4250 Nybro Lane NCITY OF EAGAN
Addition: WILD
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SANSEWTRUNK 1973 161.21 • IJLZ.85 006783 10-3-78
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 162.14 .SD 6-$b 15 140.54 006783 10-3-78
STQRM SEW TRK a1? 1979 281-11 18 ?,Y 4 x 262.37 006783 10-3-78
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LtGHT
WATER CONN. Z$Q.QQ 10667 6-2$-78
BUILDING PER. #4860
sac _7g
PARK ,'(o • y
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122
DATE
RECEI V ED
19
AMOUNT $ I
6 DOLLARS
' oa
? CASH ? CHECK
FOR
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Th You
r
i ? . BY
CITY OF EAGAN
3795 Pilot Knab Raad Ee9an, MN 55122
, PHONE: 454-8100
BUILDING PERMIT ReceiRt #
t--
N! 4860
10667
Site Address Erect 0 Occupancy
Lot Block Sec/5ub. Alter ? Zoning
Parcel # Repoir ? Fire Zone
Enlorge ? Type of Const.
W Name Move ? ?' Stories
Z3 Address Demolish ? Front ft.
b Ci Phone Grode ? Depth ft.
? N Appro vals Fees
0 ame
Assessment Perrnit
?? Address Water & Sew. 5urcharge
Ci Phone k
P
h
Police ec
lan c
It, W Name Fire SAC
v? Address Eng. Water Conn.
`W C? php? Planner Woter Meter
Counti I
I hereby ncknowledge that I have read this opplication ond state that Off
Bldg
the informartion is correct and ngree To comply with oll upplicuble .
.
APC
Totol
State ot Mirtnesate Stotutes and City of Eagnn Ordinances.
Signcture of Permittee • I
`' a. i 1:r7tt.7, Litc.
A Building Permit is issued to: on the express cortdition thct
all work shall be done in accordance with all applicable Stute of Minnesota Statutes and City of Eagan Ordinonces.
Building Official
P.mir # ooa l..ma F.Mnt..
Plumbing ?% 9 3 / 5-
Mechonical j
INSPEGTIONS DATE INSP. Rough-In Finol
Footings Dote Insp, pote Irop,
Foundation ? s s• 7 Plumbir?g
Frome/ins. Mechanicul
Finol
Remorks:
Dote:
CITY OF EAGAN
3795 Pilot Kweb Roed
Eogon, Miwnetofa 55122
Wwne: 464-8100
rLUlv`?irc' - PERMiT
ti/ 1
Site Address:
4250 N. Nybro,
Lot 13 Blxk . Sub/Sec ?',i ider?iess Ri_in 6tn
. _
iiiseri riomes
Name
; Address 627 `'C1Ea.liticJ AV2.
O
City Phone:
nal ph' s E,1 u::ib1ng
Name
.
?
?
Addreu )900 kes;nrick
e
City i. °T .. ; r
., Phone:
This Permit is issued on the express condition that oll work sholl be
Minnesota Statutes and City of Eagan Ordinances.
• . . • . .. ' L ? -
«
..
No. 119
3
Receipt No.: i ' '-i6
Single I „
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair. `
Cost of Insfal?ation _
Permit Fee Z). 00
5urthc rpe ? 5c,
Tota I
done in occordance with oll opplicable Stote of
Buildin9 Offlciol
CITY OF EAGAN
3795 Pllot Knob Road
Eo9en. Mineesofa 55122
Phone: 454-8100
PERMIT No.
Dote: Receipt No.:
' ' Single I
Site Address: ?"'' . ' •'?r" •.°`.??
'
Residentiol "
?. ! i??.
Lot Block Sub/Sec Multi Res., Comm./Ind.
.
C?C^.J
Nome /Re
air
New/Alter
.
p
.
?
Address Cost of Instollction
? _
St. Paul
City Phone: Permlt Fee
?
.
Nome
Surchorge
? : 2C .. . .i. er
? Address
?
0
t?
.. • ' ." _ ' .. J , - F? ,
_:I . .?.
City Phone: Totol
This Permit is issued on the express condition that all work sholl be done in accordance with ol) appiicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3795 Pilot Knob Road
Eagon, MN 55122
Zoning:
Qwner:
Address:
Site Address:
Plum
1 agree to eomply with the City of Eagan
Ordinanees.
R..
SEWER SERVICE PERMIT
PERMIT NO.:
nerr.
No, of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Totui:
Dnte Paid:
Date of Insp.
lnsp.:
-
waTER
CIT1f pF EAGAN
pERMIT NO.:
3745 Pilot Knob Road
Eagon, MN 35722 DATE:
No, of Units:
Zoning: -
pwner:
Address: •
Site Address
Plumber: '
Connection Charge:
Meter No.:
Account Deposit:
Size: Permit Fee:
Reader No.:
1 agree to comply wi4h tfie City a4 Engan
Surcharge:
:
Misc. CFar9es:
Ordinance9.
Total: -
B Date Paid:
Y
lliiDate of Insp.: Insp.:
cirr oF EAc,AN
3793 Pilet Knob Reed Ea9en, MN 55122 N2 4860
.? PHONE: 434-8700
BUILDING PERMIT APPLICATION Receipt .# 10667
To be uma ro. SF D"'9• and Gar. Est. Value 45,000.00 Date 6/22 -, 19 78
Sire Address 4390 'N. Nvbro Lane erecr E9 occupancy I
Lot 13 Black 2 Sec/Sub.?5SJW 6t]Aiter ? Zoning Rl
Parcel # 10 84355 130 02 Repair ? Fire Zone 3
Enlarge ? Type of Const. v
c Name GarY Kedizora Move ? # Stories
? Addre 1975 NoTfolk St. Demolish {] Front 52 k.
o C. ?t. 8U1 Phom 99-1321 Grade ? Depth 24 k.
o Ny?e Tilsen HOmBS II1C. ADP?'°ls Fea?
au5nelling Ave.
?u Addra 627
t _
.
r r:... o?,...e
Name _
Address
I hereby acknowledge that I have read thls application and state that
the information is correct ond agree to comply with all applicable
State of Minnesotc $Mtutes and City of Eogan Ordinances.
Assessment S
Weter & Sew.
Police -
Fire
Eng.
Plonner -
Council _
eldg. Off. _
APG
Permit +4D•vv _
Surcharge 22050
Plan check 500•00
SAC 250.00
Water Conn. 60•00
Woter Meter
Torol 960.50
Signmure of Permittee - I
i sen omes, Inc.
A Building Permit is issued to: on the express mndition thct
cll work shoil be done in ac rdance II ap licable State of Minnesota Statutes and City of Eagan Ordinances
Building Offkial 'L Aau ?,
} BU.7U -I?G?UU
This request void 18 months from
J//g 7
Date of this Request 01-3-1970 4413
I, as $%Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at: 6,8
Street Address or Route No. 4250 TT?bra City ??a-l
Section Township
Range County Dakota
Which is occupied by Tils¢x Honoe
(Name of Occupant)
Is a roughin inspection required on this job? No ? Yes--& Ready Now ? Will Call$
Power Supplier D1.keta Ctr. Address Farning-ton
Electrical Contractor 0-R_ mhn-= Fon rl .tri . Co. Contractor's License No.433.7 35
(COmDany Name)
Mailing Address 12201 Il?tka?Rl v?. , idtka? ?5)43
Authorized Signature Phone No. 933•2521
(Eiectricai Contractor or Owner Making This Inztallatlon)
l`[?? /1 ?i'f2 ??/'? ?D ?''j ????1lJ This inspection request will nat he accepted hy ffie
? I? ?? ?r ?,? ??, ?? State Board unless proper inspection fee is encloud.
Minnesota State Board of Electricity
? 1954'Univetsity AFa., St. Paul, Minn. 55104-Phone 645-7703 87
?' - REQUEST FOR ELECTRICAL INSPECTION ? 4413
CHECK BELOW WORK COVERED BY THIS REQUEST
Type otBuilding New Add. Rep. Check Appliances W'ved For Check Fquipment Wired Foi
Home EK ? ? Range $ Temporary Wiring ?
Duplex ? ? ? WateiHeater ? LightingFix[ures ?
Apt. Bldg.
Commercial Bldg. ?
? ?
? ?
? Dr ?
Fu - Electric Heating
Silo Unloader ?
?
Industrial Bldg. ? ? ? A" ' rt ? e- e Bulk Mtlk Tank ?
parm ? O ? Li ) List
Othec . -___
?
?
? p
}
Here151 p
?
Here15.- - _-
COMPUTE INSPECTION FEE BELOW
Semice Entrance Size: # Fee Feeders&Subfeeders: x Fee Circuits: # Fee
0[0 100 Am s. 0 to 30 Am res 0 to 30 Am eres 10
IOI to 200 Am QC IIG 31 to 100 Ampeies 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Above 100 Amps.
Transformers RemoteConholCirc. Parlialorotherfee
S' ns 5 ciel lnspection Minimum fee y5.
Remazks Ha11 TOTAL FE !? 40, 5
1, the Electrical Inspector, hereby ceyYy??at t}f?'al?ove?inspection has been made.
(Rough-in) Date ? k
(Final) Date _ -7
Ttiis request void 18 months from
RESIDENTIAL BUII.DING
f ?+ l23 Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
a"1"' ? 1 ?'7/03
N¢w Canstruction Reaui2menm RemodeVReoair Reauirements Ofice Use Onlv
3 registered site surveys shmving sq. ft of lot, sq. fl. of house: and all roofed areas "s 2 copies of plan CeR of Survey Recd Y_ N
(20°k maximum lot coverage allowed) ° 1 set ot Energy Calalations for heated additions Tree Pres Ptan Recd _ Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. ? 1 site survey for additions & decks Tree Pres Reqd _ Y_ N
lutofEnergyCalculaUans Addi6on-indicatei(on-s8esepfksystem On-site5epticSystem _Y _N
3 copies of Tree Preserva6on Plan'rf bt platted aker 7/1193
Rim Joist Detail OpUons selection sheet (bldgs with 3 or less unils
Date OF / 1.2 / o.3
Site Address ?IaT lU
?- o b rr l Construction Cost G ("C)
b D Unit/Ste #
us , t .o e, r9
Description of Work U y\?
Multi-Family Bldg _ Y XN Fireplace(s) ? 0 _ 1 _ 2
PraperTy Owner G A r v S ,
?? Z/ p/^ ?9 6S
Telephone #(?'j
Contractor
Address
State .
Zip City
Telep6one # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catesorv 1 Minnesota Rules 7672
Energy Code Category . Residentlal Ventilation 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 pian? _ Y _
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
=stl',' 2S %e? pkhn`
SCP 2 9 2003
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work wil] 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 plan in the case of work which requires a review and
approval of plans.
?f1rS? S, i0 r?* ??? Q/'???
Applicazi's Printed Name ? Applic 's SigKtufel `
OFFICE USE ONLY
Su6 Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
WorkTypes 6r07'E$?r?.s 6_?p3 fJ2/irMar.4 64.
0 30 Accessary Bldg
0 31 Eut. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 31 New / ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 AddiGon ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
)!(, 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolltion (Entlre Bldg) - Give PCA handout to appliwnt
Valuatfon 7 ?l?'17
Census Code _?
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const ?
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
_ Footings(new bldg)
Footings (deck)
? Footings(addidon)
4- Foundation
Drain TIle
Roof Ice & Water Final
? Framing
Fireplace R.I. Air Test Final
? Insularion
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
Plumbing
? HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Reqining Wall
Approved By TZ.. , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
???
L? 3 ? x
?
.4?? '
lp x
l 0 900
q?
lp
Pemut Number
MECcheck Compliance Report checkea By/Date
2000 Minnesota Energy Code
MECcheck Software Version 33 Release Ic
Data filename: C:\Documents and Settings\Chad.PLANCO\Desktop103-462.cck
TITLE: #03-462
COiJNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 09/09/03
PROJECT INFORMATION:
GARY & MARIE KEDZIORA
COMPLIANCE: Passes
Maxunum UA = 96
Your Home = 79
17.7% Better Than Code
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Fiat Ceiling or Scissor Trnss 369 44.0 0.0 10
Wall l: Wood Frame, 16" o.c. 646 19.0 2.0 30
Window 1: Above Grade, Wood Frame, Double Pane with Low-E 79 0330 26
Door 3: Glass 40 0330 13
Fumace L• Forced Hot Air, 90 AFLTE
Proposed and Masimum U-Factor Averages
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0330 0370
Includes Foundation Windows > 5.6 ft2
COMPLIANCE STATEMENT: The proposed building design descrihed here is consistent with the building plans,
specifications, and other calculations submitted with the perndt application. The proposed bailding has been
designed to meet the 2000 Minnesota Energy Code requirements in MECcheck Version 33 Release lc and to
comply with the mandatory requirements I' ed in th?ECcheck Inspection Checklist.
Builder/Designe :-f°?? Date 9-.2 7- 03
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RESIDENTIAL BUII.DING
Permit Apptication
City Of Eagan ?, la •
3830 Pilot Knob Road, Eagan Mn 55122 ?
Telephone # 651-675-5675 FAX # 651-675-5674
New Conslruction Reauiremenp RemodeVReoairReauiremenfs Olfice Use 0nN
3 registered sAe suneys shmvimg sq. ft of lot sq, ft of frouse; and ? roo(ed areas 2 apies of plan _ CeR of Survey Recd
?20% mazimum lot caverage allowed) 1 set of Eneigy CakuWtlons for heatedadditions _Trea Pres Plan Reoi
2 wpies of plan showing beam 8 window sizes; poured found design, etc. 7 site survey for additions & decks _ Tree Pres Not Reqd
1 set of Eneqy Calalations Adddion -indicete ilon-sife sepfic sysfem _ On-site Septic 5ystem
3 copies of Tree preservaGon Plan il lol platted after 7/1193
Rim Joist De6i1 Options selectian sheet (bMgs with 3 ot less unils
P -
03
?3
/'
Date
! / Constructlan Cost
Site Address
? '/
/?/'
?Q U J
?ko f? Q/2 lu?
Unit/Ste #
-E G44 ?"Sl 3
ff d?
/ ?
?
?Q ?
Description o[ Work C.?J
?
i
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Pro
erry Owner (J C(?"t// ?lVa
44-CL, /CCP O(VQ T
l
h
# (t0 ?/
/ 5O? ?? ?`?
p - e
ep
one
)
Contractor
Address l? City
State Zip Telephone # ( T
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEVY BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy COde Category , Residential VentilaGOn Category 1 Worksheet . New Energy Code Worksheet
(J suhmission type) Submitted Su6mitted
• Enetgy Envelope Calculations Su6mitted
licensed Plumber
Telephone #(
Mechanical Contractor
Telephone # (
Sewer/WaterContractor Telephone#'(- )n r- Illi '? . 1
il sEr o 3 zoo"
I hereby apply for a Residential Building Permit and acknowledge that the info ahon is complete and accurate;
that the work will be in conformance with the ordinances and codes of the Ci1F6f-Eagan:and=the-Sta`1e of MN
Statutes; I understand this is not a permit, but only an application for a pernut, and work is not to start without a
permit; that the work will be in accor ce with the approved plan in the case of work which re ' es a review and
approval plans.
z4NZ&_
?
XplicanYs Printed Name / Ap icant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 18-plex O 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior)
,K 44
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) O 45
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46
? 34 ReplaCement ? 'Demolitton (Entire Bldg) • Gfva PCA handout to applicant
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multl Misc.
Siding
Fire Repair
Windows/DOOrs
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 Sprinkiered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool
Ftgs
Air/Gas Tesu
Final
_ Framing _ _
_
_
Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W PeRnit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
.- z
nnTE 41 -- a S- ??'
SUILDIt1G PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of enezgy calculations.
Valuation
To be used for ' _eF, O
site Address:f?15o N. NYbro 1a% c
,3
m?
Lot Block Sec. Sub, Parcel Number /0 JW355 130
Oxmer SCL'e,FY•. 5et??,(f Ct?
Address /R75' x -
?•,t.: y ac o',
Contractox?y/,?.Q.QQ,?ti??c?`1vi ?-t'J ?YI.C? -
AddYes5
Arch./Eng.
Address
/11t'• /
Telephone
Telephone tt) If /
Telephone
OFFICE USE
Erect
Altez _
Repair
Ltilarge
Nbv2
T)er0Iish
Grade
OFFICE USE
Oate of A oroval & Initial
4J '
Gf/
Assessment 4
, 78
Fdater/Sewer -
Police
Fire
Eng.
Planner
Council
Rldg. Off.
A.P.C.
Occupancy ?
Zonin9
Fire Zone 3
Type of Const.
# of Stories
Fronk
Depth
FEES
oU
?
Permit l?.sr ?
Surcharqe 6l3 ?
Plan Check
SAC Sa» "'V
Ptater c:onn. ,250. gd _
t9ater Meter LG . Be
ToTAr. 16 0. sv
Cities Digital
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2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date -.1 I a)q 1 _a?_
Site Street Address aS 0 !V !V Jd}f`0 /.., ll)
Unit #
Property Owner ( 7Q? y QPCA. Telephone #( )
Contractor L?Je-11,Ze
Address L7o/ (exmv,,?er fd City ti'u Telephone#
State-ft-)
Zip 56-421
The Applicant is: _ Owner ontractor _Other
Altera/tions to existing dweliing
?/ Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_ Water Turnaroun?d (?apdd $121.00 if a 5/8" meatetr is required)
_Other: Ynt'CJV`s,v- '+ ?c,?r`V?.yCSO tnn
?o dkkY $ 50.00
Water Softener _ Water Heater
_ replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair P' rebuild $ 30.00
State Surcharge $ 50
Total $ 5() ?
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in ac ord nce with the approved plan in
the event a plan is required to be reviewed and approv d.
L4 vl V? e eyi z,e 1
Applic nYs Printed Name Applic nYs Signature
I
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
? :- City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ?
-? Telephone # 651-675-5675 FAX # 651-675-5694
,C)?
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New ConsW otion ReauiremenLS RemodellRepair Reauiremenfs aYtt.?`tTse4ril?
3 registered site surveys showing sq. ft oF lot, sq. ft. of house; and all roofed areas 2 copies of plan teR of $U!vey ReCd N
(20% mauimum bt ooverage allowed) 1 set of Energy Calculations for h?ted addiGons Trce Pres P? Real
2 copies of plan showirig beam & window sizes; pouied fourid design, etc. 1 site survey for additions & decks tTrce PresRequired : M N
lsetofEnergyCalailations Addfiion-irMicateiton-sitesepticsysfem 09srte3epfioSyefem _„?;X,fy
3 copies of Tree Preservation Plan N lot platted after 717f93
Rim Joist Detail Options selecGon shaet (bldgs wifh 3 or less unAs
Date 03- / l Q l GY Construction Cost
Site Address J7',2 5 d Gl/ JVr) hli'd [!? Unit/Ste #
t?2i1/3`,?lZ
Description of Work
Multi-Family Bldg _ YFyreplace(s) _ 0 ? 1 _ 2
Proper[y Owner ?2 f" V-' ? , { P- 4& 101PK Telep6one # (irl
Contractor (3,jm
Address ?.Z d City ex?pl -,
State Zip S1Y?1 Telephone #,(Clz ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 msota Rules 7672
Energy Code Category , Residential VenUladon Category 1 Wor t ?? Energy Code Worksheet
(Jsubmissiontype) Submitted mitted
. Energy Envelope CalcuMAY 1-,0 2004
Have you previously constructed a building in Eagan with a
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
??'1 Y _
/?
Telephone # (
Telephone #(
Telephone #(
If so, 25% plan review
I hereby apply for a Residential Building Pernut 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 plan in the case of work which requires a review and
approval of plans.
G?-H v
Applicant's Printed Name
l-
A
Applic s Signature
OFFICE USE ONLY
Sub Types t
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ?'33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 08. 04-plex ? 12 12-plex Pmg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
X 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Glve PCA handout to applicant
Valuation Occupancy MCES System -
Census Code 3G?_ Zoning ?-! City Water -
SAC Units '-' Stories -?" Booster Pump -'
# of Units - Sq. Ft. PRV ?
# 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 & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: _
Base Fee v
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
ToWI
Building Inspector
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118860
Date Issued:11/08/2013
Permit Category:ePermit
Site Address: 4250 Nybro Lane N
Lot:013 Block: 002 Addition: Wilderness Run 6th
PID:10-84355-02-130
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Jayme Meyers
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Gary S Kedziora
4250 Nybro Lane N
Eagan MN 55123
Bayport Roofing And Siding Llc
10 South 5th St, Suite 700
Minnepolis MN 55402
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119154
Date Issued:11/18/2013
Permit Category:ePermit
Site Address: 4250 Nybro Lane N
Lot:013 Block: 002 Addition: Wilderness Run 6th
PID:10-84355-02-130
Use:
Description:
Sub Type:Reroof & Siding
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: 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 -
Gary S Kedziora
4250 Nybro Lane N
Eagan MN 55123
Bayport Roofing And Siding Llc
10 South 5th St, Suite 700
Minnepolis MN 55402
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature