4517 Oak Pond Rd... ' .. --.
CASH RECEIPT'
CITY OF EAGAN 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DA7'E . .. . ?tJ? 19
RECI[IVED
FROM
AMOUNT. $ ?
[:] CASH
& DOI.LARS
?oo
? CNECK
0
FOR i., . . . 1n 1 .
.. - . _ \ . , ; ,.
1 . . .?
,
F'UNO COOE AMOUNT
i r r
White-Payers Copy
Yellow-Posting Copy
Pink-File CoDY
Thank You r
B Y l... . ?
BLDG. PERMIT N0.
01-3210 Bldg. Permit - °-??
01-3422 Check '-
01-3445 5urch./Adm.
01-3446 SAC/Adm. , ? ) f
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 Permit
20-3743 Sewer Pertnit
79-3866 Sewer Conn. '
11-3855 Park Ded.
TOTAL = "?' ' ?
3830 PNot Knob R d! P.O. Bo 2G-A1 9, Eagan, MN 55121 N2 13144
BUtLDING PERMIT
Receipt #
.000
Site Address 4517 OAK PO.aU QD Erect U Occupancy `23
Lot 2 elock i Sec/Sub. FAW'J R I OGC I I Remodel O Zoning 7t1
Parcel No. Repair ? Type of Const j?
Addition ? No. Stories
W Name gURR OAK Bi.!7R' Move ? Length `?6
# Address 11461 (;QLDCNRi"!) ST Demolish ? Depth fi1
Int. Impr. ? Sq. Ft
° city CC3Q:,. Rf?Pt;,eS 4 5 2-? 9 C 6 Install ?
? W Name `?USSELI, HOME DSSxGN
? n Address 4940 V I K I AJG DR
iW Citv EDIi'rn Phone ?35-597_0
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Buiiding Permit is issued to: BURR OAK I3i.DRS
all work shall be done in accordance with all
Building
Assessment
Water & Sew.
Police
Bidg. Off.
APC
Var. Date
Permit 509.5(
Surcharge 51.4(
Plan Review 254.7!
SAC 625.04
Water Conn. 525• Q(
Water Meter 67 . Of
Road Unit 305. Uf
Tr. PI. 180.0(
Parks
Copies , ? Z !
Total
on the express condition that
of Minnesota Statutes and City of Eagan Ordinances.
PermN No. Permlt Holder Ds1e TNephone M
PIumWnp h G ) .,± .?-
3 B
M.V.A.C. J( ?? ' ~ ). '? ?S
Eieea+c .rJ
Softensr
Inspectbn Date Insp. CanmMb
FooHnys l
Footinys 11
Foundetlon
Freminy
Rodfny
Rouph Plby. - ?
Rouyh Mtp.
Imul. 3 s ?
Finpisce
Final Nty.
Final Plby
&dp. Fkai
Cert. Occ. I?
Dsck Ftp.
Deck Frmp.
Wsll
Pr. Dbp.
'? '? !;. , . . . . . r. . . { - . . , .- , . . . 1 ...?. ( . t . Wf..'.
. PERMIT #
' MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3930 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address TYPE WORK DESCRIPTION
BLDG
Lot? Block ? Sec/Sub .
R
? Ne
'
es.
w
m Name ' Add
M
l
?
Address
` -on
u
t
C
R
i
omm.
r
epa
c Cily Phone O
ther
Name FEES
?
c Address RES. HVAC 0-100 M BTU - $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 - 196 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
VeM. CFM BEYOND $1,000.00)
Gas Piping Outlets # ?
Other
FEE ' 1 • ?
S/C: ?GNATURE OF PERMITTEE
TOTAL• '
FOR: CITY OF EAGAN
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
? PHONE:454-8100
Block ? Sec/Sub
? rvameeL
? Address
c City _
? Name
c Address ? %'
-=-?-
p Ciry Phone
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
BLDG. TYPE WORK DESCAIPTION
Res. New
Mult Add-on
? F?.. r .
PERMIT #
RECEIPT # ?`??? •? ?
DATE
Comm. Repair
Other
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 PERMIT) - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPUES
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 PRIGE GOES
BEYOND $1,000)
M BTU
M BTU
M Bl
CFM
"p _
FEE:
S/C: SI E
TOTAL:
FOR: CI OF EAGAN
Site Address y-1 2 ?A k
lot ? Black / Sec
? N
? Name ?= ,Kc s,v? _?:? NC
t? Address ayg
c City Ser.4lt: Phone
rvarr
c Add
O CitY
rtt5
COMM/IND FEE - 1% OF CQNTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COfv1M/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
FOR: C1TY
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PERMIT #
RECEIPT # 7(2 S 0 o
DATE: ' ),z ° 7
BLDG. TYPE WORK QESCRIPT{ON
Res. X New X
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
MO. FIXTURES TOTAL
Water Closet - $3
00 $ .; " '
.
? Bath Tubs - $3
00 2
.
? Lavatory - $3
00 g `
.
? Shower - $3
00 ' "
.
?Ki!chen Sink - $3.00 2 - "
Urinal/Bidet - $3.00
?-Laundry Tray - $3.00
? Floor Drains - $1.50
Water Heater - $1,50
Whiripool - $3.00
Z Gas Piping Outlets - $1.50
`
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
= Rough Openings - $1.50
FEE: ,y.
'
Phane
STATE S/C:
GRAND TOYAL• ?y' ? ??
(Itrtifirate o# (Orrupanry
titp of (Eagan
11Pp1"UPitY Af %dlblM JttH}1Pt#tDri
This Certtftcale issued pursuant to Jhe requirements of Sectron 306 of the Urriform Building
Code certifying that at the ume of rssuance this structure was in compliance with the warious
ordinances of the City regulating building construclion or use. For the following:
USC CksoCIpMI Bld`. PeICLI NO. j: ..
Oocup-y Type R3 7tming Diatria ' i Type C?
oweer oe ei.wM `,FiR C?',IC Fif.?1?`_ A?= 11461 ((?.l?21hY..f?j RAi'Tic
Buddiqnaarm =547 L=htyIy'., Bi,
pe1e ,1PM
euldM oerw;.i
POST IN A CONSPICUOUS PLACE
TY OF EAGAN SEWER SERVlCE PERMR
130 Pitot KrKy Road
0. Box 2116 PERMIT NO.: ?
igan, MN 55121 DATE: ?
nin0: No_ of Units ?
Ad
of Insp.:
5urdunw: _
Misc. CM?pes:
Total:
botM Paid: _
In oF EAGA" WATER SERVICE PERMIT
130 Pilot Knk.r Road
D. Box 21199 PERMIT NO.: ?'
igan, MN 55121 DATE: 1j5 10_;
)ning: No. of Units: 1
Meter No.: Cannection Charges -`? -' ? • 0 0
Size: Account Deposit: 15.00
'
Reader No.: Permit Fee: 1 11) - 0 r
I agree to comply with the City of Eagan Surcharge: - Si?
Ordinances. Misa Charges: t1orT7 "-
Total:
BY Date Paid:
Date of Insp.: Insp,:
CITY OF EAGtAN 1MATER SEpVtcE PERMIT I
3830 Pitot Kno6 Rosd 1 ?
P.O. Box 21199 PERMIT NO.:
Eagan, M?55121 DATE: Zoning: No. of Units:
r. ,urr Oal: 3ui lders
OwneAddress: SieeAddess: ??ak Pond Road I?2 Ll fia?,-n Picige II
Plumbera- Pi (e ) a .„
,? oS ? E " .. . M Meter NO.: 3 ? _ tien Charria? ,
Size: SA' i It oG,K , ?iN
4,-r W
Reader No.: ? ` b (j, F?,S EtC. ' J
. 50-'
1 agree to comply wfth the agan Su
Qrdlnanc?. ,REQ?.IREU?i??h • . . .
Total:
BY ate Paid:
Date of I p.: Insp.:
te ee?apyr wM6 iM Ct1y ef Eyos Connsctlon Charqe:
iea. Acoount Deposit:
Permit Fee:
CITY OF EAGAN
3830 Pilot Kno6 Raad, P.O. Box 21-199, Eagan, MN 55121 Np
- 13144
' PHONE:454-8100
BUILDING PERMIT Receiptp
Tobeusedlor SF ?WG/GAR ESt.Value .$102y000 pate JANUARY-ZB. 19 87
Site Address 4517 OAK POND RD - Erect $7 OccUpancy R3
Lot 2- 81ock 1 Sec/Sub. FAWN RIDGE II Remodel ? Zoning RI -
Parcel No Repair ? Type of Const. y
. Addition ? No. Stories
w Name BURR OAK BLDR'_ __ Move ? Length 56
o
Address 11461 GOLDENROD ST Demolish ?
? Depth 84
Ft
S
City COON RA?FTW 452-2906 lntImpr.
Install ? q.
o Name $AME wpprovaIs
i?
$ a
nddress ?
Assessment
? CiTy Phone W8te1' & S6w.
F W
Name RUSSELL AOME DESIGN Police
Fire
' ?5 nddress 4940 VIKING DR ; E
'
n
9?
' <W ciryEDINA Phone 835-5970 . Blanner-
Council
lhere6yacknowledgethatlhavereadthisapplicationandstatethatthe
' gldg.
Ofl.
information is correct and agree o ply wij? all appp
cable State:of ,
MinnesotaStamtesand- i 6(E /Orcji'? .
- APC
`
Var. Date
Signature of Permitte
Fees
Permit $ 509.51
Surcharge 51.01
Plan Review 254 • 7.
Sac 625.01
Water Con n.
i
525.0
water Meter 67.0
i
Road Unit 305.0
i
Tc PI.
i
180.0
Parks
Copie` --
?
t Z
A Building Permit is issued to BU OAK BLDRS
: on the ezpress condition that
all work shall be done in accordance with all applicable t2te of Minnesot tutes and Ciry of Eagan Ordinances.
Building Official
_VL
REQUEST FOR ELECTRICAL INSPECTION • es-ooooi-os
1, Seo instructions bi comoleting this form on beck ot yellow copV.
E 27 O_?.. ' "X" Be/ow Work Covered by 7his Request
AAtl NeD. Type ol BuilEinp Aovlian<ea Wiretl EquiVmeN WireA
Home Range 7emporary Service
Duplex Water Heater LiGhtiny Fixwres
Apt. BuilAing Dryer Electrie HeaLn
Commercial Bldy. Fumace Siiu Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm omeT Pe1:i v omt„ isno,Wl
tner 5uec.fy Ujne. Oiher
ompute lnspection Fee 8elow
p Fee Service EntrenceSize F Fee faxders/Subleeders N Fon Circuits
U 1o20 0 qm s 0 to 30 Am s 0 to 30 Am>s
Above 200 Amps1 31 to 100 Ainps 31 to 100 A s
Swinmiing Pool Above 140_Am s Above 100_Amps
Transiormers Irrigation Boorris Pertial.Other Fee
Signs Special Inspection $/
emarks 3-0 TO?-?E;
/
I, t EI el
Inspactaq hereby
carlify thet the nbova
inspection has baen
mede.
This roquest void?????0? -??
18 mpnths fmm 0
E 2704U
?
flequest Uat" FireNo.
n spec?ion
Poa h-ired
Re4
mt
eatly Now ? W?II Nnlity
Inspem
EgS
'I ? ?
Yes ?flo .
lor When Ready
6bLfcensed Electrical Con[ractor 1 hereb e uest ins
y r Q pection oi above
? Owner elecvical work instelletl at
Street AAdress. Box or Ro` te No City -
cx
ecl?on o. Townshio Nama or No. RenBe No. County
Occu ant (PRINT) 7M1One No.
Power Supplier AAtlress
Elec[rical Coniractor (COmpany Neme)
L?cli,l-.t-.-. r'!<cJr«. Cnntrar.tor's License No.
?toS ?7
Malline ddress (ConV r or Owner MakinO Instailation)
d
?
,
Authorized en ure nuactor Owner Makiny Installationl Phone NumOer
? "??' - F?Fr 9 6
MINNESOTA STATE BO OF ELECTRICITV g THIS INSPECTION REQUEST WILL NOT
Griggs-Midw? .- Room N-191 CC VBE ACGEPTED 6V THE STATE BOAPD
1811 ype0 sity ve.. . ul. MN 65104 UNLESS PROPEN INSPECTION FEE IS
o...._ ? cnn_nn..n .H" C ? 1 G? ENCLOSED.
flEQUEST FOR ELECTRICAL INSPECTION AML JeJe oopooi-ops'
? See instructiona tor comoletirq this form on back af yellow topY. / Gp Sp
ir " Qn* A Q "X" Below Work Covered by 7his Request
New1AdCYRao.I Tvoe o/BuilCinn i Aoolinnces Wirod 1 Equiument Wi.ed I
ectr
Farm
M Fae ServlceEntranmSize d Fee Feeders/Subleedere # Fee Clrcul[s
13?.cD U to 200 Am 5 0 to 30 qm s 33.09 0 co 30 Am s
Above 200 qmps 31 to 100 qmps 31 to 100 Am
Swinvnin Pool Above 100_Amps Above 100_Am '
Transformers Irrigation Booms Partial.'Othor Fee
Sigis Special Inspection $
erre.ks TOT FEE
.I.?i ?
1, thet?,.al
Inapector, heFaby
cerli/y [hat tho Above
fosoection hss baen
Thig reauest vold ,.,.[?? y?'7 7C ?SU
18 months Irom ? ?
C 8 0 8 4 9 o.? '??
Remysi DaIA Fire No. Nough-in Inspection
Re ued7
I
?fleady Now Will Nolify Insper
I
?+. iQ ? Yes ?NO
tor When Ready
Licensed Elecvical Convactor 1 herebY raQUeat insoection o1 above
Owner olecirical work inalalled at
Streel Address. Box o Nouce No.
? C irv ?.
?
and
i a.k / 6a
h
ect?on o. Townshio Name or No. »nBe o. Count
[?4.Ko-4CL
Oc<upam (PflINT)
k Phone No.
urr a.
Pow r Supplier
kp+a. Elee? Adtlress I
?l3do 1qao+h
Elecvi al Conuaccor (Company N mel
idlcnd leG4ri Convactor's License No.
t(olU-?
Mailing Atldress (COmracmr or Owner MakinB lnstailation)
B?rh5
l?
?
R
h
C
-soo
/
d
o ?
v1
?
Authorize ip
na
tur
e
ConttaCtor lletion)
O erkine Insta
( 7M1One
Number
'
,
?
?
J 6
/
O ?o - G %
MINNESOTA STATE BOARD OF ELECTIIICITY THIS INSVECTION pEQUEST WILL NOT
Gripgs-Mitlwey Bidu. - Noom N-181 BE ACCEPTED BY THE STATE BOAND
IINLESS PROPER INSPECTION FEE IS
7821 Univeraitv Ava.. St. Peul. MN 65104
ohmn(atalaa2aRao ENCLOSED.
po nip -,$ 50, 5a
2007 RESIDENTIAL MECHANICAL rERMiT aPrLicaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comptete foe single family dwellings & townhomes/condos when permits are required for each unit
Da[e _? 1 5) 9 l 0-7
Site Address yQ -] Q/(k % Q/,CQy kpy, Unit #
Property Owner \Qa'l,?,L?. (?/}{.?/v Telephone #(& S"/ ) y 971
Contractor
O'Connor's One Hour
Street Ado 1904 Vemullion St. City
Hastings, M?7 55033
State _ ,/
Telephone #( fP S? ) r,37- -7 -7
Bond #: 7??7 Expires: ? Sr 0?
The Applicant is _ Owner ? Contractor _ Other
Fire repair (replace bumed out appliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to existing dwelling unit $ 50.00
? furnace _Additional _Replacement _ New
air exchanger
air conditioner
heat pump
other
Sta[e Surcharge $ .50
Tot9l $ SU ?-?
I hereby apply for a Residential Mechanical Permi[ and acknowledge ihat 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 this is not a
permit, but only an application for a permi[, and work is not to start without a permit; that [he work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
\ I Llslf[?/ " V d'l.t,C_- --
ApplicahYs Printed Name AP16Jdcant's Signature
ip 6'? Y ?
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3530 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
?7?
?-
tp
NewConsWdionRequiremenfs
3 regisiered sBe surveys showing sq. fl. of lot, sq, ft. of house; and all roofed areas RemodelJReoairReaui2meMs
2 copies of pian O(ficeklset3w
(20%maximumlofcwerageallowect) 1setofEnergyCalcuia6onsforheatedadditrorrs ?reEFCP5PiE?.f3ecp
' Y.f!3:
2 copies of plan showing beam & window sizes; poured found design, etc. . 1 site survey for addifan & decks IreBPresR?
9yt?8d
lsetofEnergyCalculations Addifion - ind'roateiton-sdesepficsyatem (7Ye53te3CptjcSy5lem
3 copies of Tree PreseNation Plan if lot platled afler 711193
Rim Jorst Detail Options seleclion sheel (Dldgs wilh 3 or less units
Date /? ? ? / ()y ,
Site Address yS! 7 ()'44
C Construction Cost
Unit/Ste #
Descriptlon of Work Pj5/?/u (F/)-.> 1 1J?X7
Mutti-Family Bldg _ Y? N Fireplace(s) _ 0 1)" 1 _ 2
Property Owner ?v ??? l ??I Telephone # ( Gj ? ) `! %J'
--, p? 't
Contractor ??lu-? ?
?
p
Address 3?? -? ? t-7
State P-i City
ZiP ?)) 7 Telephone # (?Z- ) 6 f d 67 ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CateROrv 1 Nlinnesota Rules 7672
Enefgy Code Category , Residential Ventilation Gategory 7 Worksheet • New Energy Code Worksheet
(J su6mission type) Submitted Su6mitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
I hereby apply for a Residential Building Permit and acknowtedge 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 NIN
Statutes; I understand this is not a permit, but only an application for a pernut, and work is not to start without a
permit; that the work will be in accordance with the app4AApp1i an ' case ork which requires a review and
approval of plans. °
,
Applicant's Pnnted Name t s Signare
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-piex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex ? 09 D7-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 1 D-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 36 Demolish Interior ? 44 Siding
? 32 Add'Rion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demoiftion (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIlZED 1NSPECTTON5
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
? Roof _ Ice& Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ FirepJace - RI. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Pertnit & Surcharge
Treatment Plant
License Search
Copies
Ofher
Total
44 a 5 a3 PLUMBING (RESIDENTIAL)
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 permiu are required for each unit
.?155a
Date .?0_ / _/) 3
SiteAddress q8 / -7 QQF- OYIG Unit# _
Tele
hone #( 01) Z%
O
p
Property
wner
Contractor J'`//KCf.l/'J O/a )'/Gt m h I n q
Address City/ a?C-e IJ1 ?46
State Zip SS6 4(1/ Telephone# (9-54 ?YLog -??
T6e Applicant is _ Owner ontracto _ Other
Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional eonsultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
DEC ? ? '
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigatien system
BY
_ Water sottener _'?W&fe_hcate?
$ 15.00
_ replacement _ additional
50
$
State Surcharge
$ ?
?
?d
Total `
'
I hereby apply for a Residential Plumbing Permit and acknowledge •that the information is complete and accurete; 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
permit, but only an application for a permit, and work is not to start without a permir, 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 Applica Signature
RESIDENTIAL
BUILDING PERMIT APPLICATION
53 S?? CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauiremants RemodellReoair Reauirements
• 3 registered site surveys showiig sq. ft. of lot, sq. R. of house; and all roofed areas . 2 copies of plan
(20% maximum lot coverage allowe0) • 1 set of Energy Calculations lor heated additions
• 2 copies of plan showing beam & winaow sizes; poured found design, etc.) . 1 site survey for extenor additions & decks
• 1 set of Energy Calculations . Indicate if home served 6y septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 711193
. Rim Joist Delail Options selection sheet (bldgs with 3 or less unBs)
DATE 6o`Z VALUATION CpIt 2pU o0
iOl'?ol
SITE ADDRESS `15I-7 oFK. ROJ MULTI-FAMILY BLDG _Y )?N
TYPE OF WORK _1'oC y'-i'L YooF. FIREPLACE(5) _ 0_ 1_ 2
?
APPLICANT
STREETADDRESS I no``r7 L0.kg D,(_ Wfsj- CITY +'?? tn STATE UNZIP?? 1 -7
TELEPHONE#CELLPHONE#??ia.'?a' ICi$3 FAX# `,L? :dffI
PROPERTY OWNER d v,,V, (_ "'_? TELEPHONE#
-----------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ \II\ VES(')'1 _A Ri;I.ES 7670 CA7'I:G0121' 1 S[[VNIIiSOT_1 RliLES 7672
(4 submission type) . Residential Venfilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing sysccm includcs:
Mechanical Contractor:
Mccltanic;il sy:clcm includc;:
Sewer/Water Contractor:
-- Air Couditioning
Hcat Rccovcry Syslciri
Phone #
Phone #
Pee: $90.00
? 15 ?'3 Tcc: -:67(
n Jui 2 3 2002
---------- °-------------° -°------°---------- °------°-° ------------°-------------------° °----°-_.. --------------
I hereby acknowledge that i have read ihis application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
4Vatcr Sollcner
Watcr Hcatcr
No. oI Baths
Phonc #
_ Iawn Sprinklcr
No. of R.I. 13aths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-piex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
? 04 02•plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? tt 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EnNre Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaUC.O.
_ Footings(deck) _ FinallNo C.O.
_ Footings (addi[ion) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newireplacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
I
1987 BOILDING PERMIT APPLIC9TION - CITY OF SAGAN
SINGLE FAMIL•Y DWELLINGS
IHCLODE 2 SETS OF PLANS* 3
OF SDRVSY9 1 SST OF ENERGY CALCOLATIOHS
wk
HOTE: ADDRESSES FOE COENER LOTS - CONTRACTOA/HOM60ANEH MOST DESIGNAYS WHICH ADDRESS
IS DFSIRfiD. NO CHANGSS ftILL BE ALLOZiED ONCS BDILDIHG PERHIT IS ISSIISD.
MOLTIPLS DWELLINGS - RFSIDENTIAL RfiNTAL OPITS FOR SALE UBITS
INCLUDE 2 SETS OF PLANS, CERTIFICAY6 OF SDRVEY - CHECg iiIR'H BLDG. DSPT.,
1 SET OF BNERGY CALCULATIONS
COPAERCI9L
INCLUDE 2 SETS OF ARCHZTECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOHD
To Be Used For: Valuation: bv f:r?p?
l --r--
Site Address Q p?," p? OFFI?
Lot 0 Block < [On Site Sewage
Pareel/Sub FA-t'jj,'
Owner /J Lt. P_R Of?'Ci 4?.r ?d t,.-s -JI, ?
9ddress 11y6J Sl
City/Zip Code ^ 5 Q-
Phone N?,) -?4U6
Contraetor ??}y4 t
Address
City/Zip Code
Phone
Arch./Engr. L140/t,u0 4U„m,-2.
Address 411?1Q ?
City/Zip Code ?J I vt
Phone 4
MWCC System -7
On Site Well
City Water ?
9PPROYAIS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Couneil
Bldg Off
APC
Varianee
nate: I.1dG19 Z-
Occupancy
Zoning
Type of Const
(Actual)
(Allowable)
0 of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEEs
?
5Co
Z4
1?0
Permit
Surcharge S I •
Plar Review 254. ?s
SAC9 City 10p.
SAC, MFiCC SZ5 ,
Water Conn 525,
Water Meter (o`] •
Road Unit 3p?.
Treatment Pl 18?,
Parks
Copies
TOTAL ?
5 1 7. a
24n 32 = -7 se = 44s4 ?-
' i
/V\ I?hl(o
24xZZ ?" S zg x(z- ?33?
(2?zi ? 2?2n
24-x 32
337-7z
A I
J
(D [304
.
? s7s aea7
i,b credls 6 eamocfeme, Inc.
mi??. 65413
."archltnctural Eedq?wra ol outgtan nq amoa
E7LTr.RIOR ENVEIAPE AVEtAGE "U" COMP4TATION Ia -/ 76
OIdMER PLAN NO. 2<5, ?? 1?
SYTE ADDRESS DaTE (O IS I?S?
CON'PRACTOR 15?? bl?C (?-?
Deterncine working square gootage of each
1, Total exposed wall area....o. sq.ft. x
2. Total•roofOcelZing area...... s4•ft. x
3, Total floar/cant. area....... sqaft, X?- ?
Total axpased wall area above floor ?G?? ?
8• Total W81l wind01d-'n'AS ........ ? r a.....s...r a a• ?? 1
b. Total door sefea......... ..e.....e............
C• Total SlidiTlg g1853 CIOOP &T91 s.a o o eo e?? e a???•
do Total fireplaea W81l 3PBA.essaa.a.. oee?????ee
a. Total wall framing area (average
f o TOt.81 118t. W81.1 8T'eS 8bOY9 flOOY s s o s*..a s e? s? o Z
g• Total rim joist &P9ae'ooese. 6 aes.. ae..6+s.....?
Total exposed fourrlation area
tl• Total foundation window area....me>es. a.eesoe
i. Total net foundation area above grade....... .
Determine "II" value of each wall segment
8 a
LL'J
K n U"
_._
_
b. 3 x "IIPB
ce o x pU°'
d o - x °-
?
p?
X
f
e n
g• R ?y
R
h m
? X
e
:nUn
AlUi1
? c --
?
12.,'1
4 . •a.o.a+e..e. aaems.o.o.. o........... TOiSBai ° Lif e 25
If item #4 is the same asg or less than item O9 you have met
the intent of SBC 6006(a)2.
Vzi
?
s"
.
CITY OF EAGAiV
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRESS:
LEGAL DESCR2PTION:
*R71'S: PAIfiiFTTS OF FEE AT TIME OF
AnPLsCATIorr noES Nom aorsrrTUM
APPROVAL OF PII2MIIT.
INSPECrsorr oF sEWEt r,rro/OR W=
INSrar.raTrON.S WaI, N(yP BE S(HED-
OLID UWPB, PEE2MIT AAS BEEN
APPROVID.
IF E}ISTING STRL'CILME, DATE OF ORIGINAL BC'ILDZNG PERMIT ISSL'ANC'E: '
(Nbn Year)
PRESIISf ZONING/PROPOSFD L'SE:
Cl COIYMRCIAL/REi'AIL/OFFICE =P?'-R-1 SINGLE: FAMI7,Y
Q IbIDPSTRIAL ? R-2 DL'PLEX (Tuo C?nits)
? INSTIZSPf20NAL/GOVERNMENT ? R-3 7UWNH0USE (Three + Units) ( Units)
? R-4 APARTMENT/COPIDOMINILT4 ( Units)
2)
NAME: LA-.ktf ??-
ADnREss:42- 5'97
CITY, STATE, ZIP?_??-
pxoNE: _ p91i- ? 6 0 0
3) • u i: ?-
NAME=
ADDRFSS: ?
/,.2 ?'/e 1 -':' i p rrrr?} I/? CITY, STATE, ZIP:,S P.
PHONE: S`7y?7? ? D MASTER LICENSE# C?D? ?X7/l"2 c7
4)
NAME:esg /-- Rc.c ;
ADDFtFSS: //5??? ? ?'al?C,-. ??? cs7?- ?? -
CITY, STATE, 2IP:ef5Q a_ „
PHDNE: dWpVAjNEiMWLL'-
? Active
FFxp122d
Not recorded
Sta??al
-$} ,r r• :? d. . ?. . ? - y? U-'YU5a . .
CON[3EC.TION TO CITY SEWII2 ]G? CONNFX.`PION TD CITY WATER Q OTFIEft '. .
f'C
6) ? ?• r ? PLF,ASE HOLD APPROVID PII2MIT FOR PICK-LTP BY ONE OF ABOVE '-'- --
,Lg:?PLEASE MAIL APPROVID PIIRMIT TO 1. 25:n?4, AHOVE .
(Circle one)
7) r ?_ • `7?J ?-??.? //Z ?rrL-%
F'OR :CITY USE ONLY ? -
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ bz'r'e? SEWER PERMIT (INCLODE SIIRCHARGE)
$ $ /10? ic. WATER PERMIT (INCLLDE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ?J•C?(7 ACCOUNT DEPOSIT - SEWER
$ $ /.j.ro ACCODNT DEPOSIT - WATER
$ Oci $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TR[!NK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ I a° /i• C? ?7 $ WATER TREATMENT PLANT SLRCHARGE
$ S OTHER:
(1T" TOTAL
?,?.;j ? ? ? r., ? j ?/ ?•
_
RECEIPT # RE EIPT
DOES UTI:,ITY CONNECTION REQDIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK S4ITHIN PUBLIC
?
NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING
DIVISION
LIST
.
AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
?
APPROVED BY: i
TITLE:
DATE : -J -- ?' O FI
,
PA O B F. ° T1140 EI16 avRR aAK L&144,PPfJR1S5
NElRf
PIAHNEpS and ?AHO ? UNVEYClIS
ENGIN6ERING "°":?L
COMPANY, INC. 1000 EAST 146N STREfT, Bl1pN5Y1LlE , IIINNESOTA 05337 pH 432-5000
Cer-je x}?z cctze „? u^urzr'e?
Lgaal ..Ueacrf?p2iort: LoT 2, BLOGK l, FAwN RiU6E 2NV ADDITioN,
paKOTA CouNrY, MrNNESoTq
s e99° 22'64 "E
iBO. 27
S 3Z° 24'23"E
S CALE : /" = 5-01
8 LOCK 1
LoT 2
C?%?29D pEN07E"5 EXISTIN6 ELEVATION
(9l6.5) DENOTES PROPOSED ELEVATION
/NDrcATEs DIRECTION oF
? SU/ZFACE p(LqINA6E
h ?
916.93 = F/N/$HEO 6AR46E FLOOk' ELEVA710N
\ (9oJ.0)
I \
I ?905 0i
? a DR4I/JA6E AND
UTILITY EASEMENT
I ?9Q09.0) - (94:Z,.
6.73
OU 1 ?
O ? N !
?i gl 32.00 (q
eso N2a,o0N 9/6.5) 30' 6KONT 90L0IN6
SCTBACK LINE
;-J,o
i9//.9? g o rpi,R _
E ??'
R SSy37ro74°., r3
a
N n ....? .....,i _ 8p/4 .
sa%a
I hereby certify that 2his ie a true and corract raprneentation o" tract of
land •s shown'and describad heraon.. As preparad by ma on thia 12day of
Use BLUE or BLACK Ink
-----------------i
For Office Use
a ~ I
~D37 I
1
City of Ea~a Permit
~
Permit Fee: h
3830 Pilot Knob Road I I
Eagan MN 55122 1 Date Received: `1 2 I
I
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff---------------
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing I Sewer & Water
Date: Site Address: q517 a7A ,6,J X~rl..,?Y
Tenant: Suite
RESIDENT /OWNER , Name: ,"5" nn 4,2 _ Phone: 6 SZ- !7, f 9 ,741
Address /City /Zip: '7 s~ / ~r~l~ ,~d~~ ~G, ,L~a~ o? .d'✓/~ ~027
Name: License
CONTRACTOR Address: City:
State: Zip: Phone:
Contact: Email
x
E
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Description of work: Aa e SV.4 & A)dJys0 Wk c z r.4 r AI,O! e
DESCRIPTION T
r
FEES
$60.00 /Each (includes $5.00 State Surcharge) TOTAL FEE $ ®(J
*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.citvofeacian.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 I/ x
Applicant's Printed Nam A icant's Sign
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground Rough-In -Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA129897
Date Issued:03/23/2015
Permit Category:ePermit
Site Address: 4517 Oak Pond Rd
Lot:2 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-020
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 -
Susan M Carter
4517 Oak Pond Rd
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature