4117 Oakbrooke Tr
ff I
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Uo!J 01)d Tcul'o
Ta?? ?teIl)
Address 4117 pQkbrnnkoT,-a;i Zip 55122`
?
I.Ot 5 Blk 4 Sub Dakbrooke 3rd Addition
THESE TTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTTON.
Date: Yes No Inspector: ,
Final grade (6" from siding) ?
Petmanent steps (gazage)
Permanent steps (main entry)
Permanent driveway X
Permanent gas
?
Sad/Seeded grass
TraiUcurb damage ?
Porch
Basement finish
Deck
Please verify wi[h the builder the removal of roof test caps from the plumbing system and [he shuiroff of water supply to
t6e outside lawn fauce[ before freeze poten[ial exis[s.
Contac[ engineeting division at 651-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Cupy Pink - Contractoc Copy e
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2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
' CITY OF EACNN
3830 PI851-681-4675 55122 q -(o j
3 I 3- A
RemoCel/Rendr Reaulremanh
> 3 roplstered dh wrveys showfnp aq. fl. of lot. W. R. W house
aid gg( roofed areas (20'?, mmdmian lot covaraae dbwa?
D 2 copies d plans (shpw becm d wlnHOw sizes; poured Ind. dealpn; etc.)
D 1 fat Ot 9nerqy ccAcukt{cny
> 3 copiet of hee presarvollon plan H lot PlaHed aller 7/1/93
DATE: 3 ' 6- 0O
DESCRIPT{ON OF WORK: N c'-O
STREET ADDRESS:
LOT: -? BLOCK: SUBD./P.I.D.t:
Name: Phone C
PROPER'fY wn Ptrsr
OWNER
Sheet Address:
CitY State: Zip:
Company: c-F "-1iv1i1eS'04v- PhoneM:
(area code)
CONiRACiOR
Sheet Address: ucense u 3 7/ ExP.3 31-00
Gy //??,1Jj-boTi9- &0.L64FT5 state: 4,11v Zlp: l?-
4RCHtTECT/
ENGINEER Company: Name:
Telephone A: (
2 copies M plan
1 tef W enerpy ea9aAaMOns for heated atltlitlorx
1 slte wrveY for exteAOr addllons & decka
?
CONSfRUCT10N C05f: /I 0. Om
Street Addreas: RegisHatlon #:
CHy
Sfate:
Zip:
ewer/water Ilcensed plumher (iT installina sawerJwater):_ VALLcV T"C_ vb i vA-, Phone #:
T
hereby acknowledge 1ta 1 have read ihic applbalion. state Mwf tlie infamafan is correct, arM agree b comply wNh aB aPP6cable StaFe
? Minnesotc Slalutea and Cily o( Eaflan Ordinances.
sig,rnure of nppiicanr.
OFFICE USE ONLY
3rtificates of Survey ReCeived ?Cgs _ No 6?J J?
ee Preservatfon Plan Received _ Yes _ No - t Required ?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundation O 07 OSplex O 13 16-plex O 21 Porch (3-sea.) O 31 Ext Alt - Multl
02 SF Dwelling p 08 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ext. Ait - SF
03 01 of _ plex O 09 07-plex O 18 Deck O 23 Porch (screened) 0 36 Muki
? 04 02-plex ? 10 OS-plex O 19 Lower Level ? 24 Stortn Damage
? 05 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Mlsceilaneous
4 06 04-plex ? 12 12-plex O 20 Pool O 30 Acxessory Bidg.
WORK TYPE
X 31 New O 36 Move Bldg. ? 43 Reroof
? 32 Addition O 37 Demolish (Bldg)" ? 44 Siding
0 33 Alteration p 38 Demolish (Interior) [3 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) O 48 Windows/Doors
' Give PCA handout to appiicant for demolition permit
GENERAL INFORMATIQN,
SAC Code _(`] / # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buifdings E4 Width Footprint sq. ft.
Const. (Actuai) Basement sq. ft. ?1 ???3_?p Census Code
(Allowable) Main level sq. ft. - 7 Q MG/ES System
UB C O c c u p a n c y (2A&dWsq. ft, k./ yn Ci t y Water / S
2oning oez?14 Sq, ft. / iyry Booster Pump
PRV ?
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
O Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $?POV
Surcharge - P'/
Plan Revfew
License yP?
MC/ES SAC ?
City SAC a ,
Water Conn.
Water Meter
Acct. Deposit e,/
SNV Permit ? ? ( ?
S/W Surcharge
Treatment PI.
Park Ded. ??-
Trails Ded.
Other
Copies
Total: S a ?-1- c?3
SAC Units
% SAC
? LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
,W PROPERN LEGAL ` ??'K q (a44/`B?PrX2CE F"O.V4G2T-tON
n DA7E OF SURVEY; -;Z 7-??
j
w ?'.?
LATEST REVISION:
cx
C
0
DOCUMENT STANDARDS
x g n°
o?z a
r/? ? • Registered Land Surveyor signature and company
a? ? ? • BuildingPermdApplicant
ti
L
l d
? c escnp
on
•
ega
ry ? ? • Address
r?/? ? • North artow and scale
r?
/? ? • House type (rambler, walkout, spfttwlo, split entry, lookout, etc.)
.
S ? • Direc4onal drainage artows with slope/gredient %
? ? Proposedlexisting sewer and water sernces & invert elevation
? Streetname
? ? • Dmeway
y?p ? • Lot Square Footage
? ? ? • Lot Coverege
ELEVATIONS
Ew'stina
?
? ? • Sewer senrice (or Proposed)
r,a? ? ? • Properry carners
co ? • Top of curb at the driveway
zi v
?/ ? • Elevations of any epsting adjacent homes
h
tild
t
c ? es
y
renc
Adequate footing depth af structures due to adjacent u
Prooosed
?
? ? • Garage floor
?/?
' ? • Firstfloor
V
i
d
ti
lk
ce
? ? w
n
ow)
• Lowest exposed eleva
on (wa
ou
Gir/ ? o • Property corners
:D/ ? ? • Front and rear ot home at the foundation
PONDING AREA ('rf apdicaWel
? ? • Easement line
? ? .
/ NWL
/? •
1% HWL
d ? •
? Pond # designa6on
ti
O
fl
El
? c
o • eva
on
Emergency
ver
ow
DIMENSIONS
:y ? ? • Lot Iine44Bearings & dimensions
q? ?? • Right-of-way and street width (to back of curb)
?? a • Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all structures requiring permanent footings)
N/o? • Show all easements of record and any Cily utilNes within those easements
G? ? ? • Setbacks of proposed shucture and sideyard setback of adjacent exisling structures
?[y ? • Retaining wall requirements, if any
i
Reviewed:
nnaroh tsse
cwIGIeLocvnnrtUn
? , • • ? _ '
Orkbrooke Infinity
Eagxn
Datr. 12/6/99
Address: 4117 Oakbrooke Trail
Lot/Block: Lot 5 Block 4
Plan: Amber Walkout
Options: llescription:
18015 Elevation #]
11012 Finish Basement With Craftmaster poors
25020 CraIImaster lloors
14007 Carpet Pad Upgrade
14084 l " Carpet lJpgrade
17005 Llectric Dryer Outlet
17024 Ceiling Electric Opening MBR
23005 2 "1'on A/C
32020 Two Additional Phone Jacks (I3oth 13R 93)
10055 Spacemaker Microwave
36019 Waterline Future Icemaker
21021 Gas Fireplace Wood Mantel
35049 Basement Laundry Flook Up
15031 Viny? I7pgradc Kitchen
Stain: Cider
J3
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R?•,...?j?o.. ?'"
JOB INITIATION ORDER
P.ulte Homcs of
Minnesota Corporation
7355 Mendota Haights Road, Sude 300
Mendota Heights, MN 55120-1112
Phone, (657) 452-5200 Fax. (651) 452-5727
?
-,;opnONi#.4; ?,??t?'?i;:'`='?s ?'-' • ?' DESCRIPTION'.:;?a..?,ra;M,
0000 BASE PRICE 189,990
---- LOT PREMIUM 5,000
1 18015 ELEVATION # 1 0
1 11012 Full Basement Walkout 3,000
1100, s «?t e 19a5b
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TOTAL ---?
CONTRACTOR/SUPPLI E R:
JOB NO. 0550 / 005 1 04 LEGAL DESCRIPTION LOT 5 BLOCK q UNIT 504
connnnuNirv: Oakbrooke Infinity ADDITION' 3fd
BUILDINGADDRESS: 4117 02kb?OOk@ Tf2il cITr: Eagan -- sraTe: MN ZIP: 55122
MODEL NAME: ARIb@? W!O MODEL NUMBER: 17923 ELEVATION: 1 `GARAGE: LEFf RIGHT
? F-I
BUYER'S NAME: D0n81d $ PBUId B6f115YCi11 DATE OF ORDER:
99
CURRENTADORESS 3919 Fairway Drive cirr Fairmont STATE: MN ZIP: 56031
HOME PHONE: 507-235-61 OS BUSINESS PHONE' BUSINESS PHONE:
SALES REPRESENTATIVE Kathee Sheldon
,,Builder's License N0001371
?-
APPROVED BY BUYER(S): ..?
G
APPROVED BY SALES:
RELEASED TO START CONST.:
This constitutes a contract between the :
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ING
, ,
SITE''AOORE55:
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-",-
l;"COHPUTAT I ON
CONTMCTOR: / r,G h'o .[ ? G?••?--- DATEC ?_..
INE NOItKI11C SOUAitE FOOTAGfi OF EACHs
PHOHt: ySt -S Loo
. , OETEAN
,,_ . •
.
"
"
T07AL
1 EXOOSED NALL AREA ........ %J,!-?j _ sq F t U
x
. oa
TOTAL
2 ROOFJCEILIHG AfIEA,,,.,... Z? sq Ft x"U"
. _ _., , . . . - -. .._ • .,,? ._ _
3, TDTAL EXPOSED 11AL1 AREA CAICllLAT1UN5: .
. Total exposed xa1T ?
fE
area above fiuor,,,,,,.. ? sq
. t .
' a) Tatal wa11 Nindor+ area: • .
DCUBLE g 1 azed, ,,,,, 2'1 Tj sq f t x"U"
glazed ,,,.., ?..?? Sq ft X 'IUn
' r2 5 ;q f t x??11.
[yl J ??
b) -door tirea ,,,,....+
'Tolai --?--- _ , . .. ._
c) Total slldilig giass door area:
O
r- ft X'61Vu..
?
• ?-' SQ f C X glUet °
9lazed......
`?i``s?r.e ?rr,`?`?5?'?:;?-?'.. .. _ ? r= _? ,?: .?,.>.. - • sq ft x nuil i.
?,?f7otl11?:f(replacn wall area
o,tgl wal l framing area sq ft x"U" °
H'., ??Yf Le L V? • O ?
.. }.r• ? ?. ?"r3 6'Pr?' ' ,?a.
f)'"??7ota1?'det wail aroa above
'!'??°A l za ?,?
Plaor (lnsulatld)....... 3 sq fc x !1 ?1?-1------
1r670 sq ft x "U" . .+o
g) Tatyl t(a jolst area......
" ??'?'???????., . . • . °.
? ; NATota,? _,foundatlon ? ft
. sq
area (Faposed). • . • • I ?
? d
?????s?h.):?n7otal foundatlan.......... --- ? } ---'
s 4 f t x U ?-----
_ wfedoi+ area.
I) Tota) ne: ioundatfon +( sq ft x"U" •G76 ° `?
area abave grade....... ' -------' ??I
TOTAL a) thru 1) 3• ,
.' . , .'Wth?? f? E?bf°4?
IF (iem ,43 is the same as, or less than i tem 11 YoUhave
y
• ' _ ?'; "?%°, • °-
2 itC.1R 1.16009 A and U.
' plpe 1
Cp?JFiLG_ glazed..:...
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' expola?"?
'?RYTetai'
sq
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roof/eeilidg ?rea..... ft
.
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_ ?J} Total skyliaht area...... r? sq ft x"U" '
=.,_k)?'' Total';roafleelllnq ?reming Ft?
area (Averaqe 10' • =-
1) 'Total net Insulated O? ?q.1_75
roof/eellinq area....... ??- eq f t x "U" . ?
h, - - , TOTAL"•l) thru.l) ' 2Q? •
If total oF sh Ts the samc as, or less than.F2. you have met the Intent oF
2 FIG1It 1.16008 A and 0.
.. ... 1
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. . AITERNATE BUILUIlIG ENVELDPE OESIGN
Ta utlllze the total envelape system me[had, the values establfshed by the sum
,. of items 63 and 94.shail,nat oe greacer than the snm of Tcelns fll and RZ.
• 1. + Z.
-734....---.....____.._._ ... -i' 4. °
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I herehy eertlfy that t have ealculated the "U" factors and "R"
h.f
values heraTn and that ehe huildlnq here deecrlbed mests"or'eXCeeds t e, tate
oF.Mlnnesota,Eneray Conservatfon Ac:. „ . ..., - .-=w?%i?°rr:,-,., • -
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Ir
or air
WALL SECTION (INSULATED)
--(1 Interlor air fl
iuI AL n - 10•vr4-
u-t/a-07- Z.
U - 1/R??
RIH JOISI' SECT10t1:
?1 Inter(or air Film n.6A
`z 19 im-?(J LA-npu i9.riQ °
1117-4 =FT IXmn n 1 RS : -.
- 4 a/fi7- 6IIIl -fR1'rP. • ' 7.OCQ :_.;.
5 AL1JM -I Jn 1M['O
6 Exterior air flim -0 =17-
? . TOTAI R• ? 74? -_:
i FUUNOATION INSULATION REqUTREDt
U - 1/R '
Min. R-5 an entire wa11 OR
' Min. R-10 down to frost.aepth - •
` TIaN SECTION:
FOUNDA
? -
-?-{1 Interior air fiim •?•RA ?
2. ' - I -
3 ? r?Z n1Le. [5c o t4, 17)3
._.?;
4 Exterlo M n.17 •?_:
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TOTAL R "
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U - 1/R - .y
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??IV - . .... - ..? p^u?
UALI. FRAH
-- --?' '
SLAB ON GAAOE
Unheated Slabs: -
Minimum R ¦ 6.2" •
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.tf^?= ,;'aa?"!.?af*i•"•,: - ? - _. :.::{ C
'=' _ "? ;` _ . ?' • CEILINI; 5$" CTIQN (I?15ULATED):
Interlor air'fllm
, -.. : u . - • 2 s[B ' -55Fc7lrinCK
44C0
-
'y^ys 3 4, , 4 Exterior afr Ptim stt111 q.Fi .,
, TOTAL R '
U. 1/R-.0Z
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q(R I I VENTED
FLOW ,
:
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CEII(NC FRAHING SECTION:
T _
2
3
5
CEILIIJC SE1:T10N (ItlSOLATED): '
1' Interior air film
2 `
' ; . .
4 Exterior air Film scilE 0.61
TOTAI K s
U- 1/Rs
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CEILINr, FR/WIHr. SECTION:
1• Interior air film ' ?•61
2 ..
3.
4 Exter or a r m st n.61
nehes so t wood
TOTAI R • , :,;?°'
• .,.
U@ 1/it- -
1 ,Instde air fiim n•Al
2
3 a.-
4
5 Outs+ de;a ?;Y? iM _,,y';,4: n 17
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Page 4
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- U - 1/R - jo
Surveyor's Certificate
SURVEY FOR :PULTE
DESCRIBED AS : Lot s, alock 4, OAKBROOKE 3RD ADDITION, City of Eo9on, Dakota County, Minnsota and
reserving easements of record.
s?
0
.ti.,
2o O
A
*V,..
LOT
H SE.
LOT
SQ. F00TAGE
SQ. FOOTAGE
COVERAGE _
Plan jJ 17923
PROPOSED ELEVATIONS
Top of Foundotion = Q33•0
Garage Floor = 932•y
Bosement Floor =92y,o
Aprox. Sewer Service = qiq.3 ±
Proposed Elev. = 0
Existing Elev. - -
Drainoge Directions = -
Denotes Offset Stoke = .
?ZFT
. .. ..._:1.. ...., _. ._..
SCALE. 1 incn - 30 feet
BENCHMARK,
7'NH9 Lots 146 8lkq
E+- = 43x .63
MIN, SETBACK REQUIREMENTS
Front - House Side -
Rear - Goroge Side-
JOB N0:
HEDLUND ' HEREBY LERTIFY TMAT THIS IS A TRUE AND CORRECT REPRESENTATION 99R-673
OF THE BOUNDARIES OF TME ABOVE DESCRIBED PROPERTY AS SURVEYEO
BY uE OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PACE:
PLANN/NC ENC/NEERlNC SURV6YlNC SHOW IMPROVEMENTS OR ENC ACMMENTS. EXCEPT AS I-JOWN.
2005 Pin Ook Orive Qp
Eagan, MN 55122 On7E tz / Z7/_I7 nD FILE:
Phone: (651) 405-6600 fR LINDGREN. LAND 5 vEVOR
Fnx: (651) 405-6496,,,,,_ NINNE TA UCENSE NUMBER 4376 OAKBROOKE
= 3,608
= 1, 747
48%
CITY USE ONLY
LOT ? HL ? PERMIT
suBD. O?/?'6raoAe ,3rL' RECEIPT #:
RECEIPT DATE:
2000 MECHANICAL PERMIT (RESIDENTIAL)
Date: 0 l./
Compiete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not ownedoccupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required (a; $3.00 ea.)
State Surchazge
Total
$ 30.00
6.00
3•00
3 g,v?
.50
$-222-6d
Complete this section onlv if you are remodelin¢, addiny to, or re airin an existing single-family dwelling,
townhome, or condo. Pleue indicate if it is a new item, alteration, or repair.
New Alteration
_ Furnace
Air exchanger
Reminder: Cal/ for inspections
_ Repair _ Other
yo3o _6?
Air conditioning
Other
Fee $ 30.00
State Surchazge .50
Total $ 30.50
SITEADDRESS: `7II 1 6aAC)0jpPLO llr
OWNERNAME:"To 6G? ?(?YYIQ.I PHONE#: ?QrSI - '?•?`'?- Od
( A CODE)
INSTALLER NAME: 1 I o LaC K PHONE #:
-;??` CODE)
STREETADDRESS: ,
.IN"1M C).
CITY:
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN t41 55122
651-681-4675
STATE: M ZIP: c245370
-? .
Z"j,l??d
SIGNATURE OF PERMI7TEE ?
L BL
SUBD.
APPROVED BY:
INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAL PERMIT (C02YMRCIAI.)
CITY OF EAGAN
3830 PILOT IINOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dweliing unit
DATE: '7
WORK TYPE: New consWction Install U.G. Tank
_ Interior improvement _ Remove U.G. Tank
_ Processed Piping
When Insta[ling/removing underground 1ank, ca/1 651-68I-4675 for inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: 1% of cootract price OR $30.00 minimum fee, whichever is greatcr.
Underground tank remavaVinstallation = minimum fee
Contract price: $ x 1% _$ (Base Fee)
State surcharge calculate at 5.50 for each $1,000 Base Fee
TOTAL
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
(AREA CODE)
STATE:
aP:
CITY USE ONLY
a
?
SIGNATURE OF PERMITCEE
L ? gL -?f- CITYUSEONLY RECEIPT#: I?,) ? (pzj
' SUBD. CN ?CAQ,?T,,-tT t ?YO RECEIPTDATE:
PERMIT# 7)q l I
tgWpLUM$INfi P£$MTf (ft£S1DENfIAL) ?
a? ??? ?GAN ? Z
3$30 PILOT KNOB RD ?
£AfiAcN, MN 55722
(651) 687-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
S backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas i in outlet ' minimum - i 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laundr tra 3.00 = $
Lavator 3.00 = $ ?'
Minimum fee alterations to existin dwellin 30.00 = $
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 a = $
Private Dis osal S stem abandonment 30.00 = $
RPZ new installation/re air 30.00 = $
Rou h o enin 1.50 = $G
Shower 3.00 X = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwelling under con5truction $.00 X = $
Water softener • if existin dwellin 30.00 x = $
Water turnaround 30.00 x $
State Surchar e .50 --> ----> ----> $ .50
Total --? --? ----> ----> $ Q)
Reminder: Call for inspections of aiterations, i.e. water heaters, water sofieners, etc.
------------------------------------------- ----------- ------------ - -------------------- ---------------
I hereby aGcnowledge that I have read this application, state that ihe infortna4on is correct, and a9ree to wmply wifh all applicable Ciry of Eagan ordinances.
It is the applicanfs responsibility lo notify the property owner that the City of Ea9an assumes no liability for any damages caused by [he City dunng its
normal opera6onal and maintenance actrvities to lhe facilities constructed under this perm? wilhin Ciry properly/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
TELEPHONE #:
(AREA CODE)
TELEPHONE #:
(AREA CODE)
STREETADDRESS.
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
L BL CITY USE ONLY
i
SUBD r
RECEIPT #: OA?? /-30G 7/
RECEIPTDATE: S aS' ??
PERMIT #
2000 PLUMBING PERMIT (RESIDENTIAI,)
CITY OE EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complele for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinklersystem
FIXTIIRES
EACH /i
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum • t 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic S stem newrrefurbisned `requires MPC Ilc. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installationlrepaidrebuild 30.00 x = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground s rinkler if dwelling is under conetruclion 3.00 x = $
Underground sprinkler ifexisting dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under consvuction 5.00 x = $
Water softener if axisting dwelling 30.00 x =
17
$ -
Water tumaround 30.00 x $
State Surcharge 50 --> ---> --> $ .50
TOt81 "' $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-
-s-.-
------------by ackn------------------------------------------------------------------ • - • - --- • --------- • •----------•---------------. __-
-le-dge that I have read this application, state that the infurtnation is corred, and agree to comply with all applicable City of Eagan ordinan-ce- -
I hereow-
It is the applicanYs responsibility to notify ihe property owner that the Ciry of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the tacilities consttucted under this permit wdhin City propertylright-of-wayleasement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
TELEPHONE ,(??L
( EA CODE)
TELEPHONE le o S:?
(AREA CODE)
STREET DDRESS: .S`Id- lXl.??`?"^ "/?'f oi"
CITY: ?YAI C`Tw ?Ym'l STATE: )'YI?k ZIP:
AOA/ Z' ??
SIGNATURE OF PERMITTEE
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
? 1511 CITY OF EAGAN
3830 PILOT KNOB RD - 55122
657-681 -4675
Reaulremenh
? 2-89PI604111pion T&r'2n4;1 0'6?G3 `j4'¢7
DATE: S -l/- O O CONSTRUCTION COST:
DESCRIPTION OF WORK: If mulM-famity bldg., how many unlh7
IPJDICATE THE FOLLOWIPIG EQUIP(WEPoT TO BE REPIACED AfdD BY WHOM:
_ Plumbing _ Homeowner or Contractor Name
_ Mechanical _ Homeowner or Coniractor Name
"Note: If somebody other than the homeowner is performing plumbing or mechanical work, they must apply for appropriafe
permit. Only licensed plumbing coniractor or homeowner may complete plumbing work.
STREET ADDRESS:
LOT: -5 BLOCK: !i!_ SUBD./P.I.D. #:
Name: -86-"RN STkI nl DO-A,aL71 Phone A: &Sl - 405- 485$
PROPERTY Last Firat
OWNER
Sheef Addresa: 4117 (')4{1 OrzO? T R/ L
city s?a?e: Miy ziP: ss?ZZ.
CompanyQQI :? !'10PeS Phone N: SI ' Z' S7A6
(area code)
CONTRACTOR
Street Address: I3 SS AtAi1014 Y1,70T5 Q.n License M I 37 ! Exp. 3_ 2eal
CNy &J-VI]o`?R hh+.i6//lt Sfafe: I4N Zip: 4:?5/20
I hereby acknowledge thaF I have read ihis applfeaHon, afaFe lhal 1he informalion ia
applicable Sfafe of Minnesota 31aFutes and Ciiy of Eagan Ordinances.
Signature of Appllcanf:
/??'LX.(.?l st.t,o
r71 510. S`
all
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? o1 Foundation ? 07 05-plex ? 13 16-plex 0 -21 Porch (3-sea.)
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
[3 03 01 of_plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Y or _ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)* ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) O 46 Windows/Doors
* Demolition permit - Give PCA ha ndout to applicant
GENERAL INFORMATION
No. of Units
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
Site address: ?M7\ C?C.?L.?,c?.,?Le??a•? Lot S Block 1 Subd. ?-? ! Qv k.4,
On April 15, 2000 the Minnesota Energy Cotle, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
This struclure: Is constructed lo meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
This structure: will be constructed to meet more reslrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
WaterHeater V? Mu, ??o,? M0.\OS245 SIS
Fumace ? ? G,?? 350 ? AV o3?o O S? ?'v ?•+?- ?
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's YENTED
res No
Kitchen kitchen
Bathroom t
MA.rJ ? d ?
Bathroom2 " F - 5 V C? Sp
Balhroom 3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIPECT nrMOs
\ ? !\eo.'? t?l GNo D? A- zS000 I/
I hereby acknowledge Ihat Ihe above intormation
requiremenis.
Company Name
is correct and agree to comply wilh the Minnesota Energy Code and City ot Eagan
??--'c--
Dale
This form is ihe responsibility of the General Contractor.
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA105948
Date Issued: 08/06/2012
Permit Category: ePermit
Site Address: 4117 Oakbrooke Tr
Lot: 5 Block: 4 Addition: Oakbrooke 3rd
PID: 10-53762-04-050
Use:
Description:
Sub Type: e-Reroof
Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Occupancy:
Zoning:
Square Feet: 0
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
Comments:
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $4K $103.25 0801.4085
Fee Summary:
Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00
Total:
$105.25
Contractor: Owner:
- Applicant -
Krech Exteriors Inc Donald Bernstein
5866 Blackshire Path 4117 Oakbrooke Tr
Inver Grove Heights MN 55076 Eagan MN 55122
(651) 688-6368
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127442
Date Issued:10/01/2014
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
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 .
Lisa Nyberg
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 -
Donald Bernstein
4117 Oakbrooke Tr
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128249
Date Issued:10/31/2014
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Donald Bernstein
4117 Oakbrooke Tr
Eagan MN 55122
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA158974
Date Issued:11/13/2019
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Donald Bernstein
4117 Oakbrooke Tr
Eagan MN 55122
Ray N Welter Heating
4637 Chicago Ave S
Minneapolis MN 55407
(612) 825-6867
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA169194
Date Issued:05/18/2021
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Melanie Beth Goldetsky
4291 Pintail Ct
Eagan MN 55122
(651) 228-9200
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA169196
Date Issued:05/18/2021
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
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 -
Melanie Beth Goldetsky
4291 Pintail Ct
Eagan MN 55122
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169850
Date Issued:06/11/2021
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Paul Klinge
4117 Oakbrooke Trl
Eagan MN 55122
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172159
Date Issued:09/16/2021
Permit Category:ePermit
Site Address: 4117 Oakbrooke Tr
Lot:5 Block: 4 Addition: Oakbrooke 3rd
PID:10-53762-04-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Paul Klinge
4117 Oakbrooke Trl
Eagan MN 55122
(651) 633-2643
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature