Type:Building Permit Number:EA114280 Date Issued:09/13/2013 Permit Category:ePermit Site Address: 4271 Moonstone Dr Lot:9 Block: 3 Addition: Cedar Grove 2nd PID:10-16701-03-090 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - Scott E Forsberg 4271 Moonstone Dr Eagan MN 55122 (952) 891-1919 Apex Roofing & Siding 944 Oriole Dr Apple Valley MN 55124-0000 (952) 891-1919 Applicant/Permitee: Signature Issued By: Signature / ,� ' �6 �..- v`�"� �� ' �'�� Use BLUE�BLACK Ink i� o-----------------, � For Office Use I ' �a�� • I Permit#: � � � ' �� u� � �t o a a� �� Permit Fee: I I 3830 Pilot Knob Road i Eagan MN 55122 i Date Received: f f _ j Phone: (651)675-5675 � staff: j Fax: (651)675-5694 L________ _______J 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: � � Site Address: 1 � � � O b{1 ��d n� � � Tenant: �- Suite#: R�SId�[t'�1�1Yi�t��;l'�'' Name: S � O � �` \ Q�S b 2��Phone: ��) � 'L��" O�' O�O Address/City/Zip: S 1��'" ' Name: �losh Acquistions.LLC LIC211S@#: 1 l- l�"1 �� u mg , 1�124 3rd St K ' ��,��;��,��C AddreSS: Minnea�ilis.MK 55�11 City: F� �la � �3�s� �1�� ' State: Zip: Phone: � = � � ' �p Y'1'�liE'. t�l?G� �r,' � , . �°�. Contact: �e�'n 1'e Emai� j� �:. . .i.! �,��,�, ,; _New �placement _Repair _Rebuild _Modify Space _Work in R.O.W. �, ' �� Description of work: RESIDENTIAL ' �Water Heater � Water Softener Lawn Irrigation(_RPZ/_PVB) F��'��p� Add Plumbing Fixtures�Main/_Lower Level) Septic System � �� NeW WaterTurnaround ��;, — '� � Abandonment ;,�, " �.. .. RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Wa er Heater and Softener i cludes$5.00 State Surcharge) $60.00 Lawn Irrigation(includes$5.00 minimum Sta $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge) 'Water Turnaround(add$200.00 if a 5/8"meter is required) $115.00 Septic SVStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$�_ 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.aopherstateonecall.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 wi�e approved plan in the case of work which requires a review and approval of plans rhn �� l�a�-X X ApplicanYs Printed Name Applicant's ignature �z ��:. � � _ FC�R C3FF��E USE R$Y181N�'Cl B�f �e ��" �. ��$ �' ' � � �' _�, � ' , \ �... F��{�freqd lhsp��ti��ts �nt�er�r�t�r�= �` �tr�ctg��r� ��r T�st ��„��Uas"1"�s� ��,�_..,�'�n�l �s �..:. ° �� F �� ,� ° �� M�ter F��Eat�d Ix�ms: M�t�r Siz� " F�a��t��tead �taff.a'� ` '� ' � �: . ° .; �. �.. ...�.. PERMIT City of Eagan Permit Type:Building Permit Number:EA136182 Date Issued:04/28/2016 Permit Category:ePermit Site Address: 4271 Moonstone Dr Lot:9 Block: 3 Addition: Cedar Grove 2nd PID:10-16701-03-090 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Scott E Forsberg 4271 Moonstone Dr Eagan MN 55122 (651) 405-8720 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA137260 Date Issued:06/24/2016 Permit Category:ePermit Site Address: 4271 Moonstone Dr Lot:9 Block: 3 Addition: Cedar Grove 2nd PID:10-16701-03-090 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Scott E Forsberg 4271 Moonstone Dr Eagan MN 55122 (651) 405-8720 Sunlite Window and Door 14225 Ewing Ave S Burnsville MN 55337 (952) 292-1219 Applicant/Permitee: Signature Issued By: Signature Aug 15 16 04:35p Comfort Soiutions 40111/ f'itr of 1? u n a vta� ui uuguu 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 763-657-7643 p. L RECEIVED AUG 152016 Use BLUE or BLACK Ink For Office Use 2 ry (,�/ Permit #: / JO �d Permit Fee: , 0 00 Date Received: -1S1(0 Staff: L 2016 MECHANICAL PERMIT APPLICATION ❑ Please submit//Y2 two (2) sets of plans with all commercial applications. O jj Date: /5 l ! Site Address: %/,e/�.S,/�J/9e., Cllr Tenant: Resident/Owner Contractor Name: Address / City / Zip49/724:— 4Pc; Address/i4-.4d 1 /-C,/,(%GC,/ State— Zip: a.575:::5 lo / Phone: Contact: ", ) Email: I icc Suite #: t Phone:10 7 W.,9 t License #: City: tQ (5_ e5'l S- -,2/.2-/ New )(Replacement Additional Alteration Demolition Type of Work Description of work: 4lOLr Z /9, Z. 59 i NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL ✓umace—New Constru ',.— InteriorImprovement 1/Air Conditioner Install Piping Processed Air Exchanger Gas erior HVAC Unit Heat Pump U ,: er/Above ground Tank ( Install /-emove) j _ Other Permit Type RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge COMMERCIAL FEES $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge _ $ o4° c o TOTAL FEE Contract Value $ x .01 _$ _$ _$ Permit Fee Surcharge TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordihances 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 accorda with the approved plan in the case of work which requires a review and approval of plans. P icant's Printed Name App ticn Signature FOR OFFICE USE Required Inspections: Reviewed By: Underground Rough In Air Test Gas Service Test In floor Heat Fina Date: HVAC Screening Aug 1516 04:35p Comfort Solutions )MINNESOTA DEPARTMENT OF LABOR & INDUSTRY 763-657-7643 MECHANICAL CONTRACTOR Construction Codes and Licensing Dr isfon Licensing and Certification Sen ices Website: www.dfi.mr.awlecldaso Email: dluicense@slale.m9.iis This is to certify that the certificate holder is registered as a M ECHANICAL CONTRACTOR BOND in the state of with Minnesota Statutes 326B.197, and has filed a $25,000 mechanical bond to perform gas, heating, ventilation, coo fuel burning, or refrigeration work in all areas of the. state during the registration period; provided the work performe the State Mechanical Code and the certificate holder maintains compliance with the required bond and workers' comp P.3 443 Lai Registration : MECHANICAL CONTRACTOR BOND RegNumber : MB004953 OTSEGO HEATING AND AIR CONDITIONING INC Effective Date : 03/29/2016 DBA COMFORT SOLUTIONS HEATING AND COOLIN Expiration Date : 03/2912018 11 1ST ST NW MAPLE GROVE, MN 55369 ne Road N SL Paul, MN 55155 Phone: 651.2845034 innesota and is in compliance ing, air conditioning, complies with . . ation laws./ VERIFY UP-TO-DATE STATUS4BOND, AND INSURANCE INFO AT www.cili.mn.Qovlocld/LicVerifv.asp :iENTER.NUMBER). i 1 a L 0 T Aug 15 16 04:35p Comfort Solutions 763-657-7643 • SOLUTIONS 11— 111 Street NW Osseo, MN 55369 C6ffrc77-376-57-2717) Fax — 763-5653311 FAX COVER Date - Number of Pages Att-n: NoMs: p.1 Fax # ./1 ,rn/ei /Yea% From: Aug 1516 04:35p Comfort Solutions 763-657-7643 p.4 AW D CERTIFICATE OF LIABILITY INSURANCE DATE 08/15/200 6n PRODUCER DICK PETKOFF 2049 SNELLING AVE N A ROSEVILLE, MN 55113 P: (651) 631-0505; F: (651) 631-8402 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Otsego Heating & AC Inc DBA Comfort Solutions 11 1st Street NW Osseo, MN 55369-1034 INSURER A: Stale Farm Fire and Casualty Company 25143 25143 INSURER B: State Farm Mutual Automobile Insuranee Company 25178 25178 INSURER C: INSURER D: EACH OCCURRENCE INSURER E_ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MISR LTR ADM. INSRO TYPE Of INSURANCE POLICY NUMBER POLICYEFFECTNE DATE(MM/DD/YYYY) POLICY EXPIRATION DATE(MMIDD/YYM LIMITS A GGEENERALUABILITY EACH OCCURRENCE 3 1,000,000 7C I COM MEROtAIGENERAL LIABILITY DAMAGE EoccRENTEDnce) $ 300,000 CLAIMS MADE OCCUR - MED EXP (Any one 3 5.000 _ X Contractors Policy 93-CFA467-6 02/01/2016 02/01/2017 person) PERSONAL &ADV INJURY $ 1,000,000 X Special Form 3 Coy GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.'COMPJOPAGG S 2,000,000 7 POLICY n: E� n LOC 3 B AUTOMOBILE _(Ea LIABILITY ANY AUTO COMBINED SINGLE LIMIT accident) 3 X ALL OWNED AUTOS SCHEDULED AUTOS 118 -9479 -A03 -23E 07/03/2016 01/03/2017 BODILY INJURY (Per person) 3 1,000,000 HIRED AUTOS I ON.OWNED AUTOS(Per 277-9596-F09-23 06/09/2016 12/09/2016 000117 INJURY accident), $ 1,000,000 PROPERTY DAMAGE (Per accident) . 3 1,000,000 GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY: AGG $ EXCESS / UMBRELLA LABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE' 5 5 DEDUCTIBLE 5 RETENTION 3 5 WORKERS COMPENSATION AND EMPLOYERS• LIABIUTY Y/ N WCSTA.U- TORY LIMITS OTh- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERRIIEMBER EXCLUDED? 93 -CF -A421-9 02/01/2016 02/01/2017 EL EACH ACCIDENT $ 1,000,000 (Mandatory descrne under E.L. DISEASE r EA EMPLOYEE S 1,000,000 SPECIAL PROVISIONS E- low E. L. DISEASE: POLICY LIMIT $ 1,000,000 OMER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CCCT'Can ATC ullf nco —.--. .._.__. City of Eagan 3830 Pilot Knob Rd. Eagan, MN 55122 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 130 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANYKIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Richard T. Petkoff ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001486 132849.3 04-06-2009 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA170298 Date Issued:06/25/2021 Permit Category:ePermit Site Address: 4271 Moonstone Dr Lot:9 Block: 3 Addition: Cedar Grove 2nd PID:10-16701-03-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Scott E Forsberg 4271 Moonstone Dr Saint Paul MN 55122--201 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174543 Date Issued:02/03/2022 Permit Category:ePermit Site Address: 4271 Moonstone Dr Lot:9 Block: 3 Addition: Cedar Grove 2nd PID:10-16701-03-090 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Scott E Forsberg 4271 Moonstone Dr Saint Paul MN 55122--201 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature