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3889 Palisade WayCITY OF EAGAN Remarks Sew & W-br COI1, pd. on 11-2$-72 Addition Cedar Grove #8 Lot 4 eik 7 Parcel 10 16707 C1L0 07 Owner?.l U -L-L LJ ,-?- `;' :111'1 Street 3889 Palisade WaY state Eagan?MN 55122 I ).,edlPilPn I a h Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1970 125-00 5,,00 25 Paid SEWER IATERAL ZZZ 1974 1 .1O PiCl WATERMAI N WATER LATERAL WATER AREA ? STORM SEW TRK 9 ;?. STORM SEW LAT 197 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 00.00 6897 11 -28-72 BUILDING PER. sac 2 0.00 6897 11-28- 2 PARK PLUMBING PERMIT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 Address Ciry 4p, ? Name c Address !& O City Cc,tr E,ti,,-- Phone COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE AFPLtES TOWNHOU$E 8 CbNDO - RES. AATE APPLIES, MINIMUM - RESIDENTIAL FEE = $12.00 MINIMUM - COMM/IND FEE = $26:00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES . .. . ?h' , L . . . . . PERMIT # RECEIPT # 5?55 DATE: BLOG. TYPE WORK DESCRIPTION Res. New Mult. Add-on ;.5.., ? Comm. Repair Other RES. PLBG. QNLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $100 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50„ ! - I Water Heater:;$1.5b r- - 1 PER PERMI'n well - $10,00 Private Disp. - $10.00 Rough ppenings - $1.50 FEE: STATE S/C: GRAND TOTA4: - ?? INSPECTION RECORD CITY OF EAGAN . PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota55i22-1897 Datelssued: c! ?. ;• ? Ei / (612) 681-4675 SITE ADDRESS: APPLICANT: , ?? s .i ??,. ??• ? •..ti?i i???`r' , , . , ,? , ;; . , „ ? i . , PERIIAIT SUBTYPE: TYPE OF WORK: ? ? ` _ ? Permk No. Permit Holder Date Telephona !f ELECTAIC PLUMBING HVAC Inspectlon Date Inap. Comments FOOTINGS FOUND FCiAMiNG RdOFING RpUGH PLUMBING PLBG AIR TEST RpUGH HEATING GAS SVC TEST INSUL GYP BaARD FIFiEPLACE FIREPLACE AIR TEST FINAL PIBG FINAL HTG ORSAT TEST BLDG FINAL 65MT R.I. BSMT FINAL DECK FTG DECK FINAL - - ?'----- RMA HOME SERVICES INC. Home Depot Installed Sales 3200 Cobb Galleria Pkwy., Ste. #200 Atlanta, GA 30339 763-542-8826 BC-20268257 RESIDENT'fiAL " LDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD • 55122 651-889-4675 New Constructian RevuiremeMs • 3 registered site surveys shovriig sq. fL o( l04 sq, tt. of house; and all roo(ed areas (20% maximum lot coverege allowed) • 2 copies o( plan shaxirg beam & wifWow sizes; poured found design, etc.) • i set of Energy Calculations • 3 copies of Tree Preservabon Plan i( bt platted atter 7/1l93 • Rim Joist Delail Opfions selection sheet (hldgs wAh 3 or less units) DATE JOB SITE AD 'V 99. as RemadellReoair Renuirements . 2 copies of plan • 1 set of Energy Calcula6ons fa heated addiEore • 1 site survey for extenor addibons & decks VALUATfON(EXCLUDIN6LAND)?J d7?? IF MULTI-FAMILY BUILDING, HOW MANY UNITS? v PROPERTY OWNER Cp'e.'C" LlB.UC16CAU.X TYPE OF WORK APPLICANT ADDRESS PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 F, q (check one) - Residential Ventilation Category 1 Worksheet Submitted I I? - Energy Envelope Calculations Submitted U60 N ?) I II L" MINNESOTA RUI.ES 7672 ? - New Energy Code Worksheet Submitted Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Vlcchanical5ystem Includes: Sewer/Water Contraetor: Air Conditioning _ Heat Recovery System Phone # Phone # Fee: $70.00 All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith all opplicable State of Minnesota Statutes and City of Eagan Ordinances. Slgnature of Applican?" Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Phone #: Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths _ No. of Baths FIREPLACE(S) _0 _1 _2 _3 + PHONE # gSol•345•4010 ZIPCODE SS'lW Updated 1101 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Att - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteretian • ? a,34 Demolish (Bldg)" O 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Eatire Bldg only) - Give PCA handout to applPcant ' Valuation Occupancy , . MC/ES Systgm;; • Census Code Zoning City Water SAC Units - Stories Booster Pump Nbr. of Units v, . Sq. Ft. PRV ,. , . Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) FinallNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC Drain Tile Roof Ice & Water Final Other _ Framing _ Pool _ Ftgs _ AirlGas Tesu _ Final _ F'ueplace _ R.I. _ Au Test _ Final _ Siding Stucco Srone _ Insulation _ Windows (newheplacement) Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanicai Permit License Search Copies Other Total Building Inspector /G /G;7G 7 D ?U Ci ? VILl.AGE OF EAGAN 379$ Pilot Knob Road Eagan, Alinnesota 55122 PERMIT N0. a 20j ? The Village of Eagan hereby grants to „ of 73jiI Cnnr.nrr7 r+lvr7. r. __ c..,,+ti et n.,,,i .... 55075 a P:.UifiHING Permit for: (Oumer) e?P -- . - -&i 3889 Paliaade Way 4-7- at $1 & ?' , pursuant to app ication dated Fee Paid: t6n _m dated this 9RTh day o£ Navambep ? i9--?.?• 1.50 a/c Building 7nspector p itechanical Permits: Bid Total: ? ?-7-? ? e lS • VILLAGE OF EAGAIV 3795 Pilot Knob Road Eagan, Minnesota 55122 PERti'tIT NO.:_ 287 The Village of iagan hereby grants to ,,. n ???r .rat*e C'enctrur}ion ^n of 7a1?3 r. ord u?v? ,' ,90LSG Paul 55075 a _ uT R.mTM Permit for: (Owner)_ s?ne at 3966 Elverton 4-5-8o 3889 Pa7.isade way 4-7-8, & -. , pursuant to application.dated 11/?5/M Fee Paid: (Xj,Dp dated this 28th day of NOVember 19 72 1, 0 8;c ? Building Inspecto;• -- iiechanical Permits: bid Tota1; ? EAGAN TOWNSHIP BUILDING PERMIT o wne: ---- .:'!.-0. ------ &4 :°.-'-:1-- y Q` ..". _.. .................... Addrecs (Preaeni) ------..?.....J? .........-----.--°- Builder ......................... ...__..........._............. Addreas DESCRIPTION N° . Eagan Townahip Town Hatl 2898 ./ Det° ---//- ?-?- 7 Z ----.._"_--- Sfozies To Be Used For Fron! Deplh Heighl Esl. Cosf Permi! Fee Remuka SSreel, Road or ofhes Deaesipiion of Localion Lut Block AddiiSon or Tzac! I I A `f 7 1'his permit doea aot auihori:e the use of afreels, roads, elleys or eidewalks nor does it give the owner or hia agant the righ! !o creale any si2uaiion whied is s nuisanca or which presenis a hasard !o the healih, safeip, eoavenienea and general welfare !o anpone in the eommunily. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOGRES This is !o eerlifp, fhai--?4-14'a-- l?`.c^-----_-------- haa permisaion !o eract a...:3...- ? -- •-- . . .... ..----° - uPon the above deseribed premise subjae! !o the provisions of the Suilding Oxdinance for Eagan wnahip adopled Apsi! 11, 1955. .......---.._.... . I ..... ..... ......?..?...: -?-.--.. ...... ---- -?--- rBr .................. ---?---- - a? ??. n.? a?ng ?. ,.? ? ? • . . ... t . a. ...... . . . .... . :? 2004 RESIDENTIAL BUII,DING PERMIT APPLICATION City Of Eagan ?O 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 NewConstructionReoui2menp - RemodeVReoairRequlrements 3 registered site surveys showing sq. R of lot, sq. ft. of house; and all roofed areas 2 copies of plan (200/o maximum bt coverage allowed) 1 set of Energy Calculations for heated addi0ons 2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 site suney for additlons & decks 1 set of Energy CalculaUons Addif'ron - fndicate i/ai-sde septic system 3 ME copies of Tree Preservation Plan if lol platted after 7/1193 Rlm Joist Defail Optians selection sheet (bltlgs wRh 3 or less units ' Date c?'?-_ /3uhy ! Construction Cost Site Address ? :3 lk-$ ` -ipcd UniUSte # Description of Work ? L1}CI1 I 0 C-a ) t r/V O?Y j p ? ( 1:c J - 1 n y „ -4 j? Multi-Family Bldg ? _ Y_ N Fireplace(s) _ D _ 1 _ 2 Property Owner ck'cRl & T)-Uq,( Y-w Telephone # ((c5l) IS q' (0 Tg $ RMA HOME SERVICES, INC. Contractor Home Deopt Installed Sales Address 3200 Cobb Galleria Pkwy.Ste. #200 City State Atlanta, GA 30339 Telephone #( ) 763-542-8826 BC-20268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventllation Category 1 Worksheet . New Energy Code Worksheet (dsubmissiontype) Submitted Su6mitted • Energy Envetope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. l Licensed Plumber Telephone #( Mechanical Contractor LTelephone #( Sewer/WaterContractor u'u Telephone#( I hereby apply, for a Residential Building Permit and aclrnowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pernut, 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. G.f G. ? ncr.? ? .?L ?pGy?? Applicant's Printed Name Applicant s Si?ature OFFICE USE ONLY Sub Types ?- 01- Foundation - ? 07 05-plez- - O, 13 -16-piex - ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 03 01 of_plex ? 09 07-plex O 17 Garage ? 04. 02-plex ? 10 DS-plex ? 18 Deck ? 05 03-plex ? 11 10-piex ? 19 Lower Level ? 06 04-plex ? 12 12-plex Plbg_Y or _ N Work Types 0- -20- Pool - -O 30 -Accessory Bldg - ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 24 Storm Damage ? 25 Miscellaneous ? 31 New ? 35 Int lmprovement ? 3.8 Demolish lnterior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Founda6on ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolitian (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 _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Frarriing _ Fireplace _ R.I. _ Air Test _ Final _ Insulation 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 REQUIRED INSPECTIONS Final/C.O. _ FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Siding _ Stucco _ Stone _ Brick Windaws _ Retainiiig Wall Building Inspector , -- Ins#alled Siding and Windows LIMITED POWER OF ATTORNEY CvJNTY OF COBB STATE OF GEOAGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractar of RMA Home Services, Inc., DBA Home Depot Ins?alle3 Sa1_es loca±ed at 660 MendelssolLn Avenue North, Go!den Val?ey, MN 55427, having a license number of BG 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Ina ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attarney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may he required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in arder to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (tha "Work"). The powers conveyed to the Agent by this Limited Power of AYtarney are limited solely to the express powers delineated herein and appt_y solely to the Work. This Limi±ed Power of Attorney shall expire and automatically be revoked on the 21st day of lbtay, 2004, which date is one year from the execution hereof. Further, the powe:s conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IAr WT'1_'NF-SS WHEREOF this Limited Power ofA#arney is Q.xecirtcd this 21 st day of May, 2003 David N. Katz S WORN TO AND SUB9CRIBED BEFORE ME by David N. Itatz on this 21st day of May, 2003.? Notary PtDic in for the State of eorgia My Commission Expires: January 21, 2006 396816.0 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT RESI[9EMT.IAL BUILDING PERMIT APPLICATION U? CITY OF EAGAN 3830 PILOT KNOB RD • 55122 ? 651-681-4675 New ConsW ction Reouirements RemodeNteqalr Reouiremenb • 3 regislered site surveys ahowing sq. R. of lot, sq. R. of house; and ?II roo(ed areas • 2 copies of plan (20% maximum lot coverage albwed) . 1 set af Energy Cahwlations tor heated additions • 2 copies af plan shmving beam & window sizes; paured faund design, etc.) . 1 stte survey for efterior addilions & decks • 1 set of Enecgy CalculeGons . Indicate H home served by septic system for additions • 3 copies W Tree Preseivation Plan'rf bt platted after 711193 • Rim Joist Detail Optiore selecfion sheet (bldgs with 3 or less unifs) DATE Ia•'?I1s'M •Oa VALUATION TfcJ " JOB SITE ADDRESS 691M IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWN ER GtrCkXd?-C?l-2.t TYPE OF WORKtaq CA 1 l.A"rj[L=cjik", ?U ?S'?Sn4l FIREPLACE(S) _ 0_ 1_ 2 APPLICANT ?1fY1?•1iOn?s.?k- 5x1Sk]ACC1 SAif..SPHONE# 463• 5LG • gSo"* ADDRESS -?Qb0 Ct:bb ?1?f?f1CA?LWK,.,fl?Io.V?? ? ZIPCODE 30334j PAGER # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY energy Code Category MINNESOTA RLTLFS 7670 CA'TEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet rJUN - Energy Envelope Calculations Submitted _ MIlVNESOTARULES7672 13 2002 - New Energy Code Worksheet Submitted ,. Plumbing Contractor: _ Plumbing System Includes: Mechanical Contraetor. Mechanical System Includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System Fee: $90.00 Phone # Fee: $70.00 Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the i formation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan ?ances. Signature of Applica A ' /\ Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updatetl 2002 CELL PHONE Water Softener _ Water Heater _ No. of Baths Phone Lawn Sprinkler No. of R.I. Baths JUN-07-2001 15:43 PROM-RMA HOME DEPOT AHS . - 7E56428227 T-928 P.001/001 F-768 ???? ???? ?? ???ORNEY cocNrY oF Ngja,,g2? STATE OF MINNES01'A KNOW ALL PEOPLE BY THESE PRESENTS: TXLAT Y, Todd Daniel Lewis, a resident of QAiriA V County, Minnesota ("Princigal"), and a licensed contractor of RNfA Home Services, Inc., DBA Home Depot Instailed 5ales locazed at 646 Mendelssohn Aveane North, Gotden Valley, M,N 55427, having a ticense mnnber of BC- 24268257, do hereby appoint, name and conscicute Elder-Iones Building Permic Service, Ine. ("Agent") as my true and lawfut attomey-in-fact and do authorize and grana said attomey-in-faci for me and in my name, place and stead the power co execute, aciuiowledge, sign and deliver (in such farm as may be rzquired by the municipality) a permit application, or any other instrument(s) which may 6e necessary and appropriate, ia ordet to obtain the proper permit(s) from ihe Ciry of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). Tha powers conveyed co che Agent by this Limited Power of Atrorney aze limited soleIy to the express powers delineated herein and apply solely to the Work. This Limited Power of Attomey shail expire and automaticaliy be revoked on the ?,c day of?, 2002, which date is one yeat from the execntzon hereo£ Fwtiher, the Qowers conveyed by this Limited Power of Attorney may be revoked by Principal at any rime by express revocation and shail also be revoked by the Principal's death, disability, incapaciry or incompecence. IN WITNESS WHEREOF this Limited Pawer of Attomey is executed this L'= day of 2001. Todd Danie! Lewis ?,wORN TO A1VD S'U13SC,RIBE73 BEFORE ME by Todd Daniel Lewis on this day of -?Ti hln e ' .rrv?wlMb ?AIe ub ic ia foclt e 5tate of Nfinneso gUR70N T. BROwN ? -9 N07AAY PUBUC-MINNES07'A My Commission BXpires: * WAk= A 3%816.r3 Received Time Jun. 7• 2:56PM PERMIT# '/ "I Y1 3 RECEIPT DATE: J V A 1?!!y I IbSg gESIDENTIAL PLiJM$1NG i'ERMIT APPLICATION crrYoF EasM 3$30 PILOT KAOB RD £EkBAtA, MA 551 E8 651-8$1-4678 Please complete for: ? single family dwellings D townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system Qn?1So de 1NUy SITE ADDRESS: OWNERNAME:: £ ? ),P?iPCpn??X TELEPHONE#: (AREA CODE) INSTALLER NAME: W01I1;jE TELEPHONE #: qha Q? q?o-I,?? STREETADDRESS: 6035 12fh AVBfIL'ESGIeiII (AREACODE) 11ypldns, m ..Y. CITY: Piace a check mark next to the uermit work tvne STATE: ZIP: New residential dwelling unit under construction and not owner/occupied $ 90.00 ? Add-on, modification or aiteration to existinq dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repairlrebuild of RPZ • lawn irrigation system • waterturnaround Nature of work: QyPeR ll.VVr te"f Septic System, new/refurbished - $ 225.00 • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ 50 Tota I $ !50• 5-0 Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I herebyacknowledge that I have read this applipfion, state that the information is correct, and agree to complywith all applicable City of Eagan ordinances. It is the applicant's responsibility to notiTy the properry 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 permit within CiWl operty/right-of-way/easement. ?- SI NA URE PERMITTEE Updated 1101 CITY USE ONLY LOT ? RECEIPT ?? 79(00 SUBA. RECEIPT DATE: . ? 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 Date• (612)6814675 Complete this section only if you are installin¢ HVAC in sinPle famitv, townhome, or condos that are under construction and are not owner /occupied. • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section onlv if vou are remodeline, adding to, or reoairing existing sinQie familv dwellin¢s, townhomes, or condos. !/Add-on fumace ? Add on air conditioning _ Add-on air exchanger, i.e. Vanee system, etc. _ Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surcharge Total: 20.50 srrE a,DDxEss: 'Mq ?l/?sqdt5 cJa,r/ owrrER NALME: Tewaj adexedv-t PHOxE#: INSTALLER NAME; &III/' t1Tw PHONE #: ?9r O?O 5 STREET ADDRESS: ldyyl f _L.51A11GC (/`C 1j crr5r: s rE: wi1 zrP: J:53,& ? - J/ y J? 1 ATURE OF PERMITTEE ?? Cf7Y USE ONLY L _ BL _ SUBD. RECEIPT#: RECEiPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 68l-W5 Please complete for. DATE: WORK TYPE: ? all commerciaUndustrial buildings. • mulFi--famity buiidings when separate pertniLt are no required for each dwelling unit CONTRACT PRICE: NEW CONSTRUCTION DESCRIPTION OF WORK: INTERIOR IMPROVEMENT FEES: .$25.00 minimum fee 2[ 1°k of contract price, whichever is greater. & Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of 22m2j= fee due on all pertnits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (unaROVEMeta'rs oNLv) INSTALLER: ADDRESS: cirY: PHONE A`•: STATE: Z1P: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR u INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: P.I . N. : 1e-167e7-e40-e7 LOT: 4 BLOCK: 3889 PALISADE WAY CEpAR GRQVE 8TH PERMIT SUBTYPE: DECK BUILDING 025562 05/10/95 APPLICANT: 7 VALLEY INVESTMENTS CONST (612) 454-5191 TYPE OF WORK: NEW ? ? ? _ ? ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERIVIIT CO0M PERMIT TYPE: Permit Number: B U I L DI N G Date Issued: 0 2 5 5 6 2 05/10/95 SITE ADDRESS: 3889 PALISADE WAY LQ7: Q BLOCK: 7 CEDAR GROVE 8TH F.I.N.a 10-16707-040-07 DESCRIPTION: Bj4a`Sd1ng ,?P?ermit Type DECK 0uiiding Work,Type NEW ? ¢ hy ey ?£ I 4 ' +3 E:£ y+ +.'3yiwe t ? &F s REMARKS: FEE SUMMARY: Base Fee Surcharge Lic. Search Fee Total Fee ? ?)-5 L7 "xi5?3.;F? ? CONTRACTOR: - Applicant - sT. Lzc. OWNER: VALIEY INVESTMENTS CONST 14545191 0604241 DEVEREAUX JERRY 2401 LEXINGTON AVE 5 3889 PALISADE WRY MENDOTA HTS MN 55120 EA6AN MN (612) 454-5191 ? I hereby acknaw.ledge t;h 3nfiormatian is ca`r.'reck' ° "Statutes enii' C3ty, a1'VE4; $80.00 $.50 $5.00 $36.60 Li CITY OF EAGAN 3830 PILOT KNOB RD - 55722 ?•?•-•? 1985 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681 -4675 ? 3 regiatered site surveys ? 2 mpies of plan ? 2 Copies of Dlana (nclude beam 8 wintlow slus; poured Tnd. design; stc.) ? 2 aite suneys (eMertor add'Rions 8 deeks) ? 1 energy wlwlations ? 1 energy calwlations for heated additbns ? 3 copks of tree prossrvation plan 'rf lot plattad after 7/1l93 iequired: _ Yee _ NO DATE: CONSTRUCTION COST: _els or , DESCRIPTION OF WORF STREET ADDRESS: ' LOT ? BLOCK PROPERTY OWNER Name: Phone#: Street City: State: Zip: coNTRaCTOR Company: Phone #: Street Address: nl67DK) License #• City: r??A?00?7F'-?:IGIN-E State; ,.lr} Zip ARCHITECTI Company: Phone #- ENGINEER Name: Registration #- Street Address- City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. 1 hereby acknowledge that I have read this application and state that applicable State of Minnesota Statutes and City of Eagan Ordinances. OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received 5ignature of Applicant: _ Yes _ No _ Yes _ No Penatty applies when address change and lot the information is correct and agree to comply with ali ti / MAY D 5 1995 OFFICE USE ONLY I•?`"'•; i0r... ."':. ,?-„e-. BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging o 16 ? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaiNRem. ? 17 0 03 SF Addition ? 08 8-plex ? 13 GaragelAccessory a 20 0 04 SF Porch o 09 12-plex ? 14 Firepiace a. 21 0 05 SF Misc. 0 10 _-plex c<15 Deck WORK TYPE ,,"1 New ? 33 Alterations ? 36 Move 0 32 Addition ? 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Pfanning Basement sq. ft. Main level sq. ft. sq. ft, sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Basement Finish Swim Pool Public Facility Miscelianeous MC/WS System City Water " Fire Sprinklere Id PRV I Booster Pump li Census Code. I Y3,v SAC Code Census Bldg I i Census Unit o .. . ? Permit Fee Valuation: $ Surcharge Plan Review License MCNVS 5AC City SAC Water Conn. Water Meter Acct. Deposft SNV Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: / 2-on ' % SAC SAC Units .-FLo ; 7144-.,l MASTER CAJKD LOCATION OWNER STRUCTURE AND LAND USED AS Permit No. ' ? Issued Issued To Contractor Owner BWLDING r7 i PLUMBING 1 0291 CESSPOOL - SEPTIC TANK - I WELL - i ELECTRICAL I HEATING J QR7 I ?+ GAS INSTALLING .-? SANITARI' SEWER ?.. OTHER OTHER I Items Approved (Initial) Date Remarks Distance From Well FGOTING SEPTIC FOUNDATION ?, - CESSPOOL FRAMING ? TIIE FIELQ FT. FINAL E I_ECT R I CA L HEATING ? DEPTH OF WELL GAS INSTALLATION j SEPTIC TANK CESSPOOL DRAINFlELD PLUMBING WELL SANITARY SEWER Violations Noted on Batk COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT OF 095ERVED VIOWTIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. OF INSPECTION ? NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. O ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? NON-COMPUANCE. BUILDER WILL COMPLY WITHOUT DELAY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED 8Y CONDITIONS BEYOND CONTROL. ITEMIZED AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSVECTION REVEALED CERTI F ATION -1 certify that I have carefully inapected the a6ove in which I have no interest present or prospective, and that I have reported herein all significa con itions observed <o be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-s i rovements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILOING INSPECTOft DATE , J4-7- 8 EAGP.N TOWNSHIP 3795 Pilot Knob Rosd SC. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SL+RVICE CONNECTION Date:11 Billiag Name?l(??-(?i?C ?C? Owner: 42-, P lumber :,,?\ Y? 1 LI YYl ? ? rl 4 Number. 1056 Site Address:'In2 Billing Address / c YL \,`,T,?YIo-DA N„LA ? 1/28/72 Meter No. IPermit Fee 10.00 T)d 11 28/72 Meter Reading Meter Dep. .0 pd 11/28/72 Meter Sealed: Yes` IAdd'1 Chg. NO ' Total Chg. Building is a: Residence xx I4ultiple go. Commercial Industrial Other Inspected by Date Remarka: Sy: Chief Inspector In consideration of the issue attd delivery to me of the abova permit, I hereby agree to do ttE proposed work in accordance with the rules and regulatioas of Eagan Township, Dakota County, Minaes E?a-sz B9' 1 ?L X?r Lak Please notifq the above office when ready for inepection and connectian. EAGAN TOWNSHIP :795 Pilot Knob Road St. Paul, MinneQota 55111 Telephone 454-5242 PERMIT FOR SE47ER SERVICE CONNECTION DATE; 11151,417,3, NUMBER 1222 OWNEP.Qa???.)C? \'OY1C'? Address ? Jl??9 ?0.? ?`Y)c?EA l?.C).? PLUMBER?? ?IIAYIII(??Y?? TYPE OF PZPE -7 DESCRIPTION OF BUI?A ING Industriall Commercfall Residential I Multiple Dwelling I No, of uafts Location of Connections: I Connection Charge 260.00 pd 11/28/72. Permit Pee 10.00 d 11/28/72 .50 pd 72 Street Repairs Total Inspected by: Date Remarks• By. Chief InspecCOr In consideratioa of the issue and delivery to me of the ahove permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagaa Toc•mship, Dakota County, Minnesota S Please aotify oohen ready for inapection and connection and before any portioa of the work is coverad. 2004 RESIDENTIAL BUII:DING PERMIT APPLICATION City Of Eagan S `? k-f 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construcdon Reauirements RemotleURepair Reauirements 3 registered site surveys showing sq. fl. of lot, sq, k. of house; and all roofed areas 2 copies of plan (20% manimum lot coverage aliaxed) 1 sel of Energy Caiculations for heated addNOns 2 copies of plan showing beam & window sizes; poured found design, etc. 1 sife survey for addifbns & decks 1 set of Energy Calculations Addftion - indicete 'rf on-site septic system Wft 3 copies of Tree Preservation Plan'rf lot pletted after 711193 Rim Jois[ Oetail Options selection sheet (bklgs with 3 or less units Date ? /(" Construction Cost Site Address Sq ? S IIniGSte # Description of Workq :e.C? C)7Z)C? (--+[ ` N ; 51 ?ld Malti-FamilyBldg _ Y%),j N FYreplace(s) _ 0 2 ?n}' %1"'• V Property Owner ?C Q?A l..CtCX? Telephone #( 651 RMA HOME SERVICES, INC. Contractor Home Depot Installed Sales Address 3200 Cobb Galleria Pkwy.Ste. 4200 City Atlanta, GA 30339 State 763-542-8826 _ Telephone # ( ) BC-20268257 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - M'nnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 (J su6mission type) ' Residential Venlllation Category 1 Worksheet • New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submiried Have you previously constructed a building in Eagan with a similar plan? _ Y _ fee applies. Licensed Plumber r,? rP- n m Telephone # ( Mechanical Contractor Sewer/Water Telephone #( Telephone #( N If so, 25% plan review I hereby apply for a Residential Building Permit and aclmowledge that the information is complete and accurate; that the wark will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this 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 plaryin the case of work which requires a review and apgroval of plans. . ll(X,c?a- //) X dLCri,164A 10? ) Applicant's Printed Name App icanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-ptex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg O 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 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04. 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 70-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 72 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int lmprovement ? 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, Replecement 'DemoliGOn (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) _ FinaVC.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof Ice & W ater Final _ Pool _ Ftgs _ Air/Gas Tesu Final _ _ Framing _ _ Siding _ Stucco _ Stone _ Br ick _ Fireplace _ R.I. _ Air Test _ 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 Ins#alled Siding and Windows LIMITED POWER OF ATTORNEY CvUNTY OF COBB STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of I2MA Home Services, Inc., DBA Home Depot Installed Sa1es loca+.ed at 660 Mendelssehn Aver_ue North, Cso'.den Va?ley, MrT 55427, having a license number of BG 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary arid appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power of Atterney are limited solely to the express powers.delineated herein ancl appl_y solely to the Work. This Limited Pawer ofAttomey shall ehpire and automaticalIy be revoked on the 21st day of May, 2004, which date is one year from the execution hereo£ Further, the powe: s conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WI'1_'NESS «THRRLQF this Lim?ted Pol.ver ofAttorney is e.xecirted this 21st day of May, 2003 David . Katz SWORN TO AND SUBSCRIBED BEFOFtE ME by David N. Katz on this Zlst day ofMay, 2003^ Notary P ic in for the State o eorgia h4y Commission Expires: January 21, 2006 396816.v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79•DEPOT 20071tESIDENTIAL BiTILDING rERMiT AprLicaTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsW ction ReQUirements 9 registered site surveys showing sq. R. of lot, sq. fl. of house; and all roofed areas (20 % maYimum tot coverage allowed) 1 Sods RepoR if pmposed 6uilding is to be placed on diswrhed sal 2 copies of plan shovring beam & window sizes; poured tound design, etc, 1 sel of Energy Calculations 3 copies of Tree Preservatlon Plan if IW plaked aker 711193 Rim Joist Detail Options selection sheet (buildngs vnN 3 or iess uni5) Minnegasco mechanical ventilation fortn RemodeVReoair Reouirements 2 copies of plan showing fooongs, heams,joists 1 set of Energy Calculations for heated addihons 1 site survey (w addifions 8 decks Addifion-irMitafe ifon-sife septicsystem ? fv.o c ?-? Office Use Onlv CeRofSurveyRecd- _Y _N SoilsReport:- _Y _N Tree Pres Plan Recd Y . _N TreePresReqm{ed. _Y _N Qn-site Septic System - _ Y' _ N Plans are considered ublic information unless ou state Yhe are trade secret and the reason. Date Construc[ion Cost Site Address Unit/Ste # Description of Work ^Z& 462_?Z Multi-Family Bldg _ Y V_N Fireplace(s) 00 2 . . PropertyOwner J'e rc?C? Telephoneq(Clj( )?.52 -V 7 B 8 Contractor 7-/"D x V?-`L ?`??"???C • Address 13,50 City State Zip Telephone #(j5 d? Y7 o' C?C? 0 3 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category • Residential Venfilation Category 1 Worksheet • New Energy Code Worksheei (J submission type) Submitted Submitted . Energy Envelope Calculafions Submiried In The last 12 months, has the City of Eagan issued a permit for a similar plan based on-a master plan? _ Y _ N It yes, date and address af master plan: Licensed Plumber Telephone # Mechanical Contractor Telephone #( ? Sewer/Water Contractor Telephone # ( J I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start withoue 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. ? App icant's Printed Name Applicanf's Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool . ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 77 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Declc ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Sform Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building . ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building• ?i 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bldg) - Give PCA handout ta applicant D25Cf7pt100: WaterDamage_ Yes Valuation Occupancy MCES System Plan Review _ 100°/a or _25% 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) _ Sheetrock Footings (deck) _ FinaVC.O, _ Footings (addition) _ Final/No C.O. Foundation HVAC Drain Tile Othec Roof Ice & Water Final Pool Ftgs Air/Gas Tests Fina1 _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick Fireplace R.I. Ai rTest Final Windows Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3889 Palisade Way Lot: 4 Block: 7 Addition: Cedar Grove 8th PID:10- 16707 - 040 -07 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: Crew2 Inc 2650 Minnehaha Ave Minneapolis MN 55406 (612) 276 -1680 Applicant/Permitee: Signature PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Construction Type: Occupancy: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. $88.50 $1.50 Total: $90.00 - Applicant - Owner: Barbara A Devereaux 3889 Palisade Way Eagan MN 55122- -171 Permit Type: Permit Number: Date Issued: Permit Category: 0801 9001 Issued By: Signature Building EA089603 06/09/2009 ePermit I hereby acknowledge that I have read this application and state that the information is correct and agree to comply of Minnesota Statutes and City of Eagan Ordinances. h all applicable State PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA171277 Date Issued:08/09/2021 Permit Category:ePermit Site Address: 3889 Palisade Way Lot:4 Block: 7 Addition: Cedar Grove 8th PID:10-16707-07-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner 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 - Barbara Ann Devereaux 3889 Palisade Way Saint Paul MN 55122--171 (612) 432-8969 Lofgren Heating & Air 5708 Upper 147th St W Suite 106 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature