4478 Oak Pond Rd
1
Use BLUE or BLACK Ink
- - - - - - - - - - - - - - - - -
Foi Office Use
MAY 2
of MAY 2 4110 1 Permit
City ~ I
Eajan I~ _ 1
Permit Fee: _
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:]
Phone: (651) 675-5675 i staff: t
Fax: (651) 675-5694 I 1
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: X 1-7 1 -2-C' I C Site Address: ® PoWD R A F-Aee21+v
Tenant: Suite
RESIDENT / OWNER Name: J ~ >n cx_4 1.~ t 5:VA Le. r_ Phone: L-12- . 11G7 2
Address / City / Zip: J Ike S q/1 Is, 5541 Q
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
1'is~
Construction Cost: 2-c6 Y--- 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.aopherstateonecall.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.
F
r
Applicant's Printed Name Applicant's Signature
Page 1 of 2
1
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 CG"G , l J i /G,
_ 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
Valuations Occupancy MCES System
Plan Review Code Edition M~j O 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 __2g~-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
?
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
• EAGAN, MINNESOTA 55122
?DAT£-? 19
RECE1vED
FROM
pMOVNT $ ?
?
E]CASH E]CHECK
White-Payers CopY
Yellow-Posting Copy
Pink-File Coov
Thank You
BY
_ ., y
BLDG: PERMIT N0.
. '
01-3210 Bldgl*'Permit
01-3422 Plan Checic
01-3445 Surch. /r,dm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
2Q-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
? ' l
REA(.1IVATE FbR DElX-PLPN REV7R,1FD '1 f 24 /87 ' . . . . _ . .
CITY OF EAGAN
?? .? ,? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Na 12883
BUILDIN2G PERMI? PHONE: 454-8100 : -_
Receipt #
Tobeusedior 7;4G/GA-R Fsr vai..P $77,000 natP ,i(.?'V,:•.j?t;.? 17 ?oi36
Ske Address 44 ! tS 'QAK FOND RD Erect M
R
Occupancy
Lot 9 Block 2 Sec/Sub. FA Remodel ? Zoning R l
Parcel No. Repair ? Type ot ConsL v
Addition ? No. Stories
a
=
Name RSC?l fiOMES
Move
Demolish
?
? 46
Length 46
Depth
3
° 18308 M(1!2PHY LAK
Address E BLVD
Int. Impr. ? Sq. Ft
City ?''• tOR 14one 432-24 40 Install ?
Z o Name SAME
Address
oti,..,,.
t W¢
W
?_
U?
m=
? W
Signature of
A Building Permit is issued to:
all work shall be done in acco
Building Official
Assessment Permit _
Water & Sew. Surcharge
Police Plan Revie
Fire SAC
Eng. Water Conn. 5 U U. u u
Planner Water Meter 63 . 50
>nandstatethatthe
applicable State of
? Council Road Unit 290.00
gld .Off. 10/22/d Tr, pi, 156. DU
g
APC Parks
Var. Date Copies
$2,169' U U
Total
on the express condition that
le State of Minnesota Statutes and City oi Eagan Ordinances.
. PermN No. Vwmft Holde? Dab TNophor» M
Plumbing xvz - ??• ?, . `?`. ,'?_/"/i.'k'
H.VA C.
Eleetric
L 775
SaftnK
Inspectlon Dab Insp. Commwnh
FooUnpsl ?
Footlngs II
Foundation
Framinq
Roollny
RauyhPlby. /
Rouyh Mty. »
Inaul.
Finplaee
Final Hty.
9
F
Final Plby. ?I-zS-?? l?j?-
•
&dy. FInN ?
Cort. Occ.
Deek Ftq.
DoCIc F?my lj S Sr ?? ?n1 i 2-6,40 7-0
w.u ??'c?G v?' ?r" ?L S
Pr. Dbp. 6 ? ? ?,P
?
Site
Lot.
? Name
m Address
c Ciiy - " =
Name
?
3 Address
O CitY
TYPE OF WORK
?7cz ????
PERMIT #
MECHANICAL PERMIT
RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
' PHONE: 454-8100
BLDG
TYPE
. WORK DESCRIPTION
_ Sec/Su?r
Y Hes. ? New
,,
L Mult Add-on
Comm. Repair
'hone 'py e"e"•'S`
Other
I
.
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. Z r M BTU
Vent CFM
Gas Piping Outlets #
Other
FEE:
t?
SfC: ?
TOTAL•
? ? ,: . . _...._...
icE: 7 f
19
Bloc
FEES
RES. HVAC 0-100 M BTU
-$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PER7411n - 1.50 EA.
COMM/IND FEE - t% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
!
- ?`°.? .%??,• --?....
FOR: CITY OF EAGAN
_ .,.. , ?.
4 , . . , • . ? ..f
. PERMIT # 7?? 6
MECHANICAL PERMIT RECEIPT # ?
CITIf OF EAGAN
-7? 3830 PIL OT KNOB ROAD, EAGAN. MN 55121 DATE:
CONTRACT PRICE l PHONE: 454-8100
Site Address gLpG, npE WORK DESCRIPTION
Lot Block Sec/Sub
R
?
Name es. New
M
lt Add
u
-on
m Address C
R
i
omm.
r
epa
c City Phone ?
?
?
Name ?
FEES
3 Address RES. HVAC 0-100 M BTU -$24.00
p City - • ?- '? ?'? P hone' ADDITIONAL 50 M BTU - 6.00
- ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAt 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air ! M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
,
P
G
BEYOND $1,000.00)
lping Oudets #
as
Other
FEE
i
9 . • - '
-? SJGNATURE OF PERMITTEE
S/C:
TOTAL• "
FOR: CITY OF EAGAN
r ? . ,aR?Tu q !
Site Address -
Lot
Sec/Sub
m Name
? Address
c City _11' 11 Phone '?•° v f. "
L Name ? 'c
3 Address
p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMfIND FEE - 20.00
STATE SURCHARGE PER PERMIT. - .50
(ADD $.50 S!C IF PERMIT PRICE GOES
BEYOND $1,000.00)
OF PERMITTEE
FOR: CfTY OF EAGAN
wr-. .U . , . . . . _ . , . . . ..,?., . .
PERMIT # ?'• ' -'
. PLUMBING PERMIT RECEIPT # ? - '2 ? ?CITIf OF EAGAN
(? ( f7,f 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
nunu=. Ar• 04nn
BLDG. TYPE WORK DESCRIPTION
Res. ?- New ?
M ult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAI
? Water Closet - $3
00
.
? Bath Tubs - $3.00 '
Lavatory - $3.00
/Shower - $3.00
/ Kitchen Sink - $3.00 = '
Urinal/Bidet - $3.00
? Laundry Tray - $3.00 '
Floor Drains - $1.50
/Water Heater - $1.50
Whirlpool - $3.00
/Gas Piping Outlets - $1.50
Softener - $5.00
weli - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE s
STATE S/C: s
GRAND TOTAL• 3? ? c'
. , i ..??. ...?•.?_r_.. _... .._.._.4..].u. i?'-..??_•?Y
cmr oF EAGaN
3630 Pllot Knob Road''
P.O. Box 21199
Eagan, MN 55121
Zoning: F,I
Owner.
Address: L
Site Addess: Cak Pond "n
Plumber. T-??=e Siie ?'lur.:bi
Meter No.:
Size:
Reader No.:
I agres to comply with the CFty of Eagan
Ordinances.
By
? Date of Insp.:
r...- -
WATER SERVICE PERMIT
PERMIT NO.:
DATE: "-'
No. of Units: j
1)
ConnectionCharge: ?01•'?QDd .?
Account Deposit: ?- 5• 30vd ?
Permit Fee: ? ".
Surcharge: .5?3pd ?
Misc. Charges: 1.561.002d Tr
Total: F'? _ 5?1?d r??ter
Date Paid:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pllot Knob Road 9 [, 9 '2
P.O. Box 2118io PERMIT NO.:
Eapn, MN 55121 DATE:
Zonfng: r1 No. of Units:
Owne Fcxr !{oties
c -
Address: -'-J
SiteAddress: 4' "; Gak Poi'-r' ?oad L° r
Plumber. lz1:e_Side P1u;tcbinF
I aqree to comply with fhe Clty of Eayan
Ordinanaes.
i
BY
; Date of Insp.:
i Insp.:
1
?00.40pd
Connection Charge: 47 S_ O(]nd
Account Deposit: 1 5_ Oonl
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Date Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knab Roat)
P.O. gox 211" PERMIT NO.:
Eagsn, MN 55121 DATE 1- ?_•'7
Zoning: No. ot Unlts: 1
Owner.
Address:
SfteAddess: Ca': Pon ^ d L9 ? F a-.,-n e II
Plumber. 5c)O.Oi?
Meter No.: J 76 3df^?? P???ec ion Charge: pd
c?
ST/.,4=? /Pac?C. TE! FP?{ns° ?t?? ?: 15 . 0?)p
size: c Reader No.: ?}QC r.,, l l1. !)4Fc1
I aproe to comply wlth th D Sa?er e• ? . S 0 d
Ordina . ` ?8GR C 156 . OOpd TP
Total: 63.51)pd raetor
By Date Paid:
Date ot Insp.: Insp.:
TNis reque5l voidl,3x?//6'6,
lg.nqV88
` C??
lG /' 6 O -L
v
Feauest Data /1
Fi No. ReqBhe?n ? lns
uection ?fleady NowZVill Notify Inspec-
/? ?(J ? Ves No
? ror When Headv
'15J?'dCensed ElecGica l Contrwctar I hereby request inspection of above
El Owner electricel work imtel IeA eL
Street Atldr ss Box orryfl e, yN
M C' y
ection o. Township ame or No. Hange No. County
Oc uP i1P
t?
rnc
?
Pho e Na. .O
a
P Sup0lier ^
1 ' AdCress
le ncal Conuactor ( om y Namjqj- A n ??r cticense N
?
Mafling Ad s IConVactor r Own r MekinO i?statlationl ?
S
Author' e S?gnature o trac?or Makine 1"51011ationl on mDer
lU
THIS INSPECTION PEQUEST WIIL!NOT
MINNESOTA STATE BOAHD OF ELECTRICITV
Grigpn-Midwey Bldg. - Room N•197 BE ACCEPTED BY THE STATE BOARD
1821 Univenitv Ave.. St. Peul. MN 56104 UNLESS PNOPEX INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST POR ELECTRICAL INSPECTION ee-oaooi-os
? Sea instructions for completine 1his Iarm on baek ot Yellow copy.
7W R R "X" 8elow Work Covered by This Request
M.V Addj R.p.j TVpe ot BuilOing AOPlencea Wired Equipmenl Wired
Home Range Temporary Service
° Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tenk
Fdlm ther oen y' ther ISpnr,ityl
1. ucu y ther 01h¢r
Compute Inspecuon fee Below
M Fee ServiceEntranceSixa p Fee Feaders/Subieetlers N Fee Circuiie
0 to200Ams 0 co30Ams 0 tn30Am
Above 200 qmps 1 31 to 100 Amps 31 to 100 q y
Swimmin Pool ? Above 100_Am s Above 700_Am s
Translormer5 Irrigation Booms P&rtial.'Other Fee
$igns Speciallnspection S
?
TOTA
Remarks EE
/l?.
i Hough-in , unte 1, fhe EI tri
-) - IR InsDecloq herabV
Final Dale certifv that the above
inspection hea been
Thb reouest wIC 18 monib 1rom
This request mid 1?2/?11,Fc,-
1B months (rom
C 63072L9,?4
6-SG0S
Nequest Date Fira No. Baueh-in InsoecUOn
flequireG7
?Ready Nuw KW?1I Notify InsDec-
??.^ ?No ?r When Ready
ZI-1.-censed Electrical Contractor 1 hereby reQUast inapection ol above
? Owner electricel work inetallad et
Street 'Ad/dress, Boz or Roat No.
?"? Citv
ectwn o. TownshiD ame or!NO. anBe o. County
OccuPa NIN Phone No.
Pow?¢/r' ?SuD?Plier ?.?c? i
"?-/?/ / 1 Address
Ele al Convacmr (C y Name) Comranor's Lic nse N
??
Mailine Atldress?ntracwr o .Ow-neAr MakinB ??scallationl ?? ?''?? ? ?
Authorize ' nature ( onVa tor/ M'ng Instellationl P Numb?arG / ?C
? V
MINNESOTp STATE BOARO OF ELECTNICITY TNIS INSPECTION flEQUEST WILL NOT
Orippe-Mitlway Bldp. - Room N-791 BE ACCEPTED BY THE STATE BOAND
1827 Univeraitv Ava.. 8t. Peul. MN 56704 UNLESS PNOPEN INSPECTION FEE IS
ok....e ialm Fn1.nann ENCLOSED. '
REQUEST FOR ELECTRICAL INSPECTION /E8-00001-05
? See inetruc[ione for comDlatinq thla farm on beek ot Yel low eapy.
"X" Below Wak Covered by This Request
Naw10.Ad1 Aep.l Tvoe o1 Buildina 1 Aoolinncee WireA 1 Equiument Wired I
1 I I I Duolex 1 I Water Heater I )I Liphtinu Fixturas I
ce
itioner
k Fee ServiceEntrence5ixe tt N. Feedera/Subfeetlers it Fee Circuits
0 to 200 Am s 0 to 30 Am s 0 tn 30 Am
Above 200 qm ?a 31 to 100 qmps 31 to 700 A
Swimmin Pool Above 100_Am s Above 100_Am '
Transrormers Irngation Booms Partial-Other Fee
Signs Special Inspection
Rerrarks i 5/ ?, ? TOTAL F??
I, tha Electricel
Inapector, hereby
car/ify thet fha ebove
9ns0ection hes been
ThlerepueatvolClB
...yrmst void?/^??p p?
18 nwnths trom y J fJ ^
E 2 0 6 72 ,c-1%
XjG o i
Rnquest Oaie ' -
/ ?
?.?
\ Fiie No. uph-, n l Ver.tion
qo
Raqmretl?
catly Now ? Will Nntifv
?nsVec-
[o
Wh
R
G
U ?
Yes o r
en
eady
?licensed Electrical ConlracWr 1 hereby request inspection of ebove
? Ownnr electrical work installed at:
Street Atldress, Box or Houte No.
`/yz3' a4/c (o,v.L?, f, oA0 Ciry
IF (?AK)
ecuon o. Township Name or No. HanBe No. Covmv
YJ:4k0 j?
Occupam (PRINT)
DisRy?, Phone No.
6gg -s>??
Power SupDlier Address
Elechical Contractor (CompanY Name)
GALAx(L i- c.fc.??c 1 ?%C. Conlrnr.mr's license No.
by?.a6 a
Mailin0 P.ddress IContracror ar Owna MakinB Instailationl
,?f 11?
? ?3?3 iQVoE?rI k)INO ??L. ?,iUri?'v
AuM ¢p igna? re 1 n[ r? er MakinO ???slallationl Phone Number
,
MINNESOTA STATE BOANU OF ELECTPICITY THIS INSPECTION REQUEST WILL NOT
GriBas•Midway Bldg. - Room N•191 BE ACCEPTED BY TME STATE 90AR0
UNLESS PROPEH INSPECTION FEE IS
1827 Universitv Ave.. St Paul. MN 55104
Phone (612) 642-0800 ' ENCLOSED.
,REQUEST FOR ELECTRICAL INSPECTION Es-ooooi-os
,06
^ If Sae inshuctiens lor comoleun0 this lorm on Oeck oi vellow coov.
E 2O6 -172 "X" Below Work Covered by This Reqirest
Fdd fle0. TYpe ol BuilAinO AGUliancea Wired Equiumen,, WireA
Home Ranqe Tempxary Service
Duplex Water Heater LiGhtinq Fixtwes
Apt. Buflding Dryer EleCtric HeaUn
Commercial Bldy. Fumace Silo Unlonder
InAustrial 81Ag. Air Conditioner Bulk Milk Tank
Farm OtheF peri v Oin,.r ISne,WI
t u.r Suev y ther 01her
Comnute lnsoection Fee Below
k Fea Servica EntrenceSiza h Fee Fexders/SuAteetlers IX ioe Circoits
0 to200qms 0 to30qms 0 tn30 Am
Above 200 qinpv. 37 to 700 Amps 37 to 100 A
Swimming Pool Above 100-Am ' Above 700_Aml'
Transformers Ircigation Booms S PartiaL"Other Fee
Signs Special Inspection
TO qE
Hemarks O
NoueM1-in Date
1. Electf
?ns0ec or, heroby
cer?ify Nat tha above
Finat ?^?G insoactien has baen
r mada.
Thie Mpuest roiE 18 montlm Imm
CITYbF EAGAN -
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2, 12883
PHONE• 454-8100 ?
BUILDINCyPERM1T Receipt# ?7J
7obeuaedfor SF DWG/GAR Est.Value $77,000 Defe NOVEMBER 17 1986
SiteAddress 4478 OAK POND RD Erect ?l occupancy R3
Lot 9 eiock z Sec/Sub. FAWN RIDGE ND Remodei ? Zoning R1
Parcel No. Repair ? Type of Const y
Addition ? No. Stories
W
Name RSM HOMES
Move
? 46
Length
46
3 Address 1830$ MURPHY LAKE BLVD oemolish
I
t I ?
? Depth
S
Ft
°
Ciry P RIORIAone 432-2440 n
mpr.
Install
? q.
.
_ ? Name SAME Approvals
$ Q Address Assessment
" Ciry Phone Water & Sew
? I Police -
?W Name A.P.S. DESIGN Fire
? _
u ? Address
E
ng._
i W Ciry phone 450-0867 Planner
Council
Permit $ 364.00
Surcharge 38.50
Plan Review 182.00
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63.50
Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe B1dg0n 10/22/8 Tr.PI. 156.00
information is correctiar/d agree to comply with all applica6le State of
Minnesota Statutes Ciry agan Ortlinances. APC Parks
SignatureoiPermitt e Var. Date Total Copies $2.169.00
A Building Permit is is5ued to! RSM HOMES on the express condition that
all work shall be done in accordance with all applicable tate of Mir(?pese}a? tes and City of Eagan Ordinances.
Building OHicial
3
M
NOTS: ALL CI
\
'•? ?`-' ?? .
1986 BOILDING PERMIY APPLICATION - CITY OF EAGAN
)RS M[TST BS S.ICIINS6D iiITH THE CITY OF EAGAA
" SIBGLE FAMffLY DWEI.LINBGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OE ENERGY CALCULATIONS
MOLTIPLE DiiEI.LINGS - RESIDSNTI9L RENT6L ONITS FOB SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TS OF SIIAVSY - CHECg iiITH HLDG. DBPT.,
1 SET OF ENERGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
7 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS, ?
$2,000 LANDSCAPE BOND
-77, 007 /
To Be Used For: Valuation: ? Date:
Site Address OFFICE DSS ONLY
Lot 11 Block 7,
Pareel/Sub ?civJrj ?Q h?
Owner
Address
City/Zip Code MN
Phone
?
Contractor
Address
City/Zip Code
?•
Phone
Areh./Engr.
?.
Address
City/Zip Code ?i
Phone ?k Q y C} ?? 11
Erect ? Oecupancy R 3
Remodel Zoning 12•I
Repair _ Type of Const Z
Addition # of Stories
_
Move Length 4?,
Demolish Depth 4(0
• Int.Impr. _ Sq Ft
Install
APPROVAiS FEES
Assessments Permit
Water/Sewer Sureharge 38.50
Police Plan Review l'8 Z.
Fire SAC 5-79,
Engr Water Conn 500.
Planner Water Meter ?3. S-°
Council Road Unit 7-1?.
Bldg Off ia ZZ. Treatment Pl I SCo,
APC Parks
Varianee Copies
TOT9L
NOTE: ADDBESSES FOR CORNER LOTS - CONTRACTOR/HOFIEOfiNfi@ !lQST D6SIGAATE WHICH ADDRfiSS
13 DESIRED. NO CHANGES WILL HE ALLOiiED ONCS BOILDING PERMIY IS ISSUED.
S8 3cog
?? ? ` ?2 ? 44-' If?4v
(?o? `?? ? I2 E 4600
1 Co ?(C?
I
k.
... - y
CITY OF EAGAN
APPUCATI'ON FOR PERMIT
SEWER AND/OR WATER CONNECTION
*XYP': PAYMRNT OF M AT TIME pE'
APPUCATTON mES NOr CONMTM
APPROVAL OF PII2NIIT.
qqi,c? P ease Print
,??
1) PROPERTY ADDRESS: fJa n •-
LEGAL DESCRIPTION: ~g ie??G
oc
IF E}ISTING STRCCiS.iRE, DATE OF ORIGINAL BUILDING pEliMIT ISSL'ANCE:
arce
PRESENf ZONING/PROP0.SID LTSE: (Month/YearT
0 CONMERRCIAL/REI'ATI,/Of'FIC'E I P.-1 SihG:,E FAI9FLY
0 IbIDL'STRIAL Q R-2 DL'PLEX (4Wo Dnits)
? INSTITUTIONAL/GOVERrMT ? R-3 70WNHOUSE (Three + Units) ( Units)
R-4 APARTYNEN'P/COAIDOMINILTI ( Units)
2) NAME. LA-'?e- --
ADDRESS: ?-q- L-11- c/ Z
CITY. Si'ATE, ZIP: S,4v?e'? rri.? =37Q
f
PFIONE:
3) ' i: ?• For City Use .
Plumbers License:
ADDRESS: REAcUve
xpiYed
CITY. STATE, ZIP: Not recorded
I--t
. PHONE:a O FASTER LICENSE#
j?(?a?87 /-r?'a Sta?flnitial
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NAME:??sr.;
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CITY, STATE, ZIP: f? r? a T L w.E? c J?-7 .-rJ •
PxoNE:
5) u w. . ?. : a • ? • ??
CONNECTION TO CITY SEWER F-J,,CONbIFX.TION TO CITY WATEEt QMIM '. .
6) ?? • • iC3 P7EASE HOLD APPROVID PII2bIIT FYII2 PICK-OP SY ONE OF ABOVE .__.-
? PI.EASE M712L APPROVID PIItMIT 10 1. 2.? 4. AH?7E
(Circ one)
7) di21
INsPrx-rIoiv OF sEWER r,nro/tR VMM
rrSrAraamrONS WII,L NpT gE SCHED-
tn.Ea vrrra. PEPMT BAs sffiv
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: FOR _CITY USE 4NLY `
PERMIT # TSSUED .
Pd w/Bldg. Permit FEES:
$ D - S /y SEWER PERMIT (INCLUDE SURCHARGE)
$ $ /6, 5-2) WATER PERMIT (INCLUDE SDRCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ ? fS Gi O ACCOUNT DEPOSIT - WATER
$ S-'ba'd C> $ WAC
$ ? 7S-' $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRCNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRDNK WATER
$ 'o o $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ?1
? 0
$
d
t TOTAL
RECEIPT RECE
IPT
DOES UTILITY CONNECTION REQUIRE EXCAVA TION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PE RMIT FOR WORK WITHIN PLBLIC
Q
NO ROADWAY" MUST BE I
DIVISION
LIST AS SSLED BY THE ENGINEERING
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ITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: A
TITLE:
DATE : f /.S f 7
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AOBE CpNSULTIHO ENO NE[Bf
r NGIN6EAING pLef+?+Eas nnd ?AHp ?URVEYOIlS
COMPANY, INC.
1000 EAST I461h STHEET, OURNSVILLE. YINNESOTA 59337 PH 432-5000
Cer?Z?Z crzl SZLrYe y
??4t -Ue ?^?"?,??io?t • Lo7 9, BLOCK 2, FAW1U R/D6E 2ND ADAf7/ON,
DAKOTA COUN7"y MINNESOTA
C91r--o'D DENIOTES EX1STIWG 6LEVATION
(924,,0) DENOTES PRoPOSED ELEVATIOf`l
/J INDICATES D1fZEGTION OF SURFAC-E DRAINA6E
926.33= FINISHEA GARAGE FLDOR ELEVATION
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DtZAILIA6E AND
UTILfTY EASEMENT
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N 890 22' 04" W
(918.?)
CLIFF RoAD
[ hereby certify that thia ie e true and correct repreeentation ot a tractot
tand •• shown' and deacribed hereon.. As preparad by me on this /??r/ day ot
zm?ec'e ? 19 86 , .
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hoik R5M 1-{oknES
ENG NEEAING CoH:ouINO 4H0 NE[Ilf ?
PIANNEfli and ?AHD 3UNVEYOIIf
COMPANY, INC. ?1000 EAST 1461h STREFT. OUpNSVILLE, YINNESOTA 5533T PH 4432_D000
Cer?z}?z cac? SurYe y
Z&Cgr _Dieacrl 2:, LOT 9, BLOCK 2, FAWIU R/D6E
DAKOTA CouNTY, M I NNESOTA
C1jrQ3 DEI.IOTES EXISTIN6 ELEVATION
(9241,0) DENOTES PRoPOSED ELEVATIOQ
?f WDICATES DIt2HCT1oN OF SuRFACE DRAINA6E
926.33= FINISHED GARA6E FLDOR ELEVATION
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(Yi8 .1)
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DRAI?JA6E AND
UTILITI' ? EASEMEhfr
I rereby eaMity that tTis ia a true and corraet raprasentation ot a traet of
land as •ham'and described hereon.• Ae prapared by me on tAis /r,?171 day ot
19 g6 ? .
Hinn. 1ta6. Ro. /GoB.r
2ND ADOITION,
FRpIJT BUILDING
SETBACK LINE
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SCALE : I" = 30'
Use BLUE or BLACK Ink
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City of EaEdn ; Permit
;
Permit Fee:
3830 Pilot Knob Road I 1
Eagan MN 55122 1 Date Received: ~/c/ ;
Phone: (651) 675-5675 ;
staff: 1
Fax: (651) 675-5694
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: , 7 Qekl~ uNC/ f~G
Tenant: Suite
RESIDENT I OWNER Name: J,9A1 Z r e- nn Phone: 61'd- 96~-%
Address / City / Zip: y 2e. v~ TA 4ke S, mpl_5
CONTRACTOR Name: iC i'~ n ✓~~v3 License ,6 (Z5Y/,
Address: City: IV-e&l k-2
State: l~[= Zip: 5-6071 Phone: 121d . D F - 7 ,?C-2
Contact: h4yw 2 yA nib ~eL Email: Xz P~' b+~~ ~/y7.•'1.P i~. Cv~
TYPE OF WORK _ NewReplacement _Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work: ` 4 /A L l el j-." LgZ,,,4,eS,
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
(T RPZ PVB) Main -4 Lower Level)
Septic System Water Turnaround
_ New f
Abandonment liV 15 K I't rwi I 100"T
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 you intend to dig to receive locates of underground utilities. www.ciopherstateonecall.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 wHl be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
App icant's Printed Name Ap Iicanrs Signefute
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground _Rough-In _Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113535
Date Issued:09/05/2013
Permit Category:ePermit
Site Address: 4478 Oak Pond Rd
Lot:9 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Jason Vogen
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 -
David A Hosch
4478 Oak Pond Rd
Eagan MN 55123
Elite Exteriors
1513 Southcross Drive West, Suite A
Burnsville MN 55306
(651) 688-7808
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA136437
Date Issued:05/12/2016
Permit Category:ePermit
Site Address: 4478 Oak Pond Rd
Lot:9 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David A Hosch
4478 Oak Pond Rd
Eagan MN 55123
(651) 905-1451
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143143
Date Issued:06/05/2017
Permit Category:ePermit
Site Address: 4478 Oak Pond Rd
Lot:9 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
David A Hosch
4478 Oak Pond Rd
Eagan MN 55123
Elite Exteriors
1513 Southcross Drive West, Suite A
Burnsville MN 55306
(651) 688-7808
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177048
Date Issued:06/14/2022
Permit Category:ePermit
Site Address: 4478 Oak Pond Rd
Lot:9 Block: 2 Addition: Fawn Ridge 2nd
PID:10-25801-02-090
Use:
Description:
Sub Type:Water Heater
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 -
Sfr Acquisitions 2 Llc
120 S Riverside Plz Ste 2000
Chicago IL 60606
Mikes Custom Mechanical Inc
P O Box 171
Champlin MN 55316
(763) 568-7148
Applicant/Permitee: Signature Issued By: Signature