The URL can be used to link to this page

4669 Parkridge Dr? . GASH RECEIPT - CITY OF EAGAN ? . . P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 'Itz ! 1 19 r • AMOUNT $ I & OOLL.ARS oo 7 [j CASH CHECK ?% ? ?' `l _/???? , ?-? % ?.,/? FUNO COOE AtAOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy • CASH RECEIPT ? CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 i DATE 19 - ,` • wac erven , rRda J AMOIFNT $ I [] CASH [, CHECK FOR - - J FUND CODE qtAOUNT J T, S•, . , Tha You ? BY 6 ooLLwRs 1 ao White-Payers Copy Yellow-Poating Copy Pink-File Copy -... . . . . . .-.. .. ..._,.. . -. ...._ '.f,-r , (- . ...-. .. . ... CITY OF EAGAN ?^???? 3$30 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ? PHoNe: 681-4675 ?'i ,? ? I' ? / j BUILDING PERMIT Receipt # ` To be used for ADDI7IOA1 Ee p$CK Est. vatup $19.400 Date JAN 31 ,19 92_ Site Address 4669 IPAMIDGE DR Lot 5 Block 3 Sec/Sub. PAR[CGI.IFF 2N4 Parcel No. Name .JZA1tY NALERAK Z q,?d? 4669 PA1tZCflIOG£ DK o C?y EAGAN !!H ZP cr_ Name CU5T'Ol4 E?i1CRGY IfOMES 0 Addf2SS 12645 P{oQRTDA LN city AFPLE YAW.LY lm 7jp 33124 o Phone 431-6116 U 1 Ifp.F1SP. # 000=667 I hereby acknowlege that I have read Ihis application and state that Ihe information is correct and agree to comply with all appticable State ol QFFICE USE ONLY OcCUpancy B-3 2oning - (Actuaff Consl - (Allowable) - * of Stories length Do* 3W Depth AMOn 1?7 S.F. Total - S.F. Footprinis - On Site Sewage - On Site Well - MWCC System - City Water - PRV Required - Booster Pump - Signature of Permitee ,I ' ?f ' APPROYALS A Building Permit is issued to: "•°"""" `""`""" 11, - on the express condition that all work shall be done in accordance with all Councii applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. - Building Official Variance - Bk1g. Pertnit SurGtiarge Plan Review FEES 0?0 198, 9.50 129.00 SAC, City snc, nncwcc Water Conn Water Meter Acct. Deposit S!W Permil S/W Surcharge Treatment PI Aoad Unit Park Ded. Copies TOTAL .50 397.00 Pertnit No. Permit Halder Date Talephone # SJV1/ PLUMBING HvAC . au7 ELEcTRIc c. Ao, ELECTRIC Inspection Date Insp. Comments Footings I g _ ? ?I S Foundation Framin9 2 - f ? 2 Roofing Rough Plbg. Rough Htg. isui. 2-Z,T-?C 1.J5?" FrePlace Final Htg. Orsat Test Final Pibg. Pibg. Inspector - Nofify Plumber Const. Meter Engr./Plan Bldg. Final 3-Z ? oeck Fcg. Dedt Final Well Pr. Disp. ? CITY OF EAGAN . ; 9306 3830 Pilot Knob Road, P.O. Box 21•199, Eapn, MN 55121 PH ON E: 454-8100 eUILDING IPERMIT Rece+vt # Stte Addrea ' TPGE UR Erect Lot ? Block Sec/Sub. _ C F; Remodal Repair Parcel No. Enlarge Move ? Name ? Addre City . Name Adciress City Phone !? o?upa"cY ? 2oning 2 '? Type of Conat. i ? Mo. Stories ? Length '- ? Depth ? Sq. Ft. Demoli:h Grede Assessment Woter & Sew. Police Fin Enp. Plenner Council - 1 hercby ocknowledga that I how rcad this opplitotion and stote thct gldg p{f. the inlormotion is corred and ogree to comply with oll applicoble APC Stote of Minr?esota Stotutes ond.Clty of Eaqon O?dinor+ces. Var. Date Sipnoturo of Penniltem - - Pertnit . .) • v v SurcFwrpe A • 00 Plan Review z 16- 50 SAC 1:' 5 . U 0 Watar Conn. Water Meter ' Rood Unit Parks Total G ? 7 A Buildinq Permit is issued to: 1 1 14 L, t. .? i ,, - f?._ on the expross condiNon thai all work sholt be dorw in accordonce with oll appiioable 5tofe of Minneaofo Stotufes and Gty of Eopan Ordinonces. ' Pamit No. PKmk HoldK Date TeIsphone # Plumbin4 ? T' ? eq H.VA.C. ? a' -4 Electric d Y a I? 3 ?`? ?1^.?aL(??,,.?F I? o y5 s ? w saftw.. Impsction Dm Inap. Oths? Foatin¢ Foun stion Fnminq RooHnp S - ALf Rouyh Pibg Rou¢h HVAC Inwlstion Final Plba. Final HVAC Final Cwt/Ooc. water O"c?ibe Location: YWII Sewer Pr. Dbp. ? , t?O ???? ,?Gl?2.P?CJ ?,?1Ze? ,? . ?' ?-GC-?.P ?-?iYL r CIT1( OF EAGAN 37 59 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 .' BUILDING PERMIT Receipt To be used for • ? ? Est Value Date ,19`? ` D- AJJ???? ACCIr`C IICC A/J1 V Lot elock ' Sec/Sub. PARKCL I FF 21vL- Parcel Na ac Name W = Address o r.iw J [Ll''L' 6tu I City Phone I hereby acknowledge that I har+e read this application and stat that the information is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. A On Site Sewage _ Occupancy MWCC System _ Zoning On Site Well _ Type of Const City Water _ (Actuaq {Alloweble} * of 5tories Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments - Permit WaterySewer _ Surcharge Police _ Plan Review Fire _ SAC, City Engr. _ SAC, MWCC Planner _ Water Conn. Council _ Water Meter 81dg. Off. _ Road Unit APC _ TreatmenC P1 Variance _ Parks i C op es TOTAL on the express condition that with alt applicable State of Minnesota Statutes and Citv of Eaaan Ordinances. Permit No. Permit Holder Oete Tsfephone ?t Plumbing H.V.A.C. E ner Inspection Date Inap. Commsntt Footings I Footings II Foundation Framin9 Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Decic Ftg. Frmg. Deck ?? Well Pr. Disp. Receipt 1. Date 3. Job 4. Owner , 5. Contrac 6. Address 7. CitY ' ?_ MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legib/y 2. Installation Cost ? State t Zip 8. Building Type: Residential ? Commercial O Institutional ? 9, Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type f 11. No. E,qui.pment BTU - M. Ea. Forced Air No. EQUiament CFM Air Handling: Mfg. Boilers Mfg. Mech. Exhaust Unit Heater Mf9. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8700 Permit No. Fee - S,C Tot. ?? C) ? U Receipt (? PLUMBING PERMtT Permit No. A CiTY OF EAGAN Fee . - f l ) Fill in numbered spaces S/C Type or Prini legibly Tot. ? -- ?? 1. Date , 2. Installation Cost 3. Job Address l?.ot .? Bik. Tract 1 4. Owner 1 5. Contractor Phone --i_-?7- z-?12_ 6. Address G/C -2-;? 7. City State Zip _ I S. Building Type: Residential V"* Commercial ? Institutional O I 9. Work Description: New UK Add ? Alter ? Descri be Repair ? No• ? Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs 5eptic Tank Lavatory Softner ? Shower Well Kitchen Sink Urinat/Bidet Other Laundry Tray ; Floor Drains Drinking Ftn. ? Slop Sink Gas Piping Outlets - - -? ` 12. I hereby certify that the above information is true and correct, and I agree to ? comply with all ordinances and codes governing this type of work. Signed for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: PERMIT TYPE: Permit Number: Date Issued: APPLICANT: ; TYPE OF WORK: ?r., •..s t I clq /q ijy' INSPECTION D. . D, Parmit No. Permit Holder Date Telephono ? ELECTRIC j ,fj 0a PLUMBING HVAC Inspactlon Date Insp. Commanta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL (3YP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG OHSAT TEST BLDG FINAL G BSMT R.I. BSMT FINAL OECK FfG DECK FINAL CITY OF EAGAN Remarks Addition pARKCLIFF 2ND ADDN ?ot 5 Rik 3 Parcel 10-55741-050-03 owner streec 4669 PARKtIDGE DRIVE gtate EAGAN MW 55123 Improvement Date Amount Annual Years QS Payment Receipt Date STREET SURF. STREET fiESTOR. GRADING SAN SEW TRUNK ?$ SEWER LATERAL WATERMAIN n WATER LATERAL WATER AREA STORM 5EW TRK STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT Road Unit 260.00 #48 3 12-18-84 WATER CONN. 470.00 ir BUILDING PEFi, ii if SAC PARK CITY OF EAGAN WATER SERVICE PERMR 3830 Pilot Knob Road P. O. 3ox 21199 ' PERMIT NO.: Eegan, MN 55121 pATE; °^i^o: ` No. of Units: Owner: ? ?Am ress: b Address: umbof. . .. ft - . . AAeter No.: 3L{ 9 U 7.,3, d ? Connettion ChorQe: Siu: lilSf r Accoimt Deposit: Reoder No.: 105? 3? permit Fee: 1 eem M oomply wiNi tw Cifp oi Eewn Surcttcrge: .-: J pd Ondinm?e.s. , Mrac. CFarpes: pci m.e t: Total: BY Date Paid: Date of Insp.: Insp.: 0 CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zonlnp: _Rl Owner. Otmuil Address: Site Addi Plunber. Paine SEWER SERVICE PERMtT PErtMIr No.: 7092 DATE: 12- - No. of Unlts: 1 I mom ft eompllr wkb d• 4*r .f Eelom Connection Cho.p.: 425.00 d AvliMnen. Accax+t Depowt: • P Pem+M Fet: p SurCharge: p eY Misc. Chorpss: Dote of Insp.: Totol: Insp.: Date Pcid: CITY OF EAGAN WATER SERVICE PERNUT 3830 Pilot Knob Road P. O. Box 21199 " r PERMIT NO.: ;.-. 1 Eagan, MN 55121 DATE: 12- - -,1- Zoninp: '' i No. of Units: OYYr1Qr' .'?7rlfm-i vr7PI'9')11 AddfESi: Site 11dd?ess: ''r-F3`) rr-'=ridve_D rive L5 L3 Uark Cllff `' Plumber. AAster No.: ConnecNon Charye: 1' 77. 00 vd S(ze: /?ccount Deposit: ? S. 00 pd Reader No.: Permit Fee: 10.00 nd 1sym te eom* wtlr Nw Cihr af Eelpe Su?charge: . 50 pci Ordl"noM. Miac. Chorper. 03.00, nc? -ieter Totcl: By Dote Paid: Dote of Insp.: ? CITY OF EAGAN ?d2OO74 3830 Pitot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 681-4675 A BUILDING PERMIT Receipt # Tobeusedfor ADDITION & DECK Est.Value $19,000 Date tAN 31 , t99Z Site Address 4669 PAKKRIDGE DR Lot 5 Block 3 Sec/Sub. PARKCLIFF 2ND Parcel No. N2n18 JERRY WALERAK W Address 4669 PARKRIDGE DR Z 0 Cjty EAGAN MN Zjp Phone 454-3490 q N2fi12 CiTSTOM ENERfY HOMFS o AddP25S 17645 F.OR DA .N Ciiy APPLE VALLEY MN pp 55124 ? Phone 431-6116 ucense s 0001667 I hereby acknowleqe that I hays-read,Misapplicadon and state that the information is correct and'aqree to compVy yHth all app6cable State of MinnesotaStatulesCi?olEagan'Ordi , , Signature of Permitee ? 11?< «- A Building Permit is issued to: CUSTOM ENERGY HOMES on the express condifion that all work shall be done in accordance with all applicable State of Mmnesota Statu[es and City oI Eagan Ordmances. ? Builtling Oflicial 400n R Q r.L ! TCIJ1 , ? ? OFFICE USE ONLY FEES OcCUpancy R-3 Zonmg n _ BIdg.PemiR 198.0 (Actuap Const - Surctrwge 9.50 (Allowable) - planReview 129.0? # ot Srories Lengih DeCk 3520 License Depth Addln 1?7 SAQCiry S F. Total - SAG MCWCC S F Faotprmts - On Sne Sewage _ Water Conn On Sile Well - Water Meter MWCC System _ ct. Deposit Ac Ciry Wa[er _ PRV Raquued - S/VJ Permit Booster Pump - SNJ Surcharge 7reatmenl PI APPROVALS Road Unil Plannar - park Ded. CWncll - SO BIdg.Oll _ Copies . Variance D - TOTAL 337.0 CITY OF EAGAN N 0- 9 8 0 6 3830 Pilot Knob Road, P.O. Boz 27-199, Eagan, MN 55121 PHONE: 454-8100 3 BUILDING PERMIT Receiot # - Te M wed fe, SF DWG/GAR Est. Value $100, 000 pale DECEMBER 18 Iq--u 4669 PARKRIDGE DR Erect 5a occupency R3 SiteAddress PARK CLIFF 5 3 Remodel ? Zoning Rl Sec/Sut Lot Block 2ND Repair ? TypeofCnnst. V Parcel No. Enlarge ? No. Stories Move ? Length 59 OZMUN-PEDERSON INC ? Name Demolish ? DeOth 36 ; Address 15136 GALAXIE AVE Grade ? Sq. Ft. b City APPLE VAL phane 890-2247 Instail ? Approvab Fees ? O Name Assessment Permit • 433.00 gu Address - Weter & Sew. Surchorye 50.00 1- Cit Phone V Police Plan Review 216 _ 50 F W Name Fire SAC ? 0 ?? Address Erp. Water Conn. 470-00 ?W City Phone Plonner WaterMeter?Q? Councll Rood Unit 9f;n 0 I here6y ockrowledge tFwt I hove read rhis apPlication and stote thof Bldg. Off. 12 14/8 parks tM inbrmation is correct and agree to wmply w' oopplicable APC Total $2 01 7 50 ?'ty of Eoga I9?jfes. a nd State of Minnewtu Stature s _ ? j ? ? Var. Date Siynoture of PertniMee - A Bullding Permit Is luued to: OZMUN-PEDERSON INC on the axpress caditlon thoi nll work shall be done in occordance wit I opplicab?Si3Je of M? Innewfo St tufes cnd City of Eopon Ordirwnces. ? Buildinp Officiol ? (ZD CITY OF EAGAN N2 13 7 5 9 3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121 ??? ?q, PHONE:454-8100 Receipt # ? BUILDING PERMIT To be used tor DECK Est. Value $1, 500 Date JUNE 10 1987 Site Address 4669 PARKRIDGE DR Lot 5 Block 3 Sec/Sub. PARKCLIFF 2ND Parcel No. a Name JERRY WALERAK ; Address SAHE 0 City phone 454-3490 ¢ .o Name SAME zo t Address P Ciry Phone ww Name i? Address a W City phone OFFICE USE ONLY On Site Sewage _ Occupency MWCC System _ Zoning On Site Well _ Type of Const Ciry Water _ (ACtual) (Allowable) x ol Stories Length DeOth S.F Totel Footprint S.F. APPROVALS Assessments Water/Sewer Police Fire Engr. Planner Council FEES _ Permit _ SurChflrge _ Plan Revlew _ SAGCity _ SAC, MWCC _ WaterConn. _ WaterMeter _ Road Unit _ Treatment Pt _ Parks Copies TOTAL 29.00 t_nn I hereby acknowledge that I have read this application and state I Bldg. Off. thatthe information iscorrectand agree to comply with allapplicable A? State of Minnesota Statutes and City of Eagan Ordinance? D?? Variance Signature of Permittee A Building Permit is issued to: JitiRY WALERAK all work shall be done in accordance with al5= f Mip/i Building Official ?4 on the express condition that Statutes and City of Eagan Ordinances. , .. , f o• * 433 • 00 + 50•00+ 216•50+ 525 • 00 + 470 • 00 + 63•00+ 260 • 00 + 21017•50* ? • • ,=; ? ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN ? INCLUDE Q SETS OF PLANS, CERTIFICATES O SET OF ENERGY CALCULATIONS To Be Used For: Valu?ation: -? Date: Site Address: ?..A J I 0---?'6bc> w• • Lot: .`7 Block: .:> Sect/Sub: Erect: x Occupancy: ?-3 Parcel #: Remodel: _ Zoning: 4Z-I Owner: Address: City/Zip Code: Phone #: Contractor v Q , Address: City/Zip Code: Phone # : Arch. /Eng _ Address: City/Zip Code: Phone#: Repair: Type Of Const: ILEnlarge: # Stories: Move: Length: Demolish: Depth: 3l0 Grade: Sq. Ft.: Assessments: Water/Sewer: Police: Fire: Engr.: Planner: Council: Bldg. Off.: APC: Variance: Permit: 433,= Surcharge: °-° Plan Rev.: ZI(?.'- SAC: Water Conn: 4-70 °.° Water Meter ("3 ? Road Unit: 2(00.= y ? Parks : ? °?iU/ 7'SO Zo x 2?i = 56o xs q= I ?? x c3 = z?G:,) x ScT - M I 4 3o x2Z 2O x JC9 - GGo x- c ( - 31 3`ZO 1544(1,- 72 ?v <1 132? ??BE) v ?* V15i REQUEST FOR ELECTRICAL INSPECTION , e(?`e-oo?aG'o(]..J-,os ? I3I , 5ae msttuctions for compleling ?his form on bacp'? ?Q 9e/ / ... X" Below.Work_Covered by This Request ?• Ne Add Rep. Typa of Building Appliances Wired Equipment Wired Home qange Temporary Service Duplex Water Heater Electric Heahng Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Av Conditioner Other (spectly) Contraamr's FemeBs Joos Electric will only do: Compute Inspection Fee Below: mOV2 r cess cans, add 5 rec $s cans # O[her Fee # Service Entrance Size Fee # Cvcuits/Feeders Fee Swimming Pool 0 to 200 Am s 0 to 100 Amps Transformers Above 200-Amps Above 100 _Amps 51 n5 Inspeaois Use Only l TOTAL Irrigation Booms ?, ? U 40 50 5 ecial Inspection `'E . Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electncal Inspector, hereby certify tha[ the above inspection has been made. Rmqn-in oace ?? ?{?cj ? F1Od? OFFICE USE ONLY This request void 18 months imm = 131 ? ? d ? ? .? 9? k ?, C Re ue5t ate Fue No Hougb-In Ini2ecbon ReQU iYOU must call mspector when reatly) Ins ect?on Otlter Than flough-In ? Reatly Now aWAI Notify Inspector 3 2 9 ?les ? No Da[e Reatl IR licensed contractor ?owner hereby request inspection of above electrical work at: Job Address (Street, 0ot or Raute Na ) Qry 4669 Parkridge Eagan Section No. Township Name or No Fange No County I Dakota Occup9ntPRINT) Phone No DaSCO Contractor 423-1814 Pawer Supplier Atltlress Dakota Electric Elepnc9l Conhactor (COmpany Name) ConUacfoYS License No Joos Electric fi 00961 MaiLng Atltlress (COntractar or Owner Making Installation) 3980 Beau D' Rue Drive, Eagan, MN 55122 Autnonxed SigneWre (COntrectodOwner Making Ins Phone Number ? 688-6180 1 CITV B T 1 MVtl w ay ptl g S o m S-N8 G A9 II I I I III I III STATE p E D P 5 ? ? Y ' P U e 821 ?? I I II I OPER INS EC T ON PD EO O R Phone (612) 642-D800 u ENC S g*RFQUFOR ELECTRICAL INSPECTION kV% Ea•oooai-oa '?s insuctions tor completinp this form on back of yellow capy. ? , ,? .? ?, 5 ? ? ? B?low Work -oveiedty This Request dtl ReC'. Typa ot Bwltl?ng Applmnees Wired Equipment Wir¢d Home Range emporary Service Duplex Water Heater Ltghtiny FixNres ' Apt Buildmg 9 Dryer Electric HeaUn Commeraal Bidg. Fumace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm ther veu v Other ISUeolvl t er uec,ty t e, Other Compute Inspection Fee Below k Fea Service EntranceSixe p Fea Faetlars/SuhfexdeFs # Fae C"cu'ts /O 0 to200Am s 0 to30Am s 0 to30Am s Above 200 qm s. 31 to 100 Amps 31 to 100 A Swimming Pool Above 100,Am s Above 100_Am ' Trensiormerg Irri tion Boortis PartiaL Other Fee Signs Special Inspection $ TOTAL F U Nerrerks i , rnHouBh-in Date ?,?he Ela InsDector, ?eraby cerlily thet the above ?jynal ?„?^) /J ? 9^?Bv?i, inspeciion has been / ? !/oG / / ? -4 A /'o mada. Tltls repueat wld 18 monlna lrom This request void V g-) 3V (-,o ?n H??? ? Y` /{/ 5 18 months trom . W'•?- ? rj'( o A, 094586 4?aq?9C•O??' L 5 6 3 -;em'b , fv. c? U Peauestb9le Fire No. R u h InsVection e ea, ?fleady Niiw i11 Nolify InsPec- _ ?, s ? No ??r When Neady mensed Electncal ConVxctor I hereby reouest InsOaction of above Owner eleclrical work . nsrallad a2: Sireei dress, Box or Poute No. Crt 3 L 1 eclwn o. Towns ip Name or No. Range No. C ? Ocwpant IPRINTI 1??1 oN Ph No. Pow¢r Ober q" , 6' EI tncal Con[ractor ICompa y m I ntrar.tor's License No. .? Maii, ng Ad ress (Connactor or Owner Makmg instailauon) Authonz tl g?ture ICo a or Owner ing InstallaUOn • ho?e/Number 1- MINNESOTA STATE BOAND OF EIEC ICITY THIS INSPECTION REQUEST WILL NOT Grigga•Mitiwey Bldg. - floom N•791 BE ACCEPTEO BV THE STATE eOARD 1821 Univers.tY Ave., St. Paul, MN 65704 UNLE55 PROPEN INSPECTION FEE IS Phonw 46121 297-2111 ENCLOSED. REQUEST FOR ELECTRICAL INS7ECTION ' Eg-o°°m-a See insttuet{pns tor completing this tmd ^^ t-^A of Vellow copy. I? 30 "X" Be/av Work Covere4_by 7his Request ? MM 6ddj P.P.j Type 01 Builtling ApPiienten WiteO Equipmenl Wired Home ange Temporary Service Ouplex Water Heater ightiny Fixiures Apt. Building ryer Electric Heatfn Camiercial Bldg. urnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othei Speulv iher (SUUUfy) tr peci y Other Othee Comnute /nsoec[ion Fes Below ! Fee ServiceEntrameSixe d Fee Faxders/SUbteetlers 4 Fea Circmts ')„6o 0 to 200 qm s 0 to 30 A s 0 to 30 Am s Above 200 Ampsl 31 to 100 AmPS ?. )(? 37 to 100 Am Swimning Pool Above 100_Am ti Above 00_Ampri TransTOrmers Irrigation Boorc?s 0 Partial.'Other Fee L ? ?5'gis ? I iSpeciallnsVection ?S \) .oa LeniiY thet the abov fnsoection has Gaen mede. -BS vU Li Fnxn??v c?ecanve? ?,mnrav?ar I herebv repuast insPecbon of ebove QlOwner elechicel work ireW Iled at Street Address, Box or Route Nd. Uty U Q SectionNo- Townsmp ame or N. Nanpe o. Couuty Oc pant IH11NT1 , Phorve Nu. r SuDPGer re s l? Elae[riea ontractor ompeny N me) C ntracmr's License No. ? a WaJinp AtlOress IC racmr or Owne aking Instaifationl , 3 ' MAI C Aulhor' ed ?gnat e(C nhect r wner a ng In ta ation V l Phone Number a O YINNESOTp S'fp7E gpqRD OF ELECTPICITV THIS INSPECTION PEQUEST WILL NOT Griyps-Y:dway BlAq. - Room Nd91 BE ACCEPTED 9Y TME STAIE BOABD UftlLESS PROPEN INSPECTION FEE IS 1821 UniversiTyAve., St Peul, MN 65104 ENCLOSED. ? I61T 2979111 (A/a&/9 ?- rn.? -?l REOUEST FQR ELECTRICAL INSPECTION 0- See instryVms for _iFompleMq Ihis lorm on Dack W yellow copy „X" Below Work Covered by This Request /o -OOOM 05?s ?. .. , ew Atld Rep TypeofBuilding AppOancesWired EquipmenlWued Home Range Temporery Service Duplex Water Heater Electric Heating Apt Building Dryer Other (Specify) Commllndus[nal Furnace Farm Air Conditioner Otherlspecily) Conhaclor§ Femarks ? Compute lnspecnon Fee Below. /r24"J/? P'r d ???I ?i?(?/ ? N . Other Fee # ServiceEnirence5ize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps a to i00 Amps Translormers Above 200 _ Amps Above 100 _ Amps Signs Inspecror5 Use Oniy. ? TOTAL ?" p? Irngation Booms O 0 4J Special Inspection Alarm/Communication THIS INSTALLATION MAV BE OHDERED DISC;ONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO I, the Electrical Inspector, hereby Rough-in certify that the above inspection has been made. F,nai oate ? ^i OFFICE USE ONLY ? e Thrs request voitl 18 moNhs 1mm a ?i/yo?- 331 07 . ,-?3' d ? 9zi a-a ReQUesfe JJ?? ? Frte N. Rou = Reqmretl9 G Yes nspecMan G No ? Reatly Now 0011 NdiTy Inspec[or '0i'hen Rea0y9 I Licensed contractor ? owner hereby request inspection of above electrical work at Job Atl r ss (St 4 Bax Route Na ) A? L e r. Qry CUd n Sectmn No Township Name or No Range W. Couny ?A zl-a Occ ant (PRI 1 m Plio e No - II PowerSuoGlier Atltlress ^ U EI v al Conlra or COmp y Nam ('qptract 5 Lrcznsa o Mai m Ear ss ICOnha or Owner Makmg In lalla?ion) - Aul nzetl Si nalur I nV `? dorlOwner Ma in Insla?lahon r Pho e m r - MINNCSOTA STATE BOARD OF El CTFlICITV THIS INSPECTION REOUEST WILL NOT Grigga-MiOway BIEg. - Hoom 3 BE ACCEPTED BV THE STATE BOARD 1831 Univenlty Ave., SL Paul. MN 55100 UNLE55 PROPER INSPECiION FEE IS Phone (612) W2-0800 ENCLOSED , PERMIT# tsw,? ri 'Y RECEIPT DATE: 2002 iZESIDENTIAL f'LUf41BINCx ?ERMIT AP#'LICATIO1V CITY Of £lk6E4N 3830 i'ILOT KNOB itD eAenri, MN 55122 651-6$1-4675 Please complete for: SITE ADDRESS: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system OWNER NAME: : vF TELEPHONE #: 65t_c45-q '3q q0 (AREA CODE) INSTALLER NAME: 16100+6CA4 on _ TELEPHONE #: 1?57_ qS?a2' 7$-77-N (AREA STREET ADDRESS: CODE) eo i tsJ CITY: o? Ji r 12 STATE: l%1/+• ZIP: SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply . MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118) Other: _ RPZ: new installation/repaidrebuild $ 30.00 lawn irrigation system ( Y? t S? plern0042--_ tq ReplacemenUadditional: _ water softener _ water heater $ 15.00 State Surcharge j $ 50 c 2 Total I hereby acknowiedge that I have read this applicatioq sta[e thatthe information is correct, and agree to complywith eil applipbte Ciryof Eagan oNinances. It is the applicanPs responsi6ilityto notify the property owner that the City of Eagan assumes no li ility for zn damages caused by the City during its normal operational and maintenance activities to the Bcilities construded under this permit vithin C? prope ?-of-way/easeme 2 y G 2 E OF PERMITTEE 1/02 RESIDENTIAL yJC9 C? 5;2 5,2 BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681•4675 Naw Construclion Reauirements RemodellReoair Reauiraments • 3 regislered site surveys showirg sq. N of bt, sq. fl. ot house; and ail roofed areas • 2 copies of pian (20 % maximum lot coverege allowetl) . 1 set of Energy Calcula[ions for heated additions • 2 copies ot plan showing heam & window sizes; poured found desgn, etc.) • 7 site survey for eztenor additions & decks • 1 set of Energy Calculatlons . Indicate d home served by uptic system for addihans • 3 copies of Tree Preservahon Plan if lol platted aRer 711/93 . Rim Joisl Detail Ophons selection sheet (61dgs with 3 or less units) DATE G c2_?VALUATION ?92,2 r2 'D SITE ADDRESS MULTI-FAMILY BLDG _ Y ?N -Q) ° - TYPE OF WORK APPLICANT FIREPLACE(S) _ 0 _ 1 _ 2 STREETADDRESS 7'16 (o e?)MQ/t , YI r??T/? IAP CITYE-4WZIP .5.s?y?1 TELEPHONE # 9S?2- Sg/-F??4.? CELL PHONE # FAX RS/ / PROPERTYOWNER C'P_P(1 ?10_l2aK TELEPHONE# ?o`?J/-'1Sq-3"l5 ---------------------------------------------------------------------------------------°------ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MI\NESO"l':1 RULFti 7670 C:\'CLGORI' I 4[I\NL•'SOT:112ULL:S 7672 submission type) • Residentiai Venhlation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contraetor: PluinUing systcm includes: Mechanical Confractor: NIcch>utic.il sNstcm icidudcs: Sewer/Water Contractor: Phone # Phone # Ccc: $70.00 -----------------------------------------•-------------•-•------------------------------- Z ------ I hereby acknowledge that I have read this application, state that the information i?rrect, and agree t mply with all applicable State of Minnesota Statutes and City of Eagan Ordin nces. B Signature of Applican ? °-----------°°--------------------__..._._..---°...--°°-----------------------°--------°-------°---------------------"------------------------'°---- OFFICE USE ONLY Certificates of Survey Received _ Tree Preservatlon Plan Received _ Not Required _ Updafed 4/02 _ Walcr Softcner Watcr Hcatcr \'O. Ol'B1[175 PllOttC # I.awn Sptinklcr No. of R.I. 13aths -- :1ir Condilioning -- Hcat Rccovcr}' Systcm Pcc: $90.00 OFFICE USE ONLY ? 01 Foundation ? 07 OS-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 ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12•plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolition (Entire Bidg only) - Give PCA handout to applicant Valuation Occupancy MClES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. af Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footines (deck) FinavNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Air/Gas Tests Pool Ftgs Final _ Framing _ _ _ Siding S[ucco Stone _ _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total . <?? i39. a S -dy,,t2o 3.5 c? ? /va. 75 2/84 ' CITY OF EAGAN APPLICIITIGN FOR PERMIT SEWER AND/OR WATER CONNECTION ?. (PLEASt PR2NT) 1) PROPER7'Y ADDRESS: 2,4 6 LEGAL DFSCRIPT2ON: IF EXIS72G STR[ICIZ7RE. DATE OF O2IGINAL BUILDING PERC4IT ISSJANG^: a4? iMOr.u`z/Year1 PRESE^7P --,: "II1L'Y:/Pr0POSETJ IISE: 4 R-1 SIIUZ FAMII,Y 0 R-2 WPLYX (7W0 LiNITS) O R-3 4CX**r1CrV 1?947 i•,,,r..,V I •?,?T.r O R-4 APAFrIIMESIi'/CCNIDCMINIifi! UNITSI o CU4WCIALnHIA.IvoFF= o nMLZTRIAL p INS`fiRUTICNAL/Ga?P 2) APpI.TCANr (PLEASE PHIMT) IgME: '_? , aMxess: crrY, srATE, zIP: A tle 1a- V2 ,' nn s s- i? Y T PHOW: y.?.3 iyyX 3} pLdPSm ?EASE PR1MT) y FOR CITY USE QMi,Y ' NAM: 1 l1 2 ???t, r.l ? i rr h' 1t- Hrz PLUN8EP5 tICENSE: ADDRESS: ?I V /C/G.?V k YM ? I19 re rt Q Active CITY, STATE, ZIP: 4,rir>? n y f?n RASIrn hn J 7 Ga! Y ? Expired 11 Not of Record PHOddE: y?.? L' VlUNBEN LICENSE p Op_:?2 -4rj -Z%h a Zitatt n¦ ta 4) OCCUPANT/a,?, IM ?Q (P EASE PR1MT), NAWIF:: ??EL^Sc.1 ?r7 A[iDRFSS: CITY. STe1TE, ZIP: ? PE{IX`IG: 5) INDICATE W}lSCli PFR11T IS BEIIU Rfl4[3ESTID: COfSErPION 1C) CITY SEYIER ` 13. CflNNfCrION '1C) CITY WATER E] 0711ER (PLI'ASE qFS(.'F2IBE;)' . 6) P1?IC.-::7: [] P:f?`\.SE flOT-D T,I'PR(7VED PF'Rti1IT t'OF2 PII;l:-UP BY ONE OF AB(V;: ta PLEIISE MF1IL APPRC7l,'ED PF.i2.?LLT 'IC) 1. 2. Q 4 ABCIJE (Circle one) n .r .. . 7) 5.Q:.1':1_7 2c:: 0011.1- '' DA'tE: ?ROIiMfeJel?fil??arafe??p ? •• .•, ' , ' iY??iafis?i:as!laIFJ?IFJ?91F?.1?lf?l?lS??ae -\ . F 0 R C I T Y U S E O N L Y . , PER.*1IT '-` ISSUED ? FEES : $ / e . S e) $ ie_ Sd S lo.?- ?? $ $ $ O S o-d $ $ ? ?••?e--G- $ $ $ $ $ $ S SEi^iEB PE$MIT (I`ICLUP,E SUP.CHaRGc) WATER PERA4IT (INCi,UDE SliRCHARGE) WATER METER%COPPERHORN/OUTSI?E READER WATER TAP (INCLUDE CORPORATION STOP) SE:dER TA? : ?r??'i:::'T ?_.=C•$i= - .._..'? ACCOUNT D`:POSIT - WAT°R WAC SAC TR(i'NK WATER ASSESS2dE:1T TRti:7K SESJER aSSE55biE:IT LATERAL BENEFIT/TRUNK SE:•7F.'R LATERAL BENEFIT/TRUNK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL AMOUf;T PAID/qECEIPT ,'a, DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLZC RIGiIT OF WAY? ? YES IF YES, THEN A"PERMIT FOR 'AORK WITHIN ? PUBLIC ROADWAY" MUST BE ISSU£D BY THE NO ENGZNEERING DIVISIOIV. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOS4ING CONDITIONS: ' APPROVED SY: TITLE: DAT°: Cities DiQital Oualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. ? ? ?. .. t ?I ? 0 z? N y"•4 '+ NY Eyf147-, IN4 .. . -- Ec Ev; ?c?.?Et?v,=a''° _ s . - a - , ? -- -?-- _ ---? , . L'-o ---------- ? -/: .?' ?: 70. p ? ? 4``, ?`? ? ??? ?' , ?• ?? ?? ?--?2?6`'? - ---- ? ` ?,fi ,A £'? ==+V:. ?• L,.. f? l,T.Y"" ; ,^: s :?Ov .k PERMIT C'003 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 025311 (612) 681-4675 Date Issued: 0 4/ 0 3 J 9 5 SITE ADDRESS: 4669 PARKRIp6E DR LOT: 5 BLOCK: 3 PARKCLIFF 2ND P.I.N._ 10-56701-050-03 DESCRIPTION: Btjildingl? Permit 7ype 8uilding Work Type '?. r ? BASEMENT FSNISH NEW REMARKS: A SEPFIRA7E PERMIT IS REQUIRED FOR ANY PI.UMBING OR ELECTRICAL WORK FEE S MMARY: Base Fee $35.00 Surcharge $.50 Total Fee $35.50 CONTRACTOR: - qpplicant - sT. LIC. OWNER: DOSCO 14231814 0004144 WALERAK .7ERRY 14710 DELFT AVE 4669 PARKRIDGE DR ROSEMOUNT MN 55068 EAGAN MN (612) 423-1814 (612)454-3490 . I hereby acknowledge that I have read this epplication and state that the informatian is correct and agree to comply with all applicable State of Mn. ? Statutes and Gity of Eagan Qrdinences. J -^RPPL?T/PERMIT? IS ED By SIGNA??- E ? INSPECTIUN RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knoh Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILpING 025311 04/03/95 SITE ADDRESS: APPLICANT: LOTs 5 BLOCK: 3 4669 PARKRIDGE OR DOSCO PARKCLIFF 2ND (612) 423-1614 PERMIT SUBTYPE: TYPE OF WORK: BASEMENT FINISH NEW INSPECTION FRAmING D. . INSULRTION D. ROUGH IN PLBG FINAL ? REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WpRK (WORK WAS DONE BEFORE APPLICATION FOR A PERMIY WAS MADE) F L 7 - I ?, . ' CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681 -4675 New Constructien Reeuirements Remodel/Renair Reauiremenfs ? 3 registered ske wrveys ? 2 copies of plan • 2 coDies of Dlane (inGude beam 8 window sizes; poured fid. design; etc.) ? 2 site aurveys (euterlor edditlona & dedca) ? 1 energy eakulations ? 7 errergy celeulations for heated addidona ? 3 copiea M tree preservatlon plan 'rf lot pletted after 7/1J93 required: _ Yes _ No DATE: CONSTRUCTION COST: ? ?? ?' i?? DESCRIPTION OF WORK: 5/.tv STREET ADDRESS: ' LOT S BLOCK ????? '??j'F"-r k SUBD./P.I.D. #: ;?- 140211 ?hP? PROPERTY Name: J? ??y (fPi'G Ii" Phone el ?10 OwNER w * Dnnsr ? Street Address City: e, n ? State: ? h Zip: CONTRACTOR Company: G'6'3K' 17 cQJ?' °? Phone #: ?112 3-4 Street Address: IV740 t-License #• City: State: -'l''' "7 ZipT?O?? ARCHITECTI Company: kI Phone # ENGINEER Name: Registration #• Street Address• City: State: Zip: Sewer 8 water licensed plumber: change are requested once pertnit is issued. Penalry applies when address change and lot I hereby acknowledge that I have read this application and state that the information is earrect and agree to comply with all applicable State ot Minnesota Statutes and City of Eagan OMinances. , Signature of Applicant: OFFICE USE ONLY ' Certificates of Survey Received _ Yes _ No RECEIVED Tree Preservation Plan Received _ Yes _ No MAR 2 8 1995 --------------- OFFICE USE ONLY ' . ? BUILDING PERMIT TYPE 0 01 Foundation o OB Duplex o 11 Apt./Lodging p? 16 Basement Finish 0 02 SF Dweiling o 07 4-plex ? 12 Multi RepaidRem. 0 17 Swim Pool 0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous 0 05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE 0 31 New j!L'33 Alterations ? 36 Move 0 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowabie) 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. y3 I/ Depth Footprint sq. ft. SAC Code oi Census Bidg / Census Unit o APPROVALS Planning Building Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: _ Engineering Variance ? spo Valuation: $ _ % SAC SAC Units CITY OF EAGAN L J? B --?' MECHAIYICAL PERMIT SUBD. (612) 681-4675 ? RESIDENTIAL RECEIPT # DATE .r. icY S' ?- PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLEfE FOR TOR'NHOMES/CONDOS R'HEN SEPARATE PERMITS ARE REQUIRED FOR EACH DR'ELLING UNTT. OWNER: FEES STfE ADDRFSS: ADD ON/REMODEL (EXISTING CONSCRUCI70N ONM $ 15.00 !?? ? 'L'? HVAC: 0.100 M BTO 24.00 INSTALLER: ?-,c- ADDTfIONAL 50 M BTU 6.00 ADDRFSS: -1'2o GAS OUTLE'fS - MIIVIMUM 1@ $3 EA. CITY: ZIP: s( ZZ SURCHARGE: $ .50 SIGNATURE: TOTAL: ? $ S ? ? COMMERCIAL PLEASE COMPLEI'E THIS PORTION FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLEI'E FOR APARTMENT BUII,DINGS OR OTHER MULTI•FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTf. WORK DESCRIPTION: CONTRACT PRICE: 1% OF CONTRACI' FEE. FEES STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FE& $ PROCFSSED PIPING - $25.00 MINIIMUM FEE - $25•00 a OWNER: TOTAL: $ STfE ADDRESS: TENANI': SUITE IIVSTAI.I.ER: ADDRFSS: CITl': ZIP: PAONE #: CITY SIGNATURE: : SIGNATURE: T , - < - 1992 BUILDING PERMIT APPLICATION CITY OF EAGA REQUIREMENTS: 1001 SINGLE FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET ENERGY CALCS. MULTIPLE DWELIINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET OF ENERGY CALCS. # OF UNITS RENTAL FOR SALE COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS, 1 SET OF ENERGY CALCS. PENALTY APPLIES WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE JQB LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. CTj?F-cK AND .9D7>t/l0N> To Be Used For: Valuation: 1;5z?z'G?-= Date: ,? y' /?.q,;2 Site Address //6 6 9 L,.? ;? ? % % v?? ' OFFICE USE ONLY Lot ? Block FEES Occupancy R-3 Bldg Permit 198.cx` Parcel/Sub ?jr Zoning Surcharge 9• sc Actual Const Plan Review /ay. co Owner Allowable License Fee < # of stories SAC, Ciry Address t!G ' Length DE7-4; 3sx?s SAC, MWCC DepthnDarnaJ: isiZz/Erz' WaterConn. Ciry/Zip - S.F. Total Water Meter Footprint S.F. Acct. Deposit Phone ,5-y-3Y c% S/W Permit On-site sewage S/W Surcharge Contractor On-site well Treatment PI. MWCC System Road Unit Address City water Park Ded. City/Zip 4 PRV Booster Pump Trail Ded. Copies 5 o? SU Phone y3/-L,IIG License ewaiC4,7 APPROVALS Penalry Planner Lot Change Council TOTAL ? Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # Sewer/Water. Licensed Contr. . Processing time for sewer/water permits is two ays once area as en approve . agrees that all work shali be done in accordance with ignature o ermittee all applicable State of Minnesota Statutes and City of Eagan Ordinances. 7. . L uA -k-A -Ohl ? D?z ? / ? ? ?? - «. .: ,?:, •. 15%ZIX/6 %z=,Zs6x?1= ?-7)35? ?- f b' 135 , .. . . ..i '• : . . ? . , .? ?- ----- r ,: r : ` ' ) r'.. b •: -:,;?;>`. •. _ ? j d rh: ? ?: f ' t n ? x +? fi Y a Y+ - ' t.. Ui / . ? /?-7 i ) t=. '`'. .. N ?. : . .?9 . ' -"'_.....- :jq' z n?5?`. - ' ? ` ' ? r. -,;,,?a.???. .e? • ' ? ' • : . ? ? 5 ?'' - . ? ' ' " : r. .; • i ? ? . . , ., . ?l. 9c?''?Lbsv;?y?¢ 42 . ? . . ?y r ' ? Yr F r , 1 ?.. . ' . ?? ?_ .i7: ? e? .?1-10''? .. . ?- . .'S:.' ;;;;?.: - ? ,?r•?;- t. . ? ; `?' ???.v;? :,:.. f .?::Gr';t :?4`":?::,i;'. ? ' -? ?? :.tr , . • .... . - :;?;q.; , ?. ? . ' ' i ;.; < : 7 ' . ', `" ' :'c } , ,"' ..:M,'. . ? , ,?y; r-? . , , . ' , ? . , . ,.; , : a . . • .;: • + , : !. •,4ta.:5:.:,: , , , _ yy/ . r . . '?.' ":yr' " ?' V: .. ., _.. . ?' `.t. ;:_: ? i. - •_ A1.Y r{? ?'1? !\4 . . '?: ,? :; ? ' ?D? , , ; ? , .±,V ..' ? ^ - ' Y^I-n! ? l f.., . i .. . . f . ' •. '?! ? y??? -- ? . ? i ?..` . . .+ ' i??• J ` ': r: t •:;'', _ C' ? j . ?.;.: ? . - ? , . ,' ' ' • t' •`? ' ?- : . . . -. .?3.?IY$'r'.[+? ' . ( !, 1 • h ??I =._? .ty%':-.. , . , . . '? .f 3".. . . , '. ' *• ' '?: , .. . . ' _ , . , " . ...,. -11 1I1 ? i• R;.?<3=i,:^t ? M F+ ;!S n i'?i.: n`?l:??? sT::.?•1. i? :..:.. . . . .... . . . _ `4.A? `?[?:? ?? ?.i.ti.? ?. ?•1 e ,. , ,'i:9?1 . . ? . . . . ..?Y.?, *b:' , . 7tQ N .. . -- - - -- -----? EXTERIOR ENVELOPE AVII2AGE "U" COMPUTATZON DATE OWNER "A+Z SITE ADDRESS 'el /?/0 9 '44)e.e CONTRACTOR PHONE Determine Working Square Footage of Each. 1. Total Exposed Wall Area .. 6,77 Sq. Ft. X.11 2. Total Roof/Ceiling Area .. ZS . Sq. Ft. X.026 = ?o• %?J 3. Total Floor/Cant. Area .. ? Sq. Ft. x.OS = C? Total Exposed Wall Rrea Above Floor = 36 R.3(o a. Total Wall Window Area. . . . . . . . . . 8-5"O b. Total Door Area . . ... . . . . . . . . . ZO.O/ c. Total Sliding Glass Door Area ...... - d. Total Fireplace Wall Area . • - e. Total Wall Framing Area (average108) .. Z9, fee f. Total Net Wall Area Above Floor ..... Cfo G LL g. Total Rim Joist Area. . . . . . . . . . . j (o•L(o Total Exposed Foundations Area = _ h. Total Foundation Window Area .. . i. Total Net Foundation Area Above Grade Determine "U" Value of Each Wall Segment. a. 8So x "u" .31sZ = S.9t. b. zo.o/ g flull , 07 = J. Ya c. - X "U" d. ? X flue, e. Z9• k9 X "U" .09 = Z• 6L f. Zz. z.zP-' g loUt$ .aY g. 3vLb g fluot Qy h. ?- X "U" '_ i. ?- X "U" ? _ - SUBTOTAL = S?.S 88 ? Z S/. 7S 4. TOTAL = .(v3 If item N4 is the same as, or less than item q1, you have met the intent of SBC 6006 (c) 2. Total Exposed Roof/Ceiling Area zSlo.0 j. Total skylight area . . . . . . . k. Total flat roof/ceiling framing area . ?. 1. Total net inslted flat roof/ceiling area M. Total vault roof/ceiling framing area-108 ZS & o n. Total net inslted vault roof/ceiling area z 30•Y O Determine "U" value for each roof/ceiling segment. ]. - X "U° k. x "U" _ 1. X "U" _ -? M. Z'Si (Dd X °V° .??? ? • ??i n. T?'a4L? x zi..9/- 5, TOTAL = b , ^..?.. Zf item #5 is the same as, or less than item 82, you . -?. have met the intent of SBC 6006 (c) 1. Total Exposed Floor/Cant. Areas "- o. Total floor/cant. framing area (avrg. 108) p. Total net insulated loor/cant. area ... - Determine °U° value for each floor/cant. segment. o. x "U" p. ? x °U" 6. TOTAL = If total of #6 is the same as, or less than #3, you have met• the intent of SBC 6006 (c) 3. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items 84, #5 and t6 shall not be greater than the sum of items #1, #2 and $3: 1 . 88, y/ z. eo•!oS s. --? _ fl-lo, a4 4. 76•!e3 5._ ?.l?:Z_ 6. 79,36 Prepared By Da te wa Total Exposed Wall Area Above Floor a. Total wall window area . . . . . . . b. Total door area . . . . . . . . . . c. Total slidinq glassdoor area ... d. Total fireplace wall area .. • e. Total vall framing area (avrg. lOYc) f. Total net wall area above floor .. g. Total r,im joist area . . . . . . . . ... ??.v . . . s?0. 0 Z . . . Z86.U Total Exposed Foundation Area Z8.79 Total Foundation Window Area ? Total Net Foundation Area Above Grade 7,9,7 Determine "U" value of each wall segment: a. x 'iUu .3SL = .S,&3 b. y6.QZ x °U° __ e O7 a 2, 8d C. -? x "U" d. x °U" e. 31„33 x "U" . n 9 = z•8z. f- 7R0.? x °n° ,oy = //.Lo g• x 11 V" - h. • x "U" = SUBTOTAL = I Z • S , THRU STUP w/ S.R. & SIDIN6 ` >I ?I THRU CL6 MEMBER ? Int. Air .68 S.R. ,YS Stud &_g 7 Shtg. Z-ap Siding ?Io? Ext. Air .17 Total "R" = lp,p3 1/R= ifull _ ? Int. Air .61 S.R. ( ,S(?, Clg. Memb. e/.3y Ins. ( ") 30 ' Still Air .61 Total "R" _ .3&.17-- 1/R - llUit - ,03 TF1RU INS. WALL Int. Air .68 w/ S.R. E SIDING S.R. ?YS Ins. ?0 SHTG. - Zo f ' i Siding ? F..xt. Air .17 Total "lt" . / = Z,3. oc. 1 R THRiJ CLG. INSULATIOAI ww Int. Air .61 S.R. ( ") S(o Ins. ( "> 38 Still Air .61 Total "R" _ 1/R = "U" _ •q,3 THRU CONC BLOCK ? /? . . ?/ . . i / •, j , , Int. Air .68 C.B. (/L" ) 1.z9 Opt. Ins. //0 Ext. Air .17 Opt. S.R. - Opt. Sid. Total "R" _ 1.313 1/R = "U" = i .n] THRU RIM JOIST Int. Air .68 Ins. 130 Wood 11.89 I Shtg. Z•o9 Siding '4,7 F.xt. Air .17 I Opt. Brick - Total "R" 1/R = nUn = ' ? ? 3?S ^ .?, 1987 BDILDING PERMIY 9PPLICATION - CITY OF EAGAN ? SINGLE FAMILY DWELLINGS INCLODE 2 SETS OF PL6AS, 3 CERTIFICATSS OF S08VEY, 1 SST OF ENERGY C9LCOLATIONS HOTE: ADDRESSES FOH COfiNfiR LOTS - CONTRACTOR/HOMEONNES MIIST DESIGHAiE WHICH ADDRESS IS DESIRED. NO CHANGfiS WILL BE ALLOWED ONCS BOILDING PERMIT IS ISSOED. MOLTIPLS DTdELLINGS - RESIDENTIAL RENTAL QAITS FOR SALE ONI3S INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQItPE3 - CHECK WITH BLDG. ?fiPT., 1 SET OF ENERGY CALCULATIONS CONIFIERCIAL INCLUDE 2 SETS OF ARCAITECTURAL & STRUCTURAL 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND PLANS, To Be Used For: 1)9" Valuation:y? Date: 6 -g -W:? Site Address 4lp9 OFFICS USS ONLY I Lot -5- Block On Site Sewage MWCC System Pareel/$ub ? On Site Well - City Water _ Owner 9ddress City/Zip Code C?&qc /}?) Mu Phone ?"- ?n Q Contractor ? e'44i Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone !k APPROVALS Assessments Water/Sewer Police Fire Engr Planner Council Bldg Off APC Variance Oecupancy Zoning Type of Const (Actual) (Allowable) 4 of Stories Length Depth S.F. Total Footprint S.F. FSBS Permit Z 9 Sureharge I• Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL -3 ?7- }:\TER70R'.tiNVELOPE AVERAGE COMI'UTATLVN , .. . . . , . . • - ? -b -r ?? ara 'I ,ner Addresg__ ? ' S.?L.rrv Date t7?? l-Z IQ?., " rgal Desczip[ion bf Prnperty: Lot ?J Alock Addition F . . ' - • 1 ? : ?y?? • I ? "?'? ? ?'•''f^.>,?`Y?: ite Address AVERAGE LINEAL FEET OF;! % EXPQSED WALL AREA ABOVE J.RADE G y;'< ain ievel Lineal i,t. of; framed wall above grade. Z?? x height. o wall ? ? im joist area Lineal ft. of rim height,"of rim nwer level Lineal' ft. of framed wall above grades x height of wall_ 1 f _' 4? ? f?/df.X SV ?•?JY:? ? : ----?----?-^ Lineal ft. of? roasonry wall above grade__8 ,Ox height ,above gradi'ti` ,--'?; ` TOTAL wall area ebove grade including, windows and doors . I9?(??-GLiTD - D6?lfjLG: 4 L,AZ? a 4?5, 1\DOWS: Area, x"UN. value iake type ZO5¢ e--C.-3 sq.' ft. Z a ?t.I f?h"; , ?iGsy'ZO?Pj.GG, "Uu' ? /.)k'e'9 SQ. ft. Z'i ? r??r ? ??T,?' ?q ??- Crs? ° sq. ft.?x u n.._? •U g U ???r. ?- r7:a?? c t'; ' n.. ..sq. ft. ' g a?rr'?` ?m"-, .?'-'?''?,'?'?"f?'. [d ?TS ? Sq. ft aa ?'+? ' •'? ' !O??o c"G? , scj.'ft: 14 Z <G / sq. ft. a "x 14 9q. ft. - $. _X uv ? 14 SQ._ ft..`?...X .rlQ• ftrl1i??-, U > gq. ft. SQ.fft._.r--:.---?----?*'x et . n . . . ' (?. C.x atuil 8Q, ft. ;X „o,-.:..- 'sq, ft.____-=----'-"X """"'T"'.."?rx ft. • ' -? _* n,?y.? ? p7777 777, 777,770%? C: . ??F t 7ryY p ? 4,1 ')OORS: Area ?x "U" value ? /l, sq. tt. 4O 3 Nake &. type 6-6 ?? .. . ?? sq. ft. Z- . 17?GN->htz? SYf?/' ? u rt Sq. fC. 70 U I? ? G QE{?'IGi?/?/L-?..? ?G'/OGYL BQ• .ft ? ?''? ?? Ll .? ?ry? ?T2 ? ? • ? ??3 ?-?- " ?, , :` 'OPAOUE WALL CONSTRUCTION; Area'x "U" value sq« ft. ZQ'? X 1rUTi ? as u? sq. ft. X ?lUll . Uetail refer sq. ft.? y,(U}A EACO fTOlli - .?w il d < ? / 8Q. fi. 'attached . ---*-- sq. ft.----_--- x. "'?-c----? f sheets? sq. ft.?= ? . sq. ft._,__.____?_:^=--x . Z ?g?,t•8 . 7.. ic TOTAL Wall Area, Includin ? g Tora?.?'tt,?"?t+? 237, l? Windows &' Doors w r .r?.r---- r^ E 3 a r', 14VG. ,n{??? '? ?,?T ;xf.. , ' z( T07'AI. (U)(A) VALUF.S ? . ?Ol ? UiVIDEI BY TOTAL WALL.AREA AVERAGE "L'° Minimum .17 oz.Iess for 1& 2 family dwellings I*- ? . ?1inimum .22?ot less foT all other'buildings? " ,.? Codp?'reQujrQmepts Lh@'Ar NoTF: ]f avPrage "U" valves as calculated ahove do not meet the Energ Y' " "A7ernate Envelope Desigzi".* as.indicated on Page 5 may be,usQd . ` `- y 4 . y? ' . . . . . .. ? [ . ??`{ ? .. ' . . . a? s? . ? ., . ' .. . ? . . ? .t ' h,P` 'l?-•'Y .... - .,, ..?_ , -_ .... !' 5: ' _ „ - ° -. . _. ,. ,.. . . .,?. _ ;_ ?:?,;;•:•:;`;<,??: ?`r'a?? ?:? s;.:. • ` ' ' ' FRAMING MF,MBERS IN:_WAI.LS ? Top ?View' - - - ? :•: -? - _ - y N:+:,L c;1 G:luHd', _Exterior_air_filip,._,.,r,., I.Q''r,: 'uae .10;o , ? • ? y ? ? ,? ,'' -?; 01' opa4ue Siding • wall area ' i'or 1'raniin' ( -- ' Sheathing - meabere:,', 2. sofr woc,d.. syJW dr.y wall' . . ' . . .1?- ? _ Interior ai?„film . - ' _ _ ? _? . -•- ? ? , . _ . , . _ . • . . ' _ , ._ ? . " s;y.? U ="1JR " _.. . . .. ? ' . P? ' ' f' ? ?. , ? _ ? ?. ' • "4 i?? FRAMLD WALI; - .. - - .. - • ._ ., - .. r?r:;: ? Exterior aii £ilm `?1-- , Siding '_-- ?r Sheathing /,J lcav" batt ? ? =?: ? '??{?rn'be .. s;-• s ? ... .:. .: . ' '? .r, . . . . . : . - .. .. . .:^l A'4 %v ! tF f` ! r? , „? .,... - : ?*- .. C11.... . :_ - . .. ..'?.i?;?? I '?p•`," ti}d?. (z) Exterior air- film ?J, ,?, Siding % , Sheathing . 4 ' . . . .:.K.i': ? ? •.??V??. so t i :.. Interior r fi ; • , `TOTAL:',R ?, r? ' R U l/ ''' MASONRY WALL^ , • p.:i??.' ,. - 6xterior air film -,.----=--,, . 'Z 12?' concrete biocK ? _ -+= . . Ir n 'I ti l I ,i ",'S .!3 o a nsu Interior air film: -•69 1'OTAL d'-- • U = 1/R 1 _.. _ - - . _ ..?_. _,. _ _ ... . ... ....... . . . ?.. . - _ .. ROOF"CEI LIFtG , 6utside a„ir? f,i-ith ?---,-- ? , Insulation " t1 ?r/ GG`Z:.L f? ? - -- Drywali InCerlor air £31m ? TWTAI. p :7-- ? s U = l/R' iT. ? ' . . . ? ? . . - ? ? . ' ? _. • ? . . ?^;? _ . . Outside air film Iasulation. 35" Drywall ^` _ _,.-r-w.-• `:, 0 InteYior air__€31ilt 41 , 't'QTAI. ?; °. ' F ? ? .. . ? U Ontside air ?fi?m - -- ? Insulation' Wood.deeking Interior air f11m ?`? :_?? ? • ? F r. ? • , ?! TE3TAI. R --- . . U.= 1/R u ° ? f-- , . • i ;':,?' ,;? ROOF/CGILING": 1'GTAL AREA: sq . ? Detail reference 'lUll x sq. --------- 77., . X sq. ft. from above. ? ,. 'lU" = x sq ft.? „ _ , Describe openings , f " r„? ? (UP in roof t sq. fCtF ' ? ? {ry p C•? 4f . ? . V . x 9q• 14• ? r .:. ?.r- VIU . , . tty'\I 4 _,.. X $q? fr.?i „ TOTALS.`' ' ? sat ft.,? '1'OTAL,(U) (A) VALUES _ C ? A?? : "?'"?? ' pIV,IDED BY TOTAL P.UOF/ • - CL'LLI[:C ARFA .OS for AVERAGE ??!. .?? ? ventilated roofs ? .10 for a11 othar construetiorr ues as calcvlated above do not meet the £nger e va] ? ] E avera ' f4Y ?ode?%ttq?3'e`??Tk?s p, ;1(! CF.: _ "Altcrnate F:nvelope Design" as indicated on Page S.may.be..used. ..' T.. -. ? . . , ,.. . . .__. _ , _ ._ .._u ' . ._ ._ ? . ...._ . . . . ? . _ ',.? ,. ?. .. ? -.. .R _ _ -Use _B_LUE or BLACK Ink rt"1 For Office Use j My Permit of Eanan 40~ I F I Permit Fee: 3830 Pilot Knob Road i 2 Eagan MN 55122 I Date Received: - Phone: (651) 675-5675 I Staff: 1 Fax: (651) 675-5694 I 2012 MECHANICAL PERMIT APPLICATION Date: r~'(~~j f1 r Site Address: V Tenant: b Suite - r X, RESIDENT /OWNER Name: 04 1P Cl Phon_e: t~7 I i4' i ~l Address / City / Zip: F;l`j I K, 0 r _3 Name: Ron's Mechanical Inc License Address: 12010 Old Brick Yard Road city: Shakopee CONTRACTOR - State: MN Zip: 55379 Phone: 952-445-8585 Contact. Linda Email: New ✓Replacement Additional Alteration Demolition TYPE OF WORK Description of work: NOTE: Roof mounted and ground mounted Mechanical equ4mont is required to be screened by qty Code. Please contact the Mactianicid Inspector for Inky rtation on permitted screening methods. / RESIDENTIAL COMMERCIAL ✓ Furnace New Construction _ Interior Improvement t PERMIT TYPE 'Air Conditioner _ Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit _ Heat Pump Under / Above ground Tank C_ Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) J $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ (~()U TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) = $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ Surcharge If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.clopherstateonecall.ora I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, 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 1 `CYQ 1~' (~~Ct-e U x Applicant's Printed Name Applicant's S' ature FOR OFFICE USE pate: Required inspections, RwWW*d Underground Rough In Air Test Gas Service Test In-ftaof Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Building Permit Number:EA124555 Date Issued:07/07/2014 Permit Category:ePermit Site Address: 4669 Parkridge Dr Lot:5 Block: 3 Addition: Park Cliff 2nd PID:10-56701-03-050 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Amanda Mendoza 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 - Jerry D Walerak 4669 Parkridge Dr Eagan MN 55123 Exteriors Of Excellence 4580 Scott Tr Suite 204 Eagan MN 55122 (952) 239-0560 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA125624 Date Issued:07/29/2014 Permit Category:ePermit Site Address: 4669 Parkridge Dr Lot:5 Block: 3 Addition: Park Cliff 2nd PID:10-56701-03-050 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jerry D Walerak 4669 Parkridge Dr Eagan MN 55123 (612) 437-7349 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA129693 Date Issued:03/06/2015 Permit Category:ePermit Site Address: 4669 Parkridge Dr Lot:5 Block: 3 Addition: Park Cliff 2nd PID:10-56701-03-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Applicant: Linda Jernander 2026 Colburn Drive Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Jerry D Walerak 4669 Parkridge Dr Eagan MN 55123 Ron's Mechanical 12010 Old Brick Yard Rd Shakopee MN 55379 (952) 445-8585 Applicant/Permitee: Signature Issued By: Signature r'For Office Use • „ • f i , Permit#: E AGA N 7 drat•_ +drat/ 90" 0 a Permit Fee: �--- Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildincinspectionsecitvofeaaan.com 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 57' 7"/? Site Address: ''66? ,irk /Z`1c, ( 4IUc i46 p Unit#: dot ,�leM.gic6> - 7 57 - 77/b 1 Name: �� Y/n1t ' � Phone: � Resident! ,/� Or,-�� L-"-N6/11-14 An y Sl 2,,3 Owner Address/City/Zip: t16,67 P gici jj 1: Applicant is: Owner � Contractor ., Description of work: i v1 51,iu e:74-5j irep Ly I.. otr Type of Work Construction Cost: Al Jig �'r 9a Multi-Family Building: (Yes /No_k ) Company: (01) T- gy )9 h 6V) Contact: ere./7e/4" ZU Contractor Address: /t/t /Void tj reVcia- City: eLL w /Z.Th State: al- Zip: c1740// Phone:I V Pp-10;4 C Email:lgr6f11,4, Gooc;ri lttri ('4) :G 44 t License#: 421 3?oz 7 Lead Certificate#: If the project is exempt from lead certification, please explain why: �•r�Pt/1-1-e /os7 9s - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the Information may be classified as non-.ublic If u .vide s , Iflc reasons that would . It the CI to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, 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. S•ft,,'(T6 G X12 x Applicant's Printed Name App cant's S atur