4518 Oak Leaf CirCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
oare
RECEIYED
19
AMOUNT $ I
6 DOLLARS
too
? CASH ? CHECK
FOF
White-Payers Copy
Yellow-Posting CopV
Pink-File Copy
T nk You
BY
? .
c >3
BUILDING PERAAIT
Tn 1s u"d in, ?
Site Address . -
Lot Btock
Porcel #
CITY OF EAGAN
8795 Pibt Knob Rooa Eogaw, MN 35122
PHONE: 454-8100
Receipt # -
Fat Vnhw . DnM .
Sec/Sub. Mc31" d
oe Name
W
Z AddrESS
?
I hereby acknowledge thot I hrne rend this
the information is wrrect ond agree to c
Stote of Minnesata Stotutes and City of
Signoturo of Permittee
A Building Permit is issued to:
cll work shull be done in ¢ccordance with'2
Buildinfl Official A • ' ? E??
ond state that
all opplicoble
N° 4892
//<<' t-
Erect ? Occuponcy -
Alter ? Zoning
Repair ? Fire Zone -
Enlorge ? Type of Const.
Move O # Stories
Demolish ? Front ff.
Grode ? Depth ft.
ADDrO ralf Fees
Assessment , :- Pertmit -
Water & Sew. Surcharge
Police Plan check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Counci I
Bldg
Off.
.
APC Total ?
on the express condition that
applicoble Stote of Minnesota Statutes and City of Eagon Ordinances.
hmk g Oeh hned PMwMtN
Plumbing a? -)-$'-]& L
%
Mechanical 730S -,2 `7? fdcu&&L
'
INSPECTtONS DATE INSP. Rouph-In Find
Footings Oote Irap. Date Irap.
Four?dotion Plum6inq
Frome/ins. _7 Mechonitol
Final c 42-
Remarks:
a_???,-?
?!rr«t're'
C/9
cirY oF EAGAN
3795 Pilot Knob Roed
Eagan, AAlnnmsofa 55122
: Phowe: 454-8100
PERMtT
Dote:
?-29-78
Site Address: 4518 Oak Leaf Circle I
Lot Blxk I SublSec. _ ':?
Combustion Air Required
No.
1308
17??F
Receipt No.:
Single
Residential ?
Multf Res., Comm./Ind. I
Nome -`Ollefson Bt?ilr?-•?':? New/Alter./Repair ?70T'
.
; Address 13815 Holyok;-: Cost of Instollcrtion
O
City Ispp. le Va11e5' Phone: 454-C,,%' % 3 Permit Fee 20. 00
Narne F`rederickson Heatiny Suroherfle .50
.
• 'au D' Rue Drive
ddress
0
v ;5122 ?
City Phone: Total '
This Permit is issued on the express condition thot all work shall be done in accordance with all applicable State of
Minnesoto Stotutes ond City of Eogan Ordinances.
Building Offitiol
cinr oF EAG?N
* 3795 Pilot K"b Roed
Eagan, Minwssote 55122
P6one: 454-8700
PLU^1BING _ PERMIT
Date:
9-28-78
Site Address: `'-'Z8 i)ak Leaf Circle
Lot ? Block I Sub/Sec. 4
Name I , 1C'rS0?7 ?1111_i(?T?
a Address '816 1131yoke
,.>ple Valley
City Phone:
Na ??enz/Ryan Piumbint;
?
i . 745 So. Robert Trail
Address
City Phone:
This Permit is issued on the express condition that oll work sholl be
Minnesota Statutes ond City of Eogon Ordinances.
No. 44*IZZ7
Receipt No.: -
Sirple I
Residential X
Multi Ret., Comm./Ind. ?
New//41ter./Repair. Cost of Installatlon
'0.00
Pertnit Fee
. 5 !l
Surchorge
I Totol
done in accordance with all applicabla State of
Building Official
CITY OF EAGAN
Addition Lot 4 Blk
owner--,` Street 4518 Oak Leaf Circle
?
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAOING
SAN SEW TRUNK 1973 204.47 10.22 20 132.93
* SEWER LATERAL -3-?-- __
WATERMAIN
* WATER LATERAL 4A I
60. 64 75
WATER AREA Aff/ 1977 204.47 13.63 15
* S
i -- -S C006555 25
79
5
erv
ces -
-
,t STORM 5EW TRK ---- C006555 5-25-79
* STORM SEW LAT .63 35. 0 15 C006555 5-25-79
t! / 9? o ,? i 9`?!. G? 3 L'E' oG• fs,!" ? a 7
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit Char e 75.00 11106 8-1-78
WATERCONN. 2$0.00 11106 8-1-78
BUILDING PER. #4892
s,ac 500.00 11106 8-1-78
PARK
OF Fr4GAN
Pilot Kno6 Rood
MN 55122
Add ress: - TR-l-' C; !=c l.g-4,4 - ` 1_ ' " -
Nc,_ -
to wmply wifh fhe City of Eagan
By
Date of Insp.:
flot Knob Road
MN 55122
WATER SERVICE PERMIT
PERMIT NO.:
DATE: ,
No. of Units:
Connection Chorge:
c° --
ACCOUIIL D2pOS1Y:
Permit Fee:
Surcharge: = --
Misc. CFwrges:
Total:
Dote Paid:
I nsp..
PERMIT NO.: !30g
DATE: ' ^• 7,C 7f,
No. of Units:
Address: `? iibk 7?isaaf C43'E'3i? ??? ?? Clkt 4
to compip with the Citr of Eagao
of I nsp.:
? .00 pd
Connection Chorge:,
r
Account Deposit: -
Permit Fee: -
Surcharge: ? , .
- ?
- Misc. CFwrges:
_ Totol:
- Dote Poid:
3
CORRECTION NOTICE
Address "
DATE: / ^ ? ? 8,
Ordinance Nos. and Corrections - Correct By
Site Name
Telephane
For reinspection
Eagan Depi.oflnspection In5p6Ctor:
3795 Pilot Knob Rd.
Eagan, Minnesota 55122
454-81oo Dept.: _
CI'TY OF EAGAN
L 3795 plot Knob Rwd Eagan, MN 55721 No 4892
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
Te 6e uaed for SF D!•lE?Zl. &. Gd]Ed, Volue 68,000 Date 7 1 _ 1978_
Site Addreu 4518 a ea lYC 0 Erect [k Occupancy-RT-
Lot 4 Block 1 Sec/5ub. Chas Ma r 4 Alter [3 Zoning
Parcei # 10 17 103 040 01 Repalr ? Fire Zone ------ v-
Enlor
e ? e of Const
T
g .
yp
w Name An+h (]nIZ F[fctpr Move ? # Stories _T¢--
3 Address Demolish ? Front ft.
?
Ci
Phone
Grade ?
Depth ft.
o Name TOl1 f On $ CIYS- ApProvals FOBs
ZV
u?
?
Nome _
Address
4
1 hereby ackrwwledge thot I have read this upplicotion and state that
the iniormation is corred and ugree ro comply with all applicable
State of Minrresota Siotute/s and, City ot Eagon C? nances.
Signoture of Permittee ?/C 4? ^'" i L/ ?'?
Assessment ?,/ l H? Y 7
Water & Sew. -
?
Police
Fira
Eng.
Planner
Council
Bidg. Off.
APC
Permit 166 50 _
Surchorge 3d4z.??_n
Plon check
SAC snn nn
Water Conn..2. 9 0..rQ.Q
Water Meter -§.QQ_Q
Total 5.?
A Building Permit is issued : on the express candition that
cll work shall be done in mr?l nce w't all applicable Stote of Minnesota Statutes and City ot Eogan Ordinances.
Building Official ??•P
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
' CITY OF EACAN
.? I 3830 PILOT KNOB RD • 55122
651-681-4675 ?
w ConshucHon Reaulremen
? 3 registered sHe surveys showing sq. ft. oF lot, sq. fl. of hause
and QII rooted areos (20% maximLpm bt eoveraae allowed)
? 2 coples ot plans (show beam L wintlow skes; poured Ind. des(gn; etc.)
? 7 set of energy calculailons
D 3 copies of hee preservafion plan H lot plafled LBer 7/1/93
DATE: 5' 1 O -
DESCRIPTION OF WORK:
STREET ADDRESS:
CONS
? urm
5/C;: I
LOT: Lk BLOCK: ? SUBD./P.I.D. #: C" ftk` Lt4'??
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: <e V) n ? ,1JOr1 l'1 e-? Phone#: ?4-5`i ` 76041
Last F&rt
StreetAddress: lJ/U keQ? di-KCL ?
city- state: AQ zip:
Company: l'1 e,
Street
City
State:
Company: ,/«/ rl 6- Name:
Telephone #: area code ( )
Street
City
Sewer & wafer Iicensed plumber (reaulred for new conshuction onlvl:
State:
Penafiy applies when address chcnge and bt change is requesfed onee permH is issued.
Zip:
Zip:
I hereby acknowledge ihat I have read this appllcation, state that the informatiop is conect, and ogree to
STate of Minnesota Stafutes and City of Eagan Ordinances. ? (/),Y /-1
Signature of Applicant
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
OFFICE USE ONLY I
,? -- ?
No I l'
No Not Requiretl?., ?
- - .'L L.? -- ? -
I
Remodel/Reoair Reauirements
2 coPies of plan
1 aei of energy ealeulaFioas for heated addNlons
i sHe survey for erztedor addHions 6 decks
?-?^ Uv
A ?C.C J
COST: /
Phone #:
(area code)
Registration #:
License # Exp.
wffh all applicabl
?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 5iding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.` ? 41 Wood 5tove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to appli cant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bidgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
5AC Units
% SAC
, ?.
naTe 7.?_
? • i ? HUILDING PERM7T APPLICATION
include 2 sets of pJ,aaa, 1 aite plan w/elevations and 1 set of energy caiculationa.
. Q
To be uaed for Valuation ?
Site Addrasss y,s/'?'???f/Ctfr z.ot siocx jt?o?Wb. Parcel Nurd3er /a /7/D3 6</'D o I
Owner
Addrees
Telephone
Gbntzacto
Address
Arch./Eng. ?
Addresa
?
Erect
AlCer
ltepaiz
Mlarge
- Nbve
- Demo13sh
_ Grade
_OFFICE USE
Date of roval & Initial
???
?
Assessment 7r3
(l•..F}
Water/Sewer
Police
Fire
Eng.
Planner
Oouncil
Bldq. Off.
A.P.C. ?
Telephone la ,07 f
Telephone
OFFICE USE
Occupancy ?
Zoning
Fire Zone ?
Type of Const.
# of Stories
Front
Depth 3 FFEES
PeTmit J?lo ?
Surcharge 3 5? '
Plan Check
SAC Ci?
u?ater c'onn. oRSG ?o
41ate Meter -
je? 7 s - -
S?
TOTA7, /D 'YS' '
?
A
/ .1
02 ? ? [y f 6
? 3 T . _. . . .. . .- -
??-
?ef
EYy ?
??
6
F. C. JACKSON
urM u,rtlmrwt
p . -# y:f y ?--
/ ;
?
• ?/ ? /
! V? /
I HUOY CO[T1A' TIIAT TX{ ABOY[ 10 A TRUt AND ?
CT PLAT Ow A SU11V[Y OF
As cuaver[o w p[
F. C. JACKSON, MINNtSoTA R[aIS7MTwM. No. 3800
, PAMBMTtll{O 4NORIt LAWO 0/ AAT[ OR MINNZWTA
' UCONOD fY OR0IMANCt 0/ CITY O/ YINMRA/OL1S
? ----------------
I For OfficBcUse ? .
I ti 41^ ?
? Permit#: V I
I Permit Fee:
I ? I
? Date Received:
I Staff: C,y' I
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ?e) Site
Tenant:
?f (w 4ea r l?lr-
Suite #:
RESIDENT I OWNER Name: J;Lnrl n o- Phone: 6 a-46 -
k
?Q ? cicQ
t
jr
Address / City / Zip:
/V
( LU
h C
Applicant is: X Owner _ Contractor
TYPE OF WORK Description ofwork:
ti
n C
C
t
t lti-Famil
Buildin
: (Yes
M
I No X
)
ons
ruc
o
os y
g
_
u
-
CONTRACTOR Name: License #:
Address:
City: State: Zip:
Phone: Contad Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateporv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan dased on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumher: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor: Phone:
NOTE: Plans and supporteng documertfs that you submif are considered to be public information. Portions of
fhe informatron may be classiiied as non-public if you provlde speciPlc reasons thaf would permit the City to
conc(ude that the are frade seicrefs.
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; t at I understand this is not a rmit, but only an application for a permit, and work is not to start without a permit, that the work will be in
accord e with the al Prov d pla n?case of work which requires a review and. approval of plans.
x X
pp ica Ys rinted Name ApplicanYs Signature
Page 1 of 3
For Office Use
- l
City of Ea ~n I Permit 40
I r
I Permit Fee: ~O
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I CCU
Fax: (651) 675-5694 I Staff: I
I I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:4'_'~~e Site Address:
Tenant: Allk Suite
RESIDENT / OWNER Name: Phone: ~ 0 - ~oo1G%°l
Address / City / Zip: 7 ~Q r
Applicant is: X Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
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.
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; tat I understand this is not a rmit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accord a with the a prov d pla n case of work which requires a review and approval of plans.
x x cam' l~ Y'~ ~f 1
pp ica Vs Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use
1 I
I Permit 0
City of Eajan 1 Permit Fee: 60' 6 j
3830 Pilot Knob Road
-
Eagan MN 55122 I Date Received: -
Phone: (651) 675-5675 j Staff:
Fax: (651) 675.5694 1
2010 RESIDENTIAL PLUMBING PERMIT )APPLICATION
Date: LL (J Site Address: 7 K ~C
Tenant: Suite
RESIDENT / OWNER Name: lk/~ h &4 Phone: lP 4 S 7(o
Address /City / Zip:
CONTRACTOR Name: ~ /Z G ~ i se
Address: PGA
State: 41 IAL Zip: 3 a' Phone: 2 . S LAG
/?a ~
Gontact~ Email:
TYPE OF WORK _ New replacement - Repair -Rebuild - Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESI NTIAL
Water`Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures ;
RPZ / PVB) [r Main Lower Level}
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8 meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before ou intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
i hereby acknowledg hat 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 and nd 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 t pproved plan in the case of wo fequINs as review and approval of plans.
~f x
Applicant's P Name Applicant's Signature
FOR OFFIC USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125687
Date Issued:07/30/2014
Permit Category:ePermit
Site Address: 4518 Oak Leaf Cir
Lot:4 Block: 1 Addition: Ches Mar 4th
PID:10-17103-01-040
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 .
Brian Bennett
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 -
Donna M Kenny Tste
4518 Oak Leaf Cir
Eagan MN 55122--182
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150946
Date Issued:07/31/2018
Permit Category:ePermit
Site Address: 4518 Oak Leaf Cir
Lot:4 Block: 1 Addition: Ches Mar 4th
PID:10-17103-01-040
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Michael Stark
4518 Oak Leaf Cir
Eagan MN 55123
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature
r Cipt
'A
`. .0.0 E AGA NFor Office Use //�
°,% °,I Permit#: /54 0 3
'T' 1
1 "''C•
Permit Fee:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 C E 1v/E .
• Date Received:
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675- 4
buildinginspectionsa..citvofeagan.com JUN 2 1 2019 Staff: J
I
2019 RESIDENTIAL BU'I ii: ' . - ► IT APPLICATION
Date: 6/20/2109 Site Address: 4518 Oak Leaf Cir Unit#:
Name:
Mike.s.1236@yahoo.com Phone: (651) 686-0878
Resident/ 4518 Oak Leaf Cir
Owner Address/City/Zip:
Applicant is: Owner Contractor / -*--. / C k - L/
Type of Work
Description of work: (2) egress casements and galv. steel wells
Construction Cost: $4800.00 Multi-Family Building:(Yes /No ✓ )
Company: Egress Window Guy Contact: Dan Ruegemer
Address: 3410 Kilmer Ln N Cit Plymouth
Contractor y'
State: MN Zip: 55441 Phone: (763)544-277Email: DanR@egresswindowguy.com
License#: BC665399 Lead Certificate#: NAT-123125-2
If the project is exempt from lead certification, please explain why:
1978
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:
Fire Suppression Contractor: Phone:
NOTE:Plans anti 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.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeapan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
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 pe I it; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of
X Daniel Ruegemer "'
x
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE q6/ e CIRK Lc (' C-
-
2 - / / �D
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family)
Single Family/ _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi — Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
—
Alteration _ Fire Repair _ Windows _ Demolish Foundation
—
Replace _ Repair X Egress Window _ Water Damage
—
Retaining Wall *Demolition` of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 11; OO 7 Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100% ) Zoning n� City Water
Census Code Stories T- Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction j j Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
y Framing 4 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 1 L, , Building Inspector
RESIDENTIAL FEES
Base Fee 644,4C 14
Surcharge i f 1 r
Plan Review ��
MCES SAC 0 0 0
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164524
Date Issued:10/01/2020
Permit Category:ePermit
Site Address: 4518 Oak Leaf Cir
Lot:4 Block: 1 Addition: Ches Mar 4th
PID:10-17103-01-040
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Michael Stark
4518 Oak Leaf Cir
Eagan MN 55123
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature