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4373 Nybro CirNUMERICAL FILE CITY OF EAGAN 3795 PILOT KiVOB ROAD EAGAN, MINNESOTA 55122 GASH RECEIPT DATE 19 kECEIVED FROM AMOUN7 $ I & DOlLARS ,oo ? CASH ? CHECK FOR ??0457S Receipt " MECHANICAL PERMIT Permit No. CITY OF EAGAN - Fee fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation st 3. Job Address q34'73 Lot -7 Blk. ? Tract -? 4. Owner 5, Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter 0 Repair ? 10. Describe Fuel Type 11. No. Equioment BTU - M. Ea. Forced Air No. Equipment CFM Ai H ndli : Mfg, r a ng Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : - for Rough F? ?I ? Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 CITY OF EAGAN 3795 Pilo+ Knob Road Eagan, Minneaota 55122 Phone: 454-8100 WATE:R SOFTF'D?^R _ pERMIT Date: -, .:.. , . , 4373 Nyrhro Circle Site Address: Lot Block Sub/Sec. Name Jeffrey Iles o Circlf? 49 ' Address s73 NybrS '<'.?tdll City _ Phone: a12igan ? Nome lbert Co. - o g Address 1001. N3ri.e St. e City S:, Phone: This Permit is issued on the express condition thot all work shall be Minnesoto Statutes and City of Eagan Ordinunces. No. - Receipt No.: 06$48 5ingle I Residentiol Muiti Res., Comm./Ind. I New/Alter./Repair Cost of installation Permit Fee ? • ?0 Surcharge Total done in accordance with oll applicoble Stote of Building Official IN5PECTION RECORD CITY OF EAGAN PERMIT TYPE: 101" « 3830 Pilot Knob Road Permit Number: i i!a i? 1 Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPUCANT: 43 7 3 Mw Sh o (, r. i ti rI nFN?r?.•; F+liN ntH PERMIT SUBTYPE: f INAI ftt MF1.IA1 OY ANCiF: R:3rN TYPE OF WORK: &? -1 Permit No. Pertnk Holder Date Te{ephone # ELECTRIC PLUMBING HVAC Inspecdon Date Insp. Commenta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST i INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PIBG FINAL HTG ORSAT TEST 9LDG FINAL 85A4T R.I. BSMT FINAL DECK FTG DECK F1NAL I 63?? ? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: t!it [ 1_I1 T NO ,,,?? ?? 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: I s? /A`) Oh (612) 681-4675 SITE ADDRESS: APPLICANT: `r MNI1i {;'.t fa , ?..?????r?;??. ., Kt??a :??3? ??,?. ? ??;6f-I;?? PERMIT SUBTYPE: ? . . . . .. . . ?. . . . .. . .. .. . .. ?:: ;_ -. ?. ?. ?. ? ' ._;? ?. ? ? ? ? Pertnk No. Permit Holder Data Talephone B ELECTRIC PIUMBING HVAC InspecUon Dets Insp. Commenffi FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPUICE AIR TEST FINAL PLBG FiNAI HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfCi DECK FINAL CITY OF EAGAN Remarks Wilderness Run 4th Addition . 7 3 10 84353 070 03 MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, STREET RESTOR. GRADING XGA SAN SEW TRUNK 1973 163. 26 8. 16 20 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA / STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. y? SAC S pO lyor7sr PAR K CITY of EAGAN Ni° 4141 Ownex ....... SVENP. PETERSEN ........................................... Address (Presenl) .................................. BUILDING PERMIT Suildes S...... PETERSEN CONSTRIICTIOPd 4701 W. 110th St., Mpls. 55437 884-5144 Addrec? .............................................................................................. DESCRIPTION 3795 Pilo! Knob Road Eagan, MinnesoYa 55122 454•B100 / Dete ...........1.. 1......... 16/7 ..... 6 ..................... Storiec To Be Usod For Fronf Deplh Heigh! Eel. Coc! Parmit Fea - mar? - _ c/F n...i a?. c'ar -- 58' 46' 45 000 l ? 128.00 22. 50 s LOCATION ? N 4373 WR 4th This permit does nof aulhorise the use of slreets, roade, alleys or sidewalks nor does it gire the owner or his ageni the righ! !o creafe any silvaiion which is a nuisance or whieh presenM a hasard !o the healfh, safelp, coavenienp and general welfare 2o aapone in the eommuniip. THIS PEAMIT bIUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESB. This is !o cerritp. Ihaf-.'-..... o?].SG ................... hasparmiasion !o areet a.... VF T?itlq: & GaY..................... upen .... ............... the above described mise subjecY io the provisions of all applicable ' ces for f -Ciiyu f Eagan. ............ `?Y,....... -°. ----- -?-----------------° ---------------- Per ..._- --- -.... -- --- . ?T/`i :?J._._..-- •°--•--........... ? ayor Bttdinq Iaspeefos II II I?I ? I I I III III???l IIIII1 gp?Uo State Board REof Ee2 ASt.IPauIP, MN C-n 5104? * 0 2 5 9 9 1 8 L * rnone (stz) sa2-oeoo //??f4 60 61 Home Duplez Apt. Bldg. Olher: New Addn Commercial Industrial Farm Remod Re air Air Cond. H}g. Equip. Water Hfc Load Mgmt. Ofher. D er Ran e Elec. Heat Tem . Service "X" above the work covered by ihis requesi. Enter remarks in ihis spoce and on the back of the wfiife copy only. Gs3 F Cakulafe Inspecfion Fee - This Inspection Requesf will nof be accepted withouf fhe mrred fee.. Olher Fee ,F Service EMronce Size Fee # Cirails/Feedels Fce Mo6ile Home Pork Stall 0 to 200 Amps 0 fo 100 Amps $free} l}g./Traific $ig. Above 200 A 00 Amps Tmnsformer/Generafor INSPECTOR'SUSE v g?' TOTAL„ ? $ign/Oufline L}g. Xfmr, Alorm/Remote Confrol Swimming Paol - I henb mfi Ihot I ins ecb Ihe elecincal inaMllation dmcribed herein on IM1e daroe sloxd Irrigdfion Boom Rough-In D.k $pecial Inspection Investigafive Fee F?oal Doro /- THIS INSTALLATION 19 AY BE ORDE D IF NOT COMPLETED WITHIN 78 MONTHS. 2 5 9- 918 1? O?j? US ONLY This reqoest void 18 monihs from volidalion dale printel in Mis 60? / ? s? , y y, ? PLEASE PRINT OR TYPE Reqoest Dox / / - 77 ? cnon OlherThon Rm9h-In: dy Now 0 Will Call Roogh.in inspeciion requfrcdE ? Yw ? rD R d ? t,. ?You mosl mll the inzpeclur when ea y : ready? le I, licensed con}racfor ? owner hereby request inspecfion oI }he above electrical work at: Job Addmm . (Streef, 8ox, ar Roub No.1 ' 7 C???P Ciy ? ZiP C?de Section No. Township Name No. Ranga No. Firc No. Coanry p?nl 6 PFwne No- Power Soppiier - Pddrese Eledrical im r(CompanY Nome) ? Conlmnor licanse Na. " Masler Lic. N. (Planl Elen.Only) -?e..__ ? Ca?G?j J hbiling PAd?ess ?Conhatlor or O,ma Py miing Insmllation? ? G? ST /47 ?i , l? G « ?briied-L' na Ee ?.m.??rmi xmllafian) P*ho7ne No? ?? EB-00001A10 6/95 STAiEBOARDCOVY-SEEINSTRUCTIONSONBACKOFYELLOWCOW 2004 RESIDENTIAL BUII.DING PERMTT APPLICATION City Of Eagan •?r'(p ?? 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New CoreWCllon Reaui2menLa RemodeUReoair Reauiremeng 3 registered sife surveys showing sq. ft of bt sq.8 of house; and all roofed areas 2 wples of plan (20% mazimum lot mverage allowed) 7 set ot Energy Calculatlons for heated addifiorts 2 cnpies of plan shovring bmm 6 window sizes; poured found design, etc. 1 sde survey for additlom & decks 1 set of Energy Cakula0ons Addition - indfcate if on-sife septic system 3 copies of Tiee Presarvatlon PWn R bt platted after 711193 Rim Joist Detail Optlwis selection sheet (bldgs vrith 3 or less unilg Date ?/ 2 p/ e7 Constructio¢ Cost ?-7 7D, aV Site Address y 3 7 3 /) y&M G Il?GLF UnitlSte # Description of Work aalG 0 peG/( ON 0/??CK oF protCtz- Mu1ti-Family Bldg _ Y3'N Fireplace(s) _ 0_ 1 _ 2 Property Owner De?'$ Telephone #( 6 f/ ) 6,66 -S'?03 3 Contractor PI? I ?S COtis7/lvcTlo?/ ? ?F?'/?OE`L iN6 aaaress I z 6/ ? i.?••?•?H.a,?.v ,?aE State M o? ?= . city s r "u L Zip SS?/O AC Telephone #(6s/ ) 77jr-675''2-- COMPLETE THIS AREA ONLV IF Energy Code Category -M1AIlesota Rules 7670 Cate?l _ (d submission lype) • Residential Ventilation Category 1 Worksheet Su6mitted • Energy Envelope Calculations SubmfHed Have you previously constructed a building i an with a similar planZ _ Y fee applies. ?J?S ? ??nl ? ? M !s n Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheei Submitted N If so, 25% plan review Telephone #( 20?4 II Telephone #( Telephone #( I hereby apply for a Residential Building Permit and aclnowledge that the infoxmation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pernut, but only an application for a pexmit, 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 ofplans. / . . ?t G ?.v/f cp ApplicanYs Printed Name Appl' t's Signature OFFICE USE ONLY Sub Types ' ? ? Ot Foundation ? 07 05-plex ? 13 16-plex p 20 Pool ? 30 Accessory Bldg ? 02 SF Dweiling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti ? 03 01 of _ plez ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck Q 23 Porch (screen/gazebo) ? 38 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level Q 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yar _N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration 0 37 Demolish 8uilding` ? 43 Reroof ? 46 Windows/Doors O 34 Replacement `Demolition (Endre Bidg) - Give PCA handout to applicant Valuation L?qd? Occupancy MCES System Census Code y 3 y Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const VA,? Width REQUYRED INSPECTIONS Footings(new bldg) FinaVC.O. Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test -Final _ Insulation ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool Ftgs _ AidGas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total /)/?/? ;-ec c.) d ?jv ? ? ?5 J : old Car].soia 55 Wilderneg,- Flun Road ? ,a?;3n, iti?iRn. ? . ? I i ? DELMAR H. SCHWANZ - LANDSCPVFYOP Pey.ste'eC uoer Laws nf Tne S:e:e ot Mmoesota 14515 SOUTH ROBERT TRAII P.O. BO% M ROSEMOUNT, MINNESOTA 55068 SURVEYOR'S EERTIFICATE $C?il{?: : i11r',.h H:iu:i.j8 ..,. f,P.eT. G (:F.ttl)t:+'.i LT^11 . ?P.;7ti. r17 ti0 0 2 ? t J. 411( PNONE 812 1423•1769 ??. 1 ?4 t i ?. . \ LO T 7 ? L'rafnage ana utilltv -? ea8rnae;;* \ / i0 `O v ? \ t O ? IV ? ro ' S 9PO ?7 'y '?co up?, 35 3o 8 • f 30 ? I t;erebv c=rLify r:?lr3*_ ?[;in is t: true ancl er.,rrect r?presentation ef a survey or tiae botind:,ries I'?Jt •', Ll.OC4( 3CCOPf11t1P LO tClt. :{_'CoP(a@Ci p_i3t ?.;.FT'f3pf`? DS}tLl,?z (;OLS7ti:?j'i V,it1qeSCte'i. .. It a? so Showa t}le lnr3t.lon o'•` a pz'c?t?,-,srad Guildirig. Aa surveyed by me tYl{.9 Ilfn [13.;J i)n fii'1F.:_Ll.St, + n !\ MINNE;OTA RE(ilSTRATiON NO 625 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EACAN MN 55722 651-681-4675 New ConslrucGon Reauirementa • 3 registereG site surveys stwwing sq. ft. of tot, sq. ft. of house; and all mofed areas (20%maximum Ipt wverage albwed) • 2 copies of plan showiig beam 8 window sizes; poured found desgn, elc.) . t set of Eneigy Calcula[qns • 3 copies of Tree preservation Plan if lol platted aker 717/93 • Rim Jaist De1ad OOtions selection sheet (bldgs with 3 or less mifs) DATE 16 ?5.2?1?' •Oc?. RemodellRewir Reauirements • 2 copies of plan • 1 set of Eneryy Calculations br heated aaditions . 1 site survey !orextenor additions 8 decks . Intliwte if hame served hy septic system for additions VALUATION oZ,SCOSC?P SITE ADDRESS 431-?> ??7! O C-kirGVe... MULTI-FAMILY BLDG _ Y}? N TYPE OF WO APPLICANT STREET ADDRESS TELEPHONE # RENEWAL BY ANDERSEN, 1NC. l 1920 COUNTY ROAD "C" WEST i ROSEVILLE, MN 55113 CELL Pf STATE _ ZI P PROPERTYOWNER? YOa,ilC.. iELEPHONE#IQSI•(0'*•5033 ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ y[INNI:SOT.1 RCLES 7670 CA.TEGORY I -MIN\'ESOT:1 RliL1'S 7672 (+1 suhmission type) • Residential Ventilatlon Ca[egory 1 Worksheet Submitted • New Energy Code Workshee[ Suhmi[ted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # ___ _ _ Plumbing system includes: _ Water Softener _ Iatni Sprinkler Fee: $90.00 Water Hea[er No. of R.I. Baths -- No. of Baths Mechanical Confractor: Phone # Mcchanical sys-[em inclu(tes: .-1ir Conditioning Pee: 570.00 Hcat Rccovei}' Syslcm (??? Sewer/Water Contractor. Phone # n i ?. SEP 1 3 2002 i C?---- , ------ --- --- -----------;?? --- ----- -------------------------------------------------------------------------------- - I hereby acknowledge that I have read this application, state that the informotion is Qorrect, and agree to cornply -- - --_-_ ' with all applicable State of Minnesota Statutes pnd City o( Eagan XZZ?? Signature ot Appllcan} ?- NLY OFFICE USE O IREPLACE(S) _ 0 _ 1 _ 2 Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 1102 ,_.. `OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool i ? 30 Accessory 81dg ? 02 SF Dwelling p 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex 0 17 Garege 11 ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02•plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 72 12-plex Plbg_Y or _ N ? 25 Miscellaneous . ' ? 31 New ? 35 Int Improvement ? 38 Demolish (interior) ;i ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) I? 45 Fire Repair ? 33 Alteration ?' 37 Demolish (Bldg)' ? 43 Reroof I? 46' Windows/Doors' ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant Valuatian Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered ' Type of Const Width I - REQUIRED IN SPECTIONS .. ?? , _ Footings (new bldg) FinaUC.O. ; _ Footings (deck) FinaVNo C.O. _ Footings (addition) _ _ Plutnbing , _ Foundadon HVAC _ Drain Tile Other Roof Ice & Warer F inal Pool Ftgs Air/Gas Tests Finai _ Fraanng Siding Stucco Stone'l _ _ Fireplace _ R.I. _ Air Test _ _ Fina] _ Windows (new/replacement) ? _ Insulation _ Retaining Wall ----------- ----------------- --- --------- ---- Approved By !li , - Building Inspectof Base Fee --- --------------- ------------ -------- ------------------- ---------- - ------- ---- --------------- Surcharge Plan Review ; MC/ES SAC a i City SAC W ater Suppiy 8 Storage ' S&W Permit 8 Surcharge Treatment P4ant Plumbing Permit Mechanical Permit License Search Copies Other " Total ?i i . ` Date: dl/ - 0l/97l _ BUILDYP?G PER^2ST APPLICATION ? LOT 7 B:ACK -'? ADDI.ION //°/i L/??(?/1/c S i"v?L' PAR(;rL & S£CTIOP7 ANPIIISR IE tJLSPLATTED ADDRF.S3 OF EuTIC4ATGD COST x 4/ AO ocr.?? Si?C??n ?? T,? s c- ,? TEr.EPHONE rao. AJDRESS CODITRACTOR S rlt?l CV /1/1 'C7- TELEPHONE P10. j 5?'Y V ADDxass LZ 7 G) / GG' "L S. 37 ., Notes Inclede site plan, building plans, and energy application th this OPFICE USE vALUATIOi1 SAC 47ATER COIdNECTIOIS WATRR METER BUSLDING PER1,1IT FEE SURCHARGE FEE PLA1`J CEECK FEE PARK DEDICATION FEE t ? ? fa?? 22? OTHER TOTAL* APPPOVIlLS: ASSESSI4ENT CLERK BUILDING DEPT. POLICE DEPT. TilATER & SL'Y7DR DEP'i. FIItfi DEnT, P21RK DEPT. . _ IL AttA-n : A"rnold Carlaon `( l 1255 4111dernesE Run Road Eagan, Minn. I. _ DEIMAR H. SCHWANZ - LANO StJRVFYOR Ae9isteretl Under Lnwi of Tne State ol MinneSOla 10575 SOUTH RaBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55088 PMONE 812 W23-1788 SURVEYOR'SCERTIFICATE ? . ' Sc31e: ] inrh eyuale 30 feet o denotes Lron mon. rO . ? ? Cl \ S <ti? . `? ` ? ,\ S3o3/ • ? L O T 'T °? ? Drainage and utility 2 easement ° 0 /10 (0 30 ,\ JN ? « a l q o 0 ? Qry - i ? , • z2o'" ? / I ?4 92 to? o `? ? , 10 4- ! g 7ju ti >?oo 1 r O1 2e .f _ . 35.30 /y ? 8 ? / 1 30 ? Z hereb,y certify tnat L'nls is a true and correct representatlon et a survey o, the Doundaries oP: LoC 7, , f3).ock 3, W1IS)FRN1-:SS RUN FQIiF',TH ADDITLON, according to the recorded p73t themoP, Dakata Countq, Minnesota. It also showa the lncatlon of a propused building. Aa surveyed by me thia 12tn day of AuFust, 1QlF?. i ? ?• MINNESUTA HEliJ))STRATION N MASTER CARD LOCATION 4373 NYBRO CIRCLE L7 Blk 3 WR4th OWNER S. PETERSEDI CONSTR[7CTION STRUC7URE AND LAND USED AS S/F Dwelling & Garage Permit No. Issued Issued To Coniractor Owner BUaDING 4141 11/16/76 i S. Petersen c_ronst. PLUMBING ?76 L/ a??l??> CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING El SANITARY SEWER OTHER OTHER I r, Items Approved (Initial) Date Remarks Distance From Well rOOTING SEPTIC FOUNDATION CESSPOOI FRAMING FINAL ELECTRICAL TILE FIELD FT. HEATiNG DEPTH OF WELL GAS INSTALIATION SEPTIC TANK CESSPOOL DRAINFIELD ? PLUMBING ,?•? WELL SANITARY SEWER Violations Noted on Batk COMMENTS: COMPLIANCE INSPECTION ftEPORTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON•COMPLIANCE OBSERVED. ? ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. AND DESCRIBED AS FOLLOWS: NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED REVEALED DATE OF REINSPECTION CERTI FICATION - I certify that I have carefully inspected the abwe in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-sita impravements relating to the property inspected. F] ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR OATE c.r.rv oF EAGnN cnssFcI!:E<: s rr::RMzNK r!O. 709 z:,#k i: o:-3i0'.-M98 TINi["r, 13353:31 ?W.. M4M.r-..u F_i_.nF.r.,_30nes ::;:;!:!.p 9001 4373 NYks;tO C:.T.F. Si .'r.?5 205 9001 4373 NYklfi(:1 L'IFi '.DO 'frni;a:l. 1'«.;,rei.pt An:oUM, 8::30.5; e.r..r:1f3`:o`Jt3 1141_R SLi: NAN(:`{ w?:N'MRtYF'A,(?i:iF?M??hXCAF??X?YCi 1RyC'f,:?k1,;:d+?F%??I':'4"?i h?k<?Y'KYn?l7k?k?M PERMIT CJTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 CIR SITE ADDRESS: P.I.N.: 10-84353-070-03 DESCRIPTION: k 4373 NYBRO LOT: 7 BLOCK: WILDERNES3 RUN WINDOWS x8uildxn?r,,Permit Type 'Build3:ng W?C Type ? Census Code . , w `?. fF . . . . .. :.-? 3 ? \ i . LHF f^' 4TH PERMITTYPE: euzLoiNG Permit Nu mber: 031561 Date Issued: 0 3/ 0 9/ 9 8 3 SF (MZSC.) REPAIR 434 ALT. RESIDENTIAL ? On 0 1s5 I(-tH ?"?3wP ,P { REMARKS: FEE SUMMARY: VALUATION $4,060 Base Fee $87.25 Surcharge $2.00 7ota1 Fee $89.25 CONTRACTOR: _ qpplicant - s-r. LIC.OWNER: RENEWAL BY ANDERSEN 15024777 20040630 HOFFROGGE pEAN 350 73RD AVE NE 4373 NYBRO CIRCLE FRIDLEY MN 55432 EAGAN MN 55123 (612) 502-4777 (612)686-5033 I , , I i hereby ecknowledge that Z have read tkris"applicetinn and stgte that the i.nformation is corra4C and agree to complFy with all applicable State of 1M1n. ? Statutes arrd City o#,Eaga`n. Drdi,rionees.: ? , .° '• _ s. " • ? _ .. _ . , __. APPLICANT/PEFMITEE SIGNATURE ISSUE BY: ??lTl-R?? 89"?5 ' ° 997 ILDING PERMIT APPLICATION (RESIDENTIAL) 2` CITY OF EAGAN 1 3830 PILOT KNOB RD - 55122 681 -4675 New Construction Reavirements . Remodel/Reoair Reavirements ? 3 registered sde surveys # 2 copies of plan ? 2 copias of plans (indude 6eam & window s¢es: pauretl }nd, design; etc.) ? 2 site surveys (exterior additlons & decks) ? 1 energy calwlatlons ? 7 energy calculatians far heated additions ? 3 wpies ot tree preservation plan H lot platted after 711193 required: _ Yes _ Na DATE: C)?- OGJ Q?l CONSTRUCTION COST: DESCRIPTION OF WORK: STREETADDRESS: `-1 7li"-) 1V\f M-() lAV LOT I BLOCK L SUBD./P.I.D. #: PROPERTY IVame: hF?rI(1C1C' L°a vi_ Phone#: 6E& ?"33 OWNER ?'J?j- mn , Street Add City: 'Et1 (1 Q N) State: -M kk_ coNTRacTOR Company: &yV'\nIm ,I 6'(ot1'StV1 Street Address: 3Nt • ?E Zip: ?? a "? Phone License #:aC':N Cio City: Fin(llPNl State: zip: 3a ARCHITECT! Company: 10 [a ENGINEER Name: Street Address: City: Sewer & water licer.?ed plumber (new construction only): and lot change are iequested once permit is issued. Penalty applies when address chznce I hereby acknowledge that I have read this application and state that the information i correct and agree to comply with all applicabie State of Minnesota Statutes and City of Eagan Ordinances. ? /?^ A nJ Signature of Applicant: OFFICE USE ONLY V Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No _ Not Requi ed Phone Registration #: State: Zip: OFF1CE USE ONLY BUILDING PERMtT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling a 07 4-plex ? 03 SF Addition ? 08 8-plex. ? 04 SF Porch ? 09 12-plex ,0'05 SF Misc. ? 10 = plex WORK TYPE ? 31 New 0?-33 Alterations ? 32 Addition ? 34 Repair GENERAL lNFORMATION Const. (Actual) (Aliowabie) UBC Occupancy Zoning # of 5tories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS 8AC City 5AC Water Conn. Water Meter Acct. Deposit S/W Permit 5IW Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move 0 37 Demolition 1I6 Basement Finish 17 Swim Pool 20 Public Facility 21 j Miscellaneous' _ Basement sq. ft. MC/WS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered sq. ft. PRV i _ _ sq. ft. , Booster Pump _ sq. ft. Census Code. zi 3!? ' Footprint sq. ft. SAC Code ' ? Census Bldg' ? Census Unit, Building ? Engineering Variance Valuation: $ 00C7, %SAC SAC Units , 1, _. .,.? ..._ . _..'?e. C:1:7Y Opr !:?*..",[;AN 1'l0(]: 538 47 1.? g o4.. ? r.r? Yi-I--l.)i' J?cf.l?..? ?. P[..: _?.....i=.? ..:"2f_ 32 :1.I) 900:1, 4373 P<`i'!-4r:U f;TFi t2i2 S 21?5;'.5 'Ei('YO:L 43i', i4'rIilitl f,;;7:Fi l..f:)f) 7(7'I:;!l.l. I,*I'E:C'rpi,i.j:)'I; •';n'??J?l'r1t;; f.,?3. CF;(: i, ?'_ I , ,I.. •):!;; uANi:Y -? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.T.N.: 10-84353-070-03 4373 NYBRO CIR LOT: 7 BLtlCK: 3 WSLDERNES5 RUN 4TH PERMITTYPE: BuILD2NG Permit Number: 029016 Date Issued: 10 / 0 9/ 9 6 DESCRIPTION: ,ll°% (SLIpING DOOR) BiAlding-'Permit Type SF (MZSC.) ,ui'lding M%JO,rk Type REPAIR B CCensUS Code 434 RLT. RESIOEN7IAL ? ? \ >+ it y - f ?G REf1AARKS FEE SUMMARY: Base Fee Surcharge Total Fee VALUATION $62.25 $1.,00 $63.25 $2,000 CONTRACTOR: - Applicant - sT. Lzc OWNER: RENEWAL BY ANOERSEN 14307255 2004063 HOFFROGGE DEAN 1700 BUERKLE 4373 NYBRO CIR WHITE BEAR LAKE MN 55110 EAGAN MN 55123 (612) 430-7255 (612)686-5033 Ihereby - aG#cnrr'wladge ChatT kavez read this applicatian an:d state that the infiormation is correct and agree to comply with all applicable'StaCe 'of 'hln_ Statutes ancl GiCyoP Eagan Or.direances., PERMIT _??RGl.im..9 APPLICANT/PERMITEE SIGNATURE CITY OF EAGAN ? ?? 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Constntt3ion Reauiroments RemodeUReoair Reauirements ? 3 registered site surveys ? 2 copiea of plan ? 2 copfes of plans (induda beam 8 wirtdow sizes; poured fid. design; etc.) ? 2 sRe surveys (exterior addRions & decks) ? 1 energy calcuiatiare ? 1 energy celwlaUons tor heated adddions ? 3 copies of iree pra5ervation plan H Wt plalted aRer 717/83 required: _ Yes No DATE: I bL I?J h CONSTRUCTION C05T: o? i b00 ,? DESCRIPTION OF WORK: STREET ADDRESS: 7 _D LOT q BLOCK Jg SS/a3 SUBD./P.I.D. #: (.dAR,nvip PROPERTY Name:????ro 9q y Mrst-Mrs, E)ezAA Phone#: 1?r5033 OWNER • `M°T StreetAddress: `/ - 73AlvkO (71. "Ole- ? City: 5tate: MIJ Zip: 6 -51 a 3 cornw?croR Company: 1RP n P a- )13w 44d ers P? Phone #: L13 0- 7ass StreetAddress: 1700 dkewLG,-- License# : d210yo(P30 City: WA1'f?_'Be 4,- La-k?e_ 5tate: MA) Zip: t' ARCHITECT! Company: N 16- Phone #• ENGINEER Name: Registratio n #- Street Address, City: State: Zip: Sewer 8 water licensed plumber: . Penalty applies when address change and lot change are requested once permit is issued. 1 hereby acknowledge that I have read this appiication and state that the information rrectand agree to compiy with all appliqble State of Minneso[a Statutes and Cily of Eagan Ordinances. (? ?, 1,17 Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No OCT 0 8 1996 Tree Preservation Plan Received _ Yes _ No BUILDING PERMIT TYPE 0 01 Foundation a 06 Duplex 0 02 SF Dwelling ? 07 4-plex o 03 SF Addition ? OS 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. 0 10 = plex WORK TYPE 0 31 New a 33 Alterations 0 32 Addition o 34 Repair CENERe4L !'NFQRMA't!ON Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Ptan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: OFFICE USE ONLY ? 11 Apt./Lodging ? 16 Basement Finish 0 12 Multi Repair/Rem. ? 17 5wim Pool ? 13 Garage/Accessory ? 20 Public Facility ? 14 Fireplace ? 21 Misceilaneous 0 15 Deck ? 36 Move 0 37 Demolition Basement sq. ft. Main level sq. R. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Buiiding Engineering Valuation: $ ? , MC/WS System City Water Fire Sprinkiered PRV Booster Pump ?i Census Code. SAC Code Census Bidg Census Unit 11 Variance °k SAC SAC Units L BL 2_ CITY USE ONLY SUBD. J.[21&aan.,wJ ?.? ? RECEIPT #: ez/i DATE: 1996 MECHANiCAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit _ New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: [('? 3 (7 FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.D ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) qevr-- ? State Surcharge .50 0 s- TOTAL c?x SITE ADDRESS:- OWNER NAME: PHONE #: e INSTALLER NAME: STREET ADDRESS: /G?Ej G7? CITY: 675 STATE: PHONE #: ( Gl? ) 7?`? l?? < ?? cin use oNLr L BL SUBD. RECEIPT #: DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) • CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are ngi required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: ' FEES: ?$25.00 minimum fee QC 1°/a of conVact price, whichever is greater. ? Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING ' STATE SURCHARGE , TOTAL 'I SITE ADDRESS: OWNER NAME: TELEPHONE #:I TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP: ? PHONE #: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR °' ?ZC 83 RESIDENTIAL BUII.DING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Constructlon Reauirements RemadeUFieoair Reauirements OKCe Use OnN 3 registered site survays showing sq, fL of lot sq• ft of house; and all roofed areas 2 capies of plan Cert af Survey Recd _ V_ N (20% mazimum lot covera3e albwed) t set of Energy Cakulations for heated additians Tree Pres Plan Recd _ Y_ N 2 copies of plan showing heam & window sizes; poured found design, etc. 1 site survey tor additions & decks Tree Pres Reqd _ Y_ N 7setofEnergyCalculations Addifion -indicatedoo-sifesepticsystem On-siteSaptic5yste(m _Y _N 3 capies otTree Presarvation Plan if lot platted after 111l93 i0 / Rim Joist Defail Options selection sheet (bldgs wifh 3 or less uniis " L ? Date / 9/1-71 03 Site Address `/ 3-7 3 ?7 Y,61F,9 el,?GoN 1?q a? Construction Cost 5'SW• 00 e/l? G L,?7 UnifJSte # Descrip[ion of Work 1111S7-,44G 81? (,? ?/DOGJ kJ -r oOf Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2 Property Owner P,?'B ff D FFk oGGF Telephone #((s/ ) (086 -Sa Contractor Pg /G? S CO?? ?i 0Z> t 4/.U6 Address 1.261 State mN City SI P,*tC e- Zip rsld 6 Teiephane #(CS/ ) 7l P' -? 7S Z COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate2orv I Minnesota Rules 7672 Energy Code Category . Residential VentilaUon Category 1 Worksheet • New Energy Code Worksheet (J submission type) submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/water Contractor Telephone #( Telephone #( Telephone #( sUlsu LlLS OCT 1 7 2003 I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pemut, but only an application for a permit, and work is not to start without a permif; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. G . ' PIA !c c5- ApplicanYs Printed Name Appli Ys Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garege 0 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 70 08-plex ? 18 Deck ? 23 Porch (screenlgaze6o) ? 05 03-plex O 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbp_v w_ N ? 25 Miscellaneous Work Types 0 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 MWti Misc. ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundabon) ? 45 Fire Repair ? 33 Altera6on ? 37 Demolish (Bldg)• ? 43 Reroof O 46 WindowslDoors ? 34 Replacement `Demolition (EnUre Bldg) • Giva PCA handout to applleaM Valuation Occupancy MC/ES System, Census Code Zoning City Water SAC Units Stories Booster Pump ! Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered; Type of Const Width REQUIItED INSPECTIONS _ Footings(new bldg) FinaUC.O. _ Footings(deck) FinaUNo C.O. _ Footings(addirion) _ Plumbing _ Foundation HVAC _ Drain Tile pther Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final _ Framing _ _ Siding Stucco Stone _ Fireplace _ R.I. _ Au Test _ Final _ Windows (newlreplacement) _ Insularion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total v - 2005 RESIDENTIAL BUII,DING PERNIIT APPLICATION ? City Of Eagan '?0 3830 Pilot Knob Road, Eagau MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Constnktion Reauirements RamadeVReoeir Reaulrements ORice Use Onlv 3 regisle2d sile surveys shmving sq. ft of lot, sq. R af house; and all mofed a2as 2 copies of pian CeR of Survey Recd _ Y_ N (20%maximumbtcoverageallowed) 7setofEneyyCalculationsforheatadadditions TreePresPlanReW _Y _N, 2 copies of plan siwwing beam 8 window slzes; poured founxl design, etc. 1 site survey for addifions & decks Tree Pres Required _ Y_ N 1 set of Energy Calculations AddiNon - Indicate d arsfte sepUc system Onaite Septic Systein _ Y_ N 3 copies of Tree Presenatlon Plan if lol plaried atter 7/1193 Rim Joist Detail OpGons seleGbn sheet (buadogs vriN 3 or less unlts) Date -4- /2nr ! 6S Construction Cost ? , ?qJ - - Site Address ? 3?-?o6 C' N UnitlSte # Description of Work vLLl-o/lll No',o ` U Multi-Family Bidg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner `J 1A Telephane #(tos 1) ?CJ?(S Renewal By Andersen Contractor 1920 County Rd. °C" West Address Roseville, MN 55113 c'h' State 651-264-4777 _ Telephone # ( ) LicensetJ¢20130983 +A ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted Submitted • Energy Envelope Calculetions Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved lan in the case of work which requues a review and app •oval of plans. Ll'( 0.?-e r?S dv? ? Applicant's Printed Name A plicant's Signature ! ;'' % c + OFEICE USE ONLY Sub Types O 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units # of Units # of Bldgs Type of Const _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice& Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final _ Insulation Width REQUIRED INSPECTIONS FinaUC.O. FinaVNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tesu Final _ Siding _ Stucco _ Stane _ Brick Windows _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ? 07 05-plex ? 13 16-plex ? 20 Pool ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi 0 33 ExR. Alt - SF 0 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors 'DemollUon (Entire Bldg) - Glve PCA handout W apptlcant Occupancy MCES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered ?...?:,b?•?1 iuv zc.a? rna. toA a!1 +446D KCPItfI'?4t.'ldPf3lVlllSH71SI4 xe .a?. . June '7, ?Ap7 . CaY cif aagau 3836 RiItrt Kaob Rom Eagan, Ntrr s5-122 I To Whom ItNlayConoern: &ider Jones to anthOriMd tD PUU buildiffS Pftmits farRenevral6Y Andezsem. Please alIow Provide tfiis ses"vzcc far ns in date bcyond6/6101; watila Bagea, `ihia muhorizatian is valid for any to theClty. ?'ouawa! bY Antdersen manager eaPreWY revokes it in wiitiag I rcqnest this au8iozfzatiou be eccePted-axpedidously. as to not detay in the pro?essi?' our bailding Pomuti aaY furtficr. Blcaac caII mc If thc? arc ewy qacst(ona.. I can [xi g of '-On?d at ?63-502..¢70G_ . _ ., Yottr 3mmgdiate attention to tbis matter is aJprec(eted. a Sinceiely. ytnond R Rau astatiation Managcr. Ranowal by Anderacn Cotnoratian C:e.: Ksira-Flrtex Jane.¢ . . , C?H p MWYJkn,zaa 3 : b1Uu Received Time Jo-n. 1. 1'0IP)d PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA096577 Date Issued: 10/20/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 4373 Nybro Cir Lot: 007 Block: 003 Addition: Wilderness Run 4th PID:10-84353-070-03 Use: Description: Sub Type: e-Fireplace Construction Type: Work Type: Gas Fireplace (new) Description: Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimnev flue must be inspected prior to concealin,. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Heath and Home Technologies Dean C Hoffrogge 2700 N. Fairview Ave 4373 NN-bro Cir Roseville MN 55113 Eagan MN 55123 (61)633-261 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 Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - I I For Office Use Permit / 60'~ 7 City of Ea ~~11 1 Permit F ee. ! C~/ - 0 0 1 3830 Pilot Knob Road 1 I Eagan MN 55122 i Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9-?- 20 ( Site Address: /-21-7-3 14J W l rc~ C- Unit Name: ~G l1 J e )9 Phone: RESIDENT / 3 A-) OWNER Address / City / Zip: !S'517 3 Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No ) Company: Contact661) CONTRACTOR Address: jp T C' v 1 Cr ~C~ pow tity: 2-r-, e- State: 1 "I n Zip: cJ J52 J2 Phone: 5o? 2`3 / / License Lead Certificate t~ 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. 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 reasons that would permit the City to 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. www._qol)herstateonecall.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 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. ,s--- x G l r'I F0 L -S 1 6 x Applicant's Printed Name Applicant's Signature Page 1 of 3 For Office Use City of Eajan j Permit#: D 1 I R J I 3830 Pilot Knob Road j Date Received: Eagan MN 55122 L---------------- Phone: (651) 675-5685 Email: planning0cityofeacian.com 2011 ZONING PERMIT APPLICATION ✓ Please submit a set of scaled drawings with the application. PROPERTY Site Address: g373 A) byz) C i re- Name: Phone: (l/ (~<v CONTACT Address:~ f[ City/State/Zip: ~s7z3 Applicant Signature: _Zy ❑ Retaining Wall <4 feet ❑ Driveway '-M Other: TYPE OF 0 Patio E3 Sport Court WORK ❑ Sidewalk 13 Fence Description of work: Q PLANNING Setbacks, hard surface coverage, shoreland zoning, bluff zone/setbacks, etc. Approved: Yes No Date of Approval Staff: I ~ Notes: '1 i vv ~n 5 e G~) a c, IL e ` - g` aSt'/v Yv?o~C, y ~~-v 'IOU YV1rx'( ✓V U M W01 avvd d ~j `l~\w'l V✓1~`. '"~.~L~i~~ ~jCJ'C1.~~.~.lL. /~,OI Ly ~ SI (7VY~~-t.C.✓ G9 -C ~-u.S Revised Plans Approved: Yes I No Date of Approval: Staff: ENGINEERING Grading, drainage, utility easements, wetlands, erosion control, improvements in the Right-of-Way, etc. Approved: Yes I No Date of Approval: Staff: Notes: Revised Plans Approved: Yes / No Date of Approval: Staff: COMMENTS G:\Buildinglnspections\PERMITAPPLICATIONS\2011\2011 Permit Applications .old Carlson . 55 W.ildernesE Run RoaLd ,,agar, Minn. ~ , DELMAR H. SCHWANZ LAiNO SuRVF YOR RegiStereC Ulidef LAWS of Tne State of M.nnesota 14515 SOUTH ROBERT TRAIL P.O. BOX M ROSEMOUNT. MINNESOTA 55068 PHONE 612 0423-1769 LpA.. S~ u = vSy (vWax•~rr trU'iou URVEYOR'S CERTIFICATE r ("fax, h1. ~ ~^'T f d D >f Scale 'QuaAs -10 feet, G denotes Lr'~1_ 4imsc ' Ca 1,0 e v C - ss 5 141 LOT 7 shed ffFRle:',t n ag 0 ti AR. f J ~0 4S f D . J" '/"0 ,h(0~ 'O 13, Q7 CQ ti 2 •'•rO4F, ~_70 Fi S 77U 34 r 3 r r r f 30 i t; 'xe v r.e„I Lfy t':.,tt ti:ls Ls a trtAe and correct representation Tt a survey of the dE l~Ot. L'1.(7CK . Y'11 ~~"'~N r-d6,•w"~ . i _ RUN j., I F~:~,~ A-T•Ii_1l1: 3CCoI"(7$.riy to tho recorded p ,at thervof, Dakot., (*(-)Ltnty, Minnesota. it also shows the iocation building. As surveyed by me this 17t:l day of Auv1j-.rat MINNESOTA RE6151-RATfON NO 625 ' Use BLUE or BLACK Ink 1 For Office Use City of Eapn C~, r --~q i Permit ) d - Permit Fee. (l' 1 3830 Pilot Knob Road Eagan MN 55122 P;:{ i \x i Date Received: ` I Phone: (651) 675-5675 r staff Fax: (651) 675-5694 u; 1 I 4_________ _ .71'1 2011 RESIDENTIAL BUILDING PERMIT APPLICATION to Date: -1 7-0 11 Site Address: q3 C r ` r C e Unit Name: Vn ~C ~VAea=0 Phone: RESIDENT / cam` OWNER Address / City / Zip: '73-73 l U~ C f`C 1e Applicant is: Owner Contractor TYPE OF WORK Description of work: - Construction Cos 0? I-cr amity Building: (Yes / No Company:: LJ a r Contact: CONTRACTOR Address: J ZGd 7i v Oe AR City: a- fe-,1 1)p. State: Zip: Phone: 7 Z 3 S ~/b 0 - f rcense - Lead Certificate : -7 T t ject is exempt from lead certlfic ion, please explain why: (see Page 3 for additional information) C~C )c~/`c✓1 6e-r--) 6Z0 0-6- per., C COMPLETE AREA OWLT DING 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: MOTE. 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 s5( 1) 454-0002 for rotection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. -www.aoaherstateonecall.om 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 Code must be completed within 180 days of permit Issuance, x 60 ) n w~ Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE 01-336 SUB„r TYPES 1 -3, - ' Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ GarageC Porch (4-Season) _ Exterior Alteration (Single Family) T Multi _ 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 Water Damage T Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION ~,q~~ V aluation Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100%-Yj Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction yI Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/ C.O. Required Footings (Addition) , Final / No C.O. Required Foundation - V HVAC _ Gas Service Test Gas Line Air Test 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 Wald: Footings ^ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES / Base Fee Surcharge tip/lvnt"A Plan Review MCES SAC City SAC Utility Connection Charge' S t S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 : old Carlson 411( . 5 Wilderneaz Run Road .'agan j Minn. ~ DELMAR H. SCHWANZ LAND 5vRVFYOR 4 Rey-StereC U-.Cer Law; of Tne State of M.nnesota 14515 SOUTH ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 612 0423-1769 SURVEYOR'S CERTIFICATE .'~:f1 r1 0 denotes o m r t~` s < LOT ur'ara eA in(4 utl1 4 g C ` 1~j ~ .y AR'oJ . ' y ` A _ r n ~f 0 ~r p~Q ti I y p z 0 a, 9.g2 rn40 o , 0 ai 7 ti' yte o m l S ~ u ` r 35 30 ! 8 30 i hCTs eby Certify that 's a true and correct representation o a Survey the boundb trles of. T,0 t Flock , W qv'. c Rtt ri t?i' i'N 'r T'TTIC?T'~ according to the :'L'^.[?Zdeel p-: at UnAereol', Dakr)t.-x (`oanty, Minnesota. this also sh.~ws ttse L - -atlon c a pr,,,); -sf3d bui l d9.r'fLr . As sfarveyed by me this 12-th day of i'`suvl'jtct i C77r.x r ^ , T ~ MlNNESoTA REGI,`i.i RATION NO 625 VILLAGE OF EAGAN WATER SERVICE PERMIT 37,91 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the Village of Eagan Surcharge: Ordinances. Misc. Charges: Total: By / Date Paid: Date of Insp.: f ? 7~ Insp - VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comPly with the Village of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By: Misc. Charges: Date of InST.: J ? -7 .--7 Total: Insp.: - - - Date Paid: PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA127870 Date Issued:10/17/2014 Permit Category:ePermit Site Address: 4373 Nybro Cir Lot:007 Block: 003 Addition: Wilderness Run 4th PID:10-84353-03-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Craig Angell 12253 Nicollet Ave. S. Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Dean C Hoffrogge 4373 Nybro Cir Eagan MN 55123 Angell Aire 12253 Nicollet Ave S Burnsville MN 55337 (952) 746-5200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA130897 Date Issued:05/20/2015 Permit Category:ePermit Site Address: 4373 Nybro Cir Lot:007 Block: 003 Addition: Wilderness Run 4th PID:10-84353-03-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Dean C Hoffrogge 4373 Nybro Cir Eagan MN 55123 Bruckmueller Plumbing Inc 3992 Pennsylvania Ave Eagan MN 55123 (651) 686-6696 Applicant/Permitee: Signature Issued By: Signature