4122 Oakbrooke TrPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128544
Date Issued:11/18/2014
Permit Category:ePermit
Site Address: 4122 Oakbrooke Tr
Lot:12 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-120
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 .
Description:20 SQ
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 -
Arnold R Felizardo
4122 Oakbrooke Tr
Eagan MN 55122--420
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
Address r, 1 22 (1 a k h r n r, c a r r Zip 55122_
IAt 12 Blk 3 Sub oakbrooke 3rd Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 4/ 2 4/ 0 0 Yes No Inspector: ,
Final grade (6" from siding)
Permanent steps (garage) •
Permanent steps (main entry) x,
Pertnanent driveway X
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch X
Basement finish A-
Deck ?
Please verify wit6 the builder the removal of [oof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before warking in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Conuactor Copy
------------------
? For Office Use ?
j Permit
i Permit Fee:
?
Date F?B 1? 2009 ?
? Receive ?
I ?
i Statl ?
I -----------------?
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 02 ?? O SiteAddress! 4122 OAiwROOl<,t Iiv+1L.'?AGAN, MN S 9)122-
7enant: g rr-_Ll 7-AT-90 suite#:
RESIDENTlOWNER Name:??NM/p V.- fr_L1Z#:?,D0 Phone 612-"2.2 Or `l`t 41
Address/City/Zip: 41 Z2 OALtA GM..f ?_/ 55 122'
Applicant is: Owner _ Contractor
TYPE OF WORK Description of work: T?A5r-_Mv?g
Construction Cost: Multi-Family Building: (Yes No
CONTRACTOR Name: Sr-uf License
Address:
City: State: Zip.
Phone: Contact Person
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
EI18ryy COdO . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submined
(4 Submisslon type) • Energy Envelope Calcula6ons Submrtled
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 Contrector: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents ihat you sLfbmif are considered ta be publlc information. Port/ons ol
the information may be classlfied as non-public it you provide specific reasons thaT wou/d permit the City to
conclude that the are trade secrets.
I hereby acknowledge that Ihis information is complefe and accurate; that Ihework wdl be in conformance wrth the ordinances and codes of the Cily of
Eagan; ihat I understand this is not a permit, but only an apphcation for a permn, and work is not to start without a permih Ihat the work will be in
accordance with the approved plan in the case ot work which requires a review and approval ot plans. I
X ARND ?-?Z .?L I 7.AT-DD X
App icant's Printed Name Applicant's Signature
Page 1 of 3
s
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation
_ Single Family
Multi , .
01 of Plex
Accessory Building
WORK TYPES
New
Addition
? Alteration
_ Replace
_ Fireplace Porch(3-Season) Storm Damage
_ Garege _ Porch (4-Season) _ Exterior Alteration (Single Family)
Deck Porch (Screen/Gaze6olPergola) Exterior Alteration (Multi)
Yi Lower Level _
t"
Pool
_ Miscellaneous
_ Interior Improvement _ Siding _ Demolish Building•
Move Building Reroof Demolish Interior
_ Fire Repair -Windows _ Demolish Foundation
Repair Egress Window Water Damage ,
•Demolltion of entire building -give PCA handout to appiicant
Valuation
Plan Review
(25%_ 100%--)
Census Code
# of Units
# of Buildings
Type of Construction
3? afl0 _- Occupancy MCES System
Code Edition ' 117
oc'1
SAC Units
Zoning City Water
Stories Booster Pump
Square Feet PRV
Length Fire Sprinklers
W idth
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
_z.'Q Framing
Fireplace: _Rough In _Air Test _Final
? Insulation
Meter Size:
i1/ _.I./
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Sheetrock
Final ! C.O. Required
? Final / No C.O. Repuired
40 HVAC
Other:
Pool: _Footings _Air/Gas Tests _Final
_ Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall
Building Inspector
L . 2, F l ,9-T Fe.e.
a - 13 edtZG? E) y,.s
rzo??-
?
g?
ooU k0 3s 7LL
FILED j?
AB6T ACT COPY
DAK4TA CqIJMTv
CERTIFICATION OF PURPOSE OF SECONDARY
KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING
I, Arnold Felizardo, duly sworn and under oath, certify that I am the Owner of the one-family detached dwelling as
defined in Section 11.03 of the Eagan City Code located at 4122 Oakbrooke Trail and legally described as Lot 120,
Block 03, Oakbrooke 3rd, PID #10-53762-120-03.
A building permit application has been submitted on my behalf to the City to enlarge, alter, improve, remodel,
andlor finish the above-referenced dwelling, or a portion thereof, to include the installation of facilities for a
secondary kitchen within the dwelling.
The secondary kitchen facilities to be installed under the building permit are for the sole purpose ot providing
cooking and food service facilities for private entertainment of guests by the property owner at the dwelling.
I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit
to serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the
installation of the secondary kitchen facilities under the building permit is not for the purpose of providing a second
complete, independent and separate living and/or housekeeping unit within the dwelling.
Dated: ?? • ? / , 2009 ?'--
" 5<
Owner's Signature
mj)- and sworn to before me this ?_ day of ?? V1.1 12009.
SARAH JEAN BRANDEL
No ublic ? NoteryPuWio-Minnesate
My Camnlaslon E?fres Jen 31. 2014
I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities Within Single Family
Dweliing was recorded at the County Recorder's Office on , 2009.
By:
Its:
THIS INSTRUMENT WAS DRAFTED BY:
City of Eagan
Community Development Department
3830 Pilot Knob Road
Eagan MN 55122
G:\Building Inspections\FORMS\Certification of Kitchen
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BvOLDiRiG IPlSPECYI? gomsoZ
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2638763
ABSTRACTFEE $4600
Receipt#: 34296 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
ATT COPY $400
Recorded on: 212012009 0121:081PM
By TMB, Depury
Remm to'
CITY OF EAGAN
3830 PILOT KNOB ROAD Jod T Beckman County Recorder
MUNICIPAL CENTER
EAOpN, MN 561Y1 D3kDt8 COllll(Y. MN
CERTIFICATION OF PURPOSE OF SECONDARY
KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING
I, Arnold Felizardo, duly sworn and under oath, certify that I am the Owner of the one-famity detached dwelling as
defined in Section 11.03 of the Eagan City Code located at 4122 Oakbrooke Trail and legally described as Lot 120,
Block 03, Oakbrooke 3rd, PID #10-53762-120-03.
A building permit application has been submitted on my behalf to the City to enlarge, alter, improve, remodel,
and/or finish the above-referenced dwelling, or a portion thereof, to include the installation of facilities for a
secondary kitchen within the dwelling.
The secondary kitchen facilities to be installed under the buiiding permit are for the sole purpose of providing
cooking and food service facilities for private entertainment of guests by the property owner at the dwelling.
I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit
to serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the
installation of the secondary kitchen facilities under the huilding permit is not for the purpose of providing a second
complete, independent and separate living and/or housekeeping unit within the dwelling.
Dated: ?B • ? / , 2009
C`?-??' a- ? . ?• ??,?
Owner's Signature
day of F2E.Q Vl.l L?_ji/1?1 2009.
_?'
Subs ' ed and swom to before me this JO
SARAH JEAN BRANDEL ?
No ublic ?,y??
VVVV%APVVVV
I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities Within Single Family
Dwelling was recorded at the County Recorder's Office on , 2009.
By:
Its:
THIS INSTRUMENT WAS DRAFTED BY:
City of Eagan
Community Development Department
3830 Pilot Knob Road ?t
Eagan MN 55122 NOogV ??? S?GNPS.? G:\Building inspedions\FORMS1Certification of Kitchen
Ama-
City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone:(651)675-5675
Fax:(651) 675-5694
?----------------
? FarfNKee use
? Permit#: ?
I Permit Fee:
i
? Date Receivef
EB 17 2009
1 Staff
L _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 0 Z 13 O Site Address: -f I2Z OSK6KiD OKr 7?,A,I-2 F-A CiATI w MI`S W 122
Tenant: f`c17-NOLp F. F:PLjZAKDd _Suite#:
RESIDENT / OWNER Name: ??H(X-9 F. FE L1 ZAIZP0 Phone: 60 12- 2sl? -194 1
22
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FAGM
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AddresslCitylZip:
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CONTRACTOR Name: License#:
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild t! Modify Space _ Work in R.O.W.
Descri tion of work:
PERMIT TYPE RES/DENTIAL
Water Heater _ Water Softener
L1 Add Plumbing Fiutures
Lawn Irrigation
_
_
? RPZ / _ PVB) ? Main _zLower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 5tate Surcharge)
`Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Rep2ir (replace burned out appliances, dudwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate, that the work will be in contormance wim [ne oroinances ana coaes oi uie cny vl
Eagan; that I understand this is not a permi[, but only an application for a permit, and work is not to start without a permR; lhat lhe work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
XAww'WL-P R. V-F-u-zAuP0 X Cz,..? F . f;
ApplicanYs Printed Name Applicant's Signature
FOR OFFICE USE= _ Reviewed By:-" D"ate:
Required lnspections: '_Under Ground ' Rough-In ''Air Test "_Gas Sest Fina( `
?-----------------
? ??=?? ?
/ i
? Permit #:
I PermitFee' ?
?
? Dafe Received:
? staff. ?
L -----------------?
Uate:
Tenant:
RESIDENT / OWNER Name: AV' tn O L ?? Phone: CpoZZ-/ - ?` 7
Address ! City ! Zip: ql2 Z C??'c {X ? fn c3 ( ` ?V? . ?
CONTRACTOR Name. License #:
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild N Modify Space _ Work in R.O.W.
Descriptlon of work:
PERMIT TYPE RES/DENT/AL
Water Heater _ Water SoRener
_ Lawn Irrigation ?AdcJ?Plumbing Fixtures
( RPZ !_ PVB) y'r? Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge)
`Water Turnaround (add $147.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as 6uilt) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace bumed out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of
Eagan; that I understand this is not a permit, 6ut only an application for a permit, and work is not to start without a pe iC," hat the work will be in
accordan with fhe approved plan in the case of work which requires a review and approval of p?s.
x ?
ApplicanYs Printed Name ApplicanYs Signature
C
' ; a.
L7ate
?R
?
E' ?'1?4' r°x
FOR OFFI
E USE - F??
eviewed
By
??tr?,{i(?
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a
-?'??i
01
T
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Reqwredinspections UnderGY
und tRough
In ;
?
fuFTest
?
.
? _r?,.?.<.,
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
S CITY USE ONLY
L I? gL V
?BO ? ?i???_
RECEIPT #:
RECEIPT DATE:
PERMIT# ?256 7
2000 PLUMBING PERMIT (RESIDENTIAI,)
CITY OF EAGAN
3830 PILOT RNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? hackflow preventer for underground sprinkler system
FIX7'URES
EACH #
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 tublspa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavato 3.00 x = $
Septic System naw/refurbished " requires MPC lic. 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 sprinkler rf dwelling is under construdion 3.00 x = $
Underground s rinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = S
Water heater 100 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener ii existing dweliing 30.00 x = $ .4 L
Waterturnaround 30.00 x $
State Surcharge .50 -> --> -> $ .50
Total -> --> -? --_> $ J U. %
Reminder. Call for inspections of aiterations, i.e. water heaters, water softeners, etc.
-----------------------------------------------------------------------------------------------------------------------------------------
I he-reby-a-cknovAedge that I have read this application, state that the infortnation is rarrect, and agree to comply with all applica6k City of Eagan ordinances.
It is the applicanYs responsibility to notity the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this pertnit wdhin City propertylright-of-way/easement.
SITE ADDRESS: y I ,a, 2 l 1(lACif'"Ctl v-/C.l
OWNER NAME: : TELEPHONE #:
? (AREA CODE)
WSTALLER NAME: ? ' 4i"""J W TELEPHONE #: /u, S 3
STREETADD ESS (AREA CODE)
CITY: STATE: ? ZIP: ?
SIGNATURE OF PERMITTEE
? CTTY UF EFlGAN
L'A,N:CERs ,7S TEf;MINAL N0: 337
naita 01i26i00 T1rsr_: 12;3202
ID.
NAMF: F1JI_TE MAaTF:f+: I3U11_DEF
3210 9001 4118 C]AI<BROOI'. T 60.00
055 9001 4i.i9 CIAKRROOt( T 0.50
2252 3220 4:t22 C1AF:BR00F; 'f 30.00
3210 9001 4122 OAK$ROC1F. 'i ly09q.,`.'i`.i
3966 9379 4122 OAI:AfiOUt: T 10('].00
34-22 3001 49.22 OAF;BI"i001: 'i i 11.46
2275 9220 022 oai;BRooi; r i,aB9.00
3146 9001 4122 nAicBRnoE: T i.:i..oo
205 9001 Wci:? OAh:B(i001: T OoSO
3743 9220 022 UAF(Bh0OF: T 50.00
CFi 1.2c r 3'i' 0 CONTINUC
UGFk ID: JFlN ** CONT'INl7E
5+tO 39 Y-( ,L
cnnriNuE
czrv oF EnraN
CA:iHTCR; ig TERMTNAL N0; 997
DA7Ec Oi./26/00 TIHC: 0:32:33
TIi ;
NAME. f'L1lTE MASTE:fi SUILDER
2155 9001 41.22 OAF.BFiC10K T 59.00
3E169 j^cF?C) 022 OAIiBR00K 1' 492.00
306 WL1 402 fJAI:RR00F. T 04.00
3713 3220 41.22 QAF.RIi001: T 50.00
3865 3220 4122 OAI:BROOt; T 840.00
i
Tota1 fier_eipt Amoun+,. 4y r'02.Oi.
W22737
11S1=F: TT?: JAN
?X?F?XN??%?#???X??X?RNe?C?CSk??X ??FkekC %??#?e#?>k?kk:M?%k???k?X?C
1999 BUILDING PERMIT APpLICATION (RESIDENTIAL)
CITY OF EACAN
3830 PILOT KNOB RD - 55122
651-681-4675
Nm Constructlon Reauirements
D 3 regletered sNa survays ahowfng sq. R of lot, sq. R of house
sad ail raoted areas C20%muimum lotcovanae albwad)
? 2 coples of plans (show beam & wimlow strm; pourod fnd. decign; etc.)
? 7 set of energy calculations
? 3 wpbs of hee presenatlon p{m N bt plattad aRer 7YU93
DATE: ??cx?>
DESCRIPTION OF WORK:
5TREET ADDRESS: --X \
LOT: \'D-? BLOCK: - - : ?s SUBDJP.I.D. A:
PROPERTY Last
awNeR
Street Address:
City
Flnt
RemodeVReoair ReauiremeMs
`t i-( . G `--( f 51
COW I-19-00
2 eoples ot plan
1 set of energy akulatfone Por heated addXianrc
t site survey for axterbr addllione & decks
CONSTRUCTIONCOST: ?
State:
Companv:Y .5
CONTRACTOR '
Street Address'??55
City ?a?(i ?"re\?.?r.?s State: V+\
ARCHITECT!
ENGINEER Company:
Telephone #: (
Phone #:
Zip:
Phone #:
(area eode)
Lieense # ???\ E?cp. 3\ d?
zip: 55?Zo
Name:
9treet Address: Registration #:
CNy
Semr & water Iicensed
9tate: Zip:
v.`.? .
Penalty appNes vfien address change and lot ehange is requested once perihk is issued.
a?a - ARt -^Z\Z`
t hereby aeknowledge that I have mad fhis applicafion, smte that the infomiatbn is rted, and ag e W compty wilh all appiicabk Sfate of'Ainnesota Statutes and Ck
ofr•.sgan Ordinancea.
3ignature of Applicatn:
' OFFICE USE ON
Certificates of Survey Received ZZes _ No ?
Tree Preservation Plan Received - Yes _ No -S?iot Rerjuired
OFFICE USE ONLY
r
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex . ? 16 Fireplace ? 21 Porch (3-sea.)
)!r,02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Misaellaneous
WORK TYPE
73-? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/SofFits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Aiteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (interior) ? 42 Reroof
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories ? sq. ft. MC/ES System
Length ,ro sq. ft. City Water
Width -3,tr Footprint sq. ft. Booster Pump
PRV ?
Fire Sprinklered
APPROVALS
Planning Building ? A[{1. Engineering Variance
Permit Fee Valuation: $roDC7
Surcharge
iview
Lcense
MC/ES SAC
City SAC
Water Conn.
i'Vater Meter
Acc!. Deposit
SNV F'ermit
5/W Surcharge
Treatment R!.
Park Ded.
Trails Ded.
Other
Copies
Total: 171 SAC Units
°k SAC
r
,+ -
- 21?J0B INITIATION ORDER
Pulte Homes of
Minnesota Corporation CONTRACTOR/SUPPLIER:
1355 Mendota Heights Road, Suite 300
Mendota Heights, MN 55120-1112
Phone: (651) 452-5200 Fax: (651) 452-5727
JOB NO. 0550 1 012 1 03 LEGAI DESCRIPTION:
connMUNirr: Oakbrooke Infinity ADDITION: 3rd
euiLoiNG Aoortess: 4122 Oakbrooke Trail CIT'/:
MODEL NAME: Bristnl w/e MODEL NUMBER: 1793d
Eagan s7ATe: MN ZIP 55122
ELEVATION: & GARAGE: LEFT RIGHT
Fx-l F-1
BUYER'S NAME: RIChBfd 8a Dlaflfl@ ROdlilall DATE OF ORDER: Q
CURRENTADDRESS: Tl11 GI'2118d8 W8y NOrfh CITY: Oakdale STATE: MN ZA 55128
HOME PHONE: BUSINESS PHONE: BUSINESS PHONE:
SALES REPRESENTATIVE Kathee Sheldon
? TM
Builder's License #0001371
APPROVED BY BUYER(S):
APPROVED BY SALES: '
RELEASED TO START CONST.:
This constitutes a contract between the
LOT 12 BLOCK 3
?
UNIT 1203
- ' 1/ EQUAL HOUSING
OPPORTUNITY
for the above items
r
- JOB INITIATION ORDER
Pulte Homes of
Minnesota Corporation
1355 Mendota Heights Road, Suite 300
Mendota HeigMs, MN 55120-1112
Phone: (651) 452-5200 Fax: (651) 452-5727
CONTRACTOR/SVPPLI ER:
JOB NO. 0550 1 012 1 03 LEGAL DESCRIPTION: LOT 12 BLOCK 3 UNIT 1203
ConnnnuNi7Y: pakbrooke Infinity ADDITION: 3fd
BUILDING ADDRESS: 4122 08kb1'OOk@ Trdll crTy: Eagan srATE: MN ZIP: 55122
MODEL NAME: BfISY01 WIO MODEL NUMBER: 17934 ELEVATION: (56 GARAGE: LEFT RIGHT
X
BUYER'S NAME: RICFIaI'd & DI8I111@ R8(1fi1811 DATE OF ORDER: N5/ 99
CURRENTADDRESS: 1111 Gfdllddd Wdy N014h CITY: Odkd810 STATE: MN ZP: 55128
HOME PHONE: BUSINESS PHONE: BUSINESS PHONE:
SALES REPRESENTATIVE Kathee Sheldon
? TM
Builder's License #0001371
APPROVED BY BUYER(S):
APPROVED BY SALES: "
RELEASED TO START CONST.:
This constitutes a contract between the
EQUAL HOUSING
OPPORTUNITY
the above items
Cities Di lg tal
? Control
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ELEVATIONS
Easena
• Sewer service (or Proposed)
• Property comers
• Top of curb at tlie driveway
• Elevations of any exosting adjacent homes
Adequate footing depth of struclures due to adjacent udliry Venches
Prooosed
• Garagefloor
• Firstfloar
• Lowest exposed elevation (walkouVwindow)
• Property comers
• Front and rear of home at the foundadon
? ?? • PONDING AREA ('R aooC?cablel
Easement line
q' ? ? • N4VL
m//o ? . HWl
a' ?? • Pond # designatWn
? ?ra' ? • Emetgency Ovefiow Elevation
DIMENSIONS
?
? Lot lines/Bearings & dimenaions
?
? o ?
Rightaf-way and street width (to back of curb)
'
m? ?? , porches, etc.
• Proposed home dimensions induding any proposed decks, ovefiangs greater than 2
?? ?/ (i.e. all structures requiring permaneM footings)
• Show all easements ot record and any Cily uUliGes within those easements
g/ ? • Setbacks of proposed structura and sideyard setback of ad'acent existing structures
? ? • Retaining wall requirements, if any
l /
Reviewed:
nmw 1 D818
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: LvT Id ' ('i{' 3 c?WlekwXF
DATE OF SURVEY: /) -/??
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• BuildingPermitApplicant
• Legal descriptlon
• Address
• North arrow and scale
• House type (rambler, walkout, spfit wJo, splk entry, lookout, etc.)
• Dvectlonal drainage anows with slopelgradient %
• Proposedlepsting sewer and water services 8 invert elevaUOn
• Sheetname
• Dmeway
• Lot Square Footage
• Lot Coverage
Mareh 19BB
LqAqlgLppPRMf.FM
3 CITY USE ONLY
L ? BL
suBO Dal(bvaOrP, 3Y?
RECEIPT #. I ?.-> /a I
RECEIPT DATE: I- 6-6D
PERMIT # C ?
-0? f'LUM$INfi PEMIT (ftuIDENTIAL)
a. pv p crrr oe EAsAx
S$SO PILOT KNOB RD
EA6tkN, MN 5512E
(651) 6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Bath tub $ 3.00 x = I
Floor drain 3.00 x = $
Gas I in oUtlet ` minimum - 1 3.00 x = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laundr tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ` re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
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 dwellin under construction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Waterturnaround 30.00 x ---- _ $
State Surchar e .50 --> ----> ----> $ .50
Totat --? --? ----> .... > $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--------------------------------------------------------------------------- ------------------- ---------------------------
I hereby acknowledge that I have read this application, state that the informalion is covect, and agree to comply with all applicable Ciry of Ea9an ordinances
It is Ihe applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused 6y the City during its
normal opera6onal and maintenance aclivities to lhe facilities consWcted u der is permit within City pro erty/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESIE
CI,Y: ?
SIGNATURE OF PERMITTEE
?] CITY USE ONLY r
L ? BL ?1 RECEIPT#:
SUeo. 1???2p.3 rr' RECEIPTDATE:
PERMIT# ao'
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EA6AN
3830 PZLOT I@70B RD
EP.GAN, MA1 55122
651-681-6675
Please complete for: ? single family dwellings
? townhames and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
ARerations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas iping outlet ' minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic SyStem . new/refurbished 'requires MPC Ile. 75.00 X = $
Septic System ahandonment 30.00 x = $
RPZ new installatioNrepaidrebuild 30.00 X = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Under round s rinkier if dwelling is under construction 3.00 x = $
Underground sprinkler if existing dwening 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwelling under eonstructlon 5.00 x = $
Water softener if axlsting dwelling 30.00 X = $ O-
Water tumaround 30.00 x $
State Surcharge .50 -> -> --> $ 50
TOtal $ 3dL.S
Reminder: Call for inspections of alterations, f.e. water heaters, water softeners, etc.
- - - - -- - -- - - -
y? ? g appliration, state that the iMortnation is cortec[, and agree to compty wlth ail applicable City of Eagan ordinances.
I hereb aclcnowled e that ? have reatl fhis
It is the applicanPS responsibility to notify the property owner that the City of Eegan assumes no liability for any demages wused by the City during tts
nortnal operetional and maintenance activNies to the facilities construc[ed under this pertnd wkhin City propeAy/right-of-way/easement.
SITE ADDRESS: y/a)' Ci&CX??-?' Z?e
OWNER NAME: : fa& ( Y" "?V TELEPHONE 5?7
(AREA CODE)
INSTALLER NAME: i64 Jcp,U'u ?Lu' WT^-GJ TELEPHONE I' - SJ V 6S? Y
?,/ (AREA CODE)
STREET ADDRESS: ?? ?( / n/
CITY: ? ST? . ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY
LOT ? BL 3 PERMIT#:
susn. OJ kr00YLP, ?P? RECEWr 3 4?0 ?
RECEIPr nnxi: ? -15 - 00
2000 MECHANICAL PEliMIT (RESIDENTIAL)
CZTY OF EAGAN 3830 PIIAT IINOH RD
EAGAN hIDi 55122
651-681-4675
Date•
Complete this section onlv if you are installing HVAC ia a single' family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-]00MBTU
.4DDIITONAL 50 M BN
j • Gas outlets (minunum of one required @$3.00 ea)
State Surcharge
Total
Completc this section onlv if you are remodelina, addin¢ to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alterarion, or repair.
_ New _ Alteration
_ Furnace
_ Air exchanger
Fee
State Surcharge
Total
Reminder: Call for i»spections
SITE ADDRESS:
OWNERNAME: U ?YV-7?
INSTALLER NAM??t. PGk1r? ?
STREET ADDRESS: ?
CIT'Y:
_ Repair _ Other
$ 30.00
6.00
3°-°
.50
$ ?q"So
$ 30.00
.50
$ 30.50
PHONE #: d! / _ S?S ?-Sc?v2J
( CODE)
?C PHONE #: ? / d--
- _ .? r (nxEw cona)
_ STATE: ?s--? ZIP: 37
?-
SIGNATURE OF PERMI'ITEE
Air conditiooing
Other
S?
CITY USE ONLY ,
L _ BL _ PERMIT#:
SUBD. REGEI?T#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
2000 MECBANICAL PERMIT (COlY=RCIAI,)
CITY OF EAGAN
3830 PILOT INOB RD
E14GAN, MN 55122
651-681-4675
Please complete for: all commerciaUndustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: _ New construction Install U.G. Tank
_ Interio, improvement Remove U.G. Tank
_ Processed Piping -
When installing/removing underground mnk, call 651-681-4675 jor inspection by fire marshal and '
plumbing inspector. ,
Description of work:
Fees: 1% of coatract price OR $30.00 minimum fee, whichever is greater.
Undergound tank removaUinstallation = mmimum fee - --- - - --= --- --- - --- -- - --_ . ._ .
Contract price: $ x I%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (n?n cona)
(IMPROVEMENTS ONLYj:
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER: .
ADDRESS: PHONE #:
(AREA CODE)
CIT'Y: STATE: ap:
SIGNATURE OF PERMITI'EE
? 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
? 500 3830 PILOT KNOB RD - 55122
Z 651-6814675
Reaulremenh
? reepesatm
DATE: 0 - //' ocs CONSTRUCTION COST:
DESCRIPTION OF WORK: R(= 1H15oLa47?.' Ld4-*r2. L€UEt(- If mulN-famlly bldg., how many unih?
IWDICATE THE FOtlOWlidG ECIUIPPoIEfdT TO BE REPLACED AfdD BY WHOAA:
_ Plumbing _ Homeowner or Contractor Name
Mechanical Homeowner or Contractor Name
'*NofeIf somebody other than the homeowner is performing plumbing or mechanical work, ihey must apply for appropriate
permit. Only licensed plumbing contractor or homeowner may complete plumbing work.
STREET ADDRESS:
LOT: 12_ BLOCK: -2;_ SUBD./P.I.D. M: ('S?1KS/z.o?l5 3 Rn '
Name: -PADMAr1 IG? c.rfR/eD Phone #: &Sl "'?`I4' g6 ?'I
PROPERTY Lasf Firsf
OWNER
Street Address: '9' 1zZ ?R?i7? ?KL: ?2A1 ?-
cxy E&.41-j state: MN ziP: SS/ zZ,
Company: ?i?C..I ? ?{oM ?`S Phone N: 62SI - 452 - S 7A0
(area code)
CONTRACTOR
SfreetAddresa: 13M87V7X57'R HLr1'h{?SEb License# ]_7/ Exp.3 -Zo6J
cny W1t:-tibo?i+ ltele#Ts stata: M'{ nP: 55126
RECF.IVED
AUG 2 3 2000
BY:
1 hereby aeknowledge ihaf I have read fhls apptlcaNon, state fhaf the IrNormaNon is correef, and agree to comply wlfh all
applicable Stale of Minnesota Sfahdes and CHy of Eagan Ordinances.
SignaFure o} Applicaft..
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 03 01 of _ plex 0 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 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) ? 46 Windows/Doors
* Demolition permit - Give PCA ha ndou t to applicant
GENERAL INFORMATION
# of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings , Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning ft. Booster Pump
PRV
. Surveyor's Certificate
SURVEY FOR :PULrE
DESCRIBED AS : Lot 12, Block 3, OAKBROOKE 3R0 ADDITION, City of Eagan, Dokoto County, Minnsota ond
reserving easements of record.
/
C?v +, 0 , LOt"
L O T SQ. FOO TA GE = 3, 6 08
HSE. SQ. FOOTAGE = 1,811
LOT COVERAGE = 50%
Y
?of?o?lo n?,C?l?OL?C a
Plon # 1793,?,?y4
PROPOSED ELEVATIONS
Top of Foundation =933.0
Garoge Floor =43l,5
Basement Floor =424.0
Aprox. Sewer Service =91g.2±
Proposed Elev. _ C=)
Existing Elev.
Drainoge Directions = -
Denotes Offset Stoke = •
SCALE: 1 mch = 30 leel
BENCHMARK,
6
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garoge Side-
JOB ND:
HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION 99R-659
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYEO
8Y ME OR UNDER MY DIRECT SUPERVISION AND OOES NOT PURPOR7 TO BOOK: PACE:
PLANN/NC BNC/NBERlNC SURV6Y/NC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT A SHOWN.
2005 Pin Ook Drive ' ??
Eogon. MN 55122 DATE 1 ?2??,?i9q Vr • CAD FILE:
Phone: (651) 405-6600 Ff 1). IINDGREN, LAND URVEYOR
Fox: (651) 405-6606 M1IN OTA LICENSE NUM9 14576 OAKBROOKE
REGEIVED ;AN 9 ? W ?
PoND
BP-35
NW1,=912.0
HWL=921.0
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128244
Date Issued:10/31/2014
Permit Category:ePermit
Site Address: 4122 Oakbrooke Tr
Lot:12 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-120
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 -
Arnold R Felizardo
4122 Oakbrooke Tr
Eagan MN 55122--420
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:EA141023
Date Issued:02/08/2017
Permit Category:ePermit
Site Address: 4122 Oakbrooke Tr
Lot:12 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
Arnold R Felizardo
4122 Oakbrooke Tr
Eagan MN 55122--420
(612) 229-1941
St Paul Plumbing & Heating
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature