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3876 Palisade WayCITY OF EAGAN Remarks Sew street 'JC/- e . .-,. d. on 12-29-72 wtr corm, pd, on 1-20-73 '6 Palisad.e Wa Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 2< 1970 2•00 .QQ 2 P31a, ? SEWER LATERAL Z2,Z 1974 1 39.10 P31d WATERMAIN # WATER LATERAL ? WATER AREA ? STORM SEW TRK # STORM SEW LAT 1974 5 CUFIB & GUTTER SIDEWALK STREET LIGHT WATERCONN. 300.00 7357 1- O-7 BUILDING PER. SAC 260.00 7357 1-30-73 PARK INSPECTIDN RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: , AI !`AIIF 4•1AY t I?L?i+ lk??b'f N ( (1 { r, 1 4 F.4 - ;.34 0 .? E?1?11.??LN[i Ak 1 w<r I CM Krrnri 7 PERMIT SUBTYPE: TYPE QF WORK: . , r; f??l' PA I k ?:t .. ? 1 ? , ! ??r} E*!'ROlyF Permit No. Permit Holder Oate 7elephane N ELECTRIC PLUMBING HVAC Inapection Date Insp. Commenta FOOTINGS FOUND FRAMING ROOFING G 4k, AOUGH PLUMBiNG PL8C3 AIR TEST ROUGH HEATING GAS SVC TEST INSUL QYP BOARD FIREPLACE FIREPLACE AIR TEST FINAI PLBG FINAL HTG ORSAT TEST BLQG FINAL BSMT R.I. BSMT FINAL DFCK FTG DFCK FINAL SEDGWICK HEATING & AIR CONDITIONING CO. HEariNG JOBNO. rq -7 F9 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD ADDRESS CITY- <-7,. OCCUPANT )i -? a OWNER SOLD BY ?-av d INSTALLED BY MAKE LeN)' Y/ C MODEL V (? AA Ci 3!?6 SERIALNO. 7 INPUT ? c, ae, ? -L ? THERMOSTAT VALVE LIMIT SETTING- FAN SETTING _ PILOT TYPE _ IGNITION MODEL PILOTTIMING _ c PRESSURE - INPUT CFH W STACKTEMP. FORM 236 (REV. 11109) w VENTSIZE ? ?0 c' TVPE OF LINER il p ? 4 LINEF SIZE FILTERS: SIZE 6o ? NUMBER \ J WIRING TESTTAG G PERCENTCOz PERCENT Oz PEFCENT CO ?i LIGHTING INST. DATETESTED 1 ? ??_? ? COMPANY TESTING V e ' w NAMEOFTESTEFi_ ? • ??l ? ti'-' FORM DISTRIBl1TI0N: WHITE COPV, JOB FILE YELIOW COPY - CITV STILLAGE OF N:AGAN 3795 Pilot Knob ttoad Eagan, giinnesota 55122 PII2iUT N0. 3Cr7 The Village of Eagan hereby grants to Ce,. (}rppe 4'on8t*^34ti0II GO, a£ 1343 Concord ffivd. East,, So. St. Paul a PLUfOIIdG Permit £or: (Owner) same at 1876 Palisade Wm: 14-6.$ ; pursuant to applicati:on dated 1/25/73 Fee Paids $20.00 dated this 30th day of January -.36 s/c Building Inspector riechanical Permitsa Bid Total: , VILLAGE OF r:AGAN 3795 Pilot Knob ttoad Eagan, Minnesota 55122 PERMIIT N0. 307 The Village of Eagan hereby grants to Cedar Grove Constrnetion Co. o£ 7343 Concord Blvd. East, South St. Paul a HEATIAI6 Permi.t £or: (Oumer) smne at 3$76 Palieade Way 14..6-8 , pursuant to application dated 1/25/73 Fee Paid: tSO.OQ dated this 30Eh day of January , 19 73 .50 e% Building Inspector hiechanical Permits: t3id Total; YILLAOE OF EAOAN SEWER SERVICE PERMIT 3795 Pilot Kno6 Road PERMIT NO.: /127S Eagan, MN 55 II3 DATE: 12/29[ f? Zoning: R-1 No. of Unite: ? owner: Cedar Grove Construction Co, Addmse: Site Addresc• 14- - 3876 Palisade Way Pt Plumber: Stein I3 _ I agroe ro comply with ths Villaga of Eagon Connection Chazge: 260.00 1/30/7: Ordinonns. Account Depoait: Permit Fee: 10,00 pd 12/29/72 Surcharge: .50 pd t 2/29/72 By: Misa Chazges: Date of Insp.: Total: Insp.: DatePaid: ??3??3 / ve-[C-ArJal L)WJLF- 5? , EAGAN TOWNSHIP BUILDING PERMIT f Ownei ........ '.--•-_:..... T-.?L_7- ? ..................... _ _...../... _-.. _ _........ _.......----....----- Addreu (presenf) '? - .............. . '( ............. .... Builder ......._....._...................... ..................................................... .... Addrese _....... ..........................................------....---.........._.... DESCAIPTION ? N° 2932 Eagan Township Town Hall Dale .Zk-:..? j _7?Z. 5loriea To Be Used For Fsoni Depih Eieighf Esl. Coat Permii Fee Aemarks ?7 ,J 6 ; .?' ?• ?/eJ LOCATTON 5-a / • ?z Streei, aoad or other Description o! Locatioa I Lo! ?Blaek Addifion or Tract , ? °, f ?l? a.3 ? C.-+-?.-`. .s7c-•---`- .S? - ?? This permit does nof avihorise the use of stzaeffi, roads, alleps ox sidewalks nor does it give the owner or his egeni the righ22o cseafe any sifuation which is a nuisanee or whieh presenfs a hesard !0 the healih, eafety, convenience and general welfare to anpone in the eommunily. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS This ia to eerlifY. !ha!__..?:r*::-::_....F???? ...............has permissian !o erect a--__a..._?`.c:. ... r. . -------upon the ebove described premise aubjeci !o the provisions of the Building Ordinance for Eagan To?nship adopled April 11, 1955. ? ......... 2?c::"la.d:s-?:'-? ..................` --"---'-.?.?-..?" Per ....... .....----'----..................... ............................... C caxd ?S ?Buildinp Impeclor Clty Of EBpIl 3830 Pilot Knob Road Eagan MN 55122 Phone:(65Y)675-5675 Fax: (651) 675-5694 - ----, ? ? For cft.iss_ ? , Pam„#: ia7 ? ? Permit Fee: - ? I ? ? Date Received: ? i ? ? Staff: ? -- -------? 2009 MECHANICAL PERMIT APPLICATION Uate: oZ' 4 - Oq Site Address: Tenant: RESIDENT / OWNER Name: ? JD a Cm K rv?c APhone: lasl - q?5- 1,X14 Pc` ' Address / Clty / Zip: i b + a -fo t? P? M # N i n CONTRACTOR ? w? c. v. ?ense : ame: ? Address' ?464 C- lg ro0 et' CQalC U4 City: State: wr, Zip: .s$Oa 4 Phone: (?ri -7 z3A.L1 Contact Person: TYPE OF WORK - New _ Replacement _Additional / Alteration Demolition Description of work; 6 vvi 42)e4e_ i i Zow{'r' L-evel Veq4 1q7h NOTE: Soth raof mounied artd ground mouffled mechanlcal equipment is required ro be screerJed by Gify Code. Please contact the Polechantcal lnspeoor ar one of the Planners for in/ormation on rmitted screene teenesthods. RESIDENTIAL COMMERCIAL PERMIT TYPE Interior Improvement New Construction Furnace _ _ Air Conditioner - Install Piping _ Processed Air Exchanger -Gas EMerior HVAC Unit Heat Pump _ Under ! Above ground Tank L- Install /_ Remove) "" _ ? ? W hen installinglremoving tank(s), call for inspection by Fire ? O 4 Other ti Marshal and Plumhing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Flfe f@polf (replace burned out appliances, ductwork, etc.) (includes $-50 State SurCharge) TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract value $ x t% $50.50 Minimum (includes State Surcharge) Permit Fee - If P rmi Fgg is less than $1,000, surcharge is $.50. - If Pertnit Fee is> $1,000, surcharqe increases by $.50 for each =$ State Surcharge $1,000 Pertnit Fee (i.e. a$7,001-$2,000 Permit Fee requires a$1.00 surcharge). $ TOTALFEE Suite #: I hereby acknovAedge that this infortnation is complete and accura[e; [ha[ the work will be in conformance with the ordinances and codes of ihe City of Eagan; that I urWers[and this is rwt a permit, bu[ only an application for a pertnd, antl wark is not to sWrt wilhou[ a perrni[; [hat the work will he in accortlance with [he approvetl plan in the case of work which requires a review and approval W plans. x7) pLnie.I L :Dn E'I en ApplicanYs Printed Name X-? Cl . o? .111 ¢YL, ApplicanYS Signature FOR OFFICE USE - Revlewed By: Date: Required lnspections: _Under Ground' ._ Rough In --pie Test -Gas ServiceTest _In-floor Heat _Final _ Exteriot HVAC Screening Inspection MASTER CARD OWNER STRUCTURE AND LAND 115ED AS ?'7 6 ?yA/y- _ Permit No. I i Issued Issued To Coniractor ? Owner BUILDING V PLUMBING - CESSPOOL - SEPTIC TANK VJELL ELECTRICAL I HEATING GAS INSTALLING i SANITARY SEWER OTHER ` / /Aq O7HER I Items Approved (Initial) I Date Remarks Disiance From Well FOOTING 17-7 SEPTIC _ FOUNDATION / .7 36 CESSPOOL FRAMING TIIE FIELD FT. FINAL ELECTRICAL I HEATING DEPTH OF WELI GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING -/19- WELL -I SANITARY SEWER Violations No}ed on 8ack COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE IlSEO ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS Of CONSTRUCTION AT THIS WSPECTION? NO EVIDENCE Of NON-COMPLIANCE OBSERVED. ? ACCEPTABIE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REVEAIED CERTI FICATION - I certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE CITY Of EAGAN CAfiH.Y.Eftc '= TI_RMINAL. NCI: 56 DATF..° 0E3J09/96 TIMf_'c 15:28a27 IC! a hAMC: GF_NF'S HOHE CF1RC & RE.f-'AIFiS 3430 9001 3876 F''AI...T.SADF 1•I 53.50 205 9001 3876 FAI_ISADE W 0.95 Tot,a1 fieceipt Amount: 60.45 CROE,2i'93 usER zn: NANcv PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMITTYPE: auzLoztiG Eagan. Minnesota 55122-1897 Permit Number: 028525 (612) 681-4675 Date Issued: 0 8/ 0 9/ 9 6 SITE ADDRESS: 3876 PALISADE WAY LOT: 14 BLOCK: 6 CEDAR GROVE 8TH P.I.N.: 10-16707-140-06 DESCRIPTION: #1aildin`y. ?&uilding Gensus Co REROOF Permit Type 'W.ork Type ; /YT SF (MISC.) REPAIR 434 ALT. RESIOENTIAL ? -? REMARKS: FEE SUMMARY: Base Fee 3urcharge Total Fee VALUATION $59.50 $.95 $60.45 $1,900 t+vivinML.Ivn: , rr••- - , -?I . " - .VV11rvGFf: GENE'S HOME CARE & REPAIRS 14543402 0002715 HALVERSON ALGER 2017 FLINT LN 3876 PALISADE WAY EAGAN MN 55122 EAGAN MN (612) 454-3402 (612)454-1732 I hereby acknowledge that I hava read this application and state that the information is correGt anet agree to co,mply with all applicable State oF Mn. StaC.utes and City of Eagan Ordinances.? L APPIICAM/PERMITEE SIGNATURE 44?" ISSUED . SIGNATURE 3830 G PE LM T APPL B ICATION (RESIDENTIAL) 7996 BUILDIN 681-4675 RemodeUReoair Reauirements ? 3 registered eke surveys ? 2 copies of plan ? 2 copies of plans (InUude beam 8 window sizes; poured fnd, design; elc.) ? 2 site surveys (exterior additions & decks) ? t energy calwlations ? 1 energy calculations (or heated addilions ? 3 copies of tree preservation plan if lot plaNed after 711l93 required: _ Yes _ No DATE: FA? 9o CONSTRUCTION C05T: DESCRIPTION OF WORK: 1?%Av',-.'00 STREET ADDRESS: 19115-A LOT C q BLOCK w SUBD./P.I.D. #: PROPERTY Name: /A/dF,e'sdN fl?? Phone #: -3?1e-173c;Z OWNER u:, .I.s. Street Address: •3?7? %?A?/?'A4 l;Y City: ?acS?.? State: meL- Zip: SS/?-? CON7RAC7oR Company: 46?'?ss 14mEe?'x',E X57Phone #: 3?31 I99 5treet Address: ?7I7 ??? Licen°se #: 27-) 75? City: ?"?r???? State: //4/,t)_ Zip: SS?a? ARCHITECT! Company: Phone ENGINEER Name: Registration #: Street Address• City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. i hereby acknowledge that I have read this application and state that the information is corcect and agree to comply with ail appiicable State of Minnesota Statutes and Ciry of Eagan Ordinances. ? Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Fublic Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning • sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee 59 5 0_ Valuation: $ Surcharge • `7 ? Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies 7otal: (p o •4 5 % SAC SAC Units EAGAN 10WNSHIP 3795 Pilot Knob Rosd St. Paul, Minnesota 55111 Telephone 454-5242 Paid PERtUT FOR WATER SERVICE CONNECTION Date: 12/29/72 - 1/30/73 Number: 1109 387 Palisade Way Silling Name: Cedar Grove Construction Site Address: 14-6-8 Owner• same Pltmber• Stein's Meter No. ?Permit Fee 1p.00pd 12/29/72 Meter Readiag Meter Dep. .50 pd 12/29/72 1/30/73 Meter Sealed: Yes_ IAdd'1 Chg. NO f Total Chg. Building is a: Residence X t4ultiple go. Commercial Industrial Other Inspected by Date Remarks: Billing Addreas 3876 Palisade Way $25.'.?11 R:?'ri:,N?f' ? ?, r-?? ?v, In<<K';,ii'i`;L'f INSTnLLED f„citRS. By: Chief Inspector In coneideration of the issue and delivery to me of the above permit, I hereby agree to do tUe proposed work in accordance with the rules and regulatioas of Eagan Townahip, Dakota Couaty, Miattesota. By: Stein's Please aotify the above office when ready for inspection and connectioa. 6L-I y'(?j 2004 RESIDENTTAL BUII.DING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 C) //(7 ° New Construction Reouiremenls RemodeVReoalr ReauiremenLS Otfica?Jse'Fkilv 3 registered site surveys shaxing sq. R of bl, sq. ft of house; and all roo(ed areas 2 copies of plan C??a ?51i?:ReNrl ?? ?"Y N (20% mazimum lot coverape albwed) 7 set of Energy Calculations for heated additions "C IesP??1 ??,.y ,?'? 2 copies ot plan showmg beam & window s¢es; pourad faund design, etc. 1 site survey for addNOns & decks reaReq?6P' A? r?..., lsetofEnergyCalwlaCans Addition-ind'rcateifon-sdesepticsystem Onai?Sepdc??ystem ?Y _N 3 copies of Tree Preservation Plan if lot platted afler 711/93 Rim Joist Defail Oplbns selectlon sheet (61dgs with 3 or less unHs Date 4 ? // O ? Construction Cost 3(/ ?0,3? • / Site Address /V UniUSte # J 1 Description of Work Multi-Family Bldg _ YN ]Hreplace(s) _ 0 _ 1 _ 2 Property Owner Telephone #( 651 )11SLt - I7 3 Z? Contractor Address r /Oct-f( City State Zip-15SqZ9 Telephone # (7(03) COMPLETE THIS AREA ONLY IF Energy Code Category - M?esota Rules 7670 Cateeorv 1 _ . Residentlal Ventilation Category 1 Wwksheet (J submission rype) Submitted • Energy Envelope Calculations Submitted A NEW BUILDING Minnesota Rules 7672 • New Energy Code Wwksheet SubmiNed Have you previously constructed a building in Eagan with a similar planZ _ Y _ fee applies. Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor N If so, 25% plan review Telephone # ( ) Telephone #( I hereby apply for a Residential Building Pemut and aclmowledge that the information is complete and accurate; that the work will be in wnformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand tlus is not a permit, but only an application for a pernut, and work is not to start without a permit; that the work will be in accordance with the approved lan in the case of work which requires a review and approval of plans. 0 d E,er L A eE- Applicant's Printed Naxne Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 73 18-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 36 Mul6 Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? OB 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types O 31 New ? 35 Int Improvement O 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •DemollGon (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final _ Pool Ftgs _ Air/Gas Tests Final _ _ _ Framing _ Siding _ SNcco _ Stone _ Brick _ Fireplace _ R.I. _ AirTest _ Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector 5- ?ISe?S a38G_7 ?----------------- ? I j Permit I i.?7!5 ? ? Pertnit Fee_ j Date Received: ? I j I StaB: ? ?________________- I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Tenant: Suite #: RESIDENTlOWNER Name: 1`JQOn'1i f 1?nQSSIC cJC?fD Phone: _% G?7 ? !Y' 0/CJ? Address / City ! Zip: J Applicant is: _ Owner Contractor TYPE OF WORK Description of work: 4 p Q? oF.1 Construction Cost: a-P Multi-Family Building: (Yes_/ No? CONTRACTOR Name: A, ?11 i License#: Address: ?? :/%, C'ty State: kV Zip: S?JQpo Phone:(2)J1 '-l3l- "I,?90 ContactPerson: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateqorv 1 Energy Code Minnesota Rules 7672 • Residential Ventilation Category 1 Worksheet Category submitted • New Energy Cotle Worksheet (4 SubmfSSion type) • Energy Envelope Calcula}ions Submitted Sutxnined . In the last 72 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: ?°.°° °?•I °^???a= "„., ,,,,, ,,,,o??neuun rs compiete ano accurate; that the work will be in conformance with Ihe oMinances and codes of the Ciry of Eagan; thal untlerstantl this is not a pertnit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X r'1i 6U(Lr loraa.. Apphcanfs Printed Name x / 1 lcr?cRL gu-s. ApplicanY Signature 0 Page 1 of 3 City 0f E8p 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651) 675-5694 ?---------------- I ?oFOffce lls,e ? Permit#: . ? Pertnit Fee: CJ i ? Date Received: i i ? Staff: L ---------------- 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: SiteAddress: Tenant: Suite #: RESIDENTlOWNER Name: Phone: Address / City ! Zip: Jh 7&- A?, A;G -c Gc. Gl CONTRACTOR Name: License#: ?& 13,? , /? Address: ? ? _J`> City: 7ndc, State: lt'40-' Zip: > S 3?`? Phone: &/4? !FG'2? ContactPerson:??f?n TYPE OF WORK ?LNew _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Descri tionofwork: A,141-uem %n /3i,fzmcrif', PERMIT TYPE RESIDENTlAL Water Heater _ Water Softener _ Lawn Irrigation ? Add PlumbiN Fixtures (_ RPZ /_ PVB) C_ Main 5Lower Level) Septic System _ Water Turnaround New Abandonment RES/DENTIAL 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 $165.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as buiit) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ i nereoy acrcnowieage ma[ mis mrormatwn is complete and accurate; that the worK will be m Eagan; that I understand this is not a permit, but only an application for a permit, and wo prova accordance with the approved plan in the case of work which requires a review and ix7ica x ?l,fr-n Appli cant's Printed Name . 30CB WI[tl tlle OftlIn811CR5 80tl CAtles ot the GI[y ot to start WRhout a permd; that the work will be in . _ .. , . ; ,. FOR OFFICE USE Reviewed By Date: Required Inspections _Under Ground _Rough-In _Air Test _Gas Test _Final { '0" City 0f EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 6755694 ^-Fo-r O-N-ice-U-se - - - - - - - - - - - I I . j Permit #: ? Permi[Fee: I.3? I ? Date Received:Ol ' I,rJ•OC I I I Staff: ? I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Cfl IIC-U /'/5-r)I Date: 1A409 Site Address: 76 PR ASn JP c, y ZS??G f? Tenant: Suite #: RESIDENT/OWNER Name& r?rAf e..l SMSt? 5ji,l,ero Phorre??tJ7 -%:nlso ? ? Address/CitylZip: 76 ?!D ???f Sq Applicant is: _ Owner lk- Contrac[or TYPE OF WORK Description af work: L&1,hr I i is Construction Cost: ?5C-00 Multi-Family Building: (Yes _/ NoIXJ CONTRACTOR Name:l " IC1?????, [Acv.w sefvEtr aj ?(k,; r L4GLicense #: o? :6 3Da ? Address: 7? St. U/ ciry: ?rrn?nti?,r? state:zip:?SGv?y Phone: &_I 6?- C^DArI7 Contact Person: tarr-:1?cMwsC? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Verrtilation Category 1 Worksheet • New Energy Code Worksheet CBtBgOry Submitted Submitted (4 Submission type) • Eneigy Envelope Calculations Submitted In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan7 _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contrector: Phone: NOTE: Plans and supporling documents that you submit are considered ro be pub!!c informaNon. Portlons of the informatlon may be classlfled as non-public if you provlde speclflc reasons that would permlt fhe City to condude that the are trade secrets. I herehy acknowledge that this iMOrtna6on is complete and accurate; that the work will be in conformanca with the ordinances and Cotles ot the City oF Eagan; that I understand this is not a permii, but only an application for a permN, and work is not to start without a pervnit; that the work will be in axord e mm ym,64 proved plan in the case of wwk which requires a review and ap{xoval of plans. x // /4???iv? plicaM's Printed Name pl cant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundetion _ Single Family _ Multi _ Ot of _ Plex Accessory Building WORK TYPES New AddRion _k-'riteration Replace DESCRIPTION Valuation Plan Revlew (25°/a_ 100%6) Census Code # of Units # of Buildings Type of Construction _ Fireplace _ Porch (3-Season) _ Storm Damage _ Garage _ Porch (4Season) _ Exterior Atteration (Single Family) Porch (Screen/GazebolPergola) Exteriar Alteration (MuRi) Lower Level _ Pool _ Miscellaneous _ IMerior Improvement _ Move Building _ Fire Repair _ Repair _ Siding _ Reroof _ Windows _ Egress wndow Demolish Building' Demolish Interior _ Demolish Foundetlon _ Water Damage •Demolition of entire buflding - give PCA handout lo applicent 30?? ? y 344 Oxupancy ?Tfc I Code Edition A017 Zoning R- i Stories - Square Feet ? length ?- Width / Footings (New BuiWing) Footlngs(Deck) Footings (Addition) Foundation Drein Tile Roof: _Ice & Water _Final ? Framing Fireplace: _Rough In _Air Test _Final ? Insulation Meter Size: Reviewed By: Base Fee Sureharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL MCES System SAC Units City Water Booster Pump PRV Fre Sprlnklers ? Sheetrock Final / C.O. Required ? Final / No C.O. Required ? HVAC Other: Pool: _Footings _AirJGas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick ?C Windows ,Z www _ Retaining Wall Building Inspector / 30 ? City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3876 Palisade Way Lot: 14 Block: 6 Addition: Cedar Grove 8th PID:10- 16707 - 140 -06 Use: Description: Sub Type: e - Fixtures Work Type: Additional Description: Basement Fixtures Meter Size Meter Type Comments: Fee Summary: Contractor: Anastasio Silguero 3876 Palisade Way Eagan, MN 55122 651- 308 -8994 Total: Manufacturer PL - Permit Fee (miscellaneous) Surcharge -Fixed Applicant/Permitee: Signature PERMIT City of Eaan Owner: Anastasio P Silgureo 3876 Palisade Way Eagan MN 55122 Serial Number Remote Number $50.50 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4087 $0.50 9001.2195 Issued By: Signature Plumbing EA079051 07/30/2007 ePermit Line Size - Applicant - I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3876 Palisade Way Lot: 14 Block: 6 Addition: Cedar Grove 8th PID:10- 16707 - 140 -06 Use: Description: Sub Type: e- Windows/Doors Work Type: Windows/Doors - New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Applicant/Permitee: Signature Construction Type: Occupancy: Permit Type: Permit Number: Date Issued: Permit Category: Building EA079052 07/30/2007 ePermit A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Total: $90.00 Owner: Anastasio P Silgureo 3876 Palisade Way Eagan MN 55122 $88.50 0801.4085 $1.50 9001.2195 Issued By: Signature - Applicant - 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. City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3876 Palisade Way Lot: 14 Block: 6 Addition: Cedar Grove 8th PID:10- 16707 - 140 -06 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Electrical Inspector, Owner: Anastasio P Silgureo 3876 Palisade Way Eagan MN 55122 $50.00 0801.4088 $0.50 9001.2195 $50.50 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Mechanical EA079948 09/21/2007 ePermit PERMIT City of Eagan Permit Type:Building Permit Number:EA114377 Date Issued:09/16/2013 Permit Category:ePermit Site Address: 3876 Palisade Way Lot:14 Block: 6 Addition: Cedar Grove 8th PID:10-16707-06-140 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Jeff Granowski 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 - Anastasio P Silgureo 3876 Palisade Way Eagan MN 55122 All Craftsmen Exteriors Llc 1020 East 146th St Ste 226 Burnsville MN 55337 (952) 898-4680 Applicant/Permitee: Signature Issued By: Signature