4509 Oak Pond Rd
07/27/2011 11:33 9527070334 ACE GARAGE DOOR PAGE 01/01
MAP/1$/2011/WED 11:21 AM City of Eagan, PAX No, 651-975-5694 P.001/001
` Use BLUE or BLACK Ink
1 i
City of Ea I Permit,
i
Permit Fee; I
I ~
3830 Pilot Knob Road j
Etigan MN 55122 I Date Recel d: l
Phone: (651) 876-9675 15tafL
Fax: (651) 675-5094
-
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: J Site Address: _ _ 11S109 04 Unit 0:
Name' Phone: IT 8G4~'
RESIDENT I
OWNER Address I City! Zip;
Applicant is: Owner _ Contractor
Description of work: lG
TYPE OF WORK
Cona;rvaion Cost: OD0 Multi-remEly Building: (Yez No
Company; t rn ~-•U GontacU
Address: 70... / Cily: '
A 11-e
CONTRACTOR
stag. zip: ~SS._ wnona: `-P rzc a
Lloonse 0: Laod Certificate 0:
Does this prof) of requirip Lead Romodia3tion7 O Yes O No
(see Page ,3 for dtlitional information)
If no, please explaln:
COMPLETP THIS AREA ONLY IF CONSTRUC'TING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a pormtt for a similar plan bawd on a rnaster plan?
_Yes _No If yes, date and address of ma$tsr plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone;
Sewer & Water Contractor: Phone-, .
NOTE. Plans and supporting documents that you submit are considered fo be public Information.. Portions of.
the Information, m6y. be classified as non»publio if you provide specltlc 'Mgsons thaf w6uld permlt the blty to
conclude that they 00 Vtde
CALL ._BEFORE YOtJ DCall Gopher State Ona Call at (651) 454-0002 for protection against underground utility damage,
Call 48 hours before you intend to dig to receive locates of underground u(IllUes, n a II r
I herahy acknovdedge that this informatlon is aanplata and accurate; that the work will be In conformanoe with the ordinances and codas of the City of
Eagan: that 1 understand Ihls Is not a permit. but only an application for a petrnit, and work to not to start without a permlb that the work will be in
eocordencu with the approved plan in the case of work which requires a review and approval of` ans,
x r x -
Applicant'a Printed Nama Applicant's Signs Ufa
Page 1 of 3
CITY OF EAGAN
•- -• 13$ 50
3830 Pilot Knob Aoad, P.O. Box 21-199, Eagan, MN 55121
- PH O N E: 454-8100
BUILDING PERMIT Receipt ?
To ba used for Est. Value '??Date -' CLY
SiteAddress OFFICE USE ONLY
Lot Block Sec/S
b On Site Sewage _ Occupancy
-
.
u MWCC System _ Zoning T
Percel NO. On Site Well Type af Const
Gty Water = (Actuaq
M
¢ Name (Allowable) `
W
3
Address ' * Of $tOfleB
Len
th
T-
° City Phone g
Depth
F
Total
S
, p Name .
.
Footprint S.F.
? ? Address APPROVALS FEES
I' City Phone Aasessments Permit
_
? CC Water/Sewer _ Surcharqe
F W N9me Police _ Plan Revfew ' S
z
_ -
Address Fire _ SAG City -??
u=
?W
City Phone Engr.
Planner SAC, MWCC
_ WaterConn.
'
Council _ Water Meter
? hereby acknowledge that I have read this application and state Bldg. Oif. _ Road Unit
thattheinformationiBCOrrectandagreetocomplywithallappllcable APr- - TreatmentPl
State of Mlnnesota Statutes and City of Eagan Ordinances Variance _ Parks
Signature of Permittee Copies
TOTAL
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of M innesota Statutes and City of Eagan Ordinances
Buildfng Otficlal
Permit No. Permit Holder Date, Tslephone 7t
Plumbing ?g
H.V.A.C.
Electric
Softener `
Inspection Date Insp. Comments
Footings I '
Footings II r
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. 47
Isul. , b
Fireplace a,
Final Htg.
Final Plbg. Lo_
Bldg. Final
Cert. OcC.
Temp. LP r
Deck Ftg_
Deck Frmg.
Well
Pr. Disp.
m Name
? Addre
c Ciry _
L Name
c Addre
0 Ciry -
PERMIT #
MECHANICAL PERMIT RECEIPT # / ? ? '?1 C1
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
tICE: P ONE:454-8100
BLDG. TYPE WORK DESCRIPTION
81ock _ ./ Sec/S?b Res. ?- New ?
Y ??J
Mult Add-on
Comm. Repair
/'' r L. 1? Other
? a r? Phone ,
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
FEES
WA- RES
HVAC 0
100 M BTU $24
0
.
- -
.
0
ADDITIONAL 50 M BTU - 6.00
L1
IIL Ph
n ?I- (RES. HVAC INCLUDES A/C aN NEW
?
o
e CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERMIT E
(
-
) - 1.50
A.
? COMM/IND FEE - 1% OF CONTRACT FEE
??3L M BTU APT. BLDGS. - COMM. RATE APPLIES
'TOWNHOUSE & CONDOS - RES. RATE APPLIES
M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
M BTU REMODELS - 12.00
M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
CFM ? (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
FEE 9A-1
S/C: SIGNATURE OF PERMITTEE
TOTAL• ?
FOR: CITY OF EAGAN .
PERMIT #
PWMBING PERMIT RECEIPT # I `- ?
CITY OF E11GAN - ----
3830 PILOT KNOB ROAD; EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address ?? `' C' (?/' ' t ? r% , ' BLDG. TYPE WORK DESCRIPTIQN
Lot Block l Sec/Sub -? f
?.j." es. New ?
m
Name
Mult Add-on
Address Comm. Repair
? Ciry Phone Other
, ? G Np. FIXTURES TOT
AL
L S
Name Water Closet -$3
j?
'
00 $
c Address .
-7-Bath Tubs - $3.00 ? e-
p City Phone -LLavatory - $3.00
Shower - $3.00
FEES =Kitchen Sink - $3.00
Urinal/Bidet - $3.00
-
COMM/IND FEE - 1% OF CONTRACT FEE ?
Laundry Tray -$3.00
MINIMUM - RESIDENTIAL FEE - $10.00
?Floor Drains - $1.50
MINIMUM - COMM/IND FEE _ ?p0 -L?ater Heater - $1.50 ? -
STATE SURCHARGE PER PERMIT _ ,? Whirlpaol - $3.00
(ADD $.50 S/C IF PERMIT PRICE GOES TGas Piping Outlets -$1.50
BEYOND $1,000.00) , Seftener - $5.00
Wetl - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE:
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
' . ?S 'e l. 11 S
SITE ADDRESS: APPLICANT:
,) :..?i- ? ?r?s ('??IVI1 fri) r1 ,? s r; ?.i ir 1?
I f0.kN !t 1 i???; 'NU
PERMIT SUBTYPE: TYPE OF WORK:
. 1.! 1 ; . . .. •,I fiFRATTON
':iE.F'Akl'11F' PERM11.`i ItF(lU3141 !t F'C?f? RNY t'LI'I:'fRICA1 Cii? F'{ 11111IiNin l,IC11?k
? ?' ? ?
Permit No. Permit Holdx Data Telephone #
ELECTRIC #71 -1J! t?
PLUMBING
HVAC
InspecHon Date Insp. Comments
FOOTINGS
FOUND
FRP.MING
ROOFING
ROUGH
PLUMBING ' ?
PLBG
AIR TEST
ROUGH
HEATiNG
GAS SVC
TEST
INSUL
?
GYP BOARO
FIREPLACE
FIREPLACE
AIR TEST r
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
?-% r-0
. (tertif iratt uf (Orrupanry
Citp of Cagan
EPpa1"btlm Df iltafttp jwPtfiDn
This Certifrcate issued pursuant to the requirements of Section 306 of the Uniform Building
Code cernfying that ai the time of issuance this structure woas in compliance with tlie various
ordinarrces of rJie City regulating buiJding construction or use. For the following.•
u. a.&,jon SF DWG/GAR lUdg. pmrN No. 13860
O-UP-r TYa? ? Zonins naaid R I - Type cooeL
Owcer of &ulding :??n ME` Addrm 14450 $NaEVTT 7 F. PI'LTi", ,y ??ti T F
gw7diog ,Wdre? ?H ?(7 Lon1u) - ? ? $1? Z''? R??:: 'P;?s -
Darc: OCMM 30. I4; , 7
?E oificw
POST IN A CONSPICUOUS PLACE
CRY OF EAC3AN
3830 Pllot Knob Road
P.O. Box 21199
Esgin, MN 55121
'
Zoning: "1
?
? Owner: `:eylE
Address:
Site Address: 4509
Plumber. T ? 2
I agree to comply wRh 1
Ordlnances.
BY
Date of Insp.:
Insp.:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE: `?-•24 -:?7
No. of Unit,s: I
d :ioCl°S
100. 00gd
Esgan Connection Charge: 525.Obn 1
Account Deposit: 1-) .0(}=!_
Permit Fee: ? ? - 00=1-
Surcharge:
Misc. Charges: }
Total:
Date Paid:
? - -•. ,*R?T,--,? .- .
.nl Permit Na -?973
ob Road Nteter yo: y
99 Reader No:
55121
Date:
5ize:
Date:
nn. Chg: 5 2 S. 00pd Zoning: Ri
ct Dep: 15. No. of Units:
,mit Fee: U' p
rcharge: ' p 1 agree to comply wlth the City of
Plant 00pd Ordinancea.
;ter. 67• 00pa
INATER SERVICE PERMIT
OF EAGAN Permit Na Date:
30 Pllot Knob Road Meter No: -? Size:
.O..Box a1i99 Reader Date: -'
an, M N 55121
wner.
IteAddress: "" ;'o,S±c. L; 1. "awti 1 i.,: c. II
lumber C `;cctiai..Lc_al
nn. Ch 525.00pd
9? , n :
cct. Dep: o.
a? ut111L1
ll l
Permit Fee: ke{ p di? oc
iny ca
Surcharge: N E -Fi FOW&lW c'dfi'ply wlth the Cily of Eagan
Tr. Plant ? ?' ?? • "" ``
Meter. 67.
?
Misc.: '
c
By
WATER SERVICE PERMIT
CASH RECEIPT
CITY 4F EAGAN .
• , 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 ?C
, wiestvso " ? , ; ? 4 • ? r ,
neoM ,,,? - _
w uNT ' Is -I
; .
w oo?u?ws
,..
E ? ? CASH Q CN6CK
------------
f • i ?. ' - F„y""_
r?F' , ! _, . ,.
! R./ /
ruNO I coo[
I ' Thank You
sY ?.? /.? !' ; l: (.. ?`' /
f r.? 7522G YVhiH-PaYsrs CoKW
Ysllow-Patinp Copy
Pfnk-Fib CoPY
M y.3 8 5 }S ;`
BLDG: PERMIT NO / 3 KS 9
i3
.
960
01-3210
I Sldg. Permix /02 '3 SO
? 01-3422 Pl'an Check
; 01-3445• Surch./Adm. . .2 a
? 01-3446 SAC/Adm. -7 5/
I 01-2155 Surcharge . / 3
17-3860 Road Unit 00
? 20-2275 SAC
20-3865 Water Conn. , 1!?'75" o0
20-3868 Water Trmt. S?/O e o
20-3716 Water Meter a o) o 0
20-2252 Acct. Dep. '
20-3713 Water Yermit
10-3743 Sewer Permit.
79-3866 Sewer Conn. 300 0 0
11-3855 Park Ded.
? TOTAL"' ? 0
CITY OF EAGAN
N_ 13860
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt n-7 J aaa
Tobeusedfor SF DWG/GAR Est.Value $103,000 Da[e JOLY 1 I9$7
Site Address 4509 OAK POND RD
Lot 4% Block 1 Sec/Sub. FAWN RIDGE 2ND
Parcel No.
a Name ?Y1.AND HOMES
?Address 14450 BORNSVILLE PKWY
z
City B' VILLE phone 894-2636
.o Name SAME
?a Address
? City Phone
•a
W W
Name
ia Address
aw City Phone
I hereby acknowledge that I have read this ap
tbattheinformationiscorrecta reetocompl
State ot Minnesota Statutes,ity of Eagen
Signature of
A Building Permit is issued to: "" """"
all work shall be done in accordance with alt
Building Official
on and state
all applicable
OFFICE USE ONLY
OnSiteSewage Occupancy R3
-
MWCCSystem ?
Zoning R1
On Site Well Type of Const
-
City Water ? (ACtuaq
(Allowable)
# of Stories
Lengih 48
Depth 39
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments _ Permit $ 512.50
Water/Sewer _ Surcharge 51.50
Police Plan Review 296_ ?5
Fire _ SA0. City i nn . np
Enar. - SAC, MWCC 59 5_ np
Planner _ Water COnn. 59 S_ flp
Council _ WaterMeter F7.n0
Bld& Off. _ Roatl Unit 30 S_(1Q
APC _ Treatment P7 1 80. 00
Variance _ Parks
COPies
TOTAL ?? S
on the express condition that
Minnesota Stt?T)T¢tes and City of Eagan Ordinances.
w
REQUEST FOR ELECTRICAL INSPECTION EB-00001-06
? See inshuctions }or compleling this lorm on back of Vollow copy.
30 "'X" Below Work Covered by 7his Request
dd eo. Tvaa of auildine Aaoiioncea wired EquiVment Wired
Home Ranye Temporary Service
Duplex Water Heater Lightiny Fixtures
Ap4 Buildinq Dryer Electric Heatin
Cominercial Bldy. Furnace Silo Unloader
industrial BIAg. Air Conditioner Bulk Milk Tank
Farm Oth«r peulv .?hc? ISU„olvl
i er Pecify ffier Oth(.r
Compute lnspec[ron fee Befow
p Fae Service EnvancaSiza b Fee FexAers/Sublexders % Fee Circuies
U to 200 Am ?s 0 to 30 Am ps IMW 0 to 30 Am
Above 200 qinp5 31 to 100 qinps 31 to 100 Am s
Swinvning Pool qbpye 700_Amps Above 100_Amps
Transiormer5 Irrigation Booms Pdrtial'Other Fee
Signs Speciallnspection
'
S
'
Pemarks .t)
.D
5 TOTAL F
C'rl
/ . r I .f!
RouBh-in • - „
v D;/? ?} he Ele ic
(
C%? {Fsoector, hereby
t tn
tif
th
b
Final
o&a cer
y
n
e a
ove
? insoaction has been
?de.
ThIS requasl voltl 18 monihs imm
This reouest void /J ph / ai r
7p8?nwmhs^ tr^om^ n%/??o
e ¦ /I I <111 / // fg /
1.9 T 1 J V A. 7 /J / 7 - "?
Re uest Fire No. RouPh ?InsVeclion
Requ cA qeatlV Nuw ?I Notity, Inspec-
? '
`?
h ^v
?es ?No Ior When Ready
Q'Licensed Eleclrical Cmttractnr I hereby request inspection of above
I„ elncRical work inslalledat
? .,... ??.
Sveet AdAress. Boa or Roure No.
q 6, 9 ??K PaaD ?.
ecvon o. TownshiD Name or No. ftange No.
Citv
e.04,J
County
PAX6771
OccupanllPRINT) Phone No.
e LlfND
Power Su lier Address
?
?I? /-IN
•
GLGL'/• N
'
EIeGr-cal ConV cmr ICompanY Namel
?
s Licnnse Na.
Cnnvacior
Rtt?E
F}PALE
MaJing AdJress IConV ctor or Owner Ma,, e Instailationl
'
all tionl
Authorized Si nawre ICO recmr1Ow r Making In one Number
??J7Q
THIS INSPECTION flEnUEST WILI NO1
MINNESOTq STATE BOARD F ELECTRICITV BE ACCEVTED BY THE STATE eOAND
Grig9s-Midwey Blde. - poom N-197 UNLESS PFOPEA INSiECTION FEE IS
1821 Universitv Ava.. St. Peul, MN 65104 ENCLOSED.
Phone (6121 642-0800
OFFICE USE ONLY This request void 18 manllia hom volidafion dore printed in this box.
(?
!
I II I( I I I I II I I II I II I I I I I I I I I I I I I I II I II I I(?'? y?'
* 0 4 7 L 7 5 4 2?K
PLEASE PRINT OR TYPE ?
kequest Dde p,?j
3•Tun !/ Roogfrin inspection required2 Ves ? N.
(VOU musf coll Ihe Inspxmr when ready? Inspecfion Olher 71?an RougMn: ? Rsady N. Will Call
Dare Ready: $;7Q ?l r'
I, ? licensed contmcror 04 owner here6y request inspection of the above elechicol work ot:
Job Address (SVeat, Bow ar Room No )
ysd,
7 oqk Ciry Zp Code
SecNon No. iawnship Name or No. Nange No. Fire No. Couny
D.,koV-?
OccupaN
SeoP?` --c Phone No.
z/7Z
Povrer Supplier Address
Elenriml Conrcacror (Compony Name) Canhacmr License No. Moater Gc No. (Plant Elac1. Only)
Nwilirg Addresx (Connocbr or Owner Perfwming Insmllononl
AvMoraed SignaNre Conracror or Owne. Performiny Insallarian? Phare No. ?
EBUOOOIA-1 I B/96 STATE BOAHO COPY - SEE INSiBUCTIONS ON BACK OP YELLOW COPY
q( REQUEST FOR ELECTRICAL INSPECTION ?
471-7 5 4[21 g?p1 Univ rsiry A ear Rm. S-1ect28,'St. Paul, MN 55104 9
Phone (612) 642-0800
Home Du lex Apt. Bld . idker. -• New Addn
Commercial Industrial Farm Remod Re air
Air Cond. Htg. Equi . Woter Htr. Load Mgmt. Olher:
D er Range Elec. Heal Temp. Service
"X" above fhe woik covered by rhis request Enter remarks in this space and on fhe back of the white mpy only.
0- 6 ' Po 40?c.Vn6
Calculafe InspeUion Fee - This Inspection Reqaest will not be accepted wilhout Me correci lee:
Other Fee # Servicc Entranre Size Fee 7{ Circuils/Feeders Fee
Mobile Home Pork Stall 0 to 200 Amps 0 to 100 Amps
Sheet Lig./Traffic Sig. Above 200_Am s A6ove 100-Amps
Tmnsformer/Generalor INSPECTON'S IISE ONLY TOTA
Sign/Outline Lig. Xfmr.
Alorm/Remote Confrol
Swimming Pool
I hereb ceni Ihoi 1 In5 ed ?ha elenriml inatulkri describad Mreln on the dares sb.
Iffiyafion Boom Ro?Mn i Dare Cr Q
Special Inspection
Imesfigotive Fee Fin DoM
`D S
THIS INSTALLATION MAY BE OROEflED SCONNECT IF NOT COMPLETED WRHIN 78 MO THS.
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagau
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?
New Construdion Reauiremenls RemodeVReoair Reauirements Offwe Use 061
4
3 registered site surveys showing sq. ft. of lot, sq. R. of house; and all mofed areas 2 coples af plan Ced of Survey Recd .?.Y _N
(20% maximum lot coverage allowed) isetofEnergyCalalaUonsforheatedaddBbns TreePresPladRecd _Y?_N,
2 copies of plan showing beam & windOw sizes; poured found design, etc. 1 site survey for additians 8 decks Tree Pres Required _ Y_ N
i set of Energy Calculations Addition - iMicate ilarsite sep6c system Ohalte SepUC System _ Y_ N
3 cropies of Tree P2servation Plan'rf lat platled afler 7/1193
Rim Joist Detail Options seleUion sheal (6uildings with 3 orless units)
Date _C_ /Z- ?.Q/ _?_ Construction Cost a c
Site Address -l eJ U q?o C].? T(?1'C1[? ?• Unit/Ste #
Desceiption of Work '?,Ql0. C.Q RQ,T1 OclCSCN'
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2??S??OT`"•
U
Property Owner Scp* N Q('(-(,yN? Telephone # 1115 l ) to0 ) ' 1 4 1 ?1-
Renewal By Andersen
Cootractor 1920 County Rd. "C" West
Address Roseville, MN 55113 citY
State 651-264-4777 Tetephone # ( )
License # 20130983
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catezorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Calegory t Worksheet • New Energy Code Worksheet
(J submis5ion lype) Submitled Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/ W ater Contractor
Telephone #(
Telephone #( )
Telephone # (
In
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start witfiout a
permit; that the work will be in accordance with the approved lan in the case of wo k which requires a rev_iew and
a roval of plans.
Fl F, l i 1? 1! ?!.11 ??
?'??f0? ?nnSOYI '?GMJ??on5
ApplicanYs Prmted Name ApplicanYs Signature I1111
.
' OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 08-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 37 Ext. Alt- Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. AR - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgaze6o) ? 38 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
0 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement 0 38 Demolish Interior O 44 '•Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
O 34 Replacement *Demolitlon (Entire Bldg) - GWe PCA bandout to applicant ?
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas T ests Final
_ Framing _ Siding , Stucco ^ Stone _ Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
..v, va ? sa-..c a.uv .cG. vv rtid. f Od •44ba 4
o r,. ?.tv?rrkL as? ?rmute,7tstt • .
re.al
. Sune 7 2007 ' - - . ' 4•
• Csty ofEagati :
3836 PiIaf Knob Ra?d •
Eagan. MN 55122 . . .?
. To WBom Tt MaY cmtoern: .
Elder7ones i8 autho&,ed ' .
tD EIdcr Iones to pmvid ? ?builcHng pftmits PorRenevval bY Andncsca pieasa stlIow
. date bcyond 6/6101: untiI a??r jor ne in Hagaa, `titis authaclzeti[in is vslid foi sny
t° the CttY- ?` Ad°n maua= 04madY revokes it in wiiclag
I rcquesf this attttiolizstion be $ceepted.expeftoud
ottt baildiaS PcaCs ?Y ?cr. Plcasc caII mc If tLcic aea nn de2ey in the ?? of
i contacted at 763-502-4706 .. Y 4Qw?ons-. I can be
Your immgdiatc a#eation to t$Ls matter is atLr?rm ` .•-
sinoeialy,
ymond'R Itau
ustallazion Manager
Ranowal by Arad.cf5en Carporativn
C:e.: Kma-Flries Snne.a
rro?,y, ??taA[.
w,c«?u""en? rzaas
.
wuu
Received Time Jun. 1. I:OIPld-
MECHANICAL (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Plcase wmplete for: Single Family Dwellings Townhomes and Condos when pemvts are required for each unit
Date ?? ? ?? ? n,_?
Site
PropertyOwner ?7C'C?A'?"`? Cf1r?`3 ? ?
[7nit #
?k
Telephone #((t... c> ?) sc'G.
Contractor r k r
? , r..1 n..,.. - City
Street Address -? .-.
Zip ??5t1
State M NQ Telephone # ( )
The Appticant is _ Owner Conuactor Other
-
Add-on, modificariou or alteration to existing dwelling unit
J furnace replacement
air exchanger
? air conditioner
? other C),-% 'r 1-0 L1(1-2 f'
$ 30.00
.50
State Surcharge
$
Tota1
Of.,T 2 9 2003
ate; that the Work will
I hereby apply for a Residential Mechanical Permit and acknowledge that the inf o 1OnS°? o? at I understand this is not a
be in conformance with the ordinences and codes of the City of Eagan and with
permit, e with the
but only an application for a permit, and work is not to start without a permit; that the work wi11 be in accor
approved plan in the case of work which requires a review and approval of plans.
Applicant's Signature
Applicant's Printed Name
MECHANICAL (CONIMERCIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Pletase compiete for. commercial/industrial buildings
mWti-family buildings when separate permits are not required for each dwel[ing unit
Date
Site Address ' Unit # ?
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( ) ,;
II
Contractor
Street Address City '
Stete Zip Telephone # ( }
The Applicant is _ Owner _ Contractor _ Other '
Work Type
Newconstruction UndergroundTank _Install _Remove i
Interior Improvement Call for inspection du ring installatian/removal of tank
Processed Piping
Nature of Work:
?
P¢rmlt F¢¢ 550.50 Minimum Fee (includes Sta[e Surcharge) °
Contract Value $ x 1% _ $ Permit Fee
. If permit fee is $1,000 or less, add $.50 ? $ State Surcharge
If permit Fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ ' Total Fee
I hereby apply for a Commercial Mechanical Permit and aclmowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand diis 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.
Applicant's Printed Name
ApplicanYs Signature Approved By: , Inspector Date:
PLUMBING (RESIDENTTAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when pemuts aze required for each unit
-1 30 . -Z?-o
nafe 6 i 2 i.?oa3
Site Address YS?'/ c?tk O°n ? go' L?%5r'z unit #
Property Owner Jr'Ct5l? re vj Telephone #(/pSf } C Fl (`/ 7 Z
Contractor /U,( et
Address City
State Zip Telephone # ( )
The Applicant is x Owner _ Contractor Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
InGudes County fee. Additional consultant fees may apply.
Alterations To Eaisting Dwelling Unit, Including $ 50
00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater .
_ Abandonment of septlc system
_ Water turnaround (+ 5!8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
? Lawn irrigation system
f
i
1A)4 b
?
?
I
A
A
r
e/1MtH
G
Cft?
NIC. Wi
_ Wa[er softener _ Water heater $ 15.00
_ replacement _ additional
1
1,?J I? 01 I'
? I
I
Statesurcharge JUil 0 2?r? $
I I 50
Total
I hereby apply for a Residenual Plumbing Pemvt and aclmowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
perxnit, but only an applicauon for a permit, and work is not to start without a pernut that the work will be in acwrdance with the
approved plan in the case of work which requires a review and approval of plans.
?S em?l" fF . N rtdc ,d c?"Gl -%ti?-?
Applicant's Printed e Applicant's Signa e
**xtxxxxxnwFFxxxxxxxt?*****************
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 767
DATE: 04/24/00 TIME: 10:11:39
ID:
NAME: VISIONS MAINTENANCE FREE EXTER
3210 9001 4509 OAK POND R 237.25
2155 9001 4509 OAK POND R 7.00
Total Receipt Amount: 244.25
CR127102
USER ID: JAN
?**+******+***********x***************?
1 2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
?ITY aF ?GAN v405
t?
?U?? 3830 PILOT KNOB RD - 55122 651•681-4875
New ConshucHon Reaulremenh Remodel/Reoalr ReauiremeMs
> J reylsteretl sIte wrveys Ehowlny sq. IL W bf, aq. B. ol house 2 copias of Plan
and go rooled areas (4076 mmdmum bt coveraae albwed) 1 sef of eneryy calculaHOns for heafed addiMOns
> 2 coples ol plaru (show beam 3 wlndow alxea; poured fnd. design; etc.) 1 site survey lor extedw addlflona & decka
> 1 set o/ enerpy calculaMons
> J caples ol hea pretervaHon plan If lot plalted alter 7/1/93
DATE: CONSTRUCTION COST: I 3F 9? U. S?
DESCRIPTION OF WORK:
STREET ADDRESS: Lf
LOT: -L BLOCK: l SUBD./P.I.D. A:
Name: lUh ?. ?`? N?5?"olt Phonet: C?S I- ?'?(-/`f 7?•
PROPERTY Flrst
OWNER p,p
5h6et Address: `f S o?j O e6-?a.-G? citr e--- a ' statA: /11?- vp: sj ? a 3
Company: f/-\S, oL, Phone#: ?95? s'S?SS -s75` °
(area code)
COMRACTOR
Sheet Addresa: (2- 2 S i C te S license # aod v SSEL Exp.
Cm, 6 c.? r5 ?,' (/ °-- State: M? - Zip: S-S 3 3?
ARCHITECT/
ENGINEER Company: Name:
Telephone i: ( )
Sheet Address: ReglshaHon M:
CNy
State:
Sewer/water licensed plumber (Jf IrnWllina sewer/waterl: Phone #:
Zip:
I herQby aeknowledge lhaf I have read this applicaMon, stafe Mwt Ihe infortnalbn is correet, and ogree to eomply wNh an appAcable Statc
of Minneaota Statutes and CHy of Eagan Ordinancea
of Applicant
Signaiure
,
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
No
_ No
- Not Required
Z4
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex 0 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? OS 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
0 04 02-plex ? 10 08-plex ? 19 Lower Level 0 24 Stonn Damage
? 05 03-plex ? 11 10-piex Pibg _V or_ N ? 25 Miscelianeous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration O 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) O 46 Windows/Doors
` Give PCA handout to applicant for demoiition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Engineering
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 Ext. Alt - Multi
? 33 Ext. Ak - SF
? 36 MuRi
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:
SAC Units
% SAC
CITY USE ONLY
LBL I d RECEIPT#:
SUBD. RECEIPT DATE:
1997 PLUMBING PERMIT (RESIDENTIAL)
cinr oF encnN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
?
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
. backflow preventer for underground sprinkler system
FIXTURES EACH NO. TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet " minimum - 1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
water Softener ' for existlng dwelling 20.00 x =
U.G. Sprinkler 'fordwellingunderconst. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations ' to existing residence 20.00 = 20
Water Turn Around 20.00 =
Private Disposal System ' Dak Cty lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems " abandonment 20.00 =
STATE SURCHARGE .50
TOTAL 201 SD
I hereby adcnawledge that I have read fhis applicatlon, state that the iMOrtnatan is correct, and agree W comply w@h all appliceble City
of Eagan ordinances. It is the applieanPs responsibility to notify the property owner that the City oP Eagan assumes no liability for any
damages causetl by the City during its normal operational and maintenance activities to the faalRies wnstructed underthis pertnR within
City property/rightaf-wayleasement.
SITEADDRESS: d9LL m?W F-p%,-7 ewi// 5--slz3
OWNER NAME:
INSTALLER NAME: TELEPHONE #:
SThET ADDRESS:
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
(.7I1 V rlF FAGAN
CASiH:tl"_:Rs :i i[Fi"fIl?A!._ NUc 67
DnrE.n 06in4/97 rrMi::P 00002
:r.3 ;,
rIAnt:; ?.>rra7r A Nvr,r:Eu
205 9001 4509 OFlF: F'(7NiJ Ne 1.,,`;0
3430 9001 4°,i4.`:? OAI( f'ONS7 k 1.00
3211 9001 4509 UAF: F'ONI7 k. 40.00
3r^.:I.2 9001 4509 DFlI; PaKI f; i?CJ.C)Q
.'i'r?:I.il 9001 4509 DAI. F'f]NLi R 50.00
Tnta:i. ftecei.pt 6tronunt ". :I.ic?. i0
CR0i •i 9i'r.:i
L1SF.::Fi :[1?^ N(41+!;V
MMTMR?/M1TTT?TTTM'I?Y'?MMTMh??i TTmTTmTTTT?I??T?M1TTT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
030161
06JQ3jS7
SITE ADDRESS:
4509 OAK POND RD
LOT: 4 BLOCK: 1
FAWN RTDGE ZND
P.I.N,: 10-25201-090-01
DESCRIPTION:
Bti£1#lY{g'..Permit Type
Ltuilc3ing 0`Oyr:k 7yps
tertsus Gosfe.
m
i ?
i -
?a
re ?s
..;?
?
y} TV ;;'l "°i
6NSEMENT FINISH
ALTERA7ION
434 FlLT. RESIDENTIAL
?
i; R z
1}
vi 9 _"v
'"'.; ?)
dd
REMARKS:
SEPARATE I'ERMITS REQU.T,RED FOR AhY ELEC7RICAL OR PLUMBItVG WORI<
FEE SUMMARY:
6ase Fee $50.00
Surcharge $.50
ToL-al Fee $50.50
CONTRACTOR:
.
OWNER: - flpplicant -
NYGREN 5C0T7
4509 OAI< PONU RD
EAGAN MN
(612)681-1472
. ? , -. ... r. , ,, . .. _ y
I heraby ackiiowledqe that 1 have read?this application and ffitats that,ths
informatian is correct and agres Co compiy w3th alI-applieable State af Rfin.
z
Statutes and t-ity o?,Eaqan ,Ordir?anaes.-
PERMIT ?
CA' r. I Lf XL??I? ? E foY: ?a?I?ATU'?-
APPLICANT/PER E SIGNATUFiE
?5b- S-b
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
?P CITY OF EAGAN
3830 PILOT KNOB RD - 65122 U
687-4675
New Construetion ReauiremerNs $gmodeUReoeir Reoufrcmerft
? 3 registered site surveys • 2 copies of plan
? 2 copies of plans (indude 6eam & window aizes; poured fid. design; etc.) ? 2 ske surveys (extetiar aOtlitWns 8 dedcs)
? 1 energy plculaGons ? 7 energy calculatfona for heated addkions
? 3 eopies of tree preservation plan N lot platted aRer 711/93
reqWred: _Yes _ No DATE: Z Tw.r 9' 7 CONSTRUCTION COST:
DESCRIPTION OF WORK: F.:,.`s? ?F3aceswrrdc9L
STREET ADDRESS:
r
LOT BLOCK
y,s-o 9 lnrK [ranK ?4C . ?aaYrt /?/? .S$ ?Z3
? SueD./P.I.o.
?z
PROPERTY
OWNER
CONTRACTOR
Company: _N/^ Phone #:
Street Address: License
City: State: Zip:
ARCHITECT/ Company: Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer & water licensed plumber (new construction onty):
and lot change are requested once permit is issued.
Penalry applies when address change
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 af Eagan Ordinances.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
Name: NVrerr Sca 7t Phone #: 631- Jh'7Z.
w.. ?
Street Address:
City: C-174T.*1 State: In-ov Zip: ??Z 3
Signature of Appficant
_ Yes _ No
_ Yes _ No
???I'??'.??!?
-RECEIVED
JUN 1997
_ Not Required BY' !
OFFICE USE ONLY =-
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16, Basement Finish
? 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition o 08 S-plex ? 13 Garage/Accessory ? 20' Public Facility
? 04 SF Poroh ? 09 12-plex ? 14 Fireplace n 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex o 15 Deck
WORK TYPE
? 31 New ? 33 Alterations o 36 Move
? 32 Addition o 34 Repair o 37 Demolition
..?:iti'.: • .. ` `.1
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq.ft.
Buiiding
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
Variance
?
?
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
, Other
Copies
Total:
F?,I'i Engineering
Valuation: $
% SAC
SAC Units
; CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
"1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
:*OTE: PAYMFKP OF F.M AT TIME OF
: Arrr.IcaZZON noES Nom CONSTITUM
: APPROVAL OF PEF44ET.
: nvsencrioN oF sEWM nrm/oR MkTM
; a TrATToN$ WII,L N(YP ?.' $¢]@-
: UIED UN1RI, PERMIT HAS BFEN
: APPROVFD.
_ (Lot/Bloc 7Subdivision or Tax Parcel ID )
, .
IF E7ZSTING STRC'GZ[)RE, DATE pF ORIGINAL BUILDING PERMIT ISSL'ANCE:
PRRGENf ZONING/PROPQSID L'SE: (Mon Year)
[] ca+?acxAt/xa'rAU./oFFICa
rl IAIDCSTRIAL
n INSTITC'TIONAL/GOVFRNA'JENT
M'R-1 SINGLE FAMILY "
? R-2 DC?PLEX (7t?,a C?nits)
g; .
? R-3 ZOWN[IOCTSE (Three + Units) ( Onits)
? R-4 APARTPENP/CANIDOMINIC7M ( Units)
2)
NAME:
ADDRESS: ?
CZTY. STATE. ZIP:
PHONE:
3) • u c?• NAME: 0. (f, Iilc 4niL,¢ For City Use ..
P1LUnbers License:
p,oDRFSS: ya S-3 w. / (lote Active
`
CITY, STATE, ZIP:?-4??Yft .. M/l, S173 7 E7cpired
Sj Not recorded
PHoNE: gf y- ;77 ?91 MASTER LICENSE# -3 33 -7 Y,"l 7
sta?£' Initia7.
4)
•• • iDi •40
NAM:
ADDRFSS:
CZTY, STATE. ZIP:
' PHONE:
?
'5) it t a• • o• : = • ? - ??
? CONNECTION TO CITY SEWER ? CONNK..TION 'IO CITY WATIIt ? OTHER '
6) ?? • • r ? PLEASE HOLD APPROVED PEf2MIT FOR PICK-UP BY ONE OF AH3VE --'-- ---
Q PFASE MAIL APPROVED PERMIT TO 1. 2.Q 4. ABpVE .
(Circle one)
7) r ?•
?
: fOR CITY USE ONLY
PERMIT # ISSLED
D / 7
Pd w/Bldg. Permit
S
$
$ FEES:
g ? 7,
$
$
$
$
$ u-?)
$ $
$
$
$
SEWER
WATER
$ WATER
$ WATER
$ SEWER
PERMIT (INCLUDE"SURCHARGE)
PERMIT (INCLUDE;SURCAARGE)
METER/COPPERHORN/OUTSIDE READER
TAP (INCL[,'DE CORFORATION STOP)
TAP - I
ACCOUNT DEPOSIT - SEWER
$ /? -LfS ACCOONT DEPOSIT - WATER
S
WAC ?
4
$ SAC j ,.
$ TRLNK WATER ASSESSMENT
$ TRLNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRLNKI'iSEWER
$ LATERAL BENEFIT/TRLNK,WATER
$ WATER TREATMENT PLANT'?SLRCHARGE
$ OTHER:
$ ?,CI-Z1 TOTAL ?
`-?-.-ZZ-.
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQOIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F-l YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION. ,
SDBJECT TO THE FOLLOWING CONDITIONS: ?'i
2007 RESIDENTIAL PLUMBING PeRMiT aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings. uo not combine inside and c-.rsbr2e
plumbing on the same application separate appiications and Vmits are reyuired.
Date
Site Street Address Unit #
Property Owner c?Cc' , v LW Telephone #(6,A' (42?
Contractor A liance Connections Inc Telephone #( )
Address 1313 Dan ! State Zip
,
9?
The Applicant is: _ Owner & Occupan2-4454803 icensed Plumbing Contrector
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes Counry fee
- $ 100.00
Per as-built $ 10.00
Fire Repair (replace bumed out flxtures, etc.)
This fee a lies when extensive lum6in re airs are made to a buildin . $ 90.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. Triis fee includes
instailation of a water softener and/or watec heater at the same time. !f you are
installing onlv a water sofiener and/or water heater, do not complete this secdon;
move to the next section and place a checkmark next to the appliance(s) you are
installing.
_Septic System Abandonment
_ Water Tumaround (add $136.00 if a 5/8" meter is required)
Other:
Water SoHener Water Heater
Z $ 15.00
_ new replac
ement
_ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total
? y $
I iicrcoy appry ror a neswenuai rwmbing rermit and acknowledge that the in[prmation is complete and axurate; that the work will be
in confortnance with the ordinances and cades of the City of Eagan and the plumbing codes; that I understand this is not a permit, but
only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event
a plan is required to be reviewed and approved.
.I-
C1ty af EagaIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (657) 67$-5675
Fax: (651) 675-5694
-----------------,
? Kor;of1110e?usil ?
? I
; Pewrt#: 83 3 ?
I PertnR Fee? ?
Date Received?SJ
7 ? I
v
i scan? i
?----------------?
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Dafe: 'y Turl OY" SiteAddress: tlSd ! 49s.E /mn41 )laC Fa?q,c[ ,SS`?Z3
Tenant:_ Scet-ff N4? er? SuifeO:
pESIDENT/OWNER w - ? ° -9
Name: Sczdt_ NN?S/C?? PFqnB: f.f/ 6S/-983-L2C9
naarass /ciri i ziP: Ys6.5, ?L ?wq4 S3"l z3
,
Applicarrt is: _X Owner i CoMractor
TYPE OF WORK Description of work: AlcV SY4.`YS 4i+t' 6xi` /a C,c lave-e
Constructbn Cost: '¢ zm0 Multi-Family Building: (Yes No LC )
CONTRACTOR Name: Se f? License #:
Address:
City: State: Zip:
Phone: Contac[Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minneso[a Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . fiesidentiat VenDlatia+ Category 1 Workshee[ • rrew Energy Code worksnset
Category suammed suanined
(4 submisSion type) • Erier9Y Emelope Calculffiipns Su6mdted
In the last 12 maMhs, has the Clty of Eagan issued a permit far a aimilar plan based on a master planT
_Yes _No If yes, tlate and address of master plan:
Licenaed Plumber: Phone:
Mechanical CoMrector: prypne;
Sewer & Wa[er Contrac[or: Phone:
NdTE: Wans and suPPamr+9 docwinents that you subritit are considered to be public informatfon. Porteons of ,.
the in/ormation may be c/assiWas noaywtilic if yau provlde specif"w¢ ?sonS that; would pertnit fhe Clry M. ;.:
" conclude that the are t?ade seeiets. .
I heraby ackrqwledqe Ihat this infortnaGon is complete and aDcurale; tAat the work will be in confarmarae with the ordinarqes and Codes of tFre City of
Eaqan; that I uridwstand this is not a pertnit, but oMy an application fpr a permi[, and wwk is not to start witMut a pertnd; that the work will be in
accordanCe with the approved plan in the case of xvrk which requlres a review and approval of plans.
: Sco-ft /d N., q.e?, _
ApplicaM's PriMed Nam AppllcaM's Signature
Page 1 013
o5-
• DO NOT WRITE BELOW THIS LINE
SUB TYPES
, ? Foundation ? OSplex ? 16•plex ? Accessory Bullding ? Pool
? Single Family ? Obplex ? Flreplace ? Porch (3-season) ? Ext. Ak. -1Aultl
? 07 ot _ Plex ? 071p9ex ? Garage ? Porch (4-season) ? Ert AR. - SF
? 02-Plex ? 08•plex X Deck ? Porch (screeNgazebaparqda) ? Multl Misc.
? 03-Plex ? 10-plez ? Lower Level ? Storm Damage
? 04PIex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? InteHor ImprovemerM ? Siding ? Uemolish Building'
?k AddiNon ? Move Bullding ? Reroof ? Demolish Intedor
? Alteratlon ? Fire Repair ? Wlndows ? Demolish Foundatlon
? ReplacemeM ? Egress Wlndow ? Water Danmge
' Demd'rtion (errtire huiEdng) - give PCA fk'indout to applkaM
vcvvnr v?. ?l n
? V V
REQUIRED INSPECTIONS
Footlngs (new bWg)
FooTfngs (deck)
Footlngs(addklon)
FourMatlon
Drain Tile
Roof: Ice & Water Final
Freming
Flreplace:_R.I. _Air Test Final
Insulatlon
Valuatlon
upancy
Occ
MCES System
Plan Review
de Ed(tion
Co
SAC Unils
(25
%100%? Zoning GtyWater
Census Code Stori
es
Booater Pump
A of UnRs
re Feet
Sq?
PRV
# of Buildings Length Flre Sprinklers
Type of Const Width
Reviewed By:
RESIDENTlAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
UNlity Connedion Charge
SSW PermR & Surcharge
Treatment Plant
Copies
Total
Sheetrock
Ftnai/C.O.
? Fiirel/NO C.O.
Building Inspector
HVAC
Other:
Pool: _FOOtings _Air/Gas Tests Final
Siding: _Stucco Latl? _Stone Lath _Brick
Windows
Retalning Wall
GJ?IUL -
G7WO?
Page 2 of 3
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City of Eapn Permit I . CJ(J
I Permit Fee: ,
3830 Pilot Knob Road ) I
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675 1 j
Fax: (651) 675-5694 Staff:
1 I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION CQl'-uo
Date: 03' f6W ~2 Site Address: l < ✓~~UC ~LoC
Tenant: Suite
~l'6~l ly~
RESIDENT /OWNER Name: 5CO-ff iQ. >7ai~Gl/~ p_ / Phone:
Address / City / Zip: nor
Applicant is: -~lf Owner Contractor
TYPE OF WORK Description of work: e-414 'G
Construction Cost: Multi-Family Building: (Yes No t )
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, data 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 prot4de specific reasons that would permit the City to
conclude that the are trade secrets,
1 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 approvals of plans.
x -C D'P"r' x fJ r
Applicant's Printed Name Applicant's Signature T
E (r('9-1 IE 1E 0 Page 1 of 3
JUN 2 3 2009
:Por~c(
DO NOT WRITE BELOW THIS LINE r~
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi , Deck _ Porch (Screen/GazebolPergola) _ 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 Z~G 2 MCES System
Plan Review Code Edition SAC Units
(25%_ 100°/q 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
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
Meter Size: 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 3
Use BLUE or BLACK Ink
For Office Use 1
r I c9 ~ 7
I I
City Of Ea~Il I Permit
I Permit Fee: 11
3830 Pilot Knob Road I I
Eagan MN 55122 RECEIVED I Date Received:
Phone: (651) 675-5675 I Staff:
Fax: (651) 675-5694 SEP 3 0 2010 -----------------J
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: C'1100 Site Address: 4 o
Suite
Tenant:
RESIDENT/OWNER Name: Phone: ~D (6al -
Address / City / Zip:
CONTRACTOR Name: ~IL1 Y '~.J~ Li s (OSS~
Address: sns 't L/11.J1 J]V`~ City: State: Zip: Phone:
Contact:
TYPE OF WORK _ New %4-- Replacement _Repair - Rebuild - Modify Space - Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater _ Water Softener
Lawn Irrigation _ Add Plumbing Fixtures
L- RPZ / _ PVB) l- 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 $ -t -
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.orct
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.
x I.Xs ( x
Applicant's Printed Name Applicant's Signature
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:EA117841
Date Issued:10/23/2013
Permit Category:ePermit
Site Address: 4509 Oak Pond Rd
Lot:4 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-040
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 .
Rick Schwab
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 -
Scott A Nygren
4509 Oak Pond Rd
Eagan MN 55123
(651) 687-8605
Eagle Siding
1301 East Cliff Road
Suite 117
Burnsville MN 55337
(952) 746-3046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA158772
Date Issued:10/30/2019
Permit Category:ePermit
Site Address: 4509 Oak Pond Rd
Lot:4 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Scott A Nygren
4509 Oak Pond Rd
Eagan MN 55123
(651) 681-1472
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
Applicant/Permitee: Signature Issued By: Signature