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4580 Oak Pond Rd 00 Use BLUE or BLACK Ink For Office Use I ~ I U I a j Permit f' 1 Sl ~O j of EaEd I 0V C ity JUL 18 ED I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 i Date Received: Phone: (651) 675-5675 i Staff: ~L I Fax: (651) 675-5694 1 I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 7 5~ 04, dC K Tenant: Suite # RESIDENT /OWNER Name: Phone: 6; Address / City / Zip: Lls o (O d3 Applicant is: Owner 1- Contractor TYPE OF WORK Description of work: t L&f c(bm DID` waa& Construction Cost: X - C V Multi-Family Building: (Yes / No CONTRACTOR Name: k) 4n License f 7y Address: ~f 0 City: G G-CL<J~ State: t ► I Zip: Phone: Contact: Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.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 f~ f D/M6N x C)~Ma~ Applicant's Printed Name Applica Ys Signature Page 1 of 2 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN. MINNESaTA 55122 DATE RECEIVED FROM 19 AMOUNT ? I DOLLARS too ? CASH ? CHECK r ? // • B Y ?f i NUMERICAL FILE COPY CITY OF EAGAN i Al 8745 Pilot Kwob Rood Eagan, MN 55122 PHONEs 454-B100 BUILDING PERMIT ReceiPt .# Site Address t'otld Kd. Ered ? Lot Block Sec/Sub. Alter ? Porcel #. Repair ? Enlarge ? o e Name Move ? W Z qddress • ; '' i"; ; Demolish ? _ J:. Grade ? ly Name _ 0 Z ?u /lddress ? r:... Name _ /Wdress I hereby acknowledge that I have read this opplication and state that the information is correct and agree to comply with cll applicable State of Minnesota Statutes end City of Eagan Ordinantes. Signatime of Permittee N4 4780 4 ? Occuponcy . Zoning Fire Zone Type of Const. # Stories Front ft. Depth ft. Fees Assessment Woter & Sew. Police Permit _ Surchorge Plon check Fire SAC Eng. Plonner Council Water Conn. Woter Meter Bldg Off. . APC Total A Building Permit is issued to: on the express condition that cll work sholl be done in accordance with oll applicoble 5tate of Minnesoto Statutes and City of Eagan Ordinonces. Building Official " P«+.k ? psh bw.a P«wiea. Plumbing ,'i •F? f ? E'3 - 7d Mechonical "?-? r S ,y` ' .3 -?f' ? • • ?0 3? S INSPECTIONS DATE INSP. Rouph-In Find Footings -? Date InsP. pote Irrp. Foundotion Plumbing . Frome/ins. Me l c ho co ? Finai ? . ? , i D - • ?o-?zc ? ? ? Remarks: r xz;?06 r ? ,? . • ' CITY OF EAGAN • • • 3796 Pilot Kwob RosA Eaqon, Minnesoto 55122 Phone: 454-0100 . . ? . •. ? i _ .... ?., 1 ! _ PERMIT No. `Date: Receipt No.: - Sinyle I Site Addrcss• Residential Lot Block 5ub/Sec.._ - Multi Res., Comm./Ind. I Name /Repoir !1?4?t New/Alter . . /lddress - Cost of Installotion ? _ City ., '_ . Phane: Permit Fae ? , • ?? C Name ' - Surcharpe . 'g P Address e 0 U Ciry _ Phone: _ Totol This Permit is issued on the express condition thot cll work shall be done in aocordance with all appliccble Stata of Minnesoto Stntutes ond City of Eagan Ordinances. . / Buildir?g Offic o CITY OF EAGAN 9745 Pilot Knob Raad Ea9an, MinnesoM 55122 Phone: 454-8100 Dute: Site Address; Lot .,..z.,, ? ... , - PERMIT v -ak ,- o ni: r.? . Block Sub/Sec. _ No. Receipt No.: IJ15 Single Residential Multi Res., Comm./Ind. I Name _ :'in Qeidl New/Alter. /Repair ? a Address .• y'O::l:?.i7•,. Cost of Instollation _ City -"• " Phone: Permit Fee y?. Name ? - Surcharge ? ,t Address e 0 ? City Phone: Totat This Permit is issued on the express condition that oll work shall be done in accordance with all upplicable Stote of MinnesotQ Statutes ond City of Eagan Ordinances. Building Official CITY OF EAGAN 3795 Pilot Knob Roed Eogon, Minnasota 55122 Phoee: 454-8100 17ELT' _ PERhA1T =eptci..ber 12, 157, flnrn• • 30 Oak Pond Roati Site Address: ;:fa)•: :': ,n t? Lot Block $ub/Sec. _ ?i:?; .:? Sei?Il Nome ; /Wdress . ` O City Phone: _ Name i-1q1 Well i:z?lJ i:"7 I11c=. _ No. Receipt No.: SIr1glE I ?f Residentiol Multi Res., Comm./Ind. I New/Alter. / Repair Cost of Instollation Permit Fee SurcMrfle VI . PFwr+e: Totol is Permit is issued on the express condition that oll work shell be done in accordonoe with all applicoble Stote of Minnesoto Stotutes and City of Eogan Ordinances. Building Official ? ? ,. ? , r • CITY OF EAGAN 3795 Pilot Knob Road Eagon, Mineesota 55122 Phone: 454-8100 WNTM SCETMER PERMIT 12-:z1-7a Dote: Site Address: Lot 4Sl30 Caek PoM Poari Block ^ Sub/Sec. Cilk Fcc-a Ai 11 s No aso . Receipt No.: Single I Residentia l Multi Res.. Comm./Ind. I Name '-r&? "?1 New/Alter./Repoir 3 Address ?? E' ? Cost of Installution O rt. Puu1 City Phone: 727...72yl Permit Fee 5,00 :1onTCie?ra 9oft Ltabear c']). .5'? Name SurcFarge . ? Address 3901 C. tifazn'a S} . c 0 City Phone: ? Totol This Permit is issued on the express condition that oll work shall be done in atcordonce with all upplicable State of Minnesota Stotutes and City of Eagan Ordinances. Building CITY OF EAGAN Remarks Addition(A(,f, ??D 'Hjl,.j,$ AilDpj Lot 2 elk 2 Parcel Owner Street4580 ()ak Poncl Rnacl State J L?Z?ie Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWEF LATERAL WATEFiMAIN WATEfi LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. OUILQING PER. 4780 9845 5-4-78 sAC 500.00 9845 -4-78 PARK 120.00 7525 9-23-77 RESIDENTIAL BUILDING PERMITAPPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 lew Construction Reauirements 3 registered site surveys showing sq, fl. of lot, sq, ft. o( house; anM all roofed areas (20% mazimum lot coverage allowed) 2 cropies of plan showing beam & window s¢es; poured found design, elc.) 1 set of Energy Calculations 3 copies of Tree Preservatan Plan if lot platted after 7/1/93 Rim Joisl Detail Options selection sheet (Wdgs with 3 or less uniGs) )ATE IOB SITE ADDRESS IC Oa r F MULTI-FAMILY BUILDING, HOW MANY UNITS? 'ROPERTY OWNER E4 e? 4e- a Qp-P^ ? RemodellReoair Reauirements • 2 copies of plan • 1 set of Energy Calculations for heated additbns • 1 sAe survey for exterior add'Nons 8 decks • Indicate'rf home served by septic system foraddilions VALUATION d r2$??ev?i4l T7D?•'!P 'YPEOFWORK _ LZ.PlqCC /LV0 ` J ?- FIREPLACE(S) _0 ->(1 _2 3 kPPLICANT -FoVs?he.-? J ?e?e?fe? CO. ?? L PHONE# 763-q,?P-ya(2 g kDDRESS3)1? IC?a?? I?/T/?t! G? A-,?0(iQ? `?/f/T/ ZIPCODE .S'SJ?O 'AGER # CELL PHONE #(D51-sa 3^ yO(100 FAX # NEN' RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RLTLES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Plumbing System Includes: Mechanical Contractor. Mechanical System Includes: Sewer/Water Contractor: _ Air Conditioning Heat Recovery Systcm Phone # Phone # UI a6ove information must be submitted prior to processing of application. F rp? 1? IJ U m hereby acknowledge that I have read this application, state that the information is correct, arld? 711 applicable State of Minnesota Statutes and City of Eagan Ordinances. Slgnature of Applicant :ertificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ _ Water Softener _ Water Hcater _ No, of Baths Phone #: _ Lawn Sprinkler _ No. of R.I. Baths Fec: $90.00 rcc: $70.00 Updated 1101 OFFICE USE ONLY ] 01 Foundation ] 02 SF Dwelling 7 03 01 of_plex ] 04 02-plex ] 05 03-plex ] 06 04-plex ] 31 New ] 32 Addition ] 33 Alteration 7 34 Replacement /aluation :ensus Code iAC Units dbr. of Units Jbr. of Bldgs -ype of Const ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchlAddn. (4-sea.) ? 23 Porch(screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 6d. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Impravement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors "Demolition (Entire Bldg only) - Give PCA handout to applicant Footings (new bldg) Footings(deck) Footings(addirion) Foundation Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. _ Air Test _ Final Insularion Occupancy Zoning Stories Sq. Ft. Length W idth REQUIRED INSPECTIONS _ FinaUC.O. _ FinaVNo C.O. _ Plumbing HVAC MC/ES System City Water Booster Pump PRV Fire Sprinklered Other _ Pool _ Ftgs _ Au/Gas Tests _ _ Siding Stucco Stone _ Windows (new/replacemern) Approved By , Building Inspector 3ase Fee 3urcharge Ilan Review AC/ES SAC :ity SAC Nater Supply & Storage i&W Permit 8 Surcharge "reatment Plant 'lumbing Permit Aechanical Permit .icense Search :opies )ther ? 07 05-plex ? 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ioWl cirr oF Encaw 3795 Pilot Kno6 Road- Eugon, MN 53722 SF Dwlg. & GaLg. PHONEs 454-8100 BUILDING PERMIT APPLICATION $52?000. Receipt # ,.- ,- ----, ,-- 4580 Oak Pond Ma' Site Address 2 Oak LotBlock - Sec/sub. -°•- Pond Purcel # 10 53600 020 02 S w Name John Seidl ? .4ddress 33 E. Wyoming 'sc,aI- _ Ciri Phone o Name ?Q Address z ? Ci ?w Name ?w xa Address I hereby acknowledge that I hove read this applicotion and state that The informatian is correct and ngree to tAmply with all appliceble Stute of Minnesom Statutes ondLCity ot Eay6nj?oinar?es. Signoture of Permi e A Building Permit 3s is ed to: Jo eidl all work sholl be done in acc ?nce ?th al I pable State of Mir \? i Buiiding Official ^2?? ?-? ? N°. 4780 9845 78 Erect [} Occupancy I Alter 0 Zoning Rl Repoir . ? Fire Zone ? Enlarge ? Type of Const. y Move ? # Srories Demolish ? FroM 60 ft. Grode ? Depth 46 ft. Appwrah Fees Assessment _ Water & Sew. Police Fire Eng. Pionner _ Council _ Bldg. Off. _ APC Permit 14.7. :)U Surcharge 26.00 Plon eheck - yqC 500,00 Wafer Conn. Water Meter Total 669. 50 - on the express condition tfiat and City of Eogan Ordinances. This request void 18 months from ? ? o -V<Y Date of this,Request P 32 8 47 I, as D Licensed Electrical Contractor wner, do hereby re uest inspection of the above electri- --------------- cal wiring instatled at: cV a Street Address or Route No. Cita /-`i+'J Section Township Range County ? Which is occupied 45;/ {rvameo7 uccupanx) Is a roughin inspecYion required on this joh? No ? Yes ? Ready Now ? Will Call ? Power Suppli? ? ? Itie? Electrical Contrac`a?ra? Contractor's License No. _ (COmpanyName) Mailing Address ?^.-- '7 Authorized Installatlon) ?- Phone No. ictar or Owner COPY Minnesota State Board of Electricity e1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION £H?4CK.$GI,OW WORK COVERED BY THIS REQUEST i <a a .</k p 32847 Type oi Building New dd. Rep, Check Appliances Wired For Check uipment Wired For Home ? ? Range ? Temporary Wiring ? Duplex ? ? Water Hea[er ? Lighting Fiacmres ? Apt. Bldg. ? ? ? Dryer ? ` r '% '- '?? Elechic Heating ? Commercial Bldg. ? ? ? Furiiaai j?`. Silo Unloader ? Industria181dg. ? ?. ? Au;Conditioiitt??? q El BuIX Milk Tank ? Farm ? ? ? LisY' ? LJ , Lis[ Other ? ? ? p Heiersf ? Rehers? l COMPUTE INSPECTION FEE BELOW Service Entrance Size: n Fce Fceders&Subfeedeis: # Fee C¢cuits: x Fee 0 to 100 Am . 0 to 30 Am eres 0 to 30 Am eres ]Ol to 200 Amps. 31 to 100 Am eres 31 to 100 Am res Above 200_s^.mps. Above 100 Amps. Above 1D?Ampa Transformers Remote Contxol Circ. Partial ot other fee Signs Special lnspection• Minimum fee $5.00 Rem TOTAL FEE 4 the Electrical Inspector, hereby certify that the above inspection has been made. (Rough-in)_ Date (Final) Date?S?, •- `-?-? This request void 18 months froni' Minnesota State Board of Electricity 1954 {Jniversity Ave., St. Paul, Minn. 55104-Phone 645-7703 ' REQUEST FOR ELECTRICAL INSPECTION QHECK BELOW WORK COVERED BY THIS REQUEST ? 68280 Type of Building New dd. Rep. Check Applisnces Wrted Foi Check Fquipment W'ved For Home ? ? Range ? Temporary Wiring ? Duplex ? ? Wa[ex Heater ? Lighting Eixtuces ? ApL Bldg. ? ? ? Dryec ? Elec[ric Heating El Commetcial Bldg. ? ? ? Fumace ? S0o Unloader ? Industrial Bldg. ? ? ? A"u Conditioner ? Bulk Milk Tank ? Farm ? ? ? List Lisl Othec ? ? ? p Hehels? Heher3I COMPUTE INSPECTION FEE BELOW ". fl;iz?\ Se[vice En[rance Size: # Fee Fceders& # . Fee C'vcuits: # Fee 0[0 100 Am s. 0 s 0 to 30 Am eres 101 to 200 Amps. 3; 0 31 to 100 Am etes Above 200 Amps. A' e 1 Amps. Above 100 Amps. Transfoimers RemoleCont[o1C'vc. partialorotherfee _'W-c Signs Special Ins ection Minimum fee $5. Remarks ? ? TOTAL FEE ?y ? d I, the Electrical Inspector, hereby ce?yf at t? e' so?Otion has been made. (Rough-in) C/ "'av Date ?d ^ /J '' '7 ? (Final) ? Date This request void 18 months &om This request void 18 months from ///S8 Date of this Request Y? `-.--T -"' C r 68280 t, as ? Licensed Electrical Contractor Owner, do hereby request inspection of the above electri- cal wiring installed at: ?a le!9 _,? • .s9 Street Address or Route No. Section Township Range Counfy? Which is occupied by =?? (Name of OJccupant) Is a roughin inspection required on this job? No ? Yes R Ready Now ? Will Call C51" Power Electrical Contracto',Zz,.49 ? Contractor's License No. _ (COmpany Name) Mai2ing Address -K3 ??g.? d?- a -. d? (Electricffi Contractor or Owner aking This Installatlon) 7._ Authorized Signature Phone No.,=`? 4:R..38 (Electfical ContYettOf or Owner Making ThfS Installetlon) ??AU ??p. ???? ???? This inspectian request will not he accepted by the ? State Board unless proper inspection fee is enclased. RESIDENTlAL BUILDING PERMIT APPLICATION ? n r + I CITY OF EAGAN C) -.>- 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4875 New ConsWCtion Reouirements RemodeVReuair Reauirements • 3 registered si(e surveys showing sq. ft of lot, sq. ft. of house; and all mofed areas . 2 copies M plan (20% mazimum lof coverege alimred) • 1 set of Erergy Calculatiare for heated add@ioris • 2 copies af plan shmving heam & window sizes; poured tound design, etc.) • i site survey for ederiar addNOns & decks . 1 set of Energy Calculations • Indicate if home served by septic syslem kr additions • 3 copies of Tree Preservalion Poan ii bt pletted after71V93 . Rim Joist Detail Options seledion sheet (hldgs wflh 3 or less units) DATE ?1- ILq` ba- VALUATION SITE ADDRESS a K R-,uj R r? MULTI-FAMILY BLDG TYPE OF WORK? ? FIREPLACE(S) _ APPLICANT ? STREET ADDRESS CELL PHONE # FAX # _ Y )-N 0 _ 1 _ 2 STATE M.?ziP 5 (a 3 PROPERTYOWNER?IE-?U fuA r I ( \,,,3„? TELEPHONE# ??51-55z ?a75 ------------------------------------------°--------------°-------------...------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RULES 7670 CA"CP:GORY 1 MINNESOTA RULFS 7672 (4 submissian type) Plumbing Contractor: ___ Plumbing system includes: Mechanical Contractor. Mechanical system includes: Sewer/Water Conhactor. Phone # Phone # Fee: $90.00 Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicabie State of Minnesota Statutes and City of Eag Ordinanc s. .. P'S4gnature ot Applicant V v? ._..--------°-.......--°--°----...-----------------------------------------------------------------------------°----------'--°--------°°--'------___-- OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 • Residential Ventilation Category 1 Worksheet Submitted . Energy Envelope Calculations Submitted Phone # Water Softener _ Water Heater _ No. of Baths . New Energy Code Worksheet Su6m'dted I.awn Sprinkler No. of R.I. Baths _ Air Conditioning _ Heat Recovery System OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuRi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous ? 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 WindowslDoors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation 54? ? Occupancy R3 MC/ES System Census Code ? Zoning fZ f City Water SAC Un'rts Stories Booster Pump Nbr. of Units ? Sq. Ft. PRV Nbr. of Bldgs ? Length Fire Sprinklered Type of Const U W idth REQUIRED IN SPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) ? FinaUNo C.O. _ Footings (addition) _ Plumhing _ Foundarion HVAC _ Drain Tile Other Roof Ice & Water Final Pool Ftgs Air/Ga§ Tests Final ? Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement) ? InsulaGon _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total sueo. ? C) CITY USE ONLY ?p RECEIPT #: ? l L,J RECEIPT DATE: ?61I QQ PERMIT# "COyI% it 2000 PLZJMBING PERMIT (RESIDENTIAL) CITY OF EA6AN 3830 PILOT KNOB RD EAGPN, AIII 55122 651-681-4675 Please complete for: ? single family dweVlings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH N TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drein 3.00 x = $ Gas pipin outlet ' minimum -1 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund tray 3.00 x = $ Lavatory 3.00 x = S Septic System new/refurbished "requires MPC Ilc. 75.00 X = $ Septic S stem abandonment 3fl.00 x = $ RPZ new installation/repaidrebuild 30.00 X = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Undergr0und Spdnkler if dwelling is under construction 3.06 x = $ Underground sprinkler rf ezisting dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dxremng under eonswceon 5.00 x = $ Water softener if axistlng dwelling 30.00 x = $ Water turnaround 30.00 x --- = S U.? State Surcharge Total .50 --> -> --> ---> --> -> ---' $ 50 $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. ---------------•-------•-----•--•-------------------------------------------------•---------------- ------------------------ I hereby adcnowledge thal I have read this application, state that the informatian is cortect, end agree to compty with all applicable Ciry of Eagan ordinances. It is the applicant's responsibility to notify the proparty owner that the City of Eagan assumes no 1ia611ity for any damages caused by the City during its normal operetional and maintenance adivities to the facilRies consWcted under this permit within City propertylright-of-way/easement. SITE ADDRESS: ? ? ? ? 0 o-L OWNER NAME: : TELEPHONE #: (AREA CODE) WSTALLER NAME: ??? S2 R V<C ? S TELEPHONE #: G/'Z /e/ - 3a F/ (AREA CODE) STREET ADDRESS: ?P e Y lq d cirY: L4ft k-e_ vC-e STATE: /& Al ziP: vr5m?? . ? SIGNATURE OF P RMI7TE CITY USE ONLY LOT c2- BL o2 RECEIPT #: bff-? 14 SUBD70'^"" G&t?k I? RECEIPT DATE: I(I'f I Q? 1998 MECHANICAL PERMIT (RESIDENTIAL) Date: Complete this section on/v if you are installing I-IVAC in single family, townhomes or condos under construction and not owner /occupied • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Swchazge: .50 • TOTAL:. romple*.e Lh1S SeCtl^n ^/v lf yO» 2ZE *emodeling, _3'alI'i$ YO, O* 2Cr^.?riLRg CX75!:.^.^g SL1g1c f3I^.:1}' dW01ZL.gS, townhomes, or condos. Note: Mechanical pemut is not reauired for alteration/add-on to ductwork in existing residential units; but is required for the following: 74 Install furnace _ Install air conditioning _ Install sir exchanger, i.e. Vanee system, etc. _ Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surcharge 50 Total: $ 20.50 SITE ADDRESS: 7S c1 v Da K Pa4d ed OWNER NAME: FtL q n le- I 72. f? 2 r PHONE #: q5?P- INSTALLERNAME: 1,,0dA1fr5 .'ouf?isrc?o 1Y??f?cZ'tir. PxorrEa: q3/--??o99 srxEEr nnnxESS: /`/ 7 3,3 AltyacC Ael_-e CITY: CITY OF EAGAN 3830 PILOT IQi08 RD EAGAN IIIi 55122 (612) 681-4675 _ STATE: '7 ZIP: . 'JrS7a' c" SIGNATURE OF PERMI'ITEE JS/FORMS BLDftAECH PERMI7' (RES) - 1998 cirr use oNLv L _ BL _ SUBD. RECEIPT #: _ RECEIPT DATE: 1998 NECHANICAL PERMIT (CONMRCIAL) CITY OF EAGAN 3830 PILOT A408 RD EACAN, !N 55122 (612) 681-4675 Please wmplete for all commerciaVindustrial buiidings multi-family buildings when separate pertnks are not requfred for each dweliing unit DATE: CONTRACT PRICE: WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT , DESCRIPTION OF WORK: FEES: i% of contract price OR $25.00 minimum fee, whichever is greater. Processed piping - $25.00 CONTRACT PRICE x 1% PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL ($.50 per S 1,000 of mi'rt fee due on all permits.) SITE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS ONLI): INSTALLER: PHONE #: ADDRESS: PHONE #: CITY: SIGNATURE OF PERMITCEE STATE: ZIP: CITY INSPECTOR . , BUILDING PERMIT APPLICATION 4-lkl q,q nAaE ) /, ? /Ic1 Znclude 2 sets of plans, 1 site plan w/elevations and 1 set.of energy calculations. 7b be used for Valuation ys o ` Site Address; ? Lot Block See. Sub. Parcel Number ?? S3(i?D OaQ O?- Owner Telephone Address Contractor Telephone Addresa Arch./Eng. Telephone Address OFFSCr USE Erect tj Occupancy / Alter Zoning Repair Fize Zone 3 Enlarye Type of Const. L/ move 1i of Stories ? nemolish Front _ /-!? GraBe Depth OFFICE USS - Date of Approval & Initial FEES ? Assessment ??• Permit ?<13 ? --rc water/sewer SuraYlarge Police r3.an Check Fire SAC En9• ?`- t-tater Conn • « 7 Plantter 47ater Meter _ Cc)uncil - ? Rldg. Off. A.P.C. TAL ? uvt.C .LcJ ? 3`--,2 I . ` / / ? /,SO _? O s , ? J ? ? i I I , ?. *J ?. ? 3 l?? G v? ,,? i \1 ? `.? -\ \ • ?y ? i ? X r??l,?e I ?ly. n G Joti ?v S?'l?;?L.. , r-? !1? y' ?-- I ? Git70? Li (?--? - 5 (ro?UC ? v ? `I ? ? ***********?***?******************??*** CITY OF EAGAN CASHIER: JS TERMINAL NO: 766 DATE: 04/25/00 TIME: 15:10:30 ID: NAME: EUGENE J PHEIFER 3865 9220 4580 OAKPOND RD 452.00 3716 9220 4580 OAKPOND RD 114.00 2252 9220 4580 OAKPOND RD 30.00 3212 9001 4580 OAKPOND RD 30.00 3743 9220 4580 OAKPOND RD 50.00 3713 9220 4580 OAKPOND RD 50.00 2155 9001 4580 OAKPOND RD 0.5D 3865 9220 4580 OAKPOND RD 840.00 Total Receipt Amount: 1,566.50 CR127834 USER ID: JAN . . . . •. i a i d i ? * ? * * * ? * * * * ? * ? * * ? * * * * * * * * * * * * * ? ? * * * ? ? ? ? * * * ? * ? * * ? * * * * * * * * * * * * * * * * ? * * CITY OF EAGAN CASHIER: JS TERMINAL NO: 766 DATE: 04/25/00 TIME: 15:08:25 ID: NAME: EUGENE & BRENDA PFEIFER 3811 9379 4580 OAKPOND RD 900.00 3811 9378 4580 OAKPOND RD 940.00 3865 9220 4580 OAKPOND RD 40.00 Total Receipt Amount: 1,880.00 CR127832 USER ID: JAN ***********+*********:****?********??*? Lot a Block PID # Sewer /water permit # Plat Da[e ?•? ] . ? " Receipt # CITY OF EAGAN 2000 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTIMG RESIDEIdTIAL PROPERTY Lat 1 chazge @ $22.30/f Trunk 900/connection City SAC Base SAC Date paid Receipt # Account depos' Septic a onment Sewe ermit & surcharge Total Sewer Water $ ? L ral charge @ $22.551ff : ? Trun $940/connection 1? 00.00 Water s ly & storage 1,100.00 Datepai Receipt # Treatment plant 15.00 prior Water meter '"Inspection 30.00 to i ' 50.50 Account deposit g Water permit & charge ? Subtotal , $ Plumbin rmit & surcharge Sewer and Water 41 lglzc) Property owner cc: Carolyn Krech, Finance Deputment La ?? 6 /a 492.00 114.00 15.00 50.50 ?qsur?7ts?? ? ? Wt QS.CCJJ /I/Zi^' f qt7D, a 0" O? D.O c p `j 840.00 492.00 114.00 30.00 30.00 100.50 $ 'I `q (a . `D 30.50 S I OFFICE USE ONLY PRV required: ? Address u U P, f1 ?e f) R-O-W Permit: Phone number (o?? C1 5 S ? Unpaid $ Permit Fees: Plwnber S e R YI C 2 S (C h 0.c !'d I City financed: ? Sewer lateral charge @ $2230/ff . Water lateral chazge @ $22.55lff Sewer trunk @ $900/connection Water truiik @ $940/connection City SAC BaseSAC Date paid v'- '! Receipt # 19q,5 Water supply & storage Date paid Receipt # Treatrnent plant Water meter •*Inspections req'd prior ta issuing Account deposit Septic abandonmenY Sewer and water permit & surchazge Subtotal Plumbing permit & surcharge Total (? 2 n E. R -F-- C ?? ?? 6 9 ?a Y? s City'OCounty N//a L?' g2 ll ? T0: CITY OF EAGAN MAYOR PAT AWADA AND CITY COUNCIL MEMBERS CITY PLANNING DEPT. C/0 CITY ADMINISTRATOR RE: OUR PROPERTY LOCATED AT,14580 OAK POND ROAD_ CURRENT SUBDIVISION PROCEDURES LAST YEAR THE CITY DETERMINED OUR PROPERTY TO BE ASSESSED FOR TWO LOT EQUIVALENTS TO THE SUM OF $14,000 PER LOT, FOR CITY WATER AND SEWER IMPROVEMENTS TO THE OAK POND SUBDIVISION. . AT THAT TIME, WF. ASKED IF THERE WOULD BE A LONG PROCEDURE IF WE MADE THE DECISION TO ACTIIALLY SELL OFF OUR ADDITIONAL LOT, SINCE THE CITY HAD ALREADY DETERMINED THAT THE LOT WAS, IN FACT, ABLE TO BE SUBDIVIDED. WE WERE TOLD THAT THIS WAS A SIMPLE PROCEDIIRE THAT WOULD REQUIRE MAKING APPLICATION TO THE CITY. WE HAVE SINCE BEEN INFORMED OF THE LENGHTLY PROCEDURE AND FINANCIAL REQUIREMENTS NECESSARY TO ACTUALLY GET THE LOT ON THE MARKET. WE HAVE LOST TWD BUYERS. WE HAVE BEEN TOLD THAT THE CITY IS CONSIDERING A "FAST TRACK" PROCEDURE FOR SUBDIVIDING, SIMILAR TO THOSE PROCEDURES USED BY MANY OTHER CITIES THROUGH THE METRO AREA. WE HAVE BEEN TOLD THAT THIS WILL PROBABLY NOT BE RESOLVED,. ANY TIME SOON. WE FEEL, AS DO SEVERAL PEOPLE WE HAVE TALKED TO IN THE EAGAN PLANNING AND ENGINEERING DEPT.'S, THAT THE PROCEDURE AND FINANCIAL CRITERIA NECESSARY FOR REGULAR EAGAN RESIDENTS IS EXCESSIVE AND SHOULD BE CHANGED. IF YOU HAVE ALREADY DETERMINED THAT MY LOT IS SUBDIVIDABLE AND HAVE ASSESSED THAT LOT $14,000, THERE SHOULD NOT BE AN ISSUE. $28,000 IS A HUGE AMOUNT OF MONEY FOR A HOMEOWNER TO ABSORB, NO MATTER HOW YOU LOOK AT IT. WE ARE ASKING TO HAVE THIS ISSUE ADDRESSED BY THE CITY COUNCIL AND PLANNING DEPT. JUST AS SOON AS POSSIBLE. WE ACTUALLY WOULD LIKE TO BE PUT ON THE AGENDA AT THE NEXT AVAILABLE CITY COUNCIL MEETING TO ADDRESS THE COUNCIL REGARDING THIS ISSUE. THAT WOULD AT LEAST BE A BEGINNING. WE THANK YOU FOR YOUR CONSIDERATION AND TO ALL THE INDIVIDUALS WE NAVE TALKED TO THE PAST SEVERAL WEEKS WITH OUR CONCERNS. SINCERELY, GENE AND BRENDA PFEIFER 4580 OAK POND ROAD EA?1N, MN 55123 (651) 452-4955 ? ?? ?? ASSESSbIEYT DEFERR.4I. AGREEivIENT This Assessment Defeaal Agreement ("AgreemenY') is made thise? day of _qr_&? 1998, by and behxeen EUGENE PFEIFER and BRENDA PFEffER> husband and wife (hereinafter "Landowners"), and the CITY OF EAGAN, a Minnesota municipal corporation (hereinafter "Cicy") (hereinafter collectively referred to as the "Parties"). WIIEREAS, Landowners are the fee owners of property located in the City of Eagan, County of Dakota, State of ivlinnesota and legally described as: Lot Two (2), Block One (1), Oak Pond Hills Second Addition, according to the recorded plat thereof (hereinafter the "Property"); and wHEREAg, as parc of Public Improvement Project No. 732 (hereina8er the "Project"), Lhe Properry was assessed usin; a per-lot equivalent of Seven Thousand and no/100 Dollazs ($7,000.00) per lot, which per lot equivalent consisu of: Im?rovement A ou street improvement 51,000.00 sanitary sewer laterai and water lateral $6,000.00 TOTAL: $7,000.00 thereby resulting in a total assessment levied against the Property of Fourteen Thousand and no/100 ($14,000.00) (hereinafter tkte "Assessment"); WHEREAS, the Landuwners have requested that the Ciry defer a portion of the Assessment until the Property is developed; and WHEREAS, the City is willing to defer a portion of the Assessment upon the terms and conditions contained herein. NOW, THEREFOEiE, in consideration of the mutual promises contained herein and ocher good and vatuable consideratiun, the receip[ and sufficiency of which are hzreby acknowledged, the Parties do hereby agree as folluws: r . -. Page 3/ASSESSN(ENT DEFERRAL .AGREE?(E?1?I' The PropzRy shall be immediatel,v assessed for the following: [morovement Assessment Amotmt stree[ improvement $1,000.00 sanitary sewer lateral and water lateral 56,000.00 TOTAL: 57,000.00 (hereinafter the "Immediate Assessment"). The Immediate Assessment shall be payable over a term of fifteen (15) yeazs at an interest rate of six and one-half percent (6.5%) per annum. 2. The remaining portion of the Assessment, namely: imnrovement street improvement sanitary sewer lateral and water lateral TOTAL: (hereinafter the "Deferred Assessment") Accctement AIilollrit S1,000.00 56,000.00 $7,000.00 shall be deferred with interest at the rate of six and one-half percent (6.5%) pzr annum and such deferment shall end if the Property is subdivided, platted or othenvise developed or until December 31, 2022, whichever occurs first. Then, the Deferred Assessment shall. be payable over a term of five (5) yeazs with interest thereon at the rate of six and one-half percent (6.5%) per annum. 3. The Landowners hereby waive their right to object or appeal to the initial Assessment or the Defened Assessment, pursuant to Minn. Stat. §429.081 and further waive notice of hearing on this A.greement. 4. This Agreemznt shall be binding upon and inure to the benefit of [he Parties' heirs, successors and assigns andskat) run with the land. ? A Pa,e 3%ASSESSMENT DEFERRr\L AGREEMENT C(T?" OF EAGAN: B. homas A. Egan Its: hlayor STATE OF IMINNESOTA) )ss. COUNTY OF DAKOTA ) By: E, anOverbeke Its: lerk The foregoing instrument was acknowledged before me this 1??-day of 1993, by Eugene Pfeifer and Brenda Pfeifer, husband and wife. STATE OF NINNESOTA) )ss. UNTY OF DAKOTA ) OCcn ) e e Ls? o eo? . Notary Public uvowae wroea NOTAAY PU8L1C - AIINNES07A DAl(OU CIX;NiY EIy Commis;m Er.prss.kn. 31, 2W0 CO l / The foregoing instniment was acknowledged before me this?s day of ?Fdb e r , 1993, by Thomas A. Eean and E. J. VanOverbeke, the Ivlayor and Clerk of the City of Eagan, a Minnesota municipal corporation, on behalf of the municipal corporation. J'JGf 'y. J6'd;crf"iS rwT1 .sr?,?auc-An?:::?eora ? 7!7 . No , P lic Page 4iASSESSt'v(EN-[' DEEER.RAL AGEtMMENT APPROVED AS TO FORIM: City Attomey's Office Dated: APPRGVED AS TO CONTEiN'I': PL '-? L') I , c -A-? Public Works Department Dated: THIS INSTRiJMENT WAS DRAFTED BY: SEVERSON,SHELDaN,DOUGHERTY & M0LENDA, P.A. 7300 Wzst 147th Street, 5uite 600 Apple Valley vN 55124 (612) 432-3136 (RBB/kmw- 9206-15433) Project 732 CITY USE ONLY PERMIT #: 1? -I -?- I ^-.+-- RECEIPT DATE: APPROVED BY: '5 P '3 " ''9-0 ( , INSPECTOR COMMRCLAI. MECHANIClkI. PEgM1T "PLICATION CiTY OF EAHM 3850 PILOT KNOB gD EAsM, Mx 551 sa 651-6$1-4675 Please complete for: all commerciaVindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE:,_??? SITE ADDRESS: ?C90 12/-I 4 AAWII'?;?Cl ? n-? OWNERNAME: ic.- 1 %fFrPPHONE#: (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: /aC ADDRESS: /r PHONE #: (AREA CODE) CITY: STATE: /14 /Z ZIP: sS/O Z WORK TYPE: New construcrion Install U.G. Tank _ Intenor Improvement ? Remove U.G. Tank _ Processed Piping Specify Na!ure When instalfing/removing underground tank, cal! 651-681-4675 for inspection by Fire Marshal and Plumbing linspector. Underground tank removaUinsta llarion = murimum fee o1 Fees: 1% of contract price OR $50.00 minimum fee, wlrichever is greater. FSph"a-ch-S-I,KUa-seFee Contract price: 1%$?G (Base Fee) State surcharge br'Q calculate at $.50 _ TOTAL $?? 50? ?"D t?---?? SIGI>i,?.P OF PBRMITTEE vY ?eI tY ? ? ,,, 1I Updatedl/Ol I PERMIT #: CITY USE ONLY RECEIPT DATE: MIDENTiAL MECHANICAI. PFIMIT APPLICATION crrYoF Eheax 3$30 PILOT I{POB iW $A@RA l!N 557 E8 681-6$1-4675 Please complete for. ? single family dwellings townhomes and condos when permits are required for each unit Date: SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET ADDRESS: CITY: STATE: Piace a check merk next to the oermit work tvoe TELEPHONE #: (AREA CODE) 'TELEPHONE #: (AREA CODE) ZIP: New residential dwelling unit under constructionand not owner/occupied $ 70.00 Add-on, modification or alteration to existinq dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other ? Nature af work: State Surchar e $ .50 Total $ Reminder: Call for inspections. SIGNATURE OF PERMITTEE Updated 1/01 Use. BLUE or BLACK Ink F----------------- Forbffiee Use City p Permit .1 of Ea I I j 3830 Pilot Knob Road Permit Fee: J L I Eagan MN 55122 I I Date Received: I Phone: (651 675-5675 ! 1 Fax: (654) 6755694 I Staff: I 1 2010 RESIDENT Ueft os AL BUILDING PERMIT AP PLIC 3 n t&97064-1 Date: /Q -dO " I Site Address: ~V Tenant: Suite RESIDENT iOWNER Name: / Phone: Address / City / Zip: Applicant is: Owner _yContractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes /No 7L CONTRACTOR Name: License 1 Address: Q 116 City: yw)~' State: Zip: Phone: 5 - 7 - 6)-6 Cr' Contact: l 1 Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? TYes _No If yes, date and address of master plan: Licensed Plumber. Phone: 1 Mechanical Contractor: Phone: 'Sewer $ Water Contractor: Phone: 'NOSE: Plans array suRPorting aloaarrr~etrts#irat yourtbmi#~r~ co'n~dec off. $ ups trfa»atoh o Qris of 1heinformatiarrmaybe:-c10ssfed41i-0on ubiicffyorr=pro e'fsP cr$a'' t 7#sorJd permit t%erty #o ;~oncilde hoot ilia ~re[ 00 Ai _ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility dama e. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall oro 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 pl s. X C dA& X Applicants Printed Name Applicant Signature Page 1 of 2 Use BLUE or BLACK Ink r-----------------� I For Office Use � lt' I � a- J ! `�' � tt � � Permit#: � � O� � �� I Perrnit Fee: I v�� I 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 I Staff: I I I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: �y T ��. Name: �..- �� � t-�'��� ���L Phone:�� � .��.t� `q •-"��-c� 1.�. �'��#��� �r ,c� ' - � Address/Cit /Zi �t � �v v �< ��.� � ���� � `�JS l �- � �#i�' Y P� �' � �` � � `� � �� �,. Applicant is: � Owner Contractor '� ; s�� �� Description of work: ��� �`�- `� � �������O�<� - � � I'� � �� � �� � � z„ Construction Cost: � j�� Multi-Family Building: (Yes /No�) I Y, :�� �'�� ���� Company: Contact: ���� k � : ������, ��`� Address: City: � � a �� � � State: Zip: Phone: Email: � �.� ° f License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING tn the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: Al�'TE '���1�ar�f�dca�e�i��►�����������t�d�be p��" � �" ���- �a ,��� � �r�r���e������ r��r���,r��e+��`� ��s������,��c�y� ' �' n "a ,,�� �7 a<a ����� ��'+B��,. ���� `�. 3_; ������', a � �� 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.qopherstateonecall.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. X�CIk�' � ��, i , Fi ,c���-� . i � �� �, �--- Applicant's Printed Name � ApplicanYs Signature c„�_ Page 1 of 3 Citi of Earn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: 4/8/2016 Use BLUE or BLACK Ink For Office Use Permit #: /252' `_' lfj ` �/ (C. Permit F+ Date Received: Staff. 2016 MECHANICAL PERMIT APPLICATION El Please submit two (2) sets of plans with all commercial applications. Site Address: %try to OAk Tenant: ity 1 zip: 4580 Oak Pond Rd Eagan, MN 55123 Name: All -Ways Mechanical Services, inc License #: MB004427 Address: P 0 Box 240813 City: Apple Valley state: MN 55124 Phone: 651-248-6087 Contact: Ron Bakken E il: awmsheatcool(a yahoo.com ©escrt on of w s. t : Imo' Tierr it r l' of rn n • g un mom altar et Codre. Please contact fire Mechanical Inspector for RESIDENTIAL Furnace Air Conditioner Air Exchanger Heat Pump Ve Other is required to be screened by City n permitted screening methods. COMMERCIAL New Construction interior improvement Install' Piping Processed Gas Exterior HVAC Unit Under/Above ground Tank ( Install / Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100,00 Residential New, includes State Surcharge COMMERCIAL FEES $60.00 Permit Fee Minimum $70.00 Underground tank instaiiatioNremoval Surcharge = Contract Value x $0.0005 e project valuation is over $1 million, please call for Surcharge Contract Valine $ x .01 $ Permit Fee = Surcharge = $ TOTAL FEE 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 1 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 xRon Bakken AWAIIS Inc signature on file Applicant's Printed Name FOR OFFICE USE Required Inspections: Underground Rough in Air Test Cas rviceTest Date: First HVAC Screening PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA163104 Date Issued:08/17/2020 Permit Category:ePermit Site Address: 4580 Oak Pond Rd Lot:1 Block: 1 Addition: Pfeifer PID:10-57100-01-010 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jeanne Bjergo 4580 Oak Pond Rd Eagan MN 55123 Minnesota Rusco 5010 Hwy 169 N Brooklyn Park MN 55428 (952) 935-9669 Applicant/Permitee: Signature Issued By: Signature • EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 EC+ (651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694 buildinginspectionsAcityofeagan.com fF' For Office Use 36. Permit #: Permit Fee: / 3 07 ' (7 Date Received: iS Staff: 2020 RESIDENTIAL BUILNG-PERPAMAPPLICATION Date: 8/17/2020 Site Address: 4580 Oak Pond Rd Unit #: J C Resident/ Owner Name: Jeanne & Scott Bjergo Address / City / Zip: 4580 Oak Pond Rd Applicant is: Owner Contractor Phone: 4;t-1 Description of work: Bathroom remodel - please see drawing for details Construction Cost: 10,300'00 Multi -Family Building: (Yes / No ✓ ) Company: Minnesota Rusco Contact: Julee Massie Address: 5010 Hwy 169 N city: New Hope State: MN Zip: 55428 Phone: 952-935-9669 Email: julee@minnesotarusco.com License #: CR002173 Lead Certificate #: NAT21315-3 If the project is exempt from lead certification, please explain why: 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: Fire Suppression 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeacian.comfsubscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a 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. .Julee Massie Applicant's Printed Name x-/,a,2 7"rZar� Applicant's Signature DO NOT WRITE BELOW THIS LINE L-/ 00 PA ?o,'l( 36I SUB TYPES Foundation Single Family \/., Multi 01 of _ Plex Fireplace _ Garage Deck Lower Level WORK TYPES New _ Interior Improvement Addition _ Move Building Alteration _ Fire Repair Replace — Repair Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% y ) Census Code # of Units # of Buildings Type of Construction A000 REQUIRED INSPECTIONS _ Footings (New Building) Footings (Deck) Porch (3-Season) _ Porch (4-Season) Porch (Screen/Gazebo/Pergola) _ Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Footings (Addition) Foundation Foundation Before Backfill Roof: _Ice & Water _ Framing 30 Minutes Fireplace: _Rough In Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan eviewed By: Final 1 Hour Air Test Final Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Service Test Gas Line Air Test _ Hood Pool: _Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath _Stone Lath _Brick _ EFIS Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Radio Meter Read Copies TOTAL 014 0 0 0 Page 2 of 3