4130 Oakbrooke TrPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128548
Date Issued:11/18/2014
Permit Category:ePermit
Site Address: 4130 Oakbrooke Tr
Lot:8 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-080
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 -
Hartley S Forsberg Tste
4130 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 4130 (1 a k b r n n k P T r a; i Zip 5512?
IAt $ Bllc 3 Sub Oakbrooke 3rd Addition
THESE 1TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECfION.
Date: Yes No Inspector.
Final gade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Ttail/curb damage
Porch
Basement finish
Deck
Please ve ?'ywith the builder [he remoAl of roof test caps from the plumbing system and the shutoff of water supply W
the ouuide Iawn faucet before freeze potential exists.
Contact engineering division at 681-4645 befote working in rig6UOf-way or installing underground spri¢kler system. ?
White - City Copy Yellow - Resident Copy Pink - Conltactor Copy
**********************?*?***?**********
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 667
DATE: 09/18/00 TIME: 14:51:42
ID:
NAME: SOUTH METRO PLLTMBING & HEATING
3212 9001 4130 OAKBRKE TR 30.00
2155 9001 4130 OAKBRKE TR 0.50
Total Receipt Amount: 30.50
CR137416
USER ID: JAN
CITY USE ONLY
SUBD. l 1Ba I Q
RECEIPT #:
RECEIPT DATE:
PERMIT i!
2000 PLUMBING PERMIT (RESIDENTIAL*L-l
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, b41 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unft
? backflow preventer for underground sprinkler system
FIXTURES EACH /1 TOTAL
Alterations to existing dwellin - minimum fee
Describe: $ 30.00
Bathtub $ 3.00 = $
Floor drain 3.00 x = $
Gas piping 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 newrrefurmsned 'requlree MPC lic. 75.00 x = $
Septic S stem abandonment 30.00 x = $
RPZ new installation/repairlre6uild 30.00 X = $
Rou h opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler Hdwelling is underconstruction 3.00 x = $
Undergroundsprinkler Hexistingdwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener If dwellfng under eonstruction 5.00 x = $
Water softener if ezlsting dwelling 30.00 x = $ •
Waterturnaround 30.00 x --- = S
State Surcharge 50 -> -> --> $
7ota1 -> --> -> ---> $
iceminder. Cail ror inspections oi aiierations, i.e. water heaters, water softeners, etc.
I - hereby -•------• •-•acknowledge---------that-- 1 -have------re--ad--this---------applicatian---•, ----state---that----the-----info-rtn---ation-----is -co--rr- e--C-,----and---agree-----to----comp---ty--with----all------applicableCi------•ty --of-Eagan--------ordinan-----ce---s .-
It is the appliwnYs responsibility to notify the property owner ttfat the Ciry of Eagan assumes no liability for any dameges wused by the City during its
normal operational and maintenance adivkies to the hacilities constructed under this pertnit within City property/right-of-way/easement.
SITE ADDRESS: ??fO T/?iL L??Ap? /??
/
OWNER NAME: TELEPHONE
AREA CODE)
INSTALLER
STREET
' '16%2 33?'i9
5535.?,
OF PERMITTEE
*****************************?*********
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 763
DATE: 09/11/00 TIME: 13:56:59
ID:
NAME: STEVE DAHL CONSTRUCTION INC
3210 9001 4130 OKBRKE TR 60.00
2155 9001 4130 OKBRKE TR 0.50
Total Receipt Amount: 60.50
CR137214
USER ID: JAN
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
v?'1 3830 PILOT KNOB RD - 55122
651-681-4675
Bemodel/ReoWr Reauiremenh
D 3 replefereA sNe wrveys slwwlnp sq. tt. of bt, tq. R. of houae
antl ga roded areas (40X maximum bt covemae albwadf
> 2 coplea of plans (show bearn d wincbw sizex pouretl Ind. dealyn: etcJ
? 1 sef d eneryy edadaHOna
a J caples ol hee pretervallon plan M lof plaRetl aMer 7/1/93
DATE: 9 -ci? -o.?D
DESCRIPTION OF WORK: `'`- ''
STREET ADDRESS: ?7" `?
LOT: -A BLOCK: G_ SUBD./P.I.D. C_0a
? bO ` SO
CAW III
2 ooples of Dlan
1 sef ol energy ocICWaflons for healed adWMau
t qte wrvey for exleAOr addltlons A decks
CONSTRUCTION COST:
Name: V-Cw' Phone #:
PROPERIY last Flrst
OWNER
Sheei Address:41 --3'0
CNy `2C-f AL li State: Zip:
. company: co-s? Pnonex: G(6;? aar- 3??1
(area code)
CONTRACTOR
Sheet Address: I?Io 3Q ucense
city store:
ARCHITECT/
ENGINEER Company:,
Telephone N: ( )
'?'k-c nJ
Name:
zip:
Sheei Address: Reglsha8on M: _
Ciy State: UP:
?
Sewerfwater licensed plumber (if installina sewerhvater): Phone #:
I hereby acknowledge ttat I have read thfs applicalbn, state Nwt the trNomwMon is correcf. and a9ree fo compy wiM aB aPPOcable Siale
of Minnesota Stalufes and Cify of Eagan Ordinances.
Signalure of Applicanh.
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundation O 07 OSplex
O 02 SF Dwelling ? 06 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex p 10 OB-plex
? 05 03-plex ? 11 10-plex
? 06 04-Plex ? 12 12-plex
WORK TYPE
(0 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
? 73 16plex ? 21 Porch (3-sea.)
O 17 Garage ? 22 Porch/Addn. (4-sea.)
? 18 Deck ? 23 Porch (screened)
AI 19 Lower Level p 24 Storm Damage
Plbg _Y or_ N 0 25 Miscellaneous
0 20 Pool O 30 Accessory Bidg.
O 36 Move Bldg. ? 43 Reroof
O 37 Demoiish (Bldg)• ? 44 Siding
O 38 Demolish (Interior) O 45 Fire Repair
0 42 Demolish (Foundation) O 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units ?
No. of Buiidings (
Const. (Actual) S -6(/
(Allowable) S-
UBC Occupancy -3
Zoning _ 1 -jl
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
bt-4 Engineering
Valuation:
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
O 31 Ext. Alt - Muiti
? 33 Ext. Alt - SF
? 36 MuIG
Y' ??
c cr'r oF rr-.r;AN
CASHII_:fir JS T'F.FiMINAI_ N0: Ofi=i
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ID.
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2252 9220 070 (1(-tl:EtRLft1t; fi 30.00
320 5001 4130 i]F+F;PR[?ON, T qlfrqw
2866 9(373 400 Of;F:S:si:r;ol: T 1.Or1.00
3422' 7Citl9. 4i30 OAI:EtF20l?K T 773.34
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3446 9001 F1:'sU OA+:r,sRi]f.IFC '1 1i..CJU
205 9001 400 0A!(BRO`llt T 0.50
3743 922[] 4130 OFiKPP,Opl; '1 Stl.OCr
205 ,?(l(]:I. 400 Oo-;KE:f;D01. T 67,50
Wi `.:)c^..2(.1 4130 C)fi;(}+f;:47f)!: 1' 492„00
CE'I.23705 *"-fi (;(:)NiItlUf:
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CASN:I:EI"i: .7S rEF'MINAI_ P10. 045
ti:il'f.:a 02/22/00 iIP1f:: 000:3F3
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370 9220 400 0A}.BROoi:. T 50.00
3865 ::2£.>.C.1 41.3n OFlI;[;R[70F;. T 940„00
2252 ??c?Ct 4:L'3r OFtF.LiF{OOF: T 30.00
W10 9001 4j..ic? ±]r,IQ;F;Opl; i 933„75
3866 9379 032 47At:RF:00'r; 1 if)D.UO
3?22 9001 4132 aAt;Brnoi; r 645.94
2275 92e0 4132 Oar:BPr,o;: T 1709%00
3446 9001 41.32 i]AI:BI:(1C14: T i:I..dO
205 9001 40E (7FaKAliF:)CJ!; Y 0.50
CF':123705 r,aN.r.tMir.-:
USE:fi ID: JAN ?kgc CONTi.NUE
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3143 9c2Cl 4<1:3E_ Orl`E:R(.1OK l' "iC?.fJO
205 9001 402 nAKBROuK i 50.00
5868 9220 402 UFf:Br•:uni; r 492.00
37:16 9220 4:132 aai;BRnOH: T 04.00
3713 9220 413rs OA!;Br001: r 50.00
3865 9220 402 UAKr{I;CIpl: 1 840.,00
,
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r,R 1 t_ _3 7U`i
l.l£iF"F< .T.Ue JAN
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cirv oF EAcaN
3 C`?, / 3?J 3830 PILOT KNOB RD - 55122 "-7 . U
! lo / 851-881-4875 1
tdew ca,.nucnon Reawramenh RanwaeVReoalr Rewlre?ts ?-(`I • 4 U
D 3 repldered tlta wrvaYS showinp aq. fl W lot. W. fl. 01 hane 2 copiea W Plan
and 9D rooled areas /?OX mmdmum lot coveraae [9bwedl 1 set of eneryy cdadaMOns lor heafetl adtlfHOnt
? 2 coplee of Wans (tlww beom a wlntlow t@eK Pared hd dedpn: etc.) 1 fMe wrveY (or exteAOr addlllont R decb
D 1 Wf U enerpy CdculcMOna
a J coples a Iree pieiervadm plai If Id Wafled aRer 7/1/93
DATE: Z- 7- D c7. CONSTRUCTION COST: bC0
l1ESCRIPTION OF WORK: N E?.1 S;r?rl e p:;w.TL`2
.
STREETADDRESS: `4I30 fb.lLbroofce- Tr ' 1
LOT: ?'? BLOCK: ?3 SUBD./P.I.D. 0: Ot4?Sl20C??? ??Y
Name: Phone Y:
PROPERTY Lost Flrst
OWNER
Sheef Address:
CMy
State:
Zip:
company: f I f? ?DrnIEs ot' M,nvjcsZ+r.- Pr,or?e r: (0sl yos 6s7?1
CONTRACTOR (area code)
rneetnddress: l3SSr??v?nr,? rt-Wtrs Rd 50;fc ucensea `''?1\ Exp33? oa
CI1y AloVt?o774- fjt;r6;ft73 Stafe: MN Zip: SS/a0
4RCHIiECT/
ENGINEER Company:.
Tefephone N: ( )
Name:
Sheef Address: RegishaHon i:
citY
Sfate:
Zip:
ewfflwater Ifcensed plumber (if Installina sewer/water): \?h Phone #:
hemby acknowledpe that I have read ihis opplicatbn, afale ttwllhe infonrxibn is cortect, and agree fo comply with oA app0oable State
? Mirtneaota Stalutes and Cfy o} Eapan Ordinancea
I' sipnalure ot ApplkaM:
OFFICE USE ONLY
srtificates of Survey Received 0? Yes _ No '
ee Preservation Plan Received _ Yes _ No ? Not Required FEB - 7
??
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
O 01
tl?'-0 Foundation ? 07 05-plex
2 SF Dwelling ? OS 06-plex
O 03 01 of _ plex O 09 07-plax
? 04 02-plex O 10 08-plex
O 05 03-plex O 11 laplex
O 06 04-plex ? 12 12-plex
wPzK nrPe
.@( 31 New
? 32 Addition
O 33 Alteration
0 34 Repair
? 13 16-plex O 21 Poroh (3sea.) 0
O 17 Garage O 22 Porch/Addn. (4sea.) O
? 18 Deck p 23 Porch (screened) O
O 19 Lower Levei 0 24 Stortn Damage
Plbg _Y w_ N ? 25 Miscellaneous
0 20 Pool 0 30 Accessory Bldg.
? 36 Move Bldg. O 43 Reroof
? 37 Demolish (Bldg)' 0 44 Siding
13 38 Demolish (Interior) p 45 Fire Repair
0 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
1
No. of Units ?
No. of Buildings _L
Const. (Actual) ?N
(Allowable) -XW
UBCOccupancy K3 _i
Zoning • 2-1
Valuation:
MISCELLANEOUS INSPECTIONS
13 Stucco/Stone
APPROVALS
Planning Building
.
31 Ext Att - Multi
33 Ext. Alt - SF
36 Muki
I sq. ft.
7 a sq. ft.
35 Footprint sq. ft. 23 i`1
03l Census Code ) o I
)V67 MC/ES System ar
yy '7 City Water DS
Booster Pump
PRV ?
Fire Sprinklered
Engineering
Variance
Permit Fee
5urcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. it.
Cr'? •- sq. ft.
sq.ft.
? ?/,?e"oh Pc•Lk
G,.?S? W117 K? 16 =
Lc??
I-vS1 x ? i S =
$ i3yj3oo.°°
I?b7 ?Sq
26, 265
- 13`I23s j
SAC Units
% SAC
. JOB INITIATION ORDER N°4D
Pulte Homes of
Minnesota Corporation
1355 Mendota Heighis Road, Suite 300
Mendota Heights, MN 55120•1112
Phone: (612) 452-5200 Fex: (612) 452-5727
JOB NO. -C - l?/
COMKUNfN:
BUR.DINO ADORESS:
MODEL NP1YE x Y
BUYER'S NMAE:
CURREM AODRESS:
HOhE PliONE:
SALES REPHESENTATIVE
0000 BASE PRICE
- - - - LOT PREMIUM
?
CONTRACTOR/SUPPUER:
0.5=2 LEC3AL DESCRIPTION: 10T? &.OqC UNIf 9?3
ADDRION:
? CrtY• ? STATE: ZO?-
MIODEI NIRABER: ? Q ELEVATION: OARA6E: LEFT RIOHT
? ?? DA7'E OF ORDER: _'j?
CT': STATE: ?P:
BUSINESS PHONE: BUSWESS PHONE:
S
0
TOTAL
. APPROVED BY BUYER (S):
APPROVED BY SALES: ?
RELEASED TO START CONST.: eauaL sousiNc
? OPPORTUNITY
sunders ucensa a0001371 This consUtutes a corrtrect between the Seller and the Purchaser(s) for the above ftems.
WHITE - MASTER BLUE - SALES GREEN - SALES REP. YELLOW - ACCOUNTING PINK - BUYER GOLD - FIELD
Cities Di
ontrol
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
? PROPERTY IEGAL. Q9f'"t'3Ra?7.?'? -J ??
n DA7E Of SURVEY: /- 7' DU
w IATEST REVISION:
cx
? DOCUMENTSTANDARDS
og
V Registered Land Surveyor signature and company
O • Building Permi[ Appiicant
? • Legal descnption
m? ? ? • Address
p/? ? • North arrow and scale
p? ? • House type (rambler, walkout, spfR w/o, spl'rt entry, tookout, etc.)
0 ? • Directional dreinage artows with slope/gredieM °h
p" ? ? • Proposed/exdsting sewer and water services & invert elevation
aY' ? ? • Street name
p- ? ? . Driveway
R? ? a • Lot Square Footage
m-'o ? • Lot Coverage
ELEVATIONS
Existing
B/? ? • Sewer service (or Proposed)
v? ? • Property comers
Vo? • Top of curb at the drNeway
G?'?o • Elevations of any ebs5ng adjacent homes
v Adequate footing depth of structures due to adjacent udiiry trenches
Proposed
?o ? • Garagefloor
IR/ ? ? • First floor
v ? ? • Lowest exposed elevation (walkoWwindow)
? . Property comers
v ? • Front and rear of home at the foundation
PONDING AREA (if aodicaWe)
/
? M1Y o • Easement fine
q/ ? ? . NWL
q- ? ? • HWL
ry ? '
p • Pond # designadon
? ? ? • Emergency Ovetflow Elevation
ta',a ?
? ?
? ?
t9?ja ?
nf ? g,
? o%
DIMENSIONS
Lot 6nesfBearings 8 chmensions
Rightof-way and sVeet width (to back of curb)
Proposed hame dimensions induding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanentfooCnge)
Show all easements of record and any City uWifies within those easements
Setbacks of proposed sVUCture and sideyard setback ot adjacent existlng structures
Retaining wall rer ' ' '" any
Reviewed:
March 19BB
CqA419=PRNf.fM
Surveyor's Certificate
SURVEY FOR :PULrE
DESCRIBED AS : Lot 8, Biock 3, OAKBROOKE 3R0 ADDITION, City of Eagan, Dakoto County, Minnsoto and
reserving easements of record.
, .
4=
LOT SQ. FOOTAGE
HSE. SQ. FOOTAGE
LOT COVERAGE _
= 3,608
= 2,259
POND
BP-35
NWL-912.0
HWL=921.0
63/0
?
Plan # 17954
PROPOSED ELEVATIONS
Top of Foundation = 133.0
Gorage Floor =q3i.$
Basement Floor =q2y.o
Aprox. Sewer Service = q17.z 't
Proposed Elev. _ C=D
Existinq Elev. _
Drainage Directions =
Denotes Offset Stake = •
Pa lJ LLo uo l?ll l:: ?r? ? ? MI E 0
a43
SCALE: 1 inch = SO teel
BENCHMARK, rNxLO 7, e/y
eieu = 931.59
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garoge Side -
HEDL(/ND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT $UPERVISION AND DOES N01' PURPORT TO
PLANN/NG ENC/N66R/NC SURV6YlNC SHOW IMPROVEMENT$ OR ENCROACHMENTS, E%CEPT A SHOWN.
2005 Pln Oak Drive
Eogan, MN 55122 OATE 1__/_j_/Q? ? • •
Phone: (651) 405-6600 ReQ 2•%5-00 Y 0 LINDGREN, LANO RVEYOf
Fox: (651) 405-6606 INN OTA LICENSE NUMBER 14376
S ?LT
N0:
OOR-O10
FILE:
OAKBROOKE
40. Q
7-Iq-od
2000 FIREPLACE PERMIT APPL(CATION
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
Date:.-1.1 u )L??'M .
?Ij
Description of Work: , C Construct eew firep]ace dGas Mamnry _ Akerations to existing
_ Install $as inserl on[v
Job address:
Other
_ Install pas line onlv
Lot: ,91' Block: V Subdivision/P.I.D.'11Qk6C00k-3r?
Applicant (cucle one only): Owner C ntractor Permit Fee: ,860.50
Name: /TG{}^??I?S /??? Phone#: 6
?-
PROPERTY Last Fest
OWNER /?f? ?q l'
StreetAddress: `7 (o Vr'`AF? 1^o/4P TH.
City E('. la j\ , State: ? ZiP'
Comrany:
R, e- t U/??1 je f av Phone#:,o/ns
(area code)
FIItEPLACE ?S
INSTALLER Street Address: L?
city vti c Lstate: ? ;
Z?:
GAS LINE
INSTALLER Street
City
State:
Zip:
I hereby acknowledge that I have read this application and state that the information is correct and agree to
comply with all applicable State of Minnesoffi Statutes a., ity of Eag 7dinancep.
Signature
rhone #:
(area code)
J*JL 1 8
OFFICE USE ONLY
BUII,DING PERMIT TYPE
? 16 Fireplace
WORK TYPE
? 31 New ? 33 Alterations O 39 Gas L'me D 41 V?ood Stove
? 32 Addidon ? 34 Repau ? 40 Gas Insert
GENERAL INFORMATION
Census Code 434
SAC Code Ol
REMARKS
Chimney/flue must be inspected before concealing.
? CITY USE ONLY
L O BL
sUeo. aaA- h,k
RECEIPT #: I al°1In ??,
RECEIPT DATE: Q- I-OO
PERMIT # J i 4 9
1499FPLUM$IRH i'ERMiT (RESIDEN1UL)
-a? vo crrY oF EAsru
3830 Pv.or [civos Rn
1
E4fiAN, MN 55122
(651)691-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkiersystem
FIXTURES
EACH III
TOTAL
Ra}h tub S 3.00 X $
Floor drain 3.00 x $
Gas i in outlet ` minimum -1 3.00 x $
Hot tubls a 3.00 x = $
Kitchen sink 3.00 x = $ 31
Laund tra 3.00 x = $
Lavato 3.00 x = $ 0
Minimum fee aiteretions to existin dweliin 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 installationlre air 30.00 x = $
Rou h o enin 1.50 x $
Shower 3.00 x = $
Under round s rinkier if dweliin is under construction 3.00 x = $
Under round s rinkler if existin dweilin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwellin unaer construction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e .50 --> ----> ---> $ 50
TOtal --> --' ----' --->
Reminder: Cali for inspections of aiteraiions, i.e. waier inea4eis, wa4ar Sr,ftenars, atc.
-•---------------------------------------------•-------- ------------•--------.....----- ------- -------••-----------------------
application, state thal fhe infortnation is correct, and agree to comply with all applicable City of Eagan ordinances.
I hereby acknowledge that I have read this-
It is fhe applicanYs responsibility to notify the property owner that the City of EaBan assumes no liability for any damages pused by the Ciry during its
normal operational and maintenance actlvities to the facilities constructed under this perrpit within Ciry property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS
CITY:
TELEPHONE #:
(AREA CODE)
TELEPHONE #:
///I)j / ZIP: ?
SIGNATURE OF PERMITTEE
CTfY USE ONLY
LOT BL PERMIT #: 1-I U Iq p (Pq6
susn. OOY RECEIPT #: I;)_S / l D
b ?
RECE[PT DATE: 0-,g (ov
2000 MECHANICAL PERMIT (RESIDENTIAL)
Date: ? `d`7 -l 9J
Complete this section onfv if you are installing HVAC in a single family dwelling, townhome or condo under
conscruction and not owner/occunied.
x
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one requ'ved @$3.D0 ea.)
State Surcharge
Totai
$ 30.00
6.00
300
_a?t?0
.50
s39.g'D
Complete this section on if you are remodeline, addin¢ to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
n New _ Alteration _ Repair _ Other
D Fumace
_ Air exchanger
Reminder: Call for inspections
SITE ADDRESS
? Air conditioning
Other
Fee $ 30.00
State Si:rchazge .50
Total $ 30.50
OWNER NAME: s _ PHONE #: ° b-1
INSTALLERNAME. PHO? #: ? 9
=Wcr1L&' (AREA CO E)
STREETADDRESS: f ?,7/,, c' (AREA CODE)
??IQ(?// WLY II?C?D v
CITY:
CITY OF EAGAN
3830 PIIAT [QNOS RD
EAGAN DIId 55122
651-681-4675
_ STATE: ZIP: ?
SIG ATURE OF PERMITTEE
9D
L BL
SUBD.
APPROVED BY:
CITY USE ONLY
INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAI. PBRMZT (COl•MRCIAL)
CITY OF EAGAN
3830 PILOT 1Qi08 RD
EPaGAN, MN 55122
651-681-4675
Please complete for. all commerciaUndustrial buildings
multi-tamity buildings when separete pertnits are not required for each dwetling unit
DATE:
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
R'hen installing/removing underground tank, call 651-681-4675 jor inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: 1% of contract price OR $30.00 miafmum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
ConVactprice: $ xl%=S (BaseFee)
State surcharge calculate at $.50 for each 51,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNERNAME: PHONE #:
(AREA CODE)
TENANC NAME (AdPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN TH1S SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
ClTY:
STATE: Z[P:
PHONE #: -
(AREA CODE)
?
SIGNATURE OF PERMITTEE
2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
42 ?? I CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122
651-687 -4675
eeautremenrs ? # 3 IIYZJ?
y ??G(LMi
DATE: g- I I- 00 CONSTRUCTION COST:
DESCRIPTION OF WORKIZinNStiIJ4-Tir LdlAJ6'fZ LC4sa? N mu1N-famly bldg., how marry unfh7 /
IPIDICATE TNE FOLLONIIPoG EQUIPWtEPlT TO BE REPLACED AP1D BY NdHOAA:
Plumbing Homeowner or Coniractor Name
Mechanical Homeowner or Contractor Name
"Note: If somebody other ihan the homeowner is performing plumbing or mechanical work, ihey must apply for appropriate
permit Only licensed plumbing contracior or homeowner may complete ptumbing work.
STREET ADDRESS:
LOT: ? BLOCK: 3 SUBD./P.I.D. #: OcOyOO kQ? 3irA
Name: iYAMI S L'Y M 1*4anone a: 6Sl -994- /657
PROPERTY Lasf First
OWNER ,1 ?
Street Addreas: TI 30 nRkTxZGC+kE5 i7i4! L
cny Eoro.4AJ stote: MN zip: SS 122
Company: TlL rE. AOm E, phone #: bS/ - 452 - :9?ab
(area code)
CONTRACTOR lA '/.
SfreetAddreaa: I"f??s?O<] t1?/1e7qq; Vr-> Liceme# t-1,71 Eup,3-?f
cny Wl--k?Tia I-lele-Hrs s+ate: M•-4 ziP: ss IZo
Auc 2 s Zooo
1 hereby acknowledge that i have read lhls appllcaHon, sfate thaf 1he Inlormaflon Is conecf, and agree fo comply wfFh all
applicable Stafe of Mlnneso}o Stalufas and CNy of Eagcn Ordinances.
Signaiure of Applicar?
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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 11 10-plex Plbg _Y or_ N O 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 handout to applicant
GENERAL INFORMATION
# of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buiidings 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 sq. ft. Booster Pump
PRV
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA105942
Date Issued: 08/06/2012
Permit Category: ePermit
Site Address: 4130 Oakbrooke Tr
Lot: 8 Block: 3 Addition: Oakbrooke 3rd
PID: 10-53762-03-080
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 Hartley S Forsberg
5866 Blackshire Path 4130 Oakbrooke Tr
Inver Grove Heights MN 55076 Eagan MN 55122--420
(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:EA128245
Date Issued:10/31/2014
Permit Category:ePermit
Site Address: 4130 Oakbrooke Tr
Lot:8 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-080
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 -
Hartley S Forsberg Tste
4130 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:EA174092
Date Issued:12/23/2021
Permit Category:ePermit
Site Address: 4130 Oakbrooke Tr
Lot:8 Block: 3 Addition: Oakbrooke 3rd
PID:10-53762-03-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Hartley Scott Tste Forsberg
4130 Oakbrooke Trl
Eagan MN 55122
(612) 804-8548
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature