4370 Nybro CirCITY OF EAGAN Remarks
Wilderness Run 4th Addition 14 3 10 84353 140 03
Addition Lot BIk Parcel
?J
Owner?? «a Street Slate
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
STR EET R ESTOR.
GRAOING
SAN SEW TRUNK 1973 $163.26 $8.16 20 PAID
SEWER LATEFiAL
WATERMAIN
WATER LATERAL
WATER AREA P (I h water Slil II 7
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 280.00 11470 8-21-74
BUILOING PER,
snc $400.00 11470 8-21-74
PARK
VILLAGE OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMI7' NO.:. 1595
Eogan. MN 55142 DATE: 10I 7I74
'Loning: Rl No. of Units: 1
Owner:
Address:
Site Address: 4374__N}rbYO . Circ18
Plumbec A117State Plumbinq
.s?_?? o asao
Meter N
o Connection Charge344?D_0__pd._$f21/'
?
?
Size: "O ?'h• Account Deposit
/
'' ou? /o
4
,,..Q_7?
Q
Reader No.: . Pcrmit Fee:
_
_?Ooi"e
1 oqree to comply with ihe Villoga o4 Engon Surcharge: 5
Ordino es.
? Misa Charges:,
?7t
_ /y,Q Total:
B o?...?CFJ?Yt?
Y , Date Paid:
Dat of lnsp.: Insp.:
YILLAOE OF EA6AN SEWER SERVICE PERMIT
3795 PilorKnobRoad PCHMIT NO.: 2355
Eogon, MN 55122 DATE: 10/7/74
Zoning: F3=1 No. of Units: 1
Owner.Peterson Bros. Co. -
Address:
Site Address: 4370 tSyhro Circle
Plumber:Al.l -State P1}imhjng
ReC n0 11970
1 agree ro complr with the Villaga of Eagan Connection Charge: 4n0•00 pd 8/21/9
Ordimnus. Account Deposic
Permit Fee: /°, na? •?'/?
Surcharge:
By: Misa Cherges:
Da[e of Insp.: _ Total:
lnsp.: Date Paid:
..- I
CITY of EAGAN
BUILDING PERMIT
own.: . .....4?.'.......?....?/./? ^^'.... . .?. .._. . .....?le . :....... . . . ..
Addreu (PresenSl ..P..`.cs1.....0/...... .lA...... ..-. ..?...?..?
Buildar ......-'---...... C---':!i? ....' a...,.?.........!..'..?...? ..................................
.......................d?'?Y.! .?i .???`!/?: ?..
Address ...t.??.?.J?...t??../.....
DESCAIPTION
1'?
. :.
N2 3376
3795 Pilo! Knob Road
Eagan, Minaesata 55122
454•6100
Dals?''.:..2 /?,I..?.r.. ....'_.......
Siosies To Be Used For Froni Depih Haigh! Esl. Cos! Pezmi! oe Remselu
//?COr ??
TION /`o / 1 '
13 1 114
This permit does n6t au2horize the use of stxeets, roads, alleps or sidewalksaor does it give the owner os Lie agea!
!he righi !o ereate any siluafion which is a nuisanee or whiah presenta a hazard I !o the health, eafelq, eonvenSeace aad
general welfare !o anqone in the communily.
THIS PEAMIT MUST BE Fy??T ON TH PAEMISE WAILE THE WORK IS IN PAOQAE$r4
This is !o eerlitp, !hal.tL[.c}.?L:?- .r.!w? ................. ....hm permission !o ereet a....?Ff ....... .. ... ...................... _npon
the above describp? premise subjecY io-2he provisions of all appliaable O' aneeyfor. aC,-, a.-:
....---?...e?...._
? . ........... ....................
Ma or BufldinQ Impecto:
_., .-:
w- f7,
CITY OF E.1GAN 3795 Pilot Knob Road
Eagan, Nlinnesota 55122
FERNIIT NO.: 590
The City of Eagan hereby grants to RaY H• welter Heating & A/C Co.
o f 4637 Chicago F,ve. 80. , lSpls. 55407
a HIsATING Permit for: (Owner) t4areil Inc., & Peternon Bros.
1370_E. Sigfrid
at 4370?id bro Circle , pursuant to application d2ted ` 10/16/74
Fee Paid: _ $40.00 ? dated this 23 day of Oct. ? 19 74.
1.00 9/C
Bui'lding I:ispertor
N`aehaaical Permits:
Eid T:^tal:
. . . .?...T
-AP, .
eo Z, °y
CIZY OF E.SC.'?N
3795 r-iiot Knob Poaa
Eagsr., Diinnesota 55122
PERMS^1 NO.: 5
The City of Eagan hereby g.:^ants to g??efa..e ni.„„v.j„¢
of
a PLUt9RING Permit for: (Owner) F. Pederson
at 4370 rivbro Circlo , pursuant to application dated 10/15/74
FFe Paid: S20.00 dated this 15tk-day of Oct• , 19 74
.SQ s/c
iMechanical Permits:
Building Inspector
Bia Tota.l:
zoos RESIDENTIAL PLUMBING PeRnniraPPUCa-noN
CITY OF EAGAN
.3830 PILOT_KNOB ROAD, EAGAN MN 55122. .
651-675-5675
Please complete for modifications to existing residential dwellings.
Date / ?)7,
Site Street Address ?S C7 Unit#
PropertyOwner fi'h6 I UL(r r) GCT oU f"() UGII s Telephone# ((>Sj
i pewor s
??
Contractor Telephone# ( 61) 3?i7` 134 0
Address o Qa Clty State Zip
agon,
The Applicant is: _ Owner 4 Contractor _ Other
Refurbished Submit 2 sets of plans and MPC license
Septic System
New Includes County fee
_
_ $ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. H you are installing onlv a
h
not
te thi
the
t
d
l
ti
t water softener ?c?lnr:?vater-
clieck the
next s ?d'-
'
ea
er,
o
comp
e
s sec
on; move
o : .
appliance(s) you are installing. (
I
U
'
n
t
1pN 15 ZU" '
U U
_Septic System Abandonment .
_Water Tumaround (add $130.00 if a 5/8" meter is required)
Other:
L?-_1Nater Softener ? _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RP2 _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
ToWI $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance wi the approved plan in the event a plan is required to b re 'ewed and approved.
' 0?v' I
ApplicanYs P inted Name Applican's Signature
RESIDENTIAL 4
BUILDING PERMIT APPLICATION
? CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122 ?
651-681-4675
New Construdion Reauiraments RemodellReoair Reaulrements
• 3 registered sile surveys showing sq. R. of lot, sq, ft. of house; and all roofed areas • 2 copies of plan
(20%maximumlolcoverageallowed) • isetofEnergyCalculalionsforheatedaddftions
. 2 copies of plan showing beam 8 window saes; poured found desgn, etc.) • 1 site survey for exterior addiGons & decks
. 1 set of Energy Calculations • Indicate if home served by septic system for additbns
• 3 copies of Tree Preservation Plan R bt pladed after 711193
• Rim Joisl Detail Oplions selection sheet (bldgs wilh 3 or less unHs) ,
DATE VALUATION lOJ ? I? ?
fl pN?? ??ti
SITE ADDRESS MULTI-FAMILY BLDG _ Y _ N
TYPE OF
APPLICANT
STREET ADDRESS
TELEPHONE #
. Renewal By Andersen, Inc.
' 1920 County Rd. "C" West
i Roseville, MN 55113
651-264-4777
` License # 20130983
? - -- - - --- - p,?--. f -pp
PROPERTYOWNER ? ?OlLfO IC)?? TELEPHONE#(f/?I' 1fd0
Energy Code Category
(J submission rype)
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
-?dINNESO'1'A RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
• Residenlial Ventilatlon Category 1 Worksheet Submitted
• Energy Envelope Calculalions Submitted
Plumbing Contractor: ____
Plumbiiig systecn includes:
Mechanical Contractor:
Mcclianical systcin includes:
Sewer/Water Contractor:
Air Conditioning
_ Heat Recovery Systcin
Phone #
Phone #
Fee: $90.00
Fee: $70.00
I hereby acknowledge that I have read this application, state that the' fbrmation i orrect, and agree to comply
with ail applicable State of Minnesota Statutes and City of Eagan Or f(ances. ?
Signature of Applicant o
OFFICE USE ONLY
Phone #
_ Wafer Softencr
Water Heater
N0. of 13aths
FIREPLACE(S) _ 0 _ 1 _ 2
i STATE ZIP
1 PAX #
?
. New Energy Code Worksheet Submitted
_ Lawn Sprinkler
No. of R.I. Badis
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4I02
• ? ? OFFICE USE ONLY „
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ?
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ??
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ?
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ?
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundatlon) ? 45
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof • O 46
11
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning ' City Wate"r
SAC Units Stories Booster Pump
u
Nbr. of Units Sq. Ft. PRV 11
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width I
30 Accessory Bldg
31 Ext. Alt - Multi
33 Ext. Ait - SF
36 Multi
Siding
Fire Repair
Windows/Doors
REQUIRED INSPECTIQNS•
_ Footings (new bldg) Final/C.O. , _ Footings (deck) FinaUNo C.O.
_ Footings (addition) Plumbing
_ Foundarion HVAC ?
_ Drain Tile - pt}1e1 "
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding Stucco Stone'' -
_ Fireplace _ R.I. _ Au Test _ Final Windows (new/replacement)
_ Insulation _ Rehining Wall
p
_ Approved By ,
------------------------------------- ------------------------------------------------- - ----------------------?
Base Fee
Surcharge ?
Plan Review
MC/ES SAC '
City SAC
Water Supply & Storage a
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search "
Copies „
Other
Total "
Building Inspector
?.•. •••..•1.. ,u, u.oo cm 194 011 viCD ltUAf1TAL t3YQlYU1S1tb18Y
re aZ
?? .
June'7, Wo,
3s 6 ? Pit?ob xosd .
Eagen, A2N 55122 To Whom k May Conoarn:
Eld
er 7ones is authonized to priii bniidng pftmits Por Renewal by Mdeisen. Plesse stUow
Oder
date (x nes to pmvide this ses'vitco forus in Bagan. 'thia euthari2etian is vatid foT sny
Yottd 6/6/0 1; watii a R?newal by Andcrsen mattaM a VmlY revakes it in wiidnF
to the City-
I rcqucst this authori.zation be accepted•sxpedidoualy, av w not delay in rhe ?
Processiout baiiding Pcavxs uny fnxthez. Plcaac caII mc if thcm acc my quoacione. I?B ?f
contacaai at 763-502-4706. . , ,
? < ,. .
Your icnmqdiatG attentiott Lo ihis mattcr i,y
aSinocaeiy,
d R Rau
tistaon Manager
Renawftl by Ancic4scn Conporatiun
('r.: KRrn-F.ltiex 7nnea
?h NW-AVY
wuut,
Received Time Jun. 1. 1:OIPM
CITY USE ONLY
LOT BL ? PERM[TN:
SUBD. RECEIPT k:
RECEIPT DATE:
k06 14 3 ('?
2000 MECHANICAL PERMIT (fiESIDENTIAL)
crrY oF s,asaiv
S$SO PILOT KNOB iiD
f.AfiRN MA 55128
Date: C) ? 651-s8t-4675
Complete this secrion only if you are installing HVAC in a single-family dwelling, townhome or condo uuder
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.)
$ 30.00
6.00
State Surchazge .50
Total ?
Complete this section onlv if you are remodelina, adding to, or realacinQ an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
_ New Y Replacement _ Other
? Fumace
_ Air exchanger
Air conditioning
Other
Fee
State Surcharge
Total
Reminder: Call for final inspection.
SITE ADDRESS: 'I 3_? U N\I 'JrC1 r`
_? - --? ? - .
OWNERNAME: ? (lZ S?LkcOJ PHONE#:
INSTALLER NAME: CVP?b PHONE #:
STREET ADDRESS: , ?• G • ,JC1)C
CITY:
-?'O ?,L v( O l,? .'-'U 1_? G v,(l- t S
$ 30.00
.50
$ 30.50
hnY--? 55l23
1051 - L0 g-'(?o4--'
,REA CODE)
,?95 t - y2 3-892(a
L _ BL
SUBO.
APPROVED BY:
INSPECTOR
PERMIT #: _
RECEIPT#:
RECEIPT DATE:
8000 MECH"ICRL PERMIT (CO1NM£1ZCIihL)
CITY OF E46ue41V
3$30 P[LOT KNOB ftD
£,+4fiAN, biN 55122
651-661-4675
Please complete for: all commercial/indusVial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New consuucrion Install U.G. Tank
_ Inrerior Improvement _ Remove U.G. Tank
_ Processed Piping '
lYhen installing/remaving underground tank, call 651-681-4675 for inspection by fire marshal and
plumbing inspectar.
Description of work:
Fees: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaVinstallarion = minimum fee
Contract price: $ x 1% _$ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE) TENANT NAME (IMPROVEMENTS ONLl):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER: ?
ADDRESS:
CIT'Y:
arr use oNLv
PHONE #: -
(AREw CODE)
STATE:
SIGNATURE OF PERMITTEE
` 00???
2000 FIREPLACE PERMIT APPUCATION
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55]22
CRIZbq°I 651681-4675
Dace: l 1
Description of Wor c Construct aew fireplace _Gas _Mesonry _ Alterations to existing
Install gas insert on[v _ Inscall Ras line onlv
Other
Job address: O ltrd a/ t- C /to,
Lot: Block: -2D Subdivision/P.I.D. #: ? i ? G1 ?Y'Y1 P SS L. n G?
Applicant (circle one only): Owner C tractor Permit Fee: 860.50
l U- ?(C E ) IrS Phone #: 657-1?Aa
-?.J
Name: / ( ) Lt Y' (Z(A
PROPERTY Last First
OWNER StreetAddress: y ?0 /V c ? ,iJr r) d(1^cl f .
City EU Q 2 0 State: !'?V" Zip:
Company: 1'F?'PSIrVC, CCJl?HP!'/!7`??/??PI^-OS?j'P Phone#: O2 Q ?
-?? (area code)
FIREPLACE
INSTALLER StreCtAddress:
ciry U ?% S.s`33
hN . S v r l? C sace: IVN , zip:
Company: Phone #:
GAS LAT$
INSTALLER Strcet Address: C ? /"/ /?
? ?
City
(area code)
State:
Zip:
I hereby acknowledge that I have read tlris application and state that the information is correct and agree to
comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 16 Fireplace
WORK TYPE
E3 31 New
? 32 Addition
0 33 Alterations
O 34 Repair
? 39 Cras L'me D 41 Wood Stove
? 40 Gas Insert
Census Code
SAC Code
REMARKS
434
01
Chimney/flue must be inspected before concealing.
.
?
\
0
M
?
1.117?3 7?1
p? L U f'/yL r/.?'?i
--???-
1
r
i
_-_-_-?
\?..
?
s
?
?
1
/
MASTER CARD
Al
?0e ••
Permit
No.
Issued Issued To
ContractOr Owner
BUILDING
PLUMBING 19 y_2 !.'7
?
1
CESSPOOL - SEPTIC TqNK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
i
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION
FRAMING
fs--?1 CESSPOOL
TILE FIELD FT.
FINAI
ELECTRICAL i
HEATING
GAS INSTALLATION ?
?nr.-??• ??
?
?? ??• 'Jj DEPTH
OF WELL
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING p ,
WELL `
SANITARY SEWER
Violarions Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS .
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SU85TITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
? NON{OMPLIANCE. BUIIDER DOES NOT
WTEND TO COMPLY.
COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION -1 certify that I have carefully inspected the above in which I have no interes[ present or prospective, and that I have repotted herein
all significant conditions oLserved to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific raquire-
ments for off-site improvements relating to the property inspected.
D ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
ò
ÿ
ý
ÿ þýþý
üÿÿ ñðï
ùñþå ä
æåïï å
ï
ù
ÿþýüûú ÿà þ üûú
ù üûú ÿ
ú ø þêÝ
àþà åïå ðþúû
Ü
ÿÛþì
ùä á óó ò ò áã ò ëííý ä þý á è ú
þòãòþòá íàó óú ó í
àý ò ã Ûþýûö óòûä òí
ìçï
çææí
æ
íå
æ
øü
ÿþä îþ çï
çí
â
íâ
îþ ï
í
÷õ
ù ôó
úú
ü þ þ þ þ
åï
÷ûý à
õ÷ï
äýû ö ä
äá äúú ä äó ò òúûö äúúýÿ
óõ ÿ þ à û óðí
úú éò ÿ þ
þû ÿ þ
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /10 -1 l 0
/{
Permit Fee: t ?
Date Received: cam( 5 " 13
Staff
2013 RESIDENTIALfBUILDING PERMIT APPLICATION
/ 3 Site Address: L/ 3 ` 0 r v Y IOW Gi `C
Unit #:
Name: F0+ r S an) l-ey 'MOM, , 01-°4;one: 6s-/-.2 60-'77.'27
Address / City / Zip: i/370 /01 brO C71 rc'e. EoV ai t M 55 ! 23
Applicant is: Owner Contractor
Description of work ei fe,0 0.;4-'e'ANUAF - � 104 C ec)
Multi -Family Building: (Yes
ConstructionCosto 000
deck
_/NoX )
Company: be z J LLC Contact: C -k .S 3,54- &(O
Address: 73?S l 30A S # LJ City: Apple_ Va 1
State: r r 1) Zip: 5-S-62 y Phone: 657-36C /7 27
License #: .5C-6 3C,051
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 5. - 19 )y
f C4ovai-;Ddoes ,ioi d -orb aOS1 j- ?` w‘i-ramor
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:
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 130 -c -c) 0 ctfQ
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
SUB TYPES
Foundation _ Fireplace
Garage
1"" Deck
Lower Level
Single Family
Multi
01 of _ Plex
Accessory Building
DO NOT WRITE BELOW THIS LINE H.,37 0 I' jhro C; (dL_ / °q// 0
Porch (3 -Season)
T Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
WORK TYPES
_ New _ Interior Improvement
Addition____ Move Building
Alteration _ Fire Repair
Replace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%\( )
Census Code
# of Units
# of Buildings
Type of Construction
1
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
-(Z
_ Siding
Reroof
Windows
_ Egress Window
_ 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
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
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 FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
03 7
4 74/4i 4141"
1
ci !
\t- / Lk5,2;W*
/•-)' .7;e,\4-. "v4v- `-
7Ve'C-
1
32/ ----r-s---1-M V
4'7
9
AIX lorc>crJ
Cr\
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA115262
Date Issued: 09/24/2013
Permit Category: ePermit
Site Address: 4370 Nybro Cir
Lot: 014 Block: 003 Addition: Wilderness Run 4th
PID: 10-84353-03-140
Use:
Description:
Sub Type: Reroof
Work Type: Replace
Description:
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
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.
Ryan Davis
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
R Davis Construction Inc
710 N 4th St #306
Minneapolis MN 55401
(612) 259-5363
- Applicant -
Owner:
Leslie A Touroutoutoudis
4370 Nybro Cir
Eagan MN 55123
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA116087
Date Issued: 10/02/2013
Permit Category: ePermit
Site Address: 4370 Nybro Cir
Lot: 014 Block: 003 Addition: Wilderness Run 4th
PID: 10-84353-03-140
Use:
Description:
Sub Type: Windows/Doors
Work Type: Replace
Description: Two or More Windows/Doors
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 4,000.00
BL - Base Fee $4K
$103.25
Surcharge - Based on Valuation $4K $2.00
0801.4085
9001.2195
Total: $105.25
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
- Applicant -
Owner:
Leslie A Touroutoutoudis
4370 Nybro Cir
Eagan MN 55123
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA133438
Date Issued: 10/13/2015
Permit Category: ePermit
Site Address: 4370 Nybro Cir
Lot: 014 Block: 003 Addition: Wilderness Run 4th
PID: 10-84353-03-140
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Softener
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 (WS &/or WH) $59.00
Surcharge -Fixed $1.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
- Applicant -
Owner:
Leslie A Touroutoutoudis
4370 Nybro Cir
Eagan MN 55123
(651) 260-9929
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.
Applicant/Permitee: Signature
Issued By: Signature
City otEapil
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
. p i 212016
Use BLUE or BLACK Ink
For Office Use
Permit#:
Permit Fee: /7 �‘7. ,a
Date Received:
Staff:
L
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:1/ 7Cf/4 Site Address: 41g76/ k1/2 Ojgde Unit#:
Resident/
Owner
Name: fe;has'"r 1 1 1(Z1c' Ud`9 Phone:
Address / City / Zip: 4'%® /Yr1/infl ✓ / /z(k r loli 54/
r
Applicant is: Owner be Contractor
Type Of Work
Description of work: 1i(l5/J',J/ /012 cq%� (it° //W
Construction g9�6.$9.2. Multi -Family Building: (Yes / No Q( )
Contractor
"Cost:
Company: i%/ R'!N/Jk 5 //)7 5 ,771/ r _ contact:: /?®/ir JR/(/1214
Address: 3/ c 2 iri1`.'[� �2�' /c2/ City: /il1T)i 0 MI/ s zo
7590
State: OW Zip: s,/ / ,a_ l Phone: a�� �mail:/#11/4-19Y0 g2e/Id�'/yfg. 6:176,
License #: 8 C- 1 ysf /� / u � l— Lead Certificate #:
GWS
If the project is exempt from lead certification,�please explain why:
/VD >IF 790Vg/ c9 -1P g/71, r7 -_ e,--'‘
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer & Water Contractor
Fire Suppression Contractor.
Phone:
Phone:
Phone:
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 they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. CaII 48 hours
before you intend to dig to receive locates of underground utilities. www.ciooherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building C
days
of permit issuance.
X XgAi ` T x L�IJ!/VOL
Applicant's Panted Name plicant's S gna re
must be completed within 180
Page 1 err:-
11 7C) )1)0
2 ---
DO NOT WRITE BELOW THIS LINE )
SUB TYPES
Foundation_ Fireplace Porch (3 -Season) Exterior Alteration (Single Family)
—
Single Family_ Garage — Porch (4 -Season) _ Exterior Alteration (Multi)
Multi `'x Deck_ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
r, 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 [.,y'' Occupancy
Plan Review Code Edition
(25%_ 100% ?) Zoning
Census Code Stories
# of Units Square Feet
# of Buildings Length
Type of Construction Width
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
)( Footings (Deck) Final / C.O. Required
/ Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Roof: _Ice & Water _Final Pool: _Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings _ Backfill _ Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In _Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Building Inspector
001
feY1/(._ 3,Is'a
Page 2 of 3
AMP
ntib/20 aiR-
c3c3
D Lci
W6/4/ 672--&
4-4/—
„(Ner
c bc Vioa Se—
ck 5 ,po
•7`c°'
cc h-
ji
Si -re c4.-
lococ rc