4512 Oak Leaf Cir• CASH RECEIPT ?
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
R6CEIVED
FROM
AMOUNT $ (
& DOLLARS
IOD
? CASH ? CHECK
5'r ?
R C7
FUND CODE AMOUNT
1
Thank u .,
`BY
Y
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
cirY oF Er?w?N
?N 8795 Pilot Knob Road 6ogan, MN 55122
PHONEs 454-8100
N2 5196
BUILDING PERMIT .
Te bm used for " Est. Value Receipt #
Dcte " . 19
5ite Address ' `A • Erect 0 Occupancy
Lot Bixk ` Sec/Sub. t,hr- ' ' ° r ?
.-
- Alter 0 Zoning '
T7T ;
Parcel # Repair ? Fire Zone
Enlaroe ? Type of Const,
Name ?- Move p #' Stories
?
qddress "'• Demolish 0 Front ft.
36 -g ,.
..._ .,? --- Grnde n Death = ft.
?o Name • R9dei''a':
o? Addrosa
u ?
?- r;.., w,,,.,e 7?Ae
Name _
Addreu
I hereby acknowledge that I have reod this opplication and state that
the information is correct and agree to comply with oll applicable
Stute of Minnesota Statutes and City of Eagon Ordinances.
Signature of Permittee
Assessment
Woter & Sew.
Police Permit
Surcharfle
Plan check
Fire SNC
Eng.
Planner
Council Water Conn.
Water Meter
Off
Bldg
.
.
APC
Total -
A Building Permit is issued to: on the express rnndition thot
oll work sholl be done in xcordance with nll opplicable State of Minnesota Statutes ond City of Eagan Ordinonces.
Building Officicl
Poeedt # oeh lawd POMIMN
Plumbing 1 a ? fj-/3'7? wQ
Mechanical _79
INSPECTIONS DATE INSP. Rouqh-In Finol
Footings Dote Insp. Dote Inap.
Foundation Plumbing
Frome/ins. -31-77 P Mec.iwnicol ..
Final f 31 'p
i
Remarks:
?_ a (? - 60 1" 4C.O?a,71e? zeel?
Com ?j r k Or-% I pC k•
??x411yo
CITY OF EAGAN
3795 Pilot Knob Road
Eagon, Minneaota 55142
Phone: 464-8100
PERMIT
Date: 7- 9-79
4512 oak leaf an-a.e
Site Address:
Lor ? Block 1 Sub/Sec.
C'hes Mar 4th
Name ? a1 L. Wd#ixSLt
°s Address ` J ZI ?M Anui-, SCA`il
3
O : oli-
City _ Phone:
Name ' Lastirigs He8t1I-r,;
.
?
ddress i. . )9(1 {7 Tp s_`C`? rr1O'?? 4.7-, a _
City Phone:
This Permit is issued on the express condition thot ofl work sholl be
Minnesoto Stotutes and City of Eagon Ordinonces.
aa?"Y'rQa rM F=
No. 1491
Receipt No.: M 30
Single I
Residential
Multi Res., Comm./Ind. I
New/Alter./Repoir. Cost of Installation
Permit Fee ??.00
Surchurge .Sf)
Toio I `_'o.so
?
done in accordance with all applicable State of
Building Officiol
?,,,,?- ...-, . -' f-^'.c^_.^rr.,F,•'r'°,AFY9?::ta•a?s;r•= 'a.?
PLUMBING PERMIT CITY OF EAGAN
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122
PRICE PHONE 4548100
Site
? Name
? "
Address c' Z-z " 0
? City -? J, ?_,•.? ? Phone
Name
? Addl'eSS
? City ?='d`'-'?'?•-`? Phone_
FEES
COMMJIND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
FOR:
For
PERMIT #
WORK DESCRIPTIQN
Res. ? New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $9.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
UrinaVBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM -1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
e U. G. Sprinkler System - $12.00 ?
PERMIT FEE:
STATES SIC: . -SJ
? .a... GRAND TOTAL: SJ
? CITY OF EAGAN
3795 Pilot Kno6 Rood
Ea9an, Minna:ota 55122
Phone: 454-8100
PERMIT
Date:
6- 1-?--79
Site Address:
4512 oek lAbaf c3.rrle
(--rw--s '4Sl' 4t}1
Lot Block Sub/Sec, _-
Receipt No.:
Single
Residential
No. 1382
14 ?L'
I X
Name 1hIc1tsQ1 BUIC. 4 PE'?{LX3E'l1.ng t?:
New/Alter./Repair
? 6511 Log.?i AV!?. ??o.
3 Address Cost of Instollation
O
City R?ls Phone: ?69-c"132 Permit Fee 20•()G
??+rtael M?edhariral
Name Surchorge ` -
?
Address ?0 KMWbec `ve
g ?
a
0
20. G 0
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordante with all opplicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN'
3830 Pilot Knob Road
Eagan; Minnesota 55123
(612) 681-4675
SITE ADDRESS:
I' i ' ?1ii'f ( ! 11f
? }11 ', f4f11Y ?1 I 11
PERMIT SUBTYPE:
i.t, ;
INSPECTION RECORD
` PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
[k i , ??lil'• I iIJi ? I(?P)
TYPE OF WORK:
lif I I
FS111 1 F? I 1?1(i
0.':t?i
Nf;/7.A/4n
F
?
L
Permft No. Permlt Holder Dste Telephone N
S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Data tnsp. Commerns
Footfngs 1
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orset TeSt
Flnal Plbg- Plbg. Inspector - Nolily Plumber
Const. Meter
EngrJPlan
Bltlg. Final
Deck Ftg.
Deck Final
O ?
w6ll
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ''' F "' t"6
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 -
SITE ADDRESS: APPLICANT:
4?I **" nAK I.EAr r_ rR F°rRPr rt7II! rr?paVe tNc
f.11f.S NAR 41H . (??•1?i 53:3-,?561
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION . ..
?
?
? ? . . ? - '. ? . .. - . . . . , ?
Pertnft No. Permit Hulder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inapection Date Insp. Comments
FOOTWGS
FOUND
FRAMING
R04FING
ROUGH
PLUMBING
PLBG
AIR 7EST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE 'p[/• '^J' ? ?
AIFiTEST FIREPLACE
?? 1?
pL?
FINAL PLBG
FINAL MTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAI
OLCK FTG
DECK FINAL
1 - - - - -- - --
Y OF
5 Pilot Knob Rood PERMIT NO.:
m, MN 55122 DATE:
ng' _ No. of Units: _
er:
'ess: -
Address:
?-_
ber: _
' ''• ?. 00 Fsc3
ee to eompty with the City of Eagon Connection Chorge• ix2
of Insp.:
Accounf Deposit: _
Permit Fee:
Surchorge:
Misc. Charges: _
Total:
Date Poid:
arr oF WATER SERVECE PE1tMIT
3795 Pilot Kneb Road PERMIT NO.:
Eogan, MN 55122 DATE:
Zoning: No. of Units:
Owner; • ,.' .
~
Address:
'.Site Address: _ , . +, `•?+? * ?• j yrL ? ,
Plumber:
Meter No,: Conn
Size: Acco
Reader No.; Perm
g
I agree to eomply wilh the City of Eagan Surch ii
Ordinanaes. Mist.
Total
BY
D Date
ote of Insp.:
I nsp..
cirr oF eacaN
-!. 8795 Pilae Keob Rmd Fagan, MN 55121 NO. 5196
' PHONE: 454-8100
14100
BUILDING PERMIT APPLICATION $65
000 Receipt _
.
,
To be usad for SF Dwlg. Est
Value Date May 7+ )y 79
.
Site Address 4512 Oak Leaf Cr. Erect [,k Occupancy R 3
Lor 1 810 k 1 5 s Ches Mar 4th
T=
lft qlter ? zon+ny Rl _
3
Parcel # O Repair ? Fire Zone
Enlorge ? TYPe of Const. V
rc Nome V81 L Wet50n Move ? #Stories
z
;
Address 6511 Logan Ave S. oemolish ? Frant 46 n.
? 69-8132
MP g Grode ? pepth 37 N.
Ci Phone
e....?...d. Fees
a Name W,atsea Ula & Ree4edeling
?? qddresy Same Addrecc
? r.... Same oti.,.,e Same _
Name _
Address
I hereby ackrwwledge that I have read this application und state that
the information is correct ond agree to comply with oll upplicable
State of Minnesota Statutp$ and Ctityna(Epga^ O,rtlinances.
Signature of Pormittee ?-11 1 1 s-?-7! '-
A Building Permif is issued?,?1??/? V8 L W8t50n
all xrork shall be done in?Tdpnce wjfh 94 applioq6le-5l4(e-QJ-A4iY
Assessment _
Water 8 Sew.
Polite -
Fire
Eng.
Planner _
Countil _
Bidg. Off. -
APC -
Permit 32.50
Surchurge
0
Plan check 81.0
sAC 525.00
Water Conn. 270.00
Water Meter 60.00
Totoi 1205.50
on the axpress condition tFwt
Statutes and Clty of Eagan Ordirwncez
Building Officiul
This request void 18 months from
P 63598
Date of this Request 7"/F - 2 9 -I, as.f0'Licensed Electrical Contractor OOwner, do heceby request inspection of the above electri-
cal wiring installed at: L l 431 C-M 4-t-h
Stree[ Address or Route No. y?/? 04kLt'.4F City_"?
Section
Range County t?A.tv sr_ yL_
Which is occupied by VA1. W.a 4 J'a h
? (Name of Oc<upant)
Is a roughin inspection required on this job? No ? Yes 05" Ready Now O Will Call LLY
Power Supplier 04 k? ]?.4 E,4L9 C:„ Address ?N ha rT 4k1Y?/66-
Electrical Contractor v"-'?M ? Contractor's License No7??7
(COm{lany Name) ^ r_N ?
Mailing Address
Authorized Signature
(Electrlcal Contmttor or Ow
e'319??E WAlldD CyOPY
xo.4? 7-3n?
This iiupecdon request will not 6e:aceepted hy the
State Board unless.proper inspectian fee is enclosed.
mmnesota state tsoara ot tiectnciry
9954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
40F.'EQUEST FOR ELECTRICAL INSPECTION
CHE(:K BELOW WORK COVERED BY THIS REQUEST
/ "!5 a y sl
P 63598
Ty of 8uilding New Add. Rep. Check Appliances Wired Foi Check Fquipment Wved For
Homc ? ? Range ? Temporazy W'ving ?
Duplex ? ? ? Waler Heater ? Lighting Fixtuies ak?
Apt. Bldg. ? ? ? Dryex ? Elecuic Heating ?
Commercial Bldg. ? ? 13 Fumace fg SJo Unloadex ?
Industrial Bldg. ? ? 1:1 Air Con
ditiongr ? Bulk Milk Tank ?
Fa[m )
fn
?
? Jis?ic-NS
C
Other ? ? ? /
-?
pthers}/
Iiere 1 . thers?
ere f
COMPUTE INSPECTION FEE BELOW
Service Ennanre Size: # Fee Pceders&Sub[eeders: # Fee C'vcuits: u Fce
0[0 100 Am s. 0 to 30 Am eres 0 ta 30 Am exes
101 m 200 Am s. 1 31 t Am s 31 to 100 Am exes
Above 200 Amps. 1 Abo s Above 100 Amps.
Ttanaformers
Signs
Remazks 11 Rem ron
11 Spec lnsgMionilb Pai[ialorotherfee
Minimum fee 55.00
TOTAL FEE ,SO
I, the Electrical Inspector, hereby certify that the above inspection has been m e.
(Rough-in) 7/7 Date (Final) Date?j_
This request void 18 months from '
M' Y,t:?(A.:?t:?k'd;:k::;::;:?(:'K'?fi?`16'ii$iNJt:l?:%?>Y>'rv'?/..•!,t?XY,<:1?.($<X(H:.'?'";;?h(in74;,n'h,.
C.C 9'V i]:' I :f-'d=AN
i:;AEiF'I:L!i'P't;, J`:n 7lii:!{t1lNAl_ Nil,^, 37
D"iTE!t 08/20/97 TTMii u 1&5005
:(%
rar.u::::, AL!_t:=r r-,:Rr.S-DE iiar:
::300 9001 450 i?rl: L.EAr 50.00
205 `}UrN. 45:I.c'. OAF. i...l:W- 0.50
..4
To?: ?,: ? ?f....?.-,.. v_._i:> ??:?.f:: r..
i?r,?: .?a.5n
?:';:C??3CIf.irl6
,,.,,...
"F. :f.Di :?elia
t_...?-.
Y.:'1„m'X?{%F.(•?#i4::k?F?FW'l,<k'.?:.Ww:;.:r. >>.y,.???:>n;Y.).lA"YFPF.
41 y
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BuzLoirvG
Permit Number: 0 3 0 6 6 0
Date Issued: 0 8/ 2 0 J 9 7
SITE ADDRESS:
p.I.N.: 10-17103-010-01
DESCRIPTION:
4512 OAK LEAF CIR
LOT: 1 BLOCK: 1
CHES MAR 4TH
(CrAS IN3ERT ONLY)
9iai1ding;-,,?ermit Type FIREPLACE
guxlding W6.r.,k Type NEW
Ce:nsus Cqde. '434 ALT. RESIDENTIAL
?
?
r??F ?2,?) ?L?;(
??
? .
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$50.00
$50.50
CONTRACTOR: - Applicant - sT. Lzc OWNER:
FIRESIDE CORNER INC 16332561 2009091 SNIDER JOHN
?700 N FAIRVIEW AVE 4512 OAK LEAF CIR
ROSEVILLE MN 55113-0847 EAGAN MN 55123
y(612) 633-2561 (612)452-7719
Z h'ereESy akckn3swle:dga that,T? have iread.this ?PR1=?.catlan and stat? thpt,ths?e
information is correct 'and agree to comply wi.tli a11 applica6?:e State of Mn.
Stiatutes and_City of Eagan ord4-•nanoee?
, s <
L r A; J
APPLIGANTlPERMITEE SIGNATURE ISSUED 'n: SI ? TUR ? ?
? CITY OF EAGAN / ,
3830 PILOT KNOB RD - 55122 r
1997 FIItEPLACE PERMIT APPLICATION
681-4675
DATE: PERMIT FEE: 50 0
DESCRIPTION OF WORK: _ CONSTRUCT UH FIREPLACE _ A.LTERATIONS TO EXISTING
X, INSTALL GAS INSERT ONLY
INSTALL GAS LINE ONLY
OTfER:
STREET ADDRESS:
4,6-1z
0 AIc/-j LCA1? Ldreec.?
LOT BLOCK SUBD./P.I.D.
APPLICANT: (circle one only) OWNER CONTRACTOR
I hereby acknowledge that I have read this application and state that the information is conect and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY
OWNER
Name: M I i?)E`2 z? ? 'UIEC1£$(f Phone #: 'YCZ' ^ 771?
Signature:
Street Address: 45(Z b A iLLs?I ? (Zi12-
City: &-"/T43 State: Zip:
FII2EPLACE
INSTALLER
Company:
'?- 633 ?2 ?'6 /
#: 990 -07.5 8
Signature:
Street Address: 3B 67?- CU -/%L?/? j3 License #: 2-00 City :b`V-O Q--\/l State: O'l.V zip: S `? 33 Z
GAS LINE
INSTALLER
Company:
Name:
Signature:
Street A
City:
Phone #:
.,....,,. ?.Y.
t?
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 14 Fireplace
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition o 34 Repa'v
GENERAL INFORMATION
Census Code. 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
?ICITTO'F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMITTYPE: Buz?ozNc
PermiiNumber: 023856
Date Issued: @ 6/ 14 / 9 4
SITE ADDRESS:
P.I.N.: 10-17103-010-01
4512 OAK LEAF CIR
LOT: 1 BLOCK: 1
CHES MAR 4TH
DESCRIPTION:
B-uilding P`ermit Type pECK
Building Wo,r-k Type NEW
.'
l
1
?
?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search
Total Fee
$30.00
$.50
Fee $5.00
$35.50
CONTRACTOR: - ,qpplicant - ST. LxC. OWNER:
P K CONSTRUCTION 12573926 0008800 P K CONSTRUCTION
15875 260TH ST 15875 2607H ST
LINDSTROM MN 55045 LINDSTROM MN 55045
(612) 257-3926 (612)257-3926
I hereby acknowledge that 2 have read this
information is correct and agree to comply
L Statutes and City of Eagan Ordinances.
.
APPLICANT/PERMITEE SIGNATURE
applicatiorr and state that the
with all applicable State afi Mn.
?
ISSU D BY: S UFE
J
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
LOT: 1 BLOCK: 1
4512 OAK LEAF CIR P K CONSTRUCTION
CHES MAR 4TH (612) 257-3926
PERMIT SUBTYPE: TYPE OF WORK:
DECK
F-
L
? P
r_
NEW
BUILDING
023856
06/14(94
1
`J `' ??9?
i .?
?
?
a,3 ? 5
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
/
3? s a
('?" ? ;'?,•
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site sur
11AIWIVIE10e g
L
calcs. 6
1994
COMMERCIAL 2 sets of architectural & structural p t of
specifications, 1 copy of energy calcs -
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date -.94W / 6' Valuation of work 0 6
Site Address:
STREET SIIITE q
Tenant Name: (commercial only)
LOT ? BLOCK ?
, /16
FD. Y
P.I.D. #
Descri tion of work: C.,sl.-.<?,•ar o-c- AZ•= d«Z
The applicant is: ? Owner ?Contractor ? Other (Describe)
Name 5?1 i dr, AhjtidH y Phone ysq -7-??i9
Property LAST FIRST
Owner pddress _ 5,S/_-2 Cx? A-o I
STREET STE #
City 6-a-g ah Stdte Zjp Ss10t3
Company Phone d25;1- 39,?o/
3?
Contractor Address 15_,?'75- pd", 44 ? License #0°'Mop Ealp
?
?
City state Z9p s's? `lS
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
El 01 Foundation O 06 Duplex ? il Apt./Lodging
? 02 Sf Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. In 15 Deck
WORK TYPE
El 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
? Site
O Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
b Footing
ID Final
L • ?
? 16 Basement Finish
? 17 Swim Pool
0 18 Comm./Ind.
O 19 Comm./Ind. Misc.
? 20 Public Facility
O 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster PumP
Fire Sprinkler
Census Code ?i? <i
SAC Code .?.-
Census Bldg ,
Census Unit o
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
?
vatues;m: $
SpC %
5AC Units
4
M
?,? ' . . • . F?l . i ?E? _ ?'! .,(t ?
CERTIFICATE OF aURVEY
". .. _ , __? . _.. _ ... . _.. ,._.._ .,.?.
f
T '
1
. .? . . . . /.., ?y J
N 99°1048? E - 90.01'
, x? . . , .,. .... ., .. . . ?- ?y}? .... O . . . . .r '?' .
? ? ? ? . • I PRAINAOE AND
I UTILITY 9AS€MENT
LOT i
BLOCK I.
N ' PROpOSED
aOrO I A710N
is I R?P0SFD 27, ci
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s a9o 47? 20,w - 90.00 ' Cb
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. OAK o?b II;?AF ?e•z CIRC?E
,
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S}oRt1an0 eharn pre e4
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; bereliy o4rt?i#Y t#et tfiig i$ r oorlrjq?t rPPFAaentetion of a aprFnY PfE
IAO;i.' .4o4 1o Chem 1AW 6ourth'4dditlon. Dakota, qotwtqR Y4m44P*p ° '.???'?•;"
Pp4?grO?p6 to the P}&t thereot Q?,:Filo and of reoordt
; aad ?h4t :? ?a? 4 dwly reg?aterad land,eurveyor unda; t?ie ]Rlre 0?' th4 ?atq 9P,1(tu"4404?j
y
, .? . .
DikteA 04 23;d dAy of Ypsahl 1979 Cena Le JROObg. ?Ani4r aogr 499;:97#}! •? :u;??p
' " ,..,_ . . _.:... ?..,...._. . ,... ,. _ ... . ... _..,-__...; .., -._
p?trQY @v:: SCALF - 1" = 40' o DENOTES IRON MON. sEARINGS AR? AS§4JMFp'QATldb4„,
?ap?? tar ? GFNV,
vat fttsoa rt?ANR SORYEY
`'; ? ?1.?aoa ???id#?a a Ramoavi?as ° • Y ; ? , ?? ???
' 1 5 C i 3? s t L l
8¢T! 77 . '. (??[cv I
Yt ? r. "q1 ?? tq' ??F Oc ry? A'?f $Q{It?8
l '. P'r2IL7j .?s?
fh?? .-' F ? € ^ si • ' Fl#?I!AN?+S1?i ? R 1?i 6¢!2 ,`s€°_ , ? ` ,'?
.I1?4_ "w;?i?
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DATE
?
SL'Ii.DItiG PERMIC ?3°LICA'CSO::
Include '_ sets of plar.s, 1 site plan w/elevations and t set of en??}• caicua[ions.
To be used for Valuation?
alt'?Gus ?Fam??y R?s?a?E -
Site Addrzss:
Lot ? Block q Sec.!Sub. Parcel Suc6er
i C41E;S IiRRR. r- -ADAp
own
zr tJ?L o U.??'bt?1
naaress
mp?g ? ?s?a3
Telephone
Contractor WpM?N ?tI,II(Jll?IC-?W_PlIY:AVLiNC^a Telephane
aaate55 Cdo`tl i1?AN A.i?E P Sp frlPts 5S4?
Arch/Eng. KXV}?Ng Telephcne _
Address 400 Wa VESL?fk-
OFFICE L'SE ONI.Y
Erect Y
Al:er
Repair
Enlarge
:Sove
Demolish
Grade
Date of ?.O rov a d Initial
As s
sessment ?
Water/Sewer
Yolice
. Fire
Enginear
Planner
councii
g. _ ,.
Bld
C.
Occupancy _?p,• 3
Zoning
Fire Zene
Type of ConsL
4 of Stories / Ii viAP P L+ a?d?9 e
Front -46
Depth .2 :z
Fees 00
Permit ?fra-
/
Surcharge 3 Z
?
P1an Check Q j
SAC ?-
i
Water Connection Z 7?2?
Water Meter
75
?
,'.• _ _.. _ .. _._.j?a?; 5-?- --
? CERTIFICATE OF SURVEY
r • N 89010'48"E - 90.01'
in O
----75
? DRAINAGE AND
? UTILITY EASEMENT ?
? f
I LOT I ?
? BLOCK I. I -
? N
a
PROPOSED i a
?
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a 0
LOCATION
I
, 0°j ra.s' I ?R?
0
27' ? o w
3 I PROP
pSf?
rvn
411
GAR. 114OVSE c
N I
N IO I
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0
z 5
g
..F? I
-- - ? -.
9?+ 99 C
. :
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S
S 890 47' 26?W- 90.00, 9
OAK 06°' LEAF 00'? CIRCLE
Elevntions shown are axiating grades aad are sasumed datum.
I heraby oertiFy that thia is a corract representation of a aurvey of:
i.ot I. Blook 1. Ches Uar Fwrth Additioa, Dakota County, Y3aneaota,
acaording to the plat thereof on file and of record.
aad that I am a duly regiatered land aurveyor undar the lawa of the State of }Einnesota.
Re
No
7734
Dated this 23
d d
ob
ltinn
of M
h
1979 G
J
L
.
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g.
ay
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src
,
ew
.
DR, BY BL SCALE - I" = 40' o DENOTES IRON MON, BEARINGS ARE ASSUMED DATUM
Prepared for: GENE L. JACOBSON
val wataon LAND SURVEYORS
Wateon Building k Remodeling
6511 Logan Ave. South LQKEVILLE, MN 55044
Minnespo2le, Ht+ 65423
PHONE 469- 4328
?
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Requiremenis
3 ra3istered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum bt coverage allowed)
1 Soils Repod if proposed 6uilding is to be placed on disfurbed soil
2 copies of plan showing heam d window sizes; poured fiund desigq etc.
1 setof Energy Calculadons
3 cope,s oi Tree Preservation Plan if lot platted aftet 711193
Rim Joist Detail Opllons selection sheet (buildings wtlh 3 or less uni4s)
Minnegasco mechanical ven6lalion form
RemodeUf2eDair Reuuiremenis
2 copies of plan showing footings, beams, joisis
1 set of Energy Calculations for heated addNOns
1 site survey for additions & decks
Addbon - indicate if on-siie sepOc system
99, o?
Officellse-.Onlv
Cert oiSurveyIRecd -_Y N
SotlsReport .:, Y _N
TreePreS.PlaiiReM _Y _N,
TrcePresRequired _Y _N
On-Site Sephc:System -_Y ? N
Plans are considered public information unless ou state the are trade secret and the reason.
Date 5 ? 3 I ? b'] 0.DO
Construction Cost Ot-D
Site Address P
UniUSte #
tY?
De ription of Work
F/3Z ? 6u
Ov? S in? . Y- t eACx ?
Gv/ .t U-l,.. ?jr.? ' wo NernJ/M.C.. 1 Iz2?oC.+ee?L ,([k??`-
Multi-Fami1 Bldg Y? N ? Fireplace(s) k1 0 _ I Z
M; s e L's 6aSU.aLC am=
Property Owner ? D/?-'? Y/eReSR S,(,J Telephoue #(6S/ )yS- Z ` 19
Contractor 1J"k1 S C.ON(/IAG??1
Address Wi( Z 6) I y )eu P• City/3(. ?v??NC7nr-?
Sta[e A vV rJ , Zip Telephone #(73Z
? 6IZ- ? s o- 0 5's? c{ < c
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
(q submission type) Submitted Submitted
• Energy Envelope Calculations Submitted In the lost 12 months, has the City of Eagan issued a permit for a similar plan based on a master plaqy- ' [E
??L2?7 ???q p
_ Y _ N If yes, date and address of master plan: ??
Licensed Plumber
Mechanical Contractor
Sewer/Wpter Contractor
apply for a Residential
Telephone #( ) JVIAY 3 o 2007
Telephone #( )
ielephone #(
and acknowledge that the information is
accurat
that the work will be in conformance with the ordinances and codes of tfie City of Eagan and the State o2 MN
Statutes; T understand this is not a permit, hut 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 wark which requires a review and
approval ofplans.
76-;? rJngS-S
ApplicanYs Printed ame
< r6? ?
Apphc t's Si ature
A
DO NOT WRITE BELOW THIS LINE .,
Sub Tvpes
? Ot FoundaYion ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fiteplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex G 25 Miscetlaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 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) - Give PCA M1andout to appliwnt
DBSCfIptlOfl: WaterDamage_ Yes .
Valuation Occupancy MCES System
Plan Review _ 100% or _ 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQITIRED TNSPECTIONS
_ Foorings(new bldg) _ Sheetrock
_ Footings(deck) _ FinaUC.O.
_ Footings (addition) _ FinaUNo C.O.
Foundation HVAC
Drain Tile Other -
Roof _ Ice & Water Final Pool Ftgs Air/Gas Tests Final
_ Framing _
_
_ Siding _ Stucw Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Fina] _ Windows
_ InsulaUOn _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
c_ ..
2007 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos whenpermits are required for each unit
SC S0
Date -5?- / ? / -g-2
SiteAddress OA k zC4F ?9-r "l' lLCUnitti
p Iq s A?1 ,sS?a-?
Property Owner JT/y/O /?? ?N ? /? ? ?C Telephone # ( )
Contractor I GA L
Ir7Z /3/21-)Ok -,? Cit
UAoo?-Gy^l/-4o2k
y
StreetAddress
State /?'1^f Zip 5 5 yy-5- Telephone#
? Bond N: L /0 ? fl 0 Expires: `-0 ?
The Applicant is _ Owner ?Contractor _ Other
Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to exisYing dwelling unit $ 50.00
furnace ?Additional _Replacement ? New
air exchanger
air conditioner
heat pump
p41? P /''! k E(.?,1° ??/2 Gt ti' T ?D o c
? A
other
? (le /'T a D
State Surcharge $ .50
Total $
I hereby apply for a Residenfial Mechanieal Permit and acknowledge that Che information is complete and accurate; that the work will
be in conformance with the oxdinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a permit; thaf the work will be in accordance with [he
approved plan in the case of work which requires a review and approval of plans. 0,,- -
Applicant's Printed Name Applicant's Signature
2007 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pitot Knob Road, Eagan NIlV 55122
Telephone # 651-675-5675
Please completc for: commerciallndustrial buildings
multi-family buildings when se arate ermiu are not re uired for each dwellin unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owoer Telephone 1t ( )
Contractor I
Street Address City
State Zip Telephone # ( - )
Bond#: Expires:
The Appficant is _ Owner _ Contractor _ Other -
Work Type
New Conshuc6on _Interior [mprovement _Install Piping _ Processed _Gas _Exterior HVAC Unit*"
HV AC uniTS must be screened
UndedA6ove ground Tank Install Remove -
When installing/removing tank(s), call for inspection by Fire Mazshal and Plumbing lnspector
Nature of Work:
Permit Fees $70.50 Underground tank installation/removal '
550.50 Minimunr (includes State Surcharge)
or
Con[ract Value $ x 1% _ $ Pennit Fee
$ State Surcharge
. To calculatesurcharge
If Permit Fee is less than $1,000, surcharge is 50 cents.
- If Permit Fee is >$1,ODQ surcharge increases by $.50
for each $1,000 Permi[ Fee (i.e. a$1,001-$2,000 Permit
Fee requires a $1.00 surcharge).
$ Total Fee
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinarices and
codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is no[ a permit, but only an application for a permit,
and work is not to start withou[ a permit; that the work will be in accordance with the approved plan in the case o£ wark which
requues a review and appxoval of plans.
ApplicanYS Printed Name ------------------------- --------- --------- ----- --------- ----------------'--'
Appioved By: , Inspector
ApplicanYs Signature
Required Inspections _ U.G. - R.I. - Air Test - Gas Service Test - Infloor Heat - Final
Z0)V3-L
peomin Ta c ftIi; e / b4 -,e
/1/- rno/e�%�
CSsiyin te.o'`
11
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVr`
JAN 112.016
Use BLUE or BLACK Ink
For Office Used
Permit #: J $Li 19
Permit Fee:(QO . 00
Date Received: l '-11 1 1.0
`1
Staff: J
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION /
Date: .- l fQ Site Address: t O
t.
Tenant:
\
Suite #:
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) R , O O
TOTAL FEES $ (DO
Name: L' / - Phone: �e�/�J
Address / City / Zip45 r �(, j� C,1 4A/44/10
Narne: Milbert Company Inc dba Culligan Water `! WC6413 76
License #:
Address: 1J301 50th St East
Mn 55077 Phone: 651-451-2241
City: Inver Grove Hgts. ,
State: Zip:
Contact: William R Milbert
Email:
New Replacement _ Repair _ Rebuild
Description of work:
RESIDENTIAL
Water Heater
_ Lawn Irrigation (_ RPZ / PVB)
_ Septic System
New
Abandonment
_ Modify Space _Work in R.O.W.
4,Water Softener
Add Plumbing Fixtures Main / _Lower Level)
Water Turnaround
CALL BEFORE YOU DIG. Call Gopher State One Call 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.00pherstateonecall.orq
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 perinI;; that the work will be in
accor ance h the approv d plan inthe case of workyvhich requires a review and app al of plans
Applicant's Printed Arne
FOR OF
uired
Me_ erl-Related
A Ar 1
Applicant's Signature
!"
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166835
Date Issued:02/09/2021
Permit Category:ePermit
Site Address: 4512 Oak Leaf Cir
Lot:1 Block: 1 Addition: Ches Mar 4th
PID:10-17103-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Rachel Gaudreau
4512 Oak Leaf Cir
Eagan MN 55123
(952) 381-4561
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature