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4237 Nybro Lane NINSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 E41t c?.•+.y ? ?• SITE ADDRESS: PERMIT SUBTYPE: ;i I , APPLICANT: TYPE OF WORK: (it .1 t. I t' I I!iN f: k 1'A 1 I. 11,0111 I Nl'i INSPECTION D . . ; .., .. _?: ; .. . _..; I .:,.'•: ._ _ _ J "A ? -_ iAe PormR Mo. Permft Hotdw Date Tolepha» 11 ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Comments FOOTINGS FWND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATiN(3 GAS SVC TEST INSUL GYPBOARD FlREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TES7 BLDG FINAL BSMT R.I. BSMT FINAI DECK FfG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ' N ' : ' 8- N4:i+7r, r 10 - e ? L C? '1' 7 1 i R L u rJ , i. ra : hiFitl l ANf N W11llf RNi '•':• ftl1N til !d PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: ? Permk No. PsrtnR Holder Date Telaphone N ELECTRIC PLUMBING HVAC Inspaction Dste Msp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE 4-1 ? FIREPLACE AIR TEST FINAL PLBG FINAL HTG OHSAT TEST BLDG FINAL BSAAT R.I. BSMT FINAL DECK FfG DECK FINAL CITY OF EAGAN Remarks " Addition WILDERNESS RUN 6TH ADDITION Lot 11 elk 3 Parcel 10 84355 110 03 owner street 4237 North Nybro Lane state Eagan, Minnesota 55123 Improvement Oate Amount Annual Years Payment Receipt Date STREET SURF. STAEET RESTOR. GRADING SAN SEW TRUNK i 1973 161.21 8.04 20 104.79 007040 11-6-78 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 19]] 162.1L+ C, b8;-BG- 15 129,74 1-6-7 - STORM SEW TRK 1978 773 - 79 8,2 5 237.29 007040 11-6-78 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 250.00 11198 $-$-7$ BUILDING PER. #4929 SAC _8_'78 PARK CASH RECEIPT • CITY OF EAGAN 3795 PILOT KNOB RQAD EAGAN, MINNESOTA 55122 DATE 19 RBCEIVED FROM AMOUNT $ I & DOL.LARS 1 oo [:) CASH ? CHECK White-Payers Copy Yeilow-Posting Copy Pink-File Copy T nk You . pi'l' BY ' cinr oF EA"N 9795 Pilot Knob Road Eagan, MN 55112 ' PHONE: 454-5100 BUILDING PERMIT Receipt # To 6e sted for Est. Value Dote Site Address .u . .. y . : v , 3 Lot Block Sec/Sub. Porcel #k w Nome •.? ..».. ... _?......... Z tiaY' !1@S5 o3d . r? Address - , ac Name ??0 Addre f- rtr., I hereby acknowledge that I have reod this applicotion nnd stote thot the informotion is correct and agree to comply with all opplicobie State of Minnesota Stotutes and City of Eagan Ordinances. N2 4929 Erect ? Occupancy ' Alter ? Zoning Repair ? Fire Zone ? Enlarge ? Type of Const. Move ? # Stories Demolish ? Front R. Grode ? Depth ft. Aoprovels Fees Asseument 'F ' / " Water & 5ew. Pol ice Fire Eng. Picnner Council BIdg.Off. 8 ???? APC Permit - Surcharge - Plon check SAC ? Gl7 Water Conn. Woter Meter Toral 954.50 Signoture of Permittee I A Building Permit is issued to: on the express condition thot oll work sholl be done in accordance with all applicoble Stnte of Minnesota Statutes and City of Eagan Ordinances. Buildirq Off icfal pwmit # DeM lauad PxaIMN Plumbing 1,IS8 /()-,)-7' -]6 Mecfionical /a 7 - INSPEC710N5 DATE INSP. Rouqh-In Final Foptings Dot• Intp. pote Irqp. Foundation piumb;ng ? Frnme/ins. ? Mechonical Final ? Remorks: . T cinr aF UGAN 3795 Pilot Knob Road 6agan, Minnasota 55122 Phone: 454-8100 HEAT1NG _ PERMIT Date: ,'ptenber 11, 1978 Site Address: A237 No. t3vbro ISne I Lot : Block 3_ Sub/Sec. _,?k6th ? No. 1277 Receipt No.: ? ? Single I , Residential Multi Res., Comm./Ind. I Name ' i sPn Homes Inc. New/Alter./Repair ne- . ; Address f=27 SnPI 1 inq Ave. So. Cost of Irutallotion AIR a RFQTJTRETI, City ^r Paul 5511] Phone: Pertnit Fee 2. nn Name "• Binder & So!'t Itlc. Surchorge ? . ? ?.120 E. Butler Ave. `e 0 v =s? St. Pdul 5r' City Phone: Total ` This Permit is issued on the express condition thot all work shall be done in accordonce with all applitoble State of Minnesota Statutes und City of Eagan Ordirronces. Buildir?g CITY af EAGAN 3795 Pilot Knob Road PERMIT NO.: - Eogan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: _ Site Address: Plumber: 1 agree to eompiy with the City of Eogoe Connection Charge: ' Ordinances. Account Deposit• BY - bate of Insp. - vuce raia: CITY W OP EA6AN ATER SERVIC E PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner; Address: Site Address: Plumber: Meter No,: Connection Charge; Size: _ Account De posit: Reader No.: Perrnit Fee: I agree to comPIY N'iNh the Cily of Eagan Surcharge: Ordinnnees, Misc. Charges: Totai: By - Dote Paid: - I I Permit Fee: Surcharge: Misc. Charges: - Total: ? Yi s 01 ? . ?,. CITY OF EAGAN . 3795 Pilot Knob Rood Eagan, Minnesoto 55122 ; . Phone: 454-8100 PLLMIHG PERMIT No. 1258 Dote: 10-21-78 Site Address: 423' No• Nybro T,821e _ Lot ' i Block ? Sub/Sec. _ 4,nR 6zf _ Nome "gl$en _ . . c Address E)17 ?t;• ST1e 11:ii ? City ",-UL Phone: Name . + Address 9900 KeewiCk Ave. tj e 0 t lw.^ 'r pz, Phone: CiY This Perrnit is issued on the express condition that all work shnll be Minnesoto Statutes and City of Eagon Ordinonces. Receipt No.: ` 2192 Single Residential Multi Res., Comm./Ind. I New/Alter./Repoir. Cost of Instailotion .r`•;,. Permit Fee Surcharge Total done in occordance with nll applicable Stnte of Official r CITY OF EAGAN 9795 Piloe Knob Read Ea9an, MN 55122 N2 4929 PHONE: 4546100 ??? BUILDING PERMIT APPLICATION Receipt # -_L?E2 Te be uaed for S' Dw1g. & Gar. at. Value 43,000 pOfe 8/7 , 1978-- Site Addrl _ ess Lot 1 Block Parcel # Sec/Sub. z Name _-"'-- ; Address dT IlESS H _ b mNeme Tilsen zt Address 627 So. Snelling Ave. o< u? F- r.... . 8U o?.....e Name I hereby ackrwwledge that 1 have reod this apDlication and stote that ihe infortnation is correct and ugree to comply with all applicable State of Minnesota Statutes and City of Ecgon Ordinances. Signoture of Permittee A Building Permif Is iuu cll vrork shall be don?e %i Buiiding Offlcinl _'L? Erect 6 Occupancy I Alter ? Zoning Rl Repnir ? fire Zone 3 Enlarge ? Typa of Con st, v Move ? # $mries Demolish ? Front 52 ff. Grade ? Depth 46 - ft. Apprmals Fees Assessment a/ // ra Woter & Sew. Police Fire Eng. Planner Council Bldg. off. 8 7 78 APE Permit 123.00 _ Surcharge 21•50 , Plan check 5AC 500.00 Woter Conn. 5•00 Water MMer 60• 00 Torol 954.50 on the expren conditfon that Stote of Minnewta $totutes and City of Eagan Ordirmntes. OFFlCE USE ONLY This requesl wid I B monihs hom wlidotion dale printed tn ihis bon. O?' 7 ? 7r40 c-, ,Ba Gt?? ,QO? * 11 4 0 6 a 2 8 L * pLEASE PRINT OR TYPE C?f Q Neqursi Dare Roighin irupecnon ?equired2 ? Yes No Inspecnm dher Than RougMn: ? Ready N. Will Coll 2? ? (1'ou musl call Poe inspec?w when ready) D.J. Reody: I, licensed conkactor D owner hereby request inspeclion of the above electrical work at: Job Address ?Sheet, Box, rn Roule Na.) Ciy Zip Coda 2 vl Setllon No. Township Nome or No. Ra.ge No. Fire No. Coun Dcc ? Phon No. ??- oy Z Power Supplier Addrass EI nical Confracqr ?Compony Name? ( Connxor licanse No. Masror Lic. Na (Plont EIM. Only) V" 1 b, O Mai?Adress(Conha orOvmer - 7 9 Perfoiminglnsmion) w W5510 ? a ANMrized Si nalure (Cann«ror or ar er(T ng sMllonon? 7hone No. 2?33 Z2q REQUEST FOR ELECTRICAL INSPECTION & S? 4 0 6= 0 2 8 ? 8121 Univ rs ry A e?, Rm. Se128,'St. Paul, MN 55104 R4 i??? oa Phone (672) 642-0800 Home Duplex Apt.8ldg. Other: New Addn Commercial Indushial I Farm ? Remod Re oir Air Cond. Hfg. E uip. Water Htr. Load Mgmt. Ofher: Dryer Ran e Elec. Heaf Temp. Service "X" above the work covered by ihis request Enfer remorks in tlris space and on fhe bock of the while mpy only. Wth,? l,o? Calculate InspecM1on Fee - This Inspxtion Requesl will not be accepled withouf rhe correct Fee: Other Fee # Service En[rance Size Fee # Circuits/Peeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps $heet Ltg./Traffic Sig. Above 200_Am s Amps Tronsformer/Genemtor INSPECTON'S USE ONLY TAL/? Sign/Oudine Llg. Xfmr. ? ? JD Alarm/Remofe Conhol Swimming Pool I hereb c ot I i d tM electrim loiion dexri6ed herem an the dores sbted Irri90tion BoOm Roug Dote aciallns eclion S p p Investigotive Fee Dere THIS INSTALLATION MAV BE OROE D DISCONN TED IF NOT COMPLETED WITHIN 18 MONTHS. a 4V.7? l,)zoy;0 This request void 18 months from //-3 //9o-V el-1;19 0,hy 'R 4 617 Date of this Request 9-13-1978 -' 1, as iDl.icensed Electrical Contractor D Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 4237 North Rybro Ciry Eaa'an Section Township Range County Dakota Which is occupied by Tileta Homes (Name of Otcupant) Is a roughin inspection required on this job? No ? Yesl? Ready Now ? Will Call19 Power Supplier_ Dakota Cty. Address Farminaton Electncal Contractor O.B. Thompeon Pleotrio Co. Contractor's License N(#33735 (COmpany Name) Mailing Address 12201 Mtka Blvd. 9 Mtks 55343 (Electrl co ractor o ne Po?gking Tltls Installation) Authorized Signature ?`I/?y???i/i?i? Phone No. 933•252:?. (Electriwl Contract r Owner Making This Installatlon) fC`r? /1 ?? o 0??0 ? ?j ??, 0?.?(VJ This inspection requestwill not 6e accepted by the c'J ll (.?,1 U State Baard unless pmper inspection fee is enslosed. Minnesota State Board of Electricity 1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUESTFOR ELECTRICALINSPECTION CfIECK BELOW WORK COVERED BY THIS REQUEST l/7'az/- R 4617 Type ot Building New Add. Rep. Check Appliances W'ved For Check Fquipment Wired Fm Home ? ? ? Range BE Temporaxy Wiring ? Duplex ? ? ? Wa[er Heater E& Lighting Fixtures im Apt Bidg. ? ? ? Dryei ? Electric Heating ? Commercial Bldg. ? ? ? Fumace 5[ S0o Unloader ? ]ndus[rial Bidg. ? ? ? A'v - -'tio Bulk Milk Tank ? Farm ? ? ? Lis n List Other ? ? ? p He Here?S? COMPUTE INSPECTION FEE BELOW Semice Entrance Size: # Fee Fceders&Subfceders: # Fee CtiICUiu: # Fee 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eies l ]Ol to 200 AmpsQ- t II 31 to 100 Amperes 31 to 100 Am res A6ove 200_Amps. Above 100 Amps. Above 1D0 Amps. 7ransformers Remote Con Vol C'vc. Partial ot other fee S' ns Special lns ection Minimum fee Remarks TOTALF yO.0U t}DerjO I, the Electrical Inspector, hereby (Final) This request void 18 months fiom has bee?pad? L Date ? 'Uate ? ??/? 7 RESIDENTIAL 5?? 3 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConsW ction Reouiremenls • 3 registered site surveys showing sq. ft. of lot, sq. fL of house; and all roofed areas (20% maximum lot coverage allovred) • 2 copes ot plan showing 6eam & window sizes; poured found design, etc.) • isetofEnergyCalculations • 3 copie.s oi Tree Preservation Plan if lot plaited aker 111193 • Rim Joist Detail Options selection sheet (61dgs with 3 or less units) DATE J'aS??d -)- SITE ADDRESS TYPE OF APPLICANT ? STREET ADDRESS 15v7S iF- 66X?, %3 CITY TELEPHONE #e?5;7-9w'O?{?I7'CELL PHONE # ZIP 5533 7 PROPERTY OWNER S7&-71gr FD&RSTE-ie TELEPHONE#(67-GiSg-OCo(p3 ---------------------------- ---------------- ------------------------------- -------- ----------- COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RULES 7670 CATEGORY 1 MINNESO"1'A RULES 7672 submission type) • Residential Ventilation Category 1 Worksheet Submitted •New Energy Code Worksheet Submitted . Energy Envelope Calculalions Submitted . Plumbing Contractor: _-_ Ylumbing system includes: Mechanical Contractor: Mechanical system includcs: Sewer/Water Contractor: _ Air Conditioning Heat Recovery System FIREPLACE(S) _ 0 _ 1 _ 2 Phone # r?0?+ •-75 Fee: $90.00 Tee: $70.00 Phone # 110) L? re'. P r MAY 2_? 4U?L ----------------------------------------------------------------------------------------- - - - - - I hereby acknowledge that I have read this application, state that the information i correct, and agree with all applicable State of Minnesota Statutes and City of Eagan OrAnances? By _ Signature of OFFICE USE ONLY Water Softener WaCcr Heater No. of Baths MULTI-FAMILY BLDG _Y `IN VALUATION 1 L Z?.. U Z' Phone # _ Lawn Sprinkler No. of R.I. Baths RemodellReoair Reauirements . 2 wpies ot plan • 1 set of Energy Calwlations for heated additions • lsitesurveyfore:tenoradditions&decks . Indicate if home served 6y septic system for addi6ons Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 FAX # OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 ; Accessory 81dg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4-sea.) ? 33 6ct.Alt-SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage Q 06 04-plex ? 12 12-piex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (81dg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant 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 REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumhing , Foundation HVAC Drain Tile Other Roof _ Ice & W ater _ Final _ Pool _ Ftgs Air/Gas Tests _ Final _ Framing _ _ Siding SNcco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement) _ Insulation _ Rehining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ..._ ?:Y: . . . . .. .,.i:{. . ...?. . i::i?': ..IC.' . . .. .. ? . ? ?. i ... . . . . -?: .,AS;_, ??:.....:i%?:,. .... . ...... . ... ....,..-?.-+.1.._,._ "V . " • ,'c. _ ,.:. •?:..? .:..:::...:.. J'Y „_.?..., i;c....,,,?.. ?..?. .. ..,..?..... P ..-J. . . .. . r , . . . , . . . . . . .. CITY OF EAGAN .? 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-84355-110--03 PERMIT PERMITTYPE: eurLnxNc Permit Number: 0 2 9 4 5 7 Date Issued: p 1 /31 /g 7 4237 NYBRO LflNE N LOT: 11 BLOCK: 3 WILDERNESS RUN 6TH DESCRIPTION: FTREPLACE NEW 434 ALT. RESIDENTIAL 6 `? s;W? ?<?... ??°p oF - ? ?€ ? REMARKS: FEE SUMMARY: Base Fee $50.00 Swrcharge $.50 7ote1 Fee $50.50 CONTRACTOR: - Applicant - sr. Lxc OWNER: FIRESIDE GQRNER TNC 16331042 0001068 FOER5TER 5TEVE 2700 NFAIRVIEW RVE ' 4237 NYBRO LN N ROSEVILLE MN 55113 EAGAN MN 55122 (612) 633-1042 (612)688-0663 D4R4S ?1.:? 3 ? .Y.vs y 4 Y }t &u,r R a,'fLI rnA APPtfCANT7PEfiMiTEE SIGNATURE --I5 U : 51 ATLI E CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1997 FIREPLACE PERMIT APPLICATION 681-4675 $'ZiU DATE: / J ,3 o '-' ! 7 DESCRIPTION OF WORK: ->6 CONSTRUCT FiW FIREPLACE _ INSTALL GAS INSERT ONLY _ INSTALL GAS I.INE ONLY OTFER: STREETADDRESS: / '- a / - LOT ? BLOCK y? PERMIT FEE: $50.50 _ ALTERATIONS TO EXISTiNG 6 SusD./P.I.D. #: TOJV,q,at,? Rlihi L#- APPLICANT: (circle one only) OWNER CONTRACTO I hereby acknowledge that I have read this appliration and state that the information is correct and agree to comply with a11 applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OR'NER FIREPLACE IPISTALLER GAS LINE INSTALLER Name: T7oZYZ57e2 S7-avtf ?O42&r?A 4 Phone - C' 66 3 Signature: Street Address: 4z3 7-A)? IVy r3 City: E-A Gi AJ State: ? Zip: ?6-S /Z-Z ?I,? ?p °?i?St.IDE? Company: e? n? ? Phone Signature: Stre t Address:36,56 - OJ -aT'/ License #: State: Company: _ Name: Signature: - Street Address: City: Phone #: State: Zip• R?-l ;? !1?f?& 4 °'1... ?, a ?, Atd OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Alteratlons 0 32 Addition o 34 Repair GENERAL INFORMATION Cettsus Code. SAC Code REMARKS Chimney/flue must be inspected before concealing. CIfiY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-84355-110-03 DESCRIPTION: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4237 NYBRO LANE N LOTs 11 BLOCK: 3 WILDERNESS RUN 6TH (ROOFING) 8i.tI 1d 3.r9g-,P,ermit Type SF (MISC.) i n9 W6'05, TYPe REPAIR "°' ?• ?? A6t ? ? uF2C <5' ; - ?. rm ° nL' ?.E^f.n?, s! 1? q 1 k 9 ? rr? #3 ? ? F? ?._'..?=?r v, REMARKS: c2394?0 ???qlv BU LDING 025412 04/18/95 FEE SUMMARY: VALUATION Bese Fee Surcharge Total Fee $63.00 _ ?2.00 $65.00 $4,090 CONTRACTOR: - Applicant - sT. Lzc. OWNER: C& J ROOFING 16912122 0009214 FOERSI'ER STEVE 14109 WHITE ROCK Rp 4237 NYBRO LANE N BURNSVILLE MN 55337 EAGAN MN 55123 (612) 891-2122 (612)688-0663 i hereby acknawjodg,m that `I have re.asF„ this ap(i.liOotjon_ and! stat* thaC "Che '. •irrfiarmatiOn 1'-4 aor^rict an.d?agrv o? tsa ,c amP1y °w1,th s1-1-apPlicarb1e Btate a f 14 n.; L SCatutes aMd Ca.ty af' Eagan Orclinartoes-` • APPLICANT/PERMITEESIGNATURE ISSUED?aSIG TURE ? ?? CITY OF EAGAN $`? 00 3830 PILOT KNOB RD - 55122 ? 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construetion Reauirements RemadeUReoair Reauirements ? 3 registerad aite surveys ? 2 copieS of plan ? 2 copies oT plans (indude 6eam & window sizes; poured fitl. design; etc.) ? 2 nite survays (exteriw etlditions 8 decka) ? 1 energy calculaUons ? 1 errergy calculatlons (or heated eddRions ? 3 copias of tree prcservation plan if lot platled aRer 711193 requiretl: _ Yes _ No DATE: /?L / g -9S CONSTRUCTION COST: DESCRIPTION OF WORK: ? E? 2 C9 F? 't' kE -F-C>'7nv= STREETADDRESS: ' /i LOT BLOCK ,L PROPERTY OWNER CONTRACTOR ARCHITECTI ENGINEER SUBD./P.I.D. #: .A? Name: / 0- E2ST111L Si E v£ Phone #: 6 3 W} FN6T Street Address- 2 Ci L.?J City: E,14 v'5tate: Zip: -?S--5-/_0 3 Company: Phone #: g 9/'?/? a Street Address: 75116 9- (%t 4cfif 2C? License #- City: 'd uR Ns L"i? ?-t- State: d?^N Zip- LS 3 37 Company: Name: Phone #• Registration Street Address• City: State: Zip: Sewer & water licensed plumber: • Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Yes _ No _ Yes _ No OFFICE USE ONLY BUILDING PERMIT TYPE gw .. Y F .?:° 4 .n ..,,? ?.. ?. •• •- ,.. ? ? 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool 0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous 0 05 SF Misc. 0 10 _-plex ? 15 Deck WORK TYPE 0 31 New o 33 Afterations o 36 Move 0 32 Addition ? 34 Repair ? 37 Demoli6on GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bidg Census Unit APPRDVALS Planning Building Engineering Variance ? Permit Fee ? Valuation: $ 5urcharge ?. Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Pertnit S/W 5urcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies ? Total: (0 5 % SAC SAC Units W ? q q ,. . DnTE 4-?& -71 HUILDIPdG PFRMIT APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of,energy calculaYiohs. os 1b be used for yr"vLA? `?? Valuation d? 6O C3 Site Addrass; ?7 0 e?,-?r_vxv Lot B7_ock Sec, Sub.. Parcel Number Owner v2z?z2J Adr3ress ?yS . /'LLDO c1`. ?'UZ i LI`L' ?lt-CLCI_qR? ??t'1ZZ???'LY? , Contractor ti!/,'L01/T'iJ , Address 6-) %q,t 'MCic.cF' , Telephone 1-1;jcji-' Telephone 69ff `??SO/ Arch./Enq. Address Telephone OFFICE USE FSeCt V Alter P,epair Ltilarge Move nec:4olish Grade OFFICE USE Cate of Ap roval & Initia2 Assessment [dater/Sewer Police Fire Eng. Planner Lbuncil Hldg. O£f. A.P.C. Occupancy ? Zoninq Fire Zone Type of Const. $ of stories Front Depth (0 FEES Pezmit Surcharge Plan Check SAC .?i^ o-u S>7ater Mnn. ta 3Z? Ldater Meter G+0 TOTAI, ?? -S`? / l l2 ? ?j 6A) ? ? UNE? I I ? 1271 I ,?( ? \ \\ \I ?\? ? ? l? . ? ? LiN? 4,q ?3'7 LoT Black ?Q,?.e','Y'L? ???-??'}"t-E.O ?J?`''L'? • ? ? ? ?on?T',.?ROi?F?TY LIN` -PLO-r" '?P-L AN '???/ ? /a fI 4I . OML+OWNER ??7C,? J?Ci L(?? , ? (???Z? i ADDRESS,/Y 067L) U?xcr?'ZC j HARDWARF, AND APPLIANCE ORDER SHEET Company, , , , , , a , , , Company, , , , , , , , Telephone Number, . p... Telephone Number, Date Cplled, , , , , , , , Date Called, , , , , , RanRe, , , , , , , , , , , neadbolte, , , , . . . 2 3/4 Diahwasher. . , . . . . . Key Locke, , , , . . . _ Food Disposal, , , , , , e Paseage Locka, , , . . 2 3/4 Hood Fan,VentPd or Non VentPd Paeeage Locks, ,... 2 3/8 Washer, , , , , , , , , , , Privacy Locka, , . . . Dryer. . . . . . . . . . . Dummys. . . . . . . , _ Refrigerator, , , , , , , Stope: Hinge, , , . . Color, , , , , , , . . . . Spring, , . , Clothes Chute Hardware Handrail Brackets, , Towel Bara, , , , . . Tiaeue Holders, , , , Tisaue Clampe, , . , Houee Numbera, , . . Style, . . . . . . . . PERMIT City of Eagan Permit Type:Building Permit Number:EA129794 Date Issued:03/13/2015 Permit Category:ePermit Site Address: 4237 Nybro Lane N Lot:011 Block: 003 Addition: Wilderness Run 6th PID:10-84355-03-110 Use: Description: Sub Type:Reroof & Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and house wrap and leave on site. 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. Valuation: 12,000.00 Fee Summary:BL - Base Fee $12K $221.25 0801.4085 Surcharge - Based on Valuation $12K $6.00 9001.2195 $227.25 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 - Michael T Mccarthy 4237 Nybro Lane N Eagan MN 55123--174 Justkyle 3966 Riverton Ave Eagan MN 55122 (651) 230-6016 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA137741 Date Issued:07/20/2016 Permit Category:ePermit Site Address: 4237 Nybro Lane N Lot:011 Block: 003 Addition: Wilderness Run 6th PID:10-84355-03-110 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Scott A Hayes 4237 Nybro Lane N Eagan MN 55123 (612) 703-7054 Holmin Heating & Cooling Llc 3432 Denmark Avenue, #228 Eagan MN 55123 (651) 405-3853 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA138693 Date Issued:09/14/2016 Permit Category:ePermit Site Address: 4237 Nybro Lane N Lot:011 Block: 003 Addition: Wilderness Run 6th PID:10-84355-03-110 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)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Scott A Hayes 4237 Nybro Lane N Eagan MN 55123 (612) 703-7054 Aeshliman Plumbing Inc. 307 Jackson Ave. Suite #4 Elk River MN 55330 (612) 290-8959 Applicant/Permitee: Signature Issued By: Signature