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4376 Nicols Rd
CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 ?T ,L? 9 9014 PHONE: 454-8100 . ? ?- BUILDING PERMIT Receipt To be wsd fo. r?r,F? ROOF Est. Value 'F' 0 0 Date n.F'PTL 2 6 , 19 ? Q - ? 5ite Address 4376 NICQLS RD Erect ? Occuponcy Lot 1 Block 6 ,rs,b. CED GRV d 10 -16 7 0 3- 0 I 0- n 6 Alter ? Zoning Parcel No, Repoi r Q Flre 2one nAJ?RFLL & MAR,70RIi-; Mo??e ? TypeotConst. ad Name O # Stories Z Address 4376 Id T COL S r.') T ' ~ GTA!` 4 5 4-1 9 6 6 Demolish ? Length . .t 5 i phone City {',rode ? Depth Sq. Ft. ix ._ . . , Name Approvola Fmes io oU Add ? r 0 Assessment Permit ress u§ City Phone ? Water $ Sew. Surchorge ? Ji ?? h Police Plan check uW Name F7re SAC _? Address Eny. Water Conn. ? W City Phone Plonner Woter Meter Council Road Unit I hereby ocknowledge that I have recd this npplication and state that gldg. pff. the information is correct nnd ogree to comply with oil applicoble ?,(; (j l A? Tot Stote of Minnesoto Stotutea and City of Ecgan Ordinonces. a Siqnature of Permittee A 8uilding Pertnit is issued to: Pf?_RF.E:LI: & ",AR L 'C??RIF STF:on the ExpreSS tOndition Ihnt oll work sholl be done in accordante II oppliwble S, Min nesota Stetutes and City of Eagon Ordinances. Buildinp Official Permit No. Perrt?it Holder Misc. Permit No. Holder Plumbing H.V.A.C. Well Water Disp. Sawer Electric Inspection Date Insp. Other Footings Foundation Framiny RouQh Plbg. Rouph HVAC Insulation Final Plbg. Final HVAC Final _JZ_ 3 Water Describe Location: Well Sevuer Pr. Disp. u CITY OF EAGAN 3795 Pilot Knob Road Eagow, Minneaata 65122 Phone: 454-8100 _ AIR CONnITTnNTNE; PERMIT Date: 111'9dY 18, 19 T3 ste Address: 1376 Cedar Avenue Lot ? Block - 2' Sub/Sec. NOTe ??:?arrel Steine ? ? q?,e? 4376 Cedar Avenue ciry Yaqan 55122 Phone: Nome '"he Trane Co. /MinnFsot.a ? I Address '? ?5-3 Colorado Ave. So. 0 e ? Ci l.ev 55tA' ty Phone: This Permit is issued on the express condition that oll work shall be Minnesoto Statutes and City of Eagan Ordinances. No. 11 84 Receipt No.: IT) 37 Single Residential X Multi Res., Comm./Ind. I New/Alter./Repotr alteration Cost of Instollotion Permit Fee 5. 00 Surcharge Tora I done in occordance with all applicable Stote of ? Building Official GAS WORK ORDER L ?? b CQ?ar C?rove ??f ' 1082 Payne Ave. STAN DARD 410 W. Lake St. St. Paul, MN 55101 9 Minneapolis, MN 55408 651/772-2449 b HEATING O 6121824-2656 & AIR CONDITIONING A Blue Dof. Service Co. EQUIPMENT INFORMATION LAST FIRST ADDRESS Y32(0 /Z? "C--?wV/?? S? CITY ZIP L HM PH?i/ WK PH TECH DATE ?? - - a TYPE MA K , MODEL c SERIAL U-p INP . - -o f C-..- ORSAT TEST RECORD C02 % METERED INPUT (o d Cfh CHIMNEY TYPE 02 C °r6 LIMIT SETTING z2 0 FLUE SIZE ? in. CO % PILOT oUTAGE p sec cONNECTOR SIZE ? in. NET STACK TEMP 2 ?i 0 TOTAL CHIMNEY INPUT p O btuh CITY OF EAGAN Remarks * Ceda Gxvve "aisition Addition %•V++?m %zm+vr- fl`4 Lot 1 eik 6 Parcel_ 10 16703 010 06 Ownerbl0-'r rz 1 I C1-( street 4376 Cedar AVenue state Eagan, NIIV 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, STFEET RESTOR. GRADING SAN SEW TRUNK * SEWERLATERAL 1972 1,304.00 52.16 25 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 E11GAN Include 2 sets of plans, 1 Certificate,pf Survey & , BUILDING PEPJv'L APPLICATION 1 set of ener9y cal.culati.ons. To Be Used For vatuarion C) sir.e Aaaress: d f s i?", ? OFFICE USE OI?Y ?- Lot ? slock ? sec./sub. C?pa2 e? Occ upancy Parcel # : ) 03 Alter Zoning Repair Fire Zone Ovmer: ?F} n,e j d 11?A-2 1 v 21 P_ 51 e„? .o Enlarge _ Type of Const. -? ?-\j Move # Stories Address: Ie-10 /S Deirolish Front ft. City/Zip Code: r?. yJ1a1, Grade Depth ft. Phone #: Y i S-• / S ? ?0 APP"TAIS Contractor: (-? l,t /Z !5 -e 1 v e.s Assessments Address: City/Zip er/Sewer pol ce Code: 4? ,v - 5 S/ ZZFire Phone # : 51 S"? ) S`? 46 Eng' Planner Arch./Eng.: Council Bldg. Off. . 7 ' Address: AFC City/Zip Co3e: Phone #: Permit f ??v Surcharge Plan Check - SAC water Conn. water Meter Road Unit TOTAL ?- EAGAN TOWNSHIP BUILDING PERMIT Ownax ........ /(?7?M'. .......... 1?_l ............J--....____0'............ Address (pres(enf) 'Y.._e?..?6 ._._._?rF?.?.F?+-< ......... Builder ................ --- ---------------------- --------------------------- -'-----" Aaarasg ............................ -.- --...----....- -.._. .- - - --- -- - - .._...... DESCAIPTION N° 1323 Eagan Township Town Hall Dafe .. s' ?./.....?....?'......--..-.------.- 5fories To Be Used For Froni Depih Heigh! Esl. Cosf l Permii Fee Remarks I ?- AR- e20 a.7- /°?'O-d T_J I 5" ? or of I / I 6 i 6,V --4r ?4 This permit does not auShorise the use of sfree2s, roads, alleps or sidewalks nor does iS give the owner or his agent the righito creale any siluation which is a nuisanee or whieh presenfs a hasard So the healfh, safeip, eonvenie»ce and genexal welfare So anpone in the communily. THIS PEAMIT MUST BE EPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. This ia !o cexlify. !ha!..... . - ............................. has permisaion !o ereci a..... .-- --.....--_.--. _...-.- - - . - • ------upoa the above desczibed prem se auhjeet Yo the provisions of the Building Ordinance for ga?adopled •Apsil 11, 1955. .`.'!..':y`.....'----------- Per ........................... .------'/_..._?..?...2..:lU.'_'....._.. Chairman of Tna¢n ' GY $paxd Suildin InsPeclor ? ' EAGAN TOWNSHIP BUILDING PERMIT Ne j 179 Ownex --..."..=.. > ? ? --- agan Township Address (preseni) _....._.._...------ .. Town Hall Builder ._....... ................ .........._....._...._..............._ . --.............. ...... .._ ?J - Address ._._...... _.__...._-....... ? Dafe .._(../7._sz.? ------ ....__------ _._---------- _......._._ DE5CRIPTION Sfories To Be Used For Fron! Depth I HeighS Esf. Cosi Permif Fee , Aemarks _.- - ___ .--._.. LOCATION ? -- street, Aoad or ofher Descripfion of Locafion . Lo! Block Addifion or Tracf b- 3i7--f ?---- ? ?.'Z.- This permit does no1 auihorize the use of s3reels, roads, alleys or sidewalks nor does if give the owner or his agenf the righito creaie any sifuaEion which is a nuisanee or which presenis a hzzard io the healih, safety, convenience and genezal welfare fo anyone in the community. THIS PERMIT MUST SE KE"PT? O? THEJ PREMISE WHIL£ THE WORK IS IN PROGRESS. This is io cectify, lhai.d?25J.?e,y___.....__.has pezmission 1o erecY a.._/r. , .?.. upon the above described nremise subj¢ct fo the pronisior.s of the Building Ordinance for Eagan wnship adopfed pril 11. 1955. n ?G/-? -'?'^"^T`----4.L'L?Per ??1?"._..._.F-'.?'_wc .---? Cheirman of Tnwn SSoard . . . r - .......-.-........ ?* Building Inspector This request void 18 months from (af *6 ?5 n ?P 73840 Date of this Request , I, as 49,tiicensed Electrical ontractor Owner, do hereby request inspe ion of the above electri- cal wiring installed at: Street Address or Route No. 4-5-7 to C\u,: _?? . City C m Section Township Range County Which is occupied by r\1o„ ,? ? a;? (Name of OccuOanq Is a roughin inspection required on this jo6? No ? Yes ? Ready Now ? Will Cal?M_ Power Supplier Address Electrical Contractor c??..c"?x.f` r!<c Contractor's License No (C mpany Name) Mailing Address C,P n? $ r -9"?.^ allAtion (Electr cal Contra/c?`or OwnY Making ThlS?OIIC NO? y' IAuthorized SignatureGy.aa? G?i() r?.??-/ ? ? ^i lactrl<al Contrattor or Owner Making This Installatlan) s?j f? ?? n ??? ???? This inspection request will not be accePted hy the ?J (?i'? V SWte Board unless proper inspection fee is enclosed. Minnesota Statz Board nf Electricity ? 795?4 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST r / fz---;F p 73840 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired Fo: Home ? ? Range ? Tempocary W'ving ? Duplex ? ? ? Water Hea[er ? Lighting Fiutuies ? Apt. Bldg. Commercial Bldg. ? ? ? ? ? ? Dr Fu ? .-. ElecVic Heating Silo Unloade[ 0 ? Industrial Bldg. ? ? ? ? ? Av •ondit' Bulk Milk Tank ? Faxm ? ? ? pLis )r ?s Lis[ + e[st h Other ? ? ? Hete 7 He re ) COMPUTE INSPECTION FEE BELOW Service Entnnce Size: ?F Fee FeedecsdSubtcedecs: # Fee C'vcuita: # Fee 0 to 100 Am s. 0 ro 30 Am eres 0 to 30 Am eies I 101 to 200 Amps. 31 [o 100 Am ies 31 to 100 Am ces Above 200 Amps. Above 100 Amps. Above 100 Amps. Transfoxmeis RemoteControlCirc. Pactialorotherfee Signt Special lns ection Minimum fee $S Remarks TOTAL FES, ? 8•. I, the Electrical Inspector, hereby certify that the above inspection has been made (Rough•in) Date (Final) 6??? Date ,?ji y' 7 This request void 18 months from ' CITY USE ONLY LOT I BL PERMIT #: 337r SUBD. a ? RECEIPT #: RECEIPT DATE: 2000 MECHALN1Cl4L PEftMIT (ftESIDENTIRL) crrY oF swskx 3830 PaoT ttxos fto $,asnN Mx ssiEs 651-6$1-4675 Date• Complete this secrion onlv if you are in.stalling HVAC in a single-family dwelling, townhome or condo under construction and not owner/occupied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) ? Air conditioning Other State Surchazge .50 Total $ _ Complete this section onlv if you are remodeline, addinp to, or renlacinp an exisring single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or replacement. _ New X Replacement _ Other X. Fumace _ Air exchanger Reminder: Ca11 for final SITE ADDRESS: t OWNER NAME: INSTALLER NAME: STREET ADDRESS: CITY: E?.i ?rYai1?1L °,:?:7 $ 30.00 6.00 Fee State Surchazge Totai $ 30.00 b 3 $ `0.50 PHONE #: ?S I - S -- G ?o (AREA CODE) PHONE #: (AREA CODE) STATE: - -- .- -- --- -- ?? ??G??r?'- -??- -?-?'? __ -- - -- --- - - --- -- -- - -- - ? -------?-- ?': '.. i -- - -t- a -- - - - -- --- -i- -- f -- --- -- - --' ; -- -- - - - -- -- --- --- ? -- , ,? -- - - r _.- --T- -,. - - -- - - -- --- -- - - - - --- ?'__ -? - - - - - -- ?- - ---- ! p ? V . :" -f- " • ' ; -€+-"----- -- - -.. --- f -1-- -- -?' - --- -- , - - - L-- -- - - ? - - - ,-- - -- 1u._. ? --.. -"?' . . . -. -'- - ---- - ?I? . _ . . _ _ . `- ?-- --- --- -- - - -- - - -?- --'"'_'^'- - --- - ? . __... 'a:- - ? ..i- _ ------ ? --- -- ? --- - - - ?? ?- - ?- - - - ?$ - ? ? ." -- - - s? 4; _ --- - - -- -- - -- --- --- -;r'r -- - a7 - - - - l -s ? ,F y ? t- - - ,?- -- ? - - - ? - --- - - - - - - ? ? -- - ?'-?-?= ?_ ?? ? ? - - - - -- - - ."_- ??6''? ?? 3 ? i._ i?-'F , ?'?- •?-/l ?. ?' . _^ -_' ._ - _. ?j..?. ?. /? ? N'?- City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4376 Nicols Rd Lot: 1 Block: 6 Addition: Cedar Grove 4th PID:10- 16703 - 010 -06 Use: Description: Sub Type: Work Type: Reroof & Siding Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 6,000.00 Contractor: Restoration Resources 6850 Shingle Creek Parkway, #C -175 Brooklyn Center MN 55430 (763) 561 -2698 e- Reroof & Siding Construction Type: Reroof: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Siding: When installing ventilated soffit material, remove existing material (ie: debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Paul Hunder BL - Base Fee $6K Surcharge - Based on Valuation $6K Total: I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $132.75 $3.00 $135.75 Owner: Darrell Steine 4376 Nicols Rd Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: 0801 9001 Issued By: Signature Building EA085152 08/08/2008 ePermit City of EaOEall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use Li r BLACK :nk For Office Use (1/117Permit #: { Permit Fee: Z,1 .3�1 Date Received: 1 I ((l ii Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7 3- I 3 Site Address: Name: l-Q� Address / City / Zip: Applicant is Owner •Contractor Description of work: r Unit #: C T Q• 2ctyL h c_ Phone: 7 (03`300 `7 4/ 55 1 Construction Cost:)�j000 Multi -Family Building: Company: Contact: Address: City: State: Zip: icar.se #: Phone: Yes Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 1 Gio 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: IMechanical Contractor: Phone: Sewer & Water Contractor: Phone: OTE: Pins ar,d-stapporting documents that you subrnit are considered to be public to information be classified as non-pub!you provide specific reasons that anclude tnat they are trade secrets nforarratict'.£krttC �rould;per, rtit tits 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.gophersteteonecall.og 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 Applic nVs Printed Eame f 3� 1'Jtcels GT/F [TE BELOW THIS LilE SUB TYPES Foundation .04 Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Pian Review /' (25%__ 100% ✓) Census Code # of Units of Buildings Type of Construction Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair Ii3 y LERI REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window 112421 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant 24 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required __JCid Final / No C.O. Required' HVAC _ Gas Service Test Gas Line Air Test Other: Pool: Footings ____Air/Gas Tests Final Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: _ Footings Backfill — Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEE Base Fee Surcharge Pian Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL C av sr /C2 49 Page 2 of 3 4Poo C!tyofEaall Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 1 `. ( 753 Permit Fee: Date Received: Staff: 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION q-tp 1lS Tenant: Site Address: r) Address: $ State:I1 P1 Zip: 7j:3 7 Contact: Suite #: Phone: 763-34©" 7 7.17 License #: -C-77.-7c2 ? /01.0.1, City: /3u,,#L5/7 rr-( Phone: CO (c7 Y8' 'o'f Email: 66GACRvt cAQ.G J!` 1f c22i1-C.4 S/ . ` c New Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W. �cir �1-e �r'7�ckn d/u �%�, �r v���d �c/ de"..�` Description of work: RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $105.00 Septic System 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.gopherstateonecall.orq 1 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. mvo / °C4- S2( Applicant's Printed Name Applicant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA114579 Date Issued:09/17/2013 Permit Category:ePermit Site Address: 4376 Nicols Rd Lot:1 Block: 6 Addition: Cedar Grove 4th PID:10-16703-06-010 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments: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. Carbon monoxide detectors are required by law in ALL single family homes . Todd Mulvehill Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Kimberly Zaylskie 4376 Nicols Rd Eagan MN 55122 (763) 300-7999 Hometown Restoration 1940 Serendipity Ct St Paul MN 55112 (763) 494-8695 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA114327 Date Issued:09/13/2013 Permit Category:ePermit Site Address: 4376 Nicols Rd Lot:1 Block: 6 Addition: Cedar Grove 4th PID:10-16703-06-010 Use: Description: Sub Type:Reroof 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. Carbon monoxide detectors are required by law in ALL single family homes . Todd Mulvehill Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Kimberly Zaylskie 4376 Nicols Rd Eagan MN 55122 (763) 300-7999 Hometown Restoration 1940 Serendipity Ct St Paul MN 55112 (763) 494-8695 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use Permit#: '�'�" City of tapiaIl 5 o1 Permit Fee: 3830 Pilot Knob Road j Eagan MN 55122 Date Received: / - -e—/ Phone:(651)675-5675 buildinginspectionsacitvofeaoan.com j ;>;,j Staff: V J 2017 RESIDENTIAL BUILDING PERMIT APPLICATION U ' 1 Date: c-a 7"17 Site Address: ! 3 7 w tt-otS /L61 Unit#: /94 Name: (Cc 2.4 {S fr`' Pone: 70 3 3co 7 9f Resident/ -Address/City/Zip: 1 3 7& /"(C.O II kJ Applicant is: Owner Contractor K of i Descrption work: t A'-('cls �P cl" �- Oiqo1 11 (%` r-/-J%_Type of WorkL '/ rZ Construction Cost: 2 9� 0c90 Multi-Family Building: (Yes /No ". T / Company:C,(4YP(t) j/'Ic/J[V tilgod4C.0 C. Contact: J'.4Y !Mott- " 0,4147/19,/6-- Contractor Address: 3(0 3 S7' City: >"ur''r^te 4)3fiu 4), /t (t,f� State: PlN Zip: 6-5-0 Z 7 Phone: PSS( tif. t q"CEmail: c. 4,(cJMsfe•4f P T -6 4I C/,uG1 P• ftet License#: QC- (v 3(32% Lead Certificate#: l t f �jS-� �' 066/ If the project is exempt from lead certification, please explain why: fr6 w co 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 XiNo If yes,date and address of master plan: Licensed Plumber: //v Phone: Mechanical Contractor: llllll/"/�"r Phone: Sewer&Water Contractor: d Phone: Fire Suppression Contractor: N /� Phone: NOTE:Plans and supporting docum that yousubmit are considered to be public information.~,Peons of the information may be classified as non-public if you provide specific reasons that would permit.the.City to conclude that they, are trade secrets You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeadan.com/subscribe. 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. 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 with the approved plan in the case of work which requires a review and approval of plans. x *1-"41 iMYN: tt- Applicant's Printed Name Applic Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE I /(PDCP w SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family x Garage — Porch(4-Season) Exterior Alteration(Multi) Multi _ Deck — Porch(Screen/Gazebo/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 `l / 7j 7.. '6 Occupancy 2R C-4I MCES System Plan Review Code Edition AO 20,c SAC Units (25%_100% ) Zoning T2.- 1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length z.-4/ Fire Suppression Required Type of Construction Width 24/ REQUIRED INSPECTIONS X Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) A- Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test — X Roof:_Ice&Water 1C Final Pool:_Footings Air/Gas Tests _Final )C Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_FootingsBackfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 70 //t r IL 0. W 4 , Building Inspector * RESIDENTIAL FEES Base Fee 5-2 ac, $ . Pt Surcharge Plan Review 3 a;a s'$ • rT MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Property lines to be verified by contractor/owner. REVIEWED `��/{ By: Date: /D/51/7 Eagan Building Inspections Division NTL -0)5 igirotol ' r , For Office Use �y i i„: EAG :::t : /a2`(a'% ECLIv Date Received: /a7 ./Z 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 E / (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-56Staff: buildinginspections DEC' (a�citvofeagan.com 13 2019 —/9 c/ 2019 RESIDENTIAL BUIL • ' IT APPLICATION Date: /Z 43-1 5I Site Address: I/37 iP L ft(1 l E'i -#)/N Unit#: Name: 11 t OA 24 C•sh-IC Phone: Resident/ 4.1-77 ��( s A.Owner Address/City/Zip: Applicant is: Owner Contractor i` I (IIrii* V( 1 o ?" Type of Work Description of work: FC N c 1'C Je M� - P 47 Construction Cost: 6/00 C) Multi-Family Building: (Yes /No/b ) Company: G et,/LJ OR- (-f"fl i C'S 121 "L Contact: JAY frf G Contractor Address: P•D• 8 O is 3 ( (o City: L Q State: /" ✓Zip: S8 YY Phone: S? ` 63 ` ''Em� 0, p IMEJ'i'• t OJT(Get fr• C b N') License#: t; 63 (3 Z ¶ Lead Certificate#: At ftr - pzor3 sY- l If the project is exempt from lead certification, please explain why: / 9 . c9J s COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents;that you submit are considered to be public information, Portions of the information may be classified as nonpublic if you provide specific reasons that would permit the City to conclude that Meyers)trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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. x <TA'( et.r Applicant's Printed Name Applic Signature DO NOT WRITE BELOW THIS LINE 4(3 7 (� � ( b f c' �i6s-9 c l�. SUBTYPES I Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family) 7q Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi — Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement _ Siding Demolish Building* _ Addition — Move Building _ Reroof _ Demolish Interior 4SAlteration — Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation UM Occupancy au/L., MCES System Plan Review Code Edition SAC Units (25%_ 100%K) Zoning 4-"I City Water Census Code Stories � Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V po Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) 3.. Final/ No C.O. Required Foundation Foundation Before Backfill 1 HVAC_Service Test Gas Line Air Test_Hood - Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath Stone Lath _Brick_EFIS 1, Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In Final Braced Walls Erosion Control Ni.. Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee W4' Surcharge Plan Review 0 MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge N'Qr.) I Treatment Plant1\ ( , (.). io r: Radio Meter Read ICJ WA TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA159709 Date Issued:01/10/2020 Permit Category:ePermit Site Address: 4376 Nicols Rd Lot:1 Block: 6 Addition: Cedar Grove 4th PID:10-16703-06-010 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Kimberly Zaylskie 4376 Nicols Rd Eagan MN 55122 Midstate Plumbing & Heating 3500 Cannon St, Suite 100 Hastings MN 55033 (651) 480-1195 Applicant/Permitee: Signature Issued By: Signature