3861 North Ridge Dr
Use BLUE or BLACK Ink
For Office Use I
1 Permit*: City of EaV~ I - e
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 RECEIVED j Date Received: 1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 OCT 2 2 2010 ;a:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -101161110 Site Address: li D
Tenant: Suite M
RESIDENT / OWNER Name: oah T ng) - ' Phone:
Address/ City I Zip:
Applicant is: Owner Contractor r't!✓ ( z
TYPE OF WORK Description of work.
Construction Cost: Multi-Family Building: (Yes / No }
CONTRACTOR Name:. _ Budget Exteriors . License* (.7,!5ff
Address 8017 Nicollet Ave S. . City:
Bloomington, MN 55420
State: - PH: (952) 887-1613
F: (952) 887-1659
Contest.
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
ne ratecr+N a
Call 48 hours before you intend to dig to receive locates of underground utilities. )6e
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 1 understand this is not a permit, but only an application for a permit, and work is not to sta without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and apprr of plans.
X_ tl~r
Applicants Printed Name Applicant's iftnature Page 1 of 2
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Mum Deck _ Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
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 i Water Damage
Retaining Wall 'Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_^ 100%,_} Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final I C.O. Required
Footings (Addition) Final I No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: Footings Air/Gas Tests -Final
Framing Siding:, Stucco Lath -Stone Lath „Brick
Fireplace: -Rough In Air Test Final Windows
Insulation Retaining Wall: r Footings _ Backfill _ Final
Meter Size: Radon Control
Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
INSPECTION RECORD
CITY OF EAGAN PERMlT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: , ,r 4 1.", 1 C.3CtiF 0 ft
ilRHftf Nbdlltiq ?>tyNf.)'> .
PERMIT SUBTYPE:
APPLICANT:
J. .' 1 4 ti .a • Ri i. 14
TYPE OF WORK:
esil t1 t+twC;
H :!C .t '.) i F;
N x. ; C4k t ft s2
INSPECTION .. . .•
? -7]
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGN
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL '??? ?
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CERTIFICATE OF SURVEY
for
JOE MILLER HOMES
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BY
DA7E 7- 97
6UILDING INSPECTIONS DEPT.
Top curb to Gar siab
Top block = -yRtR
Lowest bsmt flr = -Mil_L
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Scale: 1" = 30'
3861 North Ridge Drive
DESCRIPTION
I hereby certify that this survey, plan, or Lot 7, Block 3,
report was prepared by me or under my direct GAftDENW00D PON?S
supervision and that I am a duly Registered
Land 5urveyor under the Laws of the State Dakota County, Minnesota
of Minnesota. Plat bearings shown
o Denotes iron monument
Date ` - 7 TUL 1997 Reg. No. 8140 . Existing? Proposed
BRANDT ENGIr+lEER1o11G & SURVEYING
1600 West 143rd Street, Su ite 206
Burnsville, MN 55306
(612) 435-1966
Nn.?9-1 588-97
CERTIFICATE OF SURVEY M 32-1588- 97
for
JOE MILLER HOMES T
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DATE
BUILDING INSPECTIONS DEP7.
Top curb to Gar slab
Top block = -99Z_33
Lowest bsmt flr = 8$11,.6.?
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,
711 .?/F7
Scale: 1" = 30'
3861 North Ridge Drive
DESCRIPTION
I hereby certify that this survey, pian, or
report was prepared by me or under my direct ? Lot 7, Block 3,
supervision and that I am a duly Registered GARDENWOOD PONDS
Land Surveyor under the Laws of the State Dakota County, Minnesota
of Minnesota. Plat bearings shown
o Denotes iron monument
-z / -- .-1
Date `7 J-U1_ 1997 Reg. No. 8140 ,Existing/ Proposed
BRANDT ENGINEERING & SURVEYING
1600 West
Burnsville,
(612) 435
143rd Street, Su ite 206
M N 55306
-1966
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PONDING AREA fif aoolicable)
Easement line
rvwL
HWL
Pond # designation
Emergency Wertlow Elevation
DIMENSIONS
Lot IinesBearings & dimensions
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (i.e. alI structures requiring permanent footings)
Show all easements of record and any City udlities within those easements
Setbacks of proposed sVUCture and sideyard setback of adjacent ebsting structures
Retaining wall requirementsAany
Reviewed:
January 1996
CRAIGi BBB/BLOGPRMf. FM
LOT SURVEY CHECKLIST FOR RESIOENTIAL
BI (ILDING PERMIT APPLICAFION
PROPERTY LEGAL:
DATE OF SURVEY:
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Building Permit ApplicaM
• Legal descripdon
• Address
• North arrow and scale
• House type (rambier, walkout, splR w/o, split entry, lookout, etc.)
• Directional drainage arrows with slope/gradient %
• Proposed/existing sewer and water services & invert elevation
• Streetname
• Driveway
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ELEVATIONS
Existina
• Sewer service (or Proposec)
• Property corners
• Top of curb at fhe driveway
• Elevations of any existlng adjacent homes
Prooosed
• Garage floor
• First floor
• Lowest exposed elevation (walkouUwindow)
• Property corners
• Front and rear of home at the foundation
?,'CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUIIDING
031916
05/05/98
SITE ADDRESS:
3861 NORTH RIDGE OR
LOT: 7 BLOCK: 3
GARDENWOOD PONOS
P.I.N.: 10-28800-070-03
DESCRIPTION:
;
Building-?Permit Type
?`•Bpilding W'o.rk Type
, CEC7.61l5 C6-de?=}.._.
PERMIT '
DECK
NEW
434 ALT. RESIDENTIAL
A 31 ?
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REMARKS:
PLAN REVIEWED BY MIKE BARCK.
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
7ota1 Fee $50.50
CONTRACTOR: - Applicant - sT. LIC.OWNER:
BRANSON BUILDER5 14834614 2007169 PRONK NICHOLA5
41 GRAMSIE RD 3861 NORTH RIDGE DR
MOREVIEW MN 55126 EAGAN MN
612) 483-4614 (612)686-9384
? I here'by acknowledge that T have read' th
information is correct end agraa to cohnF
L SCatutes and City afilagan Ordinandes °
,... .
APPLICANTlPERMI EE SIGNATURE
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a;pplica.tioe ancl staCe 'Chat the` `
V;with a11 ,applieatsle 5t6te o-f,Mtn.,
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ISSUED BN SIG UiiE
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? 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN e 0.s Q n w( I n. e
? I 3830 PII.OT KNOB RD - 55122
681-4675 Q4- y 8 3_ V b i Y.
Naw Construction Reauirements RemodeVReoair Requirements 7"11ft K k Q.J
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3 registered site surveys ? 2 copies of plan 1'1'? r1j c e
2 copies of plans (inGude beam & window sizes; poured fnd. design; etc.)
1 energy plculations
3 wpies of tree preservatlon plan rf lot plattetl after 7f1193
required: _ Yes _ No
DATE: -/ - Z R - 9 Z?
?, 2 sRe surveys (exterior adddions & dedcs)
? 1 energy calcutations Por heated additions
CONSTRUCTION COST;
DESCRIPTION OF WORK: 0? c- k l6 x z5' '
STREET ADDRESS:
3$?,(
LOT: 7 BLOCK: 3
ve :jae 1) rI , rQ
SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: peonk yV;cQ i Sfe pl.<r: e Phone#:
Last Fitst :
(.Fi6- C1384
Street Address: 3 b?( 14, k" dg a U r.-Ve
City i? a3 4?'I State: ?)i r? Zip: 2 3
Company: I J?' w v? S o v? ??• ?? e J s Phone #: S1 S 3` Zf 6/`f
Street Address: Z?/ ( gea.+^ S i e ?1 V? d License #
City v; e L,J State: ?vl '?
Company: ' /v /t
Street
City
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply wfth all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant Ir-? C?--
OFFICE USE ONLY ?
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No - Not Required
200'7l4, 98
Zip: SS J 2 ?
Phone #:
Registra6on #: _
State: Zip:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
V- 31 New ? 33 Alterations
O 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of,Stories
Length
Depth
APPROVALS
Planning
? 11
? 12
? 13
? 14
)9,-15
Apt./Lodging ? 16 Basement Finish
Multi Repair/Rem. ? „1,7 Swim Pool
Garage/Accessory ? 20 Public Facility
Firepiace ? 21 Misceilaneous
Deck I
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies.,..,?, ......--
Total:
% SAC t ?' r4
SAC Units
M16 Engineering
Valuation: $
?
?I
MC/WS System ?
City Water i ?
Fire Sprinklered
PRV
Booster Pump
Census Code. q 3 y
SAC Code o /
Census Bldg
Census Unit ' D
Variance
CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota55122-1897 PermitNumber: 030461
(612) 681-4675 Date Issued: 0 7/ 17 / 9 7
SITE ADDRESS:
3861 NORTM RIDGE DR
LOT: 7 BLOCK: 3
GflRDENW00D PONDS
P.I.N.: 10-28800-070-03
DESCRIPTION:
BuilOing..,rPermit Type
6uilding L'1o,rk Type
UBC 4ocupanc?k,?
Constxuction
Zoning
Suil;ding,4Length
B'uilding Widtfi
BuiJt?i?ng sz=ories ?:ev'
U a r e F?e t"
C`euisus, Gctde?` _
SF DWG
NEW
R-3 U-1
V-N
R-1
54
34 ;
Z
2>328
101 1 - FAM. DETACH
U
? xu
REMARKS:
5& W PLBR -M & W SEWER ANIJ WATER
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC ?
SAC Units
Subtotal
VALUATION
$1,387.25
$901.71
$100.00
$950.0@
100
1
$3,338.96
)
s?? t*???.aa% ?I
e::v
$200,000
MISCELLANEOUS $1.539.50
Total Fee $4,878•46
CONTRACTOR: - Applicant - sT. LIC OWNER:
HORTON INC OF MN, D R 14544663 2000565 JOE MILLER HOMES
,3459 WASHINGTON DR 204 3459 WASHINGTON pR 204
AEAGAN MN 55122 EAGAN MN 55122
(612) 454-4663 (612)454-4663
t
I I hereby aeknowledge that I have read this apµplication and state Ghat the I
inforrnation is correaC':an'd .agre-v` tameomply w1_th *li PP1?c.ab3e Sta?te cit Mn:,
Statutes and City of Eagan tirdinances. '
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APPLICANT/PER T IGNATURE I Eo : SI ATUR
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304LI 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN '
8830 PILOT KNOB RD - 55122
681-4675
New Construetion Reouirements FtemodeVReoair Reculroments
? 3 ropistered ake surveys • copies W Wn
• 2 copies ot plans (Inducle beam 8 window aizes; poured fid. design; etc.) ? 2 sfte surv ys (exterior adEftions 8 dedce)
? 1 energy calwlatlons ? 1 eneigy ealaletions tor heated add'Rions
? 3 eopka of tree preservatlon plan if lot platted aRer 7f7/93
requfrod: _ Yes X No -
DATE: 7-141- 9 7 CONSTRUCTION COST
DESCRIPTION OF WORK /Llew 62N Sku r,11Lr2
STREET ADDRESS: .3rp?ol /l&yA L 've
a
LOT _Z BLOCK 3 SUBD./P.I.D.#: QVL+U/ud,/ dHdS /St
PROPERTY Name:
OWNER
?
Phone #:
Street Address:
CftY: State: Zip:
CONTRACTOR Company: --:ve.. J'Vl; fier A,,,<5 Phone
Street Address: 34K4 L,A,Sk4eL License #:?XkS65/7
Ciry:_155,6.60 State: /Yl,rl Zip:
ARCHITECT! Company: Phone #:
ENGINEER
Name: Registration #:
5treet Address:
Ciry: State:
Zip:
Sewer 8 water licensed plumber (new construction ony): Mv'iAl :?? 4- 6614fii . Penalty applies when address change
and lot change are requested once permit is issued.
I hereby acknowledge that 1 have read this application and shate that the informa6on is correct and agrce to comply with all appiicabte
SYate of Minnesota Statutes and City of Eagan Ordinances. ?Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Ptan Received
RECEIVED
='e$ - N° JUL 14 1997
- Yes - No ?/'Not Required By L-*?
OFFICE USE ONLY .?
-.
?
; .?
. .
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M
SUILDING PERMIT TYPE
n 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
R' 02 SF Dwelling ? 07 4-plex ? 12 Muki Repair/Rem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex n 13 Garage/Accessory o 20 Public Facility
n 04 SF Porch a 09 12-plex o 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
,pr'31 New ? 33 Alterations o 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Jn! Basement sq. ft.
(Allowable) N Main level sq. ft.
UBC Occupancy ?-3,?-1 2e) sq. ft.
Zoning ?Z-1 ue sq. ft.
# of Stories 2 sq. ft.
Length sy , sq. ft.
Depth 3 y' Footprint sq. ft.
«y Ca MCM/S System `
I f. -7$ City Water ?
ro W Fire Sprinklered
4'so PRV
Booster Pump
Census Code.
2328 SAC Code d ?
Census Bldg r
Census Unit I
APPROVALS
Planning Building Iin8 Engineering Variance _
Permit Fee Valuation: $ zor , ovo. --
Surcharge
Plan Review ----
License 11404
MCNVS SAC 33 ? r i (.s'
CitySAC 1z.r"3 3-7.5-
Water Conn. ? 3 u 3 3
Water Meter
Acct. Deposit
zS =
y i,
i-7, s
S/W Permit 5
S/W Surcharge
Treatment PI.
Road Unit ??Z
Park Ded. - 1 1?7 ?. s-??sy= ?n s8s. ?
Trails Ded.
Other
ios
Copies
?
rb A 54 =
tp 57 724.-
TotaL• ?"`?_ •
'3 z ?- iq `08
% SAC 2 ,e 2 i
uz
SAC Units
i4q, 9 HS. s
. .
1& 2 Family Residential "Cookbook" h4elhoa
'I S(TE ADDRE55 ? ? ?? I Vty
D
I au?LDER JoE. Mi(_(.Er- oa<<
Minimum Criteria:
Rim Joisc R-19 insulauon Foundaton Wodows: Insulatcd glass, IR" air spacc, u ood or vinyl fiamc
Enw doars: li inch solid wood with storm or better
STEP 1 Window & Door Area STEP 2 Calculate area as a percent o! µ'all ?
Total Window & Door Arca in 3q. Fee[ '
WII,7DOVT5 (iacluuing fcuodation windo-ws):
Dimcnsions Qory. Arca
X 5-d' ?ft??l 15
x
zc(1_' 11 ' 169
ikl IIII ? ?
Z Cd'I z
14 1 -o` X5' a1 i ?
z'.ol x 5? o`
Z?.. " z 3? ? II ( ?-
x
x
x
DOORS:
(fJ? xv = 4 D
z ( ? Z(Z)
X L i 164
Total Area of
Window & Doors ? A
Arca
Box A(wiadow & door arca) dividcd by Box B(total
wal] ucx) times 100 equzs thc window znd door zrca
as a pcrccn[ of wall arca (Box C).
soxA 411 x 100
- ?-
BozB j I ZI C
I STEP 3 Design Features I
ASSEMBLY
FRa,NrE wa:LL:
otrrtoN
STANDARD FRAI?4ING ?
ADVANCED 1712..4h'QNG
CAVITY INS[JIATION ?- 7-I
SIE'477117NG: LE55 TIIAN R-5 ?
R-5 OR h10RE
WINDpWS (uccpt foundation windows):
U-FACIOA U-, ?j(p
From the table, dcterminc tbc roaximum pcrccot window
?& door arca for the design opoons sclectcd and cntcr thc
valuc in box D Uclow:
I Boz C must bc lcss than or cqual to Box n
Total Wall Psca in Sq. Fc.
Rlall Tocal Pcrimetcr Hcight
r .
P. Tlie building nuist not exceed the maximum window and door area as a
percentage of overall exposed tvall area listed Uelow for the combination
of framing technique, R-value of insulation within llie insulated cavit?,
sheathing R-value, and cvindow U-factor. Other mmponents must meet
lhe requirements of this su6parl.
MAXiA4UM IVINDOW AND Ta00R ARE.4
AS A Pf RCENT OF OVGRALL GXPOSGU WAI.I.
Ca?ity WinAow U-I=acror
_Framing • Instdalion ' Shcathing_ 0.49 0.36 0.31 0?7
SI'ANDARD R-13 ?R-7 13.4 17.8%a 21.3% 24.31b
STANDARp R-]S 211-5 12.90"0 17.1 % 20.11% 33.91.
STANDARD R-IB . <lt-5 .., , 11-I% 16.00L 18.80%
22.0°6
STAIqDARD R-18 2R-5 13.590 16.6°0 21.8:0 25.3%
ADVANCEp . R76 <R-5 11.1016 77.1% 20.101 23.40'
ADVANCED I1-18 2R•5 13.500 19.2% 22.50. 26.1';'
STANpARD Ij-21 <R-5 11.8°6 ; 77.0;'. . 19.901. 23.10'.
STANDARD k-21 2ft•5 14.09. 19.31L 22.50L 26.1;b
ApVANCGD i:-21 . <It-5 11.8';f. 18.1% 21.21'. 21.61L
ADVANCL•D R-21 2K-5 . 1.1.0011o 19.90"0 2329? 26.9°..
SuUp. 3. Perforniance criteria. Tlie combined thermal transmiltance (Uo)
faetors for walls, rooF/ceilings, anct floors over itnheated spaces musl Ue less llian or
equal to:
A. 0.170 T3tu/I1 ft2 °P for cvalls;
H. 0.026 t3hi/h ftZ °]' fnr roof/ceilings; and
C. 0.04 Titu/h ftz °r for Flaors.
STATAlI7'Ii: MS § 2I6C.19
NIST: IB SIi 2361
7670.0980 RepenleA, 18 SR 2361
?
A1inn. Rules Clmprtcr 7670 26 1111u: 1991
L'Z BL ? CtTY USE ONLY il RECEIPT #: ??'L?
SUBD. ?CJA?+cO?+u?rov?'L ? I? DATE:
1996 PLUMBING PERMIT (RE5IDENTIAL)
CITY OF EAGAN!
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -4675
Please complete for. ? single family dweltings
? townhomes and condos when permits are required for each unit
------------
FIXTURES
Shower. ,
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet ' minimum - 1
Rough O enin s
Wa er oftener
n S pOS31 ' Dakota Cty. Ncense
(new and refurbished systems)
U.G. Spdnkler' home under const.
AkefatlOtlS * to existing
Water Turn Around
SITE ADDRESS
OWNER NAME:.
INSTALLER NAN
STREET ADDRE
C17Y:
STATE SURCHARGE r
3.00 ?
20.00
20.00 ?
NQ. TOTAL
---t?
TOTAL ;76- ?`J 0 . ;...y:
, . . .
PRONK, STEPHANIE I , . .
3869 NORTH RIDGE DRIVE
EAGAN, MN 55723 I .
(612) 686-9384 ........,..........._- •• --- -
(8t2T 827-4033
?805 dAflFIEL
G13D AVE. SOUTH' s
--7@"??
PHONE #: (
EACti
3.00 x'
3.00 x'',
3.00 x I',
3.00 x°
3.00 x'
3.00 x?
3.00 x l
3.00 x
3.00 x?
?
3.00 x?
1.50 xii
5.00 x
50.00 ,
,
STATE: I ZIP:
i
CI7Y USE ONLY ga
L ? BL RECEIPT#: 99 SUBD. RECEIPT DATE:
1998 PLUIMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOH RD
EP,GAN, b47 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH #
Shower 3.00 , x
Water Ciosei 3A0 ' x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 a x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain, 3.00 „ x =
Gas Piping Outlet ' minimum - t 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construGion 5.00 x =
Water Softener " for existing dwelling 20.00 x =
U.G;$.pfll]kl@f _' for dwelling under const. 3.00
? . prinkler or existing dwelling 20.00 =
era ions ' to existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System * MPC iic. 75.00
=
(new and returbished systems)
Private Disposal Systems' nnandonment 20.00 =
STATE SURCHARGE
TOTAL
TOTAL
?fL-
50
?0.50
------------------------------------------------------------•--...------------°-------------- --------------.._..------•---------
I here6y adcnowledge lhat I have read this application, state that Me informaUon is corted; and agrae to compty wkh all applicable City of Eagan- o °Minance-s.
It is the applicanPs responsibility to notity the property owner that the Ciry of Eagan assumes no liability Tor any damages caused by the Ciry during Rs
normal operational and maintenance ectivities to the facilRies constructed under this pertnd within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAN
STREET ADDRE
ciTV:
JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 7998
PERMITTEE
?05 ( mQu n f" STATE: MN ZI P: ,:/??a
CITY USE ONLY
LOT 7 BL J?
SUBD. ?,t?? ?` \y"ON4l'?S.
RECEIPT #:
RECEIPT DATE:
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT K1VOH' RD
EAGAN MN 55122
(61216814675'
Dste:
11
Complete this section onlv if you are installine HVAC in single family, townhome, or condos that are
uader construcrion and are not owner /occunied. "
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets ( minunum of one required @$3.00 ea.)
• State Surcharge:
• TOTAL:
$ 24.00
6.00
("G0
.50
? 36. So
Complete this section onlv if vou are remodeline, addine to, or repairina eaistin¢ sinele familv
dwellings, townhomes, or condos. i
Add-on furnace _ Add on air condiuoning
Add-on air exchanger, i.e. Vanee system, etc. Other
Minimum fee applies to all remodel or add-ons of eatisting residences $ 20.00
State Surcharge .50
Total: $ 20.50
SiTE ADDRESS: ??6 r .UoI?,(1,- doe D. .
OWNER NAME: /_//0 ,? ,er PHONE #:
INSTALLERNAME: T`6G1?°d 141i- 11 pHONE #: 1?0-6pe?,2
STREET ADDRESS: /O
CITY: STAT'E: I`Z`v ZIP: S373a 4,/
S[GNAT F PERMITTEE
CITY USE ONLY
L _ BL _ RECEIPT;Y:
SUBD. RECEIPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete fur.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: - $25.00 minimum fee Qr 1"/o of conVact price, whichever is greater.
• Processed piping - $25.00
• State sureharge of $.50 per $1,000 of pgrmit fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPRQVEMENTS ONL`n
INSTALLER:
ADDRESS:
crrY:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE
• ali commeroiaUndusfial buildings.
? mutti--famiy buiidings when separate pertnits are pQI required for each dwelling
unit.
STATE ZIP:
CITY INSPECTOR
/ CITY USE ONLY
8L J? I RECEIPT#: / 9?o2 v
SUBD, _ RECEIPT DATE: 0 Q ?
i
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675 ',
Please complete for: ? single family dwellings
. townhomes and condos when permits are required for each unit
• backflow preventer for underground sprinkler system
FIXTURES „EACH TOTAL
Shower 3.00 x = 3100
WaterCloset 3.00 x = /Z•CQ
Bath Tub 3.00 x !P, DO
Lavatory 3.00 x to = I$. 00
Kitchen Sink 3.00 x
Laundry Tray 3.00 x
Hot Tub/Spa 3.00 x =
Water Heater i, 3.00 x
Floor Drain ' 3.00 x o0
Gas Piping Outlet 'minimum-1 3.00 x
Rough Openings 1.50 x =
Watef SoftBner * for dwellings under wnstruction I 5.00 x = = a_ Od
Water Softener ` for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under wnst. 3.00 =
U.G. Sprinkler ' for existing dwellin9 20.00 =
Alterations ' to existing residence 20.00
? =
Water Turn Around 2Q.00 =
Private Disposal System ' oak cry iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems' Abandonment "20.00 =
STATE SURCHARGE .60
TOTAL I ?!•?
I hereby acknowledge that I have read this applicetion, state that the information!is cortect, and agree to compty with ell applicable City
of Eagan ardinances. It is Cie appliqnYs responsibility to notity the property owner that the City of Eagan assumes no liability for any
damagee wused by the Ciry during its rwrtnal operational and maintenence adiuifies to the tacilities constructed under this pertnk within
City property/right-of-wap/=q==m^^t
SITE ADDRE55:
OWNER NAME:
INSTALLER NAME: GENZ-RYAN PLUMBING & HEATING 1 TELEPHONE#: 423-1144
STREETADDRESS: 1474F cn onRror Tpl
ci7Y: ROSEMOUNT STATE: MN ziP: S5068
SIGNATURE OF PERMITT
For Office Use I
4bo Permit go v I
City of Eap 1
I Permit Fee:
3830 Pilot Knob Road I l
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v f'~ ! Site Address: 3 9(ol fbY-4-17 eLd qe I
Tenant: Suite
62
RESIDENT /OWNER Name: M-Ol'! 01 e -0 K4 Phone:
Address / City / Zip: ,39& l AIM* 9-1&4e Dk-, , d!/I/1~ S5/Z 3
Applicant is: Owner V /Contractor
TYPE OF WORK Description of work: ge- V p O
Construction Cost: 1} ! U , r~U Multi-Family Building: (Yes / No
CONTRACTOR Name: L~ ~C-t~ Yl C~ ~S License JC)6
Address: Eo 1-1 t e 1 Ave,.
City: 1 ~Q (✓lrxln State:_ Zip:
Phone: 01
2 Contact Person: C l ScWtbIkIA
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(1~ submission type) • Energy Envelope Calculations Submitted
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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 Cass i,e ni-e Y x Ca4zt •
Applicant's Printed Name Applicant's Signature
Page 1 of 3
For Office Use,
Permit l~ I
City of Evan _ I
I
I Permit Fee:
3830 Pilot Knob Road 4Lj{
Eagan MN 55122 ly'~? ZDe Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694. I staff: I
L -----------------I
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 0 1 f! Nor Orr
Tenant: St WMAJ2 1' C wi✓( (O~i~ 93 Suite
RESIDENT/ OWNER Name: Pr ao k/ Phone: (C~fJr )t o&& ` t3gq
Address / City / Zip: D (y j
A'~+ WlL/~
CONTRACTOR Name: - ~IORBLO~1-P MBII~FG-VC~ License
Address: (612) 827-4033
City: 2905 GARFIELD AVE. SO. State: Zip:
MINNEAPOLIS MN 55408
Phone: ' Contact Person:
TYPE OF WORK _ New Replacement Repair _ Rebuild Modify Space _ Work in R.O.W.
Description of work: Y' v y r heffw
PERMIT TYPE RESIDENTIAL
' Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) C_ Main _ Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES;
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
i
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes county fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) 5('~
TOTAL FEES $
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 bDl" Ibl l~)'YL x .
Applicant's Printe Name A icant's Signa ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rougfl Ire Air Test Gas Test Final
PERMIT
City of Eagan Permit Type: Plumbing
Eagan. Permit Number: EA097461
Date Issued: 12/17/2010
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 3861 North Ridge Dr
Lot: 7 Block: 3 Addition: Gardemvood Ponds
PID:10-28800-070-03
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Second Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: TOE RASCIIER
712 SMITH AVE SO
ST PAUL. MN 55107
651-224-4759
Fee Summary: PL - Permit Fee (miscellaneous) $50.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Rascher Plumbing & Heating Pronk Stephanie
712 Smith Avenue South 3861 North Ridge Dr
St. Paul NIN 55107 Eagan NIN 55123
(61)224-479
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
a
#21402 $105.25 Use BLUE or BLACK Ink
�------------------
� For Office Use �
C' j Permit#: �°C' ���� j
l�� of �a�aIl .. . � Permit Fee: ��•� . ��I
3830 Pilot Knob Road � / �
Eagan MN 55122 QC�C � � ��1� � Date Received: ��—�l0- ��
Phone:(651)675-5675 '�� I � I
Fax:(651)675-5694 I Staff: i
_ m. I i
,., . .. �����������������J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
��
Date: 10/13/14 Site Address: 3861 N Ridge Drive Unit#: II
Name: Steph&Nico Pronk Phone: 651-686-9384
Resident/
QWngr Address/Cify/Zip: same as site
Applicant is: Owner Y Contractor
Type of Work
Description of work: Remove&replace 3 windows into same existing rough openings.
Construction Cost: �4,292.00 Multi-Family Building: (Yes /No�!)
Con BudgetEXt61'i01'S,Ina Contaet: JaYmi Lund
8017 Nicollet Ave.S
COIttPBCtOF Ad� Bloomington,MN 55420 City:
952-887-1613 Fax 952-887-1659
` Sta Lic.#BC006564 Exp.Date 3/31/16 '� �
License#: �eau�ertificate#: NAT-22128-0
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes �No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
NOTE:P/ans and supporting documents ti�at you submit are considered to be public information. Partions of -
the information may be c/assified as non public if you provide spec�c reasons that wauld permtt the City fo
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. wtivw.qoaherstateanecall.orp
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 woiic 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 Minne ta State Building Code must be completed within 180
days of permit issuance. - �
' Jaymi Lund 1 ' '
x
ApplicanYs Printed Name App ant' ignature
Page 1 of 3
!"
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(AA#*$2+ D4,3K* ,, &/*.+2 13,5==1,)&"@ &/*.+2 13,
a,�k�3� L10 S'-(. Use BLUE or BLACK Ink
r 1
,,� For Office Use I
,,;'!";''I,'..%,,„';,,,E 1
t;, 0 q 1
` �` � Permit#: �r�
CItV of �� ►
Permit Fee: 4" •� 0 I
3830 Pilot Knob Road I
Eagan MN 55122 I
r
<<��i��\a Date Received:
Phone: (651) 675-5675 I
Fax: (651)675-5694 AUt 18 1017 Staff: I
J
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:•. 5-1S--\`1 Site Address: 3%61 4 , 'K-‘c\�e c) c Unit#:
Name:S \) c ,e? ?cr..7C\V\ Phone: ( S \-(0556-G1.Ss k-
Resident/ 3 c
Owner Address/City/Zip: �J�S . C\A(01 c e Or LJ n SS\a -
l Applicant is: Owner �5 Contractor �J
Type
Of Work Description of work:Ce.c-c\ QO.ie c x c w�rP �c,��\r, cvvc ' \c c c e
cv�5\r� c.)pe, :c\5 m
Construction Cost: 'ZC>CD Multi-Family Building: (Yes /No )
Company: ( a�e 1; Tr. )ce-c i CDC S Contact: `�_ C`r-N.D6\.SC,y n
Contractor Address: 5'.5..)\-\ k co\.�. 'Nue- S City: Y-7\ex.3c�•S-n O'\
Statel7\t\ Zip:SLi. (� PhonetS3.- §s1-\11> Email: \Mc)`R C\ Ape.:‘ e_c\-nri%\
jLicense#: P-f-0UbSC:)t-t Lead Certificate#: a,(3,\,: ,_55 - , \
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,mhas the City of Eagan issued a permit for a similar plan based on a master plan?
Yes U No If yes, date and address of masterp lan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
►9
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 maybe classified as non-public if you provide specific reasonsthat would permit the City to
conclude that their are trade secrets,'
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 \\ ..-A.. M.LA\S(in
Applicant's Printed Name Applic Signatu •
Page 1 of 3
Vzi )i \, .
�Z°"'- For Office Use �rI
419f
`,` t :i i %,� EAGA MAY a 1 Z0� Permit#: 11 q 61
..... .'• Permit Fee: /f N
7 7,-
C C
�� Date Received: �� ✓/11' /&
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections@cityofeagan.com L
2018 RESIDENTIAL L BUILDINGDPERMIT APPLICATION
'1
Date: ,/t?O/)1- Site Address: v 1 I Or tai r - G r Unit#:
Name:cf e P A a. 4; e. 4- I"�CO ?(o N t�'L Phone:
Resident/ 364it /J� R'c�ic r
Owner Address/City/Zip: G ItitiN 5---/L3
Applicant is: Owner Contractor J
Type of Work Description of work: $ OV't7 /<:fchen Cab('rte.tr J- 1311t-t- 4- re.p lactAp //ca/
Construction Cost: /d ave7 Multi-Family Building: (Yes /No
Company: 1 1 4v. 1.°f1414• /°A Contact: j , i 1�1`SGhu\F_f/
Contractor Address: /1 15' i)keoIIe4J AA(c City: i�urKs!/t (P'e-
State: /VV/Zip: 6-66)3 1 Phone:t/VZ-1,0'7.�.�. mail: pay I es, -fi'ttvrconfraci,'n'• can.j
License#: N'-6'3114 9 3 Lead Certificate it:-NKr 4.27 11 ' Z 3 ,4-tv6.-
If the project is exempt from lead certification, please explain why:
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. Potions 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.citvofeaqan.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.org
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accorce with the approved plan in the case of work which requires a review and appro
x 2t. (/ rsch �
0 ex
Applicant's Printed Name ppli ant's Signature
DO NOT WRITE BELOW THIS LINE " 6 / (kat 'id 6 49I . IL/(9, ./ 9
SUB TYPES
_ Foundation —
Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Y 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
P 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 c' 4'SV Occupancy 3312C– I MCES System
Plan Review Code Edition "PM 20 6-- SAC Units
(25%_100%f) Zoning R—, City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction 1/.5 Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) 1p Final/No C.O. Required
Foundation Foundation Before Backfill 20 HVAC_Gas Service Test 2o Gas Line Air Test
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
! Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: IT 41 7Y2•lc , Building Inspector
RESIDENTIAL FEES i yV 59 , //- )X 2 0.9
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
For Office Use
; a Permit#:EAGAN
yi /Permit Fee:
vvv
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(a�cityofeagan.com L
( 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
lI
Date: Z6I)� Site Address: 316 I We Pcoloc $
Tenant: Suite#:
R sideritl4 truer Name: 6. i 0L-0,...)\4 �fccn S
t Phone: 6/2 5 1Q —7ss
25(/ �J
Address/City/Zip: ✓ U`� ' " �r ���►C
p) ( /� / ` �
Name: Cf I IVM�n � � License#: PC 6 �6/
Address: /911` -1 10 J r& �V v Cit : OTS E(
Contractor y
State: A V V Zi 5��6 Phone: 7‘ Vo
Contact: f Email:
Type of Work —New ,Replacement —Repair Rebuild —Modify Space —Work in R.O.W.
Description of work: ;C''" /(I T LCI 4"'' ��I`�
RESIDENTIAL
Water Heater
Lawn Irrigation(—RPZ/—PVB) Water Softener
Permit Type
Septic System Add Plumbing Fixtures( Main/ Lower Level)
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
"Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
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.
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.
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA171825
Date Issued:09/02/2021
Permit Category:ePermit
Site Address: 3861 North Ridge Dr
Lot:7 Block: 3 Addition: Gardenwood Ponds
PID:10-28800-03-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Bridget Smith
3861 North Ridge Dr
Eagan MN 55123
(612) 406-5306
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature