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