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4510 Oak Pond Rd-,.? . , - ? CASH RECEIPT ? CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ' DATE - • 19 ? RECEIVED RROM AMOUNT ? I & OOLLARS 1 oo F?GASH []CHECK FUND I COOE I AMOUNT Thank You BY White-Payers Copy Yellow-Postin9 CoPY Pink-File Copy BLDG. P,ERMIT N0. 0I-3210 Bldg. Permi 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permi 20-3743 5ewer Permi 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL ?- - r? 3830 Pilot Knob R d! P.O. Bo 2G-A1 9, Eagan, MM 55121 N2 13164 PHONE:454-8100 l ? BUILDING PERMIT Receipt M To be used ror S'r' UWG/GAi2 Est value $57,000 Date Fr BRUARY 4 19 87 Site Address 4510 OAIt ;PO,I'.) !Zi) Erect Occupancy R 3 Lot 1 Block l Sec/Sub. PA1tiV F2ZAGE 2Nll Remodel ? 2oning itl Parcel No. Repair ? Type of Const u a W Z 3 0 Oemolish ? Depth Int Impr. ? Sq. Ft Install ? $Ah1E ? W Name CRADIT d? ASSOC ?? Address 9TH & ?tiiISSI.SSIPPI E2IVER <W City h1Z'LS Phone 379-4947 I hereby acknowledge that I have read this application and state thatthe information is correct and agree to eomply vy#h all apblicabie State of Minnesota Statutes abd CitY oi Eaoen OrdifiAn?"'`------ Signature of Permittee '? ' - ' ' ' A Building Permit is issued to: BURR OAR 8LDR5 I IVC all work shall be done in accordance with all applicable State of Minnesc Approvals Fesa Assessment Permit $ 353.00 Water 8 Sew. Surcharge 28.50 Police Plan Review 176 . SU Fire SAC 625.00 Eng. Water Conn. 525.00 Planner Water Meter 67•00 Council Road Unit 305.00 Bldg. Off. Tr. PI. 180 . 00 Var. Date I CopiPs Total ?2 , ZtiO . OU on the express conditlon that Statutes and City of Eagan Ordinances. PormR No. Pwmit Holdar Date TN?phona 8 Plumbin9 ti4.( )/; H.V.i?.C. elschie v 4 /1O '7 ?i?, :J C ;,. $OIIMM (MPlCUOfI Da1e lf1ap. ?.'OfN11Mflft Footinpf I Footlnps II FoundMion Frsminy , !/f?? 7 RooNny Rouph Plbp. ; ffJ ? Rouph Htg. linul. Fkeplace Finsl Htp. 3 3c x j Fl nal Plby. L?- ?? 47 ? s Bldy. Flnal ? ?•? , ? ? _ ?' . CHt.Oec. Deck Fty. Deck Frmy. Well Pr. Dlsp. I .'r?r.+p?t' •?Y'i"..} .. - . . , . , -t . . i:, .. "7.ury . . .. :a . . . , , . , .:;j. ? rS?'-' "°riy)• y?: .. r . ' PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN ? 3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE - CONTRACT PRICE PHONE: 454-8100 Site Address ! TYPE WORK DESCRIPTION BLDG . Lot Block Sec/Sub R N ew es. m Name lt Add M ? Address -on u C R i omm. r epa c City Phone ?' c r Oth er Name t FEES _ c Address RES. HVAC 0-100 M 8TU -$24.00 p City - Phone ADDITiONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 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 (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM a BEYOND $1,000.00) Gas Piping Outlets # Other FEE , S/C' SJGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN ? .. ` . . , .,., s . ? ? . , . ,. . .. .. . . . J? . ' , '" \ ^ r` ! PERMIT # PLtI M81iYG PERMtT %?? U Ca CITY OF EAGAN RECEIPT li xl -3 Xf 3830 PILOT KNOB ROAD, EAGAN, MN 55122 QATE: 7 Site Address Lot . ' Block ? Name /-+r. S, ro Address ,6W'?? !E _L- ? c Ciry c 3 O Address City - Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MiNIMUM - RESfDENTIAL FEE - $12.00 MINIMUM - COMMIIND FEE - $2pA0 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRIGE GOES BEYOMD $1,000.00) FOR: CIN OF EAGAN BLDG. TYPE WORK DESCRIPTION Res. -r? New X Mult. Add-on Comm. Repair Other RES. PLSG. OtVLY - COMPLETE THE FQLLOW!?UG: NO. FIXTURES TQTAL Water Closet - $3.00 "- -L_Bath Tubs - $3.40 ' ? Lavatory - $3.00 - ' ' Shower - $3.00 / Kitchen Sink - $3.00 -' Urinal/Bidet - $3.00 / Laundry Tray - $3.00 _LFloor Drains - $1.50 ?Water Heater - $1.50 Whirlpool - $3.00 ' Gas Piping Outlcts - $1.50 ? (MINIMUM - 1 PER PERMIT)' Softener - $5.00 Well - $10.00 Private Disp. - $10.00 .= Rough Openings - $1.50 FEE STATE S/C: GRAND T07AL• -2 V ? `" 4 % e s (ger#i#irate o# (Orru?aury Citp of (Eagan arparimpnt of iuYtding 3wrrii.an Tlirs Certificate rssued pursuant to the requirenrenu ojSection 306 of the Uniform Building Code certifying that at rhe tirne of irsuance this structure was in compliance with the various ordinances of the City regulatfng building construcrion or use. For the following.• u.e cxssirnooo 5A I?1Gr :- elag, Rr?c No. Oocup-y lyPe ? Tvnin6 Dip+icl Sype C.- . Owner of &n7ding Addrmy 1 140 ? • Z K' a`•31 1 f• +.'? ! ' ' " Buildio6 Add?tas Loality -•! , tj2 . D,te: !+IA.?] 3i?? i?b' euming oaww PO5T IN A CONSPICUOUS PLACE cmr oF E?GAN ' 3830 PNot Knob Road WATER SERVICE PERMIT P.O. Box 21190 PERMIT NO.: E89811, MR 55121 DATE: -?'. 3i.'. i Zoning: No. 01 Units: ' I°nv. r' I a T.. r Owner . Address: Slt@ Add@sS: ? c> > ti:i'. nnn.i 1 1 $L I I Plumber: ci,t'a »7urnh in Meter No.: _ Size: Reader No.: I agree lo comply wlth the City of Eayan Ordinances. By Dete of Insp.: Connection Charge: Account Deposit: ? Permit Fee: Surcharge: ~C, ' Misc. Charges: -?.•;? :1:utCI Total: Date Paid: ' OF EAGAN SEWER SERVICE PERMIT ? Pilot Knob Road gax 21199 PERMIT NO.: m, MN 55121 DATE: - ng: No. oi Unib: Surr Ca'.: ?2.drs. Plun !o comply wlth the City of Eaqan BY Date of Insp.: Insp.: Connection Charge: ',25 . OOnd Account Deposit: 15 - 0-0Rff! ? Permit Fee: 10 -OOP' ? Surcharge: Misc. Charges: Total: ? Date Paid: • CASH RECEIPT • CITY OF EAGAN 3830 PILOT KN08 ROAD EAGAN, MI NESOTA 55122 • ._...???v??/. ._ ? oo??aws RUNO CODE pMOVNT ?? O G U ? U ? .0 Thank You ? N_ 70860 White-Payers Copy Vellow-POSting Copy Pink-File Copy ?,. CITY OF EAGAN ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 13164 , PHONE: 454-8100 BWLDING PERMIT Receipt# r ?P 7oheusedFOr SF DWG/GAR Estvalue $57,000 Date FEBRUARY 4 19 87 SiteAddress 4510 OAK POND RD Erect Occupancy R3 Lot 1 elock 2 SeciSub. FAWN RIDGE 2ND Aemodel ? zoning Rl Parcel No. Repair ? Type of Const. V Addition ? No. Stories ? Name BURR OAK BLDRS INC Move ? Length z 11461 GOLDENROD ST Demolish ? Depth 44 o Address Int. Impr. ? Sq. Ft City COON RAA;QS 452-2906 Instau ? o SAME Name = ? ? Address ? City Phone ?a Name CRADIT & ASSOC w W ?; Address 9TH & MISSISSIPPI RIVER gw Ciry MPhone 379-4947 I hereby acknowledge that I have read th is application and state that the in(ormation is correct and agree to ply all ap licable State of Minnesota Statutes dty f E r Signature of Permitte A Building Permit is issued to: RR OAK BLDRS INC all work shall be done in accordance with all of Minnesota Assessment _ water & Sew. Police Fire Eng. Planner_ Council - Bldg. Off. APC Var. Date Fees Permit $ 353.00 Surcharge 28.50 Plan Review 176.50 SnC 625.00 Water Conn. 525.00 Water Meter 67.00 Road Unit 305.00 Tr. PI. 180.00 Parks Copies T,,.,i $2,260.00 on the express condition that and Ciry ofEagan Ordinances. Building Official ° ° - ?' .3101$ 7 REQUEST FOR ELECTRICAL INSPECTION Alk EB-OOOOL 5 ? Sea instructiona lor completing this form on back of yellow copy. ? Qn QF, Q "R" Be/ow Wark Covered by 7his Request IYewIFifC1 BeD.7 Tvoe of Builtlina 1 Aooliancea Wired 1 EquiVmen[ Wired I CCtri C ndustrial p Fee ServicaEMrone95ixa p Fae Feeders/3ubfaeders N Fee Circuits lD U to 200 qm s 0 to 30 qm s 0 tn 30 Am s Above 200 qmps 31 to 100 qmps 31 to 700 Am Swinvnin Pool Above 700_Amps A6ove T00_Am s Transtormers rngation Booms O ?artial-'Other Fee u I Signs iSpeciallnspection Rem3rk5 E4TOTAL E ' ? " ' (? I, the Elecvical I ' ? n d/ ?'0? Inapector, heraby ?f cerliW lhat the xbova Finel v 0.1e inspeelion haa been ?,?; m aa. mis requeal v01E This reQuesl voitl _j,?1,11•7 18 mpnths (ram e 8 0 8 5 9?,?, fieq4est Date ? Fire No. RouPh-in Insuec ion fl iretlt Inspec- ?fleatly Now tWill Notify ? ?? aa-- r Yes ?Nn , ?or When Ready ? Licensed Elecvicel Contrecmr 1 hareby raquest inspeetion ot above ? Owner elecvical work installad ar. Stree} ACdress, Box or oute No. k ? l ? 5/ GtY E D ?t, n c f ?t 2 ecuon o. 1 Township Name or No. Flange o. Cow?ko4a' Oc pnnt IPHINT) ' ? k ? D Phone Nn. u rr a Po"? Supplier Ua ko-4a, Atltliess Elect ical ConVactor (COmvan Neme) " /?I drav?d ?iec-?sc_ Contrar,mr's License No. .?r6ro -a- Mailine Address (ConVacmr or Owner MakinB lnstailation) 2?5-0 0 W 8u?'r?scn 0d 4 ) . - o1 AuMo4yed Signature ctor Owner Making Installationl ? Phone Numbe. 84'0 -96 ?l MINNESOTA STATE BOARD OF ELECTqICITY ' . THIS INSPECTION HEQUEST WILL NOT GriBBa-Midwey Bldp• - Room N-191 . BE ACCEPTED BY THE STqTE BOAXD UNLESS PROPER INSPECTION FEE IS 1821 Univeraitv Ava.. St. Peul, MN 56104 . vnnnnf5121662.0900 , ENCLOSED. ? ?? ??} KWD.?A l t9 6 C-- R+ t / 1987 BIIII .DING PEAMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS IIiCLDDE 2 SETS OF PL6NS, 3 CERTIFICAiBS OF SORQSYt 1 SET OF ENERGY C9LCOLAYIOHS HOTE: ADDRESSES FOE COSBER LOTS - COBTEACTOR/HOMEOiiNER lIDST DESIGHASB WHICH ADDESSS IS DESIRED. NO CHANGES WILL.BE ALLOWED ONCS BDILDING PSRHIT IS ISSQSD. MQLTIPLE D{iELLINGS - RBSIDENTIAL RENT9L DAITS FOR SALS IIHIYS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRYEY - CHECB iIITH BLDG. DBPT.t 1 SET OF ENERGY CALCOLATIONS ? COMFERCIAL I ? ?? ?J INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND 5"i, ? To Be Used For: ' ? ovrr? Valuation: ? Date: a???87 4s?o Site Address V-Rg 01¢K ftJp kD OFFICE USE ONLY Lot j Bloek 1;?_ Parcel/Sub fjq?Jq) P 106E YZ Owner 914 rr &k R 1 Drs -? h c^ -? Address ?/y(/ Q0, rJ -.54. City/Zip Code r-po, Phone(6/,? )% :5-a -a wG Contractor ?'?e-wE Address City/Zip Code Phone Arch./Engr. C.?d, Ly 6 SSo c Address tSs ie[ue.r City/Zip Code ?? n IS {14 .7?_,?.r_ - Phone n 379-5'9y-2 On Site Sewage MWCC System ? On Site Well City Water ? 6PPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance Occupancy t:?3 Zoning RI Type of Const (Actual) (Allowable) ? U of Stories Length 38 Depth S.F. Total Footprint S.F. FEES Permit 353, Surcharge Zb. ? Plan Review 17(o.SO SAC, City loa • SAC, MWCC 525 , Water Conn 5zS' Water Meter 61. Road Unit 305. Treatment P1 I?O• Parks Copies TOTAL ? % (? ', ??.2 oA? aosE ?`"`?'?s ENGiNEEf?1NG ?OHSUL71H6 Eti61HEfA5 ptANHEAS aad LAHD ?URVEYOflS COMPANY, INC. ? 1?00 GLST 1461n 57A£ET, BURNSVILLE, litNN£:OTA 5??3? pN 4:2-3000 CL•'T?Z?ZCQ?e D?' tSZ.L?"7/'e[? Za?r,ct Lk.scrfe?io?z• Lt?7' I, ?(?Oc.K Z ???c?y `f??.0? zN+? ?Q,?-?oN ?A?o-x?. C??ra.? ? 1vl?NtilESoTP? ?Q\?'i2? ?a?? ??? - Q?? S 89 00 40° ^ _ 11Z?1q _ ?? iy_ ?? ? ? ?? .? ? s e -y `/ ? . ? v ° ? 30' S6T-gA?? L?taC?? Q' ?-1 r, ,? (4'to,o? - ? ,, pAi3.i. o Zo.? ??ll'?.O) L3.yZ ?d C, ? -? LO?- I i ?oroqe . Pro ased , ? ?A ? 0 0 ??' ° ? ? a Hc?ee ?-Q ?o.d ? wM t / `n ?n'? :.d " ?(Z.PrIIJ A-?.TC l?'l ll ?O? ?+1? O$? O C L VTiL?Ty 4'SA? ?> ? E/?Sc/?r.?T ? ??o.r ?' ? o I?zo. ?; 9i ? ??-? N M ,? ?- '.,. ? ?? - ?4?.00 • ?s. 8 9 ° 38' o ? ` ?N ???. =gy, zZ. 4? 39 •, ? ? ?? ? '?',. \ 4 ? .9?° 7C (?r ? 5. ` ?o`? -0 A ?o' 3 ' o.o °' .e ?l Q SG Q?E. I'_ 30` D R? c s C N . ?) a; ? ? ?o I? i ? ?a ?' ? I ? ? ?- ? ?-?? ? ?_ I. ii c?s.d ? ?enofes ?xis?'in9 ?/evo?'ions ?4zo,1> L7enofeS P?"oPoSed E/ev4fions ??- flenofies ?,'recf?on of Svrfqce Drcainczge. RZo.?3 _ ?inished Garcac?e Floor ?.,teva?'ioR I hereby cartify ihat thia ia a t:ue and carrect repraaentation of ?t tract of ?and as sl?ova'and deacribed hereon.• Aa prepared by me on this •/9n/ day ot .?.?...war?? , 19 ?7 . . , ... ?% ? Ninn. lleE. Ho. //?rS _ ? %?*-?' :.. . . V?sN .. . . .q??,J;.. . . . . . . 0 I , 579-4W7 ' ?up...wm.ee?io . ? ?om a rear •... . .. , . „ ;... . . . , ,. , .. ?' ,,. .. .. . , ' +, . . ..." , - , . , :.p. ,')a. - -'arMtlmeNral dnlgnm ol outem - e _ . . : . .. ., ?1?, . . . . _ _ .. . _ , . . - , •? . ' ',r EXTZRIOR ENVELOPE AVII?,AGE "t1" COMPDTATION OWma PLADT N0. sxrE annx.Ess naTr MAI?h? t,(9??i ?: ,' .. CON'P&ACTOR ?%RR OA(L P)UIl.D{:R12 ' PHODIE ' Determiae working'square Pootage oP eaoh 1. Total expoaed wall area...... sq.ft. x,? ? '. . 2. Total rooS/ceiling area....,. ??O,O sq.ft. x?= .. . ? . ',' T:. 3. Total floor/cant. area....... 84.ft. xALQ= " Total ezposed wall area above Yloor (51??? ?. 8e TOf.81 WSll WiIXIOW ......??• b• Total door 8I'68.......?.???????????.?????????• p Qe TOt.81 5liding g1.83S door 8P88•eo?aa 0 6 0 a???e d.' Total Pireplaoe wa11 aroa.e ................:. e. Total wall framing area (average 10?).....oee ? f. Tota2 h9t. W811 8T98 8bOV9 flOOrtateeeoe-o- . 'O . ?:. . g. Total rim joiat area ....................:...e•7 Total exposed foundatlon area ho TotRAl fOUTldati0tl WiTi[lo4i aTAao............ooe. ...... ..,' ..:.'"' , ':- i. Total net foundation area above grade........ Determine "tJ" value of eaoh wall segmeat , ? a, 11910 x "U, , 35 = 5 b. ? a "U" ' .r. '. ... Qe lo x otQw d x MUn e. x xNQw ? 57.7 f a ,o g o I .?-(e,o a "U" 041 = ' ?„ , h x nQa a i. ?O x "U" ?Ir? c oio 4 . ................................... TOtaai = I4S. , If item #4 is the same as, or less than item $19 you have met ,;. the intent oY SBC 6006(a)2. CITY OF EAGAN APPUCATION FOR PERMIT SEWER AND/OR WATER CONNECTION *R7n: PAYMFTIf OF FkE AT TIME OF APPLIcATIoN DoFS Nar aorsrIzcrM APPROVAL OF PII2hIIT. INSPDCTZON OF SF.WR ADID/Cdt MTE2 IL'ST'AT.T.ATTONS WIIS, NOT BE SQ3ED- OLID iINPILL PERNIIT fTAS BFEJ APPF20VID. P ease Print) 1) PROPERTY ADDRESS: •- LEGAI. DESCRIPTION: t v3 IF EXISTING STR[:CIS7RE, DATE OF ORIGINAL BL'ILDING PII2MZT ISSL'ANCE: ' (Mon Yearl PRESENT ZONING/PROPOSID (!SE: Q COARMERCIAL/REPAIL/OFFICE _tqZ?R-1 SINGLE FAMILY F7 IrIDL'STRIAL Q R-2 DUPLEX (1wo C?nits) n INSTITUTIONAL/GOVII2N1ENT Q R-3 RUWNHOLSE (Three + Units) Units) ? R-4 APARTTENT/COAIDOMINZUM ( Units) 2) ? NAME:_ ADDRES5:IQ Rt/G-, CITY, STATE, ZIP: PHONE:_ 7 `/ ?i -7 6 n 0 , 3) • ??; ?,. For City Use . ?`??"?= PLc'L.„ X'1 n? Plumbers License: ADDRESS: 2;n?„ ., A-v'f_? ? Eycpired Active CITY, STATE, ZIP:,S"?', /r?.?? _.S'S-?7Sl' Not recorded PHONE: 7G o r. MASTEE2 LZCIIVSE# dCi,??i'7 h'2 D St?itial 4) @_*• • ? i3• - - NAM: _ ADDRESS: CITY, STATE, ZIP:?t,sr, PHONE: 7:?'" -,) •5) ? '? ?• ' ? a: • ?• : oi • or . a? ? CONNECI'ION TC) CITY SEWEft ?CONNECTION 'IO CITY WATER Q OTHER ' . 6) wt,1106V.14 r- • r C] PLEASE HOI7] APPROVID PERMIT FY)R PICK-L'P BY ONE OF ABOVE _`- PLF.715E MAIL APPROVID PERh1IT 7CJ 1. 2. d? 4. ABOVE (Circle one) '7> FOR CITY USE ONLY PERMIT # ISSUED Pd w/Sldg. Permit c s C' $ $ $ S $ ?:z5,cc $ $ S c s /,317- cC' FEES: $ jG . 5 C' $ c $ SEWER TAP ACCOUNT DEPOSIT - SEWER U ACCOUNT DEPOSIT - WATER $ WAC $ SAC $ TRONK WATER ASSESSMENT $ TRL'NK SEWER ASSESSMENT $ LATERAL BENEFIT/TRONK SEWER $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ OTAER: $ TOTAL 11 ?c, ?aZ(c - ??, _? CP a RECEIPT RECEIPT DOES OTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PLBLIC Q ROADWAY" MUST SE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SORCHARGE) WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP (INCLC'DE CORPORATIO[V STOP) DATE : ??„? j / •> ? Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - I For Office Use I Permit I E City of Era I c 1 Permit Fee: 3830 Pilot Knob Road j I Eagan MN 55122 1 Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 L Staff: INFLOW,&r INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: Site Address: Tenant: Suite J Name: Phone: RESIDENT / OWNER Address / City / Zip: Name: License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: 1" oce 5'/1' 41 d _ DESCRIPTION FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x x Applicant's Printed Name Applicant's Sig ure FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough-In -Final Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use I Permit l -7) j City of Ea ~a~ I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: - jG Z Phone: (651) 675-5675 I , Fax: (651) 675-5694 1 Staff: tic-) I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~i zo/ 2 Site Address: /?S l6~7 "t-, Unit Name: P11 V 2 / T/Y v _s Phone: 2 5 l~ ~~SS RESIDENT / OWNER Address/City/Zip: 47'/"~/~"z Applicant is: _y_ Owner Contractor TYPE OF WORK Description of work: Construction Cost: Z 5 Multi-Family Building: (Yes / No Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 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. D Applicant's Printed Name Applica s Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA116624 Date Issued:10/09/2013 Permit Category:ePermit Site Address: 4510 Oak Pond Rd Lot:1 Block: 2 Addition: Fawn Ridge 2nd PID:10-25801-02-010 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 . Aleksey Burlakov 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 - Pavlo Trynos 4510 Oak Pond Rd Eagan MN 55123 Diamond Cut Homes Inc 965 Evergreen Tr Circle Pines MN 55014 (612) 868-9460 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA122649 Date Issued:05/15/2014 Permit Category:ePermit Site Address: 4510 Oak Pond Rd Lot:1 Block: 2 Addition: Fawn Ridge 2nd PID:10-25801-02-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Pavlo Trynos 4510 Oak Pond Rd Eagan MN 55123 Apex Energy Solutions 1509 Southcross Drive West Burnsville MN 55306 (651) 688-2739 Applicant/Permitee: Signature Issued By: Signature