4460 Oak Chase Way
Use BLUE or BLACK Ink
For Office Use
City of Ea a~ I Permit I tQ7
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
; ~.l
Date: Site Address:
Tenant: Suite M
RESIDENT / OWNER Name: -4t'VI n' Phone:
Address/City/Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ?'"vim
t"^' 3 Lr ~ W ~ 1 r~C~ 3e~~
Construction Cost: Multi-Family Building: (Yes No )
CONTRACTOR Name: License
Address: City:
State: Zip: Phone:
Contact: Email:
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 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 (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.
n .
Applicant's Printed Name Applic nt's Signature
Page 1 of 2
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Ybundation _ Fireplace _ Porch (3-Season) Storm Damage
Single Family _ Garage _ Porch (4-Season) ✓Exterior Alteration (Single Family)
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
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION o
Valuation d~ Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) -(K Final / No C.O. Required
Foundation HVAC
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 Wall: _ Footings _ Backfill Final
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
Use BLUE or BLACK Ink
For Office Use
City I
of EIjan I Permit
I Permit Fee. , I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675
Staff: I
Fax: (651) 675-5694 I I
L - - - - - - - - - - - - - - - - J
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
RESIDENT I OWNER Narne Vr_ r. xk Pfiorie k_t 4y'51' E
Address/ City/ Zip: -I q! b O' l, U4k "VAv Z 7
Applicant is: V /Owner Contractor
TYPE OF WORK Description of %work: U've T 6(Ce ~_'?_AghL-QJ 11tV + 0'
"r.) ` eh
Construction Cost: It 3 Mini-Family Building: (Yes / No
CONTRACTOR Name: License
Address: City:
State: Zip: Phone:
Contact: Email:
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 be classified may b as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Cali Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. wwwr.aopherstateonecall.ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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.
x Steve Fa ux IAL
Applicant's Printed Name Applic nfs Signa ure
Page 1 of 2
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace i Porch (3-Season) _ Storm Damage
_ Single Family _ Garage _ Porch (4-Season) ` Exterior Alteration (Single Family)
_ 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
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%_) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
T 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 Wall: Footings _ Backfill _ Final
Meter Size: Radon Control
Erosion Control
Reviewed By: . Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge '
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
Racoipt
?
Permit No.
MECHANICAL PERMIT
CITY OF EAGAN
FJlI in numbered spaces
Type or Print /egib/y
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional 0
9. Work Description: New O Add O Alter ? Repair O
10. Descri be
11.
Type
Faa
5/C
Tot
?k
No, Fn??inmanf BTU - M. Ea.
._..- - -
Forced Air No. Equipment CFM
Ai
H
Mfg. r
andling:
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 Ftn '/?
Inspections: Date Insp. Date ?/f?y ? Insp. ?
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
"aljy??q I/ l0,oo
? S •S??3 ?-c?
CITY OF EAGAN Remarks
Addition Oak Chase Addition #3 Lot 3 aik 2 Parcei 10 53502 030 02
Owner W?-t6'0, street 4460 Oak Chase W3y State Eagan, Mn 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN 5EW TRUNK
EWER LATERAL
WATERMAIN
* WATER LATERAL
* WATER AREA 15
STORM SEW TRK 1 983 lF?6.96 2?.
80
STORM SEW LAT ?
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC 00
PARK
Th,s e4uas o d
18 rtwnths from 14 g5`? ?a l D 4 l g1
A 069550 L3 b6.k
Nequest Dete Fire No. Rou9h-?n Insuection
12-5-84 peQU?red7 ? ?7FeadYMuwQWitlNnti£ylns?ec-
?Yes ? o Lor When fleedy
(j LicMOd Elgctrical Contrector I hereby reqoest inspection of above
? Owner alectricel wark insfelleA ef:
Street Atldress, Boz or Poute No. - CitY
4460 Oakdhase Way E gan
eclion o. TownshiR Name or o. flange No. Covnty
Dakota
Occupnm IPNINTI Phone No.
Walter Hanson 454-4670
Powgi Supplier Address
Electrical ConVector lCampeny Neme) Cnnhactor's License No.
Rossow, INC. 40828 8
Ma'rlinp Addrass ICorttractor or Ownsa Making Installetioo)
P.O. Box 254 Lake Elmo, MN. 55042
Author' S? ture (Contrecmr Owner MakinO Installationl Phone Number
»0-5046
MINNES0TA=57pTE BOARD OF ELECTflICITY THI3 INSPECTION NEQUEST WIIL NOT
aripgs•btidway Bldg. - Hoom N-197 BE ACCEPTED BY THE STATE BOARD
1821 UniverailV ?+?e.. St. Pe.l, MN 66104 UNLE35 PflOGEfl INSPECTION FEE IS
i fQ»1 997?ill ENCLOSED.
11111111ills- ? I(1 5?( j REQUEST FOR ELECTRICAL INSPECTION ye?e•o,?1-/(-N1r?vaj
`'17> ' Sea Inatruetions tor completinoRhla-fwm.on beck of vellow copy.
A npQr;r;n "X" Below Work Covered by This Request
NawlAAtll peo.l Tvoe af Builtlina 1 Aooliencas Wired 1 Equipment Wired ?
ic
p Fee SeruiceEnlreneeSize k Fee Feedara/3ubfeedere N Fee Circui[e
Uto200Am s Oto30Am s Om30Am
Above 2_Am )s 31 to 100 Amps 31 to 100 Amps
Swimmin Pool Above 100-Am s Above 100_Am -
Transformers Irrv tion Booms Partial."Other Fee
Signs I I iSpecialinspection
furnace replac.
$ 16I TOTAL
••°?°' ••• --' I, the EIeCSral
lespeetor, he?eby
Finel ??g ' er!IfV that the nbove
^' spaction hae been
/ ede?I
? m
roQUS6t
. CITY of EAGAN
r
Owner ._WALTER...3?ANS.QN .....................................................
. ne, F.agan
Addrew (presen!) ....2 .01 - 8 S . a . d . e .La .
„ ...........................•-?----•-----............
Sullder .....CYRIL L. DRENTLAW ...................................................................................
,?,,,Shalcooee, MN 55379
Addrau ...Rte,;,.... .. ,r„_,BOx___?I,93A ....
l ............
?^4?T7?
BUILDING PERMIT
1
s iw
N2 4121
3795 Pilo! Knob Road
Eagen, Minnesola 55122
454•8100
Dela .?-7.b ............. _.......
DESCRIPTION
6fo:ies To Be Uced Far Fron! Dep1h Heigh! Eel. Coa!' l Psrmi! Fs Rsmuks
S/F Dwlg & Gar
80'
34'
53,900 146.5
27.0 '
„s/c
LOCATION /7 ?, S ?
Slreel, Aoad or olhes Descripiion of Loealian ? Lo! I 81ock I Addilioa or Tracf
4460 Oak Chase Way
3 1 Z
Oak Chase III Addn.
This permii does not aulhoriae the use of elreels, zoeds, alleys or sidewalke nor doee it give the owner or h[s agant
the righf io creale any siluafion which is a nuisanro or whiah presents a hazard fo the heallh, safelp. eonvenienca and
general welfare !o anpone ixt the commvnity.
THIS PEAMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESB.
Thfs is !o cerlify, !hal...... Cy.riI _..?.:._.Drentlaw......... haspermissioa !o ereet a....... 5/F Dwl? & Gar ......... yP?
.. . _
the above described pre se ubjeci So the provisions of al1 applicabl in es tor iYy of Eagan
_.................. ' -----------.'-"_-'......... 1 Per
?.--.--?-?: -(/- ----.- -?-J .................................................
r ?????''?/ "r??? Buildinp Impsclor
/
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24 C?,
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? ro 24.C. m.
7..4.
1 I? f Q?" J
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a
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I DRA(MAa£ ANO
I UTILIrY EASEMENT
±"--° /OS 0 0---
5 58'44'49" E
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SCALE I "= 40'
ALL BEARINGS ASS UMED
ODfNOTES IRON MONUMENT
L?l
-1J
m ••!dJ i?Et?
OAK 9cto ?
CHASE
WAY In
`- 9G?:22
-
_?-
/ - - -
/ NEpEHY QEqT/FY THAT TM/S SUPYFY, it' AN OR qEPQRT
MAS A4EA4RE0 BY A/E OR (/NDiER MY O/RECT S7/F£RV/S/pV D E s C R i P T/ oN
ANO TNAT I AN A pUL!' REGlST£NED LAND SLVPYEYt7W
f/NQER TNE LAM'S QF TNE S?AT£ Ar M/NNESOTA.
LOT 31 BLOCK 21
DAK CHASF 3& ADD/TloN,
DAKOTA COUNT y,
: oasE /?/ s!S M I N N E s OT A
brendt anginaaring conipany
13301 oliwsr ovaeve iouth, ???'''°•
burnivilla, minntiola 55331 p5-z-77ea
(bIR) 890 -196b
qizI
Date: 10 - i?-?- 7_.Li
BUILDIP?G PEM1IT r,PPLZCA:YON
Lar 7 sLC;.x G?- ADDI^•IO:a W In (L
PARCFL & SECTIOtI NUP1BiR IF UeSPLATTED
ADDRFS3 Gr' PARCEL
v (?
701QIiQG ? OCCUPANCY ? USE?j?
ESTIylNi.'ED COST
G?:niER (a ? ???r S ?c;0 A1 -?77 (\ TELEPTiONE iVO.
ADAP.ESS ?(7 I 71 1 rn AP. I i.IA .h P
coeamRAcTox OUr,? l.. TELErxczm .ao. q 15 -5 ZOy
ADDRESS
Note: Include site plan, building plans, and energy calculations with this
appiication
Signed
OFFICE UuE
VALUI1TIOi5'
SAC
i•kATFR COi2NEC^1IOf7
WATFR bSETGR ?-bb
BDILDING PER14IT FEE
SURCHARGE FEE
PLAtS CF:ECR FES - ??
PARA DEDICATIOSd FEE I b?
OTHER
TOTAL*
APPROVALS:
ASSSSSiHE.*I' CLERK BUILDING DEPT. POLICE DEPT
GSAIER & SL•'FJER DEPT. FIRE DEPT. PARK DEPT
MASTER CARD
LOCATION 4460 OAK CPASE WAY L3 Alk 2 Oak Chase III Addn.
OWNER WAT,TER HANSO*7
STRUCTURE AND S/F Dwlg & Gar
LAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING 4121 10/29/76 Cyril L. Drentlac?
PLUMBING 2) P, 9-L'r?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INS7ALLING
?
SANIiARY SEWER
OTHER I
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING
FOUNDATION SEPTIC
CESSPOOL
FRAMInIG ?j? TILE FIELD FT.
FINAL
ELECTRICAL
HE,4TING DEPTH
OF WELI
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFlELD
PLUMBING ?
WELL
SANITARY SEWER
- Violations Noted
on Batk
COMMENTS:
VILLAGE OF EAGAN vZ - WATER SERVICE PERMIT
3795 Pilot Knob Road j I ✓ _PERMIT NO.:
vi-
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.: 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 Insp.: Total:
Insp.: - - - _ Uate Paid:
Use BLUE or BLACK Ink
~ For Office Use _ 1
I
of !j{jna n Permit
I
City I
1 Permit Fee: 1
1
I
3830 Pilot Knob Road j I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/7/13 Site Address: 4460 Oak Chase Way unit
r..
P Name: Steve Fouts Phone: 651-261-8263
Resident/
Owner Address / City Zip: 4460 Oak Chase Way, Eagan, MN
I
Applicant is: Owner X Contractor
Re-Roof and Re-Paint house
Type of Work Description of work:
X
Construction Cost: $ Multi-Family Building: (Yes _ / No )
Select Evergreen Contact: Jim
Company:
Address: 1200 Centre Point Curve STE 200 City: Mendota Heights
Contractor
State: MN Zip: 55120 Phone: 612-290-5230
License BC20547260 Lead Certificate 22743-1
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 may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One 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.aopherstateonecall.orca
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 be completed within 180
days of permit issuance.
,
x~ : ' L.
Applicants Printed Name A ants Sig ure
Page 1 of 3
CALL BEFORE YOU DIG. Call Oopher State One Cali at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.aooherststeoneceilrorg
REQUIRED, INBPECTIOkS ` .
Mydrostatic'r.' : • Flow Alarm . grain Test ' Rou In
P` TVsf" Central sta#ionital
Con' _ _
:•J' - `.y' y:'..
µ4Vn~.• Of"I
'~iA':' ~J g .4•:e •iT• `.'.'1.• a. rf d.?'~ r:'n .1.,-:4..A„a; ~':~:?:'ri'.":.iJA..e.
317
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.rn`.` ``:i a..~a.tn ~;"a.Y~„ ~d'^H, ...b.wS':'vl^,. ~'£4iv4~rr-sk-:\'~'•n.~~ ..~'.r'":.~h; y'nk a~+:. t a,• t4•ra fi+~ii+...'~%¢:.. s^.t.rw.r.~w.r.. ..u~ {i
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r., :•y~:: fi'- r.r•':R^ ~y._ 4i~*4•~y.r,,:e~'$: k:~,^'.•{ >aw'^ °r' ;i f.
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