4395 Nybro CirINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: f{?I i I n??e
?TI
3830 Pilot Knob Road Permit Number: ?+.?Hc
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
, _? . .
SITE ADDRESS: 1. cti i
• i rd v It 1; 4 1 L: 1 f+
t1{il+t?;Nt'.. ItI1N Il1ti
APPLICANT:
: ,, ? (Jl i• i<<il It,il
' { t, 1 , ) tt'ic1l .c'lt'?(f
. ?. , ? . .
? _ . . .. .._ . J
PERMIT SUBTYPE: TYPE OF WORK:
1;F1'Al[t
1iL"k0 OF
PermR No. Pertnft Holder Date Telephone M
ELECTRIC
PLUMBING
HVAC
InapecNon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
OYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
•
BSMT FINAL
DECK FTG
DECK FINAL
4
CITY OF EAGAN Remarks
Addition ilderness Run 4th Addition Loc 10 Blk 3 Parcel 10 84353 100 03
Owner Z.
Street 4395 Nybro Circle state Eaqan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. I 1977 653.66 65.37 10 653.66 C002376 10-4-76
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 163.26 8.16 20 PAID
SEWER LATERAL
WATERMAIN
WATERLA7ERAL 1972 584.91 38.99 15 3 97
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $320.00 2309 2-19-76
BUILDING PER. #38
sac $450.00 z-19-16
PARK
VILLAOE OF EAGAN WATER SERVICE PERMIT
3795 Vilot Knob Road PEHMIT NO.: 1934
Eogon, MN 5512] ppTE: 3/16/76
Zoning: No, of Units: 1
Owner: _P??fSHQg?gg}TMn?{QIy
Address:
Site Address: --434$._21gbrp_C1A le 1,j0 $3 yip,¢
Plumber: _ PL'0i2Ct Plumhina
met ?St?? a o`Y o? Connection Charge: 320.00__
Aceoun[ Deposit:
Reader No.: 795-37P Permit Fee: 10-00 pd
I ograe ro complr wifh the Villoga oi Eagan Surchazge: .5Q_p$
Ord' nce? Misc. Charges: _60.00 Pd
al:
Tot
gy ??a[ePaid:
Date of Insp.: Ins
p':
YILLACE Of EAG6N SEWER SERVICE AERMIT
3795 Pilot Knob Road PERMIT NO.: ___ 2691
Eagon, MN 55727 DATE: 3/16/76 Zoning: ]u No. of Units:
Owner. _Pe-t6_r8on Construction -
Addresa:
Site qddress: 4395 NvbrO Clrcle L10 83 WR4
Plumber: P*n jset p7 ?ypb?q
1 ogroe fo eomply with fhe Villoge of E agan Connec[ion Charge: 450.00 pd
Ordinances. Accoun[ Deposit _
Permit Fee: 10.00 Od
Surcharge: • 50 pd
Hy' Misc Charges:
Date of Insp.: Total:
Inap.: Date Paid: _
CITY of EAGAN
BUILDING PERMIT
h.. ?
own.= V........?x.A?:?.?i.^,rr.??7.a.A,t ...............
Addresa (preeenS .. `
) .f.:39. 5..... ..N.. jr.b, `r.-a.....C. in- -- - - .........
Buildee .AL'.?:P.YS.olu......?'.[lN.S.t'.Y.U.?.tY.ON ....................
Addreu .Y.7C2./...... W :...1'e p.........1!IX/..]~?Y ...........................
?
. .
N2 3835
3795 PiloY Knob Road
Eagaa, Minnesoia 55122
454•8100
ae:a .?.?.:?../.8.,,../..Y4..........
.
Sioeias Ta He Used Far Fron! Depih Heighi Eef. Cos! Permi! Fee Remarks
!"f,Sic?CN/T I-Q4'r. Sa' d?G ? p900? ?3a°2 ?
LOCATION
Sireei, Aoad or oxner uesenpuon ot a.ocanon I Loi niocs naauion or iraei
??3?``' _?l'_'t"`'?Cr ?, I ib 3 d.. in
This parmif doea not auShoriae the use of slxeefs, roeds, alleya or sidewalks nor does it give the owner os hia agenl
the righf !o creale anp siSUarion which is a nuisanee or whiah pzesenis a hazard fo ihe heelfh, safelq, convanienca and
general welfare io anpone in the community.
THIS P£RMIT MUST BE nKEPT ON THE PREMISE WHILE THE WORK IS IN PAOGAESS. ,
This is !o cerrifp. 2hai..l:? ..?i..'.P..SA.AI.....?QAL.S.*............has parmissioa !o arect a...._?:..?....?:f.v.{.'.[/L.N..?------------ _upon
the above, describ premise suhjeci to the provisions of all applicable ' nce for e i Eagan
....... 1........._ ...:^..c3..^...c ............................._..._.. ... . ......... """""_'._.....
" ....................
Ma or BuAding Inspeclor
.,
CIiI CU' rAn„PT
37e5 ni].ot ImoU Rcaa
E&;r-n, NLmF :;ota 5j1. 22
..
Pr.r ,SP IdO, "__8D9__?_----
Tbe Ci_ty of Ea.gsn hereLy g^ents to Ryan PlwabinQ & HeatinE Inc_,_
of 3&0aemount
a HEATZNG _ Pe_-rit fora (Owner)
5. Petersen
at 4395 Nybro Circ2e pursuant to application dated 3/22/76
Fee Paid: $20.00 dated this 29 day oi March , 19 76
.50 s/c
Euiidir.g Inspe^tor
M°c7`_8P_irE,]_ P2Y'[II1tS:
Bid Tota1:
o D ?
t?r?y"-"
CI'Pi'.0F iA:?yTI
3'9j ?'i].ot I;:7cb Road
Ea.,-En, Mir.7esota ?',--, 22
YKtul,/1?TP N'J,
ine Ciay of lia.gan hzieby g-ra_7ts to Pro ect Plumbina Co.
c£ 9743 Htnnboldt Ave. So•, 1?18._55341
a PLUMBINGPe°,mit for:- (Omrner)__ Svenn Petersen
at 4395 Nvbro Circle pti:rsuant to apnlication dated 3/76 _
Fee Paid: _ 520.00 nated this 16 day oi March ? 1976
.5o s/c
tuilding Inspector
A?2ch3nicaJ_ Permits:
Bid `Ioi;ai;
Ip
cImY eF F:?cn.N
3795 Pilot Knob P,oad
Eagan, P-?innesota 55122
PERMIT NO.: 78
The City of Eagan hereby grants to Commers Soft Water Co.
????? ) A P b 3
o£ 3801 California St N.E.
a Water Softener Permit for: (Owner) David HennAS -
at 4395 Nvbro Circle , pux'suant to application dated ln/2 76
Fee Paid: $5.00 dated this 29_ day of _QQtofinr ., 19
.50 s/c
Puilding Inapector
Mechanical Permits:
Bid Total:
RESIDENTIAL
• BUILDINC PERMIT APPLICATtON
CITY OF EAGAN
c/ 3830 PILOT KNOB ll EAGAN MN 55122
?Q CN ZJ?-P 651•681=4675
New CanswcUon RwulnmeMa
• 3 regislered site surveys showing sq. ft af lat, sq. ft. of house; and all mofed areas
(20%mazimum la coverage allowed)
• 2 copies of pan shoxrirg beam 8 wiiMOw s¢es; poured fouM desiqn, etc.)
• 1 set o1 Eneyy Calculadons
. 3 cppies of Tree Preservation Plan if lol platted aRer 7l1193
. R'un Jaist Oetail Options selectiuo sheet (Wdgs with 3 ar less unAS)
DATE _5- ;6 'Oa-
1-a-?s-, a-?
KlIIIGCBYRi KYpYIfllMllii
. 2 coDies of plen
. 7 set of Eneryy Calwlatlons for heated addilions
. 1 site survey far extenor addilions & decks
' . Indiwte if home served 6y Septic system tor addition5
?i
I O(D
'?vaLuAnoN$ ?.?? •'?'
ULTI-FAMILY BLDG _Y eY N
FIREPLACE(S) _ 0 Y
, 1 _ 2
APPUCANT
STREET ADDRESS
TELEPHONE #25a 7M"6W
PAX # p? 707^ &rv
PROPERTY OWNER TELEPHONE#
----------------------- °---------------------------------------°°---------°-------°----
COMPLETE THIS SECiION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
- ,
Energy Code Category _ MINtiESOT:1 RliLES 7670 CATEGORY 1 MINNESOT:1 RUI,ES 7672
(J suhmission type) • ResidenGal Ventila6an Category 1 WorksNeet Submitted • New Energy Code Worksheet Suhmitted
• Energy Envelope Calculations Submitted IPlumbing Contractor: I Phone #
Plumb? sYstem includes: Water Softener Iawn SPrinkler Fee: $90.00
?8 _
Water Heater No. of R.I. Baths
-
_ No. oC Barhs
?
Mechanical Contractor: I? Phone #
Mcchanical system includes: _ Air Condicioning Fee: $70.00
Heat Recovery System
Sewer/Water Conhactor. Phone # I ? ?
MAY 3 0 2002
-------------------------------------------------------------- -- --------------------- ------------------- -
I hereby acknowledge that I have read this application, state?lthat the information is c rrect, and agree to co ply
with all applicable State of Minnesota Siatutes and City of Eagan Ordinances. By ?
Signature of Appllclant loe,
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
i
7A?.° STATE/0
Z ZIP?
OFFICE USE ONLY
? 01 Foundatfon
? 02 Sf Owelling
? 03 01 ot _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 31 New
? 32 Addition
? 33 AReratlon
? 34 Replacement
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sE
? 23 Porch (screened)
? 24 Storm Damage
0 25 Miscellaneous
? 30 Accessory 81dg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
0 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) C] 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) O 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof O 46 Windows/Doors
•Demolition (Entire Bldg oniy) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units SWries Booster P,ump
Nbr. of Units Sq. Ft. PRV ?
?I
Nbr. of Bidgs Length Fire Sprin,klered
Type of Const Width ?
I
REQUIRED INSPECTIONS ,
_ Footings(new bldg) _ FinaUC.O. II
_ Footings (deck) _ FinaUNo C.O. ;j
Footings (addition) _ Plumbing II
Foundation HVAC !
Drain Tile Other ii
Roof _ Ice & Water _ Final _ Pool Ftgs Air/GaslTests _ Final
_ Framing _ Siding Stucco Stone ,i
_ Fireplace R.I. Au Test Final
? Windows (new/replacement) `I
Insuladon
- Re[aining Wall
il
Approved By Building Inspector
Base Pee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
l.icense Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex ? 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or_ N
? .
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDIN6
028687
08/27J96
SITE ADDRESS:
P.I.N.: 10-84353-100-03
4395 NYBRO CIR
LOT: 10 BLOCK: 3
WILDERNESS RUN 4TH
DESCRIPTION:
REROOF
1'; ?__-da._
Builng Permit Type
43uilding'`Work Type
Ge'n5u5 Code"`-,
STORM DAMAGE
REPAIR
434 ALT. RESIDENTIAL
6?{? F
,< "i 1 }si z E '?'z,'...'f .'"... I ? 7
-.
0
REMARKS:
FEE SUMMARY:
CONTRACTOR: - flpplicant - sT. Lrc.OWNER:
HORIZON ROOFING 18903900 20012795 HINES DAVID
1333 LARC INDUSTRIAL BLVD 4395 NYBRO CIR
BURNSVILLE MN 55337 EAGAN MN
(612) 890-3906 (612)688-0725
I hereby acknowledgs that I have read this application and state that the ?
inYo-.rmation ie,corrett arnFl ,agre:e to cumply w'ith .a11 applicahle State pF Mn, -
5tatutes 'and City Qf Eagen- Ordittances. L
APPLICANT/PERMITEE SIGNATURE
°--?
ISSUED : SIGNATURE
CITY OF EAGAN
(P "? 3830 PILOT KNOB RD - 55122
/ 1996 .BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
RemodeUReoair Reouirements
STo4X-t.
? 3 repistered sfte aurveys ? 2 cropies of plan
? 2 coples of plana (indude beam 8 window sizes; poured tnd. desipn; etc-) ? 2 site surveys (exterior additione 6 decks)
? 1 energy ealeulatbna ? 1 energy ealeulffiiona for heated addNions
? 3 wpies W Iree proservaNon plan H bt pleHed efter 7l1/83
iequired: _ Yea _ No
DATE: g'23'9? CONSTRUCTIONCOST: 31V , 00
DESCRIPTION OF WORK:
STREETADDRESS: 4395- AXWO G/eCLlc,
LOT BLOCK ? SUBD./P.I.D. #:
PROPERTY Name: NI?1?5 DAUID Phone#:
OWNER """
Street Address- A)Y82a C/,2G'Zf
Ciry: ?5l9&A il) State: MAJ Zip- SS/Z 3
CON7RACTOR Company: kdeae?N 994?//lIe. Phone #: 89?" 3q19o
Street Address: l 2v3 3 LAR-e- 1i110 BI?l1D License #- 'Z001Z775
city: 6uRaU5U1&t& State: MAI Zip• 55337
ARCHITECT! Company: Phone #•
ENGINEER
Name: Registration #-
Street Address
City: State: Zip:
Sewer & water licensed plumber.
change are requested once pertnit is issued.
Penalty applies when address change and lot
I hereby acknowiedge that I have read this application and state that the information is correct and agree to comply with all
applfcable State of Minnesota Statutes and City of Eagan Ordinances. 4?1.?t/r-?
Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. 0 17 $wim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous
n 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
0 31 -New o 33 Alterations o 36 Move
0 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Consk (ActuaD
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
i3asemenc sq. ii.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Permit Fee
5urcharge
Plan Review
License
MCNVS SAC
City 5AC
..ater ?a????.
Water Meter
Acct. Deposit
S1W Pertnft
SNN Surcharge
Treatment PI.
Road Unft
Park Ded.
Trails Ded.
Other
Copies
Total:
iviC/1fvS 3ysiem
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
Engineering
Valuation: $
Variance
% SAC
SAC Units
?
I?3
?I
DAmL: 1/
? _ .6 ?./;!4
i
B LDII;ti'G PEES1°I:CT 1;2: r TCA"Tr,r,i CHECR
Lot_? _ Bioclc ?? Additio.1 /) r?. -5r ?
Parcel and section nur,Uer
Streat-?`-?-.._?? ----
OFnz -r Address
Deva? ar_:;x io?? A@drass 8 , Te1e `?
? l????
Zone-Ord:inax.ce #52
Lot Size X Total area
Platted e 51 Un.p].atted --Itp
3u:ildir,g S3ze X Total .area
?
Or,cuaancy_??
Type of ccnstructia,z , fr Ut-- P
Seibacks: St;eet sides Rear ? %
' A
Sides -°? ?-OF-
Par?dng: To+.al araa I< ToL,?a spacea ? f o ,
Parki, g area setbael:s: Q ?
Strc;et side ? ar Sides
?
Landscape approval
Soecial Asse;s:nents:
Sri:i charge_
Water areac
Assessed
Bond required
v?
@ w?1??.G0 - ??v ????_..
Unassessed
Zf assesse3: ConneGtion charge
If unassessed: Conlzection ckxtrge
Lot di.zsion:
Additional assessments neede3
Lateralse
Assessed
lry'aiver o£ hearing:
Not needed
Not assessed
Not needed
Assessment clk Water & Sewer Dep+ F3uilding Dept
Police Dept Fire Dept (C .omm & Ind only)
2738 UPLAND COURT ?/? D L 1? NC F
MINNEAPOLIS, MINNESOTA 55391 FNG?^JF£+NC; 5 SiiPVF.:^:1 .,
(612)559-4444
Survey for:
SV ?:.7 PETERSEN
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CC?iY.?r, rl}/ E<J Sf I?IC:"ly--. p?
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Ll ?L l "/ /S ^I
40k3Y3s
403 EAST NEBRASKA STREET
ALGONA, IOWA 50511
(515) 295-7259
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Deacription:
' Lot 10, BZock
Ire'ILD3RNE59 RUN 4TH
ADllITIQN
I hereby certify ihat this survey, plan, specification or report was prepared by me ( under my direci supervision and that I am a duly Registered Professional Engineer W
and Land Surveyor under the laws ot the State of Minnesota. p?
21-VIn[. . CIE?i?!?.__ Date: .?`c& f0 Reg. No.,-?_-- ?
j- ?- ? ??
MASTER CARD
/o-2 W,
OWNER p.Gteraa N
STRUCTURE AND -^
LAND USED AS
Permit
No.
Issued Issued To
Con}ractor Owner
BUILDING
?.-
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
EIECTRICAL
HEATING S O R
GAS INSTALLING
SANITARY SEWER '
OTHER I
OTHER
Items Approved
(Initial)
Dafe
Remarks
Distance From Well
FGOTING SEPTIC
FOUNDATION G- ' J CESSPOOL
FRAMING C_ . TILE FIELO FT.
FINAL
ELEC7RICAL
HEATING DEPTH
OF WELL
GAS WSTALLATION ?? . s
SEPTIC TqNK
CESSPOOt
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
..n
? `
Violations Noted
on Back
COMMENTS:
Cie
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
DATE OF INSPECTION
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUi DELAY.
ITEMIZED AND pESCR18ED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FICATION - I certify that I have caretully inspected the a6ove in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
BIJILDiNG INSPECTOR
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA111354
Date Issued:06/19/2013
Permit Category:ePermit
Site Address: 4395 Nybro Cir
Lot:010 Block: 003 Addition: Wilderness Run 4th
PID:10-84353-03-100
Use:
Description:
Sub Type:Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David K Hines
4395 Nybro Cir
Eagan MN 55123
(651) 688-0725
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use I
Permit r ~S1
ing
City of EaEd Permit Fee: o a S 1
3830 Pilot Knob Road
Eagan MN 55122 1 Date Received: 5 1 L3 I
Phone: (651) 675-5675 I r~ I
Fax: (651) 675-5694 I Staff: .AID I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - Site Address: (d l~ t r Unit
Name: Phone:l
Resident/ ,j - CC
Owner Address I City ! Zip: 4,q 5 1 y I r ~t/''t J J 1 ~
Applicant is: Owner Contractor
Type of Work Description of work: CL ~-o 0-P,
I
1 Construction Cost: Multi-Family Building: (Yes ! No
I
Contact: ~n .6 _
4Company: /C~
Contractor Address: y"1 `fit>1 City:
State: - Zip: l Phone: S t' d C~ I
License Lead Certificate b a lQ 213- 3J to S-
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
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?
i
1 _Yes _No If yes, date and address of master plan:
i
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
I 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.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
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 Minnes a State Buildi Code must be completed within 180
day of percmiit,,issuance.
x OU~. x
Ap licant's Printed Name pplic ht' U ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA173371
Date Issued:11/09/2021
Permit Category:ePermit
Site Address: 4395 Nybro Cir
Lot:010 Block: 003 Addition: Wilderness Run 4th
PID:10-84353-03-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David Kenneth Hines
4395 Nybro Cir
Saint Paul MN 55123--174
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(641) 264-4088
Applicant/Permitee: Signature Issued By: Signature