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4128 New York AveINSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLIGANT: ? i .. M ! I , 1164 AVI 1li)I111 '. I I IA 1 PERMIT SUBTYPE: . - I TYPE OF WORK: flt? 1 I 1? I M?1 41E,f0'4/'?4 Permft No. Pe?rnR Holder Dete Telephone B S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspectfon Date Inap. CommeMs Foot;ngs [ 11119*1 D Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Frepiace Fnal Htg. Orsat Test Ffnal Plbg. Pibg. Inspector - Notily Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final ? ??/ Well Pr. Disp. ? ' , •i ?} PERMIT # . ? • CONTRACT PRICE Site Ad?ess ? N?' ? Lot Block Sec Sub m Name r'J L C' r?? Ctj A AJ !(?Al_ c-y Address 2 5 lU/!IG e. /%? c City A ? }'? Phone a Name 9 V ' c Address -1 5• r )) ? p City r? Phone FEES COMM/IND FEE - 196 OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 COMDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .10 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ,I---r-- 1 51GNATURE OF PERMITTEE FOR: CITY OF EAGAN PLUMBING PERMIT RECEIPT ti CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: PHONE: 454-8100 BLDG. TYPE ` WORK DESCRIPTION / Res. New L_ _ Mult. Add-on Comm. Fiepair Other RES. PLBG. ONLY - COMPLETE TH E FOLLOWING: FIXTURES TOTAL Water Closet - $3.00 Bath Tubs - $3.00 f? Lavatory - $3.00 6' Shower - $3.00 ?- = ' r Ki?chen Sink - $3.00 ' • UrinaliBidet - 53.00 TLaundry Tray - $3.00 ?=• Floor Orains - $1.50 J __ Water Heater - $1.50 _ Whirlpool - $3.00 =Gas Piping Outlets - $1.50 _ ? (MINIMUM - 1 PER PERMin Softener - $5.00 Well - $10.00 Private Disp. - $10.00 $ O Rough penings - 1.50 ' - FEE: , STATE S/C: GRANO TOTAL• -`'!' , - -' PERMIT# TC•, U . ' f MECHANICAL PERMIT RECEIPT # I Y F E C T AGAN O 3830 PILQT KNOB ROAD, EAGAN, MN 55122 DATE: Jl.tly CONTRACT PRICE: PHONE: 454-8100 Site Address 4128 N Lot Bl k ew York venue 4 S /S b gLDG. TYPE WORK DESCRIPTION oc • !: _ ? _ ec u _ Res. XX New ? i L ,..NZE Name L HEl,TING & A C Mult Add-on ?v Address 195S? 6hawaee Road Comm. Repair ? 452-15G5 Ciry ?aKan• Ph Other one ? FR?DNTIER CflMPANIES Name FEES HVAC 0-100 M BTU -$24 RES 00 c Address 3908 Sible Memorial H . . . ADDITIONAL 50 M BTU - 6.00 ? Ciry Eagan Phone 454-0433 ES. INCLU DES A/C ON NEW CO STRUCT ON) GAS OUTLETS MINIMUM 1 PER PEk AlT 1 50 EA - . ( r ) - . TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE Forced Air 80,000 M BTU 24.00 APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPIJES Boiter M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU R MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent CFM ? PERMIT PRICE GOES A Gas Piping Oudets # 50 B EYOND $1?p) Other g, FEE: 25.50 '50 :f. S/C: SIGNATURE OF PERMITTEE TOTAL• $26.00 FOR: CITY OF EAGAN CITY OF EAGAN 1 a 18_9 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 . PH O N E: 454-8100 BUILDING PERMIT Receipt # To be used for {rA? Est. Value " Date ,19 Site Address • OFFIC E USE ONLY Lot Block Sec/Sub. ;"c F?.' t'(?;: t- '• ',Ai .' On Site Sewage Occupancy MWCC System Zoning Parcel No. On Site Well (Actual) Const c Name *'- City Water (Allowable) W = Address PRV Required ik of Stories ill: ? City Phone i? Booster Pump Length Depth o Name S.F. Total , ? ? Address Footprint S.F. °-` City Phone pPPROVALS FEES yVj W Name Engr./Assess. Permit ? U g Address Planner Surcharge Q W City PhOne Council Plan Review Bidg. Off. SAC, City I hereby acknowledge that i have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with all appkcable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. ? Water Meter Signature of Permittee Road Unit • A Building Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all P applicable State of Minnesota Statutes and City of Eagan Ordinances. arks ? f ' ? TOTAL ? Building Official - ' Permft No. Permit Holder Date Telephone # Plumbing C' ? H.V.A.C. O l? O ll.i- ?J ?/ Electric ,q?j$Q j •4 ?..?'S Softener Inspection Date Insp. Comments Footings I ? Footings II Foundation Framing ? D Roofing Rough Plbg. Rough Htg. -Ad Isul. Fireplace Final Htg. Final Plbg. Bldg. Final ? Cert Occ. ? Temp. LP Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN (d° 1518 9 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 ? BUILDING PERMIT a<pai„rs ?y ? To be used for SF DWG/GAR Est. Value $$2,000 Date JUNE 14 1988 SiteAddress 4128 NEW YORK AVE Lot_39 Block4_SeGSub. STAFFORD PL.ACE Parcel No. , Name FRONTIER MIDWEST HOMES ? Address 3902 CEDARVALE DR ? City EAGAN phone 454-0433 ,o Name SAME oQ Address i- City Phone ?w Name_ Fw iz. Address u aw CitY_ Phone I hereby acknowledge that I have read this application antl state that ihe information is correct and agree to comply with all a plip?able State of Minnesota Statutes and City of Eaan QQrdina ces. Il Signature of Permittee f' A Building Permit is issued to: FRONTIER MIDWEST HOME$ on the ezpress cond ition that all work shal I be done in accordance with all applicable Slate oJf ?M?in?n?esonta Sta[ute?syay n?d City of Eagan Ordinances. BuiltlingOlficialJ.ldHAl1-I\.?5? (J1?\L OFFICE USE ONLY OnSiteSewage _ Occupancy R-3 M-1 MWCC Syatem X Zoning R-i On Site Well _ (ACtual) Const V-N City Water 7C (Allowable) V-N PRV Required _ # of Stories Booster Pump _ Length 56 ' Depth 30' S.F. Total Footprint S.F. APPROVALS FEES Engr./ASSess. Permit 502.00 Planner Surcharge 41.00 Council Plan Review 251.00 BIdg.Off. SAC,City 100•00 Variance SAC,MWCC $50.00 Water Conn. 550.00 water Meter 67.00 Road Unit _325.00 Treatment P7 204.00 Parks 590.e0 2 TO7AL , This .equest vold,3j?'/?,y 18 rrpnths tmm E 45180?J5?.?, O (C 3 & i"i ?e--Q o-, Ne4u ate l 1 Fire 1 Rou h-in Inspection ? RequireA? E]ReatlY Now ?.VfNolity Inspec- '`•' G?egs (_1 Na tor When ReadY q.L4t5'ased Electrical ConVTCtor 1 hereby requast inspection of above Q Owner eleclricel work inatalled el: Street dress, r Poute o. CiIY (^_/ eci n o, ownshi0 Name or o. Range o. Covnty Occ not 1 ? E Phone Nc. _.L 3 Power 5 r dtlress E1 ? I?C? o CnnUact License N 1?"""-'? yy?( ^ -?I llY.in ? IIpO ? 0518_ )lal?on) . _ _ 1 M1 ? ?CG4= ? 1 Au rized iPna re°IC H eeor Ol,v k' n?I?tionl Phone Numb er r,. MTNNESOTR?g?Fq4C-.gppg[?„Q F ELECTBICITV THIS INSPECTION PEQUEST WILL NOT Gria9s•Mitlway Blde. - Boom?J=T91^-^-•-•- -. .._ BE ACCEPTED BV THE STqTE BOAND 1821 UnivarsitV Ave.. St. ixul, MN 55106 - '""- UNLESS PHOPEP INSPECTION FEE IS ENCLOSEO. Phona (612) 6420800 REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-/os 1 ? See instructions tor campleting this lorm on back ol Yellow copy. ~ ?i+ ? 45180 c?? ?% E "X" Be.low Work Covered by 7his Request dtl Rw•? Type oi Builaing Apoliancee Wired Equiymenc Wired 10 Home Rmige Temporary Service Duplr,x Water Heater ightiny Fixtures Apt. Building Dryer Electrie Heabn CominercialBldG. Fumace SiloUnloaJer Industrial Bldg. Air Conditioner Bulk Milk Tank' Farm Ome, aer, v -tner ISUCCirW t Pr Syeafy? Othe, 01her COmpUtC 1nSpBC[IOn F@@ BBlOW N Fee ServiceEntreneeSize It Fee ees?SUbieednrs b Fen Circuits 0 to 200 qm ps 30 qm s 10 0 ln 30 Am Above 200 Am )s 100 Ainps IJ-A 31 to 100 Am s Swimming Pool e 100-Am s :bbo Above 100_Amps Transrormers tion 8ooms PartiaL"Oth er e SignS al Inspection 5? TOTA Bemarks U , BouBh-in P D g i I. tha ' Inspectoq he,aby certily thet the above Finsl Date ? insoaction has been ?aa. Tnis requeat vola 18 montha irom 7 oCOD ? p 7537 ? ? ^/' lY./?' r Request Dale 6/27 /91 Ire No. h-in Inspection quired? X XI Ready Now F. Will Noli(y InspectOr n P Wh d ? ? Yes No e ea y ILXlicensed coNractor ? owner hereby request inspeciion of above electrical work at: Jon ntltlress (Sireet. Box or Route Ni Glry 4128 New York Ave. Eagan Seqion No. TownsOip Name or No. Fange No. County Dakota Ottupant (PRiNT) Phone No. Blaine Duxbury 456-5372 Power Supplier Atldress Dakota Electric Co. 4300 220th st. Farmington, MN Elecvical CoNracmr ICompany Nemel Comre<tors Gcense No. Total Electric, Inc. 398424 Mading Rtldress IGOnvacmr or pwner Makmg Inslalialion) 1537 92nd Lane N.E. Slaine, MN 55434 AutM1Ob2e4 Slg alu:e IConVaceinOwner Ma'nm InstallaLOn) Phone Numb¢r ?c c_-'e, z,/ F? ??n,?% 786-5484 MINNESOTA STATE 60APD OF EIECTPIQTY THIS INSPECTION qE0UE5T `MLL NOT Griggs-MiEwey Bldg. - Hoom S-113 NE ACCEPTEO BV THE STATE BOAFD 1811 University Ave.. SC Poul) MN 55100 UNLESS PROPER INSPECTION FEE IS Phone(61Y)662-0800 ENCLOSED. s?/?/9/ REQUEST FOR ELECTRICAL WSPECTION ? lii? See'nstmc[ons tor completing ihis form on baok ot yellow copy, Q X7 F,'47 "X" Below Work Covered by This Request .;F eh?,? E900001-08 %It 1i; ??c'fOfB ew Adtl Rep. TypeofBuilding ApplianceSWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt Building ) Dryer Other (Speciy} I Comm.llndusirial Fumaca ? Farm g Air Conditioner Other ?specily? Contreolor's Ramarks'. Compufe )nspection Fee Beiow: # Other Fee # ServiCeEniranceSlze ers Fee Swimming Pool 0 to 200 Amps Transtormers Above 200 _ Amp Amps SIqOS Inspecmr's Use Only. TAL Irrigation eooms 15.50 Special Inspection AlarmlCo mmunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereay Ro°9n-'" o"e certify ihat the above inspection has been made. F;,,ai ate OFFIGE USE ONLV Tnis requesl vo-d 18 months Irom RESIDENTIAL BUILDING PERMIT APPLICATION Sq $ a ? CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NewConsWCtion Reouirements • 3 registered site surveys showiig sq. fl. of lot, sq. ff. of house; and all roofed areas (20% marimum lot coversge allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc,) • 1setofEnergyCalcNations • 3 copies of Tree Preservation Plan if lot platted after 7/1193 . Rim Joisl Detail Options seledlon sheet (hldgs wXh 3 or less units) DATE SITE ADDRESS TYPE OF WOR APPLICANT _ STREET ADDRESS TELEPHONE # Ahpa MULTI-FAMILY BLDG Y "?N FIREPLACE(S) _ 0 _ 1 _ 2 ? ?3? ?C' ?'? CITY__'ZAecA _STATe?ZIP CELL PHONE # LQ082FAX # PROPERTYOWNER s4t?-??? 'ell/P ? TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA Ri7LES 7670 CATEGORY 1 MINNN:SOTA RULES 7672 (d submission type) . Residentlal Ventllation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted • Energy Envelope Calculations Su6mitted Plumbing Contractor: ____ Plumbing system includes: Mechanical Contractor: Mechanical system includcs: Sewer/Water CoMractor: Phone # Phone # Fee: $90.00 Fee: $70.00 n iir III li I "" J I hereby acknowledge that I have read this application, state that the information is co pt, and agree to com ly with all applicable State of Minnesota Statutes and City of Eagan Ordinances. SignatureoFApplicant OFFTCE USE ONLY g-a3-c-oQ Water Soflener Water Heater No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths Air Conditioning _ Heat Recovery System RemodeVReoair ReouiremeMs . 2 copies of plan • 1 set of Eneigy Calculationa for heated additions • 1 site survey Por extenor additions & decks . Indicate d home served by sepliC system for addilions VALUATION 41387 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: Lo T: 39 B L 0 C K: q APPLICANT: 4128 NEW YORK AVE GUNDERSON HOMES, KENT STAFFORD PLACE (612) 686-8388 PERMIT SUBTYPE: DECK TYPE OF WORK: NEW 1- suzLozNG 023532 05/09/94 7 ? ? ?CIT"Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: 3 U/ILpING 023532 05/09/94 SITE ADDRESS: P.T.N.: 10-72500-390-04 DESCRIPTION: 4128 NEW YORK AVE LOT: 39 BLOCK: 4 STAFFORD PIACE Buzlding' Ps/rmit Type DECK 6uild'i.ng 4!&C.k Type NEW If? j (` ?t ?\L'i?:.:', ? .? ? •-•,. \, ? li.l,ryi?w It ll+(???{ ??l;5?'JCiu REMARKS: FEE SUMMARY: Base Fee $36.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: - GUNDERSON HOMES, KENT 3890 WORCHESTER EAGAN MN (612) 686-8388 Applicant - 16868388 DR 55123 OWNER: MEYER SUZANNE 4128 NEW YORK AVE AGAN MN 55123 Z hereby acknowledge that I have read this ap=plicat3on and state tfiat the infarmation :is correet and' agree Co camply with all appl3caGle State of'riMn. Statutes and City of Eagan Ordinantes, ? . ' APPLICA ' EESIGNATUPE fl In &ecA,! Yn.xl IS UED BY:rSIGI IATURE-C -1 13A51 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 43 ?. rj!? SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of spec9fications, 1 copy of energy calcs. enalty applies: 1) when permit is typed, but not picked up by last working day of month n which request is made, 2) address is changed or 3) lot change is requested once permit F ls issued. Date /-6/ j? Valuation of work 3?c>0 " Site Address: Z/1z--S; N6?j STREET SUITE N Tenant Name: (commercial only) LOT 37 SLOCK ? SUBD. S???. P.I.D. # ?escri tion o£ moxk: n4ltk? The applicant is: El Owner Contractor O Other (Describe) Name Phone Property LA51 FIRST Owner qddress ?17 7-g Ab-' (faze- A" STREET STE # City State Zip Company ? Phone bs6o Sa4 & Contractor Address F>5'7a License # 40057Yp EXp, 3/ 9 City State Zip ?r?mk Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. L Signature of Applicant: , -;48 Engineering weiYOrs Clvll Enpineers Services Land Plonners survellorgs G'ert?,?"tcate ? - BOOK _ PAGE - _ JOB N0. 88R-10 SURVEY FOR: Frontier Plidwest Sories Cornora.tion DESCRIBED A5: Lot 39, Ploclc 4, c'£ArFOED nLACE, G'ity of Eaf-ran, Pa.lcota County, 1+innesota_ and reserving easements, record. P 40A O F FOUNDATION O = 8 GARAGE FLOOR = 999•4 BASEhfENT FLOOR = $8?•9 SEWER SERVICE ELEV. _ ---- PROPOSED ELEVATIONS EXISTING ELEVATIONS ? DRAINAGE DIRECTIONS :---- W DENOTES LOT CORNERS : o ? ? DENOTES OFFSET STAKE: ? Z ti h . ? Q ?O NE`1? ?a° -7 Bk 37- -? ; co r c n, 2 ?r V `j` s?a.3 R'S5 'J ? Li ? S'/ Ry ? i =633 0 ? 7Z111'12-W 4201 Eact8laomlnptonFrneway Bloominpton, Minnasoto 55420 Phone: 888-0289 7?" / l - ? a (1 -? / ? Y fi \ ? ?. VI NV, I ? \ c v 2Anr % , ? ??`?3s? `? « `? CERTIFICATE OF SURVEY 1974oJ I hercby certi}y lhat this survey,plan or report was prepared by me or under my direct supervision ond thal I am a duly RegistereG tand Surveyor under tAe laws of tha State of Minnesota. Dare: 4/21 /813 Qaz? ?) . d ?:., JeHr . Li dqren , Lic e No.14375 y? Y ? 7 ? ? ? ?O D = 37 ..._ .... ? , ? ? ? - 9 ? cr? ?.? Q o . Q ?/t? ! a ?? ?s3 3o R bR '00, %, LO . . 3 If > / L , . ? y ?\ ??? ?,? ryv ?Q R • v , `33 ? ? m b - ? (:95Z , ICATE oF suRVEY . ---••- - --- -. n ? dt / 96 '•qw / ` ?2 oQ? sO' ? ? - ^ ..._. ___ ? . • r, .,, , A-- . . _ r /?2•? ? ? J _r ?-- __--- ?-- ? , ? / / ? / ? / ;ti ?? . 9 cc? n J ? g7G•aJ 19$$ BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS Is I S q INCLUDE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/BOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIAED. NO CHANGES WILL BE ALLOWED ONCE BOILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS 0 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONAtERCIAL INCLUDE 2 SETS OE ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS - - Em J li rti 9 Ym To Be Used For: New Construction Valuation: ? Date: 5-24-88 Site Address 4128 New York Avenue Lot ig, Block ( Parcel/Sub Stafford Place Owner Blaine & Robyn Duxbury AddresS513 Federal Drive, #101 City/Zip Code Eagan, MN 55122 Phone 456-5372 Contraetor Frontier Midwest Homes Corp. Address 3902 Cedarvale Drive City/Zip Code Eaaan, MN 55122 Phone 454-0433 Arch./Engr. phillins Plan Service AddresS14530 Pennock Avenue a ?i - On site sewage_ Oecupancy Q- -? NEdCC system ? Zoning R- 1 On site well Actual Const V-N City water ? Allowable V-N PRV required _ Il of stories Hooster Pump _ Length 56' Depth S.F. Total Footprint S.F. APPROVALS FEES Engr/Assess Planner Council Bldg. Off. Varianee City/Zip Code Apple Vallep, MN 55124 0 Pj1?1?Am?Mr4 /Nu.OfZ Permit 5,62 - Surcharge y/ ? Plan Review ZS I - 7??A3SAC, City ov - SAC, MWCC S5U ? Water Conn , SS v _ Water Meter 67' Road Unit Zsf? Treatment Pl 0 4' Parks Copies TOTAL Phone # 432-2044 'H e d 1 ure d E n g i n e e r i n g S e r v i c e s 9201 Eost Bloominqton Freewoy 8bominpton, Minnasota 55420 Land Surveyors qvll Enqineers Lond Planners Phone: 888-0289 AW surre#vr,(s G'e&?f jXte / - BOOK _ PAGE - _ JOB N0. 89"90 SURVEY FOR: Frontier Tiidwest Homes Corporation DESGRIBED AS: Lot 39, Flocii 4, STAFFOEP PLPCE, City of Fagan, Pakota County, r'' nesota nd re rvin easements of record ? W ? ? ? ? z ti ti $0g, 3 _.in a se ? TOP OF FOUNDATION = 896A GARAGE FLOOR = seg•` BASEMENT FLOOR =851•q SEWER SERVICE ELEV. _ ---- PROPOSED ELEVATIONS EXISTING ELEVATIONS : DRAINAGE DIRECTIONS DENOTES LOT CORNERS : o DENOTES OFFSET STAKE: o n ?L9PRO`?`?ED ? . Q ? NE? ?\ . ?_ ?- Dafe `? .I -? s 9 ? v, ? Q o ?- ,, t N? Rr - - Y ,O 0 C. / /42-- Lri - -??s v Nr: , ? ? ` \ / ? ti. .v, n ? J CERTIFICATE OF SURVEY `?'c? ; Y ? $7`•aJ I hereby cenify that ihis survey, plan or report wus preparad by me or under my direef supervision and ihat I am a duly Re9istered Land SurveYor under the laws oi ths Stote of Minnesofa. Dcre: 4?2J /sB D. Licen"se No. 14376 L-?-,{ %fJ'a ! JN L,X C CD?1FlT.'.i:CPi C'r1t1cR Blaine & Robyn Duxbury SI7= AODR't» 4128 New York Avenue CONiL",CiO2 =?OV:I=3 CO?;?vIES DATc 5-24-88 FHOY't 454-0433 • Ce:_rmine woricina square fcatace of eaca. ,I. Totzl exreszd wai7 area .... sq. ;'t. z 2. ictal rcof/c=_:1inc are? .... vsq. fft. x_.OZ.5- _ ic:_=7 exresed wail area above ;iocr a. 7ot?- i wa31 xindcw area ........................... b. Tc wl dcor are_ ................................. J? c. 7etm1 sii,iinc 5iass cccr a*e_ ................... uo d: Tc. t21 fln?;izcs wzil ar°a ...... _. ........... - e. 7oca; wzll flrar.,i,-,c =_ra=_ (aver_c-= iC.:)...:........ /?W fi. Toi=_' n_' :,ai' ar=a abcve ricor ................. /z Ts.? 7 g. TatZl rir„ jcist _ra=_ ........................... 2na, r- 7ctai expo<ed ?cu;saat;cr area = .: v c h. Tctal fcunda ti cn wiaccw are=_..... _ .. . ... . . . .. .. i • %/ i. iaal ne= ?ouncst;cn area ttvve araee ............ uy•o•? e2:-zrmiR? °U° VclU° 0? 2=Cl7 'N2ll 52=mnt. ? L"Z 2. 5' „ a. A h. ? itull „ y7 = /S •?7 c. ?ZJ ? u„ d. x ,. U' e. l=?U.3 ? ?„ull x nun ?. .//7. ! a. 2 O9 X ;.U„ ,o? = D•=Z h. . 9/ X "li" ? qJ = u.7? i• - ?? ? liU.l , lc( _ ,SSy %;1 . i= t 7.i1a - ( 3 ..................................... To:al If ite.m :3 is the sa,:.e as, or less thzn it=:n ; he intent of 58C 6005(c)2. Totai expo<_ed reor/ceiling area = ?su Total gross roof/ceiling are3 = j. Total skylicht area ........................ k. Tvtal rno°/cEiling Praming area ............• 4t 1. Total net insuTated raof/csiiing area....... SM,L De*_e-nine "U" yalue X k. vS- ? X z 4 ............................. IF totaT cr z? is t^e same as, ScC 6006(c)i. for each rcof/ceilina seement. OUa ltvli lluii •d4 = l1,7? .....Total or less than =2, you have met the intent ef To utiiized t`se total er.veiope systwm rethed, the values.estahlisned 6y the sum of iteas a3 and 64 shall nci 6e gr=ater than the sun of itenms 91 and 722. ]. s. :fATMIALS Ez:ariar A_= Sheathing I:isulat i on Sheet: ocic Intarior Air Studs Rim. Conc. BI{s. + 2, - 4. T::era. 3esistance "S,? - ? -- -. :?; • ? q7?,L;,'' • .. ? ;:. . ?:G. #2 l??'?? ri= 1-?:.?" ' ?i i? 6 ? ???1l1 L? =7:i:Crv? r ?• L```?,:?Tr? ? ? ?:?36 C:i -- •?_. ., . a i ?.?• ? ? ? ?S'• . :+ccd ^ ? •87 C, S?LA'LSI1?lG ? /3= Z.CC? 5, SIOtNG •GZ . 6. E.'c:_=:°= a-,- 0. 17 , : R?tal - ?O•,?r : . . . u ? .oy : . 2. Iater'_c= a? :Ia ' O.Sd . 2. ?f ? 4'lP3T? • _ •°? 3. •?>" ?^5°rr-_ ? !9•0 ' 4. LS/St Su 1. A 7 L+I N1G 2.OG 5 . 51 QiN?, •I Z- 6. ?xeez_°= a_- ila 0.17 ? 2o tal ZZ ?? ? J ? 1 '2Lh - Ia«,._C= 3'. 0.68 i i oo z. i?1su?. . ? . 3.. ZXlO ,)OIST ` ' ' 1.8? 2 ?•?, d, <.A'NING ?zz 5? .0 , g, SIOI?lG UZ ? 6. 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O.fil -R1Q • ! ?? • 3- ?iXU I.l!<i.rL • 7 34. ' ' • - 4. _Y'cr_-- .=i_ F;,.. (s::: 1 ?.oi • . ? • ' • . . . To:at 2, - (,?'o. r .. F;G..:5 , : . ? ' • .U = ?? . y . _ . . • ? . ' , ' • .' - • ?o.V srrt??ri vy?_ ? • .w-•?u?. ?.?.Y?,?.?,.t^??.»w.ac.? ? 1. Tr= ' !de aj: sttln O.bl . . ' ? 4. ? . i ? n ? ' ~? 1??? ` 5. 7ts'_cc ai= °='-? ToC.a1 ?. _7 ? - .. . . . . • 1 L? 7 1 L03? • . ? Ir.s' 2c ai= "lss • 0.5' -- ? ?_ ? Llov Lp • . • j.veatn3 • ? 4: ? ' i -i- . ,• •. • • 9. C?.sizc ai_ f:la o.l , • • . . • , : _ . To Cal . _ TC. 36.:. . . .... . ._ . , • - .. .. . . ? _: . . .. . . . . f04 ?`- 50 ' 'v 1. Sr.sicc air •' Iz ' -, ?.Y-.?..1_ ._•: . • 3- . ' ? «l??.`..ti°::: -'-:'= - •. 4• 0. ] ...•-•t-• .. r' , ..?;: ?.' •• • ? . G1sG?idc ai- E!la S. Total ? L:. ?. ' .,.:.•... - , • ? . ? • • ? ;:' . . . . ? . ? ?" .' ' Nota: Uso addi`cnal === s . . • SC:-ti"'i..:? •? • . ' , .secc:es3 Sar cieesil? a.nd ealcal _s= ' • .. . . ?' . • ??_ • . • ' • • . • • qxr_ i7. _ ? • " ,• ' . . . , ? . . - ?;.?t.r, f.r.r.•?:hc+; ..., y . . . ?. wll nCC? l??t• Con:.lrucl lun I' 1l-,-1-I1 -------oI IC ?i3.l. • ?i ?j ? FIC. M1 TY,I'VIt:d OF . F2INL: NALT, ? i • : Fic. az i F •'- 1 __i S'{??I, ? ?? 1 .lilCll i 1• A ?s ' 47--:- ---?-=---0 '?. ?CA i1 ?i- ---•-----t? \4? ) ' ???' • '0• ''-------"'OO r 'n' r ?_'.• ? Y I7+K- tcK }-1R.P, r- LA-C? ('?•u•:t[w t i;.i, I:-'l.tlu•:. 1. _ ...... t??m ._)1_,L8 Q S. _?!?GE..B?C.tGK ... :._ _ ..... . ._ ...11 U.1'1 U= .34W 2. ]. __?.•--^-•----_-••_•----___. 4. s. ..._...___ . ,;_; - G. Exrcr'tor eii• iiL., -o: - '---' 7'?lal-- 1. Intr.t_i?r a_ir_fiLa_...------•-•-?-f,?? 2. ----_ ..... ._.. - •-,-__ ?" d. .--=--__.----.---- ---.----.---- 5 . _---- •---- -•-. . • -• ?--- • -•- E. "- ? ?9'otal. + 1. 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CITY OF EAGAN 3830 PIIAT RIVOB ROAD " EAGAN, MN 55122 PHONE: (612) 454 8100 mGmmnm 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. rRnrgscgn PTPTNG ° $25.00 $25.00 MINIMUM FEE. PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ADD ON ? REPAIR _ OWNER NAME: SITE ADDRESS IAT: -1 y BIACK ? SUBD. INSTALLER: ADDRESS: /y. CITY: '2O S"dlu-+' ZIP: N?O 7r PHONE #:_ ?-l-S_/ -O /Of CONTRACT PRICE x 18 PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUZRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: SITE ADDRESS: IAT: BLOCK _ SUBD. INSTALLER: ADDRESS: STATE SURCHARGE $ CITY: PHONE #: FOR: CITY OF EAGAN ZIP: TOTAL: FOR CITY USE ONLY PERMIT # RECEIPT # /O $ DATE: FEES ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $? STATE SURCHARGE: .SO TOTAL: SI NATURE 0 PERMITTEE $ (SIGNATURE) APFLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION . . ? NOTE: PAMIf OF FEE AT TIME OF ? APPLICATSON DOFS Ndf CON- .*H ? SfI7[flE APPA67AL OF PIItFQT. ?*. * • w INSPDCfI(R7 OF SQWhli APID/CR 4A1fR :. t rxcmarxaTI0N5 WIIS. NdP BE S'Exnsn i[][TfiL PIItFffT HAS BEQd APPROVID. x •ttx+w??e?i:+?r?f.f.:t?ititt?f.e??*xfaw+• oF (zcacjan (PLEASE PRINT 1) PROPII2TY ADDRESS: 4128.New York Avenue Eagan MN TFf:AT. DESCRIPTION: Lot 39,Blcok 4 Staf£ord Place - Lot B ock S vision or Tax Parcel ID IF EXISTING STRC'CTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Mont Year PRESENT ZONING/PROPOSID OSE: Q CONA7ERCIAL/RETAIL/OFFICE I? R-1 SINGLE FAMILY Q INDLSTRIAL ? R-2 DT-IPLEX (3tao L'nits) Q.INSTITUTIONAL/GOVERNmENT ? R-3 TOWNII-IOUSE (Three.+. Dqits) ( Units) ? R-4 APARTMENT/COAIDDMINILM ( Lnits) 2) ? NAME: Frontier Midwest Homes Corporation ADDRESS: 3902 Cedarvale Drive CITY, STATE, ZIP: ..Eagan, MN 55122 PHONE: 454-0433 3) NAME: Star Plumbing ADDRESS: 1018 Mound Springs Terrace CITY, STATE, ZIP: Bloomington, MN 55420 PHONE: 884-4149 MASTIIt LICENSE # 3329 4) NANE: Blaine & Robyn Duxburv ADDRESS: 3513 Federal Drive, #101 CITY, STATE, ZIP: Eagan, h[N 55122 PHONE: 456-5372 Use I? Active Expired Not reCOrded St Initia 5) i? , a•?• • n 1 9e El CONNECTION TO CITY SEWEE2 E] CONNECTION TO CITY WATER O 0'IHER 6> &/8 /8s ***?*********,?*****, * ?*?****?******?************?***?****??*??**?***??*****?**********??******;; * * THE GOLD COPY OF Tt3E PEE2NIIT WILL BE SENf DIREX.TLY TO PUffi.IC WORKS 70 FACILITATE METTER PICK-OP. ? * PLEASE ALLOW 1WO NORKING DAYS FOR PROCFSSING. SONIDONE FROM TM CITY WILL OOfTrACr YOD IF MRE * * ARE ANY PROBIa1S. " '?*?*?*?*w******??***+***,?****??****?*?**?*??**???*+*,+*********«*?,+*+****?*?**********+*?+**********? F'OR CITY USE ONLY PERMIT # ISSOED ! Pd w/Bldg. Permit FEES: $ IO. S O $ SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLODE SL'RCHARGE) $ ? 7' U C) $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP $ /5'' nU $ ACCODNT DEPOSIT - SEWER $ ( ?5' (?Fv $ ACCOUNT DEPOSIT - WATER $ ?S -5?0. hD S wAc s ?56. av $ SAC $ $ TRCNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRGNK WATER $- 0`??. CTO $ WATER TREATMENT PLANT SUR A C ARGE $ $ OTHER: $- $ TOTAL y g? RECEIPT RECEIPT DOES UTILITY CONNECTION REQLIRE EXCA VATION IN PUBLIC RIGHT OF WAY? Q YES ? NO IF YES, THEN A" ROADWAY" MUST BE DIVISION. LIST PERMIT FOR WORK WITHIN POBLIC ISSOED BY THE ENGINEERING AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIOIVS: APPROVED BY: TITLE: DATE : ?? TJ%WE' .?;rrAN?, Reside„tial C ?. e wA.*fo.J ?? C Who,?(/e House W?o?ksheet EQ Mi n`y ? ? - Addon .c?/?f' cS' / /vtrs%?C'? ( ?.'Gr? • Ckr ? zjp ?M . WINTE11:0Mi0?OM1YeTMnPOf-pylMd?DWa17Nn0 070 Of.IWWbpT«nYDMfwme ?nv iUMMER:Or1110611 ppl" Torno?Qr_OF-INYdsDrlanTrwe ?Ki Oe_w"-'_---.....--'-- w t Amer'c&n $1andW4. IM, 1386 . . . wu?ur ?air?r?r sw?rr TABIE C - ADJUSTMENTfACTpRS - IHEATINGI •i. T?^?MUw OiM. 30 ?0 60 a0 70 8D 80 ?qw?m?m F?cpr ? ? 6 8 7 6 9 • nrRwn? tuu.aw? ?ryorr, ¦r.. .r?w.o... ?+?' rai w ' r: u a ai? oii u Ai? w*.w aynj' +?(,{.'? ?*a' . . ??r p r a: a '? YbM :!!: FMi+. r _l? r? ?y w y? y - MJ .. N iY Z 4 Y ? Y? iA u /IYMqy040i01 ? YONwY?rA ?Ytl v1.6 \?Y?IYW? ?D /?W?tl1YMi??«M TA6LE D - INfILTRqTION MULTIPLILq4 Wlntw qlrClunpupw Xour .. . FbGAM. YOOaMr 800.i[m 1?11m am Avw+p . t3 lA p,? p,? . ? 22 1.? 11 IA IOrMGpniplra?pp; • y? M? IOer _? 0.1 03 O.s .. SY11M0.KAkCMnyy?f FloaAw? 160G7f00 w?r7tOD ? ? ? 03 03 ?G? p.S py OA W as n? aa as 1'ub. No. 2240164 P.L (y fo. WiiiW YNr OOm • wa (?eWrs for tM Mm? Faeton wunr winUowe IrN MuiAW gMAinY bY drWerfMa M?MY?n consuuuion. tVw wMWOw . OIMWs and tlidinp pinw Goon an ur?ud u wYqpw?. /lou 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ? ?C)..? New Construction Requiremenis RemodellReoair Reouiremenis Office kJ5e0t?lu 3 registered site sumeys showing sq. N. of lot, sq. M. of house; and all roofed areas 2 copies of plan (20% maximum lot covemge allowed) 1 sef of Energy Calculations for heated additions iree Pres i'19n Recd _ Y N: 2 capies of plan showing 6eam 8 window sizes; poured found design, etc. 1 site survey for addtions 8 decks Tree Pres Aeqwred ?:• Y N lselofEnergyCatculations Addifion - indicataifonsdesepticsysfem Ons?fe3aptic5ysteh? 'W:X,...,.N 3 copies of Tree Preservation Plan if lot platled aNer 711193 Rim Joist Dehail Options selection sheet (buildings with 3 or less units) Date p d ConstrucNon Cost ? 7 U p? Site Address ?{ I oZ?` ??Lc?? ? Unit/Ste # Deacription of Work ?e.Y 3 Yv? Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property owuer Telephone # (y 5 f ) ? _T 44 - ? 3 G 3' C - ao 0200 7 & i? Contractor jj , Address 55) a-- State yl'1_? a_? -rn CrtY e Zip -S, Telephone #(763) 5- 3 7- 2 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Mimiesota Rules 7670 Cateeorv 1' Mimtesota Rules 7672 Energy Code Category , Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 2557o plan review fee applies. 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 NIN Statutes; 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 appro lan in the case of work which requires a review and approval of plans. Applicant's Printed Name Ap licanYs Signature CITY OF EAGAN Permit No: Date: • 3830 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner. Site Address: Plumber. Conn. Chg: Zoning: Acct. Dep. No. of Units: Permit Fee: Surcharge: 1 agree to comply with the City of Eagan Tr. Plant Ordinances. Meter: Misc.: Bysi- A A�1.1 WATER SERVICE PERMIT-2-1c/ CITY Of EAGAN Permit No: Date: 3830 Pilot Knob Road B/P No: Date: P.O. Box 21199 Eagan, MN 55121 Owner: Site Address: Plumber: MWCC: Zoning - City Chg: No. of Units: Acct. Deb: I agree to comply with the City of Eagan Permit Fee: Ordinances. Surcharge: , `t i t SEWER SERVICE PERMIT • '*) City of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: -%,Z r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: I 72-1q Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION / l Site Address: Resident!'. Owner Contractor Name: 5 ie Unit #: �/ Phone: - a �� 29/ .9 Address / City / Zip: Lf(Z�S nor- ( h"� C-7,\ 6/V -1 Z 5 Applicant is: Owner K -Contractor Description of work: Construction Cost: (00'00 Multi -Family Building: (Yes / No Company: '"c)) g I '� � L k c.r- .- a Contact: (SS S Address: 83G it " or -141u'; 0.7 PA -r. k City: State:M(" Zip: 7 /Z 5 Phone: �` )'37/`"{E6ail4L4d3k %o4.C- Qrig 4or).w^� License #: c_to 7 2 k 0 \ Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) pock 1973. 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: Phone: Phone: Mechanical Contractor: Sewer & Water Contractor: TE: Pl nforma and supporting documents that you ion maybe classified es nor -public conclude tha recon vide spec ItiE -d to be public ii reason. atlon. Portions of eCity to 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.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 ((095 Applicant's Printed Nanie x Applicant's Si • n Page 1 of 3 Use BLUE or BLACK Ink �.For affice use �^ � �1� f �1, j Permit#: �� I t�� 1 11�� I p � : lp �; I � erm t Fee � 3830 F11ot Knob Road Eagan MN 55122 � Date Received: I Phone:(651 j 675-5675 I I F�x:(651)675-5694 I Staff: I 1 I . �.��.�T..... . .�...._.��__.��I 2i�14 RESrDEhITIAL BUtLDING PERMIT APPLICATI�N Date: Si#e Address: I t L�� r� ��`� !$... Unit#: Name: �� -��1' �� Phorre: �fr��-��'��t�� Residenti � # �� . . O�►ller Address f City l Zip. ``��`��k' ��•,1 �t' �� Applicant is: Owner ��antractor Type of Wark Description of work: �� C9z� , ��^� Cons#ruction Cost: �� Multi-Farrrily Building: (Yes t No Company: � 1�. � � Contact: b�� / +Contractor Address: ��5 ��'�:�11.�1 ��i� � City: ✓��'�✓✓��,, State;�Zip:�.J� Phane:�7��'��J�"�� Email: •�"'�F��--°{�►W�?•a�.�,��!��1�0, License#: �� Lead Gertificate#: If the project is exempt from tead certification, please explain why: (se�Page 3 for additional information} !�!€t� Gc�� c.�~� a � ��'� CC3MPLETE THIS AREA OCVLY tF'Ct7NSTRUCT[NG A NEW BUIt�D'lNG In the tast 12 months,has the City of Eagan issusd a pern�rit for a similar ptan based an a master plan? TYes _Na If yes,da#e and address of master plan: ' Licensed Plumber: PMone: �' Mechanicat Con#ractor: Phone: Sewer&Water Gont�actar: Phone: N�TE:Plans antl supporting;documents thaf you submit are consr`dered to be pubEfc infvrmaf�on. Porfions of the informatian may 6e ciassified as non pubi3c!f you prauitle speci�c reasarts that woutd permif the City to conclude fhat ttre are trade secrets. CALL BEFORE YDU DtG. Call Gopher State Qne Ca11 at(651}454-0002 far pra#ection againsi underground utility damage. Call 48 hours befo�e you intend to dig ta receive locates of underground utilikies, www.gopherstateoneeall.orq I heFeby acknowledge that this information is complete and accurate;that the work will be in confonnance w+th the ordinances and codes of the City af Eagan;fhat I understand this is not a permit,hut oNy an application for a permit, and work is not ta start without a permit; that the work will be in accocdance wifh the appraved plan in the case of wark which requires a revf�w and approval of plans. Exterior work authvrized by a'building permit issued in accordance with the Min�esofa St�ite Building Code must be completetl within 180 days of permit issuance: x � 4�!"`CtLa �.�.r�- X Applicant's Printed'Nam Appficant`s Signa Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA176871 Date Issued:06/06/2022 Permit Category:ePermit Site Address: 4128 New York Ave Lot:39 Block: 4 Addition: Stafford Place PID:10-72500-04-390 Use: Description: Sub Type:Air Conditioner Work Type:Replace Description: Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Jesse G Ziebarth 4128 New York Ave Eagan MN 55123 Haley Comfort Systems 3708 Broadway Ave N Rochester MN 55906 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature